1 2777 124 YOGA SPINAL FLEXION POSITIONS AND VERTEBRAL COMPRESSION FRACTURE IN OSTEOPENIA OR OSTEOPOROSIS OF SPINE: CASE SERIES. OBJECTIVE: THE OBJECTIVE OF THIS REPORT IS TO RAISE AWARENESS OF THE EFFECT OF STRENUOUS YOGA FLEXION EXERCISES ON OSTEOPENIC OR OSTEOPOROTIC SPINES. WE PREVIOUSLY DESCRIBED SUBJECTS WITH KNOWN OSTEOPOROSIS IN WHOM VERTEBRAL COMPRESSION FRACTURES (VCFS) DEVELOPED AFTER SPINAL FLEXION EXERCISE (SFE) AND RECOMMENDED THAT SFES NOT BE PRESCRIBED IN PATIENTS WITH SPINAL OSTEOPOROSIS. METHODS: THIS REPORT DESCRIBES 3 HEALTHY PERSONS WITH LOW BONE MASS AND YOGA-INDUCED PAIN OR FRACTURE. RESULTS: ALL 3 PATIENTS HAD OSTEOPENIA, WERE IN GOOD HEALTH AND PAIN-FREE, AND HAD STARTED YOGA EXERCISES TO IMPROVE THEIR MUSCULOSKELETAL HEALTH. NEW PAIN AND FRACTURE AREAS OCCURRED AFTER PARTICIPATION IN YOGA FLEXION EXERCISES. CONCLUSIONS: THE DEVELOPMENT OF PAIN AND COMPLICATIONS WITH SOME FLEXION YOGA POSITIONS IN THE PATIENTS WITH OSTEOPENIA LEADS TO CONCERN THAT FRACTURE RISK WOULD INCREASE EVEN FURTHER IN OSTEOPOROSIS. ALTHOUGH EXERCISE HAS BEEN SHOWN TO BE EFFECTIVE FOR IMPROVING BONE MINERAL DENSITY AND DECREASING FRACTURE RISK, OUR SUBJECTS HAD DEVELOPMENT OF VCFS AND NECK AND BACK PAIN WITH YOGA EXERCISES. THIS FINDING SUGGESTS THAT FACTORS OTHER THAN BONE MASS SHOULD BE CONSIDERED FOR EXERCISE COUNSELING IN PATIENTS WITH BONE LOSS. THE INCREASED TORQUE PRESSURE APPLIED TO VERTEBRAL BODIES DURING SFES MAY BE A RISK. EXERCISE IS EFFECTIVE AND IMPORTANT FOR TREATMENT OF OSTEOPENIA AND OSTEOPOROSIS AND SHOULD BE PRESCRIBED FOR PATIENTS WITH VERTEBRAL BONE LOSS. SOME YOGA POSITIONS CAN CONTRIBUTE TO EXTREME STRAIN ON SPINES WITH BONE LOSS. ASSESSMENT OF FRACTURE RISK IN OLDER PERSONS PERFORMING SFES AND OTHER HIGH-IMPACT EXERCISES IS AN IMPORTANT CLINICAL CONSIDERATION.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
2 2359  57 VERTEBRAL COMPRESSION FRACTURES ASSOCIATED WITH YOGA: A CASE SERIES. BACKGROUND: THE IMPORTANCE OF EXERCISE IN SKELETAL HEALTH IS INCREASINGLY RECOGNIZED BY BOTH PATIENTS AND PROVIDERS. HOWEVER, THE SAFETY OF PRESCRIBED OR RECREATIONAL EXERCISE IN AT-RISK POPULATIONS REMAINS UNDER-REPORTED AND UNDER-PUBLICIZED. YOGA HAS GAINED WIDESPREAD POPULARITY DUE TO ITS PHYSICAL AND PSYCHOLOGICAL BENEFITS. WHEN PRACTICED IN A POPULATION AT INCREASED FRACTURE RISK, HOWEVER, SOME YOGA POSES MAY INCREASE FRACTURE RISK, PARTICULARLY AT THE SPINE, RATHER THAN INCREASING BMD AS NOTED IN RECENT POPULAR PRESS REPORTS. CASE REPORT: NINE SUBJECTS (8 WOMEN) WITH A MEDIAN AGE OF 66 YEARS (RANGE 53-87), DEVELOPED VERTEBRAL COMPRESSION FRACTURE (VCF) ONE MONTH TO SIX YEARS AFTER INITIATING YOGA-ASSOCIATED SPINAL FLEXION EXERCISES (SFE). VCF PRESENTED WITH BACK PAIN AND OCCURRED IN THE THORACICSPINE (N.=6), LUMBAR-SPINE (N.=4) AND CERVICAL-SPINE (N.=1). FOUR PATIENTS HAD OSTEOPOROSIS BY BMD CRITERIA PRIOR TO VCF AND 2 HAD OSTEOPENIA (MEDIAN T-SCORE -2.35; RANGE -3.3 TO +2.0). INTERESTINGLY, ALL PATIENTS HAD THEIR LOWEST T-SCORES AT THE SPINE. THREE PATIENTS HAD A HISTORY OF FRAGILITY FRACTURE PRIOR TO THE INDEX VCF. WHILE ONE PATIENT HAD PRIMARY HYPERPARATHYROIDISM AND ANOTHER WAS TREATED WITH HIGH DOSE PREDNISONE, NO OTHER RISK FACTORS FOR BONE LOSS INCLUDING MEDICATIONS OR SECONDARY OSTEOPOROSIS CAUSES WERE IDENTIFIED IN THE OTHER PATIENTS. CLINICAL REHABILITATION IMPACT: THIS STUDY IDENTIFIED PATIENTS IN WHOM INCREASED TORSIONAL AND COMPRESSIVE MECHANICAL LOADING PRESSURES OCCURRING DURING YOGA SFE RESULTED IN DE NOVO VCF. DESPITE THE NEED FOR SELECTIVITY IN YOGA POSES IN POPULATIONS AT INCREASED FRACTURE RISK, BOTH SCIENTIFIC AND MEDIA REPORTS CONTINUE TO ADVERTISE YOGA AS A BONE PROTECTIVE ACTIVITY. ACCORDINGLY, YOGA IS MISCONCEIVED AS A 'ONESIZE-FITS-ALL' PRESCRIPTION. INSTEAD, THE APPROPRIATE SELECTION OF PATIENTS LIKELY TO BENEFIT FROM YOGA MUST BE A CORNERSTONE OF FRACTURE PREVENTION.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
