1 2537 142 YOGA EXPERIENCE AS A PREDICTOR OF PSYCHOLOGICAL WELLNESS IN WOMEN OVER 45 YEARS. BACKGROUND: ALTHOUGH HIGH LEVELS OF SUBJECTIVE WELL-BEING (SWB) ARE COMMON IN OLD AGE, A SUBSET OF OLDER INDIVIDUALS IS DISPROPORTIONATELY VULNERABLE TO NEGATIVE AFFECT. YOGA HAS BEEN SHOWN TO HAVE MANY SHORT-TERM BENEFITS, BUT RESEARCHERS HAVE NOT DETERMINED WHETHER A LONG-TERM OR FREQUENT YOGA PRACTICE INCREASINGLY PROTECTS OLDER WOMEN FROM LOW LEVELS OF PSYCHOLOGICAL WELL-BEING. AIMS: THE PURPOSE OF THIS STUDY WAS TO EXAMINE THE EXTENT TO WHICH PSYCHOLOGICAL ATTITUDES, TRANSCENDENCE, MENTAL MASTERY, AND SUBJECTIVE VITALITY IN A SAMPLE OF FEMALE YOGA PRACTITIONERS OVER 45 YEARS VARIED ACCORDING TO THE LENGTH AND FREQUENCY OF YOGA PRACTICE. MATERIALS AND METHODS: WE ADMINISTERED ONLINE SURVEYS TO A NON-PROBABILITY SAMPLE OF 211 FEMALE YOGA PRACTITIONERS 45 TO 80. WE USED WEIGHTED LEAST SQUARES REGRESSION ANALYSES TO EVALUATE THE RELATIONSHIP OF EXTENT OF YOGA EXPERIENCE TO THE OUTCOME VARIABLES AFTER ACCOUNTING FOR AGE AND LIFESTYLE FACTORS. RESULTS: PARTICIPANTS HAD PRACTICED YOGA FOR AS LONG AS 50 YEARS AND FOR UP TO 28 H PER WEEK. THERE WERE SIGNIFICANT POSITIVE RELATIONSHIPS BETWEEN YOGA EXPERIENCE AND ALL OUTCOME VARIABLES. THESE SIGNIFICANT RELATIONSHIPS REMAINED AFTER ACCOUNTING FOR AGE AND LIFESTYLE FACTORS. WHEN WE COMPUTED YOGA EXPERIENCE IN TERMS OF TOTAL CALENDAR YEARS, WITHOUT ACCOUNTING FOR HOURS OF PRACTICE, SIGNIFICANT RELATIONSHIPS DID NOT REMAIN. TRANSCENDENCE OF THE ORDINARY WAS THE MOST STRONGLY ASSOCIATED WITH CURRENT YOGA PRACTICE FREQUENCY, AND POSITIVE PSYCHOLOGICAL ATTITUDES WERE THE MOST STRONGLY ASSOCIATED WITH TOTAL LIFETIME HOURS OF PRACTICE. CONCLUSIONS: AMONG A NON-PROBABILITY SAMPLE OF FEMALE YOGA PRACTITIONERS BETWEEN 45 AND 80 YEARS, INCREASED YOGA EXPERIENCE PREDICTED INCREASED LEVELS OF PSYCHOLOGICAL WELL-BEING. RESULTS SHOWED A DOSE-RESPONSE EFFECT, WITH YOGA EXPERIENCE EXERCISING AN INCREASINGLY PROTECTIVE EFFECT AGAINST LOW LEVELS OF SWB AND VITALITY. 2013 2 1440 95 INCREASED HATHA YOGA EXPERIENCE PREDICTS LOWER BODY MASS INDEX AND REDUCED MEDICATION USE IN WOMEN OVER 45 YEARS. BACKGROUND: YOGA HAS BEEN SHOWN TO HAVE MANY SHORT-TERM HEALTH BENEFITS, BUT LITTLE IS KNOWN ABOUT THE EXTENT TO WHICH THESE BENEFITS ACCRUE OVER A LONG TIME FRAME OR WITH FREQUENT PRACTICE. AIMS: THE PURPOSE OF THIS STUDY WAS TO EXAMINE THE EXTENT TO WHICH BODY MASS INDEX (BMI) AND MEDICATION USE IN A SAMPLE OF FEMALE YOGA PRACTITIONERS OVER 45 YEARS VARIED ACCORDING TO THE LENGTH AND FREQUENCY OF YOGA PRACTICE. MATERIALS AND METHODS: WE ADMINISTERED ONLINE SURVEYS TO 211 FEMALE YOGA PRACTITIONERS AGED 45 TO 80 YEARS. WE USED REGRESSION ANALYSES TO EVALUATE THE RELATIONSHIP OF EXTENT OF YOGA EXPERIENCE TO BOTH BMI AND MEDICATION USE AFTER ACCOUNTING FOR AGE AND LIFESTYLE FACTORS. WE ALSO CONDUCTED COMPARISONS WITH 182 MATCHED CONTROLS. RESULTS: PARTICIPANTS HAD PRACTICED YOGA FOR AS LONG AS 50 YEARS AND FOR UP TO 28 HOURS PER WEEK. THERE WERE SIGNIFICANT INVERSE RELATIONSHIPS BETWEEN YOGA EXPERIENCE AND BOTH BMI AND MEDICATION LOAD. THESE SIGNIFICANT RELATIONSHIPS REMAINED AFTER ACCOUNTING FOR AGE AND LIFESTYLE FACTORS. WHEN WE COMPUTED YOGA EXPERIENCE IN TERMS OF TOTAL CALENDAR YEARS, WITHOUT ACCOUNTING FOR HOURS OF PRACTICE, SIGNIFICANT RELATIONSHIPS DID NOT REMAIN. HOWEVER, THERE WAS NO OBESITY IN THE 49 PARTICIPANTS WITH MORE THAN 25 YEARS OF YOGA PRACTICE. YOGA PRACTITIONERS WERE LESS LIKELY THAN NON-PRACTITIONERS TO USE MEDICATION FOR METABOLIC SYNDROME, MOOD DISORDERS, INFLAMMATION, AND PAIN. CONCLUSIONS: A LONG-TERM YOGA PRACTICE WAS ASSOCIATED WITH LITTLE OR NO OBESITY IN A NON-PROBABILITY SAMPLE OF WOMEN OVER 45 YEARS. RELATIONSHIPS SHOWED A DOSE-RESPONSE EFFECT, WITH INCREASED YOGA EXPERIENCE PREDICTING LOWER BMI AND REDUCED MEDICATION USE. 2011 3 2538 46 YOGA FOR ADULT WOMEN WITH CHRONIC PTSD: A LONG-TERM FOLLOW-UP STUDY. INTRODUCTION: YOGA-THE INTEGRATIVE PRACTICE OF PHYSICAL POSTURES AND MOVEMENT, BREATH EXERCISES, AND MINDFULNESS-MAY SERVE AS A USEFUL ADJUNCTIVE COMPONENT OF TRAUMA-FOCUSED TREATMENT TO BUILD SKILLS IN TOLERATING AND MODULATING PHYSIOLOGIC AND AFFECTIVE STATES THAT HAVE BECOME DYSREGULATED BY TRAUMA EXPOSURE. A PREVIOUS RANDOMIZED CONTROLLED STUDY WAS CARRIED OUT AMONG 60 WOMEN WITH CHRONIC, TREATMENT-RESISTANT POST-TRAUMATIC STRESS DISORDER (PTSD) AND ASSOCIATED MENTAL HEALTH PROBLEMS STEMMING FROM PROLONGED OR MULTIPLE TRAUMA EXPOSURES. AFTER 10 SESSIONS OF YOGA, PARTICIPANTS EXHIBITED STATISTICALLY SIGNIFICANT DECREASES IN PTSD SYMPTOM SEVERITY AND GREATER LIKELIHOOD OF LOSS OF PTSD DIAGNOSIS, SIGNIFICANT DECREASES IN ENGAGEMENT IN NEGATIVE TENSION REDUCTION ACTIVITIES (E.G., SELF-INJURY), AND GREATER REDUCTIONS IN DISSOCIATIVE AND DEPRESSIVE SYMPTOMS WHEN COMPARED WITH THE CONTROL (A SEMINAR IN WOMEN'S HEALTH). THE CURRENT STUDY IS A LONG-TERM FOLLOW-UP ASSESSMENT OF PARTICIPANTS WHO COMPLETED THIS RANDOMIZED CONTROLLED TRIAL. METHODS: PARTICIPANTS FROM THE RANDOMIZED CONTROLLED TRIAL WERE INVITED TO PARTICIPATE IN LONG-TERM FOLLOW-UP ASSESSMENTS APPROXIMATELY 1.5 YEARS AFTER STUDY COMPLETION TO ASSESS WHETHER THE INITIAL INTERVENTION AND/OR YOGA PRACTICE AFTER TREATMENT WAS ASSOCIATED WITH ADDITIONAL CHANGES. FORTY-NINE WOMEN COMPLETED THE LONG-TERM FOLLOW-UP INTERVIEWS. HIERARCHICAL REGRESSION ANALYSIS WAS USED TO EXAMINE WHETHER TREATMENT GROUP STATUS IN THE ORIGINAL STUDY AND FREQUENCY OF YOGA PRACTICE AFTER THE STUDY PREDICTED GREATER CHANGES IN SYMPTOMS AND PTSD DIAGNOSIS. RESULTS: GROUP ASSIGNMENT IN THE ORIGINAL RANDOMIZED STUDY WAS NOT A SIGNIFICANT PREDICTOR OF LONGER-TERM OUTCOMES. HOWEVER, FREQUENCY OF CONTINUING YOGA PRACTICE SIGNIFICANTLY PREDICTED GREATER DECREASES IN PTSD SYMPTOM SEVERITY AND DEPRESSION SYMPTOM SEVERITY, AS WELL AS A GREATER LIKELIHOOD OF A LOSS OF PTSD DIAGNOSIS. CONCLUSIONS: YOGA APPEARS TO BE A USEFUL TREATMENT MODALITY; THE GREATEST LONG-TERM BENEFITS ARE DERIVED FROM MORE FREQUENT YOGA PRACTICE. 