1 1863 121 RANDOMIZED CONTROLLED TRIAL OF YOGA AND EXERCISE IN MULTIPLE SCLEROSIS. OBJECTIVE: TO DETERMINE THE EFFECT OF YOGA AND OF AEROBIC EXERCISE ON COGNITIVE FUNCTION, FATIGUE, MOOD, AND QUALITY OF LIFE IN MULTIPLE SCLEROSIS (MS). METHODS: SUBJECTS WITH CLINICALLY DEFINITE MS AND EXPANDED DISABILITY STATUS SCORE LESS THAN OR EQUAL TO 6.0 WERE RANDOMLY ASSIGNED TO ONE OF THREE GROUPS LASTING 6 MONTHS: WEEKLY IYENGAR YOGA CLASS ALONG WITH HOME PRACTICE, WEEKLY EXERCISE CLASS USING A STATIONARY BICYCLE ALONG WITH HOME EXERCISE, OR A WAITING-LIST CONTROL GROUP. OUTCOME ASSESSMENTS PERFORMED AT BASELINE AND AT THE END OF THE 6-MONTH PERIOD INCLUDED A BATTERY OF COGNITIVE MEASURES FOCUSED ON ATTENTION, PHYSIOLOGIC MEASURES OF ALERTNESS, PROFILE OF MOOD STATES, STATE-TRAIT ANXIETY INVENTORY, MULTI-DIMENSIONAL FATIGUE INVENTORY (MFI), AND SHORT FORM (SF)-36 HEALTH-RELATED QUALITY OF LIFE. RESULTS: SIXTY-NINE SUBJECTS WERE RECRUITED AND RANDOMIZED. TWELVE SUBJECTS DID NOT FINISH THE 6-MONTH INTERVENTION. THERE WERE NO ADVERSE EVENTS RELATED TO THE INTERVENTION. THERE WERE NO EFFECTS FROM EITHER OF THE ACTIVE INTERVENTIONS ON EITHER OF THE PRIMARY OUTCOME MEASURES OF ATTENTION OR ALERTNESS. BOTH ACTIVE INTERVENTIONS PRODUCED IMPROVEMENT IN SECONDARY MEASURES OF FATIGUE COMPARED TO THE CONTROL GROUP: ENERGY AND FATIGUE (VITALITY) ON THE SF-36 AND GENERAL FATIGUE ON THE MFI. THERE WERE NO CLEAR CHANGES IN MOOD RELATED TO YOGA OR EXERCISE. CONCLUSION: SUBJECTS WITH MS PARTICIPATING IN EITHER A 6-MONTH YOGA CLASS OR EXERCISE CLASS SHOWED SIGNIFICANT IMPROVEMENT IN MEASURES OF FATIGUE COMPARED TO A WAITING-LIST CONTROL GROUP. THERE WAS NO RELATIVE IMPROVEMENT OF COGNITIVE FUNCTION IN EITHER OF THE INTERVENTION GROUPS. 2004 2 2654 36 YOGA IMPROVES QUALITY OF LIFE AND BENEFIT FINDING IN WOMEN UNDERGOING RADIOTHERAPY FOR BREAST CANCER. THIS STUDY EXAMINED THE EFFECTS OF YOGA ON QUALITY OF LIFE (QOL) AND PSYCHOSOCIAL OUTCOMES IN WOMEN WITH BREAST CANCER UNDERGOING RADIOTHERAPY. SIXTY-ONE WOMEN WERE RANDOMLY ASSIGNED TO EITHER A YOGA OR A WAIT-LIST GROUP. YOGA CLASSES WERE TAUGHT BIWEEKLY DURING THE 6 WEEKS OF RADIOTHERAPY. PARTICIPANTS COMPLETED MEASURES OF QOL, FATIGUE, BENEFIT FINDING (FINDING MEANING IN THE CANCER EXPERIENCE), INTRUSIVE THOUGHTS, SLEEP DISTURBANCES, DEPRESSIVE SYMPTOMS, AND ANXIETY BEFORE RADIOTHERAPY AND THEN AGAIN 1 WEEK, 1 MONTH, AND 3 MONTHS AFTER THE END OF RADIOTHERAPY. GENERAL LINEAR MODEL ANALYSES REVEALED THAT COMPARED TO THE CONTROL GROUP, THE YOGA GROUP REPORTED SIGNIFICANTLY BETTER GENERAL HEALTH PERCEPTION (P = .005) AND PHYSICAL FUNCTIONING SCORES (P = .04) 1 WEEK