1 2415 142 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 2 465 37 CHARACTERISTICS AND PREDICTORS OF SHORT-TERM OUTCOMES IN INDIVIDUALS SELF-SELECTING YOGA OR PHYSICAL THERAPY FOR TREATMENT OF CHRONIC LOW BACK PAIN. OBJECTIVE: TO COMPARE CLINICAL AND DEMOGRAPHIC CHARACTERISTICS OF INDIVIDUALS SELF-SELECTING YOGA OR PHYSICAL THERAPY (PT) FOR TREATMENT OF CHRONIC LOW BACK PAIN (CLBP) AND TO EXAMINE PREDICTORS OF SHORT-TERM PAIN AND FUNCTIONAL OUTCOMES. DESIGN: DESCRIPTIVE, LONGITUDINAL STUDY. SETTINGS: A HOSPITAL-BASED CLINIC THAT OFFERS MODIFIED INTEGRAL YOGA CLASSES FOR CLBP AND 2 OUTPATIENT PT CLINICS THAT OFFER EXERCISE-BASED PT. PARTICIPANTS: ADULTS (N=53) WITH CLBP>/=12 WEEKS: YOGA (N=27), PT (N=26). METHODS: YOGA PARTICIPANTS ATTENDED A 6-WEEK, ONCE WEEKLY, 2-HOUR YOGA CLASS. PT PARTICIPANTS UNDERWENT TWICE WEEKLY, 1-HOUR INDIVIDUALIZED PT. DATA WERE COLLECTED AT BASELINE AND AT 6 WEEKS. GROUPS WERE COMPARED BY USING CHI2 AND INDEPENDENT SAMPLES T-TESTS. HIERARCHICAL LINEAR REGRESSION WAS USED TO PREDICT TREATMENT OUTCOMES. MAIN OUTCOME MEASURES: DISABILITY (ROLAND MORRIS DISABILITY QUESTIONNAIRE), HEALTH STATUS (RAND SHORT FORM 36 HEALTH SURVEY 1.0), PAIN BOTHERSOMENESS (NUMERICAL RATING SCALE), BACK PAIN SELF-EFFICACY (BACK PAIN SELF-EFFICACY SCALE), AND TREATMENT SATISFACTION. RESULTS: AT BASELINE, YOGA PARTICIPANTS WERE SIGNIFICANTLY LESS DISABLED (P=.013), HAD HIGHER HEALTH STATUS (P=.023), GREATER PAIN SELF-EFFICACY (P=.012), AND LESS AVERAGE PAIN BOTHERSOMENESS (P=.001) COMPARED WITH PT PARTICIPANTS. AT 6 WEEKS, WHEN CONTROLLING FOR BASELINE GROUP DIFFERENCES, GREATER PAIN SELF-EFFICACY WAS THE STRONGEST PREDICTOR FOR REDUCED PAIN AND HIGHER FUNCTION FOR THE ENTIRE SAMPLE. A SIGNIFICANT GROUP INTERACTION BY BASELINE PAIN SELF-EFFICACY PREDICTED DISABILITY AT 6 WEEKS. PT PARTICIPANTS WITH LOW PAIN SELF-EFFICACY REPORTED SIGNIFICANTLY GREATER DISABILITY THAN THOSE WITH HIGH PAIN SELF-EFFICACY. YOGA PARTICIPANTS WITH LOW AND HIGH PAIN SELF-EFFICACY HAD SIMILAR DISABILITY OUTCOMES. CONCLUSION: THESE FINDINGS STRENGTHEN EVIDENCE THAT SELF-EFFICACY IS ASSOCIATED WITH CLBP OUTCOMES, ESPECIALLY IN INDIVIDUALS SELF-SELECTING PT. FURTHER RESEARCH TO EVALUATE OUTCOMES AFTER YOGA AND PT IN PARTICIPANTS WITH LOW PAIN SELF-EFFICACY IS NEEDED. 