1 1688 177 OUTCOMES FROM A WHOLE-SYSTEMS AYURVEDIC MEDICINE AND YOGA THERAPY TREATMENT FOR OBESITY PILOT STUDY. OBJECTIVES: TO DETERMINE THE FEASIBILITY AND ACCEPTABILITY OF AN AYURVEDA/YOGA INTERVENTION FOR WEIGHT LOSS, USING DUAL-DIAGNOSIS INCLUSION CRITERIA, DUAL-PARADIGM OUTCOMES, AND A SEMISTANDARDIZED PROTOCOL WITH TAILORING ACCORDING TO THE AYURVEDIC CONSTITUTION/IMBALANCE PROFILE OF EACH PARTICIPANT. DESIGN: SEVENTEEN PARTICIPANTS ENROLLED IN A WEEKLY INTERVENTION FOR 3 MONTHS. OUTCOME MEASUREMENTS WERE PERFORMED AT BASELINE, POSTINTERVENTION, AND 3 AND 6 MONTHS FOLLOW-UP. SETTING: THE INTERVENTION WAS CONDUCTED THROUGH THE UNIVERSITY OF ARIZONA, DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE FROM APRIL THROUGH DECEMBER 2012. SUBJECTS: PARTICIPANTS INCLUDED 2 MEN AND 15 WOMEN RECRUITED FROM THE COMMUNITY OF TUCSON, AZ USING FLYERS AND HOSPITAL MESSAGE BOARDS. SEVENTEEN ENROLLED AND 12 PARTICIPANTS PROVIDED COMPLETE FOLLOW-UP DATA. INTERVENTION: PARTICIPANTS MET WITH AN AYURVEDIC PRACTITIONER TWICE MONTHLY (SIX TIMES) AND FOLLOWED SEMISTANDARDIZED DIETARY GUIDELINES WITH INDIVIDUAL TAILORING TO ADDRESS RELEVANT PSYCHOPHYSIOLOGICAL IMBALANCES OBSTRUCTING WEIGHT LOSS AND A STANDARDIZED PROTOCOL OF THERAPEUTIC YOGA CLASSES THREE TIMES WEEKLY WITH RECOMMENDED HOME PRACTICE OF TWO TO FOUR ADDITIONAL SESSIONS. OUTCOME MEASURES: PRIMARY OUTCOME WAS WEIGHT LOSS. OTHER BIOMEDICAL OUTCOMES INCLUDED BODY MASS INDEX, BODY FAT PERCENTAGE, WAIST AND HIP CIRCUMFERENCE, WAIST TO HIP RATIO, AND BLOOD PRESSURE. UNIQUE INSTRUMENTS WERE DESIGNED TO COLLECT DATA ON OUTCOMES ASSOCIATED WITH THE AYURVEDIC MEDICAL PARADIGM, INCLUDING DIETARY CHANGES BY FOOD QUALITIES, MOOD/AFFECT, RELATIONSHIPS, AND CHANGES IN AYURVEDIC IMBALANCE PROFILES. RESULTS: PARTICIPANTS LOST AN AVERAGE OF 3.5 KG DURING THE 3-MONTH INTERVENTION. WEIGHT LOSS AT 3 AND 6 MONTHS POSTINTERVENTION INCREASED TO AN AVERAGE OF 5.6 KG AND 5.9 KG, RESPECTIVELY. PARTICIPANTS WHO LOST 3% OF THEIR BODY WEIGHT DURING THE 12 WEEK INTERVENTION, LOST ON AVERAGE AN ADDITIONAL 3% DURING THE FOLLOW-UP PERIOD. PSYCHOSOCIAL OUTCOMES ALSO IMPROVED. NO ADDITIONAL SERVICES WERE PROVIDED TO PARTICIPANTS DURING THE FOLLOW-UP PERIOD. CONCLUSIONS: A WHOLE-SYSTEMS AYURVEDIC MEDICINE AND YOGA THERAPY APPROACH PROVIDES A FEASIBLE PROMISING NONINVASIVE LOW-COST ALTERNATIVE TO TRADITIONAL WEIGHT LOSS INTERVENTIONS WITH POTENTIAL ADDED BENEFITS ASSOCIATED WITH SUSTAINABLE HOLISTIC LIFESTYLE MODIFICATION AND POSITIVE PSYCHOSOCIAL CHANGES. 2019
2 2315 30 TRAUMA-SENSITIVE YOGA AS AN ADJUNCT MENTAL HEALTH TREATMENT IN GROUP THERAPY FOR SURVIVORS OF DOMESTIC VIOLENCE: A FEASIBILITY STUDY. THIS STUDY IS A FEASIBILITY TEST OF WHETHER INCORPORATING TRAUMA-SENSITIVE YOGA INTO GROUP THERAPY FOR FEMALE VICTIMS OF PARTNER VIOLENCE IMPROVES SYMPTOMS OF ANXIETY, DEPRESSION, AND POSTTRAUMATIC STRESS DISORDER (PTSD) BEYOND THAT ACHIEVED WITH GROUP THERAPY ALONE. SEVENTEEN (9 CONTROL, 8 INTERVENTION) ADULT FEMALE CLIENTS SEEKING GROUP PSYCHOTHERAPY WERE ENROLLED. A 12-WEEK TRAUMA-SENSITIVE YOGA PROTOCOL WAS ADMINISTERED ONCE WEEKLY FOR 30-40 MIN AT THE END OF EACH GROUP THERAPY SESSION. THE CONTROL GROUP RECEIVED TYPICAL GROUP PSYCHOTHERAPY. FEASIBILITY WAS ASSESSED THROUGH RECRUITMENT AND RETENTION RATES AS WELL AS PARTICIPANTS' SELF-REPORTED PERCEPTIONS OF THE SAFETY AND UTILITY OF THE STUDY. THE STUDY ENROLLED 85% (17/20) OF THOSE SCREENED ELIGIBLE. LOSS TO FOLLOW-UP WAS 30% (5/17). NO ONE REPORTED EMOTIONAL OR PHYSICAL HARM. ALL OF THE RESPONDENTS REPORTED THAT THE STUDY WAS PERSONALLY MEANINGFUL AND THAT THE RESULTS WOULD BE USEFUL TO OTHERS. 2014
3 388 43 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
4 2628 48 YOGA FOR THE MANAGEMENT OF PAIN AND SLEEP IN RHEUMATOID ARTHRITIS: A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THE AIM OF THE PRESENT STUDY WAS TO DETERMINE THE FEASIBILITY OF A RELAXATION-BASED YOGA INTERVENTION FOR RHEUMATOID ARTHRITIS, DESIGNED AND REPORTED IN ACCORDANCE WITH DELPHI RECOMMENDATIONS FOR YOGA INTERVENTIONS FOR MUSCULOSKELETAL CONDITIONS. METHODS: PARTICIPANTS WERE RECRUITED FROM A HOSPITAL DATABASE, AND RANDOMIZED TO EITHER EIGHT WEEKLY 75-MIN YOGA CLASSES OR A USUAL CARE CONTROL. FEASIBILITY WAS DETERMINED BY RECRUITMENT RATES, RETENTION, PROTOCOL ADHERENCE, PARTICIPANT SATISFACTION AND ADVERSE EVENTS. SECONDARY PHYSICAL AND PSYCHOSOCIAL OUTCOMES WERE ASSESSED USING SELF-REPORTED QUESTIONNAIRES AT BASELINE (WEEK 0), WEEK 9 (PRIMARY TIME POINT) AND WEEK 12 (FOLLOW-UP). RESULTS: OVER A 3-MONTH PERIOD, 26 