1 2506 78 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 2 666 21 EFFECT OF A 12-WEEK YOGA INTERVENTION ON FEAR OF FALLING AND BALANCE IN OLDER ADULTS: A PILOT STUDY. OBJECTIVE: TO DETERMINE WHETHER FEAR OF FALLING (FOF) AND BALANCE IMPROVED AFTER A 12-WEEK YOGA INTERVENTION AMONG OLDER ADULTS. DESIGN: A 12-WEEK YOGA INTERVENTION SINGLE-ARMED PILOT STUDY. SETTING: A RETIREMENT COMMUNITY IN A MEDIUM-SIZED UNIVERSITY TOWN IN THE MIDWEST. PARTICIPANTS: A CONVENIENCE SAMPLE OF ADULTS (N=14) OVER THE AGE OF 65 YEARS WHO ALL ENDORSED AN FOF. INTERVENTION: EACH PARTICIPANT TOOK PART IN A BIWEEKLY 12-WEEK YOGA INTERVENTION. THE YOGA SESSIONS INCLUDED BOTH PHYSICAL POSTURES AND BREATHING EXERCISES. POSTURES WERE COMPLETED IN SITTING AND STANDING POSITIONS. MAIN OUTCOME MEASURES: WE MEASURED FOF WITH THE ILLINOIS FOF MEASURE AND BALANCE WITH THE BERG BALANCE SCALE. UPPER- AND LOWER-BODY FLEXIBILITY WERE MEASURED WITH THE BACK SCRATCH TEST AND CHAIR SIT AND REACH TEST, RESPECTIVELY. RESULTS: FOF DECREASED BY 6%, STATIC BALANCE INCREASED BY 4% (P=.045), AND LOWER-BODY FLEXIBILITY INCREASED BY 34%. CONCLUSIONS: THE RESULTS INDICATE THAT YOGA MAY BE A PROMISING INTERVENTION TO MANAGE FOF AND IMPROVE BALANCE, THEREBY REDUCING FALL RISK FOR OLDER ADULTS. REHABILITATION THERAPISTS MAY WISH TO EXPLORE YOGA AS A MODALITY FOR BALANCE AND FALLS PROGRAMMING; HOWEVER, FUTURE RESEARCH IS NEEDED TO CONFIRM THE USE OF YOGA IN SUCH PROGRAMMING. 2010 3 20 27 "WE'RE ALL IN THIS TOGETHER": A QUALITATIVE STUDY OF PREDOMINANTLY LOW INCOME MINORITY PARTICIPANTS IN A YOGA TRIAL FOR CHRONIC LOW BACK PAIN. OBJECTIVE: TO EXPLORE THE EXPERIENCES OF LOW-INCOME MINORITY ADULTS TAKING PART IN A YOGA DOSING TRIAL FOR CHRONIC LOW BACK PAIN. DESIGN: INDIVIDUAL SEMI-STRUCTURED INTERVIEWS WERE CONDUCTED WITH NINETEEN PARTICIPANTS RECRUITED FROM A RANDOMIZED YOGA DOSING TRIAL FOR PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH CHRONIC LOW BACK PAIN. INTERVIEWS DISCUSSED THE IMPACT OF YOGA ON LOW BACK PAIN AND EMOTIONS; OTHER PERCEIVED ADVANTAGES OR DISADVANTAGES OF THE INTERVENTION; AND FACILITATORS AND BARRIERS TO PRACTICING YOGA. INTERVIEWS WERE AUDIO TAPED AND TRANSCRIBED, CODED USING ATLAS.TI SOFTWARE, AND ANALYZED WITH INDUCTIVE AND DEDUCTIVE THEMATIC ANALYSIS METHODS. SETTING: BOSTON MEDICAL CENTER, BOSTON, MA, USA. RESULTS: PARTICIPANTS VIEWED YOGA AS A MEANS OF PAIN RELIEF AND ATTRIBUTED IMPROVED MOOD, GREATER ABILITY TO MANAGE STRESS, AND ENHANCED RELAXATION TO YOGA. OVERALL, PARTICIPANTS FELT EMPOWERED TO SELF-MANAGE THEIR PAIN. SOME FOUND YOGA TO BE HELPFUL IN BEING MINDFUL OF THEIR EMOTIONS AND ACCEPTING OF THEIR PAIN. TRUST IN THE YOGA INSTRUCTORS WAS A COMMONLY CITED FACILITATOR FOR YOGA CLASS ATTENDANCE. LACK OF TIME, MOTIVATION, AND FEAR OF INJURY WERE REPORTED BARRIERS TO YOGA PRACTICE. CONCLUSIONS: YOGA IS A MULTIDIMENSIONAL TREATMENT FOR LOW BACK PAIN THAT HAS THE POTENTIAL TO FAVORABLY IMPACT HEALTH IN A PREDOMINANTLY LOW-INCOME MINORITY POPULATION. 