1 1461 141 INFLUENCE OF YOGA ON MOOD STATES, DISTRESS, QUALITY OF LIFE AND IMMUNE OUTCOMES IN EARLY STAGE BREAST CANCER PATIENTS UNDERGOING SURGERY. CONTEXT: BREAST CANCER PATIENTS AWAITING SURGERY EXPERIENCE HEIGHTENED DISTRESS THAT COULD AFFECT POSTOPERATIVE OUTCOMES. AIMS: THE AIM OF OUR STUDY WAS TO EVALUATE THE EFFECTS OF YOGA INTERVENTION ON MOOD STATES, TREATMENT-RELATED SYMPTOMS, QUALITY OF LIFE AND IMMUNE OUTCOMES IN BREAST CANCER PATIENTS UNDERGOING SURGERY. SETTINGS AND DESIGN: NINETY-EIGHT RECENTLY DIAGNOSED STAGE II AND III BREAST CANCER PATIENTS WERE RECRUITED FOR A RANDOMIZED CONTROLLED TRIAL COMPARING THE EFFECTS OF A YOGA PROGRAM WITH SUPPORTIVE THERAPY PLUS EXERCISE REHABILITATION ON POSTOPERATIVE OUTCOMES FOLLOWING SURGERY. MATERIALS AND METHODS: SUBJECTS WERE ASSESSED PRIOR TO SURGERY AND FOUR WEEKS THEREAFTER. PSYCHOMETRIC INSTRUMENTS WERE USED TO ASSESS SELF-REPORTED ANXIETY, DEPRESSION, TREATMENT-RELATED DISTRESS AND QUALITY OF LIFE. BLOOD SAMPLES WERE COLLECTED FOR ENUMERATION OF T LYMPHOCYTE SUBSETS (CD4 %, CD8 % AND NATURAL KILLER (NK) CELL % COUNTS) AND SERUM IMMUNOGLOBULINS (IGG, IGA AND IGM). STATISTICAL ANALYSIS USED: WE USED ANALYSIS OF COVARIANCE TO COMPARE INTERVENTIONS POSTOPERATIVELY. RESULTS: SIXTY-NINE PATIENTS CONTRIBUTED DATA TO THE CURRENT ANALYSIS (YOGA N = 33, CONTROL N = 36). THE RESULTS SUGGEST A SIGNIFICANT DECREASE IN THE STATE (P = 0.04) AND TRAIT (P = 0.004) OF ANXIETY, DEPRESSION (P = 0.01), SYMPTOM SEVERITY (P = 0.01), DISTRESS (P < 0.01) AND IMPROVEMENT IN QUALITY OF LIFE (P = 0.01) IN THE YOGA GROUP AS COMPARED TO THE CONTROLS. THERE WAS ALSO A SIGNIFICANTLY LESSER DECREASE IN CD 56% (P = 0.02) AND LOWER LEVELS OF SERUM IGA (P = 0.001) IN THE YOGA GROUP AS COMPARED TO CONTROLS FOLLOWING SURGERY. CONCLUSIONS: THE RESULTS SUGGEST POSSIBLE BENEFITS FOR YOGA IN REDUCING POSTOPERATIVE DISTRESS AND PREVENTING IMMUNE SUPPRESSION FOLLOWING SURGERY.	2008	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2 2272  28 THE ROLE OF YOGA IN INFLAMMATORY MARKERS. YOGA IS AN ANCIENT SYSTEM FOR INTEGRATING THE MIND, BODY, AND SPIRIT. IN THE HATHA YOGA ASHTANGA TRADITION (THE EIGHT LIMB PATANJALI YOGA), THREE OF THE LIMBS ARE MEDITATION, BREATHWORK (PRANAYAMA) AND PHYSICAL POSTURES (ASANA), WHICH ARE WIDELY PRACTISED IN YOGA CLASSES. THE BENEFITS OF YOGA FOR MENTAL AND PHYSICAL HEALTH ARE ROOTED IN THE PRACTICE'S ORIGINS: IN YOGA, STRESS IS SAID TO BE THE ROOT OF ALL DISEASES. THE ESTABLISHED FIELDS OF PSYCHONEUROIMMUNOLOGY AND IMMUNOPSYCHIATRY STUDY THE INTERPLAY BETWEEN THE IMMUNE SYSTEM AND MOOD OR MENTAL STATES. THIS MINI-REVIEW HAS SHIFTED THE EMPHASIS FROM RESEARCH THAT FOCUSES ON YOGA'S BENEFITS FOR STRESS, THE MOST COMMONLY STUDIED OUTCOME OF YOGA RESEARCH, TO A SUMMARY OF THE RESEARCH ON THE EFFECTS OF YOGA PRACTICES ON THE IMMUNE SYSTEM. THE CURRENT LITERATURE BEARS STRONG EVIDENCE FOR THE BENEFITS OF YOGA ON THE LEVELS OF CIRCULATING CORTISOL AND CLASSICAL INFLAMMATORY MARKERS, SUCH AS C-REACTIVE PROTEIN (CRP) AND CYTOKINES SUCH AS INTERLEUKIN-1 BETA (IL-1BETA), INTERLEUKIN 6 (IL-6), TUMOUR NECROSIS FACTOR-ALPHA (TNF-ALPHA) AND INTERFERON-GAMMA (INF-GAMMA). THE EVIDENCE FOR OTHER LESS STUDIED MARKERS, TELOMERASE ACTIVITY, BETA-ENDORPHINS, IMMUNOGLOBULIN A (IGA) AND BRAIN-DERIVED NEUROTROPHIC FACTOR (BDNF) IS ALSO GROWING. THIS MINI-REVIEW CENTRES AROUND THE INTERPLAY BETWEEN YOGA AND THESE MARKERS IN STRESS MANAGEMENT AND DEPRESSION, VASCULAR AND IMMUNE FUNCTION IN THE OLDER POPULATION, CARDIOVASCULAR AND METABOLIC DISEASES, AUTO-IMMUNE DISEASES, BREAST CANCER AND PREGNANCY. OVERALL, THE LITERATURE EXAMINED REVEALS THE NOVELTY OF THIS FIELD OF RESEARCH AND SHEDS LIGHT ON METHODOLOGICAL CHALLENGES; HOWEVER, IT UNCOVERS THE POTENTIAL FOR YOGA TO BE USED AS ADJUVANT THERAPY IN CONDITIONS WITH AN INFLAMMATORY COMPONENT.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
