1 1375 155 IMPACT OF DAILY YOGA-BASED EXERCISE ON PAIN, CATASTROPHIZING, AND SLEEP AMONGST INDIVIDUALS WITH FIBROMYALGIA. BACKGROUND: FIBROMYALGIA (FM) IS A CHRONIC WIDESPREAD PAIN DISORDER CHARACTERIZED BY NEGATIVE AFFECT, SLEEP DISTURBANCE, AND FATIGUE. THIS UNCONTROLLED PILOT STUDY INVESTIGATED THE EFFICACY OF DAILY YOGA-BASED EXERCISE TO IMPROVE FM SYMPTOMS AND EXPLORED BASELINE PHENOTYPIC CHARACTERISTICS ASSOCIATED WITH THE GREATEST BENEFIT. METHODS: FM PATIENTS (N=46, WITH 36 COMPLETERS) REPORTED PSYCHOSOCIAL FUNCTIONING AND A RANGE OF FM SYMPTOMS USING VALIDATED INSTRUMENTS BEFORE AND AFTER PARTICIPATION IN SATYANANDA YOGA, WHICH INCLUDED WEEKLY IN-PERSON PAIN-TAILORED GROUP CLASSES FOR 6 WEEKS AND DAILY HOME YOGA VIDEO PRACTICE. RESULTS: CHANGES IN FM SYMPTOMS FROM PRE- TO POST-YOGA WERE VARIABLE AMONGST PARTICIPANTS. GROUP MEANS FOR PAIN DECREASED, AS REPORTED BY AVERAGE DAILY DIARY AND BRIEF PAIN INVENTORY, WITH GREATER HOME PRACTICE MINUTES ASSOCIATED WITH A GREATER DECREASE IN PAIN. AVERAGE DAILY RATINGS OF SLEEP AND FATIGUE IMPROVED. PAIN CATASTROPHIZING WAS DECREASED OVERALL, WITH GREATER CHANGE CORRELATED TO A DECREASE IN FM SYMPTOMS. WE DID NOT OBSERVE ANY GROUP MEAN CHANGES IN ACTIGRAPHY SLEEP EFFICIENCY, PATIENT-REPORTED OUTCOMES MEASUREMENT INFORMATION SYSTEM-ANXIETY AND THE REVISED FIBROMYALGIA IMPACT QUESTIONNAIRE. MULTILEVEL MODELING ANALYSIS REVEALED A SIGNIFICANT INTERACTION BETWEEN ANXIETY AND CATASTROPHIZING FOR END-STUDY SLEEP EFFICIENCY, FATIGUE, AND PAIN, SUCH THAT PATIENTS WITH HIGHER BASELINE CATASTROPHIZING AND LOWER BASELINE ANXIETY REPORTED LESS PAIN AND FATIGUE, AND HIGHER SLEEP EFFICIENCY AFTER THE SIXTH WEEK OF YOGA PRACTICE. CONCLUSION: THIS PILOT STUDY SUGGESTS THAT YOGA MAY REDUCE PAIN AND CATASTROPHIZING, AS WELL AS IMPROVE SLEEP, BUT THESE CHANGES WERE MODEST ACROSS STUDY PARTICIPANTS. GREATER UPTAKE OF HOME YOGA PRACTICE AS WELL AS A PHENOTYPE OF HIGHER BASELINE CATASTROPHIZING COMBINED WITH LOWER BASELINE ANXIETY WERE ASSOCIATED WITH GREATER IMPACT. FUTURE RANDOMIZED, CONTROLLED TRIALS COMPARING DIFFERENT TYPES OF YOGA OR EXERCISE WILL ALLOW DETERMINATION OF THE MOST EFFECTIVE TREATMENTS FOR FM AND ALLOW CLOSER TARGETING TO THE PATIENTS WHO WILL BENEFIT MOST FROM THEM.	2019	
                                                                                                                                                                                                                                                                                                                                                                                
2 2216  56 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
3  108  39 A PILOT RANDOMIZED CONTROLLED TRIAL OF THE YOGA OF AWARENESS PROGRAM IN THE MANAGEMENT OF FIBROMYALGIA. A MOUNTING BODY OF LITERATURE RECOMMENDS THAT TREATMENT FOR FIBROMYALGIA (FM) ENCOMPASS MEDICATIONS, EXERCISE AND IMPROVEMENT OF COPING SKILLS. HOWEVER, THERE IS A SIGNIFICANT GAP IN DETERMINING AN EFFECTIVE COUNTERPART TO PHARMACOTHERAPY THAT INCORPORATES BOTH EXERCISE AND COPING. THE AIM OF THIS RANDOMIZED CONTROLLED TRIAL WAS TO EVALUATE THE EFFECTS OF A COMPREHENSIVE YOGA INTERVENTION ON FM SYMPTOMS AND COPING. A SAMPLE OF 53 FEMALE FM PATIENTS WERE RANDOMIZED TO THE 8-WEEK YOGA OF AWARENESS PROGRAM (GENTLE POSES, MEDITATION, BREATHING EXERCISES, YOGA-BASED COPING INSTRUCTIONS, GROUP DISCUSSIONS) OR TO WAIT-LISTED STANDARD CARE. DATA WERE ANALYZED BY INTENTION TO TREAT. AT POST-TREATMENT, WOMEN ASSIGNED TO THE YOGA PROGRAM SHOWED SIGNIFICANTLY GREATER IMPROVEMENTS ON STANDARDIZED MEASURES OF FM SYMPTOMS AND FUNCTIONING, INCLUDING PAIN, FATIGUE, AND MOOD, AND IN PAIN CATASTROPHIZING, ACCEPTANCE, AND OTHER COPING STRATEGIES. THIS PILOT STUDY PROVIDES PROMISING SUPPORT FOR THE POTENTIAL BENEFITS OF A YOGA PROGRAM FOR WOMEN WITH FM.	2010	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
