1 1650 150 MULTICENTER, RANDOMIZED CONTROLLED TRIAL OF YOGA FOR SLEEP QUALITY AMONG CANCER SURVIVORS. PURPOSE: THIRTY PERCENT TO 90% OF CANCER SURVIVORS REPORT IMPAIRED SLEEP QUALITY POST-TREATMENT, WHICH CAN BE SEVERE ENOUGH TO INCREASE MORBIDITY AND MORTALITY. LIFESTYLE INTERVENTIONS, SUCH AS EXERCISE, ARE RECOMMENDED IN CONJUNCTION WITH DRUGS AND COGNITIVE BEHAVIORAL THERAPY FOR THE TREATMENT OF IMPAIRED SLEEP. PRELIMINARY EVIDENCE INDICATES THAT YOGA-A MIND-BODY PRACTICE AND FORM OF EXERCISE-MAY IMPROVE SLEEP AMONG CANCER SURVIVORS. THE PRIMARY AIM OF THIS RANDOMIZED, CONTROLLED CLINICAL TRIAL WAS TO DETERMINE THE EFFICACY OF A STANDARDIZED YOGA INTERVENTION COMPARED WITH STANDARD CARE FOR IMPROVING GLOBAL SLEEP QUALITY (PRIMARY OUTCOME) AMONG POST-TREATMENT CANCER SURVIVORS. PATIENTS AND METHODS: IN ALL, 410 SURVIVORS SUFFERING FROM MODERATE OR GREATER SLEEP DISRUPTION BETWEEN 2 AND 24 MONTHS AFTER SURGERY, CHEMOTHERAPY, AND/OR RADIATION THERAPY WERE RANDOMLY ASSIGNED TO STANDARD CARE OR STANDARD CARE PLUS THE 4-WEEK YOGA INTERVENTION. THE YOGA INTERVENTION USED THE YOGA FOR CANCER SURVIVORS (YOCAS) PROGRAM CONSISTING OF PRANAYAMA (BREATHING EXERCISES), 16 GENTLE HATHA AND RESTORATIVE YOGA ASANAS (POSTURES), AND MEDITATION. PARTICIPANTS ATTENDED TWO 75-MINUTE SESSIONS PER WEEK. SLEEP QUALITY WAS ASSESSED BY USING THE PITTSBURGH SLEEP QUALITY INDEX AND ACTIGRAPHY PRE- AND POSTINTERVENTION. RESULTS: IN ALL, 410 SURVIVORS WERE ACCRUED (96% FEMALE; MEAN AGE, 54 YEARS; 75% HAD BREAST CANCER). YOGA PARTICIPANTS DEMONSTRATED GREATER IMPROVEMENTS IN GLOBAL SLEEP QUALITY AND, SECONDARILY, SUBJECTIVE SLEEP QUALITY, DAYTIME DYSFUNCTION, WAKE AFTER SLEEP ONSET, SLEEP EFFICIENCY, AND MEDICATION USE AT POSTINTERVENTION (ALL P /= 80% OF YOGA PARTICIPANTS REPORTING AVERAGE SLEEP ONSET LATENCY < 30 MINUTES AND SLEEP EFFICIENCY > 80% AT 6-MONTH FOLLOW-UP. FOR OVER 50% OF YOGA PARTICIPANTS, THE INSOMNIA SEVERITY INDEX DECREASED BY AT LEAST 8 POINTS AT END OF TREATMENT AND FOLLOW-UP. CONCLUSIONS: YOGA, TAUGHT IN A SELF-CARE FRAMEWORK WITH MINIMAL INSTRUCTOR BURDEN, WAS ASSOCIATED WITH SELF-REPORTED IMPROVEMENTS ABOVE AND BEYOND AN ACTIVE SLEEP HYGIENE COMPARISON, SUSTAINED AT 6-MONTH FOLLOW-UP. FOLLOW-UP STUDIES ARE NEEDED TO ASSESS ACTIGRAPHY AND POLYSOMNOGRAPHY OUTCOMES, AS WELL AS POSSIBLE MECHANISMS OF CHANGE. CLINICAL TRIAL REGISTRATION: REGISTRY: CLINICALTRIALS.GOV; NAME: YOGA AS A TREATMENT FOR INSOMNIA; URL: HTTPS://CLINICALTRIALS.GOV/CT2/SHOW/NCT00033865; IDENTIFIER: NCT00033865. CITATION: KHALSA SBS, GOLDSTEIN MR. TREATMENT OF CHRONIC PRIMARY SLEEP ONSET INSOMNIA WITH KUNDALINI YOGA: A RANDOMIZED CONTROLLED TRIAL WITH ACTIVE SLEEP HYGIENE COMPARISON. J CLIN SLEEP MED. 2021;17(9):1841-1852. 2021 9 1460 53 INFLUENCE OF YOGA ON CANCER-RELATED FATIGUE AND ON MEDIATIONAL RELATIONSHIPS BETWEEN CHANGES IN SLEEP AND CANCER-RELATED FATIGUE: A NATIONWIDE, MULTICENTER RANDOMIZED CONTROLLED TRIAL OF YOGA IN CANCER SURVIVORS. BACKGROUND: CANCER-RELATED FATIGUE (CRF) OFTEN CO-OCCURS WITH SLEEP DISTURBANCE AND IS ONE OF THE MOST PERVASIVE TOXICITIES RESULTING FROM CANCER AND ITS TREATMENT. WE AND OTHER INVESTIGATORS HAVE PREVIOUSLY REPORTED THAT YOGA THERAPY CAN IMPROVE SLEEP QUALITY IN CANCER PATIENTS AND SURVIVORS. NO NATIONWIDE MULTICENTER PHASE III RANDOMIZED CONTROLLED TRIAL (RCT) HAS INVESTIGATED WHETHER YOGA THERAPY IMPROVES CRF OR WHETHER IMPROVEMENTS IN SLEEP MEDIATE THE EFFECT OF YOGA ON CRF. WE EXAMINED THE EFFECT OF A STANDARDIZED, 4-WEEK, YOGA THERAPY PROGRAM (YOGA FOR CANCER SURVIVORS [YOCAS]) ON CRF AND WHETHER YOCAS-INDUCED CHANGES IN SLEEP MEDIATED CHANGES IN CRF AMONG SURVIVORS. STUDY DESIGN AND METHODS: FOUR HUNDRED TEN CANCER SURVIVORS WERE RECRUITED TO A NATIONWIDE MULTICENTER PHASE III RCT COMPARING THE EFFECT OF YOCAS TO STANDARD SURVIVORSHIP CARE ON CRF AND EXAMINING THE MEDIATING EFFECTS OF CHANGES IN SLEEP, STEMMING FROM YOGA, ON CHANGES IN CRF. CRF WAS ASSESSED BY THE MULTIDIMENSIONAL FATIGUE SYMPTOM INVENTORY. SLEEP WAS ASSESSED VIA THE PITTSBURGH SLEEP QUALITY INDEX. BETWEEN- AND WITHIN-GROUP INTERVENTION EFFECTS ON CRF WERE ASSESSED BY ANALYSIS OF COVARIANCE AND 2-TAILED T TEST, RESPECTIVELY. PATH ANALYSIS WAS USED TO EVALUATE MEDIATION. RESULTS: YOCAS PARTICIPANTS DEMONSTRATED SIGNIFICANTLY GREATER IMPROVEMENTS IN CRF COMPARED WITH PARTICIPANTS IN STANDARD SURVIVORSHIP CARE AT POST-INTERVENTION ( P < .01). IMPROVEMENTS IN OVERALL SLEEP QUALITY AND REDUCTIONS IN DAYTIME DYSFUNCTION (EG, EXCESSIVE NAPPING) RESULTING FROM YOGA SIGNIFICANTLY MEDIATED THE EFFECT OF YOGA ON CRF (22% AND 37%, RESPECTIVELY, BOTH P < .01). CONCLUSIONS: YOCAS IS EFFECTIVE FOR TREATING CRF AMONG CANCER SURVIVORS; 22% TO 37% OF THE IMPROVEMENTS IN CRF FROM YOGA THERAPY RESULT FROM IMPROVEMENTS IN SLEEP QUALITY AND DAYTIME DYSFUNCTION. ONCOLOGISTS SHOULD CONSIDER PRESCRIBING YOGA TO CANCER SURVIVORS FOR TREATING CRF AND SLEEP DISTURBANCE. 2019 10 478 42 CLINICAL CASE REPORT: YOGA FOR FATIGUE IN FIVE YOUNG ADULT SURVIVORS OF CHILDHOOD CANCER. PURPOSE: CANCER-RELATED FATIGUE (CRF) IS A DISTRESSING CONSEQUENCE OF CANCER AND ITS TREATMENT. CRF IMPACTS MANY YOUNG ADULT (YA) SURVIVORS OF CHILDHOOD CANCER, COMPROMISING WORK, SOCIAL RELATIONSHIPS, AND DAILY ACTIVITIES. NO SATISFACTORY TREATMENT EXISTS. THIS PILOT STUDY AIMED TO ASSESS THE FEASIBILITY, SAFETY, AND PRELIMINARY EFFICACY OF AN 8-WEEK TWICE/WEEK IYENGAR YOGA (IY) INTERVENTION FOR TREATING PERSISTENT FATIGUE IN YA SURVIVORS OF CHILDHOOD CANCER. METHODS: USING A SINGLE-ARM MIXED-METHODS DESIGN, ADULT CHILDHOOD CANCER SURVIVORS AGED BETWEEN 18 AND 39 YEARS WERE RECRUITED FROM A SURVIVORSHIP CLINIC AT A SINGLE INSTITUTION. QUANTITATIVE: THE PRIMARY OUTCOME WAS FATIGUE AS MEASURED BY THE FUNCTIONAL ASSESSMENT OF CHRONIC ILLNESS THERAPY-FATIGUE. SECONDARY OUTCOMES INCLUDED VITALITY, SOCIAL FUNCTIONING, MULTIDIMENSIONAL FATIGUE, MOOD, AND SLEEP. WEEKLY SELF-REPORT MONITORING DATA WERE COLLECTED. QUALITATIVE: PARTICIPANTS ALSO COMPLETED A POST-INTERVENTION INTERVIEW, MAJOR THEMES EVALUATED. RESULTS: FIVE PARTICIPANTS ENROLLED INTO THE STUDY AND FOUR COMPLETED THE INTERVENTION. ATTENDANCE WAS 92% AND THERE WERE NO ADVERSE EVENTS. BASELINE MOBILITY WAS HIGHLY VARIED, WITH ONE YA HAVING HAD A HEMIPELVECTOMY. QUANTITATIVE DATA REVEALED SIGNIFICANTLY IMPROVED FATIGUE, SOCIAL FUNCTIONING, SOMATIZATION, AND GENERAL AND EMOTIONAL MANIFESTATIONS OF FATIGUE FOLLOWING YOGA. QUALITATIVE DATA CROSS VALIDATED, CLARIFIED, AND EXPANDED UPON THE QUANTITATIVE FINDINGS. CONCLUSIONS: THE STUDY SUGGESTS THAT A BRIEF IY INTERVENTION IS SAFE FOR YA SURVIVORS OF CHILDHOOD CANCER, EVEN FOR THOSE WITH PHYSICAL DISABILITIES. PRELIMINARY EFFICACY WAS DEMONSTRATED FOR THE PRIMARY OUTCOME OF FATIGUE. QUALITATIVE DATA ELUCIDATED ADDITIONAL IMPROVEMENTS, SUCH AS WORK-RELATED SOCIAL FUNCTIONING, AND A SENSE OF CALM AND RELAXATION. 2017 11 2588 45 YOGA FOR IMPROVING SLEEP QUALITY AND QUALITY OF LIFE FOR OLDER ADULTS. CONTEXT: THE AGING PROCESS IS ASSOCIATED WITH PHYSIOLOGICAL CHANGES THAT AFFECT SLEEP. IN OLDER ADULTS, UNDIAGNOSED AND UNTREATED INSOMNIA MAY CAUSE IMPAIRED DAILY FUNCTION AND REDUCED QUALITY OF LIFE (QOL). INSOMNIA IS ALSO A RISK FACTOR FOR ACCIDENTS AND FALLS THAT ARE THE MAIN CAUSE OF ACCIDENTAL DEATHS IN OLDER ADULTS AND, THEREFORE, IS ASSOCIATED WITH HIGHER MORBIDITY AND MORTALITY RATES IN OLDER POPULATIONS. OBJECTIVES: THE RESEARCH TEAM AIMED TO (1) EXAMINE THE EFFICACY OF A YOGA INTERVENTION (YI) FOR THE TREATMENT OF INSOMNIA IN OLDER ADULTS, (2) DETERMINE THE ABILITY OF YOGA TO ENHANCE THE QOL OF OLDER ADULTS, AND (3) ESTABLISH THE APPLICABILITY OF YOGA PRACTICE FOR OLDER PEOPLE IN A WESTERN CULTURAL SETTING. DESIGN: A WAITING-LIST CONTROLLED TRIAL. SETTINGS * THE STUDY TOOK PLACE IN JERUSALEM, ISRAEL, FROM 2008-2009. PARTICIPANTS: PARTICIPANTS WERE OLDER MEN AND WOMEN (AGE >/= 60 Y) WITH INSOMNIA. INTERVENTION: THE YI GROUP PARTICIPATED IN 12 WK OF CLASSES, HELD 2 X/WK, INCORPORATING YOGA POSTURES, MEDITATIVE YOGA, AND DAILY HOME PRACTICE OF MEDITATIVE YOGA. OUTCOME MEASURES: THE STUDY USED SELF-REPORT ASSESSMENTS OF SLEEP QUALITY USING THE FOLLOWING: (1) SLEEP QUALITY-THE KAROLINSKA SLEEPINESS SCALE (KSS), THE EPWORTH SLEEPINESS SCALE (ESS), AND THE PITTSBURGH SLEEP QUALITY INDEX (PSQI), AND DAILY SLEEP AND PRACTICE LOGS; (2) MOOD STATES-THE DEPRESSION ANXIETY STRESS SCALE LONG FORM (DASS-42) AND THE PROFILE OF MOOD STATES SHORT FORM (POMS-SF); (3) A HEALTH SURVEY (SF-36); AND (4) MOBILE AT-HOME SLEEP STUDIES. RESULTS: COMPARED WITH CONTROLS, THE YI GROUP SHOWED SIGNIFICANT IMPROVEMENTS IN A RANGE OF SUBJECTIVE FACTORS, INCLUDING OVERALL SLEEP QUALITY; SLEEP EFFICIENCY; SLEEP LATENCY AND DURATION; SELF-ASSESSED SLEEP QUALITY; FATIGUE; GENERAL WELL-BEING; DEPRESSION; ANXIETY; STRESS; TENSION; ANGER; VITALITY; AND FUNCTION IN PHYSICAL, EMOTIONAL, AND SOCIAL ROLES. CONCLUSIONS: YOGA WAS SHOWN TO BE SAFE AND IMPROVED SLEEP AND QOL IN A GROUP OF OLDER ADULTS WITH INSOMNIA. OUTCOMES DEPENDED ON PRACTICE COMPLIANCE. 2014 12 252 32 A YOGA PROGRAM FOR THE SYMPTOMS OF POST-TRAUMATIC STRESS DISORDER IN VETERANS. THE PURPOSE OF THIS PILOT STUDY WAS TO EVALUATE THE FEASIBILITY AND EFFECTIVENESS OF A YOGA PROGRAM AS AN ADJUNCTIVE THERAPY FOR IMPROVING POST-TRAUMATIC STRESS DISORDER (PTSD) SYMPTOMS IN VETERANS WITH MILITARY-RELATED PTSD. VETERANS (N = 12) PARTICIPATED IN A 6 WEEK YOGA INTERVENTION HELD TWICE A WEEK. THERE WAS SIGNIFICANT IMPROVEMENT IN PTSD HYPERAROUSAL SYMPTOMS AND OVERALL SLEEP QUALITY AS WELL AS DAYTIME DYSFUNCTION RELATED TO SLEEP. THERE WERE NO SIGNIFICANT IMPROVEMENTS IN THE TOTAL PTSD, ANGER, OR QUALITY OF LIFE OUTCOME SCORES. THESE RESULTS SUGGEST THAT THIS YOGA PROGRAM MAY BE AN EFFECTIVE ADJUNCTIVE THERAPY FOR IMPROVING HYPERAROUSAL SYMPTOMS OF PTSD INCLUDING SLEEP QUALITY. THIS STUDY DEMONSTRATES THAT THE YOGA PROGRAM IS ACCEPTABLE, FEASIBLE, AND THAT THERE IS GOOD ADHERENCE IN A VETERAN POPULATION. 2013 13 2604 50 YOGA FOR PERSISTENT FATIGUE IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CANCER-RELATED FATIGUE AFFLICTS UP TO 33% OF BREAST CANCER SURVIVORS, YET THERE ARE NO EMPIRICALLY VALIDATED TREATMENTS FOR THIS SYMPTOM. METHODS: THE AUTHORS CONDUCTED A 2-GROUP RANDOMIZED CONTROLLED TRIAL TO DETERMINE THE FEASIBILITY AND EFFICACY OF AN IYENGAR YOGA INTERVENTION FOR BREAST CANCER SURVIVORS WITH PERSISTENT POST-TREATMENT FATIGUE. PARTICIPANTS WERE BREAST CANCER SURVIVORS WHO HAD COMPLETED CANCER TREATMENTS (OTHER THAN ENDOCRINE THERAPY) AT LEAST 6 MONTHS BEFORE ENROLLMENT, REPORTED SIGNIFICANT CANCER-RELATED FATIGUE, AND HAD NO OTHER MEDICAL CONDITIONS THAT WOULD ACCOUNT FOR FATIGUE SYMPTOMS OR INTERFERE WITH YOGA PRACTICE. BLOCK RANDOMIZATION WAS USED TO ASSIGN PARTICIPANTS TO A 12-WEEK, IYENGAR-BASED YOGA INTERVENTION OR TO 12 WEEKS OF HEALTH EDUCATION (CONTROL). THE PRIMARY OUTCOME WAS CHANGE IN FATIGUE MEASURED AT BASELINE, IMMEDIATELY POST-TREATMENT, AND 3 MONTHS AFTER TREATMENT COMPLETION. ADDITIONAL OUTCOMES INCLUDED CHANGES IN VIGOR, DEPRESSIVE SYMPTOMS, SLEEP, PERCEIVED STRESS, AND PHYSICAL PERFORMANCE. INTENT-TO-TREAT ANALYSES WERE CONDUCTED WITH ALL RANDOMIZED PARTICIPANTS USING LINEAR MIXED MODELS. RESULTS: THIRTY-ONE WOMEN WERE RANDOMLY ASSIGNED TO YOGA (N = 16) OR HEALTH EDUCATION (N = 15). FATIGUE SEVERITY DECLINED SIGNIFICANTLY FROM BASELINE TO POST-TREATMENT AND OVER A 3-MONTH FOLLOW-UP IN THE YOGA GROUP RELATIVE TO CONTROLS (P = .032). IN ADDITION, THE YOGA GROUP HAD SIGNIFICANT INCREASES IN VIGOR RELATIVE TO CONTROLS (P = .011). BOTH GROUPS HAD POSITIVE CHANGES IN DEPRESSIVE SYMPTOMS AND PERCEIVED STRESS (P < .05). NO SIGNIFICANT CHANGES IN SLEEP OR PHYSICAL PERFORMANCE WERE OBSERVED. CONCLUSIONS: A TARGETED YOGA INTERVENTION LED TO SIGNIFICANT IMPROVEMENTS IN FATIGUE AND VIGOR AMONG BREAST CANCER SURVIVORS WITH PERSISTENT FATIGUE SYMPTOMS. 2012 14 1379 44 IMPACT OF IYENGAR YOGA ON QUALITY OF LIFE IN YOUNG WOMEN WITH RHEUMATOID ARTHRITIS. OBJECTIVE: RHEUMATOID ARTHRITIS (RA) IS A CHRONIC, DISABLING DISEASE THAT CAN GREATLY COMPROMISE HEALTH-RELATED QUALITY OF LIFE (HRQOL). THE AIM OF THIS STUDY WAS TO ASSESS THE IMPACT OF A 6-WEEK TWICE/WEEK IYENGAR YOGA PROGRAM ON HRQOL OF YOUNG ADULTS WITH RA COMPARED WITH A USUAL-CARE WAITLIST CONTROL GROUP. METHODS: THE PROGRAM WAS DESIGNED TO IMPROVE THE PRIMARY OUTCOME OF HRQOL INCLUDING PAIN AND DISABILITY AND PSYCHOLOGICAL FUNCTIONING IN PATIENTS. ASSESSMENTS WERE COLLECTED PRETREATMENT, POSTTREATMENT, AND AT 2 MONTHS AFTER TREATMENT. WEEKLY RATINGS OF ANXIETY, DEPRESSION, PAIN, AND SLEEP WERE ALSO RECORDED. A TOTAL OF 26 PARTICIPANTS COMPLETED THE INTERVENTION (YOGA=11; USUAL-CARE WAITLIST=15). ALL PARTICIPANTS WERE FEMALE (MEAN AGE=28 Y). RESULTS: OVERALL ATTRITION WAS LOW AT 15%. ON AVERAGE, WOMEN IN THE YOGA GROUP ATTENDED 96% OF THE YOGA CLASSES. NO ADVERSE EVENTS WERE REPORTED. RELATIVE TO THE USUAL-CARE WAITLIST, WOMEN ASSIGNED TO THE YOGA PROGRAM SHOWED SIGNIFICANTLY GREATER IMPROVEMENT ON STANDARDIZED MEASURES OF HRQOL, PAIN DISABILITY, GENERAL HEALTH, MOOD, FATIGUE, ACCEPTANCE OF CHRONIC PAIN, AND SELF-EFFICACY REGARDING PAIN AT POSTTREATMENT. ALMOST HALF OF THE YOGA GROUP REPORTED CLINICALLY MEANINGFUL SYMPTOM IMPROVEMENT. ANALYSIS OF THE UNCONTROLLED EFFECTS AND MAINTENANCE OF TREATMENT EFFECTS SHOWED IMPROVEMENTS IN HRQOL GENERAL HEALTH, PAIN DISABILITY, AND WEEKLY RATINGS OF PAIN, ANXIETY, AND DEPRESSION WERE MAINTAINED AT FOLLOW-UP. CONCLUSIONS: THE FINDINGS SUGGEST THAT A BRIEF IYENGAR YOGA INTERVENTION IS A FEASIBLE AND SAFE ADJUNCTIVE TREATMENT FOR YOUNG PEOPLE WITH RA, LEADING TO HRQOL, PAIN DISABILITY, FATIGUE, AND MOOD BENEFITS. MOREOVER, IMPROVEMENTS IN QUALITY OF LIFE, PAIN DISABILITY, AND MOOD PERSISTED AT THE 2-MONTH FOLLOW-UP. 2013 15 41 44 A BRIEF YOGA INTERVENTION IMPLEMENTED DURING CHEMOTHERAPY: A RANDOMIZED CONTROLLED PILOT STUDY. OBJECTIVES: FATIGUE AND OTHER TREATMENT-RELATED SYMPTOMS (E.G., SLEEP DISTURBANCE) ARE CRITICAL TARGETS FOR IMPROVING QUALITY OF LIFE IN PATIENTS UNDERGOING CHEMOTHERAPY. YOGA MAY REDUCE THE BURDEN OF SUCH SYMPTOMS. THIS STUDY INVESTIGATED THE FEASIBILITY OF CONDUCTING A RANDOMIZED CONTROLLED STUDY OF A BRIEF YOGA INTERVENTION DURING CHEMOTHERAPY FOR COLORECTAL CANCER. DESIGN: WE RANDOMIZED ADULTS WITH COLORECTAL CANCER TO A BRIEF YOGA SKILLS TRAINING (YST) OR AN ATTENTION CONTROL (AC; EMPATHIC ATTENTION AND RECORDED EDUCATION). SETTING: THE INTERVENTIONS AND ASSESSMENTS WERE IMPLEMENTED INDIVIDUALLY IN THE CLINIC WHILE PATIENTS WERE IN THE CHAIR RECEIVING CHEMOTHERAPY. INTERVENTIONS: BOTH INTERVENTIONS CONSISTED OF THREE SESSIONS AND RECOMMENDED HOME PRACTICE. MAIN OUTCOME MEASURES: THE PRIMARY OUTCOME WAS FEASIBILITY (ACCRUAL, RETENTION, ADHERENCE, DATA COLLECTION). SELF-REPORTED OUTCOMES (I.E., FATIGUE, SLEEP DISTURBANCE, QUALITY OF LIFE) AND INFLAMMATORY BIOMARKERS WERE ALSO DESCRIBED TO INFORM FUTURE STUDIES. RESULTS: OF 52 PATIENTS INITIALLY IDENTIFIED, 28 WERE APPROACHED, AND 15 ENROLLED (AGE MEAN = 57.5 YEARS; 80% WHITE; 60% MALE). REASONS FOR DECLINING PARTICIPATION WERE: NOT INTERESTED (N = 6), DID NOT PERCEIVE A NEED (N = 2), AND OTHER (N = 5). TWO PARTICIPANTS WERE LOST TO FOLLOW-UP IN EACH GROUP DUE TO TREATMENT CHANGES. THUS, 75% OF PARTICIPANTS WERE RETAINED IN THE YST AND 71% IN THE AC ARM. PARTICIPANTS RETAINED IN THE STUDY ADHERED TO 97% OF THE IN-PERSON INTERVENTION SESSIONS AND COMPLETED ALL QUESTIONNAIRES. CONCLUSIONS: THIS STUDY DEMONSTRATED THE FEASIBILITY OF CONDUCTING A LARGER RANDOMIZED CONTROLLED TRIAL TO ASSESS YST AMONG PATIENTS RECEIVING CHEMOTHERAPY FOR COLORECTAL CANCER. DATA COLLECTED AND CHALLENGES ENCOUNTERED WILL INFORM FUTURE RESEARCH. 2016 16 172 40 A RANDOMIZED CONTROLLED PILOT STUDY OF YOGA SKILLS TRAINING VERSUS AN ATTENTION CONTROL DELIVERED DURING CHEMOTHERAPY ADMINISTRATION. CONTEXT: IT IS IMPORTANT TO ADDRESS FATIGUE AND CO-OCCURRING SYMPTOMS DURING CHEMOTHERAPY TO PRESERVE QUALITY OF LIFE IN PATIENTS WITH GASTROINTESTINAL (GI) CANCER. OBJECTIVE: TO CONDUCT A RANDOMIZED CONTROLLED PILOT STUDY OF A YOGA SKILLS TRAINING (YST) INTERVENTION COMPARED TO AN ATTENTION CONTROL (AC) AMONG ADULTS DIAGNOSED WITH GI CANCER. METHODS: YST CONSISTED OF FOUR 30-MINUTE SESSIONS DELIVERED INDIVIDUALLY DURING CHEMOTHERAPY PLUS HOME PRACTICE. AC PROVIDED EMPATHIC ATTENTION PLUS HOME DIARIES. PATIENT-REPORTED (PROMIS T-SCORE) ASSESSMENTS OF FATIGUE, DEPRESSIVE SYMPTOMS, SLEEP DISTURBANCES, AND PSYCHOLOGICAL STRESS (PERCEIVED STRESS SCALE) WERE COLLECTED AT CHEMOTHERAPY VISITS: BASELINE, WEEK 8, WEEK 10 AND WEEK 14, AND ANALYZED USING A MIXED EFFECTS MODEL. INFLAMMATORY CYTOKINES WERE ASSESSED AT BASELINE AND WEEK 10. RESULTS: FORTY-FOUR OF 77 ADULTS APPROACHED AGREED TO PARTICIPATE (57%; YST N = 23; AC N = 21). PARTICIPANTS' MEAN AGE WAS 58 YEARS AND 48% WERE MEN. PARTICIPANTS RANDOMIZED TO YST REPORTED A LARGER DECLINE IN FATIGUE (-2.4 DIFFERENCE, D = 0.30) AND DEPRESSIVE SYMPTOMS (-2.5 DIFFERENCE, D = 0.30) THAN AC PARTICIPANTS FROM BASELINE TO WEEK 10 AND SLEEP DISTURBANCES AT WEEK 8 (-3.9 DIFFERENCE, D = 0.50). DIFFERENCES IN MAGNITUDE OF CHANGE IN SYMPTOMS WERE CONSISTENT WITH OR EXCEEDED A MINIMALLY IMPORTANT DIFFERENCE. PSYCHOLOGICAL STRESS DECREASED MORE IN THE AC AT WEEK 10 (D = 0.30). REDUCTIONS IN INFLAMMATORY CYTOKINES (IL-6, STNF R1) WERE LARGER IN THE YST GROUP THAN AC. CONCLUSION: YST SHOWED PROMISE FOR IMPROVING FATIGUE, DEPRESSIVE SYMPTOMS, SLEEP DISTURBANCES, AND INFLAMMATION. YST IS ALSO FEASIBLE AND REACHES PATIENTS UNDERREPRESENTED IN YOGA RESEARCH (I.E., GI CANCER, MEN), THUS WARRANTING FURTHER EXAMINATION. 2022 17 1194 30 EXAMINING MEDIATORS AND MODERATORS OF YOGA FOR WOMEN WITH BREAST CANCER UNDERGOING RADIOTHERAPY. HYPOTHESIS THIS STUDY EXAMINES MODERATORS AND MEDIATORS OF A YOGA INTERVENTION TARGETING QUALITY-OF-LIFE (QOL) OUTCOMES IN WOMEN WITH BREAST CANCER RECEIVING RADIOTHERAPY.METHODS WOMEN UNDERGOING 6 WEEKS OF RADIOTHERAPY WERE RANDOMIZED TO A YOGA (YG; N = 53) OR STRETCHING (ST; N = 56) INTERVENTION OR A WAITLIST CONTROL GROUP (WL; N = 54). DEPRESSIVE SYMPTOMS AND SLEEP DISTURBANCES WERE MEASURED AT BASELINE. MEDIATOR (POSTTRAUMATIC STRESS SYMPTOMS, BENEFIT FINDING, AND CORTISOL SLOPE) AND OUTCOME (36-ITEM SHORT FORM [SF]-36 MENTAL AND PHYSICAL COMPONENT SCALES [MCS AND PCS]) VARIABLES WERE ASSESSED AT BASELINE, END-OF-TREATMENT, AND 1-, 3-, AND 6-MONTHS POSTTREATMENT. RESULTS BASELINE DEPRESSIVE SYMPTOMS (P = .03) AND SLEEP DISTURBANCES (P < .01) MODERATED THE GROUP X TIME EFFECT ON MCS, BUT NOT PCS. WOMEN WITH HIGH BASELINE DEPRESSIVE SYMPTOMS IN YG REPORTED MARGINALLY HIGHER 3-MONTH MCS THAN THEIR COUNTERPARTS IN WL (P = .11). WOMEN WITH HIGH BASELINE SLEEP DISTURBANCES IN YG REPORTED HIGHER 3-MONTHS MCS THAN THEIR COUNTERPARTS IN WL (P < .01) AND HIGHER 6-MONTH MCS THAN THEIR COUNTERPARTS IN ST (P = .01). YG LED TO GREATER BENEFIT FINDING THAN ST AND WL ACROSS THE FOLLOW-UP (P = .01). THREE-MONTH BENEFIT FINDING PARTIALLY MEDIATED THE EFFECT OF YG ON 6-MONTH PCS. POSTTRAUMATIC STRESS SYMPTOMS AND CORTISOL SLOPE DID NOT MEDIATE TREATMENT EFFECT ON QOL. CONCLUSION YOGA MAY PROVIDE THE GREATEST MENTAL-HEALTH-RELATED QOL BENEFITS FOR THOSE EXPERIENCING PRE-RADIOTHERAPY SLEEP DISTURBANCE AND DEPRESSIVE SYMPTOMS. YOGA MAY IMPROVE PHYSICAL-HEALTH-RELATED QOL BY INCREASING ABILITY TO FIND BENEFIT IN THE CANCER EXPERIENCE. 2016 18 2442 47 YOGA AND SELF-REPORTED COGNITIVE PROBLEMS IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: CANCER SURVIVORS OFTEN REPORT COGNITIVE PROBLEMS. FURTHERMORE, DECREASES IN PHYSICAL ACTIVITY TYPICALLY OCCUR OVER THE COURSE OF CANCER TREATMENT. ALTHOUGH PHYSICAL ACTIVITY BENEFITS COGNITIVE FUNCTION IN NONCANCER POPULATIONS, EVIDENCE LINKING PHYSICAL ACTIVITY TO COGNITIVE FUNCTION IN CANCER SURVIVORS IS LIMITED. IN OUR RECENT RANDOMIZED CONTROLLED TRIAL, BREAST CANCER SURVIVORS WHO RECEIVED A YOGA INTERVENTION HAD LOWER FATIGUE AND INFLAMMATION FOLLOWING THE TRIAL COMPARED WITH A WAIT LIST CONTROL GROUP. THIS SECONDARY ANALYSIS OF THE PARENT TRIAL ADDRESSED YOGA'S IMPACT ON COGNITIVE COMPLAINTS. METHODS: POSTTREATMENT STAGE 0-IIIA BREAST CANCER SURVIVORS (N = 200) WERE RANDOMIZED TO A 12-WEEK, TWICE-WEEKLY HATHA YOGA INTERVENTION OR A WAIT LIST CONTROL GROUP. PARTICIPANTS REPORTED COGNITIVE COMPLAINTS USING THE BREAST CANCER PREVENTION TRIAL COGNITIVE PROBLEMS SCALE AT BASELINE, IMMEDIATELY POSTINTERVENTION, AND 3-MONTH FOLLOW-UP. RESULTS: COGNITIVE COMPLAINTS DID NOT DIFFER SIGNIFICANTLY BETWEEN GROUPS IMMEDIATELY POSTINTERVENTION (P = 0.250). HOWEVER, AT 3-MONTH FOLLOW-UP, YOGA PARTICIPANTS' BREAST CANCER PREVENTION TRIAL COGNITIVE PROBLEMS SCALE SCORES WERE AN AVERAGE OF 23% LOWER THAN WAIT LIST PARTICIPANTS' SCORES (P = 0.003). THESE GROUP DIFFERENCES IN COGNITIVE COMPLAINTS REMAINED AFTER CONTROLLING FOR PSYCHOLOGICAL DISTRESS, FATIGUE, AND SLEEP QUALITY. CONSISTENT WITH THE PRIMARY RESULTS, THOSE WHO PRACTICED YOGA MORE FREQUENTLY REPORTED SIGNIFICANTLY FEWER COGNITIVE PROBLEMS AT 3-MONTH FOLLOW-UP THAN THOSE WHO PRACTICED LESS FREQUENTLY (P < 0.001). CONCLUSIONS: THESE FINDINGS SUGGEST THAT YOGA CAN EFFECTIVELY REDUCE BREAST CANCER SURVIVORS' COGNITIVE COMPLAINTS AND PROMPT FURTHER RESEARCH ON MIND-BODY AND PHYSICAL ACTIVITY INTERVENTIONS FOR IMPROVING CANCER-RELATED COGNITIVE PROBLEMS. 2015 19 1526 40 IYENGAR YOGA FOR ADOLESCENTS AND YOUNG ADULTS WITH IRRITABLE BOWEL SYNDROME. OBJECTIVES: IRRITABLE BOWEL SYNDROME (IBS) IS A CHRONIC, DISABLING CONDITION THAT GREATLY COMPROMISES PATIENT FUNCTIONING. THE AIM OF THIS STUDY WAS TO ASSESS THE IMPACT OF A 6-WEEK TWICE PER WEEK IYENGAR YOGA (IY) PROGRAM ON IBS SYMPTOMS IN ADOLESCENTS AND YOUNG ADULTS (YA) WITH IBS COMPARED WITH A USUAL-CARE WAITLIST CONTROL GROUP. METHODS: ASSESSMENTS OF SYMPTOMS, GLOBAL IMPROVEMENT, PAIN, HEALTH-RELATED QUALITY OF LIFE, PSYCHOLOGICAL DISTRESS, FUNCTIONAL DISABILITY, FATIGUE, AND SLEEP WERE COLLECTED PRE- AND POSTTREATMENT. WEEKLY RATINGS OF PAIN, IBS SYMPTOMS, AND GLOBAL IMPROVEMENT WERE ALSO RECORDED UNTIL 2-MONTH FOLLOW-UP. A TOTAL OF 51 PARTICIPANTS COMPLETED THE INTERVENTION (YOGA = 29; USUAL-CARE WAITLIST = 22). RESULTS: BASELINE ATTRITION WAS 24%. ON AVERAGE, THE YOGA GROUP ATTENDED 75% OF CLASSES. ANALYSES WERE DIVIDED BY AGE GROUP. RELATIVE TO CONTROLS, ADOLESCENTS (14-17 YEARS) ASSIGNED TO YOGA REPORTED SIGNIFICANTLY IMPROVED PHYSICAL FUNCTIONING, WHEREAS YA (18-26 YEARS) ASSIGNED TO YOGA REPORTED SIGNIFICANTLY IMPROVED IBS SYMPTOMS, GLOBAL IMPROVEMENT, DISABILITY, PSYCHOLOGICAL DISTRESS, SLEEP QUALITY, AND FATIGUE. ALTHOUGH ABDOMINAL PAIN INTENSITY WAS STATISTICALLY UNCHANGED, 44% OF ADOLESCENTS AND 46% OF YA REPORTED A MINIMALLY CLINICALLY SIGNIFICANT REDUCTION IN PAIN FOLLOWING YOGA, AND ONE-THIRD OF YA REPORTED CLINICALLY SIGNIFICANT LEVELS OF GLOBAL SYMPTOM IMPROVEMENT. ANALYSIS OF THE UNCONTROLLED EFFECTS AND MAINTENANCE OF TREATMENT EFFECTS FOR ADOLESCENTS REVEALED GLOBAL IMPROVEMENT IMMEDIATELY POST-YOGA THAT WAS NOT MAINTAINED AT FOLLOW-UP. FOR YA, GLOBAL IMPROVEMENT, WORST PAIN, CONSTIPATION, AND NAUSEA WERE SIGNIFICANTLY IMPROVED POSTYOGA, BUT ONLY GLOBAL IMPROVEMENT, WORST PAIN, AND NAUSEA MAINTAINED AT THE 2-MONTH FOLLOW-UP. CONCLUSIONS: THE FINDINGS SUGGEST THAT A BRIEF IY INTERVENTION IS A FEASIBLE AND SAFE ADJUNCTIVE TREATMENT FOR YOUNG PEOPLE WITH IBS, LEADING TO BENEFITS IN A NUMBER OF IBS-SPECIFIC AND GENERAL FUNCTIONING DOMAINS FOR YA. THE AGE-SPECIFIC RESULTS SUGGEST THAT YOGA INTERVENTIONS MAY BE MOST FRUITFUL WHEN DEVELOPMENTALLY TAILORED. 2014 20 1865 46 RANDOMIZED PILOT TRIAL OF YOGA VERSUS STRENGTHENING EXERCISES IN BREAST CANCER SURVIVORS WITH CANCER-RELATED FATIGUE. PURPOSE: FATIGUE IS ONE OF THE MOST COMMON AND BOTHERSOME REFRACTORY SYMPTOMS EXPERIENCED BY CANCER SURVIVORS. MINDFUL EXERCISE INTERVENTIONS SUCH AS YOGA IMPROVE CANCER-RELATED FATIGUE; HOWEVER, STUDIES OF YOGA HAVE INCLUDED HETEROGENEOUS SURVIVORSHIP POPULATIONS, AND THE EFFECT OF YOGA ON FATIGUED SURVIVORS REMAINS UNCLEAR. METHODS: WE RANDOMLY ASSIGNED 34 EARLY-STAGE BREAST CANCER SURVIVORS WITH CANCER-RELATED FATIGUE (>/=4 ON A LIKERT SCALE FROM 1-10) WITHIN 1 YEAR FROM DIAGNOSIS TO A 12-WEEK INTERVENTION OF HOME-BASED YOGA VERSUS STRENGTHENING EXERCISES, BOTH PRESENTED ON A DVD. THE PRIMARY ENDPOINTS WERE FEASIBILITY AND CHANGES IN FATIGUE, AS MEASURED BY THE MULTIDIMENSIONAL FATIGUE SYMPTOM INVENTORY-SHORT FORM (MFSI-SF). SECONDARY ENDPOINT WAS QUALITY OF LIFE, ASSESSED BY THE FUNCTIONAL ASSESSMENT OF CANCER THERAPIES-BREAST (FACT-B). RESULTS: WE INVITED 401 WOMEN TO PARTICIPATE IN THE STUDY; 78 RESPONDED, AND WE ENROLLED 34. BOTH GROUPS HAD SIGNIFICANT WITHIN-GROUP IMPROVEMENT IN MULTIPLE DOMAINS OF THE FATIGUE AND QUALITY OF LIFE SCORES FROM BASELINE TO POST-INTERVENTION, AND THESE BENEFITS WERE MAINTAINED AT 3 MONTHS POST-INTERVENTION. HOWEVER, THERE WAS NO SIGNIFICANT DIFFERENCE BETWEEN GROUPS IN FATIGUE OR QUALITY OF LIFE AT ANY ASSESSMENT TIME. SIMILARLY, THERE WAS NO DIFFERENCE BETWEEN GROUPS IN ADHERENCE TO THE EXERCISE INTERVENTION. CONCLUSIONS: BOTH DVD-BASED YOGA AND STRENGTHENING EXERCISES DESIGNED FOR CANCER SURVIVORS MAY BE GOOD OPTIONS TO ADDRESS FATIGUE IN BREAST CANCER SURVIVORS. BOTH HAVE REASONABLE UPTAKE, ARE CONVENIENT AND REPRODUCIBLE, AND MAY BE HELPFUL IN DECREASING FATIGUE AND IMPROVING QUALITY OF LIFE IN THE FIRST YEAR POST-DIAGNOSIS IN BREAST CANCER PATIENTS WITH CANCER-RELATED FATIGUE. 2016