1 1973 204 SHOULD ACUPUNCTURE, BIOFEEDBACK, MASSAGE, QI GONG, RELAXATION THERAPY, DEVICE-GUIDED BREATHING, YOGA AND TAI CHI BE USED TO REDUCE BLOOD PRESSURE?: RECOMMENDATIONS BASED ON HIGH-QUALITY SYSTEMATIC REVIEWS. BACKGROUND: THIS REVIEW AIMS TO RATE THE QUALITY OF EVIDENCE AND THE STRENGTH OF RECOMMENDATIONS IN HIGH-QUALITY SYSTEMATIC REVIEWS OF NON-DRUG THERAPIES. HYPERTENSIVE PATIENTS WHO ARE RESISTANT OR NON-ADHERENT TO ANTIHYPERTENSIVE DRUGS MAY BE EASIER TO MANAGE IF THEY CHOOSE ALTERNATIVE NON-DRUG THERAPIES FOR HYPERTENSION, BASED ON THIS REVIEW. METHODS: P: ADULTS (>18 YEARS), EXCEPT PREGNANT WOMEN, WITH ESSENTIAL HYPERTENSION. I: CUPPING, MOXIBUSTION, ACUPUNCTURE, ACUPOINT STIMULATION, YOGA, MEDITATION, TAI CHI, QI GONG, CHINESE MASSAGE, MASSAGE, SPINAL MANIPULATION, BIOFEEDBACK, DEVICE-GUIDED BREATHING THERAPY, AROMATHERAPY, MUSIC THERAPY, AND RELAXATION APPROACHES. C: 1. NO TREATMENT. 2. SHAM THERAPY. 3. CONVENTIONAL TREATMENT, INCLUDING ANTIHYPERTENSIVE DRUGS AND LIFESTYLE MODIFICATION (E.G., EXERCISE). O: 1. CHANGE IN THE INCIDENCE OF CARDIOVASCULAR DEATH. 2. CHANGE IN THE INCIDENCE OF MYOCARDIAL INFARCTION. 3. CHANGE IN THE INCIDENCE OF STROKE. 4. CHANGE IN BLOOD PRESSURE (BP). 5. EFFICACY RATE OF BP LOWERING. 6. ADVERSE EFFECTS (REVIEW SPECIFIC). S: SYSTEMATIC REVIEWS OF RANDOMIZED CONTROLLED TRIALS, INCLUDING META-ANALYSES AND ASSESSMENTS OF THE METHODOLOGICAL QUALITY/RISK OF BIAS. INFORMATION SOURCES: COCHRANE DATABASE OF SYSTEMATIC REVIEWS, DATABASE OF ABSTRACTS OF REVIEWS OF EFFECTS, COCHRANE LIBRARY, PUBMED, WEB OF SCIENCE, CHINA NATIONAL KNOWLEDGE INFRASTRUCTURE, AND CHINESE SCIENTIFIC JOURNAL DATABASE WERE SEARCHED. THE BIBLIOGRAPHIES OF THE INCLUDED ARTICLES WERE ALSO SEARCHED FOR RELEVANT SYSTEMATIC REVIEWS. GRADE CRITERIA WERE USED TO RATE THE QUALITY OF EVIDENCE IN SYSTEMATIC REVIEWS CONSIDERING 6 FACTORS, INCLUDING RISK OF BIAS. RESULTS: THIS REVIEW ULTIMATELY INCLUDED 13 SYSTEMATIC REVIEWS OF 14 NON-DRUG THERAPIES (ACUPUNCTURE, WET CUPPING, BADUANJIN, BLOOD LETTING, AURICULAR ACUPUNCTURE, MUSIC, MASSAGE, QI GONG, MOXIBUSTION, RELAXATION THERAPIES, BIOFEEDBACK, DEVICE-GUIDED BREATHING, YOGA AND TAI CHI) BASED ON THE INCLUSION CRITERIA. THE QUALITY OF EVIDENCE WAS GENERALLY LOW, AND WEAK RECOMMENDATIONS WERE GIVEN FOR MOST THERAPIES EXCEPT MASSAGE AND ACUPUNCTURE PLUS ANTIHYPERTENSIVE DRUG. BASED ON THE ANALYZED EVIDENCE, MASSAGE AND ACUPUNCTURE PLUS ANTIHYPERTENSIVE DRUG COULD BENEFIT PEOPLE WHO WANT TO LOWER THEIR BP AND DO NOT HAVE CONTRAINDICATIONS FOR MASSAGE AND ACUPUNCTURE PLUS ANTIHYPERTENSIVE DRUG. DISCUSSION/STRENGTH: THE GRADE APPROACH MAKES THIS REVIEW A UNIQUE REFERENCE FOR PEOPLE WHO ARE CONSIDERING THE GRADE OF QUALITY OF EVIDENCE IN SYSTEMATIC REVIEWS, THE BALANCE OF DESIRABLE AND UNDESIRABLE CONSEQUENCES AND THE STRENGTH OF RECOMMENDATIONS TO DECIDE WHICH INTERVENTION SHOULD BE USED TO REDUCE BP. LIMITATIONS: MANY NON-DRUG THERAPIES WERE EXCLUDED DUE TO THE LOW METHODOLOGICAL QUALITY OF THEIR SYSTEMATIC REVIEWS, AND ONLY 14 THERAPIES WERE EVALUATED IN THIS REVIEW. AS NO PATIENT-IMPORTANT OUTCOMES WERE REVIEWED, SURROGATE OUTCOMES WERE USED TO RATE THE STRENGTH OF RECOMMENDATIONS. THIS APPROACH MAY CAUSE A DECREASE IN EVIDENCE QUALITY ACCORDING TO GRADE, BUT WE ARGUE THAT THIS IS APPROPRIATE IN THE CONTEXT OF THIS REVIEW. 