1 805 96 EFFECT OF YOGA ON ANTIRETROVIRAL ADHERENCE POSTINCARCERATION IN HIV+ INDIVIDUALS. THE NEGATIVE IMPACTS OF STRESS ON ANTIRETROVIRAL THERAPY (ART) ADHERENCE AND THE MANY STRESSORS FACED BY PEOPLE RETURNING FROM INCARCERATION SUPPORT THE NEED FOR STRESS REDUCTION INTERVENTIONS FOR THIS POPULATION. WE HYPOTHESIZED THAT 37 RETURNING CITIZENS LIVING WITH HIV AND SUBSTANCE USE PROBLEMS RANDOMIZED TO A 12-SESSION WEEKLY YOGA INTERVENTION WOULD EXPERIENCE IMPROVED ART ADHERENCE, LOWER VIRAL LOADS, AND LOWER HEART RATE AND BLOOD PRESSURE AS COMPARED TO 36 PEOPLE RANDOMIZED TO TREATMENT AS USUAL (TAU). WE FOUND THAT ART ADHERENCE INCREASED FOR YOGA PARTICIPANTS AND DECREASED FOR TAU PARTICIPANTS. THERE WERE NO SIGNIFICANT CHANGES FOR VIRAL LOAD, HEART RATE, OR BLOOD PRESSURE. THE LACK OF STATISTICALLY SIGNIFICANT EFFECTS MAY BE DUE TO A SMALL SAMPLE SIZE AND ENROLLMENT OF PEOPLE LARGELY IN HIV TREATMENT. STUDIES WITH LARGER SAMPLE SIZES AND PARTICIPANTS EXHIBITING LOW ART ADHERENCE ARE WARRANTED TO BETTER UNDERSTAND YOGA'S IMPACT. 2020
2 1011 43 EFFECTS OF NATUROPATHY AND YOGA INTERVENTION ON CD4 COUNT OF THE INDIVIDUALS RECEIVING ANTIRETROVIRAL THERAPY-REPORT FROM A HUMAN IMMUNODEFICIENCY VIRUS SANATORIUM, PUNE. BACKGROUND: HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION IS ONE OF THE MOST DEBILITATING CONDITIONS WHICH HAVE AFFECTED NEARLY 32 MILLION PEOPLE ACROSS THE GLOBE. ANTIRETROVIRAL THERAPY (ART) IS THE STANDARD CARE GIVEN TO THE HIV POSITIVE INDIVIDUALS. BUT THE PATIENT ADHERENCE TO ART IS FOUND TO BE VERY LESS AS PER PREVIOUS STUDIES. COMPLEMENTARY AND ALTERNATIVE MEDICINE IS BECOMING A PILLAR IN THE REHABILITATIVE EFFORTS FOR MANY LIVING WITH HIV/AIDS. AIM: TO EVALUATE THE EFFECT OF NATUROPATHY AND YOGA INTERVENTION ON CD4 COUNTS OF HIV PATIENTS. METHODS: NINETY-SIX PATIENTS PREDIAGNOSED AS HIV POSITIVE WERE ENROLLED AFTER OBTAINING WRITTEN CONSENT AND TREATED WITH NATUROPATHY AND YOGA INTERVENTIONS LIKE HYDROTHERAPY, DIET THERAPY, MUD THERAPY, COUNSELING, ETC., FOR VARIOUS DURATIONS AT NATIONAL INSTITUTE OF NATUROPATHY SANATORIUM. THEY WERE GROUPED INTO FOUR GROUPS (G1: 1-7 DAYS, G2: 8-15 DAYS, G3: 16-30 DAYS, G4: >30 DAYS) BASED ON DURATION OF STAY. CD4 COUNT OF EACH INDIVIDUAL WAS RECORDED PRE- AND POST-STAY. RESULTS: ALL ANALYSES WERE CONDUCTED USING R PACKAGE VERSION 3.01. DEPENDENT SAMPLE T-TESTS WERE CONDUCTED TO EXAMINE THE SIGNIFICANCE AT 95% CONFIDENCE INTERVAL. OF THE 96 PATIENTS, MALE PATIENTS CONSTITUTE 55.2% AND FEMALE PATIENTS 44.8% WITH MEAN AGE 34.74 RECEIVED 1-180 DAYS (MEAN 28.75, STANDARD DEVIATION: 14.16) TREATMENT. SIGNIFICANT INCREASE IN THE CD4 COUNT WAS OBSERVED IN TWO OUT OF THE FOUR GROUPS (G2: P = 0.052, AND G4: P = 0.00038, RESPECTIVELY). CONCLUSION: AN INCREASING TREND IN THE CD4 COUNT WAS OBSERVED THAT WAS PROPORTIONAL TO THE LENGTH OF THE STAY OF PARTICIPANTS AT THE HIV SANATORIUM. THIS INDICATES THE POSSIBILITY OF LIFESTYLE CHANGES CAN BRING POSITIVE OUTCOMES IN PEOPLE LIVING WITH HIV/AIDS WHEN USED AS AN ADJUVANT WITH ART CARE. THE LACK OF CONTROL GROUP IS A MAJOR LIMITATION OF THIS STUDY. NO ATTEMPT WAS MADE TO STUDY THE SUBJECTIVE CHANGES IN THE QUALITY OF LIFE, VIRAL LOAD, ETC., HOWEVER, LARGER CONTROLLED STUDIES ARE WARRANTED FOR CONCLUSIVE RESULTS. 2015
3 1165 43 EVALUATING THE FEASIBILITY AND IMPACT OF A YOGA INTERVENTION ON COGNITION, PHYSICAL FUNCTION, PHYSICAL ACTIVITY, AND AFFECTIVE OUTCOMES IN PEOPLE LIVING WITH HIV: PROTOCOL FOR A RANDOMIZED PILOT TRIAL. BACKGROUND: DESPITE LOWER MORTALITY RATES DUE TO COMBINATION ANTIRETROVIRAL THERAPY, PEOPLE LIVING WITH HIV (PLWH) ARE GRAPPLING WITH INCREASINGLY COMPLEX HEALTH ISSUES, INCLUDING COGNITIVE IMPAIRMENTS IN AREAS SUCH AS MEMORY, ATTENTION, PROCESSING SPEED, AND MOTOR FUNCTION. YOGA HAS BEEN SHOWN TO BE AN EFFECTIVE FORM OF EXERCISE AND MINDFULNESS-BASED STRESS REDUCTION FOR MANY CLINICAL POPULATIONS. HOWEVER, NO RANDOMIZED TRIALS HAVE EVALUATED THE IMPACT OF YOGA ON COGNITIVE AND PHYSICAL FUNCTION AMONG PLWH. OBJECTIVE: THE AIM OF THIS PILOT RANDOMIZED TRIAL WAS TO DETERMINE THE FEASIBILITY OF A YOGA INTERVENTION TO LAY THE GROUNDWORK FOR A FULL-SCALE, MULTISITE, COMMUNITY-BASED TRIAL FOR PLWH. SPECIFIC OBJECTIVES ARE TO (1) ASSESS THE FEASIBILITY OF STUDY PROTOCOL AND PROCEDURES, (2) COMPARE COGNITION IN THE YOGA GROUP WITH THE USUAL CARE CONTROL GROUP AFTER 12 WEEKS OF THE INTERVENTION IN PLWH, AND (3) COMPARE THE EFFECTS OF THE 12-WEEK YOGA INTERVENTION VERSUS CONTROL ON BALANCE, WALKING SPEED, PHYSICAL ACTIVITY, MENTAL HEALTH, MEDICATION ADHERENCE, AND QUALITY OF LIFE AMONG PLWH. METHODS: WE PROPOSE A PILOT RANDOMIZED TRIAL WITH 2 PARALLEL GROUPS (YOGA VERSUS CONTROL). WE WILL RECRUIT 25 PLWH (>35 YEARS) FROM COMMUNITY AND HEALTH ORGANIZATIONS IN HALIFAX, CANADA. AFTER BASELINE ASSESSMENT WITH BLINDED ASSESSORS, PARTICIPANTS WILL BE RANDOMLY ASSIGNED TO THE YOGA OR CONTROL GROUP, USING A RANDOM COMPUTER GENERATOR. PARTICIPANTS IN THE YOGA GROUP WILL ENGAGE IN SUPERVISED 60-MIN GROUP-BASED YOGA SESSIONS 3 TIMES A WEEK FOR 12 WEEKS AT A YOGA STUDIO. PARTICIPANTS IN THE CONTROL GROUP WILL MAINTAIN THEIR CURRENT PHYSICAL ACTIVITY LEVELS THROUGHOUT THE STUDY. RESULTS: AS PER THE CONSOLIDATED STANDARDS OF REPORTING TRIALS EXTENSION FOR PILOT STUDIES, MEANS OF ALL OUTCOMES, MEAN CHANGE, AND 95% CIS WILL BE CALCULATED FOR EACH GROUP SEPARATELY. TWO-TAILED INDEPENDENT T TESTS AND FISHER EXACT TESTS WILL BE USED TO COMPARE GROUPS AT BASELINE. WE WILL ANALYZE QUANTITATIVE POSTINTERVENTION QUESTIONNAIRE RESPONSES USING CHI-SQUARE TESTS, AND OPEN-ENDED RESPONSES WILL BE ANALYZED THEMATICALLY. INTENTION-TO-TREAT AND PER-PROTOCOL ANALYSES WILL BE USED TO ANALYZE SECONDARY VARIABLES. CHANGES IN OUTCOME VARIABLES WILL BE EXAMINED BETWEEN GROUPS AND WITHIN GROUPS. EFFECT SIZES WILL BE REPORTED FOR EACH OUTCOME. A PRIORI ADHERENCE AND SATISFACTION CRITERIA WILL BE MET IF PARTICIPANTS ATTEND >70% OF THE YOGA SESSIONS AND IF >70% OF THE PARTICIPANTS ARE SATISFIED WITH THE INTERVENTION AS DETERMINED BY A POSTPARTICIPATION QUESTIONNAIRE. STUDY ENROLLMENT BEGAN IN JANUARY 2018, WITH RESULTS EXPECTED FOR OCTOBER 2019. CONCLUSIONS: THIS PILOT RANDOMIZED TRIAL WILL BE THE FIRST TO INVESTIGATE THE FEASIBILITY AND EFFECT OF A YOGA INTERVENTION ON COGNITIVE AND PHYSICAL OUTCOMES AMONG PLWH. THIS WORK WILL INFORM THE FEASIBILITY OF FURTHER INVESTIGATIONS IN TERMS OF CAPACITY BUILDING, PARTICIPANT RECRUITMENT AND RETENTION, AND ASSESSMENT AND INTERVENTION PROTOCOLS. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT03071562; HTTPS://CLINICALTRIALS.GOV/CT2/SHOW/NCT03071562 (ARCHIVED BY WEBCITE AT HTTP://WWW.WEBCITATION.ORG/785SFHWKW). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/13818. 2019
4 1664 22 NATUROPATHY AND YOGA AS AN ADJUVANT FOR PEOPLE LIVING WITH HIV/AIDS - A CASE SERIES REPORT. HUMAN IMMUNODEFICIENCY VIRUS (HIV) IS AN INFECTION THAT POSES A GREAT THREAT TO BOTH DEVELOPED AND DEVELOPING COUNTRIES. HEALTH FACILITIES OFFERING COMPLEMENTARY CARE, ALONG WITH STANDARD CARE, HAVE BEEN CONSIDERED AS A USEFUL STRATEGY TO OVERCOME THE BURDEN OF HIV AND PROMOTE QUALITY AND WELLBEING AMONG PEOPLE LIVING WITH HIV/AIDS (PLWHA). IN THIS REPORT, WE MAKE REFERENCE TO SEVEN PARTICIPANTS DIAGNOSED WITH HIV, WHO UNDERWENT NATUROPATHY AND YOGA BASED LIFESTYLE INTERVENTION (NYLI), FOR VARYING DURATIONS, AT A SANATORIUM FOR PLWHA. THE CASES SUGGEST THAT NYLI FUNCTIONS AS AN ADJUVANT THERAPY THAT COMPLEMENTS STANDARD CARE, IMPROVES ADHERENCE AND PROMOTES HEALTH-RELATED OUTCOMES IN HIV AFFILIATED CLINICAL MARKERS, SUCH AS HAEMOGLOBIN, WEIGHT AND CD4+ COUNTS. HOWEVER, FURTHER CONTROLLED TRIALS ARE REQUIRED TO ESTABLISH WARRANTING EVIDENCE. 2019
5 1103 27 EFFECTS OF YOGA VERSUS HYDROTHERAPY TRAINING ON HEALTH-RELATED QUALITY OF LIFE AND EXERCISE CAPACITY IN PATIENTS WITH HEART FAILURE: A RANDOMIZED CONTROLLED STUDY. AIMS: THE AIMS OF THIS STUDY WERE TO DETERMINE WHETHER YOGA AND HYDROTHERAPY TRAINING HAD AN EQUAL EFFECT ON THE HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH HEART FAILURE AND TO COMPARE THE EFFECTS ON EXERCISE CAPACITY, CLINICAL OUTCOMES, AND SYMPTOMS OF ANXIETY AND DEPRESSION BETWEEN AND WITHIN THE TWO GROUPS. METHODS: THE DESIGN WAS A RANDOMIZED CONTROLLED NON-INFERIORITY STUDY. A TOTAL OF 40 PATIENTS, 30% WOMEN (MEAN+/-SD AGE 64.9+/-8.9 YEARS) WITH HEART FAILURE WERE RANDOMIZED TO AN INTERVENTION OF 12 WEEKS, EITHER PERFORMING YOGA OR TRAINING WITH HYDROTHERAPY FOR 45-60 MINUTES TWICE A WEEK. EVALUATION AT BASELINE AND AFTER 12 WEEKS INCLUDED SELF-REPORTED HEALTH-RELATED QUALITY OF LIFE, A SIX-MINUTE WALK TEST, A SIT-TO-STAND TEST, CLINICAL VARIABLES, AND SYMPTOMS OF ANXIETY AND DEPRESSION. RESULTS: YOGA AND HYDROTHERAPY HAD AN EQUAL IMPACT ON QUALITY OF LIFE, EXERCISE CAPACITY, CLINICAL OUTCOMES, AND SYMPTOMS OF ANXIETY AND DEPRESSION. WITHIN BOTH GROUPS, EXERCISE CAPACITY SIGNIFICANTLY IMPROVED (HYDROTHERAPY P=0.02; YOGA P=0.008) AND SYMPTOMS OF ANXIETY DECREASED (HYDROTHERAPY P=0.03; YOGA P=0.01). PATIENTS IN THE YOGA GROUP SIGNIFICANTLY IMPROVED THEIR HEALTH AS RATED BY EQ-VAS ( P=0.004) AND DISEASE-SPECIFIC QUALITY OF LIFE IN THE DOMAINS SYMPTOM FREQUENCY ( P=0.03), SELF-EFFICACY ( P=0.01), CLINICAL SUMMARY AS A COMBINED MEASURE OF SYMPTOMS AND SOCIAL FACTORS ( P=0.05), AND OVERALL SUMMARY SCORE ( P=0.04). SYMPTOMS OF DEPRESSION WERE DECREASED IN THIS GROUP ( P=0.005). IN THE HYDROTHERAPY GROUP, LOWER LIMB MUSCLE STRENGTH IMPROVED SIGNIFICANTLY ( P=0.01). CONCLUSIONS: YOGA MAY BE AN ALTERNATIVE OR COMPLEMENTARY OPTION TO ESTABLISHED FORMS OF EXERCISE TRAINING SUCH AS HYDROTHERAPY FOR IMPROVEMENT IN HEALTH-RELATED QUALITY OF LIFE AND MAY DECREASE DEPRESSIVE SYMPTOMS IN PATIENTS WITH HEART FAILURE. 2017
6 1228 25 FEASIBILITY AND IMPACT OF A YOGA INTERVENTION ON COGNITION, PHYSICAL FUNCTION, PHYSICAL ACTIVITY, AND AFFECTIVE OUTCOMES AMONG PEOPLE LIVING WITH HIV: A RANDOMIZED CONTROLLED PILOT TRIAL. THE PURPOSE OF THIS PILOT RANDOMIZED CONTROLLED TRIAL IS TO ASSESS THE FEASIBILITY AND IMPACT OF A TRIWEEKLY 12-WEEK YOGA INTERVENTION AMONG PEOPLE LIVING WITH HIV (PLWH). ADDITIONAL OBJECTIVES INCLUDED EVALUATING COGNITION, PHYSICAL FUNCTION, MEDICATION ADHERENCE, HEALTH-RELATED QUALITY OF LIFE (HRQOL), AND MENTAL HEALTH AMONG YOGA PARTICIPANTS VERSUS CONTROLS USING BLINDED ASSESSORS. WE RECRUITED 22 MEDICALLY STABLE PLWH AGED >/=35 YEARS. A PRIORI FEASIBILITY CRITERIA WERE >/=70% YOGA SESSION ATTENDANCE AND >/=70% OF PARTICIPANTS SATISFIED WITH THE INTERVENTION USING A POSTPARTICIPATION QUESTIONNAIRE. TWO PARTICIPANTS WITHDREW FROM THE YOGA GROUP. MEAN YOGA CLASS ATTENDANCE WAS 82%, WITH 100% SATISFACTION. INTENTION-TO-TREAT ANALYSES (YOGA N = 11, CONTROL N = 11) SHOWED NO WITHIN- OR BETWEEN-GROUP DIFFERENCES IN COGNITIVE AND PHYSICAL FUNCTION. THE YOGA GROUP IMPROVED OVER TIME IN HRQOL COGNITION (P = .047) WITH TRENDS TOWARD IMPROVEMENTS IN HRQOL HEALTH TRANSITION (P =.063) AND DEPRESSION (P = .055). THIS PILOT STUDY PROVIDES PRELIMINARY EVIDENCE OF FEASIBILITY AND BENEFITS OF YOGA FOR PLWH. 2020
7 2011 32 SUDARSHAN KRIYA YOGA IMPROVES QUALITY OF LIFE IN HEALTHY PEOPLE LIVING WITH HIV (PLHIV): RESULTS FROM AN OPEN LABEL RANDOMIZED CLINICAL TRIAL. BACKGROUND & OBJECTIVES: IMPROVING QUALITY OF LIFE (QOL) OF HEALTHY PEOPLE LIVING WITH HIV (PLHIV) IS CRITICAL NEEDING HOME-BASED, LONG-TERM STRATEGY. SUDARSHAN KRIYA YOGA (SKY) INTERVENTION IS ACKNOWLEDGED FOR ITS POSITIVE IMPACT ON HEALTH. IT IS HYPOTHESISED THAT SKY WOULD IMPROVE PLHIV'S QOL, JUSTIFYING AN EVALUATION. METHODS: IN THIS OPEN LABEL RANDOMIZED CONTROLLED PILOT TRIAL, 61 ADULT PLHIV WITH CD4 COUNT MORE THAN 400 CELLS/MICROL AND KARNOFSKY SCALE SCORE ABOVE 70 WERE ENROLLED. THOSE WITH CARDIAC DISEASE, JAUNDICE, TUBERCULOSIS, OR ON ANTIRETROVIRAL THERAPY/YOGA INTERVENTION WERE EXCLUDED. ALL WERE GIVEN STANDARD CARE, RANDOMIZED TO SKY INTERVENTION (31: I-SKY) AND ONLY STANDARD OF CARE IN CONTROL (30: O-SOC) ARMS. THE I-SKY PARTICIPANTS WERE TRAINED FOR SIX DAYS TO PREPARE FOR DAILY PRACTICE OF SKY AT HOME FOR 30 MIN. A VALIDATED 31-ITEM WHOQOL-HIVBREF QUESTIONNAIRE WAS USED TO DOCUMENT EFFECT IN BOTH ARMS FROM BASELINE TO THREE VISITS AT 4 WK INTERVAL. RESULTS: BASELINE QOL SCORES, HYPERTENSION AND CD4 COUNT WERE SIMILAR IN BOTH ARMS. AN OVERALL 6 PER CENT IMPROVEMENT OF QOL SCORES WAS OBSERVED IN I-SKY GROUP AS COMPARED TO O-SOC GROUP, AFTER CONTROLLING FOR BASELINE VARIABLES LIKE AGE, GENDER, EDUCATION AND OCCUPATION ( P =0.016); 12 PER CENT FOR PHYSICAL ( P =0.004), 11 PER CENT PSYCHOLOGICAL (P =0.023) AND 9 PER CENT LEVEL OF INDEPENDENCE (P =0.001) DOMAINS. IMPROVEMENT IN I-SKY OBSERVED AT POST-TRAINING AND IN THE SKY ADHERENCE GROUP SHOWED INCREASE IN THESE TWO DOMAINS. CONCLUSIONS: A SIGNIFICANT IMPROVEMENT IN QOL SCORES WAS OBSERVED FOR THE THREE HEALTH RELATED QOL DOMAINS IN SKY INTERVENTION ARM. THIS LOW COST STRATEGY IMPROVED PHYSICAL AND PSYCHOLOGICAL STATE OF PLHIV CALLING FOR UPSCALING WITH EFFECTIVE MONITORING FOR SUSTAINABILITY OF QUALITY OF LIFE. 2015
8 258 27 ACCEPTABILITY AND FEASIBILITY OF A 12-WEEK YOGA VS. EDUCATIONAL FILM PROGRAM FOR THE MANAGEMENT OF RESTLESS LEGS SYNDROME (RLS): STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: RESTLESS LEGS SYNDROME (RLS) IS A COMMON AND BURDENSOME SLEEP DISORDER ASSOCIATED WITH PROFOUND IMPAIRMENT OF HEALTH, WELL-BEING, AND QUALITY OF LIFE. UNFORTUNATELY, THE MEDICATIONS USED FOR RLS MANAGEMENT CARRY RISK OF SERIOUS SIDE EFFECTS, INCLUDING AUGMENTATION OF SYMPTOMS. YOGA, AN ANCIENT MIND-BODY DISCIPLINE DESIGNED TO PROMOTE PHYSICAL, EMOTIONAL, AND MENTAL WELL-BEING, MAY OFFER A VIABLE, LOW-RISK NEW TREATMENT. THE PRIMARY OBJECTIVES OF THIS PILOT, PARALLEL-ARM, RANDOMIZED CONTROLLED TRIAL (RCT) ARE TO ASSESS THE ACCEPTABILITY AND FEASIBILITY OF A 12-WEEK YOGA VS. EDUCATIONAL FILM PROGRAM FOR THE MANAGEMENT OF RLS. METHODS: FORTY-FOUR ADULTS WITH CONFIRMED MODERATE TO SEVERE RLS WILL BE RECRUITED AND RANDOMIZED TO A 12-WEEK YOGA (N = 22) OR STANDARDIZED EDUCATIONAL FILM PROGRAM (N = 22). YOGA GROUP PARTICIPANTS WILL ATTEND TWO 75-MIN IYENGAR YOGA CLASSES PER WEEK FOR THE FIRST 4 WEEKS, THEN ONE 75-MIN CLASS PER WEEK FOR THE REMAINING 8 WEEKS, AND WILL COMPLETE A 30-MIN HOMEWORK ROUTINE ON NON-CLASS DAYS. EDUCATIONAL FILM GROUP PARTICIPANTS WILL ATTEND ONE 75-MIN CLASS PER WEEK FOR 12 WEEKS AND COMPLETE A DAILY RLS TREATMENT LOG; CLASSES WILL INCLUDE INFORMATION ON: RLS MANAGEMENT, INCLUDING SLEEP HYGIENE PRACTICES; OTHER SLEEP DISORDERS; AND COMPLEMENTARY THERAPIES LIKELY TO BE OF INTEREST TO THOSE PARTICIPATING IN A YOGA AND SLEEP EDUCATION STUDY. YOGA AND TREATMENT LOGS WILL BE COLLECTED WEEKLY. FEASIBILITY OUTCOMES WILL INCLUDE RECRUITMENT, ENROLLMENT, AND RANDOMIZATION RATES, RETENTION, ADHERENCE, AND PROGRAM SATISFACTION. PROGRAM EVALUATION AND YOGA-DOSING QUESTIONNAIRES WILL BE COLLECTED AT WEEK 12; DATA ON EXPLORATORY OUTCOMES (E.G., RLS SYMPTOM SEVERITY (IRLS), SLEEP QUALITY (PSQI), MOOD (POMS, PSS), AND HEALTH-RELATED QUALITY OF LIFE (SF-36)) WILL BE GATHERED AT BASELINE AND WEEK 12. DISCUSSION: THIS STUDY WILL LAY THE ESSENTIAL GROUNDWORK FOR A PLANNED LARGER RCT TO DETERMINE THE EFFICACY OF A YOGA PROGRAM FOR REDUCING SYMPTOMS AND ASSOCIATED BURDEN OF RLS. IF THE FINDINGS OF THE CURRENT TRIAL AND THE SUBSEQUENT LARGER RCTS ARE POSITIVE, THIS STUDY WILL ALSO HELP SUPPORT A NEW APPROACH TO CLINICAL TREATMENT OF THIS CHALLENGING DISORDER, HELP FOSTER IMPROVED UNDERSTANDING OF RLS ETIOLOGY, AND ULTIMATELY CONTRIBUTE TO REDUCING THE INDIVIDUAL, SOCIETAL, AND ECONOMIC BURDEN ASSOCIATED WITH THIS CONDITION. TRIAL REGISTRATION: CLINICALTRIALS.GOV, ID: NCT03570515 . RETROSPECTIVELY REGISTERED ON 1 FEBRUARY 2017. 2019
9 707 29 EFFECT OF INTEGRATED YOGA (IY) ON PSYCHOLOGICAL STATES AND CD4 COUNTS OF HIV-1 INFECTED PATIENTS: A RANDOMIZED CONTROLLED PILOT STUDY. BACKGROUND: HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTED INDIVIDUALS FREQUENTLY SUFFER FROM ANXIETY AND DEPRESSION. DEPRESSION HAS BEEN ASSOCIATED WITH RAPID DECLINE IN CD4 COUNTS AND WORSENED TREATMENT OUTCOMES IN HIV-INFECTED PATIENTS. YOGA HAS BEEN USED TO REDUCE PSYCHOPATHOLOGY AND IMPROVE IMMUNITY. AIM: TO STUDY THE EFFECT OF 1-MONTH INTEGRATED YOGA (IY) INTERVENTION ON ANXIETY, DEPRESSION, AND CD4 COUNTS IN PATIENTS SUFFERING FROM HIV-1 INFECTION. METHODS: FORTY FOUR HIV-1 INFECTED INDIVIDUALS FROM TWO HIV REHABILITATION CENTERS OF MANIPUR STATE OF INDIA WERE RANDOMIZED INTO TWO GROUPS: YOGA (N = 22; 12 MALES) AND CONTROL (N = 22; 14 MALES). YOGA GROUP RECEIVED IY INTERVENTION, WHICH INCLUDED PHYSICAL POSTURES (ASANAS), BREATHING PRACTICES (PRANAYAMA), RELAXATION TECHNIQUES, AND MEDITATION. IY SESSIONS WERE GIVEN 60 MIN/DAY, 6 DAYS A WEEK FOR 1 MONTH. CONTROL GROUP FOLLOWED DAILY ROUTINE DURING THIS PERIOD. ALL PATIENTS WERE ON ANTI-RETROVIRAL THERAPY (ART) AND DOSAGES WERE KEPT STABLE DURING THE STUDY. THERE WAS NO SIGNIFICANT DIFFERENCE IN AGE, GENDER, EDUCATION, CD4 COUNTS, AND ART STATUS BETWEEN THE TWO GROUPS. HOSPITAL ANXIETY AND DEPRESSION SCALE WAS USED TO ASSESS ANXIETY AND DEPRESSION, CD4 COUNTS WERE MEASURED BY FLOW CYTOMETRY BEFORE AND AFTER INTERVENTION. ANALYSIS OF VARIANCE - REPEATED MEASURES WAS APPLIED TO ANALYZE THE DATA USING SPSS VERSION 10. RESULTS: WITHIN GROUP COMPARISON SHOWED A SIGNIFICANT REDUCTION IN DEPRESSION SCORES (F [1, 21] =4.19, P < 0.05) AND NON-SIGNIFICANT REDUCTION IN ANXIETY SCORES ALONG WITH NON SIGNIFICANT INCREMENT IN CD4 COUNTS IN THE YOGA GROUP. IN THE CONTROL GROUP, THERE WAS A NON-SIGNIFICANT INCREASE IN ANXIETY AND DEPRESSION SCORES AND REDUCTION IN CD4 COUNTS. BETWEEN-GROUP COMPARISON REVEALED A SIGNIFICANT REDUCTION IN DEPRESSION SCORES (F [1, 21] =5.64, P < 0.05) AND SIGNIFICANT INCREASE IN CD4 COUNTS (F [1, 21] =5.35, P < 0.05) IN THE YOGA GROUP AS COMPARED TO THE CONTROL. CONCLUSION: ONE MONTH PRACTICE OF IY MAY REDUCE DEPRESSION AND IMPROVE IMMUNITY IN HIV-1 INFECTED ADULTS. 2016
10 2558 32 YOGA FOR CHRONIC LOW BACK PAIN IN A PREDOMINANTLY MINORITY POPULATION: A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: SEVERAL STUDIES SUGGEST YOGA MAY BE EFFECTIVE FOR CHRONIC LOW BACK PAIN; HOWEVER, TRIALS TARGETING MINORITIES HAVE NOT BEEN CONDUCTED. PRIMARY STUDY OBJECTIVES: ASSESS THE FEASIBILITY OF STUDYING YOGA IN A PREDOMINANTLY MINORITY POPULATION WITH CHRONIC LOW BACK PAIN. COLLECT PRELIMINARY DATA TO PLAN A LARGER POWERED STUDY. STUDY DESIGN: PILOT RANDOMIZED CONTROLLED TRIAL. SETTING: TWO COMMUNITY HEALTH CENTERS IN A RACIALLY DIVERSE NEIGHBORHOOD OF BOSTON, MASSACHUSETTS. PARTICIPANTS: THIRTY ENGLISH-SPEAKING ADULTS (MEAN AGE 44 YEARS, 83% FEMALE, 83% RACIAL/ETHNIC MINORITIES; 48% WITH INCOMES < OR = $30,000) WITH MODERATE-TO-SEVERE CHRONIC LOW BACK PAIN. INTERVENTIONS: STANDARDIZED SERIES OF WEEKLY HATHA YOGA CLASSES FOR 12 WEEKS COMPARED TO A WAITLIST USUAL CARE CONTROL. OUTCOME MEASURES: FEASIBILITY MEASURED BY TIME TO COMPLETE ENROLLMENT, PROPORTION OF RACIAL/ETHNIC MINORITIES ENROLLED, RETENTION RATES, AND ADVERSE EVENTS. PRIMARY EFFICACY OUTCOMES WERE CHANGES FROM BASELINE TO 12 WEEKS IN PAIN SCORE (0=NO PAIN TO 10=WORST POSSIBLE PAIN) AND BACK-RELATED FUNCTION USING THE MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE (0-23 POINT SCALE, HIGHER SCORES REFLECT POORER FUNCTION). SECONDARY EFFICACY OUTCOMES WERE ANALGESIC USE, GLOBAL IMPROVEMENT, AND QUALITY OF LIFE (SF-36). RESULTS: RECRUITMENT TOOK 2 MONTHS. RETENTION RATES WERE 97% AT 12 WEEKS AND 77% AT 26 WEEKS. MEAN PAIN SCORES FOR YOGA DECREASED FROM BASELINE TO 12 WEEKS (6.7 TO 4.4) COMPARED TO USUAL CARE, WHICH DECREASED FROM 7.5 TO 7.1 (P=.02). MEAN ROLAND SCORES FOR YOGA DECREASED FROM 14.5 TO 8.2 COMPARED TO USUAL CARE, WHICH DECREASED FROM 16.1 TO 12.5 (P=.28). AT 12 WEEKS, YOGA COMPARED TO USUAL CARE PARTICIPANTS REPORTED LESS ANALGESIC USE (13% VS 73%, P=.003), LESS OPIATE USE (0% VS 33%, P=.04), AND GREATER OVERALL IMPROVEMENT (73% VS 27%, P=.03). THERE WERE NO DIFFERENCES IN SF-36 SCORES AND NO SERIOUS ADVERSE EVENTS. CONCLUSION: A YOGA STUDY INTERVENTION IN A PREDOMINANTLY MINORITY POPULATION WITH CHRONIC LOW BACK PAIN WAS MODERATELY FEASIBLE AND MAY BE MORE EFFECTIVE THAN USUAL CARE FOR REDUCING PAIN AND PAIN MEDICATION USE. 2009
11 2821 42 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
12 1362 27 IMMUNOLOGICAL AND PSYCHOLOGICAL EFFICACY OF MEDITATION/YOGA INTERVENTION AMONG PEOPLE LIVING WITH HIV (PLWH): A SYSTEMATIC REVIEW AND META-ANALYSES OF 19 RANDOMIZED CONTROLLED TRIALS. BACKGROUND: AN EXPANDING NUMBER OF MIND-BODY THERAPIES ARE BEING USED TO REDUCE THE PSYCHOLOGICAL BURDEN OF PEOPLES LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS (HIV). HOWEVER, THE EFFECTS ON THE IMMUNE SYSTEM AND MENTAL HEALTH VARIED AMONG STUDIES. PURPOSE: THIS META-ANALYSIS WAS CONDUCTED TO SUMMARIZE THE RANDOMIZED CONTROLLED TRIALS TO DRAW COMPREHENSIVE CONCLUSIONS REGARDING THE PSYCHO-IMMUNOLOGICAL EFFICACY. METHODS: RANDOM-EFFECTS MODELS WERE USED TO ASSESS THE OUTCOME OF INTEREST. EGGER'S TESTS WERE USED TO IDENTIFY PUBLICATION BIAS. SUBGROUP AND META-REGRESSION WERE USED TO EXPLORE POTENTIAL MODERATORS. THIS REVIEW WAS REGISTERED ON THE PROSPERO DATABASE (CRD42019148118). RESULTS: NINETEEN RANDOMIZED CONTROLLED TRIALS WITH A TOTAL SAMPLE SIZE OF 1,300 WERE INCLUDED IN THIS META-ANALYSIS. REGARDING IMMUNE SYSTEM OUTCOME, MIND-BODY THERAPY SIGNIFICANTLY IMPROVED CD4 T-CELL COUNTS (COHEN'S D = 0.214, P = .027) AND MAINTAINED (0.427, P = .049). IN ADDITION, BASELINE CD4 T-CELL COUNTS AND YEARS SINCE HIV DIAGNOSIS SIGNIFICANTLY MODERATED THE EFFICACY OF MIND-BODY PRACTICES ON CD4 IMPROVEMENT (ALL PS < .001). REGARDING MENTAL HEALTH OUTCOME, MIND-BODY THERAPY SIGNIFICANTLY REDUCED STRESS, DEPRESSION, AND ANXIETY SYMPTOMS (0.422, P < .001; 0.506, P < .001, AND 0.709, P < .001, RESPECTIVELY) WHILE IMPROVING QUALITY OF LIFE (0.67, P < .001). CONCLUSIONS: MEDITATION/YOGA INTERVENTION COULD RESULT IN POTENTIAL BENEFITS WITH REGARD TO IMPROVED CD4 T-CELL COUNTS IMMEDIATELY AFTER THE INTERVENTION AND AT LONG-TERM FOLLOW-UP, WHILE ALSO IMPROVING THEIR MENTAL HEALTH. THE COST-EFFECTIVE MEDITATION/YOGA INTERVENTION SHOULD BE INTEGRATED INTO ROUTINE CARE FOR PEOPLE LIVING WITH HIV, ESPECIALLY FOR THOSE WITH LOWER CD4 BASELINE AND FEWER YEARS SINCE DIAGNOSIS. 2021
13 162 30 A RANDOMISED CONTROLLED TRIAL OF YOGA FOR THE TREATMENT OF CHRONIC LOW BACK PAIN: RESULTS OF A PILOT STUDY. OBJECTIVE: TO CONDUCT A PILOT TRIAL OF YOGA FOR THE TREATMENT OF CHRONIC LOW BACK PAIN (LBP) TO INFORM THE FEASIBILITY AND PRACTICALITY OF CONDUCTING A FULL-SCALE TRIAL IN THE UK; AND TO ASSESS THE EFFICACY OF YOGA FOR THE TREATMENT OF CHRONIC LOW BACK PAIN. DESIGN: A PRAGMATIC RANDOMISED CONTROLLED TRIAL WAS UNDERTAKEN COMPARING YOGA TO USUAL CARE. PARTICIPANTS: TWENTY PARTICIPANTS WHO HAD PRESENTED TO THEIR GP WITH CHRONIC LOW BACK PAIN IN THE PREVIOUS 18 MONTHS WERE RECRUITED VIA GP RECORDS FROM ONE PRACTICE IN YORK, UK. INTERVENTIONS: TWENTY PATIENTS WERE RANDOMISED TO EITHER 12 WEEKLY 75-MIN SESSIONS OF SPECIALISED YOGA PLUS WRITTEN ADVICE, OR USUAL CARE PLUS WRITTEN ADVICE. ALLOCATION WAS 50/50. MAIN OUTCOME MEASURES: RECRUITMENT RATE, LEVELS OF INTERVENTION ATTENDANCE, AND LOSS TO FOLLOW-UP WERE THE MAIN NON-CLINICAL OUTCOMES. CHANGE AS MEASURED BY THE ROLAND AND MORRIS DISABILITY QUESTIONNAIRE WAS THE PRIMARY CLINICAL OUTCOME. CHANGES IN THE ABERDEEN BACK PAIN SCALE, SF-12, EQ-5D, AND PAIN SELF-EFFICACY WERE SECONDARY CLINICAL OUTCOMES. DATA WERE COLLECTED VIA POSTAL QUESTIONNAIRE AT BASELINE, 4 WEEKS, AND 12 WEEKS FOLLOW-UP. RESULTS: OF THE 286 PATIENTS IDENTIFIED FROM THE GP DATABASE, 52 (18%) CONSENTED AND RETURNED THE ELIGIBILITY QUESTIONNAIRE, OUT OF THESE 20 (6.9%) WERE ELIGIBLE AND RANDOMISED. THE TOTAL PERCENTAGE OF PATIENTS RANDOMISED FROM THE GP PRACTICE POPULATION WAS 0.28%. TEN PATIENTS WERE RANDOMISED TO YOGA, RECEIVING AN AVERAGE OF 1.7 SESSIONS (RANGE 0-5), AND 10 WERE RANDOMISED TO USUAL CARE. AT 12 WEEKS FOLLOW-UP DATA WAS RECEIVED FROM 60% OF PATIENTS IN THE YOGA GROUP AND 90% OF PATIENTS IN THE USUAL CARE GROUP (75% OVERALL). NO SIGNIFICANT DIFFERENCES WERE SEEN BETWEEN GROUPS IN CLINICAL OUTCOMES APART FROM ON THE ABERDEEN BACK PAIN SCALE AT FOUR WEEKS FOLLOW-UP WHERE THE YOGA GROUP REPORTED SIGNIFICANTLY LESS PAIN. CONCLUSION: THIS PILOT STUDY PROVIDED USEFUL DATA AND INFORMATION TO INFORM THE DESIGN AND DEVELOPMENT OF A FULL-SCALE TRIAL OF YOGA FOR CLBP IN THE UK. A KEY FINDING IS THE CALCULATION OF GP PRACTICE TOTAL LIST SIZE REQUIRED FOR PATIENT RECRUITMENT IN A FULL-SCALE TRIAL, AND THE NEED TO IMPLEMENT METHODS TO INCREASE CLASS ATTENDANCE. 2010
14 2831 26 YOGA VS. PHYSICAL THERAPY VS. EDUCATION FOR CHRONIC LOW BACK PAIN IN PREDOMINANTLY MINORITY POPULATIONS: STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN CAUSES SUBSTANTIAL MORBIDITY AND COST TO SOCIETY WHILE DISPROPORTIONATELY IMPACTING LOW-INCOME AND MINORITY ADULTS. SEVERAL RANDOMIZED CONTROLLED TRIALS SHOW YOGA IS AN EFFECTIVE TREATMENT. HOWEVER, THE COMPARATIVE EFFECTIVENESS OF YOGA AND PHYSICAL THERAPY, A COMMON MAINSTREAM TREATMENT FOR CHRONIC LOW BACK PAIN, IS UNKNOWN. METHODS/DESIGN: THIS IS A RANDOMIZED CONTROLLED TRIAL FOR 320 PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH CHRONIC LOW BACK PAIN, COMPARING YOGA, PHYSICAL THERAPY, AND EDUCATION. INCLUSION CRITERIA ARE ADULTS 18-64 YEARS OLD WITH NON-SPECIFIC LOW BACK PAIN LASTING >/= 12 WEEKS AND A SELF-REPORTED AVERAGE PAIN INTENSITY OF >/= 4 ON A 0-10 SCALE. RECRUITMENT TAKES PLACE AT BOSTON MEDICAL CENTER, AN URBAN ACADEMIC SAFETY-NET HOSPITAL AND SEVEN FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS LOCATED IN DIVERSE NEIGHBORHOODS. THE 52-WEEK STUDY HAS AN INITIAL 12-WEEK TREATMENT PHASE WHERE PARTICIPANTS ARE RANDOMIZED IN A 2:2:1 RATIO INTO I) A STANDARDIZED WEEKLY HATHA YOGA CLASS SUPPLEMENTED BY HOME PRACTICE; II) A STANDARDIZED EVIDENCE-BASED EXERCISE THERAPY PROTOCOL ADAPTED FROM THE TREATMENT BASED CLASSIFICATION METHOD, INDIVIDUALLY DELIVERED BY A PHYSICAL THERAPIST AND SUPPLEMENTED BY HOME PRACTICE; AND III) EDUCATION DELIVERED THROUGH A SELF-CARE BOOK. CO-PRIMARY OUTCOME MEASURES ARE 12-WEEK PAIN INTENSITY MEASURED ON AN 11-POINT NUMERICAL RATING SCALE AND BACK-SPECIFIC FUNCTION MEASURED USING THE MODIFIED ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 40-WEEK MAINTENANCE PHASE, YOGA PARTICIPANTS ARE RE-RANDOMIZED IN A 1:1 RATIO TO EITHER STRUCTURED MAINTENANCE YOGA CLASSES OR HOME PRACTICE ONLY. PHYSICAL THERAPY PARTICIPANTS ARE SIMILARLY RE-RANDOMIZED TO EITHER FIVE BOOSTER SESSIONS OR HOME PRACTICE ONLY. EDUCATION PARTICIPANTS CONTINUE TO FOLLOW RECOMMENDATIONS OF EDUCATIONAL MATERIALS. WE WILL ALSO ASSESS COST EFFECTIVENESS FROM THE PERSPECTIVES OF THE INDIVIDUAL, INSURERS, AND SOCIETY USING CLAIMS DATABASES, ELECTRONIC MEDICAL RECORDS, SELF-REPORT COST DATA, AND STUDY RECORDS. QUALITATIVE DATA FROM INTERVIEWS WILL ADD SUBJECTIVE DETAIL TO COMPLEMENT QUANTITATIVE DATA. TRIAL REGISTRATION: THIS TRIAL IS REGISTERED IN CLINICALTRIALS.GOV, WITH THE ID NUMBER: NCT01343927. 2014
15 196 39 A RANDOMIZED TRIAL OF YOGA FOR STRESS AND SUBSTANCE USE AMONG PEOPLE LIVING WITH HIV IN REENTRY. BACKGROUND: PEOPLE IN REENTRY FROM PRISON OR JAIL (RETURNING CITIZENS) LIVING WITH HIV AND SUBSTANCE USE PROBLEMS OFTEN EXPERIENCE NUMEROUS STRESSORS AND ARE AT HIGH RISK FOR RESUMED SUBSTANCE USE. INTERVENTIONS ARE NEEDED TO MANAGE STRESS AS A PATHWAY TO REDUCED SUBSTANCE USE. OBJECTIVE: THIS STUDY EXPLORED THE EFFECT OF A HATHA YOGA INTERVENTION AS COMPARED TO TREATMENT AS USUAL ON STRESS AND SUBSTANCE USE AMONG RETURNING CITIZENS LIVING WITH HIV AND SUBSTANCE USE PROBLEMS. METHODS: PARTICIPANTS WERE RANDOMIZED TO EITHER A 12-SESSION, 90-MINUTE WEEKLY YOGA INTERVENTION OR TREATMENT AS USUAL. ALL PARTICIPANTS WERE CLIENTS OF A SERVICE PROVIDER FOR RETURNING CITIZENS THAT OFFERED CASE MANAGEMENT, HEALTH CARE, AND EDUCATIONAL CLASSES. OUTCOMES INCLUDED STRESS AS MEASURED BY THE PERCEIVED STRESS SCALE AT THE COMPLETION OF THE YOGA INTERVENTION (THREE-MONTHS) AND SUBSTANCE USE AS MEASURED BY THE TIMELINE FOLLOWBACK AT ONE-MONTH, TWO-MONTHS, AND THREE-MONTHS. RESULTS: SEVENTY-FIVE PEOPLE WERE ENROLLED, TWO OF WHOM WERE WITHDRAWN FROM THE STUDY BECAUSE THEY DID NOT HAVE HIV. OF THE 73 REMAINING PARTICIPANTS, 85% PARTICIPATED IN THE THREE-MONTH ASSESSMENT. AT THREE-MONTHS, YOGA PARTICIPANTS REPORTED LESS STRESS THAN PARTICIPANTS IN TREATMENT AS USUAL [F (1,59)=9.24, P<.05]. YOGA PARTICIPANTS REPORTED LESS SUBSTANCE USE THAN PARTICIPANTS IN TREATMENT AS USUAL AT ONE-MONTH, TWO-MONTHS, AND THREE-MONTHS [X(2) (1)=11.13, P<.001]. CONCLUSION: YOGA INTERVENTIONS FOR RETURNING CITIZENS LIVING WITH HIV AND SUBSTANCE USE PROBLEMS MAY REDUCE STRESS AND SUBSTANCE USE. THIS FINDING IS TENTATIVE BECAUSE THE CONTROL GROUP DID NOT RECEIVE AN INTERVENTION OF EQUAL TIME AND INTENSITY. 2018
16 518 27 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
17 1862 32 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
18 319 35 AN INTERVENTION WITH DANCE AND YOGA FOR GIRLS WITH FUNCTIONAL ABDOMINAL PAIN DISORDERS (JUST IN TIME): PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: FUNCTIONAL ABDOMINAL PAIN DISORDERS (FAPDS) AFFECT MANY CHILDREN WORLDWIDE, PREDOMINANTLY GIRLS, AND CAUSE CONSIDERABLE LONG-TERM NEGATIVE CONSEQUENCES FOR INDIVIDUALS AND SOCIETY. EVIDENCE-BASED AND COST-EFFECTIVE TREATMENTS ARE THEREFORE STRONGLY NEEDED. PHYSICAL ACTIVITY HAS SHOWN PROMISING EFFECTS IN THE PRACTICAL MANAGEMENT OF FAPDS. DANCE AND YOGA ARE BOTH POPULAR ACTIVITIES THAT HAVE BEEN SHOWN TO PROVIDE SIGNIFICANT PSYCHOLOGICAL AND PAIN-RELATED BENEFITS WITH MINIMAL RISK. THE ACTIVITIES COMPLEMENT EACH OTHER, IN THAT DANCE INVOLVES DYNAMIC, RHYTHMIC PHYSICAL ACTIVITY, WHILE YOGA ENHANCES RELAXATION AND FOCUS. OBJECTIVE: THIS STUDY AIMS TO EVALUATE THE EFFECTS OF A DANCE AND YOGA INTERVENTION AMONG GIRLS AGED 9 TO 13 YEARS WITH FAPDS. METHODS: THE STUDY IS A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL AMONG GIRLS AGED 9 TO 13 YEARS WITH FUNCTIONAL ABDOMINAL PAIN, IRRITABLE BOWEL SYNDROME, OR BOTH. THE TARGET SAMPLE SIZE WAS 150 GIRLS RANDOMIZED INTO 2 ARMS: AN INTERVENTION ARM THAT RECEIVES DANCE AND YOGA SESSIONS TWICE WEEKLY FOR 8 MONTHS AND A CONTROL ARM THAT RECEIVES STANDARD CARE. OUTCOMES WILL BE MEASURED AT BASELINE AND AFTER 4, 8, 12, AND 24 MONTHS, AND LONG-TERM FOLLOW-UP WILL BE CONDUCTED 5 YEARS FROM BASELINE. QUESTIONNAIRES, INTERVIEWS, AND BIOMARKER MEASURES, SUCH AS CORTISOL IN SALIVA AND FECAL MICROBIOTA, WILL BE USED. THE PRIMARY OUTCOME IS THE PROPORTION OF GIRLS IN EACH GROUP WITH REDUCED PAIN, AS MEASURED BY THE FACES PAIN SCALE-REVISED IN A PAIN DIARY, IMMEDIATELY AFTER THE INTERVENTION. SECONDARY OUTCOMES ARE GASTROINTESTINAL SYMPTOMS, GENERAL HEALTH, MENTAL HEALTH, STRESS, AND PHYSICAL ACTIVITY. THE STUDY ALSO INCLUDES QUALITATIVE EVALUATIONS AND HEALTH ECONOMIC ANALYSES. THIS STUDY WAS APPROVED BY THE REGIONAL ETHICAL REVIEW BOARD IN UPPSALA (NO. 2016/082 1-2). RESULTS: DATA COLLECTION BEGAN IN OCTOBER 2016. THE INTERVENTION HAS BEEN PERFORMED IN 3 PERIODS FROM 2016 THROUGH 2019. THE FINAL 5-YEAR FOLLOW-UP IS ANTICIPATED TO BE COMPLETED BY FALL 2023. CONCLUSIONS: COST-EFFECTIVE AND EASILY ACCESSIBLE INTERVENTIONS ARE WARRANTED TO REDUCE THE NEGATIVE CONSEQUENCES ARISING FROM FAPDS IN YOUNG GIRLS. PHYSICAL ACTIVITY IS AN EFFECTIVE STRATEGY, BUT INTERVENTION STUDIES ARE NEEDED TO BETTER UNDERSTAND WHAT TYPES OF ACTIVITIES FACILITATE REGULAR PARTICIPATION IN THIS TARGET GROUP. THE JUST IN TIME (TRY, IDENTIFY, MOVE, AND ENJOY) STUDY WILL PROVIDE INSIGHTS REGARDING THE EFFECTIVENESS OF DANCE AND YOGA AND IS ANTICIPATED TO CONTRIBUTE TO THE CHALLENGING WORK OF REDUCING THE BURDEN OF FAPDS FOR YOUNG GIRLS. TRIAL REGISTRATION: CLINICALTRIALS.GOV (NCT02920268); HTTPS://CLINICALTRIALS.GOV/CT2/SHOW/NCT02920268. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/19748. 2020
19 1130 27 EFFICACY OF YOGA FOR DEPRESSED POSTPARTUM WOMEN: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: UP TO 20% OF WOMEN EXPERIENCE POSTPARTUM DEPRESSION (PPD). PPD IS ASSOCIATED WITH ANXIETY AND POOR HEALTH-RELATED QUALITY OF LIFE (HRQOL). EFFICACIOUS TREATMENTS ARE CRITICAL; MANY WOMEN WITH PPD PREFER COMPLEMENTARY THERAPIES. THUS, THE CURRENT STUDY EXAMINED YOGA AS A COMPLEMENTARY THERAPY FOR PPD. METHODS: FIFTY-SEVEN POSTPARTUM WOMEN WITH SCORES >/=12 ON THE HAMILTON DEPRESSION RATING SCALE WERE RANDOMLY ASSIGNED TO A YOGA (N = 28) OR WAIT-LIST CONTROL (N = 29) GROUP. THE YOGA INTERVENTION CONSISTED OF 16 CLASSES OVER 8 WEEKS. OUTCOMES WERE DEPRESSION, ANXIETY, AND HRQOL. RESULTS: THE YOGA GROUP EXPERIENCED SIGNIFICANTLY GREATER RATE OF IMPROVEMENT IN DEPRESSION, ANXIETY, AND HRQOL, RELATIVE TO THE CONTROL GROUP WITH MODERATE TO LARGE EFFECTS. RELIABLE CHANGE INDEX ANALYSES REVEALED THAT 78% OF WOMEN IN THE YOGA GROUP EXPERIENCED CLINICALLY SIGNIFICANT CHANGE. CONCLUSION: THESE FINDINGS SUPPORT YOGA AS A PROMISING COMPLEMENTARY THERAPY FOR PPD, AND WARRANT LARGE-SCALE REPLICATION STUDIES. TRIAL REGISTRATION: HTTP://CLINICALTRIALS.GOV/NCT02213601. 2015
20 2852 25 YOGA, PHYSICAL THERAPY, OR EDUCATION FOR CHRONIC LOW BACK PAIN: A RANDOMIZED NONINFERIORITY TRIAL. BACKGROUND: YOGA IS EFFECTIVE FOR MILD TO MODERATE CHRONIC LOW BACK PAIN (CLBP), BUT ITS COMPARATIVE EFFECTIVENESS WITH PHYSICAL THERAPY (PT) IS UNKNOWN. MOREOVER, LITTLE IS KNOWN ABOUT YOGA'S EFFECTIVENESS IN UNDERSERVED PATIENTS WITH MORE SEVERE FUNCTIONAL DISABILITY AND PAIN. OBJECTIVE: TO DETERMINE WHETHER YOGA IS NONINFERIOR TO PT FOR CLBP. DESIGN: 12-WEEK, SINGLE-BLIND, 3-GROUP RANDOMIZED NONINFERIORITY TRIAL AND SUBSEQUENT 40-WEEK MAINTENANCE PHASE. (CLINICALTRIALS.GOV: NCT01343927). SETTING: ACADEMIC SAFETY-NET HOSPITAL AND 7 AFFILIATED COMMUNITY HEALTH CENTERS. PARTICIPANTS: 320 PREDOMINANTLY LOW-INCOME, RACIALLY DIVERSE ADULTS WITH NONSPECIFIC CLBP. INTERVENTION: PARTICIPANTS RECEIVED 12 WEEKLY YOGA CLASSES, 15 PT VISITS, OR AN EDUCATIONAL BOOK AND NEWSLETTERS. THE MAINTENANCE PHASE COMPARED YOGA DROP-IN CLASSES VERSUS HOME PRACTICE AND PT BOOSTER SESSIONS VERSUS HOME PRACTICE. MEASUREMENTS: PRIMARY OUTCOMES WERE BACK-RELATED FUNCTION, MEASURED BY THE ROLAND MORRIS DISABILITY QUESTIONNAIRE (RMDQ), AND PAIN, MEASURED BY AN 11-POINT SCALE, AT 12 WEEKS. PRESPECIFIED NONINFERIORITY MARGINS WERE 1.5 (RMDQ) AND 1.0 (PAIN). SECONDARY OUTCOMES INCLUDED PAIN MEDICATION USE, GLOBAL IMPROVEMENT, SATISFACTION WITH INTERVENTION, AND HEALTH-RELATED QUALITY OF LIFE. RESULTS: ONE-SIDED 95% LOWER CONFIDENCE LIMITS WERE 0.83 (RMDQ) AND 0.97 (PAIN), DEMONSTRATING NONINFERIORITY OF YOGA TO PT. HOWEVER, YOGA WAS NOT SUPERIOR TO EDUCATION FOR EITHER OUTCOME. YOGA AND PT WERE SIMILAR FOR MOST SECONDARY OUTCOMES. YOGA AND PT PARTICIPANTS WERE 21 AND 22 PERCENTAGE POINTS LESS LIKELY, RESPECTIVELY, THAN EDUCATION PARTICIPANTS TO USE PAIN MEDICATION AT 12 WEEKS. IMPROVEMENTS IN YOGA AND PT GROUPS WERE MAINTAINED AT 1 YEAR WITH NO DIFFERENCES BETWEEN MAINTENANCE STRATEGIES. FREQUENCY OF ADVERSE EVENTS, MOSTLY MILD SELF-LIMITED JOINT AND BACK PAIN, DID NOT DIFFER BETWEEN THE YOGA AND PT GROUPS. LIMITATIONS: PARTICIPANTS WERE NOT BLINDED TO TREATMENT ASSIGNMENT. THE PT GROUP HAD DISPROPORTIONATE LOSS TO FOLLOW-UP. CONCLUSION: A MANUALIZED YOGA PROGRAM FOR NONSPECIFIC CLBP WAS NONINFERIOR TO PT FOR FUNCTION AND PAIN. PRIMARY FUNDING SOURCE: NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH OF THE NATIONAL INSTITUTES OF HEALTH. 2017