1 1113 175 EFFICACY OF A BIOMECHANICALLY-BASED YOGA EXERCISE PROGRAM IN KNEE OSTEOARTHRITIS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: CERTAIN EXERCISES COULD OVERLOAD THE OSTEOARTHRITIC KNEE. WE DEVELOPED AN EXERCISE PROGRAM FROM YOGA POSTURES WITH A MINIMAL KNEE ADDUCTION MOMENT FOR KNEE OSTEOARTHRITIS. THE PURPOSE WAS TO COMPARE THE EFFECTIVENESS OF THIS BIOMECHANICALLY-BASED YOGA EXERCISE (YE), WITH TRADITIONAL EXERCISE (TE), AND A NO-EXERCISE ATTENTION-EQUIVALENT CONTROL (NE) FOR IMPROVING PAIN, SELF-REPORTED PHYSICAL FUNCTION AND MOBILITY PERFORMANCE IN WOMEN WITH KNEE OSTEOARTHRITIS. DESIGN: SINGLE-BLIND, THREE-ARM RANDOMIZED CONTROLLED TRIAL. SETTING: COMMUNITY IN SOUTHWESTERN ONTARIO, CANADA. PARTICIPANTS: A CONVENIENCE SAMPLE OF 31 WOMEN WITH SYMPTOMATIC KNEE OSTEOARTHRITIS WAS RECRUITED THROUGH RHEUMATOLOGY, ORTHOPAEDIC AND PHYSIOTHERAPY CLINICS, NEWSPAPERS AND WORD-OF-MOUTH. INTERVENTIONS: PARTICIPANTS WERE STRATIFIED BY DISEASE SEVERITY AND RANDOMLY ALLOCATED TO ONE OF THREE 12-WEEK, SUPERVISED INTERVENTIONS. YE INCLUDED BIOMECHANICALLY-BASED YOGA EXERCISES; TE INCLUDED TRADITIONAL LEG STRENGTHENING ON MACHINES; AND NE INCLUDED MEDITATION WITH NO EXERCISE. PARTICIPANTS WERE ASKED TO ATTEND THREE 1-HOUR GROUP CLASSES/SESSIONS EACH WEEK. MEASUREMENTS: PRIMARY OUTCOMES WERE PAIN, SELF-REPORTED PHYSICAL FUNCTION AND MOBILITY PERFORMANCE. SECONDARY OUTCOMES WERE KNEE STRENGTH, DEPRESSION, AND HEALTH-RELATED QUALITY OF LIFE. ALL WERE ASSESSED BY A BLINDED ASSESSOR AT BASELINE AND IMMEDIATELY FOLLOWING THE INTERVENTION. RESULTS: THE YE GROUP DEMONSTRATED GREATER IMPROVEMENTS IN KOOS PAIN (MEAN DIFFERENCE OF 22.9 [95% CI, 6.9 TO 38.8; P = 0.003]), INTERMITTENT PAIN (MEAN DIFFERENCE OF -19.6 [95% CI, -34.8 TO -4.4; P = 0.009]) AND SELF-REPORTED PHYSICAL FUNCTION (MEAN DIFFERENCE OF 17.2 [95% CI, 5.2 TO 29.2; P = 0.003]) COMPARED TO NE. IMPROVEMENTS IN THESE OUTCOMES WERE SIMILAR BETWEEN YE AND TE. HOWEVER, TE DEMONSTRATED A GREATER IMPROVEMENT IN KNEE FLEXOR STRENGTH COMPARED TO YE (MEAN DIFFERENCE OF 0.1 [95% CI, 0.1 TO 0.2]. IMPROVEMENTS FROM BASELINE TO FOLLOW-UP WERE PRESENT IN QUALITY OF LIFE SCORE FOR YE AND KNEE FLEXOR STRENGTH FOR TE, WHILE BOTH ALSO DEMONSTRATED IMPROVEMENTS IN MOBILITY. NO IMPROVEMENT IN ANY OUTCOME WAS PRESENT IN NE. CONCLUSIONS: THE BIOMECHANICALLY-BASED YOGA EXERCISE PROGRAM PRODUCED CLINICALLY MEANINGFUL IMPROVEMENTS IN PAIN, SELF-REPORTED PHYSICAL FUNCTION AND MOBILITY IN WOMEN WITH CLINICAL KNEE OA COMPARED TO NO EXERCISE. WHILE NOT STATISTICALLY SIGNIFICANT, IMPROVEMENTS IN THESE OUTCOMES WERE LARGER THAN THOSE ELICITED FROM THE TRADITIONAL EXERCISE-BASED PROGRAM. THOUGH THIS MAY SUGGEST THAT THE YOGA PROGRAM MAY BE MORE EFFICACIOUS FOR KNEE OA, FUTURE RESEARCH STUDYING A LARGER SAMPLE IS REQUIRED. TRIAL REGISTRATION: CLINICALTRIALS.GOV (NCT02370667). 