1 2552 159 YOGA FOR CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY AND FALL RISK: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY (CIPN) IS A COMMON, DEBILITATING SIDE EFFECT THAT WORSENS QUALITY OF LIFE AND INCREASES THE RISK OF FALLS IN CANCER SURVIVORS. EVIDENCE OF YOGA'S SAFETY AND EFFICACY IN TREATING CIPN IS LACKING. METHODS: IN A RANDOMIZED CONTROLLED STUDY, WE ASSIGNED BREAST AND GYNECOLOGICAL CANCER SURVIVORS WITH PERSISTENT MODERATE-TO-SEVERE CIPN PAIN, NUMBNESS, OR TINGLING WITH A SCORE OF 4 OR GREATER (0-10 NUMERIC RATING SCALE [NRS]) FOR AT LEAST 3 MONTHS AFTER CHEMOTHERAPY TO 8 WEEKS OF USUAL CARE OR YOGA FOCUSED ON BREATHWORK AND MUSCULOSKELETAL CONDITIONING. PRIMARY ENDPOINT WAS TREATMENT ARM DIFFERENCES FOR NRS, AND SECONDARY ENDPOINTS WERE FUNCTIONAL ASSESSMENT OF CANCER THERAPY/GYNECOLOGIC ONCOLOGY GROUP-NEUROTOXICITY SUBSCALE (FACT/GOG-NTX), AND FUNCTIONAL REACH TEST AFTER WEEK 8. WE TESTED TREATMENT ARM DIFFERENCES FOR EACH OUTCOME MEASURE USING LINEAR MIXED MODELS WITH TREATMENT-BY-TIME INTERACTIONS. ALL STATISTICAL TESTS WERE TWO-SIDED. RESULTS: WE RANDOMLY ASSIGNED 41 PARTICIPANTS INTO YOGA (N = 21) OR USUAL CARE (N = 20). AT WEEK 8, MEAN NRS PAIN DECREASED BY 1.95 POINTS (95% CONFIDENCE INTERVAL [CI] = -3.20 TO -0.70) IN YOGA VS 0.65 (95% CI = -1.81 TO 0.51) IN USUAL CARE (P = .14). FACT/GOG-NTX IMPROVED BY 4.25 (95% CI = 2.29 TO 6.20) IN YOGA VS 1.36 (95% CI = -0.47 TO 3.19) IN USUAL CARE (P = .035). FUNCTIONAL REACH, AN OBJECTIVE FUNCTIONAL MEASURE PREDICTING THE RISK OF FALLS, IMPROVED BY 7.14 CM (95% CI = 3.68 TO 10.59) IN YOGA AND DECREASED BY 1.65 CM (95% CI = -5.00 TO 1.72) IN USUAL CARE (P = .001). FOUR GRADE 1 ADVERSE EVENTS WERE OBSERVED IN THE YOGA ARM. CONCLUSION: AMONG BREAST AND GYNECOLOGICAL CANCER SURVIVORS WITH MODERATE-TO-SEVERE CIPN, YOGA WAS SAFE AND SHOWED PROMISING EFFICACY IN IMPROVING CIPN SYMPTOMS. 2020 2 920 44 EFFECTIVENESS OF YOGA AND EDUCATIONAL INTERVENTION ON DISABILITY, ANXIETY, DEPRESSION, AND PAIN IN PEOPLE WITH CLBP: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THE CURRENT STUDY INVESTIGATES THE EFFECTS OF AN 8-WEEK YOGA PROGRAM WITH EDUCATIONAL INTERVENTION COMPARED WITH AN INFORMATIONAL PAMPHLET ON DISABILITY, ANXIETY, DEPRESSION, AND PAIN, IN PEOPLE AFFECTED BY CHRONIC LOW BACK PAIN (CLBP). METHODS: THIRTY INDIVIDUALS (AGE 34.2+/-4.52YRS) WITH CLBP WERE RANDOMLY ASSIGNED INTO A YOGA GROUP (YG, N=15) AND A PAMPHLET GROUP (PG, N=15). THE YG PARTICIPATED IN AN 8-WEEK (2 DAYS PER WEEK) YOGA PROGRAM WHICH INCLUDED EDUCATION ON SPINE ANATOMY/BIOMECHANICS AND THE MANAGEMENT OF CLBP. MAIN OUTCOME MEASURES: MONITORING RESPONSE TO INTERVENTION, THE OSWESTRY LOW BACK PAIN DISABILITY QUESTIONNAIRE (ODI-I), ZUNG SELF-RATING DEPRESSION SCALE (SDS), ZUNG SELF-RATING ANXIETY SCALE (SAS) AND NUMERIC RATING SCALE FOR PAIN (NRS 0-10) WERE USED TO COLLECT DATA. RESULTS: AFTER INTERVENTION, THE YG SHOWED A SIGNIFICANT DECREASE (P<0.05) IN THE MEAN SCORE IN ALL ASSESSED VARIABLES WHEN COMPARED WITH BASELINE DATA. IN ADDITION, STATISTICALLY SIGNIFICANT (P<0.05) DIFFERENCES WERE OBSERVED AMONG GROUPS AT THE END OF INTERVENTION IN DEPRESSION, ANXIETY, AND PAIN, BUT NOT IN DISABILITY. CONCLUSIONS: THE YOGA PROGRAM AND EDUCATION TOGETHER APPEAR TO BE EFFECTIVE IN REDUCING DEPRESSION AND ANXIETY, WHICH CAN AFFECT PERCEPTION OF PAIN. 2018 3 2549 62 YOGA FOR CANCER SURVIVORS WITH CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY: HEALTH-RELATED QUALITY OF LIFE OUTCOMES. BACKGROUND: YOGA IS A MEDITATIVE MOVEMENT THERAPY FOCUSED ON MIND-BODY AWARENESS. THE IMPACT OF YOGA ON HEALTH-RELATED QUALITY OF LIFE (HRQOL) OUTCOMES IN PATIENTS WITH CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY (CIPN) IS UNCLEAR. METHODS: WE CONDUCTED A PILOT RANDOMIZED WAIT-LIST CONTROLLED TRIAL OF 8 WEEKS OF YOGA (N = 21) VERSUS WAIT-LIST CONTROL (N = 20) FOR CIPN IN 41 BREAST AND GYNECOLOGICAL CANCER SURVIVORS WITH PERSISTENT MODERATE TO SEVERE CIPN. HRQOL ENDPOINTS WERE HOSPITAL ANXIETY AND DEPRESSION SCALE (HADS), BRIEF FATIGUE INVENTORY (BFI), AND INSOMNIA SEVERITY INDEX (ISI). THE TREATMENT EXPECTANCY SCALE (TES) WAS ADMINISTERED AT BASELINE. WE ESTIMATED MEAN CHANGES AND 95% CONFIDENCE INTERVALS (CIS) FROM BASELINE TO WEEKS 8 AND 12 AND COMPARED ARMS USING CONSTRAINED LINEAR MIXED MODELS. RESULTS: AT WEEK 8, HADS ANXIETY SCORES DECREASED -1.61 (-2.75, -0.46) IN THE YOGA ARM AND -0.32 (-1.38, 0.75) POINTS IN THE WAIT-LIST CONTROL ARM (P = 0.099). AT WEEK 12, HADS ANXIETY SCORES DECREASED -1.42 (-2.57, -0.28) IN YOGA COMPARED TO AN INCREASE OF 0.46 (-0.60, 1.53) IN WAIT-LIST CONTROL (P = 0.017). THERE WERE NO SIGNIFICANT DIFFERENCES IN HADS DEPRESSION, BFI, OR ISI SCORES BETWEEN YOGA AND WAIT-LIST CONTROL. BASELINE TES WAS SIGNIFICANTLY HIGHER IN YOGA THAN IN WAIT-LIST CONTROL (14.9 VS. 12.7, P = 0.019). TES WAS NOT ASSOCIATED WITH HADS ANXIETY REDUCTION AND HADS ANXIETY REDUCTION WAS NOT ASSOCIATED WITH CIPN PAIN REDUCTION. CONCLUSIONS: YOGA MAY REDUCE ANXIETY IN PATIENTS WITH CIPN. FUTURE STUDIES ARE NEEDED TO CONFIRM THESE FINDINGS. CLINICAL TRIAL REGISTRATION NUMBER: CLINICALTRIALS.GOV IDENTIFIER: NCT03292328. 