1 2820 318 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 2 2821 295 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 3 2629 106 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 2497 97 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 5 2587 129 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 6 2543 131 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 7 2829 102 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 8 2827 114 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 9 2860 59 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 10 2614 64 YOGA FOR SCHIZOPHRENIA: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY REVIEW AND META-ANALYZE THE EFFECTS OF YOGA ON SYMPTOMS OF SCHIZOPHRENIA, QUALITY OF LIFE, FUNCTION, AND HOSPITALIZATION IN PATIENTS WITH SCHIZOPHRENIA. METHODS: MEDLINE/PUBMED, SCOPUS, THE COCHRANE LIBRARY, PSYCINFO, AND INDMED WERE SCREENED THROUGH AUGUST 2012. RANDOMIZED CONTROLLED TRIALS (RCTS) COMPARING YOGA TO USUAL CARE OR NON-PHARMACOLOGICAL INTERVENTIONS WERE ANALYZED WHEN THEY ASSESSED SYMPTOMS OR QUALITY OF LIFE IN PATIENTS WITH SCHIZOPHRENIA. COGNITIVE FUNCTION, SOCIAL FUNCTION, HOSPITALIZATION, AND SAFETY WERE DEFINED AS SECONDARY OUTCOMES. RISK OF BIAS WAS ASSESSED USING THE RISK OF BIAS TOOL RECOMMENDED BY THE COCHRANE BACK REVIEW GROUP. STANDARDIZED MEAN DIFFERENCES (SMD) AND 95% CONFIDENCE INTERVALS (CI) WERE CALCULATED. RESULTS: FIVE RCTS WITH A TOTAL OF 337 PATIENTS WERE INCLUDED; 2 RCTS HAD LOW RISK OF BIAS. TWO RCTS COMPARED YOGA TO USUAL CARE; 1 RCT COMPARED YOGA TO EXERCISE; AND 2 3-ARM RCTS COMPARED YOGA TO USUAL CARE AND EXERCISE. NO EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS OF YOGA COMPARED TO USUAL CARE ON POSITIVE SYMPTOMS (SMD = -0.58; 95% CI -1.52 TO 0.37; P = 0.23), OR NEGATIVE SYMPTOMS (SMD = -0.59; 95% CI -1.87 TO 0.69; P = 0.36). MODERATE EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS ON QUALITY OF LIFE COMPARED TO USUAL CARE (SMD = 2.28; 95% CI 0.42 TO 4.14; P = 0.02). THESE EFFECTS WERE ONLY PRESENT IN STUDIES WITH HIGH RISK OF BIAS. NO EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS ON SOCIAL FUNCTION (SMD = 1.20; 95% CI -0.78 TO 3.18; P = 0.23). COMPARING YOGA TO EXERCISE, NO EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS ON POSITIVE SYMPTOMS (SMD = -0.35; 95% CI -0.75 TO 0.05; P = 0.09), NEGATIVE SYMPTOMS (SMD = -0.28; 95% CI -1.42 TO 0.86; P = 0.63), QUALITY OF LIFE (SMD = 0.17; 95% CI -0.27 TO 0.61; P = 0.45), OR SOCIAL FUNCTION (SMD = 0.20; 95% CI -0.27 TO 0.67; P = 0.41). ONLY 1 RCT REPORTED ADVERSE EVENTS. CONCLUSIONS: THIS SYSTEMATIC REVIEW FOUND ONLY MODERATE EVIDENCE FOR SHORT-TERM EFFECTS OF YOGA ON QUALITY OF LIFE. AS THESE EFFECTS WERE NOT CLEARLY DISTINGUISHABLE FROM BIAS AND SAFETY OF THE INTERVENTION WAS UNCLEAR, NO RECOMMENDATION CAN BE MADE REGARDING YOGA AS A ROUTINE INTERVENTION FOR SCHIZOPHRENIA PATIENTS. 