1 2333 96 TWELVE-MINUTE DAILY YOGA REGIMEN REVERSES OSTEOPOROTIC BONE LOSS. OBJECTIVE: ASSESS THE EFFECTIVENESS OF SELECTED YOGA POSTURES IN RAISING BONE MINERAL DENSITY (BMD). METHODS: TEN-YEAR STUDY OF 741 INTERNET-RECRUITED VOLUNTEERS COMPARING PREYOGA BMD CHANGES WITH POSTYOGA BMD CHANGES. OUTCOME MEASURES: DUAL-ENERGY X-RAY ABSORPTIOMETRIC SCANS. OPTIONAL RADIOGRAPHS OF HIPS AND SPINE AND BONE QUALITY STUDY (7 TESLA). RESULTS: BONE MINERAL DENSITY IMPROVED IN SPINE, HIPS, AND FEMUR OF THE 227 MODERATELY AND FULLY COMPLIANT PATIENTS. MONTHLY GAIN IN BMD WAS SIGNIFICANT IN SPINE (0.0029 G/CM(2), P = .005) AND FEMUR (0.00022 G/CM(2), P = .053), BUT IN 1 COHORT, ALTHOUGH MEAN GAIN IN HIP BMD WAS 50%, LARGE INDIVIDUAL DIFFERENCES RAISED THE CONFIDENCE INTERVAL AND THE GAIN WAS NOT SIGNIFICANT FOR TOTAL HIP (0.000357 G/CM(2)). NO YOGA-RELATED SERIOUS INJURIES WERE IMAGED OR REPORTED. BONE QUALITY APPEARED QUALITATIVELY IMPROVED IN YOGA PRACTITIONERS. CONCLUSION: YOGA APPEARS TO RAISE BMD IN THE SPINE AND THE FEMUR SAFELY. 2016 2 2777 26 YOGA SPINAL FLEXION POSITIONS AND VERTEBRAL COMPRESSION FRACTURE IN OSTEOPENIA OR OSTEOPOROSIS OF SPINE: CASE SERIES. OBJECTIVE: THE OBJECTIVE OF THIS REPORT IS TO RAISE AWARENESS OF THE EFFECT OF STRENUOUS YOGA FLEXION EXERCISES ON OSTEOPENIC OR OSTEOPOROTIC SPINES. WE PREVIOUSLY DESCRIBED SUBJECTS WITH KNOWN OSTEOPOROSIS IN WHOM VERTEBRAL COMPRESSION FRACTURES (VCFS) DEVELOPED AFTER SPINAL FLEXION EXERCISE (SFE) AND RECOMMENDED THAT SFES NOT BE PRESCRIBED IN PATIENTS WITH SPINAL OSTEOPOROSIS. METHODS: THIS REPORT DESCRIBES 3 HEALTHY PERSONS WITH LOW BONE MASS AND YOGA-INDUCED PAIN OR FRACTURE. RESULTS: ALL 3 PATIENTS HAD OSTEOPENIA, WERE IN GOOD HEALTH AND PAIN-FREE, AND HAD STARTED YOGA EXERCISES TO IMPROVE THEIR MUSCULOSKELETAL HEALTH. NEW PAIN AND FRACTURE AREAS OCCURRED AFTER PARTICIPATION IN YOGA FLEXION EXERCISES. CONCLUSIONS: THE DEVELOPMENT OF PAIN AND COMPLICATIONS WITH SOME FLEXION YOGA POSITIONS IN THE PATIENTS WITH OSTEOPENIA LEADS TO CONCERN THAT FRACTURE RISK WOULD INCREASE EVEN FURTHER IN OSTEOPOROSIS. ALTHOUGH EXERCISE HAS BEEN SHOWN TO BE EFFECTIVE FOR IMPROVING BONE MINERAL DENSITY AND DECREASING FRACTURE RISK, OUR SUBJECTS HAD DEVELOPMENT OF VCFS AND NECK AND BACK PAIN WITH YOGA EXERCISES. THIS FINDING SUGGESTS THAT FACTORS OTHER THAN BONE MASS SHOULD BE CONSIDERED FOR EXERCISE COUNSELING IN PATIENTS WITH BONE LOSS. THE INCREASED TORQUE PRESSURE APPLIED TO VERTEBRAL BODIES DURING SFES MAY BE A RISK. EXERCISE IS EFFECTIVE AND IMPORTANT FOR TREATMENT OF OSTEOPENIA AND OSTEOPOROSIS AND SHOULD BE PRESCRIBED FOR PATIENTS WITH VERTEBRAL BONE LOSS. SOME YOGA POSITIONS CAN CONTRIBUTE TO EXTREME STRAIN ON SPINES WITH BONE LOSS. ASSESSMENT OF FRACTURE RISK IN OLDER PERSONS PERFORMING SFES AND OTHER HIGH-IMPACT EXERCISES IS AN IMPORTANT CLINICAL CONSIDERATION. 