2016 4 1787 40 PREFERENCE AND EXPECTATION FOR TREATMENT ASSIGNMENT IN A RANDOMIZED CONTROLLED TRIAL OF ONCE- VS TWICE-WEEKLY YOGA FOR CHRONIC LOW BACK PAIN. BACKGROUND: IN STUDIES INVOLVING NONPHARMACOLOGICAL COMPLEMENTARY AND ALTERNATIVE MEDICINE INTERVENTIONS, PARTICIPANT BLINDING IS VERY DIFFICULT. PARTICIPANT EXPECTATIONS MAY AFFECT PERCEIVED BENEFIT OF THERAPY. IN STUDIES OF YOGA AS TREATMENT FOR CHRONIC LOW BACK PAIN, LITTLE IS KNOWN ABOUT THE RELATIONSHIP BETWEEN PATIENT EXPECTATIONS AND PREFERENCES ON OUTCOMES. THIS STUDY WAS DESIGNED TO IDENTIFY BASELINE PREDICTORS OF PREFERENCE AND TO DETERMINE IF EXPECTATIONS AND PREFERENCES FOR DIFFERENT DOSES OF YOGA AFFECT BACK-RELATED FUNCTION AND LOW BACK PAIN INTENSITY. METHODS: THIS WAS A SECONDARY DATA ANALYSIS OF A 12-WEEK RANDOMIZED CONTROLLED TRIAL COMPARING ONCE-WEEKLY VS TWICE-WEEKLY YOGA FOR TREATMENT OF CHRONIC LOW BACK PAIN IN 93 ADULTS FROM A PREDOMINANTLY LOW-INCOME MINORITY POPULATION. AT BASELINE, PARTICIPANTS WERE ASKED ABOUT BACK FUNCTION, BACK PAIN, TREATMENT EXPECTATIONS, AND TREATMENT PREFERENCES. WE CREATED A VARIABLE "CONCORDANCE" TO DESCRIBE THE MATCHING OF PARTICIPANT PREFERENCE TO RANDOMIZED TREATMENT. OUR OUTCOME VARIABLES WERE CHANGE IN BACK FUNCTION AND PAIN INTENSITY AFTER 12 WEEKS OF YOGA INSTRUCTION. WE PERFORMED LOGISTIC REGRESSION TO IDENTIFY PREDICTORS OF PREFERENCE FOR ONCE- OR TWICE-WEEKLY YOGA INSTRUCTION. WE CREATED LINEAR REGRESSION MODELS TO IDENTIFY INDEPENDENT ASSOCIATIONS BETWEEN EXPECTATIONS, PREFERENCE, CONCORDANCE, AND OUTCOMES. RESULTS: WORSE BACK FUNCTION AT BASELINE WAS ASSOCIATED WITH 20% HIGHER ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 1.2, CI 1.1, 1.3). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR TWICE-WEEKLY YOGA HAD 90% HIGHER ODDS OF PREFERRING TWICE-WEEKLY VS ONCE-WEEKLY YOGA (OR 1.9, CI 1.3, 2.7). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR ONCE-WEEKLY YOGA HAD 40% LESS ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 0.6, CI 0.5, 0.9). AFTER CONTROLLING FOR BASELINE CHARACTERISTICS, WE FOUND NO STATISTICALLY SIGNIFICANT RELATIONSHIP BETWEEN TREATMENT OUTCOMES, PREFERENCE, EXPECTATION SCORES, OR CONCORDANCE. CONCLUSION: IN A POPULATION OF PREDOMINANTLY LOW-INCOME MINORITY PARTICIPANTS WITH CHRONIC LOW BACK PAIN, WORSE BACK FUNCTION WAS ASSOCIATED WITH PREFERENCE FOR MORE FREQUENT YOGA CLASSES. THOSE WHO PREFERRED MORE YOGA CLASSES HAD HIGHER EXPECTATIONS FOR THOSE CLASSES. TWELVE-WEEK CHANGE IN BACK PAIN INTENSITY AND BACK FUNCTION WERE NOT AFFECTED BY DOSING PREFERENCE, EXPECTATION SCORE, OR CONCORDANCE. MORE RESEARCH IS NEEDED TO BETTER MEASURE AND QUANTIFY PREFERENCE, EXPECTATIONS, AND THEIR RELATIONSHIP TO OUTCOMES IN YOGA RESEARCH. 2015 5 2836 38 YOGA'S IMPACT ON INFLAMMATION, MOOD, AND FATIGUE IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. PURPOSE: TO EVALUATE YOGA'S IMPACT ON INFLAMMATION, MOOD, AND FATIGUE. PATIENTS AND METHODS: A RANDOMIZED CONTROLLED 3-MONTH TRIAL WAS CONDUCTED WITH TWO POST-TREATMENT ASSESSMENTS OF 200 BREAST CANCER SURVIVORS ASSIGNED TO EITHER 12 WEEKS OF 90-MINUTE TWICE PER WEEK HATHA YOGA CLASSES OR A WAIT-LIST CONTROL. THE MAIN OUTCOME MEASURES WERE LIPOPOLYSACCHARIDE-STIMULATED PRODUCTION OF PROINFLAMMATORY CYTOKINES INTERLEUKIN-6 (IL-6), TUMOR NECROSIS FACTOR ALPHA (TNF-ALPHA), AND INTERLEUKIN-1BETA (IL-1BETA), AND SCORES ON THE MULTIDIMENSIONAL FATIGUE SYMPTOM INVENTORY-SHORT FORM (MFSI-SF), THE VITALITY SCALE FROM THE MEDICAL OUTCOMES STUDY 36-ITEM SHORT FORM (SF-36), AND THE CENTER FOR EPIDEMIOLOGICAL STUDIES-DEPRESSION (CES-D) SCALE. RESULTS: IMMEDIATELY POST-TREATMENT, FATIGUE WAS NOT LOWER (P > .05) BUT VITALITY WAS HIGHER (P = .01) IN THE YOGA GROUP COMPARED WITH THE CONTROL GROUP. AT 3 MONTHS POST-TREATMENT, FATIGUE WAS LOWER IN THE YOGA GROUP (P = .002), VITALITY WAS HIGHER (P = .01), AND IL-6 (P = .027), TNF-ALPHA (P = .027), AND IL-1BETA (P = .037) WERE LOWER FOR YOGA PARTICIPANTS COMPARED WITH THE CONTROL GROUP. GROUPS DID NOT DIFFER ON DEPRESSION AT EITHER TIME (P > .2). PLANNED SECONDARY ANALYSES SHOWED THAT THE FREQUENCY OF YOGA PRACTICE HAD STRONGER ASSOCIATIONS WITH FATIGUE AT BOTH POST-TREATMENT VISITS (P = .019; P < .001), AS WELL AS VITALITY (P = .016; P = .0045), BUT NOT DEPRESSION (P > .05) THAN SIMPLE GROUP ASSIGNMENT; MORE FREQUENT PRACTICE PRODUCED LARGER CHANGES. AT 3 MONTHS POST-TREATMENT, INCREASING YOGA PRACTICE ALSO LED TO A DECREASE IN IL-6 (P = .01) AND IL-1BETA (P = .03) PRODUCTION BUT NOT IN TNF-ALPHA PRODUCTION (P > .05). CONCLUSION: CHRONIC INFLAMMATION MAY FUEL DECLINES IN PHYSICAL FUNCTION LEADING TO FRAILTY AND DISABILITY. IF YOGA DAMPENS OR LIMITS BOTH FATIGUE AND INFLAMMATION, THEN REGULAR PRACTICE COULD HAVE SUBSTANTIAL HEALTH BENEFITS. 