1 1582 116 MEDIATORS OF YOGA AND STRETCHING FOR CHRONIC LOW BACK PAIN. ALTHOUGH YOGA IS AN EFFECTIVE TREATMENT FOR CHRONIC LOW BACK PAIN, LITTLE IS KNOWN ABOUT THE MECHANISMS RESPONSIBLE FOR ITS BENEFITS. IN A TRIAL COMPARING YOGA TO INTENSIVE STRETCHING AND SELF-CARE, WE EXPLORED WHETHER PHYSICAL (HOURS OF BACK EXERCISE/WEEK), COGNITIVE (FEAR AVOIDANCE, BODY AWARENESS, AND SELF-EFFICACY), AFFECTIVE (PSYCHOLOGICAL DISTRESS, PERCEIVED STRESS, POSITIVE STATES OF MIND, AND SLEEP), AND PHYSIOLOGICAL FACTORS (CORTISOL, DHEA) MEDIATED THE EFFECTS OF YOGA OR STRETCHING ON BACK-RELATED DYSFUNCTION (ROLAND-MORRIS DISABILITY SCALE (RDQ)). FOR YOGA, 36% OF THE EFFECT ON 12-WEEK RDQ WAS MEDIATED BY INCREASED SELF-EFFICACY, 18% BY SLEEP DISTURBANCE, 9% BY HOURS OF BACK EXERCISE, AND 61% BY THE BEST COMBINATION OF ALL POSSIBLE MEDIATORS (6 MEDIATORS). FOR STRETCHING, 23% OF THE EFFECT WAS MEDIATED BY INCREASED SELF-EFFICACY, 14% BY DAYS OF BACK EXERCISE, AND 50% BY THE BEST COMBINATION OF ALL POSSIBLE MEDIATORS (7 MEDIATORS). IN OPEN-ENDED QUESTIONS, >/=20% OF PARTICIPANTS NOTED THE FOLLOWING TREATMENT BENEFITS: LEARNING NEW EXERCISES (BOTH GROUPS), RELAXATION, INCREASED AWARENESS, AND THE BENEFITS OF BREATHING (YOGA), BENEFITS OF REGULAR PRACTICE (STRETCHING). ALTHOUGH BOTH SELF-EFFICACY AND HOURS OF BACK EXERCISE WERE THE STRONGEST MEDIATORS FOR EACH INTERVENTION, COMPARED TO SELF-CARE, QUALITATIVE DATA SUGGEST THAT THEY MAY EXERT THEIR BENEFITS THROUGH PARTIALLY DISTINCT MECHANISMS. 2013 2 1334 23 HOW DOES EXERCISE IMPROVE IMPLICIT EMOTION REGULATION ABILITY: PRELIMINARY EVIDENCE OF MIND-BODY EXERCISE INTERVENTION COMBINED WITH AEROBIC JOGGING AND MINDFULNESS-BASED YOGA. PURPOSE: THE PRIMARY AIM OF THE PRESENT STUDY IS TO EXAMINE THE EFFECT OF 8-WEEK MIND-BODY EXERCISE INTERVENTION COMBINING AEROBIC JOGGING AND MINDFULNESS-BASED YOGA ON IMPLICIT EMOTION REGULATION ABILITY. THE SECONDARY AIM IS TO EXPLORE THE SPECIFIC POTENTIAL PATHWAYS BY WHICH THE MIND-BODY EXERCISE INTERVENTION FOSTERS IMPLICIT EMOTION REGULATION. THIS MAY HELP US TO UNDERSTAND HOW THE KEY COMPONENTS OF EXERCISE INTERVENTION CONTRIBUTE TO EMOTIONAL BENEFITS. METHODS: SIXTY PARTICIPANTS WERE RANDOMLY ALLOCATED TO ONE OF TWO PARALLEL GROUPS: (1) THE INTERVENTION GROUP (N = 29) AND (2) THE WAITLIST CONTROL GROUP (N = 31). PARTICIPANTS WERE ASKED TO FILL OUT SCALES MEASURING MINDFULNESS AND INSTRUCTED TO COMPLETE AN EMOTION REGULATION TASK TO ASSESS IMPLICIT EMOTION REGULATION ABILITY AS WELL AS THE PWC 170 TEST TO EVALUATE AEROBIC FITNESS BEFORE AND AFTER THE INTERVENTION. RESULTS: THE RESULTS OF THE TWO-WAY REPEATED ANOVA REVEALED THAT 8 WEEKS OF INTERVENTION IMPROVED IMPLICIT EMOTION REGULATION, MINDFULNESS, AND AEROBIC FITNESS LEVELS. PATH ANALYSIS SHOWED THAT ONLY IMPROVED AEROBIC FITNESS MEDIATED THE INTERVENTION EFFECT ON IMPLICIT EMOTION REGULATION ABILITY, CONTROLLING FOR CHANGE IN NEGATIVE AFFECT. NOTABLY, THE RELATIONSHIP BETWEEN THE EFFECTS ON IMPLICIT EMOTION REGULATION ABILITY AND AEROBIC FITNESS WAS MODERATED BY IMPROVED MINDFULNESS. CONCLUSION: EIGHT WEEKS OF MIND-BODY EXERCISE INTERVENTION IMPROVES IMPLICIT EMOTION REGULATION ABILITY. THE AEROBIC FITNESS MAY BE AN ESSENTIAL PATHWAY WHICH MEDIATES THE EFFICACY ON IMPLICIT EMOTION REGULATION ABILITY. FURTHERMORE, DIFFERENT COMPONENTS, SUCH AS AEROBIC FITNESS AND MINDFULNESS, MAY INTERACTIVELY CONTRIBUTE TO SUCH EMOTIONAL BENEFITS. 