1 370 143 AUTONOMIC TONE AND BAROREFLEX SENSITIVITY DURING 70 DEGREES HEAD-UP TILT IN YOGA PRACTITIONERS. INTRODUCTION: THE INTERVENTION OF YOGA WAS SHOWN TO IMPROVE THE AUTONOMIC CONDITIONING IN HUMANS EVIDENT FROM THE ENHANCEMENT OF PARASYMPATHETIC ACTIVITY AND BAROREFLEX SENSITIVITY (BRS). FROM THE DOCUMENTED HEALTH BENEFITS OF YOGA, WE HYPOTHESIZED THAT THE EXPERIENCE OF YOGA MAY RESULT IN ADAPTATION TO THE ORTHOSTATIC STRESS DUE TO ENHANCED BRS. AIM: TO DECIPHER THE EFFECTS OF YOGA IN THE MODULATION OF AUTONOMIC FUNCTION DURING ORTHOSTATIC CHALLENGE. MATERIALS AND METHODS: THIS WAS A COMPARATIVE STUDY DESIGN CONDUCTED IN AUTONOMIC FUNCTION TEST LAB, OF THE DEPARTMENT OF PHYSIOLOGY, ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI, INDIA. HEART RATE VARIABILITY (HRV), BLOOD PRESSURE VARIABILITY, AND BRS WERE ANALYZED ON FORTY NAIVE TO YOGA (NY) SUBJECTS AND FORTY YOGA PRACTITIONERS WITH AN AVERAGE AGE OF 31.08 +/- 7.31 YEARS AND 29.93 +/- 7.57 YEARS, RESPECTIVELY. ALL PARTICIPANTS WERE HEALTHY. SEVENTY DEGREES HEAD UP TILT (HUT) WAS USED AS AN INTERVENTION TO EVALUATE THE CARDIOVASCULAR VARIABILITY DURING ORTHOSTATIC CHALLENGE. RESULTS: DURING HUT, THE R-R INTERVAL (P = 0.042), ROOT MEAN SQUARE OF SUCCESIVE R-R INTERVAL DIFFERENCES (RMSSD) (P = 0.039), STANDARD DEVIATION OF INSTANTANEOUS BEAT-TO-BEAT R-R INTERVAL VARIABILITY (SD1) (P = 0.039) OF HRV, AND SEQUENCE BRS (P = 0.017) AND ALPHA LOW FREQUENCY OF SPECTRAL BRS (P = 0.002) WERE HIGHER IN THE YOGA GROUP. THE DELTA DECREASE IN RRI (P = 0.033) AND BRS (P < 0.01) WAS HIGHER IN THE YOGA GROUP THAN THE NY GROUP. CONCLUSION: THE EFFERENT VAGAL ACTIVITY AND BRS WERE HIGHER IN YOGA PRACTITIONERS. THE DELTA CHANGE (DECREASE) IN PARASYMPATHETIC ACTIVITY AND BRS WAS HIGHER, WITH RELATIVELY STABLE SYSTOLIC BLOOD PRESSURE INDICATING AN ADAPTIVE RESPONSE TO ORTHOSTATIC CHALLENGE BY THE YOGA PRACTITIONERS COMPARED TO THE NY GROUP. 2020 2 190 35 A RANDOMIZED STUDY OF YOGA THERAPY FOR THE PREVENTION OF RECURRENT REFLEX VASOVAGAL SYNCOPE. AIMS: VASOVAGAL SYNCOPE (VVS) IS A COMMON CARDIOVASCULAR DYSAUTONOMIC DISORDER THAT SIGNIFICANTLY IMPACTS HEALTH AND QUALITY OF LIFE (QOL). YOGA HAS BEEN SHOWN TO HAVE A POSITIVE INFLUENCE ON CARDIOVASCULAR AUTONOMICS. THIS STUDY ASSESSED THE EFFECTIVENESS OF YOGA THERAPY ON THE RECURRENCE OF VVS AND QOL. METHODS AND RESULTS: WE RANDOMIZED SUBJECTS WITH RECURRENT REFLEX VVS (>3 EPISODES IN THE PAST 1 YEAR) AND POSITIVE HEAD-UP TILT TEST TO GUIDELINE-DIRECTED THERAPY (GROUP 1) OR YOGA THERAPY (GROUP 2). PATIENTS IN GROUP 1 WERE ADVISED GUIDELINE-DIRECTED TREATMENT AND GROUP 2 WAS TAUGHT YOGA BY A CERTIFIED INSTRUCTOR. THE PRIMARY ENDPOINT WAS VVS RECURRENCES AND QOL. BETWEEN JUNE 2015 AND FEBRUARY 2017, 97 HIGHLY SYMPTOMATIC VVS PATIENTS WERE RANDOMIZED (GROUP 1: 47 AND GROUP 2: 50). THE MEAN AGE WAS 33.1 +/- 16.6 YEARS, MALE:FEMALE OF 40:57, SYMPTOM DURATION OF 17.1 +/- 20.7 MONTHS, WITH A MEAN OF 6.4 +/- 6.1 SYNCOPE EPISODES. OVER A FOLLOW-UP OF 14.3 +/- 2.1 MONTHS GROUP 2 HAD SIGNIFICANTLY LOWER SYNCOPE BURDEN COMPARED WITH GROUP 1 AT 3 (0.8 +/- 0.9 VS. 1.8 +/- 1.4, P < 0.001), 6 (1.0 +/- 1.2 VS. 3.4 +/- 3.0, P < 0.001), AND AT 12 MONTHS (1.1 +/- 0.8 VS. 3.8 +/- 3.2, P < 0.001). THE SYNCOPE FUNCTIONAL SCORE QUESTIONNAIRE WAS SIGNIFICANTLY LOWER IN GROUP 2 COMPARED WITH GROUP 1 AT 3 (31.4 +/- 7.2 VS. 64.1 +/- 11.5, P < 0.001), 6 (26.4 +/- 6.3 VS. 61.4 +/- 10.7, P < 0.001), AND 12 MONTHS (22.2 +/- 4.7 VS. 68.3 +/- 11.4, P < 0.001). CONCLUSION: FOR PATIENTS WITH RECURRENT VVS, GUIDED YOGA THERAPY IS SUPERIOR TO CONVENTIONAL THERAPY IN REDUCING SYMPTOM BURDEN AND IMPROVING QOL. 2021 3 2065 100 THE CARDIOVASCULAR VARIABILITY DURING TRANSIENT 6 DEGREES HEAD DOWN TILT AND SLOW BREATHING IN YOGA EXPERIENCED HEALTHY INDIVIDUALS. OBJECTIVE: THE INTERVENTION OF YOGA HAS BEEN SHOWN TO IMPROVE AUTONOMIC CONDITIONING IN HUMANS AND BETTER ADAPTABILITY TO ORTHOSTATIC CHALLENGES. SIMILARLY, SLOW BREATHING AT 0.1 HZ AKIN TO PRANAYAMA ALSO INCREASES BAROREFLEX SENSITIVITY (BRS). HENCE, WE INTENDED TO INVESTIGATE WHETHER YOGA PRACTITIONERS HAVE DIFFERENT AUTONOMIC RESPONSES AT REST,DURING SLOW DEEP BREATHINGAS WELL AS DURING 6 DEGREES HEAD DOWN TILT (HDT) COMPARED TO NAIVE GROUP INDIVIDUALS. AIM: THE AIM OF THE STUDY WAS TO EVALUATE THE ACUTE EFFECTS OF SLOW BREATHING ON CARDIOVASCULAR VARIABILITY DURING HDT IN YOGA PRACTITIONERS COMPARED TO YOGA-NAIVE INDIVIDUALS. SETTINGS AND DESIGN: THIS WAS A COMPARATIVE STUDY WITH REPEATED MEASURES