1 1113 175 EFFICACY OF A BIOMECHANICALLY-BASED YOGA EXERCISE PROGRAM IN KNEE OSTEOARTHRITIS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: CERTAIN EXERCISES COULD OVERLOAD THE OSTEOARTHRITIC KNEE. WE DEVELOPED AN EXERCISE PROGRAM FROM YOGA POSTURES WITH A MINIMAL KNEE ADDUCTION MOMENT FOR KNEE OSTEOARTHRITIS. THE PURPOSE WAS TO COMPARE THE EFFECTIVENESS OF THIS BIOMECHANICALLY-BASED YOGA EXERCISE (YE), WITH TRADITIONAL EXERCISE (TE), AND A NO-EXERCISE ATTENTION-EQUIVALENT CONTROL (NE) FOR IMPROVING PAIN, SELF-REPORTED PHYSICAL FUNCTION AND MOBILITY PERFORMANCE IN WOMEN WITH KNEE OSTEOARTHRITIS. DESIGN: SINGLE-BLIND, THREE-ARM RANDOMIZED CONTROLLED TRIAL. SETTING: COMMUNITY IN SOUTHWESTERN ONTARIO, CANADA. PARTICIPANTS: A CONVENIENCE SAMPLE OF 31 WOMEN WITH SYMPTOMATIC KNEE OSTEOARTHRITIS WAS RECRUITED THROUGH RHEUMATOLOGY, ORTHOPAEDIC AND PHYSIOTHERAPY CLINICS, NEWSPAPERS AND WORD-OF-MOUTH. INTERVENTIONS: PARTICIPANTS WERE STRATIFIED BY DISEASE SEVERITY AND RANDOMLY ALLOCATED TO ONE OF THREE 12-WEEK, SUPERVISED INTERVENTIONS. YE INCLUDED BIOMECHANICALLY-BASED YOGA EXERCISES; TE INCLUDED TRADITIONAL LEG STRENGTHENING ON MACHINES; AND NE INCLUDED MEDITATION WITH NO EXERCISE. PARTICIPANTS WERE ASKED TO ATTEND THREE 1-HOUR GROUP CLASSES/SESSIONS EACH WEEK. MEASUREMENTS: PRIMARY OUTCOMES WERE PAIN, SELF-REPORTED PHYSICAL FUNCTION AND MOBILITY PERFORMANCE. SECONDARY OUTCOMES WERE KNEE STRENGTH, DEPRESSION, AND HEALTH-RELATED QUALITY OF LIFE. ALL WERE ASSESSED BY A BLINDED ASSESSOR AT BASELINE AND IMMEDIATELY FOLLOWING THE INTERVENTION. RESULTS: THE YE GROUP DEMONSTRATED GREATER IMPROVEMENTS IN KOOS PAIN (MEAN DIFFERENCE OF 22.9 [95% CI, 6.9 TO 38.8; P = 0.003]), INTERMITTENT PAIN (MEAN DIFFERENCE OF -19.6 [95% CI, -34.8 TO -4.4; P = 0.009]) AND SELF-REPORTED PHYSICAL FUNCTION (MEAN DIFFERENCE OF 17.2 [95% CI, 5.2 TO 29.2; P = 0.003]) COMPARED TO NE. IMPROVEMENTS IN THESE OUTCOMES WERE SIMILAR BETWEEN YE AND TE. HOWEVER, TE DEMONSTRATED A GREATER IMPROVEMENT IN KNEE FLEXOR STRENGTH COMPARED TO YE (MEAN DIFFERENCE OF 0.1 [95% CI, 0.1 TO 0.2]. IMPROVEMENTS FROM BASELINE TO FOLLOW-UP WERE PRESENT IN QUALITY OF LIFE SCORE FOR YE AND KNEE FLEXOR STRENGTH FOR TE, WHILE BOTH ALSO DEMONSTRATED IMPROVEMENTS IN MOBILITY. NO IMPROVEMENT IN ANY OUTCOME WAS PRESENT IN NE. CONCLUSIONS: THE BIOMECHANICALLY-BASED YOGA EXERCISE PROGRAM PRODUCED CLINICALLY MEANINGFUL IMPROVEMENTS IN PAIN, SELF-REPORTED PHYSICAL FUNCTION AND MOBILITY IN WOMEN WITH CLINICAL KNEE OA COMPARED TO NO EXERCISE. WHILE NOT STATISTICALLY SIGNIFICANT, IMPROVEMENTS IN THESE OUTCOMES WERE LARGER THAN THOSE ELICITED FROM THE TRADITIONAL EXERCISE-BASED PROGRAM. THOUGH THIS MAY SUGGEST THAT THE YOGA PROGRAM MAY BE MORE EFFICACIOUS FOR KNEE OA, FUTURE RESEARCH STUDYING A LARGER SAMPLE IS REQUIRED. TRIAL REGISTRATION: CLINICALTRIALS.GOV (NCT02370667). 2018 2 983 42 EFFECTS OF HATA YOGA ON KNEE OSTEOARTHRITIS. BACKGROUND: THE PURPOSE OF THIS RESEARCH WAS TO STUDY THE EFFECTS OF 8 WEEKS OF HATA YOGA EXERCISES ON WOMEN WITH KNEE OSTEOARTHRITIS. STUDIES ABOUT EFFECTS OF YOGA ON DIFFERENT CHRONIC DISEASES SHOW THAT THESE EXERCISES HAVE POSITIVE EFFECTS ON CHRONIC DISEASES. AS KNEE OSTEOARTHRITIS IS VERY COMMON AMONG MIDDLE AGE WOMEN WE DECIDED TO MEASURE EFFECTIVENESS OF THESE EXERCISES ON KNEE OSTEOARTHRITIS. METHODS: SAMPLE INCLUDED 30 WOMEN WITH KNEE OSTEOARTHRITIS WHO VOLUNTARILY PARTICIPATED IN THIS SEMI-EXPERIMENTAL STUDY AND WERE DIVIDED INTO A CONTROL GROUP (15) AND A YOGA GROUP (15). THE YOGA GROUP RECEIVED 60 MINUTES SESSIONS OF HATA YOGA, 3 TIMES A WEEK