PARTICIPANTS WITH MILD PAIN, MILD TO MODERATE FUNCTIONAL DISABILITY AND MODERATE DISEASE ACTIVITY WERE RECRUITED INTO THE STUDY (25% RECRUITMENT RATE). RETENTION RATES WERE 100% FOR YOGA PARTICIPANTS AND 92% FOR USUAL CARE PARTICIPANTS AT BOTH WEEKS 9 AND 12. PROTOCOL ADHERENCE AND PARTICIPANT SATISFACTION WERE HIGH. YOGA PARTICIPANTS ATTENDED A MEDIAN OF SEVEN CLASSES; ADDITIONALLY, SEVEN OF THE YOGA PARTICIPANTS (54%) REPORTED CONTINUING YOGA AT HOME DURING THE FOLLOW-UP PERIOD. NO SERIOUS ADVERSE EVENTS WERE RELATED TO THE STUDY. SECONDARY OUTCOMES SHOWED NO GROUP EFFECTS OF YOGA COMPARED WITH USUAL CARE. CONCLUSIONS: A RELAXATION-BASED YOGA PROGRAMME WAS FOUND TO BE FEASIBLE AND SAFE FOR PARTICIPANTS WITH RHEUMATOID ARTHRITIS-RELATED PAIN AND FUNCTIONAL DISABILITY. ADVERSE EVENTS WERE MINOR, AND NOT UNEXPECTED FROM AN INTERVENTION INCLUDING PHYSICAL COMPONENTS. THIS PILOT PROVIDES A FRAMEWORK FOR LARGER INTERVENTION STUDIES, AND SUPPORTS FURTHER EXPLORATION OF YOGA AS A COMPLEX INTERVENTION TO ASSIST WITH THE MANAGEMENT OF RHEUMATOID ARTHRITIS. 2018
5 2585 34 YOGA FOR HYPERTENSION: A SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS. OBJECTIVES: TO CRITICALLY EVALUATE THE EFFECTIVENESS OF YOGA AS A TREATMENT OF HYPERTENSION. METHODS: SEVENTEEN DATABASES WERE SEARCHED FROM THEIR INCEPTIONS TO JANUARY 2014. RANDOMIZED CLINICAL TRIALS (RCTS) WERE INCLUDED, IF THEY EVALUATED YOGA AGAINST ANY TYPE OF CONTROL IN PATIENTS WITH ANY FORM OF ARTERIAL HYPERTENSION. RISK OF BIAS WAS ESTIMATED USING THE COCHRANE CRITERIA. THREE INDEPENDENT REVIEWERS PERFORMED THE SELECTION OF STUDIES, DATA EXTRACTION, AND QUALITY ASSESSMENTS. RESULTS: SEVENTEEN TRIALS MET THE INCLUSION CRITERIA. ONLY TWO RCTS WERE OF ACCEPTABLE METHODOLOGICAL QUALITY. ELEVEN RCTS SUGGESTED THAT YOGA LEADS TO A SIGNIFICANTLY GREATER REDUCTION IN SYSTOLIC BLOOD PRESSURE (SBP) COMPARED TO VARIOUS FORMS OF PHARMACOTHERAPY, BREATH AWARENESS OR READING, HEALTH EDUCATION, NO TREATMENT (NT), OR USUAL CARE (UC). EIGHT RCTS SUGGESTED THAT YOGA LEADS TO A SIGNIFICANTLY GREATER REDUCTION IN DIASTOLIC BLOOD PRESSURE (DBP) OR NIGHT-TIME DBP COMPARED TO PHARMACOTHERAPY, NT, OR UC. FIVE RCTS INDICATED THAT YOGA HAD NO EFFECT ON SBP COMPARED TO DIETARY MODIFICATION (DIM), ENHANCED UC, PASSIVE RELAXATION (PR), OR PHYSICAL EXERCISES (PE). EIGHT RCTS INDICATED THAT YOGA HAD NO EFFECT ON DBP COMPARED TO DIM, ENHANCED UC, PHARMACOTHERAPY, NT, PE, PR, OR BREATH AWARENESS OR READING. ONE RCT DID NOT REPORT BETWEEN-GROUP COMPARISONS. CONCLUSION: THE EVIDENCE FOR THE EFFECTIVENESS OF YOGA AS A TREATMENT OF HYPERTENSION IS ENCOURAGING BUT INCONCLUSIVE. FURTHER, MORE RIGOROUS TRIALS SEEM WARRANTED. 2014
6 1372 43 IMPACT OF A YOGA AND MEDITATION INTERVENTION ON STUDENTS' STRESS AND ANXIETY LEVELS. OBJECTIVE. TO EVALUATE THE IMPACT OF A SIX-WEEK YOGA AND MEDITATION INTERVENTION ON COLLEGE STUDENTS' STRESS PERCEPTION, ANXIETY LEVELS, AND MINDFULNESS SKILLS. METHODS. COLLEGE STUDENTS PARTICIPATED IN A SIX-WEEK PILOT PROGRAM THAT CONSISTED OF A 60-MINUTE VINYASA FLOW YOGA CLASS ONCE WEEKLY, FOLLOWED BY GUIDED MEDITATION DELIVERED BY TRAINED FACULTY MEMBERS AT THE UNIVERSITY OF RHODE ISLAND COLLEGE OF PHARMACY. STUDENTS COMPLETED PRE- AND POST-INTERVENTION QUESTIONNAIRES TO EVALUATE CHANGES IN THE FOLLOWING OUTCOMES: STRESS LEVELS, ANXIETY LEVELS, AND MINDFULNESS SKILLS. THE QUESTIONNAIRE CONSISTED OF THREE SELF-REPORTING TOOLS: THE BECK ANXIETY INVENTORY (BAI), THE PERCEIVED STRESS SCALE (PSS), AND THE FIVE FACET MINDFULNESS QUESTIONNAIRE (FFMQ). STUDENTS' SCORES ON EACH WERE ASSESSED TO DETECT ANY CHANGES FROM BASELINE USING THE NUMERICAL AND CATEGORICAL SCALES (LOW, MEDIUM, AND HIGH) FOR EACH INSTRUMENT. RESULTS. SEVENTEEN PARTICIPANTS, AGED 19 TO 23 YEARS, COMPLETED THE STUDY. THIRTEEN PARTICIPANTS WERE FEMALE AND FOUR WERE MALE. NINE OF THE STUDENTS WERE ENROLLED IN THE DOCTOR OF PHARMACY PROGRAM AND EIGHT WERE ENROLLED IN OTHER ACADEMIC PROGRAMS. STUDENTS' ANXIETY AND STRESS SCORES DECREASED SIGNIFICANTLY WHILE THEIR TOTAL MINDFULNESS INCREASED SIGNIFICANTLY. CHANGES IN CATEGORICAL DATA FROM PRE- TO POST-INTERVENTION ON THE BAI AND PSS WERE SIGNIFICANT, WITH NO STUDENTS SCORING IN THE "HIGH" CATEGORY FOR STRESS OR ANXIETY ON THE POST-INTERVENTION QUESTIONNAIRE. CONCLUSION. STUDENTS EXPERIENCED A REDUCTION IN STRESS AND ANXIETY LEVELS AFTER COMPLETING A SIX-WEEK YOGA AND MEDITATION PROGRAM PRECEDING FINAL EXAMINATIONS. RESULTS SUGGEST THAT ADOPTING A MINDFULNESS PRACTICE FOR AS LITTLE AS ONCE PER WEEK MAY REDUCE STRESS AND ANXIETY IN COLLEGE STUDENTS. ADMINISTRATORS SHOULD CONSIDER INCLUDING INSTRUCTION IN NONPHARMACOLOGIC STRESS AND ANXIETY REDUCTION METHODS, WITHIN CURRICULA IN ORDER TO SUPPORT STUDENT SELF-CARE. 2019