2013 3 2359 19 VERTEBRAL COMPRESSION FRACTURES ASSOCIATED WITH YOGA: A CASE SERIES. BACKGROUND: THE IMPORTANCE OF EXERCISE IN SKELETAL HEALTH IS INCREASINGLY RECOGNIZED BY BOTH PATIENTS AND PROVIDERS. HOWEVER, THE SAFETY OF PRESCRIBED OR RECREATIONAL EXERCISE IN AT-RISK POPULATIONS REMAINS UNDER-REPORTED AND UNDER-PUBLICIZED. YOGA HAS GAINED WIDESPREAD POPULARITY DUE TO ITS PHYSICAL AND PSYCHOLOGICAL BENEFITS. WHEN PRACTICED IN A POPULATION AT INCREASED FRACTURE RISK, HOWEVER, SOME YOGA POSES MAY INCREASE FRACTURE RISK, PARTICULARLY AT THE SPINE, RATHER THAN INCREASING BMD AS NOTED IN RECENT POPULAR PRESS REPORTS. CASE REPORT: NINE SUBJECTS (8 WOMEN) WITH A MEDIAN AGE OF 66 YEARS (RANGE 53-87), DEVELOPED VERTEBRAL COMPRESSION FRACTURE (VCF) ONE MONTH TO SIX YEARS AFTER INITIATING YOGA-ASSOCIATED SPINAL FLEXION EXERCISES (SFE). VCF PRESENTED WITH BACK PAIN AND OCCURRED IN THE THORACICSPINE (N.=6), LUMBAR-SPINE (N.=4) AND CERVICAL-SPINE (N.=1). FOUR PATIENTS HAD OSTEOPOROSIS BY BMD CRITERIA PRIOR TO VCF AND 2 HAD OSTEOPENIA (MEDIAN T-SCORE -2.35; RANGE -3.3 TO +2.0). INTERESTINGLY, ALL PATIENTS HAD THEIR LOWEST T-SCORES AT THE SPINE. THREE PATIENTS HAD A HISTORY OF FRAGILITY FRACTURE PRIOR TO THE INDEX VCF. WHILE ONE PATIENT HAD PRIMARY HYPERPARATHYROIDISM AND ANOTHER WAS TREATED WITH HIGH DOSE PREDNISONE, NO OTHER RISK FACTORS FOR BONE LOSS INCLUDING MEDICATIONS OR SECONDARY OSTEOPOROSIS CAUSES WERE IDENTIFIED IN THE OTHER PATIENTS. CLINICAL REHABILITATION IMPACT: THIS STUDY IDENTIFIED PATIENTS IN WHOM INCREASED TORSIONAL AND COMPRESSIVE MECHANICAL LOADING PRESSURES OCCURRING DURING YOGA SFE RESULTED IN DE NOVO VCF. DESPITE THE NEED FOR SELECTIVITY IN YOGA POSES IN POPULATIONS AT INCREASED FRACTURE RISK, BOTH SCIENTIFIC AND MEDIA REPORTS CONTINUE TO ADVERTISE YOGA AS A BONE PROTECTIVE ACTIVITY. ACCORDINGLY, YOGA IS MISCONCEIVED AS A 'ONESIZE-FITS-ALL' PRESCRIPTION. INSTEAD, THE APPROPRIATE SELECTION OF PATIENTS LIKELY TO BENEFIT FROM YOGA MUST BE A CORNERSTONE OF FRACTURE PREVENTION. 