1 450 173 CHANGES IN CIRCULATING MICRORNA AFTER RECUMBENT ISOMETRIC YOGA PRACTICE BY PATIENTS WITH MYALGIC ENCEPHALOMYELITIS/CHRONIC FATIGUE SYNDROME: AN EXPLORATIVE PILOT STUDY. BACKGROUND: YOGA IS A REPRESENTATIVE MIND-BODY THERAPY. OUR PREVIOUS STUDIES HAVE DEMONSTRATED THAT ISOMETRIC YOGA (I.E. YOGA PROGRAMS THAT WE DEVELOPED SO INDIVIDUALS CAN PRACTICE YOGA POSES WITH A SELF-ADJUSTABLE ISOMETRIC LOAD) REDUCES THE FATIGUE OF PATIENTS WITH MYALGIC ENCEPHALOMYELITIS/CHRONIC FATIGUE SYNDROME (ME/CFS); HOWEVER, THE UNDERLYING MECHANISMS REMAIN UNCLEAR. SEVERAL STUDIES HAVE SUGGESTED THAT THE MICRO-RIBONUCLEIC ACID (MIRNA) EXPRESSION OF ME/CFS PATIENTS IS DIFFERENT FROM THAT OF HEALTHY SUBJECTS. HOWEVER, IT HAS NOT TO DATE BEEN DETERMINED IF THE PRACTICE OF ISOMETRIC YOGA CAN AFFECT MIRNA EXPRESSION. THEREFORE, WE SOUGHT TO INVESTIGATE IF ISOMETRIC YOGA IS ASSOCIATED WITH CHANGES IN THE EXPRESSION LEVELS OF SERUM MIRNA OF PATIENTS WITH ME/CFS. METHODS: THE STUDY INCLUDED NINE PATIENTS WITH ME/CFS WHO FAILED TO SHOW SATISFACTORY IMPROVEMENT AFTER AT LEAST 6 MONTHS OF TREATMENT ADMINISTERED AT OUR HOSPITAL. PATIENTS PRACTICED RECUMBENT ISOMETRIC YOGA FOR 3 MONTHS; THEY MET WITH A YOGA INSTRUCTOR EVERY 2 TO 4 WEEKS AND PARTICIPATED IN DAILY IN-HOME SESSIONS. THE EFFECT OF RECUMBENT ISOMETRIC YOGA ON FATIGUE WAS ASSESSED BY COMPARING PRE- AND POST-INTERVENTION SCORES ON THE JAPANESE VERSION OF THE 11-ITEM CHALDER FATIGUE SCALE (CFQ 11). PATIENT BLOOD SAMPLES WERE DRAWN PRE- AND POST-INTERVENTION, JUST PRIOR TO PRACTICING RECUMBENT ISOMETRIC YOGA WITH AN INSTRUCTOR. THE SERUM WAS USED FOR MIRNA ARRAY ANALYSIS WITH KNOWN HUMAN MIRNAS. RESULTS: THE AVERAGE CFQ 11 SCORE DECREASED SIGNIFICANTLY (FROM 25.3 +/- 5.5 TO 17.0 +/- 5.8, P < 0.0001) AFTER PRACTICING RECUMBENT ISOMETRIC YOGA FOR 3 MONTHS. THE MIRNA MICROARRAY ANALYSIS REVEALED THAT FOUR MIRNAS WERE SIGNIFICANTLY UPREGULATED, AND 42 WERE DOWNREGULATED AFTER THE INTERVENTION PERIOD. CONCLUSIONS: THIS EXPLORATIVE PILOT STUDY IS THE FIRST TO DEMONSTRATE CHANGES IN THE SERUM LEVELS OF SEVERAL MIRNAS AFTER REGULAR PRACTICE OF RECUMBENT ISOMETRIC YOGA. THESE MIRNAS MIGHT REPRESENT BIOMARKERS FOR THE FATIGUE-RELIEVING EFFECTS OF ISOMETRIC YOGA OF PATIENTS WITH ME/CFS. TRIAL REGISTRATION: UNIVERSITY HOSPITAL MEDICAL INFORMATION NETWORK (UMIN CTR) 000023472. REGISTERED AUG 4, 2016. 2019 2 610 67 DEVELOPMENT OF A RECUMBENT ISOMETRIC YOGA PROGRAM FOR PATIENTS WITH SEVERE CHRONIC FATIGUE SYNDROME/MYALGIC ENCEPHALOMYELITIS: A PILOT STUDY TO ASSESS FEASIBILITY AND EFFICACY. BACKGROUND: OUR PREVIOUS RANDOMIZED CONTROLLED TRIAL DEMONSTRATED THAT ISOMETRIC YOGA IN A SITTING POSITION REDUCES FATIGUE IN PATIENTS WITH CHRONIC FATIGUE SYNDROME/MYALGIC ENCEPHALOMYELITIS (CFS/ME). HOWEVER, SOME PATIENTS EXPERIENCE DIFFICULTIES SITTING OR PRACTICING ISOMETRIC YOGA IN A SITTING POSITION FOR LONG PERIODS. TO DATE, THERAPEUTIC INTERVENTIONS FOR PATIENTS WITH SEVERE SYMPTOMS HAVE NOT BEEN ESTABLISHED. THEREFORE, WE DEVELOPED A RECUMBENT ISOMETRIC YOGA PROGRAM, WHICH TAKES APPROXIMATELY 20 MIN TO COMPLETE, DESIGNED TO REDUCE FATIGUE IN PATIENTS WITH SEVERE CFS/ME. THE AIM OF THIS PILOT STUDY WAS TO ASSESS THE FEASIBILITY, SAFETY, AND USEFULNESS OF THIS PROGRAM. METHODS: THIS PILOT STUDY INCLUDED 12 ADULT PATIENTS WITH CFS/ME. SIX PATIENTS WERE RELUCTANT TO PRACTICE ISOMETRIC YOGA IN A SITTING POSITION BECAUSE OF THE SEVERITY OF THEIR FATIGUE (GROUP 1). THE REMAINING SIX PATIENTS HAD PREVIOUSLY PRACTICED ISOMETRIC YOGA IN A SITTING POSITION (GROUP 2). FOR 3 MONTHS, THE PATIENTS OF BOTH GROUPS PRACTICED RECUMBENT ISOMETRIC YOGA EVERY 2 TO 4 WEEKS WITH A YOGA INSTRUCTOR AND AT HOME ON OTHER DAYS IF THEY COULD. THE SHORT-TERM EFFECTS OF ISOMETRIC YOGA ON FATIGUE WERE ASSESSED USING THE PROFILE OF MOOD STATUS (POMS) QUESTIONNAIRE IMMEDIATELY BEFORE AND AFTER THEIR FINAL SESSION WITH THE YOGA INSTRUCTOR. THE LONG-TERM EFFECTS OF ISOMETRIC YOGA ON FATIGUE WERE ASSESSED USING THE CHALDER FATIGUE SCALE (FS) QUESTIONNAIRE BEFORE AND AFTER THE INTERVENTION PERIOD. ADVERSE EVENTS, SATISFACTION WITH THE PROGRAM, AND PREFERENCE OF YOGA POSITION (SITTING OR RECUMBENT) WERE ALSO RECORDED. RESULTS: ALL SUBJECTS COMPLETED THE INTERVENTION. IN BOTH GROUPS, THE POMS FATIGUE SCORE WAS SIGNIFICANTLY DECREASED AFTER PRACTICING THE 20-MIN YOGA PROGRAM AND THE CHALDER FS SCORE WAS DECREASED SIGNIFICANTLY AFTER THE 3-MONTH INTERVENTION PERIOD. THERE WERE NO SERIOUS ADVERSE EVENTS. ALL SUBJECTS IN GROUP 2 PREFERRED THE RECUMBENT ISOMETRIC YOGA PROGRAM OVER A SITTING YOGA PROGRAM. CONCLUSIONS: THIS STUDY SUGGESTS THAT RECUMBENT ISOMETRIC YOGA IS A FEASIBLE AND ACCEPTABLE TREATMENT FOR PATIENTS WITH CFS/ME, EVEN FOR PATIENTS WHO EXPERIENCE DIFFICULTY PRACTICING ISOMETRIC YOGA IN THE SITTING POSITION. 