1 1140 209 EFFICACY OF YOGA VS COGNITIVE BEHAVIORAL THERAPY VS STRESS EDUCATION FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER: A RANDOMIZED CLINICAL TRIAL. IMPORTANCE: GENERALIZED ANXIETY DISORDER (GAD) IS COMMON, IMPAIRING, AND UNDERTREATED. ALTHOUGH MANY PATIENTS WITH GAD SEEK COMPLEMENTARY AND ALTERNATIVE INTERVENTIONS, INCLUDING YOGA, DATA SUPPORTING YOGA'S EFFICACY OR HOW IT COMPARES TO FIRST-LINE TREATMENTS ARE LACKING. OBJECTIVES: TO ASSESS WHETHER YOGA (KUNDALINI YOGA) AND COGNITIVE BEHAVIORAL THERAPY (CBT) FOR GAD ARE EACH MORE EFFECTIVE THAN A CONTROL CONDITION (STRESS EDUCATION) AND WHETHER YOGA IS NONINFERIOR TO CBT FOR THE TREATMENT OF GAD. DESIGN, SETTING, AND PARTICIPANTS: FOR THIS RANDOMIZED, 3-ARM, CONTROLLED, SINGLE-BLIND (MASKED INDEPENDENT RATERS) CLINICAL TRIAL, PARTICIPANTS WERE RECRUITED FROM 2 SPECIALTY ACADEMIC CENTERS STARTING DECEMBER 1, 2013, WITH ASSESSMENT ENDING OCTOBER 25, 2019. PRIMARY ANALYSES, COMPLETED BY FEBRUARY 12, 2020, INCLUDED SUPERIORITY TESTING OF KUNDALINI YOGA AND CBT VS STRESS EDUCATION AND NONINFERIORITY TESTING OF KUNDALINI YOGA VS CBT. INTERVENTIONS: PARTICIPANTS WERE RANDOMIZED TO KUNDALINI YOGA (N = 93), CBT FOR GAD (N = 90), OR STRESS EDUCATION (N = 43), WHICH WERE EACH DELIVERED TO GROUPS OF 4 TO 6 PARTICIPANTS BY 2 INSTRUCTORS DURING TWELVE 120-MINUTE SESSIONS WITH 20 MINUTES OF DAILY HOMEWORK. MAIN OUTCOMES AND MEASURES: THE PRIMARY INTENTION-TO-TREAT OUTCOME WAS ACUTE GAD RESPONSE (CLINICAL GLOBAL IMPRESSION-IMPROVEMENT SCALE SCORE OF MUCH OR VERY MUCH IMPROVED) AFTER 12 WEEKS AS ASSESSED BY TRAINED INDEPENDENT RATERS. RESULTS: OF 538 PARTICIPANTS WHO PROVIDED CONSENT AND WERE EVALUATED, 226 (MEAN [SD] AGE, 33.4 [13.5] YEARS; 158 [69.9%] FEMALE) WITH A PRIMARY DIAGNOSIS OF GAD WERE INCLUDED IN THE TRIAL. A TOTAL OF 155 PARTICIPANTS (68.6%) COMPLETED THE POSTTREATMENT ASSESSMENT. COMPLETION RATES DID NOT DIFFER (KUNDALINI YOGA, 60 [64.5%]; CBT, 67 [74.4%]; AND STRESS EDUCATION, 28 [65.1%]: CHI2 = 2.39, DF = 2, P = .30). RESPONSE RATES WERE HIGHER IN THE KUNDALINI YOGA GROUP (54.2%) THAN IN THE STRESS EDUCATION GROUP (33.%) (ODDS RATIO [OR], 2.46 [95% CI, 1.12-5.42]; P = .03; NUMBER NEEDED TO TREAT, 4.59 [95% CI, 2.52-46.19]) AND IN THE CBT GROUP (70.8%) COMPARED WITH THE STRESS EDUCATION GROUP (33.0%) (OR, 5.00 [95% CI, 2.12-11.82]; P < .001; NUMBER NEEDED TO TREAT, 2.62 [95% CI, 1.91-5.68]). HOWEVER, THE NONINFERIORITY TEST DID NOT FIND KUNDALINI YOGA TO BE AS EFFECTIVE AS CBT (DIFFERENCE, 16.6%; P = .42 FOR NONINFERIORITY). CONCLUSIONS AND RELEVANCE: IN THIS TRIAL, KUNDALINI YOGA WAS EFFICACIOUS FOR GAD, BUT THE RESULTS SUPPORT CBT REMAINING FIRST-LINE TREATMENT. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT01912287.	2021	