2021 4 1389 55 IMPACT OF SOMATIC YOGA AND MEDITATION ON FALL RISK, FUNCTION, AND QUALITY OF LIFE FOR CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY SYNDROME IN CANCER SURVIVORS. OBJECTIVE: CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY (CIPN) SYNDROME CAUSES SIGNIFICANT PAIN AS AN ADVERSE EFFECT OF TREATMENT, WITH FEW NONPHARMACOLOGICAL INTERVENTIONS TESTED. A SOMATIC YOGA AND MEDITATION (SYM) INTERVENTION ON FUNCTIONAL OUTCOMES AND QUALITY OF LIFE (QOL) WAS INVESTIGATED. DESIGN AND METHODS: INDIVIDUALS DIAGNOSED WITH CIPN WERE ENROLLED IN AN OPEN-LABEL, SINGLE-ARM, MIXED-METHODS FEASIBILITY TRIAL. PARTICIPANTS AND SETTING: IN AN OUTPATIENT REHABILITATION CENTER, TEN PARTICIPANTS WITH MEDIAN AGE 64.4 YEARS (47-81) ATTENDED 61% OF THE SESSIONS WITH NO ADVERSE EVENTS. INTERVENTION: SYM TWICE A WEEK FOR 8 WEEKS FOR 1.5 HOURS, WITH HOME PROGRAM AND JOURNALING. MAIN OUTCOME MEASURES: PRIMARY FUNCTIONAL OUTCOMES INCLUDED SIT AND REACH (SR), FUNCTIONAL REACH (FR), AND TIMED UP AND GO (TUG). SELF-REPORTED PATIENT NEUROTOXICITY QUESTIONNAIRE (PNQ) AND FUNCTIONAL ASSESSMENT OF CANCER THERAPY-NEUROTOXICITY (FACT-GOG-NTX) WERE SECONDARY CIPN OUTCOMES. BIOMARKERS INCLUDED SALIVARY CORTISOL (STRESS) AND BIOESTHESIOMETER (VIBRATION). RESULTS: QUANTITATIVE FINDINGS. SIGNIFICANT IMPROVEMENTS WERE FOUND IN FLEXIBILITY (SR; P = .006); BALANCE (FR; P = .001) AND FALL RISK (TUG; P = .004). PNQ IMPROVED SIGNIFICANTLY ( P = .003) WITH OTHER MEASURES IMPROVING NON-SIGNIFICANTLY. QUALITATIVE FINDINGS. FIVE THEMES EMERGED: (1) VACILLATION OF CIPN PAIN PERCEPTION OVER TIME; (2) TRANSFERABILITY OF SKILLS TO DAILY ACTIVITIES; (3) IMPROVEMENT IN PHYSICAL FUNCTION; (4) PERCEIVED RELAXATION AS AN EFFECT OF SYM; AND (5) GROUP ENGAGEMENT PROVIDED A SOCIAL CONTEXT FOR NOT FEELING ISOLATED WITH CIPN. CONCLUSION: PRELIMINARY DATA SUGGEST SYM MAY IMPROVE QOL, FLEXIBILITY, AND BALANCE IN CANCER SURVIVORS WITH CIPN, WITH A FULLY POWERED RANDOMIZED CONTROLLED TRIAL INDICATED. TRIAL REGISTRATION: NCT03786055. 2019 5 2557 45 YOGA FOR CHRONIC CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY PAIN: A PILOT, RANDOMIZED CONTROLLED TRIAL. PURPOSE: TO DETERMINE THE FEASIBILITY OF IMPLEMENTING A YOGA INTERVENTION FOR CANCER SURVIVORS WITH CHRONIC CIPN PAIN, AS WELL AS THE IMPACT OF THE INTERVENTION ON PATIENT-REPORTED OUTCOMES. METHODS: CANCER SURVIVORS WITH CHRONIC CIPN PAIN WERE RECRUITED FROM THE BREAST, GASTROINTESTINAL, AND GYNECOLOGICAL ONCOLOGY CENTERS AT DANA-FARBER CANCER INSTITUTE. PARTICIPANTS WERE RANDOMIZED (2:1) TO RECEIVE AN 8-WEEK YOGA INTERVENTION OR USUAL CARE. AFTER 21/50 OF PARTICIPANTS WERE ENROLLED, THE COVID-19 PANDEMIC REQUIRED THE YOGA INTERVENTION TO BE DELIVERED VIRTUALLY (I.E., ZOOM). PRE- AND POST-INTERVENTION, PARTICIPANTS SELF-REPORTED CIPN AND CO-OCCURRING SYMPTOM SEVERITY. ADHERENCE TO THE INTERVENTION WAS DEFINED AS PRACTICING >/= 12 YOGA SESSIONS OVER THE 8-WEEK INTERVENTION PERIOD. CHANGES IN PATIENT-REPORTED OUTCOMES BETWEEN GROUPS WERE COMPARED USING WILCOXON'S RANK-SUM TESTS. RESULTS: PARTICIPANTS (N = 28 YOGA, N = 16 CONTROL) WERE MAINLY FEMALE (96%) AND DIAGNOSED WITH STAGE III/IV DISEASE (66%). OVERALL, 19/28 (67.8%) OF YOGA GROUP PARTICIPANTS WERE ADHERENT TO THE YOGA PROTOCOL. YOGA GROUP PARTICIPANTS EXPERIENCED SIGNIFICANT WITHIN-GROUP IMPROVEMENTS IN ALL PATIENT-REPORTED OUTCOMES, INCLUDING WORST CIPN PAIN (MEDIAN CHANGE = - 1.7, P < 0.0001) AND SENSORY CIPN (MEDIAN CHANGE = - 14.8, P < 0.0001), BUT ONLY IMPROVEMENTS IN FATIGUE (P = 0.05) AND DEPRESSION (P = 0.04) WERE SIGNIFICANT COMPARED TO THE CONTROL. THERE WERE NO DIFFERENCES (P > 0.05) IN CHANGES IN PATIENT-REPORTED OUTCOMES BETWEEN IN-PERSON (N = 6) OR VIRTUAL (N = 15) YOGA GROUP PARTICIPANTS. CONCLUSIONS: YOGA IS A FEASIBLE NON-PHARMACOLOGICAL MODALITY FOR CANCER SURVIVORS WITH CIPN, BUT MORE INFORMATION IS NEEDED REGARDING ITS IMPACT ON CIPN AND OTHER SYMPTOMS. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT03824860 IMPLICATIONS FOR CANCER SURVIVORS: ONCOLOGY CLINICIANS MAY CONSIDER REFERRING CANCER SURVIVORS TO YOGA FOR CHRONIC CIPN PAIN, BUT YOGA CANNOT BE CURRENTLY RECOMMENDED AS AN EFFICACIOUS TREATMENT. 