2016 4 1765 22 POSTSTROKE BALANCE IMPROVES WITH YOGA: A PILOT STUDY. BACKGROUND AND PURPOSE: BALANCE IMPAIRMENT IS COMMON AFTER STROKE; MODIFIED YOGA MAY BE ABLE TO IMPROVE BALANCE AND OTHER IMPORTANT POSTSTROKE VARIABLES. SCIENTIFIC-EVIDENCE IS NEEDED TO SUPPORT SUCH TREATMENT INTERVENTIONS. THE PURPOSE OF THIS STUDY WAS TO ASSESS THE IMPACT OF A YOGA-BASED REHABILITATION INTERVENTION ON BALANCE, BALANCE SELF-EFFICACY, FEAR OF FALLING (FOF), AND QUALITY OF LIFE AFTER STROKE. METHODS: THIS WAS A PROSPECTIVE, RANDOMIZED, PILOT STUDY OF YOGA-BASED REHABILITATION FOR PEOPLE WITH CHRONIC STROKE. ALL YOGA SESSIONS WERE TAUGHT BY A REGISTERED YOGA THERAPIST, OCCURRED TWICE PER WEEK FOR 8 WEEKS AND INCLUDED SEATED, STANDING, AND FLOOR POSTURES WITH RELAXATION AND MEDITATION. BALANCE WAS ASSESSED WITH THE BERG BALANCE SCALE, BALANCE SELF-EFFICACY WITH THE ACTIVITIES-SPECIFIC BALANCE CONFIDENCE SCALE, FOF WITH A DICHOTOMOUS YES/NO QUESTION, AND QUALITY OF LIFE WITH THE STROKE SPECIFIC QUALITY OF LIFE SCALE. RESULTS: THERE WERE NO SIGNIFICANT DIFFERENCES BETWEEN WAIT-LIST CONTROL (N=10) AND YOGA (N=37) GROUPS IN BASELINE OR FOLLOW-UP SCORES. HOWEVER, USING WITHIN-GROUP COMPARISONS, YOGA GROUP DATA DEMONSTRATED SIGNIFICANT IMPROVEMENT IN BALANCE (BERG BALANCE SCALE, 41.3+/-11.7 VS 46.3+/-9.1; P<0.001) AND FOF (51% VS 46% WITH FOF; P<0.001). CONCLUSIONS: A GROUP YOGA-BASED REHABILITATION INTERVENTION FOR PEOPLE WITH CHRONIC STROKE HAS POTENTIAL IN IMPROVING MULTIPLE POSTSTROKE VARIABLES. GROUP YOGA MAY BE COMPLEMENTARY TO REHABILITATION, MAY BE POSSIBLE IN MEDICAL-BASED AND COMMUNITY-BASED SETTINGS, AND MAY BE COST-EFFECTIVE. FURTHER TESTING OF GROUP YOGA-BASED REHABILITATION INTERVENTIONS IS WARRANTED. CLINICAL TRIAL REGISTRATION- URL: HTTP://CLINICALTRIALS.GOV. UNIQUE IDENTIFIER: NCT01109602. 2012 5 1276 21 FUNCTIONAL IMPROVEMENTS IN PARKINSON'S DISEASE FOLLOWING A RANDOMIZED TRIAL OF YOGA. INDIVIDUALS WITH PARKINSON'S DISEASE (PD) EXPERIENCE SIGNIFICANT LIMITATIONS IN MOTOR FUNCTION, FUNCTIONAL GAIT, POSTURAL STABILITY, AND BALANCE. THESE LIMITATIONS OFTEN LEAD TO HIGHER INCIDENCES OF FALLS, WHICH HAVE SIGNIFICANT COMPLICATIONS FOR INDIVIDUALS WITH PD. YOGA MAY IMPROVE THESE FUNCTIONAL DEFICITS IN INDIVIDUALS WITH PD. THE OBJECTIVE OF THIS STUDY WAS TO DETERMINE CHANGES IN MOTOR