1 2518 215 YOGA COMPARED TO NON-EXERCISE OR PHYSICAL THERAPY EXERCISE ON PAIN, DISABILITY, AND QUALITY OF LIFE FOR PATIENTS WITH CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. BACKGROUND: CHRONIC LOW BACK PAIN (CLBP) IS A COMMON AND OFTEN DISABLING MUSCULOSKELETAL CONDITION. YOGA HAS BEEN PROVEN TO BE AN EFFECTIVE THERAPY FOR CHRONIC LOW BACK PAIN. HOWEVER, THERE ARE STILL CONTROVERSIES ABOUT THE EFFECTS OF YOGA AT DIFFERENT FOLLOW-UP PERIODS AND COMPARED WITH OTHER PHYSICAL THERAPY EXERCISES. OBJECTIVE: TO CRITICALLY COMPARE THE EFFECTS OF YOGA FOR PATIENTS WITH CHRONIC LOW BACK PAIN ON PAIN, DISABILITY, QUALITY OF LIFE WITH NON-EXERCISE (E.G. USUAL CARE, EDUCATION), PHYSICAL THERAPY EXERCISE. METHODS: THIS STUDY WAS REGISTERED IN PROSPERO, AND THE REGISTRATION NUMBER WAS CRD42020159865. RANDOMIZED CONTROLLED TRIALS (RCTS) OF ONLINE DATABASES INCLUDED PUBMED, WEB OF SCIENCE, COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, EMBASE WHICH EVALUATED EFFECTS OF YOGA FOR PATIENTS WITH CHRONIC LOW BACK PAIN ON PAIN, DISABILITY, AND QUALITY OF LIFE WERE SEARCHED FROM INCEPTION TIME TO NOVEMBER 1, 2019. STUDIES WERE ELIGIBLE IF THEY ASSESSED AT LEAST ONE IMPORTANT OUTCOME, NAMELY PAIN, BACK-SPECIFIC DISABILITY, QUALITY OF LIFE. THE COCHRANE RISK OF BIAS TOOL WAS USED TO ASSESS THE METHODOLOGICAL QUALITY OF INCLUDED RANDOMIZED CONTROLLED TRIALS. THE CONTINUOUS OUTCOMES WERE ANALYZED BY CALCULATING THE MEAN DIFFERENCE (MD) OR STANDARDIZED MEAN DIFFERENCE (SMD) WITH 95% CONFIDENCE INTERVALS (CI) ACCORDING TO WHETHER COMBINING OUTCOMES MEASURED ON DIFFERENT SCALES OR NOT. RESULTS: A TOTAL OF 18 RANDOMIZED CONTROLLED TRIALS WERE INCLUDED IN THIS META-ANALYSIS. YOGA COULD SIGNIFICANTLY REDUCE PAIN AT 4 TO 8 WEEKS (MD = -0.83, 95% CI = -1.19 TO -0.48, P<0.00001, I2 = 0%), 3 MONTHS (MD = -0.43, 95% CI = -0.64 TO -0.23, P<0.0001, I2 = 0%), 6 TO 7 MONTHS (MD = -0.56, 95% CI = -1.02 TO -0.11, P = 0.02, I2 = 50%), AND WAS NOT SIGNIFICANT IN 12 MONTHS (MD = -0.52, 95% CI = -1.64 TO 0.59, P = 0.36, I2 = 87%) COMPARED WITH NON-EXERCISE. YOGA WAS BETTER THAN NON-EXERCISE ON DISABILITY AT 4 TO 8 WEEKS (SMD = -0.30, 95% CI = -0.51 TO -0.10, P = 0.003, I2 = 0%), 3 MONTHS (SMD = -0.31, 95% CI = -0.45 TO -0.18, P<0.00001, I2 = 30%), 6 MONTHS (SMD = -0.38, 95% CI = -0.53 TO -0.23, P<0.00001, I2 = 0%), 12 MONTHS (SMD = -0.33, 95% CI = -0.54 TO -0.12, P = 0.002, I2 = 9%). THERE WAS NO SIGNIFICANT DIFFERENCE ON PAIN, DISABILITY COMPARED WITH PHYSICAL THERAPY EXERCISE GROUP. FURTHERMORE, IT SUGGESTED THAT THERE WAS A NON-SIGNIFICANT DIFFERENCE ON PHYSICAL AND MENTAL QUALITY OF LIFE BETWEEN YOGA AND ANY OTHER INTERVENTIONS. CONCLUSION: THIS META-ANALYSIS PROVIDED EVIDENCE FROM VERY LOW TO MODERATE INVESTIGATING THE EFFECTIVENESS OF YOGA FOR CHRONIC LOW BACK PAIN PATIENTS AT DIFFERENT TIME POINTS. YOGA MIGHT DECREASE PAIN FROM SHORT TERM TO INTERMEDIATE TERM AND IMPROVE FUNCTIONAL DISABILITY STATUS FROM SHORT TERM TO LONG TERM COMPARED WITH NON-EXERCISE (E.G. USUAL CARE, EDUCATION). YOGA HAD THE SAME EFFECT ON PAIN AND DISABILITY AS ANY OTHER EXERCISE OR PHYSICAL THERAPY. YOGA MIGHT NOT IMPROVE THE PHYSICAL AND MENTAL QUALITY OF LIFE BASED ON THE RESULT OF A MERGING. 