2018 4 79 13 A LOW-ENERGY FEMORAL SHAFT FRACTURE FROM PERFORMING A YOGA POSTURE. THE FEMORAL SHAFT IS RARELY THE SITE OF A LOW-ENERGY FRACTURE IN A HEALTHY INDIVIDUAL. THE VAST MAJORITY OF THESE FRACTURES ARE DUE TO MAJOR TRAUMA SUCH AS MOTOR VEHICLE ACCIDENTS. ALTHOUGH LOW-ENERGY FEMORAL SHAFT FRACTURES DO OCCUR, THEY ARE TYPICALLY IN PATIENTS WITH OSTEOPOROTIC BONE, OR PROSTHESIS RELATED. IN THIS CASE REPORT, WE PRESENT A MAN IN HIS LATE 30S WHO WAS PRACTISING A SPECIFIC YOGA STANCE WHEN HE EXPERIENCED A FEMORAL SHAFT FRACTURE. 2015 5 968 34 EFFECTS OF AN 8-MONTH ASHTANGA-BASED YOGA INTERVENTION ON BONE METABOLISM IN MIDDLE-AGED PREMENOPAUSAL WOMEN: A RANDOMIZED CONTROLLED STUDY. ALTHOUGH YOGA HAS THE POTENTIAL TO BE AN ALTERNATIVE PHYSICAL ACTIVITY TO ENHANCE BONE HEALTH, THERE IS A LACK OF HIGH QUALITY EVIDENCE FOR THIS TYPE OF INTERVENTION. THE PURPOSE OF THIS RANDOMIZED CONTROLLED TRIAL WAS TO EXAMINE THE EFFECTS OF A PROGRESSIVE 8-MONTH ASHTANGA-BASED YOGA PROGRAM ON BONE TURNOVER MARKERS (BTM), AREAL BONE MINERAL DENSITY (ABMD) AND VOLUMETRIC BONE CHARACTERISTICS IN PREMENOPAUSAL WOMEN. THIRTY-FOUR PREMENOPAUSAL WOMEN (35-50 YEARS) WERE RANDOMLY ASSIGNED EITHER TO A YOGA GROUP (YE, N = 16) OR A CONTROL GROUP (CON, N = 18). PARTICIPANTS IN YE GROUP PERFORMED 60 MINUTES OF AN ASHTANGA-BASED YOGA SERIES 2 TIMES/WEEK WITH ONE DAY BETWEEN SESSIONS FOR 8 MONTHS, AND THE SESSION INTENSITY WAS PROGRESSIVELY INCREASED BY ADDING THE NUMBER OF SUN SALUTATIONS (SS). PARTICIPANTS IN CON WERE ENCOURAGED TO MAINTAIN THEIR NORMAL DAILY LIFESTYLES MONITORED BY THE BONE SPECIFIC PHYSICAL ACTIVITY QUESTIONNAIRE (BPAQ) AT 2 MONTH INTERVALS FOR 8 MONTHS. BODY COMPOSITION WAS MEASURED BY DUAL ENERGY X-RAY ABSORPTIOMETRY (DXA). BONE FORMATION (BONE ALKALINE PHOSPHATASE, BONE ALP) AND BONE RESORPTION (TARTRATE-RESISTANT ACID PHOSPHATASE-5B, TRAP5B) MARKERS WERE ASSESSED AT BASELINE AND AFTER 8 MONTHS. ABMD OF TOTAL BODY, LUMBAR SPINE AND DUAL PROXIMAL FEMUR AND TIBIA BONE CHARACTERISTICS WERE MEASURED USING DXA AND PERIPHERAL QUANTITATIVE COMPUTED TOMOGRAPHY (PQCT), RESPECTIVELY. WE FOUND THAT THE SERUM BONE ALP CONCENTRATIONS WERE MAINTAINED IN YE, BUT SIGNIFICANTLY (P = 0.005) DECREASED IN CON AFTER THE 8 MONTH INTERVENTION, AND THERE WERE SIGNIFICANT (P = 0.002) GROUP DIFFERENCES IN BONE ALP PERCENT CHANGES (YE 9.1 +/- 4.0% VS. CON -7.1 +/- 2.3%). NO CHANGES IN TRAP5B WERE FOUND IN EITHER GROUP. THE 8-MONTH YOGA PROGRAM DID NOT INCREASE ABMD OR TIBIA BONE STRENGTH VARIABLES. BODY COMPOSITION RESULTS SHOWED NO CHANGES IN WEIGHT, FAT MASS, OR % FAT, BUT SMALL SIGNIFICANT INCREASES IN BONE FREE LEAN BODY MASS OCCURRED IN BOTH GROUPS. THE FINDINGS OF THIS STUDY