4  302  53 AN EIGHT-WEEK YOGA INTERVENTION IS ASSOCIATED WITH IMPROVEMENTS IN PAIN, PSYCHOLOGICAL FUNCTIONING AND MINDFULNESS, AND CHANGES IN CORTISOL LEVELS IN WOMEN WITH FIBROMYALGIA. OBJECTIVES: FIBROMYALGIA (FM) IS A CHRONIC CONDITION CHARACTERIZED BY WIDESPREAD MUSCULOSKELETAL PAIN, FATIGUE, DEPRESSION, AND HYPOCORTISOLISM. TO DATE, PUBLISHED STUDIES HAVE NOT INVESTIGATED THE EFFECTS OF YOGA ON CORTISOL IN FM. THIS PILOT STUDY USED A TIME SERIES DESIGN TO EVALUATE PAIN, PSYCHOLOGICAL VARIABLES, MINDFULNESS, AND CORTISOL IN WOMEN WITH FM BEFORE AND AFTER A YOGA INTERVENTION. METHODS: PARTICIPANTS (N = 22) WERE RECRUITED FROM THE COMMUNITY TO PARTICIPATE IN A 75 MINUTE YOGA CLASS TWICE WEEKLY FOR 8 WEEKS. QUESTIONNAIRES CONCERNING PAIN (INTENSITY, UNPLEASANTNESS, QUALITY, SUM OF LOCAL AREAS OF PAIN, CATASTROPHIZING, ACCEPTANCE, DISABILITY), ANXIETY, DEPRESSION, AND MINDFULNESS WERE ADMINISTERED PRE-, MID- AND POST-INTERVENTION. SALIVARY CORTISOL SAMPLES WERE COLLECTED THREE TIMES A DAY FOR EACH OF TWO DAYS, PRE- AND POST-INTERVENTION. RESULTS: REPEATED MEASURES ANALYSIS OF VARIANCE (ANOVA) REVEALED THAT MEAN +/- STANDARD DEVIATION (SD) SCORES IMPROVED SIGNIFICANTLY (P < 0.05) FROM PRE- TO POST-INTERVENTION FOR CONTINUOUS PAIN (PRE: 5.18 +/- 1.72; POST: 4.44 +/- 2.03), PAIN CATASTROPHIZING (PRE: 25.33 +/- 14.77; POST: 20.40 +/- 17.01), PAIN ACCEPTANCE (PRE: 60.47 +/- 23.43; POST: 65.50 +/- 22.93), AND MINDFULNESS (PRE: 120.21 +/- 21.80; POST: 130.63 +/- 20.82). INTENTION-TO-TREAT ANALYSIS SHOWED THAT MEDIAN AUC FOR POST-INTERVENTION CORTISOL (263.69) WAS SIGNIFICANTLY HIGHER (P < 0.05) THAN MEDIAN AUC FOR PRE-INTERVENTION LEVELS (189.46). MEDIATION ANALYSIS REVEALED THAT MID-INTERVENTION MINDFULNESS SCORES SIGNIFICANTLY (P < 0.05) MEDIATED THE RELATIONSHIP BETWEEN PRE- AND POST-INTERVENTION PAIN CATASTROPHIZING SCORES. DISCUSSION: THE RESULTS SUGGEST THAT A YOGA INTERVENTION MAY REDUCE PAIN AND CATASTROPHIZING, INCREASE ACCEPTANCE AND MINDFULNESS, AND ALTER TOTAL CORTISOL LEVELS IN WOMEN WITH FM. THE CHANGES IN MINDFULNESS AND CORTISOL LEVELS MAY PROVIDE PRELIMINARY EVIDENCE FOR MECHANISMS OF A YOGA PROGRAM FOR WOMEN WITH FM. FUTURE STUDIES SHOULD USE AN RCT DESIGN WITH A LARGER SAMPLE SIZE.	2011	
                                                                                                                                                                                                                                                                                                                                                                                                   
5 1490  38 INTEREST IN YOGA AMONG FIBROMYALGIA PATIENTS: AN INTERNATIONAL INTERNET SURVEY. STUDIES IN CIRCUMSCRIBED CLINICAL SETTINGS HAVE REPORTED THE ADOPTION OF YOGA BY MANY FIBROMYALGIA (FM) PATIENTS. HOWEVER, IT IS UNCLEAR FROM EXISTING STUDIES WHICH TYPES OF YOGA PRACTICES FM PATIENTS ARE TYPICALLY ENGAGING IN AND THE EXTENT TO WHICH THEY EXPERIENCE YOGA AS HELPFUL OR NOT. THE PURPOSE OF THIS STUDY WAS TO SURVEY FM PATIENTS IN MANY DIFFERENT REGIONS TO INQUIRE ABOUT THEIR ENGAGEMENT IN VARIOUS YOGA PRACTICES, THE PERCEIVED BENEFITS, AND THE OBSTACLES TO FURTHER PRACTICE. A 13-QUESTION INTERNET SURVEY OF PERSONS SELF-IDENTIFIED AS FM PATIENTS WAS CONDUCTED AMONG SUBSCRIBERS TO 2 ELECTRONIC NEWSLETTERS ON THE TOPIC OF FM. RESPONDENTS (N = 2543) REPLIED FROM ALL 50 U.S. STATES AND ALSO FROM CANADA, AUSTRALIA, AND THE UNITED KINGDOM, AND FROM MORE THAN TWO DOZEN OTHER COUNTRIES. ON AVERAGE, RESPONDENTS WERE 57 YEARS OF AGE AND 96% WERE FEMALE, WITH AN AVERAGE TIME SINCE DIAGNOSIS OF 13 YEARS. OF THESE RESPONDENTS, 79.8% HAD CONSIDERED TRYING YOGA AND 57.8% HAD ATTENDED 1 YOGA CLASS. THE RESPONDENTS' CLASSES TYPICALLY FOCUSED ALMOST EXCLUSIVELY ON YOGA POSES, WITH MINIMAL TRAINING IN MEDITATION, BREATHING TECHNIQUES, OR OTHER PRACTICES. THE MOST COMMONLY CITED BENEFITS WERE REDUCED STIFFNESS, RELAXATION, AND BETTER BALANCE. THE MOST FREQUENTLY CITED OBSTACLES WERE CONCERNS ABOUT THE POSES BEING TOO PHYSICALLY DEMANDING AND FEAR THAT THE POSES WOULD CAUSE TOO MUCH PAIN. THESE FINDINGS CONFIRM STRONG INTEREST IN YOGA ACROSS A GEOGRAPHICALLY DIVERSE RANGE OF FM PATIENTS. HOWEVER, CONCERNS ABOUT YOGA-INDUCED PAIN AND YOGA POSES BEING TOO DIFFICULT ARE COMMON REASONS THAT FM PATIENTS DO NOT ENGAGE IN YOGA EXERCISES. THIS STUDY SUPPORTS THE NEED FOR YOGA PROGRAMS TAILORED FOR FM PATIENTS TO INCLUDE MODIFICATION OF POSES TO MINIMIZE AGGRAVATING MOVEMENTS AND SUBSTANTIVE TRAINING IN MEDITATION AND OTHER YOGA-BASED COPING METHODS TO MINIMIZE PAIN-RELATED FEAR.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
