1 2829 261 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 2 2827 214 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 3 2497 171 YOGA AS PART OF A PACKAGE OF CARE 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 THE EFFICACY OF YOGA DELIVERED AS A PACKAGE OF CARE VERSUS STANDARD CARE. OBJECTIVES: TO EXAMINE THE EFFECTS OF YOGA AS A PACKAGE OF CARE VERSUS STANDARD CARE. SEARCH METHODS: WE SEARCHED THE COCHRANE SCHIZOPHRENIA GROUP TRIALS REGISTER (LATEST 30 MARCH 2017) WHICH IS BASED ON REGULAR SEARCHES OF MEDLINE, PUBMED, EMBASE, CINAHL, BIOSS, AMED, PSYCHINFO, 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 COMPARING YOGA AS A PACKAGE OF CARE WITH STANDARD-CARE CONTROL. DATA COLLECTION AND ANALYSIS: THE REVIEW AUTHORS INDEPENDENTLY SELECTED STUDIES, QUALITY RATED THESE, AND EXTRACTED DATA. FOR BINARY OUTCOMES, WE CALCULATED RISK DIFFERENCE (RD) AND ITS 95% CONFIDENCE INTERVAL (CI), ON AN INTENTION-TO-TREAT (ITT) BASIS. FOR CONTINUOUS DATA, WE ESTIMATED THE MEAN DIFFERENCE (MD) BETWEEN GROUPS AND ITS CI. WE EMPLOYED MIXED-EFFECT AND FIXED-EFFECT MODELS FOR ANALYSIS. WE EXAMINED HETEROGENEITY (I(2) TECHNIQUE), ASSESSED RISK OF BIAS FOR INCLUDED STUDIES, AND CREATED A 'SUMMARY OF FINDINGS' TABLE USING GRADE (GRADING OF RECOMMENDATIONS ASSESSMENT, DEVELOPMENT AND EVALUATION). MAIN RESULTS: THREE STUDIES ARE INCLUDED IN THIS REVIEW. ALL OUTCOMES WERE SHORT TERM (LESS THAN EIGHT WEEKS). USEABLE DATA WERE REPORTED FOR TWO OUTCOMES ONLY; LEAVING THE STUDY EARLY AND QUALITY OF LIFE. NONE OF THE PARTICIPANTS LEFT THE STUDIES EARLY AND THERE WAS SOME EVIDENCE IN FAVOUR OF THE YOGA PACKAGE FOR QUALITY OF LIFE ENDPOINT SCORES (1 RCT, N=80, MD 22.93 CI 19.74 TO 26.12, LOW-QUALITY EVIDENCE). LEAVING THE STUDY EARLY DATA WERE EQUIVOCAL BETWEEN THE TREATMENT GROUPS (3 RCTS, N=193, RD 0.06 CI -0.01 TO 0.13, MEDIUM-QUALITY EVIDENCE, HIGH HETEROGENEITY). OVERALL, THIS REVIEW HAS AN INORDINATE NUMBER OF MISSING KEY OUTCOMES, WHICH INCLUDED MENTAL AND GLOBAL STATE, SOCIAL FUNCTIONING, PHYSICAL HEALTH, ADVERSE EFFECTS AND COSTS OF CARE. AUTHORS' CONCLUSIONS: A SMALL NUMBER OF SMALL STUDIES WERE INCLUDED IN THIS REVIEW AND THESE LACKED MANY KEY OUTCOMES. THE SPARSE DATA MEANS WE CANNOT STATE WITH ANY DEGREE OF CERTAINTY IF YOGA DELIVERED AS A PACKAGE OF CARE IS BENEFICIAL IN COMPARISON TO STANDARD CARE. 2017 4 1093 59 EFFECTS OF YOGA ON WELL-BEING AND HEALTHY AGEING: STUDY PROTOCOL FOR A RANDOMISED CONTROLLED TRIAL (FITFORAGE). INTRODUCTION: DUE TO AGEING POPULATIONS WORLDWIDE, THE BURDEN OF DISABILITY IS INCREASING. IT IS THEREFORE IMPORTANT TO DEVELOP INTERVENTIONS THAT IMPROVE HEALTHY AGEING, REDUCE DISABILITY ONSET AND ENHANCE LIFE QUALITY. PHYSICAL ACTIVITY CAN PROMOTE HEALTHY AGEING AND HELP MAINTAIN INDEPENDENCE, YET MANY OLDER ADULTS ARE INACTIVE. YOGA IS A FORM OF PHYSICAL ACTIVITY THAT AIMS TO IMPROVE HEALTH AND MAY BE PARTICULARLY SUITABLE FOR OLDER ADULTS. RESEARCH INDICATES POSITIVE EFFECTS OF YOGA ON SEVERAL HEALTH-RELATED OUTCOMES; HOWEVER, EMPIRICAL STUDIES EXAMINING THE BENEFITS OF YOGA ON WELL-BEING AMONG THE ELDERLY REMAIN SCARCE. THIS STUDY PROTOCOL REPORTS THE METHODOLOGY FOR A 12-WEEK YOGA PROGRAMME AIMED TO IMPROVE HEALTH AND WELL-BEING AMONG PHYSICALLY INACTIVE OLDER ADULTS. METHODS AND ANALYSIS: THREE GROUP PARALLEL, SINGLE-BLIND RANDOMISED CONTROLLED TRIAL. TWO COMPARISON GROUPS ARE INCLUDED: AEROBIC EXERCISE AND A NON-ACTIVE WAIT-LIST CONTROL. IN TOTAL, 180 PARTICIPANTS AGED 65-85 YEARS WILL BE RECRUITED. ASSESSMENTS WILL BE PERFORMED AT BASELINE AND POSTINTERVENTION (12-WEEK FOLLOW-UP). THE PRIMARY OUTCOME IS SUBJECTIVE WELL-BEING. SECONDARY OUTCOMES INCLUDE PHYSICAL ACTIVITY/SEDENTARY BEHAVIOUR, MOBILITY/FALL RISK, COGNITION, DEPRESSION, ANXIETY, MOOD, STRESS, PAIN, SLEEP QUALITY, SOCIAL SUPPORT AND CARDIOMETABOLIC RISK FACTORS. DATA WILL BE ANALYSED USING INTENTION-TO-TREAT ANALYSES, WITH MIXED LINEAR MODELLING. ETHICS AND DISSEMINATION: THIS STUDY IS APPROVED BY THE ETHICAL REVIEW BOARD IN STOCKHOLM (2017/1862-31/2). ALL PARTICIPANTS MUST VOLUNTARILY AGREE TO PARTICIPATE AND ARE FREE TO WITHDRAW FROM THE STUDY AT ANY POINT. WRITTEN INFORMED CONSENT WILL BE OBTAINED FROM EACH PARTICIPANT PRIOR TO INCLUSION. RESULTS WILL BE AVAILABLE THROUGH RESEARCH ARTICLES AND CONFERENCES. A SUMMARY OF KEY RESULTS WILL BE PUBLICLY AVAILABLE THROUGH NEWSPAPER ARTICLES. TRIAL REGISTRATION NUMBER: DRKS00015093, U1111-1217-4248. 