1 2415 142 YOGA AND MEDITATION FOR MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS-A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: BREAST CANCER SURVIVORS HAVE ONLY VERY LIMITED TREATMENT OPTIONS FOR MENOPAUSAL SYMPTOMS. THE OBJECTIVE OF THIS TRIAL WAS TO EVALUATE THE EFFECTS OF A 12-WEEK TRADITIONAL HATHA YOGA AND MEDITATION INTERVENTION ON MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS. METHODS: PATIENTS WERE RANDOMLY ASSIGNED EITHER TO A 12-WEEK YOGA AND MEDITATION INTERVENTION OR TO USUAL CARE. THE PRIMARY OUTCOME MEASURE WAS TOTAL MENOPAUSAL SYMPTOMS (MENOPAUSE RATING SCALE [MRS] TOTAL SCORE). SECONDARY OUTCOME MEASURES INCLUDED MRS SUBSCALES, QUALITY OF LIFE (FUNCTIONAL ASSESSMENT OF CANCER THERAPY-BREAST), FATIGUE (FUNCTIONAL ASSESSMENT OF CHRONIC ILLNESS THERAPY-FATIGUE), DEPRESSION, AND ANXIETY (HOSPITAL ANXIETY AND DEPRESSION SCALE). OUTCOMES WERE ASSESSED AT WEEK 12 AND WEEK 24 AFTER RANDOMIZATION. RESULTS: IN TOTAL, 40 WOMEN (MEAN AGE +/- STANDARD DEVIATION, 49.2 +/- 5.9 YEARS) WERE RANDOMIZED TO YOGA (N = 19) OR TO USUAL CARE (N = 21). WOMEN IN THE YOGA GROUP REPORTED SIGNIFICANTLY LOWER TOTAL MENOPAUSAL SYMPTOMS COMPARED WITH THE USUAL CARE GROUP AT WEEK 12 (MEAN DIFFERENCE, -5.6; 95% CONFIDENCE INTERVAL, -9.2 TO -1.9; P = .004) AND AT WEEK 24 (MEAN DIFFERENCE, -4.5; 95% CONFIDENCE INTERVAL, -8.3 TO -0.7; P = .023). AT WEEK 12, THE YOGA GROUP REPORTED LESS SOMATOVEGETATIVE, PSYCHOLOGICAL, AND UROGENITAL MENOPAUSAL SYMPTOMS; LESS FATIGUE; AND IMPROVED QUALITY OF LIFE (ALL P < .05). AT WEEK 24, ALL EFFECTS PERSISTED EXCEPT FOR PSYCHOLOGICAL MENOPAUSAL SYMPTOMS. SHORT-TERM EFFECTS ON MENOPAUSAL SYMPTOMS REMAINED SIGNIFICANT WHEN ONLY WOMEN WHO WERE RECEIVING ANTIESTROGEN MEDICATION (N = 36) WERE ANALYZED. SIX MINOR ADVERSE EVENTS OCCURRED IN EACH GROUP. CONCLUSIONS: YOGA COMBINED WITH MEDITATION CAN BE CONSIDERED A SAFE AND EFFECTIVE COMPLEMENTARY INTERVENTION FOR MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS. THE EFFECTS SEEM TO PERSIST FOR AT LEAST 3 MONTHS. 2015 2 829 45 EFFECT OF YOGA ON MENOPAUSAL SYMPTOMS. OBJECTIVES: TO OBSERVE THE EFFECT OF YOGA ON MENOPAUSAL SYMPTOMS USING A PROSPECTIVE, RANDOMIZED, CONTROLLED AND INTERVENTIONAL STUDY. MAIN OUTCOME MEASURES TOTAL MENOPAUSE RATING SCALE (MRS) SCORE AND THREE SUBSCALE SCORES (SOMATOVEGETATIVE, PSYCHOLOGICAL AND UROGENITAL) WERE MEASURED ON DAY 1 AND DAY 90 IN THE STUDY GROUP WHICH PERFORMED YOGA (ASANA, PRANAYAM AND MEDITATION) UNDER SUPERVISION FOR THREE MONTHS, AND WERE COMPARED WITH THE CONTROL GROUP THAT DID NOT PERFORM YOGA. MRS HAS BEEN DESIGNED TO MEASURE HEALTH-RELATED QUALITY OF LIFE OF AGEING WOMEN. IT CONSISTS OF 11 SYMPTOMS AND THREE SUBSCALES. RESULTS: IT WAS OBSERVED THAT ON DAY 1 THE SCORES IN BOTH THE GROUPS WERE COMPARABLE. ON DAY 90, THE SCORES IN THE YOGA GROUP SHOWED A REDUCTION IN SCORE ON ALL THE SUBSCALES, WHICH WAS STATISTICALLY SIGNIFICANT. NO SIGNIFICANT DIFFERENCE WAS NOTED IN THE CONTROL GROUP. CONCLUSION: YOGA IS EFFECTIVE IN REDUCING MENOPAUSAL SYMPTOMS AND SHOULD BE CONSIDERED AS ALTERNATIVE THERAPY FOR THE MANAGEMENT OF MENOPAUSAL SYMPTOMS. 