1 588 145 DETERMINING PSYCHONEUROIMMUNOLOGIC MARKERS OF YOGA AS AN INTERVENTION FOR PERSONS DIAGNOSED WITH PTSD: A SYSTEMATIC REVIEW. THERE IS A GROWING BODY OF RESEARCH ON YOGA AS A THERAPEUTIC INTERVENTION FOR PSYCHOLOGICAL SYMPTOMS OF POST-TRAUMATIC STRESS DISORDER (PTSD) ACCOMPANIED BY SPECULATIONS ON UNDERLYING PHYSIOLOGIC MECHANISMS. THE PURPOSE OF THIS SYSTEMATIC REVIEW IS TO IDENTIFY, QUALITATIVELY EVALUATE, AND SYNTHESIZE STUDIES OF YOGA AS AN INTERVENTION FOR PTSD THAT MEASURED PHYSIOLOGIC OUTCOMES IN ORDER TO GAIN INSIGHTS INTO POTENTIAL MECHANISMS. THE FOCUS IS ON STUDIES EVALUATING YOGA AS A THERAPEUTIC INTERVENTION FOR PTSD RATHER THAN FOR TRAUMA EXPOSURE, PTSD PREVENTION, OR SUBCLINICAL PTSD. MULTIPLE DATABASES WERE SEARCHED FOR PUBLICATIONS FROM THE PAST TWO DECADES USING TERMS DERIVED FROM THE QUESTION, "IN PEOPLE WITH PTSD, WHAT IS THE EFFECT OF YOGA ON OBJECTIVE OUTCOMES?" ELIGIBILITY CRITERIA INCLUDED YOGA-ONLY MODALITIES TESTED AS AN INTERVENTION FOR FORMALLY DIAGNOSED PTSD WITH AT LEAST ONE PHYSIOLOGIC OUTCOME. RESULTS OF THIS REVIEW CONFIRMED THAT, THOUGH MUCH OF THE PUBLISHED LITERATURE PROPOSES PHYSIOLOGICAL MECHANISMS UNDERLYING YOGA'S EFFECTS ON PTSD, VERY FEW STUDIES ( N = 3) HAVE ACTUALLY EVALUATED PHYSIOLOGICAL EVIDENCE. ADDITIONALLY, SEVERAL STUDIES HAD METHODOLOGICAL LIMITATIONS. IN LIGHT OF THE LIMITED DATA SUPPORTING YOGA'S BENEFICIAL EFFECTS ON AUTONOMIC NERVOUS SYSTEM DYSREGULATION, WE PRESENT A THEORETICAL MODEL OF THE PSYCHONEUROIMMUNOLOGIC PROCESSES ASSOCIATED WITH PTSD AND THE EFFECTS YOGA MAY HAVE ON THESE PROCESSES TO GUIDE FUTURE RESEARCH. GAPS IN THE LITERATURE REMAIN FOR MECHANISMS RELATED TO ACTIVATION OF THE HYPOTHALAMIC-PITUITARY-ADRENAL AXIS AND INFLAMMATION. ADDITIONAL RIGOROUS MECHANISTIC STUDIES ARE NEEDED TO GUIDE DEVELOPMENT OF EFFECTIVE YOGA INTERVENTIONS FOR PTSD TO AUGMENT EXISTING EVIDENCE-BASED PTSD TREATMENTS. 2018 2 2395 40 YOGA AND CARDIOVASCULAR HEALTH TRIAL (YACHT): A UK-BASED RANDOMISED MECHANISTIC STUDY OF A YOGA INTERVENTION PLUS USUAL CARE VERSUS USUAL CARE ALONE FOLLOWING AN ACUTE CORONARY EVENT. OBJECTIVE: TO DETERMINE THE EFFECTS OF YOGA PRACTICE ON SUBCLINICAL CARDIOVASCULAR MEASURES, RISK FACTORS AND NEURO-ENDOCRINE PATHWAYS IN PATIENTS UNDERGOING CARDIAC REHABILITATION (CR) FOLLOWING ACUTE CORONARY EVENTS. DESIGN: 3-MONTH, TWO-ARM (YOGA +USUAL CARE VS USUAL CARE ALONE) PARALLEL RANDOMISED MECHANISTIC STUDY. SETTING: ONE GENERAL HOSPITAL AND TWO PRIMARY CARE CR CENTRES IN LONDON. ASSESSMENTS WERE CONDUCTED AT IMPERIAL COLLEGE LONDON. PARTICIPANTS: 80 PARTICIPANTS, AGED 35-80 YEARS (68% MEN, 60% SOUTH ASIAN) REFERRED TO CR PROGRAMMES 2012-2014. INTERVENTION: A CERTIFIED YOGA TEACHER CONDUCTED YOGA CLASSES WHICH INCLUDED EXERCISES IN STRETCHING, BREATHING, HEALING IMAGERY AND DEEP RELAXATION. IT WAS PRE-SPECIFIED THAT AT LEAST 18 YOGA CLASSES WERE ATTENDED FOR INCLUSION IN ANALYSIS. PARTICIPANTS AND PARTNERS IN BOTH GROUPS WERE INVITED TO ATTEND WEEKLY A 6- TO 12-WEEK LOCAL STANDARD UK NATIONAL HEALTH SERVICE CR PROGRAMME. MAIN OUTCOME MEASURES: (I) ESTIMATED LEFT VENTRICULAR FILLING PRESSURE (E/E'), (II) DISTANCE WALKED, FATIGUE AND BREATHLESSNESS IN A 6 MIN WALK TEST, (III) BLOOD PRESSURE, HEART RATE AND ESTIMATED PEAK VO2 FOLLOWING A 3 MIN STEP-TEST. EFFECTS ON THE HYPOTHALAMUS-PITUITARY-ADRENAL AXIS, AUTONOMIC FUNCTION, BODY FAT, BLOOD LIPIDS AND GLUCOSE, STRESS AND GENERAL HEALTH WERE ALSO EXPLORED. RESULTS: 25 PARTICIPANTS IN THE YOGA + USUAL CARE GROUP AND 35 PARTICIPANTS IN THE USUAL CARE GROUP COMPLETED THE STUDY. FOLLOWING THE 3-MONTH INTERVENTION PERIOD, E/E' WAS NOT IMPROVED BY YOGA (E/E': BETWEEN-GROUP DIFFERENCE: YOGA MINUS USUAL CARE:-0.40 (-1.38, 0.58). EXERCISE TESTING AND SECONDARY OUTCOMES ALSO SHOWED NO BENEFITS OF YOGA. CONCLUSIONS: IN THIS SMALL UK-BASED RANDOMISED MECHANISTIC STUDY, WITH 60 COMPLETING PARTICIPANTS (OF WHOM 25 WERE IN THE YOGA + USUAL CARE GROUP), WE FOUND NO DISCERNIBLE IMPROVEMENT ASSOCIATED WITH THE ADDITION OF A STRUCTURED 3-MONTH YOGA INTERVENTION TO USUAL CR CARE IN KEY CARDIOVASCULAR AND NEUROENDOCRINE MEASURES SHOWN TO BE RESPONSIVE TO YOGA IN PREVIOUS MECHANISTIC STUDIES. TRIAL REGISTRATION NUMBER: NCT01597960; PRE-RESULTS. 