In . J . o Con emp. Res. in Mul i. PEER-REVIEWED JOURNAL Volume 4 Issue 6 [No - Dec] Yea 2025
75
© 2025 Sudha S, M idul Y. Chi aka , Madan Kuma M. K, D . Ni in U maliya. This is an open-access a icle dis ibu ed unde he e ms o he C ea i e
Commons A ibu ion 4.0 In e na ional License (CC BY NC ND).h ps://c ea i ecommons.o g/licenses/by/4.0/
Resea ch A icle
Managemen o Low Back Pain wi h Alignmen -O ien ed Yoga
Techniques and Sel -Mobilisa ion o Kukunda a Ma ma – Single
G oup P e-Pos Design S udy
Sudha S¹*, M idul Y. Chi aka ², Madan Kuma M. K³, D . Sheeja CR 4 D . Ni in U maliya 5
1 Associa e P o esso , Depa men o Swas ha i a and Yoga, Go e nmen Ayu eda College, Kannu , Ke ala, India
1 PhD Schola , D.Y. Pa il Uni e si y, Na i Mumbai, Maha ash a, India
² Associa e P o esso , Depa men o Swas ha i a, D.Y. Pa il Uni e si y, Na i Mumbai, Maha ash a, India
³ Assis an P o esso , Depa men o Rachana Sha ee a, Go . Ayu eda College, Thi u anan hapu am, Ke ala, India
4Associa e P o esso Depa men o Rachana Sa ee a Go e nmen Ayu eda College Thi u anan hapu am
5 Associa e P o esso , Depa men o Agada an a, Go . Ash ang Ayu eda College,
Indo e, Madhya P adesh, India
Co esponding Au ho : *Sudha S DOI: h ps://doi.o g/10.5281/zenodo.17669262
Abs ac
Manusc ip In o ma ion
Backg ound: Low back pain (LBP) is he mos common heal h conce n wo ldwide, equen ly
es ic ing daily ac i i ies and diminishing quali y o li e. Ch onic LBP is usually a ibu ed o
seden a y li es yles, poo pos u e, and ex ended si ing, and o en ails o p o ide endu ing
elie h ough adi ional ea men s, despi e i s p e alence. This s udy examined whe he a
sho - e m, in eg a i e app oach in ol ing alignmen - ocused yoga p ac ices and sel -
mobilisa ion o Kukunda a Ma ma (an Ayu edic i al poin co esponding o he sac oiliac
join ) could o e meaning ul imp o emen .
Me hods: The s udy included 28 adul s om Thi u anan hapu am, Ke ala, who had been
su e ing om non- adia ing low back pain o mo e han h ee mon hs. A e en olmen , 26
pa icipan s comple ed he ull 14-day in e en ion. Each day, hey ecei ed an indi idualised
session combining alignmen -based yoga and gen le Kukunda a Ma ma mobilisa ion. This
p ac ice aimed o imp o e pos u e, co e s abili y, and educe ension in he lowe back. The
Visual Analogue Scale (VAS) was used o quan i y pain le els, and he Oswes y Disabili y
Index (ODI) was used o measu e unc ional abili ies. Da a analysis was conduc ed wi h
Jamo i so wa e.
Resul s: Pa icipan s a e aged 48 yea s old and we e mainly emales. A e wo weeks, pain
le els d opped signi ican ly (median VAS om 6 o 2), and disabili y sco es imp o ed (ODI
om 26.3% o 11.9%), wi h s a is ically signi ican esul s (p < 0.001).
Conclusion: Combining yoga wi h Ma ma-based he apy yielded excellen esul s in pain and
mobili y. This in eg a i e, low-cos , and non-in asi e app oach shows p omise as a suppo i e
addi ion o con en ional ca e. Fu he esea ch is needed h ough la ge , con olled ials o
unde s and i s long- e m bene i s and po en ial o wide clinical use.
▪ ISSN No: 2583-7397
▪ Recei ed: 19-10-2025
▪ Accep ed: 02-11-2025
▪ Published: 09-11-2025
▪ IJCRM:4(6); 2025: 75-84
▪ ©2025, All Righ s Rese ed
▪ Plagia ism Checked: Yes
▪ Pee Re iew P ocess: Yes
How o Ci e his A icle
Sudha S, Chi aka MY, Madan
Kuma MK, U maliya N.
Managemen o low back pain wi h
alignmen -o ien ed yoga echniques
and sel -mobilisa ion o Kukunda a
Ma ma – single g oup p e-pos
design s udy. In J Con emp Res
Mul idiscip. 2025;4(6):75-84.
Access his A icle Online
www.mul ia iclesjou nal.com
In . J . o Con emp. Res. in Mul i. PEER-REVIEWED JOURNAL Volume 4 Issue 6 [No - Dec] Yea 2025
76
© 2025 Sudha S, M idul Y. Chi aka , Madan Kuma M. K, D . Ni in U maliya. This is an open-access a icle dis ibu ed unde he e ms o he C ea i e
Commons A ibu ion 4.0 In e na ional License (CC BY NC ND).h ps://c ea i ecommons.o g/licenses/by/4.0/
KEYWORDS: Low Back Pain, Alignmen -O ien ed Yoga, Kukunda a Ma ma, Ma ma The apy, Func ional Disabili y Index
1. INTRODUCTION
1.1. Backg ound
LBP is a p ominen cause o disabili y, a ec ing 619 million
indi iduals wo ldwide in 2020 and an expec ed 843 million by
2050. I signi ican ly impai s quali y o li e and unc ion, wi h
an age-s anda dised Yea s Li ed wi h Disabili y (YLD) a e o
832 pe 100,000 [1]. Low Back pain can be de ined as pain o
s i ness be ween he lowe ibs and glu eal olds, wi h o
wi hou leg pain. [2,3]
1.2. Pa hophysiology
The Global Bu den o Disease S udy 2019 demons a es ha
modi iable li es yle de e minan s, such as educed physical
ac i i y, obesi y, occupa ional s ess, and psychosocial ac o s,
signi ican ly in luence he pe sis ence and p og ession o low
back pain.[1] LBP a ises om a complex in e play o
biomechanical, degene a i e, and neu omusculoskele al
dys unc ions, o en in ol ing in e e eb al disc pa hology,
sac oiliac join dys unc ion, and associa ed so issue
imbalances, compounded by modi iable isk ac o s such as
poo pos u e, physical decondi ioning, and psychosocial
s esso s. [4,5]
1.3. Guidelines o Managemen
As he i s line o ea men , he WHO and ACP sugges non-
d ug, pe son-cen ed ea men s like educa ion, exe cise, yoga,
mind ulness, and manual he apies. Medica ions should only be
used when necessa y, wi h a ocus on comp ehensi e,
biopsychosocial ca e. [6,7]
1.4. Yoga o Ch onic LBP
Resea ch p o ides subs an ial da a con i ming he e icacy o
Medical Yoga The apy in enhancing pain h esholds and
s imula ing descending pain modula o y pa hways in
indi iduals wi h ch onic LBP. [8] S udies epo ha bo h yoga
and s e ching helped ease symp oms and imp o e unc ion in
ch onic low back pain, wi h bene i s las ing up o 26 weeks,
sugges ing ha while yoga's mind-body aspec s add alue,
egula physical mo emen played he key ole in elie .[9] Yoga
has been demons a ed o subs an ially alle ia e pain and
enhance unc ional impai men in indi iduals wi h ch onic
LBP, wi h bene i s main ained a ollow-up and negligible side
e ec s. [10]
1.5. Ma ma The apy and In eg a ion wi h Yoga
As desc ibed in classical Ayu edic ex s, Ma ma a e
ana omically de ined i al poin s whe e muscles, eins,
ligamen s, bones, and join s con e ge— adi ionally ega ded
as sea s o li e ene gy and inc easingly explo ed o hei
he apeu ic po en ial in in eg a i e medicine.
