1 1948 120 SCAPULAR MUSCLE ACTIVITY DURING STATIC YOGA POSTURES. STUDY DESIGN CONTROLLED, CROSS-SECTIONAL LABORATORY STUDY. BACKGROUND DESPITE THE GROWING POPULARITY OF YOGA, LITTLE IS KNOWN ABOUT THE MUSCLE ACTIVITY OF THE SCAPULAR STABILIZERS DURING ISOMETRIC YOGA POSTURES AND THEIR POTENTIAL UTILITY IN SHOULDER REHABILITATION. OBJECTIVES TO EXAMINE SCAPULAR STABILIZER MUSCLE ACTIVATION DURING VARIOUS YOGA POSTURES. METHODS TWENTY WOMEN WITH YOGA EXPERIENCE AND NO SHOULDER PAIN OR INJURY PARTICIPATED. ELECTROMYOGRAPHY WAS USED TO RECORD THE MUSCLE ACTIVITY OF THE UPPER, MIDDLE, AND LOWER TRAPEZIUS, AS WELL AS OF THE SERRATUS ANTERIOR, DURING 15 YOGA POSTURES. RESULTS MUSCLE ACTIVITY VARIED BETWEEN YOGA POSTURES (3%-57% MAXIMUM VOLUNTARY ISOMETRIC CONTRACTION [MVIC]). OVERALL, THE "LOCUST ARMS FORWARD" POSTURE ELICITED THE HIGHEST ACTIVITY FROM THE UPPER (22.4% MVIC), MIDDLE (41.8% MVIC), AND LOWER (56.8% MVIC) TRAPEZIUS, WHILE SEVERAL POSTURES ELICITED MODERATE ACTIVITY (GREATER THAN 20% MVIC) FROM THE SERRATUS ANTERIOR. CONVERSELY, THE "DANCER'S POSE RIGHT," "REVERSE TABLETOP," AND "WARRIOR II" POSTURES DEMONSTRATED LOW ACTIVITY (LESS THAN OR EQUAL TO 15.7% MVIC) OF THE SCAPULAR STABILIZERS. CONCLUSION STRENGTHENING THE SCAPULAR STABILIZER MUSCLES IS AN IMPORTANT COMPONENT OF SHOULDER REHABILITATION. YOGA POSTURES HAVE BEEN IDENTIFIED THAT ACTIVATE THE SCAPULAR STABILIZER MUSCLES AT VARYING LEVELS OF ACTIVITY. J ORTHOP SPORTS PHYS THER 2018;48(6):504-509. EPUB 6 APR 2018. DOI:10.2519/JOSPT.2018.7311.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
2  638  29 DO PHYSICAL THERAPY AND YOGA IMPROVE PAIN AND DISABILITY THROUGH PSYCHOLOGICAL MECHANISMS? A CAUSAL MEDIATION ANALYSIS OF ADULTS WITH CHRONIC LOW BACK PAIN. OBJECTIVE: TO INVESTIGATE WHETHER INDIRECT EFFECTS VIA PSYCHOLOGICAL MECHANISMS EXPLAIN THE EFFECTS OF PHYSICAL THERAPY (PT) OR YOGA, VERSUS EDUCATION, ON BACK-RELATED OUTCOMES. DESIGN: MEDIATION ANALYSES USING DATA FROM A RANDOMIZED CONTROLLED TRIAL OF PT, YOGA, AND EDUCATION INTERVENTIONS FOR CHRONIC LOW BACK PAIN. METHODS: PRIMARY OUTCOMES WERE CHANGES IN BACK-RELATED PAIN ON THE 11-POINT NUMERICAL RATING SCALE AND DISABILITY ON THE MODIFIED 23-POINT ROLAND MORRIS DISABILITY QUESTIONNAIRE, MEASURED AT 52-WEEKS POST-RANDOMIZATION. HYPOTHESIZED MEDIATORS WERE 12-WEEK CHANGES IN PAIN SELF-EFFICACY, FEAR AVOIDANCE BELIEFS, DEPRESSION, ANXIETY, PERCEIVED STRESS, AND SLEEP QUALITY. WE USED CAUSAL MEDIATION ANALYSIS TO ESTIMATE THE TOTAL EFFECT, DIRECT EFFECT, INDIRECT EFFECT, AND PROPORTION MEDIATED. RESULTS: WE ANALYZED DATA FROM 230 ADULTS (MEAN AGE = 46.2 YEARS, 69.6% FEMALE, 79.6% NON-WHITE). IN THE PT VERSUS EDUCATION MODEL, WHEN THE MEDIATOR WAS PERCEIVED STRESS, THE TOTAL EFFECT ON DISABILITY WAS 2.6 POINTS (95% CI: 0.3, 4.9) AND DECOMPOSED INTO A DIRECT EFFECT OF 1.7 POINTS (95% CI: -0.4, 3.8) AND AN INDIRECT EFFECT 0.9 POINTS (95% CI: 0.1, 2.0; PROPORTION MEDIATED 34%). NO OTHER PSYCHOLOGICAL CONSTRUCT WAS A SIGNIFICANT MEDIATOR. CONCLUSION: IMPROVEMENTS IN PERCEIVED STRESS MEDIATED IMPROVEMENTS IN DISABILITY AFTER PT TREATMENT COMPARED TO EDUCATION. OTHER PSYCHOLOGICAL OUTCOMES DID NOT MEDIATE THE EFFECT OF YOGA OR PT ON PAIN OR DISABILITY OUTCOMES COMPARED TO EDUCATION. J ORTHOP SPORTS PHYS THER, EPUB 18 MAY 2022. DOI:10.2519/JOSPT.2022.10813.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
3  235  23 A SYSTEMATIC REVIEW OF YOGA INTERVENTIONS FOR HELPING HEALTH PROFESSIONALS AND STUDENTS. HELPING HEALTH PROFESSIONALS (HHP) AND HHP STUDENTS ARE AMONG THE HIGHEST RISK OCCUPATIONAL GROUPS FOR COMPROMISED MENTAL AND PHYSICAL HEALTH. THERE IS A PAUCITY OF INFORMATION REGARDING PREVENTIVE INTERVENTIONS FOR MENTAL AND PHYSICAL HEALTH IN THIS GROUP OF HEALTHCARE PROVIDERS. OBJECTIVE: THE OBJECTIVE OF THIS REVIEW WAS TO EXAMINE THE EFFECTIVENESS OF YOGA INTERVENTIONS FOR THE PREVENTION AND REDUCTION OF MENTAL AND PHYSICAL DISORDERS AMONG HHPS AND HHP STUDENTS. DESIGN: AN EXHAUSTIVE SYSTEMATIC SEARCH WAS CONDUCTED IN MAY 2020. DATABASES SEARCHED IN THE OVID INTERFACE INCLUDED: MEDLINE(R) AND EPUB AHEAD OF PRINT, IN-PROCESS & OTHER NON-INDEXED CITATIONS AND DAILY, EMBASE, AND PSYCINFO. EBSCOHOST DATABASES SEARCHED INCLUDED: CINAHL PLUS WITH FULL TEXT, SPORTDISCUS WITH FULL TEXT, ALT HEALTHWATCH, EDUCATION RESEARCH COMPLETE, SOCINDEX WITH FULL TEXT, ERIC, AND ACADEMIC SEARCH COMPLETE. SCOPUS WAS ALSO SEARCHED. RESULTS: THE SEARCH YIELDED 4,973 RECORDS, AND AFTER REMOVAL OF DUPLICATES 3197 RECORDS REMAINED. USING INCLUSION AND EXCLUSION CRITERIA, TITLES AND ABSTRACTS WERE SCREENED AND FULL TEXT ARTICLES (N = 82) WERE RETRIEVED AND SCREENED. TWENTY-FIVE STUDIES WERE IDENTIFIED FOR INCLUSION IN THIS REVIEW. MOST FREQUENTLY REPORTED FINDINGS OF YOGA INTERVENTIONS IN THIS POPULATION INCLUDED A REDUCTION IN STRESS, ANXIETY, DEPRESSION, AND MUSCULOSKELETAL PAIN. CONCLUSION: IT IS OUR CONCLUSION THAT MENTAL AND PHYSICAL BENEFITS CAN BE OBTAINED THROUGH IMPLEMENTATION OF YOGA INTERVENTIONS FOR HHPS AND HHP STUDENTS ACROSS A VARIETY OF SETTINGS AND BACKGROUNDS. HOWEVER, RESEARCHERS WOULD BENEFIT FROM FOLLOWING RECOMMENDED GUIDELINES FOR THE DESIGN AND REPORTING OF YOGA INTERVENTIONS TO IMPROVE STUDY QUALITY AND RIGOUR.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
4  461  25 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
5  643  18 DOES YOGA ENGENDER FITNESS IN OLDER ADULTS? A CRITICAL REVIEW. INTEREST IN YOGA IS GROWING, ESPECIALLY AMONG OLDER ADULTS. THIS REVIEW CRITICALLY SUMMARIZES THE CURRENT LITERATURE TO INVESTIGATE WHETHER PHYSICAL FITNESS AND FUNCTION BENEFITS ARE ENGENDERED THROUGH THE PRACTICE OF YOGA IN OLDER ADULTS. A COMPREHENSIVE SEARCH YIELDED 507 STUDIES; 10 STUDIES WITH 544 PARTICIPANTS (69.6 +/- 6.3 YR, 71% FEMALE) WERE INCLUDED. LARGE VARIABILITY IN YOGA STYLES AND MEASUREMENT OUTCOMES MAKE IT CHALLENGING TO INTERPRET RESULTS ACROSS STUDIES. STUDIES REPORTED MODERATE IMPROVEMENTS FOR GAIT (ES = 0.54, 0.80), BALANCE (ES = 0.25-1.61), UPPER/LOWER BODY FLEXIBILITY (ES = 0.25, 0.70), LOWER BODY STRENGTH (ES = 0.51), AND WEIGHT LOSS (ES = 0.73, 0.99).YOGA MAY ENGENDER IMPROVEMENTS IN SOME COMPONENTS OF FITNESS IN OLDER ADULTS. HOWEVER, MORE EVIDENCE IS NEEDED TO DETERMINE ITS EFFECTIVENESS AS AN ALTERNATIVE EXERCISE TO PROMOTE FITNESS IN OLDER ADULTS. FURTHER INVESTIGATION INTO YOGA AS AN EXERCISE ACTIVITY FOR OLDER ADULTS IS WARRANTED.	2011	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
6  465  29 CHARACTERISTICS AND PREDICTORS OF SHORT-TERM OUTCOMES IN INDIVIDUALS SELF-SELECTING YOGA OR PHYSICAL THERAPY FOR TREATMENT OF CHRONIC LOW BACK PAIN. OBJECTIVE: TO COMPARE CLINICAL AND DEMOGRAPHIC CHARACTERISTICS OF INDIVIDUALS SELF-SELECTING YOGA OR PHYSICAL THERAPY (PT) FOR TREATMENT OF CHRONIC LOW BACK PAIN (CLBP) AND TO EXAMINE PREDICTORS OF SHORT-TERM PAIN AND FUNCTIONAL OUTCOMES. DESIGN: DESCRIPTIVE, LONGITUDINAL STUDY. SETTINGS: A HOSPITAL-BASED CLINIC THAT OFFERS MODIFIED INTEGRAL YOGA CLASSES FOR CLBP AND 2 OUTPATIENT PT CLINICS THAT OFFER EXERCISE-BASED PT. PARTICIPANTS: ADULTS (N=53) WITH CLBP>/=12 WEEKS: YOGA (N=27), PT (N=26). METHODS: YOGA PARTICIPANTS ATTENDED A 6-WEEK, ONCE WEEKLY, 2-HOUR YOGA CLASS. PT PARTICIPANTS UNDERWENT TWICE WEEKLY, 1-HOUR INDIVIDUALIZED PT. DATA WERE COLLECTED AT BASELINE AND AT 6 WEEKS. GROUPS WERE COMPARED BY USING CHI2 AND INDEPENDENT SAMPLES T-TESTS. HIERARCHICAL LINEAR REGRESSION WAS USED TO PREDICT TREATMENT OUTCOMES. MAIN OUTCOME MEASURES: DISABILITY (ROLAND MORRIS DISABILITY QUESTIONNAIRE), HEALTH STATUS (RAND SHORT FORM 36 HEALTH SURVEY 1.0), PAIN BOTHERSOMENESS (NUMERICAL RATING SCALE), BACK PAIN SELF-EFFICACY (BACK PAIN SELF-EFFICACY SCALE), AND TREATMENT SATISFACTION. RESULTS: AT BASELINE, YOGA PARTICIPANTS WERE SIGNIFICANTLY LESS DISABLED (P=.013), HAD HIGHER HEALTH STATUS (P=.023), GREATER PAIN SELF-EFFICACY (P=.012), AND LESS AVERAGE PAIN BOTHERSOMENESS (P=.001) COMPARED WITH PT PARTICIPANTS. AT 6 WEEKS, WHEN CONTROLLING FOR BASELINE GROUP DIFFERENCES, GREATER PAIN SELF-EFFICACY WAS THE STRONGEST PREDICTOR FOR REDUCED PAIN AND HIGHER FUNCTION FOR THE ENTIRE SAMPLE. A SIGNIFICANT GROUP INTERACTION BY BASELINE PAIN SELF-EFFICACY PREDICTED DISABILITY AT 6 WEEKS. PT PARTICIPANTS WITH LOW PAIN SELF-EFFICACY REPORTED SIGNIFICANTLY GREATER DISABILITY THAN THOSE WITH HIGH PAIN SELF-EFFICACY. YOGA PARTICIPANTS WITH LOW AND HIGH PAIN SELF-EFFICACY HAD SIMILAR DISABILITY OUTCOMES. CONCLUSION: THESE FINDINGS STRENGTHEN EVIDENCE THAT SELF-EFFICACY IS ASSOCIATED WITH CLBP OUTCOMES, ESPECIALLY IN INDIVIDUALS SELF-SELECTING PT. FURTHER RESEARCH TO EVALUATE OUTCOMES AFTER YOGA AND PT IN PARTICIPANTS WITH LOW PAIN SELF-EFFICACY IS NEEDED.	2010	
                                                                                                                                                                                                                                                                          
7 2374  30 WHICH CHRONIC LOW BACK PAIN PATIENTS RESPOND FAVORABLY TO YOGA, PHYSICAL THERAPY, AND A SELF-CARE BOOK? RESPONDER ANALYSES FROM A RANDOMIZED CONTROLLED TRIAL. PURPOSE: TO IDENTIFY BASELINE CHARACTERISTICS OF ADULTS WITH CHRONIC LOW BACK PAIN (CLBP) THAT PREDICT RESPONSE (I.E., A CLINICALLY IMPORTANT IMPROVEMENT) AND/OR MODIFY TREATMENT EFFECT ACROSS THREE NONPHARMACOLOGIC INTERVENTIONS. DESIGN: SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. SETTING: ACADEMIC SAFETY NET HOSPITAL AND SEVEN FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS. SUBJECTS: ADULTS WITH CLBP (N = 299). METHODS: WE REPORT PATIENT CHARACTERISTICS THAT WERE PREDICTORS OF RESPONSE AND/OR MODIFIED TREATMENT EFFECT ACROSS THREE 12-WEEK TREATMENTS: YOGA, PHYSICAL THERAPY [PT], AND A SELF-CARE BOOK. USING PRESELECTED CHARACTERISTICS, WE USED LOGISTIC REGRESSION TO IDENTIFY PREDICTORS OF "RESPONSE," DEFINED AS A >/=30% IMPROVEMENT IN THE ROLAND MORRIS DISABILITY QUESTIONNAIRE. THEN, USING "RESPONSE" AS OUR OUTCOME, WE IDENTIFIED BASELINE CHARACTERISTICS THAT WERE TREATMENT EFFECT MODIFIERS BY TESTING FOR STATISTICAL INTERACTION (P < 0.05) ACROSS TWO COMPARISONS: 1) YOGA-OR-PT VS SELF-CARE AND 2) YOGA VS PT. RESULTS: OVERALL, 39% (116/299) OF PARTICIPANTS WERE RESPONDERS, WITH MORE RESPONDERS IN THE YOGA-OR-PT GROUP (42%) THAN THE SELF-CARE (23%) GROUP. THERE WAS NO DIFFERENCE IN PROPORTION RESPONDING TO YOGA (48%) VS PT (37%, ODDS RATIO [OR] = 1.5, 95% CONFIDENCE INTERVAL = 0.88 - 2.6). PREDICTORS OF RESPONSE INCLUDED HAVING MORE THAN A HIGH SCHOOL EDUCATION, A HIGHER INCOME, EMPLOYMENT, FEW DEPRESSIVE SYMPTOMS, LOWER PERCEIVED STRESS, FEW WORK-RELATED FEAR AVOIDANCE BELIEFS, HIGH PAIN SELF-EFFICACY, AND BEING A NONSMOKER. EFFECT MODIFIERS INCLUDED USE OF PAIN MEDICATION AND FEAR AVOIDANCE BELIEFS RELATED TO PHYSICAL ACTIVITY (BOTH P = 0.02 FOR INTERACTION). WHEN COMPARING YOGA OR PT WITH SELF-CARE, A GREATER PROPORTION WERE RESPONDERS AMONG THOSE USING PAIN MEDS (OR = 5.3), WHICH DIFFERED FROM THOSE NOT TAKING PAIN MEDS (OR = 0.94) AT BASELINE. WE ALSO FOUND GREATER TREATMENT RESPONSE AMONG THOSE WITH LOWER (OR = 7.0), BUT NOT HIGH (OR = 1.3), FEAR AVOIDANCE BELIEFS AROUND PHYSICAL ACTIVITY. CONCLUSIONS: OUR FINDINGS REVEALED IMPORTANT SUBGROUPS FOR WHOM REFERRAL TO YOGA OR PT MAY IMPROVE CLBP OUTCOMES.	2021	
                                                                                                                                                                          
8  518  24 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
9  460  23 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                          
10 2852  31 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	
                                                                                                                               
11 2851  26 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	
                                                                                                                                                                                                               
12 1699  35 PARTICIPANT CHARACTERISTICS ASSOCIATED WITH SYMPTOMATIC IMPROVEMENT FROM YOGA FOR CHRONIC LOW BACK PAIN. CONTEXT: STUDIES SUGGEST THAT YOGA IS EFFECTIVE FOR MODERATE TO SEVERE CHRONIC LOW BACK PAIN (CLBP) IN DIVERSE PREDOMINANTLY LOWER SOCIOECONOMIC STATUS POPULATIONS. HOWEVER, LITTLE IS KNOWN ABOUT FACTORS ASSOCIATED WITH BENEFIT FROM THE YOGA INTERVENTION. OBJECTIVE: IDENTIFY FACTORS AT BASELINE INDEPENDENTLY ASSOCIATED WITH GREATER EFFICACY AMONG PARTICIPANTS IN A STUDY OF YOGA FOR CLBP. DESIGN: FROM SEPTEMBER-DECEMBER 2011, A 12-WEEK RANDOMIZED DOSING TRIAL WAS CONDUCTED COMPARING WEEKLY VS. TWICE-WEEKLY 75-MINUTE HATHA YOGA CLASSES FOR 95 PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH NONSPECIFIC CLBP. PARTICIPANT CHARACTERISTICS COLLECTED AT BASELINE WERE USED TO DETERMINE FACTORS BEYOND TREATMENT ASSIGNMENT (REPORTED IN THE INITIAL STUDY) THAT PREDICTED OUTCOME. WE USED BIVARIATE TESTING TO IDENTIFY BASELINE CHARACTERISTICS ASSOCIATED WITH IMPROVEMENT IN FUNCTION AND PAIN, AND INCLUDED SELECT FACTORS IN A MULTIVARIATE LINEAR REGRESSION. SETTING: RECRUITMENT AND CLASSES OCCURRED IN AN ACADEMIC SAFETY-NET HOSPITAL AND FIVE AFFILIATED COMMUNITY HEALTH CENTERS IN BOSTON, MASSACHUSETTS. PARTICIPANTS: NINETY-FIVE ADULTS WITH NONSPECIFIC CLBP, AGES RANGING FROM 20-64 (MEAN 48) YEARS; 72 WOMEN AND 23 MEN. OUTCOME MEASURES: PRIMARY OUTCOMES WERE CHANGES IN BACK-RELATED FUNCTION (MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE, RMDQ; 0-23) AND MEAN LOW BACK PAIN INTENSITY (0-10) IN THE PREVIOUS WEEK, FROM BASELINE TO WEEK 12. RESULTS: ADJUSTING FOR GROUP ASSIGNMENT, BASELINE RMDQ, AGE, AND GENDER, FOREIGN NATIONALITY AND LOWER BASELINE SF36 PHYSICAL COMPONENT SCORE (PCS) WERE INDEPENDENTLY ASSOCIATED WITH IMPROVEMENT IN RMDQ. GREATER THAN HIGH SCHOOL EDUCATION LEVEL, CLBP LESS THAN 1 YEAR, AND LOWER BASELINE SF36 PCS WERE INDEPENDENTLY ASSOCIATED WITH IMPROVEMENT IN PAIN INTENSITY. OTHER DEMOGRAPHICS INCLUDING RACE, INCOME, GENDER, BMI, AND USE OF PAIN MEDICATIONS WERE NOT ASSOCIATED WITH EITHER OUTCOME. CONCLUSIONS: POOR PHYSICAL HEALTH AT BASELINE IS ASSOCIATED WITH GREATER IMPROVEMENT FROM YOGA IN BACK-RELATED FUNCTION AND PAIN. RACE, INCOME, AND BODY MASS INDEX DO NOT AFFECT THE POTENTIAL FOR A PERSON WITH LOW BACK PAIN TO EXPERIENCE BENEFIT FROM YOGA.	2014	
                                                                                                                                                                                          
13  430  26 CAN YOGA OR PHYSICAL THERAPY FOR CHRONIC LOW BACK PAIN IMPROVE DEPRESSION AND ANXIETY AMONG ADULTS FROM A RACIALLY DIVERSE, LOW-INCOME COMMUNITY? A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: TO DETERMINE AND COMPARE THE EFFECT OF YOGA, PHYSICAL THERAPY (PT), AND EDUCATION ON DEPRESSIVE AND ANXIOUS SYMPTOMS IN PATIENTS WITH CHRONIC LOW BACK PAIN (CLBP). DESIGN: SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. SETTING: ACADEMIC SAFETY NET HOSPITAL AND 7 COMMUNITY HEALTH CENTERS. PARTICIPANTS: A TOTAL OF 320 ADULTS WITH CLBP. INTERVENTION: YOGA CLASSES, PT SESSIONS, OR AN EDUCATIONAL BOOK. OUTCOME MEASURE: DEPRESSION AND ANXIETY WERE MEASURED USING THE PATIENT HEALTH QUESTIONNAIRE AND GENERALIZED ANXIETY DISORDER 7-ITEM SCALE, RESPECTIVELY, AT BASELINE, 12, AND 52 WEEKS. WE IDENTIFIED BASELINE AND MIDTREATMENT (6-WK) FACTORS ASSOCIATED WITH CLINICALLY MEANINGFUL IMPROVEMENTS IN DEPRESSIVE (>/=3 POINTS) OR ANXIOUS (>/=2 POINTS) SYMPTOMS AT 12 WEEKS. RESULTS: PARTICIPANTS (FEMALE=64%; MEAN AGE, 46.0+/-10.7 YEARS) WERE PREDOMINANTLY NON-WHITE (82%), LOW-INCOME (<$30,000/YEAR, 59%), AND HAD NOT RECEIVED A COLLEGE DEGREE (71%). MOST PARTICIPANTS HAD MILD OR WORSE DEPRESSIVE (60%) AND ANXIOUS (50%) SYMPTOMS. AT 12 WEEKS, YOGA AND PT PARTICIPANTS EXPERIENCED MODEST WITHIN-GROUP IMPROVEMENTS IN DEPRESSIVE SYMPTOMS (MEAN DIFFERENCE [MD]=-1.23 [95% CI, -2.18 TO -0.28]; MD=-1.01 [95% CI, -2.05 TO -0.03], RESPECTIVELY). COMPARED WITH THE EDUCATION GROUP, 12-WEEK DIFFERENCES WERE NOT STATISTICALLY SIGNIFICANT, ALTHOUGH TRENDS FAVORED YOGA (MD=-0.71 [95% CI, -2.22 TO 0.81]) AND PT (MD= -0.32 [95% CI, -1.82 TO 1.18]). AT 12 WEEKS, IMPROVEMENTS IN ANXIOUS SYMPTOMS WERE ONLY FOUND IN PARTICIPANTS WHO HAD MILD OR MODERATE ANXIETY AT BASELINE. INDEPENDENT OF TREATMENT ARM, PARTICIPANTS WHO HAD 30% OR GREATER IMPROVEMENT IN PAIN OR FUNCTION MIDTREATMENT WERE MORE LIKELY TO HAVE A CLINICALLY MEANINGFUL IMPROVEMENT IN DEPRESSIVE SYMPTOMS (ODDS RATIO [OR], 1.82 [95% CI, 1.03-3.22]; OR, 1.79 [95% CI, 1.06-3.04], RESPECTIVELY). CONCLUSIONS: IN OUR SECONDARY ANALYSIS WE FOUND THAT DEPRESSION AND ANXIETY, COMMON IN THIS SAMPLE OF UNDERSERVED ADULTS WITH CLBP, MAY IMPROVE MODESTLY WITH PT AND YOGA. HOWEVER, EFFECTS WERE NOT SUPERIOR TO EDUCATION. IMPROVEMENTS IN PAIN AND FUNCTION ARE ASSOCIATED WITH A DECREASE IN DEPRESSIVE SYMPTOMS. MORE RESEARCH IS NEEDED TO OPTIMIZE THE INTEGRATION OF PHYSICAL AND PSYCHOLOGICAL WELL-BEING IN PT AND YOGA.	2021	

14  236  21 A SYSTEMATIC REVIEW: THE EFFECTS OF YOGA ON PREGNANCY. OBJECTIVE: A SYSTEMATIC REVIEW WAS CONDUCTED TO UPDATE AND PROVIDE A COMPREHENSIVE OVERVIEW ON THE PSYCHOLOGICAL EFFECTS OF ANTENATAL YOGA ON PREGNANCY COMPARED TO STANDARD PRENATAL CARE. STUDY DESIGN: FOUR DATABASES WERE SEARCHED USING KEYWORDS "YOGA", "PREGNANCY", "PERINATAL CARE", "PRENATAL CARE", "POSTNATAL CARE", "POSTPARTUM PERIOD", "PERIPARTUM PERIOD", "PATIENT OUTCOME ASSESSMENT", "OUTCOME ASSESSMENT", "PREGNANCY OUTCOME", "TREATMENT OUTCOME". TRIALS WERE CONSIDERED IF THEY WERE RANDOMIZED CONTROLLED TRIALS (RCTS) PUBLISHED FROM 2011 TO 2018 AND EVALUATED AN ANTENATAL YOGA INTERVENTION. ALL STUDIES WERE ASSESSED FOR RISK OF BIAS USING THE COCHRANE CRITERIA. TRIAL CHARACTERISTICS AND OUTCOMES WERE EXTRACTED AND SYNTHESIZED DESCRIPTIVELY WHERE POSSIBLE. DUE TO HETEROGENEITY, META-ANALYSIS WAS NOT POSSIBLE. RESULTS: OF THE 175 NON-DUPLICATED STUDIES, 16 MET CRITERIA FOR FULL-TEXT REVIEW. FIVE RCTS MET THE INCLUSION CRITERIA AND WERE INCLUDED IN THE SYSTEMATIC REVIEW. THE FINDINGS OF THE RCTS SUGGEST ANTENATAL YOGA MAY BE SAFE AND MAY EFFECTIVELY DECREASE STRESS LEVELS, ANXIETY SCORES, DEPRESSION SCORES, AND PAIN RESPONSE AS WELL AS INCREASING MATERNAL IMMUNITY AND EMOTIONAL-WELLBEING. CONCLUSION: YOGA APPEARS TO BE SAFE AND MAY IMPROVE PSYCHOLOGICAL AND PREGNANCY OUTCOMES. HOWEVER, DUE TO THE LIMITED NUMBER OF STUDIES, MORE HIGH-QUALITY, LARGE RCTS ARE NEEDED TO DRAW CONCLUSIONS ABOUT IMPROVEMENT IN OTHER PREGNANCY OUTCOMES.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
15 2066  21 THE CHARACTERISTICS AND EFFECTIVENESS OF PREGNANCY YOGA INTERVENTIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: YOGA IS A POPULAR MIND-BODY MEDICINE FREQUENTLY RECOMMENDED TO PREGNANT WOMEN. GAPS REMAIN IN OUR UNDERSTANDING OF THE CORE COMPONENTS OF EFFECTIVE PREGNANCY YOGA PROGRAMMES. THIS SYSTEMATIC REVIEW AND META-ANALYSIS EXAMINED THE CHARACTERISTICS AND EFFECTIVENESS OF PREGNANCY YOGA INTERVENTIONS, INCORPORATING THE FITT (FREQUENCY, INTENSITY, TIME/DURATION AND TYPE) PRINCIPLE OF EXERCISE PRESCRIPTION. METHODS: NINE ELECTRONIC DATABASES WERE SEARCHED: MEDLINE, PSYCINFO, EMBASE, CINAHL, WHOLIS, AMED, SCIELO, ASSIA AND WEB OF SCIENCE. RANDOMISED CONTROL TRIALS AND QUASI-EXPERIMENTAL STUDIES EXAMINING PREGNANCY YOGA INTERVENTIONS WERE ELIGIBLE. COVIDENCE WAS USED TO SCREEN TITLES, ABSTRACTS, AND FULL-TEXT ARTICLES. OUTCOMES OF INTEREST WERE STRESS, ANXIETY, DEPRESSION, QUALITY OF LIFE, LABOUR DURATION, PAIN MANAGEMENT IN LABOUR AND MODE OF BIRTH. THE COCHRANE COLLABORATION'S RISK OF BIAS ASSESSMENT TOOL WAS USED TO ASSESS METHODOLOGICAL QUALITY OF STUDIES AND GRADE CRITERIA (GRADEPRO) EVALUATED QUALITY OF THE EVIDENCE. META-ANALYSIS WAS PERFORMED USING REVMAN 5.3. RESULTS: OF 862 CITATIONS RETRIEVED, 31 STUDIES MET INCLUSION CRITERIA. TWENTY-NINE STUDIES WITH 2217 PREGNANT WOMEN WERE INCLUDED FOR META-ANALYSIS. PREGNANCY YOGA INTERVENTIONS REDUCED ANXIETY (SMD: -0.91; 95% CI: - 1.49 TO - 0.33; P = 0.002), DEPRESSION (SMD: -0.47; 95% CI: - 0.9 TO - 0.04, P = 0.03) AND PERCEIVED STRESS (SMD: -1.03; 95% CI: - 1.55 TO - 0.52; P < 0.001). YOGA INTERVENTIONS ALSO REDUCED DURATION OF LABOUR (MD = - 117.75; 95% CI - 153.80 TO - 81.71, P < 0.001) AND, INCREASED ODDS OF NORMAL VAGINAL BIRTH (OR 2.58; 95% CI 1.46-4.56, P < 0.001) AND TOLERANCE FOR PAIN. THE QUALITY OF EVIDENCE (GRADE CRITERIA) WAS LOW TO VERY LOW FOR ALL OUTCOMES. TWELVE OR MORE YOGA SESSIONS DELIVERED WEEKLY/BI-WEEKLY HAD A STATISTICALLY SIGNIFICANT IMPACT ON MODE OF BIRTH, WHILE 12 OR MORE YOGA SESSIONS OF LONG DURATION (> 60 MIN) HAD A STATISTICALLY SIGNIFICANT IMPACT ON PERCEIVED STRESS. CONCLUSION: THE EVIDENCE HIGHLIGHTS POSITIVE EFFECTS OF PREGNANCY YOGA ON ANXIETY, DEPRESSION, PERCEIVED STRESS, MODE OF BIRTH AND DURATION OF LABOUR. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42019119916. REGISTERED ON 11TH JANUARY 2019.	2022	
                                                                                                                                            
16 2506  19 YOGA ATTITUDES IN CHRONIC LOW BACK PAIN: ROLES OF CATASTROPHIZING AND FEAR OF MOVEMENT. CHRONIC LOW BACK PAIN IS A SIGNIFICANT PUBLIC HEALTH PROBLEM AND, ALTHOUGH UNDERUSED, YOGA MAY BE AN EFFECTIVE COMPLEMENTARY TREATMENT. THE CURRENT STUDY EXAMINED ASSOCIATIONS OF PAIN CATASTROPHIZING AND FEAR OF MOVEMENT WITH ATTITUDES TOWARD YOGA IN ADULTS WITH CHRONIC LOW BACK PAIN. PARTICIPANTS COMPLETED THREE QUANTITATIVE QUESTIONNAIRES ASSESSING SPECIFIC CONSTRUCTS: BELIEFS ABOUT YOGA, FEAR OF MOVEMENT, AND PAIN CATASTROPHIZING. A SEMI-STRUCTURED IN-PERSON INTERVIEW WAS THEN CONDUCTED TO OBTAIN SPECIFIC PAIN-RELATED INFORMATION. HIERARCHICAL REGRESSION AND MEDIATIONAL ANALYSES WERE USED TO TEST HYPOTHESES. CONSISTENT WITH THE FEAR-AVOIDANCE MODEL OF CHRONIC PAIN, CATASTROPHIZING AND FEAR OF MOVEMENT WERE NEGATIVELY ASSOCIATED WITH YOGA ATTITUDES. SPECIFICALLY, FEAR OF MOVEMENT WAS A MEDIATOR BETWEEN CATASTROPHIZING AND ATTITUDES TOWARD YOGA. INDIVIDUALS WITH HIGHER LEVELS OF CATASTROPHIZING AND FEAR OF MOVEMENT MAY BE LESS LIKELY TO CONSIDER A PAIN TREATMENT INVOLVING PHYSICAL MOVEMENT.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
17  218  22 A SYSTEMATIC REVIEW AND META-ANALYSIS ESTIMATING THE EXPECTED DROPOUT RATES IN RANDOMIZED CONTROLLED TRIALS ON YOGA INTERVENTIONS. A REASONABLE ESTIMATION OF EXPECTED DROPOUT RATES IS VITAL FOR ADEQUATE SAMPLE SIZE CALCULATIONS IN RANDOMIZED CONTROLLED TRIALS (RCTS). UNDERESTIMATING EXPECTED DROPOUTS RATES INCREASES THE RISK OF FALSE NEGATIVE RESULTS WHILE OVERESTIMATING RATES RESULTS IN OVERLY LARGE SAMPLE SIZES, RAISING BOTH ETHICAL AND ECONOMIC ISSUES. TO ESTIMATE EXPECTED DROPOUT RATES IN RCTS ON YOGA INTERVENTIONS, MEDLINE/PUBMED, SCOPUS, INDMED, AND THE COCHRANE LIBRARY WERE SEARCHED THROUGH FEBRUARY 2014; A TOTAL OF 168 RCTS WERE META-ANALYZED. OVERALL DROPOUT RATE WAS 11.42% (95% CONFIDENCE INTERVAL [CI] = 10.11%, 12.73%) IN THE YOGA GROUPS; RATES WERE COMPARABLE IN USUAL CARE AND PSYCHOLOGICAL CONTROL GROUPS AND WERE SLIGHTLY HIGHER IN EXERCISE CONTROL GROUPS (RATE = 14.53%; 95% CI = 11.56%, 17.50%; ODDS RATIO = 0.82; 95% CI = 0.68, 0.98; P = 0.03). FOR RCTS WITH DURATIONS ABOVE 12 WEEKS, DROPOUT RATES IN YOGA GROUPS INCREASED TO 15.23% (95% CI = 11.79%, 18.68%). THE UPPER BORDER OF 95% CIS FOR DROPOUT RATES COMMONLY WAS BELOW 20% REGARDLESS OF STUDY ORIGIN, HEALTH CONDITION, GENDER, AGE GROUPS, AND INTERVENTION CHARACTERISTICS; HOWEVER, IT EXCEEDED 40% FOR STUDIES ON HIV PATIENTS OR HETEROGENEOUS AGE GROUPS. IN CONCLUSION, DROPOUT RATES CAN BE EXPECTED TO BE LESS THAN 15 TO 20% FOR MOST RCTS ON YOGA INTERVENTIONS. YET DROPOUT RATES BEYOND 40% ARE POSSIBLE DEPENDING ON THE PARTICIPANTS' SOCIODEMOGRAPHIC AND HEALTH CONDITION.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
18  230  25 A SYSTEMATIC REVIEW OF YOGA FOR BALANCE IN A HEALTHY POPULATION. OBJECTIVE: A SYSTEMATIC REVIEW WAS DONE OF THE EVIDENCE ON YOGA FOR IMPROVING BALANCE. DESIGN: RELEVANT ARTICLES AND REVIEWS WERE IDENTIFIED IN MAJOR DATABASES (PUBMED, MEDLINE((R)), INDMED, WEB OF KNOWLEDGE, EMBASE, EBSCO, SCIENCE DIRECT, AND GOOGLE SCHOLAR), AND THEIR REFERENCE LISTS SEARCHED. KEY SEARCH WORDS WERE YOGA, BALANCE, PROPRIOCEPTION, FALLING, FEAR OF FALLING, AND FALLS. INCLUDED STUDIES WERE PEER-REVIEWED ARTICLES PUBLISHED IN ENGLISH BEFORE JUNE 2012, USING HEALTHY POPULATIONS. ALL YOGA STYLES AND STUDY DESIGNS WERE INCLUDED. TWO (2) RATERS INDIVIDUALLY RATED STUDY QUALITY USING THE DOWNS & BLACK (DB) CHECKLIST. FINAL SCORES WERE ACHIEVED BY CONSENSUS. ACHIEVABLE SCORES RANGED FROM 0 TO 27. EFFECT SIZE (ES) WAS CALCULATED WHERE POSSIBLE. RESULTS: FIFTEEN (15) OF 152 STUDIES (AGE RANGE 10-93, N=688) MET THE INCLUSION CRITERIA: 5 RANDOMIZED CONTROLLED TRIALS (RCTS), 4 QUASI-EXPERIMENTAL, 2 CROSS-SECTIONAL, AND 4 SINGLE-GROUP DESIGNS. DB SCORES RANGED FROM 10 TO 24 (RCTS), 14-19 (QUASI-EXPERIMENTAL), 6-12 (CROSS-SECTIONAL), AND 11-20 (SINGLE GROUP). STUDIES VARIED BY YOGA STYLE, FREQUENCY OF PRACTICE, AND DURATION. ELEVEN (11) STUDIES FOUND POSITIVE RESULTS (P<0.05) ON AT LEAST ONE BALANCE OUTCOME. ES RANGED FROM -0.765 TO 2.71 (FOR 8 STUDIES) AND WAS NOT ASSOCIATED WITH DB SCORE. CONCLUSIONS: YOGA MAY HAVE A BENEFICIAL EFFECT ON BALANCE, BUT VARIABLE STUDY DESIGN AND POOR REPORTING QUALITY OBSCURE THE RESULTS. BALANCE AS AN OUTCOME IS UNDERUTILIZED, AND MORE PROBING MEASURES ARE NEEDED.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
19  193  24 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
20 1283  40 GLUTEAL MUSCLE ACTIVATION DURING COMMON YOGA POSES. BACKGROUND: APPROXIMATELY 24% OF PHYSICAL THERAPISTS REPORT REGULARLY USING YOGA TO STRENGTHEN MAJOR MUSCLE GROUPS. ALTHOUGH CLINICIANS AND ATHLETES OFTEN USE YOGA AS A FORM OF STRENGTH TRAINING, LITTLE IS KNOWN ABOUT THE ACTIVATION OF SPECIFIC MUSCLE GROUPS DURING YOGA POSES, INCLUDING THE GLUTEUS MAXIMUS AND MEDIUS. HYPOTHESIS/PURPOSE: THE PURPOSE OF THIS STUDY WAS TO MEASURE GLUTEUS MAXIMIMUS AND GLUTEUS MEDIUS ACTIVATION VIA ELECTROMYOGRAPHY (EMG) DURING FIVE COMMON YOGA POSES. A SECONDARY PURPOSE OF THE CURRENT STUDY WAS TO EXAMINE DIFFERENCES IN MUSCLE ACTIVATION BETWEEN SEXES AND EXPERIENCE LEVELS. STUDY DESIGN: CROSS-SECTIONAL. METHODS: THIRTY-ONE HEALTHY MALES AND FEMALES AGED 18-35 YEARS WERE TESTED DURING FIVE YOGA POSES PERFORMED IN A RANDOMIZED ORDER. SURFACE EMG ELECTRODES WERE PLACED ON SUBJECTS' RIGHT GLUTEUS MAXIMUS AND GLUTEUS MEDIUS. SUBJECTS PERFORMED THE POSES ON BOTH SIDES FOLLOWING A MAXIMAL VOLUNTARY ISOMETRIC CONTRACTION (MVIC) TEST FOR EACH MUSCLE. ALL YOGA POSE EMG DATA WERE NORMALIZED TO THE CORRESPONDING MUSCLE MVIC DATA. RESULTS: HIGHEST GLUTEUS MAXIMUS ACTIVATION OCCURRED DURING HALF MOON POSE ON THE LIFTED/BACK LEG (63.3% MVIC), FOLLOWED BY THE STANCE/FRONT LEG DURING HALF MOON POSE (61.7%), THEN THE LIFTED/BACK LEG DURING WARRIOR THREE POSE (46.1%). HIGHEST GLUTEUS MEDIUS ACTIVATION OCCURRED DURING HALF MOON POSE ON THE LIFTED/BACK LEG (41.9%), FOLLOWED BY THE LIFTED/BACK LEG DURING THE WARRIOR THREE POSE (41.6%). A SIGNIFICANT DIFFERENCE WAS FOUND IN %MVIC OF GLUTEUS MEDIUS ACTIVITY BETWEEN MALE AND FEMALE SUBJECTS (P = 0.026), AND BETWEEN EXPERIENCED AND INEXPERIENCED SUBJECTS (P = 0.050), INDICATING HIGHER ACTIVATION AMONG MALES AND INEXPERIENCED SUBJECTS, RESPECTIVELY. CONCLUSION: HALF MOON POSE AND WARRIOR THREE POSE ELICITED THE HIGHEST ACTIVATION FOR BOTH THE GLUTEUS MAXIMUS AND THE GLUTEUS MEDIUS. HIGHER GLUTEUS MEDIUS ACTIVATION WAS SEEN IN MALES AND INEXPERIENCED SUBJECTS COMPARED TO THEIR FEMALE AND EXPERIENCED COUNTERPARTS. LEVEL OF EVIDENCE: 3.	2021