POSTRADIOTHERAPY; HIGHER LEVELS OF INTRUSIVE THOUGHTS 1 MONTH POSTRADIOTHERAPY (P = .01); AND GREATER BENEFIT FINDING 3 MONTHS POSTRADIOTHERAPY (P = .01). THERE WERE NO OTHER GROUP DIFFERENCES IN OTHER QOL SUBSCALES FOR FATIGUE, DEPRESSION, OR SLEEP SCORES. EXPLORATORY ANALYSES INDICATED THAT INTRUSIVE THOUGHTS 1 MONTH AFTER RADIOTHERAPY WERE SIGNIFICANTLY POSITIVELY CORRELATED WITH BENEFIT FINDING 3 MONTHS AFTER RADIOTHERAPY (R = .36, P = .011). OUR RESULTS INDICATED THAT THE YOGA PROGRAM WAS ASSOCIATED WITH STATISTICALLY AND CLINICALLY SIGNIFICANT IMPROVEMENTS IN ASPECTS OF QOL. 2010 3 962 30 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 4 329 39 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 5 2318 46 TREATING MAJOR DEPRESSION WITH YOGA: A PROSPECTIVE, RANDOMIZED, CONTROLLED PILOT TRIAL. BACKGROUND: CONVENTIONAL PHARMACOTHERAPIES AND PSYCHOTHERAPIES FOR MAJOR DEPRESSION ARE ASSOCIATED WITH LIMITED ADHERENCE TO CARE AND RELATIVELY LOW REMISSION RATES. YOGA MAY OFFER AN ALTERNATIVE TREATMENT OPTION, BUT RIGOROUS STUDIES ARE FEW. THIS RANDOMIZED CONTROLLED TRIAL WITH BLINDED OUTCOME ASSESSORS EXAMINED AN 8-WEEK HATHA YOGA INTERVENTION AS MONO-THERAPY FOR MILD-TO-MODERATE MAJOR DEPRESSION. METHODS: INVESTIGATORS RECRUITED 38 ADULTS IN SAN FRANCISCO MEETING CRITERIA FOR MAJOR DEPRESSION OF MILD-TO-MODERATE SEVERITY, PER STRUCTURED PSYCHIATRIC INTERVIEW AND SCORES OF 14-28 ON BECK DEPRESSION INVENTORY-II (BDI). AT SCREENING, INDIVIDUALS ENGAGED IN PSYCHOTHERAPY, ANTIDEPRESSANT PHARMACOTHERAPY, HERBAL OR NUTRACEUTICAL MOOD THERAPIES, OR MIND-BODY PRACTICES WERE EXCLUDED. PARTICIPANTS WERE 68% FEMALE, WITH MEAN AGE 43.4 YEARS (SD = 14.8, RANGE = 22-72), AND MEAN BDI SCORE 22.4 (SD = 4.5). TWENTY PARTICIPANTS WERE RANDOMIZED TO 90-MINUTE HATHA YOGA PRACTICE GROUPS TWICE WEEKLY FOR 8 WEEKS. EIGHTEEN PARTICIPANTS WERE RANDOMIZED TO 90-MINUTE ATTENTION CONTROL EDUCATION GROUPS TWICE WEEKLY FOR 8 WEEKS. CERTIFIED YOGA INSTRUCTORS DELIVERED BOTH INTERVENTIONS AT A UNIVERSITY CLINIC. PRIMARY OUTCOME WAS DEPRESSION SEVERITY, MEASURED BY BDI SCORES EVERY 2 WEEKS FROM BASELINE TO 8 WEEKS. SECONDARY OUTCOMES WERE SELF-EFFICACY AND SELF-ESTEEM, MEASURED BY SCORES ON THE GENERAL SELF-EFFICACY SCALE (GSES) AND ROSENBERG SELF-ESTEEM SCALE (RSES) AT BASELINE AND AT 8 WEEKS. RESULTS: IN INTENT-TO-TREAT ANALYSIS, YOGA PARTICIPANTS EXHIBITED SIGNIFICANTLY GREATER 8-WEEK DECLINE IN BDI SCORES THAN CONTROLS (P-VALUE = 0.034). IN SUB-ANALYSES OF PARTICIPANTS COMPLETING FINAL 8-WEEK MEASURES, YOGA PARTICIPANTS WERE MORE LIKELY TO ACHIEVE REMISSION, DEFINED PER FINAL BDI SCORE /=14, AND WERE EITHER ON NO ANTIDEPRESSANT