1 743 162 EFFECT OF RESTORATIVE YOGA VS. STRETCHING ON DIURNAL CORTISOL DYNAMICS AND PSYCHOSOCIAL OUTCOMES IN INDIVIDUALS WITH THE METABOLIC SYNDROME: THE PRYSMS RANDOMIZED CONTROLLED TRIAL. PURPOSE: CHRONIC STIMULATION AND DYSREGULATION OF THE NEUROENDOCRINE SYSTEM BY STRESS MAY CAUSE METABOLIC ABNORMALITIES. WE ESTIMATED HOW MUCH CORTISOL AND PSYCHOSOCIAL OUTCOMES IMPROVED WITH A RESTORATIVE YOGA (RELAXATION) VERSUS A LOW IMPACT STRETCHING INTERVENTION FOR INDIVIDUALS WITH THE METABOLIC SYNDROME. METHODS: WE CONDUCTED A 1-YEAR MULTI-CENTER RANDOMIZED CONTROLLED TRIAL (6-MONTH INTERVENTION AND 6-MONTH MAINTENANCE PHASE) OF RESTORATIVE YOGA VS. STRETCHING. PARTICIPANTS COMPLETED SURVEYS TO ASSESS DEPRESSION, SOCIAL SUPPORT, POSITIVE AFFECT, AND STRESS AT BASELINE, 6 MONTHS AND 12 MONTHS. FOR EACH ASSESSMENT, WE COLLECTED SALIVA AT FOUR POINTS DAILY FOR THREE DAYS AND COLLECTED RESPONSE TO DEXAMETHASONE ON THE FOURTH DAY FOR ANALYSIS OF DIURNAL CORTISOL DYNAMICS. WE ANALYZED OUR DATA USING MULTIVARIATE REGRESSION MODELS, CONTROLLING FOR STUDY SITE, MEDICATIONS (ANTIDEPRESSANTS, HORMONE THERAPY), BODY MASS INDEX, AND BASELINE CORTISOL VALUES. RESULTS: PSYCHOSOCIAL OUTCOME MEASURES WERE AVAILABLE FOR 171 STUDY PARTICIPANTS AT BASELINE, 140 AT 6 MONTHS, AND 132 AT 1 YEAR. COMPLETE CORTISOL DATA WERE AVAILABLE FOR 136 OF 171 STUDY PARTICIPANTS (72 IN RESTORATIVE YOGA AND 64 IN STRETCHING) AND WERE ONLY AVAILABLE AT BASELINE AND 6 MONTHS. AT 6 MONTHS, THE STRETCHING GROUP HAD DECREASED CORTISOL AT WAKING AND BEDTIME COMPARED TO THE RESTORATIVE YOGA GROUP. THE PATTERN OF CHANGES IN STRESS MIRRORED THIS IMPROVEMENT, WITH THE STRETCHING GROUP SHOWING REDUCTIONS IN CHRONIC STRESS SEVERITY AND PERSEVERATIVE THOUGHTS ABOUT THEIR STRESS. PERCEIVED STRESS DECREASED BY 1.5 POINTS (-0.4; 3.3, P=0.11) AT 6 MONTHS, AND BY 2.0 POINTS (0.1; 3.9, P=0.04) AT 1 YEAR IN THE STRETCHING COMPARED TO RESTORATIVE YOGA GROUPS. POST HOC ANALYSES SUGGEST THAT IN THE STRETCHING GROUP ONLY, PERCEIVED INCREASES IN SOCIAL SUPPORT (PARTICULARLY FEELINGS OF BELONGING), BUT NOT CHANGES IN STRESS WERE RELATED TO IMPROVED CORTISOL DYNAMICS. CONCLUSIONS: WE FOUND SIGNIFICANT DECREASES IN SALIVARY CORTISOL, CHRONIC STRESS SEVERITY, AND STRESS PERCEPTION IN THE STRETCHING GROUP COMPARED TO THE RESTORATIVE YOGA GROUP. GROUP SUPPORT DURING THE INTERACTIVE STRETCH CLASSES MAY HAVE CONTRIBUTED TO THESE CHANGES. 2014 2 2372 40 WHAT HELPS OLDER PEOPLE PERSEVERE WITH YOGA CLASSES? A REALIST PROCESS EVALUATION OF A COVID-19-AFFECTED YOGA PROGRAM FOR FALL PREVENTION. BACKGROUND: FALLS AMONG OLDER PEOPLE ARE A MAJOR GLOBAL HEALTH CONCERN. THIS PROCESS EVALUATION INVESTIGATES THE EXPERIENCE OF PARTICIPANTS AGED 60+ IN A YOGA PROGRAM AIMED AT PREVENTING FALLS WHICH TRANSITIONED FROM STUDIO-BASED CLASSES TO ONLINE CLASSES IN RESPONSE TO COVID-19 RESTRICTIONS. WE SOUGHT TO UNDERSTAND HOW THE SUCCESSFUL AGEING (SAGE) YOGA PROGRAM FUNCTIONED IN BOTH SETTINGS AND AS A HYBRID PROGRAM, AND TO EXPLAIN WHY IT WORKED WELL FOR MOST PARTICIPANTS. METHODS: REALIST PROCESS EVALUATION WAS USED TO EXPLORE THE FACTORS THAT FACILITATED A SUCCESSFUL TRANSITION FOR MOST PARTICIPANTS, AND TO CONSIDER WHY IT DID NOT WORK FOR A MINORITY. THIS APPROACH DEVELOPS PROGRAM THEORIES THAT DESCRIBE WHICH MECHANISMS AN INTERVENTION IS (OR IS NOT) ACTIVATING, AND HOW THIS IS MEDIATED BY CONTEXT TO GENERATE PROCESS OUTCOMES. DATA INCLUDED INTERVIEWS WITH PARTICIPANTS (N = 21) AND YOGA INSTRUCTORS (N = 3), SELF-REPORT FEEDBACK FORMS (N = 46), OBSERVATION OF CLASSES AND ROUTINE PROCESS MEASURES. RESULTS: FACTORS THAT FACILITATED A SUCCESSFUL TRANSITION FOR MOST PARTICIPANTS INCLUDED THE QUALITY OF YOGA INSTRUCTION, THE PROGRAM FORMAT AND INHERENT CHARACTERISTICS OF YOGA. GAINS IN TRANSITIONING ONLINE INCLUDED CONTINUITY AND GREATER CONVENIENCE. LOSSES INCLUDED PERCEIVED REDUCTION IN THE EFFECTIVENESS OF YOGA INSTRUCTION. THERE WERE GREATER CHALLENGES FOR PEOPLE STRUGGLING WITH PAIN AND IN DISADVANTAGEOUS HOME ENVIRONMENTS. WE IDENTIFIED SIX PROGRAM THEORIES CONFIGURED AROUND 16 MECHANISMS: 1. IT'S WORTH THE EFFORT AND 2. IN EXPERT HANDS (THESE HAD THE SAME MECHANISMS: VALUE EXPECTANCY, THERAPEUTIC ALLIANCE AND ACHIEVEMENT/MASTERY), 3. A COMMUNAL EXPERIENCE (THESE MECHANISMS WERE SHARED EXPERIENCE, SOCIAL CONNECTION, SOCIAL COMPARISON AND PEER CHECKING), 4. PUTTING YOGA WITHIN REACH (ACCESSIBILITY, CONVENIENCE, GRATITUDE), 5. BUILDING YOGA HABITS (PURPOSEFUL STRUCTURE, MOMENTUM, ACCOUNTABILITY AND CONTINUITY), AND 6. YOGA'S SPECIAL PROPERTIES (EMBODIMENT AND MINDFULNESS). CONCLUSIONS: THIS STUDY SHOWED THAT ONLINE DELIVERY OF A YOGA PROGRAM