1  524 160 COMPARISON OF COGNITIVE-BEHAVIORAL THERAPY AND YOGA FOR THE TREATMENT OF LATE-LIFE WORRY: A RANDOMIZED PREFERENCE TRIAL. BACKGROUND: THE PURPOSE OF THIS STUDY WAS TO COMPARE THE EFFECTS OF COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA ON LATE-LIFE WORRY, ANXIETY, AND SLEEP; AND EXAMINE PREFERENCE AND SELECTION EFFECTS ON THESE OUTCOMES. METHODS: A RANDOMIZED PREFERENCE TRIAL OF CBT AND YOGA WAS CONDUCTED IN COMMUNITY-DWELLING ADULTS 60 YEARS OR OLDER, WHO SCORED 26 OR ABOVE ON THE PENN STATE WORRY QUESTIONNAIRE-ABBREVIATED (PSWQ-A). CBT CONSISTED OF 10 WEEKLY TELEPHONE SESSIONS. YOGA CONSISTED OF 20 BIWEEKLY GROUP YOGA CLASSES. THE PRIMARY OUTCOME WAS WORRY (PSWQ-A); THE SECONDARY OUTCOMES WERE ANXIETY (PROMIS-ANXIETY) AND SLEEP (INSOMNIA SEVERITY INDEX [ISI]). WE EXAMINED BOTH PREFERENCE EFFECTS (AVERAGE EFFECT FOR THOSE WHO RECEIVED THEIR PREFERRED INTERVENTION [REGARDLESS OF WHETHER IT WAS CBT OR YOGA] MINUS THE AVERAGE FOR THOSE WHO DID NOT RECEIVE THEIR PREFERRED INTERVENTION [REGARDLESS OF THE INTERVENTION]) AND SELECTION EFFECT (WHICH ADDRESSES THE QUESTION OF WHETHER THERE IS A BENEFIT TO GETTING TO SELECT ONE INTERVENTION OVER THE OTHER, AND MEASURES THE EFFECT ON OUTCOMES OF SELF-SELECTION TO A SPECIFIC INTERVENTION). RESULTS: FIVE HUNDRED OLDER ADULTS WERE RANDOMIZED TO THE RANDOMIZED TRIAL (125 EACH IN CBT AND YOGA) OR THE PREFERENCE TRIAL (120 CHOSE CBT; 130 CHOSE YOGA). IN THE RANDOMIZED TRIAL, THE INTERVENTION EFFECT OF YOGA COMPARED WITH CBT ADJUSTED FOR BASELINE PSYCHOTROPIC MEDICATION USE, GENDER, AND RACE WAS 1.6 (-0.2, 3.3), P = .08 FOR THE PSWQ-A. SIMILAR RESULTS WERE OBSERVED WITH PROMIS-ANXIETY (ADJUSTED INTERVENTION EFFECT: 0.3 [-1.5, 2.2], P = .71). PARTICIPANTS RANDOMIZED TO CBT EXPERIENCED A GREATER REDUCTION IN THE ISI COMPARED WITH YOGA (ADJUSTED INTERVENTION EFFECT: 2.4 [1.2, 3.7], P < .01]). ESTIMATED IN THE COMBINED DATA SET (N = 500), THE PREFERENCE AND SELECTION EFFECTS WERE NOT SIGNIFICANT FOR THE PSWQ-A, PROMIS-ANXIETY, AND ISI. OF THE 52 ADVERSE EVENTS, ONLY TWO WERE POSSIBLY RELATED TO THE INTERVENTION. NONE OF THE 26 SERIOUS ADVERSE EVENTS WERE RELATED TO THE STUDY INTERVENTIONS. CONCLUSIONS: CBT AND YOGA WERE BOTH EFFECTIVE AT REDUCING LATE-LIFE WORRY AND ANXIETY. HOWEVER, A GREATER IMPACT WAS SEEN FOR CBT COMPARED WITH YOGA FOR IMPROVING SLEEP. NEITHER PREFERENCE NOR SELECTION EFFECTS WAS FOUND.	2020	
                                                                                                                                                                                                                                                                                                         
2  187  79 A RANDOMIZED PREFERENCE TRIAL COMPARING COGNITIVE-BEHAVIORAL THERAPY AND YOGA FOR THE TREATMENT OF LATE-LIFE WORRY: EXAMINATION OF IMPACT ON DEPRESSION, GENERALIZED ANXIETY, FATIGUE, PAIN, SOCIAL PARTICIPATION, AND PHYSICAL FUNCTION. BACKGROUND: DEPRESSION, GENERALIZED ANXIETY, FATIGUE, DIMINISHED PHYSICAL FUNCTION, REDUCED SOCIAL PARTICIPATION, AND PAIN ARE COMMON FOR MANY OLDER ADULTS AND NEGATIVELY IMPACT QUALITY OF LIFE. THE PURPOSE OF THE OVERALL TRIAL WAS TO COMPARE THE EFFECTS OF COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA ON LATE-LIFE WORRY, ANXIETY, AND SLEEP; AND EXAMINE PREFERENCE AND SELECTION EFFECTS ON THESE OUTCOMES. OBJECTIVE: THE PRESENT ANALYSES COMPARED EFFECTS OF THE 2 INTERVENTIONS ON ADDITIONAL OUTCOMES (DEPRESSIVE SYMPTOMS, GENERALIZED ANXIETY SYMPTOMS, FATIGUE, PAIN INTERFERENCE/INTENSITY, PHYSICAL FUNCTION, SOCIAL PARTICIPATION); AND EXAMINED WHETHER THERE ARE PREFERENCE AND SELECTION EFFECTS FOR THESE TREATMENTS. METHODS: A RANDOMIZED PREFERENCE TRIAL OF CBT AND YOGA WAS CONDUCTED IN ADULTS >/=60 YEARS WHO SCORED >/=26 ON THE PENN STATE WORRY QUESTIONNAIRE-ABBREVIATED (PSWQ-A), RECRUITED FROM OUTPATIENT MEDICAL CLINICS, MAILINGS, AND ADVERTISEMENTS. COGNITIVE-BEHAVIORAL THERAPY CONSISTED OF 10 WEEKLY TELEPHONE SESSIONS. YOGA CONSISTED OF 20 BI-WEEKLY GROUP YOGA CLASSES. PARTICIPANTS WERE RANDOMIZED TO(1): A RANDOMIZED CONTROLLED TRIAL (RCT) OF CBT OR YOGA (N = 250); OR (2) A PREFERENCE TRIAL IN WHICH THEY SELECTED THEIR TREATMENT (CBT OR YOGA; N = 250). OUTCOMES WERE MEASURED AT BASELINE AND POST-INTERVENTION. RESULTS: WITHIN THE RCT, THERE WERE SIGNIFICANT BETWEEN-GROUP DIFFERENCES FOR BOTH PAIN INTERFERENCE AND INTENSITY. THE PAIN INTERFERENCE SCORE IMPROVED MORE FOR THE CBT GROUP COMPARED WITH THE YOGA GROUP [INTERVENTION EFFECT OF (MEAN (95% CI) = 2.5 (.5, 4.6), P = .02]. FOR THE PAIN INTENSITY SCORE, THE INTERVENTION EFFECT ALSO FAVORED CBT OVER YOGA [.7 (.2, 1.3), P < .01]. DEPRESSIVE SYMPTOMS, GENERALIZED ANXIETY, AND FATIGUE SHOWED CLINICALLY MEANINGFUL WITHIN-GROUP CHANGES IN BOTH GROUPS. THERE WERE NO CHANGES IN OR DIFFERENCE BETWEEN PHYSICAL FUNCTION OR SOCIAL PARTICIPATION FOR EITHER GROUP. NO PREFERENCE OR SELECTION EFFECTS WERE FOUND. CONCLUSION: BOTH CBT AND YOGA MAY BE USEFUL FOR OLDER ADULTS FOR IMPROVING PSYCHOLOGICAL SYMPTOMS AND FATIGUE. COGNITIVE-BEHAVIORAL THERAPY MAY OFFER EVEN GREATER BENEFIT THAN YOGA FOR DECREASING PAIN.	2022	
                                                                                                                                                                                                                                                                  
