1 2359 174 VERTEBRAL COMPRESSION FRACTURES ASSOCIATED WITH YOGA: A CASE SERIES. BACKGROUND: THE IMPORTANCE OF EXERCISE IN SKELETAL HEALTH IS INCREASINGLY RECOGNIZED BY BOTH PATIENTS AND PROVIDERS. HOWEVER, THE SAFETY OF PRESCRIBED OR RECREATIONAL EXERCISE IN AT-RISK POPULATIONS REMAINS UNDER-REPORTED AND UNDER-PUBLICIZED. YOGA HAS GAINED WIDESPREAD POPULARITY DUE TO ITS PHYSICAL AND PSYCHOLOGICAL BENEFITS. WHEN PRACTICED IN A POPULATION AT INCREASED FRACTURE RISK, HOWEVER, SOME YOGA POSES MAY INCREASE FRACTURE RISK, PARTICULARLY AT THE SPINE, RATHER THAN INCREASING BMD AS NOTED IN RECENT POPULAR PRESS REPORTS. CASE REPORT: NINE SUBJECTS (8 WOMEN) WITH A MEDIAN AGE OF 66 YEARS (RANGE 53-87), DEVELOPED VERTEBRAL COMPRESSION FRACTURE (VCF) ONE MONTH TO SIX YEARS AFTER INITIATING YOGA-ASSOCIATED SPINAL FLEXION EXERCISES (SFE). VCF PRESENTED WITH BACK PAIN AND OCCURRED IN THE THORACICSPINE (N.=6), LUMBAR-SPINE (N.=4) AND CERVICAL-SPINE (N.=1). FOUR PATIENTS HAD OSTEOPOROSIS BY BMD CRITERIA PRIOR TO VCF AND 2 HAD OSTEOPENIA (MEDIAN T-SCORE -2.35; RANGE -3.3 TO +2.0). INTERESTINGLY, ALL PATIENTS HAD THEIR LOWEST T-SCORES AT THE SPINE. THREE PATIENTS HAD A HISTORY OF FRAGILITY FRACTURE PRIOR TO THE INDEX VCF. WHILE ONE PATIENT HAD PRIMARY HYPERPARATHYROIDISM AND ANOTHER WAS TREATED WITH HIGH DOSE PREDNISONE, NO OTHER RISK FACTORS FOR BONE LOSS INCLUDING MEDICATIONS OR SECONDARY OSTEOPOROSIS CAUSES WERE IDENTIFIED IN THE OTHER PATIENTS. CLINICAL REHABILITATION IMPACT: THIS STUDY IDENTIFIED PATIENTS IN WHOM INCREASED TORSIONAL AND COMPRESSIVE MECHANICAL LOADING PRESSURES OCCURRING DURING YOGA SFE RESULTED IN DE NOVO VCF. DESPITE THE NEED FOR SELECTIVITY IN YOGA POSES IN POPULATIONS AT INCREASED FRACTURE RISK, BOTH SCIENTIFIC AND MEDIA REPORTS CONTINUE TO ADVERTISE YOGA AS A BONE PROTECTIVE ACTIVITY. ACCORDINGLY, YOGA IS MISCONCEIVED AS A 'ONESIZE-FITS-ALL' PRESCRIPTION. INSTEAD, THE APPROPRIATE SELECTION OF PATIENTS LIKELY TO BENEFIT FROM YOGA MUST BE A CORNERSTONE OF FRACTURE PREVENTION. 2018 2 914 42 EFFECTIVENESS OF PILATES AND YOGA TO IMPROVE BONE DENSITY IN ADULT WOMEN: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: THE AGEING POPULATION BRINGS ABOUT THE APPEARANCE OF AGE-RELATED HEALTH DISORDERS, SUCH AS OSTEOPOROSIS OR OSTEOPENIA. THESE DISORDERS ARE ASSOCIATED WITH FRAGILITY FRACTURES. THE IMPACT IS GREATER AMONG POSTMENOPAUSAL WOMEN DUE TO AN ACCELERATION OF BONE MINERAL DENSITY (BMD) LOSS. OBJECTIVE: TO ESTIMATE THE EFFECTIVENESS OF PILATES