3 2217  30 THE IMPACT OF A SHORT-TERM IYENGAR YOGA PROGRAM ON THE HEALTH AND WELL-BEING OF PHYSICALLY INACTIVE OLDER ADULTS. BACKGROUND: WITH THE CURRENT CHALLENGE OF RAPIDLY AGING POPULATIONS, PRACTICES SUCH AS YOGA MAY HELP OLDER ADULTS STAY PHYSICALLY ACTIVE, HEALTHY, AND FULFILLED. METHODS: THE IMPACT OF AN 8-WEEK IYENGAR YOGA PROGRAM ON THE HOLISTIC HEALTH AND WELL-BEING OF PHYSICALLY INACTIVE PEOPLE AGED 55 YEARS AND OVER WAS ASSESSED. THIRTY-EIGHT OLDER ADULTS (MEAN AGE 73.21+/-8.38 YEARS; 19 INTERVENTION, 19 CONTROL) ENGAGED IN EITHER TWICE-WEEKLY YOGA CLASSES OR CONTINUED THEIR USUAL DAILY ROUTINES. PHYSICAL HEALTH MEASURES WERE MUSCLE STRENGTH, ACTIVE RANGE OF MOTION, RESPIRATORY FUNCTION (FEV1), RESTING BLOOD PRESSURE, AND IMMUNE FUNCTION (SALIVARY IGA AND LYSOZYME). SELF-PERCEIVED GENERAL, PHYSICAL, MENTAL, SPIRITUAL, AND SOCIAL HEALTH AND WELL-BEING WERE ASSESSED WITH THE LIFE'S ODYSSEY QUESTIONNAIRE AND THE SF12V2 HEALTH SURVEY. RESULTS: MUSCLE STRENGTH, ACTIVE RANGE OF MOTION, PHYSICAL WELL-BEING, AND ASPECTS OF MENTAL WELL-BEING (EMOTIONAL WELL-BEING AND SELF-CARE) IMPROVED SIGNIFICANTLY IN THE YOGA GROUP (P<.05). MEDIAN CHANGES IN MOST OF THESE VARIABLES WERE ALSO SIGNIFICANTLY DIFFERENT FROM THOSE IN THE CONTROL GROUP. CONCLUSIONS: PARTICIPATION IN IYENGAR YOGA PROGRAMS BY OLDER PEOPLE IS BENEFICIAL FOR HEALTH AND WELL-BEING, AND GREATER AVAILABILITY OF SUCH PROGRAMS COULD IMPROVE QUALITY OF LIFE.	2011	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
4 1462  85 INFLUENCE OF YOGA ON POSTOPERATIVE OUTCOMES AND WOUND HEALING IN EARLY OPERABLE BREAST CANCER PATIENTS UNDERGOING SURGERY. CONTEXT: PRE- AND POSTOPERATIVE DISTRESS IN BREAST CANCER PATIENTS CAN CAUSE COMPLICATIONS AND DELAY RECOVERY FROM SURGERY. OBJECTIVE: THE AIM OF OUR STUDY WAS TO EVALUATE THE EFFECTS OF YOGA INTERVENTION ON POSTOPERATIVE OUTCOMES AND WOUND HEALING IN EARLY OPERABLE BREAST CANCER PATIENTS UNDERGOING SURGERY. METHODS: NINETY-EIGHT RECENTLY DIAGNOSED STAGE II AND III BREAST CANCER PATIENTS WERE RECRUITED IN A RANDOMIZED CONTROLLED TRIAL COMPARING THE EFFECTS OF A YOGA PROGRAM WITH SUPPORTIVE THERAPY AND EXERCISE REHABILITATION ON POSTOPERATIVE OUTCOMES AND WOUND HEALING FOLLOWING SURGERY. SUBJECTS WERE ASSESSED AT THE BASELINE PRIOR TO SURGERY AND FOUR WEEKS LATER. SOCIODEMOGRAPHIC, CLINICAL AND INVESTIGATIVE NOTES WERE ASCERTAINED IN THE BEGINNING OF THE STUDY. BLOOD SAMPLES WERE COLLECTED FOR ESTIMATION OF PLASMA CYTOKINES-SOLUBLE INTERLEUKIN (IL)-2 RECEPTOR (IL-2R), TUMOR NECROSIS FACTOR (TNF)-ALPHA AND INTERFERON (IFN)-GAMMA. POSTOPERATIVE OUTCOMES SUCH AS THE DURATION OF HOSPITAL STAY AND DRAIN RETENTION, TIME OF SUTURE REMOVAL AND POSTOPERATIVE COMPLICATIONS WERE ASCERTAINED. WE USED INDEPENDENT SAMPLES T TEST AND NONPARAMETRIC MANN WHITNEY U TESTS TO COMPARE GROUPS FOR POSTOPERATIVE OUTCOMES AND PLASMA CYTOKINES. REGRESSION ANALYSIS WAS DONE TO DETERMINE PREDICTORS FOR POSTOPERATIVE OUTCOMES. RESULTS: SIXTY-NINE PATIENTS CONTRIBUTED DATA TO THE CURRENT ANALYSIS (YOGA: N = 33, CONTROL: N = 36). THE RESULTS SUGGEST A SIGNIFICANT DECREASE IN THE DURATION OF HOSPITAL STAY (P = 0.003), DAYS OF DRAIN RETENTION (P = 0.001) AND DAYS FOR SUTURE REMOVAL (P = 0.03) IN THE YOGA GROUP AS COMPARED TO THE CONTROLS. THERE WAS ALSO A SIGNIFICANT DECREASE IN PLASMA TNF ALPHA LEVELS FOLLOWING SURGERY IN THE YOGA GROUP (P < 0.001), AS COMPARED TO THE CONTROLS. REGRESSION ANALYSIS ON POSTOPERATIVE OUTCOMES SHOWED THAT THE YOGA INTERVENTION AFFECTED THE DURATION OF DRAIN RETENTION AND HOSPITAL STAY AS WELL AS TNF ALPHA LEVELS. CONCLUSION: THE RESULTS SUGGEST POSSIBLE BENEFITS OF YOGA IN REDUCING POSTOPERATIVE COMPLICATIONS IN BREAST CANCER PATIENTS.	2008	
                                                                                                                                                                                                                                                                                               
5 2836  40 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  962  49 EFFECTS OF A YOGA PROGRAM ON CORTISOL RHYTHM AND MOOD STATES IN EARLY BREAST CANCER PATIENTS UNDERGOING ADJUVANT RADIOTHERAPY: A RANDOMIZED CONTROLLED TRIAL. UNLABELLED: OBJECTIVES. THIS STUDY COMPARES THE EFFECTS OF AN INTEGRATED YOGA PROGRAM WITH BRIEF SUPPORTIVE THERAPY IN BREAST CANCER OUTPATIENTS UNDERGOING ADJUVANT RADIOTHERAPY AT A CANCER CENTER. METHODS: EIGHTY-EIGHT STAGE II AND III BREAST CANCER OUTPATIENTS ARE RANDOMLY ASSIGNED TO RECEIVE YOGA (N = 44) OR BRIEF SUPPORTIVE THERAPY (N = 44) PRIOR TO RADIOTHERAPY TREATMENT. ASSESSMENTS INCLUDE DIURNAL SALIVARY CORTISOL LEVELS 3 DAYS BEFORE AND AFTER RADIOTHERAPY AND SELF-RATINGS OF ANXIETY, DEPRESSION, AND STRESS COLLECTED BEFORE AND AFTER 6 WEEKS OF RADIOTHERAPY. RESULTS: ANALYSIS OF COVARIANCE REVEALS SIGNIFICANT DECREASES IN ANXIETY (P < .001), DEPRESSION (P = .002), PERCEIVED STRESS (P < .001), 6 A.M. SALIVARY CORTISOL (P = .009), AND POOLED MEAN CORTISOL (P = .03) IN THE YOGA GROUP COMPARED WITH CONTROLS. THERE IS A SIGNIFICANT POSITIVE CORRELATION BETWEEN MORNING SALIVARY CORTISOL LEVEL AND ANXIETY AND DEPRESSION. CONCLUSION: YOGA MIGHT HAVE A ROLE IN MANAGING SELF-REPORTED PSYCHOLOGICAL DISTRESS AND MODULATING CIRCADIAN PATTERNS OF STRESS HORMONES IN EARLY BREAST CANCER PATIENTS UNDERGOING ADJUVANT RADIOTHERAPY.	2009	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
