1 2764 209 YOGA PROGRAMME FOR TYPE-2 DIABETES PREVENTION (YOGA-DP) AMONG HIGH RISK PEOPLE IN INDIA: A MULTICENTRE FEASIBILITY RANDOMISED CONTROLLED TRIAL PROTOCOL. INTRODUCTION: A HUGE POPULATION IN INDIA IS AT HIGH RISK OF TYPE-2 DIABETES (T2DM). PHYSICAL ACTIVITY AND A HEALTHY DIET (HEALTHY LIFESTYLE) IMPROVE BLOOD GLUCOSE LEVELS IN PEOPLE AT HIGH RISK OF T2DM. HOWEVER, AN UNHEALTHY LIFESTYLE IS COMMON AMONG INDIANS. YOGA COVERS PHYSICAL ACTIVITY AND A HEALTHY DIET AND CAN HELP TO PREVENT T2DM. THE RESEARCH QUESTION TO BE ADDRESSED BY THE MAIN RANDOMISED CONTROLLED TRIAL (RCT) IS WHETHER A YOGA PROGRAMME FOR T2DM PREVENTION (YOGA-DP) IS EFFECTIVE IN PREVENTING T2DM AMONG HIGH RISK PEOPLE IN INDIA AS COMPARED WITH ENHANCED STANDARD CARE. IN THIS CURRENT STUDY, WE ARE DETERMINING THE FEASIBILITY OF UNDERTAKING THE MAIN RCT. INTERVENTION: YOGA-DP IS A STRUCTURED LIFESTYLE EDUCATION AND EXERCISE PROGRAMME. THE EXERCISE PART IS BASED ON YOGA AND INCLUDES SHITHILIKARANA VYAYAMA (LOOSENING EXERCISES), SURYA NAMASKAR (SUN SALUTATION EXERCISES), ASANA (YOGIC POSES), PRANAYAMA (BREATHING PRACTICES) AND DHYANA (MEDITATION) AND RELAXATION PRACTICES. METHODS AND ANALYSIS: THIS IS A MULTICENTRE, TWO-ARM, PARALLEL-GROUP, FEASIBILITY RCT WITH BLINDED OUTCOME ASSESSMENT AND INTEGRATED MIXED-METHODS PROCESS EVALUATION. ELIGIBLE PARTICIPANTS SHOULD BE AGED 18-74 YEARS, AT HIGH RISK OF T2DM (FASTING PLASMA GLUCOSE LEVEL 5.6-6.9 MMOL/L) AND SAFE TO PARTICIPATE IN PHYSICAL ACTIVITIES. AT LEAST 64 PARTICIPANTS WILL BE RANDOMISED TO INTERVENTION OR CONTROL GROUP WITH FINAL FOLLOW-UP AT 6 MONTHS. IMPORTANT PARAMETERS, NEEDED TO DESIGN THE MAIN RCT, WILL BE ESTIMATED, SUCH AS SD OF THE OUTCOME MEASURE (FASTING PLASMA GLUCOSE LEVEL AT 6-MONTH FOLLOW-UP), RECRUITMENT, INTERVENTION ADHERENCE, FOLLOW-UP, POTENTIAL CONTAMINATION AND TIME NEEDED TO CONDUCT THE STUDY. SEMISTRUCTURED QUALITATIVE INTERVIEWS WILL BE CONDUCTED WITH UP TO 20-30 PARTICIPANTS, A SAMPLE OF THOSE DECLINING TO PARTICIPATE, FOUR YOGA-DP INSTRUCTORS AND AROUND EIGHT STUDY STAFF TO EXPLORE THEIR PERCEPTIONS AND EXPERIENCES OF TAKING PART IN THE STUDY AND OF THE INTERVENTION, REASONS BEHIND NON-PARTICIPATION, EXPERIENCES OF DELIVERING THE INTERVENTION AND RUNNING THE STUDY, RESPECTIVELY. ETHICS AND DISSEMINATION: ETHICS APPROVAL HAS BEEN OBTAINED FROM THE FOLLOWING RESEARCH ETHICS COMMITTEES: FACULTY OF MEDICINE AND HEALTH SCIENCES, UNIVERSITY OF NOTTINGHAM (UK); CENTRE FOR CHRONIC DISEASE CONTROL (CCDC, INDIA); BAPU NATURE CURE HOSPITAL AND YOGASHRAM (BNCHY, INDIA) AND SWAMI VIVEKANANDA YOGA ANUSANDHANA SAMSTHANA (S-VYASA, INDIA). THE RESULTS WILL BE WIDELY DISSEMINATED AMONG KEY STAKEHOLDERS THROUGH VARIOUS AVENUES. TRIAL REGISTRATION NUMBER: CTRI/2019/05/018893. 2020 2 613 77 DEVELOPMENT OF A YOGA PROGRAM FOR TYPE-2 DIABETES PREVENTION (YOGA-DP) AMONG HIGH-RISK PEOPLE IN INDIA. INTRODUCTION: MANY INDIANS ARE AT HIGH-RISK OF TYPE-2 DIABETES MELLITUS (T2DM). YOGA IS AN ANCIENT INDIAN MIND-BODY DISCIPLINE, THAT HAS BEEN ASSOCIATED WITH IMPROVED GLUCOSE LEVELS AND CAN HELP TO PREVENT T2DM. THE STUDY AIMED TO SYSTEMATICALLY DEVELOP A YOGA PROGRAM FOR T2DM PREVENTION (YOGA-DP) AMONG HIGH-RISK PEOPLE IN INDIA USING A COMPLEX INTERVENTION DEVELOPMENT APPROACH. MATERIALS AND METHODS: AS PART OF THE INTERVENTION, WE DEVELOPED A BOOKLET AND A HIGH-DEFINITION VIDEO FOR PARTICIPANTS AND A MANUAL FOR YOGA-DP INSTRUCTORS. A SYSTEMATIC ITERATIVE PROCESS WAS FOLLOWED TO DEVELOP THE INTERVENTION AND INCLUDED FIVE STEPS: (I) A SYSTEMATIC REVIEW OF THE LITERATURE TO GENERATE A LIST OF YOGIC PRACTICES THAT IMPROVES BLOOD GLUCOSE LEVELS AMONG ADULTS AT HIGH-RISK OF OR WITH T2DM, (II) VALIDATION OF IDENTIFIED YOGIC PRACTICES BY YOGA EXPERTS, (III) DEVELOPMENT OF THE INTERVENTION, (IV) CONSULTATION WITH YOGA, EXERCISE, PHYSICAL ACTIVITY, DIET, BEHAVIOR CHANGE, AND/OR DIABETES EXPERTS ABOUT THE INTERVENTION, AND (V) PRETEST THE INTERVENTION AMONG YOGA PRACTITIONERS AND LAY PEOPLE (THOSE AT RISK OF T2DM AND HAD NOT PRACTICED YOGA BEFORE) IN INDIA. RESULTS: YOGA-DP IS A STRUCTURED LIFESTYLE EDUCATION AND EXERCISE PROGRAM, PROVIDED OVER A PERIOD OF 24 WEEKS. THE EXERCISE PART IS BASED ON YOGA AND INCLUDES SHITHILIKARANA VYAYAMA (LOOSENING EXERCISES), SURYA NAMASKAR (SUN SALUTATION EXERCISES), ASANA (YOGIC POSES), PRANAYAMA (BREATHING PRACTICES), AND DHYANA (MEDITATION) AND RELAXATION PRACTICES. ONCE PARTICIPANTS COMPLETE THE PROGRAM, THEY ARE STRONGLY ENCOURAGED TO MAINTAIN A HEALTHY LIFESTYLE IN THE LONG-TERM. CONCLUSIONS: WE SYSTEMATICALLY DEVELOPED A NOVEL YOGA PROGRAM FOR T2DM PREVENTION (YOGA-DP) AMONG HIGH-RISK PEOPLE IN INDIA. A MULTI-CENTER FEASIBILITY RANDOMIZED CONTROLLED TRIAL IS IN PROGRESS IN INDIA. 