1  460 153 CHANGES IN PAIN SELF-EFFICACY, COPING SKILLS, AND FEAR-AVOIDANCE BELIEFS IN A RANDOMIZED CONTROLLED TRIAL OF YOGA, PHYSICAL THERAPY, AND EDUCATION FOR CHRONIC LOW BACK PAIN. OBJECTIVE: WE EVALUATED EXERCISE INTERVENTIONS FOR COGNITIVE APPRAISAL OF CHRONIC LOW BACK PAIN (CLBP) IN AN UNDERSERVED POPULATION. METHODS: WE CONDUCTED A SECONDARY ANALYSIS OF THE BACK TO HEALTH TRIAL, SHOWING YOGA TO BE NONINFERIOR TO PHYSICAL THERAPY (PT) FOR PAIN AND FUNCTION OUTCOMES AMONG ADULTS WITH CLBP (N = 320) RECRUITED FROM PRIMARY CARE CLINICS WITH PREDOMINANTLY LOW-INCOME PATIENTS. PARTICIPANTS WERE RANDOMIZED TO 12 WEEKS OF YOGA, PT, OR EDUCATION. COGNITIVE APPRAISAL WAS ASSESSED WITH THE PAIN SELF-EFFICACY QUESTIONNAIRE (PSEQ), COPING STRATEGIES QUESTIONNAIRE (CSQ), AND FEAR-AVOIDANCE BELIEFS QUESTIONNAIRE (FABQ). USING MULTIPLE IMPUTATION AND LINEAR REGRESSION, WE ESTIMATED WITHIN- AND BETWEEN-GROUP CHANGES IN COGNITIVE APPRAISAL AT 12 AND 52 WEEKS, WITH BASELINE AND THE EDUCATION GROUP AS REFERENCES. RESULTS: PARTICIPANTS (MEAN AGE = 46 YEARS) WERE MAJORITY FEMALE (64%) AND MAJORITY BLACK (57%), AND 54% HAD AN ANNUAL HOUSEHOLD INCOME <$30,000. ALL THREE GROUPS SHOWED IMPROVEMENTS IN PSEQ (RANGE 0-60) AT 12 WEEKS (YOGA, MEAN DIFFERENCE [MD] = 7.0, 95% CONFIDENCE INTERVAL [CI]: 4.9, 9.0; PT, MD = 6.9, 95% CI: 4.7 TO 9.1; AND EDUCATION, MD = 3.4, 95% CI: 0.54 TO 6.3), WITH YOGA AND PT IMPROVEMENTS BEING CLINICALLY MEANINGFUL. AT 12 WEEKS, IMPROVEMENTS IN CATASTROPHIZING (CSQ, RANGE 0-36) WERE LARGEST IN THE YOGA AND PT GROUPS (MD = -3.0, 95% CI: -4.4 TO -1.6; MD = -2.7, 95% CI: -4.2 TO -1.2, RESPECTIVELY). CHANGES IN FABQ WERE SMALL. NO STATISTICALLY SIGNIFICANT BETWEEN-GROUP DIFFERENCES WERE OBSERVED ON PSEQ, CSQ, OR FABQ AT EITHER TIME POINT. MANY OF THE CHANGES OBSERVED AT 12 WEEKS WERE SUSTAINED AT 52 WEEKS. CONCLUSION: ALL THREE INTERVENTIONS WERE ASSOCIATED WITH IMPROVEMENTS IN SELF-EFFICACY AND CATASTROPHIZING AMONG LOW-INCOME, RACIALLY DIVERSE ADULTS WITH CLBP. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER NCT01343927.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
2  430  69 CAN YOGA OR PHYSICAL THERAPY FOR CHRONIC LOW BACK PAIN IMPROVE DEPRESSION AND ANXIETY AMONG ADULTS FROM A RACIALLY DIVERSE, LOW-INCOME COMMUNITY? A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: TO DETERMINE AND COMPARE THE EFFECT OF YOGA, PHYSICAL THERAPY (PT), AND EDUCATION ON DEPRESSIVE AND ANXIOUS SYMPTOMS IN PATIENTS WITH CHRONIC LOW BACK PAIN (CLBP). DESIGN: SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. SETTING: ACADEMIC SAFETY NET HOSPITAL AND 7 COMMUNITY HEALTH CENTERS. PARTICIPANTS: A TOTAL OF 320 ADULTS WITH CLBP. INTERVENTION: YOGA CLASSES, PT SESSIONS, OR AN EDUCATIONAL BOOK. OUTCOME MEASURE: DEPRESSION AND ANXIETY WERE MEASURED USING THE PATIENT HEALTH QUESTIONNAIRE AND GENERALIZED ANXIETY DISORDER 7-ITEM SCALE, RESPECTIVELY, AT BASELINE, 12, AND 52 WEEKS. WE IDENTIFIED BASELINE AND MIDTREATMENT (6-WK) FACTORS ASSOCIATED WITH CLINICALLY MEANINGFUL IMPROVEMENTS IN DEPRESSIVE (>/=3 POINTS) OR ANXIOUS (>/=2 POINTS) SYMPTOMS AT 12 WEEKS. RESULTS: PARTICIPANTS (FEMALE=64%; MEAN AGE, 46.0+/-10.7 YEARS) WERE PREDOMINANTLY NON-WHITE (82%), LOW-INCOME (<$30,000/YEAR, 59%), AND HAD NOT RECEIVED A COLLEGE DEGREE (71%). MOST PARTICIPANTS HAD MILD OR WORSE DEPRESSIVE (60%) AND ANXIOUS (50%) SYMPTOMS. AT 12 WEEKS, YOGA AND PT PARTICIPANTS EXPERIENCED MODEST WITHIN-GROUP IMPROVEMENTS IN DEPRESSIVE SYMPTOMS (MEAN DIFFERENCE [MD]=-1.23 [95% CI, -2.18 TO -0.28]; MD=-1.01 [95% CI, -2.05 TO -0.03], RESPECTIVELY). COMPARED WITH THE EDUCATION GROUP, 12-WEEK DIFFERENCES WERE NOT STATISTICALLY SIGNIFICANT, ALTHOUGH TRENDS FAVORED YOGA (MD=-0.71 [95% CI, -2.22 TO 0.81]) AND PT (MD= -0.32 [95% CI, -1.82 TO 1.18]). AT 12 WEEKS, IMPROVEMENTS IN ANXIOUS SYMPTOMS WERE ONLY FOUND IN PARTICIPANTS WHO HAD MILD OR MODERATE ANXIETY AT BASELINE. INDEPENDENT OF TREATMENT ARM, PARTICIPANTS WHO HAD 30% OR GREATER IMPROVEMENT IN PAIN OR FUNCTION MIDTREATMENT WERE MORE LIKELY TO HAVE A CLINICALLY MEANINGFUL IMPROVEMENT IN DEPRESSIVE SYMPTOMS (ODDS RATIO [OR], 1.82 [95% CI, 1.03-3.22]; OR, 1.79 [95% CI, 1.06-3.04], RESPECTIVELY). CONCLUSIONS: IN OUR SECONDARY ANALYSIS WE FOUND THAT DEPRESSION AND ANXIETY, COMMON IN THIS SAMPLE OF UNDERSERVED ADULTS WITH CLBP, MAY IMPROVE MODESTLY WITH PT AND YOGA. HOWEVER, EFFECTS WERE NOT SUPERIOR TO EDUCATION. IMPROVEMENTS IN PAIN AND FUNCTION ARE ASSOCIATED WITH A DECREASE IN DEPRESSIVE SYMPTOMS. MORE RESEARCH IS NEEDED TO OPTIMIZE THE INTEGRATION OF PHYSICAL AND PSYCHOLOGICAL WELL-BEING IN PT AND YOGA.	2021	
                                                       
