1 1773 140 POTENTIAL YOGA MODULES FOR TREATMENT OF HEMATOPOIETIC INHIBITION IN HIV-1 INFECTION. THIS ARTICLE IS EXPECTED TO CONTRIBUTE TOWARDS UNDERSTANDING THE THERAPEUTIC BENEFITS OF SPECIFIC YOGA MODULES ON THE INHIBITION OF REPLICATION AND ENHANCEMENT TO NORMAL LEVELS OF HEMATOPOIESIS IN HIV-1 INFECTED SUBJECTS. MORE UNIQUE COULD BE THE EFFECTS OF YOGA ON THE INDIRECT EFFECTS OF HIV-1 INDUCED HEMATOPOIETIC INHIBITION OF THE CD34+ PROGENITOR STEM CELLS, VIA THE CD4+ T LYMPHOCYTES. SUCH INDIRECT EFFECTS MAY BE CAUSED BY HOST CELLULAR FACTORS. YOGA PRACTICES MAY ALSO IMPROVE THE SELF RENEWAL CAPACITY (A STEP THAT PRECEDES COMMITMENT OF CD34+ PROGENITOR CELLS TO TERMINAL DIFFERENTIATION), VIA STAT5 GENE REGULATION. THIS MAY ELIMINATE THE NEED FOR CONSTITUTIVE STAT5 GENE EXPRESSION THROUGH GENE THERAPY. IN THIS ARTICLE RECENT RESEARCH AND ANCIENT INDIAN LITERATURE ARE REVIEWED TO DEVISE YOGA MODULES FOR THE POTENTIAL TREATMENT OF HEMATOPOIETIC INHIBITION IN HIV-1 INFECTION. THE POSSIBLE MECHANISMS THROUGH WHICH HEMATOPOIETIC INHIBITION MAY OCCUR IN HIV-1 INFECTED PATIENTS ARE FIRST DESCRIBED FOLLOWED BY THE ROLE OF STRESS IN THE PROGRESSION OF HIV WHERE PROBABLE INVOLVEMENT OF PSYCHO-NEURO-IMMUNOLOGICAL AXIS (PNI) IS HIGHLIGHTED. YOGA THERAPY IS INTRODUCED AND ITS EFFECTIVENESS IN TERMS OF EVIDENCE IN RELEVANT AREA IS REVIEWED. FURTHER, THE BASIC PRINCIPLES OF INTEGRATED APPROACH OF YOGA THERAPY [IAYT] ARE DESCRIBED AND DEPENDING ON THE POTENTIAL MECHANISMS THROUGH WHICH YOGA THERAPY MAY ACT, BOTH MODERN SCIENTIFIC RESEARCH AND ANCIENT "SCRIPTURAL" EVIDENCE ARE PROVIDED AT ALL THE FIVE LEVELS OF EXISTENCE (BODY, LIFE FORCE, EMOTIONAL, INTELLECTUAL AND BLISS). THIS WILL ENABLE TO DESIGN COMPREHENSIVE YOGA MODULES THAT MAY INTERVENE IN THIS INDIRECT INHIBITION OF HAEMATOPOIESIS IN HIV-1 INFECTED INDIVIDUALS AND POTENTIALLY RESTORE NORMAL LEVELS OF HAEMATOPOIESIS. 2010
2 446 24 CHALLENGES OF IMPLEMENTING MULTICENTER STUDIES OF YOGA FOR PEDIATRIC CANCER AND HEMATOPOIETIC STEM CELL TRANSPLANTATION RECIPIENTS. THE PRIMARY OBJECTIVE OF THIS WORK WAS TO DETERMINE THE FEASIBILITY OF A RANDOMIZED TRIAL OF INDIVIDUALIZED YOGA FOR CHILDREN RECEIVING INTENSIVE CHEMOTHERAPY AND FOR HEMATOPOIETIC STEM CELL TRANSPLANTATION (HSCT) RECIPIENTS OUTSIDE OF THE PRINCIPAL COORDINATING INSTITUTION. WE EVALUATED THE FEASIBILITY OF A RANDOMIZED TRIAL OF INDIVIDUALIZED YOGA VERSUS AN IPAD CONTROL PROGRAM AT A SITE WHERE EXTERNAL YOGA INSTRUCTORS WERE HIRED AND COMPENSATED PER SESSION. SUBJECTS WERE CHILDREN RECEIVING INTENSIVE CHEMOTHERAPY FOR HEMATOLOGICAL MALIGNANCIES AND AUTOLOGOUS OR ALLOGENEIC HSCT RECIPIENTS EXPECTED TO BE HOSPITALIZED FOR 3 WEEKS. YOGA OR IPAD CONTROL CONTACT OCCURRED DAILY FOR 21 DAYS (EXCLUDING WEEKENDS AND HOLIDAYS); FATIGUE AND QUALITY-OF-LIFE OUTCOMES WERE MEASURED AT BASELINE, DAY 10, AND DAY 21. TEN ELIGIBLE SUBJECTS WERE IDENTIFIED; SIX SUBJECTS CONSENTED AND WERE ENROLLED. THREE WERE RANDOMIZED TO THE INDIVIDUALIZED YOGA INTERVENTION AND THREE TO THE IPAD CONTROL PROGRAM. THE MEDIAN AGE OF PARTICIPANTS WAS 12 (RANGE 8-15) YEARS, AND 2 (33%) WERE BOYS. CHALLENGES PRIMARILY RELATED TO THE HIRING OF YOGA INSTRUCTORS WHO WERE NOT TRAINED IN RESEARCH METHODS. WE FOUND ISSUES WITH: (1) LOGISTICS OF HIRING, TRAINING, AND RETAINING INSTRUCTORS; (2) COMMUNICATION BETWEEN TEAMS; (3) FIDELITY TO THE PROTOCOL AND OUTCOME ASSESSMENTS; AND (4) ENSURING SAFETY. WE FOUND THAT A RANDOMIZED TRIAL OF INDIVIDUALIZED YOGA PRESENTED NEW CHALLENGES WHEN RELYING ON EXTERNALLY CONTRACTED YOGA INSTRUCTORS. FUTURE MULTICENTER STUDIES OF YOGA SHOULD SEEK TO BETTER INTEGRATE PRACTITIONERS WITHIN THE RESEARCH TEAM TO IMPROVE PROCESSES, COMMUNICATION, FIDELITY TO THE PROTOCOL, AND SAFETY. 2021
