1 1181 107 EVALUATION OF THE FEASIBILITY OF A HOME-BASED TELEYOGA INTERVENTION IN PARTICIPANTS WITH BOTH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND HEART FAILURE. OBJECTIVE: TEST THE FEASIBILITY AND CLINICAL OUTCOMES OF A HOME-BASED VIDEOCONFERENCING YOGA INTERVENTION IN PARTICIPANTS DIAGNOSED WITH BOTH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) AND HEART FAILURE (HF). BACKGROUND: YOGA HAS POTENTIAL BENEFIT FOR SYMPTOM RELIEF IN PARTICIPANTS WITH COPD AND WITH HF; HOWEVER, FUNCTIONAL IMPAIRMENT AND TRANSPORTATION ISSUES CAN HINDER ACCESS TO TYPICAL YOGA CLASSES. METHODS: A CONTROLLED, NONRANDOMIZED TRIAL WAS CONDUCTED OF AN 8-WEEK TELEYOGA INTERVENTION VERSUS AN EDUCATIONAL CONTROL (INFORMATION LEAFLETS MAILED TO PARTICIPANTS WITH ONE WEEKLY PHONE CALL). ONE-HOUR TELEYOGA CLASSES WERE IMPLEMENTED TWICE WEEKLY VIA MULTIPOINT VIDEOCONFERENCING, WHICH CONNECTED PARTICIPANTS TO LIVE CLASSES VIA AN INTERNET CONNECTION TO THEIR TELEVISIONS. RESULTS: FOURTEEN PARTICIPANTS WITH COPD AND HF TOOK PART IN THE PILOT STUDY (7 IN THE INTERVENTION GROUP AND 8 IN THE CONTROL). INTERVENTION PARTICIPANTS WERE ADHERENT TO CLASSES, ABLE TO SAFELY PARTICIPATE, AND FOUND THE CLASSES ENJOYABLE AFTER THE 8-WEEK PROGRAM. DYSPNEA AFTER EXERCISE IMPROVED IN THE INTERVENTION GROUP. CONCLUSIONS: DESPITE THEIR FRAILTY, PATIENTS DIAGNOSED WITH BOTH COPD AND HF WERE ABLE TO PERFORM YOGA SAFELY IN THE HOME SETTING. TELEYOGA WAS ACCEPTABLE AND ADHERENCE WAS GOOD; HOWEVER, TECHNICAL ISSUES WERE AN IMPORTANT HINDRANCE TO PARTICIPATION. 2017 2 336 70 APPROPRIATENESS AND ACCEPTABILITY OF A TELE-YOGA INTERVENTION FOR PEOPLE WITH HEART FAILURE AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE: QUALITATIVE FINDINGS FROM A CONTROLLED PILOT STUDY. BACKGROUND: HEART FAILURE (HF) AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) ARE HIGHLY PREVALENT AND ASSOCIATED WITH A LARGE SYMPTOM BURDEN, THAT IS COMPOUNDED IN A DUAL HF-COPD DIAGNOSIS. YOGA HAS POTENTIAL BENEFIT FOR SYMPTOM RELIEF; HOWEVER FUNCTIONAL IMPAIRMENT HINDERS ACCESS TO USUAL YOGA CLASSES. WE DEVELOPED A TELE-YOGA INTERVENTION AND EVALUATED IT IN A CONTROLLED PILOT TRIAL. THIS PAPER REPORTS ON THE APPROPRIATENESS AND ACCEPTABILITY OF THE INTERVENTION AND THE EVALUATION DESIGN. METHODS: A CONTROLLED, NON-RANDOMISED TRIAL WAS CONDUCTED OF AN 8-WEEK TELE-YOGA INTERVENTION VERSUS AN EDUCATIONAL CONTROL (INFORMATION LEAFLETS MAILED TO PARTICIPANTS WITH ONE PHONE CALL A WEEK). BIWEEKLY ONE-HOUR TELE-YOGA CLASSES WERE IMPLEMENTED VIA MULTIPOINT VIDEOCONFERENCING THAT CONNECTED PARTICIPANTS TO LIVE CLASSES VIA AN INTERNET CONNECTION TO THEIR TELEVISIONS. SEMI-STRUCTURED QUALITATIVE INTERVIEWS WERE CONDUCTED WITH PARTICIPANTS POST STUDY EXIT TO EXPLORE REASONS FOR AND EXPERIENCES OF PARTICIPATING, INCLUDING VIEWS OF STUDY OUTCOME MEASURES AND PHYSIOLOGICAL TESTS. TRANSCRIBED INTERVIEWS WERE ANALYSED USING THEMATIC CONTENT ANALYSIS. RESULTS: FIFTEEN PEOPLE PARTICIPATED IN THE PILOT STUDY (7 IN THE INTERVENTION GROUP, 8 IN THE CONTROL). OF THESE, 12 PARTICIPANTS WERE INTERVIEWED, 6 IN EACH GROUP, MEAN AGE 71.2 YEARS (SD 10.09); 3 WERE MALE. THEMES ARE REPORTED IN THE FOLLOWING CATEGORIES: ACCEPTABILITY AND APPROPRIATENESS OF THE INTERVENTION, POTENTIAL ACTIVE INGREDIENTS OF THE INTERVENTION, ACCEPTABILITY AND APPROPRIATENESS OF THE CONTROL, PARTICIPATION IN THE RESEARCH, AND ACCEPTABILITY OF THE TESTING PROCEDURES. THE INTERVENTION WAS ACCEPTABLE AND APPROPRIATE: THE INTERVENTION GROUP REPORTED ENJOYING YOGA AND VALUING THE HOME-BASED ASPECT AND PARTICIPANTS DESCRIBED A HIGH SYMPTOM BURDEN AND SOCIAL ISOLATION. HOWEVER, TECHNOLOGICAL PROBLEMS RESULTED IN POOR VIDEO-STREAMING QUALITY FOR SOME PARTICIPANTS. POTENTIAL ACTIVE INGREDIENTS INCLUDED PHYSICAL POSTURES, BREATHING EXERCISES AND GUIDANCE IN RELAXATION AND MEDITATION. THE EDUCATIONAL CONTROL INTERVENTION WAS ACCEPTABLE AND APPROPRIATE, WITH PARTICIPANTS REPORTING LITTLE EFFECT ON THEIR WELL-BEING AND NO IMPACT ON MECHANISMS HYPOTHESISED TO EXPLAIN YOGA'S EFFECTIVENESS. THE QUESTIONNAIRES AND HOME PHYSIOLOGICAL TESTING WERE ACCEPTABLE TO PARTICIPANTS. CONCLUSIONS: TELE-YOGA IS AN ACCEPTABLE AND APPROPRIATE INTERVENTION IN PEOPLE WITH HF AND COPD AND FURTHER RESEARCH IS WARRANTED TO REFINE THE TECHNOLOGY USED IN ITS DELIVERY. FINDINGS PROVIDE GUIDANCE FOR RESEARCHERS WORKING IN TELE-INTERVENTIONS, YOGA, AND SIMILAR POPULATIONS. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT02078739 (4 MARCH 2014). 2015 3 2036 41 TELE-YOGA IN LONG TERM ILLNESS-PROTOCOL FOR A RANDOMISED CONTROLLED TRIAL INCLUDING A PROCESS EVALUATION AND RESULTS FROM A PILOT STUDY. BACKGROUND: FOR PEOPLE WITH LONG-TERM ILLNESS, DEBILITATED BY SEVERE SYMPTOMS, IT CAN BE DIFFICULT TO ATTEND REGULAR YOGA CLASSES. WE HAVE THEREFORE DEVELOPED A TELE-HEALTH FORMAT OF YOGA THAT CAN BE DELIVERED IN THE HOME. THE TELE-YOGA WAS CO-DESIGNED WITH MEMBERS OF A PATIENT-ORGANISATION, YOGA-INSTRUCTOR, AND IT-TECHNICIAN. IT INCLUDES LIVE-STREAMED GROUP-YOGA SESSIONS TWICE A WEEK AND AN APP WITH INSTRUCTIONS ON HOW TO SELF-PERFORM YOGA. AIM: TO DESCRIBE A STUDY PROTOCOL FOR A RANDOMISED CONTROLLED TRIAL (RCT) INCLUDING A PROCESS EVALUATION AND REPORT ON A PILOT STUDY EVALUATING METHOD- AND INTERVENTION-RELATED COMPONENTS INCLUDING FEASIBILITY, SAFETY, AND EFFICACY. METHODS: TEN PARTICIPANTS WITH HEART FAILURE AGED BETWEEN 41-76 YEARS WERE RANDOMISED TO TELE-YOGA (N = 5) OR TO THE CONTROL GROUP (N = 5). IN THE PILOT STUDY RECRUITMENT, ENROLMENT, RANDOMISATION, AND DATA COLLECTION OF ALL OUTCOMES INCLUDING PRIMARY, SECONDARY AND PROCESS EVALUATION MEASURES WERE TESTED ACCORDING TO THE STUDY PROTOCOL. FIDELITY, ADHERENCE AND ACCEPTABILITY TO THE TELE-YOGA GROUP TRAINING AND APP USE WAS DETERMINED. SAFETY WAS ASSESSED BY ADVERSE EVENTS. RESULTS: THE PILOT REVEALED THAT THE METHODOLOGICAL ASPECT OF THE PROTOCOL WORKED SUFFICIENTLY IN ALL ASPECTS EXCEPT FOR MISSING DATA IN THE PHYSICAL TEST OF TWO PARTICIPANTS AND ONE PARTICIPANT IN THE CONTROL-GROUP THAT DROPPED OUT OF THE STUDY AT THREE MONTHS FOLLOW-UP. THE TELE-YOGA TRAINING DID NOT LEAD TO ANY ADVERSE EVENTS OR INJURIES, ADHERENCE OF TELE-YOGA WAS SUFFICIENT ACCORDING TO PRESET LIMITS. THE TELE-YOGA INTERVENTION ALSO SHOWED SOME FAVOURABLE TRENDS OF IMPROVEMENTS IN THE COMPOSITE-END POINT COMPARED TO THE ACTIVE CONTROL GROUP. HOWEVER, SINCE DATA ONLY WAS PRESENTED DESCRIPTIVELY DUE TO THE SMALL SAMPLE SIZE, THE IMPACT OF THESE TRENDS SHOULD BE INTERPRETED CAREFULLY. CONCLUSION: OUR PILOT STUDY SHOWED PROMISING RESULTS IN FEASIBILITY, SAFETY, AND ACCEPTABILITY OF THE TELE-YOGA INTERVENTION. SOME CHANGES IN THE PROTOCOL HAVE BEEN MADE TO DECREASE THE RISK OF MISSING DATA IN THE MEASURES OF PHYSICAL FUNCTION AND IN THE FULL-SCALE RCT NOW ONGOING THE RESULTS OF THE SAMPLE SIZE CALCULATION FOR 300 PARTICIPANTS HAVE INCLUDED THE ESTIMATED LEVEL OF DROP OUTS AND MISSING DATA. 2021 4 1243 38 FEASIBILITY OF A YOGA, AEROBIC AND STRETCHING-TONING EXERCISE PROGRAM FOR ADULT CANCER SURVIVORS: THE STAYFIT TRIAL. BACKGROUND: THE USE OF YOGA AS A MIND-BODY PRACTICE HAS BECOME INCREASINGLY POPULAR AMONG CLINICAL POPULATIONS AND OLDER ADULTS WHO USE THIS PRACTICE TO MANAGE AGE AND CHRONIC DISEASE-RELATED SYMPTOMS. ALTHOUGH YOGA CONTINUES TO GAIN POPULARITY AMONG PRACTITIONERS AND RESEARCHERS, PILOT STUDIES THAT EXAMINE ITS FEASIBILITY AND ACCEPTABILITY, ESPECIALLY AMONG CANCER SURVIVORS, ARE LIMITED. FEASIBILITY STUDIES PLAY A CRITICAL ROLE IN DETERMINING WHETHER THE TARGET POPULATION IS LIKELY TO ENGAGE WITH LARGER SCALE EFFICACY AND EFFECTIVENESS TRIALS. IN THIS PAPER WE PRESENT FEASIBILITY AND ACCEPTABILITY DATA FROM A 12-WEEK RANDOMIZED CONTROLLED TRIAL (RCT) CONDUCTED WITH ADULT CANCER SURVIVORS. METHODS: PARTICIPANTS N = 78 (MEAN