1  109 134 A PILOT STUDY ASSESSING ACCEPTABILITY AND FEASIBILITY OF HATHA YOGA FOR CHRONIC PAIN IN PEOPLE RECEIVING OPIOID AGONIST THERAPY FOR OPIOID USE DISORDER. THE PURPOSE OF THIS PROJECT WAS TO ASSESS THE FEASIBILITY AND ACCEPTABILITY OF A HATHA YOGA PROGRAM DESIGNED TO TARGET CHRONIC PAIN IN PEOPLE RECEIVING OPIOID AGONIST THERAPY FOR OPIOID USE DISORDER. WE CONDUCTED A PILOT RANDOMIZED TRIAL IN WHICH PEOPLE WITH CHRONIC PAIN WHO WERE RECEIVING EITHER METHADONE MAINTENANCE THERAPY (N=20) OR BUPRENORPHINE (N=20) WERE RANDOMLY ASSIGNED TO WEEKLY HATHA YOGA OR HEALTH EDUCATION (HE) CLASSES FOR 3MONTHS. WE DEMONSTRATED FEASIBILITY IN MANY DOMAINS, INCLUDING RECRUITMENT OF PARTICIPANTS (58% FEMALE, MEAN AGE 43), RETENTION FOR FOLLOW-UP ASSESSMENTS, AND ABILITY OF TEACHERS TO PROVIDE INTERVENTIONS WITH HIGH FIDELITY TO THE MANUALS. FIFTY PERCENT OF PARTICIPANTS IN YOGA (95% CI: 0.28-0.72) AND 65% OF PARTICIPANTS IN HE (95% CI: 0.44-0.87) ATTENDED AT LEAST 6 OF 12 POSSIBLE CLASSES (P=0.62). SIXTY-ONE PERCENT IN THE YOGA GROUP REPORTED PRACTICING YOGA AT HOME, WITH A MEAN NUMBER OF TIMES PRACTICING PER WEEK OF 2.67 (SD=2.37). PARTICIPANT MOOD IMPROVED PRE-CLASS TO POST-CLASS, WITH GREATER DECREASES IN ANXIETY AND PAIN FOR THOSE IN THE YOGA GROUP (P<0.05). IN CONCLUSION, YOGA CAN BE DELIVERED ON-SITE AT OPIOID AGONIST TREATMENT PROGRAMS WITH HOME PRACTICE TAKEN UP BY THE MAJORITY OF PARTICIPANTS. FUTURE RESEARCH MAY EXPLORE WAYS OF INCREASING THE YOGA "DOSAGE" RECEIVED. THIS MAY INVOLVE TESTING STRATEGIES FOR INCREASING EITHER CLASS ATTENDANCE OR THE AMOUNT OF HOME PRACTICE OR BOTH.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
2 1291  26 GROUP ACUPUNCTURE THERAPY WITH YOGA THERAPY FOR CHRONIC NECK, LOW BACK, AND OSTEOARTHRITIS PAIN IN SAFETY NET SETTING FOR AN UNDERSERVED POPULATION: DESIGN AND RATIONALE FOR A FEASIBILITY PILOT. CHRONIC PAIN IS PREVALENT IN THE UNITED STATES, WITH IMPACT ON PHYSICAL AND PSYCHOLOGICAL FUNCTIONING AS WELL AS LOST WORK PRODUCTIVITY. MINORITY AND LOWER SOCIOECONOMIC POPULATIONS HAVE INCREASED PREVALENCE OF CHRONIC PAIN WITH LESS ACCESS TO PAIN CARE, POORER OUTCOMES, AND HIGHER RISK OF FATAL OPIOID OVERDOSE. ACUPUNCTURE THERAPY IS EFFECTIVE IN TREATING CHRONIC PAIN CONDITIONS INCLUDING CHRONIC LOW BACK PAIN, NECK PAIN, SHOULDER PAIN, AND KNEE PAIN FROM OSTEOARTHRITIS. ACUPUNCTURE THERAPY, INCLUDING GROUP ACUPUNCTURE, IS FEASIBLE AND EFFECTIVE, AND SPECIFICALLY SO FOR UNDERSERVED AND DIVERSE POPULATIONS AT RISK FOR HEALTH OUTCOME DISPARITIES. ACUPUNCTURE THERAPY ALSO ENCOURAGES PATIENT ENGAGEMENT AND ACTIVATION. AS CHRONIC PAIN IMPROVES, THERE IS A NATURAL PROGRESSION TO WANT AND NEED TO INCREASE ACTIVITY AND MOVEMENT RECOVERY. DIVERSE MOVEMENT APPROACHES ARE IMPORTANT FOR IMPROVING RANGE OF MOTION, MAINTAINING GAINS, STRENGTHENING, AND PROMOTING PATIENT ENGAGEMENT AND ACTIVATION. YOGA THERAPY IS AN ACTIVE THERAPY WITH PROVEN BENEFIT IN MUSCULOSKELETAL PAIN DISORDERS AND PAIN ASSOCIATED DISABILITY. THE AIM OF THIS QUASI-EXPERIMENTAL PILOT FEASIBILITY TRIAL IS TO TEST THE BUNDLING OF THESE 2 EFFECTIVE CARE OPTIONS FOR CHRONIC PAIN, TO INFORM BOTH THE DESIGN FOR A LARGER RANDOMIZED PRAGMATIC EFFECTIVENESS TRIAL AS WELL AS IMPLEMENTATION STRATEGIES ACROSS UNDERSERVED SETTINGS.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
3 2596  47 YOGA FOR MILITARY VETERANS WITH CHRONIC LOW BACK PAIN: A RANDOMIZED CLINICAL TRIAL. INTRODUCTION: CHRONIC LOW BACK PAIN (CLBP) IS PREVALENT, ESPECIALLY AMONG MILITARY VETERANS. MANY CLBP TREATMENT OPTIONS HAVE LIMITED BENEFITS AND ARE ACCOMPANIED BY SIDE EFFECTS. MAJOR EFFORTS TO REDUCE OPIOID USE AND EMBRACE NONPHARMACOLOGICAL PAIN TREATMENTS HAVE RESULTED. RESEARCH WITH COMMUNITY CLBP PATIENTS INDICATES THAT YOGA CAN IMPROVE HEALTH OUTCOMES AND HAS FEW SIDE EFFECTS. THE BENEFITS OF YOGA AMONG MILITARY VETERANS WERE EXAMINED. DESIGN: PARTICIPANTS WERE RANDOMIZED TO EITHER YOGA OR DELAYED YOGA TREATMENT IN 2013-2015. OUTCOMES WERE ASSESSED AT BASELINE, 6 WEEKS, 12 WEEKS, AND 6 MONTHS. INTENTION-TO-TREAT ANALYSES OCCURRED IN 2016. SETTING/PARTICIPANTS: ONE HUNDRED AND FIFTY MILITARY VETERANS WITH CLBP WERE RECRUITED FROM A MAJOR VETERANS AFFAIRS MEDICAL CENTER IN CALIFORNIA. INTERVENTION: YOGA CLASSES (WITH HOME PRACTICE) WERE LED BY A CERTIFIED INSTRUCTOR TWICE WEEKLY FOR 12 WEEKS, AND CONSISTED PRIMARILY OF PHYSICAL POSTURES, MOVEMENT, AND BREATHING TECHNIQUES. MAIN OUTCOME MEASURES: THE PRIMARY OUTCOME WAS ROLAND-MORRIS DISABILITY QUESTIONNAIRE SCORES AFTER 12 WEEKS. PAIN INTENSITY WAS IDENTIFIED AS AN IMPORTANT SECONDARY OUTCOME. RESULTS: PARTICIPANT CHARACTERISTICS WERE MEAN AGE 53 YEARS, 26% WERE FEMALE, 35% WERE UNEMPLOYED OR DISABLED, AND MEAN BACK PAIN DURATION WAS 15 YEARS. IMPROVEMENTS IN ROLAND-MORRIS DISABILITY QUESTIONNAIRE SCORES DID NOT DIFFER BETWEEN THE TWO GROUPS AT 12 WEEKS, BUT YOGA PARTICIPANTS HAD GREATER REDUCTIONS IN ROLAND-MORRIS DISABILITY QUESTIONNAIRE SCORES THAN DELAYED TREATMENT PARTICIPANTS AT 6 MONTHS -2.48 (95% CI= -4.08, -0.87). YOGA PARTICIPANTS IMPROVED MORE ON PAIN INTENSITY AT 12 WEEKS AND AT 6 MONTHS. OPIOID MEDICATION USE DECLINED AMONG ALL PARTICIPANTS, BUT GROUP DIFFERENCES WERE NOT FOUND. CONCLUSIONS: YOGA IMPROVED HEALTH OUTCOMES AMONG VETERANS DESPITE EVIDENCE THEY HAD FEWER RESOURCES, WORSE HEALTH, AND MORE CHALLENGES ATTENDING YOGA SESSIONS THAN COMMUNITY SAMPLES STUDIED PREVIOUSLY. THE MAGNITUDE OF PAIN INTENSITY DECLINE WAS SMALL, BUT OCCURRED IN THE CONTEXT OF REDUCED OPIOID USE. THE FINDINGS SUPPORT WIDER IMPLEMENTATION OF YOGA PROGRAMS FOR VETERANS. TRIAL REGISTRATION: THIS STUDY IS REGISTERED AT WWW.CLINICALTRIALS.GOV NCT02524158.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