2020 3 1251 51 FEASIBILITY TRIAL OF YOGA PROGRAMME FOR TYPE 2 DIABETES PREVENTION (YOGA-DP) AMONG HIGH-RISK PEOPLE IN INDIA: A QUALITATIVE STUDY TO EXPLORE PARTICIPANTS' TRIAL- AND INTERVENTION-RELATED BARRIERS AND FACILITATORS. YOGA-BASED INTERVENTIONS CAN BE EFFECTIVE IN PREVENTING TYPE 2 DIABETES MELLITUS (T2DM). WE DEVELOPED A YOGA PROGRAMME FOR T2DM PREVENTION (YOGA-DP) AND CONDUCTED A FEASIBILITY RANDOMISED CONTROLLED TRIAL (RCT) AMONG HIGH-RISK PEOPLE IN INDIA. THIS QUALITATIVE STUDY'S OBJECTIVE WAS TO IDENTIFY AND EXPLORE PARTICIPANTS' TRIAL- AND INTERVENTION-RELATED BARRIERS AND FACILITATORS. THE FEASIBILITY TRIAL WAS CONDUCTED AT TWO YOGA CENTRES IN NEW DELHI AND BENGALURU, INDIA. IN THIS QUALITATIVE STUDY, 25 TRIAL PARTICIPANTS (13 INTERVENTION GROUP, 12 CONTROL GROUP) WERE RECRUITED FOR SEMI-STRUCTURED INTERVIEWS. DATA WERE ANALYSED USING DEDUCTIVE LOGIC AND AN INTERPRETATIVE PHENOMENOLOGICAL APPROACH. AMONGST INTERVENTION AND CONTROL PARTICIPANTS, KEY BARRIERS TO TRIAL PARTICIPATION WERE INADEQUATE INFORMATION ABOUT RECRUITMENT AND RANDOMISATION PROCESSES AND THE NEGATIVE INFLUENCE OF NON-PARTICIPANTS. FREE BLOOD TESTS TO AID T2DM PREVENTION, SITE STAFF'S FRIENDLY BEHAVIOUR AND FRIENDS' POSITIVE INFLUENCE FACILITATED TRIAL PARTICIPATION. AMONGST INTERVENTION PARTICIPANTS, READABILITY AND UNDERSTANDING OF THE PROGRAMME BOOKLETS, DISLIKE OF THE YOGA DIARY, POOR QUALITY YOGA MATS, DIFFICULTY IN USING THE PROGRAMME VIDEO, HOUSEHOLD COMMITMENT DURING HOME SESSIONS, UNPLANNED TRAVEL, DIFFICULTY IN PRACTISING YOGA POSES, HESITATION IN ATTENDING PROGRAMME SESSIONS WITH THE YOGA-DP INSTRUCTOR OF THE OPPOSITE SEX AND MIXED-SEX GROUP PROGRAMME SESSIONS WERE KEY BARRIERS TO INTERVENTION PARTICIPATION. ADEQUATE INFORMATION WAS PROVIDED ON T2DM PREVENTION AND SELF-CARE, GOOD VENUE AND OTHER SUPPORT PROVIDED FOR PROGRAMME SESSIONS, YOGA-DP INSTRUCTORS' POSITIVE BEHAVIOUR AND IMPROVEMENTS IN PHYSICAL AND MENTAL WELL-BEING FACILITATED INTERVENTION PARTICIPATION. IN CONCLUSION, WE IDENTIFIED AND EXPLORED PARTICIPANTS' TRIAL- AND INTERVENTION-RELATED BARRIERS AND FACILITATORS. WE IDENTIFIED AN ALMOST EQUAL NUMBER OF BARRIERS (N = 12) AND FACILITATORS (N = 13); HOWEVER, INTERVENTION-RELATED BARRIERS AND FACILITATORS WERE GREATER THAN FOR PARTICIPATING IN THE TRIAL. THESE FINDINGS WILL INFORM THE DESIGN OF THE PLANNED DEFINITIVE RCT DESIGN AND INTERVENTION AND CAN ALSO BE USED TO DESIGN OTHER YOGA INTERVENTIONS AND RCTS. 2022 4 2763 54 YOGA PROGRAM FOR TYPE 2 DIABETES PREVENTION (YOGA-DP) AMONG HIGH-RISK PEOPLE: QUALITATIVE STUDY TO EXPLORE REASONS FOR NON-PARTICIPATION IN A FEASIBILITY RANDOMIZED CONTROLLED TRIAL IN INDIA. BACKGROUND: YOGA-BASED INTERVENTIONS CAN BE EFFECTIVE IN PREVENTING TYPE 2 DIABETES MELLITUS (T2DM). WE DEVELOPED A YOGA PROGRAM FOR T2DM PREVENTION (YOGA-DP) AMONG HIGH-RISK PEOPLE AND CONDUCTED A FEASIBILITY RANDOMIZED CONTROLLED TRIAL (RCT) IN INDIA. THE OBJECTIVE OF THIS STUDY WAS TO IDENTIFY AND EXPLORE WHY POTENTIAL PARTICIPANTS DECLINED TO PARTICIPATE IN THE FEASIBILITY RCT. METHODS: AN EXPLORATORY QUALITATIVE STUDY, USING SEMI-STRUCTURED INTERVIEWS, WAS CONDUCTED AT A YOGA CENTER IN NEW DELHI, INDIA. FOURTEEN PEOPLE (10 WOMEN AND FOUR MEN) WHO DECLINED TO PARTICIPATE IN THE FEASIBILITY RCT WERE INTERVIEWED, AND 13 OF THEM COMPLETED THE NON-PARTICIPANT QUESTIONNAIRE, WHICH CAPTURED THEIR SOCIO-DEMOGRAPHICS, DIETS, PHYSICAL ACTIVITIES, AND REASONS FOR DECLINING. RESULTS: THREE TYPES OF BARRIERS WERE IDENTIFIED AND EXPLORED WHICH PREVENTED PARTICIPATION IN THE FEASIBILITY RCT: (1) PERSONAL BARRIERS, SUCH AS LACK OF TIME, PERCEIVED SUFFICIENCY OF KNOWLEDGE, PREFERENCES ABOUT SELF-MANAGEMENT OF HEALTH, AND TRUST IN OTHER TRADITIONAL AND ALTERNATIVE THERAPIES; (2) CONTEXTUAL BARRIERS, SUCH AS SOCIAL INFLUENCES AND LACK OF AWARENESS ABOUT PREVENTIVE CARE; AND (3) STUDY-RELATED BARRIERS, SUCH AS LACK OF STUDY INFORMATION, POOR ACCESSIBILITY TO THE YOGA SITE, AND LACK OF TRUST IN THE STUDY METHODS AND INTERVENTION. CONCLUSIONS: WE IDENTIFIED AND EXPLORED PERSONAL, CONTEXTUAL, AND STUDY-RELATED BARRIERS TO PARTICIPATION IN A FEASIBILITY RCT IN INDIA. THE FINDINGS WILL HELP TO ADDRESS RECRUITMENT CHALLENGES IN FUTURE YOGA AND OTHER RCTS. CLINICAL TRIAL REGISTRATION:WWW.CLINICALTRIALS.GOV, IDENTIFIER: CTRI/2019/05/018893. 