1 1623 157 MINDFULNESS AND MODIFIED MEDICAL YOGA AS INTERVENTION IN OLDER WOMEN WITH OSTEOPOROTIC VERTEBRAL FRACTURE. BACKGROUND: PEOPLE WITH OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES (VCFS) HAVE DECREASED HEALTH-RELATED QUALITY OF LIFE (HRQOL). YOGA AND MINDFULNESS ARE METHODS THAT CAN PROMOTE WELL-BEING. OBJECTIVE: THE AIM OF THIS ARTICLE WAS TO EXPLORE THE EFFECT OF MINDFULNESS AND MODIFIED MEDICAL YOGA ON HRQOL, STRESS, SLEEP, AND PAIN IN PEOPLE 60 YEARS OR OLDER WITH A DIAGNOSED OSTEOPOROTIC VCF. DESIGN: THE SCHOOL OF OSTEOPOROSIS IN LINKOPING (SOL) IS A PILOT STUDY WITH RANDOMIZED GROUPS. MATERIALS AND METHODS: THE SOL-STUDY WAS SCHEDULED TO ONCE A WEEK FOR 10 WEEKS. TEN PEOPLE WERE RANDOMIZED TO A THEORY (T) GROUP, AND TEN PEOPLE WERE RANDOMIZED TO A THEORY AND MINDFULNESS/MEDICAL YOGA (MMY) GROUP. THE EDUCATIONAL SESSIONS LASTED 60 MIN AND WERE SIMILAR FOR THE GROUPS, BUT THEY TOOK PLACE AT DIFFERENT FACILITIES. AN EXPERIENCED PHYSIOTHERAPIST SUPERVISED THE MMY SESSIONS FOR 60 MIN. SLEEP QUALITY AND PRESENT STRESS EXPERIENCE WERE MEASURED ON A SYMMETRIC LIKERT SCALE. THE NUMERIC RATING SCALE WAS USED FOR PAIN, AND EQ-5D, RAND-36, AND QUALEFFO-41 WERE USED FOR HRQOL. THE PATIENT ENABLEMENT INSTRUMENT (PEI) WAS USED TO REFLECT HOW THE PARTICIPANTS COPED WITH THEIR ILLNESS. RESULTS: EIGHT WOMEN IN THE MMY-GROUP AND SEVEN WOMEN IN THE T-GROUP COMPLETED THE SOL STUDY INTERVENTIONS. THE ADHERENCE TO THE INTERVENTION PROGRAM WAS 89% IN THE MMY-GROUP AND 87% IN THE T-GROUP. THERE WAS NO ADVERSE CONSEQUENCE OF THE MMY TRAINING. AFTER THE 10-WEEK INTERVENTION PERIOD, SLEEP QUALITY (P = 0.018) AND PRESENT STRESS (P = 0.043), BUT NOT PERCEIVED PAIN WERE IMPROVED IN THE MMY-GROUP. THE SOCIAL FUNCTION (SF) DOMAIN WAS IMPROVED IN THE MMY-GROUP THAT WAS MEASURED BY BOTH RAND-36 (P = 0.028) AND QUALEFFO-41 (P = 0.012). THERE WAS A TREND TOWARD A BETTER PEI-SCORE IN THE MMY-GROUP COMPARED WITH THE T-GROUP POSTINTERVENTION (P = 0.089). CONCLUSION: THIS ARTICLE SUGGESTS THAT MINDFULNESS AND MODIFIED MEDICAL YOGA SUPERVISED BY A SKILLED PHYSIOTHERAPIST MAY BE A FEASIBLE WAY TO IMPROVE SF, SLEEP, AND STRESS IN OLDER WOMEN WITH OSTEOPOROTIC VCFS. 2020 2 2653 56 YOGA IMPROVES OCCUPATIONAL PERFORMANCE, DEPRESSION, AND DAILY ACTIVITIES FOR PEOPLE WITH CHRONIC PAIN. BACKGROUND: CHRONIC PAIN IS A COMPLEX ACCUMULATION OF PHYSICAL, PSYCHOLOGICAL, AND SOCIAL CONDITIONS, THUS INTERVENTIONS THAT ADDRESS PAIN AND PROMOTE OCCUPATIONAL PERFORMANCE ARE NEEDED. A HOLISTIC INTERVENTION, WITH MIND AND BODY COMPONENTS, IS LIKELY NECESSARY TO BEST TREAT THE COMPLEXITIES OF CHRONIC PAIN. THUS, WE DEVELOPED AND TESTED A YOGA INTERVENTION FOR PEOPLE WITH CHRONIC PAIN. OBJECTIVES: IN A RANDOMIZED CONTROL TRIAL (RCT), PARTICIPANTS WITH CHRONIC PAIN WERE RANDOMIZED TO A YOGA INTERVENTION OR USUAL CARE GROUP. BETWEEN AND WITHIN GROUP DIFFERENCES FOR PRE-AND POST-OUTCOME MEASURE SCORES WERE ASSESSED FOR: OCCUPATIONAL PERFORMANCE, COMPLETION OF ACTIVITIES, AND DEPRESSION. METHODS: PILOT RCT WITH PARTICIPANT ALLOCATION TO 8 WEEKS OF YOGA OR USUAL CARE. BOTH GROUPS RECEIVED ONGOING MONTHLY SELF-MANAGEMENT PROGRAMMING. DATA WERE COLLECTED BEFORE AND AFTER THE 8-WEEK INTERVENTION. PARTICIPANTS WERE RANDOMIZED TO YOGA OR USUAL CARE AFTER BASELINE ASSESSMENTS. DEMOGRAPHICS WERE COLLECTED AND MEASURES INCLUDED: CANADIAN OCCUPATIONAL PERFORMANCE MEASURE (COPM) TO ASSESS OCCUPATIONAL PERFORMANCE; THE 15-ITEM FRENCHAY ACTIVITIES INDEX (FAI)(ACTIVITIES); AND THE 9-ITEM PATIENT HEALTH QUESTIONNAIRE (PHQ-9) FOR DEPRESSION. INDEPENDENT T-TESTS WERE USED TO ASSESS DIFFERENCES BETWEEN GROUPS. PAIRED T-TESTS WERE USED TO ASSESS DIFFERENCES BETWEEN PRE- AND POST 8-WEEK INTERVENTION FOR BOTH THE YOGA AND THE