1 2664 119 YOGA IN CHILDREN WITH EPILEPSY: A RANDOMIZED CONTROLLED TRIAL. CONTEXT: MAJORITY OF EPILEPSY BEGINS IN CHILDHOOD. TWENTY TO THIRTY PERCENT OF PATIENTS MAY NOT RESPOND TO ANTIEPILEPTIC DRUGS. YOGA AS A COMPLEMENTARY THERAPY HAS BEEN FOUND TO BE BENEFICIAL IN ADULTS, BUT HAS NOT YET BEEN STUDIED IN CHILDREN WITH EPILEPSY. AIM: TO STUDY THE EFFECT OF YOGA ON SEIZURE AND ELECTROENCEPHALOGRAM (EEG) OUTCOME IN CHILDREN WITH EPILEPSY. SETTING AND DESIGN: A RANDOMIZED CONTROLLED TRIAL WAS CONDUCTED IN THE PEDIATRIC NEUROLOGY OUTPATIENT DEPARTMENT OF A TERTIARY CARE TEACHING HOSPITAL. MATERIALS AND METHODS: TWENTY CHILDREN AGED 8-12 YEARS WITH AN UNEQUIVOCAL DIAGNOSIS OF EPILEPSY ON REGULAR ANTIEPILEPTIC DRUGS WERE ENROLLED. YOGA THERAPY WAS PROVIDED TO 10 CHILDREN (STUDY GROUP) AND 10 CHILDREN FORMED THE CONTROL GROUP. YOGA THERAPY WAS GIVEN AS 10 SESSIONS OF 1H EACH. WE COMPARED SEIZURE FREQUENCY AND EEG AT BASELINE, 3, AND 6 MONTHS. STATISTICAL ANALYSIS WAS CARRIED OUT USING STANDARD STATISTICAL TESTS. A P VALUE OF <0.05 WAS CONSIDERED SIGNIFICANT. RESULTS: NO CHILDREN HAD SEIZURES AT THE END OF 3 AND 6 MONTHS IN THE STUDY GROUP. IN THE CONTROL GROUP, AT 3 AND 6 MONTHS, FOUR AND THREE CHILDREN, RESPECTIVELY, HAD SEIZURES. EIGHT CHILDREN EACH IN BOTH THE GROUPS HAD AN ABNORMAL EEG AT ENROLLMENT. AT THE END OF 6 MONTHS, ONE EEG IN THE STUDY GROUP AND SEVEN IN THE CONTROL GROUP WERE ABNORMAL (P = 0.020). CONCLUSION: YOGA AS AN ADDITIONAL THERAPY IN CHILDREN WITH EPILEPSY LEADS TO SEIZURE FREEDOM AND SIGNIFICANT IMPROVEMENT IN EEG AT 6 MONTHS. 2018 2 2571 60 YOGA FOR EPILEPSY. BACKGROUND: THIS IS AN UPDATED VERSION OF THE ORIGINAL COCHRANE REVIEW PUBLISHED IN THE COCHRANE LIBRARY, ISSUE 1, 2002.YOGA MAY INDUCE RELAXATION AND STRESS REDUCTION, AND INFLUENCE THE ELECTROENCEPHALOGRAM AND THE AUTONOMIC NERVOUS SYSTEM, THEREBY CONTROLLING SEIZURES. YOGA WOULD BE AN ATTRACTIVE THERAPEUTIC OPTION FOR EPILEPSY IF PROVED EFFECTIVE. OBJECTIVES: TO ASSESS WHETHER PEOPLE WITH EPILEPSY TREATED WITH YOGA:(A) HAVE A GREATER PROBABILITY OF BECOMING SEIZURE FREE;(B) HAVE A SIGNIFICANT REDUCTION IN THE FREQUENCY OR DURATION OF SEIZURES, OR BOTH; AND(C) HAVE A BETTER QUALITY OF LIFE. SEARCH METHODS: WE SEARCHED THE COCHRANE EPILEPSY GROUP SPECIALIZED REGISTER (26 MARCH 2015), THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL, THE COCHRANE LIBRARY, 26 MARCH 2015), MEDLINE (OVID, 1946 TO 26 MARCH 2015), SCOPUS (1823 TO 9 JANUARY 2014), CLINICALTRIALS.GOV (26 MARCH 2015), THE WORLD HEALTH ORGANIZATION (WHO) INTERNATIONAL CLINICAL TRIALS REGISTRY PLATFORM ICTRP (26 MARCH 2015), AND ALSO REGISTRIES OF THE YOGA BIOMEDICAL TRUST AND THE RESEARCH COUNCIL FOR COMPLEMENTARY MEDICINE. IN ADDITION, WE SEARCHED THE REFERENCES OF ALL THE IDENTIFIED STUDIES. NO LANGUAGE RESTRICTIONS WERE IMPOSED. SELECTION CRITERIA: THE FOLLOWING STUDY DESIGNS WERE ELIGIBLE FOR INCLUSION: RANDOMISED CONTROLLED TRIALS (RCT) OF TREATMENT OF EPILEPSY WITH YOGA. ELIGIBLE PARTICIPANTS WERE ADULTS WITH UNCONTROLLED EPILEPSY COMPARING YOGA WITH NO TREATMENT OR DIFFERENT BEHAVIOURAL TREATMENTS. DATA COLLECTION AND ANALYSIS: THREE REVIEW AUTHORS INDEPENDENTLY SELECTED TRIALS FOR INCLUSION AND EXTRACTED DATA. THE FOLLOWING OUTCOMES WERE ASSESSED: (A) PERCENTAGE OF PEOPLE RENDERED SEIZURE FREE; (B) SEIZURE FREQUENCY AND DURATION; (C) QUALITY OF LIFE. ANALYSES WERE ON AN INTENTION-TO-TREAT BASIS. ODDS RATIO (OR) WITH 95% CONFIDENCE INTERVALS (95% CL) WERE ESTIMATED FOR THE OUTCOMES. MAIN RESULTS: TWO UNBLINDED TRIALS RECRUITED A TOTAL OF 50 PEOPLE (18 TREATED WITH YOGA AND 32 TO CONTROL INTERVENTIONS). ANTIEPILEPTIC DRUGS WERE CONTINUED IN ALL THE PARTICIPANTS. BASELINE PHASE LASTED 3 MONTHS IN BOTH STUDIES AND TREATMENT PHASE FROM 5 WEEKS TO 6 MONTHS IN THE TWO TRIALS. RANDOMISATION WAS BY ROLL OF A DIE IN ONE STUDY AND USING A COMPUTERISED RANDOMISATION TABLE IN THE OTHER ONE BUT NEITHER STUDY PROVIDED DETAILS OF CONCEALMENT OF ALLOCATION AND WERE RATED AS UNCLEAR RISK OF BIAS. OVERALL, THE TWO STUDIES WERE RATED AS LOW RISK OF BIAS (ALL PARTICIPANTS WERE INCLUDED IN THE ANALYSIS; ALL EXPECTED AND PRE-EXPECTED OUTCOMES WERE REPORTED; NO OTHER SOURCES OF BIAS). THE OVERALL OR WITH 95% CONFIDENCE INTERVAL (CI) WAS: (I) SEIZURE FREE FOR SIX MONTHS - FOR YOGA VERSUS SHAM YOGA ORS OF 14.54 (95% CI 0.67 TO 316.69) AND FOR YOGA VERSUS NO TREATMENT GROUP 17.31 (95% CI 0.80 TO 373.45); FOR ACCEPTANCE AND COMMITMENT THERAPY (ACT) VERSUS YOGA ORS OF 1.00 (95% CL 0.16 TO 6.42; (II) REDUCTION IN SEIZURE FREQUENCY - THE MEAN DIFFERENCE BETWEEN YOGA VERSUS SHAM YOGA GROUP WAS -2.10 (95% CI -3.15 TO -1.05) AND FOR YOGA VERSUS NO TREATMENT GROUP -1.10 (95% CI -1.80 TO -0.40); (III) MORE THAN 50% REDUCTION IN SEIZURE FREQUENCY - FOR YOGA VERSUS SHAM YOGA GROUP ORS OF 81.00 (95% CI 4.36 TO 1504.46) AND FOR THE YOGA VERSUS NO TREATMENT GROUP 158.33 (95% CI 5.78 TO 4335.63); ACT VERSUS YOGA ORS OF 0.78 (95% CL 0.04 TO 14.75); (IV) MORE THAN 50% REDUCTION IN SEIZURE DURATION - FOR YOGA VERSUS SHAM YOGA GROUP ORS OF 45.00 (95% CI 2.01 TO 1006.75) AND FOR YOGA VERSUS NO TREATMENT GROUP 53.57 (95% CI 2.42 TO 1187.26); ACT VERSUS YOGA ORS OF 0.67 (95% CL 0.10 TO 4.35). IN ADDITION IN PANJWANI 1996 THE AUTHORS REPORTED THAT THE ONE-WAY ANALYSIS OF VARIANCE REVEALED NO STATISTICALLY SIGNIFICANT DIFFERENCES BETWEEN THE THREE GROUPS. A P-LAMBDA TEST TAKING INTO ACCOUNT THE P VALUES BETWEEN THE THREE GROUPS ALSO INDICATED THAT THE DURATION OF EPILEPSY IN THE THREE GROUPS WAS NOT COMPARABLE. NO DATA WERE AVAILABLE REGARDING QUALITY OF LIFE. IN LUNDGREN 2008 THE AUTHORS REPORTED THAT THERE WAS NO SIGNIFICANT DIFFERENCE BETWEEN THE YOGA AND ACT GROUPS IN SEIZURE FREE RATES, 50% OR GREATER REDUCTION IN SEIZURE FREQUENCY OR SEIZURE DURATION AT ONE YEAR FOLLOW-UP. THE YOGA GROUP SHOWED SIGNIFICANT IMPROVEMENT IN THEIR QUALITY OF LIFE ACCORDING TO THE SATISFACTION WITH LIFE SCALE (SWLS) (P < 0.05), WHILE THE ACT GROUP HAD SIGNIFICANT IMPROVEMENT IN THE WORLD HEALTH ORGANIZATION QUALITY OF LIFE-BREF (WHOQOL-BREF) SCALE (P < 0.01). AUTHORS' CONCLUSIONS: STUDY OF 50 SUBJECTS WITH EPILEPSY FROM TWO TRIALS REVEALS POSSIBLE BENEFICIAL EFFECT IN CONTROL OF SEIZURES. RESULTS OF THE OVERALL EFFICACY ANALYSIS SHOW THAT YOGA TREATMENT WAS BETTER WHEN COMPARED WITH NO INTERVENTION OR INTERVENTIONS OTHER THAN YOGA (POSTURAL EXERCISES MIMICKING YOGA). THERE WAS NO DIFFERENCE BETWEEN YOGA AND ACCEPTANCE AND COMMITMENT THERAPY. HOWEVER NO RELIABLE CONCLUSIONS CAN BE DRAWN REGARDING THE EFFICACY OF YOGA AS A TREATMENT FOR UNCONTROLLED EPILEPSY, IN VIEW OF METHODOLOGICAL DEFICIENCIES SUCH AS LIMITED NUMBER OF STUDIES, LIMITED NUMBER OF PARTICIPANTS RANDOMISED TO YOGA, LACK OF BLINDING AND LIMITED DATA ON QUALITY-OF-LIFE OUTCOME. PHYSICIAN BLINDING WOULD NORMALLY BE TAKEN TO BE THE PERSON DELIVERING THE INTERVENTION, WHEREAS WE THINK THE 'PHYSICIAN' WOULD IN FACT BE THE OUTCOME ASSESSOR (WHO COULD BE BLINDED), SO THAT WOULD BE A REDUCTION IN DETECTION BIAS RATHER THAN PERFORMANCE BIAS. IN ADDITION, EVIDENCE TO INFORM OUTCOMES IS LIMITED AND OF LOW QUALITY. FURTHER HIGH-QUALITY RESEARCH IS NEEDED TO FULLY EVALUATE THE EFFICACY OF YOGA FOR REFRACTORY EPILEPSY. 2015 3 260 43 ACCEPTANCE AND COMMITMENT THERAPY AND YOGA FOR DRUG-REFRACTORY EPILEPSY: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THERE IS A NEED FOR CONTROLLED OUTCOME STUDIES ON BEHAVIORAL TREATMENT OF EPILEPSY. THE PURPOSE OF THIS STUDY WAS TO EVALUATE ACCEPTANCE AND COMMITMENT THERAPY (ACT) AND YOGA IN THE TREATMENT OF EPILEPSY. METHODS: THE DESIGN CONSISTED OF A RANDOMIZED CONTROLLED TRIAL WITH REPEATED MEASURES (N=18). ALL PARTICIPANTS HAD AN EEG-VERIFIED EPILEPSY DIAGNOSIS WITH DRUG-REFRACTORY SEIZURES. PARTICIPANTS WERE RANDOMIZED INTO ONE OF TWO GROUPS: ACT OR YOGA. THERAPEUTIC EFFECTS WERE MEASURED USING SEIZURE INDEX (FREQUENCY X DURATION) AND QUALITY OF LIFE (SATISFACTION WITH LIFE SCALE, WHOQOL-BREF). THE TREATMENT PROTOCOLS CONSISTED OF 12 HOURS OF PROFESSIONAL THERAPY DISTRIBUTED IN TWO INDIVIDUAL SESSIONS, TWO GROUP SESSIONS DURING A 5-WEEK PERIOD, AND BOOSTER SESSIONS AT 6 AND 12 MONTHS POSTTREATMENT. SEIZURE INDEX WAS CONTINUOUSLY ASSESSED DURING THE 3-MONTH BASELINE AND 12-MONTH FOLLOW-UP. QUALITY OF LIFE WAS MEASURED AFTER TREATMENT AND AT THE 6-MONTH AND 1-YEAR FOLLOW-UPS. RESULTS: THE RESULTS INDICATE THAT BOTH ACT AND YOGA SIGNIFICANTLY REDUCE SEIZURE INDEX AND INCREASE QUALITY OF LIFE OVER TIME. ACT REDUCED SEIZURE INDEX SIGNIFICANTLY MORE AS COMPARED WITH YOGA. PARTICIPANTS IN BOTH THE ACT AND YOGA GROUPS IMPROVED THEIR QUALITY OF LIFE SIGNIFICANTLY AS MEASURED BY ONE OF TWO QUALITY-OF-LIFE INSTRUMENTS. THE ACT GROUP INCREASED THEIR QUALITY OF LIFE SIGNIFICANTLY AS COMPARED WITH THE YOGA GROUP AS MEASURED BY THE WHOQOL-BREF, AND THE YOGA GROUP INCREASED THEIR QUALITY OF LIFE SIGNIFICANTLY AS COMPARED WITH THE ACT GROUP AS MEASURED BY THE SWLS. CONCLUSIONS: THE RESULTS OF THIS STUDY SUGGEST THAT COMPLEMENTARY TREATMENTS, SUCH AS ACT AND YOGA, DECREASE SEIZURE INDEX AND INCREASE QUALITY OF LIFE. 2008 4 116 41 A PILOT STUDY OF A YOGA MEDITATION PROTOCOL FOR PATIENTS WITH MEDICALLY REFRACTORY EPILEPSY. OBJECTIVE: THE OBJECTIVE WAS TO ASSESS THE EFFICACY OF A YOGA MEDITATION PROTOCOL (YMP) AS AN ADJUNCTIVE TREATMENT IN PATIENTS WITH DRUG-RESISTANT CHRONIC EPILEPSY. DESIGN: THE DESIGN WAS A PROSPECTIVE, NONRANDOMIZED, OPEN-LABEL, ADD-ON TRIAL WITH A 12-WEEK BASELINE PERIOD, FOLLOWED BY A 12-WEEK SUPERVISED YMP ADMINISTRATION PHASE. THE FREQUENCY OF COMPLEX PARTIAL SEIZURES (CPS) WAS ASSESSED AT 3, 6, AND 12 MONTHS OF THE TREATMENT PERIOD. SETTING: THE SETTING WAS A COMPREHENSIVE EPILEPSY CARE CENTER ATTACHED TO A TERTIARY REFERRAL MEDICAL INSTITUTION SITUATED ON THE SOUTHWEST COAST OF THE INDIAN PENINSULA. SUBJECTS: THE SUBJECTS WERE 20 PATIENTS (14 MALES AND 6 FEMALES, AGE RANGE 15 TO 47 YEARS, MEDIAN 27 YEARS) WITH UNEQUIVOCALLY ESTABLISHED DIAGNOSES OF EPILEPSY WITH AT LEAST 4 CPS (WITH OR WITHOUT SECONDARY GENERALIZATION) DURING THE PRECEDING 3 MONTHS. INTERVENTION: INTERVENTION CONSISTED OF A YMP 20 MINUTES TWICE DAILY (MORNINGS AND EVENINGS) AT HOME, AND SUPERVISED SESSIONS OF A YMP EVERY WEEK FOR 3 MONTHS. CONTINUATION OF THE YMP BEYOND 3 MONTHS WAS OPTIONAL. OUTCOME MEASURE: THE OUTCOME MEASURE WAS THE SEIZURE FREQUENCY AT 3, 6, AND 12 MONTHS OF THE TREATMENT PERIOD. THE SUBJECTS WITH > OR = 50% REDUCTION IN MONTHLY SEIZURE RATE FROM BASELINE WERE CLASSIFIED AS RESPONDERS, AND SUBJECTS WITH <50% SEIZURE REDUCTION AS NONRESPONDERS. RESULTS: AT 3 MONTHS, A REDUCTION IN SEIZURE FREQUENCY WAS NOTED IN ALL EXCEPT 1 PATIENT, SIX OF WHOM HAD > OR = 50% SEIZURE REDUCTION. OF 16 PATIENTS WHO CONTINUED THE YMP BEYOND 3 MONTHS, 14 PATIENTS RESPONDED AT 6 MONTHS; 6 OF THEM WERE SEIZURE-FREE FOR 3 MONTHS. ALL EIGHT PATIENTS WHO CONTINUED THE YMP BEYOND 6 MONTHS RESPONDED; THREE OF THEM WERE SEIZURE FREE FOR 6 MONTHS. CONCLUSIONS: IF CONFIRMED THROUGH RANDOMIZED TRIALS INVOLVING A LARGER NUMBER OF PATIENTS, THIS YMP MAY BECOME A COST-EFFECTIVE AND ADVERSE EFFECT-FREE ADJUNCTIVE TREATMENT IN PATIENTS WITH DRUG-RESISTANT EPILEPSIES. 2006 5 749 32 EFFECT OF SAHAJA YOGA PRACTICE ON SEIZURE CONTROL & EEG CHANGES IN PATIENTS OF EPILEPSY. THE EFFECT OF SAHAJA YOGA MEDITATION ON SEIZURE CONTROL AND ELECTROENCEPHALOGRAPHIC ALTERATIONS WAS ASSESSED IN 32 PATIENTS OF IDIOPATHIC EPILEPSY. THE SUBJECTS WERE RANDOMLY DIVIDED INTO 3 GROUPS. GROUP I (N = 10) PRACTISED SAHAJA YOGA FOR 6 MONTHS, GROUP II (N = 10) PRACTISED EXERCISES MIMICKING SAHAJA YOGA FOR 6 MONTHS AND GROUP III (N = 12) SERVED AS THE EPILEPTIC CONTROL GROUP. GROUP I SUBJECTS REPORTED A 62 PER CENT DECREASE IN SEIZURE FREQUENCY AT 3 MONTHS AND A FURTHER DECREASE OF 86 PER CENT AT 6 MONTHS OF INTERVENTION. POWER SPECTRAL ANALYSIS OF EEG SHOWED A SHIFT IN FREQUENCY FROM 0-8 HZ TOWARDS 8-20 HZ. THE RATIOS OF EEG POWERS IN DELTA (D), THETA (T), ALPHA (A) AND BETA (B) BANDS I.E., A/D, A/D + T, A/T AND A + B/D + T WERE INCREASED. PER CENT D POWER DECREASED AND PER CENT A INCREASED. NO SIGNIFICANT CHANGES IN ANY OF THE PARAMETERS WERE FOUND IN GROUPS II AND III, INDICATING THAT SAHAJA YOGA PRACTICE BRINGS ABOUT SEIZURE REDUCTION AND EEG CHANGES. SAHAJA YOGA COULD PROVE TO BE BENEFICIAL IN THE MANAGEMENT OF PATIENTS OF EPILEPSY. 1996 6 747 31 EFFECT OF SAHAJA YOGA MEDITATION ON AUDITORY EVOKED POTENTIALS (AEP) AND VISUAL CONTRAST SENSITIVITY (VCS) IN EPILEPTICS. THE EFFECT OF SAHAJA YOGA MEDITATION ON 32 PATIENTS WITH PRIMARY IDIOPATHIC EPILEPSY ON REGULAR AND MAINTAINED ANTIEPILEPTIC MEDICATION WAS STUDIED. THE PATIENTS WERE RANDOMLY DIVIDED INTO 3 GROUPS: GROUP I PRACTICED SAHAJA YOGA MEDITATION TWICE DAILY FOR 6 MONTHS UNDER PROPER GUIDANCE; GROUP II PRACTICED POSTURAL EXERCISES MIMICKING THE MEDITATION FOR THE SAME DURATION; AND GROUP III WAS THE CONTROL GROUP. VISUAL CONTRAST SENSITIVITY (VCS), AUDITORY EVOKED POTENTIALS (AEP), BRAINSTEM AUDITORY EVOKED POTENTIALS (BAEP), AND MID LATENCY RESPONSES (MLR) WERE RECORDED INITIALLY (0 MONTH) AND AT 3 AND 6 MONTHS FOR EACH GROUP. THERE WAS A SIGNIFICANT IMPROVEMENT IN VCS FOLLOWING MEDITATION PRACTICE IN GROUP I PARTICIPANTS. NA, THE FIRST PROMINENT NEGATIVE PEAK OF MLR AND PA, THE POSITIVE PEAK FOLLOWING NA DID NOT REGISTER CHANGES IN LATENCY. THE NA-PA AMPLITUDE OF MLR ALSO SHOWED A SIGNIFICANT INCREASE. THERE WERE NO SIGNIFICANT CHANGES IN THE ABSOLUTE AND INTERPEAK LATENCIES OF BAEP. THE REDUCED LEVEL OF STRESS FOLLOWING MEDITATION PRACTICE MAY MAKE PATIENTS MORE RESPONSIVE TO SPECIFIC STIMULI. SAHAJA YOGA MEDITATION APPEARS TO BRING ABOUT CHANGES IN SOME OF THE ELECTROPHYSIOLOGICAL RESPONSES STUDIED IN EPILEPTIC PATIENTS. 2000 7 2821 49 YOGA TREATMENT FOR CHRONIC NON-SPECIFIC LOW BACK PAIN. BACKGROUND: NON-SPECIFIC LOW BACK PAIN IS A COMMON, POTENTIALLY DISABLING CONDITION USUALLY TREATED WITH SELF-CARE AND NON-PRESCRIPTION MEDICATION. FOR CHRONIC LOW BACK PAIN, CURRENT GUIDELINES STATE THAT EXERCISE THERAPY MAY BE BENEFICIAL. YOGA IS A MIND-BODY EXERCISE SOMETIMES USED FOR NON-SPECIFIC LOW BACK PAIN. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA FOR TREATING CHRONIC NON-SPECIFIC LOW BACK PAIN, COMPARED TO NO SPECIFIC TREATMENT, A MINIMAL INTERVENTION (E.G. EDUCATION), OR ANOTHER ACTIVE TREATMENT, WITH A FOCUS ON PAIN, FUNCTION, AND ADVERSE EVENTS. SEARCH METHODS: WE SEARCHED CENTRAL, MEDLINE, EMBASE, FIVE OTHER DATABASES AND FOUR TRIALS REGISTERS TO 11 MARCH 2016 WITHOUT RESTRICTION OF LANGUAGE OR PUBLICATION STATUS. WE SCREENED REFERENCE LISTS AND CONTACTED EXPERTS IN THE FIELD TO IDENTIFY ADDITIONAL STUDIES. SELECTION CRITERIA: WE INCLUDED RANDOMIZED CONTROLLED TRIALS OF YOGA TREATMENT IN PEOPLE WITH CHRONIC NON-SPECIFIC LOW BACK PAIN. WE INCLUDED STUDIES COMPARING YOGA TO ANY OTHER INTERVENTION OR TO NO INTERVENTION. WE ALSO INCLUDED STUDIES COMPARING YOGA AS AN ADJUNCT TO OTHER THERAPIES, VERSUS THOSE OTHER THERAPIES ALONE. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SCREENED AND SELECTED STUDIES, EXTRACTED OUTCOME DATA, AND ASSESSED RISK OF BIAS. WE CONTACTED STUDY AUTHORS TO OBTAIN MISSING OR UNCLEAR INFORMATION. WE EVALUATED THE OVERALL CERTAINTY OF EVIDENCE USING THE GRADE APPROACH. MAIN RESULTS: WE INCLUDED 12 TRIALS (1080 PARTICIPANTS) CARRIED OUT IN THE USA (SEVEN TRIALS), INDIA (THREE TRIALS), AND THE UK (TWO TRIALS). STUDIES WERE UNFUNDED (ONE TRIAL), FUNDED BY A YOGA INSTITUTION (ONE TRIAL), FUNDED BY NON-PROFIT OR GOVERNMENT SOURCES (SEVEN TRIALS), OR DID NOT REPORT ON FUNDING (THREE TRIALS). MOST TRIALS USED IYENGAR, HATHA, OR VINIYOGA FORMS OF YOGA. THE TRIALS COMPARED YOGA TO NO INTERVENTION OR A NON-EXERCISE INTERVENTION SUCH AS EDUCATION (SEVEN TRIALS), AN EXERCISE INTERVENTION (THREE TRIALS), OR BOTH EXERCISE AND NON-EXERCISE INTERVENTIONS (TWO TRIALS). ALL TRIALS WERE AT HIGH RISK OF PERFORMANCE AND DETECTION BIAS BECAUSE PARTICIPANTS AND PROVIDERS WERE NOT BLINDED TO TREATMENT ASSIGNMENT, AND OUTCOMES WERE SELF-ASSESSED. THEREFORE, WE DOWNGRADED ALL OUTCOMES TO 'MODERATE' CERTAINTY EVIDENCE BECAUSE OF RISK OF BIAS, AND WHEN THERE WAS ADDITIONAL SERIOUS RISK OF BIAS, UNEXPLAINED HETEROGENEITY BETWEEN STUDIES, OR THE ANALYSES WERE IMPRECISE, WE DOWNGRADED THE CERTAINTY OF THE EVIDENCE FURTHER.FOR YOGA COMPARED TO NON-EXERCISE CONTROLS (9 TRIALS; 810 PARTICIPANTS), THERE WAS LOW-CERTAINTY EVIDENCE THAT YOGA PRODUCED SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE TO FOUR MONTHS (STANDARDIZED MEAN DIFFERENCE (SMD) -0.40, 95% CONFIDENCE INTERVAL (CI) -0.66 TO -0.14; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MEAN DIFFERENCE (MD) -2.18, 95% -3.60 TO -0.76), MODERATE-CERTAINTY EVIDENCE FOR SMALL TO MODERATE IMPROVEMENTS AT SIX MONTHS (SMD -0.44, 95% CI -0.66 TO -0.22; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -2.15, 95% -3.23 TO -1.08), AND LOW-CERTAINTY EVIDENCE FOR SMALL IMPROVEMENTS AT 12 MONTHS (SMD -0.26, 95% CI -0.46 TO -0.05; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -1.36, 95% -2.41 TO -0.26). ON A 0-100 SCALE THERE WAS VERY LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA WAS SLIGHTLY BETTER FOR PAIN AT THREE TO FOUR MONTHS (MD -4.55, 95% CI -7.04 TO -2.06), SIX MONTHS (MD -7.81, 95% CI -13.37 TO -2.25), AND 12 MONTHS (MD -5.40, 95% CI -14.50 TO -3.70), HOWEVER WE PRE-DEFINED CLINICALLY SIGNIFICANT CHANGES IN PAIN AS 15 POINTS OR GREATER AND THIS THRESHOLD WAS NOT MET. BASED ON INFORMATION FROM SIX TRIALS, THERE WAS MODERATE-CERTAINTY EVIDENCE THAT THE RISK OF ADVERSE EVENTS, PRIMARILY INCREASED BACK PAIN, WAS HIGHER IN YOGA THAN IN NON-EXERCISE CONTROLS (RISK DIFFERENCE (RD) 5%, 95% CI 2% TO 8%).FOR YOGA COMPARED TO NON-YOGA EXERCISE CONTROLS (4 TRIALS; 394 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE IN BACK-RELATED FUNCTION AT THREE MONTHS (SMD -0.22, 95% CI -0.65 TO 0.20; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -0.99, 95% -2.87 TO 0.90) AND SIX MONTHS (SMD -0.20, 95% CI -0.59 TO 0.19; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -0.90, 95% -2.61 TO 0.81), AND NO INFORMATION ON BACK-RELATED FUNCTION AFTER SIX MONTHS. THERE WAS VERY LOW-CERTAINTY EVIDENCE FOR LOWER PAIN ON A 0-100 SCALE AT SEVEN MONTHS (MD -20.40, 95% CI -25.48 TO -15.32), AND NO INFORMATION ON PAIN AT THREE MONTHS OR AFTER SEVEN MONTHS. BASED ON INFORMATION FROM THREE TRIALS, THERE WAS LOW-CERTAINTY EVIDENCE FOR NO DIFFERENCE IN THE RISK OF ADVERSE EVENTS BETWEEN YOGA AND NON-YOGA EXERCISE CONTROLS (RD 1%, 95% CI -4% TO 6%).FOR YOGA ADDED TO EXERCISE COMPARED TO EXERCISE ALONE (1 TRIAL; 24 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE AT 10 WEEKS IN BACK-RELATED FUNCTION (SMD -0.60, 95% CI -1.42 TO 0.22; CORRESPONDING TO A CHANGE IN THE OSWESTRY DISABILITY INDEX OF MD -17.05, 95% -22.96 TO 11.14) OR PAIN ON A 0-100 SCALE (MD -3.20, 95% CI -13.76 TO 7.36). THERE WAS NO INFORMATION ON OUTCOMES AT OTHER TIME POINTS. THERE WAS NO INFORMATION ON ADVERSE EVENTS.STUDIES PROVIDED LIMITED EVIDENCE ON RISK OF CLINICAL IMPROVEMENT, MEASURES OF QUALITY OF LIFE, AND DEPRESSION. THERE WAS NO EVIDENCE ON WORK-RELATED DISABILITY. AUTHORS' CONCLUSIONS: THERE IS LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA COMPARED TO NON-EXERCISE CONTROLS RESULTS IN SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE AND SIX MONTHS. YOGA MAY ALSO BE SLIGHTLY MORE EFFECTIVE FOR PAIN AT THREE AND SIX MONTHS, HOWEVER THE EFFECT SIZE DID NOT MEET PREDEFINED LEVELS OF MINIMUM CLINICAL IMPORTANCE. IT IS UNCERTAIN WHETHER THERE IS ANY DIFFERENCE BETWEEN YOGA AND OTHER EXERCISE FOR BACK-RELATED FUNCTION OR PAIN, OR WHETHER YOGA ADDED TO EXERCISE IS MORE EFFECTIVE THAN EXERCISE ALONE. YOGA IS ASSOCIATED WITH MORE ADVERSE EVENTS THAN NON-EXERCISE CONTROLS, BUT MAY HAVE THE SAME RISK OF ADVERSE EVENTS AS OTHER BACK-FOCUSED EXERCISE. YOGA IS NOT ASSOCIATED WITH SERIOUS ADVERSE EVENTS. THERE IS A NEED FOR ADDITIONAL HIGH-QUALITY RESEARCH TO IMPROVE CONFIDENCE IN ESTIMATES OF EFFECT, TO EVALUATE LONG-TERM OUTCOMES, AND TO PROVIDE ADDITIONAL INFORMATION ON COMPARISONS BETWEEN YOGA AND OTHER EXERCISE FOR CHRONIC NON-SPECIFIC LOW BACK PAIN. 2017 8 2507 38 YOGA BASED CARDIAC REHABILITATION AFTER CORONARY ARTERY BYPASS SURGERY: ONE-YEAR RESULTS ON LVEF, LIPID PROFILE AND PSYCHOLOGICAL STATES--A RANDOMIZED CONTROLLED STUDY. OBJECTIVE: TO COMPARE THE LONG TERM EFFECTS OF YOGA BASED CARDIAC REHABILITATION PROGRAM WITH ONLY PHYSIOTHERAPY BASED PROGRAM AS AN ADD-ON TO CONVENTIONAL REHABILITATION AFTER CORONARY ARTERY BYPASS GRAFTING (CABG) ON RISK FACTORS. METHODS: IN THIS SINGLE BLIND PROSPECTIVE RANDOMIZED PARALLEL TWO ARMED ACTIVE CONTROL STUDY, 1026 PATIENTS POSTED FOR CABG AT NARAYANA HRUDAYALAYA INSTITUTE OF CARDIAC SCIENCES, BENGALURU (INDIA) WERE SCREENED. OF THESE, 250 MALE PARTICIPANTS (35-65 YEARS) WHO SATISFIED THE SELECTION CRITERIA AND CONSENTED WERE RANDOMIZED INTO TWO GROUPS. WITHIN AND BETWEEN GROUP COMPARISONS WERE DONE AT THREE POINTS OF FOLLOW UP (I.E. 6TH WEEK, 6TH MONTH, AND 12TH MONTH) BY USING WILCOXON'S SIGNED RANKS TEST AND MANN WHITNEY U TEST RESPECTIVELY. RESULTS: YOGA GROUP HAD SIGNIFICANTLY (P = 0.001, MANN WHITNEY) BETTER IMPROVEMENT IN LVEF THAN CONTROL GROUP IN THOSE WITH ABNORMAL BASELINE EF (<53%) AFTER 1 YEAR. THERE WAS A BETTER REDUCTION IN BMI IN THE YOGA GROUP (P = 0.038, BETWEEN GROUPS) IN THOSE WITH HIGH BASELINE BMI (>/=23) AFTER 12 MONTHS. YOGA GROUP SHOWED SIGNIFICANT (P = 0.008, WILCOXON'S) REDUCTION IN BLOOD GLUCOSE AT ONE YEAR IN THOSE WITH HIGH BASELINE FBS >/=110 MG/DL. THERE WAS SIGNIFICANTLY BETTER IMPROVEMENT IN YOGA THAN THE CONTROL GROUP IN HDL (P = 0.003), LDL (P = 0.01) AND VLDL (P = 0.03) IN THOSE WITH ABNORMAL BASELINE VALUES. THERE WAS SIGNIFICANTLY BETTER IMPROVEMENT (P = 0.02, BETWEEN GROUPS) IN POSITIVE AFFECT IN YOGA GROUP. WITHIN YOGA GROUP, THERE WAS SIGNIFICANT DECREASE IN PERCEIVED STRESS (P = 0.001), ANXIETY (P = 0.001), DEPRESSION (P = 0.001), AND NEGATIVE AFFECT (P = 0.03) WHILE IN THE CONTROL GROUP THERE WAS REDUCTION (P = 0.003) ONLY IN SCORES ON ANXIETY. CONCLUSION: ADDITION OF YOGA BASED RELAXATION TO CONVENTIONAL POST-CABG CARDIAC REHABILITATION HELPS IN BETTER MANAGEMENT OF RISK FACTORS IN THOSE WITH ABNORMAL BASELINE VALUES AND MAY HELP IN PREVENTING RECURRENCE. 