Predicting the potential of middle- and long-distance track runners by evaluating the performance improvement rate.

BACKGROUND: The aim of this study was twofold: 1) to determine the rate of performance improvement among France's top 10 athletes in middle- and long-distance events (e.g., 800 m, 1500 m and 5000 m) by analyzing their personal best performances per season over several years; and 2) to develop an index of the optimal performance improvement rate for use by elite coaches and athletes in assessing athletes' progression, predicting potential performances, and possibly detecting high-potential athletes. METHODS: The top 10 athletes in the Fédération Française d'Athlétisme (FFA) rankings of the 800-m, 1500-m and 5000-m events for each sex were assessed for their history of race times before achieving their best race time (BRT). For each athlete, the difference between the current BRT and last season's BRT was defined as the 1-season improvement rate (1-SIR), whereas the average improvement rate in the last and preceding seasons was the multiseason improvement rate (M-SIR). RESULTS: Sex differences were observed in the 5000 m only for M-SIR (%) (P<0.05), and significantly higher rates of improvement were observed for 1-SIR (min) and M-SIR mostly for the 5000 m as opposed to the 800 m and 1500 m. CONCLUSIONS: Prediction using this index may be used to detect talents (those who have the potential for high level performances and/or the potential to break national records) and to follow and optimize training strategy and competitions.

Valid and accurate simple equation to predict 3,000-m steeplechase performance.

Introduction: Predict running performances is very important for athletes and trainers. Sport researchers have therefore developed certain tools to predict running performances, but only in non-obstacle races. This study aimed to develop and test the validity and accuracy of an equation for predicting 3,000-m steeplechase performance (PerfSteeple ). Methods: The official rankings of French runners for the 3,000-m track-running (Perf3000 ) and 3,000-m steeplechase events were examined. Age, height and body mass were collected. From 146 included athletes, two groups were randomly composed: one comprising 80% of the sample (n = 117) to develop a simple equation to predict PerfSteeple (i.e., development group) and the other comprising the remaining 20% (n = 29) to test the validity and accuracy of the developed prediction equation (i.e., cross-validation group). Results: The simple prediction equation included Perf3000 and age: P e r f S t e e p l e = - 57 , 165 + 1 , 147 × P e r f 3000 + 0 , 955 × a g e . No significant difference was noted between the actual and predicted performances. Predicted performances were significantly correlated with the actual ones, with a very high correlation coefficient (p < 0.001; r = 0.929). Bias and 95% limits of agreement were -5 ± 24 s, i.e., -0.8 ± 7.6%. In 95 of 100 new predictions, the difference between actual and predicted performance would be less or equal to-5 ± 24 s. Discussion: The study confirms the validity and accuracy of the equation for predicting PerfSteeple . Predictions using this simple equation may be used in training and competitions for athletes and coaches. PerfSteeple = -57,165 + 1,147 X Perf3000 + 0,955 X age.

Is test specificity the issue in assessing aerobic fitness and performance of runners? A systematic review.

INTRODUCTION: Various tests have been developed to evaluate aerobic fitness and performance of runners. However, a systematic understanding of which methods are more accurate is necessary to provide coaches and the sports sciences community with useful and confident outcomes. This study aims to summarize the evidence regarding the validity, reliability and sensitivity of tests for measuring aerobic fitness and performance in runners of several background of training. EVIDENCE ACQUISITION: A systematic search was conducted of Web of Science, PubMed and Scopus up to 31st December 2022 according to PRISMA statement guidelines. Studies that reported findings about tests covering maximal aerobic speed, final velocity achieved during the test, average running speed or other method of evaluating the reference speed during the test were included. We evaluated the risk of bias in the included articles using the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS). The tests were categorized into continuous incremental tests, intermittent tests and time-trial test. EVIDENCE SYNTHESIS: A total of 23 studies met eligibility criteria. These studies contained three background of training: track and road runners (N.=15), trail runners (N.=7) and inexperienced runners (N.=1). Criterion validity was assessed in 73% of the studies, while only 41% of studies examined convergent validity. The majority of the reviewed studies (87%) ignored test-retest reliability. Test sensitivity was not reported in any study. CONCLUSIONS: At least one aerobic fitness and performance test was identified for each types of background of training. However, some methodological aspects were not provided in the included articles. Most studies examined at least one aspect of validity (i.e., criterion or convergent-related validity), whilst few studies investigated test-retest reliability. Researchers and practitioners can use the information provided in this systematic review to select appropriate tests.