2 2577  57 YOGA FOR GENERALIZED ANXIETY DISORDER: DESIGN OF A RANDOMIZED CONTROLLED CLINICAL TRIAL. GENERALIZED ANXIETY DISORDER (GAD) IS A COMMON DISORDER ASSOCIATED WITH SIGNIFICANT DISTRESS AND INTERFERENCE. ALTHOUGH COGNITIVE BEHAVIORAL THERAPY (CBT) HAS BEEN SHOWN TO BE THE MOST EFFECTIVE FORM OF PSYCHOTHERAPY, FEW PATIENTS RECEIVE OR HAVE ACCESS TO THIS INTERVENTION. YOGA THERAPY OFFERS ANOTHER PROMISING, YET UNDER-RESEARCHED, INTERVENTION THAT IS GAINING INCREASING POPULARITY IN THE GENERAL PUBLIC, AS AN ANXIETY REDUCTION INTERVENTION. THE PURPOSE OF THIS INNOVATIVE CLINICAL TRIAL PROTOCOL IS TO INVESTIGATE THE EFFICACY OF A KUNDALINI YOGA INTERVENTION, RELATIVE TO CBT AND A CONTROL CONDITION. KUNDALINI YOGA AND CBT ARE COMPARED WITH EACH OTHER IN A NONINFERIORITY TEST AND BOTH TREATMENTS ARE COMPARED TO STRESS EDUCATION TRAINING, AN ATTENTION CONTROL INTERVENTION, IN SUPERIORITY TESTS. THE SAMPLE WILL CONSIST OF 230 INDIVIDUALS WITH A PRIMARY DSM-5 DIAGNOSIS OF GAD. THIS RANDOMIZED CONTROLLED TRIAL WILL COMPARE YOGA (N=95) TO BOTH CBT FOR GAD (N=95) AND STRESS EDUCATION (N=40), A COMMONLY USED CONTROL CONDITION. ALL THREE TREATMENTS WILL BE ADMINISTERED BY TWO INSTRUCTORS IN A GROUP FORMAT OVER 12 WEEKLY SESSIONS WITH FOUR TO SIX PATIENTS PER GROUP. GROUPS WILL BE RANDOMIZED USING PERMUTED BLOCK RANDOMIZATION, WHICH WILL BE STRATIFIED BY SITE. TREATMENT OUTCOME WILL BE EVALUATED BI-WEEKLY AND AT 6MONTH FOLLOW-UP. FURTHERMORE, POTENTIAL MEDIATORS OF TREATMENT OUTCOME WILL BE INVESTIGATED. GIVEN THE INDIVIDUAL AND ECONOMIC BURDEN ASSOCIATED WITH GAD, IDENTIFYING ACCESSIBLE ALTERNATIVE BEHAVIORAL TREATMENTS WILL HAVE SUBSTANTIVE PUBLIC HEALTH IMPLICATIONS.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
3 2187  51 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
4 1543  30 KUNDALINI YOGA FOR GENERALIZED ANXIETY DISORDER: AN EXPLORATION OF TREATMENT EFFICACY AND POSSIBLE MECHANISMS. THE AIM OF THIS STUDY WAS TO EXAMINE THE EFFICACY OF KUNDALINI YOGA IN REDUCING SYMPTOMS OF GENERALIZED ANXIETY DISORDER (GAD) COMPARED TO A COMMON TREATMENT-AS-USUAL CONDITION USING COGNITIVE TECHNIQUES. A SECONDARY OBJECTIVE WAS TO EXPLORE POTENTIAL TREATMENT MECHANISMS. FEMALES AGED 24 TO 75 YEARS WITH GAD ( N = 49) RECEIVED EITHER AN 8-WEEK KUNDALINI YOGA INTERVENTION ( N = 34) OR AN 8-WEEK TREATMENT-AS-USUAL CONDITION ( N = 15). THE YOGA CONDITION RESULTED IN LOWER LEVELS OF ANXIETY RELATIVE TO THE TREATMENT-AS-USUAL CONDITION. FURTHERMORE, CHANGES IN SOMATIC SYMPTOMS MEDIATED TREATMENT OUTCOME FOR KUNDALINI YOGA. KUNDALINI YOGA MAY SHOW PROMISE AS A TREATMENT FOR GAD, AND THIS TREATMENT MIGHT CONVEY ITS EFFECT ON SYMPTOM SEVERITY BY REDUCING SOMATIC SYMPTOMS.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
5  187  58 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	
                                                                                                                                                                                                                                                                                                                      
6 2374  60 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	
                                                                                                                                                                                                                                                                                                                                                                                                                               
7 1242  51 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
8 1557  51 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
9  290  49 ADJUNCTIVE YOGA V. HEALTH EDUCATION FOR PERSISTENT MAJOR DEPRESSION: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: THE OBJECTIVE OF THIS STUDY WAS TO DETERMINE WHETHER HATHA YOGA IS AN EFFICACIOUS ADJUNCTIVE INTERVENTION FOR INDIVIDUALS WITH CONTINUED DEPRESSIVE SYMPTOMS DESPITE ANTIDEPRESSANT TREATMENT. METHOD: WE CONDUCTED A RANDOMIZED CONTROLLED TRIAL OF WEEKLY YOGA CLASSES (N = 63) V. HEALTH EDUCATION CLASSES (HEALTHY LIVING WORKSHOP; HLW; N = 59) IN INDIVIDUALS WITH ELEVATED DEPRESSION SYMPTOMS AND ANTIDEPRESSANT MEDICATION USE. HLW SERVED AS AN ATTENTION-CONTROL GROUP. THE INTERVENTION PERIOD WAS 10 WEEKS, WITH FOLLOW-UP ASSESSMENTS 3 AND 6 MONTHS AFTERWARDS. THE PRIMARY OUTCOME WAS DEPRESSION SYMPTOM SEVERITY ASSESSED BY BLIND RATER AT 10 WEEKS. SECONDARY OUTCOMES INCLUDED DEPRESSION SYMPTOMS OVER THE ENTIRE INTERVENTION AND FOLLOW-UP PERIODS, SOCIAL AND ROLE FUNCTIONING, GENERAL HEALTH PERCEPTIONS, PAIN, AND PHYSICAL FUNCTIONING. RESULTS: AT 10 WEEKS, WE DID NOT FIND A STATISTICALLY SIGNIFICANT DIFFERENCE BETWEEN GROUPS IN DEPRESSION SYMPTOMS (B = -0.82, S.E. = 0.88, P = 0.36). HOWEVER, OVER THE ENTIRE INTERVENTION AND FOLLOW-UP PERIOD, WHEN CONTROLLING FOR BASELINE, YOGA PARTICIPANTS SHOWED LOWER LEVELS OF DEPRESSION THAN HLW PARTICIPANTS (B = -1.38, S.E. = 0.57, P = 0.02). AT 6-MONTH FOLLOW-UP, 51% OF YOGA PARTICIPANTS DEMONSTRATED A RESPONSE (50% REDUCTION IN DEPRESSION SYMPTOMS) COMPARED WITH 31% OF HLW PARTICIPANTS (ODDS RATIO = 2.31; P = 0.04). YOGA PARTICIPANTS SHOWED SIGNIFICANTLY BETTER SOCIAL AND ROLE FUNCTIONING AND GENERAL HEALTH PERCEPTIONS OVER TIME. CONCLUSIONS: ALTHOUGH WE DID NOT SEE A DIFFERENCE IN DEPRESSION SYMPTOMS AT THE END OF THE INTERVENTION PERIOD, YOGA PARTICIPANTS SHOWED FEWER DEPRESSION SYMPTOMS OVER THE ENTIRE FOLLOW-UP PERIOD. BENEFITS OF YOGA MAY ACCUMULATE OVER TIME.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
10 1784  46 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
11 1841  48 QIGONG OR YOGA VERSUS NO INTERVENTION IN OLDER ADULTS WITH CHRONIC LOW BACK PAIN-A RANDOMIZED CONTROLLED TRIAL. UNLABELLED: THE AIM OF THIS STUDY WAS TO ASSESS THE EFFECTIVENESS OF THE REDUCTION OF CHRONIC LOWER BACK PAIN IN OLDER ADULTS USING EITHER YOGA CLASSES OR QIGONG CLASSES COMPARED WITH NO INTERVENTION. OLDER ADULTS (65 YEARS OF AGE AND OLDER) WITH CHRONIC LOW BACK PAIN WERE ENROLLED IN AND RANDOMLY ALLOCATED TO: 1) YOGA (24 CLASSES, 45 MINUTES EACH, DURING 3 MONTHS), 2) QIGONG (12 CLASSES, 90 MINUTES EACH, DURING 3 MONTHS), OR 3) A CONTROL GROUP WHO RECEIVED NO ADDITIONAL INTERVENTION. THE PAIN INTENSITY ITEM OF THE FUNCTIONAL RATING INDEX AFTER 3 MONTHS WAS USED AS PRIMARY OUTCOME PARAMETER. A TOTAL OF 176 PATIENTS WERE RANDOMIZED (N = 61 YOGA, N = 58 QIGONG, N = 57 CONTROL; MEAN AGE 73 +/- 5.6 YEARS, 89% FEMALE). THE MEAN ADJUSTED PAIN INTENSITY AFTER 3 MONTHS WAS 1.71 FOR THE YOGA GROUP (95% CONFIDENCE INTERVAL [CI], 1.54-1.89), 1.67 FOR THE QIGONG GROUP (95% CI, 1.45-1.89), AND 1.89 FOR NO INTERVENTION (95% CI, 1.67-2.11). NO STATISTICALLY SIGNIFICANT GROUP DIFFERENCES WERE OBSERVED. POSSIBLE EXPLANATIONS FOR THIS LACK OF PAIN RELIEF MIGHT INCLUDE THE INEFFECTIVENESS OF INTERVENTIONS, INAPPROPRIATE OUTCOMES, OR DIFFERENCES IN PAIN PERCEPTION AND PROCESSING IN OLDER ADULTS. PERSPECTIVE: THE AIM OF THIS STUDY WAS TO ASSESS THE EFFECTIVENESS OF THE REDUCTION OF CHRONIC LOWER BACK PAIN IN OLDER ADULTS USING EITHER YOGA CLASSES OR QIGONG CLASSES COMPARED WITH NO INTERVENTION. THIS 3-ARMED RANDOMIZED TRIAL WITH 176 OLDER ADULTS SHOWED THAT YOGA AND QIGONG WERE NOT SUPERIOR TO NO TREATMENT IN REDUCING PAIN AND INCREASING QUALITY OF LIFE.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
12 2811  47 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
13 1585  43 MEDICAL YOGA FOR PATIENTS WITH STRESS-RELATED SYMPTOMS AND DIAGNOSES IN PRIMARY HEALTH CARE: A RANDOMIZED CONTROLLED TRIAL. AN INCREASING NUMBER OF PATIENTS ARE SUFFERING FROM STRESS-RELATED SYMPTOMS AND DIAGNOSES. THE PURPOSE OF THIS STUDY WAS TO EVALUATE THE MEDICAL YOGA TREATMENT IN PATIENTS WITH STRESS-RELATED SYMPTOMS AND DIAGNOSES IN PRIMARY HEALTH CARE. A RANDOMIZED CONTROLLED STUDY WAS PERFORMED AT A PRIMARY HEALTH CARE CENTRE IN SWEDEN FROM MARCH TO JUNE, 2011. PATIENTS WERE RANDOMLY ALLOCATED TO A CONTROL GROUP RECEIVING STANDARD CARE OR A YOGA GROUP TREATED WITH MEDICAL YOGA FOR 1 HOUR, ONCE A WEEK, OVER A 12-WEEK PERIOD IN ADDITION TO THE STANDARD CARE. A TOTAL OF 37 MEN AND WOMEN, MEAN AGE OF 53 +/- 12 YEARS WERE INCLUDED. GENERAL STRESS LEVEL (MEASURED USING PERCEIVED STRESS SCALE (PSS)), BURNOUT (SHIROM-MELAMED BURNOUT QUESTIONNAIRE (SMBQ)), ANXIETY AND DEPRESSION (HOSPITAL ANXIETY AND DEPRESSION SCALE (HADS)), INSOMNIA SEVERITY (INSOMNIA SEVERITY INDEX (ISI)), PAIN (VISUAL ANALOGUE SCALE (VAS)), AND OVERALL HEALTH STATUS (EURO QUALITY OF LIFE VAS (EQ-VAS)) WERE MEASURED BEFORE AND AFTER 12 WEEKS. PATIENTS ASSIGNED TO THE YOGA GROUP SHOWED SIGNIFICANTLY GREATER IMPROVEMENTS ON MEASURES OF GENERAL STRESS LEVEL (P < 0.000), ANXIETY (P < 0.019), AND OVERALL HEALTH STATUS (P < 0.018) COMPARED TO CONTROLS. TREATMENT WITH MEDICAL YOGA IS EFFECTIVE IN REDUCING LEVELS OF STRESS AND ANXIETY IN PATIENTS WITH STRESS-RELATED SYMPTOMS IN PRIMARY HEALTH CARE.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