2014 9 2820 47 YOGA TREATMENT FOR CHRONIC NON-SPECIFIC LOW BACK PAIN (2017). WIELAND LS, SKOETZ N, PILKINGTON K, VEMPATI R, DADAMO CR, BERMAN BM. YOGA TREATMENT FOR CHRONIC NON-SPECIFIC LOW BACK PAIN.COCHRANE DATABASE SYST REV2017, ISSUE 1. ART. NO.: CD010671. DOI: 10.1002/14651858.CD010671.PUB2. BACKGROUND: NON-SPECIFIC LOW BACK PAIN IS A COMMON, POTENTIALLY DISABLING CONDITION USUALLY TREATED WITH SELF-CARE AND NON-PRESCRIPTION MEDICATION. FOR CHRONIC LOW BACK PAIN, CURRENT GUIDELINES STATE THAT EXERCISE THERAPY MAY BE BENEFICIAL. YOGA IS A MIND-BODY EXERCISE SOMETIMES USED FOR NON-SPECIFIC LOW BACK PAIN. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA FOR TREATING CHRONIC NON-SPECIFIC LOW BACK PAIN, COMPARED TO NO SPECIFIC TREATMENT, A MINIMAL INTERVENTION (E.G., EDUCATION), OR ANOTHER ACTIVE TREATMENT, WITH A FOCUS ON PAIN, FUNCTION, AND ADVERSE EVENTS. SEARCH METHODS: WE SEARCHED CENTRAL, MEDLINE, EMBASE, FIVE OTHER DATABASES, AND FOUR TRIALS REGISTERS TO 11 MARCH 2016 WITHOUT RESTRICTION OF LANGUAGE OR PUBLICATION STATUS. WE SCREENED REFERENCE LISTS AND CONTACTED EXPERTS IN THE FIELD TO IDENTIFY ADDITIONAL STUDIES. SELECTION CRITERIA: WE INCLUDED RANDOMIZED CONTROLLED TRIALS OF YOGA TREATMENT IN PEOPLE WITH CHRONIC NON-SPECIFIC LOW BACK PAIN. WE INCLUDED STUDIES COMPARING YOGA TO ANY OTHER INTERVENTION OR TO NO INTERVENTION. WE ALSO INCLUDED STUDIES COMPARING YOGA AS AN ADJUNCT TO OTHER THERAPIES, VERSUS THOSE OTHER THERAPIES ALONE. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SCREENED AND SELECTED STUDIES, EXTRACTED OUTCOME DATA, AND ASSESSED RISK OF BIAS. WE CONTACTED STUDY AUTHORS TO OBTAIN MISSING OR UNCLEAR INFORMATION. WE EVALUATED THE OVERALL CERTAINTY OF EVIDENCE USING THE GRADE APPROACH. MAIN RESULTS: WE INCLUDED 12 TRIALS (1080 PARTICIPANTS) CARRIED OUT IN THE USA (SEVEN TRIALS), INDIA (THREE TRIALS), AND THE UK (TWO TRIALS). STUDIES WERE UNFUNDED (ONE TRIAL), FUNDED BY A YOGA INSTITUTION (ONE TRIAL), FUNDED BY NON-PROFIT OR GOVERNMENT SOURCES (SEVEN TRIALS), OR DID NOT REPORT ON FUNDING (THREE TRIALS). MOST TRIALS USED IYENGAR, HATHA, OR VINIYOGA FORMS OF YOGA. THE TRIALS COMPARED YOGA TO NO INTERVENTION OR A NON-EXERCISE INTERVENTION SUCH AS EDUCATION (SEVEN TRIALS), AN EXERCISE INTERVENTION (THREE TRIALS), OR BOTH EXERCISE AND NON-EXERCISE INTERVENTIONS (TWO TRIALS). ALL TRIALS WERE AT HIGH RISK OF PERFORMANCE AND DETECTION BIAS BECAUSE PARTICIPANTS AND PROVIDERS WERE NOT BLINDED TO TREATMENT ASSIGNMENT, AND OUTCOMES WERE SELF-ASSESSED. THEREFORE, WE DOWNGRADED ALL OUTCOMES TO "MODERATE" CERTAINTY EVIDENCE BECAUSE OF RISK OF BIAS, AND WHEN THERE WAS ADDITIONAL SERIOUS RISK OF BIAS, UNEXPLAINED HETEROGENEITY BETWEEN STUDIES, OR THE ANALYSES WERE IMPRECISE, WE DOWNGRADED THE CERTAINTY OF THE EVIDENCE FURTHER. FOR YOGA COMPARED TO NON-EXERCISE CONTROLS (9 TRIALS; 810 PARTICIPANTS), THERE WAS LOW-CERTAINTY EVIDENCE THAT YOGA PRODUCED SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE TO FOUR MONTHS [STANDARDIZED MEAN DIFFERENCE (SMD) = -0.40, 95% CI: -0.66 TO -0.14; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MEAN DIFFERENCE (MD) = -2.18, 95% CI: -3.60 TO -0.76], MODERATE-CERTAINTY EVIDENCE FOR SMALL TO MODERATE IMPROVEMENTS AT SIX MONTHS (SMD = -0.44, 95% CI: -0.66 TO -0.22; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD = -2.15, 95% CI: -3.23 TO -1.08), AND LOW-CERTAINTY EVIDENCE FOR SMALL IMPROVEMENTS AT 12 MONTHS (SMD = -0.26, 95% CI: -0.46 TO -0.05; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD = -1.36, 95% CI: -2.41 TO -0.26). ON A 0-100 SCALE THERE WAS VERY LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA WAS SLIGHTLY BETTER FOR PAIN AT THREE TO FOUR MONTHS (MD = -4.55, 95% CI: -7.04 TO -2.06), SIX MONTHS (MD = -7.81, 95% CI: -13.37 TO -2.25), AND 12 MONTHS (MD = -5.40, 95% CI: -14.50 TO -3.70); HOWEVER, WE PRE-DEFINED CLINICALLY SIGNIFICANT CHANGES IN PAIN AS 15 POINTS OR GREATER AND THIS THRESHOLD WAS NOT MET. BASED ON INFORMATION FROM SIX TRIALS, THERE WAS MODERATE-CERTAINTY EVIDENCE THAT THE RISK OF ADVERSE EVENTS, PRIMARILY INCREASED BACK PAIN, WAS HIGHER IN YOGA THAN IN NON-EXERCISE CONTROLS [RISK DIFFERENCE (RD) = 5%, 95% CI: 2-8%]. FOR YOGA COMPARED TO NON-YOGA EXERCISE CONTROLS (4 TRIALS; 394 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE IN BACK-RELATED FUNCTION AT THREE MONTHS (SMD = -0.22, 95% CI: -0.65 TO 0.20; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD = -0.99, 95% CI: -2.87 TO 0.90) AND SIX MONTHS (SMD = -0.20, 95% CI: -0.59 TO 0.19; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD = -0.90, 95% CI: -2.61 TO 0.81), AND NO INFORMATION ON BACK-RELATED FUNCTION AFTER SIX MONTHS. THERE WAS VERY LOW-CERTAINTY EVIDENCE FOR LOWER PAIN ON A 0-100 SCALE AT SEVEN MONTHS (MD = -20.40, 95% CI: -25.48 TO -15.32), AND NO INFORMATION ON PAIN AT THREE MONTHS OR AFTER SEVEN MONTHS. BASED ON INFORMATION FROM THREE TRIALS, THERE WAS LOW-CERTAINTY EVIDENCE FOR NO DIFFERENCE IN THE RISK OF ADVERSE EVENTS BETWEEN YOGA AND NON-YOGA EXERCISE CONTROLS (RD = 1%, 95% CI: -4% TO 6%). FOR YOGA ADDED TO EXERCISE COMPARED TO EXERCISE ALONE (1 TRIAL; 24 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE AT 10 WEEKS IN BACK-RELATED FUNCTION (SMD = -0.60, 95% CI: -1.42 TO 0.22; CORRESPONDING TO A CHANGE IN THE OSWESTRY DISABILITY INDEX OF MD = -17.05, 95% CI: -22.96 TO 11.14) OR PAIN ON A 0-100 SCALE (MD = -3.20, 95% CI: -13.76 TO 7.36). THERE WAS NO INFORMATION ON OUTCOMES AT OTHER TIME POINTS. THERE WAS NO INFORMATION ON ADVERSE EVENTS. STUDIES PROVIDED LIMITED EVIDENCE ON RISK OF CLINICAL IMPROVEMENT, MEASURES OF QUALITY OF LIFE, AND DEPRESSION. THERE WAS NO EVIDENCE ON WORK-RELATED DISABILITY. 2017 10 2857 37 YOGA-BASED CARDIAC REHABILITATION AFTER ACUTE MYOCARDIAL INFARCTION: A RANDOMIZED TRIAL. BACKGROUND: GIVEN THE SHORTAGE OF CARDIAC REHABILITATION (CR) PROGRAMS IN INDIA AND POOR UPTAKE WORLDWIDE, THERE IS AN URGENT NEED TO FIND ALTERNATIVE MODELS OF CR THAT ARE INEXPENSIVE AND MAY OFFER CHOICE TO SUBGROUPS WITH POOR UPTAKE (E.G., WOMEN AND ELDERLY). OBJECTIVES: THIS STUDY SOUGHT TO EVALUATE THE EFFECTS OF YOGA-BASED CR (YOGA-CARE) ON MAJOR CARDIOVASCULAR EVENTS AND SELF-RATED HEALTH IN A MULTICENTER RANDOMIZED CONTROLLED TRIAL. METHODS: THE TRIAL WAS CONDUCTED IN 24 MEDICAL CENTERS ACROSS INDIA. THIS STUDY RECRUITED 3,959 PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITH A MEDIAN AND MINIMUM FOLLOW-UP OF 22 AND 6 MONTHS. PATIENTS WERE INDIVIDUALLY RANDOMIZED TO RECEIVE EITHER A YOGA-CARE PROGRAM (N = 1,970) OR ENHANCED STANDARD CARE INVOLVING EDUCATIONAL ADVICE (N = 1,989). THE CO-PRIMARY OUTCOMES WERE: 1) FIRST OCCURRENCE OF MAJOR ADVERSE CARDIOVASCULAR EVENTS (MACE) (COMPOSITE OF ALL-CAUSE MORTALITY, MYOCARDIAL INFARCTION, STROKE, OR EMERGENCY CARDIOVASCULAR HOSPITALIZATION); AND 2) SELF-RATED HEALTH ON THE EUROPEAN QUALITY OF LIFE-5 DIMENSIONS-5 LEVEL VISUAL ANALOGUE SCALE AT 12 WEEKS. RESULTS: MACE OCCURRED IN 131 (6.7%) PATIENTS IN THE YOGA-CARE GROUP AND 146 (7.4%) PATIENTS IN THE ENHANCED STANDARD CARE GROUP (HAZARD RATIO WITH YOGA-CARE: 0.90; 95% CONFIDENCE INTERVAL [CI]: 0.71 TO 1.15; P = 0.41). SELF-RATED HEALTH WAS 77 IN YOGA-CARE AND 75.7 IN THE ENHANCED STANDARD CARE GROUP (BASELINE-ADJUSTED MEAN DIFFERENCE IN FAVOR OF YOGA-CARE: 1.5; 95% CI: 0.5 TO 2.5; P = 0.002). THE YOGA-CARE GROUP HAD GREATER RETURN TO PRE-INFARCT ACTIVITIES, BUT THERE WAS NO DIFFERENCE IN TOBACCO CESSATION OR MEDICATION ADHERENCE BETWEEN THE TREATMENT GROUPS (SECONDARY OUTCOMES). CONCLUSIONS: YOGA-CARE IMPROVED SELF-RATED HEALTH AND RETURN TO PRE-INFARCT ACTIVITIES AFTER ACUTE MYOCARDIAL INFARCTION, BUT THE TRIAL LACKED STATISTICAL POWER TO SHOW A DIFFERENCE IN MACE. YOGA-CARE MAY BE AN OPTION WHEN CONVENTIONAL CR IS UNAVAILABLE OR UNACCEPTABLE TO INDIVIDUALS. (A STUDY ON EFFECTIVENESS OF YOGA BASED CARDIAC REHABILITATION PROGRAMME IN INDIA AND UNITED KINGDOM; CTRI/2012/02/002408). 2020 11 2543 52 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 12 2629 41 YOGA FOR THE PRIMARY PREVENTION OF CARDIOVASCULAR DISEASE. BACKGROUND: A SEDENTARY LIFESTYLE AND STRESS ARE MAJOR RISK FACTORS FOR CARDIOVASCULAR DISEASE (CVD). SINCE YOGA INVOLVES EXERCISE AND IS THOUGHT TO HELP IN STRESS REDUCTION IT MAY BE AN EFFECTIVE STRATEGY IN THE PRIMARY PREVENTION OF CVD. OBJECTIVES: TO DETERMINE THE EFFECT OF ANY TYPE OF YOGA ON THE PRIMARY PREVENTION OF CVD. SEARCH METHODS: WE SEARCHED THE FOLLOWING ELECTRONIC DATABASES: THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL) (2013, ISSUE 11) IN THE COCHRANE LIBRARY; MEDLINE (OVID) (1946 TO NOVEMBER WEEK 3 2013); EMBASE CLASSIC + EMBASE (OVID) (1947 TO 2013 WEEK 48); WEB OF SCIENCE (THOMSON REUTERS) (1970 TO 4 DECEMBER 2013); DATABASE OF ABSTRACTS OF REVIEWS OF EFFECTS (DARE), HEALTH TECHNOLOGY ASSESSMENT DATABASE AND HEALTH ECONOMICS EVALUATIONS DATABASE (ISSUE 4 OF 4, 2013) IN THE COCHRANE LIBRARY. WE ALSO SEARCHED A NUMBER OF ASIAN DATABASES AND THE ALLIED AND COMPLEMENTARY MEDICINE DATABASE (AMED) (INCEPTION TO DECEMBER 2012). WE SEARCHED TRIAL REGISTERS AND REFERENCE LISTS OF REVIEWS AND ARTICLES, AND APPROACHED EXPERTS IN THE FIELD. WE APPLIED NO LANGUAGE RESTRICTIONS. SELECTION CRITERIA: RANDOMISED CONTROLLED TRIALS LASTING AT LEAST THREE MONTHS INVOLVING HEALTHY ADULTS OR THOSE AT HIGH RISK OF CVD. TRIALS EXAMINED ANY TYPE OF YOGA AND THE COMPARISON GROUP WAS NO INTERVENTION OR MINIMAL INTERVENTION. OUTCOMES OF INTEREST WERE CLINICAL CVD EVENTS AND MAJOR CVD RISK FACTORS. WE DID NOT INCLUDE ANY TRIALS THAT INVOLVED MULTIFACTORIAL LIFESTYLE INTERVENTIONS OR WEIGHT LOSS. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SELECTED TRIALS FOR INCLUSION, EXTRACTED DATA AND ASSESSED THE RISK OF BIAS. MAIN RESULTS: WE IDENTIFIED 11 TRIALS (800 PARTICIPANTS) AND TWO ONGOING STUDIES. STYLE AND DURATION OF YOGA DIFFERED BETWEEN TRIALS. HALF OF THE PARTICIPANTS RECRUITED TO THE STUDIES WERE AT HIGH RISK OF CVD. MOST OF STUDIES WERE AT RISK OF PERFORMANCE BIAS, WITH INADEQUATE DETAILS REPORTED IN MANY OF THEM TO JUDGE THE RISK OF SELECTION BIAS.NO STUDY REPORTED CARDIOVASCULAR MORTALITY, ALL-CAUSE MORTALITY OR NON-FATAL EVENTS, AND MOST STUDIES WERE SMALL AND SHORT-TERM. THERE WAS SUBSTANTIAL HETEROGENEITY BETWEEN STUDIES MAKING IT IMPOSSIBLE TO COMBINE STUDIES STATISTICALLY FOR SYSTOLIC BLOOD PRESSURE AND TOTAL CHOLESTEROL. YOGA WAS FOUND TO PRODUCE REDUCTIONS IN DIASTOLIC BLOOD PRESSURE (MEAN DIFFERENCE (MD) -2.90 MMHG, 95% CONFIDENCE INTERVAL (CI) -4.52 TO -1.28), WHICH WAS STABLE ON SENSITIVITY ANALYSIS, TRIGLYCERIDES (MD -0.27 MMOL/L, 95% CI -0.44 TO -0.11) AND HIGH-DENSITY LIPOPROTEIN (HDL) CHOLESTEROL (MD 0.08 MMOL/L, 95% CI 0.02 TO 0.14). HOWEVER, THE CONTRIBUTING STUDIES WERE SMALL, SHORT-TERM AND AT UNCLEAR OR HIGH RISK OF BIAS. THERE WAS NO CLEAR EVIDENCE OF A DIFFERENCE BETWEEN GROUPS FOR LOW-DENSITY LIPOPROTEIN (LDL) CHOLESTEROL (MD -0.09 MMOL/L, 95% CI -0.48 TO 0.30), ALTHOUGH THERE WAS MODERATE STATISTICAL HETEROGENEITY. ADVERSE EVENTS, OCCURRENCE OF TYPE 2 DIABETES AND COSTS WERE NOT REPORTED IN ANY OF THE INCLUDED STUDIES. QUALITY OF LIFE WAS MEASURED IN THREE TRIALS BUT THE RESULTS WERE INCONCLUSIVE. AUTHORS' CONCLUSIONS: THE LIMITED EVIDENCE COMES FROM SMALL, SHORT-TERM, LOW-QUALITY STUDIES. THERE IS SOME EVIDENCE THAT YOGA HAS FAVOURABLE EFFECTS ON DIASTOLIC BLOOD PRESSURE, HDL CHOLESTEROL AND TRIGLYCERIDES, AND UNCERTAIN EFFECTS ON LDL CHOLESTEROL. THESE RESULTS SHOULD BE CONSIDERED AS EXPLORATORY AND INTERPRETED WITH CAUTION. 2014 13 881 37 EFFECT OF YOGA TRAINING ON INFLAMMATORY CYTOKINES AND C-REACTIVE PROTEIN IN EMPLOYEES OF SMALL-SCALE INDUSTRIES. OBJECTIVE: THE PRESENT STUDY INTENDS TO SEE THE EFFECT OF YOGA PRACTICES ON LIPID PROFILE, INTERLEUKIN (IL)-6, TUMOR NECROSIS FACTOR (TNF)-ALPHA, AND HIGH-SENSITIVITY-C-REACTIVE PROTEIN (HS-CRP) AMONG APPARENTLY HEALTHY ADULTS EXPOSED TO OCCUPATIONAL HAZARDS. MATERIALS AND METHODS: IN THE PRESENT STUDY, 48 PARTICIPANTS AGED 30-58 YEARS (41.5 +/- 5.2) WHO WERE EXPOSED TO OCCUPATIONAL HAZARDS WERE RANDOMIZED INTO TWO GROUPS, THAT IS, EXPERIMENTAL AND WAIT-LIST CONTROL. ALL THE PARTICIPANTS WERE ASSESSED FOR LIPID PROFILE, IL-6, TNF-ALPHA, AND HS-CRP AT THE BASELINE AND AFTER COMPLETION OF 3 MONTHS OF YOGA TRAINING INTERVENTION. THE EXPERIMENTAL GROUP UNDERWENT YOGA TRAINING INTERVENTION FOR 1 H FOR 6 DAYS A WEEK FOR 3 MONTHS, WHEREAS CONTROL GROUP CONTINUED WITH THEIR DAILY ACTIVITIES EXCEPT YOGA TRAINING. DATA ANALYSIS WAS DONE USING STATISTICAL SOFTWARE SPSS VERSION 20.0. DATA WERE ANALYZED USING PAIRED T-TESTS AND INDEPENDENT T-TEST. RESULTS: THE RESULTS OF WITHIN GROUP COMPARISON REVEALED HIGHLY SIGNIFICANT CHANGES IN CHOLESTEROL (P < 0.001), HIGH-DENSITY LIPOPROTEIN (P < 0.001), LOW-DENSITY LIPOPROTEIN (LDL)(P < 0.01), HS-CRP (P < 0.01), IL-6 (P < 0.001), AND TNF-ALPHA (P < 0.001) IN EXPERIMENTAL GROUP. COMPARISON BETWEEN EXPERIMENTAL AND CONTROL GROUP REVEALED SIGNIFICANT CHANGES IN CHOLESTEROL (P < 0.01), LDL (P < 0.05), IL-6 (P < 0.01), TNF-ALPHA (P < 0.01), AND HS-CRP (P < 0.01). CONCLUSION: A YOGA-BASED LIFESTYLE INTERVENTION SEEMS TO BE A HIGHLY PROMISING ALTERNATIVE THERAPY WHICH FAVORABLY ALTERS INFLAMMATORY MARKERS AND METABOLIC RISK FACTORS. 