1 2829 261 YOGA VERSUS STANDARD CARE FOR SCHIZOPHRENIA. BACKGROUND: YOGA IS AN ANCIENT SPIRITUAL PRACTICE THAT ORIGINATED IN INDIA AND IS CURRENTLY ACCEPTED IN THE WESTERN WORLD AS A FORM OF RELAXATION AND EXERCISE. IT HAS BEEN OF INTEREST FOR PEOPLE WITH SCHIZOPHRENIA TO DETERMINE ITS EFFICACY AS AN ADJUNCT TO STANDARD-CARE TREATMENT. OBJECTIVES: TO EXAMINE THE EFFECTS OF YOGA VERSUS STANDARD CARE FOR PEOPLE WITH SCHIZOPHRENIA. SEARCH METHODS: WE SEARCHED THE COCHRANE SCHIZOPHRENIA GROUP TRIALS REGISTER (NOVEMBER 2012 AND JANUARY 29, 2015), WHICH IS BASED ON REGULAR SEARCHES OF MEDLINE, PUBMED, EMBASE, CINAHL, BIOSIS, AMED, PSYCINFO, AND REGISTRIES OF CLINICAL TRIALS. WE SEARCHED THE REFERENCES OF ALL INCLUDED STUDIES. THERE WERE NO LANGUAGE, DATE, DOCUMENT TYPE, OR PUBLICATION STATUS LIMITATIONS FOR INCLUSION OF RECORDS IN THE REGISTER. SELECTION CRITERIA: ALL RANDOMISED CONTROLLED TRIALS (RCTS) INCLUDING PEOPLE WITH SCHIZOPHRENIA COMPARING YOGA TO STANDARD-CARE CONTROL. DATA COLLECTION AND ANALYSIS: THE REVIEW TEAM INDEPENDENTLY SELECTED STUDIES, QUALITY RATED THESE, AND EXTRACTED DATA. FOR BINARY OUTCOMES, WE CALCULATED RISK RATIO (RR) AND ITS 95% CONFIDENCE INTERVAL (CI), ON AN INTENTION-TO-TREAT BASIS. FOR CONTINUOUS DATA, WE ESTIMATED THE MEAN DIFFERENCE (MD) BETWEEN GROUPS AND ITS 95% CI. WE EMPLOYED MIXED-EFFECT AND FIXED-EFFECT MODELS FOR ANALYSES. WE EXAMINED DATA FOR HETEROGENEITY (I(2) TECHNIQUE), ASSESSED RISK OF BIAS FOR INCLUDED STUDIES, AND CREATED 'SUMMARY OF FINDINGS' TABLES USING GRADE (GRADING OF RECOMMENDATIONS ASSESSMENT, DEVELOPMENT AND EVALUATION). MAIN RESULTS: WE INCLUDED EIGHT STUDIES IN THE REVIEW. ALL OUTCOMES WERE SHORT TERM (LESS THAN SIX MONTHS). THERE WERE CLEAR DIFFERENCES IN A NUMBER OF OUTCOMES IN FAVOUR OF THE YOGA GROUP, ALTHOUGH THESE WERE BASED ON ONE STUDY EACH, WITH THE EXCEPTION OF LEAVING THE STUDY EARLY. THESE INCLUDED MENTAL STATE (IMPROVEMENT IN POSITIVE AND NEGATIVE SYNDROME SCALE, 1 RCT, N = 83, RR 0.70 CI 0.55 TO 0.88, MEDIUM-QUALITY EVIDENCE), SOCIAL FUNCTIONING (IMPROVEMENT IN SOCIAL OCCUPATIONAL FUNCTIONING SCALE, 1 RCT, N = 83, RR 0.88 CI 0.77 TO 1, MEDIUM-QUALITY EVIDENCE), QUALITY OF LIFE (AVERAGE CHANGE 36-ITEM SHORT FORM SURVEY (SF-36) QUALITY-OF-LIFE SUBSCALE, 1 RCT, N = 60, MD 15.50, 95% CI 4.27 TO 26.73, LOW-QUALITY EVIDENCE), AND LEAVING THE STUDY EARLY (8 RCTS, N = 457, RR 0.91 CI 0.6 TO 1.37, MEDIUM-QUALITY EVIDENCE). FOR THE OUTCOME OF PHYSICAL HEALTH, THERE WAS NOT A CLEAR DIFFERENCE BETWEEN GROUPS (AVERAGE CHANGE SF-36 PHYSICAL-HEALTH SUBSCALE, 1 RCT, N = 60, MD 6.60, 95% CI -2.44 TO 15.64, LOW-QUALITY EVIDENCE). ONLY ONE STUDY REPORTED ADVERSE EFFECTS, FINDING NO INCIDENCE OF ADVERSE EVENTS IN EITHER TREATMENT GROUP. THIS REVIEW WAS SUBJECT TO A CONSIDERABLE NUMBER OF MISSING OUTCOMES, WHICH INCLUDED GLOBAL STATE, CHANGE IN COGNITION, COSTS OF CARE, EFFECT ON STANDARD CARE, SERVICE INTERVENTION, DISABILITY, AND ACTIVITIES OF DAILY LIVING. AUTHORS' CONCLUSIONS: EVEN THOUGH WE FOUND SOME POSITIVE EVIDENCE IN FAVOUR OF YOGA OVER STANDARD-CARE CONTROL, THIS SHOULD BE INTERPRETED CAUTIOUSLY IN VIEW OF OUTCOMES LARGELY BASED EACH ON ONE STUDY WITH LIMITED SAMPLE SIZES AND SHORT-TERM FOLLOW-UP. OVERALL, MANY OUTCOMES WERE NOT REPORTED AND EVIDENCE PRESENTED IN THIS REVIEW IS OF LOW TO MODERATE QUALITY - -TOO WEAK TO INDICATE THAT YOGA IS SUPERIOR TO STANDARD-CARE CONTROL FOR THE MANAGEMENT OF SCHIZOPHRENIA. 2015 2 2518 89 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 3 2629 108 YOGA FOR THE PRIMARY PREVENTION OF CARDIOVASCULAR DISEASE. BACKGROUND: A SEDENTARY LIFESTYLE AND STRESS ARE MAJOR RISK FACTORS FOR CARDIOVASCULAR DISEASE (CVD). SINCE YOGA INVOLVES EXERCISE AND IS THOUGHT TO HELP IN STRESS REDUCTION IT MAY BE AN EFFECTIVE STRATEGY IN THE PRIMARY PREVENTION OF CVD. OBJECTIVES: TO DETERMINE THE EFFECT OF ANY TYPE OF YOGA ON THE PRIMARY PREVENTION OF CVD. SEARCH METHODS: WE SEARCHED THE FOLLOWING ELECTRONIC DATABASES: THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL) (2013, ISSUE 11) IN THE COCHRANE LIBRARY; MEDLINE (OVID) (1946 TO NOVEMBER WEEK 3 2013); EMBASE CLASSIC + EMBASE (OVID) (1947 TO 2013 WEEK 48); WEB OF SCIENCE (THOMSON REUTERS) (1970 TO 4 DECEMBER 2013); DATABASE OF ABSTRACTS OF REVIEWS OF EFFECTS (DARE), HEALTH TECHNOLOGY ASSESSMENT DATABASE AND HEALTH ECONOMICS EVALUATIONS DATABASE (ISSUE 4 OF 4, 2013) IN THE COCHRANE LIBRARY. WE ALSO SEARCHED A NUMBER OF ASIAN DATABASES AND THE ALLIED AND COMPLEMENTARY MEDICINE DATABASE (AMED) (INCEPTION TO DECEMBER 2012). WE SEARCHED TRIAL REGISTERS AND REFERENCE LISTS OF REVIEWS AND ARTICLES, AND APPROACHED EXPERTS IN THE FIELD. WE APPLIED NO LANGUAGE RESTRICTIONS. SELECTION CRITERIA: RANDOMISED CONTROLLED TRIALS LASTING AT LEAST THREE MONTHS INVOLVING HEALTHY ADULTS OR THOSE AT HIGH RISK OF CVD. TRIALS EXAMINED ANY TYPE OF YOGA AND THE COMPARISON GROUP WAS NO INTERVENTION OR MINIMAL INTERVENTION. OUTCOMES OF INTEREST WERE CLINICAL CVD EVENTS AND MAJOR CVD RISK FACTORS. WE DID NOT INCLUDE ANY TRIALS THAT INVOLVED MULTIFACTORIAL LIFESTYLE INTERVENTIONS OR WEIGHT LOSS. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SELECTED TRIALS FOR INCLUSION, EXTRACTED DATA AND ASSESSED THE RISK OF BIAS. MAIN RESULTS: WE IDENTIFIED 11 TRIALS (800 PARTICIPANTS) AND TWO ONGOING STUDIES. STYLE AND DURATION OF YOGA DIFFERED BETWEEN TRIALS. HALF OF THE PARTICIPANTS RECRUITED TO THE STUDIES WERE AT HIGH RISK OF CVD. MOST OF STUDIES WERE AT RISK OF PERFORMANCE BIAS, WITH INADEQUATE DETAILS REPORTED IN MANY OF THEM TO JUDGE THE RISK OF SELECTION BIAS.NO STUDY REPORTED CARDIOVASCULAR MORTALITY, ALL-CAUSE MORTALITY OR NON-FATAL EVENTS, AND MOST STUDIES WERE SMALL AND SHORT-TERM. THERE WAS SUBSTANTIAL HETEROGENEITY BETWEEN STUDIES MAKING IT IMPOSSIBLE TO COMBINE STUDIES STATISTICALLY FOR SYSTOLIC BLOOD PRESSURE AND TOTAL CHOLESTEROL. YOGA WAS FOUND TO PRODUCE REDUCTIONS IN DIASTOLIC BLOOD PRESSURE (MEAN DIFFERENCE (MD) -2.90 MMHG, 95% CONFIDENCE INTERVAL (CI) -4.52 TO -1.28), WHICH WAS STABLE ON