1  743 162 EFFECT OF RESTORATIVE YOGA VS. STRETCHING ON DIURNAL CORTISOL DYNAMICS AND PSYCHOSOCIAL OUTCOMES IN INDIVIDUALS WITH THE METABOLIC SYNDROME: THE PRYSMS RANDOMIZED CONTROLLED TRIAL. PURPOSE: CHRONIC STIMULATION AND DYSREGULATION OF THE NEUROENDOCRINE SYSTEM BY STRESS MAY CAUSE METABOLIC ABNORMALITIES. WE ESTIMATED HOW MUCH CORTISOL AND PSYCHOSOCIAL OUTCOMES IMPROVED WITH A RESTORATIVE YOGA (RELAXATION) VERSUS A LOW IMPACT STRETCHING INTERVENTION FOR INDIVIDUALS WITH THE METABOLIC SYNDROME. METHODS: WE CONDUCTED A 1-YEAR MULTI-CENTER RANDOMIZED CONTROLLED TRIAL (6-MONTH INTERVENTION AND 6-MONTH MAINTENANCE PHASE) OF RESTORATIVE YOGA VS. STRETCHING. PARTICIPANTS COMPLETED SURVEYS TO ASSESS DEPRESSION, SOCIAL SUPPORT, POSITIVE AFFECT, AND STRESS AT BASELINE, 6 MONTHS AND 12 MONTHS. FOR EACH ASSESSMENT, WE COLLECTED SALIVA AT FOUR POINTS DAILY FOR THREE DAYS AND COLLECTED RESPONSE TO DEXAMETHASONE ON THE FOURTH DAY FOR ANALYSIS OF DIURNAL CORTISOL DYNAMICS. WE ANALYZED OUR DATA USING MULTIVARIATE REGRESSION MODELS, CONTROLLING FOR STUDY SITE, MEDICATIONS (ANTIDEPRESSANTS, HORMONE THERAPY), BODY MASS INDEX, AND BASELINE CORTISOL VALUES. RESULTS: PSYCHOSOCIAL OUTCOME MEASURES WERE AVAILABLE FOR 171 STUDY PARTICIPANTS AT BASELINE, 140 AT 6 MONTHS, AND 132 AT 1 YEAR. COMPLETE CORTISOL DATA WERE AVAILABLE FOR 136 OF 171 STUDY PARTICIPANTS (72 IN RESTORATIVE YOGA AND 64 IN STRETCHING) AND WERE ONLY AVAILABLE AT BASELINE AND 6 MONTHS. AT 6 MONTHS, THE STRETCHING GROUP HAD DECREASED CORTISOL AT WAKING AND BEDTIME COMPARED TO THE RESTORATIVE YOGA GROUP. THE PATTERN OF CHANGES IN STRESS MIRRORED THIS IMPROVEMENT, WITH THE STRETCHING GROUP SHOWING REDUCTIONS IN CHRONIC STRESS SEVERITY AND PERSEVERATIVE THOUGHTS ABOUT THEIR STRESS. PERCEIVED STRESS DECREASED BY 1.5 POINTS (-0.4; 3.3, P=0.11) AT 6 MONTHS, AND BY 2.0 POINTS (0.1; 3.9, P=0.04) AT 1 YEAR IN THE STRETCHING COMPARED TO RESTORATIVE YOGA GROUPS. POST HOC ANALYSES SUGGEST THAT IN THE STRETCHING GROUP ONLY, PERCEIVED INCREASES IN SOCIAL SUPPORT (PARTICULARLY FEELINGS OF BELONGING), BUT NOT CHANGES IN STRESS WERE RELATED TO IMPROVED CORTISOL DYNAMICS. CONCLUSIONS: WE FOUND SIGNIFICANT DECREASES IN SALIVARY CORTISOL, CHRONIC STRESS SEVERITY, AND STRESS PERCEPTION IN THE STRETCHING GROUP COMPARED TO THE RESTORATIVE YOGA GROUP. GROUP SUPPORT DURING THE INTERACTIVE STRETCH CLASSES MAY HAVE CONTRIBUTED TO THESE CHANGES.	2014	
                                                                                                                                                                                                                                                                                                                                                                 
2 2241  37 THE INFLUENCE OF HATHA YOGA AS AN ADD-ON TREATMENT IN MAJOR DEPRESSION ON HYPOTHALAMIC-PITUITARY-ADRENAL-AXIS ACTIVITY: A RANDOMIZED TRIAL. OBJECTIVES: THE IMPACT OF HATHA YOGA AS ADD-ON TREATMENT TO QUETIAPINE FUMARATE EXTENDED RELEASE (QXR) OR ESCITALOPRAM (ESC) IN DEPRESSED PATIENTS ON HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS ACTIVITY WAS ASSESSED. METHODS: 60 INPATIENTS SUFFERING FROM MAJOR DEPRESSIVE DISORDER (MDD) ACCORDING TO DSM-IV WERE RANDOMIZED FOR A 5 WEEK TREATMENT WITH YOGA OR NOT (CONTROL GROUP) AND WITH EITHER QXR (300 MG/DAY) OR ESC (10 MG/DAY). SERIAL DEXAMETHASONE/CORTICOTROPIN RELEASING HORMONE (DEX/CRH) TESTS WERE PERFORMED TO ASSESS HPA AXIS FUNCTION. THE HAMILTON DEPRESSION RATING SCALE (21-HAMD) WAS USED WEEKLY. RESULTS: A MORE PRONOUNCED DOWN REGULATION OF THE HPA AXIS ACTIVITY DUE TO YOGA COULD NOT BE DETECTED. THE STEPWISE LONG TERM CORTISOL REDUCTION WAS SEEN IN BOTH MEDICATION GROUPS, IRRESPECTIVELY OF YOGA ADD-ON TREATMENT. IN ADDITION, CORTISOL IMPROVERS IN WEEK 1 OF THERAPY (REDUCTION IN CORTISOL PEAK VALUE WITHIN THE DEX/CRH TEST) REACHED SIGNIFICANT GREATER AMELIORATION OF DEPRESSIVE SYMPTOMS AFTER 5 WEEKS. CONCLUSIONS: OUR RESULTS SUGGEST THAT ANTIDEPRESSANT AGENTS DOWN REGULATE HPA AXIS FUNCTION TO A GREATER EXTENT THAN ADDITIONAL HATHA YOGA TREATMENT. MOREOVER, AN EARLY REDUCTION OF HPA SYSTEM HYPERACTIVITY AFTER ONE WEEK OF PHARMACOLOGICAL TREATMENT SEEMS TO RAISE THE POSSIBILITY OF A FAVORABLE TREATMENT RESPONSE.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
3  945  50 EFFECTS OF A 12-WEEK YOGA VERSUS A 12-WEEK EDUCATIONAL FILM INTERVENTION ON SYMPTOMS OF RESTLESS LEGS SYNDROME AND RELATED OUTCOMES: AN EXPLORATORY RANDOMIZED CONTROLLED TRIAL. STUDY OBJECTIVES: TO ASSESS THE EFFECTS OF A YOGA VERSUS EDUCATIONAL FILM (EF) PROGRAM ON RESTLESS LEGS SYNDROME (RLS) SYMPTOMS AND RELATED OUTCOMES IN ADULTS WITH RLS. METHODS: FORTY-ONE COMMUNITY-DWELLING, AMBULATORY NONPREGNANT ADULTS WITH MODERATE TO SEVERE RLS WERE RANDOMIZED TO A 12-WEEK YOGA (N = 19) OR EF PROGRAM (N = 22). IN ADDITION TO ATTENDING CLASSES, ALL PARTICIPANTS COMPLETED PRACTICE/TREATMENT LOGS. YOGA GROUP PARTICIPANTS WERE ASKED TO PRACTICE AT HOME 30 MINUTES PER DAY ON NONCLASS DAYS; EF PARTICIPANTS WERE INSTRUCTED TO RECORD ANY RLS TREATMENTS USED ON THEIR DAILY LOGS. CORE OUTCOMES ASSESSED PRETREATMENT AND POSTTREATMENT WERE RLS SYMPTOMS AND SYMPTOM SEVERITY (INTERNATIONAL RLS STUDY GROUP SCALE (IRLS) AND RLS ORDINAL SCALE), SLEEP QUALITY, MOOD, PERCEIVED STRESS, AND QUALITY OF LIFE (QOL). RESULTS: THIRTY ADULTS (13 YOGA, 17 EF), AGED 24 TO 73 (MEAN = 50.4 +/- 2.4 YEARS), COMPLETED THE 12-WEEK STUDY (78% FEMALE, 80.5% WHITE). POST-INTERVENTION, BOTH GROUPS SHOWED SIGNIFICANT IMPROVEMENT IN RLS SYMPTOMS AND SEVERITY, PERCEIVED STRESS, MOOD, AND QOL-MENTAL HEALTH (P </= .04). RELATIVE TO THE EF GROUP, YOGA PARTICIPANTS DEMONSTRATED SIGNIFICANTLY GREATER REDUCTIONS IN RLS SYMPTOMS AND SYMPTOM SEVERITY (P </= .01), AND GREATER IMPROVEMENTS IN PERCEIVED STRESS AND MOOD (P </= .04), AS WELL AS SLEEP QUALITY (P = .09); RLS SYMPTOMS DECREASED TO MINIMAL/MILD IN 77% OF YOGA GROUP PARTICIPANTS, WITH NONE SCORING IN THE SEVERE RANGE BY WEEK 12, VERSUS 24% AND 12%, RESPECTIVELY, IN EF PARTICIPANTS. IN THE YOGA GROUP, IRLS AND RLS SEVERITY SCORES DECLINED WITH INCREASING MINUTES OF HOMEWORK PRACTICE (R = .7, P = .009 AND R = .6, P = .03, RESPECTIVELY), SUGGESTING A POSSIBLE DOSE-RESPONSE RELATIONSHIP. CONCLUSIONS: FINDINGS OF THIS EXPLORATORY RCT SUGGEST THAT YOGA MAY BE EFFECTIVE IN REDUCING RLS SYMPTOMS AND SYMPTOM SEVERITY, DECREASING PERCEIVED STRESS, AND IMPROVING MOOD AND SLEEP IN ADULTS WITH RLS. CLINICAL TRIAL REGISTRATION: REGISTRY: CLINICALTRIALS.GOV; TITLE: YOGA VS. EDUCATION FOR RESTLESS LEGS: A FEASIBILITY STUDY; IDENTIFIER: NCT03570515; URL: HTTPS://CLINICALTRIALS.GOV/CT2/SHOW/NCT03570515.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                     
4 1898  48 RESTORATIVE YOGA AND METABOLIC RISK FACTORS: THE PRACTICING RESTORATIVE YOGA VS. STRETCHING FOR THE METABOLIC SYNDROME (PRYSMS) RANDOMIZED TRIAL. AIMS: INTENSIVE LIFESTYLE CHANGE PREVENTS TYPE 2 DIABETES BUT IS DIFFICULT TO SUSTAIN. PRELIMINARY EVIDENCE SUGGESTS THAT YOGA MAY IMPROVE METABOLIC FACTORS. WE TESTED A RESTORATIVE YOGA INTERVENTION VS. ACTIVE STRETCHING FOR METABOLIC OUTCOMES. METHODS: IN 2009-2012, WE CONDUCTED A 48-WEEK RANDOMIZED TRIAL COMPARING RESTORATIVE YOGA VS. STRETCHING AMONG UNDERACTIVE ADULTS WITH THE METABOLIC SYNDROME AT THE UNIVERSITIES OF CALIFORNIA, SAN FRANCISCO AND SAN DIEGO. WE PROVIDED LIFESTYLE COUNSELING AND A TAPERING SERIES OF 90-MIN GROUP CLASSES IN THE 24-WEEK INTERVENTION PERIOD AND 24-WEEK MAINTENANCE PERIOD. FASTING AND 2-H GLUCOSE, HBA1C, TRIGLYCERIDES, HDL-CHOLESTEROL, INSULIN, SYSTOLIC BLOOD PRESSURE, VISCERAL FAT, AND QUALITY OF LIFE WERE ASSESSED AT BASELINE, 6- AND 12-MONTHS. RESULTS: 180 PARTICIPANTS WERE RANDOMIZED AND 135 (75%) COMPLETED THE TRIAL. AT 12 MONTHS, FASTING GLUCOSE DECREASED MORE IN THE YOGA GROUP THAN IN THE STRETCHING GROUP (-0.35 MMOL/L VS. -0.03 MMOL/L; P=0.002); THERE WERE NO OTHER SIGNIFICANT DIFFERENCES BETWEEN GROUPS. AT 6 MONTHS FAVORABLE CHANGES WITHIN THE YOGA GROUP INCLUDED REDUCTIONS IN FASTING GLUCOSE, INSULIN, AND HBA1C AND AN INCREASE IN HDL-CHOLESTEROL THAT WERE NOT SUSTAINED AT 1 YEAR EXCEPT CHANGES IN FASTING GLUCOSE. THE STRETCHING GROUP HAD A SIGNIFICANT REDUCTION IN TRIGLYCERIDES AT 6 MONTHS WHICH WAS NOT SUSTAINED AT 1 YEAR BUT HAD IMPROVED QUALITY OF LIFE AT BOTH TIME-POINTS. CONCLUSIONS: RESTORATIVE YOGA WAS MARGINALLY BETTER THAN STRETCHING FOR IMPROVING FASTING GLUCOSE BUT NOT OTHER METABOLIC FACTORS.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
5  451  44 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	
                                                                                                                                                   
6  555  43 CORTISOL AND ANTIDEPRESSANT EFFECTS OF YOGA. CONTEXT: HYPERCORTISOLEMIA IS WELL-KNOWN IN DEPRESSION AND YOGA HAS BEEN DEMONSTRATED EARLIER TO REDUCE THE PARAMETERS OF STRESS, INCLUDING CORTISOL LEVELS. AIM: WE AIMED TO FIND THE ROLE OF YOGA AS AN ANTIDEPRESSANT AS WELL AS ITS ACTION ON LOWERING THE SERUM CORTISOL LEVELS. SETTINGS AND DESIGN: AN OPEN-LABELED STUDY CONSISTING OF THREE GROUPS (YOGA ALONE, YOGA ALONG WITH ANTIDEPRESSANT MEDICATION AND ANTIDEPRESSANT MEDICATION ALONE) WAS CONDUCTED AT A TERTIARY CARE PSYCHIATRY HOSPITAL. METHODOLOGY: OUT-PATIENT DEPRESSIVES WHO WERE NOT SUICIDAL WERE OFFERED YOGA AS A POSSIBLE ANTIDEPRESSANT THERAPY. A VALIDATED YOGA MODULE WAS USED AS THERAPY TAUGHT OVER A MONTH AND TO BE PRACTICED AT HOME DAILY. PATIENTS WERE FREE TO CHOOSE THE DRUGS IF THEIR PSYCHIATRIST ADVISED. PATIENTS (N=54) WERE RATED ON HAMILTON DEPRESSION RATING SCALE (HDRS) WITH SERUM CORTISOL MEASUREMENTS AT BASELINE AND AFTER 3 MONTHS. IN 54 PATIENTS, ASSESSMENTS AND BLOOD TEST RESULTS WERE BOTH AVAILABLE. 19 EACH RECEIVED YOGA ALONE OR WITH DRUGS AND 16 RECEIVED DRUGS ONLY. HEALTHY COMPARISON SUBJECTS (N=18) TOO UNDERWENT MORNING CORTISOL MEASUREMENTS ONCE. RESULTS: SERUM CORTISOL WAS HIGHER IN DEPRESSIVES COMPARED WITH CONTROLS. IN THE TOTAL SAMPLE, THE CORTISOL LEVEL DROPPED SIGNIFICANTLY AT THE END OF TREATMENT. MORE PATIENTS IN THE YOGA GROUPS HAD A DROP IN CORTISOL LEVELS AS COMPARED TO DRUG-ONLY GROUP. IN THE YOGA-ONLY GROUP, THE CORTISOL DROP CORRELATED WITH THE DROP IN HDRS SCORE (ANTIDEPRESSANT EFFECT). CONCLUSION: THE FINDINGS SUPPORT THAT YOGA MAY ACT AT THE LEVEL OF THE HYPOTHALAMUS BY ITS 'ANTI-STRESS' EFFECTS (REDUCING THE CORTISOL), TO BRING ABOUT RELIEF IN DEPRESSION.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
7  326  38 ANTIDEPRESSANT EFFICACY AND HORMONAL EFFECTS OF SUDARSHANA KRIYA YOGA (SKY) IN ALCOHOL DEPENDENT INDIVIDUALS. BACKGROUND: SUDARSHANA KRIYA YOGA (SKY) HAS DEMONSTRABLE ANTIDEPRESSANT EFFECTS. SKY WAS TESTED FOR THIS EFFECT IN INPATIENTS OF ALCOHOL DEPENDENCE. METHODS: FOLLOWING A WEEK OF DETOXIFICATION MANAGEMENT CONSENTING SUBJECTS (N=60) WERE EQUALLY RANDOMIZED TO RECEIVE SKY THERAPY OR NOT (CONTROLS) FOR A TWO-WEEK STUDY. SKY THERAPY INCLUDED ALTERNATE DAY PRACTICE OF SPECIFIED BREATHING EXERCISE UNDER SUPERVISION OF A TRAINED THERAPIST. SUBJECTS COMPLETED THE BECK DEPRESSION INVENTORY (BDI) BEFORE AND AFTER THE TWO WEEKS OF THIS INTERVENTION. MORNING PLASMA CORTISOL, ACTH AND PROLACTIN TOO WERE MEASURED BEFORE AND AT THE END OF TWO WEEKS. RESULTS: IN BOTH GROUPS REDUCTIONS IN BDI SCORES OCCURRED BUT SIGNIFICANTLY MORE SO IN SKY GROUP. LIKEWISE, IN BOTH GROUPS PLASMA CORTISOL AS WELL AS ACTH FELL AFTER TWO WEEKS BUT SIGNIFICANTLY MORE SO IN SKY GROUP. REDUCTION IN BDI SCORES CORRELATED WITH THAT IN CORTISOL IN SKY BUT NOT IN CONTROL GROUP. LIMITATIONS: ANTIDEPRESSANT EFFECTS OF SKY WERE DEMONSTRATED IN EARLY ABSTINENCE THAT ALSO HAD SUBSTANTIAL SPONTANEOUS IMPROVEMENT. IT IS NOT KNOWN IF THIS EFFECT CONTRIBUTES TO SUSTAINED ABSTINENCE. CONCLUSION: RESULTS EXTEND THE ANTIDEPRESSANT EFFECTS OF SKY IN ALCOHOL DEPENDENCE SUBJECTS. REDUCTION IN STRESS-HORMONE LEVELS (CORTISOL AND ACTH) ALONG WITH BDI REDUCTIONS POSSIBLY SUPPORT A BIOLOGICAL MECHANISM OF SKY IN PRODUCING BENEFICIAL EFFECTS.	2006	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
8  851  48 EFFECT OF YOGA ON SLEEP QUALITY AND NEUROENDOCRINE IMMUNE RESPONSE IN METASTATIC BREAST CANCER PATIENTS. BACKGROUND: STUDIES HAVE SHOWN THAT DISTRESS AND ACCOMPANYING NEUROENDOCRINE STRESS RESPONSES AS IMPORTANT PREDICTOR OF SURVIVAL IN ADVANCED BREAST CANCER PATIENTS. SOME PSYCHOTHERAPEUTIC INTERVENTION STUDIES HAVE SHOWN HAVE MODULATION OF NEUROENDOCRINE-IMMUNE RESPONSES IN ADVANCED BREAST CANCER PATIENTS. IN THIS STUDY, WE EVALUATE THE EFFECTS OF YOGA ON PERCEIVED STRESS, SLEEP, DIURNAL CORTISOL, AND NATURAL KILLER (NK) CELL COUNTS IN PATIENTS WITH METASTATIC CANCER. METHODS: IN THIS STUDY, 91 PATIENTS WITH METASTATIC BREAST CANCER WHO SATISFIED SELECTION CRITERIA AND CONSENTED TO PARTICIPATE WERE RECRUITED AND RANDOMIZED TO RECEIVE "INTEGRATED YOGA BASED STRESS REDUCTION PROGRAM" (N = 45) OR STANDARD "EDUCATION AND SUPPORTIVE THERAPY SESSIONS" (N = 46) OVER A 3 MONTH PERIOD. PSYCHOMETRIC ASSESSMENTS FOR SLEEP QUALITY WERE DONE BEFORE AND AFTER INTERVENTION. BLOOD DRAWS FOR NK CELL COUNTS WERE COLLECTED BEFORE AND AFTER THE INTERVENTION. SALIVA SAMPLES WERE COLLECTED FOR THREE CONSECUTIVE DAYS BEFORE AND AFTER INTERVENTION. DATA WERE ANALYZED USING THE ANALYSIS OF COVARIANCE ON POSTMEASURES USING RESPECTIVE BASELINE MEASURE AS A COVARIATE. RESULTS: THERE WAS A SIGNIFICANT DECREASE IN SCALES OF SYMPTOM DISTRESS (P < 0.001), SLEEP PARAMETERS (P = 0.02), AND IMPROVEMENT IN QUALITY OF SLEEP (P = 0.001) AND INSOMNIA RATING SCALE SLEEP SCORE (P = 0.001) FOLLOWING INTERVENTION. THERE WAS A DECREASE IN MORNING WAKING CORTISOL IN YOGA GROUP (P = 0.003) ALONE FOLLOWING INTERVENTION. THERE WAS A SIGNIFICANT IMPROVEMENT IN NK CELL PERCENT (P = 0.03) FOLLOWING INTERVENTION IN YOGA GROUP COMPARED TO CONTROL GROUP. CONCLUSION: THE RESULTS SUGGEST MODULATION OF NEUROENDOCRINE RESPONSES AND IMPROVEMENT IN SLEEP IN PATIENTS WITH ADVANCED BREAST CANCER FOLLOWING YOGA INTERVENTION.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
9 2854  40 YOGA- AND MEDITATION-BASED LIFESTYLE INTERVENTION INCREASES NEUROPLASTICITY AND REDUCES SEVERITY OF MAJOR DEPRESSIVE DISORDER: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CURRENT INTERVENTIONS FOR MAJOR DEPRESSIVE DISORDER (MDD) ARE SUBOPTIMAL, AND ONLY ONE THIRD RESPOND TO THEM ON INITIAL TREATMENT. NEUROPLASTICITY THEORIES ARE THE BASIS FOR SEVERAL EMERGING TREATMENTS. EVIDENCE ON THE IMPACT OF YOGA, A WELL-KNOWN MIND-BODY INTERVENTION, ON NEUROPLASTICITY IN MDD IS LIMITED. OBJECTIVES: TO DETERMINE THE EFFECTS OF 12-WEEK YOGA- AND MEDITATION-BASED LIFESTYLE INTERVENTION (YMLI) ON DEPRESSION SEVERITY AND SYSTEMIC BIOMARKERS OF NEUROPLASTICITY IN ADULT MDD PATIENTS ON ROUTINE DRUG TREATMENT. METHODS: A TOTAL OF 58 MDD PATIENTS WERE RANDOMIZED INTO YOGA OR CONTROL GROUP. THE SEVERITY OF DEPRESSION WAS ASSESSED WITH BECK DEPRESSION INVENTORY-II SCALE (BDI-II). BLOOD SAMPLES WERE COLLECTED BEFORE AND AFTER INTERVENTION FOR THE MEASUREMENT OF THE BIOMARKERS THAT CHARACTERIZE NEUROPLASTICITY, INCLUDING MIND-BODY COMMUNICATIVE AND CELLULAR HEALTH BIOMARKERS. RESULTS: THERE WAS A SIGNIFICANT DECREASE [DIFFERENCE BETWEEN MEANS, (95% CI)] IN BDI-II SCORE [-5.83 (-7.27, -4.39), P < 0.001] AND SIGNIFICANT INCREASE IN BDNF (NG/ML) [5.48 (3.50, 7.46), P < 0.001] AFTER YMLI COMPARED TO CONTROL GROUP. YMLI SIGNIFICANTLY INCREASED DHEAS, SIRTUIN 1, AND TELOMERASE ACTIVITY LEVELS, AND DECREASED CORTISOL, AND IL-6 LEVELS, IN ADDITION TO DECREASING DNA DAMAGE AND BALANCING OXIDATIVE STRESS. MULTIPLE REGRESSION ANALYSES WERE USED TO ASSOCIATE NEUROPLASTICITY BIOMARKERS WITH DEPRESSION SEVERITY. A 'POST-INTERVENTION CHANGE IN BDNF' X 'GROUP' INTERACTION INDICATED THAT YOGA GROUP HAD MORE BDNF IN ASSOCIATION WITH LESS BDI-II SCORES RELATIVE TO CONTROLS. INCREASED SIRTUIN 1 AND TELOMERASE ACTIVITY AND DECREASED CORTISOL SIGNIFICANTLY PREDICTED THIS ASSOCIATION (ALL P < 0.05). CONCLUSION: THESE RESULTS SUGGEST THAT DECREASE IN DEPRESSION SEVERITY AFTER YMLI IN MDD IS ASSOCIATED WITH IMPROVED SYSTEMIC BIOMARKERS OF NEUROPLASTICITY. THUS YMLI CAN BE CONSIDERED AS A THERAPEUTIC INTERVENTION IN MDD MANAGEMENT.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
10 2250  46 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	

11 2325  43 TREATMENT OF MAJOR DEPRESSIVE DISORDER WITH IYENGAR YOGA AND COHERENT BREATHING: A RANDOMIZED CONTROLLED DOSING STUDY. OBJECTIVES: THE AIMS OF THIS STUDY WERE TO ASSESS THE EFFECTS OF AN INTERVENTION OF IYENGAR YOGA AND COHERENT BREATHING AT FIVE BREATHS PER MINUTE ON DEPRESSIVE SYMPTOMS AND TO DETERMINE OPTIMAL INTERVENTION YOGA DOSING FOR FUTURE STUDIES IN INDIVIDUALS WITH MAJOR DEPRESSIVE DISORDER (MDD). METHODS: SUBJECTS WERE RANDOMIZED TO THE HIGH-DOSE GROUP (HDG) OR LOW-DOSE GROUP (LDG) FOR A 12-WEEK INTERVENTION OF THREE OR TWO INTERVENTION CLASSES PER WEEK, RESPECTIVELY. ELIGIBLE SUBJECTS WERE 18-64 YEARS OLD WITH MDD, HAD BASELINE BECK DEPRESSION INVENTORY-II (BDI-II) SCORES >/=14, AND WERE EITHER ON NO ANTIDEPRESSANT MEDICATIONS OR ON A STABLE DOSE OF ANTIDEPRESSANTS FOR >/=3 MONTHS. THE INTERVENTION INCLUDED 90-MIN CLASSES PLUS HOMEWORK. OUTCOME MEASURES WERE BDI-II SCORES AND INTERVENTION COMPLIANCE. RESULTS: FIFTEEN HDG (MAGE = 38.4 +/- 15.1 YEARS) AND 15 LDG (MAGE = 34.7 +/- 10.4 YEARS) SUBJECTS COMPLETED THE INTERVENTION. BDI-II SCORES AT SCREENING AND COMPLIANCE DID NOT DIFFER BETWEEN GROUPS (P = 0.26). BDI-II SCORES DECLINED SIGNIFICANTLY FROM SCREENING (24.6 +/- 1.7) TO WEEK 12 (6.0 +/- 3.8) FOR THE HDG (-18.6 +/- 6.6; P < 0.001), AND FROM SCREENING (27.7 +/- 2.1) TO WEEK 12 (10.1 +/- 7.9) IN THE LDG (-17.7 +/- 9.3; P < 0.001). THERE WERE NO SIGNIFICANT DIFFERENCES BETWEEN GROUPS, BASED ON RESPONSE (I.E., >50% DECREASE IN BDI-II SCORES; P = 0.65) FOR THE HDG (13/15 SUBJECTS) AND LDG (11/15 SUBJECTS) OR REMISSION (I.E., NUMBER OF SUBJECTS WITH BDI-II SCORES <14; P = 1.00) FOR THE HDG (14/15 SUBJECTS) AND LDG (13/15 SUBJECTS) AFTER THE 12-WEEK INTERVENTION, ALTHOUGH A GREATER NUMBER OF SUBJECTS IN THE HDG HAD 12-WEEK BDI-II SCORES </=10 (P = 0.04). CONCLUSION: DURING THIS 12-WEEK INTERVENTION OF YOGA PLUS COHERENT BREATHING, DEPRESSIVE SYMPTOMS DECLINED SIGNIFICANTLY IN PATIENTS WITH MDD IN BOTH THE HDG AND LDG. BOTH GROUPS SHOWED COMPARABLE COMPLIANCE AND CLINICAL IMPROVEMENTS, WITH MORE SUBJECTS IN THE HDG EXHIBITING BDI-II SCORES </=10 AT WEEK 12.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
12  720  40 EFFECT OF IYENGAR YOGA PRACTICE ON FATIGUE AND DIURNAL SALIVARY CORTISOL CONCENTRATION IN BREAST CANCER SURVIVORS. PURPOSE: TO EXAMINE THE EFFECT OF REGULAR IYENGAR YOGA PRACTICE ON MEASURES OF SELF-PERCEIVED PSYCHOSOCIAL FUNCTION AND DIURNAL SALIVARY CORTISOL SECRETION IN STAGE II-IV BREAST CANCER SURVIVORS (N = 18). DATA SOURCES: WOMEN WERE RANDOMLY ASSIGNED TO ATTEND YOGA PRACTICE FOR 90 MIN TWICE WEEKLY FOR 8 WEEKS (N = 9) OR TO A WAIT-LISTED, NONINTERVENTIONAL CONTROL GROUP (N = 9). TRADITIONAL IYENGAR YOGA ROUTINES THAT PROGRESSIVELY INCREASED IN DIFFICULTY AS PARTICIPANTS GAINED STRENGTH AND FLEXIBILITY WERE USED. AT BASELINE AND AFTER THE 8-WEEK STUDY PERIOD, WOMEN COMPLETED SELF-REPORT INSTRUMENTS TO DOCUMENT VARIOUS ASPECTS OF PSYCHOSOCIAL AND PHYSICAL FUNCTIONING, AND COLLECTED SALIVARY SAMPLES FOR CORTISOL ANALYSIS FOUR TIMES DURING THE DAY FOR TWO CONSECUTIVE DAYS. CONCLUSIONS: THE YOGA GROUP HAD LOWER MORNING AND 5 P.M. SALIVARY CORTISOL AND IMPROVED EMOTIONAL WELL-BEING AND FATIGUE SCORES. IMPLICATIONS FOR PRACTICE: BREAST CANCER SURVIVORS ARE AT RISK FOR CHRONIC PSYCHOSOCIAL DISTRESS THAT MAY ALTER ACTIVITY OF THE HYPOTHALAMIC-PITUITARY-ADRENAL AXIS, RESULTING IN ABERRANT REGULATION OF CORTISOL SECRETION AND INCREASED RISK OF IMMUNE DYSFUNCTION AND CANCER PROGRESSION. REGULAR YOGA PRACTICE MAY BE A LOW-RISK, COST-EFFECTIVE WAY TO IMPROVE PSYCHOSOCIAL FUNCTIONING, FATIGUE, AND REGULATION OF CORTISOL SECRETION IN BREAST CANCER SURVIVORS. THESE FINDINGS REQUIRE VALIDATION WITH A LARGER RANDOMIZED STUDY.	2011	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
13  780  42 EFFECT OF YOGA AS AN ADD-ON THERAPY IN THE MODULATION OF HEART RATE VARIABILITY IN CHILDREN WITH DUCHENNE MUSCULAR DYSTROPHY. BACKGROUND: DUCHENE MUSCULAR DYSTROPHY (DMD) IS A PROGRESSIVE MUSCULAR DISORDER. CARDIAC DISORDER IS THE SECOND-MOST COMMON CAUSE OF DEATH IN CHILDREN WITH DMD, WITH 10%-20% OF THEM DYING OF CARDIAC FAILURE. HEART RATE VARIABILITY (HRV) IS SHOWN TO BE A PREDICTOR OF CARDIO-AUTONOMIC FUNCTION. PHYSIOTHERAPY (PT) IS ADVISED FOR THESE CHILDREN AS A REGULAR TREATMENT FOR MAINTAINING THEIR FUNCTIONAL STATUS. THE EFFECT OF YOGIC PRACTICES ON THE CARDIO-AUTONOMIC FUNCTIONS HAS BEEN DEMONSTRATED IN VARIOUS NEUROLOGICAL CONDITIONS AND MAY PROVE BENEFICIAL IN DMD. MATERIALS AND METHODS: IN THIS STUDY, 124 PATIENTS WITH DMD WERE RANDOMIZED TO PT ALONE OR PT WITH YOGA INTERVENTION. HOME-BASED PT AND YOGA WERE ADVISED. ADHERENCE WAS SERIALLY ASSESSED AT A FOLLOW-UP INTERVAL OF 3 MONTHS. ERROR-FREE, ELECTROCARDIOGRAM WAS RECORDED IN ALL PATIENTS AT REST IN THE SUPINE POSITION. HRV PARAMETERS WERE COMPUTED IN TIME AND FREQUENCY DOMAINS. HRV WAS RECORDED AT BASELINE AND AT AN INTERVAL OF 3 MONTHS UP TO 1 YEAR. REPEATED-MEASURES ANOVA WAS USED TO ANALYZE LONGITUDINAL FOLLOW-UP AND LEAST SIGNIFICANT DIFFERENCE FOR POST HOC ANALYSIS AND P < 0.05 WAS CONSIDERED STATISTICALLY SIGNIFICANT. RESULTS: IN OUR STUDY, WITH PT PROTOCOL, STANDARD DEVIATION OF NN, ROOT OF SQUARE MEAN OF SUCCESSIVE NN, TOTAL POWER, LOW FREQUENCY, HIGH-FREQUENCY NORMALIZED UNITS (HFNU), AND SYMPATHOVAGAL BALANCE IMPROVED AT VARYING TIME POINTS AND THE IMPROVEMENT LASTED UP FOR 6-9 MONTHS, WHEREAS PT AND YOGA PROTOCOL SHOWED AN IMPROVEMENT IN HFNU DURING THE LAST 3 MONTHS OF THE STUDY PERIOD AND ALL THE OTHER PARAMETERS WERE STABLE UP TO 1 YEAR. THUS, IT IS EVIDENT THAT BOTH THE GROUPS IMPROVED CARDIAC FUNCTIONS IN DMD. HOWEVER, NO SIGNIFICANT DIFFERENCE WAS NOTED IN THE CHANGES OBSERVED BETWEEN THE GROUPS. CONCLUSION: THE INTENSE PT AND PT WITH YOGA, PARTICULARLY HOME-BASED PROGRAM, IS INDEED BENEFICIAL AS A THERAPEUTIC STRATEGY IN DMD CHILDREN TO MAINTAIN AND/OR TO SUSTAIN HRV IN DMD.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
14  521  45 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 1423  33 IMPROVEMENT IN NEUROCOGNITIVE FUNCTIONS AND SERUM BRAIN-DERIVED NEUROTROPHIC FACTOR LEVELS IN PATIENTS WITH DEPRESSION TREATED WITH ANTIDEPRESSANTS AND YOGA. CONTEXT AND AIMS: IMPAIRMENT IN COGNITION IS WELL-KNOWN IN PATIENTS WITH MAJOR DEPRESSIVE DISORDER. THIS STUDY EXAMINED THE EFFECT OF YOGA THERAPY WITH OR WITHOUT ANTIDEPRESSANTS AND ANTIDEPRESSANTS ALONE ON CERTAIN NEUROPSYCHOLOGICAL FUNCTIONS IN PATIENTS WITH DEPRESSION. CORRELATION BETWEEN CHANGES IN NEUROPSYCHOLOGICAL TEST PERFORMANCE AND SERUM BRAIN-DERIVED NEUROTROPHIC FACTOR (BDNF) LEVELS WAS ALSO EXPLORED. MATERIALS AND METHODS: ANTIDEPRESSANT-NAIVE/ANTIDEPRESSANT-FREE OUTPATIENTS WITH DEPRESSION RECEIVED ANTIDEPRESSANT MEDICATION ALONE (N = 23) OR YOGA THERAPY WITH (N = 26) OR WITHOUT (N = 16) ANTIDEPRESSANTS. DEPRESSION WAS ASSESSED USING THE HAMILTON DEPRESSION RATING SCALE. NEUROPSYCHOLOGICAL TESTS INCLUDED DIGIT-SPAN FORWARD AND BACKWARD, REY AUDITORY VERBAL LEARNING TEST, AND TRAIL MAKING TESTS (TMT-A AND B). THESE TESTS WERE ADMINISTERED BEFORE AND 3 MONTHS AFTER THE TREATMENT IN PATIENTS, AND ONCE IN HEALTHY COMPARISON SUBJECTS (N = 19). STATISTICAL ANALYSIS: BASELINE DIFFERENCES WERE ANALYZED USING INDEPENDENT SAMPLE T-TEST, CHI-SQUARE, AND ONE-WAY ANOVA. PAIRED T-TEST WAS USED TO ANALYZE THE CHANGE FROM BASELINE TO FOLLOW-UP. PEARSON'S CORRELATION WAS USED TO EXPLORE THE ASSOCIATION OF CHANGE BETWEEN 2 VARIABLES. RESULTS: PATIENTS HAD IMPAIRED PERFORMANCE ON MOST NEUROPSYCHOLOGICAL TESTS. AFTER 3 MONTHS, THERE WAS SIGNIFICANT IMPROVEMENT - PATIENTS' PERFORMANCE WAS COMPARABLE TO THAT OF HEALTHY CONTROLS ON MAJORITY OF THE TESTS. SIGNIFICANT INVERSE CORRELATION WAS OBSERVED BETWEEN INCREASE IN BDNF LEVELS AND IMPROVEMENT IN TMT "A" DURATION IN YOGA-ALONE GROUP (R = -0.647; P = 0.009). CONCLUSIONS: TO CONCLUDE THAT, YOGA THERAPY, ALONE OR IN COMBINATION WITH MEDICATIONS, IS ASSOCIATED WITH IMPROVED NEUROPSYCHOLOGICAL FUNCTIONS AND NEUROPLASTIC EFFECTS IN PATIENTS WITH DEPRESSION.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
16 2743  44 YOGA PRACTICE IMPROVES EXECUTIVE FUNCTION BY ATTENUATING STRESS LEVELS. BACKGROUND: PROLONGED ACTIVATION OF THE HYPOTHALAMUS-PITUITARY-ADRENAL SYSTEM IS THOUGHT TO HAVE DELETERIOUS EFFECTS ON BRAIN FUNCTION. NEUROENDOCRINE STUDIES SUGGEST THAT BRAIN EXPOSURE TO HIGHER CORTISOL CONCENTRATIONS CONTRIBUTE TO COGNITIVE DEFICITS AS WE AGE. MIND-BODY TECHNIQUES SUCH AS YOGA HAVE SHOWN TO IMPROVE STRESS LEVELS BY RESTORING THE BODY'S SYMPATHETIC-PARASYMPATHETIC BALANCE. THE OBJECTIVE OF THIS STUDY WAS TO DETERMINE WHETHER YOGA PRACTICE MODERATED THE STRESS RESPONSE RESULTING IN IMPROVED EXECUTIVE FUNCTION. METHODS: SEDENTARY COMMUNITY DWELLING OLDER ADULTS (N=118, MEAN AGE=62.02) WERE RANDOMIZED TO AN 8-WEEK YOGA INTERVENTION OR A STRETCHING CONTROL GROUP. AT BASELINE AND FOLLOWING 8 WEEKS, ALL PARTICIPANTS COMPLETED MEASURES OF EXECUTIVE FUNCTION, SELF-REPORTED STRESS AND ANXIETY AND PROVIDED SALIVA SAMPLES BEFORE AND AFTER COGNITIVE TESTING TO ASSESS CORTISOL. RESULTS: YOGA PARTICIPANTS SHOWED IMPROVED ACCURACY ON EXECUTIVE FUNCTION MEASURES AND AN ATTENUATED CORTISOL RESPONSE COMPARED TO THEIR STRETCHING COUNTERPARTS WHO SHOWED INCREASED CORTISOL LEVELS AND POOR COGNITIVE PERFORMANCE AT FOLLOW UP. THE CHANGE IN CORTISOL LEVELS AS WELL AS SELF-REPORTED STRESS AND ANXIETY LEVELS PREDICTED PERFORMANCE ON THE RUNNING SPAN TASK, N-BACK WORKING MEMORY AND TASK SWITCHING PARADIGM (BETA'S=0.27-0.38, P'S</=0.05 FOR YOGA AND BETA'S=-0.37-0.47, P'S</=0.01 FOR STRETCHING CONTROL). CONCLUSION: EIGHT WEEKS OF REGULAR YOGA PRACTICE RESULTED IN IMPROVED WORKING MEMORY PERFORMANCE THAT WAS MEDIATED BY AN ATTENUATED RESPONSE TO STRESS AS MEASURED BY SELF-REPORT STRESS AND OBJECTIVE SALIVARY CORTISOL MEASUREMENTS. THIS TRIAL OFFERS EVIDENCE FOR NON-TRADITIONAL PHYSICAL ACTIVITY INTERVENTIONS SUCH AS YOGA THAT MAY BE HELPFUL IN RESTORING HPA BALANCE IN OLDER ADULTS, THEREBY PREVENTING COGNITIVE DECLINE.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
17 2852  42 YOGA, PHYSICAL THERAPY, OR EDUCATION FOR CHRONIC LOW BACK PAIN: A RANDOMIZED NONINFERIORITY TRIAL. BACKGROUND: YOGA IS EFFECTIVE FOR MILD TO MODERATE CHRONIC LOW BACK PAIN (CLBP), BUT ITS COMPARATIVE EFFECTIVENESS WITH PHYSICAL THERAPY (PT) IS UNKNOWN. MOREOVER, LITTLE IS KNOWN ABOUT YOGA'S EFFECTIVENESS IN UNDERSERVED PATIENTS WITH MORE SEVERE FUNCTIONAL DISABILITY AND PAIN. OBJECTIVE: TO DETERMINE WHETHER YOGA IS NONINFERIOR TO PT FOR CLBP. DESIGN: 12-WEEK, SINGLE-BLIND, 3-GROUP RANDOMIZED NONINFERIORITY TRIAL AND SUBSEQUENT 40-WEEK MAINTENANCE PHASE. (CLINICALTRIALS.GOV: NCT01343927). SETTING: ACADEMIC SAFETY-NET HOSPITAL AND 7 AFFILIATED COMMUNITY HEALTH CENTERS. PARTICIPANTS: 320 PREDOMINANTLY LOW-INCOME, RACIALLY DIVERSE ADULTS WITH NONSPECIFIC CLBP. INTERVENTION: PARTICIPANTS RECEIVED 12 WEEKLY YOGA CLASSES, 15 PT VISITS, OR AN EDUCATIONAL BOOK AND NEWSLETTERS. THE MAINTENANCE PHASE COMPARED YOGA DROP-IN CLASSES VERSUS HOME PRACTICE AND PT BOOSTER SESSIONS VERSUS HOME PRACTICE. MEASUREMENTS: PRIMARY OUTCOMES WERE BACK-RELATED FUNCTION, MEASURED BY THE ROLAND MORRIS DISABILITY QUESTIONNAIRE (RMDQ), AND PAIN, MEASURED BY AN 11-POINT SCALE, AT 12 WEEKS. PRESPECIFIED NONINFERIORITY MARGINS WERE 1.5 (RMDQ) AND 1.0 (PAIN). SECONDARY OUTCOMES INCLUDED PAIN MEDICATION USE, GLOBAL IMPROVEMENT, SATISFACTION WITH INTERVENTION, AND HEALTH-RELATED QUALITY OF LIFE. RESULTS: ONE-SIDED 95% LOWER CONFIDENCE LIMITS WERE 0.83 (RMDQ) AND 0.97 (PAIN), DEMONSTRATING NONINFERIORITY OF YOGA TO PT. HOWEVER, YOGA WAS NOT SUPERIOR TO EDUCATION FOR EITHER OUTCOME. YOGA AND PT WERE SIMILAR FOR MOST SECONDARY OUTCOMES. YOGA AND PT PARTICIPANTS WERE 21 AND 22 PERCENTAGE POINTS LESS LIKELY, RESPECTIVELY, THAN EDUCATION PARTICIPANTS TO USE PAIN MEDICATION AT 12 WEEKS. IMPROVEMENTS IN YOGA AND PT GROUPS WERE MAINTAINED AT 1 YEAR WITH NO DIFFERENCES BETWEEN MAINTENANCE STRATEGIES. FREQUENCY OF ADVERSE EVENTS, MOSTLY MILD SELF-LIMITED JOINT AND BACK PAIN, DID NOT DIFFER BETWEEN THE YOGA AND PT GROUPS. LIMITATIONS: PARTICIPANTS WERE NOT BLINDED TO TREATMENT ASSIGNMENT. THE PT GROUP HAD DISPROPORTIONATE LOSS TO FOLLOW-UP. CONCLUSION: A MANUALIZED YOGA PROGRAM FOR NONSPECIFIC CLBP WAS NONINFERIOR TO PT FOR FUNCTION AND PAIN. PRIMARY FUNDING SOURCE: NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH OF THE NATIONAL INSTITUTES OF HEALTH.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                             
18 1831  44 PSYCHOLOGICAL FUNCTION, IYENGAR YOGA, AND COHERENT BREATHING: A RANDOMIZED CONTROLLED DOSING STUDY. BACKGROUND: EVIDENCE SUGGESTS THAT YOGA MAY BE AN EFFECTIVE TREATMENT FOR MAJOR DEPRESSIVE DISORDER (MDD). STUDIES EVALUATING THE "DOSING" OF YOGA TREATMENT AND EFFICACY FOR MDD ARE NEEDED. THE GOAL OF THIS STUDY WAS TO ASSESS THE EFFECTS OF AN INTERVENTION COMBINING IYENGAR YOGA AND COHERENT BREATHING IN PARTICIPANTS WITH MDD AND DETERMINE THE OPTIMAL INTERVENTION DOSE. METHODS: THIRTY-TWO PARTICIPANTS (18 TO 65 Y OF AGE) DIAGNOSED WITH MDD WERE RANDOMIZED TO A HIGH-DOSE GROUP (HDG) OR A LOW-DOSE GROUP (LDG) OF YOGA AND COHERENT BREATHING FOR 12 WEEKS. THE HDG (N=15) INVOLVED THREE 90-MINUTE YOGA CLASSES AND FOUR 30-MINUTE HOMEWORK SESSIONS PER WEEK. THE LDG (N=15) INVOLVED TWO 90-MINUTE YOGA CLASSES AND THREE 30-MINUTE HOMEWORK SESSIONS PER WEEK. PARTICIPANTS WERE EVALUATED AT BASELINE, WEEK 4, WEEK 8, AND WEEK 12 WITH THE FOLLOWING INSTRUMENTS: POSITIVITY SELF-TEST, SPIELBERGER STATE ANXIETY INVENTORY, PATIENT HEALTH QUESTIONNAIRE-9, PITTSBURGH SLEEP QUALITY INDEX, AND EXERCISE-INDUCED FEELING INVENTORY. DATA WERE ANALYZED USING INTENT-TO-TREAT METHODS. RESULTS: SIGNIFICANT IMPROVEMENTS IN ALL OUTCOME MEASURES WERE FOUND FOR BOTH GROUPS, WITH ACUTE AND CUMULATIVE BENEFITS. ALTHOUGH THE HDG SHOWED GREATER IMPROVEMENTS ON ALL SCALES, BETWEEN-GROUP DIFFERENCES DID NOT REACH SIGNIFICANCE, POSSIBLY DUE TO LACK OF POWER BECAUSE OF THE SMALL SAMPLE SIZE. CUMULATIVE YOGA MINUTES WERE CORRELATED WITH IMPROVEMENT IN OUTCOME MEASURES. LIMITATION: THIS DOSING STUDY DID NOT INCLUDE A NON-YOGA CONTROL. CONCLUSIONS: IMPROVEMENT IN PSYCHOLOGICAL SYMPTOMS CORRELATED WITH CUMULATIVE YOGA PRACTICE. BOTH INTERVENTIONS REDUCED SYMPTOMS OF DEPRESSION AND ANXIETY AND INCREASED FEELINGS OF POSITIVITY. THE TIME COMMITMENT FOR YOGA PRACTICE NEEDS TO BE WEIGHED AGAINST BENEFITS WHEN DESIGNING YOGA INTERVENTIONS.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
19  287  25 ADJUNCT YOGA THERAPY: INFLUENCE ON HEART RATE VARIABILITY IN MAJOR DEPRESSIVE DISORDER - A RANDOMIZED CONTROLLED TRIAL. HRV IS INVERSELY PROPORTIONAL TO SEVERITY OF DEPRESSION. EFFECT OF 12-WEEKS ADJUNCT YOGA THERAPY ON HRV IN PATIENTS WITH MDD WAS ASSESSED THROUGH A RANDOMIZED CONTROLLED TRIAL. SIXTY-EIGHT SUBJECTS (40 FEMALES) WITH MEAN AGE 31.58 +/- 8.79 YEARS, SCORING >/= 18 ON HDRS WERE RANDOMIZED TO EITHER (YG; N = 35) OR (WG; N = 33). LINEAR MIXED MODEL ANALYSIS SHOWED NO SIGNIFICANT DIFFERENCE BETWEEN GROUPS. ON COMPARING CHANGE IN MEAN PERCENTAGE, SUBSTANTIAL MORE DECREASE COULD BE ELICITED ONLY FOR LF/HF RATIO IN YG COMPARED TO WG, WHILE BEING COMPARABLE FOR OTHER VARIABLES ACROSS THE GROUPS. FINDINGS SUGGEST YOGA THERAPY MAY HELP IN BRINGING PARASYMPATHETIC DOMINANCE IN PATIENTS WITH MDD.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
20  988  39 EFFECTS OF HATHA YOGA ON BLOOD PRESSURE, SALIVARY ALPHA-AMYLASE, AND CORTISOL FUNCTION AMONG NORMOTENSIVE AND PREHYPERTENSIVE YOUTH. OBJECTIVE: EVIDENCE IS ACCUMULATING, PREDOMINANTLY AMONG CLINICAL TRIALS IN ADULTS, THAT YOGA IMPROVES BLOOD PRESSURE (BP) CONTROL, WITH DOWNREGULATION OF THE HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS AND THE SYMPATHETIC NERVOUS SYSTEM (SNS) PROJECTED AS UNDERLYING MECHANISMS. THIS PILOT STUDY ASSESSED WHETHER HATHA YOGA HAS THE POTENTIAL TO REDUCE BP AMONG YOUTH AND WHETHER DAMPENING OF THE SNS AND/OR HPA ACTIVITY IS A LIKELY PATHWAY OF CHANGE. DESIGN: THIRTY-ONE SEVENTH GRADERS WERE RANDOMLY ASSIGNED TO A HATHA YOGA PROGRAM (HYP) OR ATTENTION CONTROL (AC) MUSIC OR ART CLASS. BASELINE AND 3-MONTH EVALUATIONS INCLUDED RESTING BP; OVERNIGHT URINE SAMPLES; AND SALIVA COLLECTED AT BEDTIME, UPON AWAKENING, AND AT 30 AND 60 MINUTES AFTER AWAKENING FOR ALPHA-AMYLASE AND CORTISOL ASSAYS. RESULTS: TWENTY-EIGHT (14 IN THE HYP GROUP AND 14 IN THE AC GROUP) STUDENTS WERE ASSESSED BOTH BEFORE AND AFTER THE INTERVENTION. BP CHANGES FROM PRE- TO POST-INTERVENTION WERE -3.0/-2.0 MMHG FOR THE HYP GROUP AND -0.07/-0.79 MMHG FOR THE AC GROUP (P=0.30 AND 0.57, RESPECTIVELY). CHANGES IN SYSTOLIC BP (SBP)/DIASTOLIC BP (DBP) FOR THE PREHYPERTENSIVE (75TH-94TH PERCENTILES FOR SBP) SUBGROUP ANALYSES WERE -10.75/-8.25 MMHG FOR THE HYP GROUP (N=4) VERSUS 1.8/1.0 MMHG FOR THE AC GROUP (N=5) (P FOR SBP=0.02; P FOR DBP=0.09). ALTHOUGH NO STATISTICALLY SIGNIFICANT GROUP DIFFERENCES WERE OBSERVED WITH CHANGES IN SNS OR HPA AWAKENING CURVES (AREA UNDER CURVE FOR ALPHA-AMYLASE AND CORTISOL, RESPECTIVELY), A SMALL TO MODERATE EFFECT SIZE WAS SEEN FAVORING A REDUCTION OF ALPHA-AMYLASE ACTIVATION FOR THE HYP GROUP (COHEN D=0.34; PREHYPERTENSIVE D=0.20). CONCLUSIONS: A SCHOOL-BASED HATHA YOGA PROGRAM DEMONSTRATED POTENTIAL TO DECREASE RESTING BP, PARTICULARLY AMONG PREHYPERTENSIVE YOUTH. REDUCED SNS DRIVE MAY BE AN UNDERLYING NEUROHORMONAL PATHWAY BENEFICIALLY AFFECTED BY THE PROGRAM. A LARGE-SCALE EFFICACY/EFFECTIVENESS RANDOMIZED CLINICAL TRIAL IS WARRANTED.	2014