1 2636 319 YOGA FOR TREATING URINARY INCONTINENCE IN WOMEN. BACKGROUND: URINARY INCONTINENCE IN WOMEN IS ASSOCIATED WITH POOR QUALITY OF LIFE AND DIFFICULTIES IN SOCIAL, PSYCHOLOGICAL AND SEXUAL FUNCTIONING. THE CONDITION MAY AFFECT UP TO 15% OF MIDDLE-AGED OR OLDER WOMEN IN THE GENERAL POPULATION. CONSERVATIVE TREATMENTS SUCH AS LIFESTYLE INTERVENTIONS, BLADDER TRAINING AND PELVIC FLOOR MUSCLE TRAINING (USED EITHER ALONE OR IN COMBINATION WITH OTHER INTERVENTIONS) ARE THE INITIAL APPROACHES TO THE MANAGEMENT OF URINARY INCONTINENCE. MANY WOMEN ARE INTERESTED IN ADDITIONAL TREATMENTS SUCH AS YOGA, A SYSTEM OF PHILOSOPHY, LIFESTYLE AND PHYSICAL PRACTICE THAT ORIGINATED IN ANCIENT INDIA. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA FOR TREATING URINARY INCONTINENCE IN WOMEN. SEARCH METHODS: WE SEARCHED THE COCHRANE INCONTINENCE AND COCHRANE COMPLEMENTARY MEDICINE SPECIALISED REGISTERS. WE SEARCHED THE WORLD HEALTH ORGANIZATION INTERNATIONAL CLINICAL TRIALS REGISTRY PLATFORM (WHO ICTRP) AND CLINICALTRIALS.GOV TO IDENTIFY ANY ONGOING OR UNPUBLISHED STUDIES. WE HANDSEARCHED PROCEEDINGS OF THE INTERNATIONAL CONGRESS ON COMPLEMENTARY MEDICINE RESEARCH AND THE EUROPEAN CONGRESS FOR INTEGRATIVE MEDICINE. WE SEARCHED THE NHS ECONOMIC EVALUATION DATABASE FOR ECONOMIC STUDIES, AND SUPPLEMENTED THIS SEARCH WITH SEARCHES FOR ECONOMICS STUDIES IN MEDLINE AND EMBASE FROM 2015 ONWARDS. DATABASE SEARCHES ARE UP-TO-DATE AS OF 21 JUNE 2018. SELECTION CRITERIA: RANDOMISED CONTROLLED TRIALS IN WOMEN DIAGNOSED WITH URINARY INCONTINENCE IN WHICH ONE GROUP WAS ALLOCATED TO TREATMENT WITH YOGA. DATA COLLECTION AND ANALYSIS: TWO REVIEW AUTHORS INDEPENDENTLY SCREENED TITLES AND ABSTRACTS OF ALL RETRIEVED ARTICLES, SELECTED STUDIES FOR INCLUSION, EXTRACTED DATA, ASSESSED RISK OF BIAS AND EVALUATED THE CERTAINTY OF THE EVIDENCE FOR EACH REPORTED OUTCOME. ANY DISAGREEMENTS WERE RESOLVED BY CONSENSUS. WE PLANNED TO COMBINE CLINICALLY COMPARABLE STUDIES IN REVIEW MANAGER 5 USING RANDOM-EFFECTS META-ANALYSIS AND TO CARRY OUT SENSITIVITY AND SUBGROUP ANALYSES. WE PLANNED TO CREATE A TABLE LISTING ECONOMIC STUDIES ON YOGA FOR INCONTINENCE BUT NOT CARRY OUT ANY ANALYSES ON THESE STUDIES. MAIN RESULTS: WE INCLUDED TWO STUDIES (INVOLVING A TOTAL OF 49 WOMEN). EACH STUDY COMPARED YOGA TO A DIFFERENT COMPARATOR, THEREFORE WE WERE UNABLE TO COMBINE THE DATA IN A META-ANALYSIS. A THIRD STUDY THAT HAS BEEN COMPLETED BUT NOT YET FULLY REPORTED IS AWAITING ASSESSMENT.ONE INCLUDED STUDY WAS A SIX-WEEK STUDY COMPARING YOGA TO A WAITING LIST IN 19 WOMEN WITH EITHER URGENCY URINARY INCONTINENCE OR STRESS URINARY INCONTINENCE. WE JUDGED THE CERTAINTY OF THE EVIDENCE FOR ALL REPORTED OUTCOMES AS VERY LOW DUE TO PERFORMANCE BIAS, DETECTION BIAS, AND IMPRECISION. THE NUMBER OF WOMEN REPORTING CURE WAS NOT REPORTED. WE ARE UNCERTAIN WHETHER YOGA RESULTS IN SATISFACTION WITH CURE OR IMPROVEMENT OF INCONTINENCE (RISK RATIO (RR) 6.33, 95% CONFIDENCE INTERVAL (CI) 1.44 TO 27.88; AN INCREASE OF 592 FROM 111 PER 1000, 95% CI 160 TO 1000). WE ARE UNCERTAIN WHETHER THERE IS A DIFFERENCE BETWEEN YOGA AND WAITING LIST IN CONDITION-SPECIFIC QUALITY OF LIFE AS MEASURED ON THE INCONTINENCE IMPACT QUESTIONNAIRE SHORT FORM (MEAN DIFFERENCE (MD) 1.74, 95% CI -33.02 TO 36.50); THE NUMBER OF MICTURITIONS (MD -0.77, 95% CI -2.13 TO 0.59); THE NUMBER OF INCONTINENCE EPISODES (MD -1.57, 95% CI -2.83 TO -0.31); OR THE BOTHERSOMENESS OF INCONTINENCE AS MEASURED ON THE UROGENITAL DISTRESS INVENTORY 6 (MD -0.90, 95% CI -1.46 TO -0.34). THERE WAS NO EVIDENCE OF A DIFFERENCE IN THE NUMBER OF WOMEN WHO EXPERIENCED AT LEAST ONE ADVERSE EVENT (RISK DIFFERENCE 0%, 95% CI -38% TO 38%; NO DIFFERENCE FROM 222 PER 1000, 95% CI 380 FEWER TO 380 MORE).THE SECOND INCLUDED STUDY WAS AN EIGHT-WEEK STUDY IN 30 WOMEN WITH URGENCY URINARY INCONTINENCE THAT COMPARED MINDFULNESS-BASED STRESS REDUCTION (MBSR) TO AN ACTIVE CONTROL INTERVENTION OF YOGA CLASSES. THE STUDY WAS UNBLINDED, AND THERE WAS HIGH ATTRITION FROM BOTH STUDY ARMS FOR ALL OUTCOME ASSESSMENTS. WE JUDGED THE CERTAINTY OF THE EVIDENCE FOR ALL REPORTED OUTCOMES AS VERY LOW DUE TO PERFORMANCE BIAS, ATTRITION BIAS, IMPRECISION AND INDIRECTNESS. THE NUMBER OF WOMEN REPORTING CURE WAS NOT REPORTED. WE ARE UNCERTAIN WHETHER WOMEN IN THE YOGA GROUP WERE LESS LIKELY TO REPORT IMPROVEMENT IN INCONTINENCE AT EIGHT WEEKS COMPARED TO WOMEN IN THE MBSR GROUP (RR 0.09, 95% CI 0.01 TO 1.43; A DECREASE OF 419 FROM 461 PER 1000, 95% CI 5 TO 660). WE ARE UNCERTAIN ABOUT THE EFFECT OF MBSR COMPARED TO YOGA ON REPORTS OF CURE OR IMPROVEMENT IN INCONTINENCE, IMPROVEMENT IN CONDITION-SPECIFIC QUALITY OF LIFE MEASURED ON THE OVERACTIVE BLADDER HEALTH-RELATED QUALITY OF LIFE SCALE, REDUCTION IN INCONTINENCE EPISODES OR REDUCTION IN BOTHERSOMENESS OF INCONTINENCE AS MEASURED ON THE OVERACTIVE BLADDER SYMPTOM AND QUALITY OF LIFE-SHORT FORM AT EIGHT WEEKS. THE STUDY DID NOT REPORT ON ADVERSE EFFECTS. AUTHORS' CONCLUSIONS: WE IDENTIFIED FEW TRIALS ON YOGA FOR INCONTINENCE, AND THE EXISTING TRIALS WERE SMALL AND AT HIGH RISK OF BIAS. IN ADDITION, WE DID NOT FIND ANY STUDIES OF ECONOMIC OUTCOMES RELATED TO YOGA FOR URINARY INCONTINENCE. DUE TO THE LACK OF EVIDENCE TO ANSWER THE REVIEW QUESTION, WE ARE UNCERTAIN WHETHER YOGA IS USEFUL FOR WOMEN WITH URINARY INCONTINENCE. ADDITIONAL, WELL-CONDUCTED TRIALS WITH LARGER SAMPLE SIZES ARE NEEDED. 2019 2 528 70 COMPARISON OF MINDFULNESS-BASED STRESS REDUCTION VERSUS YOGA ON URINARY URGE INCONTINENCE: A RANDOMIZED PILOT STUDY. WITH 6-MONTH AND 1-YEAR FOLLOW-UP VISITS. OBJECTIVES: THE OBJECTIVE OF THIS STUDY IS TO COMPARE THE EFFECTS OF MINDFULNESS-BASED STRESS REDUCTION (MBSR) VERSUS YOGA ON URINARY URGE INCONTINENCE (UI) AT 8 WEEKS, 6 MONTHS, AND 1 YEAR AFTER BEGINNING AN 8-WEEK PROGRAM. MATERIALS AND METHODS: PARTICIPANTS IN THIS PROSPECTIVE RANDOMIZED SINGLE-MASKED PILOT STUDY WERE WOMEN AGED 18 YEARS OR OLDER WITH URGE-PREDOMINANT INCONTINENCE, 5 OR MORE UI EPISODES (UIES) ON A 3-DAY VOIDING DIARY, AND NO RECENT ANTICHOLINERGIC USE. WOMEN WERE RANDOMIZED TO MBSR OR YOGA. THE PRIMARY OUTCOME WAS THE PERCENT CHANGE OF UIE. RESULTS: OF 30 ENROLLEES (15 IN MBSR, 15 IN YOGA), 24 COMPLETED AT LEAST 5 OF 8 SESSIONS (13 IN MBSR AND 11 IN YOGA). TWENTY AND 21 WOMEN COMPLETED THE 6-MONTH AND 12-MONTH FOLLOW-UP VISITS, RESPECTIVELY. AT 8 WEEKS, 6 MONTHS, AND 12 MONTHS, THE MEDIAN PERCENT CHANGE FROM THE BASELINE IN UIE ON THE INTENTION-TO-TREAT ANALYSIS WAS GREATER FOR THE MBSR GROUP (-55.6, -71.4, AND -66.7, RESPECTIVELY) COMPARED WITH THAT FOR THE YOGA GROUP (-33.3, -11.8, AND -16.7, RESPECTIVELY), WITH P VALUES RANGING FROM 0.01 TO 0.08. ON INTENTION-TO-TREAT ANALYSIS, THE MEDIAN PERCENT CHANGE IN THE OVERACTIVE BLADDER SYMPTOM AND QUALITY OF LIFE-SHORT FORM AND THE HEALTH-RELATED QUALITY OF LIFE WAS GREATER AT EACH TIME POINT FOR MBSR THAN FOR YOGA BUT WAS STATISTICALLY SIGNIFICANT ONLY AT 8 WEEKS (P = 0.003 AND 0.02, RESPECTIVELY). AS PER PROTOCOL ANALYSIS, AT 8 WEEKS, 6/13 AND 0/11 WOMEN IN MBSR AND YOGA, RESPECTIVELY, REPORTED THEY WERE VERY MUCH OR MUCH BETTER (P = 0.02), WHEREAS AT 1 YEAR, 6/12 AND 1/9 WOMEN IN MBSR AND YOGA, RESPECTIVELY, DID SO (P = 0.16). DISCUSSION: THESE RESULTS SUPPORT LARGER SCALE TRIALS TO EVALUATE MBSR, WHICH SEEMS TO BE A PROMISING TREATMENT OF UI. 2014 3 1916 35 ROLE OF TEMPORALIS MUSCLE OVER ACTIVITY IN CHRONIC TENSION TYPE HEADACHE: EFFECT OF YOGA BASED