1 2446 122 YOGA AND TAI CHI: A MIND-BODY APPROACH IN MANAGING RESPIRATORY SYMPTOMS IN OBSTRUCTIVE LUNG DISEASES. PURPOSE OF REVIEW: CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IS CHARACTERIZED BY AIRFLOW LIMITATION BECAUSE OF AIRWAY AND/OR ALVEOLAR ABNORMALITIES. SYMPTOMS INCLUDE DYSPNEA, COUGH, CHRONIC SPUTUM PRODUCTION. AS THE THIRD-RANKED CAUSE OF DEATH AS WELL AS DISABILITY-ADJUSTED LIFE YEARS (DALYS), IT POSES A SIGNIFICANT BURDEN ON PATIENTS, FAMILIES, HEALTHCARE SYSTEM AND SOCIETY. REGULAR PHYSICAL ACTIVITY IS LINKED TO DECREASE IN MORBIDITY AND MORTALITY ASSOCIATED WITH COPD, BUT IMPLEMENTATION REMAINS CHALLENGING. THERE IS A NEED FOR COMMUNITY-BASED INTERVENTIONS THAT PROMOTE PHYSICAL ACTIVITY. YOGA AND TAI CHI ARE WIDELY AVAILABLE IN THE COMMUNITY AND HAVE BEEN SHOWN TO BE BENEFICIAL IN PATIENTS WITH COPD AS WELL AS MANY OF THE CO-MORBID CONDITIONS ASSOCIATED WITH COPD. RECENT FINDINGS: YOGA AND TAI CHI HAVE BEEN FOUND TO BE MORE EFFECTIVE THAN USUAL CARE IN COPD WITH CLINICALLY MEANINGFUL IMPROVEMENTS IN 6-MIN WALK DISTANCE (6MWD), FORCED EXPIRATORY VOLUME IN 1 S (FEV1), AND HEALTH-RELATED QUALITY OF LIFE (HRQOL). THEY HAVE ALSO BEEN FOUND TO BE COMPARABLE TO PULMONARY REHABILITATION INTERVENTIONS. SUMMARY: YOGA AND TAI CHI PROVIDE COMMUNITY-BASED OPTIONS FOR PATIENTS WITH COPD TO IMPROVE THEIR PHYSICAL ACTIVITY, QUALITY OF LIFE, AND PULMONARY FUNCTION. 2020 2 1141 26 EFFICACY OF YOGA, TAI CHI AND QI GONG ON THE MAIN SYMPTOMS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A SYSTEMATIC REVIEW. INTRODUCTION: THE AIM OF THIS SYSTEMATIC REVIEW WAS TO SUMMARIZE THE EFFECTS OF YOGA, QI GONG OR TAI CHI IN COPD PATIENTS. METHODS: STUDIES EVALUATING EFFECTS OF THE SELECTED COMPLEMENTARY THERAPIES ON LUNG FUNCTION, DYSPNEA, QUALITY OF LIFE OR FUNCTIONAL EXERCISE CAPACITY IN COPD PATIENTS WERE IDENTIFIED AND REVIEWED FROM THREE DATABASES. RESULTS: EIGHTEEN STUDIES WERE INCLUDED. SIX STUDIES EVALUATED THE EFFECTS OF YOGA AND THE OTHERS FOCUSED ON TAI CHI OR QI GONG SEPARATELY OR COMBINED. THE DURATION OF THE PROGRAMS RANGED FROM 6 WEEKS TO 6 MONTHS AND THE FREQUENCY FROM 2 TO 7 TIMES A WEEK. EACH SESSION REACHED 30 TO 90 MINUTES. BENEFITS WERE OBSERVED ON LUNG FUNCTION AND FUNCTIONAL EXERCISE CAPACITY BUT BENEFIT WAS CLEARLY STATED NEITHER ON QUALITY OF LIFE NOR ON DYSPNEA. CONCLUSION: THIS SYSTEMATIC REVIEW HIGHLIGHTS THE POTENTIAL OF THESE THERAPIES AS COMPLEMENTARY THERAPEUTIC APPROACH IN COPD PATIENTS. 2019 3 786 44 EFFECT OF YOGA BREATHING (PRANAYAMA) ON EXERCISE TOLERANCE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A RANDOMIZED, CONTROLLED TRIAL. OBJECTIVE: PULMONARY REHABILITATION IMPROVES EXERCISE TOLERANCE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). HOWEVER, MANY PATIENTS DO NOT HAVE ACCESS TO PULMONARY REHABILITATION PROGRAMS. WE HYPOTHESIZED THAT AN ALTERNATIVE TO PULMONARY REHABILITATION TO IMPROVE EXERCISE TOLERANCE IS THE PRACTICE OF PRANAYAMA, OR YOGA BREATHING, WHICH COULD BE DONE INDEPENDENTLY AT HOME. WE ALSO SOUGHT TO DETERMINE WHETHER YOGA NONPROFESSIONALS COULD ADEQUATELY TEACH PRANAYAMA TO PATIENTS. DESIGN: PROOF-OF-CONCEPT, RANDOMIZED, DOUBLE-BLIND, CONTROLLED PILOT TRIAL. SETTINGS/LOCATION: TWO ACADEMIC PULMONARY PRACTICES. SUBJECTS: FORTY-THREE PATIENTS WITH SYMPTOMATIC, MODERATE-TO-SEVERE COPD. INTERVENTIONS: TWELVE WEEKS OF PRANAYAMA PLUS EDUCATION VERSUS EDUCATION ALONE. TWO YOGA PROFESSIONALS TRAINED THE RESEARCH COORDINATORS TO CONDUCT ALL PRANAYAMA TEACHING AND MONITORED THE QUALITY OF THE TEACHING