1 1140 209 EFFICACY OF YOGA VS COGNITIVE BEHAVIORAL THERAPY VS STRESS EDUCATION FOR THE TREATMENT OF GENERALIZED ANXIETY DISORDER: A RANDOMIZED CLINICAL TRIAL. IMPORTANCE: GENERALIZED ANXIETY DISORDER (GAD) IS COMMON, IMPAIRING, AND UNDERTREATED. ALTHOUGH MANY PATIENTS WITH GAD SEEK COMPLEMENTARY AND ALTERNATIVE INTERVENTIONS, INCLUDING YOGA, DATA SUPPORTING YOGA'S EFFICACY OR HOW IT COMPARES TO FIRST-LINE TREATMENTS ARE LACKING. OBJECTIVES: TO ASSESS WHETHER YOGA (KUNDALINI YOGA) AND COGNITIVE BEHAVIORAL THERAPY (CBT) FOR GAD ARE EACH MORE EFFECTIVE THAN A CONTROL CONDITION (STRESS EDUCATION) AND WHETHER YOGA IS NONINFERIOR TO CBT FOR THE TREATMENT OF GAD. DESIGN, SETTING, AND PARTICIPANTS: FOR THIS RANDOMIZED, 3-ARM, CONTROLLED, SINGLE-BLIND (MASKED INDEPENDENT RATERS) CLINICAL TRIAL, PARTICIPANTS WERE RECRUITED FROM 2 SPECIALTY ACADEMIC CENTERS STARTING DECEMBER 1, 2013, WITH ASSESSMENT ENDING OCTOBER 25, 2019. PRIMARY ANALYSES, COMPLETED BY FEBRUARY 12, 2020, INCLUDED SUPERIORITY TESTING OF KUNDALINI YOGA AND CBT VS STRESS EDUCATION AND NONINFERIORITY TESTING OF KUNDALINI YOGA VS CBT. INTERVENTIONS: PARTICIPANTS WERE RANDOMIZED TO KUNDALINI YOGA (N = 93), CBT FOR GAD (N = 90), OR STRESS EDUCATION (N = 43), WHICH WERE EACH DELIVERED TO GROUPS OF 4 TO 6 PARTICIPANTS BY 2 INSTRUCTORS DURING TWELVE 120-MINUTE SESSIONS WITH 20 MINUTES OF DAILY HOMEWORK. MAIN OUTCOMES AND MEASURES: THE PRIMARY INTENTION-TO-TREAT OUTCOME WAS ACUTE GAD RESPONSE (CLINICAL GLOBAL IMPRESSION-IMPROVEMENT SCALE SCORE OF MUCH OR VERY MUCH IMPROVED) AFTER 12 WEEKS AS ASSESSED BY TRAINED INDEPENDENT RATERS. RESULTS: OF 538 PARTICIPANTS WHO PROVIDED CONSENT AND WERE EVALUATED, 226 (MEAN [SD] AGE, 33.4 [13.5] YEARS; 158 [69.9%] FEMALE) WITH A PRIMARY DIAGNOSIS OF GAD WERE INCLUDED IN THE TRIAL. A TOTAL OF 155 PARTICIPANTS (68.6%) COMPLETED THE POSTTREATMENT ASSESSMENT. COMPLETION RATES DID NOT DIFFER (KUNDALINI YOGA, 60 [64.5%]; CBT, 67 [74.4%]; AND STRESS EDUCATION, 28 [65.1%]: CHI2 = 2.39, DF = 2, P = .30). RESPONSE RATES WERE HIGHER IN THE KUNDALINI YOGA GROUP (54.2%) THAN IN THE STRESS EDUCATION GROUP (33.%) (ODDS RATIO [OR], 2.46 [95% CI, 1.12-5.42]; P = .03; NUMBER NEEDED TO TREAT, 4.59 [95% CI, 2.52-46.19]) AND IN THE CBT GROUP (70.8%) COMPARED WITH THE STRESS EDUCATION GROUP (33.0%) (OR, 5.00 [95% CI, 2.12-11.82]; P < .001; NUMBER NEEDED TO TREAT, 2.62 [95% CI, 1.91-5.68]). HOWEVER, THE NONINFERIORITY TEST DID NOT FIND KUNDALINI YOGA TO BE AS EFFECTIVE AS CBT (DIFFERENCE, 16.6%; P = .42 FOR NONINFERIORITY). CONCLUSIONS AND RELEVANCE: IN THIS TRIAL, KUNDALINI YOGA WAS EFFICACIOUS FOR GAD, BUT THE RESULTS SUPPORT CBT REMAINING FIRST-LINE TREATMENT. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT01912287. 2021 2 1494 35 INTERRATER RELIABILITY OF AN OBSERVATIONAL RATING SCALE AND VIDEO ANALYSIS OF YOGA POSES. CONTEXT: YOGA IS INCREASINGLY POPULAR, NOT ONLY AS A FORM OF RECREATIONAL EXERCISE BUT ALSO AS A PHYSICIAN-RECOMMENDED INTERVENTION FOR HEALTH CONDITIONS. WHILE SERIOUS ADVERSE EFFECTS ACCOMPANYING YOGA PRACTICE ARE RARE, POSES THAT INVOLVE UPPER-EXTREMITY WEIGHT-BEARING HAVE A HIGH RISK OF DISCOMFORT. TO BETTER UNDERSTAND FACTORS CONTRIBUTING TO ADVERSE EFFECTS, THERE IS A CRITICAL NEED FOR ROBUST INSTRUMENTS THAT OBJECTIVELY EVALUATE POSE PERFORMANCE. THE PURPOSE OF THIS STUDY WAS TO ASSESS THE INTERRATER RELIABILITY OF AN OBSERVATIONAL SCALE DEVELOPED TO ASSESS THE ALIGNMENT OF 3 YOGA POSES. DESIGN: CROSS-SECTIONAL EXPERIMENTAL STUDY. METHODS: THIRTY-EIGHT INDIVIDUALS WERE GIVEN