1 2522 160 YOGA DECREASES KYPHOSIS IN SENIOR WOMEN AND MEN WITH ADULT-ONSET HYPERKYPHOSIS: RESULTS OF A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: TO ASSESS WHETHER A SPECIFICALLY DESIGNED YOGA INTERVENTION CAN REDUCE HYPERKYPHOSIS. DESIGN: A 6-MONTH, TWO-GROUP, RANDOMIZED, CONTROLLED, SINGLE-MASKED TRIAL. SETTING: COMMUNITY RESEARCH UNIT. PARTICIPANTS: ONE HUNDRED EIGHTEEN WOMEN AND MEN AGED 60 AND OLDER WITH A KYPHOSIS ANGLE OF 40 DEGREES OR GREATER. MAJOR EXCLUSIONS WERE SERIOUS MEDICAL COMORBIDITY, USE OF ASSISTIVE DEVICE, INABILITY TO HEAR OR SEE ADEQUATELY FOR PARTICIPATION, AND INABILITY TO PASS A PHYSICAL SAFETY SCREEN. INTERVENTION: THE ACTIVE TREATMENT GROUP ATTENDED HOUR-LONG YOGA CLASSES 3 DAYS PER WEEK FOR 24 WEEKS. THE CONTROL GROUP ATTENDED A MONTHLY LUNCHEON AND SEMINAR AND RECEIVED MAILINGS. MEASUREMENTS: PRIMARY OUTCOMES WERE CHANGE (BASELINE TO 6 MONTHS) IN DEBRUNNER KYPHOMETER-ASSESSED KYPHOSIS ANGLE, STANDING HEIGHT, TIMED CHAIR STANDS, FUNCTIONAL REACH, AND WALKING SPEED. SECONDARY OUTCOMES WERE CHANGE IN KYPHOSIS INDEX, FLEXICURVE KYPHOSIS ANGLE, RANCHO BERNARDO BLOCKS POSTURE ASSESSMENT, AND HEALTH-RELATED QUALITY OF LIFE (HRQOL). RESULTS: COMPARED WITH CONTROL PARTICIPANTS, PARTICIPANTS RANDOMIZED TO YOGA EXPERIENCED A 4.4% IMPROVEMENT IN FLEXICURVE KYPHOSIS ANGLE (P=.006) AND A 5% IMPROVEMENT IN KYPHOSIS INDEX (P=.004). THE INTERVENTION DID NOT RESULT IN STATISTICALLY SIGNIFICANT IMPROVEMENT IN DEBRUNNER KYPHOMETER ANGLE, MEASURED PHYSICAL PERFORMANCE, OR SELF-ASSESSED HRQOL (EACH P>.1). CONCLUSION: THE DECREASE IN FLEXICURVE KYPHOSIS ANGLE IN THE YOGA TREATMENT GROUP SHOWS THAT HYPERKYPHOSIS IS REMEDIABLE, A CRITICAL FIRST STEP IN THE PATHWAY TO TREATING OR PREVENTING THIS CONDITION. LARGER, MORE-DEFINITIVE STUDIES OF YOGA OR OTHER INTERVENTIONS FOR HYPERKYPHOSIS SHOULD BE CONSIDERED. TARGETING INDIVIDUALS WITH MORE-MALLEABLE SPINES AND USING LONGITUDINALLY PRECISE MEASURES OF KYPHOSIS COULD STRENGTHEN THE TREATMENT EFFECT.	2009	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
2 1990  31 SPINAL CURVATURES OF YOGA PRACTITIONERS COMPARED TO CONTROL PARTICIPANTS-A CROSS-SECTIONAL STUDY. PURPOSE: THE ANGLES OF THORACIC KYPHOSIS AND LUMBAR LORDOSIS DETERMINE THE SPINAL ALIGNMENT IN THE SAGITTAL PLANE. THE AIM OF THIS STUDY WAS TO COMPARE THE THORACIC KYPHOSIS AND LUMBAR LORDOSIS OF MALE AND FEMALE YOGA PRACTITIONERS WITH NON-PRACTICING PARTICIPANTS AND TO DETERMINE THE POSSIBLE DEPENDENCIES BETWEEN SAGITTAL SPINAL CURVATURES AND SOMATIC PARAMETERS, TIME SPENT ON YOGA EXERCISE, AND UNDERTAKING OTHER PHYSICAL ACTIVITIES IN YOGA PRACTITIONERS. METHODS: THE STUDY INVOLVED 576 WOMEN AND 91 MEN AGES 18-68 YEARS (MEAN = 38.5 +/- 9) WHO WERE PRACTICING YOGA, AND 402 WOMEN AND 176 MEN AGES 18-30 YEARS (MEAN = 20.2 +/- 1.3) AS A CONTROL GROUP. THE ANGLES OF THORACIC KYPHOSIS AND LUMBAR LORDOSIS WERE MEASURED USING A PLURIMETER-V GRAVITY INCLINOMETER. RESULTS: THE TWO-WAY ANOVA DEMONSTRATED THE INFLUENCE OF GROUP (P < .0001) AND SEX (P = .03) ON THE ANGLE OF THORACIC KYPHOSIS, AS WELL AS THE INFLUENCE OF GROUP (P < .0001) AND SEX (P < .0001) ON THE ANGLE OF LUMBAR LORDOSIS. IT WAS NOTED THAT YOGA PRACTITIONERS HAD LESS PRONOUNCED THORACIC KYPHOSIS AND LUMBAR LORDOSIS AND WERE MORE OFTEN CHARACTERIZED BY NORMAL OR SMALLER THORACIC KYPHOSIS AND LUMBAR LORDOSIS THAN STUDENTS FROM THE CONTROL GROUP. IN YOGA PRACTITIONERS, THE ANGLE OF THORACIC KYPHOSIS WAS POSITIVELY CORRELATED WITH AGE, BODY MASS, BMI, AND UNDERTAKING OTHER FORMS OF PHYSICAL ACTIVITY. THE ANGLE OF LUMBAR LORDOSIS WAS NEGATIVELY CORRELATED WITH BODY HEIGHT AND BODY MASS. CONCLUSIONS: THE RESULTS SUGGEST THAT YOGA EXERCISES CAN AFFECT THE SHAPE OF THE ANTERIOR-POSTERIOR CURVES OF THE SPINE AND MAY BE AN EFFICIENT TRAINING METHOD FOR SHAPING PROPER POSTURE IN ADULTS.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