MEDICATIONS OR ON A STABLE DOSE OF ANTIDEPRESSANTS FOR >/=3 MONTHS. THE INTERVENTION INCLUDED 90-MIN CLASSES PLUS HOMEWORK. OUTCOME MEASURES WERE BDI-II SCORES AND INTERVENTION COMPLIANCE. RESULTS: FIFTEEN HDG (MAGE = 38.4 +/- 15.1 YEARS) AND 15 LDG (MAGE = 34.7 +/- 10.4 YEARS) SUBJECTS COMPLETED THE INTERVENTION. BDI-II SCORES AT SCREENING AND COMPLIANCE DID NOT DIFFER BETWEEN GROUPS (P = 0.26). BDI-II SCORES DECLINED SIGNIFICANTLY FROM SCREENING (24.6 +/- 1.7) TO WEEK 12 (6.0 +/- 3.8) FOR THE HDG (-18.6 +/- 6.6; P < 0.001), AND FROM SCREENING (27.7 +/- 2.1) TO WEEK 12 (10.1 +/- 7.9) IN THE LDG (-17.7 +/- 9.3; P < 0.001). THERE WERE NO SIGNIFICANT DIFFERENCES BETWEEN GROUPS, BASED ON RESPONSE (I.E., >50% DECREASE IN BDI-II SCORES; P = 0.65) FOR THE HDG (13/15 SUBJECTS) AND LDG (11/15 SUBJECTS) OR REMISSION (I.E., NUMBER OF SUBJECTS WITH BDI-II SCORES <14; P = 1.00) FOR THE HDG (14/15 SUBJECTS) AND LDG (13/15 SUBJECTS) AFTER THE 12-WEEK INTERVENTION, ALTHOUGH A GREATER NUMBER OF SUBJECTS IN THE HDG HAD 12-WEEK BDI-II SCORES .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 10 1087 38 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 11 2415 45 YOGA AND MEDITATION FOR MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS-A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: BREAST CANCER SURVIVORS HAVE ONLY VERY LIMITED TREATMENT OPTIONS FOR MENOPAUSAL SYMPTOMS. THE OBJECTIVE OF THIS TRIAL WAS TO EVALUATE THE EFFECTS OF A 12-WEEK TRADITIONAL HATHA YOGA AND MEDITATION INTERVENTION ON MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS. METHODS: PATIENTS WERE RANDOMLY ASSIGNED EITHER TO A 12-WEEK YOGA AND MEDITATION INTERVENTION OR TO USUAL CARE. THE PRIMARY OUTCOME MEASURE WAS TOTAL MENOPAUSAL SYMPTOMS (MENOPAUSE RATING SCALE [MRS] TOTAL SCORE). SECONDARY OUTCOME MEASURES INCLUDED MRS SUBSCALES, QUALITY OF LIFE (FUNCTIONAL ASSESSMENT OF CANCER THERAPY-BREAST), FATIGUE (FUNCTIONAL ASSESSMENT OF CHRONIC ILLNESS THERAPY-FATIGUE), DEPRESSION, AND ANXIETY (HOSPITAL ANXIETY AND DEPRESSION SCALE). OUTCOMES WERE ASSESSED AT WEEK 12 AND WEEK 24 AFTER RANDOMIZATION. RESULTS: IN TOTAL, 40 WOMEN (MEAN AGE +/- STANDARD DEVIATION, 49.2 +/- 5.9 YEARS) WERE RANDOMIZED TO YOGA (N = 19) OR TO USUAL CARE (N = 21). WOMEN IN THE YOGA GROUP REPORTED SIGNIFICANTLY LOWER TOTAL MENOPAUSAL SYMPTOMS COMPARED WITH THE USUAL CARE GROUP AT WEEK 12 (MEAN DIFFERENCE, -5.6; 95% CONFIDENCE INTERVAL, -9.2 TO -1.9; P = .004) AND AT WEEK 24 (MEAN DIFFERENCE, -4.5; 95% CONFIDENCE INTERVAL, -8.3 TO -0.7; P = .023). AT WEEK 12, THE YOGA GROUP REPORTED LESS SOMATOVEGETATIVE, PSYCHOLOGICAL, AND UROGENITAL MENOPAUSAL