USUAL CARE GROUPS. PERCENT CHANGE SCORES AND EFFECT SIZES WERE CALCULATED. RESULTS: 83 PEOPLE WERE RECRUITED FOR THE STUDY AND COMPLETED BASELINE ASSESSMENTS; 44 INDIVIDUALS WERE RANDOMIZED TO YOGA AND 39 TO THE CONTROL GROUP. THE AVERAGE AGE OF ALL PARTICIPANTS WAS 51.4+/-10.5 YEARS, 68% WERE FEMALE; AND 60% HAD AT LEAST SOME COLLEGE EDUCATION. THERE WERE NO SIGNIFICANT DIFFERENCES IN DEMOGRAPHICS OR OUTCOME MEASURES BETWEEN GROUPS AT BASELINE OR 8 WEEKS; HOWEVER, THE STUDY WAS NOT POWERED TO SEE SUCH DIFFERENCES. INDIVIDUALS RANDOMIZED TO THE CONTROL GROUP DID NOT SIGNIFICANTLY IMPROVE IN ANY OUTCOME MEASURE OVER THE 8 WEEKS. THERE WERE SIGNIFICANT IMPROVEMENTS IN COPM PERFORMANCE AND COPM SATISFACTION SCORES FOR INDIVIDUALS RANDOMIZED TO THE YOGA GROUP; BOTH SCORES SIGNIFICANTLY IMPROVED. COPM PERFORMANCE IMPROVED BY 27% WITH A MODERATE TO LARGE EFFECT SIZE (3.66+/-1.85 VS 4.66+/-1.93, P < 0.001, D = 0.76). COPM SATISFACTION SIGNIFICANTLY IMPROVED BY 78% (2.14+/-2.31 VS. 3.80+/-2.50, P < 0.001) AND HAD A LARGE EFFECTS SIZE (D = 1.02). FAI SCORES IMPROVED, INDICATING INCREASED ACTIVITY OR ENGAGEMENT IN DAILY OCCUPATION DURING THE 8-WEEK INTERVENTION. SCORES INCREASED BY 5% (38.13+/-8.48 VS. 39.90+/-8.57, P = 0.024) WITH A SMALL EFFECT SIZE (D = 0.37). DEPRESSION SIGNIFICANTLY DECREASED FROM 13.21+/-5.60 TO 11.41+/-5.82, P = 0.041, WITH A SMALL EFFECT SIZE. CONCLUSION: DATA FROM THIS PILOT RCT INDICATE YOGA MAY BE AN EFFECTIVE THERAPEUTIC INTERVENTION WITH PEOPLE IN CHRONIC PAIN TO IMPROVE OCCUPATIONAL PERFORMANCE, INCREASE ENGAGEMENT IN ACTIVITIES, AND DECREASE DEPRESSION. OCCUPATIONAL THERAPY PRACTITIONERS MAY CONSIDER ADDING YOGA AS A TREATMENT INTERVENTION TO ADDRESS THE NEEDS OF PEOPLE WITH PAIN. 2019 3 1364 38 IMPACT OF 10-MIN DAILY YOGA EXERCISES ON PHYSICAL AND MENTAL DISCOMFORT OF HOME-OFFICE WORKERS DURING COVID-19. OBJECTIVE: EVALUATE THE EFFECTS OF 10 MIN/DAY OF YOGA FOR 1 MONTH ON MUSCULOSKELETAL DISCOMFORT AND MOOD DISTURBANCE OF HOME-OFFICE WORKERS. BACKGROUND: THE COVID-19 PANDEMIC FORCED MANY PEOPLE TO SWITCH TO TELEWORKING. THE ABRUPT CHANGE FROM AN OFFICE SETTING TO AN IMPROVISED HOME-OFFICE MAY NEGATIVELY AFFECT THE MUSCULOSKELETAL AND EMOTIONAL HEALTH OF WORKERS. BY PROVIDING MENTAL AND PHYSICAL EXERCISES, YOGA MAY BE EFFECTIVE IN REDUCING ADVERSE EFFECTS. METHOD: FIFTY-FOUR PARTICIPANTS (42 WOMEN, 12 MEN) FOLLOWED A 1-MONTH YOGA PROGRAM, WHILE 40 PARTICIPANTS (26 WOMEN, 14 MEN) CONTINUED WITH THEIR COMMON WORK ROUTINE. THE CORNELL MUSCULOSKELETAL DISCOMFORT QUESTIONNAIRE WAS USED TO EVALUATE SEVERITY, INTERFERENCE WITH WORK AND FREQUENCY OF PAIN, AND TO OBTAIN A TOTAL DISCOMFORT SCORE FOR 25 BODY AREAS. MOOD DISTURBANCE WAS EVALUATED WITH THE PROFILE OF MOOD STATES QUESTIONNAIRE. BOTH GROUPS COMPLETED BOTH QUESTIONNAIRES, BEFORE AND AFTER THE EXPERIMENTATION PERIOD. RESULTS: AFTER 1 MONTH, FOR THE YOGA GROUP ONLY, SIGNIFICANT REDUCTIONS WERE OBSERVED IN THE DISCOMFORT OF EYES, HEAD, NECK, UPPER AND LOWER BACK, RIGHT WRIST, AND HIPS/BUTTOCKS, AS WELL AS REDUCTIONS IN DISCOMFORT SEVERITY, FREQUENCY AND INTERFERENCE FOR THE NECK, UPPER AND LOWER BACK. TOTAL MOOD DISTURBANCE WAS ALSO SIGNIFICANTLY REDUCED FOR THE YOGA GROUP ONLY. NO FAVORABLE CHANGES OCCURRED FOR THE CONTROL GROUP. CONCLUSION: THE YOGA INTERVENTION PROGRAM APPEARS TO REDUCE MUSCULOSKELETAL DISCOMFORT AND MOOD DISTURBANCE OF HOME-OFFICE WORKERS. APPLICATION: SEDENTARY WORKERS MAY BENEFIT FROM 10 MIN/DAY OF YOGA DURING THE WORKDAY TO ATTENUATE POTENTIAL PHYSICAL AND EMOTIONAL DISCOMFORT DURING THE CURRENT PANDEMIC AND BEYOND. 