1 722 136 EFFECT OF KARAMARDADI YOGA VERSUS DICLOFENAC SODIUM IN POST-OPERATIVE PAIN MANAGEMENT: A RANDOMIZED COMPARATIVE CLINICAL TRIAL. INTRODUCTION: POST-OPERATIVE PAIN IS NOCICEPTIVE I.E., ANTICIPATED UNAVOIDABLE PHYSIOLOGICAL PAIN WHICH IS CAUSED DUE TO TISSUE TRAUMA. DRUGS SUCH AS NSAIDS (NON STEROIDAL ANTI INFLAMMATORY DRUGS) AND OPIOIDS ARE USED FOR POST-OPERATIVE PAIN MANAGEMENT BUT ARE ASSOCIATED WITH THEIR OWN DRAWBACKS. KARAMARDADI YOGA HAS BEEN IN USE IN AYURVEDIC PRACTICE FOR ANALGESIA. IT IS KNOWN TO RELIEVE PAIN AND CAN BE USED TO SUPPLEMENT ANAESTHESIA AND ALSO GET RID OF ADVERSE EFFECT OF MODERN ANALGESIC DRUGS. AIMS AND OBJECTIVE: TO STUDY THE COMPARATIVE EFFECT OF KARAMARDADI YOGA AND DICLOFENAC SODIUM IN POST-OPERATIVE PAIN MANAGEMENT. MATERIALS AND METHODS: RANDOMIZED CLINICAL TRIAL WITH GROUP A (CONTROL GROUP: TAB DICLOFENAC SODIUM 50 MG AS A SINGLE DOSE) AND GROUP B (TRIAL GROUP: CAP KARAMARDADI YOGA 500 MG AS A SINGLE DOSE). THOSE WHO HAD UNDERGONE HAEMORRHOIDECTOMY OPERATION UNDER LOCAL ANAESTHESIA WERE SELECTED AS PER INCLUSION CRITERIA. VITALS, DESIRABLE EFFECT AND UNDESIRABLE EFFECT, TOTAL SURGICAL TIME, REQUIREMENT OF 1(ST) DOSE OF ANALGESIC, REQUIREMENT OF RESCUE ANALGESIC AND PAIN DETERMINED BY VAS (VISUAL ANALOG SCALE) WERE THE ASSESSMENT CRITERIA AND WERE OBSERVED AND RECORDED. RESULTS: KARAMARDADI YOGA DOES NOT SHOW ANY UNDESIRABLE OR SERIOUS ILL EFFECTS AND ALTERED VALUES OF VITALS AS PER STATISTICAL ANALYSIS. AS PER VAS SCALE, PAIN FELT BY TRIAL GROUP WAS EARLIER THAN CONTROL GROUP. CONCLUSIONS: KARAMARDADI YOGA HAS ANALGESIC PROPERTY BUT ITS ANALGESIC PROPERTY AND PAIN THRESHOLD CAPACITY IS LESSER THAN THOSE OF DICLOFENAC SODIUM. 2016 2 279 32 ADHERENCE AND RETENTION OF AFRICAN AMERICANS IN A RANDOMIZED CONTROLLED TRIAL WITH A YOGA-BASED INTERVENTION: THE EFFECTS OF HEALTH PROMOTING PROGRAMS ON CARDIOVASCULAR DISEASE RISK STUDY. OBJECTIVES: SEDENTARY LIFESTYLE IS A RISK FACTOR FOR CARDIOVASCULAR DISEASE (CVD). FEW ALTERNATIVE LIFESTYLE INTERVENTIONS, SUCH AS YOGA PRACTICE, FOCUS ON AFRICAN AMERICANS (AA), THE POPULATION MOST VULNERABLE TO CVD. OUR OBJECTIVE IS TO COMPARE THE RETENTION AND ADHERENCE RATES BETWEEN YOGA, WALKING, AND HEALTH EDUCATION INTERVENTIONS WHILE PROVIDING INFORMATION ABOUT THE ACCEPTANCE OF VARIOUS YOGA REGIMENS. DESIGN: THREE HUNDRED SEVENTY-FIVE AA PARTICIPANTS WERE RECRUITED EXCLUSIVELY FROM AN ACTIVE COHORT STUDY AND RANDOMIZED INTO A 48-WEEK STUDY (24 WEEKS INTERVENTION, 24 WEEKS FOLLOW-UP) WITH 5 HEALTH PROMOTION INTERVENTIONS: HIGH FREQUENCY YOGA, MODERATE FREQUENCY YOGA, LOW FREQUENCY YOGA, GUIDED WALKING, AND HEALTH EDUCATION. IN ADDITION TO EXAMINING THE SEPARATE YOGA INTERVENTIONS, A POOLED YOGA INTERVENTION IS CONSIDERED FOR COMPARISON TO GUIDED WALKING AND HEALTH EDUCATION. PARTICIPANT RETENTION, ADHERENCE, AND VITALS WERE MONITORED AT EACH INTERVENTION SESSION. PARTICIPANTS WERE ALSO SCHEDULED FOR FOUR CLINIC VISITS THROUGHOUT THE STUDY WHERE BLOOD PANELS, HEALTH BEHAVIOR, AND MEDICATION SURVEYS WERE ADMINISTERED. RESULTS: OF THE 375 PARTICIPANTS RECRUITED, 31.7% DID NOT COMPLETE THE STUDY. AT BASELINE, IN BOTH THE GUIDED WALKING GROUP AND THE HIGH FREQUENCY YOGA GROUP, THERE WERE SIGNIFICANT DIFFERENCES BETWEEN THOSE WHO COMPLETED THE STUDY AND THOSE WHO DID NOT. ALTHOUGH INTERVENTION RETENTION IN THE POOLED YOGA PROGRAM (78.3%) WAS HIGHER COMPARED TO THE WALKING (60%) AND EDUCATION PROGRAMS (74.3%) (P = 0.007), DIFFERENCES IN POST-INTERVENTION RETENTION WAS NOT SIGNIFICANT. MEDIAN ADHERENCE RATES FOR THE POOLED YOGA PROGRAM EXCEEDED RATES FOR GUIDED WALKING AND EDUCATION WITH MODERATE FREQUENCY YOGA OUT PERFORMING HIGH AND LOW FREQUENCY YOGA. CONCLUSION: STUDY-DEFINED RETENTION SUCCESS RATES WERE NOT REACHED BY ALL HEALTH PROMOTION PROGRAMS. HOWEVER, RETENTION AND ADHERENCE RATES FOR THE POOLED YOGA PROGRAM SHOW THAT OLDER AFRICAN AMERICANS ARE RECEPTIVE TO PARTICIPATING IN YOGA-BASED HEALTH PROMOTION PRACTICES. 