2017 3 2250 82 THE LONGITUDINAL EFFECTS OF SEATED ISOMETRIC YOGA ON BLOOD BIOMARKERS, AUTONOMIC FUNCTIONS, AND PSYCHOLOGICAL PARAMETERS OF PATIENTS WITH CHRONIC FATIGUE SYNDROME: A PILOT STUDY. BACKGROUND: IN A PREVIOUS RANDOMIZED CONTROLLED TRIAL, WE FOUND THAT PRACTICING SEATED ISOMETRIC YOGA REGULARLY FOR 2 MONTHS IMPROVED THE FATIGUE OF PATIENTS WITH CHRONIC FATIGUE SYNDROME (CFS) WHO ARE RESISTANT TO CONVENTIONAL THERAPY. THE AIM OF THIS PILOT STUDY WAS TO INVESTIGATE THE POSSIBLE MECHANISMS BEHIND THIS FINDING BY COMPARING BLOOD BIOMARKERS, AUTONOMIC NERVOUS FUNCTION, AND PSYCHOLOGICAL INDICES BEFORE VERSUS AFTER AN INTERVENTION PERIOD OF SEATED ISOMETRIC YOGA PRACTICE. METHODS: FIFTEEN PATIENTS WITH CFS WHO DID NOT SHOW SATISFACTORY IMPROVEMENTS AFTER AT LEAST 6 MONTHS OF CONVENTIONAL THERAPY PRACTICED SEATED ISOMETRIC YOGA (BIWEEKLY 20-MIN SESSIONS WITH A YOGA INSTRUCTOR AND DAILY PRACTICE AT HOME) FOR 2 MONTHS. THE LONGITUDINAL EFFECTS OF SEATED ISOMETRIC YOGA ON FATIGUE, BLOOD BIOMARKERS, AUTONOMIC FUNCTION, AND PSYCHOLOGICAL STATE WERE INVESTIGATED BY COMPARING THE FOLLOWING PARAMETERS BEFORE AND AFTER THE INTERVENTION PERIOD: FATIGUE SEVERITY WAS ASSESSED BY THE CHALDER FATIGUE SCALE (FS) SCORE. LEVELS OF THE BLOOD BIOMARKERS CORTISOL, DHEA-S, TNF-ALPHA, IL-6, PROLACTIN, CARNITINE, TGF-BETA1, BDNF, MHPG, HVA, AND ALPHA-MSH WERE MEASURED. THE AUTONOMIC NERVOUS FUNCTIONS ASSESSED WERE HEART RATE (HR) AND HR VARIABILITY. PSYCHOLOGICAL INDICES INCLUDED THE 20-ITEM TORONTO ALEXITHYMIA SCALE (TAS-20) AND THE HOSPITAL ANXIETY AND DEPRESSION SCALE (HADS). RESULTS: PRACTICING SEATED ISOMETRIC YOGA FOR 2 MONTHS RESULTED IN SIGNIFICANT REDUCTIONS IN THE CHALDER FS (P = 0.002) AND HADS-DEPRESSION (P = 0.02) SCORES. NO SIGNIFICANT CHANGES WERE OBSERVED IN ANY OTHER PARAMETER EVALUATED. THE CHANGE IN CHALDER FS SCORE WAS NOT CORRELATED WITH THE CHANGE IN HADS-DEPRESSION SCORE. HOWEVER, THIS CHANGE WAS POSITIVELY CORRELATED WITH CHANGES IN THE SERUM TNF-ALPHA LEVELS (P = 0.048), THE HIGH FREQUENCY COMPONENT OF HR VARIABILITY (P = 0.042), AND TAS-20 SCORES (P = 0.001). CONCLUSIONS: REGULAR PRACTICE OF SEATED ISOMETRIC YOGA FOR 2 MONTHS REDUCED THE FATIGUE AND DEPRESSIVE SYMPTOM SCORES OF PATIENTS WITH CFS WITHOUT AFFECTING ANY OTHER PARAMETERS WE INVESTIGATED. THIS STUDY FAILED TO IDENTIFY THE MARKERS RESPONSIBLE FOR THE LONGITUDINAL FATIGUE-RELIEVING EFFECT OF SEATED ISOMETRIC YOGA. HOWEVER, CONSIDERING THAT THE REDUCED FATIGUE WAS ASSOCIATED WITH DECREASED SERUM TNF-ALPHA LEVEL AND TAS-20 SCORES, FATIGUE IMPROVEMENT MIGHT BE RELATED TO REDUCED INFLAMMATION AND IMPROVED ALEXITHYMIA IN THESE PATIENTS. TRIAL REGISTRATION: UNIVERSITY HOSPITAL MEDICAL INFORMATION NETWORK (UMIN CTR) UMIN000009646. REGISTERED DEC 27, 2012. 2019 4 451 71 CHANGES IN FATIGUE, AUTONOMIC FUNCTIONS, AND BLOOD BIOMARKERS DUE TO SITTING ISOMETRIC YOGA IN PATIENTS WITH CHRONIC FATIGUE SYNDROME. BACKGROUND: IN A PREVIOUS RANDOMIZED CONTROLLED TRIAL, WE FOUND THAT SITTING ISOMETRIC YOGA IMPROVES FATIGUE IN PATIENTS WITH CHRONIC FATIGUE SYNDROME (CFS) WHO ARE RESISTANT TO CONVENTIONAL THERAPY. THE AIM OF THIS STUDY WAS TO INVESTIGATE POSSIBLE MECHANISMS BEHIND THIS FINDING, FOCUSING ON THE SHORT-TERM FATIGUE-RELIEVING EFFECT, BY COMPARING AUTONOMIC NERVOUS FUNCTION AND BLOOD BIOMARKERS BEFORE AND AFTER A SESSION OF ISOMETRIC YOGA. METHODS: FIFTEEN PATIENTS WITH CFS WHO REMAINED SYMPTOMATIC DESPITE AT LEAST 6 MONTHS OF CONVENTIONAL THERAPY PRACTICED SITTING ISOMETRIC YOGA (BIWEEKLY 20 MIN PRACTICE WITH A YOGA INSTRUCTOR AND DAILY HOME PRACTICE) FOR EIGHT WEEKS. ACUTE EFFECTS OF SITTING ISOMETRIC YOGA ON FATIGUE, AUTONOMIC FUNCTION, AND BLOOD BIOMARKERS WERE INVESTIGATED AFTER THE FINAL SESSION WITH AN INSTRUCTOR. THE EFFECT OF A SINGLE SESSION OF SITTING ISOMETRIC YOGA ON FATIGUE WAS ASSESSED BY THE PROFILE OF MOOD STATUS (POMS) QUESTIONNAIRE IMMEDIATELY BEFORE AND AFTER THE SESSION. AUTONOMIC NERVOUS FUNCTION (HEART RATE (HR) VARIABILITY) AND BLOOD BIOMARKERS (CORTISOL, DHEA-S, TNF-ALPHA, IL-6, IFN-GAMMA, IFN-ALPHA, PROLACTIN, CARNITINE, TGF-BETA1, BDNF, MHPG, AND HVA) WERE COMPARED BEFORE AND AFTER THE SESSION. RESULTS: SITTING ISOMETRIC YOGA SIGNIFICANTLY REDUCED THE POMS FATIGUE SCORE (P < 0.01) AND INCREASED THE VIGOR SCORE (P < 0.01). IT ALSO REDUCED HR (P < 0.05) AND INCREASED THE HIGH FREQUENCY POWER (P < 0.05) OF HR VARIABILITY. SITTING ISOMETRIC YOGA INCREASED SERUM LEVELS OF DHEA-S (P < 0.05), REDUCED LEVELS OF CORTISOL (P < 0.05) AND TNF-ALPHA (P < 0.05), AND HAD A TENDENCY TO REDUCE SERUM LEVELS OF PROLACTIN (P < 0.1). DECREASES IN FATIGUE SCORES CORRELATED WITH CHANGES IN PLASMA LEVELS OF TGF-BETA1 AND BDNF. IN CONTRAST, INCREASED VIGOR POSITIVELY CORRELATED WITH HVA. CONCLUSIONS: A SINGLE SESSION OF SITTING ISOMETRIC YOGA REDUCED FATIGUE AND INCREASED VIGOR IN PATIENTS WITH CFS. YOGA ALSO INCREASED VAGAL NERVE FUNCTION AND CHANGED BLOOD BIOMARKERS IN A PATTERN THAT SUGGESTED ANTI-STRESS AND ANTI-INFLAMMATORY EFFECTS. THESE CHANGES APPEAR TO BE RELATED TO THE SHORT-TERM FATIGUE-RELIEVING EFFECT OF SITTING ISOMETRIC YOGA IN PATIENTS WITH CFS. FURTHERMORE, DOPAMINERGIC NERVOUS SYSTEM ACTIVATION MIGHT ACCOUNT FOR SITTING ISOMETRIC YOGA-INDUCED INCREASES IN ENERGY IN THIS PATIENT POPULATION. TRIAL REGISTRATION: UNIVERSITY HOSPITAL MEDICAL INFORMATION NETWORK (UMIN CTR) UMIN000009646. REGISTERED DEC 27, 2012. 