DESIGN CONDUCTED IN AUTONOMIC FUNCTION TEST LAB OF THE DEPARTMENT OF PHYSIOLOGY, ALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI, INDIA. MATERIALS AND METHODS: TIME DOMAIN AND FREQUENCY DOMAIN PARAMETERS OF HEART RATE VARIABILITY, BLOOD PRESSURE VARIABILITY (BPV), AND BRS WERE EVALUATED DURING 6 DEGREES HDT AND SLOW BREATHING AT 0.1 HZ ON FORTY YOGA-NAIVE INDIVIDUALS AND FORTY YOGA PRACTITIONERS WITH AN AVERAGE AGE OF 31.08 +/- 7.31 YEARS AND 29.93 +/- 7.57 YEARS, RESPECTIVELY. ALL OF THE PARTICIPANTS WERE HEALTHY. STATISTICAL ANALYSIS USED: GENERAL LINEAR MIXED MODEL ANOVA WAS APPLIED WITH YOGA EXPERIENCE AS A BETWEEN-GROUP FACTOR IN REPEATED MEASURES. INDEPENDENT SAMPLE T-TEST WAS APPLIED FOR BETWEEN GROUP COMPARISON OF RESPIRATORY RATE, DEMOGRAPHIC, AND ANTHROPOMETRIC DATA. P <0.05 IS CONSIDERED STATISTICALLY SIGNIFICANT. RESULTS: BETWEEN-GROUP COMPARISON DURING HDT WITH SPONTANEOUS BREATHING HAS SHOWN A SIGNIFICANTLY LOWER HEART RATE (P = 0.004) WITH HIGHER RR INTERVAL (RRI) (P = 0.002) AND PNN50% (P = 0.019) IN YOGA PRACTITIONERS. THE SEQUENCE BRS (P < 0.0001) AND ALPHA LOW FREQUENCY (LF) OF SPECTRAL BRS (P = 0.035) WERE ALSO SIGNIFICANTLY HIGHER IN THE YOGA GROUP COMPARED TO THE NAIVE GROUP. SIMILARLY, DURING HDT WITH SLOW BREATHING, THE HEART RATE WAS LOWER (P = 0.01); WITH HIGHER RRI (P = 0.009); PNN50% (P = 0.048). STANDARD DEVIATION OF SUCCESSIVE RR INTERVAL DIFFERENCE OF SYSTOLIC BPV WAS LOWER (P = 0.024) WITH HIGHER SEQUENCE BRS (P = 0.001) AND ALPHA LF OF SPECTRAL BRS (P = 0.002) IN YOGA GROUP THAN NAIVE GROUP. CONCLUSION: THE YOGA EXPERIENCED INDIVIDUALS EXHIBIT HIGHER RESTING PARASYMPATHETIC ACTIVITY, LOWER SYSTOLIC BPV, AND HIGHER BRS THAN NAIVE TO YOGA INDIVIDUALS. IT IS INFERRED FROM THE FINDINGS THAT YOGA PRACTITIONERS WERE BETTER ADAPTED TO TRANSIENT CEPHALAD FLUID SHIFT THAT HAPPENS DURING 6 DEGREES HDT. FURTHERMORE, ACUTE SLOW BREATHING DURING 6 DEGREES HDT REDUCED THE SYSTOLIC BLOOD PRESSURE IN ALL THE PARTICIPANTS SUGGESTING THE BENEFICIAL ROLE OF SLOW BREATHING DURING EXPOSURE TO EXTREME CONDITIONS SUCH AS MICROGRAVITY WHICH MIGHT HELP IN THE PREVENTION OF ADVERSE EFFECTS OF CEPHALAD FLUID SHIFT DURING LONG-TERM WEIGHTLESSNESS AND MAINTAIN THE ASTRONAUT HEALTH. FUTURE MECHANISTIC STUDIES WITH ACTIVE YOGA INTERVENTION ARE NECESSARY TO UNDERSTAND THE ADAPTIVE MECHANISMS INVOLVING CENTRAL AND VASCULAR MODULATIONS CONTRIBUTING TO EITHER ATTENUATION OR ACCENTUATION OF THE CARDIOVAGAL BAROREFLEX DURING HDT AND SLOW BREATHING IN HEALTHY INDIVIDUALS. 2021 4 816 37 EFFECT OF YOGA ON CLINICAL OUTCOMES AND QUALITY OF LIFE IN PATIENTS WITH VASOVAGAL SYNCOPE (LIVE-YOGA). OBJECTIVES: THIS STUDY AIMS TO DETERMINE THE IMPACT OF YOGA AS AN ADJUNCT TO STANDARD THERAPY VERSUS STANDARD THERAPY ALONE ON THE SYMPTOMATIC BURDEN IN PATIENTS WITH RECURRENT VASOVAGAL SYNCOPE (VVS). BACKGROUND: THERE IS A SIGNIFICANT REDUCTION IN THE QUALITY OF LIFE (QOL) OF PATIENTS WITH RECURRENT VVS. EXISTING MANAGEMENT THERAPIES HAVE BEEN LARGELY INEFFECTIVE. RECENT TRIALS HAVE DEMONSTRATED THE EFFICACY OF YOGA IN DISEASES WITH AUTONOMIC IMBALANCE, SUGGESTING ITS POSSIBLE UTILITY IN VVS. METHODS: PATIENTS WITH RECURRENT VVS WERE RANDOMIZED TO RECEIVE EITHER A SPECIALIZED YOGA TRAINING PROGRAM IN ADDITION TO CURRENT GUIDELINE-BASED THERAPY (INTERVENTION ARM, GROUP 1) OR CURRENT GUIDELINE-BASED THERAPY ALONE (CONTROL ARM, GROUP 2). THE PRIMARY OUTCOME WAS A COMPOSITE OF THE NUMBER OF EPISODES OF SYNCOPE AND PRESYNCOPE AT 12 MONTHS. SECONDARY OUTCOMES INCLUDED QOL ASSESSMENT BY WORLD HEALTH ORGANIZATION QUALITY OF LIFE BRIEF FIELD QUESTIONNAIRE (WHOQOL-BREF) SCORES AND SYNCOPE FUNCTIONAL STATUS QUESTIONNAIRE SCORES AT 12 MONTHS, HEAD UP TILT TEST, AND HEART RATE VARIABILITY AT 6 WEEKS. RESULTS: A TOTAL OF 55 PATIENTS UNDERWENT RANDOMIZATION. THE MEAN NUMBER OF SYNCOPAL OR PRESYNCOPAL EVENTS AT 12 MONTHS WAS 0.7 +/- 0.7 IN THE INTERVENTION ARM COMPARED TO 2.52 +/- 1.93 IN THE CONTROL ARM (P < 0.01). IN THE INTERVENTION ARM, 13 (43.3%) PATIENTS REMAINED FREE OF EVENTS VERSUS 4 (16.0%) PATIENTS IN THE CONTROL ARM (P = 0.02). QOL AT 12 MONTHS SHOWED SIGNIFICANT IMPROVEMENT OF ALL SYNCOPE FUNCTIONAL STATUS QUESTIONNAIRE SCORES AND 2 DOMAINS OF WHOQOL-BREF SCORES (P < 0.05). CONCLUSIONS: YOGA AS ADJUNCTIVE THERAPY IS SUPERIOR TO STANDARD THERAPY ALONE IN REDUCING THE SYMPTOMATIC BURDEN AND IMPROVING QOL IN PATIENTS WITH RECURRENT VVS. 2022 5 758 60 EFFECT OF SLOW BREATHING ON AUTONOMIC TONE & BAROREFLEX SENSITIVITY IN YOGA