AND FOR 8 WEEKS. PAIN, SYMPTOMS, DAILY ACTIVITIES, SPORTS AND SPARE-TIME ACTIVITIES, AND QUALITY OF LIFE WERE RESPECTIVELY MEASURED BY VISUAL ANALOG SCALE (VAS) AND KNEE INJURY AND OSTEOARTHRITIS OUTCOME SCALE (KOOS) QUESTIONNAIRE. THE ANALYSIS OF VARIANCE (ANOVA) METHOD FOR REPETITIVE DATA WAS USED TO ANALYZE THE RESULTS (P = 0.05). RESULTS: FINDINGS SHOWED THAT PAIN AND SYMPTOMS WERE SIGNIFICANTLY DECREASED AND SCORES OF DAILY ACTIVITIES, SPORTS, SPARE-TIME ACTIVITIES, AND QUALITY OF LIFE WERE SIGNIFICANTLY INCREASED IN THE YOGA GROUP. CONCLUSIONS: IT SEEMS THAT YOGA CAN BE USED AS A CONSERVATIVE TREATMENT BESIDES USUAL TREATMENTS AND MEDICATIONS TO IMPROVE THE CONDITION OF PEOPLE WITH OSTEOARTHRITIS. 2013 3 675 40 EFFECT OF A SIX-MONTH YOGA EXERCISE INTERVENTION ON FITNESS OUTCOMES FOR BREAST CANCER SURVIVORS. YOGA-BASED EXERCISE HAS PROVEN TO BE BENEFICIAL FOR PRACTITIONERS, INCLUDING CANCER SURVIVORS. THIS STUDY REPORTS ON THE IMPROVEMENTS IN PHYSICAL FITNESS FOR 20 BREAST CANCER SURVIVORS WHO PARTICIPATED IN A SIX-MONTH YOGA-BASED EXERCISE PROGRAM (YE). RESULTS ARE COMPARED TO A COMPREHENSIVE EXERCISE (CE) PROGRAM GROUP AND A COMPARISON (C) EXERCISE GROUP WHO CHOSE THEIR OWN EXERCISES. "PRE" AND "POST" FITNESS ASSESSMENTS INCLUDED MEASURES OF ANTHROPOMETRICS, CARDIORESPIRATORY CAPACITY, STRENGTH AND FLEXIBILITY. DESCRIPTIVE STATISTICS, EFFECT SIZE (D), DEPENDENT SAMPLE 'T' TESTS FOR ALL OUTCOME MEASURES WERE CALCULATED FOR THE YE GROUP. SIGNIFICANT IMPROVEMENTS INCLUDED: DECREASED % BODY FAT (-3.00%, D = -0.44, P < 0.001); INCREASED SIT TO STAND LEG STRENGTH REPETITIONS (2.05, D = 0.48, P = 0.003); FORWARD REACH (3.59 CM, D = 0.61, P = 0.01); AND RIGHT ARM SAGITTAL RANGE OF MOTION (6.50 DEGREES , D = 0.92, P = 0.05). TO COMPARE YE OUTCOMES WITH THE OTHER TWO GROUPS, A ONE-WAY ANALYSIS OF VARIANCE (ANOVA) WAS USED. YE PARTICIPANTS SIGNIFICANTLY OUTPERFORMED C PARTICIPANTS ON "FORWARD REACH" (3.59 CM GAINED VERSUS -2.44 CM LOST), (P = 0.009) AND OUTPERFORMED CE PARTICIPANTS (3.59 CM GAINED VERSUS 1.35 CM GAINED), BUT NOT STATISTICALLY SIGNIFICANT. OUR RESULTS SUPPORT YOGA-BASED EXERCISE MODIFIED FOR BREAST CANCER SURVIVORS AS SAFE AND EFFECTIVE. 2015 4 1133 53 EFFICACY OF YOGA FOR VASOMOTOR SYMPTOMS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THIS STUDY AIMS TO DETERMINE THE EFFICACY OF YOGA IN ALLEVIATING VASOMOTOR SYMPTOMS (VMS) FREQUENCY AND BOTHER. METHODS: THIS STUDY WAS A THREE-BY-TWO FACTORIAL, RANDOMIZED CONTROLLED TRIAL. ELIGIBLE WOMEN WERE RANDOMIZED TO YOGA (N = 107), EXERCISE (N = 106), OR USUAL ACTIVITY (N = 142), AND WERE SIMULTANEOUSLY RANDOMIZED TO A DOUBLE-BLIND COMPARISON OF OMEGA-3 FATTY ACID (N = 177) OR PLACEBO (N = 178) CAPSULES. YOGA INTERVENTION CONSISTED OF 12 WEEKLY 90-MINUTE YOGA CLASSES WITH DAILY HOME PRACTICE. PRIMARY OUTCOMES WERE VMS FREQUENCY AND BOTHER ASSESSED BY DAILY DIARIES AT BASELINE, 6 WEEKS, AND 12 WEEKS. SECONDARY OUTCOMES INCLUDED INSOMNIA SYMPTOMS (INSOMNIA SEVERITY INDEX) AT BASELINE AND 12 WEEKS. RESULTS: AMONG 249 RANDOMIZED WOMEN, 237 (95%) COMPLETED 12-WEEK ASSESSMENTS. THE MEAN BASELINE VMS FREQUENCY WAS 7.4 PER DAY (95% CI, 6.6 TO 8.1) IN THE YOGA GROUP AND 8.0 PER DAY (95% CI, 7.3 TO 8.7) IN THE USUAL ACTIVITY GROUP. INTENT-TO-TREAT ANALYSES INCLUDED ALL PARTICIPANTS WITH RESPONSE DATA (N = 237). THERE WAS NO DIFFERENCE BETWEEN INTERVENTION GROUPS IN THE CHANGE IN VMS FREQUENCY FROM BASELINE TO 6 AND 12 WEEKS (MEAN DIFFERENCE [YOGA--USUAL ACTIVITY] FROM BASELINE AT 6 WK, -0.3 [95% CI, -1.1 TO 0.5]; MEAN DIFFERENCE [YOGA--USUAL ACTIVITY] FROM BASELINE AT 12 WK, -0.3 [95% CI, -1.2 TO 0.6]; P = 0.119 ACROSS BOTH TIME POINTS). RESULTS WERE SIMILAR FOR VMS BOTHER. AT WEEK 12, YOGA WAS ASSOCIATED WITH AN IMPROVEMENT IN INSOMNIA SYMPTOMS (MEAN DIFFERENCE [YOGA - USUAL ACTIVITY] IN THE CHANGE IN INSOMNIA SEVERITY INDEX, 1.3 [95% CI, -2.5 TO -0.1]; P = 0.007). CONCLUSIONS: AMONG HEALTHY WOMEN, 12 WEEKS OF YOGA CLASS PLUS HOME PRACTICE, COMPARED WITH USUAL ACTIVITY, DO NOT IMPROVE VMS FREQUENCY OR BOTHER BUT REDUCE INSOMNIA SYMPTOMS. 