1 2604 136 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 2 2836 57 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 3 2415 53 YOGA AND MEDITATION FOR MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS-A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: BREAST CANCER SURVIVORS HAVE ONLY VERY LIMITED TREATMENT OPTIONS FOR MENOPAUSAL SYMPTOMS. THE OBJECTIVE OF THIS TRIAL WAS TO EVALUATE THE EFFECTS OF A 12-WEEK TRADITIONAL HATHA YOGA AND MEDITATION INTERVENTION ON MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS. METHODS: PATIENTS WERE RANDOMLY ASSIGNED EITHER TO A 12-WEEK YOGA AND MEDITATION INTERVENTION OR TO USUAL CARE. THE PRIMARY OUTCOME MEASURE WAS TOTAL MENOPAUSAL SYMPTOMS (MENOPAUSE RATING SCALE [MRS] TOTAL SCORE). SECONDARY OUTCOME MEASURES INCLUDED MRS SUBSCALES, QUALITY OF LIFE (FUNCTIONAL ASSESSMENT OF CANCER THERAPY-BREAST), FATIGUE (FUNCTIONAL ASSESSMENT OF CHRONIC ILLNESS THERAPY-FATIGUE), DEPRESSION, AND ANXIETY (HOSPITAL ANXIETY AND DEPRESSION SCALE). OUTCOMES WERE ASSESSED AT WEEK 12 AND WEEK 24 AFTER RANDOMIZATION. RESULTS: IN TOTAL, 40 WOMEN (MEAN AGE +/- STANDARD DEVIATION, 49.2 +/- 5.9 YEARS) WERE RANDOMIZED TO YOGA (N = 19) OR TO USUAL CARE (N = 21). WOMEN IN THE YOGA GROUP REPORTED SIGNIFICANTLY LOWER TOTAL MENOPAUSAL SYMPTOMS COMPARED WITH THE USUAL CARE GROUP AT WEEK 12 (MEAN DIFFERENCE, -5.6; 95% CONFIDENCE INTERVAL, -9.2 TO -1.9; P = .004) AND AT WEEK 24 (MEAN DIFFERENCE, -4.5; 95% CONFIDENCE INTERVAL, -8.3 TO -0.7; P = .023). AT WEEK 12, THE YOGA GROUP REPORTED LESS SOMATOVEGETATIVE, PSYCHOLOGICAL, AND UROGENITAL MENOPAUSAL SYMPTOMS; LESS FATIGUE; AND IMPROVED QUALITY OF LIFE (ALL P < .05). AT WEEK 24, ALL EFFECTS PERSISTED EXCEPT FOR PSYCHOLOGICAL MENOPAUSAL SYMPTOMS. SHORT-TERM EFFECTS ON MENOPAUSAL SYMPTOMS REMAINED SIGNIFICANT WHEN ONLY WOMEN WHO WERE RECEIVING ANTIESTROGEN MEDICATION (N = 36) WERE ANALYZED. SIX MINOR ADVERSE EVENTS OCCURRED IN EACH GROUP. CONCLUSIONS: YOGA COMBINED WITH MEDITATION CAN BE CONSIDERED A SAFE AND EFFECTIVE COMPLEMENTARY INTERVENTION FOR MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS. THE EFFECTS SEEM TO PERSIST FOR AT LEAST 3 MONTHS. 2015 4 2553 36 YOGA FOR CHILDREN AND ADOLESCENTS AFTER COMPLETING CANCER TREATMENT. SURVIVORS OF CHILDHOOD CANCER MAY EXPERIENCE PERSISTENT SYMPTOMS, INCLUDING FATIGUE, SLEEP DISTURBANCE, AND BALANCE IMPAIRMENT. YOGA IS A COMPLEMENTARY THERAPY THAT IMPROVES FATIGUE, SLEEP, AND QUALITY OF LIFE IN ADULT CANCER SURVIVORS. USING A ONE GROUP, REPEATED MEASURES DESIGN, WE EVALUATED THE FEASIBILITY OF A YOGA PROGRAM AND ASSESSED IF CANCER SURVIVOR PARTICIPANTS AGES 10 TO 17 YEARS (N = 13) HAD SIGNIFICANTLY LESS FATIGUE AND ANXIETY, AND BETTER BALANCE AND SLEEP, AFTER A 6-WEEK YOGA INTERVENTION COMPARED WITH A 6-WEEK PRE-INTERVENTION WAIT PERIOD. STUDY RECRUITMENT WAS CHALLENGING WITH A 32% ENROLLMENT RATE; YOGA ATTENDANCE WAS 90%. NONE OF THE SCORES FOR ANXIETY, FATIGUE, SLEEP, AND BALANCE HAD SIGNIFICANT CHANGES DURING THE WAIT PERIOD. AFTER THE 6-WEEK YOGA PROGRAM, CHILDREN (N = 7) HAD A SIGNIFICANT DECREASE IN ANXIETY SCORE (P = .04) WHILE ADOLESCENT SCORES (N = 7) SHOWED A DECREASING TREND (P = .10). SCORES FOR FATIGUE, SLEEP, AND BALANCE REMAINED STABLE POST-INTERVENTION. FATIGUE AND BALANCE SCORES WERE BELOW NORMS FOR HEALTH CHILDREN/ADOLESCENTS WHILE SLEEP AND ANXIETY SCORES WERE SIMILAR TO HEALTHY PEERS. 