1 2283 202 THE USE OF INTEGRATIVE THERAPY BASED ON YOGA AND AYURVEDA IN THE TREATMENT OF A HIGH-RISK CASE OF COVID-19/SARS-COV-2 WITH MULTIPLE COMORBIDITIES: A CASE REPORT. BACKGROUND: WE REPORT A HIGH-RISK CASE OF A CORONAVIRUS DISEASE 19 (COVID-19)-POSITIVE PATIENT WITH COMORBIDITIES INCLUDING DIABETES MELLITUS (DM), HYPERTENSION (HTN), HYPOTHYROIDISM AND CHRONIC KIDNEY DISEASE (CKD), TREATED SUCCESSFULLY USING AN INTEGRATIVE THERAPY PLAN BASED ON AYURVEDA AND YOGA, ALONG WITH GOVERNMENT-MANDATED COMPULSORY MODERN WESTERN MEDICINE (MWM) TREATMENT. RECENTLY, SOME EVIDENCE HAS BEEN EMERGING ON THE USE OF AYURVEDA FOR TREATMENT OF COVID-19. THE CLASSICAL TEXTS OF AYURVEDIC MEDICINE SUCH AS CHARAKA SAMHITA AND SUSHRUTA SAMHITA CONTAIN DESCRIPTIONS OF PANDEMICS OF SIMILAR PROPORTIONS AND DESCRIBE THEM AS JANAPADODDHVANSA, MEANING THE DESTRUCTION OF COMMUNITIES, ALONG WITH THEIR CAUSES AND TREATMENT. CASE PRESENTATION: THE CASE REPORTED HEREIN IS A 55-YEAR-OLD MAN FROM DELHI, INDIA, WITH CONFIRMED (TESTED) COVID-19, WHO FIRST TOOK MWM FOR 7 DAYS BEFORE SEEKING INTEGRATIVE THERAPY. THE PATIENT HAS COMORBIDITIES INCLUDING DM, HTN, HYPOTHYROIDISM AND CKD AND HAD DEVELOPED SYMPTOMS INCLUDING FEVER (WHICH WAS RESOLVED BY THE TIME INTEGRATIVE THERAPY WAS STARTED), SORE THROAT, DRY COUGH, BODY ACHES, WEAKNESS, BAD TASTE AND SMELL, AND HEAVINESS IN THE ABDOMEN. BASED ON THE PATIENT'S SYMPTOMS AND COMORBIDITIES, A TREATMENT PLAN INCLUDING AYURVEDIC MEDICINES, YOGA PROTOCOL, DIETARY RECOMMENDATIONS AND LIFESTYLE MODIFICATIONS WAS PRESCRIBED BY A REGISTERED AYURVEDA DOCTOR AND A YOGA CONSULTANT. THE PATIENT STARTED EXPERIENCING IMPROVEMENT IN ALL THE SYMPTOMS WITHIN 2 DAYS AFTER STARTING THE TREATMENT; HE REPORTED APPROXIMATELY [FORMULA: SEE TEXT] RELIEF FROM THE SYMPTOMS AFTER 5 DAYS, AND ALMOST COMPLETE RELIEF WITHIN 9 DAYS. ALSO, THE BLOOD SUGAR LEVELS (BOTH FASTING BLOOD SUGAR [FBS] AND POSTPRANDIAL BLOOD SUGAR [PPBS]) EXHIBITED SIGNIFICANT IMPROVEMENT AFTER 5 DAYS, AND DECREASED TO WITHIN THE NORMAL RANGE WITHIN 12 DAYS. BESIDES RELIEF IN SYMPTOMS, THE PATIENT'S REAL-TIME REVERSE TRANSCRIPTION POLYMERASE CHAIN REACTION (RT-PCR) TEST DONE ON THE 19TH DAY RETURNED NEGATIVE RESULTS. CONCLUSIONS: INTEGRATIVE THERAPY WAS FOUND TO BE EFFECTIVE IN MITIGATING THE SYMPTOMS OF COVID-19 IN THIS PATIENT WITH MULTIPLE COMORBIDITIES. MOREOVER, A SIGNIFICANT IMPROVEMENT IN BLOOD SUGAR LEVELS (NOT UNDER CONTROL WITH MODERN MEDICINE) WAS ALSO ACHIEVED. INTEGRATIVE THERAPY BASED ON THE CLASSICAL TEXTS OF AYURVEDA AND YOGA MAY OFFER A PROMISING AND SCALABLE TREATMENT OPTION FOR COVID-19 PATIENTS. A CASE SERIES OR A SUITABLY DESIGNED RANDOMIZED CONTROLLED TRIAL IS NEEDED TO ASSESS ITS EFFICACY. 2021 2 2446 28 YOGA AND TAI CHI: A MIND-BODY APPROACH IN MANAGING RESPIRATORY SYMPTOMS IN OBSTRUCTIVE LUNG DISEASES. PURPOSE OF REVIEW: CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IS CHARACTERIZED BY AIRFLOW LIMITATION BECAUSE OF AIRWAY AND/OR ALVEOLAR ABNORMALITIES. SYMPTOMS INCLUDE DYSPNEA, COUGH, CHRONIC SPUTUM PRODUCTION. AS THE THIRD-RANKED CAUSE OF DEATH AS WELL AS DISABILITY-ADJUSTED LIFE YEARS (DALYS), IT POSES A SIGNIFICANT BURDEN ON PATIENTS, FAMILIES, HEALTHCARE SYSTEM AND SOCIETY. REGULAR PHYSICAL ACTIVITY IS LINKED TO DECREASE IN MORBIDITY AND MORTALITY ASSOCIATED WITH COPD, BUT IMPLEMENTATION REMAINS CHALLENGING. THERE IS A NEED FOR COMMUNITY-BASED INTERVENTIONS THAT PROMOTE PHYSICAL ACTIVITY. YOGA AND