3 1557  63 LONG-TERM EFFECTS OF COGNITIVE-BEHAVIORAL THERAPY AND YOGA FOR WORRIED OLDER ADULTS. OBJECTIVES: COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA DECREASE WORRY AND ANXIETY. THERE ARE NO LONG-TERM DATA COMPARING CBT AND YOGA FOR WORRY, ANXIETY, AND SLEEP IN OLDER ADULTS. THE IMPACT OF PREFERENCE AND SELECTION ON THESE OUTCOMES IS UNKNOWN. IN THIS SECONDARY DATA ANALYSIS, WE COMPARED LONG-TERM EFFECTS OF CBT BY TELEPHONE AND YOGA ON WORRY, ANXIETY, SLEEP, DEPRESSIVE SYMPTOMS, FATIGUE, PHYSICAL FUNCTION, SOCIAL PARTICIPATION, AND PAIN; AND EXAMINED PREFERENCE AND SELECTION EFFECTS. DESIGN: IN THIS RANDOMIZED PREFERENCE TRIAL, PARTICIPANTS (N = 500) WERE RANDOMIZED TO A: 1) RANDOMIZED CONTROLLED TRIAL (RCT) OF CBT OR YOGA (N = 250); OR 2) PREFERENCE TRIAL (SELECTED CBT OR YOGA; N = 250). OUTCOMES WERE MEASURED AT BASELINE AND WEEK 37. SETTING: COMMUNITY. PARTICIPANTS: COMMUNITY-DWELLING OLDER ADULTS (AGE 60+ YEARS). INTERVENTIONS: CBT (BY TELEPHONE) AND YOGA (IN-PERSON GROUP CLASSES). MEASUREMENTS: PENN STATE WORRY QUESTIONNAIRE - ABBREVIATED (WORRY);(1)(,)(2) INSOMNIA SEVERITY INDEX (SLEEP);(3) PROMIS ANXIETY SHORT FORM V1.0 (ANXIETY);(4)(,)(5) GENERALIZED ANXIETY DISORDER SCREENER (GENERALIZED ANXIETY);(6)(,)(7) AND PROMIS-29 (DEPRESSION, FATIGUE, PHYSICAL FUNCTION, SOCIAL PARTICIPATION, PAIN).(8)(,)(9) RESULTS: SIX MONTHS AFTER INTERVENTION COMPLETION, CBT AND YOGA RCT PARTICIPANTS REPORTED SUSTAINED IMPROVEMENTS FROM BASELINE IN WORRY, ANXIETY, SLEEP, DEPRESSIVE SYMPTOMS, FATIGUE, AND SOCIAL PARTICIPATION (NO SIGNIFICANT BETWEEN-GROUP DIFFERENCES). USING DATA COMBINED FROM THE RANDOMIZED AND PREFERENCE TRIALS, THERE WERE NO SIGNIFICANT PREFERENCE OR SELECTION EFFECTS. LONG-TERM INTERVENTION EFFECTS WERE OBSERVED AT CLINICALLY MEANINGFUL LEVELS FOR MOST OF THE STUDY OUTCOMES. CONCLUSIONS: CBT AND YOGA BOTH DEMONSTRATED MAINTAINED IMPROVEMENTS FROM BASELINE ON MULTIPLE OUTCOMES SIX MONTHS AFTER INTERVENTION COMPLETION IN A LARGE SAMPLE OF OLDER ADULTS. TRIAL REGISTRATION: WWW. CLINICALTRIALS: GOV IDENTIFIER NCT02968238.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
4  188  61 A RANDOMIZED PREFERENCE TRIAL OF COGNITIVE-BEHAVIORAL THERAPY AND YOGA FOR THE TREATMENT OF WORRY IN ANXIOUS OLDER ADULTS. BACKGROUND: WORRY IS A COMMON PROBLEM AMONG OLDER ADULTS. COGNITIVE-BEHAVIORAL THERAPY IS THE MOST STUDIED NONPHARMACOLOGICAL INTERVENTION AND IT HAS DEMONSTRATED EFFICACY IN REDUCING LATE-LIFE WORRY AND ANXIETY. ALTHOUGH THE EVIDENCE-BASE IS SMALLER, YOGA HAS BEEN SHOWN TO REDUCE ANXIETY AND STRESS. HOWEVER, LITTLE IS KNOWN ABOUT THE RELATIVE EFFECTIVENESS OF THESE TWO NONPHARMACOLOGICAL INTERVENTIONS. FURTHER, THE IMPACT OF PATIENT PREFERENCE ON OUTCOMES IS UNKNOWN.PURPOSE: THE PURPOSE TO THIS STUDY IS TO COMPARE THE EFFECTIVENESS OF COGNITIVE-BEHAVIORAL THERAPY (CBT) WITH YOGA FOR IMPROVING LATE-LIFE WORRY, ANXIETY, AND SLEEP. WE WILL ALSO EXAMINE THE EFFECTS OF PREFERENCE AND SELECTION ON OUTCOMES, ADHERENCE, AND ATTRITION. METHODS: WE ARE CONDUCTING A TWO-STAGE RANDOMIZED PREFERENCE TRIAL COMPARING CBT AND YOGA FOR THE REDUCTION OF WORRY IN A SAMPLE OF ANXIOUS OLDER ADULTS. FIVE HUNDRED PARTICIPANTS WILL BE RANDOMIZED TO EITHER THE PREFERENCE TRIAL (PARTICIPANTS CHOOSE THE INTERVENTION; N=250) OR TO THE RANDOMIZED TRIAL (PARTICIPANTS ARE RANDOMIZED TO ONE OF THE TWO INTERVENTIONS; N=250) WITH EQUAL PROBABILITY. CBT CONSISTS OF 10 TELEPHONE-BASED SESSIONS WITH AN ACCOMPANYING WORKBOOK. YOGA CONSISTS OF 10 WEEKS OF GROUP YOGA CLASSES (TWICE A WEEK) THAT IS MODIFIED FOR USE WITH OLDER ADULTS. CONCLUSIONS: THE STUDY DESIGN IS BASED ON FEEDBACK FROM ANXIOUS OLDER ADULTS WHO WANTED MORE NONPHARMACOLOGICAL OPTIONS FOR INTERVENTION AS WELL AS MORE INPUT INTO THE INTERVENTION THEY RECEIVE. IT IS THE FIRST HEAD-TO-HEAD COMPARISON OF CBT AND YOGA FOR REDUCING LATE-LIFE WORRY AND ANXIETY. IT WILL ALSO PROVIDE INFORMATION ABOUT HOW INTERVENTION PREFERENCE AFFECTS OUTCOMES. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT02968238.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