7 1072 54 EFFECTS OF YOGA ON OXIDATIVE STRESS, MOTOR FUNCTION, AND NON-MOTOR SYMPTOMS IN PARKINSON'S DISEASE: A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: TO EXAMINE THE FEASIBILITY, ACCEPTABILITY, AND PRELIMINARY EFFECTS OF HATHA YOGA ON OXIDATIVE STRESS, MOTOR FUNCTION, AND NON-MOTOR SYMPTOMS AMONG INDIVIDUALS WITH PARKINSON'S DISEASE (PD). METHODS: THE STUDY HAS A PILOT RANDOMIZED CONTROLLED TRIAL DESIGN WITH TWO ARMS: AN IMMEDIATE TREATMENT GROUP AND A WAIT-LIST CONTROL GROUP. THE YOGA-FOR-PD PROGRAM WAS IMPLEMENTED VIA TWICE WEEKLY 60-MIN GROUP-BASED CLASSES FOR 12 WEEKS. PARTICIPANTS WERE ASSESSED AT BASELINE, 12 WEEKS, AND 6 MONTHS POST-INTERVENTION. OUTCOME MEASURES INCLUDED OXIDATIVE STRESS, MOTOR FUNCTION, PHYSICAL ACTIVITY, COGNITIVE FUNCTION, SLEEP QUALITY, AND QUALITY OF LIFE. DATA ON PROGRAM ACCEPTABILITY AND YOGA ADHERENCE WERE COLLECTED DURING THE INTERVENTION AND AT 6 MONTHS POST-INTERVENTION. RESULTS: PARTICIPANTS (N = 20) HAD A MEAN AGE OF 63 YEARS (SD 8, RANGE 49-75) AND DISEASE DURATION 4.8 YEARS (SD 2.9, RANGE 1-13). ALL PARTICIPANTS HAD MILD-MODERATE DISEASE SEVERITY; 18 (90%) WERE ON DOPAMINERGIC MEDICATIONS. SEVENTEEN PARTICIPANTS (85%) ATTENDED AT LEAST 75% OF THE CLASSES AND 4 (20%) ATTENDED ALL CLASSES. MOST PARTICIPANTS (N = 17) REPORTED THEY "DEFINITELY ENJOYED" THE INTERVENTION PROGRAM. NO ADVERSE EVENTS WERE REPORTED. AT 12 WEEKS, THERE WERE NO MAJOR DIFFERENCES IN BLOOD OXIDATIVE STRESS MARKERS BETWEEN THE TWO GROUPS. MOTOR FUNCTION BASED ON THE UNIFIED PARKINSON'S DISEASE RATING SCALE WAS BETTER IN THE TREATMENT GROUP, BUT THEIR SCORES ON SLEEP AND OUTLOOK IN PARKINSON'S DISEASE QUALITY OF LIFE (PDQUALIF) SCALE AND THE PHYSICAL ACTIVITY LEVELS BASED ON THE LONGITUDINAL AGING STUDY AMSTERDAM PHYSICAL ACTIVITY QUESTIONNAIRE WERE WORSE THAN THOSE OF THE CONTROL GROUP. IN WITHIN-GROUP COMPARISONS, MOTOR FUNCTION, COGNITIVE FUNCTION, AND CATALASE IMPROVED BUT THREE PDQUALIF DOMAINS (SOCIAL AND ROLE FUNCTION, SLEEP, AND OUTLOOK) AND PHYSICAL ACTIVITY LEVEL WORSENED BY THE END OF THE YOGA INTERVENTION PROGRAM COMPARED TO BASELINE. THE RESPONSE RATE FOR THE 6-MONTH FOLLOW-UP SURVEY WAS 74% (N = 14) WITH SIX PARTICIPANTS (43%) WHO SIGNED UP FOR A YOGA CLASS AND FOUR (29%) WHO PRACTICED IT INDEPENDENTLY. HEALTH PROBLEMS WERE THE MAIN BARRIER TO YOGA PRACTICE. CONCLUSION: YOGA IS FEASIBLE AND ACCEPTABLE AND MAY SERVE AS A COMPLEMENTARY METHOD FOR IMPROVING MOTOR FUNCTION IN PD. FURTHER RESEARCH USING A LARGER SAMPLE SIZE IS NEEDED TO DETERMINE ITS IMPACT ON OXIDATIVE STRESS AND NON-MOTOR SYMPTOMS. TRIAL REGISTRATION: CLINICALTRIALS.GOV REGISTRATION NUMBER: NCT02509610031. 2018
8 1281 31 GENTLE HATHA YOGA AND REDUCTION OF FIBROMYALGIA-RELATED SYMPTOMS: A PRELIMINARY REPORT. OBJECTIVES AND METHODS: THIS STUDY EXAMINED WHETHER GENTLE HATHA YOGA REDUCED FIBROMYALGIA-RELATED SYMPTOMS FOR A CONVENIENCE SAMPLE OF 10 PARTICIPANTS RANGING IN AGE FROM 39 TO 64 YEARS WHO RECEIVED YOGA INSTRUCTION 2 TIMES PER WEEK FOR 8 WEEKS. METHODS: RESPONDENTS COMPLETED THE FIBROMYALGIA IMPACT QUESTIONNAIRE 1 TIME PER WEEK AND PROVIDED WEEKLY JOURNAL REPORTS REGARDING THEIR HEALTH STATUS. PRE- AND POST-INTERVENTION MANUAL TENDER POINT EVALUATIONS WERE ALSO CONDUCTED. RESULTS: FINDINGS PROVIDE EVIDENCE OF ASSOCIATION BETWEEN PARTICIPATING IN GENTLE HATHA YOGA CLASSES AND REDUCED FIBROMYALGIA - RELATED SYMPTOMS. CONCLUSIONS: ADDITIONAL RANDOMIZED CONTROLLED TRIALS WITH LARGER SAMPLE SIZES AND GREATER EMPIRICAL RIGOR ARE NEEDED TO MORE FULLY UNDERSTAND THIS RELATIONSHIP. 2012
9 2575 31 YOGA FOR FUNCTIONAL ABILITY, PAIN AND PSYCHOSOCIAL OUTCOMES IN MUSCULOSKELETAL CONDITIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVES: MUSCULOSKELETAL CONDITIONS (MSCS) ARE THE LEADING CAUSE OF DISABILITY AND CHRONIC PAIN IN THE DEVELOPED WORLD, IMPACTING BOTH FUNCTIONAL ABILITY AND PSYCHOSOCIAL HEALTH. THE CURRENT REVIEW INVESTIGATES THE EFFECTIVENESS OF YOGA ON PRIMARY OUTCOMES OF FUNCTIONAL ABILITY, PAIN AND PSYCHOSOCIAL OUTCOMES ACROSS A RANGE OF MSCS. METHODS: A COMPREHENSIVE SEARCH OF 20 DATABASES WAS CONDUCTED FOR FULL-TEXT, RANDOMIZED CONTROLLED TRIALS OF YOGA IN CLINICALLY DIAGNOSED MSCS. RESULT: SEVENTEEN STUDIES MET THE INCLUSION CRITERIA, INVOLVING 1,626 PARTICIPANTS WITH LOW BACK PAIN (LBP), OSTEOARTHRITIS (OA), RHEUMATOID ARTHRITIS (RA), KYPHOSIS OR FIBROMYALGIA. STUDIES WERE QUALITY RATED, AND ANALYSED FOR THE EFFECT OF YOGA ON PRIMARY OUTCOMES, IMMEDIATELY POST-INTERVENTION. TWELVE STUDIES WERE RATED AS GOOD QUALITY. YOGA INTERVENTIONS RESULTED IN A CLINICALLY SIGNIFICANT IMPROVEMENT IN FUNCTIONAL OUTCOMES IN MILD-TO-MODERATE LBP AND FIBROMYALGIA, AND SHOWED A TREND TO IMPROVEMENT IN KYPHOSIS. YOGA SIGNIFICANTLY IMPROVED PAIN IN OA, RA AND MILD-TO-SEVERE LBP. PSYCHOSOCIAL OUTCOMES WERE SIGNIFICANTLY IMPROVED IN MILD-TO-MODERATE LBP AND OA. META-ANALYSIS OF GOOD-QUALITY STUDIES SHOWED A MODERATE TREATMENT EFFECT FOR YOGA OF -0.64 (95%CI -0.89 TO -0.39) FOR FUNCTIONAL OUTCOMES AND -0.61 (95%CI -0.97 TO -0.26) FOR PAIN OUTCOMES. CONCLUSIONS: EVIDENCE SUGGESTS THAT YOGA IS AN ACCEPTABLE AND SAFE INTERVENTION, WHICH MAY RESULT IN CLINICALLY RELEVANT IMPROVEMENTS IN PAIN AND FUNCTIONAL OUTCOMES ASSOCIATED WITH A RANGE OF MSCS. FUTURE ANALYSIS OF OUTCOMES WHICH TAKE INTO ACCOUNT THE AMOUNT OF YOGA RECEIVED BY PARTICIPANTS MAY PROVIDE INSIGHT INTO ANY PUTATIVE DURATION OR DOSAGE EFFECTS OF YOGA INTERVENTIONS FOR MSCS. 2013
10 105 74 A PILOT FEASIBILITY STUDY OF WHOLE-SYSTEMS AYURVEDIC MEDICINE AND YOGA THERAPY FOR WEIGHT LOSS. OBJECTIVE: TO DEVELOP AND TEST THE FEASIBILITY OF A WHOLE-SYSTEMS LIFESTYLE INTERVENTION FOR OBESITY TREATMENT BASED ON THE PRACTICES OF AYURVEDIC MEDICINE/ YOGA THERAPY. DESIGN: A PRE-POST WEIGHT LOSS INTERVENTION PILOT STUDY USING CONVENTIONAL AND AYURVEDIC DIAGNOSIS INCLUSION CRITERIA, TAILORED TREATMENT WITHIN A STANDARDIZED TREATMENT ALGORITHM, AND STANDARDIZED DATA COLLECTION INSTRUMENTS FOR COLLECTING AYURVEDIC OUTCOMES. PARTICIPANTS: A CONVENIENCE SAMPLE OF OVERWEIGHT/OBESE ADULT COMMUNITY MEMBERS FROM TUCSON, ARIZONA INTERESTED IN A "HOLISTIC WEIGHT LOSS PROGRAM" AND MEETING PREDETERMINED INCLUSION/EXCLUSION CRITERIA. INTERVENTION: A COMPREHENSIVE DIET, ACTIVITY, AND LIFESTYLE MODIFICATION PROGRAM BASED ON PRINCIPLES OF AYURVEDIC MEDICINE/YOGA THERAPY WITH SIGNIFICANT SELF-MONITORING OF LIFESTYLE BEHAVIORS. THE 3-MONTH PROGRAM WAS DESIGNED TO CHANGE EATING AND ACTIVITY PATTERNS AND TO IMPROVE SELF-EFFICACY, QUALITY OF LIFE, WELL-BEING, VITALITY, AND SELF-AWARENESS AROUND FOOD CHOICES, STRESS MANAGEMENT, AND BARRIERS TO WEIGHT LOSS. PRIMARY OUTCOME MEASURES: CHANGES IN BODY WEIGHT, BODY MASS INDEX; BODY FAT PERCENTAGE, FAT/LEAN MASS, WAIST/HIP CIRCUMFERENCE AND RATIO, AND BLOOD PRESSURE. SECONDARY OUTCOME MEASURES: DIET AND EXERCISE SELF-EFFICACY SCALES; PERCEIVED STRESS SCALE; VISUAL ANALOG SCALES (VAS) OF ENERGY, APPETITE, STRESS, QUALITY OF LIFE, WELL-BEING, AND PROGRAM SATISFACTION AT ALL TIME POINTS. RESULTS: TWENTY-TWO ADULTS ATTENDED AN IN-PERSON AYURVEDIC SCREENING; 17 INITIATED THE INTERVENTION, AND 12 COMPLETED THE 3-MONTH INTERVENTION. TWELVE COMPLETED FOLLOW-UP AT 6 MONTHS AND 11 COMPLETED FOLLOW-UP AT 9 MONTHS. MEAN WEIGHT LOSS AT 3 MONTHS WAS 3.54 KG (SD 4.76); 6 MONTHS: 4.63 KG, (SD 6.23) AND 9 MONTHS: 5.9 KG (SD 8.52). SELF-REPORT OF PROGRAM SATISFACTION WAS MORE THAN 90% AT ALL TIME POINTS. CONCLUSIONS: AN AYURVEDA-/YOGA-BASED LIFESTYLE MODIFICATION PROGRAM IS AN ACCEPTABLE AND FEASIBLE APPROACH TO WEIGHT MANAGEMENT. DATA COLLECTION, INCLUDING SELF-MONITORING AND CONVENTIONAL AND AYURVEDIC OUTCOMES, DID NOT UNDULY BURDEN PARTICIPANTS, WITH ATTRITION SIMILAR TO THAT OF OTHER WEIGHT LOSS STUDIES. 2014
11 162 49 A RANDOMISED CONTROLLED TRIAL OF YOGA FOR THE TREATMENT OF CHRONIC LOW BACK PAIN: RESULTS OF A PILOT STUDY. OBJECTIVE: TO CONDUCT A PILOT TRIAL OF YOGA FOR THE TREATMENT OF CHRONIC LOW BACK PAIN (LBP) TO INFORM THE FEASIBILITY AND PRACTICALITY OF CONDUCTING A FULL-SCALE TRIAL IN THE UK; AND TO ASSESS THE EFFICACY OF YOGA FOR THE TREATMENT OF CHRONIC LOW BACK PAIN. DESIGN: A PRAGMATIC RANDOMISED CONTROLLED TRIAL WAS UNDERTAKEN COMPARING YOGA TO USUAL CARE. PARTICIPANTS: TWENTY PARTICIPANTS WHO HAD PRESENTED TO THEIR GP WITH CHRONIC LOW BACK PAIN IN THE PREVIOUS 18 MONTHS WERE RECRUITED VIA GP RECORDS FROM ONE PRACTICE IN YORK, UK. INTERVENTIONS: TWENTY PATIENTS WERE RANDOMISED TO EITHER 12 WEEKLY 75-MIN SESSIONS OF SPECIALISED YOGA PLUS WRITTEN ADVICE, OR USUAL CARE PLUS WRITTEN ADVICE. ALLOCATION WAS 50/50. MAIN OUTCOME MEASURES: RECRUITMENT RATE, LEVELS OF INTERVENTION ATTENDANCE, AND LOSS TO FOLLOW-UP WERE THE MAIN NON-CLINICAL OUTCOMES. CHANGE AS MEASURED BY THE ROLAND AND MORRIS DISABILITY QUESTIONNAIRE WAS THE PRIMARY CLINICAL OUTCOME. CHANGES IN THE ABERDEEN BACK PAIN SCALE, SF-12, EQ-5D, AND PAIN SELF-EFFICACY WERE SECONDARY CLINICAL OUTCOMES. DATA WERE COLLECTED VIA