4 2638  38 YOGA FOR VETERANS WITH CHRONIC LOW BACK PAIN: DESIGN AND METHODS OF A RANDOMIZED CLINICAL TRIAL. CHRONIC LOW BACK PAIN (CLBP) AFFLICTS MILLIONS OF PEOPLE WORLDWIDE, WITH PARTICULARLY HIGH PREVALENCE IN MILITARY VETERANS. MANY TREATMENT OPTIONS EXIST FOR CLBP, BUT MOST HAVE LIMITED EFFECTIVENESS AND SOME HAVE SIGNIFICANT SIDE EFFECTS. IN GENERAL POPULATIONS WITH CLBP, YOGA HAS BEEN SHOWN TO IMPROVE HEALTH OUTCOMES WITH FEW SIDE EFFECTS. HOWEVER, YOGA HAS NOT BEEN ADEQUATELY STUDIED IN MILITARY VETERAN POPULATIONS. IN THE CURRENT PAPER WE WILL DESCRIBE THE DESIGN AND METHODS OF A RANDOMIZED CLINICAL TRIAL AIMED AT EXAMINING WHETHER YOGA CAN EFFECTIVELY REDUCE DISABILITY AND PAIN IN US MILITARY VETERANS WITH CLBP. A TOTAL OF 144 US MILITARY VETERANS WITH CLBP WILL BE RANDOMIZED TO EITHER YOGA OR A DELAYED TREATMENT COMPARISON GROUP. THE YOGA INTERVENTION WILL CONSIST OF 2X WEEKLY YOGA CLASSES FOR 12WEEKS, COMPLEMENTED BY REGULAR HOME PRACTICE GUIDED BY A MANUAL. THE DELAYED TREATMENT GROUP WILL RECEIVE THE SAME INTERVENTION AFTER SIX MONTHS. THE PRIMARY OUTCOME IS THE CHANGE IN BACK PAIN-RELATED DISABILITY MEASURED WITH THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE AT BASELINE AND 12-WEEKS. SECONDARY OUTCOMES INCLUDE PAIN INTENSITY, PAIN INTERFERENCE, DEPRESSION, ANXIETY, FATIGUE/ENERGY, QUALITY OF LIFE, SELF-EFFICACY, SLEEP QUALITY, AND MEDICATION USAGE. ADDITIONAL PROCESS AND/OR MEDIATIONAL FACTORS WILL BE MEASURED TO EXAMINE DOSE RESPONSE AND EFFECT MECHANISMS. ASSESSMENTS WILL BE CONDUCTED AT BASELINE, 6-WEEKS, 12-WEEKS, AND 6-MONTHS. ALL RANDOMIZED PARTICIPANTS WILL BE INCLUDED IN INTENTION-TO-TREAT ANALYSES. STUDY RESULTS WILL PROVIDE MUCH NEEDED EVIDENCE ON THE FEASIBILITY AND EFFECTIVENESS OF YOGA AS A THERAPEUTIC MODALITY FOR THE TREATMENT OF CLBP IN US MILITARY VETERANS.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
5 2477  39 YOGA AS AN ADJUNCTIVE INTERVENTION TO MEDICATION-ASSISTED TREATMENT WITH BUPRENORPHINE+NALOXONE. OBJECTIVE: ACCORDING TO THE CDC, 2.6 MILLION PEOPLE IN THE UNITED STATES HAVE AN OPIOID USE DISORDER AND DRUG OVERDOSE IS THE LEADING CAUSE OF ACCIDENTAL DEATH. OPIOIDS ARE INVOLVED IN 63% OF OVERDOSE DEATHS. IT IS IMPERATIVE THAT WE IDENTIFY EVIDENCE BASED TREATMENTS TO STEM THE TIDE OF THIS EPIDEMIC. THIS PILOT STUDY SERVES TO EXPLORE THE FEASIBILITY AND EFFECTIVENESS OF YOGA AS AN ADJUNCTIVE INTERVENTION FOR INDIVIDUALS WITH OPIOID USE DISORDER IN ACTIVE MEDICATION-ASSISTED TREATMENT (MAT). METHODS: PARTICIPANTS (N=26) WERE RECRUITED FROM A BUPRENORPHINE/NALOXONE MAT PROGRAM TO PARTICIPATE IN THIS STUDY. 13 PARTICIPANTS ENGAGED IN A 12 WEEK ADJUNCTIVE YOGA INTERVENTION WHILE REMAINING IN TREATMENT AS USUAL (TAU) MAT. 13 MATCHED CONTROLS WERE RECRUITED AND REMAINED IN TAU MAT. BOTH GROUPS WERE EVALUATED AT BASELINE, 45 DAYS AND 90 DAYS FOR CHANGES IN CRAVING FOR OPIOIDS, TREATMENT RETENTION, RELAPSE RATES, SLEEP, AND SYMPTOMS OF ANXIETY AND PERCEIVED STRESS. RESULTS: A TWO-WAY TREATMENT BY TIME ANALYSIS OF VARIANCE WAS PERFORMED USING A MIXED EFFECTS MODEL. THE TREATMENT BY FOLLOW-UP TIME INTERACTION EFFECT WAS SIGNIFICANT FOR PERCEIVED STRESS (P=0.026) INDICATING THAT THE YOGA INTERVENTION HAD A LARGER EFFECT THAN TAU (MAT). CHANGES IN PERCEIVED STRESS DECREASED SIGNIFICANTLY OVER TIME IN BOTH THE YOGA INTERVENTION GROUP AND THE TAU MAT MATCHED CONTROL GROUP. CONCLUSION: THIS PILOT STUDY INDICATED STRONG EVIDENCE FOR YOGA BEING AN EFFECTIVE ADJUNCTIVE TREATMENT TO MAT TAU IN REDUCING PERCEIVED STRESS. FURTHER RESEARCH WITH A LARGER POPULATION IS NEEDED TO DETERMINE IMPACT ON OTHER MENTAL HEALTH SYMPTOMS AND RELAPSE AND RETENTION RATES.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