2021 6 1133 42 EFFICACY OF YOGA FOR VASOMOTOR SYMPTOMS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THIS STUDY AIMS TO DETERMINE THE EFFICACY OF YOGA IN ALLEVIATING VASOMOTOR SYMPTOMS (VMS) FREQUENCY AND BOTHER. METHODS: THIS STUDY WAS A THREE-BY-TWO FACTORIAL, RANDOMIZED CONTROLLED TRIAL. ELIGIBLE WOMEN WERE RANDOMIZED TO YOGA (N = 107), EXERCISE (N = 106), OR USUAL ACTIVITY (N = 142), AND WERE SIMULTANEOUSLY RANDOMIZED TO A DOUBLE-BLIND COMPARISON OF OMEGA-3 FATTY ACID (N = 177) OR PLACEBO (N = 178) CAPSULES. YOGA INTERVENTION CONSISTED OF 12 WEEKLY 90-MINUTE YOGA CLASSES WITH DAILY HOME PRACTICE. PRIMARY OUTCOMES WERE VMS FREQUENCY AND BOTHER ASSESSED BY DAILY DIARIES AT BASELINE, 6 WEEKS, AND 12 WEEKS. SECONDARY OUTCOMES INCLUDED INSOMNIA SYMPTOMS (INSOMNIA SEVERITY INDEX) AT BASELINE AND 12 WEEKS. RESULTS: AMONG 249 RANDOMIZED WOMEN, 237 (95%) COMPLETED 12-WEEK ASSESSMENTS. THE MEAN BASELINE VMS FREQUENCY WAS 7.4 PER DAY (95% CI, 6.6 TO 8.1) IN THE YOGA GROUP AND 8.0 PER DAY (95% CI, 7.3 TO 8.7) IN THE USUAL ACTIVITY GROUP. INTENT-TO-TREAT ANALYSES INCLUDED ALL PARTICIPANTS WITH RESPONSE DATA (N = 237). THERE WAS NO DIFFERENCE BETWEEN INTERVENTION GROUPS IN THE CHANGE IN VMS FREQUENCY FROM BASELINE TO 6 AND 12 WEEKS (MEAN DIFFERENCE [YOGA--USUAL ACTIVITY] FROM BASELINE AT 6 WK, -0.3 [95% CI, -1.1 TO 0.5]; MEAN DIFFERENCE [YOGA--USUAL ACTIVITY] FROM BASELINE AT 12 WK, -0.3 [95% CI, -1.2 TO 0.6]; P = 0.119 ACROSS BOTH TIME POINTS). RESULTS WERE SIMILAR FOR VMS BOTHER. AT WEEK 12, YOGA WAS ASSOCIATED WITH AN IMPROVEMENT IN INSOMNIA SYMPTOMS (MEAN DIFFERENCE [YOGA - USUAL ACTIVITY] IN THE CHANGE IN INSOMNIA SEVERITY INDEX, 1.3 [95% CI, -2.5 TO -0.1]; P = 0.007). CONCLUSIONS: AMONG HEALTHY WOMEN, 12 WEEKS OF YOGA CLASS PLUS HOME PRACTICE, COMPARED WITH USUAL ACTIVITY, DO NOT IMPROVE VMS FREQUENCY OR BOTHER BUT REDUCE INSOMNIA SYMPTOMS. 2014 7 2415 64 YOGA AND MEDITATION FOR MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS-A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: BREAST CANCER SURVIVORS HAVE ONLY VERY LIMITED TREATMENT OPTIONS FOR MENOPAUSAL SYMPTOMS. THE OBJECTIVE OF THIS TRIAL WAS TO EVALUATE THE EFFECTS OF A 12-WEEK TRADITIONAL HATHA YOGA AND MEDITATION INTERVENTION ON MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS. METHODS: PATIENTS WERE RANDOMLY ASSIGNED EITHER TO A 12-WEEK YOGA AND MEDITATION INTERVENTION OR TO USUAL CARE. THE PRIMARY OUTCOME MEASURE WAS TOTAL MENOPAUSAL SYMPTOMS (MENOPAUSE RATING SCALE [MRS] TOTAL SCORE). SECONDARY OUTCOME MEASURES INCLUDED MRS SUBSCALES, QUALITY OF LIFE (FUNCTIONAL ASSESSMENT OF CANCER THERAPY-BREAST), FATIGUE (FUNCTIONAL ASSESSMENT OF CHRONIC ILLNESS THERAPY-FATIGUE), DEPRESSION, AND ANXIETY (HOSPITAL ANXIETY AND DEPRESSION SCALE). OUTCOMES WERE ASSESSED AT WEEK 12 AND WEEK 24 AFTER RANDOMIZATION. RESULTS: IN TOTAL, 40 WOMEN (MEAN AGE +/- STANDARD DEVIATION, 49.2 +/- 5.9 YEARS) WERE RANDOMIZED TO YOGA (N = 19) OR TO USUAL CARE (N = 21). WOMEN IN THE YOGA GROUP REPORTED SIGNIFICANTLY LOWER TOTAL MENOPAUSAL SYMPTOMS COMPARED WITH THE USUAL CARE GROUP AT WEEK 12 (MEAN DIFFERENCE, -5.6; 95% CONFIDENCE INTERVAL, -9.2 TO -1.9; P = .004) AND AT WEEK 24 (MEAN DIFFERENCE, -4.5; 95% CONFIDENCE INTERVAL, -8.3 TO -0.7; P = .023). AT WEEK 12, THE YOGA GROUP REPORTED LESS SOMATOVEGETATIVE, PSYCHOLOGICAL, AND UROGENITAL MENOPAUSAL SYMPTOMS; LESS FATIGUE; AND IMPROVED QUALITY OF LIFE (ALL P < .05). AT WEEK 24, ALL EFFECTS PERSISTED EXCEPT FOR PSYCHOLOGICAL MENOPAUSAL SYMPTOMS. SHORT-TERM EFFECTS ON MENOPAUSAL SYMPTOMS REMAINED SIGNIFICANT WHEN ONLY WOMEN WHO WERE RECEIVING ANTIESTROGEN MEDICATION (N = 36) WERE ANALYZED. SIX MINOR ADVERSE EVENTS OCCURRED IN EACH GROUP. CONCLUSIONS: YOGA COMBINED WITH MEDITATION CAN BE CONSIDERED A SAFE AND EFFECTIVE COMPLEMENTARY INTERVENTION FOR MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS. THE EFFECTS SEEM TO PERSIST FOR AT LEAST 3 MONTHS. 2015 8 507 49 COMPARATIVE EFFECTIVENESS OF PILATES AND YOGA GROUP EXERCISE INTERVENTIONS FOR CHRONIC MECHANICAL NECK PAIN: QUASI-RANDOMISED PARALLEL CONTROLLED STUDY. OBJECTIVES: TO DETERMINE THE EFFECTIVENESS OF PILATES AND YOGA GROUP EXERCISE INTERVENTIONS FOR INDIVIDUALS WITH CHRONIC NECK PAIN (CNP). DESIGN: QUASI-RANDOMISED PARALLEL CONTROLLED STUDY. SETTING: COMMUNITY, UNIVERSITY AND PRIVATE PRACTICE SETTINGS IN FOUR LOCATIONS. PARTICIPANTS: FIFTY-SIX INDIVIDUALS WITH CNP SCORING >/=3/10 ON THE NUMERIC PAIN RATING SCALE FOR >3 MONTHS (CONTROLS N=17, PILATES N=20, YOGA N=19). INTERVENTIONS: EXERCISE PARTICIPANTS COMPLETED 12 SMALL-GROUP SESSIONS WITH MODIFICATIONS AND PROGRESSIONS SUPERVISED BY A PHYSIOTHERAPIST. MAIN OUTCOME MEASURES: THE PRIMARY OUTCOME MEASURE WAS THE NECK DISABILITY INDEX (NDI). SECONDARY OUTCOMES WERE PAIN RATINGS, RANGE OF MOVEMENT AND POSTURAL MEASUREMENTS COLLECTED AT BASELINE, 6 WEEKS AND 12 WEEKS. FOLLOW-UP WAS PERFORMED 6 WEEKS AFTER COMPLETION OF THE EXERCISE CLASSES (WEEK 18). RESULTS: NDI DECREASED SIGNIFICANTLY IN THE PILATES {BASELINE: 11.1 [STANDARD DEVIATION (SD) 4.3] VS WEEK 12: 6.8 (SD 