2016 5 1859 55 RANDOMIZED CONTROLLED PILOT TRIAL OF YOGA IN OVERWEIGHT AND OBESE BREAST CANCER SURVIVORS: EFFECTS ON QUALITY OF LIFE AND ANTHROPOMETRIC MEASURES. PURPOSE: TO OBTAIN ESTIMATES OF TIME TO RECRUIT THE STUDY SAMPLE, RETENTION, FACILITY-BASED CLASS ATTENDANCE AND HOME PRACTICE FOR A STUDY OF YOGA IN BREAST CANCER SURVIVORS, AND ITS EFFICACY ON FATIGUE, QUALITY OF LIFE (QOL), AND WEIGHT CHANGE. METHODS: SIXTY-THREE POST-TREATMENT STAGES 0-III BORDERLINE OVERWEIGHT AND OBESE (BODY MASS INDEX >/= 24 KG/M(2)) BREAST CANCER SURVIVORS WERE RANDOMLY ASSIGNED TO A 6-MONTH, FACILITY- AND HOME-BASED VINIYOGA INTERVENTION (N = 32) OR A WAITLIST CONTROL GROUP (N = 31). THE YOGA GOAL WAS FIVE PRACTICES PER WEEK. PRIMARY OUTCOME MEASURES WERE CHANGES IN QOL, FATIGUE, AND WEIGHT FROM BASELINE TO 6 MONTHS. SECONDARY OUTCOMES INCLUDED CHANGES IN WAIST AND HIP CIRCUMFERENCE. RESULTS: IT TOOK 12 MONTHS TO COMPLETE RECRUITMENT. PARTICIPANTS ATTENDED A MEAN OF 19.6 CLASSES AND PRACTICED AT HOME A MEAN OF 55.8 TIMES DURING THE 6-MONTH PERIOD. AT FOLLOW-UP, 90% OF PARTICIPANTS COMPLETED QUESTIONNAIRES AND 87% COMPLETED ANTHROPOMETRIC MEASUREMENTS. QOL AND FATIGUE IMPROVED TO A GREATER EXTENT AMONG WOMEN IN THE YOGA GROUP RELATIVE TO WOMEN IN THE CONTROL GROUP, ALTHOUGH NO DIFFERENCES WERE STATISTICALLY SIGNIFICANT. WAIST CIRCUMFERENCE DECREASED 3.1 CM (95% CI, -5.7 AND -0.4) MORE AMONG WOMEN IN THE YOGA COMPARED WITH THE CONTROL GROUP, WITH NO DIFFERENCE IN WEIGHT CHANGE. CONCLUSIONS: THIS STUDY PROVIDES IMPORTANT INFORMATION REGARDING RECRUITMENT, RETENTION, AND PRACTICE LEVELS ACHIEVED DURING A 6-MONTH, INTENSIVE YOGA INTERVENTION IN OVERWEIGHT AND OBESE BREAST CANCER SURVIVORS. YOGA MAY HELP DECREASE WAIST CIRCUMFERENCE AND IMPROVE QUALITY OF LIFE; FUTURE STUDIES ARE NEEDED TO CONFIRM THESE RESULTS. 2012 6 2442 53 YOGA AND SELF-REPORTED COGNITIVE PROBLEMS IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: CANCER SURVIVORS OFTEN REPORT COGNITIVE PROBLEMS. FURTHERMORE, DECREASES IN PHYSICAL ACTIVITY TYPICALLY OCCUR OVER THE COURSE OF CANCER TREATMENT. ALTHOUGH PHYSICAL ACTIVITY BENEFITS COGNITIVE FUNCTION IN NONCANCER POPULATIONS, EVIDENCE LINKING PHYSICAL ACTIVITY TO COGNITIVE FUNCTION IN CANCER SURVIVORS IS LIMITED. IN OUR RECENT RANDOMIZED CONTROLLED TRIAL, BREAST CANCER SURVIVORS WHO RECEIVED A YOGA INTERVENTION HAD LOWER FATIGUE AND INFLAMMATION FOLLOWING THE TRIAL COMPARED WITH A WAIT LIST CONTROL GROUP. THIS SECONDARY ANALYSIS OF THE PARENT TRIAL ADDRESSED YOGA'S IMPACT ON COGNITIVE COMPLAINTS. METHODS: POSTTREATMENT STAGE 0-IIIA BREAST CANCER SURVIVORS (N = 200) WERE RANDOMIZED TO A 12-WEEK, TWICE-WEEKLY HATHA YOGA INTERVENTION OR A WAIT LIST CONTROL GROUP. PARTICIPANTS REPORTED COGNITIVE COMPLAINTS USING THE BREAST CANCER PREVENTION TRIAL COGNITIVE PROBLEMS SCALE AT BASELINE, IMMEDIATELY POSTINTERVENTION, AND 3-MONTH FOLLOW-UP. RESULTS: COGNITIVE COMPLAINTS DID NOT DIFFER SIGNIFICANTLY BETWEEN GROUPS IMMEDIATELY POSTINTERVENTION (P = 0.250). HOWEVER, AT 3-MONTH FOLLOW-UP, YOGA PARTICIPANTS' BREAST CANCER PREVENTION TRIAL COGNITIVE PROBLEMS SCALE SCORES WERE AN AVERAGE OF 23% LOWER THAN WAIT LIST PARTICIPANTS' SCORES (P = 0.003). THESE GROUP DIFFERENCES IN COGNITIVE COMPLAINTS REMAINED AFTER CONTROLLING FOR PSYCHOLOGICAL DISTRESS, FATIGUE, AND SLEEP QUALITY. CONSISTENT WITH THE PRIMARY RESULTS, THOSE WHO PRACTICED YOGA MORE FREQUENTLY REPORTED SIGNIFICANTLY FEWER COGNITIVE PROBLEMS AT 3-MONTH FOLLOW-UP THAN THOSE WHO PRACTICED LESS FREQUENTLY (P < 0.001). CONCLUSIONS: THESE FINDINGS SUGGEST THAT YOGA CAN EFFECTIVELY REDUCE BREAST CANCER SURVIVORS' COGNITIVE COMPLAINTS AND PROMPT FURTHER RESEARCH ON MIND-BODY AND PHYSICAL ACTIVITY INTERVENTIONS FOR IMPROVING CANCER-RELATED COGNITIVE PROBLEMS. 