Yoga for generalized anxiety disorder: design of a randomized controlled clinical trial

Hofmann, Stefan G.; Curtiss, Joshua; Khalsa, Sat Bir S.; Hoge, Elizabeth A.; Rosenfield, David; Bui, Éric; Keshaviah, Aparna; Simon, Naomi M.

doi:10.1016/j.cct.2015.08.003

Cited by 19 publications

(18 citation statements)

References 57 publications

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“…This study is the first head-to-head comparison of CBT and yoga for treating late-life worry. We are aware of only one other study in progress comparing CBT and yoga using an RCT design for adults ≥18 years with GAD [ 59 ]. CBT and yoga likely reduce worry and anxiety via different mechanisms.…”

Section: Discussionmentioning

confidence: 99%

A randomized preference trial of cognitive-behavioral therapy and yoga for the treatment of worry in anxious older adults

Brenes

Divers

Miller

et al. 2018

Contemporary Clinical Trials Communications

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BackgroundWorry is a common problem among older adults. Cognitive-behavioral therapy is the most studied nonpharmacological intervention and it has demonstrated efficacy in reducing late-life worry and anxiety. Although the evidence-base is smaller, yoga has been shown to reduce anxiety and stress. However, little is known about the relative effectiveness of these two nonpharmacological interventions. Further, the impact of patient preference on outcomes is unknown.Purpose: The purpose to this study is to compare the effectiveness of cognitive-behavioral therapy (CBT) with yoga for improving late-life worry, anxiety, and sleep. We will also examine the effects of preference and selection on outcomes, adherence, and attrition.MethodsWe are conducting a two-stage randomized preference trial comparing CBT and yoga for the reduction of worry in a sample of anxious older adults. Five hundred participants will be randomized to either the preference trial (participants choose the intervention; N = 250) or to the randomized trial (participants are randomized to one of the two interventions; N = 250) with equal probability. CBT consists of 10 telephone-based sessions with an accompanying workbook. Yoga consists of 10 weeks of group yoga classes (twice a week) that is modified for use with older adults.ConclusionsThe study design is based on feedback from anxious older adults who wanted more nonpharmacological options for intervention as well as more input into the intervention they receive. It is the first head-to-head comparison of CBT and yoga for reducing late-life worry and anxiety. It will also provide information about how intervention preference affects outcomes.Trial registrationClinicalTrials.gov NCT02968238.

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Section: Discussionmentioning

confidence: 99%

A randomized preference trial of cognitive-behavioral therapy and yoga for the treatment of worry in anxious older adults

Brenes

Divers

Miller

et al. 2018

Contemporary Clinical Trials Communications

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“…Safety included weekly adverse event tracking, strict guidelines for increased monitoring, and discontinuation criteria. 23…”

Section: Discussionmentioning

confidence: 99%

“…The protocol included physical postures and exercises, breathing techniques, relaxation exercises, meditation and mindfulness practices, yoga theory, philosophy, and psychology. 23 Cognitive behavioral therapy used an evidence-based GAD protocol, including 5 core treatment modules (psychoeducation, cognitive restructuring, progressive muscle relaxation, worry exposures, and in vivo exposure exercises) and targeted metacognitions (ie, worrying about worrying) but no explicit mindfulness components. 23 Stress education is a standardized control condition, 12 including lectures on physiologic, psychological, and medical effects of stress; effects of lifestyle behaviors, such as caffeine, alcohol, and smoking; resilience factors; and the importance of exercise and diet.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of Yoga vs Cognitive Behavioral Therapy vs Stress Education for the Treatment of Generalized Anxiety Disorder

et al. 2021

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IMPORTANCE Generalized anxiety disorder (GAD) is common, impairing, and undertreated. Although many patients with GAD seek complementary and alternative interventions, including yoga, data supporting yoga's efficacy or how it compares to first-line treatments are lacking.OBJECTIVES To assess whether yoga (Kundalini yoga) and cognitive behavioral therapy (CBT) for GAD are each more effective than a control condition (stress education) and whether yoga is noninferior to CBT for the treatment of GAD.DESIGN, SETTING, AND PARTICIPANTS For this randomized, 3-arm, controlled, single-blind (masked independent raters) clinical trial, participants were recruited from 2 specialty academic centers starting December 1, 2013, with assessment ending October 25, 2019. Primary analyses, completed by February 12, 2020, included superiority testing of Kundalini yoga and CBT vs stress education and noninferiority testing of Kundalini yoga vs CBT.INTERVENTIONS Participants were randomized to Kundalini yoga (n = 93), CBT for GAD (n = 90), or stress education (n = 43), which were each delivered to groups of 4 to 6 participants by 2 instructors during twelve 120-minute sessions with 20 minutes of daily homework. MAIN OUTCOMES AND MEASURESThe primary intention-to-treat outcome was acute GAD response (Clinical Global Impression-Improvement Scale score of much or very much improved) after 12 weeks as assessed by trained independent raters. RESULTSOf 538 participants who provided consent and were evaluated, 226 (mean [SD] age, 33.4 [13.5] years; 158 [69.9%] female) with a primary diagnosis of GAD were included in the trial. A total of 155 participants (68.6%) completed the posttreatment assessment. Completion rates did not differ (Kundalini yoga, 60 [64.5%]; CBT, 67 [74.4%]; and stress education, 28 [65.1%]: χ 2 = 2.39, df = 2, P = .30). Response rates were higher in the Kundalini yoga group (54.2%) than in the stress education group (33.%) (odds ratio [OR], 2.46 [95% CI, 1.12-5.42]; P = .03; number needed to treat, 4.59 [95% CI,) and in the CBT group (70.8%) compared with the stress education group (33.0%) (OR, 5.00 [95% CI, 2.12-11.82]; P < .001; number needed to treat, 2.62 [95% CI, 1.91-5.68]). However, the noninferiority test did not find Kundalini yoga to be as effective as CBT (difference, 16.6%; P = .42 for noninferiority). CONCLUSIONS AND RELEVANCEIn this trial, Kundalini yoga was efficacious for GAD, but the results support CBT remaining first-line treatment.

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“…[13]Yoga also improves the diffusion capacity in this group.It has been found that helps in reducing the associated stress and anxiety and help in improving the quality of life. [14][15][16][17]…”

Section: Role Of Yoga In Copdmentioning

confidence: 99%

Benefits of Yoga in Respiratory Diseases

Agnihotri

Gaur

Bhattacharya

et al. 2018

IJPBR

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Breathing sustains life, natural breathing brings happiness and keep healthy. It clears the mind and calms all the emotions hence it can helps in release of the vitalizing flow of energy within us. Air pollution is responsible for various respiratory diseases such as nasal allergy, asthma, chronic bronchitis and lung cancer. It has been found that Yoga has improved pulmonary parameters in several scientific studies, both in healthy as well as in diseased individuals. It helps in increase in vital capacity, tidal volume, FeV1, Fev1/FVC ratio, expiratory reserve volume, breath holding time and many other pulmonary parameters. These changes suggest a potential preventive and therapeutic role of yoga in pulmonary diseases.It is a method of learning which aims to attain the unity of mind, body and spirit through three main yoga steps includes exercise, breathing and meditation. Results of previous research studies report that many people with serious respiratory ailments have found a solution in yoga. It has been proventhattheyogic practices help in prevention, control as well as rehabilitation of many respiratory diseases. A vital scientific and therapeutic aspect of yoga is Pranayama. Few exercises of pranayama are like Anulomaviloma, Kapalbhati, Bhramari which are the components of yoga and are the best remedies which can be help to tackle respiratory illness caused by air pollution and other naturally occurring respiratory diseases.

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Yoga for generalized anxiety disorder: design of a randomized controlled clinical trial

Cited by 19 publications

References 57 publications

A randomized preference trial of cognitive-behavioral therapy and yoga for the treatment of worry in anxious older adults

A randomized preference trial of cognitive-behavioral therapy and yoga for the treatment of worry in anxious older adults

Efficacy of Yoga vs Cognitive Behavioral Therapy vs Stress Education for the Treatment of Generalized Anxiety Disorder

Benefits of Yoga in Respiratory Diseases

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