2019 5 2860 66 YOGA-BASED EXERCISE IMPROVES HEALTH-RELATED QUALITY OF LIFE AND MENTAL WELL-BEING IN OLDER PEOPLE: A SYSTEMATIC REVIEW OF RANDOMISED CONTROLLED TRIALS. OBJECTIVE: HEALTH-RELATED QUALITY OF LIFE (HRQOL) AND MENTAL WELL-BEING ARE ASSOCIATED WITH HEALTHY AGEING. PHYSICAL ACTIVITY POSITIVELY IMPACTS BOTH HRQOL AND MENTAL WELL-BEING. YOGA IS A PHYSICAL ACTIVITY THAT CAN BE MODIFIED TO SUITS THE NEEDS OF OLDER PEOPLE AND IS GROWING IN POPULARITY. WE CONDUCTED A SYSTEMATIC REVIEW WITH META-ANALYSIS TO DETERMINE THE IMPACT OF YOGA-BASED EXERCISE ON HRQOL AND MENTAL WELL-BEING IN PEOPLE AGED 60+. METHODS: SEARCHES WERE CONDUCTED FOR RELEVANT TRIALS IN THE FOLLOWING ELECTRONIC DATABASES; MEDLINE, EMBASE, COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, CINAHL, ALLIED AND COMPLEMENTARY MEDICINE DATABASE, PSYCINFO AND THE PHYSIOTHERAPY EVIDENCE DATABASE (PEDRO) FROM INCEPTION TO JANUARY 2017. TRIALS THAT EVALUATED THE EFFECT OF PHYSICAL YOGA ON HRQOL AND/OR ON MENTAL WELL-BEING IN PEOPLE AGED 60+ YEARS WERE INCLUDED. DATA ON HRQOL AND MENTAL WELL-BEING WERE EXTRACTED. STANDARDISED MEAN DIFFERENCES AND 95% CONFIDENCE INTERVALS (CI) WERE CALCULATED USING RANDOM EFFECTS MODELS. METHODOLOGICAL QUALITY OF TRIALS WAS ASSESSED USING THE PEDRO SCALE. RESULTS: TWELVE TRIALS OF HIGH METHODOLOGICAL QUALITY (MEAN PEDRO SCORE 6.1), TOTALLING 752 PARTICIPANTS, WERE IDENTIFIED AND PROVIDED DATA FOR THE META-ANALYSIS. YOGA PRODUCED A MEDIUM EFFECT ON HRQOL (HEDGES' G = 0.51, 95% CI 0.25-0.76, 12 TRIALS) AND A SMALL EFFECT ON MENTAL WELL-BEING (HEDGES' G = 0.38, 95% CI 0.15-0.62, 12 TRIALS). CONCLUSION: YOGA INTERVENTIONS RESULTED IN SMALL TO MODERATE IMPROVEMENTS IN BOTH HRQOL AND MENTAL WELL-BEING IN PEOPLE AGED 60+ YEARS. FURTHER, RESEARCH IS NEEDED TO DETERMINE THE OPTIMAL DOSE OF YOGA TO MAXIMISE HEALTH IMPACT. PROSPERO REGISTRATION NUMBER: (CRD42016052458). 2018 6 2496 96 YOGA AS PART OF A PACKAGE OF CARE VERSUS NON-STANDARD CARE FOR SCHIZOPHRENIA. BACKGROUND: YOGA IS AN ANCIENT BODY-MIND PRACTICE WHICH ORIGINATED IN INDIA AND IS POPULAR IN THE WESTERN WORLD AS A FORM OF RELAXATION AND EXERCISE. IT HAS BEEN OF INTEREST FOR PEOPLE WITH SCHIZOPHRENIA TO DETERMINE THE EFFICACY OF YOGA DELIVERED AS A PACKAGE OF CARE VERSUS NON-STANDARD CARE. OBJECTIVES: TO EXAMINE THE EFFECTS OF YOGA AS PART OF A PACKAGE OF CARE VERSUS NON-STANDARD CARE FOR SCHIZOPHRENIA. SEARCH METHODS: WE SEARCHED THE COCHRANE SCHIZOPHRENIA GROUP TRIALS REGISTER (LATEST 15 MAY 2018) WHICH IS BASED ON REGULAR SEARCHES OF MEDLINE, PUBMED, EMBASE, CINAHL, BIOSS, AMED, PSYCHINFO, 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 COMPARING YOGA AS PART OF A PACKAGE OF CARE WITH NON-STANDARD CARE. DATA COLLECTION AND ANALYSIS: THERE WERE NO DATA TO ANALYSE AS NO STUDIES MET THE INCLUSION CRITERIA. MAIN RESULTS: THE SEARCHES IDENTIFIED 30 STUDIES THAT COULD BE RELEVANT TO THIS REVIEW. AFTER CAREFUL INSPECTION, 29 WERE EXCLUDED AND ONE IS AWAITING CLASSIFICATION. NO DATA WERE AVAILABLE FOR ANALYSES. AUTHORS' CONCLUSIONS: IN VIEW OF THE LACK OF EVIDENCE FROM RCTS, IT IS CURRENTLY NOT POSSIBLE FOR US TO COMMENT ON THE USE OF YOGA AS PART OF A PACKAGE OF CARE VERSUS NON-STANDARD CARE. 2019 7 2587 113 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 8 199 48 A RESEARCH PROTOCOL FOR A PILOT, RANDOMIZED CONTROLLED TRIAL DESIGNED TO EXAMINE THE FEASIBILITY OF A DYADIC VERSUS INDIVIDUAL YOGA PROGRAM FOR FAMILY CAREGIVERS OF GLIOMA PATIENTS UNDERGOING RADIOTHERAPY. BACKGROUND: ALTHOUGH THE DIAGNOSIS AND TREATMENT OF A PRIMARY BRAIN TUMOR PRESENT UNIQUE CHALLENGES TO PATIENTS AND THEIR FAMILY CAREGIVERS, EVIDENCE-BASED SUPPORTIVE CARE INTERVENTIONS ARE GENERALLY LACKING. THE PRIMARY AIM OF THIS RESEARCH PROTOCOL IS TO DETERMINE THE FEASIBILITY OF IMPLEMENTING A DYADIC YOGA (DY) VERSUS A CAREGIVER YOGA (CY) INTERVENTION OR A WAIT-LIST CONTROL (WLC) GROUP USING A RANDOMIZED CONTROLLED TRIAL DESIGN. METHODS: SEVENTY-FIVE GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR FAMILY CAREGIVERS ARE RANDOMIZED TO THE DY, CY, OR A WLC GROUP. PATIENT-CAREGIVER DYADS IN THE DY GROUP AND CAREGIVERS IN THE CY GROUP RECEIVE 15 SESSIONS (45 MIN EACH) OVER THE COURSE OF PATIENTS' STANDARD RADIOTHERAPY (6 WEEKS). PATIENTS AND CAREGIVERS IN ALL GROUPS COMPLETE BASELINE ASSESSMENTS OF SYMPTOMS, QUALITY OF LIFE (QOL), AND HEALTH UTILIZATION OUTCOMES PRIOR TO RANDOMIZATION. FOLLOW-UP ASSESSMENTS ARE PERFORMED 6 WEEKS AND THEN AGAIN 3 MONTHS LATER. THE PRIMARY OUTCOME IS FEASIBILITY (I.E., >/= 50% OF ELIGIBLE DYADS CONSENT, >/= 70% OF ENROLLED DYADS COMPLETE ALL ASSESSMENTS, AND >/= 50% OF ALL PRACTICE SESSIONS ARE ATTENDED). WE WILL ALSO PERFORM PRIMARILY DESCRIPTIVE ANALYSES OF THE SELF-REPORTED OUTCOMES (E.G., FATIGUE, OVERALL QOL) AND EXPLORE POTENTIAL INTERVENTION MODERATORS (E.G., PERFORMANCE STATUS) TO INFORM A LARGER FUTURE TRIAL. CONCLUSION: THIS TRIAL WILL PROVIDE IMPORTANT INFORMATION REGARDING THE FEASIBILITY OF A DYADIC VERSUS A CAREGIVER YOGA INTERVENTION REGARDING SYMPTOM, QOL, AND HEALTH UTILIZATION OUTCOMES IN GLIOMA PATIENTS AND THEIR CAREGIVERS. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT02481349. 2019 9 2843 40 YOGA, COGNITIVE-BEHAVIOURAL THERAPY VERSUS EDUCATION TO IMPROVE QUALITY OF LIFE AND REDUCE HEALTHCARE COSTS IN PEOPLE WITH ENDOMETRIOSIS: A RANDOMISED CONTROLLED TRIAL. INTRODUCTION: ENDOMETRIOSIS IS A DEBILITATING CHRONIC INFLAMMATORY CONDITION HIGHLY BURDENSOME TO THE HEALTHCARE SYSTEM. THE PRESENT TRIAL WILL ESTABLISH THE EFFICACY OF (1) YOGA AND (2) COGNITIVE-BEHAVIOURAL THERAPY (CBT), ABOVE (3) EDUCATION, ON QUALITY OF LIFE, BIOPSYCHOSOCIAL OUTCOMES AND COST-EFFECTIVENESS. METHODS AND ANALYSIS: THIS STUDY IS A PARALLEL RANDOMISED CONTROLLED TRIAL. PARTICIPANTS WILL BE RANDOMLY ALLOCATED TO YOGA, CBT OR EDUCATION. PARTICIPANTS WILL BE ENGLISH-SPEAKING ADULTS, HAVE A DIAGNOSIS OF ENDOMETRIOSIS BY A QUALIFIED PHYSICIAN, WITH PAIN FOR AT LEAST 6 MONTHS, AND ACCESS TO INTERNET. PARTICIPANTS WILL ATTEND 8 WEEKLY GROUP CBT SESSIONS OF 120 MIN; OR 8 WEEKLY GROUP YOGA SESSIONS OF 60 MIN; OR RECEIVE WEEKLY EDUCATIONAL HANDOUTS ON ENDOMETRIOSIS. THE PRIMARY OUTCOME MEASURE IS QUALITY OF LIFE. THE ANALYSIS WILL INCLUDE MIXED-EFFECTS ANALYSIS OF VARIANCE AND LINEAR MODELS, COST-UTILITY ANALYSIS FROM A SOCIETAL AND HEALTH SYSTEM PERSPECTIVE AND QUALITATIVE THEMATIC ANALYSIS. ETHICS AND DISSEMINATION: ENROLMENT IN THE STUDY IS VOLUNTARY AND PARTICIPANTS CAN WITHDRAW AT ANY TIME. PARTICIPANTS WILL BE GIVEN THE OPTION TO DISCUSS THE STUDY WITH THEIR NEXT OF KIN/TREATING PHYSICIAN. FINDINGS WILL BE DISSEMINATED VIA PUBLICATIONS, CONFERENCES AND BRIEFS TO PROFESSIONAL ORGANISATIONS. THE UNIVERSITY'S MEDIA TEAM WILL ALSO BE USED TO FURTHER DISSEMINATE VIA LAY PERSON ARTICLES AND MEDIA RELEASES. TRIAL REGISTRATION NUMBER: ACTRN12620000756921P; PRE-RESULTS. 2021 10 2657 108 YOGA IN ADDITION TO STANDARD CARE FOR PATIENTS WITH HAEMATOLOGICAL MALIGNANCIES. BACKGROUND: HAEMATOLOGICAL MALIGNANCIES ARE MALIGNANT NEOPLASMS OF THE MYELOID OR LYMPHATIC CELL LINES INCLUDING LEUKAEMIA, LYMPHOMA AND MYELOMA. IN ORDER TO MANAGE PHYSICAL AND PSYCHOLOGICAL ASPECTS OF THE DISEASE AND ITS TREATMENT, COMPLEMENTARY THERAPIES LIKE YOGA ARE COMING INCREASINGLY INTO FOCUS. HOWEVER, THE EFFECTIVENESS OF YOGA PRACTICE FOR PEOPLE SUFFERING FROM HAEMATOLOGICAL MALIGNANCIES REMAINS UNCLEAR. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA PRACTICE IN ADDITION TO STANDARD CANCER TREATMENT FOR PEOPLE WITH HAEMATOLOGICAL MALIGNANCIES. SEARCH METHODS: OUR SEARCH STRATEGY INCLUDED THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL), MEDLINE (1950 TO 4TH FEBRUARY 2014), DATABASES OF ONGOING TRIALS (CONTROLLED-TRIALS.COM; CLINICALTRIALS.GOV), CONFERENCE PROCEEDINGS OF THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY, THE AMERICAN SOCIETY OF HEMATOLOGY, THE EUROPEAN HAEMATOLOGY ASSOCIATION, THE EUROPEAN CONGRESS FOR INTEGRATIVE MEDICINE, AND GLOBAL ADVANCES IN HEALTH AND MEDICINE. WE HANDSEARCHED REFERENCES OF THESE STUDIES FROM IDENTIFIED TRIALS AND RELEVANT REVIEW ARTICLES. TWO REVIEW AUTHORS INDEPENDENTLY SCREENED THE SEARCH RESULTS. SELECTION CRITERIA: WE INCLUDED RANDOMISED CONTROLLED TRIALS (RCTS) OF YOGA IN ADDITION TO STANDARD CARE FOR HAEMATOLOGICAL MALIGNANCIES COMPARED WITH STANDARD CARE ONLY. WE DID NOT RESTRICT THIS TO ANY SPECIFIC STYLE OF YOGA. DATA COLLECTION AND ANALYSIS: TWO REVIEW AUTHORS INDEPENDENTLY EXTRACTED DATA FOR ELIGIBLE STUDIES AND ASSESSED THE RISK OF BIAS ACCORDING TO PREDEFINED CRITERIA. WE EVALUATED DISTRESS, FATIGUE, ANXIETY, DEPRESSION AND QUALITY OF SLEEP. FURTHER OUTCOMES WE PLANNED TO ASSESS WERE HEALTH-RELATED QUALITY OF LIFE (HRQOL), OVERALL SURVIVAL (OS) AND ADVERSE EVENTS (AE), BUT DATA ON THESE WERE NOT AVAILABLE. MAIN RESULTS: OUR SEARCH STRATEGIES LED TO 149 POTENTIALLY RELEVANT REFERENCES, BUT ONLY A SINGLE SMALL STUDY MET OUR INCLUSION CRITERIA. THE INCLUDED STUDY WAS PUBLISHED AS A FULL TEXT ARTICLE AND INVESTIGATED THE FEASIBILITY AND EFFECT OF TIBETAN YOGA ADDITIONAL TO STANDARD CARE (N = 20; 1 PERSON DROPPED OUT BEFORE ATTENDING ANY CLASSES AND NO DATA WERE COLLECTED) COMPARED TO STANDARD CARE ONLY (N = 19). THE STUDY INCLUDED PEOPLE WITH ALL STAGES OF HODGKIN AND NON-HODGKIN'S LYMPHOMA, WITH AND WITHOUT CURRENT CANCER TREATMENT. THE MEAN AGE WAS 51 YEARS.WE JUDGED THE OVERALL RISK OF BIAS AS HIGH AS WE FOUND A HIGH RISK FOR PERFORMANCE, DETECTION AND ATTRITION BIAS. ADDITIONALLY, POTENTIAL OUTCOME REPORTING BIAS COULD NOT BE COMPLETELY RULED OUT. FOLLOWING THE RECOMMENDATIONS OF GRADE, WE JUDGED THE OVERALL QUALITY OF THE BODY OF EVIDENCE FOR ALL PREDEFINED OUTCOMES AS 'VERY LOW', DUE TO THE METHODICAL LIMITATIONS AND THE VERY SMALL SAMPLE SIZE.THE INFLUENCE OF YOGA ON HRQOL AND OS WAS NOT REPORTED. THERE IS NO EVIDENCE THAT YOGA IN ADDITION TO STANDARD CARE COMPARED WITH STANDARD CARE ONLY CAN IMPROVE DISTRESS IN PEOPLE WITH HAEMATOLOGICAL MALIGNANCIES (MEAN DIFFERENCE (MD) -0.30, 95% CONFIDENCE INTERVAL (CI) -5.55 TO 4.95; P = 0.91). SIMILARLY, THERE IS NO EVIDENCE OF A DIFFERENCE BETWEEN EITHER GROUP FOR FATIGUE (MD 0.00, 95% CI -0.94 TO 0.94; P = 1.00), ANXIETY (MD 0.30, 95% CI -5.01 TO 5.61; P = 0.91) OR DEPRESSION (MD -0.70, 95% CI -3.21 TO 1.81; P = 0.58).THERE IS VERY LOW QUALITY EVIDENCE THAT YOGA IMPROVES THE OVERALL QUALITY OF SLEEP (MD -2.30, 95% CI -3.78 TO -0.82; P = 0.002). THE YOGA GROUPS' TOTAL SCORE FOR THE PITTSBURGH SLEEP QUALITY INDEX (PSQI) WAS 5.8 (+/- 2.3 SD) AND BETTER THAN THE TOTAL SCORE (8.1 (+/- 2.4 SD)) OF THE CONTROL GROUP. A PSQI TOTAL SCORE OF 0 TO 5 INDICATES GOOD SLEEP WHEREAS PSQI TOTAL SCORE 6 TO 21 POINTS TOWARDS SIGNIFICANT SLEEP DISTURBANCES. THE OCCURRENCE OF AES WAS NOT REPORTED. AUTHORS' CONCLUSIONS: THE CURRENTLY AVAILABLE DATA PROVIDE LITTLE INFORMATION ABOUT THE EFFECTIVENESS OF YOGA INTERVENTIONS FOR PEOPLE SUFFERING FROM HAEMATOLOGICAL MALIGNANCIES. THE FINDING THAT YOGA MAY BE BENEFICIAL FOR THE PATIENTS' QUALITY OF SLEEP IS BASED ON A VERY SMALL BODY OF EVIDENCE. THEREFORE, THE ROLE OF YOGA AS AN ADDITIONAL THERAPY FOR HAEMATOLOGICAL MALIGNANCIES REMAINS UNCLEAR. FURTHER HIGH-QUALITY RANDOMISED CONTROLLED TRIALS WITH LARGER NUMBERS OF PARTICIPANTS ARE NEEDED TO MAKE A DEFINITIVE STATEMENT. 2014 11 2831 49 YOGA VS. PHYSICAL THERAPY VS. EDUCATION FOR CHRONIC LOW BACK PAIN IN PREDOMINANTLY MINORITY POPULATIONS: STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN CAUSES SUBSTANTIAL MORBIDITY AND COST TO SOCIETY WHILE DISPROPORTIONATELY IMPACTING LOW-INCOME AND MINORITY ADULTS. SEVERAL RANDOMIZED CONTROLLED TRIALS SHOW YOGA IS AN EFFECTIVE TREATMENT. HOWEVER, THE COMPARATIVE EFFECTIVENESS OF YOGA AND PHYSICAL THERAPY, A COMMON MAINSTREAM TREATMENT FOR CHRONIC LOW BACK PAIN, IS UNKNOWN. METHODS/DESIGN: THIS IS A RANDOMIZED CONTROLLED TRIAL FOR 320 PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH CHRONIC LOW BACK PAIN, COMPARING YOGA, PHYSICAL THERAPY, AND EDUCATION. INCLUSION CRITERIA ARE ADULTS 18-64 YEARS OLD WITH NON-SPECIFIC LOW BACK PAIN LASTING >/= 12 WEEKS AND A SELF-REPORTED AVERAGE PAIN INTENSITY