1 1862 160 RANDOMIZED CONTROLLED TRIAL OF YOGA AMONG A MULTIETHNIC SAMPLE OF BREAST CANCER PATIENTS: EFFECTS ON QUALITY OF LIFE. PURPOSE: THIS STUDY EXAMINES THE IMPACT OF YOGA, INCLUDING PHYSICAL POSES, BREATHING, AND MEDITATION EXERCISES, ON QUALITY OF LIFE (QOL), FATIGUE, DISTRESSED MOOD, AND SPIRITUAL WELL-BEING AMONG A MULTIETHNIC SAMPLE OF BREAST CANCER PATIENTS. PATIENTS AND METHODS: ONE HUNDRED TWENTY-EIGHT PATIENTS (42% AFRICAN AMERICAN, 31% HISPANIC) RECRUITED FROM AN URBAN CANCER CENTER WERE RANDOMLY ASSIGNED (2:1 RATIO) TO A 12-WEEK YOGA INTERVENTION (N = 84) OR A 12-WEEK WAITLIST CONTROL GROUP (N = 44). CHANGES IN QOL (EG, FUNCTIONAL ASSESSMENT OF CANCER THERAPY) FROM BEFORE RANDOM ASSIGNMENT (T1) TO THE 3-MONTH FOLLOW-UP (T3) WERE EXAMINED; PREDICTORS OF ADHERENCE WERE ALSO ASSESSED. NEARLY HALF OF ALL PATIENTS WERE RECEIVING MEDICAL TREATMENT. RESULTS: REGRESSION ANALYSES INDICATED THAT THE CONTROL GROUP HAD A GREATER DECREASE IN SOCIAL WELL-BEING COMPARED WITH THE INTERVENTION GROUP AFTER CONTROLLING FOR BASELINE SOCIAL WELL-BEING AND COVARIATES (P < .0001). SECONDARY ANALYSES OF 71 PATIENTS NOT RECEIVING CHEMOTHERAPY DURING THE INTERVENTION PERIOD INDICATED FAVORABLE OUTCOMES FOR THE INTERVENTION GROUP COMPARED WITH THE CONTROL GROUP IN OVERALL QOL (P < .008), EMOTIONAL WELL-BEING (P < .015), SOCIAL WELL-BEING (P < .004), SPIRITUAL WELL-BEING (P < .009), AND DISTRESSED MOOD (P < .031). SIXTY-NINE PERCENT OF INTERVENTION PARTICIPANTS ATTENDED CLASSES (MEAN NUMBER OF CLASSES ATTENDED BY ACTIVE CLASS PARTICIPANTS = 7.00 +/- 3.80), WITH LOWER ADHERENCE ASSOCIATED WITH INCREASED FATIGUE (P < .001), RADIOTHERAPY (P < .0001), YOUNGER AGE (P < .008), AND NO ANTIESTROGEN THERAPY (P < .02). CONCLUSION: DESPITE LIMITED ADHERENCE, THIS INTENT-TO-TREAT ANALYSIS SUGGESTS THAT YOGA IS ASSOCIATED WITH BENEFICIAL EFFECTS ON SOCIAL FUNCTIONING AMONG A MEDICALLY DIVERSE SAMPLE OF BREAST CANCER SURVIVORS. AMONG PATIENTS NOT RECEIVING CHEMOTHERAPY, YOGA APPEARS TO ENHANCE EMOTIONAL WELL-BEING AND MOOD AND MAY SERVE TO BUFFER DETERIORATION IN BOTH OVERALL AND SPECIFIC DOMAINS OF QOL. 2007 2 2415 51 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 3 2552 46 YOGA FOR CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY AND FALL RISK: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY (CIPN) IS A COMMON, DEBILITATING SIDE EFFECT THAT WORSENS QUALITY OF LIFE AND INCREASES THE RISK OF FALLS IN CANCER SURVIVORS. EVIDENCE OF YOGA'S SAFETY AND EFFICACY IN TREATING CIPN IS LACKING. METHODS: IN A RANDOMIZED CONTROLLED STUDY, WE ASSIGNED BREAST AND GYNECOLOGICAL CANCER SURVIVORS WITH PERSISTENT MODERATE-TO-SEVERE CIPN PAIN, NUMBNESS, OR TINGLING WITH A SCORE OF 4 OR GREATER (0-10 NUMERIC RATING SCALE [NRS]) FOR AT LEAST 3 MONTHS AFTER CHEMOTHERAPY TO 8 WEEKS OF USUAL CARE OR YOGA FOCUSED ON BREATHWORK AND MUSCULOSKELETAL CONDITIONING. PRIMARY ENDPOINT WAS TREATMENT ARM DIFFERENCES FOR NRS, AND SECONDARY ENDPOINTS WERE FUNCTIONAL ASSESSMENT OF CANCER THERAPY/GYNECOLOGIC ONCOLOGY GROUP-NEUROTOXICITY SUBSCALE (FACT/GOG-NTX), AND FUNCTIONAL REACH TEST AFTER WEEK 8. WE TESTED TREATMENT ARM DIFFERENCES FOR EACH OUTCOME MEASURE USING LINEAR MIXED MODELS WITH TREATMENT-BY-TIME INTERACTIONS. ALL STATISTICAL TESTS WERE TWO-SIDED. RESULTS: WE RANDOMLY ASSIGNED 41 PARTICIPANTS INTO YOGA (N = 21) OR USUAL CARE (N = 20). AT WEEK 8, MEAN NRS PAIN DECREASED BY 1.95 POINTS (95% CONFIDENCE INTERVAL [CI] = -3.20 TO -0.70) IN YOGA VS 0.65 (95% CI = -1.81 TO 0.51) IN USUAL CARE (P = .14). FACT/GOG-NTX IMPROVED BY 4.25 (95% CI = 2.29 TO 6.20) IN YOGA VS 1.36 (95% CI = -0.47 TO 3.19) IN USUAL CARE (P = .035). FUNCTIONAL REACH, AN OBJECTIVE FUNCTIONAL MEASURE PREDICTING THE RISK OF FALLS, IMPROVED BY 7.14 CM (95% CI = 3.68 TO 10.59) IN YOGA AND DECREASED BY 1.65 CM (95% CI = -5.00 TO 1.72) IN USUAL CARE (P = .001). FOUR GRADE 1 ADVERSE EVENTS WERE OBSERVED IN THE YOGA ARM. CONCLUSION: AMONG BREAST AND GYNECOLOGICAL CANCER SURVIVORS WITH MODERATE-TO-SEVERE CIPN, YOGA WAS SAFE AND SHOWED PROMISING EFFICACY IN IMPROVING CIPN SYMPTOMS. 2020 4 1748 47 PILOT RANDOMIZED, CONTROLLED TRIAL OF A DYADIC YOGA PROGRAM FOR GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR FAMILY CAREGIVERS. BACKGROUND: WHILE THE USE OF BEHAVIORAL MEDICINE IN MANAGING GLIOMA PATIENTS' SYMPTOMS IS NOT WELL STUDIED, THE HIGH SYMPTOM BURDEN IN PATIENTS AND THEIR FAMILY CAREGIVERS IS WELL ESTABLISHED. WE CONDUCTED A PILOT RANDOMIZED, CONTROLLED TRIAL TO EXAMINE THE FEASIBILITY AND PRELIMINARY EFFICACY OF A DYADIC YOGA (DY) INTERVENTION AS A SUPPORTIVE CARE STRATEGY. METHODS: GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR CAREGIVERS WERE RANDOMIZED TO A 12-SESSION DY OR WAITLIST CONTROL (WLC) GROUP. PRIOR TO RADIOTHERAPY AND RANDOMIZATION, BOTH GROUPS COMPLETED MEASURES OF CANCER-RELATED SYMPTOMS (MD ANDERSON SYMPTOM INVENTORY-BRAIN TUMOR MODULE), DEPRESSIVE SYMPTOMS (CENTER FOR EPIDEMIOLOGICAL STUDIES-DEPRESSION MEASURE), FATIGUE (BRIEF FATIGUE INVENTORY), AND OVERALL QUALITY OF LIFE (QOL; MEDICAL OUTCOMES STUDY 36-ITEM SHORT-FORM SURVEY). DYADS WERE REASSESSED AT THE LAST DAY OF RADIOTHERAPY. RESULTS: TWENTY PATIENTS (MEAN AGE: 46 YEARS, 50% FEMALE, 80% WHO GRADE IV AND CAREGIVERS (MEAN AGE: 50 YEARS, 70% FEMALE, 50% SPOUSES) PARTICIPATED IN THE TRIAL. A PRIORI FEASIBILITY CRITERIA WERE MET REGARDING CONSENT (70%), ADHERENCE (88%), AND RETENTION (95%) RATES. CONTROLLING FOR RELEVANT COVARIATES, CHANGE SCORE ANALYSES REVEALED CLINICALLY SIGNIFICANT IMPROVEMENTS FOR PATIENTS IN THE DY COMPARED WITH THE WLC GROUP FOR OVERALL CANCER SYMPTOM SEVERITY (D = 0.96) AND SYMPTOM INTERFERENCE (D = 0.74), DEPRESSIVE SYMPTOMS (D = 0.71), AND MENTAL QOL (D = 0.69). CAREGIVERS IN THE DY GROUP REPORTED CLINICALLY SIGNIFICANT IMPROVEMENTS IN DEPRESSIVE SYMPTOMS (D = 1.12), FATIGUE (D = 0.89), AND MENTAL QOL (D = 0.49) RELATIVE TO THOSE IN THE WLC GROUP. CONCLUSION: A DY INTERVENTION APPEARS TO BE A FEASIBLE AND BENEFICIAL SYMPTOM AND QOL MANAGEMENT STRATEGY FOR GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR CAREGIVERS. AN EFFICACY TRIAL WITH A MORE STRINGENT CONTROL GROUP IS WARRANTED. CLINICAL TRIAL NUMBER: NCT02481349. 