1 2506 78 YOGA ATTITUDES IN CHRONIC LOW BACK PAIN: ROLES OF CATASTROPHIZING AND FEAR OF MOVEMENT. CHRONIC LOW BACK PAIN IS A SIGNIFICANT PUBLIC HEALTH PROBLEM AND, ALTHOUGH UNDERUSED, YOGA MAY BE AN EFFECTIVE COMPLEMENTARY TREATMENT. THE CURRENT STUDY EXAMINED ASSOCIATIONS OF PAIN CATASTROPHIZING AND FEAR OF MOVEMENT WITH ATTITUDES TOWARD YOGA IN ADULTS WITH CHRONIC LOW BACK PAIN. PARTICIPANTS COMPLETED THREE QUANTITATIVE QUESTIONNAIRES ASSESSING SPECIFIC CONSTRUCTS: BELIEFS ABOUT YOGA, FEAR OF MOVEMENT, AND PAIN CATASTROPHIZING. A SEMI-STRUCTURED IN-PERSON INTERVIEW WAS THEN CONDUCTED TO OBTAIN SPECIFIC PAIN-RELATED INFORMATION. HIERARCHICAL REGRESSION AND MEDIATIONAL ANALYSES WERE USED TO TEST HYPOTHESES. CONSISTENT WITH THE FEAR-AVOIDANCE MODEL OF CHRONIC PAIN, CATASTROPHIZING AND FEAR OF MOVEMENT WERE NEGATIVELY ASSOCIATED WITH YOGA ATTITUDES. SPECIFICALLY, FEAR OF MOVEMENT WAS A MEDIATOR BETWEEN CATASTROPHIZING AND ATTITUDES TOWARD YOGA. INDIVIDUALS WITH HIGHER LEVELS OF CATASTROPHIZING AND FEAR OF MOVEMENT MAY BE LESS LIKELY TO CONSIDER A PAIN TREATMENT INVOLVING PHYSICAL MOVEMENT. 2015 2 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 3 1375 31 IMPACT OF DAILY YOGA-BASED EXERCISE ON PAIN, CATASTROPHIZING, AND SLEEP AMONGST INDIVIDUALS WITH FIBROMYALGIA. BACKGROUND: FIBROMYALGIA (FM) IS A CHRONIC WIDESPREAD PAIN DISORDER CHARACTERIZED BY NEGATIVE AFFECT, SLEEP DISTURBANCE, AND FATIGUE. THIS UNCONTROLLED PILOT STUDY INVESTIGATED THE EFFICACY OF DAILY YOGA-BASED EXERCISE TO IMPROVE FM SYMPTOMS AND EXPLORED BASELINE PHENOTYPIC CHARACTERISTICS ASSOCIATED WITH THE GREATEST BENEFIT. METHODS: FM PATIENTS (N=46, WITH 36 COMPLETERS) REPORTED PSYCHOSOCIAL FUNCTIONING AND A RANGE OF FM SYMPTOMS USING VALIDATED INSTRUMENTS BEFORE AND AFTER PARTICIPATION IN SATYANANDA YOGA, WHICH INCLUDED WEEKLY IN-PERSON PAIN-TAILORED GROUP CLASSES FOR 6 WEEKS AND DAILY HOME YOGA VIDEO PRACTICE. RESULTS: CHANGES IN FM SYMPTOMS FROM PRE- TO POST-YOGA WERE VARIABLE AMONGST PARTICIPANTS. GROUP MEANS FOR PAIN DECREASED, AS REPORTED BY AVERAGE DAILY DIARY AND BRIEF PAIN INVENTORY, WITH GREATER HOME PRACTICE MINUTES ASSOCIATED WITH A GREATER DECREASE IN PAIN. AVERAGE DAILY RATINGS OF SLEEP AND FATIGUE IMPROVED. PAIN CATASTROPHIZING WAS DECREASED OVERALL, WITH GREATER CHANGE CORRELATED TO A DECREASE IN FM SYMPTOMS. WE DID NOT OBSERVE ANY GROUP MEAN CHANGES IN ACTIGRAPHY SLEEP EFFICIENCY, PATIENT-REPORTED OUTCOMES MEASUREMENT INFORMATION SYSTEM-ANXIETY AND THE REVISED FIBROMYALGIA IMPACT QUESTIONNAIRE. MULTILEVEL MODELING ANALYSIS REVEALED A SIGNIFICANT INTERACTION BETWEEN ANXIETY AND CATASTROPHIZING FOR END-STUDY SLEEP EFFICIENCY, FATIGUE, AND PAIN, SUCH THAT PATIENTS WITH HIGHER BASELINE CATASTROPHIZING AND LOWER BASELINE ANXIETY REPORTED LESS PAIN AND FATIGUE, AND HIGHER SLEEP EFFICIENCY AFTER THE SIXTH WEEK OF YOGA PRACTICE. CONCLUSION: THIS PILOT STUDY SUGGESTS THAT YOGA MAY REDUCE PAIN AND CATASTROPHIZING, AS WELL AS IMPROVE SLEEP, BUT THESE CHANGES WERE MODEST ACROSS STUDY PARTICIPANTS. GREATER UPTAKE OF HOME YOGA PRACTICE AS WELL AS A PHENOTYPE OF HIGHER BASELINE CATASTROPHIZING COMBINED WITH LOWER BASELINE ANXIETY WERE ASSOCIATED WITH GREATER IMPACT. FUTURE RANDOMIZED, CONTROLLED TRIALS COMPARING DIFFERENT TYPES OF YOGA OR EXERCISE WILL ALLOW DETERMINATION OF THE MOST EFFECTIVE TREATMENTS FOR FM AND ALLOW CLOSER TARGETING TO THE PATIENTS WHO WILL BENEFIT MOST FROM THEM. 2019 4 108 18 A PILOT RANDOMIZED CONTROLLED TRIAL OF THE YOGA OF AWARENESS PROGRAM IN THE MANAGEMENT OF FIBROMYALGIA. A MOUNTING BODY OF LITERATURE RECOMMENDS THAT TREATMENT FOR FIBROMYALGIA (FM) ENCOMPASS MEDICATIONS, EXERCISE AND IMPROVEMENT OF COPING