2010 3 2553 35 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 4 521 54 COMPARING YOGA, EXERCISE, AND A SELF-CARE BOOK FOR CHRONIC LOW BACK PAIN: A RANDOMIZED, CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN IS A COMMON PROBLEM THAT HAS ONLY MODESTLY EFFECTIVE TREATMENT OPTIONS. OBJECTIVE: TO DETERMINE WHETHER YOGA IS MORE EFFECTIVE THAN CONVENTIONAL THERAPEUTIC EXERCISE OR A SELF-CARE BOOK FOR PATIENTS WITH CHRONIC LOW BACK PAIN. DESIGN: RANDOMIZED, CONTROLLED TRIAL. SETTING: A NONPROFIT, INTEGRATED HEALTH CARE SYSTEM. PATIENTS: 101 ADULTS WITH CHRONIC LOW BACK PAIN. INTERVENTION: 12-WEEK SESSIONS OF YOGA OR CONVENTIONAL THERAPEUTIC EXERCISE CLASSES OR A SELF-CARE BOOK. MEASUREMENTS: PRIMARY OUTCOMES WERE BACK-RELATED FUNCTIONAL STATUS (MODIFIED 24-POINT ROLAND DISABILITY SCALE) AND "BOTHERSOMENESS" OF PAIN (11-POINT NUMERICAL SCALE). THE PRIMARY TIME POINT WAS 12 WEEKS. CLINICALLY SIGNIFICANT CHANGE WAS CONSIDERED TO BE 2.5 POINTS ON THE FUNCTIONAL STATUS SCALE AND 1.5 POINTS ON THE BOTHERSOMENESS SCALE. SECONDARY OUTCOMES WERE DAYS OF RESTRICTED ACTIVITY, GENERAL HEALTH STATUS, AND MEDICATION USE. RESULTS: AFTER ADJUSTMENT FOR BASELINE VALUES, BACK-RELATED FUNCTION IN THE YOGA GROUP WAS SUPERIOR TO THE BOOK AND EXERCISE GROUPS AT 12 WEEKS (YOGA VS. BOOK: MEAN DIFFERENCE, -3.4 [95% CI, -5.1 TO - 1.6] [P < 0.001]; YOGA VS. EXERCISE: MEAN DIFFERENCE, -1.8 [CI, -3.5 TO - 0.1] [P = 0.034]). NO SIGNIFICANT DIFFERENCES IN SYMPTOM BOTHERSOMENESS WERE FOUND BETWEEN ANY 2 GROUPS AT 12 WEEKS; AT 26 WEEKS, THE YOGA GROUP WAS SUPERIOR TO THE BOOK GROUP WITH RESPECT TO THIS MEASURE (MEAN DIFFERENCE, -2.2 [CI, -3.2 TO - 1.2]; P < 0.001). AT 26 WEEKS, BACK-RELATED FUNCTION IN THE YOGA GROUP WAS SUPERIOR TO THE BOOK GROUP (MEAN DIFFERENCE, -3.6 [CI, -5.4 TO - 1.8]; P < 0.001). LIMITATIONS: PARTICIPANTS IN THIS STUDY WERE FOLLOWED FOR ONLY 26 WEEKS AFTER RANDOMIZATION. ONLY 1 INSTRUCTOR DELIVERED EACH INTERVENTION. CONCLUSIONS: YOGA WAS MORE EFFECTIVE THAN A SELF-CARE BOOK FOR IMPROVING FUNCTION AND REDUCING CHRONIC LOW BACK PAIN, AND THE BENEFITS PERSISTED FOR AT LEAST SEVERAL MONTHS. 