1 2565 168 YOGA FOR CORRECTION OF LYMPHEDEMA'S IMPAIRMENT OF GAIT AS AN ADJUNCT TO LYMPHATIC DRAINAGE: A PILOT OBSERVATIONAL STUDY. INTRODUCTION: YOGA USED AS A MAJOR COMPONENT OF INTEGRATIVE TREATMENT PROTOCOL IN 14 INDIAN VILLAGE CAMPS IMPROVED QUALITY-OF-LIFE IN 425 LYMPHATIC FILARIASIS PATIENTS. THEY EXPERIENCED BETTER MOBILITY AND REDUCED DISABILITY. THIS PAPER DOCUMENTS THE GAIT ABNORMALITIES OBSERVED IN LOWER LIMB LYMPHEDEMA PATIENTS AND THE LOCOMOTOR CHANGES FOLLOWING INTEGRATIVE TREATMENT. MATERIALS AND METHODS: YOGA POSTURES WERE PERFORMED AS EXPLAINED BY TRADITIONAL YOGA PRACTICE IN TWO SESSIONS: BEFORE AYURVEDIC OIL MASSAGE WITHOUT COMPRESSION BANDAGES AND AFTER THE MASSAGE WITH COMPRESSION BANDAGES. EACH YOGA POSTURE LASTED FOR 5 MIN AND THE WHOLE SESSION ENDED IN 45 MIN. THROUGHOUT EACH SESSION, WE ADVISED PATIENTS TO DO LONG, DIAPHRAGMATIC BREATHING, CONCENTRATING ON EACH BREATH. THE FLEXION OF JOINTS WAS COORDINATED WITH EXHALATION AND EXTENSION WITH INHALATION. WE EDUCATED THE PATIENTS TO DO LONGER EXPIRATION THAN INSPIRATION. RESULTS AND DISCUSSION: A TOTAL OF 98 PATIENTS (133 LIMBS) ATTENDING THE 6(TH) MONTH FOLLOW-UP WERE EVALUATED. THE MOST COMMON GAIT ABNORMALITY WAS ANTALGIC GAIT. STRUCTURAL AND FUNCTIONAL ABNORMALITIES WERE OBSERVED IN HIP, KNEE AND ANKLE JOINTS. WE FOUND THAT YOGA AS AN ADJUNCT TO OTHER COMPONENTS IN INTEGRATIVE TREATMENT IMPROVED THE GAIT PROBLEMS. LONG STANDING LYMPHEDEMA CAUSED ALTERED GAIT AND JOINT DEFORMITIES. THIS WAS MOSTLY DUE TO INACTIVITY CAUSING MUSCLE WEAKNESS AND EDEMA WITHIN AND AROUND THE MUSCLES. BOTH LARGE AND SMALL LIMBS HAVE SHOWN SIGNIFICANT VOLUME REDUCTION (P < 0.01) DURING FOLLOW-UP AFTER 6 MONTHS. CONCLUSION: THERE CAN BE A MIXED ETIOLOGY FOR GAIT RELATED PROBLEMS IN LYMPHEDEMA PATIENTS. FURTHER STUDIES ARE RECOMMENDED TO UNDERSTAND THE CAUSES OF DEFORMITIES IN LYMPHEDEMA PATIENTS AND AN EXACT ROLE OF YOGA. 2015 2 2766 63 YOGA PROTOCOL FOR TREATMENT OF BREAST CANCER-RELATED LYMPHEDEMA. INTRODUCTION: VAQAS AND RYAN (2003) ADVOCATED YOGA AND BREATHING EXERCISES FOR LYMPHEDEMA. NARAHARI ET AL. (2007) DEVELOPED AN INTEGRATIVE MEDICINE PROTOCOL FOR LOWER-LIMB LYMPHEDEMA USING YOGA. STUDIES HAVE HYPOTHESIZED THAT YOGA PLAYS A SIMILAR ROLE AS THAT OF CENTRAL MANUAL LYMPH DRAINAGE OF FOLDI'S TECHNIQUE. THIS STUDY EXPLAINS HOW WE HAVE USED YOGA AND BREATHING AS A SELF-CARE INTERVENTION FOR BREAST CANCER-RELATED LYMPHEDEMA (BCRL). METHODS: THE STUDY OUTCOME WAS TO CREATE A YOGA PROTOCOL FOR BCRL. SELECTION OF YOGA WAS BASED ON THE ACTIONS OF MUSCLES ON JOINTS, ANATOMICAL AREAS ASSOCIATED WITH DIFFERENT GROUPS OF LYMPH NODES, STRETCHING OF SKIN, AND METHOD OF BREATHING IN EACH YOGA. THE PROTOCOL WAS PILOTED IN EIGHT BCRL PATIENTS, OBSERVED ITS DIFFICULTIES BY INTERACTING WITH PATIENTS. A LITERATURE SEARCH WAS CONDUCTED IN PUBMED AND COCHRANE LIBRARY TO IDENTIFY THE YOGA PROTOCOLS FOR BCRL. RESULTS: TWENTY YOGA AND 5 BREATHING EXERCISES WERE ADOPTED. THEY HAVE SLOW, METHODICAL JOINT MOVEMENTS WHICH HELPED PATIENTS TO TOLERATE PAIN. BREATHING WAS LONG AND DIAPHRAGMATIC. FLEXION OF JOINTS WAS COORDINATED WITH EXHALATION AND EXTENSION WITH INHALATION. ALTERNATE YOGA WAS INTRODUCED TO FACILITATE PATIENTS TO PERFORM COMPLEX MOVEMENTS. YOGA'S JOINT MOVEMENTS, INITIAL POSITIONS, AND MODE OF BREATHING WERE COMPARED TO TWO OTHER PROTOCOLS. THE VOLUME REDUCED FROM 2.4 TO 1.2 L IN EIGHT PATIENTS AFTER CONTINUOUS PRACTICE OF YOGA AND COMPRESSION AT HOME FOR 3 MONTHS. THERE WAS IMPROVEMENT IN THE RANGE OF MOVEMENT AND INTENSITY OF PAIN. DISCUSSION: YOGA EXERCISES WERE SELECTED ON THE BASIS OF THEIR ROLE IN CHEST EXPANSION, MAXIMIZING RANGE OF MOVEMENTS: FLEXION OF LARGE MUSCLES, MAXIMUM STRETCH OF SKIN, AND THUS PART-BY-PART LYMPH DRAINAGE FROM CENTER AND PERIPHERY. THIS PROTOCOL