1  465 145 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
2 1783  36 PREDICTORS OF HEALTH-RELATED QUALITY OF LIFE IN INDIANS WITH METABOLIC SYNDROME UNDERGOING RANDOMIZED CONTROLLED TRIAL OF YOGA-BASED LIFESTYLE INTERVENTION VS DIETARY INTERVENTION. THE PRESENT STUDY EXPLORES THE EFFICACY OF 12-WEEK YOGA + DIET-BASED LIFESTYLE INTERVENTION (YBLI) VS DIETARY INTERVENTION (DI) ON HEALTH-RELATED QUALITY OF LIFE (HRQOL) AND IDENTIFIES THE PREDICTORS OF CHANGE IN HRQOL IN INDIANS WITH METABOLIC SYNDROME (MET S). DATA FROM THE HISTORICAL RANDOMIZED CONTROLLED TRIAL WAS USED INCLUDING ADULTS (N = 260, 20-45 YEARS) WITH MET S. FOUR DOMAINS OF HRQOL WERE MEASURED AT BASELINE, 2 AND 12 WEEKS USING WHOQOL-BREF QUESTIONNAIRE. GENERALIZED ESTIMATING EQUATION AND CHI-SQUARE TEST WAS USED TO COMPARE 12-WEEK CHANGES IN HRQOL DOMAINS AND PROPORTION OF SUBJECTS, RESPECTIVELY. CHANGES IN HRQOL WERE PREDICTED USING REGRESSION MODELS CONCERNING CHANGES IN BODY MASS INDEX (BMI), PHYSICAL ACTIVITY, TOTAL CALORIE INTAKE, ADIPONECTIN, AND SUPEROXIDE DISMUTASE (SOD) LEVELS. EXPLORATORY MEDIATION ANALYSIS WAS CARRIED OUT USING BARON & KENNY APPROACH. YBLI RESULTED IN A SIGNIFICANTLY GREATER INCREASE IN THE PHYSICAL DOMAIN SCORE OF HRQOL THAN DI. A SIGNIFICANTLY GREATER PROPORTION OF SUBJECTS IN YBLI GROUP (71%) SHOWED AN INCREASE IN PHYSICAL DOMAIN SCORES COMPARED TO DI (51%). A UNIT CHANGE IN BMI NEGATIVELY PREDICTED A UNIT CHANGE IN PHYSICAL, PSYCHOLOGICAL AND ENVIRONMENTAL HEALTH. WHEREAS, A UNIT CHANGE IN ADIPONECTIN AND SOD LEVELS POSITIVELY PREDICTED A UNIT CHANGE IN PHYSICAL AND ENVIRONMENTAL HEALTH. PARTIAL MEDIATION BETWEEN YBLI INTERVENTION AND PHYSICAL HRQOL DOMAIN WAS OBSERVED VIA ADIPONECTIN. IN CONCLUSION, A 12-WEEK YBLI HAS A POSITIVE AND GREATER EFFECT ON HRQOL PHYSICAL DOMAIN SCORE THAN FOLLOWING DI ALONE. CHANGES IN BMI, ADIPONECTIN, AND SOD LEVELS MAY PREDICT CHANGES IN HRQOL DOMAINS AFTER LIFESTYLE INTERVENTION.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
3 1699  55 PARTICIPANT CHARACTERISTICS ASSOCIATED WITH SYMPTOMATIC IMPROVEMENT FROM YOGA FOR CHRONIC LOW BACK PAIN. CONTEXT: STUDIES SUGGEST THAT YOGA IS EFFECTIVE FOR MODERATE TO SEVERE CHRONIC LOW BACK PAIN (CLBP) IN DIVERSE PREDOMINANTLY LOWER SOCIOECONOMIC STATUS POPULATIONS. HOWEVER, LITTLE IS KNOWN ABOUT FACTORS ASSOCIATED WITH BENEFIT FROM THE YOGA INTERVENTION. OBJECTIVE: IDENTIFY FACTORS AT BASELINE INDEPENDENTLY ASSOCIATED WITH GREATER EFFICACY AMONG PARTICIPANTS IN A STUDY OF YOGA FOR CLBP. DESIGN: FROM SEPTEMBER-DECEMBER 2011, A 12-WEEK RANDOMIZED DOSING TRIAL WAS CONDUCTED COMPARING WEEKLY VS. TWICE-WEEKLY 75-MINUTE HATHA YOGA CLASSES FOR 95 PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH NONSPECIFIC CLBP. PARTICIPANT CHARACTERISTICS COLLECTED AT BASELINE WERE USED TO DETERMINE FACTORS BEYOND TREATMENT ASSIGNMENT (REPORTED IN THE INITIAL STUDY) THAT PREDICTED OUTCOME. WE USED BIVARIATE TESTING TO IDENTIFY BASELINE CHARACTERISTICS ASSOCIATED WITH IMPROVEMENT IN FUNCTION AND PAIN, AND INCLUDED SELECT FACTORS IN A MULTIVARIATE LINEAR REGRESSION. SETTING: RECRUITMENT AND CLASSES OCCURRED IN AN ACADEMIC SAFETY-NET HOSPITAL AND FIVE AFFILIATED COMMUNITY HEALTH CENTERS IN BOSTON, MASSACHUSETTS. PARTICIPANTS: NINETY-FIVE ADULTS WITH NONSPECIFIC CLBP, AGES RANGING FROM 20-64 (MEAN 48) YEARS; 72 WOMEN AND 23 MEN. OUTCOME MEASURES: PRIMARY OUTCOMES WERE CHANGES IN BACK-RELATED FUNCTION (MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE, RMDQ; 0-23) AND MEAN LOW BACK PAIN INTENSITY (0-10) IN THE PREVIOUS WEEK, FROM BASELINE TO WEEK 12. RESULTS: ADJUSTING FOR GROUP ASSIGNMENT, BASELINE RMDQ, AGE, AND GENDER, FOREIGN NATIONALITY AND LOWER BASELINE SF36 PHYSICAL COMPONENT SCORE (PCS) WERE INDEPENDENTLY ASSOCIATED WITH IMPROVEMENT IN RMDQ. GREATER THAN HIGH SCHOOL EDUCATION LEVEL, CLBP LESS THAN 1 YEAR, AND LOWER BASELINE SF36 PCS WERE INDEPENDENTLY ASSOCIATED WITH IMPROVEMENT IN PAIN INTENSITY. OTHER DEMOGRAPHICS INCLUDING RACE, INCOME, GENDER, BMI, AND USE OF PAIN MEDICATIONS WERE NOT ASSOCIATED WITH EITHER OUTCOME. CONCLUSIONS: POOR PHYSICAL HEALTH AT BASELINE IS ASSOCIATED WITH GREATER IMPROVEMENT FROM YOGA IN BACK-RELATED FUNCTION AND PAIN. RACE, INCOME, AND BODY MASS INDEX DO NOT AFFECT THE POTENTIAL FOR A PERSON WITH LOW BACK PAIN TO EXPERIENCE BENEFIT FROM YOGA.	2014	
                                                                                                                                                                                                                                                                                                                                                                                           
