1 2228 74 THE IMPACT OF YOGA ON ATRIAL FIBRILLATION: A REVIEW OF THE YOGA MY HEART STUDY. ATRIAL FIBRILLATION IS A COMMON ARRHYTHMIA AFFECTING THOUSANDS OF INDIVIDUALS WORLDWIDE. IT IS A CONDUCTION DISORDER THAT CAUSES THE HEART TO BEAT IRREGULARLY AND RAPIDLY. THERE ARE A FEW MEDICAL APPROACHES TO MANAGE THIS COSTLY HEALTH CARE BURDEN: ANTIARRHYTHMICS TO MAINTAIN NORMAL SINUS RHYTHM, BETA BLOCKERS TO ACHIEVE RATE CONTROL WHILE ALLOWING ATRIAL FIBRILLATION TO PERSIST, AND ELECTRO-PHYSIOLOGIC INTERVENTION FOR RATE AND RHYTHM CONTROL. THESE TREATMENTS CAN BE COSTLY AND ARE NOT WITHOUT SIDE EFFECTS. YOGA, AN INTERVENTION THAT IS AVAILABLE TO PEOPLE WORLDWIDE, HAS SHOWN SOME PROMISE IN COMBATING THIS WIDESPREAD HEART DISORDER. 2015 2 2338 18 UNIQUE AUTONOMIC RESPONSES TO PAIN IN YOGA PRACTITIONERS. OBJECTIVE: AUTONOMIC NERVOUS SYSTEM ACTIVITY IS ASSOCIATED WITH NEUROBEHAVIORAL ASPECTS OF PAIN. YOGIS USE BREATHING, RELAXATION, AND MINDFULNESS TO TOLERATE PAIN, WHICH COULD INFLUENCE AUTONOMIC RESPONSES. TO EVALUATE HOW THE LINK BETWEEN AUTONOMIC RESPONSES AND PAIN IS ALTERED BY OTHER FACTORS, WE COMPARED PERCEPTUAL AND AUTONOMIC RESPONSES TO PAIN BETWEEN YOGIS AND CONTROLS. METHODS: NINETEEN YOGIS AND 15 CONTROLS RATED WARM AND PAINFULLY HOT STIMULI (1-CM THERMODE ON CALF), WITH VISUAL ANTICIPATORY CUES INDICATING CERTAINLY PAINFUL, CERTAINLY NONPAINFUL, OR UNCERTAINLY EITHER PAINFUL OR NONPAINFUL. HEART RATE, SKIN CONDUCTANCE, RESPIRATION, AND BLOOD PRESSURE WERE MEASURED. RESULTS: AT BASELINE, YOGIS BREATHED SLOWER AND DEEPER THAN DID CONTROLS, WITH NO DIFFERENCES IN OTHER AUTONOMIC MEASURES. DURING THE TASK, PERCEPTUAL RATINGS DID NOT DIFFER BETWEEN GROUPS IN EITHER THE CERTAIN OR UNCERTAIN CONDITIONS. NEVERTHELESS, YOGIS HAD HIGHER PHASIC SKIN CONDUCTANCE RESPONSES IN ANTICIPATION OF AND RESPONSE TO ALL STIMULI, BUT PARTICULARLY DURING PAINFUL HEAT IN UNCERTAIN CONTEXTS (UNCERTAIN: 0.46 [0.34] MUS; CERTAIN: 0.37 [0.28] MUS; T(18) = 3.962, P = .001). FURTHERMORE, CONTROLS SHOWED A DECREASE IN HEART RATE TO WARM (-2.51 [2.17] BEATS/MIN) VERSUS PAINFUL STIMULI (0.83 [1.63] BEATS/MIN; T(13) = 5.212, P < .001) AND LOWER RESPIRATORY SINUS ARRHYTHMIA DURING PAIN COMPARED WITH WARM TRIALS, WHEREAS YOGIS HAD SIMILAR REACTIONS TO PAINFUL AND NONPAINFUL STIMULI. CONCLUSIONS: AUTONOMIC RESPONSES TO PAIN DIFFERED IN YOGIS AND HEALTHY VOLUNTEERS, DESPITE SIMILAR PAIN RATINGS. THUS, AUTONOMIC REACTIVITY TO PAIN MAY BE ALTERED BY ENVIRONMENTAL AND PSYCHOLOGICAL FACTORS THROUGHOUT AN INDIVIDUAL'S LIFE. 2018 3 205 23 A REVIEW ON ROLE OF YOGA IN THE MANAGEMENT OF PATIENTS WITH CARDIAC ARRHYTHMIAS. EVIDENCE SUGGESTS THAT YOGA IS SAFE AND EFFECTIVE IN IMPROVING VARIOUS RISK FACTORS, QUALITY OF LIFE (QOL), AND PSYCHOLOGICAL BURDEN THAT IS RELATED TO ARRHYTHMIA. HOWEVER, THIS IS THE FIRST-EVER SYSTEMATIC REVIEW PERFORMED TO REPORT THE ROLE OF YOGA IN ARRHYTHMIA. WE HAVE PERFORMED A LITERATURE SEARCH USING COCHRANE LIBRARY, MEDLINE/PUBMED, WEB OF SCIENCE CORE COLLECTION, AND INDMED ELECTRONIC DATABASES UP TO 3, JANUARY 2018. OF 240 ARTICLES, 6 POTENTIALLY ELIGIBLE ARTICLES WERE IDENTIFIED AND INCLUDED IN THE REVIEW. RESULTS SHOWED THAT YOGA COULD BE CONSIDERED AN EFFICIENT ADJUVANT IN REDUCING ARRHYTHMIA (PAROXYSMAL ATRIAL FIBRILLATION, VENTRICULAR TACHYARRHYTHMIA, AND PALPITATION) RELATED HEALTH PROBLEMS; BLOOD PRESSURE, HEART RATE, DEPRESSION AND ANXIETY SCORES; AND IN IMPROVING HEALTH-RELATED QOL OF ARRHYTHMIA PATIENTS. HOWEVER, THERE IS A LACK OF RANDOMIZED CONTROLLED TRIALS AND A CLEAR MECHANISM BEHIND THE EFFECT OF YOGA; STUDIES HAD RELATIVELY A SMALL SAMPLE SIZE AND DIFFERENT YOGA PROTOCOLS. 2021 4 350 26 ASSESSMENT OF CARDIAC AUTONOMIC TONE FOLLOWING LONG SUDARSHAN KRIYA YOGA IN ART OF LIVING PRACTITIONERS. OBJECTIVE: THE BREATHING PROCESSES ARE KNOWN TO MODULATE CARDIAC AUTONOMIC TONE AND IMPROVE PSYCHOLOGICAL STATUS. WE INVESTIGATED CARDIAC AUTONOMIC TONE FOLLOWING LONG SUDARSHAN KRIYA YOGA (SKY) USING HEART RATE VARIABILITY (HRV) AND SKIN CONDUCTANCE LEVEL (SCL). METHODS: THIRTY HEALTHY VOLUNTEERS (AGE 28.3 +/- 8.4 YEARS; 23 M: 7 F) PARTICIPATED IN THE STUDY. ELECTROCARDIOGRAM (ECG) AND SCL WERE RECORDED FOR 5 MIN EACH, BEFORE AND AFTER LONG SKY. LONG SKY IS A COMBINATION OF PRANAYAMA AND CYCLIC RHYTHMIC BREATHING AND IS PERFORMED BY FOLLOWING THE GUIDED AUDIO INSTRUCTIONS. HRV ANALYSIS WAS USED FOR THE ASSESSMENT OF CARDIAC AUTONOMIC TONE. TIME AND FREQUENCY DOMAIN PARAMETERS OF HRV WERE CALCULATED BY USING RR INTERVAL OF ECG. SCL WAS ACQUIRED USING GALVANIC SKIN RESPONSE (GSR) AMPLIFIER OF POWERLAB IN MICROSEIMENS (MUS). RESULTS: TIME DOMAIN PARAMETERS OF HRV, INCLUDING MEAN RR INTERVAL (P = 0.000), RESPIRATORY SINUS ARRHYTHMIA (RSA) (P = 0.037), STANDARD DEVIATION OF ALL NN INTERVALS (SDNN) (P = 