2013 11 2616 74 YOGA FOR SECONDARY PREVENTION OF CORONARY HEART DISEASE. BACKGROUND: CORONARY HEART DISEASE (CHD) IS THE MAJOR CAUSE OF EARLY MORBIDITY AND MORTALITY IN MOST DEVELOPED COUNTRIES. SECONDARY PREVENTION AIMS TO PREVENT REPEAT CARDIAC EVENTS AND DEATH IN PEOPLE WITH ESTABLISHED CHD. LIFESTYLE MODIFICATIONS PLAY AN IMPORTANT ROLE IN SECONDARY PREVENTION. YOGA HAS BEEN REGARDED AS A TYPE OF PHYSICAL ACTIVITY AS WELL AS A STRESS MANAGEMENT STRATEGY. GROWING EVIDENCE SUGGESTS THE BENEFICIAL EFFECTS OF YOGA ON VARIOUS AILMENTS. OBJECTIVES: TO DETERMINE THE EFFECTIVENESS OF YOGA FOR THE SECONDARY PREVENTION OF MORTALITY AND MORBIDITY IN, AND ON THE HEALTH-RELATED QUALITY OF LIFE OF, INDIVIDUALS WITH CHD. SEARCH METHODS: THIS IS AN UPDATE OF A REVIEW PREVIOUSLY PUBLISHED IN 2012. FOR THIS UPDATED REVIEW, WE SEARCHED THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL) IN THE COCHRANE LIBRARY (ISSUE 1 OF 12, 2014), MEDLINE (1948 TO FEBRUARY WEEK 1 2014), EMBASE (1980 TO 2014 WEEK 6), WEB OF SCIENCE (THOMSON REUTERS, 1970 TO 12 FEBRUARY 2014), CHINA JOURNAL NET (1994 TO MAY 2014), WANFANG DATA (1990 TO MAY 2014), AND INDEX TO CHINESE PERIODICALS OF HONG KONG (HKINCHIP) (FROM 1980). ONGOING STUDIES WERE IDENTIFIED IN THE METAREGISTER OF CONTROLLED TRIALS (MAY 2014) AND THE WORLD HEALTH ORGANIZATION INTERNATIONAL CLINICAL TRIALS REGISTRY PLATFORM (MAY 2014). WE APPLIED NO LANGUAGE RESTRICTIONS. SELECTION CRITERIA: WE PLANNED TO INCLUDE RANDOMISED CONTROLLED TRIALS (RCTS) INVESTIGATING THE INFLUENCE OF YOGA PRACTICE ON CHD OUTCOMES IN MEN AND WOMEN (AGED 18 YEARS AND OVER) WITH A DIAGNOSIS OF ACUTE OR CHRONIC CHD. STUDIES WERE ELIGIBLE FOR INCLUSION IF THEY HAD A FOLLOW-UP DURATION OF SIX MONTHS OR MORE. WE CONSIDERED STUDIES THAT COMPARED ONE GROUP PRACTICING A TYPE OF YOGA WITH A CONTROL GROUP RECEIVING EITHER NO INTERVENTION OR INTERVENTIONS OTHER THAN YOGA. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SELECTED STUDIES ACCORDING TO PRESPECIFIED INCLUSION CRITERIA. WE RESOLVED DISAGREEMENTS EITHER BY CONSENSUS OR BY DISCUSSION WITH A THIRD AUTHOR. MAIN RESULTS: WE FOUND NO ELIGIBLE RCTS THAT MET THE INCLUSION CRITERIA OF THE REVIEW AND THUS WE WERE UNABLE TO PERFORM A META-ANALYSIS. AUTHORS' CONCLUSIONS: THE EFFECTIVENESS OF YOGA FOR SECONDARY PREVENTION IN CHD REMAINS UNCERTAIN. LARGE RCTS OF HIGH QUALITY ARE NEEDED. 