2021 4 579 40 DESIGNING A YOGA INTERVENTION PROGRAM TO IMPROVE WELL-BEING FOR PHYSICIAN TRAINEES: CHALLENGES AND LESSONS LEARNED. WELL-BEING ACTIVITIES MAY HELP TO COUNTERACT PHYSICIAN BURNOUT. YOGA IS KNOWN TO ENHANCE WELL-BEING, BUT THERE ARE FEW STUDIES OF YOGA AS AN INTERVENTION FOR PHYSICIANS IN TRAINING. THIS PROSPECTIVE METHODOLOGY-DEVELOPMENT STUDY AIMED TO EXPLORE HOW TO ESTABLISH A YOGA-BASED WELL-BEING INTERVENTION FOR PHYSICIAN TRAINEES IN A LARGE URBAN TRAINING HOSPITAL. WE AIMED TO IDENTIFY FACTORS THAT CONTRIBUTE TO TRAINEE PARTICIPATION AND EXPLORE AN INSTRUMENT TO MEASURE CHANGES IN SELF-REPORTED WELL-BEING AFTER YOGA. COHORTS INCLUDED A REQUIRED-ATTENDANCE GROUP, A VOLUNTARY-ATTENDANCE GROUP, AND AN UNASSIGNED WALK-IN YOGA GROUP. WEEKLY 1-HOUR YOGA SESSIONS WERE LED BY A QUALIFIED YOGA INSTRUCTOR FOR 4 WEEKS. THE SEVEN-QUESTION RESIDENT PHYSICIAN WELL-BEING INDEX (RPWBI) WAS USED TO MEASURE RESIDENT WELL-BEING BEFORE YOGA, AFTER 4 WEEKS OF YOGA, AND 6 MONTHS POST-YOGA. TRAINEES ATTENDING EACH SESSION RANGED FROM 17 FOR REQUIRED YOGA TO 0-2 FOR VOLUNTARY YOGA, 2-9 FOR LUNCHTIME WALK-IN YOGA, AND 1-7 FOR EVENING WALK-IN YOGA. IN THE REQUIRED-YOGA GROUP (N = 17), OVERALL RPWBI MEAN SCORES DID NOT CHANGE SIGNIFICANTLY ACROSS THE THREE QUERY TIMES, AND PARTICIPATION IN THE SURVEY DECLINED OVER TIME. THE MEAN BASELINE RPWBI SCORE FOR THE REQUIRED GROUP BEFORE YOGA WAS IN THE NON-DISTRESSED RANGE AND ANSWERS TO THE SEVEN INDIVIDUAL QUESTIONS VARIED. REQUIRING A YOGA ACTIVITY FOR MEDICAL TRAINEES MAY BE A GOOD STRATEGY FOR PROMOTING PARTICIPATION IN YOGA. THE RPWBI MAY HAVE LIMITED UTILITY FOR MEASURING CHANGES IN OVERALL GROUP WELL-BEING AFTER A YOGA INTERVENTION. 2021 5 97 34 A NONRANDOMIZED COMPARISON STUDY OF SELF-HYPNOSIS, YOGA, AND COGNITIVE-BEHAVIORAL THERAPY TO REDUCE EMOTIONAL DISTRESS IN BREAST CANCER PATIENTS. THE AUTHORS ASKED BREAST CANCER (BC) PATIENTS TO PARTICIPATE IN 1 OF 3 MIND-BODY INTERVENTIONS (COGNITIVE-BEHAVIORAL THERAPY (CBT), YOGA, OR SELF-HYPNOSIS) TO EXPLORE THEIR FEASIBILITY, EASE OF COMPLIANCE, AND IMPACT ON THE PARTICIPANTS' DISTRESS, QUALITY OF LIFE (QOL), SLEEP, AND MENTAL ADJUSTMENT. NINETY-NINE PATIENTS COMPLETED AN INTERVENTION (CBT: N = 10; YOGA: N = 21; AND SELF-HYPNOSIS: N = 68). RESULTS SHOWED HIGH FEASIBILITY AND HIGH COMPLIANCE. AFTER THE INTERVENTIONS, THERE WAS NO SIGNIFICANT EFFECT IN THE CBT GROUP BUT SIGNIFICANT POSITIVE EFFECTS ON DISTRESS IN THE YOGA AND SELF-HYPNOSIS GROUPS, AND, ALSO, ON QOL, SLEEP, AND MENTAL ADJUSTMENT IN THE SELF-HYPNOSIS GROUP. IN CONCLUSION, MIND-BODY INTERVENTIONS CAN DECREASE DISTRESS IN BC PATIENTS, BUT RCTS ARE NEEDED TO CONFIRM THESE FINDINGS. 2017 6 2890 32 YOGA: POTENTIAL BENEFITS FOR PERSONS WHO STUTTER. YOGA HAS BEEN DEMONSTRATED TO MODULATE AUTONOMIC NERVOUS SYSTEM ACTIVITY, DECREASING ANXIETY AND STRESS, AND IMPROVING QUALITY OF LIFE. THIS PRELIMINARY STUDY SOUGHT TO EXAMINE THE USE OF YOGIC TECHNIQUES ON PERSONS WHO STUTTER GIVEN THE INTERACTION BETWEEN PHYSIOLOGICAL AROUSAL/ANXIETY AND STUTTERING THAT CURRENT MULTIFACTORIAL MODELS OF STUTTERING PROPOSE. FOUR PARTICIPANTS (M = 52 YR, SD = 10; 2 FEMALE, 2 MALE), RECRUITED FROM LOCAL STUTTERING SUPPORT GROUPS IN THE GREATER PHILADELPHIA COMMUNITY VOLUNTEERED TO PARTICIPATE. STUTTERING SEVERITY, ANXIETY, AND EXPERIENCES REGARDING STUTTERING AND COMMUNICATION WERE MEASURED AT BASELINE, POST INTERVENTION, AND AT 4 MONTHS FOLLOW-UP. THE PARTICIPANTS ATTENDED GROUP YOGA SESSIONS AND ENGAGED IN HOME PRACTICE. DESCRIPTIVE RESULTS REVEALED THAT PARTICIPANTS SHOWED IMPROVEMENTS ACROSS OUTCOME MEASURES, WITH THE MOST IMPROVEMENT RELATED TO ANXIETY. PARTICIPANTS ALSO REPORTED IMPROVEMENTS IN THEIR PERCEPTIONS ABOUT COMMUNICATION AS PER QUALITATIVE ANALYSIS OF RESPONSES TO THE OPEN-ENDED QUESTIONNAIRES. THE RESULTS SUGGEST THE POTENTIAL BENEFITS OF YOGA FOR PERSONS WHO STUTTER AND WARRANTS FURTHER STUDY USING AN EXPERIMENTAL DESIGN. 