4  307  40 AN EVALUATION OF YOGA AND MEDITATION TO IMPROVE ATTENTION, HYPERACTIVITY, AND STRESS IN HIGH-SCHOOL STUDENTS. OBJECTIVE: PROBLEMS WITH ATTENTION AND STRESS ARE COMMON IN CHILDREN AND PREDICT ACADEMIC DIFFICULTIES AND OTHER BEHAVIORAL AND EMOTIONAL PROBLEMS. MIND-BODY INTERVENTIONS SUCH AS YOGA AND MEDITATION IMPROVE ATTENTION AND REDUCE STRESS. IN THIS STUDY, WE EXAMINED THE IMPACT OF HATHA YOGA ON ATTENTION AND STRESS IN NINTH GRADERS. DESIGN: A TOTAL OF 174 NINTH GRADERS FROM A TEXAS HIGH SCHOOL WERE ENROLLED IN THE STUDY. TEACHERS ASSIGNED STUDENTS TO A YOGA GROUP (YG) OR CONTROL GROUP (CG) BASED ON THEIR CLASS SCHEDULE. THE YG PARTICIPATED IN 25-MIN HATHA YOGA CLASSES TWICE WEEKLY OVER 12 WEEKS (N = 123). THE CG INCLUDED 51 STUDENTS. STUDENT SELF-REPORTS ON MEASURES OF INATTENTION AND HYPERACTIVITY (THE STRENGTHS AND WEAKNESSES OF ADHD [ATTENTION-DEFICIT/HYPERACTIVITY DISORDER] SYMPTOMS AND NORMAL BEHAVIOR RATING SCALE FOR ADHD) AND STRESS (PERCEIVED STRESS SCALE) WERE OBTAINED AT BASELINE AND AT 12 WEEKS. RESULTS: THERE WERE NO SIGNIFICANT DIFFERENCES IN BASELINE LEVELS OF INATTENTION (P = 0.86), HYPERACTIVITY (P = 0.25), AND PERCEIVED STRESS (P = 0.28) BETWEEN THE YG AND CG. REGARDING INATTENTION SCORES, THERE WAS A SIGNIFICANT INTERACTION OF GROUP AND TIME (B = -1.09, STANDARD ERROR [SE] = 0.30, P < 0.001). PAIRWISE T-TESTS SHOWED A SIGNIFICANT REDUCTION IN INATTENTION FOR THE YG (D = 0.27) BUT A SIGNIFICANT INCREASE IN INATTENTION FOR THE CG. REGARDING HYPERACTIVITY, THERE WAS NO SIGNIFICANT INTERACTION OF GROUP AND TIME (B = -0.43, SE = 0.26, P = 0.1). PAIRWISE T-TESTS DEMONSTRATED A SIGNIFICANT REDUCTION IN HYPERACTIVITY FOR THE YG (D = 0.22), BUT NOT THE CG. THE INTERACTION OF GROUP AND TIME WAS NOT SIGNIFICANT IN PREDICTING THE SLOPE OF CHANGE IN PERCEIVED DISTRESS (B = -0.93, SE = 1.19, P = 0.43). PAIRWISE T-TESTS DID NOT SHOW A SIGNIFICANT REDUCTION IN PERCEIVED DISTRESS FOR EITHER GROUP. CONCLUSION: THESE FINDINGS SUGGEST THAT HATHA YOGA MAY IMPROVE ATTENTION AND HYPERACTIVITY IN HIGH SCHOOL STUDENTS.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
5 1787  51 PREFERENCE AND EXPECTATION FOR TREATMENT ASSIGNMENT IN A RANDOMIZED CONTROLLED TRIAL OF ONCE- VS TWICE-WEEKLY YOGA FOR CHRONIC LOW BACK PAIN. BACKGROUND: IN STUDIES INVOLVING NONPHARMACOLOGICAL COMPLEMENTARY AND ALTERNATIVE MEDICINE INTERVENTIONS, PARTICIPANT BLINDING IS VERY DIFFICULT. PARTICIPANT EXPECTATIONS MAY AFFECT PERCEIVED BENEFIT OF THERAPY. IN STUDIES OF YOGA AS TREATMENT FOR CHRONIC LOW BACK PAIN, LITTLE IS KNOWN ABOUT THE RELATIONSHIP BETWEEN PATIENT EXPECTATIONS AND PREFERENCES ON OUTCOMES. THIS STUDY WAS DESIGNED TO IDENTIFY BASELINE PREDICTORS OF PREFERENCE AND TO DETERMINE IF EXPECTATIONS AND PREFERENCES FOR DIFFERENT DOSES OF YOGA AFFECT BACK-RELATED FUNCTION AND LOW BACK PAIN INTENSITY. METHODS: THIS WAS A SECONDARY DATA ANALYSIS OF A 12-WEEK RANDOMIZED CONTROLLED TRIAL COMPARING ONCE-WEEKLY VS TWICE-WEEKLY YOGA FOR TREATMENT OF CHRONIC LOW BACK PAIN IN 93 ADULTS FROM A PREDOMINANTLY LOW-INCOME MINORITY POPULATION. AT BASELINE, PARTICIPANTS WERE ASKED ABOUT BACK FUNCTION, BACK PAIN, TREATMENT EXPECTATIONS, AND TREATMENT PREFERENCES. WE CREATED A VARIABLE "CONCORDANCE" TO DESCRIBE THE MATCHING OF PARTICIPANT PREFERENCE TO RANDOMIZED TREATMENT. OUR OUTCOME VARIABLES WERE CHANGE IN BACK FUNCTION AND PAIN INTENSITY AFTER 12 WEEKS OF YOGA INSTRUCTION. WE PERFORMED LOGISTIC REGRESSION TO IDENTIFY PREDICTORS OF PREFERENCE FOR ONCE- OR TWICE-WEEKLY YOGA INSTRUCTION. WE CREATED LINEAR REGRESSION MODELS TO IDENTIFY INDEPENDENT ASSOCIATIONS BETWEEN EXPECTATIONS, PREFERENCE, CONCORDANCE, AND OUTCOMES. RESULTS: WORSE BACK FUNCTION AT BASELINE WAS ASSOCIATED WITH 20% HIGHER ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 1.2, CI 1.1, 1.3). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR TWICE-WEEKLY YOGA HAD 90% HIGHER ODDS OF PREFERRING TWICE-WEEKLY VS ONCE-WEEKLY YOGA (OR 1.9, CI 1.3, 2.7). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR ONCE-WEEKLY YOGA HAD 40% LESS ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 0.6, CI 0.5, 0.9). AFTER CONTROLLING FOR BASELINE CHARACTERISTICS, WE FOUND NO STATISTICALLY SIGNIFICANT RELATIONSHIP BETWEEN TREATMENT OUTCOMES, PREFERENCE, EXPECTATION SCORES, OR CONCORDANCE. CONCLUSION: IN A POPULATION OF PREDOMINANTLY LOW-INCOME MINORITY PARTICIPANTS WITH CHRONIC LOW BACK PAIN, WORSE BACK FUNCTION WAS ASSOCIATED WITH PREFERENCE FOR MORE FREQUENT YOGA CLASSES. THOSE WHO PREFERRED MORE YOGA CLASSES HAD HIGHER EXPECTATIONS FOR THOSE CLASSES. TWELVE-WEEK CHANGE IN BACK PAIN INTENSITY AND BACK FUNCTION WERE NOT AFFECTED BY DOSING PREFERENCE, EXPECTATION SCORE, OR CONCORDANCE. MORE RESEARCH IS NEEDED TO BETTER MEASURE AND QUANTIFY PREFERENCE, EXPECTATIONS, AND THEIR RELATIONSHIP TO OUTCOMES IN YOGA RESEARCH.	2015	

6 2320  41 TREATMENT CREDIBILITY, EXPECTANCY, AND PREFERENCE: PREDICTION OF TREATMENT ENGAGEMENT AND OUTCOME IN A RANDOMIZED CLINICAL TRIAL OF HATHA YOGA VS. HEALTH EDUCATION AS ADJUNCT TREATMENTS FOR DEPRESSION. BACKGROUND: HATHA YOGA MAY BE HELPFUL FOR ALLEVIATING DEPRESSION SYMPTOMS. THE PURPOSE OF THIS ANALYSIS IS TO DETERMINE WHETHER TREATMENT PROGRAM PREFERENCE, CREDIBILITY, OR EXPECTANCY PREDICT ENGAGEMENT IN DEPRESSION INTERVENTIONS (YOGA OR A CONTROL CLASS) OR DEPRESSION SYMPTOM SEVERITY OVER TIME. METHODS: THIS IS A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL (RCT) OF HATHA YOGA VS. A HEALTH EDUCATION CONTROL GROUP FOR TREATMENT OF DEPRESSION. DEPRESSED PARTICIPANTS (N=122) ATTENDED UP TO 20 CLASSES OVER A PERIOD OF 10 WEEKS, AND THEN COMPLETED ADDITIONAL ASSESSMENTS AFTER 3 AND 6 MONTHS. WE ASSESSED TREATMENT PREFERENCE PRIOR TO RANDOMIZATION, AND TREATMENT CREDIBILITY AND EXPECTANCY AFTER PARTICIPANTS ATTENDED THEIR FIRST CLASS. TREATMENT "CONCORDANCE" INDICATED THAT TREATMENT PREFERENCE MATCHED ASSIGNED TREATMENT. RESULTS: TREATMENT CREDIBILITY, EXPECTANCY, AND CONCORDANCE WERE NOT ASSOCIATED WITH TREATMENT ENGAGEMENT. TREATMENT EXPECTANCY MODERATED THE ASSOCIATION BETWEEN TREATMENT GROUP AND DEPRESSION. DEPRESSION SEVERITY OVER TIME DIFFERED BY EXPECTANCY LEVEL FOR THE YOGA GROUP BUT NOT FOR THE HEALTH EDUCATION GROUP. CONTROLLING FOR BASELINE DEPRESSION, PARTICIPANTS IN THE YOGA GROUP WITH AN AVERAGE OR HIGH EXPECTANCY FOR IMPROVEMENT SHOWED LOWER DEPRESSION SYMPTOMS ACROSS THE ACUTE INTERVENTION AND FOLLOW-UP PERIOD THAN THOSE WITH A LOW EXPECTANCY FOR IMPROVEMENT. THERE WAS A TREND FOR A SIMILAR PATTERN FOR CREDIBILITY. CONCORDANCE WAS NOT ASSOCIATED WITH TREATMENT OUTCOME. LIMITATIONS: THIS IS A SECONDARY, POST-HOC ANALYSIS AND SHOULD BE CONSIDERED HYPOTHESIS-GENERATING. CONCLUSIONS: RESULTS SUGGEST THAT EXPECTANCY IMPROVES THE LIKELIHOOD OF SUCCESS ONLY FOR A INTERVENTION THOUGHT TO ACTIVELY TARGET DEPRESSION (YOGA) AND NOT A CONTROL INTERVENTION.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
7  282  40 ADHERENCE TO YOGA AND EXERCISE INTERVENTIONS IN A 6-MONTH CLINICAL TRIAL. BACKGROUND: TO DETERMINE FACTORS THAT PREDICT ADHERENCE TO A MIND-BODY INTERVENTION IN A RANDOMIZED TRIAL. DESIGN: WE ANALYZED ADHERENCE DATA FROM A 3-ARM TRIAL INVOLVING 135 GENERALLY HEALTHY SENIORS 65-85 YEARS OF AGE RANDOMIZED TO A 6-MONTH INTERVENTION CONSISTING OF: AN IYENGAR YOGA CLASS WITH HOME PRACTICE, AN EXERCISE CLASS WITH HOME PRACTICE, OR A WAIT-LIST CONTROL GROUP. OUTCOME MEASURES INCLUDED COGNITIVE FUNCTION, MOOD, FATIGUE, ANXIETY, HEALTH-RELATED QUALITY OF LIFE, AND PHYSICAL MEASURES. ADHERENCE TO THE INTERVENTION WAS OBTAINED BY CLASS ATTENDANCE AND BIWEEKLY HOME PRACTICE LOGS. RESULTS: THE DROP-OUT RATE WAS 13%. AMONG THE COMPLETERS OF THE TWO ACTIVE INTERVENTIONS, AVERAGE YOGA CLASS ATTENDANCE WAS 77% AND HOME PRACTICE OCCURRED 64% OF ALL DAYS. AVERAGE EXERCISE CLASS ATTENDANCE WAS 69% AND HOME EXERCISE OCCURRED 54% OF ALL DAYS. THERE WERE NO CLEAR EFFECTS OF ADHERENCE ON THE SIGNIFICANT STUDY OUTCOMES (QUALITY OF LIFE AND PHYSICAL MEASURES). CLASS ATTENDANCE WAS SIGNIFICANTLY CORRELATED WITH BASELINE MEASURES OF DEPRESSION, FATIGUE, AND PHYSICAL COMPONENTS OF HEALTH-RELATED QUALITY OF LIFE. SIGNIFICANT DIFFERENCES IN BASELINE MEASURES WERE ALSO FOUND BETWEEN