2014 6 1466 42 INJURY IN YOGA ASANA PRACTICE: ASSESSMENT OF THE RISKS. BACKGROUND: THE RISK OF INJURY FROM MODERN YOGA ASANA PRACTICE IS POORLY CHARACTERIZED IN THE SCIENTIFIC LITERATURE, BUT ANECDOTAL REPORTS IN THE LAY LITERATURE AND PRESS HAVE POSED QUESTIONS ABOUT THE POSSIBILITY OF FREQUENT, SEVERE INJURIES. DESIGN: WE PERFORMED A CROSS-SECTIONAL SURVEY OF YOGA ASANA PARTICIPANTS ASSESSING THEIR EXPERIENCE WITH YOGA-RELATED INJURY, USING A VOLUNTARY CONVENIENCE SAMPLE. RESULTS: A TOTAL OF 2620 PARTICIPANTS RESPONDED TO OUR SURVEY. SEVENTY-NINE PERCENT WERE BETWEEN AGES 31 AND 60 AND 84% WERE FEMALE. THE MAJORITY OF RESPONDENTS LIVED IN NORTH AMERICA OR EUROPE. FORTY-FIVE PERCENT OF PARTICIPANTS REPORTED EXPERIENCING NO INJURIES DURING THE TIME THEY HAD BEEN PRACTICING YOGA. OF THOSE WHO DID EXPERIENCE AN INJURY FROM ASANA PRACTICE, 28% WERE MILD (E.G., SPRAINS OR NONSPECIFIC PAINS NOT REQUIRING A MEDICAL PROCEDURE, WITH SYMPTOMS LASTING LESS THAN 6 MONTHS) AND 63% WERE MODERATE (E.G., SPRAINS OR NONSPECIFIC PAINS NOT REQUIRING A MEDICAL PROCEDURE, WITH SYMPTOMS LASTING FROM 6 MONTHS TO 1 YEAR). ONLY 9% OF THOSE REPORTING INJURIES (4% OF THE TOTAL SAMPLE) HAD A SEVERE INJURY. THE STRONGEST PREDICTORS FOR INCREASED PROBABILITY OF REPORTING AN INJURY OVER A LIFETIME OF YOGA PRACTICE WERE GREATER NUMBER OF YEARS OF PRACTICE (P<.0001) AND TEACHING YOGA (P=.0177). OTHER ASPECTS OF PARTICIPANT DEMOGRAPHICS OR YOGA PRACTICE HABITS WERE NOT RELATED TO LIKELIHOOD OF REPORTING A YOGA-RELATED INJURY. CONCLUSIONS: WE FOUND THE NUMBER OF INJURIES REPORTED BY YOGA PARTICIPANTS PER YEARS OF PRACTICE EXPOSURE TO BE LOW AND THE OCCURRENCE OF SERIOUS INJURIES IN YOGA TO BE INFREQUENT COMPARED TO OTHER PHYSICAL ACTIVITIES, SUGGESTING THAT YOGA IS NOT A HIGH-RISK PHYSICAL ACTIVITY. MORE WORK IS NEEDED TO CLARIFY THE CAUSAL RELATIONSHIPS BETWEEN THE YOGA PARTICIPANT CHARACTERISTICS, THE ASANA PRACTICE STYLE, AND THE RISK OF SIGNIFICANT INJURY. 2019 7 2824 35 YOGA VERSUS EDUCATION FOR VETERANS WITH CHRONIC LOW BACK PAIN: STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN IS THE MOST FREQUENT PAIN CONDITION IN VETERANS AND CAUSES SUBSTANTIAL SUFFERING, DECREASED FUNCTIONAL CAPACITY, AND LOWER QUALITY OF LIFE. SYMPTOMS OF POST-TRAUMATIC STRESS, DEPRESSION, AND MILD TRAUMATIC BRAIN INJURY ARE HIGHLY PREVALENT IN VETERANS WITH BACK PAIN. YOGA FOR LOW BACK PAIN HAS BEEN DEMONSTRATED TO BE EFFECTIVE FOR CIVILIANS IN RANDOMIZED CONTROLLED TRIALS. HOWEVER, IT IS UNKNOWN IF RESULTS FROM PREVIOUSLY PUBLISHED TRIALS GENERALIZE TO MILITARY POPULATIONS. METHODS/DESIGN: THIS STUDY IS A PARALLEL RANDOMIZED CONTROLLED TRIAL COMPARING YOGA TO EDUCATION FOR 120 VETERANS WITH CHRONIC LOW BACK PAIN. PARTICIPANTS ARE VETERANS >/=18 YEARS OLD WITH LOW BACK PAIN PRESENT ON AT LEAST HALF THE DAYS IN THE PAST SIX MONTHS AND A SELF-REPORTED AVERAGE PAIN INTENSITY IN THE PREVIOUS WEEK OF >/=4 ON A 0-10 SCALE. THE 24-WEEK STUDY HAS AN INITIAL 12-WEEK INTERVENTION PERIOD, WHERE PARTICIPANTS ARE RANDOMIZED EQUALLY INTO (1) A STANDARDIZED WEEKLY GROUP YOGA CLASS WITH HOME PRACTICE OR (2) EDUCATION DELIVERED WITH A SELF-CARE BOOK. PRIMARY OUTCOME MEASURES ARE CHANGE AT 12 WEEKS IN LOW BACK PAIN INTENSITY MEASURED BY THE DEFENSE AND VETERANS PAIN RATING SCALE (0-10) AND BACK-RELATED FUNCTION USING THE 23-POINT ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 12-WEEK FOLLOW-UP PERIOD, YOGA PARTICIPANTS ARE ENCOURAGED TO CONTINUE HOME YOGA PRACTICE AND EDUCATION PARTICIPANTS CONTINUE FOLLOWING RECOMMENDATIONS FROM THE BOOK. QUALITATIVE INTERVIEWS WITH VETERANS IN THE YOGA GROUP AND THEIR PARTNERS EXPLORE THE IMPACT OF CHRONIC LOW BACK PAIN AND YOGA ON FAMILY RELATIONSHIPS. WE ALSO ASSESS COST-EFFECTIVENESS FROM THREE PERSPECTIVES: THE VETERAN, THE VETERANS HEALTH ADMINISTRATION, AND SOCIETY USING ELECTRONIC MEDICAL RECORDS, SELF-REPORTED COST DATA, AND STUDY RECORDS. DISCUSSION: THIS STUDY WILL HELP DETERMINE IF YOGA CAN BECOME AN EFFECTIVE TREATMENT FOR VETERANS WITH CHRONIC LOW BACK PAIN AND PSYCHOLOGICAL COMORBIDITIES. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT02224183. 2016 8 1699 36 PARTICIPANT CHARACTERISTICS ASSOCIATED WITH SYMPTOMATIC IMPROVEMENT FROM YOGA FOR CHRONIC LOW BACK PAIN. CONTEXT: STUDIES SUGGEST THAT YOGA IS EFFECTIVE FOR MODERATE TO SEVERE CHRONIC LOW BACK PAIN (CLBP) IN DIVERSE PREDOMINANTLY LOWER SOCIOECONOMIC STATUS POPULATIONS. HOWEVER, LITTLE IS KNOWN ABOUT FACTORS ASSOCIATED WITH BENEFIT FROM THE YOGA INTERVENTION. OBJECTIVE: IDENTIFY FACTORS AT BASELINE INDEPENDENTLY ASSOCIATED WITH GREATER EFFICACY AMONG PARTICIPANTS IN A STUDY OF YOGA FOR CLBP. DESIGN: FROM SEPTEMBER-DECEMBER 2011, A 12-WEEK RANDOMIZED DOSING TRIAL WAS CONDUCTED COMPARING WEEKLY VS. TWICE-WEEKLY 75-MINUTE HATHA YOGA CLASSES FOR 95 PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH NONSPECIFIC CLBP. PARTICIPANT CHARACTERISTICS COLLECTED AT BASELINE WERE USED TO DETERMINE FACTORS BEYOND TREATMENT ASSIGNMENT (REPORTED IN THE INITIAL STUDY) THAT PREDICTED OUTCOME. WE USED BIVARIATE TESTING TO IDENTIFY BASELINE CHARACTERISTICS