Characteristics and Predictors of Short‐Term Outcomes in Individuals Self‐selecting Yoga or Physical Therapy for Treatment of Chronic Low Back Pain

• DOI: 10.1016/j.pmrj.2010.07.006
• Publication Date: 2010-11-20T09:45:08Z
• Authors: Dian Dowling Evans; Michael Carter; Richard Panico; Laura Kimble; Jennifer T. Morlock; Manjula Judith Sp...
• Keywords: Adult; Male; Yoga; Middle Aged; 16. Peace & justice; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Chronic Disease; Health Status Indicators; Humans; Female; Low Back Pain; Physical Therapy Modalities

ObjectiveTo compare clinical and demographic characteristics of individuals self‐selecting yoga or physical therapy (PT) for treatment of chronic low back pain (cLBP) and to examine predictors of short‐term pain and functional outcomes.DesignDescriptive, longitudinal study.SettingsA hospital‐based clinic that offers modified integral yoga classes for cLBP and 2 outpatient PT clinics that offer exercise‐based PT.ParticipantsAdults (n = 53) with cLBP ≥12 weeks: yoga (n = 27), PT (n = 26).MethodsYoga participants attended a 6‐week, once weekly, 2‐hour yoga class. PT participants underwent twice weekly, 1‐hour individualized PT. Data were collected at baseline and at 6 weeks. Groups were compared by using χ2 and independent samples t‐tests. Hierarchical linear regression was used to predict treatment outcomes.Main Outcome MeasuresDisability (Roland Morris Disability Questionnaire), health status (Rand Short Form 36 Health Survey 1.0), pain bothersomeness (numerical rating scale), back pain self‐efficacy (Back Pain Self‐Efficacy Scale), and treatment satisfaction.ResultsAt baseline, yoga participants were significantly less disabled (P = .013), had higher health status (P = .023), greater pain self‐efficacy (P = .012), and less average pain bothersomeness (P = .001) compared with PT participants. At 6 weeks, when controlling for baseline group differences, greater pain self‐efficacy was the strongest predictor for reduced pain and higher function for the entire sample. A significant group interaction by baseline pain self‐efficacy predicted disability at 6 weeks. PT participants with low pain self‐efficacy reported significantly greater disability than those with high pain self‐efficacy. Yoga participants with low and high pain self‐efficacy had similar disability outcomes.ConclusionThese findings strengthen evidence that self‐efficacy is associated with cLBP outcomes, especially in individuals self‐selecting PT. Further research to evaluate outcomes after yoga and PT in participants with low pain self‐efficacy is needed.