AGE: 55 YEARS) WERE RANDOMIZED TO ONE OF THREE GROUPS: A HATHA YOGA, AEROBIC EXERCISE, OR STRETCHING-TONING CONTROL GROUP WITH GROUP EXERCISE CLASSES HELD FOR 150 MIN/WEEK FOR 12 WEEKS. HEREIN WE REPORT FEASIBILITY AND ACCEPTABILITY, INCLUDING ENROLLMENT RATES, ATTENDANCE, ATTRITION AND ADVERSE EVENTS, AND PARTICIPANT FEEDBACK AND SATISFACTION DATA. RESULTS: OF THE 233 ADULTS SCREENED, 109 WERE ELIGIBLE AND 78 RANDOMIZED TO ONE OF THE THREE INTERVENTION ARMS. SESSION ATTENDANCE WAS HIGH FOR ALL GROUPS (75.5-89.5%) AND 17 PARTICIPANTS DROPPED OUT DURING THE 12-WEEK INTERVENTION. PROGRAM SATISFACTION WAS HIGH (4.8 OR HIGHER OUT OF 5) AND NO ADVERSE EVENTS WERE REPORTED. ONE COHORT (N = 15) OF THE INTERVENTION TRANSITIONED TO REMOTE INTERVENTION DELIVERY DUE TO THE COVID-19 PANDEMIC. FEASIBILITY DATA FROM THESE PARTICIPANTS SUGGESTED THAT SYNCHRONIZED GROUP EXERCISE CLASSES VIA ZOOM WITH A LIVE INSTRUCTOR WERE ACCEPTABLE AND ENJOYABLE. PARTICIPANT FEEDBACK REGARDING MOST AND LEAST HELPFUL ASPECTS OF THE PROGRAM AS WELL AS SUGGESTIONS FOR FUTURE YOGA INTERVENTIONS ARE SUMMARIZED. CONCLUSIONS: OVERALL, THE YOGA INTERVENTION WAS HIGHLY FEASIBLE AND ACCEPTABLE. THE FEASIBILITY PARAMETERS FROM THIS TRIAL CAN AID RESEARCHERS IN ESTIMATING RECRUITMENT RATES FOR DESIRED SAMPLE SIZES TO SUCCESSFULLY RANDOMIZE AND RETAIN CANCER SURVIVORS IN SHORT- AND LONG-TERM YOGA-BASED EFFICACY AND EFFECTIVENESS TRIALS. THE FINDINGS ALSO PROVIDE EVIDENCE TO CLINICIANS WHO CAN RECOMMEND UP TO 150 MIN OF A COMBINATION OF EXERCISES-AEROBIC, YOGA, OR STRETCHING-TONING TO THEIR CANCER PATIENTS IN ORDER TO IMPROVE HEALTH AND WELLBEING DURING CANCER SURVIVORSHIP. 2021 5 2360 32 VIDEOCONFERENCED YOGA INTERVENTIONS FOR CANCER PATIENTS AND THEIR CAREGIVERS DURING THE COVID-19 PANDEMIC: A REPORT FROM A CLINICIAN'S PERSPECTIVE. BACKGROUND: THE ACCEPTABILITY OF VIDEOCONFERENCING DELIVERY OF YOGA INTERVENTIONS IN THE ADVANCED CANCER SETTING IS RELATIVELY UNEXPLORED. THE CURRENT REPORT SUMMARIZES THE CHALLENGES AND SOLUTIONS OF THE TRANSITION FROM AN IN-PERSON (IE, FACE-TO-FACE) TO A VIDEOCONFERENCE INTERVENTION DELIVERY APPROACH IN RESPONSE TO THE CORONAVIRUS DISEASE PANDEMIC. METHOD: PARTICIPANTS INCLUDED PATIENT-FAMILY CAREGIVER DYADS WHO WERE ENROLLED IN ONGOING YOGA TRIALS AND 2 CERTIFIED YOGA THERAPISTS WHO DELIVERED THE YOGA SESSIONS. WE SUMMARIZED THEIR EXPERIENCES USING RECORDINGS OF THE YOGA SESSIONS AND INTERVENTIONISTS' PROGRESS NOTES. RESULTS: OUT OF 7 DYADS PARTICIPATING IN THE PARENT TRIAL, 1 DECLINED THE VIDEOCONFERENCED SESSIONS. PARTICIPANTS WERE BETWEEN THE AGES OF 55 AND 76 AND MOSTLY NON-HISPANIC WHITE (83%). PATIENTS WERE MAINLY MALE (83%), ALL HAD STAGE III OR IV CANCER AND WERE UNDERGOING RADIOTHERAPY. CAREGIVERS WERE ALL FEMALE. DESPITE CHALLENGES IN THE AREAS OF TECHNOLOGY, LOCATION, AND SETTING, INSTRUCTION AND PERSONAL CONNECTION, THE OVERALL ACCEPTABILITY WAS HIGH AMONG PATIENTS, CAREGIVERS, AND INSTRUCTORS. THROUGH THIS TRANSITION PROCESS, SOLUTIONS TO THESE CHALLENGES WERE FOUND, WHICH ARE DESCRIBED HERE. CONCLUSION: ALTHOUGH IN-PERSON INTERVENTIONS ARE FAVORED BY BOTH THE STUDY PARTICIPANTS AND THE INTERVENTIONISTS, VIDEOCONFERENCE SESSIONS WERE DEEMED ACCEPTABLE. ALL PARTICIPANTS HAD THE BENEFIT OF A PREVIOUS IN-PERSON EXPERIENCE, WHICH WAS HELPFUL AND PERHAPS NECESSARY FOR OLDER AND ADVANCED CANCER PATIENTS REQUIRING PRACTICE MODIFICATIONS. IN A REMOTE SETTING, THE ASSISTANCE OF CAREGIVERS SEEMS PARTICULARLY BENEFICIAL TO ENSURE PRACTICE SAFETY. CLINICALTRIALS.GOV: NCT03948100; NCT02481349. 