2018 2 2064 39 THE BIOMECHANICAL DEMANDS OF STANDING YOGA POSES IN SENIORS: THE YOGA EMPOWERS SENIORS STUDY (YESS). BACKGROUND: THE NUMBER OF OLDER ADULTS PARTICIPATING IN YOGA HAS INCREASED DRAMATICALLY IN RECENT YEARS; YET, THE PHYSICAL DEMANDS ASSOCIATED WITH YOGA PERFORMANCE HAVE NOT BEEN REPORTED. THE PRIMARY AIM OF THE YOGA EMPOWERS SENIORS STUDY (YESS) WAS TO USE BIOMECHANICAL METHODS TO QUANTIFY THE PHYSICAL DEMANDS ASSOCIATED WITH THE PERFORMANCE OF 7 COMMONLY-PRACTICED STANDING YOGA POSES IN OLDER ADULTS. METHODS: 20 AMBULATORY OLDER ADULTS (70.7+-3.8 YRS) ATTENDED 2 WEEKLY 60-MINUTE HATHA YOGA CLASSES FOR 32 WEEKS. THE LOWER-EXTREMITY NET JOINT MOMENTS OF FORCE (JMOFS), WERE OBTAINED DURING THE PERFORMANCE OF THE FOLLOWING POSES: CHAIR, WALL PLANK, TREE, WARRIOR II, SIDE STRETCH, CRESCENT, AND ONE-LEGGED BALANCE. REPEATED-MEASURE ANOVA AND TUKEY'S POST-HOC TESTS WERE USED TO IDENTIFY DIFFERENCES IN JMOFS AMONG THE POSES. ELECTROMYOGRAPHIC ANALYSIS WAS USED TO SUPPORT THE JMOF FINDINGS. RESULTS: THERE WAS A SIGNIFICANT MAIN EFFECT FOR POSE, AT THE ANKLE, KNEE AND HIP, IN THE FRONTAL AND SAGITTAL PLANES (P=0.00-0.03). THE CRESCENT, CHAIR, WARRIOR II, AND ONE-LEGGED BALANCE POSES GENERATED THE GREATEST AVERAGE SUPPORT MOMENTS. SIDE STRETCH GENERATED THE GREATEST AVERAGE HIP EXTENSOR AND KNEE FLEXOR JMOFS. CRESCENT PLACED THE HIGHEST DEMANDS ON THE HIP FLEXORS AND KNEE EXTENSORS. ALL OF THE POSES PRODUCED ANKLE PLANTAR-FLEXOR JMOFS. IN THE FRONTAL PLANE, THE TREE GENERATED THE GREATEST AVERAGE HIP AND KNEE ABDUCTOR JMOFS; WHEREAS WARRIOR II GENERATED THE GREATEST AVERAGE HIP AND KNEE ADDUCTOR JMOFS. WARRIOR II AND ONE-LEGGED BALANCE INDUCED THE LARGEST AVERAGE ANKLE EVERTOR AND INVERTOR JMOFS, RESPECTIVELY. THE ELECTROMYOGRAPHIC FINDINGS WERE CONSISTENT WITH THE JMOF RESULTS. CONCLUSIONS: MUSCULOSKELETAL DEMAND VARIED SIGNIFICANTLY ACROSS THE DIFFERENT POSES. THESE FINDINGS MAY BE USED TO GUIDE THE DESIGN OF EVIDENCE-BASED YOGA INTERVENTIONS THAT ADDRESS INDIVIDUAL-SPECIFIC TRAINING AND REHABILITATION GOALS IN SENIORS. CLINICAL TRIAL REGISTRATION: THIS STUDY IS REGISTERED WITH NIH CLINICALTRIALS.GOV #NCT 01411059. 2013 3 253 68 A YOGA STRENGTHENING PROGRAM DESIGNED TO MINIMIZE THE KNEE ADDUCTION MOMENT FOR WOMEN WITH KNEE OSTEOARTHRITIS: A PROOF-OF-PRINCIPLE COHORT STUDY. UNLABELLED: PEOPLE WITH KNEE OSTEOARTHRITIS MAY BENEFIT FROM EXERCISE PRESCRIPTIONS THAT MINIMIZE KNEE LOADS IN THE FRONTAL PLANE. THE PRIMARY OBJECTIVE OF THIS STUDY WAS TO DETERMINE WHETHER A NOVEL 12-WEEK STRENGTHENING PROGRAM DESIGNED TO MINIMIZE EXPOSURE TO THE KNEE ADDUCTION MOMENT (KAM) COULD IMPROVE SYMPTOMS AND KNEE STRENGTH IN WOMEN WITH SYMPTOMATIC KNEE OSTEOARTHRITIS. A SECONDARY OBJECTIVE WAS TO DETERMINE WHETHER THE PROGRAM COULD IMPROVE MOBILITY AND FITNESS, AND DECREASE PEAK KAM DURING GAIT. THE TERTIARY OBJECTIVE WAS TO EVALUATE THE BIOMECHANICAL CHARACTERISTICS OF THIS YOGA PROGRAM. IN PARTICULAR, WE COMPARED THE PEAK KAM DURING GAIT WITH THAT DURING YOGA POSTURES AT BASELINE. WE ALSO COMPARED LOWER LIMB NORMALIZED MEAN ELECTROMYOGRAPHY (EMG) AMPLITUDES DURING YOGA POSTURES BETWEEN BASELINE AND FOLLOW-UP. PRIMARY MEASURES INCLUDED SELF-REPORTED PAIN AND PHYSICAL FUNCTION (KNEE INJURY AND OSTEOARTHRITIS OUTCOME SCORE) AND KNEE STRENGTH (EXTENSOR AND FLEXOR TORQUES). SECONDARY MEASURES INCLUDED MOBILITY (SIX-MINUTE WALK, 30-SECOND CHAIR STAND, STAIR CLIMBING), FITNESS (SUBMAXIMAL CYCLE ERGOMETER TEST), AND CLINICAL GAIT ANALYSIS USING MOTION CAPTURE SYNCHRONIZED WITH ELECTROMYOGRAPHY AND FORCE MEASUREMENT. ALSO, KAM AND NORMALIZED MEAN EMG AMPLITUDES WERE COLLECTED DURING YOGA POSTURES. FORTY-FIVE WOMEN OVER AGE 50 WITH SYMPTOMATIC KNEE OSTEOARTHRITIS, CONSISTENT WITH THE AMERICAN COLLEGE OF RHEUMATOLOGY CRITERIA, ENROLLED IN OUR 