Abstract
An estimated 70% of people will experience low back pain at some point in their lives, and recurrence rates can be as high as 85%. Recent studies suggest that yoga – a widely practiced physical/mental discipline – may relieve back pain and reduce functional disability. The objective of this study was to conduct a systematic review and meta-analysis of the existing research on the effects of yoga on chronic low back pain and function. Our literature search began April 2011 and continued through October 2011. Cochrane, PubMed, CINAHL, Embase, ProQuest Dissertations and Theses, Google Scholar, and Clinicaltrials.gov databases were searched electronically. The search terms used were: yoga AND back pain. A total of 58 relevant studies were originally identified through the database searches. Of those, 45 were excluded on the basis of the title and/or review of the abstract. The 13 remaining studies were fully evaluated via a careful review of the full text. On the basis of the inclusion and exclusion criteria, 6 studies were excluded, leaving a total of 7 studies to be included in the meta-analyses of the impact of yoga on low back pain and function. Effect sizes were calculated as the standardized mean difference and meta-analyses were completed using a random-effects model. Overall, yoga was found to result in a medium, beneficial effect on chronic low back pain [overall effect size (ES) = 0.58, p<0.001], indicating that subjects practicing yoga reported significantly less pain than control subjects. Yoga subjects also reported significantly less functional disability after the intervention (overall ES = 0.53, p<0.001). Moreover, the improvements in pain and function for yoga subjects remained statistically significant 12-24 weeks after the end of the intervention (overall ES = 0.44-0.54, p≤0.002). In conclusion, yoga practice can significantly reduce pain and increase functional ability in chronic low back pain patients.
Highlights
Ancient Rishis of India have intuitively analyzed all aspects of human life and one such example is swarodaya vijnan, the ultradian nasal cycle as codified in the Shivaswarodaya [1]
The absence of any significant increase in heart rate (HR) or blood pressure (BP) following suryanadi pranayama (SNP) goes against earlier theories that it may be dangerous for hypertensive patients due to its sympathomimetic nature
Our study offers evidence that exclusive right nostril breathing as performed in SNP may be safe in patients of HT
Summary
Ancient Rishis of India have intuitively analyzed all aspects of human life and one such example is swarodaya vijnan, the ultradian nasal cycle as codified in the Shivaswarodaya [1] This has captured the imagination of scientists in recent times with numerous reports on differential physiological and psychological effects of exclusive right or left nostril breathing [2,3,4,5,6,7,8]. Previous studies have suggested that exclusive right uni-nostril breathing known as suryanadi pranayama (SNP) or surya anuloma viloma pranayama (SAVP) has sympathomimetic effects including increase in metabolism, baseline oxygen consumption, systolic pressure (SP) and heart rate (HR) [6] These effects have been demonstrated after a month -long training [3] as well as immediately after 45 minutes of the practice [4]. This has clinical significance in determining whether such a potentially sympathomimetic practice is safe in such a population
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