2019 3 2421 31 YOGA AND MINDFULNESS AS A TOOL FOR INFLUENCING AFFECTIVITY, ANXIETY, MENTAL HEALTH, AND STRESS AMONG HEALTHCARE WORKERS: RESULTS OF A SINGLE-ARM CLINICAL TRIAL. MINDFULNESS-BASED INTERVENTIONS HAVE EMERGED AS UNIQUE APPROACHES FOR ADDRESSING A RANGE OF CLINICAL AND SUBCLINICAL DIFFICULTIES SUCH AS STRESS, CHRONIC PAIN, ANXIETY, OR RECURRENT DEPRESSION. MOREOVER, THERE IS STRONG EVIDENCE ABOUT THE POSITIVE EFFECTS OF YOGA PRACTICE ON STRESS MANAGEMENT AND PREVENTION OF BURNOUT AMONG HEALTHCARE WORKERS. THE AIM OF THIS STUDY WAS TO CONDUCT A SINGLE-ARM CLINICAL TRIAL TO ASSESS THE EFFECTIVENESS OF AN INTERVENTION BASED ON MINDFULNESS-BASED STRESS REDUCTION AND YOGA IN IMPROVING HEALTHCARE WORKERS' QUALITY OF LIFE. HEALTHCARE WORKERS OF TWO HOSPITALS IN ROME WERE ENROLLED IN A 4-WEEK YOGA AND MINDFULNESS COURSE. FOUR QUESTIONNAIRES WERE ADMINISTERED AT DIFFERENT TIMES (SHORT FORM-12 (SF-12), STATE-TRAIT ANXIETY INVENTORY (STAI) Y1 AND Y2, AND POSITIVE AND NEGATIVE AFFECT SCHEDULE (PANAS)) TO EVALUATE THE EFFICACY OF THE INTERVENTION. FORTY PARTICIPANTS TOOK PART TO THE STUDY (83.3 %). THE MENTAL COMPOSITE SCORE-12, THAT IS PART OF THE QUALITY OF LIFE ASSESSMENT, PASSED FROM A MEDIAN OF 43.5 PREINTERVENTION TO 48.1 POSTINTERVENTION (P = 0.041), AND THE NEGATIVE AFFECT PASSED FROM A SCORE OF 16 IN THE PREINTERVENTION TO 10 IN THE POSTINTERVENTION (P < 0.001). BOTH THE FORMS OF THE STAI QUESTIONNAIRES SHOWED A DECREASE AFTER THE INTERVENTION. YOGA AND MINDFULNESS ADMINISTERED TOGETHER SEEM TO BE EFFECTIVE TO REDUCE STRESS AND ANXIETY IN HEALTHCARE WORKERS, PROVIDING THEM WITH MORE CONSCIOUSNESS AND ABILITY TO MANAGE WORK STRESSFUL DEMANDS. 2020 4 2543 64 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 5 1927 38 ROLE OF YOGA IN CARDIAC DISEASE AND REHABILITATION. PURPOSE: CARDIOVASCULAR DISEASE CONTINUES TO BE THE LEADING CAUSE OF MORBIDITY AND MORTALITY AROUND THE WORLD. YOGA, A COMBINATION OF PHYSICAL POSTURES (ASANA), BREATHING EXERCISES (PRANAYAMA), AND MEDITATION (DHYANA), HAS GAINED INCREASING RECOGNITION AS A FORM OF MIND-BODY EXERCISE. IN THIS NARRATIVE REVIEW, WE INTENDED TO REVIEW THE EMERGING EVIDENCE ASSESSING THE PHYSIOLOGIC AND CLINICAL EFFECTS OF YOGA ON THE CARDIOVASCULAR SYSTEM AND THE POTENTIAL ROLE OF YOGA AS A COMPONENT OF COMPREHENSIVE CARDIAC REHABILITATION. METHODS: WE SEARCHED PUBMED, GOOGLE SCHOLAR, EMBASE, AND COCHRANE DATABASES FOR LITERATURE RELATED TO CARDIOVASCULAR EFFECTS OF YOGA FROM INCEPTION UP UNTIL 2017. RESULTS: YOGA HAS BEEN SHOWN TO HAVE FAVORABLE EFFECTS ON SYSTEMIC INFLAMMATION, STRESS, THE CARDIAC AUTONOMIC NERVOUS SYSTEM, AND TRADITIONAL AND EMERGING CARDIOVASCULAR RISK FACTORS. CONCLUSIONS: YOGA HAS SHOWN PROMISE AS A USEFUL LIFESTYLE INTERVENTION THAT CAN BE INCORPORATED INTO CARDIOVASCULAR DISEASE MANAGEMENT ALGORITHMS. ALTHOUGH MANY INVESTIGATORS HAVE REPORTED THE CLINICAL BENEFITS OF YOGA IN REDUCING CARDIOVASCULAR EVENTS, MORBIDITY, AND MORTALITY, EVIDENCE SUPPORTING THESE CONCLUSIONS IS SOMEWHAT LIMITED, THEREBY EMPHASIZING THE NEED FOR LARGE, WELL-DESIGNED RANDOMIZED TRIALS THAT MINIMIZE BIAS AND METHODOLOGICAL DRAWBACKS. 2019 6 1202 34 EXERCISE, YOGA, AND TAI CHI FOR TREATMENT OF MAJOR DEPRESSIVE DISORDER IN OUTPATIENT SETTINGS: A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVE: EXERCISE, YOGA, AND TAI CHI ARE COMMONLY USED COMPLEMENTARY APPROACHES FOR HEALTH AND WELLNESS. THIS REVIEW AIMS TO SYNTHESIZE THE EVIDENCE FOR EXERCISE, YOGA, AND TAI CHI IN THE OUTPATIENT TREATMENT OF MAJOR DEPRESSIVE DISORDER. STUDY SELECTION: A SYSTEMATIC SEARCH OF THE OVID MEDLINE, EMBASE, PSYCINFO, AND COCHRANE DATABASES WAS CONDUCTED FOR RANDOMIZED CONTROLLED TRIALS OF EXERCISE, YOGA, AND TAI CHI FOR MAJOR DEPRESSIVE DISORDER. DATA EXTRACTION: STANDARDIZED MEAN DIFFERENCES WERE CALCULATED AND META-ANALYZED USING A RANDOM EFFECTS MULTILEVEL MODELING FRAMEWORK. HETEROGENEITY AND SUBGROUP ANALYSIS WAS CONDUCTED. RESULTS: TWENTY-FIVE STUDIES WERE INCLUDED FOR FINAL ANALYSIS (EXERCISE: 15, YOGA: 7, TAI CHI: 3). OVERALL, META-ANALYSIS SHOWED A MODERATE SIGNIFICANT CLINICAL EFFECT. HOWEVER, WHEN ONLY STUDIES (6 STUDIES) WITH THE LOWEST RISK OF BIAS WERE INCLUDED, THE OVERALL EFFECT SIZE WAS REDUCED TO LOW TO MODERATE EFFICACY. OVERALL QUALITY OF EVIDENCE WAS LOW. HETEROGENEITY AND PUBLICATION BIAS WERE HIGH. CONCLUSIONS: THE CURRENT META-ANALYSIS OF OUTPATIENT EXERCISE, YOGA, AND TAI CHI FOR TREATMENT OF MAJOR DEPRESSIVE DISORDER SUGGESTS THAT ADJUNCTIVE EXERCISE AND YOGA MAY HAVE SMALL ADDITIVE CLINICAL EFFECTS IN COMPARISON TO CONTROL FOR REDUCING DEPRESSIVE SYMPTOMS. THE EVIDENCE FOR TAI CHI IS INSUFFICIENT TO DRAW CONCLUSIONS. THE CONCERNS WITH QUALITY OF STUDIES, HIGH HETEROGENEITY, AND EVIDENCE OF PUBLICATION BIAS PRECLUDE MAKING FIRM CONCLUSIONS. 2020 7 2629 47 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 8 2616 49 YOGA FOR SECONDARY PREVENTION OF CORONARY HEART DISEASE. BACKGROUND: CORONARY HEART DISEASE (CHD) IS THE MAJOR CAUSE OF EARLY MORBIDITY AND MORTALITY IN MOST DEVELOPED COUNTRIES. SECONDARY PREVENTION AIMS TO PREVENT REPEAT CARDIAC EVENTS AND DEATH IN PEOPLE WITH ESTABLISHED CHD. LIFESTYLE MODIFICATIONS PLAY AN IMPORTANT ROLE IN SECONDARY PREVENTION. YOGA HAS BEEN REGARDED AS A TYPE OF PHYSICAL ACTIVITY AS WELL AS A STRESS MANAGEMENT STRATEGY. GROWING EVIDENCE SUGGESTS THE BENEFICIAL EFFECTS OF YOGA ON VARIOUS AILMENTS. OBJECTIVES: TO DETERMINE THE EFFECTIVENESS OF YOGA FOR THE SECONDARY PREVENTION OF MORTALITY AND MORBIDITY IN, AND ON THE HEALTH-RELATED QUALITY OF LIFE OF, INDIVIDUALS WITH CHD. SEARCH METHODS: THIS IS AN UPDATE OF A REVIEW PREVIOUSLY PUBLISHED IN 2012. FOR THIS UPDATED REVIEW, WE SEARCHED THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL) IN THE COCHRANE LIBRARY (ISSUE 1 OF 12, 2014), MEDLINE (1948 TO FEBRUARY WEEK 1 2014), EMBASE (1980 TO 2014 WEEK 6), WEB OF SCIENCE (THOMSON REUTERS, 1970 TO 12 FEBRUARY 2014), CHINA JOURNAL NET (1994 TO MAY 2014), WANFANG DATA (1990 TO MAY 2014), AND INDEX TO CHINESE PERIODICALS OF HONG KONG (HKINCHIP) (FROM 1980). ONGOING STUDIES WERE IDENTIFIED IN THE METAREGISTER OF CONTROLLED TRIALS (MAY 2014) AND THE WORLD HEALTH ORGANIZATION INTERNATIONAL CLINICAL TRIALS REGISTRY PLATFORM (MAY 2014). WE APPLIED NO LANGUAGE RESTRICTIONS. SELECTION CRITERIA: WE PLANNED TO INCLUDE RANDOMISED CONTROLLED TRIALS (RCTS) INVESTIGATING THE INFLUENCE OF YOGA PRACTICE ON CHD OUTCOMES IN MEN AND WOMEN (AGED 18 YEARS AND OVER) WITH A DIAGNOSIS OF ACUTE OR CHRONIC CHD. STUDIES WERE ELIGIBLE FOR INCLUSION IF THEY HAD A FOLLOW-UP DURATION OF SIX MONTHS OR MORE. WE CONSIDERED STUDIES THAT COMPARED ONE GROUP PRACTICING A TYPE OF YOGA WITH A CONTROL GROUP RECEIVING EITHER NO INTERVENTION OR INTERVENTIONS OTHER THAN YOGA. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SELECTED STUDIES ACCORDING TO PRESPECIFIED INCLUSION CRITERIA. WE RESOLVED DISAGREEMENTS EITHER BY CONSENSUS OR BY DISCUSSION WITH A THIRD AUTHOR. MAIN RESULTS: WE FOUND NO ELIGIBLE RCTS THAT MET THE INCLUSION CRITERIA OF THE REVIEW AND THUS WE WERE UNABLE TO PERFORM A META-ANALYSIS. AUTHORS' CONCLUSIONS: THE EFFECTIVENESS OF YOGA FOR SECONDARY PREVENTION IN CHD REMAINS UNCERTAIN. LARGE RCTS OF HIGH QUALITY ARE NEEDED. 2015 9 2821 59 YOGA TREATMENT FOR CHRONIC NON-SPECIFIC LOW BACK PAIN. BACKGROUND: NON-SPECIFIC LOW BACK PAIN IS A COMMON, POTENTIALLY DISABLING CONDITION USUALLY TREATED WITH SELF-CARE AND NON-PRESCRIPTION MEDICATION. FOR CHRONIC LOW BACK PAIN, CURRENT GUIDELINES STATE THAT EXERCISE THERAPY MAY BE BENEFICIAL. YOGA IS A MIND-BODY EXERCISE SOMETIMES USED FOR NON-SPECIFIC LOW BACK PAIN. OBJECTIVES: TO ASSESS THE EFFECTS OF YOGA FOR TREATING CHRONIC NON-SPECIFIC LOW BACK PAIN, COMPARED TO NO SPECIFIC TREATMENT, A MINIMAL INTERVENTION (E.G. EDUCATION), OR ANOTHER ACTIVE TREATMENT, WITH A FOCUS ON PAIN, FUNCTION, AND ADVERSE EVENTS. SEARCH METHODS: WE SEARCHED CENTRAL, MEDLINE, EMBASE, FIVE OTHER DATABASES AND FOUR TRIALS REGISTERS TO 11 MARCH 2016 WITHOUT RESTRICTION OF LANGUAGE OR PUBLICATION STATUS. WE SCREENED REFERENCE LISTS AND CONTACTED EXPERTS IN THE FIELD TO IDENTIFY ADDITIONAL STUDIES. SELECTION CRITERIA: WE INCLUDED RANDOMIZED CONTROLLED TRIALS OF YOGA TREATMENT IN PEOPLE WITH CHRONIC NON-SPECIFIC LOW BACK PAIN. WE INCLUDED STUDIES COMPARING YOGA TO ANY OTHER INTERVENTION OR TO NO INTERVENTION. WE ALSO INCLUDED STUDIES COMPARING YOGA AS AN ADJUNCT TO OTHER THERAPIES, VERSUS THOSE OTHER THERAPIES ALONE. DATA COLLECTION AND ANALYSIS: TWO AUTHORS INDEPENDENTLY SCREENED AND SELECTED STUDIES, EXTRACTED OUTCOME DATA, AND ASSESSED RISK OF BIAS. WE CONTACTED STUDY AUTHORS TO OBTAIN MISSING OR UNCLEAR INFORMATION. WE EVALUATED THE OVERALL CERTAINTY OF EVIDENCE USING THE GRADE APPROACH. MAIN RESULTS: WE INCLUDED 12 TRIALS (1080 PARTICIPANTS) CARRIED OUT IN THE USA (SEVEN TRIALS), INDIA (THREE TRIALS), AND THE UK (TWO TRIALS). STUDIES WERE UNFUNDED (ONE TRIAL), FUNDED BY A YOGA INSTITUTION (ONE TRIAL), FUNDED BY NON-PROFIT OR GOVERNMENT SOURCES (SEVEN TRIALS), OR DID NOT REPORT ON FUNDING (THREE TRIALS). MOST TRIALS USED IYENGAR, HATHA, OR VINIYOGA FORMS OF YOGA. THE TRIALS COMPARED YOGA TO NO INTERVENTION OR A NON-EXERCISE INTERVENTION SUCH AS