2017 14 2829 42 YOGA VERSUS STANDARD CARE FOR SCHIZOPHRENIA. BACKGROUND: YOGA IS AN ANCIENT SPIRITUAL PRACTICE THAT ORIGINATED IN INDIA AND IS CURRENTLY ACCEPTED IN THE WESTERN WORLD AS A FORM OF RELAXATION AND EXERCISE. IT HAS BEEN OF INTEREST FOR PEOPLE WITH SCHIZOPHRENIA TO DETERMINE ITS EFFICACY AS AN ADJUNCT TO STANDARD-CARE TREATMENT. OBJECTIVES: TO EXAMINE THE EFFECTS OF YOGA VERSUS STANDARD CARE FOR PEOPLE WITH SCHIZOPHRENIA. SEARCH METHODS: WE SEARCHED THE COCHRANE SCHIZOPHRENIA GROUP TRIALS REGISTER (NOVEMBER 2012 AND JANUARY 29, 2015), WHICH IS BASED ON REGULAR SEARCHES OF MEDLINE, PUBMED, EMBASE, CINAHL, BIOSIS, AMED, PSYCINFO, AND REGISTRIES OF CLINICAL TRIALS. WE SEARCHED THE REFERENCES OF ALL INCLUDED STUDIES. THERE WERE NO LANGUAGE, DATE, DOCUMENT TYPE, OR PUBLICATION STATUS LIMITATIONS FOR INCLUSION OF RECORDS IN THE REGISTER. SELECTION CRITERIA: ALL RANDOMISED CONTROLLED TRIALS (RCTS) INCLUDING PEOPLE WITH SCHIZOPHRENIA COMPARING YOGA TO STANDARD-CARE CONTROL. DATA COLLECTION AND ANALYSIS: THE REVIEW TEAM INDEPENDENTLY SELECTED STUDIES, QUALITY RATED THESE, AND EXTRACTED DATA. FOR BINARY OUTCOMES, WE CALCULATED RISK RATIO (RR) AND ITS 95% CONFIDENCE INTERVAL (CI), ON AN INTENTION-TO-TREAT BASIS. FOR CONTINUOUS DATA, WE ESTIMATED THE MEAN DIFFERENCE (MD) BETWEEN GROUPS AND ITS 95% CI. WE EMPLOYED MIXED-EFFECT AND FIXED-EFFECT MODELS FOR ANALYSES. WE EXAMINED DATA FOR HETEROGENEITY (I(2) TECHNIQUE), ASSESSED RISK OF BIAS FOR INCLUDED STUDIES, AND CREATED 'SUMMARY OF FINDINGS' TABLES USING GRADE (GRADING OF RECOMMENDATIONS ASSESSMENT, DEVELOPMENT AND EVALUATION). MAIN RESULTS: WE INCLUDED EIGHT STUDIES IN THE REVIEW. ALL OUTCOMES WERE SHORT TERM (LESS THAN SIX MONTHS). THERE WERE CLEAR DIFFERENCES IN A NUMBER OF OUTCOMES IN FAVOUR OF THE YOGA GROUP, ALTHOUGH THESE WERE BASED ON ONE STUDY EACH, WITH THE EXCEPTION OF LEAVING THE STUDY EARLY. THESE INCLUDED MENTAL STATE (IMPROVEMENT IN POSITIVE AND NEGATIVE SYNDROME SCALE, 1 RCT, N = 83, RR 0.70 CI 0.55 TO 0.88, MEDIUM-QUALITY EVIDENCE), SOCIAL FUNCTIONING (IMPROVEMENT IN SOCIAL OCCUPATIONAL FUNCTIONING SCALE, 1 RCT, N = 83, RR 0.88 CI 0.77 TO 1, MEDIUM-QUALITY EVIDENCE), QUALITY OF LIFE (AVERAGE CHANGE 36-ITEM SHORT FORM SURVEY (SF-36) QUALITY-OF-LIFE SUBSCALE, 1 RCT, N = 60, MD 15.50, 95% CI 4.27 TO 26.73, LOW-QUALITY EVIDENCE), AND LEAVING THE STUDY EARLY (8 RCTS, N = 457, RR 0.91 CI 0.6 TO 1.37, MEDIUM-QUALITY EVIDENCE). FOR THE OUTCOME OF PHYSICAL HEALTH, THERE WAS NOT A CLEAR DIFFERENCE BETWEEN GROUPS (AVERAGE CHANGE SF-36 PHYSICAL-HEALTH SUBSCALE, 1 RCT, N = 60, MD 6.60, 95% CI -2.44 TO 15.64, LOW-QUALITY EVIDENCE). ONLY ONE STUDY REPORTED ADVERSE EFFECTS, FINDING NO INCIDENCE OF ADVERSE EVENTS IN EITHER TREATMENT GROUP. THIS REVIEW WAS SUBJECT TO A CONSIDERABLE NUMBER OF MISSING OUTCOMES, WHICH INCLUDED GLOBAL STATE, CHANGE IN COGNITION, COSTS OF CARE, EFFECT ON STANDARD CARE, SERVICE INTERVENTION, DISABILITY, AND ACTIVITIES OF DAILY LIVING. AUTHORS' CONCLUSIONS: EVEN THOUGH WE FOUND SOME POSITIVE EVIDENCE IN FAVOUR OF YOGA OVER STANDARD-CARE CONTROL, THIS SHOULD BE INTERPRETED CAUTIOUSLY IN VIEW OF OUTCOMES LARGELY BASED EACH ON ONE STUDY WITH LIMITED SAMPLE SIZES AND SHORT-TERM FOLLOW-UP. OVERALL, MANY OUTCOMES WERE NOT REPORTED AND EVIDENCE PRESENTED IN THIS REVIEW IS OF LOW TO MODERATE QUALITY - -TOO WEAK TO INDICATE THAT YOGA IS SUPERIOR TO STANDARD-CARE CONTROL FOR THE MANAGEMENT OF SCHIZOPHRENIA. 2015 15 2827 43 YOGA VERSUS NON-STANDARD CARE FOR SCHIZOPHRENIA. BACKGROUND: YOGA IS AN ANCIENT SPIRITUAL PRACTICE THAT ORIGINATED IN INDIA AND IS CURRENTLY ACCEPTED IN THE WESTERN WORLD AS A FORM OF RELAXATION AND EXERCISE. IT HAS BEEN OF INTEREST FOR PEOPLE WITH SCHIZOPHRENIA AS AN ALTERNATIVE OR ADJUNCTIVE TREATMENT. OBJECTIVES: TO SYSTEMATICALLY ASSESS THE EFFECTS OF YOGA VERSUS NON-STANDARD CARE FOR PEOPLE WITH SCHIZOPHRENIA. SEARCH METHODS: THE INFORMATION SPECIALIST OF THE COCHRANE SCHIZOPHRENIA GROUP SEARCHED THEIR SPECIALISED TRIALS REGISTER (LATEST 30 MARCH 2017), WHICH IS BASED ON REGULAR SEARCHES OF MEDLINE, PUBMED, EMBASE, CINAHL, BIOSIS, AMED, PSYCINFO, AND REGISTRIES OF CLINICAL TRIALS. WE SEARCHED THE REFERENCES OF ALL INCLUDED STUDIES. THERE ARE NO LANGUAGE, DATE, DOCUMENT TYPE, OR PUBLICATION STATUS LIMITATIONS FOR INCLUSION OF RECORDS IN THE REGISTER. SELECTION CRITERIA: ALL RANDOMISED CONTROLLED TRIALS (RCTS) INCLUDING PEOPLE WITH SCHIZOPHRENIA AND COMPARING YOGA WITH NON-STANDARD CARE. WE INCLUDED TRIALS THAT MET OUR SELECTION CRITERIA AND REPORTED USEABLE DATA. DATA COLLECTION AND ANALYSIS: THE REVIEW TEAM INDEPENDENTLY SELECTED STUDIES, ASSESSED QUALITY, AND EXTRACTED DATA. FOR BINARY OUTCOMES, WE CALCULATED RISK RATIO (RR) AND ITS 95% CONFIDENCE INTERVAL (CI), ON AN INTENTION-TO-TREAT BASIS. FOR CONTINUOUS DATA, WE ESTIMATED THE MEAN DIFFERENCE (MD) BETWEEN GROUPS AND ITS 95% CI. WE EMPLOYED A FIXED-EFFECT MODELS FOR ANALYSES. WE EXAMINED DATA FOR HETEROGENEITY (I(2) TECHNIQUE), ASSESSED RISK OF BIAS FOR INCLUDED STUDIES, AND CREATED A 'SUMMARY OF FINDINGS' TABLE FOR SEVEN MAIN OUTCOMES OF INTEREST USING GRADE (GRADING OF RECOMMENDATIONS ASSESSMENT, DEVELOPMENT AND EVALUATION). MAIN RESULTS: WE WERE ABLE TO INCLUDE SIX STUDIES (586 PARTICIPANTS). NON-STANDARD CARE CONSISTED SOLELY OF ANOTHER TYPE OF EXERCISE PROGRAMME. ALL OUTCOMES WERE SHORT TERM (LESS THAN SIX MONTHS). THERE WAS A CLEAR DIFFERENCE IN THE OUTCOME LEAVING THE STUDY EARLY (6 RCTS, N=586, RR 0.64 CI 0.49 TO 0.83, MEDIUM QUALITY EVIDENCE) IN FAVOUR OF THE YOGA GROUP. THERE WERE NO CLEAR DIFFERENCES BETWEEN GROUPS FOR THE REMAINING OUTCOMES. THESE INCLUDED MENTAL STATE (IMPROVEMENT IN POSITIVE AND NEGATIVE SYNDROME SCALE, 1 RCT, N=84, RR 0.81 CI 0.62 TO 1.07, LOW QUALITY EVIDENCE), SOCIAL FUNCTIONING (IMPROVEMENT IN SOCIAL OCCUPATIONAL FUNCTIONING SCALE, 1 RCT, N=84, RR 0.90 CI 0.78 TO 1.04, LOW QUALITY EVIDENCE), QUALITY OF LIFE (MENTAL HEALTH) (AVERAGE CHANGE 36-ITEM SHORT FORM SURVEY (SF-36) QUALITY-OF-LIFE SUB-SCALE, 1 RCT, N=69, MD -5.30 CI -17.78 TO 7.18, LOW QUALITY EVIDENCE), PHYSICAL HEALTH, (AVERAGE CHANGE WHOQOL-BREF PHYSICAL-HEALTH SUB-SCALE, 1 RCT, N=69, MD 9.22 CI -0.42 TO 18.86, LOW QUALITY EVIDENCE). ONLY ONE STUDY REPORTED ADVERSE EFFECTS, FINDING NO INCIDENCE OF ADVERSE EVENTS IN EITHER TREATMENT GROUP. THERE WERE A CONSIDERABLE NUMBER OF MISSING OUTCOMES, WHICH INCLUDED RELAPSE, CHANGE IN COGNITION, COSTS OF CARE, EFFECT ON STANDARD CARE, SERVICE INTERVENTION, DISABILITY, AND ACTIVITIES OF DAILY LIVING. AUTHORS' CONCLUSIONS: WE FOUND MINIMAL DIFFERENCES BETWEEN YOGA AND NON-STANDARD CARE, THE LATTER CONSISTING OF ANOTHER EXERCISE COMPARATOR, WHICH COULD BE BROADLY CONSIDERED AEROBIC EXERCISE. OUTCOMES WERE LARGELY BASED ON SINGLE STUDIES WITH LIMITED SAMPLE SIZES AND SHORT-TERM FOLLOW-UP. OVERALL, MANY OUTCOMES WERE NOT REPORTED AND EVIDENCE PRESENTED IN THIS REVIEW IS OF LOW TO MODERATE QUALITY - TOO WEAK TO INDICATE THAT YOGA IS SUPERIOR OR INFERIOR TO NON-STANDARD CARE CONTROL FOR MANAGEMENT OF PEOPLE WITH SCHIZOPHRENIA. 2017 16 2636 45 YOGA FOR TREATING URINARY INCONTINENCE IN WOMEN. BACKGROUND: URINARY INCONTINENCE IN WOMEN IS ASSOCIATED WITH POOR QUALITY OF LIFE AND DIFFICULTIES IN SOCIAL, PSYCHOLOGICAL AND SEXUAL FUNCTIONING. THE CONDITION MAY AFFECT UP TO 15% OF MIDDLE-AGED OR OLDER WOMEN IN THE GENERAL POPULATION. CONSERVATIVE TREATMENTS SUCH AS LIFESTYLE INTERVENTIONS, BLADDER TRAINING AND PELVIC FLOOR MUSCLE TRAINING (USED EITHER ALONE OR IN COMBINATION WITH OTHER INTERVENTIONS) ARE THE INITIAL APPROACHES TO THE MANAGEMENT OF URINARY INCONTINENCE. MANY WOMEN ARE INTERESTED IN ADDITIONAL TREATMENTS SUCH AS YOGA, A SYSTEM OF PHILOSOPHY, LIFESTYLE AND PHYSICAL PRACTICE THAT ORIGINATED IN ANCIENT INDIA. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA FOR TREATING URINARY INCONTINENCE IN WOMEN. SEARCH METHODS: WE SEARCHED THE COCHRANE INCONTINENCE AND COCHRANE COMPLEMENTARY MEDICINE SPECIALISED REGISTERS. WE SEARCHED THE WORLD HEALTH ORGANIZATION INTERNATIONAL CLINICAL TRIALS REGISTRY PLATFORM (WHO ICTRP) AND CLINICALTRIALS.GOV TO IDENTIFY ANY ONGOING OR UNPUBLISHED STUDIES. WE HANDSEARCHED PROCEEDINGS OF THE INTERNATIONAL CONGRESS ON COMPLEMENTARY MEDICINE RESEARCH AND THE EUROPEAN CONGRESS FOR INTEGRATIVE MEDICINE. WE SEARCHED THE NHS ECONOMIC EVALUATION DATABASE FOR ECONOMIC STUDIES, AND SUPPLEMENTED THIS SEARCH WITH SEARCHES FOR ECONOMICS STUDIES IN MEDLINE AND EMBASE FROM 2015 ONWARDS. DATABASE SEARCHES ARE UP-TO-DATE AS OF 21 JUNE 2018. SELECTION CRITERIA: RANDOMISED CONTROLLED TRIALS IN WOMEN DIAGNOSED WITH URINARY INCONTINENCE IN WHICH ONE GROUP WAS ALLOCATED TO TREATMENT WITH YOGA. DATA COLLECTION AND ANALYSIS: TWO REVIEW AUTHORS INDEPENDENTLY SCREENED TITLES AND ABSTRACTS OF ALL RETRIEVED ARTICLES, SELECTED STUDIES FOR INCLUSION, EXTRACTED DATA, ASSESSED RISK OF BIAS AND EVALUATED THE CERTAINTY OF THE EVIDENCE FOR EACH REPORTED OUTCOME. ANY DISAGREEMENTS WERE RESOLVED BY CONSENSUS. WE PLANNED TO COMBINE CLINICALLY COMPARABLE STUDIES IN REVIEW MANAGER 5 USING RANDOM-EFFECTS META-ANALYSIS AND TO CARRY OUT SENSITIVITY AND SUBGROUP ANALYSES. WE PLANNED TO CREATE A TABLE LISTING ECONOMIC STUDIES ON YOGA FOR INCONTINENCE BUT NOT CARRY OUT ANY ANALYSES ON THESE STUDIES. MAIN RESULTS: WE INCLUDED TWO STUDIES (INVOLVING A TOTAL OF 49 WOMEN). EACH STUDY COMPARED YOGA TO A DIFFERENT COMPARATOR, THEREFORE WE WERE UNABLE TO COMBINE THE DATA IN A META-ANALYSIS. A THIRD STUDY THAT HAS BEEN COMPLETED BUT NOT YET FULLY REPORTED IS AWAITING ASSESSMENT.ONE INCLUDED STUDY WAS A SIX-WEEK STUDY COMPARING YOGA TO A WAITING LIST IN 19 WOMEN WITH EITHER URGENCY URINARY INCONTINENCE OR STRESS URINARY INCONTINENCE. WE JUDGED THE CERTAINTY OF THE EVIDENCE FOR ALL REPORTED OUTCOMES AS VERY LOW DUE TO PERFORMANCE BIAS, DETECTION BIAS, AND IMPRECISION. THE NUMBER OF WOMEN REPORTING CURE WAS NOT REPORTED. WE ARE UNCERTAIN WHETHER YOGA RESULTS IN SATISFACTION WITH CURE OR IMPROVEMENT OF INCONTINENCE (RISK RATIO (RR) 6.33, 95% CONFIDENCE INTERVAL (CI) 1.44 TO 27.88; AN INCREASE OF 592 FROM 111 PER 1000, 95% CI 160 TO 1000). WE ARE UNCERTAIN WHETHER THERE IS A DIFFERENCE BETWEEN YOGA AND WAITING LIST IN CONDITION-SPECIFIC QUALITY OF LIFE AS MEASURED ON THE INCONTINENCE IMPACT QUESTIONNAIRE SHORT FORM (MEAN DIFFERENCE (MD) 1.74, 95% CI -33.02 TO 36.50); THE NUMBER OF MICTURITIONS (MD -0.77, 95% CI -2.13 TO 0.59); THE NUMBER OF INCONTINENCE EPISODES (MD -1.57, 95% CI -2.83 TO -0.31); OR THE BOTHERSOMENESS OF INCONTINENCE AS MEASURED ON THE UROGENITAL DISTRESS INVENTORY 6 (MD -0.90, 95% CI -1.46 TO -0.34). THERE WAS NO EVIDENCE OF A DIFFERENCE IN THE NUMBER OF WOMEN WHO EXPERIENCED AT LEAST ONE ADVERSE EVENT (RISK DIFFERENCE 0%, 95% CI -38% TO 38%; NO DIFFERENCE FROM 222 PER 1000, 95% CI 380 FEWER TO 380 MORE).THE SECOND INCLUDED STUDY WAS AN EIGHT-WEEK STUDY IN 30 WOMEN WITH URGENCY URINARY INCONTINENCE THAT COMPARED MINDFULNESS-BASED STRESS REDUCTION (MBSR) TO AN ACTIVE CONTROL INTERVENTION OF YOGA CLASSES. THE STUDY WAS UNBLINDED, AND THERE WAS HIGH ATTRITION FROM BOTH STUDY ARMS FOR ALL OUTCOME ASSESSMENTS. WE JUDGED THE CERTAINTY OF THE EVIDENCE FOR ALL REPORTED OUTCOMES AS VERY LOW DUE TO PERFORMANCE BIAS, ATTRITION BIAS, IMPRECISION AND INDIRECTNESS. THE NUMBER OF WOMEN REPORTING CURE WAS NOT REPORTED. WE ARE UNCERTAIN WHETHER WOMEN IN THE YOGA GROUP WERE LESS LIKELY TO REPORT IMPROVEMENT IN INCONTINENCE AT EIGHT WEEKS COMPARED TO WOMEN IN THE MBSR GROUP (RR 0.09, 95% CI 0.01 TO 1.43; A DECREASE OF 419 FROM 461 PER 1000, 95% CI 5 TO 660). WE ARE UNCERTAIN ABOUT THE EFFECT OF MBSR COMPARED TO YOGA ON REPORTS OF CURE OR IMPROVEMENT IN INCONTINENCE, IMPROVEMENT IN CONDITION-SPECIFIC QUALITY OF LIFE MEASURED ON THE OVERACTIVE BLADDER HEALTH-RELATED QUALITY OF LIFE SCALE, REDUCTION IN INCONTINENCE EPISODES OR REDUCTION IN BOTHERSOMENESS OF INCONTINENCE AS MEASURED ON THE OVERACTIVE BLADDER SYMPTOM AND QUALITY OF LIFE-SHORT FORM AT EIGHT WEEKS. THE STUDY DID NOT REPORT ON ADVERSE EFFECTS. AUTHORS' CONCLUSIONS: WE IDENTIFIED FEW TRIALS ON YOGA FOR INCONTINENCE, AND THE EXISTING TRIALS WERE SMALL AND AT HIGH RISK OF BIAS. IN ADDITION, WE DID NOT FIND ANY STUDIES OF ECONOMIC OUTCOMES RELATED TO YOGA FOR URINARY INCONTINENCE. DUE TO THE LACK OF EVIDENCE TO ANSWER THE REVIEW QUESTION, WE ARE UNCERTAIN WHETHER YOGA IS USEFUL FOR WOMEN WITH URINARY INCONTINENCE. ADDITIONAL, WELL-CONDUCTED TRIALS WITH LARGER SAMPLE SIZES ARE NEEDED. 2019 17 2518 41 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 18 2587 47 YOGA FOR IMPROVING HEALTH-RELATED QUALITY OF LIFE, MENTAL HEALTH AND CANCER-RELATED SYMPTOMS IN WOMEN DIAGNOSED WITH BREAST CANCER. BACKGROUND: BREAST CANCER IS THE CANCER MOST FREQUENTLY DIAGNOSED IN WOMEN WORLDWIDE. EVEN THOUGH SURVIVAL RATES ARE CONTINUALLY INCREASING, BREAST CANCER IS OFTEN ASSOCIATED WITH LONG-TERM PSYCHOLOGICAL DISTRESS, CHRONIC PAIN, FATIGUE AND IMPAIRED QUALITY OF LIFE. YOGA COMPRISES ADVICE FOR AN ETHICAL LIFESTYLE, SPIRITUAL PRACTICE, PHYSICAL ACTIVITY, BREATHING EXERCISES AND MEDITATION. IT IS A COMPLEMENTARY THERAPY THAT IS COMMONLY RECOMMENDED FOR BREAST CANCER-RELATED IMPAIRMENTS AND HAS BEEN SHOWN TO IMPROVE PHYSICAL AND MENTAL HEALTH IN PEOPLE WITH DIFFERENT CANCER TYPES. OBJECTIVES: TO ASSESS EFFECTS OF YOGA ON HEALTH-RELATED QUALITY OF LIFE, MENTAL HEALTH AND CANCER-RELATED SYMPTOMS AMONG WOMEN WITH A DIAGNOSIS OF BREAST CANCER WHO ARE RECEIVING ACTIVE TREATMENT OR HAVE COMPLETED TREATMENT. SEARCH METHODS: WE SEARCHED THE COCHRANE BREAST CANCER SPECIALISED REGISTER, MEDLINE (VIA PUBMED), EMBASE, THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL; 2016, ISSUE 1), INDEXING OF INDIAN MEDICAL JOURNALS (INDMED), THE WORLD HEALTH ORGANIZATION (WHO) INTERNATIONAL CLINICAL TRIALS REGISTRY PLATFORM (ICTRP) SEARCH PORTAL AND CLINICALTRIALS.GOV ON 29 JANUARY 2016. WE ALSO SEARCHED REFERENCE LISTS OF IDENTIFIED RELEVANT TRIALS OR REVIEWS, AS WELL AS CONFERENCE PROCEEDINGS OF THE INTERNATIONAL CONGRESS ON COMPLEMENTARY MEDICINE RESEARCH (ICCMR), THE EUROPEAN CONGRESS FOR INTEGRATIVE MEDICINE (ECIM) AND THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY (ASCO). WE APPLIED NO LANGUAGE RESTRICTIONS. SELECTION CRITERIA: RANDOMISED CONTROLLED TRIALS WERE ELIGIBLE WHEN THEY (1) COMPARED YOGA INTERVENTIONS VERSUS NO THERAPY OR VERSUS ANY OTHER ACTIVE THERAPY IN WOMEN WITH A DIAGNOSIS OF NON-METASTATIC OR METASTATIC BREAST CANCER, AND (2) ASSESSED AT LEAST ONE OF THE PRIMARY OUTCOMES ON PATIENT-REPORTED INSTRUMENTS, INCLUDING HEALTH-RELATED QUALITY OF LIFE, DEPRESSION, ANXIETY, FATIGUE OR SLEEP DISTURBANCES. DATA COLLECTION AND ANALYSIS: TWO REVIEW AUTHORS INDEPENDENTLY COLLECTED DATA ON METHODS AND RESULTS. WE EXPRESSED OUTCOMES AS STANDARDISED MEAN DIFFERENCES (SMDS) WITH 95% CONFIDENCE INTERVALS (CIS) AND CONDUCTED RANDOM-EFFECTS MODEL META-ANALYSES. WE ASSESSED POTENTIAL RISK OF PUBLICATION BIAS THROUGH VISUAL ANALYSIS OF FUNNEL PLOT SYMMETRY AND HETEROGENEITY BETWEEN STUDIES BY USING THE CHI(2) TEST AND THE I(2) STATISTIC. WE CONDUCTED SUBGROUP ANALYSES FOR CURRENT TREATMENT STATUS, TIME SINCE DIAGNOSIS, STAGE OF CANCER AND TYPE OF YOGA INTERVENTION. MAIN RESULTS: WE INCLUDED 24 STUDIES WITH A TOTAL OF 2166 PARTICIPANTS, 23 OF WHICH PROVIDED DATA FOR META-ANALYSIS. THIRTEEN STUDIES HAD LOW RISK OF SELECTION BIAS, FIVE STUDIES REPORTED ADEQUATE BLINDING OF OUTCOME ASSESSMENT AND 15 STUDIES HAD LOW RISK OF ATTRITION BIAS.SEVENTEEN STUDIES THAT COMPARED YOGA VERSUS NO THERAPY PROVIDED MODERATE-QUALITY EVIDENCE SHOWING THAT YOGA IMPROVED HEALTH-RELATED QUALITY OF LIFE (POOLED SMD 0.22, 95% CI 0.04 TO 0.40; 10 STUDIES, 675 PARTICIPANTS), REDUCED FATIGUE (POOLED SMD -0.48, 95% CI -0.75 TO -0.20; 11 STUDIES, 883 PARTICIPANTS) AND REDUCED SLEEP DISTURBANCES IN THE SHORT TERM (POOLED SMD -0.25, 95% CI -0.40 TO -0.09; SIX STUDIES, 657 PARTICIPANTS). THE FUNNEL PLOT FOR HEALTH-RELATED QUALITY OF LIFE WAS ASYMMETRICAL, FAVOURING NO THERAPY, AND THE FUNNEL PLOT FOR FATIGUE WAS ROUGHLY SYMMETRICAL. THIS HINTS AT OVERALL LOW RISK OF PUBLICATION BIAS. YOGA DID NOT APPEAR TO REDUCE DEPRESSION (POOLED SMD -0.13, 95% CI -0.31 TO 0.05; SEVEN STUDIES, 496 PARTICIPANTS; LOW-QUALITY EVIDENCE) OR ANXIETY (POOLED SMD -0.53, 95% CI -1.10 TO 0.04; SIX STUDIES, 346 PARTICIPANTS; VERY LOW-QUALITY EVIDENCE) IN THE SHORT TERM AND HAD NO MEDIUM-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE (POOLED SMD 0.10, 95% CI -0.23 TO 0.42; TWO STUDIES, 146 PARTICIPANTS; LOW-QUALITY EVIDENCE) OR FATIGUE (POOLED SMD -0.04, 95% CI -0.36 TO 0.29; TWO STUDIES, 146 PARTICIPANTS; LOW-QUALITY EVIDENCE). INVESTIGATORS REPORTED NO SERIOUS ADVERSE EVENTS.FOUR STUDIES THAT COMPARED YOGA VERSUS PSYCHOSOCIAL/EDUCATIONAL INTERVENTIONS PROVIDED MODERATE-QUALITY EVIDENCE INDICATING THAT YOGA CAN REDUCE DEPRESSION (POOLED SMD -2.29, 95% CI -3.97 TO -0.61; FOUR STUDIES, 226 PARTICIPANTS), ANXIETY (POOLED SMD -2.21, 95% CI -3.90 TO -0.52; THREE STUDIES, 195 PARTICIPANTS) AND FATIGUE (POOLED SMD -0.90, 95% CI -1.31 TO -0.50; TWO STUDIES, 106 PARTICIPANTS) IN THE SHORT TERM. VERY LOW-QUALITY EVIDENCE SHOWED NO SHORT-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE (POOLED SMD 0.81, 95% CI -0.50 TO 2.12; TWO STUDIES, 153 PARTICIPANTS) OR SLEEP DISTURBANCES (POOLED SMD -0.21, 95% CI -0.76 TO 0.34; TWO STUDIES, 119 PARTICIPANTS). NO TRIAL ADEQUATELY REPORTED SAFETY-RELATED DATA.THREE STUDIES THAT COMPARED YOGA VERSUS EXERCISE PRESENTED VERY LOW-QUALITY EVIDENCE SHOWING NO SHORT-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE (POOLED SMD -0.04, 95% CI -0.30 TO 0.23; THREE STUDIES, 233 PARTICIPANTS) OR FATIGUE (POOLED SMD -0.21, 95% CI -0.66 TO 0.25; THREE STUDIES, 233 PARTICIPANTS); NO TRIAL PROVIDED SAFETY-RELATED DATA. AUTHORS' CONCLUSIONS: MODERATE-QUALITY EVIDENCE SUPPORTS THE RECOMMENDATION OF YOGA AS A SUPPORTIVE INTERVENTION FOR IMPROVING HEALTH-RELATED QUALITY OF LIFE AND REDUCING FATIGUE AND SLEEP DISTURBANCES WHEN COMPARED WITH NO THERAPY, AS WELL AS FOR REDUCING DEPRESSION, ANXIETY AND FATIGUE, WHEN COMPARED WITH PSYCHOSOCIAL/EDUCATIONAL INTERVENTIONS. VERY LOW-QUALITY EVIDENCE SUGGESTS THAT YOGA MIGHT BE AS EFFECTIVE AS OTHER EXERCISE INTERVENTIONS AND MIGHT BE USED AS AN ALTERNATIVE TO OTHER EXERCISE PROGRAMMES. 2017 19 780 47 EFFECT OF YOGA AS AN ADD-ON THERAPY IN THE MODULATION OF HEART RATE VARIABILITY IN CHILDREN WITH DUCHENNE MUSCULAR DYSTROPHY. BACKGROUND: DUCHENE MUSCULAR DYSTROPHY (DMD) IS A PROGRESSIVE MUSCULAR DISORDER. CARDIAC DISORDER IS THE SECOND-MOST COMMON CAUSE OF DEATH IN CHILDREN WITH DMD, WITH 10%-20% OF THEM DYING OF CARDIAC FAILURE. HEART RATE VARIABILITY (HRV) IS SHOWN TO BE A PREDICTOR OF CARDIO-AUTONOMIC FUNCTION. PHYSIOTHERAPY (PT) IS ADVISED FOR THESE CHILDREN AS A REGULAR TREATMENT FOR MAINTAINING THEIR FUNCTIONAL STATUS. THE EFFECT OF YOGIC PRACTICES ON THE CARDIO-AUTONOMIC FUNCTIONS HAS BEEN DEMONSTRATED IN VARIOUS NEUROLOGICAL CONDITIONS AND MAY PROVE BENEFICIAL IN DMD. MATERIALS AND METHODS: IN THIS STUDY, 124 PATIENTS WITH DMD WERE RANDOMIZED TO PT ALONE OR PT WITH YOGA INTERVENTION. HOME-BASED PT AND YOGA WERE ADVISED. ADHERENCE WAS SERIALLY ASSESSED AT A FOLLOW-UP INTERVAL OF 3 MONTHS. ERROR-FREE, ELECTROCARDIOGRAM WAS RECORDED IN ALL PATIENTS AT REST IN THE SUPINE POSITION. HRV PARAMETERS WERE COMPUTED IN TIME AND FREQUENCY DOMAINS. HRV WAS RECORDED AT BASELINE AND AT AN INTERVAL OF 3 MONTHS UP TO 1 YEAR. REPEATED-MEASURES ANOVA WAS USED TO ANALYZE LONGITUDINAL FOLLOW-UP AND LEAST SIGNIFICANT DIFFERENCE FOR POST HOC ANALYSIS AND P < 0.05 WAS CONSIDERED STATISTICALLY SIGNIFICANT. RESULTS: IN OUR STUDY, WITH PT PROTOCOL, STANDARD DEVIATION OF NN, ROOT OF SQUARE MEAN OF SUCCESSIVE NN, TOTAL POWER, LOW FREQUENCY, HIGH-FREQUENCY NORMALIZED UNITS (HFNU), AND SYMPATHOVAGAL BALANCE IMPROVED AT VARYING TIME POINTS AND THE IMPROVEMENT LASTED UP FOR 6-9 MONTHS, WHEREAS PT AND YOGA PROTOCOL SHOWED AN IMPROVEMENT IN HFNU DURING THE LAST 3 MONTHS OF THE STUDY PERIOD AND ALL THE OTHER PARAMETERS WERE STABLE UP TO 1 YEAR. THUS, IT IS EVIDENT THAT BOTH THE GROUPS IMPROVED CARDIAC FUNCTIONS IN DMD. HOWEVER, NO SIGNIFICANT DIFFERENCE WAS NOTED IN THE CHANGES OBSERVED BETWEEN THE GROUPS. CONCLUSION: THE INTENSE PT AND PT WITH YOGA, PARTICULARLY HOME-BASED PROGRAM, IS INDEED BENEFICIAL AS A THERAPEUTIC STRATEGY IN DMD CHILDREN TO MAINTAIN AND/OR TO SUSTAIN HRV IN DMD. 2019 20 1026 34 EFFECTS OF YOGA BREATHING EXERCISES ON PULMONARY FUNCTION IN PATIENTS WITH DUCHENNE MUSCULAR DYSTROPHY: AN EXPLORATORY ANALYSIS. OBJECTIVE: DUCHENNE MUSCULAR DYSTROPHY (DMD) IS THE MOST COMMON FORM OF MUSCULAR DYSTROPHY IN CHILDREN, AND CHILDREN WITH DMD DIE PREMATURELY BECAUSE OF RESPIRATORY FAILURE. WE SOUGHT TO DETERMINE THE EFFICACY AND SAFETY OF YOGA BREATHING EXERCISES, AS WELL AS THE EFFECTS OF THOSE EXERCISES ON RESPIRATORY FUNCTION, IN SUCH CHILDREN. METHODS: THIS WAS A PROSPECTIVE OPEN-LABEL STUDY OF PATIENTS WITH A CONFIRMED DIAGNOSIS OF DMD, RECRUITED FROM AMONG THOSE FOLLOWED AT THE NEUROLOGY OUTPATIENT CLINIC OF A UNIVERSITY HOSPITAL IN THE CITY OF SAO PAULO, BRAZIL. PARTICIPANTS WERE TAUGHT HOW TO PERFORM HATHA YOGA BREATHING EXERCISES AND WERE INSTRUCTED TO PERFORM THE EXERCISES THREE TIMES A DAY FOR 10 MONTHS. RESULTS: OF THE 76 PATIENTS WHO ENTERED THE STUDY, 35 DROPPED OUT AND 15 WERE UNABLE TO PERFORM THE BREATHING EXERCISES, 26 HAVING THEREFORE COMPLETED THE STUDY (MEAN AGE, 9.5 +/- 2.3 YEARS; BODY MASS INDEX, 18.2 +/- 3.8 KG/M(2)). THE YOGA BREATHING EXERCISES RESULTED IN A SIGNIFICANT INCREASE IN FVC (% OF PREDICTED: 82.3 +/- 18.6% AT BASELINE VS. 90.3 +/- 22.5% AT 10 MONTHS LATER; P = 0.02) AND FEV1 (% OF PREDICTED: 83.8 +/- 16.6% AT BASELINE VS. 90.1 +/- 17.4% AT 10 MONTHS LATER; P = 0.04). CONCLUSIONS: YOGA BREATHING EXERCISES CAN IMPROVE PULMONARY FUNCTION IN PATIENTS WITH DMD. 2014