Classical Ayu edic sc ip u es desc ibe Ma ma as ana omically
de ined i al places whe e muscles, eins, ligamen s, bones, and
join s in e sec . They a e conside ed li e o ce cen es and a e
inc easingly s udied in in eg a i e medicine.[11] Acco ding o
WHO’s In e na ional S anda d Te minologies on Ayu eda
(ITA-3.16.44), Kukunda a Ma ma is ana omically jus in e io
o he sac oiliac join (SIJ), which s abilises he pel is and
ansmi s s ain.[12] Owing o hei close ana omical ela ionship
and he con inui y o ascial and ligamen ous s uc u es in his
egion, Kukunda a Ma ma shows a no able s uc u al and
unc ional o e lap wi h he SIJ. Sac oiliac join s ans e spine-
o-lowe -limb s ess. Lumbopel ic s abili y depends on he
ho acolumba ascia, ligamen s, and muscles. Small limb join
angles can a ec sagi al e ical axis (SVA) eadings. Pos u e
is c ucial o spinal alignmen e i ica ion. [13,14]
1.6. Ra ionale: The pu pose o his s udy is o ill in he gaps in
cu en ea men s o ch onic low back pain by looking a an
in eg a ed, indi idualised, and cul u ally based he apy
in e en ion. This me hod combines he biomechanical bene i s
o alignmen -o ien ed yoga wi h he sub le ene ge ic ocus o
Ma ma ea men . I s goal is o ease symp oms and encou age
long- e m unc ional eco e y and o e all heal h.
1.7. Aim: The goal o his s udy is o ind ou i alignmen -
based yoga p ac ices and sel -mobilisa ion o Kukunda a
Ma ma can help adul s (20–60 yea s) wi h low back pain eel
less pain and unc ion be e , as measu ed by he Visual
Analogue Scale (VAS) and he Oswes y Disabili y Index
(ODI).
2. METHODOLOGY
2.1. T ail Design: An obse a ional s udy using a s uc u ed
ques ionnai e o demog aphic da a, ollowed by clinical
examina ion abou low back ache, along wi h VAS and ODI
scales, was used o conduc he s udy in he
Thi u anan hapu am co po a ion om July o Oc obe 2024.
2.2. E hical conside a ion: The E hics Commi ee o he
Go e nmen Ayu eda College, Thi u anan hapu am, app o ed
his s udy. On July 16, 2024, he Clinical T ials Regis y o
India egis e ed he ial as CTRI/2024/07/070759.
2.3. Pa icipan s: Eligible pa icipan s (n=28) we e ec ui ed
h ough a consecu i e sampling p ocess om he Swas ha i a
ou pa ien uni o Go e nmen Ayu eda College,
Thi u anan hapu am, o sel - e e ed in esponse o communi y
ad e isemen s. The sample size was de e mined using a mean
di e ence o 2.02 in VAS sco es pos - ea men , wi h a
s anda d de ia ion o 3.4, a 80% powe and 5% signi icance
( wo- ailed). This yielded a equi ed sample size o 24.7, which
was ounded up o 28 a e accoun ing o a 10% d opou a e.
2.4. Inclusion c i e ia: Indi iduals aged 20–60 yea s wi h a
clinical diagnosis o non-speci ic ch onic low back pain, who
consen ed o pa icipa e and had no engaged in yoga o
s e ching du ing he p e ious yea , we e included.
2.5. Exclusion c i e ia: Exclusion co e ed hose using an i-
in lamma o y d ugs, wi h p io lowe limb inju ies o su ge ies,
ecen su ge y o immobilisa ion, sys emic illnesses,
malignancies, low back pain seconda y o o he diseases,
p egnancy, lac a ion, o excessi e mens ual bleeding. [15]
2.6. Rec ui men : Eligible indi iduals we e ec ui ed upon
consen ing o pa icipa e and a ended an in oduc ion session
las ing abou 60–70 minu es, wi h indi idualised sessions o 14
In . J . o Con emp. Res. in Mul i. PEER-REVIEWED JOURNAL Volume 4 Issue 6 [No - Dec] Yea 2025
77
© 2025 Sudha S, M idul Y. Chi aka , Madan Kuma M. K, D . Ni in U maliya. This is an open-access a icle dis ibu ed unde he e ms o he C ea i e
Commons A ibu ion 4.0 In e na ional License (CC BY NC ND).h ps://c ea i ecommons.o g/licenses/by/4.0/
days. The p ocess occu ed in eal ime, meaning he
in e en ion begins immedia ely once a pa icipan is en olled
(wi hou wai ing o a whole ba ch o pa icipan s). VAS and
ODI sco es we e epo ed be o e and on he inal day a e he
in e en ion.
2.7. In e en ions
2.7.1. O ien a ion and Indi idualisa ion. Be o e he
commencemen o he yoga sessions, all pa icipan s we e
ho oughly b ie ed ega ding he in e en ion, including he
sequence o p ac ices, he use o p ops, sa e y conside a ions,
and he impo ance o sel -paced pa icipa ion wi hou s ain o
discom o . Yoga p ac ices and Ma ma mobilisa ion we e
adap ed o each pa icipan ’s pos u e, lexibili y, and pain le el
using alignmen cues, p ops, and guided modi ica ions o ensu e
sa e, e ec i e, and indi idualised ca e. P ope alignmen du ing
yoga asana p ac ice was main ained du ing Yoga sessions o
p e en se ious musculoskele al and neu ological inju ies
caused by misalignmen , emphasising he impo ance o expe
supe ision and indi idualised ins uc ion. [16] Pa icipan s
p ac ised yoga echniques and sel -mobilisa ion o he
Kukunda a Ma ma, a ge ing imp o ed co e s abili y,
lexibili y, and men al elaxa ion. Sessions included b ea hing
exe cises, elaxa ion p ac ices, and g adually challenging
asanas, all ailo ed o indi idual capaci ies.
