1 2425 122 YOGA AND NATUROPATHY INTERVENTION FOR REDUCING ANXIETY AND DEPRESSION OF COVID-19 PATIENTS - A PILOT STUDY. BACKGROUND: CORONAVIRUS DISEASE 2019 (COVID-19) INFECTION HAS CAUSED A PROMINENT PSYCHOLOGICAL AND MENTAL HAVOC AMONG THE PATIENTS. TILL NOW, THERE IS PAUCITY IN LITERATURE FOR THE MANAGEMENT OF PSYCHOLOGICAL PROBLEMS AMONG PATIENTS WITH COVID-19. SO WE AIMED IN OUR STUDY TO ASSESS THE EFFECT OF YOGA AND NATUROPATHY INTERVENTION ON ANXIETY AND DEPRESSION OF COVID-19 PATIENTS. METHODS: THIS QUASI EXPERIMENTAL STUDY WAS CONDUCTED AMONG 130 COVID-19 POSITIVE PATIENTS ADMITTED IN A TERTIARY CARE HOSPITAL. YOGA AND NATUROPATHIC INTERVENTION WAS GIVEN FOR 60 MIN A DAY FOR TWO WEEKS. HOSPITAL ANXIETY DEPRESSION SCALE (HADS) AND CORONA ANXIETY SCALE (CAS) WAS USED TO ASSESS THE GENERALIZED ANXIETY AND DEPRESSION AMONG THE PATIENTS. RESULTS: AVERAGE AGE OF THE PATIENTS PARTICIPATED WAS 44 WITH THE RANGE FROM 36 TO 53 YEARS. AMONG THEM 85 WERE MALE AND 45 WERE FEMALE. OF ALL 130 PATIENTS, 33% HAD SYMPTOMS OF BORDERLINE DEPRESSION, 9.2% HAD SEVERE DEPRESSION, 40% HAD BORDERLINE ANXIETY AND 12.3% HAD SEVERE ANXIETY. IN CAS, 59 PATIENTS (45.38%) REPORTED COVID-19 RELATED DYSFUNCTIONAL ANXIETY. ALL THE PATIENTS SHOWED A SIGNIFICANT REDUCTION IN THE HADS- ANXIETY (P < 0.01), HADS-DEPRESSION (P < 0.01) AND CAS (P < 0.01) SCORE AFTER THE INTERVENTION. CONCLUSION: THE PRESENT STUDY SHOWED SIGNIFICANT REDUCTION OF ANXIETY AND DEPRESSION LEVEL AMONG THE COVID-19 PATIENTS. THESE INTERVENTIONS CAN BE ADDED TO THE CONVENTIONAL CARE FOR BETTER MENTAL AND PHYSICAL WELLBEING OF THE PATIENTS AFTER VALIDATING THE FINDINGS WITH JUSTIFIED STUDY DESIGN. 2021 2 85 30 A MINDFUL YOGA INTERVENTION FOR CHILDREN WITH SEVERE ASTHMA: A PILOT STUDY. INTRODUCTION: CHILDREN WITH SEVERE ASTHMA MAY BENEFIT FROM NON-PHARMACOLOGICAL APPROACHES TO SYMPTOM MANAGEMENT, YET LITTLE IS KNOWN REGARDING THE IMPACT OF MIND-BODY APPROACHES SUCH AS MINDFUL YOGA IN THIS POPULATION. THIS PILOT STUDY EXAMINED THE TOLERABILITY, FEASIBILITY, ACCEPTABILITY AND IMMEDIATE EFFECTS OF A MINDFUL YOGA INTERVENTION IN CHILDREN WITH SEVERE ASTHMA. METHOD: FIFTEEN CHILDREN AGES 7-11 WITH SEVERE ASTHMA PARTICIPATED IN A SINGLE MINDFUL YOGA SESSION, FOLLOWED BY SEMI-STRUCTURED INTERVIEWS WITH THE CHILD AND CAREGIVER. VITAL SIGNS AND PULMONARY FUNCTION TESTS WERE COLLECTED PRE- AND POST-INTERVENTION. RESULTS: ALL CHILDREN REPORTED POSITIVE