4.3); MEAN DIFFERENCE -4.3 (95% CONFIDENCE INTERVAL -1.64 TO -6.7); P<0.001} AND YOGA GROUPS [BASELINE: 12.8 (SD 7.4) VS WEEK 12: 8.1 (SD 5.6); MEAN DIFFERENCE -4.7 (95% CONFIDENCE INTERVAL -2.1 TO -7.4); P<0.00], WITH NO CHANGE IN THE CONTROL GROUP. PAIN RATINGS ALSO IMPROVED SIGNIFICANTLY. MODERATE-TO-LARGE EFFECT SIZES (0.7 TO 1.8) AND LOW NUMBERS NEEDED TO TREAT WERE FOUND. THERE WERE NO DIFFERENCES IN OUTCOMES BETWEEN THE EXERCISE GROUPS OR ASSOCIATED ADVERSE EFFECTS. NO IMPROVEMENTS IN RANGE OF MOVEMENT OR POSTURE WERE FOUND. CONCLUSIONS: PILATES AND YOGA GROUP EXERCISE INTERVENTIONS WITH APPROPRIATE MODIFICATIONS AND SUPERVISION WERE SAFE AND EQUALLY EFFECTIVE FOR DECREASING DISABILITY AND PAIN COMPARED WITH THE CONTROL GROUP FOR INDIVIDUALS WITH MILD-TO-MODERATE CNP. PHYSIOTHERAPISTS MAY CONSIDER INCLUDING THESE APPROACHES IN A PLAN OF CARE. CLINICAL TRIAL REGISTRATION NUMBER: CLINICALTRIALS.GOV NCT01999283. 2016 9 521 50 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 10 460 45 CHANGES IN PAIN SELF-EFFICACY, COPING SKILLS, AND FEAR-AVOIDANCE BELIEFS IN A RANDOMIZED CONTROLLED TRIAL OF YOGA, PHYSICAL THERAPY, AND EDUCATION FOR CHRONIC LOW BACK PAIN. OBJECTIVE: WE EVALUATED EXERCISE INTERVENTIONS FOR COGNITIVE APPRAISAL OF CHRONIC LOW BACK PAIN (CLBP) IN AN UNDERSERVED POPULATION. METHODS: WE CONDUCTED A SECONDARY ANALYSIS OF THE BACK TO HEALTH TRIAL, SHOWING YOGA TO BE NONINFERIOR TO PHYSICAL THERAPY (PT) FOR PAIN AND FUNCTION OUTCOMES AMONG ADULTS WITH CLBP (N = 320) RECRUITED FROM PRIMARY CARE CLINICS WITH PREDOMINANTLY LOW-INCOME PATIENTS. PARTICIPANTS WERE RANDOMIZED TO 12 WEEKS OF YOGA, PT, OR EDUCATION. COGNITIVE APPRAISAL WAS ASSESSED WITH THE PAIN SELF-EFFICACY QUESTIONNAIRE (PSEQ), COPING STRATEGIES QUESTIONNAIRE (CSQ), AND FEAR-AVOIDANCE BELIEFS QUESTIONNAIRE (FABQ). USING MULTIPLE IMPUTATION AND LINEAR REGRESSION, WE ESTIMATED WITHIN- AND BETWEEN-GROUP CHANGES IN COGNITIVE APPRAISAL AT 12 AND 52 WEEKS, WITH BASELINE AND THE EDUCATION GROUP AS REFERENCES. RESULTS: PARTICIPANTS (MEAN AGE = 46 YEARS) WERE MAJORITY FEMALE (64%) AND MAJORITY BLACK (57%), AND 54% HAD AN ANNUAL HOUSEHOLD INCOME <$30,000. ALL THREE GROUPS SHOWED IMPROVEMENTS IN PSEQ (RANGE 0-60) AT 12 WEEKS (YOGA, MEAN DIFFERENCE [MD] = 7.0, 95% CONFIDENCE INTERVAL [CI]: 4.9, 9.0; PT, MD = 6.9, 95% CI: 4.7 TO 9.1; AND EDUCATION, MD = 3.4, 95% CI: 0.54 TO 6.3), WITH YOGA AND PT IMPROVEMENTS BEING CLINICALLY MEANINGFUL. AT 12 WEEKS, IMPROVEMENTS IN CATASTROPHIZING (CSQ, RANGE 0-36) WERE LARGEST IN THE YOGA AND PT GROUPS (MD = -3.0, 95% CI: -4.4 TO -1.6; MD = -2.7, 95% CI: -4.2 TO -1.2, RESPECTIVELY). CHANGES IN FABQ WERE SMALL. NO STATISTICALLY SIGNIFICANT BETWEEN-GROUP DIFFERENCES WERE OBSERVED ON PSEQ, CSQ, OR FABQ AT EITHER TIME POINT. MANY OF THE CHANGES OBSERVED AT 12 WEEKS WERE SUSTAINED AT 52 WEEKS. CONCLUSION: ALL THREE INTERVENTIONS WERE ASSOCIATED WITH IMPROVEMENTS IN SELF-EFFICACY AND CATASTROPHIZING AMONG LOW-INCOME, RACIALLY DIVERSE ADULTS WITH CLBP. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER NCT01343927. 2022 11 189 46 A RANDOMIZED STUDY OF YOGA FOR FATIGUE AND QUALITY OF LIFE IN WOMEN WITH BREAST CANCER UNDERGOING (NEO) ADJUVANT CHEMOTHERAPY. OBJECTIVES: TO COMPARE THE EFFECTIVENESS OF YOGA ADDED TO STANDARD CARE (SC) VERSUS SC ONLY, IN WOMEN WITH BREAST CANCER DURING CHEMOTHERAPY. DESIGN: A MULTICENTER PRAGMATIC, RANDOMIZED CONTROLLED STUDY. SETTINGS/LOCATION: THREE HOSPITALS IN THE NETHERLANDS. SUBJECTS: WOMEN WITH STAGE I-III BREAST CANCER UNDERGOING CHEMOTHERAPY. INTERVENTIONS: WOMEN WERE RANDOMIZED EITHER TO A PROGRAM BASED ON DRU YOGA, ONCE A WEEK YOGA SESSIONS FOR 12 WEEKS (N = 47), OR SC ONLY (N = 36). OUTCOME MEASURES: PRIMARY OUTCOME FATIGUE (MULTIDIMENSIONAL FATIGUE INVENTORY [MFI]; GENERAL FATIGUE) AND SECONDARY OUTCOMES FATIGUE (MFI, FATIGUE QUALITY LIST [FQL]), QUALITY OF LIFE (30-ITEM QUALITY OF LIFE QUESTIONNAIRE-C OF THE EUROPEAN ORGANIZATION FOR RESEARCH AND TREATMENT OF CANCER [EORTC-QLQ-C-30]) AND PSYCHOLOGICAL DISTRESS (HOSPITAL ANXIETY DEPRESSION SCALE [HADS], IMPACT OF EVENTS SCALE [IES]) WERE MEASURED AT BASELINE (T0), 3 MONTHS (T1), AND 6 MONTHS (T2) AND ANALYZED ON OBSERVED CASES. OTHER OUTCOMES WERE ADEQUATE RELIEF, REINTEGRATION TO WORK, AND ADVERSE EVENTS. RESULTS: NO SIGNIFICANT DIFFERENCES WERE FOUND IN GENERAL FATIGUE AT T1 (MFI: YOGA; 14.6 +/- 4.5 VS. SC; 14.2 +/- 4.2, P = 0.987). SIMILAR FINDINGS WERE OBSERVED FOR OTHER FATIGUE (SUB)SCALES OF MFI AND FQL AND FUNCTIONAL DOMAINS OF EORTC. WITH RESPECT TO EORTCS SYMPTOM SCALES, WOMEN IN THE YOGA GROUP REPORTED SIGNIFICANTLY LESS NAUSEA AND VOMITING COMPARED WITH SC AT T2 (P = 0.004), BUT NOT AT T1 (P = 0.807). DEPRESSIVE SYMPTOMS WERE SIGNIFICANTLY LOWER WITH YOGA AT T1 (HADS: YOGA; 4.7 +/- 4.1 VS. SC; 5.1 +/- 4.2, P = 0.031). MORE WOMEN IN THE YOGA GROUP EXPERIENCED ADEQUATE RELIEF COMPARED WITH SC AT T1 (YOGA; 51% VS. SC; 19%) AND HAD RETURNED TO WORK AT T2 (YOGA; 53% VS. SC; 23%). NO ADVERSE EVENTS WERE REPORTED WITH YOGA. CONCLUSIONS: A DRU-BASED YOGA PROGRAM FAILED TO DEMONSTRATE A SIGNIFICANT BENEFICIAL EFFECT ON FATIGUE. POSSIBLE FAVORABLE EFFECTS OF THE YOGA PROGRAM ON NAUSEA AND VOMITING AND EARLY RETURN TO WORK IN BREAST CANCER SURVIVORS WARRANT FURTHER RESEARCH. 2018 12 779 48 EFFECT OF YOGA AS ADD-ON THERAPY IN MIGRAINE (CONTAIN): A RANDOMIZED CLINICAL TRIAL. OBJECTIVE: TO EVALUATE THE EFFECTIVENESS OF YOGA AS AN ADJUVANT TO CONVENTIONAL MEDICAL MANAGEMENT ON CLINICAL OUTCOMES IN PATIENTS WITH MIGRAINE. METHODS: CONTAIN WAS A PROSPECTIVE, RANDOMIZED, OPEN-LABEL SUPERIORITY TRIAL WITH BLINDED ENDPOINT ASSESSMENT CARRIED OUT AT A SINGLE TERTIARY CARE ACADEMIC HOSPITAL IN NEW DELHI, INDIA. PATIENTS ENROLLED WERE AGED 18-50 YEARS WITH A DIAGNOSIS OF EPISODIC MIGRAINE AND WERE RANDOMIZED INTO MEDICAL AND YOGA GROUPS (1:1). RANDOMIZATION WAS COMPUTER-GENERATED WITH A VARIABLE BLOCK SIZE AND CONCEALED. A PREDESIGNED YOGA INTERVENTION WAS GIVEN FOR 3 MONTHS. OUTCOMES WERE RECORDED BY A BLINDED ASSESSOR. THE PRIMARY ENDPOINT WAS A DECREASE IN HEADACHE FREQUENCY, HEADACHE INTENSITY, AND HEADACHE IMPACT TEST (HIT)-6 SCORE. SECONDARY OUTCOMES INCLUDED CHANGE IN MIGRAINE DISABILITY ASSESSMENT (MIDAS) SCORE, PILL COUNT, AND PROPORTION OF HEADACHE FREE PATIENTS. RESULTS: BETWEEN APRIL 2017 AND AUGUST 2018, 160 PATIENTS WITH EPISODIC MIGRAINE WERE RANDOMLY ASSIGNED TO MEDICAL AND YOGA GROUPS. A TOTAL OF 114 PATIENTS COMPLETED THE TRIAL. BASELINE MEASURES WERE COMPARABLE EXCEPT FOR A HIGHER MEAN HEADACHE FREQUENCY IN THE YOGA GROUP. COMPARED TO MEDICAL THERAPY, THE YOGA GROUP SHOWED A SIGNIFICANT MEAN DELTA VALUE REDUCTION IN HEADACHE FREQUENCY (DELTA DIFFERENCE 3.53 [95% CONFIDENCE INTERVAL 2.52-4.54]; P < 0.0001), HEADACHE INTENSITY (1.31 [0.60-2.01]; P = 0.0004), HIT SCORE (8.0 [4.78-11.22]; P < 0.0001), MIDAS SCORE (7.85 [4.98-10.97]; P < 0.0001), AND PILL COUNT (2.28 [1.06-3.51]; P < 0.0003). CONCLUSION: YOGA AS AN ADD-ON THERAPY IN MIGRAINE IS SUPERIOR TO MEDICAL THERAPY ALONE. IT MAY BE USEFUL TO INTEGRATE A COST-EFFECTIVE AND SAFE INTERVENTION LIKE YOGA INTO THE MANAGEMENT OF MIGRAINE. CLINICALTRIALSGOV IDENTIFIER: CTRI/2017/03/008041. CLASSIFICATION OF EVIDENCE: THIS STUDY PROVIDES CLASS III EVIDENCE THAT FOR PATIENTS WITH EPISODIC MIGRAINE, YOGA AS ADJUVANT TO MEDICAL THERAPY IMPROVES HEADACHE FREQUENCY, INTENSITY, IMPACT, AND DISABILITY. 2020 13 910 49 EFFECTIVENESS OF HATHA YOGA VERSUS CONVENTIONAL THERAPEUTIC EXERCISES FOR CHRONIC NONSPECIFIC LOW-BACK PAIN. OBJECTIVE: TO DETERMINE WHETHER THE EFFECTIVENESS OF HATHA YOGA THERAPY IS COMPARABLE TO CONVENTIONAL THERAPEUTIC EXERCISES (CTES) FOR REDUCING BACK PAIN INTENSITY AND BACK-RELATED DYSFUNCTION IN PATIENTS WITH CHRONIC NONSPECIFIC LOW-BACK PAIN (CNLBP). DESIGN: THE STUDY WAS A PROSPECTIVE RANDOMIZED COMPARATIVE TRIAL, DIVIDED INTO TWO PHASES: AN INITIAL 6-WEEKLY SUPERVISED INTERVENTION PERIOD FOLLOWED BY A 6-WEEK FOLLOW-UP PERIOD. SETTINGS: THIS STUDY WAS CONDUCTED AT DEPARTMENT OF PHYSICAL MEDICINE AND REHABILITATION AND CENTRE FOR INTEGRATIVE MEDICINE AND RESEARCH OF A TERTIARY CARE HOSPITAL. SUBJECTS: PATIENTS BETWEEN 18 AND 55 YEARS OF AGE WITH COMPLAINT OF CNLBP PERSISTING >/=12 WEEKS WITH PAIN RATING >/=4 ON A NUMERICAL RATING SCALE (0-10). INTERVENTION: A TOTAL OF SIX STANDARDIZED 35-MIN WEEKLY HATHA YOGA SESSIONS (YOGA GROUP) AND SIMILARLY 35-MIN WEEKLY SESSIONS OF CTES (CTE GROUP), DESIGNED FOR PEOPLE WITH CNLBP UNACCUSTOMED TO STRUCTURED YOGA OR CTE PROGRAM. PARTICIPANTS WERE ASKED TO PRACTICE ON NONCLASS DAYS AT HOME. OUTCOME MEASURES: THE PRIMARY OUTCOME MEASURES WERE DEFENSE AND VETERANS PAIN RATING SCALE (DVPRS) (0-10) AND 24-POINT ROLAND MORRIS DISABILITY QUESTIONNAIRE (RDQ). SECONDARY OUTCOMES WERE PAIN MEDICATION USAGE PER WEEK AND A POSTINTERVENTION PERCEIVED RECOVERY (LIKERT SEVEN-POINT SCALE) OF BACK-RELATED DYSFUNCTION. OUTCOMES WERE RECORDED AT THE BASELINE, 6-WEEK FOLLOW-UP, AND 12-WEEK FOLLOW-UP. RESULTS: SEVENTY SUBJECTS WERE RANDOMIZED TO EITHER YOGA (N = 35) OR CTE GROUP (N = 35). DATA WERE ANALYZED USING INTENTION-TO-TREAT, WITH LAST OBSERVATION CARRIED FORWARD. BOTH YOGA AND THE CTE GROUP HAVE SHOWN SIGNIFICANT IMPROVEMENT IN BACK PAIN INTENSITY AND BACK-RELATED DYSFUNCTION WITHIN BOTH THE GROUPS AT 6- AND 12-WEEK FOLLOW-UPS COMPARED TO BASELINE. NO STATISTICALLY SIGNIFICANT DIFFERENCES IN THE PAIN INTENSITY (DVPRS; AT 6 WEEKS: N = 35, DIFFERENCE OF MEDIANS 1.0, 95% CONFIDENCE INTERVAL [-5.3 TO 3.0], P = 0.5; AT 12 WEEKS: N = 35, 0.0 [-4.2 TO 5.0], 0.7) AND BACK-RELATED DYSFUNCTION (RDQ; AT 6 WEEKS: N = 35, 1.0 [-9.6 TO 10.6], 0.4; AT 12 WEEKS: N = 35, 0.0 [-8.8 TO 10.6], 0.3) WERE NOTED BETWEEN TWO GROUPS. IMPROVEMENTS IN PILL CONSUMPTION AND PERCEIVED RECOVERY WERE ALSO COMPARABLE BETWEEN THE GROUPS. CONCLUSION: YOGA PROVIDED SIMILAR IMPROVEMENT COMPARED WITH CTES, IN PATIENTS WITH CNLBP. 