1 2583 155 YOGA FOR HEART RATE VARIABILITY: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CLINICAL TRIALS. THE OBJECTIVE OF THIS SYSTEMATIC REVIEW IS TO SUMMARIZE AND CRITICALLY ASSESS THE EFFECTS OF YOGA ON HEART RATE VARIABILITY (HRV). NINE DATABASES WERE SEARCHED FROM THEIR INCEPTIONS TO JUNE 2014. WE INCLUDED RANDOMIZED CLINICAL TRIALS (RCTS) COMPARING YOGA AGAINST ANY TYPE OF CONTROL INTERVENTION IN HEALTHY INDIVIDUALS OR PATIENTS WITH ANY MEDICAL CONDITION. RISK OF BIAS WAS ASSESSED USING THE COCHRANE CRITERIA. TWO REVIEWERS PERFORMED THE SELECTION OF STUDIES, DATA EXTRACTION, AND QUALITY ASSESSMENTS INDEPENDENT OF ONE ANOTHER. FOURTEEN TRIALS MET THE INCLUSION CRITERIA. ONLY TWO OF THEM WERE OF ACCEPTABLE METHODOLOGICAL QUALITY. TEN RCTS REPORTED FAVOURABLE EFFECTS OF YOGA ON VARIOUS DOMAINS OF HRV, WHEREAS NINE OF THEM FAILED TO DO SO. ONE RCT DID NOT REPORT BETWEEN-GROUP COMPARISONS. THE META-ANALYSIS (MA) OF TWO TRIALS DID NOT SHOW FAVOURABLE EFFECTS OF YOGA COMPARED TO USUAL CARE ON E:I RATIO (N = 61, SMDS = 0.63; 95% CIS [-0.72 TO 1.99], P = 0.36; HETEROGENEITY: R(2) = 0.79, CHI(2) = 5.48, DF = 1, (P = 0.02); I(2) = 82%). THE MA ALSO FAILED TO SHOW STATISTICALLY SIGNIFICANT DIFFERENCES BETWEEN THE GROUPS REGARDING THE 30:15 RATIO (N = 61, SMDS = 0.20; 95% CIS [-0.43 TO 0.84], P = 0.53; HETEROGENEITY: R(2) = 0.07, CHI(2) = 1.45, DF = 1, (P = 0.23); I(2) = 31%). THE DATA FROM THE REMAINING RCTS WERE TOO HETEROGENEOUS FOR POOLING. THESE RESULTS PROVIDE NO CONVINCING EVIDENCE FOR THE EFFECTIVENESS OF YOGA IN MODULATING HRV IN PATIENTS OR HEALTHY SUBJECTS. FUTURE INVESTIGATIONS IN THIS AREA SHOULD OVERCOME THE MULTIPLE METHODOLOGICAL WEAKNESSES OF THE PREVIOUS RESEARCH. 2015 2 2540 52 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 3 2597 52 YOGA FOR MULTIPLE SCLEROSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS. WHILE YOGA SEEMS TO BE EFFECTIVE IN A NUMBER OF NEUROPSYCHIATRIC DISORDERS, THE EVIDENCE OF EFFICACY IN MULTIPLE SCLEROSIS REMAINS UNCLEAR. THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY ASSESS AND META-ANALYZE THE AVAILABLE DATA ON EFFICACY AND SAFETY OF YOGA IN PATIENTS WITH MULTIPLE SCLEROSIS. MEDLINE/PUBMED, SCOPUS, THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, PSYCINFO, CAM-QUEST, CAMBASE, AND INDMED WERE SEARCHED THROUGH MARCH 2014. RANDOMIZED CONTROLLED TRIALS (RCTS) OF YOGA FOR PATIENTS WITH MULTIPLE SCLEROSIS WERE INCLUDED IF THEY ASSESSED HEALTH-RELATED QUALITY OF LIFE, FATIGUE, AND/OR MOBILITY. MOOD, COGNITIVE FUNCTION, AND SAFETY WERE DEFINED AS SECONDARY OUTCOME MEASURES. RISK OF BIAS WAS ASSESSED USING THE COCHRANE TOOL. SEVEN RCTS WITH A TOTAL OF 670 PATIENTS WERE INCLUDED. EVIDENCE FOR SHORT-TERM EFFECTS OF YOGA COMPARED TO USUAL CARE WERE FOUND FOR FATIGUE (STANDARDIZED MEAN DIFFERENCE [SMD] = -0.52; 95% CONFIDENCE INTERVALS (CI) = -1.02 TO -0.02; P = 0.04; HETEROGENEITY: I2 = 60%; CHI2 = 7.43; P = 0.06) AND MOOD (SMD = -0.55; 95%CI = -0.96 TO -0.13; P = 0.01; HETEROGENEITY: I2 = 0%; CHI2 = 1.25; P = 0.53), BUT NOT FOR HEALTH-RELATED QUALITY OF LIFE, MUSCLE FUNCTION, OR COGNITIVE FUNCTION. THE EFFECTS ON FATIGUE AND MOOD WERE NOT ROBUST AGAINST BIAS. NO SHORT-TERM OR LONGER TERM EFFECTS OF YOGA COMPARED TO EXERCISE WERE FOUND. YOGA WAS NOT ASSOCIATED WITH SERIOUS ADVERSE EVENTS. IN CONCLUSION, SINCE NO METHODOLOGICAL SOUND EVIDENCE WAS FOUND, NO RECOMMENDATION CAN BE MADE REGARDING YOGA AS A ROUTINE INTERVENTION FOR PATIENTS WITH MULTIPLE SCLEROSIS. YOGA MIGHT BE CONSIDERED A TREATMENT OPTION FOR PATIENTS WHO ARE NOT ADHERENT TO RECOMMENDED EXERCISE REGIMENS. 