1 2344 148 USING A STANDARDIZED VINIYOGA PROTOCOL FOR LUNG CANCER SURVIVORS: A PILOT STUDY EXAMINING EFFECTS ON BREATHING EASE. ALTHOUGH LUNG CANCER IS PERCEIVED AS A DIRE DIAGNOSIS, INCREASES IN THE 5-YEAR SURVIVAL RATE OF INDIVIDUALS WITH NON-SMALL CELL LUNG CANCER (NSCLC) HAVE BEEN REPORTED. SURVIVORS, HOWEVER, CONTINUE TO BE EXCESSIVELY BURDENED WITH SYMPTOMS SUCH AS RESPIRATORY DISTRESS WHICH INTERFERE WITH FUNCTIONING AND QUALITY OF LIFE. WHILE EXERCISE AND PHYSICAL ACTIVITY ARE STRONGLY RECOMMENDED, NSCLC SURVIVORS MAY BE RELUCTANT TO PARTICIPATE DUE TO ACTUAL OR ANTICIPATED SHORTNESS OF BREATH EXACERBATED WITH MOVEMENT.THIS QUASI-EXPERIMENTAL, INTERVENTION-ONLY PILOT STUDY AIMED TO DETERMINE THE EFFECTS OF AN 8-WEEK STANDARDIZED YOGA PROTOCOL FOR STAGE I-IIIA NSCLC SURVIVORS (N=9). THE PROTOCOL WAS DEVELOPED WITHIN THE VINIYOGA (HATHA) TRADITION WITH RESPIRATORY EXPERTS. BREATHING EASE, DYSPNEA, OXYGEN SATURATION, AND RESPIRATORY FUNCTION WERE EXPLORED IN RELATIONSHIP TO YOGA PRACTICE (45-MINUTE SESSIONS ONCE PER WEEK AND HOME PRACTICE) USING REPEATED-MEASURES ANALYSIS. NUMBER OF PARTICIPANTS REPORTING DYSPNEA RANGED FROM 25 TO 50% PRIOR TO PRACTICE WITH NO SIGNIFICANT INCREASE DURING SESSIONS, AND MODERATE DECREASES NOTED AT TIMES. OXYGEN SATURATION REMAINED HIGH AND VITAL SIGNS STABLE; FORCED EXPIRATORY VOLUME IN 1 SECOND (FEV1) VALUES INCREASED SIGNIFICANTLY OVER THE 14-WEEK STUDY PERIOD (P<0.0001). YOGA, WITH AN EMPHASIS ON POSTURES COORDINATED WITH BREATHING AND MEDITATION PRACTICES, OFFERS A POTENTIALLY FEASIBLE AND BENEFICIAL OPTION THAT REQUIRES FURTHER STUDY IN THIS POPULATION. 2013 2 1941 45 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 3 200 46 A RESPONDER ANALYSIS OF THE EFFECTS OF YOGA FOR INDIVIDUALS WITH COPD: WHO BENEFITS AND HOW? BACKGROUND: WE PREVIOUSLY REPORTED THAT A TWICE-WEEKLY, MODIFIED IYENGAR YOGA PROGRAM WAS A SAFE AND VIABLE SELF-MANAGEMENT STRATEGY FOR PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). 1 OBJECTIVE: THE PRIMARY PURPOSE OF THIS EXPLORATORY ANALYSIS WAS TO CLASSIFY YOGA PARTICIPANTS INTO 1 OF 3 RESPONDER CATEGORIES BY USING MINIMUM CLINICALLY IMPORTANT DIFFERENCE (MCID) CRITERIA FOR EACH OF 3 VARIABLES: 6-MINUTE WALK DISTANCE (6MW), DISTRESS RELATED TO DYSPNEA (SHORTNESS OF BREATH; DD), AND FUNCTIONAL PERFORMANCE (FPI). CHANGES IN HEALTH-RELATED QUALITY OF LIFE (HRQL) AND IN PSYCHOLOGICAL WELL-BEING (ANXIETY AND DEPRESSION), AND PARTICIPANTS' SELF-REPORTED IMPROVEMENTS BY RESPONDER CATEGORY WERE ALSO EXAMINED. A SECONDARY GOAL WAS TO IDENTIFY BASELINE PARTICIPANT CHARACTERISTICS, INCLUDING INITIAL RANDOMIZATION ASSIGNMENT THAT MIGHT PREDICT RESPONSE TO TREATMENT. METHODS: PARTICIPANTS WERE RANDOMLY ASSIGNED TO EITHER AN INITIAL YOGA (IY) OR AN ENHANCED WAIT-LIST CONTROL (WLC) GROUP. THOSE IN THE WLC GROUP WERE OFFERED THE YOGA PROGRAM IMMEDIATELY FOLLOWING THE IY GROUP'S PARTICIPATION. INDIVIDUALS FROM BOTH GROUPS WHO COMPLETED AT LEAST 18 OF 24 YOGA CLASSES WERE CATEGORIZED AS RESPONDERS, PARTIAL RESPONDERS, OR NON-RESPONDERS FOR EACH OF THE 3 OUTCOME VARIABLES (6MW, DD, FPI) ON THE BASIS OF MCID CRITERIA. BASELINE CHARACTERISTICS AND CHANGES IN HRQL AND PSYCHOLOGICAL WELL-BEING WERE ALSO ANALYZED. RESULTS: NONE OF THE PARTICIPANTS DEMONSTRATED MCIDS FOR ALL 3 OUTCOMES; HOWEVER, 6 WERE CLASSIFIED AS RESPONDERS FOR 2 OUT-COME VARIABLES AND 4 WERE CLASSIFIED AS NON-RESPONDERS FOR ALL 3 OUTCOME VARIABLES. TWO-THIRDS OF THE FEMALE PARTICIPANT GROUP AND ONE-THIRD OF THE MALE PARTICIPANT GROUP COMPLETED THE YOGA PROGRAM. DD RESPONDERS SHOWED INCREASED ANXIETY LEVELS, WHEREAS ANXIETY LEVELS OF THE DD NON-RESPONDERS REMAINED UNCHANGED. FPI RESPONDERS REPORTED SIGNIFICANT IMPROVEMENTS IN PHYSICAL FUNCTION, WHEREAS PARTIAL AND NON-FPI RESPONDERS NOTED DECLINED FUNCTION. PARTICIPANTS ASSIGNED TO THE IY GROUP DEMONSTRATED GREATER BENEFIT FROM YOGA THAN DID THOSE IN THE W LC GROUP. CONCLUSIONS: ALTHOUGH THIS MODIFIED IYENGAR YOGA PROGRAM APPEARS TO HAVE BENEFITED SOME INDIVIDUALS WITH COPD, FURTHER STUDIES ARE REQUIRED TO ASSESS WHO THE INTERVENTION WORKS FOR AND UNDER WHAT CONDITIONS. 