2005 5 1863 45 RANDOMIZED CONTROLLED TRIAL OF YOGA AND EXERCISE IN MULTIPLE SCLEROSIS. OBJECTIVE: TO DETERMINE THE EFFECT OF YOGA AND OF AEROBIC EXERCISE ON COGNITIVE FUNCTION, FATIGUE, MOOD, AND QUALITY OF LIFE IN MULTIPLE SCLEROSIS (MS). METHODS: SUBJECTS WITH CLINICALLY DEFINITE MS AND EXPANDED DISABILITY STATUS SCORE LESS THAN OR EQUAL TO 6.0 WERE RANDOMLY ASSIGNED TO ONE OF THREE GROUPS LASTING 6 MONTHS: WEEKLY IYENGAR YOGA CLASS ALONG WITH HOME PRACTICE, WEEKLY EXERCISE CLASS USING A STATIONARY BICYCLE ALONG WITH HOME EXERCISE, OR A WAITING-LIST CONTROL GROUP. OUTCOME ASSESSMENTS PERFORMED AT BASELINE AND AT THE END OF THE 6-MONTH PERIOD INCLUDED A BATTERY OF COGNITIVE MEASURES FOCUSED ON ATTENTION, PHYSIOLOGIC MEASURES OF ALERTNESS, PROFILE OF MOOD STATES, STATE-TRAIT ANXIETY INVENTORY, MULTI-DIMENSIONAL FATIGUE INVENTORY (MFI), AND SHORT FORM (SF)-36 HEALTH-RELATED QUALITY OF LIFE. RESULTS: SIXTY-NINE SUBJECTS WERE RECRUITED AND RANDOMIZED. TWELVE SUBJECTS DID NOT FINISH THE 6-MONTH INTERVENTION. THERE WERE NO ADVERSE EVENTS RELATED TO THE INTERVENTION. THERE WERE NO EFFECTS FROM EITHER OF THE ACTIVE INTERVENTIONS ON EITHER OF THE PRIMARY OUTCOME MEASURES OF ATTENTION OR ALERTNESS. BOTH ACTIVE INTERVENTIONS PRODUCED IMPROVEMENT IN SECONDARY MEASURES OF FATIGUE COMPARED TO THE CONTROL GROUP: ENERGY AND FATIGUE (VITALITY) ON THE SF-36 AND GENERAL FATIGUE ON THE MFI. THERE WERE NO CLEAR CHANGES IN MOOD RELATED TO YOGA OR EXERCISE. CONCLUSION: SUBJECTS WITH MS PARTICIPATING IN EITHER A 6-MONTH YOGA CLASS OR EXERCISE CLASS SHOWED SIGNIFICANT IMPROVEMENT IN MEASURES OF FATIGUE COMPARED TO A WAITING-LIST CONTROL GROUP. THERE WAS NO RELATIVE IMPROVEMENT OF COGNITIVE FUNCTION IN EITHER OF THE INTERVENTION GROUPS. 2004 6 167 65 A RANDOMIZED CONTROLLED BICENTER TRIAL OF YOGA FOR PATIENTS WITH COLORECTAL CANCER. OBJECTIVE: THE AIM OF THIS TRIAL WAS TO EVALUATE THE EFFECTS OF YOGA ON HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH COLORECTAL CANCER. METHODS: PATIENTS WITH NON-METASTATIC COLORECTAL CANCER WERE RANDOMLY ASSIGNED TO A 10-WEEK YOGA INTERVENTION (90 MIN ONCE WEEKLY) OR A WAITLIST CONTROL GROUP. PRIMARY OUTCOME MEASURE WAS DISEASE-SPECIFIC QUALITY OF LIFE (FUNCTIONAL ASSESSMENT OF CANCER THERAPY - COLORECTAL [FACT-C]) AT WEEK 10. SECONDARY OUTCOME MEASURES INCLUDED FACT-C SUBSCALES: SPIRITUAL WELL-BEING (FACT - SPIRITUALITY); FATIGUE (FACT - FATIGUE); SLEEP DISTURBANCES (PITTSBURGH SLEEP QUALITY INVENTORY); DEPRESSION AND ANXIETY (HOSPITAL ANXIETY AND DEPRESSION SCALE); BODY AWARENESS (SCALE OF BODY CONNECTION); AND BODY-EFFICACY EXPECTATIONS (BODY-EFFICACY EXPECTATIONS SCALE). OUTCOMES WERE ASSESSED AT WEEK 10 AND WEEK 22 AFTER RANDOMIZATION. RESULTS: FIFTY-FOUR PATIENTS (MEAN AGE 68.3 +/- 9.7 YEARS) WERE RANDOMIZED TO YOGA (N = 27; ATTRITION RATE 22.2%) AND CONTROL GROUP (N = 27; ATTRITION RATE 18.5%). PATIENTS IN THE YOGA GROUP ATTENDED A MEAN OF 5.3 +/- 4.0 YOGA CLASSES. NO SIGNIFICANT GROUP DIFFERENCES FOR THE FACT-C TOTAL SCORE WERE FOUND. GROUP DIFFERENCES WERE FOUND FOR EMOTIONAL WELL-BEING AT WEEK 22 ( = 1.59; 95% CI = 0.27,2.90; P = 0.019), SLEEP DISTURBANCES AT WEEK 22 ( = -1.08; 95% CI = -2.13, -0.03; P = 0.043), ANXIETY AT WEEK 10 ( = -1.14; 95% CI = -2.20, -0.09; P = 0.043), AND DEPRESSION AT WEEK 10 ( = -1.34; 95% CI = -2.61, -0.8; P = 0.038). NO SERIOUS ADVERSE EVENTS OCCURRED IN THE YOGA GROUP, WHILE LIVER METASTASES WERE DIAGNOSED IN ONE PATIENT IN THE CONTROL GROUP. CONCLUSION: THIS RANDOMIZED TRIAL FOUND NO EFFECTS OF YOGA ON HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH COLORECTAL CANCER. GIVEN THE HIGH ATTRITION RATE AND LOW INTERVENTION ADHERENCE, NO DEFINITE CONCLUSIONS CAN BE DRAWN FROM THIS TRIAL. 2016 7 1180 52 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 8 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 9 963 41 EFFECTS OF A YOGA PROGRAM ON MENSTRUAL CRAMPS AND MENSTRUAL DISTRESS IN UNDERGRADUATE STUDENTS WITH PRIMARY DYSMENORRHEA: A SINGLE-BLIND, RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: TO INVESTIGATE THE EFFECTS OF A YOGA PROGRAM ON MENSTRUAL CRAMPS AND MENSTRUAL DISTRESS IN UNDERGRADUATE STUDENTS WITH PRIMARY DYSMENORRHEA. DESIGN: SINGLE-BLIND, RANDOMIZED CONTROLLED TRIAL. PARTICIPANTS: 40 RANDOMLY SELECTED UNDERGRADUATE NURSING STUDENTS, WITH 20 EACH ASSIGNED TO AN EXERCISE OR A CONTROL GROUP. INTERVENTION: THE PARTICIPANTS ENGAGED IN A YOGA PROGRAM FOR 60 MINUTES ONCE A WEEK FOR 12 WEEKS. THE PROGRAM CONSISTED OF PHYSICAL EXERCISE COMBINED WITH RELAXATION AND MEDITATION. OUTCOME MEASURES: MENSTRUAL CRAMPS AND MENSTRUAL DISTRESS LEVELS WERE MEASURED BY USING THE VISUAL ANALOGUE SCALE FOR PAIN AND THE MENSTRUAL DISTRESS QUESTIONNAIRE, RESPECTIVELY. DATA WERE ANALYZED BY USING THE KOLMOGOROV-SMIRNOV AND SHAPIRO-WILK NORMALITY TESTS, T-TEST, CHI-SQUARE TEST, LOGISTIC REGRESSION ANALYSIS, AND MULTIVARIATE ANALYSIS OF VARIANCE (SPSS PROGRAM). RESULTS: MENSTRUAL PAIN INTENSITY (GROUP DIFFERENCE, -0.94; 95% CONFIDENCE INTERVAL [CI], -1.47 TO -0.42; P = 0.001) AND MENSTRUAL DISTRESS (GROUP DIFFERENCE, -1.13; 95% CI, -1.43 TO -0.82; P < 0.0001) SCORES DECREASED SIGNIFICANTLY IN THE EXPERIMENTAL GROUP COMPARED WITH THE CONTROL GROUP. CONCLUSIONS: THESE FINDINGS INDICATE THAT YOGA INTERVENTIONS MAY REDUCE MENSTRUAL CRAMPS AND MENSTRUAL DISTRESS IN FEMALE UNDERGRADUATE STUDENTS WITH PRIMARY DYSMENORRHEA. 