1 388 147 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 2 2604 50 YOGA FOR PERSISTENT FATIGUE IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CANCER-RELATED FATIGUE AFFLICTS UP TO 33% OF BREAST CANCER SURVIVORS, YET THERE ARE NO EMPIRICALLY VALIDATED TREATMENTS FOR THIS SYMPTOM. METHODS: THE AUTHORS CONDUCTED A 2-GROUP RANDOMIZED CONTROLLED TRIAL TO DETERMINE THE FEASIBILITY AND EFFICACY OF AN IYENGAR YOGA INTERVENTION FOR BREAST CANCER SURVIVORS WITH PERSISTENT POST-TREATMENT FATIGUE. PARTICIPANTS WERE BREAST CANCER SURVIVORS WHO HAD COMPLETED CANCER TREATMENTS (OTHER THAN ENDOCRINE THERAPY) AT LEAST 6 MONTHS BEFORE ENROLLMENT, REPORTED SIGNIFICANT CANCER-RELATED FATIGUE, AND HAD NO OTHER MEDICAL CONDITIONS THAT WOULD ACCOUNT FOR FATIGUE SYMPTOMS OR INTERFERE WITH YOGA PRACTICE. BLOCK RANDOMIZATION WAS USED TO ASSIGN PARTICIPANTS TO A 12-WEEK, IYENGAR-BASED YOGA INTERVENTION OR TO 12 WEEKS OF HEALTH EDUCATION (CONTROL). THE PRIMARY OUTCOME WAS CHANGE IN FATIGUE MEASURED AT BASELINE, IMMEDIATELY POST-TREATMENT, AND 3 MONTHS AFTER TREATMENT COMPLETION. ADDITIONAL OUTCOMES INCLUDED CHANGES IN VIGOR, DEPRESSIVE SYMPTOMS, SLEEP, PERCEIVED STRESS, AND PHYSICAL PERFORMANCE. INTENT-TO-TREAT ANALYSES WERE CONDUCTED WITH ALL RANDOMIZED PARTICIPANTS USING LINEAR MIXED MODELS. RESULTS: THIRTY-ONE WOMEN WERE RANDOMLY ASSIGNED TO YOGA (N = 16) OR HEALTH EDUCATION (N = 15). FATIGUE SEVERITY DECLINED SIGNIFICANTLY FROM BASELINE TO POST-TREATMENT AND OVER A 3-MONTH FOLLOW-UP IN THE YOGA GROUP RELATIVE TO CONTROLS (P = .032). IN ADDITION, THE YOGA GROUP HAD SIGNIFICANT INCREASES IN VIGOR RELATIVE TO CONTROLS (P = .011). BOTH GROUPS HAD POSITIVE CHANGES IN DEPRESSIVE SYMPTOMS AND PERCEIVED STRESS (P < .05). NO SIGNIFICANT CHANGES IN SLEEP OR PHYSICAL PERFORMANCE WERE OBSERVED. CONCLUSIONS: A TARGETED YOGA INTERVENTION LED TO SIGNIFICANT IMPROVEMENTS IN FATIGUE AND VIGOR AMONG BREAST CANCER SURVIVORS WITH PERSISTENT FATIGUE SYMPTOMS. 2012 3 172 40 A RANDOMIZED CONTROLLED PILOT STUDY OF YOGA SKILLS TRAINING VERSUS AN ATTENTION CONTROL DELIVERED DURING CHEMOTHERAPY ADMINISTRATION. CONTEXT: IT IS IMPORTANT TO ADDRESS FATIGUE AND CO-OCCURRING SYMPTOMS DURING CHEMOTHERAPY TO PRESERVE QUALITY OF LIFE IN PATIENTS WITH GASTROINTESTINAL (GI) CANCER. OBJECTIVE: TO CONDUCT A RANDOMIZED CONTROLLED PILOT STUDY OF A YOGA SKILLS TRAINING (YST) INTERVENTION COMPARED TO AN ATTENTION CONTROL (AC) AMONG ADULTS DIAGNOSED WITH GI CANCER. METHODS: YST CONSISTED OF FOUR 30-MINUTE SESSIONS DELIVERED INDIVIDUALLY DURING CHEMOTHERAPY PLUS HOME PRACTICE. AC PROVIDED EMPATHIC ATTENTION PLUS HOME DIARIES. PATIENT-REPORTED (PROMIS T-SCORE) ASSESSMENTS OF FATIGUE, DEPRESSIVE SYMPTOMS, SLEEP DISTURBANCES, AND PSYCHOLOGICAL STRESS (PERCEIVED STRESS SCALE) WERE COLLECTED AT CHEMOTHERAPY VISITS: BASELINE, WEEK 8, WEEK 10 AND WEEK 14, AND ANALYZED USING A MIXED EFFECTS MODEL. INFLAMMATORY CYTOKINES WERE ASSESSED AT BASELINE AND WEEK 10. RESULTS: FORTY-FOUR OF 77 ADULTS APPROACHED AGREED TO PARTICIPATE (57%; YST N = 23; AC N = 21). PARTICIPANTS' MEAN AGE WAS 58 YEARS AND 48% WERE MEN. PARTICIPANTS RANDOMIZED TO YST REPORTED A LARGER DECLINE IN FATIGUE (-2.4 DIFFERENCE, D = 0.30) AND DEPRESSIVE SYMPTOMS (-2.5 DIFFERENCE, D = 0.30) THAN AC PARTICIPANTS FROM BASELINE TO WEEK 10 AND SLEEP DISTURBANCES AT WEEK 8 (-3.9 DIFFERENCE, D = 0.50). DIFFERENCES IN MAGNITUDE OF CHANGE IN SYMPTOMS WERE CONSISTENT WITH OR EXCEEDED A MINIMALLY IMPORTANT DIFFERENCE. PSYCHOLOGICAL STRESS DECREASED MORE IN THE AC AT WEEK 10 (D = 0.30). REDUCTIONS IN INFLAMMATORY CYTOKINES (IL-6, STNF R1) WERE LARGER IN THE YST GROUP THAN AC. CONCLUSION: YST SHOWED PROMISE FOR IMPROVING FATIGUE, DEPRESSIVE SYMPTOMS, SLEEP DISTURBANCES, AND INFLAMMATION. YST IS ALSO FEASIBLE AND REACHES PATIENTS UNDERREPRESENTED IN YOGA RESEARCH (I.E., GI CANCER, MEN), THUS WARRANTING FURTHER EXAMINATION. 2022 4 1240 42 FEASIBILITY OF A MINDFUL YOGA PROGRAM FOR WOMEN WITH METASTATIC BREAST CANCER: RESULTS OF A RANDOMIZED PILOT STUDY. PURPOSE: PATIENTS WITH METASTATIC BREAST CANCER (MBC) EXPERIENCE HIGH LEVELS OF SYMPTOMS. YOGA INTERVENTIONS HAVE SHOWN PROMISE FOR IMPROVING CANCER SYMPTOMS BUT HAVE RARELY BEEN TESTED IN PATIENTS WITH ADVANCED DISEASE. THIS STUDY EXAMINED THE ACCEPTABILITY OF A COMPREHENSIVE YOGA PROGRAM FOR MBC AND THE FEASIBILITY OF CONDUCTING A RANDOMIZED TRIAL TESTING THE INTERVENTION. METHODS: SIXTY-THREE WOMEN WITH MBC WERE RANDOMIZED WITH A 2:1 ALLOCATION TO YOGA OR A SUPPORT GROUP COMPARISON CONDITION. BOTH INTERVENTIONS INVOLVED EIGHT WEEKLY GROUP SESSIONS. FEASIBILITY WAS QUANTIFIED USING RATES OF ACCRUAL, ATTRITION, AND