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 2506 25 YOGA ATTITUDES IN CHRONIC LOW BACK PAIN: ROLES OF CATASTROPHIZING AND FEAR OF MOVEMENT. CHRONIC LOW BACK PAIN IS A SIGNIFICANT PUBLIC HEALTH PROBLEM AND, ALTHOUGH UNDERUSED, YOGA MAY BE AN EFFECTIVE COMPLEMENTARY TREATMENT. THE CURRENT STUDY EXAMINED ASSOCIATIONS OF PAIN CATASTROPHIZING AND FEAR OF MOVEMENT WITH ATTITUDES TOWARD YOGA IN ADULTS WITH CHRONIC LOW BACK PAIN. PARTICIPANTS COMPLETED THREE QUANTITATIVE QUESTIONNAIRES ASSESSING SPECIFIC CONSTRUCTS: BELIEFS ABOUT YOGA, FEAR OF MOVEMENT, AND PAIN CATASTROPHIZING. A SEMI-STRUCTURED IN-PERSON INTERVIEW WAS THEN CONDUCTED TO OBTAIN SPECIFIC PAIN-RELATED INFORMATION. HIERARCHICAL REGRESSION AND MEDIATIONAL ANALYSES WERE USED TO TEST HYPOTHESES. CONSISTENT WITH THE FEAR-AVOIDANCE MODEL OF CHRONIC PAIN, CATASTROPHIZING AND FEAR OF MOVEMENT WERE NEGATIVELY ASSOCIATED WITH YOGA ATTITUDES. SPECIFICALLY, FEAR OF MOVEMENT WAS A MEDIATOR BETWEEN CATASTROPHIZING AND ATTITUDES TOWARD YOGA. INDIVIDUALS WITH HIGHER LEVELS OF CATASTROPHIZING AND FEAR OF MOVEMENT MAY BE LESS LIKELY TO CONSIDER A PAIN TREATMENT INVOLVING PHYSICAL MOVEMENT. 2015 3 2457 30 YOGA AS A COMPLEMENTARY TREATMENT FOR SMOKING CESSATION: RATIONALE, STUDY DESIGN AND PARTICIPANT CHARACTERISTICS OF THE QUITTING-IN-BALANCE STUDY. BACKGROUND: TOBACCO SMOKING REMAINS THE LEADING PREVENTABLE CAUSE OF DEATH AMONG AMERICAN WOMEN. EXERCISE HAS SHOWN PROMISE AS AN AID TO SMOKING CESSATION BECAUSE IT REDUCES WEIGHT GAIN AND WEIGHT CONCERNS, IMPROVES AFFECT, AND REDUCES NICOTINE WITHDRAWAL SYMPTOMS AND CIGARETTE CRAVING. STUDIES HAVE SHOWN THAT THE PRACTICE OF YOGA IMPROVES WEIGHT CONTROL, AND REDUCES PERCEIVED STRESS AND NEGATIVE AFFECT. YOGA PRACTICE ALSO INCLUDES REGULATION OF BREATHING AND FOCUSED ATTENTION, BOTH OF WHICH MAY ENHANCE STRESS REDUCTION AND IMPROVE MOOD AND WELL-BEING AND MAY IMPROVE CESSATION OUTCOMES. METHODS/DESIGN: THIS PILOT EFFICACY STUDY IS DESIGNED TO EXAMINE THE RATES OF CESSATION AMONG WOMEN RANDOMIZED TO EITHER A NOVEL, 8-WEEK YOGA PLUS COGNITIVE BEHAVIORAL THERAPY (CBT) SMOKING CESSATION INTERVENTION VERSUS A WELLNESS PROGRAM PLUS THE SAME CBT SMOKING CESSATION INTERVENTION. OUTCOME MEASURES INCLUDE 7-DAY POINT PREVALENCE ABSTINENCE AT END OF TREATMENT, 3 AND 6 MONTHS FOLLOW UP AND POTENTIAL MEDIATING VARIABLES (E.G., CONFIDENCE IN QUITTING SMOKING, SELF-EFFICACY). OTHER ASSESSMENTS INCLUDE MEASURES OF MINDFULNESS, SPIRITUALITY, DEPRESSIVE SYMPTOMS, ANXIETY AND PERCEIVED HEALTH (SF-36). DISCUSSION: INNOVATIVE TREATMENTS ARE NEEDED THAT ADDRESS BARRIERS TO SUCCESSFUL SMOKING CESSATION AMONG MEN AND WOMEN. THE DESIGN CHOSEN FOR THIS STUDY WILL ALLOW US TO EXPLORE POTENTIAL MEDIATORS OF INTERVENTION EFFICACY SO THAT WE MAY BETTER UNDERSTAND THE MECHANISM(S) BY WHICH YOGA MAY ACT AS AN EFFECTIVE COMPLEMENTARY TREATMENT FOR SMOKING CESSATION. IF SHOWN TO BE EFFECTIVE, YOGA CAN OFFER AN ALTERNATIVE TO TRADITIONAL EXERCISE FOR REDUCING NEGATIVE SYMPTOMS THAT OFTEN ACCOMPANY SMOKING CESSATION AND PREDICT RELAPSE TO SMOKING AMONG RECENT QUITTERS. TRIAL REGISTRATION: CLINICALTRIALS NCT00492310. 