2011 3 2604 53 YOGA FOR PERSISTENT FATIGUE IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CANCER-RELATED FATIGUE AFFLICTS UP TO 33% OF BREAST CANCER SURVIVORS, YET THERE ARE NO EMPIRICALLY VALIDATED TREATMENTS FOR THIS SYMPTOM. METHODS: THE AUTHORS CONDUCTED A 2-GROUP RANDOMIZED CONTROLLED TRIAL TO DETERMINE THE FEASIBILITY AND EFFICACY OF AN IYENGAR YOGA INTERVENTION FOR BREAST CANCER SURVIVORS WITH PERSISTENT POST-TREATMENT FATIGUE. PARTICIPANTS WERE BREAST CANCER SURVIVORS WHO HAD COMPLETED CANCER TREATMENTS (OTHER THAN ENDOCRINE THERAPY) AT LEAST 6 MONTHS BEFORE ENROLLMENT, REPORTED SIGNIFICANT CANCER-RELATED FATIGUE, AND HAD NO OTHER MEDICAL CONDITIONS THAT WOULD ACCOUNT FOR FATIGUE SYMPTOMS OR INTERFERE WITH YOGA PRACTICE. BLOCK RANDOMIZATION WAS USED TO ASSIGN PARTICIPANTS TO A 12-WEEK, IYENGAR-BASED YOGA INTERVENTION OR TO 12 WEEKS OF HEALTH EDUCATION (CONTROL). THE PRIMARY OUTCOME WAS CHANGE IN FATIGUE MEASURED AT BASELINE, IMMEDIATELY POST-TREATMENT, AND 3 MONTHS AFTER TREATMENT COMPLETION. ADDITIONAL OUTCOMES INCLUDED CHANGES IN VIGOR, DEPRESSIVE SYMPTOMS, SLEEP, PERCEIVED STRESS, AND PHYSICAL PERFORMANCE. INTENT-TO-TREAT ANALYSES WERE CONDUCTED WITH ALL RANDOMIZED PARTICIPANTS USING LINEAR MIXED MODELS. RESULTS: THIRTY-ONE WOMEN WERE RANDOMLY ASSIGNED TO YOGA (N = 16) OR HEALTH EDUCATION (N = 15). FATIGUE SEVERITY DECLINED SIGNIFICANTLY FROM BASELINE TO POST-TREATMENT AND OVER A 3-MONTH FOLLOW-UP IN THE YOGA GROUP RELATIVE TO CONTROLS (P = .032). IN ADDITION, THE YOGA GROUP HAD SIGNIFICANT INCREASES IN VIGOR RELATIVE TO CONTROLS (P = .011). BOTH GROUPS HAD POSITIVE CHANGES IN DEPRESSIVE SYMPTOMS AND PERCEIVED STRESS (P < .05). NO SIGNIFICANT CHANGES IN SLEEP OR PHYSICAL PERFORMANCE WERE OBSERVED. CONCLUSIONS: A TARGETED YOGA INTERVENTION LED TO SIGNIFICANT IMPROVEMENTS IN FATIGUE AND VIGOR AMONG BREAST CANCER SURVIVORS WITH PERSISTENT FATIGUE SYMPTOMS. 2012 4 428 46 CAN YOGA HAVE ANY EFFECT ON SHOULDER AND ARM PAIN AND QUALITY OF LIFE IN PATIENTS WITH BREAST CANCER? A RANDOMIZED, CONTROLLED, SINGLE-BLIND TRIAL. OBJECTIVE: TO EXAMINE THE EFFECTS OF YOGA ON SHOULDER AND ARM PAIN, QUALITY OF LIFE (QOL), DEPRESSION, AND PHYSICAL PERFORMANCE IN PATIENTS WITH BREAST CANCER. METHODS: THIS PROSPECTIVE, RANDOMIZED STUDY INCLUDED 42 PATIENTS. THE PATIENTS IN GROUP 1 UNDERWENT A 10-WEEK HATHA YOGA EXERCISE PROGRAM. THE PATIENTS IN GROUP 2 WERE INCLUDED IN A 10-WEEK FOLLOW-UP PROGRAM. OUR PRIMARY ENDPOINT WAS ARM AND SHOULDER PAIN INTENSITY. RESULTS: THE GROUP RECEIVING YOGA SHOWED A SIGNIFICANT IMPROVEMENT IN THEIR PAIN SEVERITY FROM BASELINE TO POST-TREATMENT, AND THESE BENEFITS WERE MAINTAINED AT 2.5 MONTHS POST-TREATMENT. WHEN COMPARED TO THE CONTROL GROUP, THERE WERE NO STATISTICALLY SIGNIFICANT DIFFERENCES BETWEEN THE 2 GROUPS WITH RESPECT TO THE PARAMETERS ASSESSED AT THE END OF WEEK 10. CONCLUSION: YOGA WAS AN EFFECTIVE AND SAFE EXERCISE FOR ALLEVIATING SHOULDER AND ARM PAIN, WHICH IS A COMPLICATION WITH A HIGH PREVALENCE IN PATIENTS WITH BREAST CANCER. 