STUDY COMPLETERS AND DROP-OUTS IN THE ACTIVE INTERVENTIONS. ADHERENCE WAS NOT RELATED TO AGE, GENDER, OR EDUCATION LEVEL. CONCLUSION: HEALTHY SENIORS HAVE GOOD ATTENDANCE AT CLASSES WITH A PHYSICALLY ACTIVE INTERVENTION. HOME PRACTICE TAKES PLACE OVER HALF OF THE TIME. DECREASED ADHERENCE TO A POTENTIALLY BENEFICIAL INTERVENTION HAS THE POTENTIAL TO DECREASE THE EFFECT OF THE INTERVENTION IN A CLINICAL TRIAL BECAUSE SUBJECTS WHO MIGHT SUSTAIN THE GREATEST BENEFIT WILL RECEIVE A LOWER DOSE OF THE INTERVENTION AND SUBJECTS WITH HIGHER ADHERENCE RATES MAY BE FUNCTIONING CLOSER TO MAXIMUM ABILITY BEFORE THE INTERVENTION. STRATEGIES TO MAXIMIZE ADHERENCE AMONG SUBJECTS AT GREATER RISK FOR LOW ADHERENCE WILL BE IMPORTANT FOR FUTURE TRIALS, ESPECIALLY COMPLEMENTARY TREATMENTS REQUIRING GREATER EFFORT THAN SIMPLE PILL-TAKING.	2007	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
8 1450  32 INFLUENCE OF INTENSITY AND DURATION OF YOGA ON ANXIETY AND DEPRESSION SCORES ASSOCIATED WITH CHRONIC ILLNESS. BACKGROUND: CHRONIC ILLNESS IS COMMONLY ASSOCIATED WITH ANXIETY AND DEPRESSION. BOTH ANXIETY AND DEPRESSION RESPOND TO YOGA. HOWEVER, THERE IS NO REPORT ON THE ASSOCIATION BETWEEN THE INTENSITY AND DURATION OF YOGA PRACTICE WITH THE BENEFITS SEEN. AIM: THE PRESENT STUDY WAS INTENDED TO DETERMINE WHETHER THE DAILY DURATION OF YOGA PRACTICE AND THE DURATION OF EXPERIENCE IN MONTHS WOULD PREDICT ANXIETY AND DEPRESSION, ASSOCIATED WITH CHRONIC ILLNESS. SUBJECTS AND METHODS: SEVEN HUNDRED AND SIXTY-THREE VOLUNTEERS WITH AGES BETWEEN 14 AND 86 YEARS (GROUP MEAN AGE STANDARD DEVIATION, 50.2 [14.2]) WHO ATTENDED A 7 DAY RESIDENTIAL YOGA CAMP IN THE NORTH OF INDIA WERE INCLUDED IN THIS CROSS-SECTIONAL STUDY. ALL PARTICIPANTS HAD CHRONIC ILLNESSES, WHICH WERE UNDER CONTROL WITH TREATMENT, AND WHICH WERE CATEGORIZED AND ARE DETAILED. PARTICIPANTS WERE ASSESSED FOR STATE ANXIETY SCORES USING STATE-TRAIT ANXIETY INVENTORY AND FOR ANXIETY WITH HOSPITAL ANXIETY AND DEPRESSION SCALE (HADS-A), AND DEPRESSION WAS ASSESSED USING HADS-D SCORES OF THE HADS. LINEAR MULTIPLE REGRESSION ANALYSES WERE PERFORMED USING PASW SPSS VERSION 18.0 (ARMONK, NEW YORK, U.S.) TO DETERMINE HOW THE DAILY AND MONTHLY DURATION OF YOGA PRACTICE COULD INFLUENCE STATE ANXIETY, HOSPITAL ANXIETY AND DEPRESSION OF THE PARTICIPANTS. RESULTS: YOGA PRACTICE IN MONTHS AND THE TIME SPENT PRACTICING YOGA EACH DAY SIGNIFICANTLY PREDICT THE LEVEL OF STATE ANXIETY (P < 0.001, P = 0.03) AND HAD-A (P < 0.01, P < 0.01). THE DURATION OF YOGA PRACTICE IN MONTHS ALONE WAS A SIGNIFICANT PREDICTOR OF THE HAD-D (P < 0.01). CONCLUSIONS: THE RESULTS SUGGEST THAT THE DURATION OF YOGA PRACTICE IN MONTHS AND DAILY PRACTICE IN MINUTES PREDICT ANXIETY ASSOCIATED WITH CHRONIC ILLNESS. IN CONTRAST THE DURATION OF YOGA PRACTICE IN MONTHS ALONE, PREDICTED DEPRESSION SCORES.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
9 2374  59 WHICH CHRONIC LOW BACK PAIN PATIENTS RESPOND FAVORABLY TO YOGA, PHYSICAL THERAPY, AND A SELF-CARE BOOK? RESPONDER ANALYSES FROM A RANDOMIZED CONTROLLED TRIAL. PURPOSE: TO IDENTIFY BASELINE CHARACTERISTICS OF ADULTS WITH CHRONIC LOW BACK PAIN (CLBP) THAT PREDICT RESPONSE (I.E., A CLINICALLY IMPORTANT IMPROVEMENT) AND/OR MODIFY TREATMENT EFFECT ACROSS THREE NONPHARMACOLOGIC INTERVENTIONS. DESIGN: SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. SETTING: ACADEMIC SAFETY NET HOSPITAL AND SEVEN FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS. SUBJECTS: ADULTS WITH CLBP (N = 299). METHODS: WE REPORT PATIENT CHARACTERISTICS THAT WERE PREDICTORS OF RESPONSE AND/OR MODIFIED TREATMENT EFFECT ACROSS THREE 12-WEEK TREATMENTS: YOGA, PHYSICAL THERAPY [PT], AND A SELF-CARE BOOK. USING PRESELECTED CHARACTERISTICS, WE USED LOGISTIC REGRESSION TO IDENTIFY PREDICTORS OF "RESPONSE," DEFINED AS A >/=30% IMPROVEMENT IN THE ROLAND MORRIS DISABILITY QUESTIONNAIRE. THEN, USING "RESPONSE" AS OUR OUTCOME, WE IDENTIFIED BASELINE CHARACTERISTICS THAT WERE TREATMENT EFFECT MODIFIERS BY TESTING FOR STATISTICAL INTERACTION (P < 0.05) ACROSS TWO COMPARISONS: 1) YOGA-OR-PT VS SELF-CARE AND 2) YOGA VS PT. RESULTS: OVERALL, 39% (116/299) OF PARTICIPANTS WERE RESPONDERS, WITH MORE RESPONDERS IN THE YOGA-OR-PT GROUP (42%) THAN THE SELF-CARE (23%) GROUP. THERE WAS NO DIFFERENCE IN PROPORTION