FUNCTION, FUNCTIONAL GAIT, POSTURAL STABILITY, AND BALANCE CONTROL FOR COMMUNITY DWELLING INDIVIDUALS WITH PD. THIS RANDOMIZED, WAIT-LIST CONTROLLED PILOT STUDY EXAMINED THE INFLUENCE OF AN 8-WEEK YOGA INTERVENTION FOR PEOPLE WITH PD WHO MET THE FOLLOWING INCLUSION CRITERIA: ENDORSING A FEAR OF FALLING, BEING ABLE TO SPEAK ENGLISH, SCORING 4/6 ON THE MINIMENTAL STATE EXAM, AND BEING WILLING TO ATTEND THE INTERVENTION TWICE WEEKLY FOR 8-WEEKS. PARTICIPANTS IN THE YOGA GROUP (N=15) EXPERIENCED IMPROVEMENTS IN MOTOR FUNCTION, POSTURAL STABILITY, FUNCTIONAL GAIT, AND FREEZING GAIT, AS WELL AS REDUCTIONS IN FALL RISK. PARTICIPANTS IN THE WAIT-LIST CONTROL (N=12) ALSO SIGNIFICANTLY IMPROVED IN POSTURAL STABILITY, ALTHOUGH THEIR FALL RISK WAS NOT REDUCED. INDIVIDUALS IN THE YOGA GROUP SIGNIFICANTLY REDUCED THEIR FALL RISK. AN 8-WEEK YOGA INTERVENTION MAY REDUCE FALL RISK AND IMPROVE POSTURAL STABILITY, AND FUNCTIONAL AND FREEZING GAIT IN INDIVIDUALS WITH PD. THIS CLINICAL TRIAL IS REGISTERED AS PROTOCOL RECORD PRO00041068 IN CLINICALTRIALS.GOV. 2018 6 12 26 "MERGING YOGA AND OCCUPATIONAL THERAPY (MY-OT): A FEASIBILITY AND PILOT STUDY". OBJECTIVE: TO EXAMINE THE FEASIBILITY AND BENEFITS OF THE MERGING YOGA AND OCCUPATIONAL THERAPY (MY-OT) INTERVENTION. DESIGN: THIS IS THE PRIMARY ANALYSIS OF A NON-CONTROLLED PRETEST-POSTTEST PILOT STUDY TO UNDERSTAND THE FEASIBILITY AND IMPACT OF MY-OT ON BALANCE, BALANCE SELF-EFFICACY, AND FALL RISK FACTOR MANAGEMENT IN PEOPLE WITH CHRONIC STROKE. SETTING: UNIVERSITY RESEARCH LABORATORY. PARTICIPANTS: PEOPLE WITH CHRONIC STROKE WERE INCLUDED IN THE STUDY IF THEY: HAD SUSTAINED A FALL OR HAD FEAR OF FALLING, WERE ABLE TO STAND, AND HAND IMPAIRED BALANCE AND WERE AT RISK FOR FALLS (/=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 12 2101 19 THE EFFECT OF YOGA ON BALANCE AND FEAR OF FALLING IN OLDER ADULTS. OBJECTIVE: TO DETERMINE THE EFFECT OF YOGA ON BALANCE AND FEAR OF FALLING IN OLDER ADULTS. DESIGN: RANDOMIZED CONTROLLED TRIAL. SETTING: JAHANDIDEGAN CENTER IN SHIRAZ, SOUTHERN IRAN. PARTICIPANTS: FORTY PERSONS (17 MEN AND 23 WOMEN) BETWEEN THE AGES OF 60-74 YEARS WITH A MODIFIED FALLS EFFICACY SCALE (MFES) SCORE <8 AND A BERG BALANCE SCALE (BBS) SCORE <45. AFTER COMPLETING THE MFES QUESTIONNAIRE AND BBS MEASUREMENT, THE PARTICIPANTS WERE DIVIDED INTO INTERVENTION AND CONTROL GROUPS. BBS MEASUREMENT AND THE MFES QUESTIONNAIRE WERE COMPLETED AGAIN IMMEDIATELY AFTER THE INTERVENTION. INTERVENTION: THE INTERVENTION GROUP PARTICIPATED IN 2 YOGA PRACTICE SESSIONS PER WEEK FOR 8 WEEKS. THE CONTROL GROUP RECEIVED NO INTERVENTION. MAIN OUTCOME MEASUREMENTS: FEAR OF FALLING WAS