2018 5 2230 47 THE IMPACT OF YOGA ON FATIGUE IN CANCER SURVIVORSHIP: A META-ANALYSIS. BACKGROUND: MIND-BODY APPROACHES, PARTICULARLY YOGA, ARE USED BY CANCER SURVIVORS TO COPE WITH TREATMENT-RELATED SYMPTOMS. CONSISTENCY OF YOGA-RELATED EFFECTS ON TREATMENT-RELATED SYMPTOMS ARE NOT KNOWN. THIS META-ANALYSIS WAS DESIGNED TO EXAMINE EFFECTS OF YOGA ON PRE- TO POSTINTERVENTION IMPROVEMENTS IN FATIGUE AMONG CANCER PATIENTS. METHODS: PUBMED AND PSYCINFO WERE SEARCHED FOR PEER-REVIEWED ARTICLES OF YOGA RANDOMIZED CONTROLLED TRIALS INCLUDING CANCER SURVIVORS AND REPORTING AT LEAST ONE FATIGUE MEASURE. TWENTY-NINE STUDIES MET INCLUSION CRITERIA (N = 1828 PATIENTS). EFFECT SIZES (HEDGE'S G) WERE CALCULATED FOR FATIGUE, DEPRESSION, AND QUALITY OF LIFE. PATIENT-RELATED AND INTERVENTION-RELATED CHARACTERISTICS WERE TESTED AS MODERATORS OF OUTCOMES. ALL STATISTICAL TESTS WERE TWO-SIDED. RESULTS: YOGA PRACTICE WAS ASSOCIATED WITH A SMALL, STATISTICALLY SIGNIFICANT DECREASE IN FATIGUE (G = 0.45, P = .013). YOGA TYPE WAS A STATISTICALLY SIGNIFICANT MODERATOR OF THIS RELATIONSHIP (P = .02). YOGA WAS ASSOCIATED WITH A MODERATE DECREASE IN DEPRESSION (G = 0.72, P = .007) BUT WAS NOT ASSOCIATED WITH STATISTICALLY SIGNIFICANT CHANGES IN QUALITY OF LIFE (P = .48). SESSION LENGTH WAS A STATISTICALLY SIGNIFICANT MODERATOR OF THE RELATIONSHIP BETWEEN YOGA AND DEPRESSION (P = .004). NEITHER TIMING OF TREATMENT (DURING TREATMENT VS POSTTREATMENT) NOR CLINICAL CHARACTERISTICS WERE STATISTICALLY SIGNIFICANT MODERATORS OF THE EFFECTS OF YOGA ON OUTCOMES. THE EFFECT OF YOGA ON FATIGUE AND DEPRESSION WAS LARGER WHEN THE COMPARATOR WAS A "WAITLIST" OR "USUAL CARE" THAN WHEN THE CONTROL GROUP WAS ANOTHER ACTIVE TREATMENT (P = .036). CONCLUSIONS: RESULTS SUGGEST YOGA MAY BE BENEFICIAL AS A COMPONENT OF TREATMENT FOR BOTH FATIGUE AND DEPRESSION IN CANCER SURVIVORS. 2020 6 1859 50 RANDOMIZED CONTROLLED PILOT TRIAL OF YOGA IN OVERWEIGHT AND OBESE BREAST CANCER SURVIVORS: EFFECTS ON QUALITY OF LIFE AND ANTHROPOMETRIC MEASURES. PURPOSE: TO OBTAIN ESTIMATES OF TIME TO RECRUIT THE STUDY SAMPLE, RETENTION, FACILITY-BASED CLASS ATTENDANCE AND HOME PRACTICE FOR A STUDY OF YOGA IN BREAST CANCER SURVIVORS, AND ITS EFFICACY ON FATIGUE, QUALITY OF LIFE (QOL), AND WEIGHT CHANGE. METHODS: SIXTY-THREE POST-TREATMENT STAGES 0-III BORDERLINE OVERWEIGHT AND OBESE (BODY MASS INDEX >/= 24 KG/M(2)) BREAST CANCER SURVIVORS WERE RANDOMLY ASSIGNED TO A 6-MONTH, FACILITY- AND HOME-BASED VINIYOGA INTERVENTION (N = 32) OR A WAITLIST CONTROL GROUP (N = 31). THE YOGA GOAL WAS FIVE PRACTICES PER WEEK. PRIMARY OUTCOME MEASURES WERE CHANGES IN QOL, FATIGUE, AND WEIGHT FROM BASELINE TO 6 MONTHS. SECONDARY OUTCOMES INCLUDED CHANGES IN WAIST AND HIP CIRCUMFERENCE. RESULTS: IT TOOK 12 MONTHS TO COMPLETE RECRUITMENT. PARTICIPANTS ATTENDED A MEAN OF 19.6 CLASSES AND PRACTICED AT HOME A MEAN OF 55.8 TIMES DURING THE 6-MONTH PERIOD. AT FOLLOW-UP, 