2020 3 2857 30 YOGA-BASED CARDIAC REHABILITATION AFTER ACUTE MYOCARDIAL INFARCTION: A RANDOMIZED TRIAL. BACKGROUND: GIVEN THE SHORTAGE OF CARDIAC REHABILITATION (CR) PROGRAMS IN INDIA AND POOR UPTAKE WORLDWIDE, THERE IS AN URGENT NEED TO FIND ALTERNATIVE MODELS OF CR THAT ARE INEXPENSIVE AND MAY OFFER CHOICE TO SUBGROUPS WITH POOR UPTAKE (E.G., WOMEN AND ELDERLY). OBJECTIVES: THIS STUDY SOUGHT TO EVALUATE THE EFFECTS OF YOGA-BASED CR (YOGA-CARE) ON MAJOR CARDIOVASCULAR EVENTS AND SELF-RATED HEALTH IN A MULTICENTER RANDOMIZED CONTROLLED TRIAL. METHODS: THE TRIAL WAS CONDUCTED IN 24 MEDICAL CENTERS ACROSS INDIA. THIS STUDY RECRUITED 3,959 PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITH A MEDIAN AND MINIMUM FOLLOW-UP OF 22 AND 6 MONTHS. PATIENTS WERE INDIVIDUALLY RANDOMIZED TO RECEIVE EITHER A YOGA-CARE PROGRAM (N = 1,970) OR ENHANCED STANDARD CARE INVOLVING EDUCATIONAL ADVICE (N = 1,989). THE CO-PRIMARY OUTCOMES WERE: 1) FIRST OCCURRENCE OF MAJOR ADVERSE CARDIOVASCULAR EVENTS (MACE) (COMPOSITE OF ALL-CAUSE MORTALITY, MYOCARDIAL INFARCTION, STROKE, OR EMERGENCY CARDIOVASCULAR HOSPITALIZATION); AND 2) SELF-RATED HEALTH ON THE EUROPEAN QUALITY OF LIFE-5 DIMENSIONS-5 LEVEL VISUAL ANALOGUE SCALE AT 12 WEEKS. RESULTS: MACE OCCURRED IN 131 (6.7%) PATIENTS IN THE YOGA-CARE GROUP AND 146 (7.4%) PATIENTS IN THE ENHANCED STANDARD CARE GROUP (HAZARD RATIO WITH YOGA-CARE: 0.90; 95% CONFIDENCE INTERVAL [CI]: 0.71 TO 1.15; P = 0.41). SELF-RATED HEALTH WAS 77 IN YOGA-CARE AND 75.7 IN THE ENHANCED STANDARD CARE GROUP (BASELINE-ADJUSTED MEAN DIFFERENCE IN FAVOR OF YOGA-CARE: 1.5; 95% CI: 0.5 TO 2.5; P = 0.002). THE YOGA-CARE GROUP HAD GREATER RETURN TO PRE-INFARCT ACTIVITIES, BUT THERE WAS NO DIFFERENCE IN TOBACCO CESSATION OR MEDICATION ADHERENCE BETWEEN THE TREATMENT GROUPS (SECONDARY OUTCOMES). CONCLUSIONS: YOGA-CARE IMPROVED SELF-RATED HEALTH AND RETURN TO PRE-INFARCT ACTIVITIES AFTER ACUTE MYOCARDIAL INFARCTION, BUT THE TRIAL LACKED STATISTICAL POWER TO SHOW A DIFFERENCE IN MACE. YOGA-CARE MAY BE AN OPTION WHEN CONVENTIONAL CR IS UNAVAILABLE OR UNACCEPTABLE TO INDIVIDUALS. (A STUDY ON EFFECTIVENESS OF YOGA BASED CARDIAC REHABILITATION PROGRAMME IN INDIA AND UNITED KINGDOM; CTRI/2012/02/002408). 2020 4 2852 35 YOGA, PHYSICAL THERAPY, OR EDUCATION FOR CHRONIC LOW BACK PAIN: A RANDOMIZED NONINFERIORITY TRIAL. BACKGROUND: YOGA IS EFFECTIVE FOR MILD TO MODERATE CHRONIC LOW BACK PAIN (CLBP), BUT ITS COMPARATIVE EFFECTIVENESS WITH PHYSICAL THERAPY (PT) IS UNKNOWN. MOREOVER, LITTLE IS KNOWN ABOUT YOGA'S EFFECTIVENESS IN UNDERSERVED PATIENTS WITH MORE SEVERE FUNCTIONAL DISABILITY AND PAIN. OBJECTIVE: TO DETERMINE WHETHER YOGA IS NONINFERIOR TO PT FOR CLBP. DESIGN: 12-WEEK, SINGLE-BLIND, 3-GROUP RANDOMIZED NONINFERIORITY TRIAL AND SUBSEQUENT 40-WEEK MAINTENANCE PHASE. (CLINICALTRIALS.GOV: NCT01343927). SETTING: ACADEMIC SAFETY-NET HOSPITAL AND 7 AFFILIATED COMMUNITY HEALTH CENTERS. PARTICIPANTS: 320 PREDOMINANTLY LOW-INCOME, RACIALLY DIVERSE ADULTS WITH NONSPECIFIC CLBP. INTERVENTION: PARTICIPANTS RECEIVED 12 WEEKLY YOGA CLASSES, 15 PT VISITS, OR AN EDUCATIONAL BOOK AND NEWSLETTERS. THE MAINTENANCE PHASE COMPARED YOGA DROP-IN CLASSES VERSUS HOME PRACTICE AND PT BOOSTER SESSIONS VERSUS HOME PRACTICE. MEASUREMENTS: PRIMARY OUTCOMES WERE BACK-RELATED FUNCTION, MEASURED BY THE ROLAND MORRIS DISABILITY QUESTIONNAIRE (RMDQ), AND PAIN, MEASURED BY AN 11-POINT SCALE, AT 12 WEEKS. PRESPECIFIED NONINFERIORITY MARGINS WERE 1.5 (RMDQ) AND 1.0 (PAIN). SECONDARY OUTCOMES INCLUDED PAIN MEDICATION USE, GLOBAL IMPROVEMENT, SATISFACTION WITH INTERVENTION, AND HEALTH-RELATED QUALITY OF LIFE. RESULTS: ONE-SIDED 95% LOWER CONFIDENCE LIMITS WERE 0.83 (RMDQ) AND 0.97 (PAIN), DEMONSTRATING NONINFERIORITY OF YOGA TO PT. HOWEVER, YOGA WAS NOT SUPERIOR TO EDUCATION FOR EITHER OUTCOME. YOGA AND PT WERE SIMILAR FOR MOST SECONDARY OUTCOMES. YOGA AND PT PARTICIPANTS WERE 21 AND 22 PERCENTAGE POINTS LESS LIKELY, RESPECTIVELY, THAN EDUCATION PARTICIPANTS TO USE PAIN MEDICATION AT 12 WEEKS. IMPROVEMENTS IN YOGA AND PT GROUPS WERE MAINTAINED AT 1 YEAR WITH NO DIFFERENCES BETWEEN MAINTENANCE STRATEGIES. FREQUENCY OF ADVERSE EVENTS, MOSTLY MILD SELF-LIMITED JOINT AND BACK PAIN, DID NOT DIFFER BETWEEN THE YOGA AND PT GROUPS. LIMITATIONS: PARTICIPANTS WERE NOT BLINDED TO TREATMENT ASSIGNMENT. THE PT GROUP HAD DISPROPORTIONATE LOSS TO FOLLOW-UP. CONCLUSION: A MANUALIZED YOGA PROGRAM FOR NONSPECIFIC CLBP WAS NONINFERIOR TO PT FOR FUNCTION AND PAIN. PRIMARY FUNDING SOURCE: NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH OF THE NATIONAL INSTITUTES OF HEALTH. 