MEASURED WITH THE MFES AND BALANCE WAS MEASURED WITH THE BBS. RESULTS: WE FOUND SIGNIFICANT CHANGES IN BOTH VARIABLES (P < .0001). MEAN DIFFERENCES BEFORE AND AFTER THE INTERVENTION FOR THE BBS FOR YOGA AND CONTROL GROUPS WERE 10.19 AND -1.16, RESPECTIVELY. MEAN DIFFERENCES BEFORE AND AFTER THE INTERVENTION FOR THE MFES FOR YOGA AND CONTROL GROUPS WERE 1.62 AND -0.21, RESPECTIVELY. CONCLUSION: YOGA IS A POTENTIAL INTERVENTION TO REDUCE FEAR OF FALLING AND IMPROVE BALANCE IN OLDER ADULTS. 2016 13 1582 25 MEDIATORS OF YOGA AND STRETCHING FOR CHRONIC LOW BACK PAIN. ALTHOUGH YOGA IS AN EFFECTIVE TREATMENT FOR CHRONIC LOW BACK PAIN, LITTLE IS KNOWN ABOUT THE MECHANISMS RESPONSIBLE FOR ITS BENEFITS. IN A TRIAL COMPARING YOGA TO INTENSIVE STRETCHING AND SELF-CARE, WE EXPLORED WHETHER PHYSICAL (HOURS OF BACK EXERCISE/WEEK), COGNITIVE (FEAR AVOIDANCE, BODY AWARENESS, AND SELF-EFFICACY), AFFECTIVE (PSYCHOLOGICAL DISTRESS, PERCEIVED STRESS, POSITIVE STATES OF MIND, AND SLEEP), AND PHYSIOLOGICAL FACTORS (CORTISOL, DHEA) MEDIATED THE EFFECTS OF YOGA OR STRETCHING ON BACK-RELATED DYSFUNCTION (ROLAND-MORRIS DISABILITY SCALE (RDQ)). FOR YOGA, 36% OF THE EFFECT ON 12-WEEK RDQ WAS MEDIATED BY INCREASED SELF-EFFICACY, 18% BY SLEEP DISTURBANCE, 9% BY HOURS OF BACK EXERCISE, AND 61% BY THE BEST COMBINATION OF ALL POSSIBLE MEDIATORS (6 MEDIATORS). FOR STRETCHING, 23% OF THE EFFECT WAS MEDIATED BY INCREASED SELF-EFFICACY, 14% BY DAYS OF BACK EXERCISE, AND 50% BY THE BEST COMBINATION OF ALL POSSIBLE MEDIATORS (7 MEDIATORS). IN OPEN-ENDED QUESTIONS, >/=20% OF PARTICIPANTS NOTED THE FOLLOWING TREATMENT BENEFITS: LEARNING NEW EXERCISES (BOTH GROUPS), RELAXATION, INCREASED AWARENESS, AND THE BENEFITS OF BREATHING (YOGA), BENEFITS OF REGULAR PRACTICE (STRETCHING). ALTHOUGH BOTH SELF-EFFICACY AND HOURS OF BACK EXERCISE WERE THE STRONGEST MEDIATORS FOR EACH INTERVENTION, COMPARED TO SELF-CARE, QUALITATIVE DATA SUGGEST THAT THEY MAY EXERT THEIR BENEFITS THROUGH PARTIALLY DISTINCT MECHANISMS. 2013 14 916 26 EFFECTIVENESS OF SOMATIC YOGA AND MEDITATION: A PILOT STUDY IN A MULTICULTURAL CANCER SURVIVOR POPULATION WITH CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY. CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY (CIPN) CAUSES SIGNIFICANT PAIN AND IS AN ADVERSE EFFECT OF TREATMENT WITH CHEMOTHERAPEUTIC AGENTS. WE EXPLORED A SOMATIC YOGA AND MEDITATION INTERVENTION IN A PREDOMINANTLY MINORITY POPULATION. GOALS INCLUDED DESCRIBING STRATEGIES FOR MINORITY INCLUSION AND TESTING FEASIBILITY AND EFFECTIVENESS. EIGHT INDIVIDUALS WITH CIPN ENROLLED IN A SINGLE-ARM FEASIBILITY TRIAL. SOMATIC YOGA AND MEDITATION WERE PROVIDED WEEKLY FOR 