2014 5 253 68 A YOGA STRENGTHENING PROGRAM DESIGNED TO MINIMIZE THE KNEE ADDUCTION MOMENT FOR WOMEN WITH KNEE OSTEOARTHRITIS: A PROOF-OF-PRINCIPLE COHORT STUDY. UNLABELLED: PEOPLE WITH KNEE OSTEOARTHRITIS MAY BENEFIT FROM EXERCISE PRESCRIPTIONS THAT MINIMIZE KNEE LOADS IN THE FRONTAL PLANE. THE PRIMARY OBJECTIVE OF THIS STUDY WAS TO DETERMINE WHETHER A NOVEL 12-WEEK STRENGTHENING PROGRAM DESIGNED TO MINIMIZE EXPOSURE TO THE KNEE ADDUCTION MOMENT (KAM) COULD IMPROVE SYMPTOMS AND KNEE STRENGTH IN WOMEN WITH SYMPTOMATIC KNEE OSTEOARTHRITIS. A SECONDARY OBJECTIVE WAS TO DETERMINE WHETHER THE PROGRAM COULD IMPROVE MOBILITY AND FITNESS, AND DECREASE PEAK KAM DURING GAIT. THE TERTIARY OBJECTIVE WAS TO EVALUATE THE BIOMECHANICAL CHARACTERISTICS OF THIS YOGA PROGRAM. IN PARTICULAR, WE COMPARED THE PEAK KAM DURING GAIT WITH THAT DURING YOGA POSTURES AT BASELINE. WE ALSO COMPARED LOWER LIMB NORMALIZED MEAN ELECTROMYOGRAPHY (EMG) AMPLITUDES DURING YOGA POSTURES BETWEEN BASELINE AND FOLLOW-UP. PRIMARY MEASURES INCLUDED SELF-REPORTED PAIN AND PHYSICAL FUNCTION (KNEE INJURY AND OSTEOARTHRITIS OUTCOME SCORE) AND KNEE STRENGTH (EXTENSOR AND FLEXOR TORQUES). SECONDARY MEASURES INCLUDED MOBILITY (SIX-MINUTE WALK, 30-SECOND CHAIR STAND, STAIR CLIMBING), FITNESS (SUBMAXIMAL CYCLE ERGOMETER TEST), AND CLINICAL GAIT ANALYSIS USING MOTION CAPTURE SYNCHRONIZED WITH ELECTROMYOGRAPHY AND FORCE MEASUREMENT. ALSO, KAM AND NORMALIZED MEAN EMG AMPLITUDES WERE COLLECTED DURING YOGA POSTURES. FORTY-FIVE WOMEN OVER AGE 50 WITH SYMPTOMATIC KNEE OSTEOARTHRITIS, CONSISTENT WITH THE AMERICAN COLLEGE OF RHEUMATOLOGY CRITERIA, ENROLLED IN OUR 12-WEEK (3 SESSIONS PER WEEK) PROGRAM. DATA FROM 38 WERE ANALYZED (SIX DROP-OUTS; ONE LOST TO CO-INTERVENTION). PARTICIPANTS EXPERIENCED REDUCED PAIN (MEAN IMPROVEMENT 10.1-20.1 NORMALIZED TO 100; P<0.001), INCREASED KNEE EXTENSOR STRENGTH (MEAN IMPROVEMENT 0.01 NM/KG; P = 0.004), AND INCREASED FLEXOR STRENGTH (MEAN IMPROVEMENT 0.01 NM/KG; P = 0.001) AT FOLLOW-UP COMPARED TO BASELINE. PARTICIPANTS IMPROVED MOBILITY ON THE SIX-MINUTE WALK (MEAN IMPROVEMENT 37.7 M; P<0.001) AND 30-SECOND CHAIR STAND (MEAN IMPROVEMENT 1.3; P = 0.006) AT FOLLOW-UP COMPARED TO BASELINE. FITNESS AND PEAK KAM DURING GAIT WERE UNCHANGED BETWEEN BASELINE AND FOLLOW-UP. AVERAGE KAM DURING THE YOGA POSTURES WERE LOWER THAN THAT OF NORMAL GAIT. NORMALIZED MEAN EMG AMPLITUDES DURING YOGA POSTURES WERE UP TO 31.0% OF MAXIMUM BUT DID NOT CHANGE BETWEEN BASELINE AND FOLLOW-UP. IN THIS COHORT STUDY, THE YOGA-BASED STRENGTHENING POSTURES THAT ELICIT LOW KAMS IMPROVED KNEE SYMPTOMS AND STRENGTH IN WOMEN WITH KNEE OA FOLLOWING A 12 WEEK PROGRAM (3 SESSIONS PER WEEK). THE PROGRAM ALSO IMPROVED MOBILITY, BUT DID NOT IMPROVE FITNESS OR REDUCE PEAK KAM DURING GAIT. THE KAM DURING THE YOGA POSTURES WERE LOWER THAN THAT OF NORMAL GAIT. OVERALL, THE PROPOSED PROGRAM MAY BE USEFUL IN IMPROVING PAIN, STRENGTH, AND MOBILITY IN WOMEN WITH KNEE OSTEOARTHRITIS. CLINICAL EFFICACY NEEDS TO BE ASSESSED USING A RANDOMIZED CONTROLLED TRIAL DESIGN. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT02146105. 2015 6 521 53 COMPARING YOGA, EXERCISE, AND A SELF-CARE BOOK FOR CHRONIC LOW BACK PAIN: A RANDOMIZED, CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN IS A COMMON PROBLEM THAT HAS ONLY MODESTLY EFFECTIVE TREATMENT OPTIONS. OBJECTIVE: TO DETERMINE WHETHER YOGA IS MORE EFFECTIVE THAN CONVENTIONAL THERAPEUTIC EXERCISE OR A SELF-CARE BOOK FOR PATIENTS WITH CHRONIC LOW BACK PAIN. DESIGN: RANDOMIZED, CONTROLLED TRIAL. SETTING: A NONPROFIT, INTEGRATED HEALTH CARE SYSTEM. PATIENTS: 101 ADULTS WITH CHRONIC LOW BACK PAIN. INTERVENTION: 12-WEEK SESSIONS OF YOGA OR CONVENTIONAL THERAPEUTIC EXERCISE CLASSES OR A SELF-CARE BOOK. MEASUREMENTS: PRIMARY OUTCOMES WERE BACK-RELATED FUNCTIONAL STATUS (MODIFIED 24-POINT ROLAND DISABILITY SCALE) AND "BOTHERSOMENESS" OF PAIN (11-POINT NUMERICAL SCALE). THE PRIMARY TIME POINT WAS 12 WEEKS. CLINICALLY SIGNIFICANT CHANGE WAS CONSIDERED TO BE 2.5 POINTS ON THE FUNCTIONAL STATUS SCALE AND 1.5 POINTS ON THE BOTHERSOMENESS SCALE. SECONDARY OUTCOMES WERE DAYS OF RESTRICTED ACTIVITY, GENERAL HEALTH STATUS, AND MEDICATION USE. RESULTS: AFTER ADJUSTMENT FOR BASELINE VALUES, BACK-RELATED FUNCTION IN THE YOGA GROUP WAS SUPERIOR TO THE BOOK AND EXERCISE GROUPS AT 12 WEEKS (YOGA VS. BOOK: MEAN DIFFERENCE, -3.4 [95% CI, -5.1 TO - 1.6] [P < 0.001]; YOGA VS. EXERCISE: MEAN DIFFERENCE, -1.8 [CI, -3.5 TO - 0.1] [P = 0.034]). NO SIGNIFICANT DIFFERENCES IN SYMPTOM BOTHERSOMENESS WERE FOUND BETWEEN ANY 2 GROUPS AT 12 WEEKS; AT 26 WEEKS, THE YOGA GROUP WAS SUPERIOR TO THE BOOK GROUP WITH RESPECT TO THIS MEASURE (MEAN DIFFERENCE, -2.2 [CI, -3.2 TO - 1.2]; P < 0.001). AT 26 WEEKS, BACK-RELATED FUNCTION IN THE YOGA GROUP WAS SUPERIOR TO THE BOOK GROUP (MEAN DIFFERENCE, -3.6 [CI, -5.4 TO - 1.8]; P < 0.001). LIMITATIONS: PARTICIPANTS IN THIS STUDY WERE FOLLOWED FOR ONLY 26 WEEKS AFTER RANDOMIZATION. ONLY 1 INSTRUCTOR DELIVERED EACH INTERVENTION. CONCLUSIONS: YOGA WAS MORE EFFECTIVE THAN A SELF-CARE BOOK FOR IMPROVING FUNCTION AND REDUCING CHRONIC LOW BACK PAIN, AND THE BENEFITS PERSISTED FOR AT LEAST SEVERAL MONTHS. 2005 7 963 44 EFFECTS OF A YOGA PROGRAM ON MENSTRUAL CRAMPS AND MENSTRUAL DISTRESS IN UNDERGRADUATE STUDENTS WITH PRIMARY DYSMENORRHEA: A SINGLE-BLIND, RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: TO INVESTIGATE THE EFFECTS OF A YOGA PROGRAM ON MENSTRUAL CRAMPS AND MENSTRUAL DISTRESS IN UNDERGRADUATE STUDENTS WITH PRIMARY DYSMENORRHEA. DESIGN: SINGLE-BLIND, RANDOMIZED CONTROLLED TRIAL. PARTICIPANTS: 40 RANDOMLY SELECTED UNDERGRADUATE NURSING STUDENTS, WITH 20 EACH ASSIGNED TO AN EXERCISE OR A CONTROL GROUP. INTERVENTION: THE PARTICIPANTS ENGAGED IN A YOGA PROGRAM FOR 60 MINUTES ONCE A WEEK FOR 12 WEEKS. THE PROGRAM CONSISTED OF PHYSICAL EXERCISE COMBINED WITH RELAXATION AND MEDITATION. OUTCOME MEASURES: MENSTRUAL CRAMPS AND MENSTRUAL DISTRESS LEVELS WERE MEASURED BY USING THE VISUAL ANALOGUE SCALE FOR PAIN AND THE MENSTRUAL DISTRESS QUESTIONNAIRE, RESPECTIVELY. DATA WERE ANALYZED BY USING THE KOLMOGOROV-SMIRNOV AND SHAPIRO-WILK NORMALITY TESTS, T-TEST, CHI-SQUARE TEST, LOGISTIC REGRESSION ANALYSIS, AND MULTIVARIATE ANALYSIS OF VARIANCE (SPSS PROGRAM). RESULTS: MENSTRUAL PAIN INTENSITY (GROUP DIFFERENCE, -0.94; 95% CONFIDENCE INTERVAL [CI], -1.47 TO -0.42; P = 0.001) AND MENSTRUAL DISTRESS (GROUP DIFFERENCE, -1.13; 95% CI, -1.43 TO -0.82; P < 0.0001) SCORES DECREASED SIGNIFICANTLY IN THE EXPERIMENTAL GROUP COMPARED WITH THE CONTROL GROUP. CONCLUSIONS: THESE FINDINGS INDICATE THAT YOGA INTERVENTIONS MAY REDUCE MENSTRUAL CRAMPS AND MENSTRUAL DISTRESS IN FEMALE UNDERGRADUATE STUDENTS WITH PRIMARY DYSMENORRHEA. 2016 8 507 52 COMPARATIVE EFFECTIVENESS OF PILATES AND YOGA GROUP EXERCISE INTERVENTIONS FOR CHRONIC MECHANICAL NECK PAIN: QUASI-RANDOMISED PARALLEL CONTROLLED STUDY. OBJECTIVES: TO DETERMINE THE EFFECTIVENESS OF PILATES AND YOGA GROUP EXERCISE INTERVENTIONS FOR INDIVIDUALS WITH CHRONIC NECK PAIN (CNP). DESIGN: QUASI-RANDOMISED PARALLEL CONTROLLED STUDY. SETTING: COMMUNITY, UNIVERSITY AND PRIVATE PRACTICE SETTINGS IN FOUR LOCATIONS. PARTICIPANTS: FIFTY-SIX INDIVIDUALS WITH CNP SCORING >/=3/10 ON THE NUMERIC PAIN RATING SCALE FOR >3 MONTHS (CONTROLS N=17, PILATES N=20, YOGA N=19). INTERVENTIONS: EXERCISE PARTICIPANTS COMPLETED 12 SMALL-GROUP SESSIONS WITH MODIFICATIONS AND PROGRESSIONS SUPERVISED BY A PHYSIOTHERAPIST. MAIN OUTCOME MEASURES: THE PRIMARY OUTCOME MEASURE WAS THE NECK DISABILITY INDEX (NDI). SECONDARY OUTCOMES WERE PAIN RATINGS, RANGE OF MOVEMENT AND POSTURAL MEASUREMENTS COLLECTED AT BASELINE, 6 WEEKS AND 12 WEEKS. FOLLOW-UP WAS PERFORMED 6 WEEKS AFTER COMPLETION OF THE EXERCISE CLASSES (WEEK 18). RESULTS: NDI DECREASED SIGNIFICANTLY IN THE PILATES {BASELINE: 11.1 [STANDARD DEVIATION (SD) 4.3] VS WEEK 12: 6.8 (SD 4.3); MEAN DIFFERENCE -4.3 (95% CONFIDENCE INTERVAL -1.64 TO -6.7); P<0.001} AND YOGA GROUPS [BASELINE: 12.8 (SD 7.4) VS WEEK 12: 8.1 (SD 5.6); MEAN DIFFERENCE -4.7 (95% CONFIDENCE INTERVAL -2.1 TO -7.4); P<0.00], WITH NO CHANGE IN THE CONTROL GROUP. PAIN RATINGS ALSO IMPROVED SIGNIFICANTLY. MODERATE-TO-LARGE EFFECT SIZES (0.7 TO 1.8) AND LOW NUMBERS NEEDED TO TREAT WERE FOUND. THERE WERE NO DIFFERENCES IN OUTCOMES BETWEEN THE EXERCISE GROUPS OR ASSOCIATED ADVERSE EFFECTS. NO IMPROVEMENTS IN RANGE OF MOVEMENT OR POSTURE WERE FOUND. CONCLUSIONS: PILATES AND YOGA GROUP EXERCISE INTERVENTIONS WITH APPROPRIATE MODIFICATIONS AND SUPERVISION WERE SAFE AND EQUALLY EFFECTIVE FOR DECREASING DISABILITY AND PAIN COMPARED WITH THE CONTROL GROUP FOR INDIVIDUALS WITH MILD-TO-MODERATE CNP. PHYSIOTHERAPISTS MAY CONSIDER INCLUDING THESE APPROACHES IN A PLAN OF CARE. CLINICAL TRIAL REGISTRATION NUMBER: CLINICALTRIALS.GOV NCT01999283. 2016 9 550 48 CONTROLLED PILOT STUDY OF THE EFFECTS OF POWER YOGA IN PARKINSON'S DISEASE. OBJECTIVES: TO EVALUATE THE EFFECTS OF A SPECIALLY DESIGNED POWER YOGA PROGRAM (YOGA) ON BRADYKINESIA, RIGIDITY, MUSCULAR PERFORMANCE AND QUALITY OF LIFE IN OLDER PATIENTS WITH PD. DESIGN: RANDOMIZED CONTROLLED TRIAL. SETTING: UNIVERSITY LABORATORY, US. INTERVENTION: TWENTY-SIX PATIENTS WITH MILD TO MODERATE PD WERE RANDOMLY ASSIGNED TO A YOGA OR CONTROL GROUP (CON). THE YOGA PROGRAM WAS THREE MONTHS, INCORPORATING TWO SESSIONS/WK OF YOGA CLASSES. MAIN OUTCOME MEASURES: UPPER AND LOWER LIMB BRADYKINESIA AND RIGIDITY SCORES FROM THE UNIFIED PARKINSON'S DISEASE RATING SCALE, ONE REPETITION MAXIMUMS (1RM) AND PEAK POWERS ON BICEPS CURL, CHEST PRESS, LEG PRESS, HIP ABDUCTION AND SEATED CALF, AND QUALITY OF LIFE (PDQ-39). RESULTS: THE YOGA GROUP PRODUCED SIGNIFICANT IMPROVEMENT IN BOTH UPPER AND LOWER LIMBS BRADYKINESIA SCORES, RIGIDITY SCORE, 1RM FOR ALL 5 MACHINES AND LEG PRESS POWER (P<.05). SIGNIFICANT IMPROVEMENTS WERE SEEN IN THE PDQ-39 OVERALL SCORE, MOBILITY AND ACTIVITIES OF DAILY LIVING DOMAIN FOR THE YOGA GROUP. CONCLUSION: THE 3-MONTH YOGA PROGRAM SIGNIFICANTLY REDUCED BRADYKINESIA AND RIGIDITY, AND INCREASED MUSCLE STRENGTH AND POWER IN OLDER PATIENTS WITH PD. POWER TRAINING IS AN EFFECTIVE TRAINING MODALITY TO IMPROVE PHYSICAL FUNCTION AND QUALITY OF LIFE FOR PD. 2016 10 1602 55 MENOPAUSAL QUALITY OF LIFE: RCT OF YOGA, EXERCISE, AND