3 2550 23 YOGA FOR CANCER-RELATED FATIGUE IN SURVIVORS OF HEMATOPOIETIC CELL TRANSPLANTATION: A FEASIBILITY STUDY. CONTEXT: CANCER-RELATED FATIGUE (CRF) IS ONE OF THE MOST COMMON SYMPTOMS EXPERIENCED BY CANCER PATIENTS AFTER HEMATOPOIETIC CELL TRANSPLANTATION (HCT). YOGA IS AN APPROACH WITH SUPPORTIVE EVIDENCE TO IMPROVE CRF IN DIFFERENT CANCER POPULATIONS, BUT TO OUR KNOWLEDGE, IT HAS NOT BEEN TESTED IN AN ADULT HCT POPULATION. OBJECTIVES: THE AIM OF THIS STUDY WAS TO EVALUATE THE FEASIBILITY OF A YOGA INTERVENTION OFFERED TO ADULT HCT SURVIVORS WITH MODERATE-TO-SEVERE CRF. METHODS: THIS FEASIBILITY STUDY USED A SINGLE-ARM, PRETEST-POSTTEST DESIGN. ADULT HCT SURVIVORS WERE ENROLLED IN A SIX-WEEK RESTORATIVE YOGA INTERVENTION THAT CONSISTED OF A ONE-HOUR ONCE-WEEKLY CLASS WITH TWICE-WEEKLY HOME PRACTICE USING A DVD. RESULTS: TWENTY PARTICIPANTS (13 WOMEN AND SEVEN MEN) ENROLLED IN THIS STUDY WITH A MEAN AGE OF 51 YEARS (SD = 12.5). THE SAMPLE CONSISTED OF 19 ALLOGENEIC HCT SURVIVORS, SEVEN OF WHOM HAD A HISTORY OF ACUTE GRAFT-VS.-HOST DISEASE (GVHD), SIX WITH ACTIVE, EXTENSIVE CHRONIC GVHD, AND ONE AUTOLOGOUS HCT SURVIVOR. THE ACCRUAL ACCEPTANCE RATE WAS 23.2% (20/86 HCT SURVIVORS) AND RETENTION RATE WAS 60% (12/20). OVERALL ADHERENCE WAS 45.4%. NO ADVERSE EVENTS WERE REPORTED. CONCLUSION: THE RESULTS OF THIS STUDY SUGGEST THAT A RESTORATIVE YOGA INTERVENTION IN ADULT HCT SURVIVORS IS SAFE AND FEASIBLE. THE INCIDENCE OF GVHD MAY HAVE IMPACTED ADHERENCE. STRATEGIES TO IMPROVE ACCRUAL ACCEPTANCE, RETENTION, AND ADHERENCE ARE NEEDED. 2020
4 615 27 DEVELOPMENT OF AN INDIVIDUALIZED YOGA INTERVENTION TO ADDRESS FATIGUE IN HOSPITALIZED CHILDREN UNDERGOING INTENSIVE CHEMOTHERAPY. PURPOSE FATIGUE IS AN IMPORTANT PROBLEM IN CHILDREN RECEIVING INTENSIVE CHEMOTHERAPY AND HEMATOPOIETIC STEM CELL TRANSPLANTATION (HSCT). EXERCISE MAY BE AN EFFECTIVE INTERVENTION FOR FATIGUE. INDIVIDUALIZED YOGA REPRESENTS AN IDEAL INTERVENTION BECAUSE IT CAN BE TAILORED ACCORDING TO AN INDIVIDUAL CHILD'S NEEDS. LITTLE IS KNOWN ABOUT HOW TO STRUCTURE A STANDARDIZED YOGA PROGRAM FOR INTENSIVELYTREATED CHILDREN. THEREFORE, THIS STUDY DESCRIBES THE DEVELOPMENT OF A YOGA PROGRAM AND AN APPROACH TO MONITORING SESSIONS SUITABLE FOR HOSPITALIZED CHILDREN RECEIVING INTENSIVE CHEMOTHERAPY OR HSCT. METHODS THE YOGA PROGRAM WAS DESIGNED TO INCREASE MOBILITY IN HOSPITALIZED CHILDREN AND TO PROVIDE CHILDREN WITH RELAXATION TECHNIQUES THAT COULD BE USED INDEPENDENTLY IN A VARIETY OF ENVIRONMENTS. THE PROGRAM WAS FOUNDED ON 4 KEY TENETS: SAFETY, ADAPTABILITY, ENVIRONMENTAL FLEXIBILITY, AND APPEAL TO CHILDREN. WE ALSO DEVELOPED QUALITY AND CONSISTENCY ASSURANCE PROCEDURES. RESULTS A MENU FORMAT WITH A FIXED STRUCTURE WAS SELECTED FOR THE YOGA PROGRAM. EACH YOGA SESSION CONTAINED UP TO 6 SECTIONS: BREATHING EXERCISES, WARMUP EXERCISES, YOGA POSES, BALANCING POSES, COOL-DOWN POSES, AND FINAL RELAXATION. YOGA INSTRUCTORS SELECTED SPECIFIC YOGA POSES FOR EACH SESSION FROM A PREDETERMINED LIST ORGANIZED BY INTENSITY LEVEL (LOW, MODERATE, OR HIGH). MONITORING PROCEDURES WERE DEVELOPED USING VIDEOTAPING AND MULTIRATER ADJUDICATION. CONCLUSION WE CREATED A STANDARDIZED YOGA PROGRAM AND AN APPROACH TO MONITORING THAT ARE NOW READY FOR INCORPORATION IN CLINICAL TRIALS. FUTURE WORK SHOULD INCLUDE THE ADAPTATION OF THE PROGRAM TO DIFFERENT PEDIATRIC POPULATIONS AND CLINICAL SETTINGS. 2016
5 127 22 A PILOT STUDY TO EVALUATE THE FEASIBILITY OF INDIVIDUALIZED YOGA FOR INPATIENT CHILDREN RECEIVING INTENSIVE CHEMOTHERAPY. BACKGROUND: FATIGUE IS AN IMPORTANT PROBLEM IN PAEDIATRIC CANCER PATIENTS AND YOGA MAY BE AN EFFECTIVE INTERVENTION. THE PRIMARY OBJECTIVE WAS TO DETERMINE THE FEASIBILITY OF INDIVIDUALIZED YOGA FOR HOSPITALIZED CHILDREN RECEIVING INTENSIVE CHEMOTHERAPY. METHODS: WE INCLUDED ENGLISH-SPEAKING CHILDREN AND ADOLESCENTS AGED 7-18 YEARS RECEIVING INTENSIVE CHEMOTHERAPY OR HAEMATOPOIETIC STEM CELL TRANSPLANTATION (HSCT). YOGA WAS CONDUCTED THREE TIMES WEEKLY FOR THREE WEEKS. THE PRIMARY OUTCOME WAS FEASIBILITY, DEFINED AS ABILITY TO DELIVER AT LEAST 60% OF PLANNED SESSIONS. SECONDARY OUTCOMES WERE PARENT-REPORTED PEDIATRIC QUALITY OF LIFE INVENTORY (PEDSQL) MULTIDIMENSIONAL FATIGUE SCALE, FATIGUE SCALE-PARENT, PEDSQL GENERIC CORE SCALES AND PEDSQL ACUTE CANCER MODULE. RESULTS: BETWEEN JANUARY AND OCTOBER 2013, 11 PATIENTS WERE ENROLLED. MEDIAN AGE WAS 14.0 (RANGE 7.7-16.4) YEARS AND 6 (55%) WERE BOYS. YOGA WAS FEASIBLE WITH 10/11 PARTICIPANTS MEETING THE THRESHOLD FOR FEASIBILITY. THE MEDIAN NUMBER OF YOGA SESSIONS WAS 9 (RANGE 3-13). NO ADVERSE EVENTS WERE ATTRIBUTED TO YOGA. MEAN+/-STANDARD DEVIATION FOR THE DAY 21 PROXY-REPORTED PEDSQL GENERAL FATIGUE SCORES WAS 55.6+/-15.5. QUALITATIVE COMMENTS SUGGESTED DESIGN CHANGES FOR FUTURE YOGA STUDIES. CONCLUSIONS: INDIVIDUALIZED YOGA IS FEASIBLE FOR INPATIENT CHILDREN RECEIVING INTENSIVE CHEMOTHERAPY. FUTURE WORK WILL INCLUDE DEVELOPMENT AND CONDUCT OF A RANDOMIZED TRIAL FOR FATIGUE AMELIORATION. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT02105389. 2015