2018 5 1523 66 ISOMETRIC YOGA IMPROVES THE FATIGUE AND PAIN OF PATIENTS WITH CHRONIC FATIGUE SYNDROME WHO ARE RESISTANT TO CONVENTIONAL THERAPY: A RANDOMIZED, CONTROLLED TRIAL. BACKGROUND: PATIENTS WITH CHRONIC FATIGUE SYNDROME (CFS) OFTEN COMPLAIN OF PERSISTENT FATIGUE EVEN AFTER CONVENTIONAL THERAPIES SUCH AS PHARMACOTHERAPY, COGNITIVE BEHAVIORAL THERAPY, OR GRADED EXERCISE THERAPY. THE AIM OF THIS STUDY WAS TO INVESTIGATE IN A RANDOMIZED, CONTROLLED TRIAL THE FEASIBILITY AND EFFICACY OF ISOMETRIC YOGA IN PATIENTS WITH CFS WHO ARE RESISTANT TO CONVENTIONAL TREATMENTS. METHODS: THIS TRIAL ENROLLED 30 PATIENTS WITH CFS WHO DID NOT HAVE SATISFACTORY IMPROVEMENT AFTER RECEIVING CONVENTIONAL THERAPY FOR AT LEAST SIX MONTHS. THEY WERE RANDOMLY DIVIDED INTO TWO GROUPS AND WERE TREATED WITH EITHER CONVENTIONAL PHARMACOTHERAPY (CONTROL GROUP, N = 15) OR CONVENTIONAL THERAPY TOGETHER WITH ISOMETRIC YOGA PRACTICE THAT CONSISTED OF BIWEEKLY, 20-MINUTE SESSIONS WITH A YOGA INSTRUCTOR AND DAILY IN-HOME SESSIONS (YOGA GROUP, N = 15) FOR APPROXIMATELY TWO MONTHS. THE SHORT-TERM EFFECT OF ISOMETRIC YOGA ON FATIGUE WAS ASSESSED BY ADMINISTRATION OF THE PROFILE OF MOOD STATUS (POMS) QUESTIONNAIRE IMMEDIATELY BEFORE AND AFTER THE FINAL 20-MINUTE SESSION WITH THE INSTRUCTOR. THE LONG-TERM EFFECT OF ISOMETRIC YOGA ON FATIGUE WAS ASSESSED BY ADMINISTRATION OF THE CHALDER'S FATIGUE SCALE (FS) QUESTIONNAIRE TO BOTH GROUPS BEFORE AND AFTER THE INTERVENTION. ADVERSE EVENTS AND CHANGES IN SUBJECTIVE SYMPTOMS WERE RECORDED FOR SUBJECTS IN THE YOGA GROUP. RESULTS: ALL SUBJECTS COMPLETED THE INTERVENTION. THE MEAN POMS FATIGUE SCORE DECREASED SIGNIFICANTLY (FROM 21.9 +/- 7.7 TO 13.8 +/- 6.7, P < 0.001) AFTER A YOGA SESSION. THE CHALDER'S FS SCORE DECREASED SIGNIFICANTLY (FROM 25.9 +/- 6.1 TO 19.2 +/- 7.5, P = 0.002) IN THE YOGA GROUP, BUT NOT IN THE CONTROL GROUP. IN ADDITION TO THE IMPROVEMENT OF FATIGUE, TWO PATIENTS WITH CFS AND FIBROMYALGIA SYNDROME IN THE YOGA GROUP ALSO REPORTED PAIN RELIEF. FURTHERMORE, MANY SUBJECTS REPORTED THAT THEIR BODIES BECAME WARMER AND LIGHTER AFTER PRACTICING ISOMETRIC YOGA. ALTHOUGH THERE WERE NO SERIOUS ADVERSE EVENTS IN THE YOGA GROUP, TWO PATIENTS COMPLAINED OF TIREDNESS AND ONE OF DIZZINESS AFTER THE FIRST YOGA SESSION WITH THE INSTRUCTOR. CONCLUSIONS: ISOMETRIC YOGA AS AN ADD-ON THERAPY IS BOTH FEASIBLE AND SUCCESSFUL AT RELIEVING THE FATIGUE AND PAIN OF A SUBSET OF THERAPY-RESISTANT PATIENTS WITH CFS. TRIAL REGISTRATION: UNIVERSITY HOSPITAL MEDICAL INFORMATION NETWORK (UMIN CTR) UMIN000009646. 2014 6 661 60 EFFECT OF 12 WEEKS OF YOGA TRAINING ON THE SOMATIZATION, PSYCHOLOGICAL SYMPTOMS, AND STRESS-RELATED BIOMARKERS OF HEALTHY WOMEN. BACKGROUND: PREVIOUS STUDIES HAVE SHOWN THAT THE PRACTICE OF YOGA REDUCES PERCEIVED STRESS AND NEGATIVE FEELINGS AND THAT IT IMPROVES PSYCHOLOGICAL SYMPTOMS. OUR PREVIOUS STUDY ALSO SUGGESTED THAT LONG-TERM YOGA TRAINING IMPROVES STRESS-RELATED PSYCHOLOGICAL SYMPTOMS SUCH AS ANXIETY AND ANGER. HOWEVER, LITTLE IS KNOWN ABOUT THE BENEFICIAL EFFECTS OF YOGA PRACTICE ON SOMATIZATION, THE MOST COMMON STRESS-RELATED PHYSICAL SYMPTOMS, AND STRESS-RELATED BIOMARKERS. WE PERFORMED A PROSPECTIVE, SINGLE ARM STUDY TO EXAMINE THE BENEFICIAL EFFECTS OF 12 WEEKS OF YOGA TRAINING ON SOMATIZATION, PSYCHOLOGICAL SYMPTOMS, AND STRESS-RELATED BIOMARKERS. METHODS: WE RECRUITED HEALTHY WOMEN WHO HAD NO EXPERIENCE WITH YOGA. THE DATA OF 24 PARTICIPANTS WHO WERE FOLLOWED DURING 12 WEEKS OF YOGA TRAINING WERE ANALYZED. SOMATIZATION AND PSYCHOLOGICAL SYMPTOMS WERE ASSESSED BEFORE AND AFTER 12 WEEKS OF YOGA TRAINING USING THE PROFILE OF MOOD STATE (POMS) AND THE SYMPTOM CHECKLIST-90-REVISED (SCL-90-R) QUESTIONNAIRES. URINARY 8-HYDROXYDEOXYGUANOSINE (8-OHDG), BIOPYRRIN, AND CORTISOL LEVELS WERE MEASURED AS STRESS-RELATED BIOMARKERS. THE WILCOXON SIGNED-RANK TEST WAS USED TO COMPARE THE STRESS-RELATED BIOMARKERS AND THE SCORES OF QUESTIONNAIRES BEFORE AND AFTER 12 WEEKS OF YOGA TRAINING. RESULTS: AFTER 12 WEEKS OF YOGA TRAINING, ALL NEGATIVE SUBSCALE SCORES (TENSION-ANXIETY, DEPRESSION, ANGER-HOSTILITY, FATIGUE, AND CONFUSION) FROM THE POMS AND SOMATIZATION, ANXIETY, DEPRESSION, AND HOSTILITY FROM THE SCL-90-R WERE SIGNIFICANTLY DECREASED COMPARED WITH THOSE BEFORE STARTING YOGA TRAINING. CONTRARY TO OUR EXPECTATION, THE URINARY 8-OHDG CONCENTRATION AFTER 12 WEEKS OF YOGA TRAINING SHOWED A SIGNIFICANT INCREASE COMPARED WITH THAT BEFORE STARTING YOGA TRAINING. NO SIGNIFICANT CHANGES WERE OBSERVED IN THE LEVELS OF URINARY BIOPYRRIN AND CORTISOL AFTER THE 12 WEEKS OF YOGA TRAINING. CONCLUSIONS: YOGA TRAINING HAS THE POTENTIAL TO REDUCE THE SOMATIZATION SCORE AND THE SCORES RELATED TO MENTAL HEALTH INDICATORS, SUCH AS ANXIETY, DEPRESSION, ANGER, AND FATIGUE. THE PRESENT FINDINGS SUGGEST THAT YOGA CAN IMPROVE SOMATIZATION AND MENTAL HEALTH STATUS AND HAS IMPLICATIONS FOR THE PREVENTION OF PSYCHOSOMATIC SYMPTOMS IN HEALTHY WOMEN. TRIAL REGISTRATION: UNIVERSITY HOSPITAL MEDICAL INFORMATION NETWORK (UMIN CTR) UMIN000007868. 