POSTAL QUESTIONNAIRE AT BASELINE, 4 WEEKS, AND 12 WEEKS FOLLOW-UP. RESULTS: OF THE 286 PATIENTS IDENTIFIED FROM THE GP DATABASE, 52 (18%) CONSENTED AND RETURNED THE ELIGIBILITY QUESTIONNAIRE, OUT OF THESE 20 (6.9%) WERE ELIGIBLE AND RANDOMISED. THE TOTAL PERCENTAGE OF PATIENTS RANDOMISED FROM THE GP PRACTICE POPULATION WAS 0.28%. TEN PATIENTS WERE RANDOMISED TO YOGA, RECEIVING AN AVERAGE OF 1.7 SESSIONS (RANGE 0-5), AND 10 WERE RANDOMISED TO USUAL CARE. AT 12 WEEKS FOLLOW-UP DATA WAS RECEIVED FROM 60% OF PATIENTS IN THE YOGA GROUP AND 90% OF PATIENTS IN THE USUAL CARE GROUP (75% OVERALL). NO SIGNIFICANT DIFFERENCES WERE SEEN BETWEEN GROUPS IN CLINICAL OUTCOMES APART FROM ON THE ABERDEEN BACK PAIN SCALE AT FOUR WEEKS FOLLOW-UP WHERE THE YOGA GROUP REPORTED SIGNIFICANTLY LESS PAIN. CONCLUSION: THIS PILOT STUDY PROVIDED USEFUL DATA AND INFORMATION TO INFORM THE DESIGN AND DEVELOPMENT OF A FULL-SCALE TRIAL OF YOGA FOR CLBP IN THE UK. A KEY FINDING IS THE CALCULATION OF GP PRACTICE TOTAL LIST SIZE REQUIRED FOR PATIENT RECRUITMENT IN A FULL-SCALE TRIAL, AND THE NEED TO IMPLEMENT METHODS TO INCREASE CLASS ATTENDANCE. 2010
12 541 35 COMPONENTS AND REPORTING OF YOGA INTERVENTIONS FOR MUSCULOSKELETAL CONDITIONS: A SYSTEMATIC REVIEW OF RANDOMISED CONTROLLED TRIALS. OBJECTIVES: TO IDENTIFY THE CONTENT AND REPORTING DETAILS OF RANDOMISED CONTROLLED TRIALS OF YOGA FOR MUSCULOSKELETAL CONDITIONS THROUGH A SYSTEMATIC REVIEW OF THE LITERATURE. DESIGN: TWENTY ELECTRONIC DATABASES WERE SEARCHED TO IDENTIFY RANDOMISED CONTROLLED TRIALS (RCTS) OF YOGA INTERVENTIONS FOR MUSCULOSKELETAL CONDITIONS. ELIGIBILITY CRITERIA WERE FULL-TEXT, PEER REVIEWED ARTICLES, OF RCTS WITH YOGA AS A PRIMARY INTERVENTION, ON A POPULATION AGED 18 YEARS AND OVER, WITH A CLINICAL DIAGNOSIS OF A MUSCULOSKELETAL CONDITION. DATA RELATING TO STUDY CHARACTERISTICS, YOGA STYLES, YOGA PRACTICES, HOME PRACTICE, AND REPORTING WERE EXTRACTED AND SUMMARISED. RESULTS: SEVENTEEN ARTICLES MET INCLUSION CRITERIA, REPRESENTING FIVE MUSCULOSKELETAL CONDITIONS: LOW BACK PAIN, OSTEOARTHRITIS, RHEUMATOID ARTHRITIS, KYPHOSIS, AND FIBROMYALGIA. 15 STUDIES WERE NON-RESIDENTIAL, AND TWO WERE RESIDENTIAL. STUDY DURATION RANGED FROM 1 TO 24 WEEKS; WEEKLY DOSAGE OF YOGA RANGED FROM 1 TO 56H. FIVE STYLES OF POSTURE-BASED HATHA YOGA WERE SPECIFIED. INTERVENTION CONTENT INCLUDED SEVEN YOGA PRACTISES: POSTURES, BREATHING, RELAXATION, MEDITATION, PHILOSOPHY, CHANTING, AND CLEANSING PRACTISES. TEN STUDIES EITHER ENCOURAGED OR REQUESTED HOME PRACTICE. REPORTING DETAILS INCLUDED CLASS PLANS, POSTURE LISTS, AND DIAGRAMS. DUE TO INSUFFICIENT DETAIL REGARDING DELIVERY OF THE YOGA INTERVENTION ONLY EIGHT OF THE 17 INTERVENTIONS WERE CONSIDERED REPLICABLE AS REPORTED. CONCLUSIONS: EVALUATION OF STUDY CHARACTERISTICS AND YOGA COMPONENTS INDICATED SEVERAL AREAS OF HOMOGENEITY ACROSS STUDIES, SUGGESTING AN EXISTING DEGREE OF STANDARDISATION. HOWEVER, HETEROGENEITY RELATED TO INTERVENTION CONTENT AND REPORTING IMPEDED DETERMINATION OF INTERVENTION CONTENT AND DELIVERY. STANDARDISATION OF CONTENT, NOMENCLATURE, AND REPORTING DETAILS IS RECOMMENDED TO ENHANCE PROTOCOL TRANSPARENCY, REPLICATION, AND COMPARISON OF INTERVENTION EFFECTIVENESS. 2014
13 997 41 EFFECTS OF INTEGRATED YOGA INTERVENTION ON PSYCHOPATHOLOGIES AND SLEEP QUALITY AMONG PROFESSIONAL CAREGIVERS OF OLDER ADULTS WITH ALZHEIMER'S DISEASE: A CONTROLLED PILOT STUDY. CONTEXT: PROVIDING CARE TO PATIENTS SUFFERING FROM CHRONIC NEUROLOGICAL PROBLEMS IS A STRESSFUL JOB. WHILE PROVIDING CARE TO THE PATIENTS, PROFESSIONAL CAREGIVERS EXPERIENCE VARIOUS KINDS OF PHYSICAL AND MENTAL CHALLENGES THAT AFFECT THEIR MENTAL HEALTH AND SLEEP. YOGA IS A FORM OF MIND-BODY MEDICINE SHOWN TO BE AN EFFECTIVE INTERVENTION IN IMPROVING PHYSICAL AND MENTAL HEALTH. OBJECTIVE: TO EXAMINE THE EFFECTS OF AN INTEGRATED YOGA (IY) INTERVENTION ON ANXIETY, DEPRESSION, STRESS, AND SLEEP QUALITY AMONG PROFESSIONAL CAREGIVERS OF OLDER ADULTS WITH ALZHEIMER'S DISEASE. SETTING: THIS STUDY WAS CONDUCTED IN AN ALZHEIMER CARE INSTITUTION LOCATED IN BANGALORE CITY IN SOUTHERN INDIA. PARTICIPANTS: PARTICIPANTS WERE PROFESSIONAL FEMALE CAREGIVERS OF OLDER ADULTS WITH ALZHEIMER'S DISEASE. PARTICIPANT AGE RANGE WAS BETWEEN 20 AND 50 Y (MEAN, 34 +/- 8.4 Y). A TOTAL OF 30 PARTICIPANTS WERE ENROLLED IN THE STUDY. SEVENTEEN PARTICIPANTS FOLLOWED IY INTERVENTION AND 13 WERE CONSIDERED IN A WAIT-LIST GROUP. INTERVENTION: PARTICIPANTS IN THE IY GROUP RECEIVED A STRUCTURED IY INTERVENTION COMPRISING YOGA ASANAS, PRANAYAMA, MEDITATION, AND RELAXATION