6 2224 26 THE IMPACT OF THE "YOGIC LIFESTYLE" ON CANCER PROGNOSIS AND SURVIVAL: CAN WE TARGET CANCER STEM CELLS WITH YOGA? CANCER HAS RECENTLY BEEN KNOWN TO ORIGINATE FROM STEM CELL-LIKE CELLS, CALLED CANCER STEM CELLS (CSCS). THEIR UNIQUE PROPERTIES OF SELF-DUPLICATION, MULTIPLICATION, AS WELL AS MIGRATION GIVE THE CSC RESISTANCE OVER CONVENTIONAL CANCER THERAPIES. NEWER THERAPIES ARE IN DEVELOPMENTAL STAGE TO TARGET THESE STEM CELL-LIKE POPULATIONS AND BECOME THE VANGUARD OF FUTURE TREATMENTS. SEVERAL COMPLEMENTARY AND ALTERNATIVE TREATMENTS HAVE BEEN USED IN CANCER MANAGEMENT AS AN ADJUNCT TO CONVENTIONAL THERAPY TO IMPROVE THE OVERALL QUALITY OF LIFE AND REDUCE RECURRENCE. YOGA STANDS AS THE THIRD MOST POPULAR OF ALL COMPLEMENTARY AND ALTERNATIVE MEDICINE TREATMENTS CURRENTLY USED IN CANCER PATIENTS TODAY. PRELIMINARY RESULTS SHOW THAT YOGA MODULATES NEURAL, HORMONAL, AND IMMUNE FUNCTIONS AT A CELLULAR LEVEL. THE SCOPE OF THIS COMMENTARY IS TO DISCUSS THE CURRENT EVIDENCE-BASED MEDICINE ON YOGA AND ITS EFFECT ON CSCS. 2017
7 491 23 CO-DESIGNING A NEW YOGA-BASED MINDFULNESS INTERVENTION FOR SURVIVORS OF STROKE: A FORMATIVE EVALUATION. MOVEMENT-BASED MINDFULNESS INTERVENTIONS (MBI) ARE COMPLEX, MULTI-COMPONENT INTERVENTIONS FOR WHICH THE DESIGN PROCESS IS RARELY REPORTED. FOR PEOPLE WITH STROKE, EMERGING EVIDENCE SUGGESTS BENEFITS, BUT MAINSTREAM PROGRAMS ARE GENERALLY UNSUITABLE. WE AIMED TO DESCRIBE THE PROCESSES INVOLVED AND TO CONDUCT A FORMATIVE EVALUATION OF THE DEVELOPMENT OF A NOVEL YOGA-BASED MBI DESIGNED FOR SURVIVORS OF STROKE. WE USED THE MEDICAL RESEARCH COUNCIL COMPLEX INTERVENTIONS FRAMEWORK AND PRINCIPLES OF CO-DESIGN. WE PURPOSEFULLY APPROACHED HEALTH PROFESSIONALS AND CONSUMERS TO ESTABLISH AN ADVISORY COMMITTEE FOR DEVELOPING THE INTERVENTION. MEMBERS COLLABORATED AND ITERATIVELY REVIEWED THE DESIGN AND CONTENT OF THE PROGRAM, FORMATTED INTO A TRAINING MANUAL. FOUR EXTERNAL YOGA TEACHERS INDEPENDENTLY REVIEWED THE PROGRAM. FORMATIVE EVALUATION INCLUDED REVIEW OF MULTIPLE DATA SOURCES AND DOCUMENTATION (E.G., FORMAL MEETING MINUTES, FOCUS GROUP DISCUSSIONS, RESEARCHER OBSERVATIONS). THE DATA WERE SYNTHESIZED USING INDUCTIVE THEMATIC ANALYSIS. THREE BROAD THEMES EMERGED: (A) MBI CONTENT AND TERMINOLOGY; (B) MANUAL DESIGN AND READABILITY; AND (C) BARRIERS AND ENABLERS TO DELIVER THE INTERVENTION. VARIOUS PERSPECTIVES AND FEEDBACK ON ESSENTIAL COMPONENTS GUIDED FINALIZING THE PROGRAM. THE DESIGN PHASE OF A NOVEL YOGA-BASED MBI WAS STRENGTHENED BY INTERDISCIPLINARY, CONSUMER CONTRIBUTIONS AND PEER REVIEW. THE 12-WEEK INTERVENTION IS READY FOR TESTING AMONG SURVIVORS OF STROKE. 2021
8 2032 27 TAILORING TRAUMA-SENSITIVE YOGA FOR HIGH-RISK POPULATIONS IN PUBLIC-SECTOR SETTINGS. LOW-INCOME, RACIAL-MINORITY, HIGH-RISK POPULATIONS HAVE LIMITED ACCESS TO EVIDENCE-BASED TREATMENTS FOR POSTTRAUMATIC STRESS DISORDER (PTSD), AND THEIR ACCEPTANCE OF COMPLEMENTARY INTERVENTIONS IS UNKNOWN. TRAUMA CENTER TRAUMA-SENSITIVE YOGA (TC-TSY), WHICH HAS DEMONSTRATED EFFICACY IN COMMUNITY SAMPLES, HAS NOT YET BEEN WIDELY USED WITH ETHNIC MINORITY LOW-INCOME INDIVIDUALS. THIS ARTICLE PRESENTS A CULTURALLY TAILORED VERSION OF A TC-TSY INTERVENTION DELIVERED AS A DROP-IN SERVICE IN A PUBLIC HOSPITAL-BASED CLINIC TO PATIENTS WITH HISTORIES OF INTERPERSONAL VIOLENCE AND SUICIDE ATTEMPTS. TC-TSY WAS ITERATIVELY TAILORED TO MEET THE UNIQUE CLINICAL NEEDS OF INDIVIDUALS WITHIN THIS SETTING. GROUP FACILITATOR OBSERVATIONS ARE SUMMARIZED; THEY DESCRIBE A SUCCESSFUL INITIAL IMPLEMENTATION AND CULTURALLY INFORMED ADAPTATION OF THE GROUP INTERVENTION. THE FACILITATORS' OBSERVATIONS ILLUSTRATED THAT GROUP MEMBERS ACCEPTED THE INTEGRATION OF THIS STRUCTURED, GENTLE YOGA PRACTICE INTO OUTPATIENT BEHAVIORAL HEALTH PROGRAMMING AND IDENTIFIED SITE-SPECIFIC MODIFICATIONS TO INFORM FORMAL STUDY. THE PROCESS BY WHICH TC-TSY WAS ADAPTED AND IMPLEMENTED FOR BLACK INDIVIDUALS WITH A HISTORY OF INTERPERSONAL TRAUMA AT RISK FOR SUICIDAL BEHAVIOR CAN SERVE AS A GUIDE FOR TAILORING OTHER COMPLEMENTARY, INTEGRATIVE INTERVENTIONS TO MEET THE NEEDS OF UNIQUE CLINICAL SETTINGS. THIS PROCESS IS OFFERED AS A FOUNDATION FOR FUTURE SYSTEMATIC TESTING OF THIS COMPLEMENTARY, INTEGRATED, CULTURALLY ADAPTED TRAUMA THERAPY IN HIGH-RISK CLINICAL POPULATIONS. 2021
