1 1573 155 MANAGING KNEE OSTEOARTHRITIS WITH YOGA OR AEROBIC/STRENGTHENING EXERCISE PROGRAMS IN OLDER ADULTS: A PILOT RANDOMIZED CONTROLLED TRIAL. ALTHOUGH EXERCISE IS OFTEN RECOMMENDED FOR MANAGING OSTEOARTHRITIS (OA), LIMITED EVIDENCE-BASED EXERCISE OPTIONS ARE AVAILABLE FOR OLDER ADULTS WITH OA. THIS STUDY COMPARED THE EFFECTS OF HATHA YOGA (HY) AND AEROBIC/STRENGTHENING EXERCISES (ASE) ON KNEE OA. RANDOMIZED CONTROLLED TRIAL WITH THREE ARMS DESIGN WAS USED: HY, ASE, AND EDUCATION CONTROL. BOTH HY AND ASE GROUPS INVOLVED 8 WEEKLY 45-MIN GROUP CLASSES WITH 2-4 DAYS/WEEK HOME PRACTICE SESSIONS. CONTROL GROUP RECEIVED OA EDUCATION BROCHURES AND WEEKLY PHONE CALLS FROM STUDY STAFF. STANDARDIZED INSTRUMENTS WERE USED TO MEASURE OA SYMPTOMS, PHYSICAL FUNCTION, MOOD, SPIRITUAL HEALTH, FEAR OF FALLING, AND QUALITY OF LIFE AT BASELINE, 4 AND 8 WEEKS. HY/ASE ADHERENCES WERE ASSESSED WEEKLY USING CLASS ATTENDANCE RECORDS AND HOME PRACTICE VIDEO RECORDINGS. PRIMARY ANALYSIS OF THE DIFFERENCE IN THE CHANGE FROM BASELINE WAS BASED ON INTENT-TO-TREAT AND ADJUSTED FOR BASELINE VALUES. EIGHT-THREE ADULTS WITH SYMPTOMATIC KNEE OA COMPLETED THE STUDY (84% FEMALE; MEAN AGE 71.6 +/- 8.0 YEARS; MEAN BMI 29.0 +/- 7.0 KG/M(2)). RETENTION RATE WAS 82%. COMPARED TO THE ASE GROUP AT 8 WEEKS, PARTICIPANTS IN THE HY GROUP HAD A SIGNIFICANT IMPROVEMENT FROM BASELINE IN PERCEPTION OF OA SYMPTOMS (-9.6 [95% CI -15.3, -4]; P = .001), ANXIETY (-1.4 [95% CI -2.7, -0]; P = .04), AND FEAR OF FALLING (-4.6 [-7.5, -1.7]; P = .002). THERE WERE NO DIFFERENCES IN CLASS/HOME PRACTICE ADHERENCE BETWEEN HY AND ASE. THREE NON-SERIOUS ADVERSE EVENTS WERE REPORTED FROM THE ASE GROUP. BOTH HY AND ASE IMPROVED SYMPTOMS AND FUNCTION BUT HY MAY HAVE SUPERIOR BENEFITS FOR OLDER ADULTS WITH KNEE OA. TRIAL REGISTRATION THE FULL TRIAL PROTOCOL IS AVAILABLE AT CLINICALTRIALS.GOV (NCT02525341). 2017 2 1560 44 LONG-TERM YOGA AND AEROBIC/STRENGTH EXERCISE ADHERENCE IN OLDER WOMEN WITH KNEE OSTEOARTHRITIS: A MIXED METHODS APPROACH. HATHA YOGA (HY) AND AEROBIC AND STRENGTHENING EXERCISE (ASE) PROGRAMS ARE RECOMMENDED FOR OPTIMAL MANAGEMENT OF OSTEOARTHRITIS. HOWEVER, EVIDENCE ON LONG-TERM ADHERENCE TO THESE PROGRAMS AND FACTORS THAT INFLUENCE IT IS LACKING IN OLDER ADULTS. THE PURPOSES OF THIS STUDY WERE TO (1) DESCRIBE AND COMPARE LONG-TERM HY AND ASE ADHERENCE IN COMMUNITY-DWELLING OLDER WOMEN WITH KNEE OSTEOARTHRITIS 12 MONTHS POST-HY/ASE INTERVENTION PROGRAMS; (2) IDENTIFY BENEFITS AND FACILITATORS OF, AND BARRIERS TO, LONG-TERM ADHERENCE; AND (3) EXAMINE OTHER SELF-CARE INTERVENTIONS USED AFTER COMPLETING HY OR ASE PROGRAMS. ADHERENCE WAS DEFINED AS FOLLOWING THE PRESCRIBED HY/ASE PROGRAM OR INCORPORATING THE PRACTICE INTO DAILY HABITS. FIVE SEMISTRUCTURED FOCUS GROUP INTERVIEWS AND 12 MONTHS OF EXERCISE DIARIES WERE OBTAINED FROM 28 WOMEN (MEAN AGE 71.2 YEARS). LONG-TERM ADHERENCE TO THE PRESCRIBED HY OR ASE REGIMEN WAS RELATIVELY HIGH, ALBEIT ADAPTED TO INDIVIDUAL NEEDS, PRIORITIES, AND PREFERENCES. OVER THE 12-MONTH FOLLOW-UP PERIOD, PARTICIPANTS SPENT ON AVERAGE 3.5 DAYS/3.1 HOURS PER WEEK ON EXERCISE. MOST PARTICIPANTS REMAINED PHYSICALLY ACTIVE BY MODIFYING THEIR PRESCRIBED PROGRAMS AND INTEGRATING ELEMENTS OF THE INTERVENTIONS INTO THEIR OWN EXERCISE REGIMENS. FACILITATORS TO LONG-TERM ADHERENCE WERE PERCEIVED BENEFITS, HAVING AN EXERCISE ROUTINE/HABIT, AND PROGRAM STRUCTURE/INSTRUCTION. POOR HEALTH STATUS, LACK OF TIME, AND EXERCISE PREFERENCES WERE IDENTIFIED AS BARRIERS. PARTICIPANTS USED A VARIETY OF SELF-CARE INTERVENTIONS INCLUDING ORAL SUPPLEMENTS AND ALTERNATIVE DIETS FOR MANAGING THEIR OSTEOARTHRITIS. THIS WORK SUGGESTS THAT EXERCISE PROGRAMS FOR OSTEOARTHRITIS THAT INCORPORATE INDIVIDUAL PREFERENCES, FLEXIBLE HOURS, AND EASY-TO-FOLLOW INSTRUCTIONS ARE MOST LIKELY TO RESULT IN LONG-TERM ADHERENCE. 