1   34 146 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
2 1801  31 PREVALENCE AND PATTERNS OF ADULT YOGA USE IN THE UNITED STATES: RESULTS OF A NATIONAL SURVEY. BACKGROUND: ALTHOUGH YOGA APPEARS TO BE POPULAR IN THE UNITED STATES, THERE ARE NO PUBLISHED STUDIES ON YOGA'S PREVALENCE OR PATTERNS OF USE. METHODS: IN 1998 WE SURVEYED BY TELEPHONE A NATIONALLY REPRESENTATIVE SAMPLE OF 2055 ENGLISH-SPEAKING U.S. ADULTS (60% WEIGHTED RESPONSE RATE) REGARDING YOGA USE. RESULTS: OF THE RESPONDENTS, 7.5% USED YOGA AT LEAST ONCE IN THEIR LIFETIME AND 3.8% USED YOGA IN THE PREVIOUS 12 MONTHS. RESPONDENTS WHO USED YOGA AT LEAST ONCE WERE MORE LIKELY THAN NON-USERS TO BE FEMALE (68% VS. 51%), COLLEGE EDUCATED (68% VS. 45%), AND URBAN DWELLERS (93% VS. 74%). FACTORS INDEPENDENTLY ASSOCIATED WITH YOGA USE AT LEAST ONCE INCLUDED FEMALE GENDER (OR 2.5 [95% CI 1.7-3.8]), BABY BOOMER AGE GROUP (AGES 34-53) COMPARED TO PRE-BABY BOOMERS (> OR = 54 (2.3 [1.4-4.0]), EDUCATION BEYOND HIGH SCHOOL (2.2 [1.4-3.5]), RESIDING IN LARGE AND SMALL METROPOLITAN AREAS COMPARED TO NON-METROPOLITAN AREAS (3.8 [1.8-7.8] AND 2.7 [1.3-5.8], RESPECTIVELY), AND USE OF OTHER CAM THERAPIES (5.3 [2.7-10.5]). OF RESPONDENTS USING YOGA IN THE PREVIOUS 12 MONTHS, 64% REPORTED USING YOGA FOR WELLNESS, 48% FOR HEALTH CONDITIONS, AND 21% SPECIFICALLY FOR BACK OR NECK PAIN. NINETY PERCENT FELT YOGA WAS VERY OR SOMEWHAT HELPFUL AND 76% DID NOT REPORT SPENDING MONEY RELATED TO THEIR YOGA. CONCLUSIONS: IN 1998 AN ESTIMATED 15.0 MILLION AMERICAN ADULTS HAD USED YOGA AT LEAST ONCE IN THEIR LIFETIME AND 7.4 MILLION DURING THE PREVIOUS YEAR. YOGA WAS USED FOR BOTH WELLNESS AND SPECIFIC HEALTH CONDITIONS OFTEN WITH PERCEIVED HELPFULNESS AND WITHOUT EXPENDITURE.	2004	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
3 1947  48 SAUNA YOGA SUPERIORLY IMPROVES FLEXIBILITY, STRENGTH, AND BALANCE: A TWO-ARMED RANDOMIZED CONTROLLED TRIAL IN HEALTHY OLDER ADULTS. BESIDES STRENGTH AND BALANCE, FLEXIBILITY IS AN IMPORTANT INDICATOR OF HEALTH-RELATED PHYSICAL FITNESS. THUS, THE AIM OF THIS TWO-ARMED RANDOMIZED CONTROLLED PILOT TRIAL WAS TO INVESTIGATE WHETHER SAUNA YOGA AT A MODERATE TEMPERATURE (50 DEGREES C) BENEFICIALLY AFFECTS FLEXIBILITY, STRENGTH, BALANCE, AND QUALITY OF LIFE (QOL) IN HEALTHY ELDERLY COMMUNITY DWELLERS. PARTICIPANTS WERE RANDOMLY ASSIGNED TO AN INTERVENTION GROUP (INT, N = 11, AGE: 68.7 +/- 5.9) OR CONTROL GROUP (CON, N = 12, AGE: 69.3 +/- 4.9), USING THE MINIMIZATION METHOD. AGE, PHYSICAL ACTIVITY, GENDER, AND THE PRIMARY OUTCOME FLEXIBILITY WERE USED AS STRATA FOR GROUP ALLOCATION. BOTH GROUPS COMPLETED SIMILAR EXERCISES IN THE SAUNA OVER EIGHT WEEKS. ONLY THE INT GROUP WAS EXPOSED TO MODERATE TEMPERATURES OF 50 DEGREES C. LARGE AND STATISTICALLY SIGNIFICANT IMPROVEMENT IN FAVOR OF THE SAUNA GROUP (INT) WAS OBSERVED FOR THE CHAIR SIT-AND-REACH TEST (INT: +83%, CON +3%, P = 0.028, NSMALL ER, CYRILLIC(2) = 0.24). THE SHOULDER AND LATERAL SPINE FLEXIBILITY WERE NOT RELEVANTLY AFFECTED. STRENGTH IN THE LOWER EXTREMITIES MERELY SHOWED A TENDENCY TO SIGNIFICANT CHANGES (INT: 16%, CON: 3%, P = 0.061, NSMALL ER, CYRILLIC(2) = 0.181). ADDITIONALLY, BALANCE ABILITIES, WITH EYES CLOSED, IMPROVED (INT: 187%, CON +58%, P = 0.056, NSMALL ER, CYRILLIC(2) = 0.189) IN FAVOR OF THE INT GROUP. QOL ONLY IMPROVED IN FAVOR OF THE INT FOR ENVIRONMENTAL DIMENSION (INT: +7%, CON: 0%, P = 0.034, NSMALL ER, CYRILLIC(2) = 0.227). THESE FIRST BUT PRELIMINARY FINDINGS INDICATE THAT SAUNA YOGA MAY SERVE AS A PROMISING AND FEASIBLE MEANS TO IMPROVE FLEXIBILITY IN ELDERLY PEOPLE. STRENGTH AND BALANCE DO NOT MEANINGFULLY BENEFIT FROM A SAUNA ENVIRONMENT, ALTHOUGH STRENGTH IMPROVED TO A SLIGHTLY HIGHER EXTENT IN THE SAUNA GROUP. FUTURE LARGE-SCALE RESEARCH IS NEEDED TO ELUCIDATE UNDERLYING MECHANISMS AND CORROBORATE THESE FINDINGS.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
4  518  42 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
5  269  62 ADAPTED YOGA TO IMPROVE PHYSICAL FUNCTION AND HEALTH-RELATED QUALITY OF LIFE IN PHYSICALLY-INACTIVE OLDER ADULTS: A RANDOMISED CONTROLLED PILOT TRIAL. BACKGROUND: YOGA IS A HOLISTIC THERAPY OF EXPANDING POPULARITY, WHICH HAS THE POTENTIAL TO PRODUCE A RANGE OF PHYSICAL, MENTAL AND SOCIAL BENEFITS. THIS TRIAL EVALUATED THE FEASIBILITY AND EFFECTS OF AN ADAPTED YOGA PROGRAMME ON PHYSICAL FUNCTION AND HEALTH-RELATED QUALITY OF LIFE IN PHYSICALLY-INACTIVE OLDER ADULTS. METHODS: IN THIS RANDOMISED CONTROLLED PILOT TRIAL, 52 OLDER ADULTS (90% FEMALE; MEAN AGE 74.8 YEARS, SD 7.2) WERE RANDOMISED 1:1 TO A YOGA PROGRAMME OR WAIT-LIST CONTROL. THE YOGA GROUP (N = 25) RECEIVED A PHYSICAL ACTIVITY EDUCATION BOOKLET AND WERE INVITED TO ATTEND TEN YOGA SESSIONS DURING A 12-WEEK PERIOD. THE CONTROL GROUP (N = 27) RECEIVED THE EDUCATION BOOKLET ONLY. MEASURES OF PHYSICAL FUNCTION (E.G., SHORT PHYSICAL PERFORMANCE BATTERY; SPPB), HEALTH STATUS (EQ-5D) AND MENTAL WELL-BEING (WARWICK-EDINBURGH MENTAL WELL-BEING SCALE; WEMWBS) WERE ASSESSED AT BASELINE AND 3 MONTHS. FEASIBILITY WAS ASSESSED USING COURSE ATTENDANCE AND ADVERSE EVENT DATA, AND PARTICIPANT INTERVIEWS. RESULTS: FORTY-SEVEN PARTICIPANTS COMPLETED FOLLOW-UP ASSESSMENTS. MEDIAN CLASS ATTENDANCE WAS 8 (RANGE 3 TO 10). AT THE 3-MONTH FOLLOW-UP, THE YOGA GROUP HAD A HIGHER SPPB TOTAL SCORE COMPARED WITH THE CONTROL GROUP (MEAN DIFFERENCE 0.9, 95% CONFIDENCE INTERVAL [CI] -0.3 TO 2.0), A FASTER TIME TO RISE FROM A CHAIR FIVE TIMES (MEAN DIFFERENCE - 1.73 S, 95% CI -4.08 TO 0.62), AND BETTER PERFORMANCE ON THE CHAIR SIT-AND-REACH LOWER-LIMB FLEXIBILITY TEST (MEAN DIFFERENCE 5 CM, 95% CI 0 TO 10). THE YOGA GROUP ALSO HAD SUPERIOR HEALTH STATUS AND MENTAL WELL-BEING (VS. CONTROL) AT 3 MONTHS, WITH MEAN DIFFERENCES IN EQ-5D AND WEMWBS SCORES OF 0.12 (95% CI, 0.03 TO 0.21) AND 6 (95% CI, 1 TO 11), RESPECTIVELY. THE INTERVIEWS INDICATED THAT PARTICIPANTS VALUED ATTENDING THE YOGA PROGRAMME, AND THAT THEY EXPERIENCED A RANGE OF BENEFITS. CONCLUSIONS: THE ADAPTED YOGA PROGRAMME APPEARED TO BE FEASIBLE AND POTENTIALLY BENEFICIAL IN TERMS OF IMPROVING MENTAL AND SOCIAL WELL-BEING AND ASPECTS OF PHYSICAL FUNCTION IN PHYSICALLY-INACTIVE OLDER ADULTS. AN APPROPRIATELY-POWERED TRIAL IS REQUIRED TO CONFIRM THE FINDINGS OF THE PRESENT STUDY AND TO DETERMINE LONGER-TERM EFFECTS. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT02663726 .	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
6 2558  50 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
7  460  46 CHANGES IN PAIN SELF-EFFICACY, COPING SKILLS, AND FEAR-AVOIDANCE BELIEFS IN A RANDOMIZED CONTROLLED TRIAL OF YOGA, PHYSICAL THERAPY, AND EDUCATION FOR CHRONIC LOW BACK PAIN. OBJECTIVE: WE EVALUATED EXERCISE INTERVENTIONS FOR COGNITIVE APPRAISAL OF CHRONIC LOW BACK PAIN (CLBP) IN AN UNDERSERVED POPULATION. METHODS: WE CONDUCTED A SECONDARY ANALYSIS OF THE BACK TO HEALTH TRIAL, SHOWING YOGA TO BE NONINFERIOR TO PHYSICAL THERAPY (PT) FOR PAIN AND FUNCTION OUTCOMES AMONG ADULTS WITH CLBP (N = 320) RECRUITED FROM PRIMARY CARE CLINICS WITH PREDOMINANTLY LOW-INCOME PATIENTS. PARTICIPANTS WERE RANDOMIZED TO 12 WEEKS OF YOGA, PT, OR EDUCATION. COGNITIVE APPRAISAL WAS ASSESSED WITH THE PAIN SELF-EFFICACY QUESTIONNAIRE (PSEQ), COPING STRATEGIES QUESTIONNAIRE (CSQ), AND FEAR-AVOIDANCE BELIEFS QUESTIONNAIRE (FABQ). USING MULTIPLE IMPUTATION AND LINEAR REGRESSION, WE ESTIMATED WITHIN- AND BETWEEN-GROUP CHANGES IN COGNITIVE APPRAISAL AT 12 AND 52 WEEKS, WITH BASELINE AND THE EDUCATION GROUP AS REFERENCES. RESULTS: PARTICIPANTS (MEAN AGE = 46 YEARS) WERE MAJORITY FEMALE (64%) AND MAJORITY BLACK (57%), AND 54% HAD AN ANNUAL HOUSEHOLD INCOME <$30,000. ALL THREE GROUPS SHOWED IMPROVEMENTS IN PSEQ (RANGE 0-60) AT 12 WEEKS (YOGA, MEAN DIFFERENCE [MD] = 7.0, 95% CONFIDENCE INTERVAL [CI]: 4.9, 9.0; PT, MD = 6.9, 95% CI: 4.7 TO 9.1; AND EDUCATION, MD = 3.4, 95% CI: 0.54 TO 6.3), WITH YOGA AND PT IMPROVEMENTS BEING CLINICALLY MEANINGFUL. AT 12 WEEKS, IMPROVEMENTS IN CATASTROPHIZING (CSQ, RANGE 0-36) WERE LARGEST IN THE YOGA AND PT GROUPS (MD = -3.0, 95% CI: -4.4 TO -1.6; MD = -2.7, 95% CI: -4.2 TO -1.2, RESPECTIVELY). CHANGES IN FABQ WERE SMALL. NO STATISTICALLY SIGNIFICANT BETWEEN-GROUP DIFFERENCES WERE OBSERVED ON PSEQ, CSQ, OR FABQ AT EITHER TIME POINT. MANY OF THE CHANGES OBSERVED AT 12 WEEKS WERE SUSTAINED AT 52 WEEKS. CONCLUSION: ALL THREE INTERVENTIONS WERE ASSOCIATED WITH IMPROVEMENTS IN SELF-EFFICACY AND CATASTROPHIZING AMONG LOW-INCOME, RACIALLY DIVERSE ADULTS WITH CLBP. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER NCT01343927.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
8 1573  51 MANAGING KNEE OSTEOARTHRITIS WITH YOGA OR AEROBIC/STRENGTHENING EXERCISE PROGRAMS IN OLDER ADULTS: A PILOT RANDOMIZED CONTROLLED TRIAL. ALTHOUGH EXERCISE IS OFTEN RECOMMENDED FOR MANAGING OSTEOARTHRITIS (OA), LIMITED EVIDENCE-BASED EXERCISE OPTIONS ARE AVAILABLE FOR OLDER ADULTS WITH OA. THIS STUDY COMPARED THE EFFECTS OF HATHA YOGA (HY) AND AEROBIC/STRENGTHENING EXERCISES (ASE) ON KNEE OA. RANDOMIZED CONTROLLED TRIAL WITH THREE ARMS DESIGN WAS USED: HY, ASE, AND EDUCATION CONTROL. BOTH HY AND ASE GROUPS INVOLVED 8 WEEKLY 45-MIN GROUP CLASSES WITH 2-4 DAYS/WEEK HOME PRACTICE SESSIONS. CONTROL GROUP RECEIVED OA EDUCATION BROCHURES AND WEEKLY PHONE CALLS FROM STUDY STAFF. STANDARDIZED INSTRUMENTS WERE USED TO MEASURE OA SYMPTOMS, PHYSICAL FUNCTION, MOOD, SPIRITUAL HEALTH, FEAR OF FALLING, AND QUALITY OF LIFE AT BASELINE, 4 AND 8 WEEKS. HY/ASE ADHERENCES WERE ASSESSED WEEKLY USING CLASS ATTENDANCE RECORDS AND HOME PRACTICE VIDEO RECORDINGS. PRIMARY ANALYSIS OF THE DIFFERENCE IN THE CHANGE FROM BASELINE WAS BASED ON INTENT-TO-TREAT AND ADJUSTED FOR BASELINE VALUES. EIGHT-THREE ADULTS WITH SYMPTOMATIC KNEE OA COMPLETED THE STUDY (84% FEMALE; MEAN AGE 71.6 +/- 8.0 YEARS; MEAN BMI 29.0 +/- 7.0 KG/M(2)). RETENTION RATE WAS 82%. COMPARED TO THE ASE GROUP AT 8 WEEKS, PARTICIPANTS IN THE HY GROUP HAD A SIGNIFICANT IMPROVEMENT FROM BASELINE IN PERCEPTION OF OA SYMPTOMS (-9.6 [95% CI -15.3, -4]; P = .001), ANXIETY (-1.4 [95% CI -2.7, -0]; P = .04), AND FEAR OF FALLING (-4.6 [-7.5, -1.7]; P = .002). THERE WERE NO DIFFERENCES IN CLASS/HOME PRACTICE ADHERENCE BETWEEN HY AND ASE. THREE NON-SERIOUS ADVERSE EVENTS WERE REPORTED FROM THE ASE GROUP. BOTH HY AND ASE IMPROVED SYMPTOMS AND FUNCTION BUT HY MAY HAVE SUPERIOR BENEFITS FOR OLDER ADULTS WITH KNEE OA. TRIAL REGISTRATION THE FULL TRIAL PROTOCOL IS AVAILABLE AT CLINICALTRIALS.GOV (NCT02525341).	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
9 2851  44 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
10 2560  44 YOGA FOR CHRONIC LOW BACK PAIN: A RANDOMIZED TRIAL. BACKGROUND: PREVIOUS STUDIES INDICATE THAT YOGA MAY BE AN EFFECTIVE TREATMENT FOR CHRONIC OR RECURRENT LOW BACK PAIN. OBJECTIVE: TO COMPARE THE EFFECTIVENESS OF YOGA AND USUAL CARE FOR CHRONIC OR RECURRENT LOW BACK PAIN. DESIGN: PARALLEL-GROUP, RANDOMIZED, CONTROLLED TRIAL USING COMPUTER-GENERATED RANDOMIZATION CONDUCTED FROM APRIL 2007 TO MARCH 2010. OUTCOMES WERE ASSESSED BY POSTAL QUESTIONNAIRE. (INTERNATIONAL STANDARD RANDOMISED CONTROLLED TRIAL NUMBER REGISTER: ISRCTN 81079604) SETTING: 13 NON-NATIONAL HEALTH SERVICE PREMISES IN THE UNITED KINGDOM. PATIENTS: 313 ADULTS WITH CHRONIC OR RECURRENT LOW BACK PAIN. INTERVENTION: YOGA (N = 156) OR USUAL CARE (N = 157). ALL PARTICIPANTS RECEIVED A BACK PAIN EDUCATION BOOKLET. THE INTERVENTION GROUP WAS OFFERED A 12-CLASS, GRADUALLY PROGRESSING YOGA PROGRAM DELIVERED BY 12 TEACHERS OVER 3 MONTHS. MEASUREMENTS: SCORES ON THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE (RMDQ) AT 3 (PRIMARY OUTCOME), 6, AND 12 (SECONDARY OUTCOMES) MONTHS; PAIN, PAIN SELF-EFFICACY, AND GENERAL HEALTH MEASURES AT 3, 6, AND 12 MONTHS (SECONDARY OUTCOMES). RESULTS: 93 (60%) PATIENTS OFFERED YOGA ATTENDED AT LEAST 3 OF THE FIRST 6 SESSIONS AND AT LEAST 3 OTHER SESSIONS. THE YOGA GROUP HAD BETTER BACK FUNCTION AT 3, 6, AND 12 MONTHS THAN THE USUAL CARE GROUP. THE ADJUSTED MEAN RMDQ SCORE WAS 2.17 POINTS (95% CI, 1.03 TO 3.31 POINTS) LOWER IN THE YOGA GROUP AT 3 MONTHS, 1.48 POINTS (CI, 0.33 TO 2.62 POINTS) LOWER AT 6 MONTHS, AND 1.57 POINTS (CI, 0.42 TO 2.71 POINTS) LOWER AT 12 MONTHS. THE YOGA AND USUAL CARE GROUPS HAD SIMILAR BACK PAIN AND GENERAL HEALTH SCORES AT 3, 6, AND 12 MONTHS, AND THE YOGA GROUP HAD HIGHER PAIN SELF-EFFICACY SCORES AT 3 AND 6 MONTHS BUT NOT AT 12 MONTHS. TWO OF THE 157 USUAL CARE PARTICIPANTS AND 12 OF THE 156 YOGA PARTICIPANTS REPORTED ADVERSE EVENTS, MOSTLY INCREASED PAIN. LIMITATION: THERE WERE MISSING DATA FOR THE PRIMARY OUTCOME (YOGA GROUP, N = 21; USUAL CARE GROUP, N = 18) AND DIFFERENTIAL MISSING DATA (MORE IN THE YOGA GROUP) FOR SECONDARY OUTCOMES. CONCLUSION: OFFERING A 12-WEEK YOGA PROGRAM TO ADULTS WITH CHRONIC OR RECURRENT LOW BACK PAIN LED TO GREATER IMPROVEMENTS IN BACK FUNCTION THAN DID USUAL CARE. PRIMARY FUNDING SOURCE: ARTHRITIS RESEARCH UK.	2011	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
11 2852  46 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
12  521  44 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
13 2846  40 YOGA, HEALTH-RELATED QUALITY OF LIFE AND MENTAL WELL-BEING: A RE-ANALYSIS OF A META-ANALYSIS USING THE QUALITY EFFECTS MODEL. BACKGROUND: PROVIDE ROBUST AND PRACTICALLY RELEVANT INFORMATION REGARDING THE ASSOCIATION BETWEEN YOGA, HEALTH-RELATED QUALITY-OF-LIFE (HRQOL), AND MENTAL WELL-BEING (MWB) IN OLDER ADULTS. METHODS: DATA WERE DERIVED FROM A RECENT META-ANALYSIS OF 12 RANDOMIZED CONTROLLED YOGA TRIALS REPRESENTING 752 ADULTS >/=60 YEARS OF AGE. STANDARDIZED MEAN DIFFERENCE EFFECT SIZES (ESS) WERE POOLED USING THE RECENTLY DEVELOPED QUALITY EFFECTS MODEL AND 95% COMPATIBILITY INTERVALS (CI). SMALL-STUDY EFFECTS WERE EXAMINED USING THE DOI PLOT AND LUIS FURUYA-KANAMORI (LFK) INDEX. SENSITIVITY AND CUMULATIVE META-ANALYSES WERE CONDUCTED AS WELL AS PERCENTILE IMPROVEMENT, NUMBER NEEDED TO TREAT (NNT), AND NUMBER TO BENEFIT. THE GRADING OF RECOMMENDATIONS ASSESSMENT, DEVELOPMENT, AND EVALUATION (GRADE) INSTRUMENT WAS USED TO ASSESS THE STRENGTH OF THE EVIDENCE. RESULTS: YOGA WAS ASSOCIATED WITH IMPROVEMENTS IN BOTH HRQOL (ES = 0.51, 95% CI, 0.25-0.77, I2 = 63.1%) AND MWB (ES = 0.39, 95% CI, 0.15-0.63, I2 =56.2%). PERCENTILE IMPROVEMENTS WERE 19.5 FOR HRQOL AND 15.3 FOR MWB WHEREAS THE NNT WAS 4 FOR HRQOL AND 5 FOR MWB. AN ESTIMATED 378,222 AND 302,578 U.S. YOGA-PRACTICING ADULTS >/=65 YEARS OF AGE COULD POTENTIALLY IMPROVE THEIR HRQOL AND MWB, RESPECTIVELY. MAJOR ASYMMETRY SUGGESTIVE OF SMALL-STUDY EFFECTS WAS OBSERVED FOR MWB BUT NOT HRQOL. FURTHER EXAMINATION FOR ASYMMETRY REVEALED THAT GREATER IMPROVEMENTS IN MWB WERE ASSOCIATED WITH MORE (151 VS. 68) MINUTES OF YOGA PER WEEK (P = .007). OVERALL STRENGTH OF EVIDENCE WAS CONSIDERED "HIGH" FOR HRQOL AND "MODERATE" FOR MWB. CONCLUSIONS: YOGA IS ASSOCIATED WITH IMPROVEMENTS IN HRQOL AND MWB AMONG OLDER ADULTS, WITH APPROXIMATELY 150 MINUTES OR MORE PER WEEK POSSIBLY OPTIMAL.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
14 2518  49 YOGA COMPARED TO NON-EXERCISE OR PHYSICAL THERAPY EXERCISE ON PAIN, DISABILITY, AND QUALITY OF LIFE FOR PATIENTS WITH CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. BACKGROUND: CHRONIC LOW BACK PAIN (CLBP) IS A COMMON AND OFTEN DISABLING MUSCULOSKELETAL CONDITION. YOGA HAS BEEN PROVEN TO BE AN EFFECTIVE THERAPY FOR CHRONIC LOW BACK PAIN. HOWEVER, THERE ARE STILL CONTROVERSIES ABOUT THE EFFECTS OF YOGA AT DIFFERENT FOLLOW-UP PERIODS AND COMPARED WITH OTHER PHYSICAL THERAPY EXERCISES. OBJECTIVE: TO CRITICALLY COMPARE THE EFFECTS OF YOGA FOR PATIENTS WITH CHRONIC LOW BACK PAIN ON PAIN, DISABILITY, QUALITY OF LIFE WITH NON-EXERCISE (E.G. USUAL CARE, EDUCATION), PHYSICAL THERAPY EXERCISE. METHODS: THIS STUDY WAS REGISTERED IN PROSPERO, AND THE REGISTRATION NUMBER WAS CRD42020159865. RANDOMIZED CONTROLLED TRIALS (RCTS) OF ONLINE DATABASES INCLUDED PUBMED, WEB OF SCIENCE, COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, EMBASE WHICH EVALUATED EFFECTS OF YOGA FOR PATIENTS WITH CHRONIC LOW BACK PAIN ON PAIN, DISABILITY, AND QUALITY OF LIFE WERE SEARCHED FROM INCEPTION TIME TO NOVEMBER 1, 2019. STUDIES WERE ELIGIBLE IF THEY ASSESSED AT LEAST ONE IMPORTANT OUTCOME, NAMELY PAIN, BACK-SPECIFIC DISABILITY, QUALITY OF LIFE. THE COCHRANE RISK OF BIAS TOOL WAS USED TO ASSESS THE METHODOLOGICAL QUALITY OF INCLUDED RANDOMIZED CONTROLLED TRIALS. THE CONTINUOUS OUTCOMES WERE ANALYZED BY CALCULATING THE MEAN DIFFERENCE (MD) OR STANDARDIZED MEAN DIFFERENCE (SMD) WITH 95% CONFIDENCE INTERVALS (CI) ACCORDING TO WHETHER COMBINING OUTCOMES MEASURED ON DIFFERENT SCALES OR NOT. RESULTS: A TOTAL OF 18 RANDOMIZED CONTROLLED TRIALS WERE INCLUDED IN THIS META-ANALYSIS. YOGA COULD SIGNIFICANTLY REDUCE PAIN AT 4 TO 8 WEEKS (MD = -0.83, 95% CI = -1.19 TO -0.48, P<0.00001, I2 = 0%), 3 MONTHS (MD = -0.43, 95% CI = -0.64 TO -0.23, P<0.0001, I2 = 0%), 6 TO 7 MONTHS (MD = -0.56, 95% CI = -1.02 TO -0.11, P = 0.02, I2 = 50%), AND WAS NOT SIGNIFICANT IN 12 MONTHS (MD = -0.52, 95% CI = -1.64 TO 0.59, P = 0.36, I2 = 87%) COMPARED WITH NON-EXERCISE. YOGA WAS BETTER THAN NON-EXERCISE ON DISABILITY AT 4 TO 8 WEEKS (SMD = -0.30, 95% CI = -0.51 TO -0.10, P = 0.003, I2 = 0%), 3 MONTHS (SMD = -0.31, 95% CI = -0.45 TO -0.18, P<0.00001, I2 = 30%), 6 MONTHS (SMD = -0.38, 95% CI = -0.53 TO -0.23, P<0.00001, I2 = 0%), 12 MONTHS (SMD = -0.33, 95% CI = -0.54 TO -0.12, P = 0.002, I2 = 9%). THERE WAS NO SIGNIFICANT DIFFERENCE ON PAIN, DISABILITY COMPARED WITH PHYSICAL THERAPY EXERCISE GROUP. FURTHERMORE, IT SUGGESTED THAT THERE WAS A NON-SIGNIFICANT DIFFERENCE ON PHYSICAL AND MENTAL QUALITY OF LIFE BETWEEN YOGA AND ANY OTHER INTERVENTIONS. CONCLUSION: THIS META-ANALYSIS PROVIDED EVIDENCE FROM VERY LOW TO MODERATE INVESTIGATING THE EFFECTIVENESS OF YOGA FOR CHRONIC LOW BACK PAIN PATIENTS AT DIFFERENT TIME POINTS. YOGA MIGHT DECREASE PAIN FROM SHORT TERM TO INTERMEDIATE TERM AND IMPROVE FUNCTIONAL DISABILITY STATUS FROM SHORT TERM TO LONG TERM COMPARED WITH NON-EXERCISE (E.G. USUAL CARE, EDUCATION). YOGA HAD THE SAME EFFECT ON PAIN AND DISABILITY AS ANY OTHER EXERCISE OR PHYSICAL THERAPY. YOGA MIGHT NOT IMPROVE THE PHYSICAL AND MENTAL QUALITY OF LIFE BASED ON THE RESULT OF A MERGING.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
15  540  41 COMPLIANCE EFFECTS IN A RANDOMISED CONTROLLED TRIAL OF YOGA FOR CHRONIC LOW BACK PAIN: A METHODOLOGICAL STUDY. STUDY DESIGN: METHODOLOGICAL STUDY NESTED WITHIN A MULTICENTRE RANDOMISED CONTROLLED TRIAL (RCT) OF YOGA PLUS USUAL GENERAL PRACTITIONER (GP) CARE VS USUAL GP CARE FOR CHRONIC LOW BACK PAIN. OBJECTIVE: TO EXPLORE THE TREATMENT EFFECTS OF NON-COMPLIANCE USING THREE APPROACHES IN AN RCT EVALUATING YOGA FOR LOW BACK PAIN. SUMMARY OF BACKGROUND DATA: A LARGE MULTICENTRE RCT USING INTENTION-TO-TREAT (ITT) ANALYSIS FOUND THAT PARTICIPANTS WITH CHRONIC LOW BACK PAIN WHO WERE OFFERED A 12-WEEK PROGRESSIVE PROGRAMME OF YOGA PLUS USUAL GP CARE HAD BETTER BACK FUNCTION THAN THOSE OFFERED USUAL GP CARE ALONE. HOWEVER, ITT ANALYSIS CAN UNDERESTIMATE THE EFFECT OF TREATMENT IN THOSE WHO COMPLY WITH TREATMENT. AS SUCH, THE DATA WERE ANALYSED USING OTHER APPROACHES TO ASSESS THE PROBLEM OF NON-COMPLIANCE. THE MAIN OUTCOME MEASURE WAS THE SELF-REPORTED ROLAND MORRIS DISABILITY QUESTIONNAIRE (RMDQ). METHODS: COMPLIER AVERAGE CAUSAL EFFECT (CACE) ANALYSIS, PER-PROTOCOL ANALYSIS AND ON-TREATMENT ANALYSIS WERE CONDUCTED ON THE DATA OF PARTICIPANTS WHO WERE FULLY COMPLIANT, PREDEFINED AS ATTENDANCE OF AT LEAST THREE OF THE FIRST SIX SESSIONS AND AT LEAST THREE OTHER SESSIONS. THE ANALYSIS WAS REPEATED FOR PARTICIPANTS WHO HAD ATTENDED AT LEAST ONE YOGA SESSION (I.E. ANY COMPLIANCE), WHICH INCLUDED PARTICIPANTS WHO WERE FULLY COMPLIANT. EACH APPROACH WAS DESCRIBED, INCLUDING STRENGTHS AND WEAKNESSES, AND THE RESULTS OF THE DIFFERENT APPROACHES WERE COMPARED WITH THOSE OF THE ITT ANALYSIS. RESULTS: FOR THE PARTICIPANTS WHO WERE FULLY COMPLIANT (N=93, 60%), A LARGER BENEFICIAL TREATMENT EFFECT WAS SEEN USING CACE ANALYSIS COMPARED WITH PER-PROTOCOL, ON-TREATMENT AND ITT ANALYSES AT 3 AND 12 MONTHS. THE DIFFERENCE IN MEAN CHANGE IN RMDQ SCORE BETWEEN RANDOMISED GROUPS WAS -3.30 [95% CONFIDENCE INTERVAL (CI) -4.90 TO -1.70, P<0.001] AT 3 MONTHS AND -2.23 (95% CI -3.93 TO -0.53, P=0.010) AT 12 MONTHS FOR CACE ANALYSIS, -3.12 (95% CI -4.26 TO -1.98, P<0.001) AT 3 MONTHS AND -2.11 (95% CI -3.33 TO -0.89, P=0.001) AT 12 MONTHS FOR PER-PROTOCOL ANALYSIS, AND -2.91 (95% CI -4.06 TO -1.76, P<0.001) AT 3 MONTHS AND -2.10 (95% CI -3.31 TO -0.89, P=0.001) AT 12 MONTHS FOR ON-TREATMENT ANALYSIS. FOR THE PARTICIPANTS WHO DEMONSTRATED ANY COMPLIANCE (N=133, 85%), THE RESULTS WERE GENERALLY CONSISTENT WITH THE FULLY COMPLIANT GROUP AT 3 MONTHS, BUT THE TREATMENT EFFECT WAS SMALLER. THE DIFFERENCE IN MEAN CHANGE IN RMDQ SCORE BETWEEN RANDOMISED GROUPS WAS -2.45 (95% CI -3.67 TO -1.24) FOR CACE ANALYSIS, -2.30 (95% CI -3.43 TO 1.17) FOR PER-PROTOCOL ANALYSIS AND -2.15 (95% CI -3.25 TO -1.06) FOR ON-TREATMENT ANALYSIS, WHICH WAS SLIGHTLY LESS THAN THAT FOR ITT ANALYSIS. IN CONTRAST, AT 12 MONTHS, PER-PROTOCOL AND ON-TREATMENT ANALYSES SHOWED A LARGER TREATMENT EFFECT COMPARED WITH CACE AND ITT ANALYSES: PER PROTOCOL ANALYSIS -1.86 (95% CI -3.02 TO -0.71), ON-TREATMENT ANALYSIS -1.99 (95% CI -3.13 TO -0.86) AND CACE ANALYSIS -1.67 (95% CI -2.95 TO -0.40). CONCLUSION: ITT ANALYSIS ESTIMATED A SLIGHTLY SMALLER TREATMENT EFFECT IN PARTICIPANTS WHO COMPLIED WITH TREATMENT. WHEN EXAMINING COMPLIANCE, CACE ANALYSIS IS MORE RIGOROUS THAN PER-PROTOCOL AND ON-TREATMENT ANALYSES. USING CACE ANALYSIS, THE TREATMENT EFFECT WAS LARGER IN PARTICIPANTS WHO COMPLIED WITH TREATMENT COMPARED WITH PARTICIPANTS WHO WERE ALLOCATED TO TREATMENT, AND THE DIFFERENCE BETWEEN ITT AND CACE ANALYSES FOR THE FULLY COMPLIANT GROUP AT 3 MONTHS WAS SMALL BUT CLINICALLY IMPORTANT. PER-PROTOCOL AND ON-TREATMENT ANALYSES MAY PRODUCE UNRELIABLE ESTIMATES WHEN THE EFFECT OF TREATMENT IS SMALL. INTERNATIONAL STANDARD RANDOMISED TRIAL NUMBER REGISTER: ISRCTN 81079604.	2014	

16  193  38 A RANDOMIZED TRIAL COMPARING YOGA, STRETCHING, AND A SELF-CARE BOOK FOR CHRONIC LOW BACK PAIN. BACKGROUND: CHRONIC LOW BACK PAIN IS A COMMON PROBLEM LACKING HIGHLY EFFECTIVE TREATMENT OPTIONS. SMALL TRIALS SUGGEST THAT YOGA MAY HAVE BENEFITS FOR THIS CONDITION. THIS TRIAL WAS DESIGNED TO DETERMINE WHETHER YOGA IS MORE EFFECTIVE THAN CONVENTIONAL STRETCHING EXERCISES OR A SELF-CARE BOOK FOR PRIMARY CARE PATIENTS WITH CHRONIC LOW BACK PAIN. METHODS: A TOTAL OF 228 ADULTS WITH CHRONIC LOW BACK PAIN WERE RANDOMIZED TO 12 WEEKLY CLASSES OF YOGA (92 PATIENTS) OR CONVENTIONAL STRETCHING EXERCISES (91 PATIENTS) OR A SELF-CARE BOOK (45 PATIENTS). BACK-RELATED FUNCTIONAL STATUS (MODIFIED ROLAND DISABILITY QUESTIONNAIRE, A 23-POINT SCALE) AND BOTHERSOMENESS OF PAIN (AN 11-POINT NUMERICAL SCALE) AT 12 WEEKS WERE THE PRIMARY OUTCOMES. OUTCOMES WERE ASSESSED AT BASELINE, 6, 12, AND 26 WEEKS BY INTERVIEWERS UNAWARE OF TREATMENT GROUP. RESULTS: AFTER ADJUSTMENT FOR BASELINE VALUES, 12-WEEK OUTCOMES FOR THE YOGA GROUP WERE SUPERIOR TO THOSE FOR THE SELF-CARE GROUP (MEAN DIFFERENCE FOR FUNCTION, -2.5 [95% CI, -3.7 TO -1.3]; P < .001; MEAN DIFFERENCE FOR SYMPTOMS, -1.1 [95% CI, -1.7 TO -0.4]; P < .001). AT 26 WEEKS, FUNCTION FOR THE YOGA GROUP REMAINED SUPERIOR (MEAN DIFFERENCE, -1.8 [95% CI, -3.1 TO -0.5]; P < .001). YOGA WAS NOT SUPERIOR TO CONVENTIONAL STRETCHING EXERCISES AT ANY TIME POINT. CONCLUSION: YOGA CLASSES WERE MORE EFFECTIVE THAN A SELF-CARE BOOK, BUT NOT MORE EFFECTIVE THAN STRETCHING CLASSES, IN IMPROVING FUNCTION AND REDUCING SYMPTOMS DUE TO CHRONIC LOW BACK PAIN, WITH BENEFITS LASTING AT LEAST SEVERAL MONTHS. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT00447668.	2011	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
17  107  48 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
18 1133  47 EFFICACY OF YOGA FOR VASOMOTOR SYMPTOMS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THIS STUDY AIMS TO DETERMINE THE EFFICACY OF YOGA IN ALLEVIATING VASOMOTOR SYMPTOMS (VMS) FREQUENCY AND BOTHER. METHODS: THIS STUDY WAS A THREE-BY-TWO FACTORIAL, RANDOMIZED CONTROLLED TRIAL. ELIGIBLE WOMEN WERE RANDOMIZED TO YOGA (N = 107), EXERCISE (N = 106), OR USUAL ACTIVITY (N = 142), AND WERE SIMULTANEOUSLY RANDOMIZED TO A DOUBLE-BLIND COMPARISON OF OMEGA-3 FATTY ACID (N = 177) OR PLACEBO (N = 178) CAPSULES. YOGA INTERVENTION CONSISTED OF 12 WEEKLY 90-MINUTE YOGA CLASSES WITH DAILY HOME PRACTICE. PRIMARY OUTCOMES WERE VMS FREQUENCY AND BOTHER ASSESSED BY DAILY DIARIES AT BASELINE, 6 WEEKS, AND 12 WEEKS. SECONDARY OUTCOMES INCLUDED INSOMNIA SYMPTOMS (INSOMNIA SEVERITY INDEX) AT BASELINE AND 12 WEEKS. RESULTS: AMONG 249 RANDOMIZED WOMEN, 237 (95%) COMPLETED 12-WEEK ASSESSMENTS. THE MEAN BASELINE VMS FREQUENCY WAS 7.4 PER DAY (95% CI, 6.6 TO 8.1) IN THE YOGA GROUP AND 8.0 PER DAY (95% CI, 7.3 TO 8.7) IN THE USUAL ACTIVITY GROUP. INTENT-TO-TREAT ANALYSES INCLUDED ALL PARTICIPANTS WITH RESPONSE DATA (N = 237). THERE WAS NO DIFFERENCE BETWEEN INTERVENTION GROUPS IN THE CHANGE IN VMS FREQUENCY FROM BASELINE TO 6 AND 12 WEEKS (MEAN DIFFERENCE [YOGA--USUAL ACTIVITY] FROM BASELINE AT 6 WK, -0.3 [95% CI, -1.1 TO 0.5]; MEAN DIFFERENCE [YOGA--USUAL ACTIVITY] FROM BASELINE AT 12 WK, -0.3 [95% CI, -1.2 TO 0.6]; P = 0.119 ACROSS BOTH TIME POINTS). RESULTS WERE SIMILAR FOR VMS BOTHER. AT WEEK 12, YOGA WAS ASSOCIATED WITH AN IMPROVEMENT IN INSOMNIA SYMPTOMS (MEAN DIFFERENCE [YOGA - USUAL ACTIVITY] IN THE CHANGE IN INSOMNIA SEVERITY INDEX, 1.3 [95% CI, -2.5 TO -0.1]; P = 0.007). CONCLUSIONS: AMONG HEALTHY WOMEN, 12 WEEKS OF YOGA CLASS PLUS HOME PRACTICE, COMPARED WITH USUAL ACTIVITY, DO NOT IMPROVE VMS FREQUENCY OR BOTHER BUT REDUCE INSOMNIA SYMPTOMS.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
19  461  42 CHANGES IN PERCEIVED STRESS AFTER YOGA, PHYSICAL THERAPY, AND EDUCATION INTERVENTIONS FOR CHRONIC LOW BACK PAIN: A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: PERCEIVED STRESS AND MUSCULOSKELETAL PAIN ARE COMMON, ESPECIALLY IN LOW-INCOME POPULATIONS. STUDIES EVALUATING TREATMENTS TO REDUCE STRESS IN PATIENTS WITH CHRONIC PAIN ARE LACKING. WE AIMED TO QUANTIFY THE EFFECT OF TWO EVIDENCE-BASED INTERVENTIONS FOR CHRONIC LOW BACK PAIN (CLBP), YOGA AND PHYSICAL THERAPY (PT), ON PERCEIVED STRESS IN ADULTS WITH CLBP. METHODS: WE USED DATA FROM AN ASSESSOR-BLINDED, PARALLEL-GROUP RANDOMIZED CONTROLLED TRIAL, WHICH RECRUITED PREDOMINANTLY LOW-INCOME AND RACIALLY DIVERSE ADULTS WITH CLBP. PARTICIPANTS (N = 320) WERE RANDOMLY ASSIGNED TO 12 WEEKS OF YOGA, PT, OR BACK PAIN EDUCATION. WE COMPARED CHANGES IN THE 10-ITEM PERCEIVED STRESS SCALE (PSS-10) FROM BASELINE TO 12- AND 52-WEEK FOLLOW-UP AMONG YOGA AND PT PARTICIPANTS WITH THOSE RECEIVING EDUCATION. SUBANALYSES WERE CONDUCTED FOR PARTICIPANTS WITH ELEVATED PRE-INTERVENTION PERCEIVED STRESS (PSS-10 SCORE >/=17). WE CONDUCTED SENSITIVITY ANALYSES USING VARIOUS IMPUTATION METHODS TO ACCOUNT FOR POTENTIAL BIASES IN OUR ESTIMATES DUE TO MISSING DATA. RESULTS: AMONG 248 PARTICIPANTS (MEAN AGE = 46.4 YEARS, 80% NONWHITE) COMPLETING ALL THREE SURVEYS, YOGA AND PT SHOWED GREATER REDUCTIONS IN PSS-10 SCORES COMPARED WITH EDUCATION AT 12 WEEKS (MEAN BETWEEN-GROUP DIFFERENCE = -2.6, 95% CONFIDENCE INTERVAL [CI] = -4.5 TO -0.66, AND MEAN BETWEEN-GROUP DIFFERENCE = -2.4, 95% CI = -4.4 TO -0.48, RESPECTIVELY). THIS EFFECT WAS STRONGER AMONG PARTICIPANTS WITH ELEVATED PRE-INTERVENTION PERCEIVED STRESS. BETWEEN-GROUP EFFECTS HAD ATTENUATED BY 52 WEEKS. RESULTS WERE SIMILAR IN SENSITIVITY ANALYSES. CONCLUSIONS: YOGA AND PT WERE MORE EFFECTIVE THAN BACK PAIN EDUCATION FOR REDUCING PERCEIVED STRESS AMONG LOW-INCOME ADULTS WITH CLBP.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
20 1486  33 INTEGRATIVE EFFECT OF YOGA PRACTICE IN PATIENTS WITH KNEE ARTHRITIS: A PRISMA-COMPLIANT META-ANALYSIS. BACKGROUND: BENEFITS OF YOGA PRACTICE IN PATIENTS WITH KNEE OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS REMAINS CONTROVERSIAL. THIS STUDY PERFORMS A META-ANALYSIS TO QUANTIFY THE EFFICIENCY OF YOGA EXERCISE FOR PATIENTS PAIN REDUCTION, FUNCTIONAL RECOVERY, AND GENERAL WELLBEING. METHODS: A COMPUTERIZED SEARCH OF PUBMED AND EMBASE WAS PERFORMED TO IDENTIFY RELEVANT STUDIES. THE OUTCOME MEASURES WERE PAIN, STIFFNESS, AND PHYSICAL FUNCTION. TWO INVESTIGATORS IDENTIFIED ELIGIBLE STUDIES AND EXTRACTED DATA INDEPENDENTLY. THE QUALITY OF CITATIONS WAS MEASURED USING JADAD SCORE. STANDARDIZED MEAN DIFFERENCES (SMDS) WITH 95% CONFIDENCE INTERVALS (CIS) WERE CALCULATED FOR PAIN, MUSCULOSKELETAL IMPAIRMENT, QUALITY OF LIFE, GENERAL WELLBEING, AND MENTAL WELLBEING. RESULTS: A TOTAL OF 13 CLINICAL TRIALS INVOLVING 1557 PATIENTS WITH KNEE OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS WERE INCLUDED IN FINAL META-ANALYSIS WITH THE AVERAGE JADAD SCORE 2.8. THE SMD WAS -0.98 (95% CI -1.18, -0.78, P < .05) FOR PAIN, -1.83 (95% CI -2.09, -1.57, P < .05) FOR FUNCTIONAL DISABILITY, WAS 0.80 (95% CI 0.59, 1.01, P < .05) FOR SHORT FORM 36 HEALTH SURVEY (SF-36) GENERAL HEALTH, 0.49 (95% CI 0.14, 0.82, P < .05) FOR SF-36 MENTAL HEALTH, AND HAQ WAS -0.55 (95% CI -0.83, -0.26, P < .05) FOR HEALTH ASSOCIATED QUESTIONNAIRE (HAQ). ALL THE RESULTS FAVOR YOGA TRAINING GROUP. CONCLUSIONS: REGULAR YOGA TRAINING IS HELPFUL IN REDUCING KNEE ARTHRITIC SYMPTOMS, PROMOTING PHYSICAL FUNCTION, AND GENERAL WELLBEING IN ARTHRITIC PATIENTS.	2018