FOR PEOPLE AGED 60+ RETAINED MUCH OF THE VALUE OF A FACE-TO-FACE PROGRAM FOR THE MAJORITY OF PARTICIPANTS, AND INCREASED THE VALUE FOR SOME. THE STRUCTURED, COMMUNAL NATURE OF AN ORGANISED GROUP PROGRAM DELIVERED BY A SKILLED INSTRUCTOR, TOGETHER WITH YOGA'S INTRINSIC FOCUS ON MINDFULNESS, FACILITATED CONTINUED ENGAGEMENT AND PERCEIVED HEALTH BENEFITS, DESPITE THE CHANGE IN DELIVERY MODE. 2022 3 2346 28 USING REALIST EVALUATION TO UNDERSTAND PROCESS OUTCOMES IN A COVID-19-IMPACTED YOGA INTERVENTION TRIAL: A WORKED EXAMPLE. REALIST EVALUATION OFFERS A VALUABLE WAY TO UNDERSTAND HOW INTERVENTIONS FUNCTION AND THUS HOW THEY CAN BE IMPROVED AND LOCALLY ADAPTED. CONSEQUENTLY, REALIST EVALUATION IS INCREASINGLY CONDUCTED IN PARALLEL WITH INTERVENTION TRIALS. IT COMPRISES A CLEAR PHILOSOPHICAL FOUNDATION AND VIEW OF CAUSALITY, PRAGMATIC MIXED DATA COLLECTION METHODS, AND A THEORY-DRIVEN APPROACH IN WHICH HYPOTHESISED PROGRAM THEORIES ARE TESTED AND REFINED. HOWEVER, DETAILED METHODS FOR DATA ANALYSIS ARE SELDOM WELL-DESCRIBED IN REALIST STUDIES AND NO CLEAR METHOD FOR ANALYSING AND PRESENTING REALIST EVALUATION DATA HAS YET EMERGED. IN THIS METHODOLOGICAL PAPER WE USE THE WORKED EXAMPLE OF OUR REALIST PROCESS EVALUATION OF THE SAGE YOGA TRIAL TO ILLUSTRATE AN APPLIED PROCESS OF DATA ANALYSIS AND PRESENTATION OF FINDINGS. WE SHOW HOW WE DREW ON OTHER REALIST STUDIES FOR IDEAS, PROVIDE EXAMPLES OF SIX KEY TASKS INVOLVED IN CONDUCTING A REALIST PROCESS EVALUATION (INCLUDING CODING DATA AND STRUCTURING RESULTS) AND DESCRIBE STRATEGIES THAT DID NOT WORK AND OUR RATIONALE FOR REJECTING THEM. THIS DETAILED ACCOUNT OF THE DECISIONS AND METHODS THAT WORKED FOR US IS INTENDED TO PROVIDE A PRACTICAL AND INFORMED POINT OF DEPARTURE FOR RESEARCHERS CONDUCTING A REALIST EVALUATION. 2021 4 1632 41 MIYOGA: A RANDOMISED CONTROLLED TRIAL OF A MINDFULNESS MOVEMENT PROGRAMME BASED ON HATHA YOGA PRINCIPLES FOR CHILDREN WITH CEREBRAL PALSY: A STUDY PROTOCOL. INTRODUCTION: CEREBRAL PALSY (CP) IS THE MOST COMMON CHILDHOOD PHYSICAL DISABILITY, WITH LIFE-LONG IMPACTS FOR 1.77 IN 1000 CHILDREN. ALTHOUGH CP IS PRIMARILY A PHYSICAL DISABILITY, CHILDREN WITH CP HAVE AN INCREASED RISK OF EXPERIENCING COGNITIVE DIFFICULTIES, PARTICULARLY ATTENTION AND EXECUTIVE FUNCTION DEFICITS. IMPAIRMENT IN COGNITIVE ABILITIES CAN LEAD TO SUBSEQUENT IMPAIRMENT IN INDEPENDENT FUNCTIONING, EDUCATION, EMPLOYMENT AND INTERPERSONAL RELATIONSHIPS. THIS PAPER REPORTS THE PROTOCOL OF A RANDOMISED CONTROLLED TRIAL OF A NOVEL FAMILY-CENTRED LIFESTYLE INTERVENTION BASED ON MINDFULNESS AND HATHA YOGA PRINCIPLES (MIYOGA). MIYOGA AIMS TO ENHANCE CHILD AND PARENT OUTCOMES FOR CHILDREN WITH CP. METHODS AND ANALYSIS: THE AIM IS TO RECRUIT 36 CHILD-PARENT DYADS (CHILDREN AGED 6-16 YEARS; BILATERAL OR UNILATERAL CP; GROSS MOTOR FUNCTION CLASSIFICATION SYSTEM I-III), WHO WILL BE RANDOMLY ASSIGNED TO TWO GROUPS: MIYOGA ANDWAITLISTT CONTROL. THE MIYOGA PROGRAMME WILL BE FACILITATED IN A GROUP FORMAT FOR 8 WEEKS. ASSESSMENTS WILL BE ADMINISTERED AT BASELINE, PRIOR TO MIYOGA, FOLLOWING COMPLETION OF MIYOGA, AND AT 6-MONTH FOLLOW-UP (RETENTION). THE PRIMARY OUTCOME WILL BE THE CHILD'S SUSTAINED ATTENTIONAL ABILITY AS MEASURED BY THE CONNER'S CONTINUOUS PERFORMANCE TEST II. OTHER OUTCOMES OF INTEREST FOR CHILDREN WITH CP CONSISTS OF ATTENTIONAL CONTROL, PHYSICAL FUNCTIONING, BEHAVIOURAL AND WELL-BEING. FOR PARENTS, THE OUTCOMES OF INTEREST ARE MINDFULNESS, PSYCHOLOGICAL FLEXIBILITY AND WELL-BEING. DATA WILL BE ANALYSED USING GENERAL LINEAR MODELS, SPECIFICALLY ANALYSIS OF COVARIANCE AND ANALYSIS OF VARIANCE. ETHICS AND DISSEMINATION: FULL ETHICAL APPROVAL FOR THIS STUDY HAS BEEN OBTAINED BY THE CHILDREN'S HEALTH QUEENSLAND HOSPITAL AND HEALTH SERVICE RESEARCH ETHICS COMMITTEE (HREC/12/QRCH/120) AND THE UNIVERSITY OF QUEENSLAND (2012000993). IF MIYOGA IS PROVEN EFFECTIVE, ITS DISSEMINATION WOULD ASSIST CHILDREN WITH CP AND COMPLEMENT THEIR ONGOING THERAPY BY IMPROVING THE ABILITY OF THE CHILD TO PAY ATTENTION AT SCHOOL AND IN THERAPY, AND ALLEVIATING ENVIRONMENTALSTRESSORSS FOR BOTH THE CHILD AND HIS/HER PARENTS. TRIAL REGISTRATION NUMBER: ACTRN12613000729729; PRE-RESULTS.HTTP://WWW.ANZCTR.ORG.AU/ACTRN12613000729729.ASPX DATE OF TRIAL REGISTRATION: PROSPECTIVELY REGISTERED ON 2 JULY 2013-PRESENT (ONGOING). FINDINGS TO DATE: RECRUITMENT IS COMPLETE. DATA ARE STILL BEING COLLECTED AT PRESENT. WE AIM TO COMPLETE DATA COLLECTION BY FEBRUARY 2017. 