RESPONDING TO YOGA (48%) VS PT (37%, ODDS RATIO [OR] = 1.5, 95% CONFIDENCE INTERVAL = 0.88 - 2.6). PREDICTORS OF RESPONSE INCLUDED HAVING MORE THAN A HIGH SCHOOL EDUCATION, A HIGHER INCOME, EMPLOYMENT, FEW DEPRESSIVE SYMPTOMS, LOWER PERCEIVED STRESS, FEW WORK-RELATED FEAR AVOIDANCE BELIEFS, HIGH PAIN SELF-EFFICACY, AND BEING A NONSMOKER. EFFECT MODIFIERS INCLUDED USE OF PAIN MEDICATION AND FEAR AVOIDANCE BELIEFS RELATED TO PHYSICAL ACTIVITY (BOTH P = 0.02 FOR INTERACTION). WHEN COMPARING YOGA OR PT WITH SELF-CARE, A GREATER PROPORTION WERE RESPONDERS AMONG THOSE USING PAIN MEDS (OR = 5.3), WHICH DIFFERED FROM THOSE NOT TAKING PAIN MEDS (OR = 0.94) AT BASELINE. WE ALSO FOUND GREATER TREATMENT RESPONSE AMONG THOSE WITH LOWER (OR = 7.0), BUT NOT HIGH (OR = 1.3), FEAR AVOIDANCE BELIEFS AROUND PHYSICAL ACTIVITY. CONCLUSIONS: OUR FINDINGS REVEALED IMPORTANT SUBGROUPS FOR WHOM REFERRAL TO YOGA OR PT MAY IMPROVE CLBP OUTCOMES.	2021	
                                                                                                                                                                                                                                                                                                                                                                          
10  200  45 A RESPONDER ANALYSIS OF THE EFFECTS OF YOGA FOR INDIVIDUALS WITH COPD: WHO BENEFITS AND HOW? BACKGROUND: WE PREVIOUSLY REPORTED THAT A TWICE-WEEKLY, MODIFIED IYENGAR YOGA PROGRAM WAS A SAFE AND VIABLE SELF-MANAGEMENT STRATEGY FOR PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). 1 OBJECTIVE: THE PRIMARY PURPOSE OF THIS EXPLORATORY ANALYSIS WAS TO CLASSIFY YOGA PARTICIPANTS INTO 1 OF 3 RESPONDER CATEGORIES BY USING MINIMUM CLINICALLY IMPORTANT DIFFERENCE (MCID) CRITERIA FOR EACH OF 3 VARIABLES: 6-MINUTE WALK DISTANCE (6MW), DISTRESS RELATED TO DYSPNEA (SHORTNESS OF BREATH; DD), AND FUNCTIONAL PERFORMANCE (FPI). CHANGES IN HEALTH-RELATED QUALITY OF LIFE (HRQL) AND IN PSYCHOLOGICAL WELL-BEING (ANXIETY AND DEPRESSION), AND PARTICIPANTS' SELF-REPORTED IMPROVEMENTS BY RESPONDER CATEGORY WERE ALSO EXAMINED. A SECONDARY GOAL WAS TO IDENTIFY BASELINE PARTICIPANT CHARACTERISTICS, INCLUDING INITIAL RANDOMIZATION ASSIGNMENT THAT MIGHT PREDICT RESPONSE TO TREATMENT. METHODS: PARTICIPANTS WERE RANDOMLY ASSIGNED TO EITHER AN INITIAL YOGA (IY) OR AN ENHANCED WAIT-LIST CONTROL (WLC) GROUP. THOSE IN THE WLC GROUP WERE OFFERED THE YOGA PROGRAM IMMEDIATELY FOLLOWING THE IY GROUP'S PARTICIPATION. INDIVIDUALS FROM BOTH GROUPS WHO COMPLETED AT LEAST 18 OF 24 YOGA CLASSES WERE CATEGORIZED AS RESPONDERS, PARTIAL RESPONDERS, OR NON-RESPONDERS FOR EACH OF THE 3 OUTCOME VARIABLES (6MW, DD, FPI) ON THE BASIS OF MCID CRITERIA. BASELINE CHARACTERISTICS AND CHANGES IN HRQL AND PSYCHOLOGICAL WELL-BEING WERE ALSO ANALYZED. RESULTS: NONE OF THE PARTICIPANTS DEMONSTRATED MCIDS FOR ALL 3 OUTCOMES; HOWEVER, 6 WERE CLASSIFIED AS RESPONDERS FOR 2 OUT-COME VARIABLES AND 4 WERE CLASSIFIED AS NON-RESPONDERS FOR ALL 3 OUTCOME VARIABLES. TWO-THIRDS OF THE FEMALE PARTICIPANT GROUP AND ONE-THIRD OF THE MALE PARTICIPANT GROUP COMPLETED THE YOGA PROGRAM. DD RESPONDERS SHOWED INCREASED ANXIETY LEVELS, WHEREAS ANXIETY LEVELS OF THE DD NON-RESPONDERS REMAINED UNCHANGED. FPI RESPONDERS REPORTED SIGNIFICANT IMPROVEMENTS IN PHYSICAL FUNCTION, WHEREAS PARTIAL AND NON-FPI RESPONDERS NOTED DECLINED FUNCTION. PARTICIPANTS ASSIGNED TO THE IY GROUP DEMONSTRATED GREATER BENEFIT FROM YOGA THAN DID THOSE IN THE W LC GROUP. CONCLUSIONS: ALTHOUGH THIS MODIFIED IYENGAR YOGA PROGRAM APPEARS TO HAVE BENEFITED SOME INDIVIDUALS WITH COPD, FURTHER STUDIES ARE REQUIRED TO ASSESS WHO THE INTERVENTION WORKS FOR AND UNDER WHAT CONDITIONS.	2012	
                                                                                                                                                                                                                                                              