AND THE PRACTICE OF PRANAYAMA BY STUDY PARTICIPANTS. OUTCOME MEASURES: THE PRIMARY OUTCOME WAS A CHANGE IN THE 6-MIN WALK DISTANCE (6MWD). SECONDARY OUTCOMES INCLUDED CHANGES IN LUNG FUNCTION, MARKERS OF OXIDATIVE STRESS AND SYSTEMIC INFLAMMATION, AND MEASURES OF DYSPNEA AND QUALITY OF LIFE. RESULTS: THE 6MWD INCREASED IN THE PRANAYAMA GROUP (LEAST SQUARE MEAN [95% CONFIDENCE INTERVAL] = 28 M [-5 TO 61]) AND DECREASED IN THE CONTROL GROUP (-15 M [-47 TO 16]), WITH A NEARLY SIGNIFICANT TREATMENT EFFECT (P = 0.06) IN FAVOR OF PRANAYAMA. PRANAYAMA ALSO RESULTED IN SMALL IMPROVEMENTS IN INSPIRATORY CAPACITY AND AIR TRAPPING. BOTH GROUPS HAD SIGNIFICANT IMPROVEMENTS IN VARIOUS MEASURES OF SYMPTOMS, BUT NO OVERALL DIFFERENCES IN RESPIRATORY SYSTEM IMPEDANCE OR MARKERS OF OXIDATIVE STRESS OR SYSTEMIC INFLAMMATION. CONCLUSION: THIS PILOT STUDY SUCCESSFULLY DEMONSTRATED THAT PRANAYAMA WAS ASSOCIATED WITH IMPROVED EXERCISE TOLERANCE IN PATIENTS WITH COPD. LAY PERSONNEL WERE ABLE TO ADEQUATELY TEACH PATIENTS TO PRACTICE PRANAYAMA. THESE RESULTS SUGGEST THAT PRANAYAMA MAY HAVE SIGNIFICANT CLINICAL BENEFITS FOR SYMPTOMATIC PATIENTS WITH COPD, A CONCEPT THAT NEEDS TO BE CONFIRMED IN FUTURE, LARGER CLINICAL TRIALS. 2017 4 2683 36 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 5 2151 35 THE EFFECTS OF REGULAR YOGA PRACTICE ON PULMONARY FUNCTION IN HEALTHY INDIVIDUALS: A LITERATURE REVIEW. OBJECTIVES: YOGA IS A POPULAR FORM OF EXERCISE IN THE WESTERN WORLD, AND YOGA'S EFFECTS ON PULMONARY FUNCTION HAVE BEEN INVESTIGATED PREVIOUSLY. THE PURPOSE OF THIS ARTICLE IS TO REVIEW THIS RESEARCH SYSTEMATICALLY AND DETERMINE IF REGULAR YOGA TRAINING IMPROVES PULMONARY FUNCTION IN APPARENTLY HEALTHY INDIVIDUALS. METHODS: USING THE ALTERNATIVE HEALTH WATCH, THE PHYSICAL EDUCATION INDEX, MEDLINE,((R)) AND THE SPORTDISCUS DATABASES; AND THE KEYWORDS YOGA, RESPIRATION, AND PULMONARY FUNCTION, A COMPREHENSIVE SEARCH WAS CONDUCTED THAT YIELDED 57 STUDIES. OF THESE STUDIES SELECTIONS WERE MADE TO INCLUDE ONLY EXPERIMENTAL STUDIES WRITTEN IN ENGLISH, PUBLISHED IN PEER-REVIEWED JOURNALS AFTER 1980, AND INVESTIGATING THE EFFECTS OF REGULAR YOGA PRACTICE ON PULMONARY FUNCTION IN HEALTHY INDIVIDUALS PARTICIPATING IN THE STUDIES. RESULTS: YOGA IMPROVED PULMONARY FUNCTION, AS MEASURED BY MAXIMUM INSPIRATORY PRESSURE, MAXIMUM EXPIRATORY PRESSURE, MAXIMUM VOLUNTARY VENTILATION, FORCED VITAL CAPACITY, FORCED EXPIRATORY VOLUME IN 1 SECOND, AND PEAK EXPIRATORY FLOW RATE, IN ALL (N=9), BUT 1, STUDY. CONCLUSIONS: OVERALL, PULMONARY FUNCTION APPEARS TO IMPROVE WITH A MINIMUM OF 10 WEEKS OF REGULAR YOGA PRACTICE, AND THE MAGNITUDE OF THIS IMPROVEMENT IS RELATED TO FITNESS LEVEL AND/OR THE LENGTH OF TIME THE SUBJECTS SPEND PRACTICING PRANAYAMA (I.E., BREATHING EXERCISES). IN OTHER WORDS, GREATER IMPROVEMENTS IN PULMONARY FUNCTION ARE MORE LIKELY TO BE SEEN IN LESS-FIT INDIVIDUALS AND/OR THOSE THAT ENGAGE IN LONGER PERIODS OF PRANAYAMA. ADDITIONAL STUDIES EXAMINING VARIOUS YOGA PRACTICES ARE WARRANTED TO GAIN A MORE COMPREHENSIVE UNDERSTANDING OF THE EFFECTS OF YOGA TECHNIQUES ON PULMONARY FUNCTIONS. 