2014 7 1898 39 RESTORATIVE YOGA AND METABOLIC RISK FACTORS: THE PRACTICING RESTORATIVE YOGA VS. STRETCHING FOR THE METABOLIC SYNDROME (PRYSMS) RANDOMIZED TRIAL. AIMS: INTENSIVE LIFESTYLE CHANGE PREVENTS TYPE 2 DIABETES BUT IS DIFFICULT TO SUSTAIN. PRELIMINARY EVIDENCE SUGGESTS THAT YOGA MAY IMPROVE METABOLIC FACTORS. WE TESTED A RESTORATIVE YOGA INTERVENTION VS. ACTIVE STRETCHING FOR METABOLIC OUTCOMES. METHODS: IN 2009-2012, WE CONDUCTED A 48-WEEK RANDOMIZED TRIAL COMPARING RESTORATIVE YOGA VS. STRETCHING AMONG UNDERACTIVE ADULTS WITH THE METABOLIC SYNDROME AT THE UNIVERSITIES OF CALIFORNIA, SAN FRANCISCO AND SAN DIEGO. WE PROVIDED LIFESTYLE COUNSELING AND A TAPERING SERIES OF 90-MIN GROUP CLASSES IN THE 24-WEEK INTERVENTION PERIOD AND 24-WEEK MAINTENANCE PERIOD. FASTING AND 2-H GLUCOSE, HBA1C, TRIGLYCERIDES, HDL-CHOLESTEROL, INSULIN, SYSTOLIC BLOOD PRESSURE, VISCERAL FAT, AND QUALITY OF LIFE WERE ASSESSED AT BASELINE, 6- AND 12-MONTHS. RESULTS: 180 PARTICIPANTS WERE RANDOMIZED AND 135 (75%) COMPLETED THE TRIAL. AT 12 MONTHS, FASTING GLUCOSE DECREASED MORE IN THE YOGA GROUP THAN IN THE STRETCHING GROUP (-0.35 MMOL/L VS. -0.03 MMOL/L; P=0.002); THERE WERE NO OTHER SIGNIFICANT DIFFERENCES BETWEEN GROUPS. AT 6 MONTHS FAVORABLE CHANGES WITHIN THE YOGA GROUP INCLUDED REDUCTIONS IN FASTING GLUCOSE, INSULIN, AND HBA1C AND AN INCREASE IN HDL-CHOLESTEROL THAT WERE NOT SUSTAINED AT 1 YEAR EXCEPT CHANGES IN FASTING GLUCOSE. THE STRETCHING GROUP HAD A SIGNIFICANT REDUCTION IN TRIGLYCERIDES AT 6 MONTHS WHICH WAS NOT SUSTAINED AT 1 YEAR BUT HAD IMPROVED QUALITY OF LIFE AT BOTH TIME-POINTS. CONCLUSIONS: RESTORATIVE YOGA WAS MARGINALLY BETTER THAN STRETCHING FOR IMPROVING FASTING GLUCOSE BUT NOT OTHER METABOLIC FACTORS. 2014 8 2604 43 YOGA FOR PERSISTENT FATIGUE IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CANCER-RELATED FATIGUE AFFLICTS UP TO 33% OF BREAST CANCER SURVIVORS, YET THERE ARE NO EMPIRICALLY VALIDATED TREATMENTS FOR THIS SYMPTOM. METHODS: THE AUTHORS CONDUCTED A 2-GROUP RANDOMIZED CONTROLLED TRIAL TO DETERMINE THE FEASIBILITY AND EFFICACY OF AN IYENGAR YOGA INTERVENTION FOR BREAST CANCER SURVIVORS WITH PERSISTENT POST-TREATMENT FATIGUE. PARTICIPANTS WERE BREAST CANCER SURVIVORS WHO HAD COMPLETED CANCER TREATMENTS (OTHER THAN ENDOCRINE THERAPY) AT LEAST 6 MONTHS BEFORE ENROLLMENT, REPORTED SIGNIFICANT CANCER-RELATED FATIGUE, AND HAD NO OTHER MEDICAL CONDITIONS THAT WOULD ACCOUNT FOR FATIGUE SYMPTOMS OR INTERFERE WITH YOGA PRACTICE. BLOCK RANDOMIZATION WAS USED TO ASSIGN PARTICIPANTS TO A 12-WEEK, IYENGAR-BASED YOGA INTERVENTION OR TO 12 WEEKS OF HEALTH EDUCATION (CONTROL). THE PRIMARY OUTCOME WAS CHANGE IN FATIGUE MEASURED AT BASELINE, IMMEDIATELY POST-TREATMENT, AND 3 MONTHS AFTER TREATMENT COMPLETION. ADDITIONAL OUTCOMES INCLUDED CHANGES IN VIGOR, DEPRESSIVE SYMPTOMS, SLEEP, PERCEIVED STRESS, AND PHYSICAL PERFORMANCE. INTENT-TO-TREAT ANALYSES WERE CONDUCTED WITH ALL RANDOMIZED PARTICIPANTS USING LINEAR MIXED MODELS. RESULTS: THIRTY-ONE WOMEN WERE RANDOMLY ASSIGNED TO YOGA (N = 16) OR HEALTH EDUCATION (N = 15). FATIGUE SEVERITY DECLINED SIGNIFICANTLY FROM BASELINE TO POST-TREATMENT AND OVER A 3-MONTH FOLLOW-UP IN THE YOGA GROUP RELATIVE TO CONTROLS (P = .032). IN ADDITION, THE YOGA GROUP HAD SIGNIFICANT INCREASES IN VIGOR RELATIVE TO CONTROLS (P = .011). BOTH GROUPS HAD POSITIVE CHANGES IN DEPRESSIVE SYMPTOMS AND PERCEIVED STRESS (P < .05). NO SIGNIFICANT CHANGES IN SLEEP OR PHYSICAL PERFORMANCE WERE OBSERVED. CONCLUSIONS: A TARGETED YOGA INTERVENTION LED TO SIGNIFICANT IMPROVEMENTS IN FATIGUE AND VIGOR AMONG BREAST CANCER SURVIVORS WITH PERSISTENT FATIGUE SYMPTOMS. 2012 9 2836 40 YOGA'S IMPACT ON INFLAMMATION, MOOD, AND FATIGUE IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. PURPOSE: TO EVALUATE YOGA'S IMPACT ON INFLAMMATION, MOOD, AND FATIGUE. PATIENTS AND METHODS: A RANDOMIZED CONTROLLED 3-MONTH TRIAL WAS CONDUCTED WITH TWO POST-TREATMENT ASSESSMENTS OF 200 BREAST CANCER SURVIVORS ASSIGNED TO EITHER 12 WEEKS OF 90-MINUTE TWICE PER WEEK HATHA YOGA CLASSES OR A WAIT-LIST CONTROL. THE MAIN OUTCOME MEASURES WERE LIPOPOLYSACCHARIDE-STIMULATED PRODUCTION OF PROINFLAMMATORY CYTOKINES INTERLEUKIN-6 (IL-6), TUMOR NECROSIS FACTOR ALPHA (TNF-ALPHA), AND INTERLEUKIN-1BETA (IL-1BETA), AND SCORES ON THE MULTIDIMENSIONAL FATIGUE SYMPTOM INVENTORY-SHORT FORM (MFSI-SF), THE VITALITY SCALE FROM THE MEDICAL OUTCOMES STUDY 36-ITEM SHORT FORM (SF-36), AND THE CENTER FOR EPIDEMIOLOGICAL STUDIES-DEPRESSION (CES-D) SCALE. RESULTS: IMMEDIATELY POST-TREATMENT, FATIGUE WAS NOT LOWER (P > .05) BUT VITALITY WAS HIGHER (P = .01) IN THE YOGA GROUP COMPARED WITH THE CONTROL GROUP. AT 3 MONTHS POST-TREATMENT, FATIGUE WAS LOWER IN THE YOGA GROUP (P = .002), VITALITY WAS HIGHER (P = .01), AND IL-6 (P = .027), TNF-ALPHA (P = .027), AND IL-1BETA (P = .037) WERE LOWER FOR YOGA PARTICIPANTS COMPARED WITH THE CONTROL GROUP. GROUPS DID NOT DIFFER ON DEPRESSION AT EITHER TIME (P > .2). PLANNED SECONDARY ANALYSES SHOWED THAT THE FREQUENCY OF YOGA PRACTICE HAD STRONGER ASSOCIATIONS WITH FATIGUE AT BOTH POST-TREATMENT VISITS (P = .019; P < .001), AS WELL AS VITALITY (P = .016; P = .0045), BUT NOT DEPRESSION (P > .05) THAN SIMPLE GROUP ASSIGNMENT; MORE FREQUENT PRACTICE PRODUCED LARGER CHANGES. AT 3 MONTHS POST-TREATMENT, INCREASING YOGA PRACTICE ALSO LED TO A DECREASE IN IL-6 (P = .01) AND IL-1BETA (P = .03) PRODUCTION BUT NOT IN TNF-ALPHA PRODUCTION (P > .05). CONCLUSION: CHRONIC INFLAMMATION MAY FUEL DECLINES IN PHYSICAL FUNCTION LEADING TO FRAILTY AND DISABILITY. IF YOGA DAMPENS OR LIMITS BOTH FATIGUE AND INFLAMMATION, THEN REGULAR PRACTICE COULD HAVE SUBSTANTIAL HEALTH BENEFITS. 