ADDRESSED FUNCTIONAL, VOLUME, AND MOVEMENT ISSUES OF BCRL AND WAS FOUND TO BE SUPERIOR TO OTHER BCRL YOGA PROTOCOLS. HOWEVER, THIS PROTOCOL NEEDS TO BE TESTED IN CENTERS ROUTINELY MANAGING BCRL. 2016 3 321 29 ANALOGY BETWEEN CLASSICAL YOGA/ZEN BREATHING AND MODERN CLINICAL RESPIRATORY THERAPY. ANESTHESIOLOGISTS AND INTENSIVISTS ARE MODERN-DAY PROFESSIONALS WHO PROVIDE APPROPRIATE RESPIRATORY CARE, VITAL FOR PATIENT SURVIVAL. RECENTLY, ANESTHESIOLOGISTS HAVE INCREASINGLY FOCUSED THEIR ATTENTION ON THE TYPE OF SPONTANEOUS BREATHING MADE BY NON-INTUBATED PATIENTS WITH PULMONARY DISEASE CARED FOR IN AN INTENSIVE CARE UNIT, AND ALSO PATIENTS WITH CHRONIC PAIN RECEIVING COGNITIVE BEHAVIORAL THERAPY. PRIOR TO OUR MODERN UNDERSTANDING OF RESPIRATORY PHYSIOLOGY, ZEN MEDITATORS RECOGNIZED THAT BREATHING HAS A SIGNIFICANT IMPACT ON A PERSON'S MENTAL STATE AND GENERAL PHYSICAL WELL-BEING. EXAMPLES OF THIS KNOWLEDGE REGARDING RESPIRATION INCLUDE THE BENEFICIAL EFFECTS OF DEEP INHALATION AND SLOW EXHALATION ON ANXIETY AND GENERAL WELLNESS. THE CLASSICAL LITERATURE HAS NOTED MANY SUGGESTIONS FOR BREATHING AND ITS PSYCHO-PHYSICAL EFFECTS. IN THE PRESENT REVIEW, WE EXAMINE THE EFFECT OF CLASSICAL BREATHING METHODS AND FIND AN ANALOGY BETWEEN TYPICAL YOGA/ZEN BREATHING AND MODERN CLINICAL RESPIRATORY THERAPY. EVIDENCE IS INCREASING ABOUT HISTORICAL BREATHING AND RELATED MEDITATION TECHNIQUES THAT MAY BE EFFECTIVE IN MODERN CLINICAL PRACTICE, ESPECIALLY IN THE FIELD OF ANESTHESIOLOGY, SUCH AS IN IMPROVING RESPIRATORY FUNCTION AND REDUCING CHRONIC PAIN. CLARIFICATION OF THE DETAILED MECHANISMS INVOLVED IS ANTICIPATED. 2020 4 1295 41 GUIDELINES FOR TEACHING YOGA TO WOMEN WITH BREAST CANCER-RELATED LYMPHOEDEMA: AN EVIDENCE-BASED APPROACH. BREAST CANCER-RELATED LYMPHOEDEMA (BCRL) IS A CHRONIC CONDITION THAT REQUIRES LIFELONG MANAGEMENT TO PREVENT THE CONDITION WORSENING AND TO REDUCE THE THREAT OF INFECTION. WOMEN ARE AFFECTED IN ALL DOMAINS OF THEIR LIFE. AS A HOLISTIC PRACTICE, YOGA MAY BE OF BENEFIT BY REDUCING BOTH THE PHYSICAL AND PSYCHOSOCIAL EFFECTS OF LYMPHOEDEMA. WOMEN WITH BCRL ARE ATTENDING YOGA CLASSES IN INCREASING NUMBERS, SO IT IS ESSENTIAL THAT YOGA BE BASED ON PRINCIPLES THAT ENSURE LYMPHOEDEMA IS CONTROLLED AND NOT EXACERBATED. TWO RANDOMISED CONTROLLED TRIALS WITH A YOGA INTERVENTION HAVE HAD POSITIVE RESULTS AFTER AN 8-WEEK INTERVENTION (N=28) AND 6-MONTHS AFTER A 4-WEEK INTERVENTION (N=18). THE FIRST STUDY HAD SEVERAL SIGNIFICANT RESULTS AND WOMEN REPORTED INCREASED BIOPSYCHOSOCIAL IMPROVEMENTS. BOTH STUDIES SHOWED TRENDS TO IMPROVED LYMPHOEDEMA STATUS. THE YOGA INTERVENTIONS COMPROMISED BREATHING, PHYSICAL POSTURES, MEDITATION AND RELAXATION PRACTICES BASED ON SATYANANDA YOGA(R), WITH MODIFICATIONS TO PROMOTE LYMPHATIC DRAINAGE AND FOLLOWING PRINCIPLES OF BEST CURRENT CARE FOR THOSE WITH BCRL. INDIVIDUAL NEEDS WERE CONSIDERED. THE YOGA PROTOCOL THAT WAS USED IN THE 8-WEEK TRIAL IS PRESENTED. OUR AIM IS TO PROVIDE PRINCIPLES FOR YOGA TEACHERS/THERAPISTS WORKING WITH THIS CLIENTELE THAT CAN BE ADAPTED TO OTHER YOGA STYLES. FURTHER, THESE PRINCIPLES MAY PROVIDE A BASIS FOR THE DEVELOPMENT OF YOGA PROGRAMS FOR PEOPLE WITH SECONDARY LYMPHOEDEMA IN OTHER AREAS OF THEIR BODY AS THE POPULATION REQUIRING CANCER TREATMENT CONTINUES TO INCREASE. WHILST THE STYLE OF YOGA PRESENTED HERE HAS HAD POSITIVE OUTCOMES, FURTHER APPLICATION AND RESEARCH IS NEEDED TO FULLY DEMONSTRATE ITS EFFECTIVENESS. 