5  133  49 A PRAGMATIC PREFERENCE TRIAL OF THERAPEUTIC YOGA AS AN ADJUNCT TO GROUP COGNITIVE BEHAVIOUR THERAPY VERSUS GROUP CBT ALONE FOR DEPRESSION AND ANXIETY. BACKGROUND: YOGA HAS SEVERAL MECHANISMS THAT MAKE IT A PROMISING TREATMENT FOR DEPRESSION AND ANXIETY, INCLUDING PHYSICAL ACTIVITY, BEHAVIOURAL ACTIVATION, AND MINDFULNESS. FOLLOWING POSITIVE OUTCOMES FROM ADAPTED CBT INTERVENTIONS INCORPORATING MINDFULNESS-BASED PRACTICES, THIS STUDY EXPLORED THE EFFECTS OF A THERAPEUTIC YOGA PROGRAM AS AN ADJUNCT TO GROUP-BASED CBT FOR DEPRESSION OR ANXIETY. METHODS: THIS WAS A PRAGMATIC PREFERENCE TRIAL INVOLVING ADULTS DIAGNOSED WITH DEPRESSION OR ANXIETY IN A REGIONAL PRIMARY MENTAL HEALTHCARE SERVICE (N = 59), COMPARING TRANSDIAGNOSTIC GROUP CBT (N = 27) WITH TRANSDIAGNOSTIC GROUP CBT COMBINED WITH AN ADJUNCT THERAPEUTIC YOGA PROGRAM (N = 32). A PREFERENCE RECRUITMENT DESIGN ALLOWED ELIGIBLE PARTICIPANTS (N = 35) TO SELF-SELECT INTO THE ADJUNCT PROGRAM. THE DEPRESSION ANXIETY STRESS SCALE-21 (DASS) WAS ASSESSED AT BASELINE, POST-INTERVENTION, AND THREE-MONTHS FOLLOW UP. RESULTS: CBT + YOGA WAS AN ACCEPTABLE ALTERNATIVE TO CBT ALONE. SIGNIFICANT REDUCTIONS WERE OBSERVED IN TOTAL DASS SCORES AND THE 3 SUBSCALES OF THE DASS FOR BOTH GROUPS, HOWEVER CBT + YOGA SHOWED SIGNIFICANTLY LOWER DEPRESSIVE AND ANXIETY SYMPTOMS POST-INTERVENTION, COMPARED TO CBT ALONE. CBT + YOGA ALSO SHOWED SUSTAINED REDUCTIONS IN DEPRESSIVE SYMPTOMS OVER THREE-MONTHS, AND MORE RAPID REDUCTIONS IN DEPRESSIVE SYMPTOMS, COMPARED TO CBT ALONE. LIMITATIONS: THESE FINDINGS SHOULD BE CONSIDERED PRELIMINARY DUE TO THE MODERATE SAMPLE SIZE, WITH A RIGOROUS RANDOMISED CONTROL TRIAL NECESSARY TO DEFINITIVELY SUPPORT THE INTEGRATION OF YOGA WITHIN MENTAL HEALTH CARE TO AUGMENT THE BENEFITS AND UPTAKE OF TRANSDIAGNOSTIC CBT FOR DEPRESSION AND ANXIETY. CONCLUSIONS: COMPLEMENTING OTHER MINDFULNESS-BASED PRACTICES, THERAPEUTIC YOGA SHOWS PROMISE AS AN ADJUNCT TO TRANSDIAGNOSTIC CBT.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
6 2811  45 YOGA TO PREVENT MOBILITY LIMITATIONS IN OLDER ADULTS: FEASIBILITY OF A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: THE LOSS OF MOBILITY DURING AGING IMPACTS INDEPENDENCE AND LEADS TO FURTHER DISABILITY, MORBIDITY, AND REDUCED LIFE EXPECTANCY. OUR OBJECTIVE WAS TO EXAMINE THE FEASIBILITY AND SAFETY OF CONDUCTING A RANDOMIZED CONTROLLED TRIAL OF YOGA FOR OLDER ADULTS AT RISK FOR MOBILITY LIMITATIONS. METHODS: SEDENTARY OLDER ADULTS (N = 46; AGE 60-89) WERE RECRUITED AND RANDOMIZED TO EITHER YOGA OR A HEALTH EDUCATION COMPARISON GROUP. YOGA SESSIONS (60-MIN) OCCURRED 2X WEEKLY, AND 90-MIN HEALTH EDUCATION SESSIONS OCCURRED WEEKLY, FOR 10 WEEKS. THE PRIMARY OUTCOMES WERE RECRUITMENT RATE, INTERVENTION ATTENDANCE, AND RETENTION AT ASSESSMENTS. ADVERSE EVENT RATES AND PARTICIPANT SATISFACTION WERE ALSO MEASURED. PHYSICAL PERFORMANCE MEASURES OF GAIT, BALANCE, AND STRENGTH AND SELF-REPORT OUTCOME MEASURES WERE ADMINISTERED AT BASELINE AND 10-WEEKS. RESULTS: RECRUITMENT LASTED 6 MONTHS. RETENTION OF PARTICIPANTS AT THE 10-WEEK FOLLOW-UP WAS HIGH (89% - PERFORMANCE MEASURES; 98% - SELF-REPORT QUESTIONNAIRES). ATTENDANCE WAS GOOD WITH 82% OF YOGA AND 74% OF HEALTH EDUCATION PARTICIPANTS ATTENDING AT LEAST 50% OF THE SESSIONS. NO SERIOUS ADVERSE EVENTS WERE REPORTED. PATIENT SATISFACTION WITH THE INTERVENTIONS WAS HIGH. THE MEAN EFFECT SIZE FOR THE PHYSICAL PERFORMANCE MEASURES WAS 0.35 WITH SOME OVER 0.50. THE MEAN EFFECT SIZE FOR SELF-REPORT OUTCOME MEASURES WAS 0.36. CONCLUSIONS: RESULTS INDICATE THAT IT IS FEASIBLE TO CONDUCT A LARGER RCT OF YOGA FOR SEDENTARY OLDER ADULTS AT RISK FOR MOBILITY PROBLEMS. THE YOGA AND COMPARISON INTERVENTIONS WERE SAFE, WELL ACCEPTED, AND WELL ATTENDED. EFFECT SIZES SUGGEST YOGA MAY HAVE IMPORTANT BENEFITS FOR THIS POPULATION AND SHOULD BE STUDIED FURTHER. TRIAL REGISTRATION: CLINICALTRIALS # NCT03544879 ; RETROSPECTIVELY REGISTERED 4 JUNE, 2018.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
7 1784  54 PREDICTORS OF PREFERENCE FOR COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA INTERVENTIONS AMONG OLDER ADULTS. THE PURPOSE OF THIS STUDY WAS TO EXAMINE FACTORS THAT INFLUENCE A PERSON'S CHOICE OF COGNITIVE-BEHAVIORAL THERAPY (CBT) OR YOGA, THE STABILITY OF THESE PREFERENCES, AND THE IMPACT OF PREFERENCE ON ENGAGEMENT AND PROCESS MEASURES. WE CONDUCTED A RANDOMIZED PREFERENCE TRIAL OF CBT AND YOGA IN 500 ADULTS >/=60 YEARS WITH SYMPTOMS OF WORRY. PARTICIPANTS REPORTED THEIR INTERVENTION PREFERENCE, STRENGTH OF PREFERENCE, AND FACTORS IMPACTING PREFERENCE. ENGAGEMENT IN THE INTERVENTION (SESSION COMPLETION AND DROPOUT RATES) WAS ASSESSED. PROCESS MEASURES INCLUDED SATISFACTION WITH THE INTERVENTION, THERAPEUTIC ALLIANCE, AND INTERVENTION EXPECTANCY. NEITHER INTERVENTION PREFERENCE (48% AND 52% CHOSE CBT AND YOGA, RESPECTIVELY) NOR STRENGTH OF PREFERENCE DIFFERED SIGNIFICANTLY BETWEEN THE TWO PREFERENCE TRIAL GROUPS. INTERVENTION EXPECTANCIES AT BASELINE AMONG THOSE IN THE PREFERENCE TRIAL WERE APPROXIMATELY 4.5 UNITS (40-POINT SCALE) HIGHER FOR THEIR PREFERRED INTERVENTION (P < .0001 WITHIN EACH GROUP). A PRINCIPAL COMPONENT ANALYSIS OF FACTORS INFLUENCING PREFERENCE IDENTIFIED THREE CONSTRUCTS. USING LOGISTIC REGRESSION, COMPONENTS FOCUSED ON ATTITUDES ABOUT CBT OR YOGA WERE PREDICTIVE OF ULTIMATE PREFERENCE (ODDS RATIO = 11.5, 95% C.I.6.3-21.0 PER 1SD DIFFERENCE IN COMPONENT 1 FOR CHOOSING CBT; ODDS RATIO = 7.8, 95% CI4.3-13.9 PER 1SD DIFFERENCE IN COMPONENT 2 FOR CHOOSING YOGA). THERE WERE NO SIGNIFICANT DIFFERENCES BETWEEN THE RANDOMIZED AND PREFERENCE TRIALS ON INTERVENTION ADHERENCE, COMPLETION OF ASSESSMENTS, INTERVENTION SATISFACTION, OR WORKING ALLIANCE. RECEIVING A PREFERRED TREATMENT HAD NO SIGNIFICANT EFFECTS ON INTERVENTION OUTCOMES THROUGH PARTICIPANT ENGAGEMENT OR PROCESS MEASURES. WHEN OPTIONS ARE LIMITED, PROVIDERS MAY HAVE CONFIDENCE IN OFFERING THE MOST READILY AVAILABLE NON-PHARMACOLOGICAL TREATMENTS.