0.013), NN50 COUNT DIVIDED BY THE TOTAL NUMBER OF ALL NN INTERVALS (PNN50) (P = 0.004), AND SQUARE ROOT OF THE MEAN OF THE SUM OF THE SQUARES OF DIFFERENCES BETWEEN ADJACENT NN INTERVALS (RMSSD) (P = 0.002) INCREASED, AND MEAN HEART RATE DECREASED (P = 0.000) FOLLOWING LONG SKY. IN FREQUENCY DOMAIN ANALYSIS, POWER OF LOW-FREQUENCY (LF) COMPONENT (P = 0.010) AND LF/HF RATIO (P = 0.008) DECREASED SIGNIFICANTLY, WHEREAS POWER OF HIGH FREQUENCY (HF) SIGNIFICANTLY INCREASED (P = 0.010). SCL DECREASED FOLLOWING LONG SKY, ALTHOUGH IT DID NOT ATTAIN STATISTICAL SIGNIFICANCE. CONCLUSIONS: THE RESULTS SUGGEST THAT LONG SKY INDUCES SIGNIFICANT OSCILLATIONS IN CARDIAC AUTONOMIC TONE. PARASYMPATHETIC ACTIVITY INCREASES AND SYMPATHETIC ACTIVITY DECREASES AND SYMPATHOVAGAL BALANCE IMPROVES FOLLOWING LONG SKY. DECREASE IN SYMPATHETIC ACTIVITY IS ALSO DEMONSTRATED BY DECREASE IN CONDUCTANCE ALTHOUGH IT DID NOT REACH STATISTICAL SIGNIFICANCE. FROM THIS STUDY IT CAN BE CONCLUDED THAT LONG SKY HAS A BENEFICIAL EFFECT ON CARDIAC AUTONOMIC TONE, AND PSYCHOPHYSIOLOGICAL RELAXATION. IT MAY SERVE AS A TOOL TO IMPROVE HRV, WHICH IS THE MARKER OF CARDIOVASCULAR HEALTH. 2017 5 1319 21 HEART RATE VARIABILITY, FLOW, MOOD AND MENTAL STRESS DURING YOGA PRACTICES IN YOGA PRACTITIONERS, NON-YOGA PRACTITIONERS AND PEOPLE WITH METABOLIC SYNDROME. HEART RATE VARIABILITY (HRV) AND RESPIRATORY SINUS ARRHYTHMIA ARE DIRECTLY ASSOCIATED WITH AUTONOMIC FLEXIBILITY, SELF-REGULATION AND WELL-BEING, AND INVERSELY ASSOCIATED WITH PHYSIOLOGICAL STRESS, PSYCHOLOGICAL STRESS AND PATHOLOGY. YOGA ENHANCES AUTONOMIC ACTIVITY, MITIGATES STRESS AND BENEFITS STRESS-RELATED CLINICAL CONDITIONS, YET THE RELATIONSHIP BETWEEN AUTONOMIC ACTIVITY AND PSYCHOPHYSIOLOGICAL RESPONSES DURING YOGA PRACTICES AND STRESSFUL STIMULI HAS NOT BEEN WIDELY EXPLORED. THIS EXPERIMENTAL STUDY EXPLORED THE RELATIONSHIP BETWEEN HRV, MOOD STATES AND FLOW EXPERIENCES IN REGULAR YOGA PRACTITIONERS (YP), NON-YOGA PRACTITIONERS (NY) AND PEOPLE WITH METABOLIC SYNDROME (METS), DURING MENTAL ARITHMETIC STRESS TEST (MAST) AND VARIOUS YOGA PRACTICES. THE STUDY FOUND THAT THE MAST PLACED A CARDIO-AUTONOMIC BURDEN IN ALL PARTICIPANTS WITH THE YP GROUP SHOWING THE GREATEST REACTIVITY AND THE MOST RAPID RECOVERY, WHILE THE METS GROUP HAD SIGNIFICANTLY BLUNTED RECOVERY. THE YP GROUP ALSO REPORTED A HEIGHTENED EXPERIENCE OF FLOW AND POSITIVE MOOD STATES COMPARED TO NY AND METS GROUPS AS WELL AS HAVING A HIGHER VAGAL TONE DURING ALL RESTING CONDITIONS. THESE RESULTS SUGGEST YOGA PRACTITIONERS HAVE A GREATER HOMEOSTATIC CAPACITY AND AUTONOMIC, METABOLIC AND PHYSIOLOGICAL RESILIENCE. FURTHER STUDIES ARE NOW NEEDED TO DETERMINE IF REGULAR YOGA PRACTICE MAY IMPROVE AUTONOMIC FLEXIBILITY IN NON-YOGA PRACTITIONERS AND METABOLIC SYNDROME PATIENTS. CLINICAL TRIAL NO 'ACTRN 2614001075673'. 2016 6 1403 20 IMPACT OF YOGA ON CARDIAC AUTONOMIC FUNCTION AND ARRHYTHMIAS. WITH THE EXPANDING INTEGRATION OF COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) PRACTICES IN CONJUNCTION WITH MODERN MEDICINE, YOGA HAS QUICKLY RISEN TO BEING ONE OF THE MOST COMMON CAM PRACTICES ACROSS THE WORLD. DESPITE WIDESPREAD USE OF YOGA, LIMITED STUDIES ARE AVAILABLE, PARTICULARLY IN THE SETTING OF DYSRHYTHMIA. PRELIMINARY STUDIES DEMONSTRATE PROMISING RESULTS FROM INTEGRATION OF YOGA AS AN ADJUNCT TO MEDICAL THERAPY FOR MANAGEMENT OF DYSRHYTHMIAS. IN THIS REVIEW, WE DISCUSS THE ROLE OF AUTONOMIC NERVOUS SYSTEM IN CARDIAC ARRHYTHMIA,INTERACTION OF YOGA WITH AUTONOMIC TONE AND ITS SUBSEQUENT IMPACT ON THESE DISEASE STATES. THE ROLE OF YOGA IN SPECIFIC DISEASE STATES, AND POTENTIAL FUTURE DIRECTION FOR STUDIES ASSESSING THE ROLE OF YOGA IN DYSRHYTHMIA. 2020 7 807 23 EFFECT OF YOGA ON ARRHYTHMIA BURDEN, ANXIETY, DEPRESSION, AND QUALITY OF LIFE IN PAROXYSMAL ATRIAL FIBRILLATION: THE YOGA MY HEART STUDY. OBJECTIVES: THE PURPOSE OF THIS STUDY WAS TO EXAMINE THE IMPACT OF YOGA ON ATRIAL FIBRILLATION (AF) BURDEN, QUALITY OF LIFE (QOL), DEPRESSION, AND ANXIETY SCORES. BACKGROUND: YOGA IS KNOWN TO HAVE SIGNIFICANT BENEFIT ON CARDIOVASCULAR HEALTH. THE EFFECT OF YOGA IN REDUCING AF BURDEN IS UNKNOWN. METHODS: THIS SINGLE-CENTER, PRE-POST STUDY ENROLLED PATIENTS WITH SYMPTOMATIC PAROXYSMAL AF WITH AN INITIAL 3-MONTH NONINTERVENTIONAL OBSERVATION PERIOD FOLLOWED BY TWICE-WEEKLY 60-MIN YOGA TRAINING FOR NEXT 3 MONTHS. AF EPISODES DURING THE CONTROL AND STUDY PERIODS AS WELL AS SF-36, ZUNG SELF-RATED ANXIETY, AND ZUNG SELF-RATED DEPRESSION SCORES AT BASELINE, BEFORE, AND AFTER THE STUDY PHASE WERE ASSESSED. RESULTS: YOGA TRAINING REDUCED SYMPTOMATIC AF EPISODES (3.8 +/- 3 VS. 2.1 +/- 2.6, P < 0.001), SYMPTOMATIC NON-AF EPISODES (2.9 +/- 3.4 VS. 1.4 +/- 2.0; P < 0.001), ASYMPTOMATIC AF EPISODES (0.12 +/- 0.44 VS. 0.04 +/- 0.20; P < 0.001), AND DEPRESSION AND ANXIETY (P < 0.001), AND IMPROVED THE QOL PARAMETERS OF PHYSICAL FUNCTIONING, GENERAL HEALTH, VITALITY, SOCIAL FUNCTIONING, AND MENTAL HEALTH DOMAINS ON SF-36 (P = 0.017, P < 0.001, P < 0.001, P = 0.019, AND P < 0.001, RESPECTIVELY). THERE WAS SIGNIFICANT DECREASE IN HEART RATE, AND SYSTOLIC AND DIASTOLIC BLOOD PRESSURE BEFORE AND AFTER YOGA (P < 0.001). CONCLUSIONS: IN PATIENTS WITH PAROXYSMAL AF, YOGA IMPROVES SYMPTOMS, ARRHYTHMIA BURDEN, HEART RATE, BLOOD PRESSURE, ANXIETY AND DEPRESSION SCORES, AND SEVERAL DOMAINS OF QOL. 2013 8 370 20 AUTONOMIC TONE AND BAROREFLEX SENSITIVITY DURING 70 DEGREES HEAD-UP TILT IN YOGA PRACTITIONERS. INTRODUCTION: THE INTERVENTION OF YOGA WAS SHOWN TO IMPROVE THE AUTONOMIC CONDITIONING IN HUMANS EVIDENT FROM THE ENHANCEMENT OF PARASYMPATHETIC ACTIVITY AND BAROREFLEX SENSITIVITY (BRS). FROM THE DOCUMENTED HEALTH BENEFITS OF YOGA, WE HYPOTHESIZED THAT THE EXPERIENCE OF YOGA MAY RESULT IN ADAPTATION TO THE ORTHOSTATIC STRESS DUE TO ENHANCED BRS. AIM: TO DECIPHER THE EFFECTS OF YOGA IN THE MODULATION OF AUTONOMIC FUNCTION DURING ORTHOSTATIC CHALLENGE. MATERIALS AND METHODS: THIS WAS A COMPARATIVE STUDY DESIGN CONDUCTED IN AUTONOMIC FUNCTION TEST LAB, OF THE DEPARTMENT OF PHYSIOLOGY, ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI, INDIA. HEART RATE VARIABILITY (HRV), BLOOD PRESSURE VARIABILITY, AND BRS WERE ANALYZED ON FORTY NAIVE TO YOGA (NY) SUBJECTS AND FORTY YOGA PRACTITIONERS WITH AN AVERAGE AGE OF 31.08 +/- 7.31 YEARS AND 29.93 +/- 7.57 YEARS, RESPECTIVELY. ALL PARTICIPANTS WERE HEALTHY. SEVENTY DEGREES HEAD UP TILT (HUT) WAS USED AS AN INTERVENTION TO EVALUATE THE CARDIOVASCULAR VARIABILITY DURING ORTHOSTATIC CHALLENGE. RESULTS: DURING HUT, THE R-R INTERVAL (P = 0.042), ROOT MEAN SQUARE OF SUCCESIVE R-R INTERVAL DIFFERENCES (RMSSD) (P = 0.039), STANDARD DEVIATION OF INSTANTANEOUS BEAT-TO-BEAT R-R INTERVAL VARIABILITY (SD1) (P = 0.039) OF HRV, AND SEQUENCE BRS (P = 0.017) AND ALPHA LOW FREQUENCY OF SPECTRAL BRS (P = 0.002) WERE HIGHER IN THE YOGA GROUP. THE DELTA DECREASE IN RRI (P = 0.033) AND BRS (P < 0.01) WAS HIGHER IN THE YOGA GROUP THAN THE NY GROUP. CONCLUSION: THE EFFERENT VAGAL ACTIVITY AND BRS WERE HIGHER IN YOGA PRACTITIONERS. THE DELTA CHANGE (DECREASE) IN PARASYMPATHETIC ACTIVITY AND BRS WAS HIGHER, WITH RELATIVELY STABLE SYSTOLIC BLOOD PRESSURE INDICATING AN ADAPTIVE RESPONSE TO ORTHOSTATIC CHALLENGE BY THE YOGA PRACTITIONERS COMPARED TO THE NY GROUP. 2020 9 1941 26 SAFETY AND EFFICACY OF AYURVEDIC INTERVENTIONS AND YOGA ON LONG TERM EFFECTS OF COVID-19: A STRUCTURED SUMMARY OF A STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: PRIMARY OBJECTIVE * TO ASSESS THE EFFICACY OF AYURVEDA INTERVENTIONS AND YOGA IN REHABILITATION OF COVID-19 CASES SUFFERING WITH LONG TERM EFFECTS OF COVID 19 AS COMPARED TO WHO REHABILITATION SELF-MANAGEMENT AFTER COVID-19- RELATED ILLNESS. SECONDARY OBJECTIVE * TO ASSESS THE SAFETY OF AYURVEDIC INTERVENTIONS IN CASES SUFFERING WITH LONG TERM EFFECTS OF COVID 19 TRIAL DESIGN: MULTI-CENTRIC, RANDOMIZED, CONTROLLED, PARALLEL GROUP, OPEN-LABEL, EXPLORATORY STUDY. THE STUDY DURATION IS 9 MONTHS AND THE INTERVENTION PERIOD IS 90 DAYS FROM THE DAY OF ENROLMENT OF THE PARTICIPANT. PARTICIPANTS: PATIENTS OF EITHER SEX BETWEEN 18 TO 60 YEARS, AMBULATORY, WILLING TO PARTICIPATE, WITH HISTORY (NOT MORE THAN 4 WEEKS) OF POSITIVE RT-PCR FOR COVID-19 OR IGM ANTIBODIES POSITIVITY FOR SARS COV-2, BUT HAVING NEGATIVE RT-PCR FOR COVID-19 AT THE TIME OF SCREENING WILL BE CONSIDERED ELIGIBLE FOR ENROLMENT IN THE STUDY. CRITICALLY ILL PATIENTS WITH ARDS (ACUTE RESPIRATORY DISTRESS SYNDROME), REQUIRING INVASIVE RESPIRATORY SUPPORT IN THE INTENSIVE CARE UNIT, KNOWN CASE OF ANY MALIGNANCY, IMMUNE-COMPROMISED STATE (E.G. HIV), DIABETES MELLITUS, ACTIVE PULMONARY TUBERCULOSIS, PAST HISTORY OF ANY CHRONIC RESPIRATORY DISEASE, MOTOR NEURON DISEASE, MULTIPLE SCLEROSIS, STROKE, IMPAIRED COGNITION, ATRIAL FIBRILLATION, ACUTE CORONARY SYNDROME, MYOCARDIAL INFARCTION, SEVERE ARRHYTHMIA, CONCURRENT SERIOUS HEPATIC DISEASE OR RENAL DISEASE, PREGNANT OR LACTATING WOMEN, PATIENTS ON IMMUNOSUPPRESSIVE MEDICATIONS, HISTORY OF HYPERSENSITIVITY TO THE TRIAL DRUGS OR THEIR INGREDIENTS, DEPRESSIVE ILLNESS (BEFORE COVID-19), DIAGNOSED PSYCHOTIC ILLNESSES, SUBSTANCE DEPENDENCE OR ALCOHOLISM WILL BE EXCLUDED. THE TRIAL WILL BE CONDUCTED AT TWO MEDICAL COLLEGES IN MAHARASHTRA, INDIA. INTERVENTION AND COMPARATOR: INTERVENTION ARM (GROUP-I): AYURVEDA INTERVENTIONS INCLUDING AGASTYA HARITAKI SIX GRAM AND ASHWAGANDHA TABLET 500 MG TWICE DAILY ORALLY AFTER MEALS WITH WARM WATER AND TWO SESSIONS OF YOGA (MORNING 30 MINUTES AND EVENING 15 MINUTES) DAILY FOR 90 DAYS, AS PER THE POST-COVID-19 CARE PROTOCOL PROVIDED IN NATIONAL CLINICAL MANAGEMENT PROTOCOL BASED ON AYURVEDA AND YOGA FOR MANAGEMENT OF COVID-19 PUBLISHED BY MINISTRY OF AYUSH, GOVERNMENT OF INDIA. COMPARATOR ARM (GROUP-II): WHO REHABILITATION SELF-MANAGEMENT AFTER COVID-19 RELATED ILLNESS FOR 90 DAYS. THE TRIAL DRUGS ARE BEING PROCURED FROM A GMP CERTIFIED PHARMACEUTICAL COMPANY. MAIN OUTCOMES: PRIMARY OUTCOME: CHANGE IN RESPIRATORY FUNCTION TO BE ASSESSED BY SAN DIEGO SHORTNESS OF BREATH QUESTIONNAIRE, 6-MINUTES WALK TEST AND PULMONARY FUNCTION TEST. SECONDARY OUTCOMES: CHANGE IN HIGH-RESOLUTION COMPUTED TOMOGRAPHY (HRCT) CHEST CHANGE IN FATIGUE SCORE ASSESSED BY MODIFIED FATIGUE IMPACT SCALE CHANGE IN ANXIETY SCORE ASSESSED BY HOSPITAL ANXIETY AND DEPRESSION SCALE SCORE CHANGE IN SLEEP QUALITY ASSESSED BY PITTSBURGH SLEEP QUALITY INDEX CHANGE IN THE QUALITY OF LIFE ASSESSED BY COV19-QOL SCALE SAFETY OF THE INTERVENTIONS WILL BE ASSESSED BY COMPARING HEMATOLOGICAL AND BIOCHEMICAL INVESTIGATIONS BEFORE AND AFTER THE INTERVENTION PERIOD AND ADVERSE EVENT/ ADVERSE DRUG REACTION TIMELINES FOR OUTCOME ASSESSMENT: SUBJECTIVE PARAMETERS AND CLINICAL ASSESSMENT WILL BE ASSESSED AT BASELINE, 15(TH) DAY, 30(TH) DAY, 60(TH) DAY AND 90(TH) DAY. LABORATORY PARAMETERS (CBC, LFT, KFT, HBA1C, HS-CRP, D-DIMER), PULMONARY FUNCTION TEST AND HRCT CHEST WILL BE DONE AT BASELINE AND AFTER COMPLETION OF STUDY PERIOD I.E. 90(TH) DAY. RANDOMISATION: STATISTICAL PACKAGE FOR SOCIAL SCIENCES (SPSS) VERSION 15.0 IS USED TO GENERATE THE RANDOM NUMBER SEQUENCES. THE PARTICIPANTS WILL BE RANDOMIZED TO TWO STUDY GROUPS IN THE RATIO OF 1:1. BLINDING (MASKING): THE STUDY IS OPEN-LABEL DESIGN. HOWEVER, THE OUTCOME ASSESSOR WILL BE KEPT BLINDED REGARDING THE STUDY GROUP ALLOCATION OF THE PARTICIPANTS. NUMBERS TO BE RANDOMISED (SAMPLE SIZE) SAMPLE SIZE: THE SAMPLE SIZE FOR THE STUDY IS CALCULATED ASSUMING IMPROVEMENT IN 6-MINUTES WALK TEST BY 40 METER IN GROUP I AND A CHANGE OF 10 METER IN GROUP II WITH A STANDARD DEVIATION OF 50 METER BASED ON THE RESULTS OF THE PREVIOUS STUDIES, WITH 95% CONFIDENCE LEVEL (ALPHA = 0.05) AND 80% POWER AND EXPECTING A DROPOUT RATE OF 20%. THE NUMBER OF PARTICIPANTS TO BE ENROLLED IN THE STUDY SHOULD BE APPROXIMATELY 55 IN EACH GROUP. HENCE, A TOTAL OF 110 PARTICIPANTS WILL BE ENROLLED IN THE TRIAL AT EACH STUDY SITE. TRIAL STATUS: PARTICIPANTS' RECRUITMENT STARTED ON 1(ST) MAY 2021. ANTICIPATED END OF RECRUITMENT IS AUGUST 2021. PROTOCOL NUMBER: CCRAS-01 PROTOCOL VERSION NUMBER: 1.1, 13TH JANUARY 2021. TRIAL REGISTRATION: THE TRIAL IS PROSPECTIVELY REGISTERED WITH THE CLINICAL TRIAL REGISTRY OF INDIA (CTRI) ON 03(RD) MARCH 2021 [ CTRI/2021/03/031686 ]. FULL PROTOCOL: THE FULL PROTOCOL IS ATTACHED AS AN ADDITIONAL FILE, ACCESSIBLE FROM THE JOURNAL WEBSITE (ADDITIONAL FILE 1). THIS COMMUNICATION SERVES AS A SUMMARY OF THE KEY ELEMENTS OF THE FULL PROTOCOL. 2021 10 758 18 EFFECT OF SLOW BREATHING ON AUTONOMIC TONE & BAROREFLEX SENSITIVITY IN YOGA PRACTITIONERS. BACKGROUND & OBJECTIVES: SLOW BREATHING INCREASES PARASYMPATHETIC ACTIVITY AND BAROREFLEX SENSITIVITY (BRS) IN HEALTHY INDIVIDUALS, ALSO SIMILARLY OBSERVED IN YOGA PRACTITIONERS. PRANAYAMA WHICH IS AN IMPORTANT COMPONENT OF YOGA WHEN PRACTICED AT A SLOW PACE WAS AT A RESPIRATORY FREQUENCY OF AROUND 0.1 HZ (6 BREATHS/MIN). THEREFORE, IT WAS HYPOTHESIZED THAT YOGA PRACTITIONERS MIGHT HAVE ADAPTED TO SLOW BREATHING. THIS STUDY WAS AIMED TO DECIPHER THE ROLE OF YOGA ON CARDIOVASCULAR VARIABILITY DURING SLOW BREATHING (0.1 HZ) IN YOGA PRACTITIONERS. METHODS: A CROSS-SECTIONAL STUDY WAS UNDERTAKEN IN NAIVE-TO-YOGA INDIVIDUALS (N=40) AND YOGA PRACTITIONERS (N=40) WITH AN AVERAGE AGE OF 31.08 +/- 7.31 AND 29.93 +/- 7.57 YR, RESPECTIVELY. THE ANALYSIS OF HEART RATE VARIABILITY, BLOOD PRESSURE VARIABILITY (BPV) AND BRS DURING SPONTANEOUS AND SLOW BREATHING WAS COMPARED BETWEEN THE TWO GROUPS. RESULTS: DURING SLOW BREATHING, THE HEART RATE (P<0.01) WAS LOWER, RESPIRATORY RATE INTERVAL (P<0.05) AND PNN50 PER CENT (P=0.01) WERE HIGHER, MEAN SYSTOLIC BP (SBP) (P<0.05) AND SDSD (STANDARD DEVIATION OF SUCCESSIVE BEAT TO BEAT SYSTOLIC BLOOD PRESSURE DIFFERENCES) (P<0.01) OF SBP VARIABILITY WERE LOWER WITH SEQUENCE BRS (P<0.001) AND ALPHA LOW FREQUENCY (P<0.01) AND ALPHA HIGH FREQUENCY (P<0.001) OF SPECTRAL BRS WERE HIGHER IN YOGA PRACTITIONERS. INTERPRETATION & CONCLUSIONS: THE PRESENT STUDY INDICATED HIGHER PARASYMPATHETIC ACTIVITY AND BRS WITH LOWER SBP VARIABILITY AT REST AND DURING SLOW BREATHING IN YOGA PRACTITIONERS COMPARED TO NAIVE GROUP. FINDINGS INDICATE THAT THE SHORT-TERM PRACTICE OF SLOW BREATHING COMPLEMENTS THE AUGMENTED PARASYMPATHETIC ACTIVITY AND BRS IN THE YOGA GROUP. 2020 11 2759 20 YOGA PRACTITIONERS EXHIBIT HIGHER PARASYMPATHETIC ACTIVITY AND BAROREFLEX SENSITIVITY AND BETTER ADAPTABILITY TO 40 MM HG LOWER-BODY NEGATIVE PRESSURE. YOGA HAS BEEN SHOWN TO IMPROVE AUTONOMIC CONDITIONING IN HUMANS, AS EVIDENCED BY THE ENHANCEMENT OF PARASYM-PATHETIC ACTIVITY AND BAROREFLEX SENSITIVITY. THEREFORE, WE HYPOTHESIZED THAT THE EXPERIENCE OF YOGA MAY RESULT IN ADAPTATION TO ACUTE HEMODYNAMIC CHANGES. TO DECIPHER THE LONG-TERM EFFECTS OF YOGA ON CARDIOVASCULAR VARIABILITY, YOGA PRACTITIONERS WERE COMPARED TO YOGA-NAIVE SUBJECTS DURING EXPOSURE TO -40 MM HG LOWER-BODY NEGATIVE PRESSURE (LBNP). A COMPARATIVE STUDY WAS CONDUCTED ON 40 YOGANAIVE SUBJECTS AND 40 YOGA PRACTITIONERS WITH AN AVERAGE AGE OF 31.08 +/- 7.31 YEARS AND 29.93 +/- 7.57 YEARS, RESPECTIVELY. HEART RATE VARIABILITY, BLOOD PRESSURE VARIABILITY, BAROREFLEX SENSITIVITY, AND CORRELATION BETWEEN SYSTOLIC BLOOD PRESSURE AND RR INTERVAL WERE EVALUATED AT REST AND DURING LBNP. IN YOGA PRACTITIONERS, THE HEART RATE WAS LOWER IN SUPINE REST (P = 0.011) AND DURING LBNP (P = 0.043); THE PNN50 MEASURE OF HEART RATE VARIABILITY WAS HIGHER IN SUPINE REST (P = 0.011) AND DURING LBNP (P = 0.034). THE YOGA PRACTITIONERS' STANDARD DEVIATION OF SUCCESSIVE BEAT-TO-BEAT BLOOD PRESSURE INTERVALS OF SYSTOLIC BLOOD PRESSURE VARIABILITY WAS LOWER IN SUPINE REST (P = 0.034) AND DURING LBNP (P = 0.007), WITH HIGHER SEQUENCE BAROREFLEX SENSITIVITY (P = 0.019) AND ~ HIGH-FREQUENCY BAROREFLEX SENSITIVITY. MEAN SYSTOLIC BLOOD PRESSURE AND RR INTERVAL WERE INVERSELY CORRELATED IN THE YOGA GROUP (R = -0.317, P = 0.049). THE YOGA PRACTITIONERS EXHIBITED HIGHER PARASYMPATHETIC ACTIVITY AND BAROREFLEX SENSITIVITY WITH LOWER SYSTOLIC BLOOD PRESSURE VARIABILITY, INDICATING BETTER ADAPTABILITY TO LBNP COMPARED TO THE YOGA-NAIVE GROUP. OUR FINDINGS INDICATE THAT THE YOGA MODULE WAS HELPFUL IN CONDITIONS OF HYPOVOLEMIA IN HEALTHY SUBJECTS; IT IS PROPOSED TO BE BENEFICIAL IN CLINICAL CONDITIONS ASSOCIATED WITH SYMPATHETIC DOMINANCE, IMPAIRED BARORE-FLEX SENSITIVITY, AND ORTHOSTATIC INTOLERANCE. 2021 12 1578 18 MEASUREMENT OF THE EFFECT OF ISHA YOGA ON CARDIAC AUTONOMIC NERVOUS SYSTEM USING SHORT-TERM HEART RATE VARIABILITY. BACKGROUND: BENEFICIAL EFFECTS OF YOGA HAVE BEEN POSTULATED TO BE DUE TO MODULATION OF THE AUTONOMIC NERVOUS SYSTEM. OBJECTIVE: TO ASSESS THE EFFECT OF ISHA YOGA PRACTICES ON CARDIOVASCULAR AUTONOMIC NERVOUS SYSTEM THROUGH SHORT-TERM HEART RATE VARIABILITY (HRV). DESIGN OF THE STUDY: SHORT-TERM HRV OF LONG-TERM REGULAR HEALTHY 14 (12 MALES AND 2 FEMALES) ISHA YOGA PRACTITIONERS WAS COMPARED WITH THAT OF AGE- AND GENDER-MATCHED 14 (12 MALES AND 2 FEMALES) NON-YOGA PRACTITIONERS. METHODS AND MATERIALS: ECG LEAD II AND RESPIRATORY MOVEMENTS WERE RECORDED IN BOTH GROUPS USING POLYRITE DURING SUPINE REST FOR 5 MIN AND CONTROLLED DEEP BREATHING FOR 1 MINUTE. FREQUENCY DOMAIN ANALYSIS [RR INTERVAL IS THE MEAN OF DISTANCE BETWEEN SUBSEQUENT R WAVE PEAKS IN ECG], LOW FREQUENCY (LF) POWER, HIGH FREQUENCY (HF) POWER, LF NORMALIZED UNITS (NU), HF NU, LF/HF RATIO] AND TIME DOMAIN ANALYSIS [STANDARD DEVIATION OF NORMAL TO NORMAL INTERVAL (SDNN), SQUARE OF MEAN SQUARED DIFFERENCE OF SUCCESSIVE NORMAL TO NORMAL INTERVALS (RMSSD), NORMAL TO NORMAL INTERVALS WHICH ARE DIFFERING BY 50 MS (NN50), AND PERCENTAGE OF NN50 (PNN50)] OF HRV VARIABLES WERE ANALYZED FOR SUPINE REST. TIME DOMAIN ANALYSIS WAS RECORDED FOR DEEP BREATHING. RESULTS: RESULTS SHOWED STATISTICALLY SIGNIFICANT DIFFERENCES BETWEEN ISHA YOGA PRACTITIONERS AND CONTROLS IN BOTH FREQUENCY AND TIME DOMAIN ANALYSES OF HRV INDICES, WITH NO DIFFERENCE IN RESTING HEART RATE BETWEEN THE GROUPS. CONCLUSIONS: PRACTITIONERS OF ISHA YOGA SHOWED WELL-BALANCED BENEFICIAL ACTIVITY OF VAGAL EFFERENTS, AN OVERALL INCREASED HRV, AND SYMPATHOVAGAL BALANCE, COMPARED TO NON-YOGA PRACTITIONERS DURING SUPINE REST AND DEEP BREATHING. 2012 13 2065 27 THE CARDIOVASCULAR VARIABILITY DURING TRANSIENT 6 DEGREES HEAD DOWN TILT AND SLOW BREATHING IN YOGA EXPERIENCED HEALTHY INDIVIDUALS. OBJECTIVE: THE INTERVENTION OF YOGA HAS BEEN SHOWN TO IMPROVE AUTONOMIC CONDITIONING IN HUMANS AND BETTER ADAPTABILITY TO ORTHOSTATIC CHALLENGES. SIMILARLY, SLOW BREATHING AT 0.1 HZ AKIN TO PRANAYAMA ALSO INCREASES BAROREFLEX SENSITIVITY (BRS). HENCE, WE INTENDED TO INVESTIGATE WHETHER YOGA PRACTITIONERS HAVE DIFFERENT AUTONOMIC RESPONSES AT REST,DURING SLOW DEEP BREATHINGAS WELL AS DURING 6 DEGREES HEAD DOWN TILT (HDT) COMPARED TO NAIVE GROUP INDIVIDUALS. AIM: THE AIM OF THE STUDY WAS TO EVALUATE THE ACUTE EFFECTS OF SLOW BREATHING ON CARDIOVASCULAR VARIABILITY DURING HDT IN YOGA PRACTITIONERS COMPARED TO YOGA-NAIVE INDIVIDUALS. SETTINGS AND DESIGN: THIS WAS A COMPARATIVE STUDY WITH REPEATED MEASURES DESIGN CONDUCTED IN AUTONOMIC FUNCTION TEST LAB OF THE DEPARTMENT OF PHYSIOLOGY, ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI, INDIA. MATERIALS AND METHODS: TIME DOMAIN AND FREQUENCY DOMAIN PARAMETERS OF HEART RATE VARIABILITY, BLOOD PRESSURE VARIABILITY (BPV), AND BRS WERE EVALUATED DURING 6 DEGREES HDT AND SLOW BREATHING AT 0.1 HZ ON FORTY YOGA-NAIVE INDIVIDUALS AND FORTY YOGA PRACTITIONERS WITH AN AVERAGE AGE OF 31.08 +/- 7.31 YEARS AND 29.93 +/- 7.57 YEARS, RESPECTIVELY. ALL OF THE PARTICIPANTS WERE HEALTHY. STATISTICAL ANALYSIS USED: GENERAL LINEAR MIXED MODEL ANOVA WAS APPLIED WITH YOGA EXPERIENCE AS A BETWEEN-GROUP FACTOR IN REPEATED MEASURES. INDEPENDENT SAMPLE T-TEST WAS APPLIED FOR BETWEEN GROUP COMPARISON OF RESPIRATORY RATE, DEMOGRAPHIC, AND ANTHROPOMETRIC DATA. P <0.05 IS CONSIDERED STATISTICALLY SIGNIFICANT. RESULTS: BETWEEN-GROUP COMPARISON DURING HDT WITH SPONTANEOUS BREATHING HAS SHOWN A SIGNIFICANTLY LOWER HEART RATE (P = 0.004) WITH HIGHER RR INTERVAL (RRI) (P = 0.002) AND PNN50% (P = 0.019) IN YOGA PRACTITIONERS. THE SEQUENCE BRS (P < 0.0001) AND ALPHA LOW FREQUENCY (LF) OF SPECTRAL BRS (P = 0.035) WERE ALSO SIGNIFICANTLY HIGHER IN THE YOGA GROUP COMPARED TO THE NAIVE GROUP. SIMILARLY, DURING HDT WITH SLOW BREATHING, THE HEART RATE WAS LOWER (P = 0.01); WITH HIGHER RRI (P = 0.009); PNN50% (P = 0.048). STANDARD DEVIATION OF SUCCESSIVE RR INTERVAL DIFFERENCE OF SYSTOLIC BPV WAS LOWER (P = 0.024) WITH HIGHER SEQUENCE BRS (P = 0.001) AND ALPHA LF OF SPECTRAL BRS (P = 0.002) IN YOGA GROUP THAN NAIVE GROUP. CONCLUSION: THE YOGA EXPERIENCED INDIVIDUALS EXHIBIT HIGHER RESTING PARASYMPATHETIC ACTIVITY, LOWER SYSTOLIC BPV, AND HIGHER BRS THAN NAIVE TO YOGA INDIVIDUALS. IT IS INFERRED FROM THE FINDINGS THAT YOGA PRACTITIONERS WERE BETTER ADAPTED TO TRANSIENT CEPHALAD FLUID SHIFT THAT HAPPENS DURING 6 DEGREES HDT. FURTHERMORE, ACUTE SLOW BREATHING DURING 6 DEGREES HDT REDUCED THE SYSTOLIC BLOOD PRESSURE IN ALL THE PARTICIPANTS SUGGESTING THE BENEFICIAL ROLE OF SLOW BREATHING DURING EXPOSURE TO EXTREME CONDITIONS SUCH AS MICROGRAVITY WHICH MIGHT HELP IN THE PREVENTION OF ADVERSE EFFECTS OF CEPHALAD FLUID SHIFT DURING LONG-TERM WEIGHTLESSNESS AND MAINTAIN THE ASTRONAUT HEALTH. FUTURE MECHANISTIC STUDIES WITH ACTIVE YOGA INTERVENTION ARE NECESSARY TO UNDERSTAND THE ADAPTIVE MECHANISMS INVOLVING CENTRAL AND VASCULAR MODULATIONS CONTRIBUTING TO EITHER ATTENUATION OR ACCENTUATION OF THE CARDIOVAGAL BAROREFLEX DURING HDT AND SLOW BREATHING IN HEALTHY INDIVIDUALS. 2021 14 846 21 EFFECT OF YOGA ON PULSE RATE VARIABILITY MEASURED FROM A VENOUS PRESSURE WAVEFORM. THE BENEFITS OF YOGA HAVE BEEN STUDIED IN DIFFERENT FIELDS, FROM CHRONIC HEALTH CONDITIONS TO MENTAL DISORDERS, SHOWING THAT IT CAN HELP TO IMPROVE THE OVERALL HEALTH. IN PARTICULAR, IT HAS BEEN PROVEN THAT YOGA ALSO IMPROVES THE AUTONOMIC FUNCTION. HEART RATE VARIABILITY (HRV) AT REST IS COMMONLY USED AS A NON-INVASIVE MEASURE OF AUTONOMIC REGULATION OF HEART RATE. ALTERNATIVELY, PULSE RATE VARIABILITY (PRV) HAS BEEN PROPOSED AS A SURROGATE OF HRV. VOLUMETRIX HAS DEVELOPED A NOVEL TECHNOLOGY THAT CAPTURES VENOUS WAVEFORMS VIA SENSORS ON THE VOLAR ASPECT OF THE WRIST, CALLED NIVABAND. THIS STUDY AIMS TO ASSESS THE EFFECT OF YOGA IN THE AUTONOMIC NERVOUS SYSTEM BY ANALYZING THE PRV OBTAINED FROM THE NIVA SIGNAL. TEMPORAL (STATISTICS OF THE NORMAL-TO-NORMAL INTERVALS), SPECTRAL (POWER IN LOW AND HIGH FREQUENCY BANDS) AND NONLINEAR (LAGGED POINCARE PLOT ANALYSIS) PARAMETERS ARE ANALYZED BEFORE AND AFTER A YOGA SESSION IN 20 HEALTHY VOLUNTEERS. THE PRV ANALYSIS SHOWS AN INCREASE IN PARAMETERS RELATED TO PARASYMPATHETIC ACTIVITY AND OVERALL VARIABILITY, AND A DECREASE IN PARAMETERS RELATED TO SYMPATHETIC ACTIVITY AND MEAN HEART RATE. THESE RESULTS SUPPORT THE BENEFICIAL EFFECT OF YOGA IN AUTONOMIC NERVOUS SYSTEM, INCREASING THE PARASYMPATHETIC ACTIVITY. 2019 15 1808 16 PREVENTIVE ASPECT OF AYURVEDA AND YOGA TOWARDS NEWLY EMERGING DISEASE COVID-19. THE ONGOING CORONAVIRUS PANDEMIC IS CAUSED BY SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2 (SARS COV 2) AND UNIQUE IN VARIOUS FACETS. THE EARLIER EXPERIENCE FROM THE PAST SEVERE ACUTE RESPIRATORY SYNDROME (SARS) EPIDEMICS SEEM TO BE INSUFFICIENT AND THERE IS NEED FOR BETTER STRATEGIES IN PUBLIC HEALTH AND MEDICAL CARE. AYURVED & YOG ARE WELL KNOWN FOR THEIR PREVENTIVE AND THERAPEUTIC ASPECT, BUT NOT GETTING UTILIZED PROPERLY FOR PREVENTION OF COVID 19 CRISIS WHICH MAY ALSO BE HELPFUL AS SUPPORTIVE THERAPY ALONG WITH CURRENT LINE OF MANAGEMENT. THIS PAPER IS AIMED AT UNREVEALING THE ROLE OF AYURVED AND YOGA GUIDELINES ESTABLISHED BY DEPARTMENT OF AYUSH FOR PREVENTION FROM SARS-COV-2 BY PROVIDING HELP TO IMPROVING THE QUALITY OF SUPPORTIVE/PROPHYLACTIC THERAPY IN RELATION WITH THEIR IMMUNITY. 2021 16 1530 27 IYENGAR YOGA INCREASES CARDIAC PARASYMPATHETIC NERVOUS MODULATION AMONG HEALTHY YOGA PRACTITIONERS. RELAXATION TECHNIQUES ARE ESTABLISHED IN MANAGING OF CARDIAC PATIENTS DURING REHABILITATION AIMING TO REDUCE FUTURE ADVERSE CARDIAC EVENTS. IT HAS BEEN HYPOTHESIZED THAT RELAXATION-TRAINING PROGRAMS MAY SIGNIFICANTLY IMPROVE CARDIAC AUTONOMIC NERVOUS TONE. HOWEVER, THIS HAS NOT BEEN PROVEN FOR ALL AVAILABLE RELAXATION TECHNIQUES. WE TESTED THIS ASSUMPTION BY INVESTIGATING CARDIAC VAGAL MODULATION DURING YOGA.WE EXAMINED 11 HEALTHY YOGA PRACTITIONERS (7 WOMEN AND 4 MEN, MEAN AGE: 43 +/- 11; RANGE: 26-58 YEARS). EACH INDIVIDUAL WAS SUBJECTED TO TRAINING UNITS OF 90 MIN ONCE A WEEK OVER FIVE SUCCESSIVE WEEKS. DURING TWO SESSIONS, THEY PRACTICED A YOGA PROGRAM DEVELOPED FOR CARDIAC PATIENTS BY B.K.S. IYENGAR. ON THREE SESSIONS, THEY PRACTICED A PLACEBO PROGRAM OF RELAXATION. ON EACH TRAINING DAY THEY UNDERWENT AMBULATORY 24 H HOLTER MONITORING. THE GROUP OF YOGA PRACTITIONERS WAS COMPARED TO A MATCHED GROUP OF HEALTHY INDIVIDUALS NOT PRACTICING ANY RELAXATION TECHNIQUES. PARAMETERS OF HEART RATE VARIABILITY (HRV) WERE DETERMINED HOURLY BY A BLINDED OBSERVER. MEAN RR INTERVAL (INTERVAL BETWEEN TWO R-WAVES OF THE ECG) WAS SIGNIFICANTLY HIGHER DURING THE TIME OF YOGA INTERVENTION COMPARED TO PLACEBO AND TO CONTROL (P < 0.001 FOR BOTH). THE INCREASE IN HRV PARAMETERS WAS SIGNIFICANTLY HIGHER DURING YOGA EXERCISE THAN DURING PLACEBO AND CONTROL ESPECIALLY FOR THE PARAMETERS ASSOCIATED WITH VAGAL TONE, I.E. MEAN STANDARD DEVIATION OF NN (NORMAL BEAT TO NORMAL BEAT OF THE ECG) INTERVALS FOR ALL 5-MIN INTERVALS (SDNNI, P < 0.001 FOR BOTH) AND ROOT MEAN SQUARE SUCCESSIVE DIFFERENCE (RMSSD, P < 0.01 FOR BOTH). IN CONCLUSION, RELAXATION BY YOGA TRAINING IS ASSOCIATED WITH A SIGNIFICANT INCREASE OF CARDIAC VAGAL MODULATION. SINCE THIS METHOD IS EASY TO APPLY WITH NO SIDE EFFECTS, IT COULD BE A SUITABLE INTERVENTION IN CARDIAC REHABILITATION PROGRAMS. 2007 17 2409 23 YOGA AND HEART RATE VARIABILITY: A COMPREHENSIVE REVIEW OF THE LITERATURE. HEART RATE VARIABILITY (HRV) HAS BEEN USED AS A PROXY FOR HEALTH AND FITNESS AND INDICATOR OF AUTONOMIC REGULATION AND THEREFORE, APPEARS WELL PLACED TO ASSESS THE CHANGES OCCURRING WITH MIND.-BODY PRACTICES THAT FACILITATE AUTONOMIC BALANCE. WHILE MANY STUDIES SUGGEST THAT YOGA INFLUENCES HRV, SUCH STUDIES HAVE NOT BEEN SYSTEMATICALLY REVIEWED. WE AIMED TO SYSTEMATICALLY REVIEW ALL PUBLISHED PAPERS THAT REPORT ON YOGA PRACTICES AND HRV. A COMPREHENSIVE SEARCH OF MULTIPLE DATABASES WAS CONDUCTED AND ALL STUDIES THAT REPORTED A MEASURE OF HRV ASSOCIATED WITH ANY YOGA PRACTICE WERE INCLUDED. STUDIES WERE CATEGORIZED BY THE STUDY DESIGN AND TYPE OF YOGA PRACTICE. A TOTAL OF 59 STUDIES WERE REVIEWED INVOLVING A TOTAL OF 2358 PARTICIPANTS. MOST STUDIES WERE PERFORMED IN INDIA ON RELATIVELY SMALL NUMBERS OF HEALTHY MALE YOGA PRACTITIONERS DURING A SINGLE LABORATORY SESSION. OF THE REVIEWED STUDIES, 15 WERE RANDOMIZED CONTROLLED TRIALS WITH 6 HAVING A JADAD SCORE OF 3. THE REVIEWED STUDIES SUGGEST THAT YOGA CAN AFFECT CARDIAC AUTONOMIC REGULATION WITH INCREASED HRV AND VAGAL DOMINANCE DURING YOGA PRACTICES. REGULAR YOGA PRACTITIONERS WERE ALSO FOUND TO HAVE INCREASED VAGAL TONE AT REST COMPARED TO NON-YOGA PRACTITIONERS. IT IS PREMATURE TO DRAW ANY FIRM CONCLUSIONS ABOUT YOGA AND HRV AS MOST STUDIES WERE OF POOR QUALITY, WITH SMALL SAMPLE SIZES AND INSUFFICIENT REPORTING OF STUDY DESIGN AND STATISTICAL METHODS. RIGOROUS STUDIES WITH DETAILED REPORTING OF YOGA PRACTICES AND ANY CORRESPONDING CHANGES IN RESPIRATION ARE REQUIRED TO DETERMINE THE EFFECT OF YOGA ON HRV. 2016 18 448 18 CHANGES IN AUTONOMIC VARIABLES FOLLOWING TWO MEDITATIVE STATES DESCRIBED IN YOGA TEXTS. OBJECTIVES: IN ANCIENT YOGA TEXTS THERE ARE TWO MEDITATIVE STATES DESCRIBED. ONE IS DHARANA, WHICH REQUIRES FOCUSING, THE SECOND IS DHYANA, DURING WHICH THERE IS NO FOCUSING, BUT AN EXPANSIVE MENTAL STATE IS REACHED. WHILE AN EARLIER STUDY DID SHOW IMPROVED PERFORMANCE IN AN ATTENTION TASK AFTER DHARANA, THE AUTONOMIC CHANGES DURING THESE TWO STATES HAVE NOT BEEN STUDIED. METHODS: AUTONOMIC AND RESPIRATORY VARIABLES WERE ASSESSED IN 30 HEALTHY MALE VOLUNTEERS (GROUP MEAN AGE +/- SD, 29.1 +/- 5.1 YEARS) DURING FOUR MENTAL STATES DESCRIBED IN TRADITIONAL YOGA TEXTS. THESE FOUR MENTAL STATES ARE RANDOM THINKING (CANCALATA), NONMEDITATIVE FOCUSING (EKAGRATA), MEDITATIVE FOCUSING (DHARANA), AND EFFORTLESS MEDITATION (DHYANA). ASSESSMENTS WERE MADE BEFORE (5 MINUTES), DURING (20 MINUTES), AND AFTER (5 MINUTES), EACH OF THE FOUR STATES, ON FOUR SEPARATE DAYS. RESULTS: DURING DHYANA THERE WAS A SIGNIFICANT INCREASE IN THE SKIN RESISTANCE LEVEL (P<0.001; POST HOC ANALYSIS FOLLOWING ANOVA, DURING COMPARED TO PRE) AND PHOTO-PLETHYSMOGRAM AMPLITUDE (P<0.05), WHEREAS THERE WAS A SIGNIFICANT DECREASE IN THE HEART RATE (P<0.001) AND BREATH RATE (P<0.001). THERE WAS A SIGNIFICANT DECREASE IN THE LOW FREQUENCY (LF) POWER (P<0.001) AND INCREASE IN THE HIGH FREQUENCY (HF) POWER (P<0.001) IN THE FREQUENCY DOMAIN ANALYSIS OF THE HEART RATE VARIABILITY (HRV) SPECTRUM, ON WHICH HF POWER IS ASSOCIATED WITH PARASYMPATHETIC ACTIVITY. THERE WAS ALSO A SIGNIFICANT INCREASE IN THE NN50 COUNT (THE NUMBER OF INTERVAL DIFFERENCES OF SUCCESSIVE NN INTERVALS GREATER THAN 50 MS; P<0.001) AND THE PNN50 (THE PROPORTION DERIVED BY DIVIDING NN50 BY THE TOTAL NUMBER OF NN INTERVALS; P<0.001) IN TIME DOMAIN ANALYSIS OF HRV, BOTH INDICATIVE OF PARASYMPATHETIC ACTIVITY. CONCLUSIONS: MAXIMUM CHANGES WERE SEEN IN AUTONOMIC VARIABLES AND BREATH RATE DURING THE STATE OF EFFORTLESS MEDITATION (DHYANA). THE CHANGES WERE ALL SUGGESTIVE OF REDUCED SYMPATHETIC ACTIVITY AND/OR INCREASED VAGAL MODULATION. DURING DHARANA THERE WAS AN INCREASE IN SKIN RESISTANCE. THE CHANGES IN HRV DURING EKAGRATA AND CANCALATA WERE INCONCLUSIVE. 2013 19 1089 25 EFFECTS OF YOGA ON THE AUTONOMIC NERVOUS SYSTEM, GAMMA-AMINOBUTYRIC-ACID, AND ALLOSTASIS IN EPILEPSY, DEPRESSION, AND POST-TRAUMATIC STRESS DISORDER. A THEORY IS PROPOSED TO EXPLAIN THE BENEFITS OF YOGA PRACTICES IN DIVERSE, FREQUENTLY COMORBID MEDICAL CONDITIONS BASED ON THE CONCEPT THAT YOGA PRACTICES REDUCE ALLOSTATIC LOAD IN STRESS RESPONSE SYSTEMS SUCH THAT OPTIMAL HOMEOSTASIS IS RESTORED. IT IS HYPOTHESIZED THAT STRESS INDUCES (1) IMBALANCE OF THE AUTONOMIC NERVOUS SYSTEM (ANS) WITH DECREASED PARASYMPATHETIC NERVOUS SYSTEM (PNS) AND INCREASED SYMPATHETIC NERVOUS SYSTEM (SNS) ACTIVITY, (2) UNDERACTIVITY OF THE GAMMA AMINO-BUTYRIC ACID (GABA) SYSTEM, THE PRIMARY INHIBITORY NEUROTRANSMITTER SYSTEM, AND (3) INCREASED ALLOSTATIC LOAD. IT IS FURTHER HYPOTHESIZED THAT YOGA-BASED PRACTICES (4) CORRECT UNDERACTIVITY OF THE PNS AND GABA SYSTEMS IN PART THROUGH STIMULATION OF THE VAGUS NERVES, THE MAIN PERIPHERAL PATHWAY OF THE PNS, AND (5) REDUCE ALLOSTATIC LOAD. DEPRESSION, EPILEPSY, POST TRAUMATIC STRESS DISORDER (PTSD), AND CHRONIC PAIN EXEMPLIFY MEDICAL CONDITIONS THAT ARE EXACERBATED BY STRESS, HAVE LOW HEART RATE VARIABILITY (HRV) AND LOW GABAERGIC ACTIVITY, RESPOND TO PHARMACOLOGIC AGENTS THAT INCREASE ACTIVITY OF THE GABA SYSTEM, AND SHOW SYMPTOM IMPROVEMENT IN RESPONSE TO YOGA-BASED INTERVENTIONS. THE OBSERVATION THAT TREATMENT RESISTANT CASES OF EPILEPSY AND DEPRESSION RESPOND TO VAGAL NERVE STIMULATION CORROBORATES THE NEED TO CORRECT PNS UNDERACTIVITY AS PART OF A SUCCESSFUL TREATMENT PLAN IN SOME CASES. ACCORDING TO THE PROPOSED THEORY, THE DECREASED PNS AND GABAERGIC ACTIVITY THAT UNDERLIES STRESS-RELATED DISORDERS CAN BE CORRECTED BY YOGA PRACTICES RESULTING IN AMELIORATION OF DISEASE SYMPTOMS. THIS HAS FAR-REACHING IMPLICATIONS FOR THE INTEGRATION OF YOGA-BASED PRACTICES IN THE TREATMENT OF A BROAD ARRAY OF DISORDERS EXACERBATED BY STRESS. 2012 20 1004 24 EFFECTS OF MIND(-)BODY EXERCISES (TAI CHI/YOGA) ON HEART RATE VARIABILITY PARAMETERS AND PERCEIVED STRESS: A SYSTEMATIC REVIEW WITH META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. BACKGROUND: HEART RATE VARIABILITY (HRV) AS AN ACCURATE, NONINVASIVE MEASURE OF THE AUTONOMOUS NERVOUS SYSTEM (ANS) CAN REFLECT MENTAL HEALTH (E.G., STRESS, DEPRESSION, OR ANXIETY). TAI CHI AND YOGA (TAI CHI/YOGA), AS THE MOST WIDELY PRACTICED MIND(-)BODY EXERCISES, HAVE SHOWN POSITIVE OUTCOMES OF MENTAL HEALTH. TO DATE, NO SYSTEMATIC REVIEW REGARDING THE LONG-LASTING EFFECTS OF TAI CHI/YOGA ON HRV PARAMETERS AND PERCEIVED STRESS HAS BEEN CONDUCTED. OBJECTIVE: TO CRITICALLY EVALUATE THE EXISTING LITERATURE ON THIS TOPIC. METHODS: FIVE ELECTRONIC DATABASES (WEB OF SCIENCE, PUBMED, SCOPUS, SPORTDISCUS AND COCHRANE LIBRARY) WERE SEARCHED FROM THE START OF THE RESEARCH PROJECT TO JULY 2018. STUDY SELECTION, DATA EXTRACTION, AND STUDY QUALITY ASSESSMENT WERE INDEPENDENTLY CARRIED OUT BY TWO REVIEWERS. THE POTENTIALLY IDENTIFIED RANDOMIZED CONTROLLED TRIALS (RCT) REPORTED THE USEFUL QUANTITATIVE DATA THAT WERE INCLUDED ONLY FOR META-ANALYSIS. RESULTS: META-ANALYSIS OF 17 MEDIUM-TO-HIGH QUALITY RCTS SHOWED SIGNIFICANTLY BENEFICIAL EFFECTS ON HRV PARAMETERS (NORMALIZED LOW-FREQUENCY, HEDGE'S G = -0.39, 95% CI -0.39 TO -0.56, P < 0.001, I2 = 11.62%; NORMALIZED HIGH-FREQUENCY, HEDGE'S G = 0.37, 95% CI 0.22 TO -0.52, P < 0.001, I2 = 0%; LOW-FREQUENCY TO HIGH-FREQUENCY RATIO, HEDGE'S G = -0.58, 95% CI -0.81 TO -0.35, P < 0.001, I2 = 53.78%) AND STRESS LEVEL (HEDGE'S G = -0.80, 95% CI -1.17 TO -0.44, P < 0.001, I2 = 68.54%). CONCLUSIONS: STRESS REDUCTION MAY BE ATTRIBUTED TO SYMPATHETIC-VAGAL BALANCE MODULATED BY MIND(-)BODY EXERCISES. TAI CHI/YOGA COULD BE AN ALTERNATIVE METHOD FOR STRESS REDUCTION FOR PEOPLE WHO LIVE UNDER HIGH STRESS OR NEGATIVE EMOTIONS. 2018