TAI CHI ARE WIDELY AVAILABLE IN THE COMMUNITY AND HAVE BEEN SHOWN TO BE BENEFICIAL IN PATIENTS WITH COPD AS WELL AS MANY OF THE CO-MORBID CONDITIONS ASSOCIATED WITH COPD. RECENT FINDINGS: YOGA AND TAI CHI HAVE BEEN FOUND TO BE MORE EFFECTIVE THAN USUAL CARE IN COPD WITH CLINICALLY MEANINGFUL IMPROVEMENTS IN 6-MIN WALK DISTANCE (6MWD), FORCED EXPIRATORY VOLUME IN 1 S (FEV1), AND HEALTH-RELATED QUALITY OF LIFE (HRQOL). THEY HAVE ALSO BEEN FOUND TO BE COMPARABLE TO PULMONARY REHABILITATION INTERVENTIONS. SUMMARY: YOGA AND TAI CHI PROVIDE COMMUNITY-BASED OPTIONS FOR PATIENTS WITH COPD TO IMPROVE THEIR PHYSICAL ACTIVITY, QUALITY OF LIFE, AND PULMONARY FUNCTION. 2020 3 2467 36 YOGA AS A THERAPY FOR ADOLESCENTS AND YOUNG ADULTS WITH CYSTIC FIBROSIS: A PILOT STUDY. RATIONALE: YOGA HAS BEEN SHOWN TO IMPROVE OUTCOMES IN PATIENTS WITH ASTHMA BUT HAS NOT BEEN INVESTIGATED IN CYSTIC FIBROSIS (CF) PATIENTS. METHODS: THIS WAS A PROSPECTIVE PILOT STUDY TO EVALUATE THE SAFETY OF A STANDARDIZED YOGA PROGRAM AMONG CF PATIENTS AGED 12 TO 25 YEARS. PARTICIPANTS ENGAGED IN A 50-MINUTE YOGA SESSION TWICE WEEKLY FOR 8 WEEKS CONDUCTED BY A CERTIFIED YOGA INSTRUCTOR USING A STANDARDIZED PROGRAM DESIGNED TO BE SAFE FOR HEALTH-COMPROMISED INDIVIDUALS. YOGA SESSIONS WERE INDIVIDUAL TO AVOID TRANSMISSION OF INFECTIONS. PRIMARY OUTCOME WAS SAFETY AND TOLERABILITY. SECONDARY OUTCOME MEASURES INCLUDED RESPIRATORY SYMPTOMS, THE CYSTIC FIBROSIS QUALITY OF LIFE INSTRUMENT (CFQ-R), LUNG FUNCTION, EASE OF BREATHING SCORE (MEASURE OF EXERCISE TOLERANCE), AND WEIGHT. RESULTS: ELEVEN PARTICIPANTS WERE ENROLLED, AND 10 COMPLETED THE STUDY. ADHERENCE WAS VERY GOOD; THE MEAN (SD) NUMBER OF SESSIONS COMPLETED WAS 14.2 (1.3) OUT OF 16 SESSIONS. EIGHT PATIENTS REPORTED 25 ADVERSE EVENTS. THE MOST COMMON WAS COUGH, REPORTED IN 7. TWO EVENTS WERE POSSIBLY RELATED TO STUDY PROCEDURES: CALF PAIN AND HEADACHE. THERE WERE NO SIGNIFICANT CHANGES IN DYSPNEA OR PAIN SCALES. THE MEAN (SD) CFQ-R RESPIRATORY DOMAIN SCORE INCREASED FROM SCREENING TO END OF STUDY: 67.9 (11.4) TO 82.1 (9.9), P=.04. THERE WERE NO SIGNIFICANT CHANGES IN THE OTHER OUTCOME MEASURES. CONCLUSIONS: IN THIS PILOT STUDY, A STANDARDIZED 8-WEEK YOGA PROGRAM WAS SAFE AND WELL TOLERATED AMONG ADOLESCENT AND YOUNG ADULT CF PATIENTS WITH MILD TO MODERATE LUNG DISEASE. THIS STUDY MAY BE HELPFUL TO YOGA INSTRUCTORS WHO ARE INTERESTED IN WORKING WITH CF PATIENTS. LARGER CONTROLLED TRIALS ARE WARRANTED TO DETERMINE FURTHER BENEFITS. 2015 4 786 44 EFFECT OF YOGA BREATHING (PRANAYAMA) ON EXERCISE TOLERANCE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A RANDOMIZED, CONTROLLED TRIAL. OBJECTIVE: PULMONARY REHABILITATION IMPROVES EXERCISE TOLERANCE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). HOWEVER, MANY PATIENTS DO NOT HAVE ACCESS TO PULMONARY REHABILITATION PROGRAMS. WE HYPOTHESIZED THAT AN ALTERNATIVE TO PULMONARY REHABILITATION TO IMPROVE EXERCISE TOLERANCE IS THE PRACTICE OF PRANAYAMA, OR YOGA BREATHING, WHICH COULD BE DONE INDEPENDENTLY AT HOME. WE ALSO SOUGHT TO DETERMINE WHETHER YOGA NONPROFESSIONALS COULD ADEQUATELY TEACH PRANAYAMA TO PATIENTS. DESIGN: PROOF-OF-CONCEPT, RANDOMIZED, DOUBLE-BLIND, CONTROLLED PILOT TRIAL. SETTINGS/LOCATION: TWO ACADEMIC PULMONARY PRACTICES. SUBJECTS: FORTY-THREE PATIENTS WITH SYMPTOMATIC, MODERATE-TO-SEVERE COPD. INTERVENTIONS: TWELVE WEEKS OF PRANAYAMA PLUS EDUCATION VERSUS EDUCATION ALONE. TWO YOGA PROFESSIONALS TRAINED THE