8 WEEKS, WITH AN ADDITIONAL HOME PROGRAM COMPONENT. THE PRIMARY OUTCOMES WERE SIT AND REACH, FUNCTIONAL REACH, AND TIMED UP AND GO. SECONDARY OUTCOMES WERE PATIENT NEUROTOXICITY QUESTIONNAIRE, FACT-GOG-NTX (FOR ADDRESSING PATIENT CONCERNS ASSOCIATED WITH NEUROLOGICAL SYMPTOMS), BRIEF PAIN INVENTORY, PERCEIVED STRESS SCALE, PITTSBURGH SLEEP QUALITY INDEX, AND FALLS EFFICACY SCALE. SENSITIVITY TO VIBRATION WAS MEASURED VIA BIOTHESIOMETER. PARTICIPANTS WITH A MEAN AGE OF 65 (49-73) YEARS SELF-REPORTED AS 63% AFRICAN-AMERICAN AND 37% CAUCASIAN. THEY ATTENDED 81% OF THE SESSIONS, AND NO ADVERSE EVENTS WE RE RE P O RTED. CIPN SYMPTOMS (FAC T- G O G - N T X ) IMPROVED SIGNIFICANTLY (FROM 88.88 TO 106.88, STANDARD DEVIATION = 20.03; P = 0.039). FEAR OF FALLING IMPROVED, APPROACHING SIGNIFICANCE (FROM 39.26 TO 34.38, STANDARD DEVIATION = 6.081; P = 0.058). OTHER MEASURES SHOWED IMPROVEMENT TRENDS, WITH A SLIGHT INCREASE IN BRIEF PAIN INVENTORY PAIN SEVERITY (FROM 3.50 TO 3.75, P = 0.041) POSSIBLY REFLECTING COMORBIDITIES. FOUR QUALITATIVE THEMES EMERGED: (1) CIPN SYMPTOM VARIABILITY, WITH MUSCULOSKELETAL COMORBIDITIES; (2) UTILITY OF LEARNED SKILLS; (3) IMPROVEMENT IN SELF-CONFIDENCE, BALANCE, AND STABILITY; AND (4) SOCIAL SUPPORT, WITH CIPN EXPERIENCE VALIDATION AND INCREASING HEALTH LITERACY. CHALLENGES OF RECRUITMENT AND RETENTION REQUIRE SPECIFIC OUTREACH, COMMUNITY TRUST, AND HEALTH LITERACY. PRELIMINARY DATA SUGGEST THAT SOMATIC YOGA AND MEDITATION MAY AFFECT FEAR OF FALLING AND QUALITY OF LIFE IN CANCER SURVIVORS WITH CIPN. A RANDOMIZED CONTROLLED TRIAL USING INCLUSIVE RECRUITMENT AND RETENTION METHODS IS INDICATED TO ESTABLISH THE INTERVENTION'S EFFICACY. 2020 15 638 30 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 16 88 23 A MIXED METHODS EVALUATION OF YOGA AS A FALL PREVENTION STRATEGY FOR OLDER PEOPLE IN INDIA. BACKGROUND: FALLS ARE AN EMERGING PUBLIC HEALTH ISSUE IN INDIA, WITH THE IMPACT SET TO RISE AS THE POPULATION AGES. WE SOUGHT TO EVALUATE THE ACCEPTABILITY, FEASIBILITY AND LIKELY IMPACT OF A YOGA-BASED PROGRAM AIMED AT IMPROVING BALANCE AND MOBILITY FOR OLDER RESIDENTS IN URBAN INDIA. METHODS: FIFTY LOCAL RESIDENTS AGED 60 YEARS AND OLDER WERE RECRUITED FROM URBAN HYDERABAD, ANDHRA PRADESH. THEY WERE INVITED TO ATTEND A 1-H YOGA CLASS, TWICE WEEKLY FOR 3 MONTHS. MIXED METHODS WERE USED TO EVALUATE THE ACCEPTABILITY AND FEASIBILITY (QUALITATIVE) AND LIKELY IMPACT (QUANTITATIVE). TWO FOCUS GROUPS AND EIGHT INTERVIEWS WITH PARTICIPANTS WERE CONDUCTED TO EVALUATE THE ACCEPTABILITY AND FEASIBILITY OF A YOGA PROGRAM. THEMATIC ANALYSIS WAS CONDUCTED IN CONTEXT OF PERCEPTIONS, BARRIERS AND BENEFITS