PRACTITIONERS. BACKGROUND & OBJECTIVES: SLOW BREATHING INCREASES PARASYMPATHETIC ACTIVITY AND BAROREFLEX SENSITIVITY (BRS) IN HEALTHY INDIVIDUALS, ALSO SIMILARLY OBSERVED IN YOGA PRACTITIONERS. PRANAYAMA WHICH IS AN IMPORTANT COMPONENT OF YOGA WHEN PRACTICED AT A SLOW PACE WAS AT A RESPIRATORY FREQUENCY OF AROUND 0.1 HZ (6 BREATHS/MIN). THEREFORE, IT WAS HYPOTHESIZED THAT YOGA PRACTITIONERS MIGHT HAVE ADAPTED TO SLOW BREATHING. THIS STUDY WAS AIMED TO DECIPHER THE ROLE OF YOGA ON CARDIOVASCULAR VARIABILITY DURING SLOW BREATHING (0.1 HZ) IN YOGA PRACTITIONERS. METHODS: A CROSS-SECTIONAL STUDY WAS UNDERTAKEN IN NAIVE-TO-YOGA INDIVIDUALS (N=40) AND YOGA PRACTITIONERS (N=40) WITH AN AVERAGE AGE OF 31.08 +/- 7.31 AND 29.93 +/- 7.57 YR, RESPECTIVELY. THE ANALYSIS OF HEART RATE VARIABILITY, BLOOD PRESSURE VARIABILITY (BPV) AND BRS DURING SPONTANEOUS AND SLOW BREATHING WAS COMPARED BETWEEN THE TWO GROUPS. RESULTS: DURING SLOW BREATHING, THE HEART RATE (P<0.01) WAS LOWER, RESPIRATORY RATE INTERVAL (P<0.05) AND PNN50 PER CENT (P=0.01) WERE HIGHER, MEAN SYSTOLIC BP (SBP) (P<0.05) AND SDSD (STANDARD DEVIATION OF SUCCESSIVE BEAT TO BEAT SYSTOLIC BLOOD PRESSURE DIFFERENCES) (P<0.01) OF SBP VARIABILITY WERE LOWER WITH SEQUENCE BRS (P<0.001) AND ALPHA LOW FREQUENCY (P<0.01) AND ALPHA HIGH FREQUENCY (P<0.001) OF SPECTRAL BRS WERE HIGHER IN YOGA PRACTITIONERS. INTERPRETATION & CONCLUSIONS: THE PRESENT STUDY INDICATED HIGHER PARASYMPATHETIC ACTIVITY AND BRS WITH LOWER SBP VARIABILITY AT REST AND DURING SLOW BREATHING IN YOGA PRACTITIONERS COMPARED TO NAIVE GROUP. FINDINGS INDICATE THAT THE SHORT-TERM PRACTICE OF SLOW BREATHING COMPLEMENTS THE AUGMENTED PARASYMPATHETIC ACTIVITY AND BRS IN THE YOGA GROUP. 2020 6 2759 67 YOGA PRACTITIONERS EXHIBIT HIGHER PARASYMPATHETIC ACTIVITY AND BAROREFLEX SENSITIVITY AND BETTER ADAPTABILITY TO 40 MM HG LOWER-BODY NEGATIVE PRESSURE. YOGA HAS BEEN SHOWN TO IMPROVE AUTONOMIC CONDITIONING IN HUMANS, AS EVIDENCED BY THE ENHANCEMENT OF PARASYM-PATHETIC ACTIVITY AND BAROREFLEX SENSITIVITY. THEREFORE, WE HYPOTHESIZED THAT THE EXPERIENCE OF YOGA MAY RESULT IN ADAPTATION TO ACUTE HEMODYNAMIC CHANGES. TO DECIPHER THE LONG-TERM EFFECTS OF YOGA ON CARDIOVASCULAR VARIABILITY, YOGA PRACTITIONERS WERE COMPARED TO YOGA-NAIVE SUBJECTS DURING EXPOSURE TO -40 MM HG LOWER-BODY NEGATIVE PRESSURE (LBNP). A COMPARATIVE STUDY WAS CONDUCTED ON 40 YOGANAIVE SUBJECTS AND 40 YOGA PRACTITIONERS WITH AN AVERAGE AGE OF 31.08 +/- 7.31 YEARS AND 29.93 +/- 7.57 YEARS, RESPECTIVELY. HEART RATE VARIABILITY, BLOOD PRESSURE VARIABILITY, BAROREFLEX SENSITIVITY, AND CORRELATION BETWEEN SYSTOLIC BLOOD PRESSURE AND RR INTERVAL WERE EVALUATED AT REST AND DURING LBNP. IN YOGA PRACTITIONERS, THE HEART RATE WAS LOWER IN SUPINE REST (P = 0.011) AND DURING LBNP (P = 0.043); THE PNN50 MEASURE OF HEART RATE VARIABILITY WAS HIGHER IN SUPINE REST (P = 0.011) AND DURING LBNP (P = 0.034). THE YOGA PRACTITIONERS' STANDARD DEVIATION OF SUCCESSIVE BEAT-TO-BEAT BLOOD PRESSURE INTERVALS OF SYSTOLIC BLOOD PRESSURE VARIABILITY WAS LOWER IN SUPINE REST (P = 0.034) AND DURING LBNP (P = 0.007), WITH HIGHER SEQUENCE BAROREFLEX SENSITIVITY (P = 0.019) AND ~ HIGH-FREQUENCY BAROREFLEX SENSITIVITY. MEAN SYSTOLIC BLOOD PRESSURE AND RR INTERVAL WERE INVERSELY CORRELATED IN THE YOGA GROUP (R = -0.317, P = 0.049). THE YOGA PRACTITIONERS EXHIBITED HIGHER PARASYMPATHETIC ACTIVITY AND BAROREFLEX SENSITIVITY WITH LOWER SYSTOLIC BLOOD PRESSURE VARIABILITY, INDICATING BETTER ADAPTABILITY TO LBNP COMPARED TO THE YOGA-NAIVE GROUP. OUR FINDINGS INDICATE THAT THE YOGA MODULE WAS HELPFUL IN CONDITIONS OF HYPOVOLEMIA IN HEALTHY SUBJECTS; IT IS PROPOSED TO BE BENEFICIAL IN CLINICAL CONDITIONS ASSOCIATED WITH SYMPATHETIC DOMINANCE, IMPAIRED BARORE-FLEX SENSITIVITY, AND ORTHOSTATIC INTOLERANCE. 2021 7 2471 36 YOGA AS A TREATMENT FOR VASOVAGAL SYNCOPE: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: YOGA THERAPY IS BEING USED FOR VASOVAGAL SYNCOPE (VVS). HOWEVER, THERE IS NO SUFFICIENT EVIDENCE. WE AIMED TO EVALUATE THE EFFECT OF YOGA AS AN ADJUNCT TO THE STANDARD THERAPY ON PATIENTS WITH RECURRENT VVS. METHODS: ELECTRONIC DATABASES WERE SYSTEMATICALLY SEARCHED TO COLLECT STUDIES ASSESSING THE CLINICAL EFFECTS OF YOGA ALONG WITH GUIDELINE-DIRECTED TREATMENT IN PATIENTS WITH RECURRENT VVS. THE OUTCOMES WERE THE NUMBER OF VVS ATTACKS AND QUALITY OF LIFE (QOL) ASSESSMENT BY SYNCOPE FUNCTIONAL STATUS QUESTIONNAIRE (SFSQ) SCORES AT 12 MONTHS. WE USED THE MANTEL- HAENSZEL