2021 5 1370 52 IMPACT OF A STRUCTURED YOGA PROGRAM ON BLOOD PRESSURE REDUCTION AMONG HYPERTENSIVE PATIENTS: STUDY PROTOCOL FOR A PRAGMATIC RANDOMIZED MULTICENTER TRIAL IN PRIMARY HEALTH CARE SETTINGS IN NEPAL. BACKGROUND: HYPERTENSION CONTROL REMAINS A MAJOR GLOBAL CHALLENGE. THE BEHAVIORAL APPROACHES RECOMMENDED FOR BLOOD PRESSURE REDUCTION ARE STRESS REDUCTION, INCREASED EXERCISE AND HEALTHY DIETARY HABITS. SOME STUDY FINDINGS SUGGEST THAT YOGA HAS A BENEFICIAL EFFECT IN REDUCING BLOOD PRESSURE. HOWEVER, THE ROLE OF YOGA ON BLOOD PRESSURE HAS RECEIVED LITTLE ATTENTION IN EXISTING HEALTH CARE PRACTICES IN DEVELOPING COUNTRIES. THIS STUDY WILL BE CONDUCTED IN PRIMARY HEALTH CARE FACILITIES IN NEPAL TO ASSESS THE EFFECTIVENESS OF A PRAGMATIC YOGA INTERVENTION TO COMPLEMENT STANDARD PRACTICE IN FURTHER REDUCING BLOOD PRESSURE. METHODS: THIS WILL BE MULTICENTRIC, TWO ARMS, RANDOMIZED, NONBLINDED, PRAGMATIC TRIAL. IT WILL BE CONDUCTED IN SEVEN DISTRICT AYURVEDA HEALTH CENTERS (DAHCS) IN NEPAL BETWEEN JULY 2017 AND JUNE 2018. THE STUDY PARTICIPANTS WILL CONSIST OF HYPERTENSIVE PATIENTS WITH OR WITHOUT ANTIHYPERTENSIVE MEDICATION ATTENDING TO THE OUTPATIENT DEPARTMENT (OPD). ONE HUNDRED AND FORTY PARTICIPANTS WILL BE RANDOMIZED TO TREATMENT OR CONTROL GROUPS BY USING A STRATIFIED BLOCK RANDOMIZATION. AT THE STUDY SITE, THE TREATMENT ARM PARTICIPANTS WILL RECEIVE AN INTERVENTION CONSISTING OF FIVE DAYS OF STRUCTURED YOGA TRAINING AND PRACTICE OF THE SAME PACKAGE AT HOME WITH A RECOMMENDATION OF FIVE DAYS A WEEK FOR THE FOLLOWING 90 DAYS. BOTH THE INTERVENTION AND CONTROL GROUPS WILL RECEIVE TWO HOURS OF HEALTH EDUCATION ON LIFESTYLE MODIFICATIONS. THE PRIMARY OUTCOME OF THIS TRIAL WILL BE THE CHANGE IN SYSTOLIC BLOOD PRESSURE AND IT WILL BE ASSESSED AFTER 90 DAYS OF THE INTERVENTION. DISCUSSION: THIS STUDY WILL ESTABLISH THE EXTENT TO WHICH A YOGA INTERVENTION PACKAGE CAN HELP REDUCE BLOOD PRESSURE IN HYPERTENSIVE PATIENTS. IF PROVEN EFFECTIVE, STUDY FINDINGS MAY BE USED TO RECOMMEND THE GOVERNING BODIES AND OTHER STAKEHOLDERS FOR THE INTEGRATION OF YOGA IN THE NATIONAL HEALTHCARE SYSTEM FOR THE TREATMENT AND CONTROL OF HYPERTENSION. TRIAL REGISTRATION: CLINICAL TRIAL REGISTRY- INDIA (CTRI); CTRI REG. NO- CTRI/2017/02/007822 . REGISTERED ON 10/02/2017. 2018 6 606 31 DEVELOPMENT AND VALIDATION OF YOGA PROGRAM FOR PATIENTS WITH TYPE 2 DIABETES MELLITUS (T2DM). THIS STUDY WITH AIM OF DEVELOPMENT AND VALIDATION OF A YOGA PROGRAM FOR PATIENTS WITH T2DM WAS CARRIED IN VIEW OF EMERGING EVIDENCE OF YOGA AS AN ALTERNATIVE AND/OR COMPLEMENTARY TREATMENT. CLASSICAL AND CONTEMPORARY YOGA TEXTS WERE REVIEWED FOR IDENTIFICATION OF YOGA PRACTICES. AFTER REVIEWING RESEARCH PAPERS AND YOGA TEXTS A THREE-STEP YOGA PROGRAM, IN ORDER OF INCREASING DIFFICULTY LEVEL FOR T2DM WAS PREPARED. FOR VALIDATION OF YOGA PROGRAM, MIXED METHODS APPROACH INTEGRATING QUALITATIVE AND QUANTITATIVE INPUTS WAS CONSIDERED. EIGHTEEN EXPERTS OVER THREE ROUNDS OF ITERATION CONTRIBUTED TOWARD VALIDATION OF YOGA PROGRAM. A FINAL SET OF THREE-STEP YOGA PROGRAM WAS OBTAINED WHICH FURTHER NEEDS TO BE TESTED IN STANDARDIZED RANDOMIZED CONTROLLED TRIALS.TRIAL REGISTRATION WITH INDIAN COUNCIL OF MEDICAL RESEARCH: CLINICAL TRIAL REGISTRY OF INDIA; ICMR-CTRI: DEVELOPMENT AND VALIDATION STUDY: CTRI/2013/11/004163. 2022 7 2353 42 UTILIZATION OF 3-MONTH YOGA PROGRAM FOR ADULTS AT HIGH RISK FOR TYPE 2 DIABETES: A PILOT STUDY. VARIOUS MODES OF PHYSICAL ACTIVITY, COMBINED WITH DIETING, HAVE BEEN WIDELY RECOMMENDED TO PREVENT OR DELAY TYPE 2 DIABETES. AMONG THESE, YOGA HOLDS PROMISE FOR REDUCING RISK FACTORS FOR TYPE 2 DIABETES BY PROMOTING WEIGHT LOSS, IMPROVING GLUCOSE LEVELS AND REDUCING BLOOD PRESSURE AND LIPID LEVELS. THIS PILOT STUDY AIMED TO ASSESS THE FEASIBILITY OF IMPLEMENTING A 12-WEEK YOGA PROGRAM AMONG ADULTS AT HIGH RISK FOR TYPE 2 DIABETES. TWENTY-THREE ADULTS (19 WHITES AND 4 NON-WHITES) WERE RANDOMLY ASSIGNED TO THE YOGA INTERVENTION GROUP OR THE EDUCATIONAL GROUP. THE YOGA GROUP PARTICIPATED IN A 3-MONTH YOGA INTERVENTION WITH SESSIONS TWICE PER WEEK AND THE EDUCATIONAL GROUP RECEIVED GENERAL HEALTH EDUCATIONAL MATERIALS EVERY 2 WEEKS. ALL PARTICIPANTS COMPLETED QUESTIONNAIRES AND HAD BLOOD TESTS AT BASELINE AND AT THE END OF 3 MONTHS. EFFECT SIZES WERE REPORTED TO SUMMARIZE THE EFFICACY OF THE INTERVENTION. ALL PARTICIPANTS ASSIGNED TO THE YOGA INTERVENTION COMPLETED THE YOGA PROGRAM WITHOUT COMPLICATION AND EXPRESSED HIGH SATISFACTION WITH THE PROGRAM (99.2%). THEIR YOGA SESSION ATTENDANCE RANGED FROM 58.3 TO 100%. COMPARED WITH THE EDUCATION GROUP, THE YOGA GROUP EXPERIENCED IMPROVEMENTS IN WEIGHT, BLOOD PRESSURE, INSULIN, TRIGLYCERIDES AND EXERCISE SELF-EFFICACY INDICATED BY SMALL TO LARGE EFFECT SIZES. THIS PRELIMINARY STUDY INDICATES THAT A YOGA PROGRAM WOULD BE A POSSIBLE RISK REDUCTION OPTION FOR ADULTS AT HIGH RISK FOR TYPE 2 DIABETES. IN ADDITION, YOGA HOLDS PROMISE AS AN APPROACH TO REDUCING CARDIOMETABOLIC RISK FACTORS AND INCREASING EXERCISE SELF-EFFICACY FOR THIS GROUP. 2011 8 103 45 A PILOT CROSS-SECTIONAL SURVEY ON AWARENESS AND PRACTICE REGARDING TYPE 2 DIABETES MELLITUS AND ITS MANAGEMENT WITH YOGA. DIABETES MELLITUS IS A METABOLIC DISORDER OF MULTIPLE ETIOLOGY, CHARACTERIZED BY CHRONIC HYPERGLYCAEMIA WITH DISTURBANCE OF CARBOHYDRATE, FAT, AND PROTEIN METABOLISM RESULTING FROM DEFECT IN INSULIN SECRETION, INSULIN ACTION OR BOTH. IMPROPER LIFESTYLE CONTRIBUTES TO THE INCREASING NUMBER OF PEOPLE AFFECTED WITH TYPE 2 DIABETES MELLITUS (T2DM). SYSTEMATIC REVIEWS ON THE MANAGEMENT OF T2DM IN ADULTS THROUGH YOGA REPORTED SIGNIFICANT IMPROVEMENTS IN MULTIPLE MODIFIABLE INDICES OF DIABETES MELLITUS MANAGEMENT INCLUDING GLYCEMIC CONTROL, LIPID LEVELS, AND BODY COMPOSITION. AWARENESS LEVELS OF A CONDITION AMONG THE POPULATION PLAY A CRITICAL ROLE IN BEHAVIOUR CHANGE. HOWEVER, STUDIES RELATED TO ASSESSING THE AWARENESS AND PRACTICE OF YOGA FOR MANAGING DISEASES ARE LIMITED. HENCE, THIS STUDY WAS FORMULATED WITH THE OBJECTIVE OF ASSESSING THE AWARENESS LEVEL AND EXTENT OF KNOWLEDGE ABOUT DIABETES MELLITUS AND ITS MANAGEMENT THROUGH YOGA. A CROSS-SECTIONAL SURVEY WITH A SAMPLE SIZE OF 317 WAS CONDUCTED USING A STRUCTURED QUESTIONNAIRE AT 5 DISTRICTS IN TAMIL NADU AND KERALA. 95% OF THE STUDY POPULATION WERE AWARE OF DIABETES MELLITUS WHILE 61.2% RESPONDED THAT DIABETES CAN BE PREVENTED BY REGULAR EXERCISE AND HEALTHY DIET. 62.4% PEOPLE PERCEIVED THAT YOGA PRACTICES CAN PREVENT DIABETES MELLITUS AND 59% MENTIONED THAT REGULAR YOGA PRACTICE CAN HELP IN CONTROLLING DIABETES AND PREVENT FURTHER COMPLICATIONS. ONLY 13% REPORTED TO PRACTICE YOGA REGULARLY AT LEAST THREE DAYS A WEEK. IDENTIFYING A QUALIFIED YOGA TRAINER WAS REPORTED TO BE A LIMITING FACTOR FOR REGULAR YOGA PRACTICE. THE STUDY SUGGESTED THAT THERE IS A NEED TO INCREASE THE ACCESS TO QUALIFIED YOGA PROFESSIONALS AT COMMUNITY LEVEL. FURTHER LARGE SCALE STUDIES WITH RANDOM SAMPLING METHOD TO ASSESS THE AWARENESS LEVEL AND PRACTICE OF YOGA IN DIFFERENT SETTINGS IS INDICATED. 2020 9 501 64 COMMUNITY BASED YOGA CLASSES FOR TYPE 2 DIABETES: AN EXPLORATORY RANDOMISED CONTROLLED TRIAL. BACKGROUND: YOGA IS A POPULAR THERAPY FOR DIABETES BUT ITS EFFICACY IS CONTESTED. THE AIM OF THIS STUDY WAS TO EXPLORE THE FEASIBILITY OF RESEARCHING COMMUNITY BASED YOGA CLASSES IN TYPE 2 DIABETES WITH A VIEW TO INFORMING THE DESIGN OF A DEFINITIVE, MULTI-CENTRE TRIAL METHODS: THE STUDY DESIGN WAS AN EXPLORATORY RANDOMISED CONTROLLED TRIAL WITH IN-DEPTH PROCESS EVALUATION. THE SETTING WAS TWO MULTI-ETHNIC BOROUGHS IN LONDON, UK; ONE WITH AVERAGE AND ONE WITH LOW MEAN SOCIO-ECONOMIC DEPRIVATION SCORE. CLASSES WERE HELD AT A SPORTS CENTRE OR GP SURGERY. PARTICIPANTS WERE 59 PEOPLE WITH TYPE 2 DIABETES NOT TAKING INSULIN, RECRUITED FROM GENERAL PRACTICE LISTS OR OPPORTUNISTICALLY BY GENERAL PRACTICE STAFF. THE INTERVENTION GROUP WERE OFFERED 12 WEEKS OF A TWICE-WEEKLY 90-MINUTE YOGA CLASS; THE CONTROL GROUP WAS A WAITING LIST FOR THE YOGA CLASSES. BOTH GROUPS RECEIVED ADVICE AND LEAFLETS ON HEALTHY LIFESTYLE AND WERE ENCOURAGED TO EXERCISE. PRIMARY OUTCOME MEASURE WAS HBA1C. SECONDARY OUTCOME MEASURES INCLUDED ATTENDANCE, WEIGHT, WAIST CIRCUMFERENCE, LIPID LEVELS, BLOOD PRESSURE, UKPDS CARDIOVASCULAR RISK SCORE, DIABETES-RELATED QUALITY OF LIFE (ADDQOL), AND SELF-EFFICACY. PROCESS MEASURES WERE ATTENDANCE AT YOGA SESSIONS, SELF-REPORTED FREQUENCY OF PRACTICE BETWEEN TAUGHT SESSIONS, AND QUALITATIVE DATA (INTERVIEWS WITH PATIENTS AND THERAPISTS, ETHNOGRAPHIC OBSERVATION OF THE YOGA CLASSES, AND ANALYSIS OF DOCUMENTS INCLUDING MINUTES OF MEETINGS, CORRESPONDENCE, AND EXERCISE PLANS). RESULTS: DESPITE BROAD INCLUSION CRITERIA, AROUND TWO-THIRDS OF THE PATIENTS ON GP DIABETIC REGISTERS PROVED INELIGIBLE, AND 90% OF THE REMAINDER DECLINED TO PARTICIPATE. MEAN AGE OF PARTICIPANTS WAS 60 +/- 10 YEARS. ATTENDANCE AT YOGA CLASSES WAS AROUND 50%. NOBODY DID THE EXERCISES REGULARLY AT HOME. YOGA TEACHERS FELT THAT MOST PARTICIPANTS WERE UNSUITABLE FOR 'STANDARD' YOGA EXERCISES BECAUSE OF LIMITED FLEXIBILITY, LACK OF BASIC FITNESS, CO-MORBIDITY, AND LACK OF CONFIDENCE. THERE WAS A SMALL FALL IN HBA1C IN THE YOGA GROUP WHICH WAS NOT STATISTICALLY SIGNIFICANT AND WHICH WAS NOT SUSTAINED SIX MONTHS LATER, AND NO SIGNIFICANT CHANGE IN OTHER OUTCOME MEASURES. CONCLUSION: THE BENEFITS OF YOGA IN TYPE 2 DIABETES SUGGESTED IN SOME PREVIOUS STUDIES WERE NOT CONFIRMED. POSSIBLE EXPLANATIONS (APART FROM LACK OF EFFICACY) INCLUDE RECRUITMENT CHALLENGES; PRACTICAL AND MOTIVATIONAL BARRIERS TO CLASS ATTENDANCE; PHYSICAL AND MOTIVATIONAL BARRIERS TO ENGAGING IN THE EXERCISES; INADEQUATE INTENSITY AND/OR DURATION OF YOGA INTERVENTION; AND INSUFFICIENT PERSONALISATION OF EXERCISES TO INDIVIDUAL NEEDS. ALL THESE FACTORS SHOULD BE CONSIDERED WHEN DESIGNING FUTURE TRIALS. TRIAL REGISTRATION: NATIONAL RESEARCH REGISTER (1410) AND CURRENT CONTROLLED TRIALS (ISRCTN63637211). 