3 2333  26 TWELVE-MINUTE DAILY YOGA REGIMEN REVERSES OSTEOPOROTIC BONE LOSS. OBJECTIVE: ASSESS THE EFFECTIVENESS OF SELECTED YOGA POSTURES IN RAISING BONE MINERAL DENSITY (BMD). METHODS: TEN-YEAR STUDY OF 741 INTERNET-RECRUITED VOLUNTEERS COMPARING PREYOGA BMD CHANGES WITH POSTYOGA BMD CHANGES. OUTCOME MEASURES: DUAL-ENERGY X-RAY ABSORPTIOMETRIC SCANS. OPTIONAL RADIOGRAPHS OF HIPS AND SPINE AND BONE QUALITY STUDY (7 TESLA). RESULTS: BONE MINERAL DENSITY IMPROVED IN SPINE, HIPS, AND FEMUR OF THE 227 MODERATELY AND FULLY COMPLIANT PATIENTS. MONTHLY GAIN IN BMD WAS SIGNIFICANT IN SPINE (0.0029 G/CM(2), P = .005) AND FEMUR (0.00022 G/CM(2), P = .053), BUT IN 1 COHORT, ALTHOUGH MEAN GAIN IN HIP BMD WAS 50%, LARGE INDIVIDUAL DIFFERENCES RAISED THE CONFIDENCE INTERVAL AND THE GAIN WAS NOT SIGNIFICANT FOR TOTAL HIP (0.000357 G/CM(2)). NO YOGA-RELATED SERIOUS INJURIES WERE IMAGED OR REPORTED. BONE QUALITY APPEARED QUALITATIVELY IMPROVED IN YOGA PRACTITIONERS. CONCLUSION: YOGA APPEARS TO RAISE BMD IN THE SPINE AND THE FEMUR SAFELY.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
4 2853  48 YOGA, VERTEBRAL FRACTURES, AND OSTEOPOROSIS: RESEARCH AND RECOMMENDATIONS. BACKGROUND: OSTEOPOROSIS IS CHARACTERIZED BY DECREASED BONE DENSITY THAT LEAVES BONES FRAGILE AND HIGHLY SUSCEPTIBLE TO FRACTURE. GLOBALLY, 1 IN 3 WOMEN AND 1 IN 5 MEN OLDER THAN 50 WILL SUFFER FROM AN OSTEOPOROTIC FRACTURE, AND THOSE INDIVIDUALS WILL EXPERIENCE A CONSIDERABLY HIGHER RISK OF POSTFRACTURE MORTALITY THAN WILL THE GENERAL POPULATION. GENTLE, WEIGHT-BEARING EXERCISES SUCH AS YOGA CAN HELP PREVENT OR CEASE THE PROGRESSION OF OSTEOPOROSIS; HOWEVER, THERE IS INSUFFICIENT DATA REGARDING WHICH YOGA POSES PRESENT THE LEAST RISK AND ARE MOST BENEFICIAL TO INDIVIDUALS WITH REDUCED BONE DENSITY. OBJECTIVES: REVIEW THE EXTANT LITERATURE ABOUT THE RISKS AND BENEFITS TO THE SPINE OF PARTICULAR FORMS OF MOVEMENT AND CONSIDER RECOMMENDATIONS RELATIVE TO THE PRACTICE OF YOGA. METHODS: A REVIEW OF THE PUBMED, MEDLINE, AND COCHRANE DATABASES WAS CONDUCTED THAT IDENTIFIED MANUSCRIPTS PUBLISHED BETWEEN 1966 AND 2011 ABOUT TOPICS RELATED TO OSTEOPOROSIS AND SPINAL MOVEMENT. CONCLUSIONS: MOVEMENTS INVOLVING SPINAL FLEXION CAN INCREASE RISK FOR VERTEBRAL COMPRESSION FRACTURES; HOWEVER, A COMBINATION OF MILD SPINAL FLEXION AND EXTENSION MAY PROVE BENEFICIAL. MODERATE, WEIGHT-BEARING ACTIVITIES THAT STRENGTHEN THE MUSCLES SUPPORTING THE SPINAL COLUMN, PROMOTE BALANCE, IMPROVE POSTURE, AND ENHANCE QUALITY OF LIFE APPEAR TO BE OF GREATEST BENEFIT. AMPLE EVIDENCE SUPPORTS THE IMPORTANCE OF VARIED SPINAL MOVEMENT FOR PRESERVING THE HEALTH AND STRENGTH OF THE VERTEBRAL BODIES. EXERCISE MODIFICATIONS SUITABLE FOR HIGH-RISK INDIVIDUALS MAY BE COUNTERPRODUCTIVE FOR THOSE AT LOW RISK FOR VERTEBRAL FRACTURES. YOGA THERAPISTS ARE CAUTIONED TO NOT APPLY A ONE-SIZE-FITS-ALL APPROACH WHEN WORKING WITH THIS POPULATION. WELL-DESIGNED EMPIRICAL STUDIES ARE NEEDED TO FURTHER OUR UNDERSTANDING OF WHICH YOGA POSES PRESENT THE LEAST RISK AND ARE OF GREATEST BENEFIT TO INDIVIDUALS WITH OSTEOPOROSIS.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