2020 2 1787 49 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 3 2811 49 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 4 2415 56 YOGA AND MEDITATION FOR MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS-A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: BREAST CANCER SURVIVORS HAVE ONLY VERY LIMITED TREATMENT OPTIONS FOR MENOPAUSAL SYMPTOMS. THE OBJECTIVE OF THIS TRIAL WAS TO EVALUATE THE EFFECTS OF A 12-WEEK TRADITIONAL HATHA YOGA AND MEDITATION INTERVENTION ON MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS. METHODS: PATIENTS WERE RANDOMLY ASSIGNED EITHER TO A 12-WEEK YOGA AND MEDITATION INTERVENTION OR TO USUAL CARE. THE PRIMARY OUTCOME MEASURE WAS TOTAL MENOPAUSAL SYMPTOMS (MENOPAUSE RATING SCALE [MRS] TOTAL SCORE). SECONDARY OUTCOME MEASURES INCLUDED MRS SUBSCALES, QUALITY OF LIFE (FUNCTIONAL ASSESSMENT OF CANCER THERAPY-BREAST), FATIGUE (FUNCTIONAL ASSESSMENT OF CHRONIC ILLNESS THERAPY-FATIGUE), DEPRESSION, AND ANXIETY (HOSPITAL ANXIETY AND DEPRESSION SCALE). OUTCOMES WERE ASSESSED AT WEEK 12 AND WEEK 24 AFTER RANDOMIZATION. RESULTS: IN TOTAL, 40 WOMEN (MEAN AGE +/- STANDARD DEVIATION, 49.2 +/- 5.9 YEARS) WERE RANDOMIZED TO YOGA (N = 19) OR TO USUAL CARE (N = 21). WOMEN IN THE YOGA GROUP REPORTED SIGNIFICANTLY LOWER TOTAL MENOPAUSAL SYMPTOMS COMPARED WITH THE USUAL CARE GROUP AT WEEK 12 (MEAN DIFFERENCE, -5.6; 95% CONFIDENCE INTERVAL, -9.2 TO -1.9; P = .004) AND AT WEEK 24 (MEAN DIFFERENCE, -4.5; 95% CONFIDENCE INTERVAL, -8.3 TO -0.7; P = .023). AT WEEK 12, THE YOGA GROUP REPORTED LESS SOMATOVEGETATIVE, PSYCHOLOGICAL, AND UROGENITAL MENOPAUSAL SYMPTOMS; LESS FATIGUE; AND IMPROVED QUALITY OF LIFE (ALL P < .05). AT WEEK 24, ALL EFFECTS PERSISTED EXCEPT FOR PSYCHOLOGICAL MENOPAUSAL SYMPTOMS. SHORT-TERM EFFECTS ON MENOPAUSAL SYMPTOMS REMAINED SIGNIFICANT WHEN ONLY WOMEN WHO WERE RECEIVING ANTIESTROGEN MEDICATION (N = 36) WERE ANALYZED. SIX MINOR ADVERSE EVENTS OCCURRED IN EACH GROUP. CONCLUSIONS: YOGA COMBINED WITH MEDITATION CAN BE CONSIDERED A SAFE AND EFFECTIVE COMPLEMENTARY INTERVENTION FOR MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS. THE EFFECTS SEEM TO PERSIST FOR AT LEAST 3 MONTHS. 2015 5 193 57 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 6 521 59 COMPARING YOGA, EXERCISE, AND A SELF-CARE BOOK FOR CHRONIC LOW BACK PAIN: A RANDOMIZED, CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN IS A COMMON PROBLEM THAT HAS ONLY MODESTLY EFFECTIVE TREATMENT OPTIONS. OBJECTIVE: TO DETERMINE WHETHER YOGA IS MORE EFFECTIVE THAN CONVENTIONAL THERAPEUTIC EXERCISE OR A SELF-CARE BOOK FOR PATIENTS WITH CHRONIC LOW BACK PAIN. DESIGN: RANDOMIZED, CONTROLLED TRIAL. SETTING: A NONPROFIT, INTEGRATED HEALTH CARE SYSTEM. PATIENTS: 101 ADULTS WITH CHRONIC LOW BACK PAIN. INTERVENTION: 12-WEEK SESSIONS OF YOGA OR CONVENTIONAL THERAPEUTIC EXERCISE CLASSES OR A SELF-CARE BOOK. MEASUREMENTS: PRIMARY OUTCOMES WERE BACK-RELATED FUNCTIONAL STATUS (MODIFIED 24-POINT ROLAND DISABILITY SCALE) AND "BOTHERSOMENESS" OF PAIN (11-POINT NUMERICAL SCALE). THE PRIMARY TIME POINT WAS 12 WEEKS. CLINICALLY SIGNIFICANT CHANGE WAS CONSIDERED TO BE 2.5 POINTS ON THE FUNCTIONAL STATUS SCALE AND 1.5 POINTS ON THE BOTHERSOMENESS SCALE. SECONDARY OUTCOMES WERE DAYS OF RESTRICTED ACTIVITY, GENERAL HEALTH STATUS, AND MEDICATION USE. RESULTS: AFTER ADJUSTMENT FOR BASELINE VALUES, BACK-RELATED FUNCTION IN THE YOGA GROUP WAS SUPERIOR TO THE BOOK AND EXERCISE GROUPS AT 12 WEEKS (YOGA VS. BOOK: MEAN DIFFERENCE, -3.4 [95% CI, -5.1 TO - 1.6] [P < 0.001]; YOGA VS. EXERCISE: MEAN DIFFERENCE, -1.8 [CI, -3.5 TO - 0.1] [P = 0.034]). NO SIGNIFICANT DIFFERENCES IN SYMPTOM BOTHERSOMENESS WERE FOUND BETWEEN ANY 2 GROUPS AT 12 WEEKS; AT 26 WEEKS, THE YOGA GROUP WAS SUPERIOR TO THE BOOK GROUP WITH RESPECT TO THIS MEASURE (MEAN DIFFERENCE, -2.2 [CI, -3.2 TO - 1.2]; P < 0.001). AT 26 WEEKS, BACK-RELATED FUNCTION IN THE YOGA GROUP WAS SUPERIOR TO THE BOOK GROUP (MEAN DIFFERENCE, -3.6 [CI, -5.4 TO - 1.8]; P < 0.001). LIMITATIONS: PARTICIPANTS IN THIS STUDY WERE FOLLOWED FOR ONLY 26 WEEKS AFTER RANDOMIZATION. ONLY 1 INSTRUCTOR DELIVERED EACH INTERVENTION. CONCLUSIONS: YOGA WAS MORE EFFECTIVE THAN A SELF-CARE BOOK FOR IMPROVING FUNCTION AND REDUCING CHRONIC LOW BACK PAIN, AND THE BENEFITS PERSISTED FOR AT LEAST SEVERAL MONTHS. 