2016 7 2173 31 THE EFFECTS OF YOGA ON DYSPNEA, SLEEP AND FATIGUE IN CHRONIC RESPIRATORY DISEASES. PURPOSE: THIS STUDY WAS CARRIED OUT TO FIND OUT THE EFFECTS OF YOGA APPLIED TO CHRONIC RESPIRATORY DISEASE PATIENTS ON DYSPNEA, SLEEP QUALITY AND FATIGUE. MATERIAL AND METHOD: THE STUDY WAS CONDUCTED BETWEEN MAY AND AUGUST 2020 AS A RANDOMIZED CONTROLLED STUDY. 'PERSONAL INFORMATION FORM', 'RESPIRATORY FUNCTIONS MONITORING FORM', 'COPD AND ASTHMA FATIGUE SCALE (CAFS), "ASTHMA AND COPD SLEEP IMPACT SCALE (CASIS)" AND MODIFIED MEDICAL RESEARCH COUNCIL DYSPNEA SCALE (MMRC) WERE USED IN DATA COLLECTION. RESULTS: WHEN THE POST-TEST MEAN SCORES OF THE PATIENTS IN THE EXPERIMENTAL AND CONTROL GROUP WERE COMPARED, IT WAS FOUND THAT CAFS, CASIS AND MMRC MEAN SCORES OF THE PATIENTS IN THE EXPERIMENTAL GROUP DECREASED POSITIVELY COMPARED TO THE PATIENTS IN THE CONTROL GROUP AND THE DIFFERENCE BETWEEN WAS FOUND TO BE STATISTICALLY SIGNIFICANT (P < 0.05). CONCLUSION: YOGA HAS BEEN FOUND TO REDUCE THE SEVERITY OF DYSPNEA AND FATIGUE AND IMPROVE SLEEP QUALITY IN CHRONIC RESPIRATORY DISEASES. 2021 8 2833 36 YOGA'S EFFECT ON FALLS IN RURAL, OLDER ADULTS. BACKGROUND: UNINTENTIONAL FALLS AFFECT 30% OF PEOPLE OVER AGE 65 YEARS. YOGA HAS BEEN SHOWN TO IMPROVE BALANCE. WE DESIGNED THIS STUDY TO EXAMINE IF YOGA REDUCES FALLS. METHODS: WE CONDUCTED 16 SESSIONS OF HATHA YOGA OVER 8 WEEKS. PARTICIPANTS WERE RANDOMLY ASSIGNED TO PRACTICE 10MIN OF YOGA DAILY AT HOME IN ADDITION TO 5-MIN RELAXATION EXERCISES OR RELAXATION EXERCISES ONLY (CONTROL GROUP). RESULTS: OF THE 38 PARTICIPANTS COMPLETING THE INTERVENTION, 15 PARTICIPANTS REPORTED A TOTAL OF 27 FALLS IN THE 6-MONTHS BEFORE THE STUDY, COMPARED TO 13 PARTICIPANTS SUSTAINING 14 FALLS IN THE 6 MONTHS FROM THE START OF THE STUDY (P<0.047), WITHOUT DIFFERENCE BETWEEN YOGA HOME-EXERCISE AND HOME RELAXATION-ONLY GROUPS. COMPARED TO BASELINE SCORES, ALL PARTICIPANTS IMPROVED ON THE BERG BALANCE SCALE (53-54 OUT OF 56, P=0.002), THE FUNCTIONAL GAIT ASSESSMENT (22.9-25.8 OUT OF 30 POINTS, P<0.001), AND THE DYNAMIC GAIT INDEX (20.6-22.4 OUT OF 24 POINTS, P<0.001). RIGHT LEG STAND TIME IMPROVED FROM A MEAN OF 13.3S TO 17.1S (P=0.020) AND STANDING FORWARD REACH DISTANCE FROM 26.0CM TO 29.6CM (P<0.001). WITHOUT DIFFERENCE BETWEEN GROUPS. CONFIDENCE, WITH THE ACTIVITIES-SPECIFIC BALANCE CONFIDENCE SCALE, INCREASED IN THE YOGA HOME-EXERCISE GROUP (88%-93%, P=0.037) COMPARED TO 90% UNCHANGED FROM PRE-INTERVENTION IN THE HOME RELAXATION-ONLY GROUP. CONCLUSION: YOGA CLASSES REDUCE SELF-REPORTED FALLS AND IMPROVE BALANCE MEASURES. THE ADDITION OF HOME YOGA EXERCISES DID NOT ENHANCE BENEFIT OVER RELAXATION EXERCISE ONLY. 2017 9 1046 41 EFFECTS OF YOGA ON ANXIETY AND DEPRESSION FOR HIGH RISK MOTHERS ON HOSPITAL BEDREST. BACKGROUND: AND PURPOSE: IN RECENT YEARS, YOGA PRACTITIONERS HAVE JOINED FORCES WITH MEDICAL PROGRAMS TO APPROACH PATIENTS' WELL-BEING HOLISTICALLY. THIS STUDY IS A RANDOMIZED CONTROLLED TRIAL TO ASSESS THE EFFECTS OF A SPECIALIZED ADAPTED YOGA PROGRAM ON ANXIETY AND DEPRESSION FOR HIGH-RISK EXPECTANT MOTHERS ON BEDREST IN A HOSPITAL SETTING. MATERIALS AND METHODS: SEVENTY-NINE PREGNANT SUBJECTS ON PHYSICIAN ORDERED HOSPITALIZED BEDREST WERE RANDOMIZED INTO TWO GROUPS: RECEIVING BIWEEKLY YOGA SESSIONS (INTERVENTION GROUP) OR RECEIVING NO YOGA (CONTROL GROUP). DATA COLLECTION TOOL WAS THE HOSPITAL ANXIETY AND DEPRESSION SCALE (HADS) TO ASSESS OUTCOMES AFTER DELIVERY. RESULTS: YOGA, EVEN AS LITTLE AS THREE SESSIONS, SHOWED SIGNIFICANT IMPACT IN REDUCING ANXIETY AND DEPRESSION HIGH-RISK PREGNANT WOMEN ON HOSPITALIZED BEDREST. PERCEIVED ANXIETY AND DEPRESSION OVERALL SCORES WERE LOWER IN THE INTERVENTION GROUP THAN IN THE CONTROL GROUP (P < 0.001). CONCLUSION: RESULTS DEMONSTRATED THAT YOGA IS AN EFFECTIVE INTERVENTION TO DECREASE ANXIETY AND DEPRESSION IN HIGH-RISK ANTEPARTUM WOMEN ON HOSPITALIZED BEDREST. 