2010 4 638 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 5 2039 34 TESTING THE EFFICACY OF YOGA AS A COMPLEMENTARY THERAPY FOR SMOKING CESSATION: DESIGN AND METHODS OF THE BREATHEASY TRIAL. INTRODUCTION: SMOKERS TRYING TO QUIT ENCOUNTER MANY CHALLENGES INCLUDING NICOTINE WITHDRAWAL SYMPTOMS, CIGARETTE CRAVING, INCREASED STRESS AND NEGATIVE MOOD AND CONCERN REGARDING WEIGHT GAIN. THESE PHENOMENA MAKE IT DIFFICULT TO SUCCESSFULLY QUIT SMOKING. STUDIES IN NON-SMOKING POPULATIONS SHOW THAT YOGA REDUCES STRESS AND NEGATIVE MOOD AND IMPROVES WEIGHT CONTROL. BY INCREASING MINDFULNESS WE ANTICIPATE THAT YOGA MAY ALSO IMPROVE SMOKERS' ABILITY TO COPE WITH THE NEGATIVE SYMPTOMS ASSOCIATED WITH QUITTING. YOGA MAY ALSO IMPROVE COGNITIVE DELIBERATION WHICH IS NEEDED TO MAKE EFFECTIVE CHOICES AND AVOID SMOKING IN TEMPTING SITUATIONS. METHODS/DESIGN: THE BREATHEASY STUDY IS A RIGOROUS, RANDOMIZED CONTROLLED CLINICAL TRIAL EXAMINING THE EFFICACY OF IYENGAR YOGA AS A COMPLEMENTARY THERAPY TO COGNITIVE-BEHAVIORAL THERAPY FOR SMOKING CESSATION. ALL PARTICIPANTS ARE GIVEN AN 8-WEEK PROGRAM OF SMOKING CESSATION CLASSES, AND ARE RANDOMIZED TO EITHER TWICE WEEKLY YOGA (YOGA) OR TWICE-WEEKLY HEALTH AND WELLNESS CLASSES WHICH SERVE AS A CONTROL FOR CONTACT AND PARTICIPANT BURDEN (CTL). ASSESSMENTS ARE CONDUCTED AT BASELINE, 8 WEEKS, 3, 6, AND 12 MONTHS OF FOLLOW-UP. THE PRIMARY OUTCOME IS PROLONGED ABSTINENCE USING AN INTENTION-TO-TREAT APPROACH. MULTIPLE INTERNAL AND EXTERNAL AUDITS USING BLIND DATA COLLECTION ARE EMPLOYED TO ENSURE TREATMENT FIDELITY AND RELIABILITY OF STUDY RESULTS. TO UNDERSTAND WHY YOGA MAY BE MORE EFFECTIVE THAN CTL, WE WILL EXAMINE THE MECHANISMS OF ACTION (I.E., MEDIATORS) UNDERLYING INTERVENTION EFFICACY. WE WILL EXAMINE THE MAINTENANCE OF YOGA PRACTICE AND SMOKING STATUS AT EACH FOLLOW-UP. FOCUS GROUPS AND INTERVIEWS WILL BE USED TO ENRICH OUR UNDERSTANDING OF THE RELATIONSHIP OF YOGA PRACTICE AND SMOKING ABSTINENCE. CONCLUSIONS: THIS STUDY WILL PROVIDE A STRINGENT TEST OF THE RELATIVE EFFICACY OF YOGA COMPARED TO A CONDITION THAT CONTROLS FOR CONTACT TIME AND ATTENTION. THE USE OF MIXED METHODOLOGY ALSO PROVIDES THE OPPORTUNITY TO VALIDATE EXISTING KNOWLEDGE ABOUT YOGA AND HELPS TO EXPLORE NEW THEMES FOR FUTURE MINDFULNESS AND YOGA RESEARCH. 