Yoga in the Rehabilitation of Post-Stroke Sequelae: A Non-Inferiority Randomized Controlled Trial.

Introduction: Stroke survivors can experience various consequences that affect their physical and psychological balance. Yoga seems to be relevant for this population as it allows to work on both the body and the mind. The first objective of this study was to investigate the non-inferiority of yoga compared with conventional physical activity in improving physical function in patients with chronic post-stroke sequelae. The secondary objective was to investigate the superiority of yoga in improving the mental health of these patients. Methods: A randomized controlled trial was conducted. Thirty-six patients were randomized into two groups to practice a yoga program (YOG'AVC) or the Fitness and Mobility Exercise (FAME) program. Patients were assessed in a blinding mode pre- (T0) and post-program (T1) and 3-4 months after completion (T2). The physical assessments were the Berg Balance Scale, timed up and go test, 6-minute walk test, and quadriceps strength measured by hand-held dynamometer. Questionnaire assessments were: Activities-specific Balance Confidence Scale-Simplified, State-Trait Anxiety Inventory, Beck's Depression Inventory, and the Reintegration to Normal Living Index. Results: The YOG'AVC program was not inferior to the FAME program in improving balance, functional mobility and muscle strength. Both groups showed significant improvement (p < 0.05) between T0 and T1 in their anxiety, depression, and reintegration to normal life scores, with no significant difference between groups. Discussion: Both programs seem to be valuable in improving the physical abilities and psychological well-being of chronic post-stroke patients. However, further studies are required to confirm the difference between these programs.

Psychometric validation of the French Multidimensional Chronic Asthenia Scale (MCAS) in a sample of 621 patients with chronic fatigue.

BACKGROUND: Psychometric validation of the Multidimensional Chronic Asthenia Scale (MCAS) was conducted in order to provide an effective tool for assessing the health-related quality of life of French-speaking patients with chronic asthenia (CA). METHODS: Items resulting from the initial formulation of the self-reported MCAS (along with other materials) were completed by French-speaking volunteers with inactive or active inflammatory bowel disease (IBD-I vs. IBD-A) or chronic fatigue syndrome (CFS). Responses from 621 participants (180 patients with IBD-A, 172 with IBD-I, 269 with CFS) collected in a single online survey were divided into three subsamples to test the construct validity of the MCAS (Step 1, N = 240), to confirm its factorial structure (Step 2, N = 204) and to explore its convergent-discriminant validity with the Fatigue Symptoms Inventory (FSI) and revised Piper Fatigue Scale (r-PFS, Step 3, N = 177). RESULTS: Steps 1 and 2 showed that, as expected, MCAS has four dimensions: feeling of constraint (FoC), physical (PC), life (LC) and interpersonal consequences (IC), which are also related to the duration of CA (i.e., the longer it lasts, the more the dimensions are impacted). The results further showed that the MCAS is sensitive enough to capture between-group differences, with the CFS group being the most impaired, followed by IBD-A and IBD-I. While convergent-discriminant validity between the 4 factors of MCAS and FSI and r-PFS, respectively, was satisfactory overall, Step 3 also pointed to some limitations that call for future research (e.g., shared variances between the PC and IC dimensions of MCAS and behavioral dimension of r-PFS). CONCLUSION: Despite these limitations, the MCAS clearly constitutes a promising tool for measuring quantitative differences (i.e., severity/intensity) in CA associated with various diseases, but also, and importantly, the clinically important differences in domains of its expression (i.e., qualitative differences).

Acute Effect of Four Stretching Protocols on Change of Direction in U-17 Male Soccer Players.

