Effect of integrated approach of yoga therapy on back pain as measured by rolland morris disability index

Abstract

Background and need for the study: Previous studies have demonstrated that yoga was effective for chronic low back pain (CLBP) in adults with high socioeconomic status. The effect of 7 days Integrated Approach of Yoga Therapy (IAYT) on Rolland Morris Disability Index (RMDI) was not reported adequately. Objective: To study the effect of IAYT on RMDI in patients with CLBP Methods: A seven days study with a single group pre-post design was conducted in a residential holistic health Centre at Bangalore, India. Thirty five patients (22 females, 13 males) with CLBP were selected conveniently to undergo IAYT. The IAYT consisted of a seven days-long intensive residential yoga program comprising of Äsanas (physical postures) designed for back pain, Präëäyäma (breathing practices) and meditation apart from interactive sessions on philosophical concepts of yoga. Primary outcomes were change from baseline to 7 days in 24-point RMDI, Pain Analogue Scale (PAN), Symptom Score (SS), Spinal mobility with ‘Sit and Reach’ instrument (SAR), Straight leg raising test (SLR) using a Goniometer, State-Trait Anxiety Inventory (STAI) form X1 and X2, 24- point Back Depression Inventory (BDI) and General Health Questionnaire (GHQ- 28). The clinical outcomes were blood pressure (BP), pulse rate (PR), respiratory rate (RR), breath holding time (BHT) and weight (WT). Statistical Analysis: The tests of normality (Shapiro-Wilk) and Paired Samples Test were used with the help of SPSS 16 for complete statistical analysis. Results: The significant change was observed in all the variables. The analysis showed 54.13% decrease in RMDI scores (P<0.001). Similarly, the PAS showed 86.20% decrease (P<0.001). There were 75% decrease in SS score (P<0.001), 41.9643% increase in SAR score (P<0.001), 40.57%, 34.55 increase in both right and left SLR score (P<0.001), 40.10%.38.82% decrease in STAI and STA2 score (P<0.001) and 69.90% decrease in BDI score (P<0.001). Further, the data analysis of GHQ score showed 87.76% decrease (P<0.001) in somatic symptoms, 89.29% decrease (P<0.001) in anxiety and insomnia, 86.96% decrease (P<0.001) in social dysfunction, 84.75% decrease (P<0.001) in severe depression and 87.71% decrease (P<0.001) in all medical complaints. Moreover, clinical investigation showed 6.947% decrease in Systolic BP (P<0.001), 7.5% decrease in Diastolic BP (P<0.001), 7.01% decrease in PR (P<0.001), 18.7 % decrease in RR (P<0.001), 40.57% increase in BHT (P<0.001) and 1.8 % decrease in WT (P<0.001). Conclusion:The seven days intensive residential IAYT program reduces pain, anxiety, depression and improves spinal mobility and general health in patients with CLBP. Additional randomized control trials are needed before a strong recommendation can be made.