OR YOGA ON BMD IN ADULT WOMEN. METHODS: FIVE ELECTRONICS DATABASES WERE SEARCHED UP TO APRIL 2021. RANDOMIZED CONTROLLED TRIALS (RCTS), NON-RCTS AND PRE-POST STUDIES WERE INCLUDED. THE MAIN OUTCOME WAS BMD. RISK OF BIAS WAS EVALUATED USING THE COCHRANE RISK OF BIAS TOOL. A RANDOM EFFECTS MODEL WAS USED TO POOL DATA FROM PRIMARY STUDIES. SUBGROUP ANALYSES BASED ON THE TYPE OF EXERCISE WERE CONDUCTED. RESULTS: ELEVEN STUDIES INCLUDING 591 PARTICIPANTS AGED BETWEEN 45 AND 78 YEARS WERE INCLUDED. THE MEAN LENGTH OF THE INTERVENTIONS RANGED FROM 12 TO 32 WEEKS, AND TWO STUDIES WERE PERFORMED FOR A PERIOD OF AT LEAST ONE YEAR. THE POOLED EFFECT SIZE FOR THE EFFECT OF THE INTERVENTION (PILATES/YOGA) VS THE CONTROL GROUP WAS 0.07 (95% CONFIDENCE INTERVAL [CI]: -0.05 TO 0.19; I2 = 0.0%), AND 0.10 (95% CI: 0.01 TO 0.18; I2 = 18.4%) FOR THE SECONDARY ANALYSIS OF THE PRE-POST INTERVENTION. CONCLUSIONS: DESPITE OF THE NON-SIGNIFICANT RESULTS, THE BMD MAINTENANCE IN THE POSTMENOPAUSAL POPULATION, WHEN BMD DETRIMENTAL IS EXPECTED, COULD BE UNDERSTOOD AS A POSITIVE RESULT ADDED TO THE BENEFICIAL IMPACT OF PILATES-YOGA IN MULTIPLE FRACTURE RISK FACTORS, INCLUDING BUT NOT LIMITED TO, STRENGTH AND BALANCE. 2021 3 2777 57 YOGA SPINAL FLEXION POSITIONS AND VERTEBRAL COMPRESSION FRACTURE IN OSTEOPENIA OR OSTEOPOROSIS OF SPINE: CASE SERIES. OBJECTIVE: THE OBJECTIVE OF THIS REPORT IS TO RAISE AWARENESS OF THE EFFECT OF STRENUOUS YOGA FLEXION EXERCISES ON OSTEOPENIC OR OSTEOPOROTIC SPINES. WE PREVIOUSLY DESCRIBED SUBJECTS WITH KNOWN OSTEOPOROSIS IN WHOM VERTEBRAL COMPRESSION FRACTURES (VCFS) DEVELOPED AFTER SPINAL FLEXION EXERCISE (SFE) AND RECOMMENDED THAT SFES NOT BE PRESCRIBED IN PATIENTS WITH SPINAL OSTEOPOROSIS. METHODS: THIS REPORT DESCRIBES 3 HEALTHY PERSONS WITH LOW BONE MASS AND YOGA-INDUCED PAIN OR FRACTURE. RESULTS: ALL 3 PATIENTS HAD OSTEOPENIA, WERE IN GOOD HEALTH AND PAIN-FREE, AND HAD STARTED YOGA EXERCISES TO IMPROVE THEIR MUSCULOSKELETAL HEALTH. NEW PAIN AND FRACTURE AREAS OCCURRED AFTER PARTICIPATION IN YOGA FLEXION EXERCISES. CONCLUSIONS: THE DEVELOPMENT OF PAIN AND COMPLICATIONS WITH SOME FLEXION YOGA POSITIONS IN THE PATIENTS WITH OSTEOPENIA LEADS TO CONCERN THAT FRACTURE RISK WOULD INCREASE EVEN FURTHER IN OSTEOPOROSIS. ALTHOUGH EXERCISE HAS BEEN SHOWN TO BE EFFECTIVE FOR IMPROVING BONE MINERAL DENSITY AND DECREASING FRACTURE RISK, OUR SUBJECTS HAD DEVELOPMENT OF VCFS AND NECK AND BACK PAIN WITH YOGA EXERCISES. THIS FINDING SUGGESTS THAT FACTORS OTHER THAN BONE MASS SHOULD BE CONSIDERED FOR EXERCISE COUNSELING IN PATIENTS WITH BONE LOSS. THE INCREASED TORQUE PRESSURE APPLIED TO VERTEBRAL BODIES DURING SFES MAY BE A RISK. EXERCISE IS EFFECTIVE AND IMPORTANT FOR TREATMENT OF OSTEOPENIA AND OSTEOPOROSIS AND SHOULD BE PRESCRIBED FOR PATIENTS WITH VERTEBRAL BONE LOSS. SOME YOGA POSITIONS CAN CONTRIBUTE TO EXTREME STRAIN ON SPINES WITH BONE LOSS. ASSESSMENT OF FRACTURE RISK IN OLDER PERSONS PERFORMING SFES AND OTHER HIGH-IMPACT EXERCISES IS AN IMPORTANT CLINICAL CONSIDERATION. 2013 4 2853 46 YOGA, VERTEBRAL FRACTURES, AND OSTEOPOROSIS: RESEARCH AND RECOMMENDATIONS. BACKGROUND: OSTEOPOROSIS IS CHARACTERIZED BY DECREASED BONE DENSITY THAT LEAVES BONES FRAGILE AND HIGHLY SUSCEPTIBLE TO FRACTURE. GLOBALLY, 1 IN 3 WOMEN AND 1 IN 5 MEN OLDER THAN 50 WILL SUFFER FROM AN OSTEOPOROTIC FRACTURE, AND THOSE INDIVIDUALS WILL EXPERIENCE A CONSIDERABLY HIGHER RISK OF POSTFRACTURE MORTALITY THAN WILL THE GENERAL POPULATION. GENTLE, WEIGHT-BEARING EXERCISES SUCH AS YOGA CAN HELP PREVENT OR CEASE THE PROGRESSION OF OSTEOPOROSIS; HOWEVER, THERE IS INSUFFICIENT DATA REGARDING WHICH YOGA POSES PRESENT THE LEAST RISK AND ARE MOST BENEFICIAL TO INDIVIDUALS WITH REDUCED BONE DENSITY. OBJECTIVES: REVIEW THE EXTANT LITERATURE ABOUT THE RISKS AND BENEFITS TO THE SPINE OF PARTICULAR FORMS OF MOVEMENT AND CONSIDER RECOMMENDATIONS RELATIVE TO THE PRACTICE OF YOGA. METHODS: A REVIEW OF THE PUBMED, MEDLINE, AND COCHRANE DATABASES WAS CONDUCTED THAT IDENTIFIED MANUSCRIPTS PUBLISHED BETWEEN 1966 AND 2011 ABOUT TOPICS RELATED TO OSTEOPOROSIS AND SPINAL MOVEMENT. CONCLUSIONS: MOVEMENTS INVOLVING SPINAL FLEXION CAN INCREASE RISK FOR VERTEBRAL COMPRESSION FRACTURES; HOWEVER, A COMBINATION OF MILD SPINAL FLEXION AND EXTENSION MAY PROVE BENEFICIAL. MODERATE, WEIGHT-BEARING ACTIVITIES THAT STRENGTHEN THE MUSCLES SUPPORTING THE SPINAL COLUMN, PROMOTE BALANCE, IMPROVE POSTURE, AND ENHANCE QUALITY OF LIFE APPEAR TO BE OF GREATEST BENEFIT. AMPLE EVIDENCE SUPPORTS THE IMPORTANCE OF VARIED SPINAL MOVEMENT FOR PRESERVING THE HEALTH AND STRENGTH OF THE VERTEBRAL BODIES. EXERCISE MODIFICATIONS SUITABLE FOR HIGH-RISK INDIVIDUALS MAY BE COUNTERPRODUCTIVE FOR THOSE AT LOW RISK FOR VERTEBRAL FRACTURES. YOGA THERAPISTS ARE CAUTIONED TO NOT APPLY A ONE-SIZE-FITS-ALL APPROACH WHEN WORKING WITH THIS POPULATION. WELL-DESIGNED EMPIRICAL STUDIES ARE NEEDED TO FURTHER OUR UNDERSTANDING OF WHICH YOGA POSES PRESENT THE LEAST RISK AND ARE OF GREATEST BENEFIT TO INDIVIDUALS WITH OSTEOPOROSIS. 2013 5 2518 39 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 6 1054 27 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 7 1111 33 EFFECTS OF YOGASANAS ON OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN. BACKGROUND: OSTEOPOROSIS IS COMMONLY ENCOUNTERED BY POSTMENOPAUSAL WOMEN. THERE IS AN INCREASED NEED FOR A LOW COST AND EFFICIENT TREATMENT ALTERNATIVE TO ADDRESS THIS POPULATION. AIMS: TO STUDY THE EFFECTS OF INTEGRATED YOGA ON BONE MINERAL DENSITY (BMD) IN POSTMENOPAUSAL WOMEN WITH OSTEOPOROSIS. SETTINGS AND DESIGNS: EXPERIMENTAL PRE-POST STUDY CONDUCTED IN A COMMUNITY SETTING. MATERIALS AND METHODS: 30 FEMALES IN THE AGE GROUP OF 45-62 YEARS SUFFERING FROM POSTMENOPAUSAL OSTEOPOROSIS WITH A DUAL-ENERGY X-RAY ABSORPTIOMETRY (DEXA) SCORE OF /=50 YEARS-OLD AT INCREASED RISK OF FRACTURE, TO INFORM THE UPDATED OSTEOPOROSIS CANADA CLINICAL PRACTICE GUIDELINES. SIX DATABASES WERE SEARCHED FOR OBSERVATIONAL STUDIES, RANDOMIZED CONTROLLED TRIALS AND CASE SERIES. CERTAINTY OF EVIDENCE WAS ASSESSED USING THE GRADING OF RECOMMENDATIONS, ASSESSMENT, DEVELOPMENT AND EVALUATION HANDBOOK. NINE STUDIES WERE INCLUDED AND REPORTED USING NARRATIVE SYNTHESES DUE TO THE LIMITED AVAILABLE EVIDENCE. OVERALL, THE AVAILABLE EVIDENCE WAS OF VERY LOW CERTAINTY. THERE WAS NO EFFECT OF YOGA ON HEALTH-RELATED QUALITY OF LIFE IN RANDOMIZED TRIALS. EFFECTS ON OTHER HEALTH-RELATED OUTCOMES WERE MIXED OR NOT AVAILABLE IN THE LITERATURE. FIVE STUDIES REPORTED NO ADVERSE EVENTS DIRECTLY RELATED TO THE STUDY INTERVENTION, AND 2 STUDIES DID NOT REPORT WHETHER ADVERSE EVENTS OCCURRED. HOWEVER, 2 CASE SERIES REPORTED VERTEBRAL FRACTURES RELATED TO YOGA PARTICIPATION, POSSIBLY DUE TO EXCESSIVE SPINAL FLEXION. DUE TO THE LIMITED AND VERY LOW CERTAINTY EVIDENCE, GUIDELINE DEVELOPERS WILL NEED TO DRAW INDIRECT EVIDENCE FROM YOGA STUDIES AMONG MIDDLE AGED OR OLDER ADULTS THAT ARE NOT AT FRACTURE RISK. PROSPERO: CRD42019124898. NOVELTY: EVIDENCE IN GENERAL WAS OF VERY LOW CERTAINTY. YOGA HAD NO EFFECT ON HEALTH-RELATED QUALITY OF LIFE IN RANDOMIZED TRIALS. EVIDENCE WAS MIXED OR UNAVAILABLE FOR OTHER OUTCOMES. CASE STUDIES REPORTED YOGA POSES INVOLVING SPINAL FLEXION COINCIDED WITH INCIDENTS OF VERTEBRAL COMPRESSION FRACTURE AMONG OLDER ADULTS WITH INCREASED FRACTURE RISK. 2022 10 2633 24 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 11 2333 19 TWELVE-MINUTE DAILY YOGA REGIMEN REVERSES OSTEOPOROTIC BONE LOSS. OBJECTIVE: ASSESS THE EFFECTIVENESS OF SELECTED YOGA POSTURES IN RAISING BONE MINERAL DENSITY (BMD). METHODS: TEN-YEAR STUDY OF 741 INTERNET-RECRUITED VOLUNTEERS COMPARING PREYOGA BMD CHANGES WITH POSTYOGA BMD CHANGES. OUTCOME MEASURES: DUAL-ENERGY X-RAY ABSORPTIOMETRIC SCANS. OPTIONAL RADIOGRAPHS OF HIPS AND SPINE AND BONE QUALITY STUDY (7 TESLA). RESULTS: BONE MINERAL DENSITY IMPROVED IN SPINE, HIPS, AND FEMUR OF THE 227 MODERATELY AND FULLY COMPLIANT PATIENTS. MONTHLY GAIN IN BMD WAS SIGNIFICANT IN SPINE (0.0029 G/CM(2), P = .005) AND FEMUR (0.00022 G/CM(2), P = .053), BUT IN 1 COHORT, ALTHOUGH MEAN GAIN IN HIP BMD WAS 50%, LARGE INDIVIDUAL DIFFERENCES RAISED THE CONFIDENCE INTERVAL AND THE GAIN WAS NOT SIGNIFICANT FOR TOTAL HIP (0.000357 G/CM(2)). NO YOGA-RELATED SERIOUS INJURIES WERE IMAGED OR REPORTED. BONE QUALITY APPEARED QUALITATIVELY IMPROVED IN YOGA PRACTITIONERS. CONCLUSION: YOGA APPEARS TO RAISE BMD IN THE SPINE AND THE FEMUR SAFELY. 2016 12 2599 34 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 13 834 33 EFFECT OF YOGA ON OXIDATIVE STRESS IN TYPE 2 DIABETES MELLITUS: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: DIABETES MELLITUS HAS A SIGNIFICANT IMPACT ON PUBLIC HEALTH. OXIDATIVE STRESS PLAYS A MAJOR ROLE IN THE PATHOPHYSIOLOGY OF TYPE 2 DIABETES MELLITUS (T2DM), LEADING TO VARIOUS COMPLICATIONS OF T2DM. YOGA IS BEING WIDELY USED IN THE MANAGEMENT OF T2DM. THE PRIMARY OBJECTIVE OF THIS SYSTEMATIC REVIEW AND META-ANALYSIS IS TO UNDERSTAND THE EFFECTS OF YOGA ON OXIDATIVE STRESS PARAMETERS AMONG ADULT PATIENTS DIAGNOSED WITH T2DM. MATERIALS AND METHODS: ELECTRONIC DATABASES SUCH AS PUBMED, SCOPUS, COCHRANE LIBRARY AND SCIENCE DIRECT FROM START OF THE STUDY TILL MARCH 2020 WERE SEARCHED TO OBTAIN ELIGIBLE STUDIES. STUDY DESIGNS OF ALL NATURE WERE INCLUDED (EXCEPT CASE STUDIES AND REVIEWS). THE PRIMARY OUTCOME WAS MALONDIALDEHYDE (MDA) AND SECONDARY OUTCOMES INCLUDED FASTING PLASMA GLUCOSE, HBA1C AND SUPEROXIDE DISMUTASE (SOD) LEVELS. RESULTS: A TOTAL OF FOUR TRIALS WITH A TOTAL OF 440 PATIENTS MET THE INCLUSION CRITERIA. THE RESULTS OF META-ANALYSIS INDICATED THAT YOGA SIGNIFICANTLY REDUCED MDA (SMD: -1.4; 95% CI -2.66 TO -0.13; P = 0.03; I2 = 97%), FASTING PLASMA GLUCOSE LEVELS (SMD: -1.87: 95% CI -3.83 TO -0.09; P = 0.06; I2= 99%), AND HBA1C (SMD: -1.92; 95% CI - 3.03 TO -0.81; P = 0.0007; I2 = 92%) IN PATIENTS WITH T2DM. NO SUCH EFFECT WAS FOUND FOR SOD (SMD: -1.01; 95% CI -4.41 TO 2.38; P = 0.56; I2= 99%). CONCLUSION: THE AVAILABLE EVIDENCE SUGGESTS THAT YOGA REDUCES MDA, FASTING PLASMA GLUCOSE AND HBA1C, AND THUS WOULD BE BENEFICIAL IN THE MANAGEMENT OF T2DM AS A COMPLEMENTARY THERAPY. HOWEVER, CONSIDERING THE LIMITED NUMBER OF STUDIES AND ITS HETEROGENEITY, FURTHER ROBUST STUDIES ARE NECESSARY TO STRENGTHEN OUR FINDINGS AND INVESTIGATE THE LONG-TERM BENEFITS OF YOGA. 2022 14 222 24 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 15 2568 27 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 16 2594 32 YOGA FOR METABOLIC SYNDROME: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND METABOLIC SYNDROME IS THE MOST IMPORTANT RISK FACTOR FOR DEVELOPING CARDIOVASCULAR DISEASE AND TYPE 2 DIABETES. THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY ASSESS AND PERFORM A META-ANALYSIS OF THE EFFECTS OF YOGA ON THE PARAMETERS OF METABOLIC SYNDROME. METHODS MEDLINE/PUBMED, SCOPUS, THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS AND INDMED WERE SEARCHED AND SCREENED FROM THEIR INCEPTION THROUGH TO 8 MARCH 2016 FOR RANDOMISED CONTROLLED TRIALS ON YOGA FOR PATIENTS WITH METABOLIC SYNDROME. RISK OF BIAS WAS ASSESSED USING THE COCHRANE RISK OF BIAS TOOL. RESULTS SEVEN TRIALS WITH A TOTAL OF 794 PARTICIPANTS WERE INCLUDED. NO EFFECTS OF YOGA ON RESOLUTION OF METABOLIC SYNDROME, DIASTOLIC BLOOD PRESSURE, TRIGLYCERIDES, HIGH-DENSITY LIPOPROTEIN CHOLESTEROL AND FASTING PLASMA GLUCOSE WERE FOUND, BUT YOGA WAS SUPERIOR TO USUAL CARE FOR WAIST CIRCUMFERENCE (STANDARDISED MEAN DIFFERENCE (SMD) = -0.35; 95% CONFIDENCE INTERVAL (CI) = -0.57 TO -0.13; P < 0.01) AND SYSTOLIC BLOOD PRESSURE (SMD = -0.29; 95% CI = -0.51 TO -0.07; P = 0.01). HOWEVER, THESE EFFECTS WERE NOT ROBUST AGAINST SELECTION BIAS. NO INTERVENTION-RELATED ADVERSE EVENTS WERE REPORTED. CONCLUSION BASED ON THE RESULTS OF THIS META-ANALYSIS, NO RECOMMENDATION CAN BE MADE FOR OR AGAINST YOGA IN ORDER TO INFLUENCE THE PARAMETERS OF METABOLIC SYNDROME. DESPITE METHODOLOGICAL DRAWBACKS, AND UNTIL FURTHER RESEARCH IS UNDERTAKEN, YOGA CAN BE PRELIMINARILY CONSIDERED AS A SAFE AND EFFECTIVE INTERVENTION FOR REDUCING WAIST CIRCUMFERENCE AND SYSTOLIC BLOOD PRESSURE IN INDIVIDUALS WITH METABOLIC SYNDROME WHO ARE NOT ADHERING TO CONVENTIONAL FORMS OF EXERCISE. 2016 17 2546 30 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 18 2634 30 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 19 2587 52 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 20 2629 41 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