SYMPTOMS; LESS FATIGUE; AND IMPROVED QUALITY OF LIFE (ALL P < .05). AT WEEK 24, ALL EFFECTS PERSISTED EXCEPT FOR PSYCHOLOGICAL MENOPAUSAL SYMPTOMS. SHORT-TERM EFFECTS ON MENOPAUSAL SYMPTOMS REMAINED SIGNIFICANT WHEN ONLY WOMEN WHO WERE RECEIVING ANTIESTROGEN MEDICATION (N = 36) WERE ANALYZED. SIX MINOR ADVERSE EVENTS OCCURRED IN EACH GROUP. CONCLUSIONS: YOGA COMBINED WITH MEDITATION CAN BE CONSIDERED A SAFE AND EFFECTIVE COMPLEMENTARY INTERVENTION FOR MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS. THE EFFECTS SEEM TO PERSIST FOR AT LEAST 3 MONTHS. 2015 12 974 38 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 13 1831 42 PSYCHOLOGICAL FUNCTION, IYENGAR YOGA, AND COHERENT BREATHING: A RANDOMIZED CONTROLLED DOSING STUDY. BACKGROUND: EVIDENCE SUGGESTS THAT YOGA MAY BE AN EFFECTIVE TREATMENT FOR MAJOR DEPRESSIVE DISORDER (MDD). STUDIES EVALUATING THE "DOSING" OF YOGA TREATMENT AND EFFICACY FOR MDD ARE NEEDED. THE GOAL OF THIS STUDY WAS TO ASSESS THE EFFECTS OF AN INTERVENTION COMBINING IYENGAR YOGA AND COHERENT BREATHING IN PARTICIPANTS WITH MDD AND DETERMINE THE OPTIMAL INTERVENTION DOSE. METHODS: THIRTY-TWO PARTICIPANTS (18 TO 65 Y OF AGE) DIAGNOSED WITH MDD WERE RANDOMIZED TO A HIGH-DOSE GROUP (HDG) OR A LOW-DOSE GROUP (LDG) OF YOGA AND COHERENT BREATHING FOR 12 WEEKS. THE HDG (N=15) INVOLVED THREE 90-MINUTE YOGA CLASSES AND FOUR 30-MINUTE HOMEWORK SESSIONS PER WEEK. THE LDG (N=15) INVOLVED TWO 90-MINUTE YOGA CLASSES AND THREE 30-MINUTE HOMEWORK SESSIONS PER WEEK. PARTICIPANTS WERE EVALUATED AT BASELINE, WEEK 4, WEEK 8, AND WEEK 12 WITH THE FOLLOWING INSTRUMENTS: POSITIVITY SELF-TEST, SPIELBERGER STATE ANXIETY INVENTORY, PATIENT HEALTH QUESTIONNAIRE-9, PITTSBURGH SLEEP QUALITY INDEX, AND EXERCISE-INDUCED FEELING INVENTORY. DATA WERE ANALYZED USING INTENT-TO-TREAT METHODS. RESULTS: SIGNIFICANT IMPROVEMENTS IN ALL OUTCOME MEASURES WERE FOUND FOR BOTH GROUPS, WITH ACUTE AND CUMULATIVE BENEFITS. ALTHOUGH THE HDG SHOWED GREATER IMPROVEMENTS ON ALL SCALES, BETWEEN-GROUP DIFFERENCES DID NOT REACH SIGNIFICANCE, POSSIBLY DUE TO LACK OF POWER BECAUSE OF THE SMALL SAMPLE SIZE. CUMULATIVE YOGA MINUTES WERE CORRELATED WITH IMPROVEMENT IN OUTCOME MEASURES. LIMITATION: THIS DOSING STUDY DID NOT INCLUDE A NON-YOGA CONTROL. CONCLUSIONS: IMPROVEMENT IN PSYCHOLOGICAL SYMPTOMS CORRELATED WITH CUMULATIVE YOGA PRACTICE. BOTH INTERVENTIONS REDUCED SYMPTOMS OF DEPRESSION AND ANXIETY AND INCREASED FEELINGS OF POSITIVITY. THE TIME COMMITMENT FOR YOGA PRACTICE NEEDS TO BE WEIGHED AGAINST BENEFITS WHEN DESIGNING YOGA INTERVENTIONS. 