2019 2 846 25 EFFECT OF YOGA ON PULSE RATE VARIABILITY MEASURED FROM A VENOUS PRESSURE WAVEFORM. THE BENEFITS OF YOGA HAVE BEEN STUDIED IN DIFFERENT FIELDS, FROM CHRONIC HEALTH CONDITIONS TO MENTAL DISORDERS, SHOWING THAT IT CAN HELP TO IMPROVE THE OVERALL HEALTH. IN PARTICULAR, IT HAS BEEN PROVEN THAT YOGA ALSO IMPROVES THE AUTONOMIC FUNCTION. HEART RATE VARIABILITY (HRV) AT REST IS COMMONLY USED AS A NON-INVASIVE MEASURE OF AUTONOMIC REGULATION OF HEART RATE. ALTERNATIVELY, PULSE RATE VARIABILITY (PRV) HAS BEEN PROPOSED AS A SURROGATE OF HRV. VOLUMETRIX HAS DEVELOPED A NOVEL TECHNOLOGY THAT CAPTURES VENOUS WAVEFORMS VIA SENSORS ON THE VOLAR ASPECT OF THE WRIST, CALLED NIVABAND. THIS STUDY AIMS TO ASSESS THE EFFECT OF YOGA IN THE AUTONOMIC NERVOUS SYSTEM BY ANALYZING THE PRV OBTAINED FROM THE NIVA SIGNAL. TEMPORAL (STATISTICS OF THE NORMAL-TO-NORMAL INTERVALS), SPECTRAL (POWER IN LOW AND HIGH FREQUENCY BANDS) AND NONLINEAR (LAGGED POINCARE PLOT ANALYSIS) PARAMETERS ARE ANALYZED BEFORE AND AFTER A YOGA SESSION IN 20 HEALTHY VOLUNTEERS. THE PRV ANALYSIS SHOWS AN INCREASE IN PARAMETERS RELATED TO PARASYMPATHETIC ACTIVITY AND OVERALL VARIABILITY, AND A DECREASE IN PARAMETERS RELATED TO SYMPATHETIC ACTIVITY AND MEAN HEART RATE. THESE RESULTS SUPPORT THE BENEFICIAL EFFECT OF YOGA IN AUTONOMIC NERVOUS SYSTEM, INCREASING THE PARASYMPATHETIC ACTIVITY. 2019 3 2013 38 SUDARSHAN KRIYA YOGA: A BREATH OF HOPE DURING COVID-19 PANDEMIC. IMPORTANT COUNTER MEASURES TO COMBAT AN INFECTIOUS DISEASE PANDEMIC INCLUDE VACCINATION, ANTIVIRAL THERAPY, AND IMMUNOMODULATION THERAPY. VACCINATIONS ARE DISEASE SPECIFIC AND MOREOVER STRAIN SPECIFIC, SO THE PROTECTION PROVIDED IS ALSO SPECIFIC AND LIMITED. ANTIVIRAL THERAPIES ARE COSTLY AND REQUIRE BULK PRODUCTION OF DRUGS, HENCE GLOBALLY THERE IS AN INCREASED INTEREST TOWARD LOW-RISK, COST-EFFECTIVE COMPLEMENTARY ALTERNATIVE THERAPIES, SUCH AS YOGA AND AYURVEDA TO TACKLE THE INFECTIOUS PANDEMIC, CORONAVIRUS DISEASE 2019 (COVID-19). THERE IS CLINICAL EVIDENCE AVAILABLE ON THE POTENTIAL COMPLEMENTARY ROLE OF YOGIC PRACTICES IN THE MANAGEMENT OF NONCOMMUNICABLE AND COMMUNICABLE DISEASES. VARIOUS ONLINE DATABASES WERE SEARCHED FOR ARTICLES PUBLISHED BETWEEN 2000 AND 2020. DATABASES EXPLORED WERE MEDLINE, EMBASE, INDIAN CITATION INDEX, PSYCINFO, INDEX MEDICUS FOR SOUTH-EAST ASIA REGION, AND GOOGLE SCHOLAR. ALL SEARCH RESULTS WERE SCREENED, AND ARTICLES RELATED TO KEYWORDS SUCH AS COVID-19, YOGA THERAPY, AND SUDARSHAN KRIYA YOGA (SKY) WERE SELECTED FOR DATA EXTRACTION. QUALITY OF THE STUDIES INCLUDED WAS EVALUATED ON THE BASIS OF THE CONSTRUCT VALIDITY, CONTENT VALIDITY, RELEVANCE, BIAS, CREDIBILITY RELATING TO INFORMATION, AND DATA SOURCES. SKY IS A UNIQUE YOGIC PRACTICE THAT INCLUDES SPECIFIC SEQUENTIAL BREATHING TECHNIQUES. IT BALANCES THE AUTONOMIC NERVOUS SYSTEM AND THUS CAN ALLEVIATE ANXIETY, ROUTINE STRESS, DEPRESSION, STRESS-RELATED MEDICAL DISORDERS, AND POSTTRAUMATIC STRESS. IT POTENTIATES NATURAL HOST IMMUNE DEFENSES THAT ARE ESSENTIAL TO TACKLE A PLETHORA OF MICROBIAL INFECTIONS. THIS NARRATIVE REVIEW ARTICLE PROVIDES AN OVERVIEW OF POTENTIAL THERAPEUTIC BENEFITS THAT SKY CAN OFFER TO THE POPULATION AT LARGE DURING THIS COVID-19 PANDEMIC. 