1 614 158 DEVELOPMENT OF A YOGA-BASED CARDIAC REHABILITATION (YOGA-CARE) PROGRAMME FOR SECONDARY PREVENTION OF MYOCARDIAL INFARCTION. CARDIAC REHABILITATION (CR) AFTER MYOCARDIAL INFARCTION IS HIGHLY EFFECTIVE. IT IS UNAVAILABLE IN PUBLIC HOSPITALS IN INDIA DUE TO LIMITED RESOURCES. OUR OBJECTIVE WAS TO DEVELOP A SCALABLE MODEL OF CR FOR INDIA BASED ON YOGA, WHICH COULD ALSO APPEAL TO SOME GROUPS WITH LOW UPTAKE OF CR (E.G., ETHNIC MINORITIES, WOMEN, AND OLDER PEOPLE) GLOBALLY. THE INTERVENTION WAS DEVELOPED USING A STRUCTURED PROCESS. A LITERATURE REVIEW AND CONSULTATIONS WITH YOGA EXPERTS, CR EXPERTS, AND POSTMYOCARDIAL INFARCTION PATIENTS WERE CONDUCTED TO SYSTEMATICALLY IDENTIFY AND SHORTLIST APPROPRIATE YOGA EXERCISES AND POSTURES, BREATHING EXERCISES, MEDITATION AND RELAXATION PRACTICES, AND LIFESTYLE CHANGES, WHICH WERE INCORPORATED INTO A CONVENTIONAL CR FRAMEWORK. THE DRAFT INTERVENTION WAS FURTHER REFINED BASED ON THE FEEDBACK FROM AN INTERNAL STAKEHOLDER GROUP AND AN EXTERNAL PANEL OF INTERNATIONAL EXPERTS, BEFORE BEING PILOTED WITH YOGA INSTRUCTORS AND PATIENTS WITH MYOCARDIAL INFARCTION. A FOUR-PHASE YOGA-BASED CR (YOGA-CARE) PROGRAMME WAS DEVELOPED FOR DELIVERY BY A SINGLE YOGA INSTRUCTOR WITH BASIC TRAINING. THE PROGRAMME CONSISTS OF A TOTAL OF 13 INSTRUCTOR-LED SESSIONS (2 INDIVIDUAL AND 11 GROUP) OVER A 3-MONTH PERIOD. GROUP SESSIONS INCLUDE GUIDED PRACTICE OF YOGA EXERCISES AND POSTURES, BREATHING EXERCISES, AND MEDITATION AND RELAXATION PRACTICES, AND SUPPORT FOR THE LIFESTYLE CHANGE AND COPING THROUGH A MODERATED DISCUSSION. PATIENTS ARE ENCOURAGED TO SELF-PRACTICE DAILY AT HOME AND CONTINUE LONG-TERM WITH THE HELP OF A BOOKLET AND DIGITAL VIDEO DISC (DVD). FAMILY MEMBERS/CARERS ARE ENCOURAGED TO JOIN THROUGHOUT. IN CONCLUSION, A NOVEL YOGA-BASED CR PROGRAMME HAS BEEN DEVELOPED, WHICH PROMISES TO PROVIDE A SCALABLE CR SOLUTION FOR INDIA AND AN ALTERNATIVE CHOICE FOR CR GLOBALLY. IT IS CURRENTLY BEING EVALUATED IN A LARGE MULTICENTRE RANDOMISED CONTROLLED TRIAL ACROSS INDIA. 2019 2 900 52 EFFECTIVENESS AND COST-EFFECTIVENESS OF A YOGA-BASED CARDIAC REHABILITATION (YOGA-CARE) PROGRAM FOLLOWING ACUTE MYOCARDIAL INFARCTION: STUDY RATIONALE AND DESIGN OF A MULTI-CENTER RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CARDIAC REHABILITATION (CR) IS A STANDARD TREATMENT FOR SECONDARY PREVENTION OF ACUTE MYOCARDIAL INFARCTION (AMI) IN HIGH INCOME COUNTRIES (HICS), BUT IT IS INACCESSIBLE TO MOST PATIENTS IN INDIA DUE TO HIGH COSTS AND SKILLS REQUIRED FOR MULTIDISCIPLINARY CR TEAMS. WE DEVELOPED A LOW-COST AND SCALABLE CR PROGRAM BASED ON CULTURALLY-ACCEPTABLE PRACTICE OF YOGA (YOGA-CARE). IN THIS PAPER, WE REPORT THE RATIONALE AND DESIGN FOR EVALUATION OF ITS EFFECTIVENESS AND COST-EFFECTIVENESS. METHODS: THIS IS A MULTI-CENTER, SINGLE-BLIND, TWO-ARM PARALLEL-GROUP RANDOMIZED CONTROLLED TRIAL ACROSS 22 CARDIAC CARE HOSPITALS IN INDIA. FOUR THOUSAND PATIENTS AGED 18-80YEARS WITH AMI WILL BE RECRUITED AND RANDOMIZED 1:1 TO RECEIVE YOGA-CARE PROGRAM (13 SESSIONS SUPERVISED BY AN INSTRUCTOR AND ENCOURAGEMENT TO SELF-PRACTICE DAILY) OR ENHANCED STANDARD CARE (3 SESSIONS OF HEALTH EDUCATION) DELIVERED OVER A PERIOD OF THREE MONTHS. PARTICIPANTS WILL BE FOLLOWED 3-MONTHLY TILL THE END OF THE TRIAL. THE CO-PRIMARY OUTCOMES ARE A) TIME TO OCCURRENCE OF FIRST CARDIOVASCULAR EVENT (COMPOSITE OF ALL-CAUSE MORTALITY, NON-FATAL MYOCARDIAL INFARCTION, NON-FATAL STROKE AND EMERGENCY CARDIOVASCULAR HOSPITALIZATION), AND B) QUALITY OF LIFE (EURO-QOL-5L) AT 12WEEKS. SECONDARY OUTCOMES INCLUDE NEED FOR REVASCULARIZATION PROCEDURES, RETURN TO PRE-INFARCT ACTIVITIES, TOBACCO CESSATION, MEDICATION ADHERENCE, AND COST-EFFECTIVENESS OF THE INTERVENTION. CONCLUSION: THIS TRIAL WILL ALONE CONTRIBUTE >20% PARTICIPANTS TO EXISTING META-ANALYSES OF RANDOMIZED TRIALS OF CR WORLDWIDE. IF YOGA-CARE IS FOUND TO BE EFFECTIVE, IT HAS THE POTENTIAL TO SAVE MILLIONS OF LIVES AND TRANSFORM CARE OF AMI PATIENTS IN INDIA AND OTHER LOW AND MIDDLE INCOME COUNTRY SETTINGS. 2019 3 611 44 DEVELOPMENT OF A YOGA MODULE TARGETING CARDIOVASCULAR HEALTH FOR PATIENTS WITH POST-MYOCARDIAL LEFT VENTRICULAR DYSFUNCTION IN INDIA. BACKGROUND: YOGA IS KNOWN TO CONTRIBUTE TOWARDS CARDIOVASCULAR HEALTH. THIS PAPER DESCRIBES THE DEVELOPMENT OF A NEED-BASED YOGA PROGRAM WHICH IS SUITABLE TO BE INTEGRATED INTO THE CARDIAC REHABILITATION OF POST-MYOCARDIAL INFARCTION PATIENTS WITH LEFT VENTRICULAR DYSFUNCTION. MATERIALS AND METHODS: BASED ON THE ASSESSMENT OF THE NEED OF THE PATIENTS, LITERATURE REVIEW, AND EXPERT OPINION, A YOGA MODULE WAS DEVELOPED USING THE QUALITATIVE METHOD OF INQUIRY. THE PROGRAM INCLUDED WARM-UP EXERCISES, YOGIC ASANAS, PRANAYAMA, MEDITATION AND COUNSELING SESSIONS. A STRUCTURED QUESTIONNAIRE ELICITING COMMENTS ON THE CONTENTS WAS GIVEN INDEPENDENTLY TO TEN EXPERTS WORKING IN THE FIELD OF HEALTH AND YOGA FOR VALIDATION. THE FINAL MODULE WAS DERIVED AFTER INCORPORATING THE SUGGESTIONS OF THE EXPERTS. RESULTS: USING THE RATERS' EXPERTISE IN CARDIOLOGY AND YOGA PRACTICE, THE PRACTICES WHICH CONSTITUTE THE MODULE WERE OPTIMIZED. MAJORITY OF THE EXPERTS (RATERS) AGREED WITH THE DURATION OF 1 H TRAINING FOR 1MONTH UNDER SUPERVISION AS ADEQUATE FOR SUBSEQUENT PRACTICE AT HOME. THERE WAS A 0.786 INTER-RATER RELIABILITY ESTIMATED USING THE INTERCLASS COEFFICIENT (ICC) AND 0.789 INTERNAL CONSISTENCY OF THE QUESTIONS, MEASURED USING CRONBACH'S ALPHA. BOTH VALUES INDICATE "GOOD" RELIABILITY AND CONSISTENCY OF THE YOGA MODULE. CONCLUSION: THE DEVELOPED YOGA MODULE WAS FOUND TO BE ACCEPTABLE. FUTURE RANDOMIZED CONTROL TRIALS WILL BE NECESSARY TO VALIDATE THE EFFECTIVENESS OF THIS MODULE AND IF THE MODULE DEMONSTRATES TO BE EFFECTIVE BY CLINICAL STUDIES, IT MAY ADD A THERAPEUTIC OPTION IN THE REHABILITATION OF PATIENTS WITH HEART FAILURE FOLLOWING MYOCARDIAL INFARCTION, WHICH CAN BE APPLIED IN THE HOSPITALS AND COMMUNITY LEVEL. 2019 4 2858 36 YOGA-BASED CARDIAC REHABILITATION: CURRENT PERSPECTIVES FROM RANDOMIZED CONTROLLED TRIALS IN CORONARY ARTERY DISEASE. CORONARY ARTERY DISEASE CARRIES A HIGH MORBIDITY AND MORTALITY WORLDWIDE, AND EXERCISE-BASED CARDIAC REHABILITATION PROGRAMMES PLAY A LARGE ROLE IN SECONDARY PREVENTION. EXERCISE-BASED REHABILITATION PROGRAMMES ARE EXPENSIVE, AND IN CERTAIN SUBGROUPS UPTAKE IS POOR. YOGA HAS BEEN SUGGESTED TO SHOW IMPROVEMENTS IN CARDIOVASCULAR HEALTH WHICH WOULD SUPPORT ITS USE IN CARDIAC REHABILITATION PROGRAMMES. WE CARRIED OUT A REVIEW OF CURRENT RANDOMIZED CONTROLLED TRIALS TO DETERMINE IF YOGA-BASED CARDIAC REHABILITATION LEADS TO REDUCED CARDIAC RISK FACTORS, AND IMPROVED PHYSIOLOGICAL AND PSYCHOLOGICAL OUTCOMES IN PATIENTS WITH CORONARY ARTERY DISEASE COMPARED TO STANDARD CARE. SIX RANDOMIZED CONTROLLED STUDIES WERE IDENTIFIED AFTER A MEDICAL DATABASE SEARCH, AND META-ANALYSIS WAS CARRIED OUT FOR THE DIFFERENT OUTCOMES. OVERALL, THE ADDITION OF YOGA TO STANDARD CARE RESULTED IN IMPROVED SUBJECTIVE FEELING OF CARDIAC HEALTH AND QUALITY OF LIFE. THERE WAS ALSO A TREND TOWARDS IMPROVEMENT IN LEFT VENTRICULAR SYSTOLIC FUNCTION. IMPROVEMENT IN CARDIAC RISK FACTORS, MACE AND PSYCHOLOGICAL HEALTH IN THIS COHORT HAS STILL TO BE PROVEN, BUT WAS NOT INFERIOR TO STANDARD OR ENHANCED CARE, AND THE BENEFITS BECAME MORE PRONOUNCED AT LONGER FOLLOW-UP. FUTURE STUDIES WITH LONGER FOLLOW-UP AND LARGER PATIENT NUMBERS WOULD AID IN ACCURATELY ASSESSING THE LONG-TERM BENEFIT OF YOGA-BASED REHABILITATION. 2021 5 593 36 DEVELOPMENT AND EVALUATION OF A YOGA INTERVENTION PROGRAM FOR PARKINSON'S DISEASE. PRELIMINARY RESEARCH INDICATES THAT YOGA COULD BE A VALUABLE TOOL FOR PEOPLE SUFFERING FROM PARKINSON'S DISEASE (PD). HOWEVER, LITTLE HAS BEEN PUBLISHED ABOUT THE PROCESS BY WHICH THE YOGA INTERVENTIONS WERE DESIGNED AND EVALUATED. THIS STUDY ELABORATES ON THE PROCESS OF DEVELOPING AND TESTING A BI-WEEKLY, 12-WEEK YOGA PROGRAM TO DETERMINE ITS SAFETY AND FEASIBILITY FOR PEOPLE WITH PD. THE LEAD YOGA TEACHER USED INPUT FROM A FOCUSED LITERATURE REVIEW TO DESIGN AN INITIAL DRAFT OF THE INTERVENTION PROGRAM. THIS DRAFT WAS REVIEWED BY A GROUP OF YOGA EXPERTS ( N = 6) TO DEVELOP THE FINAL INTERVENTION PROGRAM. THIS 12-WEEK INTERVENTION WAS IMPLEMENTED IN 19 PARTICIPANTS WITH PD (MEAN AGE 63 +/- 8, RANGE 49-75) VIA TWICE-WEEKLY YOGA CLASSES. THROUGH THIS COMPREHENSIVE DEVELOPMENT PROCESS, A SERIES OF 24 INDIVIDUAL 1-HOUR YOGA SEQUENCES WAS CREATED. THESE SEQUENCES INCLUDED YOGA POSTURES (ASANA), BREATHING TECHNIQUES (PRANAYAMA), AND MINDFULNESS MEDITATION PRINCIPLES SPECIFICALLY CHOSEN TO ADDRESS CONCERNS UNIQUE TO THE PD POPULATION. THE FEASIBILITY OF THE PROGRAM WAS SUPPORTED WITH EXCELLENT ATTENDANCE: 90% OF PARTICIPANTS ATTENDED > 75% OF THE CLASSES, WITH FOUR PARTICIPANTS ATTENDING 100%. NO ADVERSE EVENTS WERE REPORTED. THIS DEVELOPMENT PROCESS PRODUCED A SAFE AND ENJOYABLE YOGA PROGRAM SPECIFIC FOR THE NEEDS OF PEOPLE WITH PD. HOWEVER, THIS METHODOLOGY COULD SERVE AS A TEMPLATE FOR FUTURE STUDIES ON HOW TO DEVELOP SAFE AND EFFECTIVE YOGA INTERVENTIONS FOR OTHER POPULATIONS. 2018 6 583 33 DESIGNING, VALIDATION AND FEASIBILITY OF A YOGA-BASED INTERVENTION FOR ELDERLY. CONTEXT: AGEING IS AN UNAVOIDABLE FACET OF LIFE. YOGIC PRACTICES HAVE BEEN REPORTED TO PROMOTE HEALTHY AGING. PREVIOUS STUDIES HAVE USED EITHER YOGA THERAPY INTERVENTIONS DERIVED FROM A PARTICULAR SCHOOL OF YOGA OR HAVE TESTED SPECIFIC YOGIC PRACTICES LIKE MEDITATION. AIMS: THIS STUDY REPORTS THE DEVELOPMENT, VALIDATION AND FEASIBILITY OF A YOGA-BASED INTERVENTION FOR ELDERLY WITH OR WITHOUT MILD COGNITIVE IMPAIRMENT. SETTINGS AND DESIGN: THE STUDY WAS CONDUCTED AT THE ADVANCED CENTRE FOR YOGA, NATIONAL INSTITUTE FOR MENTAL HEALTH AND NEUROSCIENCES, BANGALORE. THE MODULE WAS DEVELOPED, VALIDATED, AND THEN PILOT-TESTED ON VOLUNTEERS. MATERIALS AND METHODS: THE FIRST PART OF THE STUDY CONSISTED OF DESIGNING OF A YOGA MODULE BASED ON TRADITIONAL AND CONTEMPORARY YOGIC LITERATURE. THIS YOGA MODULE ALONG WITH THE THREE CASE VIGNETTES OF ELDERLY WITH COGNITIVE IMPAIRMENT WERE SENT TO 10 YOGA EXPERTS TO HELP DEVELOP THE INTENDED YOGA-BASED INTERVENTION. IN THE SECOND PART, THE FEASIBILITY OF THE DEVELOPED YOGA-BASED INTERVENTION WAS TESTED. RESULTS: EXPERTS (N=10) OPINED THE YOGA-BASED INTERVENTION WILL BE USEFUL IN IMPROVING COGNITION IN ELDERLY, BUT WITH SOME MODIFICATIONS. FREQUENT SUPERVISED YOGA SESSIONS, REGULAR FOLLOW-UPS, ADDITION/DELETION/MODIFICATIONS OF YOGA POSTURES WERE SOME OF THE SUGGESTIONS. TEN ELDERLY CONSENTED AND EIGHT COMPLETED THE PILOT TESTING OF THE INTERVENTION. ALL OF THEM WERE ABLE TO PERFORM MOST OF THE SUKSMAVYAYAMA, PRANAYAMA AND NADANUSANDHANA (MEDITATION) TECHNIQUE WITHOUT DIFFICULTY. SOME OF THE PARTICIPANTS (N=3) EXPERIENCED DIFFICULTY IN PERFORMING POSTURES SEATED ON THE GROUND. MOST OF THE OLDER ADULTS EXPERIENCED DIFFICULTY IN REMEMBERING AND COMPLETING ENTIRE SEQUENCE OF YOGA-BASED INTERVENTION INDEPENDENTLY. CONCLUSIONS: THE YOGA BASED INTERVENTION IS FEASIBLE IN THE ELDERLY WITH COGNITIVE IMPAIRMENT. TESTING WITH A LARGER SAMPLE OF OLDER ADULTS IS WARRANTED. 2013 7 1370 40 IMPACT OF A STRUCTURED YOGA PROGRAM ON BLOOD PRESSURE REDUCTION AMONG HYPERTENSIVE PATIENTS: STUDY PROTOCOL FOR A PRAGMATIC RANDOMIZED MULTICENTER TRIAL IN PRIMARY HEALTH CARE SETTINGS IN NEPAL. BACKGROUND: HYPERTENSION CONTROL REMAINS A MAJOR GLOBAL CHALLENGE. THE BEHAVIORAL APPROACHES RECOMMENDED FOR BLOOD PRESSURE REDUCTION ARE STRESS REDUCTION, INCREASED EXERCISE AND HEALTHY DIETARY HABITS. SOME STUDY FINDINGS SUGGEST THAT YOGA HAS A BENEFICIAL EFFECT IN REDUCING BLOOD PRESSURE. HOWEVER, THE ROLE OF YOGA ON BLOOD PRESSURE HAS RECEIVED LITTLE ATTENTION IN EXISTING HEALTH CARE PRACTICES IN DEVELOPING COUNTRIES. THIS STUDY WILL BE CONDUCTED IN PRIMARY HEALTH CARE FACILITIES IN NEPAL TO ASSESS THE EFFECTIVENESS OF A PRAGMATIC YOGA INTERVENTION TO COMPLEMENT STANDARD PRACTICE IN FURTHER REDUCING BLOOD PRESSURE. METHODS: THIS WILL BE MULTICENTRIC, TWO ARMS, RANDOMIZED, NONBLINDED, PRAGMATIC TRIAL. IT WILL BE CONDUCTED IN SEVEN DISTRICT AYURVEDA HEALTH CENTERS (DAHCS) IN NEPAL BETWEEN JULY 2017 AND JUNE 2018. THE STUDY PARTICIPANTS WILL CONSIST OF HYPERTENSIVE PATIENTS WITH OR WITHOUT ANTIHYPERTENSIVE MEDICATION ATTENDING TO THE OUTPATIENT DEPARTMENT (OPD). ONE HUNDRED AND FORTY PARTICIPANTS WILL BE RANDOMIZED TO TREATMENT OR CONTROL GROUPS BY USING A STRATIFIED BLOCK RANDOMIZATION. AT THE STUDY SITE, THE TREATMENT ARM PARTICIPANTS WILL RECEIVE AN INTERVENTION CONSISTING OF FIVE DAYS OF STRUCTURED YOGA TRAINING AND PRACTICE OF THE SAME PACKAGE AT HOME WITH A RECOMMENDATION OF FIVE DAYS A WEEK FOR THE FOLLOWING 90 DAYS. BOTH THE INTERVENTION AND CONTROL GROUPS WILL RECEIVE TWO HOURS OF HEALTH EDUCATION ON LIFESTYLE MODIFICATIONS. THE PRIMARY OUTCOME OF THIS TRIAL WILL BE THE CHANGE IN SYSTOLIC BLOOD PRESSURE AND IT WILL BE ASSESSED AFTER 90 DAYS OF THE INTERVENTION. DISCUSSION: THIS STUDY WILL ESTABLISH THE EXTENT TO WHICH A YOGA INTERVENTION PACKAGE CAN HELP REDUCE BLOOD PRESSURE IN HYPERTENSIVE PATIENTS. IF PROVEN EFFECTIVE, STUDY FINDINGS MAY BE USED TO RECOMMEND THE GOVERNING BODIES AND OTHER STAKEHOLDERS FOR THE INTEGRATION OF YOGA IN THE NATIONAL HEALTHCARE SYSTEM FOR THE TREATMENT AND CONTROL OF HYPERTENSION. TRIAL REGISTRATION: CLINICAL TRIAL REGISTRY- INDIA (CTRI); CTRI REG. NO- CTRI/2017/02/007822 . REGISTERED ON 10/02/2017. 2018 8 544 37 CONTENT VALIDITY OF AN INTEGRATED YOGA MODULE FOR PRACTICE DURING REMISSION IN RELAPSING-REMITTING MULTIPLE SCLEROSIS PATIENTS. BACKGROUND: SOME INVESTIGATIONS POINT TO THE BENEFICIAL EFFECTS OF YOGA IN ALLEVIATING THE MOTOR AND COGNITIVE DYSFUNCTIONS IN MULTIPLE SCLEROSIS (MS) PATIENTS BY USING VARYING COMBINATIONS OF PHYSICAL, BREATHING, AND MEDITATIVE PRACTICES OF YOGA. THERE IS A NEED FOR A VALIDATED YOGA MODULE WITH A HOLISTIC APPROACH THAT CAN BE USED AS A STANDARDIZED PROTOCOL BY RESEARCHERS AND THERAPISTS. PURPOSE: TO DEVELOP AND VALIDATE AN INTEGRATED YOGA MODULE FOR PRACTICE IN RELAPSING-REMITTING MS PATIENTS TO IMPROVE THEIR QUALITY OF LIFE. METHODS: WE DID A THOROUGH REVIEW OF THE LITERATURE FOR THE DEVELOPMENT OF THE YOGA MODULE. WE FORMED AN EXPERT GROUP WITH 24 EXPERTS AND A NEUROLOGIST AND USED TWO ROUNDS OF INTERACTIVE DELPHI METHOD TO COMBINE THEIR OPINION TO OBTAIN CONTENT VALIDITY OF THE MODULE THROUGH ONLINE STRUCTURED QUESTIONNAIRE PREPARED FOR THE PURPOSE ON A GOOGLE FORM. WE INCORPORATED ALL SUGGESTIONS OBTAINED BY THE EXPERTS. THE FINAL MODULE (60 MIN PER SESSION, TWICE A DAY, FIVE DAYS PER WEEK) INCLUDED WARM-UP EXERCISES, CUSTOMIZED ASANAS, RELAXATION TECHNIQUES, AND OM MEDITATION. ADVICE ON YOGIC DIET AND DISCUSSION USING YOGIC CONCEPTS FOR STRESS MANAGEMENT ALSO FORM A PART OF THE HOLISTIC APPROACH TO YOGA LIFESTYLE MODIFICATION. RESULTS: ANALYSIS DIVULGED THAT 30 OUT OF 39 PRACTICES EXHIBITED A CONTENT VALIDITY RATIO VALUE GREATER THAN OR EQUAL TO 0.42. CONCLUSION: THE STUDY HAS SHOWN GOOD CONTENT VALIDITY OF THE INTEGRATED YOGA MODULE. FUTURE CLINICAL STUDIES ARE BEING PLANNED TO RULE THE FEASIBILITY AND RELIABILITY OF THIS MODULE. 2021 9 1854 46 RANDOMISED CONTROLLED TRIAL OF A 12 WEEK YOGA INTERVENTION ON NEGATIVE AFFECTIVE STATES, CARDIOVASCULAR AND COGNITIVE FUNCTION IN POST-CARDIAC REHABILITATION PATIENTS. BACKGROUND: NEGATIVE AFFECTIVE STATES SUCH AS ANXIETY, DEPRESSION AND STRESS ARE SIGNIFICANT RISK FACTORS FOR CARDIOVASCULAR DISEASE, PARTICULARLY IN CARDIAC AND POST-CARDIAC REHABILITATION POPULATIONS.YOGA IS A BALANCED PRACTICE OF PHYSICAL EXERCISE, BREATHING CONTROL AND MEDITATION THAT CAN REDUCE PSYCHOSOCIAL SYMPTOMS AS WELL AS IMPROVE CARDIOVASCULAR AND COGNITIVE FUNCTION. IT HAS THE POTENTIAL TO POSITIVELY AFFECT MULTIPLE DISEASE PATHWAYS AND MAY PROVE TO BE A PRACTICAL ADJUNCT TO CARDIAC REHABILITATION IN FURTHER REDUCING CARDIAC RISK FACTORS AS WELL AS IMPROVING SELF-EFFICACY AND POST-CARDIAC REHABILITATION ADHERENCE TO HEALTHY LIFESTYLE BEHAVIOURS. METHOD AND DESIGN: THIS IS A PARALLEL ARM, MULTI-CENTRE, RANDOMISED CONTROLLED TRIAL THAT WILL ASSESS THE OUTCOMES OF POST- PHASE 2 CARDIAC REHABILITATION PATIENTS ASSIGNED TO A YOGA INTERVENTION IN COMPARISON TO A NO-TREATMENT WAIT-LIST CONTROL GROUP. PARTICIPANTS RANDOMISED TO THE YOGA GROUP WILL ENGAGE IN A 12 WEEK YOGA PROGRAM COMPRISING OF TWO GROUP BASED SESSIONS AND ONE SELF-ADMINISTERED HOME SESSION EACH WEEK. GROUP BASED SESSIONS WILL BE LED BY AN EXPERIENCED YOGA INSTRUCTOR. THIS WILL INVOLVE TEACHING BEGINNER STUDENTS A HATHA YOGA SEQUENCE THAT INCORPORATES ASANA (POSES AND POSTURES), PRANAYAMA (BREATHING CONTROL) AND MEDITATION. THE PRIMARY OUTCOMES OF THIS STUDY ARE NEGATIVE AFFECTIVE STATES OF ANXIETY, DEPRESSION AND STRESS ASSESSED USING THE DEPRESSION ANXIETY STRESS SCALE. SECONDARY OUTCOMES INCLUDE MEASURES OF QUALITY OF LIFE, AND CARDIOVASCULAR AND COGNITIVE FUNCTION. THE CARDIOVASCULAR OUTCOMES WILL INCLUDE BLOOD PRESSURE, HEART RATE, HEART RATE VARIABILITY, PULSE WAVE VELOCITY, CAROTID INTIMA MEDIA THICKNESS MEASUREMENTS, LIPID/GLUCOSE PROFILES AND C-REACTIVE PROTEIN ASSAYS. ASSESSMENTS WILL BE CONDUCTED PRIOR TO (WEEK 0), MID-WAY THROUGH (WEEK 6) AND FOLLOWING THE INTERVENTION PERIOD (WEEK 12) AS WELL AS AT A FOUR WEEK FOLLOW-UP (WEEK 16). DISCUSSION: THIS STUDY WILL DETERMINE THE EFFECT OF YOGA PRACTICE ON NEGATIVE AFFECTIVE STATES, CARDIOVASCULAR AND COGNITIVE FUNCTION IN POST-PHASE 2 CARDIAC REHABILITATION PATIENTS. THE FINDINGS MAY PROVIDE EVIDENCE TO INCORPORATE YOGA INTO STANDARDISED CARDIAC REHABILITATION PROGRAMS AS A PRACTICAL ADJUNCT TO IMPROVE THE MANAGEMENT OF PSYCHOSOCIAL SYMPTOMS ASSOCIATED WITH CARDIOVASCULAR EVENTS IN ADDITION TO IMPROVING PATIENTS' COGNITIVE AND CARDIOVASCULAR FUNCTIONS. TRIAL REGISTRATION: ACTRN12612000358842. 2014 10 596 43 DEVELOPMENT AND FEASIBILITY OF YOGA THERAPY MODULE FOR OUT-PATIENTS WITH DEPRESSION IN INDIA. CONTEXT: EVIDENCE SUGGESTS THAT CERTAIN YOGA PRACTICES ARE USEFUL IN THE MANAGEMENT OF DEPRESSION. TO THE BEST OF OUR KNOWLEDGE, THERE HAS BEEN NO STUDY THAT DEALS WITH THE FORMULATION OF A YOGA MODULE FOR THE PARTICULAR CLINICAL FEATURES OF DEPRESSION. AIM: THE MAIN AIM OF OUR STUDY WAS TO DEVELOP A COMPREHENSIVE YOGA THERAPY MODULE TARGETING SPECIFIC CLINICAL FEATURES OF DEPRESSION. SETTINGS AND DESIGN: SPECIFIC YOGA PRACTICES WERE MATCHED FOR CLINICAL FEATURES OF DEPRESSION BASED ON A THOROUGH LITERATURE REVIEW. A YOGA PROGRAM WAS DEVELOPED, WHICH CONSISTED OF SUKSMAVYAYAMA, (LOOSENING EXERCISES), ASANAS (POSTURES), RELAXATION TECHNIQUES, PRANAYAMA (BREATHING EXERCISES) AND CHANTING MEDITATION TO BE TAUGHT IN A 2 WEEK PERIOD. MATERIALS AND METHODS: A STRUCTURED QUESTIONNAIRE WAS DEVELOPED FOR VALIDATION FROM NINE EXPERIENCED YOGA PROFESSIONALS. THE FINAL VERSION OF YOGA THERAPY MODULE WAS PILOT-TESTED ON SEVEN PATIENTS (FIVE FEMALES) WITH DEPRESSION RECRUITED FROM OUTPATIENT SERVICE OF NATIONAL INSTITUTE OF MENTAL HEALTH AND NEURO SCIENCES, BANGALORE. RESULTS: THE FINAL YOGA THERAPY MODULE HAD THOSE PRACTICES THAT RECEIVED A SCORE OF THREE OR MORE (MODERATELY/VERY MUCH/EXTREMELY USEFUL) FROM ALL RESPONDERS. SIX OUT OF NINE (>65%) EXPERTS SUGGESTED SUKSMAVYAYAMA SHOULD BE INCLUDED. FIVE OUT OF NINE EXPERTS OPINED THAT TRAINING WITH 10 SESSIONS (OVER 2 WEEKS) IS RATHER SHORT. ALL EXPERTS OPINED THAT THE MODULE IS EASY TO TEACH, LEARN AND PRACTICE. AT THE PILOT STAGE, THE FIVE PATIENTS WHO COMPLETED THE MODULE REPORTED MORE THAN 80% SATISFACTION ABOUT THE YOGA PRACTICES AND HOW THE YOGA WAS TAUGHT. SEVERITY OF DEPRESSION SUBSTANTIALLY REDUCED AT BOTH 1 AND 3 MONTHS FOLLOW-UP. CONCLUSION: THE DEVELOPED COMPREHENSIVE YOGA THERAPY MODULE WAS VALIDATED BY EXPERTS IN THE FIELD AND WAS FOUND TO BE FEASIBLE AND USEFUL IN PATIENTS WITH DEPRESSION. 2013 11 606 26 DEVELOPMENT AND VALIDATION OF YOGA PROGRAM FOR PATIENTS WITH TYPE 2 DIABETES MELLITUS (T2DM). THIS STUDY WITH AIM OF DEVELOPMENT AND VALIDATION OF A YOGA PROGRAM FOR PATIENTS WITH T2DM WAS CARRIED IN VIEW OF EMERGING EVIDENCE OF YOGA AS AN ALTERNATIVE AND/OR COMPLEMENTARY TREATMENT. CLASSICAL AND CONTEMPORARY YOGA TEXTS WERE REVIEWED FOR IDENTIFICATION OF YOGA PRACTICES. AFTER REVIEWING RESEARCH PAPERS AND YOGA TEXTS A THREE-STEP YOGA PROGRAM, IN ORDER OF INCREASING DIFFICULTY LEVEL FOR T2DM WAS PREPARED. FOR VALIDATION OF YOGA PROGRAM, MIXED METHODS APPROACH INTEGRATING QUALITATIVE AND QUANTITATIVE INPUTS WAS CONSIDERED. EIGHTEEN EXPERTS OVER THREE ROUNDS OF ITERATION CONTRIBUTED TOWARD VALIDATION OF YOGA PROGRAM. A FINAL SET OF THREE-STEP YOGA PROGRAM WAS OBTAINED WHICH FURTHER NEEDS TO BE TESTED IN STANDARDIZED RANDOMIZED CONTROLLED TRIALS.TRIAL REGISTRATION WITH INDIAN COUNCIL OF MEDICAL RESEARCH: CLINICAL TRIAL REGISTRY OF INDIA; ICMR-CTRI: DEVELOPMENT AND VALIDATION STUDY: CTRI/2013/11/004163. 2022 12 613 55 DEVELOPMENT OF A YOGA PROGRAM FOR TYPE-2 DIABETES PREVENTION (YOGA-DP) AMONG HIGH-RISK PEOPLE IN INDIA. INTRODUCTION: MANY INDIANS ARE AT HIGH-RISK OF TYPE-2 DIABETES MELLITUS (T2DM). YOGA IS AN ANCIENT INDIAN MIND-BODY DISCIPLINE, THAT HAS BEEN ASSOCIATED WITH IMPROVED GLUCOSE LEVELS AND CAN HELP TO PREVENT T2DM. THE STUDY AIMED TO SYSTEMATICALLY DEVELOP A YOGA PROGRAM FOR T2DM PREVENTION (YOGA-DP) AMONG HIGH-RISK PEOPLE IN INDIA USING A COMPLEX INTERVENTION DEVELOPMENT APPROACH. MATERIALS AND METHODS: AS PART OF THE INTERVENTION, WE DEVELOPED A BOOKLET AND A HIGH-DEFINITION VIDEO FOR PARTICIPANTS AND A MANUAL FOR YOGA-DP INSTRUCTORS. A SYSTEMATIC ITERATIVE PROCESS WAS FOLLOWED TO DEVELOP THE INTERVENTION AND INCLUDED FIVE STEPS: (I) A SYSTEMATIC REVIEW OF THE LITERATURE TO GENERATE A LIST OF YOGIC PRACTICES THAT IMPROVES BLOOD GLUCOSE LEVELS AMONG ADULTS AT HIGH-RISK OF OR WITH T2DM, (II) VALIDATION OF IDENTIFIED YOGIC PRACTICES BY YOGA EXPERTS, (III) DEVELOPMENT OF THE INTERVENTION, (IV) CONSULTATION WITH YOGA, EXERCISE, PHYSICAL ACTIVITY, DIET, BEHAVIOR CHANGE, AND/OR DIABETES EXPERTS ABOUT THE INTERVENTION, AND (V) PRETEST THE INTERVENTION AMONG YOGA PRACTITIONERS AND LAY PEOPLE (THOSE AT RISK OF T2DM AND HAD NOT PRACTICED YOGA BEFORE) IN INDIA. RESULTS: YOGA-DP IS A STRUCTURED LIFESTYLE EDUCATION AND EXERCISE PROGRAM, PROVIDED OVER A PERIOD OF 24 WEEKS. THE EXERCISE PART IS BASED ON YOGA AND INCLUDES SHITHILIKARANA VYAYAMA (LOOSENING EXERCISES), SURYA NAMASKAR (SUN SALUTATION EXERCISES), ASANA (YOGIC POSES), PRANAYAMA (BREATHING PRACTICES), AND DHYANA (MEDITATION) AND RELAXATION PRACTICES. ONCE PARTICIPANTS COMPLETE THE PROGRAM, THEY ARE STRONGLY ENCOURAGED TO MAINTAIN A HEALTHY LIFESTYLE IN THE LONG-TERM. CONCLUSIONS: WE SYSTEMATICALLY DEVELOPED A NOVEL YOGA PROGRAM FOR T2DM PREVENTION (YOGA-DP) AMONG HIGH-RISK PEOPLE IN INDIA. A MULTI-CENTER FEASIBILITY RANDOMIZED CONTROLLED TRIAL IS IN PROGRESS IN INDIA. 2020 13 2249 33 THE LIVED EXPERIENCE AND PATIENT-REPORTED BENEFITS OF YOGA PARTICIPATION IN AN INPATIENT BRAIN INJURY REHABILITATION SETTING. CONTEXT: THE MULTIFACTORIAL BENEFITS OF YOGA HAVE BEEN WELL DOCUMENTED IN THE LITERATURE, WITH THE INTEGRATION OF YOGA THERAPY INTO HEALTHCARE BEING AN EMERGING FIELD. IN GENERAL, YOGA THERAPY PROGRAMS ARE UTILIZED IN THE COMMUNITY AS AN ADJUNCT TO OTHER THERAPY. AT PRESENT, LIMITED REHABILITATION UNITS ROUTINELY INCORPORATE INTEGRATIVE THERAPY OPTIONS WITHIN A HOSPITAL ENVIRONMENT. AIMS: THE AIM OF THIS STUDY IS TO EXPLORE THE LIVED EXPERIENCE AND PATIENT-REPORTED BENEFITS OF YOGA IN AN INPATIENT BRAIN INJURY REHABILITATION SETTING. SETTINGS AND DESIGN: THIRTY-ONE PARTICIPANTS WERE RECRUITED TO THE STUDY AFTER VOLUNTARILY PARTICIPATING IN A YOGA CLASS WITHIN AN INPATIENT BRAIN INJURY REHABILITATION UNIT OF A MAJOR METROPOLITAN HOSPITAL. YOGA SESSIONS WERE HELD WEEKLY FOR 60 MIN AND CONSISTED OF A MODIFIED HATHA YOGA STYLE. THIS WAS A MIXED-METHODS, QUASI-EXPERIMENTAL ONE-GROUP PRETEST-POSTTEST STUDY. METHODOLOGY: QUANTITATIVE DATA WERE COLLECTED TO MEASURE PERCEPTIONS OF RELAXATION AND WELL-BEING BEFORE AND AFTER YOGA CLASSES, ALONG WITH THE SATISFACTION OF THE CLASS. SEMI-STRUCTURED INTERVIEWS WERE UTILIZED TO COLLECT QUALITATIVE DATA OF EXPERIENCES AND PERCEPTIONS ASSOCIATED WITH YOGA PARTICIPATION. STATISTICAL ANALYSIS USED: THEMATIC ANALYSIS WAS COMPLETED FOR QUALITATIVE DATA. QUANTITATIVE DATA WERE ANALYZED USING NONPARAMETRIC STATISTICAL METHODS, AND DESCRIPTIVE STATISTICS WERE ALSO PROVIDED. RESULTS: THE BENEFITS DESCRIBED BY PARTICIPANTS ARE REPORTED IN THIS PAPER. THESE INCLUDE IMPROVED RELAXATION, PHYSICAL WELL-BEING, EMOTIONAL WELL-BEING, BEING PRESENT, AND SELF-AWARENESS. CONCLUSIONS: THIS STUDY DESCRIBES THE PERSONAL BENEFITS EXPERIENCED FROM REGULAR YOGA PARTICIPATION WITHIN AN INPATIENT REHABILITATION SETTING. 2020 14 1661 32 NARRATIVE REVIEW OF YOGA INTERVENTION CLINICAL TRIALS INCLUDING WEIGHT-RELATED OUTCOMES. CONTEXT: MEDICAL AUTHORITIES HAVE IDENTIFIED OBESITY AS A CAUSAL FACTOR IN THE DEVELOPMENT OF DIABETES, HYPERTENSION, AND CARDIOVASCULAR DISEASE (CVD), AND MORE BROADLY, OF METABOLIC SYNDROME/INSULIN RESISTANCE SYNDROME. TO PROVIDE SOLUTIONS THAT CAN MODIFY THIS RISK FACTOR, RESEARCHERS NEED TO IDENTIFY METHODS OF EFFECTIVE RISK REDUCTION AND PRIMARY PREVENTION OF OBESITY. RESEARCH ON THE EFFECTIVENESS OF YOGA AS A TREATMENT FOR OBESITY IS LIMITED, AND STUDIES VARY IN OVERALL QUALITY AND METHODOLOGICAL RIGOR. OBJECTIVE: THIS NARRATIVE REVIEW ASSESSED THE QUANTITY AND QUALITY OF CLINICAL TRIALS OF YOGA AS AN INTERVENTION FOR WEIGHT LOSS OR AS A MEANS OF RISK REDUCTION OR TREATMENT FOR OBESITY AND DISEASES IN WHICH OBESITY IS A CAUSAL FACTOR. THIS REVIEW SUMMARIZED THE STUDIES' RESEARCH DESIGNS AND EVALUATED THE EFFICACY OF YOGA FOR WEIGHT LOSS VIA THE CURRENT EVIDENCE BASE. DESIGN: THE RESEARCH TEAM EVALUATED PUBLISHED STUDIES TO DETERMINE THE APPROPRIATENESS OF RESEARCH DESIGNS, COMPARABILITY OF PROGRAMS' INTERVENTION ELEMENTS, AND STANDARDIZATION OF OUTCOME MEASURES. THE RESEARCH TEAM'S LITERATURE SEARCH USED THE KEY TERMS YOGA AND OBESITY OR YOGA AND WEIGHT LOSS IN THREE PRIMARY MEDICAL-LITERATURE DATABASES (PUBMED, PSYCHINFO, AND WEB OF SCIENCE). THE STUDY EXCLUDED CLINICAL TRIALS WITH NO QUANTITATIVE OBESITY RELATED MEASURE. EXTRACTED DATA INCLUDED EACH STUDY'S (1) DESIGN; (2) SETTING AND POPULATION; (3) NATURE, DURATION, AND FREQUENCY OF INTERVENTIONS; (4) COMPARISON GROUPS; (5) RECRUITMENT STRATEGIES; (6) OUTCOME MEASURES; (7) DATA ANALYSIS AND PRESENTATION; AND (8) RESULTS AND CONCLUSIONS. THE RESEARCH TEAM DEVELOPED AN OVERALL EVALUATION PARAMETER TO COMPARE DISPARATE TRIALS. OUTCOME MEASURES: THE RESEARCH TEAM REVIEWED EACH STUDY TO DETERMINE ITS KEY FEATURES, EACH WORTH A SPECIFIED NUMBER OF POINTS, WITH A MAXIMUM TOTAL OF 20 POINTS. THE FEATURES INCLUDED A STUDY'S (1) DURATION, (2) FREQUENCY OF YOGA PRACTICE, (3) INTENSITY OF (LENGTH OF) EACH PRACTICE, (4) NUMBER OF YOGIC ELEMENTS, (5) INCLUSION OF DIETARY MODIFICATION, (6) INCLUSION OF A RESIDENTIAL COMPONENT, (7) THE NUMBER OF WEIGHT-RELATED OUTCOME MEASURES, AND (8) A DISCUSSION OF THE DETAILS OF THE YOGIC ELEMENTS. RESULTS: OVERALL, THERAPEUTIC YOGA PROGRAMS ARE FREQUENTLY EFFECTIVE IN PROMOTING WEIGHT LOSS AND/OR IMPROVEMENTS IN BODY COMPOSITION. THE EFFECTIVENESS OF YOGA FOR WEIGHT LOSS IS RELATED TO THE FOLLOWING KEY FEATURES: (1) AN INCREASED FREQUENCY OF PRACTICE; (2) A LONGER INTERVENTION DURATION (3) A YOGIC DIETARY COMPONENT; (4) A RESIDENTIAL COMPONENT; (5) THE COMPREHENSIVE INCLUSION OF YOGIC COMPONENTS; (5) AND A HOME-PRACTICE COMPONENT. CONCLUSIONS: YOGA APPEARS TO BE AN APPROPRIATE AND POTENTIALLY SUCCESSFUL INTERVENTION FOR WEIGHT MAINTENANCE, PREVENTION OF OBESITY, AND RISK REDUCTION FOR DISEASES IN WHICH OBESITY PLAYS A SIGNIFICANT CAUSAL ROLE. 2013 15 501 46 COMMUNITY BASED YOGA CLASSES FOR TYPE 2 DIABETES: AN EXPLORATORY RANDOMISED CONTROLLED TRIAL. BACKGROUND: YOGA IS A POPULAR THERAPY FOR DIABETES BUT ITS EFFICACY IS CONTESTED. THE AIM OF THIS STUDY WAS TO EXPLORE THE FEASIBILITY OF RESEARCHING COMMUNITY BASED YOGA CLASSES IN TYPE 2 DIABETES WITH A VIEW TO INFORMING THE DESIGN OF A DEFINITIVE, MULTI-CENTRE TRIAL METHODS: THE STUDY DESIGN WAS AN EXPLORATORY RANDOMISED CONTROLLED TRIAL WITH IN-DEPTH PROCESS EVALUATION. THE SETTING WAS TWO MULTI-ETHNIC BOROUGHS IN LONDON, UK; ONE WITH AVERAGE AND ONE WITH LOW MEAN SOCIO-ECONOMIC DEPRIVATION SCORE. CLASSES WERE HELD AT A SPORTS CENTRE OR GP SURGERY. PARTICIPANTS WERE 59 PEOPLE WITH TYPE 2 DIABETES NOT TAKING INSULIN, RECRUITED FROM GENERAL PRACTICE LISTS OR OPPORTUNISTICALLY BY GENERAL PRACTICE STAFF. THE INTERVENTION GROUP WERE OFFERED 12 WEEKS OF A TWICE-WEEKLY 90-MINUTE YOGA CLASS; THE CONTROL GROUP WAS A WAITING LIST FOR THE YOGA CLASSES. BOTH GROUPS RECEIVED ADVICE AND LEAFLETS ON HEALTHY LIFESTYLE AND WERE ENCOURAGED TO EXERCISE. PRIMARY OUTCOME MEASURE WAS HBA1C. SECONDARY OUTCOME MEASURES INCLUDED ATTENDANCE, WEIGHT, WAIST CIRCUMFERENCE, LIPID LEVELS, BLOOD PRESSURE, UKPDS CARDIOVASCULAR RISK SCORE, DIABETES-RELATED QUALITY OF LIFE (ADDQOL), AND SELF-EFFICACY. PROCESS MEASURES WERE ATTENDANCE AT YOGA SESSIONS, SELF-REPORTED FREQUENCY OF PRACTICE BETWEEN TAUGHT SESSIONS, AND QUALITATIVE DATA (INTERVIEWS WITH PATIENTS AND THERAPISTS, ETHNOGRAPHIC OBSERVATION OF THE YOGA CLASSES, AND ANALYSIS OF DOCUMENTS INCLUDING MINUTES OF MEETINGS, CORRESPONDENCE, AND EXERCISE PLANS). RESULTS: DESPITE BROAD INCLUSION CRITERIA, AROUND TWO-THIRDS OF THE PATIENTS ON GP DIABETIC REGISTERS PROVED INELIGIBLE, AND 90% OF THE REMAINDER DECLINED TO PARTICIPATE. MEAN AGE OF PARTICIPANTS WAS 60 +/- 10 YEARS. ATTENDANCE AT YOGA CLASSES WAS AROUND 50%. NOBODY DID THE EXERCISES REGULARLY AT HOME. YOGA TEACHERS FELT THAT MOST PARTICIPANTS WERE UNSUITABLE FOR 'STANDARD' YOGA EXERCISES BECAUSE OF LIMITED FLEXIBILITY, LACK OF BASIC FITNESS, CO-MORBIDITY, AND LACK OF CONFIDENCE. THERE WAS A SMALL FALL IN HBA1C IN THE YOGA GROUP WHICH WAS NOT STATISTICALLY SIGNIFICANT AND WHICH WAS NOT SUSTAINED SIX MONTHS LATER, AND NO SIGNIFICANT CHANGE IN OTHER OUTCOME MEASURES. CONCLUSION: THE BENEFITS OF YOGA IN TYPE 2 DIABETES SUGGESTED IN SOME PREVIOUS STUDIES WERE NOT CONFIRMED. POSSIBLE EXPLANATIONS (APART FROM LACK OF EFFICACY) INCLUDE RECRUITMENT CHALLENGES; PRACTICAL AND MOTIVATIONAL BARRIERS TO CLASS ATTENDANCE; PHYSICAL AND MOTIVATIONAL BARRIERS TO ENGAGING IN THE EXERCISES; INADEQUATE INTENSITY AND/OR DURATION OF YOGA INTERVENTION; AND INSUFFICIENT PERSONALISATION OF EXERCISES TO INDIVIDUAL NEEDS. ALL THESE FACTORS SHOULD BE CONSIDERED WHEN DESIGNING FUTURE TRIALS. TRIAL REGISTRATION: NATIONAL RESEARCH REGISTER (1410) AND CURRENT CONTROLLED TRIALS (ISRCTN63637211). 2009 16 2385 31 YOGA ADHERENCE IN OLDER WOMEN SIX MONTHS POST-OSTEOARTHRITIS INTERVENTION. BACKGROUND/OBJECTIVE: OSTEOARTHRITIS (OA) IS A HIGHLY PREVALENT CONDITION WORLDWIDE. YOGA IS POTENTIALLY A SAFE AND FEASIBLE OPTION FOR MANAGING OA; HOWEVER, THE EXTENT OF LONG-TERM YOGA ADHERENCE IS UNKNOWN. THE PURPOSE OF THIS STUDY WAS TO EXAMINE YOGA ADHERENCE 6 MONTHS AFTER PARTICIPANTS COMPLETED AN OA INTERVENTION PROGRAM. METHODS: THIS FOLLOW-UP STUDY EMPLOYED A CROSS-SECTIONAL DESCRIPTIVE DESIGN USING SURVEY, INTERVIEW, AND VIDEO RECORDINGS TO COLLECT BOTH QUANTITATIVE AND QUALITATIVE DATA. A TOTAL OF 31 PARTICIPANTS COMPLETED AND RETURNED THE SURVEY, AND 10 VIDEOTAPED THEIR YOGA PRACTICE FOR 1 WEEK AND PARTICIPATED IN A FACE-TO-FACE INTERVIEW. RESULTS: A MAJORITY OF PARTICIPANTS (N=19, 61%) REPORTED THAT THEY WERE STILL PRACTICING YOGA 6 MONTHS AFTER THE INTERVENTION PROGRAM. ON AVERAGE, PARTICIPANTS REPORTED PRACTICING 21 TO 30 MINUTES OF YOGA PER DAY (32%) 3 TO 4 DAYS PER WEEK (47%). "FEELING GOOD OR FEELING BETTER AFTER YOGA PRACTICE" (50%) AND "SET ASIDE A TIME" (31%) WERE THE MOST COMMON MOTIVATING FACTORS FOR YOGA ADHERENCE. DEALING WITH HEALTH PROBLEMS (42%), HAVING PAIN (25%), AND BEING TOO BUSY (25%) WERE THE MAJOR BARRIERS. QUALITATIVE DATA REVEALED THAT PARTICIPANTS: (1) USED MINDFUL YOGA MOVEMENT, (2) INCORPORATED OTHER FORMS OF EXERCISE AND RESOURCES DURING YOGA PRACTICE, AND (3) CREATED PERSONALIZED YOGA PROGRAMS. ADDITIONALLY, THE PARTICIPANTS REPORTED LESS OA PAIN, INCREASED PHYSICAL ENDURANCE, AND MORE RELAXATION. CONCLUSION: MANY PARTICIPANTS ADHERED TO YOGA PRACTICE 6 MONTHS POST-INTERVENTION ALTHOUGH NOT AT THE FREQUENCY AND SEQUENCE AS PRESCRIBED. FEELING BETTER AFTER PRACTICE MOTIVATED PARTICIPANTS, BUT OTHER FACTORS REMAINED KEY BARRIERS. 2015 17 609 40 DEVELOPMENT OF A MODIFIED YOGA PROGRAM FOR PULMONARY HYPERTENSION: A CASE SERIES. BACKGROUND: PULMONARY HYPERTENSION (PH) IS A HEMODYNAMIC CONDITION IN WHICH THE PRESSURE IN THE BED OF THE PULMONARY ARTERIES IS ELEVATED. ALTHOUGH MEDICATIONS HAVE IMPROVED BOTH SYMPTOMS AND MORTALITY, PH REMAINS A DEBILITATING AND DEVASTATING DISEASE. LITTLE IS KNOWN ABOUT THE EFFECTS OF NONPHARMACOLOGIC APPROACHES, SUCH AS YOGA AND MEDITATIVE BREATHING, IN TREATMENT OF THE DISEASE. OBJECTIVE: GIVEN THE UNIQUE HEMODYNAMIC CONCERNS OF PH PATIENTS, THE RESEARCH TEAM INTENDED TO DESCRIBE THE DEVELOPMENT AND SUBSEQUENT INITIATION OF A THERAPEUTIC TREATMENT PLAN THAT USES MODIFIED YOGA AND TO EVALUATE ITS BENEFITS AND SAFETY. DESIGN: THIS STUDY WAS A CASE SERIES WITH 3 PH PATIENTS OF VARYING FUNCTIONAL ABILITIES. EACH PATIENT WAS PROVIDED WITH A DVD, ACCESS TO YOUTUBE VIDEO SEGMENTS, AND A DOWNLOAD OF THE YOGA FOR PH APPLICATION. THE PATIENTS WERE ASKED TO DOCUMENT THEIR USE OF THE HOME EXERCISE REGIMEN AND JOURNAL AROUND THEIR SUBJECTIVE OBSERVATIONS. THEY WERE ALSO ADMINISTERED THE HEALTH PROMOTING LIFESTYLE PROFILE II (HPLPII) AT THE BEGINNING AND END OF THE 8 WK. SETTING: THE STUDY TOOK PLACE IN A TERTIARY CARE, ACADEMIC HOSPITAL IN A LARGE URBAN SETTING. PARTICIPANTS: IN THIS CASE SERIES, 3 PATIENTS WITH GROUP 1 PULMONARY ARTERIAL HYPERTENSION, WITH VARYING FUNCTIONAL ABILITIES, ARE DESCRIBED. INTERVENTION: THREE DISCREET YOGA PROGRAMS WERE DESIGNED WITH MODIFICATIONS SPECIFIC TO PH PATIENTS: CHAIR YOGA, INTERMEDIATE YOGA WITH A CHAIR ASSIST, AND EXPERIENCED YOGA. PATIENTS WERE PROVIDED WITH A VIDEO, YOGA FOR PH, IN THE FORM OF A DVD, A VIDEO ON YOUTUBE, AND A DOWNLOADABLE APPLICATION AND WERE INSTRUCTED TO LOG ACTIVITY AND SUBJECTIVE MARKERS OF WELL-BEING. OUTCOME MEASURES: SUBJECTIVE AND OBJECTIVE EFFECTS ON CLINICAL, PHYSICAL FUNCTION, AND PSYCHOLOGICAL OUTCOMES WERE MEASURED. SUBJECTIVE EFFECTS WERE IDENTIFIED THROUGH JOURNALING AS WELL AS THE SELF-ADMINISTERED QUESTIONNAIRE HPLPII. WHEN AVAILABLE, 6-MIN WALK DISTANCE (6MWD) TESTING AND OXYGEN SATURATION WERE ALSO USED. RESULTS: THE MODIFIED YOGA PROGRAM PROVED FEASIBLE, SAFE, AND EFFECTIVE IN THE 3 DESCRIBED CASES. PATIENTS DESCRIBED DECREASES IN ANXIETY AND JOINT PAIN, WITH IMPROVEMENTS IN HEALTH-PROMOTING BEHAVIORS AS MEASURED BY THE HPLPII. OVERALL MEAN SCORES FOR HEALTH-PROMOTING LIFESTYLE INCREASED IN EACH PATIENT, THOUGH DUE TO THE SMALL SAMPLE SIZE, STATISTICAL SIGNIFICANCE CANNOT BE MEASURED. NO PATIENT EXPERIENCED AN ADVERSE EVENT ASSOCIATED WITH THE PRACTICE. CONCLUSIONS: THE MODIFIED YOGA PROGRAM FOR PH PATIENTS CAN PROVIDE A STANDARDIZED, ACCESSIBLE STARTING POINT FOR FURTHER STUDY ON THE FEASIBILITY, EFFICACY, AND SAFETY OF SUCH A PROGRAM ON A LARGER SCALE. 2015 18 1732 31 PERSPECTIVE OF PATIENTS REFERRED TO YOGA CENTER IN A TERTIARY NEUROPSYCHIATRIC HOSPITAL: A CROSS-SECTIONAL RETROSPECTIVE STUDY. BACKGROUND: YOGA HAS BEEN EXTENSIVELY USED AS AN ALTERNATIVE OR COMPLEMENTARY THERAPY IN PSYCHIATRIC DISORDERS DEPENDING ON THE TYPE AND SEVERITY OF THE DISORDERS. HOWEVER, DATA RELATED TO PERSPECTIVE ON YOGA SERVICES AND THE BENEFITS AND ADVERSE EFFECTS ATTRIBUTED TO YOGA BY PATIENTS WITH MAJOR PSYCHIATRIC DISORDERS IS LACKING. AIM: THE AIM OF THE STUDY WAS TO ASSESS FEEDBACK OF THE PATIENTS WHO ATTENDED YOGA SESSIONS AT A YOGA CENTER IN A TERTIARY NEUROPSYCHIATRIC HOSPITAL. MATERIALS AND METHODS: THIS WAS A CROSS-SECTIONAL RETROSPECTIVE STUDY USING A SPECIFIC QUESTIONNAIRE TO GET FEEDBACK FROM PATIENTS REFERRED TO THE NIMHANS INTEGRATED CENTER FOR YOGA, AT THE END OF THEIR YOGA TRAINING. RESULTS: TWO HUNDRED AND ONE PATIENTS' DATA WERE INCLUDED IN THIS RETROSPECTIVE STUDY. MOST OF THE PATIENTS WERE REFERRED BY THE DOCTORS. THE YOGA MODULE FOR SCHIZOPHRENIA WAS MOST COMMONLY UTILIZED, FOLLOWED BY DEPRESSION. ON AN AVERAGE, PATIENTS ATTENDED 13 SESSIONS. MOST OF THEM PRACTICED YOGA FOR 1-2 WEEKS AND HAD MISSED LESS THAN 2 SESSIONS. THE GREAT MAJORITY OF THE PATIENTS REPORTED THAT PRACTICING YOGA HELPED THEM. SPEARMAN CORRELATION ANALYSIS REVEALED POSITIVE ASSOCIATIONS BETWEEN IMPROVEMENT ATTRIBUTED TO YOGA AND VARIABLES AFFECTING QUALITY OF YOGA SERVICES AT THE CENTER, INCLUDING THE QUALITY OF YOGA SESSIONS ATTENDED. OVERALL HEALTH AND SLEEP IMPROVEMENT ALSO POSITIVELY CORRELATED WITH IMPROVEMENT ATTRIBUTED TO YOGA. A MINORITY OF PATIENTS REPORTED ADVERSE EFFECTS, ALTHOUGH THESE DID NOT LEAD TO DISCONTINUATION. CONCLUSION: IN THIS RETROSPECTIVE STUDY OF PATIENTS REFERRED TO A YOGA CENTER IN A TERTIARY PSYCHIATRIC FACILITY, THE MAJORITY OF PATIENTS WITH MAJOR MENTAL DISORDERS WERE ABLE TO PRACTICE YOGA UNDER SUPERVISION AND REPORTED SIGNIFICANT IMPROVEMENT IN SYMPTOMS WITH MINIMAL ADVERSE EFFECTS. 2021 19 2586 40 YOGA FOR HYPERTENSIVE PATIENTS: A STUDY ON BARRIERS AND FACILITATORS OF ITS IMPLEMENTATION IN PRIMARY CARE. BACKGROUND: INTERNATIONAL GUIDELINES FOR HYPERTENSION TREATMENT RECOMMEND THE USE OF YOGA, PARTICULARLY AMONG LOW-RISK PATIENTS. HOWEVER, EVIDENCE IS LACKING ON THE IMPLEMENTATION POTENTIAL OF HEALTH-WORKER-LED YOGA INTERVENTIONS IN LOW-RESOURCE, PRIMARY CARE SETTINGS. OBJECTIVE: TO ASSESS BARRIERS TO AND FACILITATORS OF THE IMPLEMENTATION OF A YOGA INTERVENTION FOR HYPERTENSIVE PATIENTS IN PRIMARY CARE IN NEPAL. METHODS: THE STUDY WAS CONDUCTED USING FOCUS GROUP DISCUSSIONS, IN-DEPTH INTERVIEWS, KEY INFORMANT INTERVIEWS, AND TELEPHONE INTERVIEWS. DATA WERE COLLECTED FROM THE 'YOGA AND HYPERTENSION' (YOH) TRIAL PARTICIPANTS, YOH INTERVENTION IMPLEMENTERS, AND OFFICIALS FROM THE MINISTRY OF HEALTH AND POPULATION IN NEPAL. RESULTS: MOST YOH TRIAL PARTICIPANTS STATED THAT: (1) IT WAS EASY TO LEARN YOGA DURING A FIVE-DAY TRAINING PERIOD AND PRACTISE IT FOR THREE MONTHS AT HOME; (2) PRACTISING YOGA IMPROVED THEIR HEALTH; AND (3) GROUP YOGA SESSIONS IN A COMMUNITY CENTRE WOULD HELP THEM PRACTISE YOGA MORE REGULARLY. MOST YOH INTERVENTION IMPLEMENTERS STATED THAT: (1) THEY WERE HIGHLY MOTIVATED TO IMPLEMENT THE INTERVENTION; (2) THE COST OF IMPLEMENTATION WAS ACCEPTABLE; (3) THEY DID NOT NEED ADDITIONAL STAFF TO EFFECTIVELY IMPLEMENT THE INTERVENTION; (4) PROVIDING REMUNERATION TO THE STAFF INVOLVED IN THE INTERVENTION WOULD INCREASE THEIR MOTIVATION; AND (5) THE YOGA PROGRAMME WAS 'SIMPLE AND EASY TO FOLLOW' AND 'EASILY PERFORMED BY PARTICIPANTS OF ANY AGE'. THE GOVERNMENT OFFICIALS STATED THAT: (1) YOGA IS CONSIDERED AS A KEY HEALTH PROMOTIONAL ACTIVITY IN NEPAL; AND (2) THE INTEGRATION OF THE YOGA INTERVENTION INTO THE EXISTING HEALTH CARE PROGRAMME WOULD NOT BE TOO CHALLENGING, BECAUSE THE EXISTING PERSONNEL AND OTHER RESOURCES CAN BE UTILISED. CONCLUSION: WHILE THERE IS A GOOD POTENTIAL THAT A YOGA INTERVENTION CAN BE IMPLEMENTED IN PRIMARY CARE, CAPACITY DEVELOPMENT FOR HEALTH WORKERS AND THE INVOLVEMENT OF COMMUNITY YOGA CENTRES IN THE DELIVERY OF THE INTERVENTIONS MAY BE REQUIRED TO FACILITATE THIS IMPLEMENTATION. 2021 20 2422 31 YOGA AND MINDFULNESS AS THERAPEUTIC INTERVENTIONS FOR STROKE REHABILITATION: A SYSTEMATIC REVIEW. AIM. THIS PAPER REPORTS A SYSTEMATIC REVIEW AND CRITICAL APPRAISAL OF THE EVIDENCE ON THE EFFECTIVENESS OF BEHAVIORAL THERAPIES SUCH AS YOGA AND MINDFULNESS PRACTICES FOR STROKE REHABILITATION. BACKGROUND. THE EXPERIENCE OF STROKE CAN HAVE A NEGATIVE IMPACT ON BOTH PSYCHOLOGICAL AND PHYSICAL HEALTH AND ON QUALITY OF LIFE. YOGA AND RELEVANT PRACTICES ARE PROMISING THERAPIES THAT HAVE BEEN USED WITH PATIENTS WITH A VARIETY OF CONDITIONS. IN ORDER TO DRAW CONCLUSIONS ON EFFECTIVENESS FOR STROKE PATIENTS, THE EVIDENCE REQUIRES SYSTEMATIC ASSESSMENT. METHODS. A COMPREHENSIVE SEARCH OF MAJOR BIOMEDICAL AND COMPLEMENTARY MEDICINE DATABASES WAS CONDUCTED. RELEVANT RESEARCH WAS CATEGORIZED BY STUDY TYPE AND APPRAISED ACCORDING TO STUDY DESIGN. RESULTS. FIVE RANDOMIZED CONTROLLED CLINICAL TRIALS AND FOUR SINGLE CASE STUDIES WERE FOUND. ADDITIONALLY, ONE QUALITATIVE RESEARCH STUDY WAS IDENTIFIED. STUDIES REPORTED POSITIVE RESULTS, INCLUDING IMPROVEMENTS IN COGNITION, MOOD, AND BALANCE AND REDUCTIONS IN STRESS. MODIFICATIONS TO DIFFERENT YOGA PRACTICES MAKE COMPARISON BETWEEN STUDIES DIFFICULT, AND A LACK OF CONTROLLED STUDIES PRECLUDES ANY FIRM CONCLUSIONS ON EFFICACY. CONCLUSION. YOGA AND MINDFULNESS COULD BE CLINICALLY VALUABLE SELF-ADMINISTERED INTERVENTION OPTIONS FOR STROKE REHABILITATION. FURTHER RESEARCH IS NEEDED TO EVALUATE THESE SPECIFIC PRACTICES AND THEIR SUITABILITY IN STROKE REHABILITATION. 2013