7  851  59 EFFECT OF YOGA ON SLEEP QUALITY AND NEUROENDOCRINE IMMUNE RESPONSE IN METASTATIC BREAST CANCER PATIENTS. BACKGROUND: STUDIES HAVE SHOWN THAT DISTRESS AND ACCOMPANYING NEUROENDOCRINE STRESS RESPONSES AS IMPORTANT PREDICTOR OF SURVIVAL IN ADVANCED BREAST CANCER PATIENTS. SOME PSYCHOTHERAPEUTIC INTERVENTION STUDIES HAVE SHOWN HAVE MODULATION OF NEUROENDOCRINE-IMMUNE RESPONSES IN ADVANCED BREAST CANCER PATIENTS. IN THIS STUDY, WE EVALUATE THE EFFECTS OF YOGA ON PERCEIVED STRESS, SLEEP, DIURNAL CORTISOL, AND NATURAL KILLER (NK) CELL COUNTS IN PATIENTS WITH METASTATIC CANCER. METHODS: IN THIS STUDY, 91 PATIENTS WITH METASTATIC BREAST CANCER WHO SATISFIED SELECTION CRITERIA AND CONSENTED TO PARTICIPATE WERE RECRUITED AND RANDOMIZED TO RECEIVE "INTEGRATED YOGA BASED STRESS REDUCTION PROGRAM" (N = 45) OR STANDARD "EDUCATION AND SUPPORTIVE THERAPY SESSIONS" (N = 46) OVER A 3 MONTH PERIOD. PSYCHOMETRIC ASSESSMENTS FOR SLEEP QUALITY WERE DONE BEFORE AND AFTER INTERVENTION. BLOOD DRAWS FOR NK CELL COUNTS WERE COLLECTED BEFORE AND AFTER THE INTERVENTION. SALIVA SAMPLES WERE COLLECTED FOR THREE CONSECUTIVE DAYS BEFORE AND AFTER INTERVENTION. DATA WERE ANALYZED USING THE ANALYSIS OF COVARIANCE ON POSTMEASURES USING RESPECTIVE BASELINE MEASURE AS A COVARIATE. RESULTS: THERE WAS A SIGNIFICANT DECREASE IN SCALES OF SYMPTOM DISTRESS (P < 0.001), SLEEP PARAMETERS (P = 0.02), AND IMPROVEMENT IN QUALITY OF SLEEP (P = 0.001) AND INSOMNIA RATING SCALE SLEEP SCORE (P = 0.001) FOLLOWING INTERVENTION. THERE WAS A DECREASE IN MORNING WAKING CORTISOL IN YOGA GROUP (P = 0.003) ALONE FOLLOWING INTERVENTION. THERE WAS A SIGNIFICANT IMPROVEMENT IN NK CELL PERCENT (P = 0.03) FOLLOWING INTERVENTION IN YOGA GROUP COMPARED TO CONTROL GROUP. CONCLUSION: THE RESULTS SUGGEST MODULATION OF NEUROENDOCRINE RESPONSES AND IMPROVEMENT IN SLEEP IN PATIENTS WITH ADVANCED BREAST CANCER FOLLOWING YOGA INTERVENTION.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
8 1748  41 PILOT RANDOMIZED, CONTROLLED TRIAL OF A DYADIC YOGA PROGRAM FOR GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR FAMILY CAREGIVERS. BACKGROUND: WHILE THE USE OF BEHAVIORAL MEDICINE IN MANAGING GLIOMA PATIENTS' SYMPTOMS IS NOT WELL STUDIED, THE HIGH SYMPTOM BURDEN IN PATIENTS AND THEIR FAMILY CAREGIVERS IS WELL ESTABLISHED. WE CONDUCTED A PILOT RANDOMIZED, CONTROLLED TRIAL TO EXAMINE THE FEASIBILITY AND PRELIMINARY EFFICACY OF A DYADIC YOGA (DY) INTERVENTION AS A SUPPORTIVE CARE STRATEGY. METHODS: GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR CAREGIVERS WERE RANDOMIZED TO A 12-SESSION DY OR WAITLIST CONTROL (WLC) GROUP. PRIOR TO RADIOTHERAPY AND RANDOMIZATION, BOTH GROUPS COMPLETED MEASURES OF CANCER-RELATED SYMPTOMS (MD ANDERSON SYMPTOM INVENTORY-BRAIN TUMOR MODULE), DEPRESSIVE SYMPTOMS (CENTER FOR EPIDEMIOLOGICAL STUDIES-DEPRESSION MEASURE), FATIGUE (BRIEF FATIGUE INVENTORY), AND OVERALL QUALITY OF LIFE (QOL; MEDICAL OUTCOMES STUDY 36-ITEM SHORT-FORM SURVEY). DYADS WERE REASSESSED AT THE LAST DAY OF RADIOTHERAPY. RESULTS: TWENTY PATIENTS (MEAN AGE: 46 YEARS, 50% FEMALE, 80% WHO GRADE IV AND CAREGIVERS (MEAN AGE: 50 YEARS, 70% FEMALE, 50% SPOUSES) PARTICIPATED IN THE TRIAL. A PRIORI FEASIBILITY CRITERIA WERE MET REGARDING CONSENT (70%), ADHERENCE (88%), AND RETENTION (95%) RATES. CONTROLLING FOR RELEVANT COVARIATES, CHANGE SCORE ANALYSES REVEALED CLINICALLY SIGNIFICANT IMPROVEMENTS FOR PATIENTS IN THE DY COMPARED WITH THE WLC GROUP FOR OVERALL CANCER SYMPTOM SEVERITY (D = 0.96) AND SYMPTOM INTERFERENCE (D = 0.74), DEPRESSIVE SYMPTOMS (D = 0.71), AND MENTAL QOL (D = 0.69). CAREGIVERS IN THE DY GROUP REPORTED CLINICALLY SIGNIFICANT IMPROVEMENTS IN DEPRESSIVE SYMPTOMS (D = 1.12), FATIGUE (D = 0.89), AND MENTAL QOL (D = 0.49) RELATIVE TO THOSE IN THE WLC GROUP. CONCLUSION: A DY INTERVENTION APPEARS TO BE A FEASIBLE AND BENEFICIAL SYMPTOM AND QOL MANAGEMENT STRATEGY FOR GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR CAREGIVERS. AN EFFICACY TRIAL WITH A MORE STRINGENT CONTROL GROUP IS WARRANTED. CLINICAL TRIAL NUMBER: NCT02481349.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                          