12-WEEK (3 SESSIONS PER WEEK) PROGRAM. DATA FROM 38 WERE ANALYZED (SIX DROP-OUTS; ONE LOST TO CO-INTERVENTION). PARTICIPANTS EXPERIENCED REDUCED PAIN (MEAN IMPROVEMENT 10.1-20.1 NORMALIZED TO 100; P<0.001), INCREASED KNEE EXTENSOR STRENGTH (MEAN IMPROVEMENT 0.01 NM/KG; P = 0.004), AND INCREASED FLEXOR STRENGTH (MEAN IMPROVEMENT 0.01 NM/KG; P = 0.001) AT FOLLOW-UP COMPARED TO BASELINE. PARTICIPANTS IMPROVED MOBILITY ON THE SIX-MINUTE WALK (MEAN IMPROVEMENT 37.7 M; P<0.001) AND 30-SECOND CHAIR STAND (MEAN IMPROVEMENT 1.3; P = 0.006) AT FOLLOW-UP COMPARED TO BASELINE. FITNESS AND PEAK KAM DURING GAIT WERE UNCHANGED BETWEEN BASELINE AND FOLLOW-UP. AVERAGE KAM DURING THE YOGA POSTURES WERE LOWER THAN THAT OF NORMAL GAIT. NORMALIZED MEAN EMG AMPLITUDES DURING YOGA POSTURES WERE UP TO 31.0% OF MAXIMUM BUT DID NOT CHANGE BETWEEN BASELINE AND FOLLOW-UP. IN THIS COHORT STUDY, THE YOGA-BASED STRENGTHENING POSTURES THAT ELICIT LOW KAMS IMPROVED KNEE SYMPTOMS AND STRENGTH IN WOMEN WITH KNEE OA FOLLOWING A 12 WEEK PROGRAM (3 SESSIONS PER WEEK). THE PROGRAM ALSO IMPROVED MOBILITY, BUT DID NOT IMPROVE FITNESS OR REDUCE PEAK KAM DURING GAIT. THE KAM DURING THE YOGA POSTURES WERE LOWER THAN THAT OF NORMAL GAIT. OVERALL, THE PROPOSED PROGRAM MAY BE USEFUL IN IMPROVING PAIN, STRENGTH, AND MOBILITY IN WOMEN WITH KNEE OSTEOARTHRITIS. CLINICAL EFFICACY NEEDS TO BE ASSESSED USING A RANDOMIZED CONTROLLED TRIAL DESIGN. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT02146105. 2015 4 1743 40 PHYSICAL-PERFORMANCE OUTCOMES AND BIOMECHANICAL CORRELATES FROM THE 32-WEEK YOGA EMPOWERS SENIORS STUDY. BACKGROUND. YOGA EMPOWERS SENIORS STUDY (YESS) QUANTIFIED PHYSICAL DEMANDS ASSOCIATED WITH YOGA PERFORMANCE USING BIOMECHANICAL METHODS. THIS STUDY EVALUATED THE EFFICACY OF THE PROGRAM ON PHYSICAL FUNCTION OUTCOMES. METHODS. TWENTY COMMUNITY-DWELLING OLDER ADULTS AGED 70.7 +/- 3.8 YEARS ATTENDED BIWEEKLY 60-MINUTE HATHA YOGA CLASSES FOR 32 WEEKS. FOUR DOMAINS OF THE PHYSICAL MEASUREMENTS INCLUDING (1) FUNCTIONAL PERFORMANCE, (2) FLEXIBILITY, (3) MUSCLE STRENGTH, AND (4) BALANCE WERE TAKEN AT THE BASELINE, 16-WEEK AND 32-WEEK TIME POINTS. REPEATED-MEASURES ANOVA OMNIBUS TESTS AND TUKEY'S POST HOC TESTS WERE EMPLOYED TO EXAMINE THE DIFFERENCES IN EACH OUTCOME VARIABLE ACROSS THE 3 TIME POINTS. RESULTS. IMPROVED TIMED CHAIR STANDS (P < 0.01), 8-FOOT UP AND GO (P < 0.05), 2-MIN STEP TEST (P < 0.05), AND VERTICAL REACH (P = 0.05) PERFORMANCE WERE EVIDENT. ISOMETRIC KNEE FLEXOR STRENGTH (P < 0.05) AND REPETITIONS OF THE HEEL RISE TEST (P < 0.001) ALSO INCREASED FOLLOWING THE 32-WEEK INTERVENTION. BOTH FLEXIBILITY AND BALANCE PERFORMANCE REMAINED UNCHANGED. CONCLUSIONS. SIGNIFICANT IMPROVEMENTS IN PHYSICAL FUNCTION AND MUSCLE-SPECIFIC LOWER-EXTREMITY STRENGTH OCCUR WITH THE REGULAR PRACTICE OF A MODIFIED HATHA YOGA PROGRAM DESIGNED FOR SENIORS. THESE ADAPTATIONS CORRESPONDED WITH THE PREVIOUSLY REPORTED BIOMECHANICAL DEMANDS OF THE POSES. 