2021 4 1141 36 EFFICACY OF YOGA, TAI CHI AND QI GONG ON THE MAIN SYMPTOMS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A SYSTEMATIC REVIEW. INTRODUCTION: THE AIM OF THIS SYSTEMATIC REVIEW WAS TO SUMMARIZE THE EFFECTS OF YOGA, QI GONG OR TAI CHI IN COPD PATIENTS. METHODS: STUDIES EVALUATING EFFECTS OF THE SELECTED COMPLEMENTARY THERAPIES ON LUNG FUNCTION, DYSPNEA, QUALITY OF LIFE OR FUNCTIONAL EXERCISE CAPACITY IN COPD PATIENTS WERE IDENTIFIED AND REVIEWED FROM THREE DATABASES. RESULTS: EIGHTEEN STUDIES WERE INCLUDED. SIX STUDIES EVALUATED THE EFFECTS OF YOGA AND THE OTHERS FOCUSED ON TAI CHI OR QI GONG SEPARATELY OR COMBINED. THE DURATION OF THE PROGRAMS RANGED FROM 6 WEEKS TO 6 MONTHS AND THE FREQUENCY FROM 2 TO 7 TIMES A WEEK. EACH SESSION REACHED 30 TO 90 MINUTES. BENEFITS WERE OBSERVED ON LUNG FUNCTION AND FUNCTIONAL EXERCISE CAPACITY BUT BENEFIT WAS CLEARLY STATED NEITHER ON QUALITY OF LIFE NOR ON DYSPNEA. CONCLUSION: THIS SYSTEMATIC REVIEW HIGHLIGHTS THE POTENTIAL OF THESE THERAPIES AS COMPLEMENTARY THERAPEUTIC APPROACH IN COPD PATIENTS. 2019 5 539 40 COMPLEMENTARY THERAPIES IN PARKINSON DISEASE: A REVIEW OF ACUPUNCTURE, TAI CHI, QI GONG, YOGA, AND CANNABIS. PARKINSON DISEASE (PD) IS A PROGRESSIVE NEURODEGENERATIVE CONDITION CHARACTERIZED BY BRADYKINESIA, RIGIDITY, RESTING TREMOR, AND POSTURAL INSTABILITY. NON-MOTOR SYMPTOMS, INCLUDING PAIN, FATIGUE, INSOMNIA, ANXIETY, AND DEPRESSION TO NAME A FEW, ARE INCREASINGLY RECOGNIZED AND OFTEN JUST AS DISABLING AT MOTOR SYMPTOMS. THE MAINSTAY OF TREATMENT IS DOPAMINE REPLACEMENT; HOWEVER, THE BENEFICIAL EFFECTS TEND TO WANE OVER TIME WITH DISEASE PROGRESSION, AND PATIENTS OFTEN EXPERIENCE MOTOR FLUCTUATIONS AND MEDICATION SIDE EFFECTS. THE LACK OF A DISEASE-MODIFYING INTERVENTION AND THE SHORTCOMINGS OF TRADITIONAL SYMPTOMATIC MEDICATIONS HAVE LED MANY PATIENTS TO PURSUE COMPLEMENTARY THERAPIES TO ALLEVIATE MOTOR AND NON-MOTOR SYMPTOMS ASSOCIATED WITH PD. THE TERM COMPLEMENTARY IMPLIES THAT THE THERAPY IS USED ALONG WITH CONVENTIONAL MEDICINE AND MAY INCLUDE SUPPLEMENTS, MANIPULATIVE TREATMENTS (CHIROPRACTIC, MASSAGE), EXERCISE-BASED PROGRAMS, AND MIND-BODY PRACTICES. AS THESE PRACTICES BECOME MORE WIDESPREAD IN WESTERN MEDICINE, THERE IS A GROWING INTEREST IN EVALUATING THEIR EFFECTS ON A NUMBER OF MEDICAL CONDITIONS, PD INCLUDED. IN THIS REVIEW, WE PROVIDE AN UPDATE ON CLINICAL TRIALS THAT HAVE EVALUATED THE EFFECTIVENESS OF COMPLEMENTARY TREATMENTS FOR PATIENTS WITH PD, SPECIFICALLY FOCUSING ON ACUPUNCTURE, TAI CHI, QI GONG, YOGA, AND CANNABIS. 2020 6 1927 39 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 7 548 42 CONTENT, STRUCTURE, AND DELIVERY CHARACTERISTICS OF YOGA INTERVENTIONS FOR MANAGING HYPERTENSION: A SYSTEMATIC REVIEW PROTOCOL. AIMS: THIS SYSTEMATIC REVIEW AIMS TO SUMMARIZE THE CONTENT, STRUCTURE, AND DELIVERY CHARACTERISTICS OF YOGA INTERVENTIONS USED FOR MANAGING HYPERTENSION. INTRODUCTION: GLOBALLY, HYPERTENSION-RELATED MORBIDITY AND MORTALITY ARE HIGH. YOGA MIGHT BE A POTENTIAL SOLUTION FOR MANAGING HYPERTENSION. SEVERAL SYSTEMATIC REVIEWS HAVE EVALUATED THE EFFECTIVENESS OF YOGA INTERVENTIONS FOR MANAGING HYPERTENSION. THERE IS A NEED TO SUMMARIZE THE CONTENT, STRUCTURE, AND DELIVERY