3 2656  39 YOGA IMPROVES UPPER-EXTREMITY FUNCTION AND SCAPULAR POSTURING IN PERSONS WITH HYPERKYPHOSIS. OBJECTIVE: HYPERKYPHOSIS (EXCESS THORACIC SPINE CURVATURE) IS ASSOCIATED WITH UPPER-EXTREMITY FUNCTIONAL LIMITATIONS AND ALTERED SCAPULAR POSTURING. THE PURPOSE OF THIS STUDY WAS TO QUANTIFY THE CHANGES IN UPPER-EXTREMITY FUNCTION AND SCAPULAR POSTURING FOLLOWING A 6-MONTH YOGAINTERVENTION IN PERSONS WITH HYPERKYPHOSIS. METHODS: TWENTY-ONE OLDER ADULTS WITH HYPERKYPHOSIS (75.5+7.4 YRS) ENROLLED IN THE UCLA YOGA FOR KYPHOSIS RANDOMIZED CONTROLLED TRIAL, ELECTED TO PARTICIPATE IN THIS UNCONTROLLED, PREPOST SUBSTUDY OF UPPER-EXTREMITY FUNCTION. THEY WERE MEASURED AT BASELINE AND AFTER A 24-WEEK YOGA INTERVENTION. MAXIMUM VERTICAL REACH AND TIMED BOOK TESTS WERE USED TO EVALUATE UPPER-EXTREMITY FUNCTION. SCAPULAR POSTURING WAS QUANTIFIED USING A MOTION ANALYSIS SYSTEM AND DATA WAS OBTAINED UNDER 4 CONDITIONS: 1) QUIET-STANDING, 2) NORMAL WALKING, 3) FAST WALKING, AND 4) SEATED. PAIRED T-TESTS WERE USED TO TEST FOR CHANGES BETWEEN BASELINE AND 6-MONTH FOLLOW-UP MEASURES AND COHEN'S D WAS CALCULATED TO EXAMINE EFFECT SIZES. RESULTS: FOLLOWING THE 6-MONTH YOGA INTERVENTION, PARTICIPANTS IMPROVED THEIR BOOK TEST PERFORMANCE BY 26.4% (P < 0.001; D = 1.5). SCAPULAR PROTRACTION DECREASED BY 2.9% DURING THE STATIC-SITTING CONDITION (P < 0.001; D = 0.5) AND THE OVERALL EXCURSION OF THE SCAPULAE DECREASED FOR BOTH FAST (25.0%, P < 0.05; D = 0.6) AND SELF-SELECTED WALKING (29.4%, P < 0.01; D = 0.9). THERE WERE NO CHANGES IN MAXIMUM VERTICAL REACH. CONCLUSION: SUBJECTS DEMONSTRATED SIGNIFICANT IMPROVEMENTS WITH SMALL TO LARGE EFFECT SIZES IN THE TIMED BOOK TEST AND SCAPULAR POSTURING TO A LESS PROTRACTED POSITION DURING BOTH STATIC AND DYNAMIC CONDITIONS AFTER THE INTERVENTION. THESE ADAPTATIONS ARE LIKELY TO REDUCE THE RISK OF SCAPULAR IMPINGEMENT AND HELP PRESERVE FUNCTIONAL INDEPENDENCE IN OLDER ADULTS.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
4 2575  32 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
5 1984  26 SOFT TISSUE AND BONY INJURIES ATTRIBUTED TO THE PRACTICE OF YOGA: A BIOMECHANICAL ANALYSIS AND IMPLICATIONS FOR MANAGEMENT. OBJECTIVE: TO ANALYZE INJURIES THAT WERE DIRECTLY ASSOCIATED WITH YOGA PRACTICE AND IDENTIFY SPECIFIC POSES THAT SHOULD BE AVOIDED IN PATIENTS WITH OSTEOPENIA OR OSTEOPOROSIS. PATIENTS AND METHODS: WE RETROSPECTIVELY REVIEWED THE MEDICAL RECORDS OF PATIENTS WITH INJURIES THAT WERE PRIMARILY CAUSED BY YOGA. PATIENTS WERE SEEN FROM JANUARY 1, 2006, THROUGH DECEMBER 31, 2018. INJURIES WERE CATEGORIZED INTO 3 GROUPS: (1) SOFT TISSUE INJURY, (2) AXIAL NONBONY INJURY, AND (3) BONY INJURY. PATIENTS UNDERWENT EVALUATION AND WERE COUNSELED TO MODIFY EXERCISE ACTIVITY. RESULTS: WE IDENTIFIED 89 PATIENTS FOR INCLUSION IN THE STUDY. WITHIN THE SOFT TISSUE GROUP, 66 PATIENTS (74.2%) HAD MECHANICAL MYOFASCIAL PAIN DUE TO OVERUSE. ROTATOR CUFF INJURY WAS SEEN IN 6 (6.7%), AND TROCHANTERIC BURSOPATHY WAS OBSERVED IN 1 (1.1%). IN THE AXIAL GROUP, EXACERBATION OF PAIN IN DEGENERATIVE JOINT DISEASE (46 PATIENTS [51.7%]) AND FACET ARTHROPATHY (N=34 [38.2%]) WERE OBSERVED. RADICULOPATHY WAS SEEN IN 5 PATIENTS (5.6%). WITHIN THE BONY INJURY CATEGORY, KYPHOSCOLIOSIS WAS SEEN ON IMAGING IN 15 PATIENTS (16.9%). SPONDYLOLISTHESIS WAS PRESENT IN 15 PATIENTS (16.9%). ANTERIOR WEDGING WAS SEEN IN 16 (18.0%), AND COMPRESSION FRACTURES WERE PRESENT IN 13 (14.6%). THE POSES THAT WERE MOST COMMONLY IDENTIFIED AS CAUSING THE INJURIES INVOLVED HYPERFLEXION AND HYPEREXTENSION OF THE SPINE. WE CORRELATED THE KINESIOLOGIC EFFECT OF SUCH EXERCISES ON SPECIFIC MUSCULOSKELETAL STRUCTURES. CONCLUSION: YOGA POTENTIALLY HAS MANY BENEFITS, BUT CARE MUST BE TAKEN WHEN PERFORMING POSITIONS WITH EXTREME SPINAL FLEXION AND EXTENSION. PATIENTS WITH OSTEOPENIA OR OSTEOPOROSIS MAY HAVE HIGHER RISK OF COMPRESSION FRACTURES OR DEFORMITIES AND WOULD BENEFIT FROM AVOIDING EXTREME SPINAL FLEXION. PHYSICIANS SHOULD CONSIDER THIS RISK WHEN DISCUSSING YOGA AS EXERCISE.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
6  541  28 COMPONENTS AND REPORTING OF YOGA INTERVENTIONS FOR MUSCULOSKELETAL CONDITIONS: A SYSTEMATIC REVIEW OF RANDOMISED CONTROLLED TRIALS. OBJECTIVES: TO IDENTIFY THE CONTENT AND REPORTING DETAILS OF RANDOMISED CONTROLLED TRIALS OF YOGA FOR MUSCULOSKELETAL CONDITIONS THROUGH A SYSTEMATIC REVIEW OF THE LITERATURE. DESIGN: TWENTY ELECTRONIC DATABASES WERE SEARCHED TO IDENTIFY RANDOMISED CONTROLLED TRIALS (RCTS) OF YOGA INTERVENTIONS FOR MUSCULOSKELETAL CONDITIONS. ELIGIBILITY CRITERIA WERE FULL-TEXT, PEER REVIEWED ARTICLES, OF RCTS WITH YOGA AS A PRIMARY INTERVENTION, ON A POPULATION AGED 18 YEARS AND OVER, WITH A CLINICAL DIAGNOSIS OF A MUSCULOSKELETAL CONDITION. DATA RELATING TO STUDY CHARACTERISTICS, YOGA STYLES, YOGA PRACTICES, HOME PRACTICE, AND REPORTING WERE EXTRACTED AND SUMMARISED. RESULTS: SEVENTEEN ARTICLES MET INCLUSION CRITERIA, REPRESENTING FIVE MUSCULOSKELETAL CONDITIONS: LOW BACK PAIN, OSTEOARTHRITIS, RHEUMATOID ARTHRITIS, KYPHOSIS, AND FIBROMYALGIA. 15 STUDIES WERE NON-RESIDENTIAL, AND TWO WERE RESIDENTIAL. STUDY DURATION RANGED FROM 1 TO 24 WEEKS; WEEKLY DOSAGE OF YOGA RANGED FROM 1 TO 56H. FIVE STYLES OF POSTURE-BASED HATHA YOGA WERE SPECIFIED. INTERVENTION CONTENT INCLUDED SEVEN YOGA PRACTISES: POSTURES, BREATHING, RELAXATION, MEDITATION, PHILOSOPHY, CHANTING, AND CLEANSING PRACTISES. TEN STUDIES EITHER ENCOURAGED OR REQUESTED HOME PRACTICE. REPORTING DETAILS INCLUDED CLASS PLANS, POSTURE LISTS, AND DIAGRAMS. DUE TO INSUFFICIENT DETAIL REGARDING DELIVERY OF THE YOGA INTERVENTION ONLY EIGHT OF THE 17 INTERVENTIONS WERE CONSIDERED REPLICABLE AS REPORTED. CONCLUSIONS: EVALUATION OF STUDY CHARACTERISTICS AND YOGA COMPONENTS INDICATED SEVERAL AREAS OF HOMOGENEITY ACROSS STUDIES, SUGGESTING AN EXISTING DEGREE OF STANDARDISATION. HOWEVER, HETEROGENEITY RELATED TO INTERVENTION CONTENT AND REPORTING IMPEDED DETERMINATION OF INTERVENTION CONTENT AND DELIVERY. STANDARDISATION OF CONTENT, NOMENCLATURE, AND REPORTING DETAILS IS RECOMMENDED TO ENHANCE PROTOCOL TRANSPARENCY, REPLICATION, AND COMPARISON OF INTERVENTION EFFECTIVENESS.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
7  896  31 EFFECT OF YOGASANA INTERVENTION ON STANDING BALANCE PERFORMANCE AMONG PEOPLE WITH DIABETIC PERIPHERAL NEUROPATHY: A PILOT STUDY. BACKGROUND: DIABETIC PERIPHERAL NEUROPATHY (DPN) IS KNOWN TO CAUSE IMPAIRED BALANCE AND EVENTUALLY INCREASED RISK OF FALL. YOGASANAS CHARACTERIZED BY SLOW, GENTLE TRANSITIONS INTO POSTURES WITH A VARYING BASE OF SUPPORT AND FOCUS ON BODY AWARENESS DURING MOVEMENT HOLD POTENTIAL FOR TRAINING BALANCE CONTROL. THEREFORE, THE CURRENT STUDY AIMED TO EVALUATE EFFECT OF STRUCTURED YOGASANA INTERVENTION COMPARED TO CONVENTIONAL BALANCE EXERCISE ON STATIC AND DYNAMIC BALANCE PERFORMANCE AMONG PEOPLE WITH DIABETIC NEUROPATHY. METHODS: : THIRTY-FIVE PEOPLE WITH DPN AGED 42-70 YEARS WERE RECRUITED TO YOGASANA INTERVENTION GROUP (N = 11), CONVENTIONAL BALANCE EXERCISES GROUP (N = 10), AND CONTROL GROUP (N = 14) FOLLOWING ETHICAL APPROVAL. ALL PARTICIPANTS WERE EVALUATED AT BASELINE AND POST 12-WEEK INTERVENTION ON STAR EXCURSION BALANCE TEST, SINGLE-LIMB STANCE TEST, AND CENTER OF PRESSURE (COP) EXCURSION FOR BALANCE PERFORMANCE, MODIFIED FALL EFFICACY SCALE FOR FEAR OF FALLS AND LOWER EXTREMITY STRENGTH USING CHAIR STAND TEST AND STEP-UP TEST. RESULTS: BALANCE PERFORMANCE (STATIC AND DYNAMIC MEASURED BY STAR EXCURSION BALANCE TEST, SINGLE-LIMB STANCE TEST, AND COP EXCURSION, LOWER EXTREMITY STRENGTH (USING CHAIR STAND TEST AND STEP-UP TEST) DEMONSTRATED IMPROVEMENT AND FEAR OF FALL REDUCED AMONG YOGASANA INTERVENTION GROUP (P = 0.05) AND CONVENTIONAL BALANCE EXERCISES GROUP (P = 0.05) POST 12-WEEK INTERVENTION. COP EXCURSION INCREASED IN THE CONTROL GROUP INDICATING DETERIORATION IN BALANCE PERFORMANCE AFTER 12 WEEKS (P = 0.05). POST HOC COMPARISON REVEALED THAT YOGASANA INTERVENTION WAS MARGINALLY MORE EFFECTIVE IN IMPROVING STATIC AND DYNAMIC BALANCE PERFORMANCE COMPARED TO CONVENTIONAL BALANCE EXERCISES IN ALL VARIABLES OF STANDING BALANCE PERFORMANCE (P = 0.025). CONCLUSION: YOGASANA AND CONVENTIONAL BALANCE EXERCISES WERE EFFECTIVE IN IMPROVING STATIC AND DYNAMIC BALANCE PERFORMANCE, LOWER EXTREMITY MUSCLE STRENGTH, AND REDUCING FEAR OF FALL AMONG PEOPLE WITH DPN. YOGASANA INTERVENTION DEMONSTRATED MARGINALLY GREATER IMPROVEMENT IN STATIC AND DYNAMIC BALANCE PERFORMANCE AND LOWER EXTREMITY MUSCLE STRENGTH COMPARED TO CONVENTIONAL EXERCISE.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
8 1486  24 INTEGRATIVE EFFECT OF YOGA PRACTICE IN PATIENTS WITH KNEE ARTHRITIS: A PRISMA-COMPLIANT META-ANALYSIS. BACKGROUND: BENEFITS OF YOGA PRACTICE IN PATIENTS WITH KNEE OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS REMAINS CONTROVERSIAL. THIS STUDY PERFORMS A META-ANALYSIS TO QUANTIFY THE EFFICIENCY OF YOGA EXERCISE FOR PATIENTS PAIN REDUCTION, FUNCTIONAL RECOVERY, AND GENERAL WELLBEING. METHODS: A COMPUTERIZED SEARCH OF PUBMED AND EMBASE WAS PERFORMED TO IDENTIFY RELEVANT STUDIES. THE OUTCOME MEASURES WERE PAIN, STIFFNESS, AND PHYSICAL FUNCTION. TWO INVESTIGATORS IDENTIFIED ELIGIBLE STUDIES AND EXTRACTED DATA INDEPENDENTLY. THE QUALITY OF CITATIONS WAS MEASURED USING JADAD SCORE. STANDARDIZED MEAN DIFFERENCES (SMDS) WITH 95% CONFIDENCE INTERVALS (CIS) WERE CALCULATED FOR PAIN, MUSCULOSKELETAL IMPAIRMENT, QUALITY OF LIFE, GENERAL WELLBEING, AND MENTAL WELLBEING. RESULTS: A TOTAL OF 13 CLINICAL TRIALS INVOLVING 1557 PATIENTS WITH KNEE OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS WERE INCLUDED IN FINAL META-ANALYSIS WITH THE AVERAGE JADAD SCORE 2.8. THE SMD WAS -0.98 (95% CI -1.18, -0.78, P < .05) FOR PAIN, -1.83 (95% CI -2.09, -1.57, P < .05) FOR FUNCTIONAL DISABILITY, WAS 0.80 (95% CI 0.59, 1.01, P < .05) FOR SHORT FORM 36 HEALTH SURVEY (SF-36) GENERAL HEALTH, 0.49 (95% CI 0.14, 0.82, P < .05) FOR SF-36 MENTAL HEALTH, AND HAQ WAS -0.55 (95% CI -0.83, -0.26, P < .05) FOR HEALTH ASSOCIATED QUESTIONNAIRE (HAQ). ALL THE RESULTS FAVOR YOGA TRAINING GROUP. CONCLUSIONS: REGULAR YOGA TRAINING IS HELPFUL IN REDUCING KNEE ARTHRITIC SYMPTOMS, PROMOTING PHYSICAL FUNCTION, AND GENERAL WELLBEING IN ARTHRITIC PATIENTS.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