EXPERIENCES AND CAREGIVERS WERE GENERALLY SUPPORTIVE OF THEIR PARTICIPATION. ONE CHILD EXPERIENCED SELF-LIMITED BRONCHOCONSTRICTION WITH ASTHMA SYMPTOMS. THERE WAS NO SIGNIFICANT CHANGE IN LUNG FUNCTION OR VITAL SIGNS AFTER THE MINDFUL YOGA SESSION. DISCUSSION: OUR RESULTS WARRANT ADDITIONAL LARGER STUDIES TO EVALUATE THE SAFETY AND BENEFITS OF MINDFUL YOGA IN CHILDREN WITH SEVERE ASTHMA. 2020 3 2631 20 YOGA FOR THE TREATMENT OF INSOMNIA AMONG CANCER PATIENTS: EVIDENCE, MECHANISMS OF ACTION, AND CLINICAL RECOMMENDATIONS. UP TO 90% OF CANCER PATIENTS REPORT SYMPTOMS OF INSOMNIA DURING AND AFTER TREATMENT. SYMPTOMS OF INSOMNIA INCLUDE EXCESSIVE DAYTIME SLEEPINESS, DIFFICULTY FALLING ASLEEP, DIFFICULTY STAYING ASLEEP, AND WAKING UP TOO EARLY. INSOMNIA SYMPTOMS ARE AMONG THE MOST PREVALENT, DISTRESSING AND PERSISTENT CANCER- AND CANCER TREATMENT-RELATED TOXICITIES REPORTED BY PATIENTS, AND CAN BE SEVERE ENOUGH TO INCREASE CANCER MORBIDITY AND MORTALITY. DESPITE THE UBIQUITY OF INSOMNIA SYMPTOMS, THEY ARE UNDER-SCREENED, UNDER-DIAGNOSED, AND UNDER-TREATED IN CANCER PATIENTS. WHEN INSOMNIA SYMPTOMS ARE IDENTIFIED, PROVIDERS ARE HESITANT TO PRESCRIBE, AND PATIENTS ARE HESITANT TO TAKE PHARMACEUTICALS DUE TO POLYPHARMACY CONCERNS. IN ADDITION, SLEEP MEDICATIONS DO NOT CURE INSOMNIA. YOGA IS A WELL-TOLERATED MODE OF EXERCISE WITH PROMISING EVIDENCE FOR ITS EFFICACY IN IMPROVING INSOMNIA SYMPTOMS AMONG CANCER PATIENTS. THIS ARTICLE REVIEWS EXISTING CLINICAL RESEARCH ON THE EFFECTIVENESS OF YOGA FOR TREATING INSOMNIA AMONG CANCER PATIENTS. THE ARTICLE ALSO PROVIDES CLINICAL RECOMMENDATIONS FOR PRESCRIBING YOGA FOR THE TREATMENT OF INSOMNIA IN THIS POPULATION. 2014 4 2412 22 YOGA AND ITS IMPACT ON CHRONIC INFLAMMATORY AUTOIMMUNE ARTHRITIS. RHEUMATOID ARTHRITIS (RA) IS ONE OF THE MOST COMMON CHRONIC INFLAMMATORY AUTOIMMUNE DISEASES, WHICH ADVERSELY AFFECTS THE QUALITY OF LIFE. RA IS A DISEASE OF UNKNOWN ETIOLOGY, HOWEVER, BOTH GENETIC AND ENVIRONMENTAL FACTORS APPEAR TO CONTRIBUTE TO THE SUSCEPTIBILITY TO THIS DISEASE. THE SEVERITY AND PROGRESSION OF THE DISEASE ARE ATTRIBUTABLE TO THE RELEASE OF A HOST OF INFLAMMATORY CYTOKINES, CYTOTOXIC AND IMMUNE REGULATORY FACTORS. THE TREATMENTS OF RA ARE PRIMARILY LIMITED TO SYMPTOMATIC ALLEVIATION OF PAIN OR OTHER SYMPTOMS OR TO THE USE OF CYTOTOXIC DRUG TREATMENT IN SEVERE FORMS OF THE DISEASE WHICH IS COMMONLY ASSOCIATED WITH SIGNIFICANT SIDE