2.7.2. Yoga P ac ice P o ocol
Each session began wi h i e ounds o mind ul deep b ea hing
in Samas hi i (s anding neu al alignmen pos u e) o p omo e
b ea h awa eness and men al calm. This was ollowed by
Sookshma Vyayama—gen le, coo dina ed join mo emen s wi h
conscious b ea hing— o loosen he body and ac i a e he
musculoskele al sys em in p epa a ion o deepe p ac ice.
Pa icipan s hen pe o med 25 ounds o Bhas ika P anayama
o ene gisa ion, ollowed by Modi ied Nauli K iya in
Tadasana, in ol ing gen le inwa d abdominal mo emen s o
s imula e co e engagemen and isce al massage. A sho
Sha asana allowed elaxa ion be o e p og essing o alignmen -
ocused s anding pos u es— Tadasana wi h Uddiyana Bandha,
A dha U anasana wi h Uddiyana Bandha, and P asa i a
Pado anasana— ollowed by ano he b ie Sha asana o
neu alise spinal load. The sequence con inued wi h sea ed and
supine asanas—Baddha Konasana, Upa ish a Konasana, and
Se u Bandhasana—emphasising lexibili y and pel ic s abili y,
wi h Moola Bandha engagemen h oughou . A e ano he
sho Sha asana, he p ac ice mo ed o Shalabhasana, ollowed
by b ie elaxa ion, and concluded wi h Pa anamuk asana,
Sup a Baddha Konasana, and Anan asana. A inal ex ended
Sha asana was included o comple e physical and men al
es o a ion, and he session ended wi h i e ounds o Bh ama i
P anayama. A e he comple ion o he yoga p ac ice,
Kukunda a Ma ma Mobilisa ion was pe o med h ough
gen le s e ching echniques, including Figu e Fou S e ch,
A dha Pa anamuk asana, Ca -Cow Mo emen s, and Child’s
Pose, aiming o enhance sac oiliac join mobili y, pel ic
s abili y, and u he educe low back discom o .[17-19] To
ensu e sa e y and accessibili y, p ops and physical suppo s
we e used o pa icipan s acing di icul y wi h speci ic
pos u es.[20] Each pos u e was adap ed o he indi idual's
com o able capaci y, p omo ing a pain- ee, indi idualised
p ac ice aligned wi h yogic p inciples. The s udy ollows he
Iyenga School o Yoga, and all asanas we e pe o med
acco dingly. [21]
Table 1: Sequence o yoga echniques
S ep
P ac ice
Rounds
App oxima e Time (in minu es)
1
Mind ul Deep B ea hing in Samas hi i
5
3
2
Gen le Loosening Mo emen s (Sookshma Vyayama)
3
5
3
Bhas ika P anayama (Bellow,s b ea h)
25
5
4
Modi ied Nauli K iya (in Tadasana- Moun ain Pose)
Modi ied Nauli k iya (abdominal chu ning) o beginne s by pulling he
an e io abdominal wall inside, holding, and eleasing i slowly.
25
3-4
→
Sho Sha asana (a e Nauli)
1
2
5
Tadasana + Uddiyana Bandha (Upwa d Abdominal Lock)
3
3
6
A dha U anasana (hal -s anding o wa d old) + Uddiyana Bandha
3
3
7
P asa i a Pado anasana ( wide-leg o wa d bend)
3
3
→
Sho Sha asana (Co pse pose) (a e s anding pos u es)
1
2
8
Baddha Konasana (Bu e ly Pose) + Moola Bandha
3
3
9
Bu e ly Pose (Wide-Angle Sea ed Fo wa d Bend) + Moola Bandha
3
3
10
Se u Bandhasana (b idge pose) + Moola Bandha (Roo Lock)
3
3
→
Sho Sha asana (a e mild backbend)
1
2-3
11
Shalabhasana (Locus pose)
3
3
→
Sho Sha asana (a e Shalabhasana)
1
2-3
12
Pa anamuk asana (Wind Relie ing Pose)
3
2-3
13
Sup a Baddha Konasana (Reclining Bound Angle)
3
2-3
14
Anan asana (Side Reclining Leg Li Pose)
3
2-3
15
Final Long Sha asana
1
5
16
Bh ama i P anayama (Bee b ea h)
5
3
17
Kukunda a Ma ma Mobilisa ion (Gen le S e ches o sac o iliac join )
4
5
In . J . o Con emp. Res. in Mul i. PEER-REVIEWED JOURNAL Volume 4 Issue 6 [No - Dec] Yea 2025
78
© 2025 Sudha S, M idul Y. Chi aka , Madan Kuma M. K, D . Ni in U maliya. This is an open-access a icle dis ibu ed unde he e ms o he C ea i e
Commons A ibu ion 4.0 In e na ional License (CC BY NC ND).h ps://c ea i ecommons.o g/licenses/by/4.0/
Table 2. Sequence in he mobilisa ion o Kukunda a Ma ma
S ep
Mobilisa ion Technique
Repe i ions / Du a ion
App oxima e Time (in minu es)
1
Figu e Fou S e ch
3 on each side
2
2
A dha Pa anamuk asana
3 on each side
2
3
Ca -Cow Mo emen s
10 ounds
3
4
Child’s Pose
Hold 1-2 minu es
2-3
2.8. Ou come E alua ion
Valida ed ools and scales we e employed o assess he
ollowing:
2.8.1. Pain In ensi y
The Visual Analogue Scale (VAS) was used o measu e pain
in ensi y. Pa icipan s no ed hei pain on a 10-cm ho izon al
line ha goes om "no pain" o "wo s pain imaginable." This
was a simple, sensi i e, and ep oducible echnique o measu e
symp om se e i y o e ime. [22]
2.8.2. Func ional Disabili y Index
The Oswes y Disabili y Index (ODI) measu ed unc ional
disabili y. This e i ied sel - epo ques ionnai e examines how
low back discom o impac s daily ac i i ies like mo emen ,
sel -ca e, li ing, and socialising. F om 0 o 100, he sco e
indica es how disabled someone is: 0–20% means sligh
disabili y, 21–40% means conside able disabili y, 41–60%
means signi ican disabili y, 61–80% means c ippled, and 81–
100% means bedbound o possibly exagge a ing he disease. [23]
S a is ical analysis
This esea ch analysed he impac o alignmen -o ien ed yoga
and Kukunda a Ma ma sel -mobilisa ion on pain and disabili y
o LBP. Pain was measu ed using VAS, and disabili y using he
ODI. A Wilcoxon signed- ank es showed signi ican pain
educ ion, while pai ed - es s o ODI and ODI% indica ed
imp o ed unc ionWe se he le el o s a is ical signi icance a
p < .05 and u ilized JAMOVI 2.5.3 o look a he da a.