2019 5 518 39 COMPARING ONCE- VERSUS TWICE-WEEKLY YOGA CLASSES FOR CHRONIC LOW BACK PAIN IN PREDOMINANTLY LOW INCOME MINORITIES: A RANDOMIZED DOSING TRIAL. BACKGROUND. PREVIOUS STUDIES HAVE DEMONSTRATED THAT ONCE-WEEKLY YOGA CLASSES ARE EFFECTIVE FOR CHRONIC LOW BACK PAIN (CLBP) IN WHITE ADULTS WITH HIGH SOCIOECONOMIC STATUS. THE COMPARATIVE EFFECTIVENESS OF TWICE-WEEKLY CLASSES AND GENERALIZABILITY TO RACIALLY DIVERSE LOW INCOME POPULATIONS ARE UNKNOWN. METHODS. WE CONDUCTED A 12-WEEK RANDOMIZED, PARALLEL-GROUP, DOSING TRIAL FOR 95 ADULTS RECRUITED FROM AN URBAN SAFETY-NET HOSPITAL AND FIVE COMMUNITY HEALTH CENTERS COMPARING ONCE-WEEKLY (N = 49) VERSUS TWICE-WEEKLY (N = 46) STANDARDIZED YOGA CLASSES SUPPLEMENTED BY HOME PRACTICE. PRIMARY OUTCOMES WERE CHANGE FROM BASELINE TO 12 WEEKS IN PAIN (11-POINT SCALE) AND BACK-RELATED FUNCTION (23-POINT MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE). RESULTS. 82% OF PARTICIPANTS WERE NONWHITE; 77% HAD ANNUAL HOUSEHOLD INCOMES <$40,000. THE SAMPLE'S BASELINE MEAN PAIN INTENSITY [6.9 (SD 1.6)] AND FUNCTION [13.7 (SD 5.0)] REFLECTED MODERATE TO SEVERE BACK PAIN AND IMPAIRMENT. PAIN AND BACK-RELATED FUNCTION IMPROVED WITHIN BOTH GROUPS (P < 0.001). HOWEVER, THERE WERE NO DIFFERENCES BETWEEN ONCE-WEEKLY AND TWICE-WEEKLY GROUPS FOR PAIN REDUCTION [-2.1 (95% CI -2.9, -1.3) VERSUS -2.4 (95% CI -3.1, -1.8), P = 0.62] OR BACK-RELATED FUNCTION [-5.1 (95% CI -7.0, -3.2) VERSUS -4.9 (95% CI -6.5, -3.3), P = 0.83]. CONCLUSIONS. TWELVE WEEKS OF ONCE-WEEKLY OR TWICE-WEEKLY YOGA CLASSES WERE SIMILARLY EFFECTIVE FOR PREDOMINANTLY LOW INCOME MINORITY ADULTS WITH MODERATE TO SEVERE CHRONIC LOW BACK PAIN. THIS TRIAL IS REGISTERED WITH CLINICALTRIALS.GOV NCT01761617. 2013 6 167 51 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 7 189 46 A RANDOMIZED STUDY OF YOGA FOR FATIGUE AND QUALITY OF LIFE IN WOMEN WITH BREAST CANCER UNDERGOING (NEO) ADJUVANT CHEMOTHERAPY. OBJECTIVES: TO COMPARE THE EFFECTIVENESS OF YOGA ADDED TO STANDARD CARE (SC) VERSUS SC ONLY, IN WOMEN WITH BREAST CANCER DURING CHEMOTHERAPY. DESIGN: A MULTICENTER PRAGMATIC, RANDOMIZED CONTROLLED STUDY. SETTINGS/LOCATION: THREE HOSPITALS IN THE NETHERLANDS. SUBJECTS: WOMEN WITH STAGE I-III BREAST CANCER UNDERGOING CHEMOTHERAPY. INTERVENTIONS: WOMEN WERE RANDOMIZED EITHER TO A PROGRAM BASED ON DRU YOGA, ONCE A WEEK YOGA SESSIONS FOR 12 WEEKS (N = 47), OR SC ONLY (N = 36). OUTCOME MEASURES: PRIMARY OUTCOME FATIGUE (MULTIDIMENSIONAL FATIGUE INVENTORY [MFI]; GENERAL FATIGUE) AND SECONDARY OUTCOMES FATIGUE (MFI, FATIGUE QUALITY LIST [FQL]), QUALITY OF LIFE (30-ITEM QUALITY OF LIFE QUESTIONNAIRE-C OF THE EUROPEAN ORGANIZATION FOR RESEARCH AND TREATMENT OF CANCER [EORTC-QLQ-C-30]) AND PSYCHOLOGICAL DISTRESS (HOSPITAL ANXIETY DEPRESSION SCALE [HADS], IMPACT OF EVENTS SCALE [IES]) WERE MEASURED AT BASELINE (T0), 3 MONTHS (T1), AND 6 MONTHS (T2) AND ANALYZED ON OBSERVED CASES. OTHER OUTCOMES WERE ADEQUATE RELIEF, REINTEGRATION TO WORK, AND ADVERSE EVENTS. RESULTS: NO SIGNIFICANT DIFFERENCES WERE FOUND IN GENERAL FATIGUE AT T1 (MFI: YOGA; 14.6 +/- 4.5 VS. SC; 14.2 +/- 4.2, P = 0.987). SIMILAR FINDINGS WERE OBSERVED FOR OTHER FATIGUE (SUB)SCALES OF MFI AND FQL AND FUNCTIONAL DOMAINS OF EORTC. WITH RESPECT TO EORTCS SYMPTOM SCALES, WOMEN IN THE YOGA GROUP REPORTED SIGNIFICANTLY LESS NAUSEA AND VOMITING COMPARED WITH SC AT T2 (P = 0.004), BUT NOT AT T1 (P = 0.807). DEPRESSIVE SYMPTOMS WERE SIGNIFICANTLY LOWER WITH YOGA AT T1 (HADS: YOGA; 4.7 +/- 4.1 VS. SC; 5.1 +/- 4.2, P = 0.031). MORE WOMEN IN THE YOGA GROUP EXPERIENCED ADEQUATE RELIEF COMPARED WITH SC AT T1 (YOGA; 51% VS. SC; 19%) AND HAD RETURNED TO WORK AT T2 (YOGA; 53% VS. SC; 23%). NO ADVERSE EVENTS WERE REPORTED WITH YOGA. CONCLUSIONS: A DRU-BASED YOGA PROGRAM FAILED TO DEMONSTRATE A SIGNIFICANT BENEFICIAL EFFECT ON FATIGUE. POSSIBLE FAVORABLE EFFECTS OF THE YOGA PROGRAM ON NAUSEA AND VOMITING AND EARLY RETURN TO WORK IN BREAST CANCER SURVIVORS WARRANT FURTHER RESEARCH. 2018 8 2820 56 YOGA TREATMENT FOR CHRONIC NON-SPECIFIC LOW BACK PAIN (2017). WIELAND LS, SKOETZ N, PILKINGTON K, VEMPATI R, DADAMO CR, BERMAN BM. YOGA TREATMENT FOR CHRONIC NON-SPECIFIC LOW BACK PAIN.COCHRANE DATABASE SYST REV2017, ISSUE 1. ART. NO.: CD010671. DOI: 10.1002/14651858.CD010671.PUB2. BACKGROUND: NON-SPECIFIC LOW BACK PAIN IS A COMMON, POTENTIALLY DISABLING CONDITION USUALLY TREATED WITH SELF-CARE AND NON-PRESCRIPTION MEDICATION. FOR CHRONIC LOW BACK PAIN, CURRENT GUIDELINES STATE THAT EXERCISE THERAPY MAY BE BENEFICIAL. YOGA IS A MIND-BODY EXERCISE SOMETIMES USED FOR NON-SPECIFIC LOW BACK PAIN. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA FOR TREATING CHRONIC NON-SPECIFIC LOW BACK PAIN, COMPARED TO NO SPECIFIC TREATMENT, A MINIMAL INTERVENTION (E.G., EDUCATION), OR ANOTHER ACTIVE TREATMENT, WITH A FOCUS ON PAIN, FUNCTION, AND ADVERSE EVENTS. SEARCH METHODS: WE SEARCHED CENTRAL, MEDLINE, EMBASE, FIVE OTHER DATABASES, AND FOUR TRIALS REGISTERS TO 11 MARCH 2016 WITHOUT RESTRICTION OF LANGUAGE OR PUBLICATION STATUS. WE SCREENED REFERENCE LISTS AND CONTACTED EXPERTS IN THE FIELD TO IDENTIFY ADDITIONAL STUDIES. SELECTION CRITERIA: WE INCLUDED RANDOMIZED CONTROLLED TRIALS OF YOGA TREATMENT IN PEOPLE WITH CHRONIC NON-SPECIFIC LOW BACK PAIN. WE INCLUDED STUDIES COMPARING YOGA TO ANY OTHER INTERVENTION OR TO NO INTERVENTION. WE ALSO INCLUDED STUDIES COMPARING YOGA AS AN ADJUNCT TO OTHER THERAPIES, VERSUS THOSE OTHER THERAPIES ALONE. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SCREENED AND SELECTED STUDIES, EXTRACTED OUTCOME DATA, AND ASSESSED RISK OF BIAS. WE CONTACTED STUDY AUTHORS TO OBTAIN MISSING OR UNCLEAR INFORMATION. WE EVALUATED THE OVERALL CERTAINTY OF EVIDENCE USING THE GRADE APPROACH. MAIN RESULTS: WE INCLUDED 12 TRIALS (1080 PARTICIPANTS) CARRIED OUT IN THE USA (SEVEN TRIALS), INDIA (THREE TRIALS), AND THE UK (TWO TRIALS). STUDIES WERE UNFUNDED (ONE TRIAL), FUNDED BY A YOGA INSTITUTION (ONE TRIAL), FUNDED BY NON-PROFIT OR GOVERNMENT SOURCES (SEVEN TRIALS), OR DID NOT REPORT ON FUNDING (THREE TRIALS). MOST TRIALS USED IYENGAR, HATHA, OR VINIYOGA FORMS OF YOGA. THE TRIALS COMPARED YOGA TO NO INTERVENTION OR A NON-EXERCISE INTERVENTION SUCH AS EDUCATION (SEVEN TRIALS), AN EXERCISE INTERVENTION (THREE TRIALS), OR BOTH EXERCISE AND NON-EXERCISE INTERVENTIONS (TWO TRIALS). ALL TRIALS WERE AT HIGH RISK OF PERFORMANCE AND DETECTION BIAS BECAUSE PARTICIPANTS AND PROVIDERS WERE NOT BLINDED TO TREATMENT ASSIGNMENT, AND OUTCOMES WERE SELF-ASSESSED. THEREFORE, WE DOWNGRADED ALL OUTCOMES TO "MODERATE" CERTAINTY EVIDENCE BECAUSE OF RISK OF BIAS, AND WHEN THERE WAS ADDITIONAL SERIOUS RISK OF BIAS, UNEXPLAINED HETEROGENEITY BETWEEN STUDIES, OR THE ANALYSES WERE IMPRECISE, WE DOWNGRADED THE CERTAINTY OF THE EVIDENCE FURTHER. FOR YOGA COMPARED TO NON-EXERCISE CONTROLS (9 TRIALS; 810 PARTICIPANTS), THERE WAS LOW-CERTAINTY EVIDENCE THAT YOGA PRODUCED SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE TO FOUR MONTHS [STANDARDIZED MEAN DIFFERENCE (SMD) = -0.40, 95% CI: -0.66 TO -0.14; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MEAN DIFFERENCE (MD) = -2.18, 95% CI: -3.60 TO -0.76], MODERATE-CERTAINTY EVIDENCE FOR SMALL TO MODERATE IMPROVEMENTS AT SIX MONTHS (SMD = -0.44, 95% CI: -0.66 TO -0.22; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD = -2.15, 95% CI: -3.23 TO -1.08), AND LOW-CERTAINTY EVIDENCE FOR SMALL IMPROVEMENTS AT 12 MONTHS (SMD = -0.26, 95% CI: -0.46 TO -0.05; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD = -1.36, 95% CI: -2.41 TO -0.26). ON A 0-100 SCALE THERE WAS VERY LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA WAS SLIGHTLY BETTER FOR PAIN AT THREE TO FOUR MONTHS (MD = -4.55, 95% CI: -7.04 TO -2.06), SIX MONTHS (MD = -7.81, 95% CI: -13.37 TO -2.25), AND 12 MONTHS (MD = -5.40, 95% CI: -14.50 TO -3.70); HOWEVER, WE PRE-DEFINED CLINICALLY SIGNIFICANT CHANGES IN PAIN AS 15 POINTS OR GREATER AND THIS THRESHOLD WAS NOT MET. BASED ON INFORMATION FROM SIX TRIALS, THERE WAS MODERATE-CERTAINTY EVIDENCE THAT THE RISK OF ADVERSE EVENTS, PRIMARILY INCREASED BACK PAIN, WAS HIGHER IN YOGA THAN IN NON-EXERCISE CONTROLS [RISK DIFFERENCE (RD) = 5%, 95% CI: 2-8%]. FOR YOGA COMPARED TO NON-YOGA EXERCISE CONTROLS (4 TRIALS; 394 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE IN BACK-RELATED FUNCTION AT THREE MONTHS (SMD = -0.22, 95% CI: -0.65 TO 0.20; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD = -0.99, 95% CI: -2.87 TO 0.90) AND SIX MONTHS (SMD = -0.20, 95% CI: -0.59 TO 0.19; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD = -0.90, 95% CI: -2.61 TO 0.81), AND NO INFORMATION ON BACK-RELATED FUNCTION AFTER SIX MONTHS. THERE WAS VERY LOW-CERTAINTY EVIDENCE FOR LOWER PAIN ON A 0-100 SCALE AT SEVEN MONTHS (MD = -20.40, 95% CI: -25.48 TO -15.32), AND NO INFORMATION ON PAIN AT THREE MONTHS OR AFTER SEVEN MONTHS. BASED ON INFORMATION FROM THREE TRIALS, THERE WAS LOW-CERTAINTY EVIDENCE FOR NO DIFFERENCE IN THE RISK OF ADVERSE EVENTS BETWEEN YOGA AND NON-YOGA EXERCISE CONTROLS (RD = 1%, 95% CI: -4% TO 6%). FOR YOGA ADDED TO EXERCISE COMPARED TO EXERCISE ALONE (1 TRIAL; 24 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE AT 10 WEEKS IN BACK-RELATED FUNCTION (SMD = -0.60, 95% CI: -1.42 TO 0.22; CORRESPONDING TO A CHANGE IN THE OSWESTRY DISABILITY INDEX OF MD = -17.05, 95% CI: -22.96 TO 11.14) OR PAIN ON A 0-100 SCALE (MD = -3.20, 95% CI: -13.76 TO 7.36). THERE WAS NO INFORMATION ON OUTCOMES AT OTHER TIME POINTS. THERE WAS NO INFORMATION ON ADVERSE EVENTS. STUDIES PROVIDED LIMITED EVIDENCE ON RISK OF CLINICAL IMPROVEMENT, MEASURES OF QUALITY OF LIFE, AND DEPRESSION. THERE WAS NO EVIDENCE ON WORK-RELATED DISABILITY. 