1 2308 134 TRANSCRANIAL DIRECT CURRENT STIMULATION AND YOGA FOR FUNCTIONAL MOVEMENT DISORDERS. BACKGROUND: FUNCTIONAL MOVEMENT DISORDER (FMD), A CONVERSION DISORDER CHARACTERIZED BY INVOLUNTARY MOVEMENTS, IS DIFFICULT TO TREAT. METHODS: WE AIMED TO ASSESS THE EFFECTS OF ANODAL TRANSCRANIAL DIRECT CURRENT STIMULATION (TDCS) AND YOGA IN FMD PATIENTS (N=5). TDCS OF THE RIGHT TEMPOROPARIETAL JUNCTION, A BRAIN REGION RELEVANT IN THE SENSE OF SELF-AGENCY, WAS CONDUCTED. SUBJECTS UNDERWENT BOTH SHAM AND ANODAL TDCS WITH A WASHOUT PERIOD OF 3 WEEKS. YOGA WAS USED AS A MODE OF EXERCISE, AS WELL AS IN CONJUNCTION WITH STIMULATION TO SUSTAIN POTENTIAL CHANGES IN NEURAL PLASTICITY. RESULTS: A TOTAL OF 5 SUBJECTS COMPLETED THE STUDY [MEAN AGE: 52 (SE: 4) Y, DISEASE DURATION: 5 (SE: 1.6) Y], UNDERGOING BOTH SHAM AND ANODAL TDCS. ANODAL TDCS DOES NOT APPEAR TO BE SUPERIOR TO SHAM TDCS IN ALLEVIATING SYMPTOMS AND DISABILITY, BUT COMBINING TDCS AND YOGA APPEARS TO LEAD TO MILD IMPROVEMENT NOTED ON CLINICAL OBSERVATION, BASED ON THE CHANGE IN THE EFFICACY INDEX OF CLINICAL GLOBAL IMPRESSION FOUND IN 4 SUBJECTS. CONCLUSION: OUR STUDY RESULTS SUGGEST THAT ANODAL TDCS IS NOT SUPERIOR TO SHAM TDCS IN ALLEVIATING SUBJECTIVE SYMPTOMS AND DISABILITY IN FMD. HOWEVER, INTERPRETATION OF THESE RESULTS IS LIMITED DUE TO THE SMALL NUMBER OF STIMULATION SESSIONS AND NUMBER OF SUBJECTS. FUTURE STUDIES USING MORE FREQUENT STIMULATION SESSIONS ARE NEEDED TO FURTHER DETERMINE WHETHER ANODAL TDCS MAY HAVE A THERAPEUTIC EFFECT IN THIS PATIENT GROUP COMPARED WITH SHAM TDCS. 2021 2 1898 30 RESTORATIVE YOGA AND METABOLIC RISK FACTORS: THE PRACTICING RESTORATIVE YOGA VS. STRETCHING FOR THE METABOLIC SYNDROME (PRYSMS) RANDOMIZED TRIAL. AIMS: INTENSIVE LIFESTYLE CHANGE PREVENTS TYPE 2 DIABETES BUT IS DIFFICULT TO SUSTAIN. PRELIMINARY EVIDENCE SUGGESTS THAT YOGA MAY IMPROVE METABOLIC FACTORS. WE TESTED A RESTORATIVE YOGA INTERVENTION VS. ACTIVE STRETCHING FOR METABOLIC OUTCOMES. METHODS: IN 2009-2012, WE CONDUCTED A 48-WEEK RANDOMIZED TRIAL COMPARING RESTORATIVE YOGA VS. STRETCHING AMONG UNDERACTIVE ADULTS WITH THE METABOLIC SYNDROME AT THE UNIVERSITIES OF CALIFORNIA, SAN FRANCISCO AND SAN DIEGO. WE PROVIDED LIFESTYLE COUNSELING AND A TAPERING SERIES OF 90-MIN GROUP CLASSES IN THE 24-WEEK INTERVENTION PERIOD AND 24-WEEK MAINTENANCE PERIOD. FASTING AND 2-H GLUCOSE, HBA1C, TRIGLYCERIDES, HDL-CHOLESTEROL, INSULIN, SYSTOLIC BLOOD PRESSURE, VISCERAL FAT, AND QUALITY OF LIFE WERE ASSESSED AT BASELINE, 6- AND 12-MONTHS. RESULTS: 180 PARTICIPANTS WERE RANDOMIZED AND 135 (75%) COMPLETED THE TRIAL. AT 12 MONTHS, FASTING GLUCOSE DECREASED MORE IN THE YOGA GROUP THAN IN THE STRETCHING GROUP (-0.35 MMOL/L VS. -0.03 MMOL/L; P=0.002); THERE WERE NO OTHER SIGNIFICANT DIFFERENCES BETWEEN GROUPS. AT 6 MONTHS FAVORABLE CHANGES WITHIN THE YOGA GROUP INCLUDED REDUCTIONS IN FASTING GLUCOSE, INSULIN, AND HBA1C AND AN INCREASE IN HDL-CHOLESTEROL THAT WERE NOT SUSTAINED AT 1 YEAR EXCEPT CHANGES IN FASTING GLUCOSE. THE STRETCHING GROUP HAD A SIGNIFICANT REDUCTION IN TRIGLYCERIDES AT 6 MONTHS WHICH WAS NOT SUSTAINED AT 1 YEAR BUT HAD IMPROVED QUALITY OF LIFE AT BOTH TIME-POINTS. CONCLUSIONS: RESTORATIVE YOGA WAS MARGINALLY BETTER THAN STRETCHING FOR IMPROVING FASTING GLUCOSE BUT NOT OTHER METABOLIC FACTORS. 