2014 4 2568 51 YOGA FOR DEPRESSION: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: MIND-BODY MEDICAL INTERVENTIONS ARE COMMONLY USED TO COPE WITH DEPRESSION AND YOGA IS ONE OF THE MOST COMMONLY USED MIND-BODY INTERVENTIONS. THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY ASSESS AND META-ANALYZE THE EFFECTIVENESS OF YOGA FOR DEPRESSION. METHODS: MEDLINE/PUBMED, SCOPUS, THE COCHRANE LIBRARY, PSYCINFO, AND INDMED WERE SEARCHED THROUGH JANUARY 2013. RANDOMIZED CONTROLLED TRIALS (RCTS) OF YOGA FOR PATIENTS WITH DEPRESSIVE DISORDERS AND INDIVIDUALS WITH ELEVATED LEVELS OF DEPRESSION WERE INCLUDED. MAIN OUTCOMES WERE SEVERITY OF DEPRESSION AND REMISSION RATES, SECONDARY OUTCOMES WERE ANXIETY, QUALITY OF LIFE, AND SAFETY. RESULTS: TWELVE RCTS WITH 619 PARTICIPANTS WERE INCLUDED. THREE RCTS HAD LOW RISK OF BIAS. REGARDING SEVERITY OF DEPRESSION, THERE WAS MODERATE EVIDENCE FOR SHORT-TERM EFFECTS OF YOGA COMPARED TO USUAL CARE (STANDARDIZED MEAN DIFFERENCE (SMD) = -0.69; 95% CONFIDENCE INTERVAL (CI) -0.99, -0.39; P < .001), AND LIMITED EVIDENCE COMPARED TO RELAXATION (SMD = -0.62; 95%CI -1.03, -0.22; P = .003), AND AEROBIC EXERCISE (SMD = -0.59; 95% CI -0.99, -0.18; P = .004). LIMITED EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS OF YOGA ON ANXIETY COMPARED TO RELAXATION (SMD = -0.79; 95% CI -1.3, -0.26; P = .004). SUBGROUP ANALYSES REVEALED EVIDENCE FOR EFFECTS IN PATIENTS WITH DEPRESSIVE DISORDERS AND IN INDIVIDUALS WITH ELEVATED LEVELS OF DEPRESSION. DUE TO THE PAUCITY AND HETEROGENEITY OF THE RCTS, NO META-ANALYSES ON LONG-TERM EFFECTS WERE POSSIBLE. NO RCT REPORTED SAFETY DATA. CONCLUSIONS: DESPITE METHODOLOGICAL DRAWBACKS OF THE INCLUDED STUDIES, YOGA COULD BE CONSIDERED AN ANCILLARY TREATMENT OPTION FOR PATIENTS WITH DEPRESSIVE DISORDERS AND INDIVIDUALS WITH ELEVATED LEVELS OF DEPRESSION. 2013 5 2330 35 TWELVE WEEKS OF YOGA FOR CHRONIC NONSPECIFIC LOWER BACK PAIN: A META-ANALYSIS. OBJECTIVES: TO INVESTIGATE THE OVERALL EFFECTS OF 12 WEEKS OF YOGA PRACTICE ON CHRONIC NONSPECIFIC LOWER BACK PAIN. METHODS: PUBMED, EMBASE, PSYCINFO, WEB OF SCIENCE, AND THE COCHRANE LIBRARY DATABASES WERE SEARCHED FROM INCEPTION TO FEBRUARY 9, 2019, AND SIX RANDOMIZED CONTROLLED TRIALS WERE SELECTED FOR THIS META-ANALYSIS. RESULTS: THE POOLED FIXED-EFFECT SIZE OF SIX TRIALS SHOWED THAT 12 WEEKS OF YOGA PROGRAMS COULD SIGNIFICANTLY REDUCE CHRONIC NONSPECIFIC LOWER BACK PAIN BY 0.41 WITHIN THE TRIALS (STANDARDIZED MEAN DIFFERENCE; 95% CONFIDENCE INTERVAL: -0.58 TO -0.23; P < .0001). SUBGROUP ANALYSES ALSO SHOWED THAT SIGNIFICANT PAIN REDUCTION WAS RELATED TO TYPE OF YOGA, LENGTH OF SESSION, STUDY QUALITY, AND TIMING OF PAIN ASSESSMENT. CONCLUSIONS: THESE FINDINGS REVEAL THAT 12 WEEKS OF YOGA CAN HELP ALLEVIATE PAIN, AND YOGA PROGRAMS SHOULD TAKE INTO ACCOUNT THE SUBGROUP FACTORS TO INCREASE INDIVIDUALS' RELIEF FROM CHRONIC NONSPECIFIC LOWER BACK PAIN. 2020 6 2110 54 THE EFFECT OF YOGA ON SLEEP QUALITY AND INSOMNIA IN WOMEN WITH SLEEP PROBLEMS: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: TO EXAMINE THE EFFECTIVENESS AND SAFETY OF YOGA OF WOMEN WITH SLEEP PROBLEMS BY PERFORMING A SYSTEMATIC REVIEW AND META-ANALYSIS. METHODS: MEDLINE/PUBMED, CLINICALKEY, SCIENCEDIRECT, EMBASE, PSYCINFO, AND THE COCHRANE LIBRARY WERE SEARCHED THROUGHOUT THE MONTH OF JUNE, 2019. RANDOMIZED CONTROLLED TRIALS COMPARING YOGA GROUPS WITH CONTROL GROUPS IN WOMEN WITH SLEEP PROBLEMS WERE INCLUDED. TWO REVIEWERS INDEPENDENTLY EVALUATED RISK OF BIAS BY USING THE RISK OF BIAS TOOL SUGGESTED BY THE COCHRANE COLLABORATION FOR PROGRAMMING AND CONDUCTING SYSTEMATIC REVIEWS AND META-ANALYSES. THE MAIN OUTCOME MEASURE WAS SLEEP QUALITY OR THE SEVERITY OF INSOMNIA, WHICH WAS MEASURED USING SUBJECTIVE INSTRUMENTS, SUCH AS THE PITTSBURGH SLEEP QUALITY INDEX (PSQI), INSOMNIA SEVERITY INDEX (ISI), OR OBJECTIVE INSTRUMENTS SUCH AS POLYSOMNOGRAPHY, ACTIGRAPHY, AND SAFETY OF THE INTERVENTION. FOR EACH OUTCOME, A STANDARDIZED MEAN DIFFERENCE (SMD) AND CONFIDENCE INTERVALS (CIS) OF 95% WERE DETERMINED. RESULTS: NINETEEN STUDIES IN THIS SYSTEMATIC REVIEW INCLUDED 1832 PARTICIPANTS. THE META-ANALYSIS OF THE COMBINED DATA CONDUCTED ACCORDING TO COMPREHENSIVE META-ANALYSIS SHOWED A SIGNIFICANT IMPROVEMENT IN SLEEP (SMD = - 0.327, 95% CI = - 0.506 TO - 0.148, P < 0.001). META-ANALYSES REVEALED POSITIVE EFFECTS OF YOGA USING PSQI SCORES IN 16 RANDOMIZED CONTROL TRIALS (RCTS), COMPARED WITH THE CONTROL GROUP IN IMPROVING SLEEP QUALITY AMONG WOMEN USING PSQI (SMD = - 0.54; 95% CI = - 0.89 TO - 0.19; P = 0.003). HOWEVER, THREE RCTS REVEALED NO EFFECTS OF YOGA COMPARED TO THE CONTROL GROUP IN REDUCING INSOMNIA AMONG WOMEN USING ISI (SMD = - 