3 2374  61 WHICH CHRONIC LOW BACK PAIN PATIENTS RESPOND FAVORABLY TO YOGA, PHYSICAL THERAPY, AND A SELF-CARE BOOK? RESPONDER ANALYSES FROM A RANDOMIZED CONTROLLED TRIAL. PURPOSE: TO IDENTIFY BASELINE CHARACTERISTICS OF ADULTS WITH CHRONIC LOW BACK PAIN (CLBP) THAT PREDICT RESPONSE (I.E., A CLINICALLY IMPORTANT IMPROVEMENT) AND/OR MODIFY TREATMENT EFFECT ACROSS THREE NONPHARMACOLOGIC INTERVENTIONS. DESIGN: SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. SETTING: ACADEMIC SAFETY NET HOSPITAL AND SEVEN FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS. SUBJECTS: ADULTS WITH CLBP (N = 299). METHODS: WE REPORT PATIENT CHARACTERISTICS THAT WERE PREDICTORS OF RESPONSE AND/OR MODIFIED TREATMENT EFFECT ACROSS THREE 12-WEEK TREATMENTS: YOGA, PHYSICAL THERAPY [PT], AND A SELF-CARE BOOK. USING PRESELECTED CHARACTERISTICS, WE USED LOGISTIC REGRESSION TO IDENTIFY PREDICTORS OF "RESPONSE," DEFINED AS A >/=30% IMPROVEMENT IN THE ROLAND MORRIS DISABILITY QUESTIONNAIRE. THEN, USING "RESPONSE" AS OUR OUTCOME, WE IDENTIFIED BASELINE CHARACTERISTICS THAT WERE TREATMENT EFFECT MODIFIERS BY TESTING FOR STATISTICAL INTERACTION (P < 0.05) ACROSS TWO COMPARISONS: 1) YOGA-OR-PT VS SELF-CARE AND 2) YOGA VS PT. RESULTS: OVERALL, 39% (116/299) OF PARTICIPANTS WERE RESPONDERS, WITH MORE RESPONDERS IN THE YOGA-OR-PT GROUP (42%) THAN THE SELF-CARE (23%) GROUP. THERE WAS NO DIFFERENCE IN PROPORTION RESPONDING TO YOGA (48%) VS PT (37%, ODDS RATIO [OR] = 1.5, 95% CONFIDENCE INTERVAL = 0.88 - 2.6). PREDICTORS OF RESPONSE INCLUDED HAVING MORE THAN A HIGH SCHOOL EDUCATION, A HIGHER INCOME, EMPLOYMENT, FEW DEPRESSIVE SYMPTOMS, LOWER PERCEIVED STRESS, FEW WORK-RELATED FEAR AVOIDANCE BELIEFS, HIGH PAIN SELF-EFFICACY, AND BEING A NONSMOKER. EFFECT MODIFIERS INCLUDED USE OF PAIN MEDICATION AND FEAR AVOIDANCE BELIEFS RELATED TO PHYSICAL ACTIVITY (BOTH P = 0.02 FOR INTERACTION). WHEN COMPARING YOGA OR PT WITH SELF-CARE, A GREATER PROPORTION WERE RESPONDERS AMONG THOSE USING PAIN MEDS (OR = 5.3), WHICH DIFFERED FROM THOSE NOT TAKING PAIN MEDS (OR = 0.94) AT BASELINE. WE ALSO FOUND GREATER TREATMENT RESPONSE AMONG THOSE WITH LOWER (OR = 7.0), BUT NOT HIGH (OR = 1.3), FEAR AVOIDANCE BELIEFS AROUND PHYSICAL ACTIVITY. CONCLUSIONS: OUR FINDINGS REVEALED IMPORTANT SUBGROUPS FOR WHOM REFERRAL TO YOGA OR PT MAY IMPROVE CLBP OUTCOMES.	2021	
                                                                                                                                                                                                                                
4 2851  75 YOGA, PHYSICAL THERAPY, AND BACK PAIN EDUCATION FOR SLEEP QUALITY IN LOW-INCOME RACIALLY DIVERSE ADULTS WITH CHRONIC LOW BACK PAIN: A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: POOR SLEEP IS COMMON AMONG ADULTS WITH CHRONIC LOW BACK PAIN (CLBP), BUT THE INFLUENCE OF CLBP TREATMENTS, SUCH AS YOGA AND PHYSICAL THERAPY (PT), ON SLEEP QUALITY IS UNDER STUDIED. OBJECTIVE: EVALUATE THE EFFECTIVENESS OF YOGA AND PT FOR IMPROVING SLEEP QUALITY IN ADULTS WITH CLBP. DESIGN: SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. SETTING: ACADEMIC SAFETY-NET HOSPITAL AND 7 AFFILIATED COMMUNITY HEALTH CENTERS. PARTICIPANTS: A TOTAL OF 320 ADULTS WITH CLBP. INTERVENTION: TWELVE WEEKLY YOGA CLASSES, 1-ON-1 PT SESSIONS, OR AN EDUCATIONAL BOOK. MAIN MEASURES: SLEEP QUALITY WAS MEASURED USING THE PITTSBURGH SLEEP QUALITY INDEX (PSQI) GLOBAL SCORE (0-21) AT BASELINE, 12 WEEKS, AND 52 WEEKS. ADDITIONALLY, WE ALSO EVALUATED HOW THE PROPORTION OF PARTICIPANTS WHO ACHIEVED A CLINICALLY MEANINGFUL IMPROVEMENT IN SLEEP QUALITY (> 3-POINT REDUCTION IN PSQI) AT 12 WEEKS VARIED BY CHANGES IN PAIN AND PHYSICAL FUNCTION AT 6 WEEKS. KEY RESULTS: AMONG PARTICIPANTS (MEAN AGE = 46.0, 64% FEMALE, 82% NON-WHITE), NEARLY ALL (92%) REPORTED POOR SLEEP QUALITY (PSQI > 5) AT BASELINE. AT 12 WEEKS, MODEST IMPROVEMENTS IN SLEEP QUALITY WERE OBSERVED AMONG THE YOGA (PSQI MEAN DIFFERENCE [MD] = - 1.19, 95% CONFIDENCE INTERVAL [CI] - 1.82, - 0.55) AND PT (PSQI MD = - 0.91, 95% CI - 1.61, - 0.20) GROUPS. PARTICIPANTS WHO REPORTED A >/= 30% IMPROVEMENT IN PAIN OR PHYSICAL FUNCTION AT 6 WEEKS, COMPARED WITH THOSE WHO IMPROVED < 10%, WERE MORE LIKELY TO BE A SLEEP QUALITY RESPONDER AT 12 WEEKS (ODDS RATIO [OR] = 3.51, 95% CI 1.73, 7.11 AND OR = 2.16, 95% CI 1.18, 3.95, RESPECTIVELY). RESULTS WERE SIMILAR AT 52 WEEKS. CONCLUSION: IN A SAMPLE OF ADULTS WITH CLBP, VIRTUALLY ALL WITH POOR SLEEP QUALITY PRIOR TO INTERVENTION, MODEST BUT STATISTICALLY SIGNIFICANT IMPROVEMENTS IN SLEEP QUALITY WERE OBSERVED WITH BOTH YOGA AND PT. IRRESPECTIVE OF TREATMENT, CLINICALLY IMPORTANT SLEEP IMPROVEMENTS AT THE END OF THE INTERVENTION WERE ASSOCIATED WITH MID-INTERVENTION PAIN AND PHYSICAL FUNCTION IMPROVEMENTS. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT01343927.	2020	
                                                                                                                                                                                                                                                                      
5  461  73 CHANGES IN PERCEIVED STRESS AFTER YOGA, PHYSICAL THERAPY, AND EDUCATION INTERVENTIONS FOR CHRONIC LOW BACK PAIN: A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: PERCEIVED STRESS AND MUSCULOSKELETAL PAIN ARE COMMON, ESPECIALLY IN LOW-INCOME POPULATIONS. STUDIES EVALUATING TREATMENTS TO REDUCE STRESS IN PATIENTS WITH CHRONIC PAIN ARE LACKING. WE AIMED TO QUANTIFY THE EFFECT OF TWO EVIDENCE-BASED INTERVENTIONS FOR CHRONIC LOW BACK PAIN (CLBP), YOGA AND PHYSICAL THERAPY (PT), ON PERCEIVED STRESS IN ADULTS WITH CLBP. METHODS: WE USED DATA FROM AN ASSESSOR-BLINDED, PARALLEL-GROUP RANDOMIZED CONTROLLED TRIAL, WHICH RECRUITED PREDOMINANTLY LOW-INCOME AND RACIALLY DIVERSE ADULTS WITH CLBP. PARTICIPANTS (N = 320) WERE RANDOMLY ASSIGNED TO 12 WEEKS OF YOGA, PT, OR BACK PAIN EDUCATION. WE COMPARED CHANGES IN THE 10-ITEM PERCEIVED STRESS SCALE (PSS-10) FROM BASELINE TO 12- AND 52-WEEK FOLLOW-UP AMONG YOGA AND PT PARTICIPANTS WITH THOSE RECEIVING EDUCATION. SUBANALYSES WERE CONDUCTED FOR PARTICIPANTS WITH ELEVATED PRE-INTERVENTION PERCEIVED STRESS (PSS-10 SCORE >/=17). WE CONDUCTED SENSITIVITY ANALYSES USING VARIOUS IMPUTATION METHODS TO ACCOUNT FOR POTENTIAL BIASES IN OUR ESTIMATES DUE TO MISSING DATA. RESULTS: AMONG 248 PARTICIPANTS (MEAN AGE = 46.4 YEARS, 80% NONWHITE) COMPLETING ALL THREE SURVEYS, YOGA AND PT SHOWED GREATER REDUCTIONS IN PSS-10 SCORES COMPARED WITH EDUCATION AT 12 WEEKS (MEAN BETWEEN-GROUP DIFFERENCE = -2.6, 95% CONFIDENCE INTERVAL [CI] = -4.5 TO -0.66, AND MEAN BETWEEN-GROUP DIFFERENCE = -2.4, 95% CI = -4.4 TO -0.48, RESPECTIVELY). THIS EFFECT WAS STRONGER AMONG PARTICIPANTS WITH ELEVATED PRE-INTERVENTION PERCEIVED STRESS. BETWEEN-GROUP EFFECTS HAD ATTENUATED BY 52 WEEKS. RESULTS WERE SIMILAR IN SENSITIVITY ANALYSES. CONCLUSIONS: YOGA AND PT WERE MORE EFFECTIVE THAN BACK PAIN EDUCATION FOR REDUCING PERCEIVED STRESS AMONG LOW-INCOME ADULTS WITH CLBP.