2015 7 1862 53 RANDOMIZED CONTROLLED TRIAL OF YOGA AMONG A MULTIETHNIC SAMPLE OF BREAST CANCER PATIENTS: EFFECTS ON QUALITY OF LIFE. PURPOSE: THIS STUDY EXAMINES THE IMPACT OF YOGA, INCLUDING PHYSICAL POSES, BREATHING, AND MEDITATION EXERCISES, ON QUALITY OF LIFE (QOL), FATIGUE, DISTRESSED MOOD, AND SPIRITUAL WELL-BEING AMONG A MULTIETHNIC SAMPLE OF BREAST CANCER PATIENTS. PATIENTS AND METHODS: ONE HUNDRED TWENTY-EIGHT PATIENTS (42% AFRICAN AMERICAN, 31% HISPANIC) RECRUITED FROM AN URBAN CANCER CENTER WERE RANDOMLY ASSIGNED (2:1 RATIO) TO A 12-WEEK YOGA INTERVENTION (N = 84) OR A 12-WEEK WAITLIST CONTROL GROUP (N = 44). CHANGES IN QOL (EG, FUNCTIONAL ASSESSMENT OF CANCER THERAPY) FROM BEFORE RANDOM ASSIGNMENT (T1) TO THE 3-MONTH FOLLOW-UP (T3) WERE EXAMINED; PREDICTORS OF ADHERENCE WERE ALSO ASSESSED. NEARLY HALF OF ALL PATIENTS WERE RECEIVING MEDICAL TREATMENT. RESULTS: REGRESSION ANALYSES INDICATED THAT THE CONTROL GROUP HAD A GREATER DECREASE IN SOCIAL WELL-BEING COMPARED WITH THE INTERVENTION GROUP AFTER CONTROLLING FOR BASELINE SOCIAL WELL-BEING AND COVARIATES (P < .0001). SECONDARY ANALYSES OF 71 PATIENTS NOT RECEIVING CHEMOTHERAPY DURING THE INTERVENTION PERIOD INDICATED FAVORABLE OUTCOMES FOR THE INTERVENTION GROUP COMPARED WITH THE CONTROL GROUP IN OVERALL QOL (P < .008), EMOTIONAL WELL-BEING (P < .015), SOCIAL WELL-BEING (P < .004), SPIRITUAL WELL-BEING (P < .009), AND DISTRESSED MOOD (P < .031). SIXTY-NINE PERCENT OF INTERVENTION PARTICIPANTS ATTENDED CLASSES (MEAN NUMBER OF CLASSES ATTENDED BY ACTIVE CLASS PARTICIPANTS = 7.00 +/- 3.80), WITH LOWER ADHERENCE ASSOCIATED WITH INCREASED FATIGUE (P < .001), RADIOTHERAPY (P < .0001), YOUNGER AGE (P < .008), AND NO ANTIESTROGEN THERAPY (P < .02). CONCLUSION: DESPITE LIMITED ADHERENCE, THIS INTENT-TO-TREAT ANALYSIS SUGGESTS THAT YOGA IS ASSOCIATED WITH BENEFICIAL EFFECTS ON SOCIAL FUNCTIONING AMONG A MEDICALLY DIVERSE SAMPLE OF BREAST CANCER SURVIVORS. AMONG PATIENTS NOT RECEIVING CHEMOTHERAPY, YOGA APPEARS TO ENHANCE EMOTIONAL WELL-BEING AND MOOD AND MAY SERVE TO BUFFER DETERIORATION IN BOTH OVERALL AND SPECIFIC DOMAINS OF QOL. 2007 8 390 51 BENEFITS OF YOGA FOR PSYCHOSOCIAL WELL-BEING IN A US HIGH SCHOOL CURRICULUM: A PRELIMINARY RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: TO TEST FEASIBILITY OF YOGA WITHIN A HIGH SCHOOL CURRICULUM AND EVALUATE PREVENTIVE EFFICACY FOR PSYCHOSOCIAL WELL-BEING. METHODS: GRADE 11 OR 12 STUDENTS (N = 51) WHO REGISTERED FOR PHYSICAL EDUCATION (PE) WERE CLUSTER-RANDOMIZED BY CLASS 2:1 YOGA:PE-AS-USUAL. A KRIPALU-BASED YOGA PROGRAM OF PHYSICAL POSTURES, BREATHING EXERCISES, RELAXATION, AND MEDITATION WAS TAUGHT 2 TO 3 TIMES A WEEK FOR 10 WEEKS. SELF-REPORT QUESTIONNAIRES WERE ADMINISTERED TO STUDENTS 1 WEEK BEFORE AND AFTER. PRIMARY OUTCOME MEASURES OF PSYCHOSOCIAL WELL-BEING WERE PROFILE OF MOOD