5 1111  28 EFFECTS OF YOGASANAS ON OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN. BACKGROUND: OSTEOPOROSIS IS COMMONLY ENCOUNTERED BY POSTMENOPAUSAL WOMEN. THERE IS AN INCREASED NEED FOR A LOW COST AND EFFICIENT TREATMENT ALTERNATIVE TO ADDRESS THIS POPULATION. AIMS: TO STUDY THE EFFECTS OF INTEGRATED YOGA ON BONE MINERAL DENSITY (BMD) IN POSTMENOPAUSAL WOMEN WITH OSTEOPOROSIS. SETTINGS AND DESIGNS: EXPERIMENTAL PRE-POST STUDY CONDUCTED IN A COMMUNITY SETTING. MATERIALS AND METHODS: 30 FEMALES IN THE AGE GROUP OF 45-62 YEARS SUFFERING FROM POSTMENOPAUSAL OSTEOPOROSIS WITH A DUAL-ENERGY X-RAY ABSORPTIOMETRY (DEXA) SCORE OF </=-2.5 UNDERWENT A 6 MONTHS FULLY SUPERVISED YOGA SESSION. ALL THE PARTICIPANTS COMPLETED THE STUDY. PRETRAINING AND POSTTRAINING BMD WAS CALCULATED. OUTCOME MEASURE: DEXA SCORE AT THE LUMBAR SPINE. STATISTICAL ANALYSIS: THE STUDY WAS STATISTICALLY ANALYZED USING PAIRED T-TEST TO SEE THE SIGNIFICANCE OF PRETRAINING AND POSTTRAINING EFFECTS OF A YOGA SESSION. RESULTS: IMPROVEMENT IN T-SCORE OF DEXA SCAN OF -2.55 +/- 0.25 AT POSTTRAINING AS COMPARED TO A PRETRAINING SCORE OF -2.69 +/- 0.17. CONCLUSIONS: INTEGRATED YOGA IS A SAFE MODE OF PHYSICAL ACTIVITY WHICH INCLUDES WEIGHT BEARING AS WELL AS NOT WEIGHT BEARING ASANAS, PRANAYAMA, AND SURYANAMASKAR, ALL OF WHICH HELPS INDUCE IMPROVEMENT IN BMD IN POSTMENOPAUSAL OSTEOPOROTIC FEMALES.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
6 2722  34 YOGA MIGHT BE AN ALTERNATIVE TRAINING FOR THE QUALITY OF LIFE AND BALANCE IN POSTMENOPAUSAL OSTEOPOROSIS. AIM: OSTEOPOROTIC VERTEBRA AND HIP FRACTURES ARE MAJOR CAUSES OF DYSFUNCTION, DISABILITY, MORTALITY AND IMPAIRED LIFE QUALITY IN THE AGEING POPULATION. IN THE POSTMENOPAUSAL PERIOD, EXERCISES PREVENT RAPID BONE LOSS AND INCREASE MUSCLE STRENGTH, MOBILITY AND FLEXIBILITY THEREBY DECREASING THE RISK OF FALLS AND FRACTURES. YOGA EXERCISES, WHICH HAVE BEEN AN INSEPARABLE PART OF EASTERN CULTURE FOR HUNDREDS OF YEARS, ARE NOW BEING USED IN THE FIELD OF OSTEOPOROSIS REHABILITATION. YOGA HAS A POSITIVE EFFECT ON BALANCE, POSTURE, FLEXIBILITY, AND LIFE QUALITY RESULTING FROM ITS EFFECTS ON BALANCE, STRETCHING, RELAXATION AND STRENGTHENING. THE AIM OF THIS STUDY WAS TO EVALUATE THE EFFECT OF YOGA EXERCISES IN POSTMENOPAUSAL OSTEOPOROTIC WOMEN ON BALANCE AND LIFE QUALITY AND TO COMPARE THE RESULTS WITH A CLASSIC OSTEOPOROSIS EXERCISE PROGRAM. METHODS: TWENTY-SIX POSTMENOPAUSAL OSTEOPOROTIC WOMEN OVER 55 YEARS OF AGE WERE INCLUDED IN THE STUDY. A NEUROMUSCULAR TEST BATTERY AND THE QUALEFFO AS A LIFE QUALITY INDEX WERE USED FOR THE ASSESSMENT OF BALANCE AND LIFE QUALITY, RESPECTIVELY. RESULTS: THE RESULTS SHOWED THAT YOGA EDUCATION HAS A POSITIVE EFFECT ON PAIN, PHYSICAL FUNCTIONS, SOCIAL FUNCTIONS, GENERAL CONCLUSION: IN CONCLUSION, YOGA APPEARS TO BE AN ALTERNATIVE PHYSICAL ACTIVITY FOR THE REHABILITATION OF OSTEOPOROTIC SUBJECTS.	2010	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
7 2393  22 YOGA AND BONE HEALTH. OSTEOPOROSIS IS A PUBLIC HEALTH PROBLEM AFFECTING INDIVIDUALS GLOBALLY. YOGA HAS BEEN FOUND TO PREVENT AND REVERSE BONE LOSS. YOGA MAY RESULT IN BETTER BALANCE, IMPROVED POSTURE, AND GREATER RANGE OF MOTION, STRENGTH, AND COORDINATION, ALL FACTORS THAT ALSO MITIGATE THE RISK OF FALLS AND FRACTURES. A 12-MINUTE, 12-POSE YOGA REGIMEN IS DISCUSSED IN DETAIL. ONCE LEARNED, THE ONGOING USE OF YOGA IS SAFE, WITHOUT COST, AND MAY BE DONE LIFELONG.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
8 1984  44 SOFT TISSUE AND BONY INJURIES ATTRIBUTED TO THE PRACTICE OF YOGA: A BIOMECHANICAL ANALYSIS AND IMPLICATIONS FOR MANAGEMENT. OBJECTIVE: TO ANALYZE INJURIES THAT WERE DIRECTLY ASSOCIATED WITH YOGA PRACTICE AND IDENTIFY SPECIFIC POSES THAT SHOULD BE AVOIDED IN PATIENTS WITH OSTEOPENIA OR OSTEOPOROSIS. PATIENTS AND METHODS: WE RETROSPECTIVELY REVIEWED THE MEDICAL RECORDS OF PATIENTS WITH INJURIES THAT WERE PRIMARILY CAUSED BY YOGA. PATIENTS WERE SEEN FROM JANUARY 1, 2006, THROUGH DECEMBER 31, 2018. INJURIES WERE CATEGORIZED INTO 3 GROUPS: (1) SOFT TISSUE INJURY, (2) AXIAL NONBONY INJURY, AND (3) BONY INJURY. PATIENTS UNDERWENT EVALUATION AND WERE COUNSELED TO MODIFY EXERCISE ACTIVITY. RESULTS: WE IDENTIFIED 89 PATIENTS FOR INCLUSION IN THE STUDY. WITHIN THE