2019 14 163 43 A RANDOMIZED CONTROL TRIAL OF THE EFFECT OF YOGA ON GUNAS (PERSONALITY) AND HEALTH IN NORMAL HEALTHY VOLUNTEERS. OBJECTIVE: TO STUDY THE EFFICACY OF YOGA ON GUNA (YOGIC PERSONALITY MEASURE) AND GENERAL HEALTH IN NORMAL ADULTS. METHODS: OF THE 1228 PERSONS WHO ATTENDED INTRODUCTORY LECTURES, 226 SUBJECTS AGED 18-71 YEARS, OF BOTH SEXES, WHO SATISFIED THE INCLUSION AND EXCLUSION CRITERIA AND WHO CONSENTED TO PARTICIPATE IN THE STUDY WERE RANDOMLY ALLOCATED INTO TWO GROUPS. THE YOGA(Y) GROUP PRACTISED AN INTEGRATED YOGA MODULE THAT INCLUDED ASANAS, PRANAYAMA, MEDITATION, NOTIONAL CORRECTION AND DEVOTIONAL SESSIONS. THE CONTROL GROUP PRACTISED MILD TO MODERATE PHYSICAL EXERCISES (PE). BOTH GROUPS HAD SUPERVISED PRACTICE SESSIONS (BY TRAINED EXPERTS) FOR ONE HOUR DAILY, SIX DAYS A WEEK FOR EIGHT WEEKS. GUNA (YOGIC PERSONALITY) WAS ASSESSED BEFORE AND AFTER EIGHT WEEKS USING THE SELF-ADMINISTERED VEDIC PERSONALITY INVENTORY (VPI) WHICH ASSESSES SATTVA (GENTLE AND CONTROLLED), RAJAS (VIOLENT AND UNCONTROLLED) AND TAMAS (DULL AND UNCONTROLLED). THE GENERAL HEALTH STATUS (TOTAL HEALTH), WHICH INCLUDES FOUR DOMAINS NAMELY SOMATIC SYMPTOMS (SS), ANXIETY AND INSOMNIA (AI), SOCIAL DYSFUNCTION (SF) AND SEVERE DEPRESSION (SP), WAS ASSESSED USING A GENERAL HEALTH QUESTIONNAIRE (GHQ). RESULTS: BASELINE SCORES FOR ALL THE DOMAINS FOR BOTH THE GROUPS DID NOT DIFFER SIGNIFICANTLY (P > 0.05, INDEPENDENT SAMPLES T TEST). SATTVA SHOWED A SIGNIFICANT DIFFERENCE WITHIN THE GROUPS AND THE EFFECT SIZE WAS MORE IN THE Y THAN IN THE PE GROUP. RAJAS SHOWED A SIGNIFICANT DECREASE WITHIN AND BETWEEN THE GROUPS WITH A HIGHER EFFECT SIZE IN THE PE GROUP. TAMAS SHOWED SIGNIFICANT REDUCTION WITHIN THE PE GROUP ONLY. THE GHQ REVEALED THAT THERE WAS SIGNIFICANT DECREASE IN SS, AI, SF AND SP IN BOTH Y AND PE GROUPS (WILCOXCON SINGED RANK T TEST). SS SHOWED A SIGNIFICANT DIFFERENCE BETWEEN THE GROUPS (MANN WHITNEY U TEST). CONCLUSIONS: THERE WAS AN IMPROVEMENT IN SATTVA IN BOTH THE YOGA AND CONTROL GROUPS WITH A TREND OF HIGHER EFFECT SIZE IN YOGA; RAJAS REDUCED IN BOTH BUT SIGNIFICANTLY BETTER IN PE THAN IN YOGA AND TAMAS REDUCED IN PE. THE GENERAL HEALTH STATUS IMPROVED IN BOTH THE YOGA AND CONTROL GROUPS. 2008 15 2604 46 YOGA FOR PERSISTENT FATIGUE IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CANCER-RELATED FATIGUE AFFLICTS UP TO 33% OF BREAST CANCER SURVIVORS, YET THERE ARE NO EMPIRICALLY VALIDATED TREATMENTS FOR THIS SYMPTOM. METHODS: THE AUTHORS CONDUCTED A 2-GROUP RANDOMIZED CONTROLLED TRIAL TO DETERMINE THE FEASIBILITY AND EFFICACY OF AN IYENGAR YOGA INTERVENTION FOR BREAST CANCER SURVIVORS WITH PERSISTENT POST-TREATMENT FATIGUE. PARTICIPANTS WERE BREAST CANCER SURVIVORS WHO HAD COMPLETED