2019 14 2560 50 YOGA FOR CHRONIC LOW BACK PAIN: A RANDOMIZED TRIAL. BACKGROUND: PREVIOUS STUDIES INDICATE THAT YOGA MAY BE AN EFFECTIVE TREATMENT FOR CHRONIC OR RECURRENT LOW BACK PAIN. OBJECTIVE: TO COMPARE THE EFFECTIVENESS OF YOGA AND USUAL CARE FOR CHRONIC OR RECURRENT LOW BACK PAIN. DESIGN: PARALLEL-GROUP, RANDOMIZED, CONTROLLED TRIAL USING COMPUTER-GENERATED RANDOMIZATION CONDUCTED FROM APRIL 2007 TO MARCH 2010. OUTCOMES WERE ASSESSED BY POSTAL QUESTIONNAIRE. (INTERNATIONAL STANDARD RANDOMISED CONTROLLED TRIAL NUMBER REGISTER: ISRCTN 81079604) SETTING: 13 NON-NATIONAL HEALTH SERVICE PREMISES IN THE UNITED KINGDOM. PATIENTS: 313 ADULTS WITH CHRONIC OR RECURRENT LOW BACK PAIN. INTERVENTION: YOGA (N = 156) OR USUAL CARE (N = 157). ALL PARTICIPANTS RECEIVED A BACK PAIN EDUCATION BOOKLET. THE INTERVENTION GROUP WAS OFFERED A 12-CLASS, GRADUALLY PROGRESSING YOGA PROGRAM DELIVERED BY 12 TEACHERS OVER 3 MONTHS. MEASUREMENTS: SCORES ON THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE (RMDQ) AT 3 (PRIMARY OUTCOME), 6, AND 12 (SECONDARY OUTCOMES) MONTHS; PAIN, PAIN SELF-EFFICACY, AND GENERAL HEALTH MEASURES AT 3, 6, AND 12 MONTHS (SECONDARY OUTCOMES). RESULTS: 93 (60%) PATIENTS OFFERED YOGA ATTENDED AT LEAST 3 OF THE FIRST 6 SESSIONS AND AT LEAST 3 OTHER SESSIONS. THE YOGA GROUP HAD BETTER BACK FUNCTION AT 3, 6, AND 12 MONTHS THAN THE USUAL CARE GROUP. THE ADJUSTED MEAN RMDQ SCORE WAS 2.17 POINTS (95% CI, 1.03 TO 3.31 POINTS) LOWER IN THE YOGA GROUP AT 3 MONTHS, 1.48 POINTS (CI, 0.33 TO 2.62 POINTS) LOWER AT 6 MONTHS, AND 1.57 POINTS (CI, 0.42 TO 2.71 POINTS) LOWER AT 12 MONTHS. THE YOGA AND USUAL CARE GROUPS HAD SIMILAR BACK PAIN AND GENERAL HEALTH SCORES AT 3, 6, AND 12 MONTHS, AND THE YOGA GROUP HAD HIGHER PAIN SELF-EFFICACY SCORES AT 3 AND 6 MONTHS BUT NOT AT 12 MONTHS. TWO OF THE 157 USUAL CARE PARTICIPANTS AND 12 OF THE 156 YOGA PARTICIPANTS REPORTED ADVERSE EVENTS, MOSTLY INCREASED PAIN. LIMITATION: THERE WERE MISSING DATA FOR THE PRIMARY OUTCOME (YOGA GROUP, N = 21; USUAL CARE GROUP, N = 18) AND DIFFERENTIAL MISSING DATA (MORE IN THE YOGA GROUP) FOR SECONDARY OUTCOMES. CONCLUSION: OFFERING A 12-WEEK YOGA PROGRAM TO ADULTS WITH CHRONIC OR RECURRENT LOW BACK PAIN LED TO GREATER IMPROVEMENTS IN BACK FUNCTION THAN DID USUAL CARE. PRIMARY FUNDING SOURCE: ARTHRITIS RESEARCH UK. 2011 15 430 50 CAN YOGA OR PHYSICAL THERAPY FOR CHRONIC LOW BACK PAIN IMPROVE DEPRESSION AND ANXIETY AMONG ADULTS FROM A RACIALLY DIVERSE, LOW-INCOME COMMUNITY? A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: TO DETERMINE AND COMPARE THE EFFECT OF YOGA, PHYSICAL THERAPY (PT), AND EDUCATION ON DEPRESSIVE AND ANXIOUS SYMPTOMS IN PATIENTS WITH CHRONIC LOW BACK PAIN (CLBP). DESIGN: SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. SETTING: ACADEMIC SAFETY NET HOSPITAL AND 7 COMMUNITY HEALTH CENTERS. PARTICIPANTS: A TOTAL OF 320 ADULTS WITH CLBP. INTERVENTION: YOGA CLASSES, PT SESSIONS, OR AN EDUCATIONAL BOOK. OUTCOME MEASURE: DEPRESSION AND ANXIETY WERE MEASURED USING THE PATIENT HEALTH QUESTIONNAIRE AND GENERALIZED ANXIETY DISORDER 7-ITEM SCALE, RESPECTIVELY, AT BASELINE, 12, AND 52 WEEKS. WE IDENTIFIED BASELINE AND MIDTREATMENT (6-WK) FACTORS ASSOCIATED WITH CLINICALLY MEANINGFUL IMPROVEMENTS IN DEPRESSIVE (>/=3 POINTS) OR ANXIOUS (>/=2 POINTS) SYMPTOMS AT 12 WEEKS. RESULTS: PARTICIPANTS (FEMALE=64%; MEAN AGE, 46.0+/-10.7 YEARS) WERE PREDOMINANTLY NON-WHITE (82%), LOW-INCOME (<$30,000/YEAR, 59%), AND HAD NOT RECEIVED A COLLEGE DEGREE (71%). MOST PARTICIPANTS HAD MILD OR WORSE DEPRESSIVE (60%) AND ANXIOUS (50%) SYMPTOMS. AT 12 WEEKS, YOGA AND PT PARTICIPANTS EXPERIENCED MODEST WITHIN-GROUP IMPROVEMENTS IN DEPRESSIVE SYMPTOMS (MEAN DIFFERENCE [MD]=-1.23 [95% CI, -2.18 TO -0.28]; MD=-1.01 [95% CI, -2.05 TO -0.03], RESPECTIVELY). COMPARED WITH THE EDUCATION GROUP, 12-WEEK DIFFERENCES WERE NOT STATISTICALLY SIGNIFICANT, ALTHOUGH TRENDS FAVORED YOGA (MD=-0.71 [95% CI, -2.22 TO 0.81]) AND PT (MD= -0.32 [95% CI, -1.82 TO 1.18]). AT 12 WEEKS, IMPROVEMENTS IN ANXIOUS SYMPTOMS WERE ONLY FOUND IN PARTICIPANTS WHO HAD MILD OR MODERATE ANXIETY AT BASELINE. INDEPENDENT OF TREATMENT ARM, PARTICIPANTS WHO HAD 30% OR GREATER IMPROVEMENT IN PAIN OR FUNCTION MIDTREATMENT WERE MORE LIKELY TO HAVE A CLINICALLY MEANINGFUL IMPROVEMENT IN DEPRESSIVE SYMPTOMS (ODDS RATIO [OR], 1.82 [95% CI, 1.03-3.22]; OR, 1.79 [95% CI, 1.06-3.04], RESPECTIVELY). CONCLUSIONS: IN OUR SECONDARY ANALYSIS WE FOUND THAT DEPRESSION AND ANXIETY, COMMON IN THIS SAMPLE OF UNDERSERVED ADULTS WITH CLBP, MAY IMPROVE