SESSION ATTENDANCE. ACCEPTABILITY WAS ASSESSED WITH A STANDARDIZED SELF-REPORT MEASURE. PAIN, FATIGUE, SLEEP QUALITY, PSYCHOLOGICAL DISTRESS, MINDFULNESS, AND FUNCTIONAL CAPACITY WERE ASSESSED AT BASELINE, POST-INTERVENTION, AND 3 AND 6 MONTHS POST-INTERVENTION. RESULTS: WE MET GOALS FOR ACCRUAL AND RETENTION, WITH 50% OF ELIGIBLE PATIENTS ENROLLED AND 87% OF RANDOMIZED PARTICIPANTS COMPLETING POST-INTERVENTION SURVEYS. SIXTY-FIVE PERCENT OF WOMEN IN THE YOGA CONDITION AND 90% IN THE SUPPORT GROUP ATTENDED >/= 4 SESSIONS. EIGHTY PERCENT OF PARTICIPANTS IN THE YOGA CONDITION AND 65% IN THE SUPPORT GROUP INDICATED THAT THEY WERE HIGHLY SATISFIED WITH THE INTERVENTION. FOLLOWING TREATMENT, WOMEN IN THE YOGA INTERVENTION HAD MODEST IMPROVEMENTS IN SOME OUTCOMES; HOWEVER, OVERALL SYMPTOM LEVELS WERE LOW FOR WOMEN IN BOTH CONDITIONS. CONCLUSIONS: FINDINGS SUGGEST THAT THE YOGA INTERVENTION CONTENT WAS HIGHLY ACCEPTABLE TO PATIENTS WITH MBC, BUT THAT THERE ARE CHALLENGES TO IMPLEMENTING AN INTERVENTION INVOLVING EIGHT GROUP-BASED IN-PERSON SESSIONS. ALTERNATIVE MODES OF DELIVERY MAY BE NECESSARY TO REACH PATIENTS MOST IN NEED OF INTERVENTION. 2019 5 1093 43 EFFECTS OF YOGA ON WELL-BEING AND HEALTHY AGEING: STUDY PROTOCOL FOR A RANDOMISED CONTROLLED TRIAL (FITFORAGE). INTRODUCTION: DUE TO AGEING POPULATIONS WORLDWIDE, THE BURDEN OF DISABILITY IS INCREASING. IT IS THEREFORE IMPORTANT TO DEVELOP INTERVENTIONS THAT IMPROVE HEALTHY AGEING, REDUCE DISABILITY ONSET AND ENHANCE LIFE QUALITY. PHYSICAL ACTIVITY CAN PROMOTE HEALTHY AGEING AND HELP MAINTAIN INDEPENDENCE, YET MANY OLDER ADULTS ARE INACTIVE. YOGA IS A FORM OF PHYSICAL ACTIVITY THAT AIMS TO IMPROVE HEALTH AND MAY BE PARTICULARLY SUITABLE FOR OLDER ADULTS. RESEARCH INDICATES POSITIVE EFFECTS OF YOGA ON SEVERAL HEALTH-RELATED OUTCOMES; HOWEVER, EMPIRICAL STUDIES EXAMINING THE BENEFITS OF YOGA ON WELL-BEING AMONG THE ELDERLY REMAIN SCARCE. THIS STUDY PROTOCOL REPORTS THE METHODOLOGY FOR A 12-WEEK YOGA PROGRAMME AIMED TO IMPROVE HEALTH AND WELL-BEING AMONG PHYSICALLY INACTIVE OLDER ADULTS. METHODS AND ANALYSIS: THREE GROUP PARALLEL, SINGLE-BLIND RANDOMISED CONTROLLED TRIAL. TWO COMPARISON GROUPS ARE INCLUDED: AEROBIC EXERCISE AND A NON-ACTIVE WAIT-LIST CONTROL. IN TOTAL, 180 PARTICIPANTS AGED 65-85 YEARS WILL BE RECRUITED. ASSESSMENTS WILL BE PERFORMED AT BASELINE AND POSTINTERVENTION (12-WEEK FOLLOW-UP). THE PRIMARY OUTCOME IS SUBJECTIVE WELL-BEING. SECONDARY OUTCOMES INCLUDE PHYSICAL ACTIVITY/SEDENTARY BEHAVIOUR, MOBILITY/FALL RISK, COGNITION, DEPRESSION, ANXIETY, MOOD, STRESS, PAIN, SLEEP QUALITY, SOCIAL SUPPORT AND CARDIOMETABOLIC RISK FACTORS. DATA WILL BE ANALYSED USING INTENTION-TO-TREAT ANALYSES, WITH MIXED LINEAR MODELLING. ETHICS AND DISSEMINATION: THIS STUDY IS APPROVED BY THE ETHICAL REVIEW BOARD IN STOCKHOLM (2017/1862-31/2). ALL PARTICIPANTS MUST VOLUNTARILY AGREE TO PARTICIPATE AND ARE FREE TO WITHDRAW FROM THE STUDY AT ANY POINT. WRITTEN INFORMED CONSENT WILL BE OBTAINED FROM EACH PARTICIPANT PRIOR TO INCLUSION. RESULTS WILL BE AVAILABLE THROUGH RESEARCH ARTICLES AND CONFERENCES. A SUMMARY OF KEY RESULTS WILL BE PUBLICLY AVAILABLE THROUGH NEWSPAPER ARTICLES. TRIAL REGISTRATION NUMBER: DRKS00015093, U1111-1217-4248. 2019 6 478 40 CLINICAL CASE REPORT: YOGA FOR FATIGUE IN FIVE YOUNG ADULT SURVIVORS OF CHILDHOOD CANCER. PURPOSE: CANCER-RELATED FATIGUE (CRF) IS A DISTRESSING CONSEQUENCE OF CANCER AND ITS TREATMENT. CRF IMPACTS MANY YOUNG ADULT (YA) SURVIVORS OF CHILDHOOD CANCER, COMPROMISING WORK, SOCIAL RELATIONSHIPS, AND DAILY ACTIVITIES. NO SATISFACTORY TREATMENT EXISTS. THIS PILOT STUDY AIMED TO ASSESS THE FEASIBILITY, SAFETY, AND PRELIMINARY EFFICACY OF AN 8-WEEK TWICE/WEEK IYENGAR YOGA (IY) INTERVENTION FOR TREATING PERSISTENT FATIGUE IN YA SURVIVORS OF CHILDHOOD CANCER. METHODS: USING A SINGLE-ARM MIXED-METHODS DESIGN, ADULT CHILDHOOD CANCER SURVIVORS AGED BETWEEN 18 AND 39 YEARS WERE RECRUITED FROM A SURVIVORSHIP CLINIC AT A SINGLE INSTITUTION. QUANTITATIVE: THE PRIMARY OUTCOME WAS FATIGUE AS MEASURED BY THE FUNCTIONAL ASSESSMENT OF CHRONIC ILLNESS THERAPY-FATIGUE. SECONDARY OUTCOMES INCLUDED VITALITY, SOCIAL FUNCTIONING, MULTIDIMENSIONAL FATIGUE, MOOD, AND SLEEP. WEEKLY SELF-REPORT MONITORING DATA WERE COLLECTED. QUALITATIVE: PARTICIPANTS ALSO COMPLETED A POST-INTERVENTION INTERVIEW, MAJOR THEMES EVALUATED. RESULTS: FIVE PARTICIPANTS ENROLLED INTO THE STUDY AND FOUR COMPLETED THE INTERVENTION. ATTENDANCE WAS 92% AND THERE WERE NO ADVERSE EVENTS. BASELINE MOBILITY WAS HIGHLY VARIED, WITH ONE YA HAVING HAD A HEMIPELVECTOMY. QUANTITATIVE DATA REVEALED SIGNIFICANTLY IMPROVED FATIGUE, SOCIAL FUNCTIONING, SOMATIZATION, AND GENERAL AND EMOTIONAL MANIFESTATIONS OF FATIGUE FOLLOWING YOGA. QUALITATIVE DATA CROSS VALIDATED, CLARIFIED, AND EXPANDED UPON THE QUANTITATIVE FINDINGS. CONCLUSIONS: THE STUDY SUGGESTS THAT A BRIEF IY INTERVENTION IS SAFE FOR YA SURVIVORS OF CHILDHOOD CANCER, EVEN FOR THOSE WITH PHYSICAL DISABILITIES. PRELIMINARY EFFICACY WAS DEMONSTRATED FOR THE PRIMARY OUTCOME OF FATIGUE. QUALITATIVE DATA ELUCIDATED ADDITIONAL IMPROVEMENTS, SUCH AS WORK-RELATED SOCIAL FUNCTIONING, AND A SENSE OF CALM AND RELAXATION. 