STANDARDIZED INSTRUCTIONS AND PERFORMED 3 POSES (DOWNWARD DOG, PLANK, AND SIDE PLANK). LATERAL VIDEOS WERE RATED BY 2 RATERS. A RATING SCALE EVALUATING THE ALIGNMENT OF 7 REGIONS WAS DEVELOPED BY THE STUDY TEAM WITH INPUT FROM YOGA TEACHERS. DESCRIPTIVE STATISTICS WERE USED TO SUMMARIZE THE PERCENTAGE OF SUBJECTS SHOWING IDEAL ALIGNMENT AND DEVIATIONS. INTERRATER RELIABILITY WAS QUANTIFIED USING COHEN KAPPA COEFFICIENT (KAPPA). RESULTS: IN DOWNWARD DOG, THE PREVALENCE OF IDEAL ALIGNMENT WAS 20%, 28%, AND 37%, AT THE NECK, SHOULDER, AND BACK, RESPECTIVELY; KAPPA RANGED FROM .44 TO .69. IN PLANK, THE PREVALENCE OF IDEAL ALIGNMENT WAS 31%, 45%, AND 54% AT THE NECK, SHOULDER, AND BACK, RESPECTIVELY; KAPPA RANGED FROM .47 TO .95. IN SIDE PLANK, THE PREVALENCE OF IDEAL ALIGNMENT WAS 16, 41%, AND 24%, AT THE NECK, SHOULDER, AND BACK, RESPECTIVELY; KAPPA RANGED FROM .20 TO .84. CONCLUSION: THE OBSERVATIONAL SCALE FOUND A HIGH PREVALENCE OF DEVIATIONS, AND DEMONSTRATED FAIR TO SUBSTANTIAL INTERRATER AGREEMENT. 2022 3 2202 38 THE ESSENTIAL PROPERTIES OF YOGA QUESTIONNAIRE (EPYQ): PSYCHOMETRIC PROPERTIES. YOGA INTERVENTIONS ARE HETEROGENEOUS AND VARY ALONG MULTIPLE DIMENSIONS. THESE DIMENSIONS MAY AFFECT MENTAL AND PHYSICAL HEALTH OUTCOMES IN DIFFERENT WAYS OR THROUGH DIFFERENT MECHANISMS. HOWEVER, MOST STUDIES OF THE EFFECTS OF YOGA ON HEALTH DO NOT ADEQUATELY DESCRIBE OR QUANTIFY THE COMPONENTS OF THE INTERVENTIONS BEING IMPLEMENTED. THIS LACK OF DETAIL PREVENTS RESEARCHERS FROM MAKING COMPARISONS ACROSS STUDIES AND LIMITS OUR UNDERSTANDING OF THE RELATIVE EFFECTS OF DIFFERENT ASPECTS OF YOGA INTERVENTIONS. TO ADDRESS THIS PROBLEM, WE DEVELOPED THE ESSENTIAL PROPERTIES OF YOGA QUESTIONNAIRE (EPYQ), WHICH ALLOWS RESEARCHERS TO OBJECTIVELY CHARACTERIZE THEIR INTERVENTIONS. WE PRESENT HERE THE RELIABILITY AND VALIDITY DATA FROM THE FINAL PHASES OF THIS MEASURE-DEVELOPMENT PROJECT. ANALYSES IDENTIFIED FOURTEEN KEY DIMENSIONS OF YOGA INTERVENTIONS MEASURED BY THE EPYQ: ACCEPTANCE/COMPASSION, BANDHAS, BODY AWARENESS, BREATHWORK, INSTRUCTOR MENTION OF HEALTH BENEFITS, INDIVIDUAL ATTENTION, MEDITATION AND MINDFULNESS, MENTAL AND EMOTIONAL AWARENESS, PHYSICALITY, ACTIVE POSTURES, RESTORATIVE POSTURES, SOCIAL ASPECTS, SPIRITUALITY, AND YOGA PHILOSOPHY. THE EPYQ DEMONSTRATED GOOD RELIABILITY, AS ASSESSED BY INTERNAL CONSISTENCY AND TEST-RETEST RELIABILITY ANALYSIS, AND EVIDENCE SUGGESTS THAT THE EPYQ IS A VALID MEASURE OF MULTIPLE DIMENSIONS OF YOGA. THE MEASURE IS READY FOR USE BY CLINICIANS AND RESEARCHERS. RESULTS INDICATE THAT, CURRENTLY, TRAINED OBJECTIVE RATERS SHOULD SCORE INTERVENTIONS TO AVOID REFERENCE FRAME ERRORS AND POTENTIAL RATING BIAS, BUT ALTERNATIVE APPROACHES MAY BE DEVELOPED. THE EPYQ WILL ALLOW RESEARCHERS TO LINK SPECIFIC YOGA DIMENSIONS TO IDENTIFIABLE HEALTH OUTCOMES AND OPTIMIZE THE DESIGN OF YOGA INTERVENTIONS FOR SPECIFIC CONDITIONS. 2018 4 212 32 A STRUCTURED REVIEW AND EVALUATION OF ANDROID MOBILE APPLICATIONS FOR YOGA SUPPORT. ALTHOUGH THERE ARE HUNDREDS OF MOBILE YOGA APPS IN THE APP MARKET SPACE, THE QUALITY AND USEFULNESS OF THESE APPS HAVE NOT BEEN SYSTEMATICALLY TESTED. WE CONDUCTED A STRUCTURED QUALITY EVALUATION OF APPS FROM THE GOOGLE PLAY STORE, APPLYING THE VALIDATED MOBILE APPLICATION RATING SCALE (MARS) BY TWO INDEPENDENT RATERS. 