9 593 29 DEVELOPMENT AND EVALUATION OF A YOGA INTERVENTION PROGRAM FOR PARKINSON'S DISEASE. PRELIMINARY RESEARCH INDICATES THAT YOGA COULD BE A VALUABLE TOOL FOR PEOPLE SUFFERING FROM PARKINSON'S DISEASE (PD). HOWEVER, LITTLE HAS BEEN PUBLISHED ABOUT THE PROCESS BY WHICH THE YOGA INTERVENTIONS WERE DESIGNED AND EVALUATED. THIS STUDY ELABORATES ON THE PROCESS OF DEVELOPING AND TESTING A BI-WEEKLY, 12-WEEK YOGA PROGRAM TO DETERMINE ITS SAFETY AND FEASIBILITY FOR PEOPLE WITH PD. THE LEAD YOGA TEACHER USED INPUT FROM A FOCUSED LITERATURE REVIEW TO DESIGN AN INITIAL DRAFT OF THE INTERVENTION PROGRAM. THIS DRAFT WAS REVIEWED BY A GROUP OF YOGA EXPERTS ( N = 6) TO DEVELOP THE FINAL INTERVENTION PROGRAM. THIS 12-WEEK INTERVENTION WAS IMPLEMENTED IN 19 PARTICIPANTS WITH PD (MEAN AGE 63 +/- 8, RANGE 49-75) VIA TWICE-WEEKLY YOGA CLASSES. THROUGH THIS COMPREHENSIVE DEVELOPMENT PROCESS, A SERIES OF 24 INDIVIDUAL 1-HOUR YOGA SEQUENCES WAS CREATED. THESE SEQUENCES INCLUDED YOGA POSTURES (ASANA), BREATHING TECHNIQUES (PRANAYAMA), AND MINDFULNESS MEDITATION PRINCIPLES SPECIFICALLY CHOSEN TO ADDRESS CONCERNS UNIQUE TO THE PD POPULATION. THE FEASIBILITY OF THE PROGRAM WAS SUPPORTED WITH EXCELLENT ATTENDANCE: 90% OF PARTICIPANTS ATTENDED > 75% OF THE CLASSES, WITH FOUR PARTICIPANTS ATTENDING 100%. NO ADVERSE EVENTS WERE REPORTED. THIS DEVELOPMENT PROCESS PRODUCED A SAFE AND ENJOYABLE YOGA PROGRAM SPECIFIC FOR THE NEEDS OF PEOPLE WITH PD. HOWEVER, THIS METHODOLOGY COULD SERVE AS A TEMPLATE FOR FUTURE STUDIES ON HOW TO DEVELOP SAFE AND EFFECTIVE YOGA INTERVENTIONS FOR OTHER POPULATIONS. 2018
10 601 48 DEVELOPMENT AND VALIDATION OF A NEED-BASED INTEGRATED YOGA PROGRAM FOR CANCER PATIENTS: A RETROSPECTIVE STUDY. CONTEXT AND AIM: COMPLEMENTARY AND ALTERNATIVE THERAPIES (CAM) ARE GAINING POPULARITY AMONGST PATIENTS AS ADD ON TO CONVENTIONAL MEDICINE. YOGA STANDS THIRD AMONGST ALL CAM THAT IS BEING USED BY CANCER PATIENTS TODAY. DIFFERENT SCHOOLS OF YOGA USE DIFFERENT SETS OF PRACTICES, WITH SOME USING A MORE PHYSICAL APPROACH AND MANY USING MEDITATION AND/OR BREATHING. ALL THESE MODULES ARE DEVELOPED BASED ON THE NEEDS OF THE PATIENT. THIS PAPER IS AN ATTEMPT TO PROVIDE THE BASIS FOR A COMPREHENSIVE NEED BASED INTEGRATIVE YOGA MODULE FOR CANCER PATIENTS AT DIFFERENT STAGES OF TREATMENT AND FOLLOW UP. IN THIS PAPER, THE HOLISTIC MODULES OF THE INTEGRATED APPROACH OF YOGA THERAPY FOR CANCER (IAYTC) HAVE BEEN DEVELOPED BASED ON THE PATIENT NEEDS, AS PER THE OBSERVATIONS BY THE CLINICIANS AND THE CAREGIVERS. AUTHORS HAVE ATTEMPTED TO SYSTEMATICALLY CREATE HOLISTIC MODULES OF IAYTC FOR VARIOUS STAGES OF THE DISEASE AND TREATMENT. THESE MODULES HAVE BEEN USED IN RANDOMIZED TRIALS TO EVALUATE ITS EFFICACY AND HAVE SHOWN TO BE EFFECTIVE AS ADD-ON TO CONVENTIONAL MANAGEMENT OF CANCER. THUS, THE OBJECTIVE OF THIS EFFORT WAS TO PRESENT THE THEORETICAL BASIS AND VALIDATE THE NEED BASED HOLISTIC YOGA MODULES FOR CANCER PATIENTS. MATERIALS AND METHODS: LITERATURE FROM TRADITIONAL TEXTS INCLUDING VEDAS, AYURVEDA, UPANISHADS, BHAGAVAT GITA, YOGA VASISHTHA ETC. AND THEIR COMMENTARIES WERE LOOKED INTO FOR REFERENCES OF CANCER AND THERAPEUTIC DIRECTIVES. PRESENT DAY SCIENTIFIC LITERATURE WAS ALSO EXPLORED WITH REGARDS TO DEFINING CANCER, ITS ETIOPATHOLOGY AND ITS MANAGEMENT. RESULTS OF STUDIES DONE USING CAM THERAPIES WERE ALSO LOOKED AT, FOR SALIENT FINDINGS. FOCUSED GROUP DISCUSSIONS (FGD) AMONGST RESEARCHERS, EXPERIENCED GURUS, AND MEDICAL PROFESSIONALS INVOLVED IN RESEARCH AND CLINICAL CANCER PRACTICE WERE CARRIED OUT WITH THE OBJECTIVES OF DETERMINING NEEDS OF THE PATIENT AND YOGA PRACTICES THAT COULD PROVE EFFICIENT. A LIST OF NEEDS AT DIFFERENT STAGES OF CONVENTIONAL THERAPIES (SURGERY, CHEMOTHERAPY AND RADIATION THERAPY) WAS LISTED AND YOGA MODULES WERE DEVELOPED ACCORDINGLY. CONSIDERING THE NEEDS, EXPECTED SIDE EFFECTS, THE ENERGY LEVELS AND THE PSYCHOLOGICAL STATES OF THE PARTICIPANTS, EIGHT MODULES EVOLVED. RESULTS: THE RESULTS OF THE SIX STEPS FOR DEVELOPING THE VALIDATED MODULE ARE REPORTED. STEP 1: LITERATURE REVIEW FROM TRADITIONAL YOGA AND AYURVEDA TEXTS ON ETIOPATHOGENESIS AND MANAGEMENT OF CANCER (ARBUDA), AND THE RECENT LITERATURE ON CANCER STEM CELLS AND IMMUNOLOGY OF CANCER. STEP 2: FOCUSED GROUP DISCUSSIONS AND DELIBERATIONS TO COMPILE THE NEEDS OF PATIENTS BASED ON THE EXPECTED SIDE EFFECTS, ENERGY LEVELS AND THE PSYCHOLOGICAL STATE OF THE PATIENT AS OBSERVED BY THE CAREGIVERS AND THE CLINICIANS. STEP 3: CONTENT VALIDATION THROUGH CONSENSUS BY THE EXPERTS FOR THE EIGHT MODULES OF IAYTC THAT COULD BE USED AS COMPLIMENTARY TO CONVENTIONAL MANAGEMENT OF CANCER AT DIFFERENT STAGES DURING AND AFTER THE DIAGNOSIS WAS CREATED. STEP 4: FIELD TESTING FOR SAFETY AND FEASIBILITY OF THE MODULES THROUGH PILOT STUDIES. STEP 5: COMPILATION OF THE RESULTS OF EFFICACY TRIALS THROUGH RCTS AND STEP 6: A REVIEW OF OUR STUDIES ON MECHANISMS TO OFFER EVIDENCE FOR ACTION OF IAYTC ON PSYCHO-NEURO-IMMUNOLOGICAL PATHWAYS IN CANCER. CONCLUSION: THE EVIDENCE FROM THE TRADITIONAL KNOWLEDGE AND RECENT SCIENTIFIC STUDIES VALIDATES EIGHT MODULES OF INTEGRATED APPROACH OF YOGA THERAPY FOR CANCER THAT CAN BE USED SAFELY AND EFFECTIVELY AS COMPLIMENTARY DURING ALL CONVENTIONAL CANCER THERAPIES. 2012
11 1495 28 INTERVENTION PROTOCOL FOR INVESTIGATING YOGA IMPLEMENTED DURING CHEMOTHERAPY. OBJECTIVE: FATIGUE AND OTHER TREATMENT-RELATED SYMPTOMS ARE CRITICAL THERAPEUTIC TARGETS FOR IMPROVING QUALITY OF LIFE IN PATIENTS WITH COLORECTAL CANCER DURING CHEMOTHERAPY. YOGA IS A PROMISING INTERVENTION FOR IMPROVING THESE THERAPEUTIC TARGETS AND HAS BEEN PRIMARILY INVESTIGATED IN THE GROUP-CLASS FORMAT, WHICH IS LESS FEASIBLE FOR CANCER PATIENTS WITH HIGH SYMPTOM BURDEN TO ATTEND. THUS, WE DEVELOPED A PROTOCOL FOR IMPLEMENTING YOGA INDIVIDUALLY IN THE CLINIC AMONG PATIENTS RECEIVING CHEMOTHERAPY. METHODS: WE FOLLOWED RECOMMENDED DOMAINS FOR DEVELOPING A YOGA PROTOCOL TO BE USED IN AN EFFICACY TRIAL. THESE RECOMMENDATIONS INCLUDE CONSIDERATION TO THE STYLE, DELIVERY, COMPONENTS OF THE INTERVENTION, DOSE, SPECIFIC CLASS SEQUENCES, FACILITATION OF HOME PRACTICE, MEASUREMENT OF INTERVENTION FIDELITY, SELECTION OF INSTRUCTORS, AND DEALING WITH MODIFICATIONS. THE INTERVENTION PROTOCOL WAS DEVELOPED BY AN INTERDISCIPLINARY TEAM. PROTOCOL: YOGA SKILLS TRAINING (YST) CONSISTS OF FOUR 30-MINUTE IN-PERSON SESSIONS AND WAS IMPLEMENTED WHILE IN THE CHAIR DURING CHEMOTHERAPY INFUSIONS FOR COLORECTAL CANCER WITH RECOMMENDED DAILY HOME PRACTICE FOR EIGHT WEEKS. THERAPEUTIC GOALS OF THE YST ARE TO REDUCE FATIGUE, CIRCADIAN DISRUPTION, AND PSYCHOLOGICAL DISTRESS. ELEMENTS OF THE YST ARE AWARENESS MEDITATION, GENTLE SEATED MOVEMENT, BREATHING PRACTICE, AND RELAXATION MEDITATION. ATTENTION, COMFORT, AND EASE ARE ALSO HIGHLIGHTED. CONCLUSION: THIS DESCRIPTION OF A PROTOCOL FOR INTEGRATING YOGA WITH CONVENTIONAL CANCER TREATMENT WILL INFORM FUTURE STUDY DESIGNS AND CLINICAL PRACTICE. THE DESIGN OF THE YST IS NOVEL BECAUSE IT IMPLEMENTS YOGA-MOST COMMONLY STUDIED WHEN TAUGHT TO GROUPS OUTSIDE OF THE CLINICAL SETTING- INDIVIDUALLY DURING CLINICAL CARE. 2016
12 614 25 DEVELOPMENT OF A YOGA-BASED CARDIAC REHABILITATION (YOGA-CARE) PROGRAMME FOR SECONDARY PREVENTION OF MYOCARDIAL INFARCTION. CARDIAC REHABILITATION (CR) AFTER MYOCARDIAL INFARCTION IS HIGHLY EFFECTIVE. IT IS UNAVAILABLE IN PUBLIC HOSPITALS IN INDIA DUE TO LIMITED RESOURCES. OUR OBJECTIVE WAS TO DEVELOP A SCALABLE MODEL OF CR FOR INDIA BASED ON YOGA, WHICH COULD ALSO APPEAL TO SOME GROUPS WITH LOW UPTAKE OF CR (E.G., ETHNIC MINORITIES, WOMEN, AND OLDER PEOPLE) GLOBALLY. THE INTERVENTION WAS DEVELOPED USING A STRUCTURED PROCESS. A LITERATURE REVIEW AND CONSULTATIONS WITH YOGA EXPERTS, CR EXPERTS, AND POSTMYOCARDIAL INFARCTION PATIENTS WERE CONDUCTED TO SYSTEMATICALLY IDENTIFY AND SHORTLIST APPROPRIATE YOGA EXERCISES AND POSTURES, BREATHING EXERCISES, MEDITATION AND RELAXATION PRACTICES, AND LIFESTYLE CHANGES, WHICH WERE INCORPORATED INTO A CONVENTIONAL CR FRAMEWORK. THE DRAFT INTERVENTION WAS FURTHER REFINED BASED ON THE FEEDBACK FROM AN INTERNAL STAKEHOLDER GROUP AND AN EXTERNAL PANEL OF INTERNATIONAL EXPERTS, BEFORE BEING PILOTED WITH YOGA INSTRUCTORS AND PATIENTS WITH MYOCARDIAL INFARCTION. A FOUR-PHASE YOGA-BASED CR (YOGA-CARE) PROGRAMME WAS DEVELOPED FOR DELIVERY BY A SINGLE YOGA INSTRUCTOR WITH BASIC TRAINING. THE PROGRAMME CONSISTS OF A TOTAL OF 13 INSTRUCTOR-LED SESSIONS (2 INDIVIDUAL AND 11 GROUP) OVER A 3-MONTH PERIOD. GROUP SESSIONS INCLUDE GUIDED PRACTICE OF YOGA EXERCISES AND POSTURES, BREATHING EXERCISES, AND MEDITATION AND RELAXATION PRACTICES, AND SUPPORT FOR THE LIFESTYLE CHANGE AND COPING THROUGH A MODERATED DISCUSSION. PATIENTS ARE ENCOURAGED TO SELF-PRACTICE DAILY AT HOME AND CONTINUE LONG-TERM WITH THE HELP OF A BOOKLET AND DIGITAL VIDEO DISC (DVD). FAMILY MEMBERS/CARERS ARE ENCOURAGED TO JOIN THROUGHOUT. IN CONCLUSION, A NOVEL YOGA-BASED CR PROGRAMME HAS BEEN DEVELOPED, WHICH PROMISES TO PROVIDE A SCALABLE CR SOLUTION FOR INDIA AND AN ALTERNATIVE CHOICE FOR CR GLOBALLY. IT IS CURRENTLY BEING EVALUATED IN A LARGE MULTICENTRE RANDOMISED CONTROLLED TRIAL ACROSS INDIA. 2019
