1  557 143 COST-EFFECTIVENESS OF YOGA FOR CHRONIC LOW BACK PAIN IN VETERANS. BACKGROUND: YOGA INTERVENTIONS CAN IMPROVE FUNCTION AND REDUCE PAIN IN PERSONS WITH CHRONIC LOW BACK PAIN (CLBP). OBJECTIVE: USING DATA FROM A RECENT TRIAL OF YOGA FOR MILITARY VETERANS WITH CLBP, WE ANALYZED THE INCREMENTAL COST-EFFECTIVENESS OF YOGA COMPARED WITH USUAL CARE. METHODS: PARTICIPANTS (N=150) WERE RANDOMIZED TO EITHER 2X WEEKLY, 60-MINUTE YOGA SESSIONS FOR 12 WEEKS, OR TO DELAYED TREATMENT (DT). OUTCOMES WERE MEASURED AT 12 WEEKS, AND 6 MONTHS. QUALITY-ADJUSTED LIFE YEARS (QALYS) WERE MEASURED USING THE EQ-5D SCALE. A 30% IMPROVEMENT ON THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE (PRIMARY OUTCOME) SERVED AS AN ADDITIONAL EFFECTIVENESS MEASURE. INTERVENTION COSTS INCLUDING PERSONNEL, MATERIALS, AND TRANSPORTATION WERE TRACKED DURING THE STUDY. HEALTH CARE COSTS WERE OBTAINED FROM PATIENT MEDICAL RECORDS. HEALTH CARE ORGANIZATION AND SOCIETAL PERSPECTIVES WERE EXAMINED WITH A 12-MONTH HORIZON. RESULTS: INCREMENTAL QALYS GAINED BY THE YOGA GROUP OVER 12 MONTHS WERE 0.043. INTERVENTION COSTS TO DELIVER YOGA WERE $307/PARTICIPANT. NEGLIGIBLE DIFFERENCES IN HEALTH CARE COSTS WERE FOUND BETWEEN GROUPS. FROM THE HEALTH CARE ORGANIZATION PERSPECTIVE, THE INCREMENTAL COST-EFFECTIVENESS RATIO TO PROVIDE YOGA WAS $4488/QALY. FROM THE SOCIETAL PERSPECTIVE, YOGA WAS "DOMINANT" PROVIDING BOTH HEALTH BENEFIT AND COST SAVINGS. PROBABILISTIC SENSITIVITY ANALYSIS INDICATES AN 89% CHANCE OF YOGA BEING COST-EFFECTIVE AT A WILLINGNESS-TO-PAY OF $50,000. A SCENARIO COMPARING THE COSTS OF YOGA AND PHYSICAL THERAPY SUGGEST THAT YOGA MAY PRODUCE SIMILAR RESULTS AT A MUCH LOWER COST. DISCUSSION/CONCLUSIONS: YOGA IS A COST-EFFECTIVE TREATMENT FOR REDUCING PAIN AND DISABILITY AMONG MILITARY VETERANS WITH CLBP.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
2  132  62 A PRAGMATIC MULTICENTERED RANDOMIZED CONTROLLED TRIAL OF YOGA FOR CHRONIC LOW BACK PAIN: ECONOMIC EVALUATION. STUDY DESIGN: MULTICENTERED RANDOMIZED CONTROLLED TRIAL WITH QUALITY OF LIFE AND RESOURCE USE DATA COLLECTED. OBJECTIVE: THE OBJECTIVE OF THIS STUDY WAS TO EVALUATE THE COST-EFFECTIVENESS OF YOGA INTERVENTION PLUS USUAL CARE COMPARED WITH USUAL CARE ALONE FOR CHRONIC OR RECURRENT LOW BACK PAIN. SUMMARY OF BACKGROUND DATA: YOGA HAS BEEN SHOWN AS AN EFFECTIVE INTERVENTION FOR TREATING CHRONIC OR RECURRENT LOW BACK PAIN. HOWEVER, THERE IS LITTLE EVIDENCE ON ITS COST-EFFECTIVENESS. THE DATA ARE EXTRACTED FROM A PRAGMATIC, MULTICENTERED, RANDOMIZED CONTROLLED TRIAL THAT HAS BEEN CONDUCTED TO EVALUATE THE EFFECTIVENESS AND COST-EFFECTIVENESS OF A 12-WEEK PROGRESSIVE PROGRAM OF YOGA PLUS USUAL CARE IN PATIENTS WITH CHRONIC OR RECURRENT LOW BACK PAIN. METHODS: WITH THIS TRIAL DATA, A COST-EFFECTIVENESS ANALYSIS DURING THE TIME PERIOD OF 12 MONTHS FROM BOTH PERSPECTIVES OF THE UK NATIONAL HEALTH SERVICE AND THE SOCIETAL IS PRESENTED. MAIN OUTCOME MEASURE IS AN INCREMENTAL COST PER QUALITY-ADJUSTED LIFE-YEAR (QALY). RESULTS: FROM THE PERSPECTIVE OF THE U.K. NATIONAL HEALTH SERVICE, YOGA INTERVENTION YIELDS AN INCREMENTAL COST-EFFECTIVENESS RATIO OF POUND13,606 PER QALY. GIVEN A WILLINGNESS TO PAY FOR AN ADDITIONAL QALY OF POUND20,000, THE PROBABILITY OF YOGA INTERVENTION BEING COST-EFFECTIVE IS 72%. FROM THE PERSPECTIVE OF THE SOCIETY, YOGA INTERVENTION IS A DOMINANT TREATMENT COMPARED WITH USUAL CARE ALONE. THIS RESULT IS SURROUNDED BY FEWER UNCERTAINTIES-THE PROBABILITY OF YOGA BEING COST-EFFECTIVE REACHES 95% AT A WILLINGNESS TO PAY FOR AN ADDITIONAL QALY OF POUND20,000. SENSITIVE ANALYSES SUGGEST THE SAME RESULTS THAT YOGA INTERVENTION IS LIKELY TO BE COST-EFFECTIVE IN BOTH PERSPECTIVES. CONCLUSION: ON THE BASIS OF THIS TRIAL, 12 WEEKLY GROUP CLASSES OF SPECIALIZED YOGA ARE LIKELY TO BE A COST-EFFECTIVE INTERVENTION FOR TREATING PATIENTS WITH CHRONIC OR RECURRENT LOW BACK PAIN.	2012	
                                                                                                                                                                                                                                                                                                                                
3  556  50 COST-EFFECTIVENESS OF EARLY INTERVENTIONS FOR NON-SPECIFIC LOW BACK PAIN: A RANDOMIZED CONTROLLED STUDY INVESTIGATING MEDICAL YOGA, EXERCISE THERAPY AND SELF-CARE ADVICE. OBJECTIVE: TO EVALUATE THE COST-EFFECTIVENESS OF MEDICAL YOGA AS AN EARLY INTERVENTION COMPARED WITH EVIDENCE-BASED EXERCISE THERAPY AND SELF-CARE ADVICE FOR NON-SPECIFIC LOW BACK PAIN. DESIGN: RANDOMIZED CONTROLLED TRIAL WITH A COST-EFFECTIVENESS ANALYSIS. SUBJECTS: A TOTAL OF 159 PARTICIPANTS RANDOMIZED INTO THE MEDICAL YOGA GROUP (N = 52), THE EXERCISE THERAPY GROUP (N = 52) AND THE SELF-CARE ADVICE GROUP (N = 55). METHODS: THE HEALTH OUTCOME MEASURE EQ-5D WAS APPLIED TO MEASURE QUALITY OF LIFE DATA COMBINED WITH COST DATA COLLECTED FROM TREATMENT GROUPS FROM BASELINE TO 12 MONTHS FOLLOW-UP. OUTCOME MEASURE WAS HEALTH-RELATED QUALITY OF LIFE (HRQL). INCREMENTAL COST PER QUALITY ADJUSTED LIFE YEAR (QALY) WAS ALSO CALCULATED. COST-EFFECTIVENESS ANALYSIS WAS CONDUCTED PRIMARILY FROM THE SOCIETAL AND EMPLOYER PERSPECTIVES. RESULTS: MEDICAL YOGA IS COST-EFFECTIVE COMPARED WITH SELF-CARE ADVICE IF AN EMPLOYER CONSIDERS THE SIGNIFICANT IMPROVEMENT IN THE HRQL OF AN EMPLOYEE WITH LOW BACK PAIN JUSTIFIES THE ADDITIONAL COST OF TREATMENT (I.E. IN THIS STUDY EUR 150). FROM A SOCIETAL PERSPECTIVE, MEDICAL YOGA IS A COST-EFFECTIVE TREATMENT COMPARED WITH EXERCISE THERAPY AND SELF-CARE ADVICE IF AN ADDITIONAL QALY IS WORTH EUR 11,500. SENSITIVITY ANALYSIS SUGGESTS THAT MEDICAL YOGA IS MORE COST-EFFECTIVE THAN ITS ALTERNATIVES. CONCLUSION: SIX WEEKS OF UNINTERRUPTED MEDICAL YOGA THERA-PY IS A COST-EFFECTIVE EARLY INTERVENTION FOR NON-SPECIFIC LOW BACK PAIN, WHEN TREATMENT RECOMMENDATIONS ARE ADHERED TO.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
4 1953  58 SECONDARY OUTCOMES FROM A RANDOMIZED CONTROLLED TRIAL OF YOGA FOR VETERANS WITH CHRONIC LOW-BACK PAIN. CHRONIC LOW-BACK PAIN (CLBP) IS A PREVALENT CONDITION, AND RATES ARE HIGHER AMONG MILITARY VETERANS. CLBP IS A PERSISTENT CONDITION, AND TREATMENT OPTIONS HAVE EITHER MODEST EFFECTS OR A SIGNIFICANT RISK OF SIDE-EFFECTS, WHICH HAS LED TO RECENT EFFORTS TO EXPLORE MIND-BODY INTERVENTION OPTIONS AND REDUCE OPIOID MEDICATION USE. PRIOR STUDIES OF YOGA FOR CLBP IN COMMUNITY SAMPLES, AND THE MAIN RESULTS OF A RECENT TRIAL WITH MILITARY VETERANS, INDICATE THAT YOGA CAN REDUCE BACK-RELATED DISABILITY AND PAIN INTENSITY. SECONDARY OUTCOMES FROM THE TRIAL OF YOGA WITH MILITARY VETERANS ARE PRESENTED HERE. IN THE STUDY, 150 MILITARY VETERANS (VETERANS ADMINISTRATION PATIENTS) WITH CLBP WERE RANDOMIZED TO EITHER YOGA OR A DELAYED-TREATMENT GROUP RECEIVING USUAL CARE BETWEEN 2013 AND 2015. ASSESSMENTS OCCURRED AT BASELINE, 6 WEEKS, 12 WEEKS, AND 6 MONTHS. INTENT-TO-TREAT ANALYSES WERE CONDUCTED. YOGA CLASSES LASTING 60 MINUTES EACH WERE OFFERED TWICE WEEKLY FOR 12 WEEKS. YOGA SESSIONS CONSISTED OF PHYSICAL POSTURES, MOVEMENT, FOCUSED ATTENTION, AND BREATHING TECHNIQUES. HOME PRACTICE GUIDED BY A MANUAL WAS STRONGLY RECOMMENDED. THE PRIMARY OUTCOME MEASURE WAS ROLAND-MORRIS DISABILITY QUESTIONNAIRE SCORES AFTER 12 WEEKS. SECONDARY OUTCOMES INCLUDED PAIN INTENSITY, PAIN INTERFERENCE, DEPRESSION, FATIGUE, QUALITY OF LIFE, SELF-EFFICACY, AND MEDICATION USAGE. YOGA PARTICIPANTS IMPROVED MORE THAN DELAYED-TREATMENT PARTICIPANTS ON PAIN INTERFERENCE, FATIGUE, QUALITY OF LIFE, AND SELF-EFFICACY AT 12 WEEKS AND/OR 6 MONTHS. YOGA PARTICIPANTS HAD GREATER IMPROVEMENTS ACROSS A NUMBER OF IMPORTANT SECONDARY HEALTH OUTCOMES COMPARED TO CONTROLS. BENEFITS EMERGED DESPITE SOME VETERANS FACING CHALLENGES WITH ATTENDING YOGA SESSIONS IN PERSON. THE FINDINGS SUPPORT WIDER IMPLEMENTATION OF YOGA PROGRAMS FOR VETERANS, WITH ATTENTION TO INCREASING ACCESSIBILITY OF YOGA PROGRAMS IN THIS POPULATION.	2020	
                                                                                                                                                                                                                                                                                                                                             
5  558  58 COST-EFFECTIVENESS OF YOGA FOR MANAGING MUSCULOSKELETAL CONDITIONS IN THE WORKPLACE. BACKGROUND: BACK PAIN AND MUSCULOSKELETAL CONDITIONS NEGATIVELY AFFECT THE HEALTH-RELATED QUALITY OF LIFE (HRQL) OF EMPLOYEES AND GENERATE SUBSTANTIAL COSTS TO EMPLOYERS. AIMS: TO ASSESS THE COST-EFFECTIVENESS OF YOGA FOR MANAGING MUSCULOSKELETAL CONDITIONS. METHODS: A RANDOMIZED CONTROLLED TRIAL EVALUATED AN 8-WEEK YOGA PROGRAMME, WITH A 6-MONTH FOLLOW-UP, FOR NATIONAL HEALTH SERVICE (NHS) EMPLOYEES. EFFECTIVENESS IN MANAGING MUSCULOSKELETAL CONDITIONS WAS ASSESSED USING REPEATED-MEASURES GENERALIZED LINEAR MODELLING FOR THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE (RDQ) AND THE KEELE START BACK SCREENING TOOL. COST-EFFECTIVENESS WAS DETERMINED USING AREA-UNDER-THE-CURVE LINEAR REGRESSION FOR ASSESSING HRQL FROM HEALTHCARE AND SOCIETAL PERSPECTIVES. THE INCREMENTAL COST PER QUALITY-ADJUSTED LIFE YEAR (QALY) WAS ALSO CALCULATED. SICKNESS ABSENCE WAS MEASURED USING ELECTRONIC STAFF RECORDS AT 6 MONTHS. RESULTS: THERE WERE 151 PARTICIPANTS. AT 6 MONTHS, MEAN DIFFERENCES BETWEEN GROUPS FAVOURING YOGA WERE OBSERVED FOR RDQ [-0.63 (95% CI, -1.78, 0.48)], KEELE START [-0.28 (95% CI, -0.97, 0.07)] AND HRQL (0.016 QALY GAIN). FROM A HEALTHCARE PERSPECTIVE, YOGA YIELDED AN INCREMENTAL COST-EFFECTIVENESS RATIO OF POUND2103 PER QALY. GIVEN A WILLINGNESS TO PAY FOR AN ADDITIONAL QALY OF POUND20 000, THE PROBABILITY OF YOGA BEING COST-EFFECTIVE WAS 95%. FROM A SOCIETAL PERSPECTIVE, YOGA WAS THE DOMINANT TREATMENT COMPARED WITH USUAL CARE. AT 6 MONTHS, ELECTRONIC STAFF RECORDS SHOWED THAT YOGA PARTICIPANTS MISSED A TOTAL OF 2 WORKING DAYS DUE TO MUSCULOSKELETAL CONDITIONS COMPARED WITH 43 DAYS FOR USUAL CARE PARTICIPANTS. CONCLUSIONS: YOGA FOR NHS EMPLOYEES MAY ENHANCE HRQL, REDUCE DISABILITY ASSOCIATED WITH BACK PAIN, LOWER SICKNESS ABSENCE DUE TO MUSCULOSKELETAL CONDITIONS AND IS LIKELY TO BE COST-EFFECTIVE.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                        
6  721  53 EFFECT OF IYENGAR YOGA THERAPY FOR CHRONIC LOW BACK PAIN. LOW BACK PAIN IS A SIGNIFICANT PUBLIC HEALTH PROBLEM AND ONE OF THE MOST COMMONLY REPORTED REASONS FOR THE USE OF COMPLEMENTARY ALTERNATIVE MEDICINE. A RANDOMIZED CONTROL TRIAL WAS CONDUCTED IN SUBJECTS WITH NON-SPECIFIC CHRONIC LOW BACK PAIN COMPARING IYENGAR YOGA THERAPY TO AN EDUCATIONAL CONTROL GROUP. BOTH PROGRAMS WERE 16 WEEKS LONG. SUBJECTS WERE PRIMARILY SELF-REFERRED AND SCREENED BY PRIMARY CARE PHYSICIANS FOR STUDY OF INCLUSION/EXCLUSION CRITERIA. THE PRIMARY OUTCOME FOR THE STUDY WAS FUNCTIONAL DISABILITY. SECONDARY OUTCOMES INCLUDING PRESENT PAIN INTENSITY, PAIN MEDICATION USAGE, PAIN-RELATED ATTITUDES AND BEHAVIORS, AND SPINAL RANGE OF MOTION WERE MEASURED BEFORE AND AFTER THE INTERVENTIONS. SUBJECTS HAD LOW BACK PAIN FOR 11.2+/-1.54 YEARS AND 48% USED PAIN MEDICATION. OVERALL, SUBJECTS PRESENTED WITH LESS PAIN AND LOWER FUNCTIONAL DISABILITY THAN SUBJECTS IN OTHER PUBLISHED INTERVENTION STUDIES FOR CHRONIC LOW BACK PAIN. OF THE 60 SUBJECTS ENROLLED, 42 (70%) COMPLETED THE STUDY. MULTIVARIATE ANALYSES OF OUTCOMES IN THE CATEGORIES OF MEDICAL, FUNCTIONAL, PSYCHOLOGICAL AND BEHAVIORAL FACTORS INDICATED THAT SIGNIFICANT DIFFERENCES BETWEEN GROUPS EXISTED IN FUNCTIONAL AND MEDICAL OUTCOMES BUT NOT FOR THE PSYCHOLOGICAL OR BEHAVIORAL OUTCOMES. UNIVARIATE ANALYSES OF MEDICAL AND FUNCTIONAL OUTCOMES REVEALED SIGNIFICANT REDUCTIONS IN PAIN INTENSITY (64%), FUNCTIONAL DISABILITY (77%) AND PAIN MEDICATION USAGE (88%) IN THE YOGA GROUP AT THE POST AND 3-MONTH FOLLOW-UP ASSESSMENTS. THESE PRELIMINARY DATA INDICATE THAT THE MAJORITY OF SELF-REFERRED PERSONS WITH MILD CHRONIC LOW BACK PAIN WILL COMPLY TO AND REPORT IMPROVEMENT ON MEDICAL AND FUNCTIONAL PAIN-RELATED OUTCOMES FROM IYENGAR YOGA THERAPY.	2005	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
7 1413  28 IMPLEMENTING YOGA INTO THE MANAGEMENT OF PATIENTS WITH REFRACTORY LOW BACK PAIN IN AN OUTPATIENT CLINIC SETTING. PURPOSE: TO EVALUATE THE EFFECTIVENESS OF IMPLEMENTING YOGA INTO THE TREATMENT OF PATIENTS WITH CHRONIC LOW BACK PAIN. DESIGN: QUANTITATIVE ANALYSIS WITH OPPORTUNITY FOR QUALITATIVE FEEDBACK. METHOD: EFFECTIVENESS OF THIS COMPLEMENTARY TREATMENT WAS ASSESSED USING A PRETEST/POSTTEST DESIGN OF PATIENTS WHO VOLUNTEERED TO PARTICIPATE IN YOGA CLASSES AS PART OF THEIR BACK PAIN MANAGEMENT. MEASUREMENTS INCLUDED LOW BACK PAIN RATING, PERCEPTION OF BACK PAIN INTERFERENCE WITH DAILY ACTIVITIES, AND SELF-EFFICACY IN DEALING WITH CHRONIC LOW BACK PAIN. FINDINGS: ALTHOUGH NO STATISTICALLY SIGNIFICANT FINDINGS WERE FOUND DUE TO THE SMALL SAMPLE SIZE, MOST PARTICIPANTS DEMONSTRATED IMPROVED INDIVIDUAL SCORES ON ALL MEASUREMENT SURVEYS INCLUDING QUALITATIVE COMMENTS. CONCLUSION: BASED ON THE FINDINGS OF THIS PILOT STUDY, FURTHER STUDIES ON IMPLEMENTING YOGA INTO THE TREATMENT OF CHRONIC LOW BACK PAIN ARE ENCOURAGED.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
8 2824  59 YOGA VERSUS EDUCATION FOR VETERANS WITH CHRONIC LOW BACK PAIN: STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN IS THE MOST FREQUENT PAIN CONDITION IN VETERANS AND CAUSES SUBSTANTIAL SUFFERING, DECREASED FUNCTIONAL CAPACITY, AND LOWER QUALITY OF LIFE. SYMPTOMS OF POST-TRAUMATIC STRESS, DEPRESSION, AND MILD TRAUMATIC BRAIN INJURY ARE HIGHLY PREVALENT IN VETERANS WITH BACK PAIN. YOGA FOR LOW BACK PAIN HAS BEEN DEMONSTRATED TO BE EFFECTIVE FOR CIVILIANS IN RANDOMIZED CONTROLLED TRIALS. HOWEVER, IT IS UNKNOWN IF RESULTS FROM PREVIOUSLY PUBLISHED TRIALS GENERALIZE TO MILITARY POPULATIONS. METHODS/DESIGN: THIS STUDY IS A PARALLEL RANDOMIZED CONTROLLED TRIAL COMPARING YOGA TO EDUCATION FOR 120 VETERANS WITH CHRONIC LOW BACK PAIN. PARTICIPANTS ARE VETERANS >/=18 YEARS OLD WITH LOW BACK PAIN PRESENT ON AT LEAST HALF THE DAYS IN THE PAST SIX MONTHS AND A SELF-REPORTED AVERAGE PAIN INTENSITY IN THE PREVIOUS WEEK OF >/=4 ON A 0-10 SCALE. THE 24-WEEK STUDY HAS AN INITIAL 12-WEEK INTERVENTION PERIOD, WHERE PARTICIPANTS ARE RANDOMIZED EQUALLY INTO (1) A STANDARDIZED WEEKLY GROUP YOGA CLASS WITH HOME PRACTICE OR (2) EDUCATION DELIVERED WITH A SELF-CARE BOOK. PRIMARY OUTCOME MEASURES ARE CHANGE AT 12 WEEKS IN LOW BACK PAIN INTENSITY MEASURED BY THE DEFENSE AND VETERANS PAIN RATING SCALE (0-10) AND BACK-RELATED FUNCTION USING THE 23-POINT ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 12-WEEK FOLLOW-UP PERIOD, YOGA PARTICIPANTS ARE ENCOURAGED TO CONTINUE HOME YOGA PRACTICE AND EDUCATION PARTICIPANTS CONTINUE FOLLOWING RECOMMENDATIONS FROM THE BOOK. QUALITATIVE INTERVIEWS WITH VETERANS IN THE YOGA GROUP AND THEIR PARTNERS EXPLORE THE IMPACT OF CHRONIC LOW BACK PAIN AND YOGA ON FAMILY RELATIONSHIPS. WE ALSO ASSESS COST-EFFECTIVENESS FROM THREE PERSPECTIVES: THE VETERAN, THE VETERANS HEALTH ADMINISTRATION, AND SOCIETY USING ELECTRONIC MEDICAL RECORDS, SELF-REPORTED COST DATA, AND STUDY RECORDS. DISCUSSION: THIS STUDY WILL HELP DETERMINE IF YOGA CAN BECOME AN EFFECTIVE TREATMENT FOR VETERANS WITH CHRONIC LOW BACK PAIN AND PSYCHOLOGICAL COMORBIDITIES. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT02224183.	2016	
                                                                                                                                                                           
9 2374  53 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	
                         
10 1242  47 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	
                                                                                                                                                                                 
11 2579  34 YOGA FOR HEALTH-RELATED QUALITY OF LIFE IN ADULT CANCER: A RANDOMIZED CONTROLLED FEASIBILITY STUDY. AN INCREASE IN PATIENT-LED UPTAKE OF COMPLEMENTARY THERAPIES IN ADULT CANCER HAS LED TO A NEED FOR MORE RIGOROUS STUDY OF SUCH INTERVENTIONS AND THEIR OUTCOMES. THIS STUDY THEREFORE AIMED TO EVALUATE THE FEASIBILITY AND ACCEPTABILITY OF A YOGA INTERVENTION IN MEN AND WOMEN RECEIVING CONVENTIONAL TREATMENT FOR A CANCER DIAGNOSIS. PROSPECTIVE, MIXED METHODS FEASIBILITY TRIAL ALLOCATED PARTICIPANTS TO RECEIVE ONE OF THREE YOGA INTERVENTIONS OVER A FOUR-WEEK STUDY PERIOD. DATA COLLECTION WAS COMPLETED THROUGH ONLINE SURVEY OF QOL-CA/CS AND CUSTOMIZED SURVEYS. FIFTEEN PARTICIPANTS WERE INCLUDED (11 FEMALE) UNDERGOING TREATMENT FOR BREAST, PROSTATE, COLORECTAL, BRAIN, AND BLOOD AND LUNG CANCER. TWO PARTICIPANTS DROPPED OUT AND COMPLETE QUALITATIVE AND QUANTITATIVE DATA SETS WERE COLLECTED FROM 12 PARTICIPANTS AND FOUR YOGA INSTRUCTORS. OTHER OUTCOME MEASURES INCLUDED IMPLEMENTATION COSTS PATIENT-REPORTED PREFERENCES FOR YOGA INTERVENTION AND CHANGES IN QOL-CA/CS. THREE TYPES OF YOGA INTERVENTION WERE SAFELY ADMINISTERED IN ADULT CANCER. MIXED METHODS, COST-EFFICIENCY, QOL-CA/CS, AND EVIDENCE-BASED DESIGN OF YOGA INTERVENTION HAVE BEEN USED TO ESTABLISH FEASIBILITY AND PATIENT-PREFERENCES FOR YOGA DELIVERY IN ADULT CANER. RESULTS SUGGEST THAT, WITH SOME METHODOLOGICAL IMPROVEMENTS, A LARGE-SCALE RANDOMIZED CONTROLLED TRIAL IS WARRANTED TO TEST THE EFFICACY OF YOGA FOR MALE AND FEMALE CANCER PATIENTS. THIS TRIAL IS REGISTERED WITH CLINICALTRIALS.GOV NCT02309112.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
12 2470  42 YOGA AS A TREATMENT FOR CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW OF THE LITERATURE. OBJECTIVES: CHRONIC LOW BACK PAIN (CLBP) AFFECTS MILLIONS OF PEOPLE WORLDWIDE, AND APPEARS TO BE INCREASING IN PREVALENCE. IT IS ASSOCIATED NOT ONLY WITH PAIN, BUT ALSO WITH INCREASED DISABILITY, PSYCHOLOGICAL SYMPTOMS, AND REDUCED QUALITY OF LIFE. THERE ARE VARIOUS TREATMENT OPTIONS FOR CLBP, BUT NO SINGLE THERAPY STANDS OUT AS BEING THE MOST EFFECTIVE. IN THE PAST 10 YEARS, YOGA INTERVENTIONS HAVE BEEN STUDIED AS A CLBP TREATMENT APPROACH. THE OBJECTIVE OF THIS PAPER IS TO REVIEW THE CURRENT LITERATURE SUPPORTING THE EFFICACY OF YOGA FOR CLBP. METHODS: A LITERATURE SEARCH THROUGH THE BEGINNING OF 2015 WAS CONDUCTED IN PUB MED FOR RANDOMIZED CONTROL TRIALS ADDRESSING TREATMENT OF CLBP WITH YOGA. RESULTS: IN THIS REVIEW WE EVALUATE THE USE OF YOGA AS A TREATMENT FOR CLBP. SPECIFICALLY WE EVALUATE HOW YOGA IMPACTS PHYSICAL FUNCTIONING AND DISABILITY, PAIN, AND ASSOCIATED PSYCHOLOGICAL SYMPTOMS. WE ALSO EVALUATE POSSIBLE MEDIATORS OF THE EFFECT OF YOGA AND THE SAFETY OF YOGA. DISCUSSION: WITH FEW EXCEPTIONS, PREVIOUS STUDIES AND THE RECENT RANDOMIZED CONTROL TRIALS (RCTS) INDICATE THAT YOGA CAN REDUCE PAIN AND DISABILITY, CAN BE PRACTICED SAFELY, AND IS WELL RECEIVED BY PARTICIPANTS. SOME STUDIES ALSO INDICATE THAT YOGA MAY IMPROVE PSYCHOLOGICAL SYMPTOMS, BUT THESE EFFECTS ARE CURRENTLY NOT AS WELL ESTABLISHED.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
13 2598  51 YOGA FOR OLDER ADULTS WITH MULTIMORBIDITY (THE GENTLE YEARS YOGA TRIAL): STUDY PROTOCOL FOR A RANDOMISED CONTROLLED TRIAL. BACKGROUND: MULTIMORBIDITY IS COMMON IN OLDER ADULTS AND ASSOCIATED WITH HIGH LEVELS OF ILLNESS BURDEN AND HEALTHCARE EXPENDITURE. THE EVIDENCE BASE FOR HOW TO MANAGE OLDER ADULTS WITH MULTIMORBIDITY IS WEAK. YOGA MIGHT BE A USEFUL INTERVENTION BECAUSE IT HAS THE POTENTIAL TO IMPROVE HEALTH-RELATED QUALITY OF LIFE, PHYSICAL FUNCTIONING, AND SEVERAL MEDICAL CONDITIONS. THE BRITISH WHEEL OF YOGA'S GENTLE YEARS YOGA(C) (GYY) PROGRAMME WAS DEVELOPED SPECIFICALLY FOR OLDER ADULTS, INCLUDING THOSE WITH CHRONIC MEDICAL CONDITIONS. DATA FROM A PILOT TRIAL SUGGESTED FEASIBILITY OF USING GYY IN THIS POPULATION, BUT ITS EFFECTIVENESS AND COST-EFFECTIVENESS REMAIN UNCERTAIN. METHODS: THIS IS A MULTI-SITE, INDIVIDUALLY RANDOMISED, SUPERIORITY TRIAL WITH AN EMBEDDED PROCESS EVALUATION AND AN ECONOMIC ANALYSIS OF COST-EFFECTIVENESS. THE TRIAL WILL COMPARE AN EXPERIMENTAL STRATEGY OF OFFERING A 12-WEEK GYY PROGRAMME AGAINST A CONTROL STRATEGY OF NO OFFER IN COMMUNITY-DWELLING ADULTS AGED 65 OR OVER WHO HAVE MULTIMORBIDITY, DEFINED AS HAVING TWO OR MORE CHRONIC CONDITIONS FROM A PREDEFINED LIST. THE PRIMARY OUTCOME IS HEALTH-RELATED QUALITY OF LIFE MEASURED USING THE EQ-5D-5L, THE PRIMARY ENDPOINT BEING THE OVERALL DIFFERENCE OVER 12 MONTHS. BOTH GROUPS WILL CONTINUE TO BE ABLE TO ACCESS THEIR USUAL CARE FROM PRIMARY, SECONDARY, COMMUNITY, AND SOCIAL SERVICES. PARTICIPANTS, CARE PROVIDERS, AND YOGA TEACHERS WILL NOT BE BLINDED TO THE ALLOCATED INTERVENTION. OUTCOME MEASURES ARE PRIMARILY SELF-REPORTED. THE ANALYSIS WILL FOLLOW INTENTION-TO-TREAT PRINCIPLES. DISCUSSION: THIS PRAGMATIC RANDOMISED CONTROLLED TRIAL WILL DEMONSTRATE IF THE GYY PROGRAMME IS AN EFFECTIVE, COST-EFFECTIVE, AND VIABLE ADDITION TO THE MANAGEMENT OF OLDER ADULTS WITH MULTIMORBIDITY. TRIAL REGISTRATION: ISRCTN ISRCTN13567538 . REGISTERED ON 18 MARCH 2019.	2021	
                                                                                                                                                                                                                                                                                                                                                                                  
14 2638  56 YOGA FOR VETERANS WITH CHRONIC LOW BACK PAIN: DESIGN AND METHODS OF A RANDOMIZED CLINICAL TRIAL. CHRONIC LOW BACK PAIN (CLBP) AFFLICTS MILLIONS OF PEOPLE WORLDWIDE, WITH PARTICULARLY HIGH PREVALENCE IN MILITARY VETERANS. MANY TREATMENT OPTIONS EXIST FOR CLBP, BUT MOST HAVE LIMITED EFFECTIVENESS AND SOME HAVE SIGNIFICANT SIDE EFFECTS. IN GENERAL POPULATIONS WITH CLBP, YOGA HAS BEEN SHOWN TO IMPROVE HEALTH OUTCOMES WITH FEW SIDE EFFECTS. HOWEVER, YOGA HAS NOT BEEN ADEQUATELY STUDIED IN MILITARY VETERAN POPULATIONS. IN THE CURRENT PAPER WE WILL DESCRIBE THE DESIGN AND METHODS OF A RANDOMIZED CLINICAL TRIAL AIMED AT EXAMINING WHETHER YOGA CAN EFFECTIVELY REDUCE DISABILITY AND PAIN IN US MILITARY VETERANS WITH CLBP. A TOTAL OF 144 US MILITARY VETERANS WITH CLBP WILL BE RANDOMIZED TO EITHER YOGA OR A DELAYED TREATMENT COMPARISON GROUP. THE YOGA INTERVENTION WILL CONSIST OF 2X WEEKLY YOGA CLASSES FOR 12WEEKS, COMPLEMENTED BY REGULAR HOME PRACTICE GUIDED BY A MANUAL. THE DELAYED TREATMENT GROUP WILL RECEIVE THE SAME INTERVENTION AFTER SIX MONTHS. THE PRIMARY OUTCOME IS THE CHANGE IN BACK PAIN-RELATED DISABILITY MEASURED WITH THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE AT BASELINE AND 12-WEEKS. SECONDARY OUTCOMES INCLUDE PAIN INTENSITY, PAIN INTERFERENCE, DEPRESSION, ANXIETY, FATIGUE/ENERGY, QUALITY OF LIFE, SELF-EFFICACY, SLEEP QUALITY, AND MEDICATION USAGE. ADDITIONAL PROCESS AND/OR MEDIATIONAL FACTORS WILL BE MEASURED TO EXAMINE DOSE RESPONSE AND EFFECT MECHANISMS. ASSESSMENTS WILL BE CONDUCTED AT BASELINE, 6-WEEKS, 12-WEEKS, AND 6-MONTHS. ALL RANDOMIZED PARTICIPANTS WILL BE INCLUDED IN INTENTION-TO-TREAT ANALYSES. STUDY RESULTS WILL PROVIDE MUCH NEEDED EVIDENCE ON THE FEASIBILITY AND EFFECTIVENESS OF YOGA AS A THERAPEUTIC MODALITY FOR THE TREATMENT OF CLBP IN US MILITARY VETERANS.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
15 2673  32 YOGA IN PRIMARY HEALTH CARE: A QUASI-EXPERIMENTAL STUDY TO ACCESS THE EFFECTS ON QUALITY OF LIFE AND PSYCHOLOGICAL DISTRESS. BACKGROUND: AND PURPOSE: YOGA IS GROWING IN POPULARITY, BUT ITS BENEFITS AND INTEGRATION INTO PRIMARY CARE REMAIN UNCERTAIN. HERE, WE DETERMINE YOGA EFFECTS ON QUALITY OF LIFE AND PSYCHOLOGICAL DISTRESS, AND EVALUATE THE FEASIBILITY OF INTRODUCING YOGA AT PRIMARY CARE LEVEL. MATERIALS AND METHODS: THIS IS A PROSPECTIVE, LONGITUDINAL, QUASI-EXPERIMENTAL STUDY, WITH AN INTERVENTION (N=49) AND A CONTROL GROUP (N=37). YOGA GROUP UNDERWENT 24-WEEKS PROGRAM OF ONE-HOUR SESSIONS. OUR PRIMARY ENDPOINT WAS QUALITY OF LIFE AND PSYCHOLOGICAL DISTRESS, AS WELL AS SATISFACTION LEVEL AND ADHERENCE RATE. RESULTS: PARTICIPANTS REPORTED A SIGNIFICANT IMPROVEMENT IN ALL DOMAINS OF QUALITY OF LIFE AND A REDUCTION OF PSYCHOLOGICAL DISTRESS. LINEAR REGRESSION ANALYSIS SHOWED THAT YOGA SIGNIFICANTLY IMPROVES PSYCHOLOGICAL QUALITY OF LIFE (P=0.046). CONCLUSION: YOGA IN PRIMARY CARE IS FEASIBLE, SAFE AND HAS A SATISFACTORY ADHERENCE, AS WELL AS A POSITIVE EFFECT ON PSYCHOLOGICAL QUALITY OF LIFE OF PARTICIPANTS.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
16 2060  54 THE BENEFITS OF YOGA FOR WOMEN VETERANS WITH CHRONIC LOW BACK PAIN. OBJECTIVES: CHRONIC LOW BACK (CLBP) PAIN IS PREVALENT AMONG MILITARY VETERANS AND OFTEN LEADS TO FUNCTIONAL LIMITATIONS, PSYCHOLOGIC SYMPTOMS, LOWER QUALITY OF LIFE, AND HIGHER HEALTH CARE COSTS. AN INCREASING PROPORTION OF U.S. VETERANS ARE WOMEN, AND WOMEN VETERANS MAY HAVE DIFFERENT HEALTH CARE NEEDS THAN MEN VETERANS. THE PURPOSE OF THIS STUDY WAS TO ASSESS THE IMPACT OF A YOGA INTERVENTION ON WOMEN AND MEN WITH CLBP. SUBJECTS/SETTING/INTERVENTION: VA PATIENTS WITH CLBP WERE REFERRED BY PRIMARY CARE PROVIDERS TO A CLINICAL YOGA PROGRAM. DESIGN: RESEARCH PARTICIPANTS COMPLETED A BRIEF BATTERY OF QUESTIONNAIRES BEFORE THEIR FIRST YOGA CLASS AND AGAIN 10 WEEKS LATER IN A SINGLE-GROUP, PRE-POST STUDY DESIGN. OUTCOME MEASURES: QUESTIONNAIRES INCLUDED MEASURES OF PAIN (PAIN SEVERITY SCALE), DEPRESSION (CESD-10), ENERGY/FATIGUE, AND HEALTH-RELATED QUALITY OF LIFE (SF-12). YOGA ATTENDANCE AND HOME PRACTICE OF YOGA WERE ALSO MEASURED. REPEATED-MEASURES ANALYSIS OF VARIANCE WAS USED TO ANALYZE GROUP DIFFERENCES OVER TIME WHILE CONTROLLING FOR BASELINE DIFFERENCES. RESULTS: THE 53 PARTICIPANTS WHO COMPLETED BOTH ASSESSMENTS HAD A MEAN AGE OF 53 YEARS, AND WERE WELL EDUCATED, 41% NONWHITE, 49% MARRIED, AND HAD VARYING EMPLOYMENT STATUS. WOMEN PARTICIPANTS HAD SIGNIFICANTLY LARGER DECREASES IN DEPRESSION (P=0.046) AND PAIN "ON AVERAGE" (P=0.050), AND LARGER INCREASES IN ENERGY (P=0.034) AND SF-12 MENTAL HEALTH (P=0.044) THAN MEN WHO PARTICIPATED. THE GROUPS DID NOT DIFFER SIGNIFICANTLY ON YOGA ATTENDANCE OR HOME PRACTICE OF YOGA. CONCLUSIONS: THESE RESULTS SUGGEST THAT WOMEN VETERANS MAY BENEFIT MORE THAN MEN VETERANS FROM YOGA INTERVENTIONS FOR CHRONIC BACK PAIN. CONCLUSIONS ARE TENTATIVE BECAUSE OF THE SMALL SAMPLE SIZE AND QUASI-EXPERIMENTAL STUDY DESIGN. A MORE RIGOROUS STUDY IS BEING DESIGNED TO ANSWER THESE RESEARCH QUESTIONS MORE DEFINITIVELY.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                        
17 2222  55 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	

18 2187  52 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	
                                                                                                                                                                                      
19 2322  44 TREATMENT OF CHRONIC LOWER BACK PAIN: STUDY PROTOCOL OF A COMPARATIVE EFFECTIVENESS STUDY ON YOGA, EURYTHMY THERAPY, AND PHYSIOTHERAPEUTIC EXERCISES. BACKGROUND: WE AIM TO COMPARE THE EFFECTIVENESS OF 3 ACTIVE INTERVENTIONS, I.E., YOGA, EURYTHMY THERAPY, AND PHYSIOTHERAPEUTIC EXERCISE, ON CHRONIC LOWER BACK PAIN. METHODS: IN THIS RANDOMIZED CONTROLLED TRIAL OVER 16 WEEKS (8 WEEKS OF INTERVENTION, 8 WEEKS OF FOLLOW-UP), DATA OF INDIVIDUALS WITH CHRONIC LOWER BACK PAIN WILL BE ANALYZED. INTERVENTIONS ARE IMPLEMENTED AS GROUP SESSIONS (75 MIN) ONCE PER WEEK. PARTICIPANTS RECEIVE A MANUAL FOR HOME-BASED PRACTICE AND ARE ASSESSED BEFORE AND AT THE END OF THE 8-WEEK INTERVENTION PERIOD, AND AT THE END OF AN 8-WEEK FOLLOW-UP PERIOD. STANDARDIZED QUESTIONNAIRES ARE: THE ROLAND-MORRIS DISABILITY SCORE, VISUAL ANALOG SCALES MEASURING INTENSITY OF PAIN, THE BRIEF MULTIDIMENSIONAL LIFE SATISFACTION SCALE, THE PERCEIVED STRESS SCALE, THE INNER CORRESPONDENCE WITH THE PRACTICES QUESTIONNAIRE, THE FREIBURG MINDFULNESS QUESTIONNAIRE, THE GENERAL SELF-EFFICACY SCALE, A SELF-REGULATION QUESTIONNAIRE, THE INTERNAL COHERENCE SCALE, A PAIN DIARY (REGISTERING THE NEED OF ANALGESIC MEDICATION), AND A QUESTIONNAIRE ON THE PATIENTS' EXPECTATION THAT THE INTERVENTIONS WILL BE EFFECTIVE IN REDUCING PAIN AND HOW STRONG THIS REDUCTION MIGHT BE (2 SINGLE ITEMS), ETC. DISCUSSION: THIS LARGE MULTICENTER STUDY WILL PROVIDE EVIDENCE ON THE EFFECTIVENESS OF 3 CONTRASTING MOVEMENT-ORIENTATED TREATMENTS THAT SHARE SOME SIMILARITIES BUT DIFFER IN ESSENTIAL DETAILS: YOGA, EURYTHMY THERAPY, AND PHYSIOTHERAPEUTIC EXERCISES. IT WILL PROVIDE IMPORTANT DATA ON NON-PHARMACOLOGICAL OPTIONS TO TREAT LOWER BACK PAIN IN A LARGE GROUP OF AFFECTED INDIVIDUALS.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
20  536  51 COMPARISON OF YOGA VERSUS STRETCHING FOR CHRONIC LOW BACK PAIN: PROTOCOL FOR THE YOGA EXERCISE SELF-CARE (YES) TRIAL. BACKGROUND: BACK PAIN, ONE OF THE MOST PREVALENT CONDITIONS AFFLICTING AMERICAN ADULTS, IS THE LEADING REASON FOR USING COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) THERAPIES. YOGA IS AN INCREASINGLY POPULAR "MIND-BODY" CAM THERAPY OFTEN USED FOR RELIEVING BACK PAIN AND SEVERAL SMALL STUDIES HAVE FOUND YOGA EFFECTIVE FOR THIS CONDITION. THIS STUDY WILL ASSESS WHETHER YOGA IS EFFECTIVE FOR TREATING CHRONIC LOW BACK PAIN COMPARED WITH SELF CARE AND EXERCISE AND WILL EXPLORE THE MECHANISMS RESPONSIBLE FOR ANY OBSERVED BENEFITS. METHODS/DESIGN: A TOTAL OF 210 PARTICIPANTS WITH LOW BACK PAIN LASTING AT LEAST 3 MONTHS WILL BE RECRUITED FROM PRIMARY CARE CLINICS OF A LARGE HEALTHCARE SYSTEM BASED IN SEATTLE. THEY WILL BE RANDOMIZED IN A 2:2:1 RATIO TO RECEIVE 12 WEEKLY YOGA CLASSES, 12 WEEKLY CONVENTIONAL THERAPEUTIC EXERCISE CLASSES OF COMPARABLE PHYSICAL EXERTION, OR A SELF-CARE BOOK. INTERVIEWERS MASKED TO PARTICIPANTS' TREATMENT GROUP WILL ASSESS OUTCOMES AT BASELINE AND 6, 12 AND 26 WEEKS AFTER RANDOMIZATION. PRIMARY OUTCOMES WILL BE BACK-RELATED DYSFUNCTION AND SYMPTOM BOTHERSOMENESS. IN ADDITION, DATA WILL BE COLLECTED ON PHYSICAL MEASUREMENTS (E.G., FLEXION) AT BASELINE AND 12 WEEKS AND SALIVA SAMPLES WILL BE OBTAINED AT BASELINE, 6 AND 12 WEEKS. INFORMATION WILL BE COLLECTED ON SPECIFIC PHYSICAL, PSYCHOLOGICAL, AND PHYSIOLOGICAL FACTORS TO ALLOW EXPLORATION OF POSSIBLE MECHANISMS OF ACTION THROUGH WHICH YOGA COULD RELIEVE BACK PAIN AND DYSFUNCTION. THE EFFECTIVENESS OF YOGA WILL BE ASSESSED USING ANALYSIS OF COVARIANCE (USING GENERAL ESTIMATING EQUATIONS - GEE) WITHIN AN INTENTION-TO-TREAT CONTEXT. IF YOGA IS FOUND EFFECTIVE, FURTHER ANALYSES WILL EXPLORE WHETHER YOGA'S BENEFITS ARE ATTRIBUTABLE TO PHYSICAL, PSYCHOLOGICAL AND/OR PHYSIOLOGICAL FACTORS. CONCLUSIONS: THIS STUDY WILL PROVIDE THE CLEAREST EVIDENCE TO DATE ABOUT THE VALUE OF YOGA AS A THERAPEUTIC OPTION FOR TREATING CHRONIC BACK PAIN, AND IF THE RESULTS ARE POSITIVE, WILL HELP FOCUS FUTURE, MORE IN-DEPTH, RESEARCH ON THE MOST PROMISING POTENTIAL MECHANISMS OF ACTION IDENTIFIED BY THIS STUDY.	2010