1 140 173 A PROSPECTIVE STUDY ON TYPE-2 DIABETIC COMPLICATIONS AND EFFICACY OF INTEGRATED YOGA: A PAN INDIA 2017. BACKGROUND: TYPE 2 DIABETES (T2DM) CONTRIBUTES TO HIGH MORTALITY AND MORBIDITY BECAUSE OF ITS MAJOR COMPLICATIONS RELATED TO KIDNEY, HEART, BRAIN, AND EYES. IT ALSO POSES A HIGH RISK FOR MORTALITY BECAUSE OF COVID-19. STUDIES SUGGEST THE POSSIBLE IMPLICATIONS OF YOGA IN DELAYING OR ATTENUATING SUCH COMPLICATIONS. METHODOLOGY: THIS WAS A PAN-INDIA MULTI CENTERED CLUSTER-RANDOMIZED (4 LEVEL) TWO-ARMED TRIAL IN THE RURAL AND URBAN POPULATION OF ALL POPULOUS STATES OF INDIA. DATA WERE OBTAINED USING MOBILE APP IN ALL ADULTS IN THE HOUSEHOLD OF THE SELECTED CLUSTERS. RESULTS: WE REPORT THE DIABETES RELATED COMPLICATIONS IN 16623 ADULTS (48% MALES, 52% FEMALES) FROM 65 DISTRICTS (1 IN 10 DISTRICTS, 2011 CENSUS) OF 29 (OUT OF 35) STATES AND UNION TERRITORIES OF INDIA; MEAN AGE WAS 48.2 +/- 12.46 YEARS. OUT OF THIS 40% LIVED IN RURAL AND 62% IN URBAN LOCATIONS. IN HIGH RISK DIABETES INDIVIDUALS (SCORED >/= 60 POINTS ON INDIAN DIABETES RISK SCORE KEY), 18.0% HAD SELF-REPORTED HISTORY OF (PERIPHERAL NEUROPATHY, 6.1% HAD H/O MAJOR STROKES, 5.5% HAD MINOR STROKES (TRANSIENT ISCHEMIC EPISODES), 18.1% HAD LOWER LIMB CLAUDICATION, 20.5% LEG ULCERS, 4.4% HAD H/O CARDIAC SURGERY, 4.8% ANGIOPLASTY, AND 15.1% HAD DIABETES RETINOPATHY. COMPLICATIONS WERE HIGHER IN RURAL THAN IN URBAN AREAS, HIGHER IN PEOPLE WITH EXTENDED DURATION OF DIABETES. INTEGRATED YOGA MODULE FOR THREE MONTHS (ONE HOUR DAILY) SHOWED SIGNIFICANTLY BETTER REDUCTION IN SYMPTOMS RELATED TO COMPLICATIONS AS COMPARED TO CONTROL GROUP (P < .001). CONCLUSION: THE ALARMING HIGH PREVALENCE OF COMPLICATIONS IN DIABETES POPULATION CALLS FOR URGENT ACTION, WHERE YOGA MAY SHOW THE BENEFITS IN REDUCTION OF SYMPTOMS OF COMPLICATIONS. 2021 2 1803 55 PREVALENCE OF DIABETES AND ITS DETERMINANTS IN THE YOUNG ADULTS INDIAN POPULATION-CALL FOR YOGA INTERVENTION. BACKGROUND: THE YOUNG INDIAN POPULATION, WHICH CONSTITUTES 65% OF THE COUNTRY, IS FAST ADAPTING TO A NEW LIFESTYLE, WHICH WAS NOT KNOWN EARLIER. THEY ARE AT A HIGH RISK OF THE INCREASING BURDEN OF DIABETES AND ASSOCIATED COMPLICATIONS. THE NEW EVOLVING LIFESTYLE IS NOT ONLY AFFECTING PEOPLE'S HEALTH BUT ALSO MOUNTING THE MONETARY BURDEN ON A DEVELOPING COUNTRY SUCH AS INDIA. AIM: WE AIMED TO COLLECT INFORMATION REGARDING THE PREVALENCE OF RISK OF DIABETES IN YOUNG ADULTS (<35 YEARS) IN THE 29 MOST POPULOUS STATES AND UNION TERRITORIES (7 ZONES) OF INDIA, USING A VALIDATED QUESTIONNAIRE. METHODS: A USER-FRIENDLY QUESTIONNAIRE-BASED SURVEY USING A MOBILE APPLICATION WAS CONDUCTED ON ALL ADULTS IN THE 29 MOST POPULOUS STATES/UNION TERRITORIES OF INDIA, AFTER OBTAINING ETHICAL CLEARANCE FOR THE STUDY. HERE, WE REPORT THE ESTIMATION OF THE PREVALENCE OF THE RISK OF DIABETES AND SELF-REPORTED DIABETES ON 58,821 YOUNG INDIVIDUALS BELOW THE AGE OF 35 YEARS. RISK FOR DIABETES WAS ASSESSED USING A STANDARDIZED INSTRUMENT, THE INDIAN DIABETES RISK SCORE (IDRS), THAT HAS 4 FACTORS (AGE, FAMILY HISTORY OF DIABETES, WAIST CIRCUMFERENCE, AND PHYSICAL ACTIVITY). SPEARMAN'S CORRELATION COEFFICIENT WAS USED TO CHECK THE CORRELATIONS. RESULTS: THE PREVALENCE OF HIGH (IDRS SCORE > 60), MODERATE (IDRS SCORE 30-50), AND LOW (IDRS < 30) DIABETES RISK IN YOUNG ADULTS (<35 YEARS) WAS 10.2%, 33.1%, AND 56.7%, RESPECTIVELY. THOSE WITH HIGH-RISK SCORES WERE HIGHEST (14.4%) IN THE JAMMU ZONE AND LOWEST (4.1%) IN THE CENTRAL ZONE. THE PREVALENCE OF SELF-REPORTED DIABETES WAS 1.8% WITH A SMALL DIFFERENCE BETWEEN MEN (1.7%) AND WOMEN (1.9%), AND THE HIGHEST (8.4%) IN THOSE WITH A PARENTAL HISTORY OF DIABETES. THE SOUTH ZONE HAD THE HIGHEST (2.5%), AND THE NORTH WEST ZONE HAD THE LOWEST (4.4%) PREVALENCE. CONCLUSIONS: INDIAN YOUTH ARE AT HIGH RISK FOR DIABETES, WHICH CALLS FOR AN URGENT ACTION PLAN THROUGH INTENSIVE EFFORTS TO PROMOTE LIFESTYLE BEHAVIOR MODIFICATIONS DURING THE PANDEMICS OF BOTH COMMUNICABLE AND NONCOMMUNICABLE DISEASES. 