13 1725 24 PERCEPTIONS OF YOGA THERAPY EMBEDDED IN TWO INPATIENT REHABILITATION HOSPITALS: AGENCY PERSPECTIVES. INPATIENT MEDICAL REHABILITATION HAS MAINTAINED A TYPICAL MEDICAL-MODEL FOCUS AND STRUCTURE FOR MANY YEARS. HOWEVER, AS INTEGRATIVE THERAPIES, SUCH AS YOGA THERAPY, EMERGE AS TREATMENTS WHICH CAN ENHANCE THE PHYSICAL AND MENTAL HEALTH OF ITS PARTICIPANTS, IT IS IMPORTANT TO DETERMINE IF THEY CAN BE EASILY IMPLEMENTED INTO THE TRADITIONAL REHABILITATION STRUCTURE AND MILIEU. THEREFORE, THE PURPOSE OF THIS STUDY WAS TO EXAMINE THE PERCEPTIONS OF KEY AGENCY PERSONNEL ON THE FEASIBILITY AND UTILITY OF YOGA THERAPY IMPLEMENTED IN INPATIENT REHABILITATION. THIS STUDY REPORTS THE RESULTS OF FOCUS GROUPS AND AN INDIVIDUAL INTERVIEW WITH KEY STAKEHOLDERS (ADMINISTRATORS AND REHABILITATION THERAPISTS) FROM TWO REHABILITATION HOSPITALS FOLLOWING THE IMPLEMENTATION OF YOGA THERAPY. RESULTS FOCUSED ON SEVERAL KEY THEMES: FEASIBILITY FROM THE THERAPIST AND ADMINISTRATOR PERSPECTIVES, CHALLENGES TO IMPLEMENTATION, AND UTILITY AND BENEFIT. OVERALL, THE IMPLEMENTATION AND INTEGRATION OF YOGA THERAPY WERE POSITIVE; HOWEVER, SOME PROGRAMMATIC AND POLICY AND ORGANIZATIONAL CONSIDERATIONS REMAIN. IMPLICATIONS FOR PRACTICE AND FUTURE RESEARCH ARE PROVIDED. 2015
14 475 20 CLARIFY 2021: EXPLANATION AND ELABORATION OF THE DELPHI-BASED GUIDELINES FOR THE REPORTING OF YOGA RESEARCH. BACKGROUND: REPORTING OF YOGA RESEARCH OFTEN LACKS THE DETAIL REQUIRED FOR CLINICAL APPLICATION, STUDY REPLICATION, SUMMARY RESEARCH AND COMPARATIVE EFFECTIVENESS STUDIES. METHODS: TO IMPROVE THE TRANSPARENCY OF REPORTING YOGA INTERVENTIONS, AND BUILDING ON THE DEVELOPMENT OF PREVIOUS REPORTING GUIDELINES, A GROUP OF INTERNATIONAL YOGA RESEARCH STAKEHOLDERS DEVELOPED THE CONSENSUS-BASED CHECKLIST STANDARDISING THE REPORTING OF INTERVENTIONS FOR YOGA (CLARIFY) GUIDELINES. RESULTS: THE 21-ITEM CLARIFY CHECKLIST OUTLINES THE MINIMUM DETAILS CONSIDERED NECESSARY FOR HIGH-QUALITY REPORTING OF YOGA RESEARCH. THIS PAPER PROVIDES A DETAILED EXPLANATION OF EACH OF THE 21 ITEMS OF THE CLARIFY CHECKLIST, TOGETHER WITH MODEL EXAMPLES OF HOW TO INTEGRATE EACH ITEM INTO PUBLICATIONS OF YOGA RESEARCH. THE CLARIFY GUIDELINE SERVES AS AN EXTENSION FOR EXISTING RESEARCH REPORTING GUIDELINES, AND IS FLEXIBLE FOR USE ACROSS ALL STUDY DESIGNS. CONCLUSION: WE STRONGLY ENCOURAGE THE UPTAKE OF THESE REPORTING GUIDELINES BY RESEARCHERS AND JOURNALS, TO FACILITATE IMPROVEMENTS IN THE TRANSPARENCY AND UTILITY OF YOGA RESEARCH. 2021
15 1872 13 RAPID CONVERSION OF A GROUP-BASED YOGA TRIAL FOR DIVERSE OLDER WOMEN TO HOME-BASED TELEHEALTH: LESSONS LEARNED USING ZOOM TO DELIVER MOVEMENT-BASED INTERVENTIONS. THIS BRIEF REPORT DESCRIBES THE RAPID CONVERSION OF A RANDOMIZED TRIAL OF A HATHA-BASED YOGA PROGRAM FOR OLDER WOMEN WITH URINARY INCONTINENCE TO A TELEHEALTH VIDEOCONFERENCE PLATFORM DURING THE CORONAVIRUS DISEASE 2019 (COVID-19) PANDEMIC. INTERIM RESULTS DEMONSTRATE THE FEASIBILITY OF RECRUITING AND RETAINING PARTICIPANTS ACROSS A WIDE RANGE OF AGES AND ETHNIC BACKGROUNDS, BUT ALSO POINT TO POTENTIAL OBSTACLES AND SAFETY CONCERNS ARISING FROM TELEHEALTH-BASED INSTRUCTION. THE INVESTIGATORS PRESENT LESSONS LEARNED ABOUT THE BENEFITS AND CHALLENGES OF USING TELEHEALTH PLATFORMS TO DELIVER MOVEMENT-BASED INTERVENTIONS AND CONSIDER STRATEGIES TO PROMOTE ACCESSIBLE AND WELL-TOLERATED TELEHEALTH-BASED YOGA PROGRAMS FOR OLDER AND DIVERSE POPULATIONS. CLINICAL TRIAL REGISTRATION NUMBER: NCT03672461. 2022