3. RESULTS
3.1. Pa icipan Flow
We checked 36 people o see i hey we e eligible. Eigh people
we e le ou o he s udy: six didn' ma ch he equi emen s o
inclusion, and wo chose no o pa icipa e. This le 28 people
who we e en olled in he s udy. Howe e , wo pa icipan s
wi hd ew because o schedule issues, lea ing a inal sample o
26 pa icipan s who comple ed he 14-day s udy p o ocol and
subsequen assessmen s.
Eigh we e excluded—six o no mee ing he inclusion c i e ia
and wo who declined o pa icipa e, esul ing in 28 pa icipan s
en olled in he s udy. Howe e , wo pa icipan s d opped ou
due o scheduling con lic s, esul ing in a inal sample o 26
pa icipan s who comple ed he 14-day s udy p o ocol and pos -
in e en ion assessmen s.
Pa icipan s
en olled n= 28
Comple ed s udy n = 26
Subs an ial elie n = 24
D op ou n = 2 (scheduling issues)
No signi ican elie n = 2
Assessed o
eligibili y n = 36
Excluded (n=8)
• No mee ing inclusion c i e ia (n=6).
• Declined o pa icipa e due o inabili y
o ollow up on he appoin men (n=2)
In . J . o Con emp. Res. in Mul i. PEER-REVIEWED JOURNAL Volume 4 Issue 6 [No - Dec] Yea 2025
79
© 2025 Sudha S, M idul Y. Chi aka , Madan Kuma M. K, D . Ni in U maliya. This is an open-access a icle dis ibu ed unde he e ms o he C ea i e
Commons A ibu ion 4.0 In e na ional License (CC BY NC ND).h ps://c ea i ecommons.o g/licenses/by/4.0/
3.2. Demog aphic Cha ac e is ics: The ages o he
pa icipan s anged om 24 o 59, wi h an a e age o 48.1
yea s. The e we e 18 women and 10 men in he s udy, which is
64.3% and 35.7%, espec i ely. The e we e 14.3% om he
lowe classes and
85.7% om he highe o uppe -middle classes. The sample
was mos ly made up o ci ies (75%). The a e age body mass
index (BMI) was 27.6±3.2. 14.3% had a heal hy BMI, 60.7%
we e o e weigh , and 25% we e obese.
Table 3: Baseline demog aphic da a o he pa icipan s
Va iable
Ca ego y
F equency
Pe cen age (%)
Age (yea s)
21–30
2
7.1
31–40
3
10.7
41–50
9
32.1
>50
14
50.0
Sex
Female
18
64.3
Male
10
35.7
Socio-economic S a us
BPL
24
85.7
APL
4
14.3
Occupa ion
Manual Labo
12
42.9
Housewi e
10
35.7
Employed
5
17.9
S uden
1
3.6
Educa ion
10 h S anda d
5
17.9
Plus Two
6
21.4
G adua e
13
46.4
Pos g adua e
4
14.3
BMI Ca ego y
No mal
4
14.3
O e weigh
17
60.7
Obese
7
25.0
3.3. Pain In ensi y (VAS): Nine een pa icipan s had a leas
one como bidi y (diabe es melli us [DM], hype ension [HTN],
dyslipidaemia [DLP], o hy oid dys unc ion [TDF]). A o al o
7 pa icipan s had wo o mo e como bidi ies among DM, HTN,
DLP, and TDF. These condi ions we e sel - epo ed and
e i ied h ough a ailable medical eco ds. Among 28
pa icipan s, he e was localised ende ness a 28.6% (n=8), and
swelling was a 7.1% (n=2). Rega ding pain du a ion, 14.3%
(n=4) had symp oms o 3 mon hs o 1 yea , 67.9% (n=19) o
1–5 yea s, and 17.9% (n=5) o o e 5 yea s, indica ing a
p edominan ly ch onic pa e n. On inspec ion, 92.9% (n=26)
showed no isible spinal abno mali ies, wi h swelling obse ed
in 7.1% (n=2). Palpa ion e ealed no ende ness in 75% (n=21),
mild ende ness (GRADE-1) in 17.9% (n=5), and mode a e
ende ness (GRADE-2) in 3.6% (n=1). Mos pa icipan s
showed no mal lumbo-sac al mobili y. The median VAS sco e
was ini ially eco ded as 6 wi h an in e qua ile ange (IQR) o
4.3 o 7, which was educed o 2 a e in e en ion, wi h an IQR
o 1.8 o 4. This conside able dec ease sugges s a shi owa d
lowe pain le els among pa icipan s. Using he Wilcoxon
Signed Ranks Tes , he s udy's esul s indica ed a signi ican
di e ence in he sco es. The o al numbe o pa icipan s was
26, wi h a Z alue o 4.245 and a p- alue o less han 0.001,
showing s ong s a is ical signi icance.
Table 4: E ec o In e en ion on Pain In ensi y: VAS Sco e Analysis (Wilcoxon Tes )
N
VAS sco e
Mean Rank
Sum o
Ranks
Median
IQR
Nega i e Ranks
24
6
4.3 - 7
13.29
319
Posi i e Ranks
1
2
1.8 - 4
6
6
Ties
1
To al
26
Table 5: VAS Sco e Analysis con d
Wilcoxon Signed Ranks Tes
Z
4.245
p
<0.001
3.4. Func ional Disabili y (ODI)
A e he in e en ion, ODI d opped om 26.3% (SD = 18.3) o
11.9% (SD = 9.5). This d op indica es ha he in e en ion
imp o ed unc ional skills and educed back pain- ela ed
cons ain s. A pai ed - es analysis o ODI sco es e ealed a
mean di e ence o 14.7, s anda d de ia ion o 16.1, - alue o
4.667, and a signi ican p- alue o <0.001. These s a is ical da a
show ha he in e en ion educes disabili y clinically and
s a is ically.
Table 5: E ec o In e en ion on Pain In ensi y: ODI% % Sco e Analysis
(Pai ed es )
N
ODI%
Pai ed
di e ence
Pai ed - es
Mean
sd
Mean
sd
p
Be o e
28
26.3
18.3
14.7
16.1
4.667
<0.001
A e
26
11.9
9.5
In . J . o Con emp. Res. in Mul i. PEER-REVIEWED JOURNAL Volume 4 Issue 6 [No - Dec] Yea 2025
80
© 2025 Sudha S, M idul Y. Chi aka , Madan Kuma M. K, D . Ni in U maliya. This is an open-access a icle dis ibu ed unde he e ms o he C ea i e
Commons A ibu ion 4.0 In e na ional License (CC BY NC ND).h ps://c ea i ecommons.o g/licenses/by/4.0/
3.5. ODI Domain-wise Analysis
Ac oss he domains, a no able imp o emen in median sco es
was obse ed ollowing he in e en ion. The median sco e o
pain in ensi y (ODI-1) dec eased om 2.5 a baseline o 1 pos -
in e en ion. In he pe sonal ca e domain (ODI-2), he median
changed om 1 o 0. In li ing (ODI-3), he median shi ed om
1 o 0.5. Walking (ODI-4) demons a ed a change om 1 o 0.