2017 5 1347 32 HYPOXIA IN CNS PATHOLOGIES: EMERGING ROLE OF MIRNA-BASED NEUROTHERAPEUTICS AND YOGA BASED ALTERNATIVE THERAPIES. CELLULAR RESPIRATION IS A VITAL PROCESS FOR THE EXISTENCE OF LIFE. ANY CONDITION THAT RESULTS IN DEPRIVATION OF OXYGEN (ALSO TERMED AS HYPOXIA) MAY EVENTUALLY LEAD TO DELETERIOUS EFFECTS ON THE FUNCTIONING OF TISSUES. BRAIN BEING THE HIGHEST CONSUMER OF OXYGEN IS PRONE TO INCREASED RISK OF HYPOXIA-INDUCED NEUROLOGICAL INSULTS. THIS IN TURN HAS BEEN ASSOCIATED WITH MANY DISEASES OF CENTRAL NERVOUS SYSTEM (CNS) SUCH AS STROKE, ALZHEIMER'S, ENCEPHALOPATHY ETC. ALTHOUGH SEVERAL STUDIES HAVE INVESTIGATED THE PATHOPHYSIOLOGICAL MECHANISMS UNDERLYING ISCHEMIC/HYPOXIC CNS DISEASES, THE KNOWLEDGE ABOUT PROTECTIVE THERAPEUTIC STRATEGIES TO AMELIORATE THE AFFECTED NEURONAL CELLS IS MEAGER. THIS HAS AUGMENTED THE NEED TO IMPROVE OUR UNDERSTANDING OF THE HYPOXIC AND ISCHEMIC EVENTS OCCURRING IN THE BRAIN AND IDENTIFY NOVEL AND ALTERNATE TREATMENT MODALITIES FOR SUCH INSULTS. MICRORNA (MIRNAS), SMALL NON-CODING RNA MOLECULES, HAVE RECENTLY EMERGED AS POTENTIAL NEUROPROTECTIVE AGENTS AS WELL AS TARGETS, UNDER HYPOXIC CONDITIONS. THESE 18-22 NUCLEOTIDE LONG RNA MOLECULES ARE PROFUSELY PRESENT IN BRAIN AND OTHER ORGANS AND FUNCTION AS GENE REGULATORS BY CLEAVING AND SILENCING THE GENE EXPRESSION. IN BRAIN, THESE ARE KNOWN TO BE INVOLVED IN NEURONAL DIFFERENTIATION AND PLASTICITY. THEREFORE, TARGETING MIRNA EXPRESSION REPRESENTS A NOVEL THERAPEUTIC APPROACH TO INTERCEDE AGAINST HYPOXIC AND ISCHEMIC BRAIN INJURY. IN THE FIRST PART OF THIS REVIEW, WE WILL DISCUSS THE NEUROPHYSIOLOGICAL CHANGES CAUSED AS A RESULT OF HYPOXIA, FOLLOWED BY THE CONTRIBUTION OF HYPOXIA IN THE NEURODEGENERATIVE DISEASES. SECONDLY, WE WILL PROVIDE RECENT UPDATES AND INSIGHTS INTO THE ROLES OF MIRNA IN THE REGULATION OF GENES IN OXYGEN AND GLUCOSE DEPRIVED BRAIN IN ASSOCIATION WITH CIRCADIAN RHYTHMS AND HOW THESE CAN BE TARGETED AS NEUROPROTECTIVE AGENTS FOR CNS INJURIES. FINALLY, WE WILL EMPHASIZE ON ALTERNATE BREATHING OR YOGIC INTERVENTIONS TO OVERCOME THE HYPOXIA ASSOCIATED ANOMALIES THAT COULD ULTIMATELY LEAD TO IMPROVEMENT IN CEREBRAL PERFUSION. 2017 6 2157 33 THE EFFECTS OF UPPER LIMB EXERCISE THROUGH YOGA ON LIMB SWELLING IN CHINESE BREAST CANCER SURVIVORS - A PILOT STUDY. PURPOSE: BREAST CANCER IS THE MOST COMMON FEMALE CANCER. THE AIM OF THIS STUDY WAS TO ASSESS THE IMPACT OF YOGA ON LYMPHEDEMA IN BREAST CANCER SURVIVORS. DESIGN: REPEATED MEASURES BEFORE AND AFTER THE INTERVENTION. WE ENROLLED 15 WOMEN WITH BREAST CANCER WHO HAD NOT PREVIOUSLY WORN ELASTIC CLOTHING TO TREAT LYMPHEDEMA. METHODS: THE PROGRAM WAS LED BY A CERTIFIED TRAINER AND CONSISTED OF 60-MINUTE SESSIONS, THREE TIMES A WEEK FOR 12 WEEKS. THE VOLUMES OF THE AFFECTED AND NORMAL LIMBS WERE MEASURED. A SELF-ASSESSED EDEMA SCORE WAS ALSO RECORDED. FINDINGS: FIFTEEN PATIENTS COMPLETED THE PROGRAM, NONE OF WHOM SUFFERED FROM COMPLICATIONS RELATED TO EXERCISE. THERE WAS NO SIGNIFICANT EDEMA AFTER EXERCISE. NO SIGNIFICANT DIFFERENCES WERE NOTED IN SUBGROUP ANALYSIS BY AGE OR THE AFFECTED ARM. CONCLUSIONS: YOGA DOES NOT INDUCE LYMPHEDEMA. CLINICAL RELEVANCE: LYMPHEDEMA IS USUALLY TREATED WITH UNCOMFORTABLE ELASTIC CLOTHING, AND HIGH-RESISTANCE EXERCISE MAY INDUCE EDEMA. YOGA MAY BE SUITABLE FOR THESE PATIENTS. 2017 7 322 31 ANKLE MOTION IN COMMON YOGA POSES. BACKGROUND: MOTION OF THE ANKLE IS ESSENTIAL FOR MANY YOGA POSES. AN UNDERSTANDING OF RANGE OF ANKLE MOTION DURING TYPICAL YOGA POSES MAY HELP THE CLINICIAN TO UNDERSTAND EXPECTED OUTCOMES OF PATIENTS WHEN RETURNING FROM ANKLE SURGERY OR INJURY TO YOGA. METHODS: THE BIOMECHANICS OF TWENTY HEALTHY ACTIVE YOGIS WERE COLLECTED DURING SEVEN YOGA POSES THAT ARE COMMON WITHIN THEIR PRACTICES. MOTION CAPTURE AND FORCE PLATES WERE USED TO ASSESS THE RANGE OF MOTION AND JOINT MOMENTS OF THE ANKLE FOR EACH POSE. RESULTS: ALL POSES RESULTED IN PLANTARFLEXION AND EXTERNAL ROTATION MOMENTS AT THE ANKLE JOINTS. JOINT LOADING WAS HIGHEST IN SINGLE LEG POSES. THE ARC OF MOTION USED BY THE STUDY PARTICIPANTS IN THE POSES WAS 29 DEGREES OF SAGITTAL MOTION, 20 DEGREES OF FRONTAL MOTION AND 35 DEGREES OF TRANSVERSE MOTION. DISCUSSION: ANKLE MOTION WAS EVALUATED WHEN HEALTHY YOGIS PERFORM STANDARD POSES. THESE RESULTS MAY HELP IN DISCUSSION WITH PATIENTS REGARDING EXPECTED OUTCOMES AFTER ANKLE INJURY OR SURGERY. 