CANCER TREATMENTS (OTHER THAN ENDOCRINE THERAPY) AT LEAST 6 MONTHS BEFORE ENROLLMENT, REPORTED SIGNIFICANT CANCER-RELATED FATIGUE, AND HAD NO OTHER MEDICAL CONDITIONS THAT WOULD ACCOUNT FOR FATIGUE SYMPTOMS OR INTERFERE WITH YOGA PRACTICE. BLOCK RANDOMIZATION WAS USED TO ASSIGN PARTICIPANTS TO A 12-WEEK, IYENGAR-BASED YOGA INTERVENTION OR TO 12 WEEKS OF HEALTH EDUCATION (CONTROL). THE PRIMARY OUTCOME WAS CHANGE IN FATIGUE MEASURED AT BASELINE, IMMEDIATELY POST-TREATMENT, AND 3 MONTHS AFTER TREATMENT COMPLETION. ADDITIONAL OUTCOMES INCLUDED CHANGES IN VIGOR, DEPRESSIVE SYMPTOMS, SLEEP, PERCEIVED STRESS, AND PHYSICAL PERFORMANCE. INTENT-TO-TREAT ANALYSES WERE CONDUCTED WITH ALL RANDOMIZED PARTICIPANTS USING LINEAR MIXED MODELS. RESULTS: THIRTY-ONE WOMEN WERE RANDOMLY ASSIGNED TO YOGA (N = 16) OR HEALTH EDUCATION (N = 15). FATIGUE SEVERITY DECLINED SIGNIFICANTLY FROM BASELINE TO POST-TREATMENT AND OVER A 3-MONTH FOLLOW-UP IN THE YOGA GROUP RELATIVE TO CONTROLS (P = .032). IN ADDITION, THE YOGA GROUP HAD SIGNIFICANT INCREASES IN VIGOR RELATIVE TO CONTROLS (P = .011). BOTH GROUPS HAD POSITIVE CHANGES IN DEPRESSIVE SYMPTOMS AND PERCEIVED STRESS (P < .05). NO SIGNIFICANT CHANGES IN SLEEP OR PHYSICAL PERFORMANCE WERE OBSERVED. CONCLUSIONS: A TARGETED YOGA INTERVENTION LED TO SIGNIFICANT IMPROVEMENTS IN FATIGUE AND VIGOR AMONG BREAST CANCER SURVIVORS WITH PERSISTENT FATIGUE SYMPTOMS. 2012 16 189 46 A RANDOMIZED STUDY OF YOGA FOR FATIGUE AND QUALITY OF LIFE IN WOMEN WITH BREAST CANCER UNDERGOING (NEO) ADJUVANT CHEMOTHERAPY. OBJECTIVES: TO COMPARE THE EFFECTIVENESS OF YOGA ADDED TO STANDARD CARE (SC) VERSUS SC ONLY, IN WOMEN WITH BREAST CANCER DURING CHEMOTHERAPY. DESIGN: A MULTICENTER PRAGMATIC, RANDOMIZED CONTROLLED STUDY. SETTINGS/LOCATION: THREE HOSPITALS IN THE NETHERLANDS. SUBJECTS: WOMEN WITH STAGE I-III BREAST CANCER UNDERGOING CHEMOTHERAPY. INTERVENTIONS: WOMEN WERE RANDOMIZED EITHER TO A PROGRAM BASED ON DRU YOGA, ONCE A WEEK YOGA SESSIONS FOR 12 WEEKS (N = 47), OR SC ONLY (N = 36). OUTCOME MEASURES: PRIMARY OUTCOME FATIGUE (MULTIDIMENSIONAL FATIGUE INVENTORY [MFI]; GENERAL FATIGUE) AND SECONDARY OUTCOMES FATIGUE (MFI, FATIGUE QUALITY LIST [FQL]), QUALITY OF LIFE (30-ITEM QUALITY OF LIFE QUESTIONNAIRE-C OF THE EUROPEAN ORGANIZATION FOR RESEARCH AND TREATMENT OF CANCER [EORTC-QLQ-C-30]) AND PSYCHOLOGICAL DISTRESS (HOSPITAL ANXIETY DEPRESSION SCALE [HADS], IMPACT OF EVENTS SCALE [IES]) WERE MEASURED AT BASELINE (T0), 3 MONTHS (T1), AND 6 MONTHS (T2) AND ANALYZED ON OBSERVED CASES. OTHER OUTCOMES WERE ADEQUATE RELIEF, REINTEGRATION TO WORK, AND ADVERSE EVENTS. RESULTS: NO SIGNIFICANT DIFFERENCES