OF >/= 4 ON A 0-10 SCALE. RECRUITMENT TAKES PLACE AT BOSTON MEDICAL CENTER, AN URBAN ACADEMIC SAFETY-NET HOSPITAL AND SEVEN FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS LOCATED IN DIVERSE NEIGHBORHOODS. THE 52-WEEK STUDY HAS AN INITIAL 12-WEEK TREATMENT PHASE WHERE PARTICIPANTS ARE RANDOMIZED IN A 2:2:1 RATIO INTO I) A STANDARDIZED WEEKLY HATHA YOGA CLASS SUPPLEMENTED BY HOME PRACTICE; II) A STANDARDIZED EVIDENCE-BASED EXERCISE THERAPY PROTOCOL ADAPTED FROM THE TREATMENT BASED CLASSIFICATION METHOD, INDIVIDUALLY DELIVERED BY A PHYSICAL THERAPIST AND SUPPLEMENTED BY HOME PRACTICE; AND III) EDUCATION DELIVERED THROUGH A SELF-CARE BOOK. CO-PRIMARY OUTCOME MEASURES ARE 12-WEEK PAIN INTENSITY MEASURED ON AN 11-POINT NUMERICAL RATING SCALE AND BACK-SPECIFIC FUNCTION MEASURED USING THE MODIFIED ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 40-WEEK MAINTENANCE PHASE, YOGA PARTICIPANTS ARE RE-RANDOMIZED IN A 1:1 RATIO TO EITHER STRUCTURED MAINTENANCE YOGA CLASSES OR HOME PRACTICE ONLY. PHYSICAL THERAPY PARTICIPANTS ARE SIMILARLY RE-RANDOMIZED TO EITHER FIVE BOOSTER SESSIONS OR HOME PRACTICE ONLY. EDUCATION PARTICIPANTS CONTINUE TO FOLLOW RECOMMENDATIONS OF EDUCATIONAL MATERIALS. WE WILL ALSO ASSESS COST EFFECTIVENESS FROM THE PERSPECTIVES OF THE INDIVIDUAL, INSURERS, AND SOCIETY USING CLAIMS DATABASES, ELECTRONIC MEDICAL RECORDS, SELF-REPORT COST DATA, AND STUDY RECORDS. QUALITATIVE DATA FROM INTERVIEWS WILL ADD SUBJECTIVE DETAIL TO COMPLEMENT QUANTITATIVE DATA. TRIAL REGISTRATION: THIS TRIAL IS REGISTERED IN CLINICALTRIALS.GOV, WITH THE ID NUMBER: NCT01343927. 2014 12 2543 117 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 13 2636 114 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 2638 53 YOGA FOR VETERANS WITH CHRONIC LOW BACK PAIN: DESIGN AND METHODS OF A RANDOMIZED CLINICAL TRIAL. CHRONIC LOW BACK PAIN (CLBP) AFFLICTS MILLIONS OF PEOPLE WORLDWIDE, WITH PARTICULARLY HIGH PREVALENCE IN MILITARY VETERANS. MANY TREATMENT OPTIONS EXIST FOR CLBP, BUT MOST HAVE LIMITED EFFECTIVENESS AND SOME HAVE SIGNIFICANT SIDE EFFECTS. IN GENERAL POPULATIONS WITH CLBP, YOGA HAS BEEN SHOWN TO IMPROVE HEALTH OUTCOMES WITH FEW SIDE EFFECTS. HOWEVER, YOGA HAS NOT BEEN ADEQUATELY STUDIED IN MILITARY VETERAN POPULATIONS. IN THE CURRENT PAPER WE WILL DESCRIBE THE DESIGN AND METHODS OF A RANDOMIZED CLINICAL TRIAL AIMED AT EXAMINING WHETHER YOGA CAN EFFECTIVELY REDUCE DISABILITY AND PAIN IN US MILITARY VETERANS WITH CLBP. A TOTAL OF 144 US MILITARY VETERANS WITH CLBP WILL BE RANDOMIZED TO EITHER YOGA OR A DELAYED TREATMENT COMPARISON GROUP. THE YOGA INTERVENTION WILL CONSIST OF 2X WEEKLY YOGA CLASSES FOR 12WEEKS, COMPLEMENTED BY REGULAR HOME PRACTICE GUIDED BY A MANUAL. THE DELAYED TREATMENT GROUP WILL RECEIVE THE SAME INTERVENTION AFTER SIX MONTHS. THE PRIMARY OUTCOME IS THE CHANGE IN BACK PAIN-RELATED DISABILITY MEASURED WITH THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE AT BASELINE AND 12-WEEKS. SECONDARY OUTCOMES INCLUDE PAIN INTENSITY, PAIN INTERFERENCE, DEPRESSION, ANXIETY, FATIGUE/ENERGY, QUALITY OF LIFE, SELF-EFFICACY, SLEEP QUALITY, AND MEDICATION USAGE. ADDITIONAL PROCESS AND/OR MEDIATIONAL FACTORS WILL BE MEASURED TO EXAMINE DOSE RESPONSE AND EFFECT MECHANISMS. ASSESSMENTS WILL BE CONDUCTED AT BASELINE, 6-WEEKS, 12-WEEKS, AND 6-MONTHS. ALL RANDOMIZED PARTICIPANTS WILL BE INCLUDED IN INTENTION-TO-TREAT ANALYSES. STUDY RESULTS WILL PROVIDE MUCH NEEDED EVIDENCE ON THE FEASIBILITY AND EFFECTIVENESS OF YOGA AS A THERAPEUTIC MODALITY FOR THE TREATMENT OF CLBP IN US MILITARY VETERANS. 