2019 8 1574 32 MANAGING LYMPHEDEMA, INCREASING RANGE OF MOTION, AND QUALITY OF LIFE THROUGH YOGA THERAPY AMONG BREAST CANCER SURVIVORS: A SYSTEMATIC REVIEW. LYMPHEDEMA IS A COMMON COMPLICATION OF BREAST CANCER TREATMENT. YOGA IS A NONCONVENTIONAL AND NONINVASIVE INTERVENTION THAT IS REPORTED TO SHOW BENEFICIAL EFFECTS IN PATIENTS WITH BREAST CANCER-RELATED LYMPHEDEMA (BCRL). THIS STUDY ATTEMPTED TO SYSTEMATICALLY REVIEW THE EFFECT OF YOGA THERAPY ON MANAGING LYMPHEDEMA, INCREASING THE RANGE OF MOTION (ROM), AND QUALITY OF LIFE (QOL) AMONG BREAST CANCER SURVIVORS. THE REVIEW SEARCH INCLUDED STUDIES FROM ELECTRONIC BIBLIOGRAPHIC DATABASES, NAMELY MEDLINE (PUBMED), EMBASE, AND GOOGLE SCHOLAR TILL JUNE 2019. STUDIES WHICH ASSESSED THE OUTCOME VARIABLES SUCH AS QOL AND MANAGEMENT OF LYMPHEDEMA OR RELATED PHYSICAL SYMPTOMS AS EFFECT OF YOGA INTERVENTION WERE CONSIDERED FOR REVIEW. TWO AUTHORS INDIVIDUALLY REVIEWED, SELECTED ACCORDING TO COCHRANE GUIDELINES, AND EXTRACTED THE ARTICLES USING COVIDENCE SOFTWARE. SCREENING PROCESS OF THIS REVIEW RESULTED IN A TOTAL OF SEVEN STUDIES. THE DIFFERENT STYLES OF YOGA EMPLOYED IN THE STUDIES WERE IYENGAR YOGA (N = 2), SATYANANDA YOGA (N = 2), HATHA YOGA (N = 2), AND ASHTANGA YOGA (N = 1). THE LENGTH OF INTERVENTION AND POST INTERVENTION ANALYSIS RANGED FROM 8 WEEKS TO 12 MONTHS. FOUR STUDIES INCLUDED HOME PRACTICE SESSIONS. QOL, ROM, AND MUSCULOSKELETAL SYMPTOMS SHOWED IMPROVEMENT IN ALL THE STUDIES. YOGA COULD BE A SAFE AND FEASIBLE EXERCISE INTERVENTION FOR BCRL PATIENTS. EVIDENCE GENERATED FROM THESE STUDIES WAS OF MODERATE STRENGTH. FURTHER LONG-TERM CLINICAL TRIALS WITH LARGE SAMPLE SIZE ARE ESSENTIAL FOR THE DEVELOPMENT AND STANDARDIZATION OF YOGA INTERVENTION GUIDELINES FOR BCRL PATIENTS. 2021 9 2013 30 SUDARSHAN KRIYA YOGA: A BREATH OF HOPE DURING COVID-19 PANDEMIC. IMPORTANT COUNTER MEASURES TO COMBAT AN INFECTIOUS DISEASE PANDEMIC INCLUDE VACCINATION, ANTIVIRAL THERAPY, AND IMMUNOMODULATION THERAPY. VACCINATIONS ARE DISEASE SPECIFIC AND MOREOVER STRAIN SPECIFIC, SO THE PROTECTION PROVIDED IS ALSO SPECIFIC AND LIMITED. ANTIVIRAL THERAPIES ARE COSTLY AND REQUIRE BULK PRODUCTION OF DRUGS, HENCE GLOBALLY THERE IS AN INCREASED INTEREST TOWARD LOW-RISK, COST-EFFECTIVE COMPLEMENTARY ALTERNATIVE THERAPIES, SUCH AS YOGA AND AYURVEDA TO TACKLE THE INFECTIOUS PANDEMIC, CORONAVIRUS DISEASE 2019 (COVID-19). THERE IS CLINICAL EVIDENCE AVAILABLE ON THE POTENTIAL COMPLEMENTARY ROLE OF YOGIC PRACTICES IN THE MANAGEMENT OF NONCOMMUNICABLE AND COMMUNICABLE DISEASES. VARIOUS ONLINE DATABASES WERE SEARCHED FOR ARTICLES PUBLISHED BETWEEN 2000 AND 2020. DATABASES EXPLORED WERE MEDLINE, EMBASE, INDIAN CITATION INDEX, PSYCINFO, INDEX MEDICUS FOR SOUTH-EAST ASIA REGION, AND GOOGLE SCHOLAR. ALL SEARCH RESULTS WERE SCREENED, AND ARTICLES RELATED TO KEYWORDS SUCH AS COVID-19, YOGA THERAPY, AND SUDARSHAN KRIYA YOGA (SKY) WERE SELECTED FOR DATA EXTRACTION. QUALITY OF THE STUDIES INCLUDED WAS EVALUATED ON THE BASIS OF THE CONSTRUCT VALIDITY, CONTENT VALIDITY, RELEVANCE, BIAS, CREDIBILITY RELATING TO INFORMATION, AND DATA SOURCES. SKY IS A UNIQUE YOGIC PRACTICE THAT INCLUDES SPECIFIC SEQUENTIAL BREATHING TECHNIQUES. IT BALANCES THE AUTONOMIC NERVOUS SYSTEM AND THUS CAN ALLEVIATE ANXIETY, ROUTINE STRESS, DEPRESSION, STRESS-RELATED MEDICAL DISORDERS, AND POSTTRAUMATIC STRESS. IT POTENTIATES NATURAL HOST IMMUNE DEFENSES THAT ARE ESSENTIAL TO TACKLE A PLETHORA OF MICROBIAL INFECTIONS. THIS NARRATIVE REVIEW ARTICLE PROVIDES AN OVERVIEW OF POTENTIAL THERAPEUTIC BENEFITS THAT SKY CAN OFFER TO THE POPULATION AT LARGE DURING THIS COVID-19 PANDEMIC. 