2022 3 280 35 ADHERENCE TO A YOGA PROGRAM IN OLDER WOMEN WITH KNEE OSTEOARTHRITIS. YOGA IS BENEFICIAL FOR OSTEOARTHRITIS (OA) MANAGEMENT IN OLDER ADULTS; HOWEVER, ADHERENCE TO YOGA PRACTICE IS UNKNOWN. THE PURPOSES OF THIS SECONDARY ANALYSIS WERE TO EXAMINE: (1) YOGA ADHERENCE DURING THE INTERVENTION AND FOLLOW-UP PERIODS; (2) THE RELATIONSHIP BETWEEN SOCIAL COGNITIVE THEORY (SCT) CONSTRUCTS AND ADHERENCE; AND (3) THE IMPACT OF ADHERENCE ON OA-RELATED SYMPTOMS IN 36 COMMUNITY-DWELLING OLDER WOMEN WITH KNEE OA. SCT WAS USED AS A FRAMEWORK TO PROMOTE ADHERENCE TO A YOGA INTERVENTION PROGRAM THAT INCLUDED BOTH GROUP/HOMEBASED PRACTICES. ADHERENCE TO YOGA WAS HIGH DURING THE INTERVENTION PERIOD BUT DECREASED OVER TIME. ALTHOUGH SCT WAS A USEFUL FRAMEWORK FOR REDUCING ATTRITION DURING THE INTERVENTION, SELF-EFFICACY WAS THE ONLY CONSTRUCT THAT CORRELATED WITH CLASS ATTENDANCE. HIGHER YOGA ADHERENCE WAS CORRELATED WITH IMPROVED SYMPTOMS, PHYSICAL FUNCTION, SLEEP QUALITY, AND QUALITY OF LIFE. YOGA ADHERERS WERE LIKELY TO BE OLDER, LESS EDUCATED, AND HAD A LOWER BODY MASS INDEX THAN NONADHERERS. 2016 4 2078 48 THE EFFECT OF CHAIR YOGA ON BIOPSYCHOSOCIAL CHANGES IN ENGLISH- AND SPANISH-SPEAKING COMMUNITY-DWELLING OLDER ADULTS WITH LOWER-EXTREMITY OSTEOARTHRITIS. CHAIR YOGA (CY), A MIND-BODY THERAPY, IS A SAFE NONPHARMACOLOGICAL APPROACH FOR MANAGING OSTEOARTHRITIS (OA) IN OLDER ADULTS WHO CANNOT PARTICIPATE IN STANDING EXERCISE. HOWEVER, THERE IS NO LINGUISTICALLY TAILORED CY PROGRAM FOR THOSE WITH LIMITED ENGLISH PROFICIENCY (LEP). THIS 2-ARM RANDOMIZED CONTROLLED TRIAL COMPARED THE EFFECTS OF A LINGUISTICALLY TAILORED YOGA PROGRAM (ENGLISH AND SPANISH VERSIONS) ON THE OUTCOMES OF PAIN, PHYSICAL FUNCTION, AND PSYCHOSOCIAL FACTORS COMPARED TO THE EFFECTS OF A LINGUISTICALLY TAILORED HEALTH EDUCATION PROGRAM (HEP; ENGLISH AND SPANISH VERSIONS). PARTICIPANTS WITH LOWER-EXTREMITY OA, RECRUITED FROM 2 COMMUNITY SITES, COMPLETED THE SPANISH (N = 40) OR ENGLISH (N = 60) VERSION OF TWICE-WEEKLY 45-MIN CY OR HEP SESSIONS FOR 8 WEEKS. DATA WERE COLLECTED AT BASELINE, 4 WEEKS, 8 WEEKS, AND 1- AND 3-MONTH FOLLOW-UPS. ENGLISH AND SPANISH CY GROUPS (BUT NEITHER HEP LANGUAGE GROUP) SHOWED SIGNIFICANT DECREASES IN PAIN INTERFERENCE. MEASURES OF OA SYMPTOMS, BALANCE, DEPRESSION, AND SOCIAL ACTIVITIES WERE NOT SIGNIFICANTLY DIFFERENT BETWEEN ENGLISH AND SPANISH VERSIONS OF CY AND ENGLISH AND SPANISH VERSIONS OF HEP. IT WAS CONCLUDED THAT THE SPANISH AND ENGLISH VERSIONS OF CY AND HEP WERE EQUIVALENT. LINGUISTICALLY TAILORED CY COULD BE IMPLEMENTED IN AGING-SERVING COMMUNITIES FOR PERSONS WITH LEP. 2016 5 34 51 A 12-WEEK IYENGAR YOGA PROGRAM IMPROVED BALANCE AND MOBILITY IN OLDER COMMUNITY-DWELLING PEOPLE: A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: EXERCISE THAT CHALLENGES BALANCE CAN IMPROVE MOBILITY AND PREVENT FALLS IN OLDER ADULTS. YOGA AS A PHYSICAL ACTIVITY OPTION FOR OLDER ADULTS IS NOT WELL STUDIED. THIS TRIAL EVALUATED THE FEASIBILITY AND EFFECT OF A 12-WEEK IYENGAR YOGA PROGRAM ON BALANCE AND MOBILITY IN OLDER PEOPLE. METHODS: WE CONDUCTED A BLINDED, PILOT RANDOMIZED CONTROLLED TRIAL WITH INTENTION-TO-TREAT ANALYSIS. PARTICIPANTS WERE 54 COMMUNITY DWELLERS (MEAN AGE 68 YEARS, SD 7.1) NOT CURRENTLY PARTICIPATING IN YOGA OR TAI CHI. THE INTERVENTION GROUP (N = 27) PARTICIPATED IN A 12-WEEK, TWICE-WEEKLY YOGA PROGRAM FOCUSED ON STANDING POSTURES AND RECEIVED A FALL PREVENTION EDUCATION BOOKLET. THE CONTROL GROUP (N = 27) RECEIVED THE EDUCATION BOOKLET ONLY. PRIMARY OUTCOME WAS STANDING BALANCE COMPONENT OF THE SHORT PHYSICAL PERFORMANCE BATTERY WITH ADDITION OF ONE-LEGGED STANCE TIME (STANDING BALANCE). SECONDARY OUTCOMES WERE THE TIMED SIT-TO-STAND TEST, TIMED 4-M WALK, ONE-LEGGED STAND WITH EYES CLOSED, AND SHORT FALLS EFFICACY SCALE-INTERNATIONAL. FEASIBILITY WAS MEASURED BY RECORDING CLASS ATTENDANCE AND ADVERSE EVENTS. RESULTS: FIFTY-TWO PARTICIPANTS COMPLETED FOLLOW-UP ASSESSMENTS. THE INTERVENTION GROUP SIGNIFICANTLY IMPROVED COMPARED WITH CONTROL GROUP ON STANDING BALANCE (MEAN DIFFERENCE = 1.52 SECONDS, 95% CI 0.10-2.96, P = .04), SIT-TO-STAND TEST (MEAN DIFFERENCE = -3.43 SECONDS, 95% CI -5.23 TO -1.64, P < .001), 4-M WALK (MEAN DIFFERENCE = -0.50 SECONDS, 95% CI -0.72 TO -0.28, P < .001), AND ONE-LEGGED STAND WITH EYES CLOSED (MEAN DIFFERENCE = 1.93 SECONDS, 95% CI 0.40-3.46, P = .02). AVERAGE CLASS ATTENDANCE WAS 20 OF 24 CLASSES (83%). NO SERIOUS ADVERSE EVENTS OCCURRED. CONCLUSIONS: THIS TRIAL DEMONSTRATES THE BALANCE AND MOBILITY-RELATED BENEFITS AND FEASIBILITY OF IYENGAR YOGA FOR OLDER PEOPLE. THE FALL PREVENTION EFFECT OF IYENGAR YOGA WARRANTS FURTHER INVESTIGATION. 