2017 9 1602 50 MENOPAUSAL QUALITY OF LIFE: RCT OF YOGA, EXERCISE, AND OMEGA-3 SUPPLEMENTS. OBJECTIVE: THE PURPOSE OF THIS STUDY WAS TO DETERMINE THE EFFICACY OF 3 NONHORMONAL THERAPIES FOR THE IMPROVEMENT OF MENOPAUSE-RELATED QUALITY OF LIFE IN WOMEN WITH VASOMOTOR SYMPTOMS. STUDY DESIGN: WE CONDUCTED A 12-WEEK 3 X 2 RANDOMIZED, CONTROLLED, FACTORIAL DESIGN TRIAL. PERI- AND POSTMENOPAUSAL WOMEN, 40-62 YEARS OLD, WERE ASSIGNED RANDOMLY TO YOGA (N = 107), EXERCISE (N = 106), OR USUAL ACTIVITY (N = 142) AND ALSO ASSIGNED RANDOMLY TO A DOUBLE-BLIND COMPARISON OF OMEGA-3 (N = 177) OR PLACEBO (N = 178) CAPSULES. WE PERFORMED THE FOLLOWING INTERVENTIONS: (1) WEEKLY 90-MINUTE YOGA CLASSES WITH DAILY AT-HOME PRACTICE, (2) INDIVIDUALIZED FACILITY-BASED AEROBIC EXERCISE TRAINING 3 TIMES/WEEK, AND (3) 0.615 G OMEGA-3 SUPPLEMENT, 3 TIMES/DAY. THE OUTCOMES WERE ASSESSED WITH THE FOLLOWING SCORES: MENOPAUSAL QUALITY OF LIFE QUESTIONNAIRE (MENQOL) TOTAL AND DOMAIN (VASOMOTOR SYMPTOMS, PSYCHOSOCIAL, PHYSICAL AND SEXUAL). RESULTS: AMONG 355 RANDOMLY ASSIGNED WOMEN WHO AVERAGE AGE WAS 54.7 YEARS, 338 WOMEN (95%) COMPLETED 12-WEEK ASSESSMENTS. MEAN BASELINE VASOMOTOR SYMPTOMS FREQUENCY WAS 7.6/DAY, AND THE MEAN BASELINE TOTAL MENQOL SCORE WAS 3.8 (RANGE, 1-8 FROM BETTER TO WORSE) WITH NO BETWEEN-GROUP DIFFERENCES. FOR YOGA COMPARED TO USUAL ACTIVITY, BASELINE TO 12-WEEK IMPROVEMENTS WERE SEEN FOR MENQOL TOTAL -0.3 (95% CONFIDENCE INTERVAL, -0.6 TO 0; P = .02), VASOMOTOR SYMPTOM DOMAIN (P = .02), AND SEXUALITY DOMAIN (P = .03) SCORES. FOR WOMEN WHO UNDERWENT EXERCISE AND OMEGA-3 THERAPY COMPARED WITH CONTROL SUBJECTS, IMPROVEMENTS IN BASELINE TO 12-WEEK TOTAL MENQOL SCORES WERE NOT OBSERVED. EXERCISE SHOWED BENEFIT IN THE MENQOL PHYSICAL DOMAIN SCORE AT 12 WEEKS (P = .02). CONCLUSION: ALL WOMEN BECOME MENOPAUSAL, AND MANY OF THEM SEEK MEDICAL ADVICE ON WAYS TO IMPROVE QUALITY OF LIFE; LITTLE EVIDENCE-BASED INFORMATION EXISTS. WE FOUND THAT, AMONG HEALTHY SEDENTARY MENOPAUSAL WOMEN, YOGA APPEARS TO IMPROVE MENOPAUSAL QUALITY OF LIFE; THE CLINICAL SIGNIFICANCE OF OUR FINDING IS UNCERTAIN BECAUSE OF THE MODEST EFFECT. 2014 10 2821 57 YOGA TREATMENT FOR CHRONIC NON-SPECIFIC LOW BACK PAIN. BACKGROUND: NON-SPECIFIC LOW BACK PAIN IS A COMMON, POTENTIALLY DISABLING CONDITION USUALLY TREATED WITH SELF-CARE AND NON-PRESCRIPTION MEDICATION. FOR CHRONIC LOW BACK PAIN, CURRENT GUIDELINES STATE THAT EXERCISE THERAPY MAY BE BENEFICIAL. YOGA IS A MIND-BODY EXERCISE SOMETIMES USED FOR NON-SPECIFIC LOW BACK PAIN. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA FOR TREATING CHRONIC NON-SPECIFIC LOW BACK PAIN, COMPARED TO NO SPECIFIC TREATMENT, A MINIMAL INTERVENTION (E.G. EDUCATION), OR ANOTHER ACTIVE TREATMENT, WITH A FOCUS ON PAIN, FUNCTION, AND ADVERSE EVENTS. SEARCH METHODS: WE SEARCHED CENTRAL, MEDLINE, EMBASE, FIVE OTHER DATABASES AND FOUR TRIALS REGISTERS TO 11 MARCH 2016 WITHOUT RESTRICTION OF LANGUAGE OR PUBLICATION STATUS. WE SCREENED REFERENCE LISTS AND CONTACTED EXPERTS IN THE FIELD TO IDENTIFY ADDITIONAL STUDIES. SELECTION CRITERIA: WE INCLUDED RANDOMIZED CONTROLLED TRIALS OF YOGA TREATMENT IN PEOPLE WITH CHRONIC NON-SPECIFIC LOW BACK PAIN. WE INCLUDED STUDIES COMPARING YOGA TO ANY OTHER INTERVENTION OR TO NO INTERVENTION. WE ALSO INCLUDED STUDIES COMPARING YOGA AS AN ADJUNCT TO OTHER THERAPIES, VERSUS THOSE OTHER THERAPIES ALONE. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SCREENED AND SELECTED STUDIES, EXTRACTED OUTCOME DATA, AND ASSESSED RISK OF BIAS. WE CONTACTED STUDY AUTHORS TO OBTAIN MISSING OR UNCLEAR INFORMATION. WE EVALUATED THE OVERALL CERTAINTY OF EVIDENCE USING THE GRADE APPROACH. MAIN RESULTS: WE INCLUDED 12 TRIALS (1080 PARTICIPANTS) CARRIED OUT IN THE USA (SEVEN TRIALS), INDIA (THREE TRIALS), AND THE UK (TWO TRIALS). STUDIES WERE UNFUNDED (ONE TRIAL), FUNDED BY A YOGA INSTITUTION (ONE TRIAL), FUNDED BY NON-PROFIT OR GOVERNMENT SOURCES (SEVEN TRIALS), OR DID NOT REPORT ON FUNDING (THREE TRIALS). MOST TRIALS USED IYENGAR, HATHA, OR VINIYOGA FORMS OF YOGA. THE TRIALS COMPARED YOGA TO NO INTERVENTION OR A NON-EXERCISE INTERVENTION SUCH AS EDUCATION (SEVEN TRIALS), AN EXERCISE INTERVENTION (THREE TRIALS), OR BOTH EXERCISE AND NON-EXERCISE INTERVENTIONS (TWO TRIALS). ALL TRIALS WERE AT HIGH RISK OF PERFORMANCE AND DETECTION BIAS BECAUSE PARTICIPANTS AND PROVIDERS WERE NOT BLINDED TO TREATMENT ASSIGNMENT, AND OUTCOMES WERE SELF-ASSESSED. THEREFORE, WE DOWNGRADED ALL OUTCOMES TO 'MODERATE' CERTAINTY EVIDENCE BECAUSE OF RISK OF BIAS, AND WHEN THERE WAS ADDITIONAL SERIOUS RISK OF BIAS, UNEXPLAINED HETEROGENEITY BETWEEN STUDIES, OR THE ANALYSES WERE IMPRECISE, WE DOWNGRADED THE CERTAINTY OF THE EVIDENCE FURTHER.FOR YOGA COMPARED TO NON-EXERCISE CONTROLS (9 TRIALS; 810 PARTICIPANTS), THERE WAS LOW-CERTAINTY EVIDENCE THAT YOGA PRODUCED SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE TO FOUR MONTHS (STANDARDIZED MEAN DIFFERENCE (SMD) -0.40, 95% CONFIDENCE INTERVAL (CI) -0.66 TO -0.14; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MEAN DIFFERENCE (MD) -2.18, 95% -3.60 TO -0.76), MODERATE-CERTAINTY EVIDENCE FOR SMALL TO MODERATE IMPROVEMENTS AT SIX MONTHS (SMD -0.44, 95% CI -0.66 TO -0.22; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -2.15, 95% -3.23 TO -1.08), AND LOW-CERTAINTY EVIDENCE FOR SMALL IMPROVEMENTS AT 12 MONTHS (SMD -0.26, 95% CI -0.46 TO -0.05; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -1.36, 95% -2.41 TO -0.26). ON A 0-100 SCALE THERE WAS VERY LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA WAS SLIGHTLY BETTER FOR PAIN AT THREE TO FOUR MONTHS (MD -4.55, 95% CI -7.04 TO -2.06), SIX MONTHS (MD -7.81, 95% CI -13.37 TO -2.25), AND 12 MONTHS (MD -5.40, 95% CI -14.50 TO -3.70), HOWEVER WE PRE-DEFINED CLINICALLY SIGNIFICANT CHANGES IN PAIN AS 15 POINTS OR GREATER AND THIS THRESHOLD WAS NOT