1  383 144 BENDING WITHOUT BREAKING: A NARRATIVE REVIEW OF TRAUMA-SENSITIVE YOGA FOR WOMEN WITH PTSD. OBJECTIVE: THE PURPOSE OF THIS REVIEW IS TO EVALUATE THE PEER-REVIEWED EMPIRICAL EVIDENCE ON THE USE OF TRAUMA-SENSITIVE YOGA (TSY) FOR THE TREATMENT OF WOMEN WITH POST-TRAUMATIC STRESS DISORDER (PTSD): SPECIFICALLY INTERPERSONAL TRAUMA SUCH AS INTIMATE PARTNER VIOLENCE. TO DATE, NO SUCH REVIEW HAS BEEN CONDUCTED. METHODS: ARTICLES MEETING STUDY INCLUSIONARY CRITERIA WERE IDENTIFIED THROUGH ELECTRONIC DATABASE SEARCHES. A TOTAL OF FIVE STUDIES (N = 5) WERE SELECTED AND REVIEWED. THESE STUDIES INCLUDED TWO RANDOMIZED CONTROLLED TRIALS (RCT), ONE FOLLOW-UP OF AN RCT, ONE QUASI-EXPERIMENTAL STUDY, AND ONE QUALITATIVE STUDY. RESULTS: THERE IS TENTATIVE EVIDENCE TO SUPPORT THE EFFICACY OF TSY IN REDUCING PTSD, DEPRESSION, AND ANXIETY SYMPTOMATOLOGY FOR WOMEN WITH PTSD; THERE IS ALSO TENTATIVE EVIDENCE CONFIRMING THE FEASIBILITY OF IMPLEMENTING TSY AS AN ADJUNCTIVE MENTAL HEALTH INTERVENTION, PARTICULARLY FOR INDIVIDUALS WHO ARE NON-RESPONSIVE TO COGNITIVE-BASED PSYCHOTHERAPIES. THE QUALITATIVE FINDINGS SPEAK TO A NUMBER OF BENEFITS OF YOGA PRACTICE STIMULATED BY TSY PARTICIPATION CENTERING ON THE PHENOMENON OF PEACEFUL EMBODIMENT. CONCLUSIONS: REPLICATION OF THESE RESULTS USING LARGER AND MORE DIVERSE SAMPLES AND RIGOROUS STUDY DESIGNS BY INDEPENDENT RESEARCHERS WOULD ADD CREDIBILITY TO THESE FINDINGS AND CONTRIBUTE TO THE GROWING BODY OF KNOWLEDGE ON TSY. ADDITIONALLY, THERE IS A DEARTH OF STUDIES ON THIS NASCENT FORM OF THERAPEUTIC YOGA. THEREFORE, FURTHER RESEARCH IS NEEDED TO EXPLORE THE POTENTIAL EFFICACY OF TSY WITH OTHER TYPES OF TRAUMA, POPULATIONS, AND SETTINGS.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
2 2060  41 THE BENEFITS OF YOGA FOR WOMEN VETERANS WITH CHRONIC LOW BACK PAIN. OBJECTIVES: CHRONIC LOW BACK (CLBP) PAIN IS PREVALENT AMONG MILITARY VETERANS AND OFTEN LEADS TO FUNCTIONAL LIMITATIONS, PSYCHOLOGIC SYMPTOMS, LOWER QUALITY OF LIFE, AND HIGHER HEALTH CARE COSTS. AN INCREASING PROPORTION OF U.S. VETERANS ARE WOMEN, AND WOMEN VETERANS MAY HAVE DIFFERENT HEALTH CARE NEEDS THAN MEN VETERANS. THE PURPOSE OF THIS STUDY WAS TO ASSESS THE IMPACT OF A YOGA INTERVENTION ON WOMEN AND MEN WITH CLBP. SUBJECTS/SETTING/INTERVENTION: VA PATIENTS WITH CLBP WERE REFERRED BY PRIMARY CARE PROVIDERS TO A CLINICAL YOGA PROGRAM. DESIGN: RESEARCH PARTICIPANTS COMPLETED A BRIEF BATTERY OF QUESTIONNAIRES BEFORE THEIR FIRST YOGA CLASS AND AGAIN 10 WEEKS LATER IN A SINGLE-GROUP, PRE-POST STUDY DESIGN. OUTCOME MEASURES: QUESTIONNAIRES INCLUDED MEASURES OF PAIN (PAIN SEVERITY SCALE), DEPRESSION (CESD-10), ENERGY/FATIGUE, AND HEALTH-RELATED QUALITY OF LIFE (SF-12). YOGA ATTENDANCE AND HOME PRACTICE OF YOGA WERE ALSO MEASURED. REPEATED-MEASURES ANALYSIS OF VARIANCE WAS USED TO ANALYZE GROUP DIFFERENCES OVER TIME WHILE CONTROLLING FOR BASELINE DIFFERENCES. RESULTS: THE 53 PARTICIPANTS WHO COMPLETED BOTH ASSESSMENTS HAD A MEAN AGE OF 53 YEARS, AND WERE WELL EDUCATED, 41% NONWHITE, 49% MARRIED, AND HAD VARYING EMPLOYMENT STATUS. WOMEN PARTICIPANTS HAD SIGNIFICANTLY LARGER DECREASES IN DEPRESSION (P=0.046) AND PAIN "ON AVERAGE" (P=0.050), AND LARGER INCREASES IN ENERGY (P=0.034) AND SF-12 MENTAL HEALTH (P=0.044) THAN MEN WHO PARTICIPATED. THE GROUPS DID NOT DIFFER SIGNIFICANTLY ON YOGA ATTENDANCE OR HOME PRACTICE OF YOGA. CONCLUSIONS: THESE RESULTS SUGGEST THAT WOMEN VETERANS MAY BENEFIT MORE THAN MEN VETERANS FROM YOGA INTERVENTIONS FOR CHRONIC BACK PAIN. CONCLUSIONS ARE TENTATIVE BECAUSE OF THE SMALL SAMPLE SIZE AND QUASI-EXPERIMENTAL STUDY DESIGN. A MORE RIGOROUS STUDY IS BEING DESIGNED TO ANSWER THESE RESEARCH QUESTIONS MORE DEFINITIVELY.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
3 2008  35 STUDY PROTOCOL FOR YOGA-BASED LIFESTYLE INTERVENTION FOR HEALTHY AGEING PHENOTYPE IN THE OLDER ADULTS (YHAP): A TWO-ARMED, WAITLIST RANDOMISED CONTROLLED TRIAL WITH MULTIPLE PRIMARY OUTCOMES. INTRODUCTION: THE CONCEPTUALISATION OF HEALTHY AGEING PHENOTYPE (HAP) AND THE AVAILABILITY OF A TENTATIVE PANEL FOR HAP BIOMARKERS RAISE THE NEED TO TEST THE EFFICACY OF POTENTIAL INTERVENTIONS TO PROMOTE HEALTH IN OLDER ADULTS. THIS STUDY PROTOCOL REPORTS THE METHODOLOGY FOR A 24-WEEK PROGRAMME TO EXPLORE THE HOLISTIC INFLUENCE OF THE YOGA-BASED INTERVENTION ON THE (BIO)MARKERS OF HAP. METHODS AND ANALYSIS: THE STUDY IS A TWO-ARMED, RANDOMISED WAITLIST CONTROLLED TRIAL WITH BLINDED OUTCOME ASSESSORS AND MULTIPLE PRIMARY OUTCOMES. WE AIM TO RECRUIT 250 SUBJECTS, AGED 60-80 YEARS FROM THE RESIDENTIAL COMMUNITIES AND OLD AGE CLUBS IN BANGALORE CITY, INDIA, WHO WILL UNDERGO RANDOMISATION INTO INTERVENTION OR CONTROL ARMS (1:1). THE INTERVENTION WILL INCLUDE A YOGA-BASED PROGRAMME TAILORED FOR THE OLDER ADULTS, 1 HOUR PER DAY FOR 6 DAYS A WEEK, SPREAD FOR 24 WEEKS. DATA WOULD BE COLLECTED AT THE BASELINE AND POST-INTERVENTION, THE 24TH WEEK. THE MULTIPLE PRIMARY OUTCOMES OF THE STUDY ARE THE (BIO)MARKERS OF HAP: GLYCATED HAEMOGLOBIN, LOW-DENSITY LIPOPROTEIN CHOLESTEROL (LDL-C), SYSTOLIC BLOOD PRESSURE, AND FORCED EXPIRATORY VOLUME IN 1 S FOR PHYSIOLOGICAL AND METABOLIC HEALTH; DIGIT SYMBOL SUBSTITUTION TEST, TRAIL MAKING TESTS A AND B FOR COGNITION; HAND GRIP STRENGTH AND GAIT SPEED FOR PHYSICAL CAPABILITY; LONELINESS FOR SOCIAL WELL-BEING AND WHO QUALITY OF LIFE INSTRUMENT-SHORT FORM FOR QUALITY OF LIFE. THE SECONDARY OUTCOMES INCLUDE INFLAMMATORY MARKERS, TUMOUR NECROSIS FACTOR-ALPHA RECEPTOR II, C REACTIVE PROTEIN, INTERLEUKIN 6 AND SERUM KLOTHO LEVELS. ANALYSES WILL BE BY INTENTION-TO-TREAT AND THE HOLISTIC IMPACT OF YOGA ON HAP WILL BE ASSESSED USING GLOBAL STATISTICAL TEST. ETHICS AND DISSEMINATION: THE STUDY IS APPROVED BY THE INSTITUTIONAL ETHICS COMMITTEE OF SWAMI VIVEKANANDA YOGA ANUSANDHANA SAMSTHANA UNIVERSITY, BANGALORE (ID: RES/IEC-SVYASA/143/2019). WRITTEN INFORMED CONSENT WILL BE OBTAINED FROM EACH PARTICIPANT PRIOR TO INCLUSION. RESULTS WILL BE AVAILABLE THROUGH RESEARCH ARTICLES AND CONFERENCES. TRIAL REGISTRATION NUMBER: CTRI/2021/02/031373.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
4 2639  38 YOGA FOR VETERANS WITH CHRONIC LOW-BACK PAIN. OBJECTIVES: CHRONIC BACK PAIN AFFECTS A LARGE PROPORTION OF BOTH THE GENERAL POPULATION AND OF MILITARY VETERANS. ALTHOUGH NUMEROUS THERAPIES EXIST FOR TREATING CHRONIC BACK PAIN, THEY CAN BE COSTLY AND TEND TO HAVE LIMITED EFFECTIVENESS. THUS, DEMONSTRATING THE EFFICACY AND COST-EFFECTIVENESS OF ADDITIONAL TREATMENT ALTERNATIVES IS IMPORTANT. THE PURPOSE OF OUR STUDY WAS TO EXAMINE THE BENEFITS OF A YOGA INTERVENTION FOR VETERANS ADMINISTRATION (VA) PATIENTS. SUBJECTS/INTERVENTION: VA PATIENTS WITH CHRONIC BACK PAIN WERE REFERRED BY THEIR PRIMARY CARE PROVIDERS TO A YOGA PROGRAM AS PART OF CLINICAL CARE. BEFORE STARTING YOGA, A VA PHYSICIAN TRAINED IN YOGA EVALUATED EACH PATIENT TO ENSURE THAT THEY COULD PARTICIPATE SAFELY. DESIGN: THE RESEARCH STUDY CONSISTED OF COMPLETING A SHORT BATTERY OF QUESTIONNAIRES AT BASELINE AND AGAIN 10 WEEKS LATER. OUTCOME MEASURES: QUESTIONNAIRES INCLUDED MEASURES OF PAIN, DEPRESSION, ENERGY/FATIGUE, HEALTH-RELATED QUALITY OF LIFE, AND PROGRAM SATISFACTION. PAIRED T-TESTS WERE USED TO COMPARE BASELINE SCORES TO THOSE AT THE 10-WEEK FOLLOW-UP FOR THE SINGLE GROUP, PRE-POST DESIGN. CORRELATIONS WERE USED TO EXAMINE WHETHER YOGA ATTENDANCE AND HOME PRACTICE WERE ASSOCIATED WITH BETTER OUTCOMES. RESULTS: BASELINE AND FOLLOW-UP DATA WERE AVAILABLE FOR 33 PARTICIPANTS. PARTICIPANTS WERE VA PATIENTS WITH A MEAN AGE OF 55 YEARS. THEY WERE 21% FEMALE, 70% WHITE, 52% MARRIED, 68% COLLEGE GRADUATES, AND 44% WERE RETIRED. SIGNIFICANT IMPROVEMENTS WERE FOUND FOR PAIN, DEPRESSION, ENERGY/FATIGUE, AND THE SHORT FORM-12 MENTAL HEALTH SCALE. THE NUMBER OF YOGA SESSIONS ATTENDED AND THE FREQUENCY OF HOME PRACTICE WERE ASSOCIATED WITH IMPROVED OUTCOMES. PARTICIPANTS APPEARED HIGHLY SATISFIED WITH THE YOGA INSTRUCTOR AND MODERATELY SATISFIED WITH THE EASE OF PARTICIPATION AND HEALTH BENEFITS OF THE YOGA PROGRAM. CONCLUSIONS: PRELIMINARY DATA SUGGEST THAT A YOGA INTERVENTION FOR VA PATIENTS WITH CHRONIC BACK PAIN MAY IMPROVE THE HEALTH OF VETERANS. HOWEVER, THE LIMITATIONS OF A PRE-POST STUDY DESIGN MAKE CONCLUSIONS TENTATIVE. A LARGER RANDOMIZED, CONTROLLED TRIAL OF THE YOGA PROGRAM IS PLANNED.	2008	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
5  196  33 A RANDOMIZED TRIAL OF YOGA FOR STRESS AND SUBSTANCE USE AMONG PEOPLE LIVING WITH HIV IN REENTRY. BACKGROUND: PEOPLE IN REENTRY FROM PRISON OR JAIL (RETURNING CITIZENS) LIVING WITH HIV AND SUBSTANCE USE PROBLEMS OFTEN EXPERIENCE NUMEROUS STRESSORS AND ARE AT HIGH RISK FOR RESUMED SUBSTANCE USE. INTERVENTIONS ARE NEEDED TO MANAGE STRESS AS A PATHWAY TO REDUCED SUBSTANCE USE. OBJECTIVE: THIS STUDY EXPLORED THE EFFECT OF A HATHA YOGA INTERVENTION AS COMPARED TO TREATMENT AS USUAL ON STRESS AND SUBSTANCE USE AMONG RETURNING CITIZENS LIVING WITH HIV AND SUBSTANCE USE PROBLEMS. METHODS: PARTICIPANTS WERE RANDOMIZED TO EITHER A 12-SESSION, 90-MINUTE WEEKLY YOGA INTERVENTION OR TREATMENT AS USUAL. ALL PARTICIPANTS WERE CLIENTS OF A SERVICE PROVIDER FOR RETURNING CITIZENS THAT OFFERED CASE MANAGEMENT, HEALTH CARE, AND EDUCATIONAL CLASSES. OUTCOMES INCLUDED STRESS AS MEASURED BY THE PERCEIVED STRESS SCALE AT THE COMPLETION OF THE YOGA INTERVENTION (THREE-MONTHS) AND SUBSTANCE USE AS MEASURED BY THE TIMELINE FOLLOWBACK AT ONE-MONTH, TWO-MONTHS, AND THREE-MONTHS. RESULTS: SEVENTY-FIVE PEOPLE WERE ENROLLED, TWO OF WHOM WERE WITHDRAWN FROM THE STUDY BECAUSE THEY DID NOT HAVE HIV. OF THE 73 REMAINING PARTICIPANTS, 85% PARTICIPATED IN THE THREE-MONTH ASSESSMENT. AT THREE-MONTHS, YOGA PARTICIPANTS REPORTED LESS STRESS THAN PARTICIPANTS IN TREATMENT AS USUAL [F (1,59)=9.24, P<.05]. YOGA PARTICIPANTS REPORTED LESS SUBSTANCE USE THAN PARTICIPANTS IN TREATMENT AS USUAL AT ONE-MONTH, TWO-MONTHS, AND THREE-MONTHS [X(2) (1)=11.13, P<.001]. CONCLUSION: YOGA INTERVENTIONS FOR RETURNING CITIZENS LIVING WITH HIV AND SUBSTANCE USE PROBLEMS MAY REDUCE STRESS AND SUBSTANCE USE. THIS FINDING IS TENTATIVE BECAUSE THE CONTROL GROUP DID NOT RECEIVE AN INTERVENTION OF EQUAL TIME AND INTENSITY.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
6 1541  37 KRIPALU YOGA FOR MILITARY VETERANS WITH PTSD: A RANDOMIZED TRIAL. OBJECTIVES: THIS RANDOMIZED CONTROLLED TRIAL OF YOGA FOR MILITARY VETERANS AND ACTIVE DUTY PERSONNEL WITH POSTTRAUMATIC STRESS DISORDER (PTSD) EVALUATED THE EFFICACY OF A 10-WEEK YOGA INTERVENTION ON PTSD. METHOD: FIFTY-ONE PARTICIPANTS WERE RANDOMIZED INTO YOGA OR NO-TREATMENT ASSESSMENT-ONLY CONTROL GROUPS. PRIMARY OUTCOME MEASURES INCLUDED QUESTIONNAIRES AND THE CLINICIAN ADMINISTERED PTSD SCALE. RESULTS: BOTH YOGA (N = 9) AND CONTROL (N = 6) PARTICIPANTS SHOWED SIGNIFICANT DECREASES IN REEXPERIENCING SYMPTOMS, WITH NO SIGNIFICANT BETWEEN-GROUP DIFFERENCES. SECONDARY WITHIN-GROUP ANALYSES OF A SELF-SELECTED WAIT-LIST YOGA GROUP (N = 7) SHOWED SIGNIFICANT REDUCTIONS IN PTSD SYMPTOMS AFTER YOGA PARTICIPATION, IN CONTRAST TO THEIR CONTROL GROUP PARTICIPATION. CONSISTENT WITH CURRENT LITERATURE REGARDING HIGH RATES OF PTSD TREATMENT DROPOUT FOR VETERANS, THIS STUDY FACED CHALLENGES RETAINING PARTICIPANTS ACROSS CONDITIONS. CONCLUSION: THESE RESULTS ARE CONSISTENT WITH RECENT LITERATURE INDICATING THAT YOGA MAY HAVE POTENTIAL AS A PTSD THERAPY IN A VETERAN OR MILITARY POPULATION. HOWEVER, ADDITIONAL LARGER SAMPLE SIZE TRIALS ARE NECESSARY TO CONFIRM THIS CONCLUSION.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
7 1831  36 PSYCHOLOGICAL FUNCTION, IYENGAR YOGA, AND COHERENT BREATHING: A RANDOMIZED CONTROLLED DOSING STUDY. BACKGROUND: EVIDENCE SUGGESTS THAT YOGA MAY BE AN EFFECTIVE TREATMENT FOR MAJOR DEPRESSIVE DISORDER (MDD). STUDIES EVALUATING THE "DOSING" OF YOGA TREATMENT AND EFFICACY FOR MDD ARE NEEDED. THE GOAL OF THIS STUDY WAS TO ASSESS THE EFFECTS OF AN INTERVENTION COMBINING IYENGAR YOGA AND COHERENT BREATHING IN PARTICIPANTS WITH MDD AND DETERMINE THE OPTIMAL INTERVENTION DOSE. METHODS: THIRTY-TWO PARTICIPANTS (18 TO 65 Y OF AGE) DIAGNOSED WITH MDD WERE RANDOMIZED TO A HIGH-DOSE GROUP (HDG) OR A LOW-DOSE GROUP (LDG) OF YOGA AND COHERENT BREATHING FOR 12 WEEKS. THE HDG (N=15) INVOLVED THREE 90-MINUTE YOGA CLASSES AND FOUR 30-MINUTE HOMEWORK SESSIONS PER WEEK. THE LDG (N=15) INVOLVED TWO 90-MINUTE YOGA CLASSES AND THREE 30-MINUTE HOMEWORK SESSIONS PER WEEK. PARTICIPANTS WERE EVALUATED AT BASELINE, WEEK 4, WEEK 8, AND WEEK 12 WITH THE FOLLOWING INSTRUMENTS: POSITIVITY SELF-TEST, SPIELBERGER STATE ANXIETY INVENTORY, PATIENT HEALTH QUESTIONNAIRE-9, PITTSBURGH SLEEP QUALITY INDEX, AND EXERCISE-INDUCED FEELING INVENTORY. DATA WERE ANALYZED USING INTENT-TO-TREAT METHODS. RESULTS: SIGNIFICANT IMPROVEMENTS IN ALL OUTCOME MEASURES WERE FOUND FOR BOTH GROUPS, WITH ACUTE AND CUMULATIVE BENEFITS. ALTHOUGH THE HDG SHOWED GREATER IMPROVEMENTS ON ALL SCALES, BETWEEN-GROUP DIFFERENCES DID NOT REACH SIGNIFICANCE, POSSIBLY DUE TO LACK OF POWER BECAUSE OF THE SMALL SAMPLE SIZE. CUMULATIVE YOGA MINUTES WERE CORRELATED WITH IMPROVEMENT IN OUTCOME MEASURES. LIMITATION: THIS DOSING STUDY DID NOT INCLUDE A NON-YOGA CONTROL. CONCLUSIONS: IMPROVEMENT IN PSYCHOLOGICAL SYMPTOMS CORRELATED WITH CUMULATIVE YOGA PRACTICE. BOTH INTERVENTIONS REDUCED SYMPTOMS OF DEPRESSION AND ANXIETY AND INCREASED FEELINGS OF POSITIVITY. THE TIME COMMITMENT FOR YOGA PRACTICE NEEDS TO BE WEIGHED AGAINST BENEFITS WHEN DESIGNING YOGA INTERVENTIONS.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
8  391  40 BENEFITS OF YOGA IN THE TREATMENT OF EATING DISORDERS: RESULTS OF A RANDOMIZED CONTROLLED TRIAL. YOGA HAS BEGUN TO BE INCORPORATED INTO THE TREATMENT OF EATING DISORDERS DESPITE LIMITED EMPIRICAL SUPPORT FOR THIS PRACTICE. THE PURPOSE OF THIS STUDY WAS TO INVESTIGATE THE EFFICACY OF INCORPORATING YOGA INTO THE TREATMENT OF EATING DISORDERS. THIS PRELIMINARY RANDOMIZED CONTROLLED TRIAL INVESTIGATED THE BENEFITS OF PARTICIPATING IN AN EIGHT-WEEK KRIPALU YOGA PROGRAM FOR 53 WOMEN WITH SYMPTOMS OF BULIMIA NERVOSA AND BINGE EATING DISORDER. COMPARED TO WAITLIST CONTROLS, YOGA PARTICIPANTS EXPERIENCED DECREASES IN BINGE EATING FREQUENCY, EMOTIONAL REGULATION DIFFICULTIES AND SELF-CRITICISM, AND INCREASES IN SELF-COMPASSION. YOGA PARTICIPANTS ALSO EXPERIENCED INCREASES IN STATE MINDFULNESS SKILLS ACROSS THE EIGHT WEEKS OF THE YOGA PROGRAM. WHILE THESE RESULTS ARE ENCOURAGING AND SUGGEST YOGA MAY HAVE A VALUABLE ROLE TO PLAY IN THE TREATMENT OF EATING DISORDERS, IT IS IMPORTANT TO STRESS THEIR TENTATIVE NATURE. FURTHER RESEARCH, ADOPTING A MORE RIGOROUS DESIGN, IS NEEDED TO ADDRESS THE LIMITATIONS OF THE PRESENT STUDY AND EXPAND ON THESE FINDINGS.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
9 1613  49 MILITARY-TAILORED YOGA FOR VETERANS WITH POST-TRAUMATIC STRESS DISORDER. INTRODUCTION: AMONG VETERANS OF POST-9/11 CONFLICTS, ESTIMATES OF POST-TRAUMATIC STRESS DISORDER (PTSD) RANGE FROM 9% SHORTLY AFTER RETURNING FROM DEPLOYMENT TO 31% A YEAR AFTER DEPLOYMENT. CLINICAL AND PHARMACEUTICALLY BASED TREATMENTS ARE UNDERUTILIZED. THIS COULD BE DUE TO CONCERNS RELATED TO LOST DUTY DAYS, AS WELL AS PTSD PATIENTS' FEARS OF STIGMA OF HAVING A MENTAL HEALTH CONDITION. YOGA HAS BEEN SHOWN TO REDUCE PTSD SYMPTOMS IN THE CIVILIAN POPULATION, BUT FEW STUDIES HAVE TESTED THE IMPACT OF YOGA ON VETERANS OF POST-9/11 CONFLICTS. THE PURPOSE OF THIS STUDY IS TO TEST THE IMPACT OF YOGA ON POST-9/11 VETERANS DIAGNOSED WITH PTSD. MATERIALS AND METHODS: PARTICIPANTS WERE 18 YR OF AGE OR OLDER AND VETERANS OF POST-9/11 CONFLICTS. THEY HAD SUBTHRESHOLD OR DIAGNOSTIC-LEVEL PTSD RELATED TO THEIR COMBAT MILITARY SERVICE, AS DETERMINED BY A SCORE OF 30 OR HIGHER ON THE PTSD CHECKLIST-MILITARY VERSION (PCL-M). VETERANS PARTICIPATED IN 60-MIN WEEKLY YOGA SESSIONS FOR 6 WK TAUGHT BY A WARRIORS AT EASE-TRAINED YOGA INSTRUCTOR WHO IS A, POST-9/11 VETERAN. THE YOGA SESSIONS INCORPORATED VINYASA-STYLE YOGA AND A TRAUMA-SENSITIVE, MILITARY-CULTURE INFORMED APPROACH ADVOCATED BY TWO SEPARATE ORGANIZATIONS: WARRIORS AT EASE AND MEGHAN'S FOUNDATION. DATA WERE COLLECTED AT BASELINE AND AGAIN AFTER 7 WK. THE PRIMARY OUTCOME WAS PCL-M SCORE. PARTICIPANTS ALSO COMPLETED THE PATIENT HEALTH QUESTIONNAIRE, THE BECK ANXIETY INVENTORY, THE PITTSBURGH SLEEP QUALITY INDEX, AND THE MINDFUL ATTENTION AWARENESS SCALE AT BOTH TIME POINTS. RESULTS: EIGHTEEN OPERATION ENDURING FREEDOM, OPERATION IRAQI FREEDOM, AND OPERATION NEW DAWN VETERANS COMPLETED THE PRE- AND POST-INTERVENTION SELF-REPORT QUESTIONNAIRES. AGE RANGED FROM 26 TO 62 YR (MEDIAN = 43 YR), LENGTH OF SERVICE RANGED FROM 2 TO 34 YR (MEDIAN = 18.8 YR), AND 13 (72.2%) HAD COMPLETED COLLEGE. DECREASED PTSD SYMPTOMATOLOGY WAS DEMONSTRATED IN THE THREE-SYMPTOM CLUSTERS REPRESENTED IN THE PCL-M (I.E., HYPERAROUSAL, RE-EXPERIENCING, AND AVOIDANCE). IN ADDITION, THE TOTAL SCORE ON THE PCL-M DECREASED SIGNIFICANTLY, BY BOTH STATISTICAL AND CLINICAL MEASURES. THE PARTICIPANTS ALSO DEMONSTRATED IMPROVED MINDFULNESS SCORES AND REPORTED DECREASED INSOMNIA, DEPRESSION, AND ANXIETY SYMPTOMS. CONCLUSION: THIS STUDY DEMONSTRATES THAT A TRAUMA-SENSITIVE YOGA INTERVENTION MAY BE EFFECTIVE FOR VETERANS WITH PTSD SYMPTOMS, WHETHER AS STAND-ALONE OR ADJUNCTIVE THERAPY. THE IMPRESSIVE DECREASE IN PTSD SYMPTOMATOLOGY MAY BE DUE TO THE TAILORED MILITARY-SPECIFIC NATURE OF THIS INTERVENTION AND THE FACT THAT IT WAS LED BY A VETERAN OF POST-9/11 CONFLICTS. MORE RESEARCH IS NEEDED WITH A LARGER SAMPLE AND A MORE DIVERSE VETERAN POPULATION.	2018	

10 1164  41 EVALUATING THE EFFECTS OF A YOGA-BASED PROGRAM INTEGRATED WITH THIRD-WAVE COGNITIVE BEHAVIORAL THERAPY COMPONENTS ON SELF-REGULATION IN CHILDREN ON THE AUTISM SPECTRUM: A PILOT RANDOMIZED CONTROLLED TRIAL. LAY ABSTRACT: CHILDREN ON THE AUTISM SPECTRUM MAY EXPERIENCE DIFFICULTIES WITH THE REGULATION OF ATTENTION, THOUGHTS, EMOTIONS, AND BEHAVIOR, UNDERSTANDING, AND EXPRESSING THEIR EMOTIONS APPROPRIATELY, AS WELL AS ANXIETY, AND SLEEP. IN AUTISM RESEARCH, CONTEMPLATIVE PRACTICES THAT WORK THROUGH BOTH BODY AND MIND HAVE SHOWN TENTATIVELY PROMISING RESULTS. HOWEVER, THERE ARE LIMITED STUDIES ON THIS TOPIC, AND THE USE OF YOGA TO FACILITATE EXECUTIVE CONTROL HAS NOT BEEN RESEARCHED YET. THE INCREDIBLE EXPLORERS (6-WEEK PROGRAM), A YOGA-INFORMED INTERVENTION PROGRAM FOR CHILDREN (8-12 YEARS), WAS DEVELOPED TO UNDERSTAND WHETHER, FOR CHILDREN ON THE AUTISM SPECTRUM, THE TRAINING COULD IMPROVE THE ABILITY TO SELF-REGULATE, REDUCE ANXIETY AND SLEEP PROBLEMS, AND INCREASE AWARENESS OF EMOTIONS. IN OUR SAMPLE, 61 CHILDREN WITH ONE OF THEIR PARENTS COMPLETED THE PROGRAM. HALF OF THE GROUP RECEIVED THE INTERVENTION, AND THE OTHER HALF HAD TO WAIT UNTIL THE YOGA GROUP COMPLETED THEIR TRIAL. THE PARTICIPANTS WERE ASKED TO GIVE THEIR FEEDBACK IMMEDIATELY AFTER PROGRAM COMPLETION AND AT 6-WEEK FOLLOW-UP. COMPARED TO THE GROUP THAT WAS WAITING TO RECEIVE THE INTERVENTION, PARENTS IN THE YOGA GROUP REPORTED SIGNIFICANT GAINS FOR THEIR CHILDREN IN REGULATING THEIR OVERALL EXECUTIVE CONTROL IMMEDIATELY AFTER THE SESSION AND AGAIN AT FOLLOW-UP. THE PARENTS REPORTED A REDUCTION IN SOME OF THE SLEEP PROBLEMS POST-TREATMENT. CHILDREN INDICATED AN IMPROVED ABILITY TO COMMUNICATE THEIR FEELINGS AND WILLINGNESS TO ANALYZE THEIR EMOTIONS POST-INTERVENTION. HOWEVER, THE STUDY HAD SEVERAL SHORTCOMINGS AND GIVEN THAT THIS WAS THE FIRST TRIAL OF THE PROGRAM, THE RESULTS NEED TO BE INTERPRETED WITH CAUTION. FURTHER RESEARCH IS RECOMMENDED.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
11 2638  35 YOGA FOR VETERANS WITH CHRONIC LOW BACK PAIN: DESIGN AND METHODS OF A RANDOMIZED CLINICAL TRIAL. CHRONIC LOW BACK PAIN (CLBP) AFFLICTS MILLIONS OF PEOPLE WORLDWIDE, WITH PARTICULARLY HIGH PREVALENCE IN MILITARY VETERANS. MANY TREATMENT OPTIONS EXIST FOR CLBP, BUT MOST HAVE LIMITED EFFECTIVENESS AND SOME HAVE SIGNIFICANT SIDE EFFECTS. IN GENERAL POPULATIONS WITH CLBP, YOGA HAS BEEN SHOWN TO IMPROVE HEALTH OUTCOMES WITH FEW SIDE EFFECTS. HOWEVER, YOGA HAS NOT BEEN ADEQUATELY STUDIED IN MILITARY VETERAN POPULATIONS. IN THE CURRENT PAPER WE WILL DESCRIBE THE DESIGN AND METHODS OF A RANDOMIZED CLINICAL TRIAL AIMED AT EXAMINING WHETHER YOGA CAN EFFECTIVELY REDUCE DISABILITY AND PAIN IN US MILITARY VETERANS WITH CLBP. A TOTAL OF 144 US MILITARY VETERANS WITH CLBP WILL BE RANDOMIZED TO EITHER YOGA OR A DELAYED TREATMENT COMPARISON GROUP. THE YOGA INTERVENTION WILL CONSIST OF 2X WEEKLY YOGA CLASSES FOR 12WEEKS, COMPLEMENTED BY REGULAR HOME PRACTICE GUIDED BY A MANUAL. THE DELAYED TREATMENT GROUP WILL RECEIVE THE SAME INTERVENTION AFTER SIX MONTHS. THE PRIMARY OUTCOME IS THE CHANGE IN BACK PAIN-RELATED DISABILITY MEASURED WITH THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE AT BASELINE AND 12-WEEKS. SECONDARY OUTCOMES INCLUDE PAIN INTENSITY, PAIN INTERFERENCE, DEPRESSION, ANXIETY, FATIGUE/ENERGY, QUALITY OF LIFE, SELF-EFFICACY, SLEEP QUALITY, AND MEDICATION USAGE. ADDITIONAL PROCESS AND/OR MEDIATIONAL FACTORS WILL BE MEASURED TO EXAMINE DOSE RESPONSE AND EFFECT MECHANISMS. ASSESSMENTS WILL BE CONDUCTED AT BASELINE, 6-WEEKS, 12-WEEKS, AND 6-MONTHS. ALL RANDOMIZED PARTICIPANTS WILL BE INCLUDED IN INTENTION-TO-TREAT ANALYSES. STUDY RESULTS WILL PROVIDE MUCH NEEDED EVIDENCE ON THE FEASIBILITY AND EFFECTIVENESS OF YOGA AS A THERAPEUTIC MODALITY FOR THE TREATMENT OF CLBP IN US MILITARY VETERANS.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
12 1953  39 SECONDARY OUTCOMES FROM A RANDOMIZED CONTROLLED TRIAL OF YOGA FOR VETERANS WITH CHRONIC LOW-BACK PAIN. CHRONIC LOW-BACK PAIN (CLBP) IS A PREVALENT CONDITION, AND RATES ARE HIGHER AMONG MILITARY VETERANS. CLBP IS A PERSISTENT CONDITION, AND TREATMENT OPTIONS HAVE EITHER MODEST EFFECTS OR A SIGNIFICANT RISK OF SIDE-EFFECTS, WHICH HAS LED TO RECENT EFFORTS TO EXPLORE MIND-BODY INTERVENTION OPTIONS AND REDUCE OPIOID MEDICATION USE. PRIOR STUDIES OF YOGA FOR CLBP IN COMMUNITY SAMPLES, AND THE MAIN RESULTS OF A RECENT TRIAL WITH MILITARY VETERANS, INDICATE THAT YOGA CAN REDUCE BACK-RELATED DISABILITY AND PAIN INTENSITY. SECONDARY OUTCOMES FROM THE TRIAL OF YOGA WITH MILITARY VETERANS ARE PRESENTED HERE. IN THE STUDY, 150 MILITARY VETERANS (VETERANS ADMINISTRATION PATIENTS) WITH CLBP WERE RANDOMIZED TO EITHER YOGA OR A DELAYED-TREATMENT GROUP RECEIVING USUAL CARE BETWEEN 2013 AND 2015. ASSESSMENTS OCCURRED AT BASELINE, 6 WEEKS, 12 WEEKS, AND 6 MONTHS. INTENT-TO-TREAT ANALYSES WERE CONDUCTED. YOGA CLASSES LASTING 60 MINUTES EACH WERE OFFERED TWICE WEEKLY FOR 12 WEEKS. YOGA SESSIONS CONSISTED OF PHYSICAL POSTURES, MOVEMENT, FOCUSED ATTENTION, AND BREATHING TECHNIQUES. HOME PRACTICE GUIDED BY A MANUAL WAS STRONGLY RECOMMENDED. THE PRIMARY OUTCOME MEASURE WAS ROLAND-MORRIS DISABILITY QUESTIONNAIRE SCORES AFTER 12 WEEKS. SECONDARY OUTCOMES INCLUDED PAIN INTENSITY, PAIN INTERFERENCE, DEPRESSION, FATIGUE, QUALITY OF LIFE, SELF-EFFICACY, AND MEDICATION USAGE. YOGA PARTICIPANTS IMPROVED MORE THAN DELAYED-TREATMENT PARTICIPANTS ON PAIN INTERFERENCE, FATIGUE, QUALITY OF LIFE, AND SELF-EFFICACY AT 12 WEEKS AND/OR 6 MONTHS. YOGA PARTICIPANTS HAD GREATER IMPROVEMENTS ACROSS A NUMBER OF IMPORTANT SECONDARY HEALTH OUTCOMES COMPARED TO CONTROLS. BENEFITS EMERGED DESPITE SOME VETERANS FACING CHALLENGES WITH ATTENDING YOGA SESSIONS IN PERSON. THE FINDINGS SUPPORT WIDER IMPLEMENTATION OF YOGA PROGRAMS FOR VETERANS, WITH ATTENTION TO INCREASING ACCESSIBILITY OF YOGA PROGRAMS IN THIS POPULATION.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
13  168  37 A RANDOMIZED CONTROLLED DOSING STUDY OF IYENGAR YOGA AND COHERENT BREATHING FOR THE TREATMENT OF MAJOR DEPRESSIVE DISORDER: IMPACT ON SUICIDAL IDEATION AND SAFETY FINDINGS. BACKGROUND: YOGA INTERVENTIONS OFFER PROMISE FOR THE TREATMENT OF MAJOR DEPRESSIVE DISORDER (MDD), YET THEIR SAFETY AND POTENTIAL IMPACT ON SUICIDAL IDEATION (SI) HAVE NOT BEEN WELL DOCUMENTED. THIS STUDY EVALUATED THE SAFETY OF A RANDOMIZED CONTROLLED DOSE-FINDING TRIAL OF IYENGAR YOGA PLUS COHERENT BREATHING FOR INDIVIDUALS WITH MDD, AS WELL AS THE POTENTIAL EFFECTS OF THE INTERVENTION ON SI WITHOUT INTENT. METHODS: PARTICIPANTS WITH BECK DEPRESSION INVENTORY-II (BDI-II) SCORES >/=14 AND A DIAGNOSIS OF MDD (USING DSM-IV CRITERIA) WERE RANDOMIZED TO EITHER A LOW DOSE GROUP (LDG) OR HIGH DOSE GROUP (HDG) AND RECEIVED A 12-WEEK MANUALIZED INTERVENTION. THE LDG INCLUDED TWO 90-MIN YOGA CLASSES PLUS THREE 30-MIN HOMEWORK SESSIONS WEEKLY. THE HDG OFFERED THREE 90-MIN CLASSES PLUS FOUR 30-MIN HOMEWORK SESSIONS WEEKLY. RESULTS: THIRTY-TWO INDIVIDUALS WITH MDD WERE RANDOMIZED, OF WHICH 30 COMPLETED THE PROTOCOL. AT SCREENING, SI WITHOUT INTENT WAS ENDORSED ON THE BDI-II BY 9 PARTICIPANTS; AFTER COMPLETING THE INTERVENTION, 8 OUT OF 9 REPORTED RESOLUTION OF SI. THERE WERE 17 ADVERSE EVENTS POSSIBLY-RELATED AND 15 DEFINITELY-RELATED TO THE INTERVENTION. THE MOST COMMON PROTOCOL-RELATED ADVERSE EVENT WAS MUSCULOSKELETAL PAIN, WHICH RESOLVED OVER THE COURSE OF THE STUDY. CONCLUSIONS: THE IYENGAR YOGA PLUS COHERENT BREATHING INTERVENTION WAS ASSOCIATED WITH THE RESOLUTION OF SI IN 8 OUT OF 9 PARTICIPANTS, WITH MILD SIDE EFFECTS THAT WERE PRIMARILY MUSCULOSKELETAL IN NATURE. THIS PRELIMINARY EVIDENCE SUGGESTS THAT THIS INTERVENTION MAY REDUCE SI WITHOUT INTENT AND BE SAFE FOR USE IN THOSE WITH MDD.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
14 1093  44 EFFECTS OF YOGA ON WELL-BEING AND HEALTHY AGEING: STUDY PROTOCOL FOR A RANDOMISED CONTROLLED TRIAL (FITFORAGE). INTRODUCTION: DUE TO AGEING POPULATIONS WORLDWIDE, THE BURDEN OF DISABILITY IS INCREASING. IT IS THEREFORE IMPORTANT TO DEVELOP INTERVENTIONS THAT IMPROVE HEALTHY AGEING, REDUCE DISABILITY ONSET AND ENHANCE LIFE QUALITY. PHYSICAL ACTIVITY CAN PROMOTE HEALTHY AGEING AND HELP MAINTAIN INDEPENDENCE, YET MANY OLDER ADULTS ARE INACTIVE. YOGA IS A FORM OF PHYSICAL ACTIVITY THAT AIMS TO IMPROVE HEALTH AND MAY BE PARTICULARLY SUITABLE FOR OLDER ADULTS. RESEARCH INDICATES POSITIVE EFFECTS OF YOGA ON SEVERAL HEALTH-RELATED OUTCOMES; HOWEVER, EMPIRICAL STUDIES EXAMINING THE BENEFITS OF YOGA ON WELL-BEING AMONG THE ELDERLY REMAIN SCARCE. THIS STUDY PROTOCOL REPORTS THE METHODOLOGY FOR A 12-WEEK YOGA PROGRAMME AIMED TO IMPROVE HEALTH AND WELL-BEING AMONG PHYSICALLY INACTIVE OLDER ADULTS. METHODS AND ANALYSIS: THREE GROUP PARALLEL, SINGLE-BLIND RANDOMISED CONTROLLED TRIAL. TWO COMPARISON GROUPS ARE INCLUDED: AEROBIC EXERCISE AND A NON-ACTIVE WAIT-LIST CONTROL. IN TOTAL, 180 PARTICIPANTS AGED 65-85 YEARS WILL BE RECRUITED. ASSESSMENTS WILL BE PERFORMED AT BASELINE AND POSTINTERVENTION (12-WEEK FOLLOW-UP). THE PRIMARY OUTCOME IS SUBJECTIVE WELL-BEING. SECONDARY OUTCOMES INCLUDE PHYSICAL ACTIVITY/SEDENTARY BEHAVIOUR, MOBILITY/FALL RISK, COGNITION, DEPRESSION, ANXIETY, MOOD, STRESS, PAIN, SLEEP QUALITY, SOCIAL SUPPORT AND CARDIOMETABOLIC RISK FACTORS. DATA WILL BE ANALYSED USING INTENTION-TO-TREAT ANALYSES, WITH MIXED LINEAR MODELLING. ETHICS AND DISSEMINATION: THIS STUDY IS APPROVED BY THE ETHICAL REVIEW BOARD IN STOCKHOLM (2017/1862-31/2). ALL PARTICIPANTS MUST VOLUNTARILY AGREE TO PARTICIPATE AND ARE FREE TO WITHDRAW FROM THE STUDY AT ANY POINT. WRITTEN INFORMED CONSENT WILL BE OBTAINED FROM EACH PARTICIPANT PRIOR TO INCLUSION. RESULTS WILL BE AVAILABLE THROUGH RESEARCH ARTICLES AND CONFERENCES. A SUMMARY OF KEY RESULTS WILL BE PUBLICLY AVAILABLE THROUGH NEWSPAPER ARTICLES. TRIAL REGISTRATION NUMBER: DRKS00015093, U1111-1217-4248.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
15  252  33 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
16 2843  27 YOGA, COGNITIVE-BEHAVIOURAL THERAPY VERSUS EDUCATION TO IMPROVE QUALITY OF LIFE AND REDUCE HEALTHCARE COSTS IN PEOPLE WITH ENDOMETRIOSIS: A RANDOMISED CONTROLLED TRIAL. INTRODUCTION: ENDOMETRIOSIS IS A DEBILITATING CHRONIC INFLAMMATORY CONDITION HIGHLY BURDENSOME TO THE HEALTHCARE SYSTEM. THE PRESENT TRIAL WILL ESTABLISH THE EFFICACY OF (1) YOGA AND (2) COGNITIVE-BEHAVIOURAL THERAPY (CBT), ABOVE (3) EDUCATION, ON QUALITY OF LIFE, BIOPSYCHOSOCIAL OUTCOMES AND COST-EFFECTIVENESS. METHODS AND ANALYSIS: THIS STUDY IS A PARALLEL RANDOMISED CONTROLLED TRIAL. PARTICIPANTS WILL BE RANDOMLY ALLOCATED TO YOGA, CBT OR EDUCATION. PARTICIPANTS WILL BE ENGLISH-SPEAKING ADULTS, HAVE A DIAGNOSIS OF ENDOMETRIOSIS BY A QUALIFIED PHYSICIAN, WITH PAIN FOR AT LEAST 6 MONTHS, AND ACCESS TO INTERNET. PARTICIPANTS WILL ATTEND 8 WEEKLY GROUP CBT SESSIONS OF 120 MIN; OR 8 WEEKLY GROUP YOGA SESSIONS OF 60 MIN; OR RECEIVE WEEKLY EDUCATIONAL HANDOUTS ON ENDOMETRIOSIS. THE PRIMARY OUTCOME MEASURE IS QUALITY OF LIFE. THE ANALYSIS WILL INCLUDE MIXED-EFFECTS ANALYSIS OF VARIANCE AND LINEAR MODELS, COST-UTILITY ANALYSIS FROM A SOCIETAL AND HEALTH SYSTEM PERSPECTIVE AND QUALITATIVE THEMATIC ANALYSIS. ETHICS AND DISSEMINATION: ENROLMENT IN THE STUDY IS VOLUNTARY AND PARTICIPANTS CAN WITHDRAW AT ANY TIME. PARTICIPANTS WILL BE GIVEN THE OPTION TO DISCUSS THE STUDY WITH THEIR NEXT OF KIN/TREATING PHYSICIAN. FINDINGS WILL BE DISSEMINATED VIA PUBLICATIONS, CONFERENCES AND BRIEFS TO PROFESSIONAL ORGANISATIONS. THE UNIVERSITY'S MEDIA TEAM WILL ALSO BE USED TO FURTHER DISSEMINATE VIA LAY PERSON ARTICLES AND MEDIA RELEASES. TRIAL REGISTRATION NUMBER: ACTRN12620000756921P; PRE-RESULTS.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
17 2596  40 YOGA FOR MILITARY VETERANS WITH CHRONIC LOW BACK PAIN: A RANDOMIZED CLINICAL TRIAL. INTRODUCTION: CHRONIC LOW BACK PAIN (CLBP) IS PREVALENT, ESPECIALLY AMONG MILITARY VETERANS. MANY CLBP TREATMENT OPTIONS HAVE LIMITED BENEFITS AND ARE ACCOMPANIED BY SIDE EFFECTS. MAJOR EFFORTS TO REDUCE OPIOID USE AND EMBRACE NONPHARMACOLOGICAL PAIN TREATMENTS HAVE RESULTED. RESEARCH WITH COMMUNITY CLBP PATIENTS INDICATES THAT YOGA CAN IMPROVE HEALTH OUTCOMES AND HAS FEW SIDE EFFECTS. THE BENEFITS OF YOGA AMONG MILITARY VETERANS WERE EXAMINED. DESIGN: PARTICIPANTS WERE RANDOMIZED TO EITHER YOGA OR DELAYED YOGA TREATMENT IN 2013-2015. OUTCOMES WERE ASSESSED AT BASELINE, 6 WEEKS, 12 WEEKS, AND 6 MONTHS. INTENTION-TO-TREAT ANALYSES OCCURRED IN 2016. SETTING/PARTICIPANTS: ONE HUNDRED AND FIFTY MILITARY VETERANS WITH CLBP WERE RECRUITED FROM A MAJOR VETERANS AFFAIRS MEDICAL CENTER IN CALIFORNIA. INTERVENTION: YOGA CLASSES (WITH HOME PRACTICE) WERE LED BY A CERTIFIED INSTRUCTOR TWICE WEEKLY FOR 12 WEEKS, AND CONSISTED PRIMARILY OF PHYSICAL POSTURES, MOVEMENT, AND BREATHING TECHNIQUES. MAIN OUTCOME MEASURES: THE PRIMARY OUTCOME WAS ROLAND-MORRIS DISABILITY QUESTIONNAIRE SCORES AFTER 12 WEEKS. PAIN INTENSITY WAS IDENTIFIED AS AN IMPORTANT SECONDARY OUTCOME. RESULTS: PARTICIPANT CHARACTERISTICS WERE MEAN AGE 53 YEARS, 26% WERE FEMALE, 35% WERE UNEMPLOYED OR DISABLED, AND MEAN BACK PAIN DURATION WAS 15 YEARS. IMPROVEMENTS IN ROLAND-MORRIS DISABILITY QUESTIONNAIRE SCORES DID NOT DIFFER BETWEEN THE TWO GROUPS AT 12 WEEKS, BUT YOGA PARTICIPANTS HAD GREATER REDUCTIONS IN ROLAND-MORRIS DISABILITY QUESTIONNAIRE SCORES THAN DELAYED TREATMENT PARTICIPANTS AT 6 MONTHS -2.48 (95% CI= -4.08, -0.87). YOGA PARTICIPANTS IMPROVED MORE ON PAIN INTENSITY AT 12 WEEKS AND AT 6 MONTHS. OPIOID MEDICATION USE DECLINED AMONG ALL PARTICIPANTS, BUT GROUP DIFFERENCES WERE NOT FOUND. CONCLUSIONS: YOGA IMPROVED HEALTH OUTCOMES AMONG VETERANS DESPITE EVIDENCE THEY HAD FEWER RESOURCES, WORSE HEALTH, AND MORE CHALLENGES ATTENDING YOGA SESSIONS THAN COMMUNITY SAMPLES STUDIED PREVIOUSLY. THE MAGNITUDE OF PAIN INTENSITY DECLINE WAS SMALL, BUT OCCURRED IN THE CONTEXT OF REDUCED OPIOID USE. THE FINDINGS SUPPORT WIDER IMPLEMENTATION OF YOGA PROGRAMS FOR VETERANS. TRIAL REGISTRATION: THIS STUDY IS REGISTERED AT WWW.CLINICALTRIALS.GOV NCT02524158.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                             
18  181  42 A RANDOMIZED CONTROLLED TRIAL OF YOGA VS NONAEROBIC EXERCISE FOR VETERANS WITH PTSD: UNDERSTANDING EFFICACY, MECHANISMS OF CHANGE, AND MODE OF DELIVERY. BACKGROUND AND OBJECTIVES: POSTTRAUMATIC STRESS DISORDER (PTSD) IS A CHRONIC, DISABLING, AND PREVALENT MENTAL HEALTH DISORDER AMONG VETERANS. DESPITE THE AVAILABILITY OF EMPIRICALLY SUPPORTED PSYCHOTHERAPIES, MANY VETERANS REMAIN SYMPTOMATIC AFTER TREATMENT AND/OR PREFER TO SEEK COMPLEMENTARY AND INTEGRATIVE HEALTH APPROACHES, INCLUDING YOGA, TO MANAGE PTSD. THE RANDOMIZED CONTROLLED TRIAL (RCT) DESCRIBED HEREIN WILL EVALUATE THE EFFICACY OF A MANUALIZED YOGA PROGRAM AS COMPARED TO NONAEROBIC EXERCISE IN REDUCING PTSD SEVERITY AMONG VETERANS. A SECONDARY AIM OF THIS STUDY IS TO BETTER UNDERSTAND THE MECHANISMS OF CHANGE. METHODS: VETERANS (N = 192) WITH PTSD WILL BE RANDOMIZED TO HATHA YOGA OR NONAEROBIC PHYSICAL ACTIVITY CONTROL; BOTH GROUPS CONSIST OF 12 WEEKLY, 60-MIN GROUP OR ONLINE TRAINING SESSIONS WITH 15-20 MIN OF DAILY AT-HOME PRACTICE. OUTCOME MEASURES WILL BE ADMINISTERED AT BASELINE, MID-TREATMENT, POSTTREATMENT, AND 12-WEEK FOLLOW-UP. PROJECTED OUTCOMES: THIS STUDY WILL EVALUATE CHANGES IN PTSD SEVERITY (PRIMARY OUTCOME) AS WELL AS DEPRESSION, ANXIETY, ANGER, SLEEP PROBLEMS, AND PSYCHOSOCIAL DISABILITY (SECONDARY OUTCOMES). WE WILL ALSO USE MULTIPLE MEDIATION TO EXAMINE TWO POTENTIAL MODELS OF THE MECHANISMS OF CLINICAL EFFECT: THE ATTENTION MODEL (I.E., YOGA INCREASES ATTENTIONAL CONTROL, WHICH REDUCES PTSD SYMPTOMS), THE COPING MODEL (I.E., YOGA INCREASES DISTRESS TOLERANCE, WHICH IMPROVES COPING, WHICH REDUCES PTSD SYMPTOMS), AND THE COMBINATION OF THESE MODELS. THIS ASPECT OF THE STUDY IS INNOVATIVE AND IMPORTANT GIVEN THE ABSENCE OF AN EXISTING, COMPREHENSIVE MODEL FOR UNDERSTANDING YOGA'S IMPACT ON PTSD. ULTIMATELY, WE HOPE TO DEVELOP GUIDELINES FOR APPLICATION OF YOGA TO PTSD RECOVERY.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
19 2824  38 YOGA VERSUS EDUCATION FOR VETERANS WITH CHRONIC LOW BACK PAIN: STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN IS THE MOST FREQUENT PAIN CONDITION IN VETERANS AND CAUSES SUBSTANTIAL SUFFERING, DECREASED FUNCTIONAL CAPACITY, AND LOWER QUALITY OF LIFE. SYMPTOMS OF POST-TRAUMATIC STRESS, DEPRESSION, AND MILD TRAUMATIC BRAIN INJURY ARE HIGHLY PREVALENT IN VETERANS WITH BACK PAIN. YOGA FOR LOW BACK PAIN HAS BEEN DEMONSTRATED TO BE EFFECTIVE FOR CIVILIANS IN RANDOMIZED CONTROLLED TRIALS. HOWEVER, IT IS UNKNOWN IF RESULTS FROM PREVIOUSLY PUBLISHED TRIALS GENERALIZE TO MILITARY POPULATIONS. METHODS/DESIGN: THIS STUDY IS A PARALLEL RANDOMIZED CONTROLLED TRIAL COMPARING YOGA TO EDUCATION FOR 120 VETERANS WITH CHRONIC LOW BACK PAIN. PARTICIPANTS ARE VETERANS >/=18 YEARS OLD WITH LOW BACK PAIN PRESENT ON AT LEAST HALF THE DAYS IN THE PAST SIX MONTHS AND A SELF-REPORTED AVERAGE PAIN INTENSITY IN THE PREVIOUS WEEK OF >/=4 ON A 0-10 SCALE. THE 24-WEEK STUDY HAS AN INITIAL 12-WEEK INTERVENTION PERIOD, WHERE PARTICIPANTS ARE RANDOMIZED EQUALLY INTO (1) A STANDARDIZED WEEKLY GROUP YOGA CLASS WITH HOME PRACTICE OR (2) EDUCATION DELIVERED WITH A SELF-CARE BOOK. PRIMARY OUTCOME MEASURES ARE CHANGE AT 12 WEEKS IN LOW BACK PAIN INTENSITY MEASURED BY THE DEFENSE AND VETERANS PAIN RATING SCALE (0-10) AND BACK-RELATED FUNCTION USING THE 23-POINT ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 12-WEEK FOLLOW-UP PERIOD, YOGA PARTICIPANTS ARE ENCOURAGED TO CONTINUE HOME YOGA PRACTICE AND EDUCATION PARTICIPANTS CONTINUE FOLLOWING RECOMMENDATIONS FROM THE BOOK. QUALITATIVE INTERVIEWS WITH VETERANS IN THE YOGA GROUP AND THEIR PARTNERS EXPLORE THE IMPACT OF CHRONIC LOW BACK PAIN AND YOGA ON FAMILY RELATIONSHIPS. WE ALSO ASSESS COST-EFFECTIVENESS FROM THREE PERSPECTIVES: THE VETERAN, THE VETERANS HEALTH ADMINISTRATION, AND SOCIETY USING ELECTRONIC MEDICAL RECORDS, SELF-REPORTED COST DATA, AND STUDY RECORDS. DISCUSSION: THIS STUDY WILL HELP DETERMINE IF YOGA CAN BECOME AN EFFECTIVE TREATMENT FOR VETERANS WITH CHRONIC LOW BACK PAIN AND PSYCHOLOGICAL COMORBIDITIES. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT02224183.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
20 2019  37 SYNCHRONOUS TELEHEALTH YOGA AND COGNITIVE PROCESSING GROUP THERAPIES FOR WOMEN VETERANS WITH POSTTRAUMATIC STRESS DISORDER: A MULTISITE RANDOMIZED CONTROLLED TRIAL ADAPTED FOR COVID-19. BACKGROUND: PROVIDING CARE OVER TELEHEALTH GREW SLOWLY UNTIL THE COVID-19 PANDEMIC. SINCE THE ONSET OF THE COVID-19 PANDEMIC, PROVIDING MENTAL HEALTH CARE WAS READILY ADAPTED TO VIRTUAL MEANS; HOWEVER, CLINICAL TRIAL RESEARCH IS NASCENT IN ADAPTING METHODS AND PROCEDURES TO THE VIRTUAL WORLD. METHODS: WE PRESENT PROTOCOL MODIFICATIONS TO PIVOT A MULTISITE RANDOMIZED CONTROLLED TRIAL STUDY, CONDUCTED AT SOUTHEASTERN AND PACIFIC NORTHWESTERN VETERANS AFFAIRS HEALTH CARE SYSTEMS, FROM BEING CONDUCTED IN-PERSON TO VIRTUALLY, FOLLOWING THE ONSET OF THE COVID-19 PANDEMIC. WE MEASURED OUTCOMES OF POSTTRAUMATIC STRESS DISORDER (PTSD) SYMPTOMS AND PSYCHOPHYSIOLOGICAL MARKERS OF STRESS AMONG FEMALE VETERANS WITH PTSD SECONDARY TO MILITARY SEXUAL TRAUMA. WE COLLECTED QUALITATIVE DATA ABOUT PROVIDER AND PARTICIPANT EXPERIENCES WITH TELEHEALTH. RESULTS: ACROSS SITES, 200 PARTICIPANTS WERE CONSENTED (48 VIRTUALLY), 132 WERE RANDOMIZED (28 TO VIRTUAL GROUPS), AND 117 COMPLETED DATA COLLECTION AND TREATMENT (69 COMPLETED ALL OR SOME DATA COLLECTION OR TREATMENT VIRTUALLY). CONCLUSIONS: THE PIVOTS MADE FOR THIS STUDY WERE IN RESPONSE TO THE COVID-19 PANDEMIC AND OFFER INNOVATIVE PROCEDURES LEVERAGING TECHNOLOGY AND CONTRIBUTING TO THE BROADER LANDSCAPE OF CONDUCTING RESEARCH VIRTUALLY. CLINICAL TRIALS NUMBER: NCT02640690.	2022