0.13; 95% CI = - 0.74 TO 0.48; P = 0.69). SEVEN RCTS REVEALED NO EVIDENCE FOR EFFECTS OF YOGA COMPARED WITH THE CONTROL GROUP IN IMPROVING SLEEP QUALITY FOR WOMEN WITH BREAST CANCER USING PSQI (SMD = - 0.15; 95% CI = - 0.31 TO 0.01; P = 0.5). FOUR RCTS REVEALED NO EVIDENCE FOR THE EFFECTS OF YOGA COMPARED WITH THE CONTROL GROUP IN IMPROVING THE SLEEP QUALITY FOR PERI/POSTMENOPAUSAL WOMEN USING PSQI (SMD = - 0.31; 95% CI = - 0.95 TO 0.33; P = 0.34). YOGA WAS NOT ASSOCIATED WITH ANY SERIOUS ADVERSE EVENTS. DISCUSSION: THIS SYSTEMATIC REVIEW AND META-ANALYSIS DEMONSTRATED THAT YOGA INTERVENTION IN WOMEN CAN BE BENEFICIAL WHEN COMPARED TO NON-ACTIVE CONTROL CONDITIONS IN TERM OF MANAGING SLEEP PROBLEMS. THE MODERATOR ANALYSES SUGGEST THAT PARTICIPANTS IN THE NON-BREAST CANCER SUBGROUP AND PARTICIPANTS IN THE NON-PERI/POSTMENOPAUSAL SUBGROUP WERE ASSOCIATED WITH GREATER BENEFITS, WITH A DIRECT CORRELATION OF TOTAL CLASS TIME WITH QUALITY OF SLEEP AMONG OTHER RELATED BENEFITS. 2020 7 2607 46 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 8 1299 52 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 9 2594 52 YOGA FOR METABOLIC SYNDROME: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND METABOLIC SYNDROME IS THE MOST IMPORTANT RISK FACTOR FOR DEVELOPING CARDIOVASCULAR DISEASE AND TYPE 2 DIABETES. THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY ASSESS AND PERFORM A META-ANALYSIS OF THE EFFECTS OF YOGA ON THE PARAMETERS OF METABOLIC SYNDROME. METHODS MEDLINE/PUBMED, SCOPUS, THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS AND INDMED WERE SEARCHED AND SCREENED FROM THEIR INCEPTION THROUGH TO 8 MARCH 2016 FOR RANDOMISED CONTROLLED TRIALS ON YOGA FOR PATIENTS WITH METABOLIC SYNDROME. RISK OF BIAS WAS ASSESSED USING THE COCHRANE RISK OF BIAS TOOL. RESULTS SEVEN TRIALS WITH A TOTAL OF 794 PARTICIPANTS WERE INCLUDED. NO EFFECTS OF YOGA ON RESOLUTION OF METABOLIC SYNDROME, DIASTOLIC BLOOD PRESSURE, TRIGLYCERIDES, HIGH-DENSITY LIPOPROTEIN CHOLESTEROL AND FASTING PLASMA GLUCOSE WERE FOUND, BUT YOGA WAS SUPERIOR TO USUAL CARE FOR WAIST CIRCUMFERENCE (STANDARDISED MEAN DIFFERENCE (SMD) = -0.35; 95% CONFIDENCE INTERVAL (CI) = -0.57 TO -0.13; P < 0.01) AND SYSTOLIC BLOOD PRESSURE (SMD = -0.29; 95% CI = -0.51 TO -0.07; P = 0.01). HOWEVER, THESE EFFECTS WERE NOT ROBUST AGAINST SELECTION BIAS. NO INTERVENTION-RELATED ADVERSE EVENTS WERE REPORTED. CONCLUSION BASED ON THE RESULTS OF THIS META-ANALYSIS, NO RECOMMENDATION CAN BE MADE FOR OR AGAINST YOGA IN ORDER TO INFLUENCE THE PARAMETERS OF METABOLIC SYNDROME. DESPITE METHODOLOGICAL DRAWBACKS, AND UNTIL FURTHER RESEARCH IS UNDERTAKEN, YOGA CAN BE PRELIMINARILY CONSIDERED AS A SAFE AND EFFECTIVE INTERVENTION FOR REDUCING WAIST CIRCUMFERENCE AND SYSTOLIC BLOOD PRESSURE IN INDIVIDUALS WITH METABOLIC SYNDROME WHO ARE NOT ADHERING TO CONVENTIONAL FORMS OF EXERCISE. 2016 10 232 44 A SYSTEMATIC REVIEW OF YOGA FOR MAJOR DEPRESSIVE DISORDER. BACKGROUND: THE PURPOSE OF THIS REVIEW WAS TO INVESTIGATE THE EFFICACY AND SAFETY OF YOGA INTERVENTIONS IN TREATING PATIENTS WITH MAJOR DEPRESSIVE DISORDER. METHODS: MEDLINE, SCOPUS, AND THE COCHRANE LIBRARY WERE SCREENED THROUGH DECEMBER 2016. RANDOMIZED CONTROLLED TRIALS (RCTS) COMPARING YOGA TO INACTIVE OR ACTIVE COMPARATORS IN PATIENTS WITH MAJOR DEPRESSIVE DISORDER WERE ELIGIBLE. PRIMARY OUTCOMES INCLUDED REMISSION RATES AND SEVERITY OF DEPRESSION. ANXIETY AND ADVERSE EVENTS WERE SECONDARY OUTCOMES. RISK OF BIAS WAS ASSESSED USING THE COCHRANE TOOL. RESULTS: SEVEN RCTS WITH 240 PARTICIPANTS WERE INCLUDED. RISK OF BIAS WAS UNCLEAR FOR MOST RCTS. COMPARED TO AEROBIC EXERCISE, NO SHORT- OR MEDIUM-TERM GROUP DIFFERENCES IN DEPRESSION SEVERITY WAS FOUND. HIGHER SHORT-TERM DEPRESSION SEVERITY WAS FOUND FOR YOGA COMPARED TO ELECTRO-CONVULSIVE THERAPY; REMISSION RATES DID NOT DIFFER BETWEEN GROUPS. NO SHORT-TERM GROUP DIFFERENCES OCCURRED WHEN YOGA WAS COMPARED TO ANTIDEPRESSANT MEDICATION. CONFLICTING EVIDENCE WAS FOUND WHEN YOGA WAS COMPARED TO ATTENTION-CONTROL INTERVENTIONS, OR WHEN YOGA AS AN ADD-ON TO ANTIDEPRESSANT MEDICATION WAS COMPARED TO MEDICATION ALONE. ONLY TWO RCTS ASSESSED ADVERSE EVENTS AND REPORTED THAT NO TREATMENT-RELATED ADVERSE EVENTS WERE REPORTED. LIMITATIONS: FEW RCTS WITH LOW SAMPLE SIZE. CONCLUSIONS: THIS REVIEW FOUND SOME EVIDENCE FOR POSITIVE EFFECTS BEYOND PLACEBO AND COMPARABLE EFFECTS COMPARED TO EVIDENCE-BASED INTERVENTIONS. HOWEVER, METHODOLOGICAL PROBLEMS AND THE UNCLEAR RISK-BENEFIT RATIO PRECLUDE DEFINITIVE RECOMMENDATIONS FOR OR AGAINST YOGA AS AN ADJUNCT TREATMENT FOR MAJOR DEPRESSIVE DISORDER. LARGER AND ADEQUATELY POWERED RCTS USING NON-INFERIORITY DESIGNS ARE NEEDED. 