Mediators of Yoga and Stretching for Chronic Low Back Pain
Although yoga is an effective treatment for chronic low back pain, little is known about the mechanisms responsible for its benefits. In a trial comparing yoga to intensive stretching and self-care, we explored whether physical (hours of back exercise/week), cognitive (fear avoidance, body awareness...
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2013-01-01
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Series: | Evidence-Based Complementary and Alternative Medicine |
Online Access: | http://dx.doi.org/10.1155/2013/130818 |
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doaj-50c34327ae064392a7703d44441448842020-11-25T00:46:50ZengHindawi LimitedEvidence-Based Complementary and Alternative Medicine1741-427X1741-42882013-01-01201310.1155/2013/130818130818Mediators of Yoga and Stretching for Chronic Low Back PainKaren J. Sherman0Robert D. Wellman1Andrea J. Cook2Daniel C. Cherkin3Rachel M. Ceballos4Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USAGroup Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USAGroup Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USAGroup Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USADepartments of Family Medicine and Health Services, University of Washington, Seattle, WA 98101, USAAlthough yoga is an effective treatment for chronic low back pain, little is known about the mechanisms responsible for its benefits. In a trial comparing yoga to intensive stretching and self-care, we explored whether physical (hours of back exercise/week), cognitive (fear avoidance, body awareness, and self-efficacy), affective (psychological distress, perceived stress, positive states of mind, and sleep), and physiological factors (cortisol, DHEA) mediated the effects of yoga or stretching on back-related dysfunction (Roland-Morris Disability Scale (RDQ)). For yoga, 36% of the effect on 12-week RDQ was mediated by increased self-efficacy, 18% by sleep disturbance, 9% by hours of back exercise, and 61% by the best combination of all possible mediators (6 mediators). For stretching, 23% of the effect was mediated by increased self-efficacy, 14% by days of back exercise, and 50% by the best combination of all possible mediators (7 mediators). In open-ended questions, ≥20% of participants noted the following treatment benefits: learning new exercises (both groups), relaxation, increased awareness, and the benefits of breathing (yoga), benefits of regular practice (stretching). Although both self-efficacy and hours of back exercise were the strongest mediators for each intervention, compared to self-care, qualitative data suggest that they may exert their benefits through partially distinct mechanisms.http://dx.doi.org/10.1155/2013/130818 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Karen J. Sherman Robert D. Wellman Andrea J. Cook Daniel C. Cherkin Rachel M. Ceballos |
spellingShingle |
Karen J. Sherman Robert D. Wellman Andrea J. Cook Daniel C. Cherkin Rachel M. Ceballos Mediators of Yoga and Stretching for Chronic Low Back Pain Evidence-Based Complementary and Alternative Medicine |
author_facet |
Karen J. Sherman Robert D. Wellman Andrea J. Cook Daniel C. Cherkin Rachel M. Ceballos |
author_sort |
Karen J. Sherman |
title |
Mediators of Yoga and Stretching for Chronic Low Back Pain |
title_short |
Mediators of Yoga and Stretching for Chronic Low Back Pain |
title_full |
Mediators of Yoga and Stretching for Chronic Low Back Pain |
title_fullStr |
Mediators of Yoga and Stretching for Chronic Low Back Pain |
title_full_unstemmed |
Mediators of Yoga and Stretching for Chronic Low Back Pain |
title_sort |
mediators of yoga and stretching for chronic low back pain |
publisher |
Hindawi Limited |
series |
Evidence-Based Complementary and Alternative Medicine |
issn |
1741-427X 1741-4288 |
publishDate |
2013-01-01 |
description |
Although yoga is an effective treatment for chronic low back pain, little is known about the mechanisms responsible for its benefits. In a trial comparing yoga to intensive stretching and self-care, we explored whether physical (hours of back exercise/week), cognitive (fear avoidance, body awareness, and self-efficacy), affective (psychological distress, perceived stress, positive states of mind, and sleep), and physiological factors (cortisol, DHEA) mediated the effects of yoga or stretching on back-related dysfunction (Roland-Morris Disability Scale (RDQ)). For yoga, 36% of the effect on 12-week RDQ was mediated by increased self-efficacy, 18% by sleep disturbance, 9% by hours of back exercise, and 61% by the best combination of all possible mediators (6 mediators). For stretching, 23% of the effect was mediated by increased self-efficacy, 14% by days of back exercise, and 50% by the best combination of all possible mediators (7 mediators). In open-ended questions, ≥20% of participants noted the following treatment benefits: learning new exercises (both groups), relaxation, increased awareness, and the benefits of breathing (yoga), benefits of regular practice (stretching). Although both self-efficacy and hours of back exercise were the strongest mediators for each intervention, compared to self-care, qualitative data suggest that they may exert their benefits through partially distinct mechanisms. |
url |
http://dx.doi.org/10.1155/2013/130818 |
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