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
6  193  46 A RANDOMIZED TRIAL COMPARING YOGA, STRETCHING, AND A SELF-CARE BOOK FOR CHRONIC LOW BACK PAIN. BACKGROUND: CHRONIC LOW BACK PAIN IS A COMMON PROBLEM LACKING HIGHLY EFFECTIVE TREATMENT OPTIONS. SMALL TRIALS SUGGEST THAT YOGA MAY HAVE BENEFITS FOR THIS CONDITION. THIS TRIAL WAS DESIGNED TO DETERMINE WHETHER YOGA IS MORE EFFECTIVE THAN CONVENTIONAL STRETCHING EXERCISES OR A SELF-CARE BOOK FOR PRIMARY CARE PATIENTS WITH CHRONIC LOW BACK PAIN. METHODS: A TOTAL OF 228 ADULTS WITH CHRONIC LOW BACK PAIN WERE RANDOMIZED TO 12 WEEKLY CLASSES OF YOGA (92 PATIENTS) OR CONVENTIONAL STRETCHING EXERCISES (91 PATIENTS) OR A SELF-CARE BOOK (45 PATIENTS). BACK-RELATED FUNCTIONAL STATUS (MODIFIED ROLAND DISABILITY QUESTIONNAIRE, A 23-POINT SCALE) AND BOTHERSOMENESS OF PAIN (AN 11-POINT NUMERICAL SCALE) AT 12 WEEKS WERE THE PRIMARY OUTCOMES. OUTCOMES WERE ASSESSED AT BASELINE, 6, 12, AND 26 WEEKS BY INTERVIEWERS UNAWARE OF TREATMENT GROUP. RESULTS: AFTER ADJUSTMENT FOR BASELINE VALUES, 12-WEEK OUTCOMES FOR THE YOGA GROUP WERE SUPERIOR TO THOSE FOR THE SELF-CARE GROUP (MEAN DIFFERENCE FOR FUNCTION, -2.5 [95% CI, -3.7 TO -1.3]; P < .001; MEAN DIFFERENCE FOR SYMPTOMS, -1.1 [95% CI, -1.7 TO -0.4]; P < .001). AT 26 WEEKS, FUNCTION FOR THE YOGA GROUP REMAINED SUPERIOR (MEAN DIFFERENCE, -1.8 [95% CI, -3.1 TO -0.5]; P < .001). YOGA WAS NOT SUPERIOR TO CONVENTIONAL STRETCHING EXERCISES AT ANY TIME POINT. CONCLUSION: YOGA CLASSES WERE MORE EFFECTIVE THAN A SELF-CARE BOOK, BUT NOT MORE EFFECTIVE THAN STRETCHING CLASSES, IN IMPROVING FUNCTION AND REDUCING SYMPTOMS DUE TO CHRONIC LOW BACK PAIN, WITH BENEFITS LASTING AT LEAST SEVERAL MONTHS. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT00447668.	2011	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
7 2558  56 YOGA FOR CHRONIC LOW BACK PAIN IN A PREDOMINANTLY MINORITY POPULATION: A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: SEVERAL STUDIES SUGGEST YOGA MAY BE EFFECTIVE FOR CHRONIC LOW BACK PAIN; HOWEVER, TRIALS TARGETING MINORITIES HAVE NOT BEEN CONDUCTED. PRIMARY STUDY OBJECTIVES: ASSESS THE FEASIBILITY OF STUDYING YOGA IN A PREDOMINANTLY MINORITY POPULATION WITH CHRONIC LOW BACK PAIN. COLLECT PRELIMINARY DATA TO PLAN A LARGER POWERED STUDY. STUDY DESIGN: PILOT RANDOMIZED CONTROLLED TRIAL. SETTING: TWO COMMUNITY HEALTH CENTERS IN A RACIALLY DIVERSE NEIGHBORHOOD OF BOSTON, MASSACHUSETTS. PARTICIPANTS: THIRTY ENGLISH-SPEAKING ADULTS (MEAN AGE 44 YEARS, 83% FEMALE, 83% RACIAL/ETHNIC MINORITIES; 48% WITH INCOMES < OR = $30,000) WITH MODERATE-TO-SEVERE CHRONIC LOW BACK PAIN. INTERVENTIONS: STANDARDIZED SERIES OF WEEKLY HATHA YOGA CLASSES FOR 12 WEEKS COMPARED TO A WAITLIST USUAL CARE CONTROL. OUTCOME MEASURES: FEASIBILITY MEASURED BY TIME TO COMPLETE ENROLLMENT, PROPORTION OF RACIAL/ETHNIC MINORITIES ENROLLED, RETENTION RATES, AND ADVERSE EVENTS. PRIMARY EFFICACY OUTCOMES WERE CHANGES FROM BASELINE TO 12 WEEKS IN PAIN SCORE (0=NO PAIN TO 10=WORST POSSIBLE PAIN) AND BACK-RELATED FUNCTION USING THE MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE (0-23 POINT SCALE, HIGHER SCORES REFLECT POORER FUNCTION). SECONDARY EFFICACY OUTCOMES WERE ANALGESIC USE, GLOBAL IMPROVEMENT, AND QUALITY OF LIFE (SF-36). RESULTS: RECRUITMENT TOOK 2 MONTHS. RETENTION RATES WERE 97% AT 12 WEEKS AND 77% AT 26 WEEKS. MEAN PAIN SCORES FOR YOGA DECREASED FROM BASELINE TO 12 WEEKS (6.7 TO 4.4) COMPARED TO USUAL CARE, WHICH DECREASED FROM 7.5 TO 7.1 (P=.02). MEAN ROLAND SCORES FOR YOGA DECREASED FROM 14.5 TO 8.2 COMPARED TO USUAL CARE, WHICH DECREASED FROM 16.1 TO 12.5 (P=.28). AT 12 WEEKS, YOGA COMPARED TO USUAL CARE PARTICIPANTS REPORTED LESS ANALGESIC USE (13% VS 73%, P=.003), LESS OPIATE USE (0% VS 33%, P=.04), AND GREATER OVERALL IMPROVEMENT (73% VS 27%, P=.03). THERE WERE NO DIFFERENCES IN SF-36 SCORES AND NO SERIOUS ADVERSE EVENTS. CONCLUSION: A YOGA STUDY INTERVENTION IN A PREDOMINANTLY MINORITY POPULATION WITH CHRONIC LOW BACK PAIN WAS MODERATELY FEASIBLE AND MAY BE MORE EFFECTIVE THAN USUAL CARE FOR REDUCING PAIN AND PAIN MEDICATION USE.	2009	
                                                                                                                                                                                                                                                                                             