2021 6 1242 41 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 7 2628 34 YOGA FOR THE MANAGEMENT OF PAIN AND SLEEP IN RHEUMATOID ARTHRITIS: A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THE AIM OF THE PRESENT STUDY WAS TO DETERMINE THE FEASIBILITY OF A RELAXATION-BASED YOGA INTERVENTION FOR RHEUMATOID ARTHRITIS, DESIGNED AND REPORTED IN ACCORDANCE WITH DELPHI RECOMMENDATIONS FOR YOGA INTERVENTIONS FOR MUSCULOSKELETAL CONDITIONS. METHODS: PARTICIPANTS WERE RECRUITED FROM A HOSPITAL DATABASE, AND RANDOMIZED TO EITHER EIGHT WEEKLY 75-MIN YOGA CLASSES OR A USUAL CARE CONTROL. FEASIBILITY WAS DETERMINED BY RECRUITMENT RATES, RETENTION, PROTOCOL ADHERENCE, PARTICIPANT SATISFACTION AND ADVERSE EVENTS. SECONDARY PHYSICAL AND PSYCHOSOCIAL OUTCOMES WERE ASSESSED USING SELF-REPORTED QUESTIONNAIRES AT BASELINE (WEEK 0), WEEK 9 (PRIMARY TIME POINT) AND WEEK 12 (FOLLOW-UP). RESULTS: OVER A 3-MONTH PERIOD, 26 PARTICIPANTS WITH MILD PAIN, MILD TO MODERATE FUNCTIONAL DISABILITY AND MODERATE DISEASE ACTIVITY WERE RECRUITED INTO THE STUDY (25% RECRUITMENT RATE). RETENTION RATES WERE 100% FOR YOGA PARTICIPANTS AND 92% FOR USUAL CARE PARTICIPANTS AT BOTH WEEKS 9 AND 12. PROTOCOL ADHERENCE AND PARTICIPANT SATISFACTION WERE HIGH. YOGA PARTICIPANTS ATTENDED A MEDIAN OF SEVEN CLASSES; ADDITIONALLY, SEVEN OF THE YOGA PARTICIPANTS (54%) REPORTED CONTINUING YOGA AT HOME DURING THE FOLLOW-UP PERIOD. NO SERIOUS ADVERSE EVENTS WERE RELATED TO THE STUDY. SECONDARY OUTCOMES SHOWED NO GROUP EFFECTS OF YOGA COMPARED WITH USUAL CARE. CONCLUSIONS: A RELAXATION-BASED YOGA PROGRAMME WAS FOUND TO BE FEASIBLE AND SAFE FOR PARTICIPANTS WITH RHEUMATOID ARTHRITIS-RELATED PAIN AND FUNCTIONAL DISABILITY. ADVERSE EVENTS WERE MINOR, AND NOT UNEXPECTED FROM AN INTERVENTION INCLUDING PHYSICAL COMPONENTS. THIS PILOT PROVIDES A FRAMEWORK FOR LARGER INTERVENTION STUDIES, AND SUPPORTS FURTHER EXPLORATION OF YOGA AS A COMPLEX INTERVENTION TO ASSIST WITH THE MANAGEMENT OF RHEUMATOID ARTHRITIS. 2018 8 786 43 EFFECT OF YOGA BREATHING (PRANAYAMA) ON EXERCISE TOLERANCE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A RANDOMIZED, CONTROLLED TRIAL. OBJECTIVE: PULMONARY REHABILITATION IMPROVES EXERCISE TOLERANCE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). HOWEVER, MANY PATIENTS DO NOT HAVE ACCESS TO PULMONARY REHABILITATION PROGRAMS. WE HYPOTHESIZED THAT AN ALTERNATIVE TO PULMONARY REHABILITATION TO IMPROVE EXERCISE TOLERANCE IS THE PRACTICE OF PRANAYAMA, OR YOGA BREATHING, WHICH COULD BE DONE INDEPENDENTLY AT HOME. WE ALSO SOUGHT TO DETERMINE WHETHER YOGA NONPROFESSIONALS COULD ADEQUATELY TEACH PRANAYAMA TO PATIENTS. DESIGN: PROOF-OF-CONCEPT, RANDOMIZED, DOUBLE-BLIND, CONTROLLED PILOT TRIAL. SETTINGS/LOCATION: TWO ACADEMIC PULMONARY PRACTICES. SUBJECTS: FORTY-THREE PATIENTS WITH SYMPTOMATIC, MODERATE-TO-SEVERE COPD. INTERVENTIONS: TWELVE WEEKS OF PRANAYAMA PLUS EDUCATION VERSUS EDUCATION ALONE. TWO YOGA PROFESSIONALS TRAINED THE RESEARCH COORDINATORS TO CONDUCT ALL PRANAYAMA TEACHING AND MONITORED THE QUALITY OF THE TEACHING AND THE PRACTICE OF PRANAYAMA BY STUDY PARTICIPANTS. OUTCOME MEASURES: THE PRIMARY OUTCOME WAS A CHANGE IN THE 6-MIN WALK DISTANCE (6MWD). SECONDARY OUTCOMES INCLUDED CHANGES IN LUNG FUNCTION, MARKERS OF OXIDATIVE STRESS AND SYSTEMIC INFLAMMATION, AND MEASURES OF DYSPNEA AND QUALITY OF LIFE. RESULTS: THE 6MWD INCREASED IN THE PRANAYAMA GROUP (LEAST SQUARE MEAN [95% CONFIDENCE INTERVAL] = 28 M [-5 TO 61]) AND DECREASED IN THE CONTROL GROUP (-15 M [-47 TO 16]), WITH A NEARLY SIGNIFICANT TREATMENT EFFECT (P = 0.06) IN FAVOR OF PRANAYAMA. PRANAYAMA ALSO RESULTED IN SMALL IMPROVEMENTS IN INSPIRATORY CAPACITY AND AIR TRAPPING. BOTH GROUPS HAD SIGNIFICANT IMPROVEMENTS IN VARIOUS MEASURES OF SYMPTOMS, BUT NO OVERALL DIFFERENCES IN RESPIRATORY SYSTEM IMPEDANCE OR MARKERS OF OXIDATIVE STRESS OR SYSTEMIC INFLAMMATION. CONCLUSION: THIS PILOT STUDY SUCCESSFULLY DEMONSTRATED THAT PRANAYAMA WAS ASSOCIATED WITH IMPROVED EXERCISE TOLERANCE IN PATIENTS WITH COPD. LAY PERSONNEL WERE ABLE TO ADEQUATELY TEACH PATIENTS TO PRACTICE PRANAYAMA. THESE RESULTS SUGGEST THAT PRANAYAMA MAY HAVE SIGNIFICANT CLINICAL BENEFITS FOR SYMPTOMATIC PATIENTS WITH COPD, A CONCEPT THAT NEEDS TO BE CONFIRMED IN FUTURE, LARGER CLINICAL TRIALS. 