1 2250 172 THE LONGITUDINAL EFFECTS OF SEATED ISOMETRIC YOGA ON BLOOD BIOMARKERS, AUTONOMIC FUNCTIONS, AND PSYCHOLOGICAL PARAMETERS OF PATIENTS WITH CHRONIC FATIGUE SYNDROME: A PILOT STUDY. BACKGROUND: IN A PREVIOUS RANDOMIZED CONTROLLED TRIAL, WE FOUND THAT PRACTICING SEATED ISOMETRIC YOGA REGULARLY FOR 2 MONTHS IMPROVED THE FATIGUE OF PATIENTS WITH CHRONIC FATIGUE SYNDROME (CFS) WHO ARE RESISTANT TO CONVENTIONAL THERAPY. THE AIM OF THIS PILOT STUDY WAS TO INVESTIGATE THE POSSIBLE MECHANISMS BEHIND THIS FINDING BY COMPARING BLOOD BIOMARKERS, AUTONOMIC NERVOUS FUNCTION, AND PSYCHOLOGICAL INDICES BEFORE VERSUS AFTER AN INTERVENTION PERIOD OF SEATED ISOMETRIC YOGA PRACTICE. METHODS: FIFTEEN PATIENTS WITH CFS WHO DID NOT SHOW SATISFACTORY IMPROVEMENTS AFTER AT LEAST 6 MONTHS OF CONVENTIONAL THERAPY PRACTICED SEATED ISOMETRIC YOGA (BIWEEKLY 20-MIN SESSIONS WITH A YOGA INSTRUCTOR AND DAILY PRACTICE AT HOME) FOR 2 MONTHS. THE LONGITUDINAL EFFECTS OF SEATED ISOMETRIC YOGA ON FATIGUE, BLOOD BIOMARKERS, AUTONOMIC FUNCTION, AND PSYCHOLOGICAL STATE WERE INVESTIGATED BY COMPARING THE FOLLOWING PARAMETERS BEFORE AND AFTER THE INTERVENTION PERIOD: FATIGUE SEVERITY WAS ASSESSED BY THE CHALDER FATIGUE SCALE (FS) SCORE. LEVELS OF THE BLOOD BIOMARKERS CORTISOL, DHEA-S, TNF-ALPHA, IL-6, PROLACTIN, CARNITINE, TGF-BETA1, BDNF, MHPG, HVA, AND ALPHA-MSH WERE MEASURED. THE AUTONOMIC NERVOUS FUNCTIONS ASSESSED WERE HEART RATE (HR) AND HR VARIABILITY. PSYCHOLOGICAL INDICES INCLUDED THE 20-ITEM TORONTO ALEXITHYMIA SCALE (TAS-20) AND THE HOSPITAL ANXIETY AND DEPRESSION SCALE (HADS). RESULTS: PRACTICING SEATED ISOMETRIC YOGA FOR 2 MONTHS RESULTED IN SIGNIFICANT REDUCTIONS IN THE CHALDER FS (P = 0.002) AND HADS-DEPRESSION (P = 0.02) SCORES. NO SIGNIFICANT CHANGES WERE OBSERVED IN ANY OTHER PARAMETER EVALUATED. THE CHANGE IN CHALDER FS SCORE WAS NOT CORRELATED WITH THE CHANGE IN HADS-DEPRESSION SCORE. HOWEVER, THIS CHANGE WAS POSITIVELY CORRELATED WITH CHANGES IN THE SERUM TNF-ALPHA LEVELS (P = 0.048), THE HIGH FREQUENCY COMPONENT OF HR VARIABILITY (P = 0.042), AND TAS-20 SCORES (P = 0.001). CONCLUSIONS: REGULAR PRACTICE OF SEATED ISOMETRIC YOGA FOR 2 MONTHS REDUCED THE FATIGUE AND DEPRESSIVE SYMPTOM SCORES OF PATIENTS WITH CFS WITHOUT AFFECTING ANY OTHER PARAMETERS WE INVESTIGATED. THIS STUDY FAILED TO IDENTIFY THE MARKERS RESPONSIBLE FOR THE LONGITUDINAL FATIGUE-RELIEVING EFFECT OF SEATED ISOMETRIC YOGA. HOWEVER, CONSIDERING THAT THE REDUCED FATIGUE WAS ASSOCIATED WITH DECREASED SERUM TNF-ALPHA LEVEL AND TAS-20 SCORES, FATIGUE IMPROVEMENT MIGHT BE RELATED TO REDUCED INFLAMMATION AND IMPROVED ALEXITHYMIA IN THESE PATIENTS. TRIAL REGISTRATION: UNIVERSITY HOSPITAL MEDICAL INFORMATION NETWORK (UMIN CTR) UMIN000009646. REGISTERED DEC 27, 2012.	2019	

2  451 111 CHANGES IN FATIGUE, AUTONOMIC FUNCTIONS, AND BLOOD BIOMARKERS DUE TO SITTING ISOMETRIC YOGA IN PATIENTS WITH CHRONIC FATIGUE SYNDROME. BACKGROUND: IN A PREVIOUS RANDOMIZED CONTROLLED TRIAL, WE FOUND THAT SITTING ISOMETRIC YOGA IMPROVES FATIGUE IN PATIENTS WITH CHRONIC FATIGUE SYNDROME (CFS) WHO ARE RESISTANT TO CONVENTIONAL THERAPY. THE AIM OF THIS STUDY WAS TO INVESTIGATE POSSIBLE MECHANISMS BEHIND THIS FINDING, FOCUSING ON THE SHORT-TERM FATIGUE-RELIEVING EFFECT, BY COMPARING AUTONOMIC NERVOUS FUNCTION AND BLOOD BIOMARKERS BEFORE AND AFTER A SESSION OF ISOMETRIC YOGA. METHODS: FIFTEEN PATIENTS WITH CFS WHO REMAINED SYMPTOMATIC DESPITE AT LEAST 6 MONTHS OF CONVENTIONAL THERAPY PRACTICED SITTING ISOMETRIC YOGA (BIWEEKLY 20 MIN PRACTICE WITH A YOGA INSTRUCTOR AND DAILY HOME PRACTICE) FOR EIGHT WEEKS. ACUTE EFFECTS OF SITTING ISOMETRIC YOGA ON FATIGUE, AUTONOMIC FUNCTION, AND BLOOD BIOMARKERS WERE INVESTIGATED AFTER THE FINAL SESSION WITH AN INSTRUCTOR. THE EFFECT OF A SINGLE SESSION OF SITTING ISOMETRIC YOGA ON FATIGUE WAS ASSESSED BY THE PROFILE OF MOOD STATUS (POMS) QUESTIONNAIRE IMMEDIATELY BEFORE AND AFTER THE SESSION. AUTONOMIC NERVOUS FUNCTION (HEART RATE (HR) VARIABILITY) AND BLOOD BIOMARKERS (CORTISOL, DHEA-S, TNF-ALPHA, IL-6, IFN-GAMMA, IFN-ALPHA, PROLACTIN, CARNITINE, TGF-BETA1, BDNF, MHPG, AND HVA) WERE COMPARED BEFORE AND AFTER THE SESSION. RESULTS: SITTING ISOMETRIC YOGA SIGNIFICANTLY REDUCED THE POMS FATIGUE SCORE (P < 0.01) AND INCREASED THE VIGOR SCORE (P < 0.01). IT ALSO REDUCED HR (P < 0.05) AND INCREASED THE HIGH FREQUENCY POWER (P < 0.05) OF HR VARIABILITY. SITTING ISOMETRIC YOGA INCREASED SERUM LEVELS OF DHEA-S (P < 0.05), REDUCED LEVELS OF CORTISOL (P < 0.05) AND TNF-ALPHA (P < 0.05), AND HAD A TENDENCY TO REDUCE SERUM LEVELS OF PROLACTIN (P < 0.1). DECREASES IN FATIGUE SCORES CORRELATED WITH CHANGES IN PLASMA LEVELS OF TGF-BETA1 AND BDNF. IN CONTRAST, INCREASED VIGOR POSITIVELY CORRELATED WITH HVA. CONCLUSIONS: A SINGLE SESSION OF SITTING ISOMETRIC YOGA REDUCED FATIGUE AND INCREASED VIGOR IN PATIENTS WITH CFS. YOGA ALSO INCREASED VAGAL NERVE FUNCTION AND CHANGED BLOOD BIOMARKERS IN A PATTERN THAT SUGGESTED ANTI-STRESS AND ANTI-INFLAMMATORY EFFECTS. THESE CHANGES APPEAR TO BE RELATED TO THE SHORT-TERM FATIGUE-RELIEVING EFFECT OF SITTING ISOMETRIC YOGA IN PATIENTS WITH CFS. FURTHERMORE, DOPAMINERGIC NERVOUS SYSTEM ACTIVATION MIGHT ACCOUNT FOR SITTING ISOMETRIC YOGA-INDUCED INCREASES IN ENERGY IN THIS PATIENT POPULATION. TRIAL REGISTRATION: UNIVERSITY HOSPITAL MEDICAL INFORMATION NETWORK (UMIN CTR) UMIN000009646. REGISTERED DEC 27, 2012.	2018	
                                                                                                                                                  
3 2134  35 THE EFFECTS OF A THERAPEUTIC YOGA PROGRAM ON POSTURAL CONTROL, MOBILITY, AND GAIT SPEED IN COMMUNITY-DWELLING OLDER ADULTS. OBJECTIVE: TO EXAMINE THE EFFECTS OF A 12-WEEK THERAPEUTIC YOGA PROGRAM ON GAIT SPEED, POSTURAL CONTROL, AND MOBILITY IN COMMUNITY-DWELLING OLDER ADULTS. DESIGN: QUASI-EXPERIMENTAL STUDY WITH A PRETEST/POST-TEST DESIGN. RESEARCHERS EVALUATED CHANGES OVER TIME (PRETEST TO POST-TEST) IN ALL OUTCOME MEASURES. PAIRED T-TESTS WERE USED TO ANALYZE NORMAL AND FAST GAIT SPEED, TIMED UP AND GO TEST, AND TIMED UP AND GO DUAL TASK. WILCOXON SIGNED-RANK TEST WAS USED TO EVALUATE SCORES FOR THE MINI-BESTEST (MBT). SETTING: YOGA CLASSES WERE PERFORMED AT A LOCAL SENIOR CENTER. BLIND EXAMINERS WHO WERE PREVIOUSLY TRAINED IN THE OUTCOME MEASURES PERFORMED ALL PRETESTS AND POST-TESTS AT THE SITE. PARTICIPANTS: THIRTEEN ADULTS (12 WOMEN AND 1 MAN, WITH A MEAN AGE+/-STANDARD DEVIATION OF 72+/-6.9 YEARS) COMPLETED THE STUDY. RESEARCH PARTICIPANTS HAD MINIMAL TO NO YOGA EXPERIENCE. INTERVENTIONS: A 12-WEEK, 60-MINUTE, BIWEEKLY KRIPALU YOGA CLASS DESIGNED SPECIFICALLY FOR COMMUNITY-DWELLING OLDER ADULTS. OUTCOME MEASURES: POSTURAL CONTROL (MBT), MOBILITY (TIMED UP AND GO TEST), AND GAIT SPEED (NORMAL AND FAST) WERE ASSESSED. RESULTS: ALL 13 PARTICIPANTS ATTENDED AT LEAST 19 OF THE 24 CLASSES (80% ATTENDANCE). STATISTICALLY SIGNIFICANT IMPROVEMENTS WERE SEEN IN THE MBT (P=0.039), NORMAL GAIT SPEED (P=0.015), FAST GAIT SPEED (P=0.001), TIMED UP AND GO TEST (P=0.045), AND TIMED UP AND GO DUAL-TASK (P=0.05). CONCLUSIONS: IMPROVEMENTS IN POSTURAL CONTROL AND MOBILITY AS MEASURED BY THE MBT AND TIMED UP AND GO GAIT AS MEASURED BY FAST GAIT SPEED INDICATE THAT RESEARCH PARTICIPANTS BENEFITTED FROM THE THERAPEUTIC YOGA INTERVENTION. THE YOGA PROGRAM DESIGNED FOR THIS STUDY INCLUDED ACTIVITIES IN STANDING, SITTING, AND LYING ON THE FLOOR AND MAY BE EFFECTIVE IN IMPROVING MOBILITY, POSTURAL CONTROL, AND GAIT SPEED IN COMMUNITY-DWELLING OLDER ADULTS.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
4 1523  73 ISOMETRIC YOGA IMPROVES THE FATIGUE AND PAIN OF PATIENTS WITH CHRONIC FATIGUE SYNDROME WHO ARE RESISTANT TO CONVENTIONAL THERAPY: A RANDOMIZED, CONTROLLED TRIAL. BACKGROUND: PATIENTS WITH CHRONIC FATIGUE SYNDROME (CFS) OFTEN COMPLAIN OF PERSISTENT FATIGUE EVEN AFTER CONVENTIONAL THERAPIES SUCH AS PHARMACOTHERAPY, COGNITIVE BEHAVIORAL THERAPY, OR GRADED EXERCISE THERAPY. THE AIM OF THIS STUDY WAS TO INVESTIGATE IN A RANDOMIZED, CONTROLLED TRIAL THE FEASIBILITY AND EFFICACY OF ISOMETRIC YOGA IN PATIENTS WITH CFS WHO ARE RESISTANT TO CONVENTIONAL TREATMENTS. METHODS: THIS TRIAL ENROLLED 30 PATIENTS WITH CFS WHO DID NOT HAVE SATISFACTORY IMPROVEMENT AFTER RECEIVING CONVENTIONAL THERAPY FOR AT LEAST SIX MONTHS. THEY WERE RANDOMLY DIVIDED INTO TWO GROUPS AND WERE TREATED WITH EITHER CONVENTIONAL PHARMACOTHERAPY (CONTROL GROUP, N = 15) OR CONVENTIONAL THERAPY TOGETHER WITH ISOMETRIC YOGA PRACTICE THAT CONSISTED OF BIWEEKLY, 20-MINUTE SESSIONS WITH A YOGA INSTRUCTOR AND DAILY IN-HOME SESSIONS (YOGA GROUP, N = 15) FOR APPROXIMATELY TWO MONTHS. THE SHORT-TERM EFFECT OF ISOMETRIC YOGA ON FATIGUE WAS ASSESSED BY ADMINISTRATION OF THE PROFILE OF MOOD STATUS (POMS) QUESTIONNAIRE IMMEDIATELY BEFORE AND AFTER THE FINAL 20-MINUTE SESSION WITH THE INSTRUCTOR. THE LONG-TERM EFFECT OF ISOMETRIC YOGA ON FATIGUE WAS ASSESSED BY ADMINISTRATION OF THE CHALDER'S FATIGUE SCALE (FS) QUESTIONNAIRE TO BOTH GROUPS BEFORE AND AFTER THE INTERVENTION. ADVERSE EVENTS AND CHANGES IN SUBJECTIVE SYMPTOMS WERE RECORDED FOR SUBJECTS IN THE YOGA GROUP. RESULTS: ALL SUBJECTS COMPLETED THE INTERVENTION. THE MEAN POMS FATIGUE SCORE DECREASED SIGNIFICANTLY (FROM 21.9 +/- 7.7 TO 13.8 +/- 6.7, P < 0.001) AFTER A YOGA SESSION. THE CHALDER'S FS SCORE DECREASED SIGNIFICANTLY (FROM 25.9 +/- 6.1 TO 19.2 +/- 7.5, P = 0.002) IN THE YOGA GROUP, BUT NOT IN THE CONTROL GROUP. IN ADDITION TO THE IMPROVEMENT OF FATIGUE, TWO PATIENTS WITH CFS AND FIBROMYALGIA SYNDROME IN THE YOGA GROUP ALSO REPORTED PAIN RELIEF. FURTHERMORE, MANY SUBJECTS REPORTED THAT THEIR BODIES BECAME WARMER AND LIGHTER AFTER PRACTICING ISOMETRIC YOGA. ALTHOUGH THERE WERE NO SERIOUS ADVERSE EVENTS IN THE YOGA GROUP, TWO PATIENTS COMPLAINED OF TIREDNESS AND ONE OF DIZZINESS AFTER THE FIRST YOGA SESSION WITH THE INSTRUCTOR. CONCLUSIONS: ISOMETRIC YOGA AS AN ADD-ON THERAPY IS BOTH FEASIBLE AND SUCCESSFUL AT RELIEVING THE FATIGUE AND PAIN OF A SUBSET OF THERAPY-RESISTANT PATIENTS WITH CFS. TRIAL REGISTRATION: UNIVERSITY HOSPITAL MEDICAL INFORMATION NETWORK (UMIN CTR) UMIN000009646.	2014	
                                                                                                                                                                                                                     
5   34  36 A 12-WEEK IYENGAR YOGA PROGRAM IMPROVED BALANCE AND MOBILITY IN OLDER COMMUNITY-DWELLING PEOPLE: A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: EXERCISE THAT CHALLENGES BALANCE CAN IMPROVE MOBILITY AND PREVENT FALLS IN OLDER ADULTS. YOGA AS A PHYSICAL ACTIVITY OPTION FOR OLDER ADULTS IS NOT WELL STUDIED. THIS TRIAL EVALUATED THE FEASIBILITY AND EFFECT OF A 12-WEEK IYENGAR YOGA PROGRAM ON BALANCE AND MOBILITY IN OLDER PEOPLE. METHODS: WE CONDUCTED A BLINDED, PILOT RANDOMIZED CONTROLLED TRIAL WITH INTENTION-TO-TREAT ANALYSIS. PARTICIPANTS WERE 54 COMMUNITY DWELLERS (MEAN AGE 68 YEARS, SD 7.1) NOT CURRENTLY PARTICIPATING IN YOGA OR TAI CHI. THE INTERVENTION GROUP (N = 27) PARTICIPATED IN A 12-WEEK, TWICE-WEEKLY YOGA PROGRAM FOCUSED ON STANDING POSTURES AND RECEIVED A FALL PREVENTION EDUCATION BOOKLET. THE CONTROL GROUP (N = 27) RECEIVED THE EDUCATION BOOKLET ONLY. PRIMARY OUTCOME WAS STANDING BALANCE COMPONENT OF THE SHORT PHYSICAL PERFORMANCE BATTERY WITH ADDITION OF ONE-LEGGED STANCE TIME (STANDING BALANCE). SECONDARY OUTCOMES WERE THE TIMED SIT-TO-STAND TEST, TIMED 4-M WALK, ONE-LEGGED STAND WITH EYES CLOSED, AND SHORT FALLS EFFICACY SCALE-INTERNATIONAL. FEASIBILITY WAS MEASURED BY RECORDING CLASS ATTENDANCE AND ADVERSE EVENTS. RESULTS: FIFTY-TWO PARTICIPANTS COMPLETED FOLLOW-UP ASSESSMENTS. THE INTERVENTION GROUP SIGNIFICANTLY IMPROVED COMPARED WITH CONTROL GROUP ON STANDING BALANCE (MEAN DIFFERENCE = 1.52 SECONDS, 95% CI 0.10-2.96, P = .04), SIT-TO-STAND TEST (MEAN DIFFERENCE = -3.43 SECONDS, 95% CI -5.23 TO -1.64, P < .001), 4-M WALK (MEAN DIFFERENCE = -0.50 SECONDS, 95% CI -0.72 TO -0.28, P < .001), AND ONE-LEGGED STAND WITH EYES CLOSED (MEAN DIFFERENCE = 1.93 SECONDS, 95% CI 0.40-3.46, P = .02). AVERAGE CLASS ATTENDANCE WAS 20 OF 24 CLASSES (83%). NO SERIOUS ADVERSE EVENTS OCCURRED. CONCLUSIONS: THIS TRIAL DEMONSTRATES THE BALANCE AND MOBILITY-RELATED BENEFITS AND FEASIBILITY OF IYENGAR YOGA FOR OLDER PEOPLE. THE FALL PREVENTION EFFECT OF IYENGAR YOGA WARRANTS FURTHER INVESTIGATION.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
6  524  47 COMPARISON OF COGNITIVE-BEHAVIORAL THERAPY AND YOGA FOR THE TREATMENT OF LATE-LIFE WORRY: A RANDOMIZED PREFERENCE TRIAL. BACKGROUND: THE PURPOSE OF THIS STUDY WAS TO COMPARE THE EFFECTS OF COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA ON LATE-LIFE WORRY, ANXIETY, AND SLEEP; AND EXAMINE PREFERENCE AND SELECTION EFFECTS ON THESE OUTCOMES. METHODS: A RANDOMIZED PREFERENCE TRIAL OF CBT AND YOGA WAS CONDUCTED IN COMMUNITY-DWELLING ADULTS 60 YEARS OR OLDER, WHO SCORED 26 OR ABOVE ON THE PENN STATE WORRY QUESTIONNAIRE-ABBREVIATED (PSWQ-A). CBT CONSISTED OF 10 WEEKLY TELEPHONE SESSIONS. YOGA CONSISTED OF 20 BIWEEKLY GROUP YOGA CLASSES. THE PRIMARY OUTCOME WAS WORRY (PSWQ-A); THE SECONDARY OUTCOMES WERE ANXIETY (PROMIS-ANXIETY) AND SLEEP (INSOMNIA SEVERITY INDEX [ISI]). WE EXAMINED BOTH PREFERENCE EFFECTS (AVERAGE EFFECT FOR THOSE WHO RECEIVED THEIR PREFERRED INTERVENTION [REGARDLESS OF WHETHER IT WAS CBT OR YOGA] MINUS THE AVERAGE FOR THOSE WHO DID NOT RECEIVE THEIR PREFERRED INTERVENTION [REGARDLESS OF THE INTERVENTION]) AND SELECTION EFFECT (WHICH ADDRESSES THE QUESTION OF WHETHER THERE IS A BENEFIT TO GETTING TO SELECT ONE INTERVENTION OVER THE OTHER, AND MEASURES THE EFFECT ON OUTCOMES OF SELF-SELECTION TO A SPECIFIC INTERVENTION). RESULTS: FIVE HUNDRED OLDER ADULTS WERE RANDOMIZED TO THE RANDOMIZED TRIAL (125 EACH IN CBT AND YOGA) OR THE PREFERENCE TRIAL (120 CHOSE CBT; 130 CHOSE YOGA). IN THE RANDOMIZED TRIAL, THE INTERVENTION EFFECT OF YOGA COMPARED WITH CBT ADJUSTED FOR BASELINE PSYCHOTROPIC MEDICATION USE, GENDER, AND RACE WAS 1.6 (-0.2, 3.3), P = .08 FOR THE PSWQ-A. SIMILAR RESULTS WERE OBSERVED WITH PROMIS-ANXIETY (ADJUSTED INTERVENTION EFFECT: 0.3 [-1.5, 2.2], P = .71). PARTICIPANTS RANDOMIZED TO CBT EXPERIENCED A GREATER REDUCTION IN THE ISI COMPARED WITH YOGA (ADJUSTED INTERVENTION EFFECT: 2.4 [1.2, 3.7], P < .01]). ESTIMATED IN THE COMBINED DATA SET (N = 500), THE PREFERENCE AND SELECTION EFFECTS WERE NOT SIGNIFICANT FOR THE PSWQ-A, PROMIS-ANXIETY, AND ISI. OF THE 52 ADVERSE EVENTS, ONLY TWO WERE POSSIBLY RELATED TO THE INTERVENTION. NONE OF THE 26 SERIOUS ADVERSE EVENTS WERE RELATED TO THE STUDY INTERVENTIONS. CONCLUSIONS: CBT AND YOGA WERE BOTH EFFECTIVE AT REDUCING LATE-LIFE WORRY AND ANXIETY. HOWEVER, A GREATER IMPACT WAS SEEN FOR CBT COMPARED WITH YOGA FOR IMPROVING SLEEP. NEITHER PREFERENCE NOR SELECTION EFFECTS WAS FOUND.	2020	
                                                                                                                                                                                                                                                                                                                                                                                     
7  965  37 EFFECTS OF A YOGA PROGRAM ON POSTURAL CONTROL, MOBILITY, AND GAIT SPEED IN COMMUNITY-LIVING OLDER ADULTS: A PILOT STUDY. OBJECTIVES: TO EXAMINE THE IMPACT OF AN 8-WEEK THERAPEUTIC YOGA PROGRAM ON POSTURAL CONTROL, MOBILITY, RISING FROM THE FLOOR, AND GAIT SPEED IN COMMUNITY-LIVING OLDER ADULTS. DESIGN: PRETEST/POSTTEST DESIGN WITH AN EXPERIMENTAL GROUP AND AN AGE-MATCHED CONTROL GROUP. CHANGES OVER TIME (PRETEST TO POSTTEST) WERE EVALUATED IN ALL OUTCOME MEASURES USING PAIRED T TESTS. SETTING: THE YOGA CLASS WAS PERFORMED AT A LOCAL CONTINUING CARE RETIREMENT COMMUNITY. ALL TESTING WAS PERFORMED AT THE SITE. CONTROL-SUBJECT PRETESTS AND POSTTESTS WERE PERFORMED AT A SECOND CONTINUING CARE RETIREMENT COMMUNITY. PARTICIPANTS: EIGHT RESEARCH PARTICIPANTS, ALL WOMEN, WITH A MEAN AGE OF 84 (4.6) YEARS, 8 CONTROL PARTICIPANTS, 5 WOMEN AND 3 MEN, AGED 81.3 (4.9) YEARS. RESEARCH PARTICIPANTS WERE NAIVE TO YOGA. INTERVENTIONS: AN 8-WEEK, 80-MINUTE, BIWEEKLY KRIPALU YOGA CLASS DESIGNED SPECIFICALLY FOR COMMUNITY-DWELLING OLDER ADULTS. MAIN OUTCOME MEASURES: POSTURAL CONTROL (BERG BALANCE SCALE), MOBILITY (TIME TO RISE FROM THE FLOOR TO STANDING, TIMED UP AND GO), GAIT (USUAL AND FAST GAIT SPEED), AND BALANCE CONFIDENCE (ACTIVITIES-SPECIFIC BALANCE SCALE). RESULTS: ALL SUBJECTS ATTENDED AT LEAST 10 OF THE 16 CLASSES (62% ATTENDANCE). POSTTEST DIFFERENCES WERE FOUND FOR YOGA PARTICIPANTS IN BALANCE SCORES (P < .003) AND FAST WALKING SPEED (P < .031). NO OTHER SIGNIFICANT CHANGES WERE NOTED. CONCLUSIONS: IMPROVEMENTS IN POSTURAL CONTROL AS MEASURED BY THE BERG BALANCE SCALE AND GAIT AS MEASURED BY FAST GAIT SPEED INDICATE THAT RESEARCH SUBJECTS BENEFITED FROM THE YOGA INTERVENTION. THE YOGA PROGRAM DESIGNED FOR THIS STUDY INCLUDED THE ACTIVITIES OF STANDING, SITTING, AND LYING ON THE FLOOR. THEREFORE, SUBJECTS PERFORM ACTIVITIES DURING YOGA THAT CAN IMPROVE POSTURAL CONTROL, MOBILITY, AND GAIT SPEED.	2011	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
8  666  34 EFFECT OF A 12-WEEK YOGA INTERVENTION ON FEAR OF FALLING AND BALANCE IN OLDER ADULTS: A PILOT STUDY. OBJECTIVE: TO DETERMINE WHETHER FEAR OF FALLING (FOF) AND BALANCE IMPROVED AFTER A 12-WEEK YOGA INTERVENTION AMONG OLDER ADULTS. DESIGN: A 12-WEEK YOGA INTERVENTION SINGLE-ARMED PILOT STUDY. SETTING: A RETIREMENT COMMUNITY IN A MEDIUM-SIZED UNIVERSITY TOWN IN THE MIDWEST. PARTICIPANTS: A CONVENIENCE SAMPLE OF ADULTS (N=14) OVER THE AGE OF 65 YEARS WHO ALL ENDORSED AN FOF. INTERVENTION: EACH PARTICIPANT TOOK PART IN A BIWEEKLY 12-WEEK YOGA INTERVENTION. THE YOGA SESSIONS INCLUDED BOTH PHYSICAL POSTURES AND BREATHING EXERCISES. POSTURES WERE COMPLETED IN SITTING AND STANDING POSITIONS. MAIN OUTCOME MEASURES: WE MEASURED FOF WITH THE ILLINOIS FOF MEASURE AND BALANCE WITH THE BERG BALANCE SCALE. UPPER- AND LOWER-BODY FLEXIBILITY WERE MEASURED WITH THE BACK SCRATCH TEST AND CHAIR SIT AND REACH TEST, RESPECTIVELY. RESULTS: FOF DECREASED BY 6%, STATIC BALANCE INCREASED BY 4% (P=.045), AND LOWER-BODY FLEXIBILITY INCREASED BY 34%. CONCLUSIONS: THE RESULTS INDICATE THAT YOGA MAY BE A PROMISING INTERVENTION TO MANAGE FOF AND IMPROVE BALANCE, THEREBY REDUCING FALL RISK FOR OLDER ADULTS. REHABILITATION THERAPISTS MAY WISH TO EXPLORE YOGA AS A MODALITY FOR BALANCE AND FALLS PROGRAMMING; HOWEVER, FUTURE RESEARCH IS NEEDED TO CONFIRM THE USE OF YOGA IN SUCH PROGRAMMING.	2010	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
9  107  40 A PILOT RANDOMIZED CONTROLLED TRIAL OF THE EFFECTS OF CHAIR YOGA ON PAIN AND PHYSICAL FUNCTION AMONG COMMUNITY-DWELLING OLDER ADULTS WITH LOWER EXTREMITY OSTEOARTHRITIS. OBJECTIVES: TO DETERMINE EFFECTS OF SIT 'N' FIT CHAIR YOGA, COMPARED TO A HEALTH EDUCATION PROGRAM (HEP), ON PAIN AND PHYSICAL FUNCTION IN OLDER ADULTS WITH LOWER EXTREMITY OSTEOARTHRITIS (OA) WHO COULD NOT PARTICIPATE IN STANDING EXERCISE. DESIGN: TWO-ARM RANDOMIZED CONTROLLED TRIAL. SETTING: ONE HUD SENIOR HOUSING FACILITY AND ONE DAY SENIOR CENTER IN SOUTH FLORIDA. PARTICIPANTS: COMMUNITY-DWELLING OLDER ADULTS (N = 131) WERE RANDOMLY ASSIGNED TO CHAIR YOGA (N = 66) OR HEP (N = 65). THIRTEEN DROPPED AFTER ASSIGNMENT BUT PRIOR TO THE INTERVENTION; SIX DROPPED DURING THE INTERVENTION; 106 OF 112 COMPLETED AT LEAST 12 OF 16 SESSIONS (95% RETENTION RATE). INTERVENTIONS: PARTICIPANTS ATTENDED EITHER CHAIR YOGA OR HEP. BOTH INTERVENTIONS CONSISTED OF TWICE-WEEKLY 45-MINUTE SESSIONS FOR 8 WEEKS. MEASUREMENTS: PRIMARY: PAIN, PAIN INTERFERENCE; SECONDARY: BALANCE, GAIT SPEED, FATIGUE, FUNCTIONAL ABILITY MEASURED AT BASELINE, AFTER 4 WEEKS OF INTERVENTION, AT THE END OF THE 8-WEEK INTERVENTION, AND POST-INTERVENTION (1 AND 3 MONTHS). RESULTS: THE CHAIR YOGA GROUP SHOWED GREATER REDUCTION IN PAIN INTERFERENCE DURING THE INTERVENTION (P = .01), SUSTAINED THROUGH 3 MONTHS (P = .022). WOMAC PAIN (P = .048), GAIT SPEED (P = .024), AND FATIGUE (P = .037) WERE IMPROVED IN THE YOGA GROUP DURING THE INTERVENTION (P = .048) BUT IMPROVEMENTS WERE NOT SUSTAINED POST INTERVENTION. CHAIR YOGA HAD NO EFFECT ON BALANCE. CONCLUSION: AN 8-WEEK CHAIR YOGA PROGRAM WAS ASSOCIATED WITH REDUCTION IN PAIN, PAIN INTERFERENCE, AND FATIGUE, AND IMPROVEMENT IN GAIT SPEED, BUT ONLY THE EFFECTS ON PAIN INTERFERENCE WERE SUSTAINED 3 MONTHS POST INTERVENTION. CHAIR YOGA SHOULD BE FURTHER EXPLORED AS A NONPHARMACOLOGIC INTERVENTION FOR OLDER PEOPLE WITH OA IN THE LOWER EXTREMITIES. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT02113410.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
10 2654  38 YOGA IMPROVES QUALITY OF LIFE AND BENEFIT FINDING IN WOMEN UNDERGOING RADIOTHERAPY FOR BREAST CANCER. THIS STUDY EXAMINED THE EFFECTS OF YOGA ON QUALITY OF LIFE (QOL) AND PSYCHOSOCIAL OUTCOMES IN WOMEN WITH BREAST CANCER UNDERGOING RADIOTHERAPY. SIXTY-ONE WOMEN WERE RANDOMLY ASSIGNED TO EITHER A YOGA OR A WAIT-LIST GROUP. YOGA CLASSES WERE TAUGHT BIWEEKLY DURING THE 6 WEEKS OF RADIOTHERAPY. PARTICIPANTS COMPLETED MEASURES OF QOL, FATIGUE, BENEFIT FINDING (FINDING MEANING IN THE CANCER EXPERIENCE), INTRUSIVE THOUGHTS, SLEEP DISTURBANCES, DEPRESSIVE SYMPTOMS, AND ANXIETY BEFORE RADIOTHERAPY AND THEN AGAIN 1 WEEK, 1 MONTH, AND 3 MONTHS AFTER THE END OF RADIOTHERAPY. GENERAL LINEAR MODEL ANALYSES REVEALED THAT COMPARED TO THE CONTROL GROUP, THE YOGA GROUP REPORTED SIGNIFICANTLY BETTER GENERAL HEALTH PERCEPTION (P = .005) AND PHYSICAL FUNCTIONING SCORES (P = .04) 1 WEEK POSTRADIOTHERAPY; HIGHER LEVELS OF INTRUSIVE THOUGHTS 1 MONTH POSTRADIOTHERAPY (P = .01); AND GREATER BENEFIT FINDING 3 MONTHS POSTRADIOTHERAPY (P = .01). THERE WERE NO OTHER GROUP DIFFERENCES IN OTHER QOL SUBSCALES FOR FATIGUE, DEPRESSION, OR SLEEP SCORES. EXPLORATORY ANALYSES INDICATED THAT INTRUSIVE THOUGHTS 1 MONTH AFTER RADIOTHERAPY WERE SIGNIFICANTLY POSITIVELY CORRELATED WITH BENEFIT FINDING 3 MONTHS AFTER RADIOTHERAPY (R = .36, P = .011). OUR RESULTS INDICATED THAT THE YOGA PROGRAM WAS ASSOCIATED WITH STATISTICALLY AND CLINICALLY SIGNIFICANT IMPROVEMENTS IN ASPECTS OF QOL.	2010	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
11 1244  46 FEASIBILITY OF ESTABLISHING A COMPREHENSIVE YOGA PROGRAM AND ITS DOSE-EFFECT RELATIONSHIP ON CARDIOVASCULAR RISK FACTORS AND WELLNESS PARAMETERS: A PILOT STUDY. BACKGROUND: WE SOUGHT TO STUDY THE FEASIBILITY OF ESTABLISHING A COMPREHENSIVE, MOSTLY SELF-DIRECTED YOGA PROGRAM IN A HOSPITAL AND ITS DOSE-EFFECT RELATIONSHIP ON CARDIOVASCULAR RISK FACTORS AND QUALITY OF LIFE (QOL) MEASURES OVER SIX MONTHS. METHODS: YOGA-BASED TECHNIQUES (ADVANCED YOGA PRACTICES; AYP; ADVANCEDYOGAPRACTICES.COM) WERE TAUGHT IN 12 BIWEEKLY GROUP SESSIONS AND SELF-DIRECTED PRACTICE AT HOME WAS EMPHASIZED. CARDIOVASCULAR RISK FACTORS WERE ELUCIDATED BY INTERVIEW AND REVIEW OF MEDICAL HISTORY. QUALITY OF LIFE (QOL) OUTCOMES INCLUDED THE SF-36, THE COHEN PERCEIVED STRESS SCALE (CPSS), AND THE HOSPITAL ANXIETY AND DEPRESSION SCALE (HADS). RISK FACTORS AND QOL MEASURES WERE COMPARED IN PARTICIPANTS AT BASELINE AND SIX MONTHS, AS WELL AS BETWEEN THOSE PRACTICING >/= 7 TIMES VERSUS < 7 TIMES PER WEEK. RESULTS: A TOTAL OF 22 INDIVIDUALS (19 WOMEN, MEAN AGE 59 +/- 8.7 YEARS) COMPLETED THE STUDY. AT SIX MONTHS, CHANGES WERE NOTED IN THE MENTAL COMPONENT SCALE (MCS) OF THE SF-36 (P=0.0004) AND THE CPSS (P = 0.022). A GREATER IMPROVEMENT IN CPSS WAS NOTED IN THOSE PRACTICING >/= 7 TIMES VERSUS < 7 TIMES A WEEK (P=0.045). NO CHANGES WERE NOTED IN CARDIOVASCULAR RISK FACTORS. CONCLUSIONS: THE PRESCRIPTION OF A SELF-DIRECTED YOGA PROGRAM WAS FEASIBLE IN A HOSPITAL SETTING AND RESULTED IN IMPROVEMENT IN QOL MEASURES AT SIX MONTHS. PRACTICING MORE THAN SEVEN TIMES PER WEEK CORRELATED WITH GREATER IMPROVEMENT IN THE PERCEPTION OF STRESS. THUS, AT LEAST A ONCE-DAILY DOSE OF AYP TECHNIQUES FOR A SIGNIFICANT IMPROVEMENT IN PERCEIVED STRESS IS AN APPROPRIATE DOSE TO EMPLOY AND STUDY IN HOSPITAL SETTINGS.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
12 2558  39 YOGA FOR CHRONIC LOW BACK PAIN IN A PREDOMINANTLY MINORITY POPULATION: A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: SEVERAL STUDIES SUGGEST YOGA MAY BE EFFECTIVE FOR CHRONIC LOW BACK PAIN; HOWEVER, TRIALS TARGETING MINORITIES HAVE NOT BEEN CONDUCTED. PRIMARY STUDY OBJECTIVES: ASSESS THE FEASIBILITY OF STUDYING YOGA IN A PREDOMINANTLY MINORITY POPULATION WITH CHRONIC LOW BACK PAIN. COLLECT PRELIMINARY DATA TO PLAN A LARGER POWERED STUDY. STUDY DESIGN: PILOT RANDOMIZED CONTROLLED TRIAL. SETTING: TWO COMMUNITY HEALTH CENTERS IN A RACIALLY DIVERSE NEIGHBORHOOD OF BOSTON, MASSACHUSETTS. PARTICIPANTS: THIRTY ENGLISH-SPEAKING ADULTS (MEAN AGE 44 YEARS, 83% FEMALE, 83% RACIAL/ETHNIC MINORITIES; 48% WITH INCOMES < OR = $30,000) WITH MODERATE-TO-SEVERE CHRONIC LOW BACK PAIN. INTERVENTIONS: STANDARDIZED SERIES OF WEEKLY HATHA YOGA CLASSES FOR 12 WEEKS COMPARED TO A WAITLIST USUAL CARE CONTROL. OUTCOME MEASURES: FEASIBILITY MEASURED BY TIME TO COMPLETE ENROLLMENT, PROPORTION OF RACIAL/ETHNIC MINORITIES ENROLLED, RETENTION RATES, AND ADVERSE EVENTS. PRIMARY EFFICACY OUTCOMES WERE CHANGES FROM BASELINE TO 12 WEEKS IN PAIN SCORE (0=NO PAIN TO 10=WORST POSSIBLE PAIN) AND BACK-RELATED FUNCTION USING THE MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE (0-23 POINT SCALE, HIGHER SCORES REFLECT POORER FUNCTION). SECONDARY EFFICACY OUTCOMES WERE ANALGESIC USE, GLOBAL IMPROVEMENT, AND QUALITY OF LIFE (SF-36). RESULTS: RECRUITMENT TOOK 2 MONTHS. RETENTION RATES WERE 97% AT 12 WEEKS AND 77% AT 26 WEEKS. MEAN PAIN SCORES FOR YOGA DECREASED FROM BASELINE TO 12 WEEKS (6.7 TO 4.4) COMPARED TO USUAL CARE, WHICH DECREASED FROM 7.5 TO 7.1 (P=.02). MEAN ROLAND SCORES FOR YOGA DECREASED FROM 14.5 TO 8.2 COMPARED TO USUAL CARE, WHICH DECREASED FROM 16.1 TO 12.5 (P=.28). AT 12 WEEKS, YOGA COMPARED TO USUAL CARE PARTICIPANTS REPORTED LESS ANALGESIC USE (13% VS 73%, P=.003), LESS OPIATE USE (0% VS 33%, P=.04), AND GREATER OVERALL IMPROVEMENT (73% VS 27%, P=.03). THERE WERE NO DIFFERENCES IN SF-36 SCORES AND NO SERIOUS ADVERSE EVENTS. CONCLUSION: A YOGA STUDY INTERVENTION IN A PREDOMINANTLY MINORITY POPULATION WITH CHRONIC LOW BACK PAIN WAS MODERATELY FEASIBLE AND MAY BE MORE EFFECTIVE THAN USUAL CARE FOR REDUCING PAIN AND PAIN MEDICATION USE.	2009	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
13 2604  47 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
14  521  46 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
15  465  34 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
16  282  49 ADHERENCE TO YOGA AND EXERCISE INTERVENTIONS IN A 6-MONTH CLINICAL TRIAL. BACKGROUND: TO DETERMINE FACTORS THAT PREDICT ADHERENCE TO A MIND-BODY INTERVENTION IN A RANDOMIZED TRIAL. DESIGN: WE ANALYZED ADHERENCE DATA FROM A 3-ARM TRIAL INVOLVING 135 GENERALLY HEALTHY SENIORS 65-85 YEARS OF AGE RANDOMIZED TO A 6-MONTH INTERVENTION CONSISTING OF: AN IYENGAR YOGA CLASS WITH HOME PRACTICE, AN EXERCISE CLASS WITH HOME PRACTICE, OR A WAIT-LIST CONTROL GROUP. OUTCOME MEASURES INCLUDED COGNITIVE FUNCTION, MOOD, FATIGUE, ANXIETY, HEALTH-RELATED QUALITY OF LIFE, AND PHYSICAL MEASURES. ADHERENCE TO THE INTERVENTION WAS OBTAINED BY CLASS ATTENDANCE AND BIWEEKLY HOME PRACTICE LOGS. RESULTS: THE DROP-OUT RATE WAS 13%. AMONG THE COMPLETERS OF THE TWO ACTIVE INTERVENTIONS, AVERAGE YOGA CLASS ATTENDANCE WAS 77% AND HOME PRACTICE OCCURRED 64% OF ALL DAYS. AVERAGE EXERCISE CLASS ATTENDANCE WAS 69% AND HOME EXERCISE OCCURRED 54% OF ALL DAYS. THERE WERE NO CLEAR EFFECTS OF ADHERENCE ON THE SIGNIFICANT STUDY OUTCOMES (QUALITY OF LIFE AND PHYSICAL MEASURES). CLASS ATTENDANCE WAS SIGNIFICANTLY CORRELATED WITH BASELINE MEASURES OF DEPRESSION, FATIGUE, AND PHYSICAL COMPONENTS OF HEALTH-RELATED QUALITY OF LIFE. SIGNIFICANT DIFFERENCES IN BASELINE MEASURES WERE ALSO FOUND BETWEEN STUDY COMPLETERS AND DROP-OUTS IN THE ACTIVE INTERVENTIONS. ADHERENCE WAS NOT RELATED TO AGE, GENDER, OR EDUCATION LEVEL. CONCLUSION: HEALTHY SENIORS HAVE GOOD ATTENDANCE AT CLASSES WITH A PHYSICALLY ACTIVE INTERVENTION. HOME PRACTICE TAKES PLACE OVER HALF OF THE TIME. DECREASED ADHERENCE TO A POTENTIALLY BENEFICIAL INTERVENTION HAS THE POTENTIAL TO DECREASE THE EFFECT OF THE INTERVENTION IN A CLINICAL TRIAL BECAUSE SUBJECTS WHO MIGHT SUSTAIN THE GREATEST BENEFIT WILL RECEIVE A LOWER DOSE OF THE INTERVENTION AND SUBJECTS WITH HIGHER ADHERENCE RATES MAY BE FUNCTIONING CLOSER TO MAXIMUM ABILITY BEFORE THE INTERVENTION. STRATEGIES TO MAXIMIZE ADHERENCE AMONG SUBJECTS AT GREATER RISK FOR LOW ADHERENCE WILL BE IMPORTANT FOR FUTURE TRIALS, ESPECIALLY COMPLEMENTARY TREATMENTS REQUIRING GREATER EFFORT THAN SIMPLE PILL-TAKING.	2007	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
17  187  48 A RANDOMIZED PREFERENCE TRIAL COMPARING COGNITIVE-BEHAVIORAL THERAPY AND YOGA FOR THE TREATMENT OF LATE-LIFE WORRY: EXAMINATION OF IMPACT ON DEPRESSION, GENERALIZED ANXIETY, FATIGUE, PAIN, SOCIAL PARTICIPATION, AND PHYSICAL FUNCTION. BACKGROUND: DEPRESSION, GENERALIZED ANXIETY, FATIGUE, DIMINISHED PHYSICAL FUNCTION, REDUCED SOCIAL PARTICIPATION, AND PAIN ARE COMMON FOR MANY OLDER ADULTS AND NEGATIVELY IMPACT QUALITY OF LIFE. THE PURPOSE OF THE OVERALL TRIAL WAS TO COMPARE THE EFFECTS OF COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA ON LATE-LIFE WORRY, ANXIETY, AND SLEEP; AND EXAMINE PREFERENCE AND SELECTION EFFECTS ON THESE OUTCOMES. OBJECTIVE: THE PRESENT ANALYSES COMPARED EFFECTS OF THE 2 INTERVENTIONS ON ADDITIONAL OUTCOMES (DEPRESSIVE SYMPTOMS, GENERALIZED ANXIETY SYMPTOMS, FATIGUE, PAIN INTERFERENCE/INTENSITY, PHYSICAL FUNCTION, SOCIAL PARTICIPATION); AND EXAMINED WHETHER THERE ARE PREFERENCE AND SELECTION EFFECTS FOR THESE TREATMENTS. METHODS: A RANDOMIZED PREFERENCE TRIAL OF CBT AND YOGA WAS CONDUCTED IN ADULTS >/=60 YEARS WHO SCORED >/=26 ON THE PENN STATE WORRY QUESTIONNAIRE-ABBREVIATED (PSWQ-A), RECRUITED FROM OUTPATIENT MEDICAL CLINICS, MAILINGS, AND ADVERTISEMENTS. COGNITIVE-BEHAVIORAL THERAPY CONSISTED OF 10 WEEKLY TELEPHONE SESSIONS. YOGA CONSISTED OF 20 BI-WEEKLY GROUP YOGA CLASSES. PARTICIPANTS WERE RANDOMIZED TO(1): A RANDOMIZED CONTROLLED TRIAL (RCT) OF CBT OR YOGA (N = 250); OR (2) A PREFERENCE TRIAL IN WHICH THEY SELECTED THEIR TREATMENT (CBT OR YOGA; N = 250). OUTCOMES WERE MEASURED AT BASELINE AND POST-INTERVENTION. RESULTS: WITHIN THE RCT, THERE WERE SIGNIFICANT BETWEEN-GROUP DIFFERENCES FOR BOTH PAIN INTERFERENCE AND INTENSITY. THE PAIN INTERFERENCE SCORE IMPROVED MORE FOR THE CBT GROUP COMPARED WITH THE YOGA GROUP [INTERVENTION EFFECT OF (MEAN (95% CI) = 2.5 (.5, 4.6), P = .02]. FOR THE PAIN INTENSITY SCORE, THE INTERVENTION EFFECT ALSO FAVORED CBT OVER YOGA [.7 (.2, 1.3), P < .01]. DEPRESSIVE SYMPTOMS, GENERALIZED ANXIETY, AND FATIGUE SHOWED CLINICALLY MEANINGFUL WITHIN-GROUP CHANGES IN BOTH GROUPS. THERE WERE NO CHANGES IN OR DIFFERENCE BETWEEN PHYSICAL FUNCTION OR SOCIAL PARTICIPATION FOR EITHER GROUP. NO PREFERENCE OR SELECTION EFFECTS WERE FOUND. CONCLUSION: BOTH CBT AND YOGA MAY BE USEFUL FOR OLDER ADULTS FOR IMPROVING PSYCHOLOGICAL SYMPTOMS AND FATIGUE. COGNITIVE-BEHAVIORAL THERAPY MAY OFFER EVEN GREATER BENEFIT THAN YOGA FOR DECREASING PAIN.	2022	
                                                                                                                                                                                                                                                                                                                                             
18  518  40 COMPARING ONCE- VERSUS TWICE-WEEKLY YOGA CLASSES FOR CHRONIC LOW BACK PAIN IN PREDOMINANTLY LOW INCOME MINORITIES: A RANDOMIZED DOSING TRIAL. BACKGROUND. PREVIOUS STUDIES HAVE DEMONSTRATED THAT ONCE-WEEKLY YOGA CLASSES ARE EFFECTIVE FOR CHRONIC LOW BACK PAIN (CLBP) IN WHITE ADULTS WITH HIGH SOCIOECONOMIC STATUS. THE COMPARATIVE EFFECTIVENESS OF TWICE-WEEKLY CLASSES AND GENERALIZABILITY TO RACIALLY DIVERSE LOW INCOME POPULATIONS ARE UNKNOWN. METHODS. WE CONDUCTED A 12-WEEK RANDOMIZED, PARALLEL-GROUP, DOSING TRIAL FOR 95 ADULTS RECRUITED FROM AN URBAN SAFETY-NET HOSPITAL AND FIVE COMMUNITY HEALTH CENTERS COMPARING ONCE-WEEKLY (N = 49) VERSUS TWICE-WEEKLY (N = 46) STANDARDIZED YOGA CLASSES SUPPLEMENTED BY HOME PRACTICE. PRIMARY OUTCOMES WERE CHANGE FROM BASELINE TO 12 WEEKS IN PAIN (11-POINT SCALE) AND BACK-RELATED FUNCTION (23-POINT MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE). RESULTS. 82% OF PARTICIPANTS WERE NONWHITE; 77% HAD ANNUAL HOUSEHOLD INCOMES <$40,000. THE SAMPLE'S BASELINE MEAN PAIN INTENSITY [6.9 (SD 1.6)] AND FUNCTION [13.7 (SD 5.0)] REFLECTED MODERATE TO SEVERE BACK PAIN AND IMPAIRMENT. PAIN AND BACK-RELATED FUNCTION IMPROVED WITHIN BOTH GROUPS (P < 0.001). HOWEVER, THERE WERE NO DIFFERENCES BETWEEN ONCE-WEEKLY AND TWICE-WEEKLY GROUPS FOR PAIN REDUCTION [-2.1 (95% CI -2.9, -1.3) VERSUS -2.4 (95% CI -3.1, -1.8), P = 0.62] OR BACK-RELATED FUNCTION [-5.1 (95% CI -7.0, -3.2) VERSUS -4.9 (95% CI -6.5, -3.3), P = 0.83]. CONCLUSIONS. TWELVE WEEKS OF ONCE-WEEKLY OR TWICE-WEEKLY YOGA CLASSES WERE SIMILARLY EFFECTIVE FOR PREDOMINANTLY LOW INCOME MINORITY ADULTS WITH MODERATE TO SEVERE CHRONIC LOW BACK PAIN. THIS TRIAL IS REGISTERED WITH CLINICALTRIALS.GOV NCT01761617.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
19 2851  42 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
20 2811  37 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