SUGGEST THAT REGULAR LONG-TERM ASHTANGA YOGA HAD A SMALL POSITIVE EFFECT ON BONE FORMATION BUT DID NOT ALTER ABMD OR TIBIA BONE CHARACTERISTICS IN PREMENOPAUSAL WOMEN. KEY POINTSREGULAR LONG-TERM ASHTANGA-BASED YOGA PROGRAM HAD A SMALL POSITIVE EFFECT ON BONE FORMATION, BUT NO EFFECTS WERE FOUND ON BONE RESORPTION.NONE OF THE BONE DENSITY OR GEOMETRY VARIABLES WERE CHANGED BY THE 8-MONTH ASHTANGA-BASED YOGA INTERVENTION.FUTURE YOGA INTERVENTIONS SHOULD FOCUS ON LONGER DURATION AND GREATER FREQUENCY TO ELICIT IMPROVEMENTS IN BONE MINERAL DENSITY. 2015 6 433 12 CAN YOGA THERAPY STIMULATE STEM CELL TRAFFICKING FROM BONE MARROW? IT HAS BEEN ESTABLISHED THAT MESENCHYMAL STROMAL CELLS (MSCS) FROM BONE MARROW ENTER THE PERIPHERAL CIRCULATION INTERMITTENTLY FOR POSSIBLE TISSUE REGENERATION, REPAIR AND TO TAKE CARE OF DAILY WEAR AND TEAR. THIS IS EVIDENT FROM THE DETECTION OF MSCS FROM PERIPHERAL BLOOD. THE FACTORS GOVERNING THIS MIGRATION REMAIN ELUSIVE. THESE MSCS CARRY OUT THE WORK OF POLICING AND ARE SUPPOSED TO REPAIR THE INJURED TISSUES. THUS, THESE CELLS HELP IN MAINTAINING THE TISSUE AND ORGAN HOMEOSTASIS. YOGA AND PRANAYAMA ORIGINATED IN INDIA AND IS NOW BEING PRACTICED ALL OVER THE WORLD FOR POSITIVE HEALTH. SO FAR, THE CHEMICAL STIMULATION OF BONE MARROW HAS BEEN WIDELY USED EMPLOYING INJECTION OF COLONY STIMULATING FACTOR. HOWEVER, THE ROLE OF PHYSICAL FACTORS SUCH AS MECHANICAL STIMULATION AND STRETCHING HAS NOT BEEN SUBSTANTIATED. IT IS CLAIMED THAT PRACTICING YOGA DELAYS SENESCENCE, IMPROVES THE PHYSIOLOGICAL FUNCTIONS OF HEART AND LUNG AND YOGA POSTURES MAKE THE BODY ELASTIC. IT REMAINS TO BE SEEN WHETHER THE YOGA THERAPY PROMOTES TRAFFICKING OF THE STEM CELLS FROM BONE MARROW FOR POSSIBLE REPAIR AND REGENERATION OF WORN OUT AND DEGENERATING TISSUES. WE COVER IN THIS SHORT REVIEW, MAINLY THE ROLE OF PHYSICAL FACTORS ESPECIALLY THE YOGA THERAPY ON STEM CELLS TRAFFICKING FROM BONE MARROW. 2016 7 2853 23 YOGA, VERTEBRAL FRACTURES, AND OSTEOPOROSIS: RESEARCH AND RECOMMENDATIONS. BACKGROUND: OSTEOPOROSIS IS CHARACTERIZED BY DECREASED BONE DENSITY THAT LEAVES BONES FRAGILE AND HIGHLY SUSCEPTIBLE TO FRACTURE. GLOBALLY, 1 IN 3 WOMEN AND 1 IN 5 MEN OLDER THAN 50 WILL SUFFER FROM AN OSTEOPOROTIC FRACTURE, AND THOSE INDIVIDUALS WILL EXPERIENCE A CONSIDERABLY HIGHER RISK OF POSTFRACTURE MORTALITY THAN WILL THE GENERAL POPULATION. GENTLE, WEIGHT-BEARING EXERCISES SUCH AS YOGA CAN HELP PREVENT OR CEASE THE PROGRESSION OF OSTEOPOROSIS; HOWEVER, THERE IS INSUFFICIENT DATA REGARDING