2017 5 732 35 EFFECT OF MINDFULNESS YOGA PROGRAMME MIYOGA ON ATTENTION, BEHAVIOUR, AND PHYSICAL OUTCOMES IN CEREBRAL PALSY: A RANDOMIZED CONTROLLED TRIAL. AIM: TO INVESTIGATE THE EFFICACY OF AN EMBODIED MINDFULNESS-BASED MOVEMENT PROGRAMME (MIYOGA), TARGETING ATTENTION IN CHILDREN WITH CEREBRAL PALSY (CP). METHOD: TOTAL NUMBER OF PARTICIPANTS 42, WITH 24 BOYS (57.1%) AND 18 GIRLS (42.9%); MEAN AGE 9Y 1MO, SD 3Y; GROSS MOTOR FUNCTION CLASSIFICATION SYSTEM LEVELS I=22, II=12, III=8) AND THEIR PARENTS WERE RANDOMIZED TO EITHER MIYOGA (N=21) OR WAITLIST COMPARISON (N=21) GROUPS. THE PRIMARY OUTCOME WAS ATTENTION POSTINTERVENTION MEASURED BY THE CONNERS' CONTINUOUS PERFORMANCE TEST, SECOND EDITION (CCPT). SECONDARY OUTCOMES INCLUDED PARENT AND CHILD MINDFULNESS, CHILD QUALITY OF LIFE, PARENTAL WELL-BEING, CHILD EXECUTIVE FUNCTION, CHILD BEHAVIOUR, CHILD PHYSICAL MEASURES, AND THE PARENT-CHILD RELATIONSHIP. RESULTS: CHILDREN IN THE MIYOGA GROUP DEMONSTRATED SIGNIFICANTLY BETTER ATTENTION POSTINTERVENTION THAN THE WAITLIST COMPARISON GROUP, WITH LOWER INATTENTION SCORES ON THE HIT REACTION TIME STANDARD ERROR (F1,33 =4.59, P=0.04, PARTIAL ETA-SQUARED [ETAP2]=0.13) VARIABLE AND FEWER PERSEVERATION ERRORS (F1,33 =4.60, P=0.04, ETAP2=0.13) ON THE CCPT. INTENTION-TO-TREAT ANALYSIS ALSO REVEALED THAT SUSTAINED ATTENTION IN THE MIYOGA GROUP WAS SIGNIFICANTLY BETTER THAN IN THE WAITLIST COMPARISON GROUP POSTINTERVENTION (F1,37 =5.97, P=0.02, ETAP2=0.14). PARENTS IN THE MIYOGA GROUP DEMONSTRATED SIGNIFICANTLY DECREASED MINDFULNESS (MINDFULNESS ATTENTION AWARENESS SCALE; F1,33 =10.130, P=0.003, ETAP2=0.246). INTERPRETATION: MIYOGA OFFERS A LIFESTYLE INTERVENTION THAT IMPROVES ATTENTION IN CHILDREN WITH CP. MIYOGA CAN BE CONSIDERED AS AN ADDITIONAL OPTION TO STANDARD REHABILITATION TO ENHANCE ATTENTION FOR CHILDREN WITH CP. WHAT THIS PAPER ADDS: MIYOGA, AN EMBODIED MINDFULNESS-BASED MOVEMENT PROGRAMME, CAN ENHANCE ATTENTION (MORE ATTENTIVE AND CONSISTENT PERFORMANCE) IN CHILDREN WITH CEREBRAL PALSY. MIYOGA HAD NO SIGNIFICANT EFFECT ON PHYSICAL FUNCTIONING. 2018 6 1205 31 EXPERIENCES OF CHILDREN AND PARENTS IN MIYOGA, AN EMBODIED MINDFULNESS YOGA PROGRAM FOR CEREBRAL PALSY: A MIXED METHOD STUDY. BACKGROUND AND PURPOSE: A MINDFULNESS YOGA PROGRAM (MIYOGA) WAS DEVELOPED AND TRIALLED WITH CHILDREN WITH CEREBRAL PALSY AND THEIR PARENTS. THIS MIXED-METHOD STUDY EXPLORES THE EXPERIENCES OF CHILDREN AND PARENTS WHO PARTICIPATED IN MIYOGA, TO ASSESS ITS ACCEPTABILITY, FEASIBILITY AND IMPLEMENTATION. MATERIALS AND METHODS: OF THE FORTY-TWO CHILD-PARENT DYADS WHO PARTICIPATED IN THE MIYOGA RANDOMISED CONTROL TRIAL, 19 CHILDREN AND 22 PARENTS WERE INTERVIEWED INDIVIDUALLY IN A SEMI-STRUCTURED WAY ABOUT THEIR EXPERIENCES OF MIYOGA. PARTICIPANTS RATED THEIR MOOD ON A 5-POINT SCALE BEFORE AND AFTER EACH SESSION AND COMPLETED SHORT QUESTIONNAIRES AT THE END OF EACH SESSION. RESULTS: CHILDREN AND PARENTS REPORTED IMPROVED MOOD AFTER EACH MIYOGA SESSION. PARENTS REPORTED BEING MORE AWARE OF THEIR THOUGHTS AND FEELINGS AND POSSIBLY BECAME MORE AWARE OF THEIR DAY-TO-DAY MINDLESSNESS. CONCLUSION: MIYOGA SIGNIFICANTLY IMPROVED CHILDREN AND PARENTS' MOOD. PARENTS REPORTED GAINS IN AWARENESS AS WELL AS CHALLENGES OF ADHERING TO THE HOME PRACTICE. 2019 7 1976 45 SIX-MONTH FOLLOW-UP OF A MINDFULNESS YOGA PROGRAM, MIYOGA, ON ATTENTION, EXECUTIVE FUNCTION, BEHAVIOUR AND PHYSICAL OUTCOMES IN CEREBRAL PALSY. PURPOSE: A RANDOMISED CONTROLLED TRIAL (RCT) OF A MINDFULNESS-BASED YOGA PROGRAM, MIYOGA, FOR CEREBRAL PALSY (CP) DEMONSTRATED IMPROVED ATTENTION IN CHILDREN AND DECREASED MINDFULNESS IN PARENTS POST-INTERVENTION. THIS PAPER EVALUATES THE RETENTION OF TREATMENT EFFECTS AT 6-MONTHS FOLLOW-UP. METHODS: 42 CHILDREN WITH CP AND THEIR PARENTS PARTICIPATED IN A RCT WITH TWO GROUPS MIYOGA (N = 21) AND WAITLIST CONTROL GROUP (N = 21). WAITLIST CONTROL PARTICIPANTS WERE OFFERED MIYOGA FOLLOWING THE POST-INTERVENTION ASSESSMENT. 23 OUT OF 42 CHILD-PARENT DYADS FROM BOTH GROUPS COMPLETED FOLLOW-UP ASSESSMENT 6-MONTHS AFTER COMPLETING MIYOGA. THIS PAPER EVALUATES AND REPORTS DATA FROM BOTH GROUPS COLLAPSED (N = 23; MIYOGA N = 11; AND WAITLIST CONTROL N = 12; 47.8% MALE; MEAN AGE = 9:10 +/- 2.4 YEARS) TO ASSESS RETENTION FROM POST-MIYOGA TO FOLLOW-UP AND PRE-MIYOGA TO FOLLOW-UP. THE PRIMARY OUTCOME WAS ATTENTION, MEASURED BY CONNER'S CONTINUOUS PERFORMANCE TEST II (CCPT). SECONDARY OUTCOMES INCLUDED CHILD EXECUTIVE FUNCTION, PHYSICAL FUNCTION, BEHAVIOUR, QUALITY OF LIFE, CHILD AND PARENT MINDFULNESS, PERSONAL WELLBEING, PSYCHOLOGICAL WELLBEING AND PARENT-CHILD RELATIONSHIP. RESULTS: PAIRED T-TESTS SHOWED NO SIGNIFICANT CHANGES BETWEEN POST-MIYOGA TO FOLLOW-UP AND PRE-MIYOGA TO FOLLOW-UP FOR VARIABLES THAT SHOWED AN INTERVENTION EFFECT IMMEDIATELY AFTER MIYOGA, NAMELY, CHILDREN'S ATTENTION