ASSOCIATED WITH IMPROVEMENT IN FUNCTION AND PAIN, AND INCLUDED SELECT FACTORS IN A MULTIVARIATE LINEAR REGRESSION. SETTING: RECRUITMENT AND CLASSES OCCURRED IN AN ACADEMIC SAFETY-NET HOSPITAL AND FIVE AFFILIATED COMMUNITY HEALTH CENTERS IN BOSTON, MASSACHUSETTS. PARTICIPANTS: NINETY-FIVE ADULTS WITH NONSPECIFIC CLBP, AGES RANGING FROM 20-64 (MEAN 48) YEARS; 72 WOMEN AND 23 MEN. OUTCOME MEASURES: PRIMARY OUTCOMES WERE CHANGES IN BACK-RELATED FUNCTION (MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE, RMDQ; 0-23) AND MEAN LOW BACK PAIN INTENSITY (0-10) IN THE PREVIOUS WEEK, FROM BASELINE TO WEEK 12. RESULTS: ADJUSTING FOR GROUP ASSIGNMENT, BASELINE RMDQ, AGE, AND GENDER, FOREIGN NATIONALITY AND LOWER BASELINE SF36 PHYSICAL COMPONENT SCORE (PCS) WERE INDEPENDENTLY ASSOCIATED WITH IMPROVEMENT IN RMDQ. GREATER THAN HIGH SCHOOL EDUCATION LEVEL, CLBP LESS THAN 1 YEAR, AND LOWER BASELINE SF36 PCS WERE INDEPENDENTLY ASSOCIATED WITH IMPROVEMENT IN PAIN INTENSITY. OTHER DEMOGRAPHICS INCLUDING RACE, INCOME, GENDER, BMI, AND USE OF PAIN MEDICATIONS WERE NOT ASSOCIATED WITH EITHER OUTCOME. CONCLUSIONS: POOR PHYSICAL HEALTH AT BASELINE IS ASSOCIATED WITH GREATER IMPROVEMENT FROM YOGA IN BACK-RELATED FUNCTION AND PAIN. RACE, INCOME, AND BODY MASS INDEX DO NOT AFFECT THE POTENTIAL FOR A PERSON WITH LOW BACK PAIN TO EXPERIENCE BENEFIT FROM YOGA. 2014 9 2441 29 YOGA AND SCHIZOPHRENIA-A COMPREHENSIVE ASSESSMENT OF NEUROPLASTICITY: PROTOCOL FOR A SINGLE BLIND RANDOMIZED CONTROLLED STUDY OF YOGA IN SCHIZOPHRENIA. INTRODUCTION: SCHIZOPHRENIA IS ONE OF THE MOST SEVERE MENTAL DISORDERS WITH A PREVALENCE OF ABOUT 1% AND A LEADING CAUSE OF DISABILITY AMONG YOUNG ADULTS. PHARMACOTHERAPY IS THE MAINSTAY IN THE MANAGEMENT OF SCHIZOPHRENIA. HOWEVER, EVEN WITH THE BEST OF MEDICATION, SEVERAL PROBLEMS LIKE REFRACTORINESS, NEGATIVE SYMPTOMS, FREQUENT RELAPSES, AND COGNITIVE IMPAIRMENTS PERSIST. METHODS: THIS IS A RANDOMIZED-CONTROLLED CLINICAL STUDY INCLUDING PATIENTS FROM AN URBAN TERTIARY HOSPITAL AND A SEMI-URBAN COMMUNITY CENTER, WITH A BETWEEN-GROUP, REPEATED-MEASURES, LONGITUDINAL DESIGN. THIS STUDY WILL RECRUIT 160 PATIENTS WITH DSM 5 DIAGNOSIS OF SCHIZOPHRENIA WHO ARE ON STABLE MEDICATION FOR A MINIMUM OF 6 WEEKS; THEY WILL BE RANDOMLY ASSIGNED INTO 2 ARMS VIZ., YOGA THERAPY (YT), AND TREATMENT-AS-USUAL (TAU) WITH 80 PATIENTS IN EACH ARM. PARTICIPANTS WILL UNDERGO CLINICAL, LABORATORY, AND RADIOLOGICAL ASSESSMENTS AT BASELINE AND AT INTERVALS OF 1 MONTH, 3 MONTHS, AND 6 MONTHS FROM THE BASELINE. IT IS HYPOTHESIZED THAT YOGA WILL IMPROVE PSYCHOPATHOLOGY AND EMOTION PROCESSING, INCREASE SERUM BRAIN DERIVED NEUROTROPHIC FACTOR (BDNF) AND PLASMA OXYTOCIN LEVELS AND EFFECT CHANGES IN CEREBRAL ACTIVATION IN AREAS OF THE BRAIN ASSOCIATED WITH SCHIZOPHRENIA. DISCUSSION: THIS STUDY AIMS TO MEASURE THE EFFICACY OF A YOGA-BASED INTERVENTION AS AN ADJUNCT IN PATIENTS WITH SCHIZOPHRENIA AS WELL AS THE MECHANISMS OF THESE EFFECTS. TRIAL REGISTRATION: REGISTERED RETROSPECTIVELY WITH CLINICAL TRIAL REGISTRY - INDIA (CTRI) WITH REGISTRATION NUMBER CTRI/2017/08/009219. 2019 10 1313 44 HEALTH-RELATED BENEFITS AND ADVERSE EVENTS ASSOCIATED WITH YOGA CLASSES AMONG PARTICIPANTS THAT ARE HEALTHY, IN POOR HEALTH, OR WITH CHRONIC DISEASES. BACKGROUND: OUR PREVIOUS STUDY DEMONSTRATED THAT 42% OF YOGA CLASS PARTICIPANTS IN JAPAN HAD CHRONIC DISEASES REQUIRING MEDICATION. THIS RAISES THE QUESTION AS TO WHETHER THOSE WITH CHRONIC DISEASES WOULD BENEFIT FROM PRACTICING YOGA OR IF THEY ARE AT HIGHER RISK FOR SPECIFIC ADVERSE EVENTS COMPARED TO HEALTHY INDIVIDUALS RECEIVING THE SAME INSTRUCTION. METHODS: TO ADDRESS THESE QUESTIONS, 328 ADULTS WHO STARTED PRACTICING YOGA FOR THE FIRST TIME WERE ASKED TO COMPLETE THE PROFILE OF MOOD STATES (POMS), PERCEIVED STRESS SCALE (PSS), AND MEDICAL OUTCOMES STUDY SHORT FORM 8, STANDARD VERSION (SF-8) AND TO RECORD ANY ADVERSE EVENTS ON THE FIRST DAY OF THE YOGA CLASS AND AGAIN THREE MONTHS LATER. THE PARTICIPANTS CONSISTED OF THREE GROUPS: A HEALTHY (H) GROUP (N = 70), A POOR HEALTH (PH) GROUP (N = 117), AND A CHRONIC DISEASE (CD) GROUP (N = 141). THE DEGREE OF SUBJECTIVE SYMPTOMS WAS ALSO COMPARED BETWEEN THE PRE- AND POST-INTERVENTION PERIOD IN THE PH AND CD GROUPS. RESULTS: TYPICALLY, YOGA CLASSES WERE HELD ONCE A WEEK FOR 60-90 MIN. THE PROGRAMS INCLUDED ASANAS, PRANAYAMAS, MEDITATION, ISOMETRIC YOGA, AND SUKSHMA VYAYAMA. IN THE PH AND CD GROUPS, THE POMS TENSION-ANXIETY AND FATIGUE SCORES DECREASED AND THE VIGOR SCORE INCREASED SIGNIFICANTLY AFTER THE FIRST CLASS. FURTHERMORE, PSS SCORES DECREASED AND THE SF-8 SCORES INCREASED SIGNIFICANTLY THREE MONTHS LATER. THE DEGREE OF SUBJECTIVE SYMPTOMS SUCH AS EASY FATIGABILITY, SHOULDER STIFFNESS, AND INSOMNIA ALSO DECREASED OVER THREE MONTHS. INDIVIDUALS IN THESE GROUPS EXPERIENCED MORE FREQUENT ADVERSE EVENTS THAN THOSE IN THE H GROUP. THE PH AND CD GROUPS ALSO EXPERIENCED A GREATER VARIETY OF SYMPTOMS, INCLUDING PSYCHOLOGICAL ONES, NOT REPORTED BY THE H GROUP. ADVERSE EVENTS WERE NOT SO SERIOUS THAT PARTICIPANTS STOPPED PRACTICING YOGA DURING THE CLASS. ABOUT 60% OF ALL PARTICIPANTS WERE HIGHLY SATISFIED WITH PARTICIPATING IN YOGA CLASSES. CONCLUSIONS: IF YOGA CLASSES ARE CONDUCTED WITH ATTENTION TO POSSIBLE ADVERSE EVENTS, YOGA PRACTICE IN