1 408 145 BIOMECHANICAL CHARACTERISTICS ON THE LOWER EXTREMITY OF THREE TYPICAL YOGA MANOEUVRES. THIS STUDY WAS AIMED AT EXPLORING THE BIOMECHANICAL CHARACTERISTICS OF THE LOWER EXTREMITY AMONGST THREE TYPICAL YOGA MANOEUVRES. A TOTAL OF THIRTEEN EXPERIENCED FEMALE YOGA PRACTITIONERS WERE RECRUITED IN THE CURRENT STUDY; THEY WERE ALL CERTIFIED WITH THE YOGA ALLIANCE. A THREE-DIMENSIONAL MOTION CAPTURE SYSTEM WITH 10 CAMERAS COMBINED WITH FOUR SYNCHRONISED FORCE PLATES WAS USED TO COLLECT KINEMATICS OF THE LOWER EXTREMITY AND GROUND REACTIVE FORCE WHILST THE PARTICIPANTS PERFORMED THE CRESCENT LUNGE POSE, WARRIOR II POSE, AND TRIANGLE POSE. ONE-WAY REPEATED ANOVA WAS USED IN EXPLORING THE DIFFERENCES AMONGST THE THREE YOGA MOVEMENTS, AND THE SIGNIFICANCE WAS SET TO ALPHA < 0.05. THE TRIANGLE POSE PERFORMED THE LARGEST RANGE OF MOTION (ROM) OF THE HIP (90.5 DEGREES +/- 22.9 DEGREES ), KNEE (68.8 DEGREES +/- 23.1 DEGREES ), AND ANKLE (46.4 DEGREES +/- 11.3 DEGREES ) IN THE SAGITTAL PLANE AND THE HIP (54.8 DEGREES +/- 6.5 DEGREES ), KNEE (42.4 DEGREES +/- 12.8 DEGREES ), AND ANKLE (4.8 DEGREES +/- 1.7 DEGREES ) IN THE FRONTAL PLANE AMONGST THE THREE MANOEUVRES (P < 0.05). NO SIGNIFICANT DIFFERENCE WAS FOUND FOR THE HIP AND ANKLE JOINT MOMENT AMONGST THE THREE MANOEUVRES (P > 0.05). KNEE JOINT TRAVELLED INTO 9.5 DEGREES OF EXTENSION AND SLIGHT ADDUCTION OF 1.94 DEGREES WHILST EXPRESSING THE LARGEST KNEE JOINT ADDUCTION MOMENTS (0.30 +/- 0.22 NM/KG) IN THE TRIANGLE POSE. THE DISTRIBUTION OF THE ANGULAR IMPULSE OF THE LOWER LIMB JOINTS INDICATED THAT THE HIP JOINT CONTRIBUTED SIGNIFICANTLY THE MOST IN THE SAGITTAL AND FRONTAL PLANES OF THE THREE YOGA MANOEUVRES (P < 0.05), RANGING FROM 51.67% TO 70.56%. RESULTS INDICATED THAT TRIANGLE POSE MAY BE SUPERIOR TO THE OTHER TWO MANOEUVRES, WHICH IMPROVED HIP JOINT ROM, STRENGTH, AND DYNAMIC STABILITY. HOWEVER, KNEE INJURIES SUCH AS OSTEOARTHRITIS (OA) SHOULD BE CONSIDERED BECAUSE OF THE LARGE KNEE EXTENSOR ANGLE AND ADDUCTOR MOMENTS. 2021 2 322 34 ANKLE MOTION IN COMMON YOGA POSES. BACKGROUND: MOTION OF THE ANKLE IS ESSENTIAL FOR MANY YOGA POSES. AN UNDERSTANDING OF RANGE OF ANKLE MOTION DURING TYPICAL YOGA POSES MAY HELP THE CLINICIAN TO UNDERSTAND EXPECTED OUTCOMES OF PATIENTS WHEN RETURNING FROM ANKLE SURGERY OR INJURY TO YOGA. METHODS: THE BIOMECHANICS OF TWENTY HEALTHY ACTIVE YOGIS WERE COLLECTED DURING SEVEN YOGA POSES THAT ARE COMMON WITHIN THEIR PRACTICES. MOTION CAPTURE AND FORCE PLATES WERE USED TO ASSESS THE RANGE OF MOTION AND JOINT MOMENTS OF THE ANKLE FOR EACH POSE. RESULTS: ALL POSES RESULTED IN PLANTARFLEXION AND EXTERNAL ROTATION MOMENTS AT THE ANKLE JOINTS. JOINT LOADING WAS HIGHEST IN SINGLE LEG POSES. THE ARC OF MOTION USED BY THE STUDY PARTICIPANTS IN THE POSES WAS 29 DEGREES OF SAGITTAL MOTION, 20 DEGREES OF FRONTAL MOTION AND 35 DEGREES OF TRANSVERSE MOTION. DISCUSSION: ANKLE MOTION WAS EVALUATED WHEN HEALTHY YOGIS PERFORM STANDARD POSES. THESE RESULTS MAY HELP IN DISCUSSION WITH PATIENTS REGARDING EXPECTED OUTCOMES AFTER ANKLE INJURY OR SURGERY. 2019 3 81 23 A MATHEMATICAL MODEL OF EFFECTS ON SPECIFIC JOINTS DURING PRACTICE OF THE SUN SALUTATION--A SEQUENCE OF YOGA POSTURES. THE 'SUN SALUTATION' CONSISTS OF A SEQUENCE OF TEN YOGA POSTURES, EACH POSTURE COUNTERACTING THE PRECEDING ONE PRODUCING A BALANCE BETWEEN FLEXION AND EXTENSION, PERFORMED WITH SYNCHRONIZED BREATHING AND AEROBIC ACTIVITY. AS THIS SEQUENCE IS OFTEN PERFORMED AND RECOMMENDED BY MANY YOGA PRACTITIONERS, THERE IS A NEED FOR THE DEVELOPMENT OF A BIOMECHANICAL MODEL TO SUPPORT ITS REPORTED CLINICAL BENEFITS. THIS REQUIRES A DETAILED KNOWLEDGE OF THE NATURE OF THE FORCES AND MOMENTS AT THE VARIOUS JOINTS INVOLVED. A SIMPLE MATHEMATICAL MODEL BASED ON RIGID BODY MECHANICS IS DEVELOPED FOR EACH OF THE SUN SALUTATION POSTURES. DYNAMIC MOMENTS WITH HIGH MAGNITUDES AND RATES, APPLIED WITH UNUSUAL DISTRIBUTION PATTERNS, OPTIMAL FOR OSTEOGENESIS, ARE FOUND TO OCCUR. ALSO, THE JOINTS ARE SUBJECTED TO SUBMAXIMAL LOADINGS THUS ENSURING THAT NONE OF THE JOINTS ARE OVERSTRESSED. 