RANDOM-EFFECTS MODEL TO CALCULATE THE MEAN DIFFERENCE (MD) AND 95% CONFIDENCE INTERVAL (CI). WE USED THE COCHRANE COLLABORATION RISK OF BIAS TOOL AND NEWCASTLE-OTTAWA SCALE FOR RISK OF BIAS ASSESSMENT. RESULTS: FOUR STUDIES WERE INCLUDED, TWO RCTS AND TWO OBSERVATIONAL STUDIES. THE TOTAL OF PARTICIPANTS WAS 309, WITH A MEAN AGE OF 36.4 +/- 13.5 YEARS. THE MALE PARTICIPANTS REPRESENTED 141 (45.6%) BEING MALES. THE BASELINE SYNCOPE BURDEN WAS 3.5 +/- 2.38 EPISODES OVER 15.6 +/- 12.8 MONTHS. YOGA THERAPY SIGNIFICANTLY REDUCED THE NUMBER OF EPISODES OF SYNCOPE AND PRESYNCOPE COMPARED TO THE CONTROL GROUP (MD -1.86; 95% CI -3.30, -0.43; P = 0.01). NEVERTHELESS, YOGA THERAPY DID NOT SHOW SIGNIFICANT IMPROVEMENT IN THE QOL ASSESSED BY SFSQ SCORES (MD -30.69; 95% CI -62.22,0.83; P = 0.06). CONCLUSION: YOGA THERAPY IS A USEFUL LIFESTYLE INTERVENTION THAT CAN REDUCE THE FREQUENCY OF SYNCOPE AND PRESYNCOPE AMONG PATIENTS WITH RECURRENT VVS. HOWEVER, HIGHER-QUALITY RCTS ARE NEEDED TO CONFIRM OUR RESULTS. 2022 8 1923 38 ROLE OF YOGA AS AN ADJUNCTIVE THERAPY IN PATIENTS WITH NEUROCARDIOGENIC SYNCOPE: A PILOT STUDY. BACKGROUND: NEUROCARDIOGENIC SYNCOPE (NCS) IS A COMMON CLINICAL CONDITION CHARACTERIZED BY ABRUPT CARDIOVASCULAR AUTONOMIC CHANGES RESULTING IN SYNCOPE. THIS IS A RECURRING CONDITION WITH MIXED RESULTS FROM CURRENT STRATEGIES OF TREATMENT. METHODS: SUBJECTS WITH A DIAGNOSIS OF NCS WERE SCREENED AND ENROLLED. ALL THE PARTICIPANTS WERE GIVEN A DVD CONTAINING YOGA VIDEOS AND WERE INSTRUCTED TO PRACTICE YOGA THERAPY FOR 60 MIN, THREE TIMES A WEEK FOR 3 CONSECUTIVE MONTHS. SYNCOPE FUNCTIONAL STATUS QUESTIONNAIRE SCORE (SFSQS) WAS ADMINISTERED AT THE BEGINNING AND THE END OF THE STUDY. THE SUBJECTS WERE FOLLOWED FOR 3 MONTHS AND UNDERWENT REPEAT TILT TABLE TESTING AT THE END OF THE STUDY. RESULTS: OF THE 60 PATIENTS SCREENED, 44 SUBJECTS WERE ENROLLED, 21 IN THE INTERVENTION GROUP AND 23 IN THE CONTROL GROUP. MOST OF THE PARTICIPANTS WERE FEMALES, AND THE MEAN AGE WAS 21 +/- 3 YEARS. IN THE INTERVENTION GROUP, WHO FINISHED THE YOGA REGIMEN, THERE WAS A STATISTICALLY SIGNIFICANT IMPROVEMENT FROM CONTROL PHASE TO THE INTERVENTION PHASE, IN NUMBER OF EPISODES OF SYNCOPE (4 +/- 1 VS 1.3 +/- 0.7, P < 0.001) AND PRESYNCOPE (4.7 +/- 1.5 VS 1.5 +/- 0.5, P < 0.001). THE MEAN SFSQS ALSO DECREASED FROM 67 +/- 7.8 TO 29.8 +/- 4.6 (P < 0.001). ALL SUBJECTS HAD POSITIVE HEAD UP TILT TABLE (HUTT) STUDY AT THE TIME OF ENROLLMENT COMPARED TO ONLY SIX PATIENTS AT THE COMPLETION OF INTERVENTION PHASE (10/100 VS 6/28 %, P < 0.0001). CONCLUSION: YOGA THERAPY CAN POTENTIALLY IMPROVE THE SYMPTOMS OF PRESYNCOPE AND SYNCOPE IN YOUNG FEMALE PATIENTS WITH NCS. 2015 9 350 54 ASSESSMENT OF CARDIAC AUTONOMIC TONE FOLLOWING LONG SUDARSHAN KRIYA YOGA IN ART OF LIVING PRACTITIONERS. OBJECTIVE: THE BREATHING PROCESSES ARE KNOWN TO MODULATE CARDIAC AUTONOMIC TONE AND IMPROVE PSYCHOLOGICAL STATUS. WE INVESTIGATED CARDIAC AUTONOMIC TONE FOLLOWING LONG SUDARSHAN KRIYA YOGA (SKY) USING HEART RATE VARIABILITY (HRV) AND SKIN CONDUCTANCE LEVEL (SCL). METHODS: THIRTY HEALTHY VOLUNTEERS (AGE 28.3 +/- 8.4 YEARS; 23 M: 7 F) PARTICIPATED IN THE STUDY. ELECTROCARDIOGRAM (ECG) AND SCL WERE RECORDED FOR 5 MIN EACH, BEFORE AND AFTER LONG SKY. LONG SKY IS A COMBINATION OF PRANAYAMA AND CYCLIC RHYTHMIC BREATHING AND IS PERFORMED BY FOLLOWING THE GUIDED AUDIO INSTRUCTIONS. HRV ANALYSIS WAS USED FOR THE ASSESSMENT OF CARDIAC AUTONOMIC TONE. TIME AND FREQUENCY DOMAIN PARAMETERS OF HRV WERE CALCULATED BY USING RR INTERVAL OF ECG. SCL WAS ACQUIRED USING GALVANIC SKIN RESPONSE (GSR) AMPLIFIER OF POWERLAB IN MICROSEIMENS (MUS). RESULTS: TIME DOMAIN PARAMETERS OF HRV, INCLUDING MEAN RR INTERVAL (P = 0.000), RESPIRATORY SINUS ARRHYTHMIA (RSA) (P = 0.037), STANDARD DEVIATION OF ALL NN INTERVALS (SDNN) (P = 0.013), NN50 COUNT DIVIDED BY THE TOTAL NUMBER OF ALL NN INTERVALS (PNN50) (P = 0.004), AND SQUARE ROOT OF THE MEAN OF THE SUM OF THE SQUARES OF DIFFERENCES BETWEEN ADJACENT NN INTERVALS (RMSSD) (P = 0.002) INCREASED, AND MEAN HEART RATE DECREASED (P = 0.000) FOLLOWING LONG SKY. IN FREQUENCY DOMAIN ANALYSIS, POWER OF LOW-FREQUENCY (LF) COMPONENT (P = 0.010) AND LF/HF RATIO (P = 0.008) DECREASED SIGNIFICANTLY, WHEREAS POWER OF HIGH FREQUENCY (HF) SIGNIFICANTLY INCREASED (P = 0.010). SCL DECREASED FOLLOWING LONG SKY, ALTHOUGH IT DID NOT ATTAIN STATISTICAL SIGNIFICANCE. CONCLUSIONS: THE RESULTS SUGGEST THAT LONG SKY INDUCES SIGNIFICANT OSCILLATIONS IN CARDIAC AUTONOMIC TONE. PARASYMPATHETIC ACTIVITY INCREASES AND SYMPATHETIC ACTIVITY DECREASES AND SYMPATHOVAGAL BALANCE IMPROVES FOLLOWING LONG SKY. DECREASE IN SYMPATHETIC ACTIVITY IS ALSO DEMONSTRATED BY DECREASE IN CONDUCTANCE ALTHOUGH IT DID NOT REACH STATISTICAL SIGNIFICANCE. FROM THIS STUDY IT CAN BE CONCLUDED THAT LONG SKY HAS A BENEFICIAL EFFECT ON CARDIAC AUTONOMIC TONE, AND PSYCHOPHYSIOLOGICAL RELAXATION. IT MAY SERVE AS A TOOL TO IMPROVE HRV, WHICH IS THE MARKER OF CARDIOVASCULAR HEALTH. 