8 1841  46 QIGONG OR YOGA VERSUS NO INTERVENTION IN OLDER ADULTS WITH CHRONIC LOW BACK PAIN-A RANDOMIZED CONTROLLED TRIAL. UNLABELLED: THE AIM OF THIS STUDY WAS TO ASSESS THE EFFECTIVENESS OF THE REDUCTION OF CHRONIC LOWER BACK PAIN IN OLDER ADULTS USING EITHER YOGA CLASSES OR QIGONG CLASSES COMPARED WITH NO INTERVENTION. OLDER ADULTS (65 YEARS OF AGE AND OLDER) WITH CHRONIC LOW BACK PAIN WERE ENROLLED IN AND RANDOMLY ALLOCATED TO: 1) YOGA (24 CLASSES, 45 MINUTES EACH, DURING 3 MONTHS), 2) QIGONG (12 CLASSES, 90 MINUTES EACH, DURING 3 MONTHS), OR 3) A CONTROL GROUP WHO RECEIVED NO ADDITIONAL INTERVENTION. THE PAIN INTENSITY ITEM OF THE FUNCTIONAL RATING INDEX AFTER 3 MONTHS WAS USED AS PRIMARY OUTCOME PARAMETER. A TOTAL OF 176 PATIENTS WERE RANDOMIZED (N = 61 YOGA, N = 58 QIGONG, N = 57 CONTROL; MEAN AGE 73 +/- 5.6 YEARS, 89% FEMALE). THE MEAN ADJUSTED PAIN INTENSITY AFTER 3 MONTHS WAS 1.71 FOR THE YOGA GROUP (95% CONFIDENCE INTERVAL [CI], 1.54-1.89), 1.67 FOR THE QIGONG GROUP (95% CI, 1.45-1.89), AND 1.89 FOR NO INTERVENTION (95% CI, 1.67-2.11). NO STATISTICALLY SIGNIFICANT GROUP DIFFERENCES WERE OBSERVED. POSSIBLE EXPLANATIONS FOR THIS LACK OF PAIN RELIEF MIGHT INCLUDE THE INEFFECTIVENESS OF INTERVENTIONS, INAPPROPRIATE OUTCOMES, OR DIFFERENCES IN PAIN PERCEPTION AND PROCESSING IN OLDER ADULTS. PERSPECTIVE: THE AIM OF THIS STUDY WAS TO ASSESS THE EFFECTIVENESS OF THE REDUCTION OF CHRONIC LOWER BACK PAIN IN OLDER ADULTS USING EITHER YOGA CLASSES OR QIGONG CLASSES COMPARED WITH NO INTERVENTION. THIS 3-ARMED RANDOMIZED TRIAL WITH 176 OLDER ADULTS SHOWED THAT YOGA AND QIGONG WERE NOT SUPERIOR TO NO TREATMENT IN REDUCING PAIN AND INCREASING QUALITY OF LIFE.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
9  465  45 CHARACTERISTICS AND PREDICTORS OF SHORT-TERM OUTCOMES IN INDIVIDUALS SELF-SELECTING YOGA OR PHYSICAL THERAPY FOR TREATMENT OF CHRONIC LOW BACK PAIN. OBJECTIVE: TO COMPARE CLINICAL AND DEMOGRAPHIC CHARACTERISTICS OF INDIVIDUALS SELF-SELECTING YOGA OR PHYSICAL THERAPY (PT) FOR TREATMENT OF CHRONIC LOW BACK PAIN (CLBP) AND TO EXAMINE PREDICTORS OF SHORT-TERM PAIN AND FUNCTIONAL OUTCOMES. DESIGN: DESCRIPTIVE, LONGITUDINAL STUDY. SETTINGS: A HOSPITAL-BASED CLINIC THAT OFFERS MODIFIED INTEGRAL YOGA CLASSES FOR CLBP AND 2 OUTPATIENT PT CLINICS THAT OFFER EXERCISE-BASED PT. PARTICIPANTS: ADULTS (N=53) WITH CLBP>/=12 WEEKS: YOGA (N=27), PT (N=26). METHODS: YOGA PARTICIPANTS ATTENDED A 6-WEEK, ONCE WEEKLY, 2-HOUR YOGA CLASS. PT PARTICIPANTS UNDERWENT TWICE WEEKLY, 1-HOUR INDIVIDUALIZED PT. DATA WERE COLLECTED AT BASELINE AND AT 6 WEEKS. GROUPS WERE COMPARED BY USING CHI2 AND INDEPENDENT SAMPLES T-TESTS. HIERARCHICAL LINEAR REGRESSION WAS USED TO PREDICT TREATMENT OUTCOMES. MAIN OUTCOME MEASURES: DISABILITY (ROLAND MORRIS DISABILITY QUESTIONNAIRE), HEALTH STATUS (RAND SHORT FORM 36 HEALTH SURVEY 1.0), PAIN BOTHERSOMENESS (NUMERICAL RATING SCALE), BACK PAIN SELF-EFFICACY (BACK PAIN SELF-EFFICACY SCALE), AND TREATMENT SATISFACTION. RESULTS: AT BASELINE, YOGA PARTICIPANTS WERE SIGNIFICANTLY LESS DISABLED (P=.013), HAD HIGHER HEALTH STATUS (P=.023), GREATER PAIN SELF-EFFICACY (P=.012), AND LESS AVERAGE PAIN BOTHERSOMENESS (P=.001) COMPARED WITH PT PARTICIPANTS. AT 6 WEEKS, WHEN CONTROLLING FOR BASELINE GROUP DIFFERENCES, GREATER PAIN SELF-EFFICACY WAS THE STRONGEST PREDICTOR FOR REDUCED PAIN AND HIGHER FUNCTION FOR THE ENTIRE SAMPLE. A SIGNIFICANT GROUP INTERACTION BY BASELINE PAIN SELF-EFFICACY PREDICTED DISABILITY AT 6 WEEKS. PT PARTICIPANTS WITH LOW PAIN SELF-EFFICACY REPORTED SIGNIFICANTLY GREATER DISABILITY THAN THOSE WITH HIGH PAIN SELF-EFFICACY. YOGA PARTICIPANTS WITH LOW AND HIGH PAIN SELF-EFFICACY HAD SIMILAR DISABILITY OUTCOMES. CONCLUSION: THESE FINDINGS STRENGTHEN EVIDENCE THAT SELF-EFFICACY IS ASSOCIATED WITH CLBP OUTCOMES, ESPECIALLY IN INDIVIDUALS SELF-SELECTING PT. FURTHER RESEARCH TO EVALUATE OUTCOMES AFTER YOGA AND PT IN PARTICIPANTS WITH LOW PAIN SELF-EFFICACY IS NEEDED.	2010	
                                                                                                                                                                                                                                                                                                                                
10 1448  32 INDIVIDUALLY TAILORED YOGA FOR CHRONIC NECK OR BACK PAIN IN A LOW-INCOME POPULATION: A PILOT STUDY. BACKGROUND: LOW-INCOME PEOPLE ARE DISPROPORTIONATELY AFFECTED BY CHRONIC BACK AND NECK PAIN. YOGA MAY BE AN EFFECTIVE THERAPY. AIMS: THIS FEASIBILITY PILOT STUDY EVALUATED AN INDIVIDUALIZED YOGA PLAN FOR THE TREATMENT OF CHRONIC SPINAL PAIN. METHODS: RESULTS: INDIVIDUALS SHOWED A MEAN CHANGE OF -2.4 FROM PRE/POST 10-CM PAIN SCALE RECORDINGS (P = 0.028, 95% CONFIDENCE INTERVAL [CI]: -0.390--4.477) AND A MEAN INCREASE OF 0.26 ON THE EQ-5D-3L (P = 0.029, 95% CI: 0.04-0.47). THE INTERVENTION WAS WELL-RECEIVED. CONCLUSIONS: AN INDIVIDUALLY TAILORED YOGA PROGRAM WAS ACCEPTABLE TO THESE PARTICIPANTS. PAIN AND QUALITY OF LIFE SCORES APPEARED TO IMPROVE.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