14  430  67 CAN YOGA OR PHYSICAL THERAPY FOR CHRONIC LOW BACK PAIN IMPROVE DEPRESSION AND ANXIETY AMONG ADULTS FROM A RACIALLY DIVERSE, LOW-INCOME COMMUNITY? A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: TO DETERMINE AND COMPARE THE EFFECT OF YOGA, PHYSICAL THERAPY (PT), AND EDUCATION ON DEPRESSIVE AND ANXIOUS SYMPTOMS IN PATIENTS WITH CHRONIC LOW BACK PAIN (CLBP). DESIGN: SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. SETTING: ACADEMIC SAFETY NET HOSPITAL AND 7 COMMUNITY HEALTH CENTERS. PARTICIPANTS: A TOTAL OF 320 ADULTS WITH CLBP. INTERVENTION: YOGA CLASSES, PT SESSIONS, OR AN EDUCATIONAL BOOK. OUTCOME MEASURE: DEPRESSION AND ANXIETY WERE MEASURED USING THE PATIENT HEALTH QUESTIONNAIRE AND GENERALIZED ANXIETY DISORDER 7-ITEM SCALE, RESPECTIVELY, AT BASELINE, 12, AND 52 WEEKS. WE IDENTIFIED BASELINE AND MIDTREATMENT (6-WK) FACTORS ASSOCIATED WITH CLINICALLY MEANINGFUL IMPROVEMENTS IN DEPRESSIVE (>/=3 POINTS) OR ANXIOUS (>/=2 POINTS) SYMPTOMS AT 12 WEEKS. RESULTS: PARTICIPANTS (FEMALE=64%; MEAN AGE, 46.0+/-10.7 YEARS) WERE PREDOMINANTLY NON-WHITE (82%), LOW-INCOME (<$30,000/YEAR, 59%), AND HAD NOT RECEIVED A COLLEGE DEGREE (71%). MOST PARTICIPANTS HAD MILD OR WORSE DEPRESSIVE (60%) AND ANXIOUS (50%) SYMPTOMS. AT 12 WEEKS, YOGA AND PT PARTICIPANTS EXPERIENCED MODEST WITHIN-GROUP IMPROVEMENTS IN DEPRESSIVE SYMPTOMS (MEAN DIFFERENCE [MD]=-1.23 [95% CI, -2.18 TO -0.28]; MD=-1.01 [95% CI, -2.05 TO -0.03], RESPECTIVELY). COMPARED WITH THE EDUCATION GROUP, 12-WEEK DIFFERENCES WERE NOT STATISTICALLY SIGNIFICANT, ALTHOUGH TRENDS FAVORED YOGA (MD=-0.71 [95% CI, -2.22 TO 0.81]) AND PT (MD= -0.32 [95% CI, -1.82 TO 1.18]). AT 12 WEEKS, IMPROVEMENTS IN ANXIOUS SYMPTOMS WERE ONLY FOUND IN PARTICIPANTS WHO HAD MILD OR MODERATE ANXIETY AT BASELINE. INDEPENDENT OF TREATMENT ARM, PARTICIPANTS WHO HAD 30% OR GREATER IMPROVEMENT IN PAIN OR FUNCTION MIDTREATMENT WERE MORE LIKELY TO HAVE A CLINICALLY MEANINGFUL IMPROVEMENT IN DEPRESSIVE SYMPTOMS (ODDS RATIO [OR], 1.82 [95% CI, 1.03-3.22]; OR, 1.79 [95% CI, 1.06-3.04], RESPECTIVELY). CONCLUSIONS: IN OUR SECONDARY ANALYSIS WE FOUND THAT DEPRESSION AND ANXIETY, COMMON IN THIS SAMPLE OF UNDERSERVED ADULTS WITH CLBP, MAY IMPROVE MODESTLY WITH PT AND YOGA. HOWEVER, EFFECTS WERE NOT SUPERIOR TO EDUCATION. IMPROVEMENTS IN PAIN AND FUNCTION ARE ASSOCIATED WITH A DECREASE IN DEPRESSIVE SYMPTOMS. MORE RESEARCH IS NEEDED TO OPTIMIZE THE INTEGRATION OF PHYSICAL AND PSYCHOLOGICAL WELL-BEING IN PT AND YOGA.	2021	
                                                                                                                                                                                                                                                     
15 2708  58 YOGA IS EFFECTIVE IN TREATING SYMPTOMS OF GULF WAR ILLNESS: A RANDOMIZED CLINICAL TRIAL. MANY VETERANS OF THE 1990-1991 GULF WAR REPORT SYMPTOMS OF GULF WAR ILLNESS, A CONDITION INVOLVING NUMEROUS CHRONIC SYMPTOMS INCLUDING PAIN, FATIGUE, AND MOOD/COGNITION SYMPTOMS. LITTLE IS KNOWN ABOUT THIS CONDITION'S ETIOLOGY AND TREATMENT. THIS STUDY REPORTS OUTCOMES FROM A RANDOMIZED CONTROLLED SINGLE-BLIND TRIAL COMPARING YOGA TO COGNITIVE BEHAVIORAL THERAPY FOR CHRONIC PAIN AND OTHER SYMPTOMS OF GULF WAR ILLNESS. PARTICIPANTS WERE VETERANS WITH SYMPTOMS OF GWI: CHRONIC PAIN, FATIGUE AND COGNITION-MOOD SYMPTOMS. SEVENTY-FIVE VETERANS