9 1036  53 EFFECTS OF YOGA IN MANAGING FATIGUE IN BREAST CANCER PATIENTS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CANCER-RELATED FATIGUE IS WIDELY PREVALENT IN CANCER PATIENTS AND AFFECTS QUALITY OF LIFE IN ADVANCED CANCER PATIENTS. FATIGUE IS CAUSED DUE TO BOTH PSYCHOLOGIC DISTRESS AND PHYSIOLOGICAL SEQUEL FOLLOWING CANCER PROGRESSION AND ITS TREATMENT. IN THIS STUDY, WE EVALUATE THE EFFECTS OF YOGIC INTERVENTION IN MANAGING FATIGUE IN METASTATIC BREAST CANCER PATIENTS. METHODS: NINETY-ONE PATIENTS WITH METASTATIC BREAST CANCER WERE RANDOMIZED TO RECEIVE INTEGRATED YOGA PROGRAM (N = 46) OR SUPPORTIVE THERAPY AND EDUCATION (N = 45) OVER A 3-MONTH PERIOD. ASSESSMENTS SUCH AS PERCEIVED STRESS, FATIGUE SYMPTOM INVENTORY, DIURNAL SALIVARY CORTISOL, AND NATURAL KILLER CELL COUNTS WERE CARRIED OUT BEFORE AND AFTER INTERVENTION. ANALYSIS WAS DONE USING AN INTENTION-TO-TREAT APPROACH. POSTMEASURES FOR THE ABOVE OUTCOMES WERE ASSESSED USING ANCOVA WITH RESPECTIVE BASELINE MEASURE AS A COVARIATE. RESULTS: THE RESULTS SUGGEST THAT YOGA REDUCES PERCEIVED STRESS (P = 0.001), FATIGUE FREQUENCY (P < 0.001), FATIGUE SEVERITY (P < 0.001), INTERFERENCE (P < 0.001), AND DIURNAL VARIATION (P < 0.001) WHEN COMPARED TO SUPPORTIVE THERAPY. THERE WAS A POSITIVE CORRELATION OF CHANGE IN FATIGUE SEVERITY WITH 9 A.M. SALIVARY CORTISOL LEVELS. CONCLUSION: THE RESULTS SUGGEST THAT YOGA REDUCES FATIGUE IN ADVANCED BREAST CANCER PATIENTS.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
10 1789  31 PRELIMINARY INDICATIONS OF THE EFFECT OF A BRIEF YOGA INTERVENTION ON MARKERS OF INFLAMMATION AND DNA METHYLATION IN CHRONICALLY STRESSED WOMEN. YOGA IS ASSOCIATED WITH REDUCED STRESS AND INCREASED WELL-BEING, ALTHOUGH THE MOLECULAR BASIS FOR THESE BENEFITS IS NOT CLEAR. MOUNTING EVIDENCE IMPLICATES THE IMMUNE RESPONSE, WITH CURRENT STUDIES FOCUSED ON PROTEIN IMMUNE MARKERS (SUCH AS CYTOKINES) IN CLINICAL POPULATIONS. TO EXPLORE THE MOLECULAR IMPACT, THIS PILOT STUDY USES A SUBSAMPLE (N=28) FROM A RANDOMISED WAITLIST CONTROL TRIAL INVESTIGATING THE IMPACT OF AN 8-WEEK YOGA INTERVENTION IN A COMMUNITY POPULATION OF WOMEN REPORTING PSYCHOLOGICAL DISTRESS (N=116). WE MEASURED INTERLEUKIN-6 (IL-6), TUMOUR NECROSIS FACTOR (TNF) AND C-REACTIVE PROTEIN (CRP) PROTEIN LEVELS, AND THE DNA METHYLATION OF THESE GENES AND THE GLOBAL INDICATOR, LINE-1. CORRELATIONS BETWEEN THESE AND PSYCHOLOGICAL VARIABLES WERE EXPLORED, IDENTIFYING MODERATE CORRELATIONS WITH CRP PROTEIN LEVELS, AND METHYLATION OF IL-6, CRP AND LINE-1. MANY CYTOKINE SAMPLES WERE BELOW DETECTION, HOWEVER A MANN-WHITNEY U DEMONSTRATED A TREND OF MODERATE BETWEEN-GROUP EFFECT FOR ELEVATED IL-6 IN THE YOGA GROUP. METHYLATION ANALYSES APPLIED CROSS-SECTIONAL AND NON-CONTROLLED LONGITUDINAL ANALYSES. WAIST-TO-HEIGHT RATIO AND AGE WERE COVARIED. WE DEMONSTRATED REDUCED METHYLATION OF THE TNF REGION IN THE YOGA GROUP RELATIVE TO THE WAITLIST CONTROL GROUP. NO OTHER GENES DEMONSTRATED A SIGNIFICANT DIFFERENCE. LONGITUDINAL ANALYSIS FURTHER SUPPORTED THESE RESULTS. THIS STUDY IS ONE OF THE FIRST TO EXPLORE YOGA AND IMMUNOLOGICAL MARKERS IN A NON-CLINICAL POPULATION, AND IS THE FIRST STUDY TO EXPLORE DNA METHYLATION. THESE FINDINGS INDICATE THAT FURTHER RESEARCH INTO MOLECULAR IMPACT OF YOGA ON MARKERS OF IMMUNE FUNCTION IS WARRANTED, WITH LARGER STUDIES REQUIRED.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