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
8 2320  44 TREATMENT CREDIBILITY, EXPECTANCY, AND PREFERENCE: PREDICTION OF TREATMENT ENGAGEMENT AND OUTCOME IN A RANDOMIZED CLINICAL TRIAL OF HATHA YOGA VS. HEALTH EDUCATION AS ADJUNCT TREATMENTS FOR DEPRESSION. BACKGROUND: HATHA YOGA MAY BE HELPFUL FOR ALLEVIATING DEPRESSION SYMPTOMS. THE PURPOSE OF THIS ANALYSIS IS TO DETERMINE WHETHER TREATMENT PROGRAM PREFERENCE, CREDIBILITY, OR EXPECTANCY PREDICT ENGAGEMENT IN DEPRESSION INTERVENTIONS (YOGA OR A CONTROL CLASS) OR DEPRESSION SYMPTOM SEVERITY OVER TIME. METHODS: THIS IS A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL (RCT) OF HATHA YOGA VS. A HEALTH EDUCATION CONTROL GROUP FOR TREATMENT OF DEPRESSION. DEPRESSED PARTICIPANTS (N=122) ATTENDED UP TO 20 CLASSES OVER A PERIOD OF 10 WEEKS, AND THEN COMPLETED ADDITIONAL ASSESSMENTS AFTER 3 AND 6 MONTHS. WE ASSESSED TREATMENT PREFERENCE PRIOR TO RANDOMIZATION, AND TREATMENT CREDIBILITY AND EXPECTANCY AFTER PARTICIPANTS ATTENDED THEIR FIRST CLASS. TREATMENT "CONCORDANCE" INDICATED THAT TREATMENT PREFERENCE MATCHED ASSIGNED TREATMENT. RESULTS: TREATMENT CREDIBILITY, EXPECTANCY, AND CONCORDANCE WERE NOT ASSOCIATED WITH TREATMENT ENGAGEMENT. TREATMENT EXPECTANCY MODERATED THE ASSOCIATION BETWEEN TREATMENT GROUP AND DEPRESSION. DEPRESSION SEVERITY OVER TIME DIFFERED BY EXPECTANCY LEVEL FOR THE YOGA GROUP BUT NOT FOR THE HEALTH EDUCATION GROUP. CONTROLLING FOR BASELINE DEPRESSION, PARTICIPANTS IN THE YOGA GROUP WITH AN AVERAGE OR HIGH EXPECTANCY FOR IMPROVEMENT SHOWED LOWER DEPRESSION SYMPTOMS ACROSS THE ACUTE INTERVENTION AND FOLLOW-UP PERIOD THAN THOSE WITH A LOW EXPECTANCY FOR IMPROVEMENT. THERE WAS A TREND FOR A SIMILAR PATTERN FOR CREDIBILITY. CONCORDANCE WAS NOT ASSOCIATED WITH TREATMENT OUTCOME. LIMITATIONS: THIS IS A SECONDARY, POST-HOC ANALYSIS AND SHOULD BE CONSIDERED HYPOTHESIS-GENERATING. CONCLUSIONS: RESULTS SUGGEST THAT EXPECTANCY IMPROVES THE LIKELIHOOD OF SUCCESS ONLY FOR A INTERVENTION THOUGHT TO ACTIVELY TARGET DEPRESSION (YOGA) AND NOT A CONTROL INTERVENTION.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
9  345  44 ASSESSING FEASIBILITY AND ACCEPTABILITY OF YOGA AND GROUP CBT FOR ADOLESCENTS WITH DEPRESSION: A PILOT RANDOMIZED CLINICAL TRIAL. PURPOSE: GIVEN INCREASING RATES OF DEPRESSION IN ADOLESCENTS, THERE IS A CLEAR NEED FOR INNOVATIVE TREATMENTS. IN THIS PILOT RANDOMIZED CLINICAL TRIAL, WE ASSESSED ACCEPTABILITY AND FEASIBILITY OF TWO GROUP-BASED INTERVENTIONS: YOGA AND COGNITIVE-BEHAVIORAL THERAPY (CBT). THE GOAL OF THIS WORK IS TO PREPARE FOR A FUTURE FULLY POWERED RANDOMIZED TRIAL TO TEST THE HYPOTHESIS THAT YOGA IS NOT INFERIOR TO AN ESTABLISHED ADOLESCENT DEPRESSION TREATMENT, NAMELY, GROUP CBT. METHODS: WE ENROLLED 42 ADOLESCENTS WITH ELEVATED DEPRESSION SYMPTOMS. PARTICIPANTS WERE RANDOMLY ASSIGNED TO A 12-WEEK GROUP-BASED INTERVENTION, YOGA OR CBT. WE HAD A PRIORI FEASIBILITY AND ACCEPTABILITY TARGETS, INCLUDING FOR RECRUITMENT RATE, RETENTION RATE, EXPECTANCY, CREDIBILITY, PROGRAM SATISFACTION, CLASS ATTENDANCE, ENGAGEMENT IN HOME PRACTICE, AND INSTRUCTOR/LEADER MANUAL ADHERENCE. WE ASSESSED ADVERSE EVENTS, AND WITHIN-SUBJECT CHANGES IN OUTCOMES (DEPRESSION, ANXIETY, IMPAIRMENT, SLEEP DISTURBANCE) AND POSSIBLE MEDIATORS (MINDFULNESS, SELF-COMPASSION). RESULTS: BOTH INTERVENTIONS MET MOST ACCEPTABILITY AND FEASIBILITY TARGETS. THE ONLY TARGET NOT MET RELATED TO LOW ENGAGEMENT IN HOME PRACTICE. PARTICIPANTS WITHIN EACH STUDY ARM SHOWED DECREASED DEPRESSION SYMPTOMS OVER TIME AND INCREASED SELF-COMPASSION. CONCLUSIONS: A YOGA INTERVENTION APPEARS TO BE ACCEPTABLE AND FEASIBLE TO ADOLESCENTS WITH DEPRESSION. HOWEVER, IT MAY BE CHALLENGING FOR THIS GROUP TO ENGAGE IN UNSTRUCTURED HOME PRACTICE.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
10 1156  56 ENSURING YOGA INTERVENTION FIDELITY IN A RANDOMIZED PREFERENCE TRIAL FOR THE TREATMENT OF WORRY IN OLDER ADULTS. INTRODUCTION: YOGA FOR TREATMENT OF WORRY IN OLDER ADULTS IS AN INTERVENTION THAT IS ESPECIALLY LIKELY TO TRANSLATE INTO REAL-WORLD PRACTICE. ASSESSING TREATMENT FIDELITY IMPROVES CONFIDENCE THAT EFFECTIVE INTERVENTIONS CAN BE CONSISTENTLY APPLIED AND ALLOWS RESEARCHERS TO EXPLORE IF ANY NULL RESULTS FOR EFFECTIVENESS ARE INDEED THE RESULT OF A LACK OF INTERVENTION EFFICACY OR LACK OF PROPER INTERVENTION IMPLEMENTATION. METHODS: THIS STUDY DESCRIBES TREATMENT FIDELITY OF A YOGA INTERVENTION IN A RANDOMIZED PREFERENCE TRIAL THAT COMPARED COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA FOR THE TREATMENT OF WORRY, ANXIETY, AND SLEEP IN WORRIED OLDER (>/=60 YEARS) ADULTS. ESTABLISHED METHODS FOR ASSESSING TREATMENT FIDELITY OF CBT GUIDED THE PROCEDURE FOR ENSURING THAT THE YOGA INTERVENTION WAS DELIVERED AS INTENDED. THE YOGA INTERVENTION CONSISTED OF 20, 75-MIN, IN-PERSON, GROUP, GENTLE YOGA CLASSES HELD TWICE WEEKLY. RESULTS: SIX FEMALE INSTRUCTORS (MEAN AGE = 64 YEARS) TAUGHT 660 YOGA CLASSES THAT WERE VIDEOTAPED. TEN PERCENT OF THESE CLASSES, STRATIFIED BY INSTRUCTOR, WERE RANDOMLY SELECTED FOR REVIEW. THE AVERAGE ADHERENCE SCORE FOR YOGA INSTRUCTORS WAS 6.84 (RANGE 4-8). THE AVERAGE COMPETENCY SCORES WERE CONSISTENTLY HIGH, WITH AN AVERAGE SCORE OF 7.24 (RANGE 6-8). TEACHING CONTENT NOT INCLUDED IN THE PROTOCOL OCCURRED IN 26 (38.1%) SESSIONS AND DECREASED OVER TIME. OBSERVED RATINGS OF INSTRUCTOR ADHERENCE WERE SIGNIFICANTLY RELATED TO RATINGS OF COMPETENCY. INSTRUCTOR ADHERENCE WAS ALSO SIGNIFICANTLY ASSOCIATED WITH LOWER PARTICIPANT ATTENDANCE, BUT NOT WITH ANY OF THE OTHER PROCESS OR OUTCOME MEASURES. CONCLUSIONS: THE LARGER RANGE FOUND IN ADHERENCE RELATIVE TO COMPETENCE SCORES DEMONSTRATED THAT TEACHING A YOGA CLASS ACCORDING TO A PROTOCOL REQUIRES DIFFERENT SKILLS THAN COMPETENTLY TEACHING A YOGA CLASS IN THE COMMUNITY, AND THESE SKILLS IMPROVED WITH FEEDBACK. THESE RESULTS MAY FOSTER DIALOG BETWEEN THE YOGA RESEARCH AND PRACTICE COMMUNITIES. CLINICAL TRIAL REGISTRATION NO.: NCT02968238.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
11 1787  47 PREFERENCE AND EXPECTATION FOR TREATMENT ASSIGNMENT IN A RANDOMIZED CONTROLLED TRIAL OF ONCE- VS TWICE-WEEKLY YOGA FOR CHRONIC LOW BACK PAIN. BACKGROUND: IN STUDIES INVOLVING NONPHARMACOLOGICAL COMPLEMENTARY AND ALTERNATIVE MEDICINE INTERVENTIONS, PARTICIPANT BLINDING IS VERY DIFFICULT. PARTICIPANT EXPECTATIONS MAY AFFECT PERCEIVED BENEFIT OF THERAPY. IN STUDIES OF YOGA AS TREATMENT FOR CHRONIC LOW BACK PAIN, LITTLE IS KNOWN ABOUT THE RELATIONSHIP BETWEEN PATIENT EXPECTATIONS AND PREFERENCES ON OUTCOMES. THIS STUDY WAS DESIGNED TO IDENTIFY BASELINE PREDICTORS OF PREFERENCE AND TO DETERMINE IF EXPECTATIONS AND PREFERENCES FOR DIFFERENT DOSES OF YOGA AFFECT BACK-RELATED FUNCTION AND LOW BACK PAIN INTENSITY. METHODS: THIS WAS A SECONDARY DATA ANALYSIS OF A 12-WEEK RANDOMIZED CONTROLLED TRIAL COMPARING ONCE-WEEKLY VS TWICE-WEEKLY YOGA FOR TREATMENT OF CHRONIC LOW BACK PAIN IN 93 ADULTS FROM A PREDOMINANTLY LOW-INCOME MINORITY POPULATION. AT BASELINE, PARTICIPANTS WERE ASKED ABOUT BACK FUNCTION, BACK PAIN, TREATMENT EXPECTATIONS, AND TREATMENT PREFERENCES. WE CREATED A VARIABLE "CONCORDANCE" TO DESCRIBE THE MATCHING OF PARTICIPANT PREFERENCE TO RANDOMIZED TREATMENT. OUR OUTCOME VARIABLES WERE CHANGE IN BACK FUNCTION AND PAIN INTENSITY AFTER 12 WEEKS OF YOGA INSTRUCTION. WE PERFORMED LOGISTIC REGRESSION TO IDENTIFY PREDICTORS OF PREFERENCE FOR ONCE- OR TWICE-WEEKLY YOGA INSTRUCTION. WE CREATED LINEAR REGRESSION MODELS TO IDENTIFY INDEPENDENT ASSOCIATIONS BETWEEN EXPECTATIONS, PREFERENCE, CONCORDANCE, AND OUTCOMES. RESULTS: WORSE BACK FUNCTION AT BASELINE WAS ASSOCIATED WITH 20% HIGHER ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 1.2, CI 1.1, 1.3). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR TWICE-WEEKLY YOGA HAD 90% HIGHER ODDS OF PREFERRING TWICE-WEEKLY VS ONCE-WEEKLY YOGA (OR 1.9, CI 1.3, 2.7). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR ONCE-WEEKLY YOGA HAD 40% LESS ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 0.6, CI 0.5, 0.9). AFTER CONTROLLING FOR BASELINE CHARACTERISTICS, WE FOUND NO STATISTICALLY SIGNIFICANT RELATIONSHIP BETWEEN TREATMENT OUTCOMES, PREFERENCE, EXPECTATION SCORES, OR CONCORDANCE. CONCLUSION: IN A POPULATION OF PREDOMINANTLY LOW-INCOME MINORITY PARTICIPANTS WITH CHRONIC LOW BACK PAIN, WORSE BACK FUNCTION WAS ASSOCIATED WITH PREFERENCE FOR MORE FREQUENT YOGA CLASSES. THOSE WHO PREFERRED MORE YOGA CLASSES HAD HIGHER EXPECTATIONS FOR THOSE CLASSES. TWELVE-WEEK CHANGE IN BACK PAIN INTENSITY AND BACK FUNCTION WERE NOT AFFECTED BY DOSING PREFERENCE, EXPECTATION SCORE, OR CONCORDANCE. MORE RESEARCH IS NEEDED TO BETTER MEASURE AND QUANTIFY PREFERENCE, EXPECTATIONS, AND THEIR RELATIONSHIP TO OUTCOMES IN YOGA RESEARCH.	2015	

12 1180  46 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	
                                                                                                                                           