2017 5 1552 28 LIFESTYLE MODIFICATION IN BLOOD PRESSURE STUDY II (LIMBS): STUDY PROTOCOL OF A RANDOMIZED CONTROLLED TRIAL ASSESSING THE EFFICACY OF A 24 WEEK STRUCTURED YOGA PROGRAM VERSUS LIFESTYLE MODIFICATION ON BLOOD PRESSURE REDUCTION. HYPERTENSION IS A MAJOR PUBLIC HEALTH ISSUE AFFECTING 68 MILLION ADULTS IN THE UNITED STATES. LIFESTYLE MODIFICATIONS INCLUDING COMPLEMENTARY THERAPIES SUCH AS THE MOVEMENT BASED MIND BODY PRACTICE OF YOGA HAVE BECOME INCREASINGLY POPULAR IN THE UNITED STATES AND HAVE BEEN CONSIDERED AS A POTENTIAL ALTERNATIVE TO MEDICATION IN BLOOD PRESSURE REDUCTION. WE COMPLETED A PILOT STUDY IN 2009 WHICH SHOWED MEANINGFUL DECREASES IN 24-HOUR AMBULATORY BLOOD PRESSURE READINGS AFTER A 12 WEEK PERIOD OF YOGA PARTICIPATION. BASED ON DATA FROM OUR PILOT STUDY WE ARE NOW COMPLETING THE LIFESTYLE MODIFICATION AND BLOOD PRESSURE STUDY (LIMBS II) WHICH IS A PHASE 2 RANDOMIZED CONTROLLED TRIAL DESIGNED TO DETERMINE THE EFFECTS OF YOGA THERAPY AND ENHANCED LIFESTYLE MODIFICATION ON LOWERING BLOOD PRESSURE IN PRE-HYPERTENSIVE AND STAGE 1 HYPERTENSIVE SUBJECTS. USING 24-HOUR AMBULATORY BLOOD PRESSURE MONITORING, LIMBS II AIMS TO COMPARE THE EFFECTS ON BLOOD PRESSURE REDUCTION IN SUBJECTS RANDOMIZED FOR 24 WEEKS TO ONE OF THE THREE FOLLOWING GROUPS: YOGA THERAPY VERSUS BLOOD PRESSURE EDUCATION PROGRAM (SODIUM RESTRICTION AND WALKING PROGRAM) VERSUS A COMBINATION PROGRAM THAT INVOLVES COMPONENTS OF BOTH GROUPS. LIMBS II WILL ALSO EXAMINE THE IMPACT THAT CHANGES IN BLOOD PRESSURE HAVE ON CEREBRAL BLOOD FLOW. IF SUCCESSFUL, THE LIMBS STUDY WILL DETERMINE IF YOGA THERAPY COMBINED WITH ENHANCED LIFESTYLE MODIFICATION WILL RESULT IN CLINICALLY MEANINGFUL DECREASES IN BLOOD PRESSURE AND THUS CAN BE IMPLEMENTED AS AN ALTERNATIVE TO DRUG THERAPY FOR PATIENTS WITH PREHYPERTENSION AND STAGE 1 HYPERTENSION. 2013 6 2731 32 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 7 1675 24 OBESITY-RELATED INFLAMMATION & CARDIOVASCULAR DISEASE: EFFICACY OF A YOGA-BASED LIFESTYLE INTERVENTION. OBESITY IS A GLOBAL HEALTH BURDEN AND ITS PREVALENCE IS INCREASING SUBSTANTIALLY DUE TO CHANGING LIFESTYLE. CHRONIC ADIPOSITY IS ASSOCIATED WITH METABOLIC IMBALANCE LEADING TO DYSLIPIDAEMIA, DIABETES, HYPERTENSION AND CARDIOVASCULAR DISEASES (CVD). ADIPOSE TISSUE ACTS AS AN ENDOCRINE ORGAN RELEASING SEVERAL ADIPOCYTOKINES, AND IS ASSOCIATED WITH INCREASED LEVELS OF TISSUE AND CIRCULATING INFLAMMATORY BIOMOLECULES CAUSING VASCULAR INFLAMMATION AND ATHEROGENESIS. FURTHER, INFLAMMATION IS ALSO ASSOCIATED INDEPENDENTLY WITH OBESITY AS WELL AS CVD. KEEPING THIS IN VIEW, IT IS POSSIBLE THAT A REDUCTION IN WEIGHT MAY LEAD TO A DECREASE IN INFLAMMATION, RESULTING IN CVD RISK REDUCTION, AND BETTER MANAGEMENT OF PATIENTS WITH CVD. LIFESTYLE INTERVENTION HAS BEEN ENDORSED BY SEVERAL HEALTH AUTHORITIES IN PREVENTION AND MANAGEMENT OF CHRONIC DISEASES. A YOGA-BASED LIFESTYLE INTERVENTION APPEARS TO BE A PROMISING OPTION IN REDUCING THE RISK FOR CVD AS WELL AS MANAGEMENT OF PATIENTS WITH CVD AS IT IS SIMPLE TO FOLLOW AND COST-EFFECTIVE WITH HIGH COMPLIANCE. THE EFFICACY OF SUCH LIFESTYLE INTERVENTION PROGRAMMES IS MULTIFACETED, AND IS ACHIEVED VIA REDUCTION IN WEIGHT, OBESITY-RELATED INFLAMMATION AND STRESS, THEREBY CULMINATING INTO RISK REDUCTION TOWARDS SEVERAL CHRONIC DISEASES INCLUDING CVD. IN THIS REVIEW, THE ASSOCIATION BETWEEN OBESITY-RELATED INFLAMMATION AND CVD, AND THE ROLE OF YOGA-BASED LIFESTYLE INTERVENTION IN PREVENTION AND MANAGEMENT OF CVD ARE DISCUSSED. 2014 8 1318 36 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 9 780 34 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 10 1374 29 IMPACT OF AN INTEGRATED YOGA THERAPY PROTOCOL ON INSULIN RESISTANCE AND GLYCEMIC CONTROL IN PATIENTS WITH TYPE 2 DIABETES MELLITUS. OBJECTIVE: DIABETES MELLITUS (DM), CHARACTERIZED BY CHRONIC HYPERGLYCEMIA, IS ATTRIBUTED TO RELATIVE INSULIN DEFICIENCY OR RESISTANCE, OR BOTH. STUDIES HAVE SHOWN THAT YOGA CAN MODULATE PARAMETERS OF INSULIN RESISTANCE. THE PRESENT STUDY EXPLORED THE POSSIBLE BENEFICIAL EFFECTS OF INTEGRATED YOGA THERAPY WITH REFERENCE TO GLYCEMIC CONTROL AND INSULIN RESISTANCE (IR) IN INDIVIDUALS WITH DIABETES MAINTAINED ON STANDARD ORAL MEDICAL CARE WITH YOGA THERAPY, COMPARED TO THOSE ON