MET. BASED ON INFORMATION FROM SIX TRIALS, THERE WAS MODERATE-CERTAINTY EVIDENCE THAT THE RISK OF ADVERSE EVENTS, PRIMARILY INCREASED BACK PAIN, WAS HIGHER IN YOGA THAN IN NON-EXERCISE CONTROLS (RISK DIFFERENCE (RD) 5%, 95% CI 2% TO 8%).FOR YOGA COMPARED TO NON-YOGA EXERCISE CONTROLS (4 TRIALS; 394 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE IN BACK-RELATED FUNCTION AT THREE MONTHS (SMD -0.22, 95% CI -0.65 TO 0.20; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -0.99, 95% -2.87 TO 0.90) AND SIX MONTHS (SMD -0.20, 95% CI -0.59 TO 0.19; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -0.90, 95% -2.61 TO 0.81), AND NO INFORMATION ON BACK-RELATED FUNCTION AFTER SIX MONTHS. THERE WAS VERY LOW-CERTAINTY EVIDENCE FOR LOWER PAIN ON A 0-100 SCALE AT SEVEN MONTHS (MD -20.40, 95% CI -25.48 TO -15.32), AND NO INFORMATION ON PAIN AT THREE MONTHS OR AFTER SEVEN MONTHS. BASED ON INFORMATION FROM THREE TRIALS, THERE WAS LOW-CERTAINTY EVIDENCE FOR NO DIFFERENCE IN THE RISK OF ADVERSE EVENTS BETWEEN YOGA AND NON-YOGA EXERCISE CONTROLS (RD 1%, 95% CI -4% TO 6%).FOR YOGA ADDED TO EXERCISE COMPARED TO EXERCISE ALONE (1 TRIAL; 24 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE AT 10 WEEKS IN BACK-RELATED FUNCTION (SMD -0.60, 95% CI -1.42 TO 0.22; CORRESPONDING TO A CHANGE IN THE OSWESTRY DISABILITY INDEX OF MD -17.05, 95% -22.96 TO 11.14) OR PAIN ON A 0-100 SCALE (MD -3.20, 95% CI -13.76 TO 7.36). THERE WAS NO INFORMATION ON OUTCOMES AT OTHER TIME POINTS. THERE WAS NO INFORMATION ON ADVERSE EVENTS.STUDIES PROVIDED LIMITED EVIDENCE ON RISK OF CLINICAL IMPROVEMENT, MEASURES OF QUALITY OF LIFE, AND DEPRESSION. THERE WAS NO EVIDENCE ON WORK-RELATED DISABILITY. AUTHORS' CONCLUSIONS: THERE IS LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA COMPARED TO NON-EXERCISE CONTROLS RESULTS IN SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE AND SIX MONTHS. YOGA MAY ALSO BE SLIGHTLY MORE EFFECTIVE FOR PAIN AT THREE AND SIX MONTHS, HOWEVER THE EFFECT SIZE DID NOT MEET PREDEFINED LEVELS OF MINIMUM CLINICAL IMPORTANCE. IT IS UNCERTAIN WHETHER THERE IS ANY DIFFERENCE BETWEEN YOGA AND OTHER EXERCISE FOR BACK-RELATED FUNCTION OR PAIN, OR WHETHER YOGA ADDED TO EXERCISE IS MORE EFFECTIVE THAN EXERCISE ALONE. YOGA IS ASSOCIATED WITH MORE ADVERSE EVENTS THAN NON-EXERCISE CONTROLS, BUT MAY HAVE THE SAME RISK OF ADVERSE EVENTS AS OTHER BACK-FOCUSED EXERCISE. YOGA IS NOT ASSOCIATED WITH SERIOUS ADVERSE EVENTS. THERE IS A NEED FOR ADDITIONAL HIGH-QUALITY RESEARCH TO IMPROVE CONFIDENCE IN ESTIMATES OF EFFECT, TO EVALUATE LONG-TERM OUTCOMES, AND TO PROVIDE ADDITIONAL INFORMATION ON COMPARISONS BETWEEN YOGA AND OTHER EXERCISE FOR CHRONIC NON-SPECIFIC LOW BACK PAIN. 2017 11 1866 41 RANDOMIZED TRIAL OF TIBETAN YOGA IN PATIENTS WITH BREAST CANCER UNDERGOING CHEMOTHERAPY. BACKGROUND: THE CURRENT RANDOMIZED TRIAL EXAMINED THE EFFECTS OF A TIBETAN YOGA PROGRAM (TYP) VERSUS A STRETCHING PROGRAM (STP) AND USUAL CARE (UC) ON SLEEP AND FATIGUE IN WOMEN WITH BREAST CANCER WHO WERE UNDERGOING CHEMOTHERAPY. METHODS: WOMEN WITH STAGE (AMERICAN JOINT COMMITTEE ON CANCER (AJCC) TNM) I TO III BREAST CANCER WHO WERE UNDERGOING CHEMOTHERAPY WERE RANDOMIZED TO TYP (74 WOMEN), STP (68 WOMEN), OR UC (85 WOMEN). PARTICIPANTS IN THE TYP AND STP GROUPS PARTICIPATED IN 4 SESSIONS DURING CHEMOTHERAPY, FOLLOWED BY 3 BOOSTER SESSIONS OVER THE SUBSEQUENT 6 MONTHS, AND WERE ENCOURAGED TO PRACTICE AT HOME. SELF-REPORT MEASURES OF SLEEP DISTURBANCES (PITTSBURGH SLEEP QUALITY INDEX), FATIGUE (BRIEF FATIGUE INVENTORY), AND ACTIGRAPHY WERE COLLECTED AT BASELINE; 1 WEEK AFTER TREATMENT; AND AT 3, 6, AND 12 MONTHS. RESULTS: THERE WERE NO GROUP DIFFERENCES NOTED IN TOTAL SLEEP DISTURBANCES OR FATIGUE LEVELS OVER TIME. HOWEVER, PATIENTS IN THE TYP GROUP REPORTED FEWER DAILY DISTURBANCES 1 WEEK AFTER TREATMENT COMPARED WITH THOSE IN THE STP (DIFFERENCE, -0.43; 95% CONFIDENCE INTERVAL [95% CI], -0.82 TO -0.04 [P = .03]) AND UC (DIFFERENCE, -0.41; 95% CI, -0.77 TO -0.05 [P = .02]) GROUPS. GROUP DIFFERENCES AT THE OTHER TIME POINTS WERE MAINTAINED FOR TYP VERSUS STP. ACTIGRAPHY DATA REVEALED GREATER MINUTES AWAKE AFTER SLEEP ONSET FOR PATIENTS IN THE STP GROUP 1 WEEK AFTER TREATMENT VERSUS THOSE IN THE TYP (DIFFERENCE, 15.36; 95% CI, 7.25-23.48 [P = .0003]) AND UC (DIFFERENCE, 14.48; 95% CI, 7.09-21.87 [P = .0002]) GROUPS. PATIENTS IN THE TYP GROUP WHO PRACTICED AT LEAST 2 TIMES A WEEK DURING FOLLOW-UP REPORTED BETTER PITTSBURGH SLEEP QUALITY INDEX AND ACTIGRAPHY OUTCOMES AT 3 MONTHS AND 6 MONTHS AFTER TREATMENT COMPARED WITH THOSE WHO DID NOT AND BETTER OUTCOMES COMPARED WITH THOSE IN THE UC GROUP. CONCLUSIONS: PARTICIPATING IN TYP DURING CHEMOTHERAPY RESULTED IN MODEST SHORT-TERM BENEFITS IN SLEEP QUALITY, WITH LONG-TERM BENEFITS EMERGING OVER TIME FOR THOSE WHO PRACTICED TYP AT LEAST 2 TIMES A WEEK. CANCER 2018;124:36-45. (C) 2017 AMERICAN CANCER SOCIETY. 