13  282  50 ADHERENCE TO YOGA AND EXERCISE INTERVENTIONS IN A 6-MONTH CLINICAL TRIAL. BACKGROUND: TO DETERMINE FACTORS THAT PREDICT ADHERENCE TO A MIND-BODY INTERVENTION IN A RANDOMIZED TRIAL. DESIGN: WE ANALYZED ADHERENCE DATA FROM A 3-ARM TRIAL INVOLVING 135 GENERALLY HEALTHY SENIORS 65-85 YEARS OF AGE RANDOMIZED TO A 6-MONTH INTERVENTION CONSISTING OF: AN IYENGAR YOGA CLASS WITH HOME PRACTICE, AN EXERCISE CLASS WITH HOME PRACTICE, OR A WAIT-LIST CONTROL GROUP. OUTCOME MEASURES INCLUDED COGNITIVE FUNCTION, MOOD, FATIGUE, ANXIETY, HEALTH-RELATED QUALITY OF LIFE, AND PHYSICAL MEASURES. ADHERENCE TO THE INTERVENTION WAS OBTAINED BY CLASS ATTENDANCE AND BIWEEKLY HOME PRACTICE LOGS. RESULTS: THE DROP-OUT RATE WAS 13%. AMONG THE COMPLETERS OF THE TWO ACTIVE INTERVENTIONS, AVERAGE YOGA CLASS ATTENDANCE WAS 77% AND HOME PRACTICE OCCURRED 64% OF ALL DAYS. AVERAGE EXERCISE CLASS ATTENDANCE WAS 69% AND HOME EXERCISE OCCURRED 54% OF ALL DAYS. THERE WERE NO CLEAR EFFECTS OF ADHERENCE ON THE SIGNIFICANT STUDY OUTCOMES (QUALITY OF LIFE AND PHYSICAL MEASURES). CLASS ATTENDANCE WAS SIGNIFICANTLY CORRELATED WITH BASELINE MEASURES OF DEPRESSION, FATIGUE, AND PHYSICAL COMPONENTS OF HEALTH-RELATED QUALITY OF LIFE. SIGNIFICANT DIFFERENCES IN BASELINE MEASURES WERE ALSO FOUND BETWEEN STUDY COMPLETERS AND DROP-OUTS IN THE ACTIVE INTERVENTIONS. ADHERENCE WAS NOT RELATED TO AGE, GENDER, OR EDUCATION LEVEL. CONCLUSION: HEALTHY SENIORS HAVE GOOD ATTENDANCE AT CLASSES WITH A PHYSICALLY ACTIVE INTERVENTION. HOME PRACTICE TAKES PLACE OVER HALF OF THE TIME. DECREASED ADHERENCE TO A POTENTIALLY BENEFICIAL INTERVENTION HAS THE POTENTIAL TO DECREASE THE EFFECT OF THE INTERVENTION IN A CLINICAL TRIAL BECAUSE SUBJECTS WHO MIGHT SUSTAIN THE GREATEST BENEFIT WILL RECEIVE A LOWER DOSE OF THE INTERVENTION AND SUBJECTS WITH HIGHER ADHERENCE RATES MAY BE FUNCTIONING CLOSER TO MAXIMUM ABILITY BEFORE THE INTERVENTION. STRATEGIES TO MAXIMIZE ADHERENCE AMONG SUBJECTS AT GREATER RISK FOR LOW ADHERENCE WILL BE IMPORTANT FOR FUTURE TRIALS, ESPECIALLY COMPLEMENTARY TREATMENTS REQUIRING GREATER EFFORT THAN SIMPLE PILL-TAKING.	2007	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
14 2628  42 YOGA FOR THE MANAGEMENT OF PAIN AND SLEEP IN RHEUMATOID ARTHRITIS: A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THE AIM OF THE PRESENT STUDY WAS TO DETERMINE THE FEASIBILITY OF A RELAXATION-BASED YOGA INTERVENTION FOR RHEUMATOID ARTHRITIS, DESIGNED AND REPORTED IN ACCORDANCE WITH DELPHI RECOMMENDATIONS FOR YOGA INTERVENTIONS FOR MUSCULOSKELETAL CONDITIONS. METHODS: PARTICIPANTS WERE RECRUITED FROM A HOSPITAL DATABASE, AND RANDOMIZED TO EITHER EIGHT WEEKLY 75-MIN YOGA CLASSES OR A USUAL CARE CONTROL. FEASIBILITY WAS DETERMINED BY RECRUITMENT RATES, RETENTION, PROTOCOL ADHERENCE, PARTICIPANT SATISFACTION AND ADVERSE EVENTS. SECONDARY PHYSICAL AND PSYCHOSOCIAL OUTCOMES WERE ASSESSED USING SELF-REPORTED QUESTIONNAIRES AT BASELINE (WEEK 0), WEEK 9 (PRIMARY TIME POINT) AND WEEK 12 (FOLLOW-UP). RESULTS: OVER A 3-MONTH PERIOD, 26 PARTICIPANTS WITH MILD PAIN, MILD TO MODERATE FUNCTIONAL DISABILITY AND MODERATE DISEASE ACTIVITY WERE RECRUITED INTO THE STUDY (25% RECRUITMENT RATE). RETENTION RATES WERE 100% FOR YOGA PARTICIPANTS AND 92% FOR USUAL CARE PARTICIPANTS AT BOTH WEEKS 9 AND 12. PROTOCOL ADHERENCE AND PARTICIPANT SATISFACTION WERE HIGH. YOGA PARTICIPANTS ATTENDED A MEDIAN OF SEVEN CLASSES; ADDITIONALLY, SEVEN OF THE YOGA PARTICIPANTS (54%) REPORTED CONTINUING YOGA AT HOME DURING THE FOLLOW-UP PERIOD. NO SERIOUS ADVERSE EVENTS WERE RELATED TO THE STUDY. SECONDARY OUTCOMES SHOWED NO GROUP EFFECTS OF YOGA COMPARED WITH USUAL CARE. CONCLUSIONS: A RELAXATION-BASED YOGA PROGRAMME WAS FOUND TO BE FEASIBLE AND SAFE FOR PARTICIPANTS WITH RHEUMATOID ARTHRITIS-RELATED PAIN AND FUNCTIONAL DISABILITY. ADVERSE EVENTS WERE MINOR, AND NOT UNEXPECTED FROM AN INTERVENTION INCLUDING PHYSICAL COMPONENTS. THIS PILOT PROVIDES A FRAMEWORK FOR LARGER INTERVENTION STUDIES, AND SUPPORTS FURTHER EXPLORATION OF YOGA AS A COMPLEX INTERVENTION TO ASSIST WITH THE MANAGEMENT OF RHEUMATOID ARTHRITIS.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
15 1527  42 IYENGAR YOGA FOR DISTRESSED WOMEN: A 3-ARMED RANDOMIZED CONTROLLED TRIAL. DISTRESS IS AN INCREASING PUBLIC HEALTH PROBLEM. WE AIMED TO INVESTIGATE THE EFFECTS OF AN IYENGAR YOGA PROGRAM ON PERCEIVED STRESS AND PSYCHOLOGICAL OUTCOMES IN DISTRESSED WOMEN AND EVALUATED A POTENTIAL DOSE-EFFECT RELATIONSHIP. SEVENTY-TWO FEMALE DISTRESSED SUBJECTS WERE INCLUDED INTO A 3-ARMED RANDOMIZED CONTROLLED TRIAL AND ALLOCATED TO YOGA GROUP 1 (N = 24) WITH TWELVE 90 MIN SESSIONS OVER 3 MONTHS, YOGA GROUP 2 (N = 24) WITH 24 SESSIONS OVER 3 MONTHS, OR A WAITING LIST CONTROL GROUP (N = 24). THE PRIMARY OUTCOME WAS STRESS PERCEPTION, MEASURED BY COHEN STRESS SCALE; SECONDARY OUTCOMES INCLUDED STATE TRAIT ANXIETY, DEPRESSION, PSYCHOLOGICAL AND PHYSICAL QUALITY OF LIFE (QOL), PROFILE OF MOOD STATES, WELL BEING, AND BODILY COMPLAINTS. AFTER THREE MONTHS, WOMEN IN THE YOGA GROUPS SHOWED SIGNIFICANT IMPROVEMENTS