11  388  51 BENEFITS OF THE RESTORATIVE EXERCISE AND STRENGTH TRAINING FOR OPERATIONAL RESILIENCE AND EXCELLENCE YOGA PROGRAM FOR CHRONIC LOW BACK PAIN IN SERVICE MEMBERS: A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: TO EXAMINE THE FEASIBILITY AND PRELIMINARY EFFECTIVENESS OF AN INDIVIDUALIZED YOGA PROGRAM. DESIGN: PILOT RANDOMIZED CONTROLLED TRIAL. SETTING: MILITARY MEDICAL CENTER. PARTICIPANTS: PATIENTS (N=68) WITH CHRONIC LOW BACK PAIN. INTERVENTIONS: RESTORATIVE EXERCISE AND STRENGTH TRAINING FOR OPERATIONAL RESILIENCE AND EXCELLENCE (RESTORE) PROGRAM (9-12 INDIVIDUAL YOGA SESSIONS) OR TREATMENT AS USUAL (CONTROL) FOR AN 8-WEEK PERIOD. MAIN OUTCOME MEASURES: THE PRIMARY OUTCOME WAS PAST 24-HOUR PAIN (DEFENSE & VETERANS PAIN RATING SCALE 2.0). SECONDARY OUTCOMES INCLUDED DISABILITY (ROLAND-MORRIS DISABILITY QUESTIONNAIRE) AND PHYSICAL FUNCTIONING AND SYMPTOM BURDEN (PATIENT-REPORTED OUTCOMES MEASUREMENT INFORMATION SYSTEM-29 SUBSCALES). ASSESSMENT OCCURRED AT BASELINE, WEEK 4, WEEK 8, 3-MONTH FOLLOW-UP, AND 6-MONTH FOLLOW-UP. EXPLORATORY OUTCOMES INCLUDED THE PROPORTION OF PARTICIPANTS IN EACH GROUP REPORTING CLINICALLY MEANINGFUL CHANGES AT 3- AND 6-MONTH FOLLOW-UPS. RESULTS: GENERALIZED LINEAR MIXED MODELS WITH SEQUENTIAL BONFERRONI-ADJUSTED PAIRWISE SIGNIFICANCE TESTS AND CHI-SQUARE ANALYSES EXAMINED LONGITUDINAL OUTCOMES. SECONDARY OUTCOME SIGNIFICANCE TESTS WERE BONFERRONI ADJUSTED FOR MULTIPLE OUTCOMES. THE RESTORE GROUP REPORTED IMPROVED PAIN COMPARED WITH THE CONTROL GROUP. SECONDARY OUTCOMES DID NOT RETAIN SIGNIFICANCE AFTER BONFERRONI ADJUSTMENTS FOR MULTIPLE OUTCOMES, ALTHOUGH A HIGHER PROPORTION OF RESTORE PARTICIPANTS REPORTED CLINICALLY MEANINGFULLY CHANGES IN ALL OUTCOMES AT 3-MONTH FOLLOW-UP AND IN SYMPTOM BURDEN AT 6-MONTH FOLLOW-UP. CONCLUSIONS: RESTORE MAY BE A VIABLE NONPHARMACOLOGICAL TREATMENT FOR LOW BACK PAIN WITH MINIMAL SIDE EFFECTS, AND RESEARCH EFFORTS ARE NEEDED TO COMPARE THE EFFECTIVENESS OF RESTORE DELIVERY FORMATS (EG, GROUP VS INDIVIDUAL) WITH THAT OF OTHER TREATMENT MODALITIES.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
12  521  50 COMPARING YOGA, EXERCISE, AND A SELF-CARE BOOK FOR CHRONIC LOW BACK PAIN: A RANDOMIZED, CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN IS A COMMON PROBLEM THAT HAS ONLY MODESTLY EFFECTIVE TREATMENT OPTIONS. OBJECTIVE: TO DETERMINE WHETHER YOGA IS MORE EFFECTIVE THAN CONVENTIONAL THERAPEUTIC EXERCISE OR A SELF-CARE BOOK FOR PATIENTS WITH CHRONIC LOW BACK PAIN. DESIGN: RANDOMIZED, CONTROLLED TRIAL. SETTING: A NONPROFIT, INTEGRATED HEALTH CARE SYSTEM. PATIENTS: 101 ADULTS WITH CHRONIC LOW BACK PAIN. INTERVENTION: 12-WEEK SESSIONS OF YOGA OR CONVENTIONAL THERAPEUTIC EXERCISE CLASSES OR A SELF-CARE BOOK. MEASUREMENTS: PRIMARY OUTCOMES WERE BACK-RELATED FUNCTIONAL STATUS (MODIFIED 24-POINT ROLAND DISABILITY SCALE) AND "BOTHERSOMENESS" OF PAIN (11-POINT NUMERICAL SCALE). THE PRIMARY TIME POINT WAS 12 WEEKS. CLINICALLY SIGNIFICANT CHANGE WAS CONSIDERED TO BE 2.5 POINTS ON THE FUNCTIONAL STATUS SCALE AND 1.5 POINTS ON THE BOTHERSOMENESS SCALE. SECONDARY OUTCOMES WERE DAYS OF RESTRICTED ACTIVITY, GENERAL HEALTH STATUS, AND MEDICATION USE. RESULTS: AFTER ADJUSTMENT FOR BASELINE VALUES, BACK-RELATED FUNCTION IN THE YOGA GROUP WAS SUPERIOR TO THE BOOK AND EXERCISE GROUPS AT 12 WEEKS (YOGA VS. BOOK: MEAN DIFFERENCE, -3.4 [95% CI, -5.1 TO - 1.6] [P < 0.001]; YOGA VS. EXERCISE: MEAN DIFFERENCE, -1.8 [CI, -3.5 TO - 0.1] [P = 0.034]). NO SIGNIFICANT DIFFERENCES IN SYMPTOM BOTHERSOMENESS WERE FOUND BETWEEN ANY 2 GROUPS AT 12 WEEKS; AT 26 WEEKS, THE YOGA GROUP WAS SUPERIOR TO THE BOOK GROUP WITH RESPECT TO THIS MEASURE (MEAN DIFFERENCE, -2.2 [CI, -3.2 TO - 1.2]; P < 0.001). AT 26 WEEKS, BACK-RELATED FUNCTION IN THE YOGA GROUP WAS SUPERIOR TO THE BOOK GROUP (MEAN DIFFERENCE, -3.6 [CI, -5.4 TO - 1.8]; P < 0.001). LIMITATIONS: PARTICIPANTS IN THIS STUDY WERE FOLLOWED FOR ONLY 26 WEEKS AFTER RANDOMIZATION. ONLY 1 INSTRUCTOR DELIVERED EACH INTERVENTION. CONCLUSIONS: YOGA WAS MORE EFFECTIVE THAN A SELF-CARE BOOK FOR IMPROVING FUNCTION AND REDUCING CHRONIC LOW BACK PAIN, AND THE BENEFITS PERSISTED FOR AT LEAST SEVERAL MONTHS.	2005	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
13 2852  55 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	
                                                                                                                                                                                                                                                                                                                               