EFFECTS. DESPITE LACK OF A CURE, THE DISEASE MAY BE CONTROLLED BY MIND-BODY INTERVENTIONS. HOLISTIC TREATMENTS SUCH AS YOGA SIGNIFICANTLY IMPROVE AND REDUCE THE PSYCHO-SOMATIC SYMPTOMS, PAIN PERCEPTION, DISABILITY QUOTIENT, JOINT FLEXIBILITY, RANGE OF MOTION, POSTURE, MUSCLE STRENGTH, COORDINATION, AND DISEASE ACTIVITY. HERE, WE DISCUSS THE FEATURES OF RA AND ADDRESS HOW YOGA CAN BE USED AS A THERAPEUTIC REGIMEN TO IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH RA. 2021 5 78 34 A LARGE-SCALE SURVEY OF ADVERSE EVENTS EXPERIENCED IN YOGA CLASSES. BACKGROUND: YOGA IS A REPRESENTATIVE MIND-BODY THERAPY OF COMPLEMENTARY AND ALTERNATIVE MEDICINE. IN JAPAN, YOGA IS PRACTICED WIDELY TO PROMOTE HEALTH, BUT YOGA-ASSOCIATED ADVERSE EVENTS HAVE ALSO BEEN REPORTED. TO DATE, THE FREQUENCIES AND CHARACTERISTICS OF YOGA-RELATED ADVERSE EVENTS HAVE NOT BEEN ELUCIDATED. THIS STUDY WAS CONDUCTED TO ELUCIDATE THE FREQUENCIES AND CHARACTERISTICS OF ADVERSE EVENTS OF YOGA PERFORMED IN CLASSES AND THE RISK FACTORS OF SUCH EVENTS. METHODS: THE SUBJECTS WERE 2508 PEOPLE TAKING YOGA CLASSES AND 271 YOGA THERAPISTS CONDUCTING THE CLASSES. A SURVEY FOR YOGA CLASS ATTENDEES WAS PERFORMED ON ADVERSE EVENTS THAT OCCURRED DURING A YOGA CLASS ON THE SURVEY DAY. A SURVEY FOR YOGA THERAPISTS WAS PERFORMED ON ADVERSE EVENTS THAT THE THERAPISTS HAD OBSERVED IN THEIR STUDENTS TO DATE. ADVERSE EVENTS WERE DEFINED AS "UNDESIRABLE SYMPTOMS OR RESPONSES THAT OCCURRED DURING A YOGA CLASS". RESULTS: AMONG 2508 YOGA CLASS ATTENDEES, 1343 (53.5%) HAD CHRONIC DISEASES AND 1063 (42.3%) WERE RECEIVING MEDICATION AT HOSPITALS. THERE WERE 687 CLASS ATTENDEES (27.8%) WHO REPORTED SOME TYPE OF UNDESIRABLE SYMPTOMS AFTER TAKING A YOGA CLASS. MUSCULOSKELETAL SYMPTOMS SUCH AS MYALGIA WERE THE MOST COMMON SYMPTOMS, INVOLVING 297 CASES, FOLLOWED BY NEUROLOGICAL SYMPTOMS AND RESPIRATORY SYMPTOMS. MOST ADVERSE EVENTS (63.8%) WERE MILD AND DID NOT INTERFERE WITH CLASS PARTICIPATION. THE RISK FACTORS FOR ADVERSE EVENTS WERE EXAMINED, AND THE ODDS RATIOS FOR ADVERSE EVENTS WERE SIGNIFICANTLY HIGHER IN ATTENDEES WITH CHRONIC DISEASE, POOR PHYSICAL CONDITION ON THE SURVEY DAY, OR A FEELING THAT THE CLASS WAS PHYSICALLY AND MENTALLY STRESSFUL. IN PARTICULAR, THE OCCURRENCE OF SEVERE ADVERSE EVENTS THAT INTERFERED WITH SUBSEQUENT YOGA PRACTICE WAS HIGH AMONG ELDERLY PARTICIPANTS (70 YEARS OR OLDER) AND THOSE WITH CHRONIC MUSCULOSKELETAL DISEASES. CONCLUSIONS: THE RESULTS OF THIS LARGE-SCALE SURVEY DEMONSTRATED THAT APPROXIMATELY 30% OF YOGA CLASS ATTENDEES HAD EXPERIENCED SOME TYPE OF ADVERSE EVENT. ALTHOUGH THE MAJORITY HAD MILD SYMPTOMS, THE SURVEY RESULTS INDICATED THAT ATTENDEES WITH CHRONIC DISEASES WERE MORE LIKELY TO EXPERIENCE ADVERSE EVENTS ASSOCIATED WITH THEIR DISEASE. THEREFORE, SPECIAL ATTENTION IS NECESSARY WHEN YOGA IS INTRODUCED TO PATIENTS WITH STRESS-RELATED, CHRONIC DISEASES. 2015 6 1650 36 MULTICENTER, RANDOMIZED CONTROLLED TRIAL OF YOGA FOR SLEEP QUALITY AMONG CANCER SURVIVORS. PURPOSE: THIRTY PERCENT TO 90% OF CANCER SURVIVORS REPORT IMPAIRED SLEEP QUALITY POST-TREATMENT, WHICH CAN BE SEVERE ENOUGH TO INCREASE MORBIDITY AND MORTALITY. LIFESTYLE INTERVENTIONS, SUCH AS EXERCISE, ARE RECOMMENDED IN CONJUNCTION WITH DRUGS AND COGNITIVE BEHAVIORAL THERAPY FOR THE TREATMENT OF IMPAIRED SLEEP. PRELIMINARY EVIDENCE INDICATES THAT YOGA-A MIND-BODY PRACTICE AND FORM OF EXERCISE-MAY IMPROVE SLEEP AMONG CANCER SURVIVORS. THE PRIMARY AIM OF THIS RANDOMIZED, CONTROLLED CLINICAL TRIAL WAS TO DETERMINE THE EFFICACY OF A STANDARDIZED YOGA INTERVENTION COMPARED WITH STANDARD CARE FOR IMPROVING GLOBAL SLEEP QUALITY (PRIMARY OUTCOME) AMONG POST-TREATMENT CANCER SURVIVORS. PATIENTS AND METHODS: IN ALL, 410 SURVIVORS SUFFERING FROM MODERATE OR GREATER SLEEP DISRUPTION BETWEEN 2 AND 24 MONTHS AFTER SURGERY, CHEMOTHERAPY, AND/OR RADIATION THERAPY WERE RANDOMLY ASSIGNED TO STANDARD CARE OR STANDARD CARE PLUS THE 4-WEEK YOGA INTERVENTION. THE YOGA INTERVENTION USED THE YOGA FOR CANCER SURVIVORS (YOCAS) PROGRAM CONSISTING OF PRANAYAMA (BREATHING EXERCISES), 16 GENTLE HATHA AND RESTORATIVE YOGA ASANAS (POSTURES), AND MEDITATION. PARTICIPANTS ATTENDED TWO 75-MINUTE SESSIONS PER WEEK. SLEEP QUALITY WAS ASSESSED BY USING THE PITTSBURGH SLEEP QUALITY INDEX AND ACTIGRAPHY PRE- AND POSTINTERVENTION. RESULTS: IN ALL, 410 SURVIVORS WERE ACCRUED (96% FEMALE; MEAN AGE, 54 YEARS; 75% HAD BREAST CANCER). YOGA PARTICIPANTS DEMONSTRATED GREATER IMPROVEMENTS IN GLOBAL SLEEP QUALITY AND, SECONDARILY, SUBJECTIVE SLEEP QUALITY, DAYTIME DYSFUNCTION, WAKE AFTER SLEEP ONSET, SLEEP EFFICIENCY, AND MEDICATION USE AT POSTINTERVENTION (ALL P OR =4 MODERATE TO SEVERE HOT FLUSHES PER DAY OR > OR =30 MODERATE TO SEVERE HOT FLUSHES PER WEEK. THE INTERVENTION CONSISTED OF EIGHT RESTORATIVE YOGA POSES TAUGHT IN A 3-H INTRODUCTORY SESSION AND 8 WEEKLY 90-MIN