2014 6 2278 17 THE ROLES OF SELF-COMPASSION, BODY SURVEILLANCE, AND BODY APPRECIATION IN PREDICTING INTRINSIC MOTIVATION FOR PHYSICAL ACTIVITY: CROSS-SECTIONAL ASSOCIATIONS, AND PROSPECTIVE CHANGES WITHIN A YOGA CONTEXT. ENGAGING IN PHYSICAL ACTIVITY FOR THE IMMEDIATE INTERNAL EXPERIENCES IT BRINGS (E.G., PLEASURE, SATISFACTION) IS CRITICAL FOR LONG-TERM EXERCISE ADHERENCE. INVESTIGATIONS OF HOW FACTORS SUCH AS BODY IMAGE CONTRIBUTE TO INTRINSIC MOTIVATION FOR PHYSICAL ACTIVITY ARE NEEDED. THE PRESENT STUDY EXAMINED BODY SURVEILLANCE AND BODY APPRECIATION AS MEDIATORS OF THE RELATIONSHIP BETWEEN SELF-COMPASSION AND INTRINSIC MOTIVATION FOR PHYSICAL ACTIVITY CROSS-SECTIONALLY AND PROSPECTIVELY. ONE SAMPLE OF COLLEGE WOMEN COMPLETED MEASURES OF STUDY VARIABLES AT ONE TIME POINT (SAMPLE 1; N = 269, MAGE = 19.96) AND A SECOND SAMPLE DID SO DURING WEEKS 1, 8, AND 16 WHILE PARTICIPATING IN A 16-WEEK YOGA COURSE (SAMPLE 2; N = 323, MAGE = 20.31). IN SAMPLE 1, LATENT VARIABLE STRUCTURAL EQUATION MODELING SUPPORTED BODY APPRECIATION AS A MEDIATOR BETWEEN SELF-COMPASSION AND INTRINSIC MOTIVATION FOR PHYSICAL ACTIVITY. IN SAMPLE 2, LATENT GROWTH CURVE ANALYSES REVEALED THAT CHANGE IN SELF-COMPASSION PREDICTED CHANGES IN BODY SURVEILLANCE AND BODY APPRECIATION IN EXPECTED DIRECTIONS. FURTHER, CHANGE IN BODY APPRECIATION POSITIVELY PREDICTED CHANGE IN INTRINSIC MOTIVATION. TARGETING SELF-COMPASSION AND BODY APPRECIATION MAY HELP SUPPORT WOMEN'S INTRINSIC MOTIVATION FOR PHYSICAL ACTIVITY. 2019 7 16 33 "SMOKING DOES NOT GO WITH YOGA:" A QUALITATIVE STUDY OF WOMEN'S PHENOMENOLOGICAL PERCEPTIONS DURING YOGA AND SMOKING CESSATION. INTRODUCTION: SMOKING CESSATION IS OFTEN ACCOMPANIED BY WITHDRAWAL SYMPTOMS, CIGARETTE CRAVING, INCREASED NEGATIVE AFFECT, AND INCREASED EXPERIENCE OF STRESS. BECAUSE YOGA HAS BEEN SHOWN TO REDUCE STRESS AND NEGATIVE AFFECT, IT MAY BE AN EFFECTIVE AID TO SMOKING CESSATION. THE OBJECTIVE OF THIS STUDY WAS TO EXAMINE WOMEN'S PHENOMENOLOGICAL EXPERIENCES OF VINYASA YOGA AS PART OF A SMOKING CESSATION PROGRAM. METHODS: FOCUS GROUPS WERE CONDUCTED POST-INTERVENTION WITH WOMEN (N = 20) WHO PARTICIPATED IN A PILOT RANDOMIZED CONTROLLED TRIAL OF YOGA AS A COMPLEMENTARY THERAPY FOR SMOKING CESSATION. THE 8-WEEK VINYASA YOGA INTERVENTION INCLUDED TWICE WEEKLY 60-MINUTE CLASSES THAT INVOLVED BREATHING EXERCISES, POSTURES (ASANAS), AND RELAXATION TECHNIQUES. FOCUS GROUPS WERE AUDIO RECORDED AND TRANSCRIBED. THEMATIC ANALYSIS FOCUSED ON DESCRIPTIONS OF YOGA, BREATHING, AND BODILY SENSATIONS INCLUDING CIGARETTE CRAVING. RESULTS: FOCUS GROUP PARTICIPANTS DESCRIBED VINYASA YOGA AS PHYSICALLY CHALLENGING. MOST REPORTED DELIBERATE USE OF YOGIC BREATHING TO COPE WITH CIGARETTE CRAVING AND STRESS. OTHER PERCEIVED EFFECTS INCLUDED RELAXATION AND AN INCREASED SENSE OF BODY AWARENESS AND WELLBEING. CONCLUSIONS: PARTICIPANTS VIEWED YOGA AS POSITIVE AND POTENTIALLY HELPFUL FOR QUITTING SMOKING. YOGA MAY BE AN EFFECTIVE ADJUNCT FOR SMOKING CESSATION. 