2017 11 2518 62 YOGA COMPARED TO NON-EXERCISE OR PHYSICAL THERAPY EXERCISE ON PAIN, DISABILITY, AND QUALITY OF LIFE FOR PATIENTS WITH CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. BACKGROUND: CHRONIC LOW BACK PAIN (CLBP) IS A COMMON AND OFTEN DISABLING MUSCULOSKELETAL CONDITION. YOGA HAS BEEN PROVEN TO BE AN EFFECTIVE THERAPY FOR CHRONIC LOW BACK PAIN. HOWEVER, THERE ARE STILL CONTROVERSIES ABOUT THE EFFECTS OF YOGA AT DIFFERENT FOLLOW-UP PERIODS AND COMPARED WITH OTHER PHYSICAL THERAPY EXERCISES. OBJECTIVE: TO CRITICALLY COMPARE THE EFFECTS OF YOGA FOR PATIENTS WITH CHRONIC LOW BACK PAIN ON PAIN, DISABILITY, QUALITY OF LIFE WITH NON-EXERCISE (E.G. USUAL CARE, EDUCATION), PHYSICAL THERAPY EXERCISE. METHODS: THIS STUDY WAS REGISTERED IN PROSPERO, AND THE REGISTRATION NUMBER WAS CRD42020159865. RANDOMIZED CONTROLLED TRIALS (RCTS) OF ONLINE DATABASES INCLUDED PUBMED, WEB OF SCIENCE, COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, EMBASE WHICH EVALUATED EFFECTS OF YOGA FOR PATIENTS WITH CHRONIC LOW BACK PAIN ON PAIN, DISABILITY, AND QUALITY OF LIFE WERE SEARCHED FROM INCEPTION TIME TO NOVEMBER 1, 2019. STUDIES WERE ELIGIBLE IF THEY ASSESSED AT LEAST ONE IMPORTANT OUTCOME, NAMELY PAIN, BACK-SPECIFIC DISABILITY, QUALITY OF LIFE. THE COCHRANE RISK OF BIAS TOOL WAS USED TO ASSESS THE METHODOLOGICAL QUALITY OF INCLUDED RANDOMIZED CONTROLLED TRIALS. THE CONTINUOUS OUTCOMES WERE ANALYZED BY CALCULATING THE MEAN DIFFERENCE (MD) OR STANDARDIZED MEAN DIFFERENCE (SMD) WITH 95% CONFIDENCE INTERVALS (CI) ACCORDING TO WHETHER COMBINING OUTCOMES MEASURED ON DIFFERENT SCALES OR NOT. RESULTS: A TOTAL OF 18 RANDOMIZED CONTROLLED TRIALS WERE INCLUDED IN THIS META-ANALYSIS. YOGA COULD SIGNIFICANTLY REDUCE PAIN AT 4 TO 8 WEEKS (MD = -0.83, 95% CI = -1.19 TO -0.48, P<0.00001, I2 = 0%), 3 MONTHS (MD = -0.43, 95% CI = -0.64 TO -0.23, P<0.0001, I2 = 0%), 6 TO 7 MONTHS (MD = -0.56, 95% CI = -1.02 TO -0.11, P = 0.02, I2 = 50%), AND WAS NOT SIGNIFICANT IN 12 MONTHS (MD = -0.52, 95% CI = -1.64 TO 0.59, P = 0.36, I2 = 87%) COMPARED WITH NON-EXERCISE. YOGA WAS BETTER THAN NON-EXERCISE ON DISABILITY AT 4 TO 8 WEEKS (SMD = -0.30, 95% CI = -0.51 TO -0.10, P = 0.003, I2 = 0%), 3 MONTHS (SMD = -0.31, 95% CI = -0.45 TO -0.18, P<0.00001, I2 = 30%), 6 MONTHS (SMD = -0.38, 95% CI = -0.53 TO -0.23, P<0.00001, I2 = 0%), 12 MONTHS (SMD = -0.33, 95% CI = -0.54 TO -0.12, P = 0.002, I2 = 9%). THERE WAS NO SIGNIFICANT DIFFERENCE ON PAIN, DISABILITY COMPARED WITH PHYSICAL THERAPY EXERCISE GROUP. FURTHERMORE, IT SUGGESTED THAT THERE WAS A NON-SIGNIFICANT DIFFERENCE ON PHYSICAL AND MENTAL QUALITY OF LIFE BETWEEN YOGA AND ANY OTHER INTERVENTIONS. CONCLUSION: THIS META-ANALYSIS PROVIDED EVIDENCE FROM VERY LOW TO MODERATE INVESTIGATING THE EFFECTIVENESS OF YOGA FOR CHRONIC LOW BACK PAIN PATIENTS AT DIFFERENT TIME POINTS. YOGA MIGHT DECREASE PAIN FROM SHORT TERM TO INTERMEDIATE TERM AND IMPROVE FUNCTIONAL DISABILITY STATUS FROM SHORT TERM TO LONG TERM COMPARED WITH NON-EXERCISE (E.G. USUAL CARE, EDUCATION). YOGA HAD THE SAME EFFECT ON PAIN AND DISABILITY AS ANY OTHER EXERCISE OR PHYSICAL THERAPY. YOGA MIGHT NOT IMPROVE THE PHYSICAL AND MENTAL QUALITY OF LIFE BASED ON THE RESULT OF A MERGING. 