1 2359 174 VERTEBRAL COMPRESSION FRACTURES ASSOCIATED WITH YOGA: A CASE SERIES. BACKGROUND: THE IMPORTANCE OF EXERCISE IN SKELETAL HEALTH IS INCREASINGLY RECOGNIZED BY BOTH PATIENTS AND PROVIDERS. HOWEVER, THE SAFETY OF PRESCRIBED OR RECREATIONAL EXERCISE IN AT-RISK POPULATIONS REMAINS UNDER-REPORTED AND UNDER-PUBLICIZED. YOGA HAS GAINED WIDESPREAD POPULARITY DUE TO ITS PHYSICAL AND PSYCHOLOGICAL BENEFITS. WHEN PRACTICED IN A POPULATION AT INCREASED FRACTURE RISK, HOWEVER, SOME YOGA POSES MAY INCREASE FRACTURE RISK, PARTICULARLY AT THE SPINE, RATHER THAN INCREASING BMD AS NOTED IN RECENT POPULAR PRESS REPORTS. CASE REPORT: NINE SUBJECTS (8 WOMEN) WITH A MEDIAN AGE OF 66 YEARS (RANGE 53-87), DEVELOPED VERTEBRAL COMPRESSION FRACTURE (VCF) ONE MONTH TO SIX YEARS AFTER INITIATING YOGA-ASSOCIATED SPINAL FLEXION EXERCISES (SFE). VCF PRESENTED WITH BACK PAIN AND OCCURRED IN THE THORACICSPINE (N.=6), LUMBAR-SPINE (N.=4) AND CERVICAL-SPINE (N.=1). FOUR PATIENTS HAD OSTEOPOROSIS BY BMD CRITERIA PRIOR TO VCF AND 2 HAD OSTEOPENIA (MEDIAN T-SCORE -2.35; RANGE -3.3 TO +2.0). INTERESTINGLY, ALL PATIENTS HAD THEIR LOWEST T-SCORES AT THE SPINE. THREE PATIENTS HAD A HISTORY OF FRAGILITY FRACTURE PRIOR TO THE INDEX VCF. WHILE ONE PATIENT HAD PRIMARY HYPERPARATHYROIDISM AND ANOTHER WAS TREATED WITH HIGH DOSE PREDNISONE, NO OTHER RISK FACTORS FOR BONE LOSS INCLUDING MEDICATIONS OR SECONDARY OSTEOPOROSIS CAUSES WERE IDENTIFIED IN THE OTHER PATIENTS. CLINICAL REHABILITATION IMPACT: THIS STUDY IDENTIFIED PATIENTS IN WHOM INCREASED TORSIONAL AND COMPRESSIVE MECHANICAL LOADING PRESSURES OCCURRING DURING YOGA SFE RESULTED IN DE NOVO VCF. DESPITE THE NEED FOR SELECTIVITY IN YOGA POSES IN POPULATIONS AT INCREASED FRACTURE RISK, BOTH SCIENTIFIC AND MEDIA REPORTS CONTINUE TO ADVERTISE YOGA AS A BONE PROTECTIVE ACTIVITY. ACCORDINGLY, YOGA IS MISCONCEIVED AS A 'ONESIZE-FITS-ALL' PRESCRIPTION. INSTEAD, THE APPROPRIATE SELECTION OF PATIENTS LIKELY TO BENEFIT FROM YOGA MUST BE A CORNERSTONE OF FRACTURE PREVENTION.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
2 2777  57 YOGA SPINAL FLEXION POSITIONS AND VERTEBRAL COMPRESSION FRACTURE IN OSTEOPENIA OR OSTEOPOROSIS OF SPINE: CASE SERIES. OBJECTIVE: THE OBJECTIVE OF THIS REPORT IS TO RAISE AWARENESS OF THE EFFECT OF STRENUOUS YOGA FLEXION EXERCISES ON OSTEOPENIC OR OSTEOPOROTIC SPINES. WE PREVIOUSLY DESCRIBED SUBJECTS WITH KNOWN OSTEOPOROSIS IN WHOM VERTEBRAL COMPRESSION FRACTURES (VCFS) DEVELOPED AFTER SPINAL FLEXION EXERCISE (SFE) AND RECOMMENDED THAT SFES NOT BE PRESCRIBED IN PATIENTS WITH SPINAL OSTEOPOROSIS. METHODS: THIS REPORT DESCRIBES 3 HEALTHY PERSONS WITH LOW BONE MASS AND YOGA-INDUCED PAIN OR FRACTURE. RESULTS: ALL 3 PATIENTS HAD OSTEOPENIA, WERE IN GOOD HEALTH AND PAIN-FREE, AND HAD STARTED YOGA EXERCISES TO IMPROVE THEIR MUSCULOSKELETAL HEALTH. NEW PAIN AND FRACTURE AREAS OCCURRED AFTER PARTICIPATION IN YOGA FLEXION EXERCISES. CONCLUSIONS: THE DEVELOPMENT OF PAIN AND COMPLICATIONS WITH SOME FLEXION YOGA POSITIONS IN THE PATIENTS WITH OSTEOPENIA LEADS TO CONCERN THAT FRACTURE RISK WOULD INCREASE EVEN FURTHER IN OSTEOPOROSIS. ALTHOUGH EXERCISE HAS BEEN SHOWN TO BE EFFECTIVE FOR IMPROVING BONE MINERAL DENSITY AND DECREASING FRACTURE RISK, OUR SUBJECTS HAD DEVELOPMENT OF VCFS AND NECK AND BACK PAIN WITH YOGA EXERCISES. THIS FINDING SUGGESTS THAT FACTORS OTHER THAN BONE MASS SHOULD BE CONSIDERED FOR EXERCISE COUNSELING IN PATIENTS WITH BONE LOSS. THE INCREASED TORQUE PRESSURE APPLIED TO VERTEBRAL BODIES DURING SFES MAY BE A RISK. EXERCISE IS EFFECTIVE AND IMPORTANT FOR TREATMENT OF OSTEOPENIA AND OSTEOPOROSIS AND SHOULD BE PRESCRIBED FOR PATIENTS WITH VERTEBRAL BONE LOSS. SOME YOGA POSITIONS CAN CONTRIBUTE TO EXTREME STRAIN ON SPINES WITH BONE LOSS. ASSESSMENT OF FRACTURE RISK IN OLDER PERSONS PERFORMING SFES AND OTHER HIGH-IMPACT EXERCISES IS AN IMPORTANT CLINICAL CONSIDERATION.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
3 1623  35 MINDFULNESS AND MODIFIED MEDICAL YOGA AS INTERVENTION IN OLDER WOMEN WITH OSTEOPOROTIC VERTEBRAL FRACTURE. BACKGROUND: PEOPLE WITH OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES (VCFS) HAVE DECREASED HEALTH-RELATED QUALITY OF LIFE (HRQOL). YOGA AND MINDFULNESS ARE METHODS THAT CAN PROMOTE WELL-BEING. OBJECTIVE: THE AIM OF THIS ARTICLE WAS TO EXPLORE THE EFFECT OF MINDFULNESS AND MODIFIED MEDICAL YOGA ON HRQOL, STRESS, SLEEP, AND PAIN IN PEOPLE 60 YEARS OR OLDER WITH A DIAGNOSED OSTEOPOROTIC VCF. DESIGN: THE SCHOOL OF OSTEOPOROSIS IN LINKOPING (SOL) IS A PILOT STUDY WITH RANDOMIZED GROUPS. MATERIALS AND METHODS: THE SOL-STUDY WAS SCHEDULED TO ONCE A WEEK FOR 10 WEEKS. TEN PEOPLE WERE RANDOMIZED TO A THEORY (T) GROUP, AND TEN PEOPLE WERE RANDOMIZED TO A THEORY AND MINDFULNESS/MEDICAL YOGA (MMY) GROUP. THE EDUCATIONAL SESSIONS LASTED 60 MIN AND WERE SIMILAR FOR THE GROUPS, BUT THEY TOOK PLACE AT DIFFERENT FACILITIES. AN EXPERIENCED PHYSIOTHERAPIST SUPERVISED THE MMY SESSIONS FOR 60 MIN. SLEEP QUALITY AND PRESENT STRESS EXPERIENCE WERE MEASURED ON A SYMMETRIC LIKERT SCALE. THE NUMERIC RATING SCALE WAS USED FOR PAIN, AND EQ-5D, RAND-36, AND QUALEFFO-41 WERE USED FOR HRQOL. THE PATIENT ENABLEMENT INSTRUMENT (PEI) WAS USED TO REFLECT HOW THE PARTICIPANTS COPED WITH THEIR ILLNESS. RESULTS: EIGHT WOMEN IN THE MMY-GROUP AND SEVEN WOMEN IN THE T-GROUP COMPLETED THE SOL STUDY INTERVENTIONS. THE ADHERENCE TO THE INTERVENTION PROGRAM WAS 89% IN THE MMY-GROUP AND 87% IN THE T-GROUP. THERE WAS NO ADVERSE CONSEQUENCE OF THE MMY TRAINING. AFTER THE 10-WEEK INTERVENTION PERIOD, SLEEP QUALITY (P = 0.018) AND PRESENT STRESS (P = 0.043), BUT NOT PERCEIVED PAIN WERE IMPROVED IN THE MMY-GROUP. THE SOCIAL FUNCTION (SF) DOMAIN WAS IMPROVED IN THE MMY-GROUP THAT WAS MEASURED BY BOTH RAND-36 (P = 0.028) AND QUALEFFO-41 (P = 0.012). THERE WAS A TREND TOWARD A BETTER PEI-SCORE IN THE MMY-GROUP COMPARED WITH THE T-GROUP POSTINTERVENTION (P = 0.089). CONCLUSION: THIS ARTICLE SUGGESTS THAT MINDFULNESS AND MODIFIED MEDICAL YOGA SUPERVISED BY A SKILLED PHYSIOTHERAPIST MAY BE A FEASIBLE WAY TO IMPROVE SF, SLEEP, AND STRESS IN OLDER WOMEN WITH OSTEOPOROTIC VCFS.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
4 2853  46 YOGA, VERTEBRAL FRACTURES, AND OSTEOPOROSIS: RESEARCH AND RECOMMENDATIONS. BACKGROUND: OSTEOPOROSIS IS CHARACTERIZED BY DECREASED BONE DENSITY THAT LEAVES BONES FRAGILE AND HIGHLY SUSCEPTIBLE TO FRACTURE. GLOBALLY, 1 IN 3 WOMEN AND 1 IN 5 MEN OLDER THAN 50 WILL SUFFER FROM AN OSTEOPOROTIC FRACTURE, AND THOSE INDIVIDUALS WILL EXPERIENCE A CONSIDERABLY HIGHER RISK OF POSTFRACTURE MORTALITY THAN WILL THE GENERAL POPULATION. GENTLE, WEIGHT-BEARING EXERCISES SUCH AS YOGA CAN HELP PREVENT OR CEASE THE PROGRESSION OF OSTEOPOROSIS; HOWEVER, THERE IS INSUFFICIENT DATA REGARDING WHICH YOGA POSES PRESENT THE LEAST RISK AND ARE MOST BENEFICIAL TO INDIVIDUALS WITH REDUCED BONE DENSITY. OBJECTIVES: REVIEW THE EXTANT LITERATURE ABOUT THE RISKS AND BENEFITS TO THE SPINE OF PARTICULAR FORMS OF MOVEMENT AND CONSIDER RECOMMENDATIONS RELATIVE TO THE PRACTICE OF YOGA. METHODS: A REVIEW OF THE PUBMED, MEDLINE, AND COCHRANE DATABASES WAS CONDUCTED THAT IDENTIFIED MANUSCRIPTS PUBLISHED BETWEEN 1966 AND 2011 ABOUT TOPICS RELATED TO OSTEOPOROSIS AND SPINAL MOVEMENT. CONCLUSIONS: MOVEMENTS INVOLVING SPINAL FLEXION CAN INCREASE RISK FOR VERTEBRAL COMPRESSION FRACTURES; HOWEVER, A COMBINATION OF MILD SPINAL FLEXION AND EXTENSION MAY PROVE BENEFICIAL. MODERATE, WEIGHT-BEARING ACTIVITIES THAT STRENGTHEN THE MUSCLES SUPPORTING THE SPINAL COLUMN, PROMOTE BALANCE, IMPROVE POSTURE, AND ENHANCE QUALITY OF LIFE APPEAR TO BE OF GREATEST BENEFIT. AMPLE EVIDENCE SUPPORTS THE IMPORTANCE OF VARIED SPINAL MOVEMENT FOR PRESERVING THE HEALTH AND STRENGTH OF THE VERTEBRAL BODIES. EXERCISE MODIFICATIONS SUITABLE FOR HIGH-RISK INDIVIDUALS MAY BE COUNTERPRODUCTIVE FOR THOSE AT LOW RISK FOR VERTEBRAL FRACTURES. YOGA THERAPISTS ARE CAUTIONED TO NOT APPLY A ONE-SIZE-FITS-ALL APPROACH WHEN WORKING WITH THIS POPULATION. WELL-DESIGNED EMPIRICAL STUDIES ARE NEEDED TO FURTHER OUR UNDERSTANDING OF WHICH YOGA POSES PRESENT THE LEAST RISK AND ARE OF GREATEST BENEFIT TO INDIVIDUALS WITH OSTEOPOROSIS.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
5  914  42 EFFECTIVENESS OF PILATES AND YOGA TO IMPROVE BONE DENSITY IN ADULT WOMEN: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: THE AGEING POPULATION BRINGS ABOUT THE APPEARANCE OF AGE-RELATED HEALTH DISORDERS, SUCH AS OSTEOPOROSIS OR OSTEOPENIA. THESE DISORDERS ARE ASSOCIATED WITH FRAGILITY FRACTURES. THE IMPACT IS GREATER AMONG POSTMENOPAUSAL WOMEN DUE TO AN ACCELERATION OF BONE MINERAL DENSITY (BMD) LOSS. OBJECTIVE: TO ESTIMATE THE EFFECTIVENESS OF PILATES OR YOGA ON BMD IN ADULT WOMEN. METHODS: FIVE ELECTRONICS DATABASES WERE SEARCHED UP TO APRIL 2021. RANDOMIZED CONTROLLED TRIALS (RCTS), NON-RCTS AND PRE-POST STUDIES WERE INCLUDED. THE MAIN OUTCOME WAS BMD. RISK OF BIAS WAS EVALUATED USING THE COCHRANE RISK OF BIAS TOOL. A RANDOM EFFECTS MODEL WAS USED TO POOL DATA FROM PRIMARY STUDIES. SUBGROUP ANALYSES BASED ON THE TYPE OF EXERCISE WERE CONDUCTED. RESULTS: ELEVEN STUDIES INCLUDING 591 PARTICIPANTS AGED BETWEEN 45 AND 78 YEARS WERE INCLUDED. THE MEAN LENGTH OF THE INTERVENTIONS RANGED FROM 12 TO 32 WEEKS, AND TWO STUDIES WERE PERFORMED FOR A PERIOD OF AT LEAST ONE YEAR. THE POOLED EFFECT SIZE FOR THE EFFECT OF THE INTERVENTION (PILATES/YOGA) VS THE CONTROL GROUP WAS 0.07 (95% CONFIDENCE INTERVAL [CI]: -0.05 TO 0.19; I2 = 0.0%), AND 0.10 (95% CI: 0.01 TO 0.18; I2 = 18.4%) FOR THE SECONDARY ANALYSIS OF THE PRE-POST INTERVENTION. CONCLUSIONS: DESPITE OF THE NON-SIGNIFICANT RESULTS, THE BMD MAINTENANCE IN THE POSTMENOPAUSAL POPULATION, WHEN BMD DETRIMENTAL IS EXPECTED, COULD BE UNDERSTOOD AS A POSITIVE RESULT ADDED TO THE BENEFICIAL IMPACT OF PILATES-YOGA IN MULTIPLE FRACTURE RISK FACTORS, INCLUDING BUT NOT LIMITED TO, STRENGTH AND BALANCE.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
6 2722  38 YOGA MIGHT BE AN ALTERNATIVE TRAINING FOR THE QUALITY OF LIFE AND BALANCE IN POSTMENOPAUSAL OSTEOPOROSIS. AIM: OSTEOPOROTIC VERTEBRA AND HIP FRACTURES ARE MAJOR CAUSES OF DYSFUNCTION, DISABILITY, MORTALITY AND IMPAIRED LIFE QUALITY IN THE AGEING POPULATION. IN THE POSTMENOPAUSAL PERIOD, EXERCISES PREVENT RAPID BONE LOSS AND INCREASE MUSCLE STRENGTH, MOBILITY AND FLEXIBILITY THEREBY DECREASING THE RISK OF FALLS AND FRACTURES. YOGA EXERCISES, WHICH HAVE BEEN AN INSEPARABLE PART OF EASTERN CULTURE FOR HUNDREDS OF YEARS, ARE NOW BEING USED IN THE FIELD OF OSTEOPOROSIS REHABILITATION. YOGA HAS A POSITIVE EFFECT ON BALANCE, POSTURE, FLEXIBILITY, AND LIFE QUALITY RESULTING FROM ITS EFFECTS ON BALANCE, STRETCHING, RELAXATION AND STRENGTHENING. THE AIM OF THIS STUDY WAS TO EVALUATE THE EFFECT OF YOGA EXERCISES IN POSTMENOPAUSAL OSTEOPOROTIC WOMEN ON BALANCE AND LIFE QUALITY AND TO COMPARE THE RESULTS WITH A CLASSIC OSTEOPOROSIS EXERCISE PROGRAM. METHODS: TWENTY-SIX POSTMENOPAUSAL OSTEOPOROTIC WOMEN OVER 55 YEARS OF AGE WERE INCLUDED IN THE STUDY. A NEUROMUSCULAR TEST BATTERY AND THE QUALEFFO AS A LIFE QUALITY INDEX WERE USED FOR THE ASSESSMENT OF BALANCE AND LIFE QUALITY, RESPECTIVELY. RESULTS: THE RESULTS SHOWED THAT YOGA EDUCATION HAS A POSITIVE EFFECT ON PAIN, PHYSICAL FUNCTIONS, SOCIAL FUNCTIONS, GENERAL CONCLUSION: IN CONCLUSION, YOGA APPEARS TO BE AN ALTERNATIVE PHYSICAL ACTIVITY FOR THE REHABILITATION OF OSTEOPOROTIC SUBJECTS.	2010	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
7  825  42 EFFECT OF YOGA ON HEALTH-RELATED OUTCOMES IN PEOPLE AT RISK OF FRACTURES: A SYSTEMATIC REVIEW. WE SUMMARIZED THE EFFECTS OF YOGA ON HEALTH-RELATED OUTCOMES AND ADVERSE EVENTS IN MEN AND POSTMENOPAUSAL WOMEN >/=50 YEARS-OLD AT INCREASED RISK OF FRACTURE, TO INFORM THE UPDATED OSTEOPOROSIS CANADA CLINICAL PRACTICE GUIDELINES. SIX DATABASES WERE SEARCHED FOR OBSERVATIONAL STUDIES, RANDOMIZED CONTROLLED TRIALS AND CASE SERIES. CERTAINTY OF EVIDENCE WAS ASSESSED USING THE GRADING OF RECOMMENDATIONS, ASSESSMENT, DEVELOPMENT AND EVALUATION HANDBOOK. NINE STUDIES WERE INCLUDED AND REPORTED USING NARRATIVE SYNTHESES DUE TO THE LIMITED AVAILABLE EVIDENCE. OVERALL, THE AVAILABLE EVIDENCE WAS OF VERY LOW CERTAINTY. THERE WAS NO EFFECT OF YOGA ON HEALTH-RELATED QUALITY OF LIFE IN RANDOMIZED TRIALS. EFFECTS ON OTHER HEALTH-RELATED OUTCOMES WERE MIXED OR NOT AVAILABLE IN THE LITERATURE. FIVE STUDIES REPORTED NO ADVERSE EVENTS DIRECTLY RELATED TO THE STUDY INTERVENTION, AND 2 STUDIES DID NOT REPORT WHETHER ADVERSE EVENTS OCCURRED. HOWEVER, 2 CASE SERIES REPORTED VERTEBRAL FRACTURES RELATED TO YOGA PARTICIPATION, POSSIBLY DUE TO EXCESSIVE SPINAL FLEXION. DUE TO THE LIMITED AND VERY LOW CERTAINTY EVIDENCE, GUIDELINE DEVELOPERS WILL NEED TO DRAW INDIRECT EVIDENCE FROM YOGA STUDIES AMONG MIDDLE AGED OR OLDER ADULTS THAT ARE NOT AT FRACTURE RISK. PROSPERO: CRD42019124898. NOVELTY: EVIDENCE IN GENERAL WAS OF VERY LOW CERTAINTY. YOGA HAD NO EFFECT ON HEALTH-RELATED QUALITY OF LIFE IN RANDOMIZED TRIALS. EVIDENCE WAS MIXED OR UNAVAILABLE FOR OTHER OUTCOMES. CASE STUDIES REPORTED YOGA POSES INVOLVING SPINAL FLEXION COINCIDED WITH INCIDENTS OF VERTEBRAL COMPRESSION FRACTURE AMONG OLDER ADULTS WITH INCREASED FRACTURE RISK.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
8 1111  33 EFFECTS OF YOGASANAS ON OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN. BACKGROUND: OSTEOPOROSIS IS COMMONLY ENCOUNTERED BY POSTMENOPAUSAL WOMEN. THERE IS AN INCREASED NEED FOR A LOW COST AND EFFICIENT TREATMENT ALTERNATIVE TO ADDRESS THIS POPULATION. AIMS: TO STUDY THE EFFECTS OF INTEGRATED YOGA ON BONE MINERAL DENSITY (BMD) IN POSTMENOPAUSAL WOMEN WITH OSTEOPOROSIS. SETTINGS AND DESIGNS: EXPERIMENTAL PRE-POST STUDY CONDUCTED IN A COMMUNITY SETTING. MATERIALS AND METHODS: 30 FEMALES IN THE AGE GROUP OF 45-62 YEARS SUFFERING FROM POSTMENOPAUSAL OSTEOPOROSIS WITH A DUAL-ENERGY X-RAY ABSORPTIOMETRY (DEXA) SCORE OF </=-2.5 UNDERWENT A 6 MONTHS FULLY SUPERVISED YOGA SESSION. ALL THE PARTICIPANTS COMPLETED THE STUDY. PRETRAINING AND POSTTRAINING BMD WAS CALCULATED. OUTCOME MEASURE: DEXA SCORE AT THE LUMBAR SPINE. STATISTICAL ANALYSIS: THE STUDY WAS STATISTICALLY ANALYZED USING PAIRED T-TEST TO SEE THE SIGNIFICANCE OF PRETRAINING AND POSTTRAINING EFFECTS OF A YOGA SESSION. RESULTS: IMPROVEMENT IN T-SCORE OF DEXA SCAN OF -2.55 +/- 0.25 AT POSTTRAINING AS COMPARED TO A PRETRAINING SCORE OF -2.69 +/- 0.17. CONCLUSIONS: INTEGRATED YOGA IS A SAFE MODE OF PHYSICAL ACTIVITY WHICH INCLUDES WEIGHT BEARING AS WELL AS NOT WEIGHT BEARING ASANAS, PRANAYAMA, AND SURYANAMASKAR, ALL OF WHICH HELPS INDUCE IMPROVEMENT IN BMD IN POSTMENOPAUSAL OSTEOPOROTIC FEMALES.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
9  507  32 COMPARATIVE EFFECTIVENESS OF PILATES AND YOGA GROUP EXERCISE INTERVENTIONS FOR CHRONIC MECHANICAL NECK PAIN: QUASI-RANDOMISED PARALLEL CONTROLLED STUDY. OBJECTIVES: TO DETERMINE THE EFFECTIVENESS OF PILATES AND YOGA GROUP EXERCISE INTERVENTIONS FOR INDIVIDUALS WITH CHRONIC NECK PAIN (CNP). DESIGN: QUASI-RANDOMISED PARALLEL CONTROLLED STUDY. SETTING: COMMUNITY, UNIVERSITY AND PRIVATE PRACTICE SETTINGS IN FOUR LOCATIONS. PARTICIPANTS: FIFTY-SIX INDIVIDUALS WITH CNP SCORING >/=3/10 ON THE NUMERIC PAIN RATING SCALE FOR >3 MONTHS (CONTROLS N=17, PILATES N=20, YOGA N=19). INTERVENTIONS: EXERCISE PARTICIPANTS COMPLETED 12 SMALL-GROUP SESSIONS WITH MODIFICATIONS AND PROGRESSIONS SUPERVISED BY A PHYSIOTHERAPIST. MAIN OUTCOME MEASURES: THE PRIMARY OUTCOME MEASURE WAS THE NECK DISABILITY INDEX (NDI). SECONDARY OUTCOMES WERE PAIN RATINGS, RANGE OF MOVEMENT AND POSTURAL MEASUREMENTS COLLECTED AT BASELINE, 6 WEEKS AND 12 WEEKS. FOLLOW-UP WAS PERFORMED 6 WEEKS AFTER COMPLETION OF THE EXERCISE CLASSES (WEEK 18). RESULTS: NDI DECREASED SIGNIFICANTLY IN THE PILATES {BASELINE: 11.1 [STANDARD DEVIATION (SD) 4.3] VS WEEK 12: 6.8 (SD 4.3); MEAN DIFFERENCE -4.3 (95% CONFIDENCE INTERVAL -1.64 TO -6.7); P<0.001} AND YOGA GROUPS [BASELINE: 12.8 (SD 7.4) VS WEEK 12: 8.1 (SD 5.6); MEAN DIFFERENCE -4.7 (95% CONFIDENCE INTERVAL -2.1 TO -7.4); P<0.00], WITH NO CHANGE IN THE CONTROL GROUP. PAIN RATINGS ALSO IMPROVED SIGNIFICANTLY. MODERATE-TO-LARGE EFFECT SIZES (0.7 TO 1.8) AND LOW NUMBERS NEEDED TO TREAT WERE FOUND. THERE WERE NO DIFFERENCES IN OUTCOMES BETWEEN THE EXERCISE GROUPS OR ASSOCIATED ADVERSE EFFECTS. NO IMPROVEMENTS IN RANGE OF MOVEMENT OR POSTURE WERE FOUND. CONCLUSIONS: PILATES AND YOGA GROUP EXERCISE INTERVENTIONS WITH APPROPRIATE MODIFICATIONS AND SUPERVISION WERE SAFE AND EQUALLY EFFECTIVE FOR DECREASING DISABILITY AND PAIN COMPARED WITH THE CONTROL GROUP FOR INDIVIDUALS WITH MILD-TO-MODERATE CNP. PHYSIOTHERAPISTS MAY CONSIDER INCLUDING THESE APPROACHES IN A PLAN OF CARE. CLINICAL TRIAL REGISTRATION NUMBER: CLINICALTRIALS.GOV NCT01999283.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
10  518  30 COMPARING ONCE- VERSUS TWICE-WEEKLY YOGA CLASSES FOR CHRONIC LOW BACK PAIN IN PREDOMINANTLY LOW INCOME MINORITIES: A RANDOMIZED DOSING TRIAL. BACKGROUND. PREVIOUS STUDIES HAVE DEMONSTRATED THAT ONCE-WEEKLY YOGA CLASSES ARE EFFECTIVE FOR CHRONIC LOW BACK PAIN (CLBP) IN WHITE ADULTS WITH HIGH SOCIOECONOMIC STATUS. THE COMPARATIVE EFFECTIVENESS OF TWICE-WEEKLY CLASSES AND GENERALIZABILITY TO RACIALLY DIVERSE LOW INCOME POPULATIONS ARE UNKNOWN. METHODS. WE CONDUCTED A 12-WEEK RANDOMIZED, PARALLEL-GROUP, DOSING TRIAL FOR 95 ADULTS RECRUITED FROM AN URBAN SAFETY-NET HOSPITAL AND FIVE COMMUNITY HEALTH CENTERS COMPARING ONCE-WEEKLY (N = 49) VERSUS TWICE-WEEKLY (N = 46) STANDARDIZED YOGA CLASSES SUPPLEMENTED BY HOME PRACTICE. PRIMARY OUTCOMES WERE CHANGE FROM BASELINE TO 12 WEEKS IN PAIN (11-POINT SCALE) AND BACK-RELATED FUNCTION (23-POINT MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE). RESULTS. 82% OF PARTICIPANTS WERE NONWHITE; 77% HAD ANNUAL HOUSEHOLD INCOMES <$40,000. THE SAMPLE'S BASELINE MEAN PAIN INTENSITY [6.9 (SD 1.6)] AND FUNCTION [13.7 (SD 5.0)] REFLECTED MODERATE TO SEVERE BACK PAIN AND IMPAIRMENT. PAIN AND BACK-RELATED FUNCTION IMPROVED WITHIN BOTH GROUPS (P < 0.001). HOWEVER, THERE WERE NO DIFFERENCES BETWEEN ONCE-WEEKLY AND TWICE-WEEKLY GROUPS FOR PAIN REDUCTION [-2.1 (95% CI -2.9, -1.3) VERSUS -2.4 (95% CI -3.1, -1.8), P = 0.62] OR BACK-RELATED FUNCTION [-5.1 (95% CI -7.0, -3.2) VERSUS -4.9 (95% CI -6.5, -3.3), P = 0.83]. CONCLUSIONS. TWELVE WEEKS OF ONCE-WEEKLY OR TWICE-WEEKLY YOGA CLASSES WERE SIMILARLY EFFECTIVE FOR PREDOMINANTLY LOW INCOME MINORITY ADULTS WITH MODERATE TO SEVERE CHRONIC LOW BACK PAIN. THIS TRIAL IS REGISTERED WITH CLINICALTRIALS.GOV NCT01761617.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
11 1107  32 EFFECTS OF YOGA, STRENGTH TRAINING AND ADVICE ON BACK PAIN: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: AMONG THE WORKING POPULATION, NON-SPECIFIC LOW-BACK PAIN AND NECK PAIN ARE ONE OF THE MOST COMMON REASONS FOR SICKNESS ABSENTEEISM. THE AIM WAS TO EVALUATE THE EFFECTS OF AN EARLY INTERVENTION OF YOGA - COMPARED WITH STRENGTH TRAINING OR EVIDENCE-BASED ADVICE - ON SICKNESS ABSENTEEISM, SICKNESS PRESENTEEISM, BACK AND NECK PAIN AND DISABILITY AMONG A WORKING POPULATION. METHODS: A RANDOMIZED CONTROLLED TRIAL WAS CONDUCTED ON 159 PARTICIPANTS WITH PREDOMINANTLY (90%) CHRONIC BACK AND NECK PAIN. AFTER SCREENING, THE PARTICIPANTS WERE RANDOMIZED TO KUNDALINI YOGA, STRENGTH TRAINING OR EVIDENCE-BASED ADVICE. PRIMARY OUTCOME WAS SICKNESS ABSENTEEISM. SECONDARY OUTCOMES WERE SICKNESS PRESENTEEISM, BACK AND NECK PAIN AND DISABILITY. SELF-REPORTED QUESTIONNAIRES AND SMS TEXT MESSAGES WERE COMPLETED AT BASELINE, 6 WEEKS, 6 AND 12 MONTHS. RESULTS: THE RESULTS DID NOT INDICATE THAT KUNDALINI YOGA AND STRENGTH TRAINING HAD ANY STATISTICALLY SIGNIFICANT EFFECTS ON THE PRIMARY OUTCOME COMPARED WITH EVIDENCE-BASED ADVICE. AN INTERACTION EFFECT WAS FOUND BETWEEN ADHERENCE TO RECOMMENDATIONS AND SICKNESS ABSENTEEISM, INDICATING LARGER SIGNIFICANT EFFECTS AMONG THE ADHERERS TO KUNDALINI YOGA VERSUS EVIDENCE-BASED ADVICE: RR = 0.47 (CI 0.30; 0.74, P = 0.001), STRENGTH TRAINING VERSUS EVIDENCE-BASED ADVICE: RR = 0.60 (CI 0.38; 0.96, P = 0.032). SOME SIGNIFICANT DIFFERENCES WERE ALSO FOUND FOR THE SECONDARY OUTCOMES TO THE ADVANTAGE OF KUNDALINI YOGA AND STRENGTH TRAINING. CONCLUSIONS: GUIDED EXERCISE IN THE FORMS OF KUNDALINI YOGA OR STRENGTH TRAINING DOES NOT REDUCE SICKNESS ABSENTEEISM MORE THAN EVIDENCE-BASED ADVICE ALONE. HOWEVER, SECONDARY ANALYSES REVEAL THAT AMONG THOSE WHO PURSUE KUNDALINI YOGA OR STRENGTH TRAINING AT LEAST TWO TIMES A WEEK, A SIGNIFICANTLY REDUCTION IN SICKNESS ABSENTEEISM WAS FOUND. METHODS TO INCREASE ADHERENCE TO TREATMENT RECOMMENDATIONS SHOULD BE FURTHER DEVELOPED AND APPLIED IN EXERCISE INTERVENTIONS. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT01653782, DATE OF REGISTRATION: JUNE, 28, 2012, RETROSPECTIVELY REGISTERED.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
12 2518  39 YOGA COMPARED TO NON-EXERCISE OR PHYSICAL THERAPY EXERCISE ON PAIN, DISABILITY, AND QUALITY OF LIFE FOR PATIENTS WITH CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. BACKGROUND: CHRONIC LOW BACK PAIN (CLBP) IS A COMMON AND OFTEN DISABLING MUSCULOSKELETAL CONDITION. YOGA HAS BEEN PROVEN TO BE AN EFFECTIVE THERAPY FOR CHRONIC LOW BACK PAIN. HOWEVER, THERE ARE STILL CONTROVERSIES ABOUT THE EFFECTS OF YOGA AT DIFFERENT FOLLOW-UP PERIODS AND COMPARED WITH OTHER PHYSICAL THERAPY EXERCISES. OBJECTIVE: TO CRITICALLY COMPARE THE EFFECTS OF YOGA FOR PATIENTS WITH CHRONIC LOW BACK PAIN ON PAIN, DISABILITY, QUALITY OF LIFE WITH NON-EXERCISE (E.G. USUAL CARE, EDUCATION), PHYSICAL THERAPY EXERCISE. METHODS: THIS STUDY WAS REGISTERED IN PROSPERO, AND THE REGISTRATION NUMBER WAS CRD42020159865. RANDOMIZED CONTROLLED TRIALS (RCTS) OF ONLINE DATABASES INCLUDED PUBMED, WEB OF SCIENCE, COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, EMBASE WHICH EVALUATED EFFECTS OF YOGA FOR PATIENTS WITH CHRONIC LOW BACK PAIN ON PAIN, DISABILITY, AND QUALITY OF LIFE WERE SEARCHED FROM INCEPTION TIME TO NOVEMBER 1, 2019. STUDIES WERE ELIGIBLE IF THEY ASSESSED AT LEAST ONE IMPORTANT OUTCOME, NAMELY PAIN, BACK-SPECIFIC DISABILITY, QUALITY OF LIFE. THE COCHRANE RISK OF BIAS TOOL WAS USED TO ASSESS THE METHODOLOGICAL QUALITY OF INCLUDED RANDOMIZED CONTROLLED TRIALS. THE CONTINUOUS OUTCOMES WERE ANALYZED BY CALCULATING THE MEAN DIFFERENCE (MD) OR STANDARDIZED MEAN DIFFERENCE (SMD) WITH 95% CONFIDENCE INTERVALS (CI) ACCORDING TO WHETHER COMBINING OUTCOMES MEASURED ON DIFFERENT SCALES OR NOT. RESULTS: A TOTAL OF 18 RANDOMIZED CONTROLLED TRIALS WERE INCLUDED IN THIS META-ANALYSIS. YOGA COULD SIGNIFICANTLY REDUCE PAIN AT 4 TO 8 WEEKS (MD = -0.83, 95% CI = -1.19 TO -0.48, P<0.00001, I2 = 0%), 3 MONTHS (MD = -0.43, 95% CI = -0.64 TO -0.23, P<0.0001, I2 = 0%), 6 TO 7 MONTHS (MD = -0.56, 95% CI = -1.02 TO -0.11, P = 0.02, I2 = 50%), AND WAS NOT SIGNIFICANT IN 12 MONTHS (MD = -0.52, 95% CI = -1.64 TO 0.59, P = 0.36, I2 = 87%) COMPARED WITH NON-EXERCISE. YOGA WAS BETTER THAN NON-EXERCISE ON DISABILITY AT 4 TO 8 WEEKS (SMD = -0.30, 95% CI = -0.51 TO -0.10, P = 0.003, I2 = 0%), 3 MONTHS (SMD = -0.31, 95% CI = -0.45 TO -0.18, P<0.00001, I2 = 30%), 6 MONTHS (SMD = -0.38, 95% CI = -0.53 TO -0.23, P<0.00001, I2 = 0%), 12 MONTHS (SMD = -0.33, 95% CI = -0.54 TO -0.12, P = 0.002, I2 = 9%). THERE WAS NO SIGNIFICANT DIFFERENCE ON PAIN, DISABILITY COMPARED WITH PHYSICAL THERAPY EXERCISE GROUP. FURTHERMORE, IT SUGGESTED THAT THERE WAS A NON-SIGNIFICANT DIFFERENCE ON PHYSICAL AND MENTAL QUALITY OF LIFE BETWEEN YOGA AND ANY OTHER INTERVENTIONS. CONCLUSION: THIS META-ANALYSIS PROVIDED EVIDENCE FROM VERY LOW TO MODERATE INVESTIGATING THE EFFECTIVENESS OF YOGA FOR CHRONIC LOW BACK PAIN PATIENTS AT DIFFERENT TIME POINTS. YOGA MIGHT DECREASE PAIN FROM SHORT TERM TO INTERMEDIATE TERM AND IMPROVE FUNCTIONAL DISABILITY STATUS FROM SHORT TERM TO LONG TERM COMPARED WITH NON-EXERCISE (E.G. USUAL CARE, EDUCATION). YOGA HAD THE SAME EFFECT ON PAIN AND DISABILITY AS ANY OTHER EXERCISE OR PHYSICAL THERAPY. YOGA MIGHT NOT IMPROVE THE PHYSICAL AND MENTAL QUALITY OF LIFE BASED ON THE RESULT OF A MERGING.	2020	

13 2590  40 YOGA FOR MANAGING KNEE OSTEOARTHRITIS IN OLDER WOMEN: A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: OSTEOARTHRITIS (OA) IS A COMMON PROBLEM IN OLDER WOMEN THAT IS ASSOCIATED WITH PAIN AND DISABILITIES. ALTHOUGH YOGA IS RECOMMENDED AS AN EXERCISE INTERVENTION TO MANAGE ARTHRITIS, THERE IS LIMITED EVIDENCE DOCUMENTING ITS EFFECTIVENESS, WITH LITTLE KNOWN ABOUT ITS LONG TERM BENEFITS. THIS STUDY'S AIMS WERE TO ASSESS THE FEASIBILITY AND POTENTIAL EFFICACY OF A HATHA YOGA EXERCISE PROGRAM IN MANAGING OA-RELATED SYMPTOMS IN OLDER WOMEN WITH KNEE OA. METHODS: ELIGIBLE PARTICIPANTS (N=36; MEAN AGE 72 YEARS) WERE RANDOMLY ASSIGNED TO 8-WEEK YOGA PROGRAM INVOLVING GROUP AND HOME-BASED SESSIONS OR WAIT-LIST CONTROL. THE YOGA INTERVENTION PROGRAM WAS DEVELOPED BY A GROUP OF YOGA EXPERTS (N=5). THE PRIMARY OUTCOME WAS THE WESTERN ONTARIO AND MCMASTER UNIVERSITIES OSTEOARTHRITIS INDEX (WOMAC) TOTAL SCORE THAT MEASURES KNEE OA PAIN, STIFFNESS, AND FUNCTION AT 8 WEEKS. THE SECONDARY OUTCOMES, PHYSICAL FUNCTION OF THE LOWER EXTREMITIES, BODY MASS INDEX (BMI), QUALITY OF SLEEP (QOS), AND QUALITY OF LIFE (QOL), WERE MEASURED USING WEIGHT, HEIGHT, THE SHORT PHYSICAL PERFORMANCE BATTERY (SPPB), THE PITTSBURGH SLEEP QUALITY INDEX (PSQI), THE CANTRIL SELF-ANCHORING LADDER, AND THE SF12V2 HEALTH SURVEY. DATA WERE COLLECTED AT BASELINE, 4 WEEKS AND 8 WEEKS, AND 20 WEEKS. RESULTS: THE RECRUITMENT TARGET WAS MET, WITH STUDY RETENTION AT 95%. BASED ON ANCOVAS, PARTICIPANTS IN THE TREATMENT GROUP EXHIBITED SIGNIFICANTLY GREATER IMPROVEMENT IN WOMAC PAIN (ADJUSTED MEANS [SE]) (8.3 [.67], 5.8 [.67]; P=.01), STIFFNESS (4.7 [.28], 3.4 [.28]; P=.002) AND SPPB (REPEATED CHAIR STANDS) (2.0 [.23], 2.8 [.23]; P=.03) AT 8 WEEKS. SIGNIFICANT TREATMENT AND TIME EFFECTS WERE SEEN IN WOMAC PAIN (7.0 [.46], 5.4 [.54]; P=.03), FUNCTION (24.5 [1.8], 19.9 [1.6]; P=.01) AND TOTAL SCORES (35.4 [2.3], 28.6 [2.1]; P=.01) FROM 4 TO 20 WEEKS. SLEEP DISTURBANCE WAS IMPROVED BUT THE PSQI TOTAL SCORE DECLINED SIGNIFICANTLY AT 20 WEEKS. CHANGES IN BMI AND QOL WERE NOT SIGNIFICANT. NO YOGA RELATED ADVERSE EVENTS WERE OBSERVED. CONCLUSIONS: A WEEKLY YOGA PROGRAM WITH HOME PRACTICE IS FEASIBLE, ACCEPTABLE, AND SAFE FOR OLDER WOMEN WITH KNEE OA, AND SHOWS THERAPEUTIC BENEFITS. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT01832155.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
14 2831  34 YOGA VS. PHYSICAL THERAPY VS. EDUCATION FOR CHRONIC LOW BACK PAIN IN PREDOMINANTLY MINORITY POPULATIONS: STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN CAUSES SUBSTANTIAL MORBIDITY AND COST TO SOCIETY WHILE DISPROPORTIONATELY IMPACTING LOW-INCOME AND MINORITY ADULTS. SEVERAL RANDOMIZED CONTROLLED TRIALS SHOW YOGA IS AN EFFECTIVE TREATMENT. HOWEVER, THE COMPARATIVE EFFECTIVENESS OF YOGA AND PHYSICAL THERAPY, A COMMON MAINSTREAM TREATMENT FOR CHRONIC LOW BACK PAIN, IS UNKNOWN. METHODS/DESIGN: THIS IS A RANDOMIZED CONTROLLED TRIAL FOR 320 PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH CHRONIC LOW BACK PAIN, COMPARING YOGA, PHYSICAL THERAPY, AND EDUCATION. INCLUSION CRITERIA ARE ADULTS 18-64 YEARS OLD WITH NON-SPECIFIC LOW BACK PAIN LASTING >/= 12 WEEKS AND A SELF-REPORTED AVERAGE PAIN INTENSITY OF >/= 4 ON A 0-10 SCALE. RECRUITMENT TAKES PLACE AT BOSTON MEDICAL CENTER, AN URBAN ACADEMIC SAFETY-NET HOSPITAL AND SEVEN FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS LOCATED IN DIVERSE NEIGHBORHOODS. THE 52-WEEK STUDY HAS AN INITIAL 12-WEEK TREATMENT PHASE WHERE PARTICIPANTS ARE RANDOMIZED IN A 2:2:1 RATIO INTO I) A STANDARDIZED WEEKLY HATHA YOGA CLASS SUPPLEMENTED BY HOME PRACTICE; II) A STANDARDIZED EVIDENCE-BASED EXERCISE THERAPY PROTOCOL ADAPTED FROM THE TREATMENT BASED CLASSIFICATION METHOD, INDIVIDUALLY DELIVERED BY A PHYSICAL THERAPIST AND SUPPLEMENTED BY HOME PRACTICE; AND III) EDUCATION DELIVERED THROUGH A SELF-CARE BOOK. CO-PRIMARY OUTCOME MEASURES ARE 12-WEEK PAIN INTENSITY MEASURED ON AN 11-POINT NUMERICAL RATING SCALE AND BACK-SPECIFIC FUNCTION MEASURED USING THE MODIFIED ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 40-WEEK MAINTENANCE PHASE, YOGA PARTICIPANTS ARE RE-RANDOMIZED IN A 1:1 RATIO TO EITHER STRUCTURED MAINTENANCE YOGA CLASSES OR HOME PRACTICE ONLY. PHYSICAL THERAPY PARTICIPANTS ARE SIMILARLY RE-RANDOMIZED TO EITHER FIVE BOOSTER SESSIONS OR HOME PRACTICE ONLY. EDUCATION PARTICIPANTS CONTINUE TO FOLLOW RECOMMENDATIONS OF EDUCATIONAL MATERIALS. WE WILL ALSO ASSESS COST EFFECTIVENESS FROM THE PERSPECTIVES OF THE INDIVIDUAL, INSURERS, AND SOCIETY USING CLAIMS DATABASES, ELECTRONIC MEDICAL RECORDS, SELF-REPORT COST DATA, AND STUDY RECORDS. QUALITATIVE DATA FROM INTERVIEWS WILL ADD SUBJECTIVE DETAIL TO COMPLEMENT QUANTITATIVE DATA. TRIAL REGISTRATION: THIS TRIAL IS REGISTERED IN CLINICALTRIALS.GOV, WITH THE ID NUMBER: NCT01343927.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
15   74  27 A GROUP-BASED YOGA THERAPY INTERVENTION FOR URINARY INCONTINENCE IN WOMEN: A PILOT RANDOMIZED TRIAL. OBJECTIVE: THE AIM OF THIS STUDY IS TO EXAMINE THE FEASIBILITY, EFFICACY, AND SAFETY OF A GROUP-BASED YOGA THERAPY INTERVENTION FOR MIDDLE-AGED AND OLDER WOMEN WITH URINARY INCONTINENCE. METHODS: WE CONDUCTED A PILOT RANDOMIZED TRIAL OF AMBULATORY WOMEN AGED 40 YEARS AND OLDER WITH STRESS, URGENCY, OR MIXED-TYPE INCONTINENCE. WOMEN WERE RANDOMIZED TO A 6-WEEK YOGA THERAPY PROGRAM (N = 10) CONSISTING OF TWICE WEEKLY GROUP CLASSES AND ONCE WEEKLY HOME PRACTICE OR A WAIT-LIST CONTROL GROUP (N = 9). ALL PARTICIPANTS ALSO RECEIVED WRITTEN PAMPHLETS ABOUT STANDARD BEHAVIORAL SELF-MANAGEMENT STRATEGIES FOR INCONTINENCE. CHANGES IN INCONTINENCE WERE ASSESSED WITH 7-DAY VOIDING DIARIES. RESULTS: THE MEAN (SD) AGE WAS 61.4 (8.2) YEARS, AND THE MEAN BASELINE FREQUENCY OF INCONTINENCE WAS 2.5 (1.3) EPISODES/D. AFTER 6 WEEKS, THE TOTAL INCONTINENCE FREQUENCY DECREASED BY 70% (1.8 [0.9] FEWER EPISODES/D) IN THE YOGA THERAPY VERSUS 13% (0.3 [1.7] FEWER EPISODES/D) IN THE CONTROL GROUP (P = 0.049). PARTICIPANTS IN THE YOGA THERAPY GROUP ALSO REPORTED AN AVERAGE OF 71% DECREASE IN STRESS INCONTINENCE FREQUENCY (0.7 [0.8] FEWER EPISODES/D) COMPARED WITH A 25% INCREASE IN CONTROLS (0.2 [1.1] MORE EPISODES/D) (P = 0.039). NO SIGNIFICANT DIFFERENCES IN REDUCTION IN URGENCY INCONTINENCE WERE DETECTED BETWEEN THE YOGA THERAPY VERSUS CONTROL GROUPS (1.0 [1.0] VERSUS 0.5 [0.5] FEWER EPISODES/D; P = 0.20). ALL WOMEN STARTING THE YOGA THERAPY PROGRAM COMPLETED AT LEAST 90% OF THE GROUP CLASSES AND PRACTICE SESSIONS. TWO PARTICIPANTS IN EACH GROUP REPORTED ADVERSE EVENTS UNRELATED TO THE INTERVENTION. CONCLUSIONS: FINDINGS PROVIDE PRELIMINARY EVIDENCE TO SUPPORT THE FEASIBILITY, EFFICACY, AND SAFETY OF A GROUP-BASED YOGA THERAPY INTERVENTION TO IMPROVE URINARY INCONTINENCE IN WOMEN.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
16  521  35 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	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
17 1870  31 RANDOMIZED-CONTROLLED TRIAL COMPARING YOGA AND HOME-BASED EXERCISE FOR CHRONIC NECK PAIN. OBJECTIVES: CHRONIC NECK PAIN IS A SIGNIFICANT PUBLIC HEALTH PROBLEM WITH ONLY VERY FEW EVIDENCE-BASED TREATMENT OPTIONS. THERE IS GROWING EVIDENCE FOR THE EFFECTIVENESS OF YOGA FOR RELIEVING MUSCULOSKELETAL DISORDERS. THE AIM OF THIS STUDY WAS TO EVALUATE THE EFFECT OF IYENGAR YOGA COMPARED WITH EXERCISE ON CHRONIC NONSPECIFIC NECK PAIN. METHODS: PATIENTS WERE RANDOMLY ASSIGNED TO EITHER YOGA OR EXERCISE. THE YOGA GROUP ATTENDED A 9-WEEK YOGA COURSE AND THE EXERCISE GROUP RECEIVED A SELF-CARE MANUAL ON HOME-BASED EXERCISES FOR NECK PAIN RELIEF. THE MAIN OUTCOME MEASURE WAS THE PRESENT NECK PAIN INTENSITY (100 MM VISUAL ANALOG SCALE). SECONDARY OUTCOME MEASURES INCLUDED FUNCTIONAL DISABILITY (NECK DISABILITY INDEX), PAIN AT MOTION (VISUAL ANALOG SCALE), HEALTH-RELATED QUALITY OF LIFE (SHORT FORM-36 QUESTIONNAIRE), CERVICAL RANGE OF MOTION, PROPRIOCEPTIVE ACUITY, AND PRESSURE PAIN THRESHOLD. RESULTS: FIFTY-ONE PATIENTS (MEAN AGE 47.8 Y ; 82.4% FEMALE) WERE RANDOMIZED TO YOGA (N=25) AND EXERCISE (N=26) INTERVENTION. AFTER THE STUDY PERIOD, PATIENTS IN THE YOGA GROUP REPORTED SIGNIFICANTLY LESS NECK PAIN INTENSITY COMPARED WITH THE EXERCISE GROUP [MEAN DIFFERENCE: -13.9 MM (95% CI, -26.4 TO -1.4), P=0.03]. THE YOGA GROUP REPORTED LESS DISABILITY AND BETTER MENTAL QUALITY OF LIFE. RANGE OF MOTION AND PROPRIOCEPTIVE ACUITY WERE IMPROVED AND THE PRESSURE PAIN THRESHOLD WAS ELEVATED IN THE YOGA GROUP. DISCUSSION: YOGA WAS MORE EFFECTIVE IN RELIEVING CHRONIC NONSPECIFIC NECK PAIN THAN A HOME-BASED EXERCISE PROGRAM. YOGA REDUCED NECK PAIN INTENSITY AND DISABILITY AND IMPROVED HEALTH-RELATED QUALITY OF LIFE. MOREOVER, YOGA SEEMS TO INFLUENCE THE FUNCTIONAL STATUS OF NECK MUSCLES, AS INDICATED BY IMPROVEMENT OF PHYSIOLOGICAL MEASURES OF NECK PAIN.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
18  269  35 ADAPTED YOGA TO IMPROVE PHYSICAL FUNCTION AND HEALTH-RELATED QUALITY OF LIFE IN PHYSICALLY-INACTIVE OLDER ADULTS: A RANDOMISED CONTROLLED PILOT TRIAL. BACKGROUND: YOGA IS A HOLISTIC THERAPY OF EXPANDING POPULARITY, WHICH HAS THE POTENTIAL TO PRODUCE A RANGE OF PHYSICAL, MENTAL AND SOCIAL BENEFITS. THIS TRIAL EVALUATED THE FEASIBILITY AND EFFECTS OF AN ADAPTED YOGA PROGRAMME ON PHYSICAL FUNCTION AND HEALTH-RELATED QUALITY OF LIFE IN PHYSICALLY-INACTIVE OLDER ADULTS. METHODS: IN THIS RANDOMISED CONTROLLED PILOT TRIAL, 52 OLDER ADULTS (90% FEMALE; MEAN AGE 74.8 YEARS, SD 7.2) WERE RANDOMISED 1:1 TO A YOGA PROGRAMME OR WAIT-LIST CONTROL. THE YOGA GROUP (N = 25) RECEIVED A PHYSICAL ACTIVITY EDUCATION BOOKLET AND WERE INVITED TO ATTEND TEN YOGA SESSIONS DURING A 12-WEEK PERIOD. THE CONTROL GROUP (N = 27) RECEIVED THE EDUCATION BOOKLET ONLY. MEASURES OF PHYSICAL FUNCTION (E.G., SHORT PHYSICAL PERFORMANCE BATTERY; SPPB), HEALTH STATUS (EQ-5D) AND MENTAL WELL-BEING (WARWICK-EDINBURGH MENTAL WELL-BEING SCALE; WEMWBS) WERE ASSESSED AT BASELINE AND 3 MONTHS. FEASIBILITY WAS ASSESSED USING COURSE ATTENDANCE AND ADVERSE EVENT DATA, AND PARTICIPANT INTERVIEWS. RESULTS: FORTY-SEVEN PARTICIPANTS COMPLETED FOLLOW-UP ASSESSMENTS. MEDIAN CLASS ATTENDANCE WAS 8 (RANGE 3 TO 10). AT THE 3-MONTH FOLLOW-UP, THE YOGA GROUP HAD A HIGHER SPPB TOTAL SCORE COMPARED WITH THE CONTROL GROUP (MEAN DIFFERENCE 0.9, 95% CONFIDENCE INTERVAL [CI] -0.3 TO 2.0), A FASTER TIME TO RISE FROM A CHAIR FIVE TIMES (MEAN DIFFERENCE - 1.73 S, 95% CI -4.08 TO 0.62), AND BETTER PERFORMANCE ON THE CHAIR SIT-AND-REACH LOWER-LIMB FLEXIBILITY TEST (MEAN DIFFERENCE 5 CM, 95% CI 0 TO 10). THE YOGA GROUP ALSO HAD SUPERIOR HEALTH STATUS AND MENTAL WELL-BEING (VS. CONTROL) AT 3 MONTHS, WITH MEAN DIFFERENCES IN EQ-5D AND WEMWBS SCORES OF 0.12 (95% CI, 0.03 TO 0.21) AND 6 (95% CI, 1 TO 11), RESPECTIVELY. THE INTERVIEWS INDICATED THAT PARTICIPANTS VALUED ATTENDING THE YOGA PROGRAMME, AND THAT THEY EXPERIENCED A RANGE OF BENEFITS. CONCLUSIONS: THE ADAPTED YOGA PROGRAMME APPEARED TO BE FEASIBLE AND POTENTIALLY BENEFICIAL IN TERMS OF IMPROVING MENTAL AND SOCIAL WELL-BEING AND ASPECTS OF PHYSICAL FUNCTION IN PHYSICALLY-INACTIVE OLDER ADULTS. AN APPROPRIATELY-POWERED TRIAL IS REQUIRED TO CONFIRM THE FINDINGS OF THE PRESENT STUDY AND TO DETERMINE LONGER-TERM EFFECTS. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT02663726 .	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
19 1054  27 EFFECTS OF YOGA ON CHRONIC NECK PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVE: THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY ASSESS AND META-ANALYZE THE EFFECTIVENESS OF YOGA IN RELIEVING CHRONIC NECK PAIN. METHODS: PUBMED/MEDLINE, THE COCHRANE LIBRARY, SCOPUS, AND INDMED WERE SCREENED THROUGH JANUARY 2017 FOR RANDOMIZED CONTROLLED TRIALS ASSESSING NECK PAIN INTENSITY AND/OR NECK PAIN-RELATED DISABILITY IN CHRONIC NECK PAIN PATIENTS. SECONDARY OUTCOME MEASURES INCLUDED QUALITY OF LIFE, MOOD, AND SAFETY. RISK OF BIAS WAS ASSESSED USING THE COCHRANE TOOL. RESULTS: THREE STUDIES ON 188 PATIENTS WITH CHRONIC NON-SPECIFIC NECK PAIN COMPARING YOGA TO USUAL CARE WERE INCLUDED. TWO STUDIES HAD OVERALL LOW RISK OF BIAS; AND ONE HAD HIGH OR UNCLEAR RISK OF BIAS FOR SEVERAL DOMAINS. EVIDENCE FOR SHORT-TERM EFFECTS WAS FOUND FOR NECK PAIN INTENSITY (STANDARDIZED MEAN DIFFERENCE (SMD) = -1.28; 95% CONFIDENCE INTERVAL (CI) = -1.18, -0.75; P < 0.001), NECK PAIN-RELATED DISABILITY (SMD = -0.97; 95% CI = -1.44, -0.50; P < 0.001), QUALITY OF LIFE (SMD = 0.57; 95% CI = 0.17, 0.197; P = 0.005), AND MOOD (SMD = -1.02; 95% CI = -1.38, -0.65; P < 0.001). EFFECTS WERE ROBUST AGAINST POTENTIAL METHODOLOGICAL BIAS AND DID NOT DIFFER BETWEEN DIFFERENT INTERVENTION SUBGROUPS. IN THE TWO STUDIES THAT INCLUDED SAFETY DATA, NO SERIOUS ADVERSE EVENTS OCCURRED. CONCLUSION: YOGA HAS SHORT-TERM EFFECTS ON CHRONIC NECK PAIN, ITS RELATED DISABILITY, QUALITY OF LIFE, AND MOOD SUGGESTING THAT YOGA MIGHT BE A GOOD TREATMENT OPTION.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
20 2389  44 YOGA AND AEROBIC DANCE FOR PAIN MANAGEMENT IN JUVENILE IDIOPATHIC ARTHRITIS: PROTOCOL FOR A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: JUVENILE IDIOPATHIC ARTHRITIS (JIA) IS ONE OF THE MOST COMMON TYPES OF ARTHRITIS AMONG CHILDREN. ACCORDING TO JIA GUIDELINES FOR PHYSICAL ACTIVITY (PA), STRUCTURED PA INTERVENTIONS LED TO IMPROVED HEALTH OUTCOMES. HOWEVER, MANY PA PROGRAMS, SUCH AS YOGA AND AEROBIC DANCE, HAVE NOT BEEN STUDIED IN THIS POPULATION DESPITE BEING POPULAR AMONG YOUTH. WEB-BASED PA PROGRAMS COULD PROVIDE PATIENTS WITH ACCESSIBLE AND AFFORDABLE INTERVENTIONS. OBJECTIVE: THE PRIMARY AIMS OF THE PROPOSED PILOT RANDOMIZED CONTROLLED TRIAL (RCT) ARE TO EXAMINE (1) THE FEASIBILITY OF CONDUCTING A FULL-SCALE RCT TO EVALUATE THE EFFECTIVENESS OF TWO POPULAR TYPES OF PA: A YOGA TRAINING PROGRAM AND AN AEROBIC DANCE TRAINING PROGRAM, IN FEMALE ADOLESCENTS (AGED 13-18 YEARS) WITH JIA COMPARED WITH AN ELECTRONIC PAMPHLET CONTROL GROUP; AND (2) THE ACCEPTABILITY OF THESE INTERVENTIONS. METHODS: A THREE-ARM PROSPECTIVE RANDOMIZED OPEN-LABEL STUDY WITH A PARALLEL GROUP DESIGN WILL BE USED. A TOTAL OF 25 FEMALE ADOLESCENTS WITH JIA WHO HAVE PAIN WILL BE RANDOMIZED IN A RATIO OF 2:2:1 TO ONE OF THE 3 GROUPS: (1) ONLINE YOGA TRAINING PROGRAM (GROUP A: N=10); (2) ONLINE AEROBIC DANCE TRAINING PROGRAM (GROUP B: N=10); AND (3) ELECTRONIC PAMPHLET CONTROL GROUP (GROUP C: N=5). PARTICIPANTS IN GROUPS A AND B WILL COMPLETE 3 INDIVIDUAL 1-HOUR SESSIONS PER WEEK USING ONLINE EXERCISE VIDEOS, AS WELL AS A 1-HOUR VIRTUAL GROUP SESSION PER WEEK USING A VIDEOCONFERENCING PLATFORM FOR 12 WEEKS. PARTICIPANTS FROM ALL GROUPS WILL HAVE ACCESS TO AN ELECTRONIC EDUCATIONAL PAMPHLET ON PA FOR ARTHRITIS DEVELOPED BY THE ARTHRITIS SOCIETY. ALL PARTICIPANTS WILL ALSO TAKE PART IN WEEKLY ONLINE CONSULTATIONS WITH A RESEARCH COORDINATOR AND DISCUSSIONS ON FACEBOOK WITH PARTICIPANTS FROM THEIR OWN GROUP. FEASIBILITY (IE, RECRUITMENT RATE, SELF-REPORTED ADHERENCE TO THE INTERVENTIONS, DROPOUT RATES, AND PERCENTAGE OF MISSING DATA), ACCEPTABILITY, AND USABILITY OF FACEBOOK AND THE VIDEOCONFERENCING PLATFORM WILL BE ASSESSED AT THE END OF THE PROGRAM. PAIN INTENSITY, PARTICIPATION IN GENERAL PA, MORNING STIFFNESS, FUNCTIONAL STATUS, FATIGUE, SELF-EFFICACY, PATIENT GLOBAL ASSESSMENT, DISEASE ACTIVITY, AND ADVERSE EVENTS WILL BE ASSESSED USING SELF-ADMINISTERED ELECTRONIC SURVEYS AT BASELINE AND THEN WEEKLY UNTIL THE END OF THE 12-WEEK PROGRAM. RESULTS: THIS PILOT RCT HAS BEEN FUNDED BY THE ARTHRITIS HEALTH PROFESSIONS ASSOCIATION. THIS PROTOCOL WAS APPROVED BY THE CHILDREN'S HOSPITAL OF EASTERN ONTARIO RESEARCH ETHICS BOARD (#17/08X). AS OF MAY 11, 2020, RECRUITMENT AND DATA COLLECTION HAVE NOT STARTED. CONCLUSIONS: TO OUR KNOWLEDGE, THIS IS THE FIRST STUDY TO EVALUATE THE EFFECTIVENESS OF YOGA AND AEROBIC DANCE AS PAIN MANAGEMENT INTERVENTIONS FOR FEMALE ADOLESCENTS WITH JIA. THE USE OF ONLINE PROGRAMS TO DISSEMINATE THESE 2 PA INTERVENTIONS MAY FACILITATE ACCESS TO ALTERNATIVE METHODS OF PAIN MANAGEMENT. THIS STUDY CAN LEAD TO A FULL-SCALE RCT. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/12823.	2020