2016 10 2851 47 YOGA, PHYSICAL THERAPY, AND BACK PAIN EDUCATION FOR SLEEP QUALITY IN LOW-INCOME RACIALLY DIVERSE ADULTS WITH CHRONIC LOW BACK PAIN: A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: POOR SLEEP IS COMMON AMONG ADULTS WITH CHRONIC LOW BACK PAIN (CLBP), BUT THE INFLUENCE OF CLBP TREATMENTS, SUCH AS YOGA AND PHYSICAL THERAPY (PT), ON SLEEP QUALITY IS UNDER STUDIED. OBJECTIVE: EVALUATE THE EFFECTIVENESS OF YOGA AND PT FOR IMPROVING SLEEP QUALITY IN ADULTS WITH CLBP. DESIGN: SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. SETTING: ACADEMIC SAFETY-NET HOSPITAL AND 7 AFFILIATED COMMUNITY HEALTH CENTERS. PARTICIPANTS: A TOTAL OF 320 ADULTS WITH CLBP. INTERVENTION: TWELVE WEEKLY YOGA CLASSES, 1-ON-1 PT SESSIONS, OR AN EDUCATIONAL BOOK. MAIN MEASURES: SLEEP QUALITY WAS MEASURED USING THE PITTSBURGH SLEEP QUALITY INDEX (PSQI) GLOBAL SCORE (0-21) AT BASELINE, 12 WEEKS, AND 52 WEEKS. ADDITIONALLY, WE ALSO EVALUATED HOW THE PROPORTION OF PARTICIPANTS WHO ACHIEVED A CLINICALLY MEANINGFUL IMPROVEMENT IN SLEEP QUALITY (> 3-POINT REDUCTION IN PSQI) AT 12 WEEKS VARIED BY CHANGES IN PAIN AND PHYSICAL FUNCTION AT 6 WEEKS. KEY RESULTS: AMONG PARTICIPANTS (MEAN AGE = 46.0, 64% FEMALE, 82% NON-WHITE), NEARLY ALL (92%) REPORTED POOR SLEEP QUALITY (PSQI > 5) AT BASELINE. AT 12 WEEKS, MODEST IMPROVEMENTS IN SLEEP QUALITY WERE OBSERVED AMONG THE YOGA (PSQI MEAN DIFFERENCE [MD] = - 1.19, 95% CONFIDENCE INTERVAL [CI] - 1.82, - 0.55) AND PT (PSQI MD = - 0.91, 95% CI - 1.61, - 0.20) GROUPS. PARTICIPANTS WHO REPORTED A >/= 30% IMPROVEMENT IN PAIN OR PHYSICAL FUNCTION AT 6 WEEKS, COMPARED WITH THOSE WHO IMPROVED < 10%, WERE MORE LIKELY TO BE A SLEEP QUALITY RESPONDER AT 12 WEEKS (ODDS RATIO [OR] = 3.51, 95% CI 1.73, 7.11 AND OR = 2.16, 95% CI 1.18, 3.95, RESPECTIVELY). RESULTS WERE SIMILAR AT 52 WEEKS. CONCLUSION: IN A SAMPLE OF ADULTS WITH CLBP, VIRTUALLY ALL WITH POOR SLEEP QUALITY PRIOR TO INTERVENTION, MODEST BUT STATISTICALLY SIGNIFICANT IMPROVEMENTS IN SLEEP QUALITY WERE OBSERVED WITH BOTH YOGA AND PT. IRRESPECTIVE OF TREATMENT, CLINICALLY IMPORTANT SLEEP IMPROVEMENTS AT THE END OF THE INTERVENTION WERE ASSOCIATED WITH MID-INTERVENTION PAIN AND PHYSICAL FUNCTION IMPROVEMENTS. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT01343927. 2020 11 2318 42 TREATING MAJOR DEPRESSION WITH YOGA: A PROSPECTIVE, RANDOMIZED, CONTROLLED PILOT TRIAL. BACKGROUND: CONVENTIONAL PHARMACOTHERAPIES AND PSYCHOTHERAPIES FOR MAJOR DEPRESSION ARE ASSOCIATED WITH LIMITED ADHERENCE TO CARE AND RELATIVELY LOW REMISSION RATES. YOGA MAY OFFER AN ALTERNATIVE TREATMENT OPTION, BUT RIGOROUS STUDIES ARE FEW. THIS RANDOMIZED CONTROLLED TRIAL WITH BLINDED OUTCOME ASSESSORS EXAMINED AN 8-WEEK HATHA YOGA INTERVENTION AS MONO-THERAPY FOR MILD-TO-MODERATE MAJOR DEPRESSION. METHODS: INVESTIGATORS RECRUITED 38 ADULTS IN SAN FRANCISCO MEETING CRITERIA FOR MAJOR DEPRESSION OF MILD-TO-MODERATE SEVERITY, PER STRUCTURED PSYCHIATRIC INTERVIEW AND SCORES OF 14-28 ON BECK DEPRESSION INVENTORY-II (BDI). AT SCREENING, INDIVIDUALS ENGAGED IN PSYCHOTHERAPY, ANTIDEPRESSANT PHARMACOTHERAPY, HERBAL OR NUTRACEUTICAL MOOD THERAPIES, OR MIND-BODY PRACTICES WERE EXCLUDED. PARTICIPANTS WERE 68% FEMALE, WITH MEAN AGE 43.4 YEARS (SD = 14.8, RANGE = 22-72), AND MEAN BDI SCORE 22.4 (SD = 4.5). TWENTY PARTICIPANTS WERE RANDOMIZED TO 90-MINUTE HATHA YOGA PRACTICE GROUPS TWICE WEEKLY FOR 8 WEEKS. EIGHTEEN PARTICIPANTS WERE RANDOMIZED TO 90-MINUTE ATTENTION CONTROL EDUCATION GROUPS TWICE WEEKLY FOR 8 WEEKS. CERTIFIED YOGA INSTRUCTORS DELIVERED BOTH INTERVENTIONS AT A UNIVERSITY CLINIC. PRIMARY OUTCOME WAS DEPRESSION SEVERITY, MEASURED BY BDI SCORES EVERY 2 WEEKS FROM BASELINE TO 8 WEEKS. SECONDARY OUTCOMES WERE SELF-EFFICACY AND SELF-ESTEEM, MEASURED BY SCORES ON THE GENERAL SELF-EFFICACY SCALE (GSES) AND ROSENBERG SELF-ESTEEM SCALE (RSES) AT BASELINE AND AT 8 WEEKS. RESULTS: IN INTENT-TO-TREAT ANALYSIS, YOGA PARTICIPANTS EXHIBITED SIGNIFICANTLY GREATER 8-WEEK DECLINE IN BDI SCORES THAN CONTROLS (P-VALUE = 0.034). IN SUB-ANALYSES OF PARTICIPANTS COMPLETING FINAL 8-WEEK MEASURES, YOGA PARTICIPANTS WERE MORE LIKELY TO ACHIEVE REMISSION, DEFINED PER FINAL BDI SCORE /=17). WE CONDUCTED SENSITIVITY ANALYSES USING VARIOUS IMPUTATION METHODS TO ACCOUNT FOR POTENTIAL BIASES IN OUR ESTIMATES DUE TO MISSING DATA. RESULTS: AMONG 248 PARTICIPANTS (MEAN AGE = 46.4 YEARS, 80% NONWHITE) COMPLETING ALL THREE SURVEYS, YOGA AND PT SHOWED GREATER REDUCTIONS IN PSS-10 SCORES COMPARED WITH EDUCATION