SOFT TISSUE GROUP, 66 PATIENTS (74.2%) HAD MECHANICAL MYOFASCIAL PAIN DUE TO OVERUSE. ROTATOR CUFF INJURY WAS SEEN IN 6 (6.7%), AND TROCHANTERIC BURSOPATHY WAS OBSERVED IN 1 (1.1%). IN THE AXIAL GROUP, EXACERBATION OF PAIN IN DEGENERATIVE JOINT DISEASE (46 PATIENTS [51.7%]) AND FACET ARTHROPATHY (N=34 [38.2%]) WERE OBSERVED. RADICULOPATHY WAS SEEN IN 5 PATIENTS (5.6%). WITHIN THE BONY INJURY CATEGORY, KYPHOSCOLIOSIS WAS SEEN ON IMAGING IN 15 PATIENTS (16.9%). SPONDYLOLISTHESIS WAS PRESENT IN 15 PATIENTS (16.9%). ANTERIOR WEDGING WAS SEEN IN 16 (18.0%), AND COMPRESSION FRACTURES WERE PRESENT IN 13 (14.6%). THE POSES THAT WERE MOST COMMONLY IDENTIFIED AS CAUSING THE INJURIES INVOLVED HYPERFLEXION AND HYPEREXTENSION OF THE SPINE. WE CORRELATED THE KINESIOLOGIC EFFECT OF SUCH EXERCISES ON SPECIFIC MUSCULOSKELETAL STRUCTURES. CONCLUSION: YOGA POTENTIALLY HAS MANY BENEFITS, BUT CARE MUST BE TAKEN WHEN PERFORMING POSITIONS WITH EXTREME SPINAL FLEXION AND EXTENSION. PATIENTS WITH OSTEOPENIA OR OSTEOPOROSIS MAY HAVE HIGHER RISK OF COMPRESSION FRACTURES OR DEFORMITIES AND WOULD BENEFIT FROM AVOIDING EXTREME SPINAL FLEXION. PHYSICIANS SHOULD CONSIDER THIS RISK WHEN DISCUSSING YOGA AS EXERCISE.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
9  914  35 EFFECTIVENESS OF PILATES AND YOGA TO IMPROVE BONE DENSITY IN ADULT WOMEN: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: THE AGEING POPULATION BRINGS ABOUT THE APPEARANCE OF AGE-RELATED HEALTH DISORDERS, SUCH AS OSTEOPOROSIS OR OSTEOPENIA. THESE DISORDERS ARE ASSOCIATED WITH FRAGILITY FRACTURES. THE IMPACT IS GREATER AMONG POSTMENOPAUSAL WOMEN DUE TO AN ACCELERATION OF BONE MINERAL DENSITY (BMD) LOSS. OBJECTIVE: TO ESTIMATE THE EFFECTIVENESS OF PILATES OR YOGA ON BMD IN ADULT WOMEN. METHODS: FIVE ELECTRONICS DATABASES WERE SEARCHED UP TO APRIL 2021. RANDOMIZED CONTROLLED TRIALS (RCTS), NON-RCTS AND PRE-POST STUDIES WERE INCLUDED. THE MAIN OUTCOME WAS BMD. RISK OF BIAS WAS EVALUATED USING THE COCHRANE RISK OF BIAS TOOL. A RANDOM EFFECTS MODEL WAS USED TO POOL DATA FROM PRIMARY STUDIES. SUBGROUP ANALYSES BASED ON THE TYPE OF EXERCISE WERE CONDUCTED. RESULTS: ELEVEN STUDIES INCLUDING 591 PARTICIPANTS AGED BETWEEN 45 AND 78 YEARS WERE INCLUDED. THE MEAN LENGTH OF THE INTERVENTIONS RANGED FROM 12 TO 32 WEEKS, AND TWO STUDIES WERE PERFORMED FOR A PERIOD OF AT LEAST ONE YEAR. THE POOLED EFFECT SIZE FOR THE EFFECT OF THE INTERVENTION (PILATES/YOGA) VS THE CONTROL GROUP WAS 0.07 (95% CONFIDENCE INTERVAL [CI]: -0.05 TO 0.19; I2 = 0.0%), AND 0.10 (95% CI: 0.01 TO 0.18; I2 = 18.4%) FOR THE SECONDARY ANALYSIS OF THE PRE-POST INTERVENTION. CONCLUSIONS: DESPITE OF THE NON-SIGNIFICANT RESULTS, THE BMD MAINTENANCE IN THE POSTMENOPAUSAL POPULATION, WHEN BMD DETRIMENTAL IS EXPECTED, COULD BE UNDERSTOOD AS A POSITIVE RESULT ADDED TO THE BENEFICIAL IMPACT OF PILATES-YOGA IN MULTIPLE FRACTURE RISK FACTORS, INCLUDING BUT NOT LIMITED TO, STRENGTH AND BALANCE.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
10 2015  31 SUGGESTIONS FOR ADAPTING YOGA TO THE NEEDS OF OLDER ADULTS WITH OSTEOPOROSIS. BACKGROUND: EXERCISE SUCH AS YOGA MAY HAVE HEALTH BENEFITS FOR OLDER ADULTS WITH OSTEOPOROSIS, BUT WITHOUT ATTENTION TO SAFE MOVEMENT YOGA CAN ALSO INCREASE THE RISK FOR INJURY. OBJECTIVE: THE CURRENT ARTICLE PROVIDES SUGGESTIONS FOR HOW TO ADAPT YOGA TO THE NEEDS OF OLDER ADULTS WITH OSTEOPOROSIS. SUGGESTIONS: A GENERAL GUIDELINES FOR EXERCISE IS THAT OLDER ADULTS WITH OSTEOPOROSIS SHOULD PARTICIPATE IN A MULTICOMPONENT EXERCISE PROGRAM, INCLUDING RESISTANCE AND BALANCE TRAINING. CONTRAINDICATED MOVEMENTS INCLUDE END-RANGE FLEXION/EXTENSION/ROTATION OF THE SPINE AND INTERNAL/EXTERNAL ROTATION OF THE HIP. YOGA POSTURES THAT SHOULD BE ENCOURAGED INCLUDE POSTURES EMPHASIZING SPINAL ALIGNMENT AND EXTENSION TO MID-RANGE IN STANDING AND ON THE FLOOR. OVERARCHING CONSIDERATIONS FOR PARTICIPATION IN YOGA ARE THAT CLASSES SHOULD BE DESIGNED FOR HIGHER-RISK OLDER ADULTS, LED BY AN INSTRUCTOR WHO HAS HAD PROPER TRAINING WITH INDIVIDUALS WITH OSTEOPOROSIS, SHOULD BE A NONCOMPETITIVE ENVIRONMENT, AND SHOULD GIVE ATTENTION TO WHICH POSTURES ARE SAFE AND HOW TO TRANSITION SAFELY.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