2014 3 780 41 EFFECT OF YOGA AS AN ADD-ON THERAPY IN THE MODULATION OF HEART RATE VARIABILITY IN CHILDREN WITH DUCHENNE MUSCULAR DYSTROPHY. BACKGROUND: DUCHENE MUSCULAR DYSTROPHY (DMD) IS A PROGRESSIVE MUSCULAR DISORDER. CARDIAC DISORDER IS THE SECOND-MOST COMMON CAUSE OF DEATH IN CHILDREN WITH DMD, WITH 10%-20% OF THEM DYING OF CARDIAC FAILURE. HEART RATE VARIABILITY (HRV) IS SHOWN TO BE A PREDICTOR OF CARDIO-AUTONOMIC FUNCTION. PHYSIOTHERAPY (PT) IS ADVISED FOR THESE CHILDREN AS A REGULAR TREATMENT FOR MAINTAINING THEIR FUNCTIONAL STATUS. THE EFFECT OF YOGIC PRACTICES ON THE CARDIO-AUTONOMIC FUNCTIONS HAS BEEN DEMONSTRATED IN VARIOUS NEUROLOGICAL CONDITIONS AND MAY PROVE BENEFICIAL IN DMD. MATERIALS AND METHODS: IN THIS STUDY, 124 PATIENTS WITH DMD WERE RANDOMIZED TO PT ALONE OR PT WITH YOGA INTERVENTION. HOME-BASED PT AND YOGA WERE ADVISED. ADHERENCE WAS SERIALLY ASSESSED AT A FOLLOW-UP INTERVAL OF 3 MONTHS. ERROR-FREE, ELECTROCARDIOGRAM WAS RECORDED IN ALL PATIENTS AT REST IN THE SUPINE POSITION. HRV PARAMETERS WERE COMPUTED IN TIME AND FREQUENCY DOMAINS. HRV WAS RECORDED AT BASELINE AND AT AN INTERVAL OF 3 MONTHS UP TO 1 YEAR. REPEATED-MEASURES ANOVA WAS USED TO ANALYZE LONGITUDINAL FOLLOW-UP AND LEAST SIGNIFICANT DIFFERENCE FOR POST HOC ANALYSIS AND P < 0.05 WAS CONSIDERED STATISTICALLY SIGNIFICANT. RESULTS: IN OUR STUDY, WITH PT PROTOCOL, STANDARD DEVIATION OF NN, ROOT OF SQUARE MEAN OF SUCCESSIVE NN, TOTAL POWER, LOW FREQUENCY, HIGH-FREQUENCY NORMALIZED UNITS (HFNU), AND SYMPATHOVAGAL BALANCE IMPROVED AT VARYING TIME POINTS AND THE IMPROVEMENT LASTED UP FOR 6-9 MONTHS, WHEREAS PT AND YOGA PROTOCOL SHOWED AN IMPROVEMENT IN HFNU DURING THE LAST 3 MONTHS OF THE STUDY PERIOD AND ALL THE OTHER PARAMETERS WERE STABLE UP TO 1 YEAR. THUS, IT IS EVIDENT THAT BOTH THE GROUPS IMPROVED CARDIAC FUNCTIONS IN DMD. HOWEVER, NO SIGNIFICANT DIFFERENCE WAS NOTED IN THE CHANGES OBSERVED BETWEEN THE GROUPS. CONCLUSION: THE INTENSE PT AND PT WITH YOGA, PARTICULARLY HOME-BASED PROGRAM, IS INDEED BENEFICIAL AS A THERAPEUTIC STRATEGY IN DMD CHILDREN TO MAINTAIN AND/OR TO SUSTAIN HRV IN DMD. 2019 4 282 36 ADHERENCE TO YOGA AND EXERCISE INTERVENTIONS IN A 6-MONTH CLINICAL TRIAL. BACKGROUND: TO DETERMINE FACTORS THAT PREDICT ADHERENCE TO A MIND-BODY INTERVENTION IN A RANDOMIZED TRIAL. DESIGN: WE ANALYZED ADHERENCE DATA FROM A 3-ARM TRIAL INVOLVING 135 GENERALLY HEALTHY SENIORS 65-85 YEARS OF AGE RANDOMIZED TO A 6-MONTH INTERVENTION CONSISTING OF: AN IYENGAR YOGA CLASS WITH HOME PRACTICE, AN EXERCISE CLASS WITH HOME PRACTICE, OR A WAIT-LIST CONTROL GROUP. OUTCOME MEASURES INCLUDED COGNITIVE FUNCTION, MOOD, FATIGUE, ANXIETY, HEALTH-RELATED QUALITY OF LIFE, AND PHYSICAL MEASURES. ADHERENCE TO THE INTERVENTION WAS OBTAINED BY CLASS ATTENDANCE AND BIWEEKLY HOME PRACTICE LOGS. RESULTS: THE DROP-OUT RATE WAS 13%. AMONG THE COMPLETERS OF THE TWO ACTIVE INTERVENTIONS, AVERAGE YOGA CLASS ATTENDANCE WAS 77% AND HOME PRACTICE OCCURRED 64% OF ALL DAYS. AVERAGE EXERCISE CLASS ATTENDANCE WAS 69% AND HOME EXERCISE OCCURRED 54% OF ALL DAYS. THERE WERE NO CLEAR EFFECTS OF ADHERENCE ON THE SIGNIFICANT STUDY OUTCOMES (QUALITY OF LIFE AND PHYSICAL MEASURES). CLASS ATTENDANCE WAS SIGNIFICANTLY CORRELATED WITH BASELINE MEASURES OF DEPRESSION, FATIGUE, AND PHYSICAL COMPONENTS OF HEALTH-RELATED QUALITY OF LIFE. SIGNIFICANT DIFFERENCES IN BASELINE MEASURES WERE ALSO FOUND BETWEEN STUDY COMPLETERS AND DROP-OUTS IN THE ACTIVE INTERVENTIONS. ADHERENCE WAS NOT RELATED TO AGE, GENDER, OR EDUCATION LEVEL. CONCLUSION: HEALTHY SENIORS HAVE GOOD ATTENDANCE AT CLASSES WITH A PHYSICALLY ACTIVE INTERVENTION. HOME PRACTICE TAKES PLACE OVER HALF OF THE TIME. DECREASED ADHERENCE TO A POTENTIALLY BENEFICIAL INTERVENTION HAS THE POTENTIAL TO DECREASE THE EFFECT OF THE INTERVENTION IN A CLINICAL TRIAL BECAUSE SUBJECTS WHO MIGHT SUSTAIN THE GREATEST BENEFIT WILL RECEIVE A LOWER DOSE OF THE INTERVENTION AND SUBJECTS WITH HIGHER ADHERENCE RATES MAY BE FUNCTIONING CLOSER TO MAXIMUM ABILITY BEFORE THE INTERVENTION. STRATEGIES TO MAXIMIZE ADHERENCE AMONG SUBJECTS AT GREATER RISK FOR LOW ADHERENCE WILL BE IMPORTANT FOR FUTURE TRIALS, ESPECIALLY COMPLEMENTARY TREATMENTS REQUIRING GREATER EFFORT THAN SIMPLE PILL-TAKING. 