TECHNIQUES, 1 H/D, 6 D/WK, FOR 1 MO. PARTICIPANTS IN THE WAIT-LIST CONTROL GROUP FOLLOWED THEIR DAILY ACTIVITIES. OUTCOME MEASURES: BLOOD PRESSURE, HEART RATE, ANXIETY, DEPRESSION, STRESS, AND SLEEP QUALITY WERE ASSESSED AT BASELINE AFTER 1 MO FOR BOTH THE GROUPS. DATA WERE ANALYZED WITH AN APPROPRIATE STATISTICAL TEST USING SPSS VERSION 16 SOFTWARE (IBM, ARMONK, NY, USA). RESULTS: THE IY GROUP SHOWED SIGNIFICANT IMPROVEMENT IN HEART RATE, BLOOD PRESSURE, STRESS, DEPRESSION, ANXIETY, AND SLEEP QUALITY AFTER 1 MO COMPARED WITH BASELINE. IN CONTRAST TO THE IY GROUP, THE WAIT-LISTED CONTROL GROUP SHOWED SIGNIFICANT INCREASE IN ANXIETY, DEPRESSION, AND STRESS AND SIGNIFICANT DECREASE IN SLEEP QUALITY AFTER 1 MO COMPARED WITH BASELINE. CONCLUSIONS: THE PRESENT STUDY SHOWED THE POTENTIAL USE OF IY INTERVENTION IN REDUCING STRESS, ANXIETY, AND DEPRESSION. THE STUDY ALSO SUGGESTS THAT IY IMPROVES SLEEP QUALITY AMONG PROFESSIONAL CAREGIVERS. HOWEVER, FURTHER STUDIES USING A RANDOMIZED CONTROLLED TRIAL METHOD WITH A LARGER SAMPLE SIZE AND FOR A LONGER DURATION SHOULD BE CONDUCTED TO CONFIRM THE PRESENT FINDINGS. 2018
14 1240 38 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
15 12 46 "MERGING YOGA AND OCCUPATIONAL THERAPY (MY-OT): A FEASIBILITY AND PILOT STUDY". OBJECTIVE: TO EXAMINE THE FEASIBILITY AND BENEFITS OF THE MERGING YOGA AND OCCUPATIONAL THERAPY (MY-OT) INTERVENTION. DESIGN: THIS IS THE PRIMARY ANALYSIS OF A NON-CONTROLLED PRETEST-POSTTEST PILOT STUDY TO UNDERSTAND THE FEASIBILITY AND IMPACT OF MY-OT ON BALANCE, BALANCE SELF-EFFICACY, AND FALL RISK FACTOR MANAGEMENT IN PEOPLE WITH CHRONIC STROKE. SETTING: UNIVERSITY RESEARCH LABORATORY. PARTICIPANTS: PEOPLE WITH CHRONIC STROKE WERE INCLUDED IN THE STUDY IF THEY: HAD SUSTAINED A FALL OR HAD FEAR OF FALLING, WERE ABLE TO STAND, AND HAND IMPAIRED BALANCE AND WERE AT RISK FOR FALLS (</=46 ON THE BERG BALANCE SCALE (BBS)). INTERVENTIONS: INDIVIDUALS COMPLETED AN 8 WEEK INTERVENTION THAT INCLUDED 16 SESSIONS OF BOTH YOGA AND GROUP OCCUPATIONAL THERAPY (OT). YOGA INCLUDED PHYSICAL POSTURES, BREATHING EXERCISES, AND MEDITATION. OT FOCUSED ON POST-STROKE FALL RISK FACTOR MANAGEMENT. MAIN OUTCOME MEASURES: THE BBS WAS USED TO ASSESS BALANCE, THE ACTIVITIES-SPECIFIC BALANCE CONFIDENCE SCALE (ABC) WAS USED TO MEASURE BALANCE SELF-EFFICACY. FIVE FALL RISK FACTOR MANAGEMENT SCALES WERE USED. RESULTS: OVERALL, THE INTERVENTION WAS CONSIDERED FEASIBLE, AS INDIVIDUALS WERE ABLE TO SAFELY COMPLETE THE INTERVENTION WITH LITTLE ATTRITION AND HIGH ATTENDANCE. BALANCE IMPROVED BY 30% (P=0.002). BALANCE SELF-EFFICACY IMPROVED BY 15% (P=0.034). EACH OF THE FIVE FALL RISK FACTOR MANAGEMENT SCALES IMPROVED, BUT ONLY TWO SIGNIFICANTLY IMPROVED (FALL PREVENTION AND MANAGEMENT QUESTIONNAIRE, 29%, P=0.004 AND FALL PREVENTION STRATEGY SURVEY, 42%, P=0.032). CONCLUSION: THE RESULTS DEMONSTRATE THAT MY-OT IS A POTENTIAL INTERVENTION TO IMPROVE MULTIPLE FALL RELATED OUTCOMES FOR PEOPLE WITH STROKE. THERAPISTS MAY CONSIDER THESE INTERVENTIONS FOR PEOPLE WITH STROKE, BUT ADDITIONAL RESEARCH IS WARRANTED. 2016
16 2830 44 YOGA VS STRETCHING IN VETERANS WITH CHRONIC LOWER BACK PAIN AND THE ROLE OF MINDFULNESS: A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THE PURPOSE OF THIS STUDY WAS TO INVESTIGATE THE FEASIBILITY OF RECRUITING, RANDOMIZING, ENROLLING, AND COLLECTING OUTCOME DATA ON VETERAN PATIENTS WITH CHRONIC LOW BACK PAIN (CLBP) WHO UNDERGO AN 8-WEEK, ACTIVE EXERCISE CLASS WITH MINDFULNESS (YOGA CLASS) AND WITHOUT (STRETCHING CLASS). METHODS: UNITED STATES VETERANS WITH CLBP BASED ON INCLUSION/EXCLUSION CRITERIA WERE RANDOMIZED TO 1 OF 2 GROUPS. THE STUDY DESIGN WAS A PILOT RANDOMIZED CONTROLLED TRIAL. TWENTY CLBP PATIENTS ATTENDED A YOGA CLASS OR STRETCHING CLASS ONCE PER WEEK FOR 8 WEEKS AT THE VETERANS AFFAIRS ROCHESTER OUTPATIENT CENTER, ROCHESTER, NEW YORK. THE FOLLOWING MEASUREMENTS WERE OBTAINED: RECRUITMENT OR ENROLLMENT DATA, COMPLIANCE DATA TO INCLUDE CLASS ATTENDANCE AND HOME EXERCISE, AND COMPLIANCE DATA REGARDING ABILITY TO COLLECT OUTCOME MEASURES AT BASELINE AND AT COMPLETION. OUTCOME MEASURES INCLUDED PAIN (PEG), QUALITY OF LIFE (PROMIS GLOBAL HEALTH SURVEY), SELF-EFFICACY (2-ITEM QUESTIONNAIRE), FEAR AVOIDANCE BELIEF, CATASTROPHIZING, AND SOCIAL ENGAGEMENT IN ADDITION TO QUALITATIVE CLINICIAN OPEN-ENDED QUESTIONS POSTINTERVENTION. RESULTS: FORTY-FIVE VETERANS WERE QUERIED REGARDING INTEREST IN PARTICIPATION. OF THESE, 34 (76%) MET THE STUDY'S CRITERIA. TWENTY (44%) AGREED TO PARTICIPATE AND WERE CONSENTED, RANDOMIZED, AND ENROLLED IN THE STUDY. INITIAL AND FINAL OUTCOME MEASURES WERE OBTAINED FOR EACH PARTICIPANT (100%). FORTY PERCENT ATTENDED MORE THAN 80% OF THE SESSIONS FOR BOTH YOGA AND STRETCHING GROUPS. CONCLUSION: THIS PILOT STUDY DEMONSTRATED FEASIBILITY OF RECRUITING, ENROLLING, AND COLLECTING OUTCOME DATA ON CLBP VETERAN PATIENTS PARTICIPATING IN YOGA AND STRETCHING CLASS. THE DATA FROM THIS PILOT WILL INFORM THE DEVELOPMENT OF A RANDOMIZED, COMPARATIVE EFFECTIVENESS STUDY OF YOGA WITH AND WITHOUT MINDFULNESS IN THE MANAGEMENT OF CLBP. 2020