CHARACTERISTICS OF YOGA INTERVENTIONS USED FOR MANAGING HYPERTENSION. INCLUSION CRITERIA: RANDOMIZED CONTROLLED TRIALS ASSESSING THE EFFECTIVENESS OF YOGA INTERVENTIONS FOR MANAGING HYPERTENSION IN ADULTS AND REPORTING EITHER THE CONTENT, STRUCTURE, OR DELIVERY CHARACTERISTICS WILL BE INCLUDED IN THIS SYSTEMATIC REVIEW. METHODS: THE JOANNA BRIGGS INSTITUTE SYSTEMATIC REVIEW METHODOLOGY WILL BE FOLLOWED TO CONDUCT THE REVIEW. WE AIM TO SEARCH FOR A WIDE RANGE OF SOURCES TO FIND BOTH PUBLISHED AND UNPUBLISHED STUDIES. THE FOLLOWING DATABASES WILL BE SEARCHED: MEDLINE, EMBASE, CINAHL, PSYCINFO, ALLIED AND COMPLEMENTARY MEDICINE (AMED), WEB OF SCIENCE, COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS (CENTRAL), TURNING RESEARCH INTO PRACTICE (TRIP), AYUSH RESEARCH PORTAL, A BIBLIOGRAPHY OF INDIAN MEDICINE (ABIM), DIGITAL HELPLINE FOR AYURVEDA RESEARCH ARTICLES (DHARA), CAM-QUEST, AND DIRECTORY OF OPEN ACCESS JOURNALS (DOAJ). THE SEARCH FOR UNPUBLISHED STUDIES WILL INCLUDE OPENGREY, ETHOS, AND PROQUEST DISSERTATIONS AND THESES. DATABASES WILL BE SEARCHED FROM THEIR INCEPTION DATES, AND NO LANGUAGE RESTRICTIONS WILL BE APPLIED. A NARRATIVE DESCRIPTION OF THE FINDINGS WILL BE WRITTEN, STRUCTURED AROUND THE AIMS OF THIS SYSTEMATIC REVIEW. SYSTEMATIC REVIEW REGISTRATION NUMBER: CRD42019139404. 2020 8 1202 44 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 9 1089 34 EFFECTS OF YOGA ON THE AUTONOMIC NERVOUS SYSTEM, GAMMA-AMINOBUTYRIC-ACID, AND ALLOSTASIS IN EPILEPSY, DEPRESSION, AND POST-TRAUMATIC STRESS DISORDER. A THEORY IS PROPOSED TO EXPLAIN THE BENEFITS OF YOGA PRACTICES IN DIVERSE, FREQUENTLY COMORBID MEDICAL CONDITIONS BASED ON THE CONCEPT THAT YOGA PRACTICES REDUCE ALLOSTATIC LOAD IN STRESS RESPONSE SYSTEMS SUCH THAT OPTIMAL HOMEOSTASIS IS RESTORED. IT IS HYPOTHESIZED THAT STRESS INDUCES (1) IMBALANCE OF THE AUTONOMIC NERVOUS SYSTEM (ANS) WITH DECREASED PARASYMPATHETIC NERVOUS SYSTEM (PNS) AND INCREASED SYMPATHETIC NERVOUS SYSTEM (SNS) ACTIVITY, (2) UNDERACTIVITY OF THE GAMMA AMINO-BUTYRIC ACID (GABA) SYSTEM, THE PRIMARY INHIBITORY NEUROTRANSMITTER SYSTEM, AND (3) INCREASED ALLOSTATIC LOAD. IT IS FURTHER HYPOTHESIZED THAT YOGA-BASED PRACTICES (4) CORRECT UNDERACTIVITY OF THE PNS AND GABA SYSTEMS IN PART THROUGH STIMULATION OF THE VAGUS NERVES, THE MAIN PERIPHERAL PATHWAY OF THE PNS, AND (5) REDUCE ALLOSTATIC LOAD. DEPRESSION, EPILEPSY, POST TRAUMATIC STRESS DISORDER (PTSD), AND CHRONIC PAIN EXEMPLIFY MEDICAL CONDITIONS THAT ARE EXACERBATED BY STRESS, HAVE LOW HEART RATE VARIABILITY (HRV) AND LOW GABAERGIC ACTIVITY, RESPOND TO PHARMACOLOGIC AGENTS THAT INCREASE ACTIVITY OF THE GABA SYSTEM, AND SHOW SYMPTOM IMPROVEMENT IN RESPONSE TO YOGA-BASED INTERVENTIONS. THE OBSERVATION THAT TREATMENT RESISTANT CASES OF EPILEPSY AND DEPRESSION RESPOND TO VAGAL NERVE STIMULATION CORROBORATES THE NEED TO CORRECT PNS UNDERACTIVITY AS PART OF A SUCCESSFUL TREATMENT PLAN IN SOME CASES. ACCORDING TO THE PROPOSED THEORY, THE DECREASED PNS AND GABAERGIC ACTIVITY THAT UNDERLIES STRESS-RELATED DISORDERS CAN BE CORRECTED BY YOGA PRACTICES RESULTING IN AMELIORATION OF DISEASE SYMPTOMS. THIS HAS FAR-REACHING IMPLICATIONS FOR THE INTEGRATION OF YOGA-BASED PRACTICES IN THE TREATMENT OF A BROAD ARRAY OF DISORDERS EXACERBATED BY STRESS. 