STANDARD ORAL MEDICAL CARE ALONE. METHODS: IN THIS STUDY, THE SUBJECTS ON YOGA INTERVENTION COMPRISED 35 TYPE 2 DIABETICS, AND AN EQUAL NUMBER OF VOLUNTEERS CONSTITUTED THE CONTROL GROUP. SUBJECTS RANGED IN AGE FROM 30 TO 70 YEARS, WITH HEMOGLOBIN A1C (HBA1C) TEST MORE THAN 7%, AND WERE MAINTAINED ON DIABETIC DIET AND ORAL HYPOGLYCEMIC AGENTS. BLOOD SAMPLES WERE DRAWN PRIOR TO AND AFTER 120 DAYS OF INTEGRATED YOGA THERAPY INTERVENTION. FASTING BLOOD GLUCOSE (FBG), POST-PRANDIAL BLOOD GLUCOSE (PPBG), HBA1C, INSULIN, AND LIPID PROFILE WERE ASSESSED IN BOTH THE INTERVENTION AND CONTROL GROUPS. RESULTS: THE INTERVENTION GROUP REVEALED SIGNIFICANT IMPROVEMENTS IN BODY MASS INDEX (BMI) (0.7 KG/M(2) MEDIAN DECREASE; P=0.001), FBG (20 MG/DL MEDIAN DECREASE; P<0.001), PPBG (33 MG/DL MEDIAN DECREASE; P<0.001), HBA1C (0.4% MEDIAN DECREASE; P<0.001), HOMEOSTATIC MODEL ASSESSMENT FOR INSULIN RESISTANCE (HOMA-IR) (1.2 MEDIAN DECREASE; P<0.001), CHOLESTEROL (13 MG/DL MEDIAN DECREASE, P=0.006), TRIACYLGLYCEROL (22 MG/DL MEDIAN DECREASE; P=0.027), LOW-DENSITY LIPOPROTEIN (6 MG/DL MEDIAN DECREASE; P=0.004), AND VERY-LOW-DENSITY LIPOPROTEIN LEVELS (4 MG/DL MEDIAN DECREASE; P=0.032). INCREASES IN HIGH-DENSITY LIPOPROTEIN AFTER 120 DAYS WERE NOT SIGNIFICANT (6 MG/DL MEDIAN INCREASE; P=0.15). HOWEVER, WHEN COMPARED TO CHANGES OBSERVED IN PATIENTS IN THE CONTROL GROUP, ALL THESE IMPROVEMENTS PROVED TO BE SIGNIFICANT. CONCLUSION: ADMINISTRATION OF INTEGRATED YOGA THERAPY TO INDIVIDUALS WITH DIABETES LEADS TO A SIGNIFICANT IMPROVEMENT IN GLYCEMIC CONTROL, INSULIN RESISTANCE, AND KEY BIOCHEMICAL PARAMETERS. 2022 11 2389 45 YOGA AND AEROBIC DANCE FOR PAIN MANAGEMENT IN JUVENILE IDIOPATHIC ARTHRITIS: PROTOCOL FOR A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: JUVENILE IDIOPATHIC ARTHRITIS (JIA) IS ONE OF THE MOST COMMON TYPES OF ARTHRITIS AMONG CHILDREN. ACCORDING TO JIA GUIDELINES FOR PHYSICAL ACTIVITY (PA), STRUCTURED PA INTERVENTIONS LED TO IMPROVED HEALTH OUTCOMES. HOWEVER, MANY PA PROGRAMS, SUCH AS YOGA AND AEROBIC DANCE, HAVE NOT BEEN STUDIED IN THIS POPULATION DESPITE BEING POPULAR AMONG YOUTH. WEB-BASED PA PROGRAMS COULD PROVIDE PATIENTS WITH ACCESSIBLE AND AFFORDABLE INTERVENTIONS. OBJECTIVE: THE PRIMARY AIMS OF THE PROPOSED PILOT RANDOMIZED CONTROLLED TRIAL (RCT) ARE TO EXAMINE (1) THE FEASIBILITY OF CONDUCTING A FULL-SCALE RCT TO EVALUATE THE EFFECTIVENESS OF TWO POPULAR TYPES OF PA: A YOGA TRAINING PROGRAM AND AN AEROBIC DANCE TRAINING PROGRAM, IN FEMALE ADOLESCENTS (AGED 13-18 YEARS) WITH JIA COMPARED WITH AN ELECTRONIC PAMPHLET CONTROL GROUP; AND (2) THE ACCEPTABILITY OF THESE INTERVENTIONS. METHODS: A THREE-ARM PROSPECTIVE RANDOMIZED OPEN-LABEL STUDY WITH A PARALLEL GROUP DESIGN WILL BE USED. A TOTAL OF 25 FEMALE ADOLESCENTS WITH JIA WHO HAVE PAIN WILL BE RANDOMIZED IN A RATIO OF 2:2:1 TO ONE OF THE 3 GROUPS: (1) ONLINE YOGA TRAINING PROGRAM (GROUP A: N=10); (2) ONLINE AEROBIC DANCE TRAINING PROGRAM (GROUP B: N=10); AND (3) ELECTRONIC PAMPHLET CONTROL GROUP (GROUP C: N=5). PARTICIPANTS IN GROUPS A AND B WILL COMPLETE 3 INDIVIDUAL 1-HOUR SESSIONS PER WEEK USING ONLINE EXERCISE VIDEOS, AS WELL AS A 1-HOUR VIRTUAL GROUP SESSION PER WEEK USING A VIDEOCONFERENCING PLATFORM FOR 12 WEEKS. PARTICIPANTS FROM ALL GROUPS WILL HAVE ACCESS TO AN ELECTRONIC EDUCATIONAL PAMPHLET ON PA FOR ARTHRITIS DEVELOPED BY THE ARTHRITIS SOCIETY. ALL PARTICIPANTS WILL ALSO TAKE PART IN WEEKLY ONLINE CONSULTATIONS WITH A RESEARCH COORDINATOR AND DISCUSSIONS ON FACEBOOK WITH PARTICIPANTS FROM THEIR OWN GROUP. FEASIBILITY (IE, RECRUITMENT RATE, SELF-REPORTED ADHERENCE TO THE INTERVENTIONS, DROPOUT RATES, AND PERCENTAGE OF MISSING DATA), ACCEPTABILITY, AND USABILITY OF FACEBOOK AND THE VIDEOCONFERENCING PLATFORM WILL BE ASSESSED AT THE END OF THE PROGRAM. PAIN INTENSITY, PARTICIPATION IN GENERAL PA, MORNING STIFFNESS, FUNCTIONAL STATUS, FATIGUE, SELF-EFFICACY, PATIENT GLOBAL ASSESSMENT, DISEASE ACTIVITY, AND ADVERSE EVENTS WILL BE ASSESSED USING SELF-ADMINISTERED ELECTRONIC SURVEYS AT BASELINE AND THEN WEEKLY UNTIL THE END OF THE 12-WEEK PROGRAM. RESULTS: THIS PILOT RCT HAS BEEN FUNDED BY THE ARTHRITIS HEALTH PROFESSIONS ASSOCIATION. THIS PROTOCOL WAS APPROVED BY THE CHILDREN'S HOSPITAL OF EASTERN ONTARIO RESEARCH ETHICS BOARD (#17/08X). AS OF MAY 11, 2020, RECRUITMENT AND DATA COLLECTION HAVE NOT STARTED. CONCLUSIONS: TO OUR KNOWLEDGE, THIS IS THE FIRST STUDY TO EVALUATE THE EFFECTIVENESS OF YOGA AND AEROBIC DANCE AS PAIN MANAGEMENT INTERVENTIONS FOR FEMALE ADOLESCENTS WITH JIA. THE USE OF ONLINE PROGRAMS TO DISSEMINATE THESE 2 PA INTERVENTIONS MAY FACILITATE ACCESS TO ALTERNATIVE METHODS OF PAIN MANAGEMENT. THIS STUDY CAN LEAD TO A FULL-SCALE RCT. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/12823. 2020 12 2831 28 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 13 1904 36 RETARDATION OF CORONARY ATHEROSCLEROSIS WITH YOGA LIFESTYLE INTERVENTION. BACKGROUND: YOGA HAS POTENTIAL FOR BENEFIT FOR PATIENTS WITH CORONARY ARTERY DISEASE THOUGH OBJECTIVE, ANGIOGRAPHIC STUDIES ARE LACKING. MATERIAL AND METHODS: WE EVALUATED POSSIBLE ROLE OF LIFESTYLE MODIFICATION INCORPORATING YOGA, ON RETARDATION OF CORONARY ATHEROSCLEROTIC DISEASE. IN THIS PROSPECTIVE, RANDOMIZED, CONTROLLED TRIAL, 42 MEN WITH ANGIOGRAPHICALLY PROVEN CORONARY ARTERY DISEASE (CAD) WERE RANDOMIZED TO CONTROL (N = 21) AND YOGA INTERVENTION GROUP (N = 21) AND WERE FOLLOWED FOR ONE YEAR. THE ACTIVE GROUP WAS TREATED WITH A USER-FRIENDLY PROGRAM CONSISTING OF YOGA, CONTROL OF RISK FACTORS, DIET CONTROL AND MODERATE AEROBIC EXERCISE. THE CONTROL GROUP WAS MANAGED BY CONVENTIONAL METHODS I.E. RISK FACTOR CONTROL AND AMERICAN HEART ASSOCIATION STEP I DIET. RESULTS: AT ONE YEAR, THE YOGA GROUPS SHOWED SIGNIFICANT REDUCTION IN NUMBER OF ANGINAL EPISODES PER WEEK, IMPROVED EXERCISE CAPACITY AND DECREASE IN BODY WEIGHT. SERUM TOTAL CHOLESTEROL, LDL CHOLESTEROL AND TRIGLYCERIDE LEVELS ALSO SHOWED GREATER REDUCTIONS AS COMPARED WITH CONTROL GROUP. REVASCULARISATION PROCEDURES (CORONARY ANGIOPLASTY OR BYPASS SURGERY) WERE LESS FREQUENTLY REQUIRED IN THE YOGA GROUP (ONE VERSUS EIGHT PATIENTS; RELATIVE RISK = 5.45; P = 0.01). CORONARY ANGIOGRAPHY REPEATED AT ONE YEAR SHOWED THAT SIGNIFICANTLY MORE LESIONS REGRESSED (20% VERSUS 2%) AND LESS LESIONS PROGRESSED (5% VERSUS 37%) IN THE YOGA GROUP (CHI-SQUARE = 24.9; P < 0.0001). THE COMPLIANCE TO THE TOTAL PROGRAM WAS EXCELLENT AND NO SIDE EFFECTS WERE OBSERVED. CONCLUSION: YOGA LIFESTYLE INTERVENTION RETARDS PROGRESSION AND INCREASES REGRESSION OF CORONARY ATHEROSCLEROSIS IN PATIENTS WITH SEVERE CORONARY ARTERY DISEASE. IT ALSO IMPROVES SYMPTOMATIC STATUS, FUNCTIONAL CLASS AND RISK FACTOR PROFILE. 2000 14 692 27 EFFECT OF COMMUNITY-BASED YOGA INTERVENTION ON OXIDATIVE STRESS AND GLYCEMIC PARAMETERS IN PREDIABETES: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: TO STUDY THE EFFECTIVENESS OF YOGA INTERVENTION ON OXIDATIVE STRESS, GLYCEMIC STATUS, BLOOD PRESSURE AND ANTHROPOMETRY IN PREDIABETES. DESIGN: RANDOMIZED-CONTROLLED TRIAL. PARTICIPANTS: TWENTY NINE PREDIABETES SUBJECTS AGED 30-75 YEARS. SETTING: YOGA WAS CONDUCTED AT 4 DIFFERENT COMMUNITY DIABETES CLINICS IN MANGALORE, INDIA. INTERVENTIONS: PARTICIPANTS WERE RANDOMIZED TO EITHER 3-MONTH YOGA OR WAIT-LIST CONTROL GROUPS. MAIN OUTCOME MEASURES: MALONDIALDEHYDE, GLUTATHIONE, VITAMIN C, VITAMIN E, SUPEROXIDE DISMUTASE, PLASMA GLUCOSE, GLYCATED HAEMOGLOBIN, BMI, WAIST CIRCUMFERENCE, WAIST-TO-HIP RATIO AND BLOOD PRESSURE. RESULTS: YOGA INTERVENTION RESULTED IN A SIGNIFICANT DECLINE IN MALONDIALDEHYDE (P<0.001), RELATIVE TO THE CONTROL GROUP. IN COMPARISON WITH THE CONTROL, THERE WAS A SIGNIFICANT IMPROVEMENT IN BMI, WAIST CIRCUMFERENCE, SYSTOLIC BLOOD PRESSURE AND FASTING GLUCOSE LEVELS AT FOLLOW-UP. NO SIGNIFICANT IMPROVEMENT IN GLYCATED HAEMOGLOBIN, WAIST-TO-HIP RATIO OR ANY OF THE ANTIOXIDANTS WAS OBSERVED. CONCLUSIONS: YOGA INTERVENTION MAY BE HELPFUL IN CONTROL OF OXIDATIVE STRESS IN PREDIABETES SUBJECTS. YOGA CAN ALSO BE BENEFICIAL IN REDUCTION IN BMI, WAIST CIRCUMFERENCE, SYSTOLIC BLOOD PRESSURE AND FASTING GLUCOSE. EFFECT OF YOGA ON ANTIOXIDANT PARAMETERS WAS NOT EVIDENT IN THIS STUDY. THE FINDINGS OF THIS STUDY NEED TO BE CONFIRMED IN LARGER TRIALS INVOLVING ACTIVE CONTROL GROUPS. 