2021 10 1698 30 PAIN-RELATED ENCEPHALIC REGIONS INFLUENCED BY YOGA MEDITATION: AN INTEGRATIVE REVIEW. INTRODUCTION: THE MECHANISMS UNDERLYING THE USE OF YOGA IN PAIN RELIEF ARE STILL UNCLEAR. THIS STUDY REVIEWED LITERATURE REPORTS ON ENCEPHALIC ACTIVITY RELATED TO ANALGESIA INDUCED BY YOGA MEDITATION PRACTICE. METHODS: THIS INTEGRATIVE REVIEW EXAMINED STUDIES PUBLISHED IN THE PUBMED, LILACS AND MEDLINE DATABASES WITHOUT RESTRICTION OF THE YEAR OF PUBLICATION. THE RESEARCH INVOLVED 16 DESCRIPTORS RELATED TO THE WORDS: YOGA, PAIN AND NEUROIMAGING METHODS. INCLUSION CRITERIA INVOLVED ONLY THE PUBLICATIONS AVAILABLE ONLINE, WITH FREE ACCESS AND WRITTEN IN ENGLISH. RESULTS: 2 CASE STUDIES AND 1 PILOT STUDY MET THE CRITERIA. YOGA MEDITATION PRACTICE INDUCES ANALGESIA PRIMARILY THROUGH ATTENUATION OF THE MEDIAL PAIN PERCEPTION SYSTEM INCLUDING THE ANTERIOR CINGULATE CORTEX AND INSULA REGIONS, AS WELL AS THE LATERAL SYSTEM INCLUDING THE SECONDARY SENSORY CORTEX AND THALAMUS. CONCLUSION: YOGA INDUCED ANALGESIA IS A POTENTIALLY IMPORTANT ADJUNCT TO CURRENT PAIN MANAGEMENT. THIS INTEGRATIVE REVIEW REVEALED THAT THERE IS A NEED FOR FURTHER RESEARCH THAT ANALYZES THE ENCEPHALIC REGIONS RELATED TO ANALGESIA INDUCED BY YOGA PRACTICE. 2018 11 1266 22 FLUID INTELLIGENCE AND BRAIN FUNCTIONAL ORGANIZATION IN AGING YOGA AND MEDITATION PRACTITIONERS. NUMEROUS STUDIES HAVE DOCUMENTED THE NORMAL AGE-RELATED DECLINE OF NEURAL STRUCTURE, FUNCTION, AND COGNITIVE PERFORMANCE. PRELIMINARY EVIDENCE SUGGESTS THAT MEDITATION MAY REDUCE DECLINE IN SPECIFIC COGNITIVE DOMAINS AND IN BRAIN STRUCTURE. HERE WE EXTENDED THIS RESEARCH BY INVESTIGATING THE RELATION BETWEEN AGE AND FLUID INTELLIGENCE AND RESTING STATE BRAIN FUNCTIONAL NETWORK ARCHITECTURE USING GRAPH THEORY, IN MIDDLE-AGED YOGA AND MEDITATION PRACTITIONERS, AND MATCHED CONTROLS. FLUID INTELLIGENCE DECLINED SLOWER IN YOGA PRACTITIONERS AND MEDITATORS COMBINED THAN IN CONTROLS. RESTING STATE FUNCTIONAL NETWORKS OF YOGA PRACTITIONERS AND MEDITATORS COMBINED WERE MORE INTEGRATED AND MORE RESILIENT TO DAMAGE THAN THOSE OF CONTROLS. FURTHERMORE, MINDFULNESS WAS POSITIVELY CORRELATED WITH FLUID INTELLIGENCE, RESILIENCE, AND GLOBAL NETWORK EFFICIENCY. THESE FINDINGS REVEAL THE POSSIBILITY TO INCREASE RESILIENCE AND TO SLOW THE DECLINE OF FLUID INTELLIGENCE AND BRAIN FUNCTIONAL ARCHITECTURE AND SUGGEST THAT MINDFULNESS PLAYS A MECHANISTIC ROLE IN THIS PRESERVATION. 2014 12 1918 21 ROLE OF YOGA AND MEDITATION AS COMPLIMENTARY THERAPEUTIC REGIME FOR STRESS-RELATED NEUROPSYCHIATRIC DISORDERS: UTILIZATION OF BRAIN WAVES ACTIVITY AS NOVEL TOOL. DURING RECENT DECADES, STRESS-RELATED NEUROPSYCHIATRIC DISORDERS SUCH AS ANXIETY, DEPRESSION, CHRONIC TENSION HEADACHE, AND MIGRAINE HAVE ESTABLISHED THEIR STRONGHOLD IN THE LIVES OF A VAST NUMBER OF PEOPLE WORLDWIDE. IN ORDER TO ADDRESS THIS GLOBAL PHENOMENON, INTENSIVE STUDIES HAVE BEEN CARRIED OUT LEADING TO THE ADVANCEMENT OF DRUGS LIKE ANTI-DEPRESSANTS, ANXIOLYTICS, AND ANALGESICS WHICH ALTHOUGH HELP IN COMBATING THE SYMPTOMS OF SUCH DISORDERS BUT ALSO CREATE LONG-TERM SIDE EFFECTS. THUS, AS AN ALTERNATIVE TO SUCH CLINICAL PRACTICES, VARIOUS COMPLEMENTARY THERAPIES SUCH AS YOGA AND MEDITATION HAVE BEEN PROVED TO BE EFFECTIVE IN ALLEVIATING THE CAUSES AND SYMPTOMS OF DIFFERENT NEUROPSYCHIATRIC DISORDERS. THE ROLE OF ALTERED BRAIN WAVES IN THIS CONTEXT HAS BEEN RECOGNIZED AND NEEDS TO BE PURSUED AT THE HIGHEST LEVEL. THUS, THE CURRENT STUDY PROVIDES A REVIEW FOCUSED ON DESCRIBING THE EFFECTS OF YOGA AND MEDITATION ON ANXIETY AND DEPRESSION AS WELL AS EXPLORING BRAIN WAVES AS A TOOL FOR ASSESSING THE POTENTIAL OF THESE COMPLEMENTARY THERAPIES FOR SUCH DISORDERS. 