2015 12 2121 60 THE EFFECTIVENESS AND CHARACTERISTICS OF PREGNANCY YOGA INTERVENTIONS: A SYSTEMATIC REVIEW PROTOCOL. BACKGROUND: THE PURPOSE OF THIS REVIEW IS TO SYSTEMATICALLY EXAMINE THE REPORTED CLINICAL EFFECTIVENESS OF PREGNANCY YOGA. THE REVIEW WILL USE THE FITT (FREQUENCY, INTENSITY, TIME/DURATION AND TYPE) PRINCIPLE OF PHYSICAL ACTIVITY TO CHARACTERISE THE DIFFERENT TYPES OF YOGA INTERVENTIONS THAT HAVE BEEN EVALUATED IN THE INCLUDED STUDIES. STUDIES WILL BE CATEGORISED AS EFFECTIVENESS OR EFFICACY STUDIES AND THIS CONTINUUM OF EFFICACY VERSUS EFFECTIVENESS WILL BE INCORPORATED INTO THE FULL REVIEW. METHODS/DESIGN: THE FOLLOWING ELECTRONIC DATABASES WILL BE SEARCHED USING A DETAILED SEARCH STRATEGY: MEDLINE, PSYCINFO, EMBASE, CINAHL, WHOLIS, AMED, SCIELO, ASSIA AND WEB OF SCIENCE. RANDOMISED CONTROL TRIALS AND QUASI-EXPERIMENTAL STUDIES EXAMINING PREGNANCY YOGA AND REPORTING ON EFFECT WILL BE INCLUDED. TITLES, ABSTRACTS AND FULL ARTICLES WILL BE SCREENED BY TWO INVESTIGATORS INDEPENDENTLY TO IDENTIFY ELIGIBLE STUDIES. THE COCHRANE COLLABORATION'S RISK OF BIAS ASSESSMENT TOOL WILL BE USED TO ASSESS STUDY QUALITY. QUALITY OF THE EVIDENCE WILL BE EVALUATED USING THE GRADE CRITERIA. A STANDARDISED DATA EXTRACTION FORM WILL BE USED TO EXTRACT DATA. EFFECT SIZES WILL BE ESTIMATED USING MEAN DIFFERENCES FOR CONTINUOUS OUTCOMES, AND RELATIVE RISKS FOR DICHOTOMOUS OUTCOME. WHERE POSSIBLE, POOLING OF EFFECT ESTIMATES WILL BE DONE USING A RANDOM EFFECT MODEL. THE OUTCOMES OF INTEREST ARE QUALITY OF LIFE, STRESS, ANXIETY, DEPRESSION, MODE OF BIRTH, LABOUR DURATION AND PAIN MANAGEMENT IN LABOUR. DISCUSSION: THIS REVIEW WILL SYNTHESISE THE BEST AVAILABLE EVIDENCE ON THE EFFECTIVENESS OF YOGA DURING PREGNANCY AND PROVIDE VALUABLE HIGH-QUALITY INFORMATION FOR CLINICIANS AND HEALTH POLICYMAKERS. FINDINGS WILL BE DISSEMINATED THROUGH PUBLICATION IN A PEER-REVIEWED JOURNAL AND PRESENTATION AT RELEVANT CONFERENCE PROCEEDINGS. THE REVIEW WILL MAKE RECOMMENDATIONS FOR THE APPROPRIATE VOLUME, INTENSITY AND TYPE OF PREGNANCY YOGA FOR MAXIMUM EFFECT AND MAY HAVE IMPLICATIONS FOR POLICY AND PRACTICE RELATING TO PREGNANCY YOGA AS AN INTERVENTION. REGISTRATION: PROSPERO, CRD42019119916. REGISTERED ON 11TH JANUARY 2019. 