1 526 127 COMPARISON OF LAUGHTER YOGA AND ANTI-ANXIETY MEDICATION ON ANXIETY AND GASTROINTESTINAL SYMPTOMS OF PATIENTS WITH IRRITABLE BOWEL SYNDROME. BACKGROUND IRRITABLE BOWEL SYNDROME (IBS) IS THE MOST COMMON CHRONIC GASTROINTESTINAL (GI) DISORDER. PATIENTS WITH IBS USUALLY SUFFER FROM ANXIETY AND DEPRESSION. A COMBINATION OF PSYCHOLOGICAL APPROACHES AND PHARMACOLOGICAL TREATMENTS CAN BE A SIGNIFICANTLY EFFECTIVE TREATMENT FOR IBS. THE MAIN OBJECTIVE OF THE PRESENT STUDY WAS TO PROVIDE A THERAPEUTIC PLAN BASED ON LAUGHTER YOGA AND ANTI-ANXIETY MEDICATION, EMPLOYED FOR THE VERY FIRST TIME, AND TO DETERMINE THE EFFECTIVENESS OF THESE TREATMENTS ON THE ANXIETY AND GI SYMPTOMS OF PATIENTS WITH IBS. METHODS IN THIS RANDOMIZED, CONTROLLED, CLINICAL TRIAL, THE PARTICIPANTS WERE 60 PATIENTS SELECTED FROM THOSE WHO REFERRED TO THE GI CLINIC OF VALI-ASR HOSPITAL (BIRJAND, IRAN) DURING THE STUDY PERIOD (APRIL 2017 TO MARCH 2017) AND WERE DIAGNOSED AS HAVING IBS BASED ON ROME III CRITERIA. THE PARTICIPANTS WERE RANDOMLY ASSIGNED TO EITHER THE LAUGHTER YOGA GROUP, THE ANTI-ANXIETY MEDICATION GROUP, OR THE SYMPTOMATIC TREATMENT (CONTROL) GROUP. SEVERITY LEVELS OF ANXIETY AND GI SYMPTOMS BEFORE AND AFTER INTERVENTION WERE DETERMINED AND COMPARED AMONG THESE THREE GROUPS ACCORDING TO APPROVED PROTOCOLS. RESULTS THE SEVERITY OF IBS SYMPTOMS AFTER THE INTERVENTIONS WAS MORE GREATLY REDUCED IN THE LAUGHTER YOGA GROUP THAN IN THE ANTI-ANXIETY MEDICATION AND CONTROL GROUPS (P = 0.006). THE SEVERITY OF ANXIETY AFTER INTERVENTIONS DECREASED IN ALL THREE GROUPS, ESPECIALLY IN THE YOGA TREATMENT GROUP, BUT THE DIFFERENCE WAS NOT STATISTICALLY SIGNIFICANT (P = 0.1). CONCLUSION LAUGHTER YOGA IS MORE EFFECTIVE THAN ANTI-ANXIETY MEDICATION IN REDUCING THE GI SYMPTOMS OF PATIENTS WITH IBS. THEREFORE, APPLYING LAUGHTER YOGA ALONG WITH COMMON PHARMACOLOGICAL THERAPIES FOR PATIENTS WITH IBS MIGHT BE STRONGLY ADVISED. 2019 2 1506 30 IRRITABLE BOWEL SYNDROME: YOGA AS REMEDIAL THERAPY. IRRITABLE BOWEL SYNDROME (IBS) IS A GROUP OF SYMPTOMS MANIFESTING AS A FUNCTIONAL GASTROINTESTINAL (GI) DISORDER IN WHICH PATIENTS EXPERIENCE ABDOMINAL PAIN, DISCOMFORT, AND BLOATING THAT IS OFTEN RELIEVED WITH DEFECATION. IBS IS OFTEN ASSOCIATED WITH A HOST OF SECONDARY COMORBIDITIES SUCH AS ANXIETY, DEPRESSION, HEADACHES, AND FATIGUE. IN THIS REVIEW, WE EXAMINED THE BASIC PRINCIPLES OF PANCHA KOSHA (FIVE SHEATHS OF HUMAN EXISTENCE) CONCEPT FROM AN INDIAN SCRIPTURE TAITTIRIYA UPANISHAD AND THE PATHOPHYSIOLOGY OF A DISEASE FROM THE YOGA APPROACH, YOGA VASISTHA'S ADHI (ORIGINATED FROM MIND) AND VYADHI (AILMENT/DISEASE) CONCEPT. AN ANALOGY BETWEEN THE AGE OLD, THE MOST PROFOUND CONCEPT OF ADHI-VYADHI, AND MODERN SCIENTIFIC STRESS-INDUCED DYSREGULATION OF BRAIN-GUT AXIS, AS IT RELATES TO IBS THAT COULD PAVE WAY FOR IMPACTING IBS, IS EMPHASIZED. BASED ON THESE PERSPECTIVES, A PLAUSIBLE YOGA MODULE AS A REMEDIAL THERAPY IS PROVIDED TO BETTER MANAGE THE PRIMARY AND SECONDARY SYMPTOMS OF IBS. 2015 3 1526 42 IYENGAR YOGA FOR ADOLESCENTS AND YOUNG ADULTS WITH IRRITABLE BOWEL SYNDROME. OBJECTIVES: IRRITABLE BOWEL SYNDROME (IBS) IS A CHRONIC, DISABLING CONDITION THAT GREATLY COMPROMISES PATIENT FUNCTIONING. THE AIM OF THIS STUDY WAS TO ASSESS THE IMPACT OF A 6-WEEK TWICE PER WEEK IYENGAR YOGA (IY) PROGRAM ON IBS SYMPTOMS IN ADOLESCENTS AND YOUNG ADULTS (YA) WITH IBS COMPARED WITH A USUAL-CARE WAITLIST CONTROL GROUP. METHODS: ASSESSMENTS OF SYMPTOMS, GLOBAL IMPROVEMENT, PAIN, HEALTH-RELATED QUALITY OF LIFE, PSYCHOLOGICAL DISTRESS, FUNCTIONAL DISABILITY, FATIGUE, AND SLEEP WERE COLLECTED PRE- AND POSTTREATMENT. WEEKLY RATINGS OF PAIN, IBS SYMPTOMS, AND GLOBAL IMPROVEMENT WERE ALSO RECORDED UNTIL 2-MONTH FOLLOW-UP. A TOTAL OF 51 PARTICIPANTS COMPLETED THE INTERVENTION (YOGA = 29; USUAL-CARE WAITLIST = 22). RESULTS: BASELINE ATTRITION WAS 24%. ON AVERAGE, THE YOGA GROUP ATTENDED 75% OF CLASSES. ANALYSES WERE DIVIDED BY AGE GROUP. RELATIVE TO CONTROLS, ADOLESCENTS (14-17 YEARS) ASSIGNED TO YOGA REPORTED