EDUCATION (SEVEN TRIALS), AN EXERCISE INTERVENTION (THREE TRIALS), OR BOTH EXERCISE AND NON-EXERCISE INTERVENTIONS (TWO TRIALS). ALL TRIALS WERE AT HIGH RISK OF PERFORMANCE AND DETECTION BIAS BECAUSE PARTICIPANTS AND PROVIDERS WERE NOT BLINDED TO TREATMENT ASSIGNMENT, AND OUTCOMES WERE SELF-ASSESSED. THEREFORE, WE DOWNGRADED ALL OUTCOMES TO 'MODERATE' CERTAINTY EVIDENCE BECAUSE OF RISK OF BIAS, AND WHEN THERE WAS ADDITIONAL SERIOUS RISK OF BIAS, UNEXPLAINED HETEROGENEITY BETWEEN STUDIES, OR THE ANALYSES WERE IMPRECISE, WE DOWNGRADED THE CERTAINTY OF THE EVIDENCE FURTHER.FOR YOGA COMPARED TO NON-EXERCISE CONTROLS (9 TRIALS; 810 PARTICIPANTS), THERE WAS LOW-CERTAINTY EVIDENCE THAT YOGA PRODUCED SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE TO FOUR MONTHS (STANDARDIZED MEAN DIFFERENCE (SMD) -0.40, 95% CONFIDENCE INTERVAL (CI) -0.66 TO -0.14; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MEAN DIFFERENCE (MD) -2.18, 95% -3.60 TO -0.76), MODERATE-CERTAINTY EVIDENCE FOR SMALL TO MODERATE IMPROVEMENTS AT SIX MONTHS (SMD -0.44, 95% CI -0.66 TO -0.22; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -2.15, 95% -3.23 TO -1.08), AND LOW-CERTAINTY EVIDENCE FOR SMALL IMPROVEMENTS AT 12 MONTHS (SMD -0.26, 95% CI -0.46 TO -0.05; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -1.36, 95% -2.41 TO -0.26). ON A 0-100 SCALE THERE WAS VERY LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA WAS SLIGHTLY BETTER FOR PAIN AT THREE TO FOUR MONTHS (MD -4.55, 95% CI -7.04 TO -2.06), SIX MONTHS (MD -7.81, 95% CI -13.37 TO -2.25), AND 12 MONTHS (MD -5.40, 95% CI -14.50 TO -3.70), HOWEVER WE PRE-DEFINED CLINICALLY SIGNIFICANT CHANGES IN PAIN AS 15 POINTS OR GREATER AND THIS THRESHOLD WAS NOT MET. BASED ON INFORMATION FROM SIX TRIALS, THERE WAS MODERATE-CERTAINTY EVIDENCE THAT THE RISK OF ADVERSE EVENTS, PRIMARILY INCREASED BACK PAIN, WAS HIGHER IN YOGA THAN IN NON-EXERCISE CONTROLS (RISK DIFFERENCE (RD) 5%, 95% CI 2% TO 8%).FOR YOGA COMPARED TO NON-YOGA EXERCISE CONTROLS (4 TRIALS; 394 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE IN BACK-RELATED FUNCTION AT THREE MONTHS (SMD -0.22, 95% CI -0.65 TO 0.20; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -0.99, 95% -2.87 TO 0.90) AND SIX MONTHS (SMD -0.20, 95% CI -0.59 TO 0.19; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MD -0.90, 95% -2.61 TO 0.81), AND NO INFORMATION ON BACK-RELATED FUNCTION AFTER SIX MONTHS. THERE WAS VERY LOW-CERTAINTY EVIDENCE FOR LOWER PAIN ON A 0-100 SCALE AT SEVEN MONTHS (MD -20.40, 95% CI -25.48 TO -15.32), AND NO INFORMATION ON PAIN AT THREE MONTHS OR AFTER SEVEN MONTHS. BASED ON INFORMATION FROM THREE TRIALS, THERE WAS LOW-CERTAINTY EVIDENCE FOR NO DIFFERENCE IN THE RISK OF ADVERSE EVENTS BETWEEN YOGA AND NON-YOGA EXERCISE CONTROLS (RD 1%, 95% CI -4% TO 6%).FOR YOGA ADDED TO EXERCISE COMPARED TO EXERCISE ALONE (1 TRIAL; 24 PARTICIPANTS), THERE WAS VERY-LOW-CERTAINTY EVIDENCE FOR LITTLE OR NO DIFFERENCE AT 10 WEEKS IN BACK-RELATED FUNCTION (SMD -0.60, 95% CI -1.42 TO 0.22; CORRESPONDING TO A CHANGE IN THE OSWESTRY DISABILITY INDEX OF MD -17.05, 95% -22.96 TO 11.14) OR PAIN ON A 0-100 SCALE (MD -3.20, 95% CI -13.76 TO 7.36). THERE WAS NO INFORMATION ON OUTCOMES AT OTHER TIME POINTS. THERE WAS NO INFORMATION ON ADVERSE EVENTS.STUDIES PROVIDED LIMITED EVIDENCE ON RISK OF CLINICAL IMPROVEMENT, MEASURES OF QUALITY OF LIFE, AND DEPRESSION. THERE WAS NO EVIDENCE ON WORK-RELATED DISABILITY. AUTHORS' CONCLUSIONS: THERE IS LOW- TO MODERATE-CERTAINTY EVIDENCE THAT YOGA COMPARED TO NON-EXERCISE CONTROLS RESULTS IN SMALL TO MODERATE IMPROVEMENTS IN BACK-RELATED FUNCTION AT THREE AND SIX MONTHS. YOGA MAY ALSO BE SLIGHTLY MORE EFFECTIVE FOR PAIN AT THREE AND SIX MONTHS, HOWEVER THE EFFECT SIZE DID NOT MEET PREDEFINED LEVELS OF MINIMUM CLINICAL IMPORTANCE. IT IS UNCERTAIN WHETHER THERE IS ANY DIFFERENCE BETWEEN YOGA AND OTHER EXERCISE FOR BACK-RELATED FUNCTION OR PAIN, OR WHETHER YOGA ADDED TO EXERCISE IS MORE EFFECTIVE THAN EXERCISE ALONE. YOGA IS ASSOCIATED WITH MORE ADVERSE EVENTS THAN NON-EXERCISE CONTROLS, BUT MAY HAVE THE SAME RISK OF ADVERSE EVENTS AS OTHER BACK-FOCUSED EXERCISE. YOGA IS NOT ASSOCIATED WITH SERIOUS ADVERSE EVENTS. THERE IS A NEED FOR ADDITIONAL HIGH-QUALITY RESEARCH TO IMPROVE CONFIDENCE IN ESTIMATES OF EFFECT, TO EVALUATE LONG-TERM OUTCOMES, AND TO PROVIDE ADDITIONAL INFORMATION ON COMPARISONS BETWEEN YOGA AND OTHER EXERCISE FOR CHRONIC NON-SPECIFIC LOW BACK PAIN. 2017 10 1907 45 REVIEW OF YOGA