MANAGEMENT. THE ROLE OF CENTRAL VERSUS PERIPHERAL MECHANISMS HAS ALWAYS BEEN QUESTIONED WHILE EXPLAINING THE ETIOPATHOGENESIS OF CHRONIC TENSION TYPE HEADACHE (CTTH). THE FOLLOWING STUDY WAS DONE TO STUDY THE ROLE OF MUSCLE SPASM IN CTTH. 15 PATIENTS OF CTTH AND 7 AGE MATCHED CONTROLS WERE INCLUDED IN THE STUDY AND THEIR M. TEMPORALIS EMG WAS RECORDED FOR ONE MINUTE EACH DURING REST, MENTAL ACTIVITY AND MAXIMAL VOLUNTARY CONTRACTION AND SUBJECTIVE PAIN SCORING WAS DONE BY VISUAL ANALOGUE SCALE. THE RESULTS REVEALED SIGNIFICANT OVERACTIVITY OF M.TEMPORALIS IN CTTH PATIENTS AT REST WHEN COMPARED WITH CONTROL SUBJECTS (P = 0.01 AND 0.03 LEFT AND RIGHT SIDE RESPECTIVELY). AFTER RESPECTIVE INTERVENTIONS NAMELY NON STEROIDAL ANTI INFLAMMATORY DRUGS, BOTULINUM TOXIN INJECTIONS AND YOGIC LIFE STYLE COURSE, THE EMG RECORDS REVEALED DECREASE IN THE MEAN EMG AMPLITUDE OF M. TEMPORALIS DURING REST AND MENTAL ACTIVITY MORE SIGNIFICANTLY AFTER YOGA BASED INTERVENTIONS (P = 0.03) AND SUBJECTIVE PAIN SCORES DECREASED FROM 7.00 +/- 2.10 TO 2.00 +/- 1.26 (P = 0.02) SUPPORTING THE BENEFICIAL EFFECT OF SUCH NON INVASIVE TECHNIQUES. 2007 4 2880 30 YOGA: A BIOBEHAVIORAL APPROACH TO REDUCE SYMPTOM DISTRESS IN WOMEN WITH URGE URINARY INCONTINENCE. URGE URINARY INCONTINENCE IS A DEBILITATING CHRONIC CONDITION THAT POSES CHALLENGES FOR AFFECTED WOMEN AND THE CLINICIANS WHO CARE FOR THEM. MULTICOMPONENT BEHAVIORAL THERAPIES HAVE SHOWN PROMISE IN ALLOWING WOMEN TO MANAGE THEIR SYMPTOMS. NEW EVIDENCE SUGGESTS AN UNDERLYING PATHOPHYSIOLOGIC INFLAMMATORY PROCESS FOR URGE URINARY INCONTINENCE, AND COMPLEMENTARY THERAPIES THAT ADDRESS THE PSYCHONEUROIMMUNOLOGY COMPONENT MAY IMPROVE THE HEALTH AND QUALITY OF LIFE FOR THE MILLIONS OF WOMEN WITH THIS CONDITION. YOGA, A MIND-BODY THERAPY, HAS BEEN SHOWN TO REDUCE INFLAMMATION AND MAY HELP IMPROVE SYMPTOMS OF URGE URINARY INCONTINENCE. MORE RESEARCH IS NECESSARY TO DEMONSTRATE THE EFFECTIVENESS OF YOGA TO REDUCE URGE URINARY INCONTINENCE SYMPTOM BURDEN AND IMPROVE QUALITY OF LIFE. 2014 5 74 58 A GROUP-BASED YOGA THERAPY INTERVENTION FOR URINARY INCONTINENCE IN WOMEN: A PILOT RANDOMIZED TRIAL. OBJECTIVE: THE AIM OF THIS STUDY IS TO EXAMINE THE FEASIBILITY, EFFICACY, AND SAFETY OF A GROUP-BASED YOGA THERAPY INTERVENTION FOR MIDDLE-AGED AND OLDER WOMEN WITH URINARY INCONTINENCE. METHODS: WE CONDUCTED A PILOT RANDOMIZED TRIAL OF AMBULATORY WOMEN AGED 40 YEARS AND OLDER WITH STRESS, URGENCY, OR MIXED-TYPE INCONTINENCE. WOMEN WERE RANDOMIZED TO A 6-WEEK YOGA THERAPY PROGRAM (N = 10) CONSISTING OF TWICE WEEKLY GROUP CLASSES AND ONCE WEEKLY HOME PRACTICE OR A WAIT-LIST CONTROL GROUP (N = 9). ALL PARTICIPANTS ALSO RECEIVED WRITTEN PAMPHLETS ABOUT STANDARD BEHAVIORAL SELF-MANAGEMENT STRATEGIES FOR INCONTINENCE. CHANGES IN INCONTINENCE WERE ASSESSED WITH 7-DAY VOIDING DIARIES. RESULTS: THE MEAN (SD) AGE WAS 61.4 (8.2) YEARS, AND THE MEAN BASELINE FREQUENCY OF INCONTINENCE WAS 2.5 (1.3) EPISODES/D. AFTER 6 WEEKS, THE TOTAL INCONTINENCE FREQUENCY DECREASED BY 70% (1.8 [0.9] FEWER EPISODES/D) IN THE YOGA THERAPY VERSUS 13% (0.3 [1.7] FEWER EPISODES/D) IN THE CONTROL GROUP (P = 0.049). PARTICIPANTS IN THE YOGA THERAPY GROUP ALSO REPORTED AN AVERAGE OF 71% DECREASE IN STRESS INCONTINENCE FREQUENCY (0.7 [0.8] FEWER EPISODES/D) COMPARED WITH A 25% INCREASE IN CONTROLS (0.2 [1.1] MORE EPISODES/D) (P = 0.039). NO SIGNIFICANT DIFFERENCES IN REDUCTION IN URGENCY INCONTINENCE WERE DETECTED BETWEEN THE YOGA THERAPY VERSUS CONTROL GROUPS (1.0 [1.0] VERSUS 0.5 [0.5] FEWER EPISODES/D; P = 0.20). ALL WOMEN STARTING THE YOGA THERAPY PROGRAM COMPLETED AT LEAST 90% OF THE GROUP CLASSES AND PRACTICE SESSIONS. TWO PARTICIPANTS IN EACH GROUP REPORTED ADVERSE EVENTS UNRELATED TO THE INTERVENTION. CONCLUSIONS: FINDINGS PROVIDE PRELIMINARY EVIDENCE TO SUPPORT THE FEASIBILITY, EFFICACY, AND SAFETY OF A GROUP-BASED YOGA THERAPY INTERVENTION TO IMPROVE URINARY INCONTINENCE IN WOMEN. 2014 6 2640 49 YOGA FOR VETERANS WITH PTSD: COGNITIVE FUNCTIONING, MENTAL HEALTH, AND SALIVARY CORTISOL. OBJECTIVE: RESEARCH INDICATES THAT COGNITIVE FUNCTIONING IS NEGATIVELY IMPACTED BY EXPOSURE TO CHRONIC STRESS DUE TO OVERACTIVATION OF THE STRESS RESPONSE. YOGA HAS DEMONSTRATED BENEFITS WHEN PRACTICED BY INDIVIDUALS DIAGNOSED WITH POSTTRAUMATIC STRESS DISORDER (PTSD). THIS QUASI-EXPERIMENTAL PILOT STUDY EXAMINED THE IMPACT OF A YOGA INTERVENTION ON COGNITIVE FUNCTIONING, SYMPTOMS OF PTSD, AND THE BIOLOGICAL STRESS RESPONSE IN VETERANS DIAGNOSED WITH PTSD. METHOD: COGNITIVE FUNCTIONING, SELF-REPORT MEASURES OF MENTAL HEALTH SYMPTOMS, AND SALIVARY CORTISOL WERE MEASURED WITHIN TWO WEEKS PRIOR TO BEGINNING AND FOLLOWING COMPLETION OF A 10-WEEK YOGA PROTOCOL. VETERANS WITH PTSD PARTICIPATED IN GENDER-SPECIFIC GROUPS OF THE YOGA INTERVENTION. PAIRED T TESTS AND CORRELATIONAL ANALYSES WERE USED TO ANALYZE QUANTITATIVE DATA. RESULTS: STATISTICALLY SIGNIFICANT IMPROVEMENTS WERE OBSERVED BETWEEN BASELINE AND POSTINTERVENTION SCORES ON MEASURES OF RESPONSE INHIBITION, PTSD, DEPRESSION, SLEEP, QUALITY OF LIFE, AND SUBJECTIVE NEUROCOGNITIVE COMPLAINTS. POSITIVE CORRELATIONS WERE FOUND BETWEEN BASELINE AND POSTINTERVENTION CHANGES IN SLEEP AND DEPRESSION, AND BETWEEN CHANGE IN CORTISOL OUTPUT AND A MEASURE OF LIFE SATISFACTION. STATISTICALLY SIGNIFICANT DIFFERENCES (BASELINE TO POSTINTERVENTION) FOR OTHER OBJECTIVE MEASURES OF COGNITIVE PERFORMANCE AND CORTISOL WERE NOT DETECTED. CONCLUSIONS: RESULTS PROVIDE PRELIMINARY SUPPORT FOR THE PRACTICE OF YOGA TO IMPROVE COGNITIVE FUNCTIONING (RESPONSE INHIBITION) RELATED TO SYMPTOMS OF PTSD WHILE ALSO IMPROVING MENTAL HEALTH SYMPTOMS, SLEEP, AND QUALITY OF LIFE. POSITIVE CORRELATIONS AFFIRM THE ROLE OF SLEEP IN MOOD SYMPTOMS AND INDICATE THE NEED FOR FURTHER EXAMINATION OF THE ROLE OF CORTISOL IN LIFE SATISFACTION. (PSYCINFO DATABASE RECORD (C) 2020 APA, ALL RIGHTS RESERVED). 2020 7 2821 125 YOGA TREATMENT FOR CHRONIC NON-SPECIFIC LOW BACK PAIN. BACKGROUND: NON-SPECIFIC LOW BACK PAIN IS A COMMON, POTENTIALLY DISABLING CONDITION USUALLY TREATED WITH SELF-CARE AND NON-PRESCRIPTION MEDICATION. FOR CHRONIC LOW BACK PAIN, CURRENT GUIDELINES STATE THAT EXERCISE THERAPY MAY BE BENEFICIAL. YOGA IS A MIND-BODY EXERCISE SOMETIMES USED FOR NON-SPECIFIC LOW BACK PAIN. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA FOR TREATING CHRONIC NON-SPECIFIC LOW BACK PAIN, COMPARED TO NO SPECIFIC TREATMENT, A MINIMAL INTERVENTION (E.G. EDUCATION), OR ANOTHER ACTIVE TREATMENT, WITH A FOCUS ON PAIN, FUNCTION, AND ADVERSE EVENTS. SEARCH METHODS: WE SEARCHED CENTRAL, MEDLINE, EMBASE, FIVE OTHER DATABASES AND FOUR TRIALS REGISTERS TO 11 MARCH 2016 WITHOUT RESTRICTION OF LANGUAGE OR PUBLICATION STATUS. WE SCREENED REFERENCE LISTS AND CONTACTED EXPERTS IN THE FIELD TO IDENTIFY ADDITIONAL STUDIES. SELECTION CRITERIA: WE INCLUDED RANDOMIZED CONTROLLED TRIALS OF YOGA TREATMENT IN PEOPLE WITH CHRONIC NON-SPECIFIC LOW BACK PAIN. WE INCLUDED STUDIES COMPARING YOGA TO ANY OTHER INTERVENTION OR TO NO INTERVENTION. WE ALSO INCLUDED STUDIES COMPARING YOGA AS AN ADJUNCT TO OTHER THERAPIES, VERSUS THOSE OTHER THERAPIES ALONE. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SCREENED AND SELECTED STUDIES, EXTRACTED OUTCOME DATA, AND ASSESSED RISK OF BIAS. WE CONTACTED STUDY AUTHORS TO OBTAIN MISSING OR UNCLEAR INFORMATION. WE EVALUATED THE OVERALL CERTAINTY OF EVIDENCE USING THE GRADE APPROACH. MAIN RESULTS: WE INCLUDED 12 TRIALS (1080 PARTICIPANTS) CARRIED OUT IN THE USA (SEVEN TRIALS), INDIA (THREE TRIALS), AND THE UK (TWO TRIALS). STUDIES WERE UNFUNDED (ONE TRIAL), FUNDED BY A YOGA INSTITUTION (ONE TRIAL), FUNDED BY NON-PROFIT OR GOVERNMENT SOURCES (SEVEN TRIALS), OR DID NOT REPORT ON FUNDING (THREE TRIALS). MOST TRIALS USED IYENGAR, HATHA, OR VINIYOGA FORMS OF YOGA. THE TRIALS COMPARED YOGA TO NO INTERVENTION OR A NON-EXERCISE INTERVENTION SUCH AS EDUCATION (SEVEN TRIALS), AN EXERCISE INTERVENTION (THREE TRIALS), OR BOTH EXERCISE AND NON-EXERCISE INTERVENTIONS (TWO TRIALS). ALL TRIALS WERE AT HIGH RISK OF PERFORMANCE AND DETECTION BIAS BECAUSE PARTICIPANTS AND PROVIDERS WERE NOT BLINDED TO TREATMENT ASSIGNMENT, AND OUTCOMES WERE SELF-ASSESSED. THEREFORE, WE DOWNGRADED ALL OUTCOMES TO 'MODERATE' CERTAINTY EVIDENCE BECAUSE OF RISK OF BIAS, AND WHEN THERE WAS ADDITIONAL SERIOUS RISK OF BIAS, UNEXPLAINED HETEROGENEITY BETWEEN STUDIES, OR THE ANALYSES WERE IMPRECISE, WE DOWNGRADED THE CERTAINTY OF THE EVIDENCE FURTHER.FOR YOGA COMPARED TO NON-EXERCISE CONTROLS (9 TRIALS; 810 PARTICIPANTS), THERE WAS LOW-CERTAINTY EVIDENCE THAT YOGA PRODUCED SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE TO FOUR MONTHS (STANDARDIZED MEAN DIFFERENCE (SMD) -0.40, 95% CONFIDENCE INTERVAL (CI) -0.66 TO -0.14; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MEAN DIFFERENCE (MD) -2.18, 95% -3.60 TO -0.76), MODERATE-CERTAINTY EVIDENCE FOR SMALL TO MODERATE IMPROVEMENTS AT SIX MONTHS (SMD -0.44, 95% CI -0.66 TO -0.22; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -2.15, 95% -3.23 TO -1.08), AND LOW-CERTAINTY EVIDENCE FOR SMALL IMPROVEMENTS AT 12 MONTHS (SMD -0.26, 95% CI -0.46 TO -0.05; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -1.36, 95% -2.41 TO -0.26). ON A 0-100 SCALE THERE WAS VERY LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA WAS SLIGHTLY BETTER FOR PAIN AT THREE TO FOUR MONTHS (MD -4.55, 95% CI -7.04 TO -2.06), SIX MONTHS (MD -7.81, 95% CI -13.37 TO -2.25), AND 12 MONTHS (MD -5.40, 95% CI -14.50 TO -3.70), HOWEVER WE PRE-DEFINED CLINICALLY SIGNIFICANT CHANGES IN PAIN AS 15 POINTS OR GREATER AND THIS THRESHOLD WAS NOT MET. BASED ON INFORMATION FROM SIX TRIALS, THERE WAS MODERATE-CERTAINTY EVIDENCE THAT THE RISK OF ADVERSE EVENTS, PRIMARILY INCREASED BACK PAIN, WAS HIGHER IN YOGA THAN IN NON-EXERCISE CONTROLS (RISK DIFFERENCE (RD) 5%, 95% CI 2% TO 8%).FOR YOGA COMPARED TO NON-YOGA EXERCISE CONTROLS (4 TRIALS; 394 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE IN BACK-RELATED FUNCTION AT THREE MONTHS (SMD -0.22, 95% CI -0.65 TO 0.20; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -0.99, 95% -2.87 TO 0.90) AND SIX MONTHS (SMD -0.20, 95% CI -0.59 TO 0.19; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -0.90, 95% -2.61 TO 0.81), AND NO INFORMATION ON BACK-RELATED FUNCTION AFTER SIX MONTHS. THERE WAS VERY LOW-CERTAINTY EVIDENCE FOR LOWER PAIN ON A 0-100 SCALE AT SEVEN MONTHS (MD -20.40, 95% CI -25.48 TO -15.32), AND NO INFORMATION ON PAIN AT THREE MONTHS OR AFTER SEVEN MONTHS. BASED ON INFORMATION FROM THREE TRIALS, THERE WAS LOW-CERTAINTY EVIDENCE FOR NO DIFFERENCE IN THE RISK OF ADVERSE EVENTS BETWEEN YOGA AND NON-YOGA EXERCISE CONTROLS (RD 1%, 95% CI -4% TO 6%).FOR YOGA ADDED TO EXERCISE COMPARED TO EXERCISE ALONE (1 TRIAL; 24 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE AT 10 WEEKS IN BACK-RELATED FUNCTION (SMD -0.60, 95% CI -1.42 TO 0.22; CORRESPONDING TO A CHANGE IN THE OSWESTRY DISABILITY INDEX OF MD -17.05, 95% -22.96 TO 11.14) OR PAIN ON A 0-100 SCALE (MD -3.20, 95% CI -13.76 TO 7.36). THERE WAS NO INFORMATION ON OUTCOMES AT OTHER TIME POINTS. THERE WAS NO INFORMATION ON ADVERSE EVENTS.STUDIES PROVIDED LIMITED EVIDENCE ON RISK OF CLINICAL IMPROVEMENT, MEASURES OF QUALITY OF LIFE, AND DEPRESSION. THERE WAS NO EVIDENCE ON WORK-RELATED DISABILITY. AUTHORS' CONCLUSIONS: THERE IS LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA COMPARED TO NON-EXERCISE CONTROLS RESULTS IN SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE AND SIX MONTHS. YOGA MAY ALSO BE SLIGHTLY MORE EFFECTIVE FOR PAIN AT THREE AND SIX MONTHS, HOWEVER THE EFFECT SIZE DID NOT MEET PREDEFINED LEVELS OF MINIMUM CLINICAL IMPORTANCE. IT IS UNCERTAIN WHETHER THERE IS ANY DIFFERENCE BETWEEN YOGA AND OTHER EXERCISE FOR BACK-RELATED FUNCTION OR PAIN, OR WHETHER YOGA ADDED TO EXERCISE IS MORE EFFECTIVE THAN EXERCISE ALONE. YOGA IS ASSOCIATED WITH MORE ADVERSE EVENTS THAN NON-EXERCISE CONTROLS, BUT MAY HAVE THE SAME RISK OF ADVERSE EVENTS AS OTHER BACK-FOCUSED EXERCISE. YOGA IS NOT ASSOCIATED WITH SERIOUS ADVERSE EVENTS. THERE IS A NEED FOR ADDITIONAL HIGH-QUALITY RESEARCH TO IMPROVE CONFIDENCE IN ESTIMATES OF EFFECT, TO EVALUATE LONG-TERM OUTCOMES, AND TO PROVIDE ADDITIONAL INFORMATION ON COMPARISONS BETWEEN YOGA AND OTHER EXERCISE FOR CHRONIC NON-SPECIFIC LOW BACK PAIN. 2017 8 2543 141 YOGA FOR ASTHMA. BACKGROUND: ASTHMA IS A COMMON CHRONIC INFLAMMATORY DISORDER AFFECTING ABOUT 300 MILLION PEOPLE WORLDWIDE. AS A HOLISTIC THERAPY, YOGA HAS THE POTENTIAL TO RELIEVE BOTH THE PHYSICAL AND PSYCHOLOGICAL SUFFERING OF PEOPLE WITH ASTHMA, AND ITS POPULARITY HAS EXPANDED GLOBALLY. A NUMBER OF CLINICAL TRIALS HAVE BEEN CARRIED OUT TO EVALUATE THE EFFECTS OF YOGA PRACTICE, WITH INCONSISTENT RESULTS. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA IN PEOPLE WITH ASTHMA. SEARCH METHODS: WE SYSTEMATICALLY SEARCHED THE COCHRANE AIRWAYS GROUP REGISTER OF TRIALS, WHICH IS DERIVED FROM SYSTEMATIC SEARCHES OF BIBLIOGRAPHIC DATABASES INCLUDING THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, AND PSYCINFO, AND HANDSEARCHING OF RESPIRATORY JOURNALS AND MEETING ABSTRACTS. WE ALSO SEARCHED PEDRO. WE SEARCHED CLINICALTRIALS.GOV AND THE WHO ICTRP SEARCH PORTAL. WE SEARCHED ALL DATABASES FROM THEIR INCEPTION TO 22 JULY 2015, AND USED NO RESTRICTION ON LANGUAGE OF PUBLICATION. WE CHECKED THE REFERENCE LISTS OF ELIGIBLE STUDIES AND RELEVANT REVIEW ARTICLES FOR ADDITIONAL STUDIES. WE ATTEMPTED TO CONTACT INVESTIGATORS OF ELIGIBLE STUDIES AND EXPERTS IN THE FIELD TO LEARN OF OTHER PUBLISHED AND UNPUBLISHED STUDIES. SELECTION CRITERIA: WE INCLUDED RANDOMISED CONTROLLED TRIALS (RCTS) THAT COMPARED YOGA WITH USUAL CARE (OR NO INTERVENTION) OR SHAM INTERVENTION IN PEOPLE WITH ASTHMA AND REPORTED AT LEAST ONE OF THE FOLLOWING OUTCOMES: QUALITY OF LIFE, ASTHMA SYMPTOM SCORE, ASTHMA CONTROL, LUNG FUNCTION MEASURES, ASTHMA MEDICATION USAGE, AND ADVERSE EVENTS. DATA COLLECTION AND ANALYSIS: WE EXTRACTED BIBLIOGRAPHIC INFORMATION, CHARACTERISTICS OF PARTICIPANTS, CHARACTERISTICS OF INTERVENTIONS AND CONTROLS, CHARACTERISTICS OF METHODOLOGY, AND RESULTS FOR THE OUTCOMES OF OUR INTEREST FROM ELIGIBLE STUDIES. FOR CONTINUOUS OUTCOMES, WE USED MEAN DIFFERENCE (MD) WITH 95% CONFIDENCE INTERVAL (CI) TO DENOTE THE TREATMENT EFFECTS, IF THE OUTCOMES WERE MEASURED BY THE SAME SCALE ACROSS STUDIES. ALTERNATIVELY, IF THE OUTCOMES WERE MEASURED BY DIFFERENT SCALES ACROSS STUDIES, WE USED STANDARDISED MEAN DIFFERENCE (SMD) WITH 95% CI. FOR DICHOTOMOUS OUTCOMES, WE USED RISK RATIO (RR) WITH 95% CI TO MEASURE THE TREATMENT EFFECTS. WE PERFORMED META-ANALYSIS WITH REVIEW MANAGER 5.3. WE USED THE FIXED-EFFECT MODEL TO POOL THE DATA, UNLESS THERE WAS SUBSTANTIAL HETEROGENEITY AMONG STUDIES, IN WHICH CASE WE USED THE RANDOM-EFFECTS MODEL INSTEAD. FOR OUTCOMES INAPPROPRIATE OR IMPOSSIBLE TO POOL QUANTITATIVELY, WE