2007 5 2397 35 YOGA AND COGNITION: A META-ANALYSIS OF CHRONIC AND ACUTE EFFECTS. OBJECTIVES: TO REVIEW AND SYNTHESIZE THE EXISTING LITERATURE ON THE EFFECTS OF YOGA ON COGNITIVE FUNCTION BY DETERMINING EFFECT SIZES THAT COULD SERVE AS A PLATFORM TO DESIGN, CALCULATE STATISTICAL POWER, AND IMPLEMENT FUTURE STUDIES. METHODS: THROUGH ELECTRONIC DATABASES, WE IDENTIFIED ACUTE STUDIES AND RANDOMIZED CONTROLLED TRIALS (RCTS) OF YOGA THAT REPORTED COGNITIVE OUTCOMES. INCLUSION CRITERIA INCLUDED THE FOLLOWING: USE OF AN OBJECTIVE MEASURE OF COGNITION AND SUFFICIENT DATA REPORTED TO ESTIMATE AN EFFECT SIZE. THE META-ANALYSIS WAS CONDUCTED USING COMPREHENSIVE META-ANALYSIS SOFTWARE. A RANDOM-EFFECTS MODEL WAS USED TO CALCULATE THE OVERALL WEIGHTED EFFECT SIZES, EXPRESSED AS HEDGE G. RESULTS: FIFTEEN RCTS AND 7 ACUTE EXPOSURE STUDIES EXAMINED THE EFFECTS OF YOGA ON COGNITION. A MODERATE EFFECT (G = 0.33, STANDARD ERROR = 0.08, 95% CONFIDENCE INTERVAL = 0.18-0.48, P < .001) OF YOGA ON COGNITION WAS OBSERVED FOR RCTS, WITH THE STRONGEST EFFECT FOR ATTENTION AND PROCESSING SPEED (G = 0.29, P < .001), FOLLOWED BY EXECUTIVE FUNCTION (G = 0.27, P = .001) AND MEMORY (G = 0.18, P = .051). ACUTE STUDIES SHOWED A STRONGER OVERALL EFFECT OF YOGA ON COGNITION (G = 0.56, STANDARD ERROR = 0.11, 95% CONFIDENCE INTERVAL = 0.33-0.78, P < .001). THE EFFECT WAS STRONGEST FOR MEMORY (G = 0.78, P < .001), FOLLOWED BY ATTENTION AND PROCESSING SPEED MEASURES (G = 0.49, P < .001) AND EXECUTIVE FUNCTIONS (G = 0.39, P < .003). CONCLUSIONS: YOGA PRACTICE SEEMS TO BE ASSOCIATED WITH MODERATE IMPROVEMENTS IN COGNITIVE FUNCTION. ALTHOUGH THE STUDIES ARE LIMITED BY SAMPLE SIZE, HETEROGENEOUS POPULATION CHARACTERISTICS, VARIED DOSES OF YOGA INTERVENTIONS, AND A MYRIAD OF COGNITIVE TESTS, THESE FINDINGS WARRANT RIGOROUS SYSTEMATIC RCTS AND WELL-DESIGNED COUNTERBALANCED ACUTE STUDIES TO COMPREHENSIVELY EXPLORE YOGA AS A MEANS TO IMPROVE OR SUSTAIN COGNITIVE ABILITIES ACROSS THE LIFE SPAN. 2015 6 2245 39 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 7 1822 36 PROTOCOL TO EVALUATE THE IMPACT OF YOGA SUPPLEMENTATION ON COGNITIVE FUNCTION IN SCHIZOPHRENIA: A RANDOMISED CONTROLLED TRIAL. BACKGROUND: SCHIZOPHRENIA (SZ) IS A CHRONIC ILLNESS THAT IS TREATED SYMPTOMATICALLY. COGNITIVE DYSFUNCTION IS A CORE FEATURE OF SZ THAT IS RELATIVELY INTRACTABLE TO PHARMACOTHERAPY. YOGA CAN IMPROVE COGNITIVE FUNCTION AMONG HEALTHY INDIVIDUALS. A RECENT OPEN TRIAL INDICATED SIGNIFICANT BENEFITS OF YOGA TRAINING (YT) IN CONJUNCTION WITH CONVENTIONAL PHARMACOTHERAPY AMONG PATIENTS WITH SZ. AIMS: TO DESCRIBE THE PROTOCOL FOR AN ONGOING RANDOMISED CONTROLLED TRIAL DESIGNED TO TEST WHETHER THE REPORTED BENEFICIAL EFFECTS OF YT ON COGNITIVE FUNCTION AMONG SZ PATIENTS CAN BE REPLICATED. SECONDARILY, THE EFFECTS OF YT ON DAILY FUNCTIONING LIVING SKILLS ARE EVALUATED. METHODS: CONSENTING PATIENTS WITH SZ RECEIVE ROUTINE CLINICAL TREATMENT AND ARE RANDOMISED TO ADJUNCTIVE YT, ADJUNCTIVE PHYSICAL