2012 10 2821 67 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 11 2014 33 SUDARSHAN KRIYA YOGA: BREATHING FOR HEALTH. BREATHING TECHNIQUES ARE REGULARLY RECOMMENDED FOR RELAXATION, STRESS MANAGEMENT, CONTROL OF PSYCHOPHYSIOLOGICAL STATES, AND TO IMPROVE ORGAN FUNCTION. YOGIC BREATHING, DEFINED AS A MANIPULATION OF BREATH MOVEMENT, HAS BEEN SHOWN TO POSITIVELY AFFECT IMMUNE FUNCTION, AUTONOMIC NERVOUS SYSTEM IMBALANCES, AND PSYCHOLOGICAL OR STRESS-RELATED DISORDERS. THE AIM OF THIS STUDY WAS TO ASSESS AND PROVIDE A COMPREHENSIVE REVIEW OF THE PHYSIOLOGICAL MECHANISMS, THE MIND-BODY CONNECTION, AND THE BENEFITS OF SUDARSHAN KRIYA YOGA (SKY) IN A WIDE RANGE OF CLINICAL CONDITIONS. VARIOUS ONLINE DATABASES SEARCHED WERE MEDLINE, PSYCHINFO, EMBASE, AND GOOGLE SCHOLAR. ALL THE RESULTS WERE CAREFULLY SCREENED AND ARTICLES ON SKY WERE SELECTED. THE REFERENCES FROM THESE ARTICLES WERE CHECKED TO FIND ANY OTHER POTENTIALLY RELEVANT ARTICLES. SKY, A UNIQUE YOGIC BREATHING PRACTICE, INVOLVES SEVERAL TYPES OF CYCLICAL BREATHING PATTERNS, RANGING FROM SLOW AND CALMING TO RAPID AND STIMULATING. THERE IS MOUNTING EVIDENCE TO SUGGEST THAT SKY CAN BE A BENEFICIAL, LOW-RISK, LOW-COST ADJUNCT TO THE TREATMENT OF STRESS, ANXIETY, POST-TRAUMATIC STRESS DISORDER, DEPRESSION, STRESS-RELATED MEDICAL ILLNESSES, SUBSTANCE ABUSE, AND REHABILITATION OF CRIMINAL OFFENDERS. 2013 12 2454 44 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 13 811 59 EFFECT OF YOGA ON BLOOD PRESSURE IN PREHYPERTENSION: A SYSTEMATIC REVIEW AND META-ANALYSIS. INTRODUCTION: PREHYPERTENSION IS A PRECURSOR FOR DEVELOPING HYPERTENSION AND IS A RISK FACTOR FOR CARDIOVASCULAR DISEASES. YOGA THERAPY MAY HAVE A ROLE IN LOWERING THE BLOOD PRESSURES IN PREHYPERTENSION AND HYPERTENSION. THIS SYSTEMATIC REVIEW AIMS TO SYNTHESIZE THE AVAILABLE LITERATURE FOR THE SAME. METHODOLOGY. DATABASES SUCH AS PUBMED, EMBASE, SCOPUS, AND WEB OF SCIENCE WERE SEARCHED FOR RANDOMISED CONTROL TRIALS ONLY IN THE TIME DURATION OF 2010-2021. THE MAIN OUTCOME OF INTEREST WAS SYSTOLIC AND DIASTOLIC BLOOD PRESSURES. ARTICLES WERE SCREENED BASED ON THE INCLUSION CRITERIA, AND 8 ARTICLES WERE RECRUITED FOR THE REVIEW. META-ANALYSIS WAS DONE FOR SUITABLE ARTICLES. REVMAN 5.4 BY COCHRANE WAS USED FOR META-ANALYSIS AND FOREST PLOT CONSTRUCTION. RISK OF BIAS WAS DETERMINED USING THE DOWNS AND BLACK CHECKLIST BY THREE INDEPENDENT AUTHORS. RESULTS: THE META-ANALYSIS OF THE ARTICLES FAVOURED YOGA INTERVENTION OVER THE CONTROL INTERVENTION. YOGA THERAPY HAD SIGNIFICANTLY REDUCED THE SYSTOLIC PRESSURE (-0.62 STANDARD MEAN DIFFERENCE, AT IV FIXED 95% CI: -0.83, -0.41) AND DIASTOLIC PRESSURE (-0.81 STANDARD MEAN DIFFERENCE, AT IV RANDOM 95% CI: -1.39, -0.22). SECONDARY OUTCOME MEASURES STUDIED WERE HEART RATE, WEIGHT, BMI, WAIST CIRCUMFERENCE, AND LIPID PROFILE. THE MAIN PROTOCOL OF YOGA THERAPY INCLUDED POSTURES, BREATHING EXERCISES, AND DIFFERENT MEDITATION TECHNIQUES. A SIGNIFICANT REDUCTION IN SECONDARY OUTCOMES WAS OBSERVED, EXCEPT FOR HDL VALUES IN LIPID PROFILE WHICH SHOWED A GRADUAL INCREASE IN YOGA GROUP IN COMPARISON WITH ALTERNATIVE THERAPY. CONCLUSION: YOGA THERAPY HAS SHOWN TO BE SIGNIFICANT IN THE REDUCTION OF SYSTOLIC AND DIASTOLIC PRESSURE IN PREHYPERTENSIVE POPULATION. SUPPORTING EVIDENCE LACKS IN PROVIDING A PROPER STRUCTURED DOSAGE OF YOGA ASANAS AND BREATHING TECHNIQUES. CONSIDERING THE EXISTING LITERATURE AND EVIDENCE, YOGA THERAPY CAN BE USED AND RECOMMENDED IN PREHYPERTENSIVE POPULATION AND CAN BE BENEFICIAL IN REDUCING THE CHANCES OF DEVELOPING HYPERTENSION OR CARDIOVASCULAR DISEASES. 