BACKGROUND: The ability to rapidly change direction while sprinting is a desirable athletic skill in soccer. Enhancing change of direction (COD) performance depends almost exclusively on specific training, with stretching traditionally considered one such intervention. However, the comparative impact of diverse stretching methods on COD in soccer players remains an area of interest. Therefore, this study aimed to compare the effects of different stretching methods on COD ability in soccer players. METHODS: Twelve male soccer players playing in the national championship football division II (age: 16.3 ± 0.3 years, height: 1.81 ± 0.10 m, body mass: 67.7 ± 7.2 kg) were tested for COD performance (i.e., Illinois agility test) after (1) control condition (20 min general warm-up without stretching), (2) static stretching, (3) dynamic stretching, (4) combined static-dynamic stretching, and (5) combined dynamic-static stretching. The duration of stretching intervention was approximately 6 min for static and dynamic stretching and 12 min for both the combined stretching conditions. The experimental sessions were separated by 72 h. RESULTS: COD improved after dynamic stretching when compared to any other condition (p: 0.03-0.002; ηp2: 0.56-0.73), except for the control condition (p = 0.146; ηp2 = 0.18). In contrast, static stretching induced a detrimental effect on COD when compared only to the dynamic stretching condition (p < 0.01; ES = 1.35). CONCLUSION: Dynamic stretching exercises used by male soccer players in the warm-up improved COD. Other forms of stretching exercises, particularly static stretching, negatively impacted the COD performance. Therefore, coaches can consider integrating dynamic stretching protocols tailored to the athletes' specific needs. Moreover, extending the investigation to encompass a wider range of athletes, including different age groups and genders, would enhance the applicability and generalization of the findings.

Long- and Short-Term High-Intensity Interval Training on Lipid Profile and Cardiovascular Disorders in Obese Male Adolescents.

This study investigated the effects of short-term and long-term periods (8 and 16 weeks) of high-intensity interval training (HIIT) on cardiovascular components, blood lipids, and 6-min walking test performance in obese young boys (age = 16.2 ± 0.7) with >34% body fat. The participants were split into two groups: severe obesity (SOG; n = 17) and moderate obesity (MOG; n = 16). All participants performed on a cycle ergometer for 16 weeks (3 times per week) of HIIT at 100% peak power output at the ventilatory threshold and recovered at 50% of peak power. Except for BMI, both groups improved all body composition measures after 16 weeks, with a higher percentage of change (Δ) in SOG. The 6-min walking test increased in both groups (p < 0.001). Furthermore, cardiovascular variables, blood lactate concentration at rest and after 5-min post-exercise, blood lipids, and insulin concentrations improved significantly in both groups. After 16 weeks, MOG significantly improved in HRpeak, blood glucose concentration, and rating of perceived exertion (RPE), but the percentage of change (Δ) was higher in SOG for all the other variables. SOG showed a higher (Δ) waist-to-hip ratio, maximum heart rate, resting heart rate, systolic blood pressure, blood lactate at 5-min post-exercise, and triglyceride concentrations after 8 and 16 weeks of training. In conclusion, a long-term HIIT program appears to be an appropriate training approach for obese boys with extra body fat. However, considering the RPE values, short-duration training sessions should be planned.

Effects of Insoles on Gait Kinematics and Low Back Pain in Patients with Leg Length Inequality: A Systematic Review.

The aim of this systematic review was to examine the effects of foot orthoses on gait kinematics and low back pain (LBP) in individuals with leg length inequality (LLI). This review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and has been undertaken in the PubMed-NCBI, EBSCO Host, Cochrane Library, and ScienceDirect databases. Inclusion criteria were the analysis of kinematic parameters during walking or LBP before and after foot orthosis use in patients with LLI. Ultimately, five studies were retained. We extracted the following information: study identity, patients, type of foot orthosis, duration of orthopedic treatment, protocols, methods, and data to assess gait kinematics and LBP. The results showed that insoles seem to reduce pelvic drop and active compensations of the spine when LLI is moderate/severe. However, insoles do not always seem to be efficient in improving gait kinematics in patients with low LLI. All of the studies noted a significant reduction of LBP with use of insoles. Consequently, although these studies revealed no consensus on whether and how insoles affect gait kinematics, the orthoses seemed helpful in relieving LBP.

Prediction of performance in a 100-km run from a simple equation.