WHICH YOGA POSES PRESENT THE LEAST RISK AND ARE MOST BENEFICIAL TO INDIVIDUALS WITH REDUCED BONE DENSITY. OBJECTIVES: REVIEW THE EXTANT LITERATURE ABOUT THE RISKS AND BENEFITS TO THE SPINE OF PARTICULAR FORMS OF MOVEMENT AND CONSIDER RECOMMENDATIONS RELATIVE TO THE PRACTICE OF YOGA. METHODS: A REVIEW OF THE PUBMED, MEDLINE, AND COCHRANE DATABASES WAS CONDUCTED THAT IDENTIFIED MANUSCRIPTS PUBLISHED BETWEEN 1966 AND 2011 ABOUT TOPICS RELATED TO OSTEOPOROSIS AND SPINAL MOVEMENT. CONCLUSIONS: MOVEMENTS INVOLVING SPINAL FLEXION CAN INCREASE RISK FOR VERTEBRAL COMPRESSION FRACTURES; HOWEVER, A COMBINATION OF MILD SPINAL FLEXION AND EXTENSION MAY PROVE BENEFICIAL. MODERATE, WEIGHT-BEARING ACTIVITIES THAT STRENGTHEN THE MUSCLES SUPPORTING THE SPINAL COLUMN, PROMOTE BALANCE, IMPROVE POSTURE, AND ENHANCE QUALITY OF LIFE APPEAR TO BE OF GREATEST BENEFIT. AMPLE EVIDENCE SUPPORTS THE IMPORTANCE OF VARIED SPINAL MOVEMENT FOR PRESERVING THE HEALTH AND STRENGTH OF THE VERTEBRAL BODIES. EXERCISE MODIFICATIONS SUITABLE FOR HIGH-RISK INDIVIDUALS MAY BE COUNTERPRODUCTIVE FOR THOSE AT LOW RISK FOR VERTEBRAL FRACTURES. YOGA THERAPISTS ARE CAUTIONED TO NOT APPLY A ONE-SIZE-FITS-ALL APPROACH WHEN WORKING WITH THIS POPULATION. WELL-DESIGNED EMPIRICAL STUDIES ARE NEEDED TO FURTHER OUR UNDERSTANDING OF WHICH YOGA POSES PRESENT THE LEAST RISK AND ARE OF GREATEST BENEFIT TO INDIVIDUALS WITH OSTEOPOROSIS. 2013 8 2393 12 YOGA AND BONE HEALTH. OSTEOPOROSIS IS A PUBLIC HEALTH PROBLEM AFFECTING INDIVIDUALS GLOBALLY. YOGA HAS BEEN FOUND TO PREVENT AND REVERSE BONE LOSS. YOGA MAY RESULT IN BETTER BALANCE, IMPROVED POSTURE, AND GREATER RANGE OF MOTION, STRENGTH, AND COORDINATION, ALL FACTORS THAT ALSO MITIGATE THE RISK OF FALLS AND FRACTURES. A 12-MINUTE, 12-POSE YOGA REGIMEN IS DISCUSSED IN DETAIL. ONCE LEARNED, THE ONGOING USE OF YOGA IS SAFE, WITHOUT COST, AND MAY BE DONE LIFELONG. 2021 9 1111 27 EFFECTS OF YOGASANAS ON OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN. BACKGROUND: OSTEOPOROSIS IS COMMONLY ENCOUNTERED BY POSTMENOPAUSAL WOMEN. THERE IS AN INCREASED NEED FOR A LOW COST AND EFFICIENT TREATMENT ALTERNATIVE TO ADDRESS THIS POPULATION. AIMS: TO STUDY THE EFFECTS OF INTEGRATED YOGA ON BONE MINERAL DENSITY (BMD) IN POSTMENOPAUSAL WOMEN WITH OSTEOPOROSIS. SETTINGS AND DESIGNS: EXPERIMENTAL PRE-POST STUDY CONDUCTED IN A COMMUNITY SETTING. MATERIALS AND METHODS: 30 FEMALES IN THE AGE GROUP OF 45-62 YEARS SUFFERING FROM POSTMENOPAUSAL OSTEOPOROSIS WITH A DUAL-ENERGY X-RAY ABSORPTIOMETRY (DEXA) SCORE OF