1 2543 325 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 WE ATTEMPTED TO CONTACT INVESTIGATORS OF ELIGIBLE STUDIES AND EXPERTS IN THE FIELD TO LEARN OF OTHER PUBLISHED AND UNPUBLISHED STUDIES.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 2 2330 49 TWELVE WEEKS OF YOGA FOR CHRONIC NONSPECIFIC LOWER BACK PAIN: A META-ANALYSIS. OBJECTIVES: TO INVESTIGATE THE OVERALL EFFECTS OF 12 WEEKS OF YOGA PRACTICE ON CHRONIC NONSPECIFIC LOWER BACK PAIN. METHODS: PUBMED, EMBASE, PSYCINFO, WEB OF SCIENCE, AND THE COCHRANE LIBRARY DATABASES WERE SEARCHED FROM INCEPTION TO FEBRUARY 9, 2019, AND SIX RANDOMIZED CONTROLLED TRIALS WERE SELECTED FOR THIS META-ANALYSIS. RESULTS: THE POOLED FIXED-EFFECT SIZE OF SIX TRIALS SHOWED THAT 12 WEEKS OF YOGA PROGRAMS COULD SIGNIFICANTLY REDUCE CHRONIC NONSPECIFIC LOWER BACK PAIN BY 0.41 WITHIN THE TRIALS (STANDARDIZED MEAN DIFFERENCE; 95% CONFIDENCE INTERVAL: -0.58 TO -0.23; P < .0001). SUBGROUP ANALYSES ALSO SHOWED THAT SIGNIFICANT PAIN REDUCTION WAS RELATED TO TYPE OF YOGA, LENGTH OF SESSION, STUDY QUALITY, AND TIMING OF PAIN ASSESSMENT. CONCLUSIONS: THESE FINDINGS REVEAL THAT 12 WEEKS OF YOGA CAN HELP ALLEVIATE PAIN, AND YOGA PROGRAMS SHOULD TAKE INTO ACCOUNT THE SUBGROUP FACTORS TO INCREASE INDIVIDUALS' RELIEF FROM CHRONIC NONSPECIFIC LOWER BACK PAIN. 2020 3 826 65 EFFECT OF YOGA ON HEALTH-RELATED QUALITY OF LIFE IN CENTRAL NERVOUS SYSTEM DISORDERS: A SYSTEMATIC REVIEW. OBJECTIVE: INVESTIGATE THE EFFECT OF YOGA ON HEALTH-RELATED QUALITY OF LIFE (HRQOL) IN PATIENTS WITH CENTRAL NERVOUS SYSTEM DISORDERS. METHODS: A SYSTEMATIC SEARCH WAS CONDUCTED ON THE PUBMED-NCBI, EBSCO HOST, COCHRANE LIBRARY, SCOPUS AND SCIENCEDIRECT DATABASES UNTIL 05 APRIL 2021. ONLY RANDOMIZED CONTROL TRIALS PUBLISHED IN ENGLISH OR FRENCH WERE INCLUDED AND HAD TO COMPARE YOGA TO ANOTHER INTERVENTION GROUP OR A CONTROL GROUP. THEY ALSO HAD TO CLEARLY MEASURE HRQOL. METHODOLOGICAL QUALITY WAS ASSESSED WITH THE REVISED COCHRANE RISK-OF-BIAS TOOL FOR RANDOMIZED TRIALS AND THE QUALITY OF EVIDENCE WAS EVALUATED USING THE GRADING OF RECOMMENDATIONS ASSESSMENT, DEVELOPMENT AND EVALUATION (GRADE) CRITERIA. RESULTS: SIXTEEN STUDIES WERE FOUND, INCLUDING SIX FOR MULTIPLE SCLEROSIS, FIVE FOR PARKINSON'S DISEASE, TWO FOR STROKE, ONE FOR DEMENTIA, ONE FOR EPILEPSY AND ONE FOR BRAIN TUMOUR. ONLY 12 STUDIES PERFORMED BETWEEN-GROUP STATISTICS AND 8 FOUND A SIGNIFICANT DIFFERENCE BETWEEN GROUPS AFTER TREATMENT. WHEN YOGA WAS COMPARED TO NO INTERVENTION, THE RESULTS WERE GENERALLY IN FAVOUR OF THE YOGA GROUP, BUT WHEN YOGA WAS COMPARED TO ANOTHER INTERVENTION PROGRAMME, THERE WAS GENERALLY NO SIGNIFICANT DIFFERENCE BETWEEN GROUPS. THERE WERE MANY DIFFERENT HRQOL QUESTIONNAIRES, EVEN WITHIN THE SAME DISEASE, WHICH REDUCES THE COMPARABILITY OF STUDIES. CONCLUSIONS: WITH LOW TO MODERATE QUALITY OF THE EVIDENCE, YOGA SEEMS EFFECTIVE TO IMPROVE HRQOL IN PEOPLE WITH PARKINSON'S DISEASE. FOR MULTIPLE SCLEROSIS, STROKE, DEMENTIA, EPILEPSY AND BRAIN TUMOUR, THE QUALITY OF THE EVIDENCE IS STILL INSUFFICIENT TO CONCLUDE OF THE EFFECTIVENESS OF YOGA. 2021 4 1740 70 PHYSICAL AND PSYCHOSOCIAL BENEFITS OF YOGA IN CANCER PATIENTS AND SURVIVORS, A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. BACKGROUND: THIS STUDY AIMED TO SYSTEMATICALLY REVIEW THE EVIDENCE FROM RANDOMIZED CONTROLLED TRIALS (RCTS) AND TO CONDUCT A META-ANALYSIS OF THE EFFECTS OF YOGA ON PHYSICAL AND PSYCHOSOCIAL OUTCOMES IN CANCER PATIENTS AND SURVIVORS. METHODS: A SYSTEMATIC LITERATURE SEARCH IN TEN DATABASES WAS CONDUCTED IN NOVEMBER 2011. STUDIES WERE INCLUDED IF THEY HAD AN RCT DESIGN, FOCUSED ON CANCER PATIENTS OR SURVIVORS, INCLUDED PHYSICAL POSTURES IN THE YOGA PROGRAM, COMPARED YOGA WITH A NON-EXERCISE OR WAITLIST CONTROL GROUP, AND EVALUATED PHYSICAL AND/OR PSYCHOSOCIAL OUTCOMES. TWO RESEARCHERS INDEPENDENTLY RATED THE QUALITY OF THE INCLUDED RCTS, AND HIGH QUALITY WAS DEFINED AS >50% OF THE TOTAL POSSIBLE SCORE. EFFECT SIZES (COHEN'S D) WERE CALCULATED FOR OUTCOMES STUDIED IN MORE THAN THREE STUDIES AMONG