WERE FOUND IN GENERAL FATIGUE AT T1 (MFI: YOGA; 14.6 +/- 4.5 VS. SC; 14.2 +/- 4.2, P = 0.987). SIMILAR FINDINGS WERE OBSERVED FOR OTHER FATIGUE (SUB)SCALES OF MFI AND FQL AND FUNCTIONAL DOMAINS OF EORTC. WITH RESPECT TO EORTCS SYMPTOM SCALES, WOMEN IN THE YOGA GROUP REPORTED SIGNIFICANTLY LESS NAUSEA AND VOMITING COMPARED WITH SC AT T2 (P = 0.004), BUT NOT AT T1 (P = 0.807). DEPRESSIVE SYMPTOMS WERE SIGNIFICANTLY LOWER WITH YOGA AT T1 (HADS: YOGA; 4.7 +/- 4.1 VS. SC; 5.1 +/- 4.2, P = 0.031). MORE WOMEN IN THE YOGA GROUP EXPERIENCED ADEQUATE RELIEF COMPARED WITH SC AT T1 (YOGA; 51% VS. SC; 19%) AND HAD RETURNED TO WORK AT T2 (YOGA; 53% VS. SC; 23%). NO ADVERSE EVENTS WERE REPORTED WITH YOGA. CONCLUSIONS: A DRU-BASED YOGA PROGRAM FAILED TO DEMONSTRATE A SIGNIFICANT BENEFICIAL EFFECT ON FATIGUE. POSSIBLE FAVORABLE EFFECTS OF THE YOGA PROGRAM ON NAUSEA AND VOMITING AND EARLY RETURN TO WORK IN BREAST CANCER SURVIVORS WARRANT FURTHER RESEARCH. 2018 17 1036 31 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 18 2549 38 YOGA FOR CANCER SURVIVORS WITH CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY: HEALTH-RELATED QUALITY OF LIFE OUTCOMES. BACKGROUND: YOGA IS A MEDITATIVE MOVEMENT THERAPY FOCUSED ON MIND-BODY AWARENESS. THE IMPACT OF YOGA ON HEALTH-RELATED QUALITY OF LIFE (HRQOL) OUTCOMES IN PATIENTS WITH CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY (CIPN) IS UNCLEAR. METHODS: WE CONDUCTED A PILOT RANDOMIZED WAIT-LIST CONTROLLED TRIAL OF 8 WEEKS OF YOGA (N = 21) VERSUS WAIT-LIST CONTROL (N = 20) FOR CIPN IN 41 BREAST AND GYNECOLOGICAL CANCER SURVIVORS WITH PERSISTENT MODERATE TO SEVERE CIPN. HRQOL ENDPOINTS WERE HOSPITAL ANXIETY AND DEPRESSION SCALE (HADS), BRIEF FATIGUE INVENTORY (BFI), AND INSOMNIA SEVERITY INDEX (ISI). THE TREATMENT EXPECTANCY SCALE (TES) WAS ADMINISTERED AT BASELINE. WE ESTIMATED MEAN CHANGES AND 95% CONFIDENCE INTERVALS (CIS) FROM BASELINE TO WEEKS 8 AND 12 AND COMPARED ARMS USING CONSTRAINED LINEAR MIXED MODELS. RESULTS: AT WEEK 8, HADS ANXIETY SCORES DECREASED -1.61 (-2.75, -0.46) IN THE YOGA ARM AND -0.32 (-1.38, 0.75) POINTS IN THE WAIT-LIST CONTROL ARM (P = 0.099). AT WEEK 12, HADS ANXIETY SCORES DECREASED -1.42 (-2.57, -0.28) IN YOGA COMPARED TO AN INCREASE OF 0.46 (-0.60, 1.53) IN WAIT-LIST CONTROL (P = 0.017). THERE WERE NO SIGNIFICANT DIFFERENCES IN HADS DEPRESSION, BFI, OR ISI SCORES BETWEEN YOGA AND WAIT-LIST CONTROL. BASELINE TES WAS SIGNIFICANTLY HIGHER IN YOGA THAN IN WAIT-LIST CONTROL (14.9 VS. 12.7, P = 0.019). TES WAS NOT ASSOCIATED WITH HADS ANXIETY REDUCTION AND HADS ANXIETY REDUCTION WAS NOT ASSOCIATED WITH CIPN PAIN REDUCTION. CONCLUSIONS: YOGA MAY REDUCE ANXIETY IN PATIENTS WITH CIPN. FUTURE STUDIES ARE NEEDED TO CONFIRM THESE FINDINGS. CLINICAL TRIAL REGISTRATION NUMBER: CLINICALTRIALS.GOV IDENTIFIER: NCT03292328. 