2018 12 1133 45 EFFICACY OF YOGA FOR VASOMOTOR SYMPTOMS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THIS STUDY AIMS TO DETERMINE THE EFFICACY OF YOGA IN ALLEVIATING VASOMOTOR SYMPTOMS (VMS) FREQUENCY AND BOTHER. METHODS: THIS STUDY WAS A THREE-BY-TWO FACTORIAL, RANDOMIZED CONTROLLED TRIAL. ELIGIBLE WOMEN WERE RANDOMIZED TO YOGA (N = 107), EXERCISE (N = 106), OR USUAL ACTIVITY (N = 142), AND WERE SIMULTANEOUSLY RANDOMIZED TO A DOUBLE-BLIND COMPARISON OF OMEGA-3 FATTY ACID (N = 177) OR PLACEBO (N = 178) CAPSULES. YOGA INTERVENTION CONSISTED OF 12 WEEKLY 90-MINUTE YOGA CLASSES WITH DAILY HOME PRACTICE. PRIMARY OUTCOMES WERE VMS FREQUENCY AND BOTHER ASSESSED BY DAILY DIARIES AT BASELINE, 6 WEEKS, AND 12 WEEKS. SECONDARY OUTCOMES INCLUDED INSOMNIA SYMPTOMS (INSOMNIA SEVERITY INDEX) AT BASELINE AND 12 WEEKS. RESULTS: AMONG 249 RANDOMIZED WOMEN, 237 (95%) COMPLETED 12-WEEK ASSESSMENTS. THE MEAN BASELINE VMS FREQUENCY WAS 7.4 PER DAY (95% CI, 6.6 TO 8.1) IN THE YOGA GROUP AND 8.0 PER DAY (95% CI, 7.3 TO 8.7) IN THE USUAL ACTIVITY GROUP. INTENT-TO-TREAT ANALYSES INCLUDED ALL PARTICIPANTS WITH RESPONSE DATA (N = 237). THERE WAS NO DIFFERENCE BETWEEN INTERVENTION GROUPS IN THE CHANGE IN VMS FREQUENCY FROM BASELINE TO 6 AND 12 WEEKS (MEAN DIFFERENCE [YOGA--USUAL ACTIVITY] FROM BASELINE AT 6 WK, -0.3 [95% CI, -1.1 TO 0.5]; MEAN DIFFERENCE [YOGA--USUAL ACTIVITY] FROM BASELINE AT 12 WK, -0.3 [95% CI, -1.2 TO 0.6]; P = 0.119 ACROSS BOTH TIME POINTS). RESULTS WERE SIMILAR FOR VMS BOTHER. AT WEEK 12, YOGA WAS ASSOCIATED WITH AN IMPROVEMENT IN INSOMNIA SYMPTOMS (MEAN DIFFERENCE [YOGA - USUAL ACTIVITY] IN THE CHANGE IN INSOMNIA SEVERITY INDEX, 1.3 [95% CI, -2.5 TO -0.1]; P = 0.007). CONCLUSIONS: AMONG HEALTHY WOMEN, 12 WEEKS OF YOGA CLASS PLUS HOME PRACTICE, COMPARED WITH USUAL ACTIVITY, DO NOT IMPROVE VMS FREQUENCY OR BOTHER BUT REDUCE INSOMNIA SYMPTOMS. 2014 13 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 14 2518 47 YOGA COMPARED TO NON-EXERCISE OR PHYSICAL THERAPY EXERCISE ON PAIN, DISABILITY, AND QUALITY OF LIFE FOR PATIENTS WITH CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. BACKGROUND: CHRONIC LOW BACK PAIN (CLBP) IS A COMMON AND OFTEN DISABLING MUSCULOSKELETAL CONDITION. YOGA HAS BEEN PROVEN TO BE AN EFFECTIVE THERAPY FOR CHRONIC LOW BACK PAIN. HOWEVER, THERE ARE STILL CONTROVERSIES ABOUT THE EFFECTS OF YOGA AT DIFFERENT FOLLOW-UP PERIODS AND COMPARED WITH OTHER PHYSICAL THERAPY EXERCISES. OBJECTIVE: TO CRITICALLY COMPARE THE EFFECTS OF YOGA FOR PATIENTS WITH CHRONIC LOW BACK PAIN ON PAIN, DISABILITY, QUALITY OF LIFE WITH NON-EXERCISE (E.G. USUAL CARE, EDUCATION), PHYSICAL THERAPY EXERCISE. METHODS: THIS STUDY WAS REGISTERED IN PROSPERO, AND THE REGISTRATION NUMBER WAS CRD42020159865. RANDOMIZED CONTROLLED TRIALS (RCTS) OF ONLINE DATABASES INCLUDED PUBMED, WEB OF SCIENCE, COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, EMBASE WHICH EVALUATED EFFECTS OF YOGA FOR PATIENTS WITH CHRONIC LOW BACK PAIN ON PAIN, DISABILITY, AND QUALITY OF LIFE WERE SEARCHED FROM INCEPTION TIME TO NOVEMBER 1, 2019. STUDIES WERE ELIGIBLE IF THEY ASSESSED AT LEAST ONE IMPORTANT OUTCOME, NAMELY PAIN, BACK-SPECIFIC DISABILITY, QUALITY OF LIFE. THE COCHRANE RISK OF BIAS TOOL WAS USED TO ASSESS THE METHODOLOGICAL QUALITY OF INCLUDED RANDOMIZED CONTROLLED TRIALS. THE CONTINUOUS OUTCOMES WERE ANALYZED BY CALCULATING THE MEAN DIFFERENCE (MD) OR STANDARDIZED MEAN DIFFERENCE (SMD) WITH 95% CONFIDENCE INTERVALS (CI) ACCORDING TO WHETHER COMBINING OUTCOMES MEASURED ON DIFFERENT SCALES OR NOT. RESULTS: A TOTAL OF 18 RANDOMIZED CONTROLLED TRIALS WERE INCLUDED IN THIS META-ANALYSIS. YOGA COULD SIGNIFICANTLY REDUCE PAIN AT 4 TO 8 WEEKS (MD = -0.83, 95% CI = -1.19 TO -0.48, P<0.00001, I2 = 0%), 3 MONTHS (MD = -0.43, 95% CI = -0.64 TO -0.23, P<0.0001, I2 = 0%), 6 TO 7 MONTHS (MD = -0.56, 95% CI = -1.02 TO -0.11, P = 0.02, I2 = 50%), AND WAS NOT SIGNIFICANT IN 12 MONTHS (MD = -0.52, 95% CI = -1.64 TO 0.59, P = 0.36, I2 = 87%) COMPARED WITH NON-EXERCISE. YOGA WAS BETTER THAN NON-EXERCISE ON DISABILITY AT 4 TO 8 WEEKS (SMD = -0.30, 95% CI = -0.51 TO -0.10, P = 0.003, I2 = 0%), 3 MONTHS (SMD = -0.31, 95% CI = -0.45 TO -0.18, P<0.00001, I2 = 30%), 6 MONTHS (SMD = -0.38, 95% CI = -0.53 TO -0.23, P<0.00001, I2 = 0%), 12 MONTHS (SMD = -0.33, 95% CI = -0.54 TO -0.12, P = 0.002, I2 = 9%). THERE WAS NO SIGNIFICANT DIFFERENCE ON PAIN, DISABILITY COMPARED WITH PHYSICAL THERAPY EXERCISE GROUP. FURTHERMORE, IT SUGGESTED THAT THERE WAS A NON-SIGNIFICANT DIFFERENCE ON PHYSICAL AND MENTAL QUALITY OF LIFE BETWEEN YOGA AND ANY OTHER INTERVENTIONS. CONCLUSION: THIS META-ANALYSIS PROVIDED EVIDENCE FROM VERY LOW TO MODERATE INVESTIGATING THE EFFECTIVENESS OF YOGA FOR CHRONIC LOW BACK PAIN PATIENTS AT DIFFERENT TIME POINTS. YOGA MIGHT DECREASE PAIN FROM SHORT TERM TO INTERMEDIATE TERM AND IMPROVE FUNCTIONAL DISABILITY STATUS FROM SHORT TERM TO LONG TERM COMPARED WITH NON-EXERCISE (E.G. USUAL CARE, EDUCATION). YOGA HAD THE SAME EFFECT ON PAIN AND DISABILITY AS ANY OTHER EXERCISE OR PHYSICAL THERAPY. YOGA MIGHT NOT IMPROVE THE PHYSICAL AND MENTAL QUALITY OF LIFE BASED ON THE RESULT OF A MERGING. 