PATIENTS WITH BREAST CANCER USING MEANS AND STANDARD DEVIATIONS OF POST-TEST SCORES OF THE INTERVENTION AND CONTROL GROUPS. RESULTS: SIXTEEN PUBLICATIONS OF 13 RCTS MET THE INCLUSION CRITERIA, OF WHICH ONE INCLUDED PATIENTS WITH LYMPHOMAS AND THE OTHERS FOCUSED ON PATIENTS WITH BREAST CANCER. THE MEDIAN QUALITY SCORE WAS 67% (RANGE: 22-89%). THE INCLUDED STUDIES EVALUATED 23 PHYSICAL AND 20 PSYCHOSOCIAL OUTCOMES. OF THE OUTCOMES STUDIED IN MORE THAN THREE STUDIES AMONG PATIENTS WITH BREAST CANCER, WE FOUND LARGE REDUCTIONS IN DISTRESS, ANXIETY, AND DEPRESSION (D = -0.69 TO -0.75), MODERATE REDUCTIONS IN FATIGUE (D = -0.51), MODERATE INCREASES IN GENERAL QUALITY OF LIFE, EMOTIONAL FUNCTION AND SOCIAL FUNCTION (D = 0.33 TO 0.49), AND A SMALL INCREASE IN FUNCTIONAL WELL-BEING (D = 0.31). EFFECTS ON PHYSICAL FUNCTION AND SLEEP WERE SMALL AND NOT SIGNIFICANT. CONCLUSION: YOGA APPEARED TO BE A FEASIBLE INTERVENTION AND BENEFICIAL EFFECTS ON SEVERAL PHYSICAL AND PSYCHOSOCIAL SYMPTOMS WERE REPORTED. IN PATIENTS WITH BREAST CANCER, EFFECT SIZE ON FUNCTIONAL WELL-BEING WAS SMALL, AND THEY WERE MODERATE TO LARGE FOR PSYCHOSOCIAL OUTCOMES. 2012 5 2829 117 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 6 2827 124 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 7 2628 56 YOGA FOR THE MANAGEMENT OF PAIN AND SLEEP IN RHEUMATOID ARTHRITIS: A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THE AIM OF THE PRESENT STUDY WAS TO DETERMINE THE FEASIBILITY OF A RELAXATION-BASED YOGA INTERVENTION FOR RHEUMATOID ARTHRITIS, DESIGNED AND REPORTED IN ACCORDANCE WITH DELPHI RECOMMENDATIONS FOR YOGA INTERVENTIONS FOR MUSCULOSKELETAL CONDITIONS. METHODS: PARTICIPANTS WERE RECRUITED FROM A HOSPITAL DATABASE, AND RANDOMIZED TO EITHER EIGHT WEEKLY 75-MIN YOGA CLASSES OR A USUAL CARE CONTROL. FEASIBILITY WAS DETERMINED BY RECRUITMENT RATES, RETENTION, PROTOCOL ADHERENCE, PARTICIPANT SATISFACTION AND ADVERSE EVENTS. SECONDARY PHYSICAL AND PSYCHOSOCIAL OUTCOMES WERE ASSESSED USING SELF-REPORTED QUESTIONNAIRES AT BASELINE (WEEK 0), WEEK 9 (PRIMARY TIME POINT) AND WEEK 12 (FOLLOW-UP). RESULTS: OVER A 3-MONTH PERIOD, 26 PARTICIPANTS WITH MILD PAIN, MILD TO MODERATE FUNCTIONAL DISABILITY AND MODERATE DISEASE ACTIVITY WERE RECRUITED INTO THE STUDY (25% RECRUITMENT RATE). RETENTION RATES WERE 100% FOR YOGA PARTICIPANTS AND 92% FOR USUAL CARE PARTICIPANTS AT BOTH WEEKS 9 AND 12. PROTOCOL ADHERENCE AND PARTICIPANT SATISFACTION WERE HIGH. YOGA PARTICIPANTS ATTENDED A MEDIAN OF SEVEN CLASSES; ADDITIONALLY, SEVEN OF THE YOGA PARTICIPANTS (54%) REPORTED CONTINUING YOGA AT HOME DURING THE FOLLOW-UP PERIOD. NO SERIOUS ADVERSE EVENTS WERE RELATED TO THE STUDY. SECONDARY OUTCOMES SHOWED NO GROUP EFFECTS OF YOGA COMPARED WITH USUAL CARE. CONCLUSIONS: A RELAXATION-BASED YOGA PROGRAMME WAS FOUND TO BE FEASIBLE AND SAFE FOR PARTICIPANTS WITH RHEUMATOID ARTHRITIS-RELATED PAIN AND FUNCTIONAL DISABILITY. ADVERSE EVENTS WERE MINOR, AND NOT UNEXPECTED FROM AN INTERVENTION INCLUDING PHYSICAL COMPONENTS. THIS PILOT PROVIDES A FRAMEWORK FOR LARGER INTERVENTION STUDIES, AND SUPPORTS FURTHER EXPLORATION OF YOGA AS A COMPLEX INTERVENTION TO ASSIST WITH THE MANAGEMENT OF RHEUMATOID ARTHRITIS. 2018 8 2094 56 THE EFFECT OF YOGA AND PEER SUPPORT INTERVENTIONS ON THE QUALITY OF LIFE OF WOMEN WITH DIABETES: RESULTS OF A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THIS WAS AN INTERVENTIONAL STUDY TO UNDERSTAND THE EFFECT OF TWO LOW-COST INTERVENTIONS; YOGA AND PEER SUPPORT ON THE QUALITY OF LIFE (QOL) OF WOMEN WITH TYPE 2 DIABETES. METHODOLOGY: AN OPEN LABEL PARALLEL THREE-ARMED RANDOMIZED CONTROL TRIAL WAS CONDUCTED AMONG 124 RECRUITED WOMEN WITH DIABETES FOR 3 MONTHS. BLOCK RANDOMIZATION WITH A BLOCK LENGTH OF SIX WAS CARRIED OUT. IN THE YOGA ARM, SESSIONS BY AN INSTRUCTOR, CONSISTING OF A GROUP OF POSTURES COORDINATED WITH BREATHING WERE CONDUCTED FOR AN HOUR, 2 DAYS A WEEK. IN THE PEER SUPPORT ARM, EACH PEER MENTOR AFTER TRAINING VISITED 13-14 WOMEN WITH DIABETES EVERY WEEK FOLLOWED BY A PHONE CALL. THE MEETING