2011 4 2357 38 VARYING ALIGNMENT AFFECTS LOWER EXTREMITY JOINT AND LIMB LOADING DURING YOGA'S TRIANGLE (TRIKONASANA) POSE. BACKGROUND: LIMITED BIOMECHANICAL DATA EXIST DESCRIBING HOW YOGA ASANAS (POSTURES) LOAD THE LIMBS AND JOINTS, AND LITTLE EVIDENCE-BASED RECOMMENDATIONS FOR YOGA INJURY PREVENTION ARE AVAILABLE. THIS STUDY AIMED TO ESTABLISH JOINT LOADING METRICS FOR AN INJURY-PRONE, YET COMMON YOGA POSE, THE TRIANGLE ASANA (TRIKONASANA) BY IDENTIFYING HOW STANCE WIDTH ADJUSTMENTS ALTER LOWER EXTREMITY LOADING. METHODS: EIGHTEEN YOGA PRACTITIONERS UNDERWENT 3D MOTION ANALYSIS WHILE PERFORMING TRIKONASANA WITH SELF-SELECTED (SS) STANCE WIDTH AND -30, -20, -10, +10, +20, AND +30% OF SS STANCE WIDTH. GROUND REACTION FORCES (GRFS), JOINT FORCES, AND JOINT MOMENTS WERE CALCULATED FOR THE LEADING AND TRAILING LIMB ANKLE, KNEE, AND HIP. ONE-WAY REPEATED-MEASURES ANALYSIS OF VARIANCE DETERMINED DIFFERENCES IN LOADING DUE TO STANCE WIDTH. RESULTS: GRFS, NET JOINT FORCES, AND NET JOINT MOMENTS WERE SIGNIFICANTLY AFFECTED BY STANCE WIDTH WHERE INCREASING STANCE WIDTH INCREASED LEADING LIMB LOADING BUT DECREASED TRAILING LIMB LOADING. CONCLUSIONS: ALTERING STANCE WIDTH OF TRIKONASANA INFLUENCES LOWER EXTREMITY LIMB LOADING, AND THESE LOADING RESPONSES WERE LIMB-DEPENDENT. YOGA PRACTITIONERS AND INSTRUCTORS CAN USE THIS INFORMATION TO OBJECTIVELY SUPPORT INCREASING OR DECREASING STANCE WIDTH TO REDUCE OR INCREASE LIMB LOADING ACCORDING TO THEIR GOALS OR TO MAKE ACCOMMODATIONS TO GROUPS SUCH AS BEGINNERS OR AT-RISK POPULATIONS FOR SAFER, MORE ACCESSIBLE YOGA PRACTICES. CUING A WIDER OR NARROWER STANCE WIDTH WILL NOT HAVE THE SAME EFFECT ON BOTH LIMBS. 2022 5 2565 39 YOGA FOR CORRECTION OF LYMPHEDEMA'S IMPAIRMENT OF GAIT AS AN ADJUNCT TO LYMPHATIC DRAINAGE: A PILOT OBSERVATIONAL STUDY. INTRODUCTION: YOGA USED AS A MAJOR COMPONENT OF INTEGRATIVE TREATMENT PROTOCOL IN 14 INDIAN VILLAGE CAMPS IMPROVED QUALITY-OF-LIFE IN 425 LYMPHATIC FILARIASIS PATIENTS. THEY EXPERIENCED BETTER MOBILITY AND REDUCED DISABILITY. THIS PAPER DOCUMENTS THE GAIT ABNORMALITIES OBSERVED IN LOWER LIMB LYMPHEDEMA PATIENTS AND THE LOCOMOTOR CHANGES FOLLOWING INTEGRATIVE TREATMENT. MATERIALS AND METHODS: YOGA POSTURES WERE PERFORMED AS EXPLAINED BY TRADITIONAL YOGA PRACTICE IN TWO SESSIONS: BEFORE AYURVEDIC OIL MASSAGE WITHOUT COMPRESSION BANDAGES AND AFTER THE MASSAGE WITH COMPRESSION BANDAGES. EACH YOGA POSTURE LASTED FOR 5 MIN AND THE WHOLE SESSION ENDED IN 45 MIN. THROUGHOUT EACH SESSION, WE ADVISED PATIENTS TO DO LONG, DIAPHRAGMATIC BREATHING, CONCENTRATING ON EACH BREATH. THE FLEXION OF JOINTS WAS COORDINATED WITH EXHALATION AND EXTENSION WITH INHALATION. WE EDUCATED THE PATIENTS TO DO LONGER EXPIRATION THAN INSPIRATION. RESULTS AND DISCUSSION: A TOTAL OF 98 PATIENTS (133 LIMBS) ATTENDING THE 6(TH) MONTH FOLLOW-UP WERE EVALUATED. THE MOST COMMON GAIT ABNORMALITY WAS ANTALGIC GAIT. STRUCTURAL AND FUNCTIONAL ABNORMALITIES WERE OBSERVED IN HIP, KNEE AND ANKLE JOINTS. WE FOUND THAT YOGA AS AN ADJUNCT TO OTHER COMPONENTS IN INTEGRATIVE TREATMENT IMPROVED THE GAIT PROBLEMS. LONG STANDING LYMPHEDEMA CAUSED ALTERED GAIT AND JOINT DEFORMITIES. THIS WAS MOSTLY DUE TO INACTIVITY CAUSING MUSCLE WEAKNESS AND EDEMA WITHIN AND AROUND THE MUSCLES. BOTH LARGE AND SMALL LIMBS HAVE SHOWN SIGNIFICANT VOLUME REDUCTION (P < 0.01) DURING FOLLOW-UP AFTER 6 MONTHS. CONCLUSION: THERE CAN BE A MIXED ETIOLOGY FOR GAIT RELATED PROBLEMS IN LYMPHEDEMA PATIENTS. FURTHER STUDIES ARE RECOMMENDED TO UNDERSTAND THE CAUSES OF DEFORMITIES IN LYMPHEDEMA PATIENTS AND AN EXACT ROLE OF YOGA. 2015 6 971 28 EFFECTS OF AN INTEGRATED APPROACH OF HATHA YOGA THERAPY ON FUNCTIONAL DISABILITY, PAIN, AND FLEXIBILITY IN OSTEOARTHRITIS OF THE KNEE JOINT: A RANDOMIZED CONTROLLED STUDY. OBJECTIVES: THE STUDY OBJECTIVES WERE TO EVALUATE THE EFFICACY OF INTEGRATING HATHA YOGA THERAPY WITH THERAPEUTIC EXERCISES FOR OSTEOARTHRITIS (OA) OF THE KNEE JOINTS. DESIGN: THIS WAS A PROSPECTIVE, RANDOMIZED, ACTIVE CONTROLLED TRIAL. TWO HUNDRED AND FIFTY (250) PARTICIPANTS WHO HAD OA KNEES AND WHO WERE BETWEEN 35 AND 80 YEARS (YOGA 59.56+/-9.54) AND (CONTROL 59.42+/-10.66) FROM THE OUTPATIENT DEPARTMENT OF EBNEZAR ORTHOPEDIC CENTER, BENGALURU, WERE RANDOMLY ASSIGNED TO RECEIVE HATHA YOGA THERAPY OR THERAPEUTIC EXERCISES AFTER TRANSCUTANEOUS ELECTRICAL STIMULATION AND ULTRASOUND TREATMENT (20 MINUTES PER DAY). BOTH OF THE GROUPS PRACTICED SUPERVISED INTERVENTIONS (40 MINUTES PER DAY) FOR 3 MONTHS. ONE HUNDRED AND EIGHTEEN (118) (YOGA) AND 117 (CONTROL) SUBJECTS WERE AVAILABLE FOR THE FINAL ANALYSIS. RESULTS: THERE WERE SIGNIFICANT DIFFERENCES WITHIN (WILCOXON'S, P<0.001) AND BETWEEN THE GROUPS (MANN-WHITNEY U, P<0.001) ON ALL THE VARIABLES, WITH BETTER IMPROVEMENTS IN THE YOGA THAN THE CONTROL GROUPS. WALKING PAIN IN THE YOGA (37.3%, 64.9%) AND CONTROL (24.9%, 42%), KNEE DISABILITY IN THE YOGA (59.7%, 83%) AND CONTROL (32.7%, 53.6%), RANGE OF KNEE FLEXION IN YOGA (12.7%, 26.5% RIGHT, 13.5%, 28% LEFT) AND CONTROL (6.9%, 13.3% RIGHT, 5.6%, 11.5% LEFT), JOINT TENDERNESS IN YOGA (52.3%, 86.1%) AND CONTROL (28%, 57.1%), SWELLING IN YOGA (55.4%, 85.9%) AND CONTROL (32.1%, 60%), CREPITUS IN YOGA (44.0%, 79.9%) AND CONTROL (27.0%, 47.8%) AND WALKING TIME IN YOGA (26.6%, 52.8%) AND CONTROL (9.3%, 21.6%), ALL IMPROVED MORE IN THE YOGA THAN THE CONTROL GROUPS ON THE 15TH AND 90TH DAY, RESPECTIVELY. CONCLUSIONS: AN INTEGRATED APPROACH OF HATHA YOGA THERAPY IS BETTER THAN THERAPEUTIC EXERCISES AS AN ADJUNCT TO TRANSCUTANEOUS ELECTRICAL STIMULATION AND ULTRASOUND TREATMENT IN IMPROVING WALKING PAIN, RANGE OF KNEE FLEXION, WALKING TIME, TENDERNESS, SWELLING, CREPITUS, AND KNEE DISABILITY IN PATIENTS WITH OA KNEES. 2012 7 718 17 EFFECT OF INTEGRATIVE NATUROPATHY AND YOGA IN A PATIENT WITH RHEUMATOID ARTHRITIS ASSOCIATED WITH TYPE 2 DIABETES AND HYPERTENSION. A 54-YEAR OLD MARRIED WOMAN WAS DIAGNOSED WITH RHEUMATOID ARTHRITIS IN 2002, ESSENTIAL HYPERTENSION IN 2008, TYPE-2 DIABETES IN 2011 AND GANGRENE OVER 2(ND) TOE OF RIGHT FOOT. SHE UNDERWENT CONVENTIONAL MANAGEMENT IN PRIVATE HOSPITALS. HER SYMPTOMS, BEGAN WITH MODERATE TO SEVERE PAIN ASSOCIATED WITH SWELLING, STIFFNESS (MORE IN THE MORNING) IN MULTIPLE JOINTS ESPECIALLY OVER SMALL JOINTS. IN JULY-2014 SHE VISITED OUR COLLEGE HOSPITAL WITH THE COMPLAINTS OF PAIN, MILD SWELLING AND STIFFNESS OVER MULTIPLE JOINTS ASSOCIATED WITH POOR QUALITY OF SLEEP (QOS) AND QUALITY OF LIFE (QOL). SUBJECT RECEIVED INTEGRATIVE NATUROPATHY AND YOGA THERAPIES (INYT) WITH CONVENTIONAL MEDICINE DAILY FOR 10-DAYS. AFTER 10-DAYS, IMPROVEMENTS IN PAIN, BLOOD SUGAR, DEPRESSION, ANXIETY, STRESS, QOS, QOL, BLOOD ANALYSIS WITH NORMAL BLOOD PRESSURE (BP) WAS OBSERVED. THIS SUGGESTS THAT INYT COULD BE CONSIDERED AS AN ADJUVANT TO CONVENTIONAL MEDICINE IN RA ASSOCIATED WITH TYPE-2 DIABETES AND ESSENTIAL HYPERTENSION. 2017 8 1757 33 POSITION OF THE HIP IN YOGA. BACKGROUND: YOGA IS GROWING IN POPULARITY AS A FORM OF EXERCISE THROUGHOUT THE WORLD. ORTHOPEDIC PATIENTS PARTICIPATE IN YOGA, YET LITTLE IS KNOWN ABOUT THE RANGES-OF-MOTION OF THE HIP WITHIN VARIOUS YOGA POSES. ORTHOPEDIC SURGEONS ARE UNSURE ABOUT WHAT POTENTIAL POSITIONS THEIR PATIENTS ARE PLACING THEIR HIPS DURING A YOGA PRACTICE. THE AIM OF THIS STUDY IS TO QUANTIFY THE DEGREE OF HIP MOTION WITH COMMON YOGA POSES. METHODS: TWENTY HEALTHY, REGULAR PRACTITIONERS OF YOGA PERFORMED 11 DIFFERENT YOGA POSES IN A STANDARDIZED FASHION. MOTION ANALYSIS WAS USED TO CAPTURE RANGE-OF-MOTION