1 419 213 BREATHING-FOCUSED YOGA INTERVENTION ON RESPIRATORY DECLINE IN CHRONICALLY PESTICIDE-EXPOSED FARMERS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: OCCUPATIONAL EXPOSURE TO PESTICIDES HAS BEEN ASSOCIATED WITH LUNG AND COGNITIVE FUNCTION EXACERBATIONS. IN THE PRESENT STUDY, WE TESTED THE EFFECTIVENESS OF BREATHING FOCUSED YOGA INTERVENTION ON ALLEVIATION OF ADVERSE RESPIRATORY AND COGNITIVE EFFECTS ASSOCIATED WITH CHRONIC PESTICIDE EXPOSURE IN FARMERS. METHODS: WE UNDERTOOK A PARALLEL, TWO-ARMED RANDOMIZED CONTROLLED TRIAL WITH BLINDED OUTCOME ASSESSORS ON A CHRONICALLY PESTICIDE-EXPOSED FARMING POPULATION. THE STUDY WAS CONDUCTED AT DISTRICT PANIPAT, STATE HARYANA LOCATED IN THE NORTHERN PART OF INDIA FROM NOVEMBER 2019 TO AUGUST 2020. A TOTAL OF 634 FARMERS WERE SCREENED, AND 140 FARMERS WERE RANDOMIZED TO BREATHING-FOCUSED YOGA INTERVENTION (BFY, N = 70) AND WAITLIST CONTROL ARMS (N = 65). BFY WAS DELIVERED WEEKLY IN 45-MIN GROUP SESSIONS OVER 12 WEEKS FOLLOWED BY HOME-BASED PRACTICE. THE PRIMARY OUTCOME WAS THE CHANGE IN SPIROMETRY-BASED MARKERS OF PULMONARY FUNCTION FROM BASELINE EXPRESSED AS RAW VALUES, GLOBAL LUNG INITIATIVE (GLI) PERCENT PREDICTED (PP), AND GLI Z-SCORES AFTER 24 WEEKS OF INTERVENTION. SECONDARY VARIABLES WERE TRAIL MAKING TESTS (TMT A AND B), DIGIT SYMBOL SUBSTITUTION (DSST), AND WHO QUALITY OF LIFE-BREF (WHOQOL-BREF). ANALYSIS WAS BY INTENTION-TO-TREAT. MEDIATION ANALYSIS WAS DONE CONSIDERING OXIDATIVE STRESS MARKERS AS POTENTIAL MEDIATORS. RESULTS: AT THE END OF 6 MONTHS OF INTERVENTION, THE OVERALL FOLLOW-UP IN THE PARTICIPANTS WAS 87.85% (N = 123); 90% (N = 63) IN THE CONTROL GROUP, AND 85.71% IN THE YOGA GROUP (N = 60). THE MEAN AGE OF THE STUDY COHORT (N = 140) WAS 38.75 (SD = 7.50) YEARS. COMPARED WITH THE CONTROL GROUP, AT 24 WEEKS POST-INTERVENTION, THE BFY GROUP HAD SIGNIFICANTLY IMPROVED STATUS OF THE RAW SAND Z SCORES MARKERS OF AIRWAY OBSTRUCTION, AFTER ADJUSTING FOR CONFOUNDERS, FEV1, FVC, FEF25-75 [Z SCORE-ADJUSTED MEAN DIFFERENCES (95% CI); 1.66 (1.10-2.21) 1.88 (1.21-2.55), AND 6.85 (5.12-8.57), RESPECTIVELY. A FRACTION OF FEF25-75 CHANGE (MEDIATION PERCENTAGE 23.95%) WAS EXPLAINED BY GLUTATHIONE AUGMENTATION. THERE WERE ALSO SIGNIFICANT IMPROVEMENTS IN COGNITIVE SCORES OF DSST, TMT-A AND TMT-B, AND WHOQOL-BREF. CONCLUSION: IN CONCLUSION, REGULAR PRACTICE OF BFY COULD IMPROVE THE EXACERBATIONS IN THE MARKERS OF AIRWAY OBSTRUCTION IN CHRONICALLY PESTICIDE-EXPOSED FARMERS AND COGNITIVE VARIABLES. A SIGNIFICANT MEDIATING EFFECT OF GLUTATHIONE AUGMENTATION WAS ALSO OBSERVED CONCERNING THE EFFECT OF THE INTERVENTION ON FEF25-75. THESE FINDINGS PROVIDE AN IMPORTANT PIECE OF BENEFICIAL EVIDENCE OF THE BREATHING-BASED YOGA INTERVENTION THAT NEEDS VALIDATION ACROSS DIFFERENT FARMING ETHNICITIES.CLINICAL TRIAL REGISTRATION:WWW.CLINICALTRIALS.GOV, IDENTIFIER: CTRI/2019/11/021989. 