EFFECTIVENESS OF AN INTEGRATED SWASTHAVRITTA, ALIGNMENT-ORIENTED YOGA AND KUKUNDARA MARMA SELF-MOBILISATION PROGRAMME VERSUS LIFESTYLE MODIFICATION FOR LOW BACK PAIN: A RANDOMISED CONTROLLED TRIAL

Abstract

Background: Low back pain (LBP) is multifactorial and affects pain, physical functioning and quality of life. A structured programme integrating lifestyle practices, therapeutic movement and Kukundara Marma self-mobilisation may provide broader benefits than lifestyle modification alone. Objective: To evaluate the effectiveness of a 21-day integrated programme of selected Swasthavritta practices, alignment oriented Yoga and Kukundara Marma self-mobilisation compared with structured lifestyle modification in adults with LBP. Methods: This two-arm, parallel-group randomised controlled trial enrolled 290 adults aged 18–50 years with non specific LBP. Participants were allocated 1:1 to an integrated intervention (n=145) or lifestyle-modification control (n=145). The intervention was delivered for 21 consecutive days, with outcomes assessed at baseline, Day 21 and Day 61. Pain, disability and quality of life were assessed using the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) and WHOQOL-BREF. Between-group effects were evaluated using adjusted ANCOVA and longitudinal mixed-effects models. Results: At Day 21, VAS was 2.84±1.41 in the intervention group and 4.41±1.21 in the control group (between-group difference −1.57, 95% CI −1.88 to −1.26; p<0.001). ODI was 28.25±17.65 versus 51.84±16.71 (difference −23.59 percentage points, 95% CI −27.66 to −19.52; p<0.001). All four WHOQOL-BREF domains showed significantly greater improvement in the intervention group. At Day 61, between-group differences remained significant for VAS (−1.24, 95% CI −1.55 to −0.92), ODI (−19.87 percentage points, 95% CI −23.87 to −15.87), and all WHOQOL-BREF domains (all p<0.001). A clinically meaningful ≥30% reduction in pain at Day 21 occurred in 85.1% of intervention participants versus 17.1% of controls. Conclusion: A 21-day integrated programme combining alignment-oriented Yoga, Kukundara Marma self-mobilisation and selected Swasthavritta practices produced greater improvements in pain, functional disability and quality of life than structured lifestyle modification, with benefits remaining evident at two-month follow-up. Because the intervention was multicomponent and more intensively supervised than the comparator, the independent contribution of individual components cannot be determined.