CONDUCTED A DESCRIPTIVE ANALYSIS AND SUMMARISED THE FINDINGS NARRATIVELY. MAIN RESULTS: WE INCLUDED 15 RCTS WITH A TOTAL OF 1048 PARTICIPANTS. MOST OF THE TRIALS WERE CONDUCTED IN INDIA, FOLLOWED BY EUROPE AND THE UNITED STATES. THE MAJORITY OF PARTICIPANTS WERE ADULTS OF BOTH SEXES WITH MILD TO MODERATE ASTHMA FOR SIX MONTHS TO MORE THAN 23 YEARS. FIVE STUDIES INCLUDED YOGA BREATHING ALONE, WHILE THE OTHER STUDIES ASSESSED YOGA INTERVENTIONS THAT INCLUDED BREATHING, POSTURE, AND MEDITATION. INTERVENTIONS LASTED FROM TWO WEEKS TO 54 MONTHS, FOR NO MORE THAN SIX MONTHS IN THE MAJORITY OF STUDIES. THE RISK OF BIAS WAS LOW ACROSS ALL DOMAINS IN ONE STUDY AND UNCLEAR OR HIGH IN AT LEAST ONE DOMAIN FOR THE REMAINDER.THERE WAS SOME EVIDENCE THAT YOGA MAY IMPROVE QUALITY OF LIFE (MD IN ASTHMA QUALITY OF LIFE QUESTIONNAIRE (AQLQ) SCORE PER ITEM 0.57 UNITS ON A 7-POINT SCALE, 95% CI 0.37 TO 0.77; 5 STUDIES; 375 PARTICIPANTS), IMPROVE SYMPTOMS (SMD 0.37, 95% CI 0.09 TO 0.65; 3 STUDIES; 243 PARTICIPANTS), AND REDUCE MEDICATION USAGE (RR 5.35, 95% CI 1.29 TO 22.11; 2 STUDIES) IN PEOPLE WITH ASTHMA. THE MD FOR AQLQ SCORE EXCEEDED THE MINIMAL CLINICALLY IMPORTANT DIFFERENCE (MCID) OF 0.5, BUT WHETHER THE MEAN CHANGES EXCEEDED THE MCID FOR ASTHMA SYMPTOMS IS UNCERTAIN DUE TO THE LACK OF AN ESTABLISHED MCID IN THE SEVERITY SCORES USED IN THE INCLUDED STUDIES. THE EFFECTS OF YOGA ON CHANGE FROM BASELINE FORCED EXPIRATORY VOLUME IN ONE SECOND (MD 0.04 LITRES, 95% CI -0.10 TO 0.19; 7 STUDIES; 340 PARTICIPANTS; I(2) = 68%) WERE NOT STATISTICALLY SIGNIFICANT. TWO STUDIES INDICATED IMPROVED ASTHMA CONTROL, BUT DUE TO VERY SIGNIFICANT HETEROGENEITY (I(2) = 98%) WE DID NOT POOL DATA. NO SERIOUS ADVERSE EVENTS ASSOCIATED WITH YOGA WERE REPORTED, BUT THE DATA ON THIS OUTCOME WAS LIMITED. AUTHORS' CONCLUSIONS: WE FOUND MODERATE-QUALITY EVIDENCE THAT YOGA PROBABLY LEADS TO SMALL IMPROVEMENTS IN QUALITY OF LIFE AND SYMPTOMS IN PEOPLE WITH ASTHMA. THERE IS MORE UNCERTAINTY ABOUT POTENTIAL ADVERSE EFFECTS OF YOGA AND ITS IMPACT ON LUNG FUNCTION AND MEDICATION USAGE. RCTS WITH A LARGE SAMPLE SIZE AND HIGH METHODOLOGICAL AND REPORTING QUALITY ARE NEEDED TO CONFIRM THE EFFECTS OF YOGA FOR ASTHMA. 2016 9 2641 54 YOGA FOR WARRIORS: AN INTERVENTION FOR VETERANS WITH COMORBID CHRONIC PAIN AND PTSD. OBJECTIVE: COMORBID CHRONIC PAIN AND POSTTRAUMATIC STRESS DISORDER (PTSD) IS COMMON IN VETERANS; THIS COMORBIDITY IS ASSOCIATED WITH INCREASED SEVERITY AND POORER PROGNOSIS WHEN COMPARED TO EACH OUTCOME ALONE. YOGA HAS BEEN SHOWN TO BE EFFECTIVE FOR CHRONIC PAIN AND PROMISING FOR PTSD, BUT YOGA FOR COMORBID PAIN AND PTSD HAS NOT BEEN EXAMINED. THIS ARTICLE OFFERS EMPIRICAL SUPPORT FOR A YOGA INTERVENTION FOR COMORBID CHRONIC PAIN AND PTSD IN A VETERAN POPULATION. METHOD: RESULTS ARE PRESENTED FROM A 4-YEAR PILOT YOGA INTERVENTION FOR COMORBID CHRONIC PAIN AND PTSD AT A LARGE, URBAN VETERANS AFFAIRS MEDICAL CENTER. BASED ON THE FEAR AVOIDANCE MODEL OF PAIN, THE INTERVENTION USED A CROSS-SECTIONAL, OPEN-TRIAL DESIGN WITH PRE- AND POSTMEASURES. T TEST ANALYSES WERE CONDUCTED ON PROGRAM COMPLETERS (N = 49; OUT OF 87 INITIALLY ENROLLED, 44% ATTRITION RATE), WHO WERE PRIMARILY AFRICAN AMERICAN (69%) AND MALE (61%) AND HAD A MEAN AGE OF 51.41 YEARS (SD = 11.32). RESULTS: RESULTS INDICATED TREND-LEVEL REDUCTIONS IN OVERALL PTSD SYMPTOMS, AS MEASURED BY THE PTSD CHECKLIST FOR DSM-5 (P = .02, D = 0.38) AND IN SYMPTOM CLUSTER SCORES OF NEGATIVE ALTERATIONS OF COGNITIONS AND MOOD (P = .03, D = 0.36) AND AROUSAL AND REACTIVITY (P = .03, D = 0.35). VETERANS REPORTED SIGNIFICANT IMPROVEMENT IN ABILITY TO PARTICIPATE IN SOCIAL ACTIVITIES (P < .001, D = 0.44) AND SIGNIFICANT REDUCTIONS IN KINESIOPHOBIA (FEAR OF MOVEMENT OR PHYSICAL ACTIVITY; P < .001, D = 0.85). ON A SATISFACTION MEASURE WITH A RANGE OF 1 (QUITE DISSATISFIED) TO 4 (EXTREMELY SATISFIED), THE MEAN RATING WAS 3.74 (SD = 0.33). CONCLUSION: YOGA IS A FEASIBLE AND EFFECTIVE INTERVENTION FOR VETERANS WITH COMORBID CHRONIC PAIN AND PTSD. (PSYCINFO DATABASE RECORD (C) 2020 APA, ALL RIGHTS RESERVED). 2020 10 2820 117 YOGA TREATMENT FOR CHRONIC NON-SPECIFIC LOW BACK PAIN (2017). WIELAND LS, SKOETZ N, PILKINGTON K, VEMPATI R, DADAMO CR, BERMAN BM. YOGA TREATMENT FOR CHRONIC NON-SPECIFIC LOW BACK PAIN.COCHRANE DATABASE SYST REV2017, ISSUE 1. ART. NO.: CD010671. DOI: 10.1002/14651858.CD010671.PUB2. BACKGROUND: NON-SPECIFIC LOW BACK PAIN IS A COMMON, POTENTIALLY DISABLING CONDITION USUALLY TREATED WITH SELF-CARE AND NON-PRESCRIPTION MEDICATION. FOR CHRONIC LOW BACK PAIN, CURRENT GUIDELINES STATE THAT EXERCISE THERAPY MAY BE BENEFICIAL. YOGA IS A MIND-BODY EXERCISE SOMETIMES USED FOR NON-SPECIFIC LOW BACK PAIN. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA FOR TREATING CHRONIC NON-SPECIFIC LOW BACK PAIN, COMPARED TO NO SPECIFIC TREATMENT, A MINIMAL INTERVENTION (E.G., EDUCATION), OR ANOTHER ACTIVE TREATMENT, WITH A FOCUS ON PAIN, FUNCTION, AND ADVERSE EVENTS. SEARCH METHODS: WE SEARCHED CENTRAL, MEDLINE, EMBASE, FIVE OTHER DATABASES, AND FOUR TRIALS REGISTERS TO 11 MARCH 2016 WITHOUT RESTRICTION OF LANGUAGE OR PUBLICATION STATUS. WE SCREENED REFERENCE LISTS AND CONTACTED EXPERTS IN THE FIELD TO IDENTIFY ADDITIONAL STUDIES. SELECTION CRITERIA: WE INCLUDED RANDOMIZED CONTROLLED TRIALS OF YOGA TREATMENT IN PEOPLE WITH CHRONIC NON-SPECIFIC LOW BACK PAIN. WE INCLUDED STUDIES COMPARING YOGA TO ANY OTHER INTERVENTION OR TO NO INTERVENTION. WE ALSO INCLUDED STUDIES COMPARING YOGA AS AN ADJUNCT TO OTHER THERAPIES, VERSUS THOSE OTHER THERAPIES ALONE. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SCREENED AND SELECTED STUDIES, EXTRACTED OUTCOME DATA, AND ASSESSED RISK OF BIAS. WE CONTACTED STUDY AUTHORS TO OBTAIN MISSING OR UNCLEAR INFORMATION. WE EVALUATED THE OVERALL CERTAINTY OF EVIDENCE USING THE GRADE APPROACH. MAIN RESULTS: WE INCLUDED 12 TRIALS (1080 PARTICIPANTS) CARRIED OUT IN THE USA (SEVEN TRIALS), INDIA (THREE TRIALS), AND THE UK (TWO TRIALS). STUDIES WERE UNFUNDED (ONE TRIAL), FUNDED BY A YOGA INSTITUTION (ONE TRIAL), FUNDED BY NON-PROFIT OR GOVERNMENT SOURCES (SEVEN TRIALS), OR DID NOT REPORT ON FUNDING (THREE TRIALS). MOST TRIALS USED IYENGAR, HATHA, OR VINIYOGA FORMS OF YOGA. THE TRIALS COMPARED YOGA TO NO INTERVENTION OR A NON-EXERCISE INTERVENTION SUCH AS EDUCATION (SEVEN TRIALS), AN EXERCISE INTERVENTION (THREE TRIALS), OR BOTH EXERCISE AND NON-EXERCISE INTERVENTIONS (TWO TRIALS). ALL TRIALS WERE AT HIGH RISK OF PERFORMANCE AND DETECTION BIAS BECAUSE PARTICIPANTS AND PROVIDERS WERE NOT BLINDED TO TREATMENT ASSIGNMENT, AND OUTCOMES WERE SELF-ASSESSED. THEREFORE, WE DOWNGRADED ALL OUTCOMES TO "MODERATE" CERTAINTY EVIDENCE BECAUSE OF RISK OF BIAS, AND WHEN THERE WAS ADDITIONAL SERIOUS RISK OF BIAS, UNEXPLAINED HETEROGENEITY BETWEEN STUDIES, OR THE ANALYSES WERE IMPRECISE, WE DOWNGRADED THE CERTAINTY OF THE EVIDENCE FURTHER. FOR YOGA COMPARED TO NON-EXERCISE CONTROLS (9 TRIALS; 810 PARTICIPANTS), THERE WAS LOW-CERTAINTY EVIDENCE THAT YOGA PRODUCED SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE TO FOUR MONTHS [STANDARDIZED MEAN DIFFERENCE (SMD) = -0.40, 95% CI: -0.66 TO -0.14; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MEAN DIFFERENCE (MD) = -2.18, 95% CI: -3.60 TO -0.76], MODERATE-CERTAINTY EVIDENCE FOR SMALL TO MODERATE IMPROVEMENTS AT SIX MONTHS (SMD = -0.44, 95% CI: -0.66 TO -0.22; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD = -2.15, 95% CI: -3.23 TO -1.08), AND LOW-CERTAINTY EVIDENCE FOR SMALL IMPROVEMENTS AT 12 MONTHS (SMD = -0.26, 95% CI: -0.46 TO -0.05; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD = -1.36, 95% CI: -2.41 TO -0.26). ON A 0-100 SCALE THERE WAS VERY LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA WAS SLIGHTLY BETTER FOR PAIN AT THREE TO FOUR MONTHS (MD = -4.55, 95% CI: -7.04 TO -2.06), SIX MONTHS (MD = -7.81, 95% CI: -13.37 TO -2.25), AND 12 MONTHS (MD = -5.40, 95% CI: -14.50 TO -3.70); HOWEVER, WE PRE-DEFINED CLINICALLY SIGNIFICANT CHANGES IN PAIN AS 15 POINTS OR GREATER AND THIS THRESHOLD WAS NOT MET. BASED ON INFORMATION FROM SIX TRIALS, THERE WAS MODERATE-CERTAINTY EVIDENCE THAT THE RISK OF ADVERSE EVENTS, PRIMARILY INCREASED BACK PAIN, WAS HIGHER IN YOGA THAN IN NON-EXERCISE CONTROLS [RISK DIFFERENCE (RD) = 5%, 95% CI: 2-8%]. FOR YOGA COMPARED TO NON-YOGA EXERCISE CONTROLS (4 TRIALS; 394 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE IN BACK-RELATED FUNCTION AT THREE MONTHS (SMD = -0.22, 95% CI: -0.65 TO 0.20; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD = -0.99, 95% CI: -2.87 TO 0.90) AND SIX MONTHS (SMD = -0.20, 95% CI: -0.59 TO 0.19; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD = -0.90, 95% CI: -2.61 TO 0.81), AND NO INFORMATION ON BACK-RELATED FUNCTION AFTER SIX MONTHS. THERE WAS VERY LOW-CERTAINTY EVIDENCE FOR LOWER PAIN ON A 0-100 SCALE AT SEVEN MONTHS (MD = -20.40, 95% CI: -25.48 TO -15.32), AND NO INFORMATION ON PAIN AT THREE MONTHS OR AFTER SEVEN MONTHS. BASED ON INFORMATION FROM THREE TRIALS, THERE WAS LOW-CERTAINTY EVIDENCE FOR NO DIFFERENCE IN THE RISK OF ADVERSE EVENTS BETWEEN YOGA AND NON-YOGA EXERCISE CONTROLS (RD = 1%, 95% CI: -4% TO 6%). FOR YOGA ADDED TO EXERCISE COMPARED TO EXERCISE ALONE (1 TRIAL; 24 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE AT 10 WEEKS IN BACK-RELATED FUNCTION (SMD = -0.60, 95% CI: -1.42 TO 0.22; CORRESPONDING TO A CHANGE IN THE OSWESTRY DISABILITY INDEX OF MD = -17.05, 95% CI: -22.96 TO 11.14) OR PAIN ON A 0-100 SCALE (MD = -3.20, 95% CI: -13.76 TO 7.36). THERE WAS NO INFORMATION ON OUTCOMES AT OTHER TIME POINTS. THERE WAS NO INFORMATION ON ADVERSE EVENTS. STUDIES PROVIDED LIMITED EVIDENCE ON RISK OF CLINICAL IMPROVEMENT, MEASURES OF QUALITY OF LIFE, AND DEPRESSION. THERE WAS NO EVIDENCE ON WORK-RELATED DISABILITY. 2017 11 1429 49 IMPROVEMENTS IN PSYCHOLOGICAL AND OCCUPATIONAL WELL-BEING IN A PRAGMATIC CONTROLLED TRIAL OF A YOGA-BASED PROGRAM FOR PROFESSIONALS. OBJECTIVE: THE PURPOSE OF THIS PRAGMATIC CONTROLLED TRIAL WAS TO EXAMINE CHANGES IN PSYCHOLOGICAL AND OCCUPATIONAL WELL-BEING IN PROFESSIONALS WHO ATTENDED A YOGA-BASED PROGRAM. SETTING: THE 5-DAY RISE (RESILIENCE, INTEGRATION, SELF-AWARENESS, ENGAGEMENT) PROGRAM WAS DELIVERED AT THE KRIPALU CENTER FOR YOGA & HEALTH. RISE INCLUDED 5 H PER DAY OF YOGA, MEDITATION, LECTURES, AND EXPERIENTIAL ACTIVITIES. SUBJECTS: ADULT PROFESSIONALS FROM EDUCATION, CORRECTIONS, AND SOCIAL SERVICE INSTITUTIONS WERE PRAGMATICALLY ASSIGNED TO THE RISE GROUP (N = 61) OR A WAITLIST CONTROL GROUP (N = 60). OUTCOME MEASURES: MEASURES OF PSYCHOLOGICAL AND OCCUPATIONAL WELL-BEING WERE COMPLETED BEFORE RISE (BASELINE), IMMEDIATELY AFTER RISE (POSTPROGRAM), AND 2 MONTHS AFTER RISE (FOLLOW-UP). ANALYSES OF COVARIANCE WERE CONDUCTED TO COMPARE CHANGE SCORES BETWEEN GROUPS. RESULTS: EIGHTY-TWO PARTICIPANTS (RISE N = 41, CONTROL N = 41) COMPLETED BASELINE AND POSTMEASURES AND WERE INCLUDED IN THE ANALYSIS, AND 57 (RISE N = 27, CONTROL N = 30) ALSO COMPLETED THE FOLLOW-UP. RELATIVE TO CONTROLS, THE RISE GROUP REPORTED IMPROVEMENTS IN STRESS (P = 0.001, R(2) = 0.51), RESILIENCE (P = 0.028, R(2) = 0.34), POSITIVE AFFECT (P = 0.001, R(2) = 0.52), NEGATIVE AFFECT (P = 0.001, R(2) = 0.52), MINDFULNESS (P = 0.021, R(2) = 0.13), AND JOB SATISFACTION (P = 0.034, R(2) = 0.08) FROM BASELINE TO POSTPROGRAM. FROM BASELINE TO FOLLOW-UP, COMPARED WITH CONTROLS THE RISE GROUP SHOWED IMPROVEMENTS IN STRESS (P = 0.001, R(2) = 0.33), RESILIENCE (P = 0.001, R(2) = 0.24), POSITIVE AFFECT (P = 0.006, R(2) = 0.49), NEGATIVE AFFECT (P = 0.043, R(2) = 0.32), MINDFULNESS (P = 0.001, R(2) = 0.28), EMPOWERMENT (P = 0.005, R(2) = 0.20), AND SELF-COMPASSION (P = 0.011, R(2) = 0.19). CONCLUSIONS: THE RISE PROGRAM WAS ASSOCIATED WITH IMPROVEMENTS IN PSYCHOLOGICAL AND OCCUPATIONAL WELL-BEING IMMEDIATELY AFTER AND 2 MONTHS AFTER THE PROGRAM. FUTURE RESEARCH IS NEEDED TO CONFIRM THESE RESULTS. 2019 12 2587 126 YOGA FOR IMPROVING HEALTH-RELATED QUALITY OF LIFE, MENTAL HEALTH AND CANCER-RELATED SYMPTOMS IN WOMEN DIAGNOSED WITH BREAST CANCER. BACKGROUND: BREAST CANCER IS THE CANCER MOST FREQUENTLY DIAGNOSED IN WOMEN WORLDWIDE. EVEN THOUGH SURVIVAL RATES ARE CONTINUALLY INCREASING, BREAST CANCER IS OFTEN ASSOCIATED WITH LONG-TERM PSYCHOLOGICAL DISTRESS, CHRONIC PAIN, FATIGUE AND IMPAIRED QUALITY OF LIFE. YOGA COMPRISES ADVICE FOR AN ETHICAL LIFESTYLE, SPIRITUAL PRACTICE, PHYSICAL ACTIVITY, BREATHING EXERCISES AND MEDITATION. IT IS A COMPLEMENTARY THERAPY THAT IS COMMONLY RECOMMENDED FOR BREAST CANCER-RELATED IMPAIRMENTS AND HAS BEEN SHOWN TO IMPROVE PHYSICAL AND MENTAL HEALTH IN PEOPLE WITH DIFFERENT CANCER TYPES. OBJECTIVES: TO ASSESS EFFECTS OF YOGA ON HEALTH-RELATED QUALITY OF LIFE, MENTAL HEALTH AND CANCER-RELATED SYMPTOMS AMONG WOMEN WITH A DIAGNOSIS OF BREAST CANCER WHO ARE RECEIVING ACTIVE TREATMENT OR HAVE COMPLETED TREATMENT. SEARCH METHODS: WE SEARCHED THE COCHRANE BREAST CANCER SPECIALISED REGISTER, MEDLINE (VIA PUBMED), EMBASE, THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL; 2016, ISSUE 1), INDEXING OF INDIAN MEDICAL JOURNALS (INDMED), THE WORLD HEALTH ORGANIZATION (WHO) INTERNATIONAL CLINICAL TRIALS REGISTRY PLATFORM (ICTRP) SEARCH PORTAL AND CLINICALTRIALS.GOV ON 29 JANUARY 2016. WE ALSO SEARCHED REFERENCE LISTS OF IDENTIFIED RELEVANT TRIALS OR REVIEWS, AS WELL AS CONFERENCE PROCEEDINGS OF THE INTERNATIONAL CONGRESS ON COMPLEMENTARY MEDICINE RESEARCH (ICCMR), THE EUROPEAN CONGRESS FOR INTEGRATIVE MEDICINE (ECIM) AND THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY (ASCO). WE APPLIED NO LANGUAGE RESTRICTIONS. SELECTION CRITERIA: RANDOMISED CONTROLLED TRIALS WERE ELIGIBLE WHEN THEY (1) COMPARED YOGA INTERVENTIONS VERSUS NO THERAPY OR VERSUS ANY OTHER ACTIVE THERAPY IN WOMEN WITH A DIAGNOSIS OF NON-METASTATIC OR METASTATIC BREAST CANCER, AND (2) ASSESSED AT LEAST ONE OF THE PRIMARY OUTCOMES ON PATIENT-REPORTED INSTRUMENTS, INCLUDING HEALTH-RELATED QUALITY OF LIFE, DEPRESSION, ANXIETY, FATIGUE OR SLEEP DISTURBANCES. DATA COLLECTION AND ANALYSIS: TWO REVIEW AUTHORS INDEPENDENTLY COLLECTED DATA ON METHODS AND RESULTS. WE EXPRESSED OUTCOMES AS STANDARDISED MEAN DIFFERENCES (SMDS) WITH 95% CONFIDENCE INTERVALS (CIS) AND CONDUCTED RANDOM-EFFECTS MODEL META-ANALYSES. WE ASSESSED POTENTIAL RISK OF PUBLICATION BIAS THROUGH VISUAL ANALYSIS OF FUNNEL PLOT SYMMETRY AND HETEROGENEITY BETWEEN STUDIES BY USING THE CHI(2) TEST AND THE I(2) STATISTIC. WE CONDUCTED SUBGROUP ANALYSES FOR CURRENT TREATMENT STATUS, TIME SINCE DIAGNOSIS, STAGE OF CANCER AND TYPE OF YOGA INTERVENTION. MAIN RESULTS: WE INCLUDED 24 STUDIES WITH A TOTAL OF 2166 PARTICIPANTS, 23 OF WHICH PROVIDED DATA FOR META-ANALYSIS. THIRTEEN STUDIES HAD LOW RISK OF SELECTION BIAS, FIVE STUDIES REPORTED ADEQUATE BLINDING OF OUTCOME ASSESSMENT AND 15 STUDIES HAD LOW RISK OF ATTRITION BIAS.SEVENTEEN STUDIES THAT COMPARED YOGA VERSUS NO THERAPY PROVIDED MODERATE-QUALITY EVIDENCE SHOWING THAT YOGA IMPROVED HEALTH-RELATED QUALITY OF LIFE (POOLED SMD 0.22, 95% CI 0.04 TO 0.40; 10 STUDIES, 675 PARTICIPANTS), REDUCED FATIGUE (POOLED SMD -0.48, 95% CI -0.75 TO -0.20; 11 STUDIES, 883 PARTICIPANTS) AND REDUCED SLEEP DISTURBANCES IN THE SHORT TERM (POOLED SMD -0.25, 95% CI -0.40 TO -0.09; SIX STUDIES, 657 PARTICIPANTS). THE FUNNEL PLOT FOR HEALTH-RELATED QUALITY OF LIFE WAS ASYMMETRICAL, FAVOURING NO THERAPY, AND THE FUNNEL PLOT FOR FATIGUE WAS ROUGHLY SYMMETRICAL. THIS HINTS AT OVERALL LOW RISK OF PUBLICATION BIAS. YOGA DID NOT APPEAR TO REDUCE DEPRESSION (POOLED SMD -0.13, 95% CI -0.31 TO 0.05; SEVEN STUDIES, 496 PARTICIPANTS; LOW-QUALITY EVIDENCE) OR ANXIETY (POOLED SMD -0.53, 95% CI -1.10 TO 0.04; SIX STUDIES, 346 PARTICIPANTS; VERY LOW-QUALITY EVIDENCE) IN THE SHORT TERM AND HAD NO MEDIUM-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE (POOLED SMD 0.10, 95% CI -0.23 TO 0.42; TWO STUDIES, 146 PARTICIPANTS; LOW-QUALITY EVIDENCE) OR FATIGUE (POOLED SMD -0.04, 95% CI -0.36 TO 0.29; TWO STUDIES, 146 PARTICIPANTS; LOW-QUALITY EVIDENCE). INVESTIGATORS REPORTED NO SERIOUS ADVERSE EVENTS.FOUR STUDIES THAT COMPARED YOGA VERSUS PSYCHOSOCIAL/EDUCATIONAL INTERVENTIONS PROVIDED MODERATE-QUALITY EVIDENCE INDICATING THAT YOGA CAN REDUCE DEPRESSION (POOLED SMD -2.29, 95% CI -3.97 TO -0.61; FOUR STUDIES, 226 PARTICIPANTS), ANXIETY (POOLED SMD -2.21, 95% CI -3.90 TO -0.52; THREE STUDIES, 195 PARTICIPANTS) AND FATIGUE (POOLED SMD -0.90, 95% CI -1.31 TO -0.50; TWO STUDIES, 106 PARTICIPANTS) IN THE SHORT TERM. VERY LOW-QUALITY EVIDENCE SHOWED NO SHORT-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE (POOLED SMD 0.81, 95% CI -0.50 TO 2.12; TWO STUDIES, 153 PARTICIPANTS) OR SLEEP DISTURBANCES (POOLED SMD -0.21, 95% CI -0.76 TO 0.34; TWO STUDIES, 119 PARTICIPANTS). NO TRIAL ADEQUATELY REPORTED SAFETY-RELATED DATA.THREE STUDIES THAT COMPARED YOGA VERSUS EXERCISE PRESENTED VERY LOW-QUALITY EVIDENCE SHOWING NO SHORT-TERM EFFECTS ON HEALTH-RELATED QUALITY OF LIFE (POOLED SMD -0.04, 95% CI -0.30 TO 0.23; THREE STUDIES, 233 PARTICIPANTS) OR FATIGUE (POOLED SMD -0.21, 95% CI -0.66 TO 0.25; THREE STUDIES, 233 PARTICIPANTS); NO TRIAL PROVIDED SAFETY-RELATED DATA. AUTHORS' CONCLUSIONS: MODERATE-QUALITY EVIDENCE SUPPORTS THE RECOMMENDATION OF YOGA AS A SUPPORTIVE INTERVENTION FOR IMPROVING HEALTH-RELATED QUALITY OF LIFE AND REDUCING FATIGUE AND SLEEP DISTURBANCES WHEN COMPARED WITH NO THERAPY, AS WELL AS FOR REDUCING DEPRESSION, ANXIETY AND FATIGUE, WHEN COMPARED WITH PSYCHOSOCIAL/EDUCATIONAL INTERVENTIONS. VERY LOW-QUALITY EVIDENCE SUGGESTS THAT YOGA MIGHT BE AS EFFECTIVE AS OTHER EXERCISE INTERVENTIONS AND MIGHT BE USED AS AN ALTERNATIVE TO OTHER EXERCISE PROGRAMMES. 2017 13 1482 38 INTEGRATING YOGA THERAPY IN THE MANAGEMENT OF URINARY INCONTINENCE: A CASE REPORT. A 63-YEAR-OLD OVERWEIGHT FEMALE PREDIAGNOSED OF STRESS URINARY INCONTINENCE PRESENTED WITH EXACERBATED EVENTS OF URINE LEAKAGE. SHE WAS ADVISED A RESIDENTIAL LIFESTYLE AND BEHAVIORAL PROGRAM, PRIMARILY CONSISTING OF A MONITORED YOGA THERAPY MODULE, APART FROM HER ONGOING ANTICHOLINERGIC MEDICINE, FOR 21 DAYS. ASSESSMENTS WERE BASED ON A FREQUENCY VOLUME CHART, A BLADDER DIARY FOR THE ENTIRE DURATION OF TREATMENT, AND THE INTERNATIONAL CONSULTATION ON INCONTINENCE MODULAR QUESTIONNAIRE-URINARY INCONTINENCE SHORT FORM QUESTIONNAIRE ON THE DAYS OF ADMISSION AND DISCHARGE. A TOTAL OF 1.9 KG OF WEIGHT LOSS WAS OBSERVED DURING HER STAY. USAGE OF PAD, AS REPORTED IN HER DIARY, REDUCED FROM 3 TO 1 PER DAY. HER INTERNATIONAL CONSULTATION ON INCONTINENCE MODULAR QUESTIONNAIRE-URINARY INCONTINENCE SHORT FORM SCORE REDUCED FROM 16 TO 9, INDICATING BETTER CONTINENCE. SHE EXPRESSED SUBJECTIVE WELL-BEING AND CONFIDENCE IN HER SOCIAL INTERACTIONS. THIS IS PROBABLY THE FIRST CASE REPORT DEMONSTRATING FEASIBILITY OF INTEGRATION OF YOGA THERAPY IN THE MANAGEMENT OF URINARY INCONTINENCE. 2015 14 498 50 COMBINED PELVIC MUSCLE EXERCISE AND YOGA PROGRAM FOR URINARY INCONTINENCE IN MIDDLE-AGED WOMEN. AIM: URINARY INCONTINENCE IS A MAJOR HEALTH PROBLEM AMONG MIDDLE-AGED WOMEN. PELVIC MUSCLE EXERCISE IS ONE OF THE PRIMARY INTERVENTIONS, BUT DIFFICULTY PERFORMING THIS EXERCISE HAS LED RESEARCHERS TO SEEK ALTERNATIVE OR CONJUNCTIVE EXERCISE. THIS STUDY AIMED TO EXAMINE THE EFFECT OF A COMBINED PELVIC MUSCLE EXERCISE AND YOGA INTERVENTION PROGRAM ON URINARY INCONTINENCE. METHODS: A SINGLE GROUP PRE-/POST-TEST DESIGN WAS USED. SUBJECTS WERE RECRUITED FROM A COMMUNITY HEALTH CENTER IN SEOUL, KOREA, AND A QUESTIONNAIRE SURVEY WAS CONDUCTED. FIFTY-FIVE WOMEN PARTICIPATED IN THE FIRST DAY OF THE PROGRAM, 34 OF WHOM COMPLETED THE 8 WEEK, TWICE WEEKLY INTERVENTION PROGRAM. URINARY INCONTINENCE WAS MEASURED BY FIVE DOMAINS OF URINARY TRACT SYMPTOMS: FILLING FACTOR, VOIDING FACTOR, INCONTINENCE FACTOR, SEXUAL FUNCTION, AND QUALITY OF LIFE. ALSO MEASURED WERE ATTITUDE TOWARD PELVIC MUSCLE EXERCISE AND PELVIC MUSCLE STRENGTH. RESULTS: SIGNIFICANT IMPROVEMENTS WERE FOUND IN ATTITUDE TOWARD PELVIC MUSCLE EXERCISE, PELVIC MUSCLE STRENGTH, AND INCONTINENCE FACTOR. DAILY PERFORMANCE OF PELVIC MUSCLE EXERCISE WAS POSITIVELY CORRELATED WITH IMPROVED INCONTINENCE FACTOR AND WITH QUALITY OF LIFE RELATED TO URINARY TRACT SYMPTOMS. CONCLUSION: A COMBINED PELVIC MUSCLE EXERCISE AND YOGA PROGRAM WAS EFFECTIVE FOR IMPROVING OVERALL URINARY INCONTINENCE IN COMMUNITY HEALTH CENTER ATTENDEES IN KOREA. FURTHER STUDY IS NEEDED WITH A CONTROL GROUP, DIFFERENT POPULATIONS, AND A LONGER INTERVENTION PERIOD. 2015 15 2829 114 YOGA VERSUS STANDARD CARE FOR SCHIZOPHRENIA. BACKGROUND: YOGA IS AN ANCIENT SPIRITUAL PRACTICE THAT ORIGINATED IN INDIA AND IS CURRENTLY ACCEPTED IN THE WESTERN WORLD AS A FORM OF RELAXATION AND EXERCISE. IT HAS BEEN OF INTEREST FOR PEOPLE WITH SCHIZOPHRENIA TO DETERMINE ITS EFFICACY AS AN ADJUNCT TO STANDARD-CARE TREATMENT. OBJECTIVES: TO EXAMINE THE EFFECTS OF YOGA VERSUS STANDARD CARE FOR PEOPLE WITH SCHIZOPHRENIA. SEARCH METHODS: WE SEARCHED THE COCHRANE SCHIZOPHRENIA GROUP TRIALS REGISTER (NOVEMBER 2012 AND JANUARY 29, 2015), WHICH IS BASED ON REGULAR SEARCHES OF MEDLINE, PUBMED, EMBASE, CINAHL, BIOSIS, AMED, PSYCINFO, AND REGISTRIES OF CLINICAL TRIALS. WE SEARCHED THE REFERENCES OF ALL INCLUDED STUDIES. THERE WERE NO LANGUAGE, DATE, DOCUMENT TYPE, OR PUBLICATION STATUS LIMITATIONS FOR INCLUSION OF RECORDS IN THE REGISTER. SELECTION CRITERIA: ALL RANDOMISED CONTROLLED TRIALS (RCTS) INCLUDING PEOPLE WITH SCHIZOPHRENIA COMPARING YOGA TO STANDARD-CARE CONTROL. DATA COLLECTION AND ANALYSIS: THE REVIEW TEAM INDEPENDENTLY SELECTED STUDIES, QUALITY RATED THESE, AND EXTRACTED DATA. FOR BINARY OUTCOMES, WE CALCULATED RISK RATIO (RR) AND ITS 95% CONFIDENCE INTERVAL (CI), ON AN INTENTION-TO-TREAT BASIS. FOR CONTINUOUS DATA, WE ESTIMATED THE MEAN DIFFERENCE (MD) BETWEEN GROUPS AND ITS 95% CI. WE EMPLOYED MIXED-EFFECT AND FIXED-EFFECT MODELS FOR ANALYSES. WE EXAMINED DATA FOR HETEROGENEITY (I(2) TECHNIQUE), ASSESSED RISK OF BIAS FOR INCLUDED STUDIES, AND CREATED 'SUMMARY OF FINDINGS' TABLES USING GRADE (GRADING OF RECOMMENDATIONS ASSESSMENT, DEVELOPMENT AND EVALUATION). MAIN RESULTS: WE INCLUDED EIGHT STUDIES IN THE REVIEW. ALL OUTCOMES WERE SHORT TERM (LESS THAN SIX MONTHS). THERE WERE CLEAR DIFFERENCES IN A NUMBER OF OUTCOMES IN FAVOUR OF THE YOGA GROUP, ALTHOUGH THESE WERE BASED ON ONE STUDY EACH, WITH THE EXCEPTION OF LEAVING THE STUDY EARLY. THESE INCLUDED MENTAL STATE (IMPROVEMENT IN POSITIVE AND NEGATIVE SYNDROME SCALE, 1 RCT, N = 83, RR 0.70 CI 0.55 TO 0.88, MEDIUM-QUALITY EVIDENCE), SOCIAL FUNCTIONING (IMPROVEMENT IN SOCIAL OCCUPATIONAL FUNCTIONING SCALE, 1 RCT, N = 83, RR 0.88 CI 0.77 TO 1, MEDIUM-QUALITY EVIDENCE), QUALITY OF LIFE (AVERAGE CHANGE 36-ITEM SHORT FORM SURVEY (SF-36) QUALITY-OF-LIFE SUBSCALE, 1 RCT, N = 60, MD 15.50, 95% CI 4.27 TO 26.73, LOW-QUALITY EVIDENCE), AND LEAVING THE STUDY EARLY (8 RCTS, N = 457, RR 0.91 CI 0.6 TO 1.37, MEDIUM-QUALITY EVIDENCE). FOR THE OUTCOME OF PHYSICAL HEALTH, THERE WAS NOT A CLEAR DIFFERENCE BETWEEN GROUPS (AVERAGE CHANGE SF-36 PHYSICAL-HEALTH SUBSCALE, 1 RCT, N = 60, MD 6.60, 95% CI -2.44 TO 15.64, LOW-QUALITY EVIDENCE). ONLY ONE STUDY REPORTED ADVERSE EFFECTS, FINDING NO INCIDENCE OF ADVERSE EVENTS IN EITHER TREATMENT GROUP. THIS REVIEW WAS SUBJECT TO A CONSIDERABLE NUMBER OF MISSING OUTCOMES, WHICH INCLUDED GLOBAL STATE, CHANGE IN COGNITION, COSTS OF CARE, EFFECT ON STANDARD CARE, SERVICE INTERVENTION, DISABILITY, AND ACTIVITIES OF DAILY LIVING. AUTHORS' CONCLUSIONS: EVEN THOUGH WE FOUND SOME POSITIVE EVIDENCE IN FAVOUR OF YOGA OVER STANDARD-CARE CONTROL, THIS SHOULD BE INTERPRETED CAUTIOUSLY IN VIEW OF OUTCOMES LARGELY BASED EACH ON ONE STUDY WITH LIMITED SAMPLE SIZES AND SHORT-TERM FOLLOW-UP. OVERALL, MANY OUTCOMES WERE NOT REPORTED AND EVIDENCE PRESENTED IN THIS REVIEW IS OF LOW TO MODERATE QUALITY - -TOO WEAK TO INDICATE THAT YOGA IS SUPERIOR TO STANDARD-CARE CONTROL FOR THE MANAGEMENT OF SCHIZOPHRENIA. 2015 16 73 79 A GROUP-BASED YOGA PROGRAM FOR URINARY INCONTINENCE IN AMBULATORY WOMEN: FEASIBILITY, TOLERABILITY, AND CHANGE IN INCONTINENCE FREQUENCY OVER 3 MONTHS IN A SINGLE-CENTER RANDOMIZED TRIAL. BACKGROUND: BECAUSE OF THE LIMITATIONS OF EXISTING CLINICAL TREATMENTS FOR URINARY INCONTINENCE, MANY WOMEN WITH INCONTINENCE ARE INTERESTED IN COMPLEMENTARY STRATEGIES FOR MANAGING THEIR SYMPTOMS. YOGA HAS BEEN RECOMMENDED AS A BEHAVIORAL SELF-MANAGEMENT STRATEGY FOR INCONTINENCE, BUT EVIDENCE OF ITS FEASIBILITY, TOLERABILITY, AND EFFICACY IS LACKING. OBJECTIVE: TO EVALUATE THE FEASIBILITY AND TOLERABILITY OF A GROUP-BASED THERAPEUTIC YOGA PROGRAM FOR AMBULATORY MIDDLE-AGED AND OLDER WOMEN WITH INCONTINENCE, AND TO EXAMINE PRELIMINARY CHANGES IN INCONTINENCE FREQUENCY AS THE PRIMARY EFFICACY OUTCOME AFTER 3 MONTHS. MATERIALS AND METHODS: AMBULATORY WOMEN AGED 50 YEARS OR OLDER WHO REPORTED AT LEAST DAILY STRESS-, URGENCY-, OR MIXED-TYPE INCONTINENCE, WERE NOT ALREADY ENGAGED IN YOGA, AND WERE WILLING TO TEMPORARILY FORGO CLINICAL INCONTINENCE TREATMENTS WERE RECRUITED INTO A RANDOMIZED TRIAL IN THE SAN FRANCISCO BAY AREA. WOMEN WERE RANDOMLY ASSIGNED TO TAKE PART IN A PROGRAM OF TWICE-WEEKLY GROUP CLASSES AND ONCE-WEEKLY HOME PRACTICE FOCUSED ON IYENGAR-BASED YOGA TECHNIQUES SELECTED BY AN EXPERT YOGA PANEL (YOGA GROUP), OR A NONSPECIFIC MUSCLE STRETCHING AND STRENGTHENING PROGRAM DESIGNED TO PROVIDE A RIGOROUS TIME-AND-ATTENTION CONTROL (CONTROL GROUP) FOR 3 MONTHS. ALL PARTICIPANTS ALSO RECEIVED WRITTEN, EVIDENCE-BASED INFORMATION ABOUT BEHAVIORAL INCONTINENCE SELF-MANAGEMENT TECHNIQUES (PELVIC FLOOR EXERCISES, BLADDER TRAINING) CONSISTENT WITH USUAL FIRST-LINE CARE. INCONTINENCE FREQUENCY AND TYPE WERE ASSESSED BY VALIDATED VOIDING DIARIES. ANALYSIS OF COVARIANCE MODELS EXAMINED WITHIN- AND BETWEEN-GROUP CHANGES IN INCONTINENCE FREQUENCY AS THE PRIMARY EFFICACY OUTCOME OVER 3 MONTHS. RESULTS: OF THE 56 WOMEN RANDOMIZED (28 TO YOGA, 28 TO CONTROL), THE MEAN AGE WAS 65.4 (+/-8.1) YEARS (RANGE, 55-83 YEARS), THE MEAN BASELINE INCONTINENCE FREQUENCY WAS 3.5 (+/-2.0) EPISODES/D, AND 37 WOMEN (66%) HAD URGENCY-PREDOMINANT INCONTINENCE. A TOTAL OF 50 WOMEN COMPLETED THEIR ASSIGNED 3-MONTH INTERVENTION PROGRAM (89%), INCLUDING 27 IN THE YOGA AND 23 IN THE CONTROL GROUP (P = .19). OF THOSE, 24 (89%) IN THE YOGA AND 20 (87%) IN THE CONTROL GROUP ATTENDED AT LEAST 80% OF GROUP CLASSES. OVER 3 MONTHS, TOTAL INCONTINENCE FREQUENCY DECREASED BY AN AVERAGE OF 76% FROM BASELINE IN THE YOGA AND 56% IN THE CONTROL GROUP (P = .07 FOR BETWEEN-GROUP DIFFERENCE). STRESS INCONTINENCE FREQUENCY ALSO DECREASED BY AN AVERAGE OF 61% IN THE YOGA GROUP AND 35% IN CONTROLS (P = .045 FOR BETWEEN-GROUP DIFFERENCE), BUT CHANGES IN URGENCY INCONTINENCE FREQUENCY DID NOT DIFFER SIGNIFICANTLY BETWEEN GROUPS. A TOTAL OF 48 NONSERIOUS ADVERSE EVENTS WERE REPORTED, INCLUDING 23 IN THE YOGA AND 25 IN THE CONTROL GROUP, BUT NONE WERE DIRECTLY ATTRIBUTABLE TO YOGA OR CONTROL PROGRAM PRACTICE. CONCLUSION: FINDINGS DEMONSTRATE THE FEASIBILITY OF RECRUITING AND RETAINING INCONTINENT WOMEN ACROSS THE AGING SPECTRUM INTO A THERAPEUTIC YOGA PROGRAM, AND PROVIDE PRELIMINARY EVIDENCE OF REDUCTION IN TOTAL AND STRESS-TYPE INCONTINENCE FREQUENCY AFTER 3 MONTHS OF YOGA PRACTICE. WHEN TAUGHT WITH ATTENTION TO WOMEN'S CLINICAL NEEDS, YOGA MAY OFFER A POTENTIAL COMMUNITY-BASED BEHAVIORAL SELF-MANAGEMENT STRATEGY FOR INCONTINENCE TO ENHANCE CLINICAL TREATMENT, ALTHOUGH FUTURE RESEARCH SHOULD ASSESS WHETHER YOGA OFFERS UNIQUE BENEFITS FOR INCONTINENCE ABOVE AND BEYOND OTHER PHYSICAL ACTIVITY-BASED INTERVENTIONS. 2019 17 2827 118 YOGA VERSUS NON-STANDARD CARE FOR SCHIZOPHRENIA. BACKGROUND: YOGA IS AN ANCIENT SPIRITUAL PRACTICE THAT ORIGINATED IN INDIA AND IS CURRENTLY ACCEPTED IN THE WESTERN WORLD AS A FORM OF RELAXATION AND EXERCISE. IT HAS BEEN OF INTEREST FOR PEOPLE WITH SCHIZOPHRENIA AS AN ALTERNATIVE OR ADJUNCTIVE TREATMENT. OBJECTIVES: TO SYSTEMATICALLY ASSESS THE EFFECTS OF YOGA VERSUS NON-STANDARD CARE FOR PEOPLE WITH SCHIZOPHRENIA. SEARCH METHODS: THE INFORMATION SPECIALIST OF THE COCHRANE SCHIZOPHRENIA GROUP SEARCHED THEIR SPECIALISED TRIALS REGISTER (LATEST 30 MARCH 2017), WHICH IS BASED ON REGULAR SEARCHES OF MEDLINE, PUBMED, EMBASE, CINAHL, BIOSIS, AMED, PSYCINFO, AND REGISTRIES OF CLINICAL TRIALS. WE SEARCHED THE REFERENCES OF ALL INCLUDED STUDIES. THERE ARE NO LANGUAGE, DATE, DOCUMENT TYPE, OR PUBLICATION STATUS LIMITATIONS FOR INCLUSION OF RECORDS IN THE REGISTER. SELECTION CRITERIA: ALL RANDOMISED CONTROLLED TRIALS (RCTS) INCLUDING PEOPLE WITH SCHIZOPHRENIA AND COMPARING YOGA WITH NON-STANDARD CARE. WE INCLUDED TRIALS THAT MET OUR SELECTION CRITERIA AND REPORTED USEABLE DATA. DATA COLLECTION AND ANALYSIS: THE REVIEW TEAM INDEPENDENTLY SELECTED STUDIES, ASSESSED QUALITY, AND EXTRACTED DATA. FOR BINARY OUTCOMES, WE CALCULATED RISK RATIO (RR) AND ITS 95% CONFIDENCE INTERVAL (CI), ON AN INTENTION-TO-TREAT BASIS. FOR CONTINUOUS DATA, WE ESTIMATED THE MEAN DIFFERENCE (MD) BETWEEN GROUPS AND ITS 95% CI. WE EMPLOYED A FIXED-EFFECT MODELS FOR ANALYSES. WE EXAMINED DATA FOR HETEROGENEITY (I(2) TECHNIQUE), ASSESSED RISK OF BIAS FOR INCLUDED STUDIES, AND CREATED A 'SUMMARY OF FINDINGS' TABLE FOR SEVEN MAIN OUTCOMES OF INTEREST USING GRADE (GRADING OF RECOMMENDATIONS ASSESSMENT, DEVELOPMENT AND EVALUATION). MAIN RESULTS: WE WERE ABLE TO INCLUDE SIX STUDIES (586 PARTICIPANTS). NON-STANDARD CARE CONSISTED SOLELY OF ANOTHER TYPE OF EXERCISE PROGRAMME. ALL OUTCOMES WERE SHORT TERM (LESS THAN SIX MONTHS). THERE WAS A CLEAR DIFFERENCE IN THE OUTCOME LEAVING THE STUDY EARLY (6 RCTS, N=586, RR 0.64 CI 0.49 TO 0.83, MEDIUM QUALITY EVIDENCE) IN FAVOUR OF THE YOGA GROUP. THERE WERE NO CLEAR DIFFERENCES BETWEEN GROUPS FOR THE REMAINING OUTCOMES. THESE INCLUDED MENTAL STATE (IMPROVEMENT IN POSITIVE AND NEGATIVE SYNDROME SCALE, 1 RCT, N=84, RR 0.81 CI 0.62 TO 1.07, LOW QUALITY EVIDENCE), SOCIAL FUNCTIONING (IMPROVEMENT IN SOCIAL OCCUPATIONAL FUNCTIONING SCALE, 1 RCT, N=84, RR 0.90 CI 0.78 TO 1.04, LOW QUALITY EVIDENCE), QUALITY OF LIFE (MENTAL HEALTH) (AVERAGE CHANGE 36-ITEM SHORT FORM SURVEY (SF-36) QUALITY-OF-LIFE SUB-SCALE, 1 RCT, N=69, MD -5.30 CI -17.78 TO 7.18, LOW QUALITY EVIDENCE), PHYSICAL HEALTH, (AVERAGE CHANGE WHOQOL-BREF PHYSICAL-HEALTH SUB-SCALE, 1 RCT, N=69, MD 9.22 CI -0.42 TO 18.86, LOW QUALITY EVIDENCE). ONLY ONE STUDY REPORTED ADVERSE EFFECTS, FINDING NO INCIDENCE OF ADVERSE EVENTS IN EITHER TREATMENT GROUP. THERE WERE A CONSIDERABLE NUMBER OF MISSING OUTCOMES, WHICH INCLUDED RELAPSE, CHANGE IN COGNITION, COSTS OF CARE, EFFECT ON STANDARD CARE, SERVICE INTERVENTION, DISABILITY, AND ACTIVITIES OF DAILY LIVING. AUTHORS' CONCLUSIONS: WE FOUND MINIMAL DIFFERENCES BETWEEN YOGA AND NON-STANDARD CARE, THE LATTER CONSISTING OF ANOTHER EXERCISE COMPARATOR, WHICH COULD BE BROADLY CONSIDERED AEROBIC EXERCISE. OUTCOMES WERE LARGELY BASED ON SINGLE STUDIES WITH LIMITED SAMPLE SIZES AND SHORT-TERM FOLLOW-UP. OVERALL, MANY OUTCOMES WERE NOT REPORTED AND EVIDENCE PRESENTED IN THIS REVIEW IS OF LOW TO MODERATE QUALITY - TOO WEAK TO INDICATE THAT YOGA IS SUPERIOR OR INFERIOR TO NON-STANDARD CARE CONTROL FOR MANAGEMENT OF PEOPLE WITH SCHIZOPHRENIA. 2017 18 2273 61 THE ROLE OF YOGA IN THE MANAGEMENT OF BLADDER PAIN SYNDROME: A SINGLE-ARM PILOT STUDY. BACKGROUND: BLADDER PAIN SYNDROME (BPS) IS A DEVASTATING UROLOGIC CONDITION CHARACTERIZED BY IRRITATIVE BLADDER SYMPTOMS, PELVIC PAIN, AND DYSPAREUNIA. FIRST-LINE TREATMENT INCLUDES DIETARY, SELF-CARE AND BEHAVIORAL MODIFICATIONS. THE ANCIENT PRACTICE OF YOGA IS WELL SUITED TO TREAT BPS, BUT EVIDENCE IS LACKING ON ITS USE. AIMS: TO INVESTIGATE THE FEASIBILITY AND EFFICACY OF AN INTEGRATED YOGA MODULE ON BPS OUTCOMES AS MEASURED BY SELF-REPORTED QUESTIONNAIRES FROM BASELINE TO 3 MONTHS AFTER THERAPY. METHODS AND MATERIALS: THIS WAS A PROSPECTIVE SINGLE-ARM STUDY OF 8 PATIENTS WHO UNDERWENT 3 MONTHS OF INTEGRATED YOGA THERAPY. THE TREATMENT MODULE WAS PERFORMED 3 TO 4 TIMES WEEKLY AT HOME WITH 1 SESSION PERFORMED WEEKLY IN-OFFICE DURING THE FIRST MONTH TO ENSURE PROPER PERFORMANCE OF POSTURES. PATIENTS COMPLETED QUESTIONNAIRES (PELVIC PAIN AND URGENCY/FREQUENCY PATIENT SYMPTOM SCALE [PUF], PELVIC FLOOR IMPACT QUESTIONNAIRE - SHORT FORM 7 [PFIQ-7], SHORT FORM 36 QUESTIONNAIRE [SF-36], PITTSBURGH SLEEP QUALITY INDEX [PSQI]) AT BASELINE AND 3 MONTHS, INCLUDING PATIENT GLOBAL IMPRESSION OF IMPROVEMENT (PGI-I) AT THE 3-MONTH FOLLOW-UP VISIT. VOIDING DIARIES WERE ALSO REQUESTED AT BASELINE AND AT THE 3-MONTH ASSESSMENT. RESULTS: THERE WAS A TREND TOWARD IMPROVEMENT REGARDING PATIENTS' RESPONSES TO ALL QUESTIONNAIRES 3 MONTHS AFTER YOGA THERAPY, WITH THE ONLY STATISTICALLY SIGNIFICANT IMPROVEMENTS NOTED IN SOCIAL FUNCTION AND PAIN COMPONENTS OF THE SF-36. THERE WERE NO SIGNIFICANT CHANGES NOTED ON THE VOIDING DIARIES EXCEPT A NON-STATISTICALLY SIGNIFICANT TREND TOWARD INCREASED VOIDED VOLUMES. PATIENTS RATED THEIR EXPERIENCES WITH YOGA THERAPY POSITIVELY. CONCLUSIONS: YOGA THERAPY FOR BPS SHOWED EVIDENCE OF BENEFIT FOR IMPROVING BOTHERSOME BLADDER SYMPTOMS, PAIN AND VOIDING. A RANDOMIZED CONTROLLED TRIAL WILL FOLLOW TO INVESTIGATE THE EFFICACY OF THIS YOGA MODULE AGAINST A CONTROL GROUP. 2020 19 2644 58 YOGA FOR WOMEN WITH URGENCY URINARY INCONTINENCE: A PILOT STUDY. OBJECTIVES: THE OBJECTIVE OF THIS STUDY WAS TO EVALUATE THE FEASIBILITY OF A GENTLE YOGA PROGRAM FOR WOMEN WITH URGENCY URINARY INCONTINENCE (UUI). ALSO, THESE PRELIMINARY DATA CAN EVALUATE IF YOGA IMPROVES SYMPTOM BURDEN, QUALITY OF LIFE, AND INFLAMMATORY BIOMARKERS FOR WOMEN WITH UUI. METHODS: THIS PROSPECTIVE NONRANDOMIZED SINGLE-ARM PILOT STUDY EVALUATED THE EFFECTIVENESS OF A TWICE-WEEKLY, 8-WEEK GENTLE YOGA INTERVENTION TO REDUCE UUI SYMPTOM BURDEN. CHANGES IN SYMPTOM BURDEN WERE MEASURED USING THE PELVIC FLOOR DISTRESS INVENTORY 20. SECONDARY MEASURES INCLUDED QUALITY OF LIFE, DEPRESSIVE SYMPTOMS, SLEEP, STRESS, ANXIETY, AND INFLAMMATORY BIOMARKERS. OUTCOMES WERE EVALUATED WITH PAIRED T TESTING. RESULTS: TWELVE WOMEN COMPLETED THE YOGA INTERVENTION WITH NO ADVERSE OUTCOMES NOTED. URGENCY SYMPTOM BURDEN WAS SIGNIFICANTLY IMPROVED AFTER THE INTERVENTION (P = 0.01), AND WOMEN REPORTED AN INCREASE IN QUALITY OF LIFE (P = 0.04) AFTER THE YOGA INTERVENTION. FOLLOWING THE YOGA INTERVENTION, THE MAJORITY OF WOMEN REPORTED SYMPTOMS AS "MUCH BETTER" (N = 4 [33%]) AND "A LITTLE BETTER" (N = 5 [42%]), WITH 3 WOMEN (25%) REPORTING "NO CHANGE." WOMEN ALSO REPORTED SIGNIFICANT REDUCTION IN DEPRESSIVE SYMPTOMS (P = 0.03) AND BETTER QUALITY OF SLEEP (P = 0.03). NO SIGNIFICANT CHANGES WERE FOUND IN ANXIETY OR STRESS PERCEPTION. PLASMA LEVELS OF THE INFLAMMATORY BIOMARKER TUMOR NECROSIS FACTOR ALPHA WERE REDUCED AFTER YOGA INTERVENTION (P = 0.009); HOWEVER, NO SIGNIFICANT POSTYOGA CHANGES WERE FOUND FOR INTERLEUKIN 6 OR C-REACTIVE PROTEIN. CONCLUSIONS: THIS STUDY PROVIDES PRELIMINARY EVIDENCE THAT YOGA IS A FEASIBLE COMPLEMENTARY THERAPY THAT REDUCES INCONTINENCE SYMPTOM BURDEN, ALONG WITH IMPROVING QUALITY OF LIFE, DEPRESSIVE SYMPTOMS, AND SLEEP QUALITY. ADDITIONALLY, YOGA MAY LOWER INFLAMMATORY BIOMARKERS ASSOCIATED WITH INCONTINENCE. 2021 20 388 54 BENEFITS OF THE RESTORATIVE EXERCISE AND STRENGTH TRAINING FOR OPERATIONAL RESILIENCE AND EXCELLENCE YOGA PROGRAM FOR CHRONIC LOW BACK PAIN IN SERVICE MEMBERS: A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: TO EXAMINE THE FEASIBILITY AND PRELIMINARY EFFECTIVENESS OF AN INDIVIDUALIZED YOGA PROGRAM. DESIGN: PILOT RANDOMIZED CONTROLLED TRIAL. SETTING: MILITARY MEDICAL CENTER. PARTICIPANTS: PATIENTS (N=68) WITH CHRONIC LOW BACK PAIN. INTERVENTIONS: RESTORATIVE EXERCISE AND STRENGTH TRAINING FOR OPERATIONAL RESILIENCE AND EXCELLENCE (RESTORE) PROGRAM (9-12 INDIVIDUAL YOGA SESSIONS) OR TREATMENT AS USUAL (CONTROL) FOR AN 8-WEEK PERIOD. MAIN OUTCOME MEASURES: THE PRIMARY OUTCOME WAS PAST 24-HOUR PAIN (DEFENSE & VETERANS PAIN RATING SCALE 2.0). SECONDARY OUTCOMES INCLUDED DISABILITY (ROLAND-MORRIS DISABILITY QUESTIONNAIRE) AND PHYSICAL FUNCTIONING AND SYMPTOM BURDEN (PATIENT-REPORTED OUTCOMES MEASUREMENT INFORMATION SYSTEM-29 SUBSCALES). ASSESSMENT OCCURRED AT BASELINE, WEEK 4, WEEK 8, 3-MONTH FOLLOW-UP, AND 6-MONTH FOLLOW-UP. EXPLORATORY OUTCOMES INCLUDED THE PROPORTION OF PARTICIPANTS IN EACH GROUP REPORTING CLINICALLY MEANINGFUL CHANGES AT 3- AND 6-MONTH FOLLOW-UPS. RESULTS: GENERALIZED LINEAR MIXED MODELS WITH SEQUENTIAL BONFERRONI-ADJUSTED PAIRWISE SIGNIFICANCE TESTS AND CHI-SQUARE ANALYSES EXAMINED LONGITUDINAL OUTCOMES. SECONDARY OUTCOME SIGNIFICANCE TESTS WERE BONFERRONI ADJUSTED FOR MULTIPLE OUTCOMES. THE RESTORE GROUP REPORTED IMPROVED PAIN COMPARED WITH THE CONTROL GROUP. SECONDARY OUTCOMES DID NOT RETAIN SIGNIFICANCE AFTER BONFERRONI ADJUSTMENTS FOR MULTIPLE OUTCOMES, ALTHOUGH A HIGHER PROPORTION OF RESTORE PARTICIPANTS REPORTED CLINICALLY MEANINGFULLY CHANGES IN ALL OUTCOMES AT 3-MONTH FOLLOW-UP AND IN SYMPTOM BURDEN AT 6-MONTH FOLLOW-UP. CONCLUSIONS: RESTORE MAY BE A VIABLE NONPHARMACOLOGICAL TREATMENT FOR LOW BACK PAIN WITH MINIMAL SIDE EFFECTS, AND RESEARCH EFFORTS ARE NEEDED TO COMPARE THE EFFECTIVENESS OF RESTORE DELIVERY FORMATS (EG, GROUP VS INDIVIDUAL) WITH THAT OF OTHER TREATMENT MODALITIES. 2018