CLINICAL RESEARCH POSTER PRESENTATION ABSTRACTS
Please note: All posters will be displayed in
Salons 10-12.
FRIDAY, 10:15-11:00 AM
Oken BS, Kishiyama SS, Zajdel D, Flegal K.
Adherence to yoga and exercise interventions in a 6-month
clinical trial: effects of mood, fatigue, and personality.
Oregon Health & Science University oken@ohsu.edu
PURPOSE: To determine factors that predict adherence
of subjects to a mind-body intervention in a randomized clinical trial.
METHODS: We analyzed adherence data from a recently
reported 3-arm clinical trial involving 135 generally healthy men and
women aged 65-85 randomized to a 6-month intervention consisting of:
an Iyengar yoga class along with home practice; an exercise class along
with home practice; or a wait-list group with the option of enrolling
in either of the active interventions after the wait-list period. Outcome
measures included cognitive function, mood (as assessed by CESD-10 and
POMS), health-related quality of life (SF-36), and physical measures
(seated forward bend, one legged-standing). Adherence to the intervention
was obtained by class attendance and biweekly home practice logs.
RESULTS: Drop out rate was 13%. Among the completers
of the two active interventions, for the yoga group average attendance
at classes was 78% and home practice occurred on 64%of all days while
for the exercise group attendance was 69% and home exercise occurred
on 54% of all days. As already reported the yoga intervention produced
improvement in quality of life and physical measure but not on cognition
or mood. The new analyses revealed there was an effect of adherence
on some of the significant outcome measures. Additionally, adherence
as measured by class attendance was significantly correlated with several
baseline measures including mood, physical aspects of quality of life,
and fatigue measures (significant correlation coefficients from 0.23-
0.442, p values from .0005 to .05). Adherence was not related to age
or education level. A very limited number of subjects (n=28) also filled
out a five-factor personality rating scale (the NEO-PI-R) and even with
the limited number there was a trend towards the trait Conscientiousness
correlating to greater adherence.
CONCLUSIONS: Lower adherence to a physically
active intervention in a clinical trial was correlated with measures
of depression as well as with lower baseline measures of physical components
of the SF-36. Lower adherence with more depressed mood has been reported
in other clinical trials and subjects even with lower adherence in a
placebo arm of a double blind trial have worse outcomes that those with
higher adherence. Decreased adherence to a potentially beneficial intervention
has the potential to decrease the effect of the intervention in a clinical
trial because subjects who might sustain the greatest benefit will receive
a lower dose of the intervention and subjects with higher adherence
maximize rates may be functioning closer to maximum ability before the
intervention. Strategies to adherence among subjects at greater risk
for low adherence will be important for future trials, especially complementary
treatments requiring greater effort than simple pill-taking.
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