90% OF PARTICIPANTS COMPLETED QUESTIONNAIRES AND 87% COMPLETED ANTHROPOMETRIC MEASUREMENTS. QOL AND FATIGUE IMPROVED TO A GREATER EXTENT AMONG WOMEN IN THE YOGA GROUP RELATIVE TO WOMEN IN THE CONTROL GROUP, ALTHOUGH NO DIFFERENCES WERE STATISTICALLY SIGNIFICANT. WAIST CIRCUMFERENCE DECREASED 3.1 CM (95% CI, -5.7 AND -0.4) MORE AMONG WOMEN IN THE YOGA COMPARED WITH THE CONTROL GROUP, WITH NO DIFFERENCE IN WEIGHT CHANGE. CONCLUSIONS: THIS STUDY PROVIDES IMPORTANT INFORMATION REGARDING RECRUITMENT, RETENTION, AND PRACTICE LEVELS ACHIEVED DURING A 6-MONTH, INTENSIVE YOGA INTERVENTION IN OVERWEIGHT AND OBESE BREAST CANCER SURVIVORS. YOGA MAY HELP DECREASE WAIST CIRCUMFERENCE AND IMPROVE QUALITY OF LIFE; FUTURE STUDIES ARE NEEDED TO CONFIRM THESE RESULTS. 2012 7 2529 46 YOGA EFFECTIVELY REDUCES FATIGUE AND SYMPTOMS OF DEPRESSION IN PATIENTS WITH DIFFERENT TYPES OF CANCER. PURPOSE: EXAMINE THE EFFECTS OF AN 8-WEEK YOGA THERAPY ON FATIGUE IN PATIENTS WITH DIFFERENT TYPES OF CANCER. METHODS: A TOTAL OF 173 CANCER PATIENTS SUFFERING FROM MILD TO SEVERE FATIGUE WERE RANDOMLY ALLOCATED TO YOGA INTERVENTION (N = 84) (IG) VERSUS WAITLIST CONTROL GROUP (CG) (N = 88). YOGA THERAPY CONSISTED OF EIGHT WEEKLY SESSIONS WITH 60 MIN EACH. THE PRIMARY OUTCOME WAS SELF-REPORTED FATIGUE SYMPTOMS. SECONDARY OUTCOMES WERE SYMPTOMS OF DEPRESSION AND QUALITY OF LIFE (QOL). DATA WERE ASSESSED USING QUESTIONNAIRES BEFORE (T0) AND AFTER YOGA THERAPY FOR IG VERSUS WAITING PERIOD FOR CG (T1). RESULTS: A STRONGER REDUCTION OF GENERAL FATIGUE (P = .033), PHYSICAL FATIGUE (P = .048), AND DEPRESSION (P < .001) AS WELL AS A STRONGER INCREASE IN QOL (P = .002) WAS FOUND FOR PATIENTS WHO ATTENDED 7 OR 8 SESSIONS COMPARED WITH CONTROLS. WITHIN THE YOGA GROUP, BOTH HIGHER ATTENDANCE RATE AND LOWER T0-FATIGUE WERE SIGNIFICANT PREDICTORS OF LOWER T1-FATIGUE (P .05) OR ANXIETY (F = 2.7, P > .05). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: THE 8-WEEK YOGA EXERCISE PROGRAM DEVELOPED IN THIS STUDY EFFECTIVELY REDUCED FATIGUE IN PATIENTS WITH BREAST CANCER BUT DID NOT REDUCE DEPRESSION OR ANXIETY. ONCOLOGY NURSES SHOULD STRENGTHEN THEIR CLINICAL HEALTH EDUCATION AND APPLY YOGA TO REDUCE THE FATIGUE EXPERIENCED BY PATIENTS WITH BREAST CANCER WHO UNDERGO ADJUVANT CHEMOTHERAPY. 2014 11 1180 52 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 12 2553 35 YOGA FOR CHILDREN AND ADOLESCENTS AFTER COMPLETING CANCER TREATMENT. SURVIVORS OF CHILDHOOD CANCER MAY EXPERIENCE PERSISTENT SYMPTOMS, INCLUDING FATIGUE, SLEEP DISTURBANCE, AND BALANCE IMPAIRMENT. YOGA IS A COMPLEMENTARY THERAPY THAT IMPROVES FATIGUE, SLEEP, AND QUALITY OF LIFE IN ADULT CANCER SURVIVORS. USING A ONE GROUP, REPEATED MEASURES DESIGN, WE EVALUATED THE FEASIBILITY OF A YOGA PROGRAM AND ASSESSED IF CANCER SURVIVOR PARTICIPANTS AGES 10 TO 17 YEARS (N = 13) HAD SIGNIFICANTLY LESS FATIGUE AND ANXIETY, AND BETTER BALANCE AND SLEEP, AFTER A 6-WEEK YOGA INTERVENTION COMPARED WITH A 6-WEEK PRE-INTERVENTION WAIT PERIOD. STUDY RECRUITMENT WAS CHALLENGING