6   17  31 "THE PAIN LEFT, I WAS OFF AND RUNNING": A QUALITATIVE ANALYSIS OF GROUP ACUPUNCTURE AND YOGA THERAPY FOR CHRONIC PAIN IN A LOW-INCOME AND ETHNICALLY DIVERSE POPULATION. INTRODUCTION: CHRONIC PAIN AND THE CURRENT OPIOID EPIDEMIC ARE PRESSING PUBLIC HEALTH CONCERNS, ESPECIALLY IN LOW-INCOME AND ETHNICALLY DIVERSE COMMUNITIES. NONPHARMACOLOGIC THERAPIES THAT ARE SAFE, EFFECTIVE, AND ACCEPTABLE FOR THE TREATMENT OF CHRONIC PAIN CONDITIONS MAY PROVIDE A SOLUTION FOR ADDRESSING THIS ISSUE. THIS QUALITATIVE ANALYSIS EXPLORES THE EXPERIENCE OF STUDY PARTICIPANTS WHO RECEIVED COMBINED ACUPUNCTURE AND YOGA THERAPY (YT) TO TREAT CHRONIC PAIN DELIVERED IN A PRIMARY CARE SETTING. METHODS: THE GROUP ACUPUNCTURE WITH YOGA THERAPY FOR CHRONIC NECK, LOW BACK, AND OSTEOARTHRITIC PAIN TRIAL (GAPYOGA) ASSESSED THE FEASIBILITY AND EFFECTIVENESS OF GROUP ACUPUNCTURE (GA) COMBINED WITH YT IN A LOW-INCOME, RACIAL, AND ETHNICALLY DIVERSE POPULATION. INDIVIDUAL IN-DEPTH INTERVIEWS WERE CONDUCTED WITH A SUBSET OF PATIENTS IN THE TRIAL. NINETEEN PARTICIPANTS WERE INTERVIEWED FOR QUALITATIVE ANALYSIS OF THEIR EXPERIENCE. USING THE IMMERSION AND CRYSTALLIZATION METHOD, TRANSCRIBED INTERVIEWS WERE ANALYZED FOR THEMES MEANINGFULLY REPRESENTING PARTICIPANT EXPERIENCE. RESULTS: THE COMBINED GA AND YT RESULTED IN SIGNIFICANT PAIN RELIEF AND TRANSFORMATIVE HEALING EXPERIENCES. THREE THEMES EMERGED FROM PARTICIPANT NARRATIVES: (1) TRANSFORMATIVE ENGAGEMENT WITH SELF IN THE HEALING PROCESS THROUGH PAIN RELIEF, PSYCHOLOGICAL WELL-BEING, AND SELF-EFFICACY; (2) THERAPEUTIC RELATIONSHIP WITH ACUPUNCTURE AND YOGA PROVIDERS; AND (3) FOSTERING RELATIONSHIPS WITH FELLOW PARTICIPANTS IN THE GROUP. DISCUSSION: IN THIS STUDY OF A LOW-INCOME AND ETHNICALLY DIVERSE POPULATION, THE COMBINATION OF ACUPUNCTURE AND YT WAS FOUND TO ALLEVIATE PAIN, IMPROVE FUNCTION, PROMOTE PSYCHOLOGICAL WELL-BEING, AND ENGAGE PARTICIPANTS IN SELF-CARE PRACTICES IN A TRANSFORMATIVE HEALING PROCESS-RESULTING IN PHYSICAL AND PSYCHOLOGICAL BENEFITS.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
7 1953  45 SECONDARY OUTCOMES FROM A RANDOMIZED CONTROLLED TRIAL OF YOGA FOR VETERANS WITH CHRONIC LOW-BACK PAIN. CHRONIC LOW-BACK PAIN (CLBP) IS A PREVALENT CONDITION, AND RATES ARE HIGHER AMONG MILITARY VETERANS. CLBP IS A PERSISTENT CONDITION, AND TREATMENT OPTIONS HAVE EITHER MODEST EFFECTS OR A SIGNIFICANT RISK OF SIDE-EFFECTS, WHICH HAS LED TO RECENT EFFORTS TO EXPLORE MIND-BODY INTERVENTION OPTIONS AND REDUCE OPIOID MEDICATION USE. PRIOR STUDIES OF YOGA FOR CLBP IN COMMUNITY SAMPLES, AND THE MAIN RESULTS OF A RECENT TRIAL WITH MILITARY VETERANS, INDICATE THAT YOGA CAN REDUCE BACK-RELATED DISABILITY AND PAIN INTENSITY. SECONDARY OUTCOMES FROM THE TRIAL OF YOGA WITH MILITARY VETERANS ARE PRESENTED HERE. IN THE STUDY, 150 MILITARY VETERANS (VETERANS ADMINISTRATION PATIENTS) WITH CLBP WERE RANDOMIZED TO EITHER YOGA OR A DELAYED-TREATMENT GROUP RECEIVING USUAL CARE BETWEEN 2013 AND 2015. ASSESSMENTS OCCURRED AT BASELINE, 6 WEEKS, 12 WEEKS, AND 6 MONTHS. INTENT-TO-TREAT ANALYSES WERE CONDUCTED. YOGA CLASSES LASTING 60 MINUTES EACH WERE OFFERED TWICE WEEKLY FOR 12 WEEKS. YOGA SESSIONS CONSISTED OF PHYSICAL POSTURES, MOVEMENT, FOCUSED ATTENTION, AND BREATHING TECHNIQUES. HOME PRACTICE GUIDED BY A MANUAL WAS STRONGLY RECOMMENDED. THE PRIMARY OUTCOME MEASURE WAS ROLAND-MORRIS DISABILITY QUESTIONNAIRE SCORES AFTER 12 WEEKS. SECONDARY OUTCOMES INCLUDED PAIN INTENSITY, PAIN INTERFERENCE, DEPRESSION, FATIGUE, QUALITY OF LIFE, SELF-EFFICACY, AND MEDICATION USAGE. YOGA PARTICIPANTS IMPROVED MORE THAN DELAYED-TREATMENT PARTICIPANTS ON PAIN INTERFERENCE, FATIGUE, QUALITY OF LIFE, AND SELF-EFFICACY AT 12 WEEKS AND/OR 6 MONTHS. YOGA PARTICIPANTS HAD GREATER IMPROVEMENTS ACROSS A NUMBER OF IMPORTANT SECONDARY HEALTH OUTCOMES COMPARED TO CONTROLS. BENEFITS EMERGED DESPITE SOME VETERANS FACING CHALLENGES WITH ATTENDING YOGA SESSIONS IN PERSON. THE FINDINGS SUPPORT WIDER IMPLEMENTATION OF YOGA PROGRAMS FOR VETERANS, WITH ATTENTION TO INCREASING ACCESSIBILITY OF YOGA PROGRAMS IN THIS POPULATION.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
8  517  41 COMPARING HATHA YOGA WITH DYNAMIC GROUP PSYCHOTHERAPY FOR ENHANCING METHADONE MAINTENANCE TREATMENT: A RANDOMIZED CLINICAL TRIAL. BACKGROUND: AS MORE METHADONE TREATMENT PROGRAMS ARE FUNDED IN AN ATTEMPT TO CURB SUBSTANCE ABUSE AND HIV INFECTION AMONG I.V. DRUG USERS, MORE COST EFFECTIVE TREATMENT APPROACHES ARE BEING SOUGHT. OBJECTIVES: TO INVESTIGATE WHETHER CLIENTS IN OUTPATIENT METHADONE MAINTENANCE TREATMENT WHO PRACTICE WEEKLY HATHA YOGA IN A GROUP SETTING EXPERIENCE MORE FAVORABLE TREATMENT OUTCOMES THAN THOSE WHO RECEIVE CONVENTIONAL GROUP PSYCHODYNAMIC THERAPY. METHODS: AFTER A 5-DAY ASSESSMENT PERIOD, 61 PATIENTS WERE RANDOMLY ASSIGNED TO METHADONE MAINTENANCE ENHANCED BY TRADITIONAL GROUP PSYCHOTHERAPY (IE, CONVENTIONAL METHADONE TREATMENT) OR AN ALTERNATIVE HATHA YOGA THERAPY (IE, ALTERNATIVE METHADONE TREATMENT). PATIENTS WERE FOLLOWED FOR 6 MONTHS AND EVALUATED ON A VARIETY OF PSYCHOLOGICAL, SOCIOLOGICAL, AND BIOLOGICAL MEASURES. THE REVISED SYMPTOM CHECK LIST PROVIDED THE PRIMARY PSYCHOLOGICAL MEASURES; THE ADDICTION SEVERITY INDEX PROVIDED VARIOUS INDICES OF ADDICTIVE BEHAVIORS. RESULTS: THE EVIDENCE REVEALED THAT THERE WERE NO MEANINGFUL DIFFERENCES BETWEEN TRADITIONAL PSYCHODYNAMIC GROUP THERAPY AND HATHA YOGA PRESENTED IN A GROUP SETTING. BOTH TREATMENTS CONTRIBUTED TO A TREATMENT REGIMEN THAT SIGNIFICANTLY REDUCED DRUG USE AND CRIMINAL ACTIVITIES. PSYCHOPATHOLOGY AT ADMISSION WAS SIGNIFICANTLY RELATED TO PROGRAM PARTICIPATION REGARDLESS OF TREATMENT GROUP. DISCUSSION: IN ADDITION TO EXAMINING THE CHARACTERISTICS OF PATIENTS WHO PRESENT FOR TREATMENT, THIS STUDY IDENTIFIES UNEXPECTED STAFF ISSUES THAT COMPLICATE THE INTEGRATION OF ALTERNATIVE AND TRADITIONAL TREATMENT STRATEGIES. CONCLUSION: ALTERNATIVE METHADONE TREATMENT IS NOT MORE EFFECTIVE THAN CONVENTIONAL METHADONE TREATMENT, AS ORIGINALLY HYPOTHESIZED. HOWEVER, SOME PATIENTS MAY BENEFIT MORE FROM ALTERNATIVE METHADONE TREATMENT THAN CONVENTIONAL METHADONE TREATMENT. ADDITIONAL RESEARCH IS NECESSARY TO DETERMINE CHARACTERISTICS THAT IDENTIFY PATIENTS WHO MIGHT BENEFIT FROM ALTERNATIVE METHADONE TREATMENT.	1997	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
9  348  33 ASSESSING THE ACCEPTABILITY OF YOGA AMONG PATIENTS WITH AND WITHOUT CHRONIC PAIN ENROLLED IN A LICENSED OPIOID TREATMENT PROGRAM. THERE IS A PRESSING NEED TO IDENTIFY NON-OPIOID, EVIDENCE-BASED TREATMENTS TO ADDRESS THE HIGH PREVALENCE OF CHRONIC PAIN IN LICENSED OPIOID TREATMENT PROGRAMS (OTP). YOGA IS AN EFFECTIVE PAIN COPING STRATEGY BUT IS NOT WIDELY USED BY OTP PATIENTS. FEW STUDIES HAVE EXAMINED UNDERLYING FACTORS RELATED TO POOR YOGA UTILIZATION IN THIS POPULATION. SEVENTY-ONE PARTICIPANTS WITH AND WITHOUT CHRONIC PAIN ENROLLED IN A HOSPITAL-BASED OTP COMPLETED AN ACCEPTABILITY SURVEY ASSESSING PAIN, CURRENT PAIN COPING STRATEGIES, PRIOR YOGA EXPERIENCE, WILLINGNESS TO TRY YOGA, AND BELIEFS ABOUT YOGA. PARTICIPANTS WITH AND WITHOUT CHRONIC PAIN WERE COMPARED, AS WERE PARTICIPANTS WITH AND WITHOUT PRIOR YOGA EXPERIENCE. THE RELATIONSHIPS BETWEEN PRIMARY STUDY VARIABLES IN THE CHRONIC PAIN GROUP WERE ALSO EXPLORED. PARTICIPANTS REPORTED USING OVER-THE-COUNTER MEDICATIONS, MEDITATION, STRETCHING, AND EXERCISE TO MANAGE CHRONIC PAIN, BUT YOGA WAS NOT COMMONLY USED. PARTICIPANTS WITH PRIOR YOGA EXPERIENCE REPORTED HIGHER WILLINGNESS TO TRY YOGA AND MORE FAVORABLE BELIEFS ABOUT YOGA THAN PARTICIPANTS WITHOUT PRIOR YOGA EXPERIENCE. THERE WERE NO SIGNIFICANT DIFFERENCES IN WILLINGNESS TO TRY YOGA BETWEEN PARTICIPANTS WITH AND WITHOUT CHRONIC PAIN. AMONG PARTICIPANTS WITH CHRONIC PAIN, THERE WAS A POSITIVE ASSOCIATION BETWEEN TOTAL NUMBER OF PAIN COPING STRATEGIES USED AND WILLINGNESS TO TRY YOGA. THIS STUDY ADDS TO THE EXISTING LITERATURE ON THE IMPLEMENTATION OF YOGA PROGRAMS INTO OTPS BY DEMONSTRATING THE ACCEPTABILITY OF YOGA IN PATIENTS WITH OPIOID USE DISORDER, INCLUDING THOSE EXPERIENCING CHRONIC PAIN, AND ENCOURAGES ADDITIONAL RESEARCH EXPLORING IMPLEMENTATION.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
10 2284  31 THE USE OF YOGA AS A GROUP INTERVENTION FOR PEDIATRIC CHRONIC PAIN REHABILITATION: EXPLORING QUALITATIVE AND QUANTITATIVE OUTCOMES. PURPOSE: WITH THE INCREASE IN OPIOID USE OVER THE LAST DECADE, MIND-BODY APPROACHES TO PEDIATRIC PAIN MANAGEMENT HAVE BEEN TRENDING. TO DATE, THERE IS LIMITED RESEARCH REGARDING THE USE OF YOGA WITH PEDIATRIC CHRONIC PAIN. THIS STUDY AIMS TO GAUGE THE EFFECTIVENESS OF GROUP YOGA AS PART OF CHRONIC PAIN REHABILITATION AND ONE'S ABILITY TO CONTINUE PRACTICING INDEPENDENTLY BY EXPLORING QUALITATIVE AND QUANTITATIVE INFORMATION. METHODS: A SINGLE THERAPIST USED YOGA AS A GROUP PHYSICAL THERAPY INTERVENTION ONCE A WEEK FOR 60 MINUTES. YOGA EDUCATION, IYENGAR YOGA COMPONENTS, RELAXATION, AND STRETCHING WERE INCORPORATED INTO THE THERAPEUTIC YOGA SESSION. QUALITATIVE AND QUANTITATIVE INFORMATION WAS COLLECTED. RESULTS: QUALITATIVE OUTCOMES PROVIDED VALUABLE DATA ABOUT DISTRACTIONS AND BENEFITS. QUANTITATIVE OUTCOMES SHOWED THAT THERE WERE SIGNIFICANT IMPROVEMENTS IN AREAS SUCH AS MENTAL TENSION, EMOTIONAL TENSION, MUSCLE TENSION, AND PAIN (ALL P < 0.001 SIGNIFICANT). CONCLUSION: PEDIATRIC CHRONIC PAIN PATIENTS CAN IDENTIFY MANY BENEFITS AFTER A SINGLE GROUP YOGA SESSION. IT COMBINES THE PHYSICAL AND COGNITIVE ASPECTS OF INTERDISCIPLINARY PAIN REHABILITATION FOR CONTINUED USE AFTER DISCHARGE. THE USE OF YOGA IS AN ECONOMICAL MEANS OF PHYSICAL ACTIVITY AFTER DISCHARGE TO PROMOTE LONG-TERM BENEFITS.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
11  622  45 DEVELOPMENT, VALIDATION, AND FEASIBILITY TESTING OF A YOGA MODULE FOR OPIOID USE DISORDER. CONTEXT: OPIOID USE DISORDER (OUD) INVOLVES EXCESSIVE USE OF OPIOIDS-SUCH AS HEROIN, MORPHINE, FENTANYL, CODEINE, OXYCODONE, AND HYDROCODONE-LEADING TO MAJOR HEALTH, SOCIAL, AND ECONOMIC CONSEQUENCES. YOGA LIFESTYLE INTERVENTIONS HAVE BEEN FOUND TO BE USEFUL AS ADJUNCT THERAPIES IN MANAGEMENT OF SUBSTANCE USE DISORDERS AND CHRONIC PAIN CONDITIONS. OBJECTIVE: THE RESEARCH TEAM INTENDED TO DEVELOP, VALIDATE, AND TEST FOR FEASIBILITY A YOGA PROGRAM FOR OUD PATIENTS THAT COULD REDUCE OPIATE WITHDRAWAL SYMPTOMS-SUCH AS PAIN, FATIGUE, LOW MOOD, ANXIETY AND SLEEP DISTURBANCES-AND CRAVINGS ASSOCIATED WITH DRUGS. DESIGN: THE RESEARCH TEAM FIRST PERFORMED A LITERATURE REVIEW OF TRADITIONAL AND CONTEMPORARY YOGA TEXTS, SUCH AS HATHA YOGA PRADIPIKA AND LIGHT ON YOGA, AS