Yoga Improves Occupational Performance,Pain-Related Disability,and Activities of Daily Living for People With Chronic Pain

PURPOSE: The purpose of this randomized controlled trial (RCT) was to compare the effects of a yoga intervention for people with chronic pain versus usual care on occupational performance, pain-related disability, and activities of daily living (ADLs). In the United States, at least 100 million people suffer from chronic pain. Chronic pain is a complex accumulation of physical, psychological, and social conditions; thus, interventions that address pain and promote functional performance are needed. A holistic intervention with mind and body components is likely necessary to best treat the complexities of chronic pain.

METHOD: In this pilot RCT, participants were allocated to 8 wk of yoga or usual care. Both groups received ongoing monthly self-management programming. Participants were recruited from an outpatient pain clinic; inclusion criteria were self-reported chronic pain for ≥6 mo, age >18, no exercise restrictions, no consistent yoga practice for the past year, and consent to participate in the study.

Data were collected before and after the 8-wk intervention. Participants were randomized to yoga or usual care after baseline assessments. Demographics were collected, and measures included the Canadian Occupational Performance Measure (COPM), a measure of occupational performance; the 11-item Brief Pain Inventory (BPI), a measure of pain-related disability; and the 15-item Frenchay Activities Index (FAI), a measure of ADL performance. Normality of data was assessed. Independent t tests were used to assess differences between groups. Paired t tests were used to assess differences between pre- and posttest measures for both groups. Percent change scores were calculated.

RESULTS: A total of 83 people were recruited for the study and completed baseline assessments; 44 were randomized to the yoga group and 39 to the control group. Participants’ average age was 51.4 ± 10.5, 68% were female, and 60% had at least some college education. There were no significant differences in demographics or outcome measures between groups at baseline or 8 wk; however, the study was not powered to show such differences. Control group participants did not significantly improve in any outcome measure over the 8 wk. Yoga participants showed significant improvements in COPM Performance (3.7 ± 1.9 vs. 4.7 ± 1.9, p < .001, 27% ↑) and Satisfaction scores (2.1 ± 2.3 vs. 3.8 ± 2.0, p < .001, 78% ↑), pain-related disability (BPI scores; 76.2 ± 14.8 vs. 71.4 ± 16.8, p = .01, 6% ↓), and ADLs (FAI scores; 38.1 ± 8.5 vs. 39.9 ± 8.6, p = .02, 5% ↑). Pain-related disability scores worsened over the 8 wk for control participants (67.81 ± 17.1 vs. 70.8 ± 15.2, p = .36, 4% ↑).

CONCLUSION: Yoga research has been completed with people with chronic pain; however, the focus has historically addressed pain and not occupational performance or ADLs. To our knowledge, this is first yoga study to also show improvements in occupational performance and ADLs for people with chronic pain. Occupational therapy practitioners frequently encounter patients with chronic pain and may wish to treat them with a holistic intervention. With training, practitioners may implement yoga as a modality to improve functional outcomes for people with chronic pain.

IMPACT STATEMENT: Data from this pilot RCT indicate that yoga may be a therapeutic intervention to improve occupational performance, pain-related disability, and ADL skills in people with chronic pain. Occupational therapy practitioners may consider adding yoga to treatment interventions to best address the needs of people with pain. This intervention research directly addresses a chronic condition and complex needs.

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