Advertisement

Qigong or Yoga Versus No Intervention in Older Adults With Chronic Low Back Pain—A Randomized Controlled Trial

  • Michael Teut
    Correspondence
    Address reprint requests to Dr. Michael Teut, MD, Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Luisenstr 57, Berlin D-10117, Germany.
    Affiliations
    Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Berlin, Germany
    Search for articles by this author
  • Judith Knilli
    Affiliations
    Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Berlin, Germany
    Search for articles by this author
  • Dorothea Daus
    Affiliations
    Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Berlin, Germany
    Search for articles by this author
  • Stephanie Roll
    Affiliations
    Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Berlin, Germany
    Search for articles by this author
  • Claudia M. Witt
    Affiliations
    Institute for Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Berlin, Germany

    Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zürich, Zürich, Switzerland
    Search for articles by this author

      Highlights

      • Low back pain is a very common medical complaint in older adults.
      • Yoga is considered to be an effective therapy for low back pain in adults, the evidence for qigong is unclear.
      • This 3-armed trial with 176 older adults showed that yoga and qigong were not superior to no treatment in reducing pain and increasing quality of life.

      Abstract

      The aim of this study was to assess the effectiveness of the reduction of chronic lower back pain in older adults using either yoga classes or qigong classes compared with no intervention. Older adults (65 years of age and older) with chronic low back pain were enrolled in and randomly allocated to: 1) yoga (24 classes, 45 minutes each, during 3 months), 2) qigong (12 classes, 90 minutes each, during 3 months), or 3) a control group who received no additional intervention. The pain intensity item of the Functional Rating Index after 3 months was used as primary outcome parameter. A total of 176 patients were randomized (n = 61 yoga, n = 58 qigong, n = 57 control; mean age 73 ± 5.6 years, 89% female). The mean adjusted pain intensity after 3 months was 1.71 for the yoga group (95% confidence interval [CI], 1.54–1.89), 1.67 for the qigong group (95% CI, 1.45–1.89), and 1.89 for no intervention (95% CI, 1.67–2.11). No statistically significant group differences were observed. Possible explanations for this lack of pain relief might include the ineffectiveness of interventions, inappropriate outcomes, or differences in pain perception and processing in older adults.

      Perspective

      The aim of this study was to assess the effectiveness of the reduction of chronic lower back pain in older adults using either yoga classes or qigong classes compared with no intervention. This 3-armed randomized trial with 176 older adults showed that yoga and qigong were not superior to no treatment in reducing pain and increasing quality of life.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal of Pain
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Aboagye E.
        • Karlsson M.L.
        • Hagberg J.
        • Jensen I.
        Cost-effectiveness of early interventions for non-specific low back pain: A randomized controlled study investigating medical yoga, exercise therapy and self-care advice.
        J Rehabil Med. 2015; 47: 167-173
        • Blödt S.
        • Pach D.
        • Kaster T.
        • Lüdtke R.
        • Icke K.
        • Reisshauer A.
        • Witt C.M.
        Qigong versus exercise therapy for chronic low back pain in adults - A randomized controlled non-inferiority trial.
        Eur J Pain. 2015; 19: 123-131
        • Bohannon R.W.
        Hand-grip dynamometry predicts future outcomes in aging adults.
        J Geriatr Phys Ther. 2008; 31: 3-10
        • Bullinger M.
        • Kirchberger I.
        Short Form 36 Health Survey Questionnaire [German].
        Hogrefe, Göttingen1998
        • Bushnell M.C.
        • Ceko M.
        • Low L.A.
        Cognitive and emotional control of pain and its disruption in chronic pain.
        Nat Rev Neurosci. 2013; 14: 502-511
        • Chapman J.R.
        • Norvell D.C.
        • Hermsmeyer J.T.
        • Bransford R.J.
        • DeVine J.
        • McGirt M.J.
        • Lee M.J.
        Evaluating common outcomes for measuring treatment success for chronic low back pain.
        Spine. 2011; 36: S54-S68
        • Cohen K.
        The Way of Qigong: The Art and Science of Chinese Energy Healing.
        Ballantine Publishing House, New York1997
        • Cramer H.
        • Lauche R.
        • Haller H.
        • Dobos G.
        A systematic review and meta-analysis of yoga for low back pain.
        Clin J Pain. 2013; 29: 450-460
        • Dalmann I.
        • Soder M.
        Becoming healthy with yoga.
        in: Dalmann I. Soder M. Concepts and backgrounds [German]. Viveka Verlag, Berlin2004: 49-52 (Yoga)
        • Enthoven W.T.
        • Scheele J.
        • Bierma-Zeinstra S.M.
        • Bueving H.J.
        • Bohnen A.M.
        • Peul W.C.
        • van Tulder M.W.
        • Berger M.Y.
        • Koes B.W.
        • Luijsterburg P.A.
        Analgesic use in older adults with back pain: The BACE study.
        Pain Med. 2014; 15: 1704-1714
        • Feise R.J.
        • Menke J.M.
        Functional Rating Index: Literature review.
        Med Sci Monit. 2010; 16: RA25-RA36
        • Holmberg C.
        • Rappenecker J.
        • Karner J.J.
        • Witt C.M.
        The perspectives of older women with chronic neck pain on perceived effects of qigong and exercise therapy on aging: A qualitative interview study.
        Clin Interv Aging. 2014; 9: 403-410
        • Holtzman S.
        • Beggs R.T.
        Yoga for chronic low back pain: A meta-analysis of randomized controlled trials.
        Pain Res Manag. 2013; 18: 267-272
        • Huskisson E.C.
        • Scott J.
        VAS Visuelle Analog-Skalen; auch VAPS Visual Analogue Pain Scales, NRS numerische rating-Skalen; mod. Kategorialskalen.
        in: Westhoff G. Handbuch psychosozialer Messinstrumente - ein Kompendium für epidemiologische und klinische Forschung zu chronischer Krankheit. Hogrefe, Göttingen1993: 881-885
      1. Institute of Evidence-Based Chiropractic: Functional Rating Index (FRI). Available at: http://www.chiroevidence.com/fri-license. Accessed April 2016