MODESTLY WITH PT AND YOGA. HOWEVER, EFFECTS WERE NOT SUPERIOR TO EDUCATION. IMPROVEMENTS IN PAIN AND FUNCTION ARE ASSOCIATED WITH A DECREASE IN DEPRESSIVE SYMPTOMS. MORE RESEARCH IS NEEDED TO OPTIMIZE THE INTEGRATION OF PHYSICAL AND PSYCHOLOGICAL WELL-BEING IN PT AND YOGA. 2021 16 193 44 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 17 461 51 CHANGES IN PERCEIVED STRESS AFTER YOGA, PHYSICAL THERAPY, AND EDUCATION INTERVENTIONS FOR CHRONIC LOW BACK PAIN: A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: PERCEIVED STRESS AND MUSCULOSKELETAL PAIN ARE COMMON, ESPECIALLY IN LOW-INCOME POPULATIONS. STUDIES EVALUATING TREATMENTS TO REDUCE STRESS IN PATIENTS WITH CHRONIC PAIN ARE LACKING. WE AIMED TO QUANTIFY THE EFFECT OF TWO EVIDENCE-BASED INTERVENTIONS FOR CHRONIC LOW BACK PAIN (CLBP), YOGA AND PHYSICAL THERAPY (PT), ON PERCEIVED STRESS IN ADULTS WITH CLBP. METHODS: WE USED DATA FROM AN ASSESSOR-BLINDED, PARALLEL-GROUP RANDOMIZED CONTROLLED TRIAL, WHICH RECRUITED PREDOMINANTLY LOW-INCOME AND RACIALLY DIVERSE ADULTS WITH CLBP. PARTICIPANTS (N = 320) WERE RANDOMLY ASSIGNED TO 12 WEEKS OF YOGA, PT, OR BACK PAIN EDUCATION. WE COMPARED CHANGES IN THE 10-ITEM PERCEIVED STRESS SCALE (PSS-10) FROM BASELINE TO 12- AND 52-WEEK FOLLOW-UP AMONG YOGA AND PT PARTICIPANTS WITH THOSE RECEIVING EDUCATION. SUBANALYSES WERE CONDUCTED FOR PARTICIPANTS WITH ELEVATED PRE-INTERVENTION PERCEIVED STRESS (PSS-10 SCORE >/=17). WE CONDUCTED SENSITIVITY ANALYSES USING VARIOUS IMPUTATION METHODS TO ACCOUNT FOR POTENTIAL BIASES IN OUR ESTIMATES DUE TO MISSING DATA. RESULTS: AMONG 248 PARTICIPANTS (MEAN AGE = 46.4 YEARS, 80% NONWHITE) COMPLETING ALL THREE SURVEYS, YOGA AND PT SHOWED GREATER REDUCTIONS IN PSS-10 SCORES COMPARED WITH EDUCATION AT 12 WEEKS (MEAN BETWEEN-GROUP DIFFERENCE = -2.6, 95% CONFIDENCE INTERVAL [CI] = -4.5 TO -0.66, AND MEAN BETWEEN-GROUP DIFFERENCE = -2.4, 95% CI = -4.4 TO -0.48, RESPECTIVELY). THIS EFFECT WAS STRONGER AMONG PARTICIPANTS WITH ELEVATED PRE-INTERVENTION PERCEIVED STRESS. BETWEEN-GROUP EFFECTS HAD ATTENUATED BY 52 WEEKS. RESULTS WERE SIMILAR IN SENSITIVITY ANALYSES. CONCLUSIONS: YOGA AND PT WERE MORE EFFECTIVE THAN BACK PAIN EDUCATION FOR REDUCING PERCEIVED STRESS AMONG LOW-INCOME ADULTS WITH CLBP. 2020 18 540 48 COMPLIANCE EFFECTS IN A RANDOMISED CONTROLLED TRIAL OF YOGA FOR CHRONIC LOW BACK PAIN: A METHODOLOGICAL STUDY. STUDY DESIGN: METHODOLOGICAL STUDY NESTED WITHIN A MULTICENTRE RANDOMISED CONTROLLED TRIAL (RCT) OF YOGA PLUS USUAL GENERAL PRACTITIONER (GP) CARE VS USUAL GP CARE FOR CHRONIC LOW BACK PAIN. OBJECTIVE: TO EXPLORE THE TREATMENT EFFECTS OF NON-COMPLIANCE USING THREE APPROACHES IN AN RCT EVALUATING YOGA FOR LOW BACK PAIN. SUMMARY OF BACKGROUND DATA: A LARGE MULTICENTRE RCT USING INTENTION-TO-TREAT (ITT) ANALYSIS FOUND THAT PARTICIPANTS WITH CHRONIC LOW BACK PAIN WHO WERE OFFERED A 12-WEEK PROGRESSIVE PROGRAMME OF YOGA PLUS USUAL GP CARE HAD BETTER BACK FUNCTION THAN THOSE OFFERED USUAL GP CARE ALONE. HOWEVER, ITT ANALYSIS CAN UNDERESTIMATE THE EFFECT OF TREATMENT IN THOSE WHO COMPLY WITH TREATMENT. AS SUCH, THE DATA WERE ANALYSED USING OTHER APPROACHES TO ASSESS THE PROBLEM OF NON-COMPLIANCE. THE MAIN OUTCOME MEASURE WAS THE SELF-REPORTED ROLAND MORRIS DISABILITY QUESTIONNAIRE (RMDQ). METHODS: COMPLIER AVERAGE CAUSAL EFFECT (CACE) ANALYSIS, PER-PROTOCOL ANALYSIS AND ON-TREATMENT ANALYSIS WERE CONDUCTED ON THE DATA OF PARTICIPANTS WHO WERE FULLY COMPLIANT, PREDEFINED AS ATTENDANCE OF AT LEAST THREE OF THE FIRST SIX SESSIONS AND AT LEAST THREE OTHER SESSIONS. THE ANALYSIS WAS REPEATED FOR PARTICIPANTS WHO HAD ATTENDED AT LEAST ONE YOGA SESSION (I.E. ANY COMPLIANCE), WHICH INCLUDED PARTICIPANTS WHO WERE FULLY COMPLIANT. EACH APPROACH WAS DESCRIBED, INCLUDING STRENGTHS AND WEAKNESSES, AND THE RESULTS OF THE DIFFERENT APPROACHES WERE COMPARED WITH THOSE OF THE ITT ANALYSIS. RESULTS: FOR THE PARTICIPANTS WHO WERE FULLY COMPLIANT (N=93, 60%), A LARGER BENEFICIAL TREATMENT EFFECT WAS SEEN USING CACE ANALYSIS COMPARED WITH PER-PROTOCOL, ON-TREATMENT AND ITT ANALYSES AT 3 AND 12 MONTHS. THE DIFFERENCE IN MEAN CHANGE IN RMDQ SCORE BETWEEN RANDOMISED GROUPS WAS -3.30 [95% CONFIDENCE INTERVAL (CI) -4.90 TO -1.70, P<0.001] AT 3 MONTHS AND -2.23 (95% CI -3.93 TO -0.53, P=0.010) AT 12 MONTHS FOR CACE ANALYSIS, -3.12 (95% CI -4.26 TO -1.98, P<0.001) AT 3 MONTHS AND -2.11 (95% CI -3.33 TO -0.89, P=0.001) AT 12 MONTHS FOR PER-PROTOCOL ANALYSIS, AND -2.91 (95% CI -4.06 TO -1.76, P<0.001) AT 3 MONTHS AND -2.10 (95% CI -3.31 TO -0.89, P=0.001) AT 12 MONTHS FOR ON-TREATMENT ANALYSIS. FOR THE PARTICIPANTS WHO DEMONSTRATED ANY COMPLIANCE (N=133, 85%), THE RESULTS WERE GENERALLY CONSISTENT WITH THE FULLY COMPLIANT GROUP AT 3 MONTHS, BUT THE TREATMENT EFFECT WAS SMALLER. THE DIFFERENCE IN MEAN CHANGE IN RMDQ SCORE