WELL AS MODERN SCIENTIFIC LITERATURE IN THE FOLLOWING SEARCH ENGINES-GOOGLE SCHOLAR, PUBMED, AND PSYCHINFO, USING THE KEYWORDS YOGA, PRANAYAMA, HATHA YOGA, RELAXATION. MEDITATION, SUBSTANCE USE, ADDICTION, IMPULSIVITY, CRAVING, SLEEP QUALITY, AND FATIGUE. USING THE INFORMATION OBTAINED, THE TEAM DEVELOPED A YOGA PROGRAM AND DESIGNED A PILOT STUDY THAT USED THE PROGRAM. SETTING: THE STUDY TOOK PLACE IN THE DEPARTMENT OF INTEGRATIVE MEDICINE AT THE NATIONAL INSTITUTE OF MENTAL HEALTH AND NEUROSCIENCES (NIMHANS) IN BANGALORE, INDIA. PARTICIPANTS: PARTICIPANTS IN THE PILOT STUDY WERE 8 INPATIENTS, 6 MALES AND 2 FEMALES, WHO WERE ON OPIOID AGONIST TREATMENT (BUPRENORPHINE) FOR OUD. INTERVENTION: THE INTERVENTION WAS THE YOGA PROGRAM PREVIOUSLY VALIDATED BY THE RESEARCH TEAM. IN THE PILOT STUDY, PARTICIPANTS WERE TAUGHT A ONE-HOUR, YOGA-BASED INTERVENTION, WITH SESSIONS OCCURRING ONCE PER DAY, FOR 10 SESSIONS. OUTCOME MEASURES: FOR VALIDATION, 13 EXPERTS SCORED THE YOGA PROGRAM THAT THE RESEARCH TEAM HAD DEVELOPED AND GAVE SUGGESTIONS FOR EACH YOGIC PRACTICE FOR USE DURING THE ACUTE PHASE OF WITHDRAWAL AND THE MAINTENANCE PHASE RESPECTIVELY. A CONTENT VALIDITY RATIO (CVR) WAS CALCULATED FROM THEIR SCORING, AND THE RESEARCH TEAM MADE CHANGES TO THE PROGRAM BASE ON THE SCORING AND SUGGESTIONS. FOR THE PILOT STUDY, ASSESSMENTS OCCURRED AT BASELINE AND POSTINTERVENTION. THE PARTICIPANTS' YOGA PERFORMANCE WAS RATED BY THE YOGA TRAINER ON A YOGA PERFORMANCE ASSESSMENT SCALE (YPA). OTHER MEASUREMENTS INCLUDED: (1) THE CLINICAL OPIATE WITHDRAWAL SCALE (COWS), (2) THE HAMILTON'S ANXIETY RATING SCALE (HAM-A), (3) THE HAMILTON'S DEPRESSION RATING SCALE (HAM-D), (4) BUPRENORPHINE DOSAGE, (5) THE CLINICAL GLOBAL IMPRESSION SEVERITY (CGI-S) SCALE, (6) A VISUAL ANALOG SCALE (VAS) FOR PAIN, (7) SLEEP QUALITY (LATENCY AND DURATION), AND (8) THE MODULE'S SAFETY. RESULTS: FOUR PRACTICES WERE REMOVED FROM THE PROGRAM DUE TO CVR SCORES BELOW THE CUTOFF, AND ONE PRACTICE WAS FOUND NOT TO BE FEASIBLE (KAPALABHATI). TWO CATEGORIES OF YOGA MODULES EMERGED: (1) FOR THE ACUTE SYMPTOMATIC PHASE (40 MINUTES) AND (2) FOR THE MAINTENANCE PHASE (ONE HOUR). PRACTICES WERE ADDED OR EXCLUDED BASED ON THE PHASE. CONCLUSIONS: THE YOGA MODULE THAT WAS DEVELOPED FOR REDUCING WITHDRAWAL SYMPTOMS AND CRAVINGS IN OUD PATIENTS WAS FOUND TO BE SAFE, FEASIBLE, AND POTENTIALLY USEFUL AS AN ADJUNCT THERAPY TO CONVENTIONAL TREATMENT.	2021	

12 2824  40 YOGA VERSUS EDUCATION FOR VETERANS WITH CHRONIC LOW BACK PAIN: STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN IS THE MOST FREQUENT PAIN CONDITION IN VETERANS AND CAUSES SUBSTANTIAL SUFFERING, DECREASED FUNCTIONAL CAPACITY, AND LOWER QUALITY OF LIFE. SYMPTOMS OF POST-TRAUMATIC STRESS, DEPRESSION, AND MILD TRAUMATIC BRAIN INJURY ARE HIGHLY PREVALENT IN VETERANS WITH BACK PAIN. YOGA FOR LOW BACK PAIN HAS BEEN DEMONSTRATED TO BE EFFECTIVE FOR CIVILIANS IN RANDOMIZED CONTROLLED TRIALS. HOWEVER, IT IS UNKNOWN IF RESULTS FROM PREVIOUSLY PUBLISHED TRIALS GENERALIZE TO MILITARY POPULATIONS. METHODS/DESIGN: THIS STUDY IS A PARALLEL RANDOMIZED CONTROLLED TRIAL COMPARING YOGA TO EDUCATION FOR 120 VETERANS WITH CHRONIC LOW BACK PAIN. PARTICIPANTS ARE VETERANS >/=18 YEARS OLD WITH LOW BACK PAIN PRESENT ON AT LEAST HALF THE DAYS IN THE PAST SIX MONTHS AND A SELF-REPORTED AVERAGE PAIN INTENSITY IN THE PREVIOUS WEEK OF >/=4 ON A 0-10 SCALE. THE 24-WEEK STUDY HAS AN INITIAL 12-WEEK INTERVENTION PERIOD, WHERE PARTICIPANTS ARE RANDOMIZED EQUALLY INTO (1) A STANDARDIZED WEEKLY GROUP YOGA CLASS WITH HOME PRACTICE OR (2) EDUCATION DELIVERED WITH A SELF-CARE BOOK. PRIMARY OUTCOME MEASURES ARE CHANGE AT 12 WEEKS IN LOW BACK PAIN INTENSITY MEASURED BY THE DEFENSE AND VETERANS PAIN RATING SCALE (0-10) AND BACK-RELATED FUNCTION USING THE 23-POINT ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 12-WEEK FOLLOW-UP PERIOD, YOGA PARTICIPANTS ARE ENCOURAGED TO CONTINUE HOME YOGA PRACTICE AND EDUCATION PARTICIPANTS CONTINUE FOLLOWING RECOMMENDATIONS FROM THE BOOK. QUALITATIVE INTERVIEWS WITH VETERANS IN THE YOGA GROUP AND THEIR PARTNERS EXPLORE THE IMPACT OF CHRONIC LOW BACK PAIN AND YOGA ON FAMILY RELATIONSHIPS. WE ALSO ASSESS COST-EFFECTIVENESS FROM THREE PERSPECTIVES: THE VETERAN, THE VETERANS HEALTH ADMINISTRATION, AND SOCIETY USING ELECTRONIC MEDICAL RECORDS, SELF-REPORTED COST DATA, AND STUDY RECORDS. DISCUSSION: THIS STUDY WILL HELP DETERMINE IF YOGA CAN BECOME AN EFFECTIVE TREATMENT FOR VETERANS WITH CHRONIC LOW BACK PAIN AND PSYCHOLOGICAL COMORBIDITIES. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT02224183.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