OF THE HIP DURING EACH POSE. RESULTS: MANY YOGA POSES PUT THE HIP IN EXTREMES OF MOTION. POSES SUCH AS DOWNWARD DOG, FORWARD FOLD, SEATED TWIST, AND PIGEON STRESSED THE HIP IN FLEXION. WARRIOR 1, WARRIOR 2, CRESCENT LUNGE, PIGEON, AND TRIANGLE STRESSED THE HIP IN EXTENSION. EAGLE AND SEATED TWIST PUT THE HIP IN HIGHER ADDUCTION, WHILE HALF MOON, EAGLE, AND TRIANGLE PRODUCED MORE HIP INTERNAL ROTATION. CONCLUSION: MANY POSES WERE FOUND TO REACH EXTREMES OF HIP MOTION. THIS STUDY MAY HELP GUIDE THE ORTHOPEDIC SURGEON IN COUNSELING HIP ARTHROPLASTY AND HIP IMPINGEMENT PATIENTS ABOUT YOGA-RELATED ACTIVITY. BY KNOWING WHICH POSES POTENTIALLY STRESS THE HIP IN PARTICULAR PLANES OF MOTION, SURGEONS MAY BETTER INFORM THEIR PATIENTS WHO ARE RETURNING TO YOGA AFTER INJURY OR SURGERY. 2018 9 2399 29 YOGA AND CUTANEOUS FUNCTIONAL UNIT RECRUITMENT FOR A PATIENT WITH CERVICAL AND UPPER EXTREMITY BURN SCAR CONTRACTURE: CASE REPORT. BURN SCAR CONTRACTURE GREATLY LIMITS FUNCTION FOR BURN SURVIVORS, PARTICULARLY WHEN THE SCARRING CROSSES MULTIPLE JOINTS. PREVIOUS RESEARCH HAS IDENTIFIED FIELDS OF SKIN RECRUITED DURING SINGLE JOINT MOTION, CALLED CUTANEOUS FUNCTIONAL UNITS (CFU), INDICATING THAT IMPAIRMENTS MAY BE SEEN DISTAL TO THE INJURED TISSUE. THIS CASE REPORT CONNECTS THE PRINCIPLES OF CFU AND YOGA-INSPIRED THERAPY MODALITIES IN IMPROVING CLINICAL OUTCOMES FOR A BURN SURVIVOR. THE PATIENT IS A 38-YEAR-OLD MALE WHO SUSTAINED DEEP PARTIAL-THICKNESS ELECTRICAL BURNS TO HIS NECK, CHEST, AND BILATERAL UPPER EXTREMITIES, PRESENTING WITH SIGNIFICANTLY DECREASED RANGE OF MOTION. THE PATIENT ATTENDED PHYSICAL THERAPY 4 DAYS A WEEK, WHERE HE PERFORMED A SPECIFIC YOGA ASANA PROGRAM DURING EACH SESSION. OUTCOMES INCLUDING STANDARD RANGE OF MOTION MEASURES, THE VANCOUVER SCAR SCALE (VSS), AND THE NECK DISABILITY INDEX (NDI), WHICH WERE RECORDED EVERY 10 SESSIONS. CFUS OF CERVICAL EXTENSION AND SHOULDER FLEXION WERE ANALYZED VIA PHOTOGRAPHS COMPARING CUTANEOUS POSITION DURING SPECIFIED YOGA POSES AND RESTING ANATOMICAL POSITION IN STANDING. OVER 30 VISITS, CERVICAL AND SHOULDER RANGE OF MOTION INCREASED, ALTHOUGH THE VSS AND NDI DID NOT SHOW SIGNIFICANT IMPROVEMENT. YOGA POSES SHOWED OVERALL CUTANEOUS RECRUITMENT DISTAL TO THE TARGETED JOINTS, AND BURNED SKIN WAS RECRUITED SIMILARLY TO NONBURNED SKIN IN POSITIONS OF STRETCH. INCORPORATING MULTIJOINT APPROACHES FOR STRETCHING, LIKE YOGA, APPEARS TO CONTRIBUTE TO IMPROVED CLINICAL RANGE-OF-MOTION OUTCOMES WHEN PAIRED WITH TRADITIONAL BURN-REHABILITATION INTERVENTIONS. YOGA POSES INVOLVING MULTIPLE JOINTS ALIGN WITH THE PRINCIPLE OF CFUS, WARRANTING CONTINUED INVESTIGATION. 2022 10 987 33 EFFECTS OF HATHA YOGA EXERCISES ON SPINE FLEXIBILITY IN WOMEN OVER 50 YEARS OLD. [PURPOSE] THE AIM OF THIS STUDY WAS TO ACCESS THE FLEXIBILITY OF THE SPINE IN WOMEN PRACTICING YOGA AS A PART OF THE "UNIVERSITY FOR HEALTH" PROJECT. [SUBJECTS AND METHODS] THE STUDY INCLUDED 56 WOMEN RANGING IN AGE BETWEEN 50-79 AND ATTENDING 90 MINUTES HATHA YOGA SESSIONS ONCE A WEEK. THE MEASUREMENTS WERE PERFORMED TWICE-AT THE BEGINNING OF THE PROJECT AND AFTER ITS COMPLETION, I.E., AFTER 20 WEEKS OF CLASSES. THE RANGE OF SPINE MOBILITY IN THREE PLANES WAS MEASURED USING A RIPPSTEIN PLURIMETER. THE RANGE OF MOTION IN THE SAGITTAL AND FRONTAL PLANES WAS MEASURED IN A STANDING POSITION WITH THE FEET HIP-WIDTH APART. THE TORSIONAL RANGE OF MOTION OF THE SUBJECTS WAS MEASURED WITH THE TRUNK BENT AT A RIGHT ANGLE AND THE LEGS APART. THE FLEXIBILITY RANGES OF THE SPINE AND HAMSTRINGS WERE ALSO MEASURED BY THE TOE-TOUCH TEST IN A STANDING POSITION. [RESULTS] THIS STUDY SHOWED THAT THE APPLIED YOGA EXERCISES INCREASED SPINAL MOBILITY AND FLEXIBILITY OF THE HAMSTRING MUSCLES REGARDLESS OF AGE. [CONCLUSION] YOGA EXERCISES SHOULD BE RECOMMENDED TO THE ELDERLY TO MAKE THEIR MUSCLES MORE FLEXIBLE AND TO INCREASE THE RANGE OF MOTION IN THE JOINTS, WHICH IS PARTICULARLY IMPORTANT FOR IMPROVING THEIR LIFE QUALITY. 