1 2633 142 YOGA FOR TREATING HEADACHES: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: HEADACHE DISORDERS ARE CURRENTLY THE SIXTH LEADING CAUSE OF DISABILITY ACROSS THE GLOBE AND THEREFORE CARRY A SIGNIFICANT DISEASE BURDEN. THIS SYSTEMATIC REVIEW AND META-ANALYSIS AIMS TO INVESTIGATE THE EFFECTS OF YOGA ON HEADACHE DISORDERS. METHODS: MEDLINE/PUBMED, SCOPUS, THE COCHRANE LIBRARY, AND PSYCINFO WERE SCREENED THROUGH MAY 2019. RANDOMIZED CONTROLLED TRIALS (RCTS) WERE INCLUDED WHEN THEY ASSESSED THE EFFECTS OF YOGA IN PATIENTS WITH A DIAGNOSIS OF CHRONIC OR EPISODIC HEADACHE (TENSION-TYPE HEADACHE AND/OR MIGRAINE). USUAL CARE (NO SPECIFIC TREATMENT) OR ANY ACTIVE TREATMENTS WERE ACCEPTABLE AS CONTROL INTERVENTIONS. PRIMARY OUTCOME MEASURES WERE HEADACHE FREQUENCY, HEADACHE DURATION, AND PAIN INTENSITY. FOR EACH OUTCOME, STANDARDIZED MEAN DIFFERENCES (SMD) AND 95% CONFIDENCE INTERVALS (CI) WERE CALCULATED. RESULTS: META-ANALYSIS REVEALED A STATISTICALLY SIGNIFICANT OVERALL EFFECT IN FAVOR OF YOGA FOR HEADACHE FREQUENCY (5 RCTS; STANDARDIZED MEAN DIFFERENCE (SMD) = - 1.97; 95% CONFIDENCE INTERVAL (CI) - 2.75 TO - 1.20; I(2) = 63.0%, TAU(2) = 0.25, P = 0.03), HEADACHE DURATION (4 RCTS; SMD = - 1.45; 95% CI - 2.54 TO - 0.37; I(2) = 69.0%, TAU(2) = 0.33, P = 0.02), AND PAIN INTENSITY (5 RCTS; SMD = - 3.43; 95% CI - 6.08 TO - 0.70, I(2) = 95.0%, TAU(2) = 4.25, P < 0.01). THE SIGNIFICANT OVERALL EFFECT WAS MAINLY DUE TO PATIENTS WITH TENSION-TYPE HEADACHES. FOR PATIENTS WITH MIGRAINE, NO STATISTICALLY SIGNIFICANT EFFECT WAS OBSERVED. DISCUSSION: DESPITE DISCUSSED LIMITATIONS, THIS REVIEW FOUND PRELIMINARY EVIDENCE OF SHORT-TERM EFFICACY OF YOGA IN IMPROVING HEADACHE FREQUENCY, HEADACHE DURATION, AND PAIN INTENSITY IN PATIENTS SUFFERING FROM TENSION-TYPE HEADACHES. FURTHER STUDIES ARE URGENTLY NEEDED TO DRAW DEEPER CONCLUSIONS FROM THE AVAILABLE RESULTS. 2020
2 1486 38 INTEGRATIVE EFFECT OF YOGA PRACTICE IN PATIENTS WITH KNEE ARTHRITIS: A PRISMA-COMPLIANT META-ANALYSIS. BACKGROUND: BENEFITS OF YOGA PRACTICE IN PATIENTS WITH KNEE OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS REMAINS CONTROVERSIAL. THIS STUDY PERFORMS A META-ANALYSIS TO QUANTIFY THE EFFICIENCY OF YOGA EXERCISE FOR PATIENTS PAIN REDUCTION, FUNCTIONAL RECOVERY, AND GENERAL WELLBEING. METHODS: A COMPUTERIZED SEARCH OF PUBMED AND EMBASE WAS PERFORMED TO IDENTIFY RELEVANT STUDIES. THE OUTCOME MEASURES WERE PAIN, STIFFNESS, AND PHYSICAL FUNCTION. TWO INVESTIGATORS IDENTIFIED ELIGIBLE STUDIES AND EXTRACTED DATA INDEPENDENTLY. THE QUALITY OF CITATIONS WAS MEASURED USING JADAD SCORE. STANDARDIZED MEAN DIFFERENCES (SMDS) WITH 95% CONFIDENCE INTERVALS (CIS) WERE CALCULATED FOR PAIN, MUSCULOSKELETAL IMPAIRMENT, QUALITY OF LIFE, GENERAL WELLBEING, AND MENTAL WELLBEING. RESULTS: A TOTAL OF 13 CLINICAL TRIALS INVOLVING 1557 PATIENTS WITH KNEE OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS WERE INCLUDED IN FINAL META-ANALYSIS WITH THE AVERAGE JADAD SCORE 2.8. THE SMD WAS -0.98 (95% CI -1.18, -0.78, P < .05) FOR PAIN, -1.83 (95% CI -2.09, -1.57, P < .05) FOR FUNCTIONAL DISABILITY, WAS 0.80 (95% CI 0.59, 1.01, P < .05) FOR SHORT FORM 36 HEALTH SURVEY (SF-36) GENERAL HEALTH, 0.49 (95% CI 0.14, 0.82, P < .05) FOR SF-36 MENTAL HEALTH, AND HAQ WAS -0.55 (95% CI -0.83, -0.26, P < .05) FOR HEALTH ASSOCIATED QUESTIONNAIRE (HAQ). ALL THE RESULTS FAVOR YOGA TRAINING GROUP. CONCLUSIONS: REGULAR YOGA TRAINING IS HELPFUL IN REDUCING KNEE ARTHRITIC SYMPTOMS, PROMOTING PHYSICAL FUNCTION, AND GENERAL WELLBEING IN ARTHRITIC PATIENTS. 2018
3 2635 70 YOGA FOR TREATING RHEUMATOID ARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS. PURPOSE: RHEUMATOID ARTHRITIS (RA) IS A PERVASIVE INFLAMMATORY AUTOIMMUNE DISEASE THAT SERIOUSLY IMPAIRS HUMAN HEALTH AND REQUIRES MORE EFFECTIVE NON-PHARMACOLOGIC TREATMENT APPROACHES. THIS STUDY AIMS TO SYSTEMATICALLY REVIEW AND EVALUATE THE EFFICACY OF YOGA FOR PATIENTS WITH RA. METHODS: MEDLINE (THROUGH PUBMED), COCHRANE LIBRARY, EMBASE (THROUGH SCOPUS), AND WEB OF SCIENCE DATABASE WERE SCREENED THROUGH FOR ARTICLES PUBLISHED UNTIL 20 JULY 2020. RANDOMIZED CONTROLLED TRIALS (RCTS) OF YOGA IN PATIENTS WITH RA WERE INCLUDED. OUTCOMES MEASURES WERE PAIN, PHYSICAL FUNCTION, DISEASE ACTIVITY, INFLAMMATORY CYTOKINES, AND GRIP STRENGTH. FOR EACH OUTCOME, STANDARDIZED MEAN DIFFERENCES (SMD) AND 95% CONFIDENCE INTERVALS (CI) WERE CALCULATED. RESULT: TEN TRIALS INCLUDING 840 PATIENTS WITH RA AGED 30-70 YEARS WERE IDENTIFIED, WITH 86% FEMALE PARTICIPANTS. META-ANALYSIS REVEALED A STATISTICALLY SIGNIFICANT OVERALL EFFECT IN FAVOR OF YOGA FOR PHYSICAL FUNCTION (HAQ-DI) (5 RCTS; SMD = -0.32, 95% CI -0.58 TO -0.05, I (2) = 15%, P = 0.02), DISEASE ACTIVITY (DAS-28) (4 RCTS; SMD = -0.38, 95% CI -0.71 TO -0.06, I (2) = 41%, P = 0.02) AND GRIP STRENGTH (2 RCTS; SMD = 1.30, 95% CI 0.47-2.13, I (2) = 63%, P = 0.002). NO EFFECTS WERE FOUND FOR PAIN, TENDER JOINTS, SWOLLEN JOINTS COUNT OR INFLAMMATORY CYTOKINES (I.E., CRP, ESR, IL-6, AND TNF-ALPHA). SUMMARY: THE FINDINGS OF THIS META-ANALYSIS INDICATE THAT YOGA MAY BE BENEFICIAL FOR IMPROVING PHYSICAL FUNCTION, DISEASE ACTIVITY, AND GRIP STRENGTH IN PATIENTS WITH RA. HOWEVER, THE BALANCE OF EVIDENCE SHOWED THAT YOGA HAD NO SIGNIFICANT EFFECT IN IMPROVING PAIN, TENDER JOINTS, SWOLLEN JOINTS COUNT, AND INFLAMMATORY CYTOKINES IN PATIENTS SUFFERING FROM RA. CONSIDERING METHODOLOGICAL LIMITATIONS, SMALL SAMPLE SIZE, AND LOW-QUALITY, WE DRAW A VERY CAUTIOUS CONCLUSION IN THE RESULTS OF THE ESTIMATE OF THE EFFECT. HIGH-QUALITY AND LARGE-SCALE RCTS ARE URGENTLY NEEDED IN THE FUTURE, AND THE REAL RESULT MAY BE SUBSTANTIALLY DIFFERENT. 2020
4 2614 61 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
5 1054 58 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
6 2634 59 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
7 2518 63 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
8 2599 46 YOGA FOR OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS. PURPOSE OF REVIEW: THIS STUDY AIMS TO SYSTEMATICALLY REVIEW AND SUMMARISE THE EFFICACY AND SAFETY OF YOGA FOR OSTEOARTHRITIS. MEDLINE (THROUGH PUBMED), SCOPUS, AND THE COCHRANE LIBRARY WERE SEARCHED THROUGH APRIL 2018 FOR RANDOMISED CONTROLLED TRIALS OF YOGA FOR OSTEOARTHRITIS. PRIMARY OUTCOMES WERE PAIN INTENSITY, FUNCTION, AND QUALITY OF LIFE; SECONDARY OUTCOMES WERE MENTAL HEALTH AND SAFETY. RISK OF BIAS WAS ASSESSED USING THE COCHRANE TOOL AND QUALITY OF EVIDENCE THROUGH GRADE. RECENT FINDINGS: NINE TRIALS INCLUDING 640 INDIVIDUALS WITH MAINLY LOWER EXTREMITY OSTEOARTHRITIS AGED 50-80 YEARS WERE IDENTIFIED, WITH 80.3% FEMALE PARTICIPANTS (MEDIAN). META-ANALYSES REVEALED VERY LOW-QUALITY EVIDENCE FOR THE EFFECTS OF YOGA ON PAIN (VS. EXERCISE: STANDARDISED MEAN DIFFERENCE (SMD) = - 1.07; 95%CI - 1.92, - 0.21; P = 0.01; VS. NON-EXERCISE: SMD = - 0.75; 95%CI - 1.18, - 0.31; P < 0.001), PHYSICAL FUNCTION (VS. EXERCISE: SMD = 0.80; 95%CI 0.36; 1.24; P < 0.001; VS. NON-EXERCISE: SMD = 0.60; 95%CI 0.30, 0.98; P < 0.001), AND STIFFNESS (VS. EXERCISE: SMD = - 0.92; 95%CI - 1.69, - 0.14; P = 0.008; VS. NON-EXERCISE: SMD = - 0.76; 95%CI - 1.26, - 0.26; P = 0.003) IN INDIVIDUALS WITH KNEE OSTEOARTHRITIS. EFFECTS WERE NOT ROBUST AGAINST POTENTIAL METHODOLOGICAL BIAS. NO EFFECTS WERE FOUND FOR QUALITY OF LIFE, AND DEPRESSION, OR FOR HAND OSTEOARTHRITIS. SAFETY WAS RARELY REPORTED. THE FINDINGS OF THIS META-ANALYSIS INDICATE THAT YOGA MAY BE EFFECTIVE FOR IMPROVING PAIN, FUNCTION, AND STIFFNESS IN INDIVIDUALS WITH OSTEOARTHRITIS OF THE KNEE, COMPARED TO EXERCISE AND NON-EXERCISE CONTROL GROUPS. DUE TO THE LOW METHODOLOGICAL QUALITY AND POTENTIAL RISK OF BIAS, ONLY A WEAK RECOMMENDATION CAN BE MADE AT THIS TIME FOR THE USE OF YOGA IN ADULTS WITH OSTEOARTHRITIS OF THE KNEE. 2019
9 2546 62 YOGA FOR BREAST CANCER PATIENTS AND SURVIVORS: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: MANY BREAST CANCER PATIENTS AND SURVIVORS USE YOGA TO COPE WITH THEIR DISEASE. THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY ASSESS AND META-ANALYZE THE EVIDENCE FOR EFFECTS OF YOGA ON HEALTH-RELATED QUALITY OF LIFE AND PSYCHOLOGICAL HEALTH IN BREAST CANCER PATIENTS AND SURVIVORS. METHODS: MEDLINE, PSYCINFO, EMBASE, CAMBASE, AND THE COCHRANE LIBRARY WERE SCREENED THROUGH FEBRUARY 2012. RANDOMIZED CONTROLLED TRIALS (RCTS) COMPARING YOGA TO CONTROLS WERE ANALYZED WHEN THEY ASSESSED HEALTH-RELATED QUALITY OF LIFE OR PSYCHOLOGICAL HEALTH IN BREAST CANCER PATIENTS OR SURVIVORS. RISK OF BIAS WAS ASSESSED USING THE COCHRANE RISK OF BIAS TOOL. STANDARDIZED MEAN DIFFERENCES (SMD) AND 95% CONFIDENCE INTERVALS (CI) WERE CALCULATED. RESULTS: TWELVE RCTS WITH A TOTAL OF 742 PARTICIPANTS WERE INCLUDED. SEVEN RCTS COMPARED YOGA TO NO TREATMENT; 3 RCTS COMPARED YOGA TO SUPPORTIVE THERAPY; 1 RCT COMPARED YOGA TO HEALTH EDUCATION; AND 1 RCT COMPARED A COMBINATION OF PHYSIOTHERAPY AND YOGA TO PHYSIOTHERAPY ALONE. EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS ON GLOBAL HEALTH-RELATED QUALITY OF LIFE (SMD = 0.62 [95% CI: 0.04 TO 1.21]; P = 0.04), FUNCTIONAL (SMD = 0.30 [95% CI: 0.03 TO 0.57), SOCIAL (SMD = 0.29 [95% CI: 0.08 TO 0.50]; P < 0.01), AND SPIRITUAL WELL-BEING (SMD = 0.41 [95% CI: 0.08; 0.74]; P = 0.01). THESE EFFECTS WERE, HOWEVER, ONLY PRESENT IN STUDIES WITH UNCLEAR OR HIGH RISK OF SELECTION BIAS. SHORT-TERM EFFECTS ON PSYCHOLOGICAL HEALTH ALSO WERE FOUND: ANXIETY (SMD = -1.51 [95% CI: -2.47; -0.55]; P < 0.01), DEPRESSION (SMD = -1.59 [95% CI: -2.68 TO -0.51]; P < 0.01), PERCEIVED STRESS (SMD = -1.14 [95% CI:-2.16; -0.12]; P = 0.03), AND PSYCHOLOGICAL DISTRESS (SMD = -0.86 [95% CI:-1.50; -0.22]; P < 0.01). SUBGROUP ANALYSES REVEALED EVIDENCE OF EFFICACY ONLY FOR YOGA DURING ACTIVE CANCER TREATMENT BUT NOT AFTER COMPLETION OF ACTIVE TREATMENT. CONCLUSIONS: THIS SYSTEMATIC REVIEW FOUND EVIDENCE FOR SHORT-TERM EFFECTS OF YOGA IN IMPROVING PSYCHOLOGICAL HEALTH IN BREAST CANCER PATIENTS. THE SHORT-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE COULD NOT BE CLEARLY DISTINGUISHED FROM BIAS. YOGA CAN BE RECOMMENDED AS AN INTERVENTION TO IMPROVE PSYCHOLOGICAL HEALTH DURING BREAST CANCER TREATMENT. 2012
10 2544 60 YOGA FOR ASTHMA: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: ALTHOUGH YOGA IS FREQUENTLY USED BY PATIENTS WITH ASTHMA, ITS EFFICACY IN ALLEVIATING ASTHMA REMAINS UNCLEAR. OBJECTIVE: TO SYSTEMATICALLY ASSESS AND META-ANALYZE THE AVAILABLE DATA ON EFFICACY AND SAFETY OF YOGA IN ALLEVIATING ASTHMA. METHODS: MEDLINE/PUBMED, SCOPUS, THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, PSYCINFO, CAM-QUEST, CAMBASE, AND INDMED WERE SEARCHED THROUGH JANUARY 2014. RANDOMIZED CONTROLLED TRIALS OF YOGA FOR PATIENTS WITH ASTHMA WERE INCLUDED IF THEY ASSESSED ASTHMA CONTROL, SYMPTOMS, QUALITY OF LIFE, AND/OR PULMONARY FUNCTION. FOR EACH OUTCOME, STANDARDIZED MEAN DIFFERENCES (SMDS) OR RISK RATIOS (RRS) AND 95% CONFIDENCE INTERVALS (CIS) WERE CALCULATED. RISK OF BIAS WAS ASSESSED USING THE COCHRANE TOOL. RESULTS: FOURTEEN RANDOMIZED CONTROLLED TRIALS WITH 824 PATIENTS WERE INCLUDED. EVIDENCE FOR EFFECTS OF YOGA COMPARED WITH USUAL CARE WAS FOUND FOR ASTHMA CONTROL (RR, 10.64; 95% CI, 1.98 TO 57.19; P = .006), ASTHMA SYMPTOMS (SMD, -0.37; 95% CI, -0.55 TO -0.19; P < .001), QUALITY OF LIFE (SMD, 0.86; 95% CI, 0.39 TO 1.33; P < .001), PEAK EXPIRATORY FLOW RATE (SMD, 0.49; 95% CI, 0.32 TO 0.67; P < .001), AND RATIO OF FORCED EXPIRATORY VOLUME IN 1 SECOND TO FORCED VITAL CAPACITY (SMD, 0.50; 95% CI, 0.24 TO 0.75; P < .001); EVIDENCE FOR EFFECTS OF YOGA COMPARED WITH PSYCHOLOGICAL INTERVENTIONS WAS FOUND FOR QUALITY OF LIFE (SMD, 0.61; 95% CI, 0.22 TO 0.99; P = .002) AND PEAK EXPIRATORY FLOW RATE (SMD, 2.87; 95% CI, 0.14 TO 5.60; P = .04). NO EVIDENCE FOR EFFECTS OF YOGA COMPARED WITH SHAM YOGA OR BREATHING EXERCISES WAS REVEALED. NO EFFECT WAS ROBUST AGAINST ALL POTENTIAL SOURCES OF BIAS. YOGA WAS NOT ASSOCIATED WITH SERIOUS ADVERSE EVENTS. CONCLUSION: YOGA CANNOT BE CONSIDERED A ROUTINE INTERVENTION FOR ASTHMATIC PATIENTS AT THIS POINT. IT CAN BE CONSIDERED AN ANCILLARY INTERVENTION OR AN ALTERNATIVE TO BREATHING EXERCISES FOR ASTHMA PATIENTS INTERESTED IN COMPLEMENTARY INTERVENTIONS. 2014
11 2568 56 YOGA FOR DEPRESSION: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: MIND-BODY MEDICAL INTERVENTIONS ARE COMMONLY USED TO COPE WITH DEPRESSION AND YOGA IS ONE OF THE MOST COMMONLY USED MIND-BODY INTERVENTIONS. THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY ASSESS AND META-ANALYZE THE EFFECTIVENESS OF YOGA FOR DEPRESSION. METHODS: MEDLINE/PUBMED, SCOPUS, THE COCHRANE LIBRARY, PSYCINFO, AND INDMED WERE SEARCHED THROUGH JANUARY 2013. RANDOMIZED CONTROLLED TRIALS (RCTS) OF YOGA FOR PATIENTS WITH DEPRESSIVE DISORDERS AND INDIVIDUALS WITH ELEVATED LEVELS OF DEPRESSION WERE INCLUDED. MAIN OUTCOMES WERE SEVERITY OF DEPRESSION AND REMISSION RATES, SECONDARY OUTCOMES WERE ANXIETY, QUALITY OF LIFE, AND SAFETY. RESULTS: TWELVE RCTS WITH 619 PARTICIPANTS WERE INCLUDED. THREE RCTS HAD LOW RISK OF BIAS. REGARDING SEVERITY OF DEPRESSION, THERE WAS MODERATE EVIDENCE FOR SHORT-TERM EFFECTS OF YOGA COMPARED TO USUAL CARE (STANDARDIZED MEAN DIFFERENCE (SMD) = -0.69; 95% CONFIDENCE INTERVAL (CI) -0.99, -0.39; P < .001), AND LIMITED EVIDENCE COMPARED TO RELAXATION (SMD = -0.62; 95%CI -1.03, -0.22; P = .003), AND AEROBIC EXERCISE (SMD = -0.59; 95% CI -0.99, -0.18; P = .004). LIMITED EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS OF YOGA ON ANXIETY COMPARED TO RELAXATION (SMD = -0.79; 95% CI -1.3, -0.26; P = .004). SUBGROUP ANALYSES REVEALED EVIDENCE FOR EFFECTS IN PATIENTS WITH DEPRESSIVE DISORDERS AND IN INDIVIDUALS WITH ELEVATED LEVELS OF DEPRESSION. DUE TO THE PAUCITY AND HETEROGENEITY OF THE RCTS, NO META-ANALYSES ON LONG-TERM EFFECTS WERE POSSIBLE. NO RCT REPORTED SAFETY DATA. CONCLUSIONS: DESPITE METHODOLOGICAL DRAWBACKS OF THE INCLUDED STUDIES, YOGA COULD BE CONSIDERED AN ANCILLARY TREATMENT OPTION FOR PATIENTS WITH DEPRESSIVE DISORDERS AND INDIVIDUALS WITH ELEVATED LEVELS OF DEPRESSION. 2013
12 2591 45 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
13 2597 59 YOGA FOR MULTIPLE SCLEROSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS. WHILE YOGA SEEMS TO BE EFFECTIVE IN A NUMBER OF NEUROPSYCHIATRIC DISORDERS, THE EVIDENCE OF EFFICACY IN MULTIPLE SCLEROSIS REMAINS UNCLEAR. THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY ASSESS AND META-ANALYZE THE AVAILABLE DATA ON EFFICACY AND SAFETY OF YOGA IN PATIENTS WITH MULTIPLE SCLEROSIS. MEDLINE/PUBMED, SCOPUS, THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, PSYCINFO, CAM-QUEST, CAMBASE, AND INDMED WERE SEARCHED THROUGH MARCH 2014. RANDOMIZED CONTROLLED TRIALS (RCTS) OF YOGA FOR PATIENTS WITH MULTIPLE SCLEROSIS WERE INCLUDED IF THEY ASSESSED HEALTH-RELATED QUALITY OF LIFE, FATIGUE, AND/OR MOBILITY. MOOD, COGNITIVE FUNCTION, AND SAFETY WERE DEFINED AS SECONDARY OUTCOME MEASURES. RISK OF BIAS WAS ASSESSED USING THE COCHRANE TOOL. SEVEN RCTS WITH A TOTAL OF 670 PATIENTS WERE INCLUDED. EVIDENCE FOR SHORT-TERM EFFECTS OF YOGA COMPARED TO USUAL CARE WERE FOUND FOR FATIGUE (STANDARDIZED MEAN DIFFERENCE [SMD] = -0.52; 95% CONFIDENCE INTERVALS (CI) = -1.02 TO -0.02; P = 0.04; HETEROGENEITY: I2 = 60%; CHI2 = 7.43; P = 0.06) AND MOOD (SMD = -0.55; 95%CI = -0.96 TO -0.13; P = 0.01; HETEROGENEITY: I2 = 0%; CHI2 = 1.25; P = 0.53), BUT NOT FOR HEALTH-RELATED QUALITY OF LIFE, MUSCLE FUNCTION, OR COGNITIVE FUNCTION. THE EFFECTS ON FATIGUE AND MOOD WERE NOT ROBUST AGAINST BIAS. NO SHORT-TERM OR LONGER TERM EFFECTS OF YOGA COMPARED TO EXERCISE WERE FOUND. YOGA WAS NOT ASSOCIATED WITH SERIOUS ADVERSE EVENTS. IN CONCLUSION, SINCE NO METHODOLOGICAL SOUND EVIDENCE WAS FOUND, NO RECOMMENDATION CAN BE MADE REGARDING YOGA AS A ROUTINE INTERVENTION FOR PATIENTS WITH MULTIPLE SCLEROSIS. YOGA MIGHT BE CONSIDERED A TREATMENT OPTION FOR PATIENTS WHO ARE NOT ADHERENT TO RECOMMENDED EXERCISE REGIMENS. 2014
14 923 60 EFFECTIVENESS OF YOGA FOR MENOPAUSAL SYMPTOMS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. OBJECTIVES. TO SYSTEMATICALLY REVIEW AND META-ANALYZE THE EFFECTIVENESS OF YOGA FOR MENOPAUSAL SYMPTOMS. METHODS. MEDLINE, SCOPUS, THE COCHRANE LIBRARY, AND PSYCINFO WERE SCREENED THROUGH APRIL 2012. RANDOMIZED CONTROLLED TRIALS (RCTS) WERE INCLUDED IF THEY ASSESSED THE EFFECT OF YOGA ON MAJOR MENOPAUSAL SYMPTOMS, NAMELY, (1) PSYCHOLOGICAL SYMPTOMS, (2) SOMATIC SYMPTOMS, (3) VASOMOTOR SYMPTOMS, AND/OR (4) UROGENITAL SYMPTOMS. FOR EACH OUTCOME, STANDARDIZED MEAN DIFFERENCES (SMDS) AND 95% CONFIDENCE INTERVALS (CIS) WERE CALCULATED. TWO AUTHORS INDEPENDENTLY ASSESSED RISK OF BIAS USING THE RISK OF BIAS TOOL RECOMMENDED BY THE COCHRANE BACK REVIEW GROUP. RESULTS. FIVE RCTS WITH 582 PARTICIPANTS WERE INCLUDED IN THE QUALITATIVE REVIEW, AND 4 RCTS WITH 545 PARTICIPANTS WERE INCLUDED IN THE META-ANALYSIS. THERE WAS MODERATE EVIDENCE FOR SHORT-TERM EFFECTS ON PSYCHOLOGICAL SYMPTOMS (SMD = -0.37; 95% CI -0.67 TO -0.07; P = 0.02). NO EVIDENCE WAS FOUND FOR TOTAL MENOPAUSAL SYMPTOMS, SOMATIC SYMPTOMS, VASOMOTOR SYMPTOMS, OR UROGENITAL SYMPTOMS. YOGA WAS NOT ASSOCIATED WITH SERIOUS ADVERSE EVENTS. CONCLUSION. THIS SYSTEMATIC REVIEW FOUND MODERATE EVIDENCE FOR SHORT-TERM EFFECTIVENESS OF YOGA FOR PSYCHOLOGICAL SYMPTOMS IN MENOPAUSAL WOMEN. WHILE MORE RIGOROUS RESEARCH IS NEEDED TO UNDERPIN THESE RESULTS, YOGA CAN BE PRELIMINARILY RECOMMENDED AS AN ADDITIONAL INTERVENTION FOR WOMEN WHO SUFFER FROM PSYCHOLOGICAL COMPLAINTS ASSOCIATED WITH MENOPAUSE. 2012
15 222 56 A SYSTEMATIC REVIEW AND META-ANALYSIS OF YOGA FOR LOW BACK PAIN. OBJECTIVES: TO SYSTEMATICALLY REVIEW AND META-ANALYZE THE EFFECTIVENESS OF YOGA FOR LOW BACK PAIN. METHODS: MEDLINE, THE COCHRANE LIBRARY, EMBASE, CAMBASE, AND PSYCINFO, WERE SCREENED THROUGH JANUARY 2012. RANDOMIZED CONTROLLED TRIALS COMPARING YOGA TO CONTROL CONDITIONS IN PATIENTS WITH LOW BACK PAIN WERE INCLUDED. TWO AUTHORS INDEPENDENTLY ASSESSED RISK OF BIAS USING THE RISK OF BIAS TOOL RECOMMENDED BY THE COCHRANE BACK REVIEW GROUP. MAIN OUTCOME MEASURES WERE PAIN, BACK-SPECIFIC DISABILITY, GENERIC DISABILITY, HEALTH-RELATED QUALITY OF LIFE, AND GLOBAL IMPROVEMENT. FOR EACH OUTCOME, STANDARDIZED MEAN DIFFERENCES (SMD) AND 95% CONFIDENCE INTERVALS (CI) WERE CALCULATED. RESULTS: TEN RANDOMIZED CONTROLLED TRIALS WITH A TOTAL OF 967 CHRONIC LOW BACK PAIN PATIENTS WERE INCLUDED. EIGHT STUDIES HAD LOW RISK OF BIAS. THERE WAS STRONG EVIDENCE FOR SHORT-TERM EFFECTS ON PAIN (SMD=-0.48; 95% CI, -0.65 TO -0.31; P<0.01), BACK-SPECIFIC DISABILITY (SMD=-0.59; 95% CI, -0.87 TO -0.30; P<0.01), AND GLOBAL IMPROVEMENT (RISK RATIO=3.27; 95% CI, 1.89-5.66; P<0.01). THERE WAS STRONG EVIDENCE FOR A LONG-TERM EFFECT ON PAIN (SMD=-0.33; 95% CI, -0.59 TO -0.07; P=0.01) AND MODERATE EVIDENCE FOR A LONG-TERM EFFECT ON BACK-SPECIFIC DISABILITY (SMD=-0.35; 95% CI, -0.55 TO -0.15; P<0.01). THERE WAS NO EVIDENCE FOR EITHER SHORT-TERM OR LONG-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE. YOGA WAS NOT ASSOCIATED WITH SERIOUS ADVERSE EVENTS. DISCUSSION: THIS SYSTEMATIC REVIEW FOUND STRONG EVIDENCE FOR SHORT-TERM EFFECTIVENESS AND MODERATE EVIDENCE FOR LONG-TERM EFFECTIVENESS OF YOGA FOR CHRONIC LOW BACK PAIN IN THE MOST IMPORTANT PATIENT-CENTERED OUTCOMES. YOGA CAN BE RECOMMENDED AS AN ADDITIONAL THERAPY TO CHRONIC LOW BACK PAIN PATIENTS. 2013
16 2540 58 YOGA FOR ANXIETY: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. YOGA HAS BECOME A POPULAR APPROACH TO IMPROVE EMOTIONAL HEALTH. THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY ASSESS AND META-ANALYZE THE EFFECTIVENESS AND SAFETY OF YOGA FOR ANXIETY. MEDLINE/PUBMED, SCOPUS, THE COCHRANE LIBRARY, PSYCINFO, AND INDMED WERE SEARCHED THROUGH OCTOBER 2016 FOR RANDOMIZED CONTROLLED TRIALS (RCTS) OF YOGA FOR INDIVIDUALS WITH ANXIETY DISORDERS OR ELEVATED LEVELS OF ANXIETY. THE PRIMARY OUTCOMES WERE ANXIETY AND REMISSION RATES, AND SECONDARY OUTCOMES WERE DEPRESSION, QUALITY OF LIFE, AND SAFETY. RISK OF BIAS WAS ASSESSED USING THE COCHRANE TOOL. EIGHT RCTS WITH 319 PARTICIPANTS (MEAN AGE: 30.0-38.5 YEARS) WERE INCLUDED. RISK OF SELECTION BIAS WAS UNCLEAR FOR MOST RCTS. META-ANALYSES REVEALED EVIDENCE FOR SMALL SHORT-TERM EFFECTS OF YOGA ON ANXIETY COMPARED TO NO TREATMENT (STANDARDIZED MEAN DIFFERENCE [SMD] = -0.43; 95% CONFIDENCE INTERVAL [CI] = -0.74, -0.11; P = .008), AND LARGE EFFECTS COMPARED TO ACTIVE COMPARATORS (SMD = -0.86; 95% CI = -1.56, -0.15; P = .02). SMALL EFFECTS ON DEPRESSION WERE FOUND COMPARED TO NO TREATMENT (SMD = -0.35; 95% CI = -0.66, -0.04; P = .03). EFFECTS WERE ROBUST AGAINST POTENTIAL METHODOLOGICAL BIAS. NO EFFECTS WERE FOUND FOR PATIENTS WITH ANXIETY DISORDERS DIAGNOSED BY DIAGNOSTIC AND STATISTICAL MANUAL CRITERIA, ONLY FOR PATIENTS DIAGNOSED BY OTHER METHODS, AND FOR INDIVIDUALS WITH ELEVATED LEVELS OF ANXIETY WITHOUT A FORMAL DIAGNOSIS. ONLY THREE RCTS REPORTED SAFETY-RELATED DATA BUT THESE INDICATED THAT YOGA WAS NOT ASSOCIATED WITH INCREASED INJURIES. IN CONCLUSION, YOGA MIGHT BE AN EFFECTIVE AND SAFE INTERVENTION FOR INDIVIDUALS WITH ELEVATED LEVELS OF ANXIETY. THERE WAS INCONCLUSIVE EVIDENCE FOR EFFECTS OF YOGA IN ANXIETY DISORDERS. MORE HIGH-QUALITY STUDIES ARE NEEDED AND ARE WARRANTED GIVEN THESE PRELIMINARY FINDINGS AND PLAUSIBLE MECHANISMS OF ACTION. 2018
17 1044 40 EFFECTS OF YOGA INTERVENTIONS ON PAIN AND PAIN-ASSOCIATED DISABILITY: A META-ANALYSIS. UNLABELLED: WE SEARCHED DATABASES FOR CONTROLLED CLINICAL STUDIES, AND PERFORMED A META-ANALYSIS ON THE EFFECTIVENESS OF YOGA INTERVENTIONS ON PAIN AND ASSOCIATED DISABILITY. FIVE RANDOMIZED STUDIES REPORTED SINGLE-BLINDING AND HAD A HIGHER METHODOLOGICAL QUALITY; 7 STUDIES WERE RANDOMIZED BUT NOT BLINDED AND HAD MODERATE QUALITY; AND 4 NONRANDOMIZED STUDIES HAD LOW QUALITY. IN 6 STUDIES, YOGA WAS USED TO TREAT PATIENTS WITH BACK PAIN; IN 2 STUDIES TO TREAT RHEUMATOID ARTHRITIS; IN 2 STUDIES TO TREAT PATIENTS WITH HEADACHE/MIGRAINE; AND 6 STUDIES ENROLLED INDIVIDUALS FOR OTHER INDICATIONS. ALL STUDIES REPORTED POSITIVE EFFECTS IN FAVOR OF THE YOGA INTERVENTIONS. WITH RESPECT TO PAIN, A RANDOM EFFECT META-ANALYSIS ESTIMATED THE OVERALL TREATMENT EFFECT AT SMD = -.74 (CI: -.97; -.52, P < .0001), AND AN OVERALL TREATMENT EFFECT AT SMD = -.79 (CI: -1.02; -.56, P < .0001) FOR PAIN-RELATED DISABILITY. DESPITE SOME LIMITATIONS, THERE IS EVIDENCE THAT YOGA MAY BE USEFUL FOR SEVERAL PAIN-ASSOCIATED DISORDERS. MOREOVER, THERE ARE HINTS THAT EVEN SHORT-TERM INTERVENTIONS MIGHT BE EFFECTIVE. NEVERTHELESS, LARGE-SCALE FURTHER STUDIES HAVE TO IDENTIFY WHICH PATIENTS MAY BENEFIT FROM THE RESPECTIVE INTERVENTIONS. PERSPECTIVE: THIS META-ANALYSIS SUGGESTS THAT YOGA IS A USEFUL SUPPLEMENTARY APPROACH WITH MODERATE EFFECT SIZES ON PAIN AND ASSOCIATED DISABILITY. 2012
18 2583 45 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
19 1061 48 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
20 2110 58 THE EFFECT OF YOGA ON SLEEP QUALITY AND INSOMNIA IN WOMEN WITH SLEEP PROBLEMS: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: TO EXAMINE THE EFFECTIVENESS AND SAFETY OF YOGA OF WOMEN WITH SLEEP PROBLEMS BY PERFORMING A SYSTEMATIC REVIEW AND META-ANALYSIS. METHODS: MEDLINE/PUBMED, CLINICALKEY, SCIENCEDIRECT, EMBASE, PSYCINFO, AND THE COCHRANE LIBRARY WERE SEARCHED THROUGHOUT THE MONTH OF JUNE, 2019. RANDOMIZED CONTROLLED TRIALS COMPARING YOGA GROUPS WITH CONTROL GROUPS IN WOMEN WITH SLEEP PROBLEMS WERE INCLUDED. TWO REVIEWERS INDEPENDENTLY EVALUATED RISK OF BIAS BY USING THE RISK OF BIAS TOOL SUGGESTED BY THE COCHRANE COLLABORATION FOR PROGRAMMING AND CONDUCTING SYSTEMATIC REVIEWS AND META-ANALYSES. THE MAIN OUTCOME MEASURE WAS SLEEP QUALITY OR THE SEVERITY OF INSOMNIA, WHICH WAS MEASURED USING SUBJECTIVE INSTRUMENTS, SUCH AS THE PITTSBURGH SLEEP QUALITY INDEX (PSQI), INSOMNIA SEVERITY INDEX (ISI), OR OBJECTIVE INSTRUMENTS SUCH AS POLYSOMNOGRAPHY, ACTIGRAPHY, AND SAFETY OF THE INTERVENTION. FOR EACH OUTCOME, A STANDARDIZED MEAN DIFFERENCE (SMD) AND CONFIDENCE INTERVALS (CIS) OF 95% WERE DETERMINED. RESULTS: NINETEEN STUDIES IN THIS SYSTEMATIC REVIEW INCLUDED 1832 PARTICIPANTS. THE META-ANALYSIS OF THE COMBINED DATA CONDUCTED ACCORDING TO COMPREHENSIVE META-ANALYSIS SHOWED A SIGNIFICANT IMPROVEMENT IN SLEEP (SMD = - 0.327, 95% CI = - 0.506 TO - 0.148, P < 0.001). META-ANALYSES REVEALED POSITIVE EFFECTS OF YOGA USING PSQI SCORES IN 16 RANDOMIZED CONTROL TRIALS (RCTS), COMPARED WITH THE CONTROL GROUP IN IMPROVING SLEEP QUALITY AMONG WOMEN USING PSQI (SMD = - 0.54; 95% CI = - 0.89 TO - 0.19; P = 0.003). HOWEVER, THREE RCTS REVEALED NO EFFECTS OF YOGA COMPARED TO THE CONTROL GROUP IN REDUCING INSOMNIA AMONG WOMEN USING ISI (SMD = - 0.13; 95% CI = - 0.74 TO 0.48; P = 0.69). SEVEN RCTS REVEALED NO EVIDENCE FOR EFFECTS OF YOGA COMPARED WITH THE CONTROL GROUP IN IMPROVING SLEEP QUALITY FOR WOMEN WITH BREAST CANCER USING PSQI (SMD = - 0.15; 95% CI = - 0.31 TO 0.01; P = 0.5). FOUR RCTS REVEALED NO EVIDENCE FOR THE EFFECTS OF YOGA COMPARED WITH THE CONTROL GROUP IN IMPROVING THE SLEEP QUALITY FOR PERI/POSTMENOPAUSAL WOMEN USING PSQI (SMD = - 0.31; 95% CI = - 0.95 TO 0.33; P = 0.34). YOGA WAS NOT ASSOCIATED WITH ANY SERIOUS ADVERSE EVENTS. DISCUSSION: THIS SYSTEMATIC REVIEW AND META-ANALYSIS DEMONSTRATED THAT YOGA INTERVENTION IN WOMEN CAN BE BENEFICIAL WHEN COMPARED TO NON-ACTIVE CONTROL CONDITIONS IN TERM OF MANAGING SLEEP PROBLEMS. THE MODERATOR ANALYSES SUGGEST THAT PARTICIPANTS IN THE NON-BREAST CANCER SUBGROUP AND PARTICIPANTS IN THE NON-PERI/POSTMENOPAUSAL SUBGROUP WERE ASSOCIATED WITH GREATER BENEFITS, WITH A DIRECT CORRELATION OF TOTAL CLASS TIME WITH QUALITY OF SLEEP AMONG OTHER RELATED BENEFITS. 2020