Barriers and facilitators to yoga practice in adults with chronic low back pain

Abstract

Given the high prevalence of chronic low back pain in the United States and the potential beneficial effects that integrative yoga interventions may have on this condition, the current study sought to examine barriers and facilitators to trying yoga in a population of adults with chronic low back pain. Participants self-reporting chronic low back pain were recruited from community sites in a collegiate town in western Alabama. Primary analyses utilized hierarchical regression and traditional 4-step mediational analyses to examine the predictive influence of catastrophizing and fear of movement on yoga attitudes. Results indicate that fear of movement serves a mediating role between catastrophizing and yoga attitudes. Originally proposed analyses included measurement of "intent to try yoga" as a primary outcome of interest. However, relationships between predictor variables and the unstandardized intent measure were, in general, extremely weak and execution of analyses was not indicated. Measurement of intention is discussed in Appendix A. Participants also responded to items asking them about perceptions of potential barriers and facilitators to trying yoga. Responses were subjected to qualitative thematic analysis and several common themes emerged for both barriers and facilitators: physical issues, cognitive/affective issues, motivational issues, informational issues, practical issues, and social issues. Qualitative analyses are discussed in Appendix B. Identifying cognitive barriers to consideration of yoga as a potential beneficial treatment for chronic low back pain conditions has great importance for clinical treatment of pain, especially as health care focus in the U.S. shifts to be more preventative and emphasizing self-management.