2013 15 900 28 EFFECTIVENESS AND COST-EFFECTIVENESS OF A YOGA-BASED CARDIAC REHABILITATION (YOGA-CARE) PROGRAM FOLLOWING ACUTE MYOCARDIAL INFARCTION: STUDY RATIONALE AND DESIGN OF A MULTI-CENTER RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CARDIAC REHABILITATION (CR) IS A STANDARD TREATMENT FOR SECONDARY PREVENTION OF ACUTE MYOCARDIAL INFARCTION (AMI) IN HIGH INCOME COUNTRIES (HICS), BUT IT IS INACCESSIBLE TO MOST PATIENTS IN INDIA DUE TO HIGH COSTS AND SKILLS REQUIRED FOR MULTIDISCIPLINARY CR TEAMS. WE DEVELOPED A LOW-COST AND SCALABLE CR PROGRAM BASED ON CULTURALLY-ACCEPTABLE PRACTICE OF YOGA (YOGA-CARE). IN THIS PAPER, WE REPORT THE RATIONALE AND DESIGN FOR EVALUATION OF ITS EFFECTIVENESS AND COST-EFFECTIVENESS. METHODS: THIS IS A MULTI-CENTER, SINGLE-BLIND, TWO-ARM PARALLEL-GROUP RANDOMIZED CONTROLLED TRIAL ACROSS 22 CARDIAC CARE HOSPITALS IN INDIA. FOUR THOUSAND PATIENTS AGED 18-80YEARS WITH AMI WILL BE RECRUITED AND RANDOMIZED 1:1 TO RECEIVE YOGA-CARE PROGRAM (13 SESSIONS SUPERVISED BY AN INSTRUCTOR AND ENCOURAGEMENT TO SELF-PRACTICE DAILY) OR ENHANCED STANDARD CARE (3 SESSIONS OF HEALTH EDUCATION) DELIVERED OVER A PERIOD OF THREE MONTHS. PARTICIPANTS WILL BE FOLLOWED 3-MONTHLY TILL THE END OF THE TRIAL. THE CO-PRIMARY OUTCOMES ARE A) TIME TO OCCURRENCE OF FIRST CARDIOVASCULAR EVENT (COMPOSITE OF ALL-CAUSE MORTALITY, NON-FATAL MYOCARDIAL INFARCTION, NON-FATAL STROKE AND EMERGENCY CARDIOVASCULAR HOSPITALIZATION), AND B) QUALITY OF LIFE (EURO-QOL-5L) AT 12WEEKS. SECONDARY OUTCOMES INCLUDE NEED FOR REVASCULARIZATION PROCEDURES, RETURN TO PRE-INFARCT ACTIVITIES, TOBACCO CESSATION, MEDICATION ADHERENCE, AND COST-EFFECTIVENESS OF THE INTERVENTION. CONCLUSION: THIS TRIAL WILL ALONE CONTRIBUTE >20% PARTICIPANTS TO EXISTING META-ANALYSES OF RANDOMIZED TRIALS OF CR WORLDWIDE. IF YOGA-CARE IS FOUND TO BE EFFECTIVE, IT HAS THE POTENTIAL TO SAVE MILLIONS OF LIVES AND TRANSFORM CARE OF AMI PATIENTS IN INDIA AND OTHER LOW AND MIDDLE INCOME COUNTRY SETTINGS. 2019 16 2507 31 YOGA BASED CARDIAC REHABILITATION AFTER CORONARY ARTERY BYPASS SURGERY: ONE-YEAR RESULTS ON LVEF, LIPID PROFILE AND PSYCHOLOGICAL STATES--A RANDOMIZED CONTROLLED STUDY. OBJECTIVE: TO COMPARE THE LONG TERM EFFECTS OF YOGA BASED CARDIAC REHABILITATION PROGRAM WITH ONLY PHYSIOTHERAPY BASED PROGRAM AS AN ADD-ON TO CONVENTIONAL REHABILITATION AFTER CORONARY ARTERY BYPASS GRAFTING (CABG) ON RISK FACTORS. METHODS: IN THIS SINGLE BLIND PROSPECTIVE RANDOMIZED PARALLEL TWO ARMED ACTIVE CONTROL STUDY, 1026 PATIENTS POSTED FOR CABG AT NARAYANA HRUDAYALAYA INSTITUTE OF CARDIAC SCIENCES, BENGALURU (INDIA) WERE SCREENED. OF THESE, 250 MALE PARTICIPANTS (35-65 YEARS) WHO SATISFIED THE SELECTION CRITERIA AND CONSENTED WERE RANDOMIZED INTO TWO GROUPS. WITHIN AND BETWEEN GROUP COMPARISONS WERE DONE AT THREE POINTS OF FOLLOW UP (I.E. 6TH WEEK, 6TH MONTH, AND 12TH MONTH) BY USING WILCOXON'S SIGNED RANKS TEST AND MANN WHITNEY U TEST RESPECTIVELY. RESULTS: YOGA GROUP HAD SIGNIFICANTLY (P = 0.001, MANN WHITNEY) BETTER IMPROVEMENT IN LVEF THAN CONTROL GROUP IN THOSE WITH ABNORMAL BASELINE EF (<53%) AFTER 1 YEAR. THERE WAS A BETTER REDUCTION IN BMI IN THE YOGA GROUP (P = 0.038, BETWEEN GROUPS) IN THOSE WITH HIGH BASELINE BMI (>/=23) AFTER 12 MONTHS. YOGA GROUP SHOWED SIGNIFICANT (P = 0.008, WILCOXON'S) REDUCTION IN BLOOD GLUCOSE AT ONE YEAR IN THOSE WITH HIGH BASELINE FBS >/=110 MG/DL. THERE WAS SIGNIFICANTLY BETTER IMPROVEMENT IN YOGA THAN THE CONTROL GROUP IN HDL (P = 0.003), LDL (P = 0.01) AND VLDL (P = 0.03) IN THOSE WITH ABNORMAL BASELINE VALUES. THERE WAS SIGNIFICANTLY BETTER IMPROVEMENT (P = 0.02, BETWEEN GROUPS) IN POSITIVE AFFECT IN YOGA GROUP. WITHIN YOGA GROUP, THERE WAS SIGNIFICANT DECREASE IN PERCEIVED STRESS (P = 0.001), ANXIETY (P = 0.001), DEPRESSION (P = 0.001), AND NEGATIVE AFFECT (P = 0.03) WHILE IN THE CONTROL GROUP THERE WAS REDUCTION (P = 0.003) ONLY IN SCORES ON ANXIETY. CONCLUSION: ADDITION OF YOGA BASED RELAXATION TO CONVENTIONAL POST-CABG CARDIAC REHABILITATION HELPS IN BETTER MANAGEMENT OF RISK FACTORS IN THOSE WITH ABNORMAL BASELINE VALUES AND MAY HELP IN PREVENTING RECURRENCE. 