SENSITIVITY ANALYSIS, TRIGLYCERIDES (MD -0.27 MMOL/L, 95% CI -0.44 TO -0.11) AND HIGH-DENSITY LIPOPROTEIN (HDL) CHOLESTEROL (MD 0.08 MMOL/L, 95% CI 0.02 TO 0.14). HOWEVER, THE CONTRIBUTING STUDIES WERE SMALL, SHORT-TERM AND AT UNCLEAR OR HIGH RISK OF BIAS. THERE WAS NO CLEAR EVIDENCE OF A DIFFERENCE BETWEEN GROUPS FOR LOW-DENSITY LIPOPROTEIN (LDL) CHOLESTEROL (MD -0.09 MMOL/L, 95% CI -0.48 TO 0.30), ALTHOUGH THERE WAS MODERATE STATISTICAL HETEROGENEITY. ADVERSE EVENTS, OCCURRENCE OF TYPE 2 DIABETES AND COSTS WERE NOT REPORTED IN ANY OF THE INCLUDED STUDIES. QUALITY OF LIFE WAS MEASURED IN THREE TRIALS BUT THE RESULTS WERE INCONCLUSIVE. AUTHORS' CONCLUSIONS: THE LIMITED EVIDENCE COMES FROM SMALL, SHORT-TERM, LOW-QUALITY STUDIES. THERE IS SOME EVIDENCE THAT YOGA HAS FAVOURABLE EFFECTS ON DIASTOLIC BLOOD PRESSURE, HDL CHOLESTEROL AND TRIGLYCERIDES, AND UNCERTAIN EFFECTS ON LDL CHOLESTEROL. THESE RESULTS SHOULD BE CONSIDERED AS EXPLORATORY AND INTERPRETED WITH CAUTION. 2014 4 2543 117 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 5 2827 214 YOGA VERSUS NON-STANDARD CARE FOR SCHIZOPHRENIA. BACKGROUND: YOGA IS AN ANCIENT SPIRITUAL PRACTICE THAT ORIGINATED IN INDIA AND IS CURRENTLY ACCEPTED IN THE WESTERN WORLD AS A FORM OF RELAXATION AND EXERCISE. IT HAS BEEN OF INTEREST FOR PEOPLE WITH SCHIZOPHRENIA AS AN ALTERNATIVE OR ADJUNCTIVE TREATMENT. OBJECTIVES: TO SYSTEMATICALLY ASSESS THE EFFECTS OF YOGA VERSUS NON-STANDARD CARE FOR PEOPLE WITH SCHIZOPHRENIA. SEARCH METHODS: THE INFORMATION SPECIALIST OF THE COCHRANE SCHIZOPHRENIA GROUP SEARCHED THEIR SPECIALISED TRIALS REGISTER (LATEST 30 MARCH 2017), WHICH IS BASED ON REGULAR SEARCHES OF MEDLINE, PUBMED, EMBASE, CINAHL, BIOSIS, AMED, PSYCINFO, AND REGISTRIES OF CLINICAL TRIALS. WE SEARCHED THE REFERENCES OF ALL INCLUDED STUDIES. THERE ARE NO LANGUAGE, DATE, DOCUMENT TYPE, OR PUBLICATION STATUS LIMITATIONS FOR INCLUSION OF RECORDS IN THE REGISTER. SELECTION CRITERIA: ALL RANDOMISED CONTROLLED TRIALS (RCTS) INCLUDING PEOPLE WITH SCHIZOPHRENIA AND COMPARING YOGA WITH NON-STANDARD CARE. WE INCLUDED TRIALS THAT MET OUR SELECTION CRITERIA AND REPORTED USEABLE DATA. DATA COLLECTION AND ANALYSIS: THE REVIEW TEAM INDEPENDENTLY SELECTED STUDIES, ASSESSED QUALITY, AND EXTRACTED DATA. FOR BINARY OUTCOMES, WE CALCULATED RISK RATIO (RR) AND ITS 95% CONFIDENCE INTERVAL (CI), ON AN INTENTION-TO-TREAT BASIS. FOR CONTINUOUS DATA, WE ESTIMATED THE MEAN DIFFERENCE (MD) BETWEEN GROUPS AND ITS 95% CI. WE EMPLOYED A FIXED-EFFECT MODELS FOR ANALYSES. WE EXAMINED DATA FOR HETEROGENEITY (I(2) TECHNIQUE), ASSESSED RISK OF BIAS FOR INCLUDED STUDIES, AND CREATED A 'SUMMARY OF FINDINGS' TABLE FOR SEVEN MAIN OUTCOMES OF INTEREST USING GRADE (GRADING OF RECOMMENDATIONS ASSESSMENT, DEVELOPMENT AND EVALUATION). MAIN RESULTS: WE WERE ABLE TO INCLUDE SIX STUDIES (586 PARTICIPANTS). NON-STANDARD CARE CONSISTED SOLELY OF ANOTHER TYPE OF EXERCISE PROGRAMME. ALL OUTCOMES WERE SHORT TERM (LESS THAN SIX MONTHS). THERE WAS A CLEAR DIFFERENCE IN THE OUTCOME LEAVING THE STUDY EARLY (6 RCTS, N=586, RR 0.64 CI 0.49 TO 0.83, MEDIUM QUALITY EVIDENCE) IN FAVOUR OF THE YOGA GROUP. THERE WERE NO CLEAR DIFFERENCES BETWEEN GROUPS FOR THE REMAINING OUTCOMES. THESE INCLUDED MENTAL STATE (IMPROVEMENT IN POSITIVE AND NEGATIVE SYNDROME SCALE, 1 RCT, N=84, RR 0.81 CI 0.62 TO 1.07, LOW QUALITY EVIDENCE), SOCIAL FUNCTIONING (IMPROVEMENT IN SOCIAL OCCUPATIONAL FUNCTIONING SCALE, 1 RCT, N=84, RR 0.90 CI 0.78 TO 1.04, LOW QUALITY EVIDENCE), QUALITY OF LIFE (MENTAL HEALTH) (AVERAGE CHANGE 36-ITEM SHORT FORM SURVEY (SF-36) QUALITY-OF-LIFE SUB-SCALE, 1 RCT, N=69, MD -5.30 CI -17.78 TO 7.18, LOW QUALITY EVIDENCE), PHYSICAL HEALTH, (AVERAGE CHANGE WHOQOL-BREF PHYSICAL-HEALTH SUB-SCALE, 1 RCT, N=69, MD 9.22 CI -0.42 TO 18.86, LOW QUALITY EVIDENCE). ONLY ONE STUDY REPORTED ADVERSE EFFECTS, FINDING NO INCIDENCE OF ADVERSE EVENTS IN EITHER TREATMENT GROUP. THERE WERE A CONSIDERABLE NUMBER OF MISSING OUTCOMES, WHICH INCLUDED RELAPSE, CHANGE IN COGNITION, COSTS OF CARE, EFFECT ON STANDARD CARE, SERVICE INTERVENTION, DISABILITY, AND ACTIVITIES OF DAILY LIVING. AUTHORS' CONCLUSIONS: WE FOUND MINIMAL DIFFERENCES BETWEEN YOGA AND NON-STANDARD CARE, THE LATTER CONSISTING OF ANOTHER EXERCISE COMPARATOR, WHICH COULD BE BROADLY CONSIDERED AEROBIC EXERCISE. OUTCOMES WERE LARGELY BASED ON SINGLE STUDIES WITH LIMITED SAMPLE SIZES AND SHORT-TERM FOLLOW-UP. OVERALL, MANY OUTCOMES WERE NOT REPORTED AND EVIDENCE PRESENTED IN THIS REVIEW IS OF LOW TO MODERATE QUALITY - TOO WEAK TO INDICATE THAT YOGA IS SUPERIOR OR INFERIOR TO NON-STANDARD CARE CONTROL FOR MANAGEMENT OF PEOPLE WITH SCHIZOPHRENIA. 2017 6 944 57 EFFECTS OF A 12-WEEK HATHA YOGA INTERVENTION ON METABOLIC RISK AND QUALITY OF LIFE IN HONG KONG CHINESE ADULTS WITH AND WITHOUT METABOLIC SYNDROME. OBJECTIVE: TO DETERMINE THE EFFICACY OF A 12-WEEK HATHA YOGA INTERVENTION TO IMPROVE METABOLIC RISK PROFILES AND HEALTH-RELATED QUALITY OF LIFE (HRQOL) IN CHINESE ADULTS WITH AND WITHOUT METABOLIC SYNDROME (METS). METHODS: WE CONDUCTED A CONTROLLED TRIAL WITHIN AN UNIVERSITY-AFFILIATED HOSPITAL. 173 CHINESE MEN AND WOMEN AGED 18 OR ABOVE WERE ASSIGNED TO EITHER THE YOGA INTERVENTION GROUP (N = 87) OR THE CONTROL GROUP (N = 86). PRIMARY OUTCOMES INCLUDED 12-WEEK CHANGE IN METABOLIC RISK FACTORS AND METS Z SCORE. SECONDARY OUTCOME WAS HRQOL (MEDICAL OUTCOMES SHORT FORM SURVEY AT 12 WEEKS). RESULTS: THE MEAN AGE OF PARTICIPANTS WAS 52.0 (SD 7.4, RANGE 31-71) YEARS. ANALYSIS INVOLVING THE ENTIRE STUDY POPULATION REVEALED THAT THE YOGA GROUP ACHIEVED GREATER DECLINE IN WAIST CIRCUMFERENCE (P<0.001), FASTING GLUCOSE (P<0.01), TRIGLYCERIDES (P<0.05), AND METS Z SCORE (P<0.01). YOGA TRAINING ALSO IMPROVED GENERAL HEALTH PERCEPTIONS (P<0.01), PHYSICAL COMPONENT SCORE (P<0.01), AND SOCIAL FUNCTIONING (P<0.01) DOMAINS SCORE OF HRQOL. HOWEVER, NO SIGNIFICANT DIFFERENCES BETWEEN GROUPS WERE OBSERVED IN THE MEAN CHANGE OF SYSTOLIC/DIASTOLIC BLOOD PRESSURES OR HIGH-DENSITY LIPID PROTEIN CHOLESTEROL (ALL P>0.05). THERE WERE NO SIGNIFICANT DIFFERENCES IN THE INTERVENTION EFFECTS ON WAIST CIRCUMFERENCE AND METS Z SCORE BETWEEN THE METS SUBGROUPS (BOTH P>0.05). CONCLUSION: A 12-WEEK HATHA YOGA INTERVENTION IMPROVES METABOLIC RISK PROFILES AND HRQOL IN CHINESE ADULTS WITH AND WITHOUT METS. TRIAL REGISTRATION: AUSTRALIAN NEW ZEALAND CLINICAL TRIALS REGISTRY ACTRN12613000816752. 