1 74 142 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 2 73 84 A GROUP-BASED YOGA PROGRAM FOR URINARY INCONTINENCE IN AMBULATORY WOMEN: FEASIBILITY, TOLERABILITY, AND CHANGE IN INCONTINENCE FREQUENCY OVER 3 MONTHS IN A SINGLE-CENTER RANDOMIZED TRIAL. BACKGROUND: BECAUSE OF THE LIMITATIONS OF EXISTING CLINICAL TREATMENTS FOR URINARY INCONTINENCE, MANY WOMEN WITH INCONTINENCE ARE INTERESTED IN COMPLEMENTARY STRATEGIES FOR MANAGING THEIR SYMPTOMS. YOGA HAS BEEN RECOMMENDED AS A BEHAVIORAL SELF-MANAGEMENT STRATEGY FOR INCONTINENCE, BUT EVIDENCE OF ITS FEASIBILITY, TOLERABILITY, AND EFFICACY IS LACKING. OBJECTIVE: TO EVALUATE THE FEASIBILITY AND TOLERABILITY OF A GROUP-BASED THERAPEUTIC YOGA PROGRAM FOR AMBULATORY MIDDLE-AGED AND OLDER WOMEN WITH INCONTINENCE, AND TO EXAMINE PRELIMINARY CHANGES IN INCONTINENCE FREQUENCY AS THE PRIMARY EFFICACY OUTCOME AFTER 3 MONTHS. MATERIALS AND METHODS: AMBULATORY WOMEN AGED 50 YEARS OR OLDER WHO REPORTED AT LEAST DAILY STRESS-, URGENCY-, OR MIXED-TYPE INCONTINENCE, WERE NOT ALREADY ENGAGED IN YOGA, AND WERE WILLING TO TEMPORARILY FORGO CLINICAL INCONTINENCE TREATMENTS WERE RECRUITED INTO A RANDOMIZED TRIAL IN THE SAN FRANCISCO BAY AREA. WOMEN WERE RANDOMLY ASSIGNED TO TAKE PART IN A PROGRAM OF TWICE-WEEKLY GROUP CLASSES AND ONCE-WEEKLY HOME PRACTICE FOCUSED ON IYENGAR-BASED YOGA TECHNIQUES SELECTED BY AN EXPERT YOGA PANEL (YOGA GROUP), OR A NONSPECIFIC MUSCLE STRETCHING AND STRENGTHENING PROGRAM DESIGNED TO PROVIDE A RIGOROUS TIME-AND-ATTENTION CONTROL (CONTROL GROUP) FOR 3 MONTHS. ALL PARTICIPANTS ALSO RECEIVED WRITTEN, EVIDENCE-BASED INFORMATION ABOUT BEHAVIORAL INCONTINENCE SELF-MANAGEMENT TECHNIQUES (PELVIC FLOOR EXERCISES, BLADDER TRAINING) CONSISTENT WITH USUAL FIRST-LINE CARE. INCONTINENCE FREQUENCY AND TYPE WERE ASSESSED BY VALIDATED VOIDING DIARIES. ANALYSIS OF COVARIANCE MODELS EXAMINED WITHIN- AND BETWEEN-GROUP CHANGES IN INCONTINENCE FREQUENCY AS THE PRIMARY EFFICACY OUTCOME OVER 3 MONTHS. RESULTS: OF THE 56 WOMEN RANDOMIZED (28 TO YOGA, 28 TO CONTROL), THE MEAN AGE WAS 65.4 (+/-8.1) YEARS (RANGE, 55-83 YEARS), THE MEAN BASELINE INCONTINENCE FREQUENCY WAS 3.5 (+/-2.0) EPISODES/D, AND 37 WOMEN (66%) HAD URGENCY-PREDOMINANT INCONTINENCE. A TOTAL OF 50 WOMEN COMPLETED THEIR ASSIGNED 3-MONTH INTERVENTION PROGRAM (89%), INCLUDING 27 IN THE YOGA AND 23 IN THE CONTROL GROUP (P = .19). OF THOSE, 24 (89%) IN THE YOGA AND 20 (87%) IN THE CONTROL GROUP ATTENDED AT LEAST 80% OF GROUP CLASSES. OVER 3 MONTHS, TOTAL INCONTINENCE FREQUENCY DECREASED BY AN AVERAGE OF 76% FROM BASELINE IN THE YOGA AND 56% IN THE CONTROL GROUP (P = .07 FOR BETWEEN-GROUP DIFFERENCE). STRESS INCONTINENCE FREQUENCY ALSO DECREASED BY AN AVERAGE OF 61% IN THE YOGA GROUP AND 35% IN CONTROLS (P = .045 FOR BETWEEN-GROUP DIFFERENCE), BUT CHANGES IN URGENCY INCONTINENCE FREQUENCY DID NOT DIFFER SIGNIFICANTLY BETWEEN GROUPS. A TOTAL OF 48 NONSERIOUS ADVERSE EVENTS WERE REPORTED, INCLUDING 23 IN THE YOGA AND 25 IN THE CONTROL GROUP, BUT NONE WERE DIRECTLY ATTRIBUTABLE TO YOGA OR CONTROL PROGRAM PRACTICE. CONCLUSION: FINDINGS DEMONSTRATE THE FEASIBILITY OF RECRUITING AND RETAINING INCONTINENT WOMEN ACROSS THE AGING SPECTRUM INTO A THERAPEUTIC YOGA PROGRAM, AND PROVIDE PRELIMINARY EVIDENCE OF REDUCTION IN TOTAL AND STRESS-TYPE INCONTINENCE FREQUENCY AFTER 3 MONTHS OF YOGA PRACTICE. WHEN TAUGHT WITH ATTENTION TO WOMEN'S CLINICAL NEEDS, YOGA MAY OFFER A POTENTIAL COMMUNITY-BASED BEHAVIORAL SELF-MANAGEMENT STRATEGY FOR INCONTINENCE TO ENHANCE CLINICAL TREATMENT, ALTHOUGH FUTURE RESEARCH SHOULD ASSESS WHETHER YOGA OFFERS UNIQUE BENEFITS FOR INCONTINENCE ABOVE AND BEYOND OTHER PHYSICAL ACTIVITY-BASED INTERVENTIONS. 