A YOGA STUDIO MAY HAVE BENEFICIAL EFFECTS FOR PEOPLE WITH FUNCTIONAL SOMATIC SYMPTOMS AND CHRONIC DISEASES, AS WELL AS HEALTHY PARTICIPANTS. THESE BENEFITS INCLUDE REDUCTIONS IN PERCEIVED STRESS AND UNCOMFORTABLE SYMPTOMS AS WELL AS IMPROVED MOOD AND QUALITY OF LIFE. 2021 11 2320 39 TREATMENT CREDIBILITY, EXPECTANCY, AND PREFERENCE: PREDICTION OF TREATMENT ENGAGEMENT AND OUTCOME IN A RANDOMIZED CLINICAL TRIAL OF HATHA YOGA VS. HEALTH EDUCATION AS ADJUNCT TREATMENTS FOR DEPRESSION. BACKGROUND: HATHA YOGA MAY BE HELPFUL FOR ALLEVIATING DEPRESSION SYMPTOMS. THE PURPOSE OF THIS ANALYSIS IS TO DETERMINE WHETHER TREATMENT PROGRAM PREFERENCE, CREDIBILITY, OR EXPECTANCY PREDICT ENGAGEMENT IN DEPRESSION INTERVENTIONS (YOGA OR A CONTROL CLASS) OR DEPRESSION SYMPTOM SEVERITY OVER TIME. METHODS: THIS IS A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL (RCT) OF HATHA YOGA VS. A HEALTH EDUCATION CONTROL GROUP FOR TREATMENT OF DEPRESSION. DEPRESSED PARTICIPANTS (N=122) ATTENDED UP TO 20 CLASSES OVER A PERIOD OF 10 WEEKS, AND THEN COMPLETED ADDITIONAL ASSESSMENTS AFTER 3 AND 6 MONTHS. WE ASSESSED TREATMENT PREFERENCE PRIOR TO RANDOMIZATION, AND TREATMENT CREDIBILITY AND EXPECTANCY AFTER PARTICIPANTS ATTENDED THEIR FIRST CLASS. TREATMENT "CONCORDANCE" INDICATED THAT TREATMENT PREFERENCE MATCHED ASSIGNED TREATMENT. RESULTS: TREATMENT CREDIBILITY, EXPECTANCY, AND CONCORDANCE WERE NOT ASSOCIATED WITH TREATMENT ENGAGEMENT. TREATMENT EXPECTANCY MODERATED THE ASSOCIATION BETWEEN TREATMENT GROUP AND DEPRESSION. DEPRESSION SEVERITY OVER TIME DIFFERED BY EXPECTANCY LEVEL FOR THE YOGA GROUP BUT NOT FOR THE HEALTH EDUCATION GROUP. CONTROLLING FOR BASELINE DEPRESSION, PARTICIPANTS IN THE YOGA GROUP WITH AN AVERAGE OR HIGH EXPECTANCY FOR IMPROVEMENT SHOWED LOWER DEPRESSION SYMPTOMS ACROSS THE ACUTE INTERVENTION AND FOLLOW-UP PERIOD THAN THOSE WITH A LOW EXPECTANCY FOR IMPROVEMENT. THERE WAS A TREND FOR A SIMILAR PATTERN FOR CREDIBILITY. CONCORDANCE WAS NOT ASSOCIATED WITH TREATMENT OUTCOME. LIMITATIONS: THIS IS A SECONDARY, POST-HOC ANALYSIS AND SHOULD BE CONSIDERED HYPOTHESIS-GENERATING. CONCLUSIONS: RESULTS SUGGEST THAT EXPECTANCY IMPROVES THE LIKELIHOOD OF SUCCESS ONLY FOR A INTERVENTION THOUGHT TO ACTIVELY TARGET DEPRESSION (YOGA) AND NOT A CONTROL INTERVENTION. 2018 12 1541 29 KRIPALU YOGA FOR MILITARY VETERANS WITH PTSD: A RANDOMIZED TRIAL. OBJECTIVES: THIS RANDOMIZED CONTROLLED TRIAL OF YOGA FOR MILITARY VETERANS AND ACTIVE DUTY PERSONNEL WITH POSTTRAUMATIC STRESS DISORDER (PTSD) EVALUATED THE EFFICACY OF A 10-WEEK YOGA INTERVENTION ON PTSD. METHOD: FIFTY-ONE PARTICIPANTS WERE RANDOMIZED INTO YOGA OR NO-TREATMENT ASSESSMENT-ONLY CONTROL GROUPS. PRIMARY OUTCOME MEASURES INCLUDED QUESTIONNAIRES AND THE CLINICIAN ADMINISTERED PTSD SCALE. RESULTS: BOTH YOGA (N = 9) AND CONTROL (N = 6) PARTICIPANTS SHOWED SIGNIFICANT DECREASES IN REEXPERIENCING SYMPTOMS, WITH NO SIGNIFICANT BETWEEN-GROUP DIFFERENCES. SECONDARY WITHIN-GROUP ANALYSES OF A SELF-SELECTED WAIT-LIST YOGA GROUP (N = 7) SHOWED SIGNIFICANT REDUCTIONS IN PTSD SYMPTOMS AFTER YOGA PARTICIPATION, IN CONTRAST TO THEIR CONTROL GROUP PARTICIPATION. CONSISTENT WITH CURRENT LITERATURE REGARDING HIGH RATES OF PTSD TREATMENT DROPOUT FOR VETERANS, THIS STUDY FACED CHALLENGES RETAINING PARTICIPANTS ACROSS CONDITIONS. CONCLUSION: THESE RESULTS ARE CONSISTENT WITH RECENT LITERATURE INDICATING THAT YOGA MAY HAVE POTENTIAL AS A PTSD THERAPY IN A VETERAN OR MILITARY POPULATION. HOWEVER, ADDITIONAL LARGER SAMPLE SIZE TRIALS ARE NECESSARY TO CONFIRM THIS CONCLUSION. 2018 13 2831 32 YOGA VS. PHYSICAL THERAPY VS. EDUCATION FOR CHRONIC LOW BACK PAIN IN PREDOMINANTLY MINORITY POPULATIONS: STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN CAUSES SUBSTANTIAL MORBIDITY AND COST TO SOCIETY WHILE DISPROPORTIONATELY IMPACTING LOW-INCOME AND MINORITY ADULTS. SEVERAL RANDOMIZED CONTROLLED TRIALS SHOW YOGA IS AN EFFECTIVE TREATMENT. HOWEVER, THE COMPARATIVE EFFECTIVENESS OF YOGA AND PHYSICAL THERAPY, A COMMON MAINSTREAM TREATMENT FOR CHRONIC LOW BACK PAIN, IS UNKNOWN. METHODS/DESIGN: THIS IS A RANDOMIZED CONTROLLED TRIAL FOR 320 PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH CHRONIC LOW BACK PAIN, COMPARING YOGA, PHYSICAL THERAPY, AND EDUCATION. INCLUSION CRITERIA ARE ADULTS 18-64 YEARS OLD WITH NON-SPECIFIC LOW BACK PAIN LASTING >/= 12 WEEKS AND A SELF-REPORTED AVERAGE PAIN INTENSITY OF >/= 4 ON A 0-10 SCALE. RECRUITMENT TAKES PLACE AT BOSTON MEDICAL CENTER, AN URBAN ACADEMIC SAFETY-NET HOSPITAL AND SEVEN FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS LOCATED IN DIVERSE NEIGHBORHOODS. THE 52-WEEK STUDY HAS AN INITIAL 12-WEEK TREATMENT PHASE WHERE PARTICIPANTS ARE RANDOMIZED IN A 2:2:1 RATIO INTO I) A STANDARDIZED WEEKLY HATHA YOGA CLASS SUPPLEMENTED BY HOME PRACTICE; II) A STANDARDIZED EVIDENCE-BASED EXERCISE THERAPY PROTOCOL ADAPTED FROM THE TREATMENT BASED CLASSIFICATION METHOD, INDIVIDUALLY DELIVERED BY A PHYSICAL THERAPIST AND SUPPLEMENTED BY HOME PRACTICE; AND III) EDUCATION DELIVERED THROUGH A SELF-CARE BOOK. CO-PRIMARY OUTCOME MEASURES ARE 12-WEEK PAIN INTENSITY MEASURED ON AN 11-POINT NUMERICAL RATING SCALE AND BACK-SPECIFIC FUNCTION MEASURED USING THE MODIFIED ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 40-WEEK MAINTENANCE PHASE, YOGA PARTICIPANTS ARE RE-RANDOMIZED IN A 1:1 RATIO TO EITHER STRUCTURED MAINTENANCE YOGA CLASSES OR HOME PRACTICE ONLY. PHYSICAL THERAPY PARTICIPANTS ARE SIMILARLY RE-RANDOMIZED TO EITHER FIVE BOOSTER SESSIONS OR HOME PRACTICE ONLY. EDUCATION PARTICIPANTS CONTINUE TO FOLLOW RECOMMENDATIONS OF EDUCATIONAL MATERIALS. WE WILL ALSO ASSESS COST EFFECTIVENESS FROM THE PERSPECTIVES OF THE INDIVIDUAL, INSURERS, AND SOCIETY USING CLAIMS DATABASES, ELECTRONIC MEDICAL RECORDS, SELF-REPORT COST DATA, AND STUDY RECORDS. QUALITATIVE DATA FROM INTERVIEWS WILL ADD SUBJECTIVE DETAIL TO COMPLEMENT QUANTITATIVE DATA. TRIAL REGISTRATION: THIS TRIAL IS REGISTERED IN CLINICALTRIALS.GOV, WITH THE ID NUMBER: NCT01343927. 