2021 14 2629 69 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 15 2130 47 THE EFFECTIVENESS OF YOGA TO PREVENT DIABETES MELLITUS TYPE 2: A PROTOCOL FOR SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: TYPE 2 DIABETES MELLITUS (T2DM) IS BECOMING A LEADING PROBLEM WORLDWIDE. EMERGING REPORTS REVEAL ALARMING EVIDENCE OF INCREASING PREVALENCE OF T2DM THAT HAS REACHED PANDEMIC LEVELS. DESPITE THE SIGNIFICANT INCIDENCE, THERE ARE LIMITED RELIABLE DATA RESOURCES AND COMPREHENSIVE SYSTEMATIC REVIEW AND META-ANALYSIS ON THE EFFECTS OF YOGA ON PEOPLE WHO ARE A PREDIABETIC OR HIGH RISK FOR DEVELOPING T2DM. OBJECTIVE: THE OBJECTIVE OF THIS PROTOCOL IS TO CONDUCT A FULL-SCALE SYSTEMATIC REVIEW AND META-ANALYSES ON THE EFFECTS OF YOGA ON PEOPLE WHO ARE PREDIABETES OR HIGH RISK OF DEVELOPING T2DM. METHODS: THE ARTICLES ENROLLED IN THE STUDY WILL BE RETRIEVED FROM THE ONLINE DATABASES BETWEEN 2002 AND THE DATE THE SEARCHES ARE EXECUTED. THE SEARCHES WILL BE REPEATED JUST BEFORE THE FINAL ANALYSES AND FURTHER RELEVANT STUDIES FOR INCLUSION. WE WILL CONDUCT A BIBLIOGRAPHIC SEARCH IN DATABASES: MEDLINE/PUBMED, SCOPUS, COCHRANE LIBRARY, EBSCO, AND INDMED USING KEYWORDS INCLUDING PREDIABETES STATE, HIGH RISK FOR DIABETES, METABOLIC SYNDROME, AND YOGA. A DEFINED SEARCH STRATEGY WILL BE IMPLEMENTED ALONG WITH SELECTION CRITERIA TO OBTAIN FULL-TEXT ARTICLES OF RELEVANT STUDIES. THIS STUDY PROTOCOL WAS PREPARED ACCORDING TO THE PREFERRED REPORTING ITEMS FOR SYSTEMATIC REVIEWS AND META-ANALYSIS FOR PROTOCOLS 2015 GUIDELINES. THERE WILL BE NO LANGUAGE RESTRICTIONS. ETHICS AND DISSEMINATION: THE PROPOSED STUDY WILL BE BASED ON PUBLISHED STUDIES AND PUBLICLY AVAILABLE ANONYMIZED DATA WITHOUT DIRECTLY INVOLVING HUMAN PARTICIPANTS AND THEREFORE REQUIRES NEITHER FORMAL HUMAN ETHICAL REVIEW NOR APPROVAL BY A HUMAN RESEARCH ETHICS COMMITTEE. WE PUBLISHED AN OUTLINE OF THE PROTOCOL IN THE INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS (PROSPERO) IN 2018. WE PLAN TO DISSEMINATE THE FINDINGS OF THIS SYSTEMATIC REVIEW AND META-ANALYSIS THROUGH PUBLICATION IN A PEER-REVIEWED JOURNAL AND PRESENTATION AT RELEVANT CONFERENCE PROCEEDINGS. IN ADDITION, WE BELIEVE THE RESULTS OF THE SYSTEMATIC REVIEW WILL HAVE IMPLICATIONS FOR POLICY AND PRACTICE. WE WILL PREPARE POLICYMAKER SUMMARY USING A VALIDATED FORMAT, DISSEMINATE THROUGH SOCIAL MEDIA AND EMAIL DISCUSSION GROUPS. REVIEW REGISTRATION NUMBER: PROSPERO REGISTRATION NUMBER CRD 42018106657. 2019 16 2820 64 YOGA TREATMENT FOR CHRONIC NON-SPECIFIC LOW BACK PAIN (2017). WIELAND LS, SKOETZ N, PILKINGTON K, VEMPATI R, DADAMO CR, BERMAN BM. YOGA TREATMENT FOR CHRONIC NON-SPECIFIC LOW BACK PAIN.COCHRANE DATABASE SYST REV2017, ISSUE 1. ART. NO.: CD010671. DOI: 10.1002/14651858.CD010671.PUB2. 