11   79  21 A LOW-ENERGY FEMORAL SHAFT FRACTURE FROM PERFORMING A YOGA POSTURE. THE FEMORAL SHAFT IS RARELY THE SITE OF A LOW-ENERGY FRACTURE IN A HEALTHY INDIVIDUAL. THE VAST MAJORITY OF THESE FRACTURES ARE DUE TO MAJOR TRAUMA SUCH AS MOTOR VEHICLE ACCIDENTS. ALTHOUGH LOW-ENERGY FEMORAL SHAFT FRACTURES DO OCCUR, THEY ARE TYPICALLY IN PATIENTS WITH OSTEOPOROTIC BONE, OR PROSTHESIS RELATED. IN THIS CASE REPORT, WE PRESENT A MAN IN HIS LATE 30S WHO WAS PRACTISING A SPECIFIC YOGA STANCE WHEN HE EXPERIENCED A FEMORAL SHAFT FRACTURE.	2015	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
12  825  38 EFFECT OF YOGA ON HEALTH-RELATED OUTCOMES IN PEOPLE AT RISK OF FRACTURES: A SYSTEMATIC REVIEW. WE SUMMARIZED THE EFFECTS OF YOGA ON HEALTH-RELATED OUTCOMES AND ADVERSE EVENTS IN MEN AND POSTMENOPAUSAL WOMEN >/=50 YEARS-OLD AT INCREASED RISK OF FRACTURE, TO INFORM THE UPDATED OSTEOPOROSIS CANADA CLINICAL PRACTICE GUIDELINES. SIX DATABASES WERE SEARCHED FOR OBSERVATIONAL STUDIES, RANDOMIZED CONTROLLED TRIALS AND CASE SERIES. CERTAINTY OF EVIDENCE WAS ASSESSED USING THE GRADING OF RECOMMENDATIONS, ASSESSMENT, DEVELOPMENT AND EVALUATION HANDBOOK. NINE STUDIES WERE INCLUDED AND REPORTED USING NARRATIVE SYNTHESES DUE TO THE LIMITED AVAILABLE EVIDENCE. OVERALL, THE AVAILABLE EVIDENCE WAS OF VERY LOW CERTAINTY. THERE WAS NO EFFECT OF YOGA ON HEALTH-RELATED QUALITY OF LIFE IN RANDOMIZED TRIALS. EFFECTS ON OTHER HEALTH-RELATED OUTCOMES WERE MIXED OR NOT AVAILABLE IN THE LITERATURE. FIVE STUDIES REPORTED NO ADVERSE EVENTS DIRECTLY RELATED TO THE STUDY INTERVENTION, AND 2 STUDIES DID NOT REPORT WHETHER ADVERSE EVENTS OCCURRED. HOWEVER, 2 CASE SERIES REPORTED VERTEBRAL FRACTURES RELATED TO YOGA PARTICIPATION, POSSIBLY DUE TO EXCESSIVE SPINAL FLEXION. DUE TO THE LIMITED AND VERY LOW CERTAINTY EVIDENCE, GUIDELINE DEVELOPERS WILL NEED TO DRAW INDIRECT EVIDENCE FROM YOGA STUDIES AMONG MIDDLE AGED OR OLDER ADULTS THAT ARE NOT AT FRACTURE RISK. PROSPERO: CRD42019124898. NOVELTY: EVIDENCE IN GENERAL WAS OF VERY LOW CERTAINTY. YOGA HAD NO EFFECT ON HEALTH-RELATED QUALITY OF LIFE IN RANDOMIZED TRIALS. EVIDENCE WAS MIXED OR UNAVAILABLE FOR OTHER OUTCOMES. CASE STUDIES REPORTED YOGA POSES INVOLVING SPINAL FLEXION COINCIDED WITH INCIDENTS OF VERTEBRAL COMPRESSION FRACTURE AMONG OLDER ADULTS WITH INCREASED FRACTURE RISK.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
13 1623  40 MINDFULNESS AND MODIFIED MEDICAL YOGA AS INTERVENTION IN OLDER WOMEN WITH OSTEOPOROTIC VERTEBRAL FRACTURE. BACKGROUND: PEOPLE WITH OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES (VCFS) HAVE DECREASED HEALTH-RELATED QUALITY OF LIFE (HRQOL). YOGA AND MINDFULNESS ARE METHODS THAT CAN PROMOTE WELL-BEING. OBJECTIVE: THE AIM OF THIS ARTICLE WAS TO EXPLORE THE EFFECT OF MINDFULNESS AND MODIFIED MEDICAL YOGA ON HRQOL, STRESS, SLEEP, AND PAIN IN PEOPLE 60 YEARS OR OLDER WITH A DIAGNOSED OSTEOPOROTIC VCF. DESIGN: THE SCHOOL OF OSTEOPOROSIS IN LINKOPING (SOL) IS A PILOT STUDY WITH RANDOMIZED GROUPS. MATERIALS AND METHODS: THE SOL-STUDY WAS SCHEDULED TO ONCE A WEEK FOR 10 WEEKS. TEN PEOPLE WERE RANDOMIZED TO A THEORY (T) GROUP, AND TEN PEOPLE WERE RANDOMIZED TO A THEORY AND MINDFULNESS/MEDICAL YOGA (MMY) GROUP. THE EDUCATIONAL SESSIONS LASTED 60 MIN AND WERE SIMILAR FOR THE GROUPS, BUT THEY TOOK PLACE AT DIFFERENT FACILITIES. AN