2014 14 122 38 A PILOT STUDY OF YOGA AS SELF-CARE FOR ARTHRITIS IN MINORITY COMMUNITIES. BACKGROUND: WHILE ARTHRITIS IS THE MOST COMMON CAUSE OF DISABILITY, NON-HISPANIC BLACKS AND HISPANICS EXPERIENCE WORSE ARTHRITIS IMPACT DESPITE HAVING THE SAME OR LOWER PREVALENCE OF ARTHRITIS COMPARED TO NON-HISPANIC WHITES. PEOPLE WITH ARTHRITIS WHO EXERCISE REGULARLY HAVE LESS PAIN, MORE ENERGY, AND IMPROVED SLEEP, YET ARTHRITIS IS ONE OF THE MOST COMMON REASONS FOR LIMITING PHYSICAL ACTIVITY. MIND-BODY INTERVENTIONS, SUCH AS YOGA, THAT TEACH STRESS MANAGEMENT ALONG WITH PHYSICAL ACTIVITY MAY BE WELL SUITED FOR INVESTIGATION IN BOTH OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS. YOGA USERS ARE PREDOMINANTLY WHITE, FEMALE, AND COLLEGE EDUCATED. THERE ARE FEW STUDIES THAT EXAMINE YOGA IN MINORITY POPULATIONS; NONE ADDRESS ARTHRITIS. THIS PAPER PRESENTS A STUDY PROTOCOL EXAMINING THE FEASIBILITY AND ACCEPTABILITY OF PROVIDING YOGA TO AN URBAN, MINORITY POPULATION WITH ARTHRITIS. METHODS/DESIGN: IN THIS ONGOING PILOT STUDY, A CONVENIENCE SAMPLE OF 20 MINORITY ADULTS DIAGNOSED WITH EITHER OSTEOARTHRITIS OR RHEUMATOID ARTHRITIS UNDERGO AN 8-WEEK PROGRAM OF YOGA CLASSES. IT IS BELIEVED THAT BY ATTENDING YOGA CLASSES DESIGNED FOR PATIENTS WITH ARTHRITIS, WITH RACIALLY CONCORDANT INSTRUCTORS; ACCEPTABILITY OF YOGA AS AN ADJUNCT TO STANDARD ARTHRITIS TREATMENT AND SELF-CARE WILL BE ENHANCED. SELF-CARE IS DEFINED AS ADOPTING BEHAVIORS THAT IMPROVE PHYSICAL AND MENTAL WELL-BEING. THIS CONCEPT IS QUANTIFIED THROUGH COLLECTING PATIENT-REPORTED OUTCOME MEASURES RELATED TO SPIRITUAL GROWTH, HEALTH RESPONSIBILITY, INTERPERSONAL RELATIONS, AND STRESS MANAGEMENT. ADDITIONAL MEASURES COLLECTED DURING THIS STUDY INCLUDE: PHYSICAL FUNCTION, ANXIETY/DEPRESSION, FATIGUE, SLEEP DISTURBANCE, SOCIAL ROLES, AND PAIN; AS WELL AS BASELINE DEMOGRAPHIC AND CLINICAL DATA. FIELD NOTES, QUANTITATIVE AND QUALITATIVE DATA REGARDING FEASIBILITY AND ACCEPTABILITY ARE ALSO COLLECTED. ACCEPTABILITY IS DETERMINED BY RESPONSE/RETENTION RATES, POSITIVE QUALITATIVE DATA, AND CONTINUING YOGA PRACTICE AFTER THREE MONTHS. DISCUSSION: THERE ARE A NUMBER OF CHALLENGES IN RECRUITING AND RETAINING PARTICIPANTS FROM A COMMUNITY CLINIC SERVING MINORITY POPULATIONS. ADOPTING BEHAVIORS THAT IMPROVE WELL-BEING AND QUALITY OF LIFE INCLUDE THOSE THAT INTEGRATE MENTAL HEALTH (MIND) AND PHYSICAL HEALTH (BODY). FEW STUDIES HAVE EXAMINED OFFERING INTEGRATIVE MODALITIES TO THIS POPULATION. THIS PILOT WAS UNDERTAKEN TO QUANTIFY MEASURES OF FEASIBILITY AND ACCEPTABILITY THAT WILL BE USEFUL WHEN EVALUATING FUTURE PLANS FOR EXPANDING THE STUDY OF YOGA IN URBAN, MINORITY POPULATIONS WITH ARTHRITIS. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT01617421. 2013 15 686 31 EFFECT OF AN OFFICE WORKSITE-BASED YOGA PROGRAM ON HEART RATE VARIABILITY: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC WORK-RELATED STRESS IS A SIGNIFICANT AND INDEPENDENT RISK FACTOR FOR CARDIOVASCULAR AND METABOLIC DISEASES AND ASSOCIATED MORTALITY, PARTICULARLY WHEN COMPOUNDED BY A SEDENTARY WORK ENVIRONMENT. HEART RATE VARIABILITY (HRV) PROVIDES AN ESTIMATE OF PARASYMPATHETIC AND SYMPATHETIC AUTONOMIC CONTROL, AND CAN SERVE AS A MARKER OF PHYSIOLOGICAL STRESS. HATHA YOGA IS A PHYSICALLY DEMANDING PRACTICE THAT CAN HELP TO REDUCE STRESS; HOWEVER, TIME CONSTRAINTS INCURRED BY WORK AND FAMILY LIFE MAY LIMIT PARTICIPATION. THE PURPOSE OF THE PRESENT STUDY IS TO DETERMINE IF A 10-WEEK, WORKSITE-BASED YOGA PROGRAM DELIVERED DURING LUNCH HOUR CAN IMPROVE RESTING HRV AND RELATED PHYSICAL AND PSYCHOLOGICAL PARAMETERS IN SEDENTARY OFFICE WORKERS. METHODS AND DESIGN: THIS IS A PARALLEL-ARM RCT THAT WILL COMPARE THE OUTCOMES OF PARTICIPANTS ASSIGNED TO THE EXPERIMENTAL TREATMENT GROUP (YOGA) TO THOSE ASSIGNED TO A NO-TREATMENT CONTROL GROUP. PARTICIPANTS RANDOMIZED TO THE EXPERIMENTAL CONDITION WILL ENGAGE IN A 10-WEEK YOGA PROGRAM DELIVERED AT THEIR PLACE OF WORK. THE YOGA SESSIONS WILL BE GROUP-BASED, PRESCRIBED THREE TIMES PER WEEK DURING LUNCH HOUR, AND WILL BE LED BY AN EXPERIENCED YOGA INSTRUCTOR. THE PROGRAM WILL INVOLVE TEACHING BEGINNER STUDENTS SAFELY AND PROGRESSIVELY OVER 10 WEEKS A YOGA SEQUENCE THAT INCORPORATES ASANAS (POSES AND POSTURES), VINYASA (EXERCISES), PRANAYAMA (BREATHING CONTROL) AND MEDITATION. THE PRIMARY OUTCOME OF THIS STUDY IS THE HIGH FREQUENCY (HF) SPECTRAL POWER COMPONENT OF HRV (MEASURED IN ABSOLUTE UNITS; I.E. MS2), A MEASURE OF PARASYMPATHETIC AUTONOMIC CONTROL. SECONDARY OUTCOMES INCLUDE ADDITIONAL FREQUENCY AND TIME DOMAINS OF HRV, AND