# Mechanisms of Change in Yoga and Physical Activity for Veterans

> **NIH VA I01** · VA SAN DIEGO HEALTHCARE SYSTEM · 2023 · —

## Abstract

Posttraumatic stress disorder (PTSD) is a chronic, debilitating condition with a broad negative impact
on physical and mental health functioning. Excellent, empirically-supported interventions for PTSD are readily
available to Veterans, but the majority of patients who receive the best available treatments continue to have a
diagnosable disorder after treatment. This suggests that complementary interventions may be useful to fully
restore functioning. In addition, many patients seek alternatives to psychotherapy or pharmacotherapy. This is
evident in the increasing numbers of individuals with PTSD are turning to alternative approaches. At present,
however, we lack a good evidence base from which to make recommendations about the use of
complementary and alternative approaches.
 Yoga is very popular practice, touted to enhance physical, mental and spiritual well-being. Many
veterans with PTSD have turned to yoga as a part of their recovery plan, often seeking care outside the mental
health system. Initial evidence suggests that the practice leads to clinically significant change in symptoms, but
results are yet inconclusive, particularly in Veterans. Thus, this project will provide additional data as to efficacy
of yoga as compared to physical activity for Veterans with PTSD.
 One reason that the yoga literature is yet inconclusive may be the tremendous heterogeneity in the way
in which the yoga is implemented. By understanding the mechanisms by which yoga affects PTSD symptoms,
universal change processes can be identified. This project, therefore, will examine two different theoretical
models that may account for yoga’s clinical effect. With 30 million Americans practicing yoga, dissemination of
a specific protocol would not be practicable. Nonetheless, guidelines for trauma-sensitive yoga, which focus
primarily on acceptability of the practice for traumatized individuals, appear to be associated with better
outcomes for those with PTSD. This work would facilitate the extension of such guidelines to include practice
features that optimize active mechanisms of change in order to that maximize the impact of yoga on PTSD
symptoms.
 The proposed study is a randomized controlled trial involving 192 Veterans with PTSD from the San
Diego area. These Veterans will be randomized to receive a manualized hatha yoga intervention or a
supportive physical activity control condition. Both interventions will be delivered by trained instructors in a
group setting over a 12-week period. Assessment of clinical outcomes and methodological variables will take
place before, during, immediately after, and 3-months after the intervention. Analyses will focus on change in
the intervention groups over time and the degree to which change is associated with the candidate
mechanisms.
 Results of this study have the potential to inform the way in which yoga is delivered to Veterans as well
as to increase knowledge about the underlying processes by which PTSD can be ameliorate...

## Key facts

- **NIH application ID:** 10694817
- **Project number:** 5I01CX001647-06
- **Recipient organization:** VA SAN DIEGO HEALTHCARE SYSTEM
- **Principal Investigator:** Ariel J Lang
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2023
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-07-01 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10694817

## Citation

> US National Institutes of Health, RePORTER application 10694817, Mechanisms of Change in Yoga and Physical Activity for Veterans (5I01CX001647-06). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10694817. Licensed CC0.

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