WAS ABOUT APPLYING DISEASE MANAGEMENT PLANS IN DAILY LIFE. AT THE BEGINNING AND END OF THE STUDY, QOL WAS ASSESSED BY THE TRANSLATED, VALIDATED WORLD HEALTH ORGANIZATION QOL-BREF IN FOUR DOMAINS PHYSICAL, PSYCHOLOGICAL, SOCIAL, AND ENVIRONMENTAL DOMAINS. RESULTS: THE MAJORITY (96%) OF THE STUDY PARTICIPANTS PERCEIVED THE PEER SUPPORT AND YOGA INTERVENTION TO BE BENEFICIAL. PAIRED T-TEST REVEALED SIGNIFICANT INCREASES IN THE SOCIAL AND ENVIRONMENTAL DOMAIN IN THE PEER GROUP AND IN THE ENVIRONMENTAL DOMAIN IN THE YOGA GROUP, THOUGH THIS DISAPPEARED IN THE BETWEEN-GROUP COMPARISON PERHAPS DUE TO POOR GLYCEMIC CONTROL (HEMOGLOBIN A1C VARIED FROM 9.4 TO 9.6) AND THE SHORT DURATION OF 3 MONTHS OF THE STUDY. CONCLUSION: PEER SUPPORT AND YOGA IMPROVED PERCEPTIONS OF QOL THOUGH ITS IMPACT ON SCORES WAS NOT SIGNIFICANT DUE TO A SHORT PERIOD OF STUDY AMONG WOMEN WITH POOR GLYCEMIC CONTROL. 2017 9 501 81 COMMUNITY BASED YOGA CLASSES FOR TYPE 2 DIABETES: AN EXPLORATORY RANDOMISED CONTROLLED TRIAL. BACKGROUND: YOGA IS A POPULAR THERAPY FOR DIABETES BUT ITS EFFICACY IS CONTESTED. THE AIM OF THIS STUDY WAS TO EXPLORE THE FEASIBILITY OF RESEARCHING COMMUNITY BASED YOGA CLASSES IN TYPE 2 DIABETES WITH A VIEW TO INFORMING THE DESIGN OF A DEFINITIVE, MULTI-CENTRE TRIAL METHODS: THE STUDY DESIGN WAS AN EXPLORATORY RANDOMISED CONTROLLED TRIAL WITH IN-DEPTH PROCESS EVALUATION. THE SETTING WAS TWO MULTI-ETHNIC BOROUGHS IN LONDON, UK; ONE WITH AVERAGE AND ONE WITH LOW MEAN SOCIO-ECONOMIC DEPRIVATION SCORE. CLASSES WERE HELD AT A SPORTS CENTRE OR GP SURGERY. PARTICIPANTS WERE 59 PEOPLE WITH TYPE 2 DIABETES NOT TAKING INSULIN, RECRUITED FROM GENERAL PRACTICE LISTS OR OPPORTUNISTICALLY BY GENERAL PRACTICE STAFF. THE INTERVENTION GROUP WERE OFFERED 12 WEEKS OF A TWICE-WEEKLY 90-MINUTE YOGA CLASS; THE CONTROL GROUP WAS A WAITING LIST FOR THE YOGA CLASSES. BOTH GROUPS RECEIVED ADVICE AND LEAFLETS ON HEALTHY LIFESTYLE AND WERE ENCOURAGED TO EXERCISE. PRIMARY OUTCOME MEASURE WAS HBA1C. SECONDARY OUTCOME MEASURES INCLUDED ATTENDANCE, WEIGHT, WAIST CIRCUMFERENCE, LIPID LEVELS, BLOOD PRESSURE, UKPDS CARDIOVASCULAR RISK SCORE, DIABETES-RELATED QUALITY OF LIFE (ADDQOL), AND SELF-EFFICACY. PROCESS MEASURES WERE ATTENDANCE AT YOGA SESSIONS, SELF-REPORTED FREQUENCY OF PRACTICE BETWEEN TAUGHT SESSIONS, AND QUALITATIVE DATA (INTERVIEWS WITH PATIENTS AND THERAPISTS, ETHNOGRAPHIC OBSERVATION OF THE YOGA CLASSES, AND ANALYSIS OF DOCUMENTS INCLUDING MINUTES OF MEETINGS, CORRESPONDENCE, AND EXERCISE PLANS). RESULTS: DESPITE BROAD INCLUSION CRITERIA, AROUND TWO-THIRDS OF THE PATIENTS ON GP DIABETIC REGISTERS PROVED INELIGIBLE, AND 90% OF THE REMAINDER DECLINED TO PARTICIPATE. MEAN AGE OF PARTICIPANTS WAS 60 +/- 10 YEARS. ATTENDANCE AT YOGA CLASSES WAS AROUND 50%. NOBODY DID THE EXERCISES REGULARLY AT HOME. YOGA TEACHERS FELT THAT MOST PARTICIPANTS WERE UNSUITABLE FOR 'STANDARD' YOGA EXERCISES BECAUSE OF LIMITED FLEXIBILITY, LACK OF BASIC FITNESS, CO-MORBIDITY, AND LACK OF CONFIDENCE. THERE WAS A SMALL FALL IN HBA1C IN THE YOGA GROUP WHICH WAS NOT STATISTICALLY SIGNIFICANT AND WHICH WAS NOT SUSTAINED SIX MONTHS LATER, AND NO SIGNIFICANT CHANGE IN OTHER OUTCOME MEASURES. CONCLUSION: THE BENEFITS OF YOGA IN TYPE 2 DIABETES SUGGESTED IN SOME PREVIOUS STUDIES WERE NOT CONFIRMED. POSSIBLE EXPLANATIONS (APART FROM LACK OF EFFICACY) INCLUDE RECRUITMENT CHALLENGES; PRACTICAL AND MOTIVATIONAL BARRIERS TO CLASS ATTENDANCE; PHYSICAL AND MOTIVATIONAL BARRIERS TO ENGAGING IN THE EXERCISES; INADEQUATE INTENSITY AND/OR DURATION OF YOGA INTERVENTION; AND INSUFFICIENT PERSONALISATION OF EXERCISES TO INDIVIDUAL NEEDS. ALL THESE FACTORS SHOULD BE CONSIDERED WHEN DESIGNING FUTURE TRIALS. TRIAL REGISTRATION: NATIONAL RESEARCH REGISTER (1410) AND CURRENT CONTROLLED TRIALS (ISRCTN63637211). 