2015 7 2497 171 YOGA AS PART OF A PACKAGE OF CARE VERSUS STANDARD CARE FOR SCHIZOPHRENIA. BACKGROUND: YOGA IS AN ANCIENT SPIRITUAL PRACTICE THAT ORIGINATED IN INDIA AND IS CURRENTLY ACCEPTED IN THE WESTERN WORLD AS A FORM OF RELAXATION AND EXERCISE. IT HAS BEEN OF INTEREST FOR PEOPLE WITH SCHIZOPHRENIA TO DETERMINE THE EFFICACY OF YOGA DELIVERED AS A PACKAGE OF CARE VERSUS STANDARD CARE. OBJECTIVES: TO EXAMINE THE EFFECTS OF YOGA AS A PACKAGE OF CARE VERSUS STANDARD CARE. SEARCH METHODS: WE SEARCHED THE COCHRANE SCHIZOPHRENIA GROUP TRIALS REGISTER (LATEST 30 MARCH 2017) WHICH IS BASED ON REGULAR SEARCHES OF MEDLINE, PUBMED, EMBASE, CINAHL, BIOSS, AMED, PSYCHINFO, AND REGISTRIES OF CLINICAL TRIALS. WE SEARCHED THE REFERENCES OF ALL INCLUDED STUDIES. THERE ARE NO LANGUAGE, DATE, DOCUMENT TYPE, OR PUBLICATION STATUS LIMITATIONS FOR INCLUSION OF RECORDS IN THE REGISTER. SELECTION CRITERIA: ALL RANDOMISED CONTROLLED TRIALS (RCTS) INCLUDING PEOPLE WITH SCHIZOPHRENIA COMPARING YOGA AS A PACKAGE OF CARE WITH STANDARD-CARE CONTROL. DATA COLLECTION AND ANALYSIS: THE REVIEW AUTHORS INDEPENDENTLY SELECTED STUDIES, QUALITY RATED THESE, AND EXTRACTED DATA. FOR BINARY OUTCOMES, WE CALCULATED RISK DIFFERENCE (RD) AND ITS 95% CONFIDENCE INTERVAL (CI), ON AN INTENTION-TO-TREAT (ITT) BASIS. FOR CONTINUOUS DATA, WE ESTIMATED THE MEAN DIFFERENCE (MD) BETWEEN GROUPS AND ITS CI. WE EMPLOYED MIXED-EFFECT AND FIXED-EFFECT MODELS FOR ANALYSIS. WE EXAMINED HETEROGENEITY (I(2) TECHNIQUE), ASSESSED RISK OF BIAS FOR INCLUDED STUDIES, AND CREATED A 'SUMMARY OF FINDINGS' TABLE USING GRADE (GRADING OF RECOMMENDATIONS ASSESSMENT, DEVELOPMENT AND EVALUATION). MAIN RESULTS: THREE STUDIES ARE INCLUDED IN THIS REVIEW. ALL OUTCOMES WERE SHORT TERM (LESS THAN EIGHT WEEKS). USEABLE DATA WERE REPORTED FOR TWO OUTCOMES ONLY; LEAVING THE STUDY EARLY AND QUALITY OF LIFE. NONE OF THE PARTICIPANTS LEFT THE STUDIES EARLY AND THERE WAS SOME EVIDENCE IN FAVOUR OF THE YOGA PACKAGE FOR QUALITY OF LIFE ENDPOINT SCORES (1 RCT, N=80, MD 22.93 CI 19.74 TO 26.12, LOW-QUALITY EVIDENCE). LEAVING THE STUDY EARLY DATA WERE EQUIVOCAL BETWEEN THE TREATMENT GROUPS (3 RCTS, N=193, RD 0.06 CI -0.01 TO 0.13, MEDIUM-QUALITY EVIDENCE, HIGH HETEROGENEITY). OVERALL, THIS REVIEW HAS AN INORDINATE NUMBER OF MISSING KEY OUTCOMES, WHICH INCLUDED MENTAL AND GLOBAL STATE, SOCIAL FUNCTIONING, PHYSICAL HEALTH, ADVERSE EFFECTS AND COSTS OF CARE. AUTHORS' CONCLUSIONS: A SMALL NUMBER OF SMALL STUDIES WERE INCLUDED IN THIS REVIEW AND THESE LACKED MANY KEY OUTCOMES. THE SPARSE DATA MEANS WE CANNOT STATE WITH ANY DEGREE OF CERTAINTY IF YOGA DELIVERED AS A PACKAGE OF CARE IS BENEFICIAL IN COMPARISON TO STANDARD CARE. 2017 8 938 52 EFFECTS OF 1-YEAR YOGA ON CARDIOVASCULAR RISK FACTORS IN MIDDLE-AGED AND OLDER ADULTS WITH METABOLIC SYNDROME: A RANDOMIZED TRIAL. BACKGROUND: METABOLIC SYNDROME (METS) IS A CLUSTERING OF CARDIOVASCULAR RISK FACTORS, WHICH IS ASSOCIATED WITH DIABETES MELLITUS AND CARDIOVASCULAR DISEASE. LIFESTYLE INTERVENTIONS APPLIED TO PEOPLE WITH METS HAS CONSIDERABLE BENEFICIAL EFFECTS ON DISEASE PREVENTIVE OUTCOMES. THIS STUDY AIMED TO EXAMINE THE EFFECTS OF 1-YEAR OF YOGA EXERCISE ON THE CARDIOVASCULAR RISK FACTORS INCLUDING CENTRAL OBESITY, HYPERTENSION, DYSLIPIDEMIA AND HYPERGLYCEMIA IN MIDDLE-AGED AND OLDER HONG KONG CHINESE ADULTS WITH METS. METHODS: ADULTS DIAGNOSED WITH METS USING NATIONAL CHOLESTEROL EDUCATION PROGRAM CRITERIA (N = 182; MEAN +/- SD AGE = 56 +/- 9.1) WERE RANDOMLY ASSIGNED TO A 1-YEAR YOGA INTERVENTION GROUP OR CONTROL GROUP. SYSTOLIC AND DIASTOLIC BLOOD PRESSURE, WAIST CIRCUMFERENCE, FASTING PLASMA GLUCOSE, TRIGLYCERIDES, AND HIGH-DENSITY LIPOPROTEIN CHOLESTEROL WERE EXAMINED AT BASELINE, MIDWAY, AND ON COMPLETION OF THE STUDY. PHYSICAL ACTIVITY LEVEL AND CALORIC INTAKE WERE ASSESSED AND INCLUDED IN THE COVARIATE ANALYSES. RESULTS: A REDUCTION OF THE NUMBER OF DIAGNOSTIC COMPONENTS FOR METS WAS FOUND TO BE ASSOCIATED WITH THE YOGA INTERVENTION. WAIST CIRCUMFERENCE WAS SIGNIFICANTLY IMPROVED AFTER THE 1-YEAR YOGA INTERVENTION. A TREND TOWARDS A DECREASE IN SYSTOLIC BLOOD PRESSURE WAS OBSERVED FOLLOWING YOGA INTERVENTION. CONCLUSION: THESE RESULTS SUGGEST THAT YOGA EXERCISE IMPROVES THE CARDIOVASCULAR RISK FACTORS INCLUDING CENTRAL OBESITY AND BLOOD PRESSURE IN MIDDLE-AGED AND OLDER ADULTS WITH METS. THESE FINDINGS SUPPORT THE COMPLEMENTARY BENEFICIAL ROLE OF YOGA IN MANAGING METS. 2015 9 2636 114 YOGA FOR TREATING URINARY INCONTINENCE IN WOMEN. BACKGROUND: URINARY INCONTINENCE IN WOMEN IS ASSOCIATED WITH POOR QUALITY OF LIFE AND DIFFICULTIES IN SOCIAL, PSYCHOLOGICAL AND SEXUAL FUNCTIONING. THE CONDITION MAY AFFECT UP TO 15% OF MIDDLE-AGED OR OLDER WOMEN IN THE GENERAL POPULATION. CONSERVATIVE TREATMENTS SUCH AS LIFESTYLE INTERVENTIONS, BLADDER TRAINING AND PELVIC FLOOR MUSCLE TRAINING (USED EITHER ALONE OR IN COMBINATION WITH OTHER INTERVENTIONS) ARE THE INITIAL APPROACHES TO THE MANAGEMENT OF URINARY INCONTINENCE. MANY WOMEN ARE INTERESTED IN ADDITIONAL TREATMENTS SUCH AS YOGA, A SYSTEM OF PHILOSOPHY, LIFESTYLE AND PHYSICAL PRACTICE THAT ORIGINATED IN ANCIENT INDIA. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA FOR TREATING URINARY INCONTINENCE IN WOMEN. SEARCH METHODS: WE SEARCHED THE COCHRANE INCONTINENCE AND COCHRANE COMPLEMENTARY MEDICINE SPECIALISED REGISTERS. WE SEARCHED THE WORLD HEALTH ORGANIZATION INTERNATIONAL CLINICAL TRIALS REGISTRY PLATFORM (WHO ICTRP) AND CLINICALTRIALS.GOV TO IDENTIFY ANY ONGOING OR UNPUBLISHED STUDIES. WE HANDSEARCHED PROCEEDINGS OF THE INTERNATIONAL CONGRESS ON COMPLEMENTARY MEDICINE RESEARCH AND THE EUROPEAN CONGRESS FOR INTEGRATIVE MEDICINE. WE SEARCHED THE NHS ECONOMIC EVALUATION DATABASE FOR ECONOMIC STUDIES, AND SUPPLEMENTED THIS SEARCH WITH SEARCHES FOR ECONOMICS STUDIES IN MEDLINE AND EMBASE FROM 2015 ONWARDS. DATABASE SEARCHES ARE UP-TO-DATE AS OF 21 JUNE 2018. SELECTION CRITERIA: RANDOMISED CONTROLLED TRIALS IN WOMEN DIAGNOSED WITH URINARY INCONTINENCE IN WHICH ONE GROUP WAS ALLOCATED TO TREATMENT WITH YOGA. DATA COLLECTION AND ANALYSIS: TWO REVIEW AUTHORS INDEPENDENTLY SCREENED TITLES AND ABSTRACTS OF ALL RETRIEVED ARTICLES, SELECTED STUDIES FOR INCLUSION, EXTRACTED DATA, ASSESSED RISK OF BIAS AND EVALUATED THE CERTAINTY OF THE EVIDENCE FOR EACH REPORTED OUTCOME. ANY DISAGREEMENTS WERE RESOLVED BY CONSENSUS. WE PLANNED TO COMBINE CLINICALLY COMPARABLE STUDIES IN REVIEW MANAGER 5 USING RANDOM-EFFECTS META-ANALYSIS AND TO CARRY OUT SENSITIVITY AND SUBGROUP ANALYSES. WE PLANNED TO CREATE A TABLE LISTING ECONOMIC STUDIES ON YOGA FOR INCONTINENCE BUT NOT CARRY OUT ANY ANALYSES ON THESE STUDIES. MAIN RESULTS: WE INCLUDED TWO STUDIES (INVOLVING A TOTAL OF 49 WOMEN). EACH STUDY COMPARED YOGA TO A DIFFERENT COMPARATOR, THEREFORE WE WERE UNABLE TO COMBINE THE DATA IN A META-ANALYSIS. A THIRD STUDY THAT HAS BEEN COMPLETED BUT NOT YET FULLY REPORTED IS AWAITING ASSESSMENT.ONE INCLUDED STUDY WAS A SIX-WEEK STUDY COMPARING YOGA TO A WAITING LIST IN 19 WOMEN WITH EITHER URGENCY URINARY INCONTINENCE OR STRESS URINARY INCONTINENCE. WE JUDGED THE CERTAINTY OF THE EVIDENCE FOR ALL REPORTED OUTCOMES AS VERY LOW DUE TO PERFORMANCE BIAS, DETECTION BIAS, AND IMPRECISION. THE NUMBER OF WOMEN REPORTING CURE WAS NOT REPORTED. WE ARE UNCERTAIN WHETHER YOGA RESULTS IN SATISFACTION WITH CURE OR IMPROVEMENT OF INCONTINENCE (RISK RATIO (RR) 6.33, 95% CONFIDENCE INTERVAL (CI) 1.44 TO 27.88; AN INCREASE OF 592 FROM 111 PER 1000, 95% CI 160 TO 1000). WE ARE UNCERTAIN WHETHER THERE IS A DIFFERENCE BETWEEN YOGA AND WAITING LIST IN CONDITION-SPECIFIC QUALITY OF LIFE AS MEASURED ON THE INCONTINENCE IMPACT QUESTIONNAIRE SHORT FORM (MEAN DIFFERENCE (MD) 1.74, 95% CI -33.02 TO 36.50); THE NUMBER OF MICTURITIONS (MD -0.77, 95% CI -2.13 TO 0.59); THE NUMBER OF INCONTINENCE EPISODES (MD -1.57, 95% CI -2.83 TO -0.31); OR THE BOTHERSOMENESS OF INCONTINENCE AS MEASURED ON THE UROGENITAL DISTRESS INVENTORY 6 (MD -0.90, 95% CI -1.46 TO -0.34). THERE WAS NO EVIDENCE OF A DIFFERENCE IN THE NUMBER OF WOMEN WHO EXPERIENCED AT LEAST ONE ADVERSE EVENT (RISK DIFFERENCE 0%, 95% CI -38% TO 38%; NO DIFFERENCE FROM 222 PER 1000, 95% CI 380 FEWER TO 380 MORE).THE SECOND INCLUDED STUDY WAS AN EIGHT-WEEK STUDY IN 30 WOMEN WITH URGENCY URINARY INCONTINENCE THAT COMPARED MINDFULNESS-BASED STRESS REDUCTION (MBSR) TO AN ACTIVE CONTROL INTERVENTION OF YOGA CLASSES. THE STUDY WAS UNBLINDED, AND THERE WAS HIGH ATTRITION FROM BOTH STUDY ARMS FOR ALL OUTCOME ASSESSMENTS. WE JUDGED THE CERTAINTY OF THE EVIDENCE FOR ALL REPORTED OUTCOMES AS VERY LOW DUE TO PERFORMANCE BIAS, ATTRITION BIAS, IMPRECISION AND INDIRECTNESS. THE NUMBER OF WOMEN REPORTING CURE WAS NOT REPORTED. WE ARE UNCERTAIN WHETHER WOMEN IN THE YOGA GROUP WERE LESS LIKELY TO REPORT IMPROVEMENT IN INCONTINENCE AT EIGHT WEEKS COMPARED TO WOMEN IN THE MBSR GROUP (RR 0.09, 95% CI 0.01 TO 1.43; A DECREASE OF 419 FROM 461 PER 1000, 95% CI 5 TO 660). WE ARE UNCERTAIN ABOUT THE EFFECT OF MBSR COMPARED TO YOGA ON REPORTS OF CURE OR IMPROVEMENT IN INCONTINENCE, IMPROVEMENT IN CONDITION-SPECIFIC QUALITY OF LIFE MEASURED ON THE OVERACTIVE BLADDER HEALTH-RELATED QUALITY OF LIFE SCALE, REDUCTION IN INCONTINENCE EPISODES OR REDUCTION IN BOTHERSOMENESS OF INCONTINENCE AS MEASURED ON THE OVERACTIVE BLADDER SYMPTOM AND QUALITY OF LIFE-SHORT FORM AT EIGHT WEEKS. THE STUDY DID NOT REPORT ON ADVERSE EFFECTS. AUTHORS' CONCLUSIONS: WE IDENTIFIED FEW TRIALS ON YOGA FOR INCONTINENCE, AND THE EXISTING TRIALS WERE SMALL AND AT HIGH RISK OF BIAS. IN ADDITION, WE DID NOT FIND ANY STUDIES OF ECONOMIC OUTCOMES RELATED TO YOGA FOR URINARY INCONTINENCE. DUE TO THE LACK OF EVIDENCE TO ANSWER THE REVIEW QUESTION, WE ARE UNCERTAIN WHETHER YOGA IS USEFUL FOR WOMEN WITH URINARY INCONTINENCE. ADDITIONAL, WELL-CONDUCTED TRIALS WITH LARGER SAMPLE SIZES ARE NEEDED. 2019 10 2587 113 YOGA FOR IMPROVING HEALTH-RELATED QUALITY OF LIFE, MENTAL HEALTH AND CANCER-RELATED SYMPTOMS IN WOMEN DIAGNOSED WITH BREAST CANCER. BACKGROUND: BREAST CANCER IS THE CANCER MOST FREQUENTLY DIAGNOSED IN WOMEN WORLDWIDE. EVEN THOUGH SURVIVAL RATES ARE CONTINUALLY INCREASING, BREAST CANCER IS OFTEN ASSOCIATED WITH LONG-TERM PSYCHOLOGICAL DISTRESS, CHRONIC PAIN, FATIGUE AND IMPAIRED QUALITY OF LIFE. YOGA COMPRISES ADVICE FOR AN ETHICAL LIFESTYLE, SPIRITUAL PRACTICE, PHYSICAL ACTIVITY, BREATHING EXERCISES AND MEDITATION. IT IS A COMPLEMENTARY THERAPY THAT IS COMMONLY RECOMMENDED FOR BREAST CANCER-RELATED IMPAIRMENTS AND HAS BEEN SHOWN TO IMPROVE PHYSICAL AND MENTAL HEALTH IN PEOPLE WITH DIFFERENT CANCER TYPES. OBJECTIVES: TO ASSESS EFFECTS OF YOGA ON HEALTH-RELATED QUALITY OF LIFE, MENTAL HEALTH AND CANCER-RELATED SYMPTOMS AMONG WOMEN WITH A DIAGNOSIS OF BREAST CANCER WHO ARE RECEIVING ACTIVE TREATMENT OR HAVE COMPLETED TREATMENT. SEARCH METHODS: WE SEARCHED THE COCHRANE BREAST CANCER SPECIALISED REGISTER, MEDLINE (VIA PUBMED), EMBASE, THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL; 2016, ISSUE 1), INDEXING OF INDIAN MEDICAL JOURNALS (INDMED), THE WORLD HEALTH ORGANIZATION (WHO) INTERNATIONAL CLINICAL TRIALS REGISTRY PLATFORM (ICTRP) SEARCH PORTAL AND CLINICALTRIALS.GOV ON 29 JANUARY 2016. WE ALSO SEARCHED REFERENCE LISTS OF IDENTIFIED RELEVANT TRIALS OR REVIEWS, AS WELL AS CONFERENCE PROCEEDINGS OF THE INTERNATIONAL CONGRESS ON COMPLEMENTARY MEDICINE RESEARCH (ICCMR), THE EUROPEAN CONGRESS FOR INTEGRATIVE MEDICINE (ECIM) AND THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY (ASCO). WE APPLIED NO LANGUAGE RESTRICTIONS. SELECTION CRITERIA: RANDOMISED CONTROLLED TRIALS WERE ELIGIBLE WHEN THEY (1) COMPARED YOGA INTERVENTIONS VERSUS NO THERAPY OR VERSUS ANY OTHER ACTIVE THERAPY IN WOMEN WITH A DIAGNOSIS