2015 11 2766 36 YOGA PROTOCOL FOR TREATMENT OF BREAST CANCER-RELATED LYMPHEDEMA. INTRODUCTION: VAQAS AND RYAN (2003) ADVOCATED YOGA AND BREATHING EXERCISES FOR LYMPHEDEMA. NARAHARI ET AL. (2007) DEVELOPED AN INTEGRATIVE MEDICINE PROTOCOL FOR LOWER-LIMB LYMPHEDEMA USING YOGA. STUDIES HAVE HYPOTHESIZED THAT YOGA PLAYS A SIMILAR ROLE AS THAT OF CENTRAL MANUAL LYMPH DRAINAGE OF FOLDI'S TECHNIQUE. THIS STUDY EXPLAINS HOW WE HAVE USED YOGA AND BREATHING AS A SELF-CARE INTERVENTION FOR BREAST CANCER-RELATED LYMPHEDEMA (BCRL). METHODS: THE STUDY OUTCOME WAS TO CREATE A YOGA PROTOCOL FOR BCRL. SELECTION OF YOGA WAS BASED ON THE ACTIONS OF MUSCLES ON JOINTS, ANATOMICAL AREAS ASSOCIATED WITH DIFFERENT GROUPS OF LYMPH NODES, STRETCHING OF SKIN, AND METHOD OF BREATHING IN EACH YOGA. THE PROTOCOL WAS PILOTED IN EIGHT BCRL PATIENTS, OBSERVED ITS DIFFICULTIES BY INTERACTING WITH PATIENTS. A LITERATURE SEARCH WAS CONDUCTED IN PUBMED AND COCHRANE LIBRARY TO IDENTIFY THE YOGA PROTOCOLS FOR BCRL. RESULTS: TWENTY YOGA AND 5 BREATHING EXERCISES WERE ADOPTED. THEY HAVE SLOW, METHODICAL JOINT MOVEMENTS WHICH HELPED PATIENTS TO TOLERATE PAIN. BREATHING WAS LONG AND DIAPHRAGMATIC. FLEXION OF JOINTS WAS COORDINATED WITH EXHALATION AND EXTENSION WITH INHALATION. ALTERNATE YOGA WAS INTRODUCED TO FACILITATE PATIENTS TO PERFORM COMPLEX MOVEMENTS. YOGA'S JOINT MOVEMENTS, INITIAL POSITIONS, AND MODE OF BREATHING WERE COMPARED TO TWO OTHER PROTOCOLS. THE VOLUME REDUCED FROM 2.4 TO 1.2 L IN EIGHT PATIENTS AFTER CONTINUOUS PRACTICE OF YOGA AND COMPRESSION AT HOME FOR 3 MONTHS. THERE WAS IMPROVEMENT IN THE RANGE OF MOVEMENT AND INTENSITY OF PAIN. DISCUSSION: YOGA EXERCISES WERE SELECTED ON THE BASIS OF THEIR ROLE IN CHEST EXPANSION, MAXIMIZING RANGE OF MOVEMENTS: FLEXION OF LARGE MUSCLES, MAXIMUM STRETCH OF SKIN, AND THUS PART-BY-PART LYMPH DRAINAGE FROM CENTER AND PERIPHERY. THIS PROTOCOL ADDRESSED FUNCTIONAL, VOLUME, AND MOVEMENT ISSUES OF BCRL AND WAS FOUND TO BE SUPERIOR TO OTHER BCRL YOGA PROTOCOLS. HOWEVER, THIS PROTOCOL NEEDS TO BE TESTED IN CENTERS ROUTINELY MANAGING BCRL. 2016 12 1987 20 SPATIAL-TEMPORAL GRAPH CONVOLUTIONAL FRAMEWORK FOR YOGA ACTION RECOGNITION AND GRADING. THE RAPID DEVELOPMENT OF THE INTERNET HAS CHANGED OUR LIVES. MANY PEOPLE GRADUALLY LIKE ONLINE VIDEO YOGA TEACHING. HOWEVER, YOGA BEGINNERS CANNOT MASTER THE STANDARD YOGA POSES JUST BY LEARNING THROUGH VIDEOS, AND HIGH YOGA POSES CAN BRING GREAT DAMAGE OR EVEN DISABILITY TO THE BODY IF THEY ARE NOT STANDARD. TO ADDRESS THIS PROBLEM, WE PROPOSE A YOGA ACTION RECOGNITION AND GRADING SYSTEM BASED ON SPATIAL-TEMPORAL GRAPH CONVOLUTIONAL NEURAL NETWORK. FIRSTLY, WE CAPTURE YOGA MOVEMENT DATA USING A DEPTH CAMERA. THEN WE LABEL THE YOGA EXERCISE VIDEOS FRAME BY FRAME USING LONG SHORT-TERM MEMORY NETWORK; THEN WE EXTRACT THE SKELETAL JOINT POINT FEATURES SEQUENTIALLY USING GRAPH CONVOLUTION; THEN WE ARRANGE EACH VIDEO FRAME FROM SPATIAL-TEMPORAL DIMENSION AND CORRELATE THE JOINT POINTS IN EACH FRAME AND NEIGHBORING FRAMES WITH SPATIAL-TEMPORAL INFORMATION TO OBTAIN THE CONNECTION BETWEEN JOINTS. FINALLY, THE IDENTIFIED YOGA MOVEMENTS ARE PREDICTED AND GRADED. EXPERIMENT PROVES THAT OUR METHOD CAN ACCURATELY IDENTIFY AND CLASSIFY YOGA POSES; IT ALSO CAN IDENTIFY WHETHER YOGA POSES ARE STANDARD OR NOT AND GIVE FEEDBACK TO YOGIS IN TIME TO PREVENT BODY DAMAGE CAUSED BY NONSTANDARD POSES. 2022 13 2793 19 YOGA THERAPY FOR FIBROMYALGIA SYNDROME: A CASE REPORT. FIBROMYALGIA IS A RHEUMATOLOGIC SYNDROME LEADING TO INCREASED PAIN SENSITIVITY, SLEEP DISTURBANCE, FATIGUE, STIFFNESS, AND TENDERNESS OF JOINTS, MUSCLES, AND TENDONS DUE TO DYSREGULATION OF NEUROPHYSIOLOGICAL FUNCTIONS. IN THE PRESENT CASE REPORT, A 42-YEAR-OLD, NON-INDIAN, NONSMOKING, NONALCOHOLIC, FEMALE PRESENTED WITH COMPLAINTS OF SEVERE DIFFICULTY IN WALKING, JOINT PAINS, AND GENERALIZED LOSS OF BALANCE OF THE BODY. THE PATIENT WAS AN ESTABLISHED CASE OF FIBROMYALGIA. THE TREATMENT PLAN FOR THE PATIENT INCLUDED 9 MONTHS OF YOGA THERAPY. NO CONCOMITANT ALLOPATHIC MEDICATION WAS GIVEN DURING THIS WHOLE TREATMENT PERIOD. THE PATIENT WAS GIVEN SPECIAL YOGA POSTURES TO IMPROVE FLEXIBILITY AND MOVEMENT OF JOINTS, DAILY 1 HOUR, 6 DAYS/WEEK IN THE MORNING, AND EVENING FOR 9 MONTHS. THE MUSCLE FATIGUE, QUALITY OF LIFE AND SLEEP WAS ASSESSED AT THE BASELINE, 3(RD), 6(TH), AND 9(TH) MONTH. THE RESULT OF PRESENT CASE STUDY DEMONSTRATED REDUCTION IN MUSCLE FATIGUE AND IMPROVEMENT IN QUALITY OF LIFE AND SLEEP. 2020 14 2306 45 TRAINING BENEFITS AND INJURY RISKS OF STANDING YOGA APPLIED IN MUSCULOSKELETAL PROBLEMS: LOWER LIMB BIOMECHANICAL ANALYSIS. STANDING YOGA POSES STRENGTHEN A PERSON'S LEGS AND HELPS TO ACHIEVE THE GOAL OF MUSCULOSKELETAL REHABILITATION, BUT INADEQUATE EXERCISE PLANNING CAN CAUSE INJURIES. THIS STUDY INVESTIGATED CHANGES IN THE ELECTROMYOGRAM AND JOINT MOMENTS OF FORCE (JMOFS) OF LOWER EXTREMITIES DURING COMMON STANDING YOGA POSES IN ORDER TO EXPLORE THE FEASIBILITY AND POSSIBLE INJURY RISK IN DEALING WITH MUSCULOSKELETAL PROBLEMS. ELEVEN YOGA INSTRUCTORS WERE RECRUITED TO EXECUTE FIVE YOGA POSES (CHAIR, TREE, WARRIOR 1, 2, AND 3). THE RESULTS REVEALED SIGNIFICANT DIFFERENCES IN HIP, KNEE, AND ANKLE JMOFS AND VARYING DEGREES OF MUSCLE ACTIVATION AMONG THE POSES. AMONG THESE POSES, RECTUS FEMORIS MUSCLE ACTIVATION DURING THE CHAIR POSE WAS THE HIGHEST, WARRIOR 2 PRODUCED THE HIGHEST MUSCLE ACTIVATION IN THE VASTUS LATERALIS OF THE FRONT LIMB, WHILE WARRIOR 1 HAD THE HIGHEST MUSCLE ACTIVATION IN THE VASTUS MEDIALIS OF THE BACK LIMB. THEREFORE, ALL THREE POSES CAN POSSIBLY BE SUGGESTED AS A THERAPEUTIC INTERVENTION FOR QUADRICEPS STRENGTHENING. WARRIOR 1 WAS POSSIBLY SUGGESTED AS A THERAPEUTIC INTERVENTION IN ORDER TO REDUCE EXCESSIVE LATERAL OVERLOAD OF THE PATELLA, BUT THE POSSIBLE ADVERSE EFFECTS OF WARRIOR 2 WITH THE HIGHEST KNEE ADDUCTOR JMOF IN THE BACK LIMB COULD RAISE JOINT REACTION FORCES ACROSS THE MEDIAL CONDYLES. IN SINGLE-LEG BALANCE POSTURES, WARRIOR 3 HAD UNIQUE TRAINING EFFECTS ON THE HAMSTRING, AND IS THEREFORE SUGGESTED AS A PART OF HAMSTRING REHABILITATION EXERCISES. THE TREE POSE INDUCED LOW LOWER-EXTREMITY JMOFS AND A LOW LEVEL OF THIGH MUSCLE ACTIVATIONS WHEN IT WAS PERFORMED BY SENIOR INSTRUCTORS WITH EXCELLENT BALANCE CONTROL; HOWEVER, FOR YOGA BEGINNERS WITH INSUFFICIENT STABILITY, IT WILL BE A USEFUL TRAINING MODE FOR STRENGTHENING THE MUSCLES THAT HELP TO KEEP ONE UPRIGHT. THIS STUDY QUANTIFIED THE PHYSICAL DEMANDS OF YOGA POSES USING BIOMECHANICAL DATA AND ELUCIDATED THE STRUCTURES AND PRINCIPLES UNDERLYING EACH YOGA MOVEMENT. THIS IS CRUCIAL FOR YOGA PRACTITIONERS. 2021 15 362 25 ASSOCIATIONS BETWEEN YOGA PRACTICE AND JOINT PROBLEMS: A CROSS-SECTIONAL SURVEY AMONG 9151 AUSTRALIAN WOMEN. YOGA EXERCISES HAVE BEEN ASSOCIATED WITH JOINT PROBLEMS RECENTLY, INDICATING THAT YOGA PRACTICE MIGHT BE POTENTIALLY DANGEROUS FOR JOINT HEALTH. THIS STUDY AIMED TO ANALYSE WHETHER REGULAR YOGA PRACTICE IS ASSOCIATED WITH THE FREQUENCY OF JOINT PROBLEMS IN UPPER MIDDLE-AGED AUSTRALIAN WOMEN. WOMEN AGED 62-67 YEARS FROM THE AUSTRALIAN LONGITUDINAL STUDY ON WOMEN'S HEALTH (ALSWH) WERE QUESTIONED IN 2013 WHETHER THEY EXPERIENCED REGULAR JOINT PAIN OR PROBLEMS IN THE PAST 12 MONTHS AND WHETHER THEY REGULARLY PRACTICED YOGA. ASSOCIATIONS OF JOINT PROBLEMS WITH YOGA PRACTICE WERE ANALYSED USING CHI-SQUARED TESTS AND MULTIPLE LOGISTIC REGRESSION MODELLING. OF 9151 WOMEN, 29.8% REPORTED REGULAR PROBLEMS WITH STIFF OR PAINFUL JOINTS, AND 15.2, 11.9, 18.1 AND 15.9% REPORTED REGULAR PROBLEMS WITH SHOULDERS, HIPS, KNEES AND FEET, RESPECTIVELY, IN THE PAST 12 MONTHS. YOGA WAS PRACTICED SOMETIMES BY 10.1% AND OFTEN BY 8.4% OF WOMEN. PRACTICING YOGA WAS NOT ASSOCIATED WITH UPPER OR LOWER LIMB JOINT PROBLEMS. NO ASSOCIATION BETWEEN YOGA PRACTICE AND JOINT PROBLEMS HAS BEEN IDENTIFIED. FURTHER STUDIES ARE WARRANTED FOR CONCLUSIVE JUDGEMENT OF BENEFITS AND SAFETY OF YOGA IN RELATION TO JOINT PROBLEMS. 2017 16 684 30 EFFECT OF AN INTEGRATED APPROACH OF YOGA THERAPY ON QUALITY OF LIFE IN OSTEOARTHRITIS OF THE KNEE JOINT: A RANDOMIZED CONTROL STUDY. AIM: THIS STUDY WAS DESIGNED TO EVALUATE THE EFFICACY OF ADDITION OF INTEGRATED YOGA THERAPY TO THERAPEUTIC EXERCISES IN OSTEOARTHRITIS (OA) OF KNEE JOINTS. MATERIALS AND METHODS: THIS WAS A PROSPECTIVE RANDOMIZED ACTIVE CONTROL TRIAL. A TOTAL OF T PARTICIPANTS WITH OA OF KNEE JOINTS BETWEEN 35 AND 80 YEARS (YOGA, 59.56 +/- 9.54 AND CONTROL, 59.42 +/- 10.66) FROM THE OUTPATIENT DEPARTMENT OF DR. JOHN'S ORTHOPEDIC CENTER, BENGALURU, WERE RANDOMLY ASSIGNED TO RECEIVE YOGA OR PHYSIOTHERAPY EXERCISES AFTER TRANSCUTANEOUS ELECTRICAL STIMULATION AND ULTRASOUND TREATMENT OF THE AFFECTED KNEE JOINTS. BOTH GROUPS PRACTICED SUPERVISED INTERVENTION (40 MIN PER DAY) FOR 2 WEEKS (6 DAYS PER WEEK) WITH FOLLOWUP FOR 3 MONTHS. THE MODULE OF INTEGRATED YOGA CONSISTED OF SHITHILIKARANAVYAYAMA (LOOSENING AND STRENGTHENING), ASANAS, RELAXATION TECHNIQUES, PRANAYAMA, MEDITATION AND DIDACTIC LECTURES ON YAMA, NIYAMA, JNANA YOGA, BHAKTI YOGA, AND KARMA YOGA FOR A HEALTHY LIFESTYLE CHANGE. THE CONTROL GROUP ALSO HAD SUPERVISED PHYSIOTHERAPY EXERCISES. A TOTAL OF 118 (YOGA) AND 117 (CONTROL) WERE AVAILABLE FOR FINAL ANALYSIS. RESULTS: SIGNIFICANT DIFFERENCES WERE OBSERVED WITHIN (P < 0.001, WILCOXON'S) AND BETWEEN GROUPS (P < 0.001, MANN-WHITNEY U-TEST) ON ALL DOMAINS OF THE SHORT FORM-36 (P < 0.004), WITH BETTER RESULTS IN THE YOGA GROUP THAN IN THE CONTROL GROUP, BOTH AT 15(TH) DAY AND 90(TH) DAY. CONCLUSION: AN INTEGRATED APPROACH OF YOGA THERAPY IS BETTER THAN THERAPEUTIC EXERCISES AS AN ADJUNCT TO TRANSCUTANEOUS ELECTRICAL STIMULATION AND ULTRASOUND TREATMENT IN IMPROVING KNEE DISABILITY AND QUALITY OF LIFE IN PATIENTS WITH OA KNEES. 2011 17 2064 43 THE BIOMECHANICAL DEMANDS OF STANDING YOGA POSES IN SENIORS: THE YOGA EMPOWERS SENIORS STUDY (YESS). BACKGROUND: THE NUMBER OF OLDER ADULTS PARTICIPATING IN YOGA HAS INCREASED DRAMATICALLY IN RECENT YEARS; YET, THE PHYSICAL DEMANDS ASSOCIATED WITH YOGA PERFORMANCE HAVE NOT BEEN REPORTED. THE PRIMARY AIM OF THE YOGA EMPOWERS SENIORS STUDY (YESS) WAS TO USE BIOMECHANICAL METHODS TO QUANTIFY THE PHYSICAL DEMANDS ASSOCIATED WITH THE PERFORMANCE OF 7 COMMONLY-PRACTICED STANDING YOGA POSES IN OLDER ADULTS. METHODS: 20 AMBULATORY OLDER ADULTS (70.7+-3.8 YRS) ATTENDED 2 WEEKLY 60-MINUTE HATHA YOGA CLASSES FOR 32 WEEKS. THE LOWER-EXTREMITY NET JOINT MOMENTS OF FORCE (JMOFS), WERE OBTAINED DURING THE PERFORMANCE OF THE FOLLOWING POSES: CHAIR, WALL PLANK, TREE, WARRIOR II, SIDE STRETCH, CRESCENT, AND ONE-LEGGED BALANCE. REPEATED-MEASURE ANOVA AND TUKEY'S POST-HOC TESTS WERE USED TO IDENTIFY DIFFERENCES IN JMOFS AMONG THE POSES. ELECTROMYOGRAPHIC ANALYSIS WAS USED TO SUPPORT THE JMOF FINDINGS. RESULTS: THERE WAS A SIGNIFICANT MAIN EFFECT FOR POSE, AT THE ANKLE, KNEE AND HIP, IN THE FRONTAL AND SAGITTAL PLANES (P=0.00-0.03). THE CRESCENT, CHAIR, WARRIOR II, AND ONE-LEGGED BALANCE POSES GENERATED THE GREATEST AVERAGE SUPPORT MOMENTS. SIDE STRETCH GENERATED THE GREATEST AVERAGE HIP EXTENSOR AND KNEE FLEXOR JMOFS. CRESCENT PLACED THE HIGHEST DEMANDS ON THE HIP FLEXORS AND KNEE EXTENSORS. ALL OF THE POSES PRODUCED ANKLE PLANTAR-FLEXOR JMOFS. IN THE FRONTAL PLANE, THE TREE GENERATED THE GREATEST AVERAGE HIP AND KNEE ABDUCTOR JMOFS; WHEREAS WARRIOR II GENERATED THE GREATEST AVERAGE HIP AND KNEE ADDUCTOR JMOFS. WARRIOR II AND ONE-LEGGED BALANCE INDUCED THE LARGEST AVERAGE ANKLE EVERTOR AND INVERTOR JMOFS, RESPECTIVELY. THE ELECTROMYOGRAPHIC FINDINGS WERE CONSISTENT WITH THE JMOF RESULTS. CONCLUSIONS: MUSCULOSKELETAL DEMAND VARIED SIGNIFICANTLY ACROSS THE DIFFERENT POSES. THESE FINDINGS MAY BE USED TO GUIDE THE DESIGN OF EVIDENCE-BASED YOGA INTERVENTIONS THAT ADDRESS INDIVIDUAL-SPECIFIC TRAINING AND REHABILITATION GOALS IN SENIORS. CLINICAL TRIAL REGISTRATION: THIS STUDY IS REGISTERED WITH NIH CLINICALTRIALS.GOV #NCT 01411059. 2013 18 197 18 A RARE CASE OF QUADRATUS FEMORIS MUSCLE RUPTURE AFTER YOGA EXERCISES. WE PRESENT A CASE OF A FEMALE PATIENT WITH LEFT GROIN PAIN AFTER INTENSE YOGA EXERCISES. THE PATIENT PRESENTED ABNORMAL PATTERN OF GAIT WITH NO SWELLING OVER THE GROIN, THIGH, OR BUTTOCK. MAGNETIC RESONANCE IMAGING DEMONSTRATED A TEAR OF THE QUADRATUS FEMORIS MUSCLE WITH AN ASSOCIATED EXTENSIVE HEMATOMA FORMATION. PATIENT WAS TREATED WITH A REHABILITATION PROGRAM CONSISTING OF NONSTEROIDAL ANTI-INFLAMMATORY DRUGS AND PHYSIOTHERAPY. AT THE FOLLOW-UP CONTROL, THE PATIENT HAD IMPROVED HER PAIN AND FLEXIBILITY OF THE HIP, AND GRADUALLY SHE RETURNED TO DAILY ACTIVITIES AND YOGA EXERCISES. SUCH AN ENTITY IS A RARE CAUSE OF HIP PAIN AFTER EXERCISE AND SHOULD BE KEPT IN MIND BY THE ORTHOPEDIC SURGEON, IN CASES OF GLUTEAL PAIN AFTER INTENSE PHYSICAL ACTIVITY. MOREOVER, SUCH A CONDITION SHOULD BE INCLUDED IN THE DIAGNOSTIC ALGORITHM OF UNKNOWN ORIGIN HIP PAIN. 2016 19 1741 34 PHYSICAL DEMAND PROFILES OF HATHA YOGA POSTURES PERFORMED BY OLDER ADULTS. UNDERSTANDING THE PHYSICAL DEMANDS PLACED UPON THE MUSCULOSKELETAL SYSTEM BY INDIVIDUAL POSTURES MAY ALLOW EXPERIENCED INSTRUCTORS AND THERAPISTS TO DEVELOP SAFE AND EFFECTIVE YOGA PROGRAMS WHICH REDUCE UNDESIRABLE SIDE EFFECTS. THUS, WE USED BIOMECHANICAL METHODS TO QUANTIFY THE LOWER EXTREMITY JOINT ANGLES, JOINT MOMENTS OF FORCE, AND MUSCLE ACTIVITIES OF 21 HATHA YOGA POSTURES, COMMONLY USED IN SENIOR YOGA PROGRAMS. TWENTY OLDER ADULTS, 70.7 YEARS +/- 3.8 YEARS, PARTICIPATED IN A 32-WK YOGA CLASS (2 D/WK) WHERE THEY LEARNED INTRODUCTORY AND INTERMEDIATE POSTURES (ASANAS). THEY THEN PERFORMED THE ASANAS IN A MOTION ANALYSIS LABORATORY. KINEMATIC, KINETIC, AND ELECTROMYOGRAPHIC DATA WAS COLLECTED OVER THREE SECONDS WHILE THE PARTICIPANTS HELD THE POSES STATICALLY. PROFILES ILLUSTRATING THE POSTURES AND INCLUDING THE BIOMECHANICAL DATA WERE THEN GENERATED FOR EACH ASANA. OUR FINDINGS DEMONSTRATED THAT HATHA YOGA POSTURES ENGENDERED A RANGE OF APPRECIABLE JOINT ANGLES, JMOFS, AND MUSCLE ACTIVITIES ABOUT THE ANKLE, KNEE, AND HIP, AND THAT DEMANDS ASSOCIATED WITH SOME POSTURES AND POSTURE MODIFICATIONS WERE NOT ALWAYS INTUITIVE. THEY ALSO DEMONSTRATED THAT ALL OF THE POSTURES ELICITED APPRECIABLE RECTUS ABDOMINIS ACTIVITY, WHICH WAS UP TO 70% OF THAT INDUCED DURING WALKING. 2013 20 1914 26 ROLE OF INTEGRATED APPROACH OF YOGA THERAPY IN A FAILED POST-TOTAL KNEE REPLACEMENT OF BILATERAL KNEES. OA KNEE IS THE MOST COMMON ARTHRITIS. KNEE REPLACEMENT SURGERIES ARE BEING DONE INCREASINGLY IN THE PRESENT TIMES. THIS HAS LED TO THE VIOLATION OF THE STANDARD INDICATIONS AND WHEN KNEES ARE REPLACED IGNORING OTHER CO - MUSCULOSKELETAL CONDITIONS IT RESULTS IN THE SURGERY FAILING EARLY. THIS IS ABOUT A PATIENT WHO ENCOUNTERED A FAILED TKR DUE TO IMPROPER SELECTION AS PATIENT HAD BILATERAL OA HIP THAT WAS IGNORED IN THE INITIAL STAGES. TO OVERCOME THE PROBLEM SHE WAS ADVISED BILATERAL HIP REPLACEMENT WHICH WOULD LEAVE HER WITH FOUR REPLACEMENTS IN THE LOWER LIMB. SHE REFUSED SURGERY AND WAS TOLD THERE ARE NO ALTERNATIVE TREATMENT OPTIONS. THIS PATIENT UNDERWENT A 3 WEEK INTEGRATED COURSE OF IAYT AT OUR CENTER AND SHE MADE A REMARKABLE RECOVERY. IAYT IS A GOOD NON-SURGICAL TREATMENT THAT CAN BE AFFECTIVE BOTH BEFORE AND AFTER KNEE REPLACEMENT AND IT SHOULD BE CONSIDERED AS THE FIRST CHOICE OF TREATMENT BEFORE SURGERY. 2014