2009 10 2811 58 YOGA TO PREVENT MOBILITY LIMITATIONS IN OLDER ADULTS: FEASIBILITY OF A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: THE LOSS OF MOBILITY DURING AGING IMPACTS INDEPENDENCE AND LEADS TO FURTHER DISABILITY, MORBIDITY, AND REDUCED LIFE EXPECTANCY. OUR OBJECTIVE WAS TO EXAMINE THE FEASIBILITY AND SAFETY OF CONDUCTING A RANDOMIZED CONTROLLED TRIAL OF YOGA FOR OLDER ADULTS AT RISK FOR MOBILITY LIMITATIONS. METHODS: SEDENTARY OLDER ADULTS (N = 46; AGE 60-89) WERE RECRUITED AND RANDOMIZED TO EITHER YOGA OR A HEALTH EDUCATION COMPARISON GROUP. YOGA SESSIONS (60-MIN) OCCURRED 2X WEEKLY, AND 90-MIN HEALTH EDUCATION SESSIONS OCCURRED WEEKLY, FOR 10 WEEKS. THE PRIMARY OUTCOMES WERE RECRUITMENT RATE, INTERVENTION ATTENDANCE, AND RETENTION AT ASSESSMENTS. ADVERSE EVENT RATES AND PARTICIPANT SATISFACTION WERE ALSO MEASURED. PHYSICAL PERFORMANCE MEASURES OF GAIT, BALANCE, AND STRENGTH AND SELF-REPORT OUTCOME MEASURES WERE ADMINISTERED AT BASELINE AND 10-WEEKS. RESULTS: RECRUITMENT LASTED 6 MONTHS. RETENTION OF PARTICIPANTS AT THE 10-WEEK FOLLOW-UP WAS HIGH (89% - PERFORMANCE MEASURES; 98% - SELF-REPORT QUESTIONNAIRES). ATTENDANCE WAS GOOD WITH 82% OF YOGA AND 74% OF HEALTH EDUCATION PARTICIPANTS ATTENDING AT LEAST 50% OF THE SESSIONS. NO SERIOUS ADVERSE EVENTS WERE REPORTED. PATIENT SATISFACTION WITH THE INTERVENTIONS WAS HIGH. THE MEAN EFFECT SIZE FOR THE PHYSICAL PERFORMANCE MEASURES WAS 0.35 WITH SOME OVER 0.50. THE MEAN EFFECT SIZE FOR SELF-REPORT OUTCOME MEASURES WAS 0.36. CONCLUSIONS: RESULTS INDICATE THAT IT IS FEASIBLE TO CONDUCT A LARGER RCT OF YOGA FOR SEDENTARY OLDER ADULTS AT RISK FOR MOBILITY PROBLEMS. THE YOGA AND COMPARISON INTERVENTIONS WERE SAFE, WELL ACCEPTED, AND WELL ATTENDED. EFFECT SIZES SUGGEST YOGA MAY HAVE IMPORTANT BENEFITS FOR THIS POPULATION AND SHOULD BE STUDIED FURTHER. TRIAL REGISTRATION: CLINICALTRIALS # NCT03544879 ; RETROSPECTIVELY REGISTERED 4 JUNE, 2018. 2018 11 260 54 ACCEPTANCE AND COMMITMENT THERAPY AND YOGA FOR DRUG-REFRACTORY EPILEPSY: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THERE IS A NEED FOR CONTROLLED OUTCOME STUDIES ON BEHAVIORAL TREATMENT OF EPILEPSY. THE PURPOSE OF THIS STUDY WAS TO EVALUATE ACCEPTANCE AND COMMITMENT THERAPY (ACT) AND YOGA IN THE TREATMENT OF EPILEPSY. METHODS: THE DESIGN CONSISTED OF A RANDOMIZED CONTROLLED TRIAL WITH REPEATED MEASURES (N=18). ALL PARTICIPANTS HAD AN EEG-VERIFIED EPILEPSY DIAGNOSIS WITH DRUG-REFRACTORY SEIZURES. PARTICIPANTS WERE RANDOMIZED INTO ONE OF TWO GROUPS: ACT OR YOGA. THERAPEUTIC EFFECTS WERE MEASURED USING SEIZURE INDEX (FREQUENCY X DURATION) AND QUALITY OF LIFE (SATISFACTION WITH LIFE SCALE, WHOQOL-BREF). THE TREATMENT PROTOCOLS CONSISTED OF 12 HOURS OF PROFESSIONAL THERAPY DISTRIBUTED IN TWO INDIVIDUAL SESSIONS, TWO GROUP SESSIONS DURING A 5-WEEK PERIOD, AND BOOSTER SESSIONS AT 6 AND 12 MONTHS POSTTREATMENT. SEIZURE INDEX WAS CONTINUOUSLY ASSESSED DURING THE 3-MONTH BASELINE AND 12-MONTH FOLLOW-UP. QUALITY OF LIFE WAS MEASURED AFTER TREATMENT AND AT THE 6-MONTH AND 1-YEAR FOLLOW-UPS. RESULTS: THE RESULTS INDICATE THAT BOTH ACT AND YOGA SIGNIFICANTLY REDUCE SEIZURE INDEX AND INCREASE QUALITY OF LIFE OVER TIME. ACT REDUCED SEIZURE INDEX SIGNIFICANTLY MORE AS COMPARED WITH YOGA. PARTICIPANTS IN BOTH THE ACT AND YOGA GROUPS IMPROVED THEIR QUALITY OF LIFE SIGNIFICANTLY AS MEASURED BY ONE OF TWO QUALITY-OF-LIFE INSTRUMENTS. THE ACT GROUP INCREASED THEIR QUALITY OF LIFE SIGNIFICANTLY AS COMPARED WITH THE YOGA GROUP AS MEASURED BY THE WHOQOL-BREF, AND THE YOGA GROUP INCREASED THEIR QUALITY OF LIFE SIGNIFICANTLY AS COMPARED WITH THE ACT GROUP AS MEASURED BY THE SWLS. CONCLUSIONS: THE RESULTS OF THIS STUDY SUGGEST THAT COMPLEMENTARY TREATMENTS, SUCH AS ACT AND YOGA, DECREASE SEIZURE INDEX AND INCREASE QUALITY OF LIFE. 2008 12 1180 71 EVALUATION OF THE EFFECTIVENESS AND EFFICACY OF IYENGAR YOGA THERAPY ON CHRONIC LOW BACK PAIN. STUDY DESIGN: THE EFFECTIVENESS AND EFFICACY OF IYENGAR YOGA FOR CHRONIC LOW BACK PAIN (CLBP) WERE ASSESSED WITH INTENTION-TO-TREAT AND PER-PROTOCOL ANALYSIS. NINETY SUBJECTS WERE RANDOMIZED TO A YOGA (N = 43) OR CONTROL GROUP (N = 47) RECEIVING STANDARD MEDICAL CARE. PARTICIPANTS WERE FOLLOWED 6 MONTHS AFTER COMPLETION OF THE INTERVENTION. OBJECTIVE: THIS STUDY AIMED TO EVALUATE IYENGAR YOGA THERAPY ON CHRONIC LOW BACK PAIN. YOGA SUBJECTS WERE HYPOTHESIZED TO REPORT GREATER REDUCTIONS IN FUNCTIONAL DISABILITY, PAIN INTENSITY, DEPRESSION, AND PAIN MEDICATION USAGE THAN CONTROLS. SUMMARY OF BACKGROUND DATA: CLBP IS A MUSCULOSKELETAL DISORDER WITH PUBLIC HEALTH AND ECONOMIC IMPACT. PILOT STUDIES OF YOGA AND BACK PAIN HAVE REPORTED SIGNIFICANT CHANGES IN CLINICALLY IMPORTANT OUTCOMES. METHODS: SUBJECTS WERE RECRUITED THROUGH SELF-REFERRAL AND HEALTH PROFESSIONAL REFERRALS ACCORDING TO EXPLICIT INCLUSION/EXCLUSION CRITERIA. YOGA SUBJECTS PARTICIPATED IN 24 WEEKS OF BIWEEKLY YOGA CLASSES DESIGNED FOR CLBP. OUTCOMES WERE ASSESSED AT 12 (MIDWAY), 24 (IMMEDIATELY AFTER), AND 48 WEEKS (6-MONTH FOLLOW-UP) AFTER THE START OF THE INTERVENTION USING THE OSWESTRY DISABILITY QUESTIONNAIRE, A VISUAL ANALOG SCALE, THE BECK DEPRESSION INVENTORY, AND A PAIN MEDICATION-USAGE QUESTIONNAIRE. RESULTS: USING INTENTION-TO-TREAT ANALYSIS WITH REPEATED MEASURES ANOVA (GROUP X TIME), SIGNIFICANTLY GREATER REDUCTIONS IN FUNCTIONAL DISABILITY AND PAIN INTENSITY WERE OBSERVED IN THE YOGA GROUP WHEN COMPARED TO THE CONTROL GROUP AT 24 WEEKS. A SIGNIFICANTLY GREATER PROPORTION OF YOGA SUBJECTS ALSO REPORTED CLINICAL IMPROVEMENTS AT BOTH 12 AND 24 WEEKS. IN ADDITION, DEPRESSION WAS SIGNIFICANTLY LOWER IN YOGA SUBJECTS. FURTHERMORE, WHILE A REDUCTION IN PAIN MEDICATION OCCURRED, THIS WAS COMPARABLE IN BOTH GROUPS. WHEN RESULTS WERE ANALYZED USING PER-PROTOCOL ANALYSIS, IMPROVEMENTS WERE OBSERVED FOR ALL OUTCOMES IN THE YOGA GROUP, INCLUDING AGREATER TREND FOR REDUCED PAIN MEDICATION USAGE. ALTHOUGH SLIGHTLY LESS THAN AT 24 WEEKS, THE YOGA GROUP HAD STATISTICALLY SIGNIFICANT REDUCTIONS IN FUNCTIONAL DISABILITY, PAIN INTENSITY, AND DEPRESSION COMPARED TO STANDARD MEDICAL CARE 6-MONTHS POSTINTERVENTION. CONCLUSION: YOGA IMPROVES FUNCTIONAL DISABILITY, PAIN INTENSITY, AND DEPRESSION IN ADULTS WITH CLBP. THERE WAS ALSO A CLINICALLY IMPORTANT TREND FOR THE YOGA GROUP TO REDUCE THEIR PAIN MEDICATION USAGE COMPARED TO THE CONTROL GROUP. 2009 13 2677 67 YOGA IN SCHIZOPHRENIA: A SYSTEMATIC REVIEW OF RANDOMISED CONTROLLED TRIALS. OBJECTIVE: THE OBJECTIVE OF THIS SYSTEMATIC REVIEW WAS TO ASSESS THE EFFECTIVENESS OF YOGA AS A COMPLEMENTARY TREATMENT ON GENERAL PSYCHOPATHOLOGY, POSITIVE AND NEGATIVE SYMPTOMS AND HEALTH-RELATED QUALITY OF LIFE (HRQL) FOR PEOPLE WITH SCHIZOPHRENIA. METHOD: RANDOMISED CONTROLLED TRIALS (RCTS) WERE CONSIDERED WHETHER THEY INVESTIGATED A YOGA INTERVENTION IN PATIENTS WITH SCHIZOPHRENIA. THE SELECTION OF STUDIES, DATA EXTRACTION AND QUALITY ASSESSMENT WERE PERFORMED INDEPENDENTLY BY TWO REVIEWERS. RESULTS: ONLY THREE RCTS MET THE INCLUSION CRITERIA. LOWER POSITIVE AND NEGATIVE SYNDROME SCALE (PANSS) TOTAL SCORES AND SUBSCALE SCORES FOR POSITIVE AND NEGATIVE SYMPTOMS WERE OBTAINED AFTER YOGA COMPARED WITH EXERCISE OR WAITING LIST CONTROL CONDITIONS. IN THE SAME WAY, THE PHYSICAL, PSYCHOLOGICAL, SOCIAL AND ENVIRONMENTAL HRQL AS MEASURED WITH THE ABBREVIATED VERSION OF THE WORLD HEALTH ORGANIZATION QUALITY OF LIFE QUESTIONNAIRE (WHOQOL-BREF) INCREASED MORE SIGNIFICANTLY AFTER YOGA THAN AFTER EXERCISE OR WAITING LIST CONTROL CONDITIONS. NONE OF THE RCTS ENCOUNTERED ADVERSE EVENTS. DOSE-RESPONSE RELATIONSHIPS COULD, HOWEVER, NOT BE DETERMINED. CONCLUSION: ALTHOUGH THE NUMBER OF RCTS INCLUDED IN THIS REVIEW WAS LIMITED, RESULTS INDICATED THAT YOGA THERAPY CAN BE AN USEFUL ADD-ON TREATMENT TO REDUCE GENERAL PSYCHOPATHOLOGY AND POSITIVE AND NEGATIVE SYMPTOMS. IN THE SAME WAY, HRQL IMPROVED IN THOSE ANTIPSYCHOTIC-STABILISED PATIENTS WITH SCHIZOPHRENIA FOLLOWING YOGA. 2012 14 1042 78 EFFECTS OF YOGA INTERVENTIONS ON FATIGUE IN CANCER PATIENTS AND SURVIVORS: A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS. BACKGROUND: FATIGUE IS ONE OF THE MOST FREQUENTLY REPORTED, DISTRESSING SIDE EFFECTS REPORTED BY CANCER SURVIVORS AND OFTEN HAS SIGNIFICANT LONG-TERM CONSEQUENCES. RESEARCH INDICATES THAT YOGA CAN PRODUCE INVIGORATING EFFECTS ON PHYSICAL AND MENTAL ENERGY, AND