RESEARCH COORDINATORS TO CONDUCT ALL PRANAYAMA TEACHING AND MONITORED THE QUALITY OF THE TEACHING AND THE PRACTICE OF PRANAYAMA BY STUDY PARTICIPANTS. OUTCOME MEASURES: THE PRIMARY OUTCOME WAS A CHANGE IN THE 6-MIN WALK DISTANCE (6MWD). SECONDARY OUTCOMES INCLUDED CHANGES IN LUNG FUNCTION, MARKERS OF OXIDATIVE STRESS AND SYSTEMIC INFLAMMATION, AND MEASURES OF DYSPNEA AND QUALITY OF LIFE. RESULTS: THE 6MWD INCREASED IN THE PRANAYAMA GROUP (LEAST SQUARE MEAN [95% CONFIDENCE INTERVAL] = 28 M [-5 TO 61]) AND DECREASED IN THE CONTROL GROUP (-15 M [-47 TO 16]), WITH A NEARLY SIGNIFICANT TREATMENT EFFECT (P = 0.06) IN FAVOR OF PRANAYAMA. PRANAYAMA ALSO RESULTED IN SMALL IMPROVEMENTS IN INSPIRATORY CAPACITY AND AIR TRAPPING. BOTH GROUPS HAD SIGNIFICANT IMPROVEMENTS IN VARIOUS MEASURES OF SYMPTOMS, BUT NO OVERALL DIFFERENCES IN RESPIRATORY SYSTEM IMPEDANCE OR MARKERS OF OXIDATIVE STRESS OR SYSTEMIC INFLAMMATION. CONCLUSION: THIS PILOT STUDY SUCCESSFULLY DEMONSTRATED THAT PRANAYAMA WAS ASSOCIATED WITH IMPROVED EXERCISE TOLERANCE IN PATIENTS WITH COPD. LAY PERSONNEL WERE ABLE TO ADEQUATELY TEACH PATIENTS TO PRACTICE PRANAYAMA. THESE RESULTS SUGGEST THAT PRANAYAMA MAY HAVE SIGNIFICANT CLINICAL BENEFITS FOR SYMPTOMATIC PATIENTS WITH COPD, A CONCEPT THAT NEEDS TO BE CONFIRMED IN FUTURE, LARGER CLINICAL TRIALS. 2017 5 1139 23 EFFICACY OF YOGA TRAINING IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVES: TO EVALUATE THE IMPACT OF YOGA TRAINING IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). METHOD: A LITERATURE SEARCH WAS PERFORMED IN PUBMED, COCHRANE LIBRARY, EMBASE, CINAHL, AND WEB OF SCIENCE FOR RELEVANT STUDIES PUBLISHED BEFORE JUNE 2017. QUALITY ASSESSMENT, SENSITIVITY ANALYSIS AND HETEROGENEITY WERE PERFORMED. STATA12.0 SOFTWARE WAS USED FOR STATISTICAL ANALYSIS. RESULTS: TEN STUDIES WERE ELIGIBLE FOR THIS ANALYSIS. THERE WERE SIGNIFICANTLY GREATER IMPROVEMENTS IN 6MWD (P = 0.000), BORG SCALE SCORES (P = 0.018), FEV1 VALUE (P = 0. 013), PACO2 (P = 0.037), SGRQ SCORES (P = 0. 000) AND CAT SCORES (P = 0.009) IN YOGA TRAINING PATIENTS. NO STATISTICALLY SIGNIFICANT DIFFERENCE WAS OBSERVED IN THE FEV1/FVC (P = 0.75), FEV1 PREDICTED VALUE (P = 0.057) AND FVC (P = 0.05). CONCLUSIONS: THIS META-ANALYSIS INDICATES THAT YOGA TRAINING CAN BE AN ACCEPTABLE AND APPROPRIATED ADJUNCTIVE REHABILITATION PROGRAM FOR COPD PATIENTS. 2018 6 867 51 EFFECT OF YOGA REGIMEN ON LUNG FUNCTIONS INCLUDING DIFFUSION CAPACITY IN CORONARY ARTERY DISEASE PATIENTS: A RANDOMIZED CONTROLLED STUDY. BACKGROUND: LUNG FUNCTIONS ARE FOUND TO BE IMPAIRED IN CORONARY ARTERY DISEASE (CAD), CONGESTIVE HEART FAILURE, LEFT VENTRICULAR DYSFUNCTION, AND AFTER CARDIAC SURGERY. DIFFUSION CAPACITY PROGRESSIVELY WORSENS AS THE SEVERITY OF CAD INCREASES DUE TO REDUCTION IN LUNG TISSUE PARTICIPATING IN GAS EXCHANGE. AIMS AND OBJECTIVES: PRANAYAMA BREATHING EXERCISES AND YOGIC POSTURES MAY PLAY AN IMPRESSIVE ROLE IN IMPROVING CARDIO-RESPIRATORY EFFICIENCY AND FACILITATING GAS DIFFUSION AT THE ALVEOLO-CAPILLARY MEMBRANE. THIS STUDY WAS DONE TO SEE THE EFFECT OF YOGA REGIMEN ON LUNG FUNCTIONS PARTICULARLY DIFFUSION CAPACITY IN CAD PATIENTS. MATERIALS AND METHODS: A TOTAL OF 80 STABLE CAD PATIENTS BELOW 65 YEARS OF AGE OF BOTH SEXES WERE SELECTED AND RANDOMIZED INTO TWO GROUPS OF 40 EACH. GROUP I CAD PATIENTS WERE GIVEN YOGA REGIMEN FOR 3 MONTHS WHICH CONSISTED OF YOGIC POSTURES, PRANAYAMA BREATHING EXERCISES, DIETARY MODIFICATION, AND HOLISTIC TEACHING ALONG WITH THEIR CONVENTIONAL MEDICINE WHILE GROUP II CAD PATIENTS WERE PUT ONLY ON CONVENTIONAL MEDICINE. LUNG FUNCTIONS INCLUDING DIFFUSION CAPACITY WERE RECORDED THRICE IN BOTH THE GROUPS: 0 DAY AS BASELINE, 22(ND) DAY AND ON 90(TH) DAY BY USING COMPUTERIZED MS MEDISOFT CARDIO-RESPIRATORY INSTRUMENT, HYP'AIR COMPACT MODEL OF CARDIO-RESPIRATORY TESTING MACHINE WAS MANUFACTURED BY P K MORGAN, INDIA. THE RECORDED PARAMETERS WERE STATISTICALLY ANALYZED BY REPEATED MEASURES ANOVA FOLLOWED BY TUKEY'S TEST IN BOTH THE GROUPS. CARDIOVASCULAR PARAMETERS WERE ALSO COMPARED BEFORE AND AFTER INTERVENTION IN BOTH THE GROUPS. RESULTS: STATISTICALLY SIGNIFICANT IMPROVEMENTS WERE SEEN IN SLOW VITAL CAPACITY, FORCED VITAL CAPACITY, PEAK EXPIRATORY FLOW RATE, MAXIMUM VOLUNTARY VENTILATION, AND DIFFUSION FACTOR/ TRANSFER FACTOR OF LUNG FOR CARBON MONOXIDE AFTER 3 MONTHS OF YOGA REGIMEN IN GROUP I. FORCED EXPIRATORY VOLUME IN 1(ST) SEC (FEV1), AND FEV1 % ALSO SHOWED A TREND TOWARD IMPROVEMENT ALTHOUGH NOT STATISTICALLY SIGNIFICANT. HR, SBP AND DBP ALSO SHOWED SIGNIFICANT IMPROVEMENT IN GROUP-I PATIENTS WHO FOLLOWED YOGA REGIMEN. CONCLUSIONS: YOGA REGIMEN WAS FOUND TO IMPROVE LUNG FUNCTIONS AND DIFFUSION CAPACITY IN CAD PATIENTS BESIDES IMPROVING CARDIOVASCULAR FUNCTIONS. THUS, IT CAN BE USED AS A COMPLIMENTARY OR ADJUNCT THERAPY ALONG WITH THE CONVENTIONAL MEDICINE FOR THEIR TREATMENT AND REHABILITATION. 2015 7 496 30 COMBINATION OF AYURVEDA AND YOGA THERAPY REDUCES PAIN INTENSITY AND IMPROVES QUALITY OF LIFE IN PATIENTS WITH MIGRAINE HEADACHE. OBJECTIVES: TO UNDERSTAND THE EFFICACY OF AYURVEDA AND YOGA IN THE MANAGEMENT OF MIGRAINE HEADACHE. METHODS: 30 SUBJECTS RECRUITED TO AYURVEDA AND YOGA (AY) GROUP UNDERWENT TRADITIONAL PANCHAKARMA (BIO-PURIFICATORY PROCESS) USING THERAPEUTIC PURGATION FOLLOWED BY YOGA THERAPY, WHILE 30 SUBJECTS OF CONTROL (CT) GROUP CONTINUED ON SYMPTOMATIC TREATMENT (NSAID'S) FOR 90 DAYS. BODY CONSTITUTION QUESTIONNAIRE WAS ADMINISTERED TO BOTH GROUPS. THE OUTCOME MEASURES INCLUDED SYMPTOM CHECK LIST, COMPREHENSIVE HEADACHE RELATED QUALITY OF LIFE QUESTIONNAIRE AND VISUAL ANALOGUE SCALE. RESULTS: FORTY-SIX (76.6%) OUT OF 60 SUBJECTS BELONGING TO BOTH GROUPS HAD PITTA BASED BODY CONSTITUTION. FOLLOWING 90 DAYS OF INTERVENTION THE AY GROUP SHOWED SIGNIFICANT REDUCTION IN MIGRAINE SYMPTOMS INCLUDING PAIN INTENSITY (P<.001) AND IMPROVEMENT IN HEADACHE RELATED QUALITY OF LIFE (P<.001). THE CT GROUP SHOWED NO SIGNIFICANT CHANGE (P>.05). CONCLUSION: TRADITIONAL AYURVEDA ALONG WITH YOGA THERAPY REDUCES SYMPTOMS, INTENSITY OF PAIN AND IMPROVES QUALITY OF LIFE IN MIGRAINE PATIENTS. 2018 8 2821 54 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 9 2543 56 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 10 2271 35 THE RISKS AND BENEFITS OF YOGA FOR PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVES: TO DETERMINE THE EFFECTIVENESS AND SAFETY OF YOGA INTERVENTIONS ON DISEASE SYMPTOMS, QUALITY OF LIFE AND FUNCTION IN PATIENTS DIAGNOSED WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). DATA SOURCES: MEDLINE/PUBMED, SCOPUS, AND CENTRAL (COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS) WERE SEARCHED THROUGH 6 JUNE 2019. REVIEW METHODS: RANDOMIZED CONTROLLED TRIALS ASSESSING THE EFFECTS OF YOGA ON QUALITY OF LIFE, DYSPNEA, EXERCISE CAPACITY, AND PULMONARY FUNCTION (FEV1) IN PATIENTS WITH COPD WERE INCLUDED. SAFETY WAS DEFINED AS SECONDARY OUTCOME. MEAN