BETWEEN RANDOMISED GROUPS WAS -2.45 (95% CI -3.67 TO -1.24) FOR CACE ANALYSIS, -2.30 (95% CI -3.43 TO 1.17) FOR PER-PROTOCOL ANALYSIS AND -2.15 (95% CI -3.25 TO -1.06) FOR ON-TREATMENT ANALYSIS, WHICH WAS SLIGHTLY LESS THAN THAT FOR ITT ANALYSIS. IN CONTRAST, AT 12 MONTHS, PER-PROTOCOL AND ON-TREATMENT ANALYSES SHOWED A LARGER TREATMENT EFFECT COMPARED WITH CACE AND ITT ANALYSES: PER PROTOCOL ANALYSIS -1.86 (95% CI -3.02 TO -0.71), ON-TREATMENT ANALYSIS -1.99 (95% CI -3.13 TO -0.86) AND CACE ANALYSIS -1.67 (95% CI -2.95 TO -0.40). CONCLUSION: ITT ANALYSIS ESTIMATED A SLIGHTLY SMALLER TREATMENT EFFECT IN PARTICIPANTS WHO COMPLIED WITH TREATMENT. WHEN EXAMINING COMPLIANCE, CACE ANALYSIS IS MORE RIGOROUS THAN PER-PROTOCOL AND ON-TREATMENT ANALYSES. USING CACE ANALYSIS, THE TREATMENT EFFECT WAS LARGER IN PARTICIPANTS WHO COMPLIED WITH TREATMENT COMPARED WITH PARTICIPANTS WHO WERE ALLOCATED TO TREATMENT, AND THE DIFFERENCE BETWEEN ITT AND CACE ANALYSES FOR THE FULLY COMPLIANT GROUP AT 3 MONTHS WAS SMALL BUT CLINICALLY IMPORTANT. PER-PROTOCOL AND ON-TREATMENT ANALYSES MAY PRODUCE UNRELIABLE ESTIMATES WHEN THE EFFECT OF TREATMENT IS SMALL. INTERNATIONAL STANDARD RANDOMISED TRIAL NUMBER REGISTER: ISRCTN 81079604. 2014 19 1524 30 ISOMETRIC YOGA-LIKE MANEUVERS IMPROVE ADOLESCENT IDIOPATHIC SCOLIOSIS-A NONRANDOMIZED CONTROL TRIAL. OBJECTIVE: ASSESS THERAPEUTIC VALUE OF SPECIFIC YOGA POSES FOR THORACIC AND LUMBAR ADOLESCENT IDIOPATHIC SCOLIOSIS (AIS) TAUGHT IN OFFICE OR INTERNET. STUDY DESIGN: NONRANDOMIZED CONTROL TRIAL: FIFTY-SIX ADOLESCENTS (MEAN AGE 14.0 YEARS; MEAN RISSER 3.0) WERE RECRUITED FROM OUR CLINIC; 41 DID THE SIDE-PLANK, THE HALF-MOON AND ELEVATED SIDE PLANK POSES AS APPROPRIATE (TREATMENT GROUP) AND 15 DID NOT (CONTROLS). THIRTY CURVES WERE TREATED IN OFFICE, 30 VIA INTERNET. CURVE CHANGE WAS EVALUATED BY BLINDED SERIAL COBB ANGLES, AND ANALYZED USING MANN-WHITNEY U, PAIRED T-TESTS AND CHI(2). RESULTS: MEAN LUMBAR AND THORACOLUMBAR COBB ANGLE CHANGE WAS -9.2 (95% CI = -11.8, -6.6) IN THE TREATMENT GROUP AND 5.4 (95% CI = 1.7, 9.0) IN CONTROLS. BOTH TREATMENT GROUP IMPROVEMENT AND DETERIORATION IN CONTROLS WERE SIGNIFICANT (TREATMENT GROUP: PAIRED T-TEST T = -7.1, DF = 40, P = .000; CONTROLS: T = 3.2, DF = 12, P = .008). MEAN THORACIC COBB ANGLE CHANGE WAS -7.1 (95% CI = -13.1, -1.2) IN THE TREATMENT GROUP AND 9.3 (95% CI = 4.5, 14.6) IN CONTROLS. BOTH CHANGES WERE SIGNIFICANT (PAIRED T-TEST T = -3.3, DF = 21, P = .022 FOR TREATMENT GROUP; T = 4.5, DF = 5, P = .006 FOR CONTROLS). NINE INTERNET PATIENTS WERE NON-COMPLIANT VS. 6 OFFICE PATIENTS. OFFICE PATIENTS IMPROVED 1.6 DEGREES/MONTH OR 5.5%/MONTH; INTERNET PATIENTS IMPROVED .72 DEGREES/MONTH OR 3.3%/MONTH. CONCLUSION: THESE YOGA POSES SHOW PROMISE FOR REVERSING ADOLESCENT IDIOPATHIC SCOLIOSIS. TELEMEDICINE HAD GREATER NON-COMPLIANCE AND LOWER EFFICACY BUT STILL PRODUCED PATIENT IMPROVEMENT. 2021 20 2318 40 TREATING MAJOR DEPRESSION WITH YOGA: A PROSPECTIVE, RANDOMIZED, CONTROLLED PILOT TRIAL. BACKGROUND: CONVENTIONAL PHARMACOTHERAPIES AND PSYCHOTHERAPIES FOR MAJOR DEPRESSION ARE ASSOCIATED WITH LIMITED ADHERENCE TO CARE AND RELATIVELY LOW REMISSION RATES. YOGA MAY OFFER AN ALTERNATIVE TREATMENT OPTION, BUT RIGOROUS STUDIES ARE FEW. THIS RANDOMIZED CONTROLLED TRIAL WITH BLINDED OUTCOME ASSESSORS EXAMINED AN 8-WEEK HATHA YOGA INTERVENTION AS MONO-THERAPY FOR MILD-TO-MODERATE MAJOR DEPRESSION. METHODS: INVESTIGATORS RECRUITED 38 ADULTS IN SAN FRANCISCO MEETING CRITERIA FOR MAJOR DEPRESSION OF MILD-TO-MODERATE SEVERITY, PER STRUCTURED PSYCHIATRIC INTERVIEW AND SCORES OF 14-28 ON BECK DEPRESSION INVENTORY-II (BDI). AT SCREENING, INDIVIDUALS ENGAGED IN PSYCHOTHERAPY, ANTIDEPRESSANT PHARMACOTHERAPY, HERBAL OR NUTRACEUTICAL MOOD THERAPIES, OR MIND-BODY PRACTICES WERE EXCLUDED. PARTICIPANTS WERE 68% FEMALE, WITH MEAN AGE 43.4 YEARS (SD = 14.8, RANGE = 22-72), AND MEAN BDI SCORE 22.4 (SD = 4.5). TWENTY PARTICIPANTS WERE RANDOMIZED TO 90-MINUTE HATHA YOGA PRACTICE GROUPS TWICE WEEKLY FOR 8 WEEKS. EIGHTEEN PARTICIPANTS WERE RANDOMIZED TO 90-MINUTE ATTENTION CONTROL EDUCATION GROUPS TWICE WEEKLY FOR 8 WEEKS. CERTIFIED YOGA INSTRUCTORS DELIVERED BOTH INTERVENTIONS AT A UNIVERSITY CLINIC. PRIMARY OUTCOME WAS DEPRESSION SEVERITY, MEASURED BY BDI SCORES EVERY 2 WEEKS FROM BASELINE TO 8 WEEKS. SECONDARY OUTCOMES WERE SELF-EFFICACY AND SELF-ESTEEM, MEASURED BY SCORES ON THE GENERAL SELF-EFFICACY SCALE (GSES) AND ROSENBERG SELF-ESTEEM SCALE (RSES) AT BASELINE AND AT 8 WEEKS. RESULTS: IN INTENT-TO-TREAT ANALYSIS, YOGA PARTICIPANTS EXHIBITED SIGNIFICANTLY GREATER 8-WEEK DECLINE IN BDI SCORES THAN CONTROLS (P-VALUE = 0.034). IN SUB-ANALYSES OF PARTICIPANTS COMPLETING FINAL 8-WEEK MEASURES, YOGA PARTICIPANTS WERE MORE LIKELY TO ACHIEVE REMISSION, DEFINED PER FINAL BDI SCORE