1 1313 184 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 2 1466 48 INJURY IN YOGA ASANA PRACTICE: ASSESSMENT OF THE RISKS. BACKGROUND: THE RISK OF INJURY FROM MODERN YOGA ASANA PRACTICE IS POORLY CHARACTERIZED IN THE SCIENTIFIC LITERATURE, BUT ANECDOTAL REPORTS IN THE LAY LITERATURE AND PRESS HAVE POSED QUESTIONS ABOUT THE POSSIBILITY OF FREQUENT, SEVERE INJURIES. DESIGN: WE PERFORMED A CROSS-SECTIONAL SURVEY OF YOGA ASANA PARTICIPANTS ASSESSING THEIR EXPERIENCE WITH YOGA-RELATED INJURY, USING A VOLUNTARY CONVENIENCE SAMPLE. RESULTS: A TOTAL OF 2620 PARTICIPANTS RESPONDED TO OUR SURVEY. SEVENTY-NINE PERCENT WERE BETWEEN AGES 31 AND 60 AND 84% WERE FEMALE. THE MAJORITY OF RESPONDENTS LIVED IN NORTH AMERICA OR EUROPE. FORTY-FIVE PERCENT OF PARTICIPANTS REPORTED EXPERIENCING NO INJURIES DURING THE TIME THEY HAD BEEN PRACTICING YOGA. OF THOSE WHO DID EXPERIENCE AN INJURY FROM ASANA PRACTICE, 28% WERE MILD (E.G., SPRAINS OR NONSPECIFIC PAINS NOT REQUIRING A MEDICAL PROCEDURE, WITH SYMPTOMS LASTING LESS THAN 6 MONTHS) AND 63% WERE MODERATE (E.G., SPRAINS OR NONSPECIFIC PAINS NOT REQUIRING A MEDICAL PROCEDURE, WITH SYMPTOMS LASTING FROM 6 MONTHS TO 1 YEAR). ONLY 9% OF THOSE REPORTING INJURIES (4% OF THE TOTAL SAMPLE) HAD A SEVERE INJURY. THE STRONGEST PREDICTORS FOR INCREASED PROBABILITY OF REPORTING AN INJURY OVER A LIFETIME OF YOGA PRACTICE WERE GREATER NUMBER OF YEARS OF PRACTICE (P<.0001) AND TEACHING YOGA (P=.0177). OTHER ASPECTS OF PARTICIPANT DEMOGRAPHICS OR YOGA PRACTICE HABITS WERE NOT RELATED TO LIKELIHOOD OF REPORTING A YOGA-RELATED INJURY. CONCLUSIONS: WE FOUND THE NUMBER OF INJURIES REPORTED BY YOGA PARTICIPANTS PER YEARS OF PRACTICE EXPOSURE TO BE LOW AND THE OCCURRENCE OF SERIOUS INJURIES IN YOGA TO BE INFREQUENT COMPARED TO OTHER PHYSICAL ACTIVITIES, SUGGESTING THAT YOGA IS NOT A HIGH-RISK PHYSICAL ACTIVITY. MORE WORK IS NEEDED TO CLARIFY THE CAUSAL RELATIONSHIPS BETWEEN THE YOGA PARTICIPANT CHARACTERISTICS, THE ASANA PRACTICE STYLE, AND THE RISK OF SIGNIFICANT INJURY. 2019 3 1941 61 SAFETY AND EFFICACY OF AYURVEDIC INTERVENTIONS AND YOGA ON LONG TERM EFFECTS OF COVID-19: A STRUCTURED SUMMARY OF A STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: PRIMARY OBJECTIVE * TO ASSESS THE EFFICACY OF AYURVEDA INTERVENTIONS AND YOGA IN REHABILITATION OF COVID-19 CASES SUFFERING WITH LONG TERM EFFECTS OF COVID 19 AS COMPARED TO WHO REHABILITATION SELF-MANAGEMENT AFTER COVID-19- RELATED ILLNESS. SECONDARY OBJECTIVE * TO ASSESS THE SAFETY OF AYURVEDIC INTERVENTIONS IN CASES SUFFERING WITH LONG TERM EFFECTS OF COVID 19 TRIAL DESIGN: MULTI-CENTRIC, RANDOMIZED, CONTROLLED, PARALLEL GROUP, OPEN-LABEL, EXPLORATORY STUDY. THE STUDY DURATION IS 9 MONTHS AND THE INTERVENTION PERIOD IS 90 DAYS FROM THE DAY OF ENROLMENT OF THE PARTICIPANT. PARTICIPANTS: PATIENTS OF EITHER SEX BETWEEN 18 TO 60 YEARS, AMBULATORY, WILLING TO PARTICIPATE, WITH HISTORY (NOT MORE THAN 4 WEEKS) OF POSITIVE RT-PCR FOR COVID-19 OR IGM ANTIBODIES POSITIVITY FOR SARS COV-2, BUT HAVING NEGATIVE RT-PCR FOR COVID-19 AT THE TIME OF SCREENING WILL BE CONSIDERED ELIGIBLE FOR ENROLMENT IN THE STUDY. CRITICALLY ILL PATIENTS WITH ARDS (ACUTE RESPIRATORY DISTRESS SYNDROME), REQUIRING INVASIVE RESPIRATORY SUPPORT IN THE INTENSIVE CARE UNIT, KNOWN CASE OF ANY MALIGNANCY, IMMUNE-COMPROMISED STATE (E.G. HIV), DIABETES MELLITUS, ACTIVE PULMONARY TUBERCULOSIS, PAST HISTORY OF ANY CHRONIC RESPIRATORY DISEASE, MOTOR NEURON DISEASE, MULTIPLE SCLEROSIS, STROKE, IMPAIRED COGNITION, ATRIAL FIBRILLATION, ACUTE CORONARY SYNDROME, MYOCARDIAL INFARCTION, SEVERE ARRHYTHMIA, CONCURRENT SERIOUS HEPATIC DISEASE OR RENAL DISEASE, PREGNANT OR LACTATING WOMEN, PATIENTS ON IMMUNOSUPPRESSIVE MEDICATIONS, HISTORY OF HYPERSENSITIVITY TO THE TRIAL DRUGS OR THEIR INGREDIENTS, DEPRESSIVE ILLNESS (BEFORE COVID-19), DIAGNOSED PSYCHOTIC ILLNESSES, SUBSTANCE DEPENDENCE OR ALCOHOLISM WILL BE EXCLUDED. THE TRIAL WILL BE CONDUCTED AT TWO MEDICAL COLLEGES IN MAHARASHTRA, INDIA. INTERVENTION AND COMPARATOR: INTERVENTION ARM (GROUP-I): AYURVEDA INTERVENTIONS INCLUDING AGASTYA HARITAKI SIX GRAM AND ASHWAGANDHA TABLET 500 MG TWICE DAILY ORALLY AFTER MEALS WITH WARM WATER AND TWO SESSIONS OF YOGA (MORNING 30 MINUTES AND EVENING 15 MINUTES) DAILY FOR 90 DAYS, AS PER THE POST-COVID-19 CARE PROTOCOL PROVIDED IN NATIONAL CLINICAL MANAGEMENT PROTOCOL