2022 2 1199 35 EXERCISE AND YOGA DURING PREGNANCY AND THEIR IMPACT ON DEPRESSION: A SYSTEMATIC LITERATURE REVIEW. IT IS WELL ESTABLISHED THAT EXERCISE CAN IMPROVE DEPRESSIVE SYMPTOMS IN THE GENERAL POPULATION; HOWEVER, IT IS NOT CLEAR IF THESE BENEFITS ARE ALSO SEEN IN PREGNANCY. THIS REVIEW AIMED TO SYNTHESIZE THE EVIDENCE THAT EXAMINES WHETHER EXERCISE DURING PREGNANCY IMPACTS DEPRESSIVE AND ASSOCIATED SYMPTOMS (E.G. ANXIETY) DURING THE PERINATAL PERIOD. THE REVIEW WAS CONDUCTED IN ACCORDANCE WITH PRISMA GUIDELINES AND REPORTING CRITERIA; LITERATURE WAS SEARCHED USING PUBMED, SCOPUS AND WEB OF SCIENCE DATABASE ENGINES. CLINICAL TRIALS PUBLISHED IN ENGLISH EVALUATING THE EFFECTS OF A DEFINED EXERCISE PROTOCOL DURING PREGNANCY ON DEPRESSIVE AND/OR ANXIETY SYMPTOMS DURING THE PERINATAL PERIOD WERE INCLUDED. STUDIES WITHOUT A CONTROL GROUP WERE EXCLUDED. RISK OF BIAS WAS CONDUCTED BY COCHRANE ASSESSMENT TO APPRAISE THE QUALITY OF THE INCLUDED STUDIES. TWENTY-SEVEN ARTICLES, BETWEEN 1994 AND 2019, WERE INCLUDED. OF THESE, ONLY 5 SPECIFICALLY RECRUITED WOMEN WITH DEPRESSION (N = 334), WHICH ALL ASSESSED A YOGA-BASED INTERVENTION; 4 OF THESE STUDIES SHOWED A STATISTICALLY SIGNIFICANT IMPROVEMENT IN DEPRESSIVE AND/OR ANXIETY SYMPTOMS IN THE INTERVENTION GROUP COMPARED TO BASELINE; HOWEVER, 2 OF THESE STUDIES ALSO SHOWED AN IMPROVEMENT IN THE CONTROL GROUP. THE REMAINING 22 STUDIES USED VARIOUS EXERCISE INTERVENTIONS IN PREGNANT WOMEN (N = 4808) WITH 20 STUDIES REPORTING THAT EXERCISE DURING PREGNANCY HAS THE ABILITY TO IMPROVE DEPRESSIVE AND/OR ANXIETY MEASURES IN THE PERINATAL PERIOD COMPARED TO EITHER BASELINE OR CONTROL. THE EVIDENCE SUGGESTS THAT EXERCISE OF VARIOUS TYPES IN PREGNANCY CAN REDUCE DEPRESSIVE AND/OR ANXIETY SYMPTOMS IN THE PERINATAL PERIOD IN OTHERWISE HEALTHY WOMEN. SPECIFICALLY IN WOMEN WITH ANTENATAL DEPRESSION, THE INCORPORATION OF YOGA IN PREGNANCY CAN IMPROVE DEPRESSIVE/ANXIETY SYMPTOMS IN THE PERINATAL PERIOD; HOWEVER, THIS IS BASED ON A SMALL NUMBER OF STUDIES, AND IT IS NOT CLEAR WHETHER THIS IS SUPERIOR TO NON-EXERCISE CONTROLS. FURTHER STUDIES ARE NEEDED TO DETERMINE THE POTENTIAL THERAPEUTIC EFFECTS OF EXERCISE OF VARIOUS TYPES DURING PREGNANCY ON SYMPTOMS OF ANTENATAL DEPRESSION. 2022 3 2518 59 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 4 1074 55 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 5 944 52 EFFECTS OF A 12-WEEK HATHA YOGA INTERVENTION ON METABOLIC RISK AND QUALITY OF LIFE IN HONG KONG CHINESE ADULTS WITH AND WITHOUT METABOLIC SYNDROME. OBJECTIVE: TO DETERMINE THE EFFICACY OF A 12-WEEK HATHA YOGA INTERVENTION TO IMPROVE METABOLIC RISK PROFILES AND HEALTH-RELATED QUALITY OF LIFE (HRQOL) IN CHINESE ADULTS WITH AND WITHOUT METABOLIC SYNDROME (METS). METHODS: WE CONDUCTED A CONTROLLED TRIAL WITHIN AN UNIVERSITY-AFFILIATED HOSPITAL. 173 CHINESE MEN AND WOMEN AGED 18 OR ABOVE WERE ASSIGNED TO EITHER THE YOGA INTERVENTION GROUP (N = 87) OR THE CONTROL GROUP (N = 86). PRIMARY OUTCOMES INCLUDED 12-WEEK CHANGE IN METABOLIC RISK FACTORS AND METS Z SCORE. SECONDARY OUTCOME WAS HRQOL (MEDICAL OUTCOMES SHORT FORM SURVEY AT 12 WEEKS). RESULTS: THE MEAN AGE OF PARTICIPANTS WAS 52.0 (SD 7.4, RANGE 31-71) YEARS. ANALYSIS INVOLVING THE ENTIRE STUDY POPULATION REVEALED THAT THE YOGA GROUP ACHIEVED GREATER DECLINE IN WAIST CIRCUMFERENCE (P<0.001), FASTING GLUCOSE (P<0.01), TRIGLYCERIDES (P<0.05), AND METS Z SCORE (P<0.01). YOGA TRAINING ALSO IMPROVED GENERAL HEALTH PERCEPTIONS (P<0.01), PHYSICAL COMPONENT SCORE (P<0.01), AND SOCIAL FUNCTIONING (P<0.01) DOMAINS SCORE OF HRQOL. HOWEVER, NO SIGNIFICANT DIFFERENCES BETWEEN GROUPS WERE OBSERVED IN THE MEAN CHANGE OF SYSTOLIC/DIASTOLIC BLOOD PRESSURES OR HIGH-DENSITY LIPID PROTEIN CHOLESTEROL (ALL P>0.05). THERE WERE NO SIGNIFICANT DIFFERENCES IN THE INTERVENTION EFFECTS ON WAIST CIRCUMFERENCE AND METS Z SCORE BETWEEN THE METS SUBGROUPS (BOTH P>0.05). CONCLUSION: A 12-WEEK HATHA YOGA INTERVENTION IMPROVES METABOLIC RISK PROFILES AND HRQOL IN CHINESE ADULTS WITH AND WITHOUT METS. TRIAL REGISTRATION: AUSTRALIAN NEW ZEALAND CLINICAL TRIALS REGISTRY ACTRN12613000816752. 2015 6 2543 71 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 7 866 46 EFFECT OF YOGA PROGRAM ON EXECUTIVE FUNCTIONS OF ADOLESCENTS DWELLING IN AN ORPHAN HOME: A RANDOMIZED CONTROLLED STUDY. EXECUTIVE FUNCTION (EF) IS IMPORTANT FOR PHYSICAL AND MENTAL HEALTH OF CHILDREN. STUDIES HAVE SHOWN THAT CHILDREN WITH POVERTY AND EARLY LIFE STRESS HAVE REDUCED EF. THE AIM OF THE STUDY WAS TO EVALUATE THE EFFECT OF YOGA PROGRAM ON THE EF OF ORPHAN ADOLESCENTS. SEVENTY TWO APPARENTLY HEALTHY ORPHAN ADOLESCENTS RANDOMIZED AND ALLOCATED INTO TWO GROUPS AS YOGA GROUP (N = 40; 14 GIRLS, AGE = 12.69 +/- 1.35 YRS) AND WAIT LIST CONTROL (WLC) GROUP (N = 32, 13 GIRLS, AGE = 12.58 +/- 1.52 YRS). YOGA GROUP UNDERWENT THREE MONTHS OF YOGA PROGRAM IN A SCHEDULE OF 90 MIN PER DAY, FOUR DAYS PER WEEK WHEREAS THE WLC GROUP FOLLOWED THE ROUTINE ACTIVITIES. THEY WERE ASSESSED BY STROOP COLOR-WORD TASK, DIGIT SYMBOL SUBSTITUTION TEST (DSST), DIGITS SPAN TEST AND TRIAL MAKING TEST (TMT) AT THE BEGINNING AND END OF THE PROGRAM. THE REPEATED MEASURES ANOVA SHOWED SIGNIFICANT DIFFERENCE IN TIME AND GROUP INTERACTIONS (P < 0.05) FOR ALL SUBTESTS OF STROOP COLOR-WORD TASK AND DIGIT SPAN TEST AND PART-A OF TMT WHEREAS THERE WERE NO SIGNIFICANT DIFFERENCE FOUND IN DSST AND TMT (PART-B). THE POST-HOC TEST WITH BONFERRONI ADJUSTMENT ALSO SHOWED SIGNIFICANT IMPROVEMENTS (P < 0.001) WITHIN THE YOGA GROUP IN ALL TEST SCORES WHILE IN WRONG SCORE OF DSST DID NOT EXHIBIT SIGNIFICANT REDUCTION. WHEREAS THE WLC GROUP, SHOWED SIGNIFICANT IMPROVEMENT (P < 0.05) IN STROOP COLOR, COLOR-WORD SCORE, NET SCORE OF DSST, DIGIT SPAN FORWARD AND DIGIT SPAN TOTAL. THREE MONTHS YOGA PROGRAM WAS FOUND USEFUL FOR THE YOUNG ORPHAN ADOLESCENTS IN IMPROVING THEIR EXECUTIVE FUNCTIONS. 2017 8 2821 67 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 9 2271 46 THE RISKS AND BENEFITS OF YOGA FOR PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVES: TO DETERMINE THE EFFECTIVENESS AND SAFETY OF YOGA INTERVENTIONS ON DISEASE SYMPTOMS, QUALITY OF LIFE AND FUNCTION IN PATIENTS DIAGNOSED WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). DATA SOURCES: MEDLINE/PUBMED, SCOPUS, AND CENTRAL (COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS) WERE SEARCHED THROUGH 6 JUNE 2019. REVIEW METHODS: RANDOMIZED CONTROLLED TRIALS ASSESSING THE EFFECTS OF YOGA ON QUALITY OF LIFE, DYSPNEA, EXERCISE CAPACITY, AND PULMONARY FUNCTION (FEV1) IN PATIENTS WITH COPD WERE INCLUDED. SAFETY WAS DEFINED AS SECONDARY OUTCOME. MEAN DIFFERENCES (MD) AND STANDARDIZED MEAN DIFFERENCES (SMD) WITH 95% CONFIDENCE INTERVALS (CIS) WERE COMPUTED. RISK OF BIAS WAS ASSESSED USING THE COCHRANE TOOL. RESULTS: ELEVEN RANDOMIZED CONTROLLED TRIALS WITH A TOTAL OF 586 PATIENTS WERE INCLUDED. META-ANALYSIS REVEALED EVIDENCE FOR EFFECTS OF YOGA COMPARED TO NO TREATMENT ON QUALITY OF LIFE ON THE COPD ASSESSMENT TEST (MD = 3.81; 95% CI = 0.97 TO 6.65; P = 0.009, I(2) = 70%), EXERCISE CAPACITY ASSESSED BY THE 6-MINUTE WALK TEST (MD = 25.53 M; 95% CI = 12.16 M TO 38.90 M; P = 0.001, I(2) = 0%), AND PULMONARY FUNCTION ASSESSED BY FEV1 PREDICTED (MD = 3.95%; 95% CI = 2.74% TO 5.17%; P < 0.001, I(2) = 0%). ONLY THE EFFECTS ON EXERCISE CAPACITY AND PULMONARY FUNCTION WERE ROBUST AGAINST METHODOLOGICAL BIAS. EFFECTS WERE ONLY PRESENT IN BREATHING-FOCUSED YOGA INTERVENTIONS BUT NOT IN INTERVENTIONS INCLUDING YOGA POSTURES. ADVERSE EVENTS WERE REPORTED INFREQUENTLY. CONCLUSION: THIS META-ANALYSIS FOUND ROBUST EFFECTS OF YOGA ON EXERCISE CAPACITY AND PULMONARY FUNCTION IN PATIENTS WITH COPD. YOGA, SPECIFICALLY YOGA BREATHING TECHNIQUES, CAN BE AN EFFECTIVE ADJUNCT INTERVENTION FOR PATIENTS WITH COPD. YOGA'S SAFETY NEEDS TO BE ASSESSED IN MORE DEPTH IN FUTURE STUDIES. 2019 10 1912 49 ROLE OF BREATHING EXERCISES AND YOGA/PRANAYAMA IN CHILDHOOD ASTHMA: A SYSTEMATIC REVIEW. BACKGROUND: VARIOUS COMPLEMENTARY OR ALTERNATIVE MEDICINES (INCLUDING BREATHING EXERCISES AND YOGA/PRANAYAMA) HAVE BEEN TRIED AS AN ATTRACTIVE OPTION TO PHARMACOTHERAPY IN CHILDHOOD ASTHMA. OBJECTIVE: TO EVALUATE THE ROLE OF BREATHING EXERCISE AND YOGA/PRANAYAMA AS ADD ON THERAPY TO THE "PHARMACOLOGICALLY RECOMMENDED TREATMENT" OF CHILDHOOD ASTHMA. METHODS: WE SEARCHED THE PUBLISHED LITERATURE IN THE MAJOR DATABASES: MEDLINE VIA OVID, PUBMED, CENTRAL, EMBASE, AND GOOGLE SCHOLAR TILL JUNE 2018. RANDOMIZED TRIALS COMPARING BREATHING EXERCISES AND YOGA/ PRANAYAMA VERSUS CONTROL OR AS PART OF A COMPOSITE INTERVENTION VERSUS CONTROL WERE INCLUDED. THE PRIMARY OUTCOME MEASURES WERE QUALITY OF LIFE AND CHANGE IN ASTHMA SYMPTOMS. SECONDARY OUTCOMES WERE: DECREASE IN MEDICATION USE, NUMBER OF EXACERBATIONS, CHANGE IN LUNG FUNCTION AND IMMUNOLOGICAL PARAMETERS, SCHOOL ABSENTEEISM AND ADVERSE EVENTS. RESULTS: A TOTAL OF 10 TRIALS (466 CHILDREN, 6-14 YEARS AGE) WERE INCLUDED. THE SEVERITY OF ASTHMA VARIED AMONG THE TRIALS. THE DATA FOR PRIMARY OUTCOME MEASURES COULD NOT BE POOLED, THERE WERE MIXED RESULTS FOR BOTH PRIMARY AND SECONDARY OUTCOMES. NO SIGNIFICANT BENEFIT WAS OBTAINED IN ACUTE ASTHMA AND THE LUNG FUNCTION TESTS [EXCEPT PEFR % AT 4-6 WEEKS, PEF ABSOLUTE AT 3 MONTHS, AND FVC ABSOLUTE AT 3 MONTHS] IN CHRONIC ASTHMA. ONE TRIAL COMPARED BREATHING EXERCISE VERSUS YOGA AND FOUND NO DIFFERENCE. ADVERSE EVENTS WERE NOT SIGNIFICANT. CONCLUSIONS: BREATHING EXERCISE AND YOGA/ PRANAYAMA MAY HAVE SOME ADDITIVE ROLE IN THE TREATMENT OF CHILDHOOD ASTHMA. HOWEVER, AT PRESENT, IT CANNOT BE RECOMMENDED AS A STANDARD OF CARE DUE TO INSUFFICIENT DATA. 2019 11 2614 41 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 12 2829 62 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 13 232 31 A SYSTEMATIC REVIEW OF YOGA FOR MAJOR DEPRESSIVE DISORDER. BACKGROUND: THE PURPOSE OF THIS REVIEW WAS TO INVESTIGATE THE EFFICACY AND SAFETY OF YOGA INTERVENTIONS IN TREATING PATIENTS WITH MAJOR DEPRESSIVE DISORDER. METHODS: MEDLINE, SCOPUS, AND THE COCHRANE LIBRARY WERE SCREENED THROUGH DECEMBER 2016. RANDOMIZED CONTROLLED TRIALS (RCTS) COMPARING YOGA TO INACTIVE OR ACTIVE COMPARATORS IN PATIENTS WITH MAJOR DEPRESSIVE DISORDER WERE ELIGIBLE. PRIMARY OUTCOMES INCLUDED REMISSION RATES AND SEVERITY OF DEPRESSION. ANXIETY AND ADVERSE EVENTS WERE SECONDARY OUTCOMES. RISK OF BIAS WAS ASSESSED USING THE COCHRANE TOOL. RESULTS: SEVEN RCTS WITH 240 PARTICIPANTS WERE INCLUDED. RISK OF BIAS WAS UNCLEAR FOR MOST RCTS. COMPARED TO AEROBIC EXERCISE, NO SHORT- OR MEDIUM-TERM GROUP DIFFERENCES IN DEPRESSION SEVERITY WAS FOUND. HIGHER SHORT-TERM DEPRESSION SEVERITY WAS FOUND FOR YOGA COMPARED TO ELECTRO-CONVULSIVE THERAPY; REMISSION RATES DID NOT DIFFER BETWEEN GROUPS. NO SHORT-TERM GROUP DIFFERENCES OCCURRED WHEN YOGA WAS COMPARED TO ANTIDEPRESSANT MEDICATION. CONFLICTING EVIDENCE WAS FOUND WHEN YOGA WAS COMPARED TO ATTENTION-CONTROL INTERVENTIONS, OR WHEN YOGA AS AN ADD-ON TO ANTIDEPRESSANT MEDICATION WAS COMPARED TO MEDICATION ALONE. ONLY TWO RCTS ASSESSED ADVERSE EVENTS AND REPORTED THAT NO TREATMENT-RELATED ADVERSE EVENTS WERE REPORTED. LIMITATIONS: FEW RCTS WITH LOW SAMPLE SIZE. CONCLUSIONS: THIS REVIEW FOUND SOME EVIDENCE FOR POSITIVE EFFECTS BEYOND PLACEBO AND COMPARABLE EFFECTS COMPARED TO EVIDENCE-BASED INTERVENTIONS. HOWEVER, METHODOLOGICAL PROBLEMS AND THE UNCLEAR RISK-BENEFIT RATIO PRECLUDE DEFINITIVE RECOMMENDATIONS FOR OR AGAINST YOGA AS AN ADJUNCT TREATMENT FOR MAJOR DEPRESSIVE DISORDER. LARGER AND ADEQUATELY POWERED RCTS USING NON-INFERIORITY DESIGNS ARE NEEDED. 2017 14 2124 29 THE EFFECTIVENESS OF PRENATAL YOGA ON DELIVERY OUTCOMES: A META-ANALYSIS. BACKGROUND: THE EFFICACY OF YOGA ON DELIVERY OUTCOMES REMAINING CONTROVERSY. OBJECTIVES: TO EVALUATE THE EFFECTS OF PRENATAL YOGA ON DELIVERY OUTCOMES. METHODS: THE COCHRANE LIBRARY, PUBMED, EMBASE, WEB OF SCIENCE, CINAHL AND ELSEVIER DATABASES WERE SEARCHED FROM INCEPTION TO JANUARY 22, 2020, AND RANDOMIZED, QUASI-RANDOMIZED AND NON-RANDOMIZED CONTROLLED TRIALS EVALUATING THE EFFECT OF YOGA ON THE DELIVERY OUTCOMES IN PREGNANT WOMEN WERE INCLUDED. THE METHODOLOGICAL QUALITY WAS ASSESSED BY THE COCHRANE COLLABORATION'S TOOL. META-ANALYSIS WAS PERFORMED USING REVMAN 5.3. RESULTS: THIS META-ANALYSIS IDENTIFIED THAT YOGA IMPROVED VAGINAL DELIVERY, DECREASED PREMATURE DELIVERY AND BIRTH WEIGHT OF NEWBORNS, SHORTEN THE LABOR DURATION. CONCLUSION: PRENATAL YOGA IS AN EFFECTIVE COMPLEMENTARY MEDICINE TO IMPROVE DELIVERY OUTCOMES AND NOT TO INCREASE THE RISK OF FETUS, WHICH IS WORTH RECOMMENDING TO PREGNANT WOMEN. BUT STUDIES INVOLVED IN THIS META-ANALYSIS WERE NOT ALL OF HIGH QUALITY. THE REGISTRATION NUMBER IN PROSPERO IS CRD42019132490. 2020 15 2587 60 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 16 1054 37 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 17 1061 40 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 18 2279 29 THE SAFETY OF YOGA: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. AS YOGA HAS GAINED POPULARITY AS A THERAPEUTIC INTERVENTION, ITS SAFETY HAS BEEN QUESTIONED IN THE LAY PRESS. THUS, THIS REVIEW AIMED TO SYSTEMATICALLY ASSESS AND META-ANALYZE THE FREQUENCY OF ADVERSE EVENTS IN RANDOMIZED CONTROLLED TRIALS OF YOGA. MEDLINE/PUBMED, SCOPUS, THE COCHRANE LIBRARY, AND INDMED WERE SCREENED THROUGH FEBRUARY 2014. OF 301 IDENTIFIED RANDOMIZED CONTROLLED TRIALS OF YOGA, 94 (1975-2014; TOTAL OF 8,430 PARTICIPANTS) REPORTED ON ADVERSE EVENTS. LIFE-THREATENING, DISABLING ADVERSE EVENTS OR THOSE REQUIRING INTENSIVE TREATMENT WERE DEFINED AS SERIOUS AND ALL OTHER EVENTS AS NONSERIOUS. NO DIFFERENCES IN THE FREQUENCY OF INTERVENTION-RELATED, NONSERIOUS, OR SERIOUS ADVERSE EVENTS AND OF DROPOUTS DUE TO ADVERSE EVENTS WERE FOUND WHEN COMPARING YOGA WITH USUAL CARE OR EXERCISE. COMPARED WITH PSYCHOLOGICAL OR EDUCATIONAL INTERVENTIONS (E.G., HEALTH EDUCATION), MORE INTERVENTION-RELATED ADVERSE EVENTS (ODDS RATIO = 4.21, 95% CONFIDENCE INTERVAL: 1.01, 17.67; P = 0.05) AND MORE NONSERIOUS ADVERSE EVENTS (ODDS RATIO = 7.30, 95% CONFIDENCE INTERVAL: 1.91, 27.92; P < 0.01) OCCURRED IN THE YOGA GROUP; SERIOUS ADVERSE EVENTS AND DROPOUTS DUE TO ADVERSE EVENTS WERE COMPARABLE BETWEEN GROUPS. FINDINGS FROM THIS REVIEW INDICATE THAT YOGA APPEARS AS SAFE AS USUAL CARE AND EXERCISE. THE ADEQUATE REPORTING OF SAFETY DATA IN FUTURE RANDOMIZED TRIALS OF YOGA IS CRUCIAL TO CONCLUSIVELY JUDGE ITS SAFETY. 2015 19 1165 60 EVALUATING THE FEASIBILITY AND IMPACT OF A YOGA INTERVENTION ON COGNITION, PHYSICAL FUNCTION, PHYSICAL ACTIVITY, AND AFFECTIVE OUTCOMES IN PEOPLE LIVING WITH HIV: PROTOCOL FOR A RANDOMIZED PILOT TRIAL. BACKGROUND: DESPITE LOWER MORTALITY RATES DUE TO COMBINATION ANTIRETROVIRAL THERAPY, PEOPLE LIVING WITH HIV (PLWH) ARE GRAPPLING WITH INCREASINGLY COMPLEX HEALTH ISSUES, INCLUDING COGNITIVE IMPAIRMENTS IN AREAS SUCH AS MEMORY, ATTENTION, PROCESSING SPEED, AND MOTOR FUNCTION. YOGA HAS BEEN SHOWN TO BE AN EFFECTIVE FORM OF EXERCISE AND MINDFULNESS-BASED STRESS REDUCTION FOR MANY CLINICAL POPULATIONS. HOWEVER, NO RANDOMIZED TRIALS HAVE EVALUATED THE IMPACT OF YOGA ON COGNITIVE AND PHYSICAL FUNCTION AMONG PLWH. OBJECTIVE: THE AIM OF THIS PILOT RANDOMIZED TRIAL WAS TO DETERMINE THE FEASIBILITY OF A YOGA INTERVENTION TO LAY THE GROUNDWORK FOR A FULL-SCALE, MULTISITE, COMMUNITY-BASED TRIAL FOR PLWH. SPECIFIC OBJECTIVES ARE TO (1) ASSESS THE FEASIBILITY OF STUDY PROTOCOL AND PROCEDURES, (2) COMPARE COGNITION IN THE YOGA GROUP WITH THE USUAL CARE CONTROL GROUP AFTER 12 WEEKS OF THE INTERVENTION IN PLWH, AND (3) COMPARE THE EFFECTS OF THE 12-WEEK YOGA INTERVENTION VERSUS CONTROL ON BALANCE, WALKING SPEED, PHYSICAL ACTIVITY, MENTAL HEALTH, MEDICATION ADHERENCE, AND QUALITY OF LIFE AMONG PLWH. METHODS: WE PROPOSE A PILOT RANDOMIZED TRIAL WITH 2 PARALLEL GROUPS (YOGA VERSUS CONTROL). WE WILL RECRUIT 25 PLWH (>35 YEARS) FROM COMMUNITY AND HEALTH ORGANIZATIONS IN HALIFAX, CANADA. AFTER BASELINE ASSESSMENT WITH BLINDED ASSESSORS, PARTICIPANTS WILL BE RANDOMLY ASSIGNED TO THE YOGA OR CONTROL GROUP, USING A RANDOM COMPUTER GENERATOR. PARTICIPANTS IN THE YOGA GROUP WILL ENGAGE IN SUPERVISED 60-MIN GROUP-BASED YOGA SESSIONS 3 TIMES A WEEK FOR 12 WEEKS AT A YOGA STUDIO. PARTICIPANTS IN THE CONTROL GROUP WILL MAINTAIN THEIR CURRENT PHYSICAL ACTIVITY LEVELS THROUGHOUT THE STUDY. RESULTS: AS PER THE CONSOLIDATED STANDARDS OF REPORTING TRIALS EXTENSION FOR PILOT STUDIES, MEANS OF ALL OUTCOMES, MEAN CHANGE, AND 95% CIS WILL BE CALCULATED FOR EACH GROUP SEPARATELY. TWO-TAILED INDEPENDENT T TESTS AND FISHER EXACT TESTS WILL BE USED TO COMPARE GROUPS AT BASELINE. WE WILL ANALYZE QUANTITATIVE POSTINTERVENTION QUESTIONNAIRE RESPONSES USING CHI-SQUARE TESTS, AND OPEN-ENDED RESPONSES WILL BE ANALYZED THEMATICALLY. INTENTION-TO-TREAT AND PER-PROTOCOL ANALYSES WILL BE USED TO ANALYZE SECONDARY VARIABLES. CHANGES IN OUTCOME VARIABLES WILL BE EXAMINED BETWEEN GROUPS AND WITHIN GROUPS. EFFECT SIZES WILL BE REPORTED FOR EACH OUTCOME. A PRIORI ADHERENCE AND SATISFACTION CRITERIA WILL BE MET IF PARTICIPANTS ATTEND >70% OF THE YOGA SESSIONS AND IF >70% OF THE PARTICIPANTS ARE SATISFIED WITH THE INTERVENTION AS DETERMINED BY A POSTPARTICIPATION QUESTIONNAIRE. STUDY ENROLLMENT BEGAN IN JANUARY 2018, WITH RESULTS EXPECTED FOR OCTOBER 2019. CONCLUSIONS: THIS PILOT RANDOMIZED TRIAL WILL BE THE FIRST TO INVESTIGATE THE FEASIBILITY AND EFFECT OF A YOGA INTERVENTION ON COGNITIVE AND PHYSICAL OUTCOMES AMONG PLWH. THIS WORK WILL INFORM THE FEASIBILITY OF FURTHER INVESTIGATIONS IN TERMS OF CAPACITY BUILDING, PARTICIPANT RECRUITMENT AND RETENTION, AND ASSESSMENT AND INTERVENTION PROTOCOLS. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT03071562; HTTPS://CLINICALTRIALS.GOV/CT2/SHOW/NCT03071562 (ARCHIVED BY WEBCITE AT HTTP://WWW.WEBCITATION.ORG/785SFHWKW). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/13818. 2019 20 2568 36 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