9 1743  38 PHYSICAL-PERFORMANCE OUTCOMES AND BIOMECHANICAL CORRELATES FROM THE 32-WEEK YOGA EMPOWERS SENIORS STUDY. BACKGROUND. YOGA EMPOWERS SENIORS STUDY (YESS) QUANTIFIED PHYSICAL DEMANDS ASSOCIATED WITH YOGA PERFORMANCE USING BIOMECHANICAL METHODS. THIS STUDY EVALUATED THE EFFICACY OF THE PROGRAM ON PHYSICAL FUNCTION OUTCOMES. METHODS. TWENTY COMMUNITY-DWELLING OLDER ADULTS AGED 70.7 +/- 3.8 YEARS ATTENDED BIWEEKLY 60-MINUTE HATHA YOGA CLASSES FOR 32 WEEKS. FOUR DOMAINS OF THE PHYSICAL MEASUREMENTS INCLUDING (1) FUNCTIONAL PERFORMANCE, (2) FLEXIBILITY, (3) MUSCLE STRENGTH, AND (4) BALANCE WERE TAKEN AT THE BASELINE, 16-WEEK AND 32-WEEK TIME POINTS. REPEATED-MEASURES ANOVA OMNIBUS TESTS AND TUKEY'S POST HOC TESTS WERE EMPLOYED TO EXAMINE THE DIFFERENCES IN EACH OUTCOME VARIABLE ACROSS THE 3 TIME POINTS. RESULTS. IMPROVED TIMED CHAIR STANDS (P < 0.01), 8-FOOT UP AND GO (P < 0.05), 2-MIN STEP TEST (P < 0.05), AND VERTICAL REACH (P = 0.05) PERFORMANCE WERE EVIDENT. ISOMETRIC KNEE FLEXOR STRENGTH (P < 0.05) AND REPETITIONS OF THE HEEL RISE TEST (P < 0.001) ALSO INCREASED FOLLOWING THE 32-WEEK INTERVENTION. BOTH FLEXIBILITY AND BALANCE PERFORMANCE REMAINED UNCHANGED. CONCLUSIONS. SIGNIFICANT IMPROVEMENTS IN PHYSICAL FUNCTION AND MUSCLE-SPECIFIC LOWER-EXTREMITY STRENGTH OCCUR WITH THE REGULAR PRACTICE OF A MODIFIED HATHA YOGA PROGRAM DESIGNED FOR SENIORS. THESE ADAPTATIONS CORRESPONDED WITH THE PREVIOUSLY REPORTED BIOMECHANICAL DEMANDS OF THE POSES.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
10 2134  40 THE EFFECTS OF A THERAPEUTIC YOGA PROGRAM ON POSTURAL CONTROL, MOBILITY, AND GAIT SPEED IN COMMUNITY-DWELLING OLDER ADULTS. OBJECTIVE: TO EXAMINE THE EFFECTS OF A 12-WEEK THERAPEUTIC YOGA PROGRAM ON GAIT SPEED, POSTURAL CONTROL, AND MOBILITY IN COMMUNITY-DWELLING OLDER ADULTS. DESIGN: QUASI-EXPERIMENTAL STUDY WITH A PRETEST/POST-TEST DESIGN. RESEARCHERS EVALUATED CHANGES OVER TIME (PRETEST TO POST-TEST) IN ALL OUTCOME MEASURES. PAIRED T-TESTS WERE USED TO ANALYZE NORMAL AND FAST GAIT SPEED, TIMED UP AND GO TEST, AND TIMED UP AND GO DUAL TASK. WILCOXON SIGNED-RANK TEST WAS USED TO EVALUATE SCORES FOR THE MINI-BESTEST (MBT). SETTING: YOGA CLASSES WERE PERFORMED AT A LOCAL SENIOR CENTER. BLIND EXAMINERS WHO WERE PREVIOUSLY TRAINED IN THE OUTCOME MEASURES PERFORMED ALL PRETESTS AND POST-TESTS AT THE SITE. PARTICIPANTS: THIRTEEN ADULTS (12 WOMEN AND 1 MAN, WITH A MEAN AGE+/-STANDARD DEVIATION OF 72+/-6.9 YEARS) COMPLETED THE STUDY. RESEARCH PARTICIPANTS HAD MINIMAL TO NO YOGA EXPERIENCE. INTERVENTIONS: A 12-WEEK, 60-MINUTE, BIWEEKLY KRIPALU YOGA CLASS DESIGNED SPECIFICALLY FOR COMMUNITY-DWELLING OLDER ADULTS. OUTCOME MEASURES: POSTURAL CONTROL (MBT), MOBILITY (TIMED UP AND GO TEST), AND GAIT SPEED (NORMAL AND FAST) WERE ASSESSED. RESULTS: ALL 13 PARTICIPANTS ATTENDED AT LEAST 19 OF THE 24 CLASSES (80% ATTENDANCE). STATISTICALLY SIGNIFICANT IMPROVEMENTS WERE SEEN IN THE MBT (P=0.039), NORMAL GAIT SPEED (P=0.015), FAST GAIT SPEED (P=0.001), TIMED UP AND GO TEST (P=0.045), AND TIMED UP AND GO DUAL-TASK (P=0.05). CONCLUSIONS: IMPROVEMENTS IN POSTURAL CONTROL AND MOBILITY AS MEASURED BY THE MBT AND TIMED UP AND GO GAIT AS MEASURED BY FAST GAIT SPEED INDICATE THAT RESEARCH PARTICIPANTS BENEFITTED FROM THE THERAPEUTIC YOGA INTERVENTION. THE YOGA PROGRAM DESIGNED FOR THIS STUDY INCLUDED ACTIVITIES IN STANDING, SITTING, AND LYING ON THE FLOOR AND MAY BE EFFECTIVE IN IMPROVING MOBILITY, POSTURAL CONTROL, AND GAIT SPEED IN COMMUNITY-DWELLING OLDER ADULTS.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