DIFFERENCES (MD) AND STANDARDIZED MEAN DIFFERENCES (SMD) WITH 95% CONFIDENCE INTERVALS (CIS) WERE COMPUTED. RISK OF BIAS WAS ASSESSED USING THE COCHRANE TOOL. RESULTS: ELEVEN RANDOMIZED CONTROLLED TRIALS WITH A TOTAL OF 586 PATIENTS WERE INCLUDED. META-ANALYSIS REVEALED EVIDENCE FOR EFFECTS OF YOGA COMPARED TO NO TREATMENT ON QUALITY OF LIFE ON THE COPD ASSESSMENT TEST (MD = 3.81; 95% CI = 0.97 TO 6.65; P = 0.009, I(2) = 70%), EXERCISE CAPACITY ASSESSED BY THE 6-MINUTE WALK TEST (MD = 25.53 M; 95% CI = 12.16 M TO 38.90 M; P = 0.001, I(2) = 0%), AND PULMONARY FUNCTION ASSESSED BY FEV1 PREDICTED (MD = 3.95%; 95% CI = 2.74% TO 5.17%; P < 0.001, I(2) = 0%). ONLY THE EFFECTS ON EXERCISE CAPACITY AND PULMONARY FUNCTION WERE ROBUST AGAINST METHODOLOGICAL BIAS. EFFECTS WERE ONLY PRESENT IN BREATHING-FOCUSED YOGA INTERVENTIONS BUT NOT IN INTERVENTIONS INCLUDING YOGA POSTURES. ADVERSE EVENTS WERE REPORTED INFREQUENTLY. CONCLUSION: THIS META-ANALYSIS FOUND ROBUST EFFECTS OF YOGA ON EXERCISE CAPACITY AND PULMONARY FUNCTION IN PATIENTS WITH COPD. YOGA, SPECIFICALLY YOGA BREATHING TECHNIQUES, CAN BE AN EFFECTIVE ADJUNCT INTERVENTION FOR PATIENTS WITH COPD. YOGA'S SAFETY NEEDS TO BE ASSESSED IN MORE DEPTH IN FUTURE STUDIES. 2019 11 508 31 COMPARATIVE EFFICACY OF A 12 WEEK YOGA-BASED LIFESTYLE INTERVENTION AND DIETARY INTERVENTION ON ADIPOKINES, INFLAMMATION, AND OXIDATIVE STRESS IN ADULTS WITH METABOLIC SYNDROME: A RANDOMIZED CONTROLLED TRIAL. THE PRESENT RANDOMIZED CONTROLLED TRIAL (RCT) EVALUATED THE COMPARATIVE EFFICACY OF 12 WEEK YOGA-BASED LIFESTYLE INTERVENTION (YBLI) AND DIETARY INTERVENTION (DI) ALONE ON ADIPOKINES, INFLAMMATION, AND OXIDATIVE STRESS IN INDIAN ADULTS WITH METABOLIC SYNDROME (MET S). A PARALLEL, TWO ARM, RCT WAS CONDUCTED IN INTEGRAL HEALTH CLINIC (IHC), ALL INDIA INSTITUTE OF MEDICAL SCIENCES, INDIA FROM 2012 TO 2014. IHC IS AN OUTPATIENT FACILITY CONDUCTING YBLI PROGRAMS FOR PREVENTION AND MANAGEMENT OF CHRONIC DISEASES. TWO HUNDRED SIXTY MEN AND WOMEN (20-45 YEARS) VISITING THE OUTPATIENT DEPARTMENT OF A TERTIARY CARE HOSPITAL WERE DIAGNOSED WITH MET S AND RANDOMIZED 1:1 TO RECEIVE 12 WEEK YBLI (N = 130) OR DI (N = 130). PRIMARY OUTCOMES WERE CHANGE IN PLASMA LEVELS OF ADIPOKINES (LEPTIN, ADIPONECTIN, AND LEPTIN:ADIPONECTIN RATIO), MARKERS OF INFLAMMATION (TUMOR NECROSIS FACTOR [TNF]-ALPHA, INTERLEUKIN [IL]-6), MARKERS OF OXIDATIVE STRESS (THIOBARBITURIC ACID REACTIVE SUBSTANCES [TBARS], 8-HYDROXY-2'-DEOXYGUANOSINE [8-OHDG], AND SUPEROXIDE DISMUTASE [SOD]) MEASURED AT BASELINE, 2 WEEKS, AND 12 WEEKS. YBLI GROUP SHOWED A SIGNIFICANT DECREASE IN LEPTIN, LEPTIN:ADIPONECTIN RATIO, IL-6, 8-OHDG, AND TBARS LEVELS, WHEREAS THERE WAS A SIGNIFICANT INCREASE IN ADIPONECTIN AND SOD LEVELS. NO SIGNIFICANT CHANGES WERE NOTICED IN DI ALONE GROUP. YBLI SHOWED SIGNIFICANTLY GREATER REDUCTION IN TBARS LEVELS THAN IN DI GROUP, SUGGESTIVE OF REDUCED OXIDATIVE STRESS IN ADULTS WITH MET S. A 12 WEEK YBLI HAD A POSITIVE IMPACT ON OXIDATIVE STRESS VERSUS DI ALONE IN ADULTS WITH MET S. 2019 12 173 42 A RANDOMIZED CONTROLLED STUDY ON ASSESSMENT OF HEALTH STATUS, DEPRESSION, AND ANXIETY IN COAL MINERS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE FOLLOWING YOGA TRAINING. CONTEXT: PSYCHOLOGICAL COMORBIDITIES ARE PREVALENT IN COAL MINERS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) AND CONTRIBUTE TO THE SEVERITY OF THE DISEASE REDUCING THEIR HEALTH STATUS. YOGA HAS BEEN SHOWN TO