11 2560  53 YOGA FOR CHRONIC LOW BACK PAIN: A RANDOMIZED TRIAL. BACKGROUND: PREVIOUS STUDIES INDICATE THAT YOGA MAY BE AN EFFECTIVE TREATMENT FOR CHRONIC OR RECURRENT LOW BACK PAIN. OBJECTIVE: TO COMPARE THE EFFECTIVENESS OF YOGA AND USUAL CARE FOR CHRONIC OR RECURRENT LOW BACK PAIN. DESIGN: PARALLEL-GROUP, RANDOMIZED, CONTROLLED TRIAL USING COMPUTER-GENERATED RANDOMIZATION CONDUCTED FROM APRIL 2007 TO MARCH 2010. OUTCOMES WERE ASSESSED BY POSTAL QUESTIONNAIRE. (INTERNATIONAL STANDARD RANDOMISED CONTROLLED TRIAL NUMBER REGISTER: ISRCTN 81079604) SETTING: 13 NON-NATIONAL HEALTH SERVICE PREMISES IN THE UNITED KINGDOM. PATIENTS: 313 ADULTS WITH CHRONIC OR RECURRENT LOW BACK PAIN. INTERVENTION: YOGA (N = 156) OR USUAL CARE (N = 157). ALL PARTICIPANTS RECEIVED A BACK PAIN EDUCATION BOOKLET. THE INTERVENTION GROUP WAS OFFERED A 12-CLASS, GRADUALLY PROGRESSING YOGA PROGRAM DELIVERED BY 12 TEACHERS OVER 3 MONTHS. MEASUREMENTS: SCORES ON THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE (RMDQ) AT 3 (PRIMARY OUTCOME), 6, AND 12 (SECONDARY OUTCOMES) MONTHS; PAIN, PAIN SELF-EFFICACY, AND GENERAL HEALTH MEASURES AT 3, 6, AND 12 MONTHS (SECONDARY OUTCOMES). RESULTS: 93 (60%) PATIENTS OFFERED YOGA ATTENDED AT LEAST 3 OF THE FIRST 6 SESSIONS AND AT LEAST 3 OTHER SESSIONS. THE YOGA GROUP HAD BETTER BACK FUNCTION AT 3, 6, AND 12 MONTHS THAN THE USUAL CARE GROUP. THE ADJUSTED MEAN RMDQ SCORE WAS 2.17 POINTS (95% CI, 1.03 TO 3.31 POINTS) LOWER IN THE YOGA GROUP AT 3 MONTHS, 1.48 POINTS (CI, 0.33 TO 2.62 POINTS) LOWER AT 6 MONTHS, AND 1.57 POINTS (CI, 0.42 TO 2.71 POINTS) LOWER AT 12 MONTHS. THE YOGA AND USUAL CARE GROUPS HAD SIMILAR BACK PAIN AND GENERAL HEALTH SCORES AT 3, 6, AND 12 MONTHS, AND THE YOGA GROUP HAD HIGHER PAIN SELF-EFFICACY SCORES AT 3 AND 6 MONTHS BUT NOT AT 12 MONTHS. TWO OF THE 157 USUAL CARE PARTICIPANTS AND 12 OF THE 156 YOGA PARTICIPANTS REPORTED ADVERSE EVENTS, MOSTLY INCREASED PAIN. LIMITATION: THERE WERE MISSING DATA FOR THE PRIMARY OUTCOME (YOGA GROUP, N = 21; USUAL CARE GROUP, N = 18) AND DIFFERENTIAL MISSING DATA (MORE IN THE YOGA GROUP) FOR SECONDARY OUTCOMES. CONCLUSION: OFFERING A 12-WEEK YOGA PROGRAM TO ADULTS WITH CHRONIC OR RECURRENT LOW BACK PAIN LED TO GREATER IMPROVEMENTS IN BACK FUNCTION THAN DID USUAL CARE. PRIMARY FUNDING SOURCE: ARTHRITIS RESEARCH UK.	2011	
                                                                                                                                                                                                                                               
12 1034  51 EFFECTS OF YOGA IN DAILY LIFE PROGRAM IN RHEUMATOID ARTHRITIS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: TO EXPLORE THE FEASIBILITY AND EFFECTIVENESS OF A YOGA PROGRAM IN IMPROVING HEALTH-RELATED QUALITY OF LIFE (HQOL), PHYSICAL AND PSYCHOLOGICAL FUNCTIONING IN RHEUMATOID ARTHRITIS (RA) PATIENTS. DESIGN: SINGLE-CENTRE PARALLEL-ARMS RANDOMIZED CONTROLLED TRIAL COMPARING YOGA (N = 30) AND EDUCATION CONTROL GROUP (N = 27). SETTING: TERTIARY CARE UNIVERSITY HOSPITAL. INTERVENTION: A 12-WEEK YOGA PROGRAM, BASED ON THE YOGA IN DAILY LIFE SYSTEM, INCLUDED 2X WEEKLY/90-MINUTE SESSIONS. THE CONTROL GROUP HAD 1XWEEKLY/60-MINUTE EDUCATIONAL LECTURES ON ARTHRITIS-RELATED TOPICS. MAIN OUTCOME MEASURES: ASSESSMENTS WERE PERFORMED AT BASELINE, 12 (POST-INTERVENTION) AND 24 WEEKS (FOLLOW-UP). THE PRIMARY OUTCOME WAS CHANGE IN THE SHORT FORM-36 (SF-36) HQOL AT 12 WEEKS. LINEAR REGRESSION ANALYSIS WAS ADJUSTED FOR BASELINE SCORES. RESULTS: NO SIGNIFICANT BETWEEN-GROUP DIFFERENCES WERE FOUND FOR SF-36 (ALL P > 0.05). AT 12 WEEKS THE ADJUSTED MEAN DIFFERENCE BETWEEN GROUPS FAVOURED YOGA FOR FUNCTIONAL ASSESSMENT OF CHRONIC ILLNESS THERAPY-FATIGUE (5.08 CI 1.29 TO 8.86; P = 0.009) AND HOSPITAL ANXIETY AND DEPRESSION SCALE (HADS)-DEPRESSION (-1.37 CI -2.38 TO -0.36); P = 0.008) AND AT 24 WEEKS FOR HADS-ANXIETY (-1.79 CI -3.34 TO - 0.23; P = 0.025), WHILE THE IMPACT ON FATIGUE WAS SUSTAINED (5.43 CI 1.33 TO 9.54, P = 0.01). THE PROGRAM HAD NO IMPACT ON RA DISEASE ACTIVITY. FEASIBILITY OUTCOMES INCLUDED RECRUITMENT RATE 16 %, RETENTION 80.7 %, AND ADHERENCE TO YOGA 87.5 VS 82.7 % FOR CONTROL. NO SERIOUS ADVERSE EVENTS WERE RECORDED. CONCLUSIONS: YOGA IN DAILY LIFE PROGRAM WAS NOT ASSOCIATED WITH CHANGE IN HEALTH-RELATED QUALITY OF LIFE OF RA PATIENTS. SIGNIFICANT IMPROVEMENTS IN FATIGUE AND MOOD WERE OBSERVED AT POSTINTERVENTION AND FOLLOW-UP. THIS YOGA PROGRAM WAS FOUND FEASIBLE AND SAFE FOR PATIENTS AND MAY COMPLEMENT STANDARD RA TREAT-TO-TARGET STRATEGY.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
13 2681  50 YOGA IN SEDENTARY ADULTS WITH ARTHRITIS: EFFECTS OF A RANDOMIZED CONTROLLED PRAGMATIC TRIAL. OBJECTIVE: TO EVALUATE THE EFFECT OF INTEGRAL-BASED HATHA YOGA IN SEDENTARY PEOPLE WITH ARTHRITIS. METHODS: THERE WERE 75 SEDENTARY ADULTS AGED 18+ YEARS WITH RHEUMATOID ARTHRITIS (RA) OR KNEE OSTEOARTHRITIS RANDOMLY ASSIGNED TO 8 WEEKS OF YOGA (TWO 60-MIN CLASSES AND 1 HOME PRACTICE/WK) OR WAITLIST. POSES WERE MODIFIED FOR INDIVIDUAL NEEDS. THE PRIMARY ENDPOINT WAS PHYSICAL HEALTH [MEDICAL OUTCOMES STUDY SHORT FORM-36 (SF-36) PHYSICAL COMPONENT SUMMARY (PCS)] ADJUSTED FOR BASELINE; EXPLORATORY ADJUSTED OUTCOMES INCLUDED FITNESS, MOOD, STRESS, SELF-EFFICACY, SF-36 HEALTH-RELATED QUALITY OF LIFE (HRQOL), AND RA DISEASE ACTIVITY. IN EVERYONE COMPLETING YOGA, WE EXPLORED LONGTERM EFFECTS AT 9 MONTHS. RESULTS: PARTICIPANTS WERE MOSTLY FEMALE (96%), WHITE (55%), AND COLLEGE-EDUCATED (51%), WITH A MEAN (SD) AGE OF 52 YEARS (12 YRS). AVERAGE DISEASE DURATION WAS 9 YEARS AND 49% HAD RA. AT 8 WEEKS, YOGA WAS ASSOCIATED WITH SIGNIFICANTLY HIGHER PCS (6.5, 95% CI 2.0-10.7), WALKING CAPACITY (125 M, 95% CI 15-235), POSITIVE AFFECT (5.2, 95% CI 1.4-8.9), AND LOWER CENTER FOR EPIDEMIOLOGIC STUDIES DEPRESSION SCALE (-3.0, 95% CI -4.8 - -1.3). SIGNIFICANT IMPROVEMENTS (P < 0.05) WERE EVIDENT IN SF-36 ROLE PHYSICAL, PAIN, GENERAL HEALTH, VITALITY, AND MENTAL HEALTH SCALES. BALANCE, GRIP STRENGTH, AND FLEXIBILITY WERE SIMILAR BETWEEN GROUPS. TWENTY-TWO OUT OF 28 IN THE WAITLIST GROUP COMPLETED YOGA. AMONG ALL YOGA PARTICIPANTS, SIGNIFICANT (P < 0.05) IMPROVEMENTS WERE OBSERVED IN MEAN PCS, FLEXIBILITY, 6-MIN WALK, AND ALL PSYCHOLOGICAL AND MOST HRQOL DOMAINS AT 8 WEEKS WITH MOST STILL EVIDENT 9 MONTHS LATER. OF 7 ADVERSE EVENTS, NONE WERE ASSOCIATED WITH YOGA. CONCLUSION: PRELIMINARY EVIDENCE SUGGESTS YOGA MAY HELP SEDENTARY INDIVIDUALS WITH ARTHRITIS SAFELY INCREASE PHYSICAL ACTIVITY, AND IMPROVE PHYSICAL AND PSYCHOLOGICAL HEALTH AND HRQOL. CLINICAL TRIALS NCT00349869.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
