1 945 164 EFFECTS OF A 12-WEEK YOGA VERSUS A 12-WEEK EDUCATIONAL FILM INTERVENTION ON SYMPTOMS OF RESTLESS LEGS SYNDROME AND RELATED OUTCOMES: AN EXPLORATORY RANDOMIZED CONTROLLED TRIAL. STUDY OBJECTIVES: TO ASSESS THE EFFECTS OF A YOGA VERSUS EDUCATIONAL FILM (EF) PROGRAM ON RESTLESS LEGS SYNDROME (RLS) SYMPTOMS AND RELATED OUTCOMES IN ADULTS WITH RLS. METHODS: FORTY-ONE COMMUNITY-DWELLING, AMBULATORY NONPREGNANT ADULTS WITH MODERATE TO SEVERE RLS WERE RANDOMIZED TO A 12-WEEK YOGA (N = 19) OR EF PROGRAM (N = 22). IN ADDITION TO ATTENDING CLASSES, ALL PARTICIPANTS COMPLETED PRACTICE/TREATMENT LOGS. YOGA GROUP PARTICIPANTS WERE ASKED TO PRACTICE AT HOME 30 MINUTES PER DAY ON NONCLASS DAYS; EF PARTICIPANTS WERE INSTRUCTED TO RECORD ANY RLS TREATMENTS USED ON THEIR DAILY LOGS. CORE OUTCOMES ASSESSED PRETREATMENT AND POSTTREATMENT WERE RLS SYMPTOMS AND SYMPTOM SEVERITY (INTERNATIONAL RLS STUDY GROUP SCALE (IRLS) AND RLS ORDINAL SCALE), SLEEP QUALITY, MOOD, PERCEIVED STRESS, AND QUALITY OF LIFE (QOL). RESULTS: THIRTY ADULTS (13 YOGA, 17 EF), AGED 24 TO 73 (MEAN = 50.4 +/- 2.4 YEARS), COMPLETED THE 12-WEEK STUDY (78% FEMALE, 80.5% WHITE). POST-INTERVENTION, BOTH GROUPS SHOWED SIGNIFICANT IMPROVEMENT IN RLS SYMPTOMS AND SEVERITY, PERCEIVED STRESS, MOOD, AND QOL-MENTAL HEALTH (P /= 80% OF YOGA PARTICIPANTS REPORTING AVERAGE SLEEP ONSET LATENCY < 30 MINUTES AND SLEEP EFFICIENCY > 80% AT 6-MONTH FOLLOW-UP. FOR OVER 50% OF YOGA PARTICIPANTS, THE INSOMNIA SEVERITY INDEX DECREASED BY AT LEAST 8 POINTS AT END OF TREATMENT AND FOLLOW-UP. CONCLUSIONS: YOGA, TAUGHT IN A SELF-CARE FRAMEWORK WITH MINIMAL INSTRUCTOR BURDEN, WAS ASSOCIATED WITH SELF-REPORTED IMPROVEMENTS ABOVE AND BEYOND AN ACTIVE SLEEP HYGIENE COMPARISON, SUSTAINED AT 6-MONTH FOLLOW-UP. FOLLOW-UP STUDIES ARE NEEDED TO ASSESS ACTIGRAPHY AND POLYSOMNOGRAPHY OUTCOMES, AS WELL AS POSSIBLE MECHANISMS OF CHANGE. CLINICAL TRIAL REGISTRATION: REGISTRY: CLINICALTRIALS.GOV; NAME: YOGA AS A TREATMENT FOR INSOMNIA; URL: HTTPS://CLINICALTRIALS.GOV/CT2/SHOW/NCT00033865; IDENTIFIER: NCT00033865. CITATION: KHALSA SBS, GOLDSTEIN MR. TREATMENT OF CHRONIC PRIMARY SLEEP ONSET INSOMNIA WITH KUNDALINI YOGA: A RANDOMIZED CONTROLLED TRIAL WITH ACTIVE SLEEP HYGIENE COMPARISON. J CLIN SLEEP MED. 2021;17(9):1841-1852. 