Si ing (ODI-5) imp o ed om 1.5 o 1. S anding (ODI-6)
showed a educ ion om 2 o 1. In he sleeping domain (ODI-
7), he median changed om 0.5 o 0. The sex li e domain
(ODI-8) imp o ed om 1 o 0. Social li e (ODI-9) changed
om 1.5 o 1, and a elling (ODI-10) om 1 o 0. This was
closely ollowed by signi ican imp o emen s in social li e
(ODI-9), which imp o ed om 1.89 o 0.85 (a educ ion o
1.05), and a elling (ODI-10), whe e sco es dec eased om
1.82 o 0.77 (also a educ ion o 1.05). The sex li e domain
(ODI-8) demons a ed a subs an ial dec ease as well, wi h
sco es d opping om 1.54 o 0.62. The mean o al sco e on ODI
be o e he in e en ion was 9.18, dec eased o a mean pos -
in e en ion z-sco e o 7.12, e lec ing an imp o emen in
unc ional disabili y.
4. DISCUSSION
This s udy assessed he e ec i eness o alignmen -based yoga
wi h Kukunda a Ma ma sel -mobilisa ion, showing signi ican
pain elie and unc ional imp o emen using ODI and VAS.
4.1. Pa icipan P o ile and Risk Pa e ns. Mos pa icipan s
we e o e 50 yea s old (50%) and we e p edominan ly emale.
The a e age BMI was 27.6± 3.2 which is qui e ala ming.
Obesi y le els a e high in he sample, which deno es he cu en
end o his isk ac o in ou popula ion. In 2021, an es ima ed
2.11 billion adul s wo ldwide—1.00 billion men and 1.11
billion women—we e a ec ed by o e weigh and obesi y, wi h
p e alence exceeding 80% in se e al coun ies, ein o cing he
u gency o add essing his escala ing global heal h c isis. [24]
4.2. VAS sco e indings.
I was ound ha he VAS sco e showed subs an ial pain
educ ion, wi h a di e ence in median sco e o 4. Rank analysis
e eals ha , ou o 26 pa icipan s, 24 expe ienced a nega i e
ank (pain educ ion), 1 showed a posi i e ank (pain inc ease),
and 1 had no change ( ie). The mean ank o nega i e anks
was 13.29, wi h a sum o anks o alling 319, unde sco ing he
o e all end owa d pain alle ia ion.
4.3. ODI sco e analysis.
The ODI sco es showed a ma ked imp o emen o 14.4 %
di e ence in ODI sco es, which highligh s he in e en ion's
e ec i eness in enhancing unc ional s a us and educing he
ad e se impac o low back pain on pa icipan s' quali y o li e.
The o e all educ ion in ODI sco es e lec s he mul i ace ed
bene i s o combining alignmen -based yoga wi h Kukunda a
Ma ma mobilisa ion.
4.4. ODI domain analysis.
Pain in ensi y (Domain 1) showed clea imp o emen , which
e lec s ea lie indings ha yoga can ease ch onic low back
pain by combining physical mo emen wi h mind ul
engagemen , helping educe discom o and imp o e day- o-day
coping.[25]
In Domain 2, add essing pe sonal ca e, pa icipan s epo ed
inc eased ease in ac i i ies such as d essing and g ooming.
These imp o emen s may be a ibu ed o be e pos u al
alignmen and muscle ac i a ion, as poo si ing pos u e al e s
lumba muscle ac i i y and inc eases mechanical s ain.[26]
Li ing abili y (Domain 3) imp o ed consis en ly, possibly due
o enhanced unk con ol and educed biomechanical s ess, as
seen in s uc u ed exe cise p og ams o seden a y wo ke s. [27]
Walking (Domain 4) became mo e com o able and s able,
sugges ing imp o ed p op iocep ion and gai con ol—bene i s
suppo ed by s udies linking yoga o enhanced balance and
pos u al awa eness in hose wi h low back pain. [28,29]
Si ing abili y (Domain 5) also imp o ed somewha due o
ini ial pa icipan a iabili y. Howe e , using up igh alignmen
and mobilisa ion p ac ices likely educed spinal loading,
echoing indings ha p olonged unsuppo ed si ing can
exace ba e discom o h ough al e ed load dis ibu ion. [30,31]
S anding abili y (Domain 6) imp o ed h ough he
de elopmen o co e s abili y and alignmen , bo h o which
we e a ge ed h ough yoga pos u es in ol ing sus ained
s anding and symme ical engagemen . [27]
No ably, sleep quali y (Domain 7) imp o ed uni o mly ac oss
he sample. Relaxa ion echniques, such as Bh ama i
P anayama and Sha asana, likely enhanced pa asympa he ic
ac i a ion and educed discom o a nigh . [32,33] Domain 8,
conce ning sexual ac i i y, also showed imp o emen , which
may be a ibu ed o educed pain, be e pel ic alignmen , and
inc eased emo ional well-being, as suppo ed by s udies on he
holis ic bene i s o yoga. [34]
As pain and physical limi a ions eased, social li e (Domain 9)
imp o ed, enabling g ea e daily pa icipa ion—echoing
e idence ha yoga enhances bo h physical unc ion and
psychosocial engagemen in ch onic pain popula ions. [35]
T a elling (Domain 10) became easie , pa icula ly o hose
wi h g ea e ini ial limi a ions, likely due o enhanced spinal
mobili y and co e s eng h, educing mo emen - ela ed ea and
discom o . [30, 36]
4.5. O e all App aisal o he In e en ion E ec s
The imp o emen s likely e lec he mul i ace ed impac o
alignmen -o ien ed yoga, which a ge s pos u e, spinal
alignmen , co e s eng h, and p op iocep ion. [37,38]
Alignmen -o ien ed yoga, which ocuses on pos u al alignmen
and con olled mo emen s, likely educes pain and imp o es
unc ion by enhancing co e s abili y and p omo ing
musculoskele al balance as seen in s udies o Rosa ia e .al.[39]
S imula ion o Kukunda a Ma ma, associa ed wi h lowe back
s eng h and mobili y, may ha e ampli ied yoga’s e ec s by
ac i a ing ene gy pa hways o pain elie .