18 OUT OF 250 APPS WERE IDENTIFIED FOR EVALUATION AFTER APPLYING INCLUSION/EXCLUSION CRITERIA. THE MEAN MARS SCORE IS 4.11 (OUT OF 5) WITH SD = 0.38. THERE WAS HIGH INTERRATER RELIABILITY (ICC = .88; 95% CI 0.85-0.91). APPS PERFORMED WELL ON FUNCTIONALITY AND AESTHETICS. HOWEVER, THERE IS MUCH ROOM FOR IMPROVEMENT IN INFORMATION AND ENGAGEMENT. DESIGNERS AND RESEARCHERS SHOULD FOCUS ON IMPROVING USER ENGAGEMENT AND BUILDING THE EVIDENCE BASE FOR INFORMATIONAL CONTENT PROVIDED IN APPS. 2022 5 611 33 DEVELOPMENT OF A YOGA MODULE TARGETING CARDIOVASCULAR HEALTH FOR PATIENTS WITH POST-MYOCARDIAL LEFT VENTRICULAR DYSFUNCTION IN INDIA. BACKGROUND: YOGA IS KNOWN TO CONTRIBUTE TOWARDS CARDIOVASCULAR HEALTH. THIS PAPER DESCRIBES THE DEVELOPMENT OF A NEED-BASED YOGA PROGRAM WHICH IS SUITABLE TO BE INTEGRATED INTO THE CARDIAC REHABILITATION OF POST-MYOCARDIAL INFARCTION PATIENTS WITH LEFT VENTRICULAR DYSFUNCTION. MATERIALS AND METHODS: BASED ON THE ASSESSMENT OF THE NEED OF THE PATIENTS, LITERATURE REVIEW, AND EXPERT OPINION, A YOGA MODULE WAS DEVELOPED USING THE QUALITATIVE METHOD OF INQUIRY. THE PROGRAM INCLUDED WARM-UP EXERCISES, YOGIC ASANAS, PRANAYAMA, MEDITATION AND COUNSELING SESSIONS. A STRUCTURED QUESTIONNAIRE ELICITING COMMENTS ON THE CONTENTS WAS GIVEN INDEPENDENTLY TO TEN EXPERTS WORKING IN THE FIELD OF HEALTH AND YOGA FOR VALIDATION. THE FINAL MODULE WAS DERIVED AFTER INCORPORATING THE SUGGESTIONS OF THE EXPERTS. RESULTS: USING THE RATERS' EXPERTISE IN CARDIOLOGY AND YOGA PRACTICE, THE PRACTICES WHICH CONSTITUTE THE MODULE WERE OPTIMIZED. MAJORITY OF THE EXPERTS (RATERS) AGREED WITH THE DURATION OF 1 H TRAINING FOR 1MONTH UNDER SUPERVISION AS ADEQUATE FOR SUBSEQUENT PRACTICE AT HOME. THERE WAS A 0.786 INTER-RATER RELIABILITY ESTIMATED USING THE INTERCLASS COEFFICIENT (ICC) AND 0.789 INTERNAL CONSISTENCY OF THE QUESTIONS, MEASURED USING CRONBACH'S ALPHA. BOTH VALUES INDICATE "GOOD" RELIABILITY AND CONSISTENCY OF THE YOGA MODULE. CONCLUSION: THE DEVELOPED YOGA MODULE WAS FOUND TO BE ACCEPTABLE. FUTURE RANDOMIZED CONTROL TRIALS WILL BE NECESSARY TO VALIDATE THE EFFECTIVENESS OF THIS MODULE AND IF THE MODULE DEMONSTRATES TO BE EFFECTIVE BY CLINICAL STUDIES, IT MAY ADD A THERAPEUTIC OPTION IN THE REHABILITATION OF PATIENTS WITH HEART FAILURE FOLLOWING MYOCARDIAL INFARCTION, WHICH CAN BE APPLIED IN THE HOSPITALS AND COMMUNITY LEVEL. 2019 6 681 44 EFFECT OF ADD-ON YOGA ON COGNITIVE FUNCTIONS AMONG SUBSTANCE ABUSERS IN A RESIDENTIAL THERAPEUTIC CENTER: RANDOMIZED COMPARATIVE STUDY. BACKGROUND: CHRONIC VULNERABILITY CHARACTERIZES SUBSTANCE ABUSE DISORDER WITH CONSEQUENT RELAPSE. THE PROCESS OF ABSTINENCE DEPENDS ON COGNITIVE RECOVERY. HENCE, BEHAVIORAL INTERVENTION SHOULD ACCOUNT FOR COGNITIVE DIMENSION OF SUBSTANCE ABUSERS. RECENT STUDIES HIGHLIGHT YOGA-BASED INTERVENTION AS A PROMISING ADD-ON THERAPY FOR TREATING AND PREVENTING ADDICTIVE BEHAVIORS. PURPOSE: THE STUDY AIMED TO EVALUATE THE EFFICACY OF A YOGA-BASED INTERVENTION AS AN ADD-ON IN ENHANCING COGNITIVE FUNCTIONS, COMPARED WITH PHYSICAL EXERCISE TO NEWLY ADMITTED SUBSTANCE ABUSERS SEEKING AN INPATIENT TREATMENT PROGRAM. METHODS: THE STUDY WAS A SINGLE-BLIND, RANDOMIZED, COMPARATIVE DESIGN THAT INCLUDED 96 MALE PARTICIPANTS, BETWEEN 18 AND 40 YEARS IN A RESIDENTIAL REHABILITATION TREATMENT UNIT. PARTAKERS IN THE YOGA OR PHYSICAL EXERCISE GROUP RECEIVED SUPERVISED DAILY TRAINING FOR 12 WEEKS, IN ADDITION TO STANDARD REHABILITATION TREATMENT. RATERS BLIND TO THE STUDY ASSESSED THE PATIENTS ON DIGIT SPAN TASK, CANCELLATION TEST, AND STROOP TESTS AT THE BASELINE AND FOLLOWING 12 WEEKS OF INTERVENTION. RESULTS: A SIGNIFICANT ENHANCEMENT IN DIGIT FORWARD (YOGA - P < 0.0005, D = 0.81; EXERCISE - P < 0.0005, D = 0.73), DIGIT BACKWARD (YOGA - P < 0.0005, D = 0.88; EXERCISE - P < 0.0005, D = 0.58), AND LETTER CANCELLATION TEST SCORES (YOGA - P < 0.0005, D = 1.31; EXERCISE - P < 0.0005, D = 1.4) WERE OBSERVED IN BOTH THE YOGA AND THE EXERCISE GROUPS. STROOP WORD AND COLOR TASK SCORES WERE SEEN SIGNIFICANTLY HIGHER FOLLOWING YOGA (P < 0.005, D = 0.74; P < 0.005, D = 1.13) AND EXERCISE (P < 0.0005, D = 0.62; P < 0.0005, D = 0.61). FURTHERMORE, STROOP COLOR-WORD TEST SHOWED SIGNIFICANT ENHANCEMENT AFTER YOGA (P < 0.0005, D = 1.10) AND EXERCISE (P < 0.0005, D = 0.42), WITH DEGREE OF VARIATION HIGHER IN THE YOGA GROUP. CONCLUSION: OUR RESULTS SUGGEST THAT THE ADD-ON YOGA OR EXERCISE-BASED INTERVENTION SHOW ENHANCEMENT OF COGNITIVE FUNCTIONS. THESE FINDINGS PROVIDE THE UTILITY OF YOGA AND EXERCISE-BASED INTERVENTION IN IMPROVING COGNITIVE FUNCTIONS AMONG SUBSTANCE ABUSERS. FURTHERMORE, RIGOROUS TRIALS ARE NEEDED TO EXPLORE THE POTENTIAL LONG-TERM EFFECTS OF THESE PROCEDURES. 2018 7 230 39 A SYSTEMATIC REVIEW OF YOGA FOR BALANCE IN A HEALTHY POPULATION. OBJECTIVE: A SYSTEMATIC REVIEW WAS DONE OF THE EVIDENCE ON YOGA FOR IMPROVING BALANCE. DESIGN: RELEVANT ARTICLES AND REVIEWS WERE IDENTIFIED IN MAJOR DATABASES (PUBMED, MEDLINE((R)), INDMED, WEB OF KNOWLEDGE, EMBASE, EBSCO, SCIENCE DIRECT, AND GOOGLE SCHOLAR), AND THEIR REFERENCE LISTS SEARCHED. KEY SEARCH WORDS WERE YOGA, BALANCE, PROPRIOCEPTION, FALLING, FEAR OF FALLING, AND FALLS. INCLUDED STUDIES WERE PEER-REVIEWED ARTICLES PUBLISHED IN ENGLISH BEFORE JUNE 2012, USING HEALTHY POPULATIONS. ALL YOGA STYLES AND STUDY DESIGNS WERE INCLUDED. TWO (2) RATERS INDIVIDUALLY RATED STUDY QUALITY USING THE DOWNS & BLACK (DB) CHECKLIST. FINAL SCORES WERE ACHIEVED BY CONSENSUS. ACHIEVABLE SCORES RANGED FROM 0 TO 27. EFFECT SIZE (ES) WAS CALCULATED WHERE POSSIBLE. RESULTS: FIFTEEN (15) OF 152 STUDIES (AGE RANGE 10-93, N=688) MET THE INCLUSION CRITERIA: 5 RANDOMIZED CONTROLLED TRIALS (RCTS), 4 QUASI-EXPERIMENTAL, 2 CROSS-SECTIONAL, AND 4 SINGLE-GROUP DESIGNS. DB SCORES RANGED FROM 10 TO 24 (RCTS), 14-19 (QUASI-EXPERIMENTAL), 6-12 (CROSS-SECTIONAL), AND 11-20 (SINGLE GROUP). STUDIES VARIED BY YOGA STYLE, FREQUENCY OF PRACTICE, AND DURATION. ELEVEN (11) STUDIES FOUND POSITIVE RESULTS (P<0.05) ON AT LEAST ONE BALANCE OUTCOME. ES RANGED FROM -0.765 TO 2.71 (FOR 8 STUDIES) AND WAS NOT ASSOCIATED WITH DB SCORE. CONCLUSIONS: YOGA MAY HAVE A BENEFICIAL EFFECT ON BALANCE, BUT VARIABLE STUDY DESIGN AND POOR REPORTING QUALITY OBSCURE THE RESULTS. BALANCE AS AN OUTCOME IS UNDERUTILIZED, AND MORE PROBING MEASURES ARE NEEDED. 2014 8 309 47 AN EVIDENCE-BASED REVIEW OF YOGA AS A COMPLEMENTARY INTERVENTION FOR PATIENTS WITH CANCER. OBJECTIVE: TO CONDUCT AN EVIDENCE-BASED REVIEW OF YOGA AS AN INTERVENTION FOR PATIENTS WITH CANCER. SPECIFICALLY, THIS PAPER REVIEWED THE IMPACT OF YOGA ON PSYCHOLOGICAL ADJUSTMENT AMONG CANCER PATIENTS. METHODS: A SYSTEMATIC LITERATURE SEARCH WAS CONDUCTED BETWEEN MAY 2007 AND APRIL 2008. DATA FROM EACH IDENTIFIED STUDY WERE EXTRACTED BY TWO INDEPENDENT RATERS; STUDIES WERE INCLUDED IF THEY ASSESSED PSYCHOLOGICAL FUNCTIONING AND FOCUSED ON YOGA AS A MAIN INTERVENTION. USING A QUALITY RATING SCALE (RANGE = 9-45), THE RATERS ASSESSED THE METHODOLOGICAL QUALITY OF THE STUDIES, AND CONSORT GUIDELINES WERE USED TO ASSESS RANDOMIZED CONTROLLED TRIALS (RCTS). EFFECT SIZES WERE CALCULATED WHEN POSSIBLE. IN ADDITION, EACH STUDY WAS NARRATIVELY REVIEWED WITH ATTENTION TO OUTCOME VARIABLES, THE TYPE OF YOGA INTERVENTION EMPLOYED, AND METHODOLOGICAL STRENGTHS AND LIMITATIONS. RESULTS: TEN STUDIES WERE INCLUDED, INCLUDING SIX RCTS. ACROSS STUDIES, THE MAJORITY OF PARTICIPANTS WERE WOMEN, AND BREAST CANCER WAS THE MOST COMMON DIAGNOSIS. METHODOLOGICAL QUALITY RANGED GREATLY ACROSS STUDIES (RANGE = 15.5-42), WITH THE AVERAGE RATING (M = 33.55) INDICATING ADEQUATE QUALITY. STUDIES ALSO VARIED IN TERMS OF CANCER POPULATIONS AND YOGA INTERVENTIONS SAMPLED. CONCLUSIONS: THIS STUDY PROVIDED A SYSTEMATIC EVALUATION OF THE YOGA AND CANCER LITERATURE. ALTHOUGH SOME POSITIVE RESULTS WERE NOTED, VARIABILITY ACROSS STUDIES AND METHODOLOGICAL DRAWBACKS LIMIT THE EXTENT TO WHICH YOGA CAN BE DEEMED EFFECTIVE FOR MANAGING CANCER-RELATED SYMPTOMS. HOWEVER, FURTHER RESEARCH IN THIS AREA IS CERTAINLY WARRANTED. FUTURE RESEARCH SHOULD EXAMINE WHAT COMPONENTS OF YOGA ARE MOST BENEFICIAL, AND WHAT TYPES OF PATIENTS RECEIVE THE GREATEST BENEFIT FROM YOGA INTERVENTIONS. 2009 9 2629 63 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 10 1488 36 INTER-METHOD RELIABILITY OF PAPER SURVEYS AND COMPUTER ASSISTED TELEPHONE INTERVIEWS IN A RANDOMIZED CONTROLLED TRIAL OF YOGA FOR LOW BACK PAIN. BACKGROUND: LITTLE IS KNOWN ABOUT THE RELIABILITY OF DIFFERENT METHODS OF SURVEY ADMINISTRATION IN LOW BACK PAIN TRIALS. THIS ANALYSIS WAS DESIGNED TO DETERMINE THE RELIABILITY OF RESPONSES TO SELF-ADMINISTERED PAPER SURVEYS COMPARED TO COMPUTER ASSISTED TELEPHONE INTERVIEWS (CATI) FOR THE PRIMARY OUTCOMES OF PAIN INTENSITY AND BACK-RELATED FUNCTION, AND SECONDARY OUTCOMES OF PATIENT SATISFACTION, SF-36, AND GLOBAL IMPROVEMENT AMONG PARTICIPANTS ENROLLED IN A STUDY OF YOGA FOR CHRONIC LOW BACK PAIN. RESULTS: PAIN INTENSITY, BACK-RELATED FUNCTION, AND BOTH PHYSICAL AND MENTAL HEALTH COMPONENTS OF THE SF-36 SHOWED EXCELLENT RELIABILITY AT ALL THREE TIME POINTS; ICC SCORES RANGED FROM 0.82 TO 0.98. PAIN MEDICATION USE SHOWED GOOD RELIABILITY; KAPPA STATISTICS RANGED FROM 0.68 TO 0.78. PATIENT SATISFACTION HAD MODERATE TO EXCELLENT RELIABILITY; ICC SCORES RANGED FROM 0.40 TO 0.86. GLOBAL IMPROVEMENT SHOWED POOR RELIABILITY AT 6 WEEKS (ICC = 0.24) AND 12 WEEKS (ICC = 0.10). CONCLUSION: CATI SHOWS EXCELLENT RELIABILITY FOR PRIMARY OUTCOMES AND AT LEAST SOME SECONDARY OUTCOMES WHEN COMPARED TO SELF-ADMINISTERED PAPER SURVEYS IN A LOW BACK PAIN YOGA TRIAL. HAVING TWO RELIABLE OPTIONS FOR DATA COLLECTION MAY BE HELPFUL TO INCREASE RESPONSE RATES FOR CORE OUTCOMES IN BACK PAIN TRIALS. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT01761617. DATE OF TRIAL REGISTRATION: DECEMBER 4, 2012. 2014 11 2829 63 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 12 1544 58 KUNDALINI YOGA MEDITATION VERSUS THE RELAXATION RESPONSE MEDITATION FOR TREATING ADULTS WITH OBSESSIVE-COMPULSIVE DISORDER: A RANDOMIZED CLINICAL TRIAL. BACKGROUND: OBSESSIVE-COMPULSIVE DISORDER (OCD) IS OFTEN A LIFE-LONG DISORDER WITH HIGH PSYCHOSOCIAL IMPAIRMENT. SEROTONIN REUPTAKE INHIBITORS (SRIS) ARE THE ONLY FDA APPROVED DRUGS, AND APPROXIMATELY 50% OF PATIENTS ARE NON-RESPONDERS WHEN USING A CRITERION OF 25% TO 35% IMPROVEMENT WITH THE YALE-BROWN OBSESSIVE-COMPULSIVE SCALE (Y-BOCS). ABOUT 30% ARE NON-RESPONDERS TO COMBINED FIRST-LINE THERAPIES (SRIS AND EXPOSURE AND RESPONSE PREVENTION). PREVIOUS RESEARCH (ONE OPEN, ONE RANDOMIZED CLINICAL TRIAL) HAS DEMONSTRATED THAT KUNDALINI YOGA (KY) MEDITATION CAN LEAD TO AN IMPROVEMENT IN SYMPTOMS OF OBSESSIVE-COMPULSIVE SEVERITY. WE EXPAND HERE WITH A LARGER TRIAL. DESIGN: THIS TRIAL COMPARED TWO PARALLEL RUN GROUPS [KY VS. RELAXATION RESPONSE MEDITATION (RR)]. PATIENTS WERE