2014 10 1313 59 HEALTH-RELATED BENEFITS AND ADVERSE EVENTS ASSOCIATED WITH YOGA CLASSES AMONG PARTICIPANTS THAT ARE HEALTHY, IN POOR HEALTH, OR WITH CHRONIC DISEASES. BACKGROUND: OUR PREVIOUS STUDY DEMONSTRATED THAT 42% OF YOGA CLASS PARTICIPANTS IN JAPAN HAD CHRONIC DISEASES REQUIRING MEDICATION. THIS RAISES THE QUESTION AS TO WHETHER THOSE WITH CHRONIC DISEASES WOULD BENEFIT FROM PRACTICING YOGA OR IF THEY ARE AT HIGHER RISK FOR SPECIFIC ADVERSE EVENTS COMPARED TO HEALTHY INDIVIDUALS RECEIVING THE SAME INSTRUCTION. METHODS: TO ADDRESS THESE QUESTIONS, 328 ADULTS WHO STARTED PRACTICING YOGA FOR THE FIRST TIME WERE ASKED TO COMPLETE THE PROFILE OF MOOD STATES (POMS), PERCEIVED STRESS SCALE (PSS), AND MEDICAL OUTCOMES STUDY SHORT FORM 8, STANDARD VERSION (SF-8) AND TO RECORD ANY ADVERSE EVENTS ON THE FIRST DAY OF THE YOGA CLASS AND AGAIN THREE MONTHS LATER. THE PARTICIPANTS CONSISTED OF THREE GROUPS: A HEALTHY (H) GROUP (N = 70), A POOR HEALTH (PH) GROUP (N = 117), AND A CHRONIC DISEASE (CD) GROUP (N = 141). THE DEGREE OF SUBJECTIVE SYMPTOMS WAS ALSO COMPARED BETWEEN THE PRE- AND POST-INTERVENTION PERIOD IN THE PH AND CD GROUPS. RESULTS: TYPICALLY, YOGA CLASSES WERE HELD ONCE A WEEK FOR 60-90 MIN. THE PROGRAMS INCLUDED ASANAS, PRANAYAMAS, MEDITATION, ISOMETRIC YOGA, AND SUKSHMA VYAYAMA. IN THE PH AND CD GROUPS, THE POMS TENSION-ANXIETY AND FATIGUE SCORES DECREASED AND THE VIGOR SCORE INCREASED SIGNIFICANTLY AFTER THE FIRST CLASS. FURTHERMORE, PSS SCORES DECREASED AND THE SF-8 SCORES INCREASED SIGNIFICANTLY THREE MONTHS LATER. THE DEGREE OF SUBJECTIVE SYMPTOMS SUCH AS EASY FATIGABILITY, SHOULDER STIFFNESS, AND INSOMNIA ALSO DECREASED OVER THREE MONTHS. INDIVIDUALS IN THESE GROUPS EXPERIENCED MORE FREQUENT ADVERSE EVENTS THAN THOSE IN THE H GROUP. THE PH AND CD GROUPS ALSO EXPERIENCED A GREATER VARIETY OF SYMPTOMS, INCLUDING PSYCHOLOGICAL ONES, NOT REPORTED BY THE H GROUP. ADVERSE EVENTS WERE NOT SO SERIOUS THAT PARTICIPANTS STOPPED PRACTICING YOGA DURING THE CLASS. ABOUT 60% OF ALL PARTICIPANTS WERE HIGHLY SATISFIED WITH PARTICIPATING IN YOGA CLASSES. CONCLUSIONS: IF YOGA CLASSES ARE CONDUCTED WITH ATTENTION TO POSSIBLE ADVERSE EVENTS, YOGA PRACTICE IN A YOGA STUDIO MAY HAVE BENEFICIAL EFFECTS FOR PEOPLE WITH FUNCTIONAL SOMATIC SYMPTOMS AND CHRONIC DISEASES, AS WELL AS HEALTHY PARTICIPANTS. THESE BENEFITS INCLUDE REDUCTIONS IN PERCEIVED STRESS AND UNCOMFORTABLE SYMPTOMS AS WELL AS IMPROVED MOOD AND QUALITY OF LIFE. 2021 11 1683 47 ONLINE YOGA TO REDUCE POST TRAUMATIC STRESS IN WOMEN WHO HAVE EXPERIENCED STILLBIRTH: A RANDOMIZED CONTROL FEASIBILITY TRIAL. BACKGROUND: ABOUT 1 IN EVERY 150 PREGNANCIES END IN STILLBIRTH. CONSEQUENCES INCLUDE SYMPTOMS OF POST TRAUMATIC STRESS DISORDER (PTSD), DEPRESSION, AND ANXIETY. YOGA HAS BEEN USED TO TREAT PTSD IN OTHER POPULATIONS AND MAY IMPROVE HEALTH OUTCOMES FOR STILLBIRTH MOTHERS. THE PURPOSE OF THIS STUDY WAS TO DETERMINE: (A) FEASIBILITY OF A 12-WEEK HOME-BASED, ONLINE YOGA INTERVENTION WITH VARYING DOSES; (B) ACCEPTABILITY OF A "STRETCH AND TONE" CONTROL GROUP; AND (C) PRELIMINARY EFFICACY OF THE INTERVENTION ON REDUCING SYMPTOMS OF PTSD, ANXIETY, DEPRESSION, PERINATAL GRIEF, SELF-COMPASSION, EMOTIONAL REGULATION, MINDFULNESS, SLEEP QUALITY, AND SUBJECTIVE HEALTH. METHODS: PARTICIPANTS (N = 90) WERE RECRUITED NATIONALLY AND RANDOMIZED INTO ONE OF THREE GROUPS FOR YOGA OR EXERCISE (LOW DOSE (LD), 60 MIN PER WEEK; MODERATE DOSE (MD), 150 MIN PER WEEK; AND STRETCH-AND-TONE CONTROL GROUP (STC)). BASELINE AND POST-INTERVENTION SURVEYS MEASURED MAIN OUTCOMES (LISTED ABOVE). FREQUENCY ANALYSES WERE USED TO DETERMINE FEASIBILITY. REPEATED MEASURES ANCOVA WERE USED TO DETERMINE PRELIMINARY EFFICACY. MULTIPLE REGRESSION ANALYSES WERE USED TO DETERMINE A DOSE-RESPONSE RELATIONSHIP BETWEEN MINUTES OF YOGA AND EACH OUTCOME VARIABLE. RESULTS: OVER HALF OF PARTICIPANTS COMPLETED THE INTERVENTION (N = 48/90). BENCHMARKS (>/=70% REPORTED > 75% SATISFACTION) WERE MET IN EACH GROUP FOR SATISFACTION AND ENJOYMENT. PARTICIPANTS MEETING BENCHMARKS (COMPLETING > 90% OF PRESCRIBED MINUTES 9/12 WEEKS) FOR LD AND MD GROUPS WERE 44% (N = 8/18) AND 6% (N = 1/16), RESPECTIVELY. LD AND MD GROUPS AVERAGED 44.0 AND 77.3 MIN PER WEEK OF YOGA, RESPECTIVELY. THE MD GROUP REPORTED THAT 150 PRESCRIBED MINUTES PER WEEK OF YOGA WAS TOO MUCH. THERE WERE SIGNIFICANT DECREASES IN PTSD AND DEPRESSION, AND IMPROVEMENTS IN SELF-RATED HEALTH AT POST-INTERVENTION FOR BOTH INTERVENTION GROUPS. THERE WAS A SIGNIFICANT DIFFERENCE IN DEPRESSION SCORES (P = .036) AND GRIEF INTENSITY (P = .009) BETWEEN THE MD AND STC GROUPS. PTSD SHOWED NON-SIGNIFICANT DECREASES OF 43% AND 56% AT POST-INTERVENTION IN LD AND MD GROUPS, RESPECTIVELY (22% DECREASE IN CONTROL). CONCLUSIONS: THIS WAS THE FIRST STUDY TO DETERMINE THE FEASIBILITY AND PRELIMINARY EFFICACY OF AN ONLINE YOGA INTERVENTION FOR WOMEN AFTER STILLBIRTH. FUTURE RESEARCH WARRANTS A RANDOMIZED CONTROLLED TRIAL. TRIAL REGISTRATION: CLINICALTRIALS.GOV. NCT02925481. REGISTERED 10-04-16. 