2017 10 1578 47 MEASUREMENT OF THE EFFECT OF ISHA YOGA ON CARDIAC AUTONOMIC NERVOUS SYSTEM USING SHORT-TERM HEART RATE VARIABILITY. BACKGROUND: BENEFICIAL EFFECTS OF YOGA HAVE BEEN POSTULATED TO BE DUE TO MODULATION OF THE AUTONOMIC NERVOUS SYSTEM. OBJECTIVE: TO ASSESS THE EFFECT OF ISHA YOGA PRACTICES ON CARDIOVASCULAR AUTONOMIC NERVOUS SYSTEM THROUGH SHORT-TERM HEART RATE VARIABILITY (HRV). DESIGN OF THE STUDY: SHORT-TERM HRV OF LONG-TERM REGULAR HEALTHY 14 (12 MALES AND 2 FEMALES) ISHA YOGA PRACTITIONERS WAS COMPARED WITH THAT OF AGE- AND GENDER-MATCHED 14 (12 MALES AND 2 FEMALES) NON-YOGA PRACTITIONERS. METHODS AND MATERIALS: ECG LEAD II AND RESPIRATORY MOVEMENTS WERE RECORDED IN BOTH GROUPS USING POLYRITE DURING SUPINE REST FOR 5 MIN AND CONTROLLED DEEP BREATHING FOR 1 MINUTE. FREQUENCY DOMAIN ANALYSIS [RR INTERVAL IS THE MEAN OF DISTANCE BETWEEN SUBSEQUENT R WAVE PEAKS IN ECG], LOW FREQUENCY (LF) POWER, HIGH FREQUENCY (HF) POWER, LF NORMALIZED UNITS (NU), HF NU, LF/HF RATIO] AND TIME DOMAIN ANALYSIS [STANDARD DEVIATION OF NORMAL TO NORMAL INTERVAL (SDNN), SQUARE OF MEAN SQUARED DIFFERENCE OF SUCCESSIVE NORMAL TO NORMAL INTERVALS (RMSSD), NORMAL TO NORMAL INTERVALS WHICH ARE DIFFERING BY 50 MS (NN50), AND PERCENTAGE OF NN50 (PNN50)] OF HRV VARIABLES WERE ANALYZED FOR SUPINE REST. TIME DOMAIN ANALYSIS WAS RECORDED FOR DEEP BREATHING. RESULTS: RESULTS SHOWED STATISTICALLY SIGNIFICANT DIFFERENCES BETWEEN ISHA YOGA PRACTITIONERS AND CONTROLS IN BOTH FREQUENCY AND TIME DOMAIN ANALYSES OF HRV INDICES, WITH NO DIFFERENCE IN RESTING HEART RATE BETWEEN THE GROUPS. CONCLUSIONS: PRACTITIONERS OF ISHA YOGA SHOWED WELL-BALANCED BENEFICIAL ACTIVITY OF VAGAL EFFERENTS, AN OVERALL INCREASED HRV, AND SYMPATHOVAGAL BALANCE, COMPARED TO NON-YOGA PRACTITIONERS DURING SUPINE REST AND DEEP BREATHING. 2012 11 807 31 EFFECT OF YOGA ON ARRHYTHMIA BURDEN, ANXIETY, DEPRESSION, AND QUALITY OF LIFE IN PAROXYSMAL ATRIAL FIBRILLATION: THE YOGA MY HEART STUDY. OBJECTIVES: THE PURPOSE OF THIS STUDY WAS TO EXAMINE THE IMPACT OF YOGA ON ATRIAL FIBRILLATION (AF) BURDEN, QUALITY OF LIFE (QOL), DEPRESSION, AND ANXIETY SCORES. BACKGROUND: YOGA IS KNOWN TO HAVE SIGNIFICANT BENEFIT ON CARDIOVASCULAR HEALTH. THE EFFECT OF YOGA IN REDUCING AF BURDEN IS UNKNOWN. METHODS: THIS SINGLE-CENTER, PRE-POST STUDY ENROLLED PATIENTS WITH SYMPTOMATIC PAROXYSMAL AF WITH AN INITIAL 3-MONTH NONINTERVENTIONAL OBSERVATION PERIOD FOLLOWED BY TWICE-WEEKLY 60-MIN YOGA TRAINING FOR NEXT 3 MONTHS. AF EPISODES DURING THE CONTROL AND STUDY PERIODS AS WELL AS SF-36, ZUNG SELF-RATED ANXIETY, AND ZUNG SELF-RATED DEPRESSION SCORES AT BASELINE, BEFORE, AND AFTER THE STUDY PHASE WERE ASSESSED. RESULTS: YOGA TRAINING REDUCED SYMPTOMATIC AF EPISODES (3.8 +/- 3 VS. 2.1 +/- 2.6, P < 0.001), SYMPTOMATIC NON-AF EPISODES (2.9 +/- 3.4 VS. 1.4 +/- 2.0; P < 0.001), ASYMPTOMATIC AF EPISODES (0.12 +/- 0.44 VS. 0.04 +/- 0.20; P < 0.001), AND DEPRESSION AND ANXIETY (P < 0.001), AND IMPROVED THE QOL PARAMETERS OF PHYSICAL FUNCTIONING, GENERAL HEALTH, VITALITY, SOCIAL FUNCTIONING, AND MENTAL HEALTH DOMAINS ON SF-36 (P = 0.017, P < 0.001, P < 0.001, P = 0.019, AND P < 0.001, RESPECTIVELY). THERE WAS SIGNIFICANT DECREASE IN HEART RATE, AND SYSTOLIC AND DIASTOLIC BLOOD PRESSURE BEFORE AND AFTER YOGA (P < 0.001). CONCLUSIONS: IN PATIENTS WITH PAROXYSMAL AF, YOGA IMPROVES SYMPTOMS, ARRHYTHMIA BURDEN, HEART RATE, BLOOD PRESSURE, ANXIETY AND DEPRESSION SCORES, AND SEVERAL DOMAINS OF QOL. 2013 12 2731 43 YOGA OFFERS CARDIOVASCULAR PROTECTION IN EARLY POSTMENOPAUSAL WOMEN. CONTEXT: POSTMENOPAUSE, AN ESTROGEN DEFICIENT STATE COMES WITH INCREASED INCIDENCE OF CARDIOVASCULAR DISEASES (CVDS). YOGA HAS BEEN DESCRIBED AS HAVING A BENEFICIAL EFFECT ON HEART RATE VARIABILITY (HRV), A MARKER FOR CARDIAC AUTONOMIC ACTIVITY WHICH CAN ASSESS CARDIOVASCULAR RISK, IN VARIOUS POPULATIONS. AIM: THE AIM OF THE STUDY WAS TO STUDY THE EFFECT OF 3-MONTH LONG YOGA PRACTICE ON HRV IN EARLY POSTMENOPAUSAL WOMEN. SETTINGS AND DESIGN: A PROSPECTIVE LONGITUDINAL STUDY OF 67 WOMEN WITHIN 5 YEARS OF MENOPAUSE BETWEEN 45 AND 60 YEARS OF AGE ATTENDING MENOPAUSE CLINIC OF DEPARTMENT OF GYNAECOLOGY, SUCHETA KRIPLANI HOSPITAL FULFILLING INCLUSION AND EXCLUSION CRITERIA AND CONSENTING WERE ENROLLED FOR THE STUDY. SUBJECTS AND METHODS: HRV OF 37 CASES (YOGA GROUP) AND 30 CONTROLS (NON-YOGA GROUP) WAS RECORDED PRE AND 3-MONTH POSTINTERVENTION. STATISTICAL ANALYSIS USED: GRAPHPAD PRISM VERSION 5 SOFTWARE WAS USED. VALUES ARE A MEAN AND STANDARD ERROR OF MEAN. STATISTICAL SIGNIFICANCE WAS SET UP AT P < 0.05. RESULTS: IN HRV, FREQUENCY DOMAIN ANALYSIS SHOWED A SIGNIFICANT FALL IN LOW FREQUENCY (LF) IN NORMALIZED UNITS (NU) AND LF: HIGH FREQUENCY (HF) RATIO AND SIGNIFICANT RISE IN HF IN NU IN THE YOGA GROUP (DEPICTING PARASYMPATHETIC DOMINANCE) AGAINST A SIGNIFICANT RISE IN LF (NU) AND LF: HF RATIO AND SIGNIFICANT FALL IN HF (NU) IN NON-YOGA GROUP (INDICATING SYMPATHETIC DOMINANCE). TIME DOMAIN ANALYSIS SHOWED A SIGNIFICANT DECREASE IN STANDARD DEVIATION OF NN INTERVALS IN NON-YOGA GROUP AGAINST NONSIGNIFICANT CHANGES IN YOGA GROUP INDICATING DETERIORATION IN PARASYMPATHETIC ACTIVITY IN NON-YOGA GROUP. CONCLUSIONS: THREE-MONTH LONG YOGA PRACTICE IMPROVED HRV IN EARLY POSTMENOPAUSAL WOMEN SIGNIFICANTLY AND HAS THE POTENTIAL TO ATTENUATE THE CVD RISK IN POSTMENOPAUSAL WOMEN. 2018 13 74 38 A GROUP-BASED YOGA THERAPY INTERVENTION FOR URINARY INCONTINENCE IN WOMEN: A PILOT RANDOMIZED TRIAL. OBJECTIVE: THE AIM OF THIS STUDY IS TO EXAMINE THE FEASIBILITY, EFFICACY, AND SAFETY OF A GROUP-BASED YOGA THERAPY INTERVENTION FOR MIDDLE-AGED AND OLDER WOMEN WITH URINARY INCONTINENCE. METHODS: WE CONDUCTED A PILOT RANDOMIZED TRIAL OF AMBULATORY WOMEN AGED 40 YEARS AND OLDER WITH STRESS, URGENCY, OR MIXED-TYPE INCONTINENCE. WOMEN WERE RANDOMIZED TO A 6-WEEK YOGA THERAPY PROGRAM (N = 10) CONSISTING OF TWICE WEEKLY GROUP CLASSES AND ONCE WEEKLY HOME PRACTICE OR A WAIT-LIST CONTROL GROUP (N = 9). ALL PARTICIPANTS ALSO RECEIVED WRITTEN PAMPHLETS ABOUT STANDARD BEHAVIORAL SELF-MANAGEMENT STRATEGIES FOR INCONTINENCE. CHANGES IN INCONTINENCE WERE ASSESSED WITH 7-DAY VOIDING DIARIES. RESULTS: THE MEAN (SD) AGE WAS 61.4 (8.2) YEARS, AND THE MEAN BASELINE FREQUENCY OF INCONTINENCE WAS 2.5 (1.3) EPISODES/D. AFTER 6 WEEKS, THE TOTAL INCONTINENCE FREQUENCY DECREASED BY 70% (1.8 [0.9] FEWER EPISODES/D) IN THE YOGA THERAPY VERSUS 13% (0.3 [1.7] FEWER EPISODES/D) IN THE CONTROL GROUP (P = 0.049). PARTICIPANTS IN THE YOGA THERAPY GROUP ALSO REPORTED AN AVERAGE OF 71% DECREASE IN STRESS INCONTINENCE FREQUENCY (0.7 [0.8] FEWER EPISODES/D) COMPARED WITH A 25% INCREASE IN CONTROLS (0.2 [1.1] MORE EPISODES/D) (P = 0.039). NO SIGNIFICANT DIFFERENCES IN REDUCTION IN URGENCY INCONTINENCE WERE DETECTED BETWEEN THE YOGA THERAPY VERSUS CONTROL GROUPS (1.0 [1.0] VERSUS 0.5 [0.5] FEWER EPISODES/D; P = 0.20). ALL WOMEN STARTING THE YOGA THERAPY PROGRAM COMPLETED AT LEAST 90% OF THE GROUP CLASSES AND PRACTICE SESSIONS. TWO PARTICIPANTS IN EACH GROUP REPORTED ADVERSE EVENTS UNRELATED TO THE INTERVENTION. CONCLUSIONS: FINDINGS PROVIDE PRELIMINARY EVIDENCE TO SUPPORT THE FEASIBILITY, EFFICACY, AND SAFETY OF A GROUP-BASED YOGA THERAPY INTERVENTION TO IMPROVE URINARY INCONTINENCE IN WOMEN. 2014 14 671 35 EFFECT OF A GENTLE IYENGAR YOGA PROGRAM ON GAIT IN THE ELDERLY: AN EXPLORATORY STUDY. OBJECTIVE: TO DETERMINE IF A TAILORED YOGA PROGRAM COULD IMPROVE AGE-RELATED CHANGES IN HIP EXTENSION, STRIDE LENGTH, AND ASSOCIATED INDICES OF GAIT FUNCTION IN HEALTHY ELDERS, CHANGES THAT HAVE BEEN LINKED TO INCREASED RISK FOR FALLS, DEPENDENCY, AND MORTALITY IN GERIATRIC POPULATIONS. DESIGN: SINGLE GROUP PRE-POST TEST EXPLORATORY STUDY. A 3-DIMENSIONAL QUANTITATIVE GAIT EVALUATION, INCLUDING KINEMATIC AND KINETIC MEASUREMENTS, WAS PERFORMED PRE- AND POSTINTERVENTION. CHANGES OVER TIME (BASELINE TO POSTINTERVENTION) IN PRIMARY AND SECONDARY OUTCOME VARIABLES WERE ASSESSED USING REPEATED-MEASURES ANALYSIS OF VARIANCE. SETTING: YOGA EXERCISES WERE PERFORMED IN AN ACADEMIC MEDICAL CENTER (GROUP CLASSES) AND IN THE SUBJECTS' HOMES (YOGA HOME-PRACTICE ASSIGNMENTS). PRE- AND POSTASSESSMENTS WERE PERFORMED IN A GAIT LABORATORY. PARTICIPANTS: TWENTY-THREE HEALTHY ADULTS (AGE RANGE, 62-83 Y) WHO WERE NAIVE TO YOGA WERE RECRUITED; 19 PARTICIPANTS COMPLETED THE PROGRAM. INTERVENTION: AN 8-WEEK IYENGAR HATHA YOGA PROGRAM SPECIFICALLY TAILORED TO ELDERLY PERSONS AND DESIGNED TO IMPROVE LOWER-BODY STRENGTH AND FLEXIBILITY. PARTICIPANTS ATTENDED