Curr Rev Musculoskelet Med (2008) 1:39–47 41 Fig. 2 Yoga pose—Camel the wait-list control group who received a back pain edu- cational booklet and then the same intervention 3 months later. The yoga protocol was based on the consensus opinion of eight senior Iyengar yoga instructors. It involved a semi-structured format with a predeﬁned set of 28 pos- tures from which the teacher could select individual poses in varying sequences based upon the needs of the class. Four experienced Iyengar instructors taught 90-min classes twice weekly for 12 weeks. The yoga participants were also encouraged to practice yoga at home for 30 min, 5 days a week. The authors proposed primary and sec- ondary outcome measures that would be assessed at baseline and 1, 3, and 6 month follow-ups, however only presented baseline characteristics of the two groups as well as adherence rates to the yoga intervention. Demographic and clinical baseline data of the two groups was similar with participants aged 18 to 65 (mean age 43.4) with an average visual analogue scale (VAS) of 4.2 and an average pain duration of 11.3 years. The authors also reported adherence with 64% of participants in the yoga group attending classes throughout the 3 month intervention period; on average, participants attended 15 (66%) classes. They concluded, this study demonstrated the feasibility of developing a yoga protocol based on consensus by an expert panel of senior yoga teachers with moderately good adherence. Galantino et al. also published a randomized controlled pilot study in 2004 studying the effects of a modiﬁed yoga protocol on patients with CLBP [4]. Twenty-two partici- pants with nonspeciﬁc CLBP were enrolled in this study. Subjects were required to have had LBP greater than 6 months and a history of receiving two or more conser- vative medical interventions without prolonged relief. Participants were then randomly assigned to one of the two groups including 11 to the yoga group and 11 to the control group who received the same intervention after the study phase was completed. The yoga protocol was established by an ‘‘expert panel’’ of two yoga instructors with greater than 10 years experience and a physical therapist special- izing in spine treatment and consisted of postures adapted for each individual. A single certiﬁed yoga instructor administered the 1 hour protocol twice weekly for 6 weeks. In addition, yoga participants were asked to practice yoga at home for 1 h per day as frequently as possible throughout the week. Outcome measures including the Oswestry Disability Index (ODI), Beck Depression Inventory (BDI), and two secondary functional measurements of ﬂexibility and bal- ance (the Sit and Reach (SR) and Functional Reach (FR) tests) were assessed at baseline and at 6 weeks in both groups. In addition, yoga participants were given a series of questions for qualitative data analysis after each class and at 3 month follow-up to assess their perception of the yoga experience. Participants were between the ages of 30 and 65 years; at baseline, there were no statistically signiﬁcant differences between groups except for the BDI which was substantially higher in the control group. After 6 weeks, the authors reported that both 46% of the yoga group and 40% of the control group were less disabled as measured by the ODI. Regarding depression, however, 54% of the subjects in the yoga group had lower scores on the BDI compared with only 20% of the control group. In addition, the SR and FR tests improved in 64 and 90%, respectively, of the yoga group while only two participants (20%) in the control group improved on these measures. Analysis of the qualitative data from the yoga group revealed that group intervention motivated the participants and furthermore, that yoga fostered relaxation and ‘‘new awareness.’’ This study was not powered for statistical signiﬁcance, but there appears to be potentially important trends of decreased depression and improved ﬂexibility and balance in patients with CLBP undergoing a yoga intervention. In 2005, Williams et al. evaluated the efﬁcacy of an Iyengar yoga intervention compared to an educational control group on pain-related outcomes in patients with CLBP [5]. Forty-four participants with nonspeciﬁc LBP of