Yoga for Military Veterans with Chronic Low Back Pain: A Randomized Clinical Trial

Groessl, Erik J.; Liu, Lin; Chang, Douglas G.; Wetherell, Julie Loebach; Bormann, Jill E.; Atkinson, J. H.; Baxi, Sunita; Schmalzl, Laura

doi:10.1016/j.amepre.2017.05.019

Cited by 58 publications

(94 citation statements)

References 46 publications

(66 reference statements)

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“…Intervention duration ranged from 7 days to 24 weeks. Among these studies, 13 randomized controlled trials [4,13,[21][22][23][24][25][26][27][28][29][30][31] compared yoga to non-exercise control (e.g. usual care, education), and 8 randomized controlled trials [4, 10-13, 26, 32, 33] compared yoga to traditional physical therapy or exercises.…”

Section: Study Characteristicsmentioning

confidence: 99%

Yoga compared to non-exercise or physical therapy exercise on pain, disability, and quality of life for patients with chronic low back pain: A systematic review and meta-analysis of randomized controlled trials

et al. 2020

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Background Chronic low back pain (CLBP) is a common and often disabling musculoskeletal condition. Yoga has been proven to be an effective therapy for chronic low back pain. However, there are still controversies about the effects of yoga at different follow-up periods and compared with other physical therapy exercises. Objective To critically compare the effects of yoga for patients with chronic low back pain on pain, disability, quality of life with non-exercise (e.g. usual care, education), physical therapy exercise. Methods This study was registered in PROSPERO, and the registration number was CRD42020159865. Randomized controlled trials (RCTs) of online databases included PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Embase which evaluated effects of yoga for patients with chronic low back pain on pain, disability, and quality of life were searched from inception time to November 1, 2019. Studies were eligible if they assessed at least one important outcome, namely pain, back-specific disability, quality of life. The Cochrane risk of bias tool was used to assess the methodological quality of included randomized controlled trials. The continuous outcomes were analyzed by calculating the mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CI) according to whether combining outcomes measured on different scales or not.

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Section: Study Characteristicsmentioning

confidence: 99%

Yoga compared to non-exercise or physical therapy exercise on pain, disability, and quality of life for patients with chronic low back pain: A systematic review and meta-analysis of randomized controlled trials

et al. 2020

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“…35 Yoga has been found to be equivalent to both physical therapy 36 and to non-yoga exercise for LBP 37 and has specifically shown a benefit in veterans with chronic LBP when compared to usual care. 38 The ACP guidelines on LBP include a strong recommendation that yoga should be offered as a first-line treatment for chronic LBP. 2 Despite occasional non-severe and temporary worsening of pain reported in some studies, yoga appears to be as safe as usual care or exercise, 39 and is a relatively low cost self-care activity that can be done alone or in group settings.…”

Section: Exercise Therapymentioning

confidence: 99%

Clinical Policy Recommendations from the VHA State-of-the-Art Conference on Non-Pharmacological Approaches to Chronic Musculoskeletal Pain

et al. 2018

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As a large national healthcare system, Veterans Health Administration (VHA) is ideally suited to build on its work to date and develop a safe, evidence-based, and comprehensive approach to the care of chronic musculoskeletal pain conditions that de-emphasizes opioid use and emphasizes non-pharmacological strategies. The VHA Office of Health Services Research and Development (HSR&D) held a state-of-the-art (SOTA) conference titled "Non-pharmacological Approaches to Chronic Musculoskeletal Pain Management" in November 2016. Goals of the conference were (1) to establish consensus on the current state of evidence regarding non-pharmacological approaches to chronic musculoskeletal pain to inform VHA policy in this area and (2) to begin to identify priorities for the future VHA research agenda. Workgroups were established and asked to reach consensus recommendations on clinical and research priorities for the following treatment strategies: psychological/behavioral therapies, exercise/movement therapies, manual therapies, and models for delivering multimodal pain care. Participants in the SOTA identified nine non-pharmacological therapies with sufficient evidence to be implemented across the VHA system as part of pain care. Participants further recommended that effective integration of these non-pharmacological approaches across the VHA and especially into VHA primary care, pain care, and mental health settings should be a priority, and that these treatments should be offered early in the course of pain treatment and delivered in a team-based, multimodal treatment setting concurrently with active self-care and self-management approaches. In addition, we recommend that VHA leadership and policy makers systematically address the barriers to implementation of these approaches by expanding opportunities for clinician and veteran education on the effectiveness of these strategies; supporting and funding further research to determine optimal dosage, duration, sequencing, combination, and frequency of treatment; emphasizing multimodal care with rigorous evaluation grounded in team-based approaches to test integrated models of delivery and stepped-care approaches; and working to address socioeconomic and cultural barriers to veterans' access to non-pharmacological approaches.

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“…The tables summarize the studies; we delineate the results, strengths, and weaknesses of each study in this section. Three of the publications are by Groessl and colleagues [ 37 , 38 , 42 ]. Two of the papers are from the same study, with a greater number of enrollees over time.…”

Section: Resultsmentioning

confidence: 99%

“…However, this larger sample size is tempered by the study’s focus on gender differences, with only 13 women participating. The third study was an RCT conducted with veterans with chronic low back pain [ 42 ]. Significant differences were seen between the yoga and the control groups for reduced pain at 6-month follow-up, as well as for reduced pain intensity at 12 weeks (immediately after completion of the yoga sessions) and at 6-month follow-up.…”

Section: Resultsmentioning

confidence: 99%

Literature Review of Research on Chronic Pain and Yoga in Military Populations

et al. 2017

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Background: Although yoga is increasingly being provided to active duty soldiers and veterans, studies with military populations are limited and effects on chronic pain are largely unknown. We reviewed the existing body of literature and provide recommendations for future research. Methods: We conducted a literature review of electronic databases (PubMed, PsychINFO, Web of Science, Science Citation Index Expanded, Social Sciences Citation Index, Conference Proceedings Citation Index—Science, and Conference Proceedings Citation Index—Social Science & Humanities). The studies were reviewed for characteristics such as mean age of participants, sample size, yoga type, and study design. Only peer-reviewed studies were included in the review. Results: The search yielded only six studies that examined pain as an outcome of yoga for military populations. With one exception, studies were with veteran populations. Only one study was conducted with Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF) veterans. One study was a randomized controlled trial (RCT). Four of the five studies remaining used pre/post design, while the last study used a post-only design. Conclusions: Studies on the use of yoga to treat chronic pain in military populations are in their infancy. Methodological weaknesses include small sample sizes, a lack of studies with key groups (active duty, OEF/IEF veterans), and use of single group uncontrolled designs (pre/post; post only) for all but one study. Future research is needed to address these methodological limitations and build on this small body of literature.

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Yoga for Military Veterans with Chronic Low Back Pain: A Randomized Clinical Trial

Abstract: This study is registered at www.clinicaltrials.gov NCT02524158.

Cited by 58 publications

References 46 publications

Yoga compared to non-exercise or physical therapy exercise on pain, disability, and quality of life for patients with chronic low back pain: A systematic review and meta-analysis of randomized controlled trials

Yoga compared to non-exercise or physical therapy exercise on pain, disability, and quality of life for patients with chronic low back pain: A systematic review and meta-analysis of randomized controlled trials

Clinical Policy Recommendations from the VHA State-of-the-Art Conference on Non-Pharmacological Approaches to Chronic Musculoskeletal Pain

Literature Review of Research on Chronic Pain and Yoga in Military Populations

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