14 2596  58 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	
                                                                                                                                                                                                                                                                                                                                                           
15  627  28 DIFFERENCES BETWEEN MEN AND WOMEN ENROLLING IN SMOKING CESSATION PROGRAMS USING YOGA AS A COMPLEMENTARY THERAPY. THIS STUDY COMPARES THE CHARACTERISTICS OF MEN AND WOMEN, RESPECTIVELY, PARTICIPATING IN TWO RANDOMIZED CONTROLLED PILOT STUDIES WHOSE PRIMARY AIMS WERE TO TEST THE FEASIBILITY OF YOGA AS A COMPLEMENTARY THERAPY FOR SMOKING CESSATION. PARTICIPANTS WERE AGED 18-65, GENERALLY HEALTHY AND WERE DAILY SMOKERS. ANALYSIS OF VARIANCE (ANOVA) AND CHI-SQUARE TESTS EXAMINED GENDER DIFFERENCES IN SMOKING RATE, POTENTIAL TREATMENT MEDIATORS, AND COVARIATES (E.G., SMOKING HISTORY, HEALTH STATUS, WEIGHT CONCERNS, MOOD, AND PRIOR WITHDRAWAL SYMPTOMS). A TOTAL OF 55 WOMEN AND 38 MEN PARTICIPATED IN THE STUDY. DIFFERENCES BETWEEN MEN AND WOMEN AT ENROLLMENT INCLUDED: WOMEN REPORTED SIGNIFICANTLY GREATER WITHDRAWAL (P<0.005), ANXIETY (P=0.032), AND DEPRESSION (P=0.027) SYMPTOMS THAN MEN. MORE WOMEN THAN MEN (91% VS. 66%) REPORTED HAVING BEEN TOLD BY THEIR DOCTOR TO QUIT SMOKING (P=0.003), HAD AN EXISTING SMOKING-RELATED ILLNESS (33% VS. 13%; P=0.032), AND REPORTED SMOKING FOR WEIGHT CONTROL (15% VS. 0%; P=0.014). RESULTS SHOWED GOOD FEASIBILITY FOR RECRUITING BOTH MEN AND WOMEN INTO A STUDY USING YOGA AS A COMPLEMENTARY THERAPY FOR SMOKING CESSATION. RESULTS ALSO INDICATE THAT INTERVENTIONS MAY NEED TO BE TAILORED TO MEET DIFFERENT NEEDS (E.G., ADDRESSING CO-MORBID DEPRESSION) BETWEEN MEN AND WOMEN.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
16 2457  29 YOGA AS A COMPLEMENTARY TREATMENT FOR SMOKING CESSATION: RATIONALE, STUDY DESIGN AND PARTICIPANT CHARACTERISTICS OF THE QUITTING-IN-BALANCE STUDY. BACKGROUND: TOBACCO SMOKING REMAINS THE LEADING PREVENTABLE CAUSE OF DEATH AMONG AMERICAN WOMEN. EXERCISE HAS SHOWN PROMISE AS AN AID TO SMOKING CESSATION BECAUSE IT REDUCES WEIGHT GAIN AND WEIGHT CONCERNS, IMPROVES AFFECT, AND REDUCES NICOTINE WITHDRAWAL SYMPTOMS AND CIGARETTE CRAVING. STUDIES HAVE SHOWN THAT THE PRACTICE OF YOGA IMPROVES WEIGHT CONTROL, AND REDUCES PERCEIVED STRESS AND NEGATIVE AFFECT. YOGA PRACTICE ALSO INCLUDES REGULATION OF BREATHING AND FOCUSED ATTENTION, BOTH OF WHICH MAY ENHANCE STRESS REDUCTION AND IMPROVE MOOD AND WELL-BEING AND MAY IMPROVE CESSATION OUTCOMES. METHODS/DESIGN: THIS PILOT EFFICACY STUDY IS DESIGNED TO EXAMINE THE RATES OF CESSATION AMONG WOMEN RANDOMIZED TO EITHER A NOVEL, 8-WEEK YOGA PLUS COGNITIVE BEHAVIORAL THERAPY (CBT) SMOKING CESSATION INTERVENTION VERSUS A WELLNESS PROGRAM PLUS THE SAME CBT SMOKING CESSATION INTERVENTION. OUTCOME MEASURES INCLUDE 7-DAY POINT PREVALENCE ABSTINENCE AT END OF TREATMENT, 3 AND 6 MONTHS FOLLOW UP AND POTENTIAL MEDIATING VARIABLES (E.G., CONFIDENCE IN QUITTING SMOKING, SELF-EFFICACY). OTHER ASSESSMENTS INCLUDE MEASURES OF MINDFULNESS, SPIRITUALITY, DEPRESSIVE SYMPTOMS, ANXIETY AND PERCEIVED HEALTH (SF-36). DISCUSSION: INNOVATIVE TREATMENTS ARE NEEDED THAT ADDRESS BARRIERS TO SUCCESSFUL SMOKING CESSATION AMONG MEN AND WOMEN. THE DESIGN CHOSEN FOR THIS STUDY WILL ALLOW US TO EXPLORE POTENTIAL MEDIATORS OF INTERVENTION EFFICACY SO THAT WE MAY BETTER UNDERSTAND THE MECHANISM(S) BY WHICH YOGA MAY ACT AS AN EFFECTIVE COMPLEMENTARY TREATMENT FOR SMOKING CESSATION. IF SHOWN TO BE EFFECTIVE, YOGA CAN OFFER AN ALTERNATIVE TO TRADITIONAL EXERCISE FOR REDUCING NEGATIVE SYMPTOMS THAT OFTEN ACCOMPANY SMOKING CESSATION AND PREDICT RELAPSE TO SMOKING AMONG RECENT QUITTERS. TRIAL REGISTRATION: CLINICALTRIALS NCT00492310.	2010	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
