Trial reportThe Journal of orthopaedic and sports physical therapy2022
Do Physical Therapy and Yoga Improve Pain and Disability through Psychological Mechanisms? A Causal Mediation Analysis of Adults with Chronic Low Back Pain.
Trial report in The Journal of orthopaedic and sports physical therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Evaluating the effectiveness of six exercise interventions for low back pain: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2025Pooled it
- How to tackle non-specific low back pain among adult patients? A systematic review with a meta-analysis to compare four interventions.Journal of orthopaedic surgery and research · 2024Pooled it
- Mediators of the effect of chiropractic care on 12- and 52-week outcomes for U.S. active-duty military personnel with low back pain: secondary analysis of a clinical trial.Chiropractic & manual therapies · 2026Trial
- Trial
- Effect of chiropractic care on low back pain for active-duty military members: Mediation through biopsychosocial factors.PloS one · 2024Trial
- "In Class We Were All One." A Qualitative Exploration of Yoga and Educational Interventions for Predominantly Low-Income and Minority Adults with Chronic Low Back Pain.Journal of integrative and complementary medicine · 2022Trial
- Causal Mediation Analysis of the Effects of Pain Education on Disability and Pain Intensity in Individuals with Chronic Low Back Pain.Journal of clinical medicine · 2026Article
- Causal mediation analysis: what is it and how can it be used to inform practice and policy?Family practice · 2025Article
- Religious affiliations, religious practices, and health behaviors in US South Asians.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2025Article
- Reductions in Perceived Injustice are Associated with Reductions in Pain Catastrophizing in Individuals with Low Back Pain.Journal of pain research · 2025Article
- Educational differences in mental health-related quality of life during the COVID-19 pandemic in Germany: the mediating role of pandemic-induced psychosocial stress.Frontiers in public health · 2025Article
- Chronic Low Back Pain Causal Risk Factors Identified by Mendelian Randomization: a Cross-Sectional Cohort Analysis.medRxiv : the preprint server for health sciences · 2024Article
- Association between the executive dysfunction and balance function in patients with stroke.Brain and behavior · 2024Article
- Influence of Depression on Pain and Disability in Patients with Chronic Low Back Pain after Physical Therapy: A Secondary Analysis of a Randomized Controlled Trial.Depression and anxiety · 2024Article
- Toward a causal model of chronic back pain: Challenges and opportunities.Frontiers in computational neuroscience · 2022Review
- Use of complementary and alternative medicine by patients with hypermobile Ehlers-Danlos Syndrome: A qualitative study.Frontiers in medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo investigate whether indirect effects via psychological mechanisms explain the effects of physical therapy (PT) or yoga versus education on back-related outcomes.
designMediation analyses using data from a randomized controlled trial of PT, yoga, and education interventions for chronic low back pain.
methodsPrimary outcomes were changes in back-related pain on the 11-point numeric rating scale and disability on the modified 23-point Roland-Morris Disability Questionnaire, measured at 52 weeks after randomization. Hypothesized mediators were 12-week changes in pain self-efficacy, fear-avoidance beliefs, depression, anxiety, perceived stress, and sleep quality. We used causal mediation analysis to estimate the total effect, direct effect, indirect effect, and proportion mediated.
resultsWe analyzed data from 230 adults (mean age = 46.2 years, 69.6% female, 79.6% non-White). In the PT-versus-education model, when the mediator was perceived stress, the total effect on disability was 2.6 points (95% confidence interval [CI]: 0.3, 4.9) and decomposed into a direct effect of 1.7 points (95% CI: -0.4, 3.8) and an indirect effect 0.9 points (95% CI: 0.1, 2.0; proportion mediated, 34%). No other psychological construct was a significant mediator.
conclusionImprovements in perceived stress mediated improvements in disability after PT treatment compared to education. Other psychological outcomes did not mediate the effect of yoga or PT on pain or disability outcomes compared to education.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.