6 1339  50 HOW DOES YOGA WORK ON PAIN DIMENSIONS? AN INTEGRATED PERSPECTIVE IN 2 INDIVIDUALS WITH FIBROMYALGIA. CONTEXT: THE EFFECTIVENESS OF YOGA HAS BEEN STUDIED IN FIBROMYALGIA (FM) USING IMPROVEMENT IN ITS 5 KEY DIMENSIONS-PAIN, QUALITY OF LIFE, SLEEP, DEPRESSION, AND DISABILITY-AS OUTCOME MEASURES. STUDIES HAVE DEMONSTRATED AN IMPROVEMENT IN THE PSYCHOSOCIAL DIMENSIONS OF PAIN AFTER YOGA PRACTICE, BUT THESE FINDINGS FAILED TO REACH STATISTICAL SIGNIFICANCE. ALTHOUGH STUDIES HAVE SHOWN THE EFFICACY OF YOGA IN THE MODULATION OF PAIN, NO STUDY HAS YET INVESTIGATED HOW IT ACTS ON EACH DIMENSION OF PAIN. OBJECTIVE: THE STUDY INTENDED TO INVESTIGATE THE DIMENSIONS OF PAIN-SENSORY, EVALUATIVE, AND/OR AFFECTIVE-AND WHICH PSYCHOLOGICAL COMORBIDITIES-ANXIETY AND/OR DEPRESSION-THAT HATHA YOGA AFFECTS IN INDIVIDUALS WITH FM. DESIGN: THE RESEARCH TEAM PERFORMED 2 CASE STUDIES. SETTING: THE STUDY OCCURRED AT THE GIFT INSTITUTE OF INTEGRATIVE MEDICINE (PISA, ITALY). PARTICIPANTS: PARTICIPANTS WERE 2 PATIENTS AT THE INSTITUTE WHO HAD FM. INTERVENTION: AT BASELINE (T0), PARTICIPANTS WERE PRESCRIBED 8 MO OF PHARMACOLOGICAL TREATMENT. AT 2 MO AFTER BASELINE (T1), THEY PARTICIPATED IN AN 8-H, MIND-BODY, PSYCHOEDUCATIONAL COURSE (PEC) FOR SELF-MANAGEMENT OF CHRONIC PAIN. EACH PARTICIPANT WAS CONTACTED BY PHONE EVERY WEEK FOR 2 MO AFTER THE PEC (IE, UNTIL 4 MO FROM BASELINE (T2). FOR THE NEXT 2 MO, PARTICIPANTS HAD NO CONTACT WITH A HEALTH CARE PRACTITIONER, TO SUSTAIN A DEEPER PEC PROGRAM. PARTICIPANTS THEN TOOK A 2-MO HATHA YOGA PROGRAM FROM MONTHS 6 (T3) TO 8 (T4). OUTCOME MEASURES: SENSORIAL, AFFECTIVE, AND EVALUATIVE DIMENSIONS OF PAIN WERE INVESTIGATED USING THE ITALIAN PAIN QUESTIONNAIRE, AND DEPRESSION AND ANXIETY WERE INVESTIGATED USING THE HOSPITAL ANXIETY DEPRESSION AT T0, T1, T2, T3, AND T4. THE IPQ WAS ADMINISTERED WEEKLY, BEFORE AND AFTER EACH YOGA SESSION. RESULTS: HATHA YOGA PROVED TO BE AN EFFECTIVE MEANS OF RELIEVING PAIN IN FM. IN PARTICULAR, A MEASURABLE IMPROVEMENT IN SCORES OCCURRED FOR THE AFFECTIVE DIMENSION OF PAIN AFTER ONLY 4 YOGA SESSIONS; THIS EFFECT REMAINED STABLE THROUGHOUT THE REMAINDER OF THE PROGRAM. CONCLUSIONS: MONITORING THE AFFECTIVE DIMENSION OF PAIN SHOULD BE INCLUDED IN AN INTEGRATED APPROACH TO PAIN, AND HATHA YOGA MAY BE BENEFICIAL IN THE PAIN MANAGEMENT OF FM PARTICIPANTS.	2018	
                                                                                                                                                                                                                                                                                      
7 2506  31 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
8  142  35 A PROTOCOL AND PILOT STUDY FOR MANAGING FIBROMYALGIA WITH YOGA AND MEDITATION. FIBROMYALGIA IS A CHRONIC SYNDROME CHARACTERIZED BY WIDESPREAD PAIN, SLEEP DISTURBANCE, STIFFNESS, FATIGUE, HEADACHE, AND MOOD DISORDERS. RECENT RESEARCH HAS RESULTED IN AN IMPROVED UNDERSTANDING OF FIBROMYALGIA AND ITS POSSIBLE CAUSES. THIS ARTICLE HIGHLIGHTS SOME OF THE CURRENT RESEARCH, DISCUSSES A STRATEGY FOR USING YOGA AND MEDITATION AS A THERAPY FOR FIBROMYALGIA SUFFERERS, AND PRESENTS THE RESULTS OF A PRELIMINARY 8-WEEK STUDY USING YOGA AND MEDITATION TO HELP MANAGE FIBROMYALGIA SYMPTOMS. THE STUDY OF 11 PARTICIPANTS FOUND SIGNIFICANT IMPROVEMENT IN THE OVERALL HEALTH STATUS OF THE PARTICIPANTS AND IN SYMPTOMS OF STIFFNESS, ANXIETY, AND DEPRESSION. SIGNIFICANT IMPROVEMENTS WERE ALSO SEEN IN THE REPORTED NUMBER OF DAYS "FELT GOOD" AND NUMBER OF DAYS "MISSED WORK" BECAUSE OF FIBROMYALGIA. NONSIGNIFICANT IMPROVEMENTS WERE SEEN IN MEASURES OF PAIN, FATIGUE, AND HOW ONE FELT IN THE MORNING. EFFECT SIZES WERE MEDIUM TO LARGE FOR MOST TESTED AREAS. THIS STUDY SUPPORTS THE BENEFITS OF YOGA AND MEDITATION FOR INDIVIDUALS WITH FIBROMYALGIA AND ENCOURAGES FURTHER RESEARCH TO EXPLORE THEIR USE AS STANDARD THERAPIES FOR FIBROMYALGIA.	2011	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