RANDOMLY ALLOCATED BASED ON GENDER AND Y-BOCS SCORES. THEY WERE TOLD TWO DIFFERENT (UNNAMED) TYPES OF MEDITATION WOULD BE COMPARED, AND INFORMED IF ONE SHOWED GREATER BENEFITS, THE GROUPS WOULD MERGE FOR 12 MONTHS USING THE MORE EFFECTIVE INTERVENTION. RATERS WERE BLIND IN PHASE ONE (0-4.5 MONTHS) TO PATIENT ASSIGNMENTS, BUT NOT IN PHASE TWO. MAIN OUTCOME MEASURES: PRIMARY OUTCOME VARIABLE, CLINICIAN-ADMINISTERED Y-BOCS. SECONDARY SCALES: DIMENSIONAL YALE-BROWN OBSESSIVE COMPULSIVE SCALE (CLINICIAN-ADMINISTERED), PROFILE OF MOOD SCALES, BECK ANXIETY INVENTORY, BECK DEPRESSION INVENTORY, CLINICAL GLOBAL IMPRESSION, SHORT FORM 36 HEALTH SURVEY. RESULTS: PHASE ONE: BASELINE Y-BOCS SCORES: KY MEAN = 26.46 (SD 5.124; N = 24), RR MEAN = 26.79 (SD = 4.578; N = 24). AN INTENT-TO-TREAT ANALYSIS WITH THE LAST OBSERVATION CARRIED FORWARD FOR DROPOUTS SHOWED STATISTICALLY GREATER IMPROVEMENT WITH KY COMPARED TO RR ON THE Y-BOCS, AND STATISTICALLY GREATER IMPROVEMENT ON FIVE OF SIX SECONDARY MEASURES. FOR COMPLETERS, THE Y-BOCS SHOWED 40.4% IMPROVEMENT FOR KY (N = 16), 17.9% FOR RR (N = 11); 31.3% IN KY WERE JUDGED TO BE IN REMISSION COMPARED TO 9.1% IN RR. KY COMPLETERS SHOWED GREATER IMPROVEMENT ON FIVE OF SIX SECONDARY MEASURES. AT THE END OF PHASE TWO (12 MONTHS), PATIENTS, DRAWN FROM THE INITIAL GROUPS, WHO ELECTED TO RECEIVE KY CONTINUED TO SHOW IMPROVEMENT IN THEIR Y-BOCS SCORES. CONCLUSION: KY SHOWS PROMISE AS AN ADD-ON OPTION FOR OCD PATIENTS UNRESPONSIVE TO FIRST LINE THERAPIES. FUTURE STUDIES WILL ESTABLISH KY'S RELATIVE EFFICACY COMPARED TO EXPOSURE AND RESPONSE PREVENTION AND/OR MEDICATIONS, AND THE MOST EFFECTIVE TREATMENT SCHEDULE. CLINICAL TRIAL REGISTRATION: WWW.CLINICALTRIALS.GOV, IDENTIFIER NCT01833442. 2019 13 2583 43 YOGA FOR HEART RATE VARIABILITY: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CLINICAL TRIALS. THE OBJECTIVE OF THIS SYSTEMATIC REVIEW IS TO SUMMARIZE AND CRITICALLY ASSESS THE EFFECTS OF YOGA ON HEART RATE VARIABILITY (HRV). NINE DATABASES WERE SEARCHED FROM THEIR INCEPTIONS TO JUNE 2014. WE INCLUDED RANDOMIZED CLINICAL TRIALS (RCTS) COMPARING YOGA AGAINST ANY TYPE OF CONTROL INTERVENTION IN HEALTHY INDIVIDUALS OR PATIENTS WITH ANY MEDICAL CONDITION. RISK OF BIAS WAS ASSESSED USING THE COCHRANE CRITERIA. TWO REVIEWERS PERFORMED THE SELECTION OF STUDIES, DATA EXTRACTION, AND QUALITY ASSESSMENTS INDEPENDENT OF ONE ANOTHER. FOURTEEN TRIALS MET THE INCLUSION CRITERIA. ONLY TWO OF THEM WERE OF ACCEPTABLE METHODOLOGICAL QUALITY. TEN RCTS REPORTED FAVOURABLE EFFECTS OF YOGA ON VARIOUS DOMAINS OF HRV, WHEREAS NINE OF THEM FAILED TO DO SO. ONE RCT DID NOT REPORT BETWEEN-GROUP COMPARISONS. THE META-ANALYSIS (MA) OF TWO TRIALS DID NOT SHOW FAVOURABLE EFFECTS OF YOGA COMPARED TO USUAL CARE ON E:I RATIO (N = 61, SMDS = 0.63; 95% CIS [-0.72 TO 1.99], P = 0.36; HETEROGENEITY: R(2) = 0.79, CHI(2) = 5.48, DF = 1, (P = 0.02); I(2) = 82%). THE MA ALSO FAILED TO SHOW STATISTICALLY SIGNIFICANT DIFFERENCES BETWEEN THE GROUPS REGARDING THE 30:15 RATIO (N = 61, SMDS = 0.20; 95% CIS [-0.43 TO 0.84], P = 0.53; HETEROGENEITY: R(2) = 0.07, CHI(2) = 1.45, DF = 1, (P = 0.23); I(2) = 31%). THE DATA FROM THE REMAINING RCTS WERE TOO HETEROGENEOUS FOR POOLING. THESE RESULTS PROVIDE NO CONVINCING EVIDENCE FOR THE EFFECTIVENESS OF YOGA IN MODULATING HRV IN PATIENTS OR HEALTHY SUBJECTS. FUTURE INVESTIGATIONS IN THIS AREA SHOULD OVERCOME THE MULTIPLE METHODOLOGICAL WEAKNESSES OF THE PREVIOUS RESEARCH. 