SKILLS. HOWEVER, THERE IS A SIGNIFICANT GAP IN DETERMINING AN EFFECTIVE COUNTERPART TO PHARMACOTHERAPY THAT INCORPORATES BOTH EXERCISE AND COPING. THE AIM OF THIS RANDOMIZED CONTROLLED TRIAL WAS TO EVALUATE THE EFFECTS OF A COMPREHENSIVE YOGA INTERVENTION ON FM SYMPTOMS AND COPING. A SAMPLE OF 53 FEMALE FM PATIENTS WERE RANDOMIZED TO THE 8-WEEK YOGA OF AWARENESS PROGRAM (GENTLE POSES, MEDITATION, BREATHING EXERCISES, YOGA-BASED COPING INSTRUCTIONS, GROUP DISCUSSIONS) OR TO WAIT-LISTED STANDARD CARE. DATA WERE ANALYZED BY INTENTION TO TREAT. AT POST-TREATMENT, WOMEN ASSIGNED TO THE YOGA PROGRAM SHOWED SIGNIFICANTLY GREATER IMPROVEMENTS ON STANDARDIZED MEASURES OF FM SYMPTOMS AND FUNCTIONING, INCLUDING PAIN, FATIGUE, AND MOOD, AND IN PAIN CATASTROPHIZING, ACCEPTANCE, AND OTHER COPING STRATEGIES. THIS PILOT STUDY PROVIDES PROMISING SUPPORT FOR THE POTENTIAL BENEFITS OF A YOGA PROGRAM FOR WOMEN WITH FM. 2010 5 1582 25 MEDIATORS OF YOGA AND STRETCHING FOR CHRONIC LOW BACK PAIN. ALTHOUGH YOGA IS AN EFFECTIVE TREATMENT FOR CHRONIC LOW BACK PAIN, LITTLE IS KNOWN ABOUT THE MECHANISMS RESPONSIBLE FOR ITS BENEFITS. IN A TRIAL COMPARING YOGA TO INTENSIVE STRETCHING AND SELF-CARE, WE EXPLORED WHETHER PHYSICAL (HOURS OF BACK EXERCISE/WEEK), COGNITIVE (FEAR AVOIDANCE, BODY AWARENESS, AND SELF-EFFICACY), AFFECTIVE (PSYCHOLOGICAL DISTRESS, PERCEIVED STRESS, POSITIVE STATES OF MIND, AND SLEEP), AND PHYSIOLOGICAL FACTORS (CORTISOL, DHEA) MEDIATED THE EFFECTS OF YOGA OR STRETCHING ON BACK-RELATED DYSFUNCTION (ROLAND-MORRIS DISABILITY SCALE (RDQ)). FOR YOGA, 36% OF THE EFFECT ON 12-WEEK RDQ WAS MEDIATED BY INCREASED SELF-EFFICACY, 18% BY SLEEP DISTURBANCE, 9% BY HOURS OF BACK EXERCISE, AND 61% BY THE BEST COMBINATION OF ALL POSSIBLE MEDIATORS (6 MEDIATORS). FOR STRETCHING, 23% OF THE EFFECT WAS MEDIATED BY INCREASED SELF-EFFICACY, 14% BY DAYS OF BACK EXERCISE, AND 50% BY THE BEST COMBINATION OF ALL POSSIBLE MEDIATORS (7 MEDIATORS). IN OPEN-ENDED QUESTIONS, >/=20% OF PARTICIPANTS NOTED THE FOLLOWING TREATMENT BENEFITS: LEARNING NEW EXERCISES (BOTH GROUPS), RELAXATION, INCREASED AWARENESS, AND THE BENEFITS OF BREATHING (YOGA), BENEFITS OF REGULAR PRACTICE (STRETCHING). ALTHOUGH BOTH SELF-EFFICACY AND HOURS OF BACK EXERCISE WERE THE STRONGEST MEDIATORS FOR EACH INTERVENTION, COMPARED TO SELF-CARE, QUALITATIVE DATA SUGGEST THAT THEY MAY EXERT THEIR BENEFITS THROUGH PARTIALLY DISTINCT MECHANISMS. 2013 6 376 32 BARRIERS AND FACILITATORS TO YOGA USE IN A POPULATION OF INDIVIDUALS WITH SELF-REPORTED CHRONIC LOW BACK PAIN: A QUALITATIVE APPROACH. YOGA HAS BEEN FOUND TO BE EFFICACIOUS IN TREATING CHRONIC LOW BACK PAIN, YET BIOMEDICAL TREATMENTS ARE MOST COMMONLY USED FOR PAIN. PROMOTING YOGA AS PART OF INTEGRATIVE CARE WOULD REDUCE EXCLUSIVE RELIANCE ON HIGH-COST, HIGHER-RISK BIOMEDICAL TREATMENTS. ATTITUDES TOWARD YOGA PLAY A ROLE IN CONSIDERATION OF IT AS A TREATMENT. THE CURRENT STUDY EXAMINED ATTITUDES TOWARD YOGA IN ADULTS WITH CHRONIC LOW BACK PAIN AND COMPARED THESE RESULTS TO THOSE FOUND IN A 2009 GENERAL POPULATION STUDY. PARTICIPANTS COMPLETED A SEMI-STRUCTURED INTERVIEW WHERE THEY RESPONDED TO ITEMS ABOUT PERCEPTIONS OF POTENTIAL BARRIERS AND FACILITATORS TO TRYING YOGA. PARTICIPANT RESPONSES WERE ANALYZED QUALITATIVELY AND SEVERAL COMMON THEMES EMERGED. THEMES IDENTIFIED BY PARTICIPANTS INDICATED THERE IS MIXED INFORMATION ABOUT YOGA IN THE PUBLIC DOMAIN AND THAT CLARIFICATION OF WHAT YOGA IS, HOW IT CAN BE BENEFICIAL, AND WHAT IT REQUIRES ONE TO DO PHYSICALLY MAY HELP PROMOTE ITS USE. 2014 7 2216 23 THE IMPACT OF A DAILY YOGA PROGRAM FOR WOMEN WITH FIBROMYALGIA. BACKGROUND: FIBROMYALGIA (FM) IS CHARACTERIZED BY WIDESPREAD PAIN, SLEEP DISTURBANCE, NEGATIVE AFFECT, AND STRESS AND IS NOTABLY DIFFICULT TO TREAT. INDIVIDUALS WITH FM HAVE LOWER PHYSICAL ACTIVITY AND ENDORSE FEARS THAT EXERCISE MAY WORSEN PAIN. GENTLE DAILY YOGA PRACTICE MAY ALLOW A GRADUAL INCREASE IN ACTIVITY AND POSITIVELY IMPACT MANY OF THESE FM SYMPTOMS. THIS QUALITATIVE STUDY INVESTIGATED THE IMPACT OF PARTICIPATION IN A PILOT TRIAL OF GROUP AND DAILY INDIVIDUAL HOME YOGA INTERVENTION ON WOMEN WITH FM. MATERIALS AND METHODS: FIFTEEN INDIVIDUALS PARTICIPATED IN TELEPHONE INTERVIEWS AFTER PARTICIPATING IN THE YOGA INTERVENTION, WHICH INCLUDED SEMI-STRUCTURED QUESTIONS TO ELICIT INSIGHTS AND IMPRESSIONS OF THEIR EXPERIENCE. RESPONSES WERE SYSTEMATICALLY CODED AND THEMES IDENTIFIED. RESULTS: FIVE THEMES WERE IDENTIFIED: (1) PHYSICAL/BODY PERCEPTUAL CHANGES, (2) PRACTICES AFFECTING PAIN, (3) EMOTIONAL CHANGES, (4) PRACTICE MOTIVATORS AND BARRIERS, AND (5) GROUP EFFECT. PARTICIPANTS NOT ONLY REPORTED REDUCTIONS IN FM SYMPTOMS, INCLUDING PAIN AND STRESS, BUT ALSO A POSITIVE IMPACT ON MOOD, SLEEP, AND SELF-CONFIDENCE. CONCLUSIONS: PARTICIPANTS ENUMERATED BOTH PHYSICAL AND PSYCHOLOGICAL IMPACT OF STARTING YOGA PRACTICE. SPECIFIC HELPFUL POSES AND PRACTICES AND IMPORTANT BARRIERS WERE IDENTIFIED. GROUP PRACTICE AND SOCIAL CONNECTION WITH OTHERS WITH OTHER FM PATIENTS WAS AN IMPORTANT BENEFIT TO PARTICIPANTS. 2019 8 1291 23 GROUP ACUPUNCTURE THERAPY WITH YOGA THERAPY FOR CHRONIC NECK, LOW BACK, AND OSTEOARTHRITIS PAIN IN SAFETY NET SETTING FOR AN UNDERSERVED POPULATION: DESIGN AND RATIONALE FOR A FEASIBILITY PILOT. CHRONIC PAIN IS PREVALENT IN THE UNITED STATES, WITH IMPACT ON PHYSICAL AND PSYCHOLOGICAL FUNCTIONING AS WELL AS LOST WORK PRODUCTIVITY. MINORITY AND LOWER SOCIOECONOMIC POPULATIONS HAVE INCREASED PREVALENCE OF CHRONIC PAIN WITH LESS ACCESS TO PAIN CARE, POORER OUTCOMES, AND HIGHER RISK OF FATAL OPIOID OVERDOSE. ACUPUNCTURE THERAPY IS EFFECTIVE IN TREATING CHRONIC PAIN CONDITIONS INCLUDING CHRONIC LOW BACK PAIN, NECK PAIN, SHOULDER PAIN, AND KNEE PAIN FROM OSTEOARTHRITIS. ACUPUNCTURE THERAPY, INCLUDING GROUP ACUPUNCTURE, IS FEASIBLE AND EFFECTIVE, AND SPECIFICALLY SO FOR UNDERSERVED AND DIVERSE POPULATIONS AT RISK FOR HEALTH OUTCOME DISPARITIES. ACUPUNCTURE THERAPY ALSO ENCOURAGES PATIENT ENGAGEMENT AND ACTIVATION. AS CHRONIC PAIN IMPROVES, THERE IS A NATURAL PROGRESSION TO WANT AND NEED TO INCREASE ACTIVITY AND MOVEMENT RECOVERY. DIVERSE MOVEMENT APPROACHES ARE IMPORTANT FOR IMPROVING RANGE OF MOTION, MAINTAINING GAINS, STRENGTHENING, AND PROMOTING PATIENT ENGAGEMENT AND ACTIVATION. YOGA THERAPY IS AN ACTIVE THERAPY WITH PROVEN BENEFIT IN MUSCULOSKELETAL PAIN DISORDERS AND PAIN ASSOCIATED DISABILITY. THE AIM OF THIS QUASI-EXPERIMENTAL PILOT FEASIBILITY TRIAL IS TO TEST THE BUNDLING OF THESE 2 EFFECTIVE CARE OPTIONS FOR CHRONIC PAIN, TO INFORM BOTH THE DESIGN FOR A LARGER RANDOMIZED PRAGMATIC EFFECTIVENESS TRIAL AS WELL AS IMPLEMENTATION STRATEGIES ACROSS UNDERSERVED SETTINGS. 2020 9 536 28 COMPARISON OF YOGA VERSUS STRETCHING FOR CHRONIC LOW BACK PAIN: PROTOCOL FOR THE YOGA EXERCISE SELF-CARE (YES) TRIAL. BACKGROUND: BACK PAIN, ONE OF THE MOST PREVALENT CONDITIONS AFFLICTING AMERICAN ADULTS, IS THE LEADING REASON FOR USING COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) THERAPIES. YOGA IS AN INCREASINGLY POPULAR "MIND-BODY" CAM THERAPY OFTEN USED FOR RELIEVING BACK PAIN AND SEVERAL SMALL STUDIES HAVE FOUND YOGA EFFECTIVE FOR THIS CONDITION. THIS STUDY WILL ASSESS WHETHER YOGA IS EFFECTIVE FOR TREATING CHRONIC LOW BACK PAIN COMPARED WITH SELF CARE AND EXERCISE AND WILL EXPLORE THE MECHANISMS RESPONSIBLE FOR ANY OBSERVED BENEFITS. METHODS/DESIGN: A TOTAL OF 210 PARTICIPANTS WITH LOW BACK PAIN LASTING AT LEAST 3 MONTHS WILL BE RECRUITED FROM PRIMARY CARE CLINICS OF A LARGE HEALTHCARE SYSTEM BASED IN SEATTLE. THEY WILL BE RANDOMIZED IN A 2:2:1 RATIO TO RECEIVE 12 WEEKLY YOGA CLASSES, 12 WEEKLY CONVENTIONAL THERAPEUTIC EXERCISE CLASSES OF COMPARABLE PHYSICAL EXERTION, OR A SELF-CARE BOOK. INTERVIEWERS MASKED TO PARTICIPANTS' TREATMENT GROUP WILL ASSESS OUTCOMES AT BASELINE AND 6, 12 AND 26 WEEKS AFTER RANDOMIZATION. PRIMARY OUTCOMES WILL BE BACK-RELATED DYSFUNCTION AND SYMPTOM BOTHERSOMENESS. IN ADDITION, DATA WILL BE COLLECTED ON PHYSICAL MEASUREMENTS (E.G., FLEXION) AT BASELINE AND 12 WEEKS AND SALIVA SAMPLES WILL BE OBTAINED AT BASELINE, 6 AND 12 WEEKS. INFORMATION WILL BE COLLECTED ON SPECIFIC PHYSICAL, PSYCHOLOGICAL, AND PHYSIOLOGICAL FACTORS TO ALLOW EXPLORATION OF POSSIBLE MECHANISMS OF ACTION THROUGH WHICH YOGA COULD RELIEVE BACK PAIN AND DYSFUNCTION. THE EFFECTIVENESS OF YOGA WILL BE ASSESSED USING ANALYSIS OF COVARIANCE (USING GENERAL ESTIMATING EQUATIONS - GEE) WITHIN AN INTENTION-TO-TREAT CONTEXT. IF YOGA IS FOUND EFFECTIVE, FURTHER ANALYSES WILL EXPLORE WHETHER YOGA'S BENEFITS ARE ATTRIBUTABLE TO PHYSICAL, PSYCHOLOGICAL AND/OR PHYSIOLOGICAL FACTORS. CONCLUSIONS: THIS STUDY WILL PROVIDE THE CLEAREST EVIDENCE TO DATE ABOUT THE VALUE OF YOGA AS A THERAPEUTIC OPTION FOR TREATING CHRONIC BACK PAIN, AND IF THE RESULTS ARE POSITIVE, WILL HELP FOCUS FUTURE, MORE IN-DEPTH, RESEARCH ON THE MOST PROMISING POTENTIAL MECHANISMS OF ACTION IDENTIFIED BY THIS STUDY. 2010 10 2284 22 THE USE OF YOGA AS A GROUP INTERVENTION FOR PEDIATRIC CHRONIC PAIN REHABILITATION: EXPLORING QUALITATIVE AND QUANTITATIVE OUTCOMES. PURPOSE: WITH THE INCREASE IN OPIOID USE OVER THE LAST DECADE, MIND-BODY APPROACHES TO PEDIATRIC PAIN MANAGEMENT HAVE BEEN TRENDING. TO DATE, THERE IS LIMITED RESEARCH REGARDING THE USE OF YOGA WITH PEDIATRIC CHRONIC PAIN. THIS STUDY AIMS TO GAUGE THE EFFECTIVENESS OF GROUP YOGA AS PART OF CHRONIC PAIN REHABILITATION AND ONE'S ABILITY TO CONTINUE PRACTICING INDEPENDENTLY BY EXPLORING QUALITATIVE AND QUANTITATIVE INFORMATION. METHODS: A SINGLE THERAPIST USED YOGA AS A GROUP PHYSICAL THERAPY INTERVENTION ONCE A WEEK FOR 60 MINUTES. YOGA EDUCATION, IYENGAR YOGA COMPONENTS, RELAXATION, AND STRETCHING WERE INCORPORATED INTO THE THERAPEUTIC YOGA SESSION. QUALITATIVE AND QUANTITATIVE INFORMATION WAS COLLECTED. RESULTS: QUALITATIVE OUTCOMES PROVIDED VALUABLE DATA ABOUT DISTRACTIONS AND BENEFITS. QUANTITATIVE OUTCOMES SHOWED THAT THERE WERE SIGNIFICANT IMPROVEMENTS IN AREAS SUCH AS MENTAL TENSION, EMOTIONAL TENSION, MUSCLE TENSION, AND PAIN (ALL P < 0.001 SIGNIFICANT). CONCLUSION: PEDIATRIC CHRONIC PAIN PATIENTS CAN IDENTIFY MANY BENEFITS AFTER A SINGLE GROUP YOGA SESSION. IT COMBINES THE PHYSICAL AND COGNITIVE ASPECTS OF INTERDISCIPLINARY PAIN REHABILITATION FOR CONTINUED USE AFTER DISCHARGE. THE USE OF YOGA IS AN ECONOMICAL MEANS OF PHYSICAL ACTIVITY AFTER DISCHARGE TO PROMOTE LONG-TERM BENEFITS. 2020 11 721 30 EFFECT OF IYENGAR YOGA THERAPY FOR CHRONIC LOW BACK PAIN. LOW BACK PAIN IS A SIGNIFICANT PUBLIC HEALTH PROBLEM AND ONE OF THE MOST COMMONLY REPORTED REASONS FOR THE USE OF COMPLEMENTARY ALTERNATIVE MEDICINE. A RANDOMIZED CONTROL TRIAL WAS CONDUCTED IN SUBJECTS WITH NON-SPECIFIC CHRONIC LOW BACK PAIN COMPARING IYENGAR YOGA THERAPY TO AN EDUCATIONAL CONTROL GROUP. BOTH PROGRAMS WERE 16 WEEKS LONG. SUBJECTS WERE PRIMARILY SELF-REFERRED AND SCREENED BY PRIMARY CARE PHYSICIANS FOR STUDY OF INCLUSION/EXCLUSION CRITERIA. THE PRIMARY OUTCOME FOR THE STUDY WAS FUNCTIONAL DISABILITY. SECONDARY OUTCOMES INCLUDING PRESENT PAIN INTENSITY, PAIN MEDICATION USAGE, PAIN-RELATED ATTITUDES AND BEHAVIORS, AND SPINAL RANGE OF MOTION WERE MEASURED BEFORE AND AFTER THE INTERVENTIONS. SUBJECTS HAD LOW BACK PAIN FOR 11.2+/-1.54 YEARS AND 48% USED PAIN MEDICATION. OVERALL, SUBJECTS PRESENTED WITH LESS PAIN AND LOWER FUNCTIONAL DISABILITY THAN SUBJECTS IN OTHER PUBLISHED INTERVENTION STUDIES FOR CHRONIC LOW BACK PAIN. OF THE 60 SUBJECTS ENROLLED, 42 (70%) COMPLETED THE STUDY. MULTIVARIATE ANALYSES OF OUTCOMES IN THE CATEGORIES OF MEDICAL, FUNCTIONAL, PSYCHOLOGICAL AND BEHAVIORAL FACTORS INDICATED THAT SIGNIFICANT DIFFERENCES BETWEEN GROUPS EXISTED IN FUNCTIONAL AND MEDICAL OUTCOMES BUT NOT FOR THE PSYCHOLOGICAL OR BEHAVIORAL OUTCOMES. UNIVARIATE ANALYSES OF MEDICAL AND FUNCTIONAL OUTCOMES REVEALED SIGNIFICANT REDUCTIONS IN PAIN INTENSITY (64%), FUNCTIONAL DISABILITY (77%) AND PAIN MEDICATION USAGE (88%) IN THE YOGA GROUP AT THE POST AND 3-MONTH FOLLOW-UP ASSESSMENTS. THESE PRELIMINARY DATA INDICATE THAT THE MAJORITY OF SELF-REFERRED PERSONS WITH MILD CHRONIC LOW BACK PAIN WILL COMPLY TO AND REPORT IMPROVEMENT ON MEDICAL AND FUNCTIONAL PAIN-RELATED OUTCOMES FROM IYENGAR YOGA THERAPY. 2005 12 2563 19 YOGA FOR CHRONIC PAIN MANAGEMENT: A QUALITATIVE EXPLORATION. OBJECTIVE: TO EXPLORE PATIENTS' PERCEPTIONS OF THEIR PAIN WHILE PARTICIPATING IN A WEEKLY YOGA PROGRAM. METHODS: A CONSECUTIVE CONVENIENCE SAMPLE WAS RECRUITED FROM A MULTIDISCIPLINARY PAIN CENTRE. SEVEN ADULT PATIENTS (SIX WOMEN), AGREED TO PARTICIPATE IN AN 8-WEEK HATHA YOGA PROGRAM, INCLUDING WEEKLY GROUP SESSIONS AND AT-HOME PRACTICE. DATA WERE GATHERED FROM PARTICIPANT OBSERVATION AND IN-DEPTH INTERVIEWS. INTERVIEWS EXPLORED THE EXPERIENCE OF PRACTICING YOGA AND ITS RELATIONSHIP TO THE PARTICIPANT'S PAIN EXPERIENCE. AN INDUCTIVE ANALYSIS OF THE INTERVIEWS EXPLORED EMERGENT THEMES FROM PARTICIPANTS' DESCRIPTIONS OF THEIR EXPERIENCE. RESULTS: ANALYSES IDENTIFIED THREE THEMES: RENEWED AWARENESS OF THE BODY; TRANSFORMED RELATIONSHIP WITH THE BODY IN PAIN; AND ACCEPTANCE. DISCUSSION: PARTICIPANTS' DATA SUGGESTED THAT THEY REFRAMED WHAT IT MEANT TO LIVE WITH CHRONIC PAIN. SOME PARTICIPANTS REPORTED THAT THE SENSORY ASPECTS OF PAIN DID NOT CHANGE BUT THAT PAIN BECAME LESS BOTHERSOME. THEY WERE BETTER ABLE TO CONTROL THE DEGREE TO WHICH PAIN INTERFERED WITH THEIR DAILY LIFE. OTHER PARTICIPANTS REPORTED LESS FREQUENT OR LESS INTENSE PAIN EPISODES BECAUSE THEY COULD RECOGNIZE BODY SIGNALS AND ADJUST THEMSELVES TO ALLEVIATE PAINFUL SENSATIONS. THE FINDINGS SUGGEST THAT PATIENTS WHO BENEFIT FROM YOGA MAY DO SO IN PART BECAUSE YOGA ENABLES CHANGES IN COGNITIONS AND BEHAVIOURS TOWARDS PAIN. 2011 13 2470 25 YOGA AS A TREATMENT FOR CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW OF THE LITERATURE. OBJECTIVES: CHRONIC LOW BACK PAIN (CLBP) AFFECTS MILLIONS OF PEOPLE WORLDWIDE, AND APPEARS TO BE INCREASING IN PREVALENCE. IT IS ASSOCIATED NOT ONLY WITH PAIN, BUT ALSO WITH INCREASED DISABILITY, PSYCHOLOGICAL SYMPTOMS, AND REDUCED QUALITY OF LIFE. THERE ARE VARIOUS TREATMENT OPTIONS FOR CLBP, BUT NO SINGLE THERAPY STANDS OUT AS BEING THE MOST EFFECTIVE. IN THE PAST 10 YEARS, YOGA INTERVENTIONS HAVE BEEN STUDIED AS A CLBP TREATMENT APPROACH. THE OBJECTIVE OF THIS PAPER IS TO REVIEW THE CURRENT LITERATURE SUPPORTING THE EFFICACY OF YOGA FOR CLBP. METHODS: A LITERATURE SEARCH THROUGH THE BEGINNING OF 2015 WAS CONDUCTED IN PUB MED FOR RANDOMIZED CONTROL TRIALS ADDRESSING TREATMENT OF CLBP WITH YOGA. RESULTS: IN THIS REVIEW WE EVALUATE THE USE OF YOGA AS A TREATMENT FOR CLBP. SPECIFICALLY WE EVALUATE HOW YOGA IMPACTS PHYSICAL FUNCTIONING AND DISABILITY, PAIN, AND ASSOCIATED PSYCHOLOGICAL SYMPTOMS. WE ALSO EVALUATE POSSIBLE MEDIATORS OF THE EFFECT OF YOGA AND THE SAFETY OF YOGA. DISCUSSION: WITH FEW EXCEPTIONS, PREVIOUS STUDIES AND THE RECENT RANDOMIZED CONTROL TRIALS (RCTS) INDICATE THAT YOGA CAN REDUCE PAIN AND DISABILITY, CAN BE PRACTICED SAFELY, AND IS WELL RECEIVED BY PARTICIPANTS. SOME STUDIES ALSO INDICATE THAT YOGA MAY IMPROVE PSYCHOLOGICAL SYMPTOMS, BUT THESE EFFECTS ARE CURRENTLY NOT AS WELL ESTABLISHED. 2016 14 20 27 "WE'RE ALL IN THIS TOGETHER": A QUALITATIVE STUDY OF PREDOMINANTLY LOW INCOME MINORITY PARTICIPANTS IN A YOGA TRIAL FOR CHRONIC LOW BACK PAIN. OBJECTIVE: TO EXPLORE THE EXPERIENCES OF LOW-INCOME MINORITY ADULTS TAKING PART IN A YOGA DOSING TRIAL FOR CHRONIC LOW BACK PAIN. DESIGN: INDIVIDUAL SEMI-STRUCTURED INTERVIEWS WERE CONDUCTED WITH NINETEEN PARTICIPANTS RECRUITED FROM A RANDOMIZED YOGA DOSING TRIAL FOR PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH CHRONIC LOW BACK PAIN. INTERVIEWS DISCUSSED THE IMPACT OF YOGA ON LOW BACK PAIN AND EMOTIONS; OTHER PERCEIVED ADVANTAGES OR DISADVANTAGES OF THE INTERVENTION; AND FACILITATORS AND BARRIERS TO PRACTICING YOGA. INTERVIEWS WERE AUDIO TAPED AND TRANSCRIBED, CODED USING ATLAS.TI SOFTWARE, AND ANALYZED WITH INDUCTIVE AND DEDUCTIVE THEMATIC ANALYSIS METHODS. SETTING: BOSTON MEDICAL CENTER, BOSTON, MA, USA. RESULTS: PARTICIPANTS VIEWED YOGA AS A MEANS OF PAIN RELIEF AND ATTRIBUTED IMPROVED MOOD, GREATER ABILITY TO MANAGE STRESS, AND ENHANCED RELAXATION TO YOGA. OVERALL, PARTICIPANTS FELT EMPOWERED TO SELF-MANAGE THEIR PAIN. SOME FOUND YOGA TO BE HELPFUL IN BEING MINDFUL OF THEIR EMOTIONS AND ACCEPTING OF THEIR PAIN. TRUST IN THE YOGA INSTRUCTORS WAS A COMMONLY CITED FACILITATOR FOR YOGA CLASS ATTENDANCE. LACK OF TIME, MOTIVATION, AND FEAR OF INJURY WERE REPORTED BARRIERS TO YOGA PRACTICE. CONCLUSIONS: YOGA IS A MULTIDIMENSIONAL TREATMENT FOR LOW BACK PAIN THAT HAS THE POTENTIAL TO FAVORABLY IMPACT HEALTH IN A PREDOMINANTLY LOW-INCOME MINORITY POPULATION. 2016 15 1239 24 FEASIBILITY OF A MANUALIZED MINDFUL YOGA INTERVENTION FOR PATIENTS WITH CHRONIC MOOD DISORDERS. CHRONIC MOOD DISORDERS POSE AN IMPORTANT MENTAL HEALTH PROBLEM. INDIVIDUALS WITH THESE DISORDERS EXPERIENCE A SIGNIFICANT IMPAIRMENT, OFTEN FAIL TO SEEK HELP, AND THEIR ILLNESSES FREQUENTLY DO NOT RESPOND TO TREATMENT. IT IS THEREFORE IMPORTANT TO DEVELOP INNOVATIVE AND ATTRACTIVE TREATMENTS FOR THESE DISORDERS. MINDFUL YOGA REPRESENTS A PROMISING TREATMENT APPROACH. THIS PILOT STUDY TESTED THE FEASIBILITY OF A 9-WEEK MANUALIZED MINDFUL YOGA INTERVENTION FOR PATIENTS WITH CHRONIC MOOD DISORDERS. ELEVEN PATIENTS RECEIVING STANDARD TREATMENT WERE RECRUITED TO COMPLETE A 9-WEEK MINDFUL YOGA INTERVENTION. QUALITATIVE METHODS WERE USED TO ASSESS PATIENTS' EXPERIENCES OF THE INTERVENTION AND QUANTITATIVE METHODS WERE USED TO ASSESS PSYCHOLOGICAL DISTRESS AND MECHANISMS THAT PLAY A ROLE IN CHRONIC MOOD DISORDERS. EIGHT PATIENTS COMPLETED THE INTERVENTION AND RATED THE OVERALL QUALITY OF THE INTERVENTION WITH A MEAN SCORE OF 8.8 (RANGE OF 8 TO 9, USING A SCALE OF 1 TO 10). ALL PARTICIPANTS REPORTED A REDUCTION IN PSYCHOLOGICAL DISTRESS AND NO ADVERSE EVENTS. AMONG THE MECHANISMS THAT PLAY A ROLE IN CHRONIC MOOD DISORDERS, THE MOST POTENTIALLY PROMISING EFFECTS FROM THE INTERVENTION WERE FOUND FOR WORRY, FEAR OF DEPRESSION AND ANXIETY, RUMINATION, AND AREAS RELATED TO BODY AWARENESS, SUCH AS TRUSTING BODILY EXPERIENCES AND NOT DISTRACTING FROM SENSATIONS OF DISCOMFORT. A 9-WEEK MINDFUL YOGA INTERVENTION APPEARS TO BE A FEASIBLE AND ATTRACTIVE TREATMENT WHEN ADDED TO TREATMENT AS USUAL FOR A GROUP OF PATIENTS WITH CHRONIC MOOD DISORDERS. A RANDOMIZED CONTROLLED TRIAL TO STUDY THE EFFECTS OF MINDFUL YOGA IS RECOMMENDED. 2021 16 348 29 ASSESSING THE ACCEPTABILITY OF YOGA AMONG PATIENTS WITH AND WITHOUT CHRONIC PAIN ENROLLED IN A LICENSED OPIOID TREATMENT PROGRAM. THERE IS A PRESSING NEED TO IDENTIFY NON-OPIOID, EVIDENCE-BASED TREATMENTS TO ADDRESS THE HIGH PREVALENCE OF CHRONIC PAIN IN LICENSED OPIOID TREATMENT PROGRAMS (OTP). YOGA IS AN EFFECTIVE PAIN COPING STRATEGY BUT IS NOT WIDELY USED BY OTP PATIENTS. FEW STUDIES HAVE EXAMINED UNDERLYING FACTORS RELATED TO POOR YOGA UTILIZATION IN THIS POPULATION. SEVENTY-ONE PARTICIPANTS WITH AND WITHOUT CHRONIC PAIN ENROLLED IN A HOSPITAL-BASED OTP COMPLETED AN ACCEPTABILITY SURVEY ASSESSING PAIN, CURRENT PAIN COPING STRATEGIES, PRIOR YOGA EXPERIENCE, WILLINGNESS TO TRY YOGA, AND BELIEFS ABOUT YOGA. PARTICIPANTS WITH AND WITHOUT CHRONIC PAIN WERE COMPARED, AS WERE PARTICIPANTS WITH AND WITHOUT PRIOR YOGA EXPERIENCE. THE RELATIONSHIPS BETWEEN PRIMARY STUDY VARIABLES IN THE CHRONIC PAIN GROUP WERE ALSO EXPLORED. PARTICIPANTS REPORTED USING OVER-THE-COUNTER MEDICATIONS, MEDITATION, STRETCHING, AND EXERCISE TO MANAGE CHRONIC PAIN, BUT YOGA WAS NOT COMMONLY USED. PARTICIPANTS WITH PRIOR YOGA EXPERIENCE REPORTED HIGHER WILLINGNESS TO TRY YOGA AND MORE FAVORABLE BELIEFS ABOUT YOGA THAN PARTICIPANTS WITHOUT PRIOR YOGA EXPERIENCE. THERE WERE NO SIGNIFICANT DIFFERENCES IN WILLINGNESS TO TRY YOGA BETWEEN PARTICIPANTS WITH AND WITHOUT CHRONIC PAIN. AMONG PARTICIPANTS WITH CHRONIC PAIN, THERE WAS A POSITIVE ASSOCIATION BETWEEN TOTAL NUMBER OF PAIN COPING STRATEGIES USED AND WILLINGNESS TO TRY YOGA. THIS STUDY ADDS TO THE EXISTING LITERATURE ON THE IMPLEMENTATION OF YOGA PROGRAMS INTO OTPS BY DEMONSTRATING THE ACCEPTABILITY OF YOGA IN PATIENTS WITH OPIOID USE DISORDER, INCLUDING THOSE EXPERIENCING CHRONIC PAIN, AND ENCOURAGES ADDITIONAL RESEARCH EXPLORING IMPLEMENTATION. 2022 17 142 19 A PROTOCOL AND PILOT STUDY FOR MANAGING FIBROMYALGIA WITH YOGA AND MEDITATION. FIBROMYALGIA IS A CHRONIC SYNDROME CHARACTERIZED BY WIDESPREAD PAIN, SLEEP DISTURBANCE, STIFFNESS, FATIGUE, HEADACHE, AND MOOD DISORDERS. RECENT RESEARCH HAS RESULTED IN AN IMPROVED UNDERSTANDING OF FIBROMYALGIA AND ITS POSSIBLE CAUSES. THIS ARTICLE HIGHLIGHTS SOME OF THE CURRENT RESEARCH, DISCUSSES A STRATEGY FOR USING YOGA AND MEDITATION AS A THERAPY FOR FIBROMYALGIA SUFFERERS, AND PRESENTS THE RESULTS OF A PRELIMINARY 8-WEEK STUDY USING YOGA AND MEDITATION TO HELP MANAGE FIBROMYALGIA SYMPTOMS. THE STUDY OF 11 PARTICIPANTS FOUND SIGNIFICANT IMPROVEMENT IN THE OVERALL HEALTH STATUS OF THE PARTICIPANTS AND IN SYMPTOMS OF STIFFNESS, ANXIETY, AND DEPRESSION. SIGNIFICANT IMPROVEMENTS WERE ALSO SEEN IN THE REPORTED NUMBER OF DAYS "FELT GOOD" AND NUMBER OF DAYS "MISSED WORK" BECAUSE OF FIBROMYALGIA. NONSIGNIFICANT IMPROVEMENTS WERE SEEN IN MEASURES OF PAIN, FATIGUE, AND HOW ONE FELT IN THE MORNING. EFFECT SIZES WERE MEDIUM TO LARGE FOR MOST TESTED AREAS. THIS STUDY SUPPORTS THE BENEFITS OF YOGA AND MEDITATION FOR INDIVIDUALS WITH FIBROMYALGIA AND ENCOURAGES FURTHER RESEARCH TO EXPLORE THEIR USE AS STANDARD THERAPIES FOR FIBROMYALGIA. 2011 18 1723 18 PERCEPTIONS OF HATHA YOGA AMONGST PERSISTENTLY DEPRESSED INDIVIDUALS ENROLLED IN A TRIAL OF YOGA FOR DEPRESSION. OBJECTIVES: TO UNDERSTAND DEPRESSED INDIVIDUALS' EXPERIENCES IN A 10-WEEK HATHA YOGA PROGRAM. DESIGN: IN A RANDOMIZED CONTROLLED TRIAL, PARTICIPANTS WERE ASSIGNED TO EITHER 10 WEEKS OF HATHA YOGA CLASSES OR A HEALTH EDUCATION CONTROL GROUP. THIS REPORT INCLUDES RESPONSES FROM PARTICIPANTS IN YOGA CLASSES. AT THE START OF CLASSES, AVERAGE DEPRESSION SYMPTOM SEVERITY LEVEL WAS MODERATE. MAIN OUTCOME MEASURES: AFTER 10 WEEKS OF YOGA CLASSES, WE ASKED PARTICIPANTS (N=50) TO PROVIDE WRITTEN RESPONSES TO OPEN-ENDED QUESTIONS ABOUT WHAT THEY LIKED ABOUT CLASSES, WHAT THEY DID NOT LIKE OR DID NOT FIND HELPFUL, AND WHAT THEY LEARNED. WE ANALYZED QUALITATIVE DATA USING THEMATIC ANALYSIS. RESULTS AND CONCLUSIONS: ELEMENTS OF YOGA CLASSES THAT MAY INCREASE ACCEPTABILITY FOR DEPRESSED INDIVIDUALS INCLUDE HAVING INSTRUCTORS WHO PROMOTE A NON-COMPETITIVE AND NON-JUDGMENTAL ATMOSPHERE, WHO ARE KNOWLEDGEABLE AND ABLE TO PROVIDE INDIVIDUALIZED ATTENTION, AND WHO ARE KIND AND WARM. INCLUDING DEPRESSION-RELATED THEMES IN CLASSES, TEACHING MINDFULNESS, TEACHING BREATHING EXERCISES, AND PROVIDING GUIDANCE FOR TRANSLATING CLASS INTO HOME PRACTICE MAY HELP TO MAKE YOGA EFFECTIVE FOR TARGETING DEPRESSION. PARTICIPANTS' COMMENTS REINFORCED THE IMPORTANCE OF ASPECTS OF MINDFULNESS, SUCH AS ATTENTION TO THE PRESENT MOMENT AND ACCEPTANCE OF ONE'S SELF AND ONE'S EXPERIENCE, AS POTENTIAL MECHANISMS OF ACTION. OTHER POTENTIAL MECHANISMS INCLUDE USE OF BREATHING PRACTICES IN EVERYDAY LIFE AND THE BIOLOGICAL MECHANISMS THAT UNDERLIE THE POSITIVE IMPACT OF YOGIC BREATHING. THE MOST SERIOUS CONCERN HIGHLIGHTED BY A FEW PARTICIPANTS WAS THE CONCERN THAT THE YOGA CLASSES WERE TOO DIFFICULT GIVEN THEIR PHYSICAL ABILITIES. 2017 19 1684 19 OPEN TRIAL OF VINYASA YOGA FOR PERSISTENTLY DEPRESSED INDIVIDUALS: EVIDENCE OF FEASIBILITY AND ACCEPTABILITY. THE AIM OF THIS STUDY WAS TO ASSESS THE ACCEPTABILITY AND FEASIBILITY OF VINYASA YOGA AS AN ADJUNCTIVE TREATMENT FOR DEPRESSED PATIENTS WHO WERE NOT RESPONDING ADEQUATELY TO ANTIDEPRESSANT MEDICATION. THE AUTHORS ALSO PLANNED TO ASK PARTICIPANTS FOR QUALITATIVE FEEDBACK ON THEIR EXPERIENCE OF THE CLASS AND TO ASSESS CHANGE OVER TIME IN DEPRESSION AND IN POSSIBLE MEDIATING VARIABLES. THE AUTHORS RECRUITED 11 PARTICIPANTS IN 1 MONTH FOR AN 8-WEEK OPEN TRIAL OF YOGA CLASSES. THEY FOUND THAT 10 PARTICIPANTS COMPLETED FOLLOW-UP ASSESSMENTS, 9 OF 10 WERE POSITIVE ABOUT THEIR EXPERIENCE, AND ALL PROVIDED FEEDBACK ABOUT WHAT WAS AND WAS NOT HELPFUL ABOUT YOGA, AS WELL AS BARRIERS TO CLASS ATTENDANCE. OVER THE 2-MONTH PERIOD, PARTICIPANTS EXHIBITED SIGNIFICANT DECREASES IN DEPRESSION SYMPTOMS AND SIGNIFICANT INCREASES IN AN ASPECT OF MINDFULNESS AND IN BEHAVIOR ACTIVATION. THIS PILOT STUDY PROVIDED SUPPORT FOR CONTINUING TO INVESTIGATE VINYASA YOGA AS AN ADJUNCT TREATMENT FOR DEPRESSION. THE NEXT STEP REQUIRED IS A RIGOROUS RANDOMIZED CLINICAL TRIAL. 2010 20 2433 18 YOGA AND PILATES IN THE MANAGEMENT OF LOW BACK PAIN. MANY INTERVENTIONS FOR THE MANAGEMENT OF LOW BACK PAIN EXIST, HOWEVER MOST HAVE MODEST EFFICACY AT BEST, AND THERE ARE FEW WITH CLEARLY DEMONSTRATED BENEFITS ONCE PAIN BECOMES CHRONIC. THERAPEUTIC EXERCISE, ON THE OTHER HAND, DOES APPEAR TO HAVE SIGNIFICANT BENEFITS FOR MANAGING PATIENTS WITH CHRONIC LOW BACK PAIN (CLBP) IN TERMS OF DECREASING PAIN AND IMPROVING FUNCTION. IN ADDITION, BECAUSE CHRONIC PAIN IS COMPLEX AND DOES NOT FIT A SIMPLE MODEL, THERE HAVE ALSO BEEN NUMEROUS TRIALS INVESTIGATING AND DEMONSTRATING THE EFFICACY OF MULTIDISCIPLINARY PAIN PROGRAMS FOR CLBP. IT FOLLOWS THAT INTERVENTIONS THAT TREAT MORE THAN ONE ASPECT OF LBP WOULD HAVE SIGNIFICANT BENEFITS FOR THIS PATIENT POPULATION. YOGA AND PILATES WHICH HAVE, BOTH BEEN GAINING IN POPULARITY OVER THE LAST DECADE ARE TWO MIND-BODY EXERCISE INTERVENTIONS THAT ADDRESS BOTH THE PHYSICAL AND MENTAL ASPECTS OF PAIN WITH CORE STRENGTHENING, FLEXIBILITY, AND RELAXATION. THERE HAS BEEN A SLOW EVOLUTION OF THESE NONTRADITIONAL EXERCISE REGIMENS INTO TREATMENT PARADIGMS FOR LBP, ALTHOUGH FEW STUDIES EXAMINING THEIR EFFECTS HAVE BEEN PUBLISHED. THE FOLLOWING ARTICLE WILL FOCUS ON THE SCIENTIFIC AND THEORETICAL BASIS OF USING YOGA AND PILATES IN THE MANAGEMENT OF CLBP. 2008