EXERCISE (PE) OR TREATMENT AS USUAL (PROPOSED N = 234 TOTAL, N = 78 IN EACH GROUP). THE TRIAL INVOLVES YT OR PE 5 DAYS A WEEK AND LASTS 3 WEEKS. PARTICIPANTS ARE EVALUATED THRICE OVER 6 MONTHS. COGNITIVE FUNCTIONS MEASURED BY TRAIL MAKING TEST, UNIVERSITY OF PENNSYLVANIA NEUROCOGNITIVE COMPUTERISED BATTERY WERE PRIMARY OUTCOME MEASURES WHILE CLINICAL SEVERITY AND DAILY FUNCTIONING MEASURED BY INDEPENDENT LIVING SKILLS SURVEY WERE SECONDARY OUTCOME MEASURES. RESULTS: A TOTAL OF 309 PARTICIPANTS HAVE BEEN RANDOMISED AS OF 31 AUGUST 2013, WHICH EXCEEDED BEYOND 294 PROPOSED AFTER ATTRITION. ONCE PARTICIPANTS BEGIN YT OR PE THEY GENERALLY COMPLETE THE PROTOCOL. NO INJURIES HAVE BEEN REPORTED. CONCLUSIONS: SHORT TERM YT IS FEASIBLE AND ACCEPTABLE TO INDIAN SZ PATIENTS. IF BENEFICIAL EFFECTS OF YT ARE DETECTED, IT WILL PROVIDE A NOVEL ADJUNCTIVE COGNITIVE REMEDIATION STRATEGY FOR SZ PATIENTS. 2014 8 2441 36 YOGA AND SCHIZOPHRENIA-A COMPREHENSIVE ASSESSMENT OF NEUROPLASTICITY: PROTOCOL FOR A SINGLE BLIND RANDOMIZED CONTROLLED STUDY OF YOGA IN SCHIZOPHRENIA. INTRODUCTION: SCHIZOPHRENIA IS ONE OF THE MOST SEVERE MENTAL DISORDERS WITH A PREVALENCE OF ABOUT 1% AND A LEADING CAUSE OF DISABILITY AMONG YOUNG ADULTS. PHARMACOTHERAPY IS THE MAINSTAY IN THE MANAGEMENT OF SCHIZOPHRENIA. HOWEVER, EVEN WITH THE BEST OF MEDICATION, SEVERAL PROBLEMS LIKE REFRACTORINESS, NEGATIVE SYMPTOMS, FREQUENT RELAPSES, AND COGNITIVE IMPAIRMENTS PERSIST. METHODS: THIS IS A RANDOMIZED-CONTROLLED CLINICAL STUDY INCLUDING PATIENTS FROM AN URBAN TERTIARY HOSPITAL AND A SEMI-URBAN COMMUNITY CENTER, WITH A BETWEEN-GROUP, REPEATED-MEASURES, LONGITUDINAL DESIGN. THIS STUDY WILL RECRUIT 160 PATIENTS WITH DSM 5 DIAGNOSIS OF SCHIZOPHRENIA WHO ARE ON STABLE MEDICATION FOR A MINIMUM OF 6 WEEKS; THEY WILL BE RANDOMLY ASSIGNED INTO 2 ARMS VIZ., YOGA THERAPY (YT), AND TREATMENT-AS-USUAL (TAU) WITH 80 PATIENTS IN EACH ARM. PARTICIPANTS WILL UNDERGO CLINICAL, LABORATORY, AND RADIOLOGICAL ASSESSMENTS AT BASELINE AND AT INTERVALS OF 1 MONTH, 3 MONTHS, AND 6 MONTHS FROM THE BASELINE. IT IS HYPOTHESIZED THAT YOGA WILL IMPROVE PSYCHOPATHOLOGY AND EMOTION PROCESSING, INCREASE SERUM BRAIN DERIVED NEUROTROPHIC FACTOR (BDNF) AND PLASMA OXYTOCIN LEVELS AND EFFECT CHANGES IN CEREBRAL ACTIVATION IN AREAS OF THE BRAIN ASSOCIATED WITH SCHIZOPHRENIA. DISCUSSION: THIS STUDY AIMS TO MEASURE THE EFFICACY OF A YOGA-BASED INTERVENTION AS AN ADJUNCT IN PATIENTS WITH SCHIZOPHRENIA AS WELL AS THE MECHANISMS OF THESE EFFECTS. TRIAL REGISTRATION: REGISTERED RETROSPECTIVELY WITH CLINICAL TRIAL REGISTRY - INDIA (CTRI) WITH REGISTRATION NUMBER CTRI/2017/08/009219. 2019 9 2732 32 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 10 2831 32 YOGA VS. PHYSICAL THERAPY VS. EDUCATION FOR CHRONIC LOW BACK PAIN IN PREDOMINANTLY MINORITY POPULATIONS: STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN CAUSES SUBSTANTIAL MORBIDITY AND COST TO SOCIETY WHILE DISPROPORTIONATELY IMPACTING LOW-INCOME AND MINORITY ADULTS. SEVERAL RANDOMIZED CONTROLLED TRIALS SHOW YOGA IS AN EFFECTIVE TREATMENT. HOWEVER, THE COMPARATIVE EFFECTIVENESS OF YOGA AND PHYSICAL THERAPY, A COMMON MAINSTREAM TREATMENT FOR CHRONIC LOW BACK PAIN, IS UNKNOWN. METHODS/DESIGN: THIS IS A RANDOMIZED CONTROLLED TRIAL FOR 320 PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH CHRONIC LOW BACK PAIN, COMPARING YOGA, PHYSICAL THERAPY, AND EDUCATION. INCLUSION CRITERIA ARE ADULTS 18-64 YEARS OLD WITH NON-SPECIFIC LOW BACK PAIN LASTING >/= 12 WEEKS AND A