OF YOGA PARTICIPATION AND FALL ASCERTAINMENT. PHYSICAL PERFORMANCE USING THE SHORT PHYSICAL PERFORMANCE BATTERY, FEAR OF FALLING, BLOOD PRESSURE AND WEIGHT LOSS WERE MEASURED BEFORE AND AFTER THE PROGRAM. RESULTS: THE INTERVIEWS AND FOCUS GROUPS PROVIDED INSIGHTS INTO THE PREFERRED FORMAT FOR CLASSES, INCLUDING SESSION TIMES, LEVEL OF SUPERVISION AND LOCATION. IMPROVEMENTS WERE SEEN IN THE SHORT FALLS EFFICACY SCALE-INTERNATIONAL (SHORT FES-I (15.9 +/- 4.0 VS 13.8 +/- 2.1 S, P = 0.002)), THE NUMBER OF STEPS TAKEN IN THE TIMED 4-M WALK (T4MW (9.0 +/- 1.8 VS 8.6 +/- 1.8, P = 0.04)), SHORT FES-I SCORES (9.4 +/- 2.9 VS 8.6 +/- 2.9, P = 0.02) AND WEIGHT (63.8 +/- 12.4 VS 62.1 +/- 11.6, P = 0.004) WERE LOWER. NO CHANGES WERE SEEN IN STANDING BALANCE, BLOOD PRESSURE OR T4MW TIME. CONCLUSION: YOGA WAS WELL ACCEPTED AND RESULTED IN IMPROVED ABILITY TO RISE FROM A CHAIR, WEIGHT LOSS, INCREASED STEP LENGTH AND REDUCED FEAR OF FALLING. THESE RESULTS PROVIDE IMPETUS FOR FURTHER RESEARCH EVALUATING YOGA AS A FALL PREVENTION STRATEGY IN INDIA. 2018 17 1206 27 EXPERIENCES OF PREGNANT WOMEN PARTICIPATING IN ANTENATAL YOGA: A QUALITATIVE STUDY. CONTEXT: PREGNANCY YOGA IS A MODIFIED VERSION OF YOGA FOR PREGNANT WOMEN, AND IT AIMS TO REDUCE PREGNANCY-RELATED SYMPTOMS, SUCH AS INSOMNIA, LOW BACK PAIN, TIREDNESS, CONSTIPATION, LEG CRAMPS, AND SHORTNESS OF BREATH. OBJECTIVE: THE STUDY AIMED TO IDENTIFY THE EXPERIENCES AND EXPECTATIONS OF PREGNANT WOMEN RELATED TO THE PRACTICE OF YOGA. METHOD: THE RESEARCH TEAM CONDUCTED A QUALITATIVE STUDY. SETTING: THE STUDY TOOK PLACE AT THE ANTENATAL CLINIC OF A PUBLIC HOSPITAL IN THE CENTRAL ANATOLIA REGION OF TURKEY. PARTICIPANTS: THE PARTICIPANTS WERE 24 PREGNANT WOMEN AT THE CLINIC. INTERVENTION: THE STUDY INCLUDED AN INTERVENTION GROUP THAT PERFORMED YOGA AND RECEIVED ROUTINE ANTENATAL CARE; HOWEVER, NO CONTROL GROUPS WERE USED. EACH YOGA INTERVENTION WAS HELD FOR APPROXIMATELY 40-45 MINUTES, WITH YOGA ASANA PERIODS LASTING 30 MINUTES. THE PREGNANT WOMEN WERE EXPECTED TO PARTICIPATE IN YOGA PRACTICE TWICE A WEEK ON A REGULAR BASIS FOR 8 WEEKS. OUTCOME MEASURES: DATA WERE COLLECTED THROUGH SEMI-STRUCTURED INTERVIEWS. THE INTERVIEWS WERE RECORDED AND TRANSCRIBED VERBATIM AND THEMATIC ANALYSIS WAS PERFORMED. RESULTS: FOUR MAJOR THEMES EMERGED: (1) PERCEPTIONS ABOUT PREGNANCY, (2) MANAGEMENT OF PREGNANCY SYMPTOMS, (3) PRENATAL ATTACHMENT, AND (4) BIRTH PERCEPTIONS. ACCORDING TO PARTICIPANTS, THE BENEFITS OF YOGA PRACTICE WERE MANAGEMENT OF PREGNANCY SYMPTOMS, INCREASED PRENATAL ATTACHMENT, A POSITIVE PERCEPTION OF THE BIRTH, NATURAL-BIRTH BELIEFS, AND MANAGEMENT OF FEAR AND PAIN DURING BIRTH. CONCLUSIONS: THE PARTICIPANTS REPORTED BARRIERS TO PERFORMING YOGA; HOWEVER, THEY ALSO SAID THAT THEY WOULD TRY PREGNANCY YOGA IF THEY WERE ENCOURAGED BY HEALTHCARE PROFESSIONALS. ALSO, THE PARTICIPANTS STATED THAT PREGNANCY YOGA PRACTICE SHOULD BE MADE A PART OF ANTENATAL EDUCATION TO FACILITATE PARTICIPATION. 2021 18 2830 23 YOGA VS STRETCHING IN VETERANS WITH CHRONIC LOWER BACK PAIN AND THE ROLE OF MINDFULNESS: A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THE PURPOSE OF THIS STUDY WAS TO INVESTIGATE THE FEASIBILITY OF RECRUITING, RANDOMIZING, ENROLLING, AND COLLECTING OUTCOME DATA ON VETERAN PATIENTS WITH CHRONIC LOW BACK PAIN (CLBP) WHO UNDERGO AN 8-WEEK, ACTIVE EXERCISE CLASS WITH MINDFULNESS (YOGA CLASS) AND WITHOUT (STRETCHING CLASS). METHODS: UNITED STATES VETERANS WITH CLBP BASED ON INCLUSION/EXCLUSION CRITERIA WERE RANDOMIZED TO 1 OF 2 GROUPS. THE STUDY DESIGN WAS A PILOT RANDOMIZED CONTROLLED TRIAL. TWENTY CLBP PATIENTS ATTENDED A YOGA CLASS OR STRETCHING CLASS ONCE PER WEEK FOR 8 WEEKS AT THE VETERANS AFFAIRS ROCHESTER OUTPATIENT CENTER, ROCHESTER, NEW YORK. THE FOLLOWING MEASUREMENTS WERE OBTAINED: RECRUITMENT OR ENROLLMENT DATA, COMPLIANCE DATA TO INCLUDE CLASS ATTENDANCE AND HOME EXERCISE, AND COMPLIANCE DATA REGARDING ABILITY TO COLLECT OUTCOME MEASURES AT BASELINE AND AT COMPLETION. OUTCOME MEASURES INCLUDED PAIN (PEG), QUALITY OF LIFE (PROMIS GLOBAL HEALTH SURVEY), SELF-EFFICACY (2-ITEM QUESTIONNAIRE), FEAR AVOIDANCE BELIEF, CATASTROPHIZING, AND SOCIAL ENGAGEMENT IN ADDITION TO QUALITATIVE CLINICIAN OPEN-ENDED QUESTIONS POSTINTERVENTION. RESULTS: FORTY-FIVE VETERANS WERE QUERIED REGARDING INTEREST IN PARTICIPATION. OF THESE, 34 (76%) MET THE STUDY'S CRITERIA. TWENTY (44%) AGREED TO PARTICIPATE AND WERE CONSENTED, RANDOMIZED, AND ENROLLED IN THE STUDY. INITIAL AND FINAL OUTCOME MEASURES WERE OBTAINED FOR EACH PARTICIPANT (100%). FORTY PERCENT ATTENDED MORE THAN 80% OF THE SESSIONS FOR BOTH YOGA AND STRETCHING GROUPS. CONCLUSION: THIS PILOT STUDY DEMONSTRATED FEASIBILITY OF RECRUITING, ENROLLING, AND COLLECTING OUTCOME DATA ON CLBP VETERAN PATIENTS PARTICIPATING IN YOGA AND STRETCHING CLASS. THE DATA FROM THIS PILOT WILL INFORM THE DEVELOPMENT OF A RANDOMIZED, COMPARATIVE EFFECTIVENESS STUDY OF YOGA WITH AND WITHOUT MINDFULNESS IN THE MANAGEMENT OF CLBP. 2020 19 2216 23 THE IMPACT OF A DAILY YOGA PROGRAM FOR WOMEN WITH FIBROMYALGIA. BACKGROUND: FIBROMYALGIA (FM) IS CHARACTERIZED BY WIDESPREAD PAIN, SLEEP DISTURBANCE, NEGATIVE AFFECT, AND STRESS AND IS NOTABLY DIFFICULT TO TREAT. INDIVIDUALS WITH FM HAVE LOWER PHYSICAL ACTIVITY AND ENDORSE FEARS THAT EXERCISE MAY WORSEN