2014 17 267 39 ACUTE FETAL BEHAVIORAL RESPONSE TO PRENATAL YOGA: A SINGLE, BLINDED, RANDOMIZED CONTROLLED TRIAL (TRY YOGA). BACKGROUND: IN 2012, YOGA WAS PRACTICED BY 20 MILLION AMERICANS, OF WHOM 82% WERE WOMEN. A RECENT LITERATURE REVIEW ON PRENATAL YOGA NOTED A REDUCTION IN SOME PREGNANCY COMPLICATIONS (IE, PRETERM BIRTH, LUMBAR PAIN, AND GROWTH RESTRICTION) IN THOSE WHO PRACTICED YOGA; TO DATE, THERE IS NO EVIDENCE ON FETAL RESPONSE AFTER YOGA. OBJECTIVES: WE AIMED TO CHARACTERIZE THE ACUTE CHANGES IN MATERNAL AND FETAL RESPONSE TO PRENATAL YOGA EXERCISES USING COMMON STANDARDIZED TESTS TO ASSESS THE WELL-BEING OF THE MATERNAL-FETAL UNIT. STUDY DESIGN: WE CONDUCTED A SINGLE, BLINDED, RANDOMIZED CONTROLLED TRIAL. UNCOMPLICATED PREGNANCIES BETWEEN 28 0/7 AND 36 6/7 WEEKS WITH A NONANOMALOUS SINGLETON FETUS OF WOMEN WHO DID NOT SMOKE, USE NARCOTICS, OR HAVE PRIOR EXPERIENCE WITH YOGA WERE INCLUDED. A COMPUTER-GENERATED SIMPLE RANDOMIZATION SEQUENCE WITH A 1:1 ALLOCATION RATIO WAS USED TO RANDOMIZE PARTICIPANTS INTO THE YOGA OR CONTROL GROUP. WOMEN IN THE YOGA GROUP PARTICIPATED IN A 1-TIME, 1 HOUR YOGA CLASS WITH A CERTIFIED INSTRUCTOR WHO TAUGHT A PREDETERMINED YOGA SEQUENCE. IN THE CONTROL GROUP, EACH PARTICIPANT ATTENDED A 1-TIME, 1 HOUR POWERPOINT PRESENTATION BY AN OBSTETRICIAN ON AMERICAN CONGRESS OF OBSTETRICIANS AND GYNECOLOGISTS RECOMMENDATIONS FOR EXERCISE, NUTRITION, AND OBESITY IN PREGNANCY. ALL PARTICIPANTS UNDERWENT PRE- AND POSTINTERVENTION TESTING, WHICH CONSISTED OF UMBILICAL AND UTERINE ARTERY DOPPLER ULTRASOUND, NONSTRESS TESTING, A BIOPHYSICAL PROFILE, MATERNAL BLOOD PRESSURE, AND MATERNAL HEART RATE. A BOARD-CERTIFIED MATERNAL-FETAL MEDICINE SPECIALIST, AT A DIFFERENT TERTIARY CENTER, INTERPRETED ALL NONSTRESS TESTS AND BIOPHYSICAL PROFILE DATA AND WAS BLINDED TO GROUP ASSIGNMENT AND PRE- OR POSTINTERVENTION TESTING. THE PRIMARY OUTCOME WAS A CHANGE IN UMBILICAL ARTERY DOPPLER SYSTOLIC TO DIASTOLIC RATIO. SAMPLE SIZE CALCULATIONS INDICATED 19 WOMEN PER GROUP WOULD BE SUFFICIENT TO DETECT THIS DIFFERENCE IN DOPPLER INDICES (ALPHA, 0.05; POWER, 80%). DATA WERE ANALYZED USING A REPEATED-MEASURES ANALYSIS OF VARIANCE, A CHI(2), AND A FISHER EXACT TEST. A VALUE OF P < .05 WAS CONSIDERED SIGNIFICANT. RESULTS: OF THE 52 WOMEN RANDOMIZED, 46 (88%) COMPLETED THE STUDY. THERE WAS NO CLINICALLY SIGNIFICANT CHANGE IN UMBILICAL ARTERY SYSTOLIC TO DIASTOLIC RATIO (P = .34), PULSATILITY INDEX (P = .53), OR RESISTANCE INDEX (P = .66) BETWEEN THE 2 GROUPS BEFORE AND AFTER THE INTERVENTION. FETAL AND MATERNAL HEART RATE, MATERNAL BLOOD PRESSURE, AND UTERINE ARTERY DOPPLERS REMAINED UNCHANGED OVER TIME. WHEN UMBILICAL ARTERY INDICES WERE INDIVIDUALLY COMPARED WITH GESTATIONAL AGE REFERENCES, THERE WAS NO DIFFERENCE BETWEEN THOSE WHO IMPROVED OR WORSENED BETWEEN THE GROUPS. CONCLUSION: THERE WAS NO SIGNIFICANT CHANGE IN FETAL BLOOD FLOW ACUTELY AFTER PERFORMING YOGA FOR THE FIRST TIME IN PREGNANCY. YOGA CAN BE RECOMMENDED FOR LOW-RISK WOMEN TO BEGIN DURING PREGNANCY. 2016 18 938 29 EFFECTS OF 1-YEAR YOGA ON CARDIOVASCULAR RISK FACTORS IN MIDDLE-AGED AND OLDER ADULTS WITH METABOLIC SYNDROME: A RANDOMIZED TRIAL. BACKGROUND: METABOLIC SYNDROME (METS) IS A CLUSTERING OF CARDIOVASCULAR RISK FACTORS, WHICH IS ASSOCIATED WITH DIABETES MELLITUS AND CARDIOVASCULAR DISEASE. LIFESTYLE INTERVENTIONS APPLIED TO PEOPLE WITH METS HAS CONSIDERABLE BENEFICIAL EFFECTS ON DISEASE PREVENTIVE OUTCOMES. THIS STUDY AIMED TO EXAMINE THE EFFECTS OF 1-YEAR OF YOGA EXERCISE ON THE CARDIOVASCULAR RISK FACTORS INCLUDING CENTRAL OBESITY, HYPERTENSION, DYSLIPIDEMIA AND HYPERGLYCEMIA IN MIDDLE-AGED AND OLDER HONG KONG CHINESE ADULTS WITH METS. METHODS: ADULTS DIAGNOSED WITH METS USING NATIONAL CHOLESTEROL EDUCATION PROGRAM CRITERIA (N = 182; MEAN +/- SD AGE = 56 +/- 9.1) WERE RANDOMLY ASSIGNED TO A 1-YEAR YOGA INTERVENTION GROUP OR CONTROL GROUP. SYSTOLIC AND DIASTOLIC BLOOD PRESSURE, WAIST CIRCUMFERENCE, FASTING PLASMA GLUCOSE, TRIGLYCERIDES, AND HIGH-DENSITY LIPOPROTEIN CHOLESTEROL WERE EXAMINED AT BASELINE, MIDWAY, AND ON COMPLETION OF THE STUDY. PHYSICAL ACTIVITY LEVEL AND CALORIC INTAKE WERE ASSESSED AND INCLUDED IN THE COVARIATE ANALYSES. RESULTS: A REDUCTION OF THE NUMBER OF DIAGNOSTIC COMPONENTS FOR METS WAS FOUND TO BE ASSOCIATED WITH THE YOGA INTERVENTION. WAIST CIRCUMFERENCE WAS SIGNIFICANTLY IMPROVED AFTER THE 1-YEAR YOGA INTERVENTION. A TREND TOWARDS A DECREASE IN SYSTOLIC BLOOD PRESSURE WAS OBSERVED FOLLOWING YOGA INTERVENTION. CONCLUSION: THESE RESULTS SUGGEST THAT YOGA EXERCISE IMPROVES THE CARDIOVASCULAR RISK FACTORS INCLUDING CENTRAL OBESITY AND BLOOD PRESSURE IN MIDDLE-AGED AND OLDER ADULTS WITH METS. THESE FINDINGS SUPPORT