2019 13 2634 74 YOGA FOR TREATING LOW BACK PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS. ABSTRACT: YOGA IS FREQUENTLY USED FOR BACK PAIN RELIEF. HOWEVER, THE EVIDENCE WAS JUDGED TO BE OF ONLY LOW TO MODERATE CERTAINTY. TO ASSESS THE EFFICACY AND SAFETY OF YOGA IN PATIENTS WITH LOW BACK PAIN, A META-ANALYSIS WAS PERFORMED. THEREFORE, MEDLINE/PUBMED, SCOPUS, AND THE COCHRANE LIBRARY WERE SEARCHED TO MAY 26, 2020. ONLY RANDOMIZED CONTROLLED TRIALS COMPARING YOGA WITH PASSIVE CONTROL (USUAL CARE OR WAIT LIST), OR AN ACTIVE COMPARATOR, FOR PATIENTS WITH LOW BACK PAIN AND THAT ASSESSED PAIN INTENSITY OR PAIN-RELATED DISABILITY AS A PRIMARY OUTCOME WERE CONSIDERED TO BE ELIGIBLE. TWO REVIEWERS INDEPENDENTLY EXTRACTED DATA ON STUDY CHARACTERISTICS, OUTCOME MEASURES, AND RESULTS AT SHORT-TERM AND LONG-TERM FOLLOW-UP. RISK OF BIAS WAS ASSESSED USING THE COCHRANE RISK OF BIAS TOOL. THIRTY ARTICLES ON 27 INDIVIDUAL STUDIES (2702 PARTICIPANTS IN TOTAL) PROVED ELIGIBLE FOR REVIEW. COMPARED WITH PASSIVE CONTROL, YOGA WAS ASSOCIATED WITH SHORT-TERM IMPROVEMENTS IN PAIN INTENSITY (15 RCTS; MEAN DIFFERENCE [MD] = -0.74 POINTS ON A NUMERIC RATING SCALE; 95% CONFIDENCE INTERVAL [CI] = -1.04 TO -0.44; STANDARDIZED MEAN DIFFERENCE [SMD] = -0.37 95% CI = -0.52 TO -0.22), PAIN-RELATED DISABILITY (15 RCTS; MD = -2.28; 95% CI = -3.30 TO -1.26; SMD = -0.38 95% CI = -0.55 TO -0.21), MENTAL HEALTH (7 RCTS; MD = 1.70; 95% CI = 0.20-3.20; SMD = 0.17 95% CI = 0.02-0.32), AND PHYSICAL FUNCTIONING (9 RCTS; MD = 2.80; 95% CI = 1.00-4.70; SMD = 0.28 95% CI = 0.10-0.47). EXCEPT FOR MENTAL HEALTH, ALL EFFECTS WERE SUSTAINED LONG-TERM. COMPARED WITH AN ACTIVE COMPARATOR, YOGA WAS NOT ASSOCIATED WITH ANY SIGNIFICANT DIFFERENCES IN SHORT-TERM OR LONG-TERM OUTCOMES. 2022 14 477 61 CLINICAL APPLICATIONS OF YOGA FOR THE PEDIATRIC POPULATION: A SYSTEMATIC REVIEW. OBJECTIVE: THE AIM OF THIS STUDY WAS TO EVALUATE THE EVIDENCE FOR CLINICAL APPLICATIONS OF YOGA AMONG THE PEDIATRIC POPULATION. METHODS: WE CONDUCTED AN ELECTRONIC LITERATURE SEARCH INCLUDING CINAHL, COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL), EMBASE, MEDLINE, PSYCINFO, AND MANUAL SEARCH OF RETRIEVED ARTICLES FROM INCEPTION OF EACH DATABASE UNTIL DECEMBER 2008. RANDOMIZED CONTROLLED TRIALS (RCTS) AND NONRANDOMIZED CONTROLLED TRIALS (NRCTS) WERE SELECTED THAT INCLUDED YOGA OR YOGA-BASED INTERVENTIONS FOR INDIVIDUALS AGED 0 TO 21 YEARS. DATA WERE EXTRACTED AND ARTICLES CRITICALLY REVIEWED USING A MODIFIED JADAD SCORE AND DESCRIPTIVE METHODOLOGICAL CRITERIA, WITH SUMMARIZATION IN TABLES. RESULTS: THIRTY-FOUR CONTROLLED STUDIES PUBLISHED FROM 1979 TO 2008 WERE IDENTIFIED, WITH 19 RCTS AND 15 NRCTS. MANY STUDIES WERE OF LOW METHODOLOGICAL QUALITY. CLINICAL AREAS FOR WHICH YOGA HAS BEEN STUDIED INCLUDE PHYSICAL FITNESS, CARDIORESPIRATORY EFFECTS, MOTOR SKILLS/STRENGTH, MENTAL HEALTH AND PSYCHOLOGICAL DISORDERS, BEHAVIOR AND DEVELOPMENT, IRRITABLE BOWEL SYNDROME, AND BIRTH OUTCOMES FOLLOWING