9 1618  33 MINDFUL YOGA PILOT STUDY SHOWS MODULATION OF ABNORMAL PAIN PROCESSING IN FIBROMYALGIA PATIENTS. PUBLISHED FINDINGS FROM A RANDOMIZED CONTROLLED TRIAL HAVE SHOWN THAT MINDFUL YOGA TRAINING IMPROVES SYMPTOMS, FUNCTIONAL DEFICITS, AND COPING ABILITIES IN INDIVIDUALS WITH FIBROMYALGIA AND THAT THESE BENEFITS ARE REPLICABLE AND CAN BE MAINTAINED 3 MONTHS POST-TREATMENT. THE AIM OF THIS STUDY WAS TO COLLECT PILOT DATA IN FEMALE FIBROMYALGIA PATIENTS (N = 7) TO DETERMINE IF INITIAL EVIDENCE INDICATES THAT MINDFUL YOGA ALSO MODULATES THE ABNORMAL PAIN PROCESSING THAT CHARACTERIZES FIBROMYALGIA. PRE- AND POST-TREATMENT DATA WERE OBTAINED ON QUANTITATIVE SENSORY TESTS AND MEASURES OF SYMPTOMS, FUNCTIONAL DEFICITS, AND COPING ABILITIES. SEPARATION TEST ANALYSES INDICATED SIGNIFICANT IMPROVEMENTS IN HEAT PAIN TOLERANCE, PRESSURE PAIN THRESHOLD, AND HEAT PAIN AFTER-SENSATIONS AT POST-TREATMENT. FIBROMYALGIA SYMPTOMS AND FUNCTIONAL DEFICITS ALSO IMPROVED SIGNIFICANTLY, INCLUDING PHYSICAL TESTS OF STRENGTH AND BALANCE, AND PAIN COPING STRATEGIES. THESE FINDINGS INDICATE THAT FURTHER INVESTIGATION IS WARRANTED INTO THE EFFECT OF MINDFUL YOGA ON NEUROBIOLOGICAL PAIN PROCESSING.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
10 1281  35 GENTLE HATHA YOGA AND REDUCTION OF FIBROMYALGIA-RELATED SYMPTOMS: A PRELIMINARY REPORT. OBJECTIVES AND METHODS: THIS STUDY EXAMINED WHETHER GENTLE HATHA YOGA REDUCED FIBROMYALGIA-RELATED SYMPTOMS FOR A CONVENIENCE SAMPLE OF 10 PARTICIPANTS RANGING IN AGE FROM 39 TO 64 YEARS WHO RECEIVED YOGA INSTRUCTION 2 TIMES PER WEEK FOR 8 WEEKS. METHODS: RESPONDENTS COMPLETED THE FIBROMYALGIA IMPACT QUESTIONNAIRE 1 TIME PER WEEK AND PROVIDED WEEKLY JOURNAL REPORTS REGARDING THEIR HEALTH STATUS. PRE- AND POST-INTERVENTION MANUAL TENDER POINT EVALUATIONS WERE ALSO CONDUCTED. RESULTS: FINDINGS PROVIDE EVIDENCE OF ASSOCIATION BETWEEN PARTICIPATING IN GENTLE HATHA YOGA CLASSES AND REDUCED FIBROMYALGIA - RELATED SYMPTOMS. CONCLUSIONS: ADDITIONAL RANDOMIZED CONTROLLED TRIALS WITH LARGER SAMPLE SIZES AND GREATER EMPIRICAL RIGOR ARE NEEDED TO MORE FULLY UNDERSTAND THIS RELATIONSHIP.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
11 2816  31 YOGA TRAINING IMPROVES METABOLIC PARAMETERS IN OBESE BOYS. YOGA HAS BEEN KNOWN TO HAVE STIMULATORY OR INHIBITORY EFFECTS ON THE METABOLIC PARAMETERS AND TO BE UNCOMPLICATED THERAPY FOR OBESITY. THE PURPOSE OF THE PRESENT STUDY WAS TO TEST THE EFFECT OF AN 8-WEEK OF YOGA-ASANA TRAINING ON BODY COMPOSITION, LIPID PROFILE, AND INSULIN RESISTANCE (IR) IN OBESE ADOLESCENT BOYS. TWENTY VOLUNTEERS WITH BODY MASS INDEX (BMI) GREATER THAN THE 95TH PERCENTILE WERE RANDOMLY ASSIGNED TO YOGA (AGE 14.7+/-0.5 YEARS, N=10) AND CONTROL GROUPS (AGE 14.6+/-1.0 YEARS, N=10). THE YOGA GROUP PERFORMED EXERCISES THREE TIMES PER WEEK AT 40~60% OF HEART-RATE RESERVE (HRR) FOR 8 WEEKS. IR WAS DETERMINED WITH THE HOMEOSTASIS MODEL ASSESSMENT OF INSULIN RESISTANCE (HOMA-IR). AFTER YOGA TRAINING, BODY WEIGHT, BMI, FAT MASS (FM), AND BODY FAT % (BF %) WERE SIGNIFICANTLY DECREASED, AND FAT-FREE MASS AND BASAL METABOLIC RATE WERE SIGNIFICANTLY INCREASED THAN BASELINE VALUES. FM AND BF % WERE SIGNIFICANTLY IMPROVED IN THE YOGA GROUP COMPARED WITH THE CONTROL GROUP (P<0.05). TOTAL CHOLESTEROL (TC) WAS SIGNIFICANTLY DECREASED IN THE YOGA GROUP (P<0.01). HDL-CHOLESTEROL WAS DECREASED IN BOTH GROUPS (P<0.05). NO SIGNIFICANT CHANGES WERE OBSERVED BETWEEN OR WITHIN GROUPS FOR TRIGLYCERIDES, LDL-CHOLESTEROL, GLUCOSE, INSULIN, AND HOMA-IR. OUR FINDINGS SHOW THAT AN 8-WEEK OF YOGA TRAINING IMPROVES BODY COMPOSITION AND TC LEVELS IN OBESE ADOLESCENT BOYS, SUGGESTING THAT YOGA TRAINING MAY BE EFFECTIVE IN CONTROLLING SOME METABOLIC SYNDROME FACTORS IN OBESE ADOLESCENT BOYS.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
