1  638 137 DO PHYSICAL THERAPY AND YOGA IMPROVE PAIN AND DISABILITY THROUGH PSYCHOLOGICAL MECHANISMS? A CAUSAL MEDIATION ANALYSIS OF ADULTS WITH CHRONIC LOW BACK PAIN. OBJECTIVE: TO INVESTIGATE WHETHER INDIRECT EFFECTS VIA PSYCHOLOGICAL MECHANISMS EXPLAIN THE EFFECTS OF PHYSICAL THERAPY (PT) OR YOGA, VERSUS EDUCATION, ON BACK-RELATED OUTCOMES. DESIGN: MEDIATION ANALYSES USING DATA FROM A RANDOMIZED CONTROLLED TRIAL OF PT, YOGA, AND EDUCATION INTERVENTIONS FOR CHRONIC LOW BACK PAIN. METHODS: PRIMARY OUTCOMES WERE CHANGES IN BACK-RELATED PAIN ON THE 11-POINT NUMERICAL RATING SCALE AND DISABILITY ON THE MODIFIED 23-POINT ROLAND MORRIS DISABILITY QUESTIONNAIRE, MEASURED AT 52-WEEKS POST-RANDOMIZATION. HYPOTHESIZED MEDIATORS WERE 12-WEEK CHANGES IN PAIN SELF-EFFICACY, FEAR AVOIDANCE BELIEFS, DEPRESSION, ANXIETY, PERCEIVED STRESS, AND SLEEP QUALITY. WE USED CAUSAL MEDIATION ANALYSIS TO ESTIMATE THE TOTAL EFFECT, DIRECT EFFECT, INDIRECT EFFECT, AND PROPORTION MEDIATED. RESULTS: WE ANALYZED DATA FROM 230 ADULTS (MEAN AGE = 46.2 YEARS, 69.6% FEMALE, 79.6% NON-WHITE). IN THE PT VERSUS EDUCATION MODEL, WHEN THE MEDIATOR WAS PERCEIVED STRESS, THE TOTAL EFFECT ON DISABILITY WAS 2.6 POINTS (95% CI: 0.3, 4.9) AND DECOMPOSED INTO A DIRECT EFFECT OF 1.7 POINTS (95% CI: -0.4, 3.8) AND AN INDIRECT EFFECT 0.9 POINTS (95% CI: 0.1, 2.0; PROPORTION MEDIATED 34%). NO OTHER PSYCHOLOGICAL CONSTRUCT WAS A SIGNIFICANT MEDIATOR. CONCLUSION: IMPROVEMENTS IN PERCEIVED STRESS MEDIATED IMPROVEMENTS IN DISABILITY AFTER PT TREATMENT COMPARED TO EDUCATION. OTHER PSYCHOLOGICAL OUTCOMES DID NOT MEDIATE THE EFFECT OF YOGA OR PT ON PAIN OR DISABILITY OUTCOMES COMPARED TO EDUCATION. J ORTHOP SPORTS PHYS THER, EPUB 18 MAY 2022. DOI:10.2519/JOSPT.2022.10813.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
2 1613  43 MILITARY-TAILORED YOGA FOR VETERANS WITH POST-TRAUMATIC STRESS DISORDER. INTRODUCTION: AMONG VETERANS OF POST-9/11 CONFLICTS, ESTIMATES OF POST-TRAUMATIC STRESS DISORDER (PTSD) RANGE FROM 9% SHORTLY AFTER RETURNING FROM DEPLOYMENT TO 31% A YEAR AFTER DEPLOYMENT. CLINICAL AND PHARMACEUTICALLY BASED TREATMENTS ARE UNDERUTILIZED. THIS COULD BE DUE TO CONCERNS RELATED TO LOST DUTY DAYS, AS WELL AS PTSD PATIENTS' FEARS OF STIGMA OF HAVING A MENTAL HEALTH CONDITION. YOGA HAS BEEN SHOWN TO REDUCE PTSD SYMPTOMS IN THE CIVILIAN POPULATION, BUT FEW STUDIES HAVE TESTED THE IMPACT OF YOGA ON VETERANS OF POST-9/11 CONFLICTS. THE PURPOSE OF THIS STUDY IS TO TEST THE IMPACT OF YOGA ON POST-9/11 VETERANS DIAGNOSED WITH PTSD. MATERIALS AND METHODS: PARTICIPANTS WERE 18 YR OF AGE OR OLDER AND VETERANS OF POST-9/11 CONFLICTS. THEY HAD SUBTHRESHOLD OR DIAGNOSTIC-LEVEL PTSD RELATED TO THEIR COMBAT MILITARY SERVICE, AS DETERMINED BY A SCORE OF 30 OR HIGHER ON THE PTSD CHECKLIST-MILITARY VERSION (PCL-M). VETERANS PARTICIPATED IN 60-MIN WEEKLY YOGA SESSIONS FOR 6 WK TAUGHT BY A WARRIORS AT EASE-TRAINED YOGA INSTRUCTOR WHO IS A, POST-9/11 VETERAN. THE YOGA SESSIONS INCORPORATED VINYASA-STYLE YOGA AND A TRAUMA-SENSITIVE, MILITARY-CULTURE INFORMED APPROACH ADVOCATED BY TWO SEPARATE ORGANIZATIONS: WARRIORS AT EASE AND MEGHAN'S FOUNDATION. DATA WERE COLLECTED AT BASELINE AND AGAIN AFTER 7 WK. THE PRIMARY OUTCOME WAS PCL-M SCORE. PARTICIPANTS ALSO COMPLETED THE PATIENT HEALTH QUESTIONNAIRE, THE BECK ANXIETY INVENTORY, THE PITTSBURGH SLEEP QUALITY INDEX, AND THE MINDFUL ATTENTION AWARENESS SCALE AT BOTH TIME POINTS. RESULTS: EIGHTEEN OPERATION ENDURING FREEDOM, OPERATION IRAQI FREEDOM, AND OPERATION NEW DAWN VETERANS COMPLETED THE PRE- AND POST-INTERVENTION SELF-REPORT QUESTIONNAIRES. AGE RANGED FROM 26 TO 62 YR (MEDIAN = 43 YR), LENGTH OF SERVICE RANGED FROM 2 TO 34 YR (MEDIAN = 18.8 YR), AND 13 (72.2%) HAD COMPLETED COLLEGE. DECREASED PTSD SYMPTOMATOLOGY WAS DEMONSTRATED IN THE THREE-SYMPTOM CLUSTERS REPRESENTED IN THE PCL-M (I.E., HYPERAROUSAL, RE-EXPERIENCING, AND AVOIDANCE). IN ADDITION, THE TOTAL SCORE ON THE PCL-M DECREASED SIGNIFICANTLY, BY BOTH STATISTICAL AND CLINICAL MEASURES. THE PARTICIPANTS ALSO DEMONSTRATED IMPROVED MINDFULNESS SCORES AND REPORTED DECREASED INSOMNIA, DEPRESSION, AND ANXIETY SYMPTOMS. CONCLUSION: THIS STUDY DEMONSTRATES THAT A TRAUMA-SENSITIVE YOGA INTERVENTION MAY BE EFFECTIVE FOR VETERANS WITH PTSD SYMPTOMS, WHETHER AS STAND-ALONE OR ADJUNCTIVE THERAPY. THE IMPRESSIVE DECREASE IN PTSD SYMPTOMATOLOGY MAY BE DUE TO THE TAILORED MILITARY-SPECIFIC NATURE OF THIS INTERVENTION AND THE FACT THAT IT WAS LED BY A VETERAN OF POST-9/11 CONFLICTS. MORE RESEARCH IS NEEDED WITH A LARGER SAMPLE AND A MORE DIVERSE VETERAN POPULATION.	2018	

3 2641  40 YOGA FOR WARRIORS: AN INTERVENTION FOR VETERANS WITH COMORBID CHRONIC PAIN AND PTSD. OBJECTIVE: COMORBID CHRONIC PAIN AND POSTTRAUMATIC STRESS DISORDER (PTSD) IS COMMON IN VETERANS; THIS COMORBIDITY IS ASSOCIATED WITH INCREASED SEVERITY AND POORER PROGNOSIS WHEN COMPARED TO EACH OUTCOME ALONE. YOGA HAS BEEN SHOWN TO BE EFFECTIVE FOR CHRONIC PAIN AND PROMISING FOR PTSD, BUT YOGA FOR COMORBID PAIN AND PTSD HAS NOT BEEN EXAMINED. THIS ARTICLE OFFERS EMPIRICAL SUPPORT FOR A YOGA INTERVENTION FOR COMORBID CHRONIC PAIN AND PTSD IN A VETERAN POPULATION. METHOD: RESULTS ARE PRESENTED FROM A 4-YEAR PILOT YOGA INTERVENTION FOR COMORBID CHRONIC PAIN AND PTSD AT A LARGE, URBAN VETERANS AFFAIRS MEDICAL CENTER. BASED ON THE FEAR AVOIDANCE MODEL OF PAIN, THE INTERVENTION USED A CROSS-SECTIONAL, OPEN-TRIAL DESIGN WITH PRE- AND POSTMEASURES. T TEST ANALYSES WERE CONDUCTED ON PROGRAM COMPLETERS (N = 49; OUT OF 87 INITIALLY ENROLLED, 44% ATTRITION RATE), WHO WERE PRIMARILY AFRICAN AMERICAN (69%) AND MALE (61%) AND HAD A MEAN AGE OF 51.41 YEARS (SD = 11.32). RESULTS: RESULTS INDICATED TREND-LEVEL REDUCTIONS IN OVERALL PTSD SYMPTOMS, AS MEASURED BY THE PTSD CHECKLIST FOR DSM-5 (P = .02, D = 0.38) AND IN SYMPTOM CLUSTER SCORES OF NEGATIVE ALTERATIONS OF COGNITIONS AND MOOD (P = .03, D = 0.36) AND AROUSAL AND REACTIVITY (P = .03, D = 0.35). VETERANS REPORTED SIGNIFICANT IMPROVEMENT IN ABILITY TO PARTICIPATE IN SOCIAL ACTIVITIES (P < .001, D = 0.44) AND SIGNIFICANT REDUCTIONS IN KINESIOPHOBIA (FEAR OF MOVEMENT OR PHYSICAL ACTIVITY; P < .001, D = 0.85). ON A SATISFACTION MEASURE WITH A RANGE OF 1 (QUITE DISSATISFIED) TO 4 (EXTREMELY SATISFIED), THE MEAN RATING WAS 3.74 (SD = 0.33). CONCLUSION: YOGA IS A FEASIBLE AND EFFECTIVE INTERVENTION FOR VETERANS WITH COMORBID CHRONIC PAIN AND PTSD. (PSYCINFO DATABASE RECORD (C) 2020 APA, ALL RIGHTS RESERVED).	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
4 2830  38 YOGA VS STRETCHING IN VETERANS WITH CHRONIC LOWER BACK PAIN AND THE ROLE OF MINDFULNESS: A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THE PURPOSE OF THIS STUDY WAS TO INVESTIGATE THE FEASIBILITY OF RECRUITING, RANDOMIZING, ENROLLING, AND COLLECTING OUTCOME DATA ON VETERAN PATIENTS WITH CHRONIC LOW BACK PAIN (CLBP) WHO UNDERGO AN 8-WEEK, ACTIVE EXERCISE CLASS WITH MINDFULNESS (YOGA CLASS) AND WITHOUT (STRETCHING CLASS). METHODS: UNITED STATES VETERANS WITH CLBP BASED ON INCLUSION/EXCLUSION CRITERIA WERE RANDOMIZED TO 1 OF 2 GROUPS. THE STUDY DESIGN WAS A PILOT RANDOMIZED CONTROLLED TRIAL. TWENTY CLBP PATIENTS ATTENDED A YOGA CLASS OR STRETCHING CLASS ONCE PER WEEK FOR 8 WEEKS AT THE VETERANS AFFAIRS ROCHESTER OUTPATIENT CENTER, ROCHESTER, NEW YORK. THE FOLLOWING MEASUREMENTS WERE OBTAINED: RECRUITMENT OR ENROLLMENT DATA, COMPLIANCE DATA TO INCLUDE CLASS ATTENDANCE AND HOME EXERCISE, AND COMPLIANCE DATA REGARDING ABILITY TO COLLECT OUTCOME MEASURES AT BASELINE AND AT COMPLETION. OUTCOME MEASURES INCLUDED PAIN (PEG), QUALITY OF LIFE (PROMIS GLOBAL HEALTH SURVEY), SELF-EFFICACY (2-ITEM QUESTIONNAIRE), FEAR AVOIDANCE BELIEF, CATASTROPHIZING, AND SOCIAL ENGAGEMENT IN ADDITION TO QUALITATIVE CLINICIAN OPEN-ENDED QUESTIONS POSTINTERVENTION. RESULTS: FORTY-FIVE VETERANS WERE QUERIED REGARDING INTEREST IN PARTICIPATION. OF THESE, 34 (76%) MET THE STUDY'S CRITERIA. TWENTY (44%) AGREED TO PARTICIPATE AND WERE CONSENTED, RANDOMIZED, AND ENROLLED IN THE STUDY. INITIAL AND FINAL OUTCOME MEASURES WERE OBTAINED FOR EACH PARTICIPANT (100%). FORTY PERCENT ATTENDED MORE THAN 80% OF THE SESSIONS FOR BOTH YOGA AND STRETCHING GROUPS. CONCLUSION: THIS PILOT STUDY DEMONSTRATED FEASIBILITY OF RECRUITING, ENROLLING, AND COLLECTING OUTCOME DATA ON CLBP VETERAN PATIENTS PARTICIPATING IN YOGA AND STRETCHING CLASS. THE DATA FROM THIS PILOT WILL INFORM THE DEVELOPMENT OF A RANDOMIZED, COMPARATIVE EFFECTIVENESS STUDY OF YOGA WITH AND WITHOUT MINDFULNESS IN THE MANAGEMENT OF CLBP.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
5  465  46 CHARACTERISTICS AND PREDICTORS OF SHORT-TERM OUTCOMES IN INDIVIDUALS SELF-SELECTING YOGA OR PHYSICAL THERAPY FOR TREATMENT OF CHRONIC LOW BACK PAIN. OBJECTIVE: TO COMPARE CLINICAL AND DEMOGRAPHIC CHARACTERISTICS OF INDIVIDUALS SELF-SELECTING YOGA OR PHYSICAL THERAPY (PT) FOR TREATMENT OF CHRONIC LOW BACK PAIN (CLBP) AND TO EXAMINE PREDICTORS OF SHORT-TERM PAIN AND FUNCTIONAL OUTCOMES. DESIGN: DESCRIPTIVE, LONGITUDINAL STUDY. SETTINGS: A HOSPITAL-BASED CLINIC THAT OFFERS MODIFIED INTEGRAL YOGA CLASSES FOR CLBP AND 2 OUTPATIENT PT CLINICS THAT OFFER EXERCISE-BASED PT. PARTICIPANTS: ADULTS (N=53) WITH CLBP>/=12 WEEKS: YOGA (N=27), PT (N=26). METHODS: YOGA PARTICIPANTS ATTENDED A 6-WEEK, ONCE WEEKLY, 2-HOUR YOGA CLASS. PT PARTICIPANTS UNDERWENT TWICE WEEKLY, 1-HOUR INDIVIDUALIZED PT. DATA WERE COLLECTED AT BASELINE AND AT 6 WEEKS. GROUPS WERE COMPARED BY USING CHI2 AND INDEPENDENT SAMPLES T-TESTS. HIERARCHICAL LINEAR REGRESSION WAS USED TO PREDICT TREATMENT OUTCOMES. MAIN OUTCOME MEASURES: DISABILITY (ROLAND MORRIS DISABILITY QUESTIONNAIRE), HEALTH STATUS (RAND SHORT FORM 36 HEALTH SURVEY 1.0), PAIN BOTHERSOMENESS (NUMERICAL RATING SCALE), BACK PAIN SELF-EFFICACY (BACK PAIN SELF-EFFICACY SCALE), AND TREATMENT SATISFACTION. RESULTS: AT BASELINE, YOGA PARTICIPANTS WERE SIGNIFICANTLY LESS DISABLED (P=.013), HAD HIGHER HEALTH STATUS (P=.023), GREATER PAIN SELF-EFFICACY (P=.012), AND LESS AVERAGE PAIN BOTHERSOMENESS (P=.001) COMPARED WITH PT PARTICIPANTS. AT 6 WEEKS, WHEN CONTROLLING FOR BASELINE GROUP DIFFERENCES, GREATER PAIN SELF-EFFICACY WAS THE STRONGEST PREDICTOR FOR REDUCED PAIN AND HIGHER FUNCTION FOR THE ENTIRE SAMPLE. A SIGNIFICANT GROUP INTERACTION BY BASELINE PAIN SELF-EFFICACY PREDICTED DISABILITY AT 6 WEEKS. PT PARTICIPANTS WITH LOW PAIN SELF-EFFICACY REPORTED SIGNIFICANTLY GREATER DISABILITY THAN THOSE WITH HIGH PAIN SELF-EFFICACY. YOGA PARTICIPANTS WITH LOW AND HIGH PAIN SELF-EFFICACY HAD SIMILAR DISABILITY OUTCOMES. CONCLUSION: THESE FINDINGS STRENGTHEN EVIDENCE THAT SELF-EFFICACY IS ASSOCIATED WITH CLBP OUTCOMES, ESPECIALLY IN INDIVIDUALS SELF-SELECTING PT. FURTHER RESEARCH TO EVALUATE OUTCOMES AFTER YOGA AND PT IN PARTICIPANTS WITH LOW PAIN SELF-EFFICACY IS NEEDED.	2010	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
6 1582  45 MEDIATORS OF YOGA AND STRETCHING FOR CHRONIC LOW BACK PAIN. ALTHOUGH YOGA IS AN EFFECTIVE TREATMENT FOR CHRONIC LOW BACK PAIN, LITTLE IS KNOWN ABOUT THE MECHANISMS RESPONSIBLE FOR ITS BENEFITS. IN A TRIAL COMPARING YOGA TO INTENSIVE STRETCHING AND SELF-CARE, WE EXPLORED WHETHER PHYSICAL (HOURS OF BACK EXERCISE/WEEK), COGNITIVE (FEAR AVOIDANCE, BODY AWARENESS, AND SELF-EFFICACY), AFFECTIVE (PSYCHOLOGICAL DISTRESS, PERCEIVED STRESS, POSITIVE STATES OF MIND, AND SLEEP), AND PHYSIOLOGICAL FACTORS (CORTISOL, DHEA) MEDIATED THE EFFECTS OF YOGA OR STRETCHING ON BACK-RELATED DYSFUNCTION (ROLAND-MORRIS DISABILITY SCALE (RDQ)). FOR YOGA, 36% OF THE EFFECT ON 12-WEEK RDQ WAS MEDIATED BY INCREASED SELF-EFFICACY, 18% BY SLEEP DISTURBANCE, 9% BY HOURS OF BACK EXERCISE, AND 61% BY THE BEST COMBINATION OF ALL POSSIBLE MEDIATORS (6 MEDIATORS). FOR STRETCHING, 23% OF THE EFFECT WAS MEDIATED BY INCREASED SELF-EFFICACY, 14% BY DAYS OF BACK EXERCISE, AND 50% BY THE BEST COMBINATION OF ALL POSSIBLE MEDIATORS (7 MEDIATORS). IN OPEN-ENDED QUESTIONS, >/=20% OF PARTICIPANTS NOTED THE FOLLOWING TREATMENT BENEFITS: LEARNING NEW EXERCISES (BOTH GROUPS), RELAXATION, INCREASED AWARENESS, AND THE BENEFITS OF BREATHING (YOGA), BENEFITS OF REGULAR PRACTICE (STRETCHING). ALTHOUGH BOTH SELF-EFFICACY AND HOURS OF BACK EXERCISE WERE THE STRONGEST MEDIATORS FOR EACH INTERVENTION, COMPARED TO SELF-CARE, QUALITATIVE DATA SUGGEST THAT THEY MAY EXERT THEIR BENEFITS THROUGH PARTIALLY DISTINCT MECHANISMS.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
7  179  37 A RANDOMIZED CONTROLLED TRIAL OF THE INFLUENCE OF YOGA FOR WOMEN WITH SYMPTOMS OF POST-TRAUMATIC STRESS DISORDER. BACKGROUND: SURVIVORS IN MOTOR VEHICLE ACCIDENT (MVA) MAY HAVE POSTTRAUMATIC STRESS DISORDER (PTSD). YOGA IS A COMPLEMENTARY APPROACH FOR PTSD THERAPY. METHODS: THIS RANDOMIZED CONTROLLED TRIAL EXPLORED WHETHER YOGA INTERVENTION HAS EFFECTS ON REDUCING THE SYMPTOMS OF PTSD IN WOMEN SURVIVED IN MVA. PARTICIPANTS (N = 94) WERE RECRUITED AND RANDOMIZED INTO CONTROL GROUP OR YOGA GROUP. PARTICIPANTS ATTENDED 6 45-MINUITE YOGA SESSIONS IN 12 WEEKS. DEPRESSION ANXIETY STRESS SCALES (DASS) AND IMPACT OF EVENTS SCALE-REVISED (IES-R) WERE USED TO ASSESS PSYCHOLOGICAL DISTRESS. RESULTS: POST-INTERVENTION IES-R TOTAL SCORE OF YOGA GROUP WAS SIGNIFICANTLY LOWER THAN THAT OF CONTROL GROUP (P = 0.01). AT BOTH POST-INTERVENTION AND 3-MONTHS POST INTERVENTION, THE DASS-21 TOTAL SCORES OF YOGA GROUP WERE BOTH SIGNIFICANTLY LOWER THAN THOSE OF CONTROL GROUP (P = 0.043, P = 0.024). YOGA GROUP SHOWED LOWER ANXIETY AND DEPRESSION LEVEL COMPARED TO CONTROL GROUP AT BOTH POST-INTERVENTION (P = 0.033, P < 0.001) AND POST-FOLLOW-UP (P = 0.004, P = 0.035). YOGA GROUP HAD LOWER LEVELS OF INTRUSION AND AVOIDANCE COMPARED TO CONTROL GROUP AFTER INTERVENTION (P = 0.002, P < 0.001). CONCLUSION: RESULTS ILLUSTRATE THAT YOGA INTERVENTION MAY ALLEVIATE ANXIETY AND DEPRESSION AND IMPROVE THE SYMPTOMS OF PTSD IN WOMEN WITH PTSD FOLLOWING MVA.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
8 2852  52 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                  
9 1621  29 MINDFULNESS AND AVOIDANCE MEDIATE THE RELATIONSHIP BETWEEN YOGA PRACTICE AND ANXIETY. OBJECTIVES: THERE IS ACCUMULATING EVIDENCE THAT YOGA AND MINDFULNESS MEDITATION CAN ALLEVIATE SYMPTOMS OF ANXIETY, ALTHOUGH THE MECHANISMS BY WHICH THIS OCCURS REMAIN UNCLEAR. THE PURPOSE OF THIS STUDY WAS TO EXAMINE THE RELATIONSHIP BETWEEN YOGA PRACTICE AND SELF-REPORTED ANXIETY AS WELL AS THE POTENTIAL MEDIATING ROLES OF MINDFULNESS AND EMOTIONAL AVOIDANCE. METHODS: USING A CROSS-SECTIONAL DESIGN, 367 PARTICIPANTS WERE RECRUITED ONLINE AND COMPLETED MEASURES OF ANXIETY, AVOIDANCE, AND MINDFULNESS. RESULTS: RESULTS SHOWED THAT LENGTH OF YOGA PRACTICE WAS SIGNIFICANTLY CORRELATED WITH LOWER ANXIETY IN YOGA PRACTITIONERS. AVOIDANCE AND MINDFULNESS MEDIATED THE RELATIONSHIP BETWEEN LENGTH OF YOGA PRACTICE AND ANXIETY, SHEDDING LIGHT ON POSSIBLE MECHANISMS BY WHICH THESE PRACTICES REDUCE ANXIETY. CONCLUSIONS: FUTURE EXPERIMENTAL AND LONGITUDINAL RESEARCH IS NEEDED TO EXAMINE THE CAUSAL ROLE OF MINDFULNESS AND AVOIDANCE IN THE RELATIONSHIP BETWEEN YOGA PRACTICE AND ANXIETY, AND WHETHER YOGA IS A USEFUL ADJUNCT TO COGNITIVE BEHAVIOUR THERAPY FOR ANXIETY DISORDERS.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
10 2374  60 WHICH CHRONIC LOW BACK PAIN PATIENTS RESPOND FAVORABLY TO YOGA, PHYSICAL THERAPY, AND A SELF-CARE BOOK? RESPONDER ANALYSES FROM A RANDOMIZED CONTROLLED TRIAL. PURPOSE: TO IDENTIFY BASELINE CHARACTERISTICS OF ADULTS WITH CHRONIC LOW BACK PAIN (CLBP) THAT PREDICT RESPONSE (I.E., A CLINICALLY IMPORTANT IMPROVEMENT) AND/OR MODIFY TREATMENT EFFECT ACROSS THREE NONPHARMACOLOGIC INTERVENTIONS. DESIGN: SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. SETTING: ACADEMIC SAFETY NET HOSPITAL AND SEVEN FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS. SUBJECTS: ADULTS WITH CLBP (N = 299). METHODS: WE REPORT PATIENT CHARACTERISTICS THAT WERE PREDICTORS OF RESPONSE AND/OR MODIFIED TREATMENT EFFECT ACROSS THREE 12-WEEK TREATMENTS: YOGA, PHYSICAL THERAPY [PT], AND A SELF-CARE BOOK. USING PRESELECTED CHARACTERISTICS, WE USED LOGISTIC REGRESSION TO IDENTIFY PREDICTORS OF "RESPONSE," DEFINED AS A >/=30% IMPROVEMENT IN THE ROLAND MORRIS DISABILITY QUESTIONNAIRE. THEN, USING "RESPONSE" AS OUR OUTCOME, WE IDENTIFIED BASELINE CHARACTERISTICS THAT WERE TREATMENT EFFECT MODIFIERS BY TESTING FOR STATISTICAL INTERACTION (P < 0.05) ACROSS TWO COMPARISONS: 1) YOGA-OR-PT VS SELF-CARE AND 2) YOGA VS PT. RESULTS: OVERALL, 39% (116/299) OF PARTICIPANTS WERE RESPONDERS, WITH MORE RESPONDERS IN THE YOGA-OR-PT GROUP (42%) THAN THE SELF-CARE (23%) GROUP. THERE WAS NO DIFFERENCE IN PROPORTION RESPONDING TO YOGA (48%) VS PT (37%, ODDS RATIO [OR] = 1.5, 95% CONFIDENCE INTERVAL = 0.88 - 2.6). PREDICTORS OF RESPONSE INCLUDED HAVING MORE THAN A HIGH SCHOOL EDUCATION, A HIGHER INCOME, EMPLOYMENT, FEW DEPRESSIVE SYMPTOMS, LOWER PERCEIVED STRESS, FEW WORK-RELATED FEAR AVOIDANCE BELIEFS, HIGH PAIN SELF-EFFICACY, AND BEING A NONSMOKER. EFFECT MODIFIERS INCLUDED USE OF PAIN MEDICATION AND FEAR AVOIDANCE BELIEFS RELATED TO PHYSICAL ACTIVITY (BOTH P = 0.02 FOR INTERACTION). WHEN COMPARING YOGA OR PT WITH SELF-CARE, A GREATER PROPORTION WERE RESPONDERS AMONG THOSE USING PAIN MEDS (OR = 5.3), WHICH DIFFERED FROM THOSE NOT TAKING PAIN MEDS (OR = 0.94) AT BASELINE. WE ALSO FOUND GREATER TREATMENT RESPONSE AMONG THOSE WITH LOWER (OR = 7.0), BUT NOT HIGH (OR = 1.3), FEAR AVOIDANCE BELIEFS AROUND PHYSICAL ACTIVITY. CONCLUSIONS: OUR FINDINGS REVEALED IMPORTANT SUBGROUPS FOR WHOM REFERRAL TO YOGA OR PT MAY IMPROVE CLBP OUTCOMES.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
11   44  25 A CASE SERIES ON THE EFFECTS OF KRIPALU YOGA FOR GENERALIZED ANXIETY DISORDER. GENERALIZED ANXIETY DISORDER (GAD) IS A PREVALENT PSYCHIATRIC DISORDER ASSOCIATED WITH SUBSTANTIAL IMPAIRMENT AND POOR TREATMENT RESPONSE. YOGA INFLUENCES PROCESSES THAT ARE LINKED TO THE MAINTENANCE OF GAD INCLUDING MINDFULNESS, ANXIETY, AND HEART RATE VARIABILITY, BUT HAS YET TO BE EVALUATED AMONG PEOPLE WITH THE DISORDER. THE PRESENT STUDY IS A FIRST STEP TOWARD DOCUMENTING THE EFFICACY OF YOGA FOR REDUCING WORRY AMONG PEOPLE WITH GAD USING A SINGLE-SUBJECT AB DESIGN CASE SERIES AND DAILY RATINGS OF WORRY. STANDARDIZED SELF-REPORT MEASURES OF WORRY, TRAIT ANXIETY, EXPERIENTIAL AVOIDANCE, MINDFULNESS, AND HEART RATE VARIABILITY WERE ASSESSED PRE- AND POST-INTERVENTION. THREE PARTICIPANTS WITH PRIMARY GAD RECEIVED EIGHT TWICE-WEEKLY KRIPALU YOGA SESSIONS FOLLOWING A BASELINE DATA COLLECTION PERIOD. ALL PARTICIPANTS SHOWED SYSTEMATIC IMPROVEMENT IN DAILY WORRY RATINGS ON AT LEAST ONE INDEX AND ALL SCORES ON SELF-REPORTED MEASURES OF WORRY, ANXIETY, EXPERIENTIAL AVOIDANCE, AND MINDFULNESS CHANGED IN THE EXPECTED DIRECTION FOLLOWING YOGA (WITH ONE OR TWO EXCEPTIONS). PARTICIPANTS ALSO SHOWED IMPROVED HEART RATE VARIABILITY DURING A WORRY PERIOD FROM PRE- TO POST-INTERVENTION. YOGA HAS THE POTENTIAL TO IMPROVE THE PROCESSES LINKED TO GAD AND SHOULD STIMULATE FURTHER RESEARCH IN THIS AREA.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
12 2159  35 THE EFFECTS OF VR-BASED WII FIT YOGA ON PHYSICAL FUNCTION IN MIDDLE-AGED FEMALE LBP PATIENTS. [PURPOSE] THE PURPOSE OF THIS RESEARCH WAS TO DETERMINE THE EFFECTS OF A VIRTUAL REALITY-BASED YOGA PROGRAM ON MIDDLE-AGED FEMALE LOW BACK PAIN PATIENTS. [SUBJECTS AND METHODS] THIRTY MIDDLE-AGED FEMALE PATIENTS WHO SUFFERED FROM LOW BACK PAIN WERE ASSIGNED TO EITHER A PHYSICAL THERAPY PROGRAM OR A VIRTUAL REALITY-BASED YOGA PROGRAM FOR A PERIOD OF FOUR WEEKS. PARTICIPANTS COULD CHECK THEIR POSTURE AND WEIGHT BEARING ON A MONITOR AS THEY SHIFTED THEIR WEIGHT OR CHANGED THEIR POSTURES ON A WII BALANCE BOARD. THERE WERE A TOTAL OF SEVEN EXERCISE PROGRAMS. A 30-MINUTE, THREE TIMES PER WEEK, VIRTUAL REALITY-BASED WII FIT YOGA PROGRAM OR TRUNK STABILIZING EXERCISE WAS PERFORMED, RESPECTIVELY. [RESULTS] REPEATED-MEASURES ANALYSIS OF COVARIANCE REVEALED SIGNIFICANT DIFFERENCES IN BETWEEN PRE- AND POST-TRAINING VAS, ALGOMETER, OSWESTRY LOW-BACK PAIN DISABILITY INDEX (ODI), ROLAND MORRIS DISABILITY QUESTIONNAIRE (RMDQ), AND FEAR AVOIDANCE BELIEFS QUESTIONNAIRE (FBQ) SCORES. THE VAS, ALGOMETER, ODI, RMDQ, AND FBQ SCORES SHOWED SIGNIFICANT DIFFERENCES IN GROUPS. REGARDING THE EFFECT OF TIME-BY-GROUP INTERACTION, THERE WERE SIGNIFICANT DIFFERENCES IN VAS, ODI, ODI, AND FBQ SCORES. [CONCLUSION] IN CONCLUSION, FOR MIDDLE-AGED FEMALE PATIENTS WHO HAVE LOW BACK PAIN, A VIRTUAL REALITY-BASED YOGA PROGRAM WAS SHOWN TO HAVE POSITIVE EFFECTS ON PHYSICAL IMPROVEMENTS, AND THIS PROGRAM CAN BE EMPLOYED AS A THERAPEUTIC MEDIUM FOR PREVENTION AND CURE OF LOW BACK PAIN.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
13  252  24 A YOGA PROGRAM FOR THE SYMPTOMS OF POST-TRAUMATIC STRESS DISORDER IN VETERANS. THE PURPOSE OF THIS PILOT STUDY WAS TO EVALUATE THE FEASIBILITY AND EFFECTIVENESS OF A YOGA PROGRAM AS AN ADJUNCTIVE THERAPY FOR IMPROVING POST-TRAUMATIC STRESS DISORDER (PTSD) SYMPTOMS IN VETERANS WITH MILITARY-RELATED PTSD. VETERANS (N = 12) PARTICIPATED IN A 6 WEEK YOGA INTERVENTION HELD TWICE A WEEK. THERE WAS SIGNIFICANT IMPROVEMENT IN PTSD HYPERAROUSAL SYMPTOMS AND OVERALL SLEEP QUALITY AS WELL AS DAYTIME DYSFUNCTION RELATED TO SLEEP. THERE WERE NO SIGNIFICANT IMPROVEMENTS IN THE TOTAL PTSD, ANGER, OR QUALITY OF LIFE OUTCOME SCORES. THESE RESULTS SUGGEST THAT THIS YOGA PROGRAM MAY BE AN EFFECTIVE ADJUNCTIVE THERAPY FOR IMPROVING HYPERAROUSAL SYMPTOMS OF PTSD INCLUDING SLEEP QUALITY. THIS STUDY DEMONSTRATES THAT THE YOGA PROGRAM IS ACCEPTABLE, FEASIBLE, AND THAT THERE IS GOOD ADHERENCE IN A VETERAN POPULATION.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
14 1541  32 KRIPALU YOGA FOR MILITARY VETERANS WITH PTSD: A RANDOMIZED TRIAL. OBJECTIVES: THIS RANDOMIZED CONTROLLED TRIAL OF YOGA FOR MILITARY VETERANS AND ACTIVE DUTY PERSONNEL WITH POSTTRAUMATIC STRESS DISORDER (PTSD) EVALUATED THE EFFICACY OF A 10-WEEK YOGA INTERVENTION ON PTSD. METHOD: FIFTY-ONE PARTICIPANTS WERE RANDOMIZED INTO YOGA OR NO-TREATMENT ASSESSMENT-ONLY CONTROL GROUPS. PRIMARY OUTCOME MEASURES INCLUDED QUESTIONNAIRES AND THE CLINICIAN ADMINISTERED PTSD SCALE. RESULTS: BOTH YOGA (N = 9) AND CONTROL (N = 6) PARTICIPANTS SHOWED SIGNIFICANT DECREASES IN REEXPERIENCING SYMPTOMS, WITH NO SIGNIFICANT BETWEEN-GROUP DIFFERENCES. SECONDARY WITHIN-GROUP ANALYSES OF A SELF-SELECTED WAIT-LIST YOGA GROUP (N = 7) SHOWED SIGNIFICANT REDUCTIONS IN PTSD SYMPTOMS AFTER YOGA PARTICIPATION, IN CONTRAST TO THEIR CONTROL GROUP PARTICIPATION. CONSISTENT WITH CURRENT LITERATURE REGARDING HIGH RATES OF PTSD TREATMENT DROPOUT FOR VETERANS, THIS STUDY FACED CHALLENGES RETAINING PARTICIPANTS ACROSS CONDITIONS. CONCLUSION: THESE RESULTS ARE CONSISTENT WITH RECENT LITERATURE INDICATING THAT YOGA MAY HAVE POTENTIAL AS A PTSD THERAPY IN A VETERAN OR MILITARY POPULATION. HOWEVER, ADDITIONAL LARGER SAMPLE SIZE TRIALS ARE NECESSARY TO CONFIRM THIS CONCLUSION.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
15 2851  51 YOGA, PHYSICAL THERAPY, AND BACK PAIN EDUCATION FOR SLEEP QUALITY IN LOW-INCOME RACIALLY DIVERSE ADULTS WITH CHRONIC LOW BACK PAIN: A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: POOR SLEEP IS COMMON AMONG ADULTS WITH CHRONIC LOW BACK PAIN (CLBP), BUT THE INFLUENCE OF CLBP TREATMENTS, SUCH AS YOGA AND PHYSICAL THERAPY (PT), ON SLEEP QUALITY IS UNDER STUDIED. OBJECTIVE: EVALUATE THE EFFECTIVENESS OF YOGA AND PT FOR IMPROVING SLEEP QUALITY IN ADULTS WITH CLBP. DESIGN: SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. SETTING: ACADEMIC SAFETY-NET HOSPITAL AND 7 AFFILIATED COMMUNITY HEALTH CENTERS. PARTICIPANTS: A TOTAL OF 320 ADULTS WITH CLBP. INTERVENTION: TWELVE WEEKLY YOGA CLASSES, 1-ON-1 PT SESSIONS, OR AN EDUCATIONAL BOOK. MAIN MEASURES: SLEEP QUALITY WAS MEASURED USING THE PITTSBURGH SLEEP QUALITY INDEX (PSQI) GLOBAL SCORE (0-21) AT BASELINE, 12 WEEKS, AND 52 WEEKS. ADDITIONALLY, WE ALSO EVALUATED HOW THE PROPORTION OF PARTICIPANTS WHO ACHIEVED A CLINICALLY MEANINGFUL IMPROVEMENT IN SLEEP QUALITY (> 3-POINT REDUCTION IN PSQI) AT 12 WEEKS VARIED BY CHANGES IN PAIN AND PHYSICAL FUNCTION AT 6 WEEKS. KEY RESULTS: AMONG PARTICIPANTS (MEAN AGE = 46.0, 64% FEMALE, 82% NON-WHITE), NEARLY ALL (92%) REPORTED POOR SLEEP QUALITY (PSQI > 5) AT BASELINE. AT 12 WEEKS, MODEST IMPROVEMENTS IN SLEEP QUALITY WERE OBSERVED AMONG THE YOGA (PSQI MEAN DIFFERENCE [MD] = - 1.19, 95% CONFIDENCE INTERVAL [CI] - 1.82, - 0.55) AND PT (PSQI MD = - 0.91, 95% CI - 1.61, - 0.20) GROUPS. PARTICIPANTS WHO REPORTED A >/= 30% IMPROVEMENT IN PAIN OR PHYSICAL FUNCTION AT 6 WEEKS, COMPARED WITH THOSE WHO IMPROVED < 10%, WERE MORE LIKELY TO BE A SLEEP QUALITY RESPONDER AT 12 WEEKS (ODDS RATIO [OR] = 3.51, 95% CI 1.73, 7.11 AND OR = 2.16, 95% CI 1.18, 3.95, RESPECTIVELY). RESULTS WERE SIMILAR AT 52 WEEKS. CONCLUSION: IN A SAMPLE OF ADULTS WITH CLBP, VIRTUALLY ALL WITH POOR SLEEP QUALITY PRIOR TO INTERVENTION, MODEST BUT STATISTICALLY SIGNIFICANT IMPROVEMENTS IN SLEEP QUALITY WERE OBSERVED WITH BOTH YOGA AND PT. IRRESPECTIVE OF TREATMENT, CLINICALLY IMPORTANT SLEEP IMPROVEMENTS AT THE END OF THE INTERVENTION WERE ASSOCIATED WITH MID-INTERVENTION PAIN AND PHYSICAL FUNCTION IMPROVEMENTS. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT01343927.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
16 1699  48 PARTICIPANT CHARACTERISTICS ASSOCIATED WITH SYMPTOMATIC IMPROVEMENT FROM YOGA FOR CHRONIC LOW BACK PAIN. CONTEXT: STUDIES SUGGEST THAT YOGA IS EFFECTIVE FOR MODERATE TO SEVERE CHRONIC LOW BACK PAIN (CLBP) IN DIVERSE PREDOMINANTLY LOWER SOCIOECONOMIC STATUS POPULATIONS. HOWEVER, LITTLE IS KNOWN ABOUT FACTORS ASSOCIATED WITH BENEFIT FROM THE YOGA INTERVENTION. OBJECTIVE: IDENTIFY FACTORS AT BASELINE INDEPENDENTLY ASSOCIATED WITH GREATER EFFICACY AMONG PARTICIPANTS IN A STUDY OF YOGA FOR CLBP. DESIGN: FROM SEPTEMBER-DECEMBER 2011, A 12-WEEK RANDOMIZED DOSING TRIAL WAS CONDUCTED COMPARING WEEKLY VS. TWICE-WEEKLY 75-MINUTE HATHA YOGA CLASSES FOR 95 PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH NONSPECIFIC CLBP. PARTICIPANT CHARACTERISTICS COLLECTED AT BASELINE WERE USED TO DETERMINE FACTORS BEYOND TREATMENT ASSIGNMENT (REPORTED IN THE INITIAL STUDY) THAT PREDICTED OUTCOME. WE USED BIVARIATE TESTING TO IDENTIFY BASELINE CHARACTERISTICS ASSOCIATED WITH IMPROVEMENT IN FUNCTION AND PAIN, AND INCLUDED SELECT FACTORS IN A MULTIVARIATE LINEAR REGRESSION. SETTING: RECRUITMENT AND CLASSES OCCURRED IN AN ACADEMIC SAFETY-NET HOSPITAL AND FIVE AFFILIATED COMMUNITY HEALTH CENTERS IN BOSTON, MASSACHUSETTS. PARTICIPANTS: NINETY-FIVE ADULTS WITH NONSPECIFIC CLBP, AGES RANGING FROM 20-64 (MEAN 48) YEARS; 72 WOMEN AND 23 MEN. OUTCOME MEASURES: PRIMARY OUTCOMES WERE CHANGES IN BACK-RELATED FUNCTION (MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE, RMDQ; 0-23) AND MEAN LOW BACK PAIN INTENSITY (0-10) IN THE PREVIOUS WEEK, FROM BASELINE TO WEEK 12. RESULTS: ADJUSTING FOR GROUP ASSIGNMENT, BASELINE RMDQ, AGE, AND GENDER, FOREIGN NATIONALITY AND LOWER BASELINE SF36 PHYSICAL COMPONENT SCORE (PCS) WERE INDEPENDENTLY ASSOCIATED WITH IMPROVEMENT IN RMDQ. GREATER THAN HIGH SCHOOL EDUCATION LEVEL, CLBP LESS THAN 1 YEAR, AND LOWER BASELINE SF36 PCS WERE INDEPENDENTLY ASSOCIATED WITH IMPROVEMENT IN PAIN INTENSITY. OTHER DEMOGRAPHICS INCLUDING RACE, INCOME, GENDER, BMI, AND USE OF PAIN MEDICATIONS WERE NOT ASSOCIATED WITH EITHER OUTCOME. CONCLUSIONS: POOR PHYSICAL HEALTH AT BASELINE IS ASSOCIATED WITH GREATER IMPROVEMENT FROM YOGA IN BACK-RELATED FUNCTION AND PAIN. RACE, INCOME, AND BODY MASS INDEX DO NOT AFFECT THE POTENTIAL FOR A PERSON WITH LOW BACK PAIN TO EXPERIENCE BENEFIT FROM YOGA.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
17 2596  46 YOGA FOR MILITARY VETERANS WITH CHRONIC LOW BACK PAIN: A RANDOMIZED CLINICAL TRIAL. INTRODUCTION: CHRONIC LOW BACK PAIN (CLBP) IS PREVALENT, ESPECIALLY AMONG MILITARY VETERANS. MANY CLBP TREATMENT OPTIONS HAVE LIMITED BENEFITS AND ARE ACCOMPANIED BY SIDE EFFECTS. MAJOR EFFORTS TO REDUCE OPIOID USE AND EMBRACE NONPHARMACOLOGICAL PAIN TREATMENTS HAVE RESULTED. RESEARCH WITH COMMUNITY CLBP PATIENTS INDICATES THAT YOGA CAN IMPROVE HEALTH OUTCOMES AND HAS FEW SIDE EFFECTS. THE BENEFITS OF YOGA AMONG MILITARY VETERANS WERE EXAMINED. DESIGN: PARTICIPANTS WERE RANDOMIZED TO EITHER YOGA OR DELAYED YOGA TREATMENT IN 2013-2015. OUTCOMES WERE ASSESSED AT BASELINE, 6 WEEKS, 12 WEEKS, AND 6 MONTHS. INTENTION-TO-TREAT ANALYSES OCCURRED IN 2016. SETTING/PARTICIPANTS: ONE HUNDRED AND FIFTY MILITARY VETERANS WITH CLBP WERE RECRUITED FROM A MAJOR VETERANS AFFAIRS MEDICAL CENTER IN CALIFORNIA. INTERVENTION: YOGA CLASSES (WITH HOME PRACTICE) WERE LED BY A CERTIFIED INSTRUCTOR TWICE WEEKLY FOR 12 WEEKS, AND CONSISTED PRIMARILY OF PHYSICAL POSTURES, MOVEMENT, AND BREATHING TECHNIQUES. MAIN OUTCOME MEASURES: THE PRIMARY OUTCOME WAS ROLAND-MORRIS DISABILITY QUESTIONNAIRE SCORES AFTER 12 WEEKS. PAIN INTENSITY WAS IDENTIFIED AS AN IMPORTANT SECONDARY OUTCOME. RESULTS: PARTICIPANT CHARACTERISTICS WERE MEAN AGE 53 YEARS, 26% WERE FEMALE, 35% WERE UNEMPLOYED OR DISABLED, AND MEAN BACK PAIN DURATION WAS 15 YEARS. IMPROVEMENTS IN ROLAND-MORRIS DISABILITY QUESTIONNAIRE SCORES DID NOT DIFFER BETWEEN THE TWO GROUPS AT 12 WEEKS, BUT YOGA PARTICIPANTS HAD GREATER REDUCTIONS IN ROLAND-MORRIS DISABILITY QUESTIONNAIRE SCORES THAN DELAYED TREATMENT PARTICIPANTS AT 6 MONTHS -2.48 (95% CI= -4.08, -0.87). YOGA PARTICIPANTS IMPROVED MORE ON PAIN INTENSITY AT 12 WEEKS AND AT 6 MONTHS. OPIOID MEDICATION USE DECLINED AMONG ALL PARTICIPANTS, BUT GROUP DIFFERENCES WERE NOT FOUND. CONCLUSIONS: YOGA IMPROVED HEALTH OUTCOMES AMONG VETERANS DESPITE EVIDENCE THEY HAD FEWER RESOURCES, WORSE HEALTH, AND MORE CHALLENGES ATTENDING YOGA SESSIONS THAN COMMUNITY SAMPLES STUDIED PREVIOUSLY. THE MAGNITUDE OF PAIN INTENSITY DECLINE WAS SMALL, BUT OCCURRED IN THE CONTEXT OF REDUCED OPIOID USE. THE FINDINGS SUPPORT WIDER IMPLEMENTATION OF YOGA PROGRAMS FOR VETERANS. TRIAL REGISTRATION: THIS STUDY IS REGISTERED AT WWW.CLINICALTRIALS.GOV NCT02524158.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                             
18  194  32 A RANDOMIZED TRIAL OF YOGA FOR ADOLESCENTS WITH IRRITABLE BOWEL SYNDROME. BACKGROUND: ADOLESCENTS WITH IRRITABLE BOWEL SYNDROME (IBS) FREQUENTLY EXPERIENCE INTERFERENCE WITH EVERYDAY ACTIVITIES. MIND-BODY APPROACHES SUCH AS YOGA HAVE BEEN RECOMMENDED AS INTERVENTIONS FOR PATIENTS WITH IBS. DESPITE PROMISING RESULTS AMONG ADULT SAMPLES, THERE HAVE BEEN LIMITED STUDIES EXPLORING THE EFFICACY OF YOGA WITH PEDIATRIC PATIENTS. OBJECTIVE: TO CONDUCT A PRELIMINARY RANDOMIZED STUDY OF YOGA AS TREATMENT FOR ADOLESCENTS WITH IBS. METHODS: TWENTY-FIVE ADOLESCENTS AGED 11 TO 18 YEARS WITH IBS WERE RANDOMLY ASSIGNED TO EITHER A YOGA OR WAIT LIST CONTROL GROUP. BEFORE THE INTERVENTION, BOTH GROUPS COMPLETED QUESTIONNAIRES ASSESSING GASTROINTESTINAL SYMPTOMS, PAIN, FUNCTIONAL DISABILITY, COPING, ANXIETY AND DEPRESSION. THE YOGA INTERVENTION CONSISTED OF A 1 H INSTRUCTIONAL SESSION, DEMONSTRATION AND PRACTICE, FOLLOWED BY FOUR WEEKS OF DAILY HOME PRACTICE GUIDED BY A VIDEO. AFTER FOUR WEEKS, ADOLESCENTS REPEATED THE BASELINE QUESTIONNAIRES. THE WAIT LIST CONTROL GROUP THEN RECEIVED THE YOGA INTERVENTION AND FOUR WEEKS LATER COMPLETED AN ADDITIONAL SET OF QUESTIONNAIRES. RESULTS: ADOLESCENTS IN THE YOGA GROUP REPORTED LOWER LEVELS OF FUNCTIONAL DISABILITY, LESS USE OF EMOTION-FOCUSED AVOIDANCE AND LOWER ANXIETY FOLLOWING THE INTERVENTION THAN ADOLESCENTS IN THE CONTROL GROUP. WHEN THE PRE- AND POSTINTERVENTION DATA FOR THE TWO GROUPS WERE COMBINED, ADOLESCENTS HAD SIGNIFICANTLY LOWER SCORES FOR GASTROINTESTINAL SYMPTOMS AND EMOTION-FOCUSED AVOIDANCE FOLLOWING THE YOGA INTERVENTION. ADOLESCENTS FOUND THE YOGA TO BE HELPFUL AND INDICATED THEY WOULD CONTINUE TO USE IT TO MANAGE THEIR IBS. CONCLUSIONS: YOGA HOLDS PROMISE AS AN INTERVENTION FOR ADOLESCENTS WITH IBS.	2006	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
19  193  48 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
20 2506  30 YOGA ATTITUDES IN CHRONIC LOW BACK PAIN: ROLES OF CATASTROPHIZING AND FEAR OF MOVEMENT. CHRONIC LOW BACK PAIN IS A SIGNIFICANT PUBLIC HEALTH PROBLEM AND, ALTHOUGH UNDERUSED, YOGA MAY BE AN EFFECTIVE COMPLEMENTARY TREATMENT. THE CURRENT STUDY EXAMINED ASSOCIATIONS OF PAIN CATASTROPHIZING AND FEAR OF MOVEMENT WITH ATTITUDES TOWARD YOGA IN ADULTS WITH CHRONIC LOW BACK PAIN. PARTICIPANTS COMPLETED THREE QUANTITATIVE QUESTIONNAIRES ASSESSING SPECIFIC CONSTRUCTS: BELIEFS ABOUT YOGA, FEAR OF MOVEMENT, AND PAIN CATASTROPHIZING. A SEMI-STRUCTURED IN-PERSON INTERVIEW WAS THEN CONDUCTED TO OBTAIN SPECIFIC PAIN-RELATED INFORMATION. HIERARCHICAL REGRESSION AND MEDIATIONAL ANALYSES WERE USED TO TEST HYPOTHESES. CONSISTENT WITH THE FEAR-AVOIDANCE MODEL OF CHRONIC PAIN, CATASTROPHIZING AND FEAR OF MOVEMENT WERE NEGATIVELY ASSOCIATED WITH YOGA ATTITUDES. SPECIFICALLY, FEAR OF MOVEMENT WAS A MEDIATOR BETWEEN CATASTROPHIZING AND ATTITUDES TOWARD YOGA. INDIVIDUALS WITH HIGHER LEVELS OF CATASTROPHIZING AND FEAR OF MOVEMENT MAY BE LESS LIKELY TO CONSIDER A PAIN TREATMENT INVOLVING PHYSICAL MOVEMENT.	2015