SIGNIFICANTLY IMPROVED PHYSICAL FUNCTIONING, WHEREAS YA (18-26 YEARS) ASSIGNED TO YOGA REPORTED SIGNIFICANTLY IMPROVED IBS SYMPTOMS, GLOBAL IMPROVEMENT, DISABILITY, PSYCHOLOGICAL DISTRESS, SLEEP QUALITY, AND FATIGUE. ALTHOUGH ABDOMINAL PAIN INTENSITY WAS STATISTICALLY UNCHANGED, 44% OF ADOLESCENTS AND 46% OF YA REPORTED A MINIMALLY CLINICALLY SIGNIFICANT REDUCTION IN PAIN FOLLOWING YOGA, AND ONE-THIRD OF YA REPORTED CLINICALLY SIGNIFICANT LEVELS OF GLOBAL SYMPTOM IMPROVEMENT. ANALYSIS OF THE UNCONTROLLED EFFECTS AND MAINTENANCE OF TREATMENT EFFECTS FOR ADOLESCENTS REVEALED GLOBAL IMPROVEMENT IMMEDIATELY POST-YOGA THAT WAS NOT MAINTAINED AT FOLLOW-UP. FOR YA, GLOBAL IMPROVEMENT, WORST PAIN, CONSTIPATION, AND NAUSEA WERE SIGNIFICANTLY IMPROVED POSTYOGA, BUT ONLY GLOBAL IMPROVEMENT, WORST PAIN, AND NAUSEA MAINTAINED AT THE 2-MONTH FOLLOW-UP. CONCLUSIONS: THE FINDINGS SUGGEST THAT A BRIEF IY INTERVENTION IS A FEASIBLE AND SAFE ADJUNCTIVE TREATMENT FOR YOUNG PEOPLE WITH IBS, LEADING TO BENEFITS IN A NUMBER OF IBS-SPECIFIC AND GENERAL FUNCTIONING DOMAINS FOR YA. THE AGE-SPECIFIC RESULTS SUGGEST THAT YOGA INTERVENTIONS MAY BE MOST FRUITFUL WHEN DEVELOPMENTALLY TAILORED. 2014 4 793 46 EFFECT OF YOGA IN THE THERAPY OF IRRITABLE BOWEL SYNDROME: A SYSTEMATIC REVIEW. BACKGROUND & AIMS: THIS REVIEW AIMS TO SYSTEMATICALLY SURVEY THE EFFECTS OF YOGA ON SYMPTOMS OF IRRITABLE BOWEL SYNDROME (IBS), PAIN, QUALITY OF LIFE, MOOD, STRESS, AND SAFETY IN PATIENTS WITH IBS. METHODS: MEDLINE/PUBMED, SCOPUS, THE COCHRANE LIBRARY, CAM-QUEST, CAMBASE, AND INDMED WERE SCREENED THROUGH NOVEMBER 2015. RANDOMIZED CONTROLLED TRIALS COMPARING YOGA WITH USUAL CARE, NONPHARMACOLOGIC, OR PHARMACOLOGIC INTERVENTIONS WERE ANALYZED FOR PATIENTS WITH IBS. PRIMARY OUTCOMES INCLUDED GASTROINTESTINAL SYMPTOMS, QUALITY OF LIFE, AND PAIN. ANXIETY, MOOD, AND SAFETY WERE DEFINED AS SECONDARY OUTCOMES. RISK OF BIAS WAS ASSESSED ACCORDING TO THE COCHRANE COLLABORATION RECOMMENDATIONS. RESULTS: SIX RANDOMIZED CONTROLLED TRIALS WITH A TOTAL OF 273 PATIENTS WERE INCLUDED IN THE QUALITATIVE ANALYSIS. THERE WAS EVIDENCE FOR A BENEFICIAL EFFECT OF A YOGIC INTERVENTION OVER CONVENTIONAL TREATMENT IN IBS, WITH SIGNIFICANTLY DECREASED BOWEL SYMPTOMS, IBS SEVERITY, AND ANXIETY. FURTHERMORE, THERE WERE SIGNIFICANT IMPROVEMENTS IN QUALITY OF LIFE, GLOBAL IMPROVEMENT, AND PHYSICAL FUNCTIONING AFTER YOGA COMPARED WITH NO TREATMENT. TWO RANDOMIZED CONTROLLED TRIALS REPORTED SAFETY DATA STATING THAT NO ADVERSE EVENTS OCCURRED. OVERALL, RISK OF BIAS OF THE INCLUDED STUDIES WAS UNCLEAR. CONCLUSIONS: THE FINDINGS OF THIS SYSTEMATIC REVIEW SUGGEST THAT YOGA MIGHT BE A FEASIBLE AND SAFE ADJUNCTIVE TREATMENT FOR PEOPLE WITH IBS. NEVERTHELESS, NO RECOMMENDATION CAN BE MADE REGARDING YOGA AS A ROUTINE INTERVENTION FOR PATIENTS WITH IBS BECAUSE OF MAJOR FLAWS IN STUDY METHODS. MORE RESEARCH IS NEEDED WITH RESPECT TO A HIGH-QUALITY STUDY DESIGN AND CONSENSUS IN CLINICAL OUTCOME MEASUREMENTS IN IBS. CLINICALTRIALS.GOV NUMBER, NCT02721836. 2016 5 2468 33 YOGA AS A THERAPY FOR IRRITABLE BOWEL SYNDROME. THE AIM OF THIS STATE-OF-THE-ART NARRATIVE REVIEW IS TO EVALUATE THE CURRENT EVIDENCE ABOUT THE EFFECTIVENESS OF YOGA AS THERAPY FOR IBS AND EXPLORE ITS POTENTIAL MECHANISMS OF ACTION. THE CURRENT LITERATURE SUGGESTS YOGA IS EFFECTIVE AND SAFE AND MAY TARGET MULTIPLE MECHANISMS INVOLVED IN TREATMENT OF IBS. EVIDENCE FROM RANDOMIZED CONTROLLED TRIALS IDENTIFIED YOGA AS MORE EFFECTIVE COMPARED TO PHARMACOLOGICAL TREATMENT AND EQUALLY EFFECTIVE AS DIETARY INTERVENTIONS OR MODERATE-INTENSITY WALKING. IMPROVEMENTS WERE SEEN IN BOTH PHYSICAL HEALTH (IBS SYMPTOM SEVERITY, GASTRIC MOTILITY, AUTONOMIC AND SOMATIC SYMPTOM SCORES, AND PHYSICAL FUNCTIONING) AND MENTAL HEALTH OUTCOMES (DEPRESSION, ANXIETY, GASTROINTESTINAL-SPECIFIC ANXIETY, AND QUALITY OF LIFE). GIVEN FAVORABLE CHANGES IN IBS-RELATED PHYSICAL AND MENTAL HEALTH OUTCOMES, PRELIMINARY DATA SUPPORTS YOGA AS BENEFICIAL IN THIS POPULATION. HOWEVER, THE RELATIVELY LOW-QUALITY