BASED ON AYURVEDA AND YOGA FOR MANAGEMENT OF COVID-19 PUBLISHED BY MINISTRY OF AYUSH, GOVERNMENT OF INDIA. COMPARATOR ARM (GROUP-II): WHO REHABILITATION SELF-MANAGEMENT AFTER COVID-19 RELATED ILLNESS FOR 90 DAYS. THE TRIAL DRUGS ARE BEING PROCURED FROM A GMP CERTIFIED PHARMACEUTICAL COMPANY. MAIN OUTCOMES: PRIMARY OUTCOME: CHANGE IN RESPIRATORY FUNCTION TO BE ASSESSED BY SAN DIEGO SHORTNESS OF BREATH QUESTIONNAIRE, 6-MINUTES WALK TEST AND PULMONARY FUNCTION TEST. SECONDARY OUTCOMES: CHANGE IN HIGH-RESOLUTION COMPUTED TOMOGRAPHY (HRCT) CHEST CHANGE IN FATIGUE SCORE ASSESSED BY MODIFIED FATIGUE IMPACT SCALE CHANGE IN ANXIETY SCORE ASSESSED BY HOSPITAL ANXIETY AND DEPRESSION SCALE SCORE CHANGE IN SLEEP QUALITY ASSESSED BY PITTSBURGH SLEEP QUALITY INDEX CHANGE IN THE QUALITY OF LIFE ASSESSED BY COV19-QOL SCALE SAFETY OF THE INTERVENTIONS WILL BE ASSESSED BY COMPARING HEMATOLOGICAL AND BIOCHEMICAL INVESTIGATIONS BEFORE AND AFTER THE INTERVENTION PERIOD AND ADVERSE EVENT/ ADVERSE DRUG REACTION TIMELINES FOR OUTCOME ASSESSMENT: SUBJECTIVE PARAMETERS AND CLINICAL ASSESSMENT WILL BE ASSESSED AT BASELINE, 15(TH) DAY, 30(TH) DAY, 60(TH) DAY AND 90(TH) DAY. LABORATORY PARAMETERS (CBC, LFT, KFT, HBA1C, HS-CRP, D-DIMER), PULMONARY FUNCTION TEST AND HRCT CHEST WILL BE DONE AT BASELINE AND AFTER COMPLETION OF STUDY PERIOD I.E. 90(TH) DAY. RANDOMISATION: STATISTICAL PACKAGE FOR SOCIAL SCIENCES (SPSS) VERSION 15.0 IS USED TO GENERATE THE RANDOM NUMBER SEQUENCES. THE PARTICIPANTS WILL BE RANDOMIZED TO TWO STUDY GROUPS IN THE RATIO OF 1:1. BLINDING (MASKING): THE STUDY IS OPEN-LABEL DESIGN. HOWEVER, THE OUTCOME ASSESSOR WILL BE KEPT BLINDED REGARDING THE STUDY GROUP ALLOCATION OF THE PARTICIPANTS. NUMBERS TO BE RANDOMISED (SAMPLE SIZE) SAMPLE SIZE: THE SAMPLE SIZE FOR THE STUDY IS CALCULATED ASSUMING IMPROVEMENT IN 6-MINUTES WALK TEST BY 40 METER IN GROUP I AND A CHANGE OF 10 METER IN GROUP II WITH A STANDARD DEVIATION OF 50 METER BASED ON THE RESULTS OF THE PREVIOUS STUDIES, WITH 95% CONFIDENCE LEVEL (ALPHA = 0.05) AND 80% POWER AND EXPECTING A DROPOUT RATE OF 20%. THE NUMBER OF PARTICIPANTS TO BE ENROLLED IN THE STUDY SHOULD BE APPROXIMATELY 55 IN EACH GROUP. HENCE, A TOTAL OF 110 PARTICIPANTS WILL BE ENROLLED IN THE TRIAL AT EACH STUDY SITE. TRIAL STATUS: PARTICIPANTS' RECRUITMENT STARTED ON 1(ST) MAY 2021. ANTICIPATED END OF RECRUITMENT IS AUGUST 2021. PROTOCOL NUMBER: CCRAS-01 PROTOCOL VERSION NUMBER: 1.1, 13TH JANUARY 2021. TRIAL REGISTRATION: THE TRIAL IS PROSPECTIVELY REGISTERED WITH THE CLINICAL TRIAL REGISTRY OF INDIA (CTRI) ON 03(RD) MARCH 2021 [ CTRI/2021/03/031686 ]. FULL PROTOCOL: THE FULL PROTOCOL IS ATTACHED AS AN ADDITIONAL FILE, ACCESSIBLE FROM THE JOURNAL WEBSITE (ADDITIONAL FILE 1). THIS COMMUNICATION SERVES AS A SUMMARY OF THE KEY ELEMENTS OF THE FULL PROTOCOL. 2021 4 1295 47 GUIDELINES FOR TEACHING YOGA TO WOMEN WITH BREAST CANCER-RELATED LYMPHOEDEMA: AN EVIDENCE-BASED APPROACH. BREAST CANCER-RELATED LYMPHOEDEMA (BCRL) IS A CHRONIC CONDITION THAT REQUIRES LIFELONG MANAGEMENT TO PREVENT THE CONDITION WORSENING AND TO REDUCE THE THREAT OF INFECTION. WOMEN ARE AFFECTED IN ALL DOMAINS OF THEIR LIFE. AS A HOLISTIC PRACTICE, YOGA MAY BE OF BENEFIT BY REDUCING BOTH THE PHYSICAL AND PSYCHOSOCIAL EFFECTS OF LYMPHOEDEMA. WOMEN WITH BCRL ARE ATTENDING YOGA CLASSES IN INCREASING NUMBERS, SO IT IS ESSENTIAL THAT YOGA BE BASED ON PRINCIPLES THAT ENSURE LYMPHOEDEMA IS CONTROLLED AND NOT EXACERBATED. TWO RANDOMISED CONTROLLED TRIALS WITH A YOGA INTERVENTION HAVE HAD POSITIVE RESULTS AFTER AN 8-WEEK INTERVENTION (N=28) AND 6-MONTHS AFTER A 4-WEEK INTERVENTION (N=18). THE FIRST STUDY HAD SEVERAL SIGNIFICANT RESULTS AND WOMEN REPORTED INCREASED BIOPSYCHOSOCIAL IMPROVEMENTS. BOTH STUDIES SHOWED TRENDS TO IMPROVED LYMPHOEDEMA STATUS. THE YOGA INTERVENTIONS COMPROMISED BREATHING, PHYSICAL POSTURES, MEDITATION AND RELAXATION PRACTICES BASED ON SATYANANDA YOGA(R), WITH MODIFICATIONS TO PROMOTE LYMPHATIC DRAINAGE AND FOLLOWING PRINCIPLES OF BEST CURRENT CARE FOR THOSE WITH BCRL. INDIVIDUAL NEEDS WERE CONSIDERED. THE YOGA PROTOCOL THAT WAS USED IN THE 8-WEEK TRIAL IS PRESENTED. OUR AIM IS TO PROVIDE PRINCIPLES FOR YOGA TEACHERS/THERAPISTS WORKING WITH THIS CLIENTELE THAT CAN BE ADAPTED TO OTHER YOGA STYLES. FURTHER, THESE PRINCIPLES MAY PROVIDE A BASIS FOR THE DEVELOPMENT OF YOGA PROGRAMS FOR PEOPLE WITH SECONDARY LYMPHOEDEMA IN OTHER AREAS OF THEIR BODY AS THE POPULATION REQUIRING CANCER TREATMENT CONTINUES TO INCREASE. WHILST THE STYLE OF YOGA PRESENTED HERE HAS HAD POSITIVE OUTCOMES, FURTHER APPLICATION AND RESEARCH IS NEEDED TO FULLY DEMONSTRATE ITS EFFECTIVENESS. 