1 1820 187 PROTOCOL FOR A RANDOMIZED CONTROLLED STUDY OF IYENGAR YOGA FOR YOUTH WITH IRRITABLE BOWEL SYNDROME. INTRODUCTION: IRRITABLE BOWEL SYNDROME AFFECTS AS MANY AS 14% OF HIGH SCHOOL-AGED STUDENTS. SYMPTOMS INCLUDE DISCOMFORT IN THE ABDOMEN, ALONG WITH DIARRHEA AND/OR CONSTIPATION AND OTHER GASTROENTEROLOGICAL SYMPTOMS THAT CAN SIGNIFICANTLY IMPACT QUALITY OF LIFE AND DAILY FUNCTIONING. EMOTIONAL STRESS APPEARS TO EXACERBATE IRRITABLE BOWEL SYNDROME SYMPTOMS SUGGESTING THAT MIND-BODY INTERVENTIONS REDUCING AROUSAL MAY PROVE BENEFICIAL. FOR MANY SUFFERERS, SYMPTOMS CAN BE TRACED TO CHILDHOOD AND ADOLESCENCE, MAKING THE EARLY MANIFESTATION OF IRRITABLE BOWEL SYNDROME IMPORTANT TO UNDERSTAND. THE CURRENT STUDY WILL FOCUS ON YOUNG PEOPLE AGED 14-26 YEARS WITH IRRITABLE BOWEL SYNDROME. THE STUDY WILL TEST THE POTENTIAL BENEFITS OF IYENGAR YOGA ON CLINICAL SYMPTOMS, PSYCHOSPIRITUAL FUNCTIONING AND VISCERAL SENSITIVITY. YOGA IS THOUGHT TO BRING PHYSICAL, PSYCHOLOGICAL AND SPIRITUAL BENEFITS TO PRACTITIONERS AND HAS BEEN ASSOCIATED WITH REDUCED STRESS AND PAIN. THROUGH ITS FOCUS ON RESTORATION AND USE OF PROPS, IYENGAR YOGA IS ESPECIALLY DESIGNED TO DECREASE AROUSAL AND PROMOTE PSYCHOSPIRITUAL RESOURCES IN PHYSICALLY COMPROMISED INDIVIDUALS. AN EXTENSIVE AND STANDARDIZED TEACHER-TRAINING PROGRAM SUPPORT IYENGAR YOGA'S RELIABILITY AND SAFETY. IT IS HYPOTHESIZED THAT YOGA WILL BE FEASIBLE WITH LESS THAN 20% ATTRITION; AND THE YOGA GROUP WILL DEMONSTRATE SIGNIFICANTLY IMPROVED OUTCOMES COMPARED TO CONTROLS, WITH PHYSIOLOGICAL AND PSYCHOSPIRITUAL MECHANISMS CONTRIBUTING TO IMPROVEMENTS. METHODS/DESIGN: SIXTY IRRITABLE BOWEL SYNDROME PATIENTS AGED 14-26 WILL BE RANDOMLY ASSIGNED TO A STANDARDIZED 6-WEEK TWICE WEEKLY IYENGAR YOGA GROUP-BASED PROGRAM OR A WAIT-LIST USUAL CARE CONTROL GROUP. THE GROUPS WILL BE COMPARED ON THE PRIMARY CLINICAL OUTCOMES OF IRRITABLE BOWEL SYNDROME SYMPTOMS, QUALITY OF LIFE AND GLOBAL IMPROVEMENT AT POST-TREATMENT AND 2-MONTH FOLLOW-UP. SECONDARY OUTCOMES WILL INCLUDE VISCERAL PAIN SENSITIVITY ASSESSED WITH A STANDARDIZED LABORATORY TASK (WATER LOAD TASK), FUNCTIONAL DISABILITY AND PSYCHOSPIRITUAL VARIABLES INCLUDING CATASTROPHIZING, SELF-EFFICACY, MOOD, ACCEPTANCE AND MINDFULNESS. MECHANISMS OF ACTION INVOLVED IN THE PROPOSED BENEFICIAL EFFECTS OF YOGA UPON CLINICAL OUTCOMES WILL BE EXPLORED, AND INCLUDE THE MEDIATING EFFECTS OF VISCERAL SENSITIVITY, INCREASED PSYCHOSPIRITUAL RESOURCES, REGULATED AUTONOMIC NERVOUS SYSTEM RESPONSES AND REGULATED HORMONAL STRESS RESPONSE ASSESSED VIA SALIVARY CORTISOL. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT01107977. 2011 2 526 42 COMPARISON OF LAUGHTER YOGA AND ANTI-ANXIETY MEDICATION ON ANXIETY AND GASTROINTESTINAL SYMPTOMS OF PATIENTS WITH IRRITABLE BOWEL SYNDROME. BACKGROUND IRRITABLE BOWEL SYNDROME (IBS) IS THE MOST COMMON CHRONIC GASTROINTESTINAL (GI) DISORDER. PATIENTS WITH IBS USUALLY SUFFER FROM ANXIETY AND DEPRESSION. A COMBINATION OF PSYCHOLOGICAL APPROACHES AND PHARMACOLOGICAL TREATMENTS CAN BE A SIGNIFICANTLY EFFECTIVE TREATMENT FOR IBS. THE MAIN OBJECTIVE OF THE PRESENT STUDY WAS TO PROVIDE A THERAPEUTIC PLAN BASED ON LAUGHTER YOGA AND ANTI-ANXIETY MEDICATION, EMPLOYED FOR THE VERY FIRST TIME, AND TO DETERMINE THE EFFECTIVENESS OF THESE TREATMENTS ON THE ANXIETY AND GI SYMPTOMS OF PATIENTS WITH IBS. METHODS IN THIS RANDOMIZED, CONTROLLED, CLINICAL TRIAL, THE PARTICIPANTS WERE 60 PATIENTS SELECTED FROM THOSE WHO REFERRED TO THE GI CLINIC OF VALI-ASR HOSPITAL (BIRJAND, IRAN) DURING THE STUDY PERIOD (APRIL 2017 TO MARCH 2017) AND WERE DIAGNOSED AS HAVING IBS BASED ON ROME III CRITERIA. THE PARTICIPANTS WERE RANDOMLY ASSIGNED TO EITHER THE LAUGHTER YOGA GROUP, THE ANTI-ANXIETY MEDICATION GROUP, OR THE SYMPTOMATIC TREATMENT (CONTROL) GROUP. SEVERITY LEVELS OF ANXIETY AND GI SYMPTOMS BEFORE AND AFTER INTERVENTION WERE DETERMINED AND COMPARED AMONG THESE THREE GROUPS ACCORDING TO APPROVED PROTOCOLS. RESULTS THE SEVERITY OF IBS SYMPTOMS AFTER THE INTERVENTIONS WAS MORE GREATLY REDUCED IN THE LAUGHTER YOGA GROUP THAN IN THE ANTI-ANXIETY MEDICATION AND CONTROL GROUPS (P = 0.006). THE SEVERITY OF ANXIETY AFTER INTERVENTIONS DECREASED IN ALL THREE GROUPS, ESPECIALLY IN THE YOGA TREATMENT GROUP, BUT THE DIFFERENCE WAS NOT STATISTICALLY SIGNIFICANT (P = 0.1). CONCLUSION LAUGHTER YOGA IS MORE EFFECTIVE THAN ANTI-ANXIETY MEDICATION IN REDUCING THE GI SYMPTOMS OF PATIENTS WITH IBS. THEREFORE, APPLYING LAUGHTER YOGA ALONG WITH COMMON PHARMACOLOGICAL THERAPIES FOR PATIENTS WITH IBS MIGHT BE STRONGLY ADVISED. 2019 3 793 51 EFFECT OF YOGA IN THE THERAPY OF IRRITABLE BOWEL SYNDROME: A SYSTEMATIC REVIEW. BACKGROUND & AIMS: THIS REVIEW AIMS TO SYSTEMATICALLY SURVEY THE EFFECTS OF YOGA ON SYMPTOMS OF IRRITABLE BOWEL SYNDROME (IBS), PAIN, QUALITY OF LIFE, MOOD, STRESS, AND SAFETY IN PATIENTS WITH IBS. METHODS: MEDLINE/PUBMED, SCOPUS, THE COCHRANE LIBRARY, CAM-QUEST, CAMBASE, AND INDMED WERE SCREENED THROUGH NOVEMBER 2015. RANDOMIZED CONTROLLED TRIALS COMPARING YOGA WITH USUAL CARE, NONPHARMACOLOGIC, OR PHARMACOLOGIC INTERVENTIONS WERE ANALYZED FOR PATIENTS WITH IBS. PRIMARY OUTCOMES INCLUDED GASTROINTESTINAL SYMPTOMS, QUALITY OF LIFE, AND PAIN. ANXIETY, MOOD, AND SAFETY WERE DEFINED AS SECONDARY OUTCOMES. RISK OF BIAS WAS ASSESSED ACCORDING TO THE COCHRANE COLLABORATION RECOMMENDATIONS. RESULTS: SIX RANDOMIZED CONTROLLED TRIALS WITH A TOTAL OF 273 PATIENTS WERE INCLUDED IN THE QUALITATIVE ANALYSIS. THERE WAS EVIDENCE FOR A BENEFICIAL EFFECT OF A YOGIC INTERVENTION OVER CONVENTIONAL TREATMENT IN IBS, WITH SIGNIFICANTLY DECREASED BOWEL SYMPTOMS, IBS SEVERITY, AND ANXIETY. FURTHERMORE, THERE WERE SIGNIFICANT IMPROVEMENTS IN QUALITY OF LIFE, GLOBAL IMPROVEMENT, AND PHYSICAL FUNCTIONING AFTER YOGA COMPARED WITH NO TREATMENT. TWO RANDOMIZED CONTROLLED TRIALS REPORTED SAFETY DATA STATING THAT NO ADVERSE EVENTS OCCURRED. OVERALL, RISK OF BIAS OF THE INCLUDED STUDIES WAS UNCLEAR. CONCLUSIONS: THE FINDINGS OF THIS SYSTEMATIC REVIEW SUGGEST THAT YOGA MIGHT BE A FEASIBLE AND SAFE ADJUNCTIVE TREATMENT FOR PEOPLE WITH IBS. NEVERTHELESS, NO RECOMMENDATION CAN BE MADE REGARDING YOGA AS A ROUTINE INTERVENTION FOR PATIENTS WITH IBS BECAUSE OF MAJOR FLAWS IN STUDY METHODS. MORE RESEARCH IS NEEDED WITH RESPECT TO A HIGH-QUALITY STUDY DESIGN AND CONSENSUS IN CLINICAL OUTCOME MEASUREMENTS IN IBS. CLINICALTRIALS.GOV NUMBER, NCT02721836. 2016 4 1526 55 IYENGAR YOGA FOR ADOLESCENTS AND YOUNG ADULTS WITH IRRITABLE BOWEL SYNDROME. OBJECTIVES: IRRITABLE BOWEL SYNDROME (IBS) IS A CHRONIC, DISABLING CONDITION THAT GREATLY COMPROMISES PATIENT FUNCTIONING. THE AIM OF THIS STUDY WAS TO ASSESS THE IMPACT OF A 6-WEEK TWICE PER WEEK IYENGAR YOGA (IY) PROGRAM ON IBS SYMPTOMS IN ADOLESCENTS AND YOUNG ADULTS (YA) WITH IBS COMPARED WITH A USUAL-CARE WAITLIST CONTROL GROUP. METHODS: ASSESSMENTS OF SYMPTOMS, GLOBAL IMPROVEMENT, PAIN, HEALTH-RELATED QUALITY OF LIFE, PSYCHOLOGICAL DISTRESS, FUNCTIONAL DISABILITY, FATIGUE, AND SLEEP WERE COLLECTED PRE- AND POSTTREATMENT. WEEKLY RATINGS OF PAIN, IBS SYMPTOMS, AND GLOBAL IMPROVEMENT WERE ALSO RECORDED UNTIL 2-MONTH FOLLOW-UP. A TOTAL OF 51 PARTICIPANTS COMPLETED THE INTERVENTION (YOGA = 29; USUAL-CARE WAITLIST = 22). RESULTS: BASELINE ATTRITION WAS 24%. ON AVERAGE, THE YOGA GROUP ATTENDED 75% OF CLASSES. ANALYSES WERE DIVIDED BY AGE GROUP. RELATIVE TO CONTROLS, ADOLESCENTS (14-17 YEARS) ASSIGNED TO YOGA REPORTED SIGNIFICANTLY IMPROVED PHYSICAL FUNCTIONING, WHEREAS YA (18-26 YEARS) ASSIGNED TO YOGA REPORTED SIGNIFICANTLY IMPROVED IBS SYMPTOMS, GLOBAL IMPROVEMENT, DISABILITY, PSYCHOLOGICAL DISTRESS, SLEEP QUALITY, AND FATIGUE. ALTHOUGH ABDOMINAL PAIN INTENSITY WAS STATISTICALLY UNCHANGED, 44% OF ADOLESCENTS AND 46% OF YA REPORTED A MINIMALLY CLINICALLY SIGNIFICANT REDUCTION IN PAIN FOLLOWING YOGA, AND ONE-THIRD OF YA REPORTED CLINICALLY SIGNIFICANT LEVELS OF GLOBAL SYMPTOM IMPROVEMENT. ANALYSIS OF THE UNCONTROLLED EFFECTS AND MAINTENANCE OF TREATMENT EFFECTS FOR ADOLESCENTS REVEALED GLOBAL IMPROVEMENT IMMEDIATELY POST-YOGA THAT WAS NOT MAINTAINED AT FOLLOW-UP. FOR YA, GLOBAL IMPROVEMENT, WORST PAIN, CONSTIPATION, AND NAUSEA WERE SIGNIFICANTLY IMPROVED POSTYOGA, BUT ONLY GLOBAL IMPROVEMENT, WORST PAIN, AND NAUSEA MAINTAINED AT THE 2-MONTH FOLLOW-UP. CONCLUSIONS: THE FINDINGS SUGGEST THAT A BRIEF IY INTERVENTION IS A FEASIBLE AND SAFE ADJUNCTIVE TREATMENT FOR YOUNG PEOPLE WITH IBS, LEADING TO BENEFITS IN A NUMBER OF IBS-SPECIFIC AND GENERAL FUNCTIONING DOMAINS FOR YA. THE AGE-SPECIFIC RESULTS SUGGEST THAT YOGA INTERVENTIONS MAY BE MOST FRUITFUL WHEN DEVELOPMENTALLY TAILORED. 2014 5 2468 39 YOGA AS A THERAPY FOR IRRITABLE BOWEL SYNDROME. THE AIM OF THIS STATE-OF-THE-ART NARRATIVE REVIEW IS TO EVALUATE THE CURRENT EVIDENCE ABOUT THE EFFECTIVENESS OF YOGA AS THERAPY FOR IBS AND EXPLORE ITS POTENTIAL MECHANISMS OF ACTION. THE CURRENT LITERATURE SUGGESTS YOGA IS EFFECTIVE AND SAFE AND MAY TARGET MULTIPLE MECHANISMS INVOLVED IN TREATMENT OF IBS. EVIDENCE FROM RANDOMIZED CONTROLLED TRIALS IDENTIFIED YOGA AS MORE EFFECTIVE COMPARED TO PHARMACOLOGICAL TREATMENT AND EQUALLY EFFECTIVE AS DIETARY INTERVENTIONS OR MODERATE-INTENSITY WALKING. IMPROVEMENTS WERE SEEN IN BOTH PHYSICAL HEALTH (IBS SYMPTOM SEVERITY, GASTRIC MOTILITY, AUTONOMIC AND SOMATIC SYMPTOM SCORES, AND PHYSICAL FUNCTIONING) AND MENTAL HEALTH OUTCOMES (DEPRESSION, ANXIETY, GASTROINTESTINAL-SPECIFIC ANXIETY, AND QUALITY OF LIFE). GIVEN FAVORABLE CHANGES IN IBS-RELATED PHYSICAL AND MENTAL HEALTH OUTCOMES, PRELIMINARY DATA SUPPORTS YOGA AS BENEFICIAL IN THIS POPULATION. HOWEVER, THE RELATIVELY LOW-QUALITY EVIDENCE RESULTING FROM HETEROGENEITY OF STUDY DESIGNS, INTERVENTIONS, AND OUTCOME MEASURES LIMIT OUR ABILITY TO MAKE SPECIFIC RECOMMENDATIONS ABOUT THE USE OF YOGA AS THERAPY FOR PATIENTS WITH IBS. 2020 6 2625 51 YOGA FOR TEENS WITH IRRITABLE BOWEL SYNDROME: RESULTS FROM A MIXED-METHODS PILOT STUDY. IRRITABLE BOWEL SYNDROME (IBS) IS A COMMON CONDITION ASSOCIATED WITH RECURRENT ABDOMINAL PAIN AND ALTERED BOWEL HABITS. IT IS PARTICULARLY PERNICIOUS TO YOUTH, WHO MAY WITHDRAW FROM LIFE TASKS DUE TO PAIN, DIARRHEA, AND/OR FEAR OF SYMPTOMS. EMOTIONAL STRESS EXACERBATES IBS SYMPTOMS, AND MIND-BODY INTERVENTIONS MAY BE BENEFICIAL. IN THIS MIXED-METHODS STUDY OF 18 TEENS AGED 14 TO 17 YEARS UNDERTAKING A 6-WEEK IYENGAR YOGA INTERVENTION, WE AIMED TO IDENTIFY TREATMENT RESPONDERS AND TO EXPLORE DIFFERENCES BETWEEN RESPONDERS AND NONRESPONDERS ON A RANGE OF QUANTITATIVE OUTCOMES AND QUALITATIVE THEMES RELATED TO YOGA IMPACT, GOODNESS OF FIT, AND BARRIERS TO TREATMENT. HALF OF THE TEENS RESPONDED SUCCESSFULLY TO YOGA, DEFINED AS A CLINICALLY MEANINGFUL REDUCTION IN ABDOMINAL PAIN. RESPONDERS DIFFERED FROM NONRESPONDERS ON POSTINTERVENTION QUANTITATIVE OUTCOMES, INCLUDING REDUCED ABDOMINAL PAIN, IMPROVED SLEEP, AND INCREASED VISCERAL SENSITIVITY. QUALITATIVE OUTCOMES REVEALED THAT RESPONDERS REPORTED GENERALIZED BENEFITS EARLY IN TREATMENT AND THAT THEIR PARENTS WERE SUPPORTIVE AND COMMITTED TO THE INTERVENTION. RESPONDERS AND NONRESPONDERS ALIKE NOTED THE IMPORTANCE OF HOME PRACTICE TO ACHIEVE MAXIMAL, SUSTAINED BENEFITS. THIS STUDY REVEALS THE NEED FOR DEVELOPMENTALLY SENSITIVE YOGA PROGRAMS THAT INCREASE ACCESSIBILITY OF YOGA FOR ALL PATIENTS. 2018 7 194 44 A RANDOMIZED TRIAL OF YOGA FOR ADOLESCENTS WITH IRRITABLE BOWEL SYNDROME. BACKGROUND: ADOLESCENTS WITH IRRITABLE BOWEL SYNDROME (IBS) FREQUENTLY EXPERIENCE INTERFERENCE WITH EVERYDAY ACTIVITIES. MIND-BODY APPROACHES SUCH AS YOGA HAVE BEEN RECOMMENDED AS INTERVENTIONS FOR PATIENTS WITH IBS. DESPITE PROMISING RESULTS AMONG ADULT SAMPLES, THERE HAVE BEEN LIMITED STUDIES EXPLORING THE EFFICACY OF YOGA WITH PEDIATRIC PATIENTS. OBJECTIVE: TO CONDUCT A PRELIMINARY RANDOMIZED STUDY OF YOGA AS TREATMENT FOR ADOLESCENTS WITH IBS. METHODS: TWENTY-FIVE ADOLESCENTS AGED 11 TO 18 YEARS WITH IBS WERE RANDOMLY ASSIGNED TO EITHER A YOGA OR WAIT LIST CONTROL GROUP. BEFORE THE INTERVENTION, BOTH GROUPS COMPLETED QUESTIONNAIRES ASSESSING GASTROINTESTINAL SYMPTOMS, PAIN, FUNCTIONAL DISABILITY, COPING, ANXIETY AND DEPRESSION. THE YOGA INTERVENTION CONSISTED OF A 1 H INSTRUCTIONAL SESSION, DEMONSTRATION AND PRACTICE, FOLLOWED BY FOUR WEEKS OF DAILY HOME PRACTICE GUIDED BY A VIDEO. AFTER FOUR WEEKS, ADOLESCENTS REPEATED THE BASELINE QUESTIONNAIRES. THE WAIT LIST CONTROL GROUP THEN RECEIVED THE YOGA INTERVENTION AND FOUR WEEKS LATER COMPLETED AN ADDITIONAL SET OF QUESTIONNAIRES. RESULTS: ADOLESCENTS IN THE YOGA GROUP REPORTED LOWER LEVELS OF FUNCTIONAL DISABILITY, LESS USE OF EMOTION-FOCUSED AVOIDANCE AND LOWER ANXIETY FOLLOWING THE INTERVENTION THAN ADOLESCENTS IN THE CONTROL GROUP. WHEN THE PRE- AND POSTINTERVENTION DATA FOR THE TWO GROUPS WERE COMBINED, ADOLESCENTS HAD SIGNIFICANTLY LOWER SCORES FOR GASTROINTESTINAL SYMPTOMS AND EMOTION-FOCUSED AVOIDANCE FOLLOWING THE YOGA INTERVENTION. ADOLESCENTS FOUND THE YOGA TO BE HELPFUL AND INDICATED THEY WOULD CONTINUE TO USE IT TO MANAGE THEIR IBS. CONCLUSIONS: YOGA HOLDS PROMISE AS AN INTERVENTION FOR ADOLESCENTS WITH IBS. 2006 8 1960 49 SELF-REGULATION EVALUATION OF THERAPEUTIC YOGA AND WALKING FOR PATIENTS WITH IRRITABLE BOWEL SYNDROME: A PILOT STUDY. WITH LIMITED EFFICACY OF MEDICATIONS FOR SYMPTOM RELIEF, NON-MEDICATION TREATMENTS MAY PLAY AN IMPORTANT ROLE IN THE TREATMENT OF IRRITABLE BOWEL SYNDROME (IBS), THE MOST COMMON FUNCTIONAL GASTROINTESTINAL (GI) DISORDER. THIS STUDY AIMED TO EVALUATE THE EFFICACY OF TWO SELF-REGULATION STRATEGIES FOR SYMPTOM RELIEF AND MOOD MANAGEMENT IN IBS PATIENTS. THIRTY-FIVE ADULT PARTICIPANTS MEETING ROME III CRITERIA FOR IBS WERE ENROLLED, 27 OF THE 35 PARTICIPANTS (77%) COMPLETED TREATMENT AND PRE- AND POST-TREATMENT VISITS (89% WOMEN, 11% MEN; M (SD) AGE = 36 (13)), AND 20 OF THE 27 (74%) COMPLETED A 6-MONTH FOLLOW-UP. PARTICIPANTS WERE RANDOMLY ASSIGNED TO 16 BIWEEKLY GROUP SESSIONS OF IYENGAR YOGA OR A WALKING PROGRAM. RESULTS INDICATED A SIGNIFICANT GROUP BY TIME INTERACTION ON NEGATIVE AFFECT WITH THE WALKING TREATMENT SHOWING IMPROVEMENT FROM PRE- TO POST-TREATMENT WHEN COMPARED TO YOGA (P < .05). THERE WAS NO SIGNIFICANT GROUP BY TIME EFFECT ON IBS SEVERITY. EXPLORATORY ANALYSES OF SECONDARY OUTCOMES EXAMINED CHANGE SEPARATELY FOR EACH TREATMENT CONDITION. FROM PRE- TO POST-TREATMENT, YOGA SHOWED SIGNIFICANT DECREASES IN IBS SEVERITY MEASURES (P < .05), VISCERAL SENSITIVITY (P < .05), AND SEVERITY OF SOMATIC SYMPTOMS (P < .05). WALKING SHOWED SIGNIFICANT DECREASES IN OVERALL GI SYMPTOMS (P < .05), NEGATIVE AFFECT (P < .05), AND STATE ANXIETY (P < .05). AT 6-MONTH FOLLOW-UP, OVERALL GI SYMPTOMS FOR WALKING CONTINUED TO SIGNIFICANTLY DECLINE, WHILE FOR YOGA, GI SYMPTOMS REBOUNDED TOWARD BASELINE LEVELS (P < .05). WHEN ASKED ABOUT SELF-REGULATED HOME PRACTICE AT 6 MONTHS, SIGNIFICANTLY MORE PARTICIPANTS IN WALKING THAN IN YOGA PRACTICED AT LEAST WEEKLY (P < .05). IN SUM, RESULTS SUGGEST THAT YOGA AND WALKING AS MOVEMENT-BASED SELF-REGULATORY BEHAVIORAL TREATMENTS HAVE SOME DIFFERENTIAL EFFECTS BUT ARE BOTH BENEFICIAL FOR IBS PATIENTS, THOUGH MAINTENANCE OF A SELF-REGULATED WALKING PROGRAM MAY BE MORE FEASIBLE AND THEREFORE MORE EFFECTIVE LONG TERM. 2016 9 1591 50 MEDITATION AND YOGA FOR IRRITABLE BOWEL SYNDROME: STUDY PROTOCOL FOR A RANDOMISED CLINICAL TRIAL (MY-IBS STUDY). INTRODUCTION: WHEN DELIVERED IN PERSON, YOGA HAS BEEN SHOWN TO BE EFFECTIVE IN MANAGING IRRITABLE BOWEL SYNDROME (IBS) SYMPTOMS. RESEARCH IS NEEDED TO TEST THE FEASIBILITY AND EFFECTIVENESS OF YOGA AS A THERAPEUTIC OPTION WHEN DELIVERED VIRTUALLY. THE PRIMARY AIM OF THE MIND AND YOGA FOR IBS RANDOMISED CONTROLLED TRIAL IS TO DETERMINE THE EFFECTS OF AN 8-WEEK VIRTUAL MEDITATION AND YOGA INTERVENTION ON IBS SYMPTOM SEVERITY COMPARED WITH AN ADVICE-ONLY ACTIVE CONTROL GROUP. METHODS AND ANALYSIS: ADULTS DIAGNOSED WITH IBS WILL BE RANDOMISED TO RECEIVE EITHER A UPA YOGA INTERVENTION OR AN ADVICE-ONLY CONTROL GROUP. THE INTERVENTION WILL CONSIST OF WEEKLY ONLINE CLASSES FOR 8 WEEKS DELIVERED BY A FACILITATOR USING MICROSOFT OFFICE TEAMS AND DAILY HOME PRACTICE. FEASIBILITY WILL BE EVALUATED BY EXAMINING RECRUITMENT AND ATTRITION RATES, ADHERENCE, PARTICIPANT SATISFACTION WITH THE PROGRAMME AND SAFETY. THE PRIMARY OUTCOME IS IBS SYMPTOM SEVERITY, AND KEY SECONDARY OUTCOMES INCLUDE (BUT NOT LIMITED TO) QUALITY OF LIFE, ANXIETY AND DEPRESSION SYMPTOMS, COVID-19-RELATED STRESS AND ANXIETY, AND FATIGUE. OUTCOMES WILL BE ASSESSED AT BASELINE, 4 WEEKS AND 8 WEEKS. AN EMBEDDED DESIGN EXPERIMENTAL MODEL SUBSTUDY WILL BE CONDUCTED POST INTERVENTION USING QUALITATIVE RESEARCH METHODS TO IDENTIFY PARTICIPANTS' EXPERIENCES IN THE YOGA PROGRAMME. ETHICS AND DISSEMINATION: THIS STUDY HAS BEEN APPROVED BY THE CONJOINT HEALTH RESEARCH ETHICS BOARD (REB ID 20-0084). FINDINGS WILL BE DISSEMINATED THROUGH PEER-REVIEWED PUBLICATION, CONFERENCE PRESENTATION AND SOCIAL MEDIA. TRIAL REGISTRATION NUMBER: NCT04302623. 2022 10 319 64 AN INTERVENTION WITH DANCE AND YOGA FOR GIRLS WITH FUNCTIONAL ABDOMINAL PAIN DISORDERS (JUST IN TIME): PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: FUNCTIONAL ABDOMINAL PAIN DISORDERS (FAPDS) AFFECT MANY CHILDREN WORLDWIDE, PREDOMINANTLY GIRLS, AND CAUSE CONSIDERABLE LONG-TERM NEGATIVE CONSEQUENCES FOR INDIVIDUALS AND SOCIETY. EVIDENCE-BASED AND COST-EFFECTIVE TREATMENTS ARE THEREFORE STRONGLY NEEDED. PHYSICAL ACTIVITY HAS SHOWN PROMISING EFFECTS IN THE PRACTICAL MANAGEMENT OF FAPDS. DANCE AND YOGA ARE BOTH POPULAR ACTIVITIES THAT HAVE BEEN SHOWN TO PROVIDE SIGNIFICANT PSYCHOLOGICAL AND PAIN-RELATED BENEFITS WITH MINIMAL RISK. THE ACTIVITIES COMPLEMENT EACH OTHER, IN THAT DANCE INVOLVES DYNAMIC, RHYTHMIC PHYSICAL ACTIVITY, WHILE YOGA ENHANCES RELAXATION AND FOCUS. OBJECTIVE: THIS STUDY AIMS TO EVALUATE THE EFFECTS OF A DANCE AND YOGA INTERVENTION AMONG GIRLS AGED 9 TO 13 YEARS WITH FAPDS. METHODS: THE STUDY IS A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL AMONG GIRLS AGED 9 TO 13 YEARS WITH FUNCTIONAL ABDOMINAL PAIN, IRRITABLE BOWEL SYNDROME, OR BOTH. THE TARGET SAMPLE SIZE WAS 150 GIRLS RANDOMIZED INTO 2 ARMS: AN INTERVENTION ARM THAT RECEIVES DANCE AND YOGA SESSIONS TWICE WEEKLY FOR 8 MONTHS AND A CONTROL ARM THAT RECEIVES STANDARD CARE. OUTCOMES WILL BE MEASURED AT BASELINE AND AFTER 4, 8, 12, AND 24 MONTHS, AND LONG-TERM FOLLOW-UP WILL BE CONDUCTED 5 YEARS FROM BASELINE. QUESTIONNAIRES, INTERVIEWS, AND BIOMARKER MEASURES, SUCH AS CORTISOL IN SALIVA AND FECAL MICROBIOTA, WILL BE USED. THE PRIMARY OUTCOME IS THE PROPORTION OF GIRLS IN EACH GROUP WITH REDUCED PAIN, AS MEASURED BY THE FACES PAIN SCALE-REVISED IN A PAIN DIARY, IMMEDIATELY AFTER THE INTERVENTION. SECONDARY OUTCOMES ARE GASTROINTESTINAL SYMPTOMS, GENERAL HEALTH, MENTAL HEALTH, STRESS, AND PHYSICAL ACTIVITY. THE STUDY ALSO INCLUDES QUALITATIVE EVALUATIONS AND HEALTH ECONOMIC ANALYSES. THIS STUDY WAS APPROVED BY THE REGIONAL ETHICAL REVIEW BOARD IN UPPSALA (NO. 2016/082 1-2). RESULTS: DATA COLLECTION BEGAN IN OCTOBER 2016. THE INTERVENTION HAS BEEN PERFORMED IN 3 PERIODS FROM 2016 THROUGH 2019. THE FINAL 5-YEAR FOLLOW-UP IS ANTICIPATED TO BE COMPLETED BY FALL 2023. CONCLUSIONS: COST-EFFECTIVE AND EASILY ACCESSIBLE INTERVENTIONS ARE WARRANTED TO REDUCE THE NEGATIVE CONSEQUENCES ARISING FROM FAPDS IN YOUNG GIRLS. PHYSICAL ACTIVITY IS AN EFFECTIVE STRATEGY, BUT INTERVENTION STUDIES ARE NEEDED TO BETTER UNDERSTAND WHAT TYPES OF ACTIVITIES FACILITATE REGULAR PARTICIPATION IN THIS TARGET GROUP. THE JUST IN TIME (TRY, IDENTIFY, MOVE, AND ENJOY) STUDY WILL PROVIDE INSIGHTS REGARDING THE EFFECTIVENESS OF DANCE AND YOGA AND IS ANTICIPATED TO CONTRIBUTE TO THE CHALLENGING WORK OF REDUCING THE BURDEN OF FAPDS FOR YOUNG GIRLS. TRIAL REGISTRATION: CLINICALTRIALS.GOV (NCT02920268); HTTPS://CLINICALTRIALS.GOV/CT2/SHOW/NCT02920268. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/19748. 2020 11 2697 30 YOGA INTERVENTION AND FUNCTIONAL PAIN SYNDROMES: A SELECTIVE REVIEW. THE DEFINITION OF FUNCTIONAL PAIN SYNDROMES IS VARIED ACROSS LITERATURE. NO EFFORT HAS BEEN MADE TO SEE ALL FUNCTIONAL PAIN DISORDER GROUPS UNDER BROAD NOMENCLATURE WHICH WOULD EXCLUDE CONDITIONS FOR WHICH PATHOPHYSIOLOGY IS STRONGLY KNOWN. SINCE THESE DISORDERS ARE COMMONLY TREATED WITH ALTERNATIVE TREATMENT MODALITIES AND IMPOSE SIGNIFICANT BURDEN ON HEALTH UTILIZATION, AN EFFORT TO LOOK INTO STUDIES ON YOGA-BASED INTERVENTIONS ON 'FUNCTIONAL PAIN SYNDROMES' (FPS) WAS MADE. THIS STUDY DEFINED FPS AS 'CHRONIC RELAPSING REMITTING PAIN CONDITIONS, THE ORIGIN OF WHICH IS DIFFICULT TO TRACE WITH NO DEFINITE PHYSICAL PATHOLOGY ON CLINICAL SUSPICION OR AVAILABLE LABORATORY MEASURES AND ARE VALID BASED ON SUBJECTIVE PAIN REPORTING, ASSOCIATED DISTRESS AND SOCIO-OCCUPATIONAL DYSFUNCTION'. CHRONIC HEADACHE, NECK PAIN, BACK PAIN, FIBROMYALGIA, PELVIC PAIN, IRRITABLE BOWEL SYNDROME, CHRONIC FATIGUE SYNDROME, AND SOMATOFORM PAIN DISORDERS WERE INCLUDED FOR THIS REVIEW. THE REVIEW FOUND FOUR META-ANALYSES ON THE SELECTED TOPIC BOTH INDICATING MODEST EFFICACY AND BENEFIT OF YOGA IN THESE DISORDERS. FUTURE EFFORTS SHOULD BE DIRECTED TO DO A LARGE META-ANALYSIS OF FUNCTIONAL PAIN SYNDROMES. 2016 12 1506 29 IRRITABLE BOWEL SYNDROME: YOGA AS REMEDIAL THERAPY. IRRITABLE BOWEL SYNDROME (IBS) IS A GROUP OF SYMPTOMS MANIFESTING AS A FUNCTIONAL GASTROINTESTINAL (GI) DISORDER IN WHICH PATIENTS EXPERIENCE ABDOMINAL PAIN, DISCOMFORT, AND BLOATING THAT IS OFTEN RELIEVED WITH DEFECATION. IBS IS OFTEN ASSOCIATED WITH A HOST OF SECONDARY COMORBIDITIES SUCH AS ANXIETY, DEPRESSION, HEADACHES, AND FATIGUE. IN THIS REVIEW, WE EXAMINED THE BASIC PRINCIPLES OF PANCHA KOSHA (FIVE SHEATHS OF HUMAN EXISTENCE) CONCEPT FROM AN INDIAN SCRIPTURE TAITTIRIYA UPANISHAD AND THE PATHOPHYSIOLOGY OF A DISEASE FROM THE YOGA APPROACH, YOGA VASISTHA'S ADHI (ORIGINATED FROM MIND) AND VYADHI (AILMENT/DISEASE) CONCEPT. AN ANALOGY BETWEEN THE AGE OLD, THE MOST PROFOUND CONCEPT OF ADHI-VYADHI, AND MODERN SCIENTIFIC STRESS-INDUCED DYSREGULATION OF BRAIN-GUT AXIS, AS IT RELATES TO IBS THAT COULD PAVE WAY FOR IMPACTING IBS, IS EMPHASIZED. BASED ON THESE PERSPECTIVES, A PLAUSIBLE YOGA MODULE AS A REMEDIAL THERAPY IS PROVIDED TO BETTER MANAGE THE PRIMARY AND SECONDARY SYMPTOMS OF IBS. 2015 13 519 31 COMPARING THE EFFECTS OF YOGA & ORAL CALCIUM ADMINISTRATION IN ALLEVIATING SYMPTOMS OF PREMENSTRUAL SYNDROME IN MEDICAL UNDERGRADUATES. INTRODUCTION: MEDICAL UNDERGRADUATES ARE HEAVILY BURDENED BY THEIR CURRICULUM. THE FEMALES, IN ADDITION, SUFFER FROM VIVID AFFECTIVE OR SOMATIC PREMENSTRUAL SYNDROME (PMS) SYMPTOMS SUCH AS BLOATING, MASTALGIA, INSOMNIA, FATIGUE, MOOD SWINGS, IRRITABILITY, AND DEPRESSION. THE PRESENT STUDY WAS PROPOSED TO ATTENUATE THE SYMPTOMS OF PMS BY SIMPLE LIFESTYLE MEASURES LIKE YOGA AND/OR ORAL CALCIUM. METHODS: 65 MEDICAL FEMALE STUDENTS (18-22 YEARS) WITH A REGULAR MENSTRUAL CYCLE WERE ASKED TO SELF-RATE THEIR SYMPTOMS, ALONG WITH THEIR SEVERITY, IN A VALIDATED QUESTIONNAIRE FOR TWO CONSECUTIVE MENSTRUAL CYCLES. FIFTY-EIGHT STUDENTS WERE FOUND TO HAVE PMS. TWENTY GIRLS WERE GIVEN YOGA TRAINING (45 MINUTES DAILY, FIVE DAYS A WEEK, FOR THREE MONTHS). ANOTHER GROUP OF 20 WAS GIVEN ORAL TABLETS OF CALCIUM CARBONATE DAILY (500 MG, FOR THREE MONTHS) AND REST 18 GIRL SERVED AS CONTROL GROUP. DATA WERE ANALYZED BY SPSS VER.13 SOFTWARE. RESULTS: THE YOGA AND CALCIUM GROUPS SHOWED A SIGNIFICANT DECREASE IN NUMBER AND SEVERITY OF PREMENSTRUAL SYMPTOMS WHEREAS IN THE CONTROL GROUP THERE WAS NOT THE SIGNIFICANT DIFFERENCE. CONCLUSION: ENCOURAGING A REGULAR PRACTICE OF YOGA OR TAKING A TABLET OF CALCIUM DAILY IN THE MEDICAL SCHOOLS CAN DECREASE THE SYMPTOMS OF PREMENSTRUAL SYNDROME. 2016 14 783 39 EFFECT OF YOGA BASED LIFESTYLE INTERVENTION ON STATE AND TRAIT ANXIETY. CONSIDERABLE EVIDENCE EXISTS FOR THE PLACE OF MIND BODY MEDICINE IN THE TREATMENT OF ANXIETY DISORDERS. EXCESSIVE ANXIETY IS MALADAPTIVE. IT IS OFTEN CONSIDERED TO BE THE MAJOR COMPONENT OF UNHEALTHY LIFESTYLE THAT CONTRIBUTES SIGNIFICANTLY TO THE PATHOGENESIS OF NOT ONLY PSYCHIATRIC BUT ALSO MANY OTHER SYSTEMIC DISORDERS. AMONG THE APPROACHES TO REDUCE THE LEVEL OF ANXIETY HAS BEEN THE SEARCH FOR HEALTHY LIFESTYLES. THE AIM OF THE STUDY WAS TO STUDY THE SHORT-TERM IMPACT OF A COMPREHENSIVE BUT BRIEF LIFESTYLE INTERVENTION, BASED ON YOGA, ON ANXIETY LEVELS IN NORMAL AND DISEASED SUBJECTS. THE STUDY WAS THE RESULT OF OPERATIONAL RESEARCH CARRIED OUT IN THE INTEGRAL HEALTH CLINIC (IHC) AT THE DEPARTMENT OF PHYSIOLOGY OF ALL INDIA INSTITUTE OF MEDICAL SCIENCES. THE SUBJECTS HAD HISTORY OF HYPERTENSION, CORONARY ARTERY DISEASE, DIABETES MELLITUS, OBESITY, PSYCHIATRIC DISORDERS (DEPRESSION, ANXIETY, 'STRESS'), GASTROINTESTINAL PROBLEMS (NON ULCER DYSPEPSIA, DUODENAL ULCERS, IRRITABLE BOWEL DISEASE, CROHN'S DISEASE, CHRONIC CONSTIPATION) AND THYROID DISORDERS (HYPERTHYROIDISM AND HYPOTHYROIDISM). THE INTERVENTION CONSISTED OF ASANAS, PRANAYAMA, RELAXATION TECHNIQUES, GROUP SUPPORT, INDIVIDUALIZED ADVICE, AND LECTURES AND FILMS ON PHILOSOPHY OF YOGA, THE PLACE OF YOGA IN DAILY LIFE, MEDITATION, STRESS MANAGEMENT, NUTRITION, AND KNOWLEDGE ABOUT THE ILLNESS. THE OUTCOME MEASURES WERE ANXIETY SCORES, TAKEN ON THE FIRST AND LAST DAY OF THE COURSE. ANXIETY SCORES, BOTH STATE AND TRAIT ANXIETY WERE SIGNIFICANTLY REDUCED. AMONG THE DISEASED SUBJECTS SIGNIFICANT IMPROVEMENT WAS SEEN IN THE ANXIETY LEVELS OF PATIENTS OF HYPERTENSION, CORONARY ARTERY DISEASE, OBESITY, CERVICAL SPONDYLITIS AND THOSE WITH PSYCHIATRIC DISORDERS. THE OBSERVATIONS SUGGEST THAT A SHORT EDUCATIONAL PROGRAMME FOR LIFESTYLE MODIFICATION AND STRESS MANAGEMENT LEADS TO REMARKABLE REDUCTION IN THE ANXIETY SCORES WITHIN A PERIOD OF 10 DAYS. 2006 15 566 43 DANCE AND YOGA REDUCED FUNCTIONAL ABDOMINAL PAIN IN YOUNG GIRLS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: FUNCTIONAL ABDOMINAL PAIN DISORDERS (FAPDS) AFFECT CHILDREN, ESPECIALLY GIRLS, ALL OVER THE WORLD. THE EVIDENCE FOR EXISTING TREATMENTS IS MIXED, AND EFFECTIVE ACCESSIBLE TREATMENTS ARE NEEDED. DANCE, A RHYTHMIC CARDIO-RESPIRATORY ACTIVITY, COMBINED WITH YOGA, WHICH ENHANCES RELAXATION AND FOCUS, MAY PROVIDE PHYSIOLOGICAL AND PSYCHOLOGICAL BENEFITS THAT COULD HELP TO EASE PAIN. OBJECTIVES: THE AIM OF THIS STUDY WAS TO EVALUATE THE EFFECT OF A DANCE AND YOGA INTERVENTION ON MAXIMUM ABDOMINAL PAIN IN 9- TO 13-YEAR- OLD GIRLS WITH FAPDS. METHODS: THIS STUDY WAS A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL WITH 121 PARTICIPANTS RECRUITED FROM OUTPATIENT CLINICS AS WELL AS THE GENERAL PUBLIC. THE INTERVENTION GROUP PARTICIPATED IN DANCE AND YOGA TWICE WEEKLY FOR 8 MONTHS; CONTROLS RECEIVED STANDARD CARE. ABDOMINAL PAIN, AS SCORED ON THE FACES PAIN SCALE-REVISED, WAS RECORDED IN A PAIN DIARY. A LINEAR MIXED MODEL WAS USED TO ESTIMATE THE OUTCOMES AND EFFECT SIZES. RESULTS: DANCE AND YOGA WERE SUPERIOR TO STANDARD HEALTH CARE ALONE, WITH A MEDIUM TO HIGH BETWEEN-GROUP EFFECT SIZE AND SIGNIFICANTLY GREATER PAIN REDUCTION (B = -1.29, P = 0.002) AT THE END OF THE INTERVENTION. CONCLUSIONS: AN INTERVENTION USING DANCE AND YOGA IS LIKELY A FEASIBLE AND BENEFICIAL COMPLEMENTARY TREATMENT TO STANDARD HEALTH CARE FOR 9- TO 13-YEAR-OLD GIRLS WITH FAPDS. SIGNIFICANCE: FAPDS AFFECT CHILDREN, ESPECIALLY GIRLS, ALL OVER THE WORLD. THE NEGATIVE CONSEQUENCES SUCH AS ABSENCE FROM SCHOOL, HIGH CONSUMPTION OF MEDICAL CARE AND DEPRESSION POSE A CONSIDERABLE BURDEN ON CHILDREN AND THEIR FAMILIES AND EFFECTIVE TREATMENTS ARE NEEDED. THIS IS THE FIRST STUDY EXAMINING A COMBINED DANCE/YOGA INTERVENTION FOR YOUNG GIRLS WITH FAPDS AND THE RESULT SHOWED A REDUCTION OF ABDOMINAL PAIN. THESE FINDINGS CONTRIBUTE WITH NEW EVIDENCE IN THE FIELD OF MANAGING FAPDS IN A VULNERABLE TARGET GROUP. 2022 16 1035 34 EFFECTS OF YOGA IN INFLAMMATORY BOWEL DISEASES AND ON FREQUENT IBD-ASSOCIATED EXTRAINTESTINAL SYMPTOMS LIKE FATIGUE AND DEPRESSION. QUALITY OF LIFE (QOL) OF PERSONS WITH INFLAMMATORY BOWEL DISEASES (IBD) IS OFTEN IMPAIRED BY SYMPTOMS THAT DO NOT PRIMARILY RELATE TO INTESTINAL INFLAMMATION. AMONG THE MOST CHALLENGING EXTRAINTESTINAL SYMPTOMS ARE DEPRESSION AND FATIGUE, WHICH ARE ALSO FREQUENT IN OTHER CHRONIC DISEASES LIKE MULTIPLE SCLEROSIS, RHEUMATOID ARTHRITIS AND CANCER. YOGA AS AN ANCIENT INDIAN TRADITION CONTAINING POSTURES, BREATHING EXERCISES AND MEDITATION MAY POSITIVELY INFLUENCE THOSE SYMPTOMS. THIS REVIEW EVALUATES THE CURRENT LITERATURE WITH REGARD TO THE EFFECT OF YOGA-BASED INTERVENTIONS IN PERSONS WITH IBD AND WITH REGARD TO QOL, DEPRESSION AND FATIGUE IN OTHER SOMATIC DISORDERS. A SYSTEMATIC LITERATURE SEARCH YIELDED THREE TRIALS EXAMINING THE EFFECTS OF YOGA IN PATIENTS WITH IBD AND 37 TRIALS ADDRESSING DEPRESSIVE SYNDROMES OR FATIGUE IN SOMATIC DISORDERS. IN SUMMARY, BOTH IN-PERSON AND VIDEO-BASED YOGA CLASSES ARE FEASIBLE, ACCEPTABLE AND SAFE AS COMPLEMENTARY TREATMENT IN PATIENTS WITH IBD AND SIGNIFICANTLY IMPROVE ANXIETY AND IMPAIRED QUALITY OF LIFE. CURRENT LITERATURE DOES NOT PROVIDE INFORMATION ON THE EFFECT OF YOGA ON DEPRESSION AND FATIGUE IN PATIENTS WITH IBD, BUT RESEARCH FROM OTHER SOMATIC DISORDERS OR PATIENTS WITH DEPRESSIVE DISORDERS IMPLIES THE POTENTIAL OF YOGA IN THIS REGARD FOR PERSONS WITH IBD. THIS SHOULD BE SPECIFICALLY ADDRESSED IN INTERVENTIONAL TRIALS WITH STANDARDIZED YOGA MODULES INCLUDING PATIENTS WITH IBD SUFFERING FROM FATIGUE, DEPRESSION AND/OR IMPAIRED QOL. 2021 17 891 40 EFFECT OF YOGA-BASED INTERVENTION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE. BACKGROUND: INFLAMMATORY BOWEL DISEASE (IBD) IS A CHRONIC ILLNESS CHARACTERIZED BY GROSS INFLAMMATION IN THE GASTROINTESTINAL TRACT THAT CAN RESULT IN SYMPTOMS SUCH AS ABDOMINAL PAIN, CRAMPING, DIARRHEA, AND BLOODY STOOLS. IBD IS BELIEVED TO BE INFLUENCED BY PSYCHOLOGICAL FACTORS SUCH AS STRESS AND ANXIETY. THEREFORE, A YOGA INTERVENTION THAT REDUCES STRESS AND ANXIETY MAY BE AN EFFECTIVE COMPLEMENTARY TREATMENT FOR THESE DISORDERS. MATERIAL AND METHODS: A TOTAL OF 100 IBD PATIENTS [ULCERATIVE COLITIS (UC) N = 60 AND CROHN'S DISEASE (CD) N = 40] DURING THE CLINICAL REMISSION PHASE OF DISEASE WERE INCLUDED IN THE STUDY. THESE PATIENTS WERE ALLOCATED RANDOMLY TO EITHER THE YOGA GROUP THAT UNDERWENT AN 8-WEEK YOGA INTERVENTION (PHYSICAL POSTURES, PRANAYAMA, AND MEDITATION) 1- HOUR/DAY IN ADDITION TO STANDARD MEDICAL THERAPY (UC, N = 30; CD, N = 20) OR THE CONTROL GROUP (UC, N = 30; CD N = 20), WHICH CONTINUED WITH STANDARD MEDICAL THERAPY ALONE. THE MAIN OUTCOME MEASURES WERE CARDIOVASCULAR AUTONOMIC FUNCTIONS, SERUM EOSINOPHILIC CATIONIC PROTEIN, INTERLEUKIN- 2 SOLUBLE RECEPTORS, SPEILBERGER'S STATE TRAIT ANXIETY INVENTORY (STAI) SCORES, AND CLINICAL SYMPTOMS. RESULTS: BEFORE THE INTERVENTION, ALL THE OUTCOME MEASURES WERE COMPARABLE IN THE TWO GROUPS. AFTER THE 8-WEEK YOGA INTERVENTION, FEWER UC PATIENTS REPORTED ARTHRALGIA. THE NUMBER OF PATIENTS REPORTING INTESTINAL COLIC PAIN IN THE CONTROL GROUP WAS HIGHER. STATE AND TRAIT ANXIETY LEVELS WERE SIGNIFICANTLY REDUCED IN PATIENTS WITH UC. HOWEVER, NO SIGNIFICANT CHANGES WERE OBSERVED IN CARDIOVASCULAR AUTONOMIC FUNCTIONS, EOSINOPHILIC CATIONIC PROTEINS, OR INTERLEUKIN-2 SOLUBLE RECEPTORS. CONCLUSIONS: A SIMPLIFIED YOGA-BASED REGIMEN IS A SAFE AND EFFECTIVE COMPLEMENTARY CLINICAL TREATMENT MODALITY FOR PATIENTS WITH INFLAMMATORY BOWEL DISEASE DURING THE CLINICAL REMISSION PHASE. 2015 18 2794 38 YOGA THERAPY FOR MEDICALLY UNEXPLAINED PHYSICAL SYMPTOMS. MEDICALLY UNEXPLAINED PHYSICAL SYMPTOMS (MUPS) IS A COMMON, YET NEGLECTED DISEASE WITH A PREVALENCE OF AROUND 25% IN PRIMARY CARE SETTING. THESE PATIENTS PRESENT WITH MULTIPLE PHYSICAL AND PSYCHOLOGICAL SYMPTOMS, WITHOUT AN UNDERLYING DIAGNOSIS, HAMPERING THEIR FUNCTIONAL AND MENTAL WELLBEING. THE MANAGEMENT OF THESE UNDIAGNOSED SYMPTOMS THROUGH CONVENTIONAL TREATMENT HAS NOT BEEN ENCOURAGING. PATIENTS SHUTTLE BETWEEN DIFFERENT SPECIALITIES, SEEKING A DIAGNOSIS FOR THEIR SYMPTOMS, MAKING THEM DISSATISFIED AND INCREASING HEALTHCARE BURDEN. YOGA, AS AN ADJUNCT THERAPY HAS SHOWN TO BE EFFECTIVE IN THE MANAGEMENT OF MUPS RELATED DISORDERS SUCH AS SOMATOFORM DISORDER, IRRITABLE BOWEL SYNDROME (IBS) AND DEPRESSION AND ANXIETY. THUS, WE SUGGEST AN INTEGRATED YOGA MODULE WHICH MIGHT HELP IN IMPROVING BOTH PHYSICAL AND PSYCHOLOGICAL VARIABLE IN MUPS PATIENTS AND IMPROVING THEIR OVERALL QUALITY OF LIFE. FURTHERMORE, THE GAP IN THE LITERATURE ON THE EFFICACY OF YOGA IN IMPROVING MUPS, CAN BE ADDRESSED BY PLANNING A RANDOMISED CONTROLLED TRIAL BASED ON THE SUGGESTED YOGA MODULE. 2020 19 477 38 CLINICAL APPLICATIONS OF YOGA FOR THE PEDIATRIC POPULATION: A SYSTEMATIC REVIEW. OBJECTIVE: THE AIM OF THIS STUDY WAS TO EVALUATE THE EVIDENCE FOR CLINICAL APPLICATIONS OF YOGA AMONG THE PEDIATRIC POPULATION. METHODS: WE CONDUCTED AN ELECTRONIC LITERATURE SEARCH INCLUDING CINAHL, COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL), EMBASE, MEDLINE, PSYCINFO, AND MANUAL SEARCH OF RETRIEVED ARTICLES FROM INCEPTION OF EACH DATABASE UNTIL DECEMBER 2008. RANDOMIZED CONTROLLED TRIALS (RCTS) AND NONRANDOMIZED CONTROLLED TRIALS (NRCTS) WERE SELECTED THAT INCLUDED YOGA OR YOGA-BASED INTERVENTIONS FOR INDIVIDUALS AGED 0 TO 21 YEARS. DATA WERE EXTRACTED AND ARTICLES CRITICALLY REVIEWED USING A MODIFIED JADAD SCORE AND DESCRIPTIVE METHODOLOGICAL CRITERIA, WITH SUMMARIZATION IN TABLES. RESULTS: THIRTY-FOUR CONTROLLED STUDIES PUBLISHED FROM 1979 TO 2008 WERE IDENTIFIED, WITH 19 RCTS AND 15 NRCTS. MANY STUDIES WERE OF LOW METHODOLOGICAL QUALITY. CLINICAL AREAS FOR WHICH YOGA HAS BEEN STUDIED INCLUDE PHYSICAL FITNESS, CARDIORESPIRATORY EFFECTS, MOTOR SKILLS/STRENGTH, MENTAL HEALTH AND PSYCHOLOGICAL DISORDERS, BEHAVIOR AND DEVELOPMENT, IRRITABLE BOWEL SYNDROME, AND BIRTH OUTCOMES FOLLOWING PRENATAL YOGA. NO ADVERSE EVENTS WERE REPORTED IN TRIALS REVIEWED. ALTHOUGH A LARGE MAJORITY OF STUDIES WERE POSITIVE, METHODOLOGICAL LIMITATIONS SUCH AS RANDOMIZATION METHODS, WITHDRAWAL/DROPOUTS, AND DETAILS OF YOGA INTERVENTION PRECLUDE CONCLUSIVE EVIDENCE. CONCLUSIONS: THERE ARE LIMITED DATA ON THE CLINICAL APPLICATIONS OF YOGA AMONG THE PEDIATRIC POPULATION. MOST PUBLISHED CONTROLLED TRIALS WERE SUGGESTIVE OF BENEFIT, BUT RESULTS ARE PRELIMINARY BASED ON LOW QUANTITY AND QUALITY OF TRIALS. FURTHER RESEARCH OF YOGA FOR CHILDREN BY USING A HIGHER STANDARD OF METHODOLOGY AND REPORTING IS WARRANTED. 2009 20 2688 33 YOGA IN THE TREATMENT OF MOOD AND ANXIETY DISORDERS: A REVIEW. BACKGROUND: PATIENT USE OF COMPLEMENTARY AND ALTERNATIVE TREATMENTS, INCLUDING YOGA, TO MANAGE MOOD AND ANXIETY DISORDERS, HAS BEEN WELL DOCUMENTED. DESPITE RESEARCH INTEREST, THERE ARE FEW RECENT REVIEWS OF THE EVIDENCE OF THE BENEFIT OF YOGA IN THESE CONDITIONS. METHOD: THE PUBMED, MEDLINE AND PSYCINFO DATABASES WERE SEARCHED FOR LITERATURE PUBLISHED UP TO JULY 2008, RELATING TO YOGA AND DEPRESSIVE AND ANXIETY DISORDERS. RESULTS: THE PAUCITY OF REPORTED STUDIES AND SEVERAL METHODOLOGICAL CONSTRAINTS LIMIT DATA INTERPRETATION. IN DEPRESSIVE DISORDERS, YOGA MAY BE COMPARABLE TO MEDICATION AND THE COMBINATION SUPERIOR TO MEDICATION ALONE. THERE IS REASONABLE EVIDENCE FOR ITS USE AS SECOND-LINE MONOTHERAPY OR AUGMENTATION TO MEDICATION IN MILD TO MODERATE MAJOR DEPRESSION AND DYSTHYMIA, WITH EARLY EVIDENCE OF BENEFIT IN MORE SEVERE DEPRESSION. IN ANXIETY DISORDERS, YOGA MAY BE SUPERIOR TO MEDICATION FOR A SUBGROUP OF PATIENTS, BUT ITS BENEFITS IN SPECIFIC CONDITIONS ARE STILL LARGELY UNKNOWN. SECOND-LINE MONOTHERAPY IS INDICATED IN PERFORMANCE OR TEST ANXIETY, BUT ONLY PRELIMINARY EVIDENCE EXISTS FOR OBSESSIVE-COMPULSIVE DISORDER AND POST-TRAUMATIC STRESS DISORDER. YOGA APPEARS TO BE SUPERIOR TO NO TREATMENT AND PROGRESSIVE RELAXATION FOR BOTH DEPRESSION AND ANXIETY, AND MAY BENEFIT MOOD AND ANXIETY SYMPTOMS ASSOCIATED WITH MEDICAL ILLNESS. IT SHOWS GOOD SAFETY AND TOLERABILITY IN SHORT-TERM TREATMENT. CONCLUSION: REASONABLE EVIDENCE SUPPORTS THE BENEFIT OF YOGA IN SPECIFIC DEPRESSIVE DISORDERS. THE EVIDENCE IS STILL PRELIMINARY IN ANXIETY DISORDERS. GIVEN ITS PATIENT APPEAL AND THE PROMISING FINDINGS THUS FAR, FURTHER RESEARCH ON YOGA IN THESE CONDITIONS IS ENCOURAGED. 2009