THEREBY MAY IMPROVE LEVELS OF FATIGUE. THE OBJECTIVE OF THIS SYSTEMATIC REVIEW WAS TO EXAMINE THE LITERATURE THAT REPORTS THE EFFECTS OF RANDOMIZED, CONTROLLED YOGA INTERVENTIONS ON SELF-REPORTED FATIGUE IN CANCER PATIENTS AND SURVIVORS. THE ONLINE ELECTRONIC DATABASES, PUBMED AND PSYCINFO, WERE USED TO SEARCH FOR PEER-REVIEWED RESEARCH ARTICLES STUDYING THE EFFECTS OF YOGA INTERVENTIONS ON FATIGUE IN CANCER SURVIVORS. COMBINATIONS OF YOGA, CANCER, AND FATIGUE-RELATED SEARCH TERMS WERE ENTERED SIMULTANEOUSLY TO OBTAIN ARTICLES THAT INCLUDED ALL THREE ELEMENTS. STUDIES WERE INCLUDED IF THEY MET THE FOLLOWING INCLUSION CRITERIA: PARTICIPANTS WERE MALE OR FEMALE CANCER PATIENTS OR SURVIVORS PARTICIPATING IN RANDOMIZED, CONTROLLED YOGA INTERVENTIONS. THE MAIN OUTCOME OF INTEREST WAS CHANGE IN FATIGUE FROM PRE- TO POST-INTERVENTION. INTERVENTIONS OF ANY LENGTH WERE INCLUDED IN THE ANALYSIS. RISK OF BIAS USING THE FORMAT OF THE COCHRANE COLLABORATION'S TOOL FOR ASSESSING RISK OF BIAS WAS ALSO EXAMINED ACROSS STUDIES. RESULTS: TEN ARTICLES MET INCLUSION CRITERIA AND INVOLVED A TOTAL OF 583 PARTICIPANTS WHO WERE PREDOMINANTLY FEMALE, BREAST CANCER SURVIVORS. FOUR STUDIES INDICATED THAT THE YOGA INTERVENTION RESULTED IN SIGNIFICANT REDUCTIONS IN SELF-REPORTED FATIGUE FROM PRE- TO POST-INTERVENTION. THREE OF THE STUDIES REPORTED THAT THERE WERE SIGNIFICANT REDUCTIONS OF FATIGUE AMONG PARTICIPANTS WHO ATTENDED A GREATER NUMBER OF YOGA CLASSES. RISK OF BIAS WAS HIGH FOR AREAS OF ADEQUATE SELECTION, PERFORMANCE, DETECTION, AND PATIENT-REPORTED BIAS AND MIXED FOR ATTRITION AND REPORTING BIAS. RISK OF BIAS WAS UNIFORMLY LOW FOR OTHER FORMS OF BIAS, INCLUDING FINANCIAL CONFLICTS OF INTEREST. CONCLUSIONS: RESULTS OF THE STUDIES INCLUDED IN THIS REVIEW SUGGEST THAT YOGA INTERVENTIONS MAY BE BENEFICIAL FOR REDUCING CANCER-RELATED FATIGUE IN WOMEN WITH BREAST CANCER; HOWEVER, CONCLUSIONS SHOULD BE INTERPRETED WITH CAUTION AS A RESULT OF LEVELS OF BIAS AND INCONSISTENT METHODS USED ACROSS STUDIES. MORE WELL-CONSTRUCTED RANDOMIZED CONTROLLED TRIALS ARE NEEDED TO DETERMINE THE IMPACT OF YOGA INTERVENTIONS ON FATIGUE IN CANCER PATIENTS AND SURVIVORS. 2013 15 2589 63 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 16 1077 74 EFFECTS OF YOGA ON PSYCHOLOGIC FUNCTION AND QUALITY OF LIFE IN WOMEN WITH BREAST CANCER: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. OBJECTIVE: THE AIM OF THIS META-ANALYSIS WAS TO EVALUATE THE EFFECTS OF YOGA ON PSYCHOLOGIC FUNCTION AND QUALITY OF LIFE (QOL) IN WOMEN WITH BREAST CANCER. DESIGN: A SYSTEMATIC SEARCH OF PUBMED, EMBASE, THE COCHRANE LIBRARY, THE CHINESE BIOMEDICAL LITERATURE DATABASE, AND THE CHINESE DIGITAL JOURNALS FULL-TEXT DATABASE WAS CARRIED OUT. RANDOMIZED CONTROL TRIALS (RCTS) EXAMINING THE EFFECTS OF YOGA, VERSUS A CONTROL GROUP RECEIVING NO INTERVENTION, ON PSYCHOLOGIC FUNCTIONING AND QOL IN WOMEN WITH BREAST CANCER WERE INCLUDED. METHODOLOGICAL QUALITY OF INCLUDED RCTS WAS ASSESSED ACCORDING TO THE COCHRANE HANDBOOK FOR SYSTEMATIC REVIEWS OF INTERVENTIONS 5.0.1, AND DATA WERE ANALYZED USING THE COCHRANE COLLABORATION'S REVIEW MANAGER 5.1. RESULTS: SIX (6) STUDIES INVOLVING 382 PATIENTS WERE INCLUDED. THE META-ANALYSIS SHOWED THAT YOGA CAN IMPROVE QOL FOR WOMEN WITH BREAST CANCER. A STATISTICALLY SIGNIFICANT EFFECT FAVORING YOGA FOR THE OUTCOME OF QOL WAS FOUND (STANDARD MEAN DIFFERENCE=0.27, 95% CONFIDENCE INTERVAL [0.02, 0.52], P=0.03). ALTHOUGH THE EFFECTS OF YOGA ON PSYCHOLOGIC FUNCTION OUTCOMES--SUCH AS ANXIETY, DEPRESSION, DISTRESS AND SLEEP--WERE IN THE EXPECTED DIRECTION, THESE EFFECTS WERE NOT STATISTICALLY SIGNIFICANT (P>0.05). FATIGUE SHOWED NO SIGNIFICANT DIFFERENCE (P>0.05). CONCLUSIONS: THE PRESENT DATA PROVIDED LITTLE INDICATION OF HOW EFFECTIVE YOGA MIGHT BE WHEN THEY WERE APPLIED BY WOMEN WITH BREAST CANCER EXCEPT FOR MILDLY EFFECTIVE IN QOL IMPROVEMENT. THE FINDINGS WERE BASED ON A SMALL BODY OF EVIDENCE IN WHICH METHODOLOGICAL QUALITY WAS NOT HIGH. FURTHER WELL-DESIGNED RCTS WITH LARGE SAMPLE SIZE ARE NEEDED TO CLARIFY THE UTILITY OF YOGA PRACTICE FOR THIS POPULATION. 