11 2777  34 YOGA SPINAL FLEXION POSITIONS AND VERTEBRAL COMPRESSION FRACTURE IN OSTEOPENIA OR OSTEOPOROSIS OF SPINE: CASE SERIES. OBJECTIVE: THE OBJECTIVE OF THIS REPORT IS TO RAISE AWARENESS OF THE EFFECT OF STRENUOUS YOGA FLEXION EXERCISES ON OSTEOPENIC OR OSTEOPOROTIC SPINES. WE PREVIOUSLY DESCRIBED SUBJECTS WITH KNOWN OSTEOPOROSIS IN WHOM VERTEBRAL COMPRESSION FRACTURES (VCFS) DEVELOPED AFTER SPINAL FLEXION EXERCISE (SFE) AND RECOMMENDED THAT SFES NOT BE PRESCRIBED IN PATIENTS WITH SPINAL OSTEOPOROSIS. METHODS: THIS REPORT DESCRIBES 3 HEALTHY PERSONS WITH LOW BONE MASS AND YOGA-INDUCED PAIN OR FRACTURE. RESULTS: ALL 3 PATIENTS HAD OSTEOPENIA, WERE IN GOOD HEALTH AND PAIN-FREE, AND HAD STARTED YOGA EXERCISES TO IMPROVE THEIR MUSCULOSKELETAL HEALTH. NEW PAIN AND FRACTURE AREAS OCCURRED AFTER PARTICIPATION IN YOGA FLEXION EXERCISES. CONCLUSIONS: THE DEVELOPMENT OF PAIN AND COMPLICATIONS WITH SOME FLEXION YOGA POSITIONS IN THE PATIENTS WITH OSTEOPENIA LEADS TO CONCERN THAT FRACTURE RISK WOULD INCREASE EVEN FURTHER IN OSTEOPOROSIS. ALTHOUGH EXERCISE HAS BEEN SHOWN TO BE EFFECTIVE FOR IMPROVING BONE MINERAL DENSITY AND DECREASING FRACTURE RISK, OUR SUBJECTS HAD DEVELOPMENT OF VCFS AND NECK AND BACK PAIN WITH YOGA EXERCISES. THIS FINDING SUGGESTS THAT FACTORS OTHER THAN BONE MASS SHOULD BE CONSIDERED FOR EXERCISE COUNSELING IN PATIENTS WITH BONE LOSS. THE INCREASED TORQUE PRESSURE APPLIED TO VERTEBRAL BODIES DURING SFES MAY BE A RISK. EXERCISE IS EFFECTIVE AND IMPORTANT FOR TREATMENT OF OSTEOPENIA AND OSTEOPOROSIS AND SHOULD BE PRESCRIBED FOR PATIENTS WITH VERTEBRAL BONE LOSS. SOME YOGA POSITIONS CAN CONTRIBUTE TO EXTREME STRAIN ON SPINES WITH BONE LOSS. ASSESSMENT OF FRACTURE RISK IN OLDER PERSONS PERFORMING SFES AND OTHER HIGH-IMPACT EXERCISES IS AN IMPORTANT CLINICAL CONSIDERATION.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
12  973  53 EFFECTS OF AN INTEGRATED YOGA PROGRAM ON QUALITY OF LIFE, SPINAL FLEXIBILITY, AND STRENGTH IN OLDER ADULTS: A RANDOMIZED CONTROL TRIAL. CONTEXT: AGING CAN CONTRIBUTE TO A DECREASE IN PHYSICAL ACTIVITY AS A RESULT OF METABOLIC DYSFUNCTION AND HORMONAL IMBALANCE THAT CAN CAUSE DEGENERATIVE JOINT DISEASE AND AGING-RELATED INFLAMMATION. AS AGE ADVANCES, A DECREASE IN MUSCLE MASS, MUSCLE STRENGTH, AND FLEXIBILITY CAN IMPAIR PHYSICAL FUNCTION. OBJECTIVE: THE STUDY INTENDED TO EVALUATE THE EFFECTS OF AN INTEGRATED YOGA MODULE IN IMPROVING THE FLEXIBILITY, MUSCLE STRENGTH, AND QUALITY OF LIFE (QOL) OF OLDER ADULTS. DESIGN: THIS RESEARCH TEAM DESIGNED A PROSPECTIVE, TWO-ARM, OPEN-LABEL, AND PARALLEL, RANDOMIZED CONTROLLED TRIAL. SETTING: THE STUDY TOOK PLACE IN AN OUTPATIENT DEPARTMENT AT DIVINE PARK, YOGA & NATUROPATHY HOSPITAL, UDUPI, KARNATAKA, INDIA. PARTICIPANTS: PARTICIPANTS WERE 96 OLDER ADULTS, AGED 60-75 YEARS (64.1 +/- 3.95 YEARS) TAKING PART IN A YOGA PROGRAM IN THE DEPARTMENT. INTERVENTION: THE PROGRAM WAS A THREE-MONTH, YOGA-BASED LIFESTYLE INTERVENTION. THE PARTICIPANTS WERE RANDOMLY ALLOCATED TO THE INTERVENTION GROUP (N = 48) OR TO A WAITLISTED CONTROL GROUP (N = 48). THE INTERVENTION GROUP UNDERWENT THREE ONE-HOUR SESSIONS OF YOGA WEEKLY, WITH EACH SESSION INCLUDING LOOSENING EXERCISES, ASANAS, PRANAYAMA, AND MEDITATION SPANNING. OUTCOME MEASURES: AT BASELINE AND POST INTERVENTION, ASSESSMENTS WERE MADE: (1) FOR SPINAL FLEXIBILITY USING A SIT AND REACH TEST, (2) FOR BACK AND LEG STRENGTH USING A BACK LEG DYNAMOMETER, (3) FOR HANDGRIP STRENGTH (HGS) AND ENDURANCE (HGE) USING A HAND-GRIP DYNAMOMETER, AND (4) THE OLDER PEOPLE'S QUALITY OF LIFE (OPQOL) QUESTIONNAIRE. ANALYSIS WAS PERFORMED EMPLOYING WILCOXON'S SIGN RANK TESTS AND MANN WHITNEY TESTS, USING AN INTENTION-TO-TREAT APPROACH. RESULTS: COMPARED TO THE CONTROL GROUP, THE INTERVENTION GROUP EXPERIENCED A SIGNIFICANTLY GREATER INCREASE IN SPINAL FLEXIBILITY (P < .001), BACK LEG STRENGTH (P < .001), HGE (P < .01), AND QOL (P < .001) AFTER THREE MONTHS OF YOGA. CONCLUSION: YOGA CAN BE USED SAFELY FOR OLDER ADULTS TO IMPROVE FLEXIBILITY, STRENGTH, AND FUNCTIONAL QOL. LARGER RANDOMIZED CONTROLLED TRIALS WITH AN ACTIVE CONTROL INTERVENTION ARE WARRANTED.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