OMEGA-3 SUPPLEMENTS. OBJECTIVE: THE PURPOSE OF THIS STUDY WAS TO DETERMINE THE EFFICACY OF 3 NONHORMONAL THERAPIES FOR THE IMPROVEMENT OF MENOPAUSE-RELATED QUALITY OF LIFE IN WOMEN WITH VASOMOTOR SYMPTOMS. STUDY DESIGN: WE CONDUCTED A 12-WEEK 3 X 2 RANDOMIZED, CONTROLLED, FACTORIAL DESIGN TRIAL. PERI- AND POSTMENOPAUSAL WOMEN, 40-62 YEARS OLD, WERE ASSIGNED RANDOMLY TO YOGA (N = 107), EXERCISE (N = 106), OR USUAL ACTIVITY (N = 142) AND ALSO ASSIGNED RANDOMLY TO A DOUBLE-BLIND COMPARISON OF OMEGA-3 (N = 177) OR PLACEBO (N = 178) CAPSULES. WE PERFORMED THE FOLLOWING INTERVENTIONS: (1) WEEKLY 90-MINUTE YOGA CLASSES WITH DAILY AT-HOME PRACTICE, (2) INDIVIDUALIZED FACILITY-BASED AEROBIC EXERCISE TRAINING 3 TIMES/WEEK, AND (3) 0.615 G OMEGA-3 SUPPLEMENT, 3 TIMES/DAY. THE OUTCOMES WERE ASSESSED WITH THE FOLLOWING SCORES: MENOPAUSAL QUALITY OF LIFE QUESTIONNAIRE (MENQOL) TOTAL AND DOMAIN (VASOMOTOR SYMPTOMS, PSYCHOSOCIAL, PHYSICAL AND SEXUAL). RESULTS: AMONG 355 RANDOMLY ASSIGNED WOMEN WHO AVERAGE AGE WAS 54.7 YEARS, 338 WOMEN (95%) COMPLETED 12-WEEK ASSESSMENTS. MEAN BASELINE VASOMOTOR SYMPTOMS FREQUENCY WAS 7.6/DAY, AND THE MEAN BASELINE TOTAL MENQOL SCORE WAS 3.8 (RANGE, 1-8 FROM BETTER TO WORSE) WITH NO BETWEEN-GROUP DIFFERENCES. FOR YOGA COMPARED TO USUAL ACTIVITY, BASELINE TO 12-WEEK IMPROVEMENTS WERE SEEN FOR MENQOL TOTAL -0.3 (95% CONFIDENCE INTERVAL, -0.6 TO 0; P = .02), VASOMOTOR SYMPTOM DOMAIN (P = .02), AND SEXUALITY DOMAIN (P = .03) SCORES. FOR WOMEN WHO UNDERWENT EXERCISE AND OMEGA-3 THERAPY COMPARED WITH CONTROL SUBJECTS, IMPROVEMENTS IN BASELINE TO 12-WEEK TOTAL MENQOL SCORES WERE NOT OBSERVED. EXERCISE SHOWED BENEFIT IN THE MENQOL PHYSICAL DOMAIN SCORE AT 12 WEEKS (P = .02). CONCLUSION: ALL WOMEN BECOME MENOPAUSAL, AND MANY OF THEM SEEK MEDICAL ADVICE ON WAYS TO IMPROVE QUALITY OF LIFE; LITTLE EVIDENCE-BASED INFORMATION EXISTS. WE FOUND THAT, AMONG HEALTHY SEDENTARY MENOPAUSAL WOMEN, YOGA APPEARS TO IMPROVE MENOPAUSAL QUALITY OF LIFE; THE CLINICAL SIGNIFICANCE OF OUR FINDING IS UNCERTAIN BECAUSE OF THE MODEST EFFECT. 2014 11 193 47 A RANDOMIZED TRIAL COMPARING YOGA, STRETCHING, AND A SELF-CARE BOOK FOR CHRONIC LOW BACK PAIN. BACKGROUND: CHRONIC LOW BACK PAIN IS A COMMON PROBLEM LACKING HIGHLY EFFECTIVE TREATMENT OPTIONS. SMALL TRIALS SUGGEST THAT YOGA MAY HAVE BENEFITS FOR THIS CONDITION. THIS TRIAL WAS DESIGNED TO DETERMINE WHETHER YOGA IS MORE EFFECTIVE THAN CONVENTIONAL STRETCHING EXERCISES OR A SELF-CARE BOOK FOR PRIMARY CARE PATIENTS WITH CHRONIC LOW BACK PAIN. METHODS: A TOTAL OF 228 ADULTS WITH CHRONIC LOW BACK PAIN WERE RANDOMIZED TO 12 WEEKLY CLASSES OF YOGA (92 PATIENTS) OR CONVENTIONAL STRETCHING EXERCISES (91 PATIENTS) OR A SELF-CARE BOOK (45 PATIENTS). BACK-RELATED FUNCTIONAL STATUS (MODIFIED ROLAND DISABILITY QUESTIONNAIRE, A 23-POINT SCALE) AND BOTHERSOMENESS OF PAIN (AN 11-POINT NUMERICAL SCALE) AT 12 WEEKS WERE THE PRIMARY OUTCOMES. OUTCOMES WERE ASSESSED AT BASELINE, 6, 12, AND 26 WEEKS BY INTERVIEWERS UNAWARE OF TREATMENT GROUP. RESULTS: AFTER ADJUSTMENT FOR BASELINE VALUES, 12-WEEK OUTCOMES FOR THE YOGA GROUP WERE SUPERIOR TO THOSE FOR THE SELF-CARE GROUP (MEAN DIFFERENCE FOR FUNCTION, -2.5 [95% CI, -3.7 TO -1.3]; P < .001; MEAN DIFFERENCE FOR SYMPTOMS, -1.1 [95% CI, -1.7 TO -0.4]; P < .001). AT 26 WEEKS, FUNCTION FOR THE YOGA GROUP REMAINED SUPERIOR (MEAN DIFFERENCE, -1.8 [95% CI, -3.1 TO -0.5]; P < .001). YOGA WAS NOT SUPERIOR TO CONVENTIONAL STRETCHING EXERCISES AT ANY TIME POINT. CONCLUSION: YOGA CLASSES WERE MORE EFFECTIVE THAN A SELF-CARE BOOK, BUT NOT MORE EFFECTIVE THAN STRETCHING CLASSES, IN IMPROVING FUNCTION AND REDUCING SYMPTOMS DUE TO CHRONIC LOW BACK PAIN, WITH BENEFITS LASTING AT LEAST SEVERAL MONTHS. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT00447668. 2011 12 2193 40 THE EFFECTS OF YOGA TRAINING AND A SINGLE BOUT OF YOGA ON DELAYED ONSET MUSCLE SORENESS IN THE LOWER EXTREMITY. THE PURPOSE OF THIS STUDY WAS TO DETERMINE THE EFFECTS OF YOGA TRAINING AND A SINGLE BOUT OF YOGA ON THE INTENSITY OF DELAYED ONSET MUSCLE SORENESS (DOMS). 24 YOGA-TRAINED (YT; N = 12) AND NON-YOGA-TRAINED (CON; N = 12), MATCHED WOMEN VOLUNTEERS WERE ADMINISTERED A DOMS-INDUCING BENCH-STEPPING EXERCISE. MUSCLE SORENESS WAS ASSESSED AT BASELINE, 24, 48, 72, 96, AND 120 HOURS AFTER BENCH-STEPPING USING A VISUAL ANALOG SCALE (VAS). GROUPS WERE ALSO COMPARED ON BODY AWARENESS (BA), FLEXIBILITY USING THE SIT-AND-REACH TEST (SR), AND PERCEIVED EXERTION (RPE). STATISTICAL SIGNIFICANCE WAS ACCEPTED AT P /=12 WEEKS: YOGA (N=27), PT (N=26). METHODS: YOGA PARTICIPANTS ATTENDED A 6-WEEK, ONCE WEEKLY, 2-HOUR YOGA CLASS. PT PARTICIPANTS UNDERWENT TWICE WEEKLY, 1-HOUR INDIVIDUALIZED PT. DATA WERE COLLECTED AT BASELINE AND AT 6 WEEKS. GROUPS WERE COMPARED BY USING CHI2 AND INDEPENDENT SAMPLES T-TESTS. HIERARCHICAL LINEAR REGRESSION WAS USED TO PREDICT TREATMENT OUTCOMES. MAIN OUTCOME MEASURES: DISABILITY (ROLAND MORRIS DISABILITY QUESTIONNAIRE), HEALTH STATUS (RAND SHORT FORM 36 HEALTH SURVEY 1.0), PAIN BOTHERSOMENESS (NUMERICAL RATING SCALE), BACK PAIN SELF-EFFICACY (BACK PAIN SELF-EFFICACY SCALE), AND TREATMENT SATISFACTION. RESULTS: AT BASELINE, YOGA PARTICIPANTS WERE SIGNIFICANTLY LESS DISABLED (P=.013), HAD HIGHER HEALTH STATUS (P=.023), GREATER PAIN SELF-EFFICACY (P=.012), AND LESS AVERAGE PAIN BOTHERSOMENESS (P=.001) COMPARED WITH PT PARTICIPANTS. AT 6 WEEKS, WHEN CONTROLLING FOR BASELINE GROUP DIFFERENCES, GREATER PAIN SELF-EFFICACY WAS THE STRONGEST PREDICTOR FOR REDUCED PAIN AND HIGHER FUNCTION FOR THE ENTIRE SAMPLE. A SIGNIFICANT GROUP INTERACTION BY BASELINE PAIN SELF-EFFICACY PREDICTED DISABILITY AT 6 WEEKS. PT PARTICIPANTS WITH LOW PAIN SELF-EFFICACY REPORTED SIGNIFICANTLY GREATER DISABILITY THAN THOSE WITH HIGH PAIN SELF-EFFICACY. YOGA PARTICIPANTS WITH LOW AND HIGH PAIN SELF-EFFICACY HAD SIMILAR DISABILITY OUTCOMES. CONCLUSION: THESE FINDINGS STRENGTHEN EVIDENCE THAT SELF-EFFICACY IS ASSOCIATED WITH CLBP OUTCOMES, ESPECIALLY IN INDIVIDUALS SELF-SELECTING PT. FURTHER RESEARCH TO EVALUATE OUTCOMES AFTER YOGA AND PT IN PARTICIPANTS WITH LOW PAIN SELF-EFFICACY IS NEEDED. 2010 18 34 52 A 12-WEEK IYENGAR YOGA PROGRAM IMPROVED BALANCE AND MOBILITY IN OLDER COMMUNITY-DWELLING PEOPLE: A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: EXERCISE THAT CHALLENGES BALANCE CAN IMPROVE MOBILITY AND PREVENT FALLS IN OLDER ADULTS. YOGA AS A PHYSICAL ACTIVITY OPTION FOR OLDER ADULTS IS NOT WELL STUDIED. THIS TRIAL EVALUATED THE FEASIBILITY AND EFFECT OF A 12-WEEK IYENGAR YOGA PROGRAM ON BALANCE AND MOBILITY IN OLDER PEOPLE. METHODS: WE CONDUCTED A BLINDED, PILOT RANDOMIZED CONTROLLED TRIAL WITH INTENTION-TO-TREAT ANALYSIS. PARTICIPANTS WERE 54 COMMUNITY DWELLERS (MEAN AGE 68 YEARS, SD 7.1) NOT CURRENTLY PARTICIPATING IN YOGA OR TAI CHI. THE INTERVENTION GROUP (N = 27) PARTICIPATED IN A 12-WEEK, TWICE-WEEKLY YOGA PROGRAM FOCUSED ON STANDING POSTURES AND RECEIVED A FALL PREVENTION EDUCATION BOOKLET. THE CONTROL GROUP (N = 27) RECEIVED THE EDUCATION BOOKLET ONLY. PRIMARY OUTCOME WAS STANDING BALANCE COMPONENT OF THE SHORT PHYSICAL PERFORMANCE BATTERY WITH ADDITION OF ONE-LEGGED STANCE TIME (STANDING