        • Jakobsen L.H.
        • Rask I.K.
        • Kondrup J.
        Validation of handgrip strength and endurance as a measure of physical function and quality of life in healthy subjects and patients.
        Nutrition. 2010; 26: 542-550
        • Karp J.F.
        • Shega J.W.
        • Morone N.E.
        • Weiner D.K.
        Advances in understanding the mechanisms and management of persistent pain in older adults.
        Br J Anaesth. 2008; 101: 111-120
        • Keefe F.J.
        • Porter L.
        • Somers T.
        • Shelby R.
        • Wren A.V.
        Psychosocial interventions for managing pain in older adults: Outcomes and clinical implications.
        Br J Anaesth. 2013; 111: 89-94
        • Kemp C.A.
        Qigong as a therapeutic intervention with older adults.
        J Holist Nurs. 2004; 22: 351-373
        • Kohlmann T.
        • Raspe H.
        Rehabilitation (Stuttg). 1996; 35 ([in German]): I-VIII
        • Lee M.S.
        • Pittler M.H.
        • Ernst E.
        Internal qigong for pain conditions: A systematic review.
        J Pain. 2009; 10: 1121-1127
        • Linden M.
        • Gilberg R.
        • Horgas A.L.
        • Steinhagen-Thiessen E.
        Die Inanspruchnahme medizinischer und pflegerischer Hilfe im hohen alter.
        in: Lindenberger U. Smith J. Mayer K.U. Baltes P.B. Die Berliner. Akademie Verlag, Berlin2010: 499-519
        • Mathiowetz V.
        Comparison of Rolyan and Jamar dynamometers for measuring grip strength.
        Occup Ther Int. 2002; 9: 201-209
        • Molton I.R.
        • Terrill A.L.
        Overview of persistent pain in older adults.
        Am Psychol. 2014; 69: 197-207
        • Morone N.E.
        • Greco C.M.
        Mind-body interventions for chronic pain in older adults: A structured review.
        Pain Med. 2007; 8: 359-375
        • Neuhauser H.
        • Ellert U.
        • Ziese T.
        Chronic back pain in the general population in Germany 2002/2003: Prevalence and highly affected population groups.
        Gesundheitswesen. 2005; 67 ([in German]): 685-693
        • Paeck T.
        • Ferreira M.L.
        • Sun C.
        • Lin C.W.
        • Tiedemann A.
        • Maher C.G.
        Are older adults missing from low back pain clinical trials? A systematic review and meta-analysis.
        Arthritis Care Res. 2014; 6: 1220-1226
        • Posadzki P.
        • Ernst E.
        Yoga for low back pain: A systematic review of randomized clinical trials.
        Clin Rheumatol. 2011; 30: 1257-1262
        • Rendant D.
        • Pach D.
        • Lüdtke R.
        • Reisshauer A.
        • Mietzner A.
        • Willich S.N.
        • Witt C.M.
        Qigong versus exercise versus no therapy for patients with chronic neck pain: A randomized controlled trial Spine.
        (Phila Pa 1976). 2011; 36: 419-427
      2. Robert Koch Institute (eds): Facts and Figures: Results of the German 2009 Health Study. Contributions to the Federal Health Monitoring System [German]. Berlin, RKI, 2011