THERAPY DURING CANCER TREATMENT. PURPOSE: REVIEWS OF YOGA RESEARCH THAT DISTINGUISH RESULTS OF TRIALS CONDUCTED DURING (VERSUS AFTER) CANCER TREATMENT ARE NEEDED TO GUIDE FUTURE RESEARCH AND CLINICAL PRACTICE. WE THEREFORE CONDUCTED A REVIEW OF NON-RANDOMIZED STUDIES AND RANDOMIZED CONTROLLED TRIALS OF YOGA INTERVENTIONS FOR CHILDREN AND ADULTS UNDERGOING TREATMENT FOR ANY CANCER TYPE. METHODS: STUDIES WERE IDENTIFIED VIA RESEARCH DATABASES AND REFERENCE LISTS. INCLUSION CRITERIA WERE THE FOLLOWING: (1) CHILDREN OR ADULTS UNDERGOING CANCER TREATMENT, (2) INTERVENTION STATED AS YOGA OR COMPONENT OF YOGA, AND (3) PUBLICATION IN ENGLISH IN PEER-REVIEWED JOURNALS THROUGH OCTOBER 2015. EXCLUSION CRITERIA WERE THE FOLLOWING: (1) SAMPLES RECEIVING HORMONE THERAPY ONLY, (2) INTERVENTIONS INVOLVING MEDITATION ONLY, AND (3) YOGA DELIVERED WITHIN BROADER CANCER RECOVERY OR MINDFULNESS-BASED STRESS REDUCTION PROGRAMS. RESULTS: RESULTS OF NON-RANDOMIZED (ADULT N = 8, PEDIATRIC N = 4) AND RANDOMIZED CONTROLLED TRIALS (ADULT N = 13, PEDIATRIC N = 0) CONDUCTED DURING CANCER TREATMENT ARE SUMMARIZED SEPARATELY BY AGE GROUP. FINDINGS MOST CONSISTENTLY SUPPORT IMPROVEMENT IN PSYCHOLOGICAL OUTCOMES (E.G., DEPRESSION, DISTRESS, ANXIETY). SEVERAL STUDIES ALSO FOUND THAT YOGA ENHANCED QUALITY OF LIFE, THOUGH FURTHER INVESTIGATION IS NEEDED TO CLARIFY DOMAIN-SPECIFIC EFFICACY (E.G., PHYSICAL, SOCIAL, CANCER-SPECIFIC). REGARDING PHYSICAL AND BIOMEDICAL OUTCOMES, EVIDENCE INCREASINGLY SUGGESTS THAT YOGA AMELIORATES SLEEP AND FATIGUE; ADDITIONAL RESEARCH IS NEEDED TO ADVANCE PRELIMINARY FINDINGS FOR OTHER TREATMENT SEQUELAE AND STRESS/IMMUNITY BIOMARKERS. CONCLUSIONS: AMONG ADULTS UNDERGOING CANCER TREATMENT, EVIDENCE SUPPORTS RECOMMENDING YOGA FOR IMPROVING PSYCHOLOGICAL OUTCOMES, WITH POTENTIAL FOR ALSO IMPROVING PHYSICAL SYMPTOMS. EVIDENCE IS INSUFFICIENT TO EVALUATE THE EFFICACY OF YOGA IN PEDIATRIC ONCOLOGY. WE DESCRIBE SUGGESTIONS FOR STRENGTHENING YOGA RESEARCH METHODOLOGY TO INFORM CLINICAL PRACTICE GUIDELINES. 2017 11 181 39 A RANDOMIZED CONTROLLED TRIAL OF YOGA VS NONAEROBIC EXERCISE FOR VETERANS WITH PTSD: UNDERSTANDING EFFICACY, MECHANISMS OF CHANGE, AND MODE OF DELIVERY. BACKGROUND AND OBJECTIVES: POSTTRAUMATIC STRESS DISORDER (PTSD) IS A CHRONIC, DISABLING, AND PREVALENT MENTAL HEALTH DISORDER AMONG VETERANS. DESPITE THE AVAILABILITY OF EMPIRICALLY SUPPORTED PSYCHOTHERAPIES, MANY VETERANS REMAIN SYMPTOMATIC AFTER TREATMENT AND/OR PREFER TO SEEK COMPLEMENTARY AND INTEGRATIVE HEALTH APPROACHES, INCLUDING YOGA, TO MANAGE PTSD. THE RANDOMIZED CONTROLLED TRIAL (RCT) DESCRIBED HEREIN WILL EVALUATE THE EFFICACY OF A MANUALIZED YOGA PROGRAM AS COMPARED TO NONAEROBIC EXERCISE IN REDUCING PTSD SEVERITY AMONG VETERANS. A SECONDARY AIM OF THIS STUDY IS TO BETTER UNDERSTAND THE MECHANISMS OF CHANGE. METHODS: VETERANS (N = 192) WITH PTSD WILL BE RANDOMIZED TO HATHA YOGA OR NONAEROBIC PHYSICAL ACTIVITY CONTROL; BOTH GROUPS CONSIST OF 12 WEEKLY, 60-MIN GROUP OR ONLINE TRAINING SESSIONS WITH 15-20 MIN OF DAILY AT-HOME PRACTICE. OUTCOME MEASURES WILL BE ADMINISTERED AT BASELINE, MID-TREATMENT, POSTTREATMENT, AND 12-WEEK FOLLOW-UP. PROJECTED OUTCOMES: THIS STUDY WILL EVALUATE CHANGES IN PTSD SEVERITY (PRIMARY OUTCOME) AS WELL AS DEPRESSION, ANXIETY, ANGER, SLEEP PROBLEMS, AND PSYCHOSOCIAL DISABILITY (SECONDARY OUTCOMES). WE WILL ALSO USE MULTIPLE MEDIATION TO EXAMINE TWO POTENTIAL MODELS OF THE MECHANISMS OF CLINICAL EFFECT: THE ATTENTION MODEL (I.E., YOGA INCREASES ATTENTIONAL CONTROL, WHICH REDUCES PTSD SYMPTOMS), THE COPING MODEL (I.E., YOGA INCREASES DISTRESS TOLERANCE, WHICH IMPROVES COPING, WHICH REDUCES PTSD SYMPTOMS), AND THE COMBINATION OF THESE MODELS. THIS ASPECT OF THE STUDY IS INNOVATIVE AND IMPORTANT GIVEN THE ABSENCE OF AN EXISTING, COMPREHENSIVE MODEL FOR UNDERSTANDING YOGA'S IMPACT ON PTSD. ULTIMATELY, WE HOPE TO DEVELOP GUIDELINES FOR APPLICATION OF YOGA TO PTSD RECOVERY. 