WERE RANDOMIZED TO TREATMENT VIA SELECTION OF ENVELOPES FROM A BAG (39 YOGA, 36 COGNITIVE BEHAVIORAL THERAPY), WHICH CONSISTED OF TEN WEEKLY GROUP SESSIONS. THE PRIMARY OUTCOMES OF PAIN SEVERITY AND INTERFERENCE (BRIEF PAIN INVENTORY- SHORT FORM) IMPROVED IN THE YOGA CONDITION (COHEN'S D = .35, P = 0.002 AND D = 0.69, P < 0.001, RESPECTIVELY) BUT NOT IN THE CBT CONDITION (D = 0.10, P = 0.59 AND D = 0.25 P = 0.23). HOWEVER, THE DIFFERENCES BETWEEN GROUPS WERE NOT STATISTICALLY SIGNIFICANT (D = 0.25, P = 0.25; D = 0.43, P = 0.076), THOUGH THE DIFFERENCE IN AN A-PRIORI-DEFINED EXPERIMENTAL OUTCOME VARIABLE WHICH COMBINES THESE TWO VARIABLES INTO A TOTAL PAIN VARIABLE (D = 0.47, P = 0.047) WAS SIGNIFICANT. FATIGUE, AS INDICATED BY A MEASURE OF FUNCTIONAL EXERCISE CAPACITY (6-MIN WALK TEST) WAS REDUCED SIGNIFICANTLY MORE IN THE YOGA GROUP THAN IN THE CBT GROUP (BETWEEN-GROUP D = .27, P = 0.044). OTHER SECONDARY OUTCOMES OF DEPRESSION, WELLBEING, AND SELF-REPORTED AUTONOMIC NERVOUS SYSTEM SYMPTOMS DID NOT DIFFER BETWEEN GROUPS. NO ADVERSE EVENTS DUE TO TREATMENT WERE REPORTED. YOGA MAY BE AN EFFECTIVE TREATMENT FOR CORE GULF WAR ILLNESS SYMPTOMS OF PAIN AND FATIGUE, MAKING IT ONE OF FEW TREATMENTS WITH EMPIRICAL SUPPORT FOR GWI. RESULTS SUPPORT FURTHER EVALUATION OF YOGA FOR TREATING VETERANS WITH GULF WAR ILLNESS. CLINICAL TRIAL REGISTRY: CLINICALTRIALS.GOV REGISTRATION NUMBER NCT02378025.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
16  345  38 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
17   91  56 A MULTICOMPONENT YOGA-BASED, BREATH INTERVENTION PROGRAM AS AN ADJUNCTIVE TREATMENT IN PATIENTS SUFFERING FROM GENERALIZED ANXIETY DISORDER WITH OR WITHOUT COMORBIDITIES. OBJECTIVES: THE AIM OF THIS STUDY IS TO EVALUATE THE EFFICACY AND TOLERABILITY OF SUDARSHAN KRIYA YOGA (SKY) COURSE IN GENERALIZED ANXIETY DISORDER (GAD) OUTPATIENTS, WHO AFTER EIGHT WEEKS OF AN APPROPRIATE DOSE OF TRADITIONAL THERAPY HAD NOT YET ACHIEVED REMISSION. SUBJECTS: THE ADULT PARTICIPANTS (18-65 YEARS) WERE OUTPATIENTS WITH A PRIMARY DIAGNOSIS OF GAD WITH OR WITHOUT COMORBIDITIES ON THE MINI-INTERNATIONAL NEUROPSYCHIATRIC INTERVIEW (MINI). PARTICIPANTS HAD A MINIMUM OF EIGHT WEEKS STANDARD TREATMENT WITH AN APPROPRIATE DOSE OF A STANDARD PRESCRIPTION ANXIOLYTIC, A CLINICIAN GLOBAL IMPRESSION-SEVERITY (CGI-S) SCORE OF 5-7, A HAMILTON ANXIETY SCALE (HAM-A) TOTAL SCORE >/=20 INCLUDING A SCORE OF >2 ON THE ANXIOUS MOOD AND TENSION ITEMS. MATERIALS AND METHODS: FORTY-ONE PATIENTS WERE ENROLLED IN AN OPEN-LABEL TRIAL OF THE SKY COURSE AS AN ADJUNCT TO STANDARD TREATMENT OF GAD AT THE START CLINIC FOR MOOD AND ANXIETY DISORDERS, A TERTIARY CARE MOOD AND ANXIETY DISORDER CLINIC IN TORONTO. THE SKY COURSE WAS ADMINISTERED OVER FIVE DAYS (22 H TOTAL). SUBJECTS WERE ENCOURAGED TO PRACTICE THE YOGA BREATHING TECHNIQUES AT HOME FOR 20 MIN PER DAY AFTER THE COURSE AND WERE OFFERED GROUP PRACTICE SESSIONS FOR 2 H ONCE A WEEK LED BY CERTIFIED YOGA INSTRUCTORS. THE PRIMARY OUTCOME MEASURE WAS THE MEAN CHANGE FROM