SELF-REPORTED AVERAGE PAIN INTENSITY OF >/= 4 ON A 0-10 SCALE. RECRUITMENT TAKES PLACE AT BOSTON MEDICAL CENTER, AN URBAN ACADEMIC SAFETY-NET HOSPITAL AND SEVEN FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS LOCATED IN DIVERSE NEIGHBORHOODS. THE 52-WEEK STUDY HAS AN INITIAL 12-WEEK TREATMENT PHASE WHERE PARTICIPANTS ARE RANDOMIZED IN A 2:2:1 RATIO INTO I) A STANDARDIZED WEEKLY HATHA YOGA CLASS SUPPLEMENTED BY HOME PRACTICE; II) A STANDARDIZED EVIDENCE-BASED EXERCISE THERAPY PROTOCOL ADAPTED FROM THE TREATMENT BASED CLASSIFICATION METHOD, INDIVIDUALLY DELIVERED BY A PHYSICAL THERAPIST AND SUPPLEMENTED BY HOME PRACTICE; AND III) EDUCATION DELIVERED THROUGH A SELF-CARE BOOK. CO-PRIMARY OUTCOME MEASURES ARE 12-WEEK PAIN INTENSITY MEASURED ON AN 11-POINT NUMERICAL RATING SCALE AND BACK-SPECIFIC FUNCTION MEASURED USING THE MODIFIED ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 40-WEEK MAINTENANCE PHASE, YOGA PARTICIPANTS ARE RE-RANDOMIZED IN A 1:1 RATIO TO EITHER STRUCTURED MAINTENANCE YOGA CLASSES OR HOME PRACTICE ONLY. PHYSICAL THERAPY PARTICIPANTS ARE SIMILARLY RE-RANDOMIZED TO EITHER FIVE BOOSTER SESSIONS OR HOME PRACTICE ONLY. EDUCATION PARTICIPANTS CONTINUE TO FOLLOW RECOMMENDATIONS OF EDUCATIONAL MATERIALS. WE WILL ALSO ASSESS COST EFFECTIVENESS FROM THE PERSPECTIVES OF THE INDIVIDUAL, INSURERS, AND SOCIETY USING CLAIMS DATABASES, ELECTRONIC MEDICAL RECORDS, SELF-REPORT COST DATA, AND STUDY RECORDS. QUALITATIVE DATA FROM INTERVIEWS WILL ADD SUBJECTIVE DETAIL TO COMPLEMENT QUANTITATIVE DATA. TRIAL REGISTRATION: THIS TRIAL IS REGISTERED IN CLINICALTRIALS.GOV, WITH THE ID NUMBER: NCT01343927. 2014 11 2543 61 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 12 2638 36 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 13 2858 29 YOGA-BASED CARDIAC REHABILITATION: CURRENT PERSPECTIVES FROM RANDOMIZED CONTROLLED TRIALS IN CORONARY ARTERY DISEASE. CORONARY ARTERY DISEASE CARRIES A HIGH MORBIDITY AND MORTALITY WORLDWIDE, AND EXERCISE-BASED CARDIAC REHABILITATION PROGRAMMES PLAY A LARGE ROLE IN SECONDARY PREVENTION. EXERCISE-BASED REHABILITATION PROGRAMMES ARE EXPENSIVE, AND IN CERTAIN SUBGROUPS UPTAKE IS POOR. YOGA HAS BEEN SUGGESTED TO SHOW IMPROVEMENTS IN CARDIOVASCULAR HEALTH WHICH WOULD SUPPORT ITS USE IN CARDIAC REHABILITATION PROGRAMMES. WE CARRIED OUT A REVIEW OF CURRENT RANDOMIZED CONTROLLED TRIALS TO DETERMINE IF YOGA-BASED CARDIAC REHABILITATION LEADS TO REDUCED CARDIAC RISK FACTORS, AND IMPROVED PHYSIOLOGICAL AND PSYCHOLOGICAL OUTCOMES IN PATIENTS WITH CORONARY ARTERY DISEASE COMPARED TO STANDARD CARE. SIX RANDOMIZED CONTROLLED STUDIES WERE IDENTIFIED AFTER A MEDICAL DATABASE SEARCH, AND META-ANALYSIS WAS CARRIED OUT FOR THE DIFFERENT OUTCOMES. OVERALL, THE ADDITION OF YOGA TO STANDARD CARE RESULTED IN IMPROVED SUBJECTIVE FEELING OF CARDIAC HEALTH AND QUALITY OF LIFE. THERE WAS ALSO A TREND TOWARDS IMPROVEMENT IN LEFT VENTRICULAR SYSTOLIC FUNCTION. IMPROVEMENT IN CARDIAC RISK FACTORS, MACE AND PSYCHOLOGICAL HEALTH IN THIS COHORT HAS STILL TO BE PROVEN, BUT WAS NOT INFERIOR TO STANDARD OR ENHANCED CARE, AND THE BENEFITS BECAME MORE PRONOUNCED AT LONGER FOLLOW-UP. FUTURE STUDIES WITH LONGER FOLLOW-UP AND LARGER PATIENT NUMBERS WOULD AID IN ACCURATELY ASSESSING THE LONG-TERM BENEFIT OF YOGA-BASED REHABILITATION. 