2019 3 1787 42 PREFERENCE AND EXPECTATION FOR TREATMENT ASSIGNMENT IN A RANDOMIZED CONTROLLED TRIAL OF ONCE- VS TWICE-WEEKLY YOGA FOR CHRONIC LOW BACK PAIN. BACKGROUND: IN STUDIES INVOLVING NONPHARMACOLOGICAL COMPLEMENTARY AND ALTERNATIVE MEDICINE INTERVENTIONS, PARTICIPANT BLINDING IS VERY DIFFICULT. PARTICIPANT EXPECTATIONS MAY AFFECT PERCEIVED BENEFIT OF THERAPY. IN STUDIES OF YOGA AS TREATMENT FOR CHRONIC LOW BACK PAIN, LITTLE IS KNOWN ABOUT THE RELATIONSHIP BETWEEN PATIENT EXPECTATIONS AND PREFERENCES ON OUTCOMES. THIS STUDY WAS DESIGNED TO IDENTIFY BASELINE PREDICTORS OF PREFERENCE AND TO DETERMINE IF EXPECTATIONS AND PREFERENCES FOR DIFFERENT DOSES OF YOGA AFFECT BACK-RELATED FUNCTION AND LOW BACK PAIN INTENSITY. METHODS: THIS WAS A SECONDARY DATA ANALYSIS OF A 12-WEEK RANDOMIZED CONTROLLED TRIAL COMPARING ONCE-WEEKLY VS TWICE-WEEKLY YOGA FOR TREATMENT OF CHRONIC LOW BACK PAIN IN 93 ADULTS FROM A PREDOMINANTLY LOW-INCOME MINORITY POPULATION. AT BASELINE, PARTICIPANTS WERE ASKED ABOUT BACK FUNCTION, BACK PAIN, TREATMENT EXPECTATIONS, AND TREATMENT PREFERENCES. WE CREATED A VARIABLE "CONCORDANCE" TO DESCRIBE THE MATCHING OF PARTICIPANT PREFERENCE TO RANDOMIZED TREATMENT. OUR OUTCOME VARIABLES WERE CHANGE IN BACK FUNCTION AND PAIN INTENSITY AFTER 12 WEEKS OF YOGA INSTRUCTION. WE PERFORMED LOGISTIC REGRESSION TO IDENTIFY PREDICTORS OF PREFERENCE FOR ONCE- OR TWICE-WEEKLY YOGA INSTRUCTION. WE CREATED LINEAR REGRESSION MODELS TO IDENTIFY INDEPENDENT ASSOCIATIONS BETWEEN EXPECTATIONS, PREFERENCE, CONCORDANCE, AND OUTCOMES. RESULTS: WORSE BACK FUNCTION AT BASELINE WAS ASSOCIATED WITH 20% HIGHER ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 1.2, CI 1.1, 1.3). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR TWICE-WEEKLY YOGA HAD 90% HIGHER ODDS OF PREFERRING TWICE-WEEKLY VS ONCE-WEEKLY YOGA (OR 1.9, CI 1.3, 2.7). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR ONCE-WEEKLY YOGA HAD 40% LESS ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 0.6, CI 0.5, 0.9). AFTER CONTROLLING FOR BASELINE CHARACTERISTICS, WE FOUND NO STATISTICALLY SIGNIFICANT RELATIONSHIP BETWEEN TREATMENT OUTCOMES, PREFERENCE, EXPECTATION SCORES, OR CONCORDANCE. CONCLUSION: IN A POPULATION OF PREDOMINANTLY LOW-INCOME MINORITY PARTICIPANTS WITH CHRONIC LOW BACK PAIN, WORSE BACK FUNCTION WAS ASSOCIATED WITH PREFERENCE FOR MORE FREQUENT YOGA CLASSES. THOSE WHO PREFERRED MORE YOGA CLASSES HAD HIGHER EXPECTATIONS FOR THOSE CLASSES. TWELVE-WEEK CHANGE IN BACK PAIN INTENSITY AND BACK FUNCTION WERE NOT AFFECTED BY DOSING PREFERENCE, EXPECTATION SCORE, OR CONCORDANCE. MORE RESEARCH IS NEEDED TO BETTER MEASURE AND QUANTIFY PREFERENCE, EXPECTATIONS, AND THEIR RELATIONSHIP TO OUTCOMES IN YOGA RESEARCH. 2015 4 2811 44 YOGA TO PREVENT MOBILITY LIMITATIONS IN OLDER ADULTS: FEASIBILITY OF A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: THE LOSS OF MOBILITY DURING AGING IMPACTS INDEPENDENCE AND LEADS TO FURTHER DISABILITY, MORBIDITY, AND REDUCED LIFE EXPECTANCY. OUR OBJECTIVE WAS TO EXAMINE THE FEASIBILITY AND SAFETY OF CONDUCTING A RANDOMIZED CONTROLLED TRIAL OF YOGA FOR OLDER ADULTS AT RISK FOR MOBILITY LIMITATIONS. METHODS: SEDENTARY OLDER ADULTS (N = 46; AGE 60-89) WERE RECRUITED AND RANDOMIZED TO EITHER YOGA OR A HEALTH EDUCATION COMPARISON GROUP. YOGA SESSIONS (60-MIN) OCCURRED 2X WEEKLY, AND 90-MIN HEALTH EDUCATION SESSIONS OCCURRED WEEKLY, FOR 10 WEEKS. THE PRIMARY OUTCOMES WERE RECRUITMENT RATE, INTERVENTION ATTENDANCE, AND RETENTION AT ASSESSMENTS. ADVERSE EVENT RATES AND PARTICIPANT SATISFACTION WERE ALSO MEASURED. PHYSICAL PERFORMANCE MEASURES OF GAIT, BALANCE, AND STRENGTH AND SELF-REPORT OUTCOME MEASURES WERE ADMINISTERED AT BASELINE AND 10-WEEKS. RESULTS: RECRUITMENT LASTED 6 MONTHS. RETENTION OF PARTICIPANTS AT THE 10-WEEK FOLLOW-UP WAS HIGH (89% - PERFORMANCE MEASURES; 98% - SELF-REPORT QUESTIONNAIRES). ATTENDANCE WAS GOOD WITH 82% OF YOGA AND 74% OF HEALTH EDUCATION PARTICIPANTS ATTENDING AT LEAST 50% OF THE SESSIONS. NO SERIOUS ADVERSE EVENTS WERE REPORTED. PATIENT SATISFACTION WITH THE INTERVENTIONS WAS HIGH. THE MEAN EFFECT SIZE FOR THE PHYSICAL PERFORMANCE MEASURES WAS 0.35 WITH SOME OVER 0.50. THE MEAN EFFECT SIZE FOR SELF-REPORT OUTCOME MEASURES WAS 0.36. CONCLUSIONS: RESULTS INDICATE THAT IT IS FEASIBLE TO CONDUCT A LARGER RCT OF YOGA FOR SEDENTARY OLDER ADULTS AT RISK FOR MOBILITY PROBLEMS. THE YOGA AND COMPARISON INTERVENTIONS WERE SAFE, WELL ACCEPTED, AND WELL ATTENDED. EFFECT SIZES SUGGEST YOGA MAY HAVE IMPORTANT BENEFITS FOR THIS POPULATION AND SHOULD BE STUDIED FURTHER. TRIAL REGISTRATION: CLINICALTRIALS # NCT03544879 ; RETROSPECTIVELY REGISTERED 4 JUNE, 2018. 