STATES-SHORT FORM AND POSITIVE AND NEGATIVE AFFECT SCHEDULE FOR CHILDREN. ADDITIONAL MEASURES OF PSYCHOSOCIAL WELL-BEING INCLUDED PERCEIVED STRESS SCALE AND INVENTORY OF POSITIVE PSYCHOLOGICAL ATTITUDES. SECONDARY MEASURES OF SELF-REGULATORY SKILLS INCLUDED RESILIENCE SCALE, STATE TRAIT ANGER EXPRESSION INVENTORY-2, AND CHILD ACCEPTANCE MINDFULNESS MEASURE. TO ASSESS FEASIBILITY, YOGA STUDENTS COMPLETED A PROGRAM EVALUATION. ANALYSES OF COVARIANCE WERE CONDUCTED BETWEEN GROUPS WITH BASELINE AS THE COVARIATE. RESULTS: ALTHOUGH PE-AS-USUAL STUDENTS SHOWED DECREASES IN PRIMARY OUTCOMES, YOGA STUDENTS MAINTAINED OR IMPROVED. TOTAL MOOD DISTURBANCE IMPROVED IN YOGA STUDENTS AND WORSENED IN CONTROLS (P = .015), AS DID PROFILE OF MOOD STATES-SHORT FORM (POMS-SF) TENSION-ANXIETY SUBSCALE (P = .002). ALTHOUGH POSITIVE AFFECT REMAINED UNCHANGED IN BOTH, NEGATIVE AFFECT SIGNIFICANTLY WORSENED IN CONTROLS WHILE IMPROVING IN YOGA STUDENTS (P = .006). SECONDARY OUTCOMES WERE NOT SIGNIFICANT. STUDENTS RATED YOGA FAIRLY HIGH, DESPITE MODERATE ATTENDANCE. CONCLUSIONS: IMPLEMENTATION WAS FEASIBLE AND STUDENTS GENERALLY FOUND IT BENEFICIAL. ALTHOUGH NOT CAUSAL DUE TO SMALL, UNEVEN SAMPLE SIZE, THIS PRELIMINARY STUDY SUGGESTS PREVENTIVE BENEFITS IN PSYCHOSOCIAL WELL-BEING FROM KRIPALU YOGA DURING HIGH SCHOOL PE. THESE RESULTS ARE CONSISTENT WITH PREVIOUSLY PUBLISHED STUDIES OF YOGA IN SCHOOL SETTINGS. 2012 9 2734 42 YOGA PARTICIPATION ASSOCIATED WITH CHANGES IN DIETARY PATTERNS AND STRESS: A PILOT STUDY IN STRESSED ADULTS WITH POOR DIET. BACKGROUND AND PURPOSE: STRESS CONTRIBUTES TO DIETARY PATTERNS THAT IMPEDE HEALTH. YOGA IS AN INTEGRATIVE STRESS MANAGEMENT APPROACH ASSOCIATED WITH IMPROVED DIETARY PATTERNS IN BURGEONING RESEARCH. YET, NO RESEARCH HAS EXAMINED CHANGE IN DIETARY PATTERNS, BODY MASS INDEX (BMI), AND STRESS DURING A YOGA INTERVENTION AMONG STRESSED ADULTS WITH POOR DIET. MATERIALS AND METHODS: OBJECTIVELY-MEASURED BMI AND A BATTERY OF SELF-REPORT QUESTIONNAIRES WERE COLLECTED AT FOUR TIME POINTS DURING AND FOLLOWING A 12-WEEK YOGA INTERVENTION (N = 78, 71% WOMEN, MEAN BMI = 25.69 KG/M(2)+/-4.59) - PRE-TREATMENT (T1), MID-TREATMENT (6 WEEKS; T2), POST-TREATMENT (12 WEEKS; T3), AND AT 3-MONTH FOLLOW-UP (24 WEEKS; T4). RESULTS: T1 TO T3 FRUIT AND VEGETABLE INTAKE, BMI, AND STRESS SIGNIFICANTLY DECLINED IN THE OVERALL SAMPLE. REDUCTION IN VEGETABLE INTAKE WAS NO LONGER SIGNIFICANT AFTER ACCOUNTING FOR REDUCTIONS IN CALORIC INTAKE, AND REDUCTION IN CALORIC INTAKE REMAINED SIGNIFICANT AFTER ACCOUNTING FOR REDUCTIONS IN STRESS. CONCLUSION: FINDINGS MAY BE INTERPRETED AS YOGA EITHER ENCOURAGING OR ADVERSELY IMPACTING HEALTHY DIETARY PATTERNS (I.E., MINIMIZING LIKELIHOOD OF FUTURE WEIGHT GAIN VS. DECREASING VEGETABLE INTAKE AND OVERALL CALORIC INTAKE AMONG INDIVIDUALS WHO MAY NOT NEED TO LOSE WEIGHT, RESPECTIVELY). CONTINUED RESEARCH IS WARRANTED, UTILIZING CAUSAL DESIGNS. 