        • Rogers C.E.
        • Larkey L.K.
        • Keller C.
        A review of clinical trials of tai chi and qigong in older adults.
        West J Nurs Res. 2009; 31: 245-279
        • Scheele J.
        • Enthoven W.T.
        • Bierma-Zeinstra S.M.
        • Peul W.C.
        • van Tulder M.W.
        • Bohnen A.M.
        • Berger M.Y.
        • Koes B.W.
        • Luijsterburg P.A.
        Characteristics of older patients with back pain in general practice: BACE cohort study.
        Eur J Pain. 2014; 18: 279-287
        • Scheele J.
        • Luijsterburg P.A.
        • Bierma-Zeinstra S.M.
        • Koes B.W.
        Course of back complaints in older adults: a systematic literature review.
        Eur J Phys Rehabil Med. 2012; 48: 379-386
        • Schmidt C.O.
        • Raspe H.
        • Pfingsten M.
        • Hasenbring M.
        • Basler H.D.
        • Eich W.
        • Kohlmann T.
        Back pain in the German adult population: Prevalence, severity, and sociodemographic correlates in a multiregional survey. Spine.
        (Phila Pa 1976). 2007; 32: 2005-2011
        • Schützler L.
        • Witt C.M.
        Body-efficacy expectation: Assessment of beliefs concerning bodily coping capabilities with a five-item scale.
        Evid Based Complement Alternat Med. 2013; 152727: 2013
        • Sherman K.J.
        • Cherkin D.C.
        • Erro J.
        • Miglioretti D.L.
        • Deyo R.A.
        Comparing yoga, exercise, and a self-care book for chronic low back pain: A randomized, controlled trial.
        Ann Intern Med. 2005; 143: 849-856
        • Tinetti M.E.
        Performance-oriented assessment of mobility problems in elderly patients.
        J Am Geriatr Soc. 1986; 34: 119-126
        • Tsang A.
        • Von Korff M.
        • Lee S.
        • Alonso J.
        • Karam E.
        • Angermeyer M.C.
        • Borges G.L.
        • Bromet E.J.
        • Demytteneare K.
        • de Girolamo G.
        • de Graaf R.
        • Gureje O.
        • Lepine J.P.
        • Haro J.M.
        • Levinson D.
        • Oakley Browne M.A.
        • Posada-Villa J.
        • Seedat S.
        • Watanabe M.
        Common chronic pain conditions in developed and developing countries: Gender and age differences and comorbidity with depression-anxiety disorders.
        J Pain. 2008; 9: 883-891
        • von Trott P.
        • Wiedemann A.M.
        • Lüdtke R.
        • Reishauer A.
        • Willich S.N.
        • Witt C.M.
        Qigong and exercise therapy for elderly patients with chronic neck pain (QIBANE): A randomized controlled study.
        J Pain. 2009; 10: 501-508
        • Wiedemann A.M.
        • von Trott P.
        • Lüdtke R.
        • Reisszlihauer A.
        • Willich S.N.
        • Witt C.M.
        Developing a qigong intervention and an exercise therapy for elderly patients with chronic neck pain and the study protocol.
        Forsch Komplementmed. 2008; 15: 195-202
        • Yesavage J.A.
        • Brink T.L.
        • Rose T.L.
        • Lum O.
        • Huang V.
        • Adey M.
        • Leirer V.O.
        Development and validation of a geriatric depression screening scale: A preliminary report.
        J Psychiatr Res. 1982–1983; 17: 37-49