2020 12 1036 35 EFFECTS OF YOGA IN MANAGING FATIGUE IN BREAST CANCER PATIENTS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CANCER-RELATED FATIGUE IS WIDELY PREVALENT IN CANCER PATIENTS AND AFFECTS QUALITY OF LIFE IN ADVANCED CANCER PATIENTS. FATIGUE IS CAUSED DUE TO BOTH PSYCHOLOGIC DISTRESS AND PHYSIOLOGICAL SEQUEL FOLLOWING CANCER PROGRESSION AND ITS TREATMENT. IN THIS STUDY, WE EVALUATE THE EFFECTS OF YOGIC INTERVENTION IN MANAGING FATIGUE IN METASTATIC BREAST CANCER PATIENTS. METHODS: NINETY-ONE PATIENTS WITH METASTATIC BREAST CANCER WERE RANDOMIZED TO RECEIVE INTEGRATED YOGA PROGRAM (N = 46) OR SUPPORTIVE THERAPY AND EDUCATION (N = 45) OVER A 3-MONTH PERIOD. ASSESSMENTS SUCH AS PERCEIVED STRESS, FATIGUE SYMPTOM INVENTORY, DIURNAL SALIVARY CORTISOL, AND NATURAL KILLER CELL COUNTS WERE CARRIED OUT BEFORE AND AFTER INTERVENTION. ANALYSIS WAS DONE USING AN INTENTION-TO-TREAT APPROACH. POSTMEASURES FOR THE ABOVE OUTCOMES WERE ASSESSED USING ANCOVA WITH RESPECTIVE BASELINE MEASURE AS A COVARIATE. RESULTS: THE RESULTS SUGGEST THAT YOGA REDUCES PERCEIVED STRESS (P = 0.001), FATIGUE FREQUENCY (P < 0.001), FATIGUE SEVERITY (P < 0.001), INTERFERENCE (P < 0.001), AND DIURNAL VARIATION (P < 0.001) WHEN COMPARED TO SUPPORTIVE THERAPY. THERE WAS A POSITIVE CORRELATION OF CHANGE IN FATIGUE SEVERITY WITH 9 A.M. SALIVARY CORTISOL LEVELS. CONCLUSION: THE RESULTS SUGGEST THAT YOGA REDUCES FATIGUE IN ADVANCED BREAST CANCER PATIENTS. 2017 13 851 42 EFFECT OF YOGA ON SLEEP QUALITY AND NEUROENDOCRINE IMMUNE RESPONSE IN METASTATIC BREAST CANCER PATIENTS. BACKGROUND: STUDIES HAVE SHOWN THAT DISTRESS AND ACCOMPANYING NEUROENDOCRINE STRESS RESPONSES AS IMPORTANT PREDICTOR OF SURVIVAL IN ADVANCED BREAST CANCER PATIENTS. SOME PSYCHOTHERAPEUTIC INTERVENTION STUDIES HAVE SHOWN HAVE MODULATION OF NEUROENDOCRINE-IMMUNE RESPONSES IN ADVANCED BREAST CANCER PATIENTS. IN THIS STUDY, WE EVALUATE THE EFFECTS OF YOGA ON PERCEIVED STRESS, SLEEP, DIURNAL CORTISOL, AND NATURAL KILLER (NK) CELL COUNTS IN PATIENTS WITH METASTATIC CANCER. METHODS: IN THIS STUDY, 91 PATIENTS WITH METASTATIC BREAST CANCER WHO SATISFIED SELECTION CRITERIA AND CONSENTED TO PARTICIPATE WERE RECRUITED AND RANDOMIZED TO RECEIVE "INTEGRATED YOGA BASED STRESS REDUCTION PROGRAM" (N = 45) OR STANDARD "EDUCATION AND SUPPORTIVE THERAPY SESSIONS" (N = 46) OVER A 3 MONTH PERIOD. PSYCHOMETRIC ASSESSMENTS FOR SLEEP QUALITY WERE DONE BEFORE AND AFTER INTERVENTION. BLOOD DRAWS FOR NK CELL COUNTS WERE COLLECTED BEFORE AND AFTER THE INTERVENTION. SALIVA SAMPLES WERE COLLECTED FOR THREE CONSECUTIVE DAYS BEFORE AND AFTER INTERVENTION. DATA WERE ANALYZED USING THE ANALYSIS OF COVARIANCE ON POSTMEASURES USING RESPECTIVE BASELINE MEASURE AS A COVARIATE. RESULTS: THERE WAS A SIGNIFICANT DECREASE IN SCALES OF SYMPTOM DISTRESS (P < 0.001), SLEEP PARAMETERS (P = 0.02), AND IMPROVEMENT IN QUALITY OF SLEEP (P = 0.001) AND INSOMNIA RATING SCALE SLEEP SCORE (P = 0.001) FOLLOWING INTERVENTION. THERE WAS A DECREASE IN MORNING WAKING CORTISOL IN YOGA GROUP (P = 0.003) ALONE FOLLOWING INTERVENTION. THERE WAS A SIGNIFICANT IMPROVEMENT IN NK CELL PERCENT (P = 0.03) FOLLOWING INTERVENTION IN YOGA GROUP COMPARED TO CONTROL GROUP. CONCLUSION: THE RESULTS SUGGEST MODULATION OF NEUROENDOCRINE RESPONSES AND IMPROVEMENT IN SLEEP IN PATIENTS WITH ADVANCED BREAST CANCER FOLLOWING YOGA INTERVENTION. 2017 14 1761 39 POSITIVE THERAPEUTIC AND NEUROTROPIC EFFECTS OF YOGA IN DEPRESSION: A COMPARATIVE STUDY. CONTEXT: THERAPEUTIC EFFECT OF YOGA IN DEPRESSION IS RECOGNIZED. NEUROPLASTIC EFFECTS OF ANTIDEPRESSANT THERAPIES ARE INFERRED BY ELEVATIONS IN BRAIN-DERIVED NEUROTROPHIC FACTOR (BDNF). ROLE OF YOGA IN BOTH THESE EFFECTS HAS NOT BEEN STUDIED. MATERIALS AND METHODS: NON-SUICIDAL, CONSECUTIVE OUT-PATIENTS OF DEPRESSION WERE OFFERED YOGA EITHER ALONE OR WITH ANTIDEPRESSANTS. THE DEPRESSION SEVERITY WAS RATED ON HAMILTON DEPRESSION RATING SCALE (HDRS) BEFORE AND AT 3 MONTHS. SERUM BDNF LEVELS WERE MEASURED AT THE SAME TIME POINTS. REPEATED-MEASURES ANALYSIS OF VARIANCE WAS PERFORMED TO LOOK AT CHANGE ACROSS GROUPS WITH RESPECT TO HDRS SCORES AND BDNF LEVELS OVER 3 MONTHS OF FOLLOW-UP. RELATIONSHIP BETWEEN CHANGE IN SERUM BDNF LEVELS AND CHANGE IN HDRS SCORES WAS ASSESSED USING THE PEARSON'S CORRELATION COEFFICIENT. RESULTS: BOTH YOGA GROUPS WERE BETTER THAN DRUGS-ONLY GROUP WITH RESPECT TO REDUCTION IN HDRS SCORES. SERUM BDNF ROSE IN THE TOTAL SAMPLE IN THE 3-MONTH PERIOD. THIS WAS NOT, HOWEVER, DIFFERENT ACROSS TREATMENT GROUPS. THERE WAS A SIGNIFICANT POSITIVE CORRELATION BETWEEN FALL IN HDRS AND RISE IN SERUM BDNF LEVELS IN YOGA-ONLY GROUP (R=0.702; P=0.001), BUT NOT IN THOSE RECEIVING YOGA AND ANTIDEPRESSANTS OR ANTIDEPRESSANTS-ALONE. CONCLUSIONS: NEUROPLASTIC MECHANISMS MAY BE RELATED TO THE THERAPEUTIC MECHANISMS OF YOGA IN DEPRESSION. 