2020 13 1640 28 MOLECULAR SIGNATURE OF THE IMMUNE RESPONSE TO YOGA THERAPY IN STRESS-RELATED CHRONIC DISEASE CONDITIONS: AN INSIGHT. THE WORLD HEALTH ORGANIZATION DEFINES HEALTH AS COMPLETE WELL-BEING IN TERMS OF PHYSICAL, MENTAL AND SOCIAL, AND NOT MERELY THE ABSENCE OF DISEASE. TO ATTAIN THIS, INDIVIDUAL SHOULD ADAPT AND SELF-MANGE THE SOCIAL, PHYSICAL AND EMOTIONAL CHALLENGES OF LIFE. EXPOSURE TO CHRONIC STRESS DUE TO URBANIZATION, WORK STRESS, NUCLEAR FAMILY, POLLUTION, UNHEALTHY FOOD HABITS, LIFESTYLE, ACCIDENTAL DEATH IN THE FAMILY, AND NATURAL CALAMITIES ARE THE TRIGGERING FACTORS, LEADING TO HORMONAL IMBALANCE AND INFLAMMATION IN THE TISSUE. THE RELATIONSHIP BETWEEN STRESS AND ILLNESS IS COMPLEX; ALL CHRONIC ILLNESSES SUCH AS CARDIOVASCULAR DISEASE AND ASTHMA HAVE THEIR ROOT IN CHRONIC STRESS ATTRIBUTED BY INFLAMMATION. IN RECENT TIMES, YOGA THERAPY HAS EMERGED AS AN IMPORTANT COMPLEMENTARY ALTERNATIVE MEDICINE FOR MANY HUMAN DISEASES. YOGA THERAPY HAS A POSITIVE IMPACT ON MIND AND BODY; IT ACTS BY INCORPORATING APPROPRIATE BREATHING TECHNIQUES AND MINDFULNESS TO ATTAIN CONSCIOUS DIRECTION OF OUR AWARENESS OF THE PRESENT MOMENT BY MEDITATION, WHICH HELPS ACHIEVE HARMONY BETWEEN THE BODY AND MIND. STUDIES HAVE ALSO DEMONSTRATED THE IMPORTANT REGULATORY EFFECTS OF YOGA THERAPY ON BRAIN STRUCTURE AND FUNCTIONS. DESPITE THESE ADVANCES, THE CELLULAR AND MOLECULAR MECHANISMS BY WHICH YOGA THERAPY RENDERS ITS BENEFICIAL EFFECTS ARE INADEQUATELY KNOWN. A GROWING BODY OF EVIDENCE SUGGESTS THAT YOGA THERAPY HAS IMMUNOMODULATORY EFFECTS. HOWEVER, THE PRECISE MECHANISTIC BASIS HAS NOT BEEN ADDRESSED EMPIRICALLY. IN THIS REVIEW, WE HAVE ATTEMPTED TO HIGHLIGHT THE EFFECT OF YOGA THERAPY ON IMMUNE SYSTEM FUNCTIONING WITH AN AIM TO IDENTIFY IMPORTANT IMMUNOLOGICAL SIGNATURES THAT INDEX THE EFFECT OF YOGA THERAPY. TOWARD THIS, WE HAVE SUMMARIZED THE AVAILABLE SCIENTIFIC EVIDENCE SHOWING POSITIVE IMPACTS OF YOGA THERAPY. FINALLY, WE HAVE EMPHASIZED THE EFFICACY OF YOGA IN IMPROVING PHYSICAL AND MENTAL WELL-BEING. YOGA HAS BEEN A PART OF INDIAN CULTURE AND TRADITION FOR LONG; NOW, THE TIME HAS COME TO SCIENTIFICALLY VALIDATE THIS AND IMPLEMENT THIS AS AN ALTERNATIVE TREATMENT METHOD FOR STRESS-RELATED CHRONIC DISEASE. 2020 14 366 24 ASTHMA: THE YOGA PERSPECTIVE. PART I. THE SOMATOPSYCHIC IMBALANCE IN ASTHMA: TOWARDS A HOLISTIC THERAPY. WHILE THE STANDARD PHYSIOLOGICAL AND EVEN CERTAIN PSYCHOLOGICAL CHARACTERISTICS OF ASTHMATIC PATIENTS ARE WELL KNOWN, THE CURRENT DIAGNOSTIC AND THERAPEUTIC APPROACH TO ASTHMA REMAINS INADEQUATE, AS IT NEGLECTS CERTAIN INTERRELATED SOMATOPSYCHIC FACTORS VITAL TO AN OPTIMAL DIAGNOSTIC-THERAPEUTIC PROGRAMME. THESE INCLUDE THE ROLE OF SKELETAL MUSCLE TENSION AND POSTURE, THE ROLE OF THE 'VOLUNTARY' RESPIRATORY MUSCULATURE, ESPECIALLY THE DIAPHRAGM, AS WELL AS ANXIETY, EMOTIONAL SUPPRESSION AND EXCESSIVE SELF-CONSCIOUSNESS, ALL OF WHICH MAY BE PRECIPITANTS RATHER THAN THE OUTCOME OF THE ONSET OF ASTHMA. ON THE BASIS OF THESE NEGLECTED FACTORS AND OTHERS, IMPLICATIONS FOR AN OPTIMALLY EFFECTIVE THERAPY ARE DISCUSSED. THE PHYSICAL MEDICINE OR PHYSIOTHERAPEUTIC, AS WELL AS OTHER RECENT THERAPEUTIC APPROACHES, ARE REVIEWED AND EVALUATED. IT IS CONCLUDED THAT ALL OF THESE THERAPIES ARE TOO "SPECIFIC," AND THAT A MORE HOLISTIC APPROACH IS NECESSARY (WHICH IS PROVIDED IN 'ASTHMA: THE YOGA PERSPECTIVE,' PART II-"YOGA THERAPY IN THE TREATMENT OF ASTHMA"). 