1 2093 126 THE EFFECT OF YOCAS(C)(R) YOGA FOR MUSCULOSKELETAL SYMPTOMS AMONG BREAST CANCER SURVIVORS ON HORMONAL THERAPY. UP TO 50% OF BREAST CANCER SURVIVORS ON AROMATASE INHIBITOR THERAPY REPORT MUSCULOSKELETAL SYMPTOMS SUCH AS JOINT AND MUSCLE PAIN, SIGNIFICANTLY IMPACTING TREATMENT ADHERENCE AND DISCONTINUATION RATES. WE CONDUCTED A SECONDARY DATA ANALYSIS OF A NATIONWIDE, MULTI-SITE, PHASE II/III RANDOMIZED, CONTROLLED, CLINICAL TRIAL EXAMINING THE EFFICACY OF YOGA FOR IMPROVING MUSCULOSKELETAL SYMPTOMS AMONG BREAST CANCER SURVIVORS CURRENTLY RECEIVING HORMONE THERAPY (AROMATASE INHIBITORS [AI] OR TAMOXIFEN [TAM]). BREAST CANCER SURVIVORS CURRENTLY RECEIVING AI (N = 95) OR TAM (N = 72) WITH NO PARTICIPATION IN YOGA DURING THE PREVIOUS 3 MONTHS WERE RANDOMIZED INTO 2 ARMS: (1) STANDARD CARE MONITORING AND (2) STANDARD CARE PLUS THE 4-WEEK YOGA INTERVENTION (2X/WEEK; 75 MIN/SESSION) AND INCLUDED IN THIS ANALYSIS. THE YOGA INTERVENTION UTILIZED THE UR YOGA FOR CANCER SURVIVORS (YOCAS(C)((R))) PROGRAM CONSISTING OF BREATHING EXERCISES, 18 GENTLE HATHA AND RESTORATIVE YOGA POSTURES, AND MEDITATION. MUSCULOSKELETAL SYMPTOMS WERE ASSESSED PRE- AND POST-INTERVENTION. AT BASELINE, AI USERS REPORTED HIGHER LEVELS OF GENERAL PAIN, MUSCLE ACHES, AND TOTAL PHYSICAL DISCOMFORT THAN TAM USERS (ALL P /= 12 WEEKS AND A SELF-REPORTED AVERAGE PAIN INTENSITY OF >/= 4 ON A 0-10 SCALE. RECRUITMENT TAKES PLACE AT BOSTON MEDICAL CENTER, AN URBAN ACADEMIC SAFETY-NET HOSPITAL AND SEVEN FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS LOCATED IN DIVERSE NEIGHBORHOODS. THE 52-WEEK STUDY HAS AN INITIAL 12-WEEK TREATMENT PHASE WHERE PARTICIPANTS ARE RANDOMIZED IN A 2:2:1 RATIO INTO I) A STANDARDIZED WEEKLY HATHA YOGA CLASS SUPPLEMENTED BY HOME PRACTICE; II) A STANDARDIZED EVIDENCE-BASED EXERCISE THERAPY PROTOCOL ADAPTED FROM THE TREATMENT BASED CLASSIFICATION METHOD, INDIVIDUALLY DELIVERED BY A PHYSICAL THERAPIST AND SUPPLEMENTED BY HOME PRACTICE; AND III) EDUCATION DELIVERED THROUGH A SELF-CARE BOOK. CO-PRIMARY OUTCOME MEASURES ARE 12-WEEK PAIN INTENSITY MEASURED ON AN 11-POINT NUMERICAL RATING SCALE AND BACK-SPECIFIC FUNCTION MEASURED USING THE MODIFIED ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 40-WEEK MAINTENANCE PHASE, YOGA PARTICIPANTS ARE RE-RANDOMIZED IN A 1:1 RATIO TO EITHER STRUCTURED MAINTENANCE YOGA CLASSES OR HOME PRACTICE ONLY. PHYSICAL THERAPY PARTICIPANTS ARE SIMILARLY RE-RANDOMIZED TO EITHER FIVE BOOSTER SESSIONS OR HOME PRACTICE ONLY. EDUCATION PARTICIPANTS CONTINUE TO FOLLOW RECOMMENDATIONS OF EDUCATIONAL MATERIALS. WE WILL ALSO ASSESS COST EFFECTIVENESS FROM THE PERSPECTIVES OF THE INDIVIDUAL, INSURERS, AND SOCIETY USING CLAIMS DATABASES, ELECTRONIC MEDICAL RECORDS, SELF-REPORT COST DATA, AND STUDY RECORDS. QUALITATIVE DATA FROM INTERVIEWS WILL ADD SUBJECTIVE DETAIL TO COMPLEMENT QUANTITATIVE DATA. TRIAL REGISTRATION: THIS TRIAL IS REGISTERED IN CLINICALTRIALS.GOV, WITH THE ID NUMBER: NCT01343927. 2014 3 2575 31 YOGA FOR FUNCTIONAL ABILITY, PAIN AND PSYCHOSOCIAL OUTCOMES IN MUSCULOSKELETAL CONDITIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVES: MUSCULOSKELETAL CONDITIONS (MSCS) ARE THE LEADING CAUSE OF DISABILITY AND CHRONIC PAIN IN THE DEVELOPED WORLD, IMPACTING BOTH FUNCTIONAL ABILITY AND PSYCHOSOCIAL HEALTH. THE CURRENT REVIEW INVESTIGATES THE EFFECTIVENESS OF YOGA ON PRIMARY OUTCOMES OF FUNCTIONAL ABILITY, PAIN AND PSYCHOSOCIAL OUTCOMES ACROSS A RANGE OF MSCS. METHODS: A COMPREHENSIVE SEARCH OF 20 DATABASES WAS CONDUCTED FOR FULL-TEXT, RANDOMIZED CONTROLLED TRIALS OF YOGA IN CLINICALLY DIAGNOSED MSCS. RESULT: SEVENTEEN STUDIES MET THE INCLUSION CRITERIA, INVOLVING 1,626 PARTICIPANTS WITH LOW BACK PAIN (LBP), OSTEOARTHRITIS (OA), RHEUMATOID ARTHRITIS (RA), KYPHOSIS OR FIBROMYALGIA. STUDIES WERE QUALITY RATED, AND ANALYSED FOR THE EFFECT OF YOGA ON PRIMARY OUTCOMES, IMMEDIATELY POST-INTERVENTION. TWELVE STUDIES WERE RATED AS GOOD QUALITY. YOGA INTERVENTIONS RESULTED IN A CLINICALLY SIGNIFICANT