2018 5 282 44 ADHERENCE TO YOGA AND EXERCISE INTERVENTIONS IN A 6-MONTH CLINICAL TRIAL. BACKGROUND: TO DETERMINE FACTORS THAT PREDICT ADHERENCE TO A MIND-BODY INTERVENTION IN A RANDOMIZED TRIAL. DESIGN: WE ANALYZED ADHERENCE DATA FROM A 3-ARM TRIAL INVOLVING 135 GENERALLY HEALTHY SENIORS 65-85 YEARS OF AGE RANDOMIZED TO A 6-MONTH INTERVENTION CONSISTING OF: AN IYENGAR YOGA CLASS WITH HOME PRACTICE, AN EXERCISE CLASS WITH HOME PRACTICE, OR A WAIT-LIST CONTROL GROUP. OUTCOME MEASURES INCLUDED COGNITIVE FUNCTION, MOOD, FATIGUE, ANXIETY, HEALTH-RELATED QUALITY OF LIFE, AND PHYSICAL MEASURES. ADHERENCE TO THE INTERVENTION WAS OBTAINED BY CLASS ATTENDANCE AND BIWEEKLY HOME PRACTICE LOGS. RESULTS: THE DROP-OUT RATE WAS 13%. AMONG THE COMPLETERS OF THE TWO ACTIVE INTERVENTIONS, AVERAGE YOGA CLASS ATTENDANCE WAS 77% AND HOME PRACTICE OCCURRED 64% OF ALL DAYS. AVERAGE EXERCISE CLASS ATTENDANCE WAS 69% AND HOME EXERCISE OCCURRED 54% OF ALL DAYS. THERE WERE NO CLEAR EFFECTS OF ADHERENCE ON THE SIGNIFICANT STUDY OUTCOMES (QUALITY OF LIFE AND PHYSICAL MEASURES). CLASS ATTENDANCE WAS SIGNIFICANTLY CORRELATED WITH BASELINE MEASURES OF DEPRESSION, FATIGUE, AND PHYSICAL COMPONENTS OF HEALTH-RELATED QUALITY OF LIFE. SIGNIFICANT DIFFERENCES IN BASELINE MEASURES WERE ALSO FOUND BETWEEN STUDY COMPLETERS AND DROP-OUTS IN THE ACTIVE INTERVENTIONS. ADHERENCE WAS NOT RELATED TO AGE, GENDER, OR EDUCATION LEVEL. CONCLUSION: HEALTHY SENIORS HAVE GOOD ATTENDANCE AT CLASSES WITH A PHYSICALLY ACTIVE INTERVENTION. HOME PRACTICE TAKES PLACE OVER HALF OF THE TIME. DECREASED ADHERENCE TO A POTENTIALLY BENEFICIAL INTERVENTION HAS THE POTENTIAL TO DECREASE THE EFFECT OF THE INTERVENTION IN A CLINICAL TRIAL BECAUSE SUBJECTS WHO MIGHT SUSTAIN THE GREATEST BENEFIT WILL RECEIVE A LOWER DOSE OF THE INTERVENTION AND SUBJECTS WITH HIGHER ADHERENCE RATES MAY BE FUNCTIONING CLOSER TO MAXIMUM ABILITY BEFORE THE INTERVENTION. STRATEGIES TO MAXIMIZE ADHERENCE AMONG SUBJECTS AT GREATER RISK FOR LOW ADHERENCE WILL BE IMPORTANT FOR FUTURE TRIALS, ESPECIALLY COMPLEMENTARY TREATMENTS REQUIRING GREATER EFFORT THAN SIMPLE PILL-TAKING. 2007 6 312 49 AN EXPLORATORY RANDOMIZED CONTROLLED TRIAL OF A 12-WEEK YOGA VERSUS EDUCATIONAL FILM PROGRAM FOR THE MANAGEMENT OF RESTLESS LEGS SYNDROME: FEASIBILITY AND ACCEPTABILITY. OBJECTIVES: THE PRIMARY OBJECTIVES OF THIS PILOT TRIAL WERE TO ASSESS THE STUDY FEASIBILITY AND ACCEPTABILITY OF THE 12-WEEK YOGA AND EDUCATIONAL FILM PROGRAMS FOR THE MANAGEMENT OF RESTLESS LEGS SYNDROME (RLS) IN PREPARATION FOR A FUTURE RANDOMIZED CONTROLLED TRIAL (RCT). MATERIALS AND METHODS: THIS PILOT, PARALLEL-ARM, RANDOMIZED FEASIBILITY TRIAL WAS CONDUCTED AT TWO SITES, MORGANTOWN, WV AND COLUMBUS, OH. YOGA GROUP PARTICIPANTS ATTENDED 75-MIN IYENGAR YOGA CLASSES, TWICE WEEKLY FOR 4 WEEKS, THEN ONCE A WEEK FOR 8 WEEKS (16 TOTAL CLASSES), AND COMPLETED A 30-MIN HOMEWORK ROUTINE ON NONCLASS DAYS. EDUCATIONAL FILM GROUP PARTICIPANTS ATTENDED ONCE WEEKLY, 75-MIN CLASSES (12 TOTAL CLASSES), WHICH INCLUDED INFORMATION ON RLS AND OTHER SLEEP DISORDERS, RLS MANAGEMENT INCLUDING SLEEP HYGIENE PRACTICES, AND COMPLEMENTARY THERAPIES. FEASIBILITY AND ACCEPTABILITY OUTCOMES INCLUDED PROGRAM SATISFACTION AND RECRUITMENT, RETENTION, AND ADHERENCE RATES. IN ADDITION, PARTICIPANTS WERE ASKED THEIR PREFERENCES REGARDING THREE YOGA CLASS SCHEDULE SCENARIOS FOR A FUTURE STUDY. ATTENDANCE, YOGA, AND TREATMENT LOGS WERE COLLECTED WEEKLY. PROGRAM EVALUATION AND YOGA SCHEDULING QUESTIONNAIRES WERE COLLECTED AT WEEK 12. RESULTS: FORTY-ONE ADULTS WITH MODERATE TO SEVERE RLS WERE RANDOMIZED TO A 12-WEEK YOGA (N = 19) OR EDUCATIONAL FILM (N = 22) PROGRAM. THIRTY PARTICIPANTS (73%) COMPLETED THE PROGRAM. YOGA AND EDUCATION GROUP PARTICIPANTS ATTENDED AN AVERAGE OF 13.0 +/- 0.84 (81%) AND 10.3 +/- 0.3 CLASSES (85%), RESPECTIVELY. PARTICIPANTS FROM BOTH GROUPS INDICATED SATISFACTION WITH THE STUDY. ALL YOGA GROUP RESPONDENTS TO THE PROGRAM EVALUATION REPORTED THEY WOULD LIKELY (N = 6) OR VERY LIKELY (N = 7) CONTINUE YOGA PRACTICE; 86.7% OF EDUCATION GROUP RESPONDENTS (13 OF 15) INDICATED THAT THEY WERE LIKELY (N = 7) OR VERY LIKELY (N = 6) TO MAKE LASTING CHANGES BASED ON WHAT THEY HAD LEARNED. THE PREFERRED SCHEDULE FOR A FUTURE STUDY WAS A 16-WEEK STUDY WITH ONCE-WEEKLY YOGA CLASSES. CONCLUSIONS: THE FINDINGS OF THIS STUDY SUGGEST THAT A LARGER RCT COMPARING YOGA WITH AN EDUCATIONAL FILM GROUP FOR THE MANAGEMENT OF RLS IS FEASIBLE. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT03570515; 02/01/2017. 