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Occup Med (Lond). 2017 Dec 30;67(9):687-695. doi: 10.1093/occmed/kqx161.

Cost-effectiveness of yoga for managing musculoskeletal conditions in the workplace.

Author information

Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, Wales.
School of Healthcare Sciences, Bangor University, Bangor, Wales.
Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden.
College of Human and Health Sciences, Swansea University, Swansea, Wales.



Back pain and musculoskeletal conditions negatively affect the health-related quality of life (HRQL) of employees and generate substantial costs to employers.


To assess the cost-effectiveness of yoga for managing musculoskeletal conditions.


A randomized controlled trial evaluated an 8-week yoga programme, with a 6-month follow-up, for National Health Service (NHS) employees. Effectiveness in managing musculoskeletal conditions was assessed using repeated-measures generalized linear modelling for the Roland-Morris Disability Questionnaire (RDQ) and the Keele STarT Back Screening Tool. Cost-effectiveness was determined using area-under-the-curve linear regression for assessing HRQL from healthcare and societal perspectives. The incremental cost per quality-adjusted life year (QALY) was also calculated. Sickness absence was measured using electronic staff records at 6 months.


There were 151 participants. At 6 months, mean differences between groups favouring yoga were observed for RDQ [-0.63 (95% CI, -1.78, 0.48)], Keele STarT [-0.28 (95% CI, -0.97, 0.07)] and HRQL (0.016 QALY gain). From a healthcare perspective, yoga yielded an incremental cost-effectiveness ratio of £2103 per QALY. Given a willingness to pay for an additional QALY of £20 000, the probability of yoga being cost-effective was 95%. From a societal perspective, yoga was the dominant treatment compared with usual care. At 6 months, electronic staff records showed that yoga participants missed a total of 2 working days due to musculoskeletal conditions compared with 43 days for usual care participants.


Yoga for NHS employees may enhance HRQL, reduce disability associated with back pain, lower sickness absence due to musculoskeletal conditions and is likely to be cost-effective.


Back pain; cost-effectiveness; musculoskeletal conditions; occupational health; physical activity; randomized controlled trial; return-on-investment; sickness absence; workplace; yoga

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