2012 4 1396 24 IMPACT OF YOGA IN A CASE OF VOCAL CORD DYSFUNCTION WITH DYSAUTONOMIA. A 23-YEAR-OLD FEMALE WITH A PAST MEDICAL HISTORY OF GASTROESOPHAGEAL REFLUX DISEASE PRESENTED WITH SHORTNESS OF BREATH INDUCED BY EXERCISE AND CERTAIN ODORS. SHE REPORTED THE SYMPTOMS OF AUTONOMIC DYSFUNCTION INCLUDING FATIGUE, CHEST PAIN, LIGHTHEADEDNESS, HEADACHES, NUMBNESS/TINGLING IN THE ARMS AND LEGS, AND EXERCISE INTOLERANCE. VITAL SIGNS WERE SIGNIFICANT FOR ORTHOSTATIC INTOLERANCE. VOLUME FLOW LOOP IN THE PULMONARY FUNCTION TESTS SHOWED A FLATTENING OF THE INSPIRATORY PORTION CHARACTERISTIC OF VOCAL CORD DYSFUNCTION. LARYNGOSCOPY SHOWED DYSKINESIA OF THE LEFT VOCAL CORD, ESPECIALLY AFTER EXERCISE. MULTIFACTORIAL APPROACH WAS USED INCLUDING INCREASED FLUID INTAKE AND BREATHING EXERCISES. AFTER 6 WEEKS OF BREATHING AND ISOMETRIC EXERCISES, THE PATIENT REPORTED IMPROVEMENT IN DYSPNEA AFTER EXERCISE. THIS CASE REPORT DEMONSTRATES THE THERAPEUTIC ROLE OF BREATHING AND ISOMETRIC EXERCISES IN THE MANAGEMENT OF VOCAL CORD AND AUTONOMIC DYSFUNCTION. 2017 5 351 31 ASSESSMENT OF SIGNIFICANCE OF YOGA ON QUALITY OF LIFE IN ASTHMA PATIENTS: A RANDOMIZED CONTROLLED STUDY. BACKGROUND: ASTHMA IS A CHRONIC INFLAMMATORY RESPIRATORY DISEASE CHARACTERIZED BY PERIODIC ATTACKS OF WHEEZING, SHORTNESS OF BREATH AND A TIGHT FEELING IN THE CHEST. THE CURRENT STUDY IS BASED ON THE EFFECT OF YOGA ON QUALITY OF LIFE IN ASTHMATICS IN NORTHERN INDIA. MATERIALS AND METHODS: A TOTAL OF 300 PARTICIPANTS OF MILD-TO-MODERATE PERSISTENT ASTHMA (FEV1 >60%) AGED BETWEEN 12 AND 60 YEARS WERE RECRUITED FROM THE DEPARTMENT OF PULMONARY MEDICINE. THEIR QUALITY OF LIFE WAS ASSESSED WITH THE HELP OF MINI ASTHMA QUALITY-OF-LIFE QUESTIONNAIRE (AQLQ) AT BASELINE AND THEN AFTER 3(RD) AND 6(TH) MONTH FROM BASELINE. FORTY-FIVE PARTICIPANTS WERE DROPPED OUT DURING THE STUDY WHILE 255 PARTICIPANTS COMPLETED THE STUDY SUCCESSFULLY. RESULTS: IN "THE YOGA GROUP," SIGNIFICANT IMPROVEMENTS WERE FOUND IN ALL THE SUBDOMAINS OF AQLQ AT 3(RD) MONTH AND AT 6(TH) MONTH IN COMPARISON TO "THE CONTROL GROUP." THE NUMBER NEEDED TO TREAT WAS FOUND TO BE 2.67 FOR THE TOTAL AQLQ SCORE WHICH WAS GREATER THAN THE MINIMAL IMPORTANT DIFFERENCE. CONCLUSION: "THE YOGA GROUP" GOT SIGNIFICANTLY BETTER IMPROVEMENT IN ASTHMA QUALITY-OF-LIFE SCORES THAN "THE CONTROL GROUP." THUS, YOGA CAN BE USED AS AN ADJUVANT THERAPY IN THE MANAGEMENT OF ASTHMA. 2017 6 1531 36 IYENGAR YOGA THERAPY AS AN INTERVENTION FOR CRAMP MANAGEMENT IN INDIVIDUALS WITH AMYOTROPHIC LATERAL SCLEROSIS: THREE CASE REPORTS. OBJECTIVES: PATIENTS WITH AMYOTROPHIC LATERAL SCLEROSIS (ALS), A NEURODEGENERATIVE DISEASE OF MOTOR NEURONS, EXPERIENCE CRAMPS AT ALL STAGES OF THE ILLNESS. THERE IS, AT PRESENT, NO EFFECTIVE MEDICATION TO CONTROL THE CRAMPS AND NO AGREEMENT ON HOW TO TREAT THE SYMPTOM IN ALS PATIENTS. SUBJECTS: THREE INDIVIDUALS WHO WERE DIAGNOSED WITH ALS AND REPORTED SUFFERING CRAMPS IN VARIOUS PARTS OF THE BODY, WHICH LIMITED THEIR ACTIVITIES OR AFFECTED THEIR SLEEP WERE INVITED TO TRY IYENGAR YOGA. INTERVENTION AND OUTCOME: YOGA THERAPY, COMPOSED OF STRETCHING, BREATHING, AND RELAXATION EXERCISES, WAS PRESCRIBED FOR EACH CASE, BASED ON THE SUBJECT'S PHYSICAL DISABILITY AND THE PRESENCE OF OTHER SYMPTOMS. ALTHOUGH TWO SUBJECTS EXPERIENCED CRAMPS DURING THE FIRST THERAPY SESSION, ALL THREE SUBJECTS REPORTED THE COMPLETE CESSATION OF CRAMPING WITHIN 3 WEEKS TO 8 WEEKS OF THERAPY. ONE OF THE SUBJECTS DEVELOPED CRAMPS IN THE HAND AFTER DISCONTINUING YOGA THERAPY FOR 7 MONTHS. HOWEVER, THE SYMPTOM STOPPED WITHIN 2 WEEKS OF RESUMING YOGA THERAPY. CONCLUSION: THE ALLEVIATION OF CRAMPS IN THESE THREE SUBJECTS INDICATES THE POSSIBILITY OF YOGIC INTERVENTION FOR THE MANAGEMENT OF CRAMPS IN INDIVIDUALS WITH ALS, BUT FURTHER RESEARCH IS NECESSARY TO UNDERSTAND THE EFFECTIVENESS OF YOGA THERAPY AND TO DETERMINE THE EXERCISES THAT ARE MORE PRONE TO LEAD TO CRAMPING IN SOME ALS INDIVIDUALS. 2014 7 121 59 A PILOT STUDY OF THE FEASIBILITY AND OUTCOMES OF YOGA FOR LUNG CANCER SURVIVORS. PURPOSE/OBJECTIVES: TO DETERMINE THE FEASIBILITY OF A STANDARDIZED YOGA INTERVENTION FOR SURVIVORS OF NON-SMALL CELL LUNG CANCER (NSCLC) AND, EFFECTS ON SLEEP, MOOD, SALIVARY CORTISOL LEVELS, AND QUALITY OF LIFE (QOL). DESIGN: THIS 14-WEEK, ONE-GROUP, REPEATED-MEASURES STUDY INCLUDED A THREE-WEEK PREINTERVENTION PHASE, EIGHT WEEKS OF YOGA CLASSES (40 MINUTES ONCE PER WEEK) AND HOME PRACTICE, AND A THREE-WEEK POSTINTERVENTION PHASE. FOLLOW-UP OCCURRED AT THREE AND SIX MONTHS POSTSTUDY. SETTING: A COMMUNITY-BASED CANCER SUPPORT CENTER IN THE MIDWESTERN UNITED STATES. SAMPLE: 7 ADULTS WHO HAD COMPLETED INITIAL TREATMENT FOR STAGES I-IIIA NSCLC. METHODS: A STANDARDIZED YOGA PROTOCOL WAS DEVELOPED PRIOR TO THE STUDY BY EXPERTS IN THE FIELD. BREATHING EASE WAS MONITORED BEFORE, DURING, AND AFTER CLASSES TO ASSESS FEASIBILITY OF MOVEMENT WITHOUT COMPROMISING RESPIRATORY STATUS WHILE DOING YOGA. DATA ANALYSIS INCLUDED DESCRIPTIVE STATISTICS, REPEATED-MEASURES ANALYSIS OF VARIANCE, AND SALIVARY CORTISOL ANALYSIS. MAIN RESEARCH VARIABLES: SLEEP QUALITY, MOOD, SALIVARY CORTISOL, AND QOL WERE ASSESSED USING THE PITTSBURGH SLEEP QUALITY INDEX, PROFILE OF MOOD STATES-BRIEF, A CORTISOL MEASUREMENT, AND THE MEDICAL OUTCOMES SURVEY SF-36(R), RESPECTIVELY. BREATHING EASE WAS ASSESSED USING A DYSPNEA NUMERIC RATING SCALE AS WELL AS OBSERVATION OF PARTICIPANTS. FINDINGS: PARTICIPANTS WITH VARYING STAGES OF DISEASE AND LENGTH OF SURVIVORSHIP WERE ABLE TO PERFORM YOGA WITHOUT RESPIRATORY DISTRESS. CLASS ATTENDANCE EXCEEDED 95%, AND ALL PRACTICED AT HOME. MOOD, SLEEP EFFICIENCY, AND QOL SIGNIFICANTLY IMPROVED; SALIVARY CORTISOL LEVELS DECREASED OVER TIME. CONCLUSIONS: YOGA WAS FEASIBLE FOR NSCLC SURVIVORS WITHOUT FURTHER COMPROMISING BREATHING WITH MOVEMENT. POTENTIAL BENEFITS WERE IDENTIFIED, SUPPORTING THE NEED FOR FUTURE CLINICAL TRIALS WITH LARGER SAMPLES STRATIFIED BY CANCER STAGE, TREATMENT, AND LENGTH OF SURVIVORSHIP. IMPLICATIONS FOR NURSING: NURSES AND HEALTHCARE PROVIDERS SHOULD CONSIDER YOGA AS A MIND-BODY PRACTICE TO MANAGE STRESS, IMPROVE MOOD AND SLEEP, AND POTENTIALLY ENHANCE QOL FOR NSCLC SURVIVORS. 2014 8 1532 33 IYENGAR YOGA THERAPY INTERVENTION FOR ISCHIAL PRESSURE ULCERS IN A PATIENT WITH AMYOTROPHIC LATERAL SCLEROSIS: A CASE STUDY. BACKGROUND: ALTHOUGH SOME RESEARCH SUGGESTS THAT THE FORMATION OF PRESSURE ULCERS IS RARE IN PATIENTS WITH AMYOTROPHIC LATERAL SCLEROSIS (ALS), SEVERAL PATIENTS HAVE NONETHELESS DEVELOPED THIS PROBLEM. TO DATE, HOWEVER, NO CASE REPORTS IN THE LITERATURE HAVE DESCRIBED PATIENTS WITH ALS WHO DEVELOP ISCHIAL PRESSURE ULCERS. OUTSIDE OF THE ALS LITERATURE, EVIDENCE SUGGESTS THAT ISCHIAL PRESSURE ULCERS FREQUENTLY DEVELOP IN WHEELCHAIR USERS AND ALSO IN PATIENTS TREATED IN VARIOUS HEALTH CARE SETTINGS. CASE DESCRIPTION: A PATIENT DIAGNOSED WITH ALS REPORTED THE DEVELOPMENT OF ISCHIAL PRESSURE ULCERS AFTER CONSISTENT IMMOBILITY FOR 1 YEAR (32 MONTHS AFTER HER ALS DIAGNOSIS). THIS PATIENT, WHO WAS SITTING ON THE WOUNDS, WAS TREATED WITH OINTMENT AND MORPHINE; THE LATTER WAS INEFFECTIVE IN CONTROLLING THE PAIN. MOVING THE PATIENT FROM SITTING TO SUPINE, LATERAL, OR SEMILATERAL POSITIONS, EITHER ON THE BED OR WHEELCHAIR, TO SEPARATE THE ULCERS FROM THE SURFACE OF THE CHAIR OR BED WAS DEEMED IMPOSSIBLE BECAUSE OF EXAGGERATION OF OTHER SYMPTOMS, INCLUDING SHORTNESS OF BREATH AND PAIN IN OTHER PARTS OF THE BODY. A NEW METHOD OF POSTURAL ALIGNMENT WAS DEVELOPED TO ALLEVIATE THE PAIN ASSOCIATED WITH THE PRESSURE ULCER. THIS METHOD, IYENGAR YOGA THERAPY, WHICH USES PROPS TO REPOSITION A PATIENT, ALLEVIATED PAIN AND HEALING OF TWO PRESSURE ULCERS OF THE PATIENT AFTER 3 WEEKS OF STARTING THIS INTERVENTION. CONCLUSION: ALTHOUGH THE ISCHIAL PRESSURE ULCERS WERE SUCCESSFULLY TREATED IN A PATIENT WITH ALS, FURTHER STUDY IS NECESSARY TO INVESTIGATE THE EFFECTIVENESS OF THIS POSTURAL ALIGNMENT INTERVENTION IN ALS AND OTHER PATIENT POPULATIONS FOR THE MANAGEMENT OF ISCHIAL PRESSURE ULCERS. 2015 9 2831 36 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 10 786 45 EFFECT OF YOGA BREATHING (PRANAYAMA) ON EXERCISE TOLERANCE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A RANDOMIZED, CONTROLLED TRIAL. OBJECTIVE: PULMONARY REHABILITATION IMPROVES EXERCISE TOLERANCE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). HOWEVER, MANY PATIENTS DO NOT HAVE ACCESS TO PULMONARY REHABILITATION PROGRAMS. WE HYPOTHESIZED THAT AN ALTERNATIVE TO PULMONARY REHABILITATION TO IMPROVE EXERCISE TOLERANCE IS THE PRACTICE OF PRANAYAMA, OR YOGA BREATHING, WHICH COULD BE DONE INDEPENDENTLY AT HOME. WE ALSO SOUGHT TO DETERMINE WHETHER YOGA NONPROFESSIONALS COULD ADEQUATELY TEACH PRANAYAMA TO PATIENTS. DESIGN: PROOF-OF-CONCEPT, RANDOMIZED, DOUBLE-BLIND, CONTROLLED PILOT TRIAL. SETTINGS/LOCATION: TWO ACADEMIC PULMONARY PRACTICES. SUBJECTS: FORTY-THREE PATIENTS WITH SYMPTOMATIC, MODERATE-TO-SEVERE COPD. INTERVENTIONS: TWELVE WEEKS OF PRANAYAMA PLUS EDUCATION VERSUS EDUCATION ALONE. TWO YOGA PROFESSIONALS TRAINED THE RESEARCH COORDINATORS TO CONDUCT ALL PRANAYAMA TEACHING AND MONITORED THE QUALITY OF THE TEACHING AND THE PRACTICE OF PRANAYAMA BY STUDY PARTICIPANTS. OUTCOME MEASURES: THE PRIMARY OUTCOME WAS A CHANGE IN THE 6-MIN WALK DISTANCE (6MWD). SECONDARY OUTCOMES INCLUDED CHANGES IN LUNG FUNCTION, MARKERS OF OXIDATIVE STRESS AND SYSTEMIC INFLAMMATION, AND MEASURES OF DYSPNEA AND QUALITY OF LIFE. RESULTS: THE 6MWD INCREASED IN THE PRANAYAMA GROUP (LEAST SQUARE MEAN [95% CONFIDENCE INTERVAL] = 28 M [-5 TO 61]) AND DECREASED IN THE CONTROL GROUP (-15 M [-47 TO 16]), WITH A NEARLY SIGNIFICANT TREATMENT EFFECT (P = 0.06) IN FAVOR OF PRANAYAMA. PRANAYAMA ALSO RESULTED IN SMALL IMPROVEMENTS IN INSPIRATORY CAPACITY AND AIR TRAPPING. BOTH GROUPS HAD SIGNIFICANT IMPROVEMENTS IN VARIOUS MEASURES OF SYMPTOMS, BUT NO OVERALL DIFFERENCES IN RESPIRATORY SYSTEM IMPEDANCE OR MARKERS OF OXIDATIVE STRESS OR SYSTEMIC INFLAMMATION. CONCLUSION: THIS PILOT STUDY SUCCESSFULLY DEMONSTRATED THAT PRANAYAMA WAS ASSOCIATED WITH IMPROVED EXERCISE TOLERANCE IN PATIENTS WITH COPD. LAY PERSONNEL WERE ABLE TO ADEQUATELY TEACH PATIENTS TO PRACTICE PRANAYAMA. THESE RESULTS SUGGEST THAT PRANAYAMA MAY HAVE SIGNIFICANT CLINICAL BENEFITS FOR SYMPTOMATIC PATIENTS WITH COPD, A CONCEPT THAT NEEDS TO BE CONFIRMED IN FUTURE, LARGER CLINICAL TRIALS. 2017 11 258 36 ACCEPTABILITY AND FEASIBILITY OF A 12-WEEK YOGA VS. EDUCATIONAL FILM PROGRAM FOR THE MANAGEMENT OF RESTLESS LEGS SYNDROME (RLS): STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: RESTLESS LEGS SYNDROME (RLS) IS A COMMON AND BURDENSOME SLEEP DISORDER ASSOCIATED WITH PROFOUND IMPAIRMENT OF HEALTH, WELL-BEING, AND QUALITY OF LIFE. UNFORTUNATELY, THE MEDICATIONS USED FOR RLS MANAGEMENT CARRY RISK OF SERIOUS SIDE EFFECTS, INCLUDING AUGMENTATION OF SYMPTOMS. YOGA, AN ANCIENT MIND-BODY DISCIPLINE DESIGNED TO PROMOTE PHYSICAL, EMOTIONAL, AND MENTAL WELL-BEING, MAY OFFER A VIABLE, LOW-RISK NEW TREATMENT. THE PRIMARY OBJECTIVES OF THIS PILOT, PARALLEL-ARM, RANDOMIZED CONTROLLED TRIAL (RCT) ARE TO ASSESS THE ACCEPTABILITY AND FEASIBILITY OF A 12-WEEK YOGA VS. EDUCATIONAL FILM PROGRAM FOR THE MANAGEMENT OF RLS. METHODS: FORTY-FOUR ADULTS WITH CONFIRMED MODERATE TO SEVERE RLS WILL BE RECRUITED AND RANDOMIZED TO A 12-WEEK YOGA (N = 22) OR STANDARDIZED EDUCATIONAL FILM PROGRAM (N = 22). YOGA GROUP PARTICIPANTS WILL ATTEND TWO 75-MIN IYENGAR YOGA CLASSES PER WEEK FOR THE FIRST 4 WEEKS, THEN ONE 75-MIN CLASS PER WEEK FOR THE REMAINING 8 WEEKS, AND WILL COMPLETE A 30-MIN HOMEWORK ROUTINE ON NON-CLASS DAYS. EDUCATIONAL FILM GROUP PARTICIPANTS WILL ATTEND ONE 75-MIN CLASS PER WEEK FOR 12 WEEKS AND COMPLETE A DAILY RLS TREATMENT LOG; CLASSES WILL INCLUDE INFORMATION ON: RLS MANAGEMENT, INCLUDING SLEEP HYGIENE PRACTICES; OTHER SLEEP DISORDERS; AND COMPLEMENTARY THERAPIES LIKELY TO BE OF INTEREST TO THOSE PARTICIPATING IN A YOGA AND SLEEP EDUCATION STUDY. YOGA AND TREATMENT LOGS WILL BE COLLECTED WEEKLY. FEASIBILITY OUTCOMES WILL INCLUDE RECRUITMENT, ENROLLMENT, AND RANDOMIZATION RATES, RETENTION, ADHERENCE, AND PROGRAM SATISFACTION. PROGRAM EVALUATION AND YOGA-DOSING QUESTIONNAIRES WILL BE COLLECTED AT WEEK 12; DATA ON EXPLORATORY OUTCOMES (E.G., RLS SYMPTOM SEVERITY (IRLS), SLEEP QUALITY (PSQI), MOOD (POMS, PSS), AND HEALTH-RELATED QUALITY OF LIFE (SF-36)) WILL BE GATHERED AT BASELINE AND WEEK 12. DISCUSSION: THIS STUDY WILL LAY THE ESSENTIAL GROUNDWORK FOR A PLANNED LARGER RCT TO DETERMINE THE EFFICACY OF A YOGA PROGRAM FOR REDUCING SYMPTOMS AND ASSOCIATED BURDEN OF RLS. IF THE FINDINGS OF THE CURRENT TRIAL AND THE SUBSEQUENT LARGER RCTS ARE POSITIVE, THIS STUDY WILL ALSO HELP SUPPORT A NEW APPROACH TO CLINICAL TREATMENT OF THIS CHALLENGING DISORDER, HELP FOSTER IMPROVED UNDERSTANDING OF RLS ETIOLOGY, AND ULTIMATELY CONTRIBUTE TO REDUCING THE INDIVIDUAL, SOCIETAL, AND ECONOMIC BURDEN ASSOCIATED WITH THIS CONDITION. TRIAL REGISTRATION: CLINICALTRIALS.GOV, ID: NCT03570515 . RETROSPECTIVELY REGISTERED ON 1 FEBRUARY 2017. 2019 12 217 34 A STUDY PROTOCOL OF A THREE-GROUP RANDOMIZED FEASIBILITY TRIAL OF AN ONLINE YOGA INTERVENTION FOR MOTHERS AFTER STILLBIRTH (THE MINDFUL HEALTH STUDY). BACKGROUND: IN THE USA, STILLBIRTH (IN UTERO FETAL DEATH >/=20 WEEKS GESTATION) IS A MAJOR PUBLIC HEALTH ISSUE. WOMEN WHO EXPERIENCE STILLBIRTH, COMPARED TO WOMEN WITH LIVE BIRTH, HAVE A NEARLY SEVENFOLD INCREASED RISK OF A POSITIVE SCREEN FOR POST-TRAUMATIC STRESS DISORDER (PTSD) AND A FOURFOLD INCREASED RISK OF DEPRESSIVE SYMPTOMS. BECAUSE THE MAJORITY OF WOMEN WHO HAVE EXPERIENCED THE DEATH OF THEIR BABY BECOME PREGNANT WITHIN 12-18 MONTHS AND THE LACK OF INTERVENTION STUDIES CONDUCTED WITHIN THIS POPULATION, NOVEL APPROACHES TARGETING PHYSICAL AND MENTAL HEALTH, SPECIFIC TO THE NEEDS OF THIS POPULATION, ARE CRITICAL. EVIDENCE SUGGESTS THAT YOGA IS EFFICACIOUS, SAFE, ACCEPTABLE, AND COST-EFFECTIVE FOR IMPROVING MENTAL HEALTH IN A VARIETY OF POPULATIONS, INCLUDING PREGNANT AND POSTPARTUM WOMEN. TO DATE, THERE ARE NO KNOWN STUDIES EXAMINING ONLINE-STREAMING YOGA AS A STRATEGY TO HELP MOTHERS COPE WITH PTSD SYMPTOMS AFTER STILLBIRTH. METHODS: THE PRESENT STUDY IS A TWO-PHASE RANDOMIZED CONTROLLED TRIAL. PHASE 1 WILL INVOLVE (1) AN ITERATIVE DESIGN PROCESS TO DEVELOP THE ONLINE YOGA PRESCRIPTION FOR PHASE 2 AND (2) QUALITATIVE INTERVIEWS TO IDENTIFY CULTURAL BARRIERS TO RECRUITMENT IN NON-CAUCASIAN WOMEN (I.E., PREDOMINATELY HISPANIC AND/OR AFRICAN AMERICAN) WHO HAVE EXPERIENCED STILLBIRTH (N = 5). PHASE 2 IS A THREE-GROUP RANDOMIZED FEASIBILITY TRIAL WITH ASSESSMENTS AT BASELINE, AND AT 12 AND 20 WEEKS POST-INTERVENTION. NINETY WOMEN WHO HAVE EXPERIENCED A STILLBIRTH WITHIN 6 WEEKS TO 24 MONTHS WILL BE RANDOMIZED INTO ONE OF THE FOLLOWING THREE ARMS FOR 12 WEEKS: (1) INTERVENTION LOW DOSE (LD) = 60 MIN/WEEK ONLINE-STREAMING YOGA (N = 30), (2) INTERVENTION MODERATE DOSE (MD) = 150 MIN/WEEK ONLINE-STREAMING YOGA (N = 30), OR (3) STRETCH AND TONE CONTROL (STC) GROUP = 60 MIN/WEEK OF STRETCHING/TONING EXERCISES (N = 30). DISCUSSION: THIS STUDY WILL EXPLORE THE FEASIBILITY AND ACCEPTABILITY OF A 12-WEEK, HOME-BASED, ONLINE-STREAMED YOGA INTERVENTION, WITH VARYING DOSES AMONG MOTHERS AFTER A STILLBIRTH. IF FEASIBLE, THE FINDINGS FROM THIS STUDY WILL INFORM A FULL-SCALE TRIAL TO DETERMINE THE EFFECTIVENESS OF HOME-BASED ONLINE-STREAMED YOGA TO IMPROVE PTSD. LONG-TERM, HEALTH CARE PROVIDERS COULD USE ONLINE YOGA AS A NON-PHARMACEUTICAL, INEXPENSIVE RESOURCE FOR STILLBIRTH AFTERCARE. TRIAL REGISTRATION: NCT02925481. 2018 13 1206 35 EXPERIENCES OF PREGNANT WOMEN PARTICIPATING IN ANTENATAL YOGA: A QUALITATIVE STUDY. CONTEXT: PREGNANCY YOGA IS A MODIFIED VERSION OF YOGA FOR PREGNANT WOMEN, AND IT AIMS TO REDUCE PREGNANCY-RELATED SYMPTOMS, SUCH AS INSOMNIA, LOW BACK PAIN, TIREDNESS, CONSTIPATION, LEG CRAMPS, AND SHORTNESS OF BREATH. OBJECTIVE: THE STUDY AIMED TO IDENTIFY THE EXPERIENCES AND EXPECTATIONS OF PREGNANT WOMEN RELATED TO THE PRACTICE OF YOGA. METHOD: THE RESEARCH TEAM CONDUCTED A QUALITATIVE STUDY. SETTING: THE STUDY TOOK PLACE AT THE ANTENATAL CLINIC OF A PUBLIC HOSPITAL IN THE CENTRAL ANATOLIA REGION OF TURKEY. PARTICIPANTS: THE PARTICIPANTS WERE 24 PREGNANT WOMEN AT THE CLINIC. INTERVENTION: THE STUDY INCLUDED AN INTERVENTION GROUP THAT PERFORMED YOGA AND RECEIVED ROUTINE ANTENATAL CARE; HOWEVER, NO CONTROL GROUPS WERE USED. EACH YOGA INTERVENTION WAS HELD FOR APPROXIMATELY 40-45 MINUTES, WITH YOGA ASANA PERIODS LASTING 30 MINUTES. THE PREGNANT WOMEN WERE EXPECTED TO PARTICIPATE IN YOGA PRACTICE TWICE A WEEK ON A REGULAR BASIS FOR 8 WEEKS. OUTCOME MEASURES: DATA WERE COLLECTED THROUGH SEMI-STRUCTURED INTERVIEWS. THE INTERVIEWS WERE RECORDED AND TRANSCRIBED VERBATIM AND THEMATIC ANALYSIS WAS PERFORMED. RESULTS: FOUR MAJOR THEMES EMERGED: (1) PERCEPTIONS ABOUT PREGNANCY, (2) MANAGEMENT OF PREGNANCY SYMPTOMS, (3) PRENATAL ATTACHMENT, AND (4) BIRTH PERCEPTIONS. ACCORDING TO PARTICIPANTS, THE BENEFITS OF YOGA PRACTICE WERE MANAGEMENT OF PREGNANCY SYMPTOMS, INCREASED PRENATAL ATTACHMENT, A POSITIVE PERCEPTION OF THE BIRTH, NATURAL-BIRTH BELIEFS, AND MANAGEMENT OF FEAR AND PAIN DURING BIRTH. CONCLUSIONS: THE PARTICIPANTS REPORTED BARRIERS TO PERFORMING YOGA; HOWEVER, THEY ALSO SAID THAT THEY WOULD TRY PREGNANCY YOGA IF THEY WERE ENCOURAGED BY HEALTHCARE PROFESSIONALS. ALSO, THE PARTICIPANTS STATED THAT PREGNANCY YOGA PRACTICE SHOULD BE MADE A PART OF ANTENATAL EDUCATION TO FACILITATE PARTICIPATION. 2021 14 572 22 DEFINITION OF A YOGA BREATHING (PRANAYAMA) PROTOCOL THAT IMPROVES LUNG FUNCTION. THIS STUDY TESTS THE HYPOTHESIS THAT YOGA BREATHING (PRANAYAMA) IMPROVES LUNG FUNCTION IN HEALTHY VOLUNTEERS DURING A 6-WEEK PROTOCOL. A RANDOMIZED CONTROLLED PILOT STUDY DEMONSTRATED AN IMPROVEMENT IN PEAK EXPIRATORY FLOW RATE AND FORCED EXPIRATORY VOLUME. THE EASY-TO-LEARN APPROACH CAN BE TRANSLATED TO THE INPATIENT AND OUTPATIENT SETTINGS. 2019 15 2446 35 YOGA AND TAI CHI: A MIND-BODY APPROACH IN MANAGING RESPIRATORY SYMPTOMS IN OBSTRUCTIVE LUNG DISEASES. PURPOSE OF REVIEW: CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IS CHARACTERIZED BY AIRFLOW LIMITATION BECAUSE OF AIRWAY AND/OR ALVEOLAR ABNORMALITIES. SYMPTOMS INCLUDE DYSPNEA, COUGH, CHRONIC SPUTUM PRODUCTION. AS THE THIRD-RANKED CAUSE OF DEATH AS WELL AS DISABILITY-ADJUSTED LIFE YEARS (DALYS), IT POSES A SIGNIFICANT BURDEN ON PATIENTS, FAMILIES, HEALTHCARE SYSTEM AND SOCIETY. REGULAR PHYSICAL ACTIVITY IS LINKED TO DECREASE IN MORBIDITY AND MORTALITY ASSOCIATED WITH COPD, BUT IMPLEMENTATION REMAINS CHALLENGING. THERE IS A NEED FOR COMMUNITY-BASED INTERVENTIONS THAT PROMOTE PHYSICAL ACTIVITY. YOGA AND TAI CHI ARE WIDELY AVAILABLE IN THE COMMUNITY AND HAVE BEEN SHOWN TO BE BENEFICIAL IN PATIENTS WITH COPD AS WELL AS MANY OF THE CO-MORBID CONDITIONS ASSOCIATED WITH COPD. RECENT FINDINGS: YOGA AND TAI CHI HAVE BEEN FOUND TO BE MORE EFFECTIVE THAN USUAL CARE IN COPD WITH CLINICALLY MEANINGFUL IMPROVEMENTS IN 6-MIN WALK DISTANCE (6MWD), FORCED EXPIRATORY VOLUME IN 1 S (FEV1), AND HEALTH-RELATED QUALITY OF LIFE (HRQOL). THEY HAVE ALSO BEEN FOUND TO BE COMPARABLE TO PULMONARY REHABILITATION INTERVENTIONS. SUMMARY: YOGA AND TAI CHI PROVIDE COMMUNITY-BASED OPTIONS FOR PATIENTS WITH COPD TO IMPROVE THEIR PHYSICAL ACTIVITY, QUALITY OF LIFE, AND PULMONARY FUNCTION. 2020 16 1331 37 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 17 2596 34 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 18 199 32 A RESEARCH PROTOCOL FOR A PILOT, RANDOMIZED CONTROLLED TRIAL DESIGNED TO EXAMINE THE FEASIBILITY OF A DYADIC VERSUS INDIVIDUAL YOGA PROGRAM FOR FAMILY CAREGIVERS OF GLIOMA PATIENTS UNDERGOING RADIOTHERAPY. BACKGROUND: ALTHOUGH THE DIAGNOSIS AND TREATMENT OF A PRIMARY BRAIN TUMOR PRESENT UNIQUE CHALLENGES TO PATIENTS AND THEIR FAMILY CAREGIVERS, EVIDENCE-BASED SUPPORTIVE CARE INTERVENTIONS ARE GENERALLY LACKING. THE PRIMARY AIM OF THIS RESEARCH PROTOCOL IS TO DETERMINE THE FEASIBILITY OF IMPLEMENTING A DYADIC YOGA (DY) VERSUS A CAREGIVER YOGA (CY) INTERVENTION OR A WAIT-LIST CONTROL (WLC) GROUP USING A RANDOMIZED CONTROLLED TRIAL DESIGN. METHODS: SEVENTY-FIVE GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR FAMILY CAREGIVERS ARE RANDOMIZED TO THE DY, CY, OR A WLC GROUP. PATIENT-CAREGIVER DYADS IN THE DY GROUP AND CAREGIVERS IN THE CY GROUP RECEIVE 15 SESSIONS (45 MIN EACH) OVER THE COURSE OF PATIENTS' STANDARD RADIOTHERAPY (6 WEEKS). PATIENTS AND CAREGIVERS IN ALL GROUPS COMPLETE BASELINE ASSESSMENTS OF SYMPTOMS, QUALITY OF LIFE (QOL), AND HEALTH UTILIZATION OUTCOMES PRIOR TO RANDOMIZATION. FOLLOW-UP ASSESSMENTS ARE PERFORMED 6 WEEKS AND THEN AGAIN 3 MONTHS LATER. THE PRIMARY OUTCOME IS FEASIBILITY (I.E., >/= 50% OF ELIGIBLE DYADS CONSENT, >/= 70% OF ENROLLED DYADS COMPLETE ALL ASSESSMENTS, AND >/= 50% OF ALL PRACTICE SESSIONS ARE ATTENDED). WE WILL ALSO PERFORM PRIMARILY DESCRIPTIVE ANALYSES OF THE SELF-REPORTED OUTCOMES (E.G., FATIGUE, OVERALL QOL) AND EXPLORE POTENTIAL INTERVENTION MODERATORS (E.G., PERFORMANCE STATUS) TO INFORM A LARGER FUTURE TRIAL. CONCLUSION: THIS TRIAL WILL PROVIDE IMPORTANT INFORMATION REGARDING THE FEASIBILITY OF A DYADIC VERSUS A CAREGIVER YOGA INTERVENTION REGARDING SYMPTOM, QOL, AND HEALTH UTILIZATION OUTCOMES IN GLIOMA PATIENTS AND THEIR CAREGIVERS. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT02481349. 2019 19 2543 57 YOGA FOR ASTHMA. BACKGROUND: ASTHMA IS A COMMON CHRONIC INFLAMMATORY DISORDER AFFECTING ABOUT 300 MILLION PEOPLE WORLDWIDE. AS A HOLISTIC THERAPY, YOGA HAS THE POTENTIAL TO RELIEVE BOTH THE PHYSICAL AND PSYCHOLOGICAL SUFFERING OF PEOPLE WITH ASTHMA, AND ITS POPULARITY HAS EXPANDED GLOBALLY. A NUMBER OF CLINICAL TRIALS HAVE BEEN CARRIED OUT TO EVALUATE THE EFFECTS OF YOGA PRACTICE, WITH INCONSISTENT RESULTS. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA IN PEOPLE WITH ASTHMA. SEARCH METHODS: WE SYSTEMATICALLY SEARCHED THE COCHRANE AIRWAYS GROUP REGISTER OF TRIALS, WHICH IS DERIVED FROM SYSTEMATIC SEARCHES OF BIBLIOGRAPHIC DATABASES INCLUDING THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, AND PSYCINFO, AND HANDSEARCHING OF RESPIRATORY JOURNALS AND MEETING ABSTRACTS. WE ALSO SEARCHED PEDRO. WE SEARCHED CLINICALTRIALS.GOV AND THE WHO ICTRP SEARCH PORTAL. WE SEARCHED ALL DATABASES FROM THEIR INCEPTION TO 22 JULY 2015, AND USED NO RESTRICTION ON LANGUAGE OF PUBLICATION. WE CHECKED THE REFERENCE LISTS OF ELIGIBLE STUDIES AND RELEVANT REVIEW ARTICLES FOR ADDITIONAL STUDIES. WE ATTEMPTED TO CONTACT INVESTIGATORS OF ELIGIBLE STUDIES AND EXPERTS IN THE FIELD TO LEARN OF OTHER PUBLISHED AND UNPUBLISHED STUDIES. SELECTION CRITERIA: WE INCLUDED RANDOMISED CONTROLLED TRIALS (RCTS) THAT COMPARED YOGA WITH USUAL CARE (OR NO INTERVENTION) OR SHAM INTERVENTION IN PEOPLE WITH ASTHMA AND REPORTED AT LEAST ONE OF THE FOLLOWING OUTCOMES: QUALITY OF LIFE, ASTHMA SYMPTOM SCORE, ASTHMA CONTROL, LUNG FUNCTION MEASURES, ASTHMA MEDICATION USAGE, AND ADVERSE EVENTS. DATA COLLECTION AND ANALYSIS: WE EXTRACTED BIBLIOGRAPHIC INFORMATION, CHARACTERISTICS OF PARTICIPANTS, CHARACTERISTICS OF INTERVENTIONS AND CONTROLS, CHARACTERISTICS OF METHODOLOGY, AND RESULTS FOR THE OUTCOMES OF OUR INTEREST FROM ELIGIBLE STUDIES. FOR CONTINUOUS OUTCOMES, WE USED MEAN DIFFERENCE (MD) WITH 95% CONFIDENCE INTERVAL (CI) TO DENOTE THE TREATMENT EFFECTS, IF THE OUTCOMES WERE MEASURED BY THE SAME SCALE ACROSS STUDIES. ALTERNATIVELY, IF THE OUTCOMES WERE MEASURED BY DIFFERENT SCALES ACROSS STUDIES, WE USED STANDARDISED MEAN DIFFERENCE (SMD) WITH 95% CI. FOR DICHOTOMOUS OUTCOMES, WE USED RISK RATIO (RR) WITH 95% CI TO MEASURE THE TREATMENT EFFECTS. WE PERFORMED META-ANALYSIS WITH REVIEW MANAGER 5.3. WE USED THE FIXED-EFFECT MODEL TO POOL THE DATA, UNLESS THERE WAS SUBSTANTIAL HETEROGENEITY AMONG STUDIES, IN WHICH CASE WE USED THE RANDOM-EFFECTS MODEL INSTEAD. FOR OUTCOMES INAPPROPRIATE OR IMPOSSIBLE TO POOL QUANTITATIVELY, WE CONDUCTED A DESCRIPTIVE ANALYSIS AND SUMMARISED THE FINDINGS NARRATIVELY. MAIN RESULTS: WE INCLUDED 15 RCTS WITH A TOTAL OF 1048 PARTICIPANTS. MOST OF THE TRIALS WERE CONDUCTED IN INDIA, FOLLOWED BY EUROPE AND THE UNITED STATES. THE MAJORITY OF PARTICIPANTS WERE ADULTS OF BOTH SEXES WITH MILD TO MODERATE ASTHMA FOR SIX