2020 10 2059 31 THE BENEFITS OF YOGA FOR RHEUMATOID ARTHRITIS: RESULTS OF A PRELIMINARY, STRUCTURED 8-WEEK PROGRAM. THE AIM OF THIS STUDY WAS TO MEASURE THE EFFECTS OF A BI-WEEKLY RAJ YOGA PROGRAM ON RHEUMATOID ARTHRITIS (RA) DISEASE ACTIVITY. SUBJECTS WERE RECRUITED FROM AMONG RA PATIENTS IN DUBAI, UNITED ARAB EMIRATES BY EMAIL INVITATIONS OF THE RA DATABASE. DEMOGRAPHIC DATA, DISEASE ACTIVITY INDICES, HEALTH ASSESSMENT QUESTIONNAIRE (HAQ), AND QUALITY OF LIFE (QOL) BY SF-36 WERE DOCUMENTED AT ENROLLMENT AND AFTER COMPLETION OF 12 SESSIONS OF RAJ YOGA. A TOTAL OF 47 PATIENTS WERE ENROLLED: 26 YOGA AND 21 CONTROLS. BASELINE DEMOGRAPHICS WERE SIMILAR IN BOTH GROUPS. PATIENTS WHO UNDERWENT YOGA HAD STATISTICALLY SIGNIFICANT IMPROVEMENTS IN DAS28 AND HAQ, BUT NOT QOL. OUR PILOT STUDY OF 12 SESSIONS OF YOGA FOR RA WAS ABLE TO DEMONSTRATE STATISTICALLY SIGNIFICANT IMPROVEMENTS IN RA DISEASE PARAMETERS. WE BELIEVE THAT A LONGER DURATION OF TREATMENT COULD RESULT IN MORE SIGNIFICANT IMPROVEMENTS. 2009 11 2576 45 YOGA FOR FUNCTIONAL FITNESS IN ADULTS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES. BACKGROUND: YOGA IS AN EFFECTIVE INTERVENTION TO IMPROVE FUNCTIONAL FITNESS IN ADULTS WITH AND WITHOUT DISABILITIES, BUT LITTLE RESEARCH EXISTS REGARDING YOGA'S IMPACT ON FUNCTIONAL FITNESS FOR INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES (IDDS). AIMS: THE PURPOSE OF THIS STUDY WAS TO EXAMINE THE BENEFITS OF A GROUP YOGA INTERVENTION ON THE FUNCTIONAL FITNESS OF ADULTS WITH IDDS. METHODS AND MATERIALS: THIS YOGA INTERVENTION INCLUDED 12 SESSIONS OF YOGA OVER 7 WEEKS (60-MIN SESSIONS TWICE A WEEK) AT A SPECIAL POPULATION RECREATION AND LEISURE PROGRAM. THE FUNCTIONAL FITNESS TEST WAS USED TO EXAMINE PHYSICAL FUNCTIONING BEFORE AND AFTER THE YOGA INTERVENTION. RESULTS AND CONCLUSIONS: EIGHT ADULTS COMPLETED THE BASELINE AND POSTTEST MEASURES (AGE MEAN = 31; STANDARD DEVIATION = 6.55; 50% MALE). THERE WERE SIGNIFICANT IMPROVEMENTS IN LOWER-BODY STRENGTH (9.00 +/- 4.63 VS. 11.50 +/- 3.16, P = 0.04, 28% IMPROVEMENT), UPPER-BODY STRENGTH (11.25 +/- 3.54 VS. 14.25 +/- 3.37, P = 0.018, 27% IMPROVEMENT), AND AGILITY AND BALANCE (9.29 +/- 4.1 VS. 6.60 +/- 1.54, P = 0.036, 29% IMPROVEMENT). FUNCTIONAL FITNESS OFTEN DECLINES FOR PEOPLE WITH IDD AT A FASTER RATE THAN THE GENERAL POPULATION; THUS, THESE SIGNIFICANT CHANGES INDICATE THAT A YOGA INTERVENTION MAY ENHANCE FUNCTIONAL FITNESS FOR PEOPLE WITH IDD. CLINICIANS OR OTHER HEALTHCARE PROVIDERS MIGHT CONSIDER YOGA AS A MEANS TO IMPROVE FUNCTIONAL FITNESS IN ADULTS WITH IDDS. 2020 12 1417 44 IMPORTANCE OF PATIENT EDUCATION FOR AT-HOME YOGA PRACTICE IN WOMEN WITH HORMONAL THERAPY-INDUCED PAIN DURING ADJUVANT BREAST CANCER TREATMENT: A FEASIBILITY STUDY. BACKGROUND: OSTEO-ARTICULAR PAIN (OAP) IS EXPERIENCED BY APPROXIMATELY 50% OF WOMEN UNDER HORMONAL THERAPY (HT) FOR BREAST CANCER (BC), WHICH INCREASES THE RISK FOR THERAPY DISCONTINUATION. THIS STUDY WAS AIMED TO ASSESS BENEFITS OF YOGA PRACTICE COMBINED WITH PATIENT EDUCATION (PE) FOR AT-HOME PRACTICE BY EVALUATING FEASIBILITY AMONG BC PATIENTS UNDER HT AND MEASURING OAP, FLEXIBILITY AND SATISFACTION. METHODS: FEASIBILITY WAS EVALUATED BY PATIENT ADHERENCE AS ACCOMPLISHMENT OF AT LEAST 4 OUT OF 6 SUPERVISED YOGA-PE SESSIONS ALONG WITH 70% OR MORE AT-HOME YOGA SESSIONS. INTERVENTION (12 WEEKS) INCLUDED TWO 6-WEEKS PERIODS: P1 COMPRISING ONE 90-MINUTES SUPERVISED YOGA-PE SESSION/WEEK AND 15-MINUTES DAILY AT-HOME YOGA AND P2, DAILY AUTONOMOUS AT-HOME YOGA