2022 7 162 52 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 8 2628 43 YOGA FOR THE MANAGEMENT OF PAIN AND SLEEP IN RHEUMATOID ARTHRITIS: A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THE AIM OF THE PRESENT STUDY WAS TO DETERMINE THE FEASIBILITY OF A RELAXATION-BASED YOGA INTERVENTION FOR RHEUMATOID ARTHRITIS, DESIGNED AND REPORTED IN ACCORDANCE WITH DELPHI RECOMMENDATIONS FOR YOGA INTERVENTIONS FOR MUSCULOSKELETAL CONDITIONS. METHODS: PARTICIPANTS WERE RECRUITED FROM A HOSPITAL DATABASE, AND RANDOMIZED TO EITHER EIGHT WEEKLY 75-MIN YOGA CLASSES OR A USUAL CARE CONTROL. FEASIBILITY WAS DETERMINED BY RECRUITMENT RATES, RETENTION, PROTOCOL ADHERENCE, PARTICIPANT SATISFACTION AND ADVERSE EVENTS. SECONDARY PHYSICAL AND PSYCHOSOCIAL OUTCOMES WERE ASSESSED USING SELF-REPORTED QUESTIONNAIRES AT BASELINE (WEEK 0), WEEK 9 (PRIMARY TIME POINT) AND WEEK 12 (FOLLOW-UP). RESULTS: OVER A 3-MONTH PERIOD, 26 PARTICIPANTS WITH MILD PAIN, MILD TO MODERATE FUNCTIONAL DISABILITY AND MODERATE DISEASE ACTIVITY WERE RECRUITED INTO THE STUDY (25% RECRUITMENT RATE). RETENTION RATES WERE 100% FOR YOGA PARTICIPANTS AND 92% FOR USUAL CARE PARTICIPANTS AT BOTH WEEKS 9 AND 12. PROTOCOL ADHERENCE AND PARTICIPANT SATISFACTION WERE HIGH. YOGA PARTICIPANTS ATTENDED A MEDIAN OF SEVEN CLASSES; ADDITIONALLY, SEVEN OF THE YOGA PARTICIPANTS (54%) REPORTED CONTINUING YOGA AT HOME DURING THE FOLLOW-UP PERIOD. NO SERIOUS ADVERSE EVENTS WERE RELATED TO THE STUDY. SECONDARY OUTCOMES SHOWED NO GROUP EFFECTS OF YOGA COMPARED WITH USUAL CARE. CONCLUSIONS: A RELAXATION-BASED YOGA PROGRAMME WAS FOUND TO BE FEASIBLE AND SAFE FOR PARTICIPANTS WITH RHEUMATOID ARTHRITIS-RELATED PAIN AND FUNCTIONAL DISABILITY. ADVERSE EVENTS WERE MINOR, AND NOT UNEXPECTED FROM AN INTERVENTION INCLUDING PHYSICAL COMPONENTS. THIS PILOT PROVIDES A FRAMEWORK FOR LARGER INTERVENTION STUDIES, AND SUPPORTS FURTHER EXPLORATION OF YOGA AS A COMPLEX INTERVENTION TO ASSIST WITH THE MANAGEMENT OF RHEUMATOID ARTHRITIS. 2018 9 1240 41 FEASIBILITY OF A MINDFUL YOGA PROGRAM FOR WOMEN WITH METASTATIC BREAST CANCER: RESULTS OF A RANDOMIZED PILOT STUDY. PURPOSE: PATIENTS WITH METASTATIC BREAST CANCER (MBC) EXPERIENCE HIGH LEVELS OF SYMPTOMS. YOGA INTERVENTIONS HAVE SHOWN PROMISE FOR IMPROVING CANCER SYMPTOMS BUT HAVE RARELY BEEN TESTED IN PATIENTS WITH ADVANCED DISEASE. THIS STUDY EXAMINED THE ACCEPTABILITY OF A COMPREHENSIVE YOGA PROGRAM FOR MBC AND THE FEASIBILITY OF CONDUCTING A RANDOMIZED TRIAL TESTING THE INTERVENTION. METHODS: SIXTY-THREE WOMEN WITH MBC WERE RANDOMIZED WITH A 2:1 ALLOCATION TO YOGA OR A SUPPORT GROUP COMPARISON CONDITION. BOTH INTERVENTIONS INVOLVED EIGHT WEEKLY GROUP SESSIONS. FEASIBILITY WAS QUANTIFIED USING RATES OF ACCRUAL, ATTRITION, AND SESSION ATTENDANCE. ACCEPTABILITY WAS ASSESSED WITH A STANDARDIZED SELF-REPORT MEASURE. PAIN, FATIGUE, SLEEP QUALITY, PSYCHOLOGICAL DISTRESS, MINDFULNESS, AND FUNCTIONAL CAPACITY WERE ASSESSED AT BASELINE, POST-INTERVENTION, AND 3 AND 6 MONTHS POST-INTERVENTION. RESULTS: WE MET GOALS FOR ACCRUAL AND RETENTION, WITH 50% OF ELIGIBLE PATIENTS ENROLLED AND 87% OF RANDOMIZED PARTICIPANTS COMPLETING POST-INTERVENTION SURVEYS. SIXTY-FIVE PERCENT OF WOMEN IN THE YOGA CONDITION AND 90% IN THE SUPPORT GROUP ATTENDED >/= 4 SESSIONS. EIGHTY PERCENT OF PARTICIPANTS IN THE YOGA CONDITION AND 65% IN THE SUPPORT GROUP INDICATED THAT THEY WERE HIGHLY SATISFIED WITH THE INTERVENTION. FOLLOWING TREATMENT, WOMEN IN THE YOGA INTERVENTION HAD MODEST IMPROVEMENTS IN SOME OUTCOMES; HOWEVER, OVERALL SYMPTOM LEVELS WERE LOW FOR WOMEN IN BOTH CONDITIONS. CONCLUSIONS: FINDINGS SUGGEST THAT THE YOGA INTERVENTION CONTENT WAS HIGHLY ACCEPTABLE TO PATIENTS WITH MBC, BUT THAT THERE ARE CHALLENGES TO IMPLEMENTING AN INTERVENTION INVOLVING EIGHT GROUP-BASED IN-PERSON SESSIONS. ALTERNATIVE MODES OF DELIVERY MAY BE NECESSARY TO REACH PATIENTS MOST IN NEED OF INTERVENTION. 2019 10 71 34 A FEASIBILITY STUDY OF RESTORATIVE YOGA VERSUS VIGOROUS YOGA INTERVENTION FOR SEDENTARY BREAST AND OVARIAN CANCER SURVIVORS. YOGA HAS BEEN SHOWN TO IMPROVE CANCER SURVIVORS' QUALITY OF LIFE, YET REGULAR YOGA PRACTICE IS A CHALLENGE FOR THOSE WHO ARE SEDENTARY. WE CONDUCTED A PILOT RANDOMIZED CONTROLLED STUDY TO ASSESS FEASIBILITY AND ADHERENCE OF TWO TYPES OF YOGA INTERVENTION AMONG SEDENTARY CANCER SURVIVORS. SEDENTARY BREAST AND OVARIAN CANCER SURVIVORS WERE RANDOMIZED TO PRACTICE EITHER RESTORATIVE YOGA (MINIMAL PHYSICAL EXERTION, GROUP R) OR VIGOROUS YOGA (CONSIDERABLE PHYSICAL EXERTION, GROUP V) IN THREE 60-MINUTE SUPERVISED SESSIONS A WEEK FOR 12 WEEKS, FOLLOWED BY 12 WEEKS OF HOME PRACTICE. ACCRUAL, ADHERENCE, AND ATTENDANCE RATES WERE ASSESSED. OF THE 226 ELIGIBLE PATIENTS, 175 (77%) DECLINED TO PARTICIPATE IN THE STUDY, CITING TIME COMMITMENT AND TRAVEL AS THE MOST COMMON BARRIERS. FORTY-TWO SUBJECTS CONSENTED TO PARTICIPATE IN THE STUDY. OF THE 35 PARTICIPANTS WHO BEGAN THE INTERVENTION (20 IN GROUP R AND 15 IN GROUP V), ADHERENCE RATE (PERCENTAGE REMAINING IN THE STUDY AT WEEK 12) WAS 100% AND 87%, RESPECTIVELY. RATE OF ADEQUATE ATTENDANCE (MORE THAN 66% OF THE SCHEDULED SUPERVISED SESSIONS) WAS 85% AND 73%, RESPECTIVELY. RATE OF COMPLETION OF THE HOME PRACTICE PERIOD WAS 85% AND 77%, RESPECTIVELY. IN THIS STUDY, SEDENTARY CANCER SURVIVORS WERE ABLE TO ADHERE TO A LONG-TERM, REGULAR YOGA REGIMEN. THE RATE OF ADEQUATE ATTENDANCE WAS HIGHER FOR RESTORATIVE YOGA. FUTURE STUDIES FOR SEDENTARY PATIENTS SHOULD FOCUS ON REDUCING TIME COMMITMENT AND TRAVEL REQUIREMENTS TO IMPROVE RECRUITMENT, AND ON USING RESTORATIVE YOGA AS A MORE FEASIBLE INTERVENTION FOR THIS POPULATION. 2018 11 2060 42 THE BENEFITS OF YOGA FOR WOMEN VETERANS WITH CHRONIC LOW BACK PAIN. OBJECTIVES: CHRONIC LOW BACK (CLBP) PAIN IS PREVALENT AMONG MILITARY VETERANS AND OFTEN LEADS TO FUNCTIONAL LIMITATIONS, PSYCHOLOGIC SYMPTOMS, LOWER QUALITY OF LIFE, AND HIGHER HEALTH CARE COSTS. AN INCREASING PROPORTION OF U.S. VETERANS ARE WOMEN, AND WOMEN VETERANS MAY HAVE DIFFERENT HEALTH CARE NEEDS THAN MEN VETERANS. THE PURPOSE OF THIS STUDY WAS TO ASSESS THE IMPACT OF A YOGA INTERVENTION ON WOMEN AND MEN WITH CLBP. SUBJECTS/SETTING/INTERVENTION: VA PATIENTS WITH CLBP WERE REFERRED BY PRIMARY CARE PROVIDERS TO A CLINICAL YOGA PROGRAM. DESIGN: RESEARCH PARTICIPANTS COMPLETED A BRIEF BATTERY OF QUESTIONNAIRES BEFORE THEIR FIRST YOGA CLASS AND AGAIN 10 WEEKS LATER IN A SINGLE-GROUP, PRE-POST STUDY DESIGN. OUTCOME MEASURES: QUESTIONNAIRES INCLUDED MEASURES OF PAIN (PAIN SEVERITY SCALE), DEPRESSION (CESD-10), ENERGY/FATIGUE, AND HEALTH-RELATED QUALITY OF LIFE (SF-12). YOGA ATTENDANCE AND HOME PRACTICE OF YOGA WERE ALSO MEASURED. REPEATED-MEASURES ANALYSIS OF VARIANCE WAS USED TO ANALYZE GROUP DIFFERENCES OVER TIME WHILE CONTROLLING FOR BASELINE DIFFERENCES. RESULTS: THE 53 PARTICIPANTS WHO COMPLETED BOTH ASSESSMENTS HAD A MEAN AGE OF 53 YEARS, AND WERE WELL EDUCATED, 41% NONWHITE, 49% MARRIED, AND HAD VARYING EMPLOYMENT STATUS. WOMEN PARTICIPANTS HAD SIGNIFICANTLY LARGER DECREASES IN DEPRESSION (P=0.046) AND PAIN "ON AVERAGE" (P=0.050), AND LARGER INCREASES IN ENERGY (P=0.034) AND SF-12 MENTAL HEALTH (P=0.044) THAN MEN WHO PARTICIPATED. THE GROUPS DID NOT DIFFER SIGNIFICANTLY ON YOGA ATTENDANCE OR HOME PRACTICE OF YOGA. CONCLUSIONS: THESE RESULTS SUGGEST THAT WOMEN VETERANS MAY BENEFIT MORE THAN MEN VETERANS FROM YOGA INTERVENTIONS FOR CHRONIC BACK PAIN. CONCLUSIONS ARE TENTATIVE BECAUSE OF THE SMALL SAMPLE SIZE AND QUASI-EXPERIMENTAL STUDY DESIGN. A MORE RIGOROUS STUDY IS BEING DESIGNED TO ANSWER THESE RESEARCH QUESTIONS MORE DEFINITIVELY. 2012 12 2553 34 YOGA FOR CHILDREN AND ADOLESCENTS AFTER COMPLETING CANCER TREATMENT. SURVIVORS OF CHILDHOOD CANCER MAY EXPERIENCE PERSISTENT SYMPTOMS, INCLUDING FATIGUE, SLEEP DISTURBANCE, AND BALANCE IMPAIRMENT. YOGA IS A COMPLEMENTARY THERAPY THAT IMPROVES FATIGUE, SLEEP, AND QUALITY OF LIFE IN ADULT CANCER SURVIVORS. USING A ONE GROUP, REPEATED MEASURES DESIGN, WE EVALUATED THE FEASIBILITY OF A YOGA PROGRAM AND ASSESSED IF CANCER SURVIVOR PARTICIPANTS AGES 10 TO 17 YEARS (N = 13) HAD SIGNIFICANTLY LESS FATIGUE AND ANXIETY, AND BETTER BALANCE AND SLEEP, AFTER A 6-WEEK YOGA INTERVENTION COMPARED WITH A 6-WEEK PRE-INTERVENTION WAIT PERIOD. STUDY RECRUITMENT WAS CHALLENGING WITH A 32% ENROLLMENT RATE; YOGA ATTENDANCE WAS 90%. NONE OF THE SCORES FOR ANXIETY, FATIGUE, SLEEP, AND BALANCE HAD SIGNIFICANT CHANGES DURING THE WAIT PERIOD. AFTER THE 6-WEEK YOGA PROGRAM, CHILDREN (N = 7) HAD A SIGNIFICANT DECREASE IN ANXIETY SCORE (P = .04) WHILE ADOLESCENT SCORES (N = 7) SHOWED A DECREASING TREND (P = .10). SCORES FOR FATIGUE, SLEEP, AND BALANCE REMAINED STABLE POST-INTERVENTION. FATIGUE AND BALANCE SCORES WERE BELOW NORMS FOR HEALTH CHILDREN/ADOLESCENTS WHILE SLEEP AND ANXIETY SCORES WERE SIMILAR TO HEALTHY PEERS. 2016 13 2558 49 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 14 2323 44 TREATMENT OF CHRONIC PRIMARY SLEEP ONSET INSOMNIA WITH KUNDALINI YOGA: A RANDOMIZED CONTROLLED TRIAL WITH ACTIVE SLEEP HYGIENE COMPARISON. STUDY OBJECTIVES: PRIOR STUDIES HAVE SUGGESTED A BENEFIT OF YOGA FOR ALLEVIATING SLEEP DISTURBANCE; HOWEVER, MANY STUDIES HAVE HAD METHODOLOGICAL LIMITATIONS. THIS TRIAL STUDY AIMED TO EXTEND THAT LITERATURE BY INCLUDING AN ACTIVE SLEEP HYGIENE COMPARISON. METHODS: PARTICIPANTS AGED 25-59 YEARS WITH A PRIMARY COMPLAINT OF SLEEP ONSET INSOMNIA LASTING AT LEAST 6 MONTHS WERE BLOCK RANDOMIZED TO AN 8-WEEK KUNDALINI YOGA OR SLEEP HYGIENE INTERVENTION, BOTH CONSISTING OF INITIAL 60-MINUTE INSTRUCTION AND WEEKLY CHECK-INS. DAILY SLEEP DIARIES AND QUESTIONNAIRES WERE COLLECTED AT BASELINE, THROUGHOUT THE INTERVENTION, AND AT 6-MONTH FOLLOW-UP. DATA WERE ANALYZED USING LINEAR MIXED MODELS (N = 20 IN EACH GROUP). RESULTS: PARTICIPANT RATINGS OF THE INTERVENTIONS DID NOT SIGNIFICANTLY DIFFER. SLEEP HYGIENE IMPROVED SEVERAL DIARY AND QUESTIONNAIRE OUTCOMES, HOWEVER, YOGA RESULTED IN EVEN GREATER IMPROVEMENTS CORRESPONDING TO MEDIUM-TO-LARGE BETWEEN-GROUP EFFECT SIZES. TOTAL SLEEP TIME INCREASED PROGRESSIVELY ACROSS YOGA TREATMENT (D = 0.95, P = .002), CONCURRENT WITH INCREASED SLEEP EFFICIENCY (D = 1.36, P < .001) AND DECREASED SLEEP ONSET LATENCY (D = -1.16, P < .001), BUT WITHOUT CHANGES IN PRE-SLEEP AROUSAL (D =-0.30, P = .59). REMISSION RATES WERE ALSO HIGHER FOR YOGA COMPARED TO SLEEP HYGIENE, WITH >/= 80% OF YOGA PARTICIPANTS REPORTING AVERAGE SLEEP ONSET LATENCY < 30 MINUTES AND SLEEP EFFICIENCY > 80% AT 6-MONTH FOLLOW-UP. FOR OVER 50% OF YOGA PARTICIPANTS, THE INSOMNIA SEVERITY INDEX DECREASED BY AT LEAST 8 POINTS AT END OF TREATMENT AND FOLLOW-UP. CONCLUSIONS: YOGA, TAUGHT IN A SELF-CARE FRAMEWORK WITH MINIMAL INSTRUCTOR BURDEN, WAS ASSOCIATED WITH SELF-REPORTED IMPROVEMENTS ABOVE AND BEYOND AN ACTIVE SLEEP HYGIENE COMPARISON, SUSTAINED AT 6-MONTH FOLLOW-UP. FOLLOW-UP STUDIES ARE NEEDED TO ASSESS ACTIGRAPHY AND POLYSOMNOGRAPHY OUTCOMES, AS WELL AS POSSIBLE MECHANISMS OF CHANGE. CLINICAL TRIAL REGISTRATION: REGISTRY: CLINICALTRIALS.GOV; NAME: YOGA AS A TREATMENT FOR INSOMNIA; URL: HTTPS://CLINICALTRIALS.GOV/CT2/SHOW/NCT00033865; IDENTIFIER: NCT00033865. CITATION: KHALSA SBS, GOLDSTEIN MR. TREATMENT OF CHRONIC PRIMARY SLEEP ONSET INSOMNIA WITH KUNDALINI YOGA: A RANDOMIZED CONTROLLED TRIAL WITH ACTIVE SLEEP HYGIENE COMPARISON. J CLIN SLEEP MED. 2021;17(9):1841-1852. 2021 15 201 43 A RESTORATIVE YOGA INTERVENTION FOR AFRICAN-AMERICAN BREAST CANCER SURVIVORS: A PILOT STUDY. BACKGROUND: DATA SHOW THAT YOGA IS EFFECTIVE FOR IMPROVING HEALTH-RELATED OUTCOMES IN BREAST CANCER SURVIVORS. WHILE BREAST CANCER IS THE MOST COMMONLY DIAGNOSED CANCER AMONG AFRICAN-AMERICAN WOMEN (AAW), AAW ARE LESS LIKELY TO ENGAGE IN YOGA COMPARED TO OTHER ETHNIC GROUPS. THE GOALS OF THE CURRENT STUDY WERE TO ASSESS THE FEASIBILITY OF AN 8-WEEK RESTORATIVE YOGA PROGRAM AMONG AFRICAN-AMERICAN BREAST CANCER SURVIVORS (AA BCS). SPECIFICALLY, STUDY AIMS WERE TO (1) MEASURE CHANGES IN STUDY OUTCOMES IN A RESTORATIVE YOGA (RY) GROUP COMPARED TO A WAIT LIST CONTROL GROUP, (2) ASSESS ADHERENCE TO THE RY PROGRAM, AND (3) ASSESS PROGRAM SATISFACTION AMONG STUDY PARTICIPANTS. METHODS: THIRTY-THREE AA BCS WERE RANDOMLY ASSIGNED TO EITHER THE RY INTERVENTION (N = 18) OR WAIT LIST CONTROL GROUP (N = 15). RY CLASSES MET ONCE PER WEEK FOR 8 WEEKS. PRE- AND POST-TESTING ASSESSMENTS WERE MEASURED AT 0 AND 8 WEEKS (IMMEDIATELY POST-INTERVENTION). RESULTS: DEPRESSION SCORES AT FOLLOW-UP WERE SIGNIFICANTLY LOWER IN THE YOGA GROUP (M = 4.78, SD = 3.56) COMPARED TO THE CONTROL GROUP (M = 6.91, SD = 5.86). NO SIGNIFICANT GROUP DIFFERENCES WERE OBSERVED FOR SLEEP QUALITY, FATIGUE, OR PERCEIVED STRESS. YOGA PROGRAM PARTICIPANTS COMPLETING BASELINE ASSESSMENTS DEMONSTRATED 61% ADHERENCE TO THE YOGA CLASSES. AVERAGE RATING OF THE YOGA PROGRAM WAS "VERY USEFUL." RECOMMENDATIONS FOR FUTURE YOGA PROGRAMS WERE PROVIDED. CONCLUSIONS: THIS STUDY SUGGESTS THAT YOGA HAS A BENEFICIAL EFFECT ON DEPRESSION IN AA BCS. THERE IS, HOWEVER, A NEED TO FURTHER EXPLORE THE BENEFITS OF YOGA AMONG MINORITY BREAST CANCER SURVIVORS USING A STUDY WITH LARGER SAMPLE SIZES. 2018 16 1859 44 RANDOMIZED CONTROLLED PILOT TRIAL OF YOGA IN OVERWEIGHT AND OBESE BREAST CANCER SURVIVORS: EFFECTS ON QUALITY OF LIFE AND ANTHROPOMETRIC MEASURES. PURPOSE: TO OBTAIN ESTIMATES OF TIME TO RECRUIT THE STUDY SAMPLE, RETENTION, FACILITY-BASED CLASS ATTENDANCE AND HOME PRACTICE FOR A STUDY OF YOGA IN BREAST CANCER SURVIVORS, AND ITS EFFICACY ON FATIGUE, QUALITY OF LIFE (QOL), AND WEIGHT CHANGE. METHODS: SIXTY-THREE POST-TREATMENT STAGES 0-III BORDERLINE OVERWEIGHT AND OBESE (BODY MASS INDEX >/= 24 KG/M(2)) BREAST CANCER SURVIVORS WERE RANDOMLY ASSIGNED TO A 6-MONTH, FACILITY- AND HOME-BASED VINIYOGA INTERVENTION (N = 32) OR A WAITLIST CONTROL GROUP (N = 31). THE YOGA GOAL WAS FIVE PRACTICES PER WEEK. PRIMARY OUTCOME MEASURES WERE CHANGES IN QOL, FATIGUE, AND WEIGHT FROM BASELINE TO 6 MONTHS. SECONDARY OUTCOMES INCLUDED CHANGES IN WAIST AND HIP CIRCUMFERENCE. RESULTS: IT TOOK 12 MONTHS TO COMPLETE RECRUITMENT. PARTICIPANTS ATTENDED A MEAN OF 19.6 CLASSES AND PRACTICED AT HOME A MEAN OF 55.8 TIMES DURING THE 6-MONTH PERIOD. AT FOLLOW-UP, 90% OF PARTICIPANTS COMPLETED QUESTIONNAIRES AND 87% COMPLETED ANTHROPOMETRIC MEASUREMENTS. QOL AND FATIGUE IMPROVED TO A GREATER EXTENT AMONG WOMEN IN THE YOGA GROUP RELATIVE TO WOMEN IN THE CONTROL GROUP, ALTHOUGH NO DIFFERENCES WERE STATISTICALLY SIGNIFICANT. WAIST CIRCUMFERENCE DECREASED 3.1 CM (95% CI, -5.7 AND -0.4) MORE AMONG WOMEN IN THE YOGA COMPARED WITH THE CONTROL GROUP, WITH NO DIFFERENCE IN WEIGHT CHANGE. CONCLUSIONS: THIS STUDY PROVIDES IMPORTANT INFORMATION REGARDING RECRUITMENT, RETENTION, AND PRACTICE LEVELS ACHIEVED DURING A 6-MONTH, INTENSIVE YOGA INTERVENTION IN OVERWEIGHT AND OBESE BREAST CANCER SURVIVORS. YOGA MAY HELP DECREASE WAIST CIRCUMFERENCE AND IMPROVE QUALITY OF LIFE; FUTURE STUDIES ARE NEEDED TO CONFIRM THESE RESULTS. 2012 17 1156 44 ENSURING YOGA INTERVENTION FIDELITY IN A RANDOMIZED PREFERENCE TRIAL FOR THE TREATMENT OF WORRY IN OLDER ADULTS. INTRODUCTION: YOGA FOR TREATMENT OF WORRY IN OLDER ADULTS IS AN INTERVENTION THAT IS ESPECIALLY LIKELY TO TRANSLATE INTO REAL-WORLD PRACTICE. ASSESSING TREATMENT FIDELITY IMPROVES CONFIDENCE THAT EFFECTIVE INTERVENTIONS CAN BE CONSISTENTLY APPLIED AND ALLOWS RESEARCHERS TO EXPLORE IF ANY NULL RESULTS FOR EFFECTIVENESS ARE INDEED THE RESULT OF A LACK OF INTERVENTION EFFICACY OR LACK OF PROPER INTERVENTION IMPLEMENTATION. METHODS: THIS STUDY DESCRIBES TREATMENT FIDELITY OF A YOGA INTERVENTION IN A RANDOMIZED PREFERENCE TRIAL THAT COMPARED COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA FOR THE TREATMENT OF WORRY, ANXIETY, AND SLEEP IN WORRIED OLDER (>/=60 YEARS) ADULTS. ESTABLISHED METHODS FOR ASSESSING TREATMENT FIDELITY OF CBT GUIDED THE PROCEDURE FOR ENSURING THAT THE YOGA INTERVENTION WAS DELIVERED AS INTENDED. THE YOGA INTERVENTION CONSISTED OF 20, 75-MIN, IN-PERSON, GROUP, GENTLE YOGA CLASSES HELD TWICE WEEKLY. RESULTS: SIX FEMALE INSTRUCTORS (MEAN AGE = 64 YEARS) TAUGHT 660 YOGA CLASSES THAT WERE VIDEOTAPED. TEN PERCENT OF THESE CLASSES, STRATIFIED BY INSTRUCTOR, WERE RANDOMLY SELECTED FOR REVIEW. THE AVERAGE ADHERENCE SCORE FOR YOGA INSTRUCTORS WAS 6.84 (RANGE 4-8). THE AVERAGE COMPETENCY SCORES WERE CONSISTENTLY HIGH, WITH AN AVERAGE SCORE OF 7.24 (RANGE 6-8). TEACHING CONTENT NOT INCLUDED IN THE PROTOCOL OCCURRED IN 26 (38.1%) SESSIONS AND DECREASED OVER TIME. OBSERVED RATINGS OF INSTRUCTOR ADHERENCE WERE SIGNIFICANTLY RELATED TO RATINGS OF COMPETENCY. INSTRUCTOR ADHERENCE WAS ALSO SIGNIFICANTLY ASSOCIATED WITH LOWER PARTICIPANT ATTENDANCE, BUT NOT WITH ANY OF THE OTHER PROCESS OR OUTCOME MEASURES. CONCLUSIONS: THE LARGER RANGE FOUND IN ADHERENCE RELATIVE TO COMPETENCE SCORES DEMONSTRATED THAT TEACHING A YOGA CLASS ACCORDING TO A PROTOCOL REQUIRES DIFFERENT SKILLS THAN COMPETENTLY TEACHING A YOGA CLASS IN THE COMMUNITY, AND THESE SKILLS IMPROVED WITH FEEDBACK. THESE RESULTS MAY FOSTER DIALOG BETWEEN THE YOGA RESEARCH AND PRACTICE COMMUNITIES. CLINICAL TRIAL REGISTRATION NO.: NCT02968238. 2021 18 269 53 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 19 2639 45 YOGA FOR VETERANS WITH CHRONIC LOW-BACK PAIN. OBJECTIVES: CHRONIC BACK PAIN AFFECTS A LARGE PROPORTION OF BOTH THE GENERAL POPULATION AND OF MILITARY VETERANS. ALTHOUGH NUMEROUS THERAPIES EXIST FOR TREATING CHRONIC BACK PAIN, THEY CAN BE COSTLY AND TEND TO HAVE LIMITED EFFECTIVENESS. THUS, DEMONSTRATING THE EFFICACY AND COST-EFFECTIVENESS OF ADDITIONAL TREATMENT ALTERNATIVES IS IMPORTANT. THE PURPOSE OF OUR STUDY WAS TO EXAMINE THE BENEFITS OF A YOGA INTERVENTION FOR VETERANS ADMINISTRATION (VA) PATIENTS. SUBJECTS/INTERVENTION: VA PATIENTS WITH CHRONIC BACK PAIN WERE REFERRED BY THEIR PRIMARY CARE PROVIDERS TO A YOGA PROGRAM AS PART OF CLINICAL CARE. BEFORE STARTING YOGA, A VA PHYSICIAN TRAINED IN YOGA EVALUATED EACH PATIENT TO ENSURE THAT THEY COULD PARTICIPATE SAFELY. DESIGN: THE RESEARCH STUDY CONSISTED OF COMPLETING A SHORT BATTERY OF QUESTIONNAIRES AT BASELINE AND AGAIN 10 WEEKS LATER. OUTCOME MEASURES: QUESTIONNAIRES INCLUDED MEASURES OF PAIN, DEPRESSION, ENERGY/FATIGUE, HEALTH-RELATED QUALITY OF LIFE, AND PROGRAM SATISFACTION. PAIRED T-TESTS WERE USED TO COMPARE BASELINE SCORES TO THOSE AT THE 10-WEEK FOLLOW-UP FOR THE SINGLE GROUP, PRE-POST DESIGN. CORRELATIONS WERE USED TO EXAMINE WHETHER YOGA ATTENDANCE AND HOME PRACTICE WERE ASSOCIATED WITH BETTER OUTCOMES. RESULTS: BASELINE AND FOLLOW-UP DATA WERE AVAILABLE FOR 33 PARTICIPANTS. PARTICIPANTS WERE VA PATIENTS WITH A MEAN AGE OF 55 YEARS. THEY WERE 21% FEMALE, 70% WHITE, 52% MARRIED, 68% COLLEGE GRADUATES, AND 44% WERE RETIRED. SIGNIFICANT IMPROVEMENTS WERE FOUND FOR PAIN, DEPRESSION, ENERGY/FATIGUE, AND THE SHORT FORM-12 MENTAL HEALTH SCALE. THE NUMBER OF YOGA SESSIONS ATTENDED AND THE FREQUENCY OF HOME PRACTICE WERE ASSOCIATED WITH IMPROVED OUTCOMES. PARTICIPANTS APPEARED HIGHLY SATISFIED WITH THE YOGA INSTRUCTOR AND MODERATELY SATISFIED WITH THE EASE OF PARTICIPATION AND HEALTH BENEFITS OF THE YOGA PROGRAM. CONCLUSIONS: PRELIMINARY DATA SUGGEST THAT A YOGA INTERVENTION FOR VA PATIENTS WITH CHRONIC BACK PAIN MAY IMPROVE THE HEALTH OF VETERANS. HOWEVER, THE LIMITATIONS OF A PRE-POST STUDY DESIGN MAKE CONCLUSIONS TENTATIVE. A LARGER RANDOMIZED, CONTROLLED TRIAL OF THE YOGA PROGRAM IS PLANNED. 2008 20 2320 37 TREATMENT CREDIBILITY, EXPECTANCY, AND PREFERENCE: PREDICTION OF TREATMENT ENGAGEMENT AND OUTCOME IN A RANDOMIZED CLINICAL TRIAL OF HATHA YOGA VS. HEALTH EDUCATION AS ADJUNCT TREATMENTS FOR DEPRESSION. BACKGROUND: HATHA YOGA MAY BE HELPFUL FOR ALLEVIATING DEPRESSION SYMPTOMS. THE PURPOSE OF THIS ANALYSIS IS TO DETERMINE WHETHER TREATMENT PROGRAM PREFERENCE, CREDIBILITY, OR EXPECTANCY PREDICT ENGAGEMENT IN DEPRESSION INTERVENTIONS (YOGA OR A CONTROL CLASS) OR DEPRESSION SYMPTOM SEVERITY OVER TIME. METHODS: THIS IS A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL (RCT) OF HATHA YOGA VS. A HEALTH EDUCATION CONTROL GROUP FOR TREATMENT OF DEPRESSION. DEPRESSED PARTICIPANTS (N=122) ATTENDED UP TO 20 CLASSES OVER A PERIOD OF 10 WEEKS, AND THEN COMPLETED ADDITIONAL ASSESSMENTS AFTER 3 AND 6 MONTHS. WE ASSESSED TREATMENT PREFERENCE PRIOR TO RANDOMIZATION, AND TREATMENT CREDIBILITY AND EXPECTANCY AFTER PARTICIPANTS ATTENDED THEIR FIRST CLASS. TREATMENT "CONCORDANCE" INDICATED THAT TREATMENT PREFERENCE MATCHED ASSIGNED TREATMENT. RESULTS: TREATMENT CREDIBILITY, EXPECTANCY, AND CONCORDANCE WERE NOT ASSOCIATED WITH TREATMENT ENGAGEMENT. TREATMENT EXPECTANCY MODERATED THE ASSOCIATION BETWEEN TREATMENT GROUP AND DEPRESSION. DEPRESSION SEVERITY OVER TIME DIFFERED BY EXPECTANCY LEVEL FOR THE YOGA GROUP BUT NOT FOR THE HEALTH EDUCATION GROUP. CONTROLLING FOR BASELINE DEPRESSION, PARTICIPANTS IN THE YOGA GROUP WITH AN AVERAGE OR HIGH EXPECTANCY FOR IMPROVEMENT SHOWED LOWER DEPRESSION SYMPTOMS ACROSS THE ACUTE INTERVENTION AND FOLLOW-UP PERIOD THAN THOSE WITH A LOW EXPECTANCY FOR IMPROVEMENT. THERE WAS A TREND FOR A SIMILAR PATTERN FOR CREDIBILITY. CONCORDANCE WAS NOT ASSOCIATED WITH TREATMENT OUTCOME. LIMITATIONS: THIS IS A SECONDARY, POST-HOC ANALYSIS AND SHOULD BE CONSIDERED HYPOTHESIS-GENERATING. CONCLUSIONS: RESULTS SUGGEST THAT EXPECTANCY IMPROVES THE LIKELIHOOD OF SUCCESS ONLY FOR A INTERVENTION THOUGHT TO ACTIVELY TARGET DEPRESSION (YOGA) AND NOT A CONTROL INTERVENTION. 2018