In . J . o Con emp. Res. in Mul i. PEER-REVIEWED JOURNAL Volume 4 Issue 6 [No - Dec] Yea 2025
81
© 2025 Sudha S, M idul Y. Chi aka , Madan Kuma M. K, D . Ni in U maliya. This is an open-access a icle dis ibu ed unde he e ms o he C ea i e
Commons A ibu ion 4.0 In e na ional License (CC BY NC ND).h ps://c ea i ecommons.o g/licenses/by/4.0/
This yoga- and Ma ma-based app oach o e s a holis ic, non-
in asi e al e na i e o con en ional ca e, suppo ing sel -
di ec ed pain elie and unc ional es o a ion. [40] Wi h
inc easing in e es in al e na i e he apies o ch onic pain, his
s udy o e s aluable e idence suppo ing he in eg a ion o
holis ic app oaches in o mains eam pain managemen . [41]
These indings ein o ce ha indi idualised, alignmen - ocused
yoga e ec i ely imp o es musculoskele al heal h and helps
manage ch onic pain. [42] Yoga alle ia es pain and enhances
well-being in ch onic low back pain h ough mind ul,
awa eness-based p ac ices. The p esen esul s simila ly
indica e ha physical alignmen and men al ocus play key oles
in hese imp o emen s.[9] Fu u e esea ch could e alua e he
long- e m e ec s o in eg a ing speci ic Ma ma poin s wi h
yoga, including hei po en ial o lowe heal hca e cos s in
ch onic pain managemen . [43] Mos pa icipan s (85.8%) had
symp oms o >1 yea , sugges ing ch onici y bene i s om
alignmen -based in e en ions.
No ad e se e en s occu ed, suppo ing he in e en ion's sa e y
and easibili y. The in e en ion aligns wi h WHO and ACP
guidelines, p omo ing non-pha macological managemen o
ch onic LBP. B ea hwo k, mind ul mo emen , and P anic ( i al
o ce) ocus likely enhanced pa asympa he ic ac i i y, educing
pain pe cep ion, while imp o emen s in sleep and s ess
indica e b oade sys emic bene i s. [44] Signi ican
imp o emen s we e achie ed in jus wo weeks, sugges ing he
po en ial o as - ack ehabili a i e models. [45] The
in e en ion equi ed minimal equipmen and can be easily
scaled in communi y se ings. [45] While sho - e m ou comes
a e encou aging, u u e esea ch is essen ial o in es iga e he
long- e m sus ainabili y o pain elie and unc ional
imp o emen s. Wi h 75% u ban pa icipan s and highe emale
pa icipa ion (64.3%), seden a y li es yle, educed physical
ac i i y, and s ess may ha e con ibu ed o he LBP pa e ns
obse ed. [46] P ac ices may ha e imp o ed p op iocep ion and
body awa eness, aiding sel -co ec ion o ha m ul pos u es
du ing daily ac i i ies. [47-49] The in e en ion p omo ed pa ien
sel -e icacy in managing pain by encou aging ac i e
in ol emen o e passi e ea men app oaches. [50]
4.6. S eng hs o he S udy
• A clea ly de ined p o ocol combining alignmen -o ien ed
yoga and adi ional Ma ma mobilisa ion in oduced a
no el in eg a i e model o CLBP ca e.
• S anda dised ou come measu es using VAS and ODI
ensu ed a eliable quan i a i e assessmen .
• Componen -wise ODI analysis o e ed de ailed insigh s
in o speci ic a eas o unc ional imp o emen .
• The sho 2-week in e en ion enhances p ac icali y o
ou pa ien o ime-cons ained se ings.
• Indi idualised deli e y ensu ed sa e y, op imised bene i s,
and educed isk.
• High comple ion a e (92.8%) e lec s s ong easibili y
and pa icipan adhe ence.
4.7. Limi a ions
E en i his s udy has se e al good poin s, i also has some
p oblems:
• The sample size was somewha limi ed (n=28),
cons aining he gene alizabili y o he esul s.
• The s udy's single-g oup p e-pos analysis, lacking a
con ol g oup, complica ed he a ibu ion o bene i s o he
in e en ion.
• Subjec i e epo ing in VAS and ODI may be in luenced
by expec a ion o social desi abili y bias.
• The e was no long- e m ollow-up o see i he ad an ages
would las .
4.8. Recommenda ions.
Subsequen esea ch mus encompass bigge , andomised
con olled ials including a ied popula ions, accompanied by
long- e m ollow-up o e alua e endu ing ou comes and
ecu ence. In es iga ing addi ional Ma ma poin s alongside
cus omised yoga p o ocols, and inco po a ing objec i e
measu es like goniome y, EMG, o biomechanical analysis,
would enhance clinical insigh . Quali a i e me hods can deepen
unde s anding by cap u ing indi idual expe iences and
beha iou al changes beyond quan i a i e me ics.
5. CONCLUSION
This s udy sugges s a quick, in eg a ed he apy employing
alignmen -o ien ed yoga and Kukunda a Ma ma sel -
mobilisa ion o pe sis en non- adia ing low back pain.
Pa icipan s expe ienced signi ican elie om pain and
imp o emen s in daily unc ion, as e lec ed in he educed
VAS and ODI sco es. These indings sugges ha es o ing
pos u e, enhancing body awa eness, and p omo ing sac oiliac
s abili y h ough an indi idualised mind-body p ac ice can ha e
angible clinical e ec s. Func ional gains we e seen in key a eas
like li ing, walking, and sleep, poin ing o he in e en ion’s
b oad ele ance o e e yday li e. Impo an ly, no ad e se e en s
we e epo ed, and pa icipan s showed s ong engagemen ,
unde sco ing he app oach’s sa e y and accessibili y. This
aligns well wi h cu en in e na ional ecommenda ions
emphasising holis ic, pa ien -cen ed ch onic pain ca e. These
ea ly esul s a e p omising, bu la ge , longe - e m expe imen s
a e needed o con i m and b oaden hem. S ill, his wo k se s
he s age o in eg a ing adi ional wisdom wi h mode n
he apeu ics in add essing musculoskele al heal h.
6. Con iden iali y
The da a collec ed we e coded o main ain he con iden iali y o
he s udy subjec s.
7. Au ho con ibu ions
The au ho s' con ibu ion in acqui ing da a and d a ing he
manusc ip is as ollows.
SS. Concep ualisa ion, Me hodology, In es iga ion, Resou ces,
Da a Cu a ion, Supe ision, Valida ion, Fo mal analysis,
W i ing - O iginal D a , W i ing
In . J . o Con emp. Res. in Mul i. PEER-REVIEWED JOURNAL Volume 4 Issue 6 [No - Dec] Yea 2025
82
© 2025 Sudha S, M idul Y. Chi aka , Madan Kuma M. K, D . Ni in U maliya. This is an open-access a icle dis ibu ed unde he e ms o he C ea i e
Commons A ibu ion 4.0 In e na ional License (CC BY NC ND).h ps://c ea i ecommons.o g/licenses/by/4.0/
MC Concep ualisa ion, Me hodology, Da a Cu a ion,
Supe ision, Valida ion, Fo mal analysis, W i ing- Re iewing
and Edi ing, O iginal D a , Supe ision
MK Concep ualisa ion, Me hodology, Da a Cu a ion,
Supe ision, Valida ion, Fo mal analysis, W i ing - O iginal
D a , W i ing- Re iewing and Edi ing, Supe ision
8. Sou ce (s) o unding
Sel - unded. This esea ch did no ob ain a speci ic g an om
any unding body wi hin he public, comme cial, o non-p o i
sec o s.
9. Decla a ion o gene a i e AI in scien i ic w i ing
The au ho s used G amma ly o check spelling, punc ua ion,
and g amma .