OF NON-METASTATIC OR METASTATIC BREAST CANCER, AND (2) ASSESSED AT LEAST ONE OF THE PRIMARY OUTCOMES ON PATIENT-REPORTED INSTRUMENTS, INCLUDING HEALTH-RELATED QUALITY OF LIFE, DEPRESSION, ANXIETY, FATIGUE OR SLEEP DISTURBANCES. DATA COLLECTION AND ANALYSIS: TWO REVIEW AUTHORS INDEPENDENTLY COLLECTED DATA ON METHODS AND RESULTS. WE EXPRESSED OUTCOMES AS STANDARDISED MEAN DIFFERENCES (SMDS) WITH 95% CONFIDENCE INTERVALS (CIS) AND CONDUCTED RANDOM-EFFECTS MODEL META-ANALYSES. WE ASSESSED POTENTIAL RISK OF PUBLICATION BIAS THROUGH VISUAL ANALYSIS OF FUNNEL PLOT SYMMETRY AND HETEROGENEITY BETWEEN STUDIES BY USING THE CHI(2) TEST AND THE I(2) STATISTIC. WE CONDUCTED SUBGROUP ANALYSES FOR CURRENT TREATMENT STATUS, TIME SINCE DIAGNOSIS, STAGE OF CANCER AND TYPE OF YOGA INTERVENTION. MAIN RESULTS: WE INCLUDED 24 STUDIES WITH A TOTAL OF 2166 PARTICIPANTS, 23 OF WHICH PROVIDED DATA FOR META-ANALYSIS. THIRTEEN STUDIES HAD LOW RISK OF SELECTION BIAS, FIVE STUDIES REPORTED ADEQUATE BLINDING OF OUTCOME ASSESSMENT AND 15 STUDIES HAD LOW RISK OF ATTRITION BIAS.SEVENTEEN STUDIES THAT COMPARED YOGA VERSUS NO THERAPY PROVIDED MODERATE-QUALITY EVIDENCE SHOWING THAT YOGA IMPROVED HEALTH-RELATED QUALITY OF LIFE (POOLED SMD 0.22, 95% CI 0.04 TO 0.40; 10 STUDIES, 675 PARTICIPANTS), REDUCED FATIGUE (POOLED SMD -0.48, 95% CI -0.75 TO -0.20; 11 STUDIES, 883 PARTICIPANTS) AND REDUCED SLEEP DISTURBANCES IN THE SHORT TERM (POOLED SMD -0.25, 95% CI -0.40 TO -0.09; SIX STUDIES, 657 PARTICIPANTS). THE FUNNEL PLOT FOR HEALTH-RELATED QUALITY OF LIFE WAS ASYMMETRICAL, FAVOURING NO THERAPY, AND THE FUNNEL PLOT FOR FATIGUE WAS ROUGHLY SYMMETRICAL. THIS HINTS AT OVERALL LOW RISK OF PUBLICATION BIAS. YOGA DID NOT APPEAR TO REDUCE DEPRESSION (POOLED SMD -0.13, 95% CI -0.31 TO 0.05; SEVEN STUDIES, 496 PARTICIPANTS; LOW-QUALITY EVIDENCE) OR ANXIETY (POOLED SMD -0.53, 95% CI -1.10 TO 0.04; SIX STUDIES, 346 PARTICIPANTS; VERY LOW-QUALITY EVIDENCE) IN THE SHORT TERM AND HAD NO MEDIUM-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE (POOLED SMD 0.10, 95% CI -0.23 TO 0.42; TWO STUDIES, 146 PARTICIPANTS; LOW-QUALITY EVIDENCE) OR FATIGUE (POOLED SMD -0.04, 95% CI -0.36 TO 0.29; TWO STUDIES, 146 PARTICIPANTS; LOW-QUALITY EVIDENCE). INVESTIGATORS REPORTED NO SERIOUS ADVERSE EVENTS.FOUR STUDIES THAT COMPARED YOGA VERSUS PSYCHOSOCIAL/EDUCATIONAL INTERVENTIONS PROVIDED MODERATE-QUALITY EVIDENCE INDICATING THAT YOGA CAN REDUCE DEPRESSION (POOLED SMD -2.29, 95% CI -3.97 TO -0.61; FOUR STUDIES, 226 PARTICIPANTS), ANXIETY (POOLED SMD -2.21, 95% CI -3.90 TO -0.52; THREE STUDIES, 195 PARTICIPANTS) AND FATIGUE (POOLED SMD -0.90, 95% CI -1.31 TO -0.50; TWO STUDIES, 106 PARTICIPANTS) IN THE SHORT TERM. VERY LOW-QUALITY EVIDENCE SHOWED NO SHORT-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE (POOLED SMD 0.81, 95% CI -0.50 TO 2.12; TWO STUDIES, 153 PARTICIPANTS) OR SLEEP DISTURBANCES (POOLED SMD -0.21, 95% CI -0.76 TO 0.34; TWO STUDIES, 119 PARTICIPANTS). NO TRIAL ADEQUATELY REPORTED SAFETY-RELATED DATA.THREE STUDIES THAT COMPARED YOGA VERSUS EXERCISE PRESENTED VERY LOW-QUALITY EVIDENCE SHOWING NO SHORT-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE (POOLED SMD -0.04, 95% CI -0.30 TO 0.23; THREE STUDIES, 233 PARTICIPANTS) OR FATIGUE (POOLED SMD -0.21, 95% CI -0.66 TO 0.25; THREE STUDIES, 233 PARTICIPANTS); NO TRIAL PROVIDED SAFETY-RELATED DATA. AUTHORS' CONCLUSIONS: MODERATE-QUALITY EVIDENCE SUPPORTS THE RECOMMENDATION OF YOGA AS A SUPPORTIVE INTERVENTION FOR IMPROVING HEALTH-RELATED QUALITY OF LIFE AND REDUCING FATIGUE AND SLEEP DISTURBANCES WHEN COMPARED WITH NO THERAPY, AS WELL AS FOR REDUCING DEPRESSION, ANXIETY AND FATIGUE, WHEN COMPARED WITH PSYCHOSOCIAL/EDUCATIONAL INTERVENTIONS. VERY LOW-QUALITY EVIDENCE SUGGESTS THAT YOGA MIGHT BE AS EFFECTIVE AS OTHER EXERCISE INTERVENTIONS AND MIGHT BE USED AS AN ALTERNATIVE TO OTHER EXERCISE PROGRAMMES. 2017 11 2583 64 YOGA FOR HEART RATE VARIABILITY: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CLINICAL TRIALS. THE OBJECTIVE OF THIS SYSTEMATIC REVIEW IS TO SUMMARIZE AND CRITICALLY ASSESS THE EFFECTS OF YOGA ON HEART RATE VARIABILITY (HRV). NINE DATABASES WERE SEARCHED FROM THEIR INCEPTIONS TO JUNE 2014. WE INCLUDED RANDOMIZED CLINICAL TRIALS (RCTS) COMPARING YOGA AGAINST ANY TYPE OF CONTROL INTERVENTION IN HEALTHY INDIVIDUALS OR PATIENTS WITH ANY MEDICAL CONDITION. RISK OF BIAS WAS ASSESSED USING THE COCHRANE CRITERIA. TWO REVIEWERS PERFORMED THE SELECTION OF STUDIES, DATA EXTRACTION, AND QUALITY ASSESSMENTS INDEPENDENT OF ONE ANOTHER. FOURTEEN TRIALS MET THE INCLUSION CRITERIA. ONLY TWO OF THEM WERE OF ACCEPTABLE METHODOLOGICAL QUALITY. TEN RCTS REPORTED FAVOURABLE EFFECTS OF YOGA ON VARIOUS DOMAINS OF HRV, WHEREAS NINE OF THEM FAILED TO DO SO. ONE RCT DID NOT REPORT BETWEEN-GROUP COMPARISONS. THE META-ANALYSIS (MA) OF TWO TRIALS DID NOT SHOW FAVOURABLE EFFECTS OF YOGA COMPARED TO USUAL CARE ON E:I RATIO (N = 61, SMDS = 0.63; 95% CIS [-0.72 TO 1.99], P = 0.36; HETEROGENEITY: R(2) = 0.79, CHI(2) = 5.48, DF = 1, (P = 0.02); I(2) = 82%). THE MA ALSO FAILED TO SHOW STATISTICALLY SIGNIFICANT DIFFERENCES BETWEEN THE GROUPS REGARDING THE 30:15 RATIO (N = 61, SMDS = 0.20; 95% CIS [-0.43 TO 0.84], P = 0.53; HETEROGENEITY: R(2) = 0.07, CHI(2) = 1.45, DF = 1, (P = 0.23); I(2) = 31%). THE DATA FROM THE REMAINING RCTS WERE TOO HETEROGENEOUS FOR POOLING. THESE RESULTS PROVIDE NO CONVINCING EVIDENCE FOR THE EFFECTIVENESS OF YOGA IN MODULATING HRV IN PATIENTS OR HEALTHY SUBJECTS. FUTURE INVESTIGATIONS IN THIS AREA SHOULD OVERCOME THE MULTIPLE METHODOLOGICAL WEAKNESSES OF THE PREVIOUS RESEARCH. 