16 421 27 BRIDGING BODY AND MIND: CONSIDERATIONS FOR TRAUMA-INFORMED YOGA. INDIVIDUALS WHO SUFFER FROM TRAUMA-RELATED SYMPTOMS ARE A UNIQUE POPULATION THAT COULD BENEFIT FROM THE MIND-BODY PRACTICE OF YOGA-OR HAVE THEIR SYMPTOMS REACTIVATED BY IT, DEPENDING ON THE TYPE OF YOGA. TRAUMA-INFORMED YOGA (TIY), THAT IS, YOGA ADAPTED TO THE UNIQUE NEEDS OF INDIVIDUALS WORKING TO OVERCOME TRAUMA, MAY AMELIORATE SYMPTOMS BY CREATING A SAFE, TAILORED PRACTICE FOR STUDENTS TO LEARN HOW TO RESPOND, RATHER THAN REACT, TO SYMPTOMS AND CIRCUMSTANCES. YOGA NOT THUS ADAPTED, ON THE OTHER HAND, MAY INCREASE REACTIVITY AND ACTIVATE SYMPTOMS SUCH AS HYPERAROUSAL OR DISSOCIATION. THIS ARTICLE REPORTS ON EXPERT INPUT ABOUT ADAPTING YOGA FOR INDIVIDUALS WITH TRAUMA, WITH SPECIAL CONSIDERATIONS FOR MILITARY POPULATIONS. ELEVEN EXPERTS, RECRUITED BASED ON LITERATURE REVIEW AND REFERRALS, WERE INTERVIEWED IN PERSON OR VIA TELEPHONE AND ASKED SEVEN QUESTIONS ABOUT TRAUMA-INFORMED YOGA. VERBATIM TRANSCRIPTS WERE SUBJECTED TO OPEN-CODING THEMATIC ANALYSIS AND A PRIORI THEMES. FINDINGS REVEALED THAT TIY NEEDS TO EMPHASIZE BENEFICIAL PRACTICES (E.G., DIAPHRAGMATIC BREATH AND RESTORATIVE POSTURES), CONSIDER CONTRAINDICATIONS (E.G., AVOIDING SEQUENCES THAT OVERLY ENGAGE THE SYMPATHETIC NERVOUS SYSTEM), ADAPT TO LIMITATIONS AND CHALLENGES FOR TEACHING IN UNCONVENTIONAL SETTINGS (E.G., PRISONS, VA HOSPITALS), AND PROVIDE SPECIALIZED TRAINING AND PREPARATION (E.G., SPECIALIZED TIY CERTIFICATIONS, SELF-CARE OF INSTRUCTORS/THERAPISTS, ADAPTIONS FOR STUDENT NEEDS). TIY FOR VETERANS MUST ADDITIONALLY CONSIDER GENDER- AND CULTURE-RELATED BARRIERS, DIFFERING RELATIONSHIPS TO PAIN AND INJURY, AND MEDICATION AS A BARRIER TO PRACTICE. 2018
17 551 23 CONVENIENT AND LIVE MOVEMENT (CALM) FOR WOMEN UNDERGOING BREAST CANCER TREATMENT: CHALLENGES AND RECOMMENDATIONS FOR INTERNET-BASED YOGA RESEARCH. OBJECTIVE: TO CONDUCT A PILOT TRIAL OF INTERNET-BASED, CANCER-ADAPTED YOGA FOR WOMEN RECEIVING BREAST CANCER TREATMENT. DESIGN: WOMEN UNDERGOING RADIATION OR CHEMOTHERAPY FOR BREAST CANCER WERE RECRUITED FOR 12, 75-MIN, BIWEEKLY, CANCER-ADAPTED YOGA CLASSES DELIVERED VIA INTERNET-BASED, MULTIPOINT VIDEOCONFERENCING. DATA WERE COLLECTED ON FEASIBILITY AND ACCEPTABILITY, INCLUDING QUALITATIVE FEEDBACK FROM PARTICIPANTS AND THE YOGA INSTRUCTOR. RESULTS: AMONG 42 WOMEN APPROACHED, 13 DECLINED ELIGIBILITY SCREENING, AND 23 WERE INELIGIBLE. ALL 6 WOMEN WHO WERE ELIGIBLE PROVIDED CONSENT, BUT 2 WITHDREW PRIOR TO BEGINNING YOGA CLASSES. THE REMAINING 4 PARTICIPANTS ATTENDED 1-11 OF 12 ONLINE YOGA CLASSES. IN POST-INTERVENTION INTERVIEWS, PARTICIPANTS AND THE INSTRUCTOR AGREED THAT INTERNET-BASED YOGA CLASSES HOLD GREAT POTENTIAL FOR INCREASING ACCESS AND IMPROVING PSYCHOLOGICAL OUTCOMES IN ADULTS WITH CANCER. QUALITATIVE FEEDBACK FROM PARTICIPANTS REVEALED SUGGESTIONS FOR FUTURE TRIALS OF INTERNET-BASED, CANCER-ADAPTED YOGA CLASSES, INCLUDING: CONTINUED USE OF GROUP FORMAT; OFFERING MORE VARIED CLASS TIMES TO ACCOMMODATE PATIENTS' DEMANDING SCHEDULES AND FLUCTUATING SYMPTOMS; ENROLLING PATIENTS AFTER THEY HAVE ACCLIMATED TO OR COMPLETED CANCER TREATMENT; STREAMLINING THE TECHNOLOGY INTERFACE; AND CAREFUL ATTENTION TO PARTICIPANT BURDEN WHEN DESIGNING SURVEYS/FORMS. THE INSTRUCTOR RECOMMENDED CLOSED SESSION COURSES, AS OPPOSED TO ROLLING ENROLLMENT; TEACHING THE SAME MODIFIED POSES FOR ALL PARTICIPANTS, RATHER THAN INDIVIDUAL TAILORING; AND USING A LARGE SCREEN TO ALLOW CLOSER MONITORING OF STUDENTS' CLASS EXPERIENCE. CONCLUSIONS: INTERNET DELIVERY MAY INCREASE PATIENTS' ACCESS TO CANCER-ADAPTED YOGA CLASSES, BUT CANCER-RELATED AND TECHNOLOGICAL BARRIERS REMAIN. THIS STUDY INFORMS HOW TO OPTIMALLY DESIGN YOGA CLASSES, TECHNOLOGY, AND RESEARCH PROCEDURES TO MAXIMIZE FEASIBILITY AND ACCEPTABILITY IN FUTURE TRIALS. 2018
18 1294 23 GUIDELINES FOR DEVELOPING YOGA INTERVENTIONS FOR RANDOMIZED TRIALS. LITTLE GUIDANCE IS AVAILABLE TO ASSIST RESEARCHERS IN DEVELOPING TREATMENT PROTOCOLS FOR RESEARCH ON YOGA FOR HEALTH CONCERNS. BECAUSE YOGA IS A COMPLEX MULTIFACTORIAL MIND-BODY DISCIPLINE HISTORICALLY DEVELOPED FOR NONMEDICAL PURPOSES, NUMEROUS DECISIONS MUST BE MADE IN ORDER TO THOUGHTFULLY DEVELOP SUCH PROTOCOLS. IN THIS PAPER, A SYSTEMATIC APPROACH IS PROPOSED TO ASSIST RESEARCHERS IN SELECTING AN INTERVENTION THAT IS APPROPRIATE FOR THE CONDITION UNDER CONSIDERATION AND EXPLICITLY DEVELOPED. RESEARCHERS NEED TO CONSIDER THE TYPE OR "STYLE" OF YOGA, THE COMPONENTS TO INCLUDE (E.G., BREATHING EXERCISES, POSTURES) AS WELL AS THE SPECIFIC PROTOCOL FOR EACH COMPONENT, THE DOSE TO BE DELIVERED (FREQUENCY, DURATION OF PRACTICE, AND THE TOTAL DURATION OF PRACTICE), AND ISSUES RELATED TO SELECTION OF INSTRUCTORS AND MONITORING THE FIDELITY TO THE INTERVENTION. EACH OF THESE DOMAINS AND THE KEY ISSUES FOR THE DEVELOPMENT OF PROTOCOLS IS DISCUSSED. FINALLY, SOME AREAS FOR FURTHER RESEARCH RELATED TO PROTOCOL DEVELOPMENT ARE RECOMMENDED. 2012
