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

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

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.

Study Overview

• Status: Completed
• Conditions: Cervical Pain
• Intervention / Treatment: Other: Yoga Group Exercise; Other: Pilates Group Mat Exercise

Detailed Description

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.

• Study Type: Interventional
• Enrollment (Actual): 88
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Michigan
    • Bloomfield Hills, Michigan, United States, 48301
      • Equilibrium Studio
    • Detroit, Michigan, United States, 48201
      • Wayne State University
    • Novi, Michigan, United States, 48374
      • Oakland Physical Therapy
    • Rochester, Michigan, United States, 48307
      • Older Persons Commission

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: NON_RANDOMIZED
• Interventional Model: PARALLEL
• Masking: NONE

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
ACTIVE_COMPARATOR: Yoga Group Exercise; 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; 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.
ACTIVE_COMPARATOR: Pilates Group Mat Exercise; Pilates mat exercise will be taught by a licensed Physical Therapist with additional Rehabilitation Pilates certification.	Other: Pilates Group Mat Exercise; 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.
NO_INTERVENTION: Control; 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?

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

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of participants with identified potential for adverse drug responses	Descriptive analysis of number of participants with potential for adverse drug responses based on review of medication by Pharmacist	Baseline
Identification of frequency of types of medication use in individuals with chronic neck pain	Descriptive analysis of medication used both for pain relief and co-morbidities	Baseline
Frequency of types of potential adverse drug responses in patients with chronic mechanical neck pain	Identification of potential adverse drug responses by Pharmacist from medication review	Baseline

Collaborators and Investigators

• Sponsor: Wayne State University
• Investigators: Principal Investigator: Kim Dunleavy, PhD, PT, OCS, Wayne State University

Publications and helpful links

General Publications

• Dunleavy K, Kava K, Goldberg A, Malek MH, Talley SA, Tutag-Lehr V, Hildreth J. Comparative effectiveness of Pilates and yoga group exercise interventions for chronic mechanical neck pain: quasi-randomised parallel controlled study. Physiotherapy. 2016 Sep;102(3):236-42. doi: 10.1016/j.physio.2015.06.002. Epub 2015 Aug 13.

Study record dates

Study Major Dates

• Study Start: July 1, 2010
• Primary Completion (ACTUAL): May 1, 2013
• Study Completion (ACTUAL): May 1, 2013

Study Registration Dates

• First Submitted: November 19, 2013
• First Submitted That Met QC Criteria: November 25, 2013
• First Posted (ESTIMATE): December 3, 2013

Study Record Updates

• Last Update Posted (ESTIMATE): December 3, 2013
• Last Update Submitted That Met QC Criteria: November 25, 2013
• Last Verified: November 1, 2013

More Information

Terms related to this study

• Keywords: exercise; yoga; pilates; Cervical pain
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Neck Pain
• Other Study ID Numbers: WSUPT2013A