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% CI: -0.66 TO -0.14; CORRESPONDING TO A CHANGE IN THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE OF MEAN DIFFERENCE (MD) = -2.18, 95% CI: -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% CI: -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% CI: -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: 2-8%]. 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% CI: -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% CI: -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% CI: -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. 2017 17 1074 71 EFFECTS OF YOGA ON PATIENTS WITH CHRONIC NONSPECIFIC NECK PAIN: A PRISMA SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: CHRONIC NONSPECIFIC NECK PAIN (CNNP) HAS A HIGH PREVALENCE AND IS MORE COMMON AMONG YOUNGER PEOPLE. CLINICAL PRACTICE SUGGESTS THAT YOGA IS EFFECTIVE IN RELIEVING CHRONIC PAIN. OBJECTIVES: THIS META-ANALYSIS AIMED TO QUANTITATIVELY SUMMARIZE THE EFFICACY OF YOGA FOR TREATING CNNP. DATA SOURCES: WE SEARCHED FOR TRIALS IN THE ELECTRONIC DATABASES FROM THEIR INCEPTION TO JANUARY 2019. ENGLISH DATABASES INCLUDING PUBMED, MEDLINE, COCHRANE LIBRARY, EMBASE, SCOPUS, THE COCHRANE CENTRAL REGISTER OF CONTROLLED TRIALS, AND IND MED; CHINESE DATABASES INCLUDING CHINA NATIONAL KNOWLEDGE INFRASTRUCTURE (CNKI), WANFANG DATABASE, AND VIP INFORMATION. WE ALSO CONDUCTED A MANUAL SEARCH OF KEY JOURNALS AND THE REFERENCE LISTS OF ELIGIBLE PAPERS TO IDENTIFY ANY POTENTIALLY RELEVANT STUDIES WE MAY HAVE MISSED. WE PLACED NO LIMITATIONS ON LANGUAGE OR DATE OF PUBLICATION. STUDY ELIGIBILITY CRITERIA: WE INCLUDED ONLY RANDOMIZED CONTROLLED TRIALS (RCTS) AND Q-RCTS EVALUATING THE EFFECTS OF YOGA ON PATIENTS WITH CNNP. THE PRIMARY OUTCOMES FOR THIS REVIEW WERE PAIN AND DISABILITY, AND THE SECONDARY OUTCOMES WERE CERVICAL RANGE OF MOTION (CROM), QUALITY OF LIFE (QOL), AND MOOD. PARTICIPANTS AND INTERVENTIONS: TRAILS THAT EXAMINED THE CLINICAL OUTCOMES OF YOGA INTERVENTION IN ADULTS WITH CNNP COMPARED WITH THOSE OF OTHER THERAPIES EXCEPT YOGA (E.G., EXERCISE, PILATES, USUAL CARE, ET AL) WERE INCLUDED. STUDY APPRAISAL AND SYNTHESIS METHODS: COCHRANE RISK-OF-BIAS CRITERIA WERE USED TO ASSESS THE METHODOLOGICAL QUALITY, AND REVMAN 5.3 SOFTWARE WAS USED TO CONDUCT THE META-ANALYSIS. RESULTS: A TOTAL OF 10 TRIALS (N = 686) COMPARING YOGA AND INTERVENTIONS OTHER THAN YOGA WERE INCLUDED IN THE META-ANALYSIS. THE RESULTS SHOW THAT YOGA HAD A POSITIVE EFFECTS ON NECK PAIN INTENSITY (TOTAL EFFECT: SMD = -1.13, 95% CI [-1.60, -0.66], Z = 4.75, P < .00001), NECK PAIN-RELATED FUNCTIONAL DISABILITY (TOTAL EFFECT: SMD = -0.92, 95% CI [-1.38, -0.47], Z = 3.95, P < .0001), CROM (TOTAL EFFECT: SMD = 1.22, 95% CI [0.87, 1.57], Z = 6.83, P < .00001), QOL (TOTAL EFFECT: MD = 3.46, 95% CI [0.75, 6.16], Z = 2.51, P = .01), AND MOOD (TOTAL EFFECT: SMD = -0.61, 95% CI [-0.95, -0.27], Z = 3.53, P = .0004). CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: IT WAS DIFFICULT TO MAKE A COMPREHENSIVE SUMMARY OF ALL THE EVIDENCE DUE TO THE DIFFERENT SESSION AND DURATION OF THE YOGA INTERVENTIONS, AND THE DIFFERENT OUTCOME MEASUREMENT TOOLS IN THE STUDY, WE DRAW A VERY CAUTIOUS CONCLUSION THAT YOGA CAN RELIEVE NECK PAIN INTENSITY, IMPROVE PAIN-RELATED FUNCTION DISABILITY, INCREASE CROM, IMPROVE QOL, AND BOOST MOOD. THIS SUGGESTS THAT YOGA MIGHT BE AN IMPORTANT ALTERNATIVE IN THE TREATMENT OF CNNP. SYSTEMATIC REVIEW REGISTRATION NUMBER: DETAILS OF THE PROTOCOL FOR THIS SYSTEMATIC REVIEW AND META-ANALYSIS WERE REGISTERED ON PROSPERO AND CAN BE ACCESSED AT WWW.CRD.YORK.AC.UK/PROSPERO/DISPLAY_RECORD.ASP?ID=CRD42018108992. 