IMPROVEMENT IN FUNCTIONAL OUTCOMES IN MILD-TO-MODERATE LBP AND FIBROMYALGIA, AND SHOWED A TREND TO IMPROVEMENT IN KYPHOSIS. YOGA SIGNIFICANTLY IMPROVED PAIN IN OA, RA AND MILD-TO-SEVERE LBP. PSYCHOSOCIAL OUTCOMES WERE SIGNIFICANTLY IMPROVED IN MILD-TO-MODERATE LBP AND OA. META-ANALYSIS OF GOOD-QUALITY STUDIES SHOWED A MODERATE TREATMENT EFFECT FOR YOGA OF -0.64 (95%CI -0.89 TO -0.39) FOR FUNCTIONAL OUTCOMES AND -0.61 (95%CI -0.97 TO -0.26) FOR PAIN OUTCOMES. CONCLUSIONS: EVIDENCE SUGGESTS THAT YOGA IS AN ACCEPTABLE AND SAFE INTERVENTION, WHICH MAY RESULT IN CLINICALLY RELEVANT IMPROVEMENTS IN PAIN AND FUNCTIONAL OUTCOMES ASSOCIATED WITH A RANGE OF MSCS. FUTURE ANALYSIS OF OUTCOMES WHICH TAKE INTO ACCOUNT THE AMOUNT OF YOGA RECEIVED BY PARTICIPANTS MAY PROVIDE INSIGHT INTO ANY PUTATIVE DURATION OR DOSAGE EFFECTS OF YOGA INTERVENTIONS FOR MSCS. 2013 4 1584 29 MEDICAL THERAPEUTIC YOGA FOR MULTIPLE SCLEROSIS: EXAMINING SELF-EFFICACY FOR PHYSICAL ACTIVITY, MOTIVATION FOR PHYSICAL ACTIVITY, AND QUALITY OF LIFE OUTCOMES. PURPOSE: MULTIPLE SCLEROSIS (MS) IS AN INCURABLE NEURODEGENERATIVE DISEASE THAT RESULTS IN DEFICITS IN PHYSICAL AND COGNITIVE FUNCTION, AND OFTEN FOSTERS LOW LEVELS OF SELF-EFFICACY FOR PHYSICAL ACTIVITY, MOTIVATION FOR PHYSICAL ACTIVITY, AND QUALITY OF LIFE [1]. DRUG THERAPIES, PHYSICAL THERAPY REHABILITATION, AND LIFESTYLE MODIFICATIONS SUCH AS INCREASED PHYSICAL ACTIVITY ARE STANDARD PROTOCOL FOR SYMPTOM MANAGEMENT, YET PERSONS WITH MS TEND TO BE PHYSICALLY INACTIVE [2,3]. ADDITIONALLY, SINGLE-MODALITY INTERVENTIONS DO NOT INHERENTLY ADDRESS THE CHALLENGES FACED CONCURRENTLY BY INDIVIDUALS WITH MS [4,5]. METHODS: THIS PROJECT EXAMINED THE EFFECTS OF A 5-WEEK HOLISTIC BIOPSYCHOSOCIAL MEDICAL THERAPEUTIC YOGA PROGRAM ON PHYSICAL ACTIVITY BEHAVIOR OUTCOMES IN INDIVIDUALS DIAGNOSED WITH MS. A MIXED-METHODS APPROACH WAS USED TO EXAMINE SELF-EFFICACY FOR PHYSICAL ACTIVITY, MOTIVATION FOR PHYSICAL ACTIVITY, AND QUALITY OF LIFE OUTCOMES IN 15 PARTICIPANTS. RESULTS: QUANTITATIVE MEASURES DEMONSTRATED INCREASED SELF-EFFICACY (T(14) = -2.23, P = 0.042), AND EMOTIONAL QUALITY OF LIFE (T(14) = -2.66, P = 0.019). RESPONSES TO AN OPEN-ENDED WRITTEN QUESTIONNAIRE AND FOLLOW-UP INTERVIEWS INDICATED OVERALL POSITIVE RESPONSE TO THE PROGRAM INCLUDING INCREASES IN SELF-EFFICACY FOR PHYSICAL ACTIVITY, MOTIVATION FOR PHYSICAL ACTIVITY, AND QUALITY OF LIFE. THESE RESULTS MAY HELP FUTURE HOLISTIC PROGRAMMING FOR INDIVIDUALS WITH MS INCORPORATE BEHAVIORAL INTERVENTIONS WITH THERAPEUTIC REHABILITATION TO INCREASE PHYSICAL ACTIVITY ADHERENCE.IMPLICATIONS FOR REHABILITATIONMULTIPLE SCLEROSIS IS A NEUROLOGICAL DISEASE IMPACTING PHYSICAL AND COGNITIVE FUNCTIONING THAT MAY BE MANAGED WITH A COMBINATION OF DRUG THERAPIES, REHABILITATION, AND PHYSICAL ACTIVITY.INDIVIDUALS DIAGNOSED WITH MULTIPLE SCLEROSIS TEND TO BE PHYSICALLY INACTIVE AND PHYSICAL INACTIVITY IS A CHALLENGE FOR OPTIMAL DISEASE MANAGEMENT.MEDICAL THERAPEUTIC YOGA OFFERS AN INTERDISCIPLINARY BIOPSYCHOSOCIAL FRAMEWORK TO SIMULTANEOUSLY ADDRESS THE BEHAVIORAL CHALLENGES AND PHYSICAL IMPAIRMENTS FACING INDIVIDUALS DIAGNOSED WITH MULTIPLE SCLEROSIS.HEALTH CARE PROVIDERS SHOULD CONSIDER DEVELOPING PROGRAMS THAT USE A BIOPSYCHOSOCIAL FRAMEWORK TO AID IN DEVELOPING LONG-TERM ADHERENCE IN HEALTH BEHAVIORS SUCH AS PHYSICAL ACTIVITY PARTICIPATION. 2022 5 1784 42 PREDICTORS OF PREFERENCE FOR COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA INTERVENTIONS AMONG OLDER ADULTS. THE PURPOSE OF THIS STUDY WAS TO EXAMINE FACTORS THAT INFLUENCE A PERSON'S CHOICE OF COGNITIVE-BEHAVIORAL THERAPY (CBT) OR YOGA, THE STABILITY OF THESE PREFERENCES, AND THE IMPACT OF PREFERENCE ON ENGAGEMENT AND PROCESS MEASURES. WE CONDUCTED A RANDOMIZED PREFERENCE TRIAL OF CBT AND YOGA IN 500 ADULTS >/=60 YEARS WITH SYMPTOMS OF WORRY. PARTICIPANTS REPORTED THEIR INTERVENTION PREFERENCE, STRENGTH OF PREFERENCE, AND FACTORS IMPACTING PREFERENCE. ENGAGEMENT IN THE INTERVENTION (SESSION COMPLETION AND DROPOUT