2015 14 2496 40 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 15 2397 34 YOGA AND COGNITION: A META-ANALYSIS OF CHRONIC AND ACUTE EFFECTS. OBJECTIVES: TO REVIEW AND SYNTHESIZE THE EXISTING LITERATURE ON THE EFFECTS OF YOGA ON COGNITIVE FUNCTION BY DETERMINING EFFECT SIZES THAT COULD SERVE AS A PLATFORM TO DESIGN, CALCULATE STATISTICAL POWER, AND IMPLEMENT FUTURE STUDIES. METHODS: THROUGH ELECTRONIC DATABASES, WE IDENTIFIED ACUTE STUDIES AND RANDOMIZED CONTROLLED TRIALS (RCTS) OF YOGA THAT REPORTED COGNITIVE OUTCOMES. INCLUSION CRITERIA INCLUDED THE FOLLOWING: USE OF AN OBJECTIVE MEASURE OF COGNITION AND SUFFICIENT DATA REPORTED TO ESTIMATE AN EFFECT SIZE. THE META-ANALYSIS WAS CONDUCTED USING COMPREHENSIVE META-ANALYSIS SOFTWARE. A RANDOM-EFFECTS MODEL WAS USED TO CALCULATE THE OVERALL WEIGHTED EFFECT SIZES, EXPRESSED AS HEDGE G. RESULTS: FIFTEEN RCTS AND 7 ACUTE EXPOSURE STUDIES EXAMINED THE EFFECTS OF YOGA ON COGNITION. A MODERATE EFFECT (G = 0.33, STANDARD ERROR = 0.08, 95% CONFIDENCE INTERVAL = 0.18-0.48, P < .001) OF YOGA ON COGNITION WAS OBSERVED FOR RCTS, WITH THE STRONGEST EFFECT FOR ATTENTION AND PROCESSING SPEED (G = 0.29, P < .001), FOLLOWED BY EXECUTIVE FUNCTION (G = 0.27, P = .001) AND MEMORY (G = 0.18, P = .051). ACUTE STUDIES SHOWED A STRONGER OVERALL EFFECT OF YOGA ON COGNITION (G = 0.56, STANDARD ERROR = 0.11, 95% CONFIDENCE INTERVAL = 0.33-0.78, P < .001). THE EFFECT WAS STRONGEST FOR MEMORY (G = 0.78, P < .001), FOLLOWED BY ATTENTION AND PROCESSING SPEED MEASURES (G = 0.49, P < .001) AND EXECUTIVE FUNCTIONS (G = 0.39, P < .003). CONCLUSIONS: YOGA PRACTICE SEEMS TO BE ASSOCIATED WITH MODERATE IMPROVEMENTS IN COGNITIVE FUNCTION. ALTHOUGH THE STUDIES ARE LIMITED BY SAMPLE SIZE, HETEROGENEOUS POPULATION CHARACTERISTICS, VARIED DOSES OF YOGA INTERVENTIONS, AND A MYRIAD OF COGNITIVE TESTS, THESE FINDINGS WARRANT RIGOROUS SYSTEMATIC RCTS AND WELL-DESIGNED COUNTERBALANCED ACUTE STUDIES TO COMPREHENSIVELY EXPLORE YOGA AS A MEANS TO IMPROVE OR SUSTAIN COGNITIVE ABILITIES ACROSS THE LIFE SPAN. 2015 16 2543 69 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 17 477 40 CLINICAL APPLICATIONS OF YOGA FOR THE PEDIATRIC POPULATION: A SYSTEMATIC REVIEW. OBJECTIVE: THE AIM OF THIS STUDY WAS TO EVALUATE THE EVIDENCE FOR CLINICAL APPLICATIONS OF YOGA AMONG THE PEDIATRIC POPULATION. METHODS: WE CONDUCTED AN ELECTRONIC LITERATURE SEARCH INCLUDING CINAHL, COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL), EMBASE, MEDLINE, PSYCINFO, AND MANUAL SEARCH OF RETRIEVED ARTICLES FROM INCEPTION OF EACH DATABASE UNTIL DECEMBER 2008. RANDOMIZED CONTROLLED TRIALS (RCTS) AND NONRANDOMIZED CONTROLLED TRIALS (NRCTS) WERE SELECTED THAT INCLUDED YOGA OR YOGA-BASED INTERVENTIONS FOR INDIVIDUALS AGED 0 TO 21 YEARS. DATA WERE EXTRACTED AND ARTICLES CRITICALLY REVIEWED USING A MODIFIED JADAD SCORE AND DESCRIPTIVE METHODOLOGICAL CRITERIA, WITH SUMMARIZATION IN TABLES. RESULTS: THIRTY-FOUR CONTROLLED STUDIES PUBLISHED FROM 1979 TO 2008 WERE IDENTIFIED, WITH 19 RCTS AND 15 NRCTS. MANY STUDIES WERE OF LOW METHODOLOGICAL QUALITY. CLINICAL AREAS FOR WHICH YOGA HAS BEEN STUDIED INCLUDE PHYSICAL FITNESS, CARDIORESPIRATORY EFFECTS, MOTOR SKILLS/STRENGTH, MENTAL HEALTH AND PSYCHOLOGICAL DISORDERS, BEHAVIOR AND DEVELOPMENT, IRRITABLE BOWEL SYNDROME, AND BIRTH OUTCOMES FOLLOWING PRENATAL YOGA. NO ADVERSE EVENTS WERE REPORTED IN TRIALS REVIEWED. ALTHOUGH A LARGE MAJORITY OF STUDIES WERE POSITIVE, METHODOLOGICAL LIMITATIONS SUCH AS RANDOMIZATION METHODS, WITHDRAWAL/DROPOUTS, AND DETAILS OF YOGA INTERVENTION PRECLUDE CONCLUSIVE EVIDENCE. CONCLUSIONS: THERE ARE LIMITED DATA ON THE CLINICAL APPLICATIONS OF YOGA AMONG THE PEDIATRIC POPULATION. MOST PUBLISHED CONTROLLED TRIALS WERE SUGGESTIVE OF BENEFIT, BUT RESULTS ARE PRELIMINARY BASED ON LOW QUANTITY AND QUALITY OF TRIALS. FURTHER RESEARCH OF YOGA FOR CHILDREN BY USING A HIGHER STANDARD OF METHODOLOGY AND REPORTING IS WARRANTED. 