10. Decla a ion o compe ing in e es
The au ho s decla e ha he e is no con lic o in e es .
11. Acknowledgemen s
The au ho s acknowledge D.Y. Pa il Uni e si y, Na i Mumbai,
o academic suppo and Go e nmen Ayu eda College,
Thi u anan hapu am, o acili a ing he conduc o he s udy.
REFERENCES
1. Fe ei a ML, Luca K de, Haile LM, S einme z JD,
Culb e h GT, C oss M, e al. Global, egional, and na ional
bu den o low back pain, 1990–2020, i s a ibu able isk
ac o s, and p ojec ions o 2050: a sys ema ic analysis o
he Global Bu den o Disease S udy 2021. Lance
Rheuma ol. 2023;5:316–29.
2. Ai aksinen O, B ox JI, Ced aschi C, Hildeb and J, Klabe -
Mo e J, Ko acs F, e al. Chap e 4 Eu opean guidelines
o he managemen o ch onic nonspeci ic low back pain.
Eu Spine J. 2006 Ma ;15(Suppl 2): S192–300.
3. Chou R, Deyo R, F iedly J, Skelly A, Hashimo o R,
Weime M, e al. Nonpha macologic he apies o low
back pain: a sys ema ic e iew o an Ame ican College o
Physicians clinical p ac ice guideline. Ann In e n Med.
2017 Ap 4;166(7):493–505.
4. Nicodemus CL, Siko skii A, Eps ein J. Re isi ing ch onic
low back pain: e idence ha i is no non-speci ic. J
Os eopa h Med. 2023 Ma 1;123(3):143–9.
5. Malik KM, Nelson AM, Chiang TH, Imani F, Khademi
SH. The speci ics o non-speci ic low back pain: e-
e alua ing he cu en pa adigm o imp o e pa ien
ou comes. Anes hesiol Pain Med. 2022 No
1;12(4):e131499.
6. Wo ld Heal h O ganiza ion. WHO guideline o non-
su gical managemen o ch onic p ima y low back pain in
adul s in p ima y and communi y ca e se ings. Gene a:
Wo ld Heal h O ganiza ion; 2023. Repo No.: ISBN 978-
92-4-008178-9. A ailable om:
h ps://apps.who.in /i is/handle/10665/374379
7. Chou R, Qaseem A, Snow V, Casey D, C oss JT, Shekelle
P, e al. Diagnosis and ea men o low back pain: a join
clinical p ac ice guideline om he Ame ican College o
Physicians and he Ame ican Pain Socie y. Ann In e n
Med. 2007 Oc 2;147(7):478–91.
8. A ya S, Yada RK, Venka a aman S, Deepak KK, Bha ia
R. Objec i e e idence o ch onic back pain elie by
medical yoga he apy. F on Pain Res. 2022 Dec
23;3:1060685.
9. She man KJ, Che kin DC, Wellman RD, Cook AJ,
Hawkes RJ, Delaney K, e al. A andomized ial
compa ing yoga, s e ching, and a sel -ca e book o
ch onic low back pain. A ch In e n Med. 2011 Dec
12;171(22):2019–26.
10. Michalsen A, Jei le M, Kessle CS, S eckhan N, Robens
S, Os e mann T, e al. Yoga, eu y hmy he apy, and
s anda d physio he apy (YES- ial) o pa ien s wi h
ch onic non-speci ic low back pain: a h ee-a med
andomized con olled ial. J Pain. 2021 Oc
1;22(10):1233–45.
11. Wu T, Wang XY. A compa a i e s udy on ma ma and
acupoin s. J Ayu eda In eg Med. 2023 Jul;14(4):100769.
12. Wo ld Heal h O ganiza ion. WHO in e na ional s anda d
e minologies on Ayu eda. Gene a: Wo ld Heal h
O ganiza ion; 2022. Repo No.: ISBN 978-92-4-006493-
5. A ailable om:
h ps://apps.who.in /i is/handle/10665/366030
13. Van Royen BJ, Toussain HM, Kingma I, Bo SDM,
Caspe s M, Ha laa J, e al. Accu acy o he sagi al
e ical axis in a s anding la e al adiog aph as a
measu emen o balance in spinal de o mi ies. Eu Spine J.
1998 Oc 1;7(5):408–12.
14. Vleeming A, Schuenke MD, Masi AT, Ca ei o JE,
Danneels L, Willa d FH. The sac oiliac join : an o e iew
o i s ana omy, unc ion, and po en ial clinical
implica ions. J Ana . 2012;221(6):537–67.
15. Saman a J, Kendall J, Saman a A. Ch onic low back pain.
BMJ. 2003 Ma 8;326(7388):535.
16. Dha mshak u GS. Yoga- ela ed inju y in India: deep
silence and closed eyes. In J Yoga. 2020;13(3):261–2.
17. Ja ado A, Ke enci A, Aksoy C. The e iciency o manual
he apy and sac oiliac and lumba exe cises in pa ien s
wi h sac oiliac join dys unc ion synd ome. Pain Physician.
2021 May;24(3):223–33.
18. Dogan N, Sahbaz T, Di acoglu D. E ec s o mobiliza ion
ea men on sac oiliac join dys unc ion synd ome. Re
Assoc Med B as. 2021 Oc 22;67:1003–9.
19. Kamali F, Zamanlou M, Ghanba i A, Alipou A, Be is S.
Compa ison o manipula ion and s abiliza ion exe cises in
pa ien s wi h sac oiliac join dys unc ion: a andomized
clinical ial. J Bodyw Mo The . 2019 Jan;23(1):177–82.
20. E ans S, S e nlieb B, Zel ze L, Tsao JCI. Iyenga yoga
and he use o p ops o pedia ic ch onic pain: a case
s udy. Al e n The Heal h Med. 2013;19(5):66–70.
21. Williams KA, Pe onis J, Smi h D, Good ich D, Wu J,
Ra i N, e al. E ec o Iyenga yoga he apy o ch onic
low back pain. Pain. 2005 May 1;115(1):107–17.
In . J . o Con emp. Res. in Mul i. PEER-REVIEWED JOURNAL Volume 4 Issue 6 [No - Dec] Yea 2025
83
© 2025 Sudha S, M idul Y. Chi aka , Madan Kuma M. K, D . Ni in U maliya. This is an open-access a icle dis ibu ed unde he e ms o he C ea i e
Commons A ibu ion 4.0 In e na ional License (CC BY NC ND).h ps://c ea i ecommons.o g/licenses/by/4.0/
22. Aoki Y, Sugiu a S, Nakagawa K, Nakajima A, Takahashi
H, Oh o i S, e al. E alua ion o nonspeci ic low back pain
using a new de ailed isual analogue scale o pa ien s in
mo ion, s anding, and si ing: cha ac e izing nonspeci ic
low back pain in elde ly pa ien s. Pain Res T ea .
2012;2012:680496.