PRE-TREATMENT ON THE HAM-A SCALE. PSYCHOLOGICAL MEASURES WERE OBTAINED AT BASELINE AND FOUR WEEKS AFTER COMPLETING THE INTERVENTION. RESULTS: THIRTY-ONE PATIENTS COMPLETED THE PROGRAM (MEAN AGE 42.6 +/- 13.3 YEARS). AMONG COMPLETERS, SIGNIFICANT REDUCTIONS OCCURRED IN THE PRE- AND POST-INTERVENTION MEAN HAM-A TOTAL SCORE (T=4.59; P<0.01) AND PSYCHIC SUBSCALE (T=5.00; P</=0.01). THE RESPONSE RATE WAS 73% AND THE REMISSION RATE 41% AS MEASURED ON THE HAM-A. CONCLUSION: THE RESULTS OF THIS SMALL PILOT TRIAL SUGGEST THAT THE SKY COURSE REPRESENTS A POTENTIALLY VALUABLE ADJUNCT TO STANDARD PHARMACOTHERAPY IN PATIENTS WITH GAD OR TREATMENT-RESISTANT GAD, AND WARRANTS FURTHER INVESTIGATION. IN PARTICULAR, CHANGES IN WORRY AND BODY SYMPTOMS SHOWED SIGNIFICANT IMPROVEMENTS THAT MAY FURTHER OUR UNDERSTANDING OF THE MECHANISM OF CHANGE IN THE TOLERANCE OF ANXIETY AND WORRY.	2012	
                                                                                                                                                                                                                                                                                                                                                             
18 1483  35 INTEGRATING YOGA WITH PSYCHOLOGICAL GROUP-TREATMENT FOR MIXED DEPRESSION AND ANXIETY IN PRIMARY HEALTHCARE: AN EXPLORATIVE PILOT STUDY. BACKGROUND AND PURPOSE: YOGA HAS SHOWN PROMISE AS A TREATMENT FOR DEPRESSION AND ANXIETY. THE PRESENT PILOT STUDY INVESTIGATED THE FEASIBILITY OF AN EIGHT-WEEK GROUPTREATMENT INTEGRATING EMOTION-FOCUSED PSYCHOEDUCATION, COMPASSION-FOCUSED THERAPY, AND VIRYA YOGA FOR DEPRESSION AND ANXIETY IN PRIMARY HEALTHCARE. MATERIALS AND METHODS: PATIENTS SEEKING TREATMENT FOR DEPRESSION AND ANXIETY IN A PRIMARY HEALTHCARE CENTRE COMPLETED EITHER AN INTEGRATIVE GROUP-TREATMENT (N = 14) OR TREATMENT AS USUAL (TAU, N = 17). OUTCOME MEASURES WERE ANALYSED PRE- AND POSTTREATMENT. CORRELATIONS IN THE INTERVENTION GROUP WERE INVESTIGATED BETWEEN TREATMENT OUTCOMES AND AMOUNT OF YOGA PRACTICE BETWEEN SESSIONS. RESULTS: LARGE WITHIN-GROUP EFFECT SIZES ON ALL OUTCOME MEASURES WERE FOUND AT POSTTREATMENT. SYMPTOM REDUCTION DID NOT DIFFER BETWEEN GROUPS (P = 0.155). IMPROVEMENT IN ALEXITHYMIA CORRELATED SIGNIFICANTLY (P < 0.05) WITH AMOUNT OF YOGA PRACTICE BETWEEN SESSIONS. CONCLUSION: INTEGRATING YOGA WITH A PSYCHOLOGICAL GROUP-TREATMENT IS A SOMEWHAT FEASIBLE APPROACH TO TREATMENT FOR DEPRESSION AND ANXIETY IN PRIMARY HEALTHCARE.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
19 1267  41 FOLLOW-UP OF YOGA OF AWARENESS FOR FIBROMYALGIA: RESULTS AT 3 MONTHS AND REPLICATION IN THE WAIT-LIST GROUP. OBJECTIVES: PUBLISHED PRELIMINARY FINDINGS FROM A RANDOMIZED-CONTROLLED TRIAL SUGGEST THAT AN 8-WEEK YOGA OF AWARENESS INTERVENTION MAY BE EFFECTIVE FOR IMPROVING SYMPTOMS, FUNCTIONAL DEFICITS, AND COPING ABILITIES IN FIBROMYALGIA. THE PRIMARY AIMS OF THIS STUDY WERE TO EVALUATE THE SAME INTERVENTION'S POSTTREATMENT EFFECTS IN A WAIT-LIST GROUP AND TO TEST