1 584 179 DESIGNING, VALIDATION, AND FEASIBILITY OF A YOGA MODULE FOR PATIENTS WITH ANKYLOSING SPONDYLITIS. BACKGROUND: ANKYLOSING SPONDYLITIS (AS) IS A CHRONIC INFLAMMATORY DISEASE THAT CAUSES SIGNIFICANT DISABILITY AND REDUCED QUALITY OF LIFE. SCIENTIFIC STUDIES ON YOGA HAVE REVEALED ITS VARIOUS HEALTH BENEFITS IN CHRONIC CONDITIONS, INCLUDING AUTOIMMUNE DISEASES. HOWEVER, WHETHER YOGA IS FEASIBLE FOR AS PATIENTS OR NOT IS NOT STUDIED. FURTHER, NO VALIDATED YOGA MODULE IS AVAILABLE FOR AS PATIENTS. OBJECTIVE(S): THIS STUDY INTENDED TO DEVELOP A YOGA MODULE FOR AS PATIENTS AND INVESTIGATED ITS FEASIBILITY OF USE. MATERIALS AND METHODS: THE STUDY WAS COMPLETED IN THREE STAGES. IN STAGE I, SIX YOGA EXPERTS PREPARED A LIST OF 64 YOGA PRACTICES BASED ON THE CLASSICAL AND CONTEMPORARY YOGIC LITERATURE REVIEW. OF THESE PRACTICES, 41 WERE INCLUDED IN THE DESIGNED YOGA MODULE. IN STAGE II, 41 EXPERTS WITH A MINIMUM OF FIVE YEARS OF EXPERIENCE IN YOGA THERAPY WERE INVITED FOR YOGA MODULE VALIDATION. THE USEFULNESS OF THE PRACTICES WAS RATED BY EXPERTS ON A 3-POINT SCALE (1: NOT AT ALL USEFUL, 2: MODERATELY USEFUL, AND 3: VERY MUCH USEFUL). THE LAWSHE CONTENT VALIDITY RATIO (CVR) METHOD WAS USED FOR THE CONTENT VALIDITY OF THE YOGA MODULE. PRACTICES WITH A CVR SCORE OF > 0.3 WERE RETAINED IN THE FINAL YOGA MODULE. IN STAGE III, A CERTIFIED YOGA INSTRUCTOR ADMINISTERED THE VALIDATED YOGA MODULE TO 19 AS PATIENTS (AVERAGE AGE: 35.5 +/- 10.7 YEARS) THRICE WEEKLY FOR A MONTH. FEASIBILITY WAS ASSESSED ON THE BASIS OF THE ATTRITION RATE, RETENTION RATE, ATTENDANCE OF THE PARTICIPANTS, AND THE SUBJECTIVE RESPONSE ON PRACTICAL SESSIONS USING A STRUCTURED CHECKLIST. RESULTS: OF THE 41 PRACTICES IN THE MODULE, 31 HAD A CVR SCORE OF > 0.3 AND WERE INCLUDED IN THE FINAL YOGA MODULE. OF THE 25 PARTICIPANTS, 19 (76%) COMPLETED THE STUDY WHILE SIX DROPPED OUT (24%). NINETEEN PATIENTS REPORTED GREATER IMPROVEMENT IN PAIN AND FLEXIBILITY. THEY FOUND YOGA RELAXING AND EASY TO PRACTICE. MOST PARTICIPANTS (65%) WERE ABLE TO PRACTICE A MINIMUM OF 30 MIN/DAY. CONCLUSION: THE PRESENT STUDY OFFERS A VALIDATED YOGA MODULE CONSISTING OF 31 PRACTICES FOR AS PATIENTS. THE RESULTS OF THE PILOT SUGGESTED THAT THE MODULE IS FEASIBLE, ACCEPTABLE, AND EASY TO PRACTICE FOR AS PATIENTS. WE RECOMMEND THAT AS PATIENTS SHOULD PRACTICE THIS YOGA MODULE FOR A MINIMUM OF 30 MIN EVERY DAY UNDER THE SUPERVISION OF A YOGA EXPERT. 2022
2 600 48 DEVELOPMENT AND VALIDATION OF 20-MIN YOGA MODULE FOR REDUCING BURNOUT AMONG HEALTHCARE WORKER(S). BACKGROUND: A HIGH PREVALENCE OF BURNOUT HAS BEEN REPORTED AMONG HEALTHCARE WORKER(S). DURING THE CURRENT PANDEMIC, SUCH BURNOUT HAS INCREASED DUE TO EXCESSIVE LOAD OF PATIENT CARE, USE OF PERSONAL PROTECTIVE EQUIPMENT (PPE) KITS, WORKING IN LONG SHIFTS, STAYING AWAY FROM FAMILY DUE TO ISOLATION NORMS, AND DISRUPTED SOCIAL LIFE. EXISTING YOGA TECHNIQUES USED FOR REDUCING BURNOUT INCLUDE 45 MIN TO HOUR-LONG SESSIONS, WHICH MAY NOT BE FEASIBLE FOR REGULAR PRACTICE BY THE HEALTHCARE WORKER(S). OBJECTIVE: THE PROPOSED STUDY AIMED TO DEVELOP A 20-MIN YOGA MODULE TO REDUCE BURNOUT AMONG HEALTHCARE WORKER(S). METHODS: TO DEVELOP A 20-MIN YOGA MODULE, WE REVIEWED YOGA TEXTS AND RELEVANT SCIENTIFIC RESEARCH ARTICLES. COMPONENTS OF THE 20-MIN YOGA MODULE INCLUDE SUKSHMA VYAYAMA (LOOSENING EXERCISES), PRANAYAMA (REGULATED BREATHING), AND DHYANA (MEDITATION). NINETEEN YOGA EXPERTS VALIDATED THE 20-MIN YOGA MODULE WITH AN AVERAGE (SD) OF 11.47 (6.77) YEARS OF RESEARCH AND CLINICAL EXPERIENCE IN YOGA. CONTENT VALIDITY RATIO (CVR) WAS CALCULATED ACCORDING TO LAWSHE'S METHOD. ITEMS HAVING A CVR OF 0.47 AND ABOVE WERE RETAINED IN THE MODULE. RESULTS AND CONCLUSION: THE CONTENT VALIDITY INDEX (CVI) OF THE ENTIRE MODULE WAS 0.83. CVR RESULTS OF THE ELEMENTS OF THE 20-MIN YOGA MODULE INDICATED THAT EXPERTS CONSIDER THESE PRACTICES TO BE ESSENTIAL FOR REDUCING BURNOUT AMONG THE HEALTHCARE WORKER(S). THE STRENGTH OF THE 20-MIN YOGA MODULE LIES IN ITS SHORT DURATION AND EASY-TO-LEARN PRACTICES. 20-MIN YOGA MODULE CAN BE IMPLEMENTED IN PRACTICE BY THE HEALTHCARE WORKER(S) FOR REDUCING BURNOUT FOLLOWING EFFICACY STUDIES THROUGH FURTHER CLINICAL TRIALS. 2022
3 2110 43 THE EFFECT OF YOGA ON SLEEP QUALITY AND INSOMNIA IN WOMEN WITH SLEEP PROBLEMS: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: TO EXAMINE THE EFFECTIVENESS AND SAFETY OF YOGA OF WOMEN WITH SLEEP PROBLEMS BY PERFORMING A SYSTEMATIC REVIEW AND META-ANALYSIS. METHODS: MEDLINE/PUBMED, CLINICALKEY, SCIENCEDIRECT, EMBASE, PSYCINFO, AND THE COCHRANE LIBRARY WERE SEARCHED THROUGHOUT THE MONTH OF JUNE, 2019. RANDOMIZED CONTROLLED TRIALS COMPARING YOGA GROUPS WITH CONTROL GROUPS IN WOMEN WITH SLEEP PROBLEMS WERE INCLUDED. TWO REVIEWERS INDEPENDENTLY EVALUATED RISK OF BIAS BY USING THE RISK OF BIAS TOOL SUGGESTED BY THE COCHRANE COLLABORATION FOR PROGRAMMING AND CONDUCTING SYSTEMATIC REVIEWS AND META-ANALYSES. THE MAIN OUTCOME MEASURE WAS SLEEP QUALITY OR THE SEVERITY OF INSOMNIA, WHICH WAS MEASURED USING SUBJECTIVE INSTRUMENTS, SUCH AS THE PITTSBURGH SLEEP QUALITY INDEX (PSQI), INSOMNIA SEVERITY INDEX (ISI), OR OBJECTIVE INSTRUMENTS SUCH AS POLYSOMNOGRAPHY, ACTIGRAPHY, AND SAFETY OF THE INTERVENTION. FOR EACH OUTCOME, A STANDARDIZED MEAN DIFFERENCE (SMD) AND CONFIDENCE INTERVALS (CIS) OF 95% WERE DETERMINED. RESULTS: NINETEEN STUDIES IN THIS SYSTEMATIC REVIEW INCLUDED 1832 PARTICIPANTS. THE META-ANALYSIS OF THE COMBINED DATA CONDUCTED ACCORDING TO COMPREHENSIVE META-ANALYSIS SHOWED A SIGNIFICANT IMPROVEMENT IN SLEEP (SMD = - 0.327, 95% CI = - 0.506 TO - 0.148, P < 0.001). META-ANALYSES REVEALED POSITIVE EFFECTS OF YOGA USING PSQI SCORES IN 16 RANDOMIZED CONTROL TRIALS (RCTS), COMPARED WITH THE CONTROL GROUP IN IMPROVING SLEEP QUALITY AMONG WOMEN USING PSQI (SMD = - 0.54; 95% CI = - 0.89 TO - 0.19; P = 0.003). HOWEVER, THREE RCTS REVEALED NO EFFECTS OF YOGA COMPARED TO THE CONTROL GROUP IN REDUCING INSOMNIA AMONG WOMEN USING ISI (SMD = - 0.13; 95% CI = - 0.74 TO 0.48; P = 0.69). SEVEN RCTS REVEALED NO EVIDENCE FOR EFFECTS OF YOGA COMPARED WITH THE CONTROL GROUP IN IMPROVING SLEEP QUALITY FOR WOMEN WITH BREAST CANCER USING PSQI (SMD = - 0.15; 95% CI = - 0.31 TO 0.01; P = 0.5). FOUR RCTS REVEALED NO EVIDENCE FOR THE EFFECTS OF YOGA COMPARED WITH THE CONTROL GROUP IN IMPROVING THE SLEEP QUALITY FOR PERI/POSTMENOPAUSAL WOMEN USING PSQI (SMD = - 0.31; 95% CI = - 0.95 TO 0.33; P = 0.34). YOGA WAS NOT ASSOCIATED WITH ANY SERIOUS ADVERSE EVENTS. DISCUSSION: THIS SYSTEMATIC REVIEW AND META-ANALYSIS DEMONSTRATED THAT YOGA INTERVENTION IN WOMEN CAN BE BENEFICIAL WHEN COMPARED TO NON-ACTIVE CONTROL CONDITIONS IN TERM OF MANAGING SLEEP PROBLEMS. THE MODERATOR ANALYSES SUGGEST THAT PARTICIPANTS IN THE NON-BREAST CANCER SUBGROUP AND PARTICIPANTS IN THE NON-PERI/POSTMENOPAUSAL SUBGROUP WERE ASSOCIATED WITH GREATER BENEFITS, WITH A DIRECT CORRELATION OF TOTAL CLASS TIME WITH QUALITY OF SLEEP AMONG OTHER RELATED BENEFITS. 2020
4 1327 48 HIGH RATE OF RETURN TO YOGA FOR ATHLETES AFTER HIP ARTHROSCOPY FOR FEMOROACETABULAR IMPINGEMENT SYNDROME. BACKGROUND: FEMOROACETABULAR IMPINGEMENT SYNDROME (FAIS) IS MOST COMMONLY DIAGNOSED IN PATIENTS WHO PERFORM ACTIVITIES THAT REQUIRE REPETITIVE HIP FLEXION AND ROTATIONAL LOADING. YOGA IS AN ACTIVITY GROWING IN POPULARITY THAT INVOLVES THESE MOTIONS. THE PURPOSE OF THIS STUDY WAS TO EVALUATE PATIENTS' ABILITY TO RETURN TO YOGA AFTER HIP ARTHROSCOPY FOR FAIS. HYPOTHESIS: THERE WOULD BE A HIGH RATE OF RETURN TO YOGA AFTER HIP ARTHROSCOPY. STUDY DESIGN: RETROSPECTIVE ANALYSIS. LEVEL OF EVIDENCE: LEVEL 4. METHODS: CONSECUTIVE PATIENTS WITH FAIS WHO HAD IDENTIFIED THEMSELVES AS PARTICIPATING IN YOGA AND HAD UNDERGONE HIP ARTHROSCOPY FOR THE TREATMENT OF FAIS BETWEEN 2012 AND 2015 WERE REVIEWED. DEMOGRAPHIC DATA WERE COLLECTED AND ASSESSED FOR ALL PATIENTS, AS WELL AS PREOPERATIVE PHYSICAL EXAMINATION, IMAGING, AND PATIENT-REPORTED OUTCOME (PRO) SCORES, INCLUDING THE MODIFIED HARRIS HIP SCORE (MHHS), HIP OUTCOME SCORE ACTIVITIES OF DAILY LIVING (HOS-ADL) AND SPORTS-SPECIFIC (HOS-SS) SUBSCALES, AND VISUAL ANALOG SCALE (VAS) FOR PAIN. POSTOPERATIVELY, EXAMINATION AND PRO DATA WERE COLLECTED AT A MINIMUM 1 YEAR AFTER SURGERY, INCLUDING A YOGA-SPECIFIC QUESTIONNAIRE. RESULTS: A TOTAL OF 42 PATIENTS (90% FEMALE; MEAN AGE, 35 +/- 9 YEARS; MEAN BODY MASS INDEX, 23.1 +/- 3.2 KG/M(2)) WERE INCLUDED. THIRTY PATIENTS (71%) HAD TO DISCONTINUE THEIR YOGA ROUTINE PREOPERATIVELY BECAUSE OF HIP-RELATED SYMPTOMS AT A MEAN 9.5 +/- 8.2 MONTHS BEFORE SURGERY. AFTER SURGERY, 39 PATIENTS (93%) WERE ABLE TO RETURN TO YOGA AT A MEAN 5.3 +/- 2.2 MONTHS AFTER SURGERY. TWO OF THE 3 PATIENTS WHO DID NOT RETURN TO YOGA NOTED LOSS OF INTEREST AS THEIR REASON FOR STOPPING, WHILE 1 PATIENT WAS UNABLE TO RETURN BECAUSE OF PERSISTENT HIP PAIN. NINETEEN PATIENTS (45%) RETURNED TO A HIGHER LEVEL OF YOGA PRACTICE, 17 PATIENTS (40%) RETURNED TO THE SAME LEVEL, AND 3 PATIENTS (7%) RETURNED TO A LOWER LEVEL. THERE WAS NO DIFFERENCE IN THE NUMBER OF HOURS SPENT PRACTICING YOGA PER WEEK PRE- AND POSTOPERATIVELY (2.7 +/- 1.9 VS 2.5 +/- 1.3 HOURS; P = 0.44). ALL PATIENTS DEMONSTRATED SIGNIFICANT IMPROVEMENT IN ALL PROS AS WELL AS PAIN SCORES AFTER SURGERY (HOS-ADL, 67.4 +/- 18.3 TO 93.1 +/- 6.9 [ P < 0.001]; HOS-SS, 45.6 +/- 24.7 TO 81.5 +/- 18.8 [ P < 0.001]; MHHS, 62.3 +/- 11.3 TO 86.8 +/- 12.3 [ P < 0.0001]; VAS PAIN, 6.3 +/- 2.2 TO 0.90 +/- 1.1 [ P < 0.001]). CONCLUSION: PATIENTS PARTICIPATING IN YOGA RETURN TO YOGA 93% OF THE TIME AND AT A MEAN 5.3 +/- 2.2 MONTHS AFTER HIP ARTHROSCOPY FOR FAIS. CLINICAL RELEVANCE: INFORMATION REGARDING SURGICAL OUTCOMES IS CRITICAL IN COUNSELING PATIENTS, PARTICULARLY FEMALE ATHLETES, ON THEIR EXPECTATIONS WITH RESPECT TO RETURNING TO YOGA AFTER HIP ARTHROSCOPY FOR FAIS. 2018
5 20 37 "WE'RE ALL IN THIS TOGETHER": A QUALITATIVE STUDY OF PREDOMINANTLY LOW INCOME MINORITY PARTICIPANTS IN A YOGA TRIAL FOR CHRONIC LOW BACK PAIN. OBJECTIVE: TO EXPLORE THE EXPERIENCES OF LOW-INCOME MINORITY ADULTS TAKING PART IN A YOGA DOSING TRIAL FOR CHRONIC LOW BACK PAIN. DESIGN: INDIVIDUAL SEMI-STRUCTURED INTERVIEWS WERE CONDUCTED WITH NINETEEN PARTICIPANTS RECRUITED FROM A RANDOMIZED YOGA DOSING TRIAL FOR PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH CHRONIC LOW BACK PAIN. INTERVIEWS DISCUSSED THE IMPACT OF YOGA ON LOW BACK PAIN AND EMOTIONS; OTHER PERCEIVED ADVANTAGES OR DISADVANTAGES OF THE INTERVENTION; AND FACILITATORS AND BARRIERS TO PRACTICING YOGA. INTERVIEWS WERE AUDIO TAPED AND TRANSCRIBED, CODED USING ATLAS.TI SOFTWARE, AND ANALYZED WITH INDUCTIVE AND DEDUCTIVE THEMATIC ANALYSIS METHODS. SETTING: BOSTON MEDICAL CENTER, BOSTON, MA, USA. RESULTS: PARTICIPANTS VIEWED YOGA AS A MEANS OF PAIN RELIEF AND ATTRIBUTED IMPROVED MOOD, GREATER ABILITY TO MANAGE STRESS, AND ENHANCED RELAXATION TO YOGA. OVERALL, PARTICIPANTS FELT EMPOWERED TO SELF-MANAGE THEIR PAIN. SOME FOUND YOGA TO BE HELPFUL IN BEING MINDFUL OF THEIR EMOTIONS AND ACCEPTING OF THEIR PAIN. TRUST IN THE YOGA INSTRUCTORS WAS A COMMONLY CITED FACILITATOR FOR YOGA CLASS ATTENDANCE. LACK OF TIME, MOTIVATION, AND FEAR OF INJURY WERE REPORTED BARRIERS TO YOGA PRACTICE. CONCLUSIONS: YOGA IS A MULTIDIMENSIONAL TREATMENT FOR LOW BACK PAIN THAT HAS THE POTENTIAL TO FAVORABLY IMPACT HEALTH IN A PREDOMINANTLY LOW-INCOME MINORITY POPULATION. 2016
6 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
7 1043 36 EFFECTS OF YOGA INTERVENTIONS ON FATIGUE: A META-ANALYSIS. BACKGROUND. RESEARCHERS AIMED AT SYSTEMATICALLY REVIEWING AND META-ANALYZING THE EFFECTIVENESS OF YOGA INTERVENTIONS FOR FATIGUE. METHODS. PUBMED/MEDLINE WAS SEARCHED UNTIL JANUARY 2012 FOR CONTROLLED CLINICAL STUDIES. TWO REVIEWERS INDEPENDENTLY EXTRACTED THE DATA. THE METHODOLOGICAL QUALITY OF THE STUDIES WAS ASSESSED. A META-ANALYSIS WAS PERFORMED. RESULTS. NINETEEN CLINICAL STUDIES (TOTAL N = 948) WERE INCLUDED IN THIS REVIEW. INVESTIGATED YOGA STYLES INCLUDED HATHA, IYENGAR, ASANAS, PATANJALI, SAHAJA, AND TIBETAN YOGA. PARTICIPANTS WERE SUFFERING FROM CANCER, MULTIPLE SCLEROSIS, DIALYSIS, CHRONIC PANCREATITIS, FIBROMYALGIA, ASTHMA, OR WERE HEALTHY. YOGA HAD A SMALL POSITIVE EFFECT ON FATIGUE (SMD = 0.27, 59% CI = 0.23-0.31). SEVEN STUDIES RECEIVED 4 POINTS ON THE JADAD SCORE. THERE WERE BASELINE DIFFERENCES IN AT LEAST 5 STUDIES. CONCLUSION. OVERALL, THE EFFECTS OF YOGA INTERVENTIONS ON FATIGUE WERE ONLY SMALL, PARTICULARLY IN CANCER PATIENTS. ALTHOUGH YOGA IS GENERALLY A SAFE THERAPEUTIC INTERVENTION AND EFFECTIVE TO ATTENUATE OTHER HEALTH-RELATED SYMPTOMS, THIS META-ANALYSIS WAS NOT ABLE TO DEFINE THE POWERFUL EFFECT OF YOGA ON PATIENTS SUFFERING FROM FATIGUE. TREATMENT EFFECTS OF YOGA COULD BE IMPROVED IN WELL-DESIGNED FUTURE STUDIES. ACCORDING TO THE GRADE RECOMMENDATIONS ASSESSING THE OVERALL QUALITY OF EVIDENCE, THERE IS A MODERATE EFFECT OF THE CONFIDENCE PLACED IN THE ESTIMATES OF THE EFFECTS DISCUSSED HERE. 2012
8 2518 53 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
9 1362 38 IMMUNOLOGICAL AND PSYCHOLOGICAL EFFICACY OF MEDITATION/YOGA INTERVENTION AMONG PEOPLE LIVING WITH HIV (PLWH): A SYSTEMATIC REVIEW AND META-ANALYSES OF 19 RANDOMIZED CONTROLLED TRIALS. BACKGROUND: AN EXPANDING NUMBER OF MIND-BODY THERAPIES ARE BEING USED TO REDUCE THE PSYCHOLOGICAL BURDEN OF PEOPLES LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS (HIV). HOWEVER, THE EFFECTS ON THE IMMUNE SYSTEM AND MENTAL HEALTH VARIED AMONG STUDIES. PURPOSE: THIS META-ANALYSIS WAS CONDUCTED TO SUMMARIZE THE RANDOMIZED CONTROLLED TRIALS TO DRAW COMPREHENSIVE CONCLUSIONS REGARDING THE PSYCHO-IMMUNOLOGICAL EFFICACY. METHODS: RANDOM-EFFECTS MODELS WERE USED TO ASSESS THE OUTCOME OF INTEREST. EGGER'S TESTS WERE USED TO IDENTIFY PUBLICATION BIAS. SUBGROUP AND META-REGRESSION WERE USED TO EXPLORE POTENTIAL MODERATORS. THIS REVIEW WAS REGISTERED ON THE PROSPERO DATABASE (CRD42019148118). RESULTS: NINETEEN RANDOMIZED CONTROLLED TRIALS WITH A TOTAL SAMPLE SIZE OF 1,300 WERE INCLUDED IN THIS META-ANALYSIS. REGARDING IMMUNE SYSTEM OUTCOME, MIND-BODY THERAPY SIGNIFICANTLY IMPROVED CD4 T-CELL COUNTS (COHEN'S D = 0.214, P = .027) AND MAINTAINED (0.427, P = .049). IN ADDITION, BASELINE CD4 T-CELL COUNTS AND YEARS SINCE HIV DIAGNOSIS SIGNIFICANTLY MODERATED THE EFFICACY OF MIND-BODY PRACTICES ON CD4 IMPROVEMENT (ALL PS < .001). REGARDING MENTAL HEALTH OUTCOME, MIND-BODY THERAPY SIGNIFICANTLY REDUCED STRESS, DEPRESSION, AND ANXIETY SYMPTOMS (0.422, P < .001; 0.506, P < .001, AND 0.709, P < .001, RESPECTIVELY) WHILE IMPROVING QUALITY OF LIFE (0.67, P < .001). CONCLUSIONS: MEDITATION/YOGA INTERVENTION COULD RESULT IN POTENTIAL BENEFITS WITH REGARD TO IMPROVED CD4 T-CELL COUNTS IMMEDIATELY AFTER THE INTERVENTION AND AT LONG-TERM FOLLOW-UP, WHILE ALSO IMPROVING THEIR MENTAL HEALTH. THE COST-EFFECTIVE MEDITATION/YOGA INTERVENTION SHOULD BE INTEGRATED INTO ROUTINE CARE FOR PEOPLE LIVING WITH HIV, ESPECIALLY FOR THOSE WITH LOWER CD4 BASELINE AND FEWER YEARS SINCE DIAGNOSIS. 2021
10 602 50 DEVELOPMENT AND VALIDATION OF A YOGA MODULE FOR PARKINSON DISEASE. BACKGROUND PARKINSON'S DISEASE (PD), A PROGRESSIVE NEURODEGENERATIVE DISEASE, AFFECTS MOTOR AND NONMOTOR FUNCTIONS, LEADING TO SEVERE DEBILITY AND POOR QUALITY OF LIFE. STUDIES HAVE REPORTED THE BENEFICIAL ROLE OF YOGA IN ALLEVIATING THE SYMPTOMS OF PD; HOWEVER, A VALIDATED YOGA MODULE FOR PD IS UNAVAILABLE. THIS STUDY DEVELOPED AND VALIDATED AN INTEGRATED YOGA MODULE(IYM) FOR PD. METHODS THE IYM WAS PREPARED AFTER A THOROUGH REVIEW OF CLASSICAL YOGA TEXTS AND PREVIOUS FINDINGS. TWENTY EXPERIENCED YOGA EXPERTS, WHO FULFILLED THE INCLUSION CRITERIA, WERE SELECTED VALIDATING THE CONTENT OF THE IYM. A TOTAL OF 28 PRACTICES WERE INCLUDED IN THE IYM, AND EACH PRACTICE WAS DISCUSSED AND RATED AS (I) NOT ESSENTIAL, (II) USEFUL BUT NOT ESSENTIAL, AND (III) ESSENTIAL; THE CONTENT VALIDITY RATIO (CVR) WAS CALCULATED USING LAWSHE'S FORMULA. RESULTS DATA ANALYSIS REVEALED THAT OF THE 28 IYM PRACTICES, 21 EXHIBITED SIGNIFICANT CONTENT VALIDITY (CUT-OFF VALUE: 0.42, AS CALCULATED BY APPLYING LAWSHE'S FORMULA FOR THE CVR). CONCLUSIONS THE IYM IS VALID FOR PD, WITH GOOD CONTENT VALIDITY. HOWEVER, FUTURE STUDIES MUST DETERMINE THE FEASIBILITY AND EFFICACY OF THE DEVELOPED MODULE. 2017
11 2079 40 THE EFFECT OF EXERCISE, YOGA AND PHYSIOTHERAPY ON THE QUALITY OF LIFE OF PEOPLE WITH MULTIPLE SCLEROSIS: SYSTEMATIC REVIEW AND META-ANALYSIS. INTRODUCTION: MULTIPLE SCLEROSIS (MS) IS A CHRONIC AUTOIMMUNE DISEASE AFFECTING THE MYELINATED AXONS OF THE CENTRAL NERVOUS SYSTEM CAUSING NEUROLOGICAL DETERIORATION. PEOPLE LIVING WITH MS HAVE A POOR QUALITY OF LIFE (QOL) BECAUSE OF THE SYMPTOMS CAUSED BY THE DISEASE AND THERE ARE VARIOUS TYPES OF TREATMENTS TO MANAGE THE SYMPTOMS ASIDE FROM MEDICATION. OBJECTIVE: THIS META-ANALYSIS EXAMINES THE EFFECT OF EXERCISE, YOGA AND PHYSIOTHERAPY ON THE PHYSICAL, MENTAL AND SOCIAL QOL AMONG INDIVIDUALS LIVING WITH MS. SETTING: A SYSTEMATIC REVIEW WITH META-ANALYSIS WAS CONDUCTED USING PUBMED, MEDLINE, AND SCOPUS FROM 1990 TO 2017. THE STANDARD MEAN DIFFERENCE SCORES WERE COMPUTED IN EACH STUDY FOR THE DOMAINS OF PHYSICAL, MENTAL AND SOCIAL FUNCTIONING. RESULTS: EIGHTEEN STUDIES MET THE INCLUSION CRITERIA FOR THIS META-ANALYSIS. AEROBIC EXERCISE WAS EFFECTIVE IN IMPROVING SATISFACTION WITH PHYSICAL FUNCTIONING,D = 0.35 (95% CI = 0.08 TO 0.62), MENTAL FUNCTIONING D = 0.42 (95% CI = 0.11 TO 0.72), AND SOCIAL FUNCTIONING D = 0.42 (95% CI = 0.15 TO 0.69). PHYSIOTHERAPY WAS ALSO FOUND TO BE EFFECTIVE FOR PHYSICAL FUNCTIONING D = 0.50 (95% CI 0.19 TO 0.80), MENTAL FUNCTIONING D = 0.44 (95% CI 0.14 TO 0.75) AND SOCIAL FUNCTIONING D = 0.60 (95% CI 0.21 TO 0.90). HOWEVER YOGA AND COMBINATION OF EXERCISES DID NOT HAVE A SIGNIFICANT EFFECT ON ANY OF THE QOL DOMAINS. CONCLUSION: THESE FINDINGS SUGGEST THAT AEROBIC EXERCISE AND PHYSIOTHERAPY IMPROVES THE SATISFACTION OF MS PATIENTS WITH THEIR PHYSICAL, MENTAL AND SOCIAL FUNCTIONING AND MAY BE INCLUDED AS NORMAL PRACTICE IN THE TREATMENT OF MS. 2019
12 1486 34 INTEGRATIVE EFFECT OF YOGA PRACTICE IN PATIENTS WITH KNEE ARTHRITIS: A PRISMA-COMPLIANT META-ANALYSIS. BACKGROUND: BENEFITS OF YOGA PRACTICE IN PATIENTS WITH KNEE OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS REMAINS CONTROVERSIAL. THIS STUDY PERFORMS A META-ANALYSIS TO QUANTIFY THE EFFICIENCY OF YOGA EXERCISE FOR PATIENTS PAIN REDUCTION, FUNCTIONAL RECOVERY, AND GENERAL WELLBEING. METHODS: A COMPUTERIZED SEARCH OF PUBMED AND EMBASE WAS PERFORMED TO IDENTIFY RELEVANT STUDIES. THE OUTCOME MEASURES WERE PAIN, STIFFNESS, AND PHYSICAL FUNCTION. TWO INVESTIGATORS IDENTIFIED ELIGIBLE STUDIES AND EXTRACTED DATA INDEPENDENTLY. THE QUALITY OF CITATIONS WAS MEASURED USING JADAD SCORE. STANDARDIZED MEAN DIFFERENCES (SMDS) WITH 95% CONFIDENCE INTERVALS (CIS) WERE CALCULATED FOR PAIN, MUSCULOSKELETAL IMPAIRMENT, QUALITY OF LIFE, GENERAL WELLBEING, AND MENTAL WELLBEING. RESULTS: A TOTAL OF 13 CLINICAL TRIALS INVOLVING 1557 PATIENTS WITH KNEE OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS WERE INCLUDED IN FINAL META-ANALYSIS WITH THE AVERAGE JADAD SCORE 2.8. THE SMD WAS -0.98 (95% CI -1.18, -0.78, P < .05) FOR PAIN, -1.83 (95% CI -2.09, -1.57, P < .05) FOR FUNCTIONAL DISABILITY, WAS 0.80 (95% CI 0.59, 1.01, P < .05) FOR SHORT FORM 36 HEALTH SURVEY (SF-36) GENERAL HEALTH, 0.49 (95% CI 0.14, 0.82, P < .05) FOR SF-36 MENTAL HEALTH, AND HAQ WAS -0.55 (95% CI -0.83, -0.26, P < .05) FOR HEALTH ASSOCIATED QUESTIONNAIRE (HAQ). ALL THE RESULTS FAVOR YOGA TRAINING GROUP. CONCLUSIONS: REGULAR YOGA TRAINING IS HELPFUL IN REDUCING KNEE ARTHRITIC SYMPTOMS, PROMOTING PHYSICAL FUNCTION, AND GENERAL WELLBEING IN ARTHRITIC PATIENTS. 2018
13 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
14 2634 37 YOGA FOR TREATING LOW BACK PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS. ABSTRACT: YOGA IS FREQUENTLY USED FOR BACK PAIN RELIEF. HOWEVER, THE EVIDENCE WAS JUDGED TO BE OF ONLY LOW TO MODERATE CERTAINTY. TO ASSESS THE EFFICACY AND SAFETY OF YOGA IN PATIENTS WITH LOW BACK PAIN, A META-ANALYSIS WAS PERFORMED. THEREFORE, MEDLINE/PUBMED, SCOPUS, AND THE COCHRANE LIBRARY WERE SEARCHED TO MAY 26, 2020. ONLY RANDOMIZED CONTROLLED TRIALS COMPARING YOGA WITH PASSIVE CONTROL (USUAL CARE OR WAIT LIST), OR AN ACTIVE COMPARATOR, FOR PATIENTS WITH LOW BACK PAIN AND THAT ASSESSED PAIN INTENSITY OR PAIN-RELATED DISABILITY AS A PRIMARY OUTCOME WERE CONSIDERED TO BE ELIGIBLE. TWO REVIEWERS INDEPENDENTLY EXTRACTED DATA ON STUDY CHARACTERISTICS, OUTCOME MEASURES, AND RESULTS AT SHORT-TERM AND LONG-TERM FOLLOW-UP. RISK OF BIAS WAS ASSESSED USING THE COCHRANE RISK OF BIAS TOOL. THIRTY ARTICLES ON 27 INDIVIDUAL STUDIES (2702 PARTICIPANTS IN TOTAL) PROVED ELIGIBLE FOR REVIEW. COMPARED WITH PASSIVE CONTROL, YOGA WAS ASSOCIATED WITH SHORT-TERM IMPROVEMENTS IN PAIN INTENSITY (15 RCTS; MEAN DIFFERENCE [MD] = -0.74 POINTS ON A NUMERIC RATING SCALE; 95% CONFIDENCE INTERVAL [CI] = -1.04 TO -0.44; STANDARDIZED MEAN DIFFERENCE [SMD] = -0.37 95% CI = -0.52 TO -0.22), PAIN-RELATED DISABILITY (15 RCTS; MD = -2.28; 95% CI = -3.30 TO -1.26; SMD = -0.38 95% CI = -0.55 TO -0.21), MENTAL HEALTH (7 RCTS; MD = 1.70; 95% CI = 0.20-3.20; SMD = 0.17 95% CI = 0.02-0.32), AND PHYSICAL FUNCTIONING (9 RCTS; MD = 2.80; 95% CI = 1.00-4.70; SMD = 0.28 95% CI = 0.10-0.47). EXCEPT FOR MENTAL HEALTH, ALL EFFECTS WERE SUSTAINED LONG-TERM. COMPARED WITH AN ACTIVE COMPARATOR, YOGA WAS NOT ASSOCIATED WITH ANY SIGNIFICANT DIFFERENCES IN SHORT-TERM OR LONG-TERM OUTCOMES. 2022
15 2330 27 TWELVE WEEKS OF YOGA FOR CHRONIC NONSPECIFIC LOWER BACK PAIN: A META-ANALYSIS. OBJECTIVES: TO INVESTIGATE THE OVERALL EFFECTS OF 12 WEEKS OF YOGA PRACTICE ON CHRONIC NONSPECIFIC LOWER BACK PAIN. METHODS: PUBMED, EMBASE, PSYCINFO, WEB OF SCIENCE, AND THE COCHRANE LIBRARY DATABASES WERE SEARCHED FROM INCEPTION TO FEBRUARY 9, 2019, AND SIX RANDOMIZED CONTROLLED TRIALS WERE SELECTED FOR THIS META-ANALYSIS. RESULTS: THE POOLED FIXED-EFFECT SIZE OF SIX TRIALS SHOWED THAT 12 WEEKS OF YOGA PROGRAMS COULD SIGNIFICANTLY REDUCE CHRONIC NONSPECIFIC LOWER BACK PAIN BY 0.41 WITHIN THE TRIALS (STANDARDIZED MEAN DIFFERENCE; 95% CONFIDENCE INTERVAL: -0.58 TO -0.23; P < .0001). SUBGROUP ANALYSES ALSO SHOWED THAT SIGNIFICANT PAIN REDUCTION WAS RELATED TO TYPE OF YOGA, LENGTH OF SESSION, STUDY QUALITY, AND TIMING OF PAIN ASSESSMENT. CONCLUSIONS: THESE FINDINGS REVEAL THAT 12 WEEKS OF YOGA CAN HELP ALLEVIATE PAIN, AND YOGA PROGRAMS SHOULD TAKE INTO ACCOUNT THE SUBGROUP FACTORS TO INCREASE INDIVIDUALS' RELIEF FROM CHRONIC NONSPECIFIC LOWER BACK PAIN. 2020
16 222 40 A SYSTEMATIC REVIEW AND META-ANALYSIS OF YOGA FOR LOW BACK PAIN. OBJECTIVES: TO SYSTEMATICALLY REVIEW AND META-ANALYZE THE EFFECTIVENESS OF YOGA FOR LOW BACK PAIN. METHODS: MEDLINE, THE COCHRANE LIBRARY, EMBASE, CAMBASE, AND PSYCINFO, WERE SCREENED THROUGH JANUARY 2012. RANDOMIZED CONTROLLED TRIALS COMPARING YOGA TO CONTROL CONDITIONS IN PATIENTS WITH LOW BACK PAIN WERE INCLUDED. TWO AUTHORS INDEPENDENTLY ASSESSED RISK OF BIAS USING THE RISK OF BIAS TOOL RECOMMENDED BY THE COCHRANE BACK REVIEW GROUP. MAIN OUTCOME MEASURES WERE PAIN, BACK-SPECIFIC DISABILITY, GENERIC DISABILITY, HEALTH-RELATED QUALITY OF LIFE, AND GLOBAL IMPROVEMENT. FOR EACH OUTCOME, STANDARDIZED MEAN DIFFERENCES (SMD) AND 95% CONFIDENCE INTERVALS (CI) WERE CALCULATED. RESULTS: TEN RANDOMIZED CONTROLLED TRIALS WITH A TOTAL OF 967 CHRONIC LOW BACK PAIN PATIENTS WERE INCLUDED. EIGHT STUDIES HAD LOW RISK OF BIAS. THERE WAS STRONG EVIDENCE FOR SHORT-TERM EFFECTS ON PAIN (SMD=-0.48; 95% CI, -0.65 TO -0.31; P<0.01), BACK-SPECIFIC DISABILITY (SMD=-0.59; 95% CI, -0.87 TO -0.30; P<0.01), AND GLOBAL IMPROVEMENT (RISK RATIO=3.27; 95% CI, 1.89-5.66; P<0.01). THERE WAS STRONG EVIDENCE FOR A LONG-TERM EFFECT ON PAIN (SMD=-0.33; 95% CI, -0.59 TO -0.07; P=0.01) AND MODERATE EVIDENCE FOR A LONG-TERM EFFECT ON BACK-SPECIFIC DISABILITY (SMD=-0.35; 95% CI, -0.55 TO -0.15; P<0.01). THERE WAS NO EVIDENCE FOR EITHER SHORT-TERM OR LONG-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE. YOGA WAS NOT ASSOCIATED WITH SERIOUS ADVERSE EVENTS. DISCUSSION: THIS SYSTEMATIC REVIEW FOUND STRONG EVIDENCE FOR SHORT-TERM EFFECTIVENESS AND MODERATE EVIDENCE FOR LONG-TERM EFFECTIVENESS OF YOGA FOR CHRONIC LOW BACK PAIN IN THE MOST IMPORTANT PATIENT-CENTERED OUTCOMES. YOGA CAN BE RECOMMENDED AS AN ADDITIONAL THERAPY TO CHRONIC LOW BACK PAIN PATIENTS. 2013
17 2546 45 YOGA FOR BREAST CANCER PATIENTS AND SURVIVORS: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: MANY BREAST CANCER PATIENTS AND SURVIVORS USE YOGA TO COPE WITH THEIR DISEASE. THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY ASSESS AND META-ANALYZE THE EVIDENCE FOR EFFECTS OF YOGA ON HEALTH-RELATED QUALITY OF LIFE AND PSYCHOLOGICAL HEALTH IN BREAST CANCER PATIENTS AND SURVIVORS. METHODS: MEDLINE, PSYCINFO, EMBASE, CAMBASE, AND THE COCHRANE LIBRARY WERE SCREENED THROUGH FEBRUARY 2012. RANDOMIZED CONTROLLED TRIALS (RCTS) COMPARING YOGA TO CONTROLS WERE ANALYZED WHEN THEY ASSESSED HEALTH-RELATED QUALITY OF LIFE OR PSYCHOLOGICAL HEALTH IN BREAST CANCER PATIENTS OR SURVIVORS. RISK OF BIAS WAS ASSESSED USING THE COCHRANE RISK OF BIAS TOOL. STANDARDIZED MEAN DIFFERENCES (SMD) AND 95% CONFIDENCE INTERVALS (CI) WERE CALCULATED. RESULTS: TWELVE RCTS WITH A TOTAL OF 742 PARTICIPANTS WERE INCLUDED. SEVEN RCTS COMPARED YOGA TO NO TREATMENT; 3 RCTS COMPARED YOGA TO SUPPORTIVE THERAPY; 1 RCT COMPARED YOGA TO HEALTH EDUCATION; AND 1 RCT COMPARED A COMBINATION OF PHYSIOTHERAPY AND YOGA TO PHYSIOTHERAPY ALONE. EVIDENCE WAS FOUND FOR SHORT-TERM EFFECTS ON GLOBAL HEALTH-RELATED QUALITY OF LIFE (SMD = 0.62 [95% CI: 0.04 TO 1.21]; P = 0.04), FUNCTIONAL (SMD = 0.30 [95% CI: 0.03 TO 0.57), SOCIAL (SMD = 0.29 [95% CI: 0.08 TO 0.50]; P < 0.01), AND SPIRITUAL WELL-BEING (SMD = 0.41 [95% CI: 0.08; 0.74]; P = 0.01). THESE EFFECTS WERE, HOWEVER, ONLY PRESENT IN STUDIES WITH UNCLEAR OR HIGH RISK OF SELECTION BIAS. SHORT-TERM EFFECTS ON PSYCHOLOGICAL HEALTH ALSO WERE FOUND: ANXIETY (SMD = -1.51 [95% CI: -2.47; -0.55]; P < 0.01), DEPRESSION (SMD = -1.59 [95% CI: -2.68 TO -0.51]; P < 0.01), PERCEIVED STRESS (SMD = -1.14 [95% CI:-2.16; -0.12]; P = 0.03), AND PSYCHOLOGICAL DISTRESS (SMD = -0.86 [95% CI:-1.50; -0.22]; P < 0.01). SUBGROUP ANALYSES REVEALED EVIDENCE OF EFFICACY ONLY FOR YOGA DURING ACTIVE CANCER TREATMENT BUT NOT AFTER COMPLETION OF ACTIVE TREATMENT. CONCLUSIONS: THIS SYSTEMATIC REVIEW FOUND EVIDENCE FOR SHORT-TERM EFFECTS OF YOGA IN IMPROVING PSYCHOLOGICAL HEALTH IN BREAST CANCER PATIENTS. THE SHORT-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE COULD NOT BE CLEARLY DISTINGUISHED FROM BIAS. YOGA CAN BE RECOMMENDED AS AN INTERVENTION TO IMPROVE PSYCHOLOGICAL HEALTH DURING BREAST CANCER TREATMENT. 2012
18 1044 34 EFFECTS OF YOGA INTERVENTIONS ON PAIN AND PAIN-ASSOCIATED DISABILITY: A META-ANALYSIS. UNLABELLED: WE SEARCHED DATABASES FOR CONTROLLED CLINICAL STUDIES, AND PERFORMED A META-ANALYSIS ON THE EFFECTIVENESS OF YOGA INTERVENTIONS ON PAIN AND ASSOCIATED DISABILITY. FIVE RANDOMIZED STUDIES REPORTED SINGLE-BLINDING AND HAD A HIGHER METHODOLOGICAL QUALITY; 7 STUDIES WERE RANDOMIZED BUT NOT BLINDED AND HAD MODERATE QUALITY; AND 4 NONRANDOMIZED STUDIES HAD LOW QUALITY. IN 6 STUDIES, YOGA WAS USED TO TREAT PATIENTS WITH BACK PAIN; IN 2 STUDIES TO TREAT RHEUMATOID ARTHRITIS; IN 2 STUDIES TO TREAT PATIENTS WITH HEADACHE/MIGRAINE; AND 6 STUDIES ENROLLED INDIVIDUALS FOR OTHER INDICATIONS. ALL STUDIES REPORTED POSITIVE EFFECTS IN FAVOR OF THE YOGA INTERVENTIONS. WITH RESPECT TO PAIN, A RANDOM EFFECT META-ANALYSIS ESTIMATED THE OVERALL TREATMENT EFFECT AT SMD = -.74 (CI: -.97; -.52, P < .0001), AND AN OVERALL TREATMENT EFFECT AT SMD = -.79 (CI: -1.02; -.56, P < .0001) FOR PAIN-RELATED DISABILITY. DESPITE SOME LIMITATIONS, THERE IS EVIDENCE THAT YOGA MAY BE USEFUL FOR SEVERAL PAIN-ASSOCIATED DISORDERS. MOREOVER, THERE ARE HINTS THAT EVEN SHORT-TERM INTERVENTIONS MIGHT BE EFFECTIVE. NEVERTHELESS, LARGE-SCALE FURTHER STUDIES HAVE TO IDENTIFY WHICH PATIENTS MAY BENEFIT FROM THE RESPECTIVE INTERVENTIONS. PERSPECTIVE: THIS META-ANALYSIS SUGGESTS THAT YOGA IS A USEFUL SUPPLEMENTARY APPROACH WITH MODERATE EFFECT SIZES ON PAIN AND ASSOCIATED DISABILITY. 2012
19 2544 41 YOGA FOR ASTHMA: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: ALTHOUGH YOGA IS FREQUENTLY USED BY PATIENTS WITH ASTHMA, ITS EFFICACY IN ALLEVIATING ASTHMA REMAINS UNCLEAR. OBJECTIVE: TO SYSTEMATICALLY ASSESS AND META-ANALYZE THE AVAILABLE DATA ON EFFICACY AND SAFETY OF YOGA IN ALLEVIATING ASTHMA. METHODS: MEDLINE/PUBMED, SCOPUS, THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, PSYCINFO, CAM-QUEST, CAMBASE, AND INDMED WERE SEARCHED THROUGH JANUARY 2014. RANDOMIZED CONTROLLED TRIALS OF YOGA FOR PATIENTS WITH ASTHMA WERE INCLUDED IF THEY ASSESSED ASTHMA CONTROL, SYMPTOMS, QUALITY OF LIFE, AND/OR PULMONARY FUNCTION. FOR EACH OUTCOME, STANDARDIZED MEAN DIFFERENCES (SMDS) OR RISK RATIOS (RRS) AND 95% CONFIDENCE INTERVALS (CIS) WERE CALCULATED. RISK OF BIAS WAS ASSESSED USING THE COCHRANE TOOL. RESULTS: FOURTEEN RANDOMIZED CONTROLLED TRIALS WITH 824 PATIENTS WERE INCLUDED. EVIDENCE FOR EFFECTS OF YOGA COMPARED WITH USUAL CARE WAS FOUND FOR ASTHMA CONTROL (RR, 10.64; 95% CI, 1.98 TO 57.19; P = .006), ASTHMA SYMPTOMS (SMD, -0.37; 95% CI, -0.55 TO -0.19; P < .001), QUALITY OF LIFE (SMD, 0.86; 95% CI, 0.39 TO 1.33; P < .001), PEAK EXPIRATORY FLOW RATE (SMD, 0.49; 95% CI, 0.32 TO 0.67; P < .001), AND RATIO OF FORCED EXPIRATORY VOLUME IN 1 SECOND TO FORCED VITAL CAPACITY (SMD, 0.50; 95% CI, 0.24 TO 0.75; P < .001); EVIDENCE FOR EFFECTS OF YOGA COMPARED WITH PSYCHOLOGICAL INTERVENTIONS WAS FOUND FOR QUALITY OF LIFE (SMD, 0.61; 95% CI, 0.22 TO 0.99; P = .002) AND PEAK EXPIRATORY FLOW RATE (SMD, 2.87; 95% CI, 0.14 TO 5.60; P = .04). NO EVIDENCE FOR EFFECTS OF YOGA COMPARED WITH SHAM YOGA OR BREATHING EXERCISES WAS REVEALED. NO EFFECT WAS ROBUST AGAINST ALL POTENTIAL SOURCES OF BIAS. YOGA WAS NOT ASSOCIATED WITH SERIOUS ADVERSE EVENTS. CONCLUSION: YOGA CANNOT BE CONSIDERED A ROUTINE INTERVENTION FOR ASTHMATIC PATIENTS AT THIS POINT. IT CAN BE CONSIDERED AN ANCILLARY INTERVENTION OR AN ALTERNATIVE TO BREATHING EXERCISES FOR ASTHMA PATIENTS INTERESTED IN COMPLEMENTARY INTERVENTIONS. 2014
20 608 42 DEVELOPMENT OF A FALLS REDUCTION YOGA PROGRAM FOR OLDER ADULTS-A PILOT STUDY. OBJECTIVES: WORK WITH LOCAL RURAL ORGANIZATIONS TO DEVELOP AN EVIDENCE-BASED HATHA YOGA PROGRAM INTENDED TO IMPROVE CORE STRENGTH AND BALANCE TO REDUCE FALLS RISK. FEASIBILITY DETERMINED BY SUCCESSFUL RECRUITING, INTERVENTION AND EVALUATION OF PARTICIPANTS AND ACCEPTABLE FREQUENCY OF ADVERSE EVENTS. DESIGN: SINGLE-ARM PILOT STUDY. SETTING: RURAL WISCONSIN TOWN OF 4200 PEOPLE. INTERVENTION: EIGHT WEEK YOGA PROGRAM WITH WEEKLY GROUP CLASSES AND HOME YOGA PRACTICE THREE TIMES PER WEEK. MAIN OUTCOME MEASURES: THE PRIMARY OUTCOMES WERE (1) ABILITY TO ENROLL AT LEAST 20 PARTICIPANTS, (2) PARTICIPANT COMPLETION OF INTERVENTION AND POST-INTERVENTION EVALUATION, AND (3) ADVERSE EVENT DESCRIPTION AND FREQUENCY. RESULTS: A CONVENIENCE SAMPLE OF 20 ADULTS OVER AGE 59 WAS ENROLLED AND STARTED THE PROGRAM WITH ONE DROP OUT. PARTICIPANTS ATTENDED A MEAN OF 7.1 (SD 1.47) OF THE 8 CLASSES AND A TOTAL OF 141 OUT OF 160 (88.1%) CLASSES. NINETEEN (95%) COMPLETED FOLLOW UP EVALUATION. PARTICIPANTS REPORTED 4 FALLS IN THE MONTH BEFORE THE INTERVENTION AND 1 FALL THE MONTH BEFORE THE POST-INTERVENTION EVALUATION (P=0.34). NO OTHER SERIOUS ADVERSE EVENTS OCCURRED. CONCLUSIONS: THIS PROJECT SUGGESTS AN EVIDENCE-BASED YOGA PROGRAM DESIGNED TO IMPROVE CORE STRENGTH AND BALANCE IS FEASIBLE AND ACCEPTABLE TO PARTICIPANTS. FUTURE RESEARCH WILL INCLUDE A RANDOMIZED TRIAL TO ASSESS IMPACT ON FALLS RISK. 2017