IN PERCEIVED STRESS (P = 0.003), STATE TRAIT ANXIETY (P = 0.021 AND P = 0.003), DEPRESSION (P = 0.008), PSYCHOLOGICAL QOL (P = 0.012), MOOD STATES BEING (P = 0.007), AND BODILY COMPLAINTS WELL(P = 0.012) WHEN COMPARED TO CONTROLS. BOTH YOGA PROGRAMS WERE SIMILARLY EFFECTIVE FOR THESE OUTCOMES; HOWEVER, COMPLIANCE WAS BETTER IN THE GROUP WITH FEWER SESSIONS (YOGA GROUP 1). DOSE EFFECTS WERE SEEN ONLY IN THE ANALYSIS OF GROUP-INDEPENDENT EFFECTS FOR BACK PAIN, ANXIETY, AND DEPRESSION. THESE FINDINGS SUGGEST THAT IYENGAR YOGA EFFECTIVELY REDUCES DISTRESS AND IMPROVES RELATED PSYCHOLOGICAL AND PHYSICAL OUTCOMES. FURTHERMORE, ATTENDING TWICE-WEEKLY YOGA CLASSES WAS NOT SUPERIOR TO ONCE-WEEKLY CLASSES, AS A RESULT OF LIMITED COMPLIANCE IN THE TWICE-WEEKLY GROUP.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
16   44  33 A CASE SERIES ON THE EFFECTS OF KRIPALU YOGA FOR GENERALIZED ANXIETY DISORDER. GENERALIZED ANXIETY DISORDER (GAD) IS A PREVALENT PSYCHIATRIC DISORDER ASSOCIATED WITH SUBSTANTIAL IMPAIRMENT AND POOR TREATMENT RESPONSE. YOGA INFLUENCES PROCESSES THAT ARE LINKED TO THE MAINTENANCE OF GAD INCLUDING MINDFULNESS, ANXIETY, AND HEART RATE VARIABILITY, BUT HAS YET TO BE EVALUATED AMONG PEOPLE WITH THE DISORDER. THE PRESENT STUDY IS A FIRST STEP TOWARD DOCUMENTING THE EFFICACY OF YOGA FOR REDUCING WORRY AMONG PEOPLE WITH GAD USING A SINGLE-SUBJECT AB DESIGN CASE SERIES AND DAILY RATINGS OF WORRY. STANDARDIZED SELF-REPORT MEASURES OF WORRY, TRAIT ANXIETY, EXPERIENTIAL AVOIDANCE, MINDFULNESS, AND HEART RATE VARIABILITY WERE ASSESSED PRE- AND POST-INTERVENTION. THREE PARTICIPANTS WITH PRIMARY GAD RECEIVED EIGHT TWICE-WEEKLY KRIPALU YOGA SESSIONS FOLLOWING A BASELINE DATA COLLECTION PERIOD. ALL PARTICIPANTS SHOWED SYSTEMATIC IMPROVEMENT IN DAILY WORRY RATINGS ON AT LEAST ONE INDEX AND ALL SCORES ON SELF-REPORTED MEASURES OF WORRY, ANXIETY, EXPERIENTIAL AVOIDANCE, AND MINDFULNESS CHANGED IN THE EXPECTED DIRECTION FOLLOWING YOGA (WITH ONE OR TWO EXCEPTIONS). PARTICIPANTS ALSO SHOWED IMPROVED HEART RATE VARIABILITY DURING A WORRY PERIOD FROM PRE- TO POST-INTERVENTION. YOGA HAS THE POTENTIAL TO IMPROVE THE PROCESSES LINKED TO GAD AND SHOULD STIMULATE FURTHER RESEARCH IN THIS AREA.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
17  428  37 CAN YOGA HAVE ANY EFFECT ON SHOULDER AND ARM PAIN AND QUALITY OF LIFE IN PATIENTS WITH BREAST CANCER? A RANDOMIZED, CONTROLLED, SINGLE-BLIND TRIAL. OBJECTIVE: TO EXAMINE THE EFFECTS OF YOGA ON SHOULDER AND ARM PAIN, QUALITY OF LIFE (QOL), DEPRESSION, AND PHYSICAL PERFORMANCE IN PATIENTS WITH BREAST CANCER. METHODS: THIS PROSPECTIVE, RANDOMIZED STUDY INCLUDED 42 PATIENTS. THE PATIENTS IN GROUP 1 UNDERWENT A 10-WEEK HATHA YOGA EXERCISE PROGRAM. THE PATIENTS IN GROUP 2 WERE INCLUDED IN A 10-WEEK FOLLOW-UP PROGRAM. OUR PRIMARY ENDPOINT WAS ARM AND SHOULDER PAIN INTENSITY. RESULTS: THE GROUP RECEIVING YOGA SHOWED A SIGNIFICANT IMPROVEMENT IN THEIR PAIN SEVERITY FROM BASELINE TO POST-TREATMENT, AND THESE BENEFITS WERE MAINTAINED AT 2.5 MONTHS POST-TREATMENT. WHEN COMPARED TO THE CONTROL GROUP, THERE WERE NO STATISTICALLY SIGNIFICANT DIFFERENCES BETWEEN THE 2 GROUPS WITH RESPECT TO THE PARAMETERS ASSESSED AT THE END OF WEEK 10. CONCLUSION: YOGA WAS AN EFFECTIVE AND SAFE EXERCISE FOR ALLEVIATING SHOULDER AND ARM PAIN, WHICH IS A COMPLICATION WITH A HIGH PREVALENCE IN PATIENTS WITH BREAST CANCER.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
18 1242  45 FEASIBILITY OF A YOGA INTERVENTION TO DECREASE PAIN IN OLDER WOMEN: A RANDOMIZED CONTROLLED PILOT STUDY. BACKGROUND: A SIGNIFICANT PROPORTION OF OLDER WOMEN SUFFER FROM CHRONIC PAIN, WHICH CAN DECREASE QUALITY OF LIFE. THE OBJECTIVE OF THIS PILOT RANDOMIZED STUDY WAS TO EVALUATE THE FEASIBILITY OF A FLOW-RESTORATIVE YOGA INTERVENTION DESIGNED TO DECREASE PAIN AND RELATED OUTCOMES AMONG WOMEN AGED 60 OR OLDER. METHODS: FLOW-RESTORATIVE YOGA CLASSES WERE HELD TWICE WEEKLY FOR 1 HOUR AND LED BY A CERTIFIED YOGA INSTRUCTOR. PARTICIPANTS RANDOMIZED TO THE INTERVENTION GROUP ATTENDED THE YOGA CLASSES FOR 12 WEEKS AND RECEIVED SUPPLEMENTAL MATERIALS FOR AT-HOME PRACTICE. THOSE RANDOMIZED TO THE CONTROL GROUP WERE ASKED TO MAINTAIN THEIR NORMAL DAILY ROUTINE. FEASIBILITY WAS EVALUATED USING RECRUITMENT AND RETENTION RATES, CLASS AND HOME PRACTICE ADHERENCE RATES, AND PARTICIPANT SATISFACTION SURVEYS. OUTCOME MEASURES (SELF-REPORTED PAIN, INFLAMMATORY MARKERS, FUNCTIONAL FITNESS, QUALITY OF LIFE, RESILIENCE, AND SELF-REPORTED PHYSICAL ACTIVITY) WERE ASSESSED AT BASELINE AND POST-INTERVENTION. PAIRED T-TESTS OR WILCOXON SIGNED-RANK TESTS WERE USED TO EXAMINE CHANGES IN OUTCOME MEASURES WITHIN TREATMENT GROUPS. RESULTS: THIRTY-EIGHT PARTICIPANTS WERE RECRUITED AND RANDOMIZED. PARTICIPANTS WERE PRIMARILY WHITE, COLLEGE-EDUCATED, AND HIGHER FUNCTIONING, DESPITE EXPERIENCING VARIOUS FORMS OF CHRONIC PAIN. ATTENDANCE AND RETENTION RATES WERE HIGH (91 AND 97%, RESPECTIVELY) AND THE MAJORITY OF PARTICIPANTS WERE SATISFIED WITH THE YOGA PROGRAM (89%) AND WOULD RECOMMEND IT TO OTHERS (87%). INTERVENTION PARTICIPANTS ALSO EXPERIENCED REDUCTIONS IN PAIN INTERFERENCE AND IMPROVEMENTS IN ENERGY AND SOCIAL FUNCTIONING. CONCLUSIONS: THIS PILOT STUDY PROVIDES ESSENTIAL DATA TO INFORM A FULL SCALE RANDOMIZED TRIAL OF FLOW-RESTORATIVE YOGA FOR OLDER WOMEN WITH CHRONIC PAIN. FUTURE STUDIES SHOULD EMPHASIZE STRATEGIES TO RECRUIT A MORE DIVERSE STUDY POPULATION, PARTICULARLY OLDER WOMEN AT HIGHER RISK OF DISABILITY AND FUNCTIONAL DECLINE. TRIAL REGISTRATION: CLINICALTRIALS.GOV , NCT03790098 . REGISTERED 31 DECEMBER 2018 - RETROSPECTIVELY REGISTERED.