17 2472 49 YOGA AS ADJUNCT THERAPY FOR ADOLESCENTS WITH INFLAMMATORY BOWEL DISEASE: A PILOT CLINICAL TRIAL. OBJECTIVES: TO DETERMINE WHETHER UTILIZING YOGA AS AN ADJUNCTIVE THERAPY TO THE MEDICAL STANDARD OF CARE FOR ADOLESCENTS WITH INFLAMMATORY BOWEL DISEASE (IBD) IS: (1) FEASIBLE AND ACCEPTABLE, (2) EFFECTIVE IN REDUCING DISEASE SEVERITY, INTESTINAL INFLAMMATION AND IMPROVING WELLNESS. DESIGN: PROSPECTIVE, NON-RANDOMIZED, 8-WEEK PILOT STUDY FOR ADOLESCENTS WITH A DIAGNOSIS OF IBD. FEASIBILITY AND ACCEPTABILITY OF THE INTERVENTION WERE ASSESSED WEEKLY AND POST-INTERVENTION VIA SURVEYS AND A FOCUS GROUP (WEEK 8). DISEASE SEVERITY, INTESTINAL INFLAMMATION, AND WELLNESS MEASURES WERE ASSESSED AT BASELINE AND POST-INTERVENTION (WEEK 8). INTERVENTION: OVER THE 8-WEEK STUDY PERIOD, PATIENTS WERE ASSIGNED THREE 60-MINUTE, IN-PERSON YOGA CLASSES AT WEEKS 1, 3 AND 8, AND THREE 30-MINUTE, ONLINE YOGA VIDEOS PER WEEK. MAIN OUTCOME MEASURES: PRIMARY OUTCOME MEASURES WERE FEASIBILITY AND ACCEPTABILITY. SECONDARY OUTCOME MEASURES ASSESSED PRELIMINARY CLINICAL EFFICACY BY EXAMINING PRE- AND POST-INTERVENTION CHANGE IN DISEASE SEVERITY (PUCAI), INTESTINAL INFLAMMATION (FECAL CALPROTECTIN), AND SIX WELLNESS MEASURES (PROMIS-37). RESULTS: NINE ADOLESCENTS WITH IBD PARTICIPATED. EIGHT PARTICIPATED IN ONE OR MORE YOGA VIDEOS PER WEEK AND ALL NINE ATTENDED AT LEAST TWO IN-PERSON YOGA CLASSES. FOCUS GROUP THEMES REVEALED THAT THE INTERVENTION WAS WELL LIKED, WITH ALL PARTICIPANTS REPORTING REDUCED STRESS, IMPROVED EMOTIONAL SELF-AWARENESS, AND INCREASED ABILITY TO IDENTIFY AND MANAGE THE PHYSICAL SYMPTOMS OF IBD. PARTICIPANTS HAD DIFFICULTY, HOWEVER, COMPLETING THE YOGA VIDEOS DUE TO TIME LIMITATIONS AND COMPETING PRIORITIES. WE LACKED POWER TO DETECT ANY STATISTICALLY SIGNIFICANT CHANGES IN PUCAI, CALPROTECTIN, OR ANY OF THE SIX PROMIS-37 DOMAINS. CONCLUSIONS: A COMBINATION OF IN-PERSON INSTRUCTOR LED YOGA WITH VIDEO-BASED YOGA IS A FEASIBLE AND ACCEPTABLE ADJUNCT THERAPY FOR ADOLESCENTS WITH IBD. PARTICIPANTS REPORTED REDUCED STRESS AND IMPROVED ABILITY TO IDENTIFY AND MANAGE PHYSICAL SYMPTOMS. A LARGER, RANDOMIZED CONTROLLED TRIAL IS NECESSARY TO DETERMINE IF THE YOGA PROTOCOL RESULTS IN CLINICALLY AND STATISTICALLY SIGNIFICANT IMPROVEMENTS IN INFLAMMATORY BIOMARKERS AND PATIENT REPORTED OUTCOMES. 2018
18 1024 35 EFFECTS OF YOGA AND THE ADDITION OF TUI NA IN PATIENTS WITH FIBROMYALGIA. OBJECTIVES: THIS STUDY AIMED TO VERIFY WHETHER TECHNIQUES OF YOGA WITH AND WITHOUT THE ADDITION OF TUI NA MIGHT IMPROVE PAIN AND THE NEGATIVE IMPACT OF FIBROMYALGIA (FMS) ON PATIENTS' DAILY LIFE. DESIGN: FORTY (40) FMS WOMEN WERE RANDOMIZED INTO TWO GROUPS, RELAXING YOGA (RY) AND RELAXING YOGA PLUS TOUCH (RYT), FOR EIGHT WEEKLY SESSIONS OF STRETCHING, BREATHING, AND RELAXING YOGIC TECHNIQUES. RYT PATIENTS WERE FURTHER SUBMITTED TO MANIPULATIVE TECHNIQUES OF TUI NA. OUTCOME MEASURE: OUTCOME MEASURES COMPRISED THE FIBROMYALGIA IMPACT QUESTIONNAIRE (FIQ), PAIN THRESHOLD AT THE 18 FMS TENDER POINTS, AND A VERBAL GRADUATION OF PAIN ASSESSED BEFORE TREATMENT AND ON THE FOLLOWUP. THE VISUAL ANALOG SCALE (VAS) FOR PAIN WAS ASSESSED BEFORE AND AFTER EACH SESSION AND ON THE FOLLOW-UP. RESULTS: SEVENTEEN (17) RYT AND 16 RY PATIENTS COMPLETED THE STUDY. BOTH RY AND RYT GROUPS SHOWED IMPROVEMENT IN THE FIQ AND VAS SCORES, WHICH DECREASED ON ALL SESSIONS. THE RYT GROUP SHOWED LOWER VAS AND VERBAL SCORES FOR PAIN ON THE EIGHTH SESSION, BUT THIS DIFFERENCE WAS NOT MAINTAINED ON THE FOLLOW-UP. CONVERSELY, RY VAS AND VERBAL SCORES WERE SIGNIFICANTLY LOWER JUST ON THE FOLLOW-UP. CONCLUSIONS: THESE STUDY RESULTS SHOWED THAT YOGIC TECHNIQUES ARE VALID THERAPEUTIC METHODS FOR FMS. TOUCH ADDITION YIELDED GREATER IMPROVEMENT DURING THE TREATMENT. OVER TIME, HOWEVER, RY PATIENTS REPORTED LESS PAIN THAN RYT. THESE RESULTS SUGGEST THAT A PASSIVE THERAPY MAY POSSIBLY DECREASE CONTROL OVER FMS SYMPTOMS. 2007