2020 12 2079 43 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 13 923 48 EFFECTIVENESS OF YOGA FOR MENOPAUSAL SYMPTOMS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. OBJECTIVES. TO SYSTEMATICALLY REVIEW AND META-ANALYZE THE EFFECTIVENESS OF YOGA FOR MENOPAUSAL SYMPTOMS. METHODS. MEDLINE, SCOPUS, THE COCHRANE LIBRARY, AND PSYCINFO WERE SCREENED THROUGH APRIL 2012. RANDOMIZED CONTROLLED TRIALS (RCTS) WERE INCLUDED IF THEY ASSESSED THE EFFECT OF YOGA ON MAJOR MENOPAUSAL SYMPTOMS, NAMELY, (1) PSYCHOLOGICAL SYMPTOMS, (2) SOMATIC SYMPTOMS, (3) VASOMOTOR SYMPTOMS, AND/OR (4) UROGENITAL SYMPTOMS. FOR EACH OUTCOME, STANDARDIZED MEAN DIFFERENCES (SMDS) AND 95% CONFIDENCE INTERVALS (CIS) WERE CALCULATED. TWO AUTHORS INDEPENDENTLY ASSESSED RISK OF BIAS USING THE RISK OF BIAS TOOL RECOMMENDED BY THE COCHRANE BACK REVIEW GROUP. RESULTS. FIVE RCTS WITH 582 PARTICIPANTS WERE INCLUDED IN THE QUALITATIVE REVIEW, AND 4 RCTS WITH 545 PARTICIPANTS WERE INCLUDED IN THE META-ANALYSIS. THERE WAS MODERATE EVIDENCE FOR SHORT-TERM EFFECTS ON PSYCHOLOGICAL SYMPTOMS (SMD = -0.37; 95% CI -0.67 TO -0.07; P = 0.02). NO EVIDENCE WAS FOUND FOR TOTAL MENOPAUSAL SYMPTOMS, SOMATIC SYMPTOMS, VASOMOTOR SYMPTOMS, OR UROGENITAL SYMPTOMS. YOGA WAS NOT ASSOCIATED WITH SERIOUS ADVERSE EVENTS. CONCLUSION. THIS SYSTEMATIC REVIEW FOUND MODERATE EVIDENCE FOR SHORT-TERM EFFECTIVENESS OF YOGA FOR PSYCHOLOGICAL SYMPTOMS IN MENOPAUSAL WOMEN. WHILE MORE RIGOROUS RESEARCH IS NEEDED TO UNDERPIN THESE RESULTS, YOGA CAN BE PRELIMINARILY RECOMMENDED AS AN ADDITIONAL INTERVENTION FOR WOMEN WHO SUFFER FROM PSYCHOLOGICAL COMPLAINTS ASSOCIATED WITH MENOPAUSE. 2012 14 2606 46 YOGA FOR POSTTRAUMATIC STRESS DISORDER - A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: YOGA IS INCREASINGLY USED AS A THERAPEUTIC TREATMENT AND SEEMS TO IMPROVE PSYCHIATRIC CONDITIONS SUCH AS ANXIETY DISORDERS AND DEPRESSION. THE AIM OF THIS SYSTEMATIC REVIEW WAS TO ASSESS THE EVIDENCE OF YOGA FOR REDUCING SYMPTOMS OF POSTTRAUMATIC STRESS DISORDER (PTSD). METHODS: THE COCHRANE LIBRARY, MEDLINE/PUBMED, PSYCINFO, SCOPUS, AND INDMED WERE SEARCHED THROUGH JULY 2017 FOR RANDOMIZED CONTROLLED TRIALS (RCTS) ASSESSING THE EFFECTS OF YOGA ON SYMPTOMS OF PTSD. MEAN DIFFERENCES (MD) AND STANDARDIZED MEAN DIFFERENCES (SMD) WITH 95% CONFIDENCE INTERVALS (CI) WERE COMPUTED. THE QUALITY OF EVIDENCE AND THE STRENGTH OF RECOMMENDATION WERE GRADED ACCORDING TO THE GRADE RECOMMENDATIONS. RESULTS: SEVEN RCTS (N = 284) WERE INCLUDED. META-ANALYSIS REVEALED LOW QUALITY EVIDENCE FOR CLINICALLY RELEVANT EFFECTS OF YOGA ON PTSD SYMPTOMS COMPARED TO NO TREATMENT (SMD = - 1.10, 95% CI [- 1.72, - 0.47], P < .001, I(2) = 72%; MD = - 13.11, 95% CI [- 17.95, - 8.27]); AND VERY LOW EVIDENCE FOR COMPARABLE EFFECTS OF YOGA AND ATTENTION CONTROL INTERVENTIONS (SMD = - 0.31, 95%CI = [- 0.84, 0.22], P = .25; I(2) = 43%). VERY LOW EVIDENCE WAS FOUND FOR COMPARABLE RETENTION OF PATIENTS IN THE TRIAL FOR YOGA AND NO TREATMENT (OR = 0.68, 95%CI [0.06, 7.72]) OR ATTENTION CONTROL INTERVENTIONS (OR = 0.66, 95%CI [0.10, 4.46]). NO SERIOUS ADVERSE EVENTS WERE REPORTED. LIMITATIONS: FEW RCTS WITH ONLY LIMITED SAMPLE SIZE WERE AVAILABLE. CONCLUSIONS: ONLY A WEAK RECOMMENDATION FOR YOGA AS AN ADJUNCTIVE INTERVENTION FOR PTSD CAN BE MADE. MORE HIGH QUALITY RESEARCH IS NEEDED TO CONFIRM OR DISCONFIRM THESE FINDINGS. 2018 15 2546 50 YOGA FOR BREAST CANCER PATIENTS AND SURVIVORS: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: MANY BREAST CANCER PATIENTS AND SURVIVORS USE YOGA TO COPE WITH THEIR DISEASE. THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY ASSESS AND META-ANALYZE THE EVIDENCE FOR EFFECTS OF YOGA ON HEALTH-RELATED QUALITY OF LIFE AND PSYCHOLOGICAL HEALTH IN BREAST CANCER PATIENTS AND SURVIVORS. METHODS: MEDLINE, PSYCINFO, EMBASE, CAMBASE, AND THE COCHRANE LIBRARY WERE SCREENED THROUGH FEBRUARY 2012. RANDOMIZED CONTROLLED TRIALS (RCTS) COMPARING YOGA TO CONTROLS WERE ANALYZED WHEN THEY ASSESSED HEALTH-RELATED QUALITY OF LIFE OR PSYCHOLOGICAL HEALTH IN BREAST CANCER PATIENTS OR SURVIVORS. RISK OF BIAS WAS ASSESSED USING THE COCHRANE RISK OF BIAS TOOL. STANDARDIZED MEAN DIFFERENCES (SMD) AND 95% CONFIDENCE INTERVALS (CI) WERE CALCULATED. RESULTS: TWELVE RCTS WITH A TOTAL OF 742 PARTICIPANTS WERE INCLUDED. SEVEN RCTS COMPARED YOGA TO NO TREATMENT; 3 RCTS COMPARED YOGA TO SUPPORTIVE THERAPY; 1 RCT COMPARED YOGA TO HEALTH EDUCATION; AND 1 RCT COMPARED A COMBINATION OF PHYSIOTHERAPY AND YOGA TO PHYSIOTHERAPY ALONE. EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS ON GLOBAL HEALTH-RELATED QUALITY OF LIFE (SMD = 0.62 [95% CI: 0.04 TO 1.21]; P = 0.04), FUNCTIONAL (SMD = 0.30 [95% CI: 0.03 TO 0.57), SOCIAL (SMD = 0.29 [95% CI: 0.08 TO 0.50]; P < 0.01), AND SPIRITUAL WELL-BEING (SMD = 0.41 [95% CI: 0.08; 0.74]; P = 0.01). THESE EFFECTS WERE, HOWEVER, ONLY PRESENT IN STUDIES WITH UNCLEAR OR HIGH RISK OF SELECTION BIAS. SHORT-TERM EFFECTS ON PSYCHOLOGICAL HEALTH ALSO WERE FOUND: ANXIETY (SMD = -1.51 [95% CI: -2.47; -0.55]; P < 0.01), DEPRESSION (SMD = -1.59 [95% CI: -2.68 TO -0.51]; P < 0.01), PERCEIVED STRESS (SMD = -1.14 [95% CI:-2.16; -0.12]; P = 0.03), AND PSYCHOLOGICAL DISTRESS (SMD = -0.86 [95% CI:-1.50; -0.22]; P < 0.01). SUBGROUP ANALYSES REVEALED EVIDENCE OF EFFICACY ONLY FOR YOGA DURING ACTIVE CANCER TREATMENT BUT NOT AFTER COMPLETION OF ACTIVE TREATMENT. CONCLUSIONS: THIS SYSTEMATIC REVIEW FOUND EVIDENCE FOR SHORT-TERM EFFECTS OF YOGA IN IMPROVING PSYCHOLOGICAL HEALTH IN BREAST CANCER PATIENTS. THE SHORT-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE COULD NOT BE CLEARLY DISTINGUISHED FROM BIAS. YOGA CAN BE RECOMMENDED AS AN INTERVENTION TO IMPROVE PSYCHOLOGICAL HEALTH DURING BREAST CANCER TREATMENT. 2012 16 2589 54 YOGA FOR LOW BACK PAIN: A SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS. IT HAS BEEN SUGGESTED THAT YOGA HAS A POSITIVE EFFECT ON LOW BACK PAIN AND FUNCTION. THE OBJECTIVE OF THIS SYSTEMATIC REVIEW WAS TO ASSESS THE EFFECTIVENESS OF YOGA AS A TREATMENT OPTION FOR LOW BACK PAIN. SEVEN DATABASES WERE SEARCHED FROM THEIR INCEPTION TO MARCH 2011. RANDOMIZED CLINICAL TRIALS WERE CONSIDERED IF THEY INVESTIGATED YOGA IN PATIENTS WITH LOW BACK PAIN AND IF THEY ASSESSED PAIN AS AN OUTCOME MEASURE. THE SELECTION OF STUDIES, DATA EXTRACTION AND VALIDATION WERE PERFORMED INDEPENDENTLY BY TWO REVIEWERS. SEVEN RANDOMIZED CONTROLLED CLINICAL TRIALS (RCTS) MET THE INCLUSION CRITERIA. THEIR METHODOLOGICAL QUALITY RANGED BETWEEN 2 AND 4 ON THE JADAD SCALE. FIVE RCTS SUGGESTED THAT YOGA LEADS TO A SIGNIFICANTLY GREATER REDUCTION IN LOW BACK PAIN THAN USUAL CARE, EDUCATION OR CONVENTIONAL THERAPEUTIC EXERCISES. TWO RCTS SHOWED NO BETWEEN-GROUP DIFFERENCES. IT IS CONCLUDED THAT YOGA HAS THE POTENTIAL TO ALLEVIATE LOW BACK PAIN. HOWEVER, ANY DEFINITIVE CLAIMS SHOULD BE TREATED WITH CAUTION. 2011 17 2742 64 YOGA PRACTICE FOR THE MANAGEMENT OF TYPE II DIABETES MELLITUS IN ADULTS: A SYSTEMATIC REVIEW. THE EFFECT OF PRACTICING YOGA FOR THE MANAGEMENT OF TYPE II DIABETES WAS ASSESSED IN THIS SYSTEMATIC REVIEW THROUGH SEARCHING RELATED ELECTRONIC DATABASES AND THE GREY LITERATURE TO THE END OF MAY 2007 USING OVID. ALL RANDOMIZED CONTROLLED CLINICAL TRIALS (RCTS) COMPARING YOGA PRACTICE WITH OTHER TYPE OF INTERVENTION OR WITH REGULAR PRACTICE OR BOTH, WERE INCLUDED REGARDLESS OF LANGUAGE OR TYPE OF PUBLICATION. EACH STUDY WAS ASSESSED FOR QUALITY BY TWO INDEPENDENT REVIEWERS. MEAN DIFFERENCE WAS USED FOR SUMMARIZING THE EFFECT OF EACH STUDY OUTCOMES WITH 95% CONFIDENCE INTERVALS. POOLING OF THE STUDIES DID NOT TAKE PLACE DUE TO THE WIDE CLINICAL VARIATION BETWEEN THE STUDIES. PUBLICATION BIAS WAS ASSESSED BY STATISTICAL METHODS. FIVE TRIALS WITH 363 PARTICIPANTS MET THE INCLUSION CRITERIA WITH MEDIUM TO HIGH RISK OF BIAS AND DIFFERENT INTERVENTION CHARACTERISTICS. THE STUDIES' RESULTS SHOW IMPROVEMENT IN OUTCOMES AMONG PATIENTS WITH DIABETES TYPE II. THESE IMPROVEMENTS WERE MAINLY AMONG SHORT TERM OR IMMEDIATE DIABETES OUTCOMES AND NOT ALL WERE STATISTICALLY SIGNIFICANT. THE RESULTS WERE INCONCLUSIVE AND NOT SIGNIFICANT FOR THE LONG-TERM OUTCOMES. NO ADVERSE EFFECTS WERE REPORTED IN ANY OF THE INCLUDED STUDIES. SHORT-TERM BENEFITS FOR PATIENTS WITH DIABETES MAY BE ACHIEVED FROM PRACTICING YOGA. FURTHER RESEARCH IS NEEDED IN THIS AREA. FACTORS LIKE QUALITY OF THE TRIALS AND OTHER METHODOLOGICAL ISSUES SHOULD BE IMPROVED BY LARGE RANDOMIZED CONTROL TRIALS WITH ALLOCATION CONCEALMENT TO ASSESS THE EFFECTIVENESS OF YOGA ON DIABETES TYPE II. A DEFINITIVE RECOMMENDATION FOR PHYSICIANS TO ENCOURAGE THEIR PATIENTS TO PRACTICE YOGA CANNOT BE REACHED AT PRESENT. 