11  859  31 EFFECT OF YOGA PRACTICE ON LEVELS OF INFLAMMATORY MARKERS AFTER MODERATE AND STRENUOUS EXERCISE. BACKGROUND AND OBJECTIVES: TO EVALUATE THE EFFECT OF YOGA PRACTICE AND EXERCISE CHALLENGE ON TUMOUR NECROSIS FACTOR ALPHA (TNF-ALPHA), INTERLEUKIN-6 (IL-6) LEVELS AND LIPID PROFILE. MATERIALS AND METHODS: TWO HUNDRED AND EIGHTEEN SUBJECTS PARTICIPATED IN THE STUDY. ONE HUNDRED AND NINE VOLUNTEERS (51 MALES AND 58 FEMALES) IN THE AGE GROUP OF 20 TO 60 YEARS, WHO PRACTICED YOGA REGULARLY FOR OVER FIVE YEARS FOR A PERIOD OF ONE HOUR DAILY, PERFORMED A BOUT OF MODERATE EXERCISE AND A BOUT OF STRENUOUS EXERCISE AS PER STANDARDIZED SHUTTLE WALK TEST PROTOCOL. ANTHROPOMETRICALLY MATCHED, AGE MATCHED AND GENDER MATCHED SUBJECTS, WHO DID NOT PRACTICE YOGA (NON-YOGA GROUP) WERE CHOSEN AS CONTROLS (NON-YOGA, N=109). THE NON-YOGA GROUP ALSO PERFORMED SIMILAR EXERCISES. THE BLOOD SAMPLES OF BOTH THE GROUPS WERE COLLECTED BEFORE AND AFTER THE EXERCISES. TNF-ALPHA AND IL-6 WAS ANALYSED BEFORE AND AFTER THE EXERCISE BY SANDWICH ELISA (ENZYME LINKED IMMUNOSORBENT ASSAY). RESULTS: RESTING PLASMA TNF-ALPHA CONCENTRATION WAS SIGNIFICANTLY HIGHER IN NON-YOGA GROUP WHEN COMPARED TO YOGA GROUP (P<0.05). THERE WAS AN INCREASE IN TNF-ALPHA LEVELS IN BOTH THE GROUPS IN RESPONSE TO STRENUOUS EXERCISE. THERE WAS NO GENDER DIFFERENCE IN TNF-ALPHA AND IL-6 LEVELS BEFORE AND AFTER EXERCISE IN YOGA AND NON-YOGA GROUPS. CONCLUSION: REGULAR PRACTICE OF YOGA LOWERS BASAL TNF-ALPHA AND IL-6 LEVELS. IT ALSO REDUCES THE EXTENT OF INCREASE OF TNF-ALPHA AND IL-6 TO A PHYSICAL CHALLENGE OF MODERATE EXERCISE AND STRENUOUS EXERCISE. THERE IS NO SIGNIFICANT GENDER DIFFERENCE IN THE TNF-ALPHA AND IL-6 LEVELS. REGULAR PRACTICE OF YOGA CAN PROTECT THE INDIVIDUAL AGAINST INFLAMMATORY DISEASES BY FAVOURABLY ALTERING PRO-INFLAMMATORY CYTOKINE LEVELS.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
12 2847  27 YOGA, MEDITATION AND MIND-BODY HEALTH: INCREASED BDNF, CORTISOL AWAKENING RESPONSE, AND ALTERED INFLAMMATORY MARKER EXPRESSION AFTER A 3-MONTH YOGA AND MEDITATION RETREAT. THIRTY-EIGHT INDIVIDUALS (MEAN AGE: 34.8 YEARS OLD) PARTICIPATING IN A 3-MONTH YOGA AND MEDITATION RETREAT WERE ASSESSED BEFORE AND AFTER THE INTERVENTION FOR PSYCHOMETRIC MEASURES, BRAIN DERIVED NEUROTROPHIC FACTOR (BDNF), CIRCADIAN SALIVARY CORTISOL LEVELS, AND PRO- AND ANTI-INFLAMMATORY CYTOKINES. PARTICIPATION IN THE RETREAT WAS FOUND TO BE ASSOCIATED WITH DECREASES IN SELF-REPORTED ANXIETY AND DEPRESSION AS WELL AS INCREASES IN MINDFULNESS. AS HYPOTHESIZED, INCREASES IN THE PLASMA LEVELS OF BDNF AND INCREASES IN THE MAGNITUDE OF THE CORTISOL AWAKENING RESPONSE (CAR) WERE ALSO OBSERVED. THE NORMALIZED CHANGE IN BDNF LEVELS WAS INVERSELY CORRELATED WITH BSI-18 ANXIETY SCORES AT BOTH THE PRE-RETREAT (R = 0.40, P < 0.05) AND POST-RETREAT (R = 0.52, P < 0.005) SUCH THAT THOSE WITH GREATER ANXIETY SCORES TENDED TO EXHIBIT SMALLER PRE- TO POST-RETREAT INCREASES IN PLASMA BDNF LEVELS. IN LINE WITH A HYPOTHESIZED DECREASE IN INFLAMMATORY PROCESSES RESULTING FROM THE YOGA AND MEDITATION PRACTICES, WE FOUND THAT THE PLASMA LEVEL OF THE ANTI-INFLAMMATORY CYTOKINE INTERLEUKIN-10 WAS INCREASED AND THE PRO-INFLAMMATORY CYTOKINE INTERLEUKIN-12 WAS REDUCED AFTER THE RETREAT. CONTRARY TO OUR INITIAL HYPOTHESES, PLASMA LEVELS OF OTHER PRO-INFLAMMATORY CYTOKINES, INCLUDING INTERFERON GAMMA (IFN-GAMMA), TUMOR NECROSIS FACTOR (TNF-ALPHA), INTERLEUKIN-1BETA (IL-1BETA), INTERLEUKIN-6 (IL-6), AND INTERLEUKIN-8 (IL-8) WERE INCREASED AFTER THE RETREAT. GIVEN EVIDENCE FROM PREVIOUS STUDIES OF THE POSITIVE EFFECTS OF MEDITATIVE PRACTICES ON MENTAL FITNESS, AUTONOMIC HOMEOSTASIS AND INFLAMMATORY STATUS, WE HYPOTHESIZE THAT THESE FINDINGS ARE RELATED TO THE MEDITATIVE PRACTICES THROUGHOUT THE RETREAT; HOWEVER, SOME OF THE OBSERVED CHANGES MAY ALSO BE RELATED TO OTHER ASPECTS OF THE RETREAT SUCH AS PHYSICAL EXERCISE-RELATED COMPONENTS OF THE YOGA PRACTICE AND DIET. WE HYPOTHESIZE THAT THE PATTERNS OF CHANGE OBSERVED HERE REFLECT MIND-BODY INTEGRATION AND WELL-BEING. THE INCREASED BDNF LEVELS OBSERVED IS A POTENTIAL MEDIATOR BETWEEN MEDITATIVE PRACTICES AND BRAIN HEALTH, THE INCREASED CAR IS LIKELY A REFLECTION OF INCREASED DYNAMIC PHYSIOLOGICAL AROUSAL, AND THE RELATIONSHIP OF THE DUAL ENHANCEMENT OF PRO- AND ANTI-INFLAMMATORY CYTOKINE CHANGES TO HEALTHY IMMUNOLOGIC FUNCTIONING IS DISCUSSED.	2017	

