Date of Award

5-1-2024

Degree Type

DPT Project

Degree Name

Doctor of Physical Therapy (DPT)

Advisor

Balachandar Kathirvelu

Abstract

Introduction: Chronic low back pain (CLBP) is a complex diagnosis causing an increase in disability and decreased quality of life. This condition is defined as having low back pain for more than three months, in which an individual experiences a decline in function due to enduring pain. Several factors contribute to CLBP including core muscle weakness and decreased motor control to allow for lumbar stability. Though CLBP can be treated in multiple ways; this systematic review (SR) investigates the treatment effects of yoga combined with physical therapy (PT) vs. PT alone to measure the disability using the Oswestry Disability Index (ODI).

Methods: Using the PubMed, Google Scholar, Cochrane, and ScienceDirect databases, articles were found using the keywords: chronic low back pain combined with core strengthening, core stabilization, yoga, or physical therapy (Figure 1). The final articles were evaluated by four authors using the PEDro scale to determine the quality of the articles, which all included randomized control trials (RCTs). The main outcome measure used in this systematic review is disability.

Results: There were 10 articles used in this analysis to determine the effects of yoga and PT or PT alone. The effect size was determined for each RCT by comparing the groups used in each article to determine if one group was different compared to the other. CLBP patients treated with combined yoga and PT or PT only both groups showed significant improvement in disability and pain. In addition, the combined group showed improved mental health status.

Discussion: This SR suggests both yoga and PT or PT alone are beneficial to CLBP individuals and can be used to improve the quality of life and disability in this targeted population. Exercises that target the muscles supporting the lumbar spine were found to have a greater clinical effect on individuals with CLBP compared to general exercise or no treatment. The goals of the patient should be taken into consideration to make an individualized approach in which interventions chosen should be of benefit to the patient.

Limitations: Some limitations of this SR include: the potential for selection bias, some articles analyzed short-term benefits only, and the lack of blinding of therapists or assessors in some articles.

Conclusions: This SR supports the use of yoga with PT or PT alone in individuals with CLBP due to the positive benefits of both interventions on disability, pain, and mental health. Future research should focus on exercise prescription of these interventions combined for a more straightforward approach to a patient’s plan of care.

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