2021 14 1927 26 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 15 2850 39 YOGA, MINDFULNESS-BASED STRESS REDUCTION AND STRESS-RELATED PHYSIOLOGICAL MEASURES: A META-ANALYSIS. BACKGROUND AND OBJECTIVES: PRACTICES THAT INCLUDE YOGA ASANAS AND MINDFULNESS-BASED STRESS REDUCTION FOR THE MANAGEMENT OF STRESS ARE INCREASINGLY POPULAR; HOWEVER, THE NEUROBIOLOGICAL EFFECTS OF THESE PRACTICES ON STRESS REACTIVITY ARE NOT WELL UNDERSTOOD. MANY STUDIES INVESTIGATING THE EFFECTS OF SUCH PRACTICES FAIL TO INCLUDE AN ACTIVE CONTROL GROUP. GIVEN THE FREQUENCY WITH WHICH PEOPLE ARE SELECTING SUCH INTERVENTIONS AS A FORM OF SELF-MANAGEMENT, IT IS IMPORTANT TO DETERMINE THEIR EFFECTIVENESS. THUS, THIS REVIEW INVESTIGATES THE EFFECTS OF PRACTICES THAT INCLUDE YOGA ASANAS, WITH AND WITHOUT MINDFULNESS-BASED STRESS REDUCTION, COMPARED TO AN ACTIVE CONTROL, ON PHYSIOLOGICAL MARKERS OF STRESS. MATERIALS AND METHODS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMISED CONTROLLED TRIALS PUBLISHED IN ENGLISH COMPARED PRACTICES THAT INCLUDED YOGA ASANAS, WITH AND WITHOUT MINDFULNESS-BASED STRESS REDUCTION, TO AN ACTIVE CONTROL, ON STRESS-RELATED PHYSIOLOGICAL MEASURES. THE REVIEW FOCUSED ON STUDIES THAT MEASURED PHYSIOLOGICAL PARAMETERS SUCH AS BLOOD PRESSURE, HEART RATE, CORTISOL AND PERIPHERAL CYTOKINE EXPRESSION. MEDLINE, AMED, CINAHL, PSYCINFO, SOCINDEX, PUBMED, AND SCOPUS WERE SEARCHED IN MAY 2016 AND UPDATED IN DECEMBER 2016. RANDOMISED CONTROLLED TRIALS WERE INCLUDED IF THEY ASSESSED AT LEAST ONE OF THE FOLLOWING OUTCOMES: HEART RATE, BLOOD PRESSURE, HEART RATE VARIABILITY, MEAN ARTERIAL PRESSURE, C-REACTIVE PROTEIN, INTERLEUKINS OR CORTISOL. RISK OF BIAS ASSESSMENTS INCLUDED SEQUENCE GENERATION, ALLOCATION CONCEALMENT, BLINDING OF ASSESSORS, INCOMPLETE OUTCOME DATA, SELECTIVE OUTCOME REPORTING AND OTHER SOURCES OF BIAS. META-ANALYSIS WAS UNDERTAKEN USING COMPREHENSIVE META-ANALYSIS SOFTWARE VERSION 3. SENSITIVITY ANALYSES WERE PERFORMED USING 'ONE-STUDY-REMOVED' ANALYSIS. SUBGROUP ANALYSIS WAS CONDUCTED FOR DIFFERENT YOGA AND CONTROL GROUP TYPES, INCLUDING MINDFULNESS-BASED STRESS REDUCTION VERSUS NON-MINDFULNESS-BASED STRESS REDUCTION BASED INTERVENTIONS, DIFFERENT POPULATIONS, LENGTH OF INTERVENTION, AND METHOD OF DATA ANALYSIS. A RANDOM-EFFECTS MODEL WAS USED IN ALL ANALYSES. RESULTS: FORTY TWO STUDIES WERE INCLUDED IN THE META-ANALYSIS. INTERVENTIONS THAT INCLUDED YOGA ASANAS WERE ASSOCIATED WITH REDUCED EVENING CORTISOL, WAKING CORTISOL, AMBULATORY SYSTOLIC BLOOD PRESSURE, RESTING HEART RATE, HIGH FREQUENCY HEART RATE VARIABILITY, FASTING BLOOD GLUCOSE, CHOLESTEROL AND LOW DENSITY LIPOPROTEIN, COMPARED TO ACTIVE CONTROL. HOWEVER, THE REPORTED INTERVENTIONS WERE HETEROGENEOUS. CONCLUSIONS: PRACTICES THAT INCLUDE YOGA ASANAS APPEAR TO BE ASSOCIATED WITH IMPROVED REGULATION OF THE SYMPATHETIC NERVOUS SYSTEM AND HYPOTHALAMIC-PITUITARY-ADRENAL SYSTEM IN VARIOUS POPULATIONS. 2017 16 1339 33 HOW DOES YOGA WORK ON PAIN DIMENSIONS? AN INTEGRATED PERSPECTIVE IN 2 INDIVIDUALS WITH FIBROMYALGIA. CONTEXT: THE EFFECTIVENESS OF YOGA HAS BEEN STUDIED IN FIBROMYALGIA (FM) USING IMPROVEMENT IN ITS 5 KEY DIMENSIONS-PAIN, QUALITY OF LIFE, SLEEP, DEPRESSION, AND DISABILITY-AS OUTCOME MEASURES. STUDIES HAVE DEMONSTRATED AN IMPROVEMENT IN THE PSYCHOSOCIAL DIMENSIONS OF PAIN AFTER YOGA PRACTICE, BUT THESE FINDINGS FAILED TO REACH STATISTICAL SIGNIFICANCE. ALTHOUGH STUDIES HAVE SHOWN THE EFFICACY OF YOGA IN THE MODULATION OF PAIN, NO STUDY HAS YET INVESTIGATED HOW IT ACTS ON EACH DIMENSION OF PAIN. OBJECTIVE: THE STUDY INTENDED TO INVESTIGATE THE DIMENSIONS OF PAIN-SENSORY, EVALUATIVE, AND/OR AFFECTIVE-AND WHICH PSYCHOLOGICAL COMORBIDITIES-ANXIETY AND/OR DEPRESSION-THAT