13 1018  38 EFFECTS OF SIX MONTHS OF YOGA ON INFLAMMATORY SERUM MARKERS PROGNOSTIC OF RECURRENCE RISK IN BREAST CANCER SURVIVORS. YOGA-BASED EXERCISE HAS PROVEN TO BE BENEFICIAL FOR PRACTITIONERS, INCLUDING CANCER SURVIVORS. THIS STUDY REPORTS ON THE EFFECT ON INFLAMMATORY BIOLOGICAL MARKERS FOR 20 BREAST CANCER SURVIVORS WHO PARTICIPATED IN A SIX-MONTH YOGA-BASED (YE) EXERCISE PROGRAM. RESULTS ARE COMPARED TO A COMPREHENSIVE EXERCISE (CE) PROGRAM GROUP AND A COMPARISON (C) EXERCISE GROUP WHO CHOSE THEIR OWN EXERCISES. "PRE" AND "POST" ASSESSMENTS INCLUDED MEASURES OF ANTHROPOMETRICS, CARDIORESPIRATORY CAPACITY, AND INFLAMMATORY MARKERS INTERLEUKIN 6 (IL-6), INTERLEUKIN 8 (IL-8), TUMOR NECROSIS FACTOR ALPHA (TNFALPHA) AND C-REACTIVE PROTEIN (CRP). DESCRIPTIVE STATISTICS, EFFECT SIZE (D), AND DEPENDENT SAMPLE 'T' TESTS FOR ALL OUTCOME MEASURES WERE CALCULATED FOR THE YE GROUP. SIGNIFICANT IMPROVEMENTS WERE SEEN IN DECREASED % BODY FAT, (-3.00%, D = -0.44, P = <.001) BUT NOT IN CARDIORESPIRATORY CAPACITY OR IN INFLAMMATORY SERUM MARKERS. TO COMPARE YE OUTCOMES WITH THE OTHER TWO GROUPS, A ONE-WAY ANALYSIS OF CO-VARIANCE (ANCOVA) WAS USED, CONTROLLING FOR AGE, BMI, CARDIORESPIRATORY CAPACITY AND SERUM MARKER BASELINE VALUES. WE FOUND NO DIFFERENCES BETWEEN GROUPS. MOREOVER, WE DID NOT SEE SIGNIFICANT CHANGES IN ANY INFLAMMATORY MARKER FOR ANY GROUP. OUR RESULTS SUPPORT THE EFFECTIVENESS OF YOGA-BASED EXERCISE MODIFIED FOR BREAST CANCER SURVIVORS FOR IMPROVING BODY COMPOSITION. LARGER STUDIES ARE NEEDED TO DETERMINE IF THERE ARE SIGNIFICANT CHANGES IN INFLAMMATORY SERUM MARKERS AS A RESULT OF SPECIFIC EXERCISE MODALITIES.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
14 1087  54 EFFECTS OF YOGA ON SYMPTOM MANAGEMENT IN BREAST CANCER PATIENTS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: THIS STUDY COMPARES THE EFFECTS OF AN INTEGRATED YOGA PROGRAM WITH BRIEF SUPPORTIVE THERAPY ON DISTRESSFUL SYMPTOMS IN BREAST CANCER OUTPATIENTS UNDERGOING ADJUVANT RADIOTHERAPY. MATERIALS AND METHODS: EIGHTY-EIGHT STAGE II AND III BREAST CANCER OUTPATIENTS WERE RANDOMLY ASSIGNED TO RECEIVE YOGA (N = 44) OR BRIEF SUPPORTIVE THERAPY (N = 44) PRIOR TO THEIR RADIOTHERAPY TREATMENT. INTERVENTION CONSISTED OF YOGA SESSIONS LASTING 60 MIN DAILY WHILE THE CONTROL GROUP WAS IMPARTED SUPPORTIVE THERAPY ONCE IN 10 DAYS DURING THE COURSE OF THEIR ADJUVANT RADIOTHERAPY. ASSESSMENTS INCLUDED ROTTERDAM SYMPTOM CHECK LIST AND EUROPEAN ORGANIZATION FOR RESEARCH IN THE TREATMENT OF CANCER-QUALITY OF LIFE (EORTC QOL C30) SYMPTOM SCALE. ASSESSMENTS WERE DONE AT BASELINE AND AFTER 6 WEEKS OF RADIOTHERAPY TREATMENT. RESULTS: A GLM REPEATED-MEASURES ANOVA SHOWED A SIGNIFICANT DECREASE IN PSYCHOLOGICAL DISTRESS (P = 0.01), FATIGUE (P = 0.007), INSOMNIA (P = 0.001), AND APPETITE LOSS (P = 0.002) OVER TIME IN THE YOGA GROUP AS COMPARED TO CONTROLS. THERE WAS SIGNIFICANT IMPROVEMENT IN THE ACTIVITY LEVEL (P = 0.02) IN THE YOGA GROUP AS COMPARED TO CONTROLS. THERE WAS A SIGNIFICANT POSITIVE CORRELATION BETWEEN PHYSICAL AND PSYCHOLOGICAL DISTRESS AND FATIGUE, NAUSEA AND VOMITING, PAIN, DYSPNEA, INSOMNIA, APPETITE LOSS, AND CONSTIPATION. THERE WAS A SIGNIFICANT NEGATIVE CORRELATION BETWEEN THE ACTIVITY LEVEL AND FATIGUE, NAUSEA AND VOMITING, PAIN, DYSPNEA, INSOMNIA, AND APPETITE LOSS. CONCLUSION: THE RESULTS SUGGEST BENEFICIAL EFFECTS WITH YOGA INTERVENTION IN MANAGING CANCER-AND TREATMENT-RELATED SYMPTOMS IN BREAST CANCER PATIENTS.	2009	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
15  329  57 ANXIOLYTIC EFFECTS OF A YOGA PROGRAM IN EARLY BREAST CANCER PATIENTS UNDERGOING CONVENTIONAL TREATMENT: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: THIS STUDY COMPARES THE ANXIOLYTIC EFFECTS OF A YOGA PROGRAM AND SUPPORTIVE THERAPY IN BREAST CANCER OUTPATIENTS UNDERGOING CONVENTIONAL TREATMENT AT A CANCER CENTRE. METHODS: NINETY-EIGHT STAGE II AND III BREAST CANCER OUTPATIENTS WERE RANDOMLY ASSIGNED TO RECEIVE YOGA (N=45) OR BRIEF SUPPORTIVE THERAPY (N=53) PRIOR TO THEIR PRIMARY TREATMENT I.E., SURGERY. ONLY THOSE SUBJECTS WHO RECEIVED SURGERY FOLLOWED BY ADJUVANT RADIOTHERAPY AND SIX CYCLES OF CHEMOTHERAPY WERE CHOSEN FOR ANALYSIS FOLLOWING INTERVENTION (YOGA, N=18, CONTROL, N=20). INTERVENTION CONSISTED OF YOGA SESSIONS LASTING 60MIN DAILY WHILE THE CONTROL GROUP WAS IMPARTED SUPPORTIVE THERAPY DURING THEIR HOSPITAL VISITS AS A PART OF ROUTINE CARE. ASSESSMENTS INCLUDED SPEILBERGER'S STATE TRAIT ANXIETY INVENTORY AND SYMPTOM CHECKLIST. ASSESSMENTS WERE DONE AT BASELINE, AFTER SURGERY, BEFORE, DURING, AND AFTER RADIOTHERAPY AND CHEMOTHERAPY. RESULTS: A GLM-REPEATED MEASURES ANOVA SHOWED OVERALL DECREASE IN BOTH SELF-REPORTED STATE ANXIETY (P<0.001) AND TRAIT ANXIETY (P=0.005) IN YOGA GROUP AS COMPARED TO CONTROLS. THERE WAS A POSITIVE CORRELATION BETWEEN ANXIETY STATES AND TRAITS WITH SYMPTOM SEVERITY AND DISTRESS DURING CONVENTIONAL TREATMENT INTERVALS. CONCLUSION: THE RESULTS SUGGEST THAT YOGA CAN BE USED FOR MANAGING TREATMENT-RELATED SYMPTOMS AND ANXIETY IN BREAST CANCER OUTPATIENTS.	2009	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