13 2475  27 YOGA AS AN ADJUNCT FOR MANAGEMENT OF OPIOID DEPENDENCE SYNDROME: A NINE-MONTH FOLLOW-UP CASE REPORT. OPIOID DEPENDENCE SYNDROME (ODS) IS A CHRONIC RELAPSING REMITTING CONDITION ASSOCIATED WITH SIGNIFICANT IMPAIRMENT AND MORTALITY RISK. OPIOID SUBSTITUTION THERAPY IS USED WORLDWIDE, BUT LONG-TERM RETENTION RATES ARE LOW AND THERE IS RISK OF MISUSE AND DIVERSION. YOGA PRACTICE CAN IMPROVE QUALITY OF LIFE, REDUCE CHRONIC PAIN, AND ENHANCE ENDOGENOUS OPIOIDS (BETA-ENDORPHINS). WE DESCRIBE A CASE OF ODS WHERE YOGA WAS ADDED TO THE CONVENTIONAL MANAGEMENT AND WHO WAS FOLLOWED UP FOR 9 MONTHS. ASSESSMENTS WERE DONE FOR CLINICAL SYMPTOMS, URINE DRUG SCREENING, PLASMA BETA-ENDORPHINS, AND BUPRENORPHINE DOSAGE. WE OBSERVED AN IMPROVEMENT IN HIS CLINICAL SYMPTOMS AND REDUCTION IN THE REQUIREMENTS FOR BUPRENORPHINE. A SLIGHT INCREASE IN BASAL PLASMA BETA-ENDORPHIN LEVELS WAS ALSO OBSERVED AT THE 9-MONTH FOLLOW-UP (FROM 2.02 PMOL/L AT BASELINE TO 6.51 PMOL/L).	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
14 2831  37 YOGA VS. PHYSICAL THERAPY VS. EDUCATION FOR CHRONIC LOW BACK PAIN IN PREDOMINANTLY MINORITY POPULATIONS: STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN CAUSES SUBSTANTIAL MORBIDITY AND COST TO SOCIETY WHILE DISPROPORTIONATELY IMPACTING LOW-INCOME AND MINORITY ADULTS. SEVERAL RANDOMIZED CONTROLLED TRIALS SHOW YOGA IS AN EFFECTIVE TREATMENT. HOWEVER, THE COMPARATIVE EFFECTIVENESS OF YOGA AND PHYSICAL THERAPY, A COMMON MAINSTREAM TREATMENT FOR CHRONIC LOW BACK PAIN, IS UNKNOWN. METHODS/DESIGN: THIS IS A RANDOMIZED CONTROLLED TRIAL FOR 320 PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH CHRONIC LOW BACK PAIN, COMPARING YOGA, PHYSICAL THERAPY, AND EDUCATION. INCLUSION CRITERIA ARE ADULTS 18-64 YEARS OLD WITH NON-SPECIFIC LOW BACK PAIN LASTING >/= 12 WEEKS AND A SELF-REPORTED AVERAGE PAIN INTENSITY OF >/= 4 ON A 0-10 SCALE. RECRUITMENT TAKES PLACE AT BOSTON MEDICAL CENTER, AN URBAN ACADEMIC SAFETY-NET HOSPITAL AND SEVEN FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS LOCATED IN DIVERSE NEIGHBORHOODS. THE 52-WEEK STUDY HAS AN INITIAL 12-WEEK TREATMENT PHASE WHERE PARTICIPANTS ARE RANDOMIZED IN A 2:2:1 RATIO INTO I) A STANDARDIZED WEEKLY HATHA YOGA CLASS SUPPLEMENTED BY HOME PRACTICE; II) A STANDARDIZED EVIDENCE-BASED EXERCISE THERAPY PROTOCOL ADAPTED FROM THE TREATMENT BASED CLASSIFICATION METHOD, INDIVIDUALLY DELIVERED BY A PHYSICAL THERAPIST AND SUPPLEMENTED BY HOME PRACTICE; AND III) EDUCATION DELIVERED THROUGH A SELF-CARE BOOK. CO-PRIMARY OUTCOME MEASURES ARE 12-WEEK PAIN INTENSITY MEASURED ON AN 11-POINT NUMERICAL RATING SCALE AND BACK-SPECIFIC FUNCTION MEASURED USING THE MODIFIED ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 40-WEEK MAINTENANCE PHASE, YOGA PARTICIPANTS ARE RE-RANDOMIZED IN A 1:1 RATIO TO EITHER STRUCTURED MAINTENANCE YOGA CLASSES OR HOME PRACTICE ONLY. PHYSICAL THERAPY PARTICIPANTS ARE SIMILARLY RE-RANDOMIZED TO EITHER FIVE BOOSTER SESSIONS OR HOME PRACTICE ONLY. EDUCATION PARTICIPANTS CONTINUE TO FOLLOW RECOMMENDATIONS OF EDUCATIONAL MATERIALS. WE WILL ALSO ASSESS COST EFFECTIVENESS FROM THE PERSPECTIVES OF THE INDIVIDUAL, INSURERS, AND SOCIETY USING CLAIMS DATABASES, ELECTRONIC MEDICAL RECORDS, SELF-REPORT COST DATA, AND STUDY RECORDS. QUALITATIVE DATA FROM INTERVIEWS WILL ADD SUBJECTIVE DETAIL TO COMPLEMENT QUANTITATIVE DATA. TRIAL REGISTRATION: THIS TRIAL IS REGISTERED IN CLINICALTRIALS.GOV, WITH THE ID NUMBER: NCT01343927.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
15 2035  27 TELE-YOGA FOR CHRONIC PAIN: CURRENT STATUS AND FUTURE DIRECTIONS. PAIN IS A PERVASIVE, DEBILITATING DISORDER THAT IS RESISTANT TO LONG-TERM PHARMACOLOGICAL INTERVENTIONS. ALTHOUGH PSYCHOLOGICAL THERAPIES SUCH AS COGNITIVE BEHAVIOR THERAPY DEMONSTRATE MODERATE EFFICACY, MANY INDIVIDUALS CONTINUE TO HAVE ONGOING DIFFICULTIES FOLLOWING TREATMENT. THERE IS A CURRENT TREND TO ESTABLISH COMPLEMENTARY AND INTEGRATIVE HEALTH INTERVENTIONS FOR CHRONIC PAIN, FOR WHICH YOGA HAS BEEN FOUND TO HAVE EXCITING POTENTIAL. NEVERTHELESS, AN IMPORTANT CONSIDERATION WITHIN THE FIELD IS ACCESSIBILITY TO ADEQUATE CARE. TELEHEALTH CAN BE USED TO PROVIDE REAL-TIME INTERACTIVE VIDEO CONFERENCING LEADING TO INCREASED ACCESS TO HEALTH CARE FOR INDIVIDUALS LOCATED REMOTELY OR WHO OTHERWISE HAVE DIFFICULTY ACCESSING SERVICES, PERHAPS THROUGH ISSUES OF MOBILITY OR PROXIMITY OF ADEQUATE SERVICES. THIS ARTICLE ASSESSES THE CURRENT STATUS AND FEASIBILITY OF IMPLEMENTING TELE-YOGA FOR CHRONIC PAIN. METHODOLOGICAL LIMITATIONS AND RECOMMENDATIONS FOR FUTURE RESEARCH ARE DISCUSSED.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