2017 9 1413 25 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 10 2609 35 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 11 2117 28 THE EFFECT OF YOGA ON WOMEN WITH SECONDARY ARM LYMPHOEDEMA FROM BREAST CANCER TREATMENT. BACKGROUND: WOMEN WHO DEVELOP SECONDARY ARM LYMPHOEDEMA SUBSEQUENT TO TREATMENT ASSOCIATED WITH BREAST CANCER REQUIRE LIFE-LONG MANAGEMENT FOR A RANGE OF SYMPTOMS INCLUDING ARM SWELLING, HEAVINESS, TIGHTNESS IN THE ARM AND SOMETIMES THE CHEST, UPPER BODY IMPAIRMENT AND CHANGES TO A RANGE OF PARAMETERS RELATING TO QUALITY OF LIFE. WHILE EXERCISE UNDER CONTROLLED CONDITIONS HAS HAD POSITIVE OUTCOMES, THE IMPACT OF YOGA HAS NOT BEEN INVESTIGATED. THE AIM OF THIS STUDY IS TO DETERMINE THE EFFECTIVENESS OF YOGA IN THE PHYSICAL AND PSYCHO-SOCIAL DOMAINS, IN THE HOPE THAT WOMEN CAN BE OFFERED ANOTHER SAFE, HOLISTIC MODALITY TO HELP CONTROL MANY, IF NOT ALL, OF THE EFFECTS OF SECONDARY ARM LYMPHOEDEMA. METHODS AND DESIGN: A RANDOMISED CONTROLLED PILOT TRIAL WILL BE CONDUCTED IN HOBART AND LAUNCESTON WITH A TOTAL OF 40 WOMEN RECEIVING EITHER YOGA INTERVENTION OR CURRENT BEST PRACTICE CARE. INTERVENTION WILL CONSIST OF EIGHT WEEKS OF A WEEKLY TEACHER-LED YOGA CLASS WITH A HOME-BASED DAILY YOGA PRACTICE DELIVERED BY DVD. PRIMARY OUTCOME MEASURES WILL BE THE EFFECTS OF YOGA ON LYMPHOEDEMA AND ITS ASSOCIATED SYMPTOMS AND QUALITY OF LIFE. SECONDARY OUTCOME MEASURES WILL BE RANGE OF MOTION OF THE ARM AND THORACIC SPINE, SHOULDER STRENGTH, AND WEEKLY AND DAILY PHYSICAL ACTIVITY. PRIMARY AND SECONDARY OUTCOMES WILL BE MEASURED AT BASELINE, WEEKS FOUR, EIGHT AND A FOUR WEEK FOLLOW UP AT WEEK TWELVE. RANGE OF MOTION OF THE SPINE, IN A SELF-NOMINATED GROUP, WILL BE MEASURED AT BASELINE, WEEKS EIGHT AND TWELVE. A FURTHER OUTCOME WILL BE THE WOMEN'S PERCEPTIONS OF THE YOGA COLLECTED BY INTERVIEW AT WEEK EIGHT. DISCUSSION: THE RESULTS OF THIS TRIAL WILL PROVIDE INFORMATION ON THE SAFETY AND EFFECTIVENESS OF YOGA FOR WOMEN WITH SECONDARY ARM LYMPHOEDEMA FROM BREAST CANCER TREATMENT. IT WILL ALSO INFORM METHODOLOGY FOR FUTURE, LARGER TRIALS. TRIAL REGISTRATION: ACTRN12611000202965. 2012 12 2579 32 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 13 345 31 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 14 87 38 A MIXED METHODS EVALUATION OF AN INDIVIDUALISED YOGA THERAPY INTERVENTION FOR RHEUMATOID ARTHRITIS: PILOT STUDY. OBJECTIVES: TO EXPLORE PATIENTS' EXPERIENCES OF AN INDIVIDUALISED YOGA THERAPY INTERVENTION FOR RHEUMATOID ARTHRITIS (RA), SPECIFICALLY IN TERMS OF ITS ACCEPTABILITY AND IMPACT ON PATIENT-REPORTED OUTCOMES. DESIGN: TEN PATIENTS TOOK PART IN A 16 WEEK YOGA THERAPY INTERVENTION IN A HOSPITAL SETTING, CONSISTING OF 10 ONE-TO-ONE CONSULTATIONS WITH A YOGA THERAPIST FOLLOWED BY TWO GROUP REVIEW SESSIONS. CHANGES IN HEALTH (EQ-5D, HADS) WERE ASSESSED PRE- AND POST-INTERVENTION AND AT 12-MONTH FOLLOW-UP. IN-DEPTH INTERVIEWS WERE CONDUCTED POST-INTERVENTION AND ANALYSED USING THEMATIC ANALYSIS. RESULTS: ATTENDANCE OF THE 1-TO-1 SESSIONS WAS HIGH (98 %) AND ALL PARTICIPANTS REPORTED STRONG COMMITMENT TO THEIR PERSONALISED HOME PRACTICE. THERE WERE SIGNIFICANT IMPROVEMENTS IN MEASURES OF DEPRESSION, ANXIETY, PAIN, QUALITY OF LIFE AND GENERAL HEALTH AT POST-INTERVENTION AND 12-MONTHS (P < 0.05). IN INTERVIEWS, ALL BUT ONE PARTICIPANT REPORTED POSITIVE CHANGES TO THEIR SYMPTOMS AND SEVERAL REPORTED REDUCTIONS IN THEIR MEDICATION AND BROADER BENEFITS SUCH AS IMPROVED SLEEP, MOOD AND ENERGY, ENABLING RE-ENGAGEMENT WITH LIFE. THE PERSONALLY TAILORED NATURE OF THE PRACTICE AND PERCEIVED BENEFITS WERE KEY MOTIVATIONAL FACTORS. PARTICULAR VALUE WAS PLACED ON THE THERAPEUTIC FUNCTION OF THE CONSULTATION AND PROVISION OF TOOLS TO MANAGE STRESS AND BUILD RESILIENCE. CONCLUSION: THIS YOGA THERAPY INTERVENTION WAS POSITIVELY RECEIVED BY PATIENTS WITH RA, WITH HIGH LEVELS OF ADHERENCE TO BOTH THE TREATMENTS AND TAILORED HOME PRACTICE. THE FINDINGS SUGGEST THAT YOGA THERAPY HAS POTENTIAL AS AN ADJUNCT THERAPY TO IMPROVE RA SYMPTOMS, INCREASE SELF-CARE BEHAVIOURS AND MANAGE STRESS AND NEGATIVE AFFECT SUCH AS ANXIETY. A LARGER MULTI-CENTRE STUDY IS THEREFORE WARRANTED. 