1 1566 48 LOW BACK PAIN AND YOGA. ABSTRACT QUESTIONS FROM PATIENTS ABOUT PAIN CONDITIONS AND ANALGESIC PHARMACOTHERAPY AND RESPONSES FROM AUTHORS ARE PRESENTED TO HELP EDUCATE PATIENTS AND MAKE THEM MORE EFFECTIVE SELF-ADVOCATES. THE TOPIC ADDRESSED IN THIS ISSUE IS CHRONIC LOW BACK PAIN, ONE OF THE MOST COMMON REASONS TO VISIT ONE'S PRIMARY CARE DOCTOR. COMPLEMENTARY APPROACHES, INCLUDING YOGA, WILL BE ADDRESSED. 2014 2 2813 16 YOGA TO TREAT NONSPECIFIC LOW BACK PAIN. LOW BACK PAIN IS COMMON AND POSES A CHALLENGE FOR CLINICIANS TO FIND EFFECTIVE TREATMENT TO PREVENT IT FROM BECOMING CHRONIC. CHRONIC LOW BACK PAIN CAN HAVE A SIGNIFICANT IMPACT ON AN EMPLOYEE'S ABILITY TO REMAIN AN ACTIVE AND PRODUCTIVE MEMBER OF THE WORK FORCE DUE TO INCREASED ABSENTEEISM, DUTY RESTRICTIONS, OR PHYSICAL LIMITATIONS FROM PAIN. LOW BACK PAIN IS THE MOST COMMON CAUSE OF WORK-RELATED DISABILITY AMONG EMPLOYEES YOUNGER THAN 46 YEARS. ADVANCING TECHNOLOGY AND LESS INVASIVE SURGICAL PROCEDURES HAVE NOT IMPROVED OUTCOMES FOR EMPLOYEES WHO SUFFER FROM LOW BACK PAIN. MOST CONTINUE TO EXPERIENCE SOME PAIN AND DYSFUNCTION AFTER CONVENTIONAL TREATMENTS SUCH AS INJECTIONS AND SURGERY. AN ALTERNATIVE TREATMENT THAT COULD REDUCE NONSPECIFIC CHRONIC LOW BACK PAIN WOULD BENEFIT BOTH EMPLOYEES AND EMPLOYERS. EXERCISING AND REMAINING ACTIVE ARE PART OF MOST GUIDELINES' ROUTINE CARE RECOMMENDATIONS BUT ARE NOT WELL DEFINED. 2011 3 2412 16 YOGA AND ITS IMPACT ON CHRONIC INFLAMMATORY AUTOIMMUNE ARTHRITIS. RHEUMATOID ARTHRITIS (RA) IS ONE OF THE MOST COMMON CHRONIC INFLAMMATORY AUTOIMMUNE DISEASES, WHICH ADVERSELY AFFECTS THE QUALITY OF LIFE. RA IS A DISEASE OF UNKNOWN ETIOLOGY, HOWEVER, BOTH GENETIC AND ENVIRONMENTAL FACTORS APPEAR TO CONTRIBUTE TO THE SUSCEPTIBILITY TO THIS DISEASE. THE SEVERITY AND PROGRESSION OF THE DISEASE ARE ATTRIBUTABLE TO THE RELEASE OF A HOST OF INFLAMMATORY CYTOKINES, CYTOTOXIC AND IMMUNE REGULATORY FACTORS. THE TREATMENTS OF RA ARE PRIMARILY LIMITED TO SYMPTOMATIC ALLEVIATION OF PAIN OR OTHER SYMPTOMS OR TO THE USE OF CYTOTOXIC DRUG TREATMENT IN SEVERE FORMS OF THE DISEASE WHICH IS COMMONLY ASSOCIATED WITH SIGNIFICANT SIDE EFFECTS. DESPITE LACK OF A CURE, THE DISEASE MAY BE CONTROLLED BY MIND-BODY INTERVENTIONS. HOLISTIC TREATMENTS SUCH AS YOGA SIGNIFICANTLY IMPROVE AND REDUCE THE PSYCHO-SOMATIC SYMPTOMS, PAIN PERCEPTION, DISABILITY QUOTIENT, JOINT FLEXIBILITY, RANGE OF MOTION, POSTURE, MUSCLE STRENGTH, COORDINATION, AND DISEASE ACTIVITY. HERE, WE DISCUSS THE FEATURES OF RA AND ADDRESS HOW YOGA CAN BE USED AS A THERAPEUTIC REGIMEN TO IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH RA. 2021 4 2035 14 TELE-YOGA FOR CHRONIC PAIN: CURRENT STATUS AND FUTURE DIRECTIONS. PAIN IS A PERVASIVE, DEBILITATING DISORDER THAT IS RESISTANT TO LONG-TERM PHARMACOLOGICAL INTERVENTIONS. ALTHOUGH PSYCHOLOGICAL THERAPIES SUCH AS COGNITIVE BEHAVIOR THERAPY DEMONSTRATE MODERATE EFFICACY, MANY INDIVIDUALS CONTINUE TO HAVE ONGOING DIFFICULTIES FOLLOWING TREATMENT. THERE IS A CURRENT TREND TO ESTABLISH COMPLEMENTARY AND INTEGRATIVE HEALTH INTERVENTIONS FOR CHRONIC PAIN, FOR WHICH YOGA HAS BEEN FOUND TO HAVE EXCITING POTENTIAL. NEVERTHELESS, AN IMPORTANT CONSIDERATION WITHIN THE FIELD IS ACCESSIBILITY TO ADEQUATE CARE. TELEHEALTH CAN BE USED TO PROVIDE REAL-TIME INTERACTIVE VIDEO CONFERENCING LEADING TO INCREASED ACCESS TO HEALTH CARE FOR INDIVIDUALS LOCATED REMOTELY OR WHO OTHERWISE HAVE DIFFICULTY ACCESSING SERVICES, PERHAPS THROUGH ISSUES OF MOBILITY OR PROXIMITY OF ADEQUATE SERVICES. THIS ARTICLE ASSESSES THE CURRENT STATUS AND FEASIBILITY OF IMPLEMENTING TELE-YOGA FOR CHRONIC PAIN. METHODOLOGICAL LIMITATIONS AND RECOMMENDATIONS FOR FUTURE RESEARCH ARE DISCUSSED. 2018 5 122 21 A PILOT STUDY OF YOGA AS SELF-CARE FOR ARTHRITIS IN MINORITY COMMUNITIES. BACKGROUND: WHILE ARTHRITIS IS THE MOST COMMON CAUSE OF DISABILITY, NON-HISPANIC BLACKS AND HISPANICS EXPERIENCE WORSE ARTHRITIS IMPACT DESPITE HAVING THE SAME OR LOWER PREVALENCE OF ARTHRITIS COMPARED TO NON-HISPANIC WHITES. PEOPLE WITH ARTHRITIS WHO EXERCISE REGULARLY HAVE LESS PAIN, MORE ENERGY, AND IMPROVED SLEEP, YET ARTHRITIS IS ONE OF THE MOST COMMON REASONS FOR LIMITING PHYSICAL ACTIVITY. MIND-BODY INTERVENTIONS, SUCH AS YOGA, THAT TEACH STRESS MANAGEMENT ALONG WITH PHYSICAL ACTIVITY MAY BE WELL SUITED FOR INVESTIGATION IN BOTH OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS. YOGA USERS ARE PREDOMINANTLY WHITE, FEMALE, AND COLLEGE EDUCATED. THERE ARE FEW STUDIES THAT EXAMINE YOGA IN MINORITY POPULATIONS; NONE ADDRESS ARTHRITIS. THIS PAPER PRESENTS A STUDY PROTOCOL EXAMINING THE FEASIBILITY AND ACCEPTABILITY OF PROVIDING YOGA TO AN URBAN, MINORITY POPULATION WITH ARTHRITIS. METHODS/DESIGN: IN THIS ONGOING PILOT STUDY, A CONVENIENCE SAMPLE OF 20 MINORITY ADULTS DIAGNOSED WITH EITHER OSTEOARTHRITIS OR RHEUMATOID ARTHRITIS UNDERGO AN 8-WEEK PROGRAM OF YOGA CLASSES. IT IS BELIEVED THAT BY ATTENDING YOGA CLASSES DESIGNED FOR PATIENTS WITH ARTHRITIS, WITH RACIALLY CONCORDANT INSTRUCTORS; ACCEPTABILITY OF YOGA AS AN ADJUNCT TO STANDARD ARTHRITIS TREATMENT AND SELF-CARE WILL BE ENHANCED. SELF-CARE IS DEFINED AS ADOPTING BEHAVIORS THAT IMPROVE PHYSICAL AND MENTAL WELL-BEING. THIS CONCEPT IS QUANTIFIED THROUGH COLLECTING PATIENT-REPORTED OUTCOME MEASURES RELATED TO SPIRITUAL GROWTH, HEALTH RESPONSIBILITY, INTERPERSONAL RELATIONS, AND STRESS MANAGEMENT. ADDITIONAL MEASURES COLLECTED DURING THIS STUDY INCLUDE: PHYSICAL FUNCTION, ANXIETY/DEPRESSION, FATIGUE, SLEEP DISTURBANCE, SOCIAL ROLES, AND PAIN; AS WELL AS BASELINE DEMOGRAPHIC AND CLINICAL DATA. FIELD NOTES, QUANTITATIVE AND QUALITATIVE DATA REGARDING FEASIBILITY AND ACCEPTABILITY ARE ALSO COLLECTED. ACCEPTABILITY IS DETERMINED BY RESPONSE/RETENTION RATES, POSITIVE QUALITATIVE DATA, AND CONTINUING YOGA PRACTICE AFTER THREE MONTHS. DISCUSSION: THERE ARE A NUMBER OF CHALLENGES IN RECRUITING AND RETAINING PARTICIPANTS FROM A COMMUNITY CLINIC SERVING MINORITY POPULATIONS. ADOPTING BEHAVIORS THAT IMPROVE WELL-BEING AND QUALITY OF LIFE INCLUDE THOSE THAT INTEGRATE MENTAL HEALTH (MIND) AND PHYSICAL HEALTH (BODY). FEW STUDIES HAVE EXAMINED OFFERING INTEGRATIVE MODALITIES TO THIS POPULATION. THIS PILOT WAS UNDERTAKEN TO QUANTIFY MEASURES OF FEASIBILITY AND ACCEPTABILITY THAT WILL BE USEFUL WHEN EVALUATING FUTURE PLANS FOR EXPANDING THE STUDY OF YOGA IN URBAN, MINORITY POPULATIONS WITH ARTHRITIS. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT01617421. 2013 6 639 13 DO SIDE-EFFECTS/INJURIES FROM YOGA PRACTICE RESULT IN DISCONTINUED USE? RESULTS OF A NATIONAL SURVEY. CONTEXT: YOGA-RELATED INJURIES ARE OF INCREASING CONCERN AS THE USE OF YOGA CONTINUES TO RISE. AIMS: THE AIM OF THE FOLLOWING STUDY IS TO EXAMINE WHETHER A NATIONAL SAMPLE OF YOGA PRACTITIONERS WOULD REPORT DISCONTINUED USE OF YOGA DUE TO INJURY FROM THE PRACTICE, ASSESS WHAT INJURIES RESULTED IN DISCONTINUED USE, DETERMINE WHAT INJURIES WERE MOST COMMON AND IDENTIFY INJURIES REQUIRING MEDICAL ATTENTION. METHODS: SECONDARY DATA ANALYSIS OF A NATIONALLY REPRESENTATIVE SAMPLE OF ADULTS IN THE UNITED STATES (N = 23,393). RESULTS: LESS THAN 1% OF INDIVIDUALS WHO HAD EVER PRACTICED YOGA (N = 2230) REPORTED AN INJURY FROM YOGA THAT LED TO DISCONTINUED USE. OF THOSE REPORTING INJURY, LESS THAN ONE-THIRD (N = 4) REPORTED SEEKING MEDICAL ATTENTION. THE MOST COMMON SIDE-EFFECT WAS BACK PAIN. APPROXIMATELY, HALF OF THOSE REPORTING BACK PAIN SOUGHT MEDICAL ATTENTION. CONCLUSIONS: INJURY DUE TO YOGA IS AN INFREQUENT BARRIER TO CONTINUED PRACTICE AND SEVERE INJURY DUE TO YOGA IS RARE. 2014 7 440 18 CASE REPORT: THE USE OF MEDICAL YOGA FOR ADOLESCENT MENTAL HEALTH. MENTAL HEALTH ISSUES ARE EPIDEMIC AMONG YOUTH IN THE UNITED STATES TODAY. RECENT STUDIES SUGGEST THAT UP TO 50% OF ALL TEENAGERS HAVE COMPLAINTS RELATED TO STRESS, ANXIETY, AND/OR DEPRESSION. THIS PROBLEM IS ACCOMPANIED BY AN UNPRECEDENTED RISE IN THE RATES OF CHILD AND TEEN SUICIDE IN THE UNITED STATES. IN RESPONSE TO THIS EPIDEMIC, THE AMERICAN ACADEMY OF PEDIATRICS IS RECOMMENDING UNIVERSAL DEPRESSION SCREENING FOR ALL TEENS. MEDICATIONS ARE AVAILABLE TO AMELIORATE MENTAL HEALTH DISORDERS, AND MANY CAN BE SAFELY USED IN THE PRIMARY CARE SETTING. HOWEVER, MANY OF THESE MEDICATIONS HAVE UNWANTED SIDE EFFECTS OR MAY NOT BE FAMILIAR TO THE PRIMARY CARE PHYSICIAN. FOR THESE REASONS AND OTHERS, PRIMARY CARE PHYSICIANS REQUIRE ADDITIONAL APPROACHES TO RESPOND TO THE CHALLENGES IMPOSED BY A GROWING NUMBER OF PATIENTS REQUIRING MENTAL HEALTH SUPPORT. MEDICAL YOGA THERAPY, PRESCRIBED BY A PHYSICIAN WITH SPECIAL YOGA THERAPY TRAINING, OFFERS A SAFE AND EFFECTIVE WAY TO SERVE THE PATIENT WITH PHYSICAL OR MENTAL CHALLENGES DISABILITIES. MEDICAL YOGA THERAPY IS AN INDIVIDUALIZED AND PERSONAL APPROACH TO THE PATIENT, AND IT MAY BE INTEGRATED WITH ANY CURRENT THERAPY OR MEDICAL REGIMEN. HERE, EVIDENCE FOR MEDICAL YOGA IS REVIEWED IN THE CONTEXT OF AN ADOLESCENT PATIENT WITH A COMMON DISORDER. YOGA PRACTICES, WITH PARTICULAR FOCUS ON MINDFULNESS, OFFER A SAFE AND EFFECTIVE INTERVENTION FOR A GROWING NUMBER OF PEDIATRIC PATIENTS. 2019 8 2300 16 THERAPEUTIC YOGA: SYMPTOM MANAGEMENT FOR MULTIPLE SCLEROSIS. MULTIPLE SCLEROSIS (MS) IS THE MOST COMMON AUTOIMMUNE INFLAMMATORY DEMYELINATING DISEASE OF THE CENTRAL NERVOUS SYSTEM, AFFECTING OVER 2.3 MILLION PEOPLE WORLDWIDE. ACCORDING TO THE NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE, THE AGE OF DISEASE ONSET IS TYPICALLY BETWEEN 20 AND 40 YEARS, WITH A HIGHER INCIDENCE IN WOMEN. INDIVIDUALS WITH MS EXPERIENCE A WIDE RANGE OF SYMPTOMS, INCLUDING DECLINING PHYSICAL, EMOTIONAL, AND PSYCHOLOGICAL SYMPTOMS (E.G., FATIGUE, IMBALANCE, SPASTICITY, CHRONIC PAIN, COGNITIVE IMPAIRMENT, BLADDER AND BOWEL DYSFUNCTION, VISUAL AND SPEECH IMPAIRMENTS, DEPRESSION, SENSORY DISTURBANCE, AND MOBILITY IMPAIRMENT). TO DATE, BOTH THE CAUSE OF AND CURE FOR MS REMAIN UNKNOWN. IN RECENT YEARS, MORE INDIVIDUALS WITH MS HAVE BEEN PURSUING ALTERNATIVE METHODS OF TREATMENT TO MANAGE SYMPTOMS OF THE DISEASE, INCLUDING MIND-BODY THERAPIES SUCH AS YOGA, MEDITATION, BREATHING, AND RELAXATION TECHNIQUES. IT HAS BEEN SUGGESTED THAT THE PRACTICE OF YOGA MAY BE A SAFE AND EFFECTIVE WAY OF MANAGING SYMPTOMS OF MS. THEREFORE, THE PURPOSE OF THIS PAPER IS TO SUMMARIZE THE MOST RELEVANT LITERATURE ON EXERCISE AND MIND-BODY MODALITIES TO TREAT MS SYMPTOMS AND, MORE SPECIFICALLY, THE BENEFITS AND POTENTIAL ROLE OF YOGA AS AN ALTERNATIVE TREATMENT OF SYMPTOM MANAGEMENT FOR INDIVIDUALS WITH MS. THE ARTICLE ALSO DISCUSSES FUTURE DIRECTIONS FOR RESEARCH. 2015 9 536 27 COMPARISON OF YOGA VERSUS STRETCHING FOR CHRONIC LOW BACK PAIN: PROTOCOL FOR THE YOGA EXERCISE SELF-CARE (YES) TRIAL. BACKGROUND: BACK PAIN, ONE OF THE MOST PREVALENT CONDITIONS AFFLICTING AMERICAN ADULTS, IS THE LEADING REASON FOR USING COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) THERAPIES. YOGA IS AN INCREASINGLY POPULAR "MIND-BODY" CAM THERAPY OFTEN USED FOR RELIEVING BACK PAIN AND SEVERAL SMALL STUDIES HAVE FOUND YOGA EFFECTIVE FOR THIS CONDITION. THIS STUDY WILL ASSESS WHETHER YOGA IS EFFECTIVE FOR TREATING CHRONIC LOW BACK PAIN COMPARED WITH SELF CARE AND EXERCISE AND WILL EXPLORE THE MECHANISMS RESPONSIBLE FOR ANY OBSERVED BENEFITS. METHODS/DESIGN: A TOTAL OF 210 PARTICIPANTS WITH LOW BACK PAIN LASTING AT LEAST 3 MONTHS WILL BE RECRUITED FROM PRIMARY CARE CLINICS OF A LARGE HEALTHCARE SYSTEM BASED IN SEATTLE. THEY WILL BE RANDOMIZED IN A 2:2:1 RATIO TO RECEIVE 12 WEEKLY YOGA CLASSES, 12 WEEKLY CONVENTIONAL THERAPEUTIC EXERCISE CLASSES OF COMPARABLE PHYSICAL EXERTION, OR A SELF-CARE BOOK. INTERVIEWERS MASKED TO PARTICIPANTS' TREATMENT GROUP WILL ASSESS OUTCOMES AT BASELINE AND 6, 12 AND 26 WEEKS AFTER RANDOMIZATION. PRIMARY OUTCOMES WILL BE BACK-RELATED DYSFUNCTION AND SYMPTOM BOTHERSOMENESS. IN ADDITION, DATA WILL BE COLLECTED ON PHYSICAL MEASUREMENTS (E.G., FLEXION) AT BASELINE AND 12 WEEKS AND SALIVA SAMPLES WILL BE OBTAINED AT BASELINE, 6 AND 12 WEEKS. INFORMATION WILL BE COLLECTED ON SPECIFIC PHYSICAL, PSYCHOLOGICAL, AND PHYSIOLOGICAL FACTORS TO ALLOW EXPLORATION OF POSSIBLE MECHANISMS OF ACTION THROUGH WHICH YOGA COULD RELIEVE BACK PAIN AND DYSFUNCTION. THE EFFECTIVENESS OF YOGA WILL BE ASSESSED USING ANALYSIS OF COVARIANCE (USING GENERAL ESTIMATING EQUATIONS - GEE) WITHIN AN INTENTION-TO-TREAT CONTEXT. IF YOGA IS FOUND EFFECTIVE, FURTHER ANALYSES WILL EXPLORE WHETHER YOGA'S BENEFITS ARE ATTRIBUTABLE TO PHYSICAL, PSYCHOLOGICAL AND/OR PHYSIOLOGICAL FACTORS. CONCLUSIONS: THIS STUDY WILL PROVIDE THE CLEAREST EVIDENCE TO DATE ABOUT THE VALUE OF YOGA AS A THERAPEUTIC OPTION FOR TREATING CHRONIC BACK PAIN, AND IF THE RESULTS ARE POSITIVE, WILL HELP FOCUS FUTURE, MORE IN-DEPTH, RESEARCH ON THE MOST PROMISING POTENTIAL MECHANISMS OF ACTION IDENTIFIED BY THIS STUDY. 2010 10 912 21 EFFECTIVENESS OF IYENGAR YOGA IN TREATING SPINAL (BACK AND NECK) PAIN: A SYSTEMATIC REVIEW. CONSIDERABLE AMOUNT OF MONEY SPENT IN HEALTH CARE IS USED FOR TREATMENTS OF LIFESTYLE RELATED, CHRONIC HEALTH CONDITIONS, WHICH COME FROM BEHAVIORS THAT CONTRIBUTE TO MORBIDITY AND MORTALITY OF THE POPULATION. BACK AND NECK PAIN ARE TWO OF THE MOST COMMON MUSCULOSKELETAL PROBLEMS IN MODERN SOCIETY THAT HAVE SIGNIFICANT COST IN HEALTH CARE. YOGA, AS A BRANCH OF COMPLEMENTARY ALTERNATIVE MEDICINE, HAS EMERGED AND IS SHOWING TO BE AN EFFECTIVE TREATMENT AGAINST NONSPECIFIC SPINAL PAIN. RECENT STUDIES HAVE SHOWN POSITIVE OUTCOME OF YOGA IN GENERAL ON REDUCING PAIN AND FUNCTIONAL DISABILITY OF THE SPINE. THE OBJECTIVE OF THIS STUDY IS TO CONDUCT A SYSTEMATIC REVIEW OF THE EXISTING RESEARCH WITHIN IYENGAR YOGA METHOD AND ITS EFFECTIVENESS ON RELIEVING BACK AND NECK PAIN (DEFINED AS SPINAL PAIN). DATABASE RESEARCH FORM THE FOLLOWING SOURCES (COCHRANE LIBRARY, NCBI PUBMED, THE CLINICAL TRIAL REGISTRY OF THE INDIAN COUNCIL OF MEDICAL RESEARCH, GOOGLE SCHOLAR, EMBASE, CINAHL, AND PSYCHINFO) DEMONSTRATED INCLUSION AND EXCLUSION CRITERIA THAT SELECTED ONLY IYENGAR YOGA INTERVENTIONS, WHICH IN TURN, IDENTIFIED SIX RANDOMIZED CONTROL TRIALS DEDICATED TO COMPARE THE EFFECTIVENESS OF YOGA FOR BACK AND NECK PAIN VERSUS OTHER CARE. THE DIFFERENCE BETWEEN THE GROUPS ON THE POSTINTERVENTION PAIN OR FUNCTIONAL DISABILITY INTENSITY ASSESSMENT WAS, IN ALL SIX STUDIES, FAVORING THE YOGA GROUP, WHICH PROJECTED A DECREASE IN BACK AND NECK PAIN. OVERALL SIX STUDIES WITH 570 PATIENTS SHOWED, THAT IYENGAR YOGA IS AN EFFECTIVE MEANS FOR BOTH BACK AND NECK PAIN IN COMPARISON TO CONTROL GROUPS. THIS SYSTEMATIC REVIEW FOUND STRONG EVIDENCE FOR SHORT-TERM EFFECTIVENESS, BUT LITTLE EVIDENCE FOR LONG-TERM EFFECTIVENESS OF YOGA FOR CHRONIC SPINE PAIN IN THE PATIENT-CENTERED OUTCOMES. 2015 11 2688 15 YOGA IN THE TREATMENT OF MOOD AND ANXIETY DISORDERS: A REVIEW. BACKGROUND: PATIENT USE OF COMPLEMENTARY AND ALTERNATIVE TREATMENTS, INCLUDING YOGA, TO MANAGE MOOD AND ANXIETY DISORDERS, HAS BEEN WELL DOCUMENTED. DESPITE RESEARCH INTEREST, THERE ARE FEW RECENT REVIEWS OF THE EVIDENCE OF THE BENEFIT OF YOGA IN THESE CONDITIONS. METHOD: THE PUBMED, MEDLINE AND PSYCINFO DATABASES WERE SEARCHED FOR LITERATURE PUBLISHED UP TO JULY 2008, RELATING TO YOGA AND DEPRESSIVE AND ANXIETY DISORDERS. RESULTS: THE PAUCITY OF REPORTED STUDIES AND SEVERAL METHODOLOGICAL CONSTRAINTS LIMIT DATA INTERPRETATION. IN DEPRESSIVE DISORDERS, YOGA MAY BE COMPARABLE TO MEDICATION AND THE COMBINATION SUPERIOR TO MEDICATION ALONE. THERE IS REASONABLE EVIDENCE FOR ITS USE AS SECOND-LINE MONOTHERAPY OR AUGMENTATION TO MEDICATION IN MILD TO MODERATE MAJOR DEPRESSION AND DYSTHYMIA, WITH EARLY EVIDENCE OF BENEFIT IN MORE SEVERE DEPRESSION. IN ANXIETY DISORDERS, YOGA MAY BE SUPERIOR TO MEDICATION FOR A SUBGROUP OF PATIENTS, BUT ITS BENEFITS IN SPECIFIC CONDITIONS ARE STILL LARGELY UNKNOWN. SECOND-LINE MONOTHERAPY IS INDICATED IN PERFORMANCE OR TEST ANXIETY, BUT ONLY PRELIMINARY EVIDENCE EXISTS FOR OBSESSIVE-COMPULSIVE DISORDER AND POST-TRAUMATIC STRESS DISORDER. YOGA APPEARS TO BE SUPERIOR TO NO TREATMENT AND PROGRESSIVE RELAXATION FOR BOTH DEPRESSION AND ANXIETY, AND MAY BENEFIT MOOD AND ANXIETY SYMPTOMS ASSOCIATED WITH MEDICAL ILLNESS. IT SHOWS GOOD SAFETY AND TOLERABILITY IN SHORT-TERM TREATMENT. CONCLUSION: REASONABLE EVIDENCE SUPPORTS THE BENEFIT OF YOGA IN SPECIFIC DEPRESSIVE DISORDERS. THE EVIDENCE IS STILL PRELIMINARY IN ANXIETY DISORDERS. GIVEN ITS PATIENT APPEAL AND THE PROMISING FINDINGS THUS FAR, FURTHER RESEARCH ON YOGA IN THESE CONDITIONS IS ENCOURAGED. 2009 12 1646 14 MOTIVATIONS FOR ADOPTING AND MAINTAINING A YOGA PRACTICE: A NATIONAL CROSS-SECTIONAL SURVEY. BACKGROUND: YOGA PRACTICE IS BECOMING INCREASINGLY POPULAR AROUND THE WORLD, YET LITTLE IS KNOWN REGARDING WHY PEOPLE ADOPT THE PRACTICE OF YOGA OR HOW THEIR REASONS FOR PRACTICE CHANGE WITH CONTINUED PRACTICE. FURTHERMORE, WHETHER THOSE WHO PRACTICE DIFFERENT TYPES OF YOGA HAVE DIFFERENT MOTIVES REMAINS UNKNOWN. METHODS: TO ADDRESS THESE ISSUES, THE AUTHORS CONDUCTED A NATIONAL CROSS-SECTIONAL ONLINE SURVEY OF 1,702 YOGA PRACTITIONERS IN GERMANY, ASKING ABOUT DEMOGRAPHIC INFORMATION AND MOTIVES FOR INITIATING AND CONTINUING YOGA PRACTICE. RESULTS: THE MOST COMMON PRIMARY REASONS FOR STARTING YOGA WERE RELAXATION (26.6%) AND PREVENTION (25.5%), WHICH WERE ALSO THE MOST COMMON SECONDARY REASONS. NINE HUNDRED AND FORTY-ONE (55.3%) REPORTED A DIFFERENT PRIMARY REASON FOR MAINTAINING THAN FOR ADOPTING YOGA PRACTICE. PREVENTION (38.4%) AND SPIRITUALITY (26.4%) WERE THE MOST COMMONLY REPORTED PRIMARY REASONS FOR MAINTAINING YOGA PRACTICE. MORE HIGHLY EDUCATED PARTICIPANTS AND THOSE PRACTICING LONGER THAN 5 YEARS AT THE TIME OF THE SURVEY WERE MORE LIKELY TO HAVE REPORTED A DIFFERENT CURRENT PRIMARY REASON FOR YOGA PRACTICE THAN THAT FOR WHICH THEY STARTED PRACTICING. CONCLUSIONS: THESE RESULTS SHED LIGHT ON YOGA'S APPEAL TO NOVICES AND REGULAR PRACTITIONERS, WITH IMPORTANT IMPLICATIONS FOR MAKING YOGA APPEALING TO BEGINNERS AS WELL AS PROMOTING THE PRACTICE AS A LONG-TERM LIFESTYLE BEHAVIOR. 2019 13 2490 13 YOGA AS AN INTERVENTION TO MANAGE MULTIPLE SCLEROSIS SYMPTOMS. MULTIPLE SCLEROSIS (MS) IS AN AUTOIMMUNE, DEMYELINATING, INFLAMMATORY DISEASE OF CENTRAL NERVOUS SYSTEM (CNS) WHICH IS CHARACTERIZED BY SPASTICITY, FATIGUE, DEPRESSION, ANXIETY, BOWEL AND BLADDER DYSFUNCTION, IMPAIRED MOBILITY, COGNITIVE IMPAIRMENT ETC. AND AFFECTS APPROXIMATELY 2.5 MILLION PEOPLE WORLDWIDE. DISEASE MODIFYING THERAPIES FOR MS WHICH HELP IN PREVENTING ACCUMULATION OF LESIONS IN WHITE MATTER OF CNS ARE COSTLY AND HAVE SIGNIFICANT ADVERSE EFFECTS. THEREFORE, PATIENTS WITH MS ARE USING COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) AND YOGA IS ONE OF THE MOST POPULAR FORM OF CAM WHICH IS BEING USED IMMENSELY TO REDUCE OR OVERCOME THE SYMPTOMS OF MS. IN THE CURRENT REVIEW ATTEMPTED TO PRESENT THE POTENTIAL IMPACT OF YOGA PRACTICES ON REDUCING MS RELATED SYMPTOMS. 2020 14 2470 18 YOGA AS A TREATMENT FOR CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW OF THE LITERATURE. OBJECTIVES: CHRONIC LOW BACK PAIN (CLBP) AFFECTS MILLIONS OF PEOPLE WORLDWIDE, AND APPEARS TO BE INCREASING IN PREVALENCE. IT IS ASSOCIATED NOT ONLY WITH PAIN, BUT ALSO WITH INCREASED DISABILITY, PSYCHOLOGICAL SYMPTOMS, AND REDUCED QUALITY OF LIFE. THERE ARE VARIOUS TREATMENT OPTIONS FOR CLBP, BUT NO SINGLE THERAPY STANDS OUT AS BEING THE MOST EFFECTIVE. IN THE PAST 10 YEARS, YOGA INTERVENTIONS HAVE BEEN STUDIED AS A CLBP TREATMENT APPROACH. THE OBJECTIVE OF THIS PAPER IS TO REVIEW THE CURRENT LITERATURE SUPPORTING THE EFFICACY OF YOGA FOR CLBP. METHODS: A LITERATURE SEARCH THROUGH THE BEGINNING OF 2015 WAS CONDUCTED IN PUB MED FOR RANDOMIZED CONTROL TRIALS ADDRESSING TREATMENT OF CLBP WITH YOGA. RESULTS: IN THIS REVIEW WE EVALUATE THE USE OF YOGA AS A TREATMENT FOR CLBP. SPECIFICALLY WE EVALUATE HOW YOGA IMPACTS PHYSICAL FUNCTIONING AND DISABILITY, PAIN, AND ASSOCIATED PSYCHOLOGICAL SYMPTOMS. WE ALSO EVALUATE POSSIBLE MEDIATORS OF THE EFFECT OF YOGA AND THE SAFETY OF YOGA. DISCUSSION: WITH FEW EXCEPTIONS, PREVIOUS STUDIES AND THE RECENT RANDOMIZED CONTROL TRIALS (RCTS) INDICATE THAT YOGA CAN REDUCE PAIN AND DISABILITY, CAN BE PRACTICED SAFELY, AND IS WELL RECEIVED BY PARTICIPANTS. SOME STUDIES ALSO INDICATE THAT YOGA MAY IMPROVE PSYCHOLOGICAL SYMPTOMS, BUT THESE EFFECTS ARE CURRENTLY NOT AS WELL ESTABLISHED. 2016 15 1466 13 INJURY IN YOGA ASANA PRACTICE: ASSESSMENT OF THE RISKS. BACKGROUND: THE RISK OF INJURY FROM MODERN YOGA ASANA PRACTICE IS POORLY CHARACTERIZED IN THE SCIENTIFIC LITERATURE, BUT ANECDOTAL REPORTS IN THE LAY LITERATURE AND PRESS HAVE POSED QUESTIONS ABOUT THE POSSIBILITY OF FREQUENT, SEVERE INJURIES. DESIGN: WE PERFORMED A CROSS-SECTIONAL SURVEY OF YOGA ASANA PARTICIPANTS ASSESSING THEIR EXPERIENCE WITH YOGA-RELATED INJURY, USING A VOLUNTARY CONVENIENCE SAMPLE. RESULTS: A TOTAL OF 2620 PARTICIPANTS RESPONDED TO OUR SURVEY. SEVENTY-NINE PERCENT WERE BETWEEN AGES 31 AND 60 AND 84% WERE FEMALE. THE MAJORITY OF RESPONDENTS LIVED IN NORTH AMERICA OR EUROPE. FORTY-FIVE PERCENT OF PARTICIPANTS REPORTED EXPERIENCING NO INJURIES DURING THE TIME THEY HAD BEEN PRACTICING YOGA. OF THOSE WHO DID EXPERIENCE AN INJURY FROM ASANA PRACTICE, 28% WERE MILD (E.G., SPRAINS OR NONSPECIFIC PAINS NOT REQUIRING A MEDICAL PROCEDURE, WITH SYMPTOMS LASTING LESS THAN 6 MONTHS) AND 63% WERE MODERATE (E.G., SPRAINS OR NONSPECIFIC PAINS NOT REQUIRING A MEDICAL PROCEDURE, WITH SYMPTOMS LASTING FROM 6 MONTHS TO 1 YEAR). ONLY 9% OF THOSE REPORTING INJURIES (4% OF THE TOTAL SAMPLE) HAD A SEVERE INJURY. THE STRONGEST PREDICTORS FOR INCREASED PROBABILITY OF REPORTING AN INJURY OVER A LIFETIME OF YOGA PRACTICE WERE GREATER NUMBER OF YEARS OF PRACTICE (P<.0001) AND TEACHING YOGA (P=.0177). OTHER ASPECTS OF PARTICIPANT DEMOGRAPHICS OR YOGA PRACTICE HABITS WERE NOT RELATED TO LIKELIHOOD OF REPORTING A YOGA-RELATED INJURY. CONCLUSIONS: WE FOUND THE NUMBER OF INJURIES REPORTED BY YOGA PARTICIPANTS PER YEARS OF PRACTICE EXPOSURE TO BE LOW AND THE OCCURRENCE OF SERIOUS INJURIES IN YOGA TO BE INFREQUENT COMPARED TO OTHER PHYSICAL ACTIVITIES, SUGGESTING THAT YOGA IS NOT A HIGH-RISK PHYSICAL ACTIVITY. MORE WORK IS NEEDED TO CLARIFY THE CAUSAL RELATIONSHIPS BETWEEN THE YOGA PARTICIPANT CHARACTERISTICS, THE ASANA PRACTICE STYLE, AND THE RISK OF SIGNIFICANT INJURY. 2019 16 466 16 CHARACTERISTICS OF CLIENTS SEEKING YOGA THERAPY IN A UNIVERSITY-BASED STUDENT CLINIC. YOGA THERAPY IS AN EMERGING PROFESSION WITH RECENT DEVELOPMENT OF EDUCATIONAL COMPETENCIES, TRAINING PROGRAM ACCREDITATION, AND PRACTITIONER CERTIFICATION. IN THE UNITED STATES, MOST YOGA THERAPY TRAINING PROGRAMS ARE STUDIO-BASED AND DATA ON MENTORED CLINICAL ENCOUNTERS ARE LACKING. THIS STUDY AIMED TO CHARACTERIZE THE CLIENT POPULATION IN A UNIVERSITY-BASED MENTORED STUDENT CLINIC. AS PART OF A LARGER FEASIBILITY STUDY, DATA WERE COLLECTED AT ALL CLINIC VISITS FOR 70 CONSENTING CLIENTS. DATA COLLECTED INCLUDED DEMOGRAPHIC CHARACTERISTICS, REASONS FOR PURSUING CARE, USE OF OTHER HEALTHCARE APPROACHES, AND THE PATIENT-REPORTED OUTCOMES MEASUREMENT INFORMATION SYSTEM (PROMIS) FOR PHYSICAL AND MENTAL HEALTH. PARTICIPANTS WERE MOSTLY MIDDLE-AGED, WHITE, AND HIGHLY EDUCATED. COMMON REASONS FOR PURSUING CARE WERE PAIN AND MENTAL HEALTH. MOST USED MULTIPLE HEALTHCARE APPROACHES. AVERAGE SCORES FOR MOST PATIENT-REPORTED OUTCOMES FELL WITHIN NORMAL RANGE AT BASELINE. FUTURE STUDIES ARE NEEDED TO BETTER CHARACTERIZE YOGA THERAPY USERS AND TO EXPAND ACCESS FOR POPULATIONS IN WHOM THE MODALITY IS UNDERUTILIZED DESPITE EMERGING EVIDENCE OF RELEVANCE. 2021 17 2577 17 YOGA FOR GENERALIZED ANXIETY DISORDER: DESIGN OF A RANDOMIZED CONTROLLED CLINICAL TRIAL. GENERALIZED ANXIETY DISORDER (GAD) IS A COMMON DISORDER ASSOCIATED WITH SIGNIFICANT DISTRESS AND INTERFERENCE. ALTHOUGH COGNITIVE BEHAVIORAL THERAPY (CBT) HAS BEEN SHOWN TO BE THE MOST EFFECTIVE FORM OF PSYCHOTHERAPY, FEW PATIENTS RECEIVE OR HAVE ACCESS TO THIS INTERVENTION. YOGA THERAPY OFFERS ANOTHER PROMISING, YET UNDER-RESEARCHED, INTERVENTION THAT IS GAINING INCREASING POPULARITY IN THE GENERAL PUBLIC, AS AN ANXIETY REDUCTION INTERVENTION. THE PURPOSE OF THIS INNOVATIVE CLINICAL TRIAL PROTOCOL IS TO INVESTIGATE THE EFFICACY OF A KUNDALINI YOGA INTERVENTION, RELATIVE TO CBT AND A CONTROL CONDITION. KUNDALINI YOGA AND CBT ARE COMPARED WITH EACH OTHER IN A NONINFERIORITY TEST AND BOTH TREATMENTS ARE COMPARED TO STRESS EDUCATION TRAINING, AN ATTENTION CONTROL INTERVENTION, IN SUPERIORITY TESTS. THE SAMPLE WILL CONSIST OF 230 INDIVIDUALS WITH A PRIMARY DSM-5 DIAGNOSIS OF GAD. THIS RANDOMIZED CONTROLLED TRIAL WILL COMPARE YOGA (N=95) TO BOTH CBT FOR GAD (N=95) AND STRESS EDUCATION (N=40), A COMMONLY USED CONTROL CONDITION. ALL THREE TREATMENTS WILL BE ADMINISTERED BY TWO INSTRUCTORS IN A GROUP FORMAT OVER 12 WEEKLY SESSIONS WITH FOUR TO SIX PATIENTS PER GROUP. GROUPS WILL BE RANDOMIZED USING PERMUTED BLOCK RANDOMIZATION, WHICH WILL BE STRATIFIED BY SITE. TREATMENT OUTCOME WILL BE EVALUATED BI-WEEKLY AND AT 6MONTH FOLLOW-UP. FURTHERMORE, POTENTIAL MEDIATORS OF TREATMENT OUTCOME WILL BE INVESTIGATED. GIVEN THE INDIVIDUAL AND ECONOMIC BURDEN ASSOCIATED WITH GAD, IDENTIFYING ACCESSIBLE ALTERNATIVE BEHAVIORAL TREATMENTS WILL HAVE SUBSTANTIVE PUBLIC HEALTH IMPLICATIONS. 2015 18 1658 15 MUSCULOSKELETAL PAIN ASSOCIATED WITH RECREATIONAL YOGA PARTICIPATION: A PROSPECTIVE COHORT STUDY WITH 1-YEAR FOLLOW-UP. BACKGROUND: YOGA IS A POPULAR COMPLEMENTARY THERAPY FOR MUSCULOSKELETAL PAIN. THERE ARE FEW STUDIES HOWEVER, THAT HAVE EXAMINED THE RISKS OF RECREATIONAL PARTICIPATION FOR CAUSING MUSCULOSKELETAL PAIN. OBJECTIVES: TO EXAMINE THE RELATIONSHIP BETWEEN MUSCULOSKELETAL PAIN AND RECREATIONAL YOGA PARTICIPATION. METHODS: THIS WAS A PROSPECTIVE COHORT STUDY WITH ONE-YEAR FOLLOW-UP. DATA WERE COLLECTED VIA ELECTRONIC QUESTIONNAIRES, ONE YEAR APART. OUTCOMES INCLUDED INCIDENCE AND IMPACT OF PAIN CAUSED BY YOGA AND PREVALENCE OF PAIN CAUSED, EXACERBATED, UNAFFECTED, AND IMPROVED BY YOGA. PREDICTORS INCLUDED AGE, EXPERIENCE, HOURS OF PARTICIPATION, AND INTENSITY OF PARTICIPATION. RESULTS: THE FINAL SAMPLE INCLUDED 354 PARTICIPANTS FROM TWO SUBURBAN YOGA STUDIOS. THE INCIDENCE RATE OF PAIN CAUSED BY YOGA WAS 10.7%. MORE THAN ONE-THIRD OF INCIDENT CASES RESULTED IN LOST YOGA PARTICIPATION TIME AND/OR SYMPTOMS LASTING MORE THAN 3 MONTHS. NONE OF THE RISK FACTORS AT BASELINE INCREASED THE RISK FOR SUBSEQUENT INCIDENT CASES OF PAIN CAUSED BY YOGA. CONCLUSIONS: YOGA CAN CAUSE MUSCULOSKELETAL PAIN. PARTICIPANTS MAY BENEFIT FROM DISCLOSURE OF PRACTICE TO THEIR HEALTHCARE PROFESSIONALS AND BY INFORMING TEACHERS OF INJURIES THEY MAY HAVE PRIOR TO PARTICIPATION. YOGA TEACHERS SHOULD ALSO DISCUSS THE RISKS FOR INJURY WITH THEIR STUDENTS. 2018 19 376 21 BARRIERS AND FACILITATORS TO YOGA USE IN A POPULATION OF INDIVIDUALS WITH SELF-REPORTED CHRONIC LOW BACK PAIN: A QUALITATIVE APPROACH. YOGA HAS BEEN FOUND TO BE EFFICACIOUS IN TREATING CHRONIC LOW BACK PAIN, YET BIOMEDICAL TREATMENTS ARE MOST COMMONLY USED FOR PAIN. PROMOTING YOGA AS PART OF INTEGRATIVE CARE WOULD REDUCE EXCLUSIVE RELIANCE ON HIGH-COST, HIGHER-RISK BIOMEDICAL TREATMENTS. ATTITUDES TOWARD YOGA PLAY A ROLE IN CONSIDERATION OF IT AS A TREATMENT. THE CURRENT STUDY EXAMINED ATTITUDES TOWARD YOGA IN ADULTS WITH CHRONIC LOW BACK PAIN AND COMPARED THESE RESULTS TO THOSE FOUND IN A 2009 GENERAL POPULATION STUDY. PARTICIPANTS COMPLETED A SEMI-STRUCTURED INTERVIEW WHERE THEY RESPONDED TO ITEMS ABOUT PERCEPTIONS OF POTENTIAL BARRIERS AND FACILITATORS TO TRYING YOGA. PARTICIPANT RESPONSES WERE ANALYZED QUALITATIVELY AND SEVERAL COMMON THEMES EMERGED. THEMES IDENTIFIED BY PARTICIPANTS INDICATED THERE IS MIXED INFORMATION ABOUT YOGA IN THE PUBLIC DOMAIN AND THAT CLARIFICATION OF WHAT YOGA IS, HOW IT CAN BE BENEFICIAL, AND WHAT IT REQUIRES ONE TO DO PHYSICALLY MAY HELP PROMOTE ITS USE. 2014 20 2453 17 YOGA AS A COMPLEMENTARY THERAPY FOR CHILDREN AND ADOLESCENTS: A GUIDE FOR CLINICIANS. YOGA IS BEING USED BY A GROWING NUMBER OF YOUTH AND ADULTS AS A MEANS OF IMPROVING OVERALL HEALTH AND FITNESS. THERE IS ALSO A PROGRESSIVE TREND TOWARD USE OF YOGA AS A MIND-BODY COMPLEMENTARY AND ALTERNATIVE MEDICINE INTERVENTION TO IMPROVE SPECIFIC PHYSICAL AND MENTAL HEALTH CONDITIONS. TO PROVIDE CLINICIANS WITH THERAPEUTICALLY USEFUL INFORMATION ABOUT YOGA, THE EVIDENCE EVALUATING YOGA AS AN EFFECTIVE INTERVENTION FOR CHILDREN AND ADOLESCENTS WITH HEALTH PROBLEMS IS REVIEWED AND SUMMARIZED. A BRIEF OVERVIEW OF YOGA AND YOGA THERAPY IS PRESENTED ALONG WITH YOGA RESOURCES AND PRACTICAL STRATEGIES FOR CLINICAL PRACTITIONERS TO USE WITH THEIR PATIENTS. THE MAJORITY OF AVAILABLE STUDIES WITH CHILDREN AND ADOLESCENTS SUGGEST BENEFITS TO USING YOGA AS A THERAPEUTIC INTERVENTION AND SHOW VERY FEW ADVERSE EFFECTS. THESE RESULTS MUST BE INTERPRETED AS PRELIMINARY FINDINGS BECAUSE MANY OF THE STUDIES HAVE METHODOLOGICAL LIMITATIONS THAT PREVENT STRONG CONCLUSIONS FROM BEING DRAWN. YOGA APPEARS PROMISING AS A COMPLEMENTARY THERAPY FOR CHILDREN AND ADOLESCENTS. FURTHER INFORMATION ABOUT HOW TO APPLY IT MOST EFFECTIVELY AND MORE COORDINATED RESEARCH EFFORTS ARE NEEDED. 2010