2015 12 2397 59 YOGA AND COGNITION: A META-ANALYSIS OF CHRONIC AND ACUTE EFFECTS. OBJECTIVES: TO REVIEW AND SYNTHESIZE THE EXISTING LITERATURE ON THE EFFECTS OF YOGA ON COGNITIVE FUNCTION BY DETERMINING EFFECT SIZES THAT COULD SERVE AS A PLATFORM TO DESIGN, CALCULATE STATISTICAL POWER, AND IMPLEMENT FUTURE STUDIES. METHODS: THROUGH ELECTRONIC DATABASES, WE IDENTIFIED ACUTE STUDIES AND RANDOMIZED CONTROLLED TRIALS (RCTS) OF YOGA THAT REPORTED COGNITIVE OUTCOMES. INCLUSION CRITERIA INCLUDED THE FOLLOWING: USE OF AN OBJECTIVE MEASURE OF COGNITION AND SUFFICIENT DATA REPORTED TO ESTIMATE AN EFFECT SIZE. THE META-ANALYSIS WAS CONDUCTED USING COMPREHENSIVE META-ANALYSIS SOFTWARE. A RANDOM-EFFECTS MODEL WAS USED TO CALCULATE THE OVERALL WEIGHTED EFFECT SIZES, EXPRESSED AS HEDGE G. RESULTS: FIFTEEN RCTS AND 7 ACUTE EXPOSURE STUDIES EXAMINED THE EFFECTS OF YOGA ON COGNITION. A MODERATE EFFECT (G = 0.33, STANDARD ERROR = 0.08, 95% CONFIDENCE INTERVAL = 0.18-0.48, P < .001) OF YOGA ON COGNITION WAS OBSERVED FOR RCTS, WITH THE STRONGEST EFFECT FOR ATTENTION AND PROCESSING SPEED (G = 0.29, P < .001), FOLLOWED BY EXECUTIVE FUNCTION (G = 0.27, P = .001) AND MEMORY (G = 0.18, P = .051). ACUTE STUDIES SHOWED A STRONGER OVERALL EFFECT OF YOGA ON COGNITION (G = 0.56, STANDARD ERROR = 0.11, 95% CONFIDENCE INTERVAL = 0.33-0.78, P < .001). THE EFFECT WAS STRONGEST FOR MEMORY (G = 0.78, P < .001), FOLLOWED BY ATTENTION AND PROCESSING SPEED MEASURES (G = 0.49, P < .001) AND EXECUTIVE FUNCTIONS (G = 0.39, P < .003). CONCLUSIONS: YOGA PRACTICE SEEMS TO BE ASSOCIATED WITH MODERATE IMPROVEMENTS IN COGNITIVE FUNCTION. ALTHOUGH THE STUDIES ARE LIMITED BY SAMPLE SIZE, HETEROGENEOUS POPULATION CHARACTERISTICS, VARIED DOSES OF YOGA INTERVENTIONS, AND A MYRIAD OF COGNITIVE TESTS, THESE FINDINGS WARRANT RIGOROUS SYSTEMATIC RCTS AND WELL-DESIGNED COUNTERBALANCED ACUTE STUDIES TO COMPREHENSIVELY EXPLORE YOGA AS A MEANS TO IMPROVE OR SUSTAIN COGNITIVE ABILITIES ACROSS THE LIFE SPAN. 2015 13 1898 44 RESTORATIVE YOGA AND METABOLIC RISK FACTORS: THE PRACTICING RESTORATIVE YOGA VS. STRETCHING FOR THE METABOLIC SYNDROME (PRYSMS) RANDOMIZED TRIAL. AIMS: INTENSIVE LIFESTYLE CHANGE PREVENTS TYPE 2 DIABETES BUT IS DIFFICULT TO SUSTAIN. PRELIMINARY EVIDENCE SUGGESTS THAT YOGA MAY IMPROVE METABOLIC FACTORS. WE TESTED A RESTORATIVE YOGA INTERVENTION VS. ACTIVE STRETCHING FOR METABOLIC OUTCOMES. METHODS: IN 2009-2012, WE CONDUCTED A 48-WEEK RANDOMIZED TRIAL COMPARING RESTORATIVE YOGA VS. STRETCHING AMONG UNDERACTIVE ADULTS WITH THE METABOLIC SYNDROME AT THE UNIVERSITIES OF CALIFORNIA, SAN FRANCISCO AND SAN DIEGO. WE PROVIDED LIFESTYLE COUNSELING AND A TAPERING SERIES OF 90-MIN GROUP CLASSES IN THE 24-WEEK INTERVENTION PERIOD AND 24-WEEK MAINTENANCE PERIOD. FASTING AND 2-H GLUCOSE, HBA1C, TRIGLYCERIDES, HDL-CHOLESTEROL, INSULIN, SYSTOLIC BLOOD PRESSURE, VISCERAL FAT, AND QUALITY OF LIFE WERE ASSESSED AT BASELINE, 6- AND 12-MONTHS. RESULTS: 180 PARTICIPANTS WERE RANDOMIZED AND 135 (75%) COMPLETED THE TRIAL. AT 12 MONTHS, FASTING GLUCOSE DECREASED MORE IN THE YOGA GROUP THAN IN THE STRETCHING GROUP (-0.35 MMOL/L VS. -0.03 MMOL/L; P=0.002); THERE WERE NO OTHER SIGNIFICANT DIFFERENCES BETWEEN GROUPS. AT 6 MONTHS FAVORABLE CHANGES WITHIN THE YOGA GROUP INCLUDED REDUCTIONS IN FASTING GLUCOSE, INSULIN, AND HBA1C AND AN INCREASE IN HDL-CHOLESTEROL THAT WERE NOT SUSTAINED AT 1 YEAR EXCEPT CHANGES IN FASTING GLUCOSE. THE STRETCHING GROUP HAD A SIGNIFICANT REDUCTION IN TRIGLYCERIDES AT 6 MONTHS WHICH WAS NOT SUSTAINED AT 1 YEAR BUT HAD IMPROVED QUALITY OF LIFE AT BOTH TIME-POINTS. CONCLUSIONS: RESTORATIVE YOGA WAS MARGINALLY BETTER THAN STRETCHING FOR IMPROVING FASTING GLUCOSE BUT NOT OTHER METABOLIC FACTORS. 2014 14 2165 75 THE EFFECTS OF YOGA COMPARED TO ACTIVE AND INACTIVE CONTROLS ON PHYSICAL FUNCTION AND HEALTH RELATED QUALITY OF LIFE IN OLDER ADULTS- SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMISED CONTROLLED TRIALS. BACKGROUND: YOGA HAS BEEN RECOMMENDED AS A MUSCLE STRENGTHENING AND BALANCE ACTIVITY IN NATIONAL AND GLOBAL PHYSICAL ACTIVITY GUIDELINES. HOWEVER, THE EVIDENCE BASE ESTABLISHING THE EFFECTIVENESS OF YOGA IN IMPROVING PHYSICAL FUNCTION AND HEALTH RELATED QUALITY OF LIFE (HRQOL) IN AN OLDER ADULT POPULATION NOT RECRUITED ON THE BASIS OF ANY SPECIFIC DISEASE OR CONDITION, HAS NOT BEEN SYSTEMATICALLY REVIEWED. THE OBJECTIVE OF THIS STUDY WAS TO SYNTHESISE EXISTING EVIDENCE ON THE EFFECTS OF YOGA ON PHYSICAL FUNCTION AND HRQOL IN OLDER ADULTS NOT CHARACTERISED BY ANY SPECIFIC CLINICAL CONDITION. METHODS: THE FOLLOWING DATABASES WERE SYSTEMATICALLY SEARCHED IN SEPTEMBER 2017: MEDLINE, PSYCINFO, CINAHL PLUS, SCOPUS, WEB OF SCIENCE, COCHRANE LIBRARY, EMBASE, SPORTDISCUS, AMED AND PROQUEST DISSERTATIONS & THESES GLOBAL. STUDY INCLUSION CRITERIA: OLDER ADULT PARTICIPANTS WITH MEAN AGE OF 60 YEARS AND ABOVE, NOT RECRUITED ON THE BASIS OF ANY SPECIFIC DISEASE OR CONDITION; YOGA INTERVENTION COMPARED WITH INACTIVE CONTROLS (EXAMPLE: WAIT-LIST CONTROL, EDUCATION BOOKLETS) OR ACTIVE CONTROLS (EXAMPLE: WALKING, CHAIR AEROBICS); PHYSICAL FUNCTION AND HRQOL OUTCOMES; AND RANDOMISED/CLUSTER RANDOMISED CONTROLLED TRIALS PUBLISHED IN ENGLISH. A VOTE COUNTING ANALYSIS AND META-ANALYSIS WITH STANDARDISED EFFECT SIZES (HEDGES' G) COMPUTED USING RANDOM EFFECTS MODELS WERE CONDUCTED. RESULTS: A TOTAL OF 27 RECORDS FROM 22 RCTS WERE INCLUDED (17 RCTS ASSESSED PHYSICAL FUNCTION AND 20 ASSESSED HRQOL). THE META-ANALYSIS REVEALED SIGNIFICANT EFFECTS (5% LEVEL OF SIGNIFICANCE) FAVOURING THE YOGA GROUP FOR THE FOLLOWING PHYSICAL FUNCTION OUTCOMES COMPARED WITH INACTIVE CONTROLS: BALANCE (EFFECT SIZE (ES) = 0.7), LOWER BODY FLEXIBILITY (ES = 0.5), LOWER LIMB STRENGTH (ES = 0.45); COMPARED WITH ACTIVE CONTROLS: LOWER LIMB STRENGTH (ES = 0.49), LOWER BODY FLEXIBILITY (ES = 0.28). FOR HRQOL, SIGNIFICANT EFFECTS FAVOURING YOGA WERE FOUND COMPARED TO INACTIVE CONTROLS FOR: DEPRESSION (ES = 0.64), PERCEIVED MENTAL HEALTH (ES = 0.6), PERCEIVED PHYSICAL HEALTH (ES = 0.61), SLEEP QUALITY (ES = 0.65), AND VITALITY (ES = 0.31); COMPARED TO ACTIVE CONTROLS: DEPRESSION (ES = 0.54). CONCLUSION: THIS REVIEW IS THE FIRST TO COMPARE THE EFFECTS OF YOGA WITH ACTIVE AND INACTIVE CONTROLS IN OLDER ADULTS NOT CHARACTERISED BY A SPECIFIC CLINICAL CONDITION. RESULTS INDICATE THAT YOGA INTERVENTIONS IMPROVE MULTIPLE PHYSICAL FUNCTION AND HRQOL OUTCOMES IN THIS POPULATION COMPARED TO BOTH CONTROL CONDITIONS. THIS STUDY PROVIDES ROBUST EVIDENCE FOR PROMOTING YOGA IN PHYSICAL ACTIVITY GUIDELINES FOR OLDER ADULTS AS A MULTIMODAL ACTIVITY THAT IMPROVES ASPECTS OF FITNESS LIKE STRENGTH, BALANCE AND FLEXIBILITY, AS WELL AS MENTAL WELLBEING. TRIAL REGISTRATION: PROSPERO REGISTRATION NUMBER: CRD42016038052 . 