2021 12 518 48 COMPARING ONCE- VERSUS TWICE-WEEKLY YOGA CLASSES FOR CHRONIC LOW BACK PAIN IN PREDOMINANTLY LOW INCOME MINORITIES: A RANDOMIZED DOSING TRIAL. BACKGROUND. PREVIOUS STUDIES HAVE DEMONSTRATED THAT ONCE-WEEKLY YOGA CLASSES ARE EFFECTIVE FOR CHRONIC LOW BACK PAIN (CLBP) IN WHITE ADULTS WITH HIGH SOCIOECONOMIC STATUS. THE COMPARATIVE EFFECTIVENESS OF TWICE-WEEKLY CLASSES AND GENERALIZABILITY TO RACIALLY DIVERSE LOW INCOME POPULATIONS ARE UNKNOWN. METHODS. WE CONDUCTED A 12-WEEK RANDOMIZED, PARALLEL-GROUP, DOSING TRIAL FOR 95 ADULTS RECRUITED FROM AN URBAN SAFETY-NET HOSPITAL AND FIVE COMMUNITY HEALTH CENTERS COMPARING ONCE-WEEKLY (N = 49) VERSUS TWICE-WEEKLY (N = 46) STANDARDIZED YOGA CLASSES SUPPLEMENTED BY HOME PRACTICE. PRIMARY OUTCOMES WERE CHANGE FROM BASELINE TO 12 WEEKS IN PAIN (11-POINT SCALE) AND BACK-RELATED FUNCTION (23-POINT MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE). RESULTS. 82% OF PARTICIPANTS WERE NONWHITE; 77% HAD ANNUAL HOUSEHOLD INCOMES <$40,000. THE SAMPLE'S BASELINE MEAN PAIN INTENSITY [6.9 (SD 1.6)] AND FUNCTION [13.7 (SD 5.0)] REFLECTED MODERATE TO SEVERE BACK PAIN AND IMPAIRMENT. PAIN AND BACK-RELATED FUNCTION IMPROVED WITHIN BOTH GROUPS (P < 0.001). HOWEVER, THERE WERE NO DIFFERENCES BETWEEN ONCE-WEEKLY AND TWICE-WEEKLY GROUPS FOR PAIN REDUCTION [-2.1 (95% CI -2.9, -1.3) VERSUS -2.4 (95% CI -3.1, -1.8), P = 0.62] OR BACK-RELATED FUNCTION [-5.1 (95% CI -7.0, -3.2) VERSUS -4.9 (95% CI -6.5, -3.3), P = 0.83]. CONCLUSIONS. TWELVE WEEKS OF ONCE-WEEKLY OR TWICE-WEEKLY YOGA CLASSES WERE SIMILARLY EFFECTIVE FOR PREDOMINANTLY LOW INCOME MINORITY ADULTS WITH MODERATE TO SEVERE CHRONIC LOW BACK PAIN. THIS TRIAL IS REGISTERED WITH CLINICALTRIALS.GOV NCT01761617. 2013 13 2836 47 YOGA'S IMPACT ON INFLAMMATION, MOOD, AND FATIGUE IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. PURPOSE: TO EVALUATE YOGA'S IMPACT ON INFLAMMATION, MOOD, AND FATIGUE. PATIENTS AND METHODS: A RANDOMIZED CONTROLLED 3-MONTH TRIAL WAS CONDUCTED WITH TWO POST-TREATMENT ASSESSMENTS OF 200 BREAST CANCER SURVIVORS ASSIGNED TO EITHER 12 WEEKS OF 90-MINUTE TWICE PER WEEK HATHA YOGA CLASSES OR A WAIT-LIST CONTROL. THE MAIN OUTCOME MEASURES WERE LIPOPOLYSACCHARIDE-STIMULATED PRODUCTION OF PROINFLAMMATORY CYTOKINES INTERLEUKIN-6 (IL-6), TUMOR NECROSIS FACTOR ALPHA (TNF-ALPHA), AND INTERLEUKIN-1BETA (IL-1BETA), AND SCORES ON THE MULTIDIMENSIONAL FATIGUE SYMPTOM INVENTORY-SHORT FORM (MFSI-SF), THE VITALITY SCALE FROM THE MEDICAL OUTCOMES STUDY 36-ITEM SHORT FORM (SF-36), AND THE CENTER FOR EPIDEMIOLOGICAL STUDIES-DEPRESSION (CES-D) SCALE. RESULTS: IMMEDIATELY POST-TREATMENT, FATIGUE WAS NOT