Pilates/Yoga: Effect of Group Pilates and Yoga Exercise Classes for Chronic Cervical Pain

Sponsor

Wayne State University (Other)

Overall Status

Completed

CT.gov ID

NCT01999283

Collaborator

(none)

Enrollment

Locations

Arms

Duration (Months)

Patients Per Site

0.6

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

Exercise has been found to be effective in alleviating back and neck pain. Two exercise methods which are available in the community in a group format are Yoga and Pilates. While there is some research on the efficacy of these exercise methods for low back pain, there is no definitive research on the use of Yoga or Pilates group exercise for individuals with chronic cervical pain.This study investigated the effect of group Yoga and Pilates exercise compared to a wait-listed control group on impairments and function related to neck pain for individuals with chronic cervical pain.

Condition or Disease	Intervention/Treatment	Phase
Cervical Pain	Other: Yoga Group Exercise Other: Pilates Group Mat Exercise	N/A

Detailed Description

Individuals reporting chronic mild to moderate neck pain for more than 3 months were assigned to a pilates, yoga or wait-listed control group. The exercise group consisted of 12 one hour small group sessions instructed by experienced Physical Therapists with additional yoga or pilates training. Participants were evaluated at baseline, 6 weeks, and 12 weeks. Exercise participants also completed a follow up 6 weeks after completion.

Study Design

Study Type:

Interventional

Actual Enrollment :

88 participants

Allocation:

Non-Randomized

Intervention Model:

Parallel Assignment

Masking:

None (Open Label)

Primary Purpose:

Treatment

Official Title:

Effect of Group Pilates and Yoga Exercise Classes on Function, Range of Motion, Endurance, Postural Position, Medication Use and Balance in Adults With Chronic Cervical Pain

Study Start Date :

Jul 1, 2010

Actual Primary Completion Date :

May 1, 2013

Actual Study Completion Date :

May 1, 2013

Arms and Interventions

Arm	Intervention/Treatment
Active Comparator: Yoga Group Exercise Yoga group exercise will be taught by a licensed Physical Therapist. Groups consist of 4-8 individuals with 12 sessions once weekly over 12 weeks.	Other: Yoga Group Exercise Yoga poses and postures modified to diminish stress on the cervical region and improve flexibility. Breathing and mind-body focus to address stress-related discomfort. A general Hatha yoga style will be used with components from Ashtanga Yoga. Intensity and range of motion will be progressively increased as tolerated.
Active Comparator: Pilates Group Mat Exercise Pilates mat exercise will be taught by a licensed Physical Therapist with additional Rehabilitation Pilates certification.	Other: Pilates Group Mat Exercise The Pilates mat exercises focus on both spinal muscle activation and stability, progressive endurance of the stabilizing muscles with arm and leg challenges and dynamic mobility. The exercises are progressed from more supported to anti-gravity position, slow increases in arm weights and flexibility.
No Intervention: Control Wait Listed control group. Participants complete the same testing and were offered the option of attending the exercise classes on completion. The controls were not included in the exercise groups after completion.

Arm

Intervention/Treatment

Active Comparator: Yoga Group Exercise

Yoga group exercise will be taught by a licensed Physical Therapist. Groups consist of 4-8 individuals with 12 sessions once weekly over 12 weeks.

Other: Yoga Group Exercise

Yoga poses and postures modified to diminish stress on the cervical region and improve flexibility. Breathing and mind-body focus to address stress-related discomfort. A general Hatha yoga style will be used with components from Ashtanga Yoga. Intensity and range of motion will be progressively increased as tolerated.

Active Comparator: Pilates Group Mat Exercise

Pilates mat exercise will be taught by a licensed Physical Therapist with additional Rehabilitation Pilates certification.

Other: Pilates Group Mat Exercise

The Pilates mat exercises focus on both spinal muscle activation and stability, progressive endurance of the stabilizing muscles with arm and leg challenges and dynamic mobility. The exercises are progressed from more supported to anti-gravity position, slow increases in arm weights and flexibility.

No Intervention: Control

Wait Listed control group. Participants complete the same testing and were offered the option of attending the exercise classes on completion. The controls were not included in the exercise groups after completion.

Outcome Measures

Primary Outcome Measures

Change from baseline Neck Disability Index [Baseline, 6 weeks, 12 weeks, 18 weeks]
Self reported Neck Disability Index questionnaire

Secondary Outcome Measures

Change in Number of days of pain medication use in the past week [Baseline, week 6, week 12]
Self report
Change from baseline in Neck Pain Ratings (NPR) experienced on average over the past week [Baseline, week 6, week 12, week 18]
Average pain experienced over the past week (general, worst pain and experienced with functional activities - sustained positions, upper extremity movement, work, recreation)
Change from baseline Cervical range of motion measurements [Baseline, week 6, week 12, week 18]
Measured with the Cervical Range of Motion instrument (CROM)
Change from baseline differences between habitual and self corrected postural position [Baseline, week 6, week 12, week 18]
Sagittal plane position measured for Upper Cervical angle, forward head position, and thoracic width using the Cervical range of motion device.
Change from baseline in time for the Timed up and go test [Baseline, week 6, week 12, week 18]
Time to stand from a chair and walk to a standardized distance, return and sit down
Change from baseline Dynamic Gait Index score [Baselin, week 6, week 12, week 18]
Series of functional gait activities including walking, walking at different speeds, stepping over and around an obstacle, turning the head and tilting the head while walking scored by an observer.
Change from baseline in Activities Balance Confidence Scale score [Baseline, week 6, week 12, week 18]
Self reported confidence in maintaining balance for functional activities.

Other Outcome Measures

Number of participants with identified potential for adverse drug responses [Baseline]
Descriptive analysis of number of participants with potential for adverse drug responses based on review of medication by Pharmacist
Identification of frequency of types of medication use in individuals with chronic neck pain [Baseline]
Descriptive analysis of medication used both for pain relief and co-morbidities
Frequency of types of potential adverse drug responses in patients with chronic mechanical neck pain [Baseline]
Identification of potential adverse drug responses by Pharmacist from medication review

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Able to attend at 12 exercise class sessions (once a week for an hour)
Stable moderate to severe neck pain (3/10- 8/10) present for > 3 months
Able to get up and down off the floor
Able to ambulate in the community without an assistive device
Medically stable and cleared to participate in exercise

Exclusion Criteria:

Neck Pain that is easily aggravated with exercise
Neurological symptoms in the arms or legs (numbness, tingling, weakness)
History of recent whiplash, spine surgery, diagnosed osteoporosis, cervical stenosis with leg symptoms
Any medical conditions which does not allow active exercise
Unable to make medical decisions independently or have memory problems
Regularly attending Pilates or Yoga classes or individual sessions

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Equilibrium Studio	Bloomfield Hills	Michigan	United States	48301
2	Wayne State University	Detroit	Michigan	United States	48201
3	Oakland Physical Therapy	Novi	Michigan	United States	48374
4	Older Persons Commission	Rochester	Michigan	United States	48307