16  974  68 EFFECTS OF AN INTEGRATED YOGA PROGRAM ON SELF-REPORTED DEPRESSION SCORES IN BREAST CANCER PATIENTS UNDERGOING CONVENTIONAL TREATMENT: A RANDOMIZED CONTROLLED TRIAL. AIM: TO COMPARE THE EFFECTS OF YOGA PROGRAM WITH SUPPORTIVE THERAPY ON SELF-REPORTED SYMPTOMS OF DEPRESSION IN BREAST CANCER PATIENTS UNDERGOING CONVENTIONAL TREATMENT. PATIENTS AND METHODS: NINETY-EIGHT BREAST CANCER PATIENTS WITH STAGE II AND III DISEASE FROM A CANCER CENTER WERE RANDOMLY ASSIGNED TO RECEIVE YOGA (N = 45) AND SUPPORTIVE THERAPY (N = 53) OVER A 24-WEEK PERIOD DURING WHICH THEY UNDERWENT SURGERY FOLLOWED BY ADJUVANT RADIOTHERAPY (RT) OR CHEMOTHERAPY (CT) OR BOTH. THE STUDY STOPPAGE CRITERIA WAS PROGRESSIVE DISEASE RENDERING THE PATIENT BEDRIDDEN OR ANY PHYSICAL MUSCULOSKELETAL INJURY RESULTING FROM INTERVENTION OR LESS THAN 60% ATTENDANCE TO YOGA INTERVENTION. SUBJECTS UNDERWENT YOGA INTERVENTION FOR 60 MIN DAILY WITH CONTROL GROUP UNDERGOING SUPPORTIVE THERAPY DURING THEIR HOSPITAL VISITS. BECK'S DEPRESSION INVENTORY (BDI) AND SYMPTOM CHECKLIST WERE ASSESSED AT BASELINE, AFTER SURGERY, BEFORE, DURING, AND AFTER RT AND SIX CYCLES OF CT. WE USED ANALYSIS OF COVARIANCE (INTENT-TO-TREAT) TO STUDY THE EFFECTS OF INTERVENTION ON DEPRESSION SCORES AND PEARSON CORRELATION ANALYSES TO EVALUATE THE BIVARIATE RELATIONSHIPS. RESULTS: A TOTAL OF 69 PARTICIPANTS CONTRIBUTED DATA TO THE CURRENT ANALYSIS (YOGA, N = 33, AND CONTROLS, N = 36). THERE WAS 29% ATTRITION IN THIS STUDY. THE RESULTS SUGGEST AN OVERALL DECREASE IN SELF-REPORTED DEPRESSION WITH TIME IN BOTH THE GROUPS. THERE WAS A SIGNIFICANT DECREASE IN DEPRESSION SCORES IN THE YOGA GROUP AS COMPARED TO CONTROLS FOLLOWING SURGERY, RT, AND CT (P < 0.01). THERE WAS A POSITIVE CORRELATION (P < 0.001) BETWEEN DEPRESSION SCORES WITH SYMPTOM SEVERITY AND DISTRESS DURING SURGERY, RT, AND CT. CONCLUSION: THE RESULTS SUGGEST POSSIBLE ANTIDEPRESSANT EFFECTS WITH YOGA INTERVENTION IN BREAST CANCER PATIENTS UNDERGOING CONVENTIONAL TREATMENT.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
17 1149  34 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	
                                                                                                                                                                                                                                           
18 2132  37 THE EFFECTS OF A GENTLE YOGA PROGRAM ON SLEEP, MOOD, AND BLOOD PRESSURE IN OLDER WOMEN WITH RESTLESS LEGS SYNDROME (RLS): A PRELIMINARY RANDOMIZED CONTROLLED TRIAL. OBJECTIVE. TO EXAMINE THE EFFECTS OF YOGA VERSUS AN EDUCATIONAL FILM PROGRAM ON SLEEP, MOOD, PERCEIVED STRESS, AND SYMPATHETIC ACTIVATION IN OLDER WOMEN WITH RLS. METHODS. PARTICIPANTS WERE DRAWN FROM A LARGER TRIAL REGARDING THE EFFECTS OF YOGA ON CARDIOVASCULAR DISEASE RISK PROFILES IN OVERWEIGHT, SEDENTARY POSTMENOPAUSAL WOMEN. SEVENTY-FIVE WOMEN WERE RANDOMIZED TO RECEIVE EITHER AN 8-WEEK YOGA (N = 38) OR EDUCATIONAL FILM (N = 37) PROGRAM. ALL 75 PARTICIPANTS COMPLETED AN RLS SCREENING QUESTIONNAIRE. THE 20 WOMEN WHO MET ALL FOUR DIAGNOSTIC CRITERIA FOR RLS (N = 10 YOGA, 10 FILM GROUP) COMPRISED THE POPULATION FOR THIS NESTED STUDY. MAIN OUTCOMES ASSESSED PRE- AND POST-TREATMENT INCLUDED: SLEEP (PITTSBURGH SLEEP QUALITY INDEX), STRESS (PERCEIVED STRESS SCALE), MOOD (PROFILE OF MOOD STATES, STATE-TRAIT ANXIETY INVENTORY), BLOOD PRESSURE, AND HEART RATE. RESULTS. THE YOGA GROUP DEMONSTRATED SIGNIFICANTLY GREATER IMPROVEMENTS THAN CONTROLS IN MULTIPLE DOMAINS OF SLEEP QUALITY AND MOOD, AND SIGNIFICANTLY GREATER REDUCTIONS IN INSOMNIA PREVALENCE, ANXIETY, PERCEIVED STRESS, AND BLOOD PRESSURE (ALL P'S</=0.05). ADJUSTED INTERGROUP EFFECT SIZES FOR PSYCHOSOCIAL VARIABLES WERE LARGE, RANGING FROM 1.9 FOR STATE ANXIETY TO 2.6 FOR SLEEP QUALITY. CONCLUSIONS. THESE PRELIMINARY FINDINGS SUGGEST YOGA MAY OFFER AN EFFECTIVE INTERVENTION FOR IMPROVING SLEEP, MOOD, PERCEIVED STRESS, AND BLOOD PRESSURE IN OLDER WOMEN WITH RLS.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