2005 7 1859 51 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 8 269 65 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 9 232 52 A SYSTEMATIC REVIEW OF YOGA FOR MAJOR DEPRESSIVE DISORDER. BACKGROUND: THE PURPOSE OF THIS REVIEW WAS TO INVESTIGATE THE EFFICACY AND SAFETY OF YOGA INTERVENTIONS IN TREATING PATIENTS WITH MAJOR DEPRESSIVE DISORDER. METHODS: MEDLINE, SCOPUS, AND THE COCHRANE LIBRARY WERE SCREENED THROUGH DECEMBER 2016. RANDOMIZED CONTROLLED TRIALS (RCTS) COMPARING YOGA TO INACTIVE OR ACTIVE COMPARATORS IN PATIENTS WITH MAJOR DEPRESSIVE DISORDER WERE ELIGIBLE. PRIMARY OUTCOMES INCLUDED REMISSION RATES AND SEVERITY OF DEPRESSION. ANXIETY AND ADVERSE EVENTS WERE SECONDARY OUTCOMES. RISK OF BIAS WAS ASSESSED USING THE COCHRANE TOOL. RESULTS: SEVEN RCTS WITH 240 PARTICIPANTS WERE INCLUDED. RISK OF BIAS WAS UNCLEAR FOR MOST RCTS. COMPARED TO AEROBIC EXERCISE, NO SHORT- OR MEDIUM-TERM GROUP DIFFERENCES IN DEPRESSION SEVERITY WAS FOUND. HIGHER SHORT-TERM DEPRESSION SEVERITY WAS FOUND FOR YOGA COMPARED TO ELECTRO-CONVULSIVE THERAPY; REMISSION RATES DID NOT DIFFER BETWEEN GROUPS. NO SHORT-TERM GROUP DIFFERENCES OCCURRED WHEN YOGA WAS COMPARED TO ANTIDEPRESSANT MEDICATION. CONFLICTING EVIDENCE WAS FOUND WHEN YOGA WAS COMPARED TO ATTENTION-CONTROL INTERVENTIONS, OR WHEN YOGA AS AN ADD-ON TO ANTIDEPRESSANT MEDICATION WAS COMPARED TO MEDICATION ALONE. ONLY TWO RCTS ASSESSED ADVERSE EVENTS AND REPORTED THAT NO TREATMENT-RELATED ADVERSE EVENTS WERE REPORTED. LIMITATIONS: FEW RCTS WITH LOW SAMPLE SIZE. CONCLUSIONS: THIS REVIEW FOUND SOME EVIDENCE FOR POSITIVE EFFECTS BEYOND PLACEBO AND COMPARABLE EFFECTS COMPARED TO EVIDENCE-BASED INTERVENTIONS. HOWEVER, METHODOLOGICAL PROBLEMS AND THE UNCLEAR RISK-BENEFIT RATIO PRECLUDE DEFINITIVE RECOMMENDATIONS FOR OR AGAINST YOGA AS AN ADJUNCT TREATMENT FOR MAJOR DEPRESSIVE DISORDER. LARGER AND ADEQUATELY POWERED RCTS USING NON-INFERIORITY DESIGNS ARE NEEDED. 2017 10 2560 65 YOGA FOR CHRONIC LOW BACK PAIN: A RANDOMIZED TRIAL. BACKGROUND: PREVIOUS STUDIES INDICATE THAT YOGA MAY BE AN EFFECTIVE TREATMENT FOR CHRONIC OR RECURRENT LOW BACK PAIN. OBJECTIVE: TO COMPARE THE EFFECTIVENESS OF YOGA AND USUAL CARE FOR CHRONIC OR RECURRENT LOW BACK PAIN. DESIGN: PARALLEL-GROUP, RANDOMIZED, CONTROLLED TRIAL USING COMPUTER-GENERATED RANDOMIZATION CONDUCTED FROM APRIL 2007 TO MARCH 2010. OUTCOMES WERE ASSESSED BY POSTAL QUESTIONNAIRE. (INTERNATIONAL STANDARD RANDOMISED CONTROLLED TRIAL NUMBER REGISTER: ISRCTN 81079604) SETTING: 13 NON-NATIONAL HEALTH SERVICE PREMISES IN THE UNITED KINGDOM. PATIENTS: 313 ADULTS WITH CHRONIC OR RECURRENT LOW BACK PAIN. INTERVENTION: YOGA (N = 156) OR USUAL CARE (N = 157). ALL PARTICIPANTS RECEIVED A BACK PAIN EDUCATION BOOKLET. THE INTERVENTION GROUP WAS OFFERED A 12-CLASS, GRADUALLY PROGRESSING YOGA PROGRAM DELIVERED BY 12 TEACHERS OVER 3 MONTHS. MEASUREMENTS: SCORES ON THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE (RMDQ) AT 3 (PRIMARY OUTCOME), 6, AND 12 (SECONDARY OUTCOMES) MONTHS; PAIN, PAIN SELF-EFFICACY, AND GENERAL HEALTH MEASURES AT 3, 6, AND 12 MONTHS (SECONDARY OUTCOMES). RESULTS: 93 (60%) PATIENTS OFFERED YOGA ATTENDED AT LEAST 3 OF THE FIRST 6 SESSIONS AND AT LEAST 3 OTHER SESSIONS. THE YOGA GROUP HAD BETTER BACK FUNCTION AT 3, 6, AND 12 MONTHS THAN THE USUAL CARE GROUP. THE ADJUSTED MEAN RMDQ SCORE WAS 2.17 POINTS (95% CI, 1.03 TO 3.31 POINTS) LOWER IN THE YOGA GROUP AT 3 MONTHS, 1.48 POINTS (CI, 0.33 TO 2.62 POINTS) LOWER AT 6 MONTHS, AND 1.57 POINTS (CI, 0.42 TO 2.71 POINTS) LOWER AT 12 MONTHS. THE YOGA AND USUAL CARE GROUPS HAD SIMILAR BACK PAIN AND GENERAL HEALTH SCORES AT 3, 6, AND 12 MONTHS, AND THE