2021 10 388 50 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 11 1430 31 IMPROVEMENTS IN PSYCHOLOGICAL HEALTH FOLLOWING A RESIDENTIAL YOGA-BASED PROGRAM FOR FRONTLINE PROFESSIONALS. OBJECTIVE: THE PURPOSE OF THIS PILOT STUDY WAS TO EXAMINE THE EFFECTS OF A RESIDENTIAL YOGA-BASED PROGRAM ON PSYCHOLOGICAL HEALTH AND HEALTH BEHAVIORS IN FRONTLINE PROFESSIONALS. METHODS: FRONTLINE PROFESSIONALS FROM EDUCATION, HEALTH CARE, HUMAN SERVICES, AND CORRECTIONS PARTICIPATED IN THE RISE (RESILIENCE, INTEGRATION, SELF-AWARENESS, ENGAGEMENT) PROGRAM AND COMPLETED QUESTIONNAIRES AT BASELINE, POST-PROGRAM, AND 2 MONTHS FOLLOWING RISE. RESULTS: PAIRED SAMPLES T TESTS REVEALED IMPROVEMENTS IN MINDFULNESS, STRESS, RESILIENCE, AFFECT, AND SLEEP QUALITY FROM BASELINE TO POST-PROGRAM (ALL PS < 0.001, N = 55), WHICH WERE SUSTAINED AT THE 2-MONTH FOLLOW-UP (ALL PS < 0.01, N = 40). PARTICIPANTS ALSO REPORTED INCREASES IN EXERCISE, FRUIT, AND VEGETABLE CONSUMPTION POST-PROGRAM (ALL PS < 0.001), ALL OF WHICH PERSISTED AT THE 2-MONTH FOLLOW-UP (ALL PS < 0.01) EXCEPT EXERCISE. CONCLUSION: THESE FINDINGS SUGGEST THAT RISE IMPROVED INDICES OF PSYCHOLOGICAL HEALTH AND HEALTHY BEHAVIORS THAT REMAINED 2 MONTHS FOLLOWING RISE. 2018 12 1527 44 IYENGAR YOGA FOR DISTRESSED WOMEN: A 3-ARMED RANDOMIZED CONTROLLED TRIAL. DISTRESS IS AN INCREASING PUBLIC HEALTH PROBLEM. WE AIMED TO INVESTIGATE THE EFFECTS OF AN IYENGAR YOGA PROGRAM ON PERCEIVED STRESS AND PSYCHOLOGICAL OUTCOMES IN DISTRESSED WOMEN AND EVALUATED A POTENTIAL DOSE-EFFECT RELATIONSHIP. SEVENTY-TWO FEMALE DISTRESSED SUBJECTS WERE INCLUDED INTO A 3-ARMED RANDOMIZED CONTROLLED TRIAL AND ALLOCATED TO YOGA GROUP 1 (N = 24) WITH TWELVE 90 MIN SESSIONS OVER 3 MONTHS, YOGA GROUP 2 (N = 24) WITH 24 SESSIONS OVER 3 MONTHS, OR A WAITING LIST CONTROL GROUP (N = 24). THE PRIMARY OUTCOME WAS STRESS PERCEPTION, MEASURED BY COHEN STRESS SCALE; SECONDARY OUTCOMES INCLUDED STATE TRAIT ANXIETY, DEPRESSION, PSYCHOLOGICAL AND PHYSICAL QUALITY OF LIFE (QOL), PROFILE OF MOOD STATES, WELL BEING, AND BODILY COMPLAINTS. AFTER THREE MONTHS, WOMEN IN THE YOGA GROUPS SHOWED SIGNIFICANT IMPROVEMENTS IN PERCEIVED STRESS (P = 0.003), STATE TRAIT ANXIETY (P = 0.021 AND P = 0.003), DEPRESSION (P = 0.008), PSYCHOLOGICAL QOL (P = 0.012), MOOD STATES BEING (P = 0.007), AND BODILY COMPLAINTS WELL(P = 0.012) WHEN COMPARED TO CONTROLS. BOTH YOGA PROGRAMS WERE SIMILARLY EFFECTIVE FOR THESE OUTCOMES; HOWEVER, COMPLIANCE WAS BETTER IN THE GROUP WITH FEWER SESSIONS (YOGA GROUP 1). DOSE EFFECTS WERE SEEN ONLY IN THE ANALYSIS OF GROUP-INDEPENDENT EFFECTS FOR BACK PAIN, ANXIETY, AND DEPRESSION. THESE FINDINGS SUGGEST THAT IYENGAR YOGA EFFECTIVELY REDUCES DISTRESS AND IMPROVES RELATED PSYCHOLOGICAL AND PHYSICAL OUTCOMES. FURTHERMORE, ATTENDING TWICE-WEEKLY YOGA CLASSES WAS NOT SUPERIOR TO ONCE-WEEKLY CLASSES, AS A RESULT OF LIMITED COMPLIANCE IN THE TWICE-WEEKLY GROUP. 2012 13 74 46 A GROUP-BASED YOGA THERAPY INTERVENTION FOR URINARY INCONTINENCE IN WOMEN: A PILOT RANDOMIZED TRIAL. OBJECTIVE: THE AIM OF THIS STUDY IS TO EXAMINE THE FEASIBILITY, EFFICACY, AND SAFETY OF A GROUP-BASED YOGA THERAPY INTERVENTION FOR MIDDLE-AGED AND OLDER WOMEN WITH URINARY INCONTINENCE. METHODS: WE CONDUCTED A PILOT RANDOMIZED TRIAL OF AMBULATORY WOMEN AGED 40 YEARS AND OLDER WITH STRESS, URGENCY, OR MIXED-TYPE INCONTINENCE. WOMEN WERE RANDOMIZED TO A 6-WEEK YOGA THERAPY PROGRAM (N = 10) CONSISTING OF TWICE WEEKLY GROUP CLASSES AND ONCE WEEKLY HOME PRACTICE OR A WAIT-LIST CONTROL GROUP (N = 9). ALL PARTICIPANTS ALSO RECEIVED WRITTEN PAMPHLETS ABOUT STANDARD BEHAVIORAL SELF-MANAGEMENT STRATEGIES FOR INCONTINENCE. CHANGES IN INCONTINENCE WERE ASSESSED WITH 7-DAY VOIDING DIARIES. RESULTS: THE MEAN (SD) AGE WAS 61.4 (8.2) YEARS, AND