ALLEVIATE DEPRESSION AND ANXIETY ASSOCIATED WITH OTHER CHRONIC DISEASES BUT IN COPD NOT BEEN FULLY INVESTIGATED. AIM: THIS STUDY AIMED TO EVALUATE THE ROLE OF YOGA ON HEALTH STATUS, DEPRESSION, AND ANXIETY IN COAL MINERS WITH COPD. MATERIALS AND METHODS: THIS WAS A RANDOMIZED TRIAL WITH TWO STUDY ARMS (YOGA AND CONTROL), WHICH ENROLLED 81 COAL MINERS, RANGING FROM 36 TO 60 YEARS WITH STAGE II AND III STABLE COPD. BOTH GROUPS WERE EITHER ON CONVENTIONAL TREATMENT OR COMBINATION OF CONVENTIONAL CARE WITH YOGA PROGRAM FOR 12 WEEKS. RESULTS: DATA WERE COLLECTED THROUGH STANDARDIZED QUESTIONNAIRES; COPD ASSESSMENT TEST, BECK DEPRESSION INVENTORY AND STATE AND TRAIT ANXIETY INVENTORY AT THE BEGINNING AND THE END OF THE INTERVENTION. THE YOGA GROUP SHOWED STATISTICALLY SIGNIFICANT (P < 0.001) IMPROVEMENTS ON ALL SCALES WITHIN THE GROUP, ALL SIGNIFICANTLY DIFFERENT (P < 0.001) FROM CHANGES OBSERVED IN THE CONTROLS. NO SIGNIFICANT PREPOST CHANGES WERE OBSERVED IN THE CONTROL GROUP (P > 0.05). CONCLUSION: YOGA PROGRAM LED TO GREATER IMPROVEMENT IN PHYSICAL AND MENTAL HEALTH STATUS THAN DID CONVENTIONAL CARE. YOGA SEEMS TO BE A SAFE, FEASIBLE, AND EFFECTIVE TREATMENT FOR PATIENTS WITH COPD. THERE IS A NEED TO CONDUCT MORE COMPREHENSIVE, HIGH-QUALITY, EVIDENCE-BASED STUDIES TO SHED LIGHT ON THE CURRENT UNDERSTANDING OF THE EFFICACY OF YOGA IN THESE CHRONIC CONDITIONS AND IDENTIFY UNANSWERED QUESTIONS. 2016 13 2870 37 YOGA-BASED PULMONARY REHABILITATION FOR THE MANAGEMENT OF DYSPNEA IN COAL MINERS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: COAL MINE DUST EXPOSURE CAUSES CHRONIC AIRFLOW LIMITATION IN COAL MINERS RESULTING IN DYSPNEA, FATIGUE, AND EVENTUALLY CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). YOGA CAN ALLEVIATE DYSPNEA IN COPD BY IMPROVING VENTILATORY MECHANICS, REDUCING CENTRAL NEURAL DRIVE, AND PARTIALLY RESTORING NEUROMECHANICAL COUPLING OF THE RESPIRATORY SYSTEM. OBJECTIVES: TO EVALUATE THE EFFECTIVENESS OF INTEGRATED APPROACH OF YOGA THERAPY (IAYT) IN THE MANAGEMENT OF DYSPNEA AND FATIGUE IN COAL MINERS WITH COPD. MATERIALS AND METHODS: RANDOMIZED, WAITLIST CONTROLLED, SINGLE-BLIND CLINICAL TRIAL. EIGHTY-ONE COAL MINERS (36-60 YEARS) WITH STABLE STAGES II AND III COPD WERE RECRUITED. THE YOGA GROUP RECEIVED AN IAYT MODULE FOR COPD THAT INCLUDED ASANAS, LOOSENING EXERCISES, BREATHING PRACTICES, PRANAYAMA, CYCLIC MEDITATION, YOGIC COUNSELING AND LECTURES 90 MIN/DAY, 6 DAYS/WEEK FOR 12 WEEKS. MEASUREMENTS OF DYSPNEA AND FATIGUE ON THE BORG SCALE, EXERCISE CAPACITY BY THE 6 MIN WALK TEST, PERIPHERAL CAPILLARY OXYGEN SATURATION (SPO2%), AND PULSE RATE (PR) USING PULSE OXIMETRY WERE MADE BEFORE AND AFTER THE INTERVENTION. RESULTS: STATISTICALLY SIGNIFICANT WITHIN GROUP REDUCTIONS IN DYSPNEA (P < 0.001), FATIGUE (P < 0.001) SCORES, PR (P < 0.001), AND SIGNIFICANT IMPROVEMENTS IN SPO2% (P < 0.001) AND 6 MIN WALK DISTANCE (P < 0.001) WERE OBSERVED IN THE YOGA GROUP; ALL EXCEPT THE LAST WERE SIGNIFICANT COMPARED TO CONTROLS (P < 0.001). CONCLUSIONS: FINDINGS INDICATE THAT IAYT BENEFITS COAL MINERS WITH COPD, REDUCING DYSPNEA; FATIGUE AND PR, AND IMPROVING FUNCTIONAL PERFORMANCE AND PERIPHERAL CAPILLARY SPO2%. YOGA CAN NOW BE INCLUDED AS AN ADJUNCT TO CONVENTIONAL THERAPY FOR PULMONARY REHABILITATION PROGRAMS FOR COPD PATIENTS. 