2019 15 2860 66 YOGA-BASED EXERCISE IMPROVES HEALTH-RELATED QUALITY OF LIFE AND MENTAL WELL-BEING IN OLDER PEOPLE: A SYSTEMATIC REVIEW OF RANDOMISED CONTROLLED TRIALS. OBJECTIVE: HEALTH-RELATED QUALITY OF LIFE (HRQOL) AND MENTAL WELL-BEING ARE ASSOCIATED WITH HEALTHY AGEING. PHYSICAL ACTIVITY POSITIVELY IMPACTS BOTH HRQOL AND MENTAL WELL-BEING. YOGA IS A PHYSICAL ACTIVITY THAT CAN BE MODIFIED TO SUITS THE NEEDS OF OLDER PEOPLE AND IS GROWING IN POPULARITY. WE CONDUCTED A SYSTEMATIC REVIEW WITH META-ANALYSIS TO DETERMINE THE IMPACT OF YOGA-BASED EXERCISE ON HRQOL AND MENTAL WELL-BEING IN PEOPLE AGED 60+. METHODS: SEARCHES WERE CONDUCTED FOR RELEVANT TRIALS IN THE FOLLOWING ELECTRONIC DATABASES; MEDLINE, EMBASE, COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, CINAHL, ALLIED AND COMPLEMENTARY MEDICINE DATABASE, PSYCINFO AND THE PHYSIOTHERAPY EVIDENCE DATABASE (PEDRO) FROM INCEPTION TO JANUARY 2017. TRIALS THAT EVALUATED THE EFFECT OF PHYSICAL YOGA ON HRQOL AND/OR ON MENTAL WELL-BEING IN PEOPLE AGED 60+ YEARS WERE INCLUDED. DATA ON HRQOL AND MENTAL WELL-BEING WERE EXTRACTED. STANDARDISED MEAN DIFFERENCES AND 95% CONFIDENCE INTERVALS (CI) WERE CALCULATED USING RANDOM EFFECTS MODELS. METHODOLOGICAL QUALITY OF TRIALS WAS ASSESSED USING THE PEDRO SCALE. RESULTS: TWELVE TRIALS OF HIGH METHODOLOGICAL QUALITY (MEAN PEDRO SCORE 6.1), TOTALLING 752 PARTICIPANTS, WERE IDENTIFIED AND PROVIDED DATA FOR THE META-ANALYSIS. YOGA PRODUCED A MEDIUM EFFECT ON HRQOL (HEDGES' G = 0.51, 95% CI 0.25-0.76, 12 TRIALS) AND A SMALL EFFECT ON MENTAL WELL-BEING (HEDGES' G = 0.38, 95% CI 0.15-0.62, 12 TRIALS). CONCLUSION: YOGA INTERVENTIONS RESULTED IN SMALL TO MODERATE IMPROVEMENTS IN BOTH HRQOL AND MENTAL WELL-BEING IN PEOPLE AGED 60+ YEARS. FURTHER, RESEARCH IS NEEDED TO DETERMINE THE OPTIMAL DOSE OF YOGA TO MAXIMISE HEALTH IMPACT. PROSPERO REGISTRATION NUMBER: (CRD42016052458). 2018 16 2594 60 YOGA FOR METABOLIC SYNDROME: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND METABOLIC SYNDROME IS THE MOST IMPORTANT RISK FACTOR FOR DEVELOPING CARDIOVASCULAR DISEASE AND TYPE 2 DIABETES. THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY ASSESS AND PERFORM A META-ANALYSIS OF THE EFFECTS OF YOGA ON THE PARAMETERS OF METABOLIC SYNDROME. METHODS MEDLINE/PUBMED, SCOPUS, THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS AND INDMED WERE SEARCHED AND SCREENED FROM THEIR INCEPTION THROUGH TO 8 MARCH 2016 FOR RANDOMISED CONTROLLED TRIALS ON YOGA FOR PATIENTS WITH METABOLIC SYNDROME. RISK OF BIAS WAS ASSESSED USING THE COCHRANE RISK OF BIAS TOOL. RESULTS SEVEN TRIALS WITH A TOTAL OF 794 PARTICIPANTS WERE INCLUDED. NO EFFECTS OF YOGA ON RESOLUTION OF METABOLIC SYNDROME, DIASTOLIC BLOOD PRESSURE, TRIGLYCERIDES, HIGH-DENSITY LIPOPROTEIN CHOLESTEROL AND FASTING PLASMA GLUCOSE WERE FOUND, BUT YOGA WAS SUPERIOR TO USUAL CARE FOR WAIST CIRCUMFERENCE (STANDARDISED MEAN DIFFERENCE (SMD) = -0.35; 95% CONFIDENCE INTERVAL (CI) = -0.57 TO -0.13; P < 0.01) AND SYSTOLIC BLOOD PRESSURE (SMD = -0.29; 95% CI = -0.51 TO -0.07; P = 0.01). HOWEVER, THESE EFFECTS WERE NOT ROBUST AGAINST SELECTION BIAS. NO INTERVENTION-RELATED ADVERSE EVENTS WERE REPORTED. CONCLUSION BASED ON THE RESULTS OF THIS META-ANALYSIS, NO RECOMMENDATION CAN BE MADE FOR OR AGAINST YOGA IN ORDER TO INFLUENCE THE PARAMETERS OF METABOLIC SYNDROME. DESPITE METHODOLOGICAL DRAWBACKS, AND UNTIL FURTHER RESEARCH IS UNDERTAKEN, YOGA CAN BE PRELIMINARILY CONSIDERED AS A SAFE AND EFFECTIVE INTERVENTION FOR REDUCING WAIST CIRCUMFERENCE AND SYSTOLIC BLOOD PRESSURE IN INDIVIDUALS WITH METABOLIC SYNDROME WHO ARE NOT ADHERING TO CONVENTIONAL FORMS OF EXERCISE. 2016 17 247 58 A YOGA INTERVENTION FOR TYPE 2 DIABETES RISK REDUCTION: A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: TYPE 2 DIABETES IS A MAJOR HEALTH PROBLEM IN MANY COUNTRIES INCLUDING INDIA. YOGA MAY BE AN EFFECTIVE TYPE 2 DIABETES PREVENTION STRATEGY IN INDIA, PARTICULARLY GIVEN ITS CULTURAL FAMILIARITY. METHODS: THIS WAS A PARALLEL, RANDOMIZED CONTROLLED PILOT STUDY TO COLLECT FEASIBILITY AND PRELIMINARY EFFICACY DATA ON YOGA FOR DIABETES RISK FACTORS AMONG PEOPLE AT HIGH RISK OF DIABETES. PRIMARY OUTCOMES INCLUDED: CHANGES IN BMI, WAIST CIRCUMFERENCE, FASTING BLOOD GLUCOSE, POSTPRANDIAL BLOOD GLUCOSE, INSULIN, INSULIN RESISTANCE, BLOOD PRESSURE, AND CHOLESTEROL. WE ALSO LOOKED AT MEASURES OF PSYCHOLOGICAL WELL-BEING INCLUDING CHANGES IN DEPRESSION, ANXIETY, POSITIVE AND NEGATIVE AFFECT AND PERCEIVED STRESS. FORTY-ONE PARTICIPANTS WITH ELEVATED FASTING BLOOD GLUCOSE IN BANGALORE, INDIA WERE RANDOMIZED TO EITHER YOGA (N = 21) OR A WALKING CONTROL (N = 20). PARTICIPANTS WERE ASKED TO EITHER ATTEND YOGA CLASSES OR COMPLETE MONITORED WALKING 3-6 DAYS PER WEEK FOR EIGHT WEEKS. RANDOMIZATION AND ALLOCATION WAS PERFORMED USING COMPUTER-GENERATED RANDOM NUMBERS AND GROUP ASSIGNMENTS DELIVERED IN SEALED, OPAQUE ENVELOPES GENERATED BY OFF-SITE STUDY STAFF. DATA WERE ANALYZED BASED ON INTENTION TO TREAT. RESULTS: THIS STUDY WAS FEASIBLE IN TERMS OF RECRUITMENT, RETENTION AND ADHERENCE. IN ADDITION, YOGA PARTICIPANTS HAD SIGNIFICANTLY GREATER REDUCTIONS IN WEIGHT, WAIST CIRCUMFERENCE AND BMI VERSUS CONTROL (WEIGHT -0.8 +/- 2.1 VS. 1.4 +/- 3.6, P = 0.02; WAIST CIRCUMFERENCE -4.2 +/- 4.8 VS. 0.7 +/- 4.2, P < 0.01; BMI -0.2 +/- 0.8 VS. 0.6 +/- 1.6, P = 0.05). THERE WERE NO BETWEEN GROUP DIFFERENCES IN FASTING BLOOD GLUCOSE, POSTPRANDIAL BLOOD GLUCOSE, INSULIN RESISTANCE OR ANY OTHER FACTORS RELATED TO DIABETES RISK OR PSYCHOLOGICAL WELL-BEING. THERE WERE SIGNIFICANT REDUCTIONS IN SYSTOLIC AND DIASTOLIC BLOOD PRESSURE, TOTAL CHOLESTEROL, ANXIETY, DEPRESSION, NEGATIVE AFFECT AND PERCEIVED STRESS IN BOTH THE YOGA INTERVENTION AND WALKING CONTROL OVER THE COURSE OF THE STUDY. CONCLUSION: AMONG INDIANS WITH ELEVATED FASTING BLOOD GLUCOSE, WE FOUND THAT PARTICIPATION IN AN 8-WEEK YOGA INTERVENTION WAS FEASIBLE AND RESULTED IN GREATER WEIGHT LOSS AND REDUCTION IN WAIST CIRCUMFERENCE WHEN COMPARED TO A WALKING CONTROL. YOGA OFFERS A PROMISING LIFESTYLE INTERVENTION FOR DECREASING WEIGHT-RELATED TYPE 2 DIABETES RISK FACTORS AND POTENTIALLY INCREASING PSYCHOLOGICAL WELL-BEING. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIED NCT00090506. 2014 18 2607 72 YOGA FOR PRENATAL DEPRESSION: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: PRENATAL DEPRESSION CAN NEGATIVELY AFFECT THE PHYSICAL AND MENTAL HEALTH OF BOTH MOTHER AND FETUS. THE AIM OF THIS STUDY WAS TO DETERMINE THE EFFECTIVENESS OF YOGA AS AN INTERVENTION IN THE MANAGEMENT OF PRENATAL DEPRESSION. METHODS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS (RCTS) WAS CONDUCTED BY SEARCHING PUBMED, EMBASE, THE COCHRANE LIBRARY AND PSYCINFO FROM ALL RETRIEVED ARTICLES DESCRIBING SUCH TRIALS UP TO JULY 2014. RESULTS: SIX RCTS WERE IDENTIFIED IN THE SYSTEMATIC SEARCH. THE SAMPLE CONSISTED OF 375 PREGNANT WOMEN, MOST OF WHOM WERE BETWEEN 20 AND 40 YEARS OF AGE. THE DIAGNOSES OF DEPRESSION WERE DETERMINED BY THEIR SCORES ON STRUCTURED CLINICAL INTERVIEW FOR DSM-IV AND THE CENTER FOR EPIDEMIOLOGICAL STUDIES DEPRESSION SCALE. WHEN COMPARED WITH COMPARISON GROUPS (E.G., STANDARD PRENATAL CARE, STANDARD ANTENATAL EXERCISES, SOCIAL SUPPORT, ETC.), THE LEVEL OF DEPRESSION STATISTICALLY SIGNIFICANTLY REDUCED IN YOGA GROUPS (STANDARDIZED MEAN DIFFERENCE [SMD], -0.59; 95% CONFIDENCE INTERVAL [CI], -0.94 TO -0.25; P = 0.0007). ONE SUBGROUP ANALYSIS REVEALED THAT BOTH THE LEVELS OF DEPRESSIVE SYMPTOMS IN PRENATALLY DEPRESSED WOMEN (SMD, -0.46; CI, -0.90 TO -0.03; P = 0.04) AND NON-DEPRESSED WOMEN (SMD, -0.87; CI, -1.22 TO -0.52; P < 0.00001) WERE STATISTICALLY SIGNIFICANTLY LOWER IN YOGA GROUP THAN THAT IN CONTROL GROUP. THERE WERE TWO KINDS OF YOGA: THE PHYSICAL-EXERCISE-BASED YOGA AND INTEGRATED YOGA, WHICH, BESIDES PHYSICAL EXERCISES, INCLUDED PRANAYAMA, MEDITATION OR DEEP RELAXATION. THEREFORE, THE OTHER SUBGROUP ANALYSIS WAS CONDUCTED TO ESTIMATE EFFECTS OF THE TWO KINDS OF YOGA ON PRENATAL DEPRESSION. THE RESULTS SHOWED THAT THE LEVEL OF DEPRESSION WAS SIGNIFICANTLY DECREASED IN THE INTEGRATED YOGA GROUP (SMD, -0.79; CI, -1.07 TO -0.51; P < 0.00001) BUT NOT SIGNIFICANTLY REDUCED IN PHYSICAL-EXERCISE-BASED YOGA GROUP (SMD, -0.41; CI, -1.01 TO -0.18; P = 0.17). CONCLUSIONS: PRENATAL YOGA INTERVENTION IN PREGNANT WOMEN MAY BE EFFECTIVE IN PARTLY REDUCING DEPRESSIVE SYMPTOMS. 2015 19 2330 44 TWELVE WEEKS OF YOGA FOR CHRONIC NONSPECIFIC LOWER BACK PAIN: A META-ANALYSIS. OBJECTIVES: TO INVESTIGATE THE OVERALL EFFECTS OF 12 WEEKS OF YOGA PRACTICE ON CHRONIC NONSPECIFIC LOWER BACK PAIN. METHODS: PUBMED, EMBASE, PSYCINFO, WEB OF SCIENCE, AND THE COCHRANE LIBRARY DATABASES WERE SEARCHED FROM INCEPTION TO FEBRUARY 9, 2019, AND SIX RANDOMIZED CONTROLLED TRIALS WERE SELECTED FOR THIS META-ANALYSIS. RESULTS: THE POOLED FIXED-EFFECT SIZE OF SIX TRIALS SHOWED THAT 12 WEEKS OF YOGA PROGRAMS COULD SIGNIFICANTLY REDUCE CHRONIC NONSPECIFIC LOWER BACK PAIN BY 0.41 WITHIN THE TRIALS (STANDARDIZED MEAN DIFFERENCE; 95% CONFIDENCE INTERVAL: -0.58 TO -0.23; P < .0001). SUBGROUP ANALYSES ALSO SHOWED THAT SIGNIFICANT PAIN REDUCTION WAS RELATED TO TYPE OF YOGA, LENGTH OF SESSION, STUDY QUALITY, AND TIMING OF PAIN ASSESSMENT. CONCLUSIONS: THESE FINDINGS REVEAL THAT 12 WEEKS OF YOGA CAN HELP ALLEVIATE PAIN, AND YOGA PROGRAMS SHOULD TAKE INTO ACCOUNT THE SUBGROUP FACTORS TO INCREASE INDIVIDUALS' RELIEF FROM CHRONIC NONSPECIFIC LOWER BACK PAIN. 2020 20 2560 59 YOGA FOR CHRONIC LOW BACK PAIN: A RANDOMIZED TRIAL. BACKGROUND: PREVIOUS STUDIES INDICATE THAT YOGA MAY BE AN EFFECTIVE TREATMENT FOR CHRONIC OR RECURRENT LOW BACK PAIN. OBJECTIVE: TO COMPARE THE EFFECTIVENESS OF YOGA AND USUAL CARE FOR CHRONIC OR RECURRENT LOW BACK PAIN. DESIGN: PARALLEL-GROUP, RANDOMIZED, CONTROLLED TRIAL USING COMPUTER-GENERATED RANDOMIZATION CONDUCTED FROM APRIL 2007 TO MARCH 2010. OUTCOMES WERE ASSESSED BY POSTAL QUESTIONNAIRE. (INTERNATIONAL STANDARD RANDOMISED CONTROLLED TRIAL NUMBER REGISTER: ISRCTN 81079604) SETTING: 13 NON-NATIONAL HEALTH SERVICE PREMISES IN THE UNITED KINGDOM. PATIENTS: 313 ADULTS WITH CHRONIC OR RECURRENT LOW BACK PAIN. INTERVENTION: YOGA (N = 156) OR USUAL CARE (N = 157). ALL PARTICIPANTS RECEIVED A BACK PAIN EDUCATION BOOKLET. THE INTERVENTION GROUP WAS OFFERED A 12-CLASS, GRADUALLY PROGRESSING YOGA PROGRAM DELIVERED BY 12 TEACHERS OVER 3 MONTHS. MEASUREMENTS: SCORES ON THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE (RMDQ) AT 3 (PRIMARY OUTCOME), 6, AND 12 (SECONDARY OUTCOMES) MONTHS; PAIN, PAIN SELF-EFFICACY, AND GENERAL HEALTH MEASURES AT 3, 6, AND 12 MONTHS (SECONDARY OUTCOMES). RESULTS: 93 (60%) PATIENTS OFFERED YOGA ATTENDED AT LEAST 3 OF THE FIRST 6 SESSIONS AND AT LEAST 3 OTHER SESSIONS. THE YOGA GROUP HAD BETTER BACK FUNCTION AT 3, 6, AND 12 MONTHS THAN THE USUAL CARE GROUP. THE ADJUSTED MEAN RMDQ SCORE WAS 2.17 POINTS (95% CI, 1.03 TO 3.31 POINTS) LOWER IN THE YOGA GROUP AT 3 MONTHS, 1.48 POINTS (CI, 0.33 TO 2.62 POINTS) LOWER AT 6 MONTHS, AND 1.57 POINTS (CI, 0.42 TO 2.71 POINTS) LOWER AT 12 MONTHS. THE YOGA AND USUAL CARE GROUPS HAD SIMILAR BACK PAIN AND GENERAL HEALTH SCORES AT 3, 6, AND 12 MONTHS, AND THE YOGA GROUP HAD HIGHER PAIN SELF-EFFICACY SCORES AT 3 AND 6 MONTHS BUT NOT AT 12 MONTHS. TWO OF THE 157 USUAL CARE PARTICIPANTS AND 12 OF THE 156 YOGA PARTICIPANTS REPORTED ADVERSE EVENTS, MOSTLY INCREASED PAIN. LIMITATION: THERE WERE MISSING DATA FOR THE PRIMARY OUTCOME (YOGA GROUP, N = 21; USUAL CARE GROUP, N = 18) AND DIFFERENTIAL MISSING DATA (MORE IN THE YOGA GROUP) FOR SECONDARY OUTCOMES. CONCLUSION: OFFERING A 12-WEEK YOGA PROGRAM TO ADULTS WITH CHRONIC OR RECURRENT LOW BACK PAIN LED TO GREATER IMPROVEMENTS IN BACK FUNCTION THAN DID USUAL CARE. PRIMARY FUNDING SOURCE: ARTHRITIS RESEARCH UK. 2011