EVIDENCE RESULTING FROM HETEROGENEITY OF STUDY DESIGNS, INTERVENTIONS, AND OUTCOME MEASURES LIMIT OUR ABILITY TO MAKE SPECIFIC RECOMMENDATIONS ABOUT THE USE OF YOGA AS THERAPY FOR PATIENTS WITH IBS. 2020 6 1960 53 SELF-REGULATION EVALUATION OF THERAPEUTIC YOGA AND WALKING FOR PATIENTS WITH IRRITABLE BOWEL SYNDROME: A PILOT STUDY. WITH LIMITED EFFICACY OF MEDICATIONS FOR SYMPTOM RELIEF, NON-MEDICATION TREATMENTS MAY PLAY AN IMPORTANT ROLE IN THE TREATMENT OF IRRITABLE BOWEL SYNDROME (IBS), THE MOST COMMON FUNCTIONAL GASTROINTESTINAL (GI) DISORDER. THIS STUDY AIMED TO EVALUATE THE EFFICACY OF TWO SELF-REGULATION STRATEGIES FOR SYMPTOM RELIEF AND MOOD MANAGEMENT IN IBS PATIENTS. THIRTY-FIVE ADULT PARTICIPANTS MEETING ROME III CRITERIA FOR IBS WERE ENROLLED, 27 OF THE 35 PARTICIPANTS (77%) COMPLETED TREATMENT AND PRE- AND POST-TREATMENT VISITS (89% WOMEN, 11% MEN; M (SD) AGE = 36 (13)), AND 20 OF THE 27 (74%) COMPLETED A 6-MONTH FOLLOW-UP. PARTICIPANTS WERE RANDOMLY ASSIGNED TO 16 BIWEEKLY GROUP SESSIONS OF IYENGAR YOGA OR A WALKING PROGRAM. RESULTS INDICATED A SIGNIFICANT GROUP BY TIME INTERACTION ON NEGATIVE AFFECT WITH THE WALKING TREATMENT SHOWING IMPROVEMENT FROM PRE- TO POST-TREATMENT WHEN COMPARED TO YOGA (P < .05). THERE WAS NO SIGNIFICANT GROUP BY TIME EFFECT ON IBS SEVERITY. EXPLORATORY ANALYSES OF SECONDARY OUTCOMES EXAMINED CHANGE SEPARATELY FOR EACH TREATMENT CONDITION. FROM PRE- TO POST-TREATMENT, YOGA SHOWED SIGNIFICANT DECREASES IN IBS SEVERITY MEASURES (P < .05), VISCERAL SENSITIVITY (P < .05), AND SEVERITY OF SOMATIC SYMPTOMS (P < .05). WALKING SHOWED SIGNIFICANT DECREASES IN OVERALL GI SYMPTOMS (P < .05), NEGATIVE AFFECT (P < .05), AND STATE ANXIETY (P < .05). AT 6-MONTH FOLLOW-UP, OVERALL GI SYMPTOMS FOR WALKING CONTINUED TO SIGNIFICANTLY DECLINE, WHILE FOR YOGA, GI SYMPTOMS REBOUNDED TOWARD BASELINE LEVELS (P < .05). WHEN ASKED ABOUT SELF-REGULATED HOME PRACTICE AT 6 MONTHS, SIGNIFICANTLY MORE PARTICIPANTS IN WALKING THAN IN YOGA PRACTICED AT LEAST WEEKLY (P < .05). IN SUM, RESULTS SUGGEST THAT YOGA AND WALKING AS MOVEMENT-BASED SELF-REGULATORY BEHAVIORAL TREATMENTS HAVE SOME DIFFERENTIAL EFFECTS BUT ARE BOTH BENEFICIAL FOR IBS PATIENTS, THOUGH MAINTENANCE OF A SELF-REGULATED WALKING PROGRAM MAY BE MORE FEASIBLE AND THEREFORE MORE EFFECTIVE LONG TERM. 2016 7 2625 33 YOGA FOR TEENS WITH IRRITABLE BOWEL SYNDROME: RESULTS FROM A MIXED-METHODS PILOT STUDY. IRRITABLE BOWEL SYNDROME (IBS) IS A COMMON CONDITION ASSOCIATED WITH RECURRENT ABDOMINAL PAIN AND ALTERED BOWEL HABITS. IT IS PARTICULARLY PERNICIOUS TO YOUTH, WHO MAY WITHDRAW FROM LIFE TASKS DUE TO PAIN, DIARRHEA, AND/OR FEAR OF SYMPTOMS. EMOTIONAL STRESS EXACERBATES IBS SYMPTOMS, AND MIND-BODY INTERVENTIONS MAY BE BENEFICIAL. IN THIS MIXED-METHODS STUDY OF 18 TEENS AGED 14 TO 17 YEARS UNDERTAKING A 6-WEEK IYENGAR YOGA INTERVENTION, WE AIMED TO IDENTIFY TREATMENT RESPONDERS AND TO EXPLORE DIFFERENCES BETWEEN RESPONDERS AND NONRESPONDERS ON A RANGE OF QUANTITATIVE OUTCOMES AND QUALITATIVE THEMES RELATED TO YOGA IMPACT, GOODNESS OF FIT, AND BARRIERS TO TREATMENT. HALF OF THE TEENS RESPONDED SUCCESSFULLY TO YOGA, DEFINED AS A CLINICALLY MEANINGFUL REDUCTION IN ABDOMINAL PAIN. RESPONDERS DIFFERED FROM NONRESPONDERS ON POSTINTERVENTION QUANTITATIVE OUTCOMES, INCLUDING REDUCED ABDOMINAL PAIN, IMPROVED SLEEP, AND INCREASED VISCERAL SENSITIVITY. QUALITATIVE OUTCOMES REVEALED THAT RESPONDERS REPORTED GENERALIZED BENEFITS EARLY IN TREATMENT AND THAT THEIR PARENTS WERE SUPPORTIVE AND COMMITTED TO THE INTERVENTION. RESPONDERS AND NONRESPONDERS ALIKE NOTED THE IMPORTANCE OF HOME PRACTICE TO ACHIEVE MAXIMAL, SUSTAINED BENEFITS. THIS STUDY REVEALS THE NEED FOR DEVELOPMENTALLY SENSITIVE YOGA PROGRAMS THAT INCREASE ACCESSIBILITY OF YOGA FOR ALL PATIENTS. 