SESSIONS. EVALUATIONS (AT INCLUSION AND BY THE END OF EACH PERIOD) CONSISTED IN ASSESSMENT OF OAP ON VISUAL ANALOG SCALE (VAS), FORWARD FLEXIBILITY (CM) AND PATIENT SATISFACTION ON LIKERT (0-10 POINTS) SCALE. RESULTS: BETWEEN SEPTEMBER 2018 AND MAY 2019 WE INCLUDED 24 PATIENTS OF MEDIAN 53 YEARS (RANGE 36-72). FEASIBILITY WAS VALIDATED BY 83% SUCCESSFUL ADHERENCE RATE. PAIN WAS SIGNIFICANTLY REDUCED FROM MEDIAN VAS OF 6 [RANGE 4-10] TO 4 [RANGE 0-7] AT THE END OF BOTH P1 AND P2 (P < 0.01), ALBEIT WITH NO DIFFERENCE BETWEEN P1 AND P2. FORWARD FLEXIBILITY IMPROVED BY A MEDIAN GAIN OF 8 CM (END OF P2) AND MEDIAN SATISFACTION SCORE OF 10/10 [RANGE 8-10]. CONCLUSION: COMBINED PHYSIOTHERAPY-YOGA-PE INTERVENTION IS A FEASIBLE STRATEGY TO INCREASE AT-HOME YOGA PRACTICE WITH POTENTIAL BENEFIT ON PAIN, FLEXIBILITY, AND SATISFACTION, THUS PROMPTING FURTHER EVALUATIONS IN LARGER RANDOMIZED MULTICENTER TRIALS. CLINICALTRIALS.GOV: NCT04001751. 2021 13 2461 36 YOGA AS A NOVEL ADJUVANT THERAPY FOR PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOPATHIES. CONTEXT: RECENT STUDIES HAVE DEMONSTRATED THAT PHYSICAL ACTIVITY IS WELL TOLERATED BY PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOPATHIES (IIMS) AND CAN HAVE ADDITIONAL BENEFITS AS AN ADJUVANT THERAPY TO PHARMACOLOGIC AGENTS, ESPECIALLY IF STARTED EARLY. TO DATE, NO STUDIES HAVE EXAMINED THE EFFECTS OF YOGA ON PATIENTS WITH IIMS. AIMS: THE AIM OF THIS STUDY WAS TO EVALUATE THE EFFECTS OF YOGA ON SELF-REPORTED DIFFICULTY IN PERFORMING ACTIVITIES OF DAILY LIVING (ADL) AND MUSCLE STRENGTH IN PATIENTS WITH MILD-TO-MODERATE IIMS. SUBJECTS AND METHODS: A LONGITUDINAL COHORT STUDY IN WHICH PARTICIPANTS WERE ASSESSED USING THE MYOSITIS ACTIVITIES PROFILE (MAP) AND MANUAL MUSCLE TESTING (MMT) BEFORE AND AFTER THE COMPLETION OF AN 8-WEEK INSTRUCTOR-GUIDED YOGA COURSE WAS PERFORMED. STATISTICAL ANALYSIS USED: WILCOXON SIGNED-RANKED TEST WAS PERFORMED FOR STATISTICAL ANALYSIS. RESULTS: THE AVERAGE POSTTREATMENT MAP SCORES OF SIX PARTICIPANTS DEMONSTRATED AN INCREASE OF 2.51 POINTS, WHILE THE AVERAGE MMT SCORE OF FOUR PARTICIPANTS DEMONSTRATED AN INCREASE OF 11 POINTS. CONCLUSIONS: THIS STUDY IS THE FIRST STUDY TO DATE TO EXAMINE THE EFFECT OF YOGA AS AN ADJUVANT COMPLEMENTARY THERAPY FOR PATIENTS WITH IIM. CONTINUED RESEARCH SHOULD BE DONE ON THE EFFECT OF YOGA AS AN ADJUVANT THERAPY, FOR IN ADDITION TO INCREASE IN MUSCLE STRENGTH AND ABILITY TO PERFORM ADL, YOGA MAY OFFER POTENTIAL IMPROVEMENTS IN MOOD, MENTAL HEALTH, AND SLEEP. 2021 14 1708 27 PEACEBUILDING THROUGH YOGA? QUALITATIVE ASSESSMENT OF A YOGA PROGRAM IN A SOCIAL HOUSING COMPLEX IN SANTA MARTA, COLOMBIA. THE GOAL OF THE STUDY WAS TO ASSESS PERCEIVED MENTAL AND PHYSICAL HEALTH BENEFITS OF A YOGA INTERVENTION FOR PEOPLE LIVING IN CIUDAD EQUIDAD, A SOCIAL HOUSING COMPLEX IN COLOMBIA. THE STUDY PARTICIPANTS VOLUNTARILY ENROLLED TO COMPLETE TWO YOGA SESSIONS PER WEEK, EACH LASTING 1.5 HOURS, DURING A 3-MONTH PERIOD. ADDITIONALLY, THEY PARTICIPATED IN BASELINE AND POSTINTERVENTION FOCUS GROUPS. THIS QUALITATIVE ASSESSMENT WAS INTENDED TO IDENTIFY PERCEIVED CHANGES IN AGGRESSIVENESS, INTERPERSONAL RELATIONSHIPS, AND STRESS AFTER PARTICIPATING IN THE YOGA SESSIONS. DATA ANALYSIS REVEALED THAT PARTICIPANTS PERCEIVED CHANGES OVER TIME IN RELATION TO WHEN THEY BEGAN THE INTERVENTION. 