19 2831 43 YOGA VS. PHYSICAL THERAPY VS. EDUCATION FOR CHRONIC LOW BACK PAIN IN PREDOMINANTLY MINORITY POPULATIONS: STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN CAUSES SUBSTANTIAL MORBIDITY AND COST TO SOCIETY WHILE DISPROPORTIONATELY IMPACTING LOW-INCOME AND MINORITY ADULTS. SEVERAL RANDOMIZED CONTROLLED TRIALS SHOW YOGA IS AN EFFECTIVE TREATMENT. HOWEVER, THE COMPARATIVE EFFECTIVENESS OF YOGA AND PHYSICAL THERAPY, A COMMON MAINSTREAM TREATMENT FOR CHRONIC LOW BACK PAIN, IS UNKNOWN. METHODS/DESIGN: THIS IS A RANDOMIZED CONTROLLED TRIAL FOR 320 PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH CHRONIC LOW BACK PAIN, COMPARING YOGA, PHYSICAL THERAPY, AND EDUCATION. INCLUSION CRITERIA ARE ADULTS 18-64 YEARS OLD WITH NON-SPECIFIC LOW BACK PAIN LASTING >/= 12 WEEKS AND A SELF-REPORTED AVERAGE PAIN INTENSITY OF >/= 4 ON A 0-10 SCALE. RECRUITMENT TAKES PLACE AT BOSTON MEDICAL CENTER, AN URBAN ACADEMIC SAFETY-NET HOSPITAL AND SEVEN FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS LOCATED IN DIVERSE NEIGHBORHOODS. THE 52-WEEK STUDY HAS AN INITIAL 12-WEEK TREATMENT PHASE WHERE PARTICIPANTS ARE RANDOMIZED IN A 2:2:1 RATIO INTO I) A STANDARDIZED WEEKLY HATHA YOGA CLASS SUPPLEMENTED BY HOME PRACTICE; II) A STANDARDIZED EVIDENCE-BASED EXERCISE THERAPY PROTOCOL ADAPTED FROM THE TREATMENT BASED CLASSIFICATION METHOD, INDIVIDUALLY DELIVERED BY A PHYSICAL THERAPIST AND SUPPLEMENTED BY HOME PRACTICE; AND III) EDUCATION DELIVERED THROUGH A SELF-CARE BOOK. CO-PRIMARY OUTCOME MEASURES ARE 12-WEEK PAIN INTENSITY MEASURED ON AN 11-POINT NUMERICAL RATING SCALE AND BACK-SPECIFIC FUNCTION MEASURED USING THE MODIFIED ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 40-WEEK MAINTENANCE PHASE, YOGA PARTICIPANTS ARE RE-RANDOMIZED IN A 1:1 RATIO TO EITHER STRUCTURED MAINTENANCE YOGA CLASSES OR HOME PRACTICE ONLY. PHYSICAL THERAPY PARTICIPANTS ARE SIMILARLY RE-RANDOMIZED TO EITHER FIVE BOOSTER SESSIONS OR HOME PRACTICE ONLY. EDUCATION PARTICIPANTS CONTINUE TO FOLLOW RECOMMENDATIONS OF EDUCATIONAL MATERIALS. WE WILL ALSO ASSESS COST EFFECTIVENESS FROM THE PERSPECTIVES OF THE INDIVIDUAL, INSURERS, AND SOCIETY USING CLAIMS DATABASES, ELECTRONIC MEDICAL RECORDS, SELF-REPORT COST DATA, AND STUDY RECORDS. QUALITATIVE DATA FROM INTERVIEWS WILL ADD SUBJECTIVE DETAIL TO COMPLEMENT QUANTITATIVE DATA. TRIAL REGISTRATION: THIS TRIAL IS REGISTERED IN CLINICALTRIALS.GOV, WITH THE ID NUMBER: NCT01343927. 2014
20 313 42 AN EXPLORATORY STUDY OF THE ACCEPTABILITY AND FEASIBILITY OF YOGA AMONG WOMEN IN SUBSTANCE USE DISORDER RECOVERY. OBJECTIVES: THIS QUALITATIVE STUDY EXPLORED THE ACCEPTABILITY AND FEASIBILITY OF YOGA AMONG WOMEN IN SUBSTANCE USE DISORDER (SUD) RECOVERY. DESIGN: SEVENTEEN WOMEN IN SUD RECOVERY FOR 2 WEEKS OR LONGER WERE RECRUITED FROM NINE SITES IN THE MID-SOUTH, INCLUDING A MEDICATION-ASSISTED TREATMENT CLINIC IN A HOSPITAL SETTING, PRISON RE-ENTRY HOUSING, COMMUNITY-BASED PEER SUPPORT ORGANIZATIONS (E.G., ALCOHOLICS ANONYMOUS [AA], NARCOTICS ANONYMOUS [NA]), A RESIDENTIAL SUD TREATMENT FACILITY, A YOGA TEACHERS' ONLINE GROUP, AND THROUGH REFERRALS. THE MEDIAN AGE OF PARTICIPANTS WAS 41.5, WITH AGES RANGING FROM 25 TO 65. WE USED AN INTERPRETIVE DESCRIPTION APPROACH TO EXPLORE BOTH THE PERCEPTIONS OF WOMEN WITHOUT YOGA EXPERIENCE AND THE EXPERIENCES OF WOMEN WITH YOGA EXPERIENCE TO COLLECT FORMATIVE DATA FOR INTERVENTION DEVELOPMENT AND IMPLEMENTATION. THE INTERVIEWS WERE RECORDED AND TRANSCRIBED VERBATIM. A HYBRID ANALYSIS (I.E., INDUCTIVE AND DEDUCTIVE CODING) WAS APPLIED TO THE DATA. RESULTS: WOMEN'S NARRATIVES INCLUDED A HIGH PREVALENCE OF TRAUMA EXPOSURE. OVERALL, WOMEN IN THIS SAMPLE WERE INTERESTED IN EITHER BEGINNING OR CONTINUING YOGA. BARRIERS TO PARTICIPATION INCLUDED PERCEIVED LACK OF SELF-EFFICACY OF YOGA, WEIGHT, AND PHYSICAL INJURIES. ADDITIONAL ENVIRONMENTAL BARRIERS INCLUDED BALANCING CARE OF SELF WITH CARING FOR OTHERS, INCLUDING PARTNERS, CHILDREN, AND NA/AA SPONSEES; AS WELL AS PRIORITIZING FINANCES, HOUSING, EMPLOYMENT, AND TRANSPORTATION. CONCLUSION: HIGH PREVALENCE OF TRAUMA EXPOSURE AMONG WOMEN IN SUD RECOVERY NECESSITATES CAREFUL CONSIDERATION OF CO-OCCURRING PSYCHIATRIC DISORDERS SUCH AS POST-TRAUMATIC STRESS DISORDER, ANXIETY AND DEPRESSION AND THE NECESSARY PROFESSIONAL PSYCHOLOGICAL SUPPORT, AS WELL AS SERIOUS PHYSICAL INJURIES THAT REQUIRE MODIFICATION IN YOGA ASANA CLASSES. AS TRANSPORTATION AND BALANCING CARE NEEDS WERE SALIENT IN THESE DATA, RURAL SUD POPULATIONS COULD BE SERVED WITH TELEHEALTH INTERVENTIONS THAT PROVIDE SUD RECOVERY SUPPORT WITH INTEGRATIVE HEALTH PRACTICES SUCH AS ADJUNCTIVE YOGA INTERVENTIONS. 2021