1 2374 180 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	
                                                                                                                                                                                                                                
2  721  50 EFFECT OF IYENGAR YOGA THERAPY FOR CHRONIC LOW BACK PAIN. LOW BACK PAIN IS A SIGNIFICANT PUBLIC HEALTH PROBLEM AND ONE OF THE MOST COMMONLY REPORTED REASONS FOR THE USE OF COMPLEMENTARY ALTERNATIVE MEDICINE. A RANDOMIZED CONTROL TRIAL WAS CONDUCTED IN SUBJECTS WITH NON-SPECIFIC CHRONIC LOW BACK PAIN COMPARING IYENGAR YOGA THERAPY TO AN EDUCATIONAL CONTROL GROUP. BOTH PROGRAMS WERE 16 WEEKS LONG. SUBJECTS WERE PRIMARILY SELF-REFERRED AND SCREENED BY PRIMARY CARE PHYSICIANS FOR STUDY OF INCLUSION/EXCLUSION CRITERIA. THE PRIMARY OUTCOME FOR THE STUDY WAS FUNCTIONAL DISABILITY. SECONDARY OUTCOMES INCLUDING PRESENT PAIN INTENSITY, PAIN MEDICATION USAGE, PAIN-RELATED ATTITUDES AND BEHAVIORS, AND SPINAL RANGE OF MOTION WERE MEASURED BEFORE AND AFTER THE INTERVENTIONS. SUBJECTS HAD LOW BACK PAIN FOR 11.2+/-1.54 YEARS AND 48% USED PAIN MEDICATION. OVERALL, SUBJECTS PRESENTED WITH LESS PAIN AND LOWER FUNCTIONAL DISABILITY THAN SUBJECTS IN OTHER PUBLISHED INTERVENTION STUDIES FOR CHRONIC LOW BACK PAIN. OF THE 60 SUBJECTS ENROLLED, 42 (70%) COMPLETED THE STUDY. MULTIVARIATE ANALYSES OF OUTCOMES IN THE CATEGORIES OF MEDICAL, FUNCTIONAL, PSYCHOLOGICAL AND BEHAVIORAL FACTORS INDICATED THAT SIGNIFICANT DIFFERENCES BETWEEN GROUPS EXISTED IN FUNCTIONAL AND MEDICAL OUTCOMES BUT NOT FOR THE PSYCHOLOGICAL OR BEHAVIORAL OUTCOMES. UNIVARIATE ANALYSES OF MEDICAL AND FUNCTIONAL OUTCOMES REVEALED SIGNIFICANT REDUCTIONS IN PAIN INTENSITY (64%), FUNCTIONAL DISABILITY (77%) AND PAIN MEDICATION USAGE (88%) IN THE YOGA GROUP AT THE POST AND 3-MONTH FOLLOW-UP ASSESSMENTS. THESE PRELIMINARY DATA INDICATE THAT THE MAJORITY OF SELF-REFERRED PERSONS WITH MILD CHRONIC LOW BACK PAIN WILL COMPLY TO AND REPORT IMPROVEMENT ON MEDICAL AND FUNCTIONAL PAIN-RELATED OUTCOMES FROM IYENGAR YOGA THERAPY.	2005	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
3 1786  52 PREDICTORS OF YOGA USE AMONG PATIENTS WITH BREAST CANCER. OBJECTIVE: EMERGING RESEARCH SUGGESTS THAT YOGA MAY BE BENEFICIAL FOR REDUCING SYMPTOMS AND IMPROVING QUALITY OF LIFE AMONG BREAST CANCER PATIENTS. HOWEVER, VERY LITTLE IS KNOWN ABOUT THE CHARACTERISTICS OF BREAST CANCER PATIENTS WHO USE YOGA; THUS, THIS STUDY SEEKS TO IDENTIFY THE SOCIODEMOGRAPHIC AND CLINICAL CHARACTERISTICS OF YOGA USERS AMONG THIS POPULATION. DESIGN: A CROSS-SECTIONAL SURVEY STUDY WAS CONDUCTED. SETTING: THE STUDY WAS CONDUCTED AT AN OUTPATIENT BREAST ONCOLOGY CLINIC AT A LARGE UNIVERSITY HOSPITAL. PARTICIPANTS: THREE HUNDRED POSTMENOPAUSAL BREAST CANCER PATIENTS CURRENTLY RECEIVING AROMATASE INHIBITORS WERE INCLUDED IN THIS STUDY. MAIN OUTCOME MEASUREMENT: SELF-REPORTED USE OF YOGA FOLLOWING THE CANCER DIAGNOSIS WAS COLLECTED ALONG WITH SOCIODEMOGRAPHIC AND CLINICAL DATA. MULTIVARIATE LOGISTIC REGRESSION WAS USED TO IDENTIFY INDEPENDENT PREDICTORS OF YOGA USE AMONG BREAST CANCER PATIENTS. RESULTS: OF 300 PARTICIPANTS, 53 (17.7%) REPORTED HAVING USED YOGA FOLLOWING CANCER DIAGNOSIS. WHITE PATIENTS WERE SIGNIFICANTLY MORE LIKELY TO USE YOGA THAN NONWHITE PATIENTS (P = .02). HIGHER EDUCATION LEVEL, LOWER BMI (BODY MASS INDEX), PART-TIME EMPLOYMENT STATUS, PREVIOUS CHEMOTHERAPY, AND RADIATION THERAPY WERE ALL ASSOCIATED WITH GREATER YOGA USE (ALL P < .05). CONTROLLING FOR OTHER FACTORS, GREATER YOGA USE WAS INDEPENDENTLY ASSOCIATED WITH HIGHER EDUCATION LEVEL (ADJUSTED ODDS RATIO [AOR] 2.72, 95% CONFIDENCE INTERVAL [CI], 1.15-6.46), AND LOWER BMI (AOR 0.25, 95% CI, 0.09-0.66). CONCLUSION: YOGA USE FOLLOWING BREAST CANCER DIAGNOSIS WAS SUBSTANTIALLY HIGHER FOR WHITE PATIENTS AND THOSE WITH LOWER BMI AND HIGHER EDUCATION LEVELS. CONSIDERING ITS POTENTIAL BENEFITS FOR SYMPTOM MANAGEMENT IN CANCER, MORE RESEARCH IS NEEDED TO UNDERSTAND THE ATTITUDES AND BARRIERS TO YOGA USE AMONG INDIVIDUALS WITH NONWHITE RACE, LOWER EDUCATION, AND HIGHER BMI LEVEL. SUCH INVESTIGATION WILL HELP DESIGN YOGA PROGRAMS THAT ARE ALIGNED TO THE NEEDS OF THESE POPULATIONS.	2010	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
4 1242  47 FEASIBILITY OF A YOGA INTERVENTION TO DECREASE PAIN IN OLDER WOMEN: A RANDOMIZED CONTROLLED PILOT STUDY. BACKGROUND: A SIGNIFICANT PROPORTION OF OLDER WOMEN SUFFER FROM CHRONIC PAIN, WHICH CAN DECREASE QUALITY OF LIFE. THE OBJECTIVE OF THIS PILOT RANDOMIZED STUDY WAS TO EVALUATE THE FEASIBILITY OF A FLOW-RESTORATIVE YOGA INTERVENTION DESIGNED TO DECREASE PAIN AND RELATED OUTCOMES AMONG WOMEN AGED 60 OR OLDER. METHODS: FLOW-RESTORATIVE YOGA CLASSES WERE HELD TWICE WEEKLY FOR 1 HOUR AND LED BY A CERTIFIED YOGA INSTRUCTOR. PARTICIPANTS RANDOMIZED TO THE INTERVENTION GROUP ATTENDED THE YOGA CLASSES FOR 12 WEEKS AND RECEIVED SUPPLEMENTAL MATERIALS FOR AT-HOME PRACTICE. THOSE RANDOMIZED TO THE CONTROL GROUP WERE ASKED TO MAINTAIN THEIR NORMAL DAILY ROUTINE. FEASIBILITY WAS EVALUATED USING RECRUITMENT AND RETENTION RATES, CLASS AND HOME PRACTICE ADHERENCE RATES, AND PARTICIPANT SATISFACTION SURVEYS. OUTCOME MEASURES (SELF-REPORTED PAIN, INFLAMMATORY MARKERS, FUNCTIONAL FITNESS, QUALITY OF LIFE, RESILIENCE, AND SELF-REPORTED PHYSICAL ACTIVITY) WERE ASSESSED AT BASELINE AND POST-INTERVENTION. PAIRED T-TESTS OR WILCOXON SIGNED-RANK TESTS WERE USED TO EXAMINE CHANGES IN OUTCOME MEASURES WITHIN TREATMENT GROUPS. RESULTS: THIRTY-EIGHT PARTICIPANTS WERE RECRUITED AND RANDOMIZED. PARTICIPANTS WERE PRIMARILY WHITE, COLLEGE-EDUCATED, AND HIGHER FUNCTIONING, DESPITE EXPERIENCING VARIOUS FORMS OF CHRONIC PAIN. ATTENDANCE AND RETENTION RATES WERE HIGH (91 AND 97%, RESPECTIVELY) AND THE MAJORITY OF PARTICIPANTS WERE SATISFIED WITH THE YOGA PROGRAM (89%) AND WOULD RECOMMEND IT TO OTHERS (87%). INTERVENTION PARTICIPANTS ALSO EXPERIENCED REDUCTIONS IN PAIN INTERFERENCE AND IMPROVEMENTS IN ENERGY AND SOCIAL FUNCTIONING. CONCLUSIONS: THIS PILOT STUDY PROVIDES ESSENTIAL DATA TO INFORM A FULL SCALE RANDOMIZED TRIAL OF FLOW-RESTORATIVE YOGA FOR OLDER WOMEN WITH CHRONIC PAIN. FUTURE STUDIES SHOULD EMPHASIZE STRATEGIES TO RECRUIT A MORE DIVERSE STUDY POPULATION, PARTICULARLY OLDER WOMEN AT HIGHER RISK OF DISABILITY AND FUNCTIONAL DECLINE. TRIAL REGISTRATION: CLINICALTRIALS.GOV , NCT03790098 . REGISTERED 31 DECEMBER 2018 - RETROSPECTIVELY REGISTERED.	2020	
                                                                                                                                                                                                                                                                                                                                                                                         
5  430  74 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	
                                                       
6 2187  49 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	
                                                                                                                                                                                                                                                                                                                                                                                              
7 1841  41 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
8  459  48 CHANGES IN PAIN INTENSITY AND HEALTH RELATED QUALITY OF LIFE WITH IYENGAR YOGA IN NONSPECIFIC CHRONIC LOW BACK PAIN: A RANDOMIZED CONTROLLED STUDY. BACKGROUND: NONSPECIFIC CHRONIC LOW BACK (NCLBP) PAIN IS PREVALENT AMONG ADULT POPULATION AND OFTEN LEADS TO FUNCTIONAL LIMITATIONS, PSYCHOLOGICAL SYMPTOMS, LOWER QUALITY OF LIFE (QOL), AND HIGHER HEALTHCARE COSTS. THE PURPOSE OF THIS STUDY WAS TO DETERMINE THE EFFICACY OF IYENGAR YOGA THERAPY ON PAIN INTENSITY AND HEALTH RELATED QUALITY OF LIFE (HRQOL) WITH NCLBP. AIM OF THE STUDY: TO COMPARE THE EFFECT OF IYENGAR YOGA THERAPY AND CONVENTIONAL EXERCISE THERAPY ON PAIN INTENSITY AND HRQOL IN NONSPECIFIC CHRONIC LOW BACK PAIN. MATERIALS AND METHODS: EXPERIMENTAL STUDY WITH RANDOM SAMPLING TECHNIQUE. SUBJECTS/INTERVENTION: SIXTY SUBJECTS WHO FULFILLED THE SELECTION CRITERIA WERE RANDOMLY ASSIGNED TO IYENGAR YOGA (YOGA GROUP, N = 30) AND CONTROL GROUP (EXERCISE GROUP, N = 30). PARTICIPANTS COMPLETED LOW BACK PAIN EVALUATION FORM AND HRQOL-4 QUESTIONNAIRE BEFORE THEIR INTERVENTION AND AGAIN 4 WEEKS AND 6 MONTH LATER. YOGA GROUP UNDERWENT 29 YOGIC POSTURES TRAINING AND EXERCISE GROUP HAD UNDERGONE GENERAL EXERCISE PROGRAM FOR 4 WEEKS. STATISTICS: REPEATED MEASURES ANALYSIS OF VARIANCE (ANOVA) WAS USED TO ANALYZE GROUP DIFFERENCES OVER TIME, WHILE CONTROLLING FOR BASELINE DIFFERENCES. RESULTS: PATIENTS IN BOTH GROUPS EXPERIENCED SIGNIFICANT REDUCTION IN PAIN AND IMPROVEMENT IN HRQOL. IN VISUAL ANALOGUE SCALE (VAS) YOGA GROUP SHOWED REDUCTION OF 72.81% (P = 0.001) AS COMPARED TO EXERCISE GROUP 42.50% (P = 0.001). IN HRQOL, YOGA GROUP SHOWED REDUCTION OF 86.99% (P = 0.001) AS COMPARED TO EXERCISE GROUP 67.66% (P = 0.001). CONCLUSION: THESE RESULTS SUGGEST THAT IYENGAR YOGA PROVIDES BETTER IMPROVEMENT IN PAIN REDUCTION AND IMPROVEMENT IN HRQOL IN NONSPECIFIC CHRONIC BACK PAIN THAN GENERAL EXERCISE.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
9 1953  54 SECONDARY OUTCOMES FROM A RANDOMIZED CONTROLLED TRIAL OF YOGA FOR VETERANS WITH CHRONIC LOW-BACK PAIN. CHRONIC LOW-BACK PAIN (CLBP) IS A PREVALENT CONDITION, AND RATES ARE HIGHER AMONG MILITARY VETERANS. CLBP IS A PERSISTENT CONDITION, AND TREATMENT OPTIONS HAVE EITHER MODEST EFFECTS OR A SIGNIFICANT RISK OF SIDE-EFFECTS, WHICH HAS LED TO RECENT EFFORTS TO EXPLORE MIND-BODY INTERVENTION OPTIONS AND REDUCE OPIOID MEDICATION USE. PRIOR STUDIES OF YOGA FOR CLBP IN COMMUNITY SAMPLES, AND THE MAIN RESULTS OF A RECENT TRIAL WITH MILITARY VETERANS, INDICATE THAT YOGA CAN REDUCE BACK-RELATED DISABILITY AND PAIN INTENSITY. SECONDARY OUTCOMES FROM THE TRIAL OF YOGA WITH MILITARY VETERANS ARE PRESENTED HERE. IN THE STUDY, 150 MILITARY VETERANS (VETERANS ADMINISTRATION PATIENTS) WITH CLBP WERE RANDOMIZED TO EITHER YOGA OR A DELAYED-TREATMENT GROUP RECEIVING USUAL CARE BETWEEN 2013 AND 2015. ASSESSMENTS OCCURRED AT BASELINE, 6 WEEKS, 12 WEEKS, AND 6 MONTHS. INTENT-TO-TREAT ANALYSES WERE CONDUCTED. YOGA CLASSES LASTING 60 MINUTES EACH WERE OFFERED TWICE WEEKLY FOR 12 WEEKS. YOGA SESSIONS CONSISTED OF PHYSICAL POSTURES, MOVEMENT, FOCUSED ATTENTION, AND BREATHING TECHNIQUES. HOME PRACTICE GUIDED BY A MANUAL WAS STRONGLY RECOMMENDED. THE PRIMARY OUTCOME MEASURE WAS ROLAND-MORRIS DISABILITY QUESTIONNAIRE SCORES AFTER 12 WEEKS. SECONDARY OUTCOMES INCLUDED PAIN INTENSITY, PAIN INTERFERENCE, DEPRESSION, FATIGUE, QUALITY OF LIFE, SELF-EFFICACY, AND MEDICATION USAGE. YOGA PARTICIPANTS IMPROVED MORE THAN DELAYED-TREATMENT PARTICIPANTS ON PAIN INTERFERENCE, FATIGUE, QUALITY OF LIFE, AND SELF-EFFICACY AT 12 WEEKS AND/OR 6 MONTHS. YOGA PARTICIPANTS HAD GREATER IMPROVEMENTS ACROSS A NUMBER OF IMPORTANT SECONDARY HEALTH OUTCOMES COMPARED TO CONTROLS. BENEFITS EMERGED DESPITE SOME VETERANS FACING CHALLENGES WITH ATTENDING YOGA SESSIONS IN PERSON. THE FINDINGS SUPPORT WIDER IMPLEMENTATION OF YOGA PROGRAMS FOR VETERANS, WITH ATTENTION TO INCREASING ACCESSIBILITY OF YOGA PROGRAMS IN THIS POPULATION.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
10 2830  44 YOGA VS STRETCHING IN VETERANS WITH CHRONIC LOWER BACK PAIN AND THE ROLE OF MINDFULNESS: A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THE PURPOSE OF THIS STUDY WAS TO INVESTIGATE THE FEASIBILITY OF RECRUITING, RANDOMIZING, ENROLLING, AND COLLECTING OUTCOME DATA ON VETERAN PATIENTS WITH CHRONIC LOW BACK PAIN (CLBP) WHO UNDERGO AN 8-WEEK, ACTIVE EXERCISE CLASS WITH MINDFULNESS (YOGA CLASS) AND WITHOUT (STRETCHING CLASS). METHODS: UNITED STATES VETERANS WITH CLBP BASED ON INCLUSION/EXCLUSION CRITERIA WERE RANDOMIZED TO 1 OF 2 GROUPS. THE STUDY DESIGN WAS A PILOT RANDOMIZED CONTROLLED TRIAL. TWENTY CLBP PATIENTS ATTENDED A YOGA CLASS OR STRETCHING CLASS ONCE PER WEEK FOR 8 WEEKS AT THE VETERANS AFFAIRS ROCHESTER OUTPATIENT CENTER, ROCHESTER, NEW YORK. THE FOLLOWING MEASUREMENTS WERE OBTAINED: RECRUITMENT OR ENROLLMENT DATA, COMPLIANCE DATA TO INCLUDE CLASS ATTENDANCE AND HOME EXERCISE, AND COMPLIANCE DATA REGARDING ABILITY TO COLLECT OUTCOME MEASURES AT BASELINE AND AT COMPLETION. OUTCOME MEASURES INCLUDED PAIN (PEG), QUALITY OF LIFE (PROMIS GLOBAL HEALTH SURVEY), SELF-EFFICACY (2-ITEM QUESTIONNAIRE), FEAR AVOIDANCE BELIEF, CATASTROPHIZING, AND SOCIAL ENGAGEMENT IN ADDITION TO QUALITATIVE CLINICIAN OPEN-ENDED QUESTIONS POSTINTERVENTION. RESULTS: FORTY-FIVE VETERANS WERE QUERIED REGARDING INTEREST IN PARTICIPATION. OF THESE, 34 (76%) MET THE STUDY'S CRITERIA. TWENTY (44%) AGREED TO PARTICIPATE AND WERE CONSENTED, RANDOMIZED, AND ENROLLED IN THE STUDY. INITIAL AND FINAL OUTCOME MEASURES WERE OBTAINED FOR EACH PARTICIPANT (100%). FORTY PERCENT ATTENDED MORE THAN 80% OF THE SESSIONS FOR BOTH YOGA AND STRETCHING GROUPS. CONCLUSION: THIS PILOT STUDY DEMONSTRATED FEASIBILITY OF RECRUITING, ENROLLING, AND COLLECTING OUTCOME DATA ON CLBP VETERAN PATIENTS PARTICIPATING IN YOGA AND STRETCHING CLASS. THE DATA FROM THIS PILOT WILL INFORM THE DEVELOPMENT OF A RANDOMIZED, COMPARATIVE EFFECTIVENESS STUDY OF YOGA WITH AND WITHOUT MINDFULNESS IN THE MANAGEMENT OF CLBP.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
11 2222  59 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	
                                                                                                                                                                                                       
12 1413  33 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
13 1180  53 EVALUATION OF THE EFFECTIVENESS AND EFFICACY OF IYENGAR YOGA THERAPY ON CHRONIC LOW BACK PAIN. STUDY DESIGN: THE EFFECTIVENESS AND EFFICACY OF IYENGAR YOGA FOR CHRONIC LOW BACK PAIN (CLBP) WERE ASSESSED WITH INTENTION-TO-TREAT AND PER-PROTOCOL ANALYSIS. NINETY SUBJECTS WERE RANDOMIZED TO A YOGA (N = 43) OR CONTROL GROUP (N = 47) RECEIVING STANDARD MEDICAL CARE. PARTICIPANTS WERE FOLLOWED 6 MONTHS AFTER COMPLETION OF THE INTERVENTION. OBJECTIVE: THIS STUDY AIMED TO EVALUATE IYENGAR YOGA THERAPY ON CHRONIC LOW BACK PAIN. YOGA SUBJECTS WERE HYPOTHESIZED TO REPORT GREATER REDUCTIONS IN FUNCTIONAL DISABILITY, PAIN INTENSITY, DEPRESSION, AND PAIN MEDICATION USAGE THAN CONTROLS. SUMMARY OF BACKGROUND DATA: CLBP IS A MUSCULOSKELETAL DISORDER WITH PUBLIC HEALTH AND ECONOMIC IMPACT. PILOT STUDIES OF YOGA AND BACK PAIN HAVE REPORTED SIGNIFICANT CHANGES IN CLINICALLY IMPORTANT OUTCOMES. METHODS: SUBJECTS WERE RECRUITED THROUGH SELF-REFERRAL AND HEALTH PROFESSIONAL REFERRALS ACCORDING TO EXPLICIT INCLUSION/EXCLUSION CRITERIA. YOGA SUBJECTS PARTICIPATED IN 24 WEEKS OF BIWEEKLY YOGA CLASSES DESIGNED FOR CLBP. OUTCOMES WERE ASSESSED AT 12 (MIDWAY), 24 (IMMEDIATELY AFTER), AND 48 WEEKS (6-MONTH FOLLOW-UP) AFTER THE START OF THE INTERVENTION USING THE OSWESTRY DISABILITY QUESTIONNAIRE, A VISUAL ANALOG SCALE, THE BECK DEPRESSION INVENTORY, AND A PAIN MEDICATION-USAGE QUESTIONNAIRE. RESULTS: USING INTENTION-TO-TREAT ANALYSIS WITH REPEATED MEASURES ANOVA (GROUP X TIME), SIGNIFICANTLY GREATER REDUCTIONS IN FUNCTIONAL DISABILITY AND PAIN INTENSITY WERE OBSERVED IN THE YOGA GROUP WHEN COMPARED TO THE CONTROL GROUP AT 24 WEEKS. A SIGNIFICANTLY GREATER PROPORTION OF YOGA SUBJECTS ALSO REPORTED CLINICAL IMPROVEMENTS AT BOTH 12 AND 24 WEEKS. IN ADDITION, DEPRESSION WAS SIGNIFICANTLY LOWER IN YOGA SUBJECTS. FURTHERMORE, WHILE A REDUCTION IN PAIN MEDICATION OCCURRED, THIS WAS COMPARABLE IN BOTH GROUPS. WHEN RESULTS WERE ANALYZED USING PER-PROTOCOL ANALYSIS, IMPROVEMENTS WERE OBSERVED FOR ALL OUTCOMES IN THE YOGA GROUP, INCLUDING AGREATER TREND FOR REDUCED PAIN MEDICATION USAGE. ALTHOUGH SLIGHTLY LESS THAN AT 24 WEEKS, THE YOGA GROUP HAD STATISTICALLY SIGNIFICANT REDUCTIONS IN FUNCTIONAL DISABILITY, PAIN INTENSITY, AND DEPRESSION COMPARED TO STANDARD MEDICAL CARE 6-MONTHS POSTINTERVENTION. CONCLUSION: YOGA IMPROVES FUNCTIONAL DISABILITY, PAIN INTENSITY, AND DEPRESSION IN ADULTS WITH CLBP. THERE WAS ALSO A CLINICALLY IMPORTANT TREND FOR THE YOGA GROUP TO REDUCE THEIR PAIN MEDICATION USAGE COMPARED TO THE CONTROL GROUP.	2009	

14  556  41 COST-EFFECTIVENESS OF EARLY INTERVENTIONS FOR NON-SPECIFIC LOW BACK PAIN: A RANDOMIZED CONTROLLED STUDY INVESTIGATING MEDICAL YOGA, EXERCISE THERAPY AND SELF-CARE ADVICE. OBJECTIVE: TO EVALUATE THE COST-EFFECTIVENESS OF MEDICAL YOGA AS AN EARLY INTERVENTION COMPARED WITH EVIDENCE-BASED EXERCISE THERAPY AND SELF-CARE ADVICE FOR NON-SPECIFIC LOW BACK PAIN. DESIGN: RANDOMIZED CONTROLLED TRIAL WITH A COST-EFFECTIVENESS ANALYSIS. SUBJECTS: A TOTAL OF 159 PARTICIPANTS RANDOMIZED INTO THE MEDICAL YOGA GROUP (N = 52), THE EXERCISE THERAPY GROUP (N = 52) AND THE SELF-CARE ADVICE GROUP (N = 55). METHODS: THE HEALTH OUTCOME MEASURE EQ-5D WAS APPLIED TO MEASURE QUALITY OF LIFE DATA COMBINED WITH COST DATA COLLECTED FROM TREATMENT GROUPS FROM BASELINE TO 12 MONTHS FOLLOW-UP. OUTCOME MEASURE WAS HEALTH-RELATED QUALITY OF LIFE (HRQL). INCREMENTAL COST PER QUALITY ADJUSTED LIFE YEAR (QALY) WAS ALSO CALCULATED. COST-EFFECTIVENESS ANALYSIS WAS CONDUCTED PRIMARILY FROM THE SOCIETAL AND EMPLOYER PERSPECTIVES. RESULTS: MEDICAL YOGA IS COST-EFFECTIVE COMPARED WITH SELF-CARE ADVICE IF AN EMPLOYER CONSIDERS THE SIGNIFICANT IMPROVEMENT IN THE HRQL OF AN EMPLOYEE WITH LOW BACK PAIN JUSTIFIES THE ADDITIONAL COST OF TREATMENT (I.E. IN THIS STUDY EUR 150). FROM A SOCIETAL PERSPECTIVE, MEDICAL YOGA IS A COST-EFFECTIVE TREATMENT COMPARED WITH EXERCISE THERAPY AND SELF-CARE ADVICE IF AN ADDITIONAL QALY IS WORTH EUR 11,500. SENSITIVITY ANALYSIS SUGGESTS THAT MEDICAL YOGA IS MORE COST-EFFECTIVE THAN ITS ALTERNATIVES. CONCLUSION: SIX WEEKS OF UNINTERRUPTED MEDICAL YOGA THERA-PY IS A COST-EFFECTIVE EARLY INTERVENTION FOR NON-SPECIFIC LOW BACK PAIN, WHEN TREATMENT RECOMMENDATIONS ARE ADHERED TO.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
15  290  50 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
16 2740  37 YOGA PRACTICE AMONG VETERANS WITH AND WITHOUT CHRONIC PAIN: A MIXED METHODS STUDY. OBJECTIVES: THE PRIMARY AIM OF THIS STUDY WAS TO EXAMINE DIFFERENCES IN YOGA PRACTICE BETWEEN PERSONS WITH AND WITHOUT CHRONIC PAIN. SECONDARILY, WE DESCRIBE USE OF THE ESSENTIAL PROPERTIES OF YOGA QUESTIONNAIRE, SHORT FORM (EPYQ-SF) FOR SELF-REPORT. DESIGN: PARTICIPANTS WERE MEMBERS OF AN EXISTING COHORT OF VETERANS WHO COMPLETED A 2015-2016 SURVEY FOCUSED ON PAIN AND NONPHARMACOLOGICAL HEALTH PRACTICES. COHORT MEMBERS WHO REPORTED YOGA IN THE PAST YEAR [N=174 (9.4%) OF 1850] WERE ELIGIBLE FOR THE PRESENT STUDY, WHICH USED MULTIPLE-CONTACT MIXED-MODE SURVEY METHODOLOGY TO COLLECT DATA ON YOGA PRACTICES. THE EPYQ-SF WAS USED TO ASSESS PROPERTIES AND CONTEXT OF YOGA PRACTICE. PRACTICE PATTERNS WERE COMPARED FOR PARTICIPANTS WITH AND WITHOUT CHRONIC PAIN. TO EXPLORE POTENTIAL REASONS FOR REPORTED YOGA PRACTICE PATTERNS, FOCUSED SEMISTRUCTURED INTERVIEWS WERE CONDUCTED WITH A SUBSET OF PARTICIPANTS. RESULTS: OF 174 PARTICIPANTS CONTACTED, 141 (82%) RETURNED THE YOGA QUESTIONNAIRE AND 110 (78% OF RESPONDENTS) WERE STILL PRACTICING YOGA. AMONG YOGA PRACTITIONERS, 41 (37%) HAD CHRONIC PAIN. PRACTITIONERS WITH CHRONIC PAIN REPORTED GENTLER (2.8 VS. 3.1, 5-POINT SCALE) AND LESS ACTIVE (2.9 VS. 3.3) YOGA PRACTICE THAN THOSE WITHOUT. THOSE WITH CHRONIC PAIN ATTENDED YOGA STUDIOS LESS FREQUENTLY AND REPORTED SHORTER YOGA PRACTICES THAN THOSE WITHOUT. MOST YOGA PRACTICE WAS SELF-DIRECTED AND AT HOME. CONCLUSIONS: DIFFERENCES IN YOGA PRACTICE OF PERSONS WITH AND WITHOUT CHRONIC PAIN HAVE IMPLICATIONS FOR IMPLEMENTATION OF YOGA INTERVENTIONS FOR CHRONIC PAIN. FUTURE INTERVENTIONS SHOULD FOCUS ON ALTERNATIVE INDIVIDUAL DELIVERY FORMATS OR ADDRESSING BARRIERS TO GROUP PRACTICE AMONG PEOPLE WITH CHRONIC PAIN.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
17 2824  47 YOGA VERSUS EDUCATION FOR VETERANS WITH CHRONIC LOW BACK PAIN: STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN IS THE MOST FREQUENT PAIN CONDITION IN VETERANS AND CAUSES SUBSTANTIAL SUFFERING, DECREASED FUNCTIONAL CAPACITY, AND LOWER QUALITY OF LIFE. SYMPTOMS OF POST-TRAUMATIC STRESS, DEPRESSION, AND MILD TRAUMATIC BRAIN INJURY ARE HIGHLY PREVALENT IN VETERANS WITH BACK PAIN. YOGA FOR LOW BACK PAIN HAS BEEN DEMONSTRATED TO BE EFFECTIVE FOR CIVILIANS IN RANDOMIZED CONTROLLED TRIALS. HOWEVER, IT IS UNKNOWN IF RESULTS FROM PREVIOUSLY PUBLISHED TRIALS GENERALIZE TO MILITARY POPULATIONS. METHODS/DESIGN: THIS STUDY IS A PARALLEL RANDOMIZED CONTROLLED TRIAL COMPARING YOGA TO EDUCATION FOR 120 VETERANS WITH CHRONIC LOW BACK PAIN. PARTICIPANTS ARE VETERANS >/=18 YEARS OLD WITH LOW BACK PAIN PRESENT ON AT LEAST HALF THE DAYS IN THE PAST SIX MONTHS AND A SELF-REPORTED AVERAGE PAIN INTENSITY IN THE PREVIOUS WEEK OF >/=4 ON A 0-10 SCALE. THE 24-WEEK STUDY HAS AN INITIAL 12-WEEK INTERVENTION PERIOD, WHERE PARTICIPANTS ARE RANDOMIZED EQUALLY INTO (1) A STANDARDIZED WEEKLY GROUP YOGA CLASS WITH HOME PRACTICE OR (2) EDUCATION DELIVERED WITH A SELF-CARE BOOK. PRIMARY OUTCOME MEASURES ARE CHANGE AT 12 WEEKS IN LOW BACK PAIN INTENSITY MEASURED BY THE DEFENSE AND VETERANS PAIN RATING SCALE (0-10) AND BACK-RELATED FUNCTION USING THE 23-POINT ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 12-WEEK FOLLOW-UP PERIOD, YOGA PARTICIPANTS ARE ENCOURAGED TO CONTINUE HOME YOGA PRACTICE AND EDUCATION PARTICIPANTS CONTINUE FOLLOWING RECOMMENDATIONS FROM THE BOOK. QUALITATIVE INTERVIEWS WITH VETERANS IN THE YOGA GROUP AND THEIR PARTNERS EXPLORE THE IMPACT OF CHRONIC LOW BACK PAIN AND YOGA ON FAMILY RELATIONSHIPS. WE ALSO ASSESS COST-EFFECTIVENESS FROM THREE PERSPECTIVES: THE VETERAN, THE VETERANS HEALTH ADMINISTRATION, AND SOCIETY USING ELECTRONIC MEDICAL RECORDS, SELF-REPORTED COST DATA, AND STUDY RECORDS. DISCUSSION: THIS STUDY WILL HELP DETERMINE IF YOGA CAN BECOME AN EFFECTIVE TREATMENT FOR VETERANS WITH CHRONIC LOW BACK PAIN AND PSYCHOLOGICAL COMORBIDITIES. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT02224183.	2016	
                                                                                                                                                                                                                                                                                                                                                                                 
18 2060  55 THE BENEFITS OF YOGA FOR WOMEN VETERANS WITH CHRONIC LOW BACK PAIN. OBJECTIVES: CHRONIC LOW BACK (CLBP) PAIN IS PREVALENT AMONG MILITARY VETERANS AND OFTEN LEADS TO FUNCTIONAL LIMITATIONS, PSYCHOLOGIC SYMPTOMS, LOWER QUALITY OF LIFE, AND HIGHER HEALTH CARE COSTS. AN INCREASING PROPORTION OF U.S. VETERANS ARE WOMEN, AND WOMEN VETERANS MAY HAVE DIFFERENT HEALTH CARE NEEDS THAN MEN VETERANS. THE PURPOSE OF THIS STUDY WAS TO ASSESS THE IMPACT OF A YOGA INTERVENTION ON WOMEN AND MEN WITH CLBP. SUBJECTS/SETTING/INTERVENTION: VA PATIENTS WITH CLBP WERE REFERRED BY PRIMARY CARE PROVIDERS TO A CLINICAL YOGA PROGRAM. DESIGN: RESEARCH PARTICIPANTS COMPLETED A BRIEF BATTERY OF QUESTIONNAIRES BEFORE THEIR FIRST YOGA CLASS AND AGAIN 10 WEEKS LATER IN A SINGLE-GROUP, PRE-POST STUDY DESIGN. OUTCOME MEASURES: QUESTIONNAIRES INCLUDED MEASURES OF PAIN (PAIN SEVERITY SCALE), DEPRESSION (CESD-10), ENERGY/FATIGUE, AND HEALTH-RELATED QUALITY OF LIFE (SF-12). YOGA ATTENDANCE AND HOME PRACTICE OF YOGA WERE ALSO MEASURED. REPEATED-MEASURES ANALYSIS OF VARIANCE WAS USED TO ANALYZE GROUP DIFFERENCES OVER TIME WHILE CONTROLLING FOR BASELINE DIFFERENCES. RESULTS: THE 53 PARTICIPANTS WHO COMPLETED BOTH ASSESSMENTS HAD A MEAN AGE OF 53 YEARS, AND WERE WELL EDUCATED, 41% NONWHITE, 49% MARRIED, AND HAD VARYING EMPLOYMENT STATUS. WOMEN PARTICIPANTS HAD SIGNIFICANTLY LARGER DECREASES IN DEPRESSION (P=0.046) AND PAIN "ON AVERAGE" (P=0.050), AND LARGER INCREASES IN ENERGY (P=0.034) AND SF-12 MENTAL HEALTH (P=0.044) THAN MEN WHO PARTICIPATED. THE GROUPS DID NOT DIFFER SIGNIFICANTLY ON YOGA ATTENDANCE OR HOME PRACTICE OF YOGA. CONCLUSIONS: THESE RESULTS SUGGEST THAT WOMEN VETERANS MAY BENEFIT MORE THAN MEN VETERANS FROM YOGA INTERVENTIONS FOR CHRONIC BACK PAIN. CONCLUSIONS ARE TENTATIVE BECAUSE OF THE SMALL SAMPLE SIZE AND QUASI-EXPERIMENTAL STUDY DESIGN. A MORE RIGOROUS STUDY IS BEING DESIGNED TO ANSWER THESE RESEARCH QUESTIONS MORE DEFINITIVELY.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
19  936  44 EFFECTIVENESS OF YOGA VERSUS EXERCISE FOR REDUCING FALLING RISK IN OLDER ADULTS: PHYSICAL AND PSYCHOLOGICAL INDICES. OUR PURPOSE IN THIS STUDY WAS TO EXAMINE THE EFFECTIVENESS OF YOGA TO ADDRESS MULTIPLE RISK FACTORS OF FALLING IN ACTIVE AND LOW ACTIVE OLDER ADULTS. COMMUNITY-DWELLING OLDER ADULTS (N = 35) OVER THE AGE OF 65 ACTIVELY PARTICIPATED IN EITHER A YOGA PROGRAM, AN EXERCISE PROGRAM, OR A NO-PROGRAM CONTROL. PARTICIPANTS COMPLETED MEASURES ASSOCIATED WITH FALLING RISKS. PHYSICAL MEASURES INCLUDED LOWER BODY STRENGTH, STATIC BALANCE, AND LOWER BODY FLEXIBILITY. PSYCHOLOGICAL MEASURES INCLUDED PERCEIVED SELF-EFFICACY WITH RESPECT TO FALLS AND HEALTH-RELATED QUALITY OF LIFE. WE DETERMINED BETWEEN-GROUP DIFFERENCES USING PLANNED COMPARISONS, EFFECT SIZE, CONFIDENCE INTERVALS, AND PROBABILITY OF SUPERIORITY. RESULTS OF PLANNED COMPARISONS AND PRACTICAL SIGNIFICANCE TESTING INDICATED THAT YOGA PARTICIPANTS SCORED HIGHER THAN THE EXERCISE AND CONTROL PARTICIPANTS ON BOTH RIGHT AND LEFT LOWER BODY FLEXIBILITY TESTS. YOGA PARTICIPANTS ALSO SCORED HIGHER THAN THE CONTROL PARTICIPANTS ON RIGHT LEG STATIC BALANCE, AND THE RIGHT AND LEFT LOWER BODY FLEXIBILITY TESTS. THE EXERCISE PARTICIPANTS SCORED HIGHER THAN YOGA PARTICIPANTS ON THE RAND-36 QUALITY OF LIFE SUBSCALES OF ENERGY/FATIGUE, PAIN, AND GENERAL HEALTH. THE PROBABILITY OF SUPERIORITY RESULTS INDICATED THAT THE NO-PROGRAM OLDER ADULT PARTICIPANTS WOULD BENEFIT BY ENROLLING IN THE YOGA RATHER THAN THE EXERCISE PROGRAM TO REDUCE PHYSICAL RISKS OF FALLING. THESE FINDINGS WERE DISCUSSED IN RELATION TO PROMOTING PHYSICAL ACTIVITY PROGRAMS TO REDUCE RISKS OF FALLING, AND THE ROLES OF THE PROTOCOL, PRACTICAL SIGNIFICANCE, AND MEASURES EMPLOYED WHEN DETERMINING PROGRAM EFFECTIVENESS.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
20  132  41 A PRAGMATIC MULTICENTERED RANDOMIZED CONTROLLED TRIAL OF YOGA FOR CHRONIC LOW BACK PAIN: ECONOMIC EVALUATION. STUDY DESIGN: MULTICENTERED RANDOMIZED CONTROLLED TRIAL WITH QUALITY OF LIFE AND RESOURCE USE DATA COLLECTED. OBJECTIVE: THE OBJECTIVE OF THIS STUDY WAS TO EVALUATE THE COST-EFFECTIVENESS OF YOGA INTERVENTION PLUS USUAL CARE COMPARED WITH USUAL CARE ALONE FOR CHRONIC OR RECURRENT LOW BACK PAIN. SUMMARY OF BACKGROUND DATA: YOGA HAS BEEN SHOWN AS AN EFFECTIVE INTERVENTION FOR TREATING CHRONIC OR RECURRENT LOW BACK PAIN. HOWEVER, THERE IS LITTLE EVIDENCE ON ITS COST-EFFECTIVENESS. THE DATA ARE EXTRACTED FROM A PRAGMATIC, MULTICENTERED, RANDOMIZED CONTROLLED TRIAL THAT HAS BEEN CONDUCTED TO EVALUATE THE EFFECTIVENESS AND COST-EFFECTIVENESS OF A 12-WEEK PROGRESSIVE PROGRAM OF YOGA PLUS USUAL CARE IN PATIENTS WITH CHRONIC OR RECURRENT LOW BACK PAIN. METHODS: WITH THIS TRIAL DATA, A COST-EFFECTIVENESS ANALYSIS DURING THE TIME PERIOD OF 12 MONTHS FROM BOTH PERSPECTIVES OF THE UK NATIONAL HEALTH SERVICE AND THE SOCIETAL IS PRESENTED. MAIN OUTCOME MEASURE IS AN INCREMENTAL COST PER QUALITY-ADJUSTED LIFE-YEAR (QALY). RESULTS: FROM THE PERSPECTIVE OF THE U.K. NATIONAL HEALTH SERVICE, YOGA INTERVENTION YIELDS AN INCREMENTAL COST-EFFECTIVENESS RATIO OF POUND13,606 PER QALY. GIVEN A WILLINGNESS TO PAY FOR AN ADDITIONAL QALY OF POUND20,000, THE PROBABILITY OF YOGA INTERVENTION BEING COST-EFFECTIVE IS 72%. FROM THE PERSPECTIVE OF THE SOCIETY, YOGA INTERVENTION IS A DOMINANT TREATMENT COMPARED WITH USUAL CARE ALONE. THIS RESULT IS SURROUNDED BY FEWER UNCERTAINTIES-THE PROBABILITY OF YOGA BEING COST-EFFECTIVE REACHES 95% AT A WILLINGNESS TO PAY FOR AN ADDITIONAL QALY OF POUND20,000. SENSITIVE ANALYSES SUGGEST THE SAME RESULTS THAT YOGA INTERVENTION IS LIKELY TO BE COST-EFFECTIVE IN BOTH PERSPECTIVES. CONCLUSION: ON THE BASIS OF THIS TRIAL, 12 WEEKLY GROUP CLASSES OF SPECIALIZED YOGA ARE LIKELY TO BE A COST-EFFECTIVE INTERVENTION FOR TREATING PATIENTS WITH CHRONIC OR RECURRENT LOW BACK PAIN.	2012