2019 15 277 32 ADDITIONAL PRACTICE OF YOGA BREATHING WITH INTERMITTENT BREATH HOLDING ENHANCES PSYCHOLOGICAL FUNCTIONS IN YOGA PRACTITIONERS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND AND OBJECTIVE: THE PRACTICE OF YOGA IS ASSOCIATED WITH ENHANCED PSYCHOLOGICAL WELLBEING. THE CURRENT STUDY ASSESSED THE CORRELATION BETWEEN THE DURATION OF YOGA PRACTICE WITH STATE MINDFULNESS, MIND-WANDERING AND STATE ANXIETY. ALSO, WE EXAMINED IF AN ADDITIONAL 20 MIN OF YOGA BREATHING WITH INTERMITTENT BREATH HOLDING (EXPERIMENTAL GROUP) FOR 8 WEEKS WOULD AFFECT THESE PSYCHOLOGICAL VARIABLES MORE THAN REGULAR YOGA PRACTICE (CONTROL GROUP) ALONE. METHODS: ONE HUNDRED SIXTEEN SUBJECTS WERE RANDOMLY ASSIGNED TO EXPERIMENTAL (N = 60) AND CONTROL (N = 56) GROUPS. STATE MINDFULNESS ATTENTION AWARENESS SCALE (SMAAS), MIND-WANDERING QUESTIONNAIRE (MWQ) AND STATE ANXIETY INVENTORY WERE ADMINISTERED AT BASELINE AND AT THE END OF 8 WEEKS. RESULTS: BASELINE ASSESSMENT REVEALED A POSITIVE CORRELATION BETWEEN DURATION OF YOGA PRACTICE WITH SMAAS SCORES AND NEGATIVE CORRELATION WITH MWQ AND STATE ANXIETY SCORES. AT THE END OF 8 WEEKS, BOTH GROUPS DEMONSTRATED ENHANCED PSYCHOLOGICAL FUNCTIONS, BUT THE EXPERIMENTAL GROUP RECEIVING ADDITIONAL YOGA BREATHING PERFORMED BETTER THAN THE GROUP PRACTICING YOGA ALONE. CONCLUSION: AN ADDITIONAL PRACTICE OF YOGA BREATHING WITH INTERMITTENT BREATH HOLDING WAS FOUND TO ENHANCE THE PSYCHOLOGICAL FUNCTIONS IN YOUNG ADULT YOGA PRACTITIONERS. 2018 16 983 43 EFFECTS OF HATA YOGA ON KNEE OSTEOARTHRITIS. BACKGROUND: THE PURPOSE OF THIS RESEARCH WAS TO STUDY THE EFFECTS OF 8 WEEKS OF HATA YOGA EXERCISES ON WOMEN WITH KNEE OSTEOARTHRITIS. STUDIES ABOUT EFFECTS OF YOGA ON DIFFERENT CHRONIC DISEASES SHOW THAT THESE EXERCISES HAVE POSITIVE EFFECTS ON CHRONIC DISEASES. AS KNEE OSTEOARTHRITIS IS VERY COMMON AMONG MIDDLE AGE WOMEN WE DECIDED TO MEASURE EFFECTIVENESS OF THESE EXERCISES ON KNEE OSTEOARTHRITIS. METHODS: SAMPLE INCLUDED 30 WOMEN WITH KNEE OSTEOARTHRITIS WHO VOLUNTARILY PARTICIPATED IN THIS SEMI-EXPERIMENTAL STUDY AND WERE DIVIDED INTO A CONTROL GROUP (15) AND A YOGA GROUP (15). THE YOGA GROUP RECEIVED 60 MINUTES SESSIONS OF HATA YOGA, 3 TIMES A WEEK AND FOR 8 WEEKS. PAIN, SYMPTOMS, DAILY ACTIVITIES, SPORTS AND SPARE-TIME ACTIVITIES, AND QUALITY OF LIFE WERE RESPECTIVELY MEASURED BY VISUAL ANALOG SCALE (VAS) AND KNEE INJURY AND OSTEOARTHRITIS OUTCOME SCALE (KOOS) QUESTIONNAIRE. THE ANALYSIS OF VARIANCE (ANOVA) METHOD FOR REPETITIVE DATA WAS USED TO ANALYZE THE RESULTS (P = 0.05). RESULTS: FINDINGS SHOWED THAT PAIN AND SYMPTOMS WERE SIGNIFICANTLY DECREASED AND SCORES OF DAILY ACTIVITIES, SPORTS, SPARE-TIME ACTIVITIES, AND QUALITY OF LIFE WERE SIGNIFICANTLY INCREASED IN THE YOGA GROUP. CONCLUSIONS: IT SEEMS THAT YOGA CAN BE USED AS A CONSERVATIVE TREATMENT BESIDES USUAL TREATMENTS AND MEDICATIONS TO IMPROVE THE CONDITION OF PEOPLE WITH OSTEOARTHRITIS. 2013 17 918 34 EFFECTIVENESS OF TRAINING PROGRAM COMBINING CHAKRAYOGA AND MEDITATION. BACKGROUND THIS STUDY WAS DESIGNED TO EXAMINE THE EFFECTIVENESS OF PROGRAM COMBINING CHAKRAYOGA AND MEDITATION ON THE PHYSICAL HEALTH AND DISEASE-RELATED FACTORS AND PSYCHOLOGICAL FACTORS OF PEOPLE. METHODS NINETY-SEVEN SUBJECTS (32-83 YEARS OLD) WHO HAD FREE FROM PRIOR EXPERIENCES IN MEDITATION PROGRAMS OR CHAKRAYOGA TRAINING COURSES WERE ASSIGNED TO EITHER THE EXPERIMENTAL GROUP (EXP) (45 SUBJECTS; 13 MALE SUBJECTS AND 32 FEMALE SUBJECTS; AVERAGE AGE OF 60.67 YEARS, SD=11.09 YEARS) OR THE CONTROL GROUP (CONT) OF REMAINING SUBJECTS (52 SUBJECTS; 14 MALE SUBJECTS AND 38 FEMALE SUBJECTS; AVERAGE AGE OF 61.58 YEARS, SD=9.70 YEARS). SUBJECTS IN THE EXP PARTICIPATED IN THE CHAKRAYOGA MEDITATION PROGRAM FOR TWICE A WEEK FOR 2 H DURING 6 WEEKS IN EACH SESSION CONSISTED OF 1 H OF CHAKRAYOGA AND 1 H OF MEDITATION. THE MEASUREMENTS IN THIS STUDY INCLUDED THE MINDFULNESS, STRESS RESPONSE, SUBJECTIVE QUALITY OF LIFE, MEDICAL SYMPTOM CHECKLIST, DIFFICULTY IN EMOTIONAL REGULATION AND OBJECTIVE OF LIFE AND SENSE OF CONTROL. RESULTS RESULTS REVEALED THAT PARTICIPANTS IN THE EXP REPORTED SIGNIFICANTLY MORE RELIEF OF MINDFULNESS, STRESS RESPONSE, SUBJECTIVE QUALITY OF LIFE AND MEDICAL SYMPTOM CHECKLIST THAN THOSE IN THE CONT. CONCLUSIONS THESE FINDINGS PROVIDE EVIDENCE THAT THE CHAKRAYOGA MEDITATION PROGRAM CAN HELP RELIEVE THE PHYSICAL HEALTH AND DISEASE-RELATED FACTORS AND PSYCHOLOGICAL FACTORS. 