PRENATAL YOGA. NO ADVERSE EVENTS WERE REPORTED IN TRIALS REVIEWED. ALTHOUGH A LARGE MAJORITY OF STUDIES WERE POSITIVE, METHODOLOGICAL LIMITATIONS SUCH AS RANDOMIZATION METHODS, WITHDRAWAL/DROPOUTS, AND DETAILS OF YOGA INTERVENTION PRECLUDE CONCLUSIVE EVIDENCE. CONCLUSIONS: THERE ARE LIMITED DATA ON THE CLINICAL APPLICATIONS OF YOGA AMONG THE PEDIATRIC POPULATION. MOST PUBLISHED CONTROLLED TRIALS WERE SUGGESTIVE OF BENEFIT, BUT RESULTS ARE PRELIMINARY BASED ON LOW QUANTITY AND QUALITY OF TRIALS. FURTHER RESEARCH OF YOGA FOR CHILDREN BY USING A HIGHER STANDARD OF METHODOLOGY AND REPORTING IS WARRANTED. 2009 15 1061 58 EFFECTS OF YOGA ON HEALTH-RELATED QUALITY, PHYSICAL HEALTH AND PSYCHOLOGICAL HEALTH IN WOMEN WITH BREAST CANCER RECEIVING CHEMOTHERAPY: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: YOGA RECEIVE MORE ATTENTION FROM BREAST CANCER PATIENTS, HOWEVER ITS FEASIBILITY AND EFFICACY DURING CHEMOTHERAPY REMAINS CONFLICTING. WE PERFORMED THIS SYSTEMATIC REVIEW TO ASSESS THE EFFECTS OF YOGA ON HEALTH-RELATED QUALITY, PHYSICAL HEALTH AND PSYCHOLOGICAL HEALTH IN BREAST CANCER PATIENTS UNDERGOING CHEMOTHERAPY. METHODS: A SYSTEMATIC SEARCH WAS CONDUCTED TO RETRIEVE RANDOMIZED CONTROLLED TRIALS (RCTS) WHICH INVESTIGATED THE COMPARATIVE EFFICACY OF YOGA VERSUS COMPARATORS SUCH AS USUAL CARE AMONG BREAST CANCER PATIENTS FOR HEALTH-RELATED QUALITY, PHYSICAL HEALTH AND PSYCHOLOGICAL HEALTH IN PUBMED, EMBASE, COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CNETRAL), NURSING AND ALLIED HEALTH LITERATURE (CINAHL), CHINESE BIOMEDICAL LITERATURE (CBM) DATABASE, CHINA SCIENCE AND TECHNOLOGY JOURNAL (CSTJ) DATABASE, CHINA NATIONAL KNOWLEDGE INFRASTRUCTURE (CNKI), AND WANGFANG DATABASE FROM INCEPTION TO DECEMBER 2018. THE LATEST SEARCH WAS UPDATED ON SEPTEMBER 2020. ALL ANALYSES WERE COMPLETED USING REVMAN VERSION 5.3. RESULTS: SEVEN TRIALS INVOLVING 693 BREAST CANCER PATIENTS MET INCLUSION CRITERIA. META-ANALYSIS INDICATED A SHORT-TERM IMPROVEMENT IN FATIGUE [STANDARD MEAN DIFFERENCE (SMD), -0.62; 95% CONFIDENCE INTERVAL (CI), -1.17 TO -0.07], SLEEP DISTURBANCE (SMD, -0.34; 95% CI, -0.55 TO -0.12), DEPRESSION (SMD, -0.50; 95% CI, -0.70 TO -0.31) ANXIETY (SMD, -0.50; 95% CI, -0.70 TO -0.31), AND HEALTH-RELATED QUALITY OF LIFE (QOL) (SMD, 0.72; 95% CI, -0.12 TO 1.56) IN THE YOGA GROUP; HOWEVER BENEFICIAL MEDIUM- AND LONG-TERM EFFECTS IN FATIGUE, SLEEP DISTURBANCE WERE NOT IDENTIFIED. MOREOVER, QUALITATIVE ANALYSES SUGGESTED THAT YOGA WAS NOT ASSOCIATED WITH DECREASED ADVERSE EVENTS (AES) COMPARED WITH CONTROL GROUPS. CONCLUSIONS: YOGA MAY BENEFIT TO REDUCE FATIGUE, DEPRESSION AND ANXIETY, IMPROVE SLEEP DISTURBANCE, AND IMPROVE QOL IN BREAST CANCER PATIENTS RECEIVING CHEMOTHERAPY IN THE SHORT-TERM; HOWEVER, MEDIUM- AND LONG-TERM EFFECTS SHOULD BE FURTHER ESTABLISHED OWING TO LIMITATIONS. 