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

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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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

Conditions
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Cervical Pain

Intervention / Treatment
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* Other: Yoga Group Exercise
* Other: Pilates Group Mat Exercise


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Yoga Group Exercise<br>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<br>* 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.<br>|
| Active Comparator: Pilates Group Mat Exercise<br>Pilates mat exercise will be taught by a licensed Physical Therapist with additional Rehabilitation Pilates certification. | Other: Pilates Group Mat Exercise<br>* 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.<br>|
| No Intervention: Control<br>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. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline Neck Disability Index | Self reported Neck Disability Index questionnaire | Baseline, 6 weeks, 12 weeks, 18 weeks | 

Secondary Outcome Measures

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

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cervical pain, yoga, pilates, exercise