VARIABLES AND PARENT'S MINDFULNESS. PAIRED T-TESTS SHOWED THAT CHILDREN'S EXECUTIVE FUNCTION AND PHYSICAL FUNCTION AND PARENT'S WELLBEING IMPROVED SIGNIFICANTLY FROM PRE-MIYOGA TO 6-MONTHS FOLLOW-UP WHICH MAY POTENTIALLY REFLECT SLEEPER OR DELAYED EFFECTS OF MIYOGA. CONCLUSION: THIS STUDY IDENTIFIED POSSIBLE DELAYED OR SLEEPER EFFECTS IN CHILDREN'S EXECUTIVE FUNCTION AND PHYSICAL FUNCTION AND PARENT'S WELL-BEING.IMPLICATIONS FOR REHABILITATION6-MONTH FOLLOW-UP EVIDENCE FOR RETENTION OF EFFECTS OF MIYOGA ON CHILDREN'S ATTENTION WAS INCONSISTENT; THEREFORE, BOOSTER SESSIONS OR CONTINUED PRACTICE OF MIYOGA AS A LIFESTYLE OPTION ARE NEEDED TO MAINTAIN AN EFFECT ON ATTENTION.BECAUSE MIYOGA CAN BE PRACTISED DURING DAILY ACTIVITIES, IT MAY PROVIDE ADDITIONAL SUPPORT FOR CHILDREN WITH CP, COMPLEMENTING STANDARD REHABILITATION OPTIONS.BY EMBEDDING MINDFULNESS IN CHILDREN AND PARENTS' DAILY ACTIVITIES, MIYOGA, COULD PROVIDE FAMILIES WITH ACCESSIBLE AND TIME-EFFICIENT MEANS OF LEARNING AND PRACTICING MINDFULNESS. 2022 8 258 40 ACCEPTABILITY AND FEASIBILITY OF A 12-WEEK YOGA VS. EDUCATIONAL FILM PROGRAM FOR THE MANAGEMENT OF RESTLESS LEGS SYNDROME (RLS): STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: RESTLESS LEGS SYNDROME (RLS) IS A COMMON AND BURDENSOME SLEEP DISORDER ASSOCIATED WITH PROFOUND IMPAIRMENT OF HEALTH, WELL-BEING, AND QUALITY OF LIFE. UNFORTUNATELY, THE MEDICATIONS USED FOR RLS MANAGEMENT CARRY RISK OF SERIOUS SIDE EFFECTS, INCLUDING AUGMENTATION OF SYMPTOMS. YOGA, AN ANCIENT MIND-BODY DISCIPLINE DESIGNED TO PROMOTE PHYSICAL, EMOTIONAL, AND MENTAL WELL-BEING, MAY OFFER A VIABLE, LOW-RISK NEW TREATMENT. THE PRIMARY OBJECTIVES OF THIS PILOT, PARALLEL-ARM, RANDOMIZED CONTROLLED TRIAL (RCT) ARE TO ASSESS THE ACCEPTABILITY AND FEASIBILITY OF A 12-WEEK YOGA VS. EDUCATIONAL FILM PROGRAM FOR THE MANAGEMENT OF RLS. METHODS: FORTY-FOUR ADULTS WITH CONFIRMED MODERATE TO SEVERE RLS WILL BE RECRUITED AND RANDOMIZED TO A 12-WEEK YOGA (N = 22) OR STANDARDIZED EDUCATIONAL FILM PROGRAM (N = 22). YOGA GROUP PARTICIPANTS WILL ATTEND TWO 75-MIN IYENGAR YOGA CLASSES PER WEEK FOR THE FIRST 4 WEEKS, THEN ONE 75-MIN CLASS PER WEEK FOR THE REMAINING 8 WEEKS, AND WILL COMPLETE A 30-MIN HOMEWORK ROUTINE ON NON-CLASS DAYS. EDUCATIONAL FILM GROUP PARTICIPANTS WILL ATTEND ONE 75-MIN CLASS PER WEEK FOR 12 WEEKS AND COMPLETE A DAILY RLS TREATMENT LOG; CLASSES WILL INCLUDE INFORMATION ON: RLS MANAGEMENT, INCLUDING SLEEP HYGIENE PRACTICES; OTHER SLEEP DISORDERS; AND COMPLEMENTARY THERAPIES LIKELY TO BE OF INTEREST TO THOSE PARTICIPATING IN A YOGA AND SLEEP EDUCATION STUDY. YOGA AND TREATMENT LOGS WILL BE COLLECTED WEEKLY. FEASIBILITY OUTCOMES WILL INCLUDE RECRUITMENT, ENROLLMENT, AND RANDOMIZATION RATES, RETENTION, ADHERENCE, AND PROGRAM SATISFACTION. PROGRAM EVALUATION AND YOGA-DOSING QUESTIONNAIRES WILL BE COLLECTED AT WEEK 12; DATA ON EXPLORATORY OUTCOMES (E.G., RLS SYMPTOM SEVERITY (IRLS), SLEEP QUALITY (PSQI), MOOD (POMS, PSS), AND HEALTH-RELATED QUALITY OF LIFE (SF-36)) WILL BE GATHERED AT BASELINE AND WEEK 12. DISCUSSION: THIS STUDY WILL LAY THE ESSENTIAL GROUNDWORK FOR A PLANNED LARGER RCT TO DETERMINE THE EFFICACY OF A YOGA PROGRAM FOR REDUCING SYMPTOMS AND ASSOCIATED BURDEN OF RLS. IF THE FINDINGS OF THE CURRENT TRIAL AND THE SUBSEQUENT LARGER RCTS ARE POSITIVE, THIS STUDY WILL ALSO HELP SUPPORT A NEW APPROACH TO CLINICAL TREATMENT OF THIS CHALLENGING DISORDER, HELP FOSTER IMPROVED UNDERSTANDING OF RLS ETIOLOGY, AND ULTIMATELY CONTRIBUTE TO REDUCING THE INDIVIDUAL, SOCIETAL, AND ECONOMIC BURDEN ASSOCIATED WITH THIS CONDITION. TRIAL REGISTRATION: CLINICALTRIALS.GOV, ID: NCT03570515 . RETROSPECTIVELY REGISTERED ON 1 FEBRUARY 2017. 2019 9 2829 48 YOGA VERSUS STANDARD CARE FOR SCHIZOPHRENIA. BACKGROUND: YOGA IS AN ANCIENT SPIRITUAL PRACTICE THAT ORIGINATED IN INDIA AND IS CURRENTLY ACCEPTED IN THE WESTERN WORLD AS A FORM OF RELAXATION AND EXERCISE. IT HAS BEEN OF INTEREST FOR PEOPLE WITH SCHIZOPHRENIA TO DETERMINE ITS EFFICACY AS AN ADJUNCT TO STANDARD-CARE TREATMENT. OBJECTIVES: TO EXAMINE THE EFFECTS OF YOGA VERSUS STANDARD CARE FOR PEOPLE WITH SCHIZOPHRENIA. SEARCH METHODS: WE SEARCHED THE COCHRANE SCHIZOPHRENIA GROUP TRIALS REGISTER (NOVEMBER 2012 AND JANUARY 29, 2015), WHICH IS BASED ON REGULAR SEARCHES OF MEDLINE, PUBMED, EMBASE, CINAHL, BIOSIS, AMED, PSYCINFO, AND REGISTRIES OF CLINICAL TRIALS. WE SEARCHED THE REFERENCES OF ALL INCLUDED STUDIES. THERE WERE NO LANGUAGE, DATE, DOCUMENT TYPE, OR PUBLICATION STATUS LIMITATIONS FOR INCLUSION OF RECORDS IN THE REGISTER. SELECTION CRITERIA: ALL RANDOMISED CONTROLLED TRIALS (RCTS) INCLUDING PEOPLE WITH SCHIZOPHRENIA