HATHA YOGA AFFECTS IN INDIVIDUALS WITH FM. DESIGN: THE RESEARCH TEAM PERFORMED 2 CASE STUDIES. SETTING: THE STUDY OCCURRED AT THE GIFT INSTITUTE OF INTEGRATIVE MEDICINE (PISA, ITALY). PARTICIPANTS: PARTICIPANTS WERE 2 PATIENTS AT THE INSTITUTE WHO HAD FM. INTERVENTION: AT BASELINE (T0), PARTICIPANTS WERE PRESCRIBED 8 MO OF PHARMACOLOGICAL TREATMENT. AT 2 MO AFTER BASELINE (T1), THEY PARTICIPATED IN AN 8-H, MIND-BODY, PSYCHOEDUCATIONAL COURSE (PEC) FOR SELF-MANAGEMENT OF CHRONIC PAIN. EACH PARTICIPANT WAS CONTACTED BY PHONE EVERY WEEK FOR 2 MO AFTER THE PEC (IE, UNTIL 4 MO FROM BASELINE (T2). FOR THE NEXT 2 MO, PARTICIPANTS HAD NO CONTACT WITH A HEALTH CARE PRACTITIONER, TO SUSTAIN A DEEPER PEC PROGRAM. PARTICIPANTS THEN TOOK A 2-MO HATHA YOGA PROGRAM FROM MONTHS 6 (T3) TO 8 (T4). OUTCOME MEASURES: SENSORIAL, AFFECTIVE, AND EVALUATIVE DIMENSIONS OF PAIN WERE INVESTIGATED USING THE ITALIAN PAIN QUESTIONNAIRE, AND DEPRESSION AND ANXIETY WERE INVESTIGATED USING THE HOSPITAL ANXIETY DEPRESSION AT T0, T1, T2, T3, AND T4. THE IPQ WAS ADMINISTERED WEEKLY, BEFORE AND AFTER EACH YOGA SESSION. RESULTS: HATHA YOGA PROVED TO BE AN EFFECTIVE MEANS OF RELIEVING PAIN IN FM. IN PARTICULAR, A MEASURABLE IMPROVEMENT IN SCORES OCCURRED FOR THE AFFECTIVE DIMENSION OF PAIN AFTER ONLY 4 YOGA SESSIONS; THIS EFFECT REMAINED STABLE THROUGHOUT THE REMAINDER OF THE PROGRAM. CONCLUSIONS: MONITORING THE AFFECTIVE DIMENSION OF PAIN SHOULD BE INCLUDED IN AN INTEGRATED APPROACH TO PAIN, AND HATHA YOGA MAY BE BENEFICIAL IN THE PAIN MANAGEMENT OF FM PARTICIPANTS. 2018 17 1044 33 EFFECTS OF YOGA INTERVENTIONS ON PAIN AND PAIN-ASSOCIATED DISABILITY: A META-ANALYSIS. UNLABELLED: WE SEARCHED DATABASES FOR CONTROLLED CLINICAL STUDIES, AND PERFORMED A META-ANALYSIS ON THE EFFECTIVENESS OF YOGA INTERVENTIONS ON PAIN AND ASSOCIATED DISABILITY. FIVE RANDOMIZED STUDIES REPORTED SINGLE-BLINDING AND HAD A HIGHER METHODOLOGICAL QUALITY; 7 STUDIES WERE RANDOMIZED BUT NOT BLINDED AND HAD MODERATE QUALITY; AND 4 NONRANDOMIZED STUDIES HAD LOW QUALITY. IN 6 STUDIES, YOGA WAS USED TO TREAT PATIENTS WITH BACK PAIN; IN 2 STUDIES TO TREAT RHEUMATOID ARTHRITIS; IN 2 STUDIES TO TREAT PATIENTS WITH HEADACHE/MIGRAINE; AND 6 STUDIES ENROLLED INDIVIDUALS FOR OTHER INDICATIONS. ALL STUDIES REPORTED POSITIVE EFFECTS IN FAVOR OF THE YOGA INTERVENTIONS. WITH RESPECT TO PAIN, A RANDOM EFFECT META-ANALYSIS ESTIMATED THE OVERALL TREATMENT EFFECT AT SMD = -.74 (CI: -.97; -.52, P < .0001), AND AN OVERALL TREATMENT EFFECT AT SMD = -.79 (CI: -1.02; -.56, P < .0001) FOR PAIN-RELATED DISABILITY. DESPITE SOME LIMITATIONS, THERE IS EVIDENCE THAT YOGA MAY BE USEFUL FOR SEVERAL PAIN-ASSOCIATED DISORDERS. MOREOVER, THERE ARE HINTS THAT EVEN SHORT-TERM INTERVENTIONS MIGHT BE EFFECTIVE. NEVERTHELESS, LARGE-SCALE FURTHER STUDIES HAVE TO IDENTIFY WHICH PATIENTS MAY BENEFIT FROM THE RESPECTIVE INTERVENTIONS. PERSPECTIVE: THIS META-ANALYSIS SUGGESTS THAT YOGA IS A USEFUL SUPPLEMENTARY APPROACH WITH MODERATE EFFECT SIZES ON PAIN AND ASSOCIATED DISABILITY. 