RATES) WAS ASSESSED. PROCESS MEASURES INCLUDED SATISFACTION WITH THE INTERVENTION, THERAPEUTIC ALLIANCE, AND INTERVENTION EXPECTANCY. NEITHER INTERVENTION PREFERENCE (48% AND 52% CHOSE CBT AND YOGA, RESPECTIVELY) NOR STRENGTH OF PREFERENCE DIFFERED SIGNIFICANTLY BETWEEN THE TWO PREFERENCE TRIAL GROUPS. INTERVENTION EXPECTANCIES AT BASELINE AMONG THOSE IN THE PREFERENCE TRIAL WERE APPROXIMATELY 4.5 UNITS (40-POINT SCALE) HIGHER FOR THEIR PREFERRED INTERVENTION (P < .0001 WITHIN EACH GROUP). A PRINCIPAL COMPONENT ANALYSIS OF FACTORS INFLUENCING PREFERENCE IDENTIFIED THREE CONSTRUCTS. USING LOGISTIC REGRESSION, COMPONENTS FOCUSED ON ATTITUDES ABOUT CBT OR YOGA WERE PREDICTIVE OF ULTIMATE PREFERENCE (ODDS RATIO = 11.5, 95% C.I.6.3-21.0 PER 1SD DIFFERENCE IN COMPONENT 1 FOR CHOOSING CBT; ODDS RATIO = 7.8, 95% CI4.3-13.9 PER 1SD DIFFERENCE IN COMPONENT 2 FOR CHOOSING YOGA). THERE WERE NO SIGNIFICANT DIFFERENCES BETWEEN THE RANDOMIZED AND PREFERENCE TRIALS ON INTERVENTION ADHERENCE, COMPLETION OF ASSESSMENTS, INTERVENTION SATISFACTION, OR WORKING ALLIANCE. RECEIVING A PREFERRED TREATMENT HAD NO SIGNIFICANT EFFECTS ON INTERVENTION OUTCOMES THROUGH PARTICIPANT ENGAGEMENT OR PROCESS MEASURES. WHEN OPTIONS ARE LIMITED, PROVIDERS MAY HAVE CONFIDENCE IN OFFERING THE MOST READILY AVAILABLE NON-PHARMACOLOGICAL TREATMENTS. 2021 6 2824 35 YOGA VERSUS EDUCATION FOR VETERANS WITH CHRONIC LOW BACK PAIN: STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN IS THE MOST FREQUENT PAIN CONDITION IN VETERANS AND CAUSES SUBSTANTIAL SUFFERING, DECREASED FUNCTIONAL CAPACITY, AND LOWER QUALITY OF LIFE. SYMPTOMS OF POST-TRAUMATIC STRESS, DEPRESSION, AND MILD TRAUMATIC BRAIN INJURY ARE HIGHLY PREVALENT IN VETERANS WITH BACK PAIN. YOGA FOR LOW BACK PAIN HAS BEEN DEMONSTRATED TO BE EFFECTIVE FOR CIVILIANS IN RANDOMIZED CONTROLLED TRIALS. HOWEVER, IT IS UNKNOWN IF RESULTS FROM PREVIOUSLY PUBLISHED TRIALS GENERALIZE TO MILITARY POPULATIONS. METHODS/DESIGN: THIS STUDY IS A PARALLEL RANDOMIZED CONTROLLED TRIAL COMPARING YOGA TO EDUCATION FOR 120 VETERANS WITH CHRONIC LOW BACK PAIN. PARTICIPANTS ARE VETERANS >/=18 YEARS OLD WITH LOW BACK PAIN PRESENT ON AT LEAST HALF THE DAYS IN THE PAST SIX MONTHS AND A SELF-REPORTED AVERAGE PAIN INTENSITY IN THE PREVIOUS WEEK OF >/=4 ON A 0-10 SCALE. THE 24-WEEK STUDY HAS AN INITIAL 12-WEEK INTERVENTION PERIOD, WHERE PARTICIPANTS ARE RANDOMIZED EQUALLY INTO (1) A STANDARDIZED WEEKLY GROUP YOGA CLASS WITH HOME PRACTICE OR (2) EDUCATION DELIVERED WITH A SELF-CARE BOOK. PRIMARY OUTCOME MEASURES ARE CHANGE AT 12 WEEKS IN LOW BACK PAIN INTENSITY MEASURED BY THE DEFENSE AND VETERANS PAIN RATING SCALE (0-10) AND BACK-RELATED FUNCTION USING THE 23-POINT ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 12-WEEK FOLLOW-UP PERIOD, YOGA PARTICIPANTS ARE ENCOURAGED TO CONTINUE HOME YOGA PRACTICE AND EDUCATION PARTICIPANTS CONTINUE FOLLOWING RECOMMENDATIONS FROM THE BOOK. QUALITATIVE INTERVIEWS WITH VETERANS IN THE YOGA GROUP AND THEIR PARTNERS EXPLORE THE IMPACT OF CHRONIC LOW BACK PAIN AND YOGA ON FAMILY RELATIONSHIPS. WE ALSO ASSESS COST-EFFECTIVENESS FROM THREE PERSPECTIVES: THE VETERAN, THE VETERANS HEALTH ADMINISTRATION, AND SOCIETY USING ELECTRONIC MEDICAL RECORDS, SELF-REPORTED COST DATA, AND STUDY RECORDS. DISCUSSION: THIS STUDY WILL HELP DETERMINE IF YOGA CAN BECOME AN EFFECTIVE TREATMENT FOR VETERANS WITH CHRONIC LOW BACK PAIN AND PSYCHOLOGICAL COMORBIDITIES. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT02224183. 2016 7 2627 26 YOGA FOR THE MANAGEMENT OF CANCER TREATMENT-RELATED TOXICITIES. PURPOSE OF REVIEW: TO (1) EXPLAIN WHAT YOGA IS, (2) SUMMARIZE PUBLISHED LITERATURE ON THE EFFICACY OF YOGA FOR MANAGING CANCER TREATMENT-RELATED TOXICITIES, (3) PROVIDE CLINICAL RECOMMENDATIONS ON THE USE OF YOGA FOR ONCOLOGY PROFESSIONALS, AND (4) SUGGEST PROMISING AREAS FOR FUTURE RESEARCH. RECENT FINDINGS: BASED ON A TOTAL OF 24 PHASE II AND ONE PHASE III CLINICAL TRIALS, LOW-INTENSITY FORMS OF YOGA, SPECIFICALLY GENTLE HATHA AND RESTORATIVE, ARE FEASIBLE, SAFE, AND EFFECTIVE FOR TREATING SLEEP DISRUPTION, CANCER-RELATED FATIGUE, COGNITIVE IMPAIRMENT, PSYCHOSOCIAL DISTRESS, AND MUSCULOSKELETAL SYMPTOMS IN CANCER PATIENTS RECEIVING CHEMOTHERAPY AND RADIATION AND CANCER SURVIVORS. CLINICIANS SHOULD CONSIDER PRESCRIBING YOGA FOR THEIR PATIENTS SUFFERING WITH THESE TOXICITIES BY REFERRING THEM TO QUALIFIED YOGA PROFESSIONALS. MORE DEFINITIVE PHASE III CLINICAL TRIALS ARE NEEDED TO CONFIRM THESE FINDINGS AND TO INVESTIGATE OTHER TYPES, DOSES, AND DELIVERY MODES OF YOGA FOR TREATING CANCER-RELATED TOXICITIES IN PATIENTS AND SURVIVORS. 2018 8 2734 25 YOGA PARTICIPATION ASSOCIATED WITH CHANGES IN DIETARY PATTERNS AND STRESS: A PILOT STUDY IN STRESSED ADULTS WITH POOR DIET. BACKGROUND AND PURPOSE: STRESS CONTRIBUTES TO DIETARY PATTERNS THAT IMPEDE HEALTH. YOGA IS AN INTEGRATIVE STRESS MANAGEMENT APPROACH ASSOCIATED WITH IMPROVED DIETARY PATTERNS IN BURGEONING RESEARCH. YET, NO RESEARCH HAS EXAMINED CHANGE IN DIETARY PATTERNS, BODY MASS INDEX (BMI), AND STRESS DURING A YOGA INTERVENTION AMONG STRESSED ADULTS WITH POOR DIET. MATERIALS AND METHODS: OBJECTIVELY-MEASURED BMI AND A BATTERY OF SELF-REPORT QUESTIONNAIRES WERE COLLECTED AT FOUR TIME POINTS DURING AND FOLLOWING A 12-WEEK YOGA INTERVENTION (N = 78, 71% WOMEN, MEAN BMI = 25.69 KG/M(2)+/-4.59) - PRE-TREATMENT (T1), MID-TREATMENT (6 WEEKS; T2), POST-TREATMENT (12 WEEKS; T3), AND AT 3-MONTH FOLLOW-UP (24 WEEKS; T4). RESULTS: T1 TO T3 FRUIT AND VEGETABLE INTAKE, BMI, AND STRESS SIGNIFICANTLY DECLINED IN THE OVERALL SAMPLE. REDUCTION IN VEGETABLE INTAKE WAS NO LONGER SIGNIFICANT AFTER ACCOUNTING FOR REDUCTIONS IN CALORIC INTAKE, AND REDUCTION IN CALORIC INTAKE REMAINED SIGNIFICANT AFTER ACCOUNTING FOR REDUCTIONS IN STRESS. CONCLUSION: FINDINGS MAY BE INTERPRETED AS YOGA EITHER ENCOURAGING OR ADVERSELY IMPACTING HEALTHY DIETARY PATTERNS (I.E., MINIMIZING LIKELIHOOD OF FUTURE WEIGHT GAIN VS. DECREASING VEGETABLE INTAKE AND OVERALL CALORIC INTAKE AMONG INDIVIDUALS WHO MAY NOT NEED TO LOSE WEIGHT, RESPECTIVELY). CONTINUED RESEARCH IS WARRANTED, UTILIZING CAUSAL DESIGNS. 2021 9 2638 34 YOGA FOR VETERANS WITH CHRONIC LOW BACK PAIN: DESIGN AND METHODS OF A RANDOMIZED CLINICAL TRIAL. CHRONIC LOW BACK PAIN (CLBP) AFFLICTS MILLIONS OF PEOPLE WORLDWIDE, WITH PARTICULARLY HIGH PREVALENCE IN MILITARY VETERANS. MANY TREATMENT OPTIONS EXIST FOR CLBP, BUT MOST HAVE LIMITED EFFECTIVENESS AND SOME HAVE SIGNIFICANT SIDE EFFECTS. IN GENERAL POPULATIONS WITH CLBP, YOGA HAS BEEN SHOWN TO IMPROVE HEALTH OUTCOMES WITH FEW SIDE EFFECTS. HOWEVER, YOGA HAS NOT BEEN ADEQUATELY STUDIED IN MILITARY VETERAN POPULATIONS. IN THE CURRENT PAPER WE WILL DESCRIBE THE DESIGN AND METHODS OF A RANDOMIZED CLINICAL TRIAL AIMED AT EXAMINING WHETHER YOGA CAN EFFECTIVELY REDUCE DISABILITY AND PAIN IN US MILITARY VETERANS WITH CLBP. A TOTAL OF 144 US MILITARY VETERANS WITH CLBP WILL BE RANDOMIZED TO EITHER YOGA OR A DELAYED TREATMENT COMPARISON GROUP. THE YOGA INTERVENTION WILL CONSIST OF 2X WEEKLY YOGA CLASSES FOR 12WEEKS, COMPLEMENTED BY REGULAR HOME PRACTICE GUIDED BY A MANUAL. THE DELAYED TREATMENT GROUP WILL RECEIVE THE SAME INTERVENTION AFTER SIX MONTHS. THE PRIMARY OUTCOME IS THE CHANGE IN BACK PAIN-RELATED DISABILITY MEASURED WITH THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE AT BASELINE AND 12-WEEKS. SECONDARY OUTCOMES INCLUDE PAIN INTENSITY, PAIN INTERFERENCE, DEPRESSION, ANXIETY, FATIGUE/ENERGY, QUALITY OF LIFE, SELF-EFFICACY, SLEEP QUALITY, AND MEDICATION USAGE. ADDITIONAL PROCESS AND/OR MEDIATIONAL FACTORS WILL BE MEASURED TO EXAMINE DOSE RESPONSE AND EFFECT MECHANISMS. ASSESSMENTS WILL BE CONDUCTED AT BASELINE, 6-WEEKS, 12-WEEKS, AND 6-MONTHS. ALL RANDOMIZED PARTICIPANTS WILL BE INCLUDED IN INTENTION-TO-TREAT ANALYSES. STUDY RESULTS WILL PROVIDE MUCH NEEDED EVIDENCE ON THE FEASIBILITY AND EFFECTIVENESS OF YOGA AS A THERAPEUTIC MODALITY FOR THE TREATMENT OF CLBP IN US MILITARY VETERANS. 