COMPARING YOGA TO STANDARD-CARE CONTROL. DATA COLLECTION AND ANALYSIS: THE REVIEW TEAM INDEPENDENTLY SELECTED STUDIES, QUALITY RATED THESE, AND EXTRACTED DATA. FOR BINARY OUTCOMES, WE CALCULATED RISK RATIO (RR) AND ITS 95% CONFIDENCE INTERVAL (CI), ON AN INTENTION-TO-TREAT BASIS. FOR CONTINUOUS DATA, WE ESTIMATED THE MEAN DIFFERENCE (MD) BETWEEN GROUPS AND ITS 95% CI. WE EMPLOYED MIXED-EFFECT AND FIXED-EFFECT MODELS FOR ANALYSES. WE EXAMINED DATA FOR HETEROGENEITY (I(2) TECHNIQUE), ASSESSED RISK OF BIAS FOR INCLUDED STUDIES, AND CREATED 'SUMMARY OF FINDINGS' TABLES USING GRADE (GRADING OF RECOMMENDATIONS ASSESSMENT, DEVELOPMENT AND EVALUATION). MAIN RESULTS: WE INCLUDED EIGHT STUDIES IN THE REVIEW. ALL OUTCOMES WERE SHORT TERM (LESS THAN SIX MONTHS). THERE WERE CLEAR DIFFERENCES IN A NUMBER OF OUTCOMES IN FAVOUR OF THE YOGA GROUP, ALTHOUGH THESE WERE BASED ON ONE STUDY EACH, WITH THE EXCEPTION OF LEAVING THE STUDY EARLY. THESE INCLUDED MENTAL STATE (IMPROVEMENT IN POSITIVE AND NEGATIVE SYNDROME SCALE, 1 RCT, N = 83, RR 0.70 CI 0.55 TO 0.88, MEDIUM-QUALITY EVIDENCE), SOCIAL FUNCTIONING (IMPROVEMENT IN SOCIAL OCCUPATIONAL FUNCTIONING SCALE, 1 RCT, N = 83, RR 0.88 CI 0.77 TO 1, MEDIUM-QUALITY EVIDENCE), QUALITY OF LIFE (AVERAGE CHANGE 36-ITEM SHORT FORM SURVEY (SF-36) QUALITY-OF-LIFE SUBSCALE, 1 RCT, N = 60, MD 15.50, 95% CI 4.27 TO 26.73, LOW-QUALITY EVIDENCE), AND LEAVING THE STUDY EARLY (8 RCTS, N = 457, RR 0.91 CI 0.6 TO 1.37, MEDIUM-QUALITY EVIDENCE). FOR THE OUTCOME OF PHYSICAL HEALTH, THERE WAS NOT A CLEAR DIFFERENCE BETWEEN GROUPS (AVERAGE CHANGE SF-36 PHYSICAL-HEALTH SUBSCALE, 1 RCT, N = 60, MD 6.60, 95% CI -2.44 TO 15.64, LOW-QUALITY EVIDENCE). ONLY ONE STUDY REPORTED ADVERSE EFFECTS, FINDING NO INCIDENCE OF ADVERSE EVENTS IN EITHER TREATMENT GROUP. THIS REVIEW WAS SUBJECT TO A CONSIDERABLE NUMBER OF MISSING OUTCOMES, WHICH INCLUDED GLOBAL STATE, CHANGE IN COGNITION, COSTS OF CARE, EFFECT ON STANDARD CARE, SERVICE INTERVENTION, DISABILITY, AND ACTIVITIES OF DAILY LIVING. AUTHORS' CONCLUSIONS: EVEN THOUGH WE FOUND SOME POSITIVE EVIDENCE IN FAVOUR OF YOGA OVER STANDARD-CARE CONTROL, THIS SHOULD BE INTERPRETED CAUTIOUSLY IN VIEW OF OUTCOMES LARGELY BASED EACH ON ONE STUDY WITH LIMITED SAMPLE SIZES AND SHORT-TERM FOLLOW-UP. OVERALL, MANY OUTCOMES WERE NOT REPORTED AND EVIDENCE PRESENTED IN THIS REVIEW IS OF LOW TO MODERATE QUALITY - -TOO WEAK TO INDICATE THAT YOGA IS SUPERIOR TO STANDARD-CARE CONTROL FOR THE MANAGEMENT OF SCHIZOPHRENIA. 2015 10 2831 35 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 11 2821 57 YOGA TREATMENT FOR CHRONIC NON-SPECIFIC LOW BACK PAIN. BACKGROUND: NON-SPECIFIC LOW BACK PAIN IS A COMMON, POTENTIALLY DISABLING CONDITION USUALLY TREATED WITH SELF-CARE AND NON-PRESCRIPTION MEDICATION. FOR CHRONIC LOW BACK PAIN, CURRENT GUIDELINES STATE THAT EXERCISE THERAPY MAY BE BENEFICIAL. YOGA IS A MIND-BODY EXERCISE SOMETIMES USED FOR NON-SPECIFIC LOW BACK PAIN. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA FOR TREATING CHRONIC NON-SPECIFIC LOW BACK PAIN, COMPARED TO NO SPECIFIC TREATMENT, A MINIMAL INTERVENTION (E.G. EDUCATION), OR ANOTHER ACTIVE TREATMENT, WITH A FOCUS ON PAIN, FUNCTION, AND ADVERSE EVENTS. SEARCH METHODS: WE SEARCHED CENTRAL, MEDLINE, EMBASE, FIVE OTHER DATABASES AND FOUR TRIALS REGISTERS TO 11 MARCH 2016 WITHOUT RESTRICTION OF LANGUAGE OR PUBLICATION STATUS. WE SCREENED REFERENCE LISTS AND CONTACTED EXPERTS IN THE FIELD TO IDENTIFY ADDITIONAL STUDIES. SELECTION CRITERIA: WE INCLUDED RANDOMIZED CONTROLLED TRIALS OF YOGA TREATMENT IN PEOPLE WITH CHRONIC NON-SPECIFIC LOW BACK PAIN. WE INCLUDED STUDIES COMPARING YOGA TO ANY OTHER INTERVENTION OR TO NO INTERVENTION. WE ALSO INCLUDED STUDIES COMPARING YOGA AS AN ADJUNCT TO OTHER THERAPIES, VERSUS THOSE OTHER THERAPIES ALONE. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SCREENED AND SELECTED STUDIES, EXTRACTED OUTCOME DATA, AND ASSESSED RISK OF BIAS. WE CONTACTED STUDY AUTHORS TO OBTAIN MISSING OR UNCLEAR INFORMATION. WE EVALUATED THE OVERALL CERTAINTY OF EVIDENCE USING THE GRADE APPROACH. MAIN RESULTS: WE INCLUDED 12 TRIALS (1080 PARTICIPANTS) CARRIED OUT IN THE USA (SEVEN TRIALS), INDIA (THREE TRIALS), AND THE UK (TWO TRIALS). STUDIES WERE UNFUNDED (ONE TRIAL), FUNDED BY A YOGA INSTITUTION (ONE TRIAL), FUNDED BY NON-PROFIT OR GOVERNMENT SOURCES (SEVEN TRIALS), OR DID NOT REPORT ON FUNDING (THREE TRIALS). MOST TRIALS USED IYENGAR, HATHA, OR VINIYOGA FORMS OF YOGA. THE TRIALS COMPARED YOGA TO NO INTERVENTION OR A NON-EXERCISE INTERVENTION SUCH AS EDUCATION (SEVEN TRIALS), AN EXERCISE INTERVENTION (THREE TRIALS), OR BOTH EXERCISE AND NON-EXERCISE