2016 14 2518 43 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 15 2344 32 USING A STANDARDIZED VINIYOGA PROTOCOL FOR LUNG CANCER SURVIVORS: A PILOT STUDY EXAMINING EFFECTS ON BREATHING EASE. ALTHOUGH LUNG CANCER IS PERCEIVED AS A DIRE DIAGNOSIS, INCREASES IN THE 5-YEAR SURVIVAL RATE OF INDIVIDUALS WITH NON-SMALL CELL LUNG CANCER (NSCLC) HAVE BEEN REPORTED. SURVIVORS, HOWEVER, CONTINUE TO BE EXCESSIVELY BURDENED WITH SYMPTOMS SUCH AS RESPIRATORY DISTRESS WHICH INTERFERE WITH FUNCTIONING AND QUALITY OF LIFE. WHILE EXERCISE AND PHYSICAL ACTIVITY ARE STRONGLY RECOMMENDED, NSCLC SURVIVORS MAY BE RELUCTANT TO PARTICIPATE DUE TO ACTUAL OR ANTICIPATED SHORTNESS OF BREATH EXACERBATED WITH MOVEMENT.THIS QUASI-EXPERIMENTAL, INTERVENTION-ONLY PILOT STUDY AIMED TO DETERMINE THE EFFECTS OF AN 8-WEEK STANDARDIZED YOGA PROTOCOL FOR STAGE I-IIIA NSCLC SURVIVORS (N=9). THE PROTOCOL WAS DEVELOPED WITHIN THE VINIYOGA (HATHA) TRADITION WITH RESPIRATORY EXPERTS. BREATHING EASE, DYSPNEA, OXYGEN SATURATION, AND RESPIRATORY FUNCTION WERE EXPLORED IN RELATIONSHIP TO YOGA PRACTICE (45-MINUTE SESSIONS ONCE PER WEEK AND HOME PRACTICE) USING REPEATED-MEASURES ANALYSIS. NUMBER OF PARTICIPANTS REPORTING DYSPNEA RANGED FROM 25 TO 50% PRIOR TO PRACTICE WITH NO SIGNIFICANT INCREASE DURING SESSIONS, AND MODERATE DECREASES NOTED AT TIMES. OXYGEN SATURATION REMAINED HIGH AND VITAL SIGNS STABLE; FORCED EXPIRATORY VOLUME IN 1 SECOND (FEV1) VALUES INCREASED SIGNIFICANTLY OVER THE 14-WEEK STUDY PERIOD (P<0.0001). YOGA, WITH AN EMPHASIS ON POSTURES COORDINATED WITH BREATHING AND MEDITATION PRACTICES, OFFERS A POTENTIALLY FEASIBLE AND BENEFICIAL OPTION THAT REQUIRES FURTHER STUDY IN THIS POPULATION. 2013 16 351 42 ASSESSMENT OF SIGNIFICANCE OF YOGA ON QUALITY OF LIFE IN ASTHMA PATIENTS: A RANDOMIZED CONTROLLED STUDY. BACKGROUND: ASTHMA IS A CHRONIC INFLAMMATORY RESPIRATORY DISEASE CHARACTERIZED BY PERIODIC ATTACKS OF WHEEZING, SHORTNESS OF BREATH AND A TIGHT FEELING IN THE CHEST. THE CURRENT STUDY IS BASED ON THE EFFECT OF YOGA ON QUALITY OF LIFE IN ASTHMATICS IN NORTHERN INDIA. MATERIALS AND METHODS: A TOTAL OF 300 PARTICIPANTS OF MILD-TO-MODERATE PERSISTENT ASTHMA (FEV1 >60%) AGED BETWEEN 12 AND 60 YEARS WERE RECRUITED FROM THE DEPARTMENT OF PULMONARY MEDICINE. THEIR QUALITY OF LIFE WAS ASSESSED WITH THE HELP OF MINI ASTHMA QUALITY-OF-LIFE QUESTIONNAIRE (AQLQ) AT BASELINE AND THEN AFTER 3(RD) AND 6(TH) MONTH FROM BASELINE. FORTY-FIVE PARTICIPANTS WERE DROPPED OUT DURING THE STUDY WHILE 255 PARTICIPANTS COMPLETED THE STUDY SUCCESSFULLY. RESULTS: IN "THE YOGA GROUP," SIGNIFICANT IMPROVEMENTS WERE FOUND IN ALL THE SUBDOMAINS OF AQLQ AT 3(RD) MONTH AND AT 6(TH) MONTH IN COMPARISON TO "THE CONTROL GROUP." THE NUMBER NEEDED TO TREAT WAS FOUND TO BE 2.67 FOR THE TOTAL AQLQ SCORE WHICH WAS GREATER THAN THE MINIMAL IMPORTANT DIFFERENCE. CONCLUSION: "THE YOGA GROUP" GOT SIGNIFICANTLY BETTER IMPROVEMENT IN ASTHMA QUALITY-OF-LIFE SCORES THAN "THE CONTROL GROUP." THUS, YOGA CAN BE USED AS AN ADJUVANT THERAPY IN THE MANAGEMENT OF ASTHMA. 2017 17 2820 50 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 18 1912 38 ROLE OF BREATHING EXERCISES AND YOGA/PRANAYAMA IN CHILDHOOD ASTHMA: A SYSTEMATIC REVIEW. BACKGROUND: VARIOUS COMPLEMENTARY OR ALTERNATIVE MEDICINES (INCLUDING BREATHING EXERCISES AND YOGA/PRANAYAMA) HAVE BEEN TRIED AS AN ATTRACTIVE OPTION TO PHARMACOTHERAPY IN CHILDHOOD ASTHMA. OBJECTIVE: TO EVALUATE THE ROLE OF BREATHING EXERCISE AND YOGA/PRANAYAMA AS ADD ON THERAPY TO THE "PHARMACOLOGICALLY RECOMMENDED TREATMENT" OF CHILDHOOD ASTHMA. METHODS: WE SEARCHED THE PUBLISHED