2021 16 1074 90 EFFECTS OF YOGA ON PATIENTS WITH CHRONIC NONSPECIFIC NECK PAIN: A PRISMA SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: CHRONIC NONSPECIFIC NECK PAIN (CNNP) HAS A HIGH PREVALENCE AND IS MORE COMMON AMONG YOUNGER PEOPLE. CLINICAL PRACTICE SUGGESTS THAT YOGA IS EFFECTIVE IN RELIEVING CHRONIC PAIN. OBJECTIVES: THIS META-ANALYSIS AIMED TO QUANTITATIVELY SUMMARIZE THE EFFICACY OF YOGA FOR TREATING CNNP. DATA SOURCES: WE SEARCHED FOR TRIALS IN THE ELECTRONIC DATABASES FROM THEIR INCEPTION TO JANUARY 2019. ENGLISH DATABASES INCLUDING PUBMED, MEDLINE, COCHRANE LIBRARY, EMBASE, SCOPUS, THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, AND IND MED; CHINESE DATABASES INCLUDING CHINA NATIONAL KNOWLEDGE INFRASTRUCTURE (CNKI), WANFANG DATABASE, AND VIP INFORMATION. WE ALSO CONDUCTED A MANUAL SEARCH OF KEY JOURNALS AND THE REFERENCE LISTS OF ELIGIBLE PAPERS TO IDENTIFY ANY POTENTIALLY RELEVANT STUDIES WE MAY HAVE MISSED. WE PLACED NO LIMITATIONS ON LANGUAGE OR DATE OF PUBLICATION. STUDY ELIGIBILITY CRITERIA: WE INCLUDED ONLY RANDOMIZED CONTROLLED TRIALS (RCTS) AND Q-RCTS EVALUATING THE EFFECTS OF YOGA ON PATIENTS WITH CNNP. THE PRIMARY OUTCOMES FOR THIS REVIEW WERE PAIN AND DISABILITY, AND THE SECONDARY OUTCOMES WERE CERVICAL RANGE OF MOTION (CROM), QUALITY OF LIFE (QOL), AND MOOD. PARTICIPANTS AND INTERVENTIONS: TRAILS THAT EXAMINED THE CLINICAL OUTCOMES OF YOGA INTERVENTION IN ADULTS WITH CNNP COMPARED WITH THOSE OF OTHER THERAPIES EXCEPT YOGA (E.G., EXERCISE, PILATES, USUAL CARE, ET AL) WERE INCLUDED. STUDY APPRAISAL AND SYNTHESIS METHODS: COCHRANE RISK-OF-BIAS CRITERIA WERE USED TO ASSESS THE METHODOLOGICAL QUALITY, AND REVMAN 5.3 SOFTWARE WAS USED TO CONDUCT THE META-ANALYSIS. RESULTS: A TOTAL OF 10 TRIALS (N = 686) COMPARING YOGA AND INTERVENTIONS OTHER THAN YOGA WERE INCLUDED IN THE META-ANALYSIS. THE RESULTS SHOW THAT YOGA HAD A POSITIVE EFFECTS ON NECK PAIN INTENSITY (TOTAL EFFECT: SMD = -1.13, 95% CI [-1.60, -0.66], Z = 4.75, P < .00001), NECK PAIN-RELATED FUNCTIONAL DISABILITY (TOTAL EFFECT: SMD = -0.92, 95% CI [-1.38, -0.47], Z = 3.95, P < .0001), CROM (TOTAL EFFECT: SMD = 1.22, 95% CI [0.87, 1.57], Z = 6.83, P < .00001), QOL (TOTAL EFFECT: MD = 3.46, 95% CI [0.75, 6.16], Z = 2.51, P = .01), AND MOOD (TOTAL EFFECT: SMD = -0.61, 95% CI [-0.95, -0.27], Z = 3.53, P = .0004). CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: IT WAS DIFFICULT