INTERVENTIONS (TWO TRIALS). ALL TRIALS WERE AT HIGH RISK OF PERFORMANCE AND DETECTION BIAS BECAUSE PARTICIPANTS AND PROVIDERS WERE NOT BLINDED TO TREATMENT ASSIGNMENT, AND OUTCOMES WERE SELF-ASSESSED. THEREFORE, WE DOWNGRADED ALL OUTCOMES TO 'MODERATE' CERTAINTY EVIDENCE BECAUSE OF RISK OF BIAS, AND WHEN THERE WAS ADDITIONAL SERIOUS RISK OF BIAS, UNEXPLAINED HETEROGENEITY BETWEEN STUDIES, OR THE ANALYSES WERE IMPRECISE, WE DOWNGRADED THE CERTAINTY OF THE EVIDENCE FURTHER.FOR YOGA COMPARED TO NON-EXERCISE CONTROLS (9 TRIALS; 810 PARTICIPANTS), THERE WAS LOW-CERTAINTY EVIDENCE THAT YOGA PRODUCED SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE TO FOUR MONTHS (STANDARDIZED MEAN DIFFERENCE (SMD) -0.40, 95% CONFIDENCE INTERVAL (CI) -0.66 TO -0.14; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MEAN DIFFERENCE (MD) -2.18, 95% -3.60 TO -0.76), MODERATE-CERTAINTY EVIDENCE FOR SMALL TO MODERATE IMPROVEMENTS AT SIX MONTHS (SMD -0.44, 95% CI -0.66 TO -0.22; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -2.15, 95% -3.23 TO -1.08), AND LOW-CERTAINTY EVIDENCE FOR SMALL IMPROVEMENTS AT 12 MONTHS (SMD -0.26, 95% CI -0.46 TO -0.05; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -1.36, 95% -2.41 TO -0.26). ON A 0-100 SCALE THERE WAS VERY LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA WAS SLIGHTLY BETTER FOR PAIN AT THREE TO FOUR MONTHS (MD -4.55, 95% CI -7.04 TO -2.06), SIX MONTHS (MD -7.81, 95% CI -13.37 TO -2.25), AND 12 MONTHS (MD -5.40, 95% CI -14.50 TO -3.70), HOWEVER WE PRE-DEFINED CLINICALLY SIGNIFICANT CHANGES IN PAIN AS 15 POINTS OR GREATER AND THIS THRESHOLD WAS NOT MET. BASED ON INFORMATION FROM SIX TRIALS, THERE WAS MODERATE-CERTAINTY EVIDENCE THAT THE RISK OF ADVERSE EVENTS, PRIMARILY INCREASED BACK PAIN, WAS HIGHER IN YOGA THAN IN NON-EXERCISE CONTROLS (RISK DIFFERENCE (RD) 5%, 95% CI 2% TO 8%).FOR YOGA COMPARED TO NON-YOGA EXERCISE CONTROLS (4 TRIALS; 394 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE IN BACK-RELATED FUNCTION AT THREE MONTHS (SMD -0.22, 95% CI -0.65 TO 0.20; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -0.99, 95% -2.87 TO 0.90) AND SIX MONTHS (SMD -0.20, 95% CI -0.59 TO 0.19; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -0.90, 95% -2.61 TO 0.81), AND NO INFORMATION ON BACK-RELATED FUNCTION AFTER SIX MONTHS. THERE WAS VERY LOW-CERTAINTY EVIDENCE FOR LOWER PAIN ON A 0-100 SCALE AT SEVEN MONTHS (MD -20.40, 95% CI -25.48 TO -15.32), AND NO INFORMATION ON PAIN AT THREE MONTHS OR AFTER SEVEN MONTHS. BASED ON INFORMATION FROM THREE TRIALS, THERE WAS LOW-CERTAINTY EVIDENCE FOR NO DIFFERENCE IN THE RISK OF ADVERSE EVENTS BETWEEN YOGA AND NON-YOGA EXERCISE CONTROLS (RD 1%, 95% CI -4% TO 6%).FOR YOGA ADDED TO EXERCISE COMPARED TO EXERCISE ALONE (1 TRIAL; 24 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE AT 10 WEEKS IN BACK-RELATED FUNCTION (SMD -0.60, 95% CI -1.42 TO 0.22; CORRESPONDING TO A CHANGE IN THE OSWESTRY DISABILITY INDEX OF MD -17.05, 95% -22.96 TO 11.14) OR PAIN ON A 0-100 SCALE (MD -3.20, 95% CI -13.76 TO 7.36). THERE WAS NO INFORMATION ON OUTCOMES AT OTHER TIME POINTS. THERE WAS NO INFORMATION ON ADVERSE EVENTS.STUDIES PROVIDED LIMITED EVIDENCE ON RISK OF CLINICAL IMPROVEMENT, MEASURES OF QUALITY OF LIFE, AND DEPRESSION. THERE WAS NO EVIDENCE ON WORK-RELATED DISABILITY. AUTHORS' CONCLUSIONS: THERE IS LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA COMPARED TO NON-EXERCISE CONTROLS RESULTS IN SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE AND SIX MONTHS. YOGA MAY ALSO BE SLIGHTLY MORE EFFECTIVE FOR PAIN AT THREE AND SIX MONTHS, HOWEVER THE EFFECT SIZE DID NOT MEET PREDEFINED LEVELS OF MINIMUM CLINICAL IMPORTANCE. IT IS UNCERTAIN WHETHER THERE IS ANY DIFFERENCE BETWEEN YOGA AND OTHER EXERCISE FOR BACK-RELATED FUNCTION OR PAIN, OR WHETHER YOGA ADDED TO EXERCISE IS MORE EFFECTIVE THAN EXERCISE ALONE. YOGA IS ASSOCIATED WITH MORE ADVERSE EVENTS THAN NON-EXERCISE CONTROLS, BUT MAY HAVE THE SAME RISK OF ADVERSE EVENTS AS OTHER BACK-FOCUSED EXERCISE. YOGA IS NOT ASSOCIATED WITH SERIOUS ADVERSE EVENTS. THERE IS A NEED FOR ADDITIONAL HIGH-QUALITY RESEARCH TO IMPROVE CONFIDENCE IN ESTIMATES OF EFFECT, TO EVALUATE LONG-TERM OUTCOMES, AND TO PROVIDE ADDITIONAL INFORMATION ON COMPARISONS BETWEEN YOGA AND OTHER EXERCISE FOR CHRONIC NON-SPECIFIC LOW BACK PAIN. 2017 12 461 44 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 13 156 35 A QUALITATIVE STUDY OF LOVEYOURBRAIN YOGA: A GROUP-BASED YOGA WITH PSYCHOEDUCATION INTERVENTION TO FACILITATE COMMUNITY INTEGRATION FOR PEOPLE WITH TRAUMATIC BRAIN INJURY AND THEIR CAREGIVERS. PURPOSE: TO EXPLORE PARTICIPANTS' EXPERIENCES IN A