2013 6 2609 49 YOGA FOR QUALITY OF LIFE IN INDIVIDUALS WITH CHRONIC DISEASE: A SYSTEMATIC REVIEW. BACKGROUND: CHRONIC DISEASES, INCLUDING HEART DISEASE, STROKE, CANCER, AND CHRONIC PULMONARY DISEASE ARE THE LEADING CAUSES OF DEATH AND DISABILITY WORLDWIDE. COMPOUNDING SYMPTOMS AND LOSS OF FUNCTION, PEOPLE LIVING WITH CHRONIC DISEASE OFTEN EXPERIENCE REDUCED QUALITY OF LIFE (QOL). VARIOUS PHYSICAL AND MENTAL PRACTICES HAVE BEEN SHOWN TO RELIEVE STRESS AND IMPROVE QOL. YOGA IS A PHYSICAL AND MENTAL PRACTICE THAT MAY BE A VIABLE APPROACH FOR IMPROVING QOL IN PEOPLE WITH CHRONIC DISEASE. OBJECTIVE: THE OBJECTIVE OF THIS STUDY WAS TO EXAMINE AND SUMMARIZE THE EVIDENCE FOR THE EFFECTIVENESS OF YOGA ON QOL IN PATIENTS WITH CHRONIC DISEASE. DESIGN: THE STUDY DESIGN WAS A A SYSTEMATIC REVIEW WITH QUALITATIVE SYNTHESIS. METHODS: WE INCLUDED RANDOMIZED CONTROLLED TRIALS THAT EVALUATED THE EFFECT OF YOGA ON QOL OR HEALTH-RELATED QOL (HRQOL) FOR INDIVIDUALS WITH CHRONIC DISEASE. WE INCLUDED ONLY STUDIES THAT USED AT LEAST 1 PREVIOUSLY VALIDATED MEASURE OF QOL OR HRQOL AND SPECIFIED A MINIMUM DURATION OF FOLLOW-UP OF AT LEAST 1 WK. INTERVENTIONS: WE INCLUDED BOTH MOVEMENT-BASED AND BREATH-BASED YOGA PRACTICES. STUDIES THAT INCLUDED YOGA AS PART OF A LARGER INTERVENTION PROGRAM (EG, MINDFULNESS-BASED STRESS REDUCTION TRAINING) OR STUDIES THAT DID NOT PROVIDE FINDINGS SPECIFIC TO YOGA WERE EXCLUDED. PRIMARY OUTCOME MEASURES: THE PRIMARY OUTCOME ANALYZED WAS IMPROVEMENT IN QOL AS MEASURED BY A VALIDATED QOL OR HRQOL SCALE. RESULTS: AMONG THE 1488 STUDIES THAT WERE IDENTIFIED ON INITIAL SEARCH, 7 ARTICLES MET ALL INCLUSION CRITERIA. FIVE STUDIES REPORTED A STATISTICALLY SIGNIFICANT ADVANTAGE OVER USUAL CARE ALONE FOR IMPROVEMENT OF QOL IN PATIENTS WITH CHRONIC DISEASE, BUT THE CLINICAL SIGNIFICANCE OF THE DIFFERENCES WAS CLEAR IN ONLY 1 TRIAL. WE FOUND CONSIDERABLE HETEROGENEITY AMONG THE INCLUDED STUDIES AND STUDY QUALITY WAS GENERALLY LOW. CONCLUSIONS: MORE HIGH-QUALITY RESEARCH IS NEEDED TO DETERMINE THE VALUE OF YOGA AS AN ADJUNCTIVE APPROACH TO IMPROVING QOL IN PATIENTS WITH CHRONIC DISEASE. 2019 7 792 33 EFFECT OF YOGA IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE. YOGA IS ADJUNCTIVELY UTILIZED OUTSIDE THE UNITED STATES IN THE TREATMENT OF A VARIETY OF DISEASES, INCLUDING CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), BUT THERE ARE NO STUDIES ASSESSING ITS ADJUNCTIVE EFFICACY IN THE UNITED STATES. WE PROSPECTIVELY EVALUATED THE EFFECTS OF YOGA TRAINING ON THE QUALITY OF LIFE (QOL) AND THE PARAMETERS OF LUNG FUNCTION IN PATIENTS WITH COPD. THIRTY-THREE PATIENTS WITH DOCUMENTED COPD, PER GLOBAL INITIATIVE FOR OBSTRUCTIVE LUNG DISEASE CRITERIA, WERE RECRUITED. ALL PATIENTS RECEIVED STANDARD COPD CARE. THE QOL WAS ASSESSED BY THE ST. GEORGE RESPIRATORY QUESTIONNAIRE. STANDARD SPIROMETRY AND MAXIMUM INSPIRATORY (MAXIMAL INSPIRATORY PRESSURE) AND EXPIRATORY PRESSURE (MAXIMAL EXPIRATORY PRESSURE) WERE MEASURED. PATIENTS WERE TAUGHT SELECTED YOGA EXERCISES INCLUDING BREATHING EXERCISES, MEDITATION, AND YOGA POSTURES FOR 1 HOUR, THRICE A WEEK FOR 6 WEEKS BY A CERTIFIED YOGA THERAPIST. THE QUALITY OF LIFE AND LUNG FUNCTION WERE AGAIN ASSESSED AT THE END OF 6 WEEKS. TWENTY-TWO PATIENTS COMPLETED THE STUDY. DIFFERENCES IN PREYOGA VERSUS POSTYOGA SCORES WERE EVALUATED USING PAIRED T-TESTS. STATISTICALLY SIGNIFICANT IMPROVEMENTS (P < 0.05) WERE OBSERVED FOR THE ST. GEORGE RESPIRATORY QUESTIONNAIRE [95% CONFIDENCE INTERVAL (CI) 43.13-58.47], VITAL CAPACITY (95% CI 2.53-7.65), MAXIMAL INSPIRATORY PRESSURE (95% CI 6.62-23.64), AND MAXIMAL EXPIRATORY PRESSURE (95% CI 1.63-13.81). YOGA WHEN PRACTICED BY PATIENTS WITH COPD RESULTS IN IMPROVEMENT IN THE QOL AND LUNG FUNCTION ON A SHORT-TERM BASIS. ADDITIONAL RESEARCH IS NEEDED TO CONFIRM THESE FINDINGS IN A RANDOMIZED CONTROLLED TRIAL AND IN THE LONGER TERM. 2012 8 2923 26 [WHERE AND HOW DOES YOGA WORK? - A SCIENTIFIC OVERVIEW]. AS A TRADITIONAL HEALTH CARE SYSTEM, YOGA COMBINES PHYSICAL ACTIVITY, BREATHING TECHNIQUES AND MEDITATION. IT IS INCREASINGLY USED AS A PREVENTIVE OR THERAPEUTIC MEANS. YOGA HAS BEEN RESEARCHED IN HUNDREDS OF RANDOMIZED CONTROLLED TRIALS. POSITIVE EFFECTS ARE ESPECIALLY FOUND FOR CHRONIC PAIN CONDITIONS, HYPERTENSION, DEPRESSION AND IN SUPPORTIVE CANCER CARE. WHILE THERE ARE CASE REPORTS OF SERIOUS ADVERSE EVENTS ASSOCIATED WITH YOGA, THE RISK SEEMS TO BE EXTREMELY LOW AND COMPARABLE TO OTHER FORMS OF PHYSICAL ACTIVITY. YOGA CAN THUS BE CONSIDERED AS A SAFE AND EFFECTIVE ADJUNCT THERAPY FOR A NUMBER OF CONDITIONS. 2017 9 2470 38 YOGA AS A TREATMENT FOR CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW OF THE LITERATURE. OBJECTIVES: CHRONIC LOW BACK PAIN (CLBP) AFFECTS MILLIONS OF PEOPLE WORLDWIDE, AND APPEARS TO BE INCREASING IN PREVALENCE. IT IS ASSOCIATED NOT ONLY WITH PAIN, BUT ALSO WITH INCREASED DISABILITY, PSYCHOLOGICAL SYMPTOMS, AND REDUCED QUALITY OF LIFE. THERE ARE VARIOUS TREATMENT OPTIONS FOR CLBP, BUT NO SINGLE THERAPY STANDS OUT AS BEING THE MOST EFFECTIVE. IN THE PAST 10 YEARS, YOGA INTERVENTIONS HAVE BEEN STUDIED AS A CLBP TREATMENT APPROACH. THE OBJECTIVE OF THIS PAPER IS TO REVIEW THE CURRENT LITERATURE SUPPORTING THE EFFICACY OF YOGA FOR CLBP. METHODS: A LITERATURE SEARCH THROUGH THE BEGINNING OF 2015 WAS CONDUCTED IN PUB MED FOR RANDOMIZED CONTROL TRIALS ADDRESSING TREATMENT OF CLBP WITH YOGA. RESULTS: IN THIS REVIEW WE EVALUATE THE USE OF YOGA AS A TREATMENT FOR CLBP. SPECIFICALLY WE EVALUATE HOW YOGA IMPACTS PHYSICAL FUNCTIONING AND DISABILITY, PAIN, AND ASSOCIATED PSYCHOLOGICAL SYMPTOMS. WE ALSO EVALUATE POSSIBLE MEDIATORS OF THE EFFECT OF YOGA AND THE SAFETY OF YOGA. DISCUSSION: WITH FEW EXCEPTIONS, PREVIOUS STUDIES AND THE RECENT RANDOMIZED CONTROL TRIALS (RCTS) INDICATE THAT YOGA CAN REDUCE PAIN AND DISABILITY, CAN BE PRACTICED SAFELY, AND IS WELL RECEIVED BY PARTICIPANTS. SOME STUDIES ALSO INDICATE THAT YOGA MAY IMPROVE PSYCHOLOGICAL SYMPTOMS, BUT THESE EFFECTS ARE CURRENTLY NOT AS WELL ESTABLISHED. 2016 10 1768 32 POTENTIAL FOR INTEGRATING YOGA WITHIN PULMONARY REHABILITATION AND RECOMMENDATIONS OF REPORTING FRAMEWORK. THERE IS A RISING BURDEN OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IN INDIA. PULMONARY REHABILITATION (PR), IS A UNIVERSALLY RECOMMENDED MULTIDISCIPLINARY THERAPEUTIC STRATEGY FOR THE MANAGEMENT OF COPD; HOWEVER, ITS NEEDS ARE UNMET. THE DIVERSITY IN THE HEALTHCARE SYSTEMS, AVAILABILITY OF PR SPECIALISTS AND SOCIOCULTURAL MULTIFORMITY REQUIRES CONTEXTUALISED AND INNOVATIVE PR MODELS. CULTURALLY SENSITIVE ELEMENTS, SUCH AS YOGA, HAVE SOME EVIDENCE OF A POSITIVE IMPACT IN THE MANAGEMENT OF COPD. YOGA AND PR ARE BASED ON SIMILAR PRINCIPLES WITH A HOLISTIC APPROACH OF INVOLVING PHYSICAL ACTIVITIES, BEHAVIOUR CHANGE TECHNIQUES AND PSYCHOLOGICAL SUPPORT TO IMPROVE DISEASE OUTCOMES. ARGUABLY THE PRINCIPLES OF PR AND YOGA ARE COMPLEMENTARY BUT THERE ARE SOME IMPORTANT DIFFERENCES IN THE INTENSITIES OF ACTIVITIES, EXERCISE TYPES AND INCLUSION OF MINDFULNESS IN COMPONENTS THAT MUST BE CONSIDERED. COMPONENTS OF PR ENABLE AEROBIC CAPACITY BUILDING, STRENGTHENING OF MUSCLES OF THE UPPER AND LOWER EXTREMITIES AND BUILDING AWARENESS TOWARDS DISEASE MANAGEMENT. YOGA, ON THE OTHER HAND, PRIMARILY CAN FOCUS ON CORE STRENGTHENING, BREATHING CONTROL, MINDFULNESS AND SELF-AWARENESS. WE DISCUSS THE POTENTIAL OF INTEGRATING THE SOCIOCULTURAL APPEAL OF YOGA WITH PR DELIVERED AT INTERNATIONAL STANDARDS, AND HOW AN INTEGRATED APPROACH MAY LEAD TO OPTIMAL REFERRAL, UPTAKE AND COMPLETION. 2021 11 609 48 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 12 1218 30 EXPLORING THE THERAPEUTIC EFFECTS OF YOGA AND ITS ABILITY TO INCREASE QUALITY OF LIFE. THE OBJECTIVE OF THIS STUDY IS TO ASSESS THE FINDINGS OF SELECTED ARTICLES REGARDING THE THERAPEUTIC EFFECTS OF YOGA AND TO PROVIDE A COMPREHENSIVE REVIEW OF THE BENEFITS OF REGULAR YOGA PRACTICE. AS PARTICIPATION RATES IN MIND-BODY FITNESS PROGRAMS SUCH AS YOGA CONTINUE TO INCREASE, IT IS IMPORTANT FOR HEALTH CARE PROFESSIONALS TO BE INFORMED ABOUT THE NATURE OF YOGA AND THE EVIDENCE OF ITS MANY THERAPEUTIC EFFECTS. THUS, THIS MANUSCRIPT PROVIDES INFORMATION REGARDING THE THERAPEUTIC EFFECTS OF YOGA AS IT HAS BEEN STUDIED IN VARIOUS POPULATIONS CONCERNING A MULTITUDE OF DIFFERENT AILMENTS AND CONDITIONS. THERAPEUTIC YOGA IS DEFINED AS THE APPLICATION OF YOGA POSTURES AND PRACTICE TO THE TREATMENT OF HEALTH CONDITIONS AND INVOLVES INSTRUCTION IN YOGIC PRACTICES AND TEACHINGS TO PREVENT REDUCE OR ALLEVIATE STRUCTURAL, PHYSIOLOGICAL, EMOTIONAL AND SPIRITUAL PAIN, SUFFERING OR LIMITATIONS. RESULTS FROM THIS STUDY SHOW THAT YOGIC PRACTICES ENHANCE MUSCULAR STRENGTH AND BODY FLEXIBILITY, PROMOTE AND IMPROVE RESPIRATORY AND CARDIOVASCULAR FUNCTION, PROMOTE RECOVERY FROM AND TREATMENT OF ADDICTION, REDUCE STRESS, ANXIETY, DEPRESSION, AND CHRONIC PAIN, IMPROVE SLEEP PATTERNS, AND ENHANCE OVERALL WELL-BEING AND QUALITY OF LIFE. 2011 13 1088 29 EFFECTS OF YOGA ON SYMPTOMS, PHYSICAL FUNCTION, AND PSYCHOSOCIAL OUTCOMES IN ADULTS WITH OSTEOARTHRITIS: A FOCUSED REVIEW. OSTEOARTHRITIS (OA) IS A HIGHLY PREVALENT AND DISABLING CHRONIC CONDITION. BECAUSE PHYSICAL ACTIVITY IS A KEY COMPONENT IN OA MANAGEMENT, EFFECTIVE EXERCISE INTERVENTIONS ARE NEEDED. YOGA IS AN INCREASINGLY POPULAR MULTIMODAL MIND-BODY EXERCISE THAT AIMS TO PROMOTE FLEXIBILITY, STRENGTH, ENDURANCE, AND BALANCE. ITS GENTLE APPROACH IS POTENTIALLY A SAFE AND EFFECTIVE EXERCISE OPTION FOR MANAGING OA. THE PURPOSE OF THIS FOCUSED REVIEW IS TO EXAMINE THE EFFECTS OF YOGA ON OA SYMPTOMS AND PHYSICAL AND PSYCHOSOCIAL OUTCOMES. A COMPREHENSIVE SEARCH WAS CONDUCTED USING SEVEN ELECTRONIC DATABASES. TWELVE REPORTS MET INCLUSION CRITERIA INVOLVING A TOTAL OF 589 PARTICIPANTS WITH OA-RELATED SYMPTOMS. A VARIETY OF TYPES, FREQUENCIES, AND DURATIONS OF YOGA INTERVENTIONS WERE REPORTED; HATHA AND IYENGAR YOGA WERE THE MOST COMMONLY USED TYPES. FREQUENCY OF INTERVENTION RANGED FROM ONCE A WEEK TO 6 DAYS A WEEK. DURATION OF THE INTERVENTIONS RANGED FROM 45 TO 90 MINS PER SESSION FOR 6 TO 12 WKS. YOGA INTERVENTION RESULTED IN REDUCTIONS IN PAIN, STIFFNESS, AND SWELLING, BUT RESULTS ON PHYSICAL FUNCTION AND PSYCHOSOCIAL WELL-BEING WERE INCONCLUSIVE BECAUSE OF A VARIETY OF OUTCOME MEASURES BEING USED. 2016 14 2170 32 THE EFFECTS OF YOGA ON ANXIETY AND STRESS. STRESS AND ANXIETY HAVE BEEN IMPLICATED AS CONTRIBUTORS TO MANY CHRONIC DISEASES AND TO DECREASED QUALITY OF LIFE, EVEN WITH PHARMACOLOGIC TREATMENT. EFFORTS ARE UNDERWAY TO FIND NON-PHARMACOLOGIC THERAPIES TO RELIEVE STRESS AND ANXIETY, AND YOGA IS ONE OPTION FOR WHICH RESULTS ARE PROMISING. THE FOCUS OF THIS REVIEW IS ON THE RESULTS OF HUMAN TRIALS ASSESSING THE ROLE OF YOGA IN IMPROVING THE SIGNS AND SYMPTOMS OF STRESS AND ANXIETY. OF 35 TRIALS ADDRESSING THE EFFECTS OF YOGA ON ANXIETY AND STRESS, 25 NOTED A SIGNIFICANT DECREASE IN STRESS AND/OR ANXIETY SYMPTOMS WHEN A YOGA REGIMEN WAS IMPLEMENTED; HOWEVER, MANY OF THE STUDIES WERE ALSO HINDERED BY LIMITATIONS, SUCH AS SMALL STUDY POPULATIONS, LACK OF RANDOMIZATION, AND LACK OF A CONTROL GROUP. FOURTEEN OF THE 35 STUDIES REPORTED BIOCHEMICAL AND PHYSIOLOGICAL MARKERS OF STRESS AND ANXIETY, BUT YIELDED INCONSISTENT SUPPORT OF YOGA FOR RELIEF OF STRESS AND ANXIETY. EVALUATION OF THE CURRENT PRIMARY LITERATURE IS SUGGESTIVE OF BENEFITS OF YOGA IN RELIEVING STRESS AND ANXIETY, BUT FURTHER INVESTIGATION INTO THIS RELATIONSHIP USING LARGE, WELL-DEFINED POPULATIONS, ADEQUATE CONTROLS, RANDOMIZATION AND LONG DURATION SHOULD BE EXPLORED BEFORE RECOMMENDING YOGA AS A TREATMENT OPTION. 2012 15 2196 34 THE EFFICACY AND SAFETY OF YOGA IN MANAGING HYPERTENSION. HYPERTENSION IS A MAJOR PUBLIC HEALTH PROBLEM AND ONE OF THE MOST IMPORTANT CAUSES OF PREMATURE MORBIDITY AND MORTALITY. YOGA IS A TRADITIONAL INDIAN PRACTICE THAT HAS BEEN ADAPTED FOR USE IN COMPLEMENTARY AND ALTERNATIVE MEDICINE AND MAINLY INCLUDES PHYSICAL POSTURES, BREATHING TECHNIQUES, AND MEDITATION. THE IMPACT OF YOGA AS A COMPLEMENTARY INTERVENTION FOR HYPERTENSION HAS BEEN INVESTIGATED IN A NUMBER OF RANDOMIZED CONTROLLED TRIALS; WITH AN OVERALL EFFECT OF ABOUT 10 MMHG REDUCTION IN SYSTOLIC AND ABOUT 8 MMHG REDUCTION IN DIASTOLIC BLOOD PRESSURE. YOGA SEEMS TO BE EFFECTIVE ONLY FOR HYPERTENSION BUT NOT FOR PREHYPERTENSION; AND ONLY AS AN ADJUNCT TO ANTIHYPERTENSIVE PHARMACOLOGICAL TREATMENT BUT NOT AS AN ALTERNATIVE THERAPY. BREATHING AND MEDITATION RATHER THAN PHYSICAL ACTIVITY SEEM TO BE THE ACTIVE PART OF YOGA INTERVENTIONS FOR HYPERTENSIVE PATIENTS. THESE PRACTICES CAN INCREASE PARASYMPATHIC ACTIVITY AND DECREASE SYMPATHETIC ACTIVITY, ARGUABLY MAINLY BY INCREASING GABA ACTIVITY; THUS COUNTERACTING EXCESS ACTIVITY OF THE SYMPATHETIC NERVOUS SYSTEM WHICH HAS BEEN ASSOCIATED WITH HYPERTENSION. ALTHOUGH YOGA HAS BEEN ASSOCIATED WITH SERIOUS ADVERSE EVENTS IN SINGLE CASE REPORTS, POPULATION-BASED SURVEYS AS WELL AS CLINICAL TRIALS INDICATE THAT YOGA IS A RELATIVELY SAFE INTERVENTION THAT IS NOT ASSOCIATED WITH MORE ADVERSE EVENTS THAN OTHER FORMS OF PHYSICAL ACTIVITY. YOGA CAN THUS BE CONSIDERED A SAFE AND EFFECTIVE INTERVENTION FOR MANAGING HYPERTENSION. GIVEN THE POSSIBLY BETTER RISK/BENEFIT RATIO, IT MAY BE ADVISABLE TO FOCUS ON YOGIC MEDITATION AND/OR BREATHING TECHNIQUES. 2016 16 2243 43 THE INFLUENCE OF TAI CHI AND YOGA ON BALANCE AND FALLS IN A RESIDENTIAL CARE SETTING: A RANDOMISED CONTROLLED TRIAL. ABSTRACT FALLS AMONGST OLDER PEOPLE IS A GLOBAL PUBLIC HEALTH CONCERN. WHILST FALLING IS NOT A TYPICAL FEATURE OF AGEING, OLDER PEOPLE ARE MORE LIKELY TO FALL. FALL INJURIES AMONGST OLDER PEOPLE ARE A LEADING CAUSE OF DEATH AND DISABILITY. MANY OLDER PEOPLE DO NOT DO REGULAR EXERCISE SO THAT THEY LOSE MUSCLE TONE, STRENGTH, AND FLEXIBILITY WHICH AFFECT BALANCE AND PREDISPOSE THEM TO FALLS. THE MANAGEMENT OF FALLS IN RESIDENTIAL CARE SETTINGS IS A MAJOR CONCERN WITH STRATEGIES FOR PREVENTION AND MONITORING A FOCUS IN THIS SETTING. YOGA AND TAI CHI HAVE SHOWN POTENTIAL TO IMPROVE BALANCE AND PREVENT FALLS IN OLDER ADULTS. THEY ALSO HAVE POTENTIAL TO IMPROVE PAIN AND QUALITY OF LIFE. THE AIM OF THIS STUDY WAS TO DETERMINE THE FEASIBILITY OF CONDUCTING A 3-ARM RCT WITH FRAIL OLDER PEOPLE IN A RESIDENTIAL CARE SETTING TO TEST THE HYPOTHESIS THAT A 14 WEEK MODIFIED TAI CHI OR YOGA PROGRAM IS MORE EFFECTIVE THAN USUAL CARE ACTIVITY IN IMPROVING BALANCE FUNCTION, QUALITY OF LIFE, PAIN EXPERIENCE AND IN REDUCING NUMBER OF FALLS. THERE WERE NO STATISTICALLY SIGNIFICANT DIFFERENCES BETWEEN THE THREE GROUPS IN THE OCCURRENCE OF FALLS. YOGA DEMONSTRATED A SLIGHT DECREASE IN FALL INCIDENCE; QUALITY OF LIFE IMPROVED FOR THE TAI CHI GROUP. ONLY THE YOGA GROUP EXPERIENCED A REDUCTION IN AVERAGE PAIN SCORES THOUGH NOT STATISTICALLY SIGNIFICANT. THE FINDINGS OF THE STUDY SUGGEST IT IS POSSIBLE TO SAFELY IMPLEMENT MODIFIED YOGA AND TAI CHI IN A RESIDENTIAL CARE SETTING AND EVALUATE THIS USING RCT DESIGN. THEY SHOW POSITIVE CHANGES TO BALANCE, PAIN AND QUALITY OF LIFE AND A HIGH LEVEL OF INTEREST THROUGH ATTENDANCE AMONGST THE OLDER PARTICIPANTS. THE RESULTS SUPPORT OFFERING TAI CHI AND YOGA TO OLDER PEOPLE WHO ARE FRAIL AND DEPENDENT WITH PHYSICAL AND COGNITIVE LIMITATIONS. 2014 17 836 26 EFFECT OF YOGA ON PATIENTS WITH CANCER: OUR CURRENT UNDERSTANDING. OBJECTIVE: TO DETERMINE WHETHER THERAPEUTIC YOGA IMPROVES THE QUALITY OF LIFE OF PATIENTS WITH CANCER. DATA SOURCES: SEARCH OF MEDLINE DATABASE (1950-2010) USING KEY WORDS YOGA, CANCER, AND QUALITY OF LIFE. STUDY SELECTION: PRIORITY WAS GIVEN TO RANDOMIZED CONTROLLED CLINICAL STUDIES CONDUCTED TO DETERMINE THE EFFECT OF YOGA ON TYPICAL SYMPTOMS OF PATIENTS WITH CANCER IN NORTH AMERICA. SYNTHESIS: INITIALLY, 4 RANDOMIZED CONTROLLED CLINICAL STUDIES WERE ANALYZED, THEN 2 STUDIES WITHOUT CONTROL GROUPS WERE ANALYZED. THREE STUDIES CONDUCTED IN INDIA AND THE NEAR EAST PROVIDED INTERESTING INFORMATION ON METHODOLOGIES. THE INTERVENTIONS INCLUDED YOGA SESSIONS OF VARYING LENGTH AND FREQUENCY. THE PARAMETERS MEASURED ALSO VARIED AMONG STUDIES. SEVERAL SYMPTOMS IMPROVED SUBSTANTIALLY WITH YOGA (HIGHER QUALITY OF SLEEP, DECREASE IN SYMPTOMS OF ANXIETY AND DEPRESSION, IMPROVEMENT IN SPIRITUAL WELL-BEING, ETC). IT WOULD APPEAR THAT QUALITY OF LIFE, OR SOME ASPECTS THEREOF, ALSO IMPROVED. CONCLUSION: THE VARIETY OF BENEFITS DERIVED, THE ABSENCE OF SIDE EFFECTS, AND THE COST-BENEFIT RATIO OF THERAPEUTIC YOGA MAKE IT AN INTERESTING ALTERNATIVE FOR FAMILY PHYSICIANS TO SUGGEST TO THEIR PATIENTS WITH CANCER. CERTAIN METHODOLOGIC SHORTCOMINGS, INCLUDING THE LIMITED SIZE OF THE SAMPLES AND VARYING LEVELS OF ATTENDANCE ON THE PART OF THE SUBJECTS, MIGHT HAVE REDUCED THE STATISTICAL STRENGTH OF THE STUDIES PRESENTED. IT IS ALSO POSSIBLE THAT THE MEASUREMENT SCALES USED DID NOT SUIT THIS TYPE OF SITUATION AND PATIENT POPULATION, MAKING IT IMPOSSIBLE TO SEE A SIGNIFICANT EFFECT. HOWEVER, FAVOURABLE COMMENTS BY PARTICIPANTS DURING THE STUDIES AND THEIR LEVEL OF APPRECIATION AND WELL-BEING SUGGEST THAT FURTHER RESEARCH IS CALLED FOR TO FULLY UNDERSTAND THE MECHANISMS OF THESE EFFECTS. 2012 18 2292 24 THERAPEUTIC EFFECTS OF YOGA FOR CHILDREN: A SYSTEMATIC REVIEW OF THE LITERATURE. PURPOSE: WE COMPLETED A SYSTEMATIC REVIEW OF THE LITERATURE ON THE EFFECT OF YOGA ON QUALITY OF LIFE AND PHYSICAL OUTCOME MEASURES IN THE PEDIATRIC POPULATION. WE EXPLORED VARIOUS DATABASES AND INCLUDED CASE-CONTROL AND PILOT STUDIES, COHORT AND RANDOMIZED CONTROLLED TRIALS THAT EXAMINED YOGA AS AN EXERCISE INTERVENTION FOR CHILDREN. SUMMARY OF KEY POINTS: USING THE SACKETT LEVELS OF EVIDENCE, THIS ARTICLE REVIEWS THE LITERATURE ON YOGA AS A COMPLEMENTARY MIND-BODY MOVEMENT THERAPY. WE ADDRESS THE RESEARCH THROUGH THREE PRACTICE PATTERNS ACCORDING TO THE GUIDE TO PHYSICAL THERAPIST PRACTICE AND PROVIDE CONSIDERATIONS FOR THE INCLUSION OF YOGA INTO CLINICAL PRACTICE. STATEMENT OF CONCLUSIONS AND RECOMMENDATIONS FOR CLINICAL PRACTICE: THE EVIDENCE SHOWS PHYSIOLOGICAL BENEFITS OF YOGA FOR THE PEDIATRIC POPULATION THAT MAY BENEFIT CHILDREN THROUGH THE REHABILITATION PROCESS, BUT LARGER CLINICAL TRIALS, INCLUDING SPECIFIC MEASURES OF QUALITY OF LIFE ARE NECESSARY TO PROVIDE DEFINITIVE EVIDENCE. 2008 19 2383 30 YOGA & CANCER INTERVENTIONS: A REVIEW OF THE CLINICAL SIGNIFICANCE OF PATIENT REPORTED OUTCOMES FOR CANCER SURVIVORS. LIMITED RESEARCH SUGGESTS YOGA MAY BE A VIABLE GENTLE PHYSICAL ACTIVITY OPTION WITH A VARIETY OF HEALTH-RELATED QUALITY OF LIFE, PSYCHOSOCIAL AND SYMPTOM MANAGEMENT BENEFITS. THE PURPOSE OF THIS REVIEW WAS TO DETERMINE THE CLINICAL SIGNIFICANCE OF PATIENT-REPORTED OUTCOMES FROM YOGA INTERVENTIONS CONDUCTED WITH CANCER SURVIVORS. A TOTAL OF 25 PUBLISHED YOGA INTERVENTION STUDIES FOR CANCER SURVIVORS FROM 2004-2011 HAD PATIENT-REPORTED OUTCOMES, INCLUDING QUALITY OF LIFE, PSYCHOSOCIAL OR SYMPTOM MEASURES. THIRTEEN OF THESE STUDIES MET THE NECESSARY CRITERIA TO ASSESS CLINICAL SIGNIFICANCE. CLINICAL SIGNIFICANCE FOR EACH OF THE OUTCOMES OF INTEREST WAS EXAMINED BASED ON 1 STANDARD ERROR OF THE MEASUREMENT, 0.5 STANDARD DEVIATION, AND RELATIVE COMPARATIVE EFFECT SIZES AND THEIR RESPECTIVE CONFIDENCE INTERVALS. THIS REVIEW DESCRIBES IN DETAIL THESE PATIENT-REPORTED OUTCOMES, HOW THEY WERE OBTAINED, THEIR RELATIVE CLINICAL SIGNIFICANCE AND IMPLICATIONS FOR BOTH CLINICAL AND RESEARCH SETTINGS. OVERALL, CLINICALLY SIGNIFICANT CHANGES IN PATIENT-REPORTED OUTCOMES SUGGEST THAT YOGA INTERVENTIONS HOLD PROMISE FOR IMPROVING CANCER SURVIVORS' WELL-BEING. THIS RESEARCH OVERVIEW PROVIDES NEW DIRECTIONS FOR EXAMINING HOW CLINICAL SIGNIFICANCE CAN PROVIDE A UNIQUE CONTEXT FOR DESCRIBING CHANGES IN PATIENT-REPORTED OUTCOMES FROM YOGA INTERVENTIONS. RESEARCHERS ARE ENCOURAGED TO EMPLOY INDICES OF CLINICAL SIGNIFICANCE IN THE INTERPRETATION AND DISCUSSION OF RESULTS FROM YOGA STUDIES. 2012 20 1912 29 ROLE OF BREATHING EXERCISES AND YOGA/PRANAYAMA IN CHILDHOOD ASTHMA: A SYSTEMATIC REVIEW. BACKGROUND: VARIOUS COMPLEMENTARY OR ALTERNATIVE MEDICINES (INCLUDING BREATHING EXERCISES AND YOGA/PRANAYAMA) HAVE BEEN TRIED AS AN ATTRACTIVE OPTION TO PHARMACOTHERAPY IN CHILDHOOD ASTHMA. OBJECTIVE: TO EVALUATE THE ROLE OF BREATHING EXERCISE AND YOGA/PRANAYAMA AS ADD ON THERAPY TO THE "PHARMACOLOGICALLY RECOMMENDED TREATMENT" OF CHILDHOOD ASTHMA. METHODS: WE SEARCHED THE PUBLISHED LITERATURE IN THE MAJOR DATABASES: MEDLINE VIA OVID, PUBMED, CENTRAL, EMBASE, AND GOOGLE SCHOLAR TILL JUNE 2018. RANDOMIZED TRIALS COMPARING BREATHING EXERCISES AND YOGA/ PRANAYAMA VERSUS CONTROL OR AS PART OF A COMPOSITE INTERVENTION VERSUS CONTROL WERE INCLUDED. THE PRIMARY OUTCOME MEASURES WERE QUALITY OF LIFE AND CHANGE IN ASTHMA SYMPTOMS. SECONDARY OUTCOMES WERE: DECREASE IN MEDICATION USE, NUMBER OF EXACERBATIONS, CHANGE IN LUNG FUNCTION AND IMMUNOLOGICAL PARAMETERS, SCHOOL ABSENTEEISM AND ADVERSE EVENTS. RESULTS: A TOTAL OF 10 TRIALS (466 CHILDREN, 6-14 YEARS AGE) WERE INCLUDED. THE SEVERITY OF ASTHMA VARIED AMONG THE TRIALS. THE DATA FOR PRIMARY OUTCOME MEASURES COULD NOT BE POOLED, THERE WERE MIXED RESULTS FOR BOTH PRIMARY AND SECONDARY OUTCOMES. NO SIGNIFICANT BENEFIT WAS OBTAINED IN ACUTE ASTHMA AND THE LUNG FUNCTION TESTS [EXCEPT PEFR % AT 4-6 WEEKS, PEF ABSOLUTE AT 3 MONTHS, AND FVC ABSOLUTE AT 3 MONTHS] IN CHRONIC ASTHMA. ONE TRIAL COMPARED BREATHING EXERCISE VERSUS YOGA AND FOUND NO DIFFERENCE. ADVERSE EVENTS WERE NOT SIGNIFICANT. CONCLUSIONS: BREATHING EXERCISE AND YOGA/ PRANAYAMA MAY HAVE SOME ADDITIVE ROLE IN THE TREATMENT OF CHILDHOOD ASTHMA. HOWEVER, AT PRESENT, IT CANNOT BE RECOMMENDED AS A STANDARD OF CARE DUE TO INSUFFICIENT DATA. 2019