16 2852  41 YOGA, PHYSICAL THERAPY, OR EDUCATION FOR CHRONIC LOW BACK PAIN: A RANDOMIZED NONINFERIORITY TRIAL. BACKGROUND: YOGA IS EFFECTIVE FOR MILD TO MODERATE CHRONIC LOW BACK PAIN (CLBP), BUT ITS COMPARATIVE EFFECTIVENESS WITH PHYSICAL THERAPY (PT) IS UNKNOWN. MOREOVER, LITTLE IS KNOWN ABOUT YOGA'S EFFECTIVENESS IN UNDERSERVED PATIENTS WITH MORE SEVERE FUNCTIONAL DISABILITY AND PAIN. OBJECTIVE: TO DETERMINE WHETHER YOGA IS NONINFERIOR TO PT FOR CLBP. DESIGN: 12-WEEK, SINGLE-BLIND, 3-GROUP RANDOMIZED NONINFERIORITY TRIAL AND SUBSEQUENT 40-WEEK MAINTENANCE PHASE. (CLINICALTRIALS.GOV: NCT01343927). SETTING: ACADEMIC SAFETY-NET HOSPITAL AND 7 AFFILIATED COMMUNITY HEALTH CENTERS. PARTICIPANTS: 320 PREDOMINANTLY LOW-INCOME, RACIALLY DIVERSE ADULTS WITH NONSPECIFIC CLBP. INTERVENTION: PARTICIPANTS RECEIVED 12 WEEKLY YOGA CLASSES, 15 PT VISITS, OR AN EDUCATIONAL BOOK AND NEWSLETTERS. THE MAINTENANCE PHASE COMPARED YOGA DROP-IN CLASSES VERSUS HOME PRACTICE AND PT BOOSTER SESSIONS VERSUS HOME PRACTICE. MEASUREMENTS: PRIMARY OUTCOMES WERE BACK-RELATED FUNCTION, MEASURED BY THE ROLAND MORRIS DISABILITY QUESTIONNAIRE (RMDQ), AND PAIN, MEASURED BY AN 11-POINT SCALE, AT 12 WEEKS. PRESPECIFIED NONINFERIORITY MARGINS WERE 1.5 (RMDQ) AND 1.0 (PAIN). SECONDARY OUTCOMES INCLUDED PAIN MEDICATION USE, GLOBAL IMPROVEMENT, SATISFACTION WITH INTERVENTION, AND HEALTH-RELATED QUALITY OF LIFE. RESULTS: ONE-SIDED 95% LOWER CONFIDENCE LIMITS WERE 0.83 (RMDQ) AND 0.97 (PAIN), DEMONSTRATING NONINFERIORITY OF YOGA TO PT. HOWEVER, YOGA WAS NOT SUPERIOR TO EDUCATION FOR EITHER OUTCOME. YOGA AND PT WERE SIMILAR FOR MOST SECONDARY OUTCOMES. YOGA AND PT PARTICIPANTS WERE 21 AND 22 PERCENTAGE POINTS LESS LIKELY, RESPECTIVELY, THAN EDUCATION PARTICIPANTS TO USE PAIN MEDICATION AT 12 WEEKS. IMPROVEMENTS IN YOGA AND PT GROUPS WERE MAINTAINED AT 1 YEAR WITH NO DIFFERENCES BETWEEN MAINTENANCE STRATEGIES. FREQUENCY OF ADVERSE EVENTS, MOSTLY MILD SELF-LIMITED JOINT AND BACK PAIN, DID NOT DIFFER BETWEEN THE YOGA AND PT GROUPS. LIMITATIONS: PARTICIPANTS WERE NOT BLINDED TO TREATMENT ASSIGNMENT. THE PT GROUP HAD DISPROPORTIONATE LOSS TO FOLLOW-UP. CONCLUSION: A MANUALIZED YOGA PROGRAM FOR NONSPECIFIC CLBP WAS NONINFERIOR TO PT FOR FUNCTION AND PAIN. PRIMARY FUNDING SOURCE: NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH OF THE NATIONAL INSTITUTES OF HEALTH.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
17 1413  25 IMPLEMENTING YOGA INTO THE MANAGEMENT OF PATIENTS WITH REFRACTORY LOW BACK PAIN IN AN OUTPATIENT CLINIC SETTING. PURPOSE: TO EVALUATE THE EFFECTIVENESS OF IMPLEMENTING YOGA INTO THE TREATMENT OF PATIENTS WITH CHRONIC LOW BACK PAIN. DESIGN: QUANTITATIVE ANALYSIS WITH OPPORTUNITY FOR QUALITATIVE FEEDBACK. METHOD: EFFECTIVENESS OF THIS COMPLEMENTARY TREATMENT WAS ASSESSED USING A PRETEST/POSTTEST DESIGN OF PATIENTS WHO VOLUNTEERED TO PARTICIPATE IN YOGA CLASSES AS PART OF THEIR BACK PAIN MANAGEMENT. MEASUREMENTS INCLUDED LOW BACK PAIN RATING, PERCEPTION OF BACK PAIN INTERFERENCE WITH DAILY ACTIVITIES, AND SELF-EFFICACY IN DEALING WITH CHRONIC LOW BACK PAIN. FINDINGS: ALTHOUGH NO STATISTICALLY SIGNIFICANT FINDINGS WERE FOUND DUE TO THE SMALL SAMPLE SIZE, MOST PARTICIPANTS DEMONSTRATED IMPROVED INDIVIDUAL SCORES ON ALL MEASUREMENT SURVEYS INCLUDING QUALITATIVE COMMENTS. CONCLUSION: BASED ON THE FINDINGS OF THIS PILOT STUDY, FURTHER STUDIES ON IMPLEMENTING YOGA INTO THE TREATMENT OF CHRONIC LOW BACK PAIN ARE ENCOURAGED.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
18  122  38 A PILOT STUDY OF YOGA AS SELF-CARE FOR ARTHRITIS IN MINORITY COMMUNITIES. BACKGROUND: WHILE ARTHRITIS IS THE MOST COMMON CAUSE OF DISABILITY, NON-HISPANIC BLACKS AND HISPANICS EXPERIENCE WORSE ARTHRITIS IMPACT DESPITE HAVING THE SAME OR LOWER PREVALENCE OF ARTHRITIS COMPARED TO NON-HISPANIC WHITES. PEOPLE WITH ARTHRITIS WHO EXERCISE REGULARLY HAVE LESS PAIN, MORE ENERGY, AND IMPROVED SLEEP, YET ARTHRITIS IS ONE OF THE MOST COMMON REASONS FOR LIMITING PHYSICAL ACTIVITY. MIND-BODY INTERVENTIONS, SUCH AS YOGA, THAT TEACH STRESS MANAGEMENT ALONG WITH PHYSICAL ACTIVITY MAY BE WELL SUITED FOR INVESTIGATION IN BOTH OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS. YOGA USERS ARE PREDOMINANTLY WHITE, FEMALE, AND COLLEGE EDUCATED. THERE ARE FEW STUDIES THAT EXAMINE YOGA IN MINORITY POPULATIONS; NONE ADDRESS ARTHRITIS. THIS PAPER PRESENTS A STUDY PROTOCOL EXAMINING THE FEASIBILITY AND ACCEPTABILITY OF PROVIDING YOGA TO AN URBAN, MINORITY POPULATION WITH ARTHRITIS. METHODS/DESIGN: IN THIS ONGOING PILOT STUDY, A CONVENIENCE SAMPLE OF 20 MINORITY ADULTS DIAGNOSED WITH EITHER OSTEOARTHRITIS OR RHEUMATOID ARTHRITIS UNDERGO AN 8-WEEK PROGRAM OF YOGA CLASSES. IT IS BELIEVED THAT BY ATTENDING YOGA CLASSES DESIGNED FOR PATIENTS WITH ARTHRITIS, WITH RACIALLY CONCORDANT INSTRUCTORS; ACCEPTABILITY OF YOGA AS AN ADJUNCT TO STANDARD ARTHRITIS TREATMENT AND SELF-CARE WILL BE ENHANCED. SELF-CARE IS DEFINED AS ADOPTING BEHAVIORS THAT IMPROVE PHYSICAL AND MENTAL WELL-BEING. THIS CONCEPT IS QUANTIFIED THROUGH COLLECTING PATIENT-REPORTED OUTCOME MEASURES RELATED TO SPIRITUAL GROWTH, HEALTH RESPONSIBILITY, INTERPERSONAL RELATIONS, AND STRESS MANAGEMENT. ADDITIONAL MEASURES COLLECTED DURING THIS STUDY INCLUDE: PHYSICAL FUNCTION, ANXIETY/DEPRESSION, FATIGUE, SLEEP DISTURBANCE, SOCIAL ROLES, AND PAIN; AS WELL AS BASELINE DEMOGRAPHIC AND CLINICAL DATA. FIELD NOTES, QUANTITATIVE AND QUALITATIVE DATA REGARDING FEASIBILITY AND ACCEPTABILITY ARE ALSO COLLECTED. ACCEPTABILITY IS DETERMINED BY RESPONSE/RETENTION RATES, POSITIVE QUALITATIVE DATA, AND CONTINUING YOGA PRACTICE AFTER THREE MONTHS. DISCUSSION: THERE ARE A NUMBER OF CHALLENGES IN RECRUITING AND RETAINING PARTICIPANTS FROM A COMMUNITY CLINIC SERVING MINORITY POPULATIONS. ADOPTING BEHAVIORS THAT IMPROVE WELL-BEING AND QUALITY OF LIFE INCLUDE THOSE THAT INTEGRATE MENTAL HEALTH (MIND) AND PHYSICAL HEALTH (BODY). FEW STUDIES HAVE EXAMINED OFFERING INTEGRATIVE MODALITIES TO THIS POPULATION. THIS PILOT WAS UNDERTAKEN TO QUANTIFY MEASURES OF FEASIBILITY AND ACCEPTABILITY THAT WILL BE USEFUL WHEN EVALUATING FUTURE PLANS FOR EXPANDING THE STUDY OF YOGA IN URBAN, MINORITY POPULATIONS WITH ARTHRITIS. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT01617421.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
