Comparing yoga, exercise and a self-care book for chronic low back pain

Annals of Internal Medicine.

2005 Dec 20;143(12):849-56.

Sherman KJ, Cherkin DC, Erro J, Miglioretti DL, Deyo RA.

Group Health Cooperative and University of Washington, Seattle, Washington, USA.

{module [198]}


Chronic low back pain is a common problem that has only modestly effective treatment options.


To determine whether yoga is more effective than conventional therapeutic exercise or a self-care book for patients with chronic low back pain.


Randomized, controlled trial.


A nonprofit, integrated health care system.


 101 adults with chronic low back pain.


12-week sessions of yoga or conventional therapeutic exercise classes or a self-care book.


Primary outcomes were back-related functional status (modified 24-point Roland Disability Scale) and “bothersomeness” of pain (11-point numerical scale). The primary time point was 12 weeks. Clinically significant change was considered to be 2.5 points on the functional status scale and 1.5 points on the bothersomeness scale. Secondary outcomes were days of restricted activity, general health status, and medication use.


After adjustment for baseline values, back-related function in the yoga group was superior to the book and exercise groups at 12 weeks (yoga vs. book: mean difference, -3.4 [95% CI, -5.1 to – 1.6] [P < 0.001]; yoga vs. exercise: mean difference, -1.8 [CI, -3.5 to – 0.1] [P = 0.034]). No significant differences in symptom bothersomeness were found between any 2 groups at 12 weeks; at 26 weeks, the yoga group was superior to the book group with respect to this measure (mean difference, -2.2 [CI, -3.2 to – 1.2]; P < 0.001). At 26 weeks, back-related function in the yoga group was superior to the book group (mean difference, -3.6 [CI, -5.4 to – 1.8]; P < 0.001).


Participants in this study were followed for only 26 weeks after randomization. Only 1 instructor delivered each intervention.


Yoga was more effective than a self-care book for improving function and reducing chronic low back pain, and the benefits persisted for at least several months.

Effect of yoga training on exercise tolerance in adolescents with childhood asthma

The Journal of Asthma.


 Jain SC, Rai L, Valecha A, Jha UK, Bhatnagar SO, Ram K.

Laboratory Division, Central Research Institute for Yoga, New Delhi, India.

{module [198]}


Forty six young asthmatics with a history of childhood asthma were admitted for yoga training. Effects of training on resting pulmonary functions, exercise capacity, and exercise-induced bronchial lability index were measured. Yoga training resulted in a significant increase in pulmonary function and exercise capacity. A follow-up study spanning two years showed a good response with reduced symptom score and drug requirements in these subjects. It is concluded that yoga training is beneficial for young asthmatics.

Kapalabhati-yogic cleansing exercise. I

Homeostasis in Health Disease.

1991 Oct;33(3):126-34.

Stancak A Jr, Kuna M, Srinivasan, Vishnudevananda S, Dostalek C.

Institute of Physiological Regulations, Czechoslovak Academy of Sciences, Praha.


{module [198]}

We studied cardiovascular and respiratory changes during yogic breathing exercise kapalabhati (KB) in 17 advanced yoga practitioners. The exercise consisted in fast shallow abdominal respiratory movements at about 2 Hz frequency. Blood pressure, ECG and respiration were recorded continuously during three 5 min periods of KB and during pre- and post-KB resting periods. The beat-to-beat series of systolic blood pressure (SBP) and diastolic blood pressure (DBP), R-R intervals and respiration were analysed by spectral analysis of time series. The mean absolute power was calculated in three frequency bands–band of spontaneous respiration, band of 0.1 Hz rhythm and the low-frequency band greater than 15 s in all spectra. The mean modulus calculated between SBP and R-R intervals was used as a parameter of baroreceptor-cardiac reflex sensitivity (BRS). Heart rate increased by 9 beats per min during KB. SBP and DBP increased during KB by 15 and 6 mmHg respectively. All frequency bands of R-R interval variability were reduced in KB. Also the BRS parameter was reduced in KB. The amplitude of the high-frequency oscillations in SBP and DBP increased during KB. The low-frequency blood pressure oscillations were increased after KB. The results point to decreased cardiac vagal tone during KB which was due to changes in respiratory pattern and due to decreased sensitivity of arterial baroreflex. Decreased respiratory rate and increased SBP and low-frequency blood pressure oscillations after KB suggest a differentiated pattern of vegetative activation and inhibition associated with KB exercise.




Modulation of cardiovascular response to exercise by yoga training

Indian Journal of Physiology and Pharmacology.

2004 Oct;48(4):461-5.

Madanmohan, Udupa K, Bhavanani AB, Shatapathy CC, Sahai A.

Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry – 605 006, India.

{module [198]}



This study reports the effects of yoga training on cardiovascular response to exercise and the time course of recovery after the exercise. Cardiovascular response to exercise was determined by Harvard step test using a platform of 45 cm height. The subjects were asked to step up and down the platform at a rate of 30/min for a total duration of 5 min or until fatigue, whichever was earlier. Heart rate (HR) and blood pressure response to exercise were measured in supine position before exercise and at 1, 2, 3, 4, 5, 7 and 10 minutes after the exercise. Rate-pressure product [RPP = (HR x SP)/100] and double product (Do P = HR x MP), which are indices of work done by the heart were also calculated. Exercise produced a significant increase in HR, systolic pressure, RPP & DoP and a significant decrease in diastolic pressure. After two months of yoga training, exercise-induced changes in these parameters were significantly reduced. It is concluded that after yoga training a given level of exercise leads to a milder cardiovascular response, suggesting better exercise tolerance.



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