2017 5 2716 58 YOGA MANAGEMENT OF BREAST CANCER-RELATED LYMPHOEDEMA: A RANDOMISED CONTROLLED PILOT-TRIAL. BACKGROUND: SECONDARY ARM LYMPHOEDEMA CONTINUES TO AFFECT AT LEAST 20% OF WOMEN AFTER TREATMENT FOR BREAST CANCER REQUIRING LIFELONG PROFESSIONAL TREATMENT AND SELF-MANAGEMENT. THE HOLISTIC PRACTICE OF YOGA MAY OFFER BENEFITS AS AN ADJUNCT SELF-MANAGEMENT OPTION. THE AIM OF THIS SMALL PILOT TRIAL WAS TO GAIN PRELIMINARY DATA TO DETERMINE THE EFFECT OF YOGA ON WOMEN WITH STAGE ONE BREAST CANCER-RELATED LYMPHOEDEMA (BCRL). THIS PAPER REPORTS THE RESULTS FOR THE PRIMARY AND SECONDARY OUTCOMES. METHODS: PARTICIPANTS WERE RANDOMISED, AFTER BASELINE TESTING, TO RECEIVE EITHER AN 8-WEEK YOGA INTERVENTION (N = 15), CONSISTING OF A WEEKLY 90-MINUTE TEACHER-LED CLASS AND A 40-MINUTE DAILY SESSION DELIVERED BY DVD, OR TO A USUAL CARE WAIT-LISTED CONTROL GROUP (N = 13). PRIMARY OUTCOME MEASURES WERE: ARM VOLUME OF LYMPHOEDEMA MEASURED BY CIRCUMFERENCE AND EXTRA-CELLULAR FLUID MEASURED BY BIOIMPEDANCE SPECTROSCOPY. SECONDARY OUTCOME MEASURES WERE: TISSUE INDURATION MEASURED BY TONOMETRY; LEVELS OF SENSATIONS, PAIN, FATIGUE, AND THEIR LIMITING EFFECTS ALL MEASURED BY A VISUAL ANALOGUE SCALE (VAS) AND QUALITY OF LIFE BASED ON THE LYMPHOEDEMA QUALITY OF LIFE TOOL (LYMQOL). MEASUREMENTS WERE CONDUCTED AT BASELINE, WEEK 8 (POST-INTERVENTION) AND WEEK 12 (FOUR WEEKS AFTER CESSATION OF THE INTERVENTION). RESULTS: AT WEEK 8, THE INTERVENTION GROUP HAD A GREATER DECREASE IN TISSUE INDURATION OF THE AFFECTED UPPER ARM COMPARED TO THE CONTROL GROUP (P = 0.050), AS WELL AS A GREATER REDUCTION IN THE SYMPTOM SUB-SCALE FOR QOL (P = 0.038). THERE WAS NO DIFFERENCE IN ARM VOLUME OF LYMPHOEDEMA OR EXTRA-CELLULAR FLUID BETWEEN GROUPS AT WEEK 8; HOWEVER, AT WEEK 12, ARM VOLUME INCREASED MORE FOR THE INTERVENTION GROUP THAN THE CONTROL GROUP (P = 0.032). CONCLUSIONS: AN 8-WEEK YOGA INTERVENTION REDUCED TISSUE INDURATION OF THE AFFECTED UPPER ARM AND DECREASED THE QOL SUB-SCALE OF SYMPTOMS. ARM VOLUME OF LYMPHOEDEMA AND EXTRA-CELLULAR FLUID DID NOT INCREASE. THESE BENEFITS DID NOT LAST ON CESSATION OF THE INTERVENTION WHEN ARM VOLUME OF LYMPHOEDEMA INCREASED. FURTHER RESEARCH TRIALS WITH A LONGER DURATION, HIGHER LEVELS OF LYMPHOEDEMA AND LARGER NUMBERS ARE WARRANTED BEFORE DEFINITIVE CONCLUSIONS CAN BE MADE. 2014 6 462 44 CHANGES IN REACTION TIME AFTER YOGA BELLOWS-TYPE BREATHING IN HEALTHY FEMALE VOLUNTEERS. BACKGROUND: PREVIOUSLY, YOGA BELLOWS-TYPE BREATHING (BHASTRIKA PRANAYAMA) REDUCED REACTION TIME (RT) OR REDUCED ANTICIPATORY RESPONSES IN MALE PARTICIPANTS OR A MIXED GROUP OF MALE AND FEMALE PARTICIPANTS. AIMS: THE PRESENT STUDY AS A CONTROL TRIAL AIMED TO ASSESS THE EFFECTS OF YOGA BELLOWS-TYPE BREATHING ON RT IN FEMALES EXCLUSIVELY. METHODS: THE SAMPLE CONSISTED OF 25 HEALTHY FEMALES, AGED BETWEEN 19 AND 32 YEARS (GROUP MEAN +/- STANDARD DEVIATION, 22.8 +/- 3.5 YEARS). ALL OF THEM HAD PRIOR MINIMUM EXPERIENCE OF YOGA INCLUDING YOGA BELLOWS-TYPE BREATHING OF 12 MONTHS. THE RT WAS ASSESSED IN EACH PARTICIPANT BEFORE AND AFTER THREE RANDOMIZED SESSIONS DIFFERED IN THE INTERVENTION GIVEN HELD ON THREE SEPARATE DAYS. THE SESSIONS WERE (I) YOGA BELLOWS-TYPE BREATHING OR BHASTRIKA PRANAYAMA(BHK), (II) BREATH AWARENESS (BAW), AND (III) SITTING QUIETLY (CTL) AS A CONTROL SESSION. THE DURATION OF THE INTERVENTION WAS 18 MIN, AND THE PARTICIPANTS WERE ASSESSED FOR RT BEFORE AND AFTER THE INTERVENTION. RESULTS: REPEATED MEASURES ANOVA, POST HOC TESTS WITH BONFERRONI ADJUSTED SHOWED THAT THE TIME TAKEN TO OBTAIN A CORRECT RESPONSE REDUCED SIGNIFICANTLY AFTER 18 MIN OF BAW (P < 0.05) AND CTL (P < 0.05). HOWEVER, NO CHANGES WERE SEEN IN THE RT AFTER BHK. CONCLUSIONS: THE RESULTS SUGGEST THAT DIFFERENT INTERVENTIONS MAY OPTIMIZE PERFORMANCE IN TASKS REQUIRING ATTENTION IN FEMALES COMPARED TO MALES. 