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 16 881 39 EFFECT OF YOGA TRAINING ON INFLAMMATORY CYTOKINES AND C-REACTIVE PROTEIN IN EMPLOYEES OF SMALL-SCALE INDUSTRIES. OBJECTIVE: THE PRESENT STUDY INTENDS TO SEE THE EFFECT OF YOGA PRACTICES ON LIPID PROFILE, INTERLEUKIN (IL)-6, TUMOR NECROSIS FACTOR (TNF)-ALPHA, AND HIGH-SENSITIVITY-C-REACTIVE PROTEIN (HS-CRP) AMONG APPARENTLY HEALTHY ADULTS EXPOSED TO OCCUPATIONAL HAZARDS. MATERIALS AND METHODS: IN THE PRESENT STUDY, 48 PARTICIPANTS AGED 30-58 YEARS (41.5 +/- 5.2) WHO WERE EXPOSED TO OCCUPATIONAL HAZARDS WERE RANDOMIZED INTO TWO GROUPS, THAT IS, EXPERIMENTAL AND WAIT-LIST CONTROL. ALL THE PARTICIPANTS WERE ASSESSED FOR LIPID PROFILE, IL-6, TNF-ALPHA, AND HS-CRP AT THE BASELINE AND AFTER COMPLETION OF 3 MONTHS OF YOGA TRAINING INTERVENTION. THE EXPERIMENTAL GROUP UNDERWENT YOGA TRAINING INTERVENTION FOR 1 H FOR 6 DAYS A WEEK FOR 3 MONTHS, WHEREAS CONTROL GROUP CONTINUED WITH THEIR DAILY ACTIVITIES EXCEPT YOGA TRAINING. DATA ANALYSIS WAS DONE USING STATISTICAL SOFTWARE SPSS VERSION 20.0. DATA WERE ANALYZED USING PAIRED T-TESTS AND INDEPENDENT T-TEST. RESULTS: THE RESULTS OF WITHIN GROUP COMPARISON REVEALED HIGHLY SIGNIFICANT CHANGES IN CHOLESTEROL (P < 0.001), HIGH-DENSITY LIPOPROTEIN (P < 0.001), LOW-DENSITY LIPOPROTEIN (LDL)(P < 0.01), HS-CRP (P < 0.01), IL-6 (P < 0.001), AND TNF-ALPHA (P < 0.001) IN EXPERIMENTAL GROUP. COMPARISON BETWEEN EXPERIMENTAL AND CONTROL GROUP REVEALED SIGNIFICANT CHANGES IN CHOLESTEROL (P < 0.01), LDL (P < 0.05), IL-6 (P < 0.01), TNF-ALPHA (P < 0.01), AND HS-CRP (P < 0.01). CONCLUSION: A YOGA-BASED LIFESTYLE INTERVENTION SEEMS TO BE A HIGHLY PROMISING ALTERNATIVE THERAPY WHICH FAVORABLY ALTERS INFLAMMATORY MARKERS AND METABOLIC RISK FACTORS. 2017 17 329 39 ANXIOLYTIC EFFECTS OF A YOGA PROGRAM IN EARLY BREAST CANCER PATIENTS UNDERGOING CONVENTIONAL TREATMENT: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: THIS STUDY COMPARES THE ANXIOLYTIC EFFECTS OF A YOGA PROGRAM AND SUPPORTIVE THERAPY IN BREAST CANCER OUTPATIENTS UNDERGOING CONVENTIONAL TREATMENT AT A CANCER CENTRE. METHODS: NINETY-EIGHT STAGE II AND III BREAST CANCER OUTPATIENTS WERE RANDOMLY ASSIGNED TO RECEIVE YOGA (N=45) OR BRIEF SUPPORTIVE THERAPY (N=53) PRIOR TO THEIR PRIMARY TREATMENT I.E., SURGERY. ONLY THOSE SUBJECTS WHO RECEIVED SURGERY FOLLOWED BY ADJUVANT RADIOTHERAPY AND SIX CYCLES OF CHEMOTHERAPY WERE CHOSEN FOR ANALYSIS FOLLOWING INTERVENTION (YOGA, N=18, CONTROL, N=20). INTERVENTION CONSISTED OF YOGA SESSIONS LASTING 60MIN DAILY WHILE THE CONTROL GROUP WAS IMPARTED SUPPORTIVE THERAPY DURING THEIR HOSPITAL VISITS AS A PART OF ROUTINE CARE. ASSESSMENTS INCLUDED SPEILBERGER'S STATE TRAIT ANXIETY INVENTORY AND SYMPTOM CHECKLIST. ASSESSMENTS WERE DONE AT BASELINE, AFTER SURGERY, BEFORE, DURING, AND AFTER RADIOTHERAPY AND CHEMOTHERAPY. RESULTS: A GLM-REPEATED MEASURES ANOVA SHOWED OVERALL DECREASE IN BOTH SELF-REPORTED STATE ANXIETY (P<0.001) AND TRAIT ANXIETY (P=0.005) IN YOGA GROUP AS COMPARED TO CONTROLS. THERE WAS A POSITIVE CORRELATION BETWEEN ANXIETY STATES AND TRAITS WITH SYMPTOM SEVERITY AND DISTRESS DURING CONVENTIONAL TREATMENT INTERVALS. CONCLUSION: THE RESULTS SUGGEST THAT YOGA CAN BE USED FOR MANAGING TREATMENT-RELATED SYMPTOMS AND ANXIETY IN BREAST CANCER OUTPATIENTS. 2009 18 1461 43 INFLUENCE OF YOGA ON MOOD STATES, DISTRESS, QUALITY OF LIFE AND IMMUNE OUTCOMES IN EARLY STAGE BREAST CANCER PATIENTS UNDERGOING SURGERY. CONTEXT: BREAST CANCER PATIENTS AWAITING SURGERY EXPERIENCE HEIGHTENED DISTRESS THAT COULD AFFECT POSTOPERATIVE OUTCOMES. AIMS: THE AIM OF OUR STUDY WAS TO EVALUATE THE EFFECTS OF YOGA INTERVENTION ON MOOD STATES, TREATMENT-RELATED SYMPTOMS, QUALITY OF LIFE AND IMMUNE OUTCOMES IN BREAST CANCER PATIENTS UNDERGOING SURGERY. SETTINGS AND DESIGN: NINETY-EIGHT RECENTLY DIAGNOSED STAGE II AND III BREAST CANCER PATIENTS WERE RECRUITED FOR A RANDOMIZED CONTROLLED TRIAL COMPARING THE EFFECTS OF A YOGA PROGRAM WITH SUPPORTIVE THERAPY PLUS EXERCISE REHABILITATION ON POSTOPERATIVE OUTCOMES FOLLOWING SURGERY. MATERIALS AND METHODS: SUBJECTS WERE ASSESSED PRIOR TO SURGERY AND FOUR WEEKS THEREAFTER. PSYCHOMETRIC INSTRUMENTS WERE USED TO ASSESS SELF-REPORTED ANXIETY, DEPRESSION, TREATMENT-RELATED DISTRESS AND QUALITY OF LIFE. BLOOD SAMPLES WERE COLLECTED FOR ENUMERATION OF T LYMPHOCYTE SUBSETS (CD4 %, CD8 % AND NATURAL KILLER (NK) CELL % COUNTS) AND SERUM IMMUNOGLOBULINS (IGG, IGA AND IGM). STATISTICAL ANALYSIS USED: WE USED ANALYSIS OF COVARIANCE TO COMPARE INTERVENTIONS POSTOPERATIVELY. RESULTS: SIXTY-NINE PATIENTS CONTRIBUTED DATA TO THE CURRENT ANALYSIS (YOGA N = 33, CONTROL N = 36). THE RESULTS SUGGEST A SIGNIFICANT DECREASE IN THE STATE (P = 0.04) AND TRAIT (P = 0.004) OF ANXIETY, DEPRESSION (P = 0.01), SYMPTOM SEVERITY (P = 0.01), DISTRESS (P < 0.01) AND IMPROVEMENT IN QUALITY OF LIFE (P = 0.01) IN THE YOGA GROUP AS COMPARED TO THE CONTROLS. THERE WAS ALSO A SIGNIFICANTLY LESSER DECREASE IN CD 56% (P = 0.02) AND LOWER LEVELS OF SERUM IGA (P = 0.001) IN THE YOGA GROUP AS COMPARED TO CONTROLS FOLLOWING SURGERY. CONCLUSIONS: THE RESULTS SUGGEST POSSIBLE BENEFITS FOR YOGA IN REDUCING POSTOPERATIVE DISTRESS AND PREVENTING IMMUNE SUPPRESSION FOLLOWING SURGERY. 