1  430 177 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	
                                                                                                                                                                                                  
2 2852  79 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	
                                                                                                                                                                                                                                                                                                                                 
3 2851  89 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	
                                                                                                                                                                                                                                                                                                                                                                                                                 
4  460  69 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
5  518  57 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
6 2878  29 YOGA-TEACHING PROTOCOL ADAPTED FOR CHILDREN WITH VISUAL IMPAIRMENT. CONTEXT: CHILDHOOD VISUAL DEFICIENCY IMPAIRS CHILDREN'S NEURO-PSYCHOMOTOR DEVELOPMENT, CONSIDERABLY AFFECTING PHYSICAL, MENTAL, SOCIAL, AND EMOTIONAL HEALTH. YOGA'S MULTIFACETED APPROACH MAY HELP CHILDREN WITH VISUAL IMPAIRMENT (VI) TO COPE WITH THEIR CHALLENGES. AIM: THIS STUDY AIMED TO DEVELOP A SPECIAL PROTOCOL FOR TEACHING YOGA TO CHILDREN WITH VI, AND TO EVALUATE THEIR PREFERRED METHOD OF LEARNING. METHODS: THE STUDY WAS CARRIED OUT AT RAMANA MAHARISHI ACADEMY FOR THE BLIND, BENGALURU, SOUTH INDIA. FORTY-ONE STUDENTS VOLUNTEERED TO LEARN YOGA PRACTICES, AND CLASSES WERE HELD WEEKLY 5 DAYS, 1 HR PER SESSION FOR 16 WEEKS. THE STUDY INTRODUCED A NEW METHOD USING A SEQUENCE OF FIVE TEACHING STEPS: VERBAL INSTRUCTIONS, TACTILE MODELING, STEP-BY-STEP TEACHING, LEARNING IN A GROUP, AND PHYSICAL GUIDANCE. A QUESTIONNAIRE CONCERNING THE PREFERRED STEPS OF LEARNING WAS THEN GIVEN TO EACH STUDENT, AND VERBAL ANSWERS WERE OBTAINED. RESULTS: A TOTAL OF 33 (OUT OF 41), AGED 11.97 +/- 1.94, 15 GIRLS AND 18 BOYS RESPONDED. TWENTY-SIX (78.79%) CHOSE PHYSICAL GUIDANCE AS THEIR MOST FAVORED LEARNING MODE. CONCLUSIONS: SPECIALLY DESIGNED PROTOCOL MAY PAVE THE WAY TO IMPART YOGA IN AN EXCITING AND COMFORTABLE WAY TO CHILDREN WITH VI. MORE STUDIES ARE NEEDED TO FURTHER INVESTIGATE THE EFFECTIVENESS OF THIS NEW YOGA PROTOCOL IN SIMILAR SETTINGS.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
7  461  67 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
8  187  66 A RANDOMIZED PREFERENCE TRIAL COMPARING COGNITIVE-BEHAVIORAL THERAPY AND YOGA FOR THE TREATMENT OF LATE-LIFE WORRY: EXAMINATION OF IMPACT ON DEPRESSION, GENERALIZED ANXIETY, FATIGUE, PAIN, SOCIAL PARTICIPATION, AND PHYSICAL FUNCTION. BACKGROUND: DEPRESSION, GENERALIZED ANXIETY, FATIGUE, DIMINISHED PHYSICAL FUNCTION, REDUCED SOCIAL PARTICIPATION, AND PAIN ARE COMMON FOR MANY OLDER ADULTS AND NEGATIVELY IMPACT QUALITY OF LIFE. THE PURPOSE OF THE OVERALL TRIAL WAS TO COMPARE THE EFFECTS OF COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA ON LATE-LIFE WORRY, ANXIETY, AND SLEEP; AND EXAMINE PREFERENCE AND SELECTION EFFECTS ON THESE OUTCOMES. OBJECTIVE: THE PRESENT ANALYSES COMPARED EFFECTS OF THE 2 INTERVENTIONS ON ADDITIONAL OUTCOMES (DEPRESSIVE SYMPTOMS, GENERALIZED ANXIETY SYMPTOMS, FATIGUE, PAIN INTERFERENCE/INTENSITY, PHYSICAL FUNCTION, SOCIAL PARTICIPATION); AND EXAMINED WHETHER THERE ARE PREFERENCE AND SELECTION EFFECTS FOR THESE TREATMENTS. METHODS: A RANDOMIZED PREFERENCE TRIAL OF CBT AND YOGA WAS CONDUCTED IN ADULTS >/=60 YEARS WHO SCORED >/=26 ON THE PENN STATE WORRY QUESTIONNAIRE-ABBREVIATED (PSWQ-A), RECRUITED FROM OUTPATIENT MEDICAL CLINICS, MAILINGS, AND ADVERTISEMENTS. COGNITIVE-BEHAVIORAL THERAPY CONSISTED OF 10 WEEKLY TELEPHONE SESSIONS. YOGA CONSISTED OF 20 BI-WEEKLY GROUP YOGA CLASSES. PARTICIPANTS WERE RANDOMIZED TO(1): A RANDOMIZED CONTROLLED TRIAL (RCT) OF CBT OR YOGA (N = 250); OR (2) A PREFERENCE TRIAL IN WHICH THEY SELECTED THEIR TREATMENT (CBT OR YOGA; N = 250). OUTCOMES WERE MEASURED AT BASELINE AND POST-INTERVENTION. RESULTS: WITHIN THE RCT, THERE WERE SIGNIFICANT BETWEEN-GROUP DIFFERENCES FOR BOTH PAIN INTERFERENCE AND INTENSITY. THE PAIN INTERFERENCE SCORE IMPROVED MORE FOR THE CBT GROUP COMPARED WITH THE YOGA GROUP [INTERVENTION EFFECT OF (MEAN (95% CI) = 2.5 (.5, 4.6), P = .02]. FOR THE PAIN INTENSITY SCORE, THE INTERVENTION EFFECT ALSO FAVORED CBT OVER YOGA [.7 (.2, 1.3), P < .01]. DEPRESSIVE SYMPTOMS, GENERALIZED ANXIETY, AND FATIGUE SHOWED CLINICALLY MEANINGFUL WITHIN-GROUP CHANGES IN BOTH GROUPS. THERE WERE NO CHANGES IN OR DIFFERENCE BETWEEN PHYSICAL FUNCTION OR SOCIAL PARTICIPATION FOR EITHER GROUP. NO PREFERENCE OR SELECTION EFFECTS WERE FOUND. CONCLUSION: BOTH CBT AND YOGA MAY BE USEFUL FOR OLDER ADULTS FOR IMPROVING PSYCHOLOGICAL SYMPTOMS AND FATIGUE. COGNITIVE-BEHAVIORAL THERAPY MAY OFFER EVEN GREATER BENEFIT THAN YOGA FOR DECREASING PAIN.	2022	
                                                                                                                                                                                                                                                                  
9  524  53 COMPARISON OF COGNITIVE-BEHAVIORAL THERAPY AND YOGA FOR THE TREATMENT OF LATE-LIFE WORRY: A RANDOMIZED PREFERENCE TRIAL. BACKGROUND: THE PURPOSE OF THIS STUDY WAS TO COMPARE THE EFFECTS OF COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA ON LATE-LIFE WORRY, ANXIETY, AND SLEEP; AND EXAMINE PREFERENCE AND SELECTION EFFECTS ON THESE OUTCOMES. METHODS: A RANDOMIZED PREFERENCE TRIAL OF CBT AND YOGA WAS CONDUCTED IN COMMUNITY-DWELLING ADULTS 60 YEARS OR OLDER, WHO SCORED 26 OR ABOVE ON THE PENN STATE WORRY QUESTIONNAIRE-ABBREVIATED (PSWQ-A). CBT CONSISTED OF 10 WEEKLY TELEPHONE SESSIONS. YOGA CONSISTED OF 20 BIWEEKLY GROUP YOGA CLASSES. THE PRIMARY OUTCOME WAS WORRY (PSWQ-A); THE SECONDARY OUTCOMES WERE ANXIETY (PROMIS-ANXIETY) AND SLEEP (INSOMNIA SEVERITY INDEX [ISI]). WE EXAMINED BOTH PREFERENCE EFFECTS (AVERAGE EFFECT FOR THOSE WHO RECEIVED THEIR PREFERRED INTERVENTION [REGARDLESS OF WHETHER IT WAS CBT OR YOGA] MINUS THE AVERAGE FOR THOSE WHO DID NOT RECEIVE THEIR PREFERRED INTERVENTION [REGARDLESS OF THE INTERVENTION]) AND SELECTION EFFECT (WHICH ADDRESSES THE QUESTION OF WHETHER THERE IS A BENEFIT TO GETTING TO SELECT ONE INTERVENTION OVER THE OTHER, AND MEASURES THE EFFECT ON OUTCOMES OF SELF-SELECTION TO A SPECIFIC INTERVENTION). RESULTS: FIVE HUNDRED OLDER ADULTS WERE RANDOMIZED TO THE RANDOMIZED TRIAL (125 EACH IN CBT AND YOGA) OR THE PREFERENCE TRIAL (120 CHOSE CBT; 130 CHOSE YOGA). IN THE RANDOMIZED TRIAL, THE INTERVENTION EFFECT OF YOGA COMPARED WITH CBT ADJUSTED FOR BASELINE PSYCHOTROPIC MEDICATION USE, GENDER, AND RACE WAS 1.6 (-0.2, 3.3), P = .08 FOR THE PSWQ-A. SIMILAR RESULTS WERE OBSERVED WITH PROMIS-ANXIETY (ADJUSTED INTERVENTION EFFECT: 0.3 [-1.5, 2.2], P = .71). PARTICIPANTS RANDOMIZED TO CBT EXPERIENCED A GREATER REDUCTION IN THE ISI COMPARED WITH YOGA (ADJUSTED INTERVENTION EFFECT: 2.4 [1.2, 3.7], P < .01]). ESTIMATED IN THE COMBINED DATA SET (N = 500), THE PREFERENCE AND SELECTION EFFECTS WERE NOT SIGNIFICANT FOR THE PSWQ-A, PROMIS-ANXIETY, AND ISI. OF THE 52 ADVERSE EVENTS, ONLY TWO WERE POSSIBLY RELATED TO THE INTERVENTION. NONE OF THE 26 SERIOUS ADVERSE EVENTS WERE RELATED TO THE STUDY INTERVENTIONS. CONCLUSIONS: CBT AND YOGA WERE BOTH EFFECTIVE AT REDUCING LATE-LIFE WORRY AND ANXIETY. HOWEVER, A GREATER IMPACT WAS SEEN FOR CBT COMPARED WITH YOGA FOR IMPROVING SLEEP. NEITHER PREFERENCE NOR SELECTION EFFECTS WAS FOUND.	2020	
                                                                                                                                                                                                                                                                                                         
10  465  55 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
11  521  63 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
12  193  53 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
13 2104  46 THE EFFECT OF YOGA ON HEALTH-RELATED FITNESS AMONG PATIENTS WITH TYPE 2 DIABETES MELLITUS: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: THERE IS A NEED FOR A TYPE OF PHYSICAL ACTIVITY THAT COULD ADDRESS THE CHALLENGING CYCLE OF PHYSICAL INACTIVITY, IMPAIRED HEALTH-RELATED FITNESS, AND TYPE 2 DIABETES MELLITUS (T2DM) CONDITIONS. YOGA COULD BE ONE TYPE OF EXERCISE TO OVERCOME THE BARRIERS TO ADHERE TO REGULAR PHYSICAL ACTIVITY. THE CURRENT STUDY AIMED TO SYSTEMATICALLY REVIEW THE EFFECT OF YOGA ON HEALTH-RELATED FITNESS, INCLUDING CARDIORESPIRATORY FITNESS, MUSCLE STRENGTH, BODY COMPOSITION, BALANCE, AND FLEXIBILITY, AMONG PATIENTS WITH T2DM. METHODS: WE SYSTEMATICALLY SEARCHED FOUR DATABASES AND TWO REGISTRIES (PUBMED, SCOPUS, COCHRANE, EMBASE, WHO-ITCRP, AND CLINICALTRIALS.GOV) IN SEPTEMBER 2021, FOLLOWING A REGISTERED PROTOCOL ON PROSPERO (CRD42022276225). STUDY INCLUSION CRITERIA WERE T2DM PATIENTS WITH OR WITHOUT COMPLICATION, YOGA INTERVENTION AS A SINGLE COMPONENT OR AS A COMPLEMENT COMPARED TO OTHER KINDS OF EXERCISE OR AN INACTIVE CONTROL, HEALTH-RELATED FITNESS, AND A RANDOMIZED, CONTROLLED TRIAL OR QUASI-EXPERIMENTAL WITH CONTROL GROUP DESIGN. THE ROBINS-I TOOL AND ROB 2.0 TOOL WERE USED TO ASSESS THE RISK OF BIAS IN THE INCLUDED STUDIES. A VOTE-COUNTING ANALYSIS AND META-ANALYSIS COMPUTED USING RANDOM EFFECTS' MODELS WERE CONDUCTED. RESULTS: A TOTAL OF 10 RECORDS FROM 3 QUASI-EXPERIMENTAL AND 7 RANDOMIZED, CONTROLLED TRIALS WITH 815 PARTICIPANTS IN TOTAL WERE INCLUDED. THE META-ANALYSIS FAVORED YOGA GROUPS COMPARED TO INACTIVE CONTROLS IN IMPROVING MUSCLE STRENGTH BY 3.42 (95% CONFIDENCE INTERVAL 2.42 TO 4.43), REPETITIONS OF CHAIR STAND TEST, AND IMPROVING CARDIORESPIRATORY FITNESS BY 6.6% (95% CONFIDENCE INTERVAL 0.4 TO 12.8) IMPROVEMENT OF BASELINE FORCED VITAL CAPACITY. THE QUALITY OF EVIDENCE FOR BOTH OUTCOMES WAS LOW. CONCLUSION: LOW-QUALITY EVIDENCE FAVORED YOGA IN IMPROVING HEALTH-RELATED FITNESS, PARTICULARLY MUSCLE STRENGTH AND CARDIORESPIRATORY FITNESS, AMONG PATIENTS WITH T2DM. FUNDING: ALL AUTHORS IN THIS SYSTEMATIC REVIEW RECEIVED NO SPECIFIC GRANT FROM ANY FUNDING AGENCY IN THE PUBLIC, COMMERCIAL, OR NOT-FOR-PROFIT SECTORS.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
14 2360  36 VIDEOCONFERENCED YOGA INTERVENTIONS FOR CANCER PATIENTS AND THEIR CAREGIVERS DURING THE COVID-19 PANDEMIC: A REPORT FROM A CLINICIAN'S PERSPECTIVE. BACKGROUND: THE ACCEPTABILITY OF VIDEOCONFERENCING DELIVERY OF YOGA INTERVENTIONS IN THE ADVANCED CANCER SETTING IS RELATIVELY UNEXPLORED. THE CURRENT REPORT SUMMARIZES THE CHALLENGES AND SOLUTIONS OF THE TRANSITION FROM AN IN-PERSON (IE, FACE-TO-FACE) TO A VIDEOCONFERENCE INTERVENTION DELIVERY APPROACH IN RESPONSE TO THE CORONAVIRUS DISEASE PANDEMIC. METHOD: PARTICIPANTS INCLUDED PATIENT-FAMILY CAREGIVER DYADS WHO WERE ENROLLED IN ONGOING YOGA TRIALS AND 2 CERTIFIED YOGA THERAPISTS WHO DELIVERED THE YOGA SESSIONS. WE SUMMARIZED THEIR EXPERIENCES USING RECORDINGS OF THE YOGA SESSIONS AND INTERVENTIONISTS' PROGRESS NOTES. RESULTS: OUT OF 7 DYADS PARTICIPATING IN THE PARENT TRIAL, 1 DECLINED THE VIDEOCONFERENCED SESSIONS. PARTICIPANTS WERE BETWEEN THE AGES OF 55 AND 76 AND MOSTLY NON-HISPANIC WHITE (83%). PATIENTS WERE MAINLY MALE (83%), ALL HAD STAGE III OR IV CANCER AND WERE UNDERGOING RADIOTHERAPY. CAREGIVERS WERE ALL FEMALE. DESPITE CHALLENGES IN THE AREAS OF TECHNOLOGY, LOCATION, AND SETTING, INSTRUCTION AND PERSONAL CONNECTION, THE OVERALL ACCEPTABILITY WAS HIGH AMONG PATIENTS, CAREGIVERS, AND INSTRUCTORS. THROUGH THIS TRANSITION PROCESS, SOLUTIONS TO THESE CHALLENGES WERE FOUND, WHICH ARE DESCRIBED HERE. CONCLUSION: ALTHOUGH IN-PERSON INTERVENTIONS ARE FAVORED BY BOTH THE STUDY PARTICIPANTS AND THE INTERVENTIONISTS, VIDEOCONFERENCE SESSIONS WERE DEEMED ACCEPTABLE. ALL PARTICIPANTS HAD THE BENEFIT OF A PREVIOUS IN-PERSON EXPERIENCE, WHICH WAS HELPFUL AND PERHAPS NECESSARY FOR OLDER AND ADVANCED CANCER PATIENTS REQUIRING PRACTICE MODIFICATIONS. IN A REMOTE SETTING, THE ASSISTANCE OF CAREGIVERS SEEMS PARTICULARLY BENEFICIAL TO ENSURE PRACTICE SAFETY. CLINICALTRIALS.GOV: NCT03948100; NCT02481349.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
15 1557  61 LONG-TERM EFFECTS OF COGNITIVE-BEHAVIORAL THERAPY AND YOGA FOR WORRIED OLDER ADULTS. OBJECTIVES: COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA DECREASE WORRY AND ANXIETY. THERE ARE NO LONG-TERM DATA COMPARING CBT AND YOGA FOR WORRY, ANXIETY, AND SLEEP IN OLDER ADULTS. THE IMPACT OF PREFERENCE AND SELECTION ON THESE OUTCOMES IS UNKNOWN. IN THIS SECONDARY DATA ANALYSIS, WE COMPARED LONG-TERM EFFECTS OF CBT BY TELEPHONE AND YOGA ON WORRY, ANXIETY, SLEEP, DEPRESSIVE SYMPTOMS, FATIGUE, PHYSICAL FUNCTION, SOCIAL PARTICIPATION, AND PAIN; AND EXAMINED PREFERENCE AND SELECTION EFFECTS. DESIGN: IN THIS RANDOMIZED PREFERENCE TRIAL, PARTICIPANTS (N = 500) WERE RANDOMIZED TO A: 1) RANDOMIZED CONTROLLED TRIAL (RCT) OF CBT OR YOGA (N = 250); OR 2) PREFERENCE TRIAL (SELECTED CBT OR YOGA; N = 250). OUTCOMES WERE MEASURED AT BASELINE AND WEEK 37. SETTING: COMMUNITY. PARTICIPANTS: COMMUNITY-DWELLING OLDER ADULTS (AGE 60+ YEARS). INTERVENTIONS: CBT (BY TELEPHONE) AND YOGA (IN-PERSON GROUP CLASSES). MEASUREMENTS: PENN STATE WORRY QUESTIONNAIRE - ABBREVIATED (WORRY);(1)(,)(2) INSOMNIA SEVERITY INDEX (SLEEP);(3) PROMIS ANXIETY SHORT FORM V1.0 (ANXIETY);(4)(,)(5) GENERALIZED ANXIETY DISORDER SCREENER (GENERALIZED ANXIETY);(6)(,)(7) AND PROMIS-29 (DEPRESSION, FATIGUE, PHYSICAL FUNCTION, SOCIAL PARTICIPATION, PAIN).(8)(,)(9) RESULTS: SIX MONTHS AFTER INTERVENTION COMPLETION, CBT AND YOGA RCT PARTICIPANTS REPORTED SUSTAINED IMPROVEMENTS FROM BASELINE IN WORRY, ANXIETY, SLEEP, DEPRESSIVE SYMPTOMS, FATIGUE, AND SOCIAL PARTICIPATION (NO SIGNIFICANT BETWEEN-GROUP DIFFERENCES). USING DATA COMBINED FROM THE RANDOMIZED AND PREFERENCE TRIALS, THERE WERE NO SIGNIFICANT PREFERENCE OR SELECTION EFFECTS. LONG-TERM INTERVENTION EFFECTS WERE OBSERVED AT CLINICALLY MEANINGFUL LEVELS FOR MOST OF THE STUDY OUTCOMES. CONCLUSIONS: CBT AND YOGA BOTH DEMONSTRATED MAINTAINED IMPROVEMENTS FROM BASELINE ON MULTIPLE OUTCOMES SIX MONTHS AFTER INTERVENTION COMPLETION IN A LARGE SAMPLE OF OLDER ADULTS. TRIAL REGISTRATION: WWW. CLINICALTRIALS: GOV IDENTIFIER NCT02968238.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
16  106  26 A PILOT RANDOMIZED CONTROLLED TRIAL COMPARING PRENATAL YOGA TO PERINATAL HEALTH EDUCATION FOR ANTENATAL DEPRESSION. WE CONDUCTED A PILOT RANDOMIZED CONTROLLED TRIAL (RCT) COMPARING A PRENATAL YOGA INTERVENTION TO PERINATAL-FOCUSED HEALTH EDUCATION IN PREGNANT WOMEN WITH DEPRESSION. FINDINGS DOCUMENT ACCEPTABILITY AND FEASIBILITY OF THE YOGA INTERVENTION: NO YOGA-RELATED INJURIES WERE OBSERVED, INSTRUCTORS SHOWED FIDELITY TO THE YOGA MANUAL, AND WOMEN RATED INTERVENTIONS AS ACCEPTABLE. ALTHOUGH IMPROVEMENTS IN DEPRESSION WERE NOT STATISTICALLY DIFFERENT BETWEEN GROUPS, THEY FAVORED YOGA. THIS STUDY PROVIDES SUPPORT FOR A LARGER SCALE RCT EXAMINING PRENATAL YOGA TO IMPROVE MOOD DURING PREGNANCY.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
17 2558  60 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                       
18  638  59 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
19 2831  60 YOGA VS. PHYSICAL THERAPY VS. EDUCATION FOR CHRONIC LOW BACK PAIN IN PREDOMINANTLY MINORITY POPULATIONS: STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN CAUSES SUBSTANTIAL MORBIDITY AND COST TO SOCIETY WHILE DISPROPORTIONATELY IMPACTING LOW-INCOME AND MINORITY ADULTS. SEVERAL RANDOMIZED CONTROLLED TRIALS SHOW YOGA IS AN EFFECTIVE TREATMENT. HOWEVER, THE COMPARATIVE EFFECTIVENESS OF YOGA AND PHYSICAL THERAPY, A COMMON MAINSTREAM TREATMENT FOR CHRONIC LOW BACK PAIN, IS UNKNOWN. METHODS/DESIGN: THIS IS A RANDOMIZED CONTROLLED TRIAL FOR 320 PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH CHRONIC LOW BACK PAIN, COMPARING YOGA, PHYSICAL THERAPY, AND EDUCATION. INCLUSION CRITERIA ARE ADULTS 18-64 YEARS OLD WITH NON-SPECIFIC LOW BACK PAIN LASTING >/= 12 WEEKS AND A SELF-REPORTED AVERAGE PAIN INTENSITY OF >/= 4 ON A 0-10 SCALE. RECRUITMENT TAKES PLACE AT BOSTON MEDICAL CENTER, AN URBAN ACADEMIC SAFETY-NET HOSPITAL AND SEVEN FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS LOCATED IN DIVERSE NEIGHBORHOODS. THE 52-WEEK STUDY HAS AN INITIAL 12-WEEK TREATMENT PHASE WHERE PARTICIPANTS ARE RANDOMIZED IN A 2:2:1 RATIO INTO I) A STANDARDIZED WEEKLY HATHA YOGA CLASS SUPPLEMENTED BY HOME PRACTICE; II) A STANDARDIZED EVIDENCE-BASED EXERCISE THERAPY PROTOCOL ADAPTED FROM THE TREATMENT BASED CLASSIFICATION METHOD, INDIVIDUALLY DELIVERED BY A PHYSICAL THERAPIST AND SUPPLEMENTED BY HOME PRACTICE; AND III) EDUCATION DELIVERED THROUGH A SELF-CARE BOOK. CO-PRIMARY OUTCOME MEASURES ARE 12-WEEK PAIN INTENSITY MEASURED ON AN 11-POINT NUMERICAL RATING SCALE AND BACK-SPECIFIC FUNCTION MEASURED USING THE MODIFIED ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 40-WEEK MAINTENANCE PHASE, YOGA PARTICIPANTS ARE RE-RANDOMIZED IN A 1:1 RATIO TO EITHER STRUCTURED MAINTENANCE YOGA CLASSES OR HOME PRACTICE ONLY. PHYSICAL THERAPY PARTICIPANTS ARE SIMILARLY RE-RANDOMIZED TO EITHER FIVE BOOSTER SESSIONS OR HOME PRACTICE ONLY. EDUCATION PARTICIPANTS CONTINUE TO FOLLOW RECOMMENDATIONS OF EDUCATIONAL MATERIALS. WE WILL ALSO ASSESS COST EFFECTIVENESS FROM THE PERSPECTIVES OF THE INDIVIDUAL, INSURERS, AND SOCIETY USING CLAIMS DATABASES, ELECTRONIC MEDICAL RECORDS, SELF-REPORT COST DATA, AND STUDY RECORDS. QUALITATIVE DATA FROM INTERVIEWS WILL ADD SUBJECTIVE DETAIL TO COMPLEMENT QUANTITATIVE DATA. TRIAL REGISTRATION: THIS TRIAL IS REGISTERED IN CLINICALTRIALS.GOV, WITH THE ID NUMBER: NCT01343927.	2014	
                                                                                                                                                                                                                                                  
20 1787  62 PREFERENCE AND EXPECTATION FOR TREATMENT ASSIGNMENT IN A RANDOMIZED CONTROLLED TRIAL OF ONCE- VS TWICE-WEEKLY YOGA FOR CHRONIC LOW BACK PAIN. BACKGROUND: IN STUDIES INVOLVING NONPHARMACOLOGICAL COMPLEMENTARY AND ALTERNATIVE MEDICINE INTERVENTIONS, PARTICIPANT BLINDING IS VERY DIFFICULT. PARTICIPANT EXPECTATIONS MAY AFFECT PERCEIVED BENEFIT OF THERAPY. IN STUDIES OF YOGA AS TREATMENT FOR CHRONIC LOW BACK PAIN, LITTLE IS KNOWN ABOUT THE RELATIONSHIP BETWEEN PATIENT EXPECTATIONS AND PREFERENCES ON OUTCOMES. THIS STUDY WAS DESIGNED TO IDENTIFY BASELINE PREDICTORS OF PREFERENCE AND TO DETERMINE IF EXPECTATIONS AND PREFERENCES FOR DIFFERENT DOSES OF YOGA AFFECT BACK-RELATED FUNCTION AND LOW BACK PAIN INTENSITY. METHODS: THIS WAS A SECONDARY DATA ANALYSIS OF A 12-WEEK RANDOMIZED CONTROLLED TRIAL COMPARING ONCE-WEEKLY VS TWICE-WEEKLY YOGA FOR TREATMENT OF CHRONIC LOW BACK PAIN IN 93 ADULTS FROM A PREDOMINANTLY LOW-INCOME MINORITY POPULATION. AT BASELINE, PARTICIPANTS WERE ASKED ABOUT BACK FUNCTION, BACK PAIN, TREATMENT EXPECTATIONS, AND TREATMENT PREFERENCES. WE CREATED A VARIABLE "CONCORDANCE" TO DESCRIBE THE MATCHING OF PARTICIPANT PREFERENCE TO RANDOMIZED TREATMENT. OUR OUTCOME VARIABLES WERE CHANGE IN BACK FUNCTION AND PAIN INTENSITY AFTER 12 WEEKS OF YOGA INSTRUCTION. WE PERFORMED LOGISTIC REGRESSION TO IDENTIFY PREDICTORS OF PREFERENCE FOR ONCE- OR TWICE-WEEKLY YOGA INSTRUCTION. WE CREATED LINEAR REGRESSION MODELS TO IDENTIFY INDEPENDENT ASSOCIATIONS BETWEEN EXPECTATIONS, PREFERENCE, CONCORDANCE, AND OUTCOMES. RESULTS: WORSE BACK FUNCTION AT BASELINE WAS ASSOCIATED WITH 20% HIGHER ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 1.2, CI 1.1, 1.3). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR TWICE-WEEKLY YOGA HAD 90% HIGHER ODDS OF PREFERRING TWICE-WEEKLY VS ONCE-WEEKLY YOGA (OR 1.9, CI 1.3, 2.7). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR ONCE-WEEKLY YOGA HAD 40% LESS ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 0.6, CI 0.5, 0.9). AFTER CONTROLLING FOR BASELINE CHARACTERISTICS, WE FOUND NO STATISTICALLY SIGNIFICANT RELATIONSHIP BETWEEN TREATMENT OUTCOMES, PREFERENCE, EXPECTATION SCORES, OR CONCORDANCE. CONCLUSION: IN A POPULATION OF PREDOMINANTLY LOW-INCOME MINORITY PARTICIPANTS WITH CHRONIC LOW BACK PAIN, WORSE BACK FUNCTION WAS ASSOCIATED WITH PREFERENCE FOR MORE FREQUENT YOGA CLASSES. THOSE WHO PREFERRED MORE YOGA CLASSES HAD HIGHER EXPECTATIONS FOR THOSE CLASSES. TWELVE-WEEK CHANGE IN BACK PAIN INTENSITY AND BACK FUNCTION WERE NOT AFFECTED BY DOSING PREFERENCE, EXPECTATION SCORE, OR CONCORDANCE. MORE RESEARCH IS NEEDED TO BETTER MEASURE AND QUANTIFY PREFERENCE, EXPECTATIONS, AND THEIR RELATIONSHIP TO OUTCOMES IN YOGA RESEARCH.	2015