2012 18 176 38 A RANDOMIZED CONTROLLED TRIAL OF KUNDALINI YOGA IN MILD COGNITIVE IMPAIRMENT. BACKGROUND: GLOBAL POPULATION AGING WILL RESULT IN INCREASING RATES OF COGNITIVE DECLINE AND DEMENTIA. THUS, EFFECTIVE, LOW-COST, AND LOW SIDE-EFFECT INTERVENTIONS FOR THE TREATMENT AND PREVENTION OF COGNITIVE DECLINE ARE URGENTLY NEEDED. OUR STUDY IS THE FIRST TO INVESTIGATE THE EFFECTS OF KUNDALINI YOGA (KY) TRAINING ON MILD COGNITIVE IMPAIRMENT (MCI). METHODS: OLDER PARTICIPANTS (>/=55 YEARS OF AGE) WITH MCI WERE RANDOMIZED TO EITHER A 12-WEEK KY INTERVENTION OR MEMORY ENHANCEMENT TRAINING (MET; GOLD-STANDARD, ACTIVE CONTROL). COGNITIVE (I.E. MEMORY AND EXECUTIVE FUNCTIONING) AND MOOD (I.E. DEPRESSION, APATHY, AND RESILIENCE) ASSESSMENTS WERE ADMINISTERED AT BASELINE, 12 WEEKS AND 24 WEEKS. RESULTS: AT BASELINE, 81 PARTICIPANTS HAD NO SIGNIFICANT BASELINE GROUP DIFFERENCES IN CLINICAL OR DEMOGRAPHIC CHARACTERISTICS. AT 12 WEEKS AND 24 WEEKS, BOTH KY AND MET GROUPS SHOWED SIGNIFICANT IMPROVEMENT IN MEMORY; HOWEVER, ONLY KY SHOWED SIGNIFICANT IMPROVEMENT IN EXECUTIVE FUNCTIONING. ONLY THE KY GROUP SHOWED SIGNIFICANT IMPROVEMENT IN DEPRESSIVE SYMPTOMS AND RESILIENCE AT WEEK 12. CONCLUSION: KY GROUP SHOWED SHORT- AND LONG-TERM IMPROVEMENTS IN EXECUTIVE FUNCTIONING AS COMPARED TO MET, AND BROADER EFFECTS ON DEPRESSED MOOD AND RESILIENCE. THIS OBSERVATION SHOULD BE CONFIRMED IN FUTURE CLINICAL TRIALS OF YOGA INTERVENTION FOR TREATMENT AND PREVENTION OF COGNITIVE DECLINE (NCT01983930). 2017 19 2496 32 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 20 743 37 EFFECT OF RESTORATIVE YOGA VS. STRETCHING ON DIURNAL CORTISOL DYNAMICS AND PSYCHOSOCIAL OUTCOMES IN INDIVIDUALS WITH THE METABOLIC SYNDROME: THE PRYSMS RANDOMIZED CONTROLLED TRIAL. PURPOSE: CHRONIC STIMULATION AND DYSREGULATION OF THE NEUROENDOCRINE SYSTEM BY STRESS MAY CAUSE METABOLIC ABNORMALITIES. WE ESTIMATED HOW MUCH CORTISOL AND PSYCHOSOCIAL OUTCOMES IMPROVED WITH A RESTORATIVE YOGA (RELAXATION) VERSUS A LOW IMPACT STRETCHING INTERVENTION FOR INDIVIDUALS WITH THE METABOLIC SYNDROME. METHODS: WE CONDUCTED A 1-YEAR MULTI-CENTER RANDOMIZED CONTROLLED TRIAL (6-MONTH INTERVENTION AND 6-MONTH MAINTENANCE PHASE) OF RESTORATIVE YOGA VS. STRETCHING. PARTICIPANTS COMPLETED SURVEYS TO ASSESS DEPRESSION, SOCIAL SUPPORT, POSITIVE AFFECT, AND STRESS AT BASELINE, 6 MONTHS AND 12 MONTHS. FOR EACH ASSESSMENT, WE COLLECTED SALIVA AT FOUR POINTS DAILY FOR THREE DAYS AND COLLECTED RESPONSE TO DEXAMETHASONE ON THE FOURTH DAY FOR ANALYSIS OF DIURNAL CORTISOL DYNAMICS. WE ANALYZED OUR DATA USING MULTIVARIATE REGRESSION MODELS, CONTROLLING FOR STUDY SITE, MEDICATIONS (ANTIDEPRESSANTS, HORMONE THERAPY), BODY MASS INDEX, AND BASELINE CORTISOL VALUES. RESULTS: PSYCHOSOCIAL OUTCOME MEASURES WERE AVAILABLE FOR 171 STUDY PARTICIPANTS AT BASELINE, 140 AT 6 MONTHS, AND 132 AT 1 YEAR. COMPLETE CORTISOL DATA WERE AVAILABLE FOR 136 OF 171 STUDY PARTICIPANTS (72 IN RESTORATIVE YOGA AND 64 IN STRETCHING) AND WERE ONLY AVAILABLE AT BASELINE AND 6 MONTHS. AT 6 MONTHS, THE STRETCHING GROUP HAD DECREASED CORTISOL AT WAKING AND BEDTIME COMPARED TO THE RESTORATIVE YOGA GROUP. THE PATTERN OF CHANGES IN STRESS MIRRORED THIS IMPROVEMENT, WITH THE STRETCHING GROUP SHOWING REDUCTIONS IN CHRONIC STRESS SEVERITY AND PERSEVERATIVE THOUGHTS ABOUT THEIR STRESS. PERCEIVED STRESS DECREASED BY 1.5 POINTS (-0.4; 3.3, P=0.11) AT 6 MONTHS, AND BY 2.0 POINTS (0.1; 3.9, P=0.04) AT 1 YEAR IN THE STRETCHING COMPARED TO RESTORATIVE YOGA GROUPS. POST HOC ANALYSES SUGGEST THAT IN THE STRETCHING GROUP ONLY, PERCEIVED INCREASES IN SOCIAL SUPPORT (PARTICULARLY FEELINGS OF BELONGING), BUT NOT CHANGES IN STRESS WERE RELATED TO IMPROVED CORTISOL DYNAMICS. CONCLUSIONS: WE FOUND SIGNIFICANT DECREASES IN SALIVARY CORTISOL, CHRONIC STRESS SEVERITY, AND STRESS PERCEPTION IN THE STRETCHING GROUP COMPARED TO THE RESTORATIVE YOGA GROUP. GROUP SUPPORT DURING THE INTERACTIVE STRETCH CLASSES MAY HAVE CONTRIBUTED TO THESE CHANGES. 2014