2020 15 112 31 A PILOT STUDY OF A MINDFULNESS INFORMED YOGA INTERVENTION IN YOUNG PEOPLE WITH PSYCHOSIS. AIM: TO DETERMINE THE ACCEPTABILITY AND SAFETY OF A MINDFULNESS INFORMED YOGA INTERVENTION AS ADJUNCT TO USUAL CARE FOR YOUNG PEOPLE WITH EARLY PSYCHOSIS. METHODS: PEOPLE AGED 16-25 YEARS ATTENDING A COMMUNITY-BASED SPECIALIST EARLY PSYCHOSIS CLINIC WERE INVITED TO PARTICIPATE IN A 12-WEEK YOGA INTERVENTION. THE INTERVENTION CONSISTED OF 1-H WEEKLY CLASSES OF MINDFULNESS INFORMED YOGA. ACCEPTABILITY WAS MEASURED BY UPTAKE, ATTENDANCE AND PARTICIPANTS' SATISFACTION. SAFETY WAS MEASURED BY INCIDENCE OF PHYSICAL INJURY, PARTICIPANTS' LEVEL OF COMFORT, DISTRESS AND ANXIETY DURING THE SESSIONS, AND THE FOLLOWING MENTAL HEALTH OUTCOMES: POSITIVE AND NEGATIVE PSYCHOTIC, DEPRESSION, ANXIETY AND STRESS SYMPTOMS, SLEEP QUALITY AND FUNCTIONING. RESULTS: OF THOSE WHO CONSENTED TO THE STUDY, 80% (12) PARTICIPATED AND ON AVERAGE ATTENDED 4.4 YOGA CLASSES. THERE WERE NO PHYSICAL INJURIES AND PARTICIPANTS REPORTED MINIMAL DISTRESS AND ANXIETY. POST-INTERVENTION, THERE WAS A SIGNIFICANT REDUCTION IN ANXIETY SYMPTOMS AND AN IMPROVEMENT IN FUNCTION. CONCLUSIONS: MINDFULNESS-BASED YOGA INTERVENTIONS ARE BOTH ACCEPTABLE AND SAFE AS AN INTERVENTION FOR YOUTH WITH EARLY PSYCHOSIS. THOUGH NUMBERS WERE SMALL, THE STUDY SHOWS PROMISE FOR YOGA AS A POTENTIALLY USEFUL INTERVENTION. IMPORTANTLY, THERE WAS NO DETERIORATION IN MENTAL HEALTH OUTCOMES. A LARGER TRIAL EVALUATING CLINICAL EFFECTIVENESS IS NOW TIMELY. 2022 16 501 36 COMMUNITY BASED YOGA CLASSES FOR TYPE 2 DIABETES: AN EXPLORATORY RANDOMISED CONTROLLED TRIAL. BACKGROUND: YOGA IS A POPULAR THERAPY FOR DIABETES BUT ITS EFFICACY IS CONTESTED. THE AIM OF THIS STUDY WAS TO EXPLORE THE FEASIBILITY OF RESEARCHING COMMUNITY BASED YOGA CLASSES IN TYPE 2 DIABETES WITH A VIEW TO INFORMING THE DESIGN OF A DEFINITIVE, MULTI-CENTRE TRIAL METHODS: THE STUDY DESIGN WAS AN EXPLORATORY RANDOMISED CONTROLLED TRIAL WITH IN-DEPTH PROCESS EVALUATION. THE SETTING WAS TWO MULTI-ETHNIC BOROUGHS IN LONDON, UK; ONE WITH AVERAGE AND ONE WITH LOW MEAN SOCIO-ECONOMIC DEPRIVATION SCORE. CLASSES WERE HELD AT A SPORTS CENTRE OR GP SURGERY. PARTICIPANTS WERE 59 PEOPLE WITH TYPE 2 DIABETES NOT TAKING INSULIN, RECRUITED FROM GENERAL PRACTICE LISTS OR OPPORTUNISTICALLY BY GENERAL PRACTICE STAFF. THE INTERVENTION GROUP WERE OFFERED 12 WEEKS OF A TWICE-WEEKLY 90-MINUTE YOGA CLASS; THE CONTROL GROUP WAS A WAITING LIST FOR THE YOGA CLASSES. BOTH GROUPS RECEIVED ADVICE AND LEAFLETS ON HEALTHY LIFESTYLE AND WERE ENCOURAGED TO EXERCISE. PRIMARY OUTCOME MEASURE WAS HBA1C. SECONDARY OUTCOME MEASURES INCLUDED ATTENDANCE, WEIGHT, WAIST CIRCUMFERENCE, LIPID LEVELS, BLOOD PRESSURE, UKPDS CARDIOVASCULAR RISK SCORE, DIABETES-RELATED QUALITY OF LIFE (ADDQOL), AND SELF-EFFICACY. PROCESS MEASURES WERE ATTENDANCE AT YOGA SESSIONS, SELF-REPORTED FREQUENCY OF PRACTICE BETWEEN TAUGHT SESSIONS, AND QUALITATIVE DATA (INTERVIEWS WITH PATIENTS AND THERAPISTS, ETHNOGRAPHIC OBSERVATION OF THE YOGA CLASSES, AND ANALYSIS OF DOCUMENTS INCLUDING MINUTES OF MEETINGS, CORRESPONDENCE, AND EXERCISE PLANS). RESULTS: DESPITE BROAD INCLUSION CRITERIA, AROUND TWO-THIRDS OF THE PATIENTS ON GP DIABETIC REGISTERS PROVED INELIGIBLE, AND 90% OF THE REMAINDER DECLINED TO PARTICIPATE. MEAN AGE OF PARTICIPANTS WAS 60 +/- 10 YEARS. ATTENDANCE AT YOGA CLASSES WAS AROUND 50%. NOBODY DID THE EXERCISES REGULARLY AT HOME. YOGA TEACHERS FELT THAT MOST PARTICIPANTS WERE UNSUITABLE FOR 'STANDARD' YOGA EXERCISES BECAUSE OF LIMITED FLEXIBILITY, LACK OF BASIC FITNESS, CO-MORBIDITY, AND LACK OF CONFIDENCE. THERE WAS A SMALL FALL IN HBA1C IN THE YOGA GROUP WHICH WAS NOT STATISTICALLY SIGNIFICANT AND WHICH WAS NOT SUSTAINED SIX MONTHS LATER, AND NO SIGNIFICANT CHANGE IN OTHER OUTCOME MEASURES. CONCLUSION: THE BENEFITS OF YOGA IN TYPE 2 DIABETES SUGGESTED IN SOME PREVIOUS STUDIES WERE NOT CONFIRMED. POSSIBLE EXPLANATIONS (APART FROM LACK OF EFFICACY) INCLUDE RECRUITMENT CHALLENGES; PRACTICAL AND MOTIVATIONAL BARRIERS TO CLASS ATTENDANCE; PHYSICAL AND MOTIVATIONAL BARRIERS TO ENGAGING IN THE EXERCISES; INADEQUATE INTENSITY AND/OR DURATION OF YOGA INTERVENTION; AND INSUFFICIENT PERSONALISATION OF EXERCISES TO INDIVIDUAL NEEDS. ALL THESE FACTORS SHOULD BE CONSIDERED WHEN DESIGNING FUTURE TRIALS. TRIAL REGISTRATION: NATIONAL RESEARCH REGISTER (1410) AND CURRENT CONTROLLED TRIALS (ISRCTN63637211). 2009 17 2222 33 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 18 282 34 ADHERENCE TO YOGA AND EXERCISE INTERVENTIONS IN A 6-MONTH CLINICAL TRIAL. BACKGROUND: TO DETERMINE FACTORS THAT PREDICT ADHERENCE TO A MIND-BODY INTERVENTION IN A RANDOMIZED TRIAL. DESIGN: WE ANALYZED ADHERENCE DATA FROM A 3-ARM TRIAL INVOLVING 135 GENERALLY HEALTHY SENIORS 65-85 YEARS OF AGE RANDOMIZED TO A 6-MONTH INTERVENTION CONSISTING OF: AN IYENGAR YOGA CLASS WITH HOME PRACTICE, AN EXERCISE CLASS WITH HOME PRACTICE, OR A WAIT-LIST CONTROL GROUP. OUTCOME MEASURES INCLUDED COGNITIVE FUNCTION, MOOD, FATIGUE, ANXIETY, HEALTH-RELATED QUALITY OF LIFE, AND PHYSICAL MEASURES. ADHERENCE TO THE INTERVENTION WAS OBTAINED BY CLASS ATTENDANCE AND BIWEEKLY HOME PRACTICE LOGS. RESULTS: THE DROP-OUT RATE WAS 13%. AMONG THE COMPLETERS OF THE TWO ACTIVE INTERVENTIONS, AVERAGE YOGA CLASS ATTENDANCE WAS 77% AND HOME PRACTICE OCCURRED 64% OF ALL DAYS. AVERAGE EXERCISE CLASS ATTENDANCE WAS 69% AND HOME EXERCISE OCCURRED 54% OF ALL DAYS. THERE WERE NO CLEAR EFFECTS OF ADHERENCE ON THE SIGNIFICANT STUDY OUTCOMES (QUALITY OF LIFE AND PHYSICAL MEASURES). CLASS ATTENDANCE WAS SIGNIFICANTLY CORRELATED WITH BASELINE MEASURES OF DEPRESSION, FATIGUE, AND PHYSICAL COMPONENTS OF HEALTH-RELATED QUALITY OF LIFE. SIGNIFICANT DIFFERENCES IN BASELINE MEASURES WERE ALSO FOUND BETWEEN STUDY COMPLETERS AND DROP-OUTS IN THE ACTIVE INTERVENTIONS. ADHERENCE WAS NOT RELATED TO AGE, GENDER, OR EDUCATION LEVEL. CONCLUSION: HEALTHY SENIORS HAVE GOOD ATTENDANCE AT CLASSES WITH A PHYSICALLY ACTIVE INTERVENTION. HOME PRACTICE TAKES PLACE OVER HALF OF THE TIME. DECREASED ADHERENCE TO A POTENTIALLY BENEFICIAL INTERVENTION HAS THE POTENTIAL TO DECREASE THE EFFECT OF THE INTERVENTION IN A CLINICAL TRIAL BECAUSE SUBJECTS WHO MIGHT SUSTAIN THE GREATEST BENEFIT WILL RECEIVE A LOWER DOSE OF THE INTERVENTION AND SUBJECTS WITH HIGHER ADHERENCE RATES MAY BE FUNCTIONING CLOSER TO MAXIMUM ABILITY BEFORE THE INTERVENTION. STRATEGIES TO MAXIMIZE ADHERENCE AMONG SUBJECTS AT GREATER RISK FOR LOW ADHERENCE WILL BE IMPORTANT FOR FUTURE TRIALS, ESPECIALLY COMPLEMENTARY TREATMENTS REQUIRING GREATER EFFORT THAN SIMPLE PILL-TAKING. 2007 19 70 29 A FEASIBILITY STUDY EXAMINING THE IMPACT OF YOGA ON PSYCHOSOCIAL HEALTH AND SYMPTOMS IN PEDIATRIC OUTPATIENTS RECEIVING CHEMOTHERAPY. PURPOSE: PEDIATRIC CANCER PATIENTS EXPERIENCE SYMPTOMS THAT NEGATIVELY IMPACT QUALITY OF LIFE; YOGA MAY BE AN EFFECTIVE INTERVENTION. THE PRIMARY OBJECTIVE WAS TO DETERMINE THE FEASIBILITY OF A 10-WEEK, WEEKLY INDIVIDUALIZED YOGA INTERVENTION FOR CHILDREN AND ADOLESCENTS RECEIVING OUTPATIENT CANCER THERAPY PRIMARILY DELIVERED REMOTELY USING SKYPE. SECONDARY OBJECTIVES WERE TO DESCRIBE DEPRESSION, ANXIETY, ANGER, FATIGUE, QUALITY OF LIFE, AND SYMPTOMS AT 5 AND 10 WEEKS AFTER ENROLLMENT. METHODS: WE INCLUDED ENGLISH-SPEAKING PATIENTS AGED 10 TO 18 YEARS RECEIVING OUTPATIENT CHEMOTHERAPY FOR CANCER. WEEKLY INDIVIDUALIZED YOGA SESSIONS WERE OFFERED FOR 10 WEEKS. WEEKS 1, 5, AND 10 WERE IN-HOSPITAL WHILE THE REMAINING SESSIONS WERE DELIVERED REMOTELY USING SKYPE. TWICE WEEKLY, HOMEWORK WAS ASSIGNED BETWEEN EACH SESSION. THE PRIMARY OUTCOME WAS FEASIBILITY, DEFINED AS 80% OF PARTICIPANTS COMPLETING AT LEAST 60% OF PLANNED IN-HOSPITAL OR REMOTE YOGA SESSIONS. RESULTS: BETWEEN MARCH AND NOVEMBER 2017, 10 PATIENTS WERE ENROLLED. TWO PATIENTS DISCONTINUED THE STUDY AFTER ONE AND TWO SESSIONS. ONLY SIX PARTICIPANTS ACHIEVED AT LEAST 60% OF PLANNED YOGA SESSIONS AND THUS, THE STUDY DID NOT MEET THE A PRIORI DEFINED FEASIBILITY THRESHOLD. AMONG ALL PARTICIPANTS, ONLY ONE HOMEWORK SESSION WAS PERFORMED. CONCLUSIONS: A 10-WEEK INDIVIDUALIZED IN-PERSON AND REMOTELY CONDUCTED YOGA INTERVENTION WAS NOT FEASIBLE IN CHILDREN RECEIVING CANCER TREATMENTS BECAUSE OF FAILURE TO ACHIEVE THE DESIRED FREQUENCY OF YOGA SESSIONS IN A SUFFICIENT NUMBER OF PARTICIPANTS. FUTURE RESEARCH SHOULD IDENTIFY APPROACHES TO IMPROVE COMPLIANCE WITH REMOTE YOGA SESSIONS AND HOME PRACTICE. TRIAL REGISTRATION: NCT03318068. 2019 20 2194 37 THE EFFECTS OF YOGA VERSUS STRETCHING AND RESISTANCE TRAINING EXERCISES ON PSYCHOLOGICAL DISTRESS FOR PEOPLE WITH MILD-TO-MODERATE PARKINSON'S DISEASE: STUDY PRXOTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: PSYCHOLOGICAL DISTRESS IS PREVALENT AMONG PEOPLE WITH PARKINSON'S DISEASE (PD) AND AGGRAVATES THEIR MOTOR SYMPTOMS, THEREBY LEADING TO INCREASED DISABILITY, HIGH HEALTHCARE COSTS, AND POOR HEALTH-RELATED QUALITY OF LIFE (HRQOL). THE UNDER-RECOGNITION AND ADVERSE EFFECTS OF THE PHARMACOLOGICAL MANAGEMENT OF ANXIETY AND DEPRESSION AMONG THE PD POPULATION ARE CONSIDERABLE. THUS, ADOPTING A COMPLEMENTARY AND ALTERNATIVE MANAGEMENT (CAM) APPROACH TO ADDRESS THIS PROBLEM IS IMPORTANT. YOGA, ONE OF THE MOST COMMON "MIND-BODY" CAM THERAPIES, CAN IMPROVE THE PSYCHOLOGICAL WELLBEING OF PEOPLE WITH CHRONIC ILLNESSES. HOWEVER, LIMITED RESEARCH ON THE EFFECTS OF YOGA IN PEOPLE WITH PD HAS BEEN CONDUCTED. THIS STUDY WILL DETERMINE THE EFFECTS OF YOGA ON THE PSYCHOLOGICAL WELLBEING OF PEOPLE WITH MILD-TO-MODERATE PD AND WILL COMPARE THESE EFFECTS WITH THOSE OF STRETCHING AND RESISTANCE TRAINING EXERCISES. METHODS: A COMMUNITY-BASED, SINGLE-BLIND, RANDOMIZED TRIAL WILL BE CONDUCTED. A TOTAL OF 126 SUBJECTS WILL BE RECRUITED AND RANDOMLY DIVIDED INTO YOGA (N = 63) OR STRETCHING AND RESISTANCE EXERCISE (N = 63) GROUPS. FOR 8 WEEKS, THE YOGA GROUP WILL RECEIVE A WEEKLY 90-MIN SESSION OF YOGA, AND THE CONTROL GROUP WILL RECEIVE A WEEKLY 60-MIN SESSION OF STRETCHING AND RESISTANCE EXERCISES. THE PRIMARY OUTCOME WILL BE THE LEVEL OF PSYCHOLOGICAL DISTRESS MEASURED USING THE HOSPITAL ANXIETY AND DEPRESSION SCALE. THE SECONDARY OUTCOMES WILL INCLUDE THE SEVERITY OF MOTOR SYMPTOMS MEASURED BY THE MOVEMENT DISORDERS SOCIETY - UNIFIED PARKINSON'S DISEASE SCALE - PART III MOTOR EXAMINATION; MOBILITY, BALANCE, AND FALL RISK MEASURED BY THE TIMED UP AND GO TEST; SPIRITUAL WELLBEING MEASURED BY THE HOLISTIC WELLBEING SCALE; AND HRQOL MEASURED BY THE PARKINSON'S DISEASE QUESTIONNAIRE-8. ASSESSMENT WILL BE CONDUCTED AT BASELINE, 8TH, AND 20TH WEEKS OF FOLLOW-UPS. DISCUSSION: THIS STUDY WILL BE THE FIRST RANDOMIZED TRIAL TO COMPARE THE EFFECT OF YOGA VERSUS STRETCHING AND RESISTANCE TRAINING EXERCISES IN A PD POPULATION. RESULTS WILL CONTRIBUTE TO THE VALUE OF YOGA AS A THERAPEUTIC OPTION FOR MANAGING PSYCHOLOGICAL DISTRESS IN PD PATIENTS. MULTIPLE OUTCOMES INCLUDING PSYCHOLOGICAL, PHYSIOLOGICAL, AND SPIRITUAL AND HRQOL WILL ALSO BE MEASURED TO ELUCIDATE THE POTENTIAL MECHANISMS OF YOGA. THE EFFECT OF YOGA ON PEOPLE WITH CHRONIC ILLNESSES WILL FURTHER BE ELUCIDATED. THIS INFORMATION SHOULD CONTRIBUTE TO FUTURE RESEARCH, PRACTICE, AND POLICY RELATED TO PD MANAGEMENT. TRIAL REGISTRATION: WHO PRIMARY REGISTRY - CHINESE CLINICAL TRIALS REGISTRY (CHICTR): CUHK_CCRB00522 REGISTERED ON 8 OCTOBER 2016; DATE OF APPROVAL 19 AUGUST 2016. 2017