2017 7 41 51 A BRIEF YOGA INTERVENTION IMPLEMENTED DURING CHEMOTHERAPY: A RANDOMIZED CONTROLLED PILOT STUDY. OBJECTIVES: FATIGUE AND OTHER TREATMENT-RELATED SYMPTOMS (E.G., SLEEP DISTURBANCE) ARE CRITICAL TARGETS FOR IMPROVING QUALITY OF LIFE IN PATIENTS UNDERGOING CHEMOTHERAPY. YOGA MAY REDUCE THE BURDEN OF SUCH SYMPTOMS. THIS STUDY INVESTIGATED THE FEASIBILITY OF CONDUCTING A RANDOMIZED CONTROLLED STUDY OF A BRIEF YOGA INTERVENTION DURING CHEMOTHERAPY FOR COLORECTAL CANCER. DESIGN: WE RANDOMIZED ADULTS WITH COLORECTAL CANCER TO A BRIEF YOGA SKILLS TRAINING (YST) OR AN ATTENTION CONTROL (AC; EMPATHIC ATTENTION AND RECORDED EDUCATION). SETTING: THE INTERVENTIONS AND ASSESSMENTS WERE IMPLEMENTED INDIVIDUALLY IN THE CLINIC WHILE PATIENTS WERE IN THE CHAIR RECEIVING CHEMOTHERAPY. INTERVENTIONS: BOTH INTERVENTIONS CONSISTED OF THREE SESSIONS AND RECOMMENDED HOME PRACTICE. MAIN OUTCOME MEASURES: THE PRIMARY OUTCOME WAS FEASIBILITY (ACCRUAL, RETENTION, ADHERENCE, DATA COLLECTION). SELF-REPORTED OUTCOMES (I.E., FATIGUE, SLEEP DISTURBANCE, QUALITY OF LIFE) AND INFLAMMATORY BIOMARKERS WERE ALSO DESCRIBED TO INFORM FUTURE STUDIES. RESULTS: OF 52 PATIENTS INITIALLY IDENTIFIED, 28 WERE APPROACHED, AND 15 ENROLLED (AGE MEAN = 57.5 YEARS; 80% WHITE; 60% MALE). REASONS FOR DECLINING PARTICIPATION WERE: NOT INTERESTED (N = 6), DID NOT PERCEIVE A NEED (N = 2), AND OTHER (N = 5). TWO PARTICIPANTS WERE LOST TO FOLLOW-UP IN EACH GROUP DUE TO TREATMENT CHANGES. THUS, 75% OF PARTICIPANTS WERE RETAINED IN THE YST AND 71% IN THE AC ARM. PARTICIPANTS RETAINED IN THE STUDY ADHERED TO 97% OF THE IN-PERSON INTERVENTION SESSIONS AND COMPLETED ALL QUESTIONNAIRES. CONCLUSIONS: THIS STUDY DEMONSTRATED THE FEASIBILITY OF CONDUCTING A LARGER RANDOMIZED CONTROLLED TRIAL TO ASSESS YST AMONG PATIENTS RECEIVING CHEMOTHERAPY FOR COLORECTAL CANCER. DATA COLLECTED AND CHALLENGES ENCOUNTERED WILL INFORM FUTURE RESEARCH. 2016 8 2323 52 TREATMENT OF CHRONIC PRIMARY SLEEP ONSET INSOMNIA WITH KUNDALINI YOGA: A RANDOMIZED CONTROLLED TRIAL WITH ACTIVE SLEEP HYGIENE COMPARISON. STUDY OBJECTIVES: PRIOR STUDIES HAVE SUGGESTED A BENEFIT OF YOGA FOR ALLEVIATING SLEEP DISTURBANCE; HOWEVER, MANY STUDIES HAVE HAD METHODOLOGICAL LIMITATIONS. THIS TRIAL STUDY AIMED TO EXTEND THAT LITERATURE BY INCLUDING AN ACTIVE SLEEP HYGIENE COMPARISON. METHODS: PARTICIPANTS AGED 25-59 YEARS WITH A PRIMARY COMPLAINT OF SLEEP ONSET INSOMNIA LASTING AT LEAST 6 MONTHS WERE BLOCK RANDOMIZED TO AN 8-WEEK KUNDALINI YOGA OR SLEEP HYGIENE INTERVENTION, BOTH CONSISTING OF INITIAL 60-MINUTE INSTRUCTION AND WEEKLY CHECK-INS. DAILY SLEEP DIARIES AND QUESTIONNAIRES WERE COLLECTED AT BASELINE, THROUGHOUT THE INTERVENTION, AND AT 6-MONTH FOLLOW-UP. DATA WERE ANALYZED USING LINEAR MIXED MODELS (N = 20 IN EACH GROUP). RESULTS: PARTICIPANT RATINGS OF THE INTERVENTIONS DID NOT SIGNIFICANTLY DIFFER. SLEEP HYGIENE IMPROVED SEVERAL DIARY AND QUESTIONNAIRE OUTCOMES, HOWEVER, YOGA RESULTED IN EVEN GREATER IMPROVEMENTS CORRESPONDING TO MEDIUM-TO-LARGE BETWEEN-GROUP EFFECT SIZES. TOTAL SLEEP TIME INCREASED PROGRESSIVELY ACROSS YOGA TREATMENT (D = 0.95, P = .002), CONCURRENT WITH INCREASED SLEEP EFFICIENCY (D = 1.36, P < .001) AND DECREASED SLEEP ONSET LATENCY (D = -1.16, P < .001), BUT WITHOUT CHANGES IN PRE-SLEEP AROUSAL (D =-0.30, P = .59). REMISSION RATES WERE ALSO HIGHER FOR YOGA COMPARED TO SLEEP HYGIENE, WITH >/= 80% OF YOGA PARTICIPANTS REPORTING AVERAGE SLEEP ONSET LATENCY < 30 MINUTES AND SLEEP EFFICIENCY > 80% AT 6-MONTH FOLLOW-UP. FOR OVER 50% OF YOGA PARTICIPANTS, THE INSOMNIA SEVERITY INDEX DECREASED BY AT LEAST 8 POINTS AT END OF TREATMENT AND FOLLOW-UP. CONCLUSIONS: YOGA, TAUGHT IN A SELF-CARE FRAMEWORK WITH MINIMAL INSTRUCTOR BURDEN, WAS ASSOCIATED WITH SELF-REPORTED IMPROVEMENTS ABOVE AND BEYOND AN ACTIVE SLEEP HYGIENE COMPARISON, SUSTAINED AT 6-MONTH FOLLOW-UP. FOLLOW-UP STUDIES ARE NEEDED TO ASSESS ACTIGRAPHY AND POLYSOMNOGRAPHY OUTCOMES, AS WELL AS POSSIBLE MECHANISMS OF CHANGE. CLINICAL TRIAL REGISTRATION: REGISTRY: CLINICALTRIALS.GOV; NAME: YOGA AS A TREATMENT FOR INSOMNIA; URL: HTTPS://CLINICALTRIALS.GOV/CT2/SHOW/NCT00033865; IDENTIFIER: NCT00033865. CITATION: KHALSA SBS, GOLDSTEIN MR. TREATMENT OF CHRONIC PRIMARY SLEEP ONSET INSOMNIA WITH KUNDALINI YOGA: A RANDOMIZED CONTROLLED TRIAL WITH ACTIVE SLEEP HYGIENE COMPARISON. J CLIN SLEEP MED. 2021;17(9):1841-1852. 