2021 12 2732 46 YOGA ON OUR MINDS: A SYSTEMATIC REVIEW OF YOGA FOR NEUROPSYCHIATRIC DISORDERS. BACKGROUND: THE DEMAND FOR CLINICALLY EFFICACIOUS, SAFE, PATIENT ACCEPTABLE, AND COST-EFFECTIVE FORMS OF TREATMENT FOR MENTAL ILLNESS IS GROWING. SEVERAL STUDIES HAVE DEMONSTRATED BENEFIT FROM YOGA IN SPECIFIC PSYCHIATRIC SYMPTOMS AND A GENERAL SENSE OF WELL-BEING. OBJECTIVE: TO SYSTEMATICALLY EXAMINE THE EVIDENCE FOR EFFICACY OF YOGA IN THE TREATMENT OF SELECTED MAJOR PSYCHIATRIC DISORDERS. METHODS: ELECTRONIC SEARCHES OF THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS AND THE STANDARD BIBLIOGRAPHIC DATABASES, MEDLINE, EMBASE, AND PSYCINFO, WERE PERFORMED THROUGH APRIL 2011 AND AN UPDATED IN JUNE 2011 USING THE KEYWORDS YOGA AND PSYCHIATRY OR DEPRESSION OR ANXIETY OR SCHIZOPHRENIA OR COGNITION OR MEMORY OR ATTENTION AND RANDOMIZED CONTROLLED TRIAL (RCT). STUDIES WITH YOGA AS THE INDEPENDENT VARIABLE AND ONE OF THE ABOVE MENTIONED TERMS AS THE DEPENDENT VARIABLE WERE INCLUDED AND EXCLUSION CRITERIA WERE APPLIED. RESULTS: THE SEARCH YIELDED A TOTAL OF 124 TRIALS, OF WHICH 16 MET RIGOROUS CRITERIA FOR THE FINAL REVIEW. GRADE B EVIDENCE SUPPORTING A POTENTIAL ACUTE BENEFIT FOR YOGA EXISTS IN DEPRESSION (FOUR RCTS), AS AN ADJUNCT TO PHARMACOTHERAPY IN SCHIZOPHRENIA (THREE RCTS), IN CHILDREN WITH ADHD (TWO RCTS), AND GRADE C EVIDENCE IN SLEEP COMPLAINTS (THREE RCTS). RCTS IN COGNITIVE DISORDERS AND EATING DISORDERS YIELDED CONFLICTING RESULTS. NO STUDIES LOOKED AT PRIMARY PREVENTION, RELAPSE PREVENTION, OR COMPARATIVE EFFECTIVENESS VERSUS PHARMACOTHERAPY. CONCLUSION: THERE IS EMERGING EVIDENCE FROM RANDOMIZED TRIALS TO SUPPORT POPULAR BELIEFS ABOUT YOGA FOR DEPRESSION, SLEEP DISORDERS, AND AS AN AUGMENTATION THERAPY. LIMITATIONS OF LITERATURE INCLUDE INABILITY TO DO DOUBLE-BLIND STUDIES, MULTIPLICITY OF COMPARISONS WITHIN SMALL STUDIES, AND LACK OF REPLICATION. BIOMARKER AND NEUROIMAGING STUDIES, THOSE COMPARING YOGA WITH STANDARD PHARMACO- AND PSYCHOTHERAPIES, AND STUDIES OF LONG-TERM EFFICACY ARE NEEDED TO FULLY TRANSLATE THE PROMISE OF YOGA FOR ENHANCING MENTAL HEALTH. 2012 13 2245 51 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 14 1054 36 EFFECTS OF YOGA ON CHRONIC NECK PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVE: THE AIM OF THIS REVIEW WAS TO SYSTEMATICALLY ASSESS AND META-ANALYZE THE EFFECTIVENESS OF YOGA IN RELIEVING CHRONIC NECK PAIN. METHODS: PUBMED/MEDLINE, THE COCHRANE LIBRARY, SCOPUS, AND INDMED WERE SCREENED THROUGH JANUARY 2017 FOR RANDOMIZED CONTROLLED TRIALS ASSESSING NECK PAIN INTENSITY AND/OR NECK PAIN-RELATED DISABILITY IN CHRONIC NECK PAIN PATIENTS. SECONDARY OUTCOME MEASURES INCLUDED QUALITY OF LIFE, MOOD, AND SAFETY. RISK OF BIAS WAS ASSESSED USING THE COCHRANE TOOL. RESULTS: THREE STUDIES ON 188 PATIENTS WITH CHRONIC NON-SPECIFIC NECK PAIN COMPARING YOGA TO USUAL CARE WERE INCLUDED. TWO STUDIES HAD OVERALL LOW RISK OF BIAS; AND ONE HAD HIGH OR UNCLEAR RISK OF BIAS FOR SEVERAL DOMAINS. EVIDENCE FOR SHORT-TERM EFFECTS WAS FOUND FOR NECK PAIN INTENSITY (STANDARDIZED MEAN DIFFERENCE (SMD) = -1.28; 95% CONFIDENCE INTERVAL (CI) = -1.18, -0.75; P < 0.001), NECK PAIN-RELATED DISABILITY (SMD = -0.97; 95% CI = -1.44, -0.50; P < 0.001), QUALITY OF LIFE (SMD = 0.57; 95% CI = 0.17, 0.197; P = 0.005), AND MOOD (SMD = -1.02; 95% CI = -1.38, -0.65; P < 0.001). EFFECTS WERE ROBUST AGAINST POTENTIAL METHODOLOGICAL BIAS AND DID NOT DIFFER BETWEEN DIFFERENT INTERVENTION SUBGROUPS. IN THE TWO STUDIES THAT INCLUDED SAFETY DATA, NO SERIOUS ADVERSE EVENTS OCCURRED. CONCLUSION: YOGA HAS SHORT-TERM EFFECTS ON CHRONIC NECK PAIN, ITS RELATED DISABILITY, QUALITY OF LIFE, AND MOOD SUGGESTING THAT YOGA MIGHT BE A GOOD TREATMENT OPTION. 2017 15 2566 40 YOGA FOR DEPRESSION AND ANXIETY SYMPTOMS IN PEOPLE WITH CANCER: A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVE: CANCER AND ITS TREATMENT CAN LEAD TO A VARIETY OF PHYSICAL AND EMOTIONAL CONCERNS IMPACTING ON THOSE AFFECTED, INCLUDING SUBCLINICAL OR CLINICAL DEPRESSION AND ANXIETY, WHICH IN TURN HAVE A SIGNIFICANT IMPACT ON WELLBEING, QUALITY OF LIFE AND SURVIVAL. THE AIM OF THIS REVIEW WAS TO EVALUATE THE EFFECT OF YOGA-BASED INTERVENTIONS ON SELF-REPORTED DEPRESSION AND ANXIETY SYMPTOMS IN PEOPLE WITH CANCER IN RANDOMIZED CONTROLLED TRIALS. METHOD: SIX DATABASES WERE SEARCHED TO IDENTIFY RELEVANT STUDIES. SYSTEMATIC REVIEW PROCEDURES WERE FOLLOWED INCLUDING A QUALITY ASSESSMENT. META-ANALYSIS OF SUITABLE STUDIES WAS CONDUCTED. RESULTS: 26 STUDIES FROM OUR SEARCH CRITERIA WERE ELIGIBLE FOR INCLUSION FOR DEPRESSIVE AND 16 FOR ANXIETY SYMPTOMS. META-ANALYSES REVEALED EVIDENCE FOR SIGNIFICANT MEDIUM EFFECTS OF YOGA ON DEPRESSION SYMPTOMS (N = 1,486, G = -0.419, 95% CONFIDENCE INTERVAL [CI] = -0.558 TO -0.281, P < 0.001) AND ANXIETY (N = 977, G = -0.347, 95% CI = -0.473 TO -0.221, P < 0.001) COMPARED TO CONTROLS. SUBGROUP ANALYSES FOR DEPRESSIVE SYMPTOMS REVEALED SIGNIFICANT EFFECTS FOR ALL ANALYSES PERFORMED (TYPE OF CANCER, TYPE OF CONTROL, TREATMENT STATUS, DURATION OF INTERVENTION OR FREQUENCY OF YOGA SESSIONS), WITH EFFECT SIZES BEING COMPARABLE BETWEEN SUBGROUPS. SIMILAR FINDINGS WERE FOUND FOR ANXIETY SYMPTOMS EXCEPT FOR TREATMENT STATUS, WHERE THE ONLY SIGNIFICANT EFFECT WAS FOUND WHEN YOGA WAS DELIVERED DURING ACTIVE TREATMENT. CONCLUSIONS: THIS REVIEW PROVIDES EVIDENCE THAT IN PEOPLE WITH CANCER, YOGA-BASED INTERVENTIONS ARE ASSOCIATED WITH AMELIORATION OF DEPRESSION AND ANXIETY SYMPTOMS AND THEREFORE A PROMISING THERAPEUTIC MODALITY FOR THEIR MANAGEMENT. HOWEVER, THE POTENTIAL FOR RISK OF BIAS TOGETHER WITH CONTROL GROUP DESIGN CHALLENGES MEANS THE RESULTS SHOULD BE INTERPRETED WITH CAUTION. 2021 16 2638 37 YOGA FOR VETERANS WITH CHRONIC LOW BACK PAIN: DESIGN AND METHODS OF A RANDOMIZED CLINICAL TRIAL. CHRONIC LOW BACK PAIN (CLBP) AFFLICTS MILLIONS OF PEOPLE WORLDWIDE, WITH PARTICULARLY HIGH PREVALENCE IN MILITARY VETERANS. MANY TREATMENT OPTIONS EXIST FOR CLBP, BUT MOST HAVE LIMITED EFFECTIVENESS AND SOME HAVE SIGNIFICANT SIDE EFFECTS. IN GENERAL POPULATIONS WITH CLBP, YOGA HAS BEEN SHOWN TO IMPROVE HEALTH OUTCOMES WITH FEW SIDE EFFECTS. HOWEVER, YOGA HAS NOT BEEN ADEQUATELY STUDIED IN MILITARY VETERAN POPULATIONS. IN THE CURRENT PAPER WE WILL DESCRIBE THE DESIGN AND METHODS OF A RANDOMIZED CLINICAL TRIAL AIMED AT EXAMINING WHETHER YOGA CAN EFFECTIVELY REDUCE DISABILITY AND PAIN IN US MILITARY VETERANS WITH CLBP. A TOTAL OF 144 US MILITARY VETERANS WITH CLBP WILL BE RANDOMIZED TO EITHER YOGA OR A DELAYED TREATMENT COMPARISON GROUP. THE YOGA INTERVENTION WILL CONSIST OF 2X WEEKLY YOGA CLASSES FOR 12WEEKS, COMPLEMENTED BY REGULAR HOME PRACTICE GUIDED BY A MANUAL. THE DELAYED TREATMENT GROUP WILL RECEIVE THE SAME INTERVENTION AFTER SIX MONTHS. THE PRIMARY OUTCOME IS THE CHANGE IN BACK PAIN-RELATED DISABILITY MEASURED WITH THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE AT BASELINE AND 12-WEEKS. SECONDARY OUTCOMES INCLUDE PAIN INTENSITY, PAIN INTERFERENCE, DEPRESSION, ANXIETY, FATIGUE/ENERGY, QUALITY OF LIFE, SELF-EFFICACY, SLEEP QUALITY, AND MEDICATION USAGE. ADDITIONAL PROCESS AND/OR MEDIATIONAL FACTORS WILL BE MEASURED TO EXAMINE DOSE RESPONSE AND EFFECT MECHANISMS. ASSESSMENTS WILL BE CONDUCTED AT BASELINE, 6-WEEKS, 12-WEEKS, AND 6-MONTHS. ALL RANDOMIZED PARTICIPANTS WILL BE INCLUDED IN INTENTION-TO-TREAT ANALYSES. STUDY RESULTS WILL PROVIDE MUCH NEEDED EVIDENCE ON THE FEASIBILITY AND EFFECTIVENESS OF YOGA AS A THERAPEUTIC MODALITY FOR THE TREATMENT OF CLBP IN US MILITARY VETERANS. 2016 17 2496 38 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 18 2497 44 YOGA AS PART OF A PACKAGE OF CARE VERSUS STANDARD CARE FOR SCHIZOPHRENIA. BACKGROUND: YOGA IS AN ANCIENT SPIRITUAL PRACTICE THAT ORIGINATED IN INDIA AND IS CURRENTLY ACCEPTED IN THE WESTERN WORLD AS A FORM OF RELAXATION AND EXERCISE. IT HAS BEEN OF INTEREST FOR PEOPLE WITH SCHIZOPHRENIA TO DETERMINE THE EFFICACY OF YOGA DELIVERED AS A PACKAGE OF CARE VERSUS STANDARD CARE. OBJECTIVES: TO EXAMINE THE EFFECTS OF YOGA AS A PACKAGE OF CARE VERSUS STANDARD CARE. SEARCH METHODS: WE SEARCHED THE COCHRANE SCHIZOPHRENIA GROUP TRIALS REGISTER (LATEST 30 MARCH 2017) WHICH IS BASED ON REGULAR SEARCHES OF MEDLINE, PUBMED, EMBASE, CINAHL, BIOSS, AMED, PSYCHINFO, AND REGISTRIES OF CLINICAL TRIALS. WE SEARCHED THE REFERENCES OF ALL INCLUDED STUDIES. THERE ARE NO LANGUAGE, DATE, DOCUMENT TYPE, OR PUBLICATION STATUS LIMITATIONS FOR INCLUSION OF RECORDS IN THE REGISTER. SELECTION CRITERIA: ALL RANDOMISED CONTROLLED TRIALS (RCTS) INCLUDING PEOPLE WITH SCHIZOPHRENIA COMPARING YOGA AS A PACKAGE OF CARE WITH STANDARD-CARE CONTROL. DATA COLLECTION AND ANALYSIS: THE REVIEW AUTHORS INDEPENDENTLY SELECTED STUDIES, QUALITY RATED THESE, AND EXTRACTED DATA. FOR BINARY OUTCOMES, WE CALCULATED RISK DIFFERENCE (RD) AND ITS 95% CONFIDENCE INTERVAL (CI), ON AN INTENTION-TO-TREAT (ITT) BASIS. FOR CONTINUOUS DATA, WE ESTIMATED THE MEAN DIFFERENCE (MD) BETWEEN GROUPS AND ITS CI. WE EMPLOYED MIXED-EFFECT AND FIXED-EFFECT MODELS FOR ANALYSIS. WE EXAMINED HETEROGENEITY (I(2) TECHNIQUE), ASSESSED RISK OF BIAS FOR INCLUDED STUDIES, AND CREATED A 'SUMMARY OF FINDINGS' TABLE USING GRADE (GRADING OF RECOMMENDATIONS ASSESSMENT, DEVELOPMENT AND EVALUATION). MAIN RESULTS: THREE STUDIES ARE INCLUDED IN THIS REVIEW. ALL OUTCOMES WERE SHORT TERM (LESS THAN EIGHT WEEKS). USEABLE DATA WERE REPORTED FOR TWO OUTCOMES ONLY; LEAVING THE STUDY EARLY AND QUALITY OF LIFE. NONE OF THE PARTICIPANTS LEFT THE STUDIES EARLY AND THERE