BALANCE). SECONDARY OUTCOMES WERE THE TIMED SIT-TO-STAND TEST, TIMED 4-M WALK, ONE-LEGGED STAND WITH EYES CLOSED, AND SHORT FALLS EFFICACY SCALE-INTERNATIONAL. FEASIBILITY WAS MEASURED BY RECORDING CLASS ATTENDANCE AND ADVERSE EVENTS. RESULTS: FIFTY-TWO PARTICIPANTS COMPLETED FOLLOW-UP ASSESSMENTS. THE INTERVENTION GROUP SIGNIFICANTLY IMPROVED COMPARED WITH CONTROL GROUP ON STANDING BALANCE (MEAN DIFFERENCE = 1.52 SECONDS, 95% CI 0.10-2.96, P = .04), SIT-TO-STAND TEST (MEAN DIFFERENCE = -3.43 SECONDS, 95% CI -5.23 TO -1.64, P < .001), 4-M WALK (MEAN DIFFERENCE = -0.50 SECONDS, 95% CI -0.72 TO -0.28, P < .001), AND ONE-LEGGED STAND WITH EYES CLOSED (MEAN DIFFERENCE = 1.93 SECONDS, 95% CI 0.40-3.46, P = .02). AVERAGE CLASS ATTENDANCE WAS 20 OF 24 CLASSES (83%). NO SERIOUS ADVERSE EVENTS OCCURRED. CONCLUSIONS: THIS TRIAL DEMONSTRATES THE BALANCE AND MOBILITY-RELATED BENEFITS AND FEASIBILITY OF IYENGAR YOGA FOR OLDER PEOPLE. THE FALL PREVENTION EFFECT OF IYENGAR YOGA WARRANTS FURTHER INVESTIGATION. 2013 19 388 55 BENEFITS OF THE RESTORATIVE EXERCISE AND STRENGTH TRAINING FOR OPERATIONAL RESILIENCE AND EXCELLENCE YOGA PROGRAM FOR CHRONIC LOW BACK PAIN IN SERVICE MEMBERS: A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: TO EXAMINE THE FEASIBILITY AND PRELIMINARY EFFECTIVENESS OF AN INDIVIDUALIZED YOGA PROGRAM. DESIGN: PILOT RANDOMIZED CONTROLLED TRIAL. SETTING: MILITARY MEDICAL CENTER. PARTICIPANTS: PATIENTS (N=68) WITH CHRONIC LOW BACK PAIN. INTERVENTIONS: RESTORATIVE EXERCISE AND STRENGTH TRAINING FOR OPERATIONAL RESILIENCE AND EXCELLENCE (RESTORE) PROGRAM (9-12 INDIVIDUAL YOGA SESSIONS) OR TREATMENT AS USUAL (CONTROL) FOR AN 8-WEEK PERIOD. MAIN OUTCOME MEASURES: THE PRIMARY OUTCOME WAS PAST 24-HOUR PAIN (DEFENSE & VETERANS PAIN RATING SCALE 2.0). SECONDARY OUTCOMES INCLUDED DISABILITY (ROLAND-MORRIS DISABILITY QUESTIONNAIRE) AND PHYSICAL FUNCTIONING AND SYMPTOM BURDEN (PATIENT-REPORTED OUTCOMES MEASUREMENT INFORMATION SYSTEM-29 SUBSCALES). ASSESSMENT OCCURRED AT BASELINE, WEEK 4, WEEK 8, 3-MONTH FOLLOW-UP, AND 6-MONTH FOLLOW-UP. EXPLORATORY OUTCOMES INCLUDED THE PROPORTION OF PARTICIPANTS IN EACH GROUP REPORTING CLINICALLY MEANINGFUL CHANGES AT 3- AND 6-MONTH FOLLOW-UPS. RESULTS: GENERALIZED LINEAR MIXED MODELS WITH SEQUENTIAL BONFERRONI-ADJUSTED PAIRWISE SIGNIFICANCE TESTS AND CHI-SQUARE ANALYSES EXAMINED LONGITUDINAL OUTCOMES. SECONDARY OUTCOME SIGNIFICANCE TESTS WERE BONFERRONI ADJUSTED FOR MULTIPLE OUTCOMES. THE RESTORE GROUP REPORTED IMPROVED PAIN COMPARED WITH THE CONTROL GROUP. SECONDARY OUTCOMES DID NOT RETAIN SIGNIFICANCE AFTER BONFERRONI ADJUSTMENTS FOR MULTIPLE OUTCOMES, ALTHOUGH A HIGHER PROPORTION OF RESTORE PARTICIPANTS REPORTED CLINICALLY MEANINGFULLY CHANGES IN ALL OUTCOMES AT 3-MONTH FOLLOW-UP AND IN SYMPTOM BURDEN AT 6-MONTH FOLLOW-UP. CONCLUSIONS: RESTORE MAY BE A VIABLE NONPHARMACOLOGICAL TREATMENT FOR LOW BACK PAIN WITH MINIMAL SIDE EFFECTS, AND RESEARCH EFFORTS ARE NEEDED TO COMPARE THE EFFECTIVENESS OF RESTORE DELIVERY FORMATS (EG, GROUP VS INDIVIDUAL) WITH THAT OF OTHER TREATMENT MODALITIES. 2018 20 120 25 A PILOT STUDY OF THE EFFECTS OF CHAIR YOGA AND CHAIR-BASED EXERCISE ON BIOPSYCHOSOCIAL OUTCOMES IN OLDER ADULTS WITH LOWER EXTREMITY OSTEOARTHRITIS. THIS PILOT STUDY EXAMINED WHETHER CHAIR YOGA AND CHAIR-BASED EXERCISE ARE EFFECTIVE IN MANAGING BIOPSYCHOSOCIAL OUTCOMES FOR OLDER ADULTS WITH LOWER EXTREMITY OSTEOARTHRITIS. BOTH INTERVENTIONS IMPROVED PHYSICAL FUNCTION AND MOBILITY OVER TIME, ALTHOUGH NO SIGNIFICANT DIFFERENCES BETWEEN THE 2 INTERVENTIONS WERE IDENTIFIED. 2019