TWO 90-MINUTE YOGA CLASSES PER WEEK, AND WERE ASKED TO COMPLETE AT LEAST 20 MINUTES OF DIRECTED HOME PRACTICE ON ALTERNATE DAYS. MAIN OUTCOME MEASURES: PEAK HIP EXTENSION, AVERAGE ANTERIOR PELVIC TILT, AND STRIDE LENGTH AT COMFORTABLE WALKING SPEED. RESULTS: PEAK HIP EXTENSION AND STRIDE LENGTH SIGNIFICANTLY INCREASED (F1,18=15.44, P<.001; F1,18=5.57, P=.03, RESPECTIVELY). WE ALSO OBSERVED A TREND TOWARD REDUCED AVERAGE PELVIC TILT (F1,18=4.10, P=.06); ADJUSTING FOR THE MODIFYING INFLUENCE OF FREQUENCY OF HOME YOGA PRACTICE STRENGTHENED THE SIGNIFICANCE OF THIS ASSOCIATION (ADJUSTED F1,17=14.30, P=.001). BOTH THE FREQUENCY AND DURATION OF YOGA HOME PRACTICE SHOWED A STRONG, LINEAR, DOSE-RESPONSE RELATIONSHIP TO CHANGES IN HIP EXTENSION AND AVERAGE PELVIC TILT. CONCLUSIONS: FINDINGS OF THIS EXPLORATORY STUDY SUGGEST THAT YOGA PRACTICE MAY IMPROVE HIP EXTENSION, INCREASE STRIDE LENGTH, AND DECREASE ANTERIOR PELVIC TILT IN HEALTHY ELDERS, AND THAT YOGA PROGRAMS TAILORED TO ELDERLY ADULTS MAY OFFER A COST-EFFECTIVE MEANS OF PREVENTING OR REDUCING AGE-RELATED CHANGES IN THESE INDICES OF GAIT FUNCTION. 2005 15 2727 41 YOGA NIDRA RELAXATION INCREASES HEART RATE VARIABILITY AND IS UNAFFECTED BY A PRIOR BOUT OF HATHA YOGA. OBJECTIVE: THE MEASUREMENT OF HEART RATE VARIABILITY (HRV) IS OFTEN APPLIED AS AN INDEX OF AUTONOMIC NERVOUS SYSTEM (ANS) BALANCE AND, THEREFORE, MYOCARDIAL STABILITY. PREVIOUS STUDIES HAVE SUGGESTED THAT RELAXATION OR MIND-BODY EXERCISE CAN INFLUENCE ANS BALANCE POSITIVELY AS MEASURED BY HRV BUT MAY ACT VIA DIFFERENT MECHANISMS. NO STUDIES, TO THE AUTHORS' KNOWLEDGE, HAVE EXAMINED THE ACUTE RESPONSE IN HRV TO INTERVENTIONS COMBINING RELAXATION AND MIND-BODY EXERCISE. THE OBJECTIVE OF THIS STUDY WAS TO COMPARE THE ACUTE HRV RESPONSES TO YOGA NIDRA RELAXATION ALONE VERSUS YOGA NIDRA RELAXATION PRECEDED BY HATHA YOGA. DESIGN: THIS WAS A RANDOMIZED COUNTER-BALANCED TRIAL. SETTING: THE TRIAL WAS CONDUCTED IN A UNIVERSITY EXERCISE PHYSIOLOGY LABORATORY. SUBJECTS: SUBJECTS INCLUDED 20 WOMEN AND MEN (29.15+/-6.98 YEARS OF AGE, WITH A RANGE OF 18-47 YEARS). INTERVENTIONS: PARTICIPANTS COMPLETED A YOGA PLUS RELAXATION (YR) SESSION AND A RELAXATION ONLY (R) SESSION. RESULTS: THE YR CONDITION PRODUCED SIGNIFICANT CHANGES FROM BASELINE IN HEART RATE (HR; BEATS PER MINUTE [BPM], P<0.001) AND INDICES OF HRV: R-R (MS, P<0.001), PNN50 (%, P=0.009), LOW FREQUENCY (LF; %, P=0.008) AND HIGH FREQUENCY (HF; %, P=0.035). THE R CONDITION PRODUCED SIGNIFICANT CHANGES FROM BASELINE IN HEART RATE (BPM, P<0.001) AS WELL AS INDICES OF HRV: R-R (MS, P<0.001), HF (MS(2), P=0.004), LF (%, P=0.005), HF (%, P=0.008) AND LF:HF RATIO (%, P=0.008). THERE WERE NO SIGNIFICANT DIFFERENCES BETWEEN CONDITIONS AT BASELINE NOR FOR THE CHANGES FROM BASELINE FOR ANY OF THE VARIABLES. CONCLUSIONS: THESE CHANGES DEMONSTRATE A FAVORABLE SHIFT IN AUTONOMIC BALANCE TO THE PARASYMPATHETIC BRANCH OF THE ANS FOR BOTH CONDITIONS, AND THAT YOGA NIDRA RELAXATION PRODUCES FAVORABLE CHANGES IN MEASURES OF HRV WHETHER ALONE OR PRECEDED BY A BOUT OF HATHA YOGA. 2012 16 1317 34 HEART RATE VARIABILITY CHANGES DURING HIGH FREQUENCY YOGA BREATHING AND BREATH AWARENESS. BACKGROUND: PRE AND POST COMPARISON AFTER ONE MINUTE OF HIGH FREQUENCY YOGA BREATHING (HFYB) SUGGESTED THAT THE HFYB MODIFIES THE AUTONOMIC STATUS BY INCREASING SYMPATHETIC MODULATION, BUT ITS EFFECT DURING THE PRACTICE WAS NOT ASSESSED. METHODS: THIRTY-EIGHT MALE VOLUNTEERS WITH GROUP AVERAGE AGE +/- S.D., 23.3 +/- 4.4 YEARS WERE EACH ASSESSED ON TWO SEPARATE DAYS IN TWO SESSIONS, (I) HFYB AND (II) BREATH AWARENESS. EACH SESSION WAS FOR 35 MINUTES, WITH 3 PERIODS, I.E., PRE (5 MINUTES), DURING HFYB OR BREATH AWARENESS (15 MINUTES) AND POST (5 MINUTES). RESULTS: THERE WAS A SIGNIFICANT DECREASE IN NN50, PNN50 AND THE MEAN RR INTERVAL DURING AND AFTER HFYB AND AFTER BREATH AWARENESS, COMPARED TO THE RESPECTIVE 'PRE' VALUES (P < 0.05) (REPEATED MEASURES ANOVA FOLLOWED BY POST-HOC ANALYSIS). THE LF POWER INCREASED AND HF POWER DECREASED DURING AND AFTER BREATH AWARENESS AND LF/HF RATIO INCREASED AFTER BREATH AWARENESS (P < 0.05). CONCLUSION: THE RESULTS SUGGEST THAT THERE WAS REDUCED PARASYMPATHETIC MODULATION DURING AND AFTER HFYB AND INCREASED SYMPATHETIC MODULATION WITH REDUCED PARASYMPATHETIC MODULATION DURING AND AFTER BREATH AWARENESS. 2011 17 389 35 BENEFITS OF YOGA FOR AFRICAN AMERICAN HEART FAILURE PATIENTS. BACKGROUND: THE NUMBER OF AFRICAN AMERICAN (AA) PATIENTS LIVING WITH HEART FAILURE (HF) HAS BEEN INCREASING, ESPECIALLY AMONG THE ECONOMICALLY DISADVANTAGED. YOGA THERAPY HAS BEEN FOUND TO IMPROVE PHYSICAL AND PSYCHOLOGICAL PARAMETERS AMONG HEALTHY INDIVIDUALS, BUT ITS EFFECT IN PATIENTS WITH HF REMAINS UNKNOWN. THE PURPOSE OF THIS STUDY WAS TO EXAMINE THE EFFECTS OF YOGA THERAPY ON CARDIOVASCULAR ENDURANCE (VO2PEAK), FLEXIBILITY, QUALITY OF LIFE (QOL), AND INFLAMMATORY MARKERS ON MEDICALLY STABLE HF PATIENTS. METHODS: FORTY PATIENTS (38 AA, 1 ASIAN, AND 1 CAUCASIAN) WITH SYSTOLIC OR DIASTOLIC HF WERE RANDOMIZED TO THE YOGA GROUP (YG, N = 21) OR THE CONTROL GROUP (CG, N = 19). ALL PATIENTS WERE ASKED TO FOLLOW A HOME WALK PROGRAM. PREMEASUREMENT AND POSTMEASUREMENT INCLUDED A TREADMILL STRESS TEST TO PEAK EXERTION, FLEXIBILITY, INTERLEUKIN-6 (IL-6), C-REACTIVE PROTEIN (CRP), AND EXTRACELLULAR SUPEROXIDE DISMUTASE (EC-SOD). QOL WAS ASSESSED BY THE MINNESOTA LIVING WITH HEART FAILURE QUESTIONNAIRE (MLWHFQ). RESULTS: THE STATISTICAL ANALYSES (ASSESSED BY ANOVA AND T-TESTS) WERE SIGNIFICANT FOR FAVORABLE CHANGES IN THE YG, COMPARED WITH THOSE IN THE CG, FOR FLEXIBILITY (P = 0.012), TREADMILL TIME (P = 0.002), VO2PEAK (P = 0.003), AND THE BIOMARKERS (IL-6, P = 0.004; CRP, P = 0.016; AND EC-SOD, P = 0.012). WITHIN THE YG, PRETEST TO POSTTEST SCORES FOR THE TOTAL (P = 0.02) AND PHYSICAL SUBSCALES (P < 0.001) OF THE MLWHFQ WERE IMPROVED. CONCLUSIONS: YOGA THERAPY OFFERED ADDITIONAL BENEFITS TO THE STANDARD MEDICAL CARE OF PREDOMINANTLY AA HF PATIENTS BY IMPROVING CARDIOVASCULAR ENDURANCE, QOL, INFLAMMATORY MARKERS, AND FLEXIBILITY. 2010 18 1318 35 HEART RATE VARIABILITY IN CHRONIC LOW BACK PAIN PATIENTS RANDOMIZED TO YOGA OR STANDARD CARE. BACKGROUND: CHRONIC PAIN CAN ALTER THE AUTONOMIC BALANCE WITH INCREASED SYMPATHETIC ACTIVITY REFLECTED IN ALTERED HEART RATE VARIABILITY (HRV). IT HAS BEEN PROPOSED THAT YOGA CAN BE USEFUL TO CORRECT THE AUTONOMIC IMBALANCE IN PATIENTS WITH CHRONIC PAIN WHO HAVE REDUCED HRV. METHODS AND DESIGNS: IN THE PRESENT RANDOMIZED CONTROLLED TRIAL 62 PATIENTS WITH CHRONIC LOW BACK PAIN ASSOCIATED WITH ALTERED ALIGNMENT OF INTERVERTEBRAL DISCS (AGED BETWEEN 20 AND 45 YEARS, 32 MALES) WERE RANDOMIZED TO 2 GROUPS. ONE GROUP RECEIVED YOGA FOR 3 MONTHS WHILE THE OTHER GROUP CARRIED OUT STANDARD MEDICAL CARE BASED ON THE PHYSICIAN'S ADVICE. THE DURATION WAS THE SAME, I.E., 3 MONTHS. THE HEART RATE VARIABILITY AND RATE OF RESPIRATION WERE ASSESSED AT BASELINE AND AT THE END OF 3 MONTHS. RESULTS: THERE WAS A SIGNIFICANT DIFFERENCE IN THE BASELINE (PRE) VALUES BETWEEN GROUPS (P = 0.008) FOR RESPIRATION RATE WHICH WAS HIGHER IN THE YOGA GROUP. THE CHANGES REPORTED BELOW ARE PRE-POST COMPARISONS WITHIN EACH GROUP. THE YOGA GROUP SHOWED A SIGNIFICANT (P < 0.05; REPEATED MEASURES ANOVA, POST-HOC ANALYSES) DECREASE IN THE LF POWER OF HRV, RATE OF RESPIRATION AND A SIGNIFICANT INCREASE IN THE HF POWER OF HRV AND IN THE PNN50. CONCLUSION: THE RESULTS SUGGEST THAT YOGA PRACTICE CAN SHIFT THE AUTONOMIC BALANCE TOWARDS VAGAL DOMINANCE IN PATIENTS WITH CHRONIC LOW BACK PAIN ASSOCIATED WITH ALTERED ALIGNMENT OF INTERVERTEBRAL DISCS. TRIAL REGISTRATION: THE STUDY IS REGISTERED WITH THE CLINICAL TRIALS REGISTRY OF INDIA ( CTRI/2012/11/003094 ) AND CAN BE ACCESSED AT. 2016 19 1441 40 INCREASED HEART RATE VARIABILITY BUT NO EFFECT ON BLOOD PRESSURE FROM 8 WEEKS OF HATHA YOGA - A PILOT STUDY. BACKGROUND: YOGA EXERCISES ARE KNOWN TO DECREASE STRESS AND RESTORE AUTONOMIC BALANCE. YET KNOWLEDGE ABOUT THE PHYSIOLOGICAL EFFECTS OF INVERSION POSTURES IS LIMITED. THIS STUDY AIMED TO INVESTIGATE THE EFFECTS OF INVERSION POSTURES (HEAD BELOW THE HEART) ON BLOOD PRESSURE (BP) AND HEART RATE VARIABILITY (HRV). METHODS: TWELVE HEALTHY WOMEN AND MEN TOOK PART IN AN 8-WEEK YOGA PROGRAM (60 MIN ONCE A WEEK). BP WAS MEASURED WITH AN AUTOMATIC OMRON MX3 OSCILLOMETRIC MONITORING DEVICE AND HRV WITH A HOLTER 24-HOUR ECG AT BASELINE AND 8 WEEKS AFTER THE INTERVENTION. RESULTS: THERE WAS NO SIGNIFICANT EFFECT OF INVERSION POSTURES ON BP. NINE OUT OF 12 PARTICIPANTS SHOWED A SIGNIFICANT INCREASE IN HRV (P < 0.05) AT NIGHT (2 HOURS) ON PNN50% (12.7 +/- 12.5 TO 18.2 +/- 13.3). THERE WERE NO SIGNIFICANT CHANGES IN OTHER HRV MEASURES SUCH AS NN50, LF, HF, LF/HF RATIO, LF NORMALIZED UNITS (N.U.), HF N.U. AND RMSSD. CONCLUSION: EIGHT WEEKS OF HATHA YOGA IMPROVED HRV SIGNIFICANTLY WHICH SUGGESTS AN INCREASED VAGAL TONE AND REDUCED SYMPATHETIC ACTIVITY. 2013 20 780 49 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