THE INTERVENTION'S EFFECTS AT 3-MONTH FOLLOW-UP IN THE IMMEDIATE TREATMENT GROUP. METHODS: UNPAIRED T TESTS WERE USED TO COMPARE DATA FROM A PER PROTOCOL SAMPLE OF 21 WOMEN IN THE IMMEDIATE TREATMENT GROUP WHO HAD COMPLETED TREATMENT AND 18 WOMEN IN THE WAIT-LIST GROUP WHO HAD COMPLETED TREATMENT. WITHIN-GROUP PAIRED T TESTS WERE PERFORMED TO COMPARE POSTTREATMENT DATA WITH 3-MONTH FOLLOW-UP DATA IN THE IMMEDIATE TREATMENT GROUP. THE PRIMARY OUTCOME MEASURE WAS THE FIBROMYALGIA IMPACT QUESTIONNAIRE REVISED (FIQR). MULTILEVEL RANDOM-EFFECTS MODELS WERE ALSO USED TO EXAMINE ASSOCIATIONS BETWEEN YOGA PRACTICE RATES AND OUTCOMES. RESULTS: POSTTREATMENT RESULTS IN THE WAIT-LIST GROUP LARGELY MIRRORED RESULTS SEEN AT POSTTREATMENT IN THE IMMEDIATE TREATMENT GROUP, WITH THE FIQR TOTAL SCORE IMPROVING BY 31.9% ACROSS THE 2 GROUPS. FOLLOW-UP RESULTS SHOWED THAT PATIENTS SUSTAINED MOST OF THEIR POSTTREATMENT GAINS, WITH THE FIQR TOTAL SCORE REMAINING 21.9% IMPROVED AT 3 MONTHS. YOGA PRACTICE RATES WERE GOOD, AND MORE PRACTICE WAS ASSOCIATED WITH MORE BENEFIT FOR A VARIETY OF OUTCOMES. DISCUSSION: THESE FINDINGS INDICATE THAT THE BENEFITS OF YOGA OF AWARENESS IN FIBROMYALGIA ARE REPLICABLE AND CAN BE MAINTAINED.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
20 2012  51 SUDARSHAN KRIYA YOGA PROGRAM IN POSTTRAUMATIC STRESS DISORDER: A FEASIBILITY STUDY. BACKGROUND: SUDARSHAN KRIYA YOGA (SKY), A BREATH-BASED YOGA INTERVENTION, HAS DEMONSTRATED SAFETY AND EFFICACY IN POSTTRAUMATIC STRESS DISORDER (PTSD) PATIENTS SUBSEQUENT TO NATURAL DISASTER OR WAR, BUT HAS NOT BEEN EXPLORED IN CIVILIANS WITH PTSD FROM A WIDER RANGE OF TRAUMA. WE HYPOTHESIZED THAT IT WOULD BE FEASIBLE TO CONDUCT A CLINICAL TRIAL OF SKY IN PTSD RESULTING FROM A WIDE RANGE OF TRAUMA. METHODS: OUTCOMES WERE FEASIBILITY MEASURES INCLUDING RATES OF ENROLLMENT AND RETENTION, ADHERENCE TO STUDY PROTOCOL; AS WELL AS CHANGES IN PTSD SYMPTOMS, OTHER MOOD SYMPTOMS, AND PHYSIOLOGICAL MEASURES. MALE AND FEMALE PARTICIPANTS AGED 18-75 YEARS WERE ENROLLED IN A FEASIBILITY TRIAL. THEY ATTENDED A 6-DAY LEARNING PHASE OF SKY FOLLOWED BY 7 SESSIONS OVER 11 WEEKS AS AN ADJUNCT TO THEIR USUAL TREATMENT. RESULTS: FORTY-SEVEN PARTICIPANTS WERE SCREENED AND 32 WERE ENROLLED OVER 9 MONTHS. CONSISTENT WITH RETENTION RATES OF OTHER PTSD TRIALS, 13 WITHDREW FROM THE STUDY PRIOR TO WEEK 12. TWENTY-ONE PARTICIPANTS MET INTERVENTION ATTENDANCE REQUIREMENTS, COMPLETED 95% OF PLANNED STUDY ASSESSMENTS AND WERE INCLUDED IN FINAL ANALYSES. PARTICIPANTS EXPERIENCED CLINICALLY SIGNIFICANT DECREASE IN PTSD SYMPTOMS ON THE POSTTRAUMATIC STRESS DISORDER CHECKLIST (PCL-5) SCORES AT WEEK 12 MEAN DIFFERENCE, MDIFF (STANDARD DEVIATION [SD]) = -10.68 (14.03), P = 0.004; COHEN'S D = 0.58, WHICH WAS SUSTAINED AT WEEK 24 MDIFF (SD) = -16.11 (15.20), P < 0.001; COHEN'S D = 0.91. CONCLUSIONS: IT IS POSSIBLE TO CONDUCT A CLINICAL TRIAL OF SKY IN A ROUTINE PSYCHIATRY CLINIC SERVING PATIENTS WITH PTSD DUE TO A WIDE RANGE OF TRAUMA. FUTURE STUDIES SHOULD INCLUDE AN RCT DESIGN.	2020