2016 15 2440 53 YOGA AND QUALITY-OF-LIFE IMPROVEMENT IN PATIENTS WITH BREAST CANCER: A LITERATURE REVIEW. OBJECTIVE: WOMEN UNDERGOING TREATMENT FOR BREAST CANCER OFTEN TURN TO COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM), INCLUDING YOGA, FOR IMPROVEMENT OF MOOD, QUALITY OF LIFE (QOL), SLEEP, AND TREATMENT-RELATED SIDE EFFECTS. THE EXTANT LITERATURE WAS REVIEWED TO EXAMINE THE CLINICAL EFFECTS OF YOGA PRACTICE ON QOL FOR PATIENTS WITH BREAST CANCER. QOL WAS DEFINED AS PHYSICAL WELL-BEING, SOCIAL FUNCTIONING, EMOTIONAL HEALTH, AND FUNCTION-AL ADAPTATION. METHODS: SEVEN DATABASES, INCLUDING PUBMED, OVID MEDLINE, CINAHL, EMBASE, PSYCINFO, COCHRANE LIBRARY, AND WEB OF SCIENCE WERE USED TO SEARCH FOR STUDIES OF PATIENTS WITH BREAST CANCER THAT INCLUDED A YOGA INTERVENTION AND QOL ASSESSMENT. ATTENTION WAS PAID TO ASSESSING STUDY POPULATION, OUTCOME VARIABLES, THE TYPE OF YOGA INTERVENTION USED, AND METHODOLOGICAL STRENGTHS AND LIMITATIONS. RESULTS: SEVENTY-ONE ARTICLES WERE IDENTIFIED THAT FIT THE SEARCH CRITERIA. ALTHOUGH THE LITERATURE PROVIDED EVIDENCE OF QOL BENEFITS OF YOGA FOR PATIENTS WITH BREAST CANCER, NO SPECIFIC ASPECT OF YOGA WAS IDENTIFIED AS BEING MOST ADVANTAGEOUS. CONCLUSION: ALTHOUGH PARTICIPATION IN YOGA PROGRAMS APPEARED TO BENEFIT PATIENTS WITH BREAST CANCER, GREATER METHODOLOGICAL RIGOR IS REQUIRED TO UNDERSTAND THE MECHANISMS THAT CONTRIBUTE TO THEIR EFFECTIVENESS. 2012 16 1165 77 EVALUATING THE FEASIBILITY AND IMPACT OF A YOGA INTERVENTION ON COGNITION, PHYSICAL FUNCTION, PHYSICAL ACTIVITY, AND AFFECTIVE OUTCOMES IN PEOPLE LIVING WITH HIV: PROTOCOL FOR A RANDOMIZED PILOT TRIAL. BACKGROUND: DESPITE LOWER MORTALITY RATES DUE TO COMBINATION ANTIRETROVIRAL THERAPY, PEOPLE LIVING WITH HIV (PLWH) ARE GRAPPLING WITH INCREASINGLY COMPLEX HEALTH ISSUES, INCLUDING COGNITIVE IMPAIRMENTS IN AREAS SUCH AS MEMORY, ATTENTION, PROCESSING SPEED, AND MOTOR FUNCTION. YOGA HAS BEEN SHOWN TO BE AN EFFECTIVE FORM OF EXERCISE AND MINDFULNESS-BASED STRESS REDUCTION FOR MANY CLINICAL POPULATIONS. HOWEVER, NO RANDOMIZED TRIALS HAVE EVALUATED THE IMPACT OF YOGA ON COGNITIVE AND PHYSICAL FUNCTION AMONG PLWH. OBJECTIVE: THE AIM OF THIS PILOT RANDOMIZED TRIAL WAS TO DETERMINE THE FEASIBILITY OF A YOGA INTERVENTION TO LAY THE GROUNDWORK FOR A FULL-SCALE, MULTISITE, COMMUNITY-BASED TRIAL FOR PLWH. SPECIFIC OBJECTIVES ARE TO (1) ASSESS THE FEASIBILITY OF STUDY PROTOCOL AND PROCEDURES, (2) COMPARE COGNITION IN THE YOGA GROUP WITH THE USUAL CARE CONTROL GROUP AFTER 12 WEEKS OF THE INTERVENTION IN PLWH, AND (3) COMPARE THE EFFECTS OF THE 12-WEEK YOGA INTERVENTION VERSUS CONTROL ON BALANCE, WALKING SPEED, PHYSICAL ACTIVITY, MENTAL HEALTH, MEDICATION ADHERENCE, AND QUALITY OF LIFE AMONG PLWH. METHODS: WE PROPOSE A PILOT RANDOMIZED TRIAL WITH 2 PARALLEL GROUPS (YOGA VERSUS CONTROL). WE WILL RECRUIT 25 PLWH (>35 YEARS) FROM COMMUNITY AND HEALTH ORGANIZATIONS IN HALIFAX, CANADA. AFTER BASELINE ASSESSMENT WITH BLINDED ASSESSORS, PARTICIPANTS WILL BE RANDOMLY ASSIGNED TO THE YOGA OR CONTROL GROUP, USING A RANDOM COMPUTER GENERATOR. PARTICIPANTS IN THE YOGA GROUP WILL ENGAGE IN SUPERVISED 60-MIN GROUP-BASED YOGA SESSIONS 3 TIMES A WEEK FOR 12 WEEKS AT A YOGA STUDIO. PARTICIPANTS IN THE CONTROL GROUP WILL MAINTAIN THEIR CURRENT PHYSICAL ACTIVITY LEVELS THROUGHOUT THE STUDY. RESULTS: AS PER THE CONSOLIDATED STANDARDS OF REPORTING TRIALS EXTENSION FOR PILOT STUDIES, MEANS OF ALL OUTCOMES, MEAN CHANGE, AND 95% CIS WILL BE CALCULATED FOR EACH GROUP SEPARATELY. TWO-TAILED INDEPENDENT T TESTS AND FISHER EXACT TESTS WILL BE USED TO COMPARE GROUPS AT BASELINE. WE WILL ANALYZE QUANTITATIVE POSTINTERVENTION QUESTIONNAIRE RESPONSES USING CHI-SQUARE TESTS, AND OPEN-ENDED RESPONSES WILL BE ANALYZED THEMATICALLY. INTENTION-TO-TREAT AND PER-PROTOCOL ANALYSES WILL BE USED TO ANALYZE SECONDARY VARIABLES. CHANGES IN OUTCOME VARIABLES WILL BE EXAMINED BETWEEN GROUPS AND WITHIN GROUPS. EFFECT SIZES WILL BE REPORTED FOR EACH OUTCOME. A PRIORI ADHERENCE AND SATISFACTION CRITERIA WILL BE MET IF PARTICIPANTS ATTEND >70% OF THE YOGA SESSIONS AND IF >70% OF THE PARTICIPANTS ARE SATISFIED WITH THE INTERVENTION AS DETERMINED BY A POSTPARTICIPATION QUESTIONNAIRE. STUDY ENROLLMENT BEGAN IN JANUARY 2018, WITH RESULTS EXPECTED FOR OCTOBER 2019. CONCLUSIONS: THIS PILOT RANDOMIZED TRIAL WILL BE THE FIRST TO INVESTIGATE THE FEASIBILITY AND EFFECT OF A YOGA INTERVENTION ON COGNITIVE AND PHYSICAL OUTCOMES AMONG PLWH. THIS WORK WILL INFORM THE FEASIBILITY OF FURTHER INVESTIGATIONS IN TERMS OF CAPACITY BUILDING, PARTICIPANT RECRUITMENT AND RETENTION, AND ASSESSMENT AND INTERVENTION PROTOCOLS. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT03071562; HTTPS://CLINICALTRIALS.GOV/CT2/SHOW/NCT03071562 (ARCHIVED BY WEBCITE AT HTTP://WWW.WEBCITATION.ORG/785SFHWKW). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/13818. 2019 17 2763 41 YOGA PROGRAM FOR TYPE 2 DIABETES PREVENTION (YOGA-DP) AMONG HIGH-RISK PEOPLE: QUALITATIVE STUDY TO EXPLORE REASONS FOR NON-PARTICIPATION IN A FEASIBILITY RANDOMIZED CONTROLLED TRIAL IN INDIA. BACKGROUND: YOGA-BASED INTERVENTIONS CAN BE EFFECTIVE IN PREVENTING TYPE 2 DIABETES MELLITUS (T2DM). WE DEVELOPED A YOGA PROGRAM FOR T2DM PREVENTION (YOGA-DP) AMONG HIGH-RISK PEOPLE AND CONDUCTED A FEASIBILITY RANDOMIZED CONTROLLED TRIAL (RCT) IN INDIA. THE OBJECTIVE OF THIS STUDY WAS TO IDENTIFY AND EXPLORE WHY POTENTIAL PARTICIPANTS DECLINED TO PARTICIPATE IN THE FEASIBILITY RCT. METHODS: AN EXPLORATORY QUALITATIVE STUDY, USING SEMI-STRUCTURED INTERVIEWS, WAS CONDUCTED AT A YOGA CENTER IN NEW DELHI, INDIA. FOURTEEN PEOPLE (10 WOMEN AND FOUR MEN) WHO DECLINED TO PARTICIPATE IN THE FEASIBILITY RCT WERE INTERVIEWED, AND 13 OF THEM COMPLETED THE NON-PARTICIPANT QUESTIONNAIRE, WHICH CAPTURED THEIR SOCIO-DEMOGRAPHICS, DIETS, PHYSICAL ACTIVITIES, AND REASONS FOR DECLINING. RESULTS: THREE TYPES OF BARRIERS WERE IDENTIFIED AND EXPLORED WHICH PREVENTED PARTICIPATION IN THE FEASIBILITY RCT: (1) PERSONAL BARRIERS, SUCH AS LACK OF TIME, PERCEIVED SUFFICIENCY OF KNOWLEDGE, PREFERENCES ABOUT SELF-MANAGEMENT OF HEALTH, AND TRUST IN OTHER TRADITIONAL AND ALTERNATIVE THERAPIES; (2) CONTEXTUAL BARRIERS, SUCH AS SOCIAL INFLUENCES AND LACK OF AWARENESS ABOUT PREVENTIVE CARE; AND (3) STUDY-RELATED BARRIERS, SUCH AS LACK OF STUDY INFORMATION, POOR ACCESSIBILITY TO THE YOGA SITE, AND LACK OF TRUST IN THE STUDY METHODS AND INTERVENTION. CONCLUSIONS: WE IDENTIFIED AND EXPLORED PERSONAL, CONTEXTUAL, AND STUDY-RELATED BARRIERS TO PARTICIPATION IN A FEASIBILITY RCT IN INDIA. THE FINDINGS WILL HELP TO ADDRESS RECRUITMENT CHALLENGES IN FUTURE YOGA AND OTHER RCTS. CLINICAL TRIAL REGISTRATION:WWW.CLINICALTRIALS.GOV, IDENTIFIER: CTRI/2019/05/018893. 2021 18 1907 51 REVIEW OF YOGA THERAPY DURING CANCER TREATMENT. PURPOSE: REVIEWS OF YOGA RESEARCH THAT DISTINGUISH RESULTS OF TRIALS CONDUCTED DURING (VERSUS AFTER) CANCER TREATMENT ARE NEEDED TO GUIDE FUTURE RESEARCH AND CLINICAL PRACTICE. WE THEREFORE CONDUCTED A REVIEW OF NON-RANDOMIZED STUDIES AND RANDOMIZED CONTROLLED TRIALS OF YOGA INTERVENTIONS FOR CHILDREN AND ADULTS UNDERGOING TREATMENT FOR ANY CANCER TYPE. METHODS: STUDIES WERE IDENTIFIED VIA RESEARCH DATABASES AND REFERENCE LISTS. INCLUSION CRITERIA WERE THE FOLLOWING: (1) CHILDREN OR ADULTS UNDERGOING CANCER TREATMENT, (2) INTERVENTION STATED AS YOGA OR COMPONENT OF YOGA, AND (3) PUBLICATION IN ENGLISH IN PEER-REVIEWED JOURNALS THROUGH OCTOBER 2015. EXCLUSION CRITERIA WERE THE FOLLOWING: (1) SAMPLES RECEIVING HORMONE THERAPY ONLY, (2) INTERVENTIONS INVOLVING MEDITATION ONLY, AND (3) YOGA DELIVERED WITHIN BROADER CANCER RECOVERY OR MINDFULNESS-BASED STRESS REDUCTION PROGRAMS. RESULTS: RESULTS OF NON-RANDOMIZED (ADULT N = 8, PEDIATRIC N = 4) AND RANDOMIZED CONTROLLED TRIALS (ADULT N = 13, PEDIATRIC N = 0) CONDUCTED DURING CANCER TREATMENT ARE SUMMARIZED SEPARATELY BY AGE GROUP. FINDINGS MOST CONSISTENTLY SUPPORT IMPROVEMENT IN PSYCHOLOGICAL OUTCOMES (E.G., DEPRESSION, DISTRESS, ANXIETY). SEVERAL STUDIES ALSO FOUND THAT YOGA ENHANCED QUALITY OF LIFE, THOUGH FURTHER INVESTIGATION IS NEEDED TO CLARIFY DOMAIN-SPECIFIC EFFICACY (E.G., PHYSICAL, SOCIAL, CANCER-SPECIFIC). REGARDING PHYSICAL AND BIOMEDICAL OUTCOMES, EVIDENCE INCREASINGLY SUGGESTS THAT YOGA AMELIORATES SLEEP AND FATIGUE; ADDITIONAL RESEARCH IS NEEDED TO ADVANCE PRELIMINARY FINDINGS FOR OTHER TREATMENT SEQUELAE AND STRESS/IMMUNITY BIOMARKERS. CONCLUSIONS: AMONG ADULTS UNDERGOING CANCER TREATMENT, EVIDENCE SUPPORTS RECOMMENDING YOGA FOR IMPROVING PSYCHOLOGICAL OUTCOMES, WITH POTENTIAL FOR ALSO IMPROVING PHYSICAL SYMPTOMS. EVIDENCE IS INSUFFICIENT TO EVALUATE THE EFFICACY OF YOGA IN PEDIATRIC ONCOLOGY. WE DESCRIBE SUGGESTIONS FOR STRENGTHENING YOGA RESEARCH METHODOLOGY TO INFORM CLINICAL PRACTICE GUIDELINES. 