1 988 169 EFFECTS OF HATHA YOGA ON BLOOD PRESSURE, SALIVARY ALPHA-AMYLASE, AND CORTISOL FUNCTION AMONG NORMOTENSIVE AND PREHYPERTENSIVE YOUTH. OBJECTIVE: EVIDENCE IS ACCUMULATING, PREDOMINANTLY AMONG CLINICAL TRIALS IN ADULTS, THAT YOGA IMPROVES BLOOD PRESSURE (BP) CONTROL, WITH DOWNREGULATION OF THE HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS AND THE SYMPATHETIC NERVOUS SYSTEM (SNS) PROJECTED AS UNDERLYING MECHANISMS. THIS PILOT STUDY ASSESSED WHETHER HATHA YOGA HAS THE POTENTIAL TO REDUCE BP AMONG YOUTH AND WHETHER DAMPENING OF THE SNS AND/OR HPA ACTIVITY IS A LIKELY PATHWAY OF CHANGE. DESIGN: THIRTY-ONE SEVENTH GRADERS WERE RANDOMLY ASSIGNED TO A HATHA YOGA PROGRAM (HYP) OR ATTENTION CONTROL (AC) MUSIC OR ART CLASS. BASELINE AND 3-MONTH EVALUATIONS INCLUDED RESTING BP; OVERNIGHT URINE SAMPLES; AND SALIVA COLLECTED AT BEDTIME, UPON AWAKENING, AND AT 30 AND 60 MINUTES AFTER AWAKENING FOR ALPHA-AMYLASE AND CORTISOL ASSAYS. RESULTS: TWENTY-EIGHT (14 IN THE HYP GROUP AND 14 IN THE AC GROUP) STUDENTS WERE ASSESSED BOTH BEFORE AND AFTER THE INTERVENTION. BP CHANGES FROM PRE- TO POST-INTERVENTION WERE -3.0/-2.0 MMHG FOR THE HYP GROUP AND -0.07/-0.79 MMHG FOR THE AC GROUP (P=0.30 AND 0.57, RESPECTIVELY). CHANGES IN SYSTOLIC BP (SBP)/DIASTOLIC BP (DBP) FOR THE PREHYPERTENSIVE (75TH-94TH PERCENTILES FOR SBP) SUBGROUP ANALYSES WERE -10.75/-8.25 MMHG FOR THE HYP GROUP (N=4) VERSUS 1.8/1.0 MMHG FOR THE AC GROUP (N=5) (P FOR SBP=0.02; P FOR DBP=0.09). ALTHOUGH NO STATISTICALLY SIGNIFICANT GROUP DIFFERENCES WERE OBSERVED WITH CHANGES IN SNS OR HPA AWAKENING CURVES (AREA UNDER CURVE FOR ALPHA-AMYLASE AND CORTISOL, RESPECTIVELY), A SMALL TO MODERATE EFFECT SIZE WAS SEEN FAVORING A REDUCTION OF ALPHA-AMYLASE ACTIVATION FOR THE HYP GROUP (COHEN D=0.34; PREHYPERTENSIVE D=0.20). CONCLUSIONS: A SCHOOL-BASED HATHA YOGA PROGRAM DEMONSTRATED POTENTIAL TO DECREASE RESTING BP, PARTICULARLY AMONG PREHYPERTENSIVE YOUTH. REDUCED SNS DRIVE MAY BE AN UNDERLYING NEUROHORMONAL PATHWAY BENEFICIALLY AFFECTED BY THE PROGRAM. A LARGE-SCALE EFFICACY/EFFECTIVENESS RANDOMIZED CLINICAL TRIAL IS WARRANTED. 2014 2 1900 48 RESTORATIVE YOGA FOR WOMEN WITH BREAST CANCER: FINDINGS FROM A RANDOMIZED PILOT STUDY. OBJECTIVES: RESTORATIVE YOGA (RY) IS A GENTLE TYPE OF YOGA THAT MAY BE BENEFICIAL FOR CANCER PATIENTS AND POST-TREATMENT SURVIVORS. STUDY GOALS WERE: TO DETERMINE THE FEASIBILITY OF IMPLEMENTING A RY INTERVENTION FOR WOMEN WITH BREAST CANCER; AND TO EXAMINE GROUP DIFFERENCES IN SELF-REPORTED EMOTIONAL, HEALTH-RELATED QUALITY OF LIFE, AND SYMPTOM OUTCOMES. METHODS: WOMEN WITH BREAST CANCER (N=44; MEAN AGE 55.8 YEARS) ENROLLED IN THIS STUDY; 34% WERE ACTIVELY UNDERGOING CANCER TREATMENT. STUDY PARTICIPANTS WERE RANDOMIZED TO THE INTERVENTION (10 WEEKLY 75-MINUTE RY CLASSES) OR A WAITLIST CONTROL GROUP. PARTICIPANTS COMPLETED QUESTIONNAIRES AT WEEK 0 (BASELINE) AND WEEK 10 (IMMEDIATELY POST-INTERVENTION FOR THE YOGA GROUP). RESULTS: GROUP DIFFERENCES FAVORING THE YOGA GROUP WERE SEEN FOR MENTAL HEALTH, DEPRESSION, POSITIVE AFFECT, AND SPIRITUALITY (PEACE/MEANING). SIGNIFICANT BASELINE*GROUP INTERACTIONS WERE OBSERVED FOR NEGATIVE AFFECT AND EMOTIONAL WELL-BEING. WOMEN WITH HIGHER NEGATIVE AFFECT AND LOWER EMOTIONAL WELL-BEING AT BASELINE DERIVED GREATER BENEFIT FROM THE YOGA INTERVENTION COMPARED TO THOSE WITH SIMILAR VALUES AT BASELINE IN THE CONTROL GROUP. THE YOGA GROUP DEMONSTRATED A SIGNIFICANT WITHIN-GROUP IMPROVEMENT IN FATIGUE; NO SIGNIFICANT DIFFERENCE WAS NOTED FOR THE CONTROL GROUP. CONCLUSIONS: ALTHOUGH LIMITED BY SAMPLE SIZE, THESE PILOT DATA SUGGEST POTENTIAL BENEFIT OF RY ON EMOTIONAL OUTCOMES AND FATIGUE IN CANCER PATIENTS. THIS STUDY DEMONSTRATES THAT A RY INTERVENTION IS FEASIBLE FOR WOMEN WITH BREAST CANCER; IMPLICATIONS FOR STUDY DESIGN AND IMPLEMENTATION ARE NOTED WITH AN EMPHASIS ON PROGRAM ADOPTION AND PARTICIPANT ADHERENCE. 2009 3 2455 49 YOGA AS A COMPLEMENTARY THERAPY FOR SMOKING CESSATION: RESULTS FROM BREATHEASY, A RANDOMIZED CLINICAL TRIAL. INTRODUCTION: THERE IS EVIDENCE THAT YOGA MAY BE HELPFUL AS AN AID FOR SMOKING CESSATION. YOGA HAS BEEN SHOWN TO REDUCE STRESS AND NEGATIVE MOOD AND MAY AID WEIGHT CONTROL, ALL OF WHICH HAVE PROVEN TO BE BARRIERS TO QUITTING SMOKING. THIS STUDY IS THE FIRST RIGOROUS, RANDOMIZED CLINICAL TRIAL OF YOGA AS A COMPLEMENTARY THERAPY FOR SMOKERS ATTEMPTING TO QUIT. METHODS: ADULT SMOKERS (N = 227; 55.5% WOMEN) WERE RANDOMIZED TO AN 8-WEEK PROGRAM OF COGNITIVE-BEHAVIORAL SMOKING CESSATION AND EITHER TWICE-WEEKLY IYENGAR YOGA OR GENERAL WELLNESS CLASSES (CONTROL). ASSESSMENTS INCLUDED COTININE-VERIFIED 7-DAY POINT PREVALENCE ABSTINENCE AT WEEK 8, 3-MONTH, AND 6-MONTH FOLLOW-UPS. RESULTS: AT BASELINE, PARTICIPANTS' MEAN AGE WAS 46.2 (SD = 12.0) YEARS AND SMOKING RATE WAS 17.3 (SD = 7.6) CIGARETTES/DAY. LONGITUDINALLY ADJUSTED MODELS OF ABSTINENCE OUTCOMES DEMONSTRATED SIGNIFICANT GROUP EFFECTS FAVORING YOGA. YOGA PARTICIPANTS HAD 37% GREATER ODDS OF ACHIEVING ABSTINENCE THAN WELLNESS PARTICIPANTS AT THE END OF TREATMENT (EOT). LOWER BASELINE SMOKING RATES (0.05). FATIGUE SHOWED NO SIGNIFICANT DIFFERENCE (P>0.05). CONCLUSIONS: THE PRESENT DATA PROVIDED LITTLE INDICATION OF HOW EFFECTIVE YOGA MIGHT BE WHEN THEY WERE APPLIED BY WOMEN WITH BREAST CANCER EXCEPT FOR MILDLY EFFECTIVE IN QOL IMPROVEMENT. THE FINDINGS WERE BASED ON A SMALL BODY OF EVIDENCE IN WHICH METHODOLOGICAL QUALITY WAS NOT HIGH. FURTHER WELL-DESIGNED RCTS WITH LARGE SAMPLE SIZE ARE NEEDED TO CLARIFY THE UTILITY OF YOGA PRACTICE FOR THIS POPULATION. 2012 6 2132 40 THE EFFECTS OF A GENTLE YOGA PROGRAM ON SLEEP, MOOD, AND BLOOD PRESSURE IN OLDER WOMEN WITH RESTLESS LEGS SYNDROME (RLS): A PRELIMINARY RANDOMIZED CONTROLLED TRIAL. OBJECTIVE. TO EXAMINE THE EFFECTS OF YOGA VERSUS AN EDUCATIONAL FILM PROGRAM ON SLEEP, MOOD, PERCEIVED STRESS, AND SYMPATHETIC ACTIVATION IN OLDER WOMEN WITH RLS. METHODS. PARTICIPANTS WERE DRAWN FROM A LARGER TRIAL REGARDING THE EFFECTS OF YOGA ON CARDIOVASCULAR DISEASE RISK PROFILES IN OVERWEIGHT, SEDENTARY POSTMENOPAUSAL WOMEN. SEVENTY-FIVE WOMEN WERE RANDOMIZED TO RECEIVE EITHER AN 8-WEEK YOGA (N = 38) OR EDUCATIONAL FILM (N = 37) PROGRAM. ALL 75 PARTICIPANTS COMPLETED AN RLS SCREENING QUESTIONNAIRE. THE 20 WOMEN WHO MET ALL FOUR DIAGNOSTIC CRITERIA FOR RLS (N = 10 YOGA, 10 FILM GROUP) COMPRISED THE POPULATION FOR THIS NESTED STUDY. MAIN OUTCOMES ASSESSED PRE- AND POST-TREATMENT INCLUDED: SLEEP (PITTSBURGH SLEEP QUALITY INDEX), STRESS (PERCEIVED STRESS SCALE), MOOD (PROFILE OF MOOD STATES, STATE-TRAIT ANXIETY INVENTORY), BLOOD PRESSURE, AND HEART RATE. RESULTS. THE YOGA GROUP DEMONSTRATED SIGNIFICANTLY GREATER IMPROVEMENTS THAN CONTROLS IN MULTIPLE DOMAINS OF SLEEP QUALITY AND MOOD, AND SIGNIFICANTLY GREATER REDUCTIONS IN INSOMNIA PREVALENCE, ANXIETY, PERCEIVED STRESS, AND BLOOD PRESSURE (ALL P'S/= 24 KG/M(2)) BREAST CANCER SURVIVORS WERE RANDOMLY ASSIGNED TO A 6-MONTH, FACILITY- AND HOME-BASED VINIYOGA INTERVENTION (N = 32) OR A WAITLIST CONTROL GROUP (N = 31). THE YOGA GOAL WAS FIVE PRACTICES PER WEEK. PRIMARY OUTCOME MEASURES WERE CHANGES IN QOL, FATIGUE, AND WEIGHT FROM BASELINE TO 6 MONTHS. SECONDARY OUTCOMES INCLUDED CHANGES IN WAIST AND HIP CIRCUMFERENCE. RESULTS: IT TOOK 12 MONTHS TO COMPLETE RECRUITMENT. PARTICIPANTS ATTENDED A MEAN OF 19.6 CLASSES AND PRACTICED AT HOME A MEAN OF 55.8 TIMES DURING THE 6-MONTH PERIOD. AT FOLLOW-UP, 90% OF PARTICIPANTS COMPLETED QUESTIONNAIRES AND 87% COMPLETED ANTHROPOMETRIC MEASUREMENTS. QOL AND FATIGUE IMPROVED TO A GREATER EXTENT AMONG WOMEN IN THE YOGA GROUP RELATIVE TO WOMEN IN THE CONTROL GROUP, ALTHOUGH NO DIFFERENCES WERE STATISTICALLY SIGNIFICANT. WAIST CIRCUMFERENCE DECREASED 3.1 CM (95% CI, -5.7 AND -0.4) MORE AMONG WOMEN IN THE YOGA COMPARED WITH THE CONTROL GROUP, WITH NO DIFFERENCE IN WEIGHT CHANGE. CONCLUSIONS: THIS STUDY PROVIDES IMPORTANT INFORMATION REGARDING RECRUITMENT, RETENTION, AND PRACTICE LEVELS ACHIEVED DURING A 6-MONTH, INTENSIVE YOGA INTERVENTION IN OVERWEIGHT AND OBESE BREAST CANCER SURVIVORS. YOGA MAY HELP DECREASE WAIST CIRCUMFERENCE AND IMPROVE QUALITY OF LIFE; FUTURE STUDIES ARE NEEDED TO CONFIRM THESE RESULTS. 2012 11 1533 51 IYENGAR YOGA VERSUS ENHANCED USUAL CARE ON BLOOD PRESSURE IN PATIENTS WITH PREHYPERTENSION TO STAGE I HYPERTENSION: A RANDOMIZED CONTROLLED TRIAL. THE PREVALENCE OF PREHYPERTENSION AND STAGE 1 HYPERTENSION CONTINUES TO INCREASE DESPITE BEING AMENABLE TO NON-PHARMACOLOGIC INTERVENTIONS. IYENGAR YOGA (IY) HAS BEEN PURPORTED TO REDUCE BLOOD PRESSURE (BP) THOUGH EVIDENCE FROM RANDOMIZED TRIALS IS LACKING. WE CONDUCTED A RANDOMIZED CONTROLLED TRIAL TO ASSESS THE EFFECTS OF 12 WEEKS OF IY VERSUS ENHANCED USUAL CARE (EUC) (BASED ON INDIVIDUAL DIETARY ADJUSTMENT) ON 24-H AMBULATORY BP IN YOGA-NAIVE ADULTS WITH UNTREATED PREHYPERTENSION OR STAGE 1 HYPERTENSION. IN TOTAL, 26 AND 31 SUBJECTS IN THE IY AND EUC ARMS, RESPECTIVELY, COMPLETED THE STUDY. THERE WERE NO DIFFERENCES IN BP BETWEEN THE GROUPS AT 6 AND 12 WEEKS. IN THE EUC GROUP, 24-H SYSTOLIC BP (SBP), DIASTOLIC BP (DBP) AND MEAN ARTERIAL PRESSURE (MAP) SIGNIFICANTLY DECREASED BY 5, 3 AND 3 MMHG, RESPECTIVELY, FROM BASELINE AT 6 WEEKS (P < .05), BUT WERE NO LONGER SIGNIFICANT AT 12 WEEKS. IN THE IY GROUP, 24 H SBP WAS REDUCED BY 6 MMHG AT 12 WEEKS COMPARED TO BASELINE (P = .05). 24 H DBP (P < .01) AND MAP (P < .05) DECREASED SIGNIFICANTLY EACH BY 5 MMHG. NO DIFFERENCES WERE OBSERVED IN CATECHOLAMINE OR CORTISOL METABOLISM TO EXPLAIN THE DECREASE IN BP IN THE IY GROUP AT 12 WEEKS. TWELVE WEEKS OF IY PRODUCES CLINICALLY MEANINGFUL IMPROVEMENTS IN 24 H SBP AND DBP. LARGER STUDIES ARE NEEDED TO ESTABLISH THE LONG TERM EFFICACY, ACCEPTABILITY, UTILITY AND POTENTIAL MECHANISMS OF IY TO CONTROL BP. 2011 12 34 40 A 12-WEEK IYENGAR YOGA PROGRAM IMPROVED BALANCE AND MOBILITY IN OLDER COMMUNITY-DWELLING PEOPLE: A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: EXERCISE THAT CHALLENGES BALANCE CAN IMPROVE MOBILITY AND PREVENT FALLS IN OLDER ADULTS. YOGA AS A PHYSICAL ACTIVITY OPTION FOR OLDER ADULTS IS NOT WELL STUDIED. THIS TRIAL EVALUATED THE FEASIBILITY AND EFFECT OF A 12-WEEK IYENGAR YOGA PROGRAM ON BALANCE AND MOBILITY IN OLDER PEOPLE. METHODS: WE CONDUCTED A BLINDED, PILOT RANDOMIZED CONTROLLED TRIAL WITH INTENTION-TO-TREAT ANALYSIS. PARTICIPANTS WERE 54 COMMUNITY DWELLERS (MEAN AGE 68 YEARS, SD 7.1) NOT CURRENTLY PARTICIPATING IN YOGA OR TAI CHI. THE INTERVENTION GROUP (N = 27) PARTICIPATED IN A 12-WEEK, TWICE-WEEKLY YOGA PROGRAM FOCUSED ON STANDING POSTURES AND RECEIVED A FALL PREVENTION EDUCATION BOOKLET. THE CONTROL GROUP (N = 27) RECEIVED THE EDUCATION BOOKLET ONLY. PRIMARY OUTCOME WAS STANDING BALANCE COMPONENT OF THE SHORT PHYSICAL PERFORMANCE BATTERY WITH ADDITION OF ONE-LEGGED STANCE TIME (STANDING BALANCE). SECONDARY OUTCOMES WERE THE TIMED SIT-TO-STAND TEST, TIMED 4-M WALK, ONE-LEGGED STAND WITH EYES CLOSED, AND SHORT FALLS EFFICACY SCALE-INTERNATIONAL. FEASIBILITY WAS MEASURED BY RECORDING CLASS ATTENDANCE AND ADVERSE EVENTS. RESULTS: FIFTY-TWO PARTICIPANTS COMPLETED FOLLOW-UP ASSESSMENTS. THE INTERVENTION GROUP SIGNIFICANTLY IMPROVED COMPARED WITH CONTROL GROUP ON STANDING BALANCE (MEAN DIFFERENCE = 1.52 SECONDS, 95% CI 0.10-2.96, P = .04), SIT-TO-STAND TEST (MEAN DIFFERENCE = -3.43 SECONDS, 95% CI -5.23 TO -1.64, P < .001), 4-M WALK (MEAN DIFFERENCE = -0.50 SECONDS, 95% CI -0.72 TO -0.28, P < .001), AND ONE-LEGGED STAND WITH EYES CLOSED (MEAN DIFFERENCE = 1.93 SECONDS, 95% CI 0.40-3.46, P = .02). AVERAGE CLASS ATTENDANCE WAS 20 OF 24 CLASSES (83%). NO SERIOUS ADVERSE EVENTS OCCURRED. CONCLUSIONS: THIS TRIAL DEMONSTRATES THE BALANCE AND MOBILITY-RELATED BENEFITS AND FEASIBILITY OF IYENGAR YOGA FOR OLDER PEOPLE. THE FALL PREVENTION EFFECT OF IYENGAR YOGA WARRANTS FURTHER INVESTIGATION. 2013 13 2718 46 YOGA MEDITATION (YOMED) AND ITS EFFECT ON PROPRIOCEPTION AND BALANCE FUNCTION IN ELDERS WHO HAVE FALLEN: A RANDOMIZED CONTROL STUDY. OBJECTIVE: YOGA HAS BEEN SHOWN TO IMPROVE MUSCLE STRENGTH, FLEXIBILITY, AND BALANCE. HOWEVER, THE IMPACT OF MEDITATION ON DYNAMIC FACTORS SUCH AS GAIT, REACTIVE BALANCE AND PROPRIOCEPTION HAS YET TO BE EXAMINED. THE PURPOSE OF THIS STUDY WAS TO TEST IF A NOVEL YOGA MEDITATION PROGRAM (YOMED) IS AS EFFECTIVE AS A STANDARD PROPRIOCEPTIVE TRAINING IN IMPROVING PROPRIOCEPTION, BALANCE AND POWER IN OLDER INDIVIDUALS WHO HAVE FALLEN. DESIGN: SIXTEEN OLDER PERSONS WERE RANDOMLY ASSIGNED TO EITHER THE YOMED GROUP (YM) OR PROPRIOCEPTION TRAINING GROUP (PT). EACH GROUP RECEIVED 45MIN OF TRAINING, 3DAYS PER WEEK, FOR 6 WEEKS. PRETEST AND POST-TEST OUTCOME MEASURES WERE USED TO QUANTIFY THE COMPARATIVE EFFECTS OF THE INTERVENTIONS. SETTING: RESEARCH LABORATORY. INTERVENTIONS: YOGA MEDITATION AND PROPRIOCEPTIVE TRAINING. MAIN OUTCOME MEASURES: THE BALANCE ERROR SCORING SYSTEM (BESS), THE TENETTI BALANCE AND GAIT ASSESSMENT, DYNAMIC POSTUROGRAPHY, JOINT POSITION SENSE, JOINT KINESTHESIA AND LEG EXTENSOR POWER. RESULTS: THE PRIMARY FINDINGS OF THE STUDY WERE THAT NEITHER THE YM OR PT INTERVENTION GROUPS SHOWED STATISTICAL IMPROVEMENTS IN ANY VARIABLE WITH THE EXCEPTION OF THE DYNAMIC POSTUROGRAPHY OVERALL SCORE (DMA), WHICH SHOWED A SIGNIFICANT IMPROVEMENT BY THE YM GROUP (D=1.238; P=0.049). ADDITIONALLY CHANGES IN A NUMBER OF VARIABLES THAT DID NOT REACH SIGNIFICANCE DEMONSTRATED EFFECT SIZES IN THE MEDIUM TO HIGH RANGE. CONCLUSION: THESE RESULTS INDICATE THE POTENTIAL FOR THE YOMED PROGRAM TO BE USED AS A CLINICAL INTERVENTION IN OLDER INDIVIDUALS. GIVEN THESE RESULTS A LONGER STUDY USING A LARGER SAMPLE SIZE AND INDIVIDUALS AT HIGHER RISK OF FALLING IS WARRANTED. 2018 14 2046 44 THE ACUTE IMPACT OF HATHA YOGA ON CRAVING AMONG SMOKERS ATTEMPTING TO REDUCE OR QUIT. INTRODUCTION: DESPITE NEGATIVE EFFECTS OF SMOKING, SMOKERS HAVE DIFFICULTY QUITTING, SUGGESTING A NEED FOR ADDITIONAL STRATEGIES TO HELP THEM QUIT. A SINGLE-SESSION HATHA YOGA INTERVENTION ACUTELY REDUCED CRAVING AMONG NICOTINE-DEPRIVED SMOKERS NOT ATTEMPTING TO REDUCE OR QUIT, YET IT IS UNKNOWN IF IT REDUCES CRAVING AMONG THOSE ATTEMPTING TO CHANGE THEIR SMOKING. THUS, THIS STUDY TESTED THE EFFICACY OF A SINGLE-SESSION HATHA YOGA INTERVENTION FOR ACUTELY REDUCING CRAVING AMONG SMOKERS ATTEMPTING TO REDUCE OR QUIT SMOKING. METHODS: DATA PRESENTED ARE PART OF A LARGER DISSERTATION PROJECT. PARTICIPANTS WERE 55 COMMUNITY-RECRUITED SMOKERS (62% MALE) MOTIVATED TO REDUCE OR QUIT SMOKING RANDOMIZED TO ONE SESSION OF HATHA YOGA (N = 25) OR WELLNESS CONTROL (IE, READING EDUCATIONAL MATERIALS ABOUT HEALTHY LIFESTYLE; N = 30) ON THEIR INTERVENTION DAY (IE, THE DAY ON WHICH THEY BEGAN TO REDUCE OR QUIT SMOKING). PARTICIPANTS RATED, "I HAVE A DESIRE FOR A CIGARETTE RIGHT NOW," ON A 7-POINT LIKERT SCALE IMMEDIATELY BEFORE AND AFTER THE INTERVENTION. RESULTS: AFTER STATISTICALLY CONTROLLING FOR CO IN BREATH, PARTICIPANT TYPE, AGE, GENDER, RACE, AND ETHNICITY, A SIGNIFICANT TIME X CONDITION INTERACTION WAS FOUND, F(1, 47) = 4.72, P = .035, ETAP2 = .09, SUGGESTING CRAVING DECREASED AT A GREATER RATE IN THE HATHA YOGA CONDITION RELATIVE TO THE WELLNESS CONDITION. CONCLUSIONS: RESULTS FROM THIS STUDY ADD TO A GROWING BODY OF RESEARCH DEMONSTRATING THE POTENTIAL CLINICAL UTILITY OF HATHA YOGA AS AN ADJUNCTIVE INTERVENTION TOOL FOR SMOKING CESSATION. IMPLICATIONS: THIS IS THE FIRST KNOWN STUDY TO TEST THE IMPACT OF A SINGLE-SESSION HATHA YOGA INTERVENTION ON CRAVING AMONG ADULT SMOKERS ATTEMPTING TO REDUCE OR QUIT SMOKING. WE FOUND THAT 30 MINUTES OF HATHA YOGA PRODUCED A GREATER REDUCTION IN CRAVING COMPARED TO A 30-MINUTE WELLNESS CONTROL CONDITION. THIS RELATIONSHIP WAS EVIDENT EVEN AFTER STATISTICALLY ACCOUNTING FOR OTHER IMPORTANT VARIABLES (EG, GENDER). RESULTS OF THIS STUDY ADD TO A GROWING BODY OF LITERATURE DEMONSTRATING THE POTENTIAL CLINICAL UTILITY OF HATHA YOGA AS AN ADJUNCTIVE INTERVENTION STRATEGY FOR SMOKING CESSATION. 2020 15 2604 43 YOGA FOR PERSISTENT FATIGUE IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CANCER-RELATED FATIGUE AFFLICTS UP TO 33% OF BREAST CANCER SURVIVORS, YET THERE ARE NO EMPIRICALLY VALIDATED TREATMENTS FOR THIS SYMPTOM. METHODS: THE AUTHORS CONDUCTED A 2-GROUP RANDOMIZED CONTROLLED TRIAL TO DETERMINE THE FEASIBILITY AND EFFICACY OF AN IYENGAR YOGA INTERVENTION FOR BREAST CANCER SURVIVORS WITH PERSISTENT POST-TREATMENT FATIGUE. PARTICIPANTS WERE BREAST CANCER SURVIVORS WHO HAD COMPLETED CANCER TREATMENTS (OTHER THAN ENDOCRINE THERAPY) AT LEAST 6 MONTHS BEFORE ENROLLMENT, REPORTED SIGNIFICANT CANCER-RELATED FATIGUE, AND HAD NO OTHER MEDICAL CONDITIONS THAT WOULD ACCOUNT FOR FATIGUE SYMPTOMS OR INTERFERE WITH YOGA PRACTICE. BLOCK RANDOMIZATION WAS USED TO ASSIGN PARTICIPANTS TO A 12-WEEK, IYENGAR-BASED YOGA INTERVENTION OR TO 12 WEEKS OF HEALTH EDUCATION (CONTROL). THE PRIMARY OUTCOME WAS CHANGE IN FATIGUE MEASURED AT BASELINE, IMMEDIATELY POST-TREATMENT, AND 3 MONTHS AFTER TREATMENT COMPLETION. ADDITIONAL OUTCOMES INCLUDED CHANGES IN VIGOR, DEPRESSIVE SYMPTOMS, SLEEP, PERCEIVED STRESS, AND PHYSICAL PERFORMANCE. INTENT-TO-TREAT ANALYSES WERE CONDUCTED WITH ALL RANDOMIZED PARTICIPANTS USING LINEAR MIXED MODELS. RESULTS: THIRTY-ONE WOMEN WERE RANDOMLY ASSIGNED TO YOGA (N = 16) OR HEALTH EDUCATION (N = 15). FATIGUE SEVERITY DECLINED SIGNIFICANTLY FROM BASELINE TO POST-TREATMENT AND OVER A 3-MONTH FOLLOW-UP IN THE YOGA GROUP RELATIVE TO CONTROLS (P = .032). IN ADDITION, THE YOGA GROUP HAD SIGNIFICANT INCREASES IN VIGOR RELATIVE TO CONTROLS (P = .011). BOTH GROUPS HAD POSITIVE CHANGES IN DEPRESSIVE SYMPTOMS AND PERCEIVED STRESS (P < .05). NO SIGNIFICANT CHANGES IN SLEEP OR PHYSICAL PERFORMANCE WERE OBSERVED. CONCLUSIONS: A TARGETED YOGA INTERVENTION LED TO SIGNIFICANT IMPROVEMENTS IN FATIGUE AND VIGOR AMONG BREAST CANCER SURVIVORS WITH PERSISTENT FATIGUE SYMPTOMS. 2012 16 2442 41 YOGA AND SELF-REPORTED COGNITIVE PROBLEMS IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: CANCER SURVIVORS OFTEN REPORT COGNITIVE PROBLEMS. FURTHERMORE, DECREASES IN PHYSICAL ACTIVITY TYPICALLY OCCUR OVER THE COURSE OF CANCER TREATMENT. ALTHOUGH PHYSICAL ACTIVITY BENEFITS COGNITIVE FUNCTION IN NONCANCER POPULATIONS, EVIDENCE LINKING PHYSICAL ACTIVITY TO COGNITIVE FUNCTION IN CANCER SURVIVORS IS LIMITED. IN OUR RECENT RANDOMIZED CONTROLLED TRIAL, BREAST CANCER SURVIVORS WHO RECEIVED A YOGA INTERVENTION HAD LOWER FATIGUE AND INFLAMMATION FOLLOWING THE TRIAL COMPARED WITH A WAIT LIST CONTROL GROUP. THIS SECONDARY ANALYSIS OF THE PARENT TRIAL ADDRESSED YOGA'S IMPACT ON COGNITIVE COMPLAINTS. METHODS: POSTTREATMENT STAGE 0-IIIA BREAST CANCER SURVIVORS (N = 200) WERE RANDOMIZED TO A 12-WEEK, TWICE-WEEKLY HATHA YOGA INTERVENTION OR A WAIT LIST CONTROL GROUP. PARTICIPANTS REPORTED COGNITIVE COMPLAINTS USING THE BREAST CANCER PREVENTION TRIAL COGNITIVE PROBLEMS SCALE AT BASELINE, IMMEDIATELY POSTINTERVENTION, AND 3-MONTH FOLLOW-UP. RESULTS: COGNITIVE COMPLAINTS DID NOT DIFFER SIGNIFICANTLY BETWEEN GROUPS IMMEDIATELY POSTINTERVENTION (P = 0.250). HOWEVER, AT 3-MONTH FOLLOW-UP, YOGA PARTICIPANTS' BREAST CANCER PREVENTION TRIAL COGNITIVE PROBLEMS SCALE SCORES WERE AN AVERAGE OF 23% LOWER THAN WAIT LIST PARTICIPANTS' SCORES (P = 0.003). THESE GROUP DIFFERENCES IN COGNITIVE COMPLAINTS REMAINED AFTER CONTROLLING FOR PSYCHOLOGICAL DISTRESS, FATIGUE, AND SLEEP QUALITY. CONSISTENT WITH THE PRIMARY RESULTS, THOSE WHO PRACTICED YOGA MORE FREQUENTLY REPORTED SIGNIFICANTLY FEWER COGNITIVE PROBLEMS AT 3-MONTH FOLLOW-UP THAN THOSE WHO PRACTICED LESS FREQUENTLY (P < 0.001). CONCLUSIONS: THESE FINDINGS SUGGEST THAT YOGA CAN EFFECTIVELY REDUCE BREAST CANCER SURVIVORS' COGNITIVE COMPLAINTS AND PROMPT FURTHER RESEARCH ON MIND-BODY AND PHYSICAL ACTIVITY INTERVENTIONS FOR IMPROVING CANCER-RELATED COGNITIVE PROBLEMS. 2015 17 743 39 EFFECT OF RESTORATIVE YOGA VS. STRETCHING ON DIURNAL CORTISOL DYNAMICS AND PSYCHOSOCIAL OUTCOMES IN INDIVIDUALS WITH THE METABOLIC SYNDROME: THE PRYSMS RANDOMIZED CONTROLLED TRIAL. PURPOSE: CHRONIC STIMULATION AND DYSREGULATION OF THE NEUROENDOCRINE SYSTEM BY STRESS MAY CAUSE METABOLIC ABNORMALITIES. WE ESTIMATED HOW MUCH CORTISOL AND PSYCHOSOCIAL OUTCOMES IMPROVED WITH A RESTORATIVE YOGA (RELAXATION) VERSUS A LOW IMPACT STRETCHING INTERVENTION FOR INDIVIDUALS WITH THE METABOLIC SYNDROME. METHODS: WE CONDUCTED A 1-YEAR MULTI-CENTER RANDOMIZED CONTROLLED TRIAL (6-MONTH INTERVENTION AND 6-MONTH MAINTENANCE PHASE) OF RESTORATIVE YOGA VS. STRETCHING. PARTICIPANTS COMPLETED SURVEYS TO ASSESS DEPRESSION, SOCIAL SUPPORT, POSITIVE AFFECT, AND STRESS AT BASELINE, 6 MONTHS AND 12 MONTHS. FOR EACH ASSESSMENT, WE COLLECTED SALIVA AT FOUR POINTS DAILY FOR THREE DAYS AND COLLECTED RESPONSE TO DEXAMETHASONE ON THE FOURTH DAY FOR ANALYSIS OF DIURNAL CORTISOL DYNAMICS. WE ANALYZED OUR DATA USING MULTIVARIATE REGRESSION MODELS, CONTROLLING FOR STUDY SITE, MEDICATIONS (ANTIDEPRESSANTS, HORMONE THERAPY), BODY MASS INDEX, AND BASELINE CORTISOL VALUES. RESULTS: PSYCHOSOCIAL OUTCOME MEASURES WERE AVAILABLE FOR 171 STUDY PARTICIPANTS AT BASELINE, 140 AT 6 MONTHS, AND 132 AT 1 YEAR. COMPLETE CORTISOL DATA WERE AVAILABLE FOR 136 OF 171 STUDY PARTICIPANTS (72 IN RESTORATIVE YOGA AND 64 IN STRETCHING) AND WERE ONLY AVAILABLE AT BASELINE AND 6 MONTHS. AT 6 MONTHS, THE STRETCHING GROUP HAD DECREASED CORTISOL AT WAKING AND BEDTIME COMPARED TO THE RESTORATIVE YOGA GROUP. THE PATTERN OF CHANGES IN STRESS MIRRORED THIS IMPROVEMENT, WITH THE STRETCHING GROUP SHOWING REDUCTIONS IN CHRONIC STRESS SEVERITY AND PERSEVERATIVE THOUGHTS ABOUT THEIR STRESS. PERCEIVED STRESS DECREASED BY 1.5 POINTS (-0.4; 3.3, P=0.11) AT 6 MONTHS, AND BY 2.0 POINTS (0.1; 3.9, P=0.04) AT 1 YEAR IN THE STRETCHING COMPARED TO RESTORATIVE YOGA GROUPS. POST HOC ANALYSES SUGGEST THAT IN THE STRETCHING GROUP ONLY, PERCEIVED INCREASES IN SOCIAL SUPPORT (PARTICULARLY FEELINGS OF BELONGING), BUT NOT CHANGES IN STRESS WERE RELATED TO IMPROVED CORTISOL DYNAMICS. CONCLUSIONS: WE FOUND SIGNIFICANT DECREASES IN SALIVARY CORTISOL, CHRONIC STRESS SEVERITY, AND STRESS PERCEPTION IN THE STRETCHING GROUP COMPARED TO THE RESTORATIVE YOGA GROUP. GROUP SUPPORT DURING THE INTERACTIVE STRETCH CLASSES MAY HAVE CONTRIBUTED TO THESE CHANGES. 2014 18 518 37 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 19 524 37 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 20 187 44 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