MEASURES OF PHYSICAL FUNCTIONING AND PSYCHOLOGICAL HEALTH STATUS. MEASURES WILL BE COLLECTED PRIOR TO AND FOLLOWING THE INTERVENTION PERIOD, AND AT 6 MONTHS FOLLOW-UP TO DETERMINE THE EFFECT OF INTERVENTION WITHDRAWAL. DISCUSSION: THIS STUDY WILL DETERMINE THE EFFECT OF WORKSITE-BASED YOGA PRACTICE ON HRV AND PHYSICAL AND PSYCHOLOGICAL HEALTH STATUS. THE FINDINGS MAY ASSIST IN IMPLEMENTING PRACTICAL INTERVENTIONS, SUCH AS YOGA, INTO THE WORKPLACE TO MITIGATE STRESS, ENHANCE HEALTH STATUS AND REDUCE THE RISK OF CARDIOVASCULAR AND METABOLIC DISEASES. TRIAL REGISTRATION: ACTRN12611000536965URL: HTTP://WWW.ANZCTR.ORG.AU/ACTRN12611000536965.ASPX. 2011 16 1903 32 RESULTS FROM A CLINICAL YOGA PROGRAM FOR VETERANS: YOGA VIA TELEHEALTH PROVIDES COMPARABLE SATISFACTION AND HEALTH IMPROVEMENTS TO IN-PERSON YOGA. BACKGROUND: YOGA IS INCREASINGLY POPULAR, THOUGH LITTLE DATA REGARDING ITS IMPLEMENTATION IN HEALTHCARE SETTINGS IS AVAILABLE. SIMILARLY, TELEHEALTH IS BEING UTILIZED MORE FREQUENTLY TO INCREASE ACCESS TO HEALTHCARE; HOWEVER WE KNOW OF NO RESEARCH ON THE ACCEPTABILITY OR EFFECTIVENESS OF YOGA DELIVERED THROUGH TELEHEALTH. THEREFORE, WE EVALUATED THE FEASIBILITY, ACCEPTABILITY, AND PATIENT-REPORTED EFFECTIVENESS OF A CLINICAL YOGA PROGRAM AT A VETERANS AFFAIRS MEDICAL CENTER AND ASSESSED WHETHER THESE OUTCOMES DIFFERED BETWEEN THOSE PARTICIPATING IN-PERSON AND THOSE PARTICIPATING VIA TELEHEALTH. METHODS: VETERANS WHO ATTENDED A YOGA CLASS AT THE VA PALO ALTO HEALTH CARE SYSTEM WERE INVITED TO COMPLETE AN ANONYMOUS PROGRAM EVALUATION SURVEY. RESULTS: 64 VETERANS COMPLETED THE SURVEY. PARTICIPANTS REPORTED HIGH SATISFACTION WITH THE CLASSES AND THE INSTRUCTORS. MORE THAN 80% OF PARTICIPANTS WHO ENDORSED A PROBLEM WITH PAIN, ENERGY LEVEL, DEPRESSION, OR ANXIETY REPORTED IMPROVEMENT IN THESE SYMPTOMS. THOSE WHO PARTICIPATED VIA TELEHEALTH DID NOT DIFFER FROM THOSE WHO PARTICIPATED IN-PERSON IN ANY MEASURE OF SATISFACTION, OVERALL IMPROVEMENT (P = .40), OR IMPROVEMENT IN ANY OF 16 SPECIFIC HEALTH PROBLEMS. CONCLUSIONS: DELIVERING YOGA TO A WIDE RANGE OF PATIENTS WITHIN A HEALTHCARE SETTING APPEARS TO BE FEASIBLE AND ACCEPTABLE, BOTH WHEN DELIVERED IN-PERSON AND VIA TELEHEALTH. PATIENTS IN THIS CLINICAL YOGA PROGRAM REPORTED HIGH LEVELS OF SATISFACTION AND IMPROVEMENT IN MULTIPLE PROBLEM AREAS. THIS PRELIMINARY EVIDENCE FOR THE EFFECTIVENESS OF A CLINICAL YOGA PROGRAM COMPLEMENTS PRIOR EVIDENCE FOR THE EFFICACY OF YOGA AND SUPPORTS THE USE OF YOGA IN HEALTHCARE SETTINGS. 2017 17 2596 41 YOGA FOR MILITARY VETERANS WITH CHRONIC LOW BACK PAIN: A RANDOMIZED CLINICAL TRIAL. INTRODUCTION: CHRONIC LOW BACK PAIN (CLBP) IS PREVALENT, ESPECIALLY AMONG MILITARY VETERANS. MANY CLBP TREATMENT OPTIONS HAVE LIMITED BENEFITS AND ARE ACCOMPANIED BY SIDE EFFECTS. MAJOR EFFORTS TO REDUCE OPIOID USE AND EMBRACE NONPHARMACOLOGICAL PAIN TREATMENTS HAVE RESULTED. RESEARCH WITH COMMUNITY CLBP PATIENTS INDICATES THAT YOGA CAN IMPROVE HEALTH OUTCOMES AND HAS FEW SIDE EFFECTS. THE BENEFITS OF YOGA AMONG MILITARY VETERANS WERE EXAMINED. DESIGN: PARTICIPANTS WERE RANDOMIZED TO EITHER YOGA OR DELAYED YOGA TREATMENT IN 2013-2015. OUTCOMES WERE ASSESSED AT BASELINE, 6 WEEKS, 12 WEEKS, AND 6 MONTHS. INTENTION-TO-TREAT ANALYSES OCCURRED IN 2016. SETTING/PARTICIPANTS: ONE HUNDRED AND FIFTY MILITARY VETERANS WITH CLBP WERE RECRUITED FROM A MAJOR VETERANS AFFAIRS MEDICAL CENTER IN CALIFORNIA. INTERVENTION: YOGA CLASSES (WITH HOME PRACTICE) WERE LED BY A CERTIFIED INSTRUCTOR TWICE WEEKLY FOR 12 WEEKS, AND CONSISTED PRIMARILY OF PHYSICAL POSTURES, MOVEMENT, AND BREATHING TECHNIQUES. MAIN OUTCOME MEASURES: THE PRIMARY OUTCOME WAS ROLAND-MORRIS DISABILITY QUESTIONNAIRE SCORES AFTER 12 WEEKS. PAIN INTENSITY WAS IDENTIFIED AS AN IMPORTANT SECONDARY OUTCOME. RESULTS: PARTICIPANT CHARACTERISTICS WERE MEAN AGE 53 YEARS, 26% WERE FEMALE, 35% WERE UNEMPLOYED OR DISABLED, AND MEAN BACK PAIN DURATION WAS 15 YEARS. IMPROVEMENTS IN ROLAND-MORRIS DISABILITY QUESTIONNAIRE SCORES DID NOT DIFFER BETWEEN THE TWO GROUPS AT 12 WEEKS, BUT YOGA PARTICIPANTS HAD GREATER REDUCTIONS IN ROLAND-MORRIS DISABILITY QUESTIONNAIRE SCORES THAN DELAYED TREATMENT PARTICIPANTS AT 6 MONTHS -2.48 (95% CI= -4.08, -0.87). YOGA PARTICIPANTS IMPROVED MORE ON PAIN INTENSITY AT 12 WEEKS AND AT 6 MONTHS. OPIOID MEDICATION USE DECLINED AMONG ALL PARTICIPANTS, BUT GROUP DIFFERENCES WERE NOT FOUND. CONCLUSIONS: YOGA IMPROVED HEALTH OUTCOMES AMONG VETERANS DESPITE EVIDENCE THEY HAD FEWER RESOURCES, WORSE HEALTH, AND MORE CHALLENGES ATTENDING YOGA SESSIONS THAN COMMUNITY SAMPLES STUDIED PREVIOUSLY. THE MAGNITUDE OF PAIN INTENSITY DECLINE WAS SMALL, BUT OCCURRED IN THE CONTEXT OF REDUCED OPIOID USE. THE FINDINGS SUPPORT WIDER IMPLEMENTATION OF YOGA PROGRAMS FOR VETERANS. TRIAL REGISTRATION: THIS STUDY IS REGISTERED AT WWW.CLINICALTRIALS.GOV NCT02524158. 