SESSIONS. FEASIBILITY WAS MEASURED BY RECRUITMENT RATES, SUBJECT RETENTION AND ADHERENCE. ACCEPTABILITY WAS ASSESSED BY SUBJECT INTERVIEW AND QUESTIONNAIRES. EFFICACY MEASURES INCLUDED CHANGE IN FREQUENCY AND SEVERITY OF HOT FLUSHES AS RECORDED ON A 7-DAY DIARY. RESULTS: RECRUITMENT WAS ACCOMPLISHED AS PLANNED. THE MAJORITY OF STUDY SUBJECTS (93%) COMPLETED THE TRIAL. OF THOSE WHO COMPLETED THE TRIAL, 92% ATTENDED SEVEN OR MORE OF THE EIGHT YOGA SESSIONS. THE MAJORITY OF THE SUBJECTS WERE SATISFIED WITH THE STUDY AND 75% CONTINUED TO PRACTICE YOGA 3 MONTHS AFTER THE STUDY. MEAN NUMBER OF HOT FLUSHES PER WEEK DECREASED BY 30.8% (95% CI 15.6-45.9%) AND MEAN HOT FLUSH SCORE DECREASED 34.2% (95% CI 16.0-52.5%) FROM BASELINE TO WEEK 8. NO ADVERSE EVENTS WERE OBSERVED. CONCLUSIONS: THIS PILOT TRIAL DEMONSTRATES THAT IT IS FEASIBLE TO TEACH RESTORATIVE YOGA TO MIDDLE-AGED WOMEN WITHOUT PRIOR YOGA EXPERIENCE. THE HIGH RATES OF SUBJECT RETENTION AND SATISFACTION SUGGEST THAT YOGA IS AN ACCEPTABLE INTERVENTION IN THIS POPULATION. OUR RESULTS INDICATE THAT A LARGER, RANDOMIZED CONTROLLED TRIAL TO EXPLORE THE EFFICACY OF RESTORATIVE YOGA FOR TREATMENT OF MENOPAUSAL SYMPTOMS WOULD BE SAFE AND FEASIBLE. 2007 19 682 34 EFFECT OF ADJUNCT YOGA THERAPY IN DEPRESSIVE DISORDERS: FINDINGS FROM A RANDOMIZED CONTROLLED STUDY. BACKGROUND: DEPRESSION CAUSES SIGNIFICANT BURDEN BOTH TO THE INDIVIDUAL AND TO SOCIETY, AND ITS TREATMENT BY ANTIDEPRESSANTS HAS VARIOUS DISADVANTAGES. THERE IS PRELIMINARY EVIDENCE THAT ADDS ON YOGA THERAPY IMPROVES DEPRESSION BY IMPACTING THE NEUROTRANSMITTERS INVOLVED IN THE REGULATION OF MOOD, MOTIVATION, AND PLEASURE. OUR STUDY AIMED TO FIND THE EFFECT OF ADJUNCTIVE YOGA THERAPY ON OUTCOME OF DEPRESSION AND COMORBID ANXIETY. MATERIALS AND METHODS: A RANDOMIZED CONTROLLED STUDY INVOLVING PATIENTS WITH MAJOR DEPRESSIVE DISORDER (N = 80) WERE ALLOCATED TO TWO GROUPS, ONE RECEIVED STANDARD THERAPY (ANTIDEPRESSANTS AND COUNSELING) AND THE OTHER RECEIVED ADJUNCT YOGA THERAPY ALONG WITH STANDARD THERAPY. RATINGS OF DEPRESSION AND ANXIETY WERE DONE USING MONTGOMERY-ASBERG DEPRESSION RATING SCALE AND HOSPITAL ANXIETY AND DEPRESSION SCALE AT BASELINE, 10(TH) AND 30(TH) DAY. CLINICAL GLOBAL IMPRESSION (CGI) SCALE WAS APPLIED AT BASELINE AND 30(TH) DAY TO VIEW THE SEVERITY OF ILLNESS AND CLINICAL IMPROVEMENT. RESULTS: BY THE 30(TH) DAY, INDIVIDUALS IN THE YOGA GROUP HAD SIGNIFICANTLY LOWER