23. Joshi VD, Rai u ke PPP, Kulka ni AA. Validi y and
eliabili y o English and Ma a hi Oswes y Disabili y
Index ( e sion 2.1a) in he Indian popula ion. Spine. 2013
May 15;38(11):E662.
24. Global, egional, and na ional p e alence o adul
o e weigh and obesi y, 1990–2021, wi h o ecas s o
2050: a o ecas ing s udy o he Global Bu den o Disease
S udy 2021. Lance . 2025 Ma 8;405(10481):813–38.
25. Zhu F, Zhang M, Wang D, Hong Q, Zeng C, Chen W.
Yoga compa ed o non-exe cise o physical he apy
exe cise on pain, disabili y, and quali y o li e o pa ien s
wi h ch onic low back pain: a sys ema ic e iew and me a-
analysis o andomized con olled ials. PLoS One. 2020
Sep 1;15(9):e0238544.
26. Canei o JP, O’Sulli an P, Bu ne A, Ba ach A, O’Neil D,
T ei O, e al. The in luence o di e en si ing pos u es on
head/neck pos u e and muscle ac i i y. Man The . 2010
Feb 1;15(1):54–60.
27. Sipa iciene S, Kliziene I. E ec o di e en exe cise
p og ams on non-speci ic ch onic low back pain and
disabili y in people who pe o m seden a y wo k. Clin
Biomech. 2020 Ma 1;73:17–27.
28. Edwa ds N, Dickin C, Wang H. Low back pain and gol : a
e iew o biomechanical isk ac o s. Spo s Med Heal h
Sci. 2020 Ma 1;2(1):10–8.
29. Du SH, Zhang YH, Yang QH, Wang YC, Fang Y, Wang
XQ. Spinal pos u e assessmen and low back pain. EFORT
Open Re . 2023 Sep 1;8(9):708–18.
30. Wong AYL, Chan TPM, Chau AWM, Cheung HT, Kwan
KCK, Lam AKH, e al. Do di e en si ing pos u es a ec
he spinal biomechanics o asymp oma ic indi iduals? Gai
Pos u e. 2019 Jan 1;67:230–5.
31. G eene RD, F ey M, A a sha ghi S, Snow JC, Ba e M,
De Ca alho D. T ansien pe cei ed back pain induced by
p olonged si ing in a backless o ice chai : a e
biomechanical ac o s in ol ed? E gonomics. 2019 No
2;62(11):1415–25.
32. Jagadeesan T, RA, RK, Jain T, Allu AR, Sel i GT, e al.
E ec o Bh ama i P anayama in e en ion on s ess,
anxie y, dep ession, and sleep quali y among COVID-19
pa ien s in home isola ion. J Ayu eda In eg Med. 2022
Jul 1;13(3):100596.
33. Pandi-Pe umal SR, Spence DW, S i as a a N,
Kanchibho la D, Kuma K, Sha ma GS, e al. The o igin
and clinical ele ance o Yoga Nid a. Sleep Vigil.
2022;6(1):61–84.
34. Jąde ek I, Oba ska K, Lew-S a owicz M. Assessmen o
he e ec o mind ulness mono he apy on sexual
dys unc ion symp oms and sex- ela ed quali y o li e in
women. Sex Med. 2023 Jun 1;11(3):q ad022.
35. Wa d L, S ebbings S, Che kin D, Bax e GD. Yoga o
unc ional abili y, pain, and psychosocial ou comes in
musculoskele al condi ions: a sys ema ic e iew and me a-
analysis. Musculoskele al Ca e. 2013;11(4):203–17.
36. Bon up C, Taylo WR, Fliesse M, Vissche R, G een T,
Wippe PM, e al. Low back pain and i s ela ionship wi h
si ing beha iou among seden a y o ice wo ke s. Appl
E gon. 2019 No 1;81:102894.
37. Al-Subahi M, Alaya M, Alsheh i MA, Helal O, Alhasan
H, Alalawi A, e al. The e ec i eness o physio he apy
in e en ions o sac oiliac join dys unc ion: a sys ema ic
e iew. J Phys The Sci. 2017 Sep;29(9):1689–94.
38. Ba os G, McG a h L, Gel enbeyn M. Sac oiliac join
dys unc ion in pa ien s wi h low back pain. Fed P ac . 2019
Aug;36(8):370–5.
39. do Rosá io JLP, O cesi LS, Kobayashi FN, Aun AN,
Diolindo Assumpção IT, Blasioli GJ, e al. The immedia e
e ec s o modi ied yoga posi ions on musculoskele al pain
elie . J Bodyw Mo The . 2013 Oc 1;17(4):469–74.
40. Tilb ook HE, Cox H, Hewi CE, Kang’ombe AR, Chuang
LH, Jayakody S, e al. Yoga o ch onic low back pain: a
andomized ial. Ann In e n Med. 2011 No
1;155(9):569–78.
41. Sape RB, Lemas e C, Deli o A, She man KJ, He man
PM, Sadiko a E, e al. Yoga, physical he apy, o
educa ion o ch onic low back pain: a andomized
nonin e io i y ial. Ann In e n Med. 2017 Jul
18;167(2):85–94.
42. Nambi GS, Inbaseka an D, Khuman R, De i S,
Shanmuganan h N, Jaganna han K. Changes in pain
in ensi y and heal h- ela ed quali y o li e wi h Iyenga
yoga in nonspeci ic ch onic low back pain: a andomized
con olled s udy. In J Yoga. 2014 Jan;7(1):48–53.
43. Whi ehead A, Gould Foge i e S. Yoga ea men o
ch onic non-speci ic low back pain. Explo e (NY). 2017
Jul 1;13(4):281–4.
44. Oz M, Ulge O. Yoga, physical he apy, and home exe cise
e ec s on ch onic low back pain: pain pe cep ion,
unc ion, s ess, and quali y o li e in a andomized ial.
Pe cep Mo Skills. 2024 Dec 1;131(6):2216–43.
45. B uce-Low S, Smi h D, Bu ne S, Fishe J, Bissell G,
Webs e L. One lumba ex ension aining session pe
week is su icien o s eng h gains and educ ions in pain
in pa ien s wi h ch onic low back pain. E gonomics. 2012
Ap 1;55(4):500–7.
46. Liu Y, Tang G, Li J. Causa ions be ween obesi y, diabe es,
li es yle ac o s, and he isk o low back pain. Eu Spine J.
2024 Feb 1;33(2):525–32.
47. Shi J, Liu Z, Zhou X, Jin F, Chen X, Wang X, e al. E ec s
o b ea hing exe cises on low back pain in clinical: a
sys ema ic e iew and me a-analysis. Complemen The
Med. 2023 Dec 1;79:102993.
48. Gilliam JR, Geo ge SZ, No man KS, Hend en S, Sahu PK,
Sil ies SP. Mind-body exe cise pe o med by physical
he apis s o educing pain and disabili y in low back pain:
