1 2855 132 YOGA-AN ALTERNATIVE FORM OF THERAPY IN PATIENTS WITH BLUNT CHEST TRAUMA: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: YOGA AS ALTERNATIVE FORM OF THERAPY HAS SHOWN POSITIVE IMPACT ON PULMONARY FUNCTIONS, EXERCISE CAPACITY, BEHAVIORAL CHANGES, AND INFLAMMATION IN NON-TRAUMA PATIENTS. HOWEVER, THE EFFICACY OF YOGA HAS NOT BEEN STUDIED IN CHEST TRAUMA PATIENTS. METHODS: THIS RANDOMIZED CONTROLLED TRIAL WAS CONDUCTED AT LEVEL-1 TRAUMA CENTRE. ISOLATED CHEST INJURY PATIENTS WERE RANDOMIZED INTO EITHER STANDARD PHYSIOTHERAPY OR YOGATHERAPY GROUPS. PATIENTS IN PHYSIOTHERAPY GROUP RECEIVED CONVENTIONAL CHEST PHYSIOTHERAPY AND YOGATHERAPY GROUP RECEIVED A SET OF YOGIC EXERCISES IN ADDITION TO CONVENTIONAL CHEST PHYSIOTHERAPY. PRIMARY OUTCOME MEASURE WAS CHANGES IN PULMONARY FUNCTION TESTS (PFT) AT 4 WEEKS OF DISCHARGE. SECONDARY OUTCOMES WERE CHANGES IN QUALITY OF LIFE (QOL), RESPIRATORY MUSCLE STRENGTH AND ENDURANCE, CHEST WALL MOBILITY, AND LEVELS OF CYTOKINES AT 4 WEEKS. DATA WERE ANALYZED USING STATA V14.0. RESULTS: A TOTAL OF 89 ELIGIBLE PATIENTS WERE RANDOMIZED TO PHYSIOTHERAPY (N = 46) AND YOGA THERAPY (N = 43) GROUPS. DEMOGRAPHIC CHARACTERISTICS WERE COMPARABLE IN BOTH THE GROUPS. THERE WERE STATISTICALLY SIGNIFICANT IMPROVEMENTS IN PFT IN THE YOGATHERAPY GROUP COMPARED WITH PHYSIOTHERAPY WITH AN INCREASE IN FORCED VITAL CAPACITY (P = 0.02) AND FORCED EXPIRATORY VOLUME (P = 0.01) AT 4 WEEKS. IN ADDITION, THERE WERE SIGNIFICANT IMPROVEMENT IN PHYSICAL COMPONENT OF QOL, RESPIRATORY MUSCLE ENDURANCE (P = 0.003) AND AXILLARY CIRTOMETRY (P = 0.009) IN THE YOGATHERAPY GROUP. HOWEVER, NO STATISTICALLY SIGNIFICANT DIFFERENCE IN THE TRENDS OF CYTOKINE MARKERS SEEN BETWEEN THE GROUPS. CONCLUSION: YOGA WAS FOUND TO BE EFFECTIVE IN IMPROVING PULMONARY FUNCTIONS AND QOL IN PATIENTS WITH CHEST TRAUMA. (TRIAL REGISTERED AT CTRI.NIC.IN/CLINICALTRIALS/LOGIN.PHP, NUMBERREF/2016/05/011,287). 2021 2 2662 52 YOGA IN BURN: ROLE OF PRANAYAMA BREATHING EXERCISE ON PULMONARY FUNCTION, RESPIRATORY MUSCLE ACTIVITY AND EXERCISE TOLERANCE IN FULL-THICKNESS CIRCUMFERENTIAL BURNS OF THE CHEST. BACKGROUND: CIRCUMFERENTIAL BURN OF CHEST (CBC) IS A SIGNIFICANT TYPE OF BURN AND CONSIDERS AS A MAJOR CAUSE OF RESTRICTIVE LUNG DISEASE (RLD). PATIENT WHO HAS CBC WITH RLD LEADS TO RESPIRATORY SYMPTOMS SUCH AS BREATHING DIFFICULTY, AIRWAY OBSTRUCTION, REDUCED EXERCISE CAPACITY AND ALTERED PULMONARY FUNCTIONS. HOWEVER, STUDIES EXAMINING THE ROLE OF PRANAYAMA BREATHING EXERCISE ON PULMONARY FUNCTION, RESPIRATORY MUSCLE ACTIVITY AND EXERCISE TOLERANCE IN FULL THICKNESS CIRCUMFERENTIAL BURN OF CHEST ARE LACKING. OBJECTIVE: TO FIND THE SHORT TERM EFFECTS OF PRANAYAMA BREATHING EXERCISE ON PULMONARY FUNCTION, RESPIRATORY MUSCLE ACTIVITY AND EXERCISE TOLERANCE IN FULL THICKNESS CIRCUMFERENTIAL BURNS OF CHEST. METHODS: THROUGH SIMPLE RANDOM SAMPLING METHOD THIRTY SUBJECTS (N = 30) WITH RLD FOLLOWING CBC WERE ALLOCATED TO PRANAYAMA BREATHING EXERCISE GROUP (PBE-G; N = 15) AND CONVENTIONAL BREATHING EXERCISE GROUP (CBE-G; N = 15). THEY RECEIVED PRANAYAMA BREATHING EXERCISE AND CONVENTIONAL BREATHING EXERCISE FOR 4 WEEKS RESPECTIVELY. ALL THE SUBJECTS RECEIVED CHEST MOBILITY EXERCISE AS COMMON TREATMENT. PRIMARY (NUMERIC PAIN RATING SCALE - NPRS, FORCED EXPIRATORY VOLUME (FEV1), FORCED VITAL CAPACITY (FVC) AND MAXIMUM VOLUNTARY VENTILATION (MVV) AND SECONDARY (ELECTROMYOGRAM OF STERNOCLEIDOMASTOID, SCALENE, EXTERNAL INTERCOSTAL AND DIAPHRAGM MUSCLE, 6 MIN WALK TEST & GLOBAL RATING OF CHANGE - GRC) OUTCOME MEASURES WERE MEASURED AT BASELINE, AFTER FOUR WEEKS AND AFTER THREE MONTHS FOLLOW UP. RESULTS: BASELINE DEMOGRAPHIC AND CLINICAL VARIABLES SHOW HOMOGENOUS DISTRIBUTION BETWEEN THE GROUPS (P > 0.05). FOUR WEEKS FOLLOWING DIFFERENT BREATHING EXERCISES, PBE-G GROUP SHOWS MORE SIGNIFICANT CHANGES IN PAIN INTENSITY, PULMONARY FUNCTION, RESPIRATORY MUSCLE ACTIVITY, EXERCISE TOLERANCE AND GLOBAL RATING OF CHANGE THAN CBE-G GROUP (P 0.05). ALL THE PARAMETERS, EXCEPT PARENT REPORTED QUALITY OF LIFE, SIGNIFICANTLY IMPROVED IN YOGA GROUP (P < 0.05), WHERE ONLY STAIR CLIMB TEST TIMES SIGNIFICANTLY IMPROVED IN HOME EXERCISE GROUP (P < 0.05). CONCLUSIONS: YOGA SEEMS PROMISING FOR IMPROVING LOWER EXTREMITY FUNCTIONAL STATUS, PAIN, AND QUALITY OF LIFE AS AN EXERCISE INTERVENTION IN REHABILITATION PROGRAMS OF CHILDREN WITH ERA. 2021 14 792 40 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 15 2929 32 [YOGA TO IMPROVE ASTHMA CONTROL IN SEVERE ASTHMATICS TREATED WITH BIOLOGICS]. WE CONDUCTED A PROSPECTIVE OBSERVATIONAL STUDY TO EVALUATE THE EFFICACY OF YOGA IN POORLY CONTROLLED SEVERE ASTHMATIC PATIENTS TREATED WITH MAXIMAL INHALED THERAPY AND BIOLOGICS. THE OBJECTIVE OF YOGA WAS TO IMPROVE BREATHING CONSCIOUSNESS, EXERCISING CONTROLLED VENTILATION WITH AND WITHOUT RETENTION, ABDOMINAL BREATHING OBSERVATION, IMPROVEMENT OF INSPIRATORY AND EXPIRATORY MUSCLES, OPENING OF THE CHEST, DIAPHRAGM EXERCISES AND RELAXATION. WE MEASURED EXHALED NITRIC OXIDE, FORCED EXPIRATORY VOLUME IN ONE SECOND, FORCED VITAL CAPACITY, ASTHMA CONTROL AND QUALITY OF LIFE QUESTIONNAIRES, ANXIETY AND DEPRESSION QUESTIONNAIRES BEFORE AND AFTER THE TENTH YOGA COURSE (PERFORMED TWICE A WEEK). HALF OF THE PATIENTS WHO WERE INVITED TO PARTICIPATE TO THE STUDY DECLINED DUE TO ORGANIZATION PROBLEMS. TWO PATIENTS WERE EXCLUDED DUE TO BRONCHITIS AND ARTHRALGIA RESPECTIVELY. THE ANALYSIS OF THE DATA FROM 12 PARTICIPANTS REVEALED SIGNIFICANT IMPROVEMENT IN ASTHMA CONTROL AND ASTHMA QUALITY OF LIFE QUESTIONNAIRES AND A REDUCTION OF ANXIETY.THE REGULAR PRACTICE OF YOGA IN SEVERE ASTHMATICS INSUFFICIENTLY CONTROLLED DESPITE MAXIMAL INHALED TREATMENT AND BIOTHERAPY SEEMS TO BE AN INTERESTING COMPLEMENTARY OPTION TO IMPROVE ASTHMA CONTROL. OUR RESULTS MUST BE CONFIRMED IN LARGER RANDOMIZED CONTROLLED TRIALS. 2020 16 1637 31 MODULATION OF CARDIAC AUTONOMIC BALANCE WITH ADJUVANT YOGA THERAPY IN PATIENTS WITH REFRACTORY EPILEPSY. THE PRACTICE OF YOGA REGULATES BODY PHYSIOLOGY THROUGH CONTROL OF POSTURE, BREATHING, AND MEDITATION. EFFECTS OF YOGA ON AUTONOMIC FUNCTIONS OF PATIENTS WITH REFRACTORY EPILEPSY, AS QUANTIFIED BY STANDARDIZED AUTONOMIC FUNCTION TESTS (AFTS), WERE DETERMINED. THE YOGA GROUP (N=18) RECEIVED SUPERVISED TRAINING IN YOGA, AND THE EXERCISE GROUP (N=16) PRACTICED SIMPLE ROUTINE EXERCISES. AFTS WERE REPEATED AFTER 10 WEEKS OF DAILY SESSIONS. DATA WERE COMPARED WITH THOSE OF HEALTHY VOLUNTEERS (N=142). THE YOGA GROUP SHOWED SIGNIFICANT IMPROVEMENT IN PARASYMPATHETIC PARAMETERS AND A DECREASE IN SEIZURE FREQUENCY SCORES. THERE WAS NO IMPROVEMENT IN BLOOD PRESSURE PARAMETERS IN EITHER GROUP. TWO PATIENTS IN THE YOGA GROUP ACHIEVED NORMAL AUTONOMIC FUNCTIONS AT THE END OF 10 WEEKS OF THERAPY, WHEREAS THERE WERE NO CHANGES IN THE EXERCISE GROUP. THE DATA SUGGEST THAT YOGA MAY HAVE A ROLE AS AN ADJUVANT THERAPY IN THE MANAGEMENT OF AUTONOMIC DYSFUNCTION IN PATIENTS WITH REFRACTORY EPILEPSY. 2008 17 727 38 EFFECT OF LONG-TERM REGULAR YOGA ON PHYSICAL HEALTH OF YOGA PRACTITIONERS. BACKGROUND: YOGA IS A PHYSICAL, MENTAL, AND SPIRITUAL DISCIPLINE. THE EFFECT OF YOGA ON MENTAL HEALTH HAS BEEN STUDIED EXTENSIVELY IN INDIA BUT LESS IN THE CONTEXT OF PHYSICAL HEALTH. OBJECTIVE: THE OBJECTIVE WAS TO EXPLORE THE EFFECT OF LONG-TERM REGULAR YOGA ON PHYSICAL HEALTH OF YOGA PRACTITIONERS. MATERIALS AND METHODS: IT WAS AN INTERVENTIONAL STUDY. INCLUSION CRITERIA WERE STUDENTS WHO ENROLLED FOR 1-YEAR DIPLOMA COURSE AT THE YOGA CENTER. EXCLUSION CRITERIA WERE NONREGULAR YOGA PRACTITIONERS DURING THE COURSE. PHYSICAL HEALTH PARAMETERS CONSIDERED FOR ASSESSMENT BEFORE AND AFTER THE YOGA COURSE WERE PULMONARY FUNCTION TESTS, MAXIMUM OXYGEN CONSUMPTION (VO2 MAX) USING BRUCE TREADMILL TEST, FLEXIBILITY, BODY COMPOSITION ANALYSIS, AND HEMOGLOBIN LEVEL. PAIRED SAMPLE T-TEST AND CHI-SQUARE TEST WERE USED FOR STATISTICAL ANALYSIS. RESULTS: THE AEROBIC CAPACITY IMPROVED SIGNIFICANTLY IN TERMS OF MEAN (STANDARD DEVIATION [SD]) FORCED VITAL CAPACITY (P < 0.001), FORCED EXPIRATION VOLUME AT THE END OF THE FIRST SECOND (P < 0.001) AS WELL AS PEAK EXPIRATORY FLOW RATE (P = 0.04). THE MEAN (SD) FLEXIBILITY SCORE IMPROVED SIGNIFICANTLY (P < 0.001). SIMILARLY, THE ENDURANCE IMPROVED SIGNIFICANTLY IN TERMS OF MEAN (SD) VO2 MAX (< 0.001) AND TREADMILL TIME (P < 0.001). THERE WAS NO SIGNIFICANT CHANGE IN BODY COMPOSITION AND HEMOGLOBIN LEVEL. CONCLUSIONS: REGULAR YOGA PRACTITIONERS DEMONSTRATED THE IMPROVEMENT IN PULMONARY FUNCTIONS, CARDIORESPIRATORY FITNESS, ENDURANCE, AND FLEXIBILITY. 2021 18 822 41 EFFECT OF YOGA ON FEV1, 6-MINUTE WALK DISTANCE (6-MWD) AND QUALITY OF LIFE IN PATIENTS WITH COPD GROUP B. INTRODUCTION: YOGA IS USED IN THE TREATMENT OF VARIOUS DISEASES, INCLUDING CHRONIC OBSTRUCTIVE PULMONARY DISEASE. HOWEVER, NO STUDIES HAVE ASSESSED THE EFFECT OF YOGA ON COPD PATIENTS IN INDONESIA. THE DIFFERENCE BETWEEN THIS STUDY AND SIMILAR STUDIES COMPLETED IN OTHER COUNTRIES LIES IN THE TYPE OF YOGA EXERCISES COMPLETED, THE METHOD IN WHICH THEY WERE COMPLETED, AND IN CERTAIN, UNIQUE DEMOGRAPHIC CHARACTERISTICS. THIS STUDY AIMS TO ANALYZE THE EFFECT OF YOGA ON FEV1, 6-MINUTE WALK DISTANCE, AND QUALITY OF LIFE IN PATIENTS WITH COPD GROUP B IN INDONESIA. MATERIAL AND METHODS: THIS ARTICLE REFLECTS RESEARCH DONE IN THE FORM OF AN EXPERIMENTAL STUDY USING ARANDOMIZED CONTROLLED TRIAL WITH PRE AND POST-TEST CONTROL GROUP DESIGN. THE SAMPLES WERE DIVIDED INTO 2 GROUPS: THE TREATMENT GROUP (YOGA PRACTICE FOR 1 HOUR, 2 TIMES AWEEK FOR 12 WEEKS) AND THE CONTROL GROUP (UNTREATED WITH YOGA, GIVEN LUNG REHABILITATION BROCHURE). ASSESSMENT OF THE EFFECT OF YOGA EXERCISES ON LUNG FUNCTION PARAMETERS (FEV1), 6-MINUTE WALK DISTANCE AND QUALITY OF LIFE WERE USED USING SGRQ QUESTIONNAIRES IN COPD GROUP B. RESULTS: 33 COPD PATIENTS FULFILLED THE INCLUSION CRITERIA. 30 PATIENTS COMPLETED THE STUDY. PRE AND POST YOGA RESULTS WERE EVALU-ATED IN THE TREATMENT GROUP VERSUS THE CONTROL GROUP AND THEN FURTHER ASSESSED USING STATISTICAL TESTS. THERE WAS ASIGNIFICANT IN-CREASE IN FEV1, 6-MWD AND QUALITY OF LIFE USING ASGRQ QUESTIONNAIRE AFTER 12 WEEKS OF YOGA (P < 0.05) AS WELL AS AASIGNIFICANT CHANGE IN FEV1, 6-MWD AND QUALITY OF LIFE IN THE TREATMENT GROUP (P < 0.05) WHEN COMPARED WITH THE CONTROL GROUP (P > 0.05). CONCLUSIONS: YOGA AFFECTS FEV1, 6-MWD, AND QUALITY OF LIFE IN PATIENTS WITH GROUP B COPD. 2019 19 2109 34 THE EFFECT OF YOGA ON RESPIRATORY FUNCTIONS, SYMPTOM CONTROL AND LIFE QUALITY OF ASTHMA PATIENTS: A RANDOMIZED CONTROLLED STUDY. AIM: THIS STUDY WAS CONDUCTED TO FIND OUT THE EFFECT OF YOGA APPLIED TO ASTHMA PATIENTS ON THE PATIENTS' RESPIRATORY FUNCTIONS, SYMPTOM CONTROL AND QUALITY OF LIFE. METHODS: THE SAMPLE OF THE STUDY CONSISTED OF A TOTAL OF RANDOMLY CHOSEN 112 ASTHMA PATIENTS, 56 IN THE EXPERIMENTAL GROUP AND 56 IN THE CONTROL GROUP, WHO MET THE RESEARCH CRITERIA AND WHO AGREED TO PARTICIPATE IN THE STUDY. A TOTAL OF 12 YOGA SESSIONS, 2 SESSIONS A WEEK FOR 6 WEEKS, WAS APPLIED TO THE PATIENTS IN THE EXPERIMENTAL GROUP. THE PATIENTS IN THE CONTROL GROUP DID NOT RECEIVE ANY INTERVENTION. RESULTS: IN THE INTRAGROUP COMPARISON OF AVERAGE PRE-TEST AND POST-TEST SCORES OF RESPIRATORY FUNCTION AND ASTHMA CONTROL TEST (ACT) AND ASTHMA QUALITY OF LIFE SCALE (AQLQ) TOTAL AND SUB-DIMENSION SCORES OF THE PATIENTS IN THE EXPERIMENTAL AND CONTROL GROUP, THE DIFFERENCE WAS FOUND TO BE STATISTICALLY SIGNIFICANT (P<0.05). IN ADDITION, POST-TEST SCORE AVERAGES WERE FOUND TO INCREASE IN THE EXPERIMENTAL GROUP, WHILE THEY WERE FOUND TO DECREASE IN THE CONTROL GROUP. CONCLUSION: IT WAS FOUND THAT YOGA INFLUENCED RESPIRATORY FUNCTIONS, SYMPTOM CONTROL AND QUALITY OF LIFE POSITIVELY IN ASTHMA PATIENTS. THE CLINICAL TRIAL REGISTRATION NUMBER IS NCT04107415/HTTPS://CLINICALTRIALS.GOV/CT2/SHOW/NCT04107415. 2020 20 2461 30 YOGA AS A NOVEL ADJUVANT THERAPY FOR PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOPATHIES. CONTEXT: RECENT STUDIES HAVE DEMONSTRATED THAT PHYSICAL ACTIVITY IS WELL TOLERATED BY PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOPATHIES (IIMS) AND CAN HAVE ADDITIONAL BENEFITS AS AN ADJUVANT THERAPY TO PHARMACOLOGIC AGENTS, ESPECIALLY IF STARTED EARLY. TO DATE, NO STUDIES HAVE EXAMINED THE EFFECTS OF YOGA ON PATIENTS WITH IIMS. AIMS: THE AIM OF THIS STUDY WAS TO EVALUATE THE EFFECTS OF YOGA ON SELF-REPORTED DIFFICULTY IN PERFORMING ACTIVITIES OF DAILY LIVING (ADL) AND MUSCLE STRENGTH IN PATIENTS WITH MILD-TO-MODERATE IIMS. SUBJECTS AND METHODS: A LONGITUDINAL COHORT STUDY IN WHICH PARTICIPANTS WERE ASSESSED USING THE MYOSITIS ACTIVITIES PROFILE (MAP) AND MANUAL MUSCLE TESTING (MMT) BEFORE AND AFTER THE COMPLETION OF AN 8-WEEK INSTRUCTOR-GUIDED YOGA COURSE WAS PERFORMED. STATISTICAL ANALYSIS USED: WILCOXON SIGNED-RANKED TEST WAS PERFORMED FOR STATISTICAL ANALYSIS. RESULTS: THE AVERAGE POSTTREATMENT MAP SCORES OF SIX PARTICIPANTS DEMONSTRATED AN INCREASE OF 2.51 POINTS, WHILE THE AVERAGE MMT SCORE OF FOUR PARTICIPANTS DEMONSTRATED AN INCREASE OF 11 POINTS. CONCLUSIONS: THIS STUDY IS THE FIRST STUDY TO DATE TO EXAMINE THE EFFECT OF YOGA AS AN ADJUVANT COMPLEMENTARY THERAPY FOR PATIENTS WITH IIM. CONTINUED RESEARCH SHOULD BE DONE ON THE EFFECT OF YOGA AS AN ADJUVANT THERAPY, FOR IN ADDITION TO INCREASE IN MUSCLE STRENGTH AND ABILITY TO PERFORM ADL, YOGA MAY OFFER POTENTIAL IMPROVEMENTS IN MOOD, MENTAL HEALTH, AND SLEEP. 2021