2013 6 2590 71 YOGA FOR MANAGING KNEE OSTEOARTHRITIS IN OLDER WOMEN: A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: OSTEOARTHRITIS (OA) IS A COMMON PROBLEM IN OLDER WOMEN THAT IS ASSOCIATED WITH PAIN AND DISABILITIES. ALTHOUGH YOGA IS RECOMMENDED AS AN EXERCISE INTERVENTION TO MANAGE ARTHRITIS, THERE IS LIMITED EVIDENCE DOCUMENTING ITS EFFECTIVENESS, WITH LITTLE KNOWN ABOUT ITS LONG TERM BENEFITS. THIS STUDY'S AIMS WERE TO ASSESS THE FEASIBILITY AND POTENTIAL EFFICACY OF A HATHA YOGA EXERCISE PROGRAM IN MANAGING OA-RELATED SYMPTOMS IN OLDER WOMEN WITH KNEE OA. METHODS: ELIGIBLE PARTICIPANTS (N=36; MEAN AGE 72 YEARS) WERE RANDOMLY ASSIGNED TO 8-WEEK YOGA PROGRAM INVOLVING GROUP AND HOME-BASED SESSIONS OR WAIT-LIST CONTROL. THE YOGA INTERVENTION PROGRAM WAS DEVELOPED BY A GROUP OF YOGA EXPERTS (N=5). THE PRIMARY OUTCOME WAS THE WESTERN ONTARIO AND MCMASTER UNIVERSITIES OSTEOARTHRITIS INDEX (WOMAC) TOTAL SCORE THAT MEASURES KNEE OA PAIN, STIFFNESS, AND FUNCTION AT 8 WEEKS. THE SECONDARY OUTCOMES, PHYSICAL FUNCTION OF THE LOWER EXTREMITIES, BODY MASS INDEX (BMI), QUALITY OF SLEEP (QOS), AND QUALITY OF LIFE (QOL), WERE MEASURED USING WEIGHT, HEIGHT, THE SHORT PHYSICAL PERFORMANCE BATTERY (SPPB), THE PITTSBURGH SLEEP QUALITY INDEX (PSQI), THE CANTRIL SELF-ANCHORING LADDER, AND THE SF12V2 HEALTH SURVEY. DATA WERE COLLECTED AT BASELINE, 4 WEEKS AND 8 WEEKS, AND 20 WEEKS. RESULTS: THE RECRUITMENT TARGET WAS MET, WITH STUDY RETENTION AT 95%. BASED ON ANCOVAS, PARTICIPANTS IN THE TREATMENT GROUP EXHIBITED SIGNIFICANTLY GREATER IMPROVEMENT IN WOMAC PAIN (ADJUSTED MEANS [SE]) (8.3 [.67], 5.8 [.67]; P=.01), STIFFNESS (4.7 [.28], 3.4 [.28]; P=.002) AND SPPB (REPEATED CHAIR STANDS) (2.0 [.23], 2.8 [.23]; P=.03) AT 8 WEEKS. SIGNIFICANT TREATMENT AND TIME EFFECTS WERE SEEN IN WOMAC PAIN (7.0 [.46], 5.4 [.54]; P=.03), FUNCTION (24.5 [1.8], 19.9 [1.6]; P=.01) AND TOTAL SCORES (35.4 [2.3], 28.6 [2.1]; P=.01) FROM 4 TO 20 WEEKS. SLEEP DISTURBANCE WAS IMPROVED BUT THE PSQI TOTAL SCORE DECLINED SIGNIFICANTLY AT 20 WEEKS. CHANGES IN BMI AND QOL WERE NOT SIGNIFICANT. NO YOGA RELATED ADVERSE EVENTS WERE OBSERVED. CONCLUSIONS: A WEEKLY YOGA PROGRAM WITH HOME PRACTICE IS FEASIBLE, ACCEPTABLE, AND SAFE FOR OLDER WOMEN WITH KNEE OA, AND SHOWS THERAPEUTIC BENEFITS. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT01832155. 2014 7 74 49 A GROUP-BASED YOGA THERAPY INTERVENTION FOR URINARY INCONTINENCE IN WOMEN: A PILOT RANDOMIZED TRIAL. OBJECTIVE: THE AIM OF THIS STUDY IS TO EXAMINE THE FEASIBILITY, EFFICACY, AND SAFETY OF A GROUP-BASED YOGA THERAPY INTERVENTION FOR MIDDLE-AGED AND OLDER WOMEN WITH URINARY INCONTINENCE. METHODS: WE CONDUCTED A PILOT RANDOMIZED TRIAL OF AMBULATORY WOMEN AGED 40 YEARS AND OLDER WITH STRESS, URGENCY, OR MIXED-TYPE INCONTINENCE. WOMEN WERE RANDOMIZED TO A 6-WEEK YOGA THERAPY PROGRAM (N = 10) CONSISTING OF TWICE WEEKLY GROUP CLASSES AND ONCE WEEKLY HOME PRACTICE OR A WAIT-LIST CONTROL GROUP (N = 9). ALL PARTICIPANTS ALSO RECEIVED WRITTEN PAMPHLETS ABOUT STANDARD BEHAVIORAL SELF-MANAGEMENT STRATEGIES FOR INCONTINENCE. CHANGES IN INCONTINENCE WERE ASSESSED WITH 7-DAY VOIDING DIARIES. RESULTS: THE MEAN (SD) AGE WAS 61.4 (8.2) YEARS, AND THE MEAN BASELINE FREQUENCY OF INCONTINENCE WAS 2.5 (1.3) EPISODES/D. AFTER 6 WEEKS, THE TOTAL INCONTINENCE FREQUENCY DECREASED BY 70% (1.8 [0.9] FEWER EPISODES/D) IN THE YOGA THERAPY VERSUS 13% (0.3 [1.7] FEWER EPISODES/D) IN THE CONTROL GROUP (P = 0.049). PARTICIPANTS IN THE YOGA THERAPY GROUP ALSO REPORTED AN AVERAGE OF 71% DECREASE IN STRESS INCONTINENCE FREQUENCY (0.7 [0.8] FEWER EPISODES/D) COMPARED WITH A 25% INCREASE IN CONTROLS (0.2 [1.1] MORE EPISODES/D) (P = 0.039). NO SIGNIFICANT DIFFERENCES IN REDUCTION IN URGENCY INCONTINENCE WERE DETECTED BETWEEN THE YOGA THERAPY VERSUS CONTROL GROUPS (1.0 [1.0] VERSUS 0.5 [0.5] FEWER EPISODES/D; P = 0.20). ALL WOMEN STARTING THE YOGA THERAPY PROGRAM COMPLETED AT LEAST 90% OF THE GROUP CLASSES AND PRACTICE SESSIONS. TWO PARTICIPANTS IN EACH GROUP REPORTED ADVERSE EVENTS UNRELATED TO THE INTERVENTION. CONCLUSIONS: FINDINGS PROVIDE PRELIMINARY EVIDENCE TO SUPPORT THE FEASIBILITY, EFFICACY, AND SAFETY OF A GROUP-BASED YOGA THERAPY INTERVENTION TO IMPROVE URINARY INCONTINENCE IN WOMEN. 2014 8 445 31 CHAIR YOGA: FEASIBILITY AND SUSTAINABILITY STUDY WITH OLDER COMMUNITY-DWELLING ADULTS WITH OSTEOARTHRITIS. THIS STUDY MEASURED THE FEASIBILITY OF COMPLETING A RANDOMIZED CONTROL TRIAL ON AN 8-WEEK SEATED YOGA PROGRAM FOR OLDER ADULTS WITH OSTEOARTHRITIS. PART OF THE FEASIBILITY OF THIS PROGRAM WAS TO DETERMINE WHETHER PARTICIPANTS WOULD CONTINUE THE YOGA PRACTICE AT HOME USING A GUIDE BOOK AFTER THE 8-WEEK PROGRAM. FINDINGS DEMONSTRATED THAT ONCE PARTICIPANTS WERE NOT IN A GROUP SETTING FOR THE YOGA, THEY DID NOT CONTINUE WITH YOGA PRACTICE. THIS OUTCOME DEMONSTRATES THE NEED FOR GROUP PROGRAMS FOR OLDER ADULTS TO PROMOTE ADHERENCE TO MOVEMENT-BASED PROGRAMS. (TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT02113410). 2017 9 1113 50 EFFICACY OF A BIOMECHANICALLY-BASED YOGA EXERCISE PROGRAM IN KNEE OSTEOARTHRITIS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: CERTAIN EXERCISES COULD OVERLOAD THE OSTEOARTHRITIC KNEE. WE DEVELOPED AN EXERCISE PROGRAM FROM YOGA POSTURES WITH A MINIMAL KNEE ADDUCTION MOMENT FOR KNEE OSTEOARTHRITIS. THE PURPOSE WAS TO COMPARE THE EFFECTIVENESS OF THIS BIOMECHANICALLY-BASED YOGA EXERCISE (YE), WITH TRADITIONAL EXERCISE (TE), AND A NO-EXERCISE ATTENTION-EQUIVALENT CONTROL (NE) FOR IMPROVING PAIN, SELF-REPORTED PHYSICAL FUNCTION AND MOBILITY PERFORMANCE IN WOMEN WITH KNEE OSTEOARTHRITIS. DESIGN: SINGLE-BLIND, THREE-ARM RANDOMIZED CONTROLLED TRIAL. SETTING: COMMUNITY IN SOUTHWESTERN ONTARIO, CANADA. PARTICIPANTS: A CONVENIENCE SAMPLE OF 31 WOMEN WITH SYMPTOMATIC KNEE OSTEOARTHRITIS WAS RECRUITED THROUGH RHEUMATOLOGY, ORTHOPAEDIC AND PHYSIOTHERAPY CLINICS, NEWSPAPERS AND WORD-OF-MOUTH. INTERVENTIONS: PARTICIPANTS WERE STRATIFIED BY DISEASE SEVERITY AND RANDOMLY ALLOCATED TO ONE OF THREE 12-WEEK, SUPERVISED INTERVENTIONS. YE INCLUDED BIOMECHANICALLY-BASED YOGA EXERCISES; TE INCLUDED TRADITIONAL LEG STRENGTHENING ON MACHINES; AND NE INCLUDED MEDITATION WITH NO EXERCISE. PARTICIPANTS WERE ASKED TO ATTEND THREE 1-HOUR GROUP CLASSES/SESSIONS EACH WEEK. MEASUREMENTS: PRIMARY OUTCOMES WERE PAIN, SELF-REPORTED PHYSICAL FUNCTION AND MOBILITY PERFORMANCE. SECONDARY OUTCOMES WERE KNEE STRENGTH, DEPRESSION, AND HEALTH-RELATED QUALITY OF LIFE. ALL WERE ASSESSED BY A BLINDED ASSESSOR AT BASELINE AND IMMEDIATELY FOLLOWING THE INTERVENTION. RESULTS: THE YE GROUP DEMONSTRATED GREATER IMPROVEMENTS IN KOOS PAIN (MEAN DIFFERENCE OF 22.9 [95% CI, 6.9 TO 38.8; P = 0.003]), INTERMITTENT PAIN (MEAN DIFFERENCE OF -19.6 [95% CI, -34.8 TO -4.4; P = 0.009]) AND SELF-REPORTED PHYSICAL FUNCTION (MEAN DIFFERENCE OF 17.2 [95% CI, 5.2 TO 29.2; P = 0.003]) COMPARED TO NE. IMPROVEMENTS IN THESE OUTCOMES WERE SIMILAR BETWEEN YE AND TE. HOWEVER, TE DEMONSTRATED A GREATER IMPROVEMENT IN KNEE FLEXOR STRENGTH COMPARED TO YE (MEAN DIFFERENCE OF 0.1 [95% CI, 0.1 TO 0.2]. IMPROVEMENTS FROM BASELINE TO FOLLOW-UP WERE PRESENT IN QUALITY OF LIFE SCORE FOR YE AND KNEE FLEXOR STRENGTH FOR TE, WHILE BOTH ALSO DEMONSTRATED IMPROVEMENTS IN MOBILITY. NO IMPROVEMENT IN ANY OUTCOME WAS PRESENT IN NE. CONCLUSIONS: THE BIOMECHANICALLY-BASED YOGA EXERCISE PROGRAM PRODUCED CLINICALLY MEANINGFUL IMPROVEMENTS IN PAIN, SELF-REPORTED PHYSICAL FUNCTION AND MOBILITY IN WOMEN WITH CLINICAL KNEE OA COMPARED TO NO EXERCISE. WHILE NOT STATISTICALLY SIGNIFICANT, IMPROVEMENTS IN THESE OUTCOMES WERE LARGER THAN THOSE ELICITED FROM THE TRADITIONAL EXERCISE-BASED PROGRAM. THOUGH THIS MAY SUGGEST THAT THE YOGA PROGRAM MAY BE MORE EFFICACIOUS FOR KNEE OA, FUTURE RESEARCH STUDYING A LARGER SAMPLE IS REQUIRED. TRIAL REGISTRATION: CLINICALTRIALS.GOV (NCT02370667). 