2018 8 194 45 A RANDOMIZED TRIAL OF YOGA FOR ADOLESCENTS WITH IRRITABLE BOWEL SYNDROME. BACKGROUND: ADOLESCENTS WITH IRRITABLE BOWEL SYNDROME (IBS) FREQUENTLY EXPERIENCE INTERFERENCE WITH EVERYDAY ACTIVITIES. MIND-BODY APPROACHES SUCH AS YOGA HAVE BEEN RECOMMENDED AS INTERVENTIONS FOR PATIENTS WITH IBS. DESPITE PROMISING RESULTS AMONG ADULT SAMPLES, THERE HAVE BEEN LIMITED STUDIES EXPLORING THE EFFICACY OF YOGA WITH PEDIATRIC PATIENTS. OBJECTIVE: TO CONDUCT A PRELIMINARY RANDOMIZED STUDY OF YOGA AS TREATMENT FOR ADOLESCENTS WITH IBS. METHODS: TWENTY-FIVE ADOLESCENTS AGED 11 TO 18 YEARS WITH IBS WERE RANDOMLY ASSIGNED TO EITHER A YOGA OR WAIT LIST CONTROL GROUP. BEFORE THE INTERVENTION, BOTH GROUPS COMPLETED QUESTIONNAIRES ASSESSING GASTROINTESTINAL SYMPTOMS, PAIN, FUNCTIONAL DISABILITY, COPING, ANXIETY AND DEPRESSION. THE YOGA INTERVENTION CONSISTED OF A 1 H INSTRUCTIONAL SESSION, DEMONSTRATION AND PRACTICE, FOLLOWED BY FOUR WEEKS OF DAILY HOME PRACTICE GUIDED BY A VIDEO. AFTER FOUR WEEKS, ADOLESCENTS REPEATED THE BASELINE QUESTIONNAIRES. THE WAIT LIST CONTROL GROUP THEN RECEIVED THE YOGA INTERVENTION AND FOUR WEEKS LATER COMPLETED AN ADDITIONAL SET OF QUESTIONNAIRES. RESULTS: ADOLESCENTS IN THE YOGA GROUP REPORTED LOWER LEVELS OF FUNCTIONAL DISABILITY, LESS USE OF EMOTION-FOCUSED AVOIDANCE AND LOWER ANXIETY FOLLOWING THE INTERVENTION THAN ADOLESCENTS IN THE CONTROL GROUP. WHEN THE PRE- AND POSTINTERVENTION DATA FOR THE TWO GROUPS WERE COMBINED, ADOLESCENTS HAD SIGNIFICANTLY LOWER SCORES FOR GASTROINTESTINAL SYMPTOMS AND EMOTION-FOCUSED AVOIDANCE FOLLOWING THE YOGA INTERVENTION. ADOLESCENTS FOUND THE YOGA TO BE HELPFUL AND INDICATED THEY WOULD CONTINUE TO USE IT TO MANAGE THEIR IBS. CONCLUSIONS: YOGA HOLDS PROMISE AS AN INTERVENTION FOR ADOLESCENTS WITH IBS. 2006 9 1820 42 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 10 1591 42 MEDITATION AND YOGA FOR IRRITABLE BOWEL SYNDROME: STUDY PROTOCOL FOR A RANDOMISED CLINICAL TRIAL (MY-IBS STUDY). INTRODUCTION: WHEN DELIVERED IN PERSON, YOGA HAS BEEN SHOWN TO BE EFFECTIVE IN MANAGING IRRITABLE BOWEL SYNDROME (IBS) SYMPTOMS. RESEARCH IS NEEDED TO TEST THE FEASIBILITY AND EFFECTIVENESS OF YOGA AS A THERAPEUTIC OPTION WHEN DELIVERED VIRTUALLY. THE PRIMARY AIM OF THE MIND AND YOGA FOR IBS RANDOMISED CONTROLLED TRIAL IS TO DETERMINE THE EFFECTS OF AN 8-WEEK VIRTUAL MEDITATION AND YOGA INTERVENTION ON IBS SYMPTOM SEVERITY COMPARED WITH AN ADVICE-ONLY ACTIVE CONTROL GROUP. METHODS AND ANALYSIS: ADULTS DIAGNOSED WITH IBS WILL BE RANDOMISED TO RECEIVE EITHER A UPA YOGA INTERVENTION OR AN ADVICE-ONLY CONTROL GROUP. THE INTERVENTION WILL CONSIST OF WEEKLY ONLINE CLASSES FOR 8 WEEKS DELIVERED BY A FACILITATOR USING MICROSOFT OFFICE TEAMS AND DAILY HOME PRACTICE. FEASIBILITY WILL BE EVALUATED BY EXAMINING RECRUITMENT AND ATTRITION RATES, ADHERENCE, PARTICIPANT SATISFACTION WITH THE PROGRAMME AND SAFETY. THE PRIMARY OUTCOME IS IBS SYMPTOM SEVERITY, AND KEY SECONDARY OUTCOMES INCLUDE (BUT NOT LIMITED TO) QUALITY OF LIFE, ANXIETY AND DEPRESSION SYMPTOMS, COVID-19-RELATED STRESS AND ANXIETY, AND FATIGUE. OUTCOMES WILL BE ASSESSED AT BASELINE, 4 WEEKS AND 8 WEEKS. AN EMBEDDED DESIGN EXPERIMENTAL MODEL SUBSTUDY WILL BE CONDUCTED POST INTERVENTION USING QUALITATIVE RESEARCH METHODS TO IDENTIFY PARTICIPANTS' EXPERIENCES IN THE YOGA PROGRAMME. ETHICS AND DISSEMINATION: THIS STUDY HAS BEEN APPROVED BY THE CONJOINT HEALTH RESEARCH ETHICS BOARD (REB ID 20-0084). FINDINGS WILL BE DISSEMINATED THROUGH PEER-REVIEWED PUBLICATION, CONFERENCE PRESENTATION AND SOCIAL MEDIA. TRIAL REGISTRATION NUMBER: NCT04302623. 2022 11 2794 36 YOGA THERAPY FOR MEDICALLY UNEXPLAINED PHYSICAL SYMPTOMS. MEDICALLY UNEXPLAINED PHYSICAL SYMPTOMS (MUPS) IS A COMMON, YET NEGLECTED DISEASE WITH A PREVALENCE OF AROUND 25% IN PRIMARY CARE SETTING. THESE PATIENTS PRESENT WITH MULTIPLE PHYSICAL AND PSYCHOLOGICAL SYMPTOMS, WITHOUT AN UNDERLYING DIAGNOSIS, HAMPERING THEIR FUNCTIONAL AND MENTAL WELLBEING. THE MANAGEMENT OF THESE UNDIAGNOSED SYMPTOMS THROUGH CONVENTIONAL TREATMENT HAS NOT BEEN ENCOURAGING. PATIENTS SHUTTLE BETWEEN DIFFERENT SPECIALITIES, SEEKING A DIAGNOSIS FOR THEIR SYMPTOMS, MAKING THEM DISSATISFIED AND INCREASING HEALTHCARE BURDEN. YOGA, AS AN ADJUNCT THERAPY HAS SHOWN TO BE EFFECTIVE IN THE MANAGEMENT OF MUPS RELATED DISORDERS SUCH AS SOMATOFORM DISORDER, IRRITABLE BOWEL SYNDROME (IBS) AND DEPRESSION AND ANXIETY. THUS, WE SUGGEST AN INTEGRATED YOGA MODULE WHICH MIGHT HELP IN IMPROVING BOTH PHYSICAL AND PSYCHOLOGICAL VARIABLE IN MUPS PATIENTS AND IMPROVING THEIR OVERALL QUALITY OF LIFE. FURTHERMORE, THE GAP IN THE LITERATURE ON THE EFFICACY OF YOGA IN IMPROVING MUPS, CAN BE ADDRESSED BY PLANNING A RANDOMISED CONTROLLED TRIAL BASED ON THE SUGGESTED YOGA MODULE. 