2008 19 1331 43 HOME-BASED YOGA PROGRAM FOR THE PATIENTS SUFFERING FROM MALIGNANT LYMPHOMA DURING CHEMOTHERAPY: A FEASIBILITY STUDY. BACKGROUND: YOGA IS PROVEN BENEFICIAL IN IMPROVING QUALITY OF LIFE AMONG BREAST CANCER SURVIVORS RECEIVING CHEMOTHERAPY, BUT ITS EFFECTIVENESS IN LYMPHOMA PATIENTS NEEDS TO BE EXPLORED. AS CHEMOTHERAPY-INDUCED NEUTROPENIA IS VERY COMMON AMONG LYMPHOMA PATIENTS, THEY ARE MUCH PRONE TO INFECTIONS FROM THE ENVIRONMENT. FURTHERMORE, TRAINED YOGA INSTRUCTORS ARE NOT AVAILABLE IN EVERY SETTING, SO THERE IS A NEED TO DEVELOP HOME-BASED YOGA PROGRAM MODULES FOR LYMPHOMA PATIENTS RECEIVING CHEMOTHERAPY. AIM: THE AIM OF THE STUDY WAS TO EXPLORE THE FEASIBILITY AND SAFETY OF YOGIC EXERCISES AMONG LYMPHOMA PATIENTS DURING CHEMOTHERAPY. SUBJECTS AND METHODS: AN INTERVENTIONAL, SINGLE-ARM PREPOST DESIGN STUDY WAS CONDUCTED AT A TERTIARY HEALTH-CARE CENTER. PATIENTS SUFFERING FROM MALIGNANT LYMPHOMA (18-65 YEARS) WITH EASTERN COOPERATIVE ONCOLOGY GROUP PERFORMANCE STATUS FROM 0 TO 2, PLANNED TO RECEIVE CHEMOTHERAPY WERE ADMINISTERED A HOME-BASED YOGA PROGRAM OVER A PERIOD OF 2 MONTHS FROM THE START OF CHEMOTHERAPY. THE PRIMARY OUTCOME VARIABLES WERE RETENTION RATE, ACCEPTANCE RATE, SAFETY, AND ADHERENCE. HEALTH-RELATED QUALITY OF LIFE (HRQOL), FATIGUE LEVEL, OVERALL SLEEP QUALITY, DEPRESSION, ANXIETY LEVEL, AND PAIN WERE ALSO ASSESSED. STATISTICAL ANALYSIS: DESCRIPTIVE STATISTICS WAS USED TO SEE THE FEASIBILITY AND ADHERENCE. THE PAIRED T-TEST WAS USED TO COMPARE VARIOUS PRE AND POSTINTERVENTION OUTCOME MEASURES. RESULTS: FOURTEEN PATIENTS (MEDIAN AGE: 36 YEARS, RANGE13-65 YEARS) OF MALIGNANT LYMPHOMA WERE ENROLLED IN THE STUDY. MALE-TO-FEMALE RATIO WAS 9:5. NON-HODGKIN'S LYMPHOMA PATIENTS CONSTITUTED 64%. THE RECRUITMENT RATE WAS 93%. FAVORABLE RETENTION (100%), ACCEPTABILITY (97%), ADHERENCE (78.6%), AND NO SERIOUS ADVERSE EVENTS FOLLOWING YOGA PRACTICE WERE REPORTED. IMPROVEMENT WAS ALSO FOUND IN HRQOL, FATIGUE, SLEEP, DEPRESSION, AND ANXIETY. HOWEVER, IT NEEDS FURTHER VALIDATION IN A RANDOMIZED STUDY. CONCLUSION: HOME-BASED YOGA PROGRAM IS SAFE AND FEASIBLE AMONG THE PATIENTS SUFFERING FROM MALIGNANT LYMPHOMA RECEIVING CHEMOTHERAPY. 2018 20 1462 46 INFLUENCE OF YOGA ON POSTOPERATIVE OUTCOMES AND WOUND HEALING IN EARLY OPERABLE BREAST CANCER PATIENTS UNDERGOING SURGERY. CONTEXT: PRE- AND POSTOPERATIVE DISTRESS IN BREAST CANCER PATIENTS CAN CAUSE COMPLICATIONS AND DELAY RECOVERY FROM SURGERY. OBJECTIVE: THE AIM OF OUR STUDY WAS TO EVALUATE THE EFFECTS OF YOGA INTERVENTION ON POSTOPERATIVE OUTCOMES AND WOUND HEALING IN EARLY OPERABLE BREAST CANCER PATIENTS UNDERGOING SURGERY. METHODS: NINETY-EIGHT RECENTLY DIAGNOSED STAGE II AND III BREAST CANCER PATIENTS WERE RECRUITED IN A RANDOMIZED CONTROLLED TRIAL COMPARING THE EFFECTS OF A YOGA PROGRAM WITH SUPPORTIVE THERAPY AND EXERCISE REHABILITATION ON POSTOPERATIVE OUTCOMES AND WOUND HEALING FOLLOWING SURGERY. SUBJECTS WERE ASSESSED AT THE BASELINE PRIOR TO SURGERY AND FOUR WEEKS LATER. SOCIODEMOGRAPHIC, CLINICAL AND INVESTIGATIVE NOTES WERE ASCERTAINED IN THE BEGINNING OF THE STUDY. BLOOD SAMPLES WERE COLLECTED FOR ESTIMATION OF PLASMA CYTOKINES-SOLUBLE INTERLEUKIN (IL)-2 RECEPTOR (IL-2R), TUMOR NECROSIS FACTOR (TNF)-ALPHA AND INTERFERON (IFN)-GAMMA. POSTOPERATIVE OUTCOMES SUCH AS THE DURATION OF HOSPITAL STAY AND DRAIN RETENTION, TIME OF SUTURE REMOVAL AND POSTOPERATIVE COMPLICATIONS WERE ASCERTAINED. WE USED INDEPENDENT SAMPLES T TEST AND NONPARAMETRIC MANN WHITNEY U TESTS TO COMPARE GROUPS FOR POSTOPERATIVE OUTCOMES AND PLASMA CYTOKINES. REGRESSION ANALYSIS WAS DONE TO DETERMINE PREDICTORS FOR POSTOPERATIVE OUTCOMES. RESULTS: SIXTY-NINE PATIENTS CONTRIBUTED DATA TO THE CURRENT ANALYSIS (YOGA: N = 33, CONTROL: N = 36). THE RESULTS SUGGEST A SIGNIFICANT DECREASE IN THE DURATION OF HOSPITAL STAY (P = 0.003), DAYS OF DRAIN RETENTION (P = 0.001) AND DAYS FOR SUTURE REMOVAL (P = 0.03) IN THE YOGA GROUP AS COMPARED TO THE CONTROLS. THERE WAS ALSO A SIGNIFICANT DECREASE IN PLASMA TNF ALPHA LEVELS FOLLOWING SURGERY IN THE YOGA GROUP (P < 0.001), AS COMPARED TO THE CONTROLS. REGRESSION ANALYSIS ON POSTOPERATIVE OUTCOMES SHOWED THAT THE YOGA INTERVENTION AFFECTED THE DURATION OF DRAIN RETENTION AND HOSPITAL STAY AS WELL AS TNF ALPHA LEVELS. CONCLUSION: THE RESULTS SUGGEST POSSIBLE BENEFITS OF YOGA IN REDUCING POSTOPERATIVE COMPLICATIONS IN BREAST CANCER PATIENTS. 2008