2018 10 518 47 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 11 253 45 A YOGA STRENGTHENING PROGRAM DESIGNED TO MINIMIZE THE KNEE ADDUCTION MOMENT FOR WOMEN WITH KNEE OSTEOARTHRITIS: A PROOF-OF-PRINCIPLE COHORT STUDY. UNLABELLED: PEOPLE WITH KNEE OSTEOARTHRITIS MAY BENEFIT FROM EXERCISE PRESCRIPTIONS THAT MINIMIZE KNEE LOADS IN THE FRONTAL PLANE. THE PRIMARY OBJECTIVE OF THIS STUDY WAS TO DETERMINE WHETHER A NOVEL 12-WEEK STRENGTHENING PROGRAM DESIGNED TO MINIMIZE EXPOSURE TO THE KNEE ADDUCTION MOMENT (KAM) COULD IMPROVE SYMPTOMS AND KNEE STRENGTH IN WOMEN WITH SYMPTOMATIC KNEE OSTEOARTHRITIS. A SECONDARY OBJECTIVE WAS TO DETERMINE WHETHER THE PROGRAM COULD IMPROVE MOBILITY AND FITNESS, AND DECREASE PEAK KAM DURING GAIT. THE TERTIARY OBJECTIVE WAS TO EVALUATE THE BIOMECHANICAL CHARACTERISTICS OF THIS YOGA PROGRAM. IN PARTICULAR, WE COMPARED THE PEAK KAM DURING GAIT WITH THAT DURING YOGA POSTURES AT BASELINE. WE ALSO COMPARED LOWER LIMB NORMALIZED MEAN ELECTROMYOGRAPHY (EMG) AMPLITUDES DURING YOGA POSTURES BETWEEN BASELINE AND FOLLOW-UP. PRIMARY MEASURES INCLUDED SELF-REPORTED PAIN AND PHYSICAL FUNCTION (KNEE INJURY AND OSTEOARTHRITIS OUTCOME SCORE) AND KNEE STRENGTH (EXTENSOR AND FLEXOR TORQUES). SECONDARY MEASURES INCLUDED MOBILITY (SIX-MINUTE WALK, 30-SECOND CHAIR STAND, STAIR CLIMBING), FITNESS (SUBMAXIMAL CYCLE ERGOMETER TEST), AND CLINICAL GAIT ANALYSIS USING MOTION CAPTURE SYNCHRONIZED WITH ELECTROMYOGRAPHY AND FORCE MEASUREMENT. ALSO, KAM AND NORMALIZED MEAN EMG AMPLITUDES WERE COLLECTED DURING YOGA POSTURES. FORTY-FIVE WOMEN OVER AGE 50 WITH SYMPTOMATIC KNEE OSTEOARTHRITIS, CONSISTENT WITH THE AMERICAN COLLEGE OF RHEUMATOLOGY CRITERIA, ENROLLED IN OUR 12-WEEK (3 SESSIONS PER WEEK) PROGRAM. DATA FROM 38 WERE ANALYZED (SIX DROP-OUTS; ONE LOST TO CO-INTERVENTION). PARTICIPANTS EXPERIENCED REDUCED PAIN (MEAN IMPROVEMENT 10.1-20.1 NORMALIZED TO 100; P<0.001), INCREASED KNEE EXTENSOR STRENGTH (MEAN IMPROVEMENT 0.01 NM/KG; P = 0.004), AND INCREASED FLEXOR STRENGTH (MEAN IMPROVEMENT 0.01 NM/KG; P = 0.001) AT FOLLOW-UP COMPARED TO BASELINE. PARTICIPANTS IMPROVED MOBILITY ON THE SIX-MINUTE WALK (MEAN IMPROVEMENT 37.7 M; P<0.001) AND 30-SECOND CHAIR STAND (MEAN IMPROVEMENT 1.3; P = 0.006) AT FOLLOW-UP COMPARED TO BASELINE. FITNESS AND PEAK KAM DURING GAIT WERE UNCHANGED BETWEEN BASELINE AND FOLLOW-UP. AVERAGE KAM DURING THE YOGA POSTURES WERE LOWER THAN THAT OF NORMAL GAIT. NORMALIZED MEAN EMG AMPLITUDES DURING YOGA POSTURES WERE UP TO 31.0% OF MAXIMUM BUT DID NOT CHANGE BETWEEN BASELINE AND FOLLOW-UP. IN THIS COHORT STUDY, THE YOGA-BASED STRENGTHENING POSTURES THAT ELICIT LOW KAMS IMPROVED KNEE SYMPTOMS AND STRENGTH IN WOMEN WITH KNEE OA FOLLOWING A 12 WEEK PROGRAM (3 SESSIONS PER WEEK). THE PROGRAM ALSO IMPROVED MOBILITY, BUT DID NOT IMPROVE FITNESS OR REDUCE PEAK KAM DURING GAIT. THE KAM DURING THE YOGA POSTURES WERE LOWER THAN THAT OF NORMAL GAIT. OVERALL, THE PROPOSED PROGRAM MAY BE USEFUL IN IMPROVING PAIN, STRENGTH, AND MOBILITY IN WOMEN WITH KNEE OSTEOARTHRITIS. CLINICAL EFFICACY NEEDS TO BE ASSESSED USING A RANDOMIZED CONTROLLED TRIAL DESIGN. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT02146105. 2015 12 120 29 A PILOT STUDY OF THE EFFECTS OF CHAIR YOGA AND CHAIR-BASED EXERCISE ON BIOPSYCHOSOCIAL OUTCOMES IN OLDER ADULTS WITH LOWER EXTREMITY OSTEOARTHRITIS. THIS PILOT STUDY EXAMINED WHETHER CHAIR YOGA AND CHAIR-BASED EXERCISE ARE EFFECTIVE IN MANAGING BIOPSYCHOSOCIAL OUTCOMES FOR OLDER ADULTS WITH LOWER EXTREMITY OSTEOARTHRITIS. BOTH INTERVENTIONS IMPROVED PHYSICAL FUNCTION AND MOBILITY OVER TIME, ALTHOUGH NO SIGNIFICANT DIFFERENCES BETWEEN THE 2 INTERVENTIONS WERE IDENTIFIED. 2019 13 107 49 A PILOT RANDOMIZED CONTROLLED TRIAL OF THE EFFECTS OF CHAIR YOGA ON PAIN AND PHYSICAL FUNCTION AMONG COMMUNITY-DWELLING OLDER ADULTS WITH LOWER EXTREMITY OSTEOARTHRITIS. OBJECTIVES: TO DETERMINE EFFECTS OF SIT 'N' FIT CHAIR YOGA, COMPARED TO A HEALTH EDUCATION PROGRAM (HEP), ON PAIN AND PHYSICAL FUNCTION IN OLDER ADULTS WITH LOWER EXTREMITY OSTEOARTHRITIS (OA) WHO COULD NOT PARTICIPATE IN STANDING EXERCISE. DESIGN: TWO-ARM RANDOMIZED CONTROLLED TRIAL. SETTING: ONE HUD SENIOR HOUSING FACILITY AND ONE DAY SENIOR CENTER IN SOUTH FLORIDA. PARTICIPANTS: COMMUNITY-DWELLING OLDER ADULTS (N = 131) WERE RANDOMLY ASSIGNED TO CHAIR YOGA (N = 66) OR HEP (N = 65). THIRTEEN DROPPED AFTER ASSIGNMENT BUT PRIOR TO THE INTERVENTION; SIX DROPPED DURING THE INTERVENTION; 106 OF 112 COMPLETED AT LEAST 12 OF 16 SESSIONS (95% RETENTION RATE). INTERVENTIONS: PARTICIPANTS ATTENDED EITHER CHAIR YOGA OR HEP. BOTH INTERVENTIONS CONSISTED OF TWICE-WEEKLY 45-MINUTE SESSIONS FOR 8 WEEKS. MEASUREMENTS: PRIMARY: PAIN, PAIN INTERFERENCE; SECONDARY: BALANCE, GAIT SPEED, FATIGUE, FUNCTIONAL ABILITY MEASURED AT BASELINE, AFTER 4 WEEKS OF INTERVENTION, AT THE END OF THE 8-WEEK INTERVENTION, AND POST-INTERVENTION (1 AND 3 MONTHS). RESULTS: THE CHAIR YOGA GROUP SHOWED GREATER REDUCTION IN PAIN INTERFERENCE DURING THE INTERVENTION (P = .01), SUSTAINED THROUGH 3 MONTHS (P = .022). WOMAC PAIN (P = .048), GAIT SPEED (P = .024), AND FATIGUE (P = .037) WERE IMPROVED IN THE YOGA GROUP DURING THE INTERVENTION (P = .048) BUT IMPROVEMENTS WERE NOT SUSTAINED POST INTERVENTION. CHAIR YOGA HAD NO EFFECT ON BALANCE. CONCLUSION: AN 8-WEEK CHAIR YOGA PROGRAM WAS ASSOCIATED WITH REDUCTION IN PAIN, PAIN INTERFERENCE, AND FATIGUE, AND IMPROVEMENT IN GAIT SPEED, BUT ONLY THE EFFECTS ON PAIN INTERFERENCE WERE SUSTAINED 3 MONTHS POST INTERVENTION. CHAIR YOGA SHOULD BE FURTHER EXPLORED AS A NONPHARMACOLOGIC INTERVENTION FOR OLDER PEOPLE WITH OA IN THE LOWER EXTREMITIES. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT02113410. 2017 14 269 58 ADAPTED YOGA TO IMPROVE PHYSICAL FUNCTION AND HEALTH-RELATED QUALITY OF LIFE IN PHYSICALLY-INACTIVE OLDER ADULTS: A RANDOMISED CONTROLLED PILOT TRIAL. BACKGROUND: YOGA IS A HOLISTIC THERAPY OF EXPANDING POPULARITY, WHICH HAS THE POTENTIAL TO PRODUCE A RANGE OF PHYSICAL, MENTAL AND SOCIAL BENEFITS. THIS TRIAL EVALUATED THE FEASIBILITY AND EFFECTS OF AN ADAPTED YOGA PROGRAMME ON PHYSICAL FUNCTION AND HEALTH-RELATED QUALITY OF LIFE IN PHYSICALLY-INACTIVE OLDER ADULTS. METHODS: IN THIS RANDOMISED CONTROLLED PILOT TRIAL, 52 OLDER ADULTS (90% FEMALE; MEAN AGE 74.8 YEARS, SD 7.2) WERE RANDOMISED 1:1 TO A YOGA PROGRAMME OR WAIT-LIST CONTROL. THE YOGA GROUP (N = 25) RECEIVED A PHYSICAL ACTIVITY EDUCATION BOOKLET AND WERE INVITED TO ATTEND TEN YOGA SESSIONS DURING A 12-WEEK PERIOD. THE CONTROL GROUP (N = 27) RECEIVED THE EDUCATION BOOKLET ONLY. MEASURES OF PHYSICAL FUNCTION (E.G., SHORT PHYSICAL PERFORMANCE BATTERY; SPPB), HEALTH STATUS (EQ-5D) AND MENTAL WELL-BEING (WARWICK-EDINBURGH MENTAL WELL-BEING SCALE; WEMWBS) WERE ASSESSED AT BASELINE AND 3 MONTHS. FEASIBILITY WAS ASSESSED USING COURSE ATTENDANCE AND ADVERSE EVENT DATA, AND PARTICIPANT INTERVIEWS. RESULTS: FORTY-SEVEN PARTICIPANTS COMPLETED FOLLOW-UP ASSESSMENTS. MEDIAN CLASS ATTENDANCE WAS 8 (RANGE 3 TO 10). AT THE 3-MONTH FOLLOW-UP, THE YOGA GROUP HAD A HIGHER SPPB TOTAL SCORE COMPARED WITH THE CONTROL GROUP (MEAN DIFFERENCE 0.9, 95% CONFIDENCE INTERVAL [CI] -0.3 TO 2.0), A FASTER TIME TO RISE FROM A CHAIR FIVE TIMES (MEAN DIFFERENCE - 1.73 S, 95% CI -4.08 TO 0.62), AND BETTER PERFORMANCE ON THE CHAIR SIT-AND-REACH LOWER-LIMB FLEXIBILITY TEST (MEAN DIFFERENCE 5 CM, 95% CI 0 TO 10). THE YOGA GROUP ALSO HAD SUPERIOR HEALTH STATUS AND MENTAL WELL-BEING (VS. CONTROL) AT 3 MONTHS, WITH MEAN DIFFERENCES IN EQ-5D AND WEMWBS SCORES OF 0.12 (95% CI, 0.03 TO 0.21) AND 6 (95% CI, 1 TO 11), RESPECTIVELY. THE INTERVIEWS INDICATED THAT PARTICIPANTS VALUED ATTENDING THE YOGA PROGRAMME, AND THAT THEY EXPERIENCED A RANGE OF BENEFITS. CONCLUSIONS: THE ADAPTED YOGA PROGRAMME APPEARED TO BE FEASIBLE AND POTENTIALLY BENEFICIAL IN TERMS OF IMPROVING MENTAL AND SOCIAL WELL-BEING AND ASPECTS OF PHYSICAL FUNCTION IN PHYSICALLY-INACTIVE OLDER ADULTS. AN APPROPRIATELY-POWERED TRIAL IS REQUIRED TO CONFIRM THE FINDINGS OF THE PRESENT STUDY AND TO DETERMINE LONGER-TERM EFFECTS. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT02663726 . 2017 15 1133 50 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 16 2077 31 THE EFFECT OF CHAIR YOGA IN OLDER ADULTS WITH MODERATE AND SEVERE ALZHEIMER'S DISEASE. USING A QUASI-EXPERIMENTAL SINGLE-GROUP DESIGN, THIS STUDY EXAMINED THE FEASIBILITY OF OLDER ADULTS WITH ALZHEIMER'S DISEASE (AD)-TYPE DEMENTIA TO COMPLETE THE SIT 'N' FIT CHAIR YOGA PROGRAM. PHYSICAL FUNCTION OF PARTICIPANTS WHO COMPLETED THE PROGRAM WAS MEASURED. THE NINE OLDER ADULTS WITH AD (MEAN AGE = 83) PARTICIPATED IN THE 8-WEEK SIT 'N' FIT CHAIR YOGA PROGRAM. TO MEASURE PHYSICAL FUNCTION, THE SIX-MINUTE WALK TEST, THE GAIT SPEED TEST, AND THE BERG BALANCE SCALE WERE ADMINISTERED AT PRE-INTERVENTION, 4 WEEKS, 8 WEEKS, AND 1 MONTH AFTER PROGRAM COMPLETION. ALL PARTICIPANTS COMPLETED THE PROGRAM. POSITIVE CHANGES WERE SEEN ACROSS ALL PHYSICAL MEASURES. FURTHER STUDY, USING A LARGER SAMPLE AND INCLUDING A CONTROL GROUP, IS NEEDED TO FULLY DETERMINE THE EFFECT OF THE SIT 'N' FIT CHAIR YOGA PROGRAM ON OLDER ADULTS WITH MODERATE TO SEVERE AD. 2014 17 444 33 CHAIR YOGA: BENEFITS FOR COMMUNITY-DWELLING OLDER ADULTS WITH OSTEOARTHRITIS. THE AIM OF THIS PILOT STUDY WAS TO EXAMINE WHETHER CHAIR YOGA WAS EFFECTIVE IN REDUCING PAIN LEVEL AND IMPROVING PHYSICAL FUNCTION AND EMOTIONAL WELL-BEING IN A SAMPLE OF COMMUNITY-DWELLING OLDER ADULTS WITH OSTEOARTHRITIS. ONE-WAY REPEATED MEASURES ANALYSIS OF VARIANCE WAS PERFORMED TO EXAMINE THE EFFECTIVENESS OF CHAIR YOGA AT BASELINE, MIDPOINT (4 WEEKS), AND END OF THE INTERVENTION (8 WEEKS). ALTHOUGH CHAIR YOGA WAS EFFECTIVE IN IMPROVING PHYSICAL FUNCTION AND REDUCING STIFFNESS IN OLDER ADULTS WITH OSTEOARTHRITIS, IT WAS NOT EFFECTIVE IN REDUCING PAIN LEVEL OR IMPROVING DEPRESSIVE SYMPTOMS. FUTURE RESEARCH PLANNED BY THIS TEAM WILL USE RIGOROUS STUDY METHODS, INCLUDING LARGER SAMPLES, RANDOMIZED CONTROLLED TRIALS, AND FOLLOW UP FOR MONITORING HOME PRACTICE AFTER THE INTERVENTIONS. 2012 18 193 45 A RANDOMIZED TRIAL COMPARING YOGA, STRETCHING, AND A SELF-CARE BOOK FOR CHRONIC LOW BACK PAIN. BACKGROUND: CHRONIC LOW BACK PAIN IS A COMMON PROBLEM LACKING HIGHLY EFFECTIVE TREATMENT OPTIONS. SMALL TRIALS SUGGEST THAT YOGA MAY HAVE BENEFITS FOR THIS CONDITION. THIS TRIAL WAS DESIGNED TO DETERMINE WHETHER YOGA IS MORE EFFECTIVE THAN CONVENTIONAL STRETCHING EXERCISES OR A SELF-CARE BOOK FOR PRIMARY CARE PATIENTS WITH CHRONIC LOW BACK PAIN. METHODS: A TOTAL OF 228 ADULTS WITH CHRONIC LOW BACK PAIN WERE RANDOMIZED TO 12 WEEKLY CLASSES OF YOGA (92 PATIENTS) OR CONVENTIONAL STRETCHING EXERCISES (91 PATIENTS) OR A SELF-CARE BOOK (45 PATIENTS). BACK-RELATED FUNCTIONAL STATUS (MODIFIED ROLAND DISABILITY QUESTIONNAIRE, A 23-POINT SCALE) AND BOTHERSOMENESS OF PAIN (AN 11-POINT NUMERICAL SCALE) AT 12 WEEKS WERE THE PRIMARY OUTCOMES. OUTCOMES WERE ASSESSED AT BASELINE, 6, 12, AND 26 WEEKS BY INTERVIEWERS UNAWARE OF TREATMENT GROUP. RESULTS: AFTER ADJUSTMENT FOR BASELINE VALUES, 12-WEEK OUTCOMES FOR THE YOGA GROUP WERE SUPERIOR TO THOSE FOR THE SELF-CARE GROUP (MEAN DIFFERENCE FOR FUNCTION, -2.5 [95% CI, -3.7 TO -1.3]; P < .001; MEAN DIFFERENCE FOR SYMPTOMS, -1.1 [95% CI, -1.7 TO -0.4]; P < .001). AT 26 WEEKS, FUNCTION FOR THE YOGA GROUP REMAINED SUPERIOR (MEAN DIFFERENCE, -1.8 [95% CI, -3.1 TO -0.5]; P < .001). YOGA WAS NOT SUPERIOR TO CONVENTIONAL STRETCHING EXERCISES AT ANY TIME POINT. CONCLUSION: YOGA CLASSES WERE MORE EFFECTIVE THAN A SELF-CARE BOOK, BUT NOT MORE EFFECTIVE THAN STRETCHING CLASSES, IN IMPROVING FUNCTION AND REDUCING SYMPTOMS DUE TO CHRONIC LOW BACK PAIN, WITH BENEFITS LASTING AT LEAST SEVERAL MONTHS. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT00447668. 2011 19 521 50 COMPARING YOGA, EXERCISE, AND A SELF-CARE BOOK FOR CHRONIC LOW BACK PAIN: A RANDOMIZED, CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN IS A COMMON PROBLEM THAT HAS ONLY MODESTLY EFFECTIVE TREATMENT OPTIONS. OBJECTIVE: TO DETERMINE WHETHER YOGA IS MORE EFFECTIVE THAN CONVENTIONAL THERAPEUTIC EXERCISE OR A SELF-CARE BOOK FOR PATIENTS WITH CHRONIC LOW BACK PAIN. DESIGN: RANDOMIZED, CONTROLLED TRIAL. SETTING: A NONPROFIT, INTEGRATED HEALTH CARE SYSTEM. PATIENTS: 101 ADULTS WITH CHRONIC LOW BACK PAIN. INTERVENTION: 12-WEEK SESSIONS OF YOGA OR CONVENTIONAL THERAPEUTIC EXERCISE CLASSES OR A SELF-CARE BOOK. MEASUREMENTS: PRIMARY OUTCOMES WERE BACK-RELATED FUNCTIONAL STATUS (MODIFIED 24-POINT ROLAND DISABILITY SCALE) AND "BOTHERSOMENESS" OF PAIN (11-POINT NUMERICAL SCALE). THE PRIMARY TIME POINT WAS 12 WEEKS. CLINICALLY SIGNIFICANT CHANGE WAS CONSIDERED TO BE 2.5 POINTS ON THE FUNCTIONAL STATUS SCALE AND 1.5 POINTS ON THE BOTHERSOMENESS SCALE. SECONDARY OUTCOMES WERE DAYS OF RESTRICTED ACTIVITY, GENERAL HEALTH STATUS, AND MEDICATION USE. RESULTS: AFTER ADJUSTMENT FOR BASELINE VALUES, BACK-RELATED FUNCTION IN THE YOGA GROUP WAS SUPERIOR TO THE BOOK AND EXERCISE GROUPS AT 12 WEEKS (YOGA VS. BOOK: MEAN DIFFERENCE, -3.4 [95% CI, -5.1 TO - 1.6] [P < 0.001]; YOGA VS. EXERCISE: MEAN DIFFERENCE, -1.8 [CI, -3.5 TO - 0.1] [P = 0.034]). NO SIGNIFICANT DIFFERENCES IN SYMPTOM BOTHERSOMENESS WERE FOUND BETWEEN ANY 2 GROUPS AT 12 WEEKS; AT 26 WEEKS, THE YOGA GROUP WAS SUPERIOR TO THE BOOK GROUP WITH RESPECT TO THIS MEASURE (MEAN DIFFERENCE, -2.2 [CI, -3.2 TO - 1.2]; P < 0.001). AT 26 WEEKS, BACK-RELATED FUNCTION IN THE YOGA GROUP WAS SUPERIOR TO THE BOOK GROUP (MEAN DIFFERENCE, -3.6 [CI, -5.4 TO - 1.8]; P < 0.001). LIMITATIONS: PARTICIPANTS IN THIS STUDY WERE FOLLOWED FOR ONLY 26 WEEKS AFTER RANDOMIZATION. ONLY 1 INSTRUCTOR DELIVERED EACH INTERVENTION. CONCLUSIONS: YOGA WAS MORE EFFECTIVE THAN A SELF-CARE BOOK FOR IMPROVING FUNCTION AND REDUCING CHRONIC LOW BACK PAIN, AND THE BENEFITS PERSISTED FOR AT LEAST SEVERAL MONTHS. 2005 20 592 34 DEVELOPMENT AND EVALUATION OF A YOGA EXERCISE PROGRAMME FOR OLDER ADULTS. AIM: THIS STUDY REPORTS THE DEVELOPMENT AND EVALUATION OF A NEW YOGA EXERCISE PROGRAMME FOR OLDER ADULTS, CALLED THE SILVER YOGA PROGRAMME. BACKGROUND: YOGA PRACTICE IS ASSOCIATED WITH NUMEROUS HEALTH IMPROVEMENTS, INCLUDING REDUCED CARDIOVASCULAR RISK, BODY MASS INDEX AND BLOOD PRESSURE. YOGA IS ALSO ASSOCIATED WITH IMPROVED RESPIRATION, PSYCHOLOGICAL HEALTH AND PAIN MANAGEMENT. STUDIES HAVE SUGGESTED THE BENEFICIAL EFFECTS OF YOGA IN THE OLDER POPULATION. METHOD: THE STUDY WAS CONDUCTED IN 2005 AND IT HAD TWO PHASES. PHASE I CONSISTED OF SENDING A SURVEY TO 10 EXPERTS TO HELP DEVELOP THE SILVER YOGA PROGRAMME. A HARD COPY AND A VIDEO CONTAINING DETAILED DESCRIPTIONS AND DEMONSTRATIONS OF THE PROGRAMME WERE THEN SENT TO THE EXPERTS FOR REVIEW AND CRITIQUE REGARDING THE CLARITY AND FEASIBILITY OF THE YOGA POSTURES. PHASE II WAS AN ENQUIRY INTO OLDER ADULTS' VIEWS ON THE PROGRAMME USING A QUANTITATIVE EVALUATION AND SEMI-STRUCTURED QUALITATIVE INQUIRY. FOURTEEN WOMEN PARTICIPANTS FROM A SENIOR ACTIVITY CENTRE WERE INTERVIEWED INDIVIDUALLY AFTER 1 MONTH OF SILVER YOGA GROUP PRACTICE, THREE TIMES PER WEEK, 70 MINUTES PER SESSION. THEY WERE ASKED TO EVALUATE THE APPROPRIATENESS OF POSTURES BASED ON THE CRITERIA OF DIFFICULTY, ACCEPTABILITY, FEASIBILITY AND HELPFULNESS. FIVE OPEN-ENDED QUESTIONS ASKED PARTICIPANTS TO REFLECT ON THEIR YOGA EXPERIENCES. RESULTS: PARTICIPANTS' MEAN RATINGS OF THE ACCEPTABILITY, FEASIBILITY AND HELPFULNESS OF THE FOUR ASPECTS OF THE PROGRAMME (WARM-UP, HATHA YOGA, RELAXATION AND GUIDED-IMAGERY MEDITATION) RANGED FROM 8.8 +/- 1.9 TO 9.3 +/- 1.5; MEAN RATINGS OF THE DIFFICULTY OF THE PROGRAMME REVEALED THAT RELAXATION AND GUIDED-IMAGERY MEDITATION WERE FAIRLY EASY TO FOLLOW (0.1 +/- 0.3 AND 0.1 +/- 0.3 RESPECTIVELY), BUT THE POSTURES IN THE HATHA YOGA WERE RELATIVELY CHALLENGING (2.1 +/- 2.6). CONCLUSION: THE SILVER YOGA PROGRAMME SHOULD UNDERGO FURTHER PILOT-TESTING WITH LARGER SAMPLES OF OLDER ADULTS BEFORE IT IS TAKEN UP INTERNATIONALLY AS A HEALTH-PROMOTION ACTIVITY FOR OLDER ADULTS. 2007