2010 18 2614 55 YOGA FOR SCHIZOPHRENIA: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY REVIEW AND META-ANALYZE THE EFFECTS OF YOGA ON SYMPTOMS OF SCHIZOPHRENIA, QUALITY OF LIFE, FUNCTION, AND HOSPITALIZATION IN PATIENTS WITH SCHIZOPHRENIA. METHODS: MEDLINE/PUBMED, SCOPUS, THE COCHRANE LIBRARY, PSYCINFO, AND INDMED WERE SCREENED THROUGH AUGUST 2012. RANDOMIZED CONTROLLED TRIALS (RCTS) COMPARING YOGA TO USUAL CARE OR NON-PHARMACOLOGICAL INTERVENTIONS WERE ANALYZED WHEN THEY ASSESSED SYMPTOMS OR QUALITY OF LIFE IN PATIENTS WITH SCHIZOPHRENIA. COGNITIVE FUNCTION, SOCIAL FUNCTION, HOSPITALIZATION, AND SAFETY WERE DEFINED AS SECONDARY OUTCOMES. RISK OF BIAS WAS ASSESSED USING THE RISK OF BIAS TOOL RECOMMENDED BY THE COCHRANE BACK REVIEW GROUP. STANDARDIZED MEAN DIFFERENCES (SMD) AND 95% CONFIDENCE INTERVALS (CI) WERE CALCULATED. RESULTS: FIVE RCTS WITH A TOTAL OF 337 PATIENTS WERE INCLUDED; 2 RCTS HAD LOW RISK OF BIAS. TWO RCTS COMPARED YOGA TO USUAL CARE; 1 RCT COMPARED YOGA TO EXERCISE; AND 2 3-ARM RCTS COMPARED YOGA TO USUAL CARE AND EXERCISE. NO EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS OF YOGA COMPARED TO USUAL CARE ON POSITIVE SYMPTOMS (SMD = -0.58; 95% CI -1.52 TO 0.37; P = 0.23), OR NEGATIVE SYMPTOMS (SMD = -0.59; 95% CI -1.87 TO 0.69; P = 0.36). MODERATE EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS ON QUALITY OF LIFE COMPARED TO USUAL CARE (SMD = 2.28; 95% CI 0.42 TO 4.14; P = 0.02). THESE EFFECTS WERE ONLY PRESENT IN STUDIES WITH HIGH RISK OF BIAS. NO EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS ON SOCIAL FUNCTION (SMD = 1.20; 95% CI -0.78 TO 3.18; P = 0.23). COMPARING YOGA TO EXERCISE, NO EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS ON POSITIVE SYMPTOMS (SMD = -0.35; 95% CI -0.75 TO 0.05; P = 0.09), NEGATIVE SYMPTOMS (SMD = -0.28; 95% CI -1.42 TO 0.86; P = 0.63), QUALITY OF LIFE (SMD = 0.17; 95% CI -0.27 TO 0.61; P = 0.45), OR SOCIAL FUNCTION (SMD = 0.20; 95% CI -0.27 TO 0.67; P = 0.41). ONLY 1 RCT REPORTED ADVERSE EVENTS. CONCLUSIONS: THIS SYSTEMATIC REVIEW FOUND ONLY MODERATE EVIDENCE FOR SHORT-TERM EFFECTS OF YOGA ON QUALITY OF LIFE. AS THESE EFFECTS WERE NOT CLEARLY DISTINGUISHABLE FROM BIAS AND SAFETY OF THE INTERVENTION WAS UNCLEAR, NO RECOMMENDATION CAN BE MADE REGARDING YOGA AS A ROUTINE INTERVENTION FOR SCHIZOPHRENIA PATIENTS. 2013 19 1055 39 EFFECTS OF YOGA ON CHRONIC NECK PAIN: A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS. [PURPOSE] THE AIM OF THIS STUDY WAS TO INVESTIGATE THE EFFECTIVENESS OF YOGA IN THE MANAGEMENT OF CHRONIC NECK PAIN. [SUBJECTS AND METHODS] FIVE ELECTRONIC DATABASES WERE SEARCHED TO IDENTIFY RANDOMIZED CONTROLLED TRIALS (RCTS) OF YOGA INTERVENTION ON CHRONIC NECK PAIN. THE TRIALS WERE PUBLISHED IN THE ENGLISH LANGUAGE BETWEEN JANUARY 1966 AND DECEMBER 2015. THE COCHRANE RISK OF BIAS TOOL WAS USED TO ASSESS THE QUALITY OF THE TRIALS. [RESULTS] THREE TRIALS WERE IDENTIFIED AND INCLUDED IN THIS REVIEW. A CRITICAL APPRAISAL WAS PERFORMED ON THE TRIALS, AND THE RESULT INDICATED A HIGH RISK OF BIAS. A NARRATIVE DESCRIPTION WAS PROCESSED BECAUSE OF THE SMALL NUMBER OF RCTS. NECK PAIN INTENSITY AND FUNCTIONAL DISABILITY WERE SIGNIFICANTLY LOWER IN THE YOGA GROUPS THAN IN THE CONTROL GROUPS. [CONCLUSION] EVIDENCE FROM THE 3 RANDOMLY CONTROLLED TRIALS SHOWS THAT YOGA MAY BE BENEFICIAL FOR CHRONIC NECK PAIN. THE LOW-QUALITY RESULT OF THE CRITICAL APPRAISAL AND THE SMALL NUMBER OF TRIALS SUGGEST THAT HIGH-QUALITY RCTS ARE REQUIRED TO EXAMINE FURTHER THE EFFECTS OF YOGA INTERVENTION ON CHRONIC NECK PAIN RELIEF. 2016 20 2543 68 YOGA FOR ASTHMA. BACKGROUND: ASTHMA IS A COMMON CHRONIC INFLAMMATORY DISORDER AFFECTING ABOUT 300 MILLION PEOPLE WORLDWIDE. AS A HOLISTIC THERAPY, YOGA HAS THE POTENTIAL TO RELIEVE BOTH THE PHYSICAL AND PSYCHOLOGICAL SUFFERING OF PEOPLE WITH ASTHMA, AND ITS POPULARITY HAS EXPANDED GLOBALLY. A NUMBER OF CLINICAL TRIALS HAVE BEEN CARRIED OUT TO EVALUATE THE EFFECTS OF YOGA PRACTICE, WITH INCONSISTENT RESULTS. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA IN PEOPLE WITH ASTHMA. SEARCH METHODS: WE SYSTEMATICALLY SEARCHED THE COCHRANE AIRWAYS GROUP REGISTER OF TRIALS, WHICH IS DERIVED FROM SYSTEMATIC SEARCHES OF BIBLIOGRAPHIC DATABASES INCLUDING THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, AND PSYCINFO, AND HANDSEARCHING OF RESPIRATORY JOURNALS AND MEETING ABSTRACTS. WE ALSO SEARCHED PEDRO. WE SEARCHED CLINICALTRIALS.GOV AND THE WHO ICTRP SEARCH PORTAL. WE SEARCHED ALL DATABASES FROM THEIR INCEPTION TO 22 JULY 2015, AND USED NO RESTRICTION ON LANGUAGE OF PUBLICATION. WE CHECKED THE REFERENCE LISTS OF ELIGIBLE STUDIES AND RELEVANT REVIEW ARTICLES FOR ADDITIONAL STUDIES. WE ATTEMPTED TO CONTACT INVESTIGATORS OF ELIGIBLE STUDIES AND EXPERTS IN THE FIELD TO LEARN OF OTHER PUBLISHED AND UNPUBLISHED STUDIES. SELECTION CRITERIA: WE INCLUDED RANDOMISED CONTROLLED TRIALS (RCTS) THAT COMPARED YOGA WITH USUAL CARE (OR NO INTERVENTION) OR SHAM INTERVENTION IN PEOPLE WITH ASTHMA AND REPORTED AT LEAST ONE OF THE FOLLOWING OUTCOMES: QUALITY OF LIFE, ASTHMA SYMPTOM SCORE, ASTHMA CONTROL, LUNG FUNCTION MEASURES, ASTHMA MEDICATION USAGE, AND ADVERSE EVENTS. DATA COLLECTION AND ANALYSIS: WE EXTRACTED BIBLIOGRAPHIC INFORMATION, CHARACTERISTICS OF PARTICIPANTS, CHARACTERISTICS OF INTERVENTIONS AND CONTROLS, CHARACTERISTICS OF METHODOLOGY, AND RESULTS FOR THE OUTCOMES OF OUR INTEREST FROM ELIGIBLE STUDIES. FOR CONTINUOUS OUTCOMES, WE USED MEAN DIFFERENCE (MD) WITH 95% CONFIDENCE INTERVAL (CI) TO DENOTE THE TREATMENT EFFECTS, IF THE OUTCOMES WERE MEASURED BY THE SAME SCALE ACROSS STUDIES. ALTERNATIVELY, IF THE OUTCOMES WERE MEASURED BY DIFFERENT SCALES ACROSS STUDIES, WE USED STANDARDISED MEAN DIFFERENCE (SMD) WITH 95% CI. FOR DICHOTOMOUS OUTCOMES, WE USED RISK RATIO (RR) WITH 95% CI TO MEASURE THE TREATMENT EFFECTS. WE PERFORMED META-ANALYSIS WITH REVIEW MANAGER 5.3. WE USED THE FIXED-EFFECT MODEL TO POOL THE DATA, UNLESS THERE WAS SUBSTANTIAL HETEROGENEITY AMONG STUDIES, IN WHICH CASE WE USED THE RANDOM-EFFECTS MODEL INSTEAD. FOR OUTCOMES INAPPROPRIATE OR IMPOSSIBLE TO POOL QUANTITATIVELY, WE CONDUCTED A DESCRIPTIVE ANALYSIS AND SUMMARISED THE FINDINGS NARRATIVELY. MAIN RESULTS: WE INCLUDED 15 RCTS WITH A TOTAL OF 1048 PARTICIPANTS. MOST OF THE TRIALS WERE CONDUCTED IN INDIA, FOLLOWED BY EUROPE AND THE UNITED STATES. THE MAJORITY OF PARTICIPANTS WERE ADULTS OF BOTH SEXES WITH MILD TO MODERATE ASTHMA FOR SIX MONTHS TO MORE THAN 23 YEARS. FIVE STUDIES INCLUDED YOGA BREATHING ALONE, WHILE THE OTHER STUDIES ASSESSED YOGA INTERVENTIONS THAT INCLUDED BREATHING, POSTURE, AND MEDITATION. INTERVENTIONS LASTED FROM TWO WEEKS TO 54 MONTHS, FOR NO MORE THAN SIX MONTHS IN THE MAJORITY OF STUDIES. THE RISK OF BIAS WAS LOW ACROSS ALL DOMAINS IN ONE STUDY AND UNCLEAR OR HIGH IN AT LEAST ONE DOMAIN FOR THE REMAINDER.THERE WAS SOME EVIDENCE THAT YOGA MAY IMPROVE QUALITY OF LIFE (MD IN ASTHMA QUALITY OF LIFE QUESTIONNAIRE (AQLQ) SCORE PER ITEM 0.57 UNITS ON A 7-POINT SCALE, 95% CI 0.37 TO 0.77; 5 STUDIES; 375 PARTICIPANTS), IMPROVE SYMPTOMS (SMD 0.37, 95% CI 0.09 TO 0.65; 3 STUDIES; 243 PARTICIPANTS), AND REDUCE MEDICATION USAGE (RR 5.35, 95% CI 1.29 TO 22.11; 2 STUDIES) IN PEOPLE WITH ASTHMA. THE MD FOR AQLQ SCORE EXCEEDED THE MINIMAL CLINICALLY IMPORTANT DIFFERENCE (MCID) OF 0.5, BUT WHETHER THE MEAN CHANGES EXCEEDED THE MCID FOR ASTHMA SYMPTOMS IS UNCERTAIN DUE TO THE LACK OF AN ESTABLISHED MCID IN THE SEVERITY SCORES USED IN THE INCLUDED STUDIES. THE EFFECTS OF YOGA ON CHANGE FROM BASELINE FORCED EXPIRATORY VOLUME IN ONE SECOND (MD 0.04 LITRES, 95% CI -0.10 TO 0.19; 7 STUDIES; 340 PARTICIPANTS; I(2) = 68%) WERE NOT STATISTICALLY SIGNIFICANT. TWO STUDIES INDICATED IMPROVED ASTHMA CONTROL, BUT DUE TO VERY SIGNIFICANT HETEROGENEITY (I(2) = 98%) WE DID NOT POOL DATA. NO SERIOUS ADVERSE EVENTS ASSOCIATED WITH YOGA WERE REPORTED, BUT THE DATA ON THIS OUTCOME WAS LIMITED. AUTHORS' CONCLUSIONS: WE FOUND MODERATE-QUALITY EVIDENCE THAT YOGA PROBABLY LEADS TO SMALL IMPROVEMENTS IN QUALITY OF LIFE AND SYMPTOMS IN PEOPLE WITH ASTHMA. THERE IS MORE UNCERTAINTY ABOUT POTENTIAL ADVERSE EFFECTS OF YOGA AND ITS IMPACT ON LUNG FUNCTION AND MEDICATION USAGE. RCTS WITH A LARGE SAMPLE SIZE AND HIGH METHODOLOGICAL AND REPORTING QUALITY ARE NEEDED TO CONFIRM THE EFFECTS OF YOGA FOR ASTHMA. 2016