The effect of yoga as an adjunct to home-based exercise on pain, disability, and quality of life in people with chronic non-specific neck pain : a randomised controlled trial

Abstract

BACKGROUND: Previous research has investigated whether yoga is beneficial for chronic nonspecific neck pain (CNSNP), compared to home-based exercises that may be prescribed by manual therapists.

AIM: The aim of this randomised controlled trial (RCT) was to determine the degree to which yoga classes are efficacious for treating CNSNP as an addition to prescribed home-based exercises, and the role of psychosocial factors in recovery.

METHODS: The yoga intervention group (n = 13) were encouraged to attend twice-weekly, 60-minute yoga classes, and complete home-based exercises for the neck and shoulders for 10 minutes daily for 8 weeks, whilst the control group (n = 11) completed the home-based exercises only. Outcomes, measured at baseline, weeks, 4, 9, and 12, included neck pain intensity via Visual Analogue Scale (VAS), and disability via Northwick Park Neck Pain Questionnaire (NPNPQ); and, secondary outcome measures included quality of life (QoL) scores via The Medical Outcomes Study Short Form 36 item (SF 36) questionnaire. Credibility and Expectancy Questionnaire (CEQ), and Yellow Flag questionnaire scores were analysed as correlates of change in outcomes.

RESULTS: Decreases in pain intensity and disability over the 8-week intervention period were seen in both the yoga plus home-based exercises group (baseline VAS BL: 5.4 ± 1.4 (mean ± SD), week 9: 3.6 ± 1.2; baseline NPNPQ BL: 36.1 ± 9.4, week 9: 17.7 ± 8.8), and home-based exercises only group (baseline VAS BL: 5.1 ± 1.9, week 9: 3.1 ± 2.0; baseline NPNPQ BL: 32.3 ± 12.9, week 9: 18.5 ± 9.7). No additional change in pain intensity or disability was found in the yoga group compared to the exercises only group. The yoga group demonstrated a more positive improvement in the SF 36 physical functioning health dimension (P = 0.04; median 25 point improvement) from baseline to week 9, compared to the exercises only group (median 10 point improvement). A significant correlation between baseline CEQ credibility and the change in SF 36 general health dimension at week 9 was demonstrated in both groups combined (ρ = .72; P = 0.001), and in the yoga group alone (ρ = 0.82; P = .007). Correlations between CEQ and pain and disability changes from baseline to week 9 were low and nonsignificant. Additionally, there were no significant differences in outcomes between Yellow Flag scores < 90, and ≥ 90.

CONCLUSION: This RCT shows that yoga plus home-based exercises, and home-based exercises only, over an 8-week time period are both appropriate interventions to decrease pain and disability caused by CNSNP. Yoga plus home-based exercises may improve physical functioning QoL outcomes more than home-based exercises only.