2019 18 2616 60 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 19 1004 52 EFFECTS OF MIND(-)BODY EXERCISES (TAI CHI/YOGA) ON HEART RATE VARIABILITY PARAMETERS AND PERCEIVED STRESS: A SYSTEMATIC REVIEW WITH META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. BACKGROUND: HEART RATE VARIABILITY (HRV) AS AN ACCURATE, NONINVASIVE MEASURE OF THE AUTONOMOUS NERVOUS SYSTEM (ANS) CAN REFLECT MENTAL HEALTH (E.G., STRESS, DEPRESSION, OR ANXIETY). TAI CHI AND YOGA (TAI CHI/YOGA), AS THE MOST WIDELY PRACTICED MIND(-)BODY EXERCISES, HAVE SHOWN POSITIVE OUTCOMES OF MENTAL HEALTH. TO DATE, NO SYSTEMATIC REVIEW REGARDING THE LONG-LASTING EFFECTS OF TAI CHI/YOGA ON HRV PARAMETERS AND PERCEIVED STRESS HAS BEEN CONDUCTED. OBJECTIVE: TO CRITICALLY EVALUATE THE EXISTING LITERATURE ON THIS TOPIC. METHODS: FIVE ELECTRONIC DATABASES (WEB OF SCIENCE, PUBMED, SCOPUS, SPORTDISCUS AND COCHRANE LIBRARY) WERE SEARCHED FROM THE START OF THE RESEARCH PROJECT TO JULY 2018. STUDY SELECTION, DATA EXTRACTION, AND STUDY QUALITY ASSESSMENT WERE INDEPENDENTLY CARRIED OUT BY TWO REVIEWERS. THE POTENTIALLY IDENTIFIED RANDOMIZED CONTROLLED TRIALS (RCT) REPORTED THE USEFUL QUANTITATIVE DATA THAT WERE INCLUDED ONLY FOR META-ANALYSIS. RESULTS: META-ANALYSIS OF 17 MEDIUM-TO-HIGH QUALITY RCTS SHOWED SIGNIFICANTLY BENEFICIAL EFFECTS ON HRV PARAMETERS (NORMALIZED LOW-FREQUENCY, HEDGE'S G = -0.39, 95% CI -0.39 TO -0.56, P < 0.001, I2 = 11.62%; NORMALIZED HIGH-FREQUENCY, HEDGE'S G = 0.37, 95% CI 0.22 TO -0.52, P < 0.001, I2 = 0%; LOW-FREQUENCY TO HIGH-FREQUENCY RATIO, HEDGE'S G = -0.58, 95% CI -0.81 TO -0.35, P < 0.001, I2 = 53.78%) AND STRESS LEVEL (HEDGE'S G = -0.80, 95% CI -1.17 TO -0.44, P < 0.001, I2 = 68.54%). CONCLUSIONS: STRESS REDUCTION MAY BE ATTRIBUTED TO SYMPATHETIC-VAGAL BALANCE MODULATED BY MIND(-)BODY EXERCISES. TAI CHI/YOGA COULD BE AN ALTERNATIVE METHOD FOR STRESS REDUCTION FOR PEOPLE WHO LIVE UNDER HIGH STRESS OR NEGATIVE EMOTIONS. 2018 20 1064 45 EFFECTS OF YOGA ON IMMUNE FUNCTION: A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS. OBJECTIVE: THIS SYSTEMATIC REVIEW ATTEMPTS TO CONFIRM THE ADDED EVIDENCE TO ASSESS THE EFFECT OF YOGA ON IMMUNE FUNCTION. METHODS: THE COCHRANE LIBRARY, EMBASE, PSYCINFO, PUBMED, AND WEB OF SCIENCE ELECTRONIC DATABASES WERE SEARCHED ACCORDING TO THE PRISRMA METHOD TO IDENTIFY RANDOMIZED CONTROLLED TRIALS (RCTS) ON THE IMMUNOLOGICAL EFFECTS OF YOGA PUBLISHED IN THE ENGLISH LANGUAGE FROM JANUARY 1, 2017, TO DECEMBER 31, 2020. THIS REVIEW COULD ONLY BE DESCRIPTIVELY SUMMARIZED BECAUSE OF HETEROGENEITY OF THE INCLUDED RCTS. RESULTS: ELEVEN POTENTIAL TRIALS WERE IDENTIFIED AND INCLUDED IN THIS REVIEW. QUALITY APPRAISAL OF INCLUDED TRIALS RANGED FROM 3 FOR UNCLEAR RISK OF BIAS AND 8 FOR HIGH RISK OF BIAS. THERE IS EVIDENCE FROM 11 RCTS THAT YOGA MAY HAVE FAVORABLE EFFECTS FOR REDUCING THE LEVELS OF ANTI-INFLAMMATORY MARKERS. CONCLUSIONS: YOGA MAY BE USED AS A COMPLEMENTARY INTERVENTION FOR CLINICAL POPULATIONS OR HEALTHY INDIVIDUALS. 2021