14  521  54 COMPARING YOGA, EXERCISE, AND A SELF-CARE BOOK FOR CHRONIC LOW BACK PAIN: A RANDOMIZED, CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN IS A COMMON PROBLEM THAT HAS ONLY MODESTLY EFFECTIVE TREATMENT OPTIONS. OBJECTIVE: TO DETERMINE WHETHER YOGA IS MORE EFFECTIVE THAN CONVENTIONAL THERAPEUTIC EXERCISE OR A SELF-CARE BOOK FOR PATIENTS WITH CHRONIC LOW BACK PAIN. DESIGN: RANDOMIZED, CONTROLLED TRIAL. SETTING: A NONPROFIT, INTEGRATED HEALTH CARE SYSTEM. PATIENTS: 101 ADULTS WITH CHRONIC LOW BACK PAIN. INTERVENTION: 12-WEEK SESSIONS OF YOGA OR CONVENTIONAL THERAPEUTIC EXERCISE CLASSES OR A SELF-CARE BOOK. MEASUREMENTS: PRIMARY OUTCOMES WERE BACK-RELATED FUNCTIONAL STATUS (MODIFIED 24-POINT ROLAND DISABILITY SCALE) AND "BOTHERSOMENESS" OF PAIN (11-POINT NUMERICAL SCALE). THE PRIMARY TIME POINT WAS 12 WEEKS. CLINICALLY SIGNIFICANT CHANGE WAS CONSIDERED TO BE 2.5 POINTS ON THE FUNCTIONAL STATUS SCALE AND 1.5 POINTS ON THE BOTHERSOMENESS SCALE. SECONDARY OUTCOMES WERE DAYS OF RESTRICTED ACTIVITY, GENERAL HEALTH STATUS, AND MEDICATION USE. RESULTS: AFTER ADJUSTMENT FOR BASELINE VALUES, BACK-RELATED FUNCTION IN THE YOGA GROUP WAS SUPERIOR TO THE BOOK AND EXERCISE GROUPS AT 12 WEEKS (YOGA VS. BOOK: MEAN DIFFERENCE, -3.4 [95% CI, -5.1 TO - 1.6] [P < 0.001]; YOGA VS. EXERCISE: MEAN DIFFERENCE, -1.8 [CI, -3.5 TO - 0.1] [P = 0.034]). NO SIGNIFICANT DIFFERENCES IN SYMPTOM BOTHERSOMENESS WERE FOUND BETWEEN ANY 2 GROUPS AT 12 WEEKS; AT 26 WEEKS, THE YOGA GROUP WAS SUPERIOR TO THE BOOK GROUP WITH RESPECT TO THIS MEASURE (MEAN DIFFERENCE, -2.2 [CI, -3.2 TO - 1.2]; P < 0.001). AT 26 WEEKS, BACK-RELATED FUNCTION IN THE YOGA GROUP WAS SUPERIOR TO THE BOOK GROUP (MEAN DIFFERENCE, -3.6 [CI, -5.4 TO - 1.8]; P < 0.001). LIMITATIONS: PARTICIPANTS IN THIS STUDY WERE FOLLOWED FOR ONLY 26 WEEKS AFTER RANDOMIZATION. ONLY 1 INSTRUCTOR DELIVERED EACH INTERVENTION. CONCLUSIONS: YOGA WAS MORE EFFECTIVE THAN A SELF-CARE BOOK FOR IMPROVING FUNCTION AND REDUCING CHRONIC LOW BACK PAIN, AND THE BENEFITS PERSISTED FOR AT LEAST SEVERAL MONTHS.	2005	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
15  459  47 CHANGES IN PAIN INTENSITY AND HEALTH RELATED QUALITY OF LIFE WITH IYENGAR YOGA IN NONSPECIFIC CHRONIC LOW BACK PAIN: A RANDOMIZED CONTROLLED STUDY. BACKGROUND: NONSPECIFIC CHRONIC LOW BACK (NCLBP) PAIN IS PREVALENT AMONG ADULT POPULATION AND OFTEN LEADS TO FUNCTIONAL LIMITATIONS, PSYCHOLOGICAL SYMPTOMS, LOWER QUALITY OF LIFE (QOL), AND HIGHER HEALTHCARE COSTS. THE PURPOSE OF THIS STUDY WAS TO DETERMINE THE EFFICACY OF IYENGAR YOGA THERAPY ON PAIN INTENSITY AND HEALTH RELATED QUALITY OF LIFE (HRQOL) WITH NCLBP. AIM OF THE STUDY: TO COMPARE THE EFFECT OF IYENGAR YOGA THERAPY AND CONVENTIONAL EXERCISE THERAPY ON PAIN INTENSITY AND HRQOL IN NONSPECIFIC CHRONIC LOW BACK PAIN. MATERIALS AND METHODS: EXPERIMENTAL STUDY WITH RANDOM SAMPLING TECHNIQUE. SUBJECTS/INTERVENTION: SIXTY SUBJECTS WHO FULFILLED THE SELECTION CRITERIA WERE RANDOMLY ASSIGNED TO IYENGAR YOGA (YOGA GROUP, N = 30) AND CONTROL GROUP (EXERCISE GROUP, N = 30). PARTICIPANTS COMPLETED LOW BACK PAIN EVALUATION FORM AND HRQOL-4 QUESTIONNAIRE BEFORE THEIR INTERVENTION AND AGAIN 4 WEEKS AND 6 MONTH LATER. YOGA GROUP UNDERWENT 29 YOGIC POSTURES TRAINING AND EXERCISE GROUP HAD UNDERGONE GENERAL EXERCISE PROGRAM FOR 4 WEEKS. STATISTICS: REPEATED MEASURES ANALYSIS OF VARIANCE (ANOVA) WAS USED TO ANALYZE GROUP DIFFERENCES OVER TIME, WHILE CONTROLLING FOR BASELINE DIFFERENCES. RESULTS: PATIENTS IN BOTH GROUPS EXPERIENCED SIGNIFICANT REDUCTION IN PAIN AND IMPROVEMENT IN HRQOL. IN VISUAL ANALOGUE SCALE (VAS) YOGA GROUP SHOWED REDUCTION OF 72.81% (P = 0.001) AS COMPARED TO EXERCISE GROUP 42.50% (P = 0.001). IN HRQOL, YOGA GROUP SHOWED REDUCTION OF 86.99% (P = 0.001) AS COMPARED TO EXERCISE GROUP 67.66% (P = 0.001). CONCLUSION: THESE RESULTS SUGGEST THAT IYENGAR YOGA PROVIDES BETTER IMPROVEMENT IN PAIN REDUCTION AND IMPROVEMENT IN HRQOL IN NONSPECIFIC CHRONIC BACK PAIN THAN GENERAL EXERCISE.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