2020 12 125 31 A PILOT STUDY OF YOGA TREATMENT IN CHILDREN WITH FUNCTIONAL ABDOMINAL PAIN AND IRRITABLE BOWEL SYNDROME. OBJECTIVES: THE AIM OF THIS PILOT STUDY WAS TO EVALUATE THE EFFECT OF YOGA EXERCISES ON PAIN FREQUENCY AND INTENSITY AND ON QUALITY OF LIFE IN CHILDREN WITH FUNCTIONAL ABDOMINAL PAIN. DESIGN: 20 CHILDREN, AGED 8-18 YEARS, WITH IRRITABLE BOWEL SYNDROME (IBS) OR FUNCTIONAL ABDOMINAL PAIN (FAP) WERE ENROLLED AND RECEIVED 10 YOGA LESSONS. PAIN INTENSITY AND PAIN FREQUENCY WERE SCORED IN A PAIN DIARY AND QUALITY OF LIFE WAS MEASURED WITH THE KIDSCREEN QUALITY OF LIFE QUESTIONNAIRE (KQOL). RESULTS: IN THE 8-11 YEAR OLD GROUP AND THE 11-18 YEAR OLD GROUP PAIN FREQUENCY WAS SIGNIFICANTLY DECREASED AT THE END OF THERAPY (P=0.031 AND P=0.004) COMPARED TO BASELINE. IN THE 8-11 YEAR GROUP PAIN INTENSITY WAS ALSO SIGNIFICANTLY DECREASED AT THIS TIME POINT (P=0.015). AFTER 3 MONTHS THERE STILL WAS A SIGNIFICANT DECREASE IN PAIN FREQUENCY IN THE YOUNGER PATIENT GROUP (P=0.04) AND A BORDERLINE SIGNIFICANT DECREASE IN PAIN FREQUENCY IN THE TOTAL GROUP (P=0.052). PARENTS REPORTED A SIGNIFICANTLY HIGHER KQOL-SCORE AFTER YOGA TREATMENT. CONCLUSION: THIS PILOT STUDY SUGGESTS THAT YOGA EXERCISES ARE EFFECTIVE FOR CHILDREN AGED 8-18 YEARS WITH FAP, RESULTING IN SIGNIFICANT REDUCTION OF PAIN INTENSITY AND FREQUENCY, ESPECIALLY IN CHILDREN OF 8-11 YEARS OLD. 2011 13 1379 37 IMPACT OF IYENGAR YOGA ON QUALITY OF LIFE IN YOUNG WOMEN WITH RHEUMATOID ARTHRITIS. OBJECTIVE: RHEUMATOID ARTHRITIS (RA) IS A CHRONIC, DISABLING DISEASE THAT CAN GREATLY COMPROMISE HEALTH-RELATED QUALITY OF LIFE (HRQOL). THE AIM OF THIS STUDY WAS TO ASSESS THE IMPACT OF A 6-WEEK TWICE/WEEK IYENGAR YOGA PROGRAM ON HRQOL OF YOUNG ADULTS WITH RA COMPARED WITH A USUAL-CARE WAITLIST CONTROL GROUP. METHODS: THE PROGRAM WAS DESIGNED TO IMPROVE THE PRIMARY OUTCOME OF HRQOL INCLUDING PAIN AND DISABILITY AND PSYCHOLOGICAL FUNCTIONING IN PATIENTS. ASSESSMENTS WERE COLLECTED PRETREATMENT, POSTTREATMENT, AND AT 2 MONTHS AFTER TREATMENT. WEEKLY RATINGS OF ANXIETY, DEPRESSION, PAIN, AND SLEEP WERE ALSO RECORDED. A TOTAL OF 26 PARTICIPANTS COMPLETED THE INTERVENTION (YOGA=11; USUAL-CARE WAITLIST=15). ALL PARTICIPANTS WERE FEMALE (MEAN AGE=28 Y). RESULTS: OVERALL ATTRITION WAS LOW AT 15%. ON AVERAGE, WOMEN IN THE YOGA GROUP ATTENDED 96% OF THE YOGA CLASSES. NO ADVERSE EVENTS WERE REPORTED. RELATIVE TO THE USUAL-CARE WAITLIST, WOMEN ASSIGNED TO THE YOGA PROGRAM SHOWED SIGNIFICANTLY GREATER IMPROVEMENT ON STANDARDIZED MEASURES OF HRQOL, PAIN DISABILITY, GENERAL HEALTH, MOOD, FATIGUE, ACCEPTANCE OF CHRONIC PAIN, AND SELF-EFFICACY REGARDING PAIN AT POSTTREATMENT. ALMOST HALF OF THE YOGA GROUP REPORTED CLINICALLY MEANINGFUL SYMPTOM IMPROVEMENT. ANALYSIS OF THE UNCONTROLLED EFFECTS AND MAINTENANCE OF TREATMENT EFFECTS SHOWED IMPROVEMENTS IN HRQOL GENERAL HEALTH, PAIN DISABILITY, AND WEEKLY RATINGS OF PAIN, ANXIETY, AND DEPRESSION WERE MAINTAINED AT FOLLOW-UP. CONCLUSIONS: THE FINDINGS SUGGEST THAT A BRIEF IYENGAR YOGA INTERVENTION IS A FEASIBLE AND SAFE ADJUNCTIVE TREATMENT FOR YOUNG PEOPLE WITH RA, LEADING TO HRQOL, PAIN DISABILITY, FATIGUE, AND MOOD BENEFITS. MOREOVER, IMPROVEMENTS IN QUALITY OF LIFE, PAIN DISABILITY, AND MOOD PERSISTED AT THE 2-MONTH FOLLOW-UP. 2013 14 1035 33 EFFECTS OF YOGA IN INFLAMMATORY BOWEL DISEASES AND ON FREQUENT IBD-ASSOCIATED EXTRAINTESTINAL SYMPTOMS LIKE FATIGUE AND DEPRESSION. QUALITY OF LIFE (QOL) OF PERSONS WITH INFLAMMATORY BOWEL DISEASES (IBD) IS OFTEN IMPAIRED BY SYMPTOMS