2018 7 282 56 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 2360 36 VIDEOCONFERENCED YOGA INTERVENTIONS FOR CANCER PATIENTS AND THEIR CAREGIVERS DURING THE COVID-19 PANDEMIC: A REPORT FROM A CLINICIAN'S PERSPECTIVE. BACKGROUND: THE ACCEPTABILITY OF VIDEOCONFERENCING DELIVERY OF YOGA INTERVENTIONS IN THE ADVANCED CANCER SETTING IS RELATIVELY UNEXPLORED. THE CURRENT REPORT SUMMARIZES THE CHALLENGES AND SOLUTIONS OF THE TRANSITION FROM AN IN-PERSON (IE, FACE-TO-FACE) TO A VIDEOCONFERENCE INTERVENTION DELIVERY APPROACH IN RESPONSE TO THE CORONAVIRUS DISEASE PANDEMIC. METHOD: PARTICIPANTS INCLUDED PATIENT-FAMILY CAREGIVER DYADS WHO WERE ENROLLED IN ONGOING YOGA TRIALS AND 2 CERTIFIED YOGA THERAPISTS WHO DELIVERED THE YOGA SESSIONS. WE SUMMARIZED THEIR EXPERIENCES USING RECORDINGS OF THE YOGA SESSIONS AND INTERVENTIONISTS' PROGRESS NOTES. RESULTS: OUT OF 7 DYADS PARTICIPATING IN THE PARENT TRIAL, 1 DECLINED THE VIDEOCONFERENCED SESSIONS. PARTICIPANTS WERE BETWEEN THE AGES OF 55 AND 76 AND MOSTLY NON-HISPANIC WHITE (83%). PATIENTS WERE MAINLY MALE (83%), ALL HAD STAGE III OR IV CANCER AND WERE UNDERGOING RADIOTHERAPY. CAREGIVERS WERE ALL FEMALE. DESPITE CHALLENGES IN THE AREAS OF TECHNOLOGY, LOCATION, AND SETTING, INSTRUCTION AND PERSONAL CONNECTION, THE OVERALL ACCEPTABILITY WAS HIGH AMONG PATIENTS, CAREGIVERS, AND INSTRUCTORS. THROUGH THIS TRANSITION PROCESS, SOLUTIONS TO THESE CHALLENGES WERE FOUND, WHICH ARE DESCRIBED HERE. CONCLUSION: ALTHOUGH IN-PERSON INTERVENTIONS ARE FAVORED BY BOTH THE STUDY PARTICIPANTS AND THE INTERVENTIONISTS, VIDEOCONFERENCE SESSIONS WERE DEEMED ACCEPTABLE. ALL PARTICIPANTS HAD THE BENEFIT OF A PREVIOUS IN-PERSON EXPERIENCE, WHICH WAS HELPFUL AND PERHAPS NECESSARY FOR OLDER AND ADVANCED CANCER PATIENTS REQUIRING PRACTICE MODIFICATIONS. IN A REMOTE SETTING, THE ASSISTANCE OF CAREGIVERS SEEMS PARTICULARLY BENEFICIAL TO ENSURE PRACTICE SAFETY. CLINICALTRIALS.GOV: NCT03948100; NCT02481349. 2021 9 71 36 A FEASIBILITY STUDY OF RESTORATIVE YOGA VERSUS VIGOROUS YOGA INTERVENTION FOR SEDENTARY BREAST AND OVARIAN CANCER SURVIVORS. YOGA HAS BEEN SHOWN TO IMPROVE CANCER SURVIVORS' QUALITY OF LIFE, YET REGULAR YOGA PRACTICE IS A CHALLENGE FOR THOSE WHO ARE SEDENTARY. WE CONDUCTED A PILOT RANDOMIZED CONTROLLED STUDY TO ASSESS FEASIBILITY AND ADHERENCE OF TWO TYPES OF YOGA INTERVENTION AMONG SEDENTARY CANCER SURVIVORS. SEDENTARY BREAST AND OVARIAN CANCER SURVIVORS WERE RANDOMIZED TO PRACTICE EITHER RESTORATIVE YOGA (MINIMAL PHYSICAL EXERTION, GROUP R) OR VIGOROUS YOGA (CONSIDERABLE PHYSICAL EXERTION, GROUP V) IN THREE 60-MINUTE SUPERVISED SESSIONS A WEEK FOR 12 WEEKS, FOLLOWED BY 12 WEEKS OF HOME PRACTICE. ACCRUAL, ADHERENCE, AND ATTENDANCE RATES WERE ASSESSED. OF THE 226 ELIGIBLE PATIENTS, 175 (77%) DECLINED TO PARTICIPATE IN THE STUDY, CITING TIME COMMITMENT AND TRAVEL AS THE MOST COMMON BARRIERS. FORTY-TWO SUBJECTS CONSENTED TO PARTICIPATE IN THE STUDY. OF THE 35 PARTICIPANTS WHO BEGAN THE INTERVENTION (20 IN GROUP R AND 15 IN GROUP V), ADHERENCE RATE (PERCENTAGE REMAINING IN THE STUDY AT WEEK 12) WAS 100% AND 87%, RESPECTIVELY. RATE OF ADEQUATE ATTENDANCE (MORE THAN 66% OF THE SCHEDULED SUPERVISED SESSIONS) WAS 85% AND 73%, RESPECTIVELY. RATE OF COMPLETION OF THE HOME PRACTICE PERIOD WAS 85% AND 77%, RESPECTIVELY. IN THIS STUDY, SEDENTARY CANCER SURVIVORS WERE ABLE TO ADHERE TO A LONG-TERM, REGULAR YOGA REGIMEN. THE RATE OF ADEQUATE ATTENDANCE WAS HIGHER FOR RESTORATIVE YOGA. FUTURE STUDIES FOR SEDENTARY PATIENTS SHOULD FOCUS ON REDUCING TIME COMMITMENT AND TRAVEL REQUIREMENTS TO IMPROVE RECRUITMENT, AND ON USING RESTORATIVE YOGA AS A MORE FEASIBLE INTERVENTION FOR THIS POPULATION. 2018 10 1238 56 FEASIBILITY OF A GROUP-BASED LAUGHTER YOGA INTERVENTION AS AN ADJUNCTIVE TREATMENT FOR RESIDUAL SYMPTOMS OF DEPRESSION, ANXIETY AND STRESS IN PEOPLE WITH DEPRESSION. BACKGROUND: LAUGHTER YOGA (LY) IS A GROUP-BASED INTERVENTION INVOLVING SIMULATED LAUGHTER, GENTLE STRETCHING, RHYTHMIC BREATHING AND MEDITATION. THERE IS SOME LIMITED EVIDENCE THAT LY REDUCES DEPRESSIVE SYMPTOMS OVER THE SHORT TERM. HOWEVER, THE QUALITY OF PREVIOUS LY STUDIES IS POOR AND NONE INVOLVED WORKING-AGED PEOPLE WITH A CLINICAL DIAGNOSIS OF DEPRESSION. THEREFORE, THIS STUDY AIMED TO INVESTIGATE THE FEASIBILITY AND POTENTIAL EFFICACY OF LY FOR IMPROVING RESIDUAL MOOD, ANXIETY AND STRESS SYMPTOMS IN ADULTS DIAGNOSED WITH DEPRESSION. METHODS: FIFTY PARTICIPANTS WERE RANDOMISED TO THE GROUP LY INTERVENTION (N=23) CONSISTING OF EIGHT SESSIONS OVER FOUR WEEKS, OR TREATMENT-AS-USUAL (N=27). PARTICIPANTS