2021 9 2628 47 YOGA FOR THE MANAGEMENT OF PAIN AND SLEEP IN RHEUMATOID ARTHRITIS: A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THE AIM OF THE PRESENT STUDY WAS TO DETERMINE THE FEASIBILITY OF A RELAXATION-BASED YOGA INTERVENTION FOR RHEUMATOID ARTHRITIS, DESIGNED AND REPORTED IN ACCORDANCE WITH DELPHI RECOMMENDATIONS FOR YOGA INTERVENTIONS FOR MUSCULOSKELETAL CONDITIONS. METHODS: PARTICIPANTS WERE RECRUITED FROM A HOSPITAL DATABASE, AND RANDOMIZED TO EITHER EIGHT WEEKLY 75-MIN YOGA CLASSES OR A USUAL CARE CONTROL. FEASIBILITY WAS DETERMINED BY RECRUITMENT RATES, RETENTION, PROTOCOL ADHERENCE, PARTICIPANT SATISFACTION AND ADVERSE EVENTS. SECONDARY PHYSICAL AND PSYCHOSOCIAL OUTCOMES WERE ASSESSED USING SELF-REPORTED QUESTIONNAIRES AT BASELINE (WEEK 0), WEEK 9 (PRIMARY TIME POINT) AND WEEK 12 (FOLLOW-UP). RESULTS: OVER A 3-MONTH PERIOD, 26 PARTICIPANTS WITH MILD PAIN, MILD TO MODERATE FUNCTIONAL DISABILITY AND MODERATE DISEASE ACTIVITY WERE RECRUITED INTO THE STUDY (25% RECRUITMENT RATE). RETENTION RATES WERE 100% FOR YOGA PARTICIPANTS AND 92% FOR USUAL CARE PARTICIPANTS AT BOTH WEEKS 9 AND 12. PROTOCOL ADHERENCE AND PARTICIPANT SATISFACTION WERE HIGH. YOGA PARTICIPANTS ATTENDED A MEDIAN OF SEVEN CLASSES; ADDITIONALLY, SEVEN OF THE YOGA PARTICIPANTS (54%) REPORTED CONTINUING YOGA AT HOME DURING THE FOLLOW-UP PERIOD. NO SERIOUS ADVERSE EVENTS WERE RELATED TO THE STUDY. SECONDARY OUTCOMES SHOWED NO GROUP EFFECTS OF YOGA COMPARED WITH USUAL CARE. CONCLUSIONS: A RELAXATION-BASED YOGA PROGRAMME WAS FOUND TO BE FEASIBLE AND SAFE FOR PARTICIPANTS WITH RHEUMATOID ARTHRITIS-RELATED PAIN AND FUNCTIONAL DISABILITY. ADVERSE EVENTS WERE MINOR, AND NOT UNEXPECTED FROM AN INTERVENTION INCLUDING PHYSICAL COMPONENTS. THIS PILOT PROVIDES A FRAMEWORK FOR LARGER INTERVENTION STUDIES, AND SUPPORTS FURTHER EXPLORATION OF YOGA AS A COMPLEX INTERVENTION TO ASSIST WITH THE MANAGEMENT OF RHEUMATOID ARTHRITIS. 2018 10 1787 44 PREFERENCE AND EXPECTATION FOR TREATMENT ASSIGNMENT IN A RANDOMIZED CONTROLLED TRIAL OF ONCE- VS TWICE-WEEKLY YOGA FOR CHRONIC LOW BACK PAIN. BACKGROUND: IN STUDIES INVOLVING NONPHARMACOLOGICAL COMPLEMENTARY AND ALTERNATIVE MEDICINE INTERVENTIONS, PARTICIPANT BLINDING IS VERY DIFFICULT. PARTICIPANT EXPECTATIONS MAY AFFECT PERCEIVED BENEFIT OF THERAPY. IN STUDIES OF YOGA AS TREATMENT FOR CHRONIC LOW BACK PAIN, LITTLE IS KNOWN ABOUT THE RELATIONSHIP BETWEEN PATIENT EXPECTATIONS AND PREFERENCES ON OUTCOMES. THIS STUDY WAS DESIGNED TO IDENTIFY BASELINE PREDICTORS OF PREFERENCE AND TO DETERMINE IF EXPECTATIONS AND PREFERENCES FOR DIFFERENT DOSES OF YOGA AFFECT BACK-RELATED FUNCTION AND LOW BACK PAIN INTENSITY. METHODS: THIS WAS A SECONDARY DATA ANALYSIS OF A 12-WEEK RANDOMIZED CONTROLLED TRIAL COMPARING ONCE-WEEKLY VS TWICE-WEEKLY YOGA FOR TREATMENT OF CHRONIC LOW BACK PAIN IN 93 ADULTS FROM A PREDOMINANTLY LOW-INCOME MINORITY POPULATION. AT BASELINE, PARTICIPANTS WERE ASKED ABOUT BACK FUNCTION, BACK PAIN, TREATMENT EXPECTATIONS, AND TREATMENT PREFERENCES. WE CREATED A VARIABLE "CONCORDANCE" TO DESCRIBE THE MATCHING OF PARTICIPANT PREFERENCE TO RANDOMIZED TREATMENT. OUR OUTCOME VARIABLES WERE CHANGE IN BACK FUNCTION AND PAIN INTENSITY AFTER 12 WEEKS OF YOGA INSTRUCTION. WE PERFORMED LOGISTIC REGRESSION TO IDENTIFY PREDICTORS OF PREFERENCE FOR ONCE- OR TWICE-WEEKLY YOGA INSTRUCTION. WE CREATED LINEAR REGRESSION MODELS TO IDENTIFY INDEPENDENT ASSOCIATIONS BETWEEN EXPECTATIONS, PREFERENCE, CONCORDANCE, AND OUTCOMES. RESULTS: WORSE BACK FUNCTION AT BASELINE WAS ASSOCIATED WITH 20% HIGHER ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 1.2, CI 1.1, 1.3). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR TWICE-WEEKLY YOGA HAD 90% HIGHER ODDS OF PREFERRING TWICE-WEEKLY VS ONCE-WEEKLY YOGA (OR 1.9, CI 1.3, 2.7). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR ONCE-WEEKLY YOGA HAD 40% LESS ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 0.6, CI 0.5, 0.9). AFTER CONTROLLING FOR BASELINE CHARACTERISTICS, WE FOUND NO STATISTICALLY SIGNIFICANT RELATIONSHIP BETWEEN TREATMENT OUTCOMES, PREFERENCE, EXPECTATION SCORES, OR CONCORDANCE. CONCLUSION: IN A POPULATION OF PREDOMINANTLY LOW-INCOME MINORITY PARTICIPANTS WITH CHRONIC LOW BACK PAIN, WORSE BACK FUNCTION WAS ASSOCIATED WITH PREFERENCE FOR MORE FREQUENT YOGA CLASSES. THOSE WHO PREFERRED MORE YOGA CLASSES HAD HIGHER EXPECTATIONS FOR THOSE CLASSES. TWELVE-WEEK CHANGE IN BACK PAIN INTENSITY AND BACK FUNCTION WERE NOT AFFECTED BY DOSING PREFERENCE, EXPECTATION SCORE, OR CONCORDANCE. MORE RESEARCH IS NEEDED TO BETTER MEASURE AND QUANTIFY PREFERENCE, EXPECTATIONS, AND THEIR RELATIONSHIP TO OUTCOMES IN YOGA RESEARCH. 