12  908  44 EFFECTIVENESS OF DEEP CERVICAL FASCIAL MANIPULATION AND YOGA POSTURES ON PAIN, FUNCTION, AND OCULOMOTOR CONTROL IN PATIENTS WITH MECHANICAL NECK PAIN: STUDY PROTOCOL OF A PRAGMATIC, PARALLEL-GROUP, RANDOMIZED, CONTROLLED TRIAL. INTRODUCTION: MECHANICAL NECK PAIN (MNP) IS A COMMONLY OCCURRING MUSCULOSKELETAL CONDITION THAT IS USUALLY MANAGED USING ELECTRICAL MODALITIES, JOINT MOBILIZATION TECHNIQUES, AND THERAPEUTIC EXERCISES, BUT HAS LIMITED EVIDENCE OF THEIR EFFICACY. PATHOLOGY (DENSIFICATION) OF THE DEEP CERVICAL FASCIA THAT OCCURS DUE TO THE INCREASED VISCOSITY OF HYALURONIC ACID (HA) MAY INDUCE NECK PAIN AND ASSOCIATED PAINFUL SYMPTOMS OF THE UPPER QUARTER REGION. FASCIAL MANIPULATION (FM) AND YOGA POSES ARE CONSIDERED TO REDUCE THE THIXOTROPY OF THE GROUND SUBSTANCES OF THE DEEP FASCIA AND IMPROVE MUSCLE FUNCTION. THE PURPOSE OF THIS STUDY IS TO INVESTIGATE THE EFFECT OF FM AND SEQUENTIAL YOGA POSES (SYP) WHEN COMPARED TO THE USUAL CARE ON PAIN, FUNCTION, AND OCULOMOTOR CONTROL IN MNP. METHODS: THIS FACE-MAN TRIAL WILL RECRUIT 160 PATIENTS WITH SUBACUTE AND CHRONIC MECHANICAL NECK PAIN DIAGNOSED USING PREDEFINED CRITERIA. PARTICIPANTS WILL BE RANDOMIZED TO EITHER THE INTERVENTION GROUP OR THE USUAL CARE GROUP, USING A RANDOM ALLOCATION RATIO OF 1:1. PATIENTS IN THE INTERVENTION GROUP WILL RECEIVE FM (4 SESSIONS IN 4 WEEKS) AND SYP (12 WEEKS) WHEREAS THE STANDARD CARE GROUP WILL RECEIVE CERVICAL MOBILIZATION/ THORACIC MANIPULATION (4 SESSIONS IN 4 WEEKS) AND THERAPEUTIC EXERCISES (12 WEEKS). THE PRIMARY OUTCOME IS THE CHANGE IN THE NUMERIC PAIN RATING SCALE (NPRS). THE SECONDARY OUTCOMES INCLUDE CHANGES IN THE PATIENT-SPECIFIC FUNCTIONAL SCALE AND OCULOMOTOR CONTROL, MYOFASCIAL STIFFNESS, FEAR-AVOIDANCE BEHAVIOR QUESTIONNAIRE, AND ELBOW EXTENSION RANGE OF MOTION DURING NEURODYNAMICS TEST 1. DISCUSSION: IF FOUND EFFECTIVE, FM ALONG WITH SYP INVESTIGATED IN THIS TRIAL CAN BE CONSIDERED AS A TREATMENT STRATEGY IN THE MANAGEMENT OF MECHANICAL NECK PAIN. CONSIDERING THE MAGNITUDE OF THE PROBLEM, AND THE PRAGMATIC AND PATIENT-CENTERED APPROACH TO BE FOLLOWED, IT IS WORTH INVESTIGATING THIS TRIAL. TRIAL REGISTRATION: CLINICALTRIALS.GOV CTRI/2020/01/022934 . REGISTERED ON JANUARY 24, 2020 WITH CTRI.NIC.IN. CLINICAL TRIALS REGISTRY - INDIA.	2021	
                                                                                                                                                                                                                                                                                                                                            
13 1336  36 HOW DOES YOGA REDUCE STRESS? A CLINICAL TRIAL TESTING PSYCHOLOGICAL MECHANISMS. YOGA INTERVENTIONS CAN REDUCE STRESS, BUT THE MECHANISMS UNDERLYING THAT STRESS REDUCTION REMAIN LARGELY UNIDENTIFIED. UNDERSTANDING HOW YOGA WORKS IS ESSENTIAL TO OPTIMIZING INTERVENTIONS. THE PRESENT STUDY TESTED FIVE POTENTIAL PSYCHOSOCIAL MECHANISMS (INCREASED MINDFULNESS, INTEROCEPTIVE AWARENESS, SPIRITUAL WELL-BEING, SELF-COMPASSION AND SELF-CONTROL) THAT HAVE BEEN PROPOSED TO EXPLAIN YOGA'S IMPACT ON STRESS. FORTY-TWO PARTICIPANTS (62% FEMALE; 64% WHITE) IN A YOGA PROGRAM FOR STRESS REDUCTION COMPLETED SURVEYS AT BASELINE (T1), MID-INTERVENTION (T2) AND POST-INTERVENTION (12 WEEKS; T3). WE MEASURED TWO ASPECTS OF STRESS, PERCEIVED STRESS AND STRESS REACTIVITY. CHANGES WERE ASSESSED WITH PAIRED T-TESTS; ASSOCIATIONS BETWEEN CHANGES IN MECHANISMS WERE TESTED IN RESIDUAL CHANGE MODELS. ONLY STRESS REACTIVITY DECREASED, ON AVERAGE, FROM T1 TO T3. EXCEPT FOR SELF-COMPASSION, ALL PSYCHOSOCIAL MECHANISMS INCREASED FROM T1 TO T3, WITH MINIMAL CHANGES FROM T2 TO T3. EXCEPT FOR SELF-CONTROL, INCREASES IN EACH MECHANISM WERE STRONGLY ASSOCIATED WITH DECREASES IN BOTH MEASURES OF STRESS BETWEEN T1 AND T2 AND DECREASES IN PERCEIVED STRESS FROM T1 TO T3 (ALL P'S < 0.05). INCREASED PSYCHOSOCIAL RESOURCES ARE ASSOCIATED WITH STRESS REDUCTION. YOGA INTERVENTIONS TARGETING THESE RESOURCES MAY SHOW STRONGER STRESS REDUCTION EFFECTS. FUTURE RESEARCH SHOULD TEST THESE LINKAGES MORE RIGOROUSLY USING ACTIVE COMPARISON GROUPS AND LARGER SAMPLES.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