COMPLETED THE DEPRESSION ANXIETY STRESS SCALE AND THE SHORT FORM 12 ITEM HEALTH SURVEY AT BASELINE (T0), POST-INTERVENTION (T1) AND AT 3 MONTHS FOLLOW-UP (T2). LY PARTICIPANTS ALSO COMPLETED A CLIENT SATISFACTION QUESTIONNAIRE (CSQ8) AT T1 AND ELEVEN PARTICIPATED IN INDIVIDUAL QUALITATIVE INTERVIEWS AT T2. RESULTS: THE LY GROUP HAD STATISTICALLY GREATER DECREASES IN DEPRESSION AND IMPROVEMENTS IN MENTAL HEALTH RELATED QUALITY OF LIFE COMPARED TO THE CONTROL GROUP FROM T0 TO T1. THE CSQ8 SCORES INDICATED A FAVOURABLE LEVEL OF SATISFACTION WITH THE LY INTERVENTION. THE QUALITATIVE INTERVIEWS HIGHLIGHTED ASPECTS OF THE INTERVENTION THAT WERE EFFECTIVE AND THOSE REQUIRING MODIFICATION. LIMITATIONS: LIMITATIONS INCLUDE THE SMALL SAMPLE SIZE AND TREATMENT-AS-USUAL CONTROL GROUP. CONCLUSIONS: A FULL SCALE RCT OF LY COULD BE FEASIBLE IF SOME MODIFICATIONS WERE MADE TO THE PROTOCOL/INTERVENTION. THE INTERVENTION MAY BE EFFECTIVE TO IMPROVE DEPRESSION AND MENTAL HEALTH RELATED QUALITY OF LIFE IMMEDIATELY POST INTERVENTION. 2019 11 440 32 CASE REPORT: THE USE OF MEDICAL YOGA FOR ADOLESCENT MENTAL HEALTH. MENTAL HEALTH ISSUES ARE EPIDEMIC AMONG YOUTH IN THE UNITED STATES TODAY. RECENT STUDIES SUGGEST THAT UP TO 50% OF ALL TEENAGERS HAVE COMPLAINTS RELATED TO STRESS, ANXIETY, AND/OR DEPRESSION. THIS PROBLEM IS ACCOMPANIED BY AN UNPRECEDENTED RISE IN THE RATES OF CHILD AND TEEN SUICIDE IN THE UNITED STATES. IN RESPONSE TO THIS EPIDEMIC, THE AMERICAN ACADEMY OF PEDIATRICS IS RECOMMENDING UNIVERSAL DEPRESSION SCREENING FOR ALL TEENS. MEDICATIONS ARE AVAILABLE TO AMELIORATE MENTAL HEALTH DISORDERS, AND MANY CAN BE SAFELY USED IN THE PRIMARY CARE SETTING. HOWEVER, MANY OF THESE MEDICATIONS HAVE UNWANTED SIDE EFFECTS OR MAY NOT BE FAMILIAR TO THE PRIMARY CARE PHYSICIAN. FOR THESE REASONS AND OTHERS, PRIMARY CARE PHYSICIANS REQUIRE ADDITIONAL APPROACHES TO RESPOND TO THE CHALLENGES IMPOSED BY A GROWING NUMBER OF PATIENTS REQUIRING MENTAL HEALTH SUPPORT. MEDICAL YOGA THERAPY, PRESCRIBED BY A PHYSICIAN WITH SPECIAL YOGA THERAPY TRAINING, OFFERS A SAFE AND EFFECTIVE WAY TO SERVE THE PATIENT WITH PHYSICAL OR MENTAL CHALLENGES DISABILITIES. MEDICAL YOGA THERAPY IS AN INDIVIDUALIZED AND PERSONAL APPROACH TO THE PATIENT, AND IT MAY BE INTEGRATED WITH ANY CURRENT THERAPY OR MEDICAL REGIMEN. HERE, EVIDENCE FOR MEDICAL YOGA IS REVIEWED IN THE CONTEXT OF AN ADOLESCENT PATIENT WITH A COMMON DISORDER. YOGA PRACTICES, WITH PARTICULAR FOCUS ON MINDFULNESS, OFFER A SAFE AND EFFECTIVE INTERVENTION FOR A GROWING NUMBER OF PEDIATRIC PATIENTS. 2019 12 1240 42 FEASIBILITY OF A MINDFUL YOGA PROGRAM FOR WOMEN WITH METASTATIC BREAST CANCER: RESULTS OF A RANDOMIZED PILOT STUDY. PURPOSE: PATIENTS WITH METASTATIC BREAST CANCER (MBC) EXPERIENCE HIGH LEVELS OF SYMPTOMS. YOGA INTERVENTIONS HAVE SHOWN PROMISE FOR IMPROVING CANCER SYMPTOMS BUT HAVE RARELY BEEN TESTED IN PATIENTS WITH ADVANCED DISEASE. THIS STUDY EXAMINED THE ACCEPTABILITY OF A COMPREHENSIVE YOGA PROGRAM FOR MBC AND THE FEASIBILITY OF CONDUCTING A RANDOMIZED TRIAL TESTING THE INTERVENTION. METHODS: SIXTY-THREE WOMEN WITH MBC WERE RANDOMIZED WITH A 2:1 ALLOCATION TO YOGA OR A SUPPORT GROUP COMPARISON CONDITION. BOTH INTERVENTIONS INVOLVED EIGHT WEEKLY GROUP SESSIONS. FEASIBILITY WAS QUANTIFIED USING RATES OF ACCRUAL, ATTRITION, AND SESSION ATTENDANCE. ACCEPTABILITY WAS ASSESSED WITH A STANDARDIZED SELF-REPORT MEASURE. PAIN, FATIGUE, SLEEP QUALITY, PSYCHOLOGICAL DISTRESS, MINDFULNESS, AND FUNCTIONAL CAPACITY WERE ASSESSED AT BASELINE, POST-INTERVENTION, AND 3 AND 6 MONTHS POST-INTERVENTION. RESULTS: WE MET GOALS FOR ACCRUAL AND RETENTION, WITH 50% OF ELIGIBLE PATIENTS ENROLLED AND 87% OF RANDOMIZED PARTICIPANTS COMPLETING POST-INTERVENTION SURVEYS. SIXTY-FIVE PERCENT OF WOMEN IN THE YOGA CONDITION AND 90% IN THE SUPPORT GROUP ATTENDED >/= 4 SESSIONS. EIGHTY PERCENT OF PARTICIPANTS IN THE YOGA CONDITION AND 65% IN THE SUPPORT GROUP INDICATED THAT THEY WERE HIGHLY SATISFIED WITH THE INTERVENTION. FOLLOWING TREATMENT, WOMEN IN THE YOGA INTERVENTION HAD MODEST IMPROVEMENTS IN SOME OUTCOMES; HOWEVER, OVERALL SYMPTOM LEVELS WERE LOW FOR WOMEN IN BOTH CONDITIONS. CONCLUSIONS: FINDINGS SUGGEST THAT THE YOGA INTERVENTION CONTENT WAS HIGHLY ACCEPTABLE TO PATIENTS WITH MBC, BUT THAT THERE ARE CHALLENGES TO IMPLEMENTING AN INTERVENTION INVOLVING EIGHT GROUP-BASED IN-PERSON SESSIONS. ALTERNATIVE MODES OF DELIVERY MAY BE NECESSARY TO REACH PATIENTS MOST IN NEED OF INTERVENTION. 