19  465  33 CHARACTERISTICS AND PREDICTORS OF SHORT-TERM OUTCOMES IN INDIVIDUALS SELF-SELECTING YOGA OR PHYSICAL THERAPY FOR TREATMENT OF CHRONIC LOW BACK PAIN. OBJECTIVE: TO COMPARE CLINICAL AND DEMOGRAPHIC CHARACTERISTICS OF INDIVIDUALS SELF-SELECTING YOGA OR PHYSICAL THERAPY (PT) FOR TREATMENT OF CHRONIC LOW BACK PAIN (CLBP) AND TO EXAMINE PREDICTORS OF SHORT-TERM PAIN AND FUNCTIONAL OUTCOMES. DESIGN: DESCRIPTIVE, LONGITUDINAL STUDY. SETTINGS: A HOSPITAL-BASED CLINIC THAT OFFERS MODIFIED INTEGRAL YOGA CLASSES FOR CLBP AND 2 OUTPATIENT PT CLINICS THAT OFFER EXERCISE-BASED PT. PARTICIPANTS: ADULTS (N=53) WITH CLBP>/=12 WEEKS: YOGA (N=27), PT (N=26). METHODS: YOGA PARTICIPANTS ATTENDED A 6-WEEK, ONCE WEEKLY, 2-HOUR YOGA CLASS. PT PARTICIPANTS UNDERWENT TWICE WEEKLY, 1-HOUR INDIVIDUALIZED PT. DATA WERE COLLECTED AT BASELINE AND AT 6 WEEKS. GROUPS WERE COMPARED BY USING CHI2 AND INDEPENDENT SAMPLES T-TESTS. HIERARCHICAL LINEAR REGRESSION WAS USED TO PREDICT TREATMENT OUTCOMES. MAIN OUTCOME MEASURES: DISABILITY (ROLAND MORRIS DISABILITY QUESTIONNAIRE), HEALTH STATUS (RAND SHORT FORM 36 HEALTH SURVEY 1.0), PAIN BOTHERSOMENESS (NUMERICAL RATING SCALE), BACK PAIN SELF-EFFICACY (BACK PAIN SELF-EFFICACY SCALE), AND TREATMENT SATISFACTION. RESULTS: AT BASELINE, YOGA PARTICIPANTS WERE SIGNIFICANTLY LESS DISABLED (P=.013), HAD HIGHER HEALTH STATUS (P=.023), GREATER PAIN SELF-EFFICACY (P=.012), AND LESS AVERAGE PAIN BOTHERSOMENESS (P=.001) COMPARED WITH PT PARTICIPANTS. AT 6 WEEKS, WHEN CONTROLLING FOR BASELINE GROUP DIFFERENCES, GREATER PAIN SELF-EFFICACY WAS THE STRONGEST PREDICTOR FOR REDUCED PAIN AND HIGHER FUNCTION FOR THE ENTIRE SAMPLE. A SIGNIFICANT GROUP INTERACTION BY BASELINE PAIN SELF-EFFICACY PREDICTED DISABILITY AT 6 WEEKS. PT PARTICIPANTS WITH LOW PAIN SELF-EFFICACY REPORTED SIGNIFICANTLY GREATER DISABILITY THAN THOSE WITH HIGH PAIN SELF-EFFICACY. YOGA PARTICIPANTS WITH LOW AND HIGH PAIN SELF-EFFICACY HAD SIMILAR DISABILITY OUTCOMES. CONCLUSION: THESE FINDINGS STRENGTHEN EVIDENCE THAT SELF-EFFICACY IS ASSOCIATED WITH CLBP OUTCOMES, ESPECIALLY IN INDIVIDUALS SELF-SELECTING PT. FURTHER RESEARCH TO EVALUATE OUTCOMES AFTER YOGA AND PT IN PARTICIPANTS WITH LOW PAIN SELF-EFFICACY IS NEEDED.	2010	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
20 2795  28 YOGA THERAPY FOR MILITARY PERSONNEL AND VETERANS: QUALITATIVE PERSPECTIVES OF YOGA STUDENTS AND INSTRUCTORS. OBJECTIVE: MILLIONS OF MILITARY PERSONNEL AND VETERANS LIVE WITH CHRONIC MENTAL AND PHYSICAL HEALTH CONDITIONS THAT OFTEN DO NOT RESPOND WELL TO PHARMACOLOGICAL TREATMENTS. SERIOUS SIDE EFFECTS AND LACK OF TREATMENT RESPONSE HAVE LED TO WIDESPREAD EFFORTS TO STUDY AND PROMOTE NON-PHARMACOLOGICAL AND BEHAVIORAL HEALTH TREATMENTS FOR MANY CHRONIC HEALTH CONDITIONS. YOGA IS AN INCREASINGLY POPULAR MIND-BODY INTERVENTION THAT HAS GROWING RESEARCH SUPPORT FOR ITS EFFICACY AND SAFETY. OUR OBJECTIVE WAS TO EXPLORE THE ATTITUDES, PERSPECTIVES, AND PREFERENCES OF MILITARY PERSONNEL AND VETERANS TOWARD YOGA AS A THERAPEUTIC MODALITY, THUS PROVIDING NEEDED INFORMATION FOR DESIGNING AND PROMOTING YOGA INTERVENTIONS FOR THIS POPULATION. METHODS: PARTICIPANTS INCLUDED 24 INDIVIDUALS WITH YOGA EXPERIENCE AND CURRENT OR PAST MILITARY SERVICE AND 12 INSTRUCTORS WHO HAVE TAUGHT YOGA FOR MILITARY PERSONNEL AND/OR VETERANS. A SEMI-STRUCTURED SET OF QUESTIONS GUIDED INTERVIEWS WITH EACH PARTICIPANT. RESULTS: FIVE THEMES EMERGED FROM THE INTERVIEWS: (1) MENTAL HEALTH BENEFITS EXPERIENCED FROM YOGA PRACTICE; (2) PHYSICAL HEALTH BENEFITS EXPERIENCED FROM YOGA PRACTICE; (3) IMPORTANT YOGA ELEMENTS AND CONDITIONS THAT SUPPORT EFFECTIVE PRACTICE; (4) FACILITATORS FOR ENGAGING MILITARY IN YOGA PRACTICE; AND (5) CHALLENGES AND BARRIERS TO YOGA PRACTICE FOR MILITARY. CONCLUSIONS: THE STUDY HIGHLIGHTS CONSISTENT REPORTS OF MENTAL AND PHYSICAL BENEFITS OF YOGA PRACTICE, ONGOING STIGMA RESULTING IN THE NEED FOR COMBATTING AND DEMYSTIFYING YOGA AND OTHER COMPLEMENTARY AND INTEGRATIVE HEALTH (CIH) PRACTICES, THE IMPORTANCE OF DESIGNING INTERVENTIONS TO ADDRESS THE UNIQUE MENTAL HEALTH ISSUES AND PERSPECTIVES OF THIS POPULATION, AND THE IMPORTANCE OF EFFORTS BY MILITARY LEADERSHIP TO BRING CIH TO MILITARY PERSONNEL AND VETERANS. RIGOROUS RESEARCH ADDRESSING THESE FINDINGS, ALONG WITH FURTHER RESEARCH ON THE EFFICACY AND EFFECTIVENESS OF YOGA INTERVENTIONS FOR TREATING VARIOUS CONDITIONS ARE NEEDED.	2018