LOWER (P > .05) BUT VITALITY WAS HIGHER (P = .01) IN THE YOGA GROUP COMPARED WITH THE CONTROL GROUP. AT 3 MONTHS POST-TREATMENT, FATIGUE WAS LOWER IN THE YOGA GROUP (P = .002), VITALITY WAS HIGHER (P = .01), AND IL-6 (P = .027), TNF-ALPHA (P = .027), AND IL-1BETA (P = .037) WERE LOWER FOR YOGA PARTICIPANTS COMPARED WITH THE CONTROL GROUP. GROUPS DID NOT DIFFER ON DEPRESSION AT EITHER TIME (P > .2). PLANNED SECONDARY ANALYSES SHOWED THAT THE FREQUENCY OF YOGA PRACTICE HAD STRONGER ASSOCIATIONS WITH FATIGUE AT BOTH POST-TREATMENT VISITS (P = .019; P < .001), AS WELL AS VITALITY (P = .016; P = .0045), BUT NOT DEPRESSION (P > .05) THAN SIMPLE GROUP ASSIGNMENT; MORE FREQUENT PRACTICE PRODUCED LARGER CHANGES. AT 3 MONTHS POST-TREATMENT, INCREASING YOGA PRACTICE ALSO LED TO A DECREASE IN IL-6 (P = .01) AND IL-1BETA (P = .03) PRODUCTION BUT NOT IN TNF-ALPHA PRODUCTION (P > .05). CONCLUSION: CHRONIC INFLAMMATION MAY FUEL DECLINES IN PHYSICAL FUNCTION LEADING TO FRAILTY AND DISABILITY. IF YOGA DAMPENS OR LIMITS BOTH FATIGUE AND INFLAMMATION, THEN REGULAR PRACTICE COULD HAVE SUBSTANTIAL HEALTH BENEFITS. 2014 14 1683 61 ONLINE YOGA TO REDUCE POST TRAUMATIC STRESS IN WOMEN WHO HAVE EXPERIENCED STILLBIRTH: A RANDOMIZED CONTROL FEASIBILITY TRIAL. BACKGROUND: ABOUT 1 IN EVERY 150 PREGNANCIES END IN STILLBIRTH. CONSEQUENCES INCLUDE SYMPTOMS OF POST TRAUMATIC STRESS DISORDER (PTSD), DEPRESSION, AND ANXIETY. YOGA HAS BEEN USED TO TREAT PTSD IN OTHER POPULATIONS AND MAY IMPROVE HEALTH OUTCOMES FOR STILLBIRTH MOTHERS. THE PURPOSE OF THIS STUDY WAS TO DETERMINE: (A) FEASIBILITY OF A 12-WEEK HOME-BASED, ONLINE YOGA INTERVENTION WITH VARYING DOSES; (B) ACCEPTABILITY OF A "STRETCH AND TONE" CONTROL GROUP; AND (C) PRELIMINARY EFFICACY OF THE INTERVENTION ON REDUCING SYMPTOMS OF PTSD, ANXIETY, DEPRESSION, PERINATAL GRIEF, SELF-COMPASSION, EMOTIONAL REGULATION, MINDFULNESS, SLEEP QUALITY, AND SUBJECTIVE HEALTH. METHODS: PARTICIPANTS (N = 90) WERE RECRUITED NATIONALLY AND RANDOMIZED INTO ONE OF THREE GROUPS FOR YOGA OR EXERCISE (LOW DOSE (LD), 60 MIN PER WEEK; MODERATE DOSE (MD), 150 MIN PER WEEK; AND STRETCH-AND-TONE CONTROL GROUP (STC)). BASELINE AND POST-INTERVENTION SURVEYS MEASURED MAIN OUTCOMES (LISTED ABOVE). FREQUENCY ANALYSES WERE USED TO DETERMINE FEASIBILITY. REPEATED MEASURES ANCOVA WERE USED TO DETERMINE PRELIMINARY EFFICACY. MULTIPLE REGRESSION ANALYSES WERE USED TO DETERMINE A DOSE-RESPONSE RELATIONSHIP BETWEEN MINUTES OF YOGA