14 1820  39 PROTOCOL FOR A RANDOMIZED CONTROLLED STUDY OF IYENGAR YOGA FOR YOUTH WITH IRRITABLE BOWEL SYNDROME. INTRODUCTION: IRRITABLE BOWEL SYNDROME AFFECTS AS MANY AS 14% OF HIGH SCHOOL-AGED STUDENTS. SYMPTOMS INCLUDE DISCOMFORT IN THE ABDOMEN, ALONG WITH DIARRHEA AND/OR CONSTIPATION AND OTHER GASTROENTEROLOGICAL SYMPTOMS THAT CAN SIGNIFICANTLY IMPACT QUALITY OF LIFE AND DAILY FUNCTIONING. EMOTIONAL STRESS APPEARS TO EXACERBATE IRRITABLE BOWEL SYNDROME SYMPTOMS SUGGESTING THAT MIND-BODY INTERVENTIONS REDUCING AROUSAL MAY PROVE BENEFICIAL. FOR MANY SUFFERERS, SYMPTOMS CAN BE TRACED TO CHILDHOOD AND ADOLESCENCE, MAKING THE EARLY MANIFESTATION OF IRRITABLE BOWEL SYNDROME IMPORTANT TO UNDERSTAND. THE CURRENT STUDY WILL FOCUS ON YOUNG PEOPLE AGED 14-26 YEARS WITH IRRITABLE BOWEL SYNDROME. THE STUDY WILL TEST THE POTENTIAL BENEFITS OF IYENGAR YOGA ON CLINICAL SYMPTOMS, PSYCHOSPIRITUAL FUNCTIONING AND VISCERAL SENSITIVITY. YOGA IS THOUGHT TO BRING PHYSICAL, PSYCHOLOGICAL AND SPIRITUAL BENEFITS TO PRACTITIONERS AND HAS BEEN ASSOCIATED WITH REDUCED STRESS AND PAIN. THROUGH ITS FOCUS ON RESTORATION AND USE OF PROPS, IYENGAR YOGA IS ESPECIALLY DESIGNED TO DECREASE AROUSAL AND PROMOTE PSYCHOSPIRITUAL RESOURCES IN PHYSICALLY COMPROMISED INDIVIDUALS. AN EXTENSIVE AND STANDARDIZED TEACHER-TRAINING PROGRAM SUPPORT IYENGAR YOGA'S RELIABILITY AND SAFETY. IT IS HYPOTHESIZED THAT YOGA WILL BE FEASIBLE WITH LESS THAN 20% ATTRITION; AND THE YOGA GROUP WILL DEMONSTRATE SIGNIFICANTLY IMPROVED OUTCOMES COMPARED TO CONTROLS, WITH PHYSIOLOGICAL AND PSYCHOSPIRITUAL MECHANISMS CONTRIBUTING TO IMPROVEMENTS. METHODS/DESIGN: SIXTY IRRITABLE BOWEL SYNDROME PATIENTS AGED 14-26 WILL BE RANDOMLY ASSIGNED TO A STANDARDIZED 6-WEEK TWICE WEEKLY IYENGAR YOGA GROUP-BASED PROGRAM OR A WAIT-LIST USUAL CARE CONTROL GROUP. THE GROUPS WILL BE COMPARED ON THE PRIMARY CLINICAL OUTCOMES OF IRRITABLE BOWEL SYNDROME SYMPTOMS, QUALITY OF LIFE AND GLOBAL IMPROVEMENT AT POST-TREATMENT AND 2-MONTH FOLLOW-UP. SECONDARY OUTCOMES WILL INCLUDE VISCERAL PAIN SENSITIVITY ASSESSED WITH A STANDARDIZED LABORATORY TASK (WATER LOAD TASK), FUNCTIONAL DISABILITY AND PSYCHOSPIRITUAL VARIABLES INCLUDING CATASTROPHIZING, SELF-EFFICACY, MOOD, ACCEPTANCE AND MINDFULNESS. MECHANISMS OF ACTION INVOLVED IN THE PROPOSED BENEFICIAL EFFECTS OF YOGA UPON CLINICAL OUTCOMES WILL BE EXPLORED, AND INCLUDE THE MEDIATING EFFECTS OF VISCERAL SENSITIVITY, INCREASED PSYCHOSPIRITUAL RESOURCES, REGULATED AUTONOMIC NERVOUS SYSTEM RESPONSES AND REGULATED HORMONAL STRESS RESPONSE ASSESSED VIA SALIVARY CORTISOL. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT01107977.	2011	

15 1492  41 INTERNALIZED WEIGHT STIGMA AND INTUITIVE EATING AMONG STRESSED ADULTS DURING A MINDFUL YOGA INTERVENTION: ASSOCIATIONS WITH CHANGES IN MINDFULNESS AND SELF-COMPASSION. PURPOSE: INTERNALIZED WEIGHT STIGMA (IWS) IS COMMON IN THE UNITED STATES OF AMERICA ACROSS BODY WEIGHT CATEGORIES, AND IS IMPLICATED IN THE DEVELOPMENT OF DISTRESS AND UNHEALTHY EATING BEHAVIORS (E.G. OVEREATING, DISORDERED EATING) THAT CAN FOSTER POOR CARDIOMETABOLIC HEALTH. WHILE EMERGING INTERVENTION RESEARCH SHOWS EARLY PROMISE IN REDUCING IWS, LONG-TERM EFFICACY IS UNCLEAR AND NOVEL STRATEGIES REMAIN NEEDED. THIS ANALYSIS EXAMINED WHETHER PARTICIPATION IN A MINDFUL YOGA INTERVENTION WAS ASSOCIATED WITH REDUCED IWS AND INCREASED INTUITIVE EATING, AN ADAPTIVE EATING BEHAVIOR, AND WHETHER THESE CHANGES CORRELATED WITH EACH OTHER OR WITH CHANGES IN MINDFULNESS AND SELF-COMPASSION. METHODS: PARTICIPANTS WERE STRESSED ADULTS WITH LOW FRUIT AND VEGETABLE