Accepted Abstracts In order of appearance in the ...€¦ · 1. Northwestern University Feinberg School of Medicine; and Osher Center for Integrative Medicine, Chicago 2. Northwestern

2 2 I AYT 2019 SYMPOSIUM ON YOGA RESEARC H

Accepted Abstracts In order of appearance in the presentation space;

presenting author underlined. Abstracts are unedited.

1. STAKEHOLDER-ENGAGED DEVELOPMENT

OF ONLINE YOGA CLASSES FOR YOUNG

ADULT CANCER SURVIVORS

E. L. Addington,1 I. Kwok,2 V. Grote,1 E. Shiu,2

R. Kakareka,2 C. Canning,2 A. K. Hernandez2

1. Northwestern University Feinberg School of Medicine; and

Osher Center for Integrative Medicine, Chicago

2. Northwestern University Feinberg School of Medicine

Keywords: yoga, cancer, AYA, eHealth

Objective: Yoga has potential to improve symptoms (e.g.,anxiety, sleep disturbance, fatigue) that are common in youngadult cancer survivors (YACS), but few yoga trials includeYACS. Further, illness and lack of instructors with cancer-spe-cific training can limit community-based access to yoga. Web-based delivery may help to close these gaps, especially foryoung adults, who are adept internet users. We therefore aimto develop and evaluate online yoga classes for YACS, using astakeholder-engaged approach.Methods: In Phase 1, we are conducting focus groups withyoga instructors (n = 15) and separately with YACS (n = 15)to learn their views on how yoga may benefit YACS and howit may be delivered safely and effectively online. Qualitativeresults will be used to design online yoga classes for post-treat-ment YACS (ages 25–39), which we will pilot test in Phase 2(N=30). Phase 2 outcome measures include feasibility (rates ofretention and adherence) and acceptability (satisfaction rat-ings and qualitative feedback), along with preliminary effica-cy measures (PROMIS scales: anxiety, depression, positiveaffect, social functioning; sleep disturbance, fatigue, pain,physical function).Results: Phase 1 is currently underway. Preliminary qualita-tive analysis indicates prominent themes are: cancer as trau-ma, rebuilding strength and confidence in the body, relax-ation and soothing, and community. Recommended practicesto address these themes include yoga nidra, postures and med-itations designed to increase grounding and heart-opening,didactics and group discussions. Conclusion: Yoga techniques may address YACS’ psychoso-cial, physical, and existential concerns. Live, web-based deliv-ery has potential to facilitate YACS’ access to yoga and con-nection with community. Ongoing re s e a rch will furt h e rdevelop our understanding of YACS’ needs and evaluate thefeasibility and efficacy of online yoga classes to meet theseneeds.

2. INTEGRATING YOGA THERAPY PRINCI-

PLES IN BREAST CANCER SURVIVORSHIP

FOLLOW-UP CARE: TAILORING PATANJALI’S

SUTRA’S TO EMPOWER, RESTORE, AND

HEAL

V. AgarwalSalisbury University, Salisbury, MD

Keywords: breast cancer survivor care, Patanjali’s sutras,awareness, breathing, asana, empowerment

Ob j e c t i ve : To identify how yoga therapists integratePatanjali’s sutra’s in addressing long-term and late effects ofbreast cancer survivorship care.Background: Breast cancer is the most common form of can-cer in the U.S. With current 5-year breast cancer survival ratearound 90%, the need for understanding and meeting thegaps in the care continuum become critical. All breast cancersurvivors who undergo breast surgery and/or radiation are atrisk for long-term and late effects stemming from the treat-ment type.Methods: Purposive and snowball-sampling to recruit com-plementary and alternative medicine providers (N=15) fromacross the U.S. and Canada. This study reports findings froma qualitative content analysis of yoga therapists (n = 7; Table1). In-depth semi-structured interviews were audio-recordedand professionally transcribed verbatim (253 singles-spacedpages). Qualitative content analyses identified primary codesand employed memoing and iterative process between codesand categories to re- examine their definitions and relation-ships before settling into stable themes.Findings: Yoga therapists integrate five yamas in guidingpatients toward balance and mindfulness in their survivorshipjourney; niyamas through acceptance of progression of heal-ing; and asanas to rejuvenate from fatigue, anger, depression,and related biopsychosocial side effects. Therapists seek toempower patients by cultivating awareness of the breath(pranayama) to acknowledge their feelings of victimhood andfacilitate the client’s ability to take control of their healingjourney by self-confirmation.

Therapists employed asanas with awareness of breathing(prana), using narratives to help patients connect with them-s e l ves and others. The iterative movement between andthrough the sutras is tailored to the patients’ journeys by care-ful provider observation.

2 3I AYT 2019 SYMPOSIUM ON YOGA RESEARC H

Conclusion: Yoga therapists integrate Patanjali’s sutras bymoving between them to gradually empower patients to iden-tify, own, and expand the body’s experiences. Yoga therapistsconstruct awareness of the body (sarïra) as mind (chitta) andenergy (prana) by facilitating patients’ recognition of loss,pain, fear, and isolation as manifested in the body to cultivateacceptance and self-care. Therapists focus on neurophysiolog-ical processes of breathing (prana) and distinguish these with-in the cognitive (chitta) and physical (sarïra) through asanaswith carefully managing their own body language, communi-cation, and expressions.

Accepted Abstracts (continued)

Table 1. Yoga Therapist Participant Characteristics in Breast Cancer Survivor Care

#

1

2

3

4

5

6

7

Pseud.1

Asha

Mona

Rita

Sam

Lena

Stila

Tia

Age

43

52

45

53

67

30–35

50–60

Education1

BAMS

MAOM, PhD,

Yoga

Therapist,

BAMS

Ayurveda,

Homeopathy,

Reiki

BAMS,

MD in

Ayurvedic

Internal

Medicine

M.Sc. Sound

Engineering;

Yoga

Therapist

Masters,

Yoga Therapy

BA, YCAT,

Yoga Therapy

for Cancer,

500-level, +

200-level

Race1

I

I

A

I

W

A-I

C

Gender1

F

F

F

M

F

F

F

Practice

Specialty

Ayurveda

Women’s

health; Yoga

teacher

BHMS, Advanced

Ayurvedic

Wellness

Practitioner,

Reiki Master

Ayurvedic

medicine

Yoga retreats

for cancer patients

Evidence-

based yoga thera-

py for research

Certified yoga

therapist

Years in

Practice

18–19

25

15

25

28 approx.

15

8

Practice

Type

University-

affiliated and

Private

Private

Private and

Group prac-

tice

Practitioner,

Researcher,

Faculty,

Formulator,

products and

supplements

Private

practice

Fully with

cancer center

Affiliated with

3 medical

institutions

Benefit2

Quality of life

Emotional

support

Align with and

clarify health

goals

Emotional

balance and

recalibration

Victimhood to

empowerment;

depression,

anger, tension

Quality of life;

regulating

depression,

sleep, stress

Symptom

relief from

treatment and

medications

Barrier2

Licensure

Fear/trust

Accept situ-

ations in life,

low immune

system

Drug

interaction

concerns,

Communica-

tion with

care team

Cost of

program for

clients

The patient

themselves

Consistency

Total pages: 248 | Total participants in larger project, N = 15 ; Total participants for data reported in present study, yoga therapists, n = 71Pseud. = Pseudonym | M = male, F = female | Race: I = Indian, A = Asian, A-I = Asian-Indian, C = Caucasian, W = White | Education: BAMS=Bachelor of AyurvedicMedicine and Surgery, BHMS: Bachelor of Homeopathic Medicine and Surgery | BAOM: Bachelor of Ayurvedic and Oriental Medicine2Benefits: Most important benefit sought by yoga therapist for breast cancer survivor patients | Barriers: Most important barrier identified by yoga therapist in breast cancersurvivor patients' treatment.


elbow impingement/pain and spontaneous nosebleeds, symp-toms that began in the aftermath of his 8th professional fight.He also presented with bilateral shoulder tightness, sleep dys-function, and performance anxiety/stress. The client was seenover the course of five months and six sessions. The yoga ther-apy intake and assessment included: gathering past medicalhistory, self-reported functional measures in the MeasureYourself Medical Outcome Profile (MYMOP), and muscu-loskeletal evaluations. The MYMOP was repeated each ses-sion. The yoga therapy plan of care integrated restorative andactive postures to relieve joint pain and muscle tension, med-itation to increase interoception and self-awareness, mudras toencourage restful sleep, and breath practices to initiate aparasympathetic response of the autonomic nervous system.With encouragement from the yoga therapist, the client over-came his avoidance of allopathic care and visited an otolaryn-gologist who medically diagnosed and treated the root causeof his spontaneous nosebleeds. By the end of the sessions, theclient also reported improved sleep, increased energy, and theability to reduce performance anxiety/stress by practicing 1:2ratio breathing just before entering the ring to win his 9thconsecutive professional fight eight weeks after his last yogatherapy session. Conclusion: This case suggests down-regulating practicesmay be beneficial for high performance athletes, such as box-ers, to promote emotional clarity and mental focus to achieveself-regulation for maximum performance, relaxation, sleep,energy restoration; and aid in overcoming fear and avoidanceof allopathic care.

7. YOGA TEACHERS’ PERSPECTIVES ON

TEACHING ACCESSIBLE YOGA TO PEOPLE

AFFECTED BY TRAUMATIC BRAIN INJURY

THROUGH THE LOVEYOURBRAIN YOGA

PROGRAM

N. Chauhan,1 K. Donnelly2

1. The Dartmouth Institute for Health Policy and Clinical Practice,

Lebanon, NH

2. The Dartmouth Institute for Health Policy and Clinical Practice,

Lebanon, NH; and LoveYourBrain Foundation, Windsor, VT

Keywords: yoga, traumatic brain injury, trauma-informed,community-based yoga

Objective: Each year, 2.8 million people in the US suffer atraumatic brain injury (TBI). Despite the high prevalence,limited opportunities exist for holistic, community-basedrehabilitation to promote quality of life for this population.To address this gap, the LoveYourBrain Foundation offers anevidence-based yoga program for people with TBI and care-givers across North America. The objective of this study wasto identify yoga teachers’ perceptions of (1) best practices foradapting yoga for TBI and (2) experience teaching within anational yoga program to inform the delivery of accessibleyoga programming for TBI and other specialized populations.Intervention: LoveYourBrain Yoga is a free, group-based, six-session program designed to promote community integrationand resilience skills among people who have experienced aTBI or are a caregiver. Teachers are trained to use a manual-ized curriculum for each 90-minute class.Methods: A cross-sectional, mixed methods study using anonline survey among 175 yoga teachers trained to teach theLoveYourBrain Yoga program. The survey instrument includ-ed open- and closed-text questions assessing yoga teachers’perspectives on best practices for adapting asana, meditation,pranayama, and group discussion, experience and attitudesabout the LoveYourBrain Yoga training and program, andyoga teaching qualifications. Responses were analyzed usingdescriptive statistics and qualitative content analysis.Results: 49% teachers (n = 86) responded. We identified fourmain themes related to best practices for adapting yoga forTBI, including Cultivating Interoception (i.e., slow pacingand repetition, clear and concise language, and demonstra-tion), Physical Posture (i.e., position of the head and neck, useof props), Creating a Safe Space (i.e., invitational languageand environmental considerations such as limiting light), andChallenging Behaviors (i.e., time management and impulsiv-ity). 89% of teachers reported using the manual to guide theirclasses was either ‘very helpful’ or ‘extremely helpful,’ yet near-ly half (49%) adapted the manual content ‘often’ or ‘always’.Conclusions: When teaching yoga for TBI, we recommendphysical modifications for the head and neck; slow and sim-ple cueing to facilitate cognitive processing; use of invitation-al language; and managing challenging behaviors throughnormalizing facilitation. When delivering yoga programmingmore broadly, we recommend the use of a manual that allowsfor flexibility.




8. MOLECULAR AND CLINICAL INDICATORS

OF IMPROVED NEUROPLASTICITY BY YOGA:

A RANDOMIZED CLINICAL TRIAL IN MAJOR

DEPRESSIVE DISORDER

R. Dada,1 M. Tolahunase,1 R. Sagar2

1. Lab for Molecular Reproduction and Genetics, Department of

Anatomy, All India Institute of Medical Sciences, New Delhi

2. Department of Psychiatry, All India Institute of Medical

Sciences, New Delhi

Keywords: major depressive disorder, yoga, cellular aging,quality of life, biomarker, neuroplasticity

Background: Major depressive disorder (MDD) is a devastat-ing mental and physical illness associated with acceleratedaging. Evidence indicates that yoga is a profound science ofinner wellbeing and has significant antidepressant properties. Objective: To study the molecular and clinical indicators ofimproved neuroplasticity by yoga in MDD.Methods: MDD patients aged between 20 and 50 years (n =96, Male 46) were randomized to either yoga group (n = 46)receiving yoga based lifestyle intervention (YBLI) for 12weeks or control group (n = 50). Clinical and laboratoryparameters we re assessed before and after interve n t i o n .Subjects were administered clinical scales that measure differ-ent scores of depressive symptoms, stress resilience and quali-ty of life (QOL). The blood levels of systemic biomarkers ofneuroplasticity were measured. In addition blood transcrip-tome expression patterns were analyzed.Results: YBLI produced significant antidepressant responseby reduction of BDI-II scale scores and improved stressresilience and QOL by increase in CD-RISC and WHO-QOL-BREF scales scores respectively, in MDD patients ofyoga group. Furthermore, YBLI decreased cortisol and IL-6levels, and increased BDNF, melatonin, serotonin, LL-37,telomerase activity and sirt u i n - 1 l e vels. Ex p ression ofCX3CL1, GPR50 and RB1 were increased in the yoga grouprelative to the control group.Conclusion: This study is the first to explore YBLI and sys-temic indicators of neuroplasticity in MDD. Findings fromour study indicate the potential benefits of yoga to slow cellu-lar aging, increase neuroplasticity and decrease severity andsequelae of depression. YBLI increases stress resilience andQOL, and enhances the outcome of treatment in MDD.

9. SPERM MOLECULAR FACTORS IN EARLY

PREGNANCY LOSS: ROLE OF YOGA BASED

LIFESTYLE

V. Dhawan,1 S. Khan,1 D. Deka,2 N. Malhotra,2 N. Singh,2

V. Dadhwal,2 Rima Dada1

1. Laboratory for Molecular Reproduction & Genetics,

Department of Anatomy, AIIMS, New Delhi

2. Department of Obstetrics & Gynaecology, AIIMS, New Delhi

Keywords: sperm oxidative stress, genomic integrity, geneexpression, yoga, recurrent pregnancy loss

Background: Paternal factors have been cited as an importantcontributor in the normal embryonic development and havebeen associated with early pregnancy loss in both spontaneousand assisted conceptions. Compromised sperm genomicintegrity, overwhelming oxidative stress and dysregulated geneexpression has been correlated with the same. The currentmedicine is witnessing a surge in the incidence of yoga basedlifestyle intervention (YBLI) and their impact on embryonicdevelopment.Methods: This prospective exploratory study was conductedon male partners of couples who experienced recurrent preg-nancy loss (RPL) and recurrent implantation failure (RIF).Semen samples were obtained at the baseline (day 0) and atthe completion of YBLI (day 21). Semen samples were ana-lyzed by WHO 2010 criteria. The markers of oxidative stress[reactive oxygen species (ROS), DNA fragmentation index(DFI), 8-OHdG levels and total antioxidant capacity (TAC)]were assessed by chemiluminescence, sperm chromatin struc-ture assay, and ELISA respectively. Sperm gene expression, acritical determinant of embryo viability was assessed by q-PCR analysis.Results: There was a significant 74.44% and 80.2% declinein mean ROS levels with the brief YBLI (p < 0.05). Spermcount showed a significant 24.9% and 35.4% increase in RPLand RIF patient groups while progressive motility was seen toimprove by 23.2% and 29.2% increase in the patients at theend of the yoga intervention as compared to the pre interven-tion count and motility (p < 0.05). There was a minimaldecline in DFI (p > 0.05) and the levels of mutagenic baseadduct 8-OHdG showed significant decline in two groups (p< 0.05), while TAC levels were seen to improve with YBLI inthe two groups in RPL and RIF patients. The relative expres-sion of FOXG1, SOX3, STAT4, RPS6, RPL10A and RBM9were found to normalize towards that of control levels.



(MAIA) were used to assess self compassion and interoceptionpre and post intervention. Eight 1.5 hour-long sessionsincluded group discussions and a comprehensive (breath, pos-tures, relaxation and meditation) yoga practice with variousthemes, such as balance, intention and kindness. Results: After participating in 7 of the 8 sessions, increases inself compassion were seen across all subscales and the totalscore of the SCS. The largest shift was seen in the SelfJudgment subscale. There were also increases in all subscalesof the MAIA, with the largest changes in the areas of Not-Distracting, Not-Worrying, Body Listening and Trusting.Answers to qualitative questions indicated that the groups hadcontributed to both her awareness of the relationship betweenher emotions and her body and her capacity to physically andemotionally tolerate “sorrow, extreme fear, anger and pain” inher individual psychotherapy.Conclusion: Participation in a group yoga therapy programincreased self compassion and interoception for a womanmanaging symptoms of mood, trauma and substance use dis-orders. Yoga therapy may offer increased access to and toler-ance for difficult emotions by cultivating kindness towardone’s self and a positive and informative relationship to one’sbody. Group yoga therapy provides benefits as a stand aloneintervention and may have the potential to enhance otherforms of psychotherapy. More rigorous research is recom-mended around these constructs and with yoga therapy’sinfluence on other therapeutic processes.

12. THE EFFECTS OF A YOGA INTERVENTION

ON COGNITIVE FUNCTION IN OLDER ADULTS

E. EdwardsUtah State University, Logan

Keywords: yoga, cognitive function, older adults

Objective: This purpose of this study was to investigate theeffects of a six-week yoga practice on older adults in a stan-dardized response inhibition task called the stop-signal taskcompared with a sedentary control group that performed six-weeks of computer-based cognitive training exercises.Methods: Thirteen community dwelling older adults, ages60+ were recruited for the study. The average age for partici-pants was 74.6 (+/- 4.7) years old. During the preliminarytesting, MOCA scores were collected for screening purposes.Participants were randomly assigned into either the controlintervention or the yoga intervention. Participants in the yogagroup attended a six-week yoga intervention. Group classes

lasted one hour and were held twice a week on the main cam-pus of Utah State University. The classes were led by a certi-fied yoga instructor (RYT-200hr). Classes included standing,seated, and balancing poses including breathwork and media-tion. The control group performed six-weeks of hour-longcomputer-based cognitive training exercises held twice a week.Cognitive function was measured using a stop signal task( S S T) before and after treatment. Stopping ability wasassessed using the participant’s stop signal reaction time(SSRT) and processing speed was collected using go reactiontime. This study is one part of a bigger intervention studywhich also included balance ability.Results: Following the 6-week interventions, a two-waymixed model ANOVA revealed no meaningful differencesbetween either group for go reaction time (F = 0.0292, p =0.868) or SSRT (F = 0.0901, p = 0.77). There was, however,a trend toward improved SSRT with a better ability to suc-cessfully stop following both interventions (F = 3.467, p =0.092). Conclusion: An overall trend toward improvement in SSRTin both groups could possibly support both yoga and comput-er-based cognitive training as viable methods for improvingthis aspect of cognitive function. With more research support-ing this trend, these interventions could be used to help olderadults reduce cognitive decline and/or maintain cognitivefunctioning, specifically response inhibition.

13. DIFFERENCES IN MOTIVATIONAL FAC-

TORS BETWEEN PARTICIPANTS OF DIFFER-

ENT YOGA STYLES

B. Forseth,1 M. Polfuss,2 Caitlyn Hauff3

1. University of Wisconsin Milwaukee

2. University of Wisconsin Milwaukee; and Children’s Hospital of

Wisconsin, Milwaukee

3. University of South Alabama, Mobile

Keywords: motivation, yoga styles

Background: As yoga continues to be a top fitness trend inWestern cultures, it has also become a common modality inhealth promotion research. The activity of yoga is unique withmany different styles and variability in the way that each styleis practiced with variance in emphasized components (e.g.physical postures or meditation). The emphasized compo-nents within a style may attract or motivate different partici-pants to participate in that style. Understanding the motiva-tion for choosing a yoga style may assist researchers in exam-ining how yoga styles are used for health promotion and topromote yoga practice.

31IAYT 2019 SYMPOSIUM ON YOGA RESEARCH


15. EFFECT OF YOGA THERAPY ON TUMORNECROSIS FACTOR-A AND SYMPATHOVAGALBALANCE IN THE PATIENTS OF RHEUMATOIDARTHRITIS

G. G. Singh,1 G. Selvakumar,1 V. S. Negi,2 V. K. Sharma,3

G. K. Pal11. Department of Physiology, JIPMER, Puducherry, India2. Department of Clinical Immunology, JIPMER, Puducherry,India3. Government Institute of Medical Sciences, Greater Noida, UP, India

Keywords: Autonomic dysfunction, heart rate variability,rheumatoid arthritis, yoga therapy.

Background and Objectives: Autonomic dysfunction iscommon in rheumatoid arthritis (RA) patients, previous stud-ies reported that RA patients have increased sympatheticactivity and reduced parasympathetic activity. Yoga therapyimproves the autonomic balance. There is paucity of data onthe effect of yoga therapy in patients with rheumatoid arthri-tis on inflammatory markers and sympathovagal balance.Therefore, the present study was undertaken to assess theeffect of 12 weeks of yoga therapy on heart rate variability(HRV) and tumor necrosis factor-α (TNF-α) in patients withrheumatoid arthritis.Methods: This study was carried out on RA patients whowere having the disease upto 3 years of disease duration andattending outpatient department of clinical immunology, JIP-MER. 150 RA patients were recruited and randomized intotwo groups: Control Group (n = 75) and Yoga Group (n =75). HRV recording was performed as per the standard guide-lines recommended by task force on HRV. HRV analysis wasdone using the Kubios HRV analysis software. Using this soft-ware, we have analyzed the frequency domain and timedomain components of HRV. Yoga therapy was given to thesubjects in yoga group (YG), whereas subjects in controlgroup (CG) were not given yoga therapy, while all the subjectswere on standard medical treatment during study period.Analysis of Covariance was used to compare both the groupsafter 12 weeks.Results: We found that after 12 weeks of yoga therapy, TP,HFnu were increased by 46.4%, 31.2% respectively in the YGand by 6.09%, 9.12% respectively in the CG in terms of %change from baseline, on comparison between the groups, thedifference were found to be statistically significant (p <0.001). LFnu, LF: HF ratios were reduced by 17.8%, 45.8%respectively in the YG and by 5.25%, 14.1% respectively inthe CG which were statistically significant on comparison

between the groups after 12 weeks (p < 0.05). TNF-α reducedby 33.42% in the YG and by 20.78% in the CG, however oncomparison between the groups, no statistically significantdifference was observed.Conclusion: Yoga therapy if it given for 12 weeks along withstandard medical treatment improves the heart rate variabilityand reduces tumor necrosis factor-α in the patients ofrheumatoid arthritis.Funding: Jawaharlal Institute of Postgraduate MedicalEducation and Research.

16. THE EFFECTS OF A YOGA INTERVENTIONON REACTIVE BALANCE IN OLDER ADULTS

H. HayesUtah State University

Keywords: yoga, reactive balance, older adults

Objective: The purpose of this study was to examine the effi-cacy of a 6-week yoga intervention on improving reactive bal-ance in older adults using a balance task that emphasizesheightened cognitive demand. Methods: 13 older adults were randomized into a yoga group(n = 7) or a control group (n=6). Twelve subjects, 74.6 (+/-4.7) years of age, completed the study. Participants wereexcluded if they had practiced yoga or tai chi in the last year,unable to stand unassisted for 2 minutes and/or had a MOCAscore below 20. Subjects in the yoga group participated inhour long classes, twice per week for six weeks taught by a cer-tified yoga teacher. Each yoga class incorporate seated, stand-ing and lying down poses along with breathwork and medita-tion. Subjects in the control group completed hour long ses-sions of computer-based cognitive training twice per week forsix weeks. Reactive balance was tested using a custom lean andrelease device both before and after the intervention. Balanceperformance was measured as: (a) muscle onset time in thestepping leg, when a forward step was required to recover bal-ance, and (b) stepping errors (i.e. taking a step when the legwas blocked). This study is part of a larger intervention studythat also investigated changes in cognitive function. Results: In the control group all 6 participants completed thestudy and in the yoga group 5 participants completed thestudy. Using a repeated measures ANOVA, no statistically sig-nificant improvements (p = 0.447) were noted on responsetime in the muscle onset time of the Tibialis Anterior of thestepping leg between the yoga group (0.262 seconds +/-0.069) and the control group (0.297 seconds +/- 0.104).


There were no statistically significant improvements in errorrate between groups (p = 0.622). However, the data suggests aslight trend towards improvement in error rate for bothgroups, particularly the yoga group. At post-testing the yogagroup had a reduction in errors from 14.72 to 9.52 +/- 4.28and the control group 15.45 to 13.95 +/- 4.17. Conclusion: This study was an early attempt to get veryfocused measures to evaluate yoga. With this study we wereable to demonstrate the feasibility of using yoga as an inter-vention and provide insight for future studies looking at thepotential effects of yoga on reactive balance in older adults.

17. PHYSIOLOGICAL AND BEHAVIORAL

EFFECTS OF “TIYT-OVERCOME ANXIETY”

PROTOCOL ON ADULTS WITH TRAUMA

HISTORY

K. Heilman,1 T. Barnett,2 G. Yellin,2 S. Porges1

1. University of North Carolina, Chapel Hill

2. TIYT Trauma Informed Yoga Therapy

Keywords: trauma-informed yoga therapy, polyvagal theory,autonomic activity

Ob j e c t i ve : Tr a u m a - Informed Yoga T h e r a p y - O ve rc o m eAnxiety Protocol (TIYT-OAnx) was designed to reduce symp-toms associated with a trauma by drawing attention to physi-ological state and introducing techniques to calm and soothe.As the goals and skills of TIYT-OAnx closely align with thetheoretical principles of the Polyvagal Theory, a pilot studywas designed to determine whether the TIYT-OAnx protocolwill have a significant impact on the reduction and manage-ment of symptoms related to trauma, as they are describedwithin the context of a dysregulated Social EngagementSystem (SES) (as described in Polyvagal Theory.) Methods: Nine adult females with a history of trauma partic-ipated. An identical assessment protocol was administeredbefore and after completing one month of the TIYT-OAnxprotocol. The protocol includes education, svadyaya, pranaya-ma and asana, as well as components which specifically targetthe SES such as chanting and other deliberate cranial nervestimulation. The protocol additionally aims to shift the bias ofneuroception towards safety in the environment. During theassessment protocol, cardiac rhythms were recorded during anauditory processing task (SCAN), posture shift and baselines.Participants completed self-report questionnaires for symp-toms of PTSD (PCL-5) and depression, stress and anxiety(DASS).

Results: Preliminary results demonstrated the majority of par-ticipants improved functioning of the SES (i.e., auditory pro-cessing significantly improved at the post-assessment, FilteredWords: F(1, 8) = 10.32, p < .012; Competing Words: F(1, 8)= 16.67, p < .004) and reduced symptoms (PTSD, depression,s t ress and anxiety) following the T I YT- OAnx pro t o c o l .Additionally, during the post-assessment SCAN session, par-ticipants with longer heart period performed better on theCompeting Words task, r(9) = .71, p<.03. Conclusion: Pilot data demonstrate the feasibility of there s e a rch protocol, and suggestions for a full-scale studyinclude additional assessment sessions, additional outcomemeasures related to the Social Engagement System (prosody,affect recognition), and recruiting sufficient numbers of maleand female participants across several research sites to havestatistical power to evaluate the short- and long-term effects ofthe T I YT- OAnx protocol on vagal regulation, symptomreduction, and emergent social behaviors.

18. THERE IS NO RELATIONSHIP BETWEEN

THE DOSAGE OF YOGA INTERVENTIONS AND

THE REDUCTION OF ANXIETY IN YOUTH:

A SECONDARY LOOK AT A SYSTEMATIC

REVIEW

A. James-Palmer,1 E. Z. Anderson,1 L. Zucker,1 Y.Kofman,2 J. Daneault1

1. Department of Rehabilitation and Movement Sciences,

Rutgers University, Newark, NJ

2. The Yoga Way Therapy Center, Morristown, NJ

Keywords: yoga, anxiety, youth, dosage

Objective: The purpose of this secondary analysis is to iden-tify the importance of dosage of in-person group yoga inter-ventions for the reduction of symptoms of anxiety in youthbased on data gathered during a systematic review.Methods: In November 2018 we performed a systematicreview of the literature regarding yoga interventions for thereduction of anxiety in youth which is currently under review.In this secondary analysis, we examined the dosage of inter-ventions delivered in-person in group settings, the most com-mon delivery method. Studies were included if 1) participantswere �18 years-old, 2) a yoga intervention included physicalposes, 3) symptoms of anxiety were measured, 4) more thanone in-person group yoga class occurred, and 5) the study waspublished in English. Multiple logistic re g ressions we reapplied to determine if characteristics of dosage, including




minutes/session, sessions/week, total minutes, total weeks,and total sessions, were related to improvements in symptomsof anxiety.Results: Of the 27 studies included in the systematic review,17 met the inclusion criteria for this secondary analysis.Dosage characteristics varied widely across studies with somerequiring or encouraging home practice. Analysis has revealedno significant relationships between dosage characteristics andreductions in symptoms of anxiety. We identified potentialfactors that could explain these results, including the variabil-ity in instructor quality, setting, and yogic elements practicedas well as a lack of robust reporting of home practice andintervention adherence.Conclusion: The lack of a relationship between dosage char-acteristics and reduction in symptoms of anxiety may be relat-ed to many potential factors. These factors need to beaddressed via robust reporting and analysis in future studies.

19. YOGA THERAPY FOR CHRONIC PAIN AND

FATIGUE: A CASE STUDY EXPLORING IN-

PERSON AND REMOTE SESSIONS

P. Kaltenbach, L. EdoffMaryland University of Integrative Health

Keywords: yoga therapy, remote yoga therapy, chronic pain

Introduction: Chronic pain and fatigue may limit the quali-ty of life for people suffering from chronic conditions. Brainfog, disrupted sleep, abnormally sensitive skin, and muscularpain can make daily tasks challenging. Isometric chair yogahas been shown to alleviate the pain and fatigue associatedwith fibromyalgia and chronic fatigue syndrome. Yoga nidrahas been shown to relieve stress, decrease anxiety and depres-sion, and improve sleep quality. For those with chronic pain,remote yoga therapy may be an accessible method for treat-ment. This case study focuses on the importance of client-centered care and the advantages of remote yoga therapy.Case Description: A 62-year-old woman, with diagnoses offibromyalgia, osteoarthritis, obesity, ankylosing spondylitis,chronic pain and fatigue sought yoga therapy for improveddexterity, balance, weight loss, and increased daily function.The initial sessions were done in-person and consisted of anisometric chair yoga protocol with the goal of improvingphysical function. After two in-person sessions, the formattransitioned to remote yoga therapy, utilizing video confer-encing software. The at-home sessions consisted of an initialcheck-in, focused breathing, gentle stretching, yoga nidra, and

discussion of the yamas and niyamas with the aim of increas-ing parasympathetic nervous system activation, decreasingpain, and improving overall well-being. The client wasassessed using the PROMIS Global Health evaluation tool todetermine mental, physical, and social function.

The in-person sessions were challenging for the clientgiven her presenting conditions and lack of mobility. Shereported feeling unmotivated by the isometric protocol, whilealso experiencing pain during some of the movements. As hersymptoms were not improving, the protocol was changed tofocus on breathing, gentle stretching, and yoga nidra, whichwere delivered remotely in order to make the practice moreaccessible. The remote sessions resulted in elevated mood andfreedom from pain, which lasted for several hours. The clientreported benefitting from being in her own home whileresponding well to the visual connection through thecomputer.Conclusion: Adjusting the plan of care according to theclient’s response to treatment is important to the outcome ofthe yoga therapy sessions. Additionally, remotely deliveredyoga therapy, may improve adherence and accessibility forcomplex conditions.

20. TRAUMA-CENTER TRAUMA-SENSITIVE

YOGA V. PSYCHOTHERAPY FOR PTSD AND

CO-MORBID DEPRESSION FOR WOMEN

VETERANS WHO EXPERIENCED MILITARY

SEXUAL TRAUMA

U. Kelly,1 T. Haywood,2 M. Patel21. Atlanta VA Health Care System; and Emory University Nell

Hodgson Woodruff School of Nursing

2. Atlanta VA Health Care System

Keywords: trauma-sensitive, yoga, PTSD, posttraumaticstress disorder, depression, women, veterans, military sexualtrauma

Objective: To evaluate the effectiveness of Trauma CenterTrauma-Sensitive Yoga (TC-TSY) to treat PTSD and co-mor-bid depression symptoms in women Veterans with PTSD whoexperienced military sexual trauma (MST). Methods: In this RCT, women Veterans (n=80) were recruit-ed in a VAHCS from PTSD, mental health, and other out-patient clinics. Participants were randomized to TC-TSY orcognitive processing therapy (CPT). The protocol-driveninterventions were provided in 60–75 minute group sessions,for 10 (TC-TSY) and 12 (CPT) weekly sessions. Data were


collected at baseline, mid-intervention, 2-weeks post-inter-vention and 3-months post-intervention. Measures includethe PTSD Symptom Checklist (PCL-5), the ClinicianAd m i n i s t e red PTSD Scale (CAPS-5), and the Be c kDepression Inventory (BDI). Data analyses included groupcomparisons at baseline (t-tests, Mann Whitney non-para-metric tests, and chi-square tests). Multilevel mixed modelswere used to analyze the differences between the groups overtime on outcome variables.Results: PTSD symptom severity decreased significantly (p <.001) in both groups, with progressively lower scores at eachtime point for both self-reported (PCL-5) and clinicianassessed (CAPS-5) PTSD symptoms. Mean total PCL scoresdecreased from 51.44 to 36.88 (TC-TSY) and from 51.87 to30.67 (CPT), baseline and 3-months post-interve n t i o nrespectively. Mean total CAPS severity decreased from 34.29to 19.40 (TC-TSY) and 33.53 to 14.36 (CPT), from baselineto 3-months post-intervention. Depression symptom severity(BDI) also decreased significantly (p < .001) in both groups,with progressively lower scores at each time point. Mean totalBDI scores were 28.45 and 18.29 (TC-TSY) and 30.84 and16.14 (CPT), at baseline and 3-months post-intervention,respectively. There were no significant differences betweenTC-TSY and CPT groups in changes in PTSD and depres-sion symptoms over time. Conclusions: These results support TC-TSY as a cost-effec-tive scalable intervention for PTSD and comorbid depressionin women Veterans with sexual trauma that could be imple-mented in the VA nationwide, expanding treatment optionsbeyond PTSD psychotherapy, which is not universally accept-able or effective. Additional research is needed to evaluate thebenefits of TC-TSY as an alternative, precursor, or adjunctivetreatment to psychotherapy for PTSD.

21. CASE REPORT: YOGA THERAPY SLEEP

INTERVENTION FOR A VOLUNTEER

FIREFIGHTER

S. KildayMaryland University of Integrative Health

Keywords: firefighter, sleep disturbance, sleep hygiene, yoga,breath, meditation

Background: Firefighting universally requires extended workshifts and long hours of sustained wakefulness, often per-formed under highly stressful conditions. Common firefight-ing shifts include 24-hours on/48-hours off, 48-hours on/96-

hours off, or “Kelly” Shifts consisting of a nine-day cycle alter-nating 24-on/24-off for three days, followed by four consecu-tive days off. While shift schedules have built-in downtime,sleep is often interrupted by emergency responses which havean adverse effect on sleep cycles. Additionally, many firefight-ers, especially volunteers, have second jobs further affectingrecovery from shift work. Such sleep disturbances can con-tribute to conditions that increase health and safety risks forfirefighters and the communities they serve.Case Presentation: This case study involves a volunteer fire-fighter who performs in a leadership role in addition to hisnormal first-responder duties. Reporting sleep disturbancesmainly involving sleep interruption and difficulty returning tos l e e p, this fire f i g h t e r’s primary yoga therapy goal wasimproved sleep hygiene. The intervention included 10 privateYoga Therapy sessions over the course of five months, duringwhich the client rated his sleep quality utilizing the PROMIS8b-Sleep Disturbance Short Form. Interventions includedyoga postures, breathing techniques, iRest® Yoga Nidra med-itations, and sleep hygiene practices to elicit relaxation, facili-tate a parasympathetic response, and improve sleep. While anumber of yogic tools helped, the client reported the greatesti m p rovement resulting from coherence breathing withextended exhalations and legs-up-the-wall pose (Vi p a r i t aKarani). The client also reported using a bed-side notepad fordownloading his mental “To-Do” list helpful for “clearing histhoughts.” Over the course of this intervention, sleep symp-tom rankings consistently improved, ranging from “moderateto severe” at the beginning of care to “normal limits” by theend of care. Post-intervention, client self-reports continuationof improved sleep quality, which he credits to his new-foundsleep hygiene routine. Conclusion: Yoga Therapy may provide a novel interventionfor improving sleep quality for populations such as firefight-ers who work with altered sleep cycles.

22. EFFECT OF SUKSHMA VYAYAMA YOGA

ON AROMATASE INHIBITOR-INDUCED

ARTHRALGIA IN BREAST CANCER

SURVIVORS: A FEASIBILITY STUDY

CONDUCTED ON FACEBOOK

L. Leibel,1 K. Metri,2 R. Prasad,2 G. Mears1

1. Columbia University Medical Center, New York, NY

2. S-VYASA University, Bangalore, India

Keywords: yoga, sukshma vyayama, aromatase inhibitors,arthralgia, breast cancer, Facebook




Objective: Aromatase inhibitor (AI) hormonal therapy pre-scribed for estrogen positive breast cancer causes joint pain inup to half of women, and up to 20% become non-compliantwith treatment due to pain and discomfort. Non-complianceis an independent predictor of mortality yet there is no effec-tive, established treatment for this difficult problem. Thisstudy investigated the efficacy of sukshma vyayama joint loos-ening yoga in improving AI-induced joint pain and evaluatedthe feasibility of delivering the intervention on Facebook.Methods: Breast cancer patients undergoing treatment withAI’s with self-reported arthralgia were recruited via an IRB-approved announcement posted in closed breast cancer sup-port groups on Facebook to participate in a yoga study deliv-ered on Facebook. Participants completed BPI, DASH, PRAIand WOMAC questionnaires before and after the study.Intervention consisted of 12 exercises performed in a chair,once daily for 12 minutes, Monday-Friday for 4 weeks.Asynchronous video demonstrations were available in a secretFacebook group and viewing confirmed by timestamped replyin comments.Results: 200 women responded and 38 met the inclusion cri-teria/consent, 26 completed the online consent, interven-tions, and pre/post questionnaires. Paired simple t testsshowed significant (P<0.05) improvement in all pain meas-ures and quality of life parameters after yoga interventionc o m p a red to baseline (pre/post mean percent change:B PI_PSS -46.00%; BPI _ PIS -53.58%; DASH -55.07%;PRAI -49.44%; WOMAC1 -52.07%; WOMAC2 -40.59%;WOMAC3 -42.57%).Conclusion: This study provides the first evidence that it isfeasible to teach sukshma vyayama to patients on Facebookand that the intervention significantly improves AI-inducedarthralgia. Further investigation utilizing a larger sample sizeand control group is warranted. Funding: The Charles Flood Integrative Oncology Fund atColumbia University.

23. EFFICACY OF YOGA THERAPY AS PART

OF INTEGRATIVE CARE FOR A PERSON

LIVING WITH ANKYLOSING SPONDYLITIS

N. Leo-Randazzo, D. Hallkowski, D. Galliano-Grigsby

Introduction: Ankylosing Spondylitis (AS) is a progressive,chronic, inflammatory disease affecting the axial skeletonwhich may result in decreased spinal mobility and physicalfunction. Research into symptom management of AS has pri-marily focused on the benefits of physical therapy and exercise

to maintain posture and range of motion, and medication torelieve joint pain and increase mobility. While there have notbeen studies done into the benefits of yoga for AS, researchdoes support yoga as an integrative and complementary heal-ing modality that decreases inflammation, pain, and fatigue.This case study examines the efficacy of yoga therapy throughthe biopsychosocial-spiritual lens to address the primarysymptoms related to AS.Case Description: A 43-year-old woman diagnosed withankylosing spondylitis was experiencing neck/back/joint painwith subsequent fear of movement, headaches, stress, andanxiety related to her health. The individual’s medical historyincludes whiplash (from a car accident), low blood pressure,type II diabetes, and obesity. Pharmacological treatment withan NSAID and a TNF inhibitor did not relieve her pain norincrease her mobility or range of motion. Treatment consistedof five 60-minute yoga therapy sessions and a home plan ofcare that included restorative postures, joint-freeing move-ments, breathing practices (pranayama), and guided medita-tion. Using the Measure Yourself Medical Outcome Profile(MYMOP), the client reported a reduction in overall pain,i m p roved stress management, and improved sleep. Sh edemonstrated an enhanced ability to self-regulate as evidencedby her report of utilizing breathwork at times of high stress.Additionally, she experienced a sense of deep joy which sup-ported feelings of safety in larger functional movement. Conclusion: Yoga therapy can improve the quality of life forindividuals diagnosed with Ankylosing Spondylitis, bydecreasing activation of the stress response, helping to devel-op enhanced stress management and self-regulatory skills,improving sleep, and cultivating feelings of safety in function-al movement. Perhaps most importantly, for someone diag-nosed with AS, yoga therapy can help change their relation-ship to pain to help reduce pain levels, especially when tradi-tional pharmacological means fail to address pain symptoms.Further study is warranted to determine the dosage and spe-cific protocol that provides the most significant relief.

24. TRACKING THE YOGA IN YOGA

RESEARCH: INSTRUCTOR FIDELITY TO A

YOGA PROTOCOL IN A RANDOMIZED CLINI-

CAL TRIAL FOR CHRONIC PAIN IN GULF WAR

ILLNESS

L. Mahoney,1 P. Bayley,2 R. Cho,1 L. Collery,1 D. Moore-Downing,1 M. Majmundar, K. Shankar3

1. War Related Illness & Injury Study Center, VA Palo Alto

Health Care System, Palo Alto, CA


2. War Related Illness & Injury Study Center, VA Palo Alto

Health Care System, Palo Alto, CA; and Stanford University

3. VA Palo Alto Health Care System, Palo Alto, CA

Keywords: yoga, chronic pain, gulf war illness, veteran,fidelity

Objective: The purpose of the study is to analyze protocolfidelity data collected as part of a 10 week randomized con-trolled trial (RCT). Results of the trial revealed clinically andstatistically significant reduction in pain in gulf war veterans.The study examines if there is a relationship between instruc-tor fidelity to the protocol and study results. Analysis ofadherence to the planned yoga tools will be provided. Methods: The yoga protocol for a 10 week, 1 hour/week plushomework was developed by a team of 3 yoga teachers at alarge VA medical center. Each instructor was experiencedleading adaptive yoga classes for Veterans with Gulf WarIllness. Before the study began, the yoga instructors practicedadherence to the protocol by teaching the protocol to the twoother instructors. Once the study began, the lead instructortaught all sessions for Cohort A with the other 2 teachers inclass providing assistance. Cohorts B through G were taughtby the 3 yoga instructors on a rotating schedule with one ormore of the other instructors assisting each week. A fidelitycheck list was completed after each class for each cohort. Thenumber of yoga tools used in each class ranged from 28 to 36.Pranayama, asana, mudra, chanting, and meditation wereitemized individually on the weekly check lists. Results: The mean adherence to the yoga protocol was 98%with a range of 91% to 100%. Of the 70 classes taught dur-ing the study, 37(~53%) re p o rted 100 percent fidelity.Instructors reported 100 percent fidelity for session 10 acrossall cohorts. The percentage of poses skipped ranged from zerofor week 10 up to 4.76 percent for week two. Fidelityimproved across cohorts with 100 percent fidelity in 8/10 ses-sions during Cohort F. Instructors most often skipped thepranayama practice at the end of class or the combination ofprone upper and lower back extensions after doing them sep-arately. The reclining bound angle and banana poses wereamong the most frequently skipped poses as were cross-leggedreclining twist and supine modified pigeon.Conclusion: Robust planning and practice contributed to thehigh rate of fidelity to the yoga protocol throughout the study.The yoga tools chosen were appropriate and effective inreducing pain in gulf war Veterans. Postures repeating ele-ments of prior postures were skipped when necessary as werepostures requiring crossing of ankles over knees.

25. PHARMACIST LED CHAIR YOGA IN HOME

HEALTHCARE PATIENTS WITH CHRONIC PAIN

A. Margraf,1 V. Lemay,1 K. Ward,1 M. Ng,2 K. Orr,1

L. Cohen1

1. University of Rhode Island College of Pharmacy, Kingston

2. Visiting Nurse Home and Hospice, Portsmouth, RI

Keywords: yoga, chair yoga, chronic pain, home healthcare

Objective: Chair yoga (CY) is a modified practice that invitesindividuals seeking an adaptive, low-risk routine for betterwellness outcomes. By bringing CY to the patient in the com-fort of his or her own home, resistance regarding transporta-tion or anxiety of being seen by others is eliminated. Thisstudy is designed to investigate whether CY improves chronicpain in home healthcare patients that may not have the meansor will to attend a community center.Methods: Eligible participants were identified and referred bycase managers within the Vising Nurse Home and Hospice(VNHH) secure software as having chronic pain and wereexcluded for documentation of recent surgery. Upon consent,a pre-intervention survey was conducted by the lead investiga-tor assessing previous yoga exposure, baseline demographics,perceived pain using visual pain analog scale, reported qualityof life (QOL) using Likert scale responses, and prescriptionpain medication usage. After completing the initial survey,lead investigator engaged participants in 15 to 60 minutes ofone-on-one chair yoga over six weeks tailored to individualability levels and range of motion. A post-survey was conduct-ed after the final CY session assessing identical measures as thepre-survey. Paired t-test was used to assess statistical signifi-cance of data collected. Results: 7 eligible patients identified with VNHH enrolled inJanuary 2019 and consented to CY participation. The averageperceived pain was rated as 7.71 out of 10 initially with only28.6% reporting no use of prescribed pain medications priorto and during CY intervention. The perceived QOL of all par-ticipants prior to CY intervention was 3.17 out of 5.Concluding the six weeks of CY intervention, the averagepain score decreased by 4.5 (7.33 v. 2.83, p = 0.01) and QOLmeasures remained the same with no significant differencereported. No adverse events or increases to prescribed painmedications were reported during CY intervention.Conclusion: This study demonstrates a role for complemen-tary alternative medicine in patients with chronic pain. Low-risk routines such as CY offer an accessible option that maycomplement traditional therapies for patients that are unableto leave their homes.




26. DEVELOPMENT OF INTERNATIONAL

YOGA REPORTING GUIDELINES—A DELPHI

SURVEY

S. Moonaz,1 D. Nault,1 H. Cramer,2 L. Ward3

1. Maryland University of Integrative Health, Laurel, MD

2. University of Duisburg-Essen, Essen, Germany

3. University of Technology Sydney, Australia

Keywords: yoga, reporting guidelines, Delphi

Background: Due to a lack of reporting guidelines for yogaresearch, the content and delivery of yoga interventions isoften unclear, limiting their dissemination and implementa-tion. We address this issue by developing reporting guidelinesbased on the expertise and consensus of international yogaresearchers.Methods: We invited individuals involved in the conception,design, delivery, or reporting of yoga research to join thisDelphi survey. In Round 1 of the survey, developed by aninternational steering committee, panellists rated 58 items forimportance of inclusion in reporting guidelines for yogaresearch. Pre-defined consensus levels determined item inclu-sion or exclusion, and content of the subsequent surveyrounds. In Round 2 of the survey, 52 items were rated or re-rated. Based on the same pre-defined consensus levels, a thirdround is currently under development to move toward con-sensus and ultimately a final reporting guideline.Results: Fifty-two panellists, representing 11 countries, con-sented. Panellists were primarily researchers (61%); had atleast five years research experience (85%); and identified yogaas their primary research field (61%). Forty-eight panellistscompleted Round 1 (92%) and 43 completed Round 2(83%). In Round 1, quantitative analysis resulted in 15 itemsreaching consensus for inclusion in the final Delphi guide-lines, six items reaching consensus for exclusion, and 37 non-consensus items for re-rating. Qualitative analysis of Round 1comments generated an additional 15 new items; resulting ina total of 52 items forming the Round 2 survey. In Round 2,2 more items reached consensus for exclusion, 35 reachedconsensus for exclusion, and 15 non-consensus items for re-rating, five of which were reworded for clarity based on qual-itative analysis of Round 2 comments. Round 3 is currently inprogress. Delphi completion is expected in December 2019. Conclusion: The expert generation of this yoga-specificreporting guideline will enhance yoga research reportingacross study designs, including clinical trials, observationalstudies, and case reports. Quality reporting will in turnimprove clinical application, policy recommendations, publicunderstanding, literature reviews, and comparative effective-ness.

27. IMPACT OF YOGA ON IGG4 RELATED DIS-

EASES (IGG4-RD)

S. Mukhopadyay,1 M. Kaneria,1 V. Kavuri,2 K. Metri,2

R. Nagarathna,2 S. Kim,3 S. Cocke3

1. Swami Vivekananda Yoga Anusandhana Samsthana

(VYASA-LA), Los Angeles

2. Swami Vivekananda Yoga Anusandhana Samsthana

(S-VYASA) University, Bengaluru, Karnataka, India

3. St. Jude’s Healthcare System, Fullerton, CA

Keywords: yoga, autoimmune, IgG4, IgG4-RD,immunoglobulin, PSS, PSQI

Objectives: The purpose of the study was to estimate theeffect of an integrated yoga protocol on the level ofimmunoglobulin G sub-class 4 (IgG4) and related disease(RD) parameters.Methods: A single subject case study (SSCD) was designedfor a patient (based on A-B-A methodology-multiple treat-ment period followed by non- treatment periods) who hasbeen suffering of elevated IgG4-RD for a few years. Lack ofadequate sample size led to this SSCD. IgG4 is a less under-stood antibody and limited number of study points its corre-lation with Autoimmune disorders, Lymphatic disorders, anddisease related to eyes, thyroids, lungs etc. The patient’s IgG4was high, and lungs and lymph nodes were affected. Thepatient had high stress. A formal 6-month Yoga Protocol(1.25-hour protocol using asanas, pranayama, kriyas and spe-cialized meditations like Pranic Energization Technique) wasdesigned by senior practitioners of Yoga. Efforts were made tominimize the impact of extraneous variables. The patient wasbeing examined by doctors before, during and after the studyperiod. All results were measured by physicians and certifiedyoga instructors to eliminate any bias. The pre-post analysiswas done on all the parameters being measured (PSS, PSQI,Iodine, D3, IgG, iGg4, IgE) including CAT/SCAN (for thelymph nodes). In the 4 years of case study, yoga protocol wasused total 3 times—a period of yoga intervention followed bya non-intervening period.Results: In the last 6-moth intervention there was a signifi-cant improvement in the stress parameters (Perceived stressscale (PSS) from 33 to 13, Pittsburgh Sleep Quality Index(PSQI) from 9 to 4). Iodine levels improved (49 to 82).Autoimmune indicators (ANA) improved. However, IgG4level remained unchanged 300+. Lymph node size remainedunchanged (3.8 sq. mm). On the other hand, earlier Yogicinterventions showed IgG4 drop more than 7% and reduc-tion of lymph node size by 40%. Stoppage of the yogic proto-cols re versed the improvements indicating a corre l a t i o nbetween Yoga and IgG4-RD.


Conclusion: SSCD using three interventions followed bynon-intervening periods indicates that yoga had a positiveimpact on IgG4-RD. Further studies primarily controlled andrandomized studies with appropriate sample size are needed.The design of the protocols may need to change. This study iscomplex with multiple interacting variables and the researchmay need to be broken down to several subgroups for focusedstudies. Examples are Pranayama and IgG4-RD; Kriyas andIgG4-RD and variants of those. Vast possibilities exist toexplore this uncharted area.

28. YOGA REDUCES RUMINATION, WORRY,

AND NEGATIVE AFFECT IN COLLEGE STU-

DENTS REPORTING HIGH LEVELS OF STRESS

R. Nemeroff, C. PearsallWilliam Patterson University

Background: Rumination, worry, and negative emotions areassociated with psychological distress and predictive of psy-chological disorders such as depression and anxiety.Methods: In this study, we offered free yoga classes to 22 col-lege students reporting high levels of stress and psychologicaldistress. Hatha yoga classes were conducted on the college stu-dents’ campus twice each week, for one hour each class, overthe course of three weeks. Trapnell and Campbell’sRumination-Reflection Questionnaire (RRQ), The Penn StateWorry Questionnaire (PSWQ), and the Positive and NegativeAffect Schedule (PANAS) were administered before studentsbegan the yoga classes and after 3 weeks of participation in theyoga classes. Results: Statistically significant reductions in rumination,worry, and negative affect were observed. Conclusions: This research offers preliminary support for theeffectiveness of yoga in shifting cognitive patterns that mayincrease young adults’ risk of developing mental health issues.

29. A QUALITATIVE STUDY EXAMINING THE

LIVED EXPERIENCES OF STRESS AMONG

FEMALE SEXUAL ASSAULT SURVIVORS IN

AN 8-WEEK TRAUMA SENSITIVE YOGA

INTERVENTION

N. Nicotera,1 M. Connolly,1 L. Jawdat2

1. University of Denver Graduate School of Social Work,

Denver, CO

2. The Viva Center, Washington, DC

Keywords: trauma-informed, yoga, sexual assault, qualita-tive methods

Objective: Evidence supports trauma sensitive yoga’s (TSY)efficacy, but little is known about participants’ processes inTSY. This qualitative study’s purpose was to examine the livedstress experiences of sexual assault survivors in an 8-week TSYintervention.Methods: Data were collected as part of an embedded mixedmethods design testing the intervention. LCSWs-RYTs facil-itated the intervention which was informed by evidence fromthe Trauma Center TSY and the Trauma Therapy Model.Participants (n = 23 women) rated and explained reasons forstress via check-in/check-out sheets at each of 8 sessions.Analysis in Atlas-ti applied 8 steps: Independent in-vivo cod-ing 50% of data; Collaborative grouping of in-vivo codes forcommonalty-definition; Applied codes from step 2 toremaining data; Collaborative re-analysis of in-vivo codes forcommonalty-re-definition; Grouped codes into umbrella cat-egories to develop themes; Compared pre-post themes;Quantified pre-post percentages of stress ratings; Quantifiedpre-post percentages of quotes by code. Results: Three thematic categories emerged: stress; well-being;group effects. Pre-post stress sub-themes included 3 stressors(common; emotion; extraordinary), the sub-theme stress pile-up is only found at pre-group. Well-being pre-group sub-themes (self-care; coping; feeling good) differed from post-group (taking action; letting go; relaxation; connection to body).Group effects sub-themes, processing; positive mind-body-heartexperiences; integrating skills-concepts were coded as positive;triggers was coded as negative. Quantified results suggestlower stress over 8 weeks (e.g., 40% high-stress pre-session 1;20% high-stress pre-session 8; 14% high-stress post-session 1;7% high-stress post-session 8). Percentage of stress-codedquotes consistently reduced from pre-session (e.g., 39% ses-sion 1) to post-session (e.g., 5% session 1). Percentage of pre-session well-being coded quotes increased (e.g., 9% session 1;13% session 4; 28% session 8). Percentage of post-sessionwell-being coded quotes were consistent at about 27% (ses-sions 1–6) with a dip in session 7 (14%) and 8 (17%).Percentage of group effects quotes coded positive were consis-tent (e.g.,18% session 1; 15% session 4; 19% session 8).Percentage of group effects quotes coded negative were onlyin sessions 1, 3, 8, and minimal (2% – 3%).C o n c l u s i o n : Sexual assault surv i vo r s’ stress experienceschange qualitatively over the course of an 8-week TSY inter-vention.




30. DIAPHRAGMATIC BREATHING AND PER-

FORMANCE ANXIETY IN DENTAL STUDENTS

C. Pastan, S. Sauers, S. Eisen, G. Kugel, B. Magnuson,S. PagniTufts University School of Dental Medicine, Boston

Keywords: pranayama, yoga, performance anxiety, dentalstudents

Objective: Dental school is a time of immense stress for mostdental students. Professional students suffer from perform-ance anxiety which can be a debilitating experience for stu-dents during preparation for an exam or even during the examitself. This study aims to investigate dental student knowledgeand attitudes toward Diaphragmatic Breathing in order todetermine if it is correlated with student’s confidence in theirability of success and performance on dental school examina-tions.Methods: In October 2018, Dr. Christina Pastan presented alecture discussing self-regulation through breathing tech-niques. The students were also and taught how to engage inthe three-part breath or Dirgha pranayama, a yogic breathtechnique. Post lecture, a 10 question survey was distributedto up to 195 Tufts University School of Dental Medicine(TUSDM) first year students taking the Operative Dentistrycourse. In the survey students answered questions about theirattitude towards Diaphragmatic Breathing and its impact indental school, their personal lives and in their future as a den-tal provider. All data was collected anonymously.Results: A total of 81 surveys were completed by the D22Class at TUSDM. Of those students who participated in thes u rve y, 44 respondents (54%) re p o rted hearing of theDiaphragmatic breathing technique and 59 re s p o n d e n t s(72%) feel as though they experience performance anxietywhen taking exams. 72 respondents (88%) think that practic-ing Diaphragmatic Breathing will benefit them then they arepracticing dentists and 71 (87%) respondents say they woulduse it if stressed in everyday life. There is a strong correlationbetween students who feel that Diaphragmatic Breathing canhelp them perform better on exams and would be interestedin using the technique before a competency exam.Conclusion: Dental students that are given the proper train-ing in the three-part breath, can enhance their attention andimprove visuospatial processing and working memory capaci-ty during times of high stress. The survey results suggest thatthe implementation of this exercise in the dental school cur-riculum will lead to decreased stress and performance anxietyin dental students.

31. TEACHERS’ MEANING-MAKING PROCESS

OF YOGA AS AN EMBODIED SELF-REGULA-

TION TOOL: THE HIGH SCHOOL YOGA MAT

STUDY

P. PirkeyThe University of Memphis, TN

Keywords: yoga, embodied self-regulation, technology, epis-temology, pedagogy, systems thinking

Objective: In yoga-research applied to education, yoga isviewed as an embodied self-regulation (ESR) tool to benefitstudents’ and teachers’ thoughts, emotions, behaviors, andphysiology. Yoga is widely implemented into schools to facil-itate academic/non-academic growth and development. Highschool (HS) teachers are essential in providing yoga as an ESRtool to adolescents and supporting ESR development. Tounderstand yoga as a tool for teaching and learning ESR, thisresearch explored two areas: (1) initial phase of introducingand educating teachers about school-based, yoga programimplementation; (2) the complexities of teachers’ meaning-making (M-M) and learning process in understanding yoga asa tool. Methods: Using a single-site, exploratory, multiple caseresearch design and systems thinking approach, several datasources were collected to better understand HS teachers’(n=5) M-M process of this phenomenon in fall 2018. Sinceno qualitative methodology aligned with this epistemologicalpursuit as prescribed by systems philosophy, I developed aheuristic, methodological approach to fulfil the goal of thefirst aim (i.e., infusion of thematic analysis at the semanticand latent levels (Braun & Clarke, 2006), and content analy-sis (Elo & Kyngas, 2008)). Teacher participants chose theirown pseudonyms to protect anonymity.Results: Case profiles were written up for each teacher. Twomain themes emerged with re l e vant, imbedded sub-themes/categories: The Dy s regulated HS Sy s t e m a n dEmpowering the HS System via Yoga. Regarding the secondresearch question, overarching themes and sub-themes foreach teacher are as follows: Anna (Compassionate: Se l f -Acceptance and Service Orientation); Brandy (Active Learner:Inquisitive, Reflective, and Engaged; Low Ahimsa); Elizabeth(Meta-Awareness: Aware of Yoga Benefits for Self, Aware of YogaBenefits for Students, and Aware of Social Perceptions); Frank(Reflective Awareness: Reflective, Aware of Social Perceptions,Aware of Yoga Benefits for Self, Aware of Yoga Benefits forStudents, and Aware of Yoga Benefits for Teachers), and; Lollie


(Doubt). Discussion of these findings will be presented. Conclusion: Future research must focus on developing aprocess-oriented framework that describes how the researchercan support teachers’ M-M to improve collaborative effortsb e t ween teachers and re s e a rchers by improving yo g aresearchers’ approach to introducing, informing, and teachingyoga as an ESR tool in HS environments.

32. CONTENT ANALYSIS OF MOBILE HEALTH

A P P L I C ATIONS IN YOGA FOR LOW BACK PA I N

V. Purushothaman, R. Pavithra, S. KiruthigaSri Ramachandra Institute Health Education and Research (DU)

Keywords: low back pain, low back pain yoga, mobile appli-cation, content analysis, mobile health, health informatics

Background: Rapid and widespread use of smart phones hasled to the development of various app-based programmes.Health apps are one of the more popular categories of appsthat are used extensively among people who are interested inhealth and fitness. Stretching and strengthening the musclesof the back and lower extremities through physical postures,yoga may have the additional benefit of reducing stressthrough meditation and breathing exercises, contributing toan overall reduction in symptoms for individuals with lowback pain.Objective: To analyse the contents of the free available mobilehealth apps on android platform in “yoga for low back pain”and to develop a high-quality, evidence based health applica-tion for android users with proper clinical guidance and withunique and changing needs to get rid of low back painMethods: Three independent researchers evaluated and com-pared yoga for low back pain apps available in android plat-form with the goal of understanding the content, functionability and design features. The evaluation of free mobilehealth applications in yoga for low back pain was conductedthrough the assessment of 6 main features such as size lessthan 10MB, Educational tool, Age rating up to 12+, updat-ing within 3years, presence for web URL and star rating upto4. Understanding the existing apps will form a foundation todevelop a better app to encourage and mentor the people per-forming yoga to get rid of low back pain. The search keyword’low back pain yoga’ provided a total of 282 apps in theGoogle play store. A cross sectional study was performed onthis sample of 282 available mobile apps.Results: Out of 282 mobile health apps identified, there are245 free apps in the Google play store. The mobile healthapps that met the inclusion criteria were 19 apps and the

other apps focused either on general health tips or commonyoga. Of the 6 evaluated features, only 3 apps had a highestscore of 5 whereas 8 apps scored the lowest, with the score of2. Out of the 8 lowest scored apps, 4 were not in to our con-tent analysis because of the technical error in opening the app.Conclusion: The study evidences, most of the apps were rel-atively small storage size (less than 10MB) and could be usedoffline and also app sharing option available. None of the appsrequired a subscription. Most of the apps are with pictorialrepresentation except one app which has video demonstrationvia YouTube link. Few apps have some specific features likeReminder, BMI calculator and psychological motivationalvideo component. The available apps should be able to trackthe yoga practice and provide immediate feedback and con-sultation by experts.

However, there is a need for guidance by the right author-ities or health professionals and regulation both in online andmobile media because of the rising trend in accessibility ofsmart phones for health related issues. Therefore, it is recom-mended to create well-designed application by authorizedprofessionals to promote yoga in reducing low back pain.

33. YOGA INSTRUCTOR BELIEFS AND

EXPERIENCE IN PRACTICE, TEACHING, AND

TEACHER-TRAINING: DIFFERENCES ACROSS

STYLES OF YOGA

T. J. Reeves,1 C. Murphy,2 L. Benusis,3 M. Sullivan,4

T. M. J. Rybak,5 L. M. Harrell-Williams1

1. The University of Memphis

2. Mindful in Memphis

3. Columbia University

4. Maryland University of Integrative Health

5. Cincinnati Children’s Hospital

Keywords: yoga instruction, yoga styles, yoga beliefs,instruction

Objective: Yoga is a heterogeneous practice with diversity inlineage and content. The aim of this study is to explore differ-ences in epistemic and pedagogical beliefs of yo g ateachers/therapists in relation to their experience(s) in differ-ent styles of yoga.Methods: Participants (n = 324) were yoga teachers/therapistsrecruited via virtual communication to participate in anonline study about yoga instruction. Participation was volun-tary without monetary compensation. Epistemic and peda-gogical beliefs were captured using the Yoga Instructor BeliefsScale (YIBS). Style scores were derived from reported practice,




teacher training, and teaching in different styles. Correlationanalysis was conducted.Results: Significant relationships were found based on howmuch an instructor identified with a particular style (stylescores) and their scores on the YIBS scales. For epistemicbeliefs, Kundalini scores correlated positively with energetic (r= .24***) and affectual (r = .12*) scales. Power scores correlat-ed positively with physical scale (r = .14*). Holistic scores wereinversely related to physical scale (r = –.11*). For pedagogicalbeliefs, Alignment-based scores correlated positively with allbelief factors: teaching accessibility (r = .19**), differentiatedinstruction (r = .16*), student awareness (r = .15*), curricularintegration (r = .128*). Holistic scores correlated with curric-ular integration (r = .23***), student awareness (r = .21***),and accessibility (r = .15*). Gentle scores correlated withteaching accessibility (r = .20**). Beyond style-scores, diversi-ty in the styles practiced also mattered. Participants who prac-ticed more styles of yoga positively correlated to studentawareness (r = .17**), curricular integration (r = .15*), andaccessibility (r = .17*). Note: *** p< .001, ** p < .01, * p < .05.Conclusion: Findings provide evidence for epistemic andpedagogical differences in regard to yoga styles. Participantswho identified with Kundalini style rated energetic and affec-tual definitions high. Pa rticipants who identified withAlignment-based (such as Iyengar, Ansura, etc.) and Holistic(such as Kripalu, Integral, Sivananda, etc.) style-scores ratedhighly in pedagogical belief factors. Complexity of individualexperience such as diversity in experience may also influencebeliefs. Continued work to improve clarity of different stylesmay benefit both public and research contexts in supportingaccurate depictions that inform modern yoga instruction,research, and therapy.

34. IMPLICIT AND EXPLICIT THERAPEUTIC

AND PEDAGOGICAL BELIEFS OF YOGA

INSTRUCTORS

T. Reeves,1 M. Sullivan,2 K. Hawes,1 P. Pirkey,1 N. Muse1

1. The University of Memphis

2. Maryland University of Integrative Health

Keywords: yoga instruction, yoga styles, pedagogy,epistemology, yoga philosophy

Objective: Notably absent from yoga research is examinationof the role of the yoga therapist/teacher in instructional deliv-ery and/or therapeutic relationship. Given the inherent thera-peutic relationship and educational role of yoga therapists/instructors, inquiry should specifically explore the extent to

which theory and pedagogy inform practice. This qualitativeinquiry explored yoga therapists’/instructors’ expression andframing of educational and therapeutic constructs in the con-text of yoga.Methods: Using qualitative data collected in a larger studyanalysis focused on descriptive responses to semi-structuredinterview questions, participants were recruited using pur-poseful sampling (Patton, 1990) to ensure diversity in scope(N = 11). Interviews performed as conversational partners(Rubin & Rubin, 2012) and were transcribed verbatim.Transcripts were analyzed, using content analysis, for implicitand explicit assertions that were therapeutic or pedagogical innature. Results: Findings suggest interwoven systems of philosophythrough implicit and explicit expression. While varying in lev-els and strength, all participants expressed both therapeuticand pedagogical responsibility. Underlying factors such as pastexperience as a student, lineage of instruction, and individualidentity were present across interviews. Potential affectualcomponents also emerged as variant peaks in each interviewsuggesting comparative points of emphasis. Furthermore, apotential relationship between loyalty to or conviction of aparticular style/lineage/brand of yoga taught and rigidity ofpedagogical framing suggested that the training and experi-ence of a yoga therapist/teacher may influence pedagogicalbeliefs.Conclusion: Theoretical acumen shapes understanding offunction in both therapy and instruction. Continued empiri-cal inquiry surrounding theory and pedagogy may benefitfrom thorough exploration of the style, lineage, branding, andeducation of yoga therapists and instructors.

35. A SCOPING REVIEW OF YOGA AND

MINDFULNESS-BASED INTERVENTIONS FOR

THE TREATMENT AND PREVENTION OF SUB-

STANCE USE DISORDER IN ADOLESCENTS

F. Riley,1 L. Conboy,2 D. Carr,1 Y. Bradshaw1

1. Tufts University School of Medicine, Boston

2. Beth Israel Deaconess Medical Center

Keywords: yoga, mindfulness, meditation, substance use dis-order, addiction, adolescents, children

Objective: The purpose of this study was to determine theefficacy of yoga and mindfulness-based interve n t i o n s(YMBIs) for treatment and prevention of substance use disor-der (SUD) in adolescents by evaluating the quality and evi-dence of existing research.

42 IAYT 2019 SYMPOSIUM ON YOGA RESEARCH

Methods: Using a scoping review methodology, a keywordsearch was performed across three databases (PubMed,PsycINFO, and Web of Science). Retrieved studies wereincluded if the intervention contained at least one of fivemind-body techniques (yoga postures, breath exercises, relax-ation techniques, meditation, or mindfulness practices); wasdelivered in a group setting; included substance use measures;enrolled children/adolescents (birth–23 years); and was a peer-reviewed report of original research. Study data was extractedand categorically organized. Findings were compared based on(1) study design; (2) participants; (3) study aims and targets;(4) interventions; (5) measures and outcomes; (6) qualityassessment; and (7) emergent themes. A rating system basedupon the 2018 Mixed Methods Appraisal Tool (MMAT) wasdevised to aid research quality assessment.Results: Eight trials were eligible for review. Two were ran-domized controlled trials, three were non-randomized con-trolled trials, two used mixed methods, and one was a qualita-tive study. There were 1263 total participants, 12–23 years of

age, mostly Caucasian females. Trials assessed various inter-ventions, substance use, and biopsychosocial correlates.Reported outcome measures were diverse, but most fit intofive major classifications (emotional self-regulation, stress,sleep, impulsivity, and substance use). Seven trials reportedimprovement in substance use (five were statistically signifi-cant). Two studies were assigned a weak methodological qual-ity rating, four moderate, and two strong. Conclusion: Our findings suggest that YMBIs positivelyimpact adolescents and have the potential to prevent andtreat SUD in this population. However, current research evi-dence and quality is limited; and methodological heterogene-ity restricts consolidation. Greater uniformity of validatedinstruments to measure outcomes of YMBIs, better compre-hension of the psycho-emotional mechanisms of action ofYMBIs, and increased delineation between SUD symptomol-ogy vs the psychological syndrome underlying SUD are keyresearch gaps identified through our investigation.


Key: RMQ-rating = research methodological quality rating; MM = mindfulness and/or meditation; PMR = progressive muscle relaxation; CBT = cognitive behavioral thera-py; +∆ = positive change (improvement) reported; no ∆ = no change reported; n/a = outcome not tracked or not applicable; •* = change not statistically significant or statis-tics not reported; and •† = statistical analysis not applicable.



36. TOWARDS THE DEVELOPMENT OF A

YOGA PROGRAM SUPPORTING PARENTS OF

CHILDREN WITH ADHD

N. Rouleau, E. Marticotte, V. Alvo, F. VeilletteMANDALAB, CERVO Brain Research Center; and School of

Psychology, Laval University, Quebec City, Canada

Keywords: yoga, parents, ADHD, self-compassion, mindful-ness

Objective: Parents with ADHD children are known to showan increased level of parental stress. Some mindfulness pro-grams were developed for those children, such as our programPEACE, but to date, the literature does not offer any pro-grams for their parents. In order to develop an evidence-basedprogram, we aimed to study their level of self-compassion andmindfulness trait, and their relations with their experience inyoga practice.Methods: In an online survey on parental stress, parents of 8-11 year-old children (with and without ADHD) completedthe Self-compassion scale, Fi ve Facets Mi n d f u l n e s sQuestionnaire, and reported if they had already practice yoga(for a continuous minimum period of 4 months).Results: Self-compassion and Mindfulness level—A total of 579parents (n = 531 with ADHD, n = 48 without) completed thequestionnaires. A t-test revealed that parents with an ADHDchild present with a lower level of self-compassion (p = .007).However, FFMQ was not associated with any difference(p=.393). Self-compassion and Mindfulness level in relation withYoga practice in parents with ADHD children—One wayANOVAs showed a marginal effect of the practice on self-compassion (p = ,056) and a significant one with FFMQ (p =.0002). SCS and FFMA were higher in parents with a currentpractice compared to the ones who had never or already prac-ticed yoga (p = .05, and p = .002 respectively). Interestingly,the Mindfulness facets of Ob s e rvation (p =.01) andDescription (p = .001) were selectively improved for the par-ents with an actual Yoga practice compared to the ones whohad never practiced before.Conclusion: Parents of children diagnosed with ADHD pres-ent with a lower level of self-compassion. This level was clear-ly associated with their practice of yoga, particularly if theywere currently practicing. These results will guide our devel-opment of an evidence-based program to reduce the parentalstress of those parents. Yoga and self-compassion will beincluded in this program, accordingly to the results of thepresent study.

37. A 3-DAY YOGA AND MINDFULNESS-

BASED PROGRAM IMPROVED PSYCHOLOGI-

CAL HEALTH IN EDUCATION PROFESSION-

ALS

N. L. Trent,1 J. A. Dusek,2 S. Borden,1 E. Pasalis,1

M. McDonough,1 S. B. S. Khalsa3

1. Kripalu Center for Yoga & Health, Stockbridge, MA

2. Connor Integrative Health Network, University Hospitals,

Cleveland; formerly, Kripalu Center for Yoga & Health,

Stockbridge, MA

3. Brigham and Women’s Hospital, Harvard Medical School,

Boston, MA, United States

Objective: The purpose of single arm trial was to examinechanges in psychological well-being in education profession-als following a 3-day yoga and mindfulness-based program.Methods: The 3-day RISE (resilience, integration, self-aware-ness, engagement) program was administered at the KripaluCenter for Yoga & Health. RISE included 5 hours of yogaclasses, meditation training, lectures, and didactic/experien-tial activities to promote physical and psychological health.Adult education professionals (e.g., teachers, administrators)were recruited from the New York Department of Educationto attend the 3-day RISE program. Self-report measures ofpsychological and occupational well-being and health-relatedbehaviors, including the Perceived Stress Scale, ResilienceScale, Positive and Negative Affect Schedule, Five FacetMindfulness Scale, Psychological Empowerment Scale, Self-Compassion Scale, Satisfaction with Life Scale, MaslachBurnout Inventory, and Utrecht Work Engagement Scale,physical activity, fruit and vegetable intake, and sleep qualitywere completed before RISE (baseline), after RISE (post-pro-gram), and two months following RISE (follow-up). Of the132 participants that completed baseline measures, N = 52completed post measures, and N = 40 completed follow-upmeasures. Participants that completed at least the baselineand post or baseline and follow-up measures were included inthe analysis (N = 52). Paired samples t-tests were used tocompare scores between time points.Results: At post-program compared to baseline, participantsshowed improvements in self-reported perceived stress (p =.001), resilience (p = .009), positive affect (p = .001), negativeaffect (p = .001), mindfulness (p = .001), empowerment (p =.001), self-compassion (p = .001), satisfaction with life (.006),p rofessional efficacy (burnout) (p = .012), exhaustion(burnout) (p = .021), total work engagement (p = .001), vigor(work engagement) (p = .001), dedication (work engage-ment) (p = .001), job satisfaction (p = .010), and sleep quali-ty (p = .011). At follow-up, participants showed sustained


improvements in self-compassion (p = .008) and exhaustion (p= .003) compared to baseline. Conclusions: These findings suggest that the 3-day residentialRISE program improved some measures of psychological well-being in education professionals, at both post-program andfollow-up. Data collection is on-going with additional cohortsto increase the sample size.

38. A PILOT STUDY OF A SIX-WEEK YOGA

AND MINDFULNESS-BASED PROGRAM FOR

RESIDENT PHYSICIANS’ PSYCHOLOGICAL

HEALTH

N. L. Trent,1 J. Loewenthal,2 M. Lipsyc-Sharf,2 S. Borden,1

E. Pasalis,1 M. McDonough,1 D. H. Mehta,3 J. A. Dusek,4

S. B. S. Khalsa2

1. Kripalu Center for Yoga & Health, Stockbridge, MA

2. Brigham and Women’s Hospital, Harvard Medical School,

Boston

3. Medical Director, Benson-Henry Institute for Mind Body

Medicine, Massachusetts General Hospital, Boston; and Osher

Center for Integrative Medicine, Harvard Medical School and

Brigham and Women’s Hospital, Boston

4. Connor Integrative Health Network, University Hospitals,

Cleveland; formerly, Kripalu Center for Yoga & Health,

Stockbridge, MA

Objective: The purpose of this pilot study was to assess thefeasibility of a 6-week workplace yoga and mindfulness-basedprogram, RISE (resilience, integration, self-awareness, engage-ment), for internal medicine resident physicians’ psychologicalhealth.Methods: Resident physician participants (N = 40) were ran-domized to either a 6-week onsite RISE program or a waitlistcontrol group. Participants completed questionnaires assessingprogram feasibility on a visual analogue scale from 0 (not at allfeasible) to 100 (extremely feasible) at post-program, and psy-chological health outcomes at baseline, post-program, and 2-month follow-up. Post-hoc data analysis was conducted with3 groups: (1) those assigned to RISE and attended at least onesession, (2) those assigned to RISE but did not attend any ses-sions, and (3) the waitlist control group. Paired samples t-testsand ANOVAs were used for within- and between-group sig-nificance, respectively.Results: Participants rated the program as not highly feasibleto attend, mean = 24.0 (SD = 23.1), however, perceived feasi-bility increased if RISE was offered multiple times per weekon-site, mean = 60.3 (SD = 20.9), or offered remotely online,mean = 71.7 (SD = 26.3). From baseline to post-program,those who attended at least one session improved in stress (p =

0.001), mindfulness (p = 0.001), anxiety (p = 0.036), depres-sion (p = 0.031), work exhaustion (p = 0.003), interpersonaldisengagement (p = 0.002), total burnout (p = 0.001), andphysician well-being (p = 0.009) from baseline to post, andmindfulness (p = 0.001), stress (p = 0.001), work exhaustion(p = 0.014), interpersonal disengagement (p = 0.039), andtotal burnout (p = 0.036) from baseline to follow-up. Thecontrol group did not show any significant changes. Betweengroup analysis of change scores revealed statistically signifi-cant improvements in stress (p = 0.030), interpersonal disen-gagement (p = 0.020), and total burnout (p = 0.038) frombaseline to post in those that attended at least one session,compared to control. There were no significant betweengroup differences at the 2-month follow-up.Conclusions: These findings suggest that RISE can increasepsychological well-being in resident physicians, includingdecreasing burnout. Data collection is on-going and willinclude a 6-month follow-up and an additional cohort toincrease the sample size. Future work will focus on increasingthe feasibility of the program to improve its beneficial impact.

39. AN ESTIMATED PREVALENCE AND LIFE-

TIME EXPERIENCE OF YOGA AND MEDITA-

TION IN CHILDREN OF QUEBEC CITY

F. Veillette,1 V. Alvo,1 D. Harquail,2 N. Blais,2 N. Rouleau1

1. MANDALAB, CERVO Brain Research Center; and School of

Psychology, Laval University, Quebec City, Canada

2. MANDALAB, CERVO Brain Research Center; School of

Psychology, Laval University; and School Principal, Commission

Scolaire des Découvreurs, Quebec City, Canada

Keywords: yoga, meditation, prevalence, children, school

Objective: Little is known about the prevalence of mindful-ness practice in children. A US national health survey showedan increase from 2012 to 2017 among children and adoles-cents (Yoga: 3.1 to 8.4%; Meditation: 0.6 to 5.4%). The onlyavailable survey on physical and recreational activities andsports in Quebec revealed that in 2005, 2.1% of individualsover 15 years old practiced yoga during the past year. As a firststep in the development of our meditation- and yoga-basedprogram (PEACE-School), we thus aimed to know the previ-ous experience of the children within the schools of our area,in order to adapt our program accordingly. Our objectiveswere threefold, i.e. to estimate 1) their lifetime experience inyoga and meditation; 2) where they were practicing; and 3)the prevalence of children currently practicing yoga and med-itation.




Methods: A convenience sample of parents (n = 131) andchildren (n = 131, 49.6% girls, M age = 9.5; range 8-11) wereselected from our future PEACE-Schools in Quebec City.They had to report in an online questionnaire if their childhad once tried yoga and/or meditation, where they had prac-ticed (home or school), and if they were currently practicing.Results: Lifetime experience—18.3% and 9.2% of childrenhad already experienced yoga and/or meditation, respectively.Yoga was experienced more frequently than meditation, (X2

(1, N = 36) = 4.00, p = .046). Gender was equally distributedin both practices, (X2 (1, N = 36) = .892, p = .345). The largemajority were introduced at home (68.2% for yoga and 100%for meditation). Current practice—The prevalence of currentpractice was 9.9% for yoga and 6.1% for meditation.Conclusion: In our area, approximately 1 child/5 alreadytried yoga in their life, and 1/11 have tried meditation. Theestimated prevalence is 1/10 for yoga and 1/16 for meditation,which is similar to the one reported in U.S. These findingshighlight that children of our area, at least for Grades 3-4, donot easily have access to mindfulness programs in schools yet.Our evidence-based program will take into account that a pro-portion of children have been exposed to the practice in theirlives, and more frequently to yoga. This could mean that moresupport would be needed for meditation training. Finally,PEACE-School should consider including parents, since theyare main actors for introducing and likely maintaining mind-fulness practice for their children.

40. A FEASIBILITY STUDY OF YOGA FOR

INFORMAL CAREGIVERS: A MULTI-METHOD

PILOT STUDY

A. A. Walter,1 M. Van Puymbroeck,2 J. Townsend,2

S. M. Linder,2 A. A. Schmid3

1. East Carolina University, Greenville, NC

2. Clemson University, Clemson, SC

3. Colorado State University, Fort Collins

Keywords: yoga, informal caregivers, feasibility

Ob j e c t i ve : This therapeutic yoga study examined whataspects of the program were feasible for informal caregivers.Methods: A multi-method pilot study among informal care-givers. To qualify for this program individuals had to meet thefollowing criterion: 1) age 18 years or older; 2) care for some-one with a disability or disease; 3) answer ‘no’ to all questionsfrom the PAR-Q (screener for potential contraindicationsand/or adverse physical effects in response to a physical activ-ity), although if ‘yes’ was documented in response to any of

the PAR-Q questions acceptance into the program was per-mitted if a doctor approved participation; and 4) able toattend the eight-week yoga study. Informal caregivers wereasked to attend a 60-minute therapeutic yoga program twicea week for eight-weeks. Due to weather conditions one yogasession was cancelled. A yoga therapist facilitated each sessionand was selected because of her training and knowledge foradapting physical postures to meet the ability of every partic-ipant and ensure safety. The lead author developed a 14-itemevaluation of acceptability questionnaire to capture partici-pants’ view of acceptability and practicality of the therapeuticyoga program. The evaluation of acceptability questionnairewas examined using percentages and frequencies per individ-ual item. Informal caregivers were asked to attend a semi-structured focus group succeeding the last yoga class to fur-ther understand their lived experience participating in thetherapeutic yoga program. Conventional content analysiswere performed on the interview transcripts to illustrate fea-sibility of the program. Other feasibility measurements wereobtained (e.g. attendance) and analyzed. Results: Nine informal caregivers were enrolled, consented,and started participating in the therapeutic yoga program.One of the nine informal caregivers ended communication/attendance after classes the first week and one was lost toattrition following week seven due to a misunderstanding ofwhat yoga is. The mean score for the evaluation of acceptabil-ity questionnaire was 60.2 (out of 70) with a standard devia-tion of ±5.82. The two items in the questionnaire that expe-rienced the greatest levels of acceptability included ‘I enjoyedattending yoga class’ and ‘Overall, I tolerated the breathingtechniques in each class.’ The semi-structured focus grouplasted approximately 34 minutes and two phone interviews(performed due to scheduling conflicts) combined wereapproximately 11 minutes. The conventional content analy-sis resulted in 41 codes that shaped three emerging categories:programmatic aspects, safety concerns, and care recipient sep-aration. Fifteen classes were offered in the eight-week period(one was cancelled due to snow). The minimum number ofclasses attended were eight, the maximum 15, with a meanclass attendance of 13.13 and standard deviation of 2.42.Retention over the course of the eight-week program was77.78% of participants. One additional breathing techniquewas included on the first day of class that was not in the ini-tial sequence and continued throughout the yoga program.Two types of breath work were condensed because of the oneclass cancelation due to weather. Once the yoga therapistdetermined the different physical abilities of each informalcaregiver several physical postures were modified/added. Conclusion: The results from this eight-week therapeuticyoga program revealed that it was feasible for informal care-givers.

46 IAYT 2019 SYMPOSIUM ON YOGA RESEARCH

41. IMPROVING PRESCHOOLERS’ CLASS-ROOM BEHAVIORS WITH A MINDFUL YOGAPROGRAM

C. Wengrovius, S. C. Bauer, K. Q. Scott-Andrews, L. E. RobinsonUniversity of Michigan, Ann Arbor

Keywords: yoga, mindfulness, preschool children, self-regu-lation, interpersonal skills

Objective: To determine the effects of a mindful yoga pro-gram on classroom self-regulation and interpersonal skills inpreschool-aged children. This analysis is part of an ongoingpilot study that is also examining preschool children’s balanceand sleep habits.Methods: The study used a cluster-randomized, wait-list con-trol study design. Nine preschool classrooms across two cen-ters participated in the study. Classrooms were randomizedinto two groups: Wait-List Control Group (n = 75) and YogaGroup (n = 61). The yoga program was implemented in fourclassrooms and lasted for eight weeks (2, 30-minute lessonsper week). Embodied cognition and growth mindset theoriesguided the intervention development and implementation.Each yoga lesson included static and dynamic physical pos-tures, regulated breathing activities, mindfulness practice, anddeep relaxation. Classroom self-regulation and interpersonal

skills were measured using the teacher-report Child BehaviorRating Scale (CBRS). To decrease risk of teacher bias,researchers and teachers collaboratively completed the CBRS.An analysis of covariance (ANCOVA) was used to examinebetween group differences of the change in pre-test (T1) andpost-test (T2) measurements. Sex was used as a covariatesince teachers may perceive females to have higher self-regu-lation and interpersonal skills.Results: 136 preschoolers (46% female, Mage = 4.1 years)were evaluated on their classroom self-regulation and inter-personal skills at T1 and T2. The change between T1 and T2total scores on the CBRS was significantly different betweenthe Wait-List Control and Yoga group, F(1, 116) = 7.05, p =.009, ηp2 = .06. Group differences were more prominent inthe CBRS Interpersonal Skills subscale, F(1, 116) = 9.40, p =.003, ηp2 = .08, compared to the CBRS Classroom Self-Regulation subscale, F(1, 116) = 3.60, p = .06, ηp2 = .03.Specifically, the yoga group demonstrated an increase overtime for interpersonal skills (MT1 = 22.52, MT2 = 23.69)while the control group decreased (MT1 = 24.80, MT2 =23.97). For self-regulation, the yoga group remained stable(MT1 = 34.25, MT2 = 34.25) and the control group declined(MT1 = 36.59, MT2 = 34.60).Conclusion: The integration of mindful yoga in an earlychildhood education setting positively influenced or main-tained preschool children’s interpersonal skills and self-regu-lation, respectively.


Documents

Accepted Abstracts In order of appearance in the ...€¦ · 1. Northwestern University Feinberg School of Medicine; and Osher Center for Integrative Medicine, Chicago 2. Northwestern