THE MEAN BASELINE FREQUENCY OF INCONTINENCE WAS 2.5 (1.3) EPISODES/D. AFTER 6 WEEKS, THE TOTAL INCONTINENCE FREQUENCY DECREASED BY 70% (1.8 [0.9] FEWER EPISODES/D) IN THE YOGA THERAPY VERSUS 13% (0.3 [1.7] FEWER EPISODES/D) IN THE CONTROL GROUP (P = 0.049). PARTICIPANTS IN THE YOGA THERAPY GROUP ALSO REPORTED AN AVERAGE OF 71% DECREASE IN STRESS INCONTINENCE FREQUENCY (0.7 [0.8] FEWER EPISODES/D) COMPARED WITH A 25% INCREASE IN CONTROLS (0.2 [1.1] MORE EPISODES/D) (P = 0.039). NO SIGNIFICANT DIFFERENCES IN REDUCTION IN URGENCY INCONTINENCE WERE DETECTED BETWEEN THE YOGA THERAPY VERSUS CONTROL GROUPS (1.0 [1.0] VERSUS 0.5 [0.5] FEWER EPISODES/D; P = 0.20). ALL WOMEN STARTING THE YOGA THERAPY PROGRAM COMPLETED AT LEAST 90% OF THE GROUP CLASSES AND PRACTICE SESSIONS. TWO PARTICIPANTS IN EACH GROUP REPORTED ADVERSE EVENTS UNRELATED TO THE INTERVENTION. CONCLUSIONS: FINDINGS PROVIDE PRELIMINARY EVIDENCE TO SUPPORT THE FEASIBILITY, EFFICACY, AND SAFETY OF A GROUP-BASED YOGA THERAPY INTERVENTION TO IMPROVE URINARY INCONTINENCE IN WOMEN. 2014 14 2132 39 THE EFFECTS OF A GENTLE YOGA PROGRAM ON SLEEP, MOOD, AND BLOOD PRESSURE IN OLDER WOMEN WITH RESTLESS LEGS SYNDROME (RLS): A PRELIMINARY RANDOMIZED CONTROLLED TRIAL. OBJECTIVE. TO EXAMINE THE EFFECTS OF YOGA VERSUS AN EDUCATIONAL FILM PROGRAM ON SLEEP, MOOD, PERCEIVED STRESS, AND SYMPATHETIC ACTIVATION IN OLDER WOMEN WITH RLS. METHODS. PARTICIPANTS WERE DRAWN FROM A LARGER TRIAL REGARDING THE EFFECTS OF YOGA ON CARDIOVASCULAR DISEASE RISK PROFILES IN OVERWEIGHT, SEDENTARY POSTMENOPAUSAL WOMEN. SEVENTY-FIVE WOMEN WERE RANDOMIZED TO RECEIVE EITHER AN 8-WEEK YOGA (N = 38) OR EDUCATIONAL FILM (N = 37) PROGRAM. ALL 75 PARTICIPANTS COMPLETED AN RLS SCREENING QUESTIONNAIRE. THE 20 WOMEN WHO MET ALL FOUR DIAGNOSTIC CRITERIA FOR RLS (N = 10 YOGA, 10 FILM GROUP) COMPRISED THE POPULATION FOR THIS NESTED STUDY. MAIN OUTCOMES ASSESSED PRE- AND POST-TREATMENT INCLUDED: SLEEP (PITTSBURGH SLEEP QUALITY INDEX), STRESS (PERCEIVED STRESS SCALE), MOOD (PROFILE OF MOOD STATES, STATE-TRAIT ANXIETY INVENTORY), BLOOD PRESSURE, AND HEART RATE. RESULTS. THE YOGA GROUP DEMONSTRATED SIGNIFICANTLY GREATER IMPROVEMENTS THAN CONTROLS IN MULTIPLE DOMAINS OF SLEEP QUALITY AND MOOD, AND SIGNIFICANTLY GREATER REDUCTIONS IN INSOMNIA PREVALENCE, ANXIETY, PERCEIVED STRESS, AND BLOOD PRESSURE (ALL P'S/=4 ON A LIKERT SCALE FROM 1-10) WITHIN 1 YEAR FROM DIAGNOSIS TO A 12-WEEK INTERVENTION OF HOME-BASED YOGA VERSUS STRENGTHENING EXERCISES, BOTH PRESENTED ON A DVD. THE PRIMARY ENDPOINTS WERE FEASIBILITY AND CHANGES IN FATIGUE, AS MEASURED BY THE MULTIDIMENSIONAL FATIGUE SYMPTOM INVENTORY-SHORT FORM (MFSI-SF). SECONDARY ENDPOINT WAS QUALITY OF LIFE, ASSESSED BY THE FUNCTIONAL ASSESSMENT OF CANCER THERAPIES-BREAST (FACT-B). RESULTS: WE INVITED 401 WOMEN TO PARTICIPATE IN THE STUDY; 78 RESPONDED, AND WE ENROLLED 34. BOTH GROUPS HAD SIGNIFICANT WITHIN-GROUP IMPROVEMENT IN MULTIPLE DOMAINS OF THE FATIGUE AND QUALITY OF LIFE SCORES FROM BASELINE TO POST-INTERVENTION, AND THESE BENEFITS WERE MAINTAINED AT 3 MONTHS POST-INTERVENTION. HOWEVER, THERE WAS NO SIGNIFICANT DIFFERENCE BETWEEN GROUPS IN FATIGUE OR QUALITY OF LIFE AT ANY ASSESSMENT TIME. SIMILARLY, THERE WAS NO DIFFERENCE BETWEEN GROUPS IN ADHERENCE TO THE EXERCISE INTERVENTION. CONCLUSIONS: BOTH DVD-BASED YOGA AND STRENGTHENING EXERCISES DESIGNED FOR CANCER SURVIVORS MAY BE GOOD OPTIONS TO ADDRESS FATIGUE IN BREAST CANCER SURVIVORS. BOTH HAVE REASONABLE UPTAKE, ARE CONVENIENT AND REPRODUCIBLE, AND MAY BE HELPFUL IN DECREASING FATIGUE AND IMPROVING QUALITY OF LIFE IN THE FIRST YEAR POST-DIAGNOSIS IN BREAST CANCER PATIENTS WITH CANCER-RELATED FATIGUE. 