16 2187  48 THE EFFECTS OF YOGA ON STUDENT MENTAL HEALTH: A RANDOMISED CONTROLLED TRIAL. BACKGROUND: UNIVERSITIES AROUND THE WORLD ARE FACING AN EPIDEMIC OF MENTAL DISTRESS AMONG THEIR STUDENTS. THE PROBLEM IS TRULY A PUBLIC HEALTH ISSUE, AFFECTING MANY AND WITH SERIOUS CONSEQUENCES. THE GLOBAL BURDEN OF DISEASE-AGENDA CALLS FOR EFFECTIVE INTERVENTIONS WITH LASTING EFFECTS THAT HAVE THE POTENTIAL TO IMPROVE THE MENTAL HEALTH OF YOUNG ADULTS. IN THIS STUDY WE AIMED TO DETERMINE WHETHER YOGA, A POPULAR AND WIDELY AVAILABLE MIND-BODY PRACTICE, CAN IMPROVE STUDENT MENTAL HEALTH. METHODS: WE PERFORMED A RANDOMISED CONTROLLED TRIAL WITH 202 HEALTHY UNIVERSITY STUDENTS IN THE OSLO AREA. THE PARTICIPANTS WERE ASSIGNED TO A YOGA GROUP OR WAITLIST CONTROL GROUP IN A 1:1 RATIO BY A SIMPLE ONLINE RANDOMISATION PROGRAM. THE INTERVENTION GROUP WAS OFFERED 24 YOGA SESSIONS OVER 12 WEEKS. MEASUREMENTS WERE TAKEN AT WEEK 0 (BASELINE), WEEK 12 (POST-INTERVENTION), AND WEEK 24 (FOLLOW-UP). THE PRIMARY OUTCOME WAS PSYCHOLOGICAL DISTRESS ASSESSED BY THE HSCL-25 QUESTIONNAIRE. ANALYSIS WAS PERFORMED BASED ON THE INTENTION TO TREAT-PRINCIPLE. RESULTS: BETWEEN 24 JANUARY 2017, AND 27 AUGUST 2017, WE RANDOMLY ASSIGNED 202 STUDENTS TO A YOGA INTERVENTION GROUP (N = 100), OR WAITLIST CONTROL GROUP (N = 102). COMPARED WITH THE CONTROL GROUP, THE YOGA PARTICIPANTS DEMONSTRATED A SIGNIFICANT REDUCTION IN DISTRESS SYMPTOMS BOTH AT POST-INTERVENTION (ADJUSTED DIFFERENCE IN THE MEAN CHANGE -0.15, 95% CI -0.26 TO -0.03, P = 0.0110) AND FOLLOW-UP (ADJUSTED DIFFERENCE IN THE MEAN CHANGE -0.18, 95% CI -0.29 TO -0.06, P = 0.0025). SLEEP QUALITY ALSO IMPROVED AT POST-INTERVENTION AND FOLLOW-UP. NO ADVERSE EVENTS WERE REPORTED. CONCLUSIONS: OUR FINDINGS SUGGEST THAT YOGA HAS A MODERATELY LARGE AND LASTING EFFECT, AT LEAST FOR SOME MONTHS, REDUCING SYMPTOMS OF DISTRESS AND IMPROVING SLEEP QUALITY AMONG STUDENTS. FURTHER RESEARCH SHOULD SEEK WAYS TO ENHANCE THE EFFECT, ASSESS AN EVEN LONGER FOLLOW-UP PERIOD, INCLUDE ACTIVE CONTROL GROUPS, AND CONSIDER PERFORMING SIMILAR STUDIES IN OTHER CULTURAL SETTINGS.TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT04258540.	2020	
                                                                                                                                                                                                                                                                                                                                                                                             
17 2845  50 YOGA, EURYTHMY THERAPY AND STANDARD PHYSIOTHERAPY (YES-TRIAL) FOR PATIENTS WITH CHRONIC NON-SPECIFIC LOW BACK PAIN: A THREE-ARMED RANDOMIZED CONTROLLED TRIAL. WE AIMED TO EVALUATE THE EFFECTS OF YOGA AND EURYTHMY THERAPY COMPARED TO CONVENTIONAL PHYSIOTHERAPY EXERCISES IN PATIENTS WITH CHRONIC LOW BACK PAIN. IN A THREE-ARMED, MULTICENTRE, RANDOMIZED CONTROLLED TRIAL, PATIENTS WITH CHRONIC LOW BACK PAIN WERE TREATED FOR 8 WEEKS IN GROUP SESSIONS (75 MINUTES ONCE PER WEEK). PRIMARY OUTCOME WAS PATIENTS' PHYSICAL DISABILITY (MEASURED BY RMDQ) FROM BASELINE TO WEEK 8. SECONDARY OUTCOME VARIABLES WERE PAIN INTENSITY AND PAIN-RELATED BOTHERSOMENESS (VAS), HEALTH-RELATED QUALITY OF LIFE (SF-12) AND LIFE SATISFACTION (BMLSS). OUTCOMES WERE ASSESSED AT BASELINE, AFTER THE INTERVENTION AT 8 WEEKS AND AT A 16-WEEK FOLLOW UP. DATA OF 274 PARTICIPANTS WERE USED FOR STATISTICAL ANALYSES. THERE WERE NO SIGNIFICANT DIFFERENCES BETWEEN THE THREE GROUPS FOR THE PRIMARY AND ALL SECONDARY OUTCOMES. IN ALL GROUPS, RMDQ DECREASED COMPARABLY AT 8 WEEKS, BUT DID NOT REACH CLINICAL MEANINGFULNESS. PAIN INTENSITY AND PAIN-RELATED BOTHERSOMENESS DECREASED, WHILE QUALITY OF LIFE INCREASED IN ALL 3 GROUPS. IN EXPLORATIVE GENERAL LINEAR MODELS FOR THE SF-12'S MENTAL HEALTH COMPONENT PARTICIPANTS IN THE EURYTHMY ARM BENEFITTED SIGNIFICANTLY MORE COMPARED TO PHYSIOTHERAPY AND YOGA. FURTHERMORE, WITHIN-GROUP ANALYSES SHOWED IMPROVEMENTS OF SF-12 MENTAL SCORE FOR YOGA AND EURYTHMY THERAPY ONLY. ALL INTERVENTIONS WERE SAFE. CLINICAL TRIALS REGISTER: DRKS-ID: DRKS00004651 PERSPECTIVE: THIS ARTICLE PRESENTS THE RESULTS OF A MULTICENTRE THREE-ARMED RANDOMIZED CONTROLLED TRIAL ON THE CLINICAL EFFECTS OF THREE 8-WEEK PROGRAMS IN PATIENTS WITH CHRONIC LOW BACK PAIN. COMPARED TO THE 'GOLD STANDARD' OF CONVENTIONAL PHYSIOTHERAPEUTIC EXERCISES, EURYTHMY THERAPY AND YOGA THERAPY LEAD TO COMPARABLE SYMPTOMATIC IMPROVEMENTS IN PATIENTS WITH CHRONIC LOW BACK PAIN. HOWEVER, THE WITHIN-GROUP EFFECT SIZES WERE SMALL TO MODERATE AND DID NOT REACH CLINICAL MEANINGFULNESS ON PATIENTS' PHYSICAL DISABILITY (RMDQ).	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                     
18 1180  52 EVALUATION OF THE EFFECTIVENESS AND EFFICACY OF IYENGAR YOGA THERAPY ON CHRONIC LOW BACK PAIN. STUDY DESIGN: THE EFFECTIVENESS AND EFFICACY OF IYENGAR YOGA FOR CHRONIC LOW BACK PAIN (CLBP) WERE ASSESSED WITH INTENTION-TO-TREAT AND PER-PROTOCOL ANALYSIS. NINETY SUBJECTS WERE RANDOMIZED TO A YOGA (N = 43) OR CONTROL GROUP (N = 47) RECEIVING STANDARD MEDICAL CARE. PARTICIPANTS WERE FOLLOWED 6 MONTHS AFTER COMPLETION OF THE INTERVENTION. OBJECTIVE: THIS STUDY AIMED TO EVALUATE IYENGAR YOGA THERAPY ON CHRONIC LOW BACK PAIN. YOGA SUBJECTS WERE HYPOTHESIZED TO REPORT GREATER REDUCTIONS IN FUNCTIONAL DISABILITY, PAIN INTENSITY, DEPRESSION, AND PAIN MEDICATION USAGE THAN CONTROLS. SUMMARY OF BACKGROUND DATA: CLBP IS A MUSCULOSKELETAL DISORDER WITH PUBLIC HEALTH AND ECONOMIC IMPACT. PILOT STUDIES OF YOGA AND BACK PAIN HAVE REPORTED SIGNIFICANT CHANGES IN CLINICALLY IMPORTANT OUTCOMES. METHODS: SUBJECTS WERE RECRUITED THROUGH SELF-REFERRAL AND HEALTH PROFESSIONAL REFERRALS ACCORDING TO EXPLICIT INCLUSION/EXCLUSION CRITERIA. YOGA SUBJECTS PARTICIPATED IN 24 WEEKS OF BIWEEKLY YOGA CLASSES DESIGNED FOR CLBP. OUTCOMES WERE ASSESSED AT 12 (MIDWAY), 24 (IMMEDIATELY AFTER), AND 48 WEEKS (6-MONTH FOLLOW-UP) AFTER THE START OF THE INTERVENTION USING THE OSWESTRY DISABILITY QUESTIONNAIRE, A VISUAL ANALOG SCALE, THE BECK DEPRESSION INVENTORY, AND A PAIN MEDICATION-USAGE QUESTIONNAIRE. RESULTS: USING INTENTION-TO-TREAT ANALYSIS WITH REPEATED MEASURES ANOVA (GROUP X TIME), SIGNIFICANTLY GREATER REDUCTIONS IN FUNCTIONAL DISABILITY AND PAIN INTENSITY WERE OBSERVED IN THE YOGA GROUP WHEN COMPARED TO THE CONTROL GROUP AT 24 WEEKS. A SIGNIFICANTLY GREATER PROPORTION OF YOGA SUBJECTS ALSO REPORTED CLINICAL IMPROVEMENTS AT BOTH 12 AND 24 WEEKS. IN ADDITION, DEPRESSION WAS SIGNIFICANTLY LOWER IN YOGA SUBJECTS. FURTHERMORE, WHILE A REDUCTION IN PAIN MEDICATION OCCURRED, THIS WAS COMPARABLE IN BOTH GROUPS. WHEN RESULTS WERE ANALYZED USING PER-PROTOCOL ANALYSIS, IMPROVEMENTS WERE OBSERVED FOR ALL OUTCOMES IN THE YOGA GROUP, INCLUDING AGREATER TREND FOR REDUCED PAIN MEDICATION USAGE. ALTHOUGH SLIGHTLY LESS THAN AT 24 WEEKS, THE YOGA GROUP HAD STATISTICALLY SIGNIFICANT REDUCTIONS IN FUNCTIONAL DISABILITY, PAIN INTENSITY, AND DEPRESSION COMPARED TO STANDARD MEDICAL CARE 6-MONTHS POSTINTERVENTION. CONCLUSION: YOGA IMPROVES FUNCTIONAL DISABILITY, PAIN INTENSITY, AND DEPRESSION IN ADULTS WITH CLBP. THERE WAS ALSO A CLINICALLY IMPORTANT TREND FOR THE YOGA GROUP TO REDUCE THEIR PAIN MEDICATION USAGE COMPARED TO THE CONTROL GROUP.	2009	

19  290  43 ADJUNCTIVE YOGA V. HEALTH EDUCATION FOR PERSISTENT MAJOR DEPRESSION: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: THE OBJECTIVE OF THIS STUDY WAS TO DETERMINE WHETHER HATHA YOGA IS AN EFFICACIOUS ADJUNCTIVE INTERVENTION FOR INDIVIDUALS WITH CONTINUED DEPRESSIVE SYMPTOMS DESPITE ANTIDEPRESSANT TREATMENT. METHOD: WE CONDUCTED A RANDOMIZED CONTROLLED TRIAL OF WEEKLY YOGA CLASSES (N = 63) V. HEALTH EDUCATION CLASSES (HEALTHY LIVING WORKSHOP; HLW; N = 59) IN INDIVIDUALS WITH ELEVATED DEPRESSION SYMPTOMS AND ANTIDEPRESSANT MEDICATION USE. HLW SERVED AS AN ATTENTION-CONTROL GROUP. THE INTERVENTION PERIOD WAS 10 WEEKS, WITH FOLLOW-UP ASSESSMENTS 3 AND 6 MONTHS AFTERWARDS. THE PRIMARY OUTCOME WAS DEPRESSION SYMPTOM SEVERITY ASSESSED BY BLIND RATER AT 10 WEEKS. SECONDARY OUTCOMES INCLUDED DEPRESSION SYMPTOMS OVER THE ENTIRE INTERVENTION AND FOLLOW-UP PERIODS, SOCIAL AND ROLE FUNCTIONING, GENERAL HEALTH PERCEPTIONS, PAIN, AND PHYSICAL FUNCTIONING. RESULTS: AT 10 WEEKS, WE DID NOT FIND A STATISTICALLY SIGNIFICANT DIFFERENCE BETWEEN GROUPS IN DEPRESSION SYMPTOMS (B = -0.82, S.E. = 0.88, P = 0.36). HOWEVER, OVER THE ENTIRE INTERVENTION AND FOLLOW-UP PERIOD, WHEN CONTROLLING FOR BASELINE, YOGA PARTICIPANTS SHOWED LOWER LEVELS OF DEPRESSION THAN HLW PARTICIPANTS (B = -1.38, S.E. = 0.57, P = 0.02). AT 6-MONTH FOLLOW-UP, 51% OF YOGA PARTICIPANTS DEMONSTRATED A RESPONSE (50% REDUCTION IN DEPRESSION SYMPTOMS) COMPARED WITH 31% OF HLW PARTICIPANTS (ODDS RATIO = 2.31; P = 0.04). YOGA PARTICIPANTS SHOWED SIGNIFICANTLY BETTER SOCIAL AND ROLE FUNCTIONING AND GENERAL HEALTH PERCEPTIONS OVER TIME. CONCLUSIONS: ALTHOUGH WE DID NOT SEE A DIFFERENCE IN DEPRESSION SYMPTOMS AT THE END OF THE INTERVENTION PERIOD, YOGA PARTICIPANTS SHOWED FEWER DEPRESSION SYMPTOMS OVER THE ENTIRE FOLLOW-UP PERIOD. BENEFITS OF YOGA MAY ACCUMULATE OVER TIME.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
20  910  56 EFFECTIVENESS OF HATHA YOGA VERSUS CONVENTIONAL THERAPEUTIC EXERCISES FOR CHRONIC NONSPECIFIC LOW-BACK PAIN. OBJECTIVE: TO DETERMINE WHETHER THE EFFECTIVENESS OF HATHA YOGA THERAPY IS COMPARABLE TO CONVENTIONAL THERAPEUTIC EXERCISES (CTES) FOR REDUCING BACK PAIN INTENSITY AND BACK-RELATED DYSFUNCTION IN PATIENTS WITH CHRONIC NONSPECIFIC LOW-BACK PAIN (CNLBP). DESIGN: THE STUDY WAS A PROSPECTIVE RANDOMIZED COMPARATIVE TRIAL, DIVIDED INTO TWO PHASES: AN INITIAL 6-WEEKLY SUPERVISED INTERVENTION PERIOD FOLLOWED BY A 6-WEEK FOLLOW-UP PERIOD. SETTINGS: THIS STUDY WAS CONDUCTED AT DEPARTMENT OF PHYSICAL MEDICINE AND REHABILITATION AND CENTRE FOR INTEGRATIVE MEDICINE AND RESEARCH OF A TERTIARY CARE HOSPITAL. SUBJECTS: PATIENTS BETWEEN 18 AND 55 YEARS OF AGE WITH COMPLAINT OF CNLBP PERSISTING >/=12 WEEKS WITH PAIN RATING >/=4 ON A NUMERICAL RATING SCALE (0-10). INTERVENTION: A TOTAL OF SIX STANDARDIZED 35-MIN WEEKLY HATHA YOGA SESSIONS (YOGA GROUP) AND SIMILARLY 35-MIN WEEKLY SESSIONS OF CTES (CTE GROUP), DESIGNED FOR PEOPLE WITH CNLBP UNACCUSTOMED TO STRUCTURED YOGA OR CTE PROGRAM. PARTICIPANTS WERE ASKED TO PRACTICE ON NONCLASS DAYS AT HOME. OUTCOME MEASURES: THE PRIMARY OUTCOME MEASURES WERE DEFENSE AND VETERANS PAIN RATING SCALE (DVPRS) (0-10) AND 24-POINT ROLAND MORRIS DISABILITY QUESTIONNAIRE (RDQ). SECONDARY OUTCOMES WERE PAIN MEDICATION USAGE PER WEEK AND A POSTINTERVENTION PERCEIVED RECOVERY (LIKERT SEVEN-POINT SCALE) OF BACK-RELATED DYSFUNCTION. OUTCOMES WERE RECORDED AT THE BASELINE, 6-WEEK FOLLOW-UP, AND 12-WEEK FOLLOW-UP. RESULTS: SEVENTY SUBJECTS WERE RANDOMIZED TO EITHER YOGA (N = 35) OR CTE GROUP (N = 35). DATA WERE ANALYZED USING INTENTION-TO-TREAT, WITH LAST OBSERVATION CARRIED FORWARD. BOTH YOGA AND THE CTE GROUP HAVE SHOWN SIGNIFICANT IMPROVEMENT IN BACK PAIN INTENSITY AND BACK-RELATED DYSFUNCTION WITHIN BOTH THE GROUPS AT 6- AND 12-WEEK FOLLOW-UPS COMPARED TO BASELINE. NO STATISTICALLY SIGNIFICANT DIFFERENCES IN THE PAIN INTENSITY (DVPRS; AT 6 WEEKS: N = 35, DIFFERENCE OF MEDIANS 1.0, 95% CONFIDENCE INTERVAL [-5.3 TO 3.0], P = 0.5; AT 12 WEEKS: N = 35, 0.0 [-4.2 TO 5.0], 0.7) AND BACK-RELATED DYSFUNCTION (RDQ; AT 6 WEEKS: N = 35, 1.0 [-9.6 TO 10.6], 0.4; AT 12 WEEKS: N = 35, 0.0 [-8.8 TO 10.6], 0.3) WERE NOTED BETWEEN TWO GROUPS. IMPROVEMENTS IN PILL CONSUMPTION AND PERCEIVED RECOVERY WERE ALSO COMPARABLE BETWEEN THE GROUPS. CONCLUSION: YOGA PROVIDED SIMILAR IMPROVEMENT COMPARED WITH CTES, IN PATIENTS WITH CNLBP.	2019