1 2852 177 YOGA, PHYSICAL THERAPY, OR EDUCATION FOR CHRONIC LOW BACK PAIN: A RANDOMIZED NONINFERIORITY TRIAL. BACKGROUND: YOGA IS EFFECTIVE FOR MILD TO MODERATE CHRONIC LOW BACK PAIN (CLBP), BUT ITS COMPARATIVE EFFECTIVENESS WITH PHYSICAL THERAPY (PT) IS UNKNOWN. MOREOVER, LITTLE IS KNOWN ABOUT YOGA'S EFFECTIVENESS IN UNDERSERVED PATIENTS WITH MORE SEVERE FUNCTIONAL DISABILITY AND PAIN. OBJECTIVE: TO DETERMINE WHETHER YOGA IS NONINFERIOR TO PT FOR CLBP. DESIGN: 12-WEEK, SINGLE-BLIND, 3-GROUP RANDOMIZED NONINFERIORITY TRIAL AND SUBSEQUENT 40-WEEK MAINTENANCE PHASE. (CLINICALTRIALS.GOV: NCT01343927). SETTING: ACADEMIC SAFETY-NET HOSPITAL AND 7 AFFILIATED COMMUNITY HEALTH CENTERS. PARTICIPANTS: 320 PREDOMINANTLY LOW-INCOME, RACIALLY DIVERSE ADULTS WITH NONSPECIFIC CLBP. INTERVENTION: PARTICIPANTS RECEIVED 12 WEEKLY YOGA CLASSES, 15 PT VISITS, OR AN EDUCATIONAL BOOK AND NEWSLETTERS. THE MAINTENANCE PHASE COMPARED YOGA DROP-IN CLASSES VERSUS HOME PRACTICE AND PT BOOSTER SESSIONS VERSUS HOME PRACTICE. MEASUREMENTS: PRIMARY OUTCOMES WERE BACK-RELATED FUNCTION, MEASURED BY THE ROLAND MORRIS DISABILITY QUESTIONNAIRE (RMDQ), AND PAIN, MEASURED BY AN 11-POINT SCALE, AT 12 WEEKS. PRESPECIFIED NONINFERIORITY MARGINS WERE 1.5 (RMDQ) AND 1.0 (PAIN). SECONDARY OUTCOMES INCLUDED PAIN MEDICATION USE, GLOBAL IMPROVEMENT, SATISFACTION WITH INTERVENTION, AND HEALTH-RELATED QUALITY OF LIFE. RESULTS: ONE-SIDED 95% LOWER CONFIDENCE LIMITS WERE 0.83 (RMDQ) AND 0.97 (PAIN), DEMONSTRATING NONINFERIORITY OF YOGA TO PT. HOWEVER, YOGA WAS NOT SUPERIOR TO EDUCATION FOR EITHER OUTCOME. YOGA AND PT WERE SIMILAR FOR MOST SECONDARY OUTCOMES. YOGA AND PT PARTICIPANTS WERE 21 AND 22 PERCENTAGE POINTS LESS LIKELY, RESPECTIVELY, THAN EDUCATION PARTICIPANTS TO USE PAIN MEDICATION AT 12 WEEKS. IMPROVEMENTS IN YOGA AND PT GROUPS WERE MAINTAINED AT 1 YEAR WITH NO DIFFERENCES BETWEEN MAINTENANCE STRATEGIES. FREQUENCY OF ADVERSE EVENTS, MOSTLY MILD SELF-LIMITED JOINT AND BACK PAIN, DID NOT DIFFER BETWEEN THE YOGA AND PT GROUPS. LIMITATIONS: PARTICIPANTS WERE NOT BLINDED TO TREATMENT ASSIGNMENT. THE PT GROUP HAD DISPROPORTIONATE LOSS TO FOLLOW-UP. CONCLUSION: A MANUALIZED YOGA PROGRAM FOR NONSPECIFIC CLBP WAS NONINFERIOR TO PT FOR FUNCTION AND PAIN. PRIMARY FUNDING SOURCE: NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH OF THE NATIONAL INSTITUTES OF HEALTH.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
2  521  69 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
3  518  65 COMPARING ONCE- VERSUS TWICE-WEEKLY YOGA CLASSES FOR CHRONIC LOW BACK PAIN IN PREDOMINANTLY LOW INCOME MINORITIES: A RANDOMIZED DOSING TRIAL. BACKGROUND. PREVIOUS STUDIES HAVE DEMONSTRATED THAT ONCE-WEEKLY YOGA CLASSES ARE EFFECTIVE FOR CHRONIC LOW BACK PAIN (CLBP) IN WHITE ADULTS WITH HIGH SOCIOECONOMIC STATUS. THE COMPARATIVE EFFECTIVENESS OF TWICE-WEEKLY CLASSES AND GENERALIZABILITY TO RACIALLY DIVERSE LOW INCOME POPULATIONS ARE UNKNOWN. METHODS. WE CONDUCTED A 12-WEEK RANDOMIZED, PARALLEL-GROUP, DOSING TRIAL FOR 95 ADULTS RECRUITED FROM AN URBAN SAFETY-NET HOSPITAL AND FIVE COMMUNITY HEALTH CENTERS COMPARING ONCE-WEEKLY (N = 49) VERSUS TWICE-WEEKLY (N = 46) STANDARDIZED YOGA CLASSES SUPPLEMENTED BY HOME PRACTICE. PRIMARY OUTCOMES WERE CHANGE FROM BASELINE TO 12 WEEKS IN PAIN (11-POINT SCALE) AND BACK-RELATED FUNCTION (23-POINT MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE). RESULTS. 82% OF PARTICIPANTS WERE NONWHITE; 77% HAD ANNUAL HOUSEHOLD INCOMES <$40,000. THE SAMPLE'S BASELINE MEAN PAIN INTENSITY [6.9 (SD 1.6)] AND FUNCTION [13.7 (SD 5.0)] REFLECTED MODERATE TO SEVERE BACK PAIN AND IMPAIRMENT. PAIN AND BACK-RELATED FUNCTION IMPROVED WITHIN BOTH GROUPS (P < 0.001). HOWEVER, THERE WERE NO DIFFERENCES BETWEEN ONCE-WEEKLY AND TWICE-WEEKLY GROUPS FOR PAIN REDUCTION [-2.1 (95% CI -2.9, -1.3) VERSUS -2.4 (95% CI -3.1, -1.8), P = 0.62] OR BACK-RELATED FUNCTION [-5.1 (95% CI -7.0, -3.2) VERSUS -4.9 (95% CI -6.5, -3.3), P = 0.83]. CONCLUSIONS. TWELVE WEEKS OF ONCE-WEEKLY OR TWICE-WEEKLY YOGA CLASSES WERE SIMILARLY EFFECTIVE FOR PREDOMINANTLY LOW INCOME MINORITY ADULTS WITH MODERATE TO SEVERE CHRONIC LOW BACK PAIN. THIS TRIAL IS REGISTERED WITH CLINICALTRIALS.GOV NCT01761617.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
4 1140  61 EFFICACY OF YOGA VS COGNITIVE BEHAVIORAL THERAPY VS STRESS EDUCATION FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER: A RANDOMIZED CLINICAL TRIAL. IMPORTANCE: GENERALIZED ANXIETY DISORDER (GAD) IS COMMON, IMPAIRING, AND UNDERTREATED. ALTHOUGH MANY PATIENTS WITH GAD SEEK COMPLEMENTARY AND ALTERNATIVE INTERVENTIONS, INCLUDING YOGA, DATA SUPPORTING YOGA'S EFFICACY OR HOW IT COMPARES TO FIRST-LINE TREATMENTS ARE LACKING. OBJECTIVES: TO ASSESS WHETHER YOGA (KUNDALINI YOGA) AND COGNITIVE BEHAVIORAL THERAPY (CBT) FOR GAD ARE EACH MORE EFFECTIVE THAN A CONTROL CONDITION (STRESS EDUCATION) AND WHETHER YOGA IS NONINFERIOR TO CBT FOR THE TREATMENT OF GAD. DESIGN, SETTING, AND PARTICIPANTS: FOR THIS RANDOMIZED, 3-ARM, CONTROLLED, SINGLE-BLIND (MASKED INDEPENDENT RATERS) CLINICAL TRIAL, PARTICIPANTS WERE RECRUITED FROM 2 SPECIALTY ACADEMIC CENTERS STARTING DECEMBER 1, 2013, WITH ASSESSMENT ENDING OCTOBER 25, 2019. PRIMARY ANALYSES, COMPLETED BY FEBRUARY 12, 2020, INCLUDED SUPERIORITY TESTING OF KUNDALINI YOGA AND CBT VS STRESS EDUCATION AND NONINFERIORITY TESTING OF KUNDALINI YOGA VS CBT. INTERVENTIONS: PARTICIPANTS WERE RANDOMIZED TO KUNDALINI YOGA (N = 93), CBT FOR GAD (N = 90), OR STRESS EDUCATION (N = 43), WHICH WERE EACH DELIVERED TO GROUPS OF 4 TO 6 PARTICIPANTS BY 2 INSTRUCTORS DURING TWELVE 120-MINUTE SESSIONS WITH 20 MINUTES OF DAILY HOMEWORK. MAIN OUTCOMES AND MEASURES: THE PRIMARY INTENTION-TO-TREAT OUTCOME WAS ACUTE GAD RESPONSE (CLINICAL GLOBAL IMPRESSION-IMPROVEMENT SCALE SCORE OF MUCH OR VERY MUCH IMPROVED) AFTER 12 WEEKS AS ASSESSED BY TRAINED INDEPENDENT RATERS. RESULTS: OF 538 PARTICIPANTS WHO PROVIDED CONSENT AND WERE EVALUATED, 226 (MEAN [SD] AGE, 33.4 [13.5] YEARS; 158 [69.9%] FEMALE) WITH A PRIMARY DIAGNOSIS OF GAD WERE INCLUDED IN THE TRIAL. A TOTAL OF 155 PARTICIPANTS (68.6%) COMPLETED THE POSTTREATMENT ASSESSMENT. COMPLETION RATES DID NOT DIFFER (KUNDALINI YOGA, 60 [64.5%]; CBT, 67 [74.4%]; AND STRESS EDUCATION, 28 [65.1%]: CHI2 = 2.39, DF = 2, P = .30). RESPONSE RATES WERE HIGHER IN THE KUNDALINI YOGA GROUP (54.2%) THAN IN THE STRESS EDUCATION GROUP (33.%) (ODDS RATIO [OR], 2.46 [95% CI, 1.12-5.42]; P = .03; NUMBER NEEDED TO TREAT, 4.59 [95% CI, 2.52-46.19]) AND IN THE CBT GROUP (70.8%) COMPARED WITH THE STRESS EDUCATION GROUP (33.0%) (OR, 5.00 [95% CI, 2.12-11.82]; P < .001; NUMBER NEEDED TO TREAT, 2.62 [95% CI, 1.91-5.68]). HOWEVER, THE NONINFERIORITY TEST DID NOT FIND KUNDALINI YOGA TO BE AS EFFECTIVE AS CBT (DIFFERENCE, 16.6%; P = .42 FOR NONINFERIORITY). CONCLUSIONS AND RELEVANCE: IN THIS TRIAL, KUNDALINI YOGA WAS EFFICACIOUS FOR GAD, BUT THE RESULTS SUPPORT CBT REMAINING FIRST-LINE TREATMENT. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT01912287.	2021	
                                                                                                        
5  193  56 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
6   34  46 A 12-WEEK IYENGAR YOGA PROGRAM IMPROVED BALANCE AND MOBILITY IN OLDER COMMUNITY-DWELLING PEOPLE: A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: EXERCISE THAT CHALLENGES BALANCE CAN IMPROVE MOBILITY AND PREVENT FALLS IN OLDER ADULTS. YOGA AS A PHYSICAL ACTIVITY OPTION FOR OLDER ADULTS IS NOT WELL STUDIED. THIS TRIAL EVALUATED THE FEASIBILITY AND EFFECT OF A 12-WEEK IYENGAR YOGA PROGRAM ON BALANCE AND MOBILITY IN OLDER PEOPLE. METHODS: WE CONDUCTED A BLINDED, PILOT RANDOMIZED CONTROLLED TRIAL WITH INTENTION-TO-TREAT ANALYSIS. PARTICIPANTS WERE 54 COMMUNITY DWELLERS (MEAN AGE 68 YEARS, SD 7.1) NOT CURRENTLY PARTICIPATING IN YOGA OR TAI CHI. THE INTERVENTION GROUP (N = 27) PARTICIPATED IN A 12-WEEK, TWICE-WEEKLY YOGA PROGRAM FOCUSED ON STANDING POSTURES AND RECEIVED A FALL PREVENTION EDUCATION BOOKLET. THE CONTROL GROUP (N = 27) RECEIVED THE EDUCATION BOOKLET ONLY. PRIMARY OUTCOME WAS STANDING BALANCE COMPONENT OF THE SHORT PHYSICAL PERFORMANCE BATTERY WITH ADDITION OF ONE-LEGGED STANCE TIME (STANDING BALANCE). SECONDARY OUTCOMES WERE THE TIMED SIT-TO-STAND TEST, TIMED 4-M WALK, ONE-LEGGED STAND WITH EYES CLOSED, AND SHORT FALLS EFFICACY SCALE-INTERNATIONAL. FEASIBILITY WAS MEASURED BY RECORDING CLASS ATTENDANCE AND ADVERSE EVENTS. RESULTS: FIFTY-TWO PARTICIPANTS COMPLETED FOLLOW-UP ASSESSMENTS. THE INTERVENTION GROUP SIGNIFICANTLY IMPROVED COMPARED WITH CONTROL GROUP ON STANDING BALANCE (MEAN DIFFERENCE = 1.52 SECONDS, 95% CI 0.10-2.96, P = .04), SIT-TO-STAND TEST (MEAN DIFFERENCE = -3.43 SECONDS, 95% CI -5.23 TO -1.64, P < .001), 4-M WALK (MEAN DIFFERENCE = -0.50 SECONDS, 95% CI -0.72 TO -0.28, P < .001), AND ONE-LEGGED STAND WITH EYES CLOSED (MEAN DIFFERENCE = 1.93 SECONDS, 95% CI 0.40-3.46, P = .02). AVERAGE CLASS ATTENDANCE WAS 20 OF 24 CLASSES (83%). NO SERIOUS ADVERSE EVENTS OCCURRED. CONCLUSIONS: THIS TRIAL DEMONSTRATES THE BALANCE AND MOBILITY-RELATED BENEFITS AND FEASIBILITY OF IYENGAR YOGA FOR OLDER PEOPLE. THE FALL PREVENTION EFFECT OF IYENGAR YOGA WARRANTS FURTHER INVESTIGATION.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
7 2560  70 YOGA FOR CHRONIC LOW BACK PAIN: A RANDOMIZED TRIAL. BACKGROUND: PREVIOUS STUDIES INDICATE THAT YOGA MAY BE AN EFFECTIVE TREATMENT FOR CHRONIC OR RECURRENT LOW BACK PAIN. OBJECTIVE: TO COMPARE THE EFFECTIVENESS OF YOGA AND USUAL CARE FOR CHRONIC OR RECURRENT LOW BACK PAIN. DESIGN: PARALLEL-GROUP, RANDOMIZED, CONTROLLED TRIAL USING COMPUTER-GENERATED RANDOMIZATION CONDUCTED FROM APRIL 2007 TO MARCH 2010. OUTCOMES WERE ASSESSED BY POSTAL QUESTIONNAIRE. (INTERNATIONAL STANDARD RANDOMISED CONTROLLED TRIAL NUMBER REGISTER: ISRCTN 81079604) SETTING: 13 NON-NATIONAL HEALTH SERVICE PREMISES IN THE UNITED KINGDOM. PATIENTS: 313 ADULTS WITH CHRONIC OR RECURRENT LOW BACK PAIN. INTERVENTION: YOGA (N = 156) OR USUAL CARE (N = 157). ALL PARTICIPANTS RECEIVED A BACK PAIN EDUCATION BOOKLET. THE INTERVENTION GROUP WAS OFFERED A 12-CLASS, GRADUALLY PROGRESSING YOGA PROGRAM DELIVERED BY 12 TEACHERS OVER 3 MONTHS. MEASUREMENTS: SCORES ON THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE (RMDQ) AT 3 (PRIMARY OUTCOME), 6, AND 12 (SECONDARY OUTCOMES) MONTHS; PAIN, PAIN SELF-EFFICACY, AND GENERAL HEALTH MEASURES AT 3, 6, AND 12 MONTHS (SECONDARY OUTCOMES). RESULTS: 93 (60%) PATIENTS OFFERED YOGA ATTENDED AT LEAST 3 OF THE FIRST 6 SESSIONS AND AT LEAST 3 OTHER SESSIONS. THE YOGA GROUP HAD BETTER BACK FUNCTION AT 3, 6, AND 12 MONTHS THAN THE USUAL CARE GROUP. THE ADJUSTED MEAN RMDQ SCORE WAS 2.17 POINTS (95% CI, 1.03 TO 3.31 POINTS) LOWER IN THE YOGA GROUP AT 3 MONTHS, 1.48 POINTS (CI, 0.33 TO 2.62 POINTS) LOWER AT 6 MONTHS, AND 1.57 POINTS (CI, 0.42 TO 2.71 POINTS) LOWER AT 12 MONTHS. THE YOGA AND USUAL CARE GROUPS HAD SIMILAR BACK PAIN AND GENERAL HEALTH SCORES AT 3, 6, AND 12 MONTHS, AND THE YOGA GROUP HAD HIGHER PAIN SELF-EFFICACY SCORES AT 3 AND 6 MONTHS BUT NOT AT 12 MONTHS. TWO OF THE 157 USUAL CARE PARTICIPANTS AND 12 OF THE 156 YOGA PARTICIPANTS REPORTED ADVERSE EVENTS, MOSTLY INCREASED PAIN. LIMITATION: THERE WERE MISSING DATA FOR THE PRIMARY OUTCOME (YOGA GROUP, N = 21; USUAL CARE GROUP, N = 18) AND DIFFERENTIAL MISSING DATA (MORE IN THE YOGA GROUP) FOR SECONDARY OUTCOMES. CONCLUSION: OFFERING A 12-WEEK YOGA PROGRAM TO ADULTS WITH CHRONIC OR RECURRENT LOW BACK PAIN LED TO GREATER IMPROVEMENTS IN BACK FUNCTION THAN DID USUAL CARE. PRIMARY FUNDING SOURCE: ARTHRITIS RESEARCH UK.	2011	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
8 1113  57 EFFICACY OF A BIOMECHANICALLY-BASED YOGA EXERCISE PROGRAM IN KNEE OSTEOARTHRITIS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: CERTAIN EXERCISES COULD OVERLOAD THE OSTEOARTHRITIC KNEE. WE DEVELOPED AN EXERCISE PROGRAM FROM YOGA POSTURES WITH A MINIMAL KNEE ADDUCTION MOMENT FOR KNEE OSTEOARTHRITIS. THE PURPOSE WAS TO COMPARE THE EFFECTIVENESS OF THIS BIOMECHANICALLY-BASED YOGA EXERCISE (YE), WITH TRADITIONAL EXERCISE (TE), AND A NO-EXERCISE ATTENTION-EQUIVALENT CONTROL (NE) FOR IMPROVING PAIN, SELF-REPORTED PHYSICAL FUNCTION AND MOBILITY PERFORMANCE IN WOMEN WITH KNEE OSTEOARTHRITIS. DESIGN: SINGLE-BLIND, THREE-ARM RANDOMIZED CONTROLLED TRIAL. SETTING: COMMUNITY IN SOUTHWESTERN ONTARIO, CANADA. PARTICIPANTS: A CONVENIENCE SAMPLE OF 31 WOMEN WITH SYMPTOMATIC KNEE OSTEOARTHRITIS WAS RECRUITED THROUGH RHEUMATOLOGY, ORTHOPAEDIC AND PHYSIOTHERAPY CLINICS, NEWSPAPERS AND WORD-OF-MOUTH. INTERVENTIONS: PARTICIPANTS WERE STRATIFIED BY DISEASE SEVERITY AND RANDOMLY ALLOCATED TO ONE OF THREE 12-WEEK, SUPERVISED INTERVENTIONS. YE INCLUDED BIOMECHANICALLY-BASED YOGA EXERCISES; TE INCLUDED TRADITIONAL LEG STRENGTHENING ON MACHINES; AND NE INCLUDED MEDITATION WITH NO EXERCISE. PARTICIPANTS WERE ASKED TO ATTEND THREE 1-HOUR GROUP CLASSES/SESSIONS EACH WEEK. MEASUREMENTS: PRIMARY OUTCOMES WERE PAIN, SELF-REPORTED PHYSICAL FUNCTION AND MOBILITY PERFORMANCE. SECONDARY OUTCOMES WERE KNEE STRENGTH, DEPRESSION, AND HEALTH-RELATED QUALITY OF LIFE. ALL WERE ASSESSED BY A BLINDED ASSESSOR AT BASELINE AND IMMEDIATELY FOLLOWING THE INTERVENTION. RESULTS: THE YE GROUP DEMONSTRATED GREATER IMPROVEMENTS IN KOOS PAIN (MEAN DIFFERENCE OF 22.9 [95% CI, 6.9 TO 38.8; P = 0.003]), INTERMITTENT PAIN (MEAN DIFFERENCE OF -19.6 [95% CI, -34.8 TO -4.4; P = 0.009]) AND SELF-REPORTED PHYSICAL FUNCTION (MEAN DIFFERENCE OF 17.2 [95% CI, 5.2 TO 29.2; P = 0.003]) COMPARED TO NE. IMPROVEMENTS IN THESE OUTCOMES WERE SIMILAR BETWEEN YE AND TE. HOWEVER, TE DEMONSTRATED A GREATER IMPROVEMENT IN KNEE FLEXOR STRENGTH COMPARED TO YE (MEAN DIFFERENCE OF 0.1 [95% CI, 0.1 TO 0.2]. IMPROVEMENTS FROM BASELINE TO FOLLOW-UP WERE PRESENT IN QUALITY OF LIFE SCORE FOR YE AND KNEE FLEXOR STRENGTH FOR TE, WHILE BOTH ALSO DEMONSTRATED IMPROVEMENTS IN MOBILITY. NO IMPROVEMENT IN ANY OUTCOME WAS PRESENT IN NE. CONCLUSIONS: THE BIOMECHANICALLY-BASED YOGA EXERCISE PROGRAM PRODUCED CLINICALLY MEANINGFUL IMPROVEMENTS IN PAIN, SELF-REPORTED PHYSICAL FUNCTION AND MOBILITY IN WOMEN WITH CLINICAL KNEE OA COMPARED TO NO EXERCISE. WHILE NOT STATISTICALLY SIGNIFICANT, IMPROVEMENTS IN THESE OUTCOMES WERE LARGER THAN THOSE ELICITED FROM THE TRADITIONAL EXERCISE-BASED PROGRAM. THOUGH THIS MAY SUGGEST THAT THE YOGA PROGRAM MAY BE MORE EFFICACIOUS FOR KNEE OA, FUTURE RESEARCH STUDYING A LARGER SAMPLE IS REQUIRED. TRIAL REGISTRATION: CLINICALTRIALS.GOV (NCT02370667).	2018	

9  161  34 A RANDOMISED CONTROLLED TRIAL OF ADJUNCTIVE YOGA AND ADJUNCTIVE PHYSICAL EXERCISE TRAINING FOR COGNITIVE DYSFUNCTION IN SCHIZOPHRENIA. BACKGROUND: YOGA AND PHYSICAL EXERCISE HAVE BEEN USED AS ADJUNCTIVE INTERVENTION FOR COGNITIVE DYSFUNCTION IN SCHIZOPHRENIA (SZ), BUT CONTROLLED COMPARISONS ARE LACKING. AIMS A SINGLE-BLIND RANDOMISED CONTROLLED TRIAL WAS DESIGNED TO EVALUATE WHETHER YOGA TRAINING OR PHYSICAL EXERCISE TRAINING ENHANCE COGNITIVE FUNCTIONS IN SZ, BASED ON A PRIOR PILOT STUDY. METHODS: CONSENTING, CLINICALLY STABLE, ADULT OUTPATIENTS WITH SZ (N=286) COMPLETED BASELINE ASSESSMENTS AND WERE RANDOMISED TO TREATMENT AS USUAL (TAU), SUPERVISED YOGA TRAINING WITH TAU (YT) OR SUPERVISED PHYSICAL EXERCISE TRAINING WITH TAU (PE). BASED ON THE PILOT STUDY, THE PRIMARY OUTCOME MEASURE WAS SPEED INDEX FOR THE COGNITIVE DOMAIN OF 'ATTENTION' IN THE PENN COMPUTERISED NEUROCOGNITIVE BATTERY. USING MIXED MODELS AND CONTRASTS, COGNITIVE FUNCTIONS AT BASELINE, 21 DAYS (END OF TRAINING), 3 AND 6 MONTHS POST-TRAINING WERE EVALUATED WITH INTENTION-TO-TREAT PARADIGM. RESULTS: SPEED INDEX OF ATTENTION DOMAIN IN THE YT GROUP SHOWED GREATER IMPROVEMENT THAN PE AT 6 MONTHS FOLLOW-UP (P<0.036, EFFECT SIZE 0.51). IN THE PE GROUP, 'ACCURACY INDEX OF ATTENTION DOMAIN SHOWED GREATER IMPROVEMENT THAN TAU ALONE AT 6-MONTH FOLLOW-UP (P<0.025, EFFECT SIZE 0.61). FOR SEVERAL OTHER COGNITIVE DOMAINS, SIGNIFICANT IMPROVEMENTS WERE OBSERVED WITH YT OR PE COMPARED WITH TAU ALONE (P<0.05, EFFECT SIZES 0.30-1.97). CONCLUSIONS: BOTH YT AND PE IMPROVED ATTENTION AND ADDITIONAL COGNITIVE DOMAINS WELL PAST THE TRAINING PERIOD, SUPPORTING OUR PRIOR REPORTED BENEFICIAL EFFECT OF YT ON SPEED INDEX OF ATTENTION DOMAIN. AS ADJUNCTS, YT OR PE CAN BENEFIT INDIVIDUALS WITH SZ.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
10  963  38 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
11  507  54 COMPARATIVE EFFECTIVENESS OF PILATES AND YOGA GROUP EXERCISE INTERVENTIONS FOR CHRONIC MECHANICAL NECK PAIN: QUASI-RANDOMISED PARALLEL CONTROLLED STUDY. OBJECTIVES: TO DETERMINE THE EFFECTIVENESS OF PILATES AND YOGA GROUP EXERCISE INTERVENTIONS FOR INDIVIDUALS WITH CHRONIC NECK PAIN (CNP). DESIGN: QUASI-RANDOMISED PARALLEL CONTROLLED STUDY. SETTING: COMMUNITY, UNIVERSITY AND PRIVATE PRACTICE SETTINGS IN FOUR LOCATIONS. PARTICIPANTS: FIFTY-SIX INDIVIDUALS WITH CNP SCORING >/=3/10 ON THE NUMERIC PAIN RATING SCALE FOR >3 MONTHS (CONTROLS N=17, PILATES N=20, YOGA N=19). INTERVENTIONS: EXERCISE PARTICIPANTS COMPLETED 12 SMALL-GROUP SESSIONS WITH MODIFICATIONS AND PROGRESSIONS SUPERVISED BY A PHYSIOTHERAPIST. MAIN OUTCOME MEASURES: THE PRIMARY OUTCOME MEASURE WAS THE NECK DISABILITY INDEX (NDI). SECONDARY OUTCOMES WERE PAIN RATINGS, RANGE OF MOVEMENT AND POSTURAL MEASUREMENTS COLLECTED AT BASELINE, 6 WEEKS AND 12 WEEKS. FOLLOW-UP WAS PERFORMED 6 WEEKS AFTER COMPLETION OF THE EXERCISE CLASSES (WEEK 18). RESULTS: NDI DECREASED SIGNIFICANTLY IN THE PILATES {BASELINE: 11.1 [STANDARD DEVIATION (SD) 4.3] VS WEEK 12: 6.8 (SD 4.3); MEAN DIFFERENCE -4.3 (95% CONFIDENCE INTERVAL -1.64 TO -6.7); P<0.001} AND YOGA GROUPS [BASELINE: 12.8 (SD 7.4) VS WEEK 12: 8.1 (SD 5.6); MEAN DIFFERENCE -4.7 (95% CONFIDENCE INTERVAL -2.1 TO -7.4); P<0.00], WITH NO CHANGE IN THE CONTROL GROUP. PAIN RATINGS ALSO IMPROVED SIGNIFICANTLY. MODERATE-TO-LARGE EFFECT SIZES (0.7 TO 1.8) AND LOW NUMBERS NEEDED TO TREAT WERE FOUND. THERE WERE NO DIFFERENCES IN OUTCOMES BETWEEN THE EXERCISE GROUPS OR ASSOCIATED ADVERSE EFFECTS. NO IMPROVEMENTS IN RANGE OF MOVEMENT OR POSTURE WERE FOUND. CONCLUSIONS: PILATES AND YOGA GROUP EXERCISE INTERVENTIONS WITH APPROPRIATE MODIFICATIONS AND SUPERVISION WERE SAFE AND EQUALLY EFFECTIVE FOR DECREASING DISABILITY AND PAIN COMPARED WITH THE CONTROL GROUP FOR INDIVIDUALS WITH MILD-TO-MODERATE CNP. PHYSIOTHERAPISTS MAY CONSIDER INCLUDING THESE APPROACHES IN A PLAN OF CARE. CLINICAL TRIAL REGISTRATION NUMBER: CLINICALTRIALS.GOV NCT01999283.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
12   74  46 A GROUP-BASED YOGA THERAPY INTERVENTION FOR URINARY INCONTINENCE IN WOMEN: A PILOT RANDOMIZED TRIAL. OBJECTIVE: THE AIM OF THIS STUDY IS TO EXAMINE THE FEASIBILITY, EFFICACY, AND SAFETY OF A GROUP-BASED YOGA THERAPY INTERVENTION FOR MIDDLE-AGED AND OLDER WOMEN WITH URINARY INCONTINENCE. METHODS: WE CONDUCTED A PILOT RANDOMIZED TRIAL OF AMBULATORY WOMEN AGED 40 YEARS AND OLDER WITH STRESS, URGENCY, OR MIXED-TYPE INCONTINENCE. WOMEN WERE RANDOMIZED TO A 6-WEEK YOGA THERAPY PROGRAM (N = 10) CONSISTING OF TWICE WEEKLY GROUP CLASSES AND ONCE WEEKLY HOME PRACTICE OR A WAIT-LIST CONTROL GROUP (N = 9). ALL PARTICIPANTS ALSO RECEIVED WRITTEN PAMPHLETS ABOUT STANDARD BEHAVIORAL SELF-MANAGEMENT STRATEGIES FOR INCONTINENCE. CHANGES IN INCONTINENCE WERE ASSESSED WITH 7-DAY VOIDING DIARIES. RESULTS: THE MEAN (SD) AGE WAS 61.4 (8.2) YEARS, AND THE MEAN BASELINE FREQUENCY OF INCONTINENCE WAS 2.5 (1.3) EPISODES/D. AFTER 6 WEEKS, THE TOTAL INCONTINENCE FREQUENCY DECREASED BY 70% (1.8 [0.9] FEWER EPISODES/D) IN THE YOGA THERAPY VERSUS 13% (0.3 [1.7] FEWER EPISODES/D) IN THE CONTROL GROUP (P = 0.049). PARTICIPANTS IN THE YOGA THERAPY GROUP ALSO REPORTED AN AVERAGE OF 71% DECREASE IN STRESS INCONTINENCE FREQUENCY (0.7 [0.8] FEWER EPISODES/D) COMPARED WITH A 25% INCREASE IN CONTROLS (0.2 [1.1] MORE EPISODES/D) (P = 0.039). NO SIGNIFICANT DIFFERENCES IN REDUCTION IN URGENCY INCONTINENCE WERE DETECTED BETWEEN THE YOGA THERAPY VERSUS CONTROL GROUPS (1.0 [1.0] VERSUS 0.5 [0.5] FEWER EPISODES/D; P = 0.20). ALL WOMEN STARTING THE YOGA THERAPY PROGRAM COMPLETED AT LEAST 90% OF THE GROUP CLASSES AND PRACTICE SESSIONS. TWO PARTICIPANTS IN EACH GROUP REPORTED ADVERSE EVENTS UNRELATED TO THE INTERVENTION. CONCLUSIONS: FINDINGS PROVIDE PRELIMINARY EVIDENCE TO SUPPORT THE FEASIBILITY, EFFICACY, AND SAFETY OF A GROUP-BASED YOGA THERAPY INTERVENTION TO IMPROVE URINARY INCONTINENCE IN WOMEN.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
13 2851  74 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
14 2558  68 YOGA FOR CHRONIC LOW BACK PAIN IN A PREDOMINANTLY MINORITY POPULATION: A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: SEVERAL STUDIES SUGGEST YOGA MAY BE EFFECTIVE FOR CHRONIC LOW BACK PAIN; HOWEVER, TRIALS TARGETING MINORITIES HAVE NOT BEEN CONDUCTED. PRIMARY STUDY OBJECTIVES: ASSESS THE FEASIBILITY OF STUDYING YOGA IN A PREDOMINANTLY MINORITY POPULATION WITH CHRONIC LOW BACK PAIN. COLLECT PRELIMINARY DATA TO PLAN A LARGER POWERED STUDY. STUDY DESIGN: PILOT RANDOMIZED CONTROLLED TRIAL. SETTING: TWO COMMUNITY HEALTH CENTERS IN A RACIALLY DIVERSE NEIGHBORHOOD OF BOSTON, MASSACHUSETTS. PARTICIPANTS: THIRTY ENGLISH-SPEAKING ADULTS (MEAN AGE 44 YEARS, 83% FEMALE, 83% RACIAL/ETHNIC MINORITIES; 48% WITH INCOMES < OR = $30,000) WITH MODERATE-TO-SEVERE CHRONIC LOW BACK PAIN. INTERVENTIONS: STANDARDIZED SERIES OF WEEKLY HATHA YOGA CLASSES FOR 12 WEEKS COMPARED TO A WAITLIST USUAL CARE CONTROL. OUTCOME MEASURES: FEASIBILITY MEASURED BY TIME TO COMPLETE ENROLLMENT, PROPORTION OF RACIAL/ETHNIC MINORITIES ENROLLED, RETENTION RATES, AND ADVERSE EVENTS. PRIMARY EFFICACY OUTCOMES WERE CHANGES FROM BASELINE TO 12 WEEKS IN PAIN SCORE (0=NO PAIN TO 10=WORST POSSIBLE PAIN) AND BACK-RELATED FUNCTION USING THE MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE (0-23 POINT SCALE, HIGHER SCORES REFLECT POORER FUNCTION). SECONDARY EFFICACY OUTCOMES WERE ANALGESIC USE, GLOBAL IMPROVEMENT, AND QUALITY OF LIFE (SF-36). RESULTS: RECRUITMENT TOOK 2 MONTHS. RETENTION RATES WERE 97% AT 12 WEEKS AND 77% AT 26 WEEKS. MEAN PAIN SCORES FOR YOGA DECREASED FROM BASELINE TO 12 WEEKS (6.7 TO 4.4) COMPARED TO USUAL CARE, WHICH DECREASED FROM 7.5 TO 7.1 (P=.02). MEAN ROLAND SCORES FOR YOGA DECREASED FROM 14.5 TO 8.2 COMPARED TO USUAL CARE, WHICH DECREASED FROM 16.1 TO 12.5 (P=.28). AT 12 WEEKS, YOGA COMPARED TO USUAL CARE PARTICIPANTS REPORTED LESS ANALGESIC USE (13% VS 73%, P=.003), LESS OPIATE USE (0% VS 33%, P=.04), AND GREATER OVERALL IMPROVEMENT (73% VS 27%, P=.03). THERE WERE NO DIFFERENCES IN SF-36 SCORES AND NO SERIOUS ADVERSE EVENTS. CONCLUSION: A YOGA STUDY INTERVENTION IN A PREDOMINANTLY MINORITY POPULATION WITH CHRONIC LOW BACK PAIN WAS MODERATELY FEASIBLE AND MAY BE MORE EFFECTIVE THAN USUAL CARE FOR REDUCING PAIN AND PAIN MEDICATION USE.	2009	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
15  162  59 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
16 2782  34 YOGA THERAPY AS AN ADD-ON TREATMENT IN THE MANAGEMENT OF PATIENTS WITH SCHIZOPHRENIA--A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: TREATMENT OF SCHIZOPHRENIA HAS REMAINED UNSATISFACTORY DESPITE THE AVAILABILITY OF ANTIPSYCHOTICS. THIS STUDY EXAMINED THE EFFICACY OF YOGA THERAPY (YT) AS AN ADD-ON TREATMENT TO THE ONGOING ANTIPSYCHOTIC TREATMENT. METHOD: SIXTY-ONE MODERATELY ILL SCHIZOPHRENIA PATIENTS WERE RANDOMLY ASSIGNED TO YT (N = 31) AND PHYSICAL EXERCISE THERAPY (PT; N = 30) FOR 4 MONTHS. THEY WERE ASSESSED AT BASELINE AND 4 MONTHS AFTER THE START OF INTERVENTION, BY A RATER WHO WAS BLIND TO THEIR GROUP STATUS. RESULTS: FORTY-ONE SUBJECTS (YT = 21; PT = 20) WERE AVAILABLE AT THE END OF 4 MONTHS FOR ASSESSMENT. SUBJECTS IN THE YT GROUP HAD SIGNIFICANTLY LESS PSYCHOPATHOLOGY THAN THOSE IN THE PT GROUP AT THE END OF 4 MONTHS. THEY ALSO HAD SIGNIFICANTLY GREATER SOCIAL AND OCCUPATIONAL FUNCTIONING AND QUALITY OF LIFE. CONCLUSION: BOTH NON-PHARMACOLOGICAL INTERVENTIONS CONTRIBUTE TO REDUCTION IN SYMPTOMS, WITH YT HAVING BETTER EFFICACY.	2007	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
17 2845  53 YOGA, EURYTHMY THERAPY AND STANDARD PHYSIOTHERAPY (YES-TRIAL) FOR PATIENTS WITH CHRONIC NON-SPECIFIC LOW BACK PAIN: A THREE-ARMED RANDOMIZED CONTROLLED TRIAL. WE AIMED TO EVALUATE THE EFFECTS OF YOGA AND EURYTHMY THERAPY COMPARED TO CONVENTIONAL PHYSIOTHERAPY EXERCISES IN PATIENTS WITH CHRONIC LOW BACK PAIN. IN A THREE-ARMED, MULTICENTRE, RANDOMIZED CONTROLLED TRIAL, PATIENTS WITH CHRONIC LOW BACK PAIN WERE TREATED FOR 8 WEEKS IN GROUP SESSIONS (75 MINUTES ONCE PER WEEK). PRIMARY OUTCOME WAS PATIENTS' PHYSICAL DISABILITY (MEASURED BY RMDQ) FROM BASELINE TO WEEK 8. SECONDARY OUTCOME VARIABLES WERE PAIN INTENSITY AND PAIN-RELATED BOTHERSOMENESS (VAS), HEALTH-RELATED QUALITY OF LIFE (SF-12) AND LIFE SATISFACTION (BMLSS). OUTCOMES WERE ASSESSED AT BASELINE, AFTER THE INTERVENTION AT 8 WEEKS AND AT A 16-WEEK FOLLOW UP. DATA OF 274 PARTICIPANTS WERE USED FOR STATISTICAL ANALYSES. THERE WERE NO SIGNIFICANT DIFFERENCES BETWEEN THE THREE GROUPS FOR THE PRIMARY AND ALL SECONDARY OUTCOMES. IN ALL GROUPS, RMDQ DECREASED COMPARABLY AT 8 WEEKS, BUT DID NOT REACH CLINICAL MEANINGFULNESS. PAIN INTENSITY AND PAIN-RELATED BOTHERSOMENESS DECREASED, WHILE QUALITY OF LIFE INCREASED IN ALL 3 GROUPS. IN EXPLORATIVE GENERAL LINEAR MODELS FOR THE SF-12'S MENTAL HEALTH COMPONENT PARTICIPANTS IN THE EURYTHMY ARM BENEFITTED SIGNIFICANTLY MORE COMPARED TO PHYSIOTHERAPY AND YOGA. FURTHERMORE, WITHIN-GROUP ANALYSES SHOWED IMPROVEMENTS OF SF-12 MENTAL SCORE FOR YOGA AND EURYTHMY THERAPY ONLY. ALL INTERVENTIONS WERE SAFE. CLINICAL TRIALS REGISTER: DRKS-ID: DRKS00004651 PERSPECTIVE: THIS ARTICLE PRESENTS THE RESULTS OF A MULTICENTRE THREE-ARMED RANDOMIZED CONTROLLED TRIAL ON THE CLINICAL EFFECTS OF THREE 8-WEEK PROGRAMS IN PATIENTS WITH CHRONIC LOW BACK PAIN. COMPARED TO THE 'GOLD STANDARD' OF CONVENTIONAL PHYSIOTHERAPEUTIC EXERCISES, EURYTHMY THERAPY AND YOGA THERAPY LEAD TO COMPARABLE SYMPTOMATIC IMPROVEMENTS IN PATIENTS WITH CHRONIC LOW BACK PAIN. HOWEVER, THE WITHIN-GROUP EFFECT SIZES WERE SMALL TO MODERATE AND DID NOT REACH CLINICAL MEANINGFULNESS ON PATIENTS' PHYSICAL DISABILITY (RMDQ).	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
18  461  54 CHANGES IN PERCEIVED STRESS AFTER YOGA, PHYSICAL THERAPY, AND EDUCATION INTERVENTIONS FOR CHRONIC LOW BACK PAIN: A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: PERCEIVED STRESS AND MUSCULOSKELETAL PAIN ARE COMMON, ESPECIALLY IN LOW-INCOME POPULATIONS. STUDIES EVALUATING TREATMENTS TO REDUCE STRESS IN PATIENTS WITH CHRONIC PAIN ARE LACKING. WE AIMED TO QUANTIFY THE EFFECT OF TWO EVIDENCE-BASED INTERVENTIONS FOR CHRONIC LOW BACK PAIN (CLBP), YOGA AND PHYSICAL THERAPY (PT), ON PERCEIVED STRESS IN ADULTS WITH CLBP. METHODS: WE USED DATA FROM AN ASSESSOR-BLINDED, PARALLEL-GROUP RANDOMIZED CONTROLLED TRIAL, WHICH RECRUITED PREDOMINANTLY LOW-INCOME AND RACIALLY DIVERSE ADULTS WITH CLBP. PARTICIPANTS (N = 320) WERE RANDOMLY ASSIGNED TO 12 WEEKS OF YOGA, PT, OR BACK PAIN EDUCATION. WE COMPARED CHANGES IN THE 10-ITEM PERCEIVED STRESS SCALE (PSS-10) FROM BASELINE TO 12- AND 52-WEEK FOLLOW-UP AMONG YOGA AND PT PARTICIPANTS WITH THOSE RECEIVING EDUCATION. SUBANALYSES WERE CONDUCTED FOR PARTICIPANTS WITH ELEVATED PRE-INTERVENTION PERCEIVED STRESS (PSS-10 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  388  52 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
20 2596  66 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