2016 16 2644 45 YOGA FOR WOMEN WITH URGENCY URINARY INCONTINENCE: A PILOT STUDY. OBJECTIVES: THE OBJECTIVE OF THIS STUDY WAS TO EVALUATE THE FEASIBILITY OF A GENTLE YOGA PROGRAM FOR WOMEN WITH URGENCY URINARY INCONTINENCE (UUI). ALSO, THESE PRELIMINARY DATA CAN EVALUATE IF YOGA IMPROVES SYMPTOM BURDEN, QUALITY OF LIFE, AND INFLAMMATORY BIOMARKERS FOR WOMEN WITH UUI. METHODS: THIS PROSPECTIVE NONRANDOMIZED SINGLE-ARM PILOT STUDY EVALUATED THE EFFECTIVENESS OF A TWICE-WEEKLY, 8-WEEK GENTLE YOGA INTERVENTION TO REDUCE UUI SYMPTOM BURDEN. CHANGES IN SYMPTOM BURDEN WERE MEASURED USING THE PELVIC FLOOR DISTRESS INVENTORY 20. SECONDARY MEASURES INCLUDED QUALITY OF LIFE, DEPRESSIVE SYMPTOMS, SLEEP, STRESS, ANXIETY, AND INFLAMMATORY BIOMARKERS. OUTCOMES WERE EVALUATED WITH PAIRED T TESTING. RESULTS: TWELVE WOMEN COMPLETED THE YOGA INTERVENTION WITH NO ADVERSE OUTCOMES NOTED. URGENCY SYMPTOM BURDEN WAS SIGNIFICANTLY IMPROVED AFTER THE INTERVENTION (P = 0.01), AND WOMEN REPORTED AN INCREASE IN QUALITY OF LIFE (P = 0.04) AFTER THE YOGA INTERVENTION. FOLLOWING THE YOGA INTERVENTION, THE MAJORITY OF WOMEN REPORTED SYMPTOMS AS "MUCH BETTER" (N = 4 [33%]) AND "A LITTLE BETTER" (N = 5 [42%]), WITH 3 WOMEN (25%) REPORTING "NO CHANGE." WOMEN ALSO REPORTED SIGNIFICANT REDUCTION IN DEPRESSIVE SYMPTOMS (P = 0.03) AND BETTER QUALITY OF SLEEP (P = 0.03). NO SIGNIFICANT CHANGES WERE FOUND IN ANXIETY OR STRESS PERCEPTION. PLASMA LEVELS OF THE INFLAMMATORY BIOMARKER TUMOR NECROSIS FACTOR ALPHA WERE REDUCED AFTER YOGA INTERVENTION (P = 0.009); HOWEVER, NO SIGNIFICANT POSTYOGA CHANGES WERE FOUND FOR INTERLEUKIN 6 OR C-REACTIVE PROTEIN. CONCLUSIONS: THIS STUDY PROVIDES PRELIMINARY EVIDENCE THAT YOGA IS A FEASIBLE COMPLEMENTARY THERAPY THAT REDUCES INCONTINENCE SYMPTOM BURDEN, ALONG WITH IMPROVING QUALITY OF LIFE, DEPRESSIVE SYMPTOMS, AND SLEEP QUALITY. ADDITIONALLY, YOGA MAY LOWER INFLAMMATORY BIOMARKERS ASSOCIATED WITH INCONTINENCE. 2021 17 1787 43 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 18 1180 55 EVALUATION OF THE EFFECTIVENESS AND EFFICACY OF IYENGAR YOGA THERAPY ON CHRONIC LOW BACK PAIN. STUDY DESIGN: THE EFFECTIVENESS AND EFFICACY OF IYENGAR YOGA FOR CHRONIC LOW BACK PAIN (CLBP) WERE ASSESSED WITH INTENTION-TO-TREAT AND PER-PROTOCOL ANALYSIS. NINETY SUBJECTS WERE RANDOMIZED TO A YOGA (N = 43) OR CONTROL GROUP (N = 47) RECEIVING STANDARD MEDICAL CARE. PARTICIPANTS WERE FOLLOWED 6 MONTHS AFTER COMPLETION OF THE INTERVENTION. OBJECTIVE: THIS STUDY AIMED TO EVALUATE IYENGAR YOGA THERAPY ON CHRONIC LOW BACK PAIN. YOGA SUBJECTS WERE HYPOTHESIZED TO REPORT GREATER REDUCTIONS IN FUNCTIONAL DISABILITY, PAIN INTENSITY, DEPRESSION, AND PAIN MEDICATION USAGE THAN CONTROLS. SUMMARY OF BACKGROUND DATA: CLBP IS A MUSCULOSKELETAL DISORDER WITH PUBLIC HEALTH AND ECONOMIC IMPACT. PILOT STUDIES OF YOGA AND BACK PAIN HAVE REPORTED SIGNIFICANT CHANGES IN CLINICALLY IMPORTANT OUTCOMES. METHODS: SUBJECTS WERE RECRUITED THROUGH SELF-REFERRAL AND HEALTH PROFESSIONAL REFERRALS