THE COMPLEMENTARY BENEFICIAL ROLE OF YOGA IN MANAGING METS. 2015 19 247 32 A YOGA INTERVENTION FOR TYPE 2 DIABETES RISK REDUCTION: A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: TYPE 2 DIABETES IS A MAJOR HEALTH PROBLEM IN MANY COUNTRIES INCLUDING INDIA. YOGA MAY BE AN EFFECTIVE TYPE 2 DIABETES PREVENTION STRATEGY IN INDIA, PARTICULARLY GIVEN ITS CULTURAL FAMILIARITY. METHODS: THIS WAS A PARALLEL, RANDOMIZED CONTROLLED PILOT STUDY TO COLLECT FEASIBILITY AND PRELIMINARY EFFICACY DATA ON YOGA FOR DIABETES RISK FACTORS AMONG PEOPLE AT HIGH RISK OF DIABETES. PRIMARY OUTCOMES INCLUDED: CHANGES IN BMI, WAIST CIRCUMFERENCE, FASTING BLOOD GLUCOSE, POSTPRANDIAL BLOOD GLUCOSE, INSULIN, INSULIN RESISTANCE, BLOOD PRESSURE, AND CHOLESTEROL. WE ALSO LOOKED AT MEASURES OF PSYCHOLOGICAL WELL-BEING INCLUDING CHANGES IN DEPRESSION, ANXIETY, POSITIVE AND NEGATIVE AFFECT AND PERCEIVED STRESS. FORTY-ONE PARTICIPANTS WITH ELEVATED FASTING BLOOD GLUCOSE IN BANGALORE, INDIA WERE RANDOMIZED TO EITHER YOGA (N = 21) OR A WALKING CONTROL (N = 20). PARTICIPANTS WERE ASKED TO EITHER ATTEND YOGA CLASSES OR COMPLETE MONITORED WALKING 3-6 DAYS PER WEEK FOR EIGHT WEEKS. RANDOMIZATION AND ALLOCATION WAS PERFORMED USING COMPUTER-GENERATED RANDOM NUMBERS AND GROUP ASSIGNMENTS DELIVERED IN SEALED, OPAQUE ENVELOPES GENERATED BY OFF-SITE STUDY STAFF. DATA WERE ANALYZED BASED ON INTENTION TO TREAT. RESULTS: THIS STUDY WAS FEASIBLE IN TERMS OF RECRUITMENT, RETENTION AND ADHERENCE. IN ADDITION, YOGA PARTICIPANTS HAD SIGNIFICANTLY GREATER REDUCTIONS IN WEIGHT, WAIST CIRCUMFERENCE AND BMI VERSUS CONTROL (WEIGHT -0.8 +/- 2.1 VS. 1.4 +/- 3.6, P = 0.02; WAIST CIRCUMFERENCE -4.2 +/- 4.8 VS. 0.7 +/- 4.2, P < 0.01; BMI -0.2 +/- 0.8 VS. 0.6 +/- 1.6, P = 0.05). THERE WERE NO BETWEEN GROUP DIFFERENCES IN FASTING BLOOD GLUCOSE, POSTPRANDIAL BLOOD GLUCOSE, INSULIN RESISTANCE OR ANY OTHER FACTORS RELATED TO DIABETES RISK OR PSYCHOLOGICAL WELL-BEING. THERE WERE SIGNIFICANT REDUCTIONS IN SYSTOLIC AND DIASTOLIC BLOOD PRESSURE, TOTAL CHOLESTEROL, ANXIETY, DEPRESSION, NEGATIVE AFFECT AND PERCEIVED STRESS IN BOTH THE YOGA INTERVENTION AND WALKING CONTROL OVER THE COURSE OF THE STUDY. CONCLUSION: AMONG INDIANS WITH ELEVATED FASTING BLOOD GLUCOSE, WE FOUND THAT PARTICIPATION IN AN 8-WEEK YOGA INTERVENTION WAS FEASIBLE AND RESULTED IN GREATER WEIGHT LOSS AND REDUCTION IN WAIST CIRCUMFERENCE WHEN COMPARED TO A WALKING CONTROL. YOGA OFFERS A PROMISING LIFESTYLE INTERVENTION FOR DECREASING WEIGHT-RELATED TYPE 2 DIABETES RISK FACTORS AND POTENTIALLY INCREASING PSYCHOLOGICAL WELL-BEING. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIED NCT00090506. 2014 20 324 27 ANTHROPOMETRIC, BIOCHEMICAL AND CLINICAL PARAMETERS IN CLIMACTERIC YOGA PRACTITIONERS. OBJECTIVE: THIS STUDY AIMED TO EVALUATE ANTHROPOMETRIC, BIOCHEMICAL AND CLINICAL PARAMETERS IN CLIMACTERIC YOGA PRACTITIONERS. METHODS: THIS STUDY INVESTIGATED 108 CLIMACTERIC WOMEN. WE RECRUITED 28 WOMEN BETWEEN 40 AND 65 YEARS OLD WHO STARTED YOGA PRACTICES IN PREMENOPAUSE AND HAD ALREADY PRACTICED FOR AT LEAST 5 YEARS. AS CONTROLS, WE SELECTED 30 PHYSICAL ACTIVITY (PA) PRACTITIONERS WHO HAD PRACTICED FOR AT LEAST 5 YEARS AND 50 SEDENTARY WOMEN IN THE SAME AGE RANGE. WE CONDUCED ANTHROPOMETRIC, BIOCHEMICAL AND BLOOD PRESSURE MEASUREMENTS. RESULTS: THE YOGA GROUP HAD SIGNIFICANTLY LOWER FASTING BLOOD GLUCOSE THAN THE PA PRACTITIONERS AND SEDENTARY WOMEN. YOGA PRACTITIONERS ALSO HAD LOWER WEIGHT, BODY MASS INDEX, WAIST CIRCUMFERENCE, BODY FAT PERCENTAGE AND WAIST-TO-HEIGHT RATIO; HIGHER LEVELS OF HIGH-DENSITY LIPOPROTEIN CHOLESTEROL; LOWER LEVELS OF TRIGLYCERIDES, INSULIN, HOMEOSTASIS MODEL ASSESSMENT OF INSULIN RESISTANCE, URIC ACID, APOLIPOPROTEIN B AND HIGH-SENSITIVITY C-REACTIVE PROTEIN; AND LOWER FREQUENCY OF METABOLIC SYNDROME, LIPID ACCUMULATION PRODUCT, VISCERAL ADIPOSITY INDEX AND SYSTOLIC BLOOD PRESSURE THAN THE SEDENTARY WOMEN. CONCLUSION: YOGA PRACTITIONERS HAD LOWER GLUCOSE SERUM CONCENTRATIONS THAN THE PA PRACTITIONERS AND SEDENTARY WOMEN. OVERALL, THE YOGA GROUP ALSO HAD BETTER ANTHROPOMETRIC, BIOCHEMICAL AND CLINICAL VARIABLES THAN THE OTHER GROUPS. ALTHOUGH FURTHER INVESTIGATION IS REQUIRED, YOGA PRACTICE IN PREMENOPAUSE SEEMS TO BE BENEFICIAL FOR WOMEN WHEN THEY REACH MENOPAUSE. 2022