2019 13 2596 55 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 14 1331 47 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 15 1215 51 EXPLORING THE EFFECTS OF YOGA THERAPY ON HEART RATE VARIABILITY AND PATIENT-REPORTED OUTCOMES AFTER CANCER TREATMENT: A STUDY PROTOCOL. BACKGROUND: FOLLOWING CANCER TREATMENT, ADULTS COMMONLY REPORT WORSENED PATIENT-REPORTED OUTCOMES (PROS) SUCH AS ANXIETY, STRESS, DEPRESSION, PERSISTENT AND UPSETTING COGNITIVE COMPLAINTS, UNRELENTING FATIGUE, AND REDUCED QUALITY OF LIFE. POORER PROS ARE ASSOCIATED WITH DISRUPTED AUTONOMIC NERVOUS SYSTEM FUNCTIONING AS MEASURED BY HEART RATE VARIABILITY (HRV), BOTH OF WHICH HAVE BEEN ASSOCIATED WITH GREATER MORBIDITY AND MORTALITY. INTERVENTIONS TO IMPROVE HRV AND PROS AMONG ADULTS FOLLOWING CANCER TREATMENT ARE NEEDED. YOGA THERAPY HOLDS PROMISE AS AN INTERVENTION TO IMPROVE HRV AND PROS. THEREFORE, WE CONDUCTED A SINGLE-SUBJECT EXPLORATORY EXPERIMENTAL STUDY TO INVESTIGATE THE EFFECTS OF YOGA THERAPY ON HRV AND SPECIFIC PROS (IE, CANCER-RELATED FATIGUE, ANXIETY, COGNITIVE FUNCTION, DEPRESSION, STRESS, QUALITY OF LIFE) IN ADULTS TREATED FOR CANCER. TO REDUCE PUBLICATION BIAS, IMPROVE REPRODUCIBILITY, AND SERVE AS A REFERENCE FOR FORTHCOMING REPORTING OF STUDY RESULTS, WE PRESENT THE STUDY PROTOCOL FOR THIS STUDY HEREIN. METHODS: PARTICIPANTS WERE ADULTS WHO COMPLETED CANCER TREATMENT THAT WERE RECRUITED FROM THE OTTAWA INTEGRATIVE CANCER CENTRE. CONSENTING AND ELIGIBLE PARTICIPANTS RECEIVED ONE 1:1 YOGA THERAPY SESSION (IE, 1 PARTICIPANT, 1 YOGA THERAPIST) AND 6 WEEKLY GROUP-BASED YOGA THERAPY SESSIONS (IE, 2-3 PARTICIPANTS, 1 YOGA THERAPIST). PARTICIPANTS COMPLETED ASSESSMENTS 7 TIMES: 3 TIMES PRIOR TO THE PROGRAM (IE, -6 WEEKS, -3 WEEKS, IMMEDIATELY PRIOR TO THE 1:1 YOGA THERAPY SESSION), IMMEDIATELY FOLLOWING THE 1:1 YOGA THERAPY SESSION, PRIOR TO THE FIRST GROUP-BASED YOGA THERAPY SESSION, AFTER THE LAST GROUP-BASED YOGA THERAPY SESSION, AND AT A 6-WEEK FOLLOW-UP. HIERARCHICAL LINEAR MODELING WILL BE USED TO TEST THE AVERAGE EFFECTS OF THE YOGA THERAPY PROGRAM ACROSS PARTICIPANTS. DISCUSSION: THIS STUDY WILL EXPLORE SEVERAL NOVEL HYPOTHESES, INCLUDING WHETHER YOGA THERAPY CAN IMPROVE HRV AND/OR SPECIFIC PROS AMONG ADULTS TREATED FOR CANCER ACUTELY (IE, DURING A 1:1 YOGA THERAPY SESSION) AND/OR THROUGH REPEATED EXPOSURE (IE, AFTER COMPLETING 6 WEEKS OF GROUP-BASED YOGA THERAPY). ALTHOUGH THE FINDINGS WILL REQUIRE CONFIRMATION OR REFUTATION IN FUTURE TRIALS, THEY MAY PROVIDE INITIAL EVIDENCE THAT YT MAY BENEFIT ADULTS TREATED FOR CANCER. TRIAL REGISTRATION: ISRCTN REGISTRY, ISRCTN64763228. REGISTERED ON DECEMBER 12, 2021. THIS TRIAL WAS REGISTERED RETROSPECTIVELY. URL OF TRIAL REGISTRY RECORD: HTTPS://WWW.ISRCTN.COM/ISRCTN64763228. 2022 16 1903 42 RESULTS FROM A CLINICAL YOGA PROGRAM FOR VETERANS: YOGA VIA TELEHEALTH PROVIDES COMPARABLE SATISFACTION AND HEALTH IMPROVEMENTS TO IN-PERSON YOGA. BACKGROUND: YOGA IS INCREASINGLY POPULAR, THOUGH LITTLE DATA REGARDING ITS IMPLEMENTATION IN HEALTHCARE SETTINGS IS AVAILABLE. SIMILARLY, TELEHEALTH IS BEING UTILIZED MORE FREQUENTLY TO INCREASE ACCESS TO HEALTHCARE; HOWEVER WE KNOW OF NO RESEARCH ON THE ACCEPTABILITY OR EFFECTIVENESS OF YOGA DELIVERED THROUGH TELEHEALTH. THEREFORE, WE EVALUATED THE FEASIBILITY, ACCEPTABILITY, AND PATIENT-REPORTED EFFECTIVENESS OF A CLINICAL YOGA PROGRAM AT A VETERANS AFFAIRS MEDICAL CENTER AND ASSESSED WHETHER THESE OUTCOMES DIFFERED BETWEEN THOSE PARTICIPATING IN-PERSON AND THOSE PARTICIPATING VIA TELEHEALTH. METHODS: VETERANS WHO ATTENDED A YOGA CLASS AT THE VA PALO ALTO HEALTH CARE SYSTEM WERE INVITED TO COMPLETE AN ANONYMOUS PROGRAM EVALUATION SURVEY. RESULTS: 64 VETERANS COMPLETED THE SURVEY. PARTICIPANTS REPORTED HIGH SATISFACTION WITH THE CLASSES AND THE INSTRUCTORS. MORE THAN 80% OF PARTICIPANTS WHO ENDORSED A PROBLEM WITH PAIN, ENERGY LEVEL, DEPRESSION, OR ANXIETY REPORTED IMPROVEMENT IN THESE SYMPTOMS. THOSE WHO PARTICIPATED VIA TELEHEALTH DID NOT DIFFER FROM THOSE WHO PARTICIPATED IN-PERSON IN ANY MEASURE OF SATISFACTION, OVERALL IMPROVEMENT (P = .40), OR IMPROVEMENT IN ANY OF 16 SPECIFIC HEALTH PROBLEMS. CONCLUSIONS: DELIVERING YOGA TO A WIDE RANGE OF PATIENTS WITHIN A HEALTHCARE SETTING APPEARS TO BE FEASIBLE AND ACCEPTABLE, BOTH WHEN DELIVERED IN-PERSON AND VIA TELEHEALTH. PATIENTS IN THIS CLINICAL YOGA PROGRAM REPORTED HIGH LEVELS OF SATISFACTION AND IMPROVEMENT IN MULTIPLE PROBLEM AREAS. THIS PRELIMINARY EVIDENCE FOR THE EFFECTIVENESS OF A CLINICAL YOGA PROGRAM COMPLEMENTS PRIOR EVIDENCE FOR THE EFFICACY OF YOGA AND SUPPORTS THE USE OF YOGA IN HEALTHCARE SETTINGS. 