WAS SOME EVIDENCE IN FAVOUR OF THE YOGA PACKAGE FOR QUALITY OF LIFE ENDPOINT SCORES (1 RCT, N=80, MD 22.93 CI 19.74 TO 26.12, LOW-QUALITY EVIDENCE). LEAVING THE STUDY EARLY DATA WERE EQUIVOCAL BETWEEN THE TREATMENT GROUPS (3 RCTS, N=193, RD 0.06 CI -0.01 TO 0.13, MEDIUM-QUALITY EVIDENCE, HIGH HETEROGENEITY). OVERALL, THIS REVIEW HAS AN INORDINATE NUMBER OF MISSING KEY OUTCOMES, WHICH INCLUDED MENTAL AND GLOBAL STATE, SOCIAL FUNCTIONING, PHYSICAL HEALTH, ADVERSE EFFECTS AND COSTS OF CARE. AUTHORS' CONCLUSIONS: A SMALL NUMBER OF SMALL STUDIES WERE INCLUDED IN THIS REVIEW AND THESE LACKED MANY KEY OUTCOMES. THE SPARSE DATA MEANS WE CANNOT STATE WITH ANY DEGREE OF CERTAINTY IF YOGA DELIVERED AS A PACKAGE OF CARE IS BENEFICIAL IN COMPARISON TO STANDARD CARE. 2017 19 2121 44 THE EFFECTIVENESS AND CHARACTERISTICS OF PREGNANCY YOGA INTERVENTIONS: A SYSTEMATIC REVIEW PROTOCOL. BACKGROUND: THE PURPOSE OF THIS REVIEW IS TO SYSTEMATICALLY EXAMINE THE REPORTED CLINICAL EFFECTIVENESS OF PREGNANCY YOGA. THE REVIEW WILL USE THE FITT (FREQUENCY, INTENSITY, TIME/DURATION AND TYPE) PRINCIPLE OF PHYSICAL ACTIVITY TO CHARACTERISE THE DIFFERENT TYPES OF YOGA INTERVENTIONS THAT HAVE BEEN EVALUATED IN THE INCLUDED STUDIES. STUDIES WILL BE CATEGORISED AS EFFECTIVENESS OR EFFICACY STUDIES AND THIS CONTINUUM OF EFFICACY VERSUS EFFECTIVENESS WILL BE INCORPORATED INTO THE FULL REVIEW. METHODS/DESIGN: THE FOLLOWING ELECTRONIC DATABASES WILL BE SEARCHED USING A DETAILED SEARCH STRATEGY: MEDLINE, PSYCINFO, EMBASE, CINAHL, WHOLIS, AMED, SCIELO, ASSIA AND WEB OF SCIENCE. RANDOMISED CONTROL TRIALS AND QUASI-EXPERIMENTAL STUDIES EXAMINING PREGNANCY YOGA AND REPORTING ON EFFECT WILL BE INCLUDED. TITLES, ABSTRACTS AND FULL ARTICLES WILL BE SCREENED BY TWO INVESTIGATORS INDEPENDENTLY TO IDENTIFY ELIGIBLE STUDIES. THE COCHRANE COLLABORATION'S RISK OF BIAS ASSESSMENT TOOL WILL BE USED TO ASSESS STUDY QUALITY. QUALITY OF THE EVIDENCE WILL BE EVALUATED USING THE GRADE CRITERIA. A STANDARDISED DATA EXTRACTION FORM WILL BE USED TO EXTRACT DATA. EFFECT SIZES WILL BE ESTIMATED USING MEAN DIFFERENCES FOR CONTINUOUS OUTCOMES, AND RELATIVE RISKS FOR DICHOTOMOUS OUTCOME. WHERE POSSIBLE, POOLING OF EFFECT ESTIMATES WILL BE DONE USING A RANDOM EFFECT MODEL. THE OUTCOMES OF INTEREST ARE QUALITY OF LIFE, STRESS, ANXIETY, DEPRESSION, MODE OF BIRTH, LABOUR DURATION AND PAIN MANAGEMENT IN LABOUR. DISCUSSION: THIS REVIEW WILL SYNTHESISE THE BEST AVAILABLE EVIDENCE ON THE EFFECTIVENESS OF YOGA DURING PREGNANCY AND PROVIDE VALUABLE HIGH-QUALITY INFORMATION FOR CLINICIANS AND HEALTH POLICYMAKERS. FINDINGS WILL BE DISSEMINATED THROUGH PUBLICATION IN A PEER-REVIEWED JOURNAL AND PRESENTATION AT RELEVANT CONFERENCE PROCEEDINGS. THE REVIEW WILL MAKE RECOMMENDATIONS FOR THE APPROPRIATE VOLUME, INTENSITY AND TYPE OF PREGNANCY YOGA FOR MAXIMUM EFFECT AND MAY HAVE IMPLICATIONS FOR POLICY AND PRACTICE RELATING TO PREGNANCY YOGA AS AN INTERVENTION. REGISTRATION: PROSPERO, CRD42019119916. REGISTERED ON 11TH JANUARY 2019. 2019 20 2454 39 YOGA AS A COMPLEMENTARY THERAPY FOR METABOLIC SYNDROME: A NARRATIVE REVIEW. METABOLIC SYNDROME (MS) IS ASSOCIATED WITH A SEDENTARY AND STRESSFUL LIFESTYLE AND AFFECTS UNDERACTIVE PEOPLE DISPROPORTIONATELY. YOGA IS CONSIDERED TO BE A LOW-IMPACT MIND-BODY STRESS-RELIEVING EXERCISE, AND RESEARCHERS ARE INCREASING THEIR FOCUS ON THE BENEFITS OF YOGA FOR MANAGING METABOLIC DISORDERS. IT IS ALSO IMPORTANT FOR PHYSICIANS AND HEALTH CARE PROFESSIONALS TO UNDERSTAND THE THERAPEUTIC EFFICACY OF YOGA INTERVENTION, IN TERMS OF ITS TYPE, DURATION AND FREQUENCY ON VARIOUS MS RISK FACTORS. THE PRESENT REVIEW SUMMARIZES THE CURRENT SCIENTIFIC UNDERSTANDING OF THE EFFECTS OF YOGA ON MS RISK FACTORS SUCH AS GLUCOSE HOMEOSTASIS MARKERS, LIPID PROFILE, ADIPOCYTOKINES AND CARDIOVASCULAR RISK FACTORS, AND DISCUSSES THE POSSIBLE MECHANISMS OF ACTION. MEDLINE, PUBMED, SCOPUS AND COCHRANE LIBRARY WERE SEARCHED FROM THEIR INCEPTION UP TO DECEMBER 2019, USING THE KEYWORDS "METABOLIC SYNDROME," "DIABETES," "CARDIOVASCULAR DISEASES," "OBESITY" AND "YOGA." THE LITERATURE SUMMARIZED IN THIS REVIEW HAVE SHOWN MIXED EFFECTS OF YOGA ON MS RISK FACTORS AND DO NOT PROVIDE ROBUST EVIDENCE FOR ITS EFFICACY. MORE RIGOROUS RESEARCH AND WELL-DESIGNED TRIALS THAT HAVE A HIGHER STANDARD OF METHODOLOGY AND EVALUATE YOGA'S LONG-TERM IMPACTS ON MS ARE NEEDED. UNDERSTANDING YOGA'S BIOCHEMICAL AND MOLECULAR MECHANISMS OF ACTION ON VARIOUS METABOLIC PATHWAYS IS ALSO NEEDED. 2021