YOGA GROUP HAD HIGHER PAIN SELF-EFFICACY SCORES AT 3 AND 6 MONTHS BUT NOT AT 12 MONTHS. TWO OF THE 157 USUAL CARE PARTICIPANTS AND 12 OF THE 156 YOGA PARTICIPANTS REPORTED ADVERSE EVENTS, MOSTLY INCREASED PAIN. LIMITATION: THERE WERE MISSING DATA FOR THE PRIMARY OUTCOME (YOGA GROUP, N = 21; USUAL CARE GROUP, N = 18) AND DIFFERENTIAL MISSING DATA (MORE IN THE YOGA GROUP) FOR SECONDARY OUTCOMES. CONCLUSION: OFFERING A 12-WEEK YOGA PROGRAM TO ADULTS WITH CHRONIC OR RECURRENT LOW BACK PAIN LED TO GREATER IMPROVEMENTS IN BACK FUNCTION THAN DID USUAL CARE. PRIMARY FUNDING SOURCE: ARTHRITIS RESEARCH UK. 2011 11 1180 58 EVALUATION OF THE EFFECTIVENESS AND EFFICACY OF IYENGAR YOGA THERAPY ON CHRONIC LOW BACK PAIN. STUDY DESIGN: THE EFFECTIVENESS AND EFFICACY OF IYENGAR YOGA FOR CHRONIC LOW BACK PAIN (CLBP) WERE ASSESSED WITH INTENTION-TO-TREAT AND PER-PROTOCOL ANALYSIS. NINETY SUBJECTS WERE RANDOMIZED TO A YOGA (N = 43) OR CONTROL GROUP (N = 47) RECEIVING STANDARD MEDICAL CARE. PARTICIPANTS WERE FOLLOWED 6 MONTHS AFTER COMPLETION OF THE INTERVENTION. OBJECTIVE: THIS STUDY AIMED TO EVALUATE IYENGAR YOGA THERAPY ON CHRONIC LOW BACK PAIN. YOGA SUBJECTS WERE HYPOTHESIZED TO REPORT GREATER REDUCTIONS IN FUNCTIONAL DISABILITY, PAIN INTENSITY, DEPRESSION, AND PAIN MEDICATION USAGE THAN CONTROLS. SUMMARY OF BACKGROUND DATA: CLBP IS A MUSCULOSKELETAL DISORDER WITH PUBLIC HEALTH AND ECONOMIC IMPACT. PILOT STUDIES OF YOGA AND BACK PAIN HAVE REPORTED SIGNIFICANT CHANGES IN CLINICALLY IMPORTANT OUTCOMES. METHODS: SUBJECTS WERE RECRUITED THROUGH SELF-REFERRAL AND HEALTH PROFESSIONAL REFERRALS ACCORDING TO EXPLICIT INCLUSION/EXCLUSION CRITERIA. YOGA SUBJECTS PARTICIPATED IN 24 WEEKS OF BIWEEKLY YOGA CLASSES DESIGNED FOR CLBP. OUTCOMES WERE ASSESSED AT 12 (MIDWAY), 24 (IMMEDIATELY AFTER), AND 48 WEEKS (6-MONTH FOLLOW-UP) AFTER THE START OF THE INTERVENTION USING THE OSWESTRY DISABILITY QUESTIONNAIRE, A VISUAL ANALOG SCALE, THE BECK DEPRESSION INVENTORY, AND A PAIN MEDICATION-USAGE QUESTIONNAIRE. RESULTS: USING INTENTION-TO-TREAT ANALYSIS WITH REPEATED MEASURES ANOVA (GROUP X TIME), SIGNIFICANTLY GREATER REDUCTIONS IN FUNCTIONAL DISABILITY AND PAIN INTENSITY WERE OBSERVED IN THE YOGA GROUP WHEN COMPARED TO THE CONTROL GROUP AT 24 WEEKS. A SIGNIFICANTLY GREATER PROPORTION OF YOGA SUBJECTS ALSO REPORTED CLINICAL IMPROVEMENTS AT BOTH 12 AND 24 WEEKS. IN ADDITION, DEPRESSION WAS SIGNIFICANTLY LOWER IN YOGA SUBJECTS. FURTHERMORE, WHILE A REDUCTION IN PAIN MEDICATION OCCURRED, THIS WAS COMPARABLE IN BOTH GROUPS. WHEN RESULTS WERE ANALYZED USING PER-PROTOCOL ANALYSIS, IMPROVEMENTS WERE OBSERVED FOR ALL OUTCOMES IN THE YOGA GROUP, INCLUDING AGREATER TREND FOR REDUCED PAIN MEDICATION USAGE. ALTHOUGH SLIGHTLY LESS THAN AT 24 WEEKS, THE YOGA GROUP HAD STATISTICALLY SIGNIFICANT REDUCTIONS IN FUNCTIONAL DISABILITY, PAIN INTENSITY, AND DEPRESSION COMPARED TO STANDARD MEDICAL CARE 6-MONTHS POSTINTERVENTION. CONCLUSION: YOGA IMPROVES FUNCTIONAL DISABILITY, PAIN INTENSITY, AND DEPRESSION IN ADULTS WITH CLBP. THERE WAS ALSO A CLINICALLY IMPORTANT TREND FOR THE YOGA GROUP TO REDUCE THEIR PAIN MEDICATION USAGE COMPARED TO THE CONTROL GROUP. 2009 12 1862 47 RANDOMIZED CONTROLLED TRIAL OF YOGA AMONG A MULTIETHNIC SAMPLE OF BREAST CANCER PATIENTS: EFFECTS ON QUALITY OF LIFE. PURPOSE: THIS STUDY EXAMINES THE IMPACT OF YOGA, INCLUDING PHYSICAL POSES, BREATHING, AND MEDITATION EXERCISES, ON QUALITY OF LIFE (QOL), FATIGUE, DISTRESSED MOOD, AND SPIRITUAL WELL-BEING AMONG A MULTIETHNIC SAMPLE OF BREAST CANCER PATIENTS. PATIENTS AND METHODS: ONE HUNDRED TWENTY-EIGHT PATIENTS (42% AFRICAN AMERICAN, 31% HISPANIC) RECRUITED FROM AN URBAN CANCER CENTER WERE RANDOMLY ASSIGNED (2:1 RATIO) TO A 12-WEEK YOGA INTERVENTION (N = 84) OR A 12-WEEK WAITLIST CONTROL GROUP (N = 44). CHANGES IN QOL (EG, FUNCTIONAL ASSESSMENT OF CANCER THERAPY) FROM BEFORE RANDOM ASSIGNMENT (T1) TO THE 3-MONTH FOLLOW-UP (T3) WERE EXAMINED; PREDICTORS OF ADHERENCE WERE ALSO ASSESSED. NEARLY HALF OF ALL PATIENTS WERE RECEIVING MEDICAL TREATMENT. RESULTS: REGRESSION ANALYSES INDICATED THAT THE CONTROL GROUP HAD A GREATER DECREASE IN SOCIAL WELL-BEING COMPARED WITH THE INTERVENTION GROUP AFTER CONTROLLING FOR BASELINE SOCIAL WELL-BEING AND COVARIATES (P < .0001). SECONDARY ANALYSES OF 71 PATIENTS NOT RECEIVING CHEMOTHERAPY DURING THE INTERVENTION PERIOD INDICATED FAVORABLE OUTCOMES FOR THE INTERVENTION GROUP COMPARED WITH THE CONTROL GROUP IN OVERALL QOL (P < .008), EMOTIONAL WELL-BEING (P < .015), SOCIAL WELL-BEING (P < .004), SPIRITUAL WELL-BEING (P < .009), AND DISTRESSED MOOD (P < .031). SIXTY-NINE PERCENT OF INTERVENTION PARTICIPANTS ATTENDED CLASSES (MEAN NUMBER OF CLASSES ATTENDED BY ACTIVE CLASS PARTICIPANTS = 7.00 +/- 3.80), WITH LOWER ADHERENCE ASSOCIATED WITH INCREASED FATIGUE (P < .001), RADIOTHERAPY (P < .0001), YOUNGER AGE (P < .008), AND NO ANTIESTROGEN THERAPY (P < .02). CONCLUSION: DESPITE LIMITED ADHERENCE, THIS INTENT-TO-TREAT ANALYSIS SUGGESTS THAT YOGA IS ASSOCIATED WITH BENEFICIAL EFFECTS ON SOCIAL FUNCTIONING AMONG A MEDICALLY DIVERSE SAMPLE OF BREAST CANCER SURVIVORS. AMONG PATIENTS NOT RECEIVING CHEMOTHERAPY, YOGA APPEARS TO ENHANCE EMOTIONAL WELL-BEING AND MOOD AND MAY SERVE TO BUFFER DETERIORATION IN BOTH OVERALL AND SPECIFIC DOMAINS OF QOL. 2007 13 1902 44 RESTORATIVE YOGA IN ADULTS WITH METABOLIC SYNDROME: A RANDOMIZED, CONTROLLED PILOT TRIAL. BACKGROUND: METABOLIC SYNDROME INCREASES THE RISK OF DIABETES AND CARDIOVASCULAR DISEASE. YOGA IMPROVES SOME METABOLIC PARAMETERS, BUT IT HAS NOT BEEN STUDIED IN PERSONS WITH METABOLIC SYNDROME. WE CONDUCTED A RANDOMIZED CONTROLLED PILOT TRIAL TO DETERMINE WHETHER A RESTORATIVE YOGA INTERVENTION WAS FEASIBLE AND ACCEPTABLE IN UNDERACTIVE, OVERWEIGHT ADULTS WITH METABOLIC SYNDROME. METHODS: TWENTY SIX UNDERACTIVE, OVERWEIGHT ADULT MEN AND WOMEN WITH METABOLIC SYNDROME WERE RANDOMIZED TO ATTEND 15 YOGA SESSIONS OF 90 MINUTES EACH OVER 10 WEEKS OR TO A WAIT-LIST CONTROL GROUP. FEASIBILITY WAS MEASURED BY RECRUITMENT RATES, SUBJECT RETENTION, AND ADHERENCE. ACCEPTABILITY WAS ASSESSED BY INTERVIEW AND QUESTIONNAIRES. CHANGES IN METABOLIC OUTCOMES AND QUESTIONNAIRE MEASURES FROM BASELINE TO WEEK 10 WERE CALCULATED. RESULTS: A TOTAL OF 280 PEOPLE WERE SCREENED BY PHONE, AND 93 WITH HIGH LIKELIHOOD OF METABOLIC SYNDROME WERE INVITED TO A SCREENING VISIT. OF THE 68 WHO ATTENDED SCREENING VISITS, 26 (38%) WERE RANDOMIZED, AND 24 (92%) COMPLETED THE TRIAL. ATTENDANCE AT YOGA CLASSES AND ADHERENCE TO HOME PRACTICE EXCEEDED OUR GOALS. IN THE YOGA GROUP, ALL PARTICIPANTS GAVE THE STUDY THE HIGHEST POSSIBLE SATISFACTION RATING, AND THE MAJORITY (87%) FELT THAT THE YOGA POSES WERE EASY TO PERFORM. THERE WAS TREND TO REDUCED BLOOD PRESSURE (P = 0.07), A SIGNIFICANT INCREASE IN ENERGY LEVEL (P < 0.009), AND TRENDS TO IMPROVEMENT IN WELL-BEING (P < 0.12) AND STRESS (P < 0.22) IN THE YOGA VERSUS CONTROL GROUP. CONCLUSIONS: RESTORATIVE YOGA WAS A FEASIBLE AND ACCEPTABLE INTERVENTION IN OVERWEIGHT ADULTS WITH METABOLIC SYNDROME. THE EFFICACY OF YOGA FOR IMPROVING METABOLIC PARAMETERS IN THIS POPULATION SHOULD BE EXPLORED IN A LARGER RANDOMIZED CONTROLLED TRIAL. 2008 14 1165 68 EVALUATING THE FEASIBILITY AND IMPACT OF A YOGA INTERVENTION ON COGNITION, PHYSICAL FUNCTION, PHYSICAL ACTIVITY, AND AFFECTIVE OUTCOMES IN PEOPLE LIVING WITH HIV: PROTOCOL FOR A RANDOMIZED PILOT TRIAL. BACKGROUND: DESPITE LOWER MORTALITY RATES DUE TO COMBINATION ANTIRETROVIRAL THERAPY, PEOPLE LIVING WITH HIV (PLWH) ARE GRAPPLING WITH INCREASINGLY COMPLEX HEALTH ISSUES, INCLUDING COGNITIVE IMPAIRMENTS IN AREAS SUCH AS MEMORY, ATTENTION, PROCESSING SPEED, AND MOTOR FUNCTION. YOGA HAS BEEN SHOWN TO BE AN EFFECTIVE FORM OF EXERCISE AND MINDFULNESS-BASED STRESS REDUCTION FOR MANY CLINICAL POPULATIONS. HOWEVER, NO RANDOMIZED TRIALS HAVE EVALUATED THE IMPACT OF YOGA ON COGNITIVE AND PHYSICAL FUNCTION AMONG PLWH. OBJECTIVE: THE AIM OF THIS PILOT RANDOMIZED TRIAL WAS TO DETERMINE THE FEASIBILITY OF A YOGA INTERVENTION TO LAY THE GROUNDWORK FOR A FULL-SCALE, MULTISITE, COMMUNITY-BASED TRIAL FOR PLWH. SPECIFIC OBJECTIVES ARE TO (1) ASSESS THE FEASIBILITY OF STUDY PROTOCOL AND PROCEDURES, (2) COMPARE COGNITION IN THE YOGA GROUP WITH THE USUAL CARE CONTROL GROUP AFTER 12 WEEKS OF THE INTERVENTION IN PLWH, AND (3) COMPARE THE EFFECTS OF THE 12-WEEK YOGA INTERVENTION VERSUS CONTROL ON BALANCE, WALKING SPEED, PHYSICAL ACTIVITY, MENTAL HEALTH, MEDICATION ADHERENCE, AND QUALITY OF LIFE AMONG PLWH. METHODS: WE PROPOSE A PILOT RANDOMIZED TRIAL WITH 2 PARALLEL GROUPS (YOGA VERSUS CONTROL). WE WILL RECRUIT 25 PLWH (>35 YEARS) FROM COMMUNITY AND HEALTH ORGANIZATIONS IN HALIFAX, CANADA. AFTER BASELINE ASSESSMENT WITH BLINDED ASSESSORS, PARTICIPANTS WILL BE RANDOMLY ASSIGNED TO THE YOGA OR CONTROL GROUP, USING A RANDOM COMPUTER GENERATOR. PARTICIPANTS IN THE YOGA GROUP WILL ENGAGE IN SUPERVISED 60-MIN GROUP-BASED YOGA SESSIONS 3 TIMES A WEEK FOR 12 WEEKS AT A YOGA STUDIO. PARTICIPANTS IN THE CONTROL GROUP WILL MAINTAIN THEIR CURRENT PHYSICAL ACTIVITY LEVELS THROUGHOUT THE STUDY. RESULTS: AS PER THE CONSOLIDATED STANDARDS OF REPORTING TRIALS EXTENSION FOR PILOT STUDIES, MEANS OF ALL OUTCOMES, MEAN CHANGE, AND 95% CIS WILL BE CALCULATED FOR EACH GROUP SEPARATELY. TWO-TAILED INDEPENDENT T TESTS AND FISHER EXACT TESTS WILL BE USED TO COMPARE GROUPS AT BASELINE. WE WILL ANALYZE QUANTITATIVE POSTINTERVENTION QUESTIONNAIRE RESPONSES USING CHI-SQUARE TESTS, AND OPEN-ENDED RESPONSES WILL BE ANALYZED THEMATICALLY. INTENTION-TO-TREAT AND PER-PROTOCOL ANALYSES WILL BE USED TO ANALYZE SECONDARY VARIABLES. CHANGES IN OUTCOME VARIABLES WILL BE EXAMINED BETWEEN GROUPS AND WITHIN GROUPS. EFFECT SIZES WILL BE REPORTED FOR EACH OUTCOME. A PRIORI ADHERENCE AND SATISFACTION CRITERIA WILL BE MET IF PARTICIPANTS ATTEND >70% OF THE YOGA SESSIONS AND IF >70% OF THE PARTICIPANTS ARE SATISFIED WITH THE INTERVENTION AS DETERMINED BY A POSTPARTICIPATION QUESTIONNAIRE. STUDY ENROLLMENT BEGAN IN JANUARY 2018, WITH RESULTS EXPECTED FOR OCTOBER 2019. CONCLUSIONS: THIS PILOT RANDOMIZED TRIAL WILL BE THE FIRST TO INVESTIGATE THE FEASIBILITY AND EFFECT OF A YOGA INTERVENTION ON COGNITIVE AND PHYSICAL OUTCOMES AMONG PLWH. THIS WORK WILL INFORM THE FEASIBILITY OF FURTHER INVESTIGATIONS IN TERMS OF CAPACITY BUILDING, PARTICIPANT RECRUITMENT AND RETENTION, AND ASSESSMENT AND INTERVENTION PROTOCOLS. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT03071562; HTTPS://CLINICALTRIALS.GOV/CT2/SHOW/NCT03071562 (ARCHIVED BY WEBCITE AT HTTP://WWW.WEBCITATION.ORG/785SFHWKW). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/13818. 2019 15 2604 49 YOGA FOR PERSISTENT FATIGUE IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CANCER-RELATED FATIGUE AFFLICTS UP TO 33% OF BREAST CANCER SURVIVORS, YET THERE ARE NO EMPIRICALLY VALIDATED TREATMENTS FOR THIS SYMPTOM. METHODS: THE AUTHORS CONDUCTED A 2-GROUP RANDOMIZED CONTROLLED TRIAL TO DETERMINE THE FEASIBILITY AND EFFICACY OF AN IYENGAR YOGA INTERVENTION FOR BREAST CANCER SURVIVORS WITH PERSISTENT POST-TREATMENT FATIGUE. PARTICIPANTS WERE BREAST CANCER SURVIVORS WHO HAD COMPLETED CANCER TREATMENTS (OTHER THAN ENDOCRINE THERAPY) AT LEAST 6 MONTHS BEFORE ENROLLMENT, REPORTED SIGNIFICANT CANCER-RELATED FATIGUE, AND HAD NO OTHER MEDICAL CONDITIONS THAT WOULD ACCOUNT FOR FATIGUE SYMPTOMS OR INTERFERE WITH YOGA PRACTICE. BLOCK RANDOMIZATION WAS USED TO ASSIGN PARTICIPANTS TO A 12-WEEK, IYENGAR-BASED YOGA INTERVENTION OR TO 12 WEEKS OF HEALTH EDUCATION (CONTROL). THE PRIMARY OUTCOME WAS CHANGE IN FATIGUE MEASURED AT BASELINE, IMMEDIATELY POST-TREATMENT, AND 3 MONTHS AFTER TREATMENT COMPLETION. ADDITIONAL OUTCOMES INCLUDED CHANGES IN VIGOR, DEPRESSIVE SYMPTOMS, SLEEP, PERCEIVED STRESS, AND PHYSICAL PERFORMANCE. INTENT-TO-TREAT ANALYSES WERE CONDUCTED WITH ALL RANDOMIZED PARTICIPANTS USING LINEAR MIXED MODELS. RESULTS: THIRTY-ONE WOMEN WERE RANDOMLY ASSIGNED TO YOGA (N = 16) OR HEALTH EDUCATION (N = 15). FATIGUE SEVERITY DECLINED SIGNIFICANTLY FROM BASELINE TO POST-TREATMENT AND OVER A 3-MONTH FOLLOW-UP IN THE YOGA GROUP RELATIVE TO CONTROLS (P = .032). IN ADDITION, THE YOGA GROUP HAD SIGNIFICANT INCREASES IN VIGOR RELATIVE TO CONTROLS (P = .011). BOTH GROUPS HAD POSITIVE CHANGES IN DEPRESSIVE SYMPTOMS AND PERCEIVED STRESS (P < .05). NO SIGNIFICANT CHANGES IN SLEEP OR PHYSICAL PERFORMANCE WERE OBSERVED. CONCLUSIONS: A TARGETED YOGA INTERVENTION LED TO SIGNIFICANT IMPROVEMENTS IN FATIGUE AND VIGOR AMONG BREAST CANCER SURVIVORS WITH PERSISTENT FATIGUE SYMPTOMS. 2012 16 162 59 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 17 2628 52 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 18 1107 58 EFFECTS OF YOGA, STRENGTH TRAINING AND ADVICE ON BACK PAIN: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: AMONG THE WORKING POPULATION, NON-SPECIFIC LOW-BACK PAIN AND NECK PAIN ARE ONE OF THE MOST COMMON REASONS FOR SICKNESS ABSENTEEISM. THE AIM WAS TO EVALUATE THE EFFECTS OF AN EARLY INTERVENTION OF YOGA - COMPARED WITH STRENGTH TRAINING OR EVIDENCE-BASED ADVICE - ON SICKNESS ABSENTEEISM, SICKNESS PRESENTEEISM, BACK AND NECK PAIN AND DISABILITY AMONG A WORKING POPULATION. METHODS: A RANDOMIZED CONTROLLED TRIAL WAS CONDUCTED ON 159 PARTICIPANTS WITH PREDOMINANTLY (90%) CHRONIC BACK AND NECK PAIN. AFTER SCREENING, THE PARTICIPANTS WERE RANDOMIZED TO KUNDALINI YOGA, STRENGTH TRAINING OR EVIDENCE-BASED ADVICE. PRIMARY OUTCOME WAS SICKNESS ABSENTEEISM. SECONDARY OUTCOMES WERE SICKNESS PRESENTEEISM, BACK AND NECK PAIN AND DISABILITY. SELF-REPORTED QUESTIONNAIRES AND SMS TEXT MESSAGES WERE COMPLETED AT BASELINE, 6 WEEKS, 6 AND 12 MONTHS. RESULTS: THE RESULTS DID NOT INDICATE THAT KUNDALINI YOGA AND STRENGTH TRAINING HAD ANY STATISTICALLY SIGNIFICANT EFFECTS ON THE PRIMARY OUTCOME COMPARED WITH EVIDENCE-BASED ADVICE. AN INTERACTION EFFECT WAS FOUND BETWEEN ADHERENCE TO RECOMMENDATIONS AND SICKNESS ABSENTEEISM, INDICATING LARGER SIGNIFICANT EFFECTS AMONG THE ADHERERS TO KUNDALINI YOGA VERSUS EVIDENCE-BASED ADVICE: RR = 0.47 (CI 0.30; 0.74, P = 0.001), STRENGTH TRAINING VERSUS EVIDENCE-BASED ADVICE: RR = 0.60 (CI 0.38; 0.96, P = 0.032). SOME SIGNIFICANT DIFFERENCES WERE ALSO FOUND FOR THE SECONDARY OUTCOMES TO THE ADVANTAGE OF KUNDALINI YOGA AND STRENGTH TRAINING. CONCLUSIONS: GUIDED EXERCISE IN THE FORMS OF KUNDALINI YOGA OR STRENGTH TRAINING DOES NOT REDUCE SICKNESS ABSENTEEISM MORE THAN EVIDENCE-BASED ADVICE ALONE. HOWEVER, SECONDARY ANALYSES REVEAL THAT AMONG THOSE WHO PURSUE KUNDALINI YOGA OR STRENGTH TRAINING AT LEAST TWO TIMES A WEEK, A SIGNIFICANTLY REDUCTION IN SICKNESS ABSENTEEISM WAS FOUND. METHODS TO INCREASE ADHERENCE TO TREATMENT RECOMMENDATIONS SHOULD BE FURTHER DEVELOPED AND APPLIED IN EXERCISE INTERVENTIONS. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT01653782, DATE OF REGISTRATION: JUNE, 28, 2012, RETROSPECTIVELY REGISTERED. 2017 19 1331 50 HOME-BASED YOGA PROGRAM FOR THE PATIENTS SUFFERING FROM MALIGNANT LYMPHOMA DURING CHEMOTHERAPY: A FEASIBILITY STUDY. BACKGROUND: YOGA IS PROVEN BENEFICIAL IN IMPROVING QUALITY OF LIFE AMONG BREAST CANCER SURVIVORS RECEIVING CHEMOTHERAPY, BUT ITS EFFECTIVENESS IN LYMPHOMA PATIENTS NEEDS TO BE EXPLORED. AS CHEMOTHERAPY-INDUCED NEUTROPENIA IS VERY COMMON AMONG LYMPHOMA PATIENTS, THEY ARE MUCH PRONE TO INFECTIONS FROM THE ENVIRONMENT. FURTHERMORE, TRAINED YOGA INSTRUCTORS ARE NOT AVAILABLE IN EVERY SETTING, SO THERE IS A NEED TO DEVELOP HOME-BASED YOGA PROGRAM MODULES FOR LYMPHOMA PATIENTS RECEIVING CHEMOTHERAPY. AIM: THE AIM OF THE STUDY WAS TO EXPLORE THE FEASIBILITY AND SAFETY OF YOGIC EXERCISES AMONG LYMPHOMA PATIENTS DURING CHEMOTHERAPY. SUBJECTS AND METHODS: AN INTERVENTIONAL, SINGLE-ARM PREPOST DESIGN STUDY WAS CONDUCTED AT A TERTIARY HEALTH-CARE CENTER. PATIENTS SUFFERING FROM MALIGNANT LYMPHOMA (18-65 YEARS) WITH EASTERN COOPERATIVE ONCOLOGY GROUP PERFORMANCE STATUS FROM 0 TO 2, PLANNED TO RECEIVE CHEMOTHERAPY WERE ADMINISTERED A HOME-BASED YOGA PROGRAM OVER A PERIOD OF 2 MONTHS FROM THE START OF CHEMOTHERAPY. THE PRIMARY OUTCOME VARIABLES WERE RETENTION RATE, ACCEPTANCE RATE, SAFETY, AND ADHERENCE. HEALTH-RELATED QUALITY OF LIFE (HRQOL), FATIGUE LEVEL, OVERALL SLEEP QUALITY, DEPRESSION, ANXIETY LEVEL, AND PAIN WERE ALSO ASSESSED. STATISTICAL ANALYSIS: DESCRIPTIVE STATISTICS WAS USED TO SEE THE FEASIBILITY AND ADHERENCE. THE PAIRED T-TEST WAS USED TO COMPARE VARIOUS PRE AND POSTINTERVENTION OUTCOME MEASURES. RESULTS: FOURTEEN PATIENTS (MEDIAN AGE: 36 YEARS, RANGE13-65 YEARS) OF MALIGNANT LYMPHOMA WERE ENROLLED IN THE STUDY. MALE-TO-FEMALE RATIO WAS 9:5. NON-HODGKIN'S LYMPHOMA PATIENTS CONSTITUTED 64%. THE RECRUITMENT RATE WAS 93%. FAVORABLE RETENTION (100%), ACCEPTABILITY (97%), ADHERENCE (78.6%), AND NO SERIOUS ADVERSE EVENTS FOLLOWING YOGA PRACTICE WERE REPORTED. IMPROVEMENT WAS ALSO FOUND IN HRQOL, FATIGUE, SLEEP, DEPRESSION, AND ANXIETY. HOWEVER, IT NEEDS FURTHER VALIDATION IN A RANDOMIZED STUDY. CONCLUSION: HOME-BASED YOGA PROGRAM IS SAFE AND FEASIBLE AMONG THE PATIENTS SUFFERING FROM MALIGNANT LYMPHOMA RECEIVING CHEMOTHERAPY. 2018 20 1488 44 INTER-METHOD RELIABILITY OF PAPER SURVEYS AND COMPUTER ASSISTED TELEPHONE INTERVIEWS IN A RANDOMIZED CONTROLLED TRIAL OF YOGA FOR LOW BACK PAIN. BACKGROUND: LITTLE IS KNOWN ABOUT THE RELIABILITY OF DIFFERENT METHODS OF SURVEY ADMINISTRATION IN LOW BACK PAIN TRIALS. THIS ANALYSIS WAS DESIGNED TO DETERMINE THE RELIABILITY OF RESPONSES TO SELF-ADMINISTERED PAPER SURVEYS COMPARED TO COMPUTER ASSISTED TELEPHONE INTERVIEWS (CATI) FOR THE PRIMARY OUTCOMES OF PAIN INTENSITY AND BACK-RELATED FUNCTION, AND SECONDARY OUTCOMES OF PATIENT SATISFACTION, SF-36, AND GLOBAL IMPROVEMENT AMONG PARTICIPANTS ENROLLED IN A STUDY OF YOGA FOR CHRONIC LOW BACK PAIN. RESULTS: PAIN INTENSITY, BACK-RELATED FUNCTION, AND BOTH PHYSICAL AND MENTAL HEALTH COMPONENTS OF THE SF-36 SHOWED EXCELLENT RELIABILITY AT ALL THREE TIME POINTS; ICC SCORES RANGED FROM 0.82 TO 0.98. PAIN MEDICATION USE SHOWED GOOD RELIABILITY; KAPPA STATISTICS RANGED FROM 0.68 TO 0.78. PATIENT SATISFACTION HAD MODERATE TO EXCELLENT RELIABILITY; ICC SCORES RANGED FROM 0.40 TO 0.86. GLOBAL IMPROVEMENT SHOWED POOR RELIABILITY AT 6 WEEKS (ICC = 0.24) AND 12 WEEKS (ICC = 0.10). CONCLUSION: CATI SHOWS EXCELLENT RELIABILITY FOR PRIMARY OUTCOMES AND AT LEAST SOME SECONDARY OUTCOMES WHEN COMPARED TO SELF-ADMINISTERED PAPER SURVEYS IN A LOW BACK PAIN YOGA TRIAL. HAVING TWO RELIABLE OPTIONS FOR DATA COLLECTION MAY BE HELPFUL TO INCREASE RESPONSE RATES FOR CORE OUTCOMES IN BACK PAIN TRIALS. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT01761617. DATE OF TRIAL REGISTRATION: DECEMBER 4, 2012. 2014