2017 17 2441 33 YOGA AND SCHIZOPHRENIA-A COMPREHENSIVE ASSESSMENT OF NEUROPLASTICITY: PROTOCOL FOR A SINGLE BLIND RANDOMIZED CONTROLLED STUDY OF YOGA IN SCHIZOPHRENIA. INTRODUCTION: SCHIZOPHRENIA IS ONE OF THE MOST SEVERE MENTAL DISORDERS WITH A PREVALENCE OF ABOUT 1% AND A LEADING CAUSE OF DISABILITY AMONG YOUNG ADULTS. PHARMACOTHERAPY IS THE MAINSTAY IN THE MANAGEMENT OF SCHIZOPHRENIA. HOWEVER, EVEN WITH THE BEST OF MEDICATION, SEVERAL PROBLEMS LIKE REFRACTORINESS, NEGATIVE SYMPTOMS, FREQUENT RELAPSES, AND COGNITIVE IMPAIRMENTS PERSIST. METHODS: THIS IS A RANDOMIZED-CONTROLLED CLINICAL STUDY INCLUDING PATIENTS FROM AN URBAN TERTIARY HOSPITAL AND A SEMI-URBAN COMMUNITY CENTER, WITH A BETWEEN-GROUP, REPEATED-MEASURES, LONGITUDINAL DESIGN. THIS STUDY WILL RECRUIT 160 PATIENTS WITH DSM 5 DIAGNOSIS OF SCHIZOPHRENIA WHO ARE ON STABLE MEDICATION FOR A MINIMUM OF 6 WEEKS; THEY WILL BE RANDOMLY ASSIGNED INTO 2 ARMS VIZ., YOGA THERAPY (YT), AND TREATMENT-AS-USUAL (TAU) WITH 80 PATIENTS IN EACH ARM. PARTICIPANTS WILL UNDERGO CLINICAL, LABORATORY, AND RADIOLOGICAL ASSESSMENTS AT BASELINE AND AT INTERVALS OF 1 MONTH, 3 MONTHS, AND 6 MONTHS FROM THE BASELINE. IT IS HYPOTHESIZED THAT YOGA WILL IMPROVE PSYCHOPATHOLOGY AND EMOTION PROCESSING, INCREASE SERUM BRAIN DERIVED NEUROTROPHIC FACTOR (BDNF) AND PLASMA OXYTOCIN LEVELS AND EFFECT CHANGES IN CEREBRAL ACTIVATION IN AREAS OF THE BRAIN ASSOCIATED WITH SCHIZOPHRENIA. DISCUSSION: THIS STUDY AIMS TO MEASURE THE EFFICACY OF A YOGA-BASED INTERVENTION AS AN ADJUNCT IN PATIENTS WITH SCHIZOPHRENIA AS WELL AS THE MECHANISMS OF THESE EFFECTS. TRIAL REGISTRATION: REGISTERED RETROSPECTIVELY WITH CLINICAL TRIAL REGISTRY - INDIA (CTRI) WITH REGISTRATION NUMBER CTRI/2017/08/009219. 2019 18 1243 54 FEASIBILITY OF A YOGA, AEROBIC AND STRETCHING-TONING EXERCISE PROGRAM FOR ADULT CANCER SURVIVORS: THE STAYFIT TRIAL. BACKGROUND: THE USE OF YOGA AS A MIND-BODY PRACTICE HAS BECOME INCREASINGLY POPULAR AMONG CLINICAL POPULATIONS AND OLDER ADULTS WHO USE THIS PRACTICE TO MANAGE AGE AND CHRONIC DISEASE-RELATED SYMPTOMS. ALTHOUGH YOGA CONTINUES TO GAIN POPULARITY AMONG PRACTITIONERS AND RESEARCHERS, PILOT STUDIES THAT EXAMINE ITS FEASIBILITY AND ACCEPTABILITY, ESPECIALLY AMONG CANCER SURVIVORS, ARE LIMITED. FEASIBILITY STUDIES PLAY A CRITICAL ROLE IN DETERMINING WHETHER THE TARGET POPULATION IS LIKELY TO ENGAGE WITH LARGER SCALE EFFICACY AND EFFECTIVENESS TRIALS. IN THIS PAPER WE PRESENT FEASIBILITY AND ACCEPTABILITY DATA FROM A 12-WEEK RANDOMIZED CONTROLLED TRIAL (RCT) CONDUCTED WITH ADULT CANCER SURVIVORS. METHODS: PARTICIPANTS N = 78 (MEAN AGE: 55 YEARS) WERE RANDOMIZED TO ONE OF THREE GROUPS: A HATHA YOGA, AEROBIC EXERCISE, OR STRETCHING-TONING CONTROL GROUP WITH GROUP EXERCISE CLASSES HELD FOR 150 MIN/WEEK FOR 12 WEEKS. HEREIN WE REPORT FEASIBILITY AND ACCEPTABILITY, INCLUDING ENROLLMENT RATES, ATTENDANCE, ATTRITION AND ADVERSE EVENTS, AND PARTICIPANT FEEDBACK AND SATISFACTION DATA. RESULTS: OF THE 233 ADULTS SCREENED, 109 WERE ELIGIBLE AND 78 RANDOMIZED TO ONE OF THE THREE INTERVENTION ARMS. SESSION ATTENDANCE WAS HIGH FOR ALL GROUPS (75.5-89.5%) AND 17 PARTICIPANTS DROPPED OUT DURING THE 12-WEEK INTERVENTION. PROGRAM SATISFACTION WAS HIGH (4.8 OR HIGHER OUT OF 5) AND NO ADVERSE EVENTS WERE REPORTED. ONE COHORT (N = 15) OF THE INTERVENTION TRANSITIONED TO REMOTE INTERVENTION DELIVERY DUE TO THE COVID-19 PANDEMIC. FEASIBILITY DATA FROM THESE PARTICIPANTS SUGGESTED THAT SYNCHRONIZED GROUP EXERCISE CLASSES VIA ZOOM WITH A LIVE INSTRUCTOR WERE ACCEPTABLE AND ENJOYABLE. PARTICIPANT FEEDBACK REGARDING MOST AND LEAST HELPFUL ASPECTS OF THE PROGRAM AS WELL AS SUGGESTIONS FOR FUTURE YOGA INTERVENTIONS ARE SUMMARIZED. CONCLUSIONS: OVERALL, THE YOGA INTERVENTION WAS HIGHLY FEASIBLE AND ACCEPTABLE. THE FEASIBILITY PARAMETERS FROM THIS TRIAL CAN AID RESEARCHERS IN ESTIMATING RECRUITMENT RATES FOR DESIRED SAMPLE SIZES TO SUCCESSFULLY RANDOMIZE AND RETAIN CANCER SURVIVORS IN SHORT- AND LONG-TERM YOGA-BASED EFFICACY AND EFFECTIVENESS TRIALS. THE FINDINGS ALSO PROVIDE EVIDENCE TO CLINICIANS WHO CAN RECOMMEND UP TO 150 MIN OF A COMBINATION OF EXERCISES-AEROBIC, YOGA, OR STRETCHING-TONING TO THEIR CANCER PATIENTS IN ORDER TO IMPROVE HEALTH AND WELLBEING DURING CANCER SURVIVORSHIP. 