GROUP-BASED YOGA WITH PSYCHOEDUCATION INTERVENTION DESIGNED TO FACILITATE COMMUNITY INTEGRATION FOR PEOPLE WITH TRAUMATIC BRAIN INJURY AND THEIR CAREGIVERS.MATERIALS AND METHODS: WE CONDUCTED SEMI-STRUCTURED INTERVIEWS WITH 13 PEOPLE WITH TRAUMATIC BRAIN INJURY AND THREE CAREGIVERS WHO HAD COMPLETED LOVEYOURBRAIN YOGA, A 6-SESSION, MANUALIZED, GROUP-BASED YOGA INTERVENTION THAT INCORPORATES BREATHING EXERCISES, YOGA, MEDITATION, AND PSYCHOEDUCATION. INTERVIEWS WERE ANALYZED USING CONTENT ANALYSIS.RESULTS: WE IDENTIFIED SEVEN THEMES: EASE OF PARTICIPATION, BELONGING, SUSTAINING COMMUNITY CONNECTION, PHYSICAL HEALTH, SELF-REGULATION, SELF-EFFICACY, AND RESILIENCE. ALL PARTICIPANTS VALUED THE COMMUNITY-BASED YOGA STUDIO ENVIRONMENT AND MULTIFACETED STRUCTURE OF THE PROGRAM. PARTICIPANTS REPORTED IMPROVEMENTS IN STRENGTH, BALANCE, FLEXIBILITY, AND ATTENTION CONTROL, AND A GREATER SENSE OF BELONGING, COMMUNITY CONNECTION, AND ABILITY TO MOVE FORWARD WITH THEIR LIVES. PARTICIPANTS REPORTED ONGOING USE OF TOOLS (E.G., BREATHING EXERCISES) TO COPE WITH NEGATIVE EMOTIONS AND STRESS. ABOUT HALF OF PARTICIPANTS SUSTAINED RELATIONSHIPS BUILT DURING LOVEYOURBRAIN YOGA AND FELT MORE CAPABLE OF ACCESSING OTHER ACTIVITIES IN THEIR COMMUNITY.CONCLUSIONS: LOVEYOURBRAIN YOGA SUCCESSFULLY PROMOTED COMMUNITY INTEGRATION FOR PEOPLE WITH TRAUMATIC BRAIN INJURY. IT ALSO FACILITATED DIVERSE AND MEANINGFUL PHYSICAL, PSYCHOLOGICAL, AND SOCIAL HEALTH BENEFITS, WHICH SUGGEST THAT IT MAY BE AN EFFECTIVE MODE OF COMMUNITY-BASED REHABILITATION.IMPLICATIONS FOR REHABILITATIONTRAUMATIC BRAIN INJURY SURVIVORS OFTEN STRUGGLE TO PARTICIPATE IN THEIR COMMUNITY, THE ULTIMATE GOAL OF REHABILITATIONYOGA IS A HOLISTIC THERAPY WITH MANY BENEFITS, YET IS NOT ACCESSIBLE TO THE TRAUMATIC BRAIN INJURY POPULATION AT THE COMMUNITY LEVELPARTICIPANTS IN A COMMUNITY-BASED YOGA WITH PSYCHOEDUCATION INTERVENTION IN SIX STATES EXPERIENCED DIVERSE AND MEANINGFUL PHYSICAL, PSYCHOLOGICAL, AND SOCIAL HEALTH BENEFITSGROUP-BASED YOGA WITH PSYCHOEDUCATION MAY BE AN EFFECTIVE MODE OF COMMUNITY INTEGRATION AND COMMUNITY-BASED REHABILITATION FOR TRAUMATIC BRAIN INJURY SURVIVORS. 2020 14 518 35 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 15 1748 36 PILOT RANDOMIZED, CONTROLLED TRIAL OF A DYADIC YOGA PROGRAM FOR GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR FAMILY CAREGIVERS. BACKGROUND: WHILE THE USE OF BEHAVIORAL MEDICINE IN MANAGING GLIOMA PATIENTS' SYMPTOMS IS NOT WELL STUDIED, THE HIGH SYMPTOM BURDEN IN PATIENTS AND THEIR FAMILY CAREGIVERS IS WELL ESTABLISHED. WE CONDUCTED A PILOT RANDOMIZED, CONTROLLED TRIAL TO EXAMINE THE FEASIBILITY AND PRELIMINARY EFFICACY OF A DYADIC YOGA (DY) INTERVENTION AS A SUPPORTIVE CARE STRATEGY. METHODS: GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR CAREGIVERS WERE RANDOMIZED TO A 12-SESSION DY OR WAITLIST CONTROL (WLC) GROUP. PRIOR TO RADIOTHERAPY AND RANDOMIZATION, BOTH GROUPS COMPLETED MEASURES OF CANCER-RELATED SYMPTOMS (MD ANDERSON SYMPTOM INVENTORY-BRAIN TUMOR MODULE), DEPRESSIVE SYMPTOMS (CENTER FOR EPIDEMIOLOGICAL STUDIES-DEPRESSION MEASURE), FATIGUE (BRIEF FATIGUE INVENTORY), AND OVERALL QUALITY OF LIFE (QOL; MEDICAL OUTCOMES STUDY 36-ITEM SHORT-FORM SURVEY). DYADS WERE REASSESSED AT THE LAST DAY OF RADIOTHERAPY. RESULTS: TWENTY PATIENTS (MEAN AGE: 46 YEARS, 50% FEMALE, 80% WHO GRADE IV AND CAREGIVERS (MEAN AGE: 50 YEARS, 70% FEMALE, 50% SPOUSES) PARTICIPATED IN THE TRIAL. A PRIORI FEASIBILITY CRITERIA WERE MET REGARDING CONSENT (70%), ADHERENCE (88%), AND RETENTION (95%) RATES. CONTROLLING FOR RELEVANT COVARIATES, CHANGE SCORE ANALYSES REVEALED CLINICALLY SIGNIFICANT IMPROVEMENTS FOR PATIENTS IN THE DY COMPARED WITH THE WLC GROUP FOR OVERALL CANCER SYMPTOM SEVERITY (D = 0.96) AND SYMPTOM INTERFERENCE (D = 0.74), DEPRESSIVE SYMPTOMS (D = 0.71), AND MENTAL QOL (D = 0.69). CAREGIVERS IN THE DY GROUP REPORTED CLINICALLY SIGNIFICANT IMPROVEMENTS IN DEPRESSIVE SYMPTOMS (D = 1.12), FATIGUE (D = 0.89), AND MENTAL QOL (D = 0.49) RELATIVE TO THOSE IN THE WLC GROUP. CONCLUSION: A DY INTERVENTION APPEARS TO BE A FEASIBLE AND BENEFICIAL SYMPTOM AND QOL MANAGEMENT STRATEGY FOR GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR CAREGIVERS. AN EFFICACY TRIAL WITH A MORE STRINGENT CONTROL GROUP IS WARRANTED. CLINICAL TRIAL NUMBER: NCT02481349. 