SCORES OF DEPRESSION, ANXIETY, AND CGI SCORES, IN COMPARISON TO THE CONTROL GROUP. THE INDIVIDUALS IN THE YOGA GROUP HAD A SIGNIFICANT FALL IN DEPRESSION SCORES AND SIGNIFICANT CLINICAL IMPROVEMENT, COMPARED TO THE CONTROL GROUP, FROM BASELINE TO 30(TH) DAY AND 10(TH) TO 30(TH) DAY. IN ADDITION, THE INDIVIDUALS IN THE YOGA GROUP HAD A SIGNIFICANT FALL IN ANXIETY SCORES FROM BASELINE TO 10(TH) DAY. CONCLUSION: ANXIETY STARTS TO IMPROVE WITH SHORT-TERM YOGA SESSIONS, WHILE LONG-TERM YOGA THERAPY IS LIKELY TO BE BENEFICIAL IN THE TREATMENT OF DEPRESSION. 2019 20 1556 36 LONG-TERM CHANGES OF SYMPTOMS OF ANXIETY, DEPRESSION, AND FATIGUE IN CANCER PATIENTS 6 MONTHS AFTER THE END OF YOGA THERAPY. BACKGROUND: SYMPTOMS OF ANXIETY, DEPRESSION, AND CANCER-RELATED FATIGUE ARE COMMONLY ASSOCIATED WITH CANCER. CANCER PATIENTS INCREASINGLY USE COMPLEMENTARY AND ALTERNATIVE TREATMENTS, SUCH AS YOGA, TO COPE WITH PSYCHOLOGICAL AND PHYSICAL IMPAIRMENTS. IN THE PRESENT ARTICLE, LONG-TERM CHANGES OF ANXIETY, DEPRESSION, AND FATIGUE IN CANCER ARE EXAMINED 6 MONTHS AFTER A YOGA INTERVENTION. METHOD: WE USED AN OBSERVATIONAL DESIGN BASED ON A RANDOMIZED CONTROLLED STUDY IN CANCER PATIENTS WITH MIXED DIAGNOSES TO EVALUATE LONG-TERM CHANGES OF SYMPTOMS OF ANXIETY, DEPRESSION, AND FATIGUE 6 MONTHS AFTER THE END OF YOGA THERAPY. WE MEASURED ANXIETY SYMPTOMS WITH THE GENERALIZED ANXIETY DISORDER SCALE (GAD-7), DEPRESSIVE SYMPTOMS WITH THE PATIENT HEALTH QUESTIONNAIRE-2 (PHQ-2), AND FATIGUE WITH THE EUROPEAN ORGANIZATION FOR RESEARCH AND TREATMENT OF CANCER QUALITY OF LIFE QUESTIONNAIRE-FATIGUE SCALE (EORTC QLQ-FA13). YOGA THERAPY WAS PROVIDED IN YOGA CLASSES OF 60 MINUTES EACH ONCE A WEEK FOR 8 WEEKS IN TOTAL. THE EXERCISES PROVIDED CONTAINED BOTH BODY AND BREATHING ACTIVITIES AS WELL AS MEDITATION. RESULTS: A TOTAL OF 58 PATIENTS PARTICIPATED IN THE STUDY. SIX MONTHS AFTER THE END OF YOGA THERAPY, SYMPTOMS OF ANXIETY, DEPRESSION, AND FATIGUE WERE SIGNIFICANTLY REDUCED COMPARED WITH BASELINE. HOWEVER, SYMPTOMS OF ANXIETY AND FATIGUE SLIGHTLY INCREASED DURING THE FOLLOW-UP PERIOD, WHEREAS SYMPTOMS OF DEPRESSION REMAINED STABLE. CONCLUSION: OUR RESULTS ARE PROMISING AND SUPPORT THE INTEGRATION OF YOGA INTERVENTIONS IN SUPPORTIVE CANCER TREATMENT CONCEPTS BUT SHOULD BE CONFIRMED BY RANDOMIZED CONTROLLED TRIALS. LONG-TERM EFFECTS OF YOGA THERAPY ON CANCER PATIENTS SHOULD BE THE SUBJECT OF FURTHER RESEARCH. 2019