1980 15 1590 18 MEDITATION AND YOGA CAN MODULATE BRAIN MECHANISMS THAT AFFECT BEHAVIOR AND ANXIETY-A MODERN SCIENTIFIC PERSPECTIVE. MEDITATION AND YOGA TECHNIQUES ARE RECEIVING INCREASED ATTENTION THROUGHOUT THE WORLD, DUE TO THE ACCUMULATION OF EVIDENCE BASED RESEARCH THAT PROVES THE DIRECT AND INDIRECT BENEFITS OF SUCH PRACTICES. BASED ON STUDIES CONDUCTED SO FAR, IT HAS BEEN FOUND THAT THE PRACTICE OF MEDITATION TRIGGERS NEUROTRANSMITTERS THAT MODULATE PSYCHOLOGICAL DISORDERS SUCH AS ANXIETY. THIS PAPER WILL REVIEW THE PSYCHOLOGICAL EFFECTS OF THE PRACTICE OF MEDITATION, THE ROLE OF NEUROTRANSMITTERS, AND STUDIES USING EEG AND FMRI. 2015 16 1537 39 KNEE OSTEOARTHRITIS PAIN IN THE ELDERLY CAN BE REDUCED BY MASSAGE THERAPY, YOGA AND TAI CHI: A REVIEW. BACKGROUND AND METHODS: THIS IS A REVIEW OF RECENTLY PUBLISHED RESEARCH, BOTH EMPIRICAL STUDIES AND META-ANALYSES, ON THE EFFECTS OF COMPLEMENTARY THERAPIES INCLUDING MASSAGE THERAPY, YOGA AND TAI CHI ON PAIN ASSOCIATED WITH KNEE OSTEOARTHRITIS IN THE ELDERLY. RESULTS: THE MASSAGE THERAPY PROTOCOLS HAVE BEEN EFFECTIVE IN NOT ONLY REDUCING PAIN BUT ALSO IN INCREASING RANGE OF MOTION, SPECIFICALLY WHEN MODERATE PRESSURE MASSAGE WAS USED AND WHEN BOTH THE QUADRICEPS AND HAMSTRINGS WERE MASSAGED. THE YOGA STUDIES TYPICALLY MEASURED PAIN BY THE WOMAC. MOST OF THOSE STUDIES SHOWED A CLINICALLY SIGNIFICANT REDUCTION IN PAIN, ESPECIALLY THE RESEARCH THAT FOCUSED ON POSES (E.G. THE IYENGAR STUDIES) AS OPPOSED TO THOSE THAT HAD INTEGRATED PROTOCOLS (POSES, BREATHING AND MEDITATION EXERCISES). THE TAI CHI STUDIES ALSO ASSESSED PAIN BY SELF-REPORT ON THE WOMAC AND SHOWED SIGNIFICANT REDUCTIONS IN PAIN. THE TAI CHI STUDIES WERE DIFFICULT TO COMPARE BECAUSE OF THEIR HIGHLY VARIABLE PROTOCOLS IN TERMS OF THE FREQUENCY AND DURATION OF TREATMENT. DISCUSSION: LARGER, RANDOMIZED CONTROL TRIALS ARE NEEDED ON EACH OF THESE THERAPIES USING MORE STANDARDIZED PROTOCOLS AND MORE OBJECTIVE VARIABLES IN ADDITION TO THE SELF-REPORTED WOMAC PAIN SCALE, FOR EXAMPLE, RANGE-OF-MOTION AND OBSERVED RANGE-OF-MOTION PAIN. IN ADDITION, TREATMENT COMPARISON STUDIES SHOULD BE CONDUCTED SO, FOR EXAMPLE, IF THE LOWER-COST YOGA AND TAI CHI WERE AS EFFECTIVE AS MASSAGE THERAPY, THEY MIGHT BE USED IN COMBINATION WITH OR AS SUPPLEMENTAL TO MASSAGE THERAPY. NONETHELESS, THESE THERAPIES ARE AT LEAST REDUCING PAIN IN KNEE OSTEOARTHRITIS AND THEY DO NOT SEEM TO HAVE SIDE EFFECTS. 2016 17 2531 29 YOGA EFFECTS ON BRAIN HEALTH: A SYSTEMATIC REVIEW OF THE CURRENT LITERATURE. YOGA IS THE MOST POPULAR COMPLEMENTARY HEALTH APPROACH PRACTICED BY ADULTS IN THE UNITED STATES. IT IS AN ANCIENT MIND AND BODY PRACTICE WITH ORIGINS IN INDIAN PHILOSOPHY. YOGA COMBINES PHYSICAL POSTURES, RHYTHMIC BREATHING AND MEDITATIVE EXERCISE TO OFFER THE PRACTITIONERS A UNIQUE HOLISTIC MIND-BODY EXPERIENCE. WHILE THE HEALTH BENEFITS OF PHYSICAL EXERCISE ARE WELL ESTABLISHED, IN RECENT YEARS, THE ACTIVE ATTENTIONAL COMPONENT OF BREATHING AND MEDITATION PRACTICE HAS GARNERED INTEREST AMONG EXERCISE NEUROSCIENTISTS. AS THE SCIENTIFIC EVIDENCE FOR THE PHYSICAL AND MENTAL HEALTH BENEFITS OF YOGA CONTINUES TO GROW, THIS ARTICLE AIMS TO SUMMARIZE THE CURRENT KNOWLEDGE OF YOGA PRACTICE AND ITS DOCUMENTED POSITIVE EFFECTS FOR BRAIN STRUCTURE AND FUNCTION, AS ASSESSED WITH MRI, FMRI, AND SPECT. WE REVIEWED 11 STUDIES EXAMINING THE EFFECTS OF YOGA PRACTICE ON THE BRAIN STRUCTURES, FUNCTION AND CEREBRAL BLOOD FLOW. COLLECTIVELY, THE STUDIES DEMONSTRATE A POSITIVE EFFECT OF YOGA PRACTICE ON THE STRUCTURE AND/OR FUNCTION OF THE HIPPOCAMPUS, AMYGDALA, PREFRONTAL CORTEX, CINGULATE CORTEX AND BRAIN NETWORKS INCLUDING THE DEFAULT MODE NETWORK (DMN). THE STUDIES OFFER PROMISING EARLY EVIDENCE THAT BEHAVIORAL INTERVENTIONS LIKE YOGA MAY HOLD PROMISE TO MITIGATE AGE-RELATED AND NEURODEGENERATIVE DECLINES AS MANY OF THE REGIONS IDENTIFIED ARE KNOWN TO DEMONSTRATE SIGNIFICANT AGE-RELATED ATROPHY. 