This study aimed to identify predictive variables of performance for a 100-km race (Perf100-km) and develop an equation for predicting this performance using individual data, recent marathon performance (Perfmarathon), and environmental conditions at the start of the 100-km race. All runners who had performed official Perfmarathon and Perf100-km in France, both in 2019, were recruited. For each runner, gender, weight, height, body mass index (BMI), age, the personal marathon record (PRmarathon), date of the Perfmarathon and Perf100-km, and environmental conditions during the 100-km race (i.e., minimal and maximal air temperatures, wind speed, total amount of precipitation, relative humidity and barometric pressure) were collected. Correlations between the data were examined, and prediction equations were then developed using stepwise multiple linear regression analyses. Significant bivariate correlations were found between Perfmarathon (p<0.001, r = 0.838), wind speed (p<0.001, r = -0.545), barometric pressure (p<0.001, r = 0.535), age (p = 0.034, r = 0.246), BMI (p = 0.034, r = 0.245), PRmarathon (p = 0.065, r = 0.204) and Perf100-km in 56 athletes The, 2 prediction equations with larger sample (n = 591) were developed to predict Perf100-km, one including Perfmarathon, wind speed and PRmarathon (model 1, r² = 0.549; standard errors of the estimate, SEE = 13.2%), and the other including only Perfmarathon and PRmarathon (model 2, r² = 0.494; SEE = 14.0%). Perf100-km can be predicted with an acceptable level of accuracy from only recent Perfmarathon and PRmarathon, in amateur athletes who want to perform a 100 km for the first time.

Karatekas educated on injury prevention and supported by fitness coaches are more likely to practise injury prevention.

To determine the current perceptions and practices of top-level karate athletes concerning risk factors and injury prevention programme (IPP) implementation in training and competition. Out of 90 eligible countries (933 athletes) participating in the karate World Senior Championships (WSC) in Madrid 2018, 50 countries (55.6%) represented by 137 athletes (14.7%; 52 females and 85 males) responded to a structured questionnaire. Of the athletes responding, 45% reported that their national team did not conduct any measures to reduce injury risk (43% among females and 47% among males; p = 0.68). Kumite athletes (51%) were more likely to practise injury prevention compared to kata athletes (25%; p = 0.016). Of the respondents, 69%, 60%, 60% and 34% reported having no team doctor, fitness coach, massage therapist and physiotherapist, respectively. A greater proportion of athletes who had access to a fitness coach (part-time or full-time) engaged in injury prevention strategies (67% and 51%, respectively) than those who did not (35%; p = 0.031). Athletes who had received previous advice about injury prevention were more likely to practise injury prevention (58%) compared to the rest (21%; p < 0.001). The current study revealed that: i) almost half of the karatekas already benefited from an injury prevention programme, ii) injury prevention programmes were practised more frequently when there was a fitness coach among their coaching staff, iii) karatekas who had received education about injury prevention were more likely to practise injury prevention programmes.

Prediction of Marathon Performance using Artificial Intelligence.

Although studies used machine learning algorithms to predict performances in sports activities, none, to the best of our knowledge, have used and validated two artificial intelligence techniques: artificial neural network (ANN) and k-nearest neighbor (KNN) in the running discipline of marathon and compared the accuracy or precision of the predicted performances. Official French rankings for the 10-km road and marathon events in 2019 were scrutinized over a dataset of 820 athletes (aged 21, having run 10 km and a marathon in the same year that was run slower, etc.). For the KNN and ANN the same inputs (10-km race time, body mass index, age and sex) were used to solve a linear regression problem to estimate the marathon race time. No difference was found between the actual and predicted marathon performances for either method (p>0,05). All predicted performances were significantly correlated with the actual ones, with very high correlation coefficients (r>0,90; p<0,001). KNN outperformed ANN with a mean absolute error of 2,4 vs 5,6%. The study confirms the validity of both algorithms, with better accuracy for KNN in predicting marathon performance. Consequently, the predictions from these artificial intelligence methods may be used in training programs and competitions.

Relationships Between Sports Club Participation and Health Determinants in Adolescents and Young Adults.

Physical fitness is a powerful marker of health in adolescents and young adults. The purpose of this study was to measure the relationships between age, sex, body mass index, and sports club participation on physical fitness. The population included 49,988 participants (23,721 girls and 26,267 boys) who were divided into five age groups (11-12, 13-14, 15-16, 17-18, and 19-21 years). Body mass index was calculated. Physical fitness was assessed with the Diagnoform® Tonic battery. Sports club participation was also documented. The practiced sport was collected. The effects of age, sex, body mass index class, and sports club participation were tested. Boys' PF increased with age at a faster rate and was better than that of girls, except for flexibility (p < 0.001). For girls, a decrease was observed in endurance, speed and flