1 1004 159 EFFECTS OF MIND(-)BODY EXERCISES (TAI CHI/YOGA) ON HEART RATE VARIABILITY PARAMETERS AND PERCEIVED STRESS: A SYSTEMATIC REVIEW WITH META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. BACKGROUND: HEART RATE VARIABILITY (HRV) AS AN ACCURATE, NONINVASIVE MEASURE OF THE AUTONOMOUS NERVOUS SYSTEM (ANS) CAN REFLECT MENTAL HEALTH (E.G., STRESS, DEPRESSION, OR ANXIETY). TAI CHI AND YOGA (TAI CHI/YOGA), AS THE MOST WIDELY PRACTICED MIND(-)BODY EXERCISES, HAVE SHOWN POSITIVE OUTCOMES OF MENTAL HEALTH. TO DATE, NO SYSTEMATIC REVIEW REGARDING THE LONG-LASTING EFFECTS OF TAI CHI/YOGA ON HRV PARAMETERS AND PERCEIVED STRESS HAS BEEN CONDUCTED. OBJECTIVE: TO CRITICALLY EVALUATE THE EXISTING LITERATURE ON THIS TOPIC. METHODS: FIVE ELECTRONIC DATABASES (WEB OF SCIENCE, PUBMED, SCOPUS, SPORTDISCUS AND COCHRANE LIBRARY) WERE SEARCHED FROM THE START OF THE RESEARCH PROJECT TO JULY 2018. STUDY SELECTION, DATA EXTRACTION, AND STUDY QUALITY ASSESSMENT WERE INDEPENDENTLY CARRIED OUT BY TWO REVIEWERS. THE POTENTIALLY IDENTIFIED RANDOMIZED CONTROLLED TRIALS (RCT) REPORTED THE USEFUL QUANTITATIVE DATA THAT WERE INCLUDED ONLY FOR META-ANALYSIS. RESULTS: META-ANALYSIS OF 17 MEDIUM-TO-HIGH QUALITY RCTS SHOWED SIGNIFICANTLY BENEFICIAL EFFECTS ON HRV PARAMETERS (NORMALIZED LOW-FREQUENCY, HEDGE'S G = -0.39, 95% CI -0.39 TO -0.56, P < 0.001, I2 = 11.62%; NORMALIZED HIGH-FREQUENCY, HEDGE'S G = 0.37, 95% CI 0.22 TO -0.52, P < 0.001, I2 = 0%; LOW-FREQUENCY TO HIGH-FREQUENCY RATIO, HEDGE'S G = -0.58, 95% CI -0.81 TO -0.35, P < 0.001, I2 = 53.78%) AND STRESS LEVEL (HEDGE'S G = -0.80, 95% CI -1.17 TO -0.44, P < 0.001, I2 = 68.54%). CONCLUSIONS: STRESS REDUCTION MAY BE ATTRIBUTED TO SYMPATHETIC-VAGAL BALANCE MODULATED BY MIND(-)BODY EXERCISES. TAI CHI/YOGA COULD BE AN ALTERNATIVE METHOD FOR STRESS REDUCTION FOR PEOPLE WHO LIVE UNDER HIGH STRESS OR NEGATIVE EMOTIONS. 2018 2 2144 47 THE EFFECTS OF MEDITATION, YOGA, AND MINDFULNESS ON DEPRESSION, ANXIETY, AND STRESS IN TERTIARY EDUCATION STUDENTS: A META-ANALYSIS. BACKGROUND: MEDITATION, YOGA, AND MINDFULNESS ARE POPULAR INTERVENTIONS AT UNIVERSITIES AND TERTIARY EDUCATION INSTITUTES TO IMPROVE MENTAL HEALTH. HOWEVER, THE EFFECTS ON DEPRESSION, ANXIETY, AND STRESS ARE UNCLEAR. THIS STUDY ASSESSED THE EFFECTIVENESS OF MEDITATION, YOGA, AND MINDFULNESS ON SYMPTOMS OF DEPRESSION, ANXIETY, AND STRESS IN TERTIARY EDUCATION STUDENTS. METHODS: WE SEARCHED COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL), PUBMED, PSYCINFO AND IDENTIFIED 11,936 ARTICLES. AFTER RETRIEVING 181 PAPERS FOR FULL-TEXT SCREENING, 24 RANDOMIZED CONTROLLED TRIALS WERE INCLUDED IN THE QUALITATIVE ANALYSIS. WE CONDUCTED A RANDOM-EFFECTS META-ANALYSIS AMONGST 23 STUDIES WITH 1,373 PARTICIPANTS. RESULTS: AT POST-TEST, AFTER EXCLUSION OF OUTLIERS, EFFECT SIZES FOR DEPRESSION, G = 0.42 (95% CI: 0.16-0.69), ANXIETY G = 0.46 (95% CI: 0.34-0.59), STRESS G = 0.42 (95% CI: 0.27-0.57) WERE MODERATE. HETEROGENEITY WAS LOW (I (2) = 6%). WHEN COMPARED TO ACTIVE CONTROL, THE EFFECT DECREASED TO G = 0.13 (95% CI: -0.18-0.43). NO RCT REPORTED ON SAFETY, ONLY TWO STUDIES REPORTED ON ACADEMIC ACHIEVEMENT, MOST STUDIES HAD A HIGH RISK OF BIAS. CONCLUSIONS: MOST STUDIES WERE OF POOR QUALITY AND RESULTS SHOULD BE INTERPRETED WITH CAUTION. OVERALL MODERATE EFFECTS WERE FOUND WHICH DECREASED SUBSTANTIALLY WHEN INTERVENTIONS WERE COMPARED TO ACTIVE CONTROL. IT IS UNCLEAR WHETHER MEDITATION, YOGA OR MINDFULNESS AFFECT ACADEMIC ACHIEVEMENT OR AFFECT HAVE ANY NEGATIVE SIDE EFFECTS. 2019 3 2098 45 THE EFFECT OF YOGA INTERVENTIONS ON CANCER-RELATED FATIGUE AND QUALITY OF LIFE FOR WOMEN WITH BREAST CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. BACKGROUND: WOMEN WITH BREAST CANCER (BC) ARE LIVING LONGER WITH DEBILITATING SIDE EFFECTS SUCH AS CANCER-RELATED FATIGUE (CRF) THAT AFFECT OVERALL WELL-BEING. YOGA PROMOTES HEALTH, WELL-BEING AND MAY BE BENEFICIAL IN REDUCING CRF. ALTHOUGH THERE HAVE BEEN PREVIOUS SYSTEMATIC REVIEWS AND META-ANALYSES, THE EFFECTS OF YOGA ON CRF AND QUALITY OF LIFE (QOL) REMAIN UNCLEAR, PARTICULARLY IN COMPARISON WITH OTHER TYPES OF PHYSICAL ACTIVITY (PA). OUR OBJECTIVE IS TO CARRY OUT A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EFFECTS OF YOGA ON CRF AND QOL IN WOMEN WITH BC. METHODS: ELECTRONIC DATABASES WERE SEARCHED (MEDLINE, EMBASE CLASSIC+EMBASE AND EMB REVIEWS, COCHRANE CENTRAL CT) FROM INCEPTION TO MAY 2018. RANDOMIZED CONTROLLED TRIALS WERE INCLUDED IF THEY WERE FULL TEXT, IN ENGLISH, INCLUDED A YOGA INTERVENTION, A COMPARATOR (INCLUDING NON-PA USUAL CARE OR ALTERNATE PA INTERVENTION), AND REPORTED ON CRF OR QOL. EFFECTS OF YOGA WERE POOLED USING STANDARDIZED MEAN DIFFERENCE (SMD) VIA A RANDOM EFFECTS MODEL. RESULTS: OF THE 2468 RECORDS RETRIEVED, 24 TRIALS WERE INCLUDED; 18 STUDIES COMPARED YOGA TO A NON-PA COMPARATOR AND 6 TO A PA COMPARATOR. YOGA DEMONSTRATED STATISTICALLY SIGNIFICANT IMPROVEMENTS IN CRF OVER NON-PA (SMD -0.30 [-0.51; -0.08]) BUT NOT PA (SMD -0.17 [-0.50; 0.17]) COMPARATORS. ADDITIONALLY, YOGA DEMONSTRATED STATISTICALLY SIGNIFICANT IMPROVEMENTS IN QOL OVER NON-PA (SMD -0.27 [-0.46; -0.07]) BUT NOT PA (SMD 0.04 [-0.22; +0.31]) COMPARATORS. DISCUSSION: THIS META-ANALYSIS FOUND THAT YOGA PROVIDES SMALL TO MEDIUM IMPROVEMENTS IN CRF AND QOL COMPARED TO NON-PA, BUT NOT IN COMPARISON TO OTHER PA INTERVENTIONS. 2020 4 1299 50 HATHA YOGA FOR ACUTE, CHRONIC AND/OR TREATMENT-RESISTANT MOOD AND ANXIETY DISORDERS: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: THE AIM OF THIS STUDY WAS TO SYSTEMATICALLY INVESTIGATE THE EFFECTIVENESS OF HATHA YOGA IN TREATING ACUTE, CHRONIC AND/OR TREATMENT-RESISTANT MOOD AND ANXIETY DISORDERS. METHODS: MEDLINE, COCHRANE LIBRARY, CURRENT CONTROLLED TRIALS, CLINICAL TRIALS.GOV, NHR CENTRE FOR REVIEWS AND DISSEMINATION, PSYCINFO AND CINAHL WERE SEARCHED THROUGH JUNE 2018. RANDOMIZED CONTROLLED TRIALS WITH PATIENTS WITH MOOD AND ANXIETY DISORDERS WERE INCLUDED. MAIN OUTCOMES WERE CONTINUOUS MEASURES OF SEVERITY OF MOOD AND ANXIETY SYMPTOMS. COHEN'S D WAS CALCULATED AS A MEASURE OF EFFECT SIZE. META-ANALYSES USING A RANDOM EFFECTS MODEL WAS APPLIED TO ESTIMATE DIRECT COMPARISONS BETWEEN YOGA AND CONTROL CONDITIONS FOR DEPRESSION AND ANXIETY OUTCOMES. PUBLICATION BIAS WAS VISUALLY INSPECTED USING FUNNEL PLOTS. RESULTS: EIGHTEEN STUDIES WERE FOUND, FOURTEEN IN ACUTE PATIENTS AND FOUR IN CHRONIC PATIENTS. MOST STUDIES WERE OF LOW QUALITY. FOR DEPRESSION OUTCOMES, HATHA YOGA DID NOT SHOW A SIGNIFICANT EFFECT WHEN COMPARED TO TREATMENT AS USUAL, AN OVERALL EFFECT SIZE OF COHEN'S D -0.64 (95% CI = -1.41, 0.13) OR TO ALL ACTIVE CONTROL GROUPS, COHEN'S D -0.13 (95% CI = -0.49, 0.22). A SUB-ANALYSIS SHOWED THAT YOGA HAD A SIGNIFICANT EFFECT ON THE REDUCTION OF DEPRESSION COMPARED TO PSYCHOEDUCATION CONTROL GROUPS, COHEN'S D -0.52 (95% CI = -0.96, -0.08) BUT NOT TO OTHER ACTIVE CONTROL GROUPS, COHEN'S D 0.28 (95% CI = -0.07, 0.63) FOR STUDIES USING A FOLLOW-UP OF SIX MONTHS OR MORE, HATHA YOGA HAD NO EFFECT ON THE REDUCTION OF DEPRESSION COMPARED TO ACTIVE CONTROL GROUPS, COHEN'S D -0.14 (95% CI = -0.60, 0.33). REGARDING ANXIETY, HATHA YOGA HAD NO SIGNIFICANT EFFECT WHEN COMPARED TO ACTIVE CONTROL GROUPS, COHEN'S D -0.09 (95% CI = -0.47, 0.30). THE I2 AND Q-STATISTIC REVEALED HETEROGENEITY AMONGST COMPARISONS. QUALITATIVE ANALYSES SUGGEST SOME PROMISE OF HATHA YOGA FOR CHRONIC POPULATIONS. CONCLUSIONS: THE ABILITY TO DRAW FIRM CONCLUSIONS IS LIMITED BY THE NOTABLE HETEROGENEITY AND LOW QUALITY OF MOST OF THE INCLUDED STUDIES. WITH THIS CAVEAT IN MIND, THE RESULTS OF THE CURRENT META-ANALYSIS SUGGEST THAT HATHA YOGA DOES NOT HAVE EFFECTS ON ACUTE, CHRONIC AND/OR TREATMENT-RESISTANT MOOD AND ANXIETY DISORDERS COMPARED TO TREATMENT AS USUAL OR ACTIVE CONTROL GROUPS. HOWEVER, WHEN COMPARED TO PSYCHOEDUCATION, HATHA YOGA SHOWED MORE REDUCTIONS IN DEPRESSION. IT IS CLEAR THAT MORE HIGH-QUALITY STUDIES ARE NEEDED TO ADVANCE THE FIELD. 2018 5 2397 46 YOGA AND COGNITION: A META-ANALYSIS OF CHRONIC AND ACUTE EFFECTS. OBJECTIVES: TO REVIEW AND SYNTHESIZE THE EXISTING LITERATURE ON THE EFFECTS OF YOGA ON COGNITIVE FUNCTION BY DETERMINING EFFECT SIZES THAT COULD SERVE AS A PLATFORM TO DESIGN, CALCULATE STATISTICAL POWER, AND IMPLEMENT FUTURE STUDIES. METHODS: THROUGH ELECTRONIC DATABASES, WE IDENTIFIED ACUTE STUDIES AND RANDOMIZED CONTROLLED TRIALS (RCTS) OF YOGA THAT REPORTED COGNITIVE OUTCOMES. INCLUSION CRITERIA INCLUDED THE FOLLOWING: USE OF AN OBJECTIVE MEASURE OF COGNITION AND SUFFICIENT DATA REPORTED TO ESTIMATE AN EFFECT SIZE. THE META-ANALYSIS WAS CONDUCTED USING COMPREHENSIVE META-ANALYSIS SOFTWARE. A RANDOM-EFFECTS MODEL WAS USED TO CALCULATE THE OVERALL WEIGHTED EFFECT SIZES, EXPRESSED AS HEDGE G. RESULTS: FIFTEEN RCTS AND 7 ACUTE EXPOSURE STUDIES EXAMINED THE EFFECTS OF YOGA ON COGNITION. A MODERATE EFFECT (G = 0.33, STANDARD ERROR = 0.08, 95% CONFIDENCE INTERVAL = 0.18-0.48, P < .001) OF YOGA ON COGNITION WAS OBSERVED FOR RCTS, WITH THE STRONGEST EFFECT FOR ATTENTION AND PROCESSING SPEED (G = 0.29, P < .001), FOLLOWED BY EXECUTIVE FUNCTION (G = 0.27, P = .001) AND MEMORY (G = 0.18, P = .051). ACUTE STUDIES SHOWED A STRONGER OVERALL EFFECT OF YOGA ON COGNITION (G = 0.56, STANDARD ERROR = 0.11, 95% CONFIDENCE INTERVAL = 0.33-0.78, P < .001). THE EFFECT WAS STRONGEST FOR MEMORY (G = 0.78, P < .001), FOLLOWED BY ATTENTION AND PROCESSING SPEED MEASURES (G = 0.49, P < .001) AND EXECUTIVE FUNCTIONS (G = 0.39, P < .003). CONCLUSIONS: YOGA PRACTICE SEEMS TO BE ASSOCIATED WITH MODERATE IMPROVEMENTS IN COGNITIVE FUNCTION. ALTHOUGH THE STUDIES ARE LIMITED BY SAMPLE SIZE, HETEROGENEOUS POPULATION CHARACTERISTICS, VARIED DOSES OF YOGA INTERVENTIONS, AND A MYRIAD OF COGNITIVE TESTS, THESE FINDINGS WARRANT RIGOROUS SYSTEMATIC RCTS AND WELL-DESIGNED COUNTERBALANCED ACUTE STUDIES TO COMPREHENSIVELY EXPLORE YOGA AS A MEANS TO IMPROVE OR SUSTAIN COGNITIVE ABILITIES ACROSS THE LIFE SPAN. 2015 6 223 42 A SYSTEMATIC REVIEW AND META-ANALYSIS ON THE EFFECTS OF YOGA ON WEIGHT-RELATED OUTCOMES. INTRODUCTION: OVERWEIGHT AND OBESITY ARE AMONG THE MOST IMPORTANT MODIFIABLE RISK FACTORS FOR CHRONIC DISEASES AND PREMATURE DEATH. THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY ASSESS AND ANALYZE THE EFFECTS OF YOGA ON WEIGHT-RELATED OUTCOMES. METHODS: MEDLINE/PUBMED, SCOPUS, AND THE COCHRANE LIBRARY WERE SCREENED THROUGH MARCH 2015 FOR RANDOMIZED CONTROLLED TRIALS ON YOGA FOR WEIGHT-RELATED OUTCOMES IN THE GENERAL POPULATION OR OVERWEIGHT/OBESE INDIVIDUALS. RISK OF BIAS WAS ASSESSED USING THE COCHRANE RISK OF BIAS TOOL ON THE FOLLOWING DOMAINS: SELECTION BIAS, PERFORMANCE BIAS, DETECTION BIAS, ATTRITION BIAS, REPORTING BIAS, AND OTHER BIAS. RESULTS: OUT OF 445 RECORDS IDENTIFIED DURING LITERATURE SEARCH, 30 TRIALS WITH A TOTAL OF 2173 PARTICIPANTS WERE INCLUDED. NO EFFECTS ON WEIGHT, BODY MASS INDEX, BODY FAT PERCENTAGE OR WAIST CIRCUMFERENCE WERE FOUND. IN STUDIES WITH HEALTHY ADULT PARTICIPANTS AN EFFECT OF YOGA COMPARED TO USUAL CARE WAS FOUND REGARDING WAIST/HIP RATIO (SMD=--1.00; 95% CI=--1.44, -0.55; P<0.001). IN STUDIES WITH OVERWEIGHT/OBESE PARTICIPANTS ONLY, EFFECTS RELATIVE TO USUAL CARE WERE FOUND FOR BODY MASS INDEX (SMD=-0.99; 95% CI=-1.67, -0.31; P=0.004). EFFECTS HOWEVER WERE NOT ROBUST AGAINST SELECTION BIAS; AND PUBLICATION BIAS COULD NOT BE RULED OUT. NO INTERVENTION-RELATED ADVERSE EVENTS WERE REPORTED. CONCLUSIONS: DESPITE METHODOLOGICAL DRAWBACKS, YOGA CAN BE PRELIMINARILY CONSIDERED A SAFE AND EFFECTIVE INTERVENTION TO REDUCE BODY MASS INDEX IN OVERWEIGHT OR OBESE INDIVIDUALS. 2016 7 231 41 A SYSTEMATIC REVIEW OF YOGA FOR HEART DISEASE. BACKGROUND: THIS SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS (RCTS) AIMED TO EVALUATE THE QUALITY OF EVIDENCE AND THE STRENGTH OF RECOMMENDATION FOR YOGA AS AN ANCILLARY INTERVENTION FOR HEART DISEASE. METHODS: MEDLINE/PUBMED, SCOPUS, THE COCHRANE LIBRARY, AND INDMED WERE SEARCHED UP TO OCTOBER 2013. MAIN OUTCOME MEASURES WERE MORTALITY, NONFATAL CARDIAC EVENTS, EXERCISE CAPACITY, HEALTH-RELATED QUALITY OF LIFE, AND MODIFIABLE CARDIAC RISK FACTORS. RISK OF BIAS, QUALITY OF EVIDENCE, AND THE STRENGTH OF THE RECOMMENDATION FOR OR AGAINST YOGA WERE ASSESSED ACCORDING TO THE COCHRANE COLLABORATION AND GRADE RECOMMENDATIONS. RESULTS: SEVEN RCTS WITH 624 PATIENTS COMPARING YOGA TO USUAL CARE WERE INCLUDED. FOR CORONARY HEART DISEASE (FOUR RCTS), THERE WAS VERY LOW EVIDENCE FOR NO EFFECT ON MORTALITY, FOR A REDUCED NUMBER OF ANGINA EPISODES, AND FOR INCREASED EXERCISE CAPACITY, AND LOW EVIDENCE FOR REDUCED MODIFIABLE CARDIAC RISK FACTORS. FOR HEART FAILURE (TWO RCTS), THERE WAS VERY LOW EVIDENCE FOR NO EFFECT ON MORTALITY, AND LOW EVIDENCE FOR INCREASED EXERCISE CAPACITY, AND FOR NO EFFECT ON HEALTH-RELATED QUALITY OF LIFE. FOR CARDIAC DYSRHYTHMIAS TREATED WITH IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR (ONE RCT), THERE WAS VERY LOW EVIDENCE FOR NO EFFECT ON MORTALITY, AND FOR IMPROVED QUALITY, AND LOW EVIDENCE FOR EFFECTS ON NONFATAL DEVICE-TREATED VENTRICULAR EVENTS. THREE RCTS REPORTED SAFETY DATA AND REPORTED THAT NO ADVERSE EVENTS OCCURRED. CONCLUSIONS: BASED ON THE RESULTS OF THIS REVIEW, WEAK RECOMMENDATIONS CAN BE MADE FOR THE ANCILLARY USE OF YOGA FOR PATIENTS WITH CORONARY HEART DISEASE, HEART FAILURE, AND CARDIAC DYSRHYTHMIA AT THIS POINT. 2015 8 2566 47 YOGA FOR DEPRESSION AND ANXIETY SYMPTOMS IN PEOPLE WITH CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVE: CANCER AND ITS TREATMENT CAN LEAD TO A VARIETY OF PHYSICAL AND EMOTIONAL CONCERNS IMPACTING ON THOSE AFFECTED, INCLUDING SUBCLINICAL OR CLINICAL DEPRESSION AND ANXIETY, WHICH IN TURN HAVE A SIGNIFICANT IMPACT ON WELLBEING, QUALITY OF LIFE AND SURVIVAL. THE AIM OF THIS REVIEW WAS TO EVALUATE THE EFFECT OF YOGA-BASED INTERVENTIONS ON SELF-REPORTED DEPRESSION AND ANXIETY SYMPTOMS IN PEOPLE WITH CANCER IN RANDOMIZED CONTROLLED TRIALS. METHOD: SIX DATABASES WERE SEARCHED TO IDENTIFY RELEVANT STUDIES. SYSTEMATIC REVIEW PROCEDURES WERE FOLLOWED INCLUDING A QUALITY ASSESSMENT. META-ANALYSIS OF SUITABLE STUDIES WAS CONDUCTED. RESULTS: 26 STUDIES FROM OUR SEARCH CRITERIA WERE ELIGIBLE FOR INCLUSION FOR DEPRESSIVE AND 16 FOR ANXIETY SYMPTOMS. META-ANALYSES REVEALED EVIDENCE FOR SIGNIFICANT MEDIUM EFFECTS OF YOGA ON DEPRESSION SYMPTOMS (N = 1,486, G = -0.419, 95% CONFIDENCE INTERVAL [CI] = -0.558 TO -0.281, P < 0.001) AND ANXIETY (N = 977, G = -0.347, 95% CI = -0.473 TO -0.221, P < 0.001) COMPARED TO CONTROLS. SUBGROUP ANALYSES FOR DEPRESSIVE SYMPTOMS REVEALED SIGNIFICANT EFFECTS FOR ALL ANALYSES PERFORMED (TYPE OF CANCER, TYPE OF CONTROL, TREATMENT STATUS, DURATION OF INTERVENTION OR FREQUENCY OF YOGA SESSIONS), WITH EFFECT SIZES BEING COMPARABLE BETWEEN SUBGROUPS. SIMILAR FINDINGS WERE FOUND FOR ANXIETY SYMPTOMS EXCEPT FOR TREATMENT STATUS, WHERE THE ONLY SIGNIFICANT EFFECT WAS FOUND WHEN YOGA WAS DELIVERED DURING ACTIVE TREATMENT. CONCLUSIONS: THIS REVIEW PROVIDES EVIDENCE THAT IN PEOPLE WITH CANCER, YOGA-BASED INTERVENTIONS ARE ASSOCIATED WITH AMELIORATION OF DEPRESSION AND ANXIETY SYMPTOMS AND THEREFORE A PROMISING THERAPEUTIC MODALITY FOR THEIR MANAGEMENT. HOWEVER, THE POTENTIAL FOR RISK OF BIAS TOGETHER WITH CONTROL GROUP DESIGN CHALLENGES MEANS THE RESULTS SHOULD BE INTERPRETED WITH CAUTION. 2021 9 2620 74 YOGA FOR STROKE REHABILITATION. BACKGROUND: STROKE IS A MAJOR HEALTH ISSUE AND CAUSE OF LONG-TERM DISABILITY AND HAS A MAJOR EMOTIONAL AND SOCIOECONOMIC IMPACT. THERE IS A NEED TO EXPLORE OPTIONS FOR LONG-TERM SUSTAINABLE INTERVENTIONS THAT SUPPORT STROKE SURVIVORS TO ENGAGE IN MEANINGFUL ACTIVITIES TO ADDRESS LIFE CHALLENGES AFTER STROKE. REHABILITATION FOCUSES ON RECOVERY OF FUNCTION AND COGNITION TO THE MAXIMUM LEVEL ACHIEVABLE, AND MAY INCLUDE A WIDE RANGE OF COMPLEMENTARY STRATEGIES INCLUDING YOGA.YOGA IS A MIND-BODY PRACTICE THAT ORIGINATED IN INDIA, AND WHICH HAS BECOME INCREASINGLY WIDESPREAD IN THE WESTERN WORLD. RECENT EVIDENCE HIGHLIGHTS THE POSITIVE EFFECTS OF YOGA FOR PEOPLE WITH A RANGE OF PHYSICAL AND PSYCHOLOGICAL HEALTH CONDITIONS. A RECENT NON-COCHRANE SYSTEMATIC REVIEW CONCLUDED THAT YOGA CAN BE USED AS SELF-ADMINISTERED PRACTICE IN STROKE REHABILITATION. OBJECTIVES: TO ASSESS THE EFFECTIVENESS OF YOGA, AS A STROKE REHABILITATION INTERVENTION, ON RECOVERY OF FUNCTION AND QUALITY OF LIFE (QOL). SEARCH METHODS: WE SEARCHED THE COCHRANE STROKE GROUP TRIALS REGISTER (LAST SEARCHED JULY 2017), COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL) (LAST SEARCHED JULY 2017), MEDLINE (TO JULY 2017), EMBASE (TO JULY 2017), CINAHL (TO JULY 2017), AMED (TO JULY 2017), PSYCINFO (TO JULY 2017), LILACS (TO JULY 2017), SCIELO (TO JULY 2017), INDMED (TO JULY 2017), OTSEEKER (TO JULY 2017) AND PEDRO (TO JULY 2017). WE ALSO SEARCHED FOUR TRIALS REGISTERS, AND ONE CONFERENCE ABSTRACTS DATABASE. WE SCREENED REFERENCE LISTS OF RELEVANT PUBLICATIONS AND CONTACTED AUTHORS FOR ADDITIONAL INFORMATION. SELECTION CRITERIA: WE INCLUDED RANDOMISED CONTROLLED TRIALS (RCTS) THAT COMPARED YOGA WITH A WAITING-LIST CONTROL OR NO INTERVENTION CONTROL IN STROKE SURVIVORS. DATA COLLECTION AND ANALYSIS: TWO REVIEW AUTHORS INDEPENDENTLY EXTRACTED DATA FROM THE INCLUDED STUDIES. WE PERFORMED ALL ANALYSES USING REVIEW MANAGER (REVMAN). ONE REVIEW AUTHOR ENTERED THE DATA INTO REVMAN; ANOTHER CHECKED THE ENTRIES. WE DISCUSSED DISAGREEMENTS WITH A THIRD REVIEW AUTHOR UNTIL CONSENSUS WAS REACHED. WE USED THE COCHRANE 'RISK OF BIAS' TOOL. WHERE WE CONSIDERED STUDIES TO BE SUFFICIENTLY SIMILAR, WE CONDUCTED A META-ANALYSIS BY POOLING THE APPROPRIATE DATA. FOR OUTCOMES FOR WHICH IT WAS INAPPROPRIATE OR IMPOSSIBLE TO POOL QUANTITATIVELY, WE CONDUCTED A DESCRIPTIVE ANALYSIS AND PROVIDED A NARRATIVE SUMMARY. MAIN RESULTS: WE INCLUDED TWO RCTS INVOLVING 72 PARTICIPANTS. SIXTY-NINE PARTICIPANTS WERE INCLUDED IN ONE META-ANALYSIS (BALANCE). BOTH TRIALS ASSESSED QOL, ALONG WITH SECONDARY OUTCOMES MEASURES RELATING TO MOVEMENT AND PSYCHOLOGICAL OUTCOMES; ONE ALSO MEASURED DISABILITY.IN ONE STUDY THE STROKE IMPACT SCALE WAS USED TO MEASURE QOL ACROSS SIX DOMAINS, AT BASELINE AND POST-INTERVENTION. THE EFFECT OF YOGA ON FIVE DOMAINS (PHYSICAL, EMOTION, COMMUNICATION, SOCIAL PARTICIPATION, STROKE RECOVERY) WAS NOT SIGNIFICANT; HOWEVER, THE EFFECT OF YOGA ON THE MEMORY DOMAIN WAS SIGNIFICANT (MEAN DIFFERENCE (MD) 15.30, 95% CONFIDENCE INTERVAL (CI) 1.29 TO 29.31, P = 0.03), THE EVIDENCE FOR THIS FINDING WAS VERY LOW GRADE. IN THE SECOND STUDY, QOL WAS ASSESSED USING THE STROKE-SPECIFC QOL SCALE; NO SIGNIFICANT EFFECT WAS FOUND.SECONDARY OUTCOMES INCLUDED MOVEMENT, STRENGTH AND ENDURANCE, AND PSYCHOLOGICAL VARIABLES, PAIN, AND DISABILITY.BALANCE WAS MEASURED IN BOTH STUDIES USING THE BERG BALANCE SCALE; THE EFFECT OF INTERVENTION WAS NOT SIGNIFICANT (MD 2.38, 95% CI -1.41 TO 6.17, P = 0.22). SENSITITIVY ANALYSIS DID NOT ALTER THE DIRECTION OF EFFECT. ONE STUDY MEASURED BALANCE SELF-EFFICACY, USING THE ACTIVITIES-SPECIFIC BALANCE CONFIDENCE SCALE (MD 10.60, 95% CI -7.08,= TO 28.28, P = 0.24); THE EFFECT OF INTERVENTION WAS NOT SIGNIFICANT; THE EVIDENCE FOR THIS FINDING WAS VERY LOW GRADE.ONE STUDY MEASURED GAIT USING THE COMFORTABLE SPEED GAIT TEST (MD 1.32, 95% CI -1.35 TO 3.99, P = 0.33), AND MOTOR FUNCTION USING THE MOTOR ASSESSMENT SCALE (MD -4.00, 95% CI -12.42 TO 4.42, P = 0.35); NO SIGNIFICANT EFFECT WAS FOUND BASED ON VERY LOW-GRADE EVIDENCE.ONE STUDY MEASURED DISABILITY USING THE MODIFIED RANKIN SCALE (MRS) BUT REPORTED ONLY WHETHER PARTICIPANTS WERE INDEPENDENT OR DEPENDENT. NO SIGNIFICANT EFFECT WAS FOUND: (ODDS RATIO (OR) 2.08, 95% CI 0.50 TO 8.60, P = 0.31); THE EVIDENCE FOR THIS FINDING WAS VERY LOW GRADE.ANXIETY AND DEPRESSION WERE MEASURED IN ONE STUDY. THREE MEASURES WERE USED: THE GERIATRIC DEPRESSION SCALE-SHORT FORM (GCDS15), AND TWO FORMS OF STATE TRAIT ANXIETY INVENTORY (STAI, FORM Y) TO MEASURE STATE ANXIETY (I.E. ANXIETY EXPERIENCED IN RESPONSE TO STRESSFUL SITUATIONS) AND TRAIT ANXIETY (I.E. ANXIETY ASSOCIATED WITH CHRONIC PSYCHOLOGICAL DISORDERS). NO SIGNIFICANT EFFECT WAS FOUND FOR DEPRESSION (GDS15, MD -2.10, 95% CI -4.70 TO 0.50, P = 0.11) OR FOR TRAIT ANXIETY (STAI-Y2, MD -6.70, 95% CI -15.35 TO 1.95, P = 0.13), BASED ON VERY LOW-GRADE EVIDENCE. HOWEVER, A SIGNIFICANT EFFECT WAS FOUND FOR STATE ANXIETY: STAI-Y1 (MD -8.40, 95% CI -16.74 TO -0.06, P = 0.05); THE EVIDENCE FOR THIS FINDING WAS VERY LOW GRADE.NO ADVERSE EVENTS WERE REPORTED.QUALITY OF THE EVIDENCEWE ASSESSED THE QUALITY OF THE EVIDENCE USING GRADE. OVERALL, THE QUALITY OF THE EVIDENCE WAS VERY LOW, DUE TO THE SMALL NUMBER OF TRIALS INCLUDED IN THE REVIEW BOTH OF WHICH WERE JUDGED TO BE AT HIGH RISK OF BIAS, PARTICULARLY IN RELATION TO INCOMPLETENESS OF DATA AND SELECTIVE REPORTING, AND ESPECIALLY REGARDING THE REPRESENTATIVE NATURE OF THE SAMPLE IN ONE STUDY. AUTHORS' CONCLUSIONS: YOGA HAS THE POTENTIAL FOR BEING INCLUDED AS PART OF PATIENT-CENTRED STROKE REHABILITATION. HOWEVER, THIS REVIEW HAS IDENTIFIED INSUFFICIENT INFORMATION TO CONFIRM OR REFUTE THE EFFECTIVENESS OR SAFETY OF YOGA AS A STROKE REHABILITATION TREATMENT. FURTHER LARGE-SCALE METHODOLOGICALLY ROBUST TRIALS ARE REQUIRED TO ESTABLISH THE EFFECTIVENESS OF YOGA AS A STROKE REHABILITATION TREATMENT. 2017 10 590 51 DETERMINING THE POTENTIAL BENEFITS OF YOGA IN CHRONIC STROKE CARE: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: SURVIVORS OF STROKE HAVE LONG-TERM PHYSICAL AND PSYCHOLOGICAL CONSEQUENCES THAT IMPACT THEIR QUALITY OF LIFE. FEW INTERVENTIONS ARE AVAILABLE IN THE COMMUNITY TO ADDRESS THESE PROBLEMS. YOGA, A TYPE OF MINDFULNESS-BASED INTERVENTION, IS SHOWN TO BE EFFECTIVE IN PEOPLE WITH OTHER CHRONIC ILLNESSES AND MAY HAVE THE POTENTIAL TO ADDRESS MANY OF THE PROBLEMS REPORTED BY SURVIVORS OF STROKE. OBJECTIVES: TO DATE ONLY NARRATIVE REVIEWS HAVE BEEN PUBLISHED. WE SOUGHT TO PERFORM, THE FIRST SYSTEMATIC REVIEW WITH META-ANALYSES OF RANDOMIZED CONTROLLED TRIALS (RCTS) THAT INVESTIGATED YOGA FOR ITS POTENTIAL BENEFIT FOR CHRONIC SURVIVORS OF STROKE. METHODS: OVID MEDLINE, CINHAL PLUS, AMED, PUBMED, PSYCHINFO, PEDRO, COCHRANE DATABASE, SPORT DISCUSS, AND GOOGLE SCHOLAR WERE SEARCHED FOR PAPERS PUBLISHED BETWEEN JANUARY 1950 AND AUGUST 2016. REFERENCE LISTS OF INCLUDED PAPERS, REVIEW ARTICLES AND OPENGREY FOR GREY LITERATURE WERE ALSO SEARCHED. WE USED A MODIFIED COCHRANE TOOL TO EVALUATE RISK OF BIAS. THE METHODOLOGICAL QUALITY OF RCTS WAS ASSESSED USING THE GRADE APPROACH, RESULTS WERE COLLATED, AND RANDOM EFFECTS META-ANALYSES PERFORMED WHERE APPROPRIATE. RESULTS: THE SEARCH YIELDED FIVE ELIGIBLE PAPERS FROM FOUR RCTS WITH SMALL SAMPLE SIZES (N = 17-47). QUALITY OF RCTS WAS RATED AS LOW TO MODERATE. YOGA IS BENEFICIAL IN REDUCING STATE ANXIETY SYMPTOMS AND DEPRESSION IN THE INTERVENTION GROUP COMPARED TO THE CONTROL GROUP (MEAN DIFFERENCES FOR STATE ANXIETY 6.05, 95% CI:-0.02 TO 12.12; P = 0.05 AND STANDARDIZED MEAN DIFFERENCES FOR DEPRESSION: 0.50, 95% CI:-0.01 TO 1.02; P = 0.05). CONSISTENT BUT NONSIGNIFICANT IMPROVEMENTS WERE DEMONSTRATED FOR BALANCE, TRAIT ANXIETY, AND OVERALL QUALITY OF LIFE. CONCLUSIONS: YOGA MAY BE EFFECTIVE FOR AMELIORATING SOME OF THE LONG-TERM CONSEQUENCES OF STROKE. LARGE WELL-DESIGNED RCTS ARE NEEDED TO CONFIRM THESE FINDINGS. 2017 11 1057 39 EFFECTS OF YOGA ON DEPRESSIVE SYMPTOMS IN PEOPLE WITH MENTAL DISORDERS: A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVE: TO ASSESS WHETHER PHYSICALLY ACTIVE YOGA IS SUPERIOR TO WAITLIST CONTROL, TREATMENT AS USUAL AND ATTENTION CONTROL IN ALLEVIATING DEPRESSIVE SYMPTOMS IN PEOPLE WITH A DIAGNOSED MENTAL DISORDER RECOGNISED BY THE DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS (DSM). DESIGN: SYSTEMATIC REVIEW AND META-ANALYSIS FOLLOWING THE PREFERRED REPORTING ITEMS FOR SYSTEMATIC REVIEWS AND META-ANALYSES (PRISMA) GUIDELINES. DATA SOURCES: DATA WERE OBTAINED FROM ONLINE DATABASES (MEDLINE, EMBASE, PSYCHINFO, CENTRAL, EMCARE, PEDRO). THE SEARCH AND COLLECTION OF ELIGIBLE STUDIES WAS CONDUCTED UP TO 14 MAY 2019 (PROSPERO REGISTRATION NO CRD42018090441). ELIGIBILITY CRITERIA FOR SELECTING STUDIES: WE INCLUDED RANDOMISED CONTROLLED TRIALS WITH A YOGA INTERVENTION COMPRISING >/=50% PHYSICAL ACTIVITY IN ADULTS WITH A RECOGNISED DIAGNOSED MENTAL DISORDER ACCORDING TO DSM-3, 4 OR 5. RESULTS: 19 STUDIES WERE INCLUDED IN THE REVIEW (1080 PARTICIPANTS) AND 13 STUDIES WERE INCLUDED IN THE META-ANALYSIS (632 PARTICIPANTS). DISORDERS OF DEPRESSION, POST-TRAUMATIC STRESS, SCHIZOPHRENIA, ANXIETY, ALCOHOL DEPENDENCE AND BIPOLAR WERE INCLUDED. YOGA SHOWED GREATER REDUCTIONS IN DEPRESSIVE SYMPTOMS THAN WAITLIST, TREATMENT AS USUAL AND ATTENTION CONTROL (STANDARDISED MEAN DIFFERENCE=0.41; 95% CI -0.65 TO -0.17; P<0.001). GREATER REDUCTIONS IN DEPRESSIVE SYMPTOMS WERE ASSOCIATED WITH HIGHER FREQUENCY OF YOGA SESSIONS PER WEEK (BETA=-0.44, P<0.01). 2021 12 1202 40 EXERCISE, YOGA, AND TAI CHI FOR TREATMENT OF MAJOR DEPRESSIVE DISORDER IN OUTPATIENT SETTINGS: A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVE: EXERCISE, YOGA, AND TAI CHI ARE COMMONLY USED COMPLEMENTARY APPROACHES FOR HEALTH AND WELLNESS. THIS REVIEW AIMS TO SYNTHESIZE THE EVIDENCE FOR EXERCISE, YOGA, AND TAI CHI IN THE OUTPATIENT TREATMENT OF MAJOR DEPRESSIVE DISORDER. STUDY SELECTION: A SYSTEMATIC SEARCH OF THE OVID MEDLINE, EMBASE, PSYCINFO, AND COCHRANE DATABASES WAS CONDUCTED FOR RANDOMIZED CONTROLLED TRIALS OF EXERCISE, YOGA, AND TAI CHI FOR MAJOR DEPRESSIVE DISORDER. DATA EXTRACTION: STANDARDIZED MEAN DIFFERENCES WERE CALCULATED AND META-ANALYZED USING A RANDOM EFFECTS MULTILEVEL MODELING FRAMEWORK. HETEROGENEITY AND SUBGROUP ANALYSIS WAS CONDUCTED. RESULTS: TWENTY-FIVE STUDIES WERE INCLUDED FOR FINAL ANALYSIS (EXERCISE: 15, YOGA: 7, TAI CHI: 3). OVERALL, META-ANALYSIS SHOWED A MODERATE SIGNIFICANT CLINICAL EFFECT. HOWEVER, WHEN ONLY STUDIES (6 STUDIES) WITH THE LOWEST RISK OF BIAS WERE INCLUDED, THE OVERALL EFFECT SIZE WAS REDUCED TO LOW TO MODERATE EFFICACY. OVERALL QUALITY OF EVIDENCE WAS LOW. HETEROGENEITY AND PUBLICATION BIAS WERE HIGH. CONCLUSIONS: THE CURRENT META-ANALYSIS OF OUTPATIENT EXERCISE, YOGA, AND TAI CHI FOR TREATMENT OF MAJOR DEPRESSIVE DISORDER SUGGESTS THAT ADJUNCTIVE EXERCISE AND YOGA MAY HAVE SMALL ADDITIVE CLINICAL EFFECTS IN COMPARISON TO CONTROL FOR REDUCING DEPRESSIVE SYMPTOMS. THE EVIDENCE FOR TAI CHI IS INSUFFICIENT TO DRAW CONCLUSIONS. THE CONCERNS WITH QUALITY OF STUDIES, HIGH HETEROGENEITY, AND EVIDENCE OF PUBLICATION BIAS PRECLUDE MAKING FIRM CONCLUSIONS. 2020 13 1077 47 EFFECTS OF YOGA ON PSYCHOLOGIC FUNCTION AND QUALITY OF LIFE IN WOMEN WITH BREAST CANCER: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. OBJECTIVE: THE AIM OF THIS META-ANALYSIS WAS TO EVALUATE THE EFFECTS OF YOGA ON PSYCHOLOGIC FUNCTION AND QUALITY OF LIFE (QOL) IN WOMEN WITH BREAST CANCER. DESIGN: A SYSTEMATIC SEARCH OF PUBMED, EMBASE, THE COCHRANE LIBRARY, THE CHINESE BIOMEDICAL LITERATURE DATABASE, AND THE CHINESE DIGITAL JOURNALS FULL-TEXT DATABASE WAS CARRIED OUT. RANDOMIZED CONTROL TRIALS (RCTS) EXAMINING THE EFFECTS OF YOGA, VERSUS A CONTROL GROUP RECEIVING NO INTERVENTION, ON PSYCHOLOGIC FUNCTIONING AND QOL IN WOMEN WITH BREAST CANCER WERE INCLUDED. METHODOLOGICAL QUALITY OF INCLUDED RCTS WAS ASSESSED ACCORDING TO THE COCHRANE HANDBOOK FOR SYSTEMATIC REVIEWS OF INTERVENTIONS 5.0.1, AND DATA WERE ANALYZED USING THE COCHRANE COLLABORATION'S REVIEW MANAGER 5.1. RESULTS: SIX (6) STUDIES INVOLVING 382 PATIENTS WERE INCLUDED. THE META-ANALYSIS SHOWED THAT YOGA CAN IMPROVE QOL FOR WOMEN WITH BREAST CANCER. A STATISTICALLY SIGNIFICANT EFFECT FAVORING YOGA FOR THE OUTCOME OF QOL WAS FOUND (STANDARD MEAN DIFFERENCE=0.27, 95% CONFIDENCE INTERVAL [0.02, 0.52], P=0.03). ALTHOUGH THE EFFECTS OF YOGA ON PSYCHOLOGIC FUNCTION OUTCOMES--SUCH AS ANXIETY, DEPRESSION, DISTRESS AND SLEEP--WERE IN THE EXPECTED DIRECTION, THESE EFFECTS WERE NOT STATISTICALLY SIGNIFICANT (P>0.05). FATIGUE SHOWED NO SIGNIFICANT DIFFERENCE (P>0.05). CONCLUSIONS: THE PRESENT DATA PROVIDED LITTLE INDICATION OF HOW EFFECTIVE YOGA MIGHT BE WHEN THEY WERE APPLIED BY WOMEN WITH BREAST CANCER EXCEPT FOR MILDLY EFFECTIVE IN QOL IMPROVEMENT. THE FINDINGS WERE BASED ON A SMALL BODY OF EVIDENCE IN WHICH METHODOLOGICAL QUALITY WAS NOT HIGH. FURTHER WELL-DESIGNED RCTS WITH LARGE SAMPLE SIZE ARE NEEDED TO CLARIFY THE UTILITY OF YOGA PRACTICE FOR THIS POPULATION. 2012 14 2607 55 YOGA FOR PRENATAL DEPRESSION: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: PRENATAL DEPRESSION CAN NEGATIVELY AFFECT THE PHYSICAL AND MENTAL HEALTH OF BOTH MOTHER AND FETUS. THE AIM OF THIS STUDY WAS TO DETERMINE THE EFFECTIVENESS OF YOGA AS AN INTERVENTION IN THE MANAGEMENT OF PRENATAL DEPRESSION. METHODS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS (RCTS) WAS CONDUCTED BY SEARCHING PUBMED, EMBASE, THE COCHRANE LIBRARY AND PSYCINFO FROM ALL RETRIEVED ARTICLES DESCRIBING SUCH TRIALS UP TO JULY 2014. RESULTS: SIX RCTS WERE IDENTIFIED IN THE SYSTEMATIC SEARCH. THE SAMPLE CONSISTED OF 375 PREGNANT WOMEN, MOST OF WHOM WERE BETWEEN 20 AND 40 YEARS OF AGE. THE DIAGNOSES OF DEPRESSION WERE DETERMINED BY THEIR SCORES ON STRUCTURED CLINICAL INTERVIEW FOR DSM-IV AND THE CENTER FOR EPIDEMIOLOGICAL STUDIES DEPRESSION SCALE. WHEN COMPARED WITH COMPARISON GROUPS (E.G., STANDARD PRENATAL CARE, STANDARD ANTENATAL EXERCISES, SOCIAL SUPPORT, ETC.), THE LEVEL OF DEPRESSION STATISTICALLY SIGNIFICANTLY REDUCED IN YOGA GROUPS (STANDARDIZED MEAN DIFFERENCE [SMD], -0.59; 95% CONFIDENCE INTERVAL [CI], -0.94 TO -0.25; P = 0.0007). ONE SUBGROUP ANALYSIS REVEALED THAT BOTH THE LEVELS OF DEPRESSIVE SYMPTOMS IN PRENATALLY DEPRESSED WOMEN (SMD, -0.46; CI, -0.90 TO -0.03; P = 0.04) AND NON-DEPRESSED WOMEN (SMD, -0.87; CI, -1.22 TO -0.52; P < 0.00001) WERE STATISTICALLY SIGNIFICANTLY LOWER IN YOGA GROUP THAN THAT IN CONTROL GROUP. THERE WERE TWO KINDS OF YOGA: THE PHYSICAL-EXERCISE-BASED YOGA AND INTEGRATED YOGA, WHICH, BESIDES PHYSICAL EXERCISES, INCLUDED PRANAYAMA, MEDITATION OR DEEP RELAXATION. THEREFORE, THE OTHER SUBGROUP ANALYSIS WAS CONDUCTED TO ESTIMATE EFFECTS OF THE TWO KINDS OF YOGA ON PRENATAL DEPRESSION. THE RESULTS SHOWED THAT THE LEVEL OF DEPRESSION WAS SIGNIFICANTLY DECREASED IN THE INTEGRATED YOGA GROUP (SMD, -0.79; CI, -1.07 TO -0.51; P < 0.00001) BUT NOT SIGNIFICANTLY REDUCED IN PHYSICAL-EXERCISE-BASED YOGA GROUP (SMD, -0.41; CI, -1.01 TO -0.18; P = 0.17). CONCLUSIONS: PRENATAL YOGA INTERVENTION IN PREGNANT WOMEN MAY BE EFFECTIVE IN PARTLY REDUCING DEPRESSIVE SYMPTOMS. 2015 15 2178 46 THE EFFECTS OF YOGA ON PAIN, MOBILITY, AND QUALITY OF LIFE IN PATIENTS WITH KNEE OSTEOARTHRITIS: A SYSTEMATIC REVIEW. OBJECTIVE. TO SYSTEMATICALLY ASSESS THE EFFECTS OF YOGA ON PAIN, MOBILITY, AND QUALITY OF LIFE IN PATIENTS WITH KNEE OSTEOARTHRITIS. METHODS. PUBMED, MEDLINE, EMBASE, THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, PHYSIOTHERAPY EVIDENCE DATABASE (PEDRO), AND OTHER SOURCES WERE SEARCHED SYSTEMATICALLY IN THIS STUDY. TWO REVIEWERS IDENTIFIED ELIGIBLE STUDIES AND EXTRACTED DATA INDEPENDENTLY. DOWNS AND BLACK'S QUALITY INDEX WERE USED TO EVALUATE THE METHODOLOGICAL QUALITY OF THE INCLUDED STUDIES. RESULTS. A TOTAL OF 9 ARTICLES (6 STUDIES) INVOLVING 372 PATIENTS WITH KNEE OSTEOARTHRITIS MET THE INCLUSION CRITERIA. THE MOST COMMON YOGA PROTOCOL IS 40~90 MINUTES/SESSION, LASTING FOR AT LEAST 8 WEEKS. THE EFFECT OF YOGA ON PAIN RELIEF AND FUNCTION IMPROVEMENT COULD BE SEEN AFTER TWO-WEEK INTERVENTION. CONCLUSION. THIS SYSTEMATIC REVIEW SHOWED THAT YOGA MIGHT HAVE POSITIVE EFFECTS IN RELIEVING PAIN AND MOBILITY ON PATIENTS WITH KOA, BUT THE EFFECTS ON QUALITY OF LIFE (QOL) ARE UNCLEAR. BESIDES, MORE OUTCOME MEASURE RELATED TO MENTAL HEALTH OF YOGA EFFECTS ON PEOPLE WITH KOA SHOULD BE CONDUCTED. 2016 16 2079 42 THE EFFECT OF EXERCISE, YOGA AND PHYSIOTHERAPY ON THE QUALITY OF LIFE OF PEOPLE WITH MULTIPLE SCLEROSIS: SYSTEMATIC REVIEW AND META-ANALYSIS. INTRODUCTION: MULTIPLE SCLEROSIS (MS) IS A CHRONIC AUTOIMMUNE DISEASE AFFECTING THE MYELINATED AXONS OF THE CENTRAL NERVOUS SYSTEM CAUSING NEUROLOGICAL DETERIORATION. PEOPLE LIVING WITH MS HAVE A POOR QUALITY OF LIFE (QOL) BECAUSE OF THE SYMPTOMS CAUSED BY THE DISEASE AND THERE ARE VARIOUS TYPES OF TREATMENTS TO MANAGE THE SYMPTOMS ASIDE FROM MEDICATION. OBJECTIVE: THIS META-ANALYSIS EXAMINES THE EFFECT OF EXERCISE, YOGA AND PHYSIOTHERAPY ON THE PHYSICAL, MENTAL AND SOCIAL QOL AMONG INDIVIDUALS LIVING WITH MS. SETTING: A SYSTEMATIC REVIEW WITH META-ANALYSIS WAS CONDUCTED USING PUBMED, MEDLINE, AND SCOPUS FROM 1990 TO 2017. THE STANDARD MEAN DIFFERENCE SCORES WERE COMPUTED IN EACH STUDY FOR THE DOMAINS OF PHYSICAL, MENTAL AND SOCIAL FUNCTIONING. RESULTS: EIGHTEEN STUDIES MET THE INCLUSION CRITERIA FOR THIS META-ANALYSIS. AEROBIC EXERCISE WAS EFFECTIVE IN IMPROVING SATISFACTION WITH PHYSICAL FUNCTIONING,D = 0.35 (95% CI = 0.08 TO 0.62), MENTAL FUNCTIONING D = 0.42 (95% CI = 0.11 TO 0.72), AND SOCIAL FUNCTIONING D = 0.42 (95% CI = 0.15 TO 0.69). PHYSIOTHERAPY WAS ALSO FOUND TO BE EFFECTIVE FOR PHYSICAL FUNCTIONING D = 0.50 (95% CI 0.19 TO 0.80), MENTAL FUNCTIONING D = 0.44 (95% CI 0.14 TO 0.75) AND SOCIAL FUNCTIONING D = 0.60 (95% CI 0.21 TO 0.90). HOWEVER YOGA AND COMBINATION OF EXERCISES DID NOT HAVE A SIGNIFICANT EFFECT ON ANY OF THE QOL DOMAINS. CONCLUSION: THESE FINDINGS SUGGEST THAT AEROBIC EXERCISE AND PHYSIOTHERAPY IMPROVES THE SATISFACTION OF MS PATIENTS WITH THEIR PHYSICAL, MENTAL AND SOCIAL FUNCTIONING AND MAY BE INCLUDED AS NORMAL PRACTICE IN THE TREATMENT OF MS. 2019 17 2612 41 YOGA FOR RHEUMATIC DISEASES: A SYSTEMATIC REVIEW. OBJECTIVE: TO EVALUATE THE QUALITY OF EVIDENCE AND THE STRENGTH OF RECOMMENDATION FOR YOGA AS AN ANCILLARY INTERVENTION IN RHEUMATIC DISEASES. METHODS: MEDLINE/PUBMED, SCOPUS, THE COCHRANE LIBRARY AND INDMED WERE SEARCHED THROUGH FEBRUARY 2013. RANDOMIZED CONTROLLED TRIALS (RCTS) COMPARING YOGA WITH CONTROL INTERVENTIONS IN PATIENTS WITH RHEUMATIC DISEASES WERE INCLUDED. TWO AUTHORS INDEPENDENTLY ASSESSED THE RISK OF BIAS USING THE COCHRANE BACK REVIEW GROUP RISK OF BIAS TOOL. THE QUALITY OF EVIDENCE AND THE STRENGTH OF THE RECOMMENDATION FOR OR AGAINST YOGA WERE GRADED ACCORDING TO THE GRADE RECOMMENDATIONS. RESULTS: EIGHT RCTS WITH A TOTAL OF 559 SUBJECTS WERE INCLUDED; TWO RCTS HAD A LOW RISK OF BIAS. IN TWO RCTS ON FM SYNDROME, THERE WAS VERY LOW EVIDENCE FOR EFFECTS ON PAIN AND LOW EVIDENCE FOR EFFECTS ON DISABILITY. IN THREE RCTS ON OA, THERE WAS VERY LOW EVIDENCE FOR EFFECTS ON PAIN AND DISABILITY. BASED ON TWO RCTS, VERY LOW EVIDENCE WAS FOUND FOR EFFECTS ON PAIN IN RA. NO EVIDENCE FOR EFFECTS ON PAIN WAS FOUND IN ONE RCT ON CTS. NO RCT EXPLICITLY REPORTED SAFETY DATA. CONCLUSION: BASED ON THE RESULTS OF THIS REVIEW, ONLY WEAK RECOMMENDATIONS CAN BE MADE FOR THE ANCILLARY USE OF YOGA IN THE MANAGEMENT OF FM SYNDROME, OA AND RA AT THIS POINT. 2013 18 919 41 EFFECTIVENESS OF WORKPLACE YOGA INTERVENTIONS TO REDUCE PERCEIVED STRESS IN EMPLOYEES: A SYSTEMATIC REVIEW AND META-ANALYSIS. WORK-RELATED STRESS REPRESENTS A RELEVANT PUBLIC HEALTH ISSUE AND SOLUTION STRATEGIES ARE MANDATORY. YOGA IS A COMMON APPROACH TO MANAGE STRESS AND ITS EFFECTIVENESS HAS BEEN EXTENSIVELY CONFIRMED. THEREFORE, THIS STUDY AIMS SYSTEMATICALLY TO REVIEW THE EFFECTIVENESS OF YOGA INTERVENTIONS CARRIED OUT AT WORKPLACE ON WORK-RELATED STRESS AMONG EMPLOYEES AND TO ASSESS THEIR IMPACT QUANTITATIVELY. SPRINGERLINK, MEDLINE, PUBMED, CINAHL, WEB OF SCIENCE, SCOPUS, COCHRANE CENTRAL AND PEDRO DATABASES WERE SEARCHED. CLINICAL TRIALS COMPARING WORKPLACE YOGA INTERVENTIONS TO CONTROL GROUPS, AND EVALUATING PERCEIVED STRESS AS OUTCOME MEASURE, WERE ASSESSED FOR ELIGIBILITY. ALL FORMS AND STYLES OF YOGA WERE CONSIDERED FOR THE ANALYSIS. OUT OF 3392 INITIALLY IDENTIFIED, 6 STUDIES WERE INCLUDED IN THE META-ANALYSIS; 266 PARTICIPANTS PRACTICING YOGA INTERVENTIONS AT WORKSITE WERE COMPARED TO 221 SUBJECTS IN CONTROL GROUP. INCLUDED STUDIES SHOWED "SOME CONCERNS" ABOUT DIFFERENT DOMAINS OF SOURCE OF BIAS. QUANTITATIVE ANALYSIS SHOWED AN OVERALL EFFECT SIZE OF -0.67 [95% CONFIDENCE INTERVAL (CI): -0.86, -0.49] IN FAVOR OF YOGA INTERVENTION IN REDUCING STRESS OUTCOME MEASURES. HENCE, WORKPLACE YOGA INTERVENTIONS WERE MORE EFFECTIVE WHEN COMPARED TO NO TREATMENT IN WORK-RELATED STRESS MANAGEMENT. FURTHER HIGH-QUALITY STUDIES ARE NEEDED TO IMPROVE THE VALIDITY OF THESE RESULTS AND TO SPECIFY MORE CHARACTERISTICS OF THE YOGA INTERVENTION, SUCH AS STYLE, VOLUME, AND FREQUENCY. 2020 19 2540 49 YOGA FOR ANXIETY: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. YOGA HAS BECOME A POPULAR APPROACH TO IMPROVE EMOTIONAL HEALTH. THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY ASSESS AND META-ANALYZE THE EFFECTIVENESS AND SAFETY OF YOGA FOR ANXIETY. MEDLINE/PUBMED, SCOPUS, THE COCHRANE LIBRARY, PSYCINFO, AND INDMED WERE SEARCHED THROUGH OCTOBER 2016 FOR RANDOMIZED CONTROLLED TRIALS (RCTS) OF YOGA FOR INDIVIDUALS WITH ANXIETY DISORDERS OR ELEVATED LEVELS OF ANXIETY. THE PRIMARY OUTCOMES WERE ANXIETY AND REMISSION RATES, AND SECONDARY OUTCOMES WERE DEPRESSION, QUALITY OF LIFE, AND SAFETY. RISK OF BIAS WAS ASSESSED USING THE COCHRANE TOOL. EIGHT RCTS WITH 319 PARTICIPANTS (MEAN AGE: 30.0-38.5 YEARS) WERE INCLUDED. RISK OF SELECTION BIAS WAS UNCLEAR FOR MOST RCTS. META-ANALYSES REVEALED EVIDENCE FOR SMALL SHORT-TERM EFFECTS OF YOGA ON ANXIETY COMPARED TO NO TREATMENT (STANDARDIZED MEAN DIFFERENCE [SMD] = -0.43; 95% CONFIDENCE INTERVAL [CI] = -0.74, -0.11; P = .008), AND LARGE EFFECTS COMPARED TO ACTIVE COMPARATORS (SMD = -0.86; 95% CI = -1.56, -0.15; P = .02). SMALL EFFECTS ON DEPRESSION WERE FOUND COMPARED TO NO TREATMENT (SMD = -0.35; 95% CI = -0.66, -0.04; P = .03). EFFECTS WERE ROBUST AGAINST POTENTIAL METHODOLOGICAL BIAS. NO EFFECTS WERE FOUND FOR PATIENTS WITH ANXIETY DISORDERS DIAGNOSED BY DIAGNOSTIC AND STATISTICAL MANUAL CRITERIA, ONLY FOR PATIENTS DIAGNOSED BY OTHER METHODS, AND FOR INDIVIDUALS WITH ELEVATED LEVELS OF ANXIETY WITHOUT A FORMAL DIAGNOSIS. ONLY THREE RCTS REPORTED SAFETY-RELATED DATA BUT THESE INDICATED THAT YOGA WAS NOT ASSOCIATED WITH INCREASED INJURIES. IN CONCLUSION, YOGA MIGHT BE AN EFFECTIVE AND SAFE INTERVENTION FOR INDIVIDUALS WITH ELEVATED LEVELS OF ANXIETY. THERE WAS INCONCLUSIVE EVIDENCE FOR EFFECTS OF YOGA IN ANXIETY DISORDERS. MORE HIGH-QUALITY STUDIES ARE NEEDED AND ARE WARRANTED GIVEN THESE PRELIMINARY FINDINGS AND PLAUSIBLE MECHANISMS OF ACTION. 2018 20 2683 42 YOGA IN THE MANAGEMENT OF CHRONIC DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: HEART DISEASE, STROKE, AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) ARE THE LEADING CAUSES OF DEATH AND DISABILITY WORLDWIDE. ALTHOUGH INDIVIDUALS WITH THESE CONDITIONS HAVE BEEN REPORTED TO BENEFIT FROM YOGA, ITS EFFECTIVENESS REMAINS UNCLEAR. OBJECTIVE: TO PERFORM A SYSTEMATIC REVIEW OF THE EFFECTIVENESS OF YOGA ON EXERCISE CAPACITY, HEALTH RELATED QUALITY OF LIFE (HRQL), AND PSYCHOLOGICAL WELL-BEING FOR INDIVIDUALS WITH CHRONIC DISEASE AND DESCRIBE THE STRUCTURE AND DELIVERY OF PROGRAMS. RESEARCH DESIGN: WE PERFORMED A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS EXAMINING YOGA PROGRAMS FOR INDIVIDUALS WITH HEART DISEASE, STROKE, AND COPD COMPARED WITH USUAL CARE. QUALITY WAS ASSESSED USING THE COCHRANE RISK OF BIAS TOOL. META-ANALYSES WERE CONDUCTED USING REVIEW MANAGER 5.3. THE PROTOCOL WAS REGISTERED ON PROSPERO (CRD42014014589). RESULTS: TEN STUDIES (431 INDIVIDUALS, MEAN AGE 56+/-8 Y) WERE INCLUDED AND WERE COMPARABLE IN THEIR DESIGN AND COMPONENTS, IRRESPECTIVE OF THE CHRONIC DISEASE. THE STANDARDIZED MEAN DIFFERENCE FOR THE MEAN CHANGE IN EXERCISE CAPACITY WAS 2.69 (95% CONFIDENCE INTERVAL, 1.39-3.99) AND FOR HRQL IT WAS 1.24 (95% CONFIDENCE INTERVAL, -0.37 TO 2.85). SYMPTOMS OF ANXIETY WERE REDUCED AFTER YOGA IN INDIVIDUALS WITH STROKE, ALTHOUGH THIS WAS NOT OBSERVED IN INDIVIDUALS WITH COPD. THE EFFECT OF YOGA ON SYMPTOMS OF DEPRESSION VARIED ACROSS STUDIES WITH NO SIGNIFICANT EFFECTS COMPARED WITH USUAL CARE. CONCLUSIONS: YOGA PROGRAMS HAVE SIMILAR DESIGNS AND COMPONENTS ACROSS CHRONIC DISEASE POPULATIONS. COMPARED WITH USUAL CARE, YOGA RESULTED IN SIGNIFICANT IMPROVEMENTS IN EXERCISE CAPACITY AND A MEAN IMPROVEMENT IN HRQL. YOGA PROGRAMS MAY BE A USEFUL ADJUNCT TO FORMAL REHABILITATION PROGRAMS. 2015