2009 10 2452 52 YOGA AS A COMPLEMENTARY THERAPY FOR ADULTS WITH TYPE 2 DIABETES: DESIGN AND RATIONALE OF THE HEALTHY, ACTIVE, AND IN CONTROL (HA1C) STUDY. DIABETES IS THE SEVENTH LEADING CAUSE OF DEATH IN THE UNITED STATES. FOR MOST PATIENTS, MEDICATION ALONE IS NOT SUFFICIENT TO ACHIEVE GLYCEMIC CONTROL; ATTENTION MUST ALSO BE PAID TO MULTIPLE HEALTHY BEHAVIORS INCLUDING DIET, REGULAR PHYSICAL ACTIVITY, AND STRESS MANAGEMENT. YOGA, A MINDFULNESS PRACTICE WITH EMPHASIS ON RELAXATION, MEDITATION, AND DEEP BREATHING, MAY HAVE SPECIAL RELEVANCE TO PEOPLE WITH TYPE 2 DIABETES MELLITUS (T2DM). YOGA PRACTICE MAY POSITIVELY AFFECT STRESS AND OTHER SELF-CARE TASKS THAT WILL CONTRIBUTE TO IMPROVED GLYCEMIC CONTROL. THE HEALTHY, ACTIVE, AND IN CONTROL (HA1C) STUDY IS DESIGNED TO EXAMINE THE FEASIBILITY AND ACCEPTABILITY OF YOGA AMONG ADULT PATIENTS WITH T2DM. IN THIS PILOT RANDOMIZED CONTROLLED TRIAL, ADULTS WITH T2DM WERE RANDOMLY ASSIGNED TO EITHER A 12-WEEK IYENGAR YOGA INTERVENTION GIVEN TWICE WEEKLY, OR A TWICE-WEEKLY 12-WEEK PROGRAM OF TRADITIONAL EXERCISE (E.G., WALKING, STATIONARY CYCLING). ASSESSMENTS ARE CONDUCTED AT THE END OF TREATMENT (12 WEEKS) AND AT 3 AND 6 MONTHS POSTINTERVENTION. THE HA1C STUDY WILL ASSESS FEASIBILITY AND ACCEPTABILITY (E.G., ATTENDANCE/RETENTION RATES, SATISFACTION WITH PROGRAM), GLYCEMIC OUTCOMES (E.G., HBA1C, FASTING BLOOD GLUCOSE, POSTPRANDIAL BLOOD GLUCOSE), AND CHANGES IN PHYSIOLOGICAL (E.G., SALIVARY CORTISOL) AND BEHAVIORAL FACTORS (E.G., PHYSICAL ACTIVITY, DIET) RELEVANT TO THE MANAGEMENT OF T2DM. FOCUS GROUPS ARE CONDUCTED AT THE END OF THE INTERVENTION TO EXPLORE PARTICIPANTS' EXPERIENCE WITH THE PROGRAM AND THEIR PERCEPTION OF THE POTENTIAL UTILITY OF YOGA FOR DIABETES MANAGEMENT. 2018 11 2861 57 YOGA-BASED EXERCISE TO PREVENT FALLS IN COMMUNITY-DWELLING PEOPLE AGED 60 YEARS AND OVER: STUDY PROTOCOL FOR THE SUCCESSFUL AGEING (SAGE) YOGA RANDOMISED CONTROLLED TRIAL. INTRODUCTION: FALLS SIGNIFICANTLY REDUCE INDEPENDENCE AND QUALITY OF LIFE IN OLDER AGE. BALANCE-SPECIFIC EXERCISE PREVENTS FALLS IN PEOPLE AGED 60+ YEARS. YOGA IS GROWING IN POPULARITY AND CAN PROVIDE A HIGH CHALLENGE TO BALANCE; HOWEVER, THE EFFECT OF YOGA ON FALLS HAS NOT BEEN EVALUATED. THIS TRIAL AIMS TO ESTABLISH THE EFFECT ON FALLS OF A YOGA EXERCISE PROGRAMME COMPARED WITH A YOGA RELAXATION PROGRAMME IN COMMUNITY-DWELLERS AGED 60+ YEARS. METHOD AND ANALYSIS: THIS RANDOMISED CONTROLLED TRIAL WILL INVOLVE 560 COMMUNITY-DWELLING PEOPLE AGED 60+ YEARS. PARTICIPANTS WILL BE RANDOMISED TO EITHER: (1) THE SUCCESSFUL AGEING (SAGE) YOGA EXERCISE PROGRAMME OR (2) A YOGA RELAXATION PROGRAMME. PRIMARY OUTCOME IS RATE OF FALLS IN THE 12 MONTHS POST RANDOMISATION. SECONDARY OUTCOMES INCLUDE MENTAL WELL-BEING, PHYSICAL ACTIVITY, HEALTH-RELATED QUALITY OF LIFE, BALANCE SELF-CONFIDENCE, PHYSICAL FUNCTION, PAIN, GOAL ATTAINMENT AND SLEEP QUALITY AT 12 MONTHS AFTER RANDOMISATION. THE NUMBER OF FALLS PER PERSON-YEAR WILL BE ANALYSED USING NEGATIVE BINOMIAL REGRESSION MODELS TO ESTIMATE BETWEEN-GROUP DIFFERENCE IN FALL RATES. GENERALISED LINEAR MODELS WILL ASSESS THE EFFECT OF GROUP ALLOCATION ON THE CONTINUOUSLY SCORED SECONDARY OUTCOMES, ADJUSTING FOR BASELINE SCORES. AN ECONOMIC ANALYSIS WILL COMPARE THE COST-EFFECTIVENESS AND COST-UTILITY OF THE TWO YOGA PROGRAMMES. ETHICS AND DISSEMINATION: PROTOCOL WAS APPROVED BY THE HUMAN RESEARCH ETHICS COMMITTEE AT THE UNIVERSITY OF SYDNEY, AUSTRALIA (APPROVAL 2019/604). TRIAL RESULTS WILL BE DISSEMINATED VIA PEER-REVIEWED ARTICLES, CONFERENCE PRESENTATIONS, LAY SUMMARIES. TRIAL REGISTRATION NUMBER: THE PROTOCOL FOR THIS TRIAL IS REGISTERED WITH THE AUSTRALIAN NEW ZEALAND CLINICAL TRIALS REGISTRY (ACTRN12619001183178). 2020 12 1707 41 PATTERNS OF YOGA PRACTICE AND PHYSICAL ACTIVITY FOLLOWING A YOGA INTERVENTION FOR ADULTS WITH OR AT RISK FOR TYPE 2 DIABETES. BACKGROUND: THE CURRENT STUDY DESCRIBED PATTERNS OF YOGA PRACTICE AND EXAMINED DIFFERENCES IN PHYSICAL ACTIVITY OVER TIME BETWEEN INDIVIDUALS WITH OR AT RISK FOR TYPE 2 DIABETES WHO COMPLETED AN 8-WEEK YOGA INTERVENTION COMPARED WITH CONTROLS. METHODS: A LONGITUDINAL COMPARATIVE DESIGN MEASURED THE EFFECT OF A YOGA INTERVENTION ON YOGA PRACTICE AND PHYSICAL ACTIVITY, USING DATA AT BASELINE AND POSTINTERVENTION MONTHS 3, 6, AND 15. RESULTS: DISPARATE PATTERNS OF YOGA PRACTICE OCCURRED BETWEEN INTERVENTION AND CONTROL PARTICIPANTS OVER TIME, BUT THE SUBJECTIVE DEFINITION OF YOGA PRACTICE LIMITS INTERPRETATION. MULTILEVEL MODEL ESTIMATES INDICATED THAT TREATMENT GROUP DID NOT HAVE A SIGNIFICANT INFLUENCE IN THE RATE OF CHANGE IN PHYSICAL ACTIVITY OVER THE STUDY PERIOD. WHILE AGE AND EDUCATION WERE NOT SIGNIFICANT INDIVIDUAL PREDICTORS, THE INCLUSION OF THESE VARIABLES IN THE MODEL DID IMPROVE FIT. CONCLUSIONS: FINDINGS INDICATE THAT AN 8-WEEK YOGA INTERVENTION HAD LITTLE EFFECT ON PHYSICAL ACTIVITY OVER TIME. FURTHER RESEARCH IS NECESSARY TO EXPLORE THE INFLUENCE OF YOGA ON BEHAVIORAL HEALTH OUTCOMES AMONG INDIVIDUALS WITH OR AT RISK FOR TYPE 2 DIABETES. 2012 13 888 67 EFFECT OF YOGA VERSUS LIGHT EXERCISE TO IMPROVE WELL-BEING AND PROMOTE HEALTHY AGING AMONG OLDER ADULTS IN CENTRAL INDIA: A STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: AGING IS A NATURAL PROCESS ASSOCIATED WITH MANY FUNCTIONAL AND STRUCTURAL CHANGES. THESE CHANGES MAY INCLUDE IMPAIRED SELF-REGULATION, CHANGES IN TISSUES AND ORGANS. AGING ALSO AFFECTS MOOD, PHYSICAL STATUS AND SOCIAL ACTIVITY. THERE ARE ADVERSE CHANGES IN COGNITIVE BEHAVIOR, PERCEIVED SENSATION AND THINKING PROCESSES. REGULAR PHYSICAL ACTIVITY CAN ALLEVIATE MANY HEALTH PROBLEMS; YET, MANY OLDER ADULTS ARE INACTIVE. YOGA IS ONE OF THE SCIENTIFIC AND POPULAR LIFESTYLE PRACTICE CONSIDERED AS THE INTEGRATION OF MIND, BODY AND SOUL. RESULTS OF PREVIOUS STUDIES REPORTED POSITIVE EFFECTS OF YOGA ON MULTIPLE HEALTH OUTCOMES IN ELDERLY. HOWEVER, THERE IS SCARCITY OF SCIENTIFIC INFORMATION WHERE YOGA'S EFFECT IS EXAMINED ON OVER WELL-BEING AND ON MULTIPLE HEALTH OUTCOMES SIMULTANEOUSLY IN ELDERLY. THIS PROTOCOL DESCRIBES METHODS FOR A 12-WEEK YOGA-BASED INTERVENTION EXPLORING THE EFFECTS OF YOGA ON WELL-BEING IN PHYSICALLY INACTIVE ELDERLY LIVING IN COMMUNITY. METHODS AND ANALYSIS: THIS TWO GROUP PARALLEL SINGLE BLIND RANDOMIZED CONTROLLED TRIAL THAT WILL BE CONDUCTED AT A DESIGNATED FACILITY OF R.D. GARDI MEDICAL COLLEGE, UJJAIN, MADHYA PRADESH, CENTRAL INDIA. A 12-WEEK 60-MIN YOGA INTERVENTION THREE TIMES WEEKLY IS DESIGNED. COMPARISON GROUP PARTICIPANTS WILL UNDERGO A 60-MIN PROGRAM COMPRISING LIGHT EXERCISE FOCUSING ON CONVENTIONAL STRETCHING TO IMPROVE MOBILITY. AFTER SCREENING, 144 PARTICIPANTS AGED 60-80 YEARS WILL BE RECRUITED. THE PRIMARY OUTCOME IS SUBJECTIVE WELL-BEING. SECONDARY OUTCOMES INCLUDE MOBILITY, FALL RISK, COGNITION, ANXIETY AND DEPRESSION, MOOD AND STRESS, SLEEP QUALITY, PAIN, PHYSICAL ACTIVITY/SEDENTARY BEHAVIOR AND CARDIO-METABOLIC RISK FACTORS. ASSESSMENTS WILL BE CONDUCTED AT BASELINE (0 WEEK), AFTER THE INTERVENTION (12+1 WEEK) AND AT FOLLOW-UP (36+1 WEEK). INTENTION-TO-TREAT ANALYSES WITH MIXED LINEAR MODELING WILL BE APPLIED. DISCUSSION: THROUGH THIS TRIAL, WE AIM TO DETERMINE WHETHER ELDERLY PEOPLE IN THE INTERVENTION GROUP PRACTICING YOGA SHOW MORE FAVORABLE PRIMARY (WELL-BEING) AND SECONDARY OUTCOMES THAN THOSE IN THE LIGHT EXERCISE FOCUSING ON CONVENTIONAL STRETCHING GROUP. WE ASSUME THAT YOGA MAY BE PRACTICED TO MAINTAIN HEALTH, REDUCE PARTICULAR SYMPTOMS COMMONLY ASSOCIATED WITH SKELETAL PAIN, ASSIST IN PAIN RELIEF AND ENHANCE WELL-BEING. WE ANTICIPATE THAT PRACTICING YOGA WILL IMPROVE WELL-BEING AND MENTAL HEALTH AND MAY LEAD TO SIGNIFICANT IMPROVEMENT IN DEPRESSION, PAIN AND SLEEP QUALITY.ETHICS AND DISSEMINATION: THIS STUDY IS APPROVED BY THE INSTITUTIONAL ETHICS COMMITTEE OF R.D. GARDI MEDICAL COLLEGE, UJJAIN, IEC REF NO. 09/2018. ALL PARTICIPANTS WOULD BE PROVIDED WITH WRITTEN AND VERBAL INFORMATION ABOUT THE PURPOSE OF THE PROJECT AND WOULD BE FREE TO WITHDRAW FROM THE STUDY AT ANY TIME. REFUSAL TO PARTICIPATE IN THE STUDY WOULD NOT HAVE ANY NEGATIVE CONSEQUENCES. CONFIDENTIALITY OF THE INFORMATION OF EACH PARTICIPANT WOULD BE ENSURED. KNOWLEDGE OBTAINED WOULD BE DISSEMINATED TO STAKEHOLDERS THROUGH WORKSHOPS, MEETINGS AND RELEVANT SCIENTIFIC CONFERENCES. TRIAL REGISTRATION: THE TRIAL IS PROSPECTIVELY REGISTERED WITH THE INDIAN COUNCIL OF MEDICAL RESEARCH TRIAL REGISTRY CTRI/2018/07/015051. 2019 14 1161 49 EVALUATING A GROUP-BASED YOGA OF STRESS RESILIENCE PROGRAMME: A PRAGMATIC BEFORE-AFTER INTERVENTIONAL STUDY PROTOCOL. INTRODUCTION: RATES OF MENTAL HEALTH ILLNESSES AND BURNOUT ARE INCREASING INTERNATIONALLY. THERAPEUTIC YOGA IS INCREASINGLY USED TO IMPROVE AND MAINTAIN PHYSICAL, MENTAL AND EMOTIONAL WELL-BEING AND GENERAL HEALTH. THIS PROTOCOL DESCRIBES A STUDY TO EVALUATE THE EFFECTIVENESS OF AN EXISTING PRIMARY CARE GROUP-BASED THERAPEUTIC YOGA PROGRAMME, THE YOGA OF STRESS RESILIENCE PROGRAMME, WHICH COMBINES YOGA AND PSYCHOTHERAPEUTIC TECHNIQUES, IN IMPROVING MENTAL HEALTH AND DECREASING BURNOUT. IMPLEMENTATION FACTORS WILL ALSO BE EVALUATED FOR POTENTIAL SCALE-UP. METHODS AND ANALYSIS: A PRAGMATIC BEFORE-AFTER INTERVENTIONAL TRIAL DESIGN WILL BE USED TO STUDY CHANGES IN OCCUPATIONAL PARTICIPATION AND MENTAL HEALTH OUTCOMES, INCLUDING ANXIETY, DEPRESSION, BURNOUT, FUNCTIONAL IMPAIRMENT, INSOMNIA, PERCEIVED STRESS, LONELINESS, SELF-COMPASSION AND READINESS FOR CHANGE IN ADULTS EXPERIENCING ANXIETY AND BURNOUT. REPEATED MEASURES ANALYSIS OF VARIANCE WILL BE USED TO DETERMINE CHANGES IN OUTCOME MEASURES OVER TIME. REGRESSION AND MULTIVARIATE ANALYSES WILL BE CONDUCTED TO EXAMINE RELATIONSHIPS BETWEEN PARTICIPANT CHARACTERISTICS AND OUTCOMES AND AMONG VARIOUS OUTCOMES. THE REACH, EFFECTIVENESS, ADOPTION, IMPLEMENTATION, AND MAINTENANCE FRAMEWORK WILL BE USED TO GUIDE THE ANALYSES. ETHICS AND DISSEMINATION: APPROVAL FROM THE HAMILTON INTEGRATED RESEARCH ETHICS BOARD HAS BEEN WAIVED: PROJECT NUMBER 7082 (FULL REVIEW WAIVED). INFORMED CONSENT WILL BE OBTAINED PRIOR TO ENROLLING ANY PARTICIPANT INTO THE STUDY. ALL DATA WILL BE KEPT CONFIDENTIAL. PEER-REVIEWED PUBLICATIONS AND PRESENTATIONS WILL TARGET RESEARCHERS AND HEALTH PROFESSIONALS. TRIAL REGISTRATION NUMBER: THE CLINICALTRIALS.GOV REGISTRY (NCT03973216). 2020 15 549 21 CONTEXTUALIZING THE EFFECTS OF YOGA THERAPY ON DIABETES MANAGEMENT: A REVIEW OF THE SOCIAL DETERMINANTS OF PHYSICAL ACTIVITY. THIS ARTICLE PROVIDES A REVIEW OF LITERATURE BOTH TO IDENTIFY THE EFFECTS OF YOGA-BASED THERAPY ON THE MANAGEMENT OF TYPE 2 DIABETES MELLITUS AND TO EXAMINE THE SOCIAL CONTEXT OF PHYSICAL ACTIVITY. FINDINGS FROM THE REVIEW INDICATE THAT YOGA HAS A POSITIVE SHORT-TERM EFFECT ON MULTIPLE DIABETES-RELATED OUTCOMES; HOWEVER, LONG-TERM EFFECTS OF YOGA THERAPY ON DIABETES MANAGEMENT REMAIN UNCLEAR. THE CONTEXT OF THE SOCIAL ENVIRONMENT, INCLUDING INTERPERSONAL RELATIONSHIPS, COMMUNITY CHARACTERISTICS, AND DISCRIMINATION, INFLUENCES THE ADOPTION AND MAINTENANCE OF HEALTH BEHAVIORS SUCH AS PHYSICAL ACTIVITY, INCLUDING YOGA PRACTICE. FURTHER RESEARCH IS NECESSARY TO DETERMINE THE EXTENT OF THIS INFLUENCE. 2008 16 283 49 ADHERENCE TO YOGA AND ITS RESULTANT EFFECTS ON BLOOD GLUCOSE IN TYPE 2 DIABETES: A COMMUNITY-BASED FOLLOW-UP STUDY. AIM: TO STUDY THE ADHERENCE TO YOGA AND ITS EFFECTS ON BLOOD GLUCOSE PARAMETERS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS. METHODS: A SINGLE GROUP LONGITUDINAL STUDY OVER 6 MONTHS WAS CONDUCTED AT VASK YOGA CENTRE, BANGALORE. FASTING BLOOD SUGAR, POST PRANDIAL BLOOD SUGAR LEVELS AND GLYCOSYLATED HEMOGLOBIN AND QUALITATIVE IN-DEPTH INTERVIEW OF THE PARTICIPANTS AND THERAPIST WAS CONDUCTED AT BASELINE, END OF 3(RD) MONTH AND END OF 6 MONTHS; INTERMEDIATE OBSERVATIONS WAS CONDUCTED AT THE END OF EVERY MONTH. RESULTS: ADHERENCE TO YOGA IN THE COMMUNITY IN BANGALORE IS AROUND 50% OVER 6 MONTHS. PARTICIPANTS WHO COMPLETED THE YOGA PROGRAMME HAD SIGNIFICANTLY LOWER HBA1C (END OF 3(RD) MONTH). AT THE END OF 6 MONTHS YOGA ADHERENCE WAS SIGNIFICANTLY NEGATIVELY CORRELATED WITH FBS AND STRESS. FURTHER THERE WAS A TREND TOWARDS THOSE WHO DROPPED OUT HAVING HIGHER FBS, CONTROLLING FOR MEDICATION INTAKE, STRESS LEVELS AND DIET PATTERN (OR = 1.027, P = 0.07). QUALITATIVE DATA REVEALED THAT MOST OF THE PARTICIPANTS JOINED AND COMPLETED THE YOGA PROGRAMME TO HELP CURE THEIR DIABETES. PARTICIPANTS WHO DROPPED OUT FROM THE YOGA PROGRAMME GAVE REASONS OF TRAVEL, ILL-HEALTH AND INCREASED WORK-LOAD AT OFFICE. CONCLUSIONS: ADHERENCE TO YOGA HAS AN EFFECT ON THE BLOOD GLUCOSE PARAMETERS IN DIABETES. HENCE, STRATEGIES TO MOTIVATE PARTICIPANTS TO UNDERGO 'LIFESTYLE MODIFICATION PRACTICES' INCLUDING MAXIMIZING ADHERENCE TO YOGA SHOULD BE THE FOCUS TO EXPERIENCE ANY BENEFICIAL EFFECTS OF YOGA. 2017 17 2586 44 YOGA FOR HYPERTENSIVE PATIENTS: A STUDY ON BARRIERS AND FACILITATORS OF ITS IMPLEMENTATION IN PRIMARY CARE. BACKGROUND: INTERNATIONAL GUIDELINES FOR HYPERTENSION TREATMENT RECOMMEND THE USE OF YOGA, PARTICULARLY AMONG LOW-RISK PATIENTS. HOWEVER, EVIDENCE IS LACKING ON THE IMPLEMENTATION POTENTIAL OF HEALTH-WORKER-LED YOGA INTERVENTIONS IN LOW-RESOURCE, PRIMARY CARE SETTINGS. OBJECTIVE: TO ASSESS BARRIERS TO AND FACILITATORS OF THE IMPLEMENTATION OF A YOGA INTERVENTION FOR HYPERTENSIVE PATIENTS IN PRIMARY CARE IN NEPAL. METHODS: THE STUDY WAS CONDUCTED USING FOCUS GROUP DISCUSSIONS, IN-DEPTH INTERVIEWS, KEY INFORMANT INTERVIEWS, AND TELEPHONE INTERVIEWS. DATA WERE COLLECTED FROM THE 'YOGA AND HYPERTENSION' (YOH) TRIAL PARTICIPANTS, YOH INTERVENTION IMPLEMENTERS, AND OFFICIALS FROM THE MINISTRY OF HEALTH AND POPULATION IN NEPAL. RESULTS: MOST YOH TRIAL PARTICIPANTS STATED THAT: (1) IT WAS EASY TO LEARN YOGA DURING A FIVE-DAY TRAINING PERIOD AND PRACTISE IT FOR THREE MONTHS AT HOME; (2) PRACTISING YOGA IMPROVED THEIR HEALTH; AND (3) GROUP YOGA SESSIONS IN A COMMUNITY CENTRE WOULD HELP THEM PRACTISE YOGA MORE REGULARLY. MOST YOH INTERVENTION IMPLEMENTERS STATED THAT: (1) THEY WERE HIGHLY MOTIVATED TO IMPLEMENT THE INTERVENTION; (2) THE COST OF IMPLEMENTATION WAS ACCEPTABLE; (3) THEY DID NOT NEED ADDITIONAL STAFF TO EFFECTIVELY IMPLEMENT THE INTERVENTION; (4) PROVIDING REMUNERATION TO THE STAFF INVOLVED IN THE INTERVENTION WOULD INCREASE THEIR MOTIVATION; AND (5) THE YOGA PROGRAMME WAS 'SIMPLE AND EASY TO FOLLOW' AND 'EASILY PERFORMED BY PARTICIPANTS OF ANY AGE'. THE GOVERNMENT OFFICIALS STATED THAT: (1) YOGA IS CONSIDERED AS A KEY HEALTH PROMOTIONAL ACTIVITY IN NEPAL; AND (2) THE INTEGRATION OF THE YOGA INTERVENTION INTO THE EXISTING HEALTH CARE PROGRAMME WOULD NOT BE TOO CHALLENGING, BECAUSE THE EXISTING PERSONNEL AND OTHER RESOURCES CAN BE UTILISED. CONCLUSION: WHILE THERE IS A GOOD POTENTIAL THAT A YOGA INTERVENTION CAN BE IMPLEMENTED IN PRIMARY CARE, CAPACITY DEVELOPMENT FOR HEALTH WORKERS AND THE INVOLVEMENT OF COMMUNITY YOGA CENTRES IN THE DELIVERY OF THE INTERVENTIONS MAY BE REQUIRED TO FACILITATE THIS IMPLEMENTATION. 2021 18 1303 32 HATHA YOGA PRACTICE FOR TYPE 2 DIABETES MELLITUS PATIENTS: A PILOT STUDY. OBJECTIVE: THIS STUDY WAS CONDUCTED TO EXAMINE THE IMPACT OF HATHA YOGA ON GLYCEMIC CONTROL, PSYCHOLOGICAL AND PHYSIOLOGICAL STRESS, AND SELF-CARE FOR INDIVIDUALS WITH TYPE 2 DIABETES MELLITUS (T2DM). METHODS: TEN SEDENTARY INDIVIDUALS WITH T2DM WHO WERE NON-INSULIN DEPENDENT, FREE OF DIABETES-RELATED COMPLICATIONS, AND HAD NO PREVIOUS YOGA EXPERIENCE COMPLETED THERAPEUTIC YOGA CLASSES FOR 6 WEEKS, 3 TIMES PER WEEK . GLYCEMIC CONTROL MEASURES INCLUDED FASTING BLOOD GLUCOSE, GLYCATED HEMOGLOBIN, AND FASTING INSULIN. THE STATE-TRAIT ANXIETY INVENTORY, PERCEIVED STRESS SCALE, AND SALIVARY CORTISOL WERE USED TO ASSESS LEVELS OF STRESS, AND THE SUMMARY OF DIABETES SELF-CARE ACTIVITIES QUESTIONNAIRE WAS USED TO ASSESS REGIMEN ADHERENCE. RESULTS: NO SIGNIFICANT CHANGES IN GLUCOSE CONTROL OR PHYSIOLOGICAL STRESS WERE FOUND; HOWEVER, SIGNIFICANT CHANGES IN PERCEIVED STRESS, STATE ANXIETY, AND SELF-CARE BEHAVIORS WERE DETECTED. CONCLUSIONS: PRELIMINARY FINDINGS SUPPORT FURTHER INVESTIGATION OF THE BENEFITS OF HATHA YOGA AS A COMPLEMENTARY THERAPY FOR THOSE WITH T2DM. 2013 19 4 35 "I COULD MOVE MOUNTAINS": ADULTS WITH OR AT RISK FOR TYPE 2 DIABETES REFLECT ON THEIR EXPERIENCES WITH YOGA PRACTICE. PURPOSE: THE PURPOSE OF THIS STUDY WAS TO DESCRIBE FIRSTHAND EXPERIENCES WITH YOGA AS SHARED BY ADULTS WITH OR AT RISK FOR TYPE 2 DIABETES AND TO EXAMINE THEIR BELIEFS REGARDING MAINTENANCE OF YOGA PRACTICE OVER TIME. METHODS: IN THIS QUALITATIVE STUDY, 13 ADULTS WITH OR AT RISK FOR TYPE 2 DIABETES DESCRIBED THEIR EXPERIENCES WITH YOGA AND THEIR BELIEFS REGARDING MAINTENANCE OF YOGA PRACTICE OVER TIME. SEMISTRUCTURED INTERVIEWS OCCURRED 16 TO 20 MONTHS AFTER COMPLETION OF AN 8-WEEK YOGA-BASED CLINICAL TRIAL. RESULTS: THEMES OF READINESS FOR CONTINUING YOGA, ENVIRONMENTAL SUPPORT FOR YOGA, AND INTEGRATING YOGA EMERGED THROUGH DATA ANALYSIS. CONCLUSIONS: FINDINGS INDICATE THAT YOGA IS APPEALING TO SOME INDIVIDUALS WITH DIABETES, BUT MAINTAINING YOGA PRACTICE OVER TIME IS A CHALLENGE. DIABETES EDUCATORS MAY BE ABLE TO SUPPORT MAINTENANCE BY DISCUSSING SPECIFIC STRATEGIES WITH INDIVIDUALS WHO EXPRESS INTEREST IN YOGA PRACTICE. 2010 20 2025 32 SYSTEMATIC REVIEW OF YOGA INTERVENTIONS TO PROMOTE CARDIOVASCULAR HEALTH IN OLDER ADULTS. THE BENEFITS OF PHYSICAL ACTIVITY ARE WELL ESTABLISHED, YET FEW OLDER ADULTS ENGAGE IN ADEQUATE PHYSICAL ACTIVITY TO OPTIMIZE HEALTH. WHILE YOGA MAY REDUCE THE RISK OF CARDIOVASCULAR DISEASE, FEW STUDIES HAVE FOCUSED ON THE EFFICACY OF YOGA-BASED PHYSICAL ACTIVITY TO PROMOTE CARDIOVASCULAR HEALTH IN OLDER ADULTS. THE OBJECTIVE OF THIS REVIEW IS TO PROVIDE AN EVALUATION OF YOGA INTERVENTIONS TO REDUCE CARDIOVASCULAR RISK IN OLDER ADULTS. FOUR DATABASES WERE SEARCHED FOR RANDOMIZED CONTROLLED TRIALS OF YOGA INTERVENTIONS IN OLDER ADULTS. STUDIES WITH CARDIOVASCULAR OUTCOMES WERE INCLUDED. LITERATURE SEARCHES IDENTIFIED NINE ARTICLES ELIGIBLE FOR REVIEW. SIGNIFICANT HEALTH BENEFITS WERE REPORTED, INCLUDING FAVORABLE CHANGES IN BLOOD PRESSURE, BODY COMPOSITION, GLUCOSE, AND LIPIDS. YOGA PRACTICES, PARTICIPANT CHARACTERISTICS, AND OUTCOME MEASURES WERE VARIABLE. THERE WAS LIMITED USE OF THEORY. YOGA IS SAFE AND FEASIBLE IN OLDER ADULTS; ADDITIONAL RESEARCH IS WARRANTED TO EXAMINE THE SPECIFIC COMPONENTS OF YOGA INTERVENTIONS ESSENTIAL TO REDUCING CARDIOVASCULAR RISK. 2016