2015 11 2811 44 YOGA TO PREVENT MOBILITY LIMITATIONS IN OLDER ADULTS: FEASIBILITY OF A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: THE LOSS OF MOBILITY DURING AGING IMPACTS INDEPENDENCE AND LEADS TO FURTHER DISABILITY, MORBIDITY, AND REDUCED LIFE EXPECTANCY. OUR OBJECTIVE WAS TO EXAMINE THE FEASIBILITY AND SAFETY OF CONDUCTING A RANDOMIZED CONTROLLED TRIAL OF YOGA FOR OLDER ADULTS AT RISK FOR MOBILITY LIMITATIONS. METHODS: SEDENTARY OLDER ADULTS (N = 46; AGE 60-89) WERE RECRUITED AND RANDOMIZED TO EITHER YOGA OR A HEALTH EDUCATION COMPARISON GROUP. YOGA SESSIONS (60-MIN) OCCURRED 2X WEEKLY, AND 90-MIN HEALTH EDUCATION SESSIONS OCCURRED WEEKLY, FOR 10 WEEKS. THE PRIMARY OUTCOMES WERE RECRUITMENT RATE, INTERVENTION ATTENDANCE, AND RETENTION AT ASSESSMENTS. ADVERSE EVENT RATES AND PARTICIPANT SATISFACTION WERE ALSO MEASURED. PHYSICAL PERFORMANCE MEASURES OF GAIT, BALANCE, AND STRENGTH AND SELF-REPORT OUTCOME MEASURES WERE ADMINISTERED AT BASELINE AND 10-WEEKS. RESULTS: RECRUITMENT LASTED 6 MONTHS. RETENTION OF PARTICIPANTS AT THE 10-WEEK FOLLOW-UP WAS HIGH (89% - PERFORMANCE MEASURES; 98% - SELF-REPORT QUESTIONNAIRES). ATTENDANCE WAS GOOD WITH 82% OF YOGA AND 74% OF HEALTH EDUCATION PARTICIPANTS ATTENDING AT LEAST 50% OF THE SESSIONS. NO SERIOUS ADVERSE EVENTS WERE REPORTED. PATIENT SATISFACTION WITH THE INTERVENTIONS WAS HIGH. THE MEAN EFFECT SIZE FOR THE PHYSICAL PERFORMANCE MEASURES WAS 0.35 WITH SOME OVER 0.50. THE MEAN EFFECT SIZE FOR SELF-REPORT OUTCOME MEASURES WAS 0.36. CONCLUSIONS: RESULTS INDICATE THAT IT IS FEASIBLE TO CONDUCT A LARGER RCT OF YOGA FOR SEDENTARY OLDER ADULTS AT RISK FOR MOBILITY PROBLEMS. THE YOGA AND COMPARISON INTERVENTIONS WERE SAFE, WELL ACCEPTED, AND WELL ATTENDED. EFFECT SIZES SUGGEST YOGA MAY HAVE IMPORTANT BENEFITS FOR THIS POPULATION AND SHOULD BE STUDIED FURTHER. TRIAL REGISTRATION: CLINICALTRIALS # NCT03544879 ; RETROSPECTIVELY REGISTERED 4 JUNE, 2018. 2018 12 1192 41 EXAMINING A THERAPEUTIC YOGA PROGRAM FOR PROSTATE CANCER SURVIVORS. BACKGROUND: IN THE EARLIER STAGES OF PROSTATE CANCER, EFFECTIVE TREATMENTS HAVE CREATED A NEED FOR RESEARCH TO FOCUS ON PRACTICES THAT MAY IMPROVE QUALITY OF LIFE THROUGHOUT SURVIVORSHIP. PHYSICAL ACTIVITY IS A SIGNIFICANT SUPPORTIVE CARE MANAGEMENT STRATEGY FOR PROSTATE CANCER SURVIVORS, THOUGH THE OPTIMAL MODALITY IS NOT YET UNDERSTOOD. HYPOTHESES: THE AUTHORS HYPOTHESIZED THAT YOGA WOULD BE A FEASIBLE PHYSICAL ACTIVITY OPTION FOR PROSTATE CANCER SURVIVORS AND THEIR SUPPORT PERSONS AND THAT THE INCORPORATION OF SOCIAL SUPPORT WOULD INCREASE PHYSICAL ACTIVITY ADHERENCE. METHODS: THIS 14-WEEK FEASIBILITY STUDY INVOLVED A 7-WEEK CLASS-BASED YOGA PROGRAM (ADHERENCE PHASE), FOLLOWED BY 7 WEEKS OF SELF-SELECTED PHYSICAL ACTIVITY (MAINTENANCE PHASE). DEMOGRAPHIC INFORMATION, PHYSICAL ACTIVITY BEHAVIOR, QUALITY OF LIFE, FATIGUE, STRESS, MOOD, AND FITNESS VARIABLES WERE ASSESSED AT 3 TIME POINTS. PROSTATE CANCER SURVIVORS' PERCEIVED SOCIAL SUPPORT WAS RATED DURING YOGA AND AFTER YOGA. RESULTS: CLASS ATTENDANCE WAS 6.1 AND 5.8 FOR PROSTATE CANCER SURVIVORS (N = 15) AND THEIR SUPPORT PERSONS (N = 10), RESPECTIVELY, FOR THE 7 CLASSES. LEVELS OF PERCEIVED SOCIAL SUPPORT WERE HIGHER FOR THOSE WHO BROUGHT A SUPPORT PERSON. SIGNIFICANT IMPROVEMENTS WITH REGARD TO STRESS, FATIGUE, AND MOOD BEFORE AND AFTER YOGA CLASS (ALL PS < .05) WERE REPORTED BY ALL PARTICIPANTS. NO CLINICALLY SIGNIFICANT CHANGES WERE NOTED ON PROSTATE CANCER SURVIVOR'S QUALITY OF LIFE OR FATIGUE OVER THE COURSE OF THE 14-WEEK STUDY. CONCLUSIONS: YOGA IS A FEASIBLE PHYSICAL ACTIVITY OPTION FOR PROSTATE CANCER SURVIVORS. THE PROGRAM HAD A PROMISING UPTAKE RATE, HIGH PROGRAM ADHERENCE RATE, AND THERE WERE ACUTE PROGRAM BENEFITS WITH REGARD TO STRESS, FATIGUE, AND MOOD FOR ALL PARTICIPANTS. FUTURE EXAMINATION IS WARRANTED WITH REGARD TO CHRONIC BENEFITS AND GROUP COHESION INFLUENCES ON LEVELS OF PERCEIVED SOCIAL SUPPORT. 