2020 15 2836 57 YOGA'S IMPACT ON INFLAMMATION, MOOD, AND FATIGUE IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. PURPOSE: TO EVALUATE YOGA'S IMPACT ON INFLAMMATION, MOOD, AND FATIGUE. PATIENTS AND METHODS: A RANDOMIZED CONTROLLED 3-MONTH TRIAL WAS CONDUCTED WITH TWO POST-TREATMENT ASSESSMENTS OF 200 BREAST CANCER SURVIVORS ASSIGNED TO EITHER 12 WEEKS OF 90-MINUTE TWICE PER WEEK HATHA YOGA CLASSES OR A WAIT-LIST CONTROL. THE MAIN OUTCOME MEASURES WERE LIPOPOLYSACCHARIDE-STIMULATED PRODUCTION OF PROINFLAMMATORY CYTOKINES INTERLEUKIN-6 (IL-6), TUMOR NECROSIS FACTOR ALPHA (TNF-ALPHA), AND INTERLEUKIN-1BETA (IL-1BETA), AND SCORES ON THE MULTIDIMENSIONAL FATIGUE SYMPTOM INVENTORY-SHORT FORM (MFSI-SF), THE VITALITY SCALE FROM THE MEDICAL OUTCOMES STUDY 36-ITEM SHORT FORM (SF-36), AND THE CENTER FOR EPIDEMIOLOGICAL STUDIES-DEPRESSION (CES-D) SCALE. RESULTS: IMMEDIATELY POST-TREATMENT, FATIGUE WAS NOT LOWER (P > .05) BUT VITALITY WAS HIGHER (P = .01) IN THE YOGA GROUP COMPARED WITH THE CONTROL GROUP. AT 3 MONTHS POST-TREATMENT, FATIGUE WAS LOWER IN THE YOGA GROUP (P = .002), VITALITY WAS HIGHER (P = .01), AND IL-6 (P = .027), TNF-ALPHA (P = .027), AND IL-1BETA (P = .037) WERE LOWER FOR YOGA PARTICIPANTS COMPARED WITH THE CONTROL GROUP. GROUPS DID NOT DIFFER ON DEPRESSION AT EITHER TIME (P > .2). PLANNED SECONDARY ANALYSES SHOWED THAT THE FREQUENCY OF YOGA PRACTICE HAD STRONGER ASSOCIATIONS WITH FATIGUE AT BOTH POST-TREATMENT VISITS (P = .019; P < .001), AS WELL AS VITALITY (P = .016; P = .0045), BUT NOT DEPRESSION (P > .05) THAN SIMPLE GROUP ASSIGNMENT; MORE FREQUENT PRACTICE PRODUCED LARGER CHANGES. AT 3 MONTHS POST-TREATMENT, INCREASING YOGA PRACTICE ALSO LED TO A DECREASE IN IL-6 (P = .01) AND IL-1BETA (P = .03) PRODUCTION BUT NOT IN TNF-ALPHA PRODUCTION (P > .05). CONCLUSION: CHRONIC INFLAMMATION MAY FUEL DECLINES IN PHYSICAL FUNCTION LEADING TO FRAILTY AND DISABILITY. IF YOGA DAMPENS OR LIMITS BOTH FATIGUE AND INFLAMMATION, THEN REGULAR PRACTICE COULD HAVE SUBSTANTIAL HEALTH BENEFITS. 2014 16 2614 37 YOGA FOR SCHIZOPHRENIA: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY REVIEW AND META-ANALYZE THE EFFECTS OF YOGA ON SYMPTOMS OF SCHIZOPHRENIA, QUALITY OF LIFE, FUNCTION, AND HOSPITALIZATION IN PATIENTS WITH SCHIZOPHRENIA. METHODS: MEDLINE/PUBMED, SCOPUS, THE COCHRANE LIBRARY, PSYCINFO, AND INDMED WERE SCREENED THROUGH AUGUST 2012. RANDOMIZED CONTROLLED TRIALS (RCTS) COMPARING YOGA TO USUAL CARE OR NON-PHARMACOLOGICAL INTERVENTIONS WERE ANALYZED WHEN THEY ASSESSED SYMPTOMS OR QUALITY OF LIFE IN PATIENTS WITH SCHIZOPHRENIA. COGNITIVE FUNCTION, SOCIAL FUNCTION, HOSPITALIZATION, AND SAFETY WERE DEFINED AS SECONDARY OUTCOMES. RISK OF BIAS WAS ASSESSED USING THE RISK OF BIAS TOOL RECOMMENDED BY THE COCHRANE BACK REVIEW GROUP. STANDARDIZED MEAN DIFFERENCES (SMD) AND 95% CONFIDENCE INTERVALS (CI) WERE CALCULATED. RESULTS: FIVE RCTS WITH A TOTAL OF 337 PATIENTS WERE INCLUDED; 2 RCTS HAD LOW RISK OF BIAS. TWO RCTS COMPARED YOGA TO USUAL CARE; 1 RCT COMPARED YOGA TO EXERCISE; AND 2 3-ARM RCTS COMPARED YOGA TO USUAL CARE AND EXERCISE. NO EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS OF YOGA COMPARED TO USUAL CARE ON POSITIVE SYMPTOMS (SMD = -0.58; 95% CI -1.52 TO 0.37; P = 0.23), OR NEGATIVE SYMPTOMS (SMD = -0.59; 95% CI -1.87 TO 0.69; P = 0.36). MODERATE EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS ON QUALITY OF LIFE COMPARED TO USUAL CARE (SMD = 2.28; 95% CI 0.42 TO 4.14; P = 0.02). THESE EFFECTS WERE ONLY PRESENT IN STUDIES WITH HIGH RISK OF BIAS. NO EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS ON SOCIAL FUNCTION (SMD = 1.20; 95% CI -0.78 TO 3.18; P = 0.23). COMPARING YOGA TO EXERCISE, NO EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS ON POSITIVE SYMPTOMS (SMD = -0.35; 95% CI -0.75 TO 0.05; P = 0.09), NEGATIVE SYMPTOMS (SMD = -0.28; 95% CI -1.42 TO 0.86; P = 0.63), QUALITY OF LIFE (SMD = 0.17; 95% CI -0.27 TO 0.61; P = 0.45), OR SOCIAL FUNCTION (SMD = 0.20; 95% CI -0.27 TO 0.67; P = 0.41). ONLY 1 RCT REPORTED ADVERSE EVENTS. CONCLUSIONS: THIS SYSTEMATIC REVIEW FOUND ONLY MODERATE EVIDENCE FOR SHORT-TERM EFFECTS OF YOGA ON QUALITY OF LIFE. AS THESE EFFECTS WERE NOT CLEARLY DISTINGUISHABLE FROM BIAS AND SAFETY OF THE INTERVENTION WAS UNCLEAR, NO RECOMMENDATION CAN BE MADE REGARDING YOGA AS A ROUTINE INTERVENTION FOR SCHIZOPHRENIA PATIENTS. 2013 17 2591 26 YOGA FOR MENOPAUSAL SYMPTOMS-A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVES: TO SYSTEMATICALLY REVIEW AND META-ANALYZE THE EFFECTIVENESS OF YOGA FOR MENOPAUSAL SYMPTOMS. METHODS: MEDLINE (VIA PUBMED), THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, AND SCOPUS WERE SCREENED THROUGH TO FEBRUARY 21, 2017 FOR RANDOMIZED CONTROLLED TRIALS (RCTS) COMPARING THE EFFECTS OF YOGA ON MENOPAUSAL SYMPTOMS TO THOSE OF NO TREATMENT OR ACTIVE COMPARATORS. STANDARDIZED MEAN DIFFERENCES (SMD) AND 95% CONFIDENCE INTERVALS (CI) WERE CALCULATED. TWO AUTHORS INDEPENDENTLY ASSESSED RISK OF BIAS USING THE COCHRANE RISK OF BIAS TOOL. RESULTS: THIRTEEN RCTS WITH 1306 PARTICIPANTS WERE INCLUDED. COMPARED WITH NO TREATMENT, YOGA REDUCED TOTAL MENOPAUSAL SYMPTOMS (SMD=-1.05; 95% CI -1.57 TO -0.53), PSYCHOLOGICAL (SMD=-0.75; 95% CI -1.17 TO -0.34), SOMATIC (SMD=-0.65; 95% CI -1.05 TO -0.25), VASOMOTOR (SMD=-0.76; 95% CI -1.27 TO -0.25), AND UROGENITAL SYMPTOMS (SMD=-0.53; 95% CI -0.81 TO -0.25). COMPARED WITH EXERCISE CONTROLS, ONLY AN EFFECT ON VASOMOTOR SYMPTOMS WAS FOUND (SMD=-0.45; 95% CI -0.87 TO -0.04). EFFECTS WERE ROBUST AGAINST SELECTION BIAS, BUT NOT AGAINST DETECTION AND ATTRITION BIAS. NO SERIOUS ADVERSE EVENTS WERE REPORTED. CONCLUSION: YOGA SEEMS TO BE EFFECTIVE AND SAFE FOR REDUCING MENOPAUSAL SYMPTOMS. EFFECTS ARE COMPARABLE TO THOSE OF OTHER EXERCISE INTERVENTIONS. 