LITERATURE IN THE MAJOR DATABASES: MEDLINE VIA OVID, PUBMED, CENTRAL, EMBASE, AND GOOGLE SCHOLAR TILL JUNE 2018. RANDOMIZED TRIALS COMPARING BREATHING EXERCISES AND YOGA/ PRANAYAMA VERSUS CONTROL OR AS PART OF A COMPOSITE INTERVENTION VERSUS CONTROL WERE INCLUDED. THE PRIMARY OUTCOME MEASURES WERE QUALITY OF LIFE AND CHANGE IN ASTHMA SYMPTOMS. SECONDARY OUTCOMES WERE: DECREASE IN MEDICATION USE, NUMBER OF EXACERBATIONS, CHANGE IN LUNG FUNCTION AND IMMUNOLOGICAL PARAMETERS, SCHOOL ABSENTEEISM AND ADVERSE EVENTS. RESULTS: A TOTAL OF 10 TRIALS (466 CHILDREN, 6-14 YEARS AGE) WERE INCLUDED. THE SEVERITY OF ASTHMA VARIED AMONG THE TRIALS. THE DATA FOR PRIMARY OUTCOME MEASURES COULD NOT BE POOLED, THERE WERE MIXED RESULTS FOR BOTH PRIMARY AND SECONDARY OUTCOMES. NO SIGNIFICANT BENEFIT WAS OBTAINED IN ACUTE ASTHMA AND THE LUNG FUNCTION TESTS [EXCEPT PEFR % AT 4-6 WEEKS, PEF ABSOLUTE AT 3 MONTHS, AND FVC ABSOLUTE AT 3 MONTHS] IN CHRONIC ASTHMA. ONE TRIAL COMPARED BREATHING EXERCISE VERSUS YOGA AND FOUND NO DIFFERENCE. ADVERSE EVENTS WERE NOT SIGNIFICANT. CONCLUSIONS: BREATHING EXERCISE AND YOGA/ PRANAYAMA MAY HAVE SOME ADDITIVE ROLE IN THE TREATMENT OF CHILDHOOD ASTHMA. HOWEVER, AT PRESENT, IT CANNOT BE RECOMMENDED AS A STANDARD OF CARE DUE TO INSUFFICIENT DATA. 2019 19 1141 22 EFFICACY OF YOGA, TAI CHI AND QI GONG ON THE MAIN SYMPTOMS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A SYSTEMATIC REVIEW. INTRODUCTION: THE AIM OF THIS SYSTEMATIC REVIEW WAS TO SUMMARIZE THE EFFECTS OF YOGA, QI GONG OR TAI CHI IN COPD PATIENTS. METHODS: STUDIES EVALUATING EFFECTS OF THE SELECTED COMPLEMENTARY THERAPIES ON LUNG FUNCTION, DYSPNEA, QUALITY OF LIFE OR FUNCTIONAL EXERCISE CAPACITY IN COPD PATIENTS WERE IDENTIFIED AND REVIEWED FROM THREE DATABASES. RESULTS: EIGHTEEN STUDIES WERE INCLUDED. SIX STUDIES EVALUATED THE EFFECTS OF YOGA AND THE OTHERS FOCUSED ON TAI CHI OR QI GONG SEPARATELY OR COMBINED. THE DURATION OF THE PROGRAMS RANGED FROM 6 WEEKS TO 6 MONTHS AND THE FREQUENCY FROM 2 TO 7 TIMES A WEEK. EACH SESSION REACHED 30 TO 90 MINUTES. BENEFITS WERE OBSERVED ON LUNG FUNCTION AND FUNCTIONAL EXERCISE CAPACITY BUT BENEFIT WAS CLEARLY STATED NEITHER ON QUALITY OF LIFE NOR ON DYSPNEA. CONCLUSION: THIS SYSTEMATIC REVIEW HIGHLIGHTS THE POTENTIAL OF THESE THERAPIES AS COMPLEMENTARY THERAPEUTIC APPROACH IN COPD PATIENTS. 2019 20 214 24 A STUDY OF THE EFFECT OF YOGA TRAINING ON PULMONARY FUNCTIONS IN PATIENTS WITH BRONCHIAL ASTHMA. THE ROLE OF YOGA BREATHING EXERCISES, AS AN ADJUNCT TREATMENT FOR BRONCHIAL ASTHMA IS WELL RECOGNIZED. ONE HUNDRED TWENTY PATIENTS OF ASTHMA WERE RANDOMIZED INTO TWO GROUPS I.E GROUP A (YOGA TRAINING GROUP) AND GROUP B (CONTROL GROUP). EACH GROUP INCLUDED SIXTY PATIENTS. PULMONARY FUNCTION TESTS WERE PERFORMED ON ALL THE PATIENTS AT BASELINE, AFTER 4 WEEKS AND THEN AFTER 8 WEEKS. MAJORITY OF THE SUBJECTS IN THE TWO GROUPS HAD MILD DISEASE (34 PATIENTS IN GROUP A AND 32 IN GROUP B). GROUP A SUBJECTS SHOWED A STATISTICALLY SIGNIFICANT INCREASING TREND (P < 0.01) IN % PREDICTED PEAK EXPIRATORY FLOW RATE (PEFR), FORCED EXPIRATORY VOLUME IN THE FIRST SECOND (FEV1), FORCED VITAL CAPACITY (FVC), FORCED MID EXPIRATORY FLOW IN 0.25-0.75 SECONDS (FEF25-75) AND FEV1/FVC% RATIO AT 4 WEEKS AND 8 WEEKS AS COMPARED TO GROUP B. THUS, YOGA BREATHING EXERCISES USED ADJUNCTIVELY WITH STANDARD PHARMACOLOGICAL TREATMENT SIGNIFICANTLY IMPROVES PULMONARY FUNCTIONS IN PATIENTS WITH BRONCHIAL ASTHMA. 2009