2019 3 638 45 DO PHYSICAL THERAPY AND YOGA IMPROVE PAIN AND DISABILITY THROUGH PSYCHOLOGICAL MECHANISMS? A CAUSAL MEDIATION ANALYSIS OF ADULTS WITH CHRONIC LOW BACK PAIN. OBJECTIVE: TO INVESTIGATE WHETHER INDIRECT EFFECTS VIA PSYCHOLOGICAL MECHANISMS EXPLAIN THE EFFECTS OF PHYSICAL THERAPY (PT) OR YOGA, VERSUS EDUCATION, ON BACK-RELATED OUTCOMES. DESIGN: MEDIATION ANALYSES USING DATA FROM A RANDOMIZED CONTROLLED TRIAL OF PT, YOGA, AND EDUCATION INTERVENTIONS FOR CHRONIC LOW BACK PAIN. METHODS: PRIMARY OUTCOMES WERE CHANGES IN BACK-RELATED PAIN ON THE 11-POINT NUMERICAL RATING SCALE AND DISABILITY ON THE MODIFIED 23-POINT ROLAND MORRIS DISABILITY QUESTIONNAIRE, MEASURED AT 52-WEEKS POST-RANDOMIZATION. HYPOTHESIZED MEDIATORS WERE 12-WEEK CHANGES IN PAIN SELF-EFFICACY, FEAR AVOIDANCE BELIEFS, DEPRESSION, ANXIETY, PERCEIVED STRESS, AND SLEEP QUALITY. WE USED CAUSAL MEDIATION ANALYSIS TO ESTIMATE THE TOTAL EFFECT, DIRECT EFFECT, INDIRECT EFFECT, AND PROPORTION MEDIATED. RESULTS: WE ANALYZED DATA FROM 230 ADULTS (MEAN AGE = 46.2 YEARS, 69.6% FEMALE, 79.6% NON-WHITE). IN THE PT VERSUS EDUCATION MODEL, WHEN THE MEDIATOR WAS PERCEIVED STRESS, THE TOTAL EFFECT ON DISABILITY WAS 2.6 POINTS (95% CI: 0.3, 4.9) AND DECOMPOSED INTO A DIRECT EFFECT OF 1.7 POINTS (95% CI: -0.4, 3.8) AND AN INDIRECT EFFECT 0.9 POINTS (95% CI: 0.1, 2.0; PROPORTION MEDIATED 34%). NO OTHER PSYCHOLOGICAL CONSTRUCT WAS A SIGNIFICANT MEDIATOR. CONCLUSION: IMPROVEMENTS IN PERCEIVED STRESS MEDIATED IMPROVEMENTS IN DISABILITY AFTER PT TREATMENT COMPARED TO EDUCATION. OTHER PSYCHOLOGICAL OUTCOMES DID NOT MEDIATE THE EFFECT OF YOGA OR PT ON PAIN OR DISABILITY OUTCOMES COMPARED TO EDUCATION. J ORTHOP SPORTS PHYS THER, EPUB 18 MAY 2022. DOI:10.2519/JOSPT.2022.10813. 2022 4 2743 38 YOGA PRACTICE IMPROVES EXECUTIVE FUNCTION BY ATTENUATING STRESS LEVELS. BACKGROUND: PROLONGED ACTIVATION OF THE HYPOTHALAMUS-PITUITARY-ADRENAL SYSTEM IS THOUGHT TO HAVE DELETERIOUS EFFECTS ON BRAIN FUNCTION. NEUROENDOCRINE STUDIES SUGGEST THAT BRAIN EXPOSURE TO HIGHER CORTISOL CONCENTRATIONS CONTRIBUTE TO COGNITIVE DEFICITS AS WE AGE. MIND-BODY TECHNIQUES SUCH AS YOGA HAVE SHOWN TO IMPROVE STRESS LEVELS BY RESTORING THE BODY'S SYMPATHETIC-PARASYMPATHETIC BALANCE. THE OBJECTIVE OF THIS STUDY WAS TO DETERMINE WHETHER YOGA PRACTICE MODERATED THE STRESS RESPONSE RESULTING IN IMPROVED EXECUTIVE FUNCTION. METHODS: SEDENTARY COMMUNITY DWELLING OLDER ADULTS (N=118, MEAN AGE=62.02) WERE RANDOMIZED TO AN 8-WEEK YOGA INTERVENTION OR A STRETCHING CONTROL GROUP. AT BASELINE AND FOLLOWING 8 WEEKS, ALL PARTICIPANTS COMPLETED MEASURES OF EXECUTIVE FUNCTION, SELF-REPORTED STRESS AND ANXIETY AND PROVIDED SALIVA SAMPLES BEFORE AND AFTER COGNITIVE TESTING TO ASSESS CORTISOL. RESULTS: YOGA PARTICIPANTS SHOWED IMPROVED ACCURACY ON EXECUTIVE FUNCTION MEASURES AND AN ATTENUATED CORTISOL RESPONSE COMPARED TO THEIR STRETCHING COUNTERPARTS WHO SHOWED INCREASED CORTISOL LEVELS AND POOR COGNITIVE PERFORMANCE AT FOLLOW UP. THE CHANGE IN CORTISOL LEVELS AS WELL AS SELF-REPORTED STRESS AND ANXIETY LEVELS PREDICTED PERFORMANCE ON THE RUNNING SPAN TASK, N-BACK WORKING MEMORY AND TASK SWITCHING PARADIGM (BETA'S=0.27-0.38, P'S50% REDUCTION ON THE HAMILTON RATING SCALE FOR DEPRESSION (HAM-D). REMISSION WAS DEFINED AS NO LONGER MEETING CRITERIA FOR DEPRESSION AND A HAM-D