AND EACH OUTCOME VARIABLE. RESULTS: OVER HALF OF PARTICIPANTS COMPLETED THE INTERVENTION (N = 48/90). BENCHMARKS (>/=70% REPORTED > 75% SATISFACTION) WERE MET IN EACH GROUP FOR SATISFACTION AND ENJOYMENT. PARTICIPANTS MEETING BENCHMARKS (COMPLETING > 90% OF PRESCRIBED MINUTES 9/12 WEEKS) FOR LD AND MD GROUPS WERE 44% (N = 8/18) AND 6% (N = 1/16), RESPECTIVELY. LD AND MD GROUPS AVERAGED 44.0 AND 77.3 MIN PER WEEK OF YOGA, RESPECTIVELY. THE MD GROUP REPORTED THAT 150 PRESCRIBED MINUTES PER WEEK OF YOGA WAS TOO MUCH. THERE WERE SIGNIFICANT DECREASES IN PTSD AND DEPRESSION, AND IMPROVEMENTS IN SELF-RATED HEALTH AT POST-INTERVENTION FOR BOTH INTERVENTION GROUPS. THERE WAS A SIGNIFICANT DIFFERENCE IN DEPRESSION SCORES (P = .036) AND GRIEF INTENSITY (P = .009) BETWEEN THE MD AND STC GROUPS. PTSD SHOWED NON-SIGNIFICANT DECREASES OF 43% AND 56% AT POST-INTERVENTION IN LD AND MD GROUPS, RESPECTIVELY (22% DECREASE IN CONTROL). CONCLUSIONS: THIS WAS THE FIRST STUDY TO DETERMINE THE FEASIBILITY AND PRELIMINARY EFFICACY OF AN ONLINE YOGA INTERVENTION FOR WOMEN AFTER STILLBIRTH. FUTURE RESEARCH WARRANTS A RANDOMIZED CONTROLLED TRIAL. TRIAL REGISTRATION: CLINICALTRIALS.GOV. NCT02925481. REGISTERED 10-04-16. 2020 15 1650 48 MULTICENTER, RANDOMIZED CONTROLLED TRIAL OF YOGA FOR SLEEP QUALITY AMONG CANCER SURVIVORS. PURPOSE: THIRTY PERCENT TO 90% OF CANCER SURVIVORS REPORT IMPAIRED SLEEP QUALITY POST-TREATMENT, WHICH CAN BE SEVERE ENOUGH TO INCREASE MORBIDITY AND MORTALITY. LIFESTYLE INTERVENTIONS, SUCH AS EXERCISE, ARE RECOMMENDED IN CONJUNCTION WITH DRUGS AND COGNITIVE BEHAVIORAL THERAPY FOR THE TREATMENT OF IMPAIRED SLEEP. PRELIMINARY EVIDENCE INDICATES THAT YOGA-A MIND-BODY PRACTICE AND FORM OF EXERCISE-MAY IMPROVE SLEEP AMONG CANCER SURVIVORS. THE PRIMARY AIM OF THIS RANDOMIZED, CONTROLLED CLINICAL TRIAL WAS TO DETERMINE THE EFFICACY OF A STANDARDIZED YOGA INTERVENTION COMPARED WITH STANDARD CARE FOR IMPROVING GLOBAL SLEEP QUALITY (PRIMARY OUTCOME) AMONG POST-TREATMENT CANCER SURVIVORS. PATIENTS AND METHODS: IN ALL, 410 SURVIVORS SUFFERING FROM MODERATE OR GREATER SLEEP DISRUPTION BETWEEN 2 AND 24 MONTHS AFTER SURGERY, CHEMOTHERAPY, AND/OR RADIATION THERAPY WERE RANDOMLY ASSIGNED TO STANDARD CARE OR STANDARD CARE PLUS THE 4-WEEK YOGA INTERVENTION. THE YOGA INTERVENTION USED THE YOGA FOR CANCER SURVIVORS (YOCAS) PROGRAM CONSISTING OF PRANAYAMA (BREATHING EXERCISES), 16 GENTLE HATHA AND RESTORATIVE YOGA ASANAS (POSTURES), AND