2016 10 1617 44 MINDFUL YOGA FOR WOMEN WITH METASTATIC BREAST CANCER: DESIGN OF A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: WOMEN WITH METASTATIC BREAST CANCER (MBC) HAVE AVERAGE LIFE EXPECTANCIES OF ABOUT 2 YEARS, AND REPORT HIGH LEVELS OF DISEASE-RELATED SYMPTOMS INCLUDING PAIN, FATIGUE, SLEEP DISTURBANCE, PSYCHOLOGICAL DISTRESS, AND FUNCTIONAL IMPAIRMENT. THERE IS GROWING RECOGNITION OF THE LIMITATIONS OF MEDICAL APPROACHES TO MANAGING SUCH SYMPTOMS. YOGA IS A MIND-BODY DISCIPLINE THAT HAS DEMONSTRATED A POSITIVE IMPACT ON PSYCHOLOGICAL AND FUNCTIONAL HEALTH IN EARLY STAGE BREAST CANCER PATIENTS AND SURVIVORS, BUT HAS NOT BEEN RIGOROUSLY STUDIED IN ADVANCED CANCER SAMPLES. METHODS: THIS RANDOMIZED CONTROLLED TRIAL EXAMINES THE FEASIBILITY AND INITIAL EFFICACY OF A MINDFUL YOGA PROGRAM, COMPARED WITH A SOCIAL SUPPORT CONDITION THAT CONTROLS FOR ATTENTION, ON MEASURES OF DISEASE-RELATED SYMPTOMS SUCH AS PAIN AND FATIGUE. THE STUDY WILL BE COMPLETED BY DECEMBER 2017. SIXTY-FIVE WOMEN WITH MBC AGE >/= 18 ARE BEING IDENTIFIED AND RANDOMIZED WITH A 2:1 ALLOCATION TO MINDFUL YOGA OR A SUPPORT GROUP CONTROL INTERVENTION. THE 120-MIN INTERVENTION SESSIONS TAKE PLACE WEEKLY FOR 8 WEEKS. THE STUDY IS CONDUCTED AT AN URBAN TERTIARY CARE ACADEMIC MEDICAL CENTER LOCATED IN DURHAM, NORTH CAROLINA. THE PRIMARY FEASIBILITY OUTCOME IS ATTENDANCE AT INTERVENTION SESSIONS. EFFICACY OUTCOMES INCLUDE PAIN, FATIGUE, SLEEP QUALITY, PSYCHOLOGICAL DISTRESS, MINDFULNESS AND FUNCTIONAL CAPACITY AT POST-INTERVENTION, 3-MONTH FOLLOW-UP, AND 6-MONTH FOLLOW-UP. DISCUSSION: IN THIS ARTICLE, WE PRESENT THE CHALLENGES OF DESIGNING A RANDOMIZED CONTROLLED TRIAL WITH LONG-TERM FOLLOW-UP AMONG WOMEN WITH MBC. THESE CHALLENGES INCLUDE ENSURING ADEQUATE RECRUITMENT INCLUDING OF MINORITIES, LIMITING AND CONTROLLING FOR SELECTION BIAS, TAILORING OF THE YOGA INTERVENTION TO ADDRESS SPECIAL NEEDS, AND MAXIMIZING ADHERENCE AND RETENTION. THIS PROJECT WILL PROVIDE IMPORTANT INFORMATION REGARDING YOGA AS AN INTERVENTION FOR WOMEN WITH ADVANCED CANCER, INCLUDING PRELIMINARY DATA ON THE PSYCHOLOGICAL AND FUNCTIONAL EFFECTS OF YOGA FOR MBC PATIENTS. THIS INVESTIGATION WILL ALSO ESTABLISH RIGOROUS METHODS FOR FUTURE RESEARCH INTO YOGA AS AN INTERVENTION FOR THIS POPULATION. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFER: NCT01927081 , REGISTERED AUGUST 16, 2013. 2017 11 133 40 A PRAGMATIC PREFERENCE TRIAL OF THERAPEUTIC YOGA AS AN ADJUNCT TO GROUP COGNITIVE BEHAVIOUR THERAPY VERSUS GROUP CBT ALONE FOR DEPRESSION AND ANXIETY. BACKGROUND: YOGA HAS SEVERAL MECHANISMS THAT MAKE IT A PROMISING TREATMENT FOR DEPRESSION AND ANXIETY, INCLUDING PHYSICAL ACTIVITY, BEHAVIOURAL ACTIVATION, AND MINDFULNESS. FOLLOWING POSITIVE OUTCOMES FROM ADAPTED CBT INTERVENTIONS INCORPORATING MINDFULNESS-BASED PRACTICES, THIS STUDY EXPLORED THE EFFECTS OF A THERAPEUTIC YOGA PROGRAM AS AN ADJUNCT TO GROUP-BASED CBT FOR DEPRESSION OR ANXIETY. METHODS: THIS WAS A PRAGMATIC PREFERENCE TRIAL INVOLVING ADULTS DIAGNOSED WITH DEPRESSION OR ANXIETY IN A REGIONAL PRIMARY MENTAL HEALTHCARE SERVICE (N = 59), COMPARING TRANSDIAGNOSTIC GROUP CBT (N = 27) WITH TRANSDIAGNOSTIC GROUP CBT COMBINED WITH AN ADJUNCT THERAPEUTIC YOGA PROGRAM (N = 32). A PREFERENCE RECRUITMENT DESIGN ALLOWED ELIGIBLE PARTICIPANTS (N = 35) TO SELF-SELECT INTO THE ADJUNCT PROGRAM. THE DEPRESSION ANXIETY STRESS SCALE-21 (DASS) WAS ASSESSED AT BASELINE, POST-INTERVENTION, AND THREE-MONTHS FOLLOW UP. RESULTS: CBT + YOGA WAS AN ACCEPTABLE ALTERNATIVE TO CBT ALONE. SIGNIFICANT REDUCTIONS WERE OBSERVED IN TOTAL DASS SCORES AND THE 3 SUBSCALES OF THE DASS FOR BOTH GROUPS, HOWEVER CBT + YOGA SHOWED SIGNIFICANTLY LOWER DEPRESSIVE AND ANXIETY SYMPTOMS POST-INTERVENTION, COMPARED TO CBT ALONE. CBT + YOGA ALSO SHOWED SUSTAINED REDUCTIONS IN DEPRESSIVE SYMPTOMS OVER THREE-MONTHS, AND MORE RAPID REDUCTIONS IN DEPRESSIVE SYMPTOMS, COMPARED TO CBT ALONE. LIMITATIONS: THESE FINDINGS SHOULD BE CONSIDERED PRELIMINARY DUE TO THE MODERATE SAMPLE SIZE, WITH A RIGOROUS