1  743 162 EFFECT OF RESTORATIVE YOGA VS. STRETCHING ON DIURNAL CORTISOL DYNAMICS AND PSYCHOSOCIAL OUTCOMES IN INDIVIDUALS WITH THE METABOLIC SYNDROME: THE PRYSMS RANDOMIZED CONTROLLED TRIAL. PURPOSE: CHRONIC STIMULATION AND DYSREGULATION OF THE NEUROENDOCRINE SYSTEM BY STRESS MAY CAUSE METABOLIC ABNORMALITIES. WE ESTIMATED HOW MUCH CORTISOL AND PSYCHOSOCIAL OUTCOMES IMPROVED WITH A RESTORATIVE YOGA (RELAXATION) VERSUS A LOW IMPACT STRETCHING INTERVENTION FOR INDIVIDUALS WITH THE METABOLIC SYNDROME. METHODS: WE CONDUCTED A 1-YEAR MULTI-CENTER RANDOMIZED CONTROLLED TRIAL (6-MONTH INTERVENTION AND 6-MONTH MAINTENANCE PHASE) OF RESTORATIVE YOGA VS. STRETCHING. PARTICIPANTS COMPLETED SURVEYS TO ASSESS DEPRESSION, SOCIAL SUPPORT, POSITIVE AFFECT, AND STRESS AT BASELINE, 6 MONTHS AND 12 MONTHS. FOR EACH ASSESSMENT, WE COLLECTED SALIVA AT FOUR POINTS DAILY FOR THREE DAYS AND COLLECTED RESPONSE TO DEXAMETHASONE ON THE FOURTH DAY FOR ANALYSIS OF DIURNAL CORTISOL DYNAMICS. WE ANALYZED OUR DATA USING MULTIVARIATE REGRESSION MODELS, CONTROLLING FOR STUDY SITE, MEDICATIONS (ANTIDEPRESSANTS, HORMONE THERAPY), BODY MASS INDEX, AND BASELINE CORTISOL VALUES. RESULTS: PSYCHOSOCIAL OUTCOME MEASURES WERE AVAILABLE FOR 171 STUDY PARTICIPANTS AT BASELINE, 140 AT 6 MONTHS, AND 132 AT 1 YEAR. COMPLETE CORTISOL DATA WERE AVAILABLE FOR 136 OF 171 STUDY PARTICIPANTS (72 IN RESTORATIVE YOGA AND 64 IN STRETCHING) AND WERE ONLY AVAILABLE AT BASELINE AND 6 MONTHS. AT 6 MONTHS, THE STRETCHING GROUP HAD DECREASED CORTISOL AT WAKING AND BEDTIME COMPARED TO THE RESTORATIVE YOGA GROUP. THE PATTERN OF CHANGES IN STRESS MIRRORED THIS IMPROVEMENT, WITH THE STRETCHING GROUP SHOWING REDUCTIONS IN CHRONIC STRESS SEVERITY AND PERSEVERATIVE THOUGHTS ABOUT THEIR STRESS. PERCEIVED STRESS DECREASED BY 1.5 POINTS (-0.4; 3.3, P=0.11) AT 6 MONTHS, AND BY 2.0 POINTS (0.1; 3.9, P=0.04) AT 1 YEAR IN THE STRETCHING COMPARED TO RESTORATIVE YOGA GROUPS. POST HOC ANALYSES SUGGEST THAT IN THE STRETCHING GROUP ONLY, PERCEIVED INCREASES IN SOCIAL SUPPORT (PARTICULARLY FEELINGS OF BELONGING), BUT NOT CHANGES IN STRESS WERE RELATED TO IMPROVED CORTISOL DYNAMICS. CONCLUSIONS: WE FOUND SIGNIFICANT DECREASES IN SALIVARY CORTISOL, CHRONIC STRESS SEVERITY, AND STRESS PERCEPTION IN THE STRETCHING GROUP COMPARED TO THE RESTORATIVE YOGA GROUP. GROUP SUPPORT DURING THE INTERACTIVE STRETCH CLASSES MAY HAVE CONTRIBUTED TO THESE CHANGES.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
2 1582  38 MEDIATORS OF YOGA AND STRETCHING FOR CHRONIC LOW BACK PAIN. ALTHOUGH YOGA IS AN EFFECTIVE TREATMENT FOR CHRONIC LOW BACK PAIN, LITTLE IS KNOWN ABOUT THE MECHANISMS RESPONSIBLE FOR ITS BENEFITS. IN A TRIAL COMPARING YOGA TO INTENSIVE STRETCHING AND SELF-CARE, WE EXPLORED WHETHER PHYSICAL (HOURS OF BACK EXERCISE/WEEK), COGNITIVE (FEAR AVOIDANCE, BODY AWARENESS, AND SELF-EFFICACY), AFFECTIVE (PSYCHOLOGICAL DISTRESS, PERCEIVED STRESS, POSITIVE STATES OF MIND, AND SLEEP), AND PHYSIOLOGICAL FACTORS (CORTISOL, DHEA) MEDIATED THE EFFECTS OF YOGA OR STRETCHING ON BACK-RELATED DYSFUNCTION (ROLAND-MORRIS DISABILITY SCALE (RDQ)). FOR YOGA, 36% OF THE EFFECT ON 12-WEEK RDQ WAS MEDIATED BY INCREASED SELF-EFFICACY, 18% BY SLEEP DISTURBANCE, 9% BY HOURS OF BACK EXERCISE, AND 61% BY THE BEST COMBINATION OF ALL POSSIBLE MEDIATORS (6 MEDIATORS). FOR STRETCHING, 23% OF THE EFFECT WAS MEDIATED BY INCREASED SELF-EFFICACY, 14% BY DAYS OF BACK EXERCISE, AND 50% BY THE BEST COMBINATION OF ALL POSSIBLE MEDIATORS (7 MEDIATORS). IN OPEN-ENDED QUESTIONS, >/=20% OF PARTICIPANTS NOTED THE FOLLOWING TREATMENT BENEFITS: LEARNING NEW EXERCISES (BOTH GROUPS), RELAXATION, INCREASED AWARENESS, AND THE BENEFITS OF BREATHING (YOGA), BENEFITS OF REGULAR PRACTICE (STRETCHING). ALTHOUGH BOTH SELF-EFFICACY AND HOURS OF BACK EXERCISE WERE THE STRONGEST MEDIATORS FOR EACH INTERVENTION, COMPARED TO SELF-CARE, QUALITATIVE DATA SUGGEST THAT THEY MAY EXERT THEIR BENEFITS THROUGH PARTIALLY DISTINCT MECHANISMS.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
3  193  37 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
4 1194  37 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
5 1898  48 RESTORATIVE YOGA AND METABOLIC RISK FACTORS: THE PRACTICING RESTORATIVE YOGA VS. STRETCHING FOR THE METABOLIC SYNDROME (PRYSMS) RANDOMIZED TRIAL. AIMS: INTENSIVE LIFESTYLE CHANGE PREVENTS TYPE 2 DIABETES BUT IS DIFFICULT TO SUSTAIN. PRELIMINARY EVIDENCE SUGGESTS THAT YOGA MAY IMPROVE METABOLIC FACTORS. WE TESTED A RESTORATIVE YOGA INTERVENTION VS. ACTIVE STRETCHING FOR METABOLIC OUTCOMES. METHODS: IN 2009-2012, WE CONDUCTED A 48-WEEK RANDOMIZED TRIAL COMPARING RESTORATIVE YOGA VS. STRETCHING AMONG UNDERACTIVE ADULTS WITH THE METABOLIC SYNDROME AT THE UNIVERSITIES OF CALIFORNIA, SAN FRANCISCO AND SAN DIEGO. WE PROVIDED LIFESTYLE COUNSELING AND A TAPERING SERIES OF 90-MIN GROUP CLASSES IN THE 24-WEEK INTERVENTION PERIOD AND 24-WEEK MAINTENANCE PERIOD. FASTING AND 2-H GLUCOSE, HBA1C, TRIGLYCERIDES, HDL-CHOLESTEROL, INSULIN, SYSTOLIC BLOOD PRESSURE, VISCERAL FAT, AND QUALITY OF LIFE WERE ASSESSED AT BASELINE, 6- AND 12-MONTHS. RESULTS: 180 PARTICIPANTS WERE RANDOMIZED AND 135 (75%) COMPLETED THE TRIAL. AT 12 MONTHS, FASTING GLUCOSE DECREASED MORE IN THE YOGA GROUP THAN IN THE STRETCHING GROUP (-0.35 MMOL/L VS. -0.03 MMOL/L; P=0.002); THERE WERE NO OTHER SIGNIFICANT DIFFERENCES BETWEEN GROUPS. AT 6 MONTHS FAVORABLE CHANGES WITHIN THE YOGA GROUP INCLUDED REDUCTIONS IN FASTING GLUCOSE, INSULIN, AND HBA1C AND AN INCREASE IN HDL-CHOLESTEROL THAT WERE NOT SUSTAINED AT 1 YEAR EXCEPT CHANGES IN FASTING GLUCOSE. THE STRETCHING GROUP HAD A SIGNIFICANT REDUCTION IN TRIGLYCERIDES AT 6 MONTHS WHICH WAS NOT SUSTAINED AT 1 YEAR BUT HAD IMPROVED QUALITY OF LIFE AT BOTH TIME-POINTS. CONCLUSIONS: RESTORATIVE YOGA WAS MARGINALLY BETTER THAN STRETCHING FOR IMPROVING FASTING GLUCOSE BUT NOT OTHER METABOLIC FACTORS.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
6 2830  38 YOGA VS STRETCHING IN VETERANS WITH CHRONIC LOWER BACK PAIN AND THE ROLE OF MINDFULNESS: A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THE PURPOSE OF THIS STUDY WAS TO INVESTIGATE THE FEASIBILITY OF RECRUITING, RANDOMIZING, ENROLLING, AND COLLECTING OUTCOME DATA ON VETERAN PATIENTS WITH CHRONIC LOW BACK PAIN (CLBP) WHO UNDERGO AN 8-WEEK, ACTIVE EXERCISE CLASS WITH MINDFULNESS (YOGA CLASS) AND WITHOUT (STRETCHING CLASS). METHODS: UNITED STATES VETERANS WITH CLBP BASED ON INCLUSION/EXCLUSION CRITERIA WERE RANDOMIZED TO 1 OF 2 GROUPS. THE STUDY DESIGN WAS A PILOT RANDOMIZED CONTROLLED TRIAL. TWENTY CLBP PATIENTS ATTENDED A YOGA CLASS OR STRETCHING CLASS ONCE PER WEEK FOR 8 WEEKS AT THE VETERANS AFFAIRS ROCHESTER OUTPATIENT CENTER, ROCHESTER, NEW YORK. THE FOLLOWING MEASUREMENTS WERE OBTAINED: RECRUITMENT OR ENROLLMENT DATA, COMPLIANCE DATA TO INCLUDE CLASS ATTENDANCE AND HOME EXERCISE, AND COMPLIANCE DATA REGARDING ABILITY TO COLLECT OUTCOME MEASURES AT BASELINE AND AT COMPLETION. OUTCOME MEASURES INCLUDED PAIN (PEG), QUALITY OF LIFE (PROMIS GLOBAL HEALTH SURVEY), SELF-EFFICACY (2-ITEM QUESTIONNAIRE), FEAR AVOIDANCE BELIEF, CATASTROPHIZING, AND SOCIAL ENGAGEMENT IN ADDITION TO QUALITATIVE CLINICIAN OPEN-ENDED QUESTIONS POSTINTERVENTION. RESULTS: FORTY-FIVE VETERANS WERE QUERIED REGARDING INTEREST IN PARTICIPATION. OF THESE, 34 (76%) MET THE STUDY'S CRITERIA. TWENTY (44%) AGREED TO PARTICIPATE AND WERE CONSENTED, RANDOMIZED, AND ENROLLED IN THE STUDY. INITIAL AND FINAL OUTCOME MEASURES WERE OBTAINED FOR EACH PARTICIPANT (100%). FORTY PERCENT ATTENDED MORE THAN 80% OF THE SESSIONS FOR BOTH YOGA AND STRETCHING GROUPS. CONCLUSION: THIS PILOT STUDY DEMONSTRATED FEASIBILITY OF RECRUITING, ENROLLING, AND COLLECTING OUTCOME DATA ON CLBP VETERAN PATIENTS PARTICIPATING IN YOGA AND STRETCHING CLASS. THE DATA FROM THIS PILOT WILL INFORM THE DEVELOPMENT OF A RANDOMIZED, COMPARATIVE EFFECTIVENESS STUDY OF YOGA WITH AND WITHOUT MINDFULNESS IN THE MANAGEMENT OF CLBP.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
7 2138  37 THE EFFECTS OF AN 8-WEEK HATHA YOGA INTERVENTION ON EXECUTIVE FUNCTION IN OLDER ADULTS. BACKGROUND: FEW SCIENTIFIC STUDIES HAVE EXAMINED MOVEMENT-BASED EMBODIED CONTEMPLATIVE PRACTICES SUCH AS YOGA AND THEIR EFFECTS ON COGNITION. THE PURPOSE OF THIS RANDOMIZED CONTROLLED TRIAL WAS TO EXAMINE THE EFFECTS OF AN 8-WEEK HATHA YOGA INTERVENTION ON EXECUTIVE FUNCTION MEASURES OF TASK SWITCHING AND WORKING MEMORY CAPACITY. METHODS: COMMUNITY-DWELLING OLDER ADULTS (N = 118; MEAN AGE = 62.0) WERE RANDOMIZED TO ONE OF TWO GROUPS: A HATHA YOGA INTERVENTION OR A STRETCHING-STRENGTHENING CONTROL. BOTH GROUPS PARTICIPATED IN HOUR-LONG EXERCISE CLASSES 3X/WEEK OVER THE 8-WEEK STUDY PERIOD. ALL PARTICIPANTS COMPLETED ESTABLISHED TESTS OF EXECUTIVE FUNCTION INCLUDING THE TASK SWITCHING PARADIGM, N-BACK AND RUNNING MEMORY SPAN AT BASELINE AND FOLLOW-UP. RESULTS: ANALYSIS OF COVARIANCES SHOWED SIGNIFICANTLY SHORTER REACTION TIMES ON THE MIXED AND REPEAT TASK SWITCHING TRIALS (PARTIAL ETA(2) = .04, P < .05) FOR THE HATHA YOGA GROUP. HIGHER ACCURACY WAS RECORDED ON THE SINGLE TRIALS (PARTIAL ETA(2) = .05, P < .05), THE 2-BACK CONDITION OF THE N-BACK (PARTIAL ETA(2) = .08, P < .001), AND PARTIAL RECALL SCORES (PARTIAL ETA(2) = .06, P < .01) OF RUNNING SPAN TASK. CONCLUSIONS: FOLLOWING 8 WEEKS OF YOGA PRACTICE, PARTICIPANTS IN THE YOGA INTERVENTION GROUP SHOWED SIGNIFICANTLY IMPROVED PERFORMANCE ON THE EXECUTIVE FUNCTION MEASURES OF WORKING MEMORY CAPACITY AND EFFICIENCY OF MENTAL SET SHIFTING AND FLEXIBILITY COMPARED WITH THEIR STRETCHING-STRENGTHENING COUNTERPARTS. ALTHOUGH THE UNDERLYING MECHANISMS NEED TO BE INVESTIGATED, THESE RESULTS DEMAND LARGER SYSTEMATIC TRIALS TO THOROUGHLY EXAMINE EFFECTS OF YOGA ON EXECUTIVE FUNCTION AS WELL AS ACROSS OTHER DOMAINS OF COGNITION, AND ITS POTENTIAL TO MAINTAIN OR IMPROVE COGNITIVE FUNCTIONING IN THE AGING PROCESS.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
8  521  45 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
9  388  41 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
10 1863  37 RANDOMIZED CONTROLLED TRIAL OF YOGA AND EXERCISE IN MULTIPLE SCLEROSIS. OBJECTIVE: TO DETERMINE THE EFFECT OF YOGA AND OF AEROBIC EXERCISE ON COGNITIVE FUNCTION, FATIGUE, MOOD, AND QUALITY OF LIFE IN MULTIPLE SCLEROSIS (MS). METHODS: SUBJECTS WITH CLINICALLY DEFINITE MS AND EXPANDED DISABILITY STATUS SCORE LESS THAN OR EQUAL TO 6.0 WERE RANDOMLY ASSIGNED TO ONE OF THREE GROUPS LASTING 6 MONTHS: WEEKLY IYENGAR YOGA CLASS ALONG WITH HOME PRACTICE, WEEKLY EXERCISE CLASS USING A STATIONARY BICYCLE ALONG WITH HOME EXERCISE, OR A WAITING-LIST CONTROL GROUP. OUTCOME ASSESSMENTS PERFORMED AT BASELINE AND AT THE END OF THE 6-MONTH PERIOD INCLUDED A BATTERY OF COGNITIVE MEASURES FOCUSED ON ATTENTION, PHYSIOLOGIC MEASURES OF ALERTNESS, PROFILE OF MOOD STATES, STATE-TRAIT ANXIETY INVENTORY, MULTI-DIMENSIONAL FATIGUE INVENTORY (MFI), AND SHORT FORM (SF)-36 HEALTH-RELATED QUALITY OF LIFE. RESULTS: SIXTY-NINE SUBJECTS WERE RECRUITED AND RANDOMIZED. TWELVE SUBJECTS DID NOT FINISH THE 6-MONTH INTERVENTION. THERE WERE NO ADVERSE EVENTS RELATED TO THE INTERVENTION. THERE WERE NO EFFECTS FROM EITHER OF THE ACTIVE INTERVENTIONS ON EITHER OF THE PRIMARY OUTCOME MEASURES OF ATTENTION OR ALERTNESS. BOTH ACTIVE INTERVENTIONS PRODUCED IMPROVEMENT IN SECONDARY MEASURES OF FATIGUE COMPARED TO THE CONTROL GROUP: ENERGY AND FATIGUE (VITALITY) ON THE SF-36 AND GENERAL FATIGUE ON THE MFI. THERE WERE NO CLEAR CHANGES IN MOOD RELATED TO YOGA OR EXERCISE. CONCLUSION: SUBJECTS WITH MS PARTICIPATING IN EITHER A 6-MONTH YOGA CLASS OR EXERCISE CLASS SHOWED SIGNIFICANT IMPROVEMENT IN MEASURES OF FATIGUE COMPARED TO A WAITING-LIST CONTROL GROUP. THERE WAS NO RELATIVE IMPROVEMENT OF COGNITIVE FUNCTION IN EITHER OF THE INTERVENTION GROUPS.	2004	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
11 2194  39 THE EFFECTS OF YOGA VERSUS STRETCHING AND RESISTANCE TRAINING EXERCISES ON PSYCHOLOGICAL DISTRESS FOR PEOPLE WITH MILD-TO-MODERATE PARKINSON'S DISEASE: STUDY PRXOTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: PSYCHOLOGICAL DISTRESS IS PREVALENT AMONG PEOPLE WITH PARKINSON'S DISEASE (PD) AND AGGRAVATES THEIR MOTOR SYMPTOMS, THEREBY LEADING TO INCREASED DISABILITY, HIGH HEALTHCARE COSTS, AND POOR HEALTH-RELATED QUALITY OF LIFE (HRQOL). THE UNDER-RECOGNITION AND ADVERSE EFFECTS OF THE PHARMACOLOGICAL MANAGEMENT OF ANXIETY AND DEPRESSION AMONG THE PD POPULATION ARE CONSIDERABLE. THUS, ADOPTING A COMPLEMENTARY AND ALTERNATIVE MANAGEMENT (CAM) APPROACH TO ADDRESS THIS PROBLEM IS IMPORTANT. YOGA, ONE OF THE MOST COMMON "MIND-BODY" CAM THERAPIES, CAN IMPROVE THE PSYCHOLOGICAL WELLBEING OF PEOPLE WITH CHRONIC ILLNESSES. HOWEVER, LIMITED RESEARCH ON THE EFFECTS OF YOGA IN PEOPLE WITH PD HAS BEEN CONDUCTED. THIS STUDY WILL DETERMINE THE EFFECTS OF YOGA ON THE PSYCHOLOGICAL WELLBEING OF PEOPLE WITH MILD-TO-MODERATE PD AND WILL COMPARE THESE EFFECTS WITH THOSE OF STRETCHING AND RESISTANCE TRAINING EXERCISES. METHODS: A COMMUNITY-BASED, SINGLE-BLIND, RANDOMIZED TRIAL WILL BE CONDUCTED. A TOTAL OF 126 SUBJECTS WILL BE RECRUITED AND RANDOMLY DIVIDED INTO YOGA (N = 63) OR STRETCHING AND RESISTANCE EXERCISE (N = 63) GROUPS. FOR 8 WEEKS, THE YOGA GROUP WILL RECEIVE A WEEKLY 90-MIN SESSION OF YOGA, AND THE CONTROL GROUP WILL RECEIVE A WEEKLY 60-MIN SESSION OF STRETCHING AND RESISTANCE EXERCISES. THE PRIMARY OUTCOME WILL BE THE LEVEL OF PSYCHOLOGICAL DISTRESS MEASURED USING THE HOSPITAL ANXIETY AND DEPRESSION SCALE. THE SECONDARY OUTCOMES WILL INCLUDE THE SEVERITY OF MOTOR SYMPTOMS MEASURED BY THE MOVEMENT DISORDERS SOCIETY - UNIFIED PARKINSON'S DISEASE SCALE - PART III MOTOR EXAMINATION; MOBILITY, BALANCE, AND FALL RISK MEASURED BY THE TIMED UP AND GO TEST; SPIRITUAL WELLBEING MEASURED BY THE HOLISTIC WELLBEING SCALE; AND HRQOL MEASURED BY THE PARKINSON'S DISEASE QUESTIONNAIRE-8. ASSESSMENT WILL BE CONDUCTED AT BASELINE, 8TH, AND 20TH WEEKS OF FOLLOW-UPS. DISCUSSION: THIS STUDY WILL BE THE FIRST RANDOMIZED TRIAL TO COMPARE THE EFFECT OF YOGA VERSUS STRETCHING AND RESISTANCE TRAINING EXERCISES IN A PD POPULATION. RESULTS WILL CONTRIBUTE TO THE VALUE OF YOGA AS A THERAPEUTIC OPTION FOR MANAGING PSYCHOLOGICAL DISTRESS IN PD PATIENTS. MULTIPLE OUTCOMES INCLUDING PSYCHOLOGICAL, PHYSIOLOGICAL, AND SPIRITUAL AND HRQOL WILL ALSO BE MEASURED TO ELUCIDATE THE POTENTIAL MECHANISMS OF YOGA. THE EFFECT OF YOGA ON PEOPLE WITH CHRONIC ILLNESSES WILL FURTHER BE ELUCIDATED. THIS INFORMATION SHOULD CONTRIBUTE TO FUTURE RESEARCH, PRACTICE, AND POLICY RELATED TO PD MANAGEMENT. TRIAL REGISTRATION: WHO PRIMARY REGISTRY - CHINESE CLINICAL TRIALS REGISTRY (CHICTR): CUHK_CCRB00522 REGISTERED ON 8 OCTOBER 2016; DATE OF APPROVAL 19 AUGUST 2016.	2017	
                                                                                                                      
12  724  41 EFFECT OF LAUGHTER YOGA ON MOOD AND HEART RATE VARIABILITY IN PATIENTS AWAITING ORGAN TRANSPLANTATION: A PILOT STUDY. CONTEXT: RESEARCH SHOWS THAT LAUGHTER HAS MYRIAD HEALTH BENEFITS, YET THE MEDICAL COMMUNITY HAS NOT IMPLEMENTED IT FORMALLY AS A TREATMENT. PATIENTS AWAITING ORGAN TRANSPLANTATION HAVE SIGNIFICANT PHYSICAL DISABILITIES AND ARE AT RISK FOR PSYCHOLOGICAL DISTRESS. ATTENUATED HEART RATE VARIABILITY (HRV) IS A RISK FACTOR FOR A NEGATIVE LONG-TERM OUTCOME IN SOME PATIENTS. OBJECTIVE: THE STUDY INTENDED TO EVALUATE THE CLINICAL UTILITY OF LAUGHTER YOGA IN IMPROVING PSYCHOLOGICAL AND PHYSIOLOGICAL MEASURES IN OUTPATIENTS AWAITING ORGAN TRANSPLANTATION. POSITIVE RESULTS WOULD INDICATE PROMISING AREAS TO PURSUE IN A FOLLOW-UP STUDY. DESIGN: SIX PARTICIPANTS MET FOR 10 SESSIONS OVER 4 WEEKS. THE RESEARCH TEAM MEASURED EACH PARTICIPANT'S HEART RATE, HRV, BLOOD PRESSURE (BP), AND IMMEDIATE MOOD BEFORE AND AFTER THE LAUGHTER AND CONTROL INTERVENTIONS. THE TEAM ASSESSED PARTICIPANTS' LONGER-TERM MOOD (ANXIETY AND DEPRESSION) AT THE STUDY'S INITIATION, AFTER A NO-TREATMENT CONTROL WEEK, AND AT THE END OF THE STUDY. SETTING: THE STUDY OCCURRED AT THE DEPARTMENT OF SURGERY AND MEDICINE AT THE UNIVERSITY OF ARIZONA HEALTH SCIENCES CENTER, TUCSON. PARTICIPANTS: PARTICIPANTS WERE PATIENTS AWAITING TRANSPLANTS (THREE HEART AND THREE LUNG), TWO WOMEN AND FOUR MEN (AGES 51-69 Y). PARTICIPANTS HAD RECEIVED NO MAJOR SURGERY IN THE 3 MONTHS PRIOR TO THE INTERVENTION, DID NOT HAVE A HERNIA OR UNCONTROLLED HYPERTENSION, AND DID NOT FALL INTO THE NEW YORK HEART ASSOCIATION FUNCTION CLASS 4. INTERVENTION: THE 20-MINUTE LAUGHTER INTERVENTION INVOLVED BREATHING AND STRETCHING EXERCISES, SIMULATED LAUGHTER (IE, UNCONDITIONAL LAUGHTER THAT IS NOT CONTINGENT ON THE ENVIRONMENT), CHANTING, CLAPPING, AND A MEDITATION. THE 20-MINUTE CONTROL INTERVENTION INVOLVED THE STUDY'S PERSONNEL DISCUSSING HEALTH AND STUDY-RELATED TOPICS WITH THE PARTICIPANTS. OUTCOME MEASURES: THE RESEARCH TEAM MEASURED BP, HEART RATE, AND HRV AND ADMINISTERED THE PROFILE OF MOOD STATES, BECK ANXIETY INVENTORY, AND BECK DEPRESSION INVENTORY-II TO EVALUATE IMMEDIATE AND LONGER-TERM MOOD. THE TEAM HAD PLANNED QUANTITATIVE STATISTICAL ANALYSIS OF THE DATA AT THE STUDY'S INITIATION BUT DID NOT COMPLETE IT BECAUSE THE NUMBER OF ENROLLED PARTICIPANTS WAS TOO LOW FOR THE ANALYSIS TO BE MEANINGFUL. THE TEAM VISUALLY EXAMINED THE DATA, HOWEVER, FOR TRENDS THAT WOULD INDICATE AREAS TO EXAMINE FURTHER IN A FOLLOW-UP STUDY. RESULTS: PARTICIPANTS SHOWED IMPROVED IMMEDIATE MOOD (VIGOR-ACTIVITY AND FRIENDLINESS) AND INCREASED HRV AFTER THE LAUGHTER INTERVENTION. BOTH THE LAUGHTER AND CONTROL INTERVENTIONS APPEARED TO IMPROVE LONGER-TERM ANXIETY. TWO PARTICIPANTS AWAITING A LUNG TRANSPLANT DROPPED OUT OF THE STUDY, AND NO ADVERSE EVENTS OCCURRED. CONCLUSION: THIS PILOT STUDY SUGGESTS THAT LAUGHTER YOGA MAY IMPROVE HRV AND SOME ASPECTS OF MOOD, AND THIS TOPIC WARRANTS FURTHER RESEARCH.	2012	

13 2604  46 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 1742  34 PHYSICAL FITNESS OF OLDER ADULTS IN SENIOR ACTIVITY CENTRES AFTER 24-WEEK SILVER YOGA EXERCISES. AIMS AND OBJECTIVES: PROMOTING PHYSICAL FITNESS OF YOUNG-OLDER ADULTS IS ESSENTIAL IN REDUCING HEALTHCARE EXPENDITURES WHICH WOULD OCCUR IN THE FUTURE FOR THOSE WITH CHRONIC HEALTH PROBLEMS. THE SILVER YOGA EXERCISE PROGRAMME WAS DEVELOPED TO ACCOMMODATE THE REDUCED BODY FLEXIBILITY EXPERIENCED BY MANY OLDER ADULTS AND WAS CRITICALLY REVIEWED BY EXPERTS AND PILOT-TESTED WITH COMMUNITY-DWELLING OLDER ADULTS. THIS STUDY AIMED TO TEST OLDER ADULTS' PHYSICAL FITNESS AFTER A 24-WEEK SILVER YOGA EXERCISE PROGRAMME AND TO EXAMINE WHETHER THE PROGRAMME COULD BE FURTHER SHORTENED TO FIT SENIOR ACTIVITY CENTRES' PROGRAMME DESIGNS. DESIGN: A QUASI-EXPERIMENTAL, PRE-POST TESTS DESIGN WAS USED: BASELINE, AT 12-WEEK AND AT 24-WEEK PERIODS. METHODS: CONVENIENCE SAMPLES OF 204 SUBJECTS WERE RECRUITED FROM EIGHT SENIOR ACTIVITY CENTRES AND 176 SUBJECTS COMPLETED THE STUDY. SUBJECTS WERE RANDOMLY ASSIGNED INTO THREE GROUPS BASED ON THE CENTRES: (1) EXPERIMENT I: COMPLETE SILVER YOGA WITH STRETCHING AND MEDITATION, (2) EXPERIMENT II: SHORTENED SILVER YOGA WITHOUT THE GUIDED-IMAGERY MEDITATION AND (3) WAIT-LIST CONTROL. THE INTERVENTIONS WERE CONDUCTED THREE TIMES PER WEEK FOR 24 WEEKS. PHYSICAL FITNESS INDICATORS INCLUDED BODY COMPOSITIONS, CARDIOVASCULAR-RESPIRATORY FUNCTIONS, PHYSICAL FUNCTIONS AND THE RANGE OF MOTION. RESULTS: AT THE END OF THE 24-WEEK PERIOD, THE PHYSICAL FITNESS OF SUBJECTS IN EXPERIMENTS I AND II HAD SIGNIFICANTLY IMPROVED WHETHER OR NOT GUIDED-IMAGERY MEDITATION WAS USED AND ALL HAD BETTER PHYSICAL FITNESS THAN SUBJECTS IN THE CONTROL GROUP (ALL P < 0.05). CONCLUSIONS: THE PHYSICAL FITNESS OF OLDER ADULTS IN BOTH THE 70-MINUTE COMPLETE SILVER YOGA GROUP AND THE 55-MINUTE SHORTENED SILVER YOGA GROUP HAD SIGNIFICANTLY IMPROVED AFTER THE INTERVENTIONS. IT WAS RECOMMENDED THAT THE SILVER YOGA PROGRAMME BE SHORTENED BY ELIMINATING THE GUIDED-IMAGERY MEDITATION. RELEVANCE TO CLINICAL PRACTICE: THE SHORTENED SILVER YOGA EXERCISE PROGRAMME IS RECOMMENDED TO BE INCORPORATED AS AN ACTIVITY PROGRAMME IN COMMUNITY-SETTINGS TO PROMOTE THE PHYSICAL FITNESS OF OLDER ADULTS.	2008	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
15 1900  40 RESTORATIVE YOGA FOR WOMEN WITH BREAST CANCER: FINDINGS FROM A RANDOMIZED PILOT STUDY. OBJECTIVES: RESTORATIVE YOGA (RY) IS A GENTLE TYPE OF YOGA THAT MAY BE BENEFICIAL FOR CANCER PATIENTS AND POST-TREATMENT SURVIVORS. STUDY GOALS WERE: TO DETERMINE THE FEASIBILITY OF IMPLEMENTING A RY INTERVENTION FOR WOMEN WITH BREAST CANCER; AND TO EXAMINE GROUP DIFFERENCES IN SELF-REPORTED EMOTIONAL, HEALTH-RELATED QUALITY OF LIFE, AND SYMPTOM OUTCOMES. METHODS: WOMEN WITH BREAST CANCER (N=44; MEAN AGE 55.8 YEARS) ENROLLED IN THIS STUDY; 34% WERE ACTIVELY UNDERGOING CANCER TREATMENT. STUDY PARTICIPANTS WERE RANDOMIZED TO THE INTERVENTION (10 WEEKLY 75-MINUTE RY CLASSES) OR A WAITLIST CONTROL GROUP. PARTICIPANTS COMPLETED QUESTIONNAIRES AT WEEK 0 (BASELINE) AND WEEK 10 (IMMEDIATELY POST-INTERVENTION FOR THE YOGA GROUP). RESULTS: GROUP DIFFERENCES FAVORING THE YOGA GROUP WERE SEEN FOR MENTAL HEALTH, DEPRESSION, POSITIVE AFFECT, AND SPIRITUALITY (PEACE/MEANING). SIGNIFICANT BASELINE*GROUP INTERACTIONS WERE OBSERVED FOR NEGATIVE AFFECT AND EMOTIONAL WELL-BEING. WOMEN WITH HIGHER NEGATIVE AFFECT AND LOWER EMOTIONAL WELL-BEING AT BASELINE DERIVED GREATER BENEFIT FROM THE YOGA INTERVENTION COMPARED TO THOSE WITH SIMILAR VALUES AT BASELINE IN THE CONTROL GROUP. THE YOGA GROUP DEMONSTRATED A SIGNIFICANT WITHIN-GROUP IMPROVEMENT IN FATIGUE; NO SIGNIFICANT DIFFERENCE WAS NOTED FOR THE CONTROL GROUP. CONCLUSIONS: ALTHOUGH LIMITED BY SAMPLE SIZE, THESE PILOT DATA SUGGEST POTENTIAL BENEFIT OF RY ON EMOTIONAL OUTCOMES AND FATIGUE IN CANCER PATIENTS. THIS STUDY DEMONSTRATES THAT A RY INTERVENTION IS FEASIBLE FOR WOMEN WITH BREAST CANCER; IMPLICATIONS FOR STUDY DESIGN AND IMPLEMENTATION ARE NOTED WITH AN EMPHASIS ON PROGRAM ADOPTION AND PARTICIPANT ADHERENCE.	2009	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
16 1215  37 EXPLORING THE EFFECTS OF YOGA THERAPY ON HEART RATE VARIABILITY AND PATIENT-REPORTED OUTCOMES AFTER CANCER TREATMENT: A STUDY PROTOCOL. BACKGROUND: FOLLOWING CANCER TREATMENT, ADULTS COMMONLY REPORT WORSENED PATIENT-REPORTED OUTCOMES (PROS) SUCH AS ANXIETY, STRESS, DEPRESSION, PERSISTENT AND UPSETTING COGNITIVE COMPLAINTS, UNRELENTING FATIGUE, AND REDUCED QUALITY OF LIFE. POORER PROS ARE ASSOCIATED WITH DISRUPTED AUTONOMIC NERVOUS SYSTEM FUNCTIONING AS MEASURED BY HEART RATE VARIABILITY (HRV), BOTH OF WHICH HAVE BEEN ASSOCIATED WITH GREATER MORBIDITY AND MORTALITY. INTERVENTIONS TO IMPROVE HRV AND PROS AMONG ADULTS FOLLOWING CANCER TREATMENT ARE NEEDED. YOGA THERAPY HOLDS PROMISE AS AN INTERVENTION TO IMPROVE HRV AND PROS. THEREFORE, WE CONDUCTED A SINGLE-SUBJECT EXPLORATORY EXPERIMENTAL STUDY TO INVESTIGATE THE EFFECTS OF YOGA THERAPY ON HRV AND SPECIFIC PROS (IE, CANCER-RELATED FATIGUE, ANXIETY, COGNITIVE FUNCTION, DEPRESSION, STRESS, QUALITY OF LIFE) IN ADULTS TREATED FOR CANCER. TO REDUCE PUBLICATION BIAS, IMPROVE REPRODUCIBILITY, AND SERVE AS A REFERENCE FOR FORTHCOMING REPORTING OF STUDY RESULTS, WE PRESENT THE STUDY PROTOCOL FOR THIS STUDY HEREIN. METHODS: PARTICIPANTS WERE ADULTS WHO COMPLETED CANCER TREATMENT THAT WERE RECRUITED FROM THE OTTAWA INTEGRATIVE CANCER CENTRE. CONSENTING AND ELIGIBLE PARTICIPANTS RECEIVED ONE 1:1 YOGA THERAPY SESSION (IE, 1 PARTICIPANT, 1 YOGA THERAPIST) AND 6 WEEKLY GROUP-BASED YOGA THERAPY SESSIONS (IE, 2-3 PARTICIPANTS, 1 YOGA THERAPIST). PARTICIPANTS COMPLETED ASSESSMENTS 7 TIMES: 3 TIMES PRIOR TO THE PROGRAM (IE, -6 WEEKS, -3 WEEKS, IMMEDIATELY PRIOR TO THE 1:1 YOGA THERAPY SESSION), IMMEDIATELY FOLLOWING THE 1:1 YOGA THERAPY SESSION, PRIOR TO THE FIRST GROUP-BASED YOGA THERAPY SESSION, AFTER THE LAST GROUP-BASED YOGA THERAPY SESSION, AND AT A 6-WEEK FOLLOW-UP. HIERARCHICAL LINEAR MODELING WILL BE USED TO TEST THE AVERAGE EFFECTS OF THE YOGA THERAPY PROGRAM ACROSS PARTICIPANTS. DISCUSSION: THIS STUDY WILL EXPLORE SEVERAL NOVEL HYPOTHESES, INCLUDING WHETHER YOGA THERAPY CAN IMPROVE HRV AND/OR SPECIFIC PROS AMONG ADULTS TREATED FOR CANCER ACUTELY (IE, DURING A 1:1 YOGA THERAPY SESSION) AND/OR THROUGH REPEATED EXPOSURE (IE, AFTER COMPLETING 6 WEEKS OF GROUP-BASED YOGA THERAPY). ALTHOUGH THE FINDINGS WILL REQUIRE CONFIRMATION OR REFUTATION IN FUTURE TRIALS, THEY MAY PROVIDE INITIAL EVIDENCE THAT YT MAY BENEFIT ADULTS TREATED FOR CANCER. TRIAL REGISTRATION: ISRCTN REGISTRY, ISRCTN64763228. REGISTERED ON DECEMBER 12, 2021. THIS TRIAL WAS REGISTERED RETROSPECTIVELY. URL OF TRIAL REGISTRY RECORD: HTTPS://WWW.ISRCTN.COM/ISRCTN64763228.	2022	
                                                                                                                                                                                                                                                                                                                                                                       
17  201  41 A RESTORATIVE YOGA INTERVENTION FOR AFRICAN-AMERICAN BREAST CANCER SURVIVORS: A PILOT STUDY. BACKGROUND: DATA SHOW THAT YOGA IS EFFECTIVE FOR IMPROVING HEALTH-RELATED OUTCOMES IN BREAST CANCER SURVIVORS. WHILE BREAST CANCER IS THE MOST COMMONLY DIAGNOSED CANCER AMONG AFRICAN-AMERICAN WOMEN (AAW), AAW ARE LESS LIKELY TO ENGAGE IN YOGA COMPARED TO OTHER ETHNIC GROUPS. THE GOALS OF THE CURRENT STUDY WERE TO ASSESS THE FEASIBILITY OF AN 8-WEEK RESTORATIVE YOGA PROGRAM AMONG AFRICAN-AMERICAN BREAST CANCER SURVIVORS (AA BCS). SPECIFICALLY, STUDY AIMS WERE TO (1) MEASURE CHANGES IN STUDY OUTCOMES IN A RESTORATIVE YOGA (RY) GROUP COMPARED TO A WAIT LIST CONTROL GROUP, (2) ASSESS ADHERENCE TO THE RY PROGRAM, AND (3) ASSESS PROGRAM SATISFACTION AMONG STUDY PARTICIPANTS. METHODS: THIRTY-THREE AA BCS WERE RANDOMLY ASSIGNED TO EITHER THE RY INTERVENTION (N = 18) OR WAIT LIST CONTROL GROUP (N = 15). RY CLASSES MET ONCE PER WEEK FOR 8 WEEKS. PRE- AND POST-TESTING ASSESSMENTS WERE MEASURED AT 0 AND 8 WEEKS (IMMEDIATELY POST-INTERVENTION). RESULTS: DEPRESSION SCORES AT FOLLOW-UP WERE SIGNIFICANTLY LOWER IN THE YOGA GROUP (M = 4.78, SD = 3.56) COMPARED TO THE CONTROL GROUP (M = 6.91, SD = 5.86). NO SIGNIFICANT GROUP DIFFERENCES WERE OBSERVED FOR SLEEP QUALITY, FATIGUE, OR PERCEIVED STRESS. YOGA PROGRAM PARTICIPANTS COMPLETING BASELINE ASSESSMENTS DEMONSTRATED 61% ADHERENCE TO THE YOGA CLASSES. AVERAGE RATING OF THE YOGA PROGRAM WAS "VERY USEFUL." RECOMMENDATIONS FOR FUTURE YOGA PROGRAMS WERE PROVIDED. CONCLUSIONS: THIS STUDY SUGGESTS THAT YOGA HAS A BENEFICIAL EFFECT ON DEPRESSION IN AA BCS. THERE IS, HOWEVER, A NEED TO FURTHER EXPLORE THE BENEFITS OF YOGA AMONG MINORITY BREAST CANCER SURVIVORS USING A STUDY WITH LARGER SAMPLE SIZES.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
18  385  36 BENEFICIAL EFFECTS OF YOGA STRETCHING ON SALIVARY STRESS HORMONES AND PARASYMPATHETIC NERVE ACTIVITY. THIS STUDY AIMED TO DETERMINE THE EFFECT OF YOGA STRETCHING ON SALIVARY STRESS HORMONES AND CARDIAC AUTONOMIC NERVOUS SYSTEM. TO OUR KNOWLEDGE, THIS STUDY IS THE FIRST TO INVESTIGATE CHANGES IN CARDIAC AUTONOMIC NERVOUS SYSTEM AFTER YOGA STRETCHING. IN THIS CROSSOVER DESIGN STUDY, 10 ADULT MEN (AGE, 26.3 +/- 2.5 YEARS) WITHOUT YOGA EXPERIENCE PARTICIPATED IN THE REST AND YOGA TRIALS FOR 90 MIN. MEASUREMENTS WERE CARRIED OUT BEFORE (PRE), IMMEDIATELY (POST), 60 MIN, AND 120 MIN AFTER REST OR YOGA STRETCHING. SALIVA SAMPLES WERE COLLECTED BY CHEWING A STERILE COTTON BALL AT A FREQUENCY OF 60 CYCLES PER MINUTE. SALIVARY CORTISOL AND TESTOSTERONE CONCENTRATIONS WERE MEASURED USING AN ENZYME-LINKED IMMUNOSORBENT ASSAY. WITH THE SUBJECTS IN THE SITTING POSITION, HEART RATE VARIABILITY WAS MEASURED USING PULSE ANALYZER PLUS FOR 150 SECONDS. AS REGARDS RATE CHANGES, SALIVARY TESTOSTERONE LEVEL TENDED TO INCREASE (P = 0.088), TESTOSTERONE/CORTISOL RATIO SIGNIFICANTLY INCREASED (P < 0.05), AND CORTISOL LEVEL SIGNIFICANTLY DECREASED (P < 0.05) AT 120 MIN AFTER YOGA STRETCHING. THE SQUARE ROOT OF THE MEAN-SQUARED DIFFERENCES OF SUCCESSIVE NORMAL-TO-NORMAL INTERVALS AND NATURAL LOGARITHM HIGH-FREQUENCY COMPONENT, WHICH ARE INDICATORS OF PARASYMPATHETIC NERVE ACTIVITY, INCREASED AT 60 MIN (P < 0.05) AND 120 MIN (P < 0.05) IN THE YOGA TRIAL, RESPECTIVELY. IN CONCLUSION, YOGA STRETCHING CAN ENHANCE PARASYMPATHETIC NERVE ACTIVITY AND IMPROVE STRESS HORMONES. THEREFORE, YOGA STRETCHING MAY BE USEFUL TO COMPENSATE FOR PHYSICAL INACTIVITY AND INCREASE LIFE EXPECTANCY IN THE GENERAL POPULATION.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
19  720  40 EFFECT OF IYENGAR YOGA PRACTICE ON FATIGUE AND DIURNAL SALIVARY CORTISOL CONCENTRATION IN BREAST CANCER SURVIVORS. PURPOSE: TO EXAMINE THE EFFECT OF REGULAR IYENGAR YOGA PRACTICE ON MEASURES OF SELF-PERCEIVED PSYCHOSOCIAL FUNCTION AND DIURNAL SALIVARY CORTISOL SECRETION IN STAGE II-IV BREAST CANCER SURVIVORS (N = 18). DATA SOURCES: WOMEN WERE RANDOMLY ASSIGNED TO ATTEND YOGA PRACTICE FOR 90 MIN TWICE WEEKLY FOR 8 WEEKS (N = 9) OR TO A WAIT-LISTED, NONINTERVENTIONAL CONTROL GROUP (N = 9). TRADITIONAL IYENGAR YOGA ROUTINES THAT PROGRESSIVELY INCREASED IN DIFFICULTY AS PARTICIPANTS GAINED STRENGTH AND FLEXIBILITY WERE USED. AT BASELINE AND AFTER THE 8-WEEK STUDY PERIOD, WOMEN COMPLETED SELF-REPORT INSTRUMENTS TO DOCUMENT VARIOUS ASPECTS OF PSYCHOSOCIAL AND PHYSICAL FUNCTIONING, AND COLLECTED SALIVARY SAMPLES FOR CORTISOL ANALYSIS FOUR TIMES DURING THE DAY FOR TWO CONSECUTIVE DAYS. CONCLUSIONS: THE YOGA GROUP HAD LOWER MORNING AND 5 P.M. SALIVARY CORTISOL AND IMPROVED EMOTIONAL WELL-BEING AND FATIGUE SCORES. IMPLICATIONS FOR PRACTICE: BREAST CANCER SURVIVORS ARE AT RISK FOR CHRONIC PSYCHOSOCIAL DISTRESS THAT MAY ALTER ACTIVITY OF THE HYPOTHALAMIC-PITUITARY-ADRENAL AXIS, RESULTING IN ABERRANT REGULATION OF CORTISOL SECRETION AND INCREASED RISK OF IMMUNE DYSFUNCTION AND CANCER PROGRESSION. REGULAR YOGA PRACTICE MAY BE A LOW-RISK, COST-EFFECTIVE WAY TO IMPROVE PSYCHOSOCIAL FUNCTIONING, FATIGUE, AND REGULATION OF CORTISOL SECRETION IN BREAST CANCER SURVIVORS. THESE FINDINGS REQUIRE VALIDATION WITH A LARGER RANDOMIZED STUDY.	2011	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
20  536  46 COMPARISON OF YOGA VERSUS STRETCHING FOR CHRONIC LOW BACK PAIN: PROTOCOL FOR THE YOGA EXERCISE SELF-CARE (YES) TRIAL. BACKGROUND: BACK PAIN, ONE OF THE MOST PREVALENT CONDITIONS AFFLICTING AMERICAN ADULTS, IS THE LEADING REASON FOR USING COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) THERAPIES. YOGA IS AN INCREASINGLY POPULAR "MIND-BODY" CAM THERAPY OFTEN USED FOR RELIEVING BACK PAIN AND SEVERAL SMALL STUDIES HAVE FOUND YOGA EFFECTIVE FOR THIS CONDITION. THIS STUDY WILL ASSESS WHETHER YOGA IS EFFECTIVE FOR TREATING CHRONIC LOW BACK PAIN COMPARED WITH SELF CARE AND EXERCISE AND WILL EXPLORE THE MECHANISMS RESPONSIBLE FOR ANY OBSERVED BENEFITS. METHODS/DESIGN: A TOTAL OF 210 PARTICIPANTS WITH LOW BACK PAIN LASTING AT LEAST 3 MONTHS WILL BE RECRUITED FROM PRIMARY CARE CLINICS OF A LARGE HEALTHCARE SYSTEM BASED IN SEATTLE. THEY WILL BE RANDOMIZED IN A 2:2:1 RATIO TO RECEIVE 12 WEEKLY YOGA CLASSES, 12 WEEKLY CONVENTIONAL THERAPEUTIC EXERCISE CLASSES OF COMPARABLE PHYSICAL EXERTION, OR A SELF-CARE BOOK. INTERVIEWERS MASKED TO PARTICIPANTS' TREATMENT GROUP WILL ASSESS OUTCOMES AT BASELINE AND 6, 12 AND 26 WEEKS AFTER RANDOMIZATION. PRIMARY OUTCOMES WILL BE BACK-RELATED DYSFUNCTION AND SYMPTOM BOTHERSOMENESS. IN ADDITION, DATA WILL BE COLLECTED ON PHYSICAL MEASUREMENTS (E.G., FLEXION) AT BASELINE AND 12 WEEKS AND SALIVA SAMPLES WILL BE OBTAINED AT BASELINE, 6 AND 12 WEEKS. INFORMATION WILL BE COLLECTED ON SPECIFIC PHYSICAL, PSYCHOLOGICAL, AND PHYSIOLOGICAL FACTORS TO ALLOW EXPLORATION OF POSSIBLE MECHANISMS OF ACTION THROUGH WHICH YOGA COULD RELIEVE BACK PAIN AND DYSFUNCTION. THE EFFECTIVENESS OF YOGA WILL BE ASSESSED USING ANALYSIS OF COVARIANCE (USING GENERAL ESTIMATING EQUATIONS - GEE) WITHIN AN INTENTION-TO-TREAT CONTEXT. IF YOGA IS FOUND EFFECTIVE, FURTHER ANALYSES WILL EXPLORE WHETHER YOGA'S BENEFITS ARE ATTRIBUTABLE TO PHYSICAL, PSYCHOLOGICAL AND/OR PHYSIOLOGICAL FACTORS. CONCLUSIONS: THIS STUDY WILL PROVIDE THE CLEAREST EVIDENCE TO DATE ABOUT THE VALUE OF YOGA AS A THERAPEUTIC OPTION FOR TREATING CHRONIC BACK PAIN, AND IF THE RESULTS ARE POSITIVE, WILL HELP FOCUS FUTURE, MORE IN-DEPTH, RESEARCH ON THE MOST PROMISING POTENTIAL MECHANISMS OF ACTION IDENTIFIED BY THIS STUDY.	2010