13  444  28 CHAIR YOGA: BENEFITS FOR COMMUNITY-DWELLING OLDER ADULTS WITH OSTEOARTHRITIS. THE AIM OF THIS PILOT STUDY WAS TO EXAMINE WHETHER CHAIR YOGA WAS EFFECTIVE IN REDUCING PAIN LEVEL AND IMPROVING PHYSICAL FUNCTION AND EMOTIONAL WELL-BEING IN A SAMPLE OF COMMUNITY-DWELLING OLDER ADULTS WITH OSTEOARTHRITIS. ONE-WAY REPEATED MEASURES ANALYSIS OF VARIANCE WAS PERFORMED TO EXAMINE THE EFFECTIVENESS OF CHAIR YOGA AT BASELINE, MIDPOINT (4 WEEKS), AND END OF THE INTERVENTION (8 WEEKS). ALTHOUGH CHAIR YOGA WAS EFFECTIVE IN IMPROVING PHYSICAL FUNCTION AND REDUCING STIFFNESS IN OLDER ADULTS WITH OSTEOARTHRITIS, IT WAS NOT EFFECTIVE IN REDUCING PAIN LEVEL OR IMPROVING DEPRESSIVE SYMPTOMS. FUTURE RESEARCH PLANNED BY THIS TEAM WILL USE RIGOROUS STUDY METHODS, INCLUDING LARGER SAMPLES, RANDOMIZED CONTROLLED TRIALS, AND FOLLOW UP FOR MONITORING HOME PRACTICE AFTER THE INTERVENTIONS.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
14 1870  33 RANDOMIZED-CONTROLLED TRIAL COMPARING YOGA AND HOME-BASED EXERCISE FOR CHRONIC NECK PAIN. OBJECTIVES: CHRONIC NECK PAIN IS A SIGNIFICANT PUBLIC HEALTH PROBLEM WITH ONLY VERY FEW EVIDENCE-BASED TREATMENT OPTIONS. THERE IS GROWING EVIDENCE FOR THE EFFECTIVENESS OF YOGA FOR RELIEVING MUSCULOSKELETAL DISORDERS. THE AIM OF THIS STUDY WAS TO EVALUATE THE EFFECT OF IYENGAR YOGA COMPARED WITH EXERCISE ON CHRONIC NONSPECIFIC NECK PAIN. METHODS: PATIENTS WERE RANDOMLY ASSIGNED TO EITHER YOGA OR EXERCISE. THE YOGA GROUP ATTENDED A 9-WEEK YOGA COURSE AND THE EXERCISE GROUP RECEIVED A SELF-CARE MANUAL ON HOME-BASED EXERCISES FOR NECK PAIN RELIEF. THE MAIN OUTCOME MEASURE WAS THE PRESENT NECK PAIN INTENSITY (100 MM VISUAL ANALOG SCALE). SECONDARY OUTCOME MEASURES INCLUDED FUNCTIONAL DISABILITY (NECK DISABILITY INDEX), PAIN AT MOTION (VISUAL ANALOG SCALE), HEALTH-RELATED QUALITY OF LIFE (SHORT FORM-36 QUESTIONNAIRE), CERVICAL RANGE OF MOTION, PROPRIOCEPTIVE ACUITY, AND PRESSURE PAIN THRESHOLD. RESULTS: FIFTY-ONE PATIENTS (MEAN AGE 47.8 Y ; 82.4% FEMALE) WERE RANDOMIZED TO YOGA (N=25) AND EXERCISE (N=26) INTERVENTION. AFTER THE STUDY PERIOD, PATIENTS IN THE YOGA GROUP REPORTED SIGNIFICANTLY LESS NECK PAIN INTENSITY COMPARED WITH THE EXERCISE GROUP [MEAN DIFFERENCE: -13.9 MM (95% CI, -26.4 TO -1.4), P=0.03]. THE YOGA GROUP REPORTED LESS DISABILITY AND BETTER MENTAL QUALITY OF LIFE. RANGE OF MOTION AND PROPRIOCEPTIVE ACUITY WERE IMPROVED AND THE PRESSURE PAIN THRESHOLD WAS ELEVATED IN THE YOGA GROUP. DISCUSSION: YOGA WAS MORE EFFECTIVE IN RELIEVING CHRONIC NONSPECIFIC NECK PAIN THAN A HOME-BASED EXERCISE PROGRAM. YOGA REDUCED NECK PAIN INTENSITY AND DISABILITY AND IMPROVED HEALTH-RELATED QUALITY OF LIFE. MOREOVER, YOGA SEEMS TO INFLUENCE THE FUNCTIONAL STATUS OF NECK MUSCLES, AS INDICATED BY IMPROVEMENT OF PHYSIOLOGICAL MEASURES OF NECK PAIN.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
15  120  19 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
16 1113  53 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	

17  521  44 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
18  193  33 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