THAT DO NOT PRIMARILY RELATE TO INTESTINAL INFLAMMATION. AMONG THE MOST CHALLENGING EXTRAINTESTINAL SYMPTOMS ARE DEPRESSION AND FATIGUE, WHICH ARE ALSO FREQUENT IN OTHER CHRONIC DISEASES LIKE MULTIPLE SCLEROSIS, RHEUMATOID ARTHRITIS AND CANCER. YOGA AS AN ANCIENT INDIAN TRADITION CONTAINING POSTURES, BREATHING EXERCISES AND MEDITATION MAY POSITIVELY INFLUENCE THOSE SYMPTOMS. THIS REVIEW EVALUATES THE CURRENT LITERATURE WITH REGARD TO THE EFFECT OF YOGA-BASED INTERVENTIONS IN PERSONS WITH IBD AND WITH REGARD TO QOL, DEPRESSION AND FATIGUE IN OTHER SOMATIC DISORDERS. A SYSTEMATIC LITERATURE SEARCH YIELDED THREE TRIALS EXAMINING THE EFFECTS OF YOGA IN PATIENTS WITH IBD AND 37 TRIALS ADDRESSING DEPRESSIVE SYNDROMES OR FATIGUE IN SOMATIC DISORDERS. IN SUMMARY, BOTH IN-PERSON AND VIDEO-BASED YOGA CLASSES ARE FEASIBLE, ACCEPTABLE AND SAFE AS COMPLEMENTARY TREATMENT IN PATIENTS WITH IBD AND SIGNIFICANTLY IMPROVE ANXIETY AND IMPAIRED QUALITY OF LIFE. CURRENT LITERATURE DOES NOT PROVIDE INFORMATION ON THE EFFECT OF YOGA ON DEPRESSION AND FATIGUE IN PATIENTS WITH IBD, BUT RESEARCH FROM OTHER SOMATIC DISORDERS OR PATIENTS WITH DEPRESSIVE DISORDERS IMPLIES THE POTENTIAL OF YOGA IN THIS REGARD FOR PERSONS WITH IBD. THIS SHOULD BE SPECIFICALLY ADDRESSED IN INTERVENTIONAL TRIALS WITH STANDARDIZED YOGA MODULES INCLUDING PATIENTS WITH IBD SUFFERING FROM FATIGUE, DEPRESSION AND/OR IMPAIRED QOL. 2021 15 1852 50 RANDOMISED CLINICAL TRIAL: YOGA VS A LOW-FODMAP DIET IN PATIENTS WITH IRRITABLE BOWEL SYNDROME. BACKGROUND: IRRITABLE BOWEL SYNDROME IS THE MOST FREQUENT GASTROINTESTINAL DISORDER. IT IS ASSUMED THAT LIFESTYLE INTERVENTIONS MIGHT BE A RATIONAL TREATMENT APPROACH. AIM: TO EXAMINE THE EFFECT OF A YOGA-BASED INTERVENTION VS A LOW-FODMAP DIET ON PATIENTS WITH IRRITABLE BOWEL SYNDROME. METHODS: FIFTY-NINE PATIENTS WITH IRRITABLE BOWEL SYNDROME UNDERTOOK A SINGLE-BLIND, RANDOMISED CONTROLLED TRIAL INVOLVING YOGA OR A LOW-FODMAP DIET FOR 12 WEEKS. PATIENTS IN THE YOGA GROUP RECEIVED TWO SESSIONS WEEKLY, WHILE PATIENTS IN THE LOW-FODMAP GROUP RECEIVED A TOTAL OF THREE SESSIONS OF NUTRITIONAL COUNSELLING. THE PRIMARY OUTCOME WAS A CHANGE IN GASTROINTESTINAL SYMPTOMS (IBS-SSS). SECONDARY OUTCOMES EXPLORED CHANGES IN QUALITY OF LIFE (IBS-QOL), HEALTH (SF-36), PERCEIVED STRESS (CPSS, PSQ), BODY AWARENESS (BAQ), BODY RESPONSIVENESS (BRS) AND SAFETY OF THE INTERVENTIONS. OUTCOMES WERE EXAMINED IN WEEKS 12 AND 24 BY ASSESSORS "BLINDED" TO PATIENTS' GROUP ALLOCATION. RESULTS: NO STATISTICALLY SIGNIFICANT DIFFERENCE WAS FOUND BETWEEN THE INTERVENTION GROUPS, WITH REGARD TO IBS-SSS SCORE, AT EITHER 12 (DELTA = 31.80; 95%CI = -11.90, 75.50; P = .151) OR 24 WEEKS (DELTA = 33.41; 95%CI = -4.21, 71.04; P = .081). WITHIN-GROUP COMPARISONS SHOWED STATISTICALLY SIGNIFICANT EFFECTS FOR YOGA AND LOW-FODMAP DIET AT BOTH 12 AND 24 WEEKS (ALL P < .001). COMPARABLE WITHIN-GROUP EFFECTS OCCURRED FOR THE OTHER OUTCOMES. ONE PATIENT IN EACH INTERVENTION GROUP EXPERIENCED SERIOUS ADVERSE EVENTS (P = 1.00) AND ANOTHER, ALSO IN EACH GROUP, EXPERIENCED NONSERIOUS ADVERSE EVENTS (P = 1.00). CONCLUSIONS: PATIENTS WITH IRRITABLE BOWEL SYNDROME MIGHT BENEFIT FROM YOGA AND A LOW-FODMAP DIET, AS BOTH GROUPS SHOWED A REDUCTION IN GASTROINTESTINAL SYMPTOMS. MORE RESEARCH ON THE UNDERLYING MECHANISMS OF BOTH INTERVENTIONS IS WARRANTED, AS WELL AS EXPLORATION OF POTENTIAL BENEFITS FROM THEIR COMBINED USE. 2018 16 1543 28 KUNDALINI YOGA FOR GENERALIZED ANXIETY DISORDER: AN EXPLORATION OF TREATMENT EFFICACY AND POSSIBLE MECHANISMS. THE AIM OF THIS STUDY WAS TO EXAMINE THE EFFICACY OF KUNDALINI YOGA IN REDUCING SYMPTOMS OF GENERALIZED ANXIETY DISORDER (GAD) COMPARED TO A COMMON TREATMENT-AS-USUAL CONDITION USING COGNITIVE TECHNIQUES. A SECONDARY OBJECTIVE WAS TO EXPLORE POTENTIAL TREATMENT MECHANISMS. FEMALES AGED 24 TO 75 YEARS WITH GAD ( N = 49) RECEIVED EITHER AN 8-WEEK KUNDALINI YOGA INTERVENTION ( N = 34) OR AN 8-WEEK TREATMENT-AS-USUAL CONDITION ( N = 15). THE YOGA CONDITION RESULTED IN LOWER LEVELS OF ANXIETY RELATIVE TO THE TREATMENT-AS-USUAL CONDITION. FURTHERMORE, CHANGES IN SOMATIC SYMPTOMS MEDIATED TREATMENT OUTCOME FOR KUNDALINI YOGA. KUNDALINI YOGA MAY SHOW PROMISE AS A TREATMENT FOR GAD, AND THIS TREATMENT MIGHT CONVEY ITS EFFECT ON SYMPTOM SEVERITY BY REDUCING SOMATIC SYMPTOMS. 