WITH A 32% ENROLLMENT RATE; YOGA ATTENDANCE WAS 90%. NONE OF THE SCORES FOR ANXIETY, FATIGUE, SLEEP, AND BALANCE HAD SIGNIFICANT CHANGES DURING THE WAIT PERIOD. AFTER THE 6-WEEK YOGA PROGRAM, CHILDREN (N = 7) HAD A SIGNIFICANT DECREASE IN ANXIETY SCORE (P = .04) WHILE ADOLESCENT SCORES (N = 7) SHOWED A DECREASING TREND (P = .10). SCORES FOR FATIGUE, SLEEP, AND BALANCE REMAINED STABLE POST-INTERVENTION. FATIGUE AND BALANCE SCORES WERE BELOW NORMS FOR HEALTH CHILDREN/ADOLESCENTS WHILE SLEEP AND ANXIETY SCORES WERE SIMILAR TO HEALTHY PEERS. 2016 13 2508 47 YOGA BREATHING FOR CANCER CHEMOTHERAPY-ASSOCIATED SYMPTOMS AND QUALITY OF LIFE: RESULTS OF A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: MANY DEBILITATING SYMPTOMS ARISE FROM CANCER AND ITS TREATMENT THAT ARE OFTEN UNRELIEVED BY ESTABLISHED METHODS. PRANAYAMA, A SERIES OF YOGIC BREATHING TECHNIQUES, MAY IMPROVE CANCER-RELATED SYMPTOMS AND QUALITY OF LIFE, BUT IT HAS NOT BEEN STUDIED FOR THIS PURPOSE. OBJECTIVES: A PILOT STUDY WAS PERFORMED TO EVALUATE FEASIBILITY AND TO TEST THE EFFECTS OF PRANAYAMA ON CANCER-ASSOCIATED SYMPTOMS AND QUALITY OF LIFE. DESIGN: THIS WAS A RANDOMIZED CONTROLLED CLINICAL TRIAL COMPARING PRANAYAMA TO USUAL CARE. SETTING: THE STUDY WAS CONDUCTED AT A UNIVERSITY MEDICAL CENTER. SUBJECTS: PATIENTS RECEIVING CANCER CHEMOTHERAPY WERE RANDOMIZED TO RECEIVE PRANAYAMA IMMEDIATELY OR AFTER A WAITING PERIOD (CONTROL GROUP). INTERVENTIONS: THE PRANAYAMA INTERVENTION CONSISTED OF FOUR BREATHING TECHNIQUES TAUGHT IN WEEKLY CLASSES AND PRACTICED AT HOME. THE TREATMENT GROUP RECEIVED PRANAYAMA DURING TWO CONSECUTIVE CYCLES OF CHEMOTHERAPY. THE CONTROL GROUP RECEIVED USUAL CARE DURING THEIR FIRST CYCLE, AND RECEIVED PRANAYAMA DURING THEIR SECOND CYCLE OF CHEMOTHERAPY. OUTCOME MEASURES: FEASIBILITY, CANCER-ASSOCIATED SYMPTOMS (FATIGUE, SLEEP DISTURBANCE, ANXIETY, DEPRESSION, STRESS), AND QUALITY OF LIFE WERE THE OUTCOMES. RESULTS: CLASS ATTENDANCE WAS NEARLY 100% IN BOTH GROUPS. SIXTEEN (16) PARTICIPANTS WERE INCLUDED IN THE FINAL INTENT-TO-TREAT ANALYSES. THE REPEATED-MEASURES ANALYSES DEMONSTRATED THAT ANY INCREASE IN PRANAYAMA DOSE, WITH DOSE MEASURED IN THE NUMBER OF HOURS PRACTICED IN CLASS OR AT HOME, RESULTED IN IMPROVED SYMPTOM AND QUALITY-OF-LIFE SCORES. SEVERAL OF THESE ASSOCIATIONS--SLEEP DISTURBANCE (P=0.04), ANXIETY (P=0.04), AND MENTAL QUALITY OF LIFE (P=0.05)--REACHED OR APPROACHED STATISTICAL SIGNIFICANCE. CONCLUSIONS: YOGA BREATHING WAS A FEASIBLE INTERVENTION AMONG PATIENTS WITH CANCER RECEIVING CHEMOTHERAPY. PRANAYAMA MAY IMPROVE SLEEP DISTURBANCE, ANXIETY, AND MENTAL QUALITY OF LIFE. A DOSE-RESPONSE RELATIONSHIP WAS FOUND BETWEEN PRANAYAMA USE AND IMPROVEMENTS IN CHEMOTHERAPY-ASSOCIATED SYMPTOMS AND QUALITY OF LIFE. THESE FINDINGS NEED TO BE CONFIRMED IN A LARGER STUDY. 2012 14 877 37 EFFECT OF YOGA THERAPY ON SYMPTOMS OF ANXIETY IN CANCER PATIENTS. BACKGROUND: MANY CANCER PATIENTS SUFFER FROM SYMPTOMS OF ANXIETY, DEPRESSION, AND FATIGUE. SUPPORTIVE TREATMENTS ARE INCREASINGLY USED TO ALLEVIATE DISTRESS IN CANCER. IN THIS STUDY, THE EFFECTS OF YOGA ON THESE SYMPTOMS ARE EXAMINED. METHODS: WE PERFORMED A RANDOMIZED CONTROLLED STUDY ON CANCER PATIENTS WITH MIXED DIAGNOSES COMPARING YOGA THERAPY WITH A WAITING LIST CONTROL GROUP. WE MEASURED ANXIETY SYMPTOMS WITH THE GENERAL ANXIETY DISORDER (GAD-7) SCALE, DEPRESSIVE SYMPTOMS WITH THE PATIENT HEALTH QUESTIONNAIRE-2 (PHQ-2), AND FATIGUE WITH THE EUROPEAN ORGANISATION FOR RESEARCH AND TREATMENT OF CANCER FATIGUE SCALE (EORTC QLQ-FA13). YOGA THERAPY WAS CARRIED OUT IN WEEKLY SESSIONS OF 60 MIN EACH FOR 8 WEEKS. THE PROGRAM PROVIDED RESTRAINED BODY AND BREATHING EXERCISES AS WELL AS MEDITATION. THE CONTROL GROUP DID NOT RECEIVE ANY YOGA THERAPY WHILE ON THE WAITING LIST. RESULTS: A TOTAL OF 70 SUBJECTS PARTICIPATED IN THE STUDY. ANXIETY WAS SIGNIFICANTLY REDUCED BY THE YOGA THERAPY IN THE INTERVENTION GROUP COMPARED TO THE CONTROL GROUP (P = 0.005). HOWEVER, YOGA THERAPY DID NOT SHOW ANY SIGNIFICANT EFFECTS ON DEPRESSION (P = 0.21) AND FATIGUE (P = 0.11) COMPARED TO THE CONTROL GROUP. CONCLUSION: YOGA THERAPY MAY BE USED TO ALLEVIATE ANXIETY SYMPTOMS IN CANCER PATIENTS AND SHOULD BE THE SUBJECT OF FURTHER RESEARCH. 2018 15 1585 51 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 16 2442 51 YOGA AND SELF-REPORTED COGNITIVE PROBLEMS IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: CANCER SURVIVORS OFTEN REPORT COGNITIVE PROBLEMS. FURTHERMORE, DECREASES IN PHYSICAL ACTIVITY TYPICALLY OCCUR OVER THE COURSE OF CANCER TREATMENT. ALTHOUGH PHYSICAL ACTIVITY BENEFITS COGNITIVE FUNCTION IN NONCANCER POPULATIONS, EVIDENCE LINKING PHYSICAL ACTIVITY TO COGNITIVE FUNCTION IN CANCER SURVIVORS IS LIMITED. IN OUR RECENT RANDOMIZED CONTROLLED TRIAL, BREAST CANCER SURVIVORS WHO RECEIVED A YOGA INTERVENTION HAD LOWER FATIGUE AND INFLAMMATION FOLLOWING THE TRIAL COMPARED WITH A WAIT LIST CONTROL GROUP. THIS SECONDARY ANALYSIS OF THE PARENT TRIAL ADDRESSED YOGA'S IMPACT ON COGNITIVE COMPLAINTS. METHODS: POSTTREATMENT STAGE 0-IIIA BREAST CANCER SURVIVORS (N = 200) WERE RANDOMIZED TO A 12-WEEK, TWICE-WEEKLY HATHA YOGA INTERVENTION OR A WAIT LIST CONTROL GROUP. PARTICIPANTS REPORTED COGNITIVE COMPLAINTS USING THE BREAST CANCER PREVENTION TRIAL COGNITIVE PROBLEMS SCALE AT BASELINE, IMMEDIATELY POSTINTERVENTION, AND 3-MONTH FOLLOW-UP. RESULTS: COGNITIVE COMPLAINTS DID NOT DIFFER SIGNIFICANTLY BETWEEN GROUPS IMMEDIATELY POSTINTERVENTION (P = 0.250). HOWEVER, AT 3-MONTH FOLLOW-UP, YOGA PARTICIPANTS' BREAST CANCER PREVENTION TRIAL COGNITIVE PROBLEMS SCALE SCORES WERE AN AVERAGE OF 23% LOWER THAN WAIT LIST PARTICIPANTS' SCORES (P = 0.003). THESE GROUP DIFFERENCES IN COGNITIVE COMPLAINTS REMAINED AFTER CONTROLLING FOR PSYCHOLOGICAL DISTRESS, FATIGUE, AND SLEEP QUALITY. CONSISTENT WITH THE PRIMARY RESULTS, THOSE WHO PRACTICED YOGA MORE FREQUENTLY REPORTED SIGNIFICANTLY FEWER COGNITIVE PROBLEMS AT 3-MONTH FOLLOW-UP THAN THOSE WHO PRACTICED LESS FREQUENTLY (P < 0.001). CONCLUSIONS: THESE FINDINGS SUGGEST THAT YOGA CAN EFFECTIVELY REDUCE BREAST CANCER SURVIVORS' COGNITIVE COMPLAINTS AND PROMPT FURTHER RESEARCH ON MIND-BODY AND PHYSICAL ACTIVITY INTERVENTIONS FOR IMPROVING CANCER-RELATED COGNITIVE PROBLEMS. 2015 17 2644 41 YOGA FOR WOMEN WITH URGENCY URINARY INCONTINENCE: A PILOT STUDY. OBJECTIVES: THE OBJECTIVE OF THIS STUDY WAS TO EVALUATE THE FEASIBILITY OF A GENTLE YOGA PROGRAM FOR WOMEN WITH URGENCY URINARY INCONTINENCE (UUI). ALSO, THESE PRELIMINARY DATA CAN EVALUATE IF YOGA IMPROVES SYMPTOM BURDEN, QUALITY OF LIFE, AND INFLAMMATORY BIOMARKERS FOR WOMEN WITH UUI. METHODS: THIS PROSPECTIVE NONRANDOMIZED SINGLE-ARM PILOT STUDY EVALUATED THE EFFECTIVENESS OF A TWICE-WEEKLY, 8-WEEK GENTLE YOGA INTERVENTION TO REDUCE UUI SYMPTOM BURDEN. CHANGES IN SYMPTOM BURDEN WERE MEASURED USING THE PELVIC FLOOR DISTRESS INVENTORY 20. SECONDARY MEASURES INCLUDED QUALITY OF LIFE, DEPRESSIVE SYMPTOMS, SLEEP, STRESS, ANXIETY, AND INFLAMMATORY BIOMARKERS. OUTCOMES WERE EVALUATED WITH PAIRED T TESTING. RESULTS: TWELVE WOMEN COMPLETED THE YOGA INTERVENTION WITH NO ADVERSE OUTCOMES NOTED. URGENCY SYMPTOM BURDEN WAS SIGNIFICANTLY IMPROVED AFTER THE INTERVENTION (P = 0.01), AND WOMEN REPORTED AN INCREASE IN QUALITY OF LIFE (P = 0.04) AFTER THE YOGA INTERVENTION. FOLLOWING THE YOGA INTERVENTION, THE MAJORITY OF WOMEN REPORTED SYMPTOMS AS "MUCH BETTER" (N = 4 [33%]) AND "A LITTLE BETTER" (N = 5 [42%]), WITH 3 WOMEN (25%) REPORTING "NO CHANGE." WOMEN ALSO REPORTED SIGNIFICANT REDUCTION IN DEPRESSIVE SYMPTOMS (P = 0.03) AND BETTER QUALITY OF SLEEP (P = 0.03). NO SIGNIFICANT CHANGES WERE FOUND IN ANXIETY OR STRESS PERCEPTION. PLASMA LEVELS OF THE INFLAMMATORY BIOMARKER TUMOR NECROSIS FACTOR ALPHA WERE REDUCED AFTER YOGA INTERVENTION (P = 0.009); HOWEVER, NO SIGNIFICANT POSTYOGA CHANGES WERE FOUND FOR INTERLEUKIN 6 OR C-REACTIVE PROTEIN. CONCLUSIONS: THIS STUDY PROVIDES PRELIMINARY EVIDENCE THAT YOGA IS A FEASIBLE COMPLEMENTARY THERAPY THAT REDUCES INCONTINENCE SYMPTOM BURDEN, ALONG WITH IMPROVING QUALITY OF LIFE, DEPRESSIVE SYMPTOMS, AND SLEEP QUALITY. ADDITIONALLY, YOGA MAY LOWER INFLAMMATORY BIOMARKERS ASSOCIATED WITH INCONTINENCE. 2021 18 1865 50 RANDOMIZED PILOT TRIAL OF YOGA VERSUS STRENGTHENING EXERCISES IN BREAST CANCER SURVIVORS WITH CANCER-RELATED FATIGUE. PURPOSE: FATIGUE IS ONE OF THE MOST COMMON AND BOTHERSOME REFRACTORY SYMPTOMS EXPERIENCED BY CANCER SURVIVORS. MINDFUL EXERCISE INTERVENTIONS SUCH AS YOGA IMPROVE CANCER-RELATED FATIGUE; HOWEVER, STUDIES OF YOGA HAVE INCLUDED HETEROGENEOUS SURVIVORSHIP POPULATIONS, AND THE EFFECT OF YOGA ON FATIGUED SURVIVORS REMAINS UNCLEAR. METHODS: WE RANDOMLY ASSIGNED 34 EARLY-STAGE BREAST CANCER SURVIVORS WITH CANCER-RELATED FATIGUE (>/=4 ON A LIKERT SCALE FROM 1-10) WITHIN 1 YEAR FROM DIAGNOSIS TO A 12-WEEK INTERVENTION OF HOME-BASED YOGA VERSUS STRENGTHENING EXERCISES, BOTH PRESENTED ON A DVD. THE PRIMARY ENDPOINTS WERE FEASIBILITY AND CHANGES IN FATIGUE, AS MEASURED BY THE MULTIDIMENSIONAL FATIGUE SYMPTOM INVENTORY-SHORT FORM (MFSI-SF). SECONDARY ENDPOINT WAS QUALITY OF LIFE, ASSESSED BY THE FUNCTIONAL ASSESSMENT OF CANCER THERAPIES-BREAST (FACT-B). RESULTS: WE INVITED 401 WOMEN TO PARTICIPATE IN THE STUDY; 78 RESPONDED, AND WE ENROLLED 34. BOTH GROUPS HAD SIGNIFICANT WITHIN-GROUP IMPROVEMENT IN MULTIPLE DOMAINS OF THE FATIGUE AND QUALITY OF LIFE SCORES FROM BASELINE TO POST-INTERVENTION, AND THESE BENEFITS WERE MAINTAINED AT 3 MONTHS POST-INTERVENTION. HOWEVER, THERE WAS NO SIGNIFICANT DIFFERENCE BETWEEN GROUPS IN FATIGUE OR QUALITY OF LIFE AT ANY ASSESSMENT TIME. SIMILARLY, THERE WAS NO DIFFERENCE BETWEEN GROUPS IN ADHERENCE TO THE EXERCISE INTERVENTION. CONCLUSIONS: BOTH DVD-BASED YOGA AND STRENGTHENING EXERCISES DESIGNED FOR CANCER SURVIVORS MAY BE GOOD OPTIONS TO ADDRESS FATIGUE IN BREAST CANCER SURVIVORS. BOTH HAVE REASONABLE UPTAKE, ARE CONVENIENT AND REPRODUCIBLE, AND MAY BE HELPFUL IN DECREASING FATIGUE AND IMPROVING QUALITY OF LIFE IN THE FIRST YEAR POST-DIAGNOSIS IN BREAST CANCER PATIENTS WITH CANCER-RELATED FATIGUE. 2016 19 2811 43 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 20 167 65 A RANDOMIZED CONTROLLED BICENTER TRIAL OF YOGA FOR PATIENTS WITH COLORECTAL CANCER. OBJECTIVE: THE AIM OF THIS TRIAL WAS TO EVALUATE THE EFFECTS OF YOGA ON HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH COLORECTAL CANCER. METHODS: PATIENTS WITH NON-METASTATIC COLORECTAL CANCER WERE RANDOMLY ASSIGNED TO A 10-WEEK YOGA INTERVENTION (90 MIN ONCE WEEKLY) OR A WAITLIST CONTROL GROUP. PRIMARY OUTCOME MEASURE WAS DISEASE-SPECIFIC QUALITY OF LIFE (FUNCTIONAL ASSESSMENT OF CANCER THERAPY - COLORECTAL [FACT-C]) AT WEEK 10. SECONDARY OUTCOME MEASURES INCLUDED FACT-C SUBSCALES: SPIRITUAL WELL-BEING (FACT - SPIRITUALITY); FATIGUE (FACT - FATIGUE); SLEEP DISTURBANCES (PITTSBURGH SLEEP QUALITY INVENTORY); DEPRESSION AND ANXIETY (HOSPITAL ANXIETY AND DEPRESSION SCALE); BODY AWARENESS (SCALE OF BODY CONNECTION); AND BODY-EFFICACY EXPECTATIONS (BODY-EFFICACY EXPECTATIONS SCALE). OUTCOMES WERE ASSESSED AT WEEK 10 AND WEEK 22 AFTER RANDOMIZATION. RESULTS: FIFTY-FOUR PATIENTS (MEAN AGE 68.3 +/- 9.7 YEARS) WERE RANDOMIZED TO YOGA (N = 27; ATTRITION RATE 22.2%) AND CONTROL GROUP (N = 27; ATTRITION RATE 18.5%). PATIENTS IN THE YOGA GROUP ATTENDED A MEAN OF 5.3 +/- 4.0 YOGA CLASSES. NO SIGNIFICANT GROUP DIFFERENCES FOR THE FACT-C TOTAL SCORE WERE FOUND. GROUP DIFFERENCES WERE FOUND FOR EMOTIONAL WELL-BEING AT WEEK 22 ( = 1.59; 95% CI = 0.27,2.90; P = 0.019), SLEEP DISTURBANCES AT WEEK 22 ( = -1.08; 95% CI = -2.13, -0.03; P = 0.043), ANXIETY AT WEEK 10 ( = -1.14; 95% CI = -2.20, -0.09; P = 0.043), AND DEPRESSION AT WEEK 10 ( = -1.34; 95% CI = -2.61, -0.8; P = 0.038). NO SERIOUS ADVERSE EVENTS OCCURRED IN THE YOGA GROUP, WHILE LIVER METASTASES WERE DIAGNOSED IN ONE PATIENT IN THE CONTROL GROUP. CONCLUSION: THIS RANDOMIZED TRIAL FOUND NO EFFECTS OF YOGA ON HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH COLORECTAL CANCER. GIVEN THE HIGH ATTRITION RATE AND LOW INTERVENTION ADHERENCE, NO DEFINITE CONCLUSIONS CAN BE DRAWN FROM THIS TRIAL. 2016