19  825  32 EFFECT OF YOGA ON HEALTH-RELATED OUTCOMES IN PEOPLE AT RISK OF FRACTURES: A SYSTEMATIC REVIEW. WE SUMMARIZED THE EFFECTS OF YOGA ON HEALTH-RELATED OUTCOMES AND ADVERSE EVENTS IN MEN AND POSTMENOPAUSAL WOMEN >/=50 YEARS-OLD AT INCREASED RISK OF FRACTURE, TO INFORM THE UPDATED OSTEOPOROSIS CANADA CLINICAL PRACTICE GUIDELINES. SIX DATABASES WERE SEARCHED FOR OBSERVATIONAL STUDIES, RANDOMIZED CONTROLLED TRIALS AND CASE SERIES. CERTAINTY OF EVIDENCE WAS ASSESSED USING THE GRADING OF RECOMMENDATIONS, ASSESSMENT, DEVELOPMENT AND EVALUATION HANDBOOK. NINE STUDIES WERE INCLUDED AND REPORTED USING NARRATIVE SYNTHESES DUE TO THE LIMITED AVAILABLE EVIDENCE. OVERALL, THE AVAILABLE EVIDENCE WAS OF VERY LOW CERTAINTY. THERE WAS NO EFFECT OF YOGA ON HEALTH-RELATED QUALITY OF LIFE IN RANDOMIZED TRIALS. EFFECTS ON OTHER HEALTH-RELATED OUTCOMES WERE MIXED OR NOT AVAILABLE IN THE LITERATURE. FIVE STUDIES REPORTED NO ADVERSE EVENTS DIRECTLY RELATED TO THE STUDY INTERVENTION, AND 2 STUDIES DID NOT REPORT WHETHER ADVERSE EVENTS OCCURRED. HOWEVER, 2 CASE SERIES REPORTED VERTEBRAL FRACTURES RELATED TO YOGA PARTICIPATION, POSSIBLY DUE TO EXCESSIVE SPINAL FLEXION. DUE TO THE LIMITED AND VERY LOW CERTAINTY EVIDENCE, GUIDELINE DEVELOPERS WILL NEED TO DRAW INDIRECT EVIDENCE FROM YOGA STUDIES AMONG MIDDLE AGED OR OLDER ADULTS THAT ARE NOT AT FRACTURE RISK. PROSPERO: CRD42019124898. NOVELTY: EVIDENCE IN GENERAL WAS OF VERY LOW CERTAINTY. YOGA HAD NO EFFECT ON HEALTH-RELATED QUALITY OF LIFE IN RANDOMIZED TRIALS. EVIDENCE WAS MIXED OR UNAVAILABLE FOR OTHER OUTCOMES. CASE STUDIES REPORTED YOGA POSES INVOLVING SPINAL FLEXION COINCIDED WITH INCIDENTS OF VERTEBRAL COMPRESSION FRACTURE AMONG OLDER ADULTS WITH INCREASED FRACTURE RISK.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
20 1494  29 INTERRATER RELIABILITY OF AN OBSERVATIONAL RATING SCALE AND VIDEO ANALYSIS OF YOGA POSES. CONTEXT: YOGA IS INCREASINGLY POPULAR, NOT ONLY AS A FORM OF RECREATIONAL EXERCISE BUT ALSO AS A PHYSICIAN-RECOMMENDED INTERVENTION FOR HEALTH CONDITIONS. WHILE SERIOUS ADVERSE EFFECTS ACCOMPANYING YOGA PRACTICE ARE RARE, POSES THAT INVOLVE UPPER-EXTREMITY WEIGHT-BEARING HAVE A HIGH RISK OF DISCOMFORT. TO BETTER UNDERSTAND FACTORS CONTRIBUTING TO ADVERSE EFFECTS, THERE IS A CRITICAL NEED FOR ROBUST INSTRUMENTS THAT OBJECTIVELY EVALUATE POSE PERFORMANCE. THE PURPOSE OF THIS STUDY WAS TO ASSESS THE INTERRATER RELIABILITY OF AN OBSERVATIONAL SCALE DEVELOPED TO ASSESS THE ALIGNMENT OF 3 YOGA POSES. DESIGN: CROSS-SECTIONAL EXPERIMENTAL STUDY. METHODS: THIRTY-EIGHT INDIVIDUALS WERE GIVEN STANDARDIZED INSTRUCTIONS AND PERFORMED 3 POSES (DOWNWARD DOG, PLANK, AND SIDE PLANK). LATERAL VIDEOS WERE RATED BY 2 RATERS. A RATING SCALE EVALUATING THE ALIGNMENT OF 7 REGIONS WAS DEVELOPED BY THE STUDY TEAM WITH INPUT FROM YOGA TEACHERS. DESCRIPTIVE STATISTICS WERE USED TO SUMMARIZE THE PERCENTAGE OF SUBJECTS SHOWING IDEAL ALIGNMENT AND DEVIATIONS. INTERRATER RELIABILITY WAS QUANTIFIED USING COHEN KAPPA COEFFICIENT (KAPPA). RESULTS: IN DOWNWARD DOG, THE PREVALENCE OF IDEAL ALIGNMENT WAS 20%, 28%, AND 37%, AT THE NECK, SHOULDER, AND BACK, RESPECTIVELY; KAPPA RANGED FROM .44 TO .69. IN PLANK, THE PREVALENCE OF IDEAL ALIGNMENT WAS 31%, 45%, AND 54% AT THE NECK, SHOULDER, AND BACK, RESPECTIVELY; KAPPA RANGED FROM .47 TO .95. IN SIDE PLANK, THE PREVALENCE OF IDEAL ALIGNMENT WAS 16, 41%, AND 24%, AT THE NECK, SHOULDER, AND BACK, RESPECTIVELY; KAPPA RANGED FROM .20 TO .84. CONCLUSION: THE OBSERVATIONAL SCALE FOUND A HIGH PREVALENCE OF DEVIATIONS, AND DEMONSTRATED FAIR TO SUBSTANTIAL INTERRATER AGREEMENT.	2022