2018 17 576 27 DEPRESSION AND ANXIETY DISORDERS: BENEFITS OF EXERCISE, YOGA, AND MEDITATION. MANY PEOPLE WITH DEPRESSION OR ANXIETY TURN TO NONPHARMACOLOGIC AND NONCONVENTIONAL INTERVENTIONS, INCLUDING EXERCISE, YOGA, MEDITATION, TAI CHI, OR QI GONG. META-ANALYSES AND SYSTEMATIC REVIEWS HAVE SHOWN THAT THESE INTERVENTIONS CAN IMPROVE SYMPTOMS OF DEPRESSION AND ANXIETY DISORDERS. AS AN ADJUNCTIVE TREATMENT, EXERCISE SEEMS MOST HELPFUL FOR TREATMENT-RESISTANT DEPRESSION, UNIPOLAR DEPRESSION, AND POSTTRAUMATIC STRESS DISORDER. YOGA AS MONOTHERAPY OR ADJUNCTIVE THERAPY SHOWS POSITIVE EFFECTS, PARTICULARLY FOR DEPRESSION. AS AN ADJUNCTIVE THERAPY, IT FACILITATES TREATMENT OF ANXIETY DISORDERS, PARTICULARLY PANIC DISORDER. TAI CHI AND QI GONG MAY BE HELPFUL AS ADJUNCTIVE THERAPIES FOR DEPRESSION, BUT EFFECTS ARE INCONSISTENT. AS MONOTHERAPY OR AN ADJUNCTIVE THERAPY, MINDFULNESS-BASED MEDITATION HAS POSITIVE EFFECTS ON DEPRESSION, AND ITS EFFECTS CAN LAST FOR SIX MONTHS OR MORE. ALTHOUGH POSITIVE FINDINGS ARE LESS COMMON IN PEOPLE WITH ANXIETY DISORDERS, THE EVIDENCE SUPPORTS ADJUNCTIVE USE. THERE ARE NO APPARENT NEGATIVE EFFECTS OF MINDFULNESS-BASED INTERVENTIONS, AND THEIR GENERAL HEALTH BENEFITS JUSTIFY THEIR USE AS ADJUNCTIVE THERAPY FOR PATIENTS WITH DEPRESSION AND ANXIETY DISORDERS. 2019 18 891 49 EFFECT OF YOGA-BASED INTERVENTION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE. BACKGROUND: INFLAMMATORY BOWEL DISEASE (IBD) IS A CHRONIC ILLNESS CHARACTERIZED BY GROSS INFLAMMATION IN THE GASTROINTESTINAL TRACT THAT CAN RESULT IN SYMPTOMS SUCH AS ABDOMINAL PAIN, CRAMPING, DIARRHEA, AND BLOODY STOOLS. IBD IS BELIEVED TO BE INFLUENCED BY PSYCHOLOGICAL FACTORS SUCH AS STRESS AND ANXIETY. THEREFORE, A YOGA INTERVENTION THAT REDUCES STRESS AND ANXIETY MAY BE AN EFFECTIVE COMPLEMENTARY TREATMENT FOR THESE DISORDERS. MATERIAL AND METHODS: A TOTAL OF 100 IBD PATIENTS [ULCERATIVE COLITIS (UC) N = 60 AND CROHN'S DISEASE (CD) N = 40] DURING THE CLINICAL REMISSION PHASE OF DISEASE WERE INCLUDED IN THE STUDY. THESE PATIENTS WERE ALLOCATED RANDOMLY TO EITHER THE YOGA GROUP THAT UNDERWENT AN 8-WEEK YOGA INTERVENTION (PHYSICAL POSTURES, PRANAYAMA, AND MEDITATION) 1- HOUR/DAY IN ADDITION TO STANDARD MEDICAL THERAPY (UC, N = 30; CD, N = 20) OR THE CONTROL GROUP (UC, N = 30; CD N = 20), WHICH CONTINUED WITH STANDARD MEDICAL THERAPY ALONE. THE MAIN OUTCOME MEASURES WERE CARDIOVASCULAR AUTONOMIC FUNCTIONS, SERUM EOSINOPHILIC CATIONIC PROTEIN, INTERLEUKIN- 2 SOLUBLE RECEPTORS, SPEILBERGER'S STATE TRAIT ANXIETY INVENTORY (STAI) SCORES, AND CLINICAL SYMPTOMS. RESULTS: BEFORE THE INTERVENTION, ALL THE OUTCOME MEASURES WERE COMPARABLE IN THE TWO GROUPS. AFTER THE 8-WEEK YOGA INTERVENTION, FEWER UC PATIENTS REPORTED ARTHRALGIA. THE NUMBER OF PATIENTS REPORTING INTESTINAL COLIC PAIN IN THE CONTROL GROUP WAS HIGHER. STATE AND TRAIT ANXIETY LEVELS WERE SIGNIFICANTLY REDUCED IN PATIENTS WITH UC. HOWEVER, NO SIGNIFICANT CHANGES WERE OBSERVED IN CARDIOVASCULAR AUTONOMIC FUNCTIONS, EOSINOPHILIC CATIONIC PROTEINS, OR INTERLEUKIN-2 SOLUBLE RECEPTORS. CONCLUSIONS: A SIMPLIFIED YOGA-BASED REGIMEN IS A SAFE AND EFFECTIVE COMPLEMENTARY CLINICAL TREATMENT MODALITY FOR PATIENTS WITH INFLAMMATORY BOWEL DISEASE DURING THE CLINICAL REMISSION PHASE. 