2017 19 558 47 COST-EFFECTIVENESS OF YOGA FOR MANAGING MUSCULOSKELETAL CONDITIONS IN THE WORKPLACE. BACKGROUND: BACK PAIN AND MUSCULOSKELETAL CONDITIONS NEGATIVELY AFFECT THE HEALTH-RELATED QUALITY OF LIFE (HRQL) OF EMPLOYEES AND GENERATE SUBSTANTIAL COSTS TO EMPLOYERS. AIMS: TO ASSESS THE COST-EFFECTIVENESS OF YOGA FOR MANAGING MUSCULOSKELETAL CONDITIONS. METHODS: A RANDOMIZED CONTROLLED TRIAL EVALUATED AN 8-WEEK YOGA PROGRAMME, WITH A 6-MONTH FOLLOW-UP, FOR NATIONAL HEALTH SERVICE (NHS) EMPLOYEES. EFFECTIVENESS IN MANAGING MUSCULOSKELETAL CONDITIONS WAS ASSESSED USING REPEATED-MEASURES GENERALIZED LINEAR MODELLING FOR THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE (RDQ) AND THE KEELE START BACK SCREENING TOOL. COST-EFFECTIVENESS WAS DETERMINED USING AREA-UNDER-THE-CURVE LINEAR REGRESSION FOR ASSESSING HRQL FROM HEALTHCARE AND SOCIETAL PERSPECTIVES. THE INCREMENTAL COST PER QUALITY-ADJUSTED LIFE YEAR (QALY) WAS ALSO CALCULATED. SICKNESS ABSENCE WAS MEASURED USING ELECTRONIC STAFF RECORDS AT 6 MONTHS. RESULTS: THERE WERE 151 PARTICIPANTS. AT 6 MONTHS, MEAN DIFFERENCES BETWEEN GROUPS FAVOURING YOGA WERE OBSERVED FOR RDQ [-0.63 (95% CI, -1.78, 0.48)], KEELE START [-0.28 (95% CI, -0.97, 0.07)] AND HRQL (0.016 QALY GAIN). FROM A HEALTHCARE PERSPECTIVE, YOGA YIELDED AN INCREMENTAL COST-EFFECTIVENESS RATIO OF POUND2103 PER QALY. GIVEN A WILLINGNESS TO PAY FOR AN ADDITIONAL QALY OF POUND20 000, THE PROBABILITY OF YOGA BEING COST-EFFECTIVE WAS 95%. FROM A SOCIETAL PERSPECTIVE, YOGA WAS THE DOMINANT TREATMENT COMPARED WITH USUAL CARE. AT 6 MONTHS, ELECTRONIC STAFF RECORDS SHOWED THAT YOGA PARTICIPANTS MISSED A TOTAL OF 2 WORKING DAYS DUE TO MUSCULOSKELETAL CONDITIONS COMPARED WITH 43 DAYS FOR USUAL CARE PARTICIPANTS. CONCLUSIONS: YOGA FOR NHS EMPLOYEES MAY ENHANCE HRQL, REDUCE DISABILITY ASSOCIATED WITH BACK PAIN, LOWER SICKNESS ABSENCE DUE TO MUSCULOSKELETAL CONDITIONS AND IS LIKELY TO BE COST-EFFECTIVE. 2017 20 1061 66 EFFECTS OF YOGA ON HEALTH-RELATED QUALITY, PHYSICAL HEALTH AND PSYCHOLOGICAL HEALTH IN WOMEN WITH BREAST CANCER RECEIVING CHEMOTHERAPY: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: YOGA RECEIVE MORE ATTENTION FROM BREAST CANCER PATIENTS, HOWEVER ITS FEASIBILITY AND EFFICACY DURING CHEMOTHERAPY REMAINS CONFLICTING. WE PERFORMED THIS SYSTEMATIC REVIEW TO ASSESS THE EFFECTS OF YOGA ON HEALTH-RELATED QUALITY, PHYSICAL HEALTH AND PSYCHOLOGICAL HEALTH IN BREAST CANCER PATIENTS UNDERGOING CHEMOTHERAPY. METHODS: A SYSTEMATIC SEARCH WAS CONDUCTED TO RETRIEVE RANDOMIZED CONTROLLED TRIALS (RCTS) WHICH INVESTIGATED THE COMPARATIVE EFFICACY OF YOGA VERSUS COMPARATORS SUCH AS USUAL CARE AMONG BREAST CANCER PATIENTS FOR HEALTH-RELATED QUALITY, PHYSICAL HEALTH AND PSYCHOLOGICAL HEALTH IN PUBMED, EMBASE, COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CNETRAL), NURSING AND ALLIED HEALTH LITERATURE (CINAHL), CHINESE BIOMEDICAL LITERATURE (CBM) DATABASE, CHINA SCIENCE AND TECHNOLOGY JOURNAL (CSTJ) DATABASE, CHINA NATIONAL KNOWLEDGE INFRASTRUCTURE (CNKI), AND WANGFANG DATABASE FROM INCEPTION TO DECEMBER 2018. THE LATEST SEARCH WAS UPDATED ON SEPTEMBER 2020. ALL ANALYSES WERE COMPLETED USING REVMAN VERSION 5.3. RESULTS: SEVEN TRIALS INVOLVING 693 BREAST CANCER PATIENTS MET INCLUSION CRITERIA. META-ANALYSIS INDICATED A SHORT-TERM IMPROVEMENT IN FATIGUE [STANDARD MEAN DIFFERENCE (SMD), -0.62; 95% CONFIDENCE INTERVAL (CI), -1.17 TO -0.07], SLEEP DISTURBANCE (SMD, -0.34; 95% CI, -0.55 TO -0.12), DEPRESSION (SMD, -0.50; 95% CI, -0.70 TO -0.31) ANXIETY (SMD, -0.50; 95% CI, -0.70 TO -0.31), AND HEALTH-RELATED QUALITY OF LIFE (QOL) (SMD, 0.72; 95% CI, -0.12 TO 1.56) IN THE YOGA GROUP; HOWEVER BENEFICIAL MEDIUM- AND LONG-TERM EFFECTS IN FATIGUE, SLEEP DISTURBANCE WERE NOT IDENTIFIED. MOREOVER, QUALITATIVE ANALYSES SUGGESTED THAT YOGA WAS NOT ASSOCIATED WITH DECREASED ADVERSE EVENTS (AES) COMPARED WITH CONTROL GROUPS. CONCLUSIONS: YOGA MAY BENEFIT TO REDUCE FATIGUE, DEPRESSION AND ANXIETY, IMPROVE SLEEP DISTURBANCE, AND IMPROVE QOL IN BREAST CANCER PATIENTS RECEIVING CHEMOTHERAPY IN THE SHORT-TERM; HOWEVER, MEDIUM- AND LONG-TERM EFFECTS SHOULD BE FURTHER ESTABLISHED OWING TO LIMITATIONS. 2021