PAIN. GENTLE DAILY YOGA PRACTICE MAY ALLOW A GRADUAL INCREASE IN ACTIVITY AND POSITIVELY IMPACT MANY OF THESE FM SYMPTOMS. THIS QUALITATIVE STUDY INVESTIGATED THE IMPACT OF PARTICIPATION IN A PILOT TRIAL OF GROUP AND DAILY INDIVIDUAL HOME YOGA INTERVENTION ON WOMEN WITH FM. MATERIALS AND METHODS: FIFTEEN INDIVIDUALS PARTICIPATED IN TELEPHONE INTERVIEWS AFTER PARTICIPATING IN THE YOGA INTERVENTION, WHICH INCLUDED SEMI-STRUCTURED QUESTIONS TO ELICIT INSIGHTS AND IMPRESSIONS OF THEIR EXPERIENCE. RESPONSES WERE SYSTEMATICALLY CODED AND THEMES IDENTIFIED. RESULTS: FIVE THEMES WERE IDENTIFIED: (1) PHYSICAL/BODY PERCEPTUAL CHANGES, (2) PRACTICES AFFECTING PAIN, (3) EMOTIONAL CHANGES, (4) PRACTICE MOTIVATORS AND BARRIERS, AND (5) GROUP EFFECT. PARTICIPANTS NOT ONLY REPORTED REDUCTIONS IN FM SYMPTOMS, INCLUDING PAIN AND STRESS, BUT ALSO A POSITIVE IMPACT ON MOOD, SLEEP, AND SELF-CONFIDENCE. CONCLUSIONS: PARTICIPANTS ENUMERATED BOTH PHYSICAL AND PSYCHOLOGICAL IMPACT OF STARTING YOGA PRACTICE. SPECIFIC HELPFUL POSES AND PRACTICES AND IMPORTANT BARRIERS WERE IDENTIFIED. GROUP PRACTICE AND SOCIAL CONNECTION WITH OTHERS WITH OTHER FM PATIENTS WAS AN IMPORTANT BENEFIT TO PARTICIPANTS. 2019 20 2625 20 YOGA FOR TEENS WITH IRRITABLE BOWEL SYNDROME: RESULTS FROM A MIXED-METHODS PILOT STUDY. IRRITABLE BOWEL SYNDROME (IBS) IS A COMMON CONDITION ASSOCIATED WITH RECURRENT ABDOMINAL PAIN AND ALTERED BOWEL HABITS. IT IS PARTICULARLY PERNICIOUS TO YOUTH, WHO MAY WITHDRAW FROM LIFE TASKS DUE TO PAIN, DIARRHEA, AND/OR FEAR OF SYMPTOMS. EMOTIONAL STRESS EXACERBATES IBS SYMPTOMS, AND MIND-BODY INTERVENTIONS MAY BE BENEFICIAL. IN THIS MIXED-METHODS STUDY OF 18 TEENS AGED 14 TO 17 YEARS UNDERTAKING A 6-WEEK IYENGAR YOGA INTERVENTION, WE AIMED TO IDENTIFY TREATMENT RESPONDERS AND TO EXPLORE DIFFERENCES BETWEEN RESPONDERS AND NONRESPONDERS ON A RANGE OF QUANTITATIVE OUTCOMES AND QUALITATIVE THEMES RELATED TO YOGA IMPACT, GOODNESS OF FIT, AND BARRIERS TO TREATMENT. HALF OF THE TEENS RESPONDED SUCCESSFULLY TO YOGA, DEFINED AS A CLINICALLY MEANINGFUL REDUCTION IN ABDOMINAL PAIN. RESPONDERS DIFFERED FROM NONRESPONDERS ON POSTINTERVENTION QUANTITATIVE OUTCOMES, INCLUDING REDUCED ABDOMINAL PAIN, IMPROVED SLEEP, AND INCREASED VISCERAL SENSITIVITY. QUALITATIVE OUTCOMES REVEALED THAT RESPONDERS REPORTED GENERALIZED BENEFITS EARLY IN TREATMENT AND THAT THEIR PARENTS WERE SUPPORTIVE AND COMMITTED TO THE INTERVENTION. RESPONDERS AND NONRESPONDERS ALIKE NOTED THE IMPORTANCE OF HOME PRACTICE TO ACHIEVE MAXIMAL, SUSTAINED BENEFITS. THIS STUDY REVEALS THE NEED FOR DEVELOPMENTALLY SENSITIVE YOGA PROGRAMS THAT INCREASE ACCESSIBILITY OF YOGA FOR ALL PATIENTS. 2018