Background: HNC causes late musculoskeletal impairment (MSI), physical symptoms & psychologic distress. A modified yoga intervention using poses, breath work, meditation & relaxation may improve outcomes. We conducted a wait list control study testing a modified Yoga program for HNC survivors. Primary aims: feasibility (recruitment, compliance), satisfaction, safety, MSI and need for pose modifications. Secondary aim: preliminary efficacy for range of motion (ROM), posture, pain, and psychological distress. Methods: Eligible subjects: completed therapy > 3m prior to study, cancer free, and medically cleared. Study arms: individualized yoga instruction tiw x 4 weeks then biw x 4 weeks or wait list control. Yoga was taught by a certified instructor. Fidelity Measures: home practice guide with16 poses for neck-shoulders-back, 8 week instruction plan detailing progression of poses and practices, assessment tools for the instructor to capture MSI and document pose modifications, videotaped yoga sessions and home practice diary. Demographics & treatment data captured at baseline. MSI and symptoms assessed at baseline, 4, & 8 weeks using questionnaires, posture analysis software, & measures of jaw-neck-shoulder ROM. Results: 73 patients recruited: 40 consented, 11 ineligible. Pt characteristics: median age 63.1 yrs, 62.5% male, 90% white, 32% single, 33% income < $30,000. Of 20 intervention subjects, 5 discontinued (1 recurrence, 2 medical conditions, 2 work). Median # sessions completed 19/20; median # of home practices reported: 35/36. Median program satisfaction 10/10 for 10 assessed components. No adverse events were reported. Seventeen impairments were noted: neck (80%), shoulder (67%), posture (53%), frailty/deconditioning (53%), and jaw (53%). Mean # impairments 5.27 (SD 1.97): Exploratory analysis of efficacy measures indicates potential benefit for the following: pain, anxiety and depression, and ROM. Conclusions: A modified yoga program in HNC pts is safe. Recruitment rates and satisfaction were high. Demographics of HNC pts did not limit recruitment. Significant limitations in movement requiring pose modifications were found. Preliminary efficacy data supports further yoga studies. 1R21CA173202-01A1 NIH/NCI Clinical trial information: NCT01951664