RANDOMISED CONTROL TRIAL NECESSARY TO DEFINITIVELY SUPPORT THE INTEGRATION OF YOGA WITHIN MENTAL HEALTH CARE TO AUGMENT THE BENEFITS AND UPTAKE OF TRANSDIAGNOSTIC CBT FOR DEPRESSION AND ANXIETY. CONCLUSIONS: COMPLEMENTING OTHER MINDFULNESS-BASED PRACTICES, THERAPEUTIC YOGA SHOWS PROMISE AS AN ADJUNCT TO TRANSDIAGNOSTIC CBT. 2022 12 181 36 A RANDOMIZED CONTROLLED TRIAL OF YOGA VS NONAEROBIC EXERCISE FOR VETERANS WITH PTSD: UNDERSTANDING EFFICACY, MECHANISMS OF CHANGE, AND MODE OF DELIVERY. BACKGROUND AND OBJECTIVES: POSTTRAUMATIC STRESS DISORDER (PTSD) IS A CHRONIC, DISABLING, AND PREVALENT MENTAL HEALTH DISORDER AMONG VETERANS. DESPITE THE AVAILABILITY OF EMPIRICALLY SUPPORTED PSYCHOTHERAPIES, MANY VETERANS REMAIN SYMPTOMATIC AFTER TREATMENT AND/OR PREFER TO SEEK COMPLEMENTARY AND INTEGRATIVE HEALTH APPROACHES, INCLUDING YOGA, TO MANAGE PTSD. THE RANDOMIZED CONTROLLED TRIAL (RCT) DESCRIBED HEREIN WILL EVALUATE THE EFFICACY OF A MANUALIZED YOGA PROGRAM AS COMPARED TO NONAEROBIC EXERCISE IN REDUCING PTSD SEVERITY AMONG VETERANS. A SECONDARY AIM OF THIS STUDY IS TO BETTER UNDERSTAND THE MECHANISMS OF CHANGE. METHODS: VETERANS (N = 192) WITH PTSD WILL BE RANDOMIZED TO HATHA YOGA OR NONAEROBIC PHYSICAL ACTIVITY CONTROL; BOTH GROUPS CONSIST OF 12 WEEKLY, 60-MIN GROUP OR ONLINE TRAINING SESSIONS WITH 15-20 MIN OF DAILY AT-HOME PRACTICE. OUTCOME MEASURES WILL BE ADMINISTERED AT BASELINE, MID-TREATMENT, POSTTREATMENT, AND 12-WEEK FOLLOW-UP. PROJECTED OUTCOMES: THIS STUDY WILL EVALUATE CHANGES IN PTSD SEVERITY (PRIMARY OUTCOME) AS WELL AS DEPRESSION, ANXIETY, ANGER, SLEEP PROBLEMS, AND PSYCHOSOCIAL DISABILITY (SECONDARY OUTCOMES). WE WILL ALSO USE MULTIPLE MEDIATION TO EXAMINE TWO POTENTIAL MODELS OF THE MECHANISMS OF CLINICAL EFFECT: THE ATTENTION MODEL (I.E., YOGA INCREASES ATTENTIONAL CONTROL, WHICH REDUCES PTSD SYMPTOMS), THE COPING MODEL (I.E., YOGA INCREASES DISTRESS TOLERANCE, WHICH IMPROVES COPING, WHICH REDUCES PTSD SYMPTOMS), AND THE COMBINATION OF THESE MODELS. THIS ASPECT OF THE STUDY IS INNOVATIVE AND IMPORTANT GIVEN THE ABSENCE OF AN EXISTING, COMPREHENSIVE MODEL FOR UNDERSTANDING YOGA'S IMPACT ON PTSD. ULTIMATELY, WE HOPE TO DEVELOP GUIDELINES FOR APPLICATION OF YOGA TO PTSD RECOVERY. 2021 13 124 21 A PILOT STUDY OF YOGA FOR CHRONIC HEADACHES IN YOUTH: PROMISE AMIDST CHALLENGES. THE PRIMARY AIM OF THE CURRENT STUDY WAS TO PROVIDE PRELIMINARY DATA ON THE FEASIBILITY, ACCEPTABILITY, AND SAFETY OF ALIGNMENT-BASED YOGA FOR YOUTHS WITH CHRONIC HEADACHES. A SECONDARY AIM WAS TO PROVIDE PRELIMINARY ESTIMATES OF YOGA'S ABILITY TO IMPROVE HEADACHE PAIN, DAILY FUNCTIONING, QUALITY OF LIFE, AND ANXIETY LEVEL IN THIS POPULATION. THE YOGA INTERVENTION CONSISTED OF 8 WEEKLY, 75-MINUTE CLASSES. PARTICIPANT FLOW DATA REVEALED CHALLENGES TO FEASIBILITY PRIMARILY DUE TO RECRUITMENT AND RETENTION. SCORES ON MOST OUTCOME MEASURES CHANGED IN THE PREDICTED DIRECTION WITH MEDIUM EFFECT SIZES FOUND FOR THE FUNCTIONAL OUTCOMES. PAIN MEASURES DID NOT CHANGE SIGNIFICANTLY. THIS PILOT SUGGESTS THAT YOGA FOR PEDIATRIC HEADACHES MAY BE ACCEPTABLE, AS INDICATED BY POSITIVE PARENT AND PARTICIPANT RATINGS OF THE YOGA EXPERIENCE. THESE PRELIMINARY FINDINGS SUGGEST THAT YOGA TRIALS FOR PEDIATRIC HEADACHES INCLUDE BOTH CHALLENGES AND PROMISE. RECOMMENDATIONS FOR OVERCOMING CHALLENGES INCLUDE DESIGNS THAT OPTIMIZE FAMILY CONVENIENCE. 2014 14 2754 41 YOGA PRACTICE PREDICTS IMPROVEMENTS IN DAY-TO-DAY PAIN IN WOMEN WITH METASTATIC BREAST CANCER. CONTEXT: WOMEN WITH METASTATIC BREAST CANCER (MBC) EXPERIENCE A SIGNIFICANT SYMPTOM BURDEN, INCLUDING CANCER PAIN. YOGA IS A MIND-BODY DISCIPLINE THAT HAS SHOWN PROMISE FOR ALLEVIATING CANCER PAIN, BUT FEW STUDIES HAVE INCLUDED PATIENTS WITH METASTATIC DISEASE OR EXAMINED THE ACUTE EFFECTS OF YOGA PRACTICE. OBJECTIVES: TO DETERMINE WHETHER DAILY PAIN CHANGED SIGNIFICANTLY DURING A RANDOMIZED CONTROLLED TRIAL OF THE MINDFUL YOGA PROGRAM AMONG WOMEN WITH MBC AND WHETHER TIME SPENT IN YOGA PRACTICE WAS RELATED TO DAILY