EXPERIENCED PHYSIOTHERAPIST SUPERVISED THE MMY SESSIONS FOR 60 MIN. SLEEP QUALITY AND PRESENT STRESS EXPERIENCE WERE MEASURED ON A SYMMETRIC LIKERT SCALE. THE NUMERIC RATING SCALE WAS USED FOR PAIN, AND EQ-5D, RAND-36, AND QUALEFFO-41 WERE USED FOR HRQOL. THE PATIENT ENABLEMENT INSTRUMENT (PEI) WAS USED TO REFLECT HOW THE PARTICIPANTS COPED WITH THEIR ILLNESS. RESULTS: EIGHT WOMEN IN THE MMY-GROUP AND SEVEN WOMEN IN THE T-GROUP COMPLETED THE SOL STUDY INTERVENTIONS. THE ADHERENCE TO THE INTERVENTION PROGRAM WAS 89% IN THE MMY-GROUP AND 87% IN THE T-GROUP. THERE WAS NO ADVERSE CONSEQUENCE OF THE MMY TRAINING. AFTER THE 10-WEEK INTERVENTION PERIOD, SLEEP QUALITY (P = 0.018) AND PRESENT STRESS (P = 0.043), BUT NOT PERCEIVED PAIN WERE IMPROVED IN THE MMY-GROUP. THE SOCIAL FUNCTION (SF) DOMAIN WAS IMPROVED IN THE MMY-GROUP THAT WAS MEASURED BY BOTH RAND-36 (P = 0.028) AND QUALEFFO-41 (P = 0.012). THERE WAS A TREND TOWARD A BETTER PEI-SCORE IN THE MMY-GROUP COMPARED WITH THE T-GROUP POSTINTERVENTION (P = 0.089). CONCLUSION: THIS ARTICLE SUGGESTS THAT MINDFULNESS AND MODIFIED MEDICAL YOGA SUPERVISED BY A SKILLED PHYSIOTHERAPIST MAY BE A FEASIBLE WAY TO IMPROVE SF, SLEEP, AND STRESS IN OLDER WOMEN WITH OSTEOPOROTIC VCFS.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
14 1290  29 GROUND REACTION FORCES GENERATED BY TWENTY-EIGHT HATHA YOGA POSTURES. ADHERENTS CLAIM MANY BENEFITS FROM THE PRACTICE OF YOGA, INCLUDING PROMOTION OF BONE HEALTH AND PREVENTION OF OSTEOPOROSIS. HOWEVER, NO KNOWN STUDIES HAVE INVESTIGATED WHETHER YOGA ENHANCES BONE MINERAL DENSITY. FURTHERMORE, NONE HAVE ESTIMATED REACTION FORCES APPLIED BY YOGA PRACTITIONERS. THE PURPOSE OF THIS STUDY WAS TO COLLECT GROUND REACTION FORCE (GRF) DATA ON A VARIETY OF HATHA YOGA POSTURES THAT WOULD COMMONLY BE PRACTICED IN FITNESS CENTERS OR PRIVATE STUDIOS. TWELVE FEMALE AND EIGHT MALE VOLUNTEERS PERFORMED A SEQUENCE OF 28 HATHA YOGA POSTURES WHILE GRF DATA WERE COLLECTED WITH AN AMTI STRAIN-GAUGE FORCE PLATFORM. THE SEQUENCE WAS REPEATED SIX TIMES BY EACH STUDY SUBJECT. FOUR DEPENDENT VARIABLES WERE STUDIED: PEAK VERTICAL GRF, MEAN VERTICAL GRF, PEAK RESULTANT GRF, AND MEAN RESULTANT GRF. UNIVARIATE ANALYSIS WAS USED TO IDENTIFY MEAN VALUES AND STANDARD DEVIATIONS FOR THE DEPENDENT VARIABLES. PEAK VERTICAL AND RESULTANT VALUES OF EACH POSTURE WERE SIMILAR FOR ALL SUBJECTS, AND STANDARD DEVIATIONS WERE SMALL. SIMILARLY, MEAN VERTICAL AND RESULTANT VALUES WERE SIMILAR FOR ALL SUBJECTS. THIS 28 POSTURE YOGA SEQUENCE PRODUCED LOW IMPACT GRF APPLIED TO UPPER AND LOWER EXTREMITIES. FURTHER RESEARCH IS WARRANTED TO DETERMINE WHETHER THESE FORCES ARE SUFFICIENT TO PROMOTE OSTEOGENESIS OR MAINTAIN CURRENT BONE HEALTH IN YOGA PRACTITIONERS.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
15 1687  18 OSTEOPATHY AND (HATHA) YOGA. DIFFERENCES AND POINTS OF CONTACT BETWEEN OSTEOPATHY AND YOGA AS REGARDS THEIR HISTORY AND PRACTICAL APPLICATION ARE OUTLINED. BOTH SEEK TO PROMOTE HEALING. YOGA SEEKS THE ATTAINMENT OF CONSCIOUSNESS; OSTEOPATHY AIMS FOR PROVIDING SUPPORT TO HEALTH. ONE FUNDAMENTAL DIFFERENCE IS THE PERSONAL INVOLVEMENT OF THE INDIVIDUAL IN YOGA. TEACHER AND STUDENT ALIKE ARE CHALLENGED TO RE-EXAMINE THE ATTITUDES OF MIND THEY HAVE ADOPTED TOWARD THEIR LIVES. OSTEOPATHY GENERALLY INVOLVES A RELATIVELY PASSIVE PATIENT WHILE THE OSTEOPATH IS ACTIVE IN PROVIDING TREATMENT. PRACTICAL EXAMPLES ARE USED TO HIGHLIGHT POINTS OF CONTACT BETWEEN YOGA AND OSTEOPATHY. THE TEXT INCLUDES A DISCUSSION OF THE IMPORTANCE OF PHYSICALITY AND A DESCRIPTION OF WAYS OF USING IT IN HEALING PROCESSES. FURTHERMORE, PROCESSES OF ATTAINING CONSCIOUSNESS ARE OUTLINED. POSSIBLE REDUCTIONIST MISCONCEPTIONS IN YOGA AND OSTEOPATHY ARE ALSO POINTED OUT. FUNDAMENTAL ATTITUDES AND FOCUS THAT COMPLEMENT EACH OTHER ARE PRESENTED, TAKING THE CONCEPT OF STILLNESS AS A PARTICULAR EXAMPLE.	2011	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
16  968  40 EFFECTS OF AN 8-MONTH ASHTANGA-BASED YOGA INTERVENTION ON BONE METABOLISM IN MIDDLE-AGED PREMENOPAUSAL WOMEN: A RANDOMIZED CONTROLLED STUDY. ALTHOUGH YOGA HAS THE POTENTIAL TO BE AN ALTERNATIVE PHYSICAL ACTIVITY TO ENHANCE BONE HEALTH, THERE IS A LACK OF HIGH QUALITY EVIDENCE FOR THIS TYPE OF INTERVENTION. THE PURPOSE OF THIS RANDOMIZED CONTROLLED TRIAL WAS TO EXAMINE THE EFFECTS OF A PROGRESSIVE 8-MONTH ASHTANGA-BASED YOGA PROGRAM ON BONE TURNOVER MARKERS (BTM), AREAL BONE MINERAL DENSITY (ABMD) AND VOLUMETRIC BONE CHARACTERISTICS IN PREMENOPAUSAL WOMEN. THIRTY-FOUR PREMENOPAUSAL WOMEN (35-50 YEARS) WERE RANDOMLY ASSIGNED EITHER TO A YOGA GROUP (YE, N = 16) OR A CONTROL GROUP (CON, N = 18). PARTICIPANTS IN YE GROUP PERFORMED 60 MINUTES OF AN ASHTANGA-BASED YOGA SERIES 2 TIMES/WEEK WITH ONE DAY BETWEEN SESSIONS FOR 8 MONTHS, AND THE SESSION INTENSITY WAS PROGRESSIVELY INCREASED BY ADDING THE NUMBER OF SUN SALUTATIONS (SS). PARTICIPANTS IN CON WERE ENCOURAGED TO MAINTAIN THEIR NORMAL DAILY LIFESTYLES MONITORED BY THE BONE SPECIFIC PHYSICAL ACTIVITY QUESTIONNAIRE (BPAQ) AT 2 MONTH INTERVALS FOR 8 MONTHS. BODY COMPOSITION WAS MEASURED BY DUAL ENERGY X-RAY ABSORPTIOMETRY (DXA). BONE FORMATION (BONE ALKALINE PHOSPHATASE, BONE ALP) AND BONE RESORPTION (TARTRATE-RESISTANT ACID PHOSPHATASE-5B, TRAP5B) MARKERS WERE ASSESSED AT BASELINE AND AFTER 8 MONTHS. ABMD OF TOTAL BODY, LUMBAR SPINE AND DUAL PROXIMAL FEMUR AND TIBIA BONE CHARACTERISTICS WERE MEASURED USING DXA AND PERIPHERAL QUANTITATIVE COMPUTED TOMOGRAPHY (PQCT), RESPECTIVELY. WE FOUND THAT THE SERUM BONE ALP CONCENTRATIONS WERE MAINTAINED IN YE, BUT SIGNIFICANTLY (P = 0.005) DECREASED IN CON AFTER THE 8 MONTH INTERVENTION, AND THERE WERE SIGNIFICANT (P = 0.002) GROUP DIFFERENCES IN BONE ALP PERCENT CHANGES (YE 9.1 +/- 4.0% VS. CON -7.1 +/- 2.3%). NO CHANGES IN TRAP5B WERE FOUND IN EITHER GROUP. THE 8-MONTH YOGA PROGRAM DID NOT INCREASE ABMD OR TIBIA BONE STRENGTH VARIABLES. BODY COMPOSITION RESULTS SHOWED NO CHANGES IN WEIGHT, FAT MASS, OR % FAT, BUT SMALL SIGNIFICANT INCREASES IN BONE FREE LEAN BODY MASS OCCURRED IN BOTH GROUPS. THE FINDINGS OF THIS STUDY SUGGEST THAT REGULAR LONG-TERM ASHTANGA YOGA HAD A SMALL POSITIVE EFFECT ON BONE FORMATION BUT DID NOT ALTER ABMD OR TIBIA BONE CHARACTERISTICS IN PREMENOPAUSAL WOMEN. KEY POINTSREGULAR LONG-TERM ASHTANGA-BASED YOGA PROGRAM HAD A SMALL POSITIVE EFFECT ON BONE FORMATION, BUT NO EFFECTS WERE FOUND ON BONE RESORPTION.NONE OF THE BONE DENSITY OR GEOMETRY VARIABLES WERE CHANGED BY THE 8-MONTH ASHTANGA-BASED YOGA INTERVENTION.FUTURE YOGA INTERVENTIONS SHOULD FOCUS ON LONGER DURATION AND GREATER FREQUENCY TO ELICIT IMPROVEMENTS IN BONE MINERAL DENSITY.	2015	

17 1655  23 MUSCULOSKELETAL INJURIES IN YOGA. WHILE YOGA HAS BEEN WIDELY STUDIED FOR ITS BENEFITS TO MANY HEALTH CONDITIONS, LITTLE RESEARCH HAS BEEN PERFORMED ON THE NATURE OF MUSCULOSKELETAL INJURIES OCCURRING DURING YOGA PRACTICE. YOGA IS CONSIDERED TO BE GENERALLY SAFE, HOWEVER, INJURY CAN OCCUR IN NEARLY ANY PART OF THE BODY-ESPECIALLY THE NECK, SHOULDERS, LUMBAR SPINE, HAMSTRINGS, AND KNEES. AS BROAD INTEREST IN YOGA GROWS, SO WILL THE NUMBER OF PATIENTS PRESENTING WITH YOGA-RELATED INJURIES. IN THIS LITERATURE REVIEW, THE PREVALENCE, TYPES OF INJURIES, FORMS OF YOGA RELATED WITH INJURY, SPECIFIC POSES (ASANAS) ASSOCIATED WITH INJURY, AND PREVENTIVE MEASURES ARE DISCUSSED IN ORDER TO FAMILIARIZE PRACTITIONERS WITH YOGA-RELATED INJURIES.	2018	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
18 2033  29 TEACHING YOGA TO SENIORS: ESSENTIAL CONSIDERATIONS TO ENHANCE SAFETY AND REDUCE RISK IN A UNIQUELY VULNERABLE AGE GROUP. BACKGROUND: SENIORS AGE 65 AND OLDER REPRESENT THE FASTEST-GROWING SECTOR OF THE POPULATION AND, LIKE MANY AMERICANS, ARE INCREASINGLY DRAWN TO YOGA. THIS PRESENTS BOTH AN EXTRAORDINARY OPPORTUNITY AND A SERIOUS CHALLENGE FOR YOGA INSTRUCTORS WHO MUST BE BOTH A RESOURCE AND GUARDIANS OF SAFETY FOR THIS UNIQUELY VULNERABLE GROUP. A TYPICAL CLASS OF SENIORS IS LIKELY TO REPRESENT THE MOST DIVERSE MIX OF ABILITIES OF ANY AGE GROUP. WHILE SOME MAY BE EXCEEDINGLY HEALTHY, MOST FIT THE PROFILE OF THE AVERAGE OLDER ADULT IN AMERICA, 80% OF WHOM HAVE AT LEAST ONE CHRONIC HEALTH CONDITION AND 50% OF WHOM HAVE AT LEAST TWO. OBJECTIVES: THIS ARTICLE DISCUSSES THE THERAPEUTIC YOGA FOR SENIORS PROGRAM, OFFERED SINCE 2007 AT DUKE INTEGRATIVE MEDICINE TO FILL A CRITICAL NEED TO HELP YOGA INSTRUCTORS WORK SAFELY AND EFFECTIVELY WITH THE INCREASING NUMBER OF OLDER ADULTS COMING TO YOGA CLASSES, AND EXPLORES THREE AREAS THAT POSE THE GREATEST RISK OF COMPROMISE TO OLDER ADULT STUDENTS: SEDENTARY LIFESTYLE, CARDIOVASCULAR DISEASE, AND OSTEOPOROSIS. TO PROVIDE A SKILLFUL FRAMEWORK FOR TEACHING YOGA TO SENIORS, WE HAVE DEVELOPED SPECIFIC PRINCIPLES OF PRACTICE THAT INTEGRATE THE KNOWLEDGE GAINED FROM WESTERN MEDICINE WITH YOGIC TEACHINGS.	2010	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
19  292  29 ADVERSE EVENTS ASSOCIATED WITH YOGA: A SYSTEMATIC REVIEW OF PUBLISHED CASE REPORTS AND CASE SERIES. WHILE YOGA IS GAINING INCREASED POPULARITY IN NORTH AMERICA AND EUROPE, ITS SAFETY HAS BEEN QUESTIONED IN THE LAY PRESS. THE AIM OF THIS SYSTEMATIC REVIEW WAS TO ASSESS PUBLISHED CASE REPORTS AND CASE SERIES ON ADVERSE EVENTS ASSOCIATED WITH YOGA. MEDLINE/PUBMED, SCOPUS, CAMBASE, INDMED AND THE CASES DATABASE WERE SCREENED THROUGH FEBRUARY 2013; AND 35 CASE REPORTS AND 2 CASE SERIES REPORTING A TOTAL OF 76 CASES WERE INCLUDED. TEN CASES HAD MEDICAL PRECONDITIONS, MAINLY GLAUCOMA AND OSTEOPENIA. PRANAYAMA, HATHA YOGA, AND BIKRAM YOGA WERE THE MOST COMMON YOGA PRACTICES; HEADSTAND, SHOULDER STAND, LOTUS POSITION, AND FORCEFUL BREATHING WERE THE MOST COMMON YOGA POSTURES AND BREATHING TECHNIQUES CITED. TWENTY-SEVEN ADVERSE EVENTS (35.5%) AFFECTED THE MUSCULOSKELETAL SYSTEM; 14 (18.4%) THE NERVOUS SYSTEM; AND 9 (11.8%) THE EYES. FIFTEEN CASES (19.7%) REACHED FULL RECOVERY; 9 CASES (11.3%) PARTIAL RECOVERY; 1 CASE (1.3%) NO RECOVERY; AND 1 CASE (1.3%) DIED. AS ANY OTHER PHYSICAL OR MENTAL PRACTICE, YOGA SHOULD BE PRACTICED CAREFULLY UNDER THE GUIDANCE OF A QUALIFIED INSTRUCTOR. BEGINNERS SHOULD AVOID EXTREME PRACTICES SUCH AS HEADSTAND, LOTUS POSITION AND FORCEFUL BREATHING. INDIVIDUALS WITH MEDICAL PRECONDITIONS SHOULD WORK WITH THEIR PHYSICIAN AND YOGA TEACHER TO APPROPRIATELY ADAPT POSTURES; PATIENTS WITH GLAUCOMA SHOULD AVOID INVERSIONS AND PATIENTS WITH COMPROMISED BONE SHOULD AVOID FORCEFUL YOGA PRACTICES.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
20 1547  21 LATE TOTAL HIP ARTHROPLASTY DISLOCATION DUE TO YOGA. YOGA HAS BECOME A POPULAR FORM OF EXERCISE, RECREATION, AND MEDITATION FOR ADULTS IN THE UNITED STATES. AS THE POPULARITY OF BOTH YOGA AND THE INCIDENCE OF HIP REPLACEMENTS HAVE BOTH COINCIDENTALLY INCREASED OVER THE LAST 2 DECADES, WE IMAGINE THAT THE NUMBER OF TOTAL HIP REPLACEMENT PATIENTS PARTAKING IN THE PRACTICE OF YOGA HAS ALSO INCREASED. THERE ARE NO CLEAR GUIDELINES AVAILABLE FOR YOGA PRACTICE FOLLOWING HIP REPLACEMENT. TO DATE, THERE HAVE BEEN NO PUBLISHED REPORTS OF PROSTHETIC HIP DISLOCATIONS DURING YOGA. WE PRESENT 2 CASES OF LATE TOTAL HIP DISLOCATIONS DURING YOGA AND PROVIDE A REVIEW OF THE AVAILABLE ORTHOPAEDIC LITERATURE AND OUR RECOMMENDATIONS ON PATIENT RESTRICTIONS AND EDUCATION WITH RESPECT TO PRACTICING YOGA AFTER A HIP REPLACEMENT.	2018