2018 18 2546 47 YOGA FOR BREAST CANCER PATIENTS AND SURVIVORS: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: MANY BREAST CANCER PATIENTS AND SURVIVORS USE YOGA TO COPE WITH THEIR DISEASE. THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY ASSESS AND META-ANALYZE THE EVIDENCE FOR EFFECTS OF YOGA ON HEALTH-RELATED QUALITY OF LIFE AND PSYCHOLOGICAL HEALTH IN BREAST CANCER PATIENTS AND SURVIVORS. METHODS: MEDLINE, PSYCINFO, EMBASE, CAMBASE, AND THE COCHRANE LIBRARY WERE SCREENED THROUGH FEBRUARY 2012. RANDOMIZED CONTROLLED TRIALS (RCTS) COMPARING YOGA TO CONTROLS WERE ANALYZED WHEN THEY ASSESSED HEALTH-RELATED QUALITY OF LIFE OR PSYCHOLOGICAL HEALTH IN BREAST CANCER PATIENTS OR SURVIVORS. RISK OF BIAS WAS ASSESSED USING THE COCHRANE RISK OF BIAS TOOL. STANDARDIZED MEAN DIFFERENCES (SMD) AND 95% CONFIDENCE INTERVALS (CI) WERE CALCULATED. RESULTS: TWELVE RCTS WITH A TOTAL OF 742 PARTICIPANTS WERE INCLUDED. SEVEN RCTS COMPARED YOGA TO NO TREATMENT; 3 RCTS COMPARED YOGA TO SUPPORTIVE THERAPY; 1 RCT COMPARED YOGA TO HEALTH EDUCATION; AND 1 RCT COMPARED A COMBINATION OF PHYSIOTHERAPY AND YOGA TO PHYSIOTHERAPY ALONE. EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS ON GLOBAL HEALTH-RELATED QUALITY OF LIFE (SMD = 0.62 [95% CI: 0.04 TO 1.21]; P = 0.04), FUNCTIONAL (SMD = 0.30 [95% CI: 0.03 TO 0.57), SOCIAL (SMD = 0.29 [95% CI: 0.08 TO 0.50]; P < 0.01), AND SPIRITUAL WELL-BEING (SMD = 0.41 [95% CI: 0.08; 0.74]; P = 0.01). THESE EFFECTS WERE, HOWEVER, ONLY PRESENT IN STUDIES WITH UNCLEAR OR HIGH RISK OF SELECTION BIAS. SHORT-TERM EFFECTS ON PSYCHOLOGICAL HEALTH ALSO WERE FOUND: ANXIETY (SMD = -1.51 [95% CI: -2.47; -0.55]; P < 0.01), DEPRESSION (SMD = -1.59 [95% CI: -2.68 TO -0.51]; P < 0.01), PERCEIVED STRESS (SMD = -1.14 [95% CI:-2.16; -0.12]; P = 0.03), AND PSYCHOLOGICAL DISTRESS (SMD = -0.86 [95% CI:-1.50; -0.22]; P < 0.01). SUBGROUP ANALYSES REVEALED EVIDENCE OF EFFICACY ONLY FOR YOGA DURING ACTIVE CANCER TREATMENT BUT NOT AFTER COMPLETION OF ACTIVE TREATMENT. CONCLUSIONS: THIS SYSTEMATIC REVIEW FOUND EVIDENCE FOR SHORT-TERM EFFECTS OF YOGA IN IMPROVING PSYCHOLOGICAL HEALTH IN BREAST CANCER PATIENTS. THE SHORT-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE COULD NOT BE CLEARLY DISTINGUISHED FROM BIAS. YOGA CAN BE RECOMMENDED AS AN INTERVENTION TO IMPROVE PSYCHOLOGICAL HEALTH DURING BREAST CANCER TREATMENT. 2012 19 1980 43 SLEEP MODERATES THE EFFECTS OF TIBETAN YOGA FOR WOMEN WITH BREAST CANCER UNDERGOING CHEMOTHERAPY. THIS STUDY EXAMINED SELF-REPORTED AND ACTIGRAPHY-ASSESSED SLEEP AND DEPRESSION AS MODERATORS OF THE EFFECT OF A TIBETAN YOGA INTERVENTION ON SLEEP AND DEPRESSION AMONG WOMEN UNDERGOING CHEMOTHERAPY FOR BREAST CANCER. THIS IS A SECONDARY ANALYSIS OF AN RCT EXAMINING A 4-SESSION TIBETAN YOGA PROGRAM (TYP; N = 74) VERSUS STRETCHING PROGRAM (STP; N = 68) OR USUAL CARE (UC; N = 85) ON SELF-REPORTED SLEEP (PITTSBURGH SLEEP QUALITY INDEX (PSQI), ACTIGRAPHY-ASSESSED SLEEP EFFICIENCY (SE)) AND DEPRESSION (CENTERS FOR EPIDEMIOLOGICAL STUDIES DEPRESSION SCALE; CES-D) FOR WOMEN UNDERGOING CHEMOTHERAPY FOR BREAST CANCER. DATA WERE COLLECTED AT BASELINE AND 1-WEEK AND 3-MONTH POST-INTERVENTION. BASELINE PSQI, ACTIGRAPHY-SE, AND CES-D WERE EXAMINED AS MODERATORS OF THE EFFECT OF GROUP ON PSQI, ACTIGRAPHY-SE, AND CES-D 1 WEEK AND 3 MONTHS AFTER TREATMENT. THERE WAS A SIGNIFICANT BASELINE ACTIGRAPHY-SE X GROUP EFFECT ON PSQI AT 1 WEEK (P < .001) AND 3 MONTHS (P = .002) AND ON CES-D AT 3 MONTHS (P = .049). SPECIFICALLY, THE NEGATIVE ASSOCIATION OF BASELINE ACTIGRAPHY-SE WITH SUBSEQUENT PSQI AND CES-D WAS BUFFERED FOR WOMEN IN THE TYP AND, TO A LESSER EXTENT IN STP, COMPARED TO THOSE IN THE UC. BASELINE PSQI AND CES-D WERE NOT SIGNIFICANT MODERATORS OF THE EFFECT OF GROUP ON ANY OUTCOME. BEHAVIORALLY ASSESSED SLEEP MAY BE A MORE ROBUST INDICATOR OF WHICH PATIENTS ARE MOST APPROPRIATE FOR A YOGA INTERVENTION THAN SELF-REPORTED SLEEP QUALITY. WOMEN WITH POOR SLEEP EFFICIENCY MAY DERIVE THE GREATEST BENEFIT IN TERMS OF SLEEP QUALITY AND MOOD FROM A YOGA INTERVENTION. 2022 20 2549 47 YOGA FOR CANCER SURVIVORS WITH CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY: HEALTH-RELATED QUALITY OF LIFE OUTCOMES. BACKGROUND: YOGA IS A MEDITATIVE MOVEMENT THERAPY FOCUSED ON MIND-BODY AWARENESS. THE IMPACT OF YOGA ON HEALTH-RELATED QUALITY OF LIFE (HRQOL) OUTCOMES IN PATIENTS WITH CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY (CIPN) IS UNCLEAR. METHODS: WE CONDUCTED A PILOT RANDOMIZED WAIT-LIST CONTROLLED TRIAL OF 8 WEEKS OF YOGA (N = 21) VERSUS WAIT-LIST CONTROL (N = 20) FOR CIPN IN 41 BREAST AND GYNECOLOGICAL CANCER SURVIVORS WITH PERSISTENT MODERATE TO SEVERE CIPN. HRQOL ENDPOINTS WERE HOSPITAL ANXIETY AND DEPRESSION SCALE (HADS), BRIEF FATIGUE INVENTORY (BFI), AND INSOMNIA SEVERITY INDEX (ISI). THE TREATMENT EXPECTANCY SCALE (TES) WAS ADMINISTERED AT BASELINE. WE ESTIMATED MEAN CHANGES AND 95% CONFIDENCE INTERVALS (CIS) FROM BASELINE TO WEEKS 8 AND 12 AND COMPARED ARMS USING CONSTRAINED LINEAR MIXED MODELS. RESULTS: AT WEEK 8, HADS ANXIETY SCORES DECREASED -1.61 (-2.75, -0.46) IN THE YOGA ARM AND -0.32 (-1.38, 0.75) POINTS IN THE WAIT-LIST CONTROL ARM (P = 0.099). AT WEEK 12, HADS ANXIETY SCORES DECREASED -1.42 (-2.57, -0.28) IN YOGA COMPARED TO AN INCREASE OF 0.46 (-0.60, 1.53) IN WAIT-LIST CONTROL (P = 0.017). THERE WERE NO SIGNIFICANT DIFFERENCES IN HADS DEPRESSION, BFI, OR ISI SCORES BETWEEN YOGA AND WAIT-LIST CONTROL. BASELINE TES WAS SIGNIFICANTLY HIGHER IN YOGA THAN IN WAIT-LIST CONTROL (14.9 VS. 12.7, P = 0.019). TES WAS NOT ASSOCIATED WITH HADS ANXIETY REDUCTION AND HADS ANXIETY REDUCTION WAS NOT ASSOCIATED WITH CIPN PAIN REDUCTION. CONCLUSIONS: YOGA MAY REDUCE ANXIETY IN PATIENTS WITH CIPN. FUTURE STUDIES ARE NEEDED TO CONFIRM THESE FINDINGS. CLINICAL TRIAL REGISTRATION NUMBER: CLINICALTRIALS.GOV IDENTIFIER: NCT03292328. 2021