MONTHS TO MORE THAN 23 YEARS. FIVE STUDIES INCLUDED YOGA BREATHING ALONE, WHILE THE OTHER STUDIES ASSESSED YOGA INTERVENTIONS THAT INCLUDED BREATHING, POSTURE, AND MEDITATION. INTERVENTIONS LASTED FROM TWO WEEKS TO 54 MONTHS, FOR NO MORE THAN SIX MONTHS IN THE MAJORITY OF STUDIES. THE RISK OF BIAS WAS LOW ACROSS ALL DOMAINS IN ONE STUDY AND UNCLEAR OR HIGH IN AT LEAST ONE DOMAIN FOR THE REMAINDER.THERE WAS SOME EVIDENCE THAT YOGA MAY IMPROVE QUALITY OF LIFE (MD IN ASTHMA QUALITY OF LIFE QUESTIONNAIRE (AQLQ) SCORE PER ITEM 0.57 UNITS ON A 7-POINT SCALE, 95% CI 0.37 TO 0.77; 5 STUDIES; 375 PARTICIPANTS), IMPROVE SYMPTOMS (SMD 0.37, 95% CI 0.09 TO 0.65; 3 STUDIES; 243 PARTICIPANTS), AND REDUCE MEDICATION USAGE (RR 5.35, 95% CI 1.29 TO 22.11; 2 STUDIES) IN PEOPLE WITH ASTHMA. THE MD FOR AQLQ SCORE EXCEEDED THE MINIMAL CLINICALLY IMPORTANT DIFFERENCE (MCID) OF 0.5, BUT WHETHER THE MEAN CHANGES EXCEEDED THE MCID FOR ASTHMA SYMPTOMS IS UNCERTAIN DUE TO THE LACK OF AN ESTABLISHED MCID IN THE SEVERITY SCORES USED IN THE INCLUDED STUDIES. THE EFFECTS OF YOGA ON CHANGE FROM BASELINE FORCED EXPIRATORY VOLUME IN ONE SECOND (MD 0.04 LITRES, 95% CI -0.10 TO 0.19; 7 STUDIES; 340 PARTICIPANTS; I(2) = 68%) WERE NOT STATISTICALLY SIGNIFICANT. TWO STUDIES INDICATED IMPROVED ASTHMA CONTROL, BUT DUE TO VERY SIGNIFICANT HETEROGENEITY (I(2) = 98%) WE DID NOT POOL DATA. NO SERIOUS ADVERSE EVENTS ASSOCIATED WITH YOGA WERE REPORTED, BUT THE DATA ON THIS OUTCOME WAS LIMITED. AUTHORS' CONCLUSIONS: WE FOUND MODERATE-QUALITY EVIDENCE THAT YOGA PROBABLY LEADS TO SMALL IMPROVEMENTS IN QUALITY OF LIFE AND SYMPTOMS IN PEOPLE WITH ASTHMA. THERE IS MORE UNCERTAINTY ABOUT POTENTIAL ADVERSE EFFECTS OF YOGA AND ITS IMPACT ON LUNG FUNCTION AND MEDICATION USAGE. RCTS WITH A LARGE SAMPLE SIZE AND HIGH METHODOLOGICAL AND REPORTING QUALITY ARE NEEDED TO CONFIRM THE EFFECTS OF YOGA FOR ASTHMA. 2016 20 2824 41 YOGA VERSUS EDUCATION FOR VETERANS WITH CHRONIC LOW BACK PAIN: STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN IS THE MOST FREQUENT PAIN CONDITION IN VETERANS AND CAUSES SUBSTANTIAL SUFFERING, DECREASED FUNCTIONAL CAPACITY, AND LOWER QUALITY OF LIFE. SYMPTOMS OF POST-TRAUMATIC STRESS, DEPRESSION, AND MILD TRAUMATIC BRAIN INJURY ARE HIGHLY PREVALENT IN VETERANS WITH BACK PAIN. YOGA FOR LOW BACK PAIN HAS BEEN DEMONSTRATED TO BE EFFECTIVE FOR CIVILIANS IN RANDOMIZED CONTROLLED TRIALS. HOWEVER, IT IS UNKNOWN IF RESULTS FROM PREVIOUSLY PUBLISHED TRIALS GENERALIZE TO MILITARY POPULATIONS. METHODS/DESIGN: THIS STUDY IS A PARALLEL RANDOMIZED CONTROLLED TRIAL COMPARING YOGA TO EDUCATION FOR 120 VETERANS WITH CHRONIC LOW BACK PAIN. PARTICIPANTS ARE VETERANS >/=18 YEARS OLD WITH LOW BACK PAIN PRESENT ON AT LEAST HALF THE DAYS IN THE PAST SIX MONTHS AND A SELF-REPORTED AVERAGE PAIN INTENSITY IN THE PREVIOUS WEEK OF >/=4 ON A 0-10 SCALE. THE 24-WEEK STUDY HAS AN INITIAL 12-WEEK INTERVENTION PERIOD, WHERE PARTICIPANTS ARE RANDOMIZED EQUALLY INTO (1) A STANDARDIZED WEEKLY GROUP YOGA CLASS WITH HOME PRACTICE OR (2) EDUCATION DELIVERED WITH A SELF-CARE BOOK. PRIMARY OUTCOME MEASURES ARE CHANGE AT 12 WEEKS IN LOW BACK PAIN INTENSITY MEASURED BY THE DEFENSE AND VETERANS PAIN RATING SCALE (0-10) AND BACK-RELATED FUNCTION USING THE 23-POINT ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 12-WEEK FOLLOW-UP PERIOD, YOGA PARTICIPANTS ARE ENCOURAGED TO CONTINUE HOME YOGA PRACTICE AND EDUCATION PARTICIPANTS CONTINUE FOLLOWING RECOMMENDATIONS FROM THE BOOK. QUALITATIVE INTERVIEWS WITH VETERANS IN THE YOGA GROUP AND THEIR PARTNERS EXPLORE THE IMPACT OF CHRONIC LOW BACK PAIN AND YOGA ON FAMILY RELATIONSHIPS. WE ALSO ASSESS COST-EFFECTIVENESS FROM THREE PERSPECTIVES: THE VETERAN, THE VETERANS HEALTH ADMINISTRATION, AND SOCIETY USING ELECTRONIC MEDICAL RECORDS, SELF-REPORTED COST DATA, AND STUDY RECORDS. DISCUSSION: THIS STUDY WILL HELP DETERMINE IF YOGA CAN BECOME AN EFFECTIVE TREATMENT FOR VETERANS WITH CHRONIC LOW BACK PAIN AND PSYCHOLOGICAL COMORBIDITIES. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT02224183. 2016