2016 5 34 52 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 6 1739 41 PHYSICAL AND PHYSIOLOGICAL EFFECTS OF YOGA FOR AN UNDERSERVED POPULATION WITH CHRONIC LOW BACK PAIN. BACKGROUND: YOGA HAS BEEN SHOWN USEFUL IN REDUCING CHRONIC LOW BACK PAIN (CLBP) THROUGH LARGELY UNKNOWN MECHANISMS. THE AIM OF THIS PILOT STUDY IS TO INVESTIGATE THE FEASIBILITY OF PROVIDING YOGA INTERVENTION TO A PREDOMINANTLY UNDERSERVED POPULATION AND EXPLORE THE POTENTIAL MECHANISMS UNDERLYING YOGA INTERVENTION IN IMPROVING CLBP PAIN. METHODS: THE QUASI-EXPERIMENTAL WITHIN-SUBJECT WAIT-LISTED CROSSOVER DESIGN TARGETED THE RECRUITMENT OF LOW-INCOME PARTICIPANTS WHO RECEIVED TWICE-WEEKLY GROUP YOGA FOR 12 WEEKS, FOLLOWING 6-12 WEEKS OF NO INTERVENTION. OUTCOME MEASURES WERE TAKEN AT BASELINE, PREINTERVENTION (6-12 WEEKS FOLLOWING BASELINE), AND THEN POSTINTERVENTION. OUTCOME MEASURES INCLUDED PAIN, DISABILITY, CORE STRENGTH, FLEXIBILITY, AND PLASMA TUMOR NECROSIS FACTOR (TNF)-ALPHA PROTEIN LEVELS. OUTCOMES MEASURES WERE ANALYZED BY ONE-WAY ANOVA AND PAIRED ONE-TAILED T-TESTS. RESULTS: EIGHT PATIENTS COMPLETED THE INTERVENTION. SIGNIFICANT IMPROVEMENTS IN PAIN SCORES MEASURED OVER TIME WERE SUPPORTED BY THE SIGNIFICANT IMPROVEMENT IN PRE- AND POST-YOGA SESSION PAIN SCORES. SIGNIFICANT IMPROVEMENTS WERE ALSO SEEN IN THE OSWESTRY DISABILITY QUESTIONNAIRE SCORES, SPINAL AND HIP FLEXOR FLEXIBILITY, AND STRENGTH OF CORE MUSCLES FOLLOWING YOGA. SIX PARTICIPANTS SAW A 28.6%-100% REDUCTION OF TNF-ALPHA PLASMA PROTEIN LEVELS AFTER YOGA, WHILE ONE SHOWED AN 82.4% INCREASE. TWO PARTICIPANTS HAD NO DETECTABLE LEVELS TO BEGIN WITH. BRAIN IMAGING ANALYSIS SHOWS INTERESTING INCREASES IN N-ACETYLASPARTATE IN THE DORSOLATERAL PREFRONTAL CORTEX AND THALAMUS. CONCLUSION: YOGA APPEARS EFFECTIVE IN REDUCING PAIN AND DISABILITY IN A LOW-INCOME CLBP POPULATION AND IN PART WORKS BY INCREASING FLEXIBILITY AND CORE STRENGTH. CHANGES IN TNF-ALPHA PROTEIN LEVELS SHOULD BE FURTHER INVESTIGATED FOR ITS INFLUENCE ON PAIN PATHWAYS. 2019 7 387 42 BENEFITS OF THAI YOGA ON PHYSICAL MOBILITY AND LOWER LIMB MUSCLE STRENGTH IN OVERWEIGHT/OBESE OLDER WOMEN: A RANDOMIZED CONTROLLED PILOT TRIAL. BACKGROUND AND PURPOSE: ALTHOUGH THAI YOGA (TY) IS REPORTED TO IMPROVE HEALTH-RELATED FITNESS FOR THE ELDERLY, NO STUDY HAS YET CARRIED OUT THE EFFECT OF TY PROGRAM ON PHYSICAL MOBILITY AND LOWER-LIMB MUSCLE STRENGTH IN OVERWEIGHT/OBESE OLDER WOMEN. MATERIALS AND METHODS: IN A RANDOMIZED CONTROLLED PILOT DESIGN, TWENTY-TWO SEDENTARY WOMEN WITH A BMI >/= 23 KG/M(2), AGED 62 +/- 1 YEARS WERE RANDOMLY ASSIGNED TO EITHER A TY GROUP FOR 60 MIN, 3 TIMES A WEEK OR TO A "NO EXERCISE" CONTROL (CON) GROUP. SIT AND REACH (SRT), FUNCTIONAL REACH (FRT) AND 30-S CHAIR STAND (CST-30), 8-FOOT UP AND GO (8UGT), 6-MIN WALK (6MWT)) AND LOWER-LIMB MUSCLE STRENGTH WERE MEASURED AT THE BEGINNING, 4, AND 8 WEEKS. RESULTS: AT WEEK 4, A SIGNIFICANT BETWEEN GROUPS WAS OBTAINED IN CST-30, 8UGT, AND 6MWT. AT WEEK 8, FRT, 8UGT, 6MWT AND KNEE FLEXOR AND EXTENSOR MUSCLE STRENGTH WERE IMPROVED IN THE TY OVER THE CON. SIGNIFICANT IMPROVEMENT WAS FOUND IN ALL VARIABLES WITHIN THE TY, BUT NO CHANGE WAS OBSERVED IN THE CON. CONCLUSION: AN 8-WEEK TY PROGRAM APPEARS TO PROVIDE BENEFICIAL IMPROVEMENTS IN PHYSICAL MOBILITY IN OVERWEIGHT/OBESE OLDER WOMEN. 