TO MAKE A COMPREHENSIVE SUMMARY OF ALL THE EVIDENCE DUE TO THE DIFFERENT SESSION AND DURATION OF THE YOGA INTERVENTIONS, AND THE DIFFERENT OUTCOME MEASUREMENT TOOLS IN THE STUDY, WE DRAW A VERY CAUTIOUS CONCLUSION THAT YOGA CAN RELIEVE NECK PAIN INTENSITY, IMPROVE PAIN-RELATED FUNCTION DISABILITY, INCREASE CROM, IMPROVE QOL, AND BOOST MOOD. THIS SUGGESTS THAT YOGA MIGHT BE AN IMPORTANT ALTERNATIVE IN THE TREATMENT OF CNNP. SYSTEMATIC REVIEW REGISTRATION NUMBER: DETAILS OF THE PROTOCOL FOR THIS SYSTEMATIC REVIEW AND META-ANALYSIS WERE REGISTERED ON PROSPERO AND CAN BE ACCESSED AT WWW.CRD.YORK.AC.UK/PROSPERO/DISPLAY_RECORD.ASP?ID=CRD42018108992. 2019 17 1054 67 EFFECTS OF YOGA ON CHRONIC NECK PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVE: THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY ASSESS AND META-ANALYZE THE EFFECTIVENESS OF YOGA IN RELIEVING CHRONIC NECK PAIN. METHODS: PUBMED/MEDLINE, THE COCHRANE LIBRARY, SCOPUS, AND INDMED WERE SCREENED THROUGH JANUARY 2017 FOR RANDOMIZED CONTROLLED TRIALS ASSESSING NECK PAIN INTENSITY AND/OR NECK PAIN-RELATED DISABILITY IN CHRONIC NECK PAIN PATIENTS. SECONDARY OUTCOME MEASURES INCLUDED QUALITY OF LIFE, MOOD, AND SAFETY. RISK OF BIAS WAS ASSESSED USING THE COCHRANE TOOL. RESULTS: THREE STUDIES ON 188 PATIENTS WITH CHRONIC NON-SPECIFIC NECK PAIN COMPARING YOGA TO USUAL CARE WERE INCLUDED. TWO STUDIES HAD OVERALL LOW RISK OF BIAS; AND ONE HAD HIGH OR UNCLEAR RISK OF BIAS FOR SEVERAL DOMAINS. EVIDENCE FOR SHORT-TERM EFFECTS WAS FOUND FOR NECK PAIN INTENSITY (STANDARDIZED MEAN DIFFERENCE (SMD) = -1.28; 95% CONFIDENCE INTERVAL (CI) = -1.18, -0.75; P < 0.001), NECK PAIN-RELATED DISABILITY (SMD = -0.97; 95% CI = -1.44, -0.50; P < 0.001), QUALITY OF LIFE (SMD = 0.57; 95% CI = 0.17, 0.197; P = 0.005), AND MOOD (SMD = -1.02; 95% CI = -1.38, -0.65; P < 0.001). EFFECTS WERE ROBUST AGAINST POTENTIAL METHODOLOGICAL BIAS AND DID NOT DIFFER BETWEEN DIFFERENT INTERVENTION SUBGROUPS. IN THE TWO STUDIES THAT INCLUDED SAFETY DATA, NO SERIOUS ADVERSE EVENTS OCCURRED. CONCLUSION: YOGA HAS SHORT-TERM EFFECTS ON CHRONIC NECK PAIN, ITS RELATED DISABILITY, QUALITY OF LIFE, AND MOOD SUGGESTING THAT YOGA MIGHT BE A GOOD TREATMENT OPTION. 2017 18 2518 99 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 19 1924 52 ROLE OF YOGA FOR PATIENTS WITH TYPE II DIABETES MELLITUS: A SYSTEMATIC REVIEW AND META-ANALYSIS. TO UNDERSTAND THE ROLE AND EFFICACY OF YOGA IN THE MANAGEMENT OF TYPE 2 DIABETES MELLITUS, THIS META-ANALYSIS WAS CONDUCTED. ELECTRONIC DATA BASES SEARCHED WERE PUBMED/MEDLINE, PROQUEST, PSYCINFO, INDMED, CENTRAL, COCHRANE LIBRARY, CAMQUEST AND CAMBASE TILL DECEMBER 17, 2014. ELIGIBLE OUTCOMES WERE FASTING BLOOD SUGAR (FBS), POST PRANDIAL BLOOD SUGAR (PPBS) AND GLYCOSYLATED HAEMOGLOBIN (HBA1C). RANDOMIZED CONTROLLED TRIALS AND CONTROLLED TRIALS WERE ELIGIBLE. STUDIES FOCUSSING ONLY ON RELAXATION OR MEDITATION OR MULTIMODAL INTERVENTION WERE NOT INCLUDED. A TOTAL OF 17 RCTS WERE INCLUDED FOR REVIEW. DATA FROM RESEARCH ARTICLES ON PATIENTS, METHODS, INTERVENTIONS- CONTROL AND RESULTS WERE EXTRACTED. MEAN AND STANDARD DEVIATIONS WERE UTILIZED FOR CALCULATING STANDARDIZED MEAN DIFFERENCE WITH 95% CONFIDENCE INTERVAL. HETEROGENEITY WAS ASSESSED WITH THE HELP OF I(2) STATISTICS. CHI(2) WAS USED TO RULE OUT THE EFFECTS OF HETEROGENEITY DUE TO CHANCE ALONE. BENEFICIAL EFFECTS OF YOGA AS AN ADD-ON INTERVENTION TO STANDARD TREATMENT IN COMPARISON TO STANDARD TREATMENT WERE OBSERVED FOR FBS [STANDARDIZED MEAN DIFFERENCE (SMD) -1.40, 95%CI -1.90 TO -0.90, P<0.00001]; PPBS [SMD -0.91, 95%CI -1.34 TO -0.48, P<0.0001] AS WELL AS HBA1C [SMD -0.64, 95%CI -0.97 TO -0.30, P<0.0002]. BUT RISK OF BIAS WAS OVERALL HIGH FOR INCLUDED STUDIES. WITH THIS AVAILABLE EVIDENCE, YOGA CAN BE CONSIDERED AS ADD-ON INTERVENTION FOR MANAGEMENT OF DIABETES. 2016 20 2591 57 YOGA FOR MENOPAUSAL SYMPTOMS-A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVES: TO SYSTEMATICALLY REVIEW AND META-ANALYZE THE EFFECTIVENESS OF YOGA FOR MENOPAUSAL SYMPTOMS. METHODS: MEDLINE (VIA PUBMED), THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, AND SCOPUS WERE SCREENED THROUGH TO FEBRUARY 21, 2017 FOR RANDOMIZED CONTROLLED TRIALS (RCTS) COMPARING THE EFFECTS OF YOGA ON MENOPAUSAL SYMPTOMS TO THOSE OF NO TREATMENT OR ACTIVE COMPARATORS. STANDARDIZED MEAN DIFFERENCES (SMD) AND 95% CONFIDENCE INTERVALS (CI) WERE CALCULATED. TWO AUTHORS INDEPENDENTLY ASSESSED RISK OF BIAS USING THE COCHRANE RISK OF BIAS TOOL. RESULTS: THIRTEEN RCTS WITH 1306 PARTICIPANTS WERE INCLUDED. COMPARED WITH NO TREATMENT, YOGA REDUCED TOTAL MENOPAUSAL SYMPTOMS (SMD=-1.05; 95% CI -1.57 TO -0.53), PSYCHOLOGICAL (SMD=-0.75; 95% CI -1.17 TO -0.34), SOMATIC (SMD=-0.65; 95% CI -1.05 TO -0.25), VASOMOTOR (SMD=-0.76; 95% CI -1.27 TO -0.25), AND UROGENITAL SYMPTOMS (SMD=-0.53; 95% CI -0.81 TO -0.25). COMPARED WITH EXERCISE CONTROLS, ONLY AN EFFECT ON VASOMOTOR SYMPTOMS WAS FOUND (SMD=-0.45; 95% CI -0.87 TO -0.04). EFFECTS WERE ROBUST AGAINST SELECTION BIAS, BUT NOT AGAINST DETECTION AND ATTRITION BIAS. NO SERIOUS ADVERSE EVENTS WERE REPORTED. CONCLUSION: YOGA SEEMS TO BE EFFECTIVE AND SAFE FOR REDUCING MENOPAUSAL SYMPTOMS. EFFECTS ARE COMPARABLE TO THOSE OF OTHER EXERCISE INTERVENTIONS. 2018