2009 18 2245 47 THE INFLUENCE OF YOGA-BASED PROGRAMS ON RISK PROFILES IN ADULTS WITH TYPE 2 DIABETES MELLITUS: A SYSTEMATIC REVIEW. THERE IS GROWING EVIDENCE THAT YOGA MAY OFFER A SAFE AND COST-EFFECTIVE INTERVENTION FOR TYPE 2 DIABETES MELLITUS (DM 2). HOWEVER, SYSTEMATIC REVIEWS ARE LACKING. THIS ARTICLE CRITICALLY REVIEWS THE PUBLISHED LITERATURE REGARDING THE EFFECTS OF YOGA-BASED PROGRAMS ON PHYSIOLOGIC AND ANTHROPOMETRIC RISK PROFILES AND RELATED CLINICAL OUTCOMES IN ADULTS WITH DM 2. WE PERFORMED A COMPREHENSIVE LITERATURE SEARCH USING FOUR COMPUTERIZED ENGLISH AND INDIAN SCIENTIFIC DATABASES. THE SEARCH WAS RESTRICTED TO ORIGINAL STUDIES (1970-2006) THAT EVALUATED THE METABOLIC AND CLINICAL EFFECTS OF YOGA IN ADULTS WITH DM 2. STUDIES TARGETING CLINICAL POPULATIONS WITH CARDIOVASCULAR DISORDERS THAT INCLUDED ADULTS WITH COMORBID DM WERE ALSO EVALUATED. DATA WERE EXTRACTED REGARDING STUDY DESIGN, SETTING, TARGET POPULATION, INTERVENTION, COMPARISON GROUP OR CONDITION, OUTCOME ASSESSMENT, DATA ANALYSIS AND PRESENTATION, FOLLOW-UP, AND KEY RESULTS, AND THE QUALITY OF EACH STUDY WAS EVALUATED ACCORDING TO SPECIFIC PREDETERMINED CRITERIA. WE IDENTIFIED 25 ELIGIBLE STUDIES, INCLUDING 15 UNCONTROLLED TRIALS, 6 NON-RANDOMIZED CONTROLLED TRIALS AND 4 RANDOMIZED CONTROLLED TRIALS (RCTS). OVERALL, THESE STUDIES SUGGEST BENEFICIAL CHANGES IN SEVERAL RISK INDICES, INCLUDING GLUCOSE TOLERANCE AND INSULIN SENSITIVITY, LIPID PROFILES, ANTHROPOMETRIC CHARACTERISTICS, BLOOD PRESSURE, OXIDATIVE STRESS, COAGULATION PROFILES, SYMPATHETIC ACTIVATION AND PULMONARY FUNCTION, AS WELL AS IMPROVEMENT IN SPECIFIC CLINICAL OUTCOMES. YOGA MAY IMPROVE RISK PROFILES IN ADULTS WITH DM 2, AND MAY HAVE PROMISE FOR THE PREVENTION AND MANAGEMENT OF CARDIOVASCULAR COMPLICATIONS IN THIS POPULATION. HOWEVER, THE LIMITATIONS CHARACTERIZING MOST STUDIES PRECLUDE DRAWING FIRM CONCLUSIONS. ADDITIONAL HIGH-QUALITY RCTS ARE NEEDED TO CONFIRM AND FURTHER ELUCIDATE THE EFFECTS OF STANDARDIZED YOGA PROGRAMS IN POPULATIONS WITH DM 2. 2007 19 1924 37 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 20 2589 38 YOGA FOR LOW BACK PAIN: A SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS. IT HAS BEEN SUGGESTED THAT YOGA HAS A POSITIVE EFFECT ON LOW BACK PAIN AND FUNCTION. THE OBJECTIVE OF THIS SYSTEMATIC REVIEW WAS TO ASSESS THE EFFECTIVENESS OF YOGA AS A TREATMENT OPTION FOR LOW BACK PAIN. SEVEN DATABASES WERE SEARCHED FROM THEIR INCEPTION TO MARCH 2011. RANDOMIZED CLINICAL TRIALS WERE CONSIDERED IF THEY INVESTIGATED YOGA IN PATIENTS WITH LOW BACK PAIN AND IF THEY ASSESSED PAIN AS AN OUTCOME MEASURE. THE SELECTION OF STUDIES, DATA EXTRACTION AND VALIDATION WERE PERFORMED INDEPENDENTLY BY TWO REVIEWERS. SEVEN RANDOMIZED CONTROLLED CLINICAL TRIALS (RCTS) MET THE INCLUSION CRITERIA. THEIR METHODOLOGICAL QUALITY RANGED BETWEEN 2 AND 4 ON THE JADAD SCALE. FIVE RCTS SUGGESTED THAT YOGA LEADS TO A SIGNIFICANTLY GREATER REDUCTION IN LOW BACK PAIN THAN USUAL CARE, EDUCATION OR CONVENTIONAL THERAPEUTIC EXERCISES. TWO RCTS SHOWED NO BETWEEN-GROUP DIFFERENCES. IT IS CONCLUDED THAT YOGA HAS THE POTENTIAL TO ALLEVIATE LOW BACK PAIN. HOWEVER, ANY DEFINITIVE CLAIMS SHOULD BE TREATED WITH CAUTION. 2011