2021 8 2077 26 THE EFFECT OF CHAIR YOGA IN OLDER ADULTS WITH MODERATE AND SEVERE ALZHEIMER'S DISEASE. USING A QUASI-EXPERIMENTAL SINGLE-GROUP DESIGN, THIS STUDY EXAMINED THE FEASIBILITY OF OLDER ADULTS WITH ALZHEIMER'S DISEASE (AD)-TYPE DEMENTIA TO COMPLETE THE SIT 'N' FIT CHAIR YOGA PROGRAM. PHYSICAL FUNCTION OF PARTICIPANTS WHO COMPLETED THE PROGRAM WAS MEASURED. THE NINE OLDER ADULTS WITH AD (MEAN AGE = 83) PARTICIPATED IN THE 8-WEEK SIT 'N' FIT CHAIR YOGA PROGRAM. TO MEASURE PHYSICAL FUNCTION, THE SIX-MINUTE WALK TEST, THE GAIT SPEED TEST, AND THE BERG BALANCE SCALE WERE ADMINISTERED AT PRE-INTERVENTION, 4 WEEKS, 8 WEEKS, AND 1 MONTH AFTER PROGRAM COMPLETION. ALL PARTICIPANTS COMPLETED THE PROGRAM. POSITIVE CHANGES WERE SEEN ACROSS ALL PHYSICAL MEASURES. FURTHER STUDY, USING A LARGER SAMPLE AND INCLUDING A CONTROL GROUP, IS NEEDED TO FULLY DETERMINE THE EFFECT OF THE SIT 'N' FIT CHAIR YOGA PROGRAM ON OLDER ADULTS WITH MODERATE TO SEVERE AD. 2014 9 107 51 A PILOT RANDOMIZED CONTROLLED TRIAL OF THE EFFECTS OF CHAIR YOGA ON PAIN AND PHYSICAL FUNCTION AMONG COMMUNITY-DWELLING OLDER ADULTS WITH LOWER EXTREMITY OSTEOARTHRITIS. OBJECTIVES: TO DETERMINE EFFECTS OF SIT 'N' FIT CHAIR YOGA, COMPARED TO A HEALTH EDUCATION PROGRAM (HEP), ON PAIN AND PHYSICAL FUNCTION IN OLDER ADULTS WITH LOWER EXTREMITY OSTEOARTHRITIS (OA) WHO COULD NOT PARTICIPATE IN STANDING EXERCISE. DESIGN: TWO-ARM RANDOMIZED CONTROLLED TRIAL. SETTING: ONE HUD SENIOR HOUSING FACILITY AND ONE DAY SENIOR CENTER IN SOUTH FLORIDA. PARTICIPANTS: COMMUNITY-DWELLING OLDER ADULTS (N = 131) WERE RANDOMLY ASSIGNED TO CHAIR YOGA (N = 66) OR HEP (N = 65). THIRTEEN DROPPED AFTER ASSIGNMENT BUT PRIOR TO THE INTERVENTION; SIX DROPPED DURING THE INTERVENTION; 106 OF 112 COMPLETED AT LEAST 12 OF 16 SESSIONS (95% RETENTION RATE). INTERVENTIONS: PARTICIPANTS ATTENDED EITHER CHAIR YOGA OR HEP. BOTH INTERVENTIONS CONSISTED OF TWICE-WEEKLY 45-MINUTE SESSIONS FOR 8 WEEKS. MEASUREMENTS: PRIMARY: PAIN, PAIN INTERFERENCE; SECONDARY: BALANCE, GAIT SPEED, FATIGUE, FUNCTIONAL ABILITY MEASURED AT BASELINE, AFTER 4 WEEKS OF INTERVENTION, AT THE END OF THE 8-WEEK INTERVENTION, AND POST-INTERVENTION (1 AND 3 MONTHS). RESULTS: THE CHAIR YOGA GROUP SHOWED GREATER REDUCTION IN PAIN INTERFERENCE DURING THE INTERVENTION (P = .01), SUSTAINED THROUGH 3 MONTHS (P = .022). WOMAC PAIN (P = .048), GAIT SPEED (P = .024), AND FATIGUE (P = .037) WERE IMPROVED IN THE YOGA GROUP DURING THE INTERVENTION (P = .048) BUT IMPROVEMENTS WERE NOT SUSTAINED POST INTERVENTION. CHAIR YOGA HAD NO EFFECT ON BALANCE. CONCLUSION: AN 8-WEEK CHAIR YOGA PROGRAM WAS ASSOCIATED WITH REDUCTION IN PAIN, PAIN INTERFERENCE, AND FATIGUE, AND IMPROVEMENT IN GAIT SPEED, BUT ONLY THE EFFECTS ON PAIN INTERFERENCE WERE SUSTAINED 3 MONTHS POST INTERVENTION. CHAIR YOGA SHOULD BE FURTHER EXPLORED AS A NONPHARMACOLOGIC INTERVENTION FOR OLDER PEOPLE WITH OA IN THE LOWER EXTREMITIES. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT02113410. 2017 10 2534 32 YOGA EMPOWERS SENIORS STUDY (YESS): DESIGN AND ASANA SERIES. THE PRACTICE OF YOGA ASANAS (POSTURES) MAY BE AN OPTIMAL METHOD OF PRESERVING OR ENHANCING PHYSICAL FUNCTION IN OLDER MEN AND WOMEN. HOWEVER, THE PHYSICAL DEMANDS, EFFICACY AND SAFETY OF AN ASANA PRACTICE FOR SENIORS HAVE NOT BEEN WELL STUDIED. THE YOGA EMPOWERS SENIORS STUDY (YESS) IS AN INTERVENTION DEVELOPMENT STUDY THAT CREATED TWO SENIOR-ADAPTED SERIES OF ASANAS TARGETED FOR AN AMBULATORY OLDER POPULATION. YESS IS USING BIOMECHANICS AND PHYSICAL PERFORMANCE TESTS TO ACQUIRE INFORMATION ABOUT THE PHYSICAL DEMANDS PLACED ON THE MUSCLES AND JOINTS BY THE ASANAS AND THE FUNCTIONAL PERFORMANCE ADAPTATIONS RESULTING FROM THE YOGA PRACTICE. THIS