Most of the following research projects were completed as part of Kathryn Curtis’s graduate work towards an MA and PhD in Clinical Psychology at York University. The last project, in progress, is part of her post-doctoral research at Toronto General Hospital, University Health Network.
Vidya Institute’s Research Department has collaborated on a variety of research projects with researchers at York University as well as various hospital networks in Toronto, Canada.
These research projects have focused on evaluating specialized yoga interventions for individuals living with various types of pain and functional impairments in day-to-day life. The yoga interventions are based upon the wealth of knowledge found in the ancient vedas and yogic scriptures, as well as the oral traditions and spiritual lineages of Sri Krishan Mantri-ji and BKS Iyengar. Although the multi-faceted benefits of yoga are well-documented in a variety of ancient scriptures and modern yoga texts, it is imperative to also investigate these practices using rigorous scientific approaches, in order to establish a knowledge base that is recognized in western health care systems.
Our research department is dedicated to creating yogic interventions that bring the gems of yoga to life and make these life-affirming boons accessible to vulnerable individuals with health impacts, in a research context.
The Goals of our Research Department:
We have completed five yoga and mindfulness projects and have one project in process. Completed projects evaluated pain and related variables (e.g., pain intensity, pain catastrophizing, pain acceptance), psychological constructs (e.g., anxiety, depressive symptoms), spirituality and well-being (e.g., mindfulness, compassion) and physical function (e.g., cortisol levels, fatigue) in the context of specialized yoga programs. The research designs include single cohort trials, randomized controlled trials, and multi-wave randomized controlled trials, with 2-3 assessment time points. The interventions all followed a relatively similar format, including a dose of 1-2 classes per week, each of 50-75 minutes in duration, for 6-8 weeks.
The yoga programs all included:
Research Landscape:
There has been a call for yoga researchers to properly document all aspects of yoga interventions for efficacy trials, including types of practices (āsana, prāṇāyāma, dhāraṇā), dose, delivery, style, sequences of postures, modifications, and any other information that may assist with replicability or provide clarity about mechanisms of yoga. It is a strength of our work that we have manualized the yoga interventions and have documented all aspects of the interventions, including the philosophy teaching plan, the āsanas, and the prāṇāyāma practices. These protocols are published in skeleton format in peer reviewed journals for researchers and practitioners who are interested in the specific class content. The Vidya Research Department is available for consultations and has provided consultations to researchers about these projects in the international arena.
PUBLISHED ABSTRACT:
An eight-week yoga intervention is associated with improvements in pain, psychological functioning and mindfulness and changes in levels of cortisol in women with fibromyalgia.
Objectives: Fibromyalgia (FM) is a chronic condition characterized by widespread musculoskeletal pain, fatigue, depression, and hypocortisolism. To date, published studies have not investigated the effects of yoga on cortisol in FM. This pilot study used a time series design to evaluate pain, psychological variables, mindfulness, and cortisol in women with FM before and after a yoga intervention.
Measures and Data Collection: Participants (n = 22) were recruited from the community to participate in a 75 minute yoga class twice weekly for 8 weeks. Questionnaires concerning pain (intensity, unpleasantness, quality, sum of local areas of pain, catastrophizing, acceptance, disability), anxiety, depression, and mindfulness were administered pre-, mid- and post-intervention. Salivary cortisol samples were collected three times a day for each of two days, pre- and post-intervention.
Results: Repeated measures analysis of variance (ANOVA) revealed that mean ± standard deviation (SD) scores improved significantly (p < 0.05) from pre- to post-intervention for continuous pain (pre: 5.18 ± 1.72; post: 4.44 ± 2.03), pain catastrophizing (pre: 25.33 ± 14.77; post: 20.40 ± 17.01), pain acceptance (pre: 60.47 ± 23.43; post: 65.50 ± 22.93), and mindfulness (pre: 120.21 ± 21.80; post: 130.63 ± 20.82). Intention-to-treat analysis showed that median AUC for post-intervention cortisol (263.69) was significantly higher (p < 0.05) than median AUC for pre-intervention levels (189.46). Mediation analysis revealed that mid-intervention mindfulness scores significantly (p < 0.05) mediated the relationship between pre- and post-intervention pain catastrophizing scores.
Discussion: The results suggest that a yoga intervention may reduce pain and catastrophizing, increase acceptance and mindfulness, and alter total cortisol levels in women with FM. The changes in mindfulness and cortisol levels may provide preliminary evidence for mechanisms of a yoga program for women with FM. Future studies should use an RCT design with a larger sample size.
NOTE: This project was conducted at Vidya Institute, Toronto, Canada, in June-August, 2010.
LINK TO FULL ARTICLE: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3160832/
DISSEMINATION:
Peer Reviewed Journal Publication:
Curtis, K., Osadchuk, A., & Katz, J. (2011). An eight-week yoga intervention is associated with improvements in pain, psychological functioning and mindfulness and changes in levels of cortisol in women with fibromyalgia. Journal of Pain Research, 4, 189-201. Doi. 10.2147/JPR.S22761
Selected Poster Presentations at Canadian Conferences:
Curtis, K., & Katz, J. Pain, psychological functioning mindfulness and salivary cortisol levels are improved after an eight-week yoga intervention for women with fibromyalgia. Pain Management Conference, Toronto, ON. November, 2011.
Curtis, K., Osadchuk, A., & Katz, J. An eight-week yoga intervention is associated with improvements in pain and psychological functioning in women with fibromyalgia. Canadian Psychological Association, Toronto, ON. June, 2011. Published in: Canadian Psychological Association, Annual Convention Issue, 52:2a, 362.
PUBLISHED ABSTRACT:
Transforming the Lived Experience of Individuals Receiving Medical Reconditioning through a Hatha Yoga Program Provided in an In-Patient Setting: A Collaborative and Tailored Approach.
Introduction: The purpose of this study was to evaluate a specialized yoga intervention for inpatients in a rehabilitation and complex continuing care hospital.
Design: Single-cohort repeated measures design.
Methods: Participants (N = 10) admitted to a rehabilitation and complex continuing care hospital were recruited to participate in a 50–60 min. Hatha Yoga class (modified for wheelchair users/seated position) once a week for eight weeks, with assigned homework practice. Questionnaires on pain (pain, pain interference, and pain catastrophizing), psychological variables (depression, anxiety, and experiences with injustice), mindfulness, self-compassion, and spiritual well-being were collected at three intervals: pre-, mid-, and post-intervention.
Results: Repeated measures ANOVAs revealed a significant main effect of time indicating improvements over the course of the yoga program on the (1) anxiety subscale of the Hospital Anxiety and Depression Scale, F(2,18) = 4.74, p < .05, and ηp2 = .35, (2) Self-Compassion Scale-Short Form, F(2,18) = 3.71, p < .05, and ηp2 = .29, and (3) Magnification subscale of the Pain Catastrophizing Scale, F(2,18) = 3. 66, p < .05, and ηp2 = .29.
Discussion: The results suggest that an 8-week Hatha Yoga program improves pain-related factors and psychological experiences in individuals admitted to a rehabilitation and complex continuing care hospital.
NOTE: This project was conducted at Bridgepoint Active Health Care, Toronto, Canada, from October-December, 2014.
LINK TO FULL ARTICLE: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5223015/
DISSEMINATION:
Peer Reviewed Journal Publication:
Curtis, K., Kuluski, K., Bechsaard, G., Ridgway, &, Katz, J. (2016). Evaluation of a
Specialized Yoga Program for In-Patients at a Complex Care Facility: A Pilot Study. Evidence-Based Complementary and Alternative Medicine, 6267879.
Published Abstract Resulting from Poster Presentation at an International Conference:
Curtis, K., Stoliker, C., Bechsgaard, G., Kuluski, K., & J., Katz, J. (2016). Evaluation of a Specialized Yoga Program for In-Patients at a Complex Care Facility: A Pilot Study. [Abstract]. International Journal of Yoga Therapy, 26, Supplement 2, pg. 22-39.Poster presented at the Symposium on Yoga Research, Massachusetts, USA. September, 2016.
PUBLISHED ABSTRACT:
Evaluation of a Modified Yoga Program for Persons with Spinal Cord Injury.
Objectives: Yoga is a promising mind-body intervention for improving health and wellbeing in a number of clinical populations. At this time, there is no evidence on the benefits of yoga for persons with spinal cord injury (SCI).
Methods: Twelve participants with SCI were recruited into a mixed-methods program evaluation of an eight-week modified yoga program. At baseline and exit, participants were evaluated on pain, fatigue, psychological factors, and mindfulness with self-report questionnaires and semistructured interviews. Five participants completed the baseline and exit assessments.
Results: Significant changes were not found on any of the outcome scores. Qualitative analysis revealed main themes regarding expectations, benefits along emotional, mental, and physical domains, program satisfaction and recommendations. Participants reported highly enjoying the yoga intervention and the qualitative data indicated a number of therapeutic benefits (i.e., decreased stress, pain relief).
Discussion: Yoga appears to be a promising therapeutic recreation intervention post-SCI and a larger clinical trial is recommended to conclusively investigate both its objectively and subjectively measured benefits.
NOTE: This project was conducted at the Lyndhurst Centre at Toronto Rehabilitation Institute, University Health Network, Toronto, Canada, in May-June, 2012.
DISSEMINATION:
Peer Reviewed Journal Publication:
Curtis, K., Hitzig, S., Leong, N., Wicks, C., Ditor, D., & Katz, J. (2015). Evaluation of a Modified Yoga Program for Persons with Spinal Cord Injury. Therapeutic Recreation Journal, 2, 97-117.
Selected Poster Presentations at Canadian Conferences:
Curtis, K., Wicks, C., Leong, N., Saunders, N., Katz, J., & Hitzig, S. A yoga intervention for pain management and well-being in individuals with spinal cord injury: A descriptive pilot study. Canadian Pain Society, Winnipeg, MA. May, 2013. Published in: Pain Research and Management, 8 (2), 97-101.
Curtis, K., Wicks, C., Leong, N., Saunders, N., Katz, J., & Hitzig, S. An eight-week specialized yoga intervention for individuals with spinal cord injury: A qualitative descriptive pilot study. Current Concepts in Balance, Fitness and Mobility: Perspectives on Intensity in Rehabilitation. Toronto Rehabilitation Institute, Toronto, ON. January, 2013.
PUBLISHED ABSTRACT:
Evaluation of a specialized yoga program for persons with a spinal cord injury: a pilot randomized controlled trial
Objectives: The purpose of this randomized controlled trial was to evaluate the effects of a specialized yoga program for individuals with a spinal cord injury (SCI) on pain, psychological, and mindfulness variables.
Materials and methods: Participants with SCI (n=23) were outpatients or community members affiliated with a rehabilitation hospital. Participants were randomized to an Iyengar yoga (IY; n=11) group or to a 6-week wait-list control (WLC; n=12) group. The IY group participated in a twice-weekly 6-week seated IY program; the WLC group participated in the same yoga program, after the IY group’s yoga program had ended. Pain, psychological, and mindfulness measures were collected at two time points for both groups (within 1–2 weeks before and after program 1 and at a third time point for the WLC group (within 1 week after program 2).
Results: Linear mixed-effect growth models were conducted to evaluate the main effects of group at T2 (postintervention), controlling for T1 (preintervention) scores. T2 depression scores were lower (F1,18=6.1, P<0.05) and T2 self-compassion scores higher (F1,18=6.57, P< 0.05) in the IY group compared to the WLC group. To increase sample size and power, the two groups were combined and analyzed across time by comparing pre- and postintervention scores. Main effects of time were found for depression scores, (F1,14.83=6.62, P<0.05), self-compassion, (F1,16.6=4.49, P<0.05), mindfulness (F1,16.79=5.42, P<0.05), mindful observing (F1,19.82=5.06, P<0.05), and mindful nonreactivity, (F1,16.53=4.92, P<0.05), all showing improvement after the intervention.
Discussion: The results indicated that a specialized 6-week yoga intervention reduced depressive symptoms and increased self-compassion in individuals with SCI, and may also have fostered greater mindfulness.
NOTE: This project was conducted at the Lyndhurst Centre at Toronto Rehabilitation Institute, University Health Network, Toronto, Canada, in May-August, 2016.
LINK TO FULL ARTICLE: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422575/
DISSEMINATION:
Peer Reviewed Journal Publication:
Curtis, K., Hitzig, S., Bechsgaard, G., Stoliker, C., Alton, C., Saunders, N., Leong, N., Katz, J.
(2017). Evaluation of a specialized yoga program for persons with a spinal cord injury: a pilot randomized controlled trial. Journal of Pain Research, 10, 999-1017. doi: 10.2147/JPR.S130530
Published Abstract Resulting from Poster Presentation at an International Conference:
Curtis, K., Stoliker, C., Bechsgaard, G., Alton, C., Saunders, N., & J., Katz, J. (2016). Evaluation of a Specialized Yoga Program for Persons with Spinal Cord Injury: A Randomized Controlled Study. [Abstract]. International Journal of Yoga Therapy, 26, Supplement 2, pg. 22-39. Poster presented at the Symposium on Yoga Research, Massachusetts, USA. September, 2016.
The relationship between stress, mood, mindfulness and neurocognitive function and a Mindfulness-Based Stress Reduction program in community dwelling seniors.
Objectives: The objectives of this pilot study were to evaluate the effects of an eight-week Mindfulness Based Stress Reduction (MBSR) intervention on measures of psychological well-being and neurocognitive functioning in a sample of community dwelling seniors.
Measures and Data Collection: Participants (N=10) were community members who participated in a standardized mindfulness-based stress reduction program for 8 weeks. All participants were given a series of questionnaires pre- (T1), mid- (T2) and post- (T3) treatment to evaluate various aspects of stress, mood, anxiety and mindfulness. Participants were asked to fill out three pencil and paper neurocognitive tasks that measure working memory, processing speed, attention, and executive function.
Results: Repeated measures analysis of variance (ANOVA) revealed that mean ± standard deviation (SD) scores improved significantly (p < 0.05) from pre- to post-intervention for HADS-A, F (2,14) = 3.78, p < 0.05, hp2 = .35, and TMT-A, F (2,14) = 7.43, p < 0.01, hp2 = .52, as well as trends towards significance for TMS-Decentering, F (2,14) = 2.96, p = .085, hp2 = .30, and Coding, F (2,14) = 3.62, p = .054, hp2 = .34. Tukey’s post-hoc testing revealed significantly lower scores on HADS-A and TMT-A at T3 when compared to T1, (p < .05).
Discussion: The results from the study suggested that seniors may experience lower levels of anxiety and increases in basic attention and processing speed related to paper-and-pencil motor tasks after participating in an 8 week MBSR program. It is possible that the changes in anxiety and attention may influence other mental experiences and cognitive faculties, which are relevant for an aging population.
NOTE: This study was conducted at Vidya Institute in June-July, 2012.
NOTE: This study is unpublished.
Evaluation of the Transitional Pain Service Surgical Yoga Program for Individuals with Persistent Pain; a Pilot Randomized Controlled Trial
Project Summary: The design of this study is a prospective, pilot multi-wave randomized controlled trial (RCT). This project evaluates the effects of a specialized yoga program (Transitional Pain Service Surgical Yoga Program) on pain and related variables, psychological symptoms, and third wave constructs, such as mindfulness. Participants are randomized to an experimental condition (yoga condition: YC) or to an eight-week wait-list control condition (WLCC). The project follows a multi-wave design to allow for small class sizes due to participant medical complexity and the need for individualized instruction. At present, this project has completed one wave, and a second wave is in progress, with a scheduled completion date of April, 2020. Results to follow in 2021.
NOTE: This project is being conducted at ELLICSR: Health, Wellness, and Cancer Survivorship Centre at Toronto General Hospital, the University Health Network, Toronto, Ontario. This study started in June, 2019 and will be completed April, 2020.