19 2768  41 YOGA REDUCES INFLAMMATORY SIGNALING IN FATIGUED BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: YOGA IS A POPULAR MIND-BODY THERAPY THAT HAS DEMONSTRATED BENEFICIAL EFFECTS ON PSYCHOLOGICAL, BEHAVIORAL, AND FUNCTIONAL OUTCOMES. HOWEVER, FEW STUDIES HAVE INVESTIGATED EFFECTS ON INFLAMMATORY PROCESSES. THIS STUDY TESTED THE HYPOTHESIS THAT AN IYENGAR YOGA INTERVENTION SPECIFICALLY DESIGNED FOR FATIGUED BREAST CANCER SURVIVORS WOULD LEAD TO DECREASES IN INFLAMMATION-RELATED GENE EXPRESSION AND CIRCULATING MARKERS OF PROINFLAMMATORY CYTOKINE ACTIVITY. METHODS: BREAST CANCER SURVIVORS WITH PERSISTENT CANCER-RELATED FATIGUE WERE RANDOMIZED TO A 12-WEEK IYENGAR YOGA INTERVENTION (N=16) OR A 12-WEEK HEALTH EDUCATION CONTROL CONDITION (N=15). BLOOD SAMPLES WERE COLLECTED AT BASELINE, POST-INTERVENTION, AND AT A 3-MONTH FOLLOW-UP FOR GENOME-WIDE TRANSCRIPTIONAL PROFILING AND BIOINFORMATIC ANALYSES. PLASMA INFLAMMATORY MARKERS AND SALIVARY CORTISOL WERE ALSO ASSESSED. RESULTS: IN PROMOTER-BASED BIOINFORMATICS ANALYSES, THE YOGA GROUP SHOWED REDUCED ACTIVITY OF THE PRO-INFLAMMATORY TRANSCRIPTION FACTOR NUCLEAR FACTOR KAPPA B (NF-KAPPAB), INCREASED ACTIVITY OF THE ANTI-INFLAMMATORY GLUCOCORTICOID RECEPTOR, AND REDUCED ACTIVITY OF CAMP RESPONSE ELEMENT-BINDING PROTEIN (CREB) FAMILY TRANSCRIPTION FACTORS RELATIVE TO CONTROLS (ALL PS<.05). THERE WAS ALSO A SIGNIFICANT INTERVENTION EFFECT ON THE SOLUBLE TUMOR NECROSIS FACTOR RECEPTOR TYPE II (STNF-RII), A MARKER OF TNF ACTIVITY; PLASMA LEVELS OF STNF-RII REMAINED STABLE IN THE YOGA GROUP, WHEREAS LEVELS OF THIS MARKER INCREASED IN THE HEALTH EDUCATION GROUP (P=.028). A SIMILAR, NON-SIGNIFICANT TREND WAS OBSERVED FOR THE INTERLEUKIN 1 RECEPTOR ANTAGONIST (P=.16). NO SIGNIFICANT CHANGES IN C REACTIVE PROTEIN (CRP), INTERLEUKIN 6 (IL-6), OR DIURNAL CORTISOL MEASURES WERE OBSERVED. CONCLUSIONS: A 12-WEEK RESTORATIVE IYENGAR YOGA INTERVENTION REDUCED INFLAMMATION-RELATED GENE EXPRESSION IN BREAST CANCER SURVIVORS WITH PERSISTENT FATIGUE. THESE FINDINGS SUGGEST THAT A TARGETED YOGA PROGRAM MAY HAVE BENEFICIAL EFFECTS ON INFLAMMATORY ACTIVITY IN THIS PATIENT POPULATION, WITH POTENTIAL RELEVANCE FOR BEHAVIORAL AND PHYSICAL HEALTH.	2014	
                                                                                                                                                                                                                                                                       
20  199  35 A RESEARCH PROTOCOL FOR A PILOT, RANDOMIZED CONTROLLED TRIAL DESIGNED TO EXAMINE THE FEASIBILITY OF A DYADIC VERSUS INDIVIDUAL YOGA PROGRAM FOR FAMILY CAREGIVERS OF GLIOMA PATIENTS UNDERGOING RADIOTHERAPY. BACKGROUND: ALTHOUGH THE DIAGNOSIS AND TREATMENT OF A PRIMARY BRAIN TUMOR PRESENT UNIQUE CHALLENGES TO PATIENTS AND THEIR FAMILY CAREGIVERS, EVIDENCE-BASED SUPPORTIVE CARE INTERVENTIONS ARE GENERALLY LACKING. THE PRIMARY AIM OF THIS RESEARCH PROTOCOL IS TO DETERMINE THE FEASIBILITY OF IMPLEMENTING A DYADIC YOGA (DY) VERSUS A CAREGIVER YOGA (CY) INTERVENTION OR A WAIT-LIST CONTROL (WLC) GROUP USING A RANDOMIZED CONTROLLED TRIAL DESIGN. METHODS: SEVENTY-FIVE GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR FAMILY CAREGIVERS ARE RANDOMIZED TO THE DY, CY, OR A WLC GROUP. PATIENT-CAREGIVER DYADS IN THE DY GROUP AND CAREGIVERS IN THE CY GROUP RECEIVE 15 SESSIONS (45 MIN EACH) OVER THE COURSE OF PATIENTS' STANDARD RADIOTHERAPY (6 WEEKS). PATIENTS AND CAREGIVERS IN ALL GROUPS COMPLETE BASELINE ASSESSMENTS OF SYMPTOMS, QUALITY OF LIFE (QOL), AND HEALTH UTILIZATION OUTCOMES PRIOR TO RANDOMIZATION. FOLLOW-UP ASSESSMENTS ARE PERFORMED 6 WEEKS AND THEN AGAIN 3 MONTHS LATER. THE PRIMARY OUTCOME IS FEASIBILITY (I.E., >/= 50% OF ELIGIBLE DYADS CONSENT, >/= 70% OF ENROLLED DYADS COMPLETE ALL ASSESSMENTS, AND >/= 50% OF ALL PRACTICE SESSIONS ARE ATTENDED). WE WILL ALSO PERFORM PRIMARILY DESCRIPTIVE ANALYSES OF THE SELF-REPORTED OUTCOMES (E.G., FATIGUE, OVERALL QOL) AND EXPLORE POTENTIAL INTERVENTION MODERATORS (E.G., PERFORMANCE STATUS) TO INFORM A LARGER FUTURE TRIAL. CONCLUSION: THIS TRIAL WILL PROVIDE IMPORTANT INFORMATION REGARDING THE FEASIBILITY OF A DYADIC VERSUS A CAREGIVER YOGA INTERVENTION REGARDING SYMPTOM, QOL, AND HEALTH UTILIZATION OUTCOMES IN GLIOMA PATIENTS AND THEIR CAREGIVERS. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT02481349.	2019