2019 18 376 30 BARRIERS AND FACILITATORS TO YOGA USE IN A POPULATION OF INDIVIDUALS WITH SELF-REPORTED CHRONIC LOW BACK PAIN: A QUALITATIVE APPROACH. YOGA HAS BEEN FOUND TO BE EFFICACIOUS IN TREATING CHRONIC LOW BACK PAIN, YET BIOMEDICAL TREATMENTS ARE MOST COMMONLY USED FOR PAIN. PROMOTING YOGA AS PART OF INTEGRATIVE CARE WOULD REDUCE EXCLUSIVE RELIANCE ON HIGH-COST, HIGHER-RISK BIOMEDICAL TREATMENTS. ATTITUDES TOWARD YOGA PLAY A ROLE IN CONSIDERATION OF IT AS A TREATMENT. THE CURRENT STUDY EXAMINED ATTITUDES TOWARD YOGA IN ADULTS WITH CHRONIC LOW BACK PAIN AND COMPARED THESE RESULTS TO THOSE FOUND IN A 2009 GENERAL POPULATION STUDY. PARTICIPANTS COMPLETED A SEMI-STRUCTURED INTERVIEW WHERE THEY RESPONDED TO ITEMS ABOUT PERCEPTIONS OF POTENTIAL BARRIERS AND FACILITATORS TO TRYING YOGA. PARTICIPANT RESPONSES WERE ANALYZED QUALITATIVELY AND SEVERAL COMMON THEMES EMERGED. THEMES IDENTIFIED BY PARTICIPANTS INDICATED THERE IS MIXED INFORMATION ABOUT YOGA IN THE PUBLIC DOMAIN AND THAT CLARIFICATION OF WHAT YOGA IS, HOW IT CAN BE BENEFICIAL, AND WHAT IT REQUIRES ONE TO DO PHYSICALLY MAY HELP PROMOTE ITS USE. 2014 19 421 23 BRIDGING BODY AND MIND: CONSIDERATIONS FOR TRAUMA-INFORMED YOGA. INDIVIDUALS WHO SUFFER FROM TRAUMA-RELATED SYMPTOMS ARE A UNIQUE POPULATION THAT COULD BENEFIT FROM THE MIND-BODY PRACTICE OF YOGA-OR HAVE THEIR SYMPTOMS REACTIVATED BY IT, DEPENDING ON THE TYPE OF YOGA. TRAUMA-INFORMED YOGA (TIY), THAT IS, YOGA ADAPTED TO THE UNIQUE NEEDS OF INDIVIDUALS WORKING TO OVERCOME TRAUMA, MAY AMELIORATE SYMPTOMS BY CREATING A SAFE, TAILORED PRACTICE FOR STUDENTS TO LEARN HOW TO RESPOND, RATHER THAN REACT, TO SYMPTOMS AND CIRCUMSTANCES. YOGA NOT THUS ADAPTED, ON THE OTHER HAND, MAY INCREASE REACTIVITY AND ACTIVATE SYMPTOMS SUCH AS HYPERAROUSAL OR DISSOCIATION. THIS ARTICLE REPORTS ON EXPERT INPUT ABOUT ADAPTING YOGA FOR INDIVIDUALS WITH TRAUMA, WITH SPECIAL CONSIDERATIONS FOR MILITARY POPULATIONS. ELEVEN EXPERTS, RECRUITED BASED ON LITERATURE REVIEW AND REFERRALS, WERE INTERVIEWED IN PERSON OR VIA TELEPHONE AND ASKED SEVEN QUESTIONS ABOUT TRAUMA-INFORMED YOGA. VERBATIM TRANSCRIPTS WERE SUBJECTED TO OPEN-CODING THEMATIC ANALYSIS AND A PRIORI THEMES. FINDINGS REVEALED THAT TIY NEEDS TO EMPHASIZE BENEFICIAL PRACTICES (E.G., DIAPHRAGMATIC BREATH AND RESTORATIVE POSTURES), CONSIDER CONTRAINDICATIONS (E.G., AVOIDING SEQUENCES THAT OVERLY ENGAGE THE SYMPATHETIC NERVOUS SYSTEM), ADAPT TO LIMITATIONS AND CHALLENGES FOR TEACHING IN UNCONVENTIONAL SETTINGS (E.G., PRISONS, VA HOSPITALS), AND PROVIDE SPECIALIZED TRAINING AND PREPARATION (E.G., SPECIALIZED TIY CERTIFICATIONS, SELF-CARE OF INSTRUCTORS/THERAPISTS, ADAPTIONS FOR STUDENT NEEDS). TIY FOR VETERANS MUST ADDITIONALLY CONSIDER GENDER- AND CULTURE-RELATED BARRIERS, DIFFERING RELATIONSHIPS TO PAIN AND INJURY, AND MEDICATION AS A BARRIER TO PRACTICE. 2018 20 925 31 EFFECTIVENESS OF YOGA INTERVENTIONS IN BREAST CANCER-RELATED LYMPHEDEMA: A SYSTEMATIC REVIEW. OBJECTIVES: TO SYNTHESIZE RECENT EMPIRICAL EVIDENCE ON YOGA-BASED INTERVENTIONS FOR PATIENTS WITH BREAST CANCER-RELATED LYMPHEDEMA. METHODS: WE SEARCHED THE PUBMED/MEDLINE, COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS AND EMBASE DATABASES FOR STUDIES PUBLISHED BETWEEN OCTOBER 2007 AND SEPTEMBER 2018 IN ANY LANGUAGE. RISK OF BIAS AND METHODOLOGICAL QUALITY WERE EVALUATED USING THE PRISMA STATEMENT AND CHECKLIST AND THE COCHRANE COLLABORATION TOOL. RESULTS: THERE WAS SIGNIFICANT IMPROVEMENT IN LYMPHEDEMA STATUS, RANGE OF SHOULDER MOTION AND SPINAL MOBILITY AFTER AN 8-WEEK YOGA INTERVENTION, WHEREAS THERE WAS NO CONSISTENCY IN QUALITY OF LIFE FOLLOWING YOGA INTERVENTION. ADDITIONALLY, THERE WAS NO DIFFERENCE IN LYMPHEDEMA STATUS, EXTRACELLULAR FLUID AND TISSUE RESISTANCE OUTCOMES IN THE AFFECTED ARM FOLLOWING A LONG-TERM YOGA PRACTICE. CONCLUSION: THE CURRENT FINDINGS COULD NOT BE CLEARLY DEMONSTRATED THAT YOGA PROGRAMME INTERVENTION AS AN ADDITION TO USUAL CARE IS SUPERIOR TO ALONG USUAL CARE, AND KEEP YOGA EXERCISE DOES NOT PROVIDE SIGNIFICANT ADDED BENEFITS. 2019