PAIN. METHODS: ON ALTERNATE WEEKS DURING THE INTERVENTION PERIOD, WE COLLECTED DAILY MEASURES OF PAIN FROM A SUBSET OF 48 WOMEN RANDOMIZED TO EITHER YOGA (N = 30) OR A SUPPORT GROUP CONDITION (N = 18). WE ALSO ASSESSED DAILY DURATION OF YOGA PRACTICE AMONG PATIENTS RANDOMIZED TO YOGA. RESULTS: PAIN LEVELS WERE LOW FOR WOMEN IN BOTH CONDITIONS, AND NO DIFFERENTIAL TREATMENT EFFECTS WERE FOUND ON DAILY PAIN. HOWEVER, AMONG WOMEN RANDOMIZED TO YOGA, A DOSE/RESPONSE RELATIONSHIP WAS FOUND BETWEEN YOGA PRACTICE DURATION AND DAILY PAIN. WHEN PATIENTS HAD SPENT RELATIVELY MORE TIME PRACTICING YOGA ACROSS TWO CONSECUTIVE DAYS, THEY WERE MORE LIKELY TO EXPERIENCE LOWER PAIN ON THE NEXT DAY. THIS FINDING IS CONSISTENT WITH AN EARLIER MBC STUDY. MEDITATION PRACTICE SHOWED THE STRONGEST ASSOCIATION WITH LOWER DAILY PAIN. CONCLUSION: FINDINGS SUGGEST THAT YOGA PRACTICE (MEDITATION PRACTICE IN PARTICULAR) IS ASSOCIATED WITH ACUTE IMPROVEMENTS IN CANCER PAIN, AND THAT YOGA INTERVENTIONS MAY BE MORE IMPACTFUL IF TESTED IN A SAMPLE OF PATIENTS WITH ADVANCED CANCER IN WHICH PAIN IS RELATIVELY ELEVATED. 2021 15 682 29 EFFECT OF ADJUNCT YOGA THERAPY IN DEPRESSIVE DISORDERS: FINDINGS FROM A RANDOMIZED CONTROLLED STUDY. BACKGROUND: DEPRESSION CAUSES SIGNIFICANT BURDEN BOTH TO THE INDIVIDUAL AND TO SOCIETY, AND ITS TREATMENT BY ANTIDEPRESSANTS HAS VARIOUS DISADVANTAGES. THERE IS PRELIMINARY EVIDENCE THAT ADDS ON YOGA THERAPY IMPROVES DEPRESSION BY IMPACTING THE NEUROTRANSMITTERS INVOLVED IN THE REGULATION OF MOOD, MOTIVATION, AND PLEASURE. OUR STUDY AIMED TO FIND THE EFFECT OF ADJUNCTIVE YOGA THERAPY ON OUTCOME OF DEPRESSION AND COMORBID ANXIETY. MATERIALS AND METHODS: A RANDOMIZED CONTROLLED STUDY INVOLVING PATIENTS WITH MAJOR DEPRESSIVE DISORDER (N = 80) WERE ALLOCATED TO TWO GROUPS, ONE RECEIVED STANDARD THERAPY (ANTIDEPRESSANTS AND COUNSELING) AND THE OTHER RECEIVED ADJUNCT YOGA THERAPY ALONG WITH STANDARD THERAPY. RATINGS OF DEPRESSION AND ANXIETY WERE DONE USING MONTGOMERY-ASBERG DEPRESSION RATING SCALE AND HOSPITAL ANXIETY AND DEPRESSION SCALE AT BASELINE, 10(TH) AND 30(TH) DAY. CLINICAL GLOBAL IMPRESSION (CGI) SCALE WAS APPLIED AT BASELINE AND 30(TH) DAY TO VIEW THE SEVERITY OF ILLNESS AND CLINICAL IMPROVEMENT. RESULTS: BY THE 30(TH) DAY, INDIVIDUALS IN THE YOGA GROUP HAD SIGNIFICANTLY LOWER SCORES OF DEPRESSION, ANXIETY, AND CGI SCORES, IN COMPARISON TO THE CONTROL GROUP. THE INDIVIDUALS IN THE YOGA GROUP HAD A SIGNIFICANT FALL IN DEPRESSION SCORES AND SIGNIFICANT CLINICAL IMPROVEMENT, COMPARED TO THE CONTROL GROUP, FROM BASELINE TO 30(TH) DAY AND 10(TH) TO 30(TH) DAY. IN ADDITION, THE INDIVIDUALS IN THE YOGA GROUP HAD A SIGNIFICANT FALL IN ANXIETY SCORES FROM BASELINE TO 10(TH) DAY. CONCLUSION: ANXIETY STARTS TO IMPROVE WITH SHORT-TERM YOGA SESSIONS, WHILE LONG-TERM YOGA THERAPY IS LIKELY TO BE BENEFICIAL IN THE TREATMENT OF DEPRESSION. 2019 16 1035 28 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 17 536 35 COMPARISON OF YOGA VERSUS STRETCHING FOR CHRONIC LOW BACK PAIN: PROTOCOL FOR THE YOGA EXERCISE SELF-CARE (YES) TRIAL. BACKGROUND: BACK PAIN, ONE OF THE MOST PREVALENT CONDITIONS AFFLICTING AMERICAN ADULTS, IS THE LEADING REASON FOR USING COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) THERAPIES. YOGA IS AN INCREASINGLY POPULAR "MIND-BODY" CAM THERAPY OFTEN USED FOR RELIEVING BACK PAIN AND SEVERAL SMALL STUDIES HAVE FOUND YOGA EFFECTIVE FOR THIS CONDITION. THIS STUDY WILL ASSESS WHETHER YOGA IS EFFECTIVE FOR TREATING CHRONIC LOW BACK PAIN COMPARED WITH SELF CARE AND EXERCISE AND WILL EXPLORE THE MECHANISMS RESPONSIBLE FOR ANY OBSERVED BENEFITS. METHODS/DESIGN: A TOTAL OF 210 PARTICIPANTS WITH LOW BACK PAIN LASTING AT LEAST 3 MONTHS WILL BE RECRUITED FROM PRIMARY CARE CLINICS OF A LARGE HEALTHCARE SYSTEM BASED IN SEATTLE. THEY WILL BE RANDOMIZED IN A 2:2:1 RATIO TO RECEIVE 12 WEEKLY YOGA CLASSES, 12 WEEKLY CONVENTIONAL THERAPEUTIC EXERCISE CLASSES OF COMPARABLE PHYSICAL EXERTION, OR A SELF-CARE BOOK. INTERVIEWERS