AT 12 WEEKS (MEAN BETWEEN-GROUP DIFFERENCE = -2.6, 95% CONFIDENCE INTERVAL [CI] = -4.5 TO -0.66, AND MEAN BETWEEN-GROUP DIFFERENCE = -2.4, 95% CI = -4.4 TO -0.48, RESPECTIVELY). THIS EFFECT WAS STRONGER AMONG PARTICIPANTS WITH ELEVATED PRE-INTERVENTION PERCEIVED STRESS. BETWEEN-GROUP EFFECTS HAD ATTENUATED BY 52 WEEKS. RESULTS WERE SIMILAR IN SENSITIVITY ANALYSES. CONCLUSIONS: YOGA AND PT WERE MORE EFFECTIVE THAN BACK PAIN EDUCATION FOR REDUCING PERCEIVED STRESS AMONG LOW-INCOME ADULTS WITH CLBP. 2020 19 2549 49 YOGA FOR CANCER SURVIVORS WITH CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY: HEALTH-RELATED QUALITY OF LIFE OUTCOMES. BACKGROUND: YOGA IS A MEDITATIVE MOVEMENT THERAPY FOCUSED ON MIND-BODY AWARENESS. THE IMPACT OF YOGA ON HEALTH-RELATED QUALITY OF LIFE (HRQOL) OUTCOMES IN PATIENTS WITH CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY (CIPN) IS UNCLEAR. METHODS: WE CONDUCTED A PILOT RANDOMIZED WAIT-LIST CONTROLLED TRIAL OF 8 WEEKS OF YOGA (N = 21) VERSUS WAIT-LIST CONTROL (N = 20) FOR CIPN IN 41 BREAST AND GYNECOLOGICAL CANCER SURVIVORS WITH PERSISTENT MODERATE TO SEVERE CIPN. HRQOL ENDPOINTS WERE HOSPITAL ANXIETY AND DEPRESSION SCALE (HADS), BRIEF FATIGUE INVENTORY (BFI), AND INSOMNIA SEVERITY INDEX (ISI). THE TREATMENT EXPECTANCY SCALE (TES) WAS ADMINISTERED AT BASELINE. WE ESTIMATED MEAN CHANGES AND 95% CONFIDENCE INTERVALS (CIS) FROM BASELINE TO WEEKS 8 AND 12 AND COMPARED ARMS USING CONSTRAINED LINEAR MIXED MODELS. RESULTS: AT WEEK 8, HADS ANXIETY SCORES DECREASED -1.61 (-2.75, -0.46) IN THE YOGA ARM AND -0.32 (-1.38, 0.75) POINTS IN THE WAIT-LIST CONTROL ARM (P = 0.099). AT WEEK 12, HADS ANXIETY SCORES DECREASED -1.42 (-2.57, -0.28) IN YOGA COMPARED TO AN INCREASE OF 0.46 (-0.60, 1.53) IN WAIT-LIST CONTROL (P = 0.017). THERE WERE NO SIGNIFICANT DIFFERENCES IN HADS DEPRESSION, BFI, OR ISI SCORES BETWEEN YOGA AND WAIT-LIST CONTROL. BASELINE TES WAS SIGNIFICANTLY HIGHER IN YOGA THAN IN WAIT-LIST CONTROL (14.9 VS. 12.7, P = 0.019). TES WAS NOT ASSOCIATED WITH HADS ANXIETY REDUCTION AND HADS ANXIETY REDUCTION WAS NOT ASSOCIATED WITH CIPN PAIN REDUCTION. CONCLUSIONS: YOGA MAY REDUCE ANXIETY IN PATIENTS WITH CIPN. FUTURE STUDIES ARE NEEDED TO CONFIRM THESE FINDINGS. CLINICAL TRIAL REGISTRATION NUMBER: CLINICALTRIALS.GOV IDENTIFIER: NCT03292328. 2021 20 193 46 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