2017 18 1788 41 PRELIMINARY EVIDENCE THAT YOGA PRACTICE PROGRESSIVELY IMPROVES MOOD AND DECREASES STRESS IN A SAMPLE OF UK PRISONERS. OBJECTIVES. IN THE FIRST RANDOMIZED CONTROLLED TRIAL OF YOGA ON UK PRISONERS, WE PREVIOUSLY SHOWED THAT YOGA PRACTICE WAS ASSOCIATED WITH IMPROVED MENTAL WELLBEING AND COGNITION. HERE, WE AIMED TO ASSESS HOW CLASS ATTENDANCE, SELF-PRACTICE, AND DEMOGRAPHIC FACTORS WERE RELATED TO OUTCOME AMONGST PRISONERS ENROLLED IN THE 10-WEEK YOGA INTERVENTION. METHODS. THE DATA OF 55 PARTICIPANTS (52 MALE, 3 FEMALE) WHO COMPLETED A 10-WEEK YOGA COURSE WERE ANALYSED. CHANGES IN PRE- AND POSTYOGA MEASURES OF AFFECT, PERCEIVED STRESS, AND PSYCHOLOGICAL SYMPTOMS WERE ENTERED INTO LINEAR REGRESSION ANALYSES WITH BIAS-CORRECTED AND ACCELERATED BOOTSTRAP CONFIDENCE INTERVALS. CLASS ATTENDANCE, SELF-PRACTICE, DEMOGRAPHIC VARIABLES, AND BASELINE PSYCHOMETRIC VARIABLES WERE INCLUDED AS REGRESSORS. RESULTS. PARTICIPANTS WHO ATTENDED MORE YOGA CLASSES AND THOSE WHO ENGAGED IN FREQUENT (5 TIMES OR MORE) SELF-PRACTICE REPORTED SIGNIFICANTLY GREATER DECREASES IN PERCEIVED STRESS. DECREASES IN NEGATIVE AFFECT WERE ALSO SIGNIFICANTLY RELATED TO HIGH FREQUENCY SELF-PRACTICE AND GREATER CLASS ATTENDANCE AT A NEAR-SIGNIFICANT LEVEL. AGE WAS POSITIVELY CORRELATED WITH YOGA CLASS ATTENDANCE, AND HIGHER LEVELS OF EDUCATION WERE ASSOCIATED WITH GREATER DECREASES IN NEGATIVE AFFECT. CONCLUSIONS. OUR RESULTS SUGGEST THAT THERE MAY BE PROGRESSIVE BENEFICIAL EFFECTS OF YOGA WITHIN PRISON POPULATIONS AND POINT TO SUBPOPULATIONS WHO MAY BENEFIT THE MOST FROM THIS PRACTICE. 2015 19 1219 37 EXPOSURE TO ADVERSE EVENTS AND ASSOCIATIONS WITH STRESS LEVELS AND THE PRACTICE OF YOGA: SURVEY FINDINGS FROM A POPULATION-BASED STUDY OF DIVERSE EMERGING YOUNG ADULTS. OBJECTIVES: THIS STUDY EXAMINES THE PREVALENCE OF EXPOSURE TO ADVERSE EVENTS AND ASSOCIATIONS WITH STRESS LEVELS AMONG A DIVERSE POPULATION-BASED SAMPLE OF YOUNG PEOPLE. THE STUDY FURTHER EXPLORES WHETHER THESE VULNERABLE POPULATIONS, WHO HAVE THE POTENTIAL TO BENEFIT FROM THE MIND-BODY PRACTICE OF YOGA, ENGAGE IN A REGULAR YOGA PRACTICE. DESIGN: EAT 2018 (EATING AND ACTIVITY OVER TIME) IS A POPULATION-BASED STUDY IN WHICH SURVEY DATA WERE COLLECTED FROM 1568 ETHNICALLY/RACIALLY DIVERSE (81.2% NONWHITE) EMERGING YOUNG ADULTS (MEAN AGE: 22.0 +/- 2.0 YEARS). RESULTS: EXPOSURE TO ADVERSE EVENTS WAS HIGHLY PREVALENT. FOR EXAMPLE, 43.9% REPORTED AT LEAST ONE ADVERSE CHILDHOOD EXPERIENCE (ACE) (E.G., PHYSICAL, EMOTIONAL, OR SEXUAL ABUSE BEFORE AGE 18), WHEREAS 40.1% REPORTED EXPERIENCING DISCRIMINATION. EXPOSURE TO ADVERSE EVENTS WAS ASSOCIATED WITH HIGHER STRESS LEVELS. PRACTICING YOGA AT LEAST 30 MIN/WEEK WAS REPORTED BY 12.7% OF THE POPULATION, WITH VARIATION ACROSS SOCIODEMOGRAPHIC CHARACTERISTICS. YOUNG ADULTS EXPOSED TO ADVERSE EVENTS WERE EITHER MORE OR SIMILARLY LIKELY TO PRACTICE YOGA THAN YOUNG ADULTS NOT REPORTING ADVERSE EVENTS. CONCLUSIONS: THE HIGH PREVALENCE OF EXPOSURE TO ADVERSE EVENTS AND ASSOCIATIONS WITH HIGHER LEVELS OF STRESS POINTS TO A NEED FOR PUBLIC HEALTH INTERVENTIONS. THUS, IT WAS PROMISING TO FIND THAT YOUNG PEOPLE EXPOSED TO ADVERSE EVENTS, WHO MAY HAVE GREATER EMOTIONAL BURDENS, PRACTICE YOGA AT EQUAL OR GREATER PROPORTIONS TO THOSE WITHOUT THESE EXPOSURES. GIVEN THE POTENTIAL BENEFITS OF YOGA FOR POPULATIONS LIVING WITH HIGH STRESS, IT IS IMPORTANT TO DEVELOP FURTHER OUTREACH EFFORTS AND PROVIDE ACCESSIBLE, ACCEPTABLE, AND AFFORDABLE OPPORTUNITIES FOR PRACTICING YOGA. 2020 20 2639 36 YOGA FOR VETERANS WITH CHRONIC LOW-BACK PAIN. OBJECTIVES: CHRONIC BACK PAIN AFFECTS A LARGE PROPORTION OF BOTH THE GENERAL POPULATION AND OF MILITARY VETERANS. ALTHOUGH NUMEROUS THERAPIES EXIST FOR TREATING CHRONIC BACK PAIN, THEY CAN BE COSTLY AND TEND TO HAVE LIMITED EFFECTIVENESS. THUS, DEMONSTRATING THE EFFICACY AND COST-EFFECTIVENESS OF ADDITIONAL TREATMENT ALTERNATIVES IS IMPORTANT. THE PURPOSE OF OUR STUDY WAS TO EXAMINE THE BENEFITS OF A YOGA INTERVENTION FOR VETERANS ADMINISTRATION (VA) PATIENTS. SUBJECTS/INTERVENTION: VA PATIENTS WITH CHRONIC BACK PAIN WERE REFERRED BY THEIR PRIMARY CARE PROVIDERS TO A YOGA PROGRAM AS PART OF CLINICAL CARE. BEFORE STARTING YOGA, A VA PHYSICIAN TRAINED IN YOGA EVALUATED EACH PATIENT TO ENSURE THAT THEY COULD PARTICIPATE SAFELY. DESIGN: THE RESEARCH STUDY CONSISTED OF COMPLETING A SHORT BATTERY OF QUESTIONNAIRES AT BASELINE AND AGAIN 10 WEEKS LATER. OUTCOME MEASURES: QUESTIONNAIRES INCLUDED MEASURES OF PAIN, DEPRESSION, ENERGY/FATIGUE, HEALTH-RELATED QUALITY OF LIFE, AND PROGRAM SATISFACTION. PAIRED T-TESTS WERE USED TO COMPARE BASELINE SCORES TO THOSE AT THE 10-WEEK FOLLOW-UP FOR THE SINGLE GROUP, PRE-POST DESIGN. CORRELATIONS WERE USED TO EXAMINE WHETHER YOGA ATTENDANCE AND HOME PRACTICE WERE ASSOCIATED WITH BETTER OUTCOMES. RESULTS: BASELINE AND FOLLOW-UP DATA WERE AVAILABLE FOR 33 PARTICIPANTS. PARTICIPANTS WERE VA PATIENTS WITH A MEAN AGE OF 55 YEARS. THEY WERE 21% FEMALE, 70% WHITE, 52% MARRIED, 68% COLLEGE GRADUATES, AND 44% WERE RETIRED. SIGNIFICANT IMPROVEMENTS WERE FOUND FOR PAIN, DEPRESSION, ENERGY/FATIGUE, AND THE SHORT FORM-12 MENTAL HEALTH SCALE. THE NUMBER OF YOGA SESSIONS ATTENDED AND THE FREQUENCY OF HOME PRACTICE WERE ASSOCIATED WITH IMPROVED OUTCOMES. PARTICIPANTS APPEARED HIGHLY SATISFIED WITH THE YOGA INSTRUCTOR AND MODERATELY SATISFIED WITH THE EASE OF PARTICIPATION AND HEALTH BENEFITS OF THE YOGA PROGRAM. CONCLUSIONS: PRELIMINARY DATA SUGGEST THAT A YOGA INTERVENTION FOR VA PATIENTS WITH CHRONIC BACK PAIN MAY IMPROVE THE HEALTH OF VETERANS. HOWEVER, THE LIMITATIONS OF A PRE-POST STUDY DESIGN MAKE CONCLUSIONS TENTATIVE. A LARGER RANDOMIZED, CONTROLLED TRIAL OF THE YOGA PROGRAM IS PLANNED. 2008