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Yoga, Eurythmy Therapy and Standard Physiotherapy (YES-Trial) for Patients With Chronic Non-specific Low Back Pain: A Three-Armed Randomized Controlled Trial

  • Author Footnotes
    2 Andreas Michalsen and Michael Jeitler contributed equally to this work.
    Andreas Michalsen
    Correspondence
    Address reprint requests to Andreas Michalsen, Immanuel Krankenhaus Berlin and Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, 14109 Berlin, Königstrasse 63, Germany
    Footnotes
    2 Andreas Michalsen and Michael Jeitler contributed equally to this work.
    Affiliations
    Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin

    Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, Germany
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  • Author Footnotes
    2 Andreas Michalsen and Michael Jeitler contributed equally to this work.
    Michael Jeitler
    Footnotes
    2 Andreas Michalsen and Michael Jeitler contributed equally to this work.
    Affiliations
    Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin

    Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, Germany
    Search for articles by this author
  • Christian S. Kessler
    Affiliations
    Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin

    Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, Germany
    Search for articles by this author
  • Nico Steckhan
    Affiliations
    Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin

    Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, Germany
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  • Sibylle Robens
    Affiliations
    Department of Psychology and Psychotherapy, Witten/Herdecke University, Germany
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  • Thomas Ostermann
    Affiliations
    Department of Psychology and Psychotherapy, Witten/Herdecke University, Germany
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  • Farid I. Kandil
    Affiliations
    Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
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  • Josephin Stankewitz
    Affiliations
    Research Institute Havelhöhe (FIH), Berlin, Germany
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  • Bettina Berger
    Affiliations
    Institute of Integrative Medicine, Witten/Herdecke University, Germany
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  • Sonny Jung
    Affiliations
    Institute of Integrative Medicine, Witten/Herdecke University, Germany
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  • Matthias Kröz
    Affiliations
    Research Institute Havelhöhe (FIH), Berlin, Germany

    Institute of Integrative Medicine, Witten/Herdecke University, Germany

    Department of Research and Sleep Medicine Arlesheim Hospital, Arlesheim, Switzerland
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  • Arndt Büssing
    Affiliations
    Institute of Integrative Medicine, Witten/Herdecke University, Germany
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  • Author Footnotes
    2 Andreas Michalsen and Michael Jeitler contributed equally to this work.

      Highlights

      • Neither yoga nor eurythmy were superior to standard physiotherapy.
      • All interventions relieve chronic low back pain to a comparable extent.
      • Further research on the additional clinical benefit to usual care is warranted.
      • All interventions were safe.

      Abstract

      We aimed to evaluate the effects of yoga and eurythmy therapy compared to conventional physiotherapy exercises in patients with chronic low back pain. In a three-armed, multicentre, randomized controlled trial, patients with chronic low back pain were treated for 8 weeks in group sessions (75 minutes once per week). Primary outcome was patients’ physical disability (measured by RMDQ) from baseline to week 8. Secondary outcome variables were pain intensity and pain-related bothersomeness (VAS), health-related quality of life (SF-12) and life satisfaction (BMLSS). Outcomes were assessed at baseline, after the intervention at 8 weeks and at a 16-week follow up. Data of 274 participants were used for statistical analyses. There were no significant differences between the three groups for the primary and all secondary outcomes. In all groups, RMDQ decreased comparably at 8 weeks, but did not reach clinical meaningfulness. Pain intensity and pain-related bothersomeness decreased, while quality of life increased in all 3 groups. In explorative general linear models for the SF-12’s mental health component participants in the eurythmy arm benefitted significantly more compared to physiotherapy and yoga. Furthermore, within-group analyses showed improvements of SF-12 mental score for yoga and eurythmy therapy only. All interventions were safe.
      Clinical Trials Register: DRKS-ID: DRKS00004651
      Perspective: This article presents the results of a multicentre three-armed randomized controlled trial on the clinical effects of three 8-week programs in patients with chronic low back pain. Compared to the ‘gold standard’ of conventional physiotherapeutic exercises, eurythmy therapy and yoga therapy lead to comparable symptomatic improvements in patients with chronic low back pain. However, the within-group effect sizes were small to moderate and did not reach clinical meaningfulness on patients’ physical disability (RMDQ).

      Keywords

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