MEDITATION. PARTICIPANTS ATTENDED TWO 75-MINUTE SESSIONS PER WEEK. SLEEP QUALITY WAS ASSESSED BY USING THE PITTSBURGH SLEEP QUALITY INDEX AND ACTIGRAPHY PRE- AND POSTINTERVENTION. RESULTS: IN ALL, 410 SURVIVORS WERE ACCRUED (96% FEMALE; MEAN AGE, 54 YEARS; 75% HAD BREAST CANCER). YOGA PARTICIPANTS DEMONSTRATED GREATER IMPROVEMENTS IN GLOBAL SLEEP QUALITY AND, SECONDARILY, SUBJECTIVE SLEEP QUALITY, DAYTIME DYSFUNCTION, WAKE AFTER SLEEP ONSET, SLEEP EFFICIENCY, AND MEDICATION USE AT POSTINTERVENTION (ALL P /= 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 20 74 49 A GROUP-BASED YOGA THERAPY INTERVENTION FOR URINARY INCONTINENCE IN WOMEN: A PILOT RANDOMIZED TRIAL. OBJECTIVE: THE AIM OF THIS STUDY IS TO EXAMINE THE FEASIBILITY, EFFICACY, AND SAFETY OF A GROUP-BASED YOGA THERAPY INTERVENTION FOR MIDDLE-AGED AND OLDER WOMEN WITH URINARY INCONTINENCE. METHODS: WE CONDUCTED A PILOT RANDOMIZED TRIAL OF AMBULATORY WOMEN AGED 40 YEARS AND OLDER WITH STRESS, URGENCY, OR MIXED-TYPE INCONTINENCE. WOMEN WERE RANDOMIZED TO A 6-WEEK YOGA THERAPY PROGRAM (N = 10) CONSISTING OF TWICE WEEKLY GROUP CLASSES AND ONCE WEEKLY HOME PRACTICE OR A WAIT-LIST CONTROL GROUP (N = 9). ALL PARTICIPANTS ALSO RECEIVED WRITTEN PAMPHLETS ABOUT STANDARD BEHAVIORAL SELF-MANAGEMENT STRATEGIES FOR INCONTINENCE. CHANGES IN INCONTINENCE WERE ASSESSED WITH 7-DAY VOIDING DIARIES. RESULTS: THE MEAN (SD) AGE WAS 61.4 (8.2) YEARS, AND THE MEAN BASELINE FREQUENCY OF INCONTINENCE WAS 2.5 (1.3) EPISODES/D. AFTER 6 WEEKS, THE TOTAL INCONTINENCE FREQUENCY DECREASED BY 70% (1.8 [0.9] FEWER EPISODES/D) IN THE YOGA THERAPY VERSUS 13% (0.3 [1.7] FEWER EPISODES/D) IN THE CONTROL GROUP (P = 0.049). PARTICIPANTS IN THE YOGA THERAPY GROUP ALSO REPORTED AN AVERAGE OF 71% DECREASE IN STRESS INCONTINENCE FREQUENCY (0.7 [0.8] FEWER EPISODES/D) COMPARED WITH A 25% INCREASE IN CONTROLS (0.2 [1.1] MORE EPISODES/D) (P = 0.039). NO SIGNIFICANT DIFFERENCES IN REDUCTION IN URGENCY INCONTINENCE WERE DETECTED BETWEEN THE YOGA THERAPY VERSUS CONTROL GROUPS (1.0 [1.0] VERSUS 0.5 [0.5] FEWER EPISODES/D; P = 0.20). ALL WOMEN STARTING THE YOGA THERAPY PROGRAM COMPLETED AT LEAST 90% OF THE GROUP CLASSES AND PRACTICE SESSIONS. TWO PARTICIPANTS IN EACH GROUP REPORTED ADVERSE EVENTS UNRELATED TO THE INTERVENTION. CONCLUSIONS: FINDINGS PROVIDE PRELIMINARY EVIDENCE TO SUPPORT THE FEASIBILITY, EFFICACY, AND SAFETY OF A GROUP-BASED YOGA THERAPY INTERVENTION TO IMPROVE URINARY INCONTINENCE IN WOMEN. 2014