2015 19 517 52 COMPARING HATHA YOGA WITH DYNAMIC GROUP PSYCHOTHERAPY FOR ENHANCING METHADONE MAINTENANCE TREATMENT: A RANDOMIZED CLINICAL TRIAL. BACKGROUND: AS MORE METHADONE TREATMENT PROGRAMS ARE FUNDED IN AN ATTEMPT TO CURB SUBSTANCE ABUSE AND HIV INFECTION AMONG I.V. DRUG USERS, MORE COST EFFECTIVE TREATMENT APPROACHES ARE BEING SOUGHT. OBJECTIVES: TO INVESTIGATE WHETHER CLIENTS IN OUTPATIENT METHADONE MAINTENANCE TREATMENT WHO PRACTICE WEEKLY HATHA YOGA IN A GROUP SETTING EXPERIENCE MORE FAVORABLE TREATMENT OUTCOMES THAN THOSE WHO RECEIVE CONVENTIONAL GROUP PSYCHODYNAMIC THERAPY. METHODS: AFTER A 5-DAY ASSESSMENT PERIOD, 61 PATIENTS WERE RANDOMLY ASSIGNED TO METHADONE MAINTENANCE ENHANCED BY TRADITIONAL GROUP PSYCHOTHERAPY (IE, CONVENTIONAL METHADONE TREATMENT) OR AN ALTERNATIVE HATHA YOGA THERAPY (IE, ALTERNATIVE METHADONE TREATMENT). PATIENTS WERE FOLLOWED FOR 6 MONTHS AND EVALUATED ON A VARIETY OF PSYCHOLOGICAL, SOCIOLOGICAL, AND BIOLOGICAL MEASURES. THE REVISED SYMPTOM CHECK LIST PROVIDED THE PRIMARY PSYCHOLOGICAL MEASURES; THE ADDICTION SEVERITY INDEX PROVIDED VARIOUS INDICES OF ADDICTIVE BEHAVIORS. RESULTS: THE EVIDENCE REVEALED THAT THERE WERE NO MEANINGFUL DIFFERENCES BETWEEN TRADITIONAL PSYCHODYNAMIC GROUP THERAPY AND HATHA YOGA PRESENTED IN A GROUP SETTING. BOTH TREATMENTS CONTRIBUTED TO A TREATMENT REGIMEN THAT SIGNIFICANTLY REDUCED DRUG USE AND CRIMINAL ACTIVITIES. PSYCHOPATHOLOGY AT ADMISSION WAS SIGNIFICANTLY RELATED TO PROGRAM PARTICIPATION REGARDLESS OF TREATMENT GROUP. DISCUSSION: IN ADDITION TO EXAMINING THE CHARACTERISTICS OF PATIENTS WHO PRESENT FOR TREATMENT, THIS STUDY IDENTIFIES UNEXPECTED STAFF ISSUES THAT COMPLICATE THE INTEGRATION OF ALTERNATIVE AND TRADITIONAL TREATMENT STRATEGIES. CONCLUSION: ALTERNATIVE METHADONE TREATMENT IS NOT MORE EFFECTIVE THAN CONVENTIONAL METHADONE TREATMENT, AS ORIGINALLY HYPOTHESIZED. HOWEVER, SOME PATIENTS MAY BENEFIT MORE FROM ALTERNATIVE METHADONE TREATMENT THAN CONVENTIONAL METHADONE TREATMENT. ADDITIONAL RESEARCH IS NECESSARY TO DETERMINE CHARACTERISTICS THAT IDENTIFY PATIENTS WHO MIGHT BENEFIT FROM ALTERNATIVE METHADONE TREATMENT. 1997 20 2472 44 YOGA AS ADJUNCT THERAPY FOR ADOLESCENTS WITH INFLAMMATORY BOWEL DISEASE: A PILOT CLINICAL TRIAL. OBJECTIVES: TO DETERMINE WHETHER UTILIZING YOGA AS AN ADJUNCTIVE THERAPY TO THE MEDICAL STANDARD OF CARE FOR ADOLESCENTS WITH INFLAMMATORY BOWEL DISEASE (IBD) IS: (1) FEASIBLE AND ACCEPTABLE, (2) EFFECTIVE IN REDUCING DISEASE SEVERITY, INTESTINAL INFLAMMATION AND IMPROVING WELLNESS. DESIGN: PROSPECTIVE, NON-RANDOMIZED, 8-WEEK PILOT STUDY FOR ADOLESCENTS WITH A DIAGNOSIS OF IBD. FEASIBILITY AND ACCEPTABILITY OF THE INTERVENTION WERE ASSESSED WEEKLY AND POST-INTERVENTION VIA SURVEYS AND A FOCUS GROUP (WEEK 8). DISEASE SEVERITY, INTESTINAL INFLAMMATION, AND WELLNESS MEASURES WERE ASSESSED AT BASELINE AND POST-INTERVENTION (WEEK 8). INTERVENTION: OVER THE 8-WEEK STUDY PERIOD, PATIENTS WERE ASSIGNED THREE 60-MINUTE, IN-PERSON YOGA CLASSES AT WEEKS 1, 3 AND 8, AND THREE 30-MINUTE, ONLINE YOGA VIDEOS PER WEEK. MAIN OUTCOME MEASURES: PRIMARY OUTCOME MEASURES WERE FEASIBILITY AND ACCEPTABILITY. SECONDARY OUTCOME MEASURES ASSESSED PRELIMINARY CLINICAL EFFICACY BY EXAMINING PRE- AND POST-INTERVENTION CHANGE IN DISEASE SEVERITY (PUCAI), INTESTINAL INFLAMMATION (FECAL CALPROTECTIN), AND SIX WELLNESS MEASURES (PROMIS-37). RESULTS: NINE ADOLESCENTS WITH IBD PARTICIPATED. EIGHT PARTICIPATED IN ONE OR MORE YOGA VIDEOS PER WEEK AND ALL NINE ATTENDED AT LEAST TWO IN-PERSON YOGA CLASSES. FOCUS GROUP THEMES REVEALED THAT THE INTERVENTION WAS WELL LIKED, WITH ALL PARTICIPANTS REPORTING REDUCED STRESS, IMPROVED EMOTIONAL SELF-AWARENESS, AND INCREASED ABILITY TO IDENTIFY AND MANAGE THE PHYSICAL SYMPTOMS OF IBD. PARTICIPANTS HAD DIFFICULTY, HOWEVER, COMPLETING THE YOGA VIDEOS DUE TO TIME LIMITATIONS AND COMPETING PRIORITIES. WE LACKED POWER TO DETECT ANY STATISTICALLY SIGNIFICANT CHANGES IN PUCAI, CALPROTECTIN, OR ANY OF THE SIX PROMIS-37 DOMAINS. CONCLUSIONS: A COMBINATION OF IN-PERSON INSTRUCTOR LED YOGA WITH VIDEO-BASED YOGA IS A FEASIBLE AND ACCEPTABLE ADJUNCT THERAPY FOR ADOLESCENTS WITH IBD. PARTICIPANTS REPORTED REDUCED STRESS AND IMPROVED ABILITY TO IDENTIFY AND MANAGE PHYSICAL SYMPTOMS. A LARGER, RANDOMIZED CONTROLLED TRIAL IS NECESSARY TO DETERMINE IF THE YOGA PROTOCOL RESULTS IN CLINICALLY AND STATISTICALLY SIGNIFICANT IMPROVEMENTS IN INFLAMMATORY BIOMARKERS AND PATIENT REPORTED OUTCOMES. 2018