2021 19 1177 22 EVALUATION OF SIDDHA SAMADHI YOGA FOR ANXIETY AND DEPRESSION SYMPTOMS: A PRELIMINARY STUDY. SIDDHA SAMADHI YOGA IS A PROGRAM IN WHICH MEDITATION IS ASSOCIATED WITH PRANAYAMA (BREATHING EXERCISES). 22 VOLUNTEERS WITH ANXIETY COMPLAINTS (M AGE = 42.8 YR., SD = 10.3) WERE ASSIGNED TO TWO GROUPS: 14 ATTENDED THE YOGA GROUP, AND 8 ATTENDED A WAITING-LIST OR CONTROL GROUP. THEY WERE EVALUATED BEFORE THE INTERVENTION AND 1 MONTH AFTER IT ON THE STATE-TRAIT ANXIETY INVENTORY, THE BECK DEPRESSION INVENTORY, TENSION FEELINGS SELF-EVALUATION SCALES, AND THE WELL-BEING SELF-EVALUATION SCALES. A SIGNIFICANT REDUCTION IN SCORES ON ANXIETY, DEPRESSION, AND TENSION WAS FOUND IN YOGA GROUP, AS WELL AS AN INCREASE IN WELL-BEING IN COMPARISON WITH THE CONTROL GROUP. 2008 20 165 39 A RANDOMIZED CONTROL TRIAL OF THE EFFECT OF YOGA ON VERBAL AGGRESSIVENESS IN NORMAL HEALTHY VOLUNTEERS. OBJECTIVE: TO STUDY THE EFFECT OF YOGA ON VERBAL AGGRESSIVENESS IN NORMAL HEALTHY ADULTS. METHODS: OF THE 1228 PERSONS WHO ATTENDED INTRODUCTORY LECTURES, 226 SUBJECTS OF BOTH SEXES WHO SATISFIED THE INCLUSION AND EXCLUSION CRITERIA AND WHO CONSENTED TO PARTICIPATE IN THE STUDY WERE RANDOMLY ALLOCATED INTO TWO GROUPS. THESE 226 SUBJECTS WERE BETWEEN THE AGES OF 17 AND 62 YEARS AND 173/226 COMPLETED THE EIGHT WEEKS OF INTERVENTION. THE YOGA (Y) GROUP PRACTISED AN INTEGRATED YOGA MODULE THAT INCLUDED ASANAS, PRANAYAMA, MEDITATION, NOTIONAL CORRECTION, AND DEVOTIONAL SESSIONS. THE CONTROL GROUP PRACTISED MILD TO MODERATE PHYSICAL EXERCISES (PE). BOTH GROUPS HAD SUPERVISED PRACTICES (BY TRAINED EXPERTS) FOR ONE HOUR DAILY, SIX DAYS A WEEK FOR EIGHT WEEKS. VERBAL AGGRESSIVENESS WAS ASSESSED BEFORE AND AFTER EIGHT WEEKS USING THE SELF-ADMINISTERED VERBAL AGGRESSIVE SCALE. RESULTS: THE BASELINE SCORE OF THE TWO GROUPS DID NOT DIFFER SIGNIFICANTLY (P = 0.66). THERE WAS A SIGNIFICANT DECREASE IN VERBAL AGGRESSIVENESS IN THE YOGA GROUP (P = 0.01 PAIRED SAMPLES T-TEST) WITH A NONSIGNIFICANT INCREASE IN THE PE GROUP. ANCOVA USING PRE- VALUES AS COVARIATES SHOWED A SIGNIFICANT DIFFERENCE BETWEEN THE GROUPS (P = 0.013). RMANOVA FOR INTERACTION BETWEEN THE SEXES OR AGE GROUPS IN CHANGE SCORES WERE NOT SIGNIFICANT. CONCLUSIONS: THIS STUDY HAS DEMONSTRATED THAT AN EIGHT WEEK INTERVENTION OF AN INTEGRATED YOGA MODULE DECREASED VERBAL AGGRESSIVENESS IN THE YOGA GROUP (IN MALES AND THOSE BELOW 25 YEARS OF AGE), WITH A NONSIGNIFICANT INCREASE IN THE PE GROUP. 2008