2021 19 2639 52 YOGA FOR VETERANS WITH CHRONIC LOW-BACK PAIN. OBJECTIVES: CHRONIC BACK PAIN AFFECTS A LARGE PROPORTION OF BOTH THE GENERAL POPULATION AND OF MILITARY VETERANS. ALTHOUGH NUMEROUS THERAPIES EXIST FOR TREATING CHRONIC BACK PAIN, THEY CAN BE COSTLY AND TEND TO HAVE LIMITED EFFECTIVENESS. THUS, DEMONSTRATING THE EFFICACY AND COST-EFFECTIVENESS OF ADDITIONAL TREATMENT ALTERNATIVES IS IMPORTANT. THE PURPOSE OF OUR STUDY WAS TO EXAMINE THE BENEFITS OF A YOGA INTERVENTION FOR VETERANS ADMINISTRATION (VA) PATIENTS. SUBJECTS/INTERVENTION: VA PATIENTS WITH CHRONIC BACK PAIN WERE REFERRED BY THEIR PRIMARY CARE PROVIDERS TO A YOGA PROGRAM AS PART OF CLINICAL CARE. BEFORE STARTING YOGA, A VA PHYSICIAN TRAINED IN YOGA EVALUATED EACH PATIENT TO ENSURE THAT THEY COULD PARTICIPATE SAFELY. DESIGN: THE RESEARCH STUDY CONSISTED OF COMPLETING A SHORT BATTERY OF QUESTIONNAIRES AT BASELINE AND AGAIN 10 WEEKS LATER. OUTCOME MEASURES: QUESTIONNAIRES INCLUDED MEASURES OF PAIN, DEPRESSION, ENERGY/FATIGUE, HEALTH-RELATED QUALITY OF LIFE, AND PROGRAM SATISFACTION. PAIRED T-TESTS WERE USED TO COMPARE BASELINE SCORES TO THOSE AT THE 10-WEEK FOLLOW-UP FOR THE SINGLE GROUP, PRE-POST DESIGN. CORRELATIONS WERE USED TO EXAMINE WHETHER YOGA ATTENDANCE AND HOME PRACTICE WERE ASSOCIATED WITH BETTER OUTCOMES. RESULTS: BASELINE AND FOLLOW-UP DATA WERE AVAILABLE FOR 33 PARTICIPANTS. PARTICIPANTS WERE VA PATIENTS WITH A MEAN AGE OF 55 YEARS. THEY WERE 21% FEMALE, 70% WHITE, 52% MARRIED, 68% COLLEGE GRADUATES, AND 44% WERE RETIRED. SIGNIFICANT IMPROVEMENTS WERE FOUND FOR PAIN, DEPRESSION, ENERGY/FATIGUE, AND THE SHORT FORM-12 MENTAL HEALTH SCALE. THE NUMBER OF YOGA SESSIONS ATTENDED AND THE FREQUENCY OF HOME PRACTICE WERE ASSOCIATED WITH IMPROVED OUTCOMES. PARTICIPANTS APPEARED HIGHLY SATISFIED WITH THE YOGA INSTRUCTOR AND MODERATELY SATISFIED WITH THE EASE OF PARTICIPATION AND HEALTH BENEFITS OF THE YOGA PROGRAM. CONCLUSIONS: PRELIMINARY DATA SUGGEST THAT A YOGA INTERVENTION FOR VA PATIENTS WITH CHRONIC BACK PAIN MAY IMPROVE THE HEALTH OF VETERANS. HOWEVER, THE LIMITATIONS OF A PRE-POST STUDY DESIGN MAKE CONCLUSIONS TENTATIVE. A LARGER RANDOMIZED, CONTROLLED TRIAL OF THE YOGA PROGRAM IS PLANNED. 2008 20 2638 41 YOGA FOR VETERANS WITH CHRONIC LOW BACK PAIN: DESIGN AND METHODS OF A RANDOMIZED CLINICAL TRIAL. CHRONIC LOW BACK PAIN (CLBP) AFFLICTS MILLIONS OF PEOPLE WORLDWIDE, WITH PARTICULARLY HIGH PREVALENCE IN MILITARY VETERANS. MANY TREATMENT OPTIONS EXIST FOR CLBP, BUT MOST HAVE LIMITED EFFECTIVENESS AND SOME HAVE SIGNIFICANT SIDE EFFECTS. IN GENERAL POPULATIONS WITH CLBP, YOGA HAS BEEN SHOWN TO IMPROVE HEALTH OUTCOMES WITH FEW SIDE EFFECTS. HOWEVER, YOGA HAS NOT BEEN ADEQUATELY STUDIED IN MILITARY VETERAN POPULATIONS. IN THE CURRENT PAPER WE WILL DESCRIBE THE DESIGN AND METHODS OF A RANDOMIZED CLINICAL TRIAL AIMED AT EXAMINING WHETHER YOGA CAN EFFECTIVELY REDUCE DISABILITY AND PAIN IN US MILITARY VETERANS WITH CLBP. A TOTAL OF 144 US MILITARY VETERANS WITH CLBP WILL BE RANDOMIZED TO EITHER YOGA OR A DELAYED TREATMENT COMPARISON GROUP. THE YOGA INTERVENTION WILL CONSIST OF 2X WEEKLY YOGA CLASSES FOR 12WEEKS, COMPLEMENTED BY REGULAR HOME PRACTICE GUIDED BY A MANUAL. THE DELAYED TREATMENT GROUP WILL RECEIVE THE SAME INTERVENTION AFTER SIX MONTHS. THE PRIMARY OUTCOME IS THE CHANGE IN BACK PAIN-RELATED DISABILITY MEASURED WITH THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE AT BASELINE AND 12-WEEKS. SECONDARY OUTCOMES INCLUDE PAIN INTENSITY, PAIN INTERFERENCE, DEPRESSION, ANXIETY, FATIGUE/ENERGY, QUALITY OF LIFE, SELF-EFFICACY, SLEEP QUALITY, AND MEDICATION USAGE. ADDITIONAL PROCESS AND/OR MEDIATIONAL FACTORS WILL BE MEASURED TO EXAMINE DOSE RESPONSE AND EFFECT MECHANISMS. ASSESSMENTS WILL BE CONDUCTED AT BASELINE, 6-WEEKS, 12-WEEKS, AND 6-MONTHS. ALL RANDOMIZED PARTICIPANTS WILL BE INCLUDED IN INTENTION-TO-TREAT ANALYSES. STUDY RESULTS WILL PROVIDE MUCH NEEDED EVIDENCE ON THE FEASIBILITY AND EFFECTIVENESS OF YOGA AS A THERAPEUTIC MODALITY FOR THE TREATMENT OF CLBP IN US MILITARY VETERANS. 2016