title: Effects of yoga, strength training and advice on back pain: a randomized controlled trial.
abstract: Among the working population, non-specific low-back pain and neck pain are one of the most common reasons for sickness absenteeism. The aim was to evaluate the effects of an early intervention of yoga - compared with strength training or evidence-based advice - on sickness absenteeism, sickness presenteeism, back and neck pain and disability among a working population.
  
  
  
  A randomized controlled trial was conducted on 159 participants with predominantly (90%) chronic back and neck pain. After screening, the participants were randomized to kundalini yoga, strength training or evidence-based advice. Primary outcome was sickness absenteeism. Secondary outcomes were sickness presenteeism, back and neck pain and disability. Self-reported questionnaires and SMS text messages were completed at baseline, 6 weeks, 6 and 12 months.
  
  
  
  The results did not indicate that kundalini yoga and strength training had any statistically significant effects on the primary outcome compared with evidence-based advice. An interaction effect was found between adherence to recommendations and sickness absenteeism, indicating larger significant effects among the adherers to kundalini yoga versus evidence-based advice: RR = 0.47 (CI 0.30; 0.74, p = 0.001), strength training versus evidence-based advice: RR = 0.60 (CI 0.38; 0.96, p = 0.032). Some significant differences were also found for the secondary outcomes to the advantage of kundalini yoga and strength training.
  
  
  
  Guided exercise in the forms of kundalini yoga or strength training does not reduce sickness absenteeism more than evidence-based advice alone. However, secondary analyses reveal that among those who pursue kundalini yoga or strength training at least two times a week, a significantly reduction in sickness absenteeism was found. Methods to increase adherence to treatment recommendations should be further developed and applied in exercise interventions.
  
  
  
  Clinicaltrials.gov NCT01653782, date of registration: June, 28, 2012, retrospectively registered.
authors.affiliation: Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Nobels väg 13, Karolinska Institutet, 171 77, Stockholm, Sweden. Elisabeth.bjork.bramberg@ki.se.
authors.forename: Elisabeth Björk
authors.initials: EB
authors.lastname: Brämberg
authors.affiliation: Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Nobels väg 13, Karolinska Institutet, 171 77, Stockholm, Sweden.|Centre for Occupational and Environmental Medicine, Stockholm County Council, Solnavägen 4, 113 65, Stockholm, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Bergström
authors.affiliation: Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Nobels väg 13, Karolinska Institutet, 171 77, Stockholm, Sweden.
authors.forename: Irene
authors.initials: I
authors.lastname: Jensen
authors.affiliation: Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Nobels väg 13, Karolinska Institutet, 171 77, Stockholm, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Hagberg
authors.affiliation: Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Nobels väg 13, Karolinska Institutet, 171 77, Stockholm, Sweden.
authors.forename: Lydia
authors.initials: L
authors.lastname: Kwak
mesh_terms: D000328:Adult; D001416:Back Pain / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D055070:Resistance Training / Q000379:methods*; D016037:Single-Blind Method; D016896:Treatment Outcome; D015013:Yoga / Q000523:psychology
keywords: Back pain; Disability; Randomized controlled trial; Sickness absenteeism; Sickness presenteeism; Strength training; Yoga