17 2455  44 YOGA AS A COMPLEMENTARY THERAPY FOR SMOKING CESSATION: RESULTS FROM BREATHEASY, A RANDOMIZED CLINICAL TRIAL. INTRODUCTION: THERE IS EVIDENCE THAT YOGA MAY BE HELPFUL AS AN AID FOR SMOKING CESSATION. YOGA HAS BEEN SHOWN TO REDUCE STRESS AND NEGATIVE MOOD AND MAY AID WEIGHT CONTROL, ALL OF WHICH HAVE PROVEN TO BE BARRIERS TO QUITTING SMOKING. THIS STUDY IS THE FIRST RIGOROUS, RANDOMIZED CLINICAL TRIAL OF YOGA AS A COMPLEMENTARY THERAPY FOR SMOKERS ATTEMPTING TO QUIT. METHODS: ADULT SMOKERS (N = 227; 55.5% WOMEN) WERE RANDOMIZED TO AN 8-WEEK PROGRAM OF COGNITIVE-BEHAVIORAL SMOKING CESSATION AND EITHER TWICE-WEEKLY IYENGAR YOGA OR GENERAL WELLNESS CLASSES (CONTROL). ASSESSMENTS INCLUDED COTININE-VERIFIED 7-DAY POINT PREVALENCE ABSTINENCE AT WEEK 8, 3-MONTH, AND 6-MONTH FOLLOW-UPS. RESULTS: AT BASELINE, PARTICIPANTS' MEAN AGE WAS 46.2 (SD = 12.0) YEARS AND SMOKING RATE WAS 17.3 (SD = 7.6) CIGARETTES/DAY. LONGITUDINALLY ADJUSTED MODELS OF ABSTINENCE OUTCOMES DEMONSTRATED SIGNIFICANT GROUP EFFECTS FAVORING YOGA. YOGA PARTICIPANTS HAD 37% GREATER ODDS OF ACHIEVING ABSTINENCE THAN WELLNESS PARTICIPANTS AT THE END OF TREATMENT (EOT). LOWER BASELINE SMOKING RATES (</=10 CIGARETTES/DAY) WERE ALSO ASSOCIATED WITH HIGHER LIKELIHOOD OF QUITTING IF GIVEN YOGA VERSUS WELLNESS (OR = 2.43, 95% CI = 1.09% TO 6.30%) CLASSES AT EOT. A SIGNIFICANT DOSE EFFECT WAS OBSERVED FOR YOGA (OR = 1.12, 95% CI = 1.09% TO 1.26%), BUT NOT WELLNESS, SUCH THAT EACH YOGA CLASS ATTENDED INCREASED QUITTING ODDS AT EOT BY 12%. LATENT CLASS MODELING REVEALED A 4-CLASS MODEL OF DISTINCT QUITTING PATTERNS AMONG PARTICIPANTS. CONCLUSIONS: YOGA APPEARS TO INCREASE THE ODDS OF SUCCESSFUL SMOKING ABSTINENCE, PARTICULARLY AMONG LIGHT SMOKERS. ADDITIONAL WORK IS NEEDED TO IDENTIFY PREDICTORS OF QUITTING PATTERNS AND INFORM ADJUSTMENTS TO THERAPY NEEDED TO ACHIEVE CESSATION AND PREVENT RELAPSE. IMPLICATIONS: THIS STUDY ADDS TO OUR KNOWLEDGE OF THE TYPES OF PHYSICAL ACTIVITY THAT AID SMOKING CESSATION. YOGA INCREASES THE ODDS OF SUCCESSFUL SMOKING ABSTINENCE, AND DOES SO IN A DOSE-RESPONSE MANNER. THIS STUDY ALSO REVEALED FOUR DISTINCT PATTERNS OF SMOKING BEHAVIOR AMONG PARTICIPANTS RELEVANT TO QUITTING SMOKING. ADDITIONAL WORK IS NEEDED TO DETERMINE WHETHER VARIABLES THAT ARE PREDICTIVE OF THESE QUITTING PATTERNS CAN BE IDENTIFIED, WHICH MIGHT SUGGEST MODIFICATIONS TO THERAPY FOR THOSE WHO ARE UNABLE TO QUIT.	2019	
                                                                                                                                                                                                                                                                              
18  518  42 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
19  461  47 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
20 2456  38 YOGA AS A COMPLEMENTARY TREATMENT FOR SMOKING CESSATION IN WOMEN. BACKGROUND: TOBACCO SMOKING REMAINS THE LEADING PREVENTABLE CAUSE OF DEATH AMONG AMERICAN WOMEN. AEROBIC EXERCISE HAS SHOWN PROMISE AS AN AID TO SMOKING CESSATION BECAUSE IT IMPROVES AFFECT AND REDUCES NICOTINE WITHDRAWAL SYMPTOMS. STUDIES OUTSIDE THE REALM OF SMOKING CESSATION HAVE SHOWN THAT YOGA PRACTICE ALSO REDUCES PERCEIVED STRESS AND NEGATIVE AFFECT. METHODS: THIS PILOT STUDY EXAMINES THE FEASIBILITY AND INITIAL EFFICACY OF YOGA AS A COMPLEMENTARY THERAPY FOR SMOKING CESSATION. FIFTY-FIVE WOMEN WERE GIVEN 8-WEEK GROUP-BASED COGNITIVE BEHAVIORAL THERAPY FOR SMOKING CESSATION AND WERE RANDOMIZED TO A TWICE-WEEKLY PROGRAM OF VINYASA YOGA OR A GENERAL HEALTH AND WELLNESS PROGRAM (CONTACT CONTROL). THE PRIMARY OUTCOME MEASURE WAS 7-DAY POINT PREVALENCE ABSTINENCE AT THE END OF TREATMENT VALIDATED BY SALIVA COTININE TESTING. LONGITUDINAL ANALYSES WERE ALSO CONDUCTED TO EXAMINE THE EFFECT OF INTERVENTION ON SMOKING CESSATION AT 3- AND 6-MONTH FOLLOW-UP. WE EXAMINED THE EFFECTS OF THE INTERVENTION ON POTENTIAL MEDIATING VARIABLES (E.G., CONFIDENCE IN QUITTING SMOKING, SELF-EFFICACY), AS WELL AS MEASURES OF DEPRESSIVE SYMPTOMS, ANXIETY, AND PERCEIVED HEALTH (SF-36). RESULTS: AT END OF TREATMENT, WOMEN IN THE YOGA GROUP HAD A GREATER 7-DAY POINT-PREVALENCE ABSTINENCE RATE THAN CONTROLS (ODDS RATIO [OR], 4.56; 95% CI, 1.1-18.6). ABSTINENCE REMAINED HIGHER AMONG YOGA PARTICIPANTS THROUGH THE SIX MONTH ASSESSMENT (OR, 1.54; 95% CI, 0.34-6.92), ALTHOUGH DIFFERENCES WERE NO LONGER STATISTICALLY SIGNIFICANT. WOMEN PARTICIPATING IN THE YOGA PROGRAM ALSO SHOWED REDUCED ANXIETY AND IMPROVEMENTS IN PERCEIVED HEALTH AND WELL-BEING WHEN COMPARED WITH CONTROLS. CONCLUSIONS: YOGA MAY BE AN EFFICACIOUS COMPLEMENTARY THERAPY FOR SMOKING CESSATION AMONG WOMEN.	2012