INTAKE (N = 78, 64.1% WHITE, M. BODY MASS INDEX 25.59 +/- 4.45) ENROLLED IN A PARENT CLINICAL TRIAL OF A 12-WEEK MINDFUL YOGA INTERVENTION. VALIDATED SELF-REPORT MEASURES OF IWS, INTUITIVE EATING, MINDFULNESS, AND SELF-COMPASSION WERE ADMINISTERED AT PRE-TREATMENT, MID-TREATMENT (8 WEEKS), POST-TREATMENT (12 WEEKS), AND 4-MONTH FOLLOW-UP (24 WEEKS). RESULTS: LINEAR MIXED MODELING REVEALED SIGNIFICANT IMPROVEMENTS IN IWS AND INTUITIVE EATING ACROSS THE FOUR TIMEPOINTS (P < .001). REDUCED IWS CORRELATED WITH INCREASED INTUITIVE EATING PRE- TO POST-TREATMENT (P = .01). IMPROVED SELF-COMPASSION AND MINDFULNESS CORRELATED WITH INTUITIVE EATING (BOTH P = . 04), BUT NOT IWS (P = .74 AND P = .56, RESPECTIVELY). CONCLUSION: THIS STUDY OFFERS PRELIMINARY SUPPORT FOR THE HYPOTHESIS THAT MINDFUL YOGA MAY PROMOTE INTUITIVE EATING AND REDUCE IWS AMONG STRESSED ADULTS WITH POOR DIET, AND SUGGESTS THAT CHANGES IN THESE FACTORS MAY CO-OCCUR OVER TIME. FURTHER INVESTIGATION WITH CONTROLLED DESIGNS IS NECESSARY TO BETTER UNDERSTAND THE TEMPORALITY AND CAUSALITY OF THESE RELATIONSHIPS.TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT02098018.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
16 2575  44 YOGA FOR FUNCTIONAL ABILITY, PAIN AND PSYCHOSOCIAL OUTCOMES IN MUSCULOSKELETAL CONDITIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVES: MUSCULOSKELETAL CONDITIONS (MSCS) ARE THE LEADING CAUSE OF DISABILITY AND CHRONIC PAIN IN THE DEVELOPED WORLD, IMPACTING BOTH FUNCTIONAL ABILITY AND PSYCHOSOCIAL HEALTH. THE CURRENT REVIEW INVESTIGATES THE EFFECTIVENESS OF YOGA ON PRIMARY OUTCOMES OF FUNCTIONAL ABILITY, PAIN AND PSYCHOSOCIAL OUTCOMES ACROSS A RANGE OF MSCS. METHODS: A COMPREHENSIVE SEARCH OF 20 DATABASES WAS CONDUCTED FOR FULL-TEXT, RANDOMIZED CONTROLLED TRIALS OF YOGA IN CLINICALLY DIAGNOSED MSCS. RESULT: SEVENTEEN STUDIES MET THE INCLUSION CRITERIA, INVOLVING 1,626 PARTICIPANTS WITH LOW BACK PAIN (LBP), OSTEOARTHRITIS (OA), RHEUMATOID ARTHRITIS (RA), KYPHOSIS OR FIBROMYALGIA. STUDIES WERE QUALITY RATED, AND ANALYSED FOR THE EFFECT OF YOGA ON PRIMARY OUTCOMES, IMMEDIATELY POST-INTERVENTION. TWELVE STUDIES WERE RATED AS GOOD QUALITY. YOGA INTERVENTIONS RESULTED IN A CLINICALLY SIGNIFICANT IMPROVEMENT IN FUNCTIONAL OUTCOMES IN MILD-TO-MODERATE LBP AND FIBROMYALGIA, AND SHOWED A TREND TO IMPROVEMENT IN KYPHOSIS. YOGA SIGNIFICANTLY IMPROVED PAIN IN OA, RA AND MILD-TO-SEVERE LBP. PSYCHOSOCIAL OUTCOMES WERE SIGNIFICANTLY IMPROVED IN MILD-TO-MODERATE LBP AND OA. META-ANALYSIS OF GOOD-QUALITY STUDIES SHOWED A MODERATE TREATMENT EFFECT FOR YOGA OF -0.64 (95%CI -0.89 TO -0.39) FOR FUNCTIONAL OUTCOMES AND -0.61 (95%CI -0.97 TO -0.26) FOR PAIN OUTCOMES. CONCLUSIONS: EVIDENCE SUGGESTS THAT YOGA IS AN ACCEPTABLE AND SAFE INTERVENTION, WHICH MAY RESULT IN CLINICALLY RELEVANT IMPROVEMENTS IN PAIN AND FUNCTIONAL OUTCOMES ASSOCIATED WITH A RANGE OF MSCS. FUTURE ANALYSIS OF OUTCOMES WHICH TAKE INTO ACCOUNT THE AMOUNT OF YOGA RECEIVED BY PARTICIPANTS MAY PROVIDE INSIGHT INTO ANY PUTATIVE DURATION OR DOSAGE EFFECTS OF YOGA INTERVENTIONS FOR MSCS.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
17 2697  35 YOGA INTERVENTION AND FUNCTIONAL PAIN SYNDROMES: A SELECTIVE REVIEW. THE DEFINITION OF FUNCTIONAL PAIN SYNDROMES IS VARIED ACROSS LITERATURE. NO EFFORT HAS BEEN MADE TO SEE ALL FUNCTIONAL PAIN DISORDER GROUPS UNDER BROAD NOMENCLATURE WHICH WOULD EXCLUDE CONDITIONS FOR WHICH PATHOPHYSIOLOGY IS STRONGLY KNOWN. SINCE THESE DISORDERS ARE COMMONLY TREATED WITH ALTERNATIVE TREATMENT MODALITIES AND IMPOSE SIGNIFICANT BURDEN ON HEALTH UTILIZATION, AN EFFORT TO LOOK INTO STUDIES ON YOGA-BASED INTERVENTIONS ON 'FUNCTIONAL PAIN SYNDROMES' (FPS) WAS MADE. THIS STUDY DEFINED FPS AS 'CHRONIC RELAPSING REMITTING PAIN CONDITIONS, THE ORIGIN OF WHICH IS DIFFICULT TO TRACE WITH NO DEFINITE PHYSICAL PATHOLOGY ON CLINICAL SUSPICION OR AVAILABLE LABORATORY MEASURES AND ARE VALID BASED ON SUBJECTIVE PAIN REPORTING, ASSOCIATED DISTRESS AND SOCIO-OCCUPATIONAL DYSFUNCTION'. CHRONIC HEADACHE, NECK PAIN, BACK PAIN, FIBROMYALGIA, PELVIC PAIN, IRRITABLE BOWEL SYNDROME, CHRONIC FATIGUE SYNDROME, AND SOMATOFORM PAIN DISORDERS WERE INCLUDED FOR THIS REVIEW. THE REVIEW FOUND FOUR META-ANALYSES ON THE SELECTED TOPIC BOTH INDICATING MODEST EFFICACY AND BENEFIT OF YOGA IN THESE DISORDERS. FUTURE EFFORTS SHOULD BE DIRECTED TO DO A LARGE META-ANALYSIS OF FUNCTIONAL PAIN SYNDROMES.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
18 1582  31 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
19 1870  39 RANDOMIZED-CONTROLLED TRIAL COMPARING YOGA AND HOME-BASED EXERCISE FOR CHRONIC NECK PAIN. OBJECTIVES: CHRONIC NECK PAIN IS A SIGNIFICANT PUBLIC HEALTH PROBLEM WITH ONLY VERY FEW EVIDENCE-BASED TREATMENT OPTIONS. THERE IS GROWING EVIDENCE FOR THE EFFECTIVENESS OF YOGA FOR RELIEVING MUSCULOSKELETAL DISORDERS. THE AIM OF THIS STUDY WAS TO EVALUATE THE EFFECT OF IYENGAR YOGA COMPARED WITH EXERCISE ON CHRONIC NONSPECIFIC NECK PAIN. METHODS: PATIENTS WERE RANDOMLY ASSIGNED TO EITHER YOGA OR EXERCISE. THE YOGA GROUP ATTENDED A 9-WEEK YOGA COURSE AND THE EXERCISE GROUP RECEIVED A SELF-CARE MANUAL ON HOME-BASED EXERCISES FOR NECK PAIN RELIEF. THE MAIN OUTCOME MEASURE WAS THE PRESENT NECK PAIN INTENSITY (100 MM VISUAL ANALOG SCALE). SECONDARY OUTCOME MEASURES INCLUDED FUNCTIONAL DISABILITY (NECK DISABILITY INDEX), PAIN AT MOTION (VISUAL ANALOG SCALE), HEALTH-RELATED QUALITY OF LIFE (SHORT FORM-36 QUESTIONNAIRE), CERVICAL RANGE OF MOTION, PROPRIOCEPTIVE ACUITY, AND PRESSURE PAIN THRESHOLD. RESULTS: FIFTY-ONE PATIENTS (MEAN AGE 47.8 Y ; 82.4% FEMALE) WERE RANDOMIZED TO YOGA (N=25) AND EXERCISE (N=26) INTERVENTION. AFTER THE STUDY PERIOD, PATIENTS IN THE YOGA GROUP REPORTED SIGNIFICANTLY LESS NECK PAIN INTENSITY COMPARED WITH THE EXERCISE GROUP [MEAN DIFFERENCE: -13.9 MM (95% CI, -26.4 TO -1.4), P=0.03]. THE YOGA GROUP REPORTED LESS DISABILITY AND BETTER MENTAL QUALITY OF LIFE. RANGE OF MOTION AND PROPRIOCEPTIVE ACUITY WERE IMPROVED AND THE PRESSURE PAIN THRESHOLD WAS ELEVATED IN THE YOGA GROUP. DISCUSSION: YOGA WAS MORE EFFECTIVE IN RELIEVING CHRONIC NONSPECIFIC NECK PAIN THAN A HOME-BASED EXERCISE PROGRAM. YOGA REDUCED NECK PAIN INTENSITY AND DISABILITY AND IMPROVED HEALTH-RELATED QUALITY OF LIFE. MOREOVER, YOGA SEEMS TO INFLUENCE THE FUNCTIONAL STATUS OF NECK MUSCLES, AS INDICATED BY IMPROVEMENT OF PHYSIOLOGICAL MEASURES OF NECK PAIN.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
20 1291  33 GROUP ACUPUNCTURE THERAPY WITH YOGA THERAPY FOR CHRONIC NECK, LOW BACK, AND OSTEOARTHRITIS PAIN IN SAFETY NET SETTING FOR AN UNDERSERVED POPULATION: DESIGN AND RATIONALE FOR A FEASIBILITY PILOT. CHRONIC PAIN IS PREVALENT IN THE UNITED STATES, WITH IMPACT ON PHYSICAL AND PSYCHOLOGICAL FUNCTIONING AS WELL AS LOST WORK PRODUCTIVITY. MINORITY AND LOWER SOCIOECONOMIC POPULATIONS HAVE INCREASED PREVALENCE OF CHRONIC PAIN WITH LESS ACCESS TO PAIN CARE, POORER OUTCOMES, AND HIGHER RISK OF FATAL OPIOID OVERDOSE. ACUPUNCTURE THERAPY IS EFFECTIVE IN TREATING CHRONIC PAIN CONDITIONS INCLUDING CHRONIC LOW BACK PAIN, NECK PAIN, SHOULDER PAIN, AND KNEE PAIN FROM OSTEOARTHRITIS. ACUPUNCTURE THERAPY, INCLUDING GROUP ACUPUNCTURE, IS FEASIBLE AND EFFECTIVE, AND SPECIFICALLY SO FOR UNDERSERVED AND DIVERSE POPULATIONS AT RISK FOR HEALTH OUTCOME DISPARITIES. ACUPUNCTURE THERAPY ALSO ENCOURAGES PATIENT ENGAGEMENT AND ACTIVATION. AS CHRONIC PAIN IMPROVES, THERE IS A NATURAL PROGRESSION TO WANT AND NEED TO INCREASE ACTIVITY AND MOVEMENT RECOVERY. DIVERSE MOVEMENT APPROACHES ARE IMPORTANT FOR IMPROVING RANGE OF MOTION, MAINTAINING GAINS, STRENGTHENING, AND PROMOTING PATIENT ENGAGEMENT AND ACTIVATION. YOGA THERAPY IS AN ACTIVE THERAPY WITH PROVEN BENEFIT IN MUSCULOSKELETAL PAIN DISORDERS AND PAIN ASSOCIATED DISABILITY. THE AIM OF THIS QUASI-EXPERIMENTAL PILOT FEASIBILITY TRIAL IS TO TEST THE BUNDLING OF THESE 2 EFFECTIVE CARE OPTIONS FOR CHRONIC PAIN, TO INFORM BOTH THE DESIGN FOR A LARGER RANDOMIZED PRAGMATIC EFFECTIVENESS TRIAL AS WELL AS IMPLEMENTATION STRATEGIES ACROSS UNDERSERVED SETTINGS.	2020