Development of generic yoga therapy protocol for nonspecific chronic low back pain

Abstract

ABSTRACT Objective: To develop a generic yoga therapy protocol for nonspecific chronic low back pain (NCLBP) on the basis of previous research studies. Methods: A comprehensive PubMed search was done using keywords of “yoga” and “back pain” for English-language articles published till November 2022. PubMed showed 332 results for the keywords from 1977 to 2022. Twenty-nine studies were found eligible and the consolidation of yogic techniques were used in the studies. The study compiled 72 yogic techniques, including Asana and Pranayama, from 332 articles on yoga and back pain. Out of these, 151 were not relevant to yoga or back pain. After analyzing 181 articles, 33 were selected for review for a yoga therapy protocol, with four excluded due to inability to access full-text articles. The protocol was later validated by 14 eminent yoga therapy experts across the globe from countries including Australia, France, USA, Canada, Italy, Switzerland, and India, who had a minimum of 10 years’ experience in the field. The validation of the techniques was done based on a questionnaire that required classification under three categories: (1) not necessary, (2) useful but not essential, and (3) essential. All the three categories were then segregated in decreasing order of “Essential percentage” and “Weightage percentage” and the final list developed. The cutoff was that the yogic techniques must have ≥50% of acceptance by all experts. The practices were then sequenced in order of performance and cross referenced with traditional teachings. Results: The Generic Yoga Therapy Protocol for NCLBP that has been developed through this rational and logical mechanism has 18 yogic techniques selected on the basis of weightage and essential percentage. It includes 13 standing, sitting, prone, and supine postures (Asanas), four energy modulating breathing practices (Pranayamas), and one relaxation. The Shavasan relaxation received 100% approval by all experts. Conclusion: This generic yoga therapy protocol for NCLBP was developed through a comprehensive methodology that took into account the techniques used in previous research studies and was consolidated after a method of scientific validation by 14 eminent yoga therapy experts.