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
19 2222  48 THE IMPACT OF MODIFIED HATHA YOGA ON CHRONIC LOW BACK PAIN: A PILOT STUDY. PURPOSE: THE PURPOSE OF THIS RANDOMIZED PILOT STUDY WAS TO EVALUATE A POSSIBLE DESIGN FOR A 6-WEEK MODIFIED HATHA YOGA PROTOCOL TO STUDY THE EFFECTS ON PARTICIPANTS WITH CHRONIC LOW BACK PAIN. PARTICIPANTS: TWENTY-TWO PARTICIPANTS (M = 4; F = 17), BETWEEN THE AGES OF 30 AND 65, WITH CHRONIC LOW BACK PAIN (CLBP) WERE RANDOMIZED TO EITHER AN IMMEDIATE YOGA BASED INTERVENTION, OR TO A CONTROL GROUP WITH NO TREATMENT DURING THE OBSERVATION PERIOD BUT RECEIVED LATER YOGA TRAINING. METHODS: A SPECIFIC CLBP YOGA PROTOCOL DESIGNED AND MODIFIED FOR THIS POPULATION BY A CERTIFIED YOGA INSTRUCTOR WAS ADMINISTERED FOR ONE HOUR, TWICE A WEEK FOR 6 WEEKS. PRIMARY FUNCTIONAL OUTCOME MEASURES INCLUDED THE FORWARD REACH (FR) AND SIT AND REACH (SR) TESTS. ALL PARTICIPANTS COMPLETED OSWESTRY DISABILITY INDEX (ODI) AND BECK DEPRESSION INVENTORY (BDI) QUESTIONNAIRES. GUIDING QUESTIONS WERE USED FOR QUALITATIVE DATA ANALYSIS TO ASCERTAIN HOW YOGA PARTICIPANTS PERCEIVED THE INSTRUCTOR, GROUP DYNAMICS, AND THE IMPACT OF YOGA ON THEIR LIFE. ANALYSIS: TO ACCOUNT FOR DROP OUTS, THE DATA WERE DIVIDED INTO BETTER OR NOT CATEGORIES, AND ANALYZED USING CHI-SQUARE TO EXAMINE DIFFERENCES BETWEEN THE GROUPS. QUALITATIVE DATA WERE ANALYZED THROUGH FREQUENCY OF POSITIVE RESPONSES. RESULTS: POTENTIALLY IMPORTANT TRENDS IN THE FUNCTIONAL MEASUREMENT SCORES SHOWED IMPROVED BALANCE AND FLEXIBILITY AND DECREASED DISABILITY AND DEPRESSION FOR THE YOGA GROUP BUT THIS PILOT WAS NOT POWERED TO REACH STATISTICAL SIGNIFICANCE. SIGNIFICANT LIMITATIONS INCLUDED A HIGH DROPOUT RATE IN THE CONTROL GROUP AND LARGE BASELINE DIFFERENCES IN THE SECONDARY MEASURES. IN ADDITION, ANALYSIS OF THE QUALITATIVE DATA REVEALED THE FOLLOWING FREQUENCY OF RESPONSES (1) GROUP INTERVENTION MOTIVATED THE PARTICIPANTS AND (2) YOGA FOSTERED RELAXATION AND NEW AWARENESS/LEARNING. CONCLUSION: A MODIFIED YOGA-BASED INTERVENTION MAY BENEFIT INDIVIDUALS WITH CLB, BUT A LARGER STUDY IS NECESSARY TO PROVIDE DEFINITIVE EVIDENCE. ALSO, THE IMPACT ON DEPRESSION AND DISABILITY COULD BE CONSIDERED AS IMPORTANT OUTCOMES FOR FURTHER STUDY. ADDITIONAL FUNCTIONAL OUTCOME MEASURES SHOULD BE EXPLORED. THIS PILOT STUDY SUPPORTS THE NEED FOR MORE RESEARCH INVESTIGATING THE EFFECT OF YOGA FOR THIS POPULATION.	2004	
                                                                                                                                                                                                                                                                                                                                                  
20  159  44 A RANDOMISED COMPARATIVE TRIAL OF YOGA AND RELAXATION TO REDUCE STRESS AND ANXIETY. OBJECTIVE: TO COMPARE YOGA AND RELAXATION AS TREATMENT MODALITIES AT 10 AND 16 WEEKS FROM STUDY BASELINE TO DETERMINE IF EITHER OF MODALITY REDUCES SUBJECT STRESS, ANXIETY, BLOOD PRESSURE AND IMPROVE QUALITY OF LIFE. DESIGN: A RANDOMISED COMPARATIVE TRIAL WAS UNDERTAKEN COMPARING YOGA WITH RELAXATION. PARTICIPANTS: ONE HUNDRED AND THIRTY-ONE SUBJECTS WITH MILD TO MODERATE LEVELS OF STRESS WERE RECRUITED FROM THE COMMUNITY IN SOUTH AUSTRALIA. INTERVENTIONS: TEN WEEKLY 1- H SESSIONS OF RELAXATION OR HATHA YOGA. MAIN OUTCOME MEASURES: CHANGES IN THE STATE TRAIT PERSONALITY INVENTORY SUB-SCALE ANXIETY, GENERAL HEALTH QUESTIONNAIRE AND THE SHORT FORM-36. RESULTS: FOLLOWING THE 10 WEEK INTERVENTION STRESS, ANXIETY AND QUALITY OF LIFE SCORES IMPROVED OVER TIME. YOGA WAS FOUND TO BE AS EFFECTIVE AS RELAXATION IN REDUCING STRESS, ANXIETY AND IMPROVING HEALTH STATUS ON SEVEN DOMAINS OF THE SF-36. YOGA WAS MORE EFFECTIVE THAN RELAXATION IN IMPROVING MENTAL HEALTH. AT THE END OF THE 6 WEEK FOLLOW-UP PERIOD THERE WERE NO DIFFERENCES BETWEEN GROUPS IN LEVELS OF STRESS, ANXIETY AND ON FIVE DOMAINS OF THE SF-36. VITALITY, SOCIAL FUNCTION AND MENTAL HEALTH SCORES ON THE SF-36 WERE HIGHER IN THE RELAXATION GROUP DURING THE FOLLOW-UP PERIOD. CONCLUSION: YOGA APPEARS TO PROVIDE A COMPARABLE IMPROVEMENT IN STRESS, ANXIETY AND HEALTH STATUS COMPARED TO RELAXATION.	2007