MASKED TO PARTICIPANTS' TREATMENT GROUP WILL ASSESS OUTCOMES AT BASELINE AND 6, 12 AND 26 WEEKS AFTER RANDOMIZATION. PRIMARY OUTCOMES WILL BE BACK-RELATED DYSFUNCTION AND SYMPTOM BOTHERSOMENESS. IN ADDITION, DATA WILL BE COLLECTED ON PHYSICAL MEASUREMENTS (E.G., FLEXION) AT BASELINE AND 12 WEEKS AND SALIVA SAMPLES WILL BE OBTAINED AT BASELINE, 6 AND 12 WEEKS. INFORMATION WILL BE COLLECTED ON SPECIFIC PHYSICAL, PSYCHOLOGICAL, AND PHYSIOLOGICAL FACTORS TO ALLOW EXPLORATION OF POSSIBLE MECHANISMS OF ACTION THROUGH WHICH YOGA COULD RELIEVE BACK PAIN AND DYSFUNCTION. THE EFFECTIVENESS OF YOGA WILL BE ASSESSED USING ANALYSIS OF COVARIANCE (USING GENERAL ESTIMATING EQUATIONS - GEE) WITHIN AN INTENTION-TO-TREAT CONTEXT. IF YOGA IS FOUND EFFECTIVE, FURTHER ANALYSES WILL EXPLORE WHETHER YOGA'S BENEFITS ARE ATTRIBUTABLE TO PHYSICAL, PSYCHOLOGICAL AND/OR PHYSIOLOGICAL FACTORS. CONCLUSIONS: THIS STUDY WILL PROVIDE THE CLEAREST EVIDENCE TO DATE ABOUT THE VALUE OF YOGA AS A THERAPEUTIC OPTION FOR TREATING CHRONIC BACK PAIN, AND IF THE RESULTS ARE POSITIVE, WILL HELP FOCUS FUTURE, MORE IN-DEPTH, RESEARCH ON THE MOST PROMISING POTENTIAL MECHANISMS OF ACTION IDENTIFIED BY THIS STUDY. 2010 18 1820 38 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 19 2412 23 YOGA AND ITS IMPACT ON CHRONIC INFLAMMATORY AUTOIMMUNE ARTHRITIS. RHEUMATOID ARTHRITIS (RA) IS ONE OF THE MOST COMMON CHRONIC INFLAMMATORY AUTOIMMUNE DISEASES, WHICH ADVERSELY AFFECTS THE QUALITY OF LIFE. RA IS A DISEASE OF UNKNOWN ETIOLOGY, HOWEVER, BOTH GENETIC AND ENVIRONMENTAL FACTORS APPEAR TO CONTRIBUTE TO THE SUSCEPTIBILITY TO THIS DISEASE. THE SEVERITY AND PROGRESSION OF THE DISEASE ARE ATTRIBUTABLE TO THE RELEASE OF A HOST OF INFLAMMATORY CYTOKINES, CYTOTOXIC AND IMMUNE REGULATORY FACTORS. THE TREATMENTS OF RA ARE PRIMARILY LIMITED TO SYMPTOMATIC ALLEVIATION OF PAIN OR OTHER SYMPTOMS OR TO THE USE OF CYTOTOXIC DRUG TREATMENT IN SEVERE FORMS OF THE DISEASE WHICH IS COMMONLY ASSOCIATED WITH SIGNIFICANT SIDE EFFECTS. DESPITE LACK OF A CURE, THE DISEASE MAY BE CONTROLLED BY MIND-BODY INTERVENTIONS. HOLISTIC TREATMENTS SUCH AS YOGA SIGNIFICANTLY IMPROVE AND REDUCE THE PSYCHO-SOMATIC SYMPTOMS, PAIN PERCEPTION, DISABILITY QUOTIENT, JOINT FLEXIBILITY, RANGE OF MOTION, POSTURE, MUSCLE STRENGTH, COORDINATION, AND DISEASE ACTIVITY. HERE, WE DISCUSS THE FEATURES OF RA AND ADDRESS HOW YOGA CAN BE USED AS A THERAPEUTIC REGIMEN TO IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH RA. 2021 20 440 24 CASE REPORT: THE USE OF MEDICAL YOGA FOR ADOLESCENT MENTAL HEALTH. MENTAL HEALTH ISSUES ARE EPIDEMIC AMONG YOUTH IN THE UNITED STATES TODAY. RECENT STUDIES SUGGEST THAT UP TO 50% OF ALL TEENAGERS HAVE COMPLAINTS RELATED TO STRESS, ANXIETY, AND/OR DEPRESSION. THIS PROBLEM IS ACCOMPANIED BY AN UNPRECEDENTED RISE IN THE RATES OF CHILD AND TEEN SUICIDE IN THE UNITED STATES. IN RESPONSE TO THIS EPIDEMIC, THE AMERICAN ACADEMY OF PEDIATRICS IS RECOMMENDING UNIVERSAL DEPRESSION SCREENING FOR ALL TEENS. MEDICATIONS ARE AVAILABLE TO AMELIORATE MENTAL HEALTH DISORDERS, AND MANY CAN BE SAFELY USED IN THE PRIMARY CARE SETTING. HOWEVER, MANY OF THESE MEDICATIONS HAVE UNWANTED SIDE EFFECTS OR MAY NOT BE FAMILIAR TO THE PRIMARY CARE PHYSICIAN. FOR THESE REASONS AND OTHERS, PRIMARY CARE PHYSICIANS REQUIRE ADDITIONAL APPROACHES TO RESPOND TO THE CHALLENGES IMPOSED BY A GROWING NUMBER OF PATIENTS REQUIRING MENTAL HEALTH SUPPORT. MEDICAL YOGA THERAPY, PRESCRIBED BY A PHYSICIAN WITH SPECIAL YOGA THERAPY TRAINING, OFFERS A SAFE AND EFFECTIVE WAY TO SERVE THE PATIENT WITH PHYSICAL OR MENTAL CHALLENGES DISABILITIES. MEDICAL YOGA THERAPY IS AN INDIVIDUALIZED AND PERSONAL APPROACH TO THE PATIENT, AND IT MAY BE INTEGRATED WITH ANY CURRENT THERAPY OR MEDICAL REGIMEN. HERE, EVIDENCE FOR MEDICAL YOGA IS REVIEWED IN THE CONTEXT OF AN ADOLESCENT PATIENT WITH A COMMON DISORDER. YOGA PRACTICES, WITH PARTICULAR FOCUS ON MINDFULNESS, OFFER A SAFE AND EFFECTIVE INTERVENTION FOR A GROWING NUMBER OF PEDIATRIC PATIENTS. 2019