ACCORDING TO EXPLICIT INCLUSION/EXCLUSION CRITERIA. YOGA SUBJECTS PARTICIPATED IN 24 WEEKS OF BIWEEKLY YOGA CLASSES DESIGNED FOR CLBP. OUTCOMES WERE ASSESSED AT 12 (MIDWAY), 24 (IMMEDIATELY AFTER), AND 48 WEEKS (6-MONTH FOLLOW-UP) AFTER THE START OF THE INTERVENTION USING THE OSWESTRY DISABILITY QUESTIONNAIRE, A VISUAL ANALOG SCALE, THE BECK DEPRESSION INVENTORY, AND A PAIN MEDICATION-USAGE QUESTIONNAIRE. RESULTS: USING INTENTION-TO-TREAT ANALYSIS WITH REPEATED MEASURES ANOVA (GROUP X TIME), SIGNIFICANTLY GREATER REDUCTIONS IN FUNCTIONAL DISABILITY AND PAIN INTENSITY WERE OBSERVED IN THE YOGA GROUP WHEN COMPARED TO THE CONTROL GROUP AT 24 WEEKS. A SIGNIFICANTLY GREATER PROPORTION OF YOGA SUBJECTS ALSO REPORTED CLINICAL IMPROVEMENTS AT BOTH 12 AND 24 WEEKS. IN ADDITION, DEPRESSION WAS SIGNIFICANTLY LOWER IN YOGA SUBJECTS. FURTHERMORE, WHILE A REDUCTION IN PAIN MEDICATION OCCURRED, THIS WAS COMPARABLE IN BOTH GROUPS. WHEN RESULTS WERE ANALYZED USING PER-PROTOCOL ANALYSIS, IMPROVEMENTS WERE OBSERVED FOR ALL OUTCOMES IN THE YOGA GROUP, INCLUDING AGREATER TREND FOR REDUCED PAIN MEDICATION USAGE. ALTHOUGH SLIGHTLY LESS THAN AT 24 WEEKS, THE YOGA GROUP HAD STATISTICALLY SIGNIFICANT REDUCTIONS IN FUNCTIONAL DISABILITY, PAIN INTENSITY, AND DEPRESSION COMPARED TO STANDARD MEDICAL CARE 6-MONTHS POSTINTERVENTION. CONCLUSION: YOGA IMPROVES FUNCTIONAL DISABILITY, PAIN INTENSITY, AND DEPRESSION IN ADULTS WITH CLBP. THERE WAS ALSO A CLINICALLY IMPORTANT TREND FOR THE YOGA GROUP TO REDUCE THEIR PAIN MEDICATION USAGE COMPARED TO THE CONTROL GROUP. 2009 19 193 40 A RANDOMIZED TRIAL COMPARING YOGA, STRETCHING, AND A SELF-CARE BOOK FOR CHRONIC LOW BACK PAIN. BACKGROUND: CHRONIC LOW BACK PAIN IS A COMMON PROBLEM LACKING HIGHLY EFFECTIVE TREATMENT OPTIONS. SMALL TRIALS SUGGEST THAT YOGA MAY HAVE BENEFITS FOR THIS CONDITION. THIS TRIAL WAS DESIGNED TO DETERMINE WHETHER YOGA IS MORE EFFECTIVE THAN CONVENTIONAL STRETCHING EXERCISES OR A SELF-CARE BOOK FOR PRIMARY CARE PATIENTS WITH CHRONIC LOW BACK PAIN. METHODS: A TOTAL OF 228 ADULTS WITH CHRONIC LOW BACK PAIN WERE RANDOMIZED TO 12 WEEKLY CLASSES OF YOGA (92 PATIENTS) OR CONVENTIONAL STRETCHING EXERCISES (91 PATIENTS) OR A SELF-CARE BOOK (45 PATIENTS). BACK-RELATED FUNCTIONAL STATUS (MODIFIED ROLAND DISABILITY QUESTIONNAIRE, A 23-POINT SCALE) AND BOTHERSOMENESS OF PAIN (AN 11-POINT NUMERICAL SCALE) AT 12 WEEKS WERE THE PRIMARY OUTCOMES. OUTCOMES WERE ASSESSED AT BASELINE, 6, 12, AND 26 WEEKS BY INTERVIEWERS UNAWARE OF TREATMENT GROUP. RESULTS: AFTER ADJUSTMENT FOR BASELINE VALUES, 12-WEEK OUTCOMES FOR THE YOGA GROUP WERE SUPERIOR TO THOSE FOR THE SELF-CARE GROUP (MEAN DIFFERENCE FOR FUNCTION, -2.5 [95% CI, -3.7 TO -1.3]; P < .001; MEAN DIFFERENCE FOR SYMPTOMS, -1.1 [95% CI, -1.7 TO -0.4]; P < .001). AT 26 WEEKS, FUNCTION FOR THE YOGA GROUP REMAINED SUPERIOR (MEAN DIFFERENCE, -1.8 [95% CI, -3.1 TO -0.5]; P < .001). YOGA WAS NOT SUPERIOR TO CONVENTIONAL STRETCHING EXERCISES AT ANY TIME POINT. CONCLUSION: YOGA CLASSES WERE MORE EFFECTIVE THAN A SELF-CARE BOOK, BUT NOT MORE EFFECTIVE THAN STRETCHING CLASSES, IN IMPROVING FUNCTION AND REDUCING SYMPTOMS DUE TO CHRONIC LOW BACK PAIN, WITH BENEFITS LASTING AT LEAST SEVERAL MONTHS. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT00447668. 2011 20 451 44 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