2016 8 1006 27 EFFECTS OF MINDFULNESS YOGA VERSUS CONVENTIONAL PHYSICAL EXERCISES ON SYMPTOM EXPERIENCES AND HEALTH-RELATED QUALITY OF LIFE IN PEOPLE WITH PARKINSON'S DISEASE: THE POTENTIAL MEDIATING ROLES OF ANXIETY AND DEPRESSION. BACKGROUND: ALTHOUGH SEVERAL STUDIES HAVE REPORTED POSITIVE EFFECTS OF MIND-BODY EXERCISES ON SYMPTOM MANAGEMENT AND HEALTH-RELATED QUALITY OF LIFE (HRQOL) OF PEOPLE LIVING WITH PARKINSON'S DISEASE (PD), IT IS NOT KNOWN WHETHER THESE EFFECTS ARE ATTRIBUTABLE TO A CHANGE IN ANXIETY AND DEPRESSION. PURPOSE: TO COMPARE THE EFFECTS OF MINDFULNESS YOGA TO CONVENTIONAL STRETCHING EXERCISES IN A RANDOMIZED CONTROLLED TRIAL WHILE EXAMINING POTENTIALLY MEDIATING EFFECTS OF ANXIETY AND DEPRESSION. METHODS: 138 ADULTS WITH PD WERE RANDOMIZED TO EIGHT WEEKLY YOGA (N = 71) OR STRETCHING (N = 67) SESSIONS. SYMPTOM EXPERIENCES, ANXIETY AND DEPRESSION, AND HRQOL OUTCOMES WERE ASSESSED AT BASELINE, IMMEDIATE POST-INTERVENTION, AND 3-MONTH POST-INTERVENTION. RESULTS: GENERALIZED ESTIMATING EQUATION ANALYSES REVEALED THAT, COMPARED TO STRETCHING, YOGA SIGNIFICANTLY IMPROVED PATIENTS' NONMOTOR (TIME-BY-GROUP INTERACTION, T1:BETA = -1.99, P = .008; T2:BETA = -2.86, P < .001) AND MOTOR (TIME-BY-GROUP INTERACTION, T1:BETA = -1.77, P = .03) SYMPTOM EXPERIENCES. THE MEDIATION ANALYSIS FOUND THAT THE CHANGES IN ANXIETY AND DEPRESSION WERE THE MEDIATORS IN THE ASSOCIATIONS BETWEEN NON-MOTOR EXPERIENCE AND HRQOL; WHILE ONLY THE CHANGES IN DEPRESSION WERE FOUND TO BE THE MEDIATOR IN THE RELATIONSHIP BETWEEN MOTOR EXPERIENCE AND HRQOL. CONCLUSIONS: YOGA IS SUPERIOR TO CONVENTIONAL STRETCHING EXERCISES IN IMPROVING NONMOTOR AND MOTOR SYMPTOMS IN DAILY LIVING. REDUCED ANXIETY AND DEPRESSION PLAY A ROLE IN MEDIATING THE POSITIVE EFFECTS OF THE MINDFULNESS YOGA INTERVENTION. TO OPTIMIZE HRQOL, REHABILITATION SHOULD REINFORCE PSYCHOLOGICAL CARE IN ADDITION TO PHARMACOLOGICAL TREATMENTS AND PHYSICAL RELIEF OF PD SYMPTOMS. FUTURE STUDIES ARE NEEDED TO IDENTIFY STRATEGIES FOR FACILITATING THE IMPLEMENTATION AND SUSTAINABILITY OF MIND-BODY REHABILITATION TO ENHANCE THE QUALITY OF CARE FOR PD. 2022 9 1861 30 RANDOMIZED CONTROLLED TRIAL OF BIKRAM YOGA AND AEROBIC EXERCISE FOR DEPRESSION IN WOMEN: EFFICACY AND STRESS-BASED MECHANISMS. BACKGROUND: THE CURRENT STUDY PRESENTS A RANDOMIZED CONTROLLED 8-WEEK TRIAL OF BIKRAM YOGA, AEROBIC EXERCISE, AND WAITLIST FOR DEPRESSION. BIKRAM YOGA WAS CHOSEN SPECIFICALLY FOR ITS STANDARDIZED NATURE. FURTHER, WE EXAMINED CHANGES IN THREE STRESS-RELATED CONSTRUCTS-PERCEIVED STRESS, RUMINATION, AND MINDFULNESS-AS MEDIATORS OF ANTIDEPRESSANT EFFECTS. METHOD: FIFTY-THREE WOMEN (AGE 18-65; 74% WHITE) WITH A UNIPOLAR DEPRESSIVE DISORDER WERE RANDOMLY ASSIGNED TO ONE OF THE THREE CONDITIONS. RESPONSE WAS DEFINED AS >50% REDUCTION ON THE HAMILTON RATING SCALE FOR DEPRESSION (HAM-D). REMISSION WAS DEFINED AS NO LONGER MEETING CRITERIA FOR DEPRESSION AND A HAM-D