19 2202 34 THE ESSENTIAL PROPERTIES OF YOGA QUESTIONNAIRE (EPYQ): PSYCHOMETRIC PROPERTIES. YOGA INTERVENTIONS ARE HETEROGENEOUS AND VARY ALONG MULTIPLE DIMENSIONS. THESE DIMENSIONS MAY AFFECT MENTAL AND PHYSICAL HEALTH OUTCOMES IN DIFFERENT WAYS OR THROUGH DIFFERENT MECHANISMS. HOWEVER, MOST STUDIES OF THE EFFECTS OF YOGA ON HEALTH DO NOT ADEQUATELY DESCRIBE OR QUANTIFY THE COMPONENTS OF THE INTERVENTIONS BEING IMPLEMENTED. THIS LACK OF DETAIL PREVENTS RESEARCHERS FROM MAKING COMPARISONS ACROSS STUDIES AND LIMITS OUR UNDERSTANDING OF THE RELATIVE EFFECTS OF DIFFERENT ASPECTS OF YOGA INTERVENTIONS. TO ADDRESS THIS PROBLEM, WE DEVELOPED THE ESSENTIAL PROPERTIES OF YOGA QUESTIONNAIRE (EPYQ), WHICH ALLOWS RESEARCHERS TO OBJECTIVELY CHARACTERIZE THEIR INTERVENTIONS. WE PRESENT HERE THE RELIABILITY AND VALIDITY DATA FROM THE FINAL PHASES OF THIS MEASURE-DEVELOPMENT PROJECT. ANALYSES IDENTIFIED FOURTEEN KEY DIMENSIONS OF YOGA INTERVENTIONS MEASURED BY THE EPYQ: ACCEPTANCE/COMPASSION, BANDHAS, BODY AWARENESS, BREATHWORK, INSTRUCTOR MENTION OF HEALTH BENEFITS, INDIVIDUAL ATTENTION, MEDITATION AND MINDFULNESS, MENTAL AND EMOTIONAL AWARENESS, PHYSICALITY, ACTIVE POSTURES, RESTORATIVE POSTURES, SOCIAL ASPECTS, SPIRITUALITY, AND YOGA PHILOSOPHY. THE EPYQ DEMONSTRATED GOOD RELIABILITY, AS ASSESSED BY INTERNAL CONSISTENCY AND TEST-RETEST RELIABILITY ANALYSIS, AND EVIDENCE SUGGESTS THAT THE EPYQ IS A VALID MEASURE OF MULTIPLE DIMENSIONS OF YOGA. THE MEASURE IS READY FOR USE BY CLINICIANS AND RESEARCHERS. RESULTS INDICATE THAT, CURRENTLY, TRAINED OBJECTIVE RATERS SHOULD SCORE INTERVENTIONS TO AVOID REFERENCE FRAME ERRORS AND POTENTIAL RATING BIAS, BUT ALTERNATIVE APPROACHES MAY BE DEVELOPED. THE EPYQ WILL ALLOW RESEARCHERS TO LINK SPECIFIC YOGA DIMENSIONS TO IDENTIFIABLE HEALTH OUTCOMES AND OPTIMIZE THE DESIGN OF YOGA INTERVENTIONS FOR SPECIFIC CONDITIONS. 2018
20 1149 41 ENHANCEMENT OF CANCER STEM CELL SUSCEPTIBILITY TO CONVENTIONAL TREATMENTS THROUGH COMPLEMENTARY YOGA THERAPY: POSSIBLE CELLULAR AND MOLECULAR MECHANISMS. CANCER STEM CELLS (CSCS) ARE STEM-LIKE TUMOR POPULATIONS THAT ARE REPORTED TO CONTRIBUTE TOWARDS TUMOR GROWTH, MAINTENANCE AND RECURRENCE AFTER THERAPY. HYPOXIA INCREASES CSC FRACTION AND PROMOTES ACQUISITION OF A STEM-CELL-LIKE STATE. CANCER STEM CELLS ARE CRITICALLY DEPENDANT ON THE HYPOXIA-INDUCIBLE FACTOR-1 (HIF-1) FOR SURVIVAL, SELF-RENEWAL, TUMOR GROWTH AND MAINTENANCE OF THEIR UNDIFFERENTIATED PHENOTYPE. RECENT RESEARCHES SHOW THAT STAGE OF DIFFERENTIATION OF THE TUMOR CELLS IS PREDICTIVE OF THEIR SUSCEPTIBILITY TO NATURAL KILLER CELL (NK) CELL MEDIATED CYTOTOXICITY AND CANCER STEM CELLS ARE SIGNIFICANT TARGETS OF NK CELL CYTOTOXICITY. STUDIES ALSO SHOW THAT REVERSION OF TUMOR CELLS TO A LESS-DIFFERENTIATED PHENOTYPE CAN BE ACHIEVED BY BLOCKING NFKAPPAB. YOGA THERAPY (YOGIC LIFESTYLE MODIFICATIONS ENCOMPASSING PHYSICAL POSTURES, BREATHING PRACTICES, RELAXATION TECHNIQUES AND MEDITATIONS) IS KNOWN TO MODULATE NEURAL, ENDOCRINE AND IMMUNE FUNCTIONS AT THE CELLULAR LEVEL THROUGH INFLUENCING CELL CYCLE CONTROL, AGING, OXIDATIVE STRESS, APOPTOSIS AND SEVERAL PATHWAYS OF STRESS SIGNALING MOLECULES. YOGA THERAPY HAS ALSO BEEN SHOWN TO ENHANCE NATURAL KILLER CELL ACTIVITY AND MODULATE STRESS AND DNA DAMAGE IN BREAST CANCER PATIENTS RECEIVING RADIOTHERAPY. RECENT STUDY FOUND THAT BRIEF DAILY YOGIC MEDITATION MAY REVERSE THE PATTERN OF INCREASED NFKAPPAB-RELATED TRANSCRIPTION OF PRO-INFLAMMATORY CYTOKINES IN LEUKOCYTES. THUS, YOGA THERAPY HAS THE POTENTIAL TO REDUCE CANCER STEM CELL SURVIVAL, SELF -RENEWAL AND TUMOR GROWTH BY MODIFYING THE TUMOR MICRO-ENVIRONMENT THROUGH VARIOUS MECHANISMS SUCH AS; 1) REDUCING HIF-1 ACTIVITY BY ENHANCED OXYGENATION, 2) PROMOTING NK CELL ACTIVITY DIRECTLY (OR INDIRECTLY THROUGH DOWN REGULATING NFKAPPAB EXPRESSION), THEREBY ENHANCING NK CELL MEDIATED CSC LYSIS, AND 3) BY MINIMIZING THE ABERRANT EXPRESSIONS OR ACTIVITIES OF VARIOUS HORMONES, CYTOKINES, CHEMOKINES AND TUMOR SIGNALING PATHWAYS. YOGA THERAPY MAY HAVE A SYNERGISTIC EFFECT WITH CONVENTIONAL MODALITIES OF TREATMENT IN PREVENTING CANCER PROGRESSION AND RECURRENCES. 2012