2012 17 70 51 A FEASIBILITY STUDY EXAMINING THE IMPACT OF YOGA ON PSYCHOSOCIAL HEALTH AND SYMPTOMS IN PEDIATRIC OUTPATIENTS RECEIVING CHEMOTHERAPY. PURPOSE: PEDIATRIC CANCER PATIENTS EXPERIENCE SYMPTOMS THAT NEGATIVELY IMPACT QUALITY OF LIFE; YOGA MAY BE AN EFFECTIVE INTERVENTION. THE PRIMARY OBJECTIVE WAS TO DETERMINE THE FEASIBILITY OF A 10-WEEK, WEEKLY INDIVIDUALIZED YOGA INTERVENTION FOR CHILDREN AND ADOLESCENTS RECEIVING OUTPATIENT CANCER THERAPY PRIMARILY DELIVERED REMOTELY USING SKYPE. SECONDARY OBJECTIVES WERE TO DESCRIBE DEPRESSION, ANXIETY, ANGER, FATIGUE, QUALITY OF LIFE, AND SYMPTOMS AT 5 AND 10 WEEKS AFTER ENROLLMENT. METHODS: WE INCLUDED ENGLISH-SPEAKING PATIENTS AGED 10 TO 18 YEARS RECEIVING OUTPATIENT CHEMOTHERAPY FOR CANCER. WEEKLY INDIVIDUALIZED YOGA SESSIONS WERE OFFERED FOR 10 WEEKS. WEEKS 1, 5, AND 10 WERE IN-HOSPITAL WHILE THE REMAINING SESSIONS WERE DELIVERED REMOTELY USING SKYPE. TWICE WEEKLY, HOMEWORK WAS ASSIGNED BETWEEN EACH SESSION. THE PRIMARY OUTCOME WAS FEASIBILITY, DEFINED AS 80% OF PARTICIPANTS COMPLETING AT LEAST 60% OF PLANNED IN-HOSPITAL OR REMOTE YOGA SESSIONS. RESULTS: BETWEEN MARCH AND NOVEMBER 2017, 10 PATIENTS WERE ENROLLED. TWO PATIENTS DISCONTINUED THE STUDY AFTER ONE AND TWO SESSIONS. ONLY SIX PARTICIPANTS ACHIEVED AT LEAST 60% OF PLANNED YOGA SESSIONS AND THUS, THE STUDY DID NOT MEET THE A PRIORI DEFINED FEASIBILITY THRESHOLD. AMONG ALL PARTICIPANTS, ONLY ONE HOMEWORK SESSION WAS PERFORMED. CONCLUSIONS: A 10-WEEK INDIVIDUALIZED IN-PERSON AND REMOTELY CONDUCTED YOGA INTERVENTION WAS NOT FEASIBLE IN CHILDREN RECEIVING CANCER TREATMENTS BECAUSE OF FAILURE TO ACHIEVE THE DESIRED FREQUENCY OF YOGA SESSIONS IN A SUFFICIENT NUMBER OF PARTICIPANTS. FUTURE RESEARCH SHOULD IDENTIFY APPROACHES TO IMPROVE COMPLIANCE WITH REMOTE YOGA SESSIONS AND HOME PRACTICE. TRIAL REGISTRATION: NCT03318068. 2019 18 2609 85 YOGA FOR QUALITY OF LIFE IN INDIVIDUALS WITH CHRONIC DISEASE: A SYSTEMATIC REVIEW. BACKGROUND: CHRONIC DISEASES, INCLUDING HEART DISEASE, STROKE, CANCER, AND CHRONIC PULMONARY DISEASE ARE THE LEADING CAUSES OF DEATH AND DISABILITY WORLDWIDE. COMPOUNDING SYMPTOMS AND LOSS OF FUNCTION, PEOPLE LIVING WITH CHRONIC DISEASE OFTEN EXPERIENCE REDUCED QUALITY OF LIFE (QOL). VARIOUS PHYSICAL AND MENTAL PRACTICES HAVE BEEN SHOWN TO RELIEVE STRESS AND IMPROVE QOL. YOGA IS A PHYSICAL AND MENTAL PRACTICE THAT MAY BE A VIABLE APPROACH FOR IMPROVING QOL IN PEOPLE WITH CHRONIC DISEASE. OBJECTIVE: THE OBJECTIVE OF THIS STUDY WAS TO EXAMINE AND SUMMARIZE THE EVIDENCE FOR THE EFFECTIVENESS OF YOGA ON QOL IN PATIENTS WITH CHRONIC DISEASE. DESIGN: THE STUDY DESIGN WAS A A SYSTEMATIC REVIEW WITH QUALITATIVE SYNTHESIS. METHODS: WE INCLUDED RANDOMIZED CONTROLLED TRIALS THAT EVALUATED THE EFFECT OF YOGA ON QOL OR HEALTH-RELATED QOL (HRQOL) FOR INDIVIDUALS WITH CHRONIC DISEASE. WE INCLUDED ONLY STUDIES THAT USED AT LEAST 1 PREVIOUSLY VALIDATED MEASURE OF QOL OR HRQOL AND SPECIFIED A MINIMUM DURATION OF FOLLOW-UP OF AT LEAST 1 WK. INTERVENTIONS: WE INCLUDED BOTH MOVEMENT-BASED AND BREATH-BASED YOGA PRACTICES. STUDIES THAT INCLUDED YOGA AS PART OF A LARGER INTERVENTION PROGRAM (EG, MINDFULNESS-BASED STRESS REDUCTION TRAINING) OR STUDIES THAT DID NOT PROVIDE FINDINGS SPECIFIC TO YOGA WERE EXCLUDED. PRIMARY OUTCOME MEASURES: THE PRIMARY OUTCOME ANALYZED WAS IMPROVEMENT IN QOL AS MEASURED BY A VALIDATED QOL OR HRQOL SCALE. RESULTS: AMONG THE 1488 STUDIES THAT WERE IDENTIFIED ON INITIAL SEARCH, 7 ARTICLES MET ALL INCLUSION CRITERIA. FIVE STUDIES REPORTED A STATISTICALLY SIGNIFICANT ADVANTAGE OVER USUAL CARE ALONE FOR IMPROVEMENT OF QOL IN PATIENTS WITH CHRONIC DISEASE, BUT THE CLINICAL SIGNIFICANCE OF THE DIFFERENCES WAS CLEAR IN ONLY 1 TRIAL. WE FOUND CONSIDERABLE HETEROGENEITY AMONG THE INCLUDED STUDIES AND STUDY QUALITY WAS GENERALLY LOW. CONCLUSIONS: MORE HIGH-QUALITY RESEARCH IS NEEDED TO DETERMINE THE VALUE OF YOGA AS AN ADJUNCTIVE APPROACH TO IMPROVING QOL IN PATIENTS WITH CHRONIC DISEASE. 