MANUSCRIPT DETAILS THE STANDARDIZED, SENIOR-ADAPTED, YESS ASANA SERIES AND THE ADDITIONAL ASANA MODIFICATIONS PROVIDED WHEN PARTICIPANTS HAD PHYSICAL LIMITATIONS. THIS PRESENTATION WILL ENABLE THE YOGA RESEARCH AND TEACHING COMMUNITIES TO INTERPRET THE BIOMECHANICS, PHYSICAL PERFORMANCE AND SIDE EFFECTS OUTCOMES OF YESS. 2012 11 518 45 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 12 2134 44 THE EFFECTS OF A THERAPEUTIC YOGA PROGRAM ON POSTURAL CONTROL, MOBILITY, AND GAIT SPEED IN COMMUNITY-DWELLING OLDER ADULTS. OBJECTIVE: TO EXAMINE THE EFFECTS OF A 12-WEEK THERAPEUTIC YOGA PROGRAM ON GAIT SPEED, POSTURAL CONTROL, AND MOBILITY IN COMMUNITY-DWELLING OLDER ADULTS. DESIGN: QUASI-EXPERIMENTAL STUDY WITH A PRETEST/POST-TEST DESIGN. RESEARCHERS EVALUATED CHANGES OVER TIME (PRETEST TO POST-TEST) IN ALL OUTCOME MEASURES. PAIRED T-TESTS WERE USED TO ANALYZE NORMAL AND FAST GAIT SPEED, TIMED UP AND GO TEST, AND TIMED UP AND GO DUAL TASK. WILCOXON SIGNED-RANK TEST WAS USED TO EVALUATE SCORES FOR THE MINI-BESTEST (MBT). SETTING: YOGA CLASSES WERE PERFORMED AT A LOCAL SENIOR CENTER. BLIND EXAMINERS WHO WERE PREVIOUSLY TRAINED IN THE OUTCOME MEASURES PERFORMED ALL PRETESTS AND POST-TESTS AT THE SITE. PARTICIPANTS: THIRTEEN ADULTS (12 WOMEN AND 1 MAN, WITH A MEAN AGE+/-STANDARD DEVIATION OF 72+/-6.9 YEARS) COMPLETED THE STUDY. RESEARCH PARTICIPANTS HAD MINIMAL TO NO YOGA EXPERIENCE. INTERVENTIONS: A 12-WEEK, 60-MINUTE, BIWEEKLY KRIPALU YOGA CLASS DESIGNED SPECIFICALLY FOR COMMUNITY-DWELLING OLDER ADULTS. OUTCOME MEASURES: POSTURAL CONTROL (MBT), MOBILITY (TIMED UP AND GO TEST), AND GAIT SPEED (NORMAL AND FAST) WERE ASSESSED. RESULTS: ALL 13 PARTICIPANTS ATTENDED AT LEAST 19 OF THE 24 CLASSES (80% ATTENDANCE). STATISTICALLY SIGNIFICANT IMPROVEMENTS WERE SEEN IN THE MBT (P=0.039), NORMAL GAIT SPEED (P=0.015), FAST GAIT SPEED (P=0.001), TIMED UP AND GO TEST (P=0.045), AND TIMED UP AND GO DUAL-TASK (P=0.05). CONCLUSIONS: IMPROVEMENTS IN POSTURAL CONTROL AND MOBILITY AS MEASURED BY THE MBT AND TIMED UP AND GO GAIT AS MEASURED BY FAST GAIT SPEED INDICATE THAT RESEARCH PARTICIPANTS BENEFITTED FROM THE THERAPEUTIC YOGA INTERVENTION. THE YOGA PROGRAM DESIGNED FOR THIS STUDY INCLUDED ACTIVITIES IN STANDING, SITTING, AND LYING ON THE FLOOR AND MAY BE EFFECTIVE IN IMPROVING MOBILITY, POSTURAL CONTROL, AND GAIT SPEED IN COMMUNITY-DWELLING OLDER ADULTS. 2014 13 408 36 BIOMECHANICAL CHARACTERISTICS ON THE LOWER EXTREMITY OF THREE TYPICAL YOGA MANOEUVRES. THIS STUDY WAS AIMED AT EXPLORING THE BIOMECHANICAL CHARACTERISTICS OF THE LOWER EXTREMITY AMONGST THREE TYPICAL YOGA MANOEUVRES. A TOTAL OF THIRTEEN EXPERIENCED FEMALE YOGA PRACTITIONERS WERE RECRUITED IN THE CURRENT STUDY; THEY WERE ALL CERTIFIED WITH THE YOGA ALLIANCE. A THREE-DIMENSIONAL MOTION CAPTURE SYSTEM WITH 10 CAMERAS COMBINED WITH FOUR SYNCHRONISED FORCE PLATES WAS USED TO COLLECT KINEMATICS OF THE LOWER EXTREMITY AND GROUND REACTIVE FORCE WHILST THE PARTICIPANTS PERFORMED THE CRESCENT LUNGE POSE, WARRIOR II POSE, AND TRIANGLE POSE. ONE-WAY REPEATED ANOVA WAS USED IN EXPLORING THE DIFFERENCES AMONGST THE THREE YOGA MOVEMENTS, AND THE SIGNIFICANCE WAS SET TO ALPHA < 0.05. THE TRIANGLE POSE PERFORMED THE LARGEST RANGE OF MOTION (ROM) OF THE HIP (90.5 DEGREES +/- 22.9 DEGREES ), KNEE (68.8 DEGREES +/- 23.1 DEGREES ), AND ANKLE (46.4 DEGREES +/- 11.3 DEGREES ) IN THE SAGITTAL PLANE AND THE HIP (54.8 DEGREES +/- 6.5 DEGREES ), KNEE (42.4 DEGREES +/- 12.8 DEGREES ), AND ANKLE (4.8 DEGREES +/- 1.7 DEGREES ) IN THE FRONTAL PLANE AMONGST THE THREE MANOEUVRES (P < 0.05). NO SIGNIFICANT DIFFERENCE WAS FOUND FOR THE HIP AND ANKLE JOINT MOMENT AMONGST THE THREE MANOEUVRES (P > 0.05). KNEE JOINT TRAVELLED INTO 9.5 DEGREES OF EXTENSION AND SLIGHT ADDUCTION OF 1.94 DEGREES WHILST EXPRESSING THE LARGEST KNEE JOINT ADDUCTION MOMENTS (0.30 +/- 0.22 NM/KG) IN THE TRIANGLE POSE. THE DISTRIBUTION OF THE ANGULAR IMPULSE OF THE LOWER LIMB JOINTS INDICATED THAT THE HIP JOINT CONTRIBUTED SIGNIFICANTLY THE MOST IN THE SAGITTAL AND FRONTAL PLANES OF THE THREE YOGA MANOEUVRES (P < 0.05), RANGING FROM 51.67% TO 70.56%. RESULTS INDICATED THAT TRIANGLE POSE MAY BE SUPERIOR TO THE OTHER TWO MANOEUVRES, WHICH IMPROVED HIP JOINT ROM, STRENGTH, AND DYNAMIC STABILITY. HOWEVER, KNEE INJURIES SUCH AS OSTEOARTHRITIS (OA) SHOULD BE CONSIDERED BECAUSE OF THE LARGE KNEE EXTENSOR ANGLE AND ADDUCTOR MOMENTS. 2021 14 2852 57 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 15 2590 60 YOGA FOR MANAGING KNEE OSTEOARTHRITIS IN OLDER WOMEN: A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: OSTEOARTHRITIS (OA) IS A COMMON PROBLEM IN OLDER WOMEN THAT IS ASSOCIATED WITH PAIN AND DISABILITIES. ALTHOUGH YOGA IS RECOMMENDED AS AN EXERCISE INTERVENTION TO MANAGE ARTHRITIS, THERE IS LIMITED EVIDENCE DOCUMENTING ITS EFFECTIVENESS, WITH LITTLE KNOWN ABOUT ITS LONG TERM BENEFITS. THIS STUDY'S AIMS WERE TO ASSESS THE FEASIBILITY AND POTENTIAL EFFICACY OF A HATHA YOGA EXERCISE PROGRAM IN MANAGING OA-RELATED SYMPTOMS IN OLDER WOMEN WITH KNEE OA. METHODS: ELIGIBLE PARTICIPANTS (N=36; MEAN AGE 72 YEARS) WERE RANDOMLY ASSIGNED TO 8-WEEK YOGA PROGRAM INVOLVING GROUP AND HOME-BASED SESSIONS OR WAIT-LIST CONTROL. THE YOGA INTERVENTION PROGRAM WAS DEVELOPED BY A GROUP OF YOGA EXPERTS (N=5). THE PRIMARY OUTCOME WAS THE WESTERN ONTARIO AND MCMASTER UNIVERSITIES OSTEOARTHRITIS INDEX (WOMAC) TOTAL SCORE THAT MEASURES KNEE OA PAIN, STIFFNESS, AND FUNCTION AT 8 WEEKS. THE SECONDARY OUTCOMES, PHYSICAL FUNCTION OF THE LOWER EXTREMITIES, BODY MASS INDEX (BMI), QUALITY OF SLEEP (QOS), AND QUALITY OF LIFE (QOL), WERE MEASURED USING WEIGHT, HEIGHT, THE SHORT PHYSICAL PERFORMANCE BATTERY (SPPB), THE PITTSBURGH SLEEP QUALITY INDEX (PSQI), THE CANTRIL SELF-ANCHORING LADDER, AND THE SF12V2 HEALTH SURVEY. DATA WERE COLLECTED AT BASELINE, 4 WEEKS AND 8 WEEKS, AND 20 WEEKS. RESULTS: THE RECRUITMENT TARGET WAS MET, WITH STUDY RETENTION AT 95%. BASED ON ANCOVAS, PARTICIPANTS IN THE TREATMENT GROUP EXHIBITED SIGNIFICANTLY GREATER IMPROVEMENT IN WOMAC PAIN (ADJUSTED MEANS [SE]) (8.3 [.67], 5.8 [.67]; P=.01), STIFFNESS (4.7 [.28], 3.4 [.28]; P=.002) AND SPPB (REPEATED CHAIR STANDS) (2.0 [.23], 2.8 [.23]; P=.03) AT 8 WEEKS. SIGNIFICANT TREATMENT AND TIME EFFECTS WERE SEEN IN WOMAC PAIN (7.0 [.46], 5.4 [.54]; P=.03), FUNCTION (24.5 [1.8], 19.9 [1.6]; P=.01) AND TOTAL SCORES (35.4 [2.3], 28.6 [2.1]; P=.01) FROM 4 TO 20 WEEKS. SLEEP DISTURBANCE WAS IMPROVED BUT THE PSQI TOTAL SCORE DECLINED SIGNIFICANTLY AT 20 WEEKS. CHANGES IN BMI AND QOL WERE NOT SIGNIFICANT. NO YOGA RELATED ADVERSE EVENTS WERE OBSERVED. CONCLUSIONS: A WEEKLY YOGA PROGRAM WITH HOME PRACTICE IS FEASIBLE, ACCEPTABLE, AND SAFE FOR OLDER WOMEN WITH KNEE OA, AND SHOWS THERAPEUTIC BENEFITS. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT01832155. 2014 16 2851 55 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 17 465 43 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 18 444 31 CHAIR YOGA: BENEFITS FOR COMMUNITY-DWELLING OLDER ADULTS WITH OSTEOARTHRITIS. THE AIM OF THIS PILOT STUDY WAS TO EXAMINE WHETHER CHAIR YOGA WAS EFFECTIVE IN REDUCING PAIN LEVEL AND IMPROVING PHYSICAL FUNCTION AND EMOTIONAL WELL-BEING IN A SAMPLE OF COMMUNITY-DWELLING OLDER ADULTS WITH OSTEOARTHRITIS. ONE-WAY REPEATED MEASURES ANALYSIS OF VARIANCE WAS PERFORMED TO EXAMINE THE EFFECTIVENESS OF CHAIR YOGA AT BASELINE, MIDPOINT (4 WEEKS), AND END OF THE INTERVENTION (8 WEEKS). ALTHOUGH CHAIR YOGA WAS EFFECTIVE IN IMPROVING PHYSICAL FUNCTION AND REDUCING STIFFNESS IN OLDER ADULTS WITH OSTEOARTHRITIS, IT WAS NOT EFFECTIVE IN REDUCING PAIN LEVEL OR IMPROVING DEPRESSIVE SYMPTOMS. FUTURE RESEARCH PLANNED BY THIS TEAM WILL USE RIGOROUS STUDY METHODS, INCLUDING LARGER SAMPLES, RANDOMIZED CONTROLLED TRIALS, AND FOLLOW UP FOR MONITORING HOME PRACTICE AFTER THE INTERVENTIONS. 2012 19 388 55 BENEFITS OF THE RESTORATIVE EXERCISE AND STRENGTH TRAINING FOR OPERATIONAL RESILIENCE AND EXCELLENCE YOGA PROGRAM FOR CHRONIC LOW BACK PAIN IN SERVICE MEMBERS: A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: TO EXAMINE THE FEASIBILITY AND PRELIMINARY EFFECTIVENESS OF AN INDIVIDUALIZED YOGA PROGRAM. DESIGN: PILOT RANDOMIZED CONTROLLED TRIAL. SETTING: MILITARY MEDICAL CENTER. PARTICIPANTS: PATIENTS (N=68) WITH CHRONIC LOW BACK PAIN. INTERVENTIONS: RESTORATIVE EXERCISE AND STRENGTH TRAINING FOR OPERATIONAL RESILIENCE AND EXCELLENCE (RESTORE) PROGRAM (9-12 INDIVIDUAL YOGA SESSIONS) OR TREATMENT AS USUAL (CONTROL) FOR AN 8-WEEK PERIOD. MAIN OUTCOME MEASURES: THE PRIMARY OUTCOME WAS PAST 24-HOUR PAIN (DEFENSE & VETERANS PAIN RATING SCALE 2.0). SECONDARY OUTCOMES INCLUDED DISABILITY (ROLAND-MORRIS DISABILITY QUESTIONNAIRE) AND PHYSICAL FUNCTIONING AND SYMPTOM BURDEN (PATIENT-REPORTED OUTCOMES MEASUREMENT INFORMATION SYSTEM-29 SUBSCALES). ASSESSMENT OCCURRED AT BASELINE, WEEK 4, WEEK 8, 3-MONTH FOLLOW-UP, AND 6-MONTH FOLLOW-UP. EXPLORATORY OUTCOMES INCLUDED THE PROPORTION OF PARTICIPANTS IN EACH GROUP REPORTING CLINICALLY MEANINGFUL CHANGES AT 3- AND 6-MONTH FOLLOW-UPS. RESULTS: GENERALIZED LINEAR MIXED MODELS WITH SEQUENTIAL BONFERRONI-ADJUSTED PAIRWISE SIGNIFICANCE TESTS AND CHI-SQUARE ANALYSES EXAMINED LONGITUDINAL OUTCOMES. SECONDARY OUTCOME SIGNIFICANCE TESTS WERE BONFERRONI ADJUSTED FOR MULTIPLE OUTCOMES. THE RESTORE GROUP REPORTED IMPROVED PAIN COMPARED WITH THE CONTROL GROUP. SECONDARY OUTCOMES DID NOT RETAIN SIGNIFICANCE AFTER BONFERRONI ADJUSTMENTS FOR MULTIPLE OUTCOMES, ALTHOUGH A HIGHER PROPORTION OF RESTORE PARTICIPANTS REPORTED CLINICALLY MEANINGFULLY CHANGES IN ALL OUTCOMES AT 3-MONTH FOLLOW-UP AND IN SYMPTOM BURDEN AT 6-MONTH FOLLOW-UP. CONCLUSIONS: RESTORE MAY BE A VIABLE NONPHARMACOLOGICAL TREATMENT FOR LOW BACK PAIN WITH MINIMAL SIDE EFFECTS, AND RESEARCH EFFORTS ARE NEEDED TO COMPARE THE EFFECTIVENESS OF RESTORE DELIVERY FORMATS (EG, GROUP VS INDIVIDUAL) WITH THAT OF OTHER TREATMENT MODALITIES. 2018 20 666 41 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