2019 18 1448 34 INDIVIDUALLY TAILORED YOGA FOR CHRONIC NECK OR BACK PAIN IN A LOW-INCOME POPULATION: A PILOT STUDY. BACKGROUND: LOW-INCOME PEOPLE ARE DISPROPORTIONATELY AFFECTED BY CHRONIC BACK AND NECK PAIN. YOGA MAY BE AN EFFECTIVE THERAPY. AIMS: THIS FEASIBILITY PILOT STUDY EVALUATED AN INDIVIDUALIZED YOGA PLAN FOR THE TREATMENT OF CHRONIC SPINAL PAIN. METHODS: RESULTS: INDIVIDUALS SHOWED A MEAN CHANGE OF -2.4 FROM PRE/POST 10-CM PAIN SCALE RECORDINGS (P = 0.028, 95% CONFIDENCE INTERVAL [CI]: -0.390--4.477) AND A MEAN INCREASE OF 0.26 ON THE EQ-5D-3L (P = 0.029, 95% CI: 0.04-0.47). THE INTERVENTION WAS WELL-RECEIVED. CONCLUSIONS: AN INDIVIDUALLY TAILORED YOGA PROGRAM WAS ACCEPTABLE TO THESE PARTICIPANTS. PAIN AND QUALITY OF LIFE SCORES APPEARED TO IMPROVE. 2020 19 1301 43 HATHA YOGA ON BODY BALANCE. BACKGROUND: A GOOD BODY BALANCE REQUIRES A PROPER FUNCTION OF VESTIBULAR, VISUAL, AND SOMATOSENSORY SYSTEMS WHICH CAN BE REACH WITH EXERCISE PRACTICE AND/OR YOGA. AIM: TO DETERMINE THE EFFECTS OF A 5-MONTH HATHA YOGA TRAINING PROGRAM ON BODY BALANCE IN YOUNG ADULTS. MATERIALS AND METHODS: THIS STUDY USED A CONTROLLED, NONRANDOMIZED DESIGN, WHERE THE EXPERIMENTAL GROUP UNDERWENT A 5-MONTH TRAINING PROGRAM AND WERE THEN COMPARED WITH THE CONTROL GROUP THAT HAD A SEDENTARY LIFESTYLE. A CONVENIENCE SAMPLE OF 34 OUT OF 40 MEN AGED 25-55 YEARS OLD (34.0 +/- 0.9) WERE DEEMED ELIGIBLE FOR THIS STUDY. THEY WERE RANDOMLY DIVIDED INTO TWO GROUPS: EXPERIMENTAL AND CONTROL GROUPS. SUBJECTS IN THE EXPERIMENTAL GROUP WERE ENGAGED IN 60 MIN SESSIONS OF HATHA YOGA THREE TIMES A WEEK FOR 5 MONTHS. WE EVALUATED POSTURAL CONTROL BY MEASURING THE LIMIT OF STABILITY AND VELOCITY OF OSCILLATION (VOS) IN THREE CONDITIONS OF THE BALANCE REHABILITATION UNIT (BRU) AND THROUGH FIELD PROCEDURES (FOUR POSITION, PLANE, FLAMINGO, HOPSCOTCH, AND DYNAMIC TEST). RESULTS: WE OBSERVED DIFFERENCES (P < 0.05) IN POSTINTERVENTION SCORES BETWEEN THE GROUPS REGARDLESS OF BRU PARAMETERS AND FIELD PROCEDURES (EXCEPT FOR FLAMINGO) EVEN AFTER ADJUSTING FOR PREINTERVENTION SCORES, SUGGESTING THAT THESE CHANGES WERE INDUCED BY HATHA YOGA TRAINING. THE PARTIAL ETA SQUARED ON BRU PARAMETERS RANGED FROM 0.78 (VOS1)-0.97 (COP2), AND FROM 0.00 (FLAMINGO)-0.94 (FOUR POSITION) FOR THE FIELD PROCEDURES. CONCLUSIONS: OUR RESULTS PROVIDE SUBSTANTIAL EVIDENCE THAT POSTURAL CONTROL IN HEALTHY YOUNG ADULTS CAN BE IMPROVED THROUGH PRACTICING HATHA YOGA. 2014 20 2112 36 THE EFFECT OF YOGA ON STRESS, ANXIETY, AND DEPRESSION IN WOMEN. BACKGROUND: IN RECENT DECADES, SEVERAL MEDICAL AND SCIENTIFIC STUDIES ON YOGA PROVED IT TO BE VERY USEFUL IN THE TREATMENT OF SOME DISEASES. THIS STUDY WAS CONDUCTED TO INVESTIGATE THE EFFECTS OF YOGA ON STRESS, ANXIETY, AND DEPRESSION IN WOMEN LIVING IN ILAM, IRAN. METHODS: THIS STUDY IS A QUASI-EXPERIMENTAL STUDY WITH PRE-POST TEST. TO COLLECT DATA, THE QUESTIONNAIRE OF DASS-21 (DEPRESSION ANXIETY STRESS SCALE-21) WAS USED. FOR ELIGIBLE SAMPLES, HATHA YOGA EXERCISES AND TRAINING SESSIONS WERE HELD FOR 4 WEEKS (3 TIME/WEEKS; 60-70 MIN EACH) BY A SPECIALIST. DATA WERE ANALYZED USING SPSS VERSION 20. RESULTS: 52 WOMEN WITH A MEAN AGE OF 33.5 +/- 6.5 WERE INCLUDED FOR ANALYSIS. DEPRESSION, ANXIETY, AND STRESS DECREASED SIGNIFICANTLY IN WOMEN AFTER 12 SESSIONS OF REGULAR HATHA YOGA PRACTICE (P < 0.001). CONCLUSIONS: YOGA HAS AN EFFECTIVE ROLE IN REDUCING STRESS, ANXIETY, AND DEPRESSION. THUS, IT CAN BE USED AS COMPLEMENTARY MEDICINE. 2018