2019 16 1336 42 HOW DOES YOGA REDUCE STRESS? A CLINICAL TRIAL TESTING PSYCHOLOGICAL MECHANISMS. YOGA INTERVENTIONS CAN REDUCE STRESS, BUT THE MECHANISMS UNDERLYING THAT STRESS REDUCTION REMAIN LARGELY UNIDENTIFIED. UNDERSTANDING HOW YOGA WORKS IS ESSENTIAL TO OPTIMIZING INTERVENTIONS. THE PRESENT STUDY TESTED FIVE POTENTIAL PSYCHOSOCIAL MECHANISMS (INCREASED MINDFULNESS, INTEROCEPTIVE AWARENESS, SPIRITUAL WELL-BEING, SELF-COMPASSION AND SELF-CONTROL) THAT HAVE BEEN PROPOSED TO EXPLAIN YOGA'S IMPACT ON STRESS. FORTY-TWO PARTICIPANTS (62% FEMALE; 64% WHITE) IN A YOGA PROGRAM FOR STRESS REDUCTION COMPLETED SURVEYS AT BASELINE (T1), MID-INTERVENTION (T2) AND POST-INTERVENTION (12 WEEKS; T3). WE MEASURED TWO ASPECTS OF STRESS, PERCEIVED STRESS AND STRESS REACTIVITY. CHANGES WERE ASSESSED WITH PAIRED T-TESTS; ASSOCIATIONS BETWEEN CHANGES IN MECHANISMS WERE TESTED IN RESIDUAL CHANGE MODELS. ONLY STRESS REACTIVITY DECREASED, ON AVERAGE, FROM T1 TO T3. EXCEPT FOR SELF-COMPASSION, ALL PSYCHOSOCIAL MECHANISMS INCREASED FROM T1 TO T3, WITH MINIMAL CHANGES FROM T2 TO T3. EXCEPT FOR SELF-CONTROL, INCREASES IN EACH MECHANISM WERE STRONGLY ASSOCIATED WITH DECREASES IN BOTH MEASURES OF STRESS BETWEEN T1 AND T2 AND DECREASES IN PERCEIVED STRESS FROM T1 TO T3 (ALL P'S < 0.05). INCREASED PSYCHOSOCIAL RESOURCES ARE ASSOCIATED WITH STRESS REDUCTION. YOGA INTERVENTIONS TARGETING THESE RESOURCES MAY SHOW STRONGER STRESS REDUCTION EFFECTS. FUTURE RESEARCH SHOULD TEST THESE LINKAGES MORE RIGOROUSLY USING ACTIVE COMPARISON GROUPS AND LARGER SAMPLES. 2021 17 2638 41 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 18 507 46 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 19 34 38 A 12-WEEK IYENGAR YOGA PROGRAM IMPROVED BALANCE AND MOBILITY IN OLDER COMMUNITY-DWELLING PEOPLE: A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: EXERCISE THAT CHALLENGES BALANCE CAN IMPROVE MOBILITY AND PREVENT FALLS IN OLDER ADULTS. YOGA AS A PHYSICAL ACTIVITY OPTION FOR OLDER ADULTS IS NOT WELL STUDIED. THIS TRIAL EVALUATED THE FEASIBILITY AND EFFECT OF A 12-WEEK IYENGAR YOGA PROGRAM ON BALANCE AND MOBILITY IN OLDER PEOPLE. METHODS: WE CONDUCTED A BLINDED, PILOT RANDOMIZED CONTROLLED TRIAL WITH INTENTION-TO-TREAT ANALYSIS. PARTICIPANTS WERE 54 COMMUNITY DWELLERS (MEAN AGE 68 YEARS, SD 7.1) NOT CURRENTLY PARTICIPATING IN YOGA OR TAI CHI. THE INTERVENTION GROUP (N = 27) PARTICIPATED IN A 12-WEEK, TWICE-WEEKLY YOGA PROGRAM FOCUSED ON STANDING POSTURES AND RECEIVED A FALL PREVENTION EDUCATION BOOKLET. THE CONTROL GROUP (N = 27) RECEIVED THE EDUCATION BOOKLET ONLY. PRIMARY OUTCOME WAS STANDING BALANCE COMPONENT OF THE SHORT PHYSICAL PERFORMANCE BATTERY WITH ADDITION OF ONE-LEGGED STANCE TIME (STANDING BALANCE). SECONDARY OUTCOMES WERE THE TIMED SIT-TO-STAND TEST, TIMED 4-M WALK, ONE-LEGGED STAND WITH EYES CLOSED, AND SHORT FALLS EFFICACY SCALE-INTERNATIONAL. FEASIBILITY WAS MEASURED BY RECORDING CLASS ATTENDANCE AND ADVERSE EVENTS. RESULTS: FIFTY-TWO PARTICIPANTS COMPLETED FOLLOW-UP ASSESSMENTS. THE INTERVENTION GROUP SIGNIFICANTLY IMPROVED COMPARED WITH CONTROL GROUP ON STANDING BALANCE (MEAN DIFFERENCE = 1.52 SECONDS, 95% CI 0.10-2.96, P = .04), SIT-TO-STAND TEST (MEAN DIFFERENCE = -3.43 SECONDS, 95% CI -5.23 TO -1.64, P < .001), 4-M WALK (MEAN DIFFERENCE = -0.50 SECONDS, 95% CI -0.72 TO -0.28, P < .001), AND ONE-LEGGED STAND WITH EYES CLOSED (MEAN DIFFERENCE = 1.93 SECONDS, 95% CI 0.40-3.46, P = .02). AVERAGE CLASS ATTENDANCE WAS 20 OF 24 CLASSES (83%). NO SERIOUS ADVERSE EVENTS OCCURRED. CONCLUSIONS: THIS TRIAL DEMONSTRATES THE BALANCE AND MOBILITY-RELATED BENEFITS AND FEASIBILITY OF IYENGAR YOGA FOR OLDER PEOPLE. THE FALL PREVENTION EFFECT OF IYENGAR YOGA WARRANTS FURTHER INVESTIGATION. 2013 20 1367 35 IMPACT OF A MINDFULNESS-BASED, WORKPLACE GROUP YOGA INTERVENTION ON BURNOUT, SELF-CARE, AND COMPASSION IN HEALTH CARE PROFESSIONALS: A PILOT STUDY. OBJECTIVE: TO INVESTIGATE WHETHER A WORKPLACE, GROUP MINDFULNESS-BASED YOGA INTERVENTION COULD HELP MANAGE BURNOUT AND IMPROVE WELLBEING AMONG HEALTH CARE PROFESSIONALS. METHODS: A TOTAL OF 43 HEALTH CARE PROFESSIONALS PARTICIPATED IN 8-WEEK SUPERVISED WORKPLACE, GROUP MINDFULNESS-BASED YOGA ACTIVITIES. THE AUTHORS USED A SINGLE-SAMPLE, PRE-POST DESIGN. AT TWO POINTS IN TIME (BASELINE AND POSTINTERVENTION), PARTICIPANTS COMPLETED A SET OF ONLINE MEASURES ASSESSING BURNOUT, DEPRESSION, ANXIETY, STRESS, RESILIENCE, AND COMPASSION. THE AUTHORS USED LINEAR MIXED MODEL ANALYSIS TO ASSESS CHANGES IN OUTCOME MEASURES. RESULTS: PARTICIPANTS HAD IMPROVEMENTS AFTER THE 8-WEEK INTERVENTION. AT POSTINTERVENTION, THEY HAD SIGNIFICANTLY BETTER SCORES ON PERSONAL ACCOMPLISHMENT, DEPRESSION, ANXIETY, STRESS, PERCEIVED RESILIENCE, AND COMPASSION. PARTICIPANTS HAD A POSITIVE PERCEPTION OF THE YOGA INTERVENTION. CONCLUSION: GROUP MINDFULNESS-BASED YOGA PROGRAM MAY BE CONVENIENT AND LOW-COST APPROACH TO SUPPORT HEALTH AND WELLBEING AMONG HEALTH CARE PROFESSIONALS. 2020