2019 19 1731 57 PERSONALIZED YOGA THERAPY FOR MULTIPLE SCLEROSIS: EFFECT ON SYMPTOM MANAGEMENT AND QUALITY OF LIFE. THIS STUDY AIMED TO ASSESS THE FEASIBILITY OF PERSONALIZED YOGA THERAPY INTERVENTION IN A PRIVATE SETTING AND ITS EFFECT ON QUALITY OF LIFE (QOL), SLEEP QUALITY, AND SYMPTOM RELIEF AMONG PATIENTS WITH MULTIPLE SCLEROSIS (MS). A SINGLE-GROUP PRE- AND POST-EXPERIMENTAL STUDY WAS CONDUCTED AMONG 10 MEMBERS OF THE MULTIPLE SCLEROSIS SOCIETY OF INDIA BETWEEN DECEMBER 2017 AND APRIL 2018. AT BASELINE AND DURING FOLLOW-UP, QOL, SLEEP QUALITY, SYMPTOMS, AND PAIN WERE ASSESSED USING THE MULTIPLE SCLEROSIS QUALITY OF LIFE, PITTSBURGH SLEEP QUALITY INDEX, MS SYMPTOM CHECKLIST, AND VISUAL ANALOGUE SCALE, RESPECTIVELY. THE INTERVENTION COMPRISED 12 PRIVATE CUSTOMIZED YOGA SESSIONS OF 1 HOUR DURATION AND THREE GROUP SESSIONS, ALL SPREAD OVER 3-MONTHS. PATIENT FEEDBACK AND DIRECT OBSERVATIONS BY THE YOGA THERAPIST WE RE DOCUMENTED AT EACH SESSION. TEN PATIENTS (SEVEN FEMALE, THREE MALE, AGE 31-52 YEARS) WERE ENROLLED IN THE YOGA INTERVENTION; SEVEN COMPLETED 8-12 SESSIONS, AND THREE COMPLETED FEWER THAN 5 SESSIONS. THERAPIST-TO-PATIENT RATIO WAS 1:2. ALL DOMAINS EXCEPT SEXUAL FUNCTION SHOWED CLINICALLY SIGNIFICANT IMPROVEMENT IN QOL SCORES. STATISTICALLY SIGNIFICANT IMPROVEMENT WAS FOUND IN SOCIAL FUNCTION (P = 0.014) AND CHANGE IN HEALTH STATUS (P = 0.029) SCORES AFTER THE INTERVENTION. ALTHOUGH THERE WAS IMPROVEMENT IN PAIN AND SLEEP QUALITY, THESE CHANGES WERE NOT STATISTICALLY SIGNIFICANT. PATIENTS REPORTED IMPROVEMENT IN SYMPTOMS WITH PRACTICE OF YOGA ALONGSIDE LIFESTYLE CHANGES. THE STUDY SUPPORTS THE FEASIBILITY OF THIS 3-MONTH YOGA INTERVENTION FOR PATIENTS WITH MS. STUDIES WITH LARGER SAMPLE SIZES ARE REQUIRED TO CONFIRM OUR FINDINGS. 2021 20 2508 71 YOGA BREATHING FOR CANCER CHEMOTHERAPY-ASSOCIATED SYMPTOMS AND QUALITY OF LIFE: RESULTS OF A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: MANY DEBILITATING SYMPTOMS ARISE FROM CANCER AND ITS TREATMENT THAT ARE OFTEN UNRELIEVED BY ESTABLISHED METHODS. PRANAYAMA, A SERIES OF YOGIC BREATHING TECHNIQUES, MAY IMPROVE CANCER-RELATED SYMPTOMS AND QUALITY OF LIFE, BUT IT HAS NOT BEEN STUDIED FOR THIS PURPOSE. OBJECTIVES: A PILOT STUDY WAS PERFORMED TO EVALUATE FEASIBILITY AND TO TEST THE EFFECTS OF PRANAYAMA ON CANCER-ASSOCIATED SYMPTOMS AND QUALITY OF LIFE. DESIGN: THIS WAS A RANDOMIZED CONTROLLED CLINICAL TRIAL COMPARING PRANAYAMA TO USUAL CARE. SETTING: THE STUDY WAS CONDUCTED AT A UNIVERSITY MEDICAL CENTER. SUBJECTS: PATIENTS RECEIVING CANCER CHEMOTHERAPY WERE RANDOMIZED TO RECEIVE PRANAYAMA IMMEDIATELY OR AFTER A WAITING PERIOD (CONTROL GROUP). INTERVENTIONS: THE PRANAYAMA INTERVENTION CONSISTED OF FOUR BREATHING TECHNIQUES TAUGHT IN WEEKLY CLASSES AND PRACTICED AT HOME. THE TREATMENT GROUP RECEIVED PRANAYAMA DURING TWO CONSECUTIVE CYCLES OF CHEMOTHERAPY. THE CONTROL GROUP RECEIVED USUAL CARE DURING THEIR FIRST CYCLE, AND RECEIVED PRANAYAMA DURING THEIR SECOND CYCLE OF CHEMOTHERAPY. OUTCOME MEASURES: FEASIBILITY, CANCER-ASSOCIATED SYMPTOMS (FATIGUE, SLEEP DISTURBANCE, ANXIETY, DEPRESSION, STRESS), AND QUALITY OF LIFE WERE THE OUTCOMES. RESULTS: CLASS ATTENDANCE WAS NEARLY 100% IN BOTH GROUPS. SIXTEEN (16) PARTICIPANTS WERE INCLUDED IN THE FINAL INTENT-TO-TREAT ANALYSES. THE REPEATED-MEASURES ANALYSES DEMONSTRATED THAT ANY INCREASE IN PRANAYAMA DOSE, WITH DOSE MEASURED IN THE NUMBER OF HOURS PRACTICED IN CLASS OR AT HOME, RESULTED IN IMPROVED SYMPTOM AND QUALITY-OF-LIFE SCORES. SEVERAL OF THESE ASSOCIATIONS--SLEEP DISTURBANCE (P=0.04), ANXIETY (P=0.04), AND MENTAL QUALITY OF LIFE (P=0.05)--REACHED OR APPROACHED STATISTICAL SIGNIFICANCE. CONCLUSIONS: YOGA BREATHING WAS A FEASIBLE INTERVENTION AMONG PATIENTS WITH CANCER RECEIVING CHEMOTHERAPY. PRANAYAMA MAY IMPROVE SLEEP DISTURBANCE, ANXIETY, AND MENTAL QUALITY OF LIFE. A DOSE-RESPONSE RELATIONSHIP WAS FOUND BETWEEN PRANAYAMA USE AND IMPROVEMENTS IN CHEMOTHERAPY-ASSOCIATED SYMPTOMS AND QUALITY OF LIFE. THESE FINDINGS NEED TO BE CONFIRMED IN A LARGER STUDY. 2012