2013 13 1541 39 KRIPALU YOGA FOR MILITARY VETERANS WITH PTSD: A RANDOMIZED TRIAL. OBJECTIVES: THIS RANDOMIZED CONTROLLED TRIAL OF YOGA FOR MILITARY VETERANS AND ACTIVE DUTY PERSONNEL WITH POSTTRAUMATIC STRESS DISORDER (PTSD) EVALUATED THE EFFICACY OF A 10-WEEK YOGA INTERVENTION ON PTSD. METHOD: FIFTY-ONE PARTICIPANTS WERE RANDOMIZED INTO YOGA OR NO-TREATMENT ASSESSMENT-ONLY CONTROL GROUPS. PRIMARY OUTCOME MEASURES INCLUDED QUESTIONNAIRES AND THE CLINICIAN ADMINISTERED PTSD SCALE. RESULTS: BOTH YOGA (N = 9) AND CONTROL (N = 6) PARTICIPANTS SHOWED SIGNIFICANT DECREASES IN REEXPERIENCING SYMPTOMS, WITH NO SIGNIFICANT BETWEEN-GROUP DIFFERENCES. SECONDARY WITHIN-GROUP ANALYSES OF A SELF-SELECTED WAIT-LIST YOGA GROUP (N = 7) SHOWED SIGNIFICANT REDUCTIONS IN PTSD SYMPTOMS AFTER YOGA PARTICIPATION, IN CONTRAST TO THEIR CONTROL GROUP PARTICIPATION. CONSISTENT WITH CURRENT LITERATURE REGARDING HIGH RATES OF PTSD TREATMENT DROPOUT FOR VETERANS, THIS STUDY FACED CHALLENGES RETAINING PARTICIPANTS ACROSS CONDITIONS. CONCLUSION: THESE RESULTS ARE CONSISTENT WITH RECENT LITERATURE INDICATING THAT YOGA MAY HAVE POTENTIAL AS A PTSD THERAPY IN A VETERAN OR MILITARY POPULATION. HOWEVER, ADDITIONAL LARGER SAMPLE SIZE TRIALS ARE NECESSARY TO CONFIRM THIS CONCLUSION. 2018 14 1865 44 RANDOMIZED PILOT TRIAL OF YOGA VERSUS STRENGTHENING EXERCISES IN BREAST CANCER SURVIVORS WITH CANCER-RELATED FATIGUE. PURPOSE: FATIGUE IS ONE OF THE MOST COMMON AND BOTHERSOME REFRACTORY SYMPTOMS EXPERIENCED BY CANCER SURVIVORS. MINDFUL EXERCISE INTERVENTIONS SUCH AS YOGA IMPROVE CANCER-RELATED FATIGUE; HOWEVER, STUDIES OF YOGA HAVE INCLUDED HETEROGENEOUS SURVIVORSHIP POPULATIONS, AND THE EFFECT OF YOGA ON FATIGUED SURVIVORS REMAINS UNCLEAR. METHODS: WE RANDOMLY ASSIGNED 34 EARLY-STAGE BREAST CANCER SURVIVORS WITH CANCER-RELATED FATIGUE (>/=4 ON A LIKERT SCALE FROM 1-10) WITHIN 1 YEAR FROM DIAGNOSIS TO A 12-WEEK INTERVENTION OF HOME-BASED YOGA VERSUS STRENGTHENING EXERCISES, BOTH PRESENTED ON A DVD. THE PRIMARY ENDPOINTS WERE FEASIBILITY AND CHANGES IN FATIGUE, AS MEASURED BY THE MULTIDIMENSIONAL FATIGUE SYMPTOM INVENTORY-SHORT FORM (MFSI-SF). SECONDARY ENDPOINT WAS QUALITY OF LIFE, ASSESSED BY THE FUNCTIONAL ASSESSMENT OF CANCER THERAPIES-BREAST (FACT-B). RESULTS: WE INVITED 401 WOMEN TO PARTICIPATE IN THE STUDY; 78 RESPONDED, AND WE ENROLLED 34. BOTH GROUPS HAD SIGNIFICANT WITHIN-GROUP IMPROVEMENT IN MULTIPLE DOMAINS OF THE FATIGUE AND QUALITY OF LIFE SCORES FROM BASELINE TO POST-INTERVENTION, AND THESE BENEFITS WERE MAINTAINED AT 3 MONTHS POST-INTERVENTION. HOWEVER, THERE WAS NO SIGNIFICANT DIFFERENCE BETWEEN GROUPS IN FATIGUE OR QUALITY OF LIFE AT ANY ASSESSMENT TIME. SIMILARLY, THERE WAS NO DIFFERENCE BETWEEN GROUPS IN ADHERENCE TO THE EXERCISE INTERVENTION. CONCLUSIONS: BOTH DVD-BASED YOGA AND STRENGTHENING EXERCISES DESIGNED FOR CANCER SURVIVORS MAY BE GOOD OPTIONS TO ADDRESS FATIGUE IN BREAST CANCER SURVIVORS. BOTH HAVE REASONABLE UPTAKE, ARE CONVENIENT AND REPRODUCIBLE, AND MAY BE HELPFUL IN DECREASING FATIGUE AND IMPROVING QUALITY OF LIFE IN THE FIRST YEAR POST-DIAGNOSIS IN BREAST CANCER PATIENTS WITH CANCER-RELATED FATIGUE. 2016 15 2442 45 YOGA AND SELF-REPORTED COGNITIVE PROBLEMS IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: CANCER SURVIVORS OFTEN REPORT COGNITIVE PROBLEMS. FURTHERMORE, DECREASES IN PHYSICAL ACTIVITY TYPICALLY OCCUR OVER THE COURSE OF CANCER TREATMENT. ALTHOUGH PHYSICAL ACTIVITY BENEFITS COGNITIVE FUNCTION IN NONCANCER POPULATIONS, EVIDENCE LINKING PHYSICAL ACTIVITY TO COGNITIVE FUNCTION IN CANCER SURVIVORS IS LIMITED. IN OUR RECENT RANDOMIZED CONTROLLED TRIAL, BREAST CANCER SURVIVORS WHO RECEIVED A YOGA INTERVENTION HAD LOWER FATIGUE AND INFLAMMATION FOLLOWING THE TRIAL COMPARED WITH A WAIT LIST CONTROL GROUP. THIS SECONDARY ANALYSIS OF THE PARENT TRIAL ADDRESSED YOGA'S IMPACT ON COGNITIVE COMPLAINTS. METHODS: POSTTREATMENT STAGE 0-IIIA BREAST CANCER SURVIVORS (N = 200) WERE RANDOMIZED TO A 12-WEEK, TWICE-WEEKLY HATHA YOGA INTERVENTION OR A WAIT LIST CONTROL GROUP. PARTICIPANTS REPORTED COGNITIVE COMPLAINTS USING THE BREAST CANCER PREVENTION TRIAL COGNITIVE PROBLEMS SCALE AT BASELINE, IMMEDIATELY POSTINTERVENTION, AND 3-MONTH FOLLOW-UP. RESULTS: COGNITIVE COMPLAINTS DID NOT DIFFER SIGNIFICANTLY BETWEEN GROUPS IMMEDIATELY POSTINTERVENTION (P = 0.250). HOWEVER, AT 3-MONTH FOLLOW-UP, YOGA PARTICIPANTS' BREAST CANCER PREVENTION TRIAL COGNITIVE PROBLEMS SCALE SCORES WERE AN AVERAGE OF 23% LOWER THAN WAIT LIST PARTICIPANTS' SCORES (P = 0.003). THESE GROUP DIFFERENCES IN COGNITIVE COMPLAINTS REMAINED AFTER CONTROLLING FOR PSYCHOLOGICAL DISTRESS, FATIGUE, AND SLEEP QUALITY. CONSISTENT WITH THE PRIMARY RESULTS, THOSE WHO PRACTICED YOGA MORE FREQUENTLY REPORTED SIGNIFICANTLY FEWER COGNITIVE PROBLEMS AT 3-MONTH FOLLOW-UP THAN THOSE WHO PRACTICED LESS FREQUENTLY (P < 0.001). CONCLUSIONS: THESE FINDINGS SUGGEST THAT YOGA CAN EFFECTIVELY REDUCE BREAST CANCER SURVIVORS' COGNITIVE COMPLAINTS AND PROMPT FURTHER RESEARCH ON MIND-BODY AND PHYSICAL ACTIVITY INTERVENTIONS FOR IMPROVING CANCER-RELATED COGNITIVE PROBLEMS. 2015 16 1862 45 RANDOMIZED CONTROLLED TRIAL OF YOGA AMONG A MULTIETHNIC SAMPLE OF BREAST CANCER PATIENTS: EFFECTS ON QUALITY OF LIFE. PURPOSE: THIS STUDY EXAMINES THE IMPACT OF YOGA, INCLUDING PHYSICAL POSES, BREATHING, AND MEDITATION EXERCISES, ON QUALITY OF LIFE (QOL), FATIGUE, DISTRESSED MOOD, AND SPIRITUAL WELL-BEING AMONG A MULTIETHNIC SAMPLE OF BREAST CANCER PATIENTS. PATIENTS AND METHODS: ONE HUNDRED TWENTY-EIGHT PATIENTS (42% AFRICAN AMERICAN, 31% HISPANIC) RECRUITED FROM AN URBAN CANCER CENTER WERE RANDOMLY ASSIGNED (2:1 RATIO) TO A 12-WEEK YOGA INTERVENTION (N = 84) OR A 12-WEEK WAITLIST CONTROL GROUP (N = 44). CHANGES IN QOL (EG, FUNCTIONAL ASSESSMENT OF CANCER THERAPY) FROM BEFORE RANDOM ASSIGNMENT (T1) TO THE 3-MONTH FOLLOW-UP (T3) WERE EXAMINED; PREDICTORS OF ADHERENCE WERE ALSO ASSESSED. NEARLY HALF OF ALL PATIENTS WERE RECEIVING MEDICAL TREATMENT. RESULTS: REGRESSION ANALYSES INDICATED THAT THE CONTROL GROUP HAD A GREATER DECREASE IN SOCIAL WELL-BEING COMPARED WITH THE INTERVENTION GROUP AFTER CONTROLLING FOR BASELINE SOCIAL WELL-BEING AND COVARIATES (P < .0001). SECONDARY ANALYSES OF 71 PATIENTS NOT RECEIVING CHEMOTHERAPY DURING THE INTERVENTION PERIOD INDICATED FAVORABLE OUTCOMES FOR THE INTERVENTION GROUP COMPARED WITH THE CONTROL GROUP IN OVERALL QOL (P < .008), EMOTIONAL WELL-BEING (P < .015), SOCIAL WELL-BEING (P < .004), SPIRITUAL WELL-BEING (P < .009), AND DISTRESSED MOOD (P < .031). SIXTY-NINE PERCENT OF INTERVENTION PARTICIPANTS ATTENDED CLASSES (MEAN NUMBER OF CLASSES ATTENDED BY ACTIVE CLASS PARTICIPANTS = 7.00 +/- 3.80), WITH LOWER ADHERENCE ASSOCIATED WITH INCREASED FATIGUE (P < .001), RADIOTHERAPY (P < .0001), YOUNGER AGE (P < .008), AND NO ANTIESTROGEN THERAPY (P < .02). CONCLUSION: DESPITE LIMITED ADHERENCE, THIS INTENT-TO-TREAT ANALYSIS SUGGESTS THAT YOGA IS ASSOCIATED WITH BENEFICIAL EFFECTS ON SOCIAL FUNCTIONING AMONG A MEDICALLY DIVERSE SAMPLE OF BREAST CANCER SURVIVORS. AMONG PATIENTS NOT RECEIVING CHEMOTHERAPY, YOGA APPEARS TO ENHANCE EMOTIONAL WELL-BEING AND MOOD AND MAY SERVE TO BUFFER DETERIORATION IN BOTH OVERALL AND SPECIFIC DOMAINS OF QOL. 2007 17 2605 37 YOGA FOR PERSISTENT FATIGUE IN BREAST CANCER SURVIVORS: RESULTS OF A PILOT STUDY. APPROXIMATELY ONE-THIRD OF BREAST CANCER SURVIVORS EXPERIENCES PERSISTENT FATIGUE FOR MONTHS OR YEARS AFTER SUCCESSFUL TREATMENT COMPLETION. THERE IS A LACK OF EVIDENCE-BASED TREATMENTS FOR CANCER-RELATED FATIGUE, PARTICULARLY AMONG CANCER SURVIVORS. THIS SINGLE-ARM PILOT STUDY EVALUATED THE FEASIBILITY AND PRELIMINARY EFFICACY OF A YOGA INTERVENTION FOR FATIGUED BREAST CANCER SURVIVORS BASED ON THE IYENGAR TRADITION. IYENGAR YOGA PRESCRIBES SPECIFIC POSES FOR INDIVIDUALS WITH SPECIFIC MEDICAL PROBLEMS AND CONDITIONS; THIS TRIAL EMPHASIZED POSTURES BELIEVED TO BE EFFECTIVE FOR REDUCING FATIGUE AMONG BREAST CANCER SURVIVORS, INCLUDING INVERSIONS AND BACKBENDS PERFORMED WITH THE SUPPORT OF PROPS. TWELVE WOMEN WERE ENROLLED IN THE TRIAL, AND 11 COMPLETED THE FULL 12-WEEK COURSE OF TREATMENT. THERE WAS A SIGNIFICANT IMPROVEMENT IN FATIGUE SCORES FROM PRE- TO POST-INTERVENTION THAT WAS MAINTAINED AT THE 3-MONTH POST-INTERVENTION FOLLOWUP. SIGNIFICANT IMPROVEMENTS WERE ALSO OBSERVED IN MEASURES OF PHYSICAL FUNCTION, DEPRESSED MOOD, AND QUALITY OF LIFE. THESE RESULTS SUPPORT THE ACCEPTABILITY OF THIS INTERVENTION AND SUGGEST THAT IT MAY HAVE BENEFICIAL EFFECTS ON PERSISTENT POST-TREATMENT FATIGUE. HOWEVER, RESULTS REQUIRE REPLICATION IN A LARGER RANDOMIZED CONTROLLED TRIAL. 2011 18 1617 47 MINDFUL YOGA FOR WOMEN WITH METASTATIC BREAST CANCER: DESIGN OF A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: WOMEN WITH METASTATIC BREAST CANCER (MBC) HAVE AVERAGE LIFE EXPECTANCIES OF ABOUT 2 YEARS, AND REPORT HIGH LEVELS OF DISEASE-RELATED SYMPTOMS INCLUDING PAIN, FATIGUE, SLEEP DISTURBANCE, PSYCHOLOGICAL DISTRESS, AND FUNCTIONAL IMPAIRMENT. THERE IS GROWING RECOGNITION OF THE LIMITATIONS OF MEDICAL APPROACHES TO MANAGING SUCH SYMPTOMS. YOGA IS A MIND-BODY DISCIPLINE THAT HAS DEMONSTRATED A POSITIVE IMPACT ON PSYCHOLOGICAL AND FUNCTIONAL HEALTH IN EARLY STAGE BREAST CANCER PATIENTS AND SURVIVORS, BUT HAS NOT BEEN RIGOROUSLY STUDIED IN ADVANCED CANCER SAMPLES. METHODS: THIS RANDOMIZED CONTROLLED TRIAL EXAMINES THE FEASIBILITY AND INITIAL EFFICACY OF A MINDFUL YOGA PROGRAM, COMPARED WITH A SOCIAL SUPPORT CONDITION THAT CONTROLS FOR ATTENTION, ON MEASURES OF DISEASE-RELATED SYMPTOMS SUCH AS PAIN AND FATIGUE. THE STUDY WILL BE COMPLETED BY DECEMBER 2017. SIXTY-FIVE WOMEN WITH MBC AGE >/= 18 ARE BEING IDENTIFIED AND RANDOMIZED WITH A 2:1 ALLOCATION TO MINDFUL YOGA OR A SUPPORT GROUP CONTROL INTERVENTION. THE 120-MIN INTERVENTION SESSIONS TAKE PLACE WEEKLY FOR 8 WEEKS. THE STUDY IS CONDUCTED AT AN URBAN TERTIARY CARE ACADEMIC MEDICAL CENTER LOCATED IN DURHAM, NORTH CAROLINA. THE PRIMARY FEASIBILITY OUTCOME IS ATTENDANCE AT INTERVENTION SESSIONS. EFFICACY OUTCOMES INCLUDE PAIN, FATIGUE, SLEEP QUALITY, PSYCHOLOGICAL DISTRESS, MINDFULNESS AND FUNCTIONAL CAPACITY AT POST-INTERVENTION, 3-MONTH FOLLOW-UP, AND 6-MONTH FOLLOW-UP. DISCUSSION: IN THIS ARTICLE, WE PRESENT THE CHALLENGES OF DESIGNING A RANDOMIZED CONTROLLED TRIAL WITH LONG-TERM FOLLOW-UP AMONG WOMEN WITH MBC. THESE CHALLENGES INCLUDE ENSURING ADEQUATE RECRUITMENT INCLUDING OF MINORITIES, LIMITING AND CONTROLLING FOR SELECTION BIAS, TAILORING OF THE YOGA INTERVENTION TO ADDRESS SPECIAL NEEDS, AND MAXIMIZING ADHERENCE AND RETENTION. THIS PROJECT WILL PROVIDE IMPORTANT INFORMATION REGARDING YOGA AS AN INTERVENTION FOR WOMEN WITH ADVANCED CANCER, INCLUDING PRELIMINARY DATA ON THE PSYCHOLOGICAL AND FUNCTIONAL EFFECTS OF YOGA FOR MBC PATIENTS. THIS INVESTIGATION WILL ALSO ESTABLISH RIGOROUS METHODS FOR FUTURE RESEARCH INTO YOGA AS AN INTERVENTION FOR THIS POPULATION. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFER: NCT01927081 , REGISTERED AUGUST 16, 2013. 2017 19 345 32 ASSESSING FEASIBILITY AND ACCEPTABILITY OF YOGA AND GROUP CBT FOR ADOLESCENTS WITH DEPRESSION: A PILOT RANDOMIZED CLINICAL TRIAL. PURPOSE: GIVEN INCREASING RATES OF DEPRESSION IN ADOLESCENTS, THERE IS A CLEAR NEED FOR INNOVATIVE TREATMENTS. IN THIS PILOT RANDOMIZED CLINICAL TRIAL, WE ASSESSED ACCEPTABILITY AND FEASIBILITY OF TWO GROUP-BASED INTERVENTIONS: YOGA AND COGNITIVE-BEHAVIORAL THERAPY (CBT). THE GOAL OF THIS WORK IS TO PREPARE FOR A FUTURE FULLY POWERED RANDOMIZED TRIAL TO TEST THE HYPOTHESIS THAT YOGA IS NOT INFERIOR TO AN ESTABLISHED ADOLESCENT DEPRESSION TREATMENT, NAMELY, GROUP CBT. METHODS: WE ENROLLED 42 ADOLESCENTS WITH ELEVATED DEPRESSION SYMPTOMS. PARTICIPANTS WERE RANDOMLY ASSIGNED TO A 12-WEEK GROUP-BASED INTERVENTION, YOGA OR CBT. WE HAD A PRIORI FEASIBILITY AND ACCEPTABILITY TARGETS, INCLUDING FOR RECRUITMENT RATE, RETENTION RATE, EXPECTANCY, CREDIBILITY, PROGRAM SATISFACTION, CLASS ATTENDANCE, ENGAGEMENT IN HOME PRACTICE, AND INSTRUCTOR/LEADER MANUAL ADHERENCE. WE ASSESSED ADVERSE EVENTS, AND WITHIN-SUBJECT CHANGES IN OUTCOMES (DEPRESSION, ANXIETY, IMPAIRMENT, SLEEP DISTURBANCE) AND POSSIBLE MEDIATORS (MINDFULNESS, SELF-COMPASSION). RESULTS: BOTH INTERVENTIONS MET MOST ACCEPTABILITY AND FEASIBILITY TARGETS. THE ONLY TARGET NOT MET RELATED TO LOW ENGAGEMENT IN HOME PRACTICE. PARTICIPANTS WITHIN EACH STUDY ARM SHOWED DECREASED DEPRESSION SYMPTOMS OVER TIME AND INCREASED SELF-COMPASSION. CONCLUSIONS: A YOGA INTERVENTION APPEARS TO BE ACCEPTABLE AND FEASIBLE TO ADOLESCENTS WITH DEPRESSION. HOWEVER, IT MAY BE CHALLENGING FOR THIS GROUP TO ENGAGE IN UNSTRUCTURED HOME PRACTICE. 2022 20 2623 40 YOGA FOR SYMPTOM MANAGEMENT IN ONCOLOGY: A REVIEW OF THE EVIDENCE BASE AND FUTURE DIRECTIONS FOR RESEARCH. BECAUSE YOGA IS INCREASINGLY RECOGNIZED AS A COMPLEMENTARY APPROACH TO CANCER SYMPTOM MANAGEMENT, PATIENTS/SURVIVORS AND PROVIDERS NEED TO UNDERSTAND ITS POTENTIAL BENEFITS AND LIMITATIONS BOTH DURING AND AFTER TREATMENT. THE AUTHORS REVIEWED RANDOMIZED CONTROLLED TRIALS (RCTS) OF YOGA CONDUCTED AT THESE POINTS IN THE CANCER CONTINUUM (N = 29; N = 13 DURING TREATMENT, N = 12 POST-TREATMENT, AND N = 4 WITH MIXED SAMPLES). FINDINGS BOTH DURING AND AFTER TREATMENT DEMONSTRATED THE EFFICACY OF YOGA TO IMPROVE OVERALL QUALITY OF LIFE (QOL), WITH IMPROVEMENT IN SUBDOMAINS OF QOL VARYING ACROSS STUDIES. FATIGUE WAS THE MOST COMMONLY MEASURED OUTCOME, AND MOST RCTS CONDUCTED DURING OR AFTER CANCER TREATMENT REPORTED IMPROVEMENTS IN FATIGUE. RESULTS ALSO SUGGESTED THAT YOGA CAN IMPROVE STRESS/DISTRESS DURING TREATMENT AND POST-TREATMENT DISTURBANCES IN SLEEP AND COGNITION. SEVERAL RCTS PROVIDED EVIDENCE THAT YOGA MAY IMPROVE BIOMARKERS OF STRESS, INFLAMMATION, AND IMMUNE FUNCTION. OUTCOMES WITH LIMITED OR MIXED FINDINGS (EG, ANXIETY, DEPRESSION, PAIN, CANCER-SPECIFIC SYMPTOMS, SUCH AS LYMPHEDEMA) AND POSITIVE PSYCHOLOGICAL OUTCOMES (SUCH AS BENEFIT-FINDING AND LIFE SATISFACTION) WARRANT FURTHER STUDY. IMPORTANT FUTURE DIRECTIONS FOR YOGA RESEARCH IN ONCOLOGY INCLUDE: ENROLLING PARTICIPANTS WITH CANCER TYPES OTHER THAN BREAST, STANDARDIZING SELF-REPORT ASSESSMENTS, INCREASING THE USE OF ACTIVE CONTROL GROUPS AND OBJECTIVE MEASURES, AND ADDRESSING THE HETEROGENEITY OF YOGA INTERVENTIONS, WHICH VARY IN TYPE, KEY COMPONENTS (MOVEMENT, MEDITATION, BREATHING), DOSE, AND DELIVERY MODE. 2019