2020 3 625 35 DIABETIC YOGA PROTOCOL IMPROVES GLYCEMIC, ANTHROPOMETRIC AND LIPID LEVELS IN HIGH RISK INDIVIDUALS FOR DIABETES: A RANDOMIZED CONTROLLED TRIAL FROM NORTHERN INDIA. PURPOSE: TO STUDY THE EFFECTIVENESS OF DIABETIC YOGA PROTOCOL (DYP) AGAINST MANAGEMENT OF CARDIOVASCULAR RISK PROFILE IN A HIGH-RISK COMMUNITY FOR DIABETES, FROM CHANDIGARH, INDIA. METHODS: THE STUDY WAS A RANDOMIZED CONTROLLED TRIAL, CONDUCTED AS A SUB STUDY OF THE PAN INDIA TRIAL NIYANTRITA MADHUMEHA BHARATH (NMB). THE COHORT WAS IDENTIFIED THROUGH THE INDIAN DIABETES RISK SCORING (IDRS) (>/= 60) AND A TOTAL OF 184 INDIVIDUALS WERE RANDOMIZED INTO INTERVENTION (N = 91) AND CONTROL GROUPS (N = 93). THE DYP GROUP UNDERWENT THE SPECIFIC DYP TRAINING WHEREAS THE CONTROL GROUP FOLLOWED THEIR DAILY REGIMEN. THE STUDY OUTCOMES INCLUDED CHANGES IN GLYCEMIC AND LIPID PROFILE. ANALYSIS WAS DONE UNDER INTENT-TO-TREAT PRINCIPLE. RESULTS: THE 3 MONTHS DYP PRACTICE SHOWED DIVERSE RESULTS SHOWING GLYCEMIC AND LIPID PROFILE OF THE HIGH RISK INDIVIDUALS. THREE MONTHS OF DYP INTERVENTION WAS FOUND TO SIGNIFICANTLY REDUCE THE LEVELS OF POST-PRANDIAL GLUCOSE LEVELS (P = 0.035) AND LDL-C LEVELS (P = 0.014) AND WAIST CIRCUMFERENCE (P = 0.001). CONCLUSION: THE FINDINGS INDICATE THAT THE DYP INTERVENTION COULD IMPROVE THE METABOLIC STATUS OF THE HIGH-DIABETES-RISK INDIVIDUALS WITH RESPECT TO THEIR GLUCOSE TOLERANCE AND LIPID LEVELS, PARTIALLY EXPLAINED BY THE REDUCTION IN ABDOMINAL OBESITY. THE STUDY HIGHLIGHTS THE POTENTIAL ROLE OF YOGA INTERVENTION IN REAL TIME IMPROVEMENT OF CARDIOVASCULAR PROFILE IN A HIGH DIABETES RISK COHORT. TRIAL REGISTRATION: CTRI, CTRI/2018/03/012804. REGISTERED 01 MARCH 2018-RETROSPECTIVELY REGISTERED, HTTP://WWW.CTRI.NIC.IN/ CTRI/2018/03/012804. 2021 4 2629 44 YOGA FOR THE PRIMARY PREVENTION OF CARDIOVASCULAR DISEASE. BACKGROUND: A SEDENTARY LIFESTYLE AND STRESS ARE MAJOR RISK FACTORS FOR CARDIOVASCULAR DISEASE (CVD). SINCE YOGA INVOLVES EXERCISE AND IS THOUGHT TO HELP IN STRESS REDUCTION IT MAY BE AN EFFECTIVE STRATEGY IN THE PRIMARY PREVENTION OF CVD. OBJECTIVES: TO DETERMINE THE EFFECT OF ANY TYPE OF YOGA ON THE PRIMARY PREVENTION OF CVD. SEARCH METHODS: WE SEARCHED THE FOLLOWING ELECTRONIC DATABASES: THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL) (2013, ISSUE 11) IN THE COCHRANE LIBRARY; MEDLINE (OVID) (1946 TO NOVEMBER WEEK 3 2013); EMBASE CLASSIC + EMBASE (OVID) (1947 TO 2013 WEEK 48); WEB OF SCIENCE (THOMSON REUTERS) (1970 TO 4 DECEMBER 2013); DATABASE OF ABSTRACTS OF REVIEWS OF EFFECTS (DARE), HEALTH TECHNOLOGY ASSESSMENT DATABASE AND HEALTH ECONOMICS EVALUATIONS DATABASE (ISSUE 4 OF 4, 2013) IN THE COCHRANE LIBRARY. WE ALSO SEARCHED A NUMBER OF ASIAN DATABASES AND THE ALLIED AND COMPLEMENTARY MEDICINE DATABASE (AMED) (INCEPTION TO DECEMBER 2012). WE SEARCHED TRIAL REGISTERS AND REFERENCE LISTS OF REVIEWS AND ARTICLES, AND APPROACHED EXPERTS IN THE FIELD. WE APPLIED NO LANGUAGE RESTRICTIONS. SELECTION CRITERIA: RANDOMISED CONTROLLED TRIALS LASTING AT LEAST THREE MONTHS INVOLVING HEALTHY ADULTS OR THOSE AT HIGH RISK OF CVD. TRIALS EXAMINED ANY TYPE OF YOGA AND THE COMPARISON GROUP WAS NO INTERVENTION OR MINIMAL INTERVENTION. OUTCOMES OF INTEREST WERE CLINICAL CVD EVENTS AND MAJOR CVD RISK FACTORS. WE DID NOT INCLUDE ANY TRIALS THAT INVOLVED MULTIFACTORIAL LIFESTYLE INTERVENTIONS OR WEIGHT LOSS. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SELECTED TRIALS FOR INCLUSION, EXTRACTED DATA AND ASSESSED THE RISK OF BIAS. MAIN RESULTS: WE IDENTIFIED 11 TRIALS (800 PARTICIPANTS) AND TWO ONGOING STUDIES. STYLE AND DURATION OF YOGA DIFFERED BETWEEN TRIALS. HALF OF THE PARTICIPANTS RECRUITED TO THE STUDIES WERE AT HIGH RISK OF CVD. MOST OF STUDIES WERE AT RISK OF PERFORMANCE BIAS, WITH INADEQUATE DETAILS REPORTED IN MANY OF THEM TO JUDGE THE RISK OF SELECTION BIAS.NO STUDY REPORTED CARDIOVASCULAR MORTALITY, ALL-CAUSE MORTALITY OR NON-FATAL EVENTS, AND MOST STUDIES WERE SMALL AND SHORT-TERM. THERE WAS SUBSTANTIAL HETEROGENEITY BETWEEN STUDIES MAKING IT IMPOSSIBLE TO COMBINE STUDIES STATISTICALLY FOR SYSTOLIC BLOOD PRESSURE AND TOTAL CHOLESTEROL. YOGA WAS FOUND TO PRODUCE REDUCTIONS IN DIASTOLIC BLOOD PRESSURE (MEAN DIFFERENCE (MD) -2.90 MMHG, 95% CONFIDENCE INTERVAL (CI) -4.52 TO -1.28), WHICH WAS STABLE ON SENSITIVITY ANALYSIS, TRIGLYCERIDES (MD -0.27 MMOL/L, 95% CI -0.44 TO -0.11) AND HIGH-DENSITY LIPOPROTEIN (HDL) CHOLESTEROL (MD 0.08 MMOL/L, 95% CI 0.02 TO 0.14). HOWEVER, THE CONTRIBUTING STUDIES WERE SMALL, SHORT-TERM AND AT UNCLEAR OR HIGH RISK OF BIAS. THERE WAS NO CLEAR EVIDENCE OF A DIFFERENCE BETWEEN GROUPS FOR LOW-DENSITY LIPOPROTEIN (LDL) CHOLESTEROL (MD -0.09 MMOL/L, 95% CI -0.48 TO 0.30), ALTHOUGH THERE WAS MODERATE STATISTICAL HETEROGENEITY. ADVERSE EVENTS, OCCURRENCE OF TYPE 2 DIABETES AND COSTS WERE NOT REPORTED IN ANY OF THE INCLUDED STUDIES. QUALITY OF LIFE WAS MEASURED IN THREE TRIALS BUT THE RESULTS WERE INCONCLUSIVE. AUTHORS' CONCLUSIONS: THE LIMITED EVIDENCE COMES FROM SMALL, SHORT-TERM, LOW-QUALITY STUDIES. THERE IS SOME EVIDENCE THAT YOGA HAS FAVOURABLE EFFECTS ON DIASTOLIC BLOOD PRESSURE, HDL CHOLESTEROL AND TRIGLYCERIDES, AND UNCERTAIN EFFECTS ON LDL CHOLESTEROL. THESE RESULTS SHOULD BE CONSIDERED AS EXPLORATORY AND INTERPRETED WITH CAUTION. 2014 5 2821 53 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 6 660 36 EFFECT OF 12 WEEKS OF YOGA THERAPY ON QUALITY OF LIFE AND INDIAN DIABETES RISK SCORE IN NORMOTENSIVE INDIAN YOUNG ADULT PREDIABETICS AND DIABETICS: RANDOMIZED CONTROL TRIAL. INTRODUCTION: INDIA HAS BECOME THE EPICENTRE FOR DIABETES, A STRESS-RELATED DISORDER AFFECTING THE WORKING SKILLS AND DAY-TO-DAY LIFESTYLE MANAGEMENT OF YOUNGER POPULATION. MOST OF THE STUDIES HAVE REPORTED THE EFFECT OF YOGA ON IMPROVING QUALITY OF LIFE (QOL) IN DIABETIC PATIENTS WITH OTHER COMORBIDITIES. TILL DATE, NO RANDOMIZED CONTROL TRIAL REPORTS ARE AVAILABLE TO SHOW THE EFFECT OF YOGA THERAPY ON QOL AND INDIAN DIABETES RISK SCORE (IDRS) IN NORMOTENSIVE PREDIABETIC AND DIABETIC YOUNG INDIVIDUALS. AIM: TO DETERMINE THE EFFECT OF 12 WEEKS OF YOGA THERAPY ON QOL AND IDRS AMONG NORMOTENSIVE PREDIABETIC AND DIABETIC YOUNG INDIAN ADULTS. MATERIALS AND METHODS: A RANDOMIZED CONTROL TRIAL WAS CONDUCTED IN ENDOCRINOLOGY OUTPATIENT DEPARTMENT (OPD). NORMOTENSIVE PARTICIPANTS (N=310) AGED 18-45 YEARS WERE DIVIDED INTO HEALTHY CONTROLS (N=62), PREDIABETICS (N=124) AND DIABETICS (N=124). STUDY GROUP SUBJECTS WERE RANDOMLY ASSIGNED TO GROUP II (N=62, PREDIABETES-STANDARD TREATMENT), GROUP III (N=62, PREDIABETES-STANDARD TREATMENT + YOGA THERAPY), GROUP IV (N=62, DIABETES-STANDARD TREATMENT) AND GROUP V (N=62, DIABETES-STANDARD TREATMENT + YOGA THERAPY). FLANAGAN QOL SCALE, IDRS QUESTIONNAIRE, FASTING PLASMA GLUCOSE (FPG) AND INSULIN WERE ASSESSED PRE AND POST 12 WEEKS OF INTERVENTION. STATISTICAL ANALYSIS WAS DONE USING STUDENT'S PAIRED T-TEST AND ONE-WAY ANOVA. RESULTS: PRE-POST INTERVENTION ANALYSIS SHOWED SIGNIFICANT IMPROVEMENT IN QOL SCALE WITH P<0.01 IN GROUP II AND GROUP IV; P<0.001 IN GROUP III AND GROUP V RESPECTIVELY. THERE WAS SIGNIFICANT REDUCTION IN IDRS IN GROUP II (P<0.05); P<0.001 IN GROUP III, GROUP IV AND GROUP V RESPECTIVELY. SIGNIFICANT DIFFERENCE (P<0.001) IN QOL SCALE AND IDRS WERE FOUND WHEN STUDY GROUPS WITH STANDARD TREATMENT ALONG WITH YOGA THERAPY WERE COMPARED TO STANDARD TREATMENT ALONE. CONCLUSION: YOGA THERAPY ALONG WITH STANDARD TREATMENT FOR 12 WEEKS IMPROVED QOL AND ATTENUATED THE DIABETES RISK AMONG INDIAN PREDIABETICS AND DIABETICS COMPARED TO STANDARD TREATMENT ALONE. 2017 7 2820 51 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 8 1116 42 EFFICACY OF A VALIDATED YOGA PROTOCOL ON DYSLIPIDEMIA IN DIABETES PATIENTS: NMB-2017 INDIA TRIAL. BACKGROUND: DYSLIPIDEMIA IS CONSIDERED A RISK FACTOR IN TYPE 2 DIABETES MELLITUS (T2DM) RESULTING IN CARDIO-VASCULAR COMPLICATIONS. YOGA PRACTICES HAVE SHOWN PROMISING RESULTS IN ALLEVIATING TYPE 2 DIABETES PATHOLOGY. METHOD: IN THIS STRATIFIED TRIAL ON A YOGA BASED LIFESTYLE PROGRAM IN CASES WITH TYPE 2 DIABETES, IN THE RURAL AND URBAN POPULATION FROM ALL ZONES OF INDIA, A TOTAL OF 17,012 ADULTS (>20 YEARS) OF BOTH GENDERS WERE SCREENED FOR LIPID PROFILE AND SUGAR LEVELS. THOSE WHO SATISFIED THE SELECTION CRITERIA WERE TAUGHT THE DIABETES YOGA PROTOCOL (DYP) FOR THREE MONTHS AND THE DATA WERE ANALYZED. RESULTS: AMONG THOSE WITH DIABETES, 29.1% HAD ELEVATED TOTAL CHOLESTEROL (TC > 200 MG/DL) LEVELS THAT WERE HIGHER IN URBAN (69%) THAN RURAL (31%) DIABETES PATIENTS. THERE WAS A POSITIVE CORRELATION (P = 0.048) BETWEEN HBA1C AND TOTAL CHOLESTEROL LEVELS. DYP INTERVENTION HELPED IN REDUCING TC FROM 232.34 +/- 31.48 MG/DL TO 189.38 +/- 40.23 MG/DL WITH SIGNIFICANT PRE POST DIFFERENCE (P < 0.001). CONVERSION RATE FROM HIGH TC (>200 MG/DL) TO NORMAL TC (<200 MG/DL) WAS OBSERVED IN 60.3% OF CASES WITH TYPE 2 DIABETES MELLITUS (T2DM); FROM HIGH LDL (>130 MG/DL) TO NORMAL LDL (<130 MG/DL) IN 73.7%; FROM HIGH TRIGLYCERIDE (>200 MG/DL) TO NORMAL TRIGLYCERIDE LEVEL (<200 MG/DL) IN 63%; FROM LOW HDL (<45 MG/DL) TO NORMAL HDL (>45 MG/DL) IN 43.7% OF T2DM PATIENTS AFTER THREE MONTHS OF DYP. CONCLUSIONS: A YOGA LIFESTYLE PROGRAM DESIGNED SPECIFICALLY TO MANAGE DIABETES HELPS IN REDUCING THE CO-MORBIDITY OF DYSLIPIDEMIA IN CASES OF PATIENTS WITH T2DM. 2019 9 2587 41 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 10 190 36 A RANDOMIZED STUDY OF YOGA THERAPY FOR THE PREVENTION OF RECURRENT REFLEX VASOVAGAL SYNCOPE. AIMS: VASOVAGAL SYNCOPE (VVS) IS A COMMON CARDIOVASCULAR DYSAUTONOMIC DISORDER THAT SIGNIFICANTLY IMPACTS HEALTH AND QUALITY OF LIFE (QOL). YOGA HAS BEEN SHOWN TO HAVE A POSITIVE INFLUENCE ON CARDIOVASCULAR AUTONOMICS. THIS STUDY ASSESSED THE EFFECTIVENESS OF YOGA THERAPY ON THE RECURRENCE OF VVS AND QOL. METHODS AND RESULTS: WE RANDOMIZED SUBJECTS WITH RECURRENT REFLEX VVS (>3 EPISODES IN THE PAST 1 YEAR) AND POSITIVE HEAD-UP TILT TEST TO GUIDELINE-DIRECTED THERAPY (GROUP 1) OR YOGA THERAPY (GROUP 2). PATIENTS IN GROUP 1 WERE ADVISED GUIDELINE-DIRECTED TREATMENT AND GROUP 2 WAS TAUGHT YOGA BY A CERTIFIED INSTRUCTOR. THE PRIMARY ENDPOINT WAS VVS RECURRENCES AND QOL. BETWEEN JUNE 2015 AND FEBRUARY 2017, 97 HIGHLY SYMPTOMATIC VVS PATIENTS WERE RANDOMIZED (GROUP 1: 47 AND GROUP 2: 50). THE MEAN AGE WAS 33.1 +/- 16.6 YEARS, MALE:FEMALE OF 40:57, SYMPTOM DURATION OF 17.1 +/- 20.7 MONTHS, WITH A MEAN OF 6.4 +/- 6.1 SYNCOPE EPISODES. OVER A FOLLOW-UP OF 14.3 +/- 2.1 MONTHS GROUP 2 HAD SIGNIFICANTLY LOWER SYNCOPE BURDEN COMPARED WITH GROUP 1 AT 3 (0.8 +/- 0.9 VS. 1.8 +/- 1.4, P < 0.001), 6 (1.0 +/- 1.2 VS. 3.4 +/- 3.0, P < 0.001), AND AT 12 MONTHS (1.1 +/- 0.8 VS. 3.8 +/- 3.2, P < 0.001). THE SYNCOPE FUNCTIONAL SCORE QUESTIONNAIRE WAS SIGNIFICANTLY LOWER IN GROUP 2 COMPARED WITH GROUP 1 AT 3 (31.4 +/- 7.2 VS. 64.1 +/- 11.5, P < 0.001), 6 (26.4 +/- 6.3 VS. 61.4 +/- 10.7, P < 0.001), AND 12 MONTHS (22.2 +/- 4.7 VS. 68.3 +/- 11.4, P < 0.001). CONCLUSION: FOR PATIENTS WITH RECURRENT VVS, GUIDED YOGA THERAPY IS SUPERIOR TO CONVENTIONAL THERAPY IN REDUCING SYMPTOM BURDEN AND IMPROVING QOL. 2021 11 2857 35 YOGA-BASED CARDIAC REHABILITATION AFTER ACUTE MYOCARDIAL INFARCTION: A RANDOMIZED TRIAL. BACKGROUND: GIVEN THE SHORTAGE OF CARDIAC REHABILITATION (CR) PROGRAMS IN INDIA AND POOR UPTAKE WORLDWIDE, THERE IS AN URGENT NEED TO FIND ALTERNATIVE MODELS OF CR THAT ARE INEXPENSIVE AND MAY OFFER CHOICE TO SUBGROUPS WITH POOR UPTAKE (E.G., WOMEN AND ELDERLY). OBJECTIVES: THIS STUDY SOUGHT TO EVALUATE THE EFFECTS OF YOGA-BASED CR (YOGA-CARE) ON MAJOR CARDIOVASCULAR EVENTS AND SELF-RATED HEALTH IN A MULTICENTER RANDOMIZED CONTROLLED TRIAL. METHODS: THE TRIAL WAS CONDUCTED IN 24 MEDICAL CENTERS ACROSS INDIA. THIS STUDY RECRUITED 3,959 PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITH A MEDIAN AND MINIMUM FOLLOW-UP OF 22 AND 6 MONTHS. PATIENTS WERE INDIVIDUALLY RANDOMIZED TO RECEIVE EITHER A YOGA-CARE PROGRAM (N = 1,970) OR ENHANCED STANDARD CARE INVOLVING EDUCATIONAL ADVICE (N = 1,989). THE CO-PRIMARY OUTCOMES WERE: 1) FIRST OCCURRENCE OF MAJOR ADVERSE CARDIOVASCULAR EVENTS (MACE) (COMPOSITE OF ALL-CAUSE MORTALITY, MYOCARDIAL INFARCTION, STROKE, OR EMERGENCY CARDIOVASCULAR HOSPITALIZATION); AND 2) SELF-RATED HEALTH ON THE EUROPEAN QUALITY OF LIFE-5 DIMENSIONS-5 LEVEL VISUAL ANALOGUE SCALE AT 12 WEEKS. RESULTS: MACE OCCURRED IN 131 (6.7%) PATIENTS IN THE YOGA-CARE GROUP AND 146 (7.4%) PATIENTS IN THE ENHANCED STANDARD CARE GROUP (HAZARD RATIO WITH YOGA-CARE: 0.90; 95% CONFIDENCE INTERVAL [CI]: 0.71 TO 1.15; P = 0.41). SELF-RATED HEALTH WAS 77 IN YOGA-CARE AND 75.7 IN THE ENHANCED STANDARD CARE GROUP (BASELINE-ADJUSTED MEAN DIFFERENCE IN FAVOR OF YOGA-CARE: 1.5; 95% CI: 0.5 TO 2.5; P = 0.002). THE YOGA-CARE GROUP HAD GREATER RETURN TO PRE-INFARCT ACTIVITIES, BUT THERE WAS NO DIFFERENCE IN TOBACCO CESSATION OR MEDICATION ADHERENCE BETWEEN THE TREATMENT GROUPS (SECONDARY OUTCOMES). CONCLUSIONS: YOGA-CARE IMPROVED SELF-RATED HEALTH AND RETURN TO PRE-INFARCT ACTIVITIES AFTER ACUTE MYOCARDIAL INFARCTION, BUT THE TRIAL LACKED STATISTICAL POWER TO SHOW A DIFFERENCE IN MACE. YOGA-CARE MAY BE AN OPTION WHEN CONVENTIONAL CR IS UNAVAILABLE OR UNACCEPTABLE TO INDIVIDUALS. (A STUDY ON EFFECTIVENESS OF YOGA BASED CARDIAC REHABILITATION PROGRAMME IN INDIA AND UNITED KINGDOM; CTRI/2012/02/002408). 2020 12 613 29 DEVELOPMENT OF A YOGA PROGRAM FOR TYPE-2 DIABETES PREVENTION (YOGA-DP) AMONG HIGH-RISK PEOPLE IN INDIA. INTRODUCTION: MANY INDIANS ARE AT HIGH-RISK OF TYPE-2 DIABETES MELLITUS (T2DM). YOGA IS AN ANCIENT INDIAN MIND-BODY DISCIPLINE, THAT HAS BEEN ASSOCIATED WITH IMPROVED GLUCOSE LEVELS AND CAN HELP TO PREVENT T2DM. THE STUDY AIMED TO SYSTEMATICALLY DEVELOP A YOGA PROGRAM FOR T2DM PREVENTION (YOGA-DP) AMONG HIGH-RISK PEOPLE IN INDIA USING A COMPLEX INTERVENTION DEVELOPMENT APPROACH. MATERIALS AND METHODS: AS PART OF THE INTERVENTION, WE DEVELOPED A BOOKLET AND A HIGH-DEFINITION VIDEO FOR PARTICIPANTS AND A MANUAL FOR YOGA-DP INSTRUCTORS. A SYSTEMATIC ITERATIVE PROCESS WAS FOLLOWED TO DEVELOP THE INTERVENTION AND INCLUDED FIVE STEPS: (I) A SYSTEMATIC REVIEW OF THE LITERATURE TO GENERATE A LIST OF YOGIC PRACTICES THAT IMPROVES BLOOD GLUCOSE LEVELS AMONG ADULTS AT HIGH-RISK OF OR WITH T2DM, (II) VALIDATION OF IDENTIFIED YOGIC PRACTICES BY YOGA EXPERTS, (III) DEVELOPMENT OF THE INTERVENTION, (IV) CONSULTATION WITH YOGA, EXERCISE, PHYSICAL ACTIVITY, DIET, BEHAVIOR CHANGE, AND/OR DIABETES EXPERTS ABOUT THE INTERVENTION, AND (V) PRETEST THE INTERVENTION AMONG YOGA PRACTITIONERS AND LAY PEOPLE (THOSE AT RISK OF T2DM AND HAD NOT PRACTICED YOGA BEFORE) IN INDIA. RESULTS: YOGA-DP IS A STRUCTURED LIFESTYLE EDUCATION AND EXERCISE PROGRAM, PROVIDED OVER A PERIOD OF 24 WEEKS. THE EXERCISE PART IS BASED ON YOGA AND INCLUDES SHITHILIKARANA VYAYAMA (LOOSENING EXERCISES), SURYA NAMASKAR (SUN SALUTATION EXERCISES), ASANA (YOGIC POSES), PRANAYAMA (BREATHING PRACTICES), AND DHYANA (MEDITATION) AND RELAXATION PRACTICES. ONCE PARTICIPANTS COMPLETE THE PROGRAM, THEY ARE STRONGLY ENCOURAGED TO MAINTAIN A HEALTHY LIFESTYLE IN THE LONG-TERM. CONCLUSIONS: WE SYSTEMATICALLY DEVELOPED A NOVEL YOGA PROGRAM FOR T2DM PREVENTION (YOGA-DP) AMONG HIGH-RISK PEOPLE IN INDIA. A MULTI-CENTER FEASIBILITY RANDOMIZED CONTROLLED TRIAL IS IN PROGRESS IN INDIA. 2020 13 2636 43 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 14 926 46 EFFECTIVENESS OF YOGA LIFESTYLE ON LIPID METABOLISM IN A VULNERABLE POPULATION-A COMMUNITY BASED MULTICENTER RANDOMIZED CONTROLLED TRIAL. BACKGROUND: DYSLIPIDEMIA POSES A HIGH RISK FOR CARDIOVASCULAR DISEASE AND STROKE IN TYPE 2 DIABETES (T2DM). THERE ARE NO STUDIES ON THE IMPACT OF A VALIDATED INTEGRATED YOGA LIFESTYLE PROTOCOL ON LIPID PROFILES IN A HIGH-RISK DIABETES POPULATION. METHODS: HERE, WE REPORT THE RESULTS OF LIPID PROFILE VALUES OF 11,254 (YOGA 5932 AND CONTROL 5322) ADULTS (20-70 YEARS) OF BOTH GENDERS WITH HIGH RISK (>/=60 ON INDIAN DIABETES RISK SCORE) FOR DIABETES FROM A NATIONWIDE RURAL AND URBAN COMMUNITY-BASED TWO GROUP (YOGA AND CONVENTIONAL MANAGEMENT) CLUSTER RANDOMIZED CONTROLLED TRIAL. THE YOGA GROUP PRACTICED A VALIDATED INTEGRATED YOGA LIFESTYLE PROTOCOL (DYP) IN NINE DAY CAMPS FOLLOWED BY DAILY ONE-HOUR PRACTICE. BIOCHEMICAL PROFILING INCLUDED GLYCATED HEMOGLOBIN AND LIPID PROFILES BEFORE AND AFTER THREE MONTHS. RESULTS: THERE WAS A SIGNIFICANT DIFFERENCE BETWEEN GROUPS (P < 0.001 ANCOVA) WITH IMPROVED SERUM TOTAL CHOLESTEROL, TRIGLYCERIDES, LOW-DENSITY LIPOPROTEIN, AND HIGH-DENSITY LIPOPROTEIN IN THE YOGA GROUP COMPARED TO THE CONTROL GROUP. FURTHER, THE REGULATORY EFFECT OF YOGA WAS NOTED WITH A SIGNIFICANT DECREASE OR INCREASE IN THOSE WITH HIGH OR LOW VALUES OF LIPIDS, RESPECTIVELY, WITH MARGINAL OR NO CHANGE IN THOSE WITHIN THE NORMAL RANGE. CONCLUSION: YOGA LIFESTYLE IMPROVES AND REGULATES (LOWERED IF HIGH, INCREASED IF LOW) THE BLOOD LIPID LEVELS IN BOTH GENDERS OF PREDIABETIC AND DIABETIC INDIVIDUALS IN BOTH RURAL AND URBAN INDIAN COMMUNITIES. 2021 15 691 36 EFFECT OF COMMUNITY-BASED STRUCTURED YOGA PROGRAM ON HBA1C LEVEL AMONG TYPE 2 DIABETES MELLITUS PATIENTS: AN INTERVENTIONAL STUDY. CONTEXT: IN VIEW OF THE RISING BURDEN OF TYPE 2 DIABETES MELLITUS (DM) CASES IN INDIA, THERE IS AN URGENT NEED FOR AN EFFECTIVE, LOW-COST, SUSTAINABLE INTERVENTION CONTROLLING DIABETES THUS PREVENTING COMPLICATIONS. AIMS: THIS STUDY AIMED TO ASSESS THE EFFECT OF STRUCTURED YOGA PROGRAMS ON DIABETES. SUBJECTS AND METHODS: THIS WAS A COMMUNITY-BASED INTERVENTIONAL STUDY THAT WAS CONDUCTED IN AN URBAN RESETTLEMENT COLONY OF DELHI, INDIA. KNOWN DIABETES PATIENTS WITH GLYCATED HEMOGLOBIN (HB1AC) >/=6.5% WERE ENROLLED FROM 12 RANDOMLY SELECTED BLOCKS OF THE COMMUNITY WITH A SAMPLE SIZE OF 192 IN EACH INTERVENTION AND WAIT-LISTED CONTROL ARM. THE INTERVENTION WAS STRUCTURED YOGA OF 50 MIN DAILY, 2 CONSECUTIVE WEEKS IN A NEARBY PARK AND HEALTH CENTER FOLLOWED BY TWICE A WEEK HOME PRACTICE UP TO THE 3(RD) MONTH. THE PRIMARY OUTCOME MEASURE WAS HBA1C% AND SECONDARY OUTCOME MEASURES WERE LIPID PROFILE AND FASTING BLOOD GLUCOSE. STATISTICAL ANALYSIS USED: APER-PROTOCOL ANALYSIS WAS DONE. MEAN, STANDARD DEVIATION (SD), AND 95% CONFIDENCE INTERVAL WERE ESTIMATED. THE LEVEL OF SIGNIFICANCE WAS CONSIDERED FOR 0.05. RESULTS: THERE WAS A SIGNIFICANT DECREASE OF HB1AC (0.5%, SD = 1.5, P = 0.02), TOTAL CHOLESTEROL (11.7 MG/DL, SD = 40.5, P < 0.01), AND LOW-DENSITY LIPOPROTEIN (3.2 MG/DL, SD = 37.4, P < 0.01) FROM BASELINE TO END LINE IN THE INTERVENTION GROUP. THESE CHANGES IN INTERVENTION GROUP WERE ALSO SIGNIFICANTLY DIFFERENT FROM THE CHANGE IN THE WAIT-LISTED CONTROL GROUP. THE OTHER VARIABLES DID NOT CHANGE SIGNIFICANTLY. CONCLUSIONS: IT REVEALED THAT STRUCTURED YOGA PROGRAM IMPROVED GLYCEMIC OUTCOME AND LIPID PROFILE OF INDIVIDUALS IN A COMMUNITY-BASED SETTING. YOGA CAN BE A FEASIBLE STRATEGY TO CONTROL HYPERGLYCEMIA, LIPID LEVELS, AND CAN HELP BETTER CONTROL TYPE 2 DM. 2021 16 2928 31 [YOGA IN GERMANY - RESULTS OF A NATIONALLY REPRESENTATIVE SURVEY]. BACKGROUND: YOGA IS INCREASINGLY USED AS A THERAPEUTIC AND PREVENTIVE METHOD WORLDWIDE. THE AIM OF THIS NATIONALLY REPRESENTATIVE SURVEY WAS TO ASSESS PREVALENCE AND PATTERNS OF YOGA PRACTICE IN GERMANY. METHODS: BETWEEN AUGUST AND SEPTEMBER 2014, A NATIONALLY REPRESENTATIVE SAMPLE OF 2,041 INDIVIDUALS OF AT LEAST 14 YEARS OF AGE WAS INTERVIEWED REGARDING ACTUAL AND PRIOR YOGA PRACTICE. DIFFERENCES BETWEEN SOCIOECONOMIC SUBGROUPS WERE ANALYZED USING CHI-SQUARED TESTS. RESULTS: LIFETIME PREVALENCE OF YOGA PRACTICE WAS 15.1%, POINT PREVALENCE 3.3%. HIGHER PREVALENCE WAS ASSOCIATED WITH FEMALE GENDER (P < 0.001), HIGHER EDUCATION (P < 0.001), EMPLOYMENT (P = 0.047), AND LIVING IN A MAJOR CITY (P < 0.001). MEAN DURATION OF YOGA PRACTICE WAS 48.2 MONTHS; 61.7% PRACTICED AT LEAST ONCE WEEKLY. THE MAIN REASONS FOR YOGA PRACTICE WERE IMPROVED PHYSICAL (62.8%) AND MENTAL WELL-BEING (56.9%) AS WELL AS PHYSICAL (54.4%) AND MENTAL CAPACITY (50.0%). POSITIVE CHANGES DUE TO YOGA WERE REPORTED BY 89.7% OF PRACTITIONERS, MAINLY INCREASED INNER BALANCE (58.8%). ANOTHER 16.1% OF THOSE WHO WERE NOT CURRENTLY PRACTICING COULD IMAGINE PRACTICING YOGA IN THE NEXT 12 MONTHS. CONCLUSION: AN ESTIMATED 15.7 MILLION GERMANS ARE CURRENTLY PRACTICING YOGA OR ARE AT LEAST INTERESTED IN STARTING TO PRACTICE, MOST COMMONLY WOMEN, METROPOLITANS, AND THOSE WITH A HIGHER EDUCATION AS WELL AS EMPLOYED PERSONS. ALMOST 90% PRACTITIONERS REPORT POSITIVE CHANGES DUE TO THEIR YOGA PRACTICE. 2015 17 291 30 ADVERSE EFFECTS OF YOGA: A NATIONAL CROSS-SECTIONAL SURVEY. BACKGROUND: WHILE YOGA IS INCREASINGLY USED FOR HEALTH PURPOSES, ITS SAFETY HAS BEEN QUESTIONED. THE AIM OF THIS CROSS-SECTIONAL SURVEY WAS TO ANALYZE YOGA-ASSOCIATED ADVERSE EFFECTS AND THEIR CORRELATES. METHODS: A CROSS-SECTIONAL ANONYMOUS NATIONAL ONLINE SURVEY AMONG GERMAN YOGA PRACTITIONERS (N = 1702; 88.9% FEMALE; 47.2 +/- 10.8 YEARS) WAS CONDUCTED FROM JANUARY TO JUNE 2016. PARTICIPANTS WERE QUERIED REGARDING THEIR YOGA PRACTICE, I.E. YOGA STYLES USED, LENGTH AND INTENSITY OF YOGA PRACTICE, PRACTICE PATTERNS, AND WHETHER THEY HAD EXPERIENCED ACUTE OR CHRONIC ADVERSE EFFECTS OF THEIR YOGA PRACTICE. INDEPENDENT PREDICTORS OF ACUTE OR CHRONIC ADVERSE EFFECTS WERE IDENTIFIED USING MULTIPLE LOGISTIC REGRESSION ANALYSES. RESULTS: ASHTANGA YOGA (15.7%), TRADITIONAL HATHA YOGA (14.2%), AND SIVANANDA YOGA (22.4%) WERE THE MOST COMMONLY USED YOGA STYLES. 364 (21.4%) YOGA USERS REPORTED 702 ACUTE ADVERSE EFFECTS, OCCURRING AFTER A MEAN OF 7.6 +/- 8.0 YEARS OF YOGA PRACTICE. THE MOST COMMONLY REPORTED YOGA PRACTICES THAT WERE ASSOCIATED WITH ACUTE ADVERSE EFFECTS WERE HAND-, SHOULDER- AND HEAD STANDS (29.4%). USING VINIYOGA WAS ASSOCIATED WITH A DECREASED RISK OF ACUTE ADVERSE EFFECTS; PRACTICING ONLY BY SELF-STUDY WITHOUT SUPERVISION WAS ASSOCIATED WITH HIGHER RISK. ONE HUNDRED SEVENTY-THREE PARTICIPANTS (10.2%) REPORTED 239 CHRONIC ADVERSE EFFECTS. THE RISK OF CHRONIC ADVERSE EFFECTS WAS HIGHER IN PARTICIPANTS WITH CHRONIC ILLNESSES AND THOSE PRACTICING ONLY BY SELF-STUDY WITHOUT SUPERVISION. MOST REPORTED ADVERSE EFFECTS CONCERNED THE MUSCULOSKELETAL SYSTEM. 76.9% OF ACUTE CASES, AND 51.6% OF CHRONIC CASES REACHED FULL RECOVERY. ON AVERAGE 0.60 INJURIES (95% CONFIDENCE INTERVAL = 0.51-0.71) PER 1000 H OF PRACTICE WERE REPORTED, WITH POWER YOGA USERS REPORTING THE HIGHEST RATE (1.50 INJURIES PER 1000 H; 95% CONFIDENCE INTERVAL = 0.98-3.15). CONCLUSIONS: ONE IN FIVE ADULT YOGA USERS REPORTED AT LEAST ONE ACUTE ADVERSE EFFECT IN THEIR YOGA PRACTICE, AND ONE IN TEN REPORTED AT LEAST ONE CHRONIC ADVERSE EFFECT, MAINLY MUSCULOSKELETAL EFFECTS. ADVERSE EFFECTS WERE ASSOCIATED WITH HAND-, SHOULDER- AND HEAD STANDS; AND WITH YOGA SELF-STUDY WITHOUT SUPERVISION. MORE THAN THREE QUARTERS OF OF CASES REACHED FULL RECOVERY. BASED ON THE OVERALL INJURY RATE PER 1000 PRACTICE HOURS, YOGA APPEARS TO BE AS SAFE OR SAFER WHEN COMPARED TO OTHER EXERCISE TYPES. 2019 18 1924 28 ROLE OF YOGA FOR PATIENTS WITH TYPE II DIABETES MELLITUS: A SYSTEMATIC REVIEW AND META-ANALYSIS. TO UNDERSTAND THE ROLE AND EFFICACY OF YOGA IN THE MANAGEMENT OF TYPE 2 DIABETES MELLITUS, THIS META-ANALYSIS WAS CONDUCTED. ELECTRONIC DATA BASES SEARCHED WERE PUBMED/MEDLINE, PROQUEST, PSYCINFO, INDMED, CENTRAL, COCHRANE LIBRARY, CAMQUEST AND CAMBASE TILL DECEMBER 17, 2014. ELIGIBLE OUTCOMES WERE FASTING BLOOD SUGAR (FBS), POST PRANDIAL BLOOD SUGAR (PPBS) AND GLYCOSYLATED HAEMOGLOBIN (HBA1C). RANDOMIZED CONTROLLED TRIALS AND CONTROLLED TRIALS WERE ELIGIBLE. STUDIES FOCUSSING ONLY ON RELAXATION OR MEDITATION OR MULTIMODAL INTERVENTION WERE NOT INCLUDED. A TOTAL OF 17 RCTS WERE INCLUDED FOR REVIEW. DATA FROM RESEARCH ARTICLES ON PATIENTS, METHODS, INTERVENTIONS- CONTROL AND RESULTS WERE EXTRACTED. MEAN AND STANDARD DEVIATIONS WERE UTILIZED FOR CALCULATING STANDARDIZED MEAN DIFFERENCE WITH 95% CONFIDENCE INTERVAL. HETEROGENEITY WAS ASSESSED WITH THE HELP OF I(2) STATISTICS. CHI(2) WAS USED TO RULE OUT THE EFFECTS OF HETEROGENEITY DUE TO CHANCE ALONE. BENEFICIAL EFFECTS OF YOGA AS AN ADD-ON INTERVENTION TO STANDARD TREATMENT IN COMPARISON TO STANDARD TREATMENT WERE OBSERVED FOR FBS [STANDARDIZED MEAN DIFFERENCE (SMD) -1.40, 95%CI -1.90 TO -0.90, P<0.00001]; PPBS [SMD -0.91, 95%CI -1.34 TO -0.48, P<0.0001] AS WELL AS HBA1C [SMD -0.64, 95%CI -0.97 TO -0.30, P<0.0002]. BUT RISK OF BIAS WAS OVERALL HIGH FOR INCLUDED STUDIES. WITH THIS AVAILABLE EVIDENCE, YOGA CAN BE CONSIDERED AS ADD-ON INTERVENTION FOR MANAGEMENT OF DIABETES. 2016 19 2616 42 YOGA FOR SECONDARY PREVENTION OF CORONARY HEART DISEASE. BACKGROUND: CORONARY HEART DISEASE (CHD) IS THE MAJOR CAUSE OF EARLY MORBIDITY AND MORTALITY IN MOST DEVELOPED COUNTRIES. SECONDARY PREVENTION AIMS TO PREVENT REPEAT CARDIAC EVENTS AND DEATH IN PEOPLE WITH ESTABLISHED CHD. LIFESTYLE MODIFICATIONS PLAY AN IMPORTANT ROLE IN SECONDARY PREVENTION. YOGA HAS BEEN REGARDED AS A TYPE OF PHYSICAL ACTIVITY AS WELL AS A STRESS MANAGEMENT STRATEGY. GROWING EVIDENCE SUGGESTS THE BENEFICIAL EFFECTS OF YOGA ON VARIOUS AILMENTS. OBJECTIVES: TO DETERMINE THE EFFECTIVENESS OF YOGA FOR THE SECONDARY PREVENTION OF MORTALITY AND MORBIDITY IN, AND ON THE HEALTH-RELATED QUALITY OF LIFE OF, INDIVIDUALS WITH CHD. SEARCH METHODS: THIS IS AN UPDATE OF A REVIEW PREVIOUSLY PUBLISHED IN 2012. FOR THIS UPDATED REVIEW, WE SEARCHED THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL) IN THE COCHRANE LIBRARY (ISSUE 1 OF 12, 2014), MEDLINE (1948 TO FEBRUARY WEEK 1 2014), EMBASE (1980 TO 2014 WEEK 6), WEB OF SCIENCE (THOMSON REUTERS, 1970 TO 12 FEBRUARY 2014), CHINA JOURNAL NET (1994 TO MAY 2014), WANFANG DATA (1990 TO MAY 2014), AND INDEX TO CHINESE PERIODICALS OF HONG KONG (HKINCHIP) (FROM 1980). ONGOING STUDIES WERE IDENTIFIED IN THE METAREGISTER OF CONTROLLED TRIALS (MAY 2014) AND THE WORLD HEALTH ORGANIZATION INTERNATIONAL CLINICAL TRIALS REGISTRY PLATFORM (MAY 2014). WE APPLIED NO LANGUAGE RESTRICTIONS. SELECTION CRITERIA: WE PLANNED TO INCLUDE RANDOMISED CONTROLLED TRIALS (RCTS) INVESTIGATING THE INFLUENCE OF YOGA PRACTICE ON CHD OUTCOMES IN MEN AND WOMEN (AGED 18 YEARS AND OVER) WITH A DIAGNOSIS OF ACUTE OR CHRONIC CHD. STUDIES WERE ELIGIBLE FOR INCLUSION IF THEY HAD A FOLLOW-UP DURATION OF SIX MONTHS OR MORE. WE CONSIDERED STUDIES THAT COMPARED ONE GROUP PRACTICING A TYPE OF YOGA WITH A CONTROL GROUP RECEIVING EITHER NO INTERVENTION OR INTERVENTIONS OTHER THAN YOGA. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SELECTED STUDIES ACCORDING TO PRESPECIFIED INCLUSION CRITERIA. WE RESOLVED DISAGREEMENTS EITHER BY CONSENSUS OR BY DISCUSSION WITH A THIRD AUTHOR. MAIN RESULTS: WE FOUND NO ELIGIBLE RCTS THAT MET THE INCLUSION CRITERIA OF THE REVIEW AND THUS WE WERE UNABLE TO PERFORM A META-ANALYSIS. AUTHORS' CONCLUSIONS: THE EFFECTIVENESS OF YOGA FOR SECONDARY PREVENTION IN CHD REMAINS UNCERTAIN. LARGE RCTS OF HIGH QUALITY ARE NEEDED. 2015 20 2543 47 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