1 558 138 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 2 132 56 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 45 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 4 557 58 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 5 2683 36 YOGA IN THE MANAGEMENT OF CHRONIC DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: HEART DISEASE, STROKE, AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) ARE THE LEADING CAUSES OF DEATH AND DISABILITY WORLDWIDE. ALTHOUGH INDIVIDUALS WITH THESE CONDITIONS HAVE BEEN REPORTED TO BENEFIT FROM YOGA, ITS EFFECTIVENESS REMAINS UNCLEAR. OBJECTIVE: TO PERFORM A SYSTEMATIC REVIEW OF THE EFFECTIVENESS OF YOGA ON EXERCISE CAPACITY, HEALTH RELATED QUALITY OF LIFE (HRQL), AND PSYCHOLOGICAL WELL-BEING FOR INDIVIDUALS WITH CHRONIC DISEASE AND DESCRIBE THE STRUCTURE AND DELIVERY OF PROGRAMS. RESEARCH DESIGN: WE PERFORMED A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS EXAMINING YOGA PROGRAMS FOR INDIVIDUALS WITH HEART DISEASE, STROKE, AND COPD COMPARED WITH USUAL CARE. QUALITY WAS ASSESSED USING THE COCHRANE RISK OF BIAS TOOL. META-ANALYSES WERE CONDUCTED USING REVIEW MANAGER 5.3. THE PROTOCOL WAS REGISTERED ON PROSPERO (CRD42014014589). RESULTS: TEN STUDIES (431 INDIVIDUALS, MEAN AGE 56+/-8 Y) WERE INCLUDED AND WERE COMPARABLE IN THEIR DESIGN AND COMPONENTS, IRRESPECTIVE OF THE CHRONIC DISEASE. THE STANDARDIZED MEAN DIFFERENCE FOR THE MEAN CHANGE IN EXERCISE CAPACITY WAS 2.69 (95% CONFIDENCE INTERVAL, 1.39-3.99) AND FOR HRQL IT WAS 1.24 (95% CONFIDENCE INTERVAL, -0.37 TO 2.85). SYMPTOMS OF ANXIETY WERE REDUCED AFTER YOGA IN INDIVIDUALS WITH STROKE, ALTHOUGH THIS WAS NOT OBSERVED IN INDIVIDUALS WITH COPD. THE EFFECT OF YOGA ON SYMPTOMS OF DEPRESSION VARIED ACROSS STUDIES WITH NO SIGNIFICANT EFFECTS COMPARED WITH USUAL CARE. CONCLUSIONS: YOGA PROGRAMS HAVE SIMILAR DESIGNS AND COMPONENTS ACROSS CHRONIC DISEASE POPULATIONS. COMPARED WITH USUAL CARE, YOGA RESULTED IN SIGNIFICANT IMPROVEMENTS IN EXERCISE CAPACITY AND A MEAN IMPROVEMENT IN HRQL. YOGA PROGRAMS MAY BE A USEFUL ADJUNCT TO FORMAL REHABILITATION PROGRAMS. 2015 6 2598 39 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 7 721 30 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 8 2559 37 YOGA FOR CHRONIC LOW BACK PAIN: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. OBJECTIVES: TO EVALUATE THE EFFICACY OF YOGA AS AN INTERVENTION FOR CHRONIC LOW BACK PAIN (CLBP) USING A META-ANALYTICAL APPROACH. RANDOMIZED CONTROLLED TRIALS (RCTS) THAT EXAMINED PAIN ANDOR FUNCTIONAL DISABILITY AS TREATMENT OUTCOMES WERE INCLUDED. POST-TREATMENT AND FOLLOW-UP OUTCOMES WERE ASSESSED. METHODS: A COMPREHENSIVE SEARCH OF RELEVANT ELECTRONIC DATABASES, FROM THE TIME OF THEIR INCEPTION UNTIL NOVEMBER 2011, WAS CONDUCTED. COHEN'S D EFFECT SIZES WERE CALCULATED AND ENTERED IN A RANDOM-EFFECTS MODEL. RESULTS: EIGHT RCTS MET THE CRITERIA FOR INCLUSION (EIGHT ASSESSING FUNCTIONAL DISABILITY AND FIVE ASSESSING PAIN) AND INVOLVED A TOTAL OF 743 PATIENTS. AT POST-TREATMENT, YOGA HAD A MEDIUM TO LARGE EFFECT ON FUNCTIONAL DISABILITY (D=0.645) AND PAIN (D=0.623). DESPITE A WIDE RANGE OF YOGA STYLES AND TREATMENT DURATIONS, HETEROGENEITY IN POST-TREATMENT EFFECT SIZES WAS LOW. FOLLOW-UP EFFECT SIZES FOR FUNCTIONAL DISABILITY AND PAIN WERE SMALLER, BUT REMAINED SIGNIFICANT (D=0.397 AND D=0.486, RESPECTIVELY); HOWEVER, THERE WAS A MODERATE TO HIGH LEVEL OF VARIABILITY IN THESE EFFECT SIZES. DISCUSSION: THE RESULTS OF THE PRESENT STUDY INDICATE THAT YOGA MAY BE AN EFFICACIOUS ADJUNCTIVE TREATMENT FOR CLBP. THE STRONGEST AND MOST CONSISTENT EVIDENCE EMERGED FOR THE SHORT-TERM BENEFITS OF YOGA ON FUNCTIONAL DISABILITY. HOWEVER, BEFORE ANY DEFINITIVE CONCLUSIONS CAN BE DRAWN, THERE ARE A NUMBER OF METHODOLOGICAL CONCERNS THAT NEED TO BE ADDRESSED. IN PARTICULAR, IT IS RECOMMENDED THAT FUTURE RCTS INCLUDE AN ACTIVE CONTROL GROUP TO DETERMINE WHETHER YOGA HAS SPECIFIC TREATMENT EFFECTS AND WHETHER YOGA OFFERS ANY ADVANTAGES OVER TRADITIONAL EXERCISE PROGRAMS AND OTHER ALTERNATIVE THERAPIES FOR CLBP. 2013 9 2187 43 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 10 131 29 A PRAGMATIC MULTI-CENTRED RANDOMISED CONTROLLED TRIAL OF YOGA FOR CHRONIC LOW BACK PAIN: TRIAL PROTOCOL. UNLABELLED: A SYSTEMATIC REVIEW REVEALED THREE SMALL RANDOMISED CONTROLLED TRIALS OF YOGA FOR LOW BACK PAIN, ALL OF WHICH SHOWED EFFECTS ON BACK PAIN THAT FAVOURED THE YOGA GROUP. TO BUILD ON THESE STUDIES A LARGER TRIAL, WITH LONGER TERM FOLLOW-UP, AND A NUMBER OF DIFFERENT YOGA TEACHERS DELIVERING THE INTERVENTION IS REQUIRED. THIS STUDY PROTOCOL DESCRIBES THE DETAILS OF A RANDOMISED CONTROLLED TRIAL (RCT) TO DETERMINE THE EFFECTIVENESS AND COST-EFFECTIVENESS OF YOGA FOR CHRONIC LOW BACK PAIN, WHICH IS FUNDED BY ARTHRITIS RESEARCH CAMPAIGN (ARC) AND IS BEING CONDUCTED BY THE UNIVERSITY OF YORK. 262 PATIENTS WILL BE RECRUITED FROM GP PRACTICES IN 5 CENTRES IN ENGLAND. PATIENTS WILL BE RANDOMISED TO RECEIVE USUAL CARE OR 12 WEEKLY CLASSES OF YOGA. A YOGA PROGRAMME WILL BE DEVISED THAT CAN BE DELIVERED BY YOGA TEACHERS OF THE TWO MAIN NATIONAL YOGA ORGANISATIONS IN THE UK (BRITISH WHEEL OF YOGA AND IYENGAR YOGA ASSOCIATION (UK)). TRIAL REGISTRATION: CURRENT CONTROLLED TRIALS REGISTRY ISRCTN81079604 (DATE REGISTERED 30/03/2007). 2010 11 536 38 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 12 2470 31 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 2610 43 YOGA FOR REDUCING PERCEIVED STRESS AND BACK PAIN AT WORK. BACKGROUND: STRESS AND BACK PAIN ARE TWO KEY FACTORS LEADING TO SICKNESS ABSENCE AT WORK. RECENT RESEARCH INDICATES THAT YOGA CAN BE EFFECTIVE FOR REDUCING PERCEIVED STRESS, ALLEVIATING BACK PAIN, AND IMPROVING PSYCHOLOGICAL WELL-BEING. AIMS: TO DETERMINE THE EFFECTIVENESS OF A YOGA-BASED INTERVENTION FOR REDUCING PERCEIVED STRESS AND BACK PAIN AT WORK. METHODS: PARTICIPANTS WERE RECRUITED FROM A BRITISH LOCAL GOVERNMENT AUTHORITY AND RANDOMIZED INTO A YOGA GROUP WHO RECEIVED ONE 50 MIN DRU YOGA SESSION EACH WEEK FOR 8 WEEKS AND A 20 MIN DVD FOR HOME PRACTICE AND A CONTROL GROUP WHO RECEIVED NO INTERVENTION. BASELINE AND END-PROGRAMME MEASUREMENTS OF SELF-REPORTED STRESS, BACK PAIN AND PSYCHOLOGICAL WELL-BEING WERE ASSESSED WITH THE PERCEIVED STRESS SCALE, ROLAND MORRIS DISABILITY QUESTIONNAIRE AND THE POSITIVE AND NEGATIVE AFFECT SCALE. RESULTS: THERE WERE 37 PARTICIPANTS IN EACH GROUP. ANALYSIS OF VARIANCE AND MULTIPLE LINEAR REGRESSION SHOWED THAT IN COMPARISON TO THE CONTROL GROUP, THE YOGA GROUP REPORTED SIGNIFICANT REDUCTIONS IN PERCEIVED STRESS AND BACK PAIN, AND A SUBSTANTIAL IMPROVEMENT IN PSYCHOLOGICAL WELL-BEING. WHEN COMPARED WITH THE CONTROL GROUP AT THE END OF THE PROGRAMME, THE YOGA GROUP SCORES WERE SIGNIFICANTLY LOWER FOR PERCEIVED STRESS, BACK PAIN, SADNESS AND HOSTILITY, AND SUBSTANTIALLY HIGHER FOR FEELING SELF-ASSURED, ATTENTIVE AND SERENE. CONCLUSIONS: THE RESULTS INDICATE THAT A WORKPLACE YOGA INTERVENTION CAN REDUCE PERCEIVED STRESS AND BACK PAIN AND IMPROVE PSYCHOLOGICAL WELL-BEING. LARGER RANDOMIZED CONTROLLED TRIALS ARE NEEDED TO DETERMINE THE BROADER EFFICACY OF YOGA FOR IMPROVING WORKPLACE PRODUCTIVITY AND REDUCING SICKNESS ABSENCE. 2012 14 1413 22 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 15 2637 18 YOGA FOR TREATMENT OF URINARY INCONTINENCE IN WOMEN. THIS IS A PROTOCOL FOR A COCHRANE REVIEW (INTERVENTION). THE OBJECTIVES ARE AS FOLLOWS: TO ASSESS THE EFFECTIVENESS AND SAFETY OF YOGA FOR TREATMENT OF URINARY INCONTINENCE IN WOMEN, COMPARED TO NO SPECIFIC TREATMENT, TO ANOTHER ACTIVE TREATMENT, OR TO AN ACTIVE TREATMENT WITHOUT ADJUVANT YOGA, WITH A FOCUS ON PATIENT SYMPTOMS AND QUALITY OF LIFE. 2017 16 2673 26 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 17 2609 37 YOGA FOR QUALITY OF LIFE IN INDIVIDUALS WITH CHRONIC DISEASE: A SYSTEMATIC REVIEW. BACKGROUND: CHRONIC DISEASES, INCLUDING HEART DISEASE, STROKE, CANCER, AND CHRONIC PULMONARY DISEASE ARE THE LEADING CAUSES OF DEATH AND DISABILITY WORLDWIDE. COMPOUNDING SYMPTOMS AND LOSS OF FUNCTION, PEOPLE LIVING WITH CHRONIC DISEASE OFTEN EXPERIENCE REDUCED QUALITY OF LIFE (QOL). VARIOUS PHYSICAL AND MENTAL PRACTICES HAVE BEEN SHOWN TO RELIEVE STRESS AND IMPROVE QOL. YOGA IS A PHYSICAL AND MENTAL PRACTICE THAT MAY BE A VIABLE APPROACH FOR IMPROVING QOL IN PEOPLE WITH CHRONIC DISEASE. OBJECTIVE: THE OBJECTIVE OF THIS STUDY WAS TO EXAMINE AND SUMMARIZE THE EVIDENCE FOR THE EFFECTIVENESS OF YOGA ON QOL IN PATIENTS WITH CHRONIC DISEASE. DESIGN: THE STUDY DESIGN WAS A A SYSTEMATIC REVIEW WITH QUALITATIVE SYNTHESIS. METHODS: WE INCLUDED RANDOMIZED CONTROLLED TRIALS THAT EVALUATED THE EFFECT OF YOGA ON QOL OR HEALTH-RELATED QOL (HRQOL) FOR INDIVIDUALS WITH CHRONIC DISEASE. WE INCLUDED ONLY STUDIES THAT USED AT LEAST 1 PREVIOUSLY VALIDATED MEASURE OF QOL OR HRQOL AND SPECIFIED A MINIMUM DURATION OF FOLLOW-UP OF AT LEAST 1 WK. INTERVENTIONS: WE INCLUDED BOTH MOVEMENT-BASED AND BREATH-BASED YOGA PRACTICES. STUDIES THAT INCLUDED YOGA AS PART OF A LARGER INTERVENTION PROGRAM (EG, MINDFULNESS-BASED STRESS REDUCTION TRAINING) OR STUDIES THAT DID NOT PROVIDE FINDINGS SPECIFIC TO YOGA WERE EXCLUDED. PRIMARY OUTCOME MEASURES: THE PRIMARY OUTCOME ANALYZED WAS IMPROVEMENT IN QOL AS MEASURED BY A VALIDATED QOL OR HRQOL SCALE. RESULTS: AMONG THE 1488 STUDIES THAT WERE IDENTIFIED ON INITIAL SEARCH, 7 ARTICLES MET ALL INCLUSION CRITERIA. FIVE STUDIES REPORTED A STATISTICALLY SIGNIFICANT ADVANTAGE OVER USUAL CARE ALONE FOR IMPROVEMENT OF QOL IN PATIENTS WITH CHRONIC DISEASE, BUT THE CLINICAL SIGNIFICANCE OF THE DIFFERENCES WAS CLEAR IN ONLY 1 TRIAL. WE FOUND CONSIDERABLE HETEROGENEITY AMONG THE INCLUDED STUDIES AND STUDY QUALITY WAS GENERALLY LOW. CONCLUSIONS: MORE HIGH-QUALITY RESEARCH IS NEEDED TO DETERMINE THE VALUE OF YOGA AS AN ADJUNCTIVE APPROACH TO IMPROVING QOL IN PATIENTS WITH CHRONIC DISEASE. 2019 18 2374 38 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 19 2824 48 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 20 228 34 A SYSTEMATIC REVIEW OF THE EFFECTIVENESS OF YOGA ON PAIN, PHYSICAL FUNCTION, AND QUALITY OF LIFE IN OLDER ADULTS WITH CHRONIC MUSCULOSKELETAL CONDITIONS. OBJECTIVES: EXERCISE INTERVENTIONS SUITABLE FOR OLDER ADULTS CAN HELP TO SLOW AND MANAGE AGE-RELATED CONDITIONS. THIS SYSTEMATIC REVIEW LOOKS AT AGE-RELATED MUSCULOSKELETAL CONDITIONS IN A POPULATION WITH A MEAN AGE OVER 50 YEARS, EVALUATING THE EFFECTIVENESS OF YOGA FOR PAIN, PHYSICAL FUNCTION, AND QUALITY OF LIFE. METHODS: CENTRAL,CINAHL, PUBMED, PSYCINFO, SCOPUS, SPORTS DISCUS, WEB OF SCIENCE CORE COLLECTION, AND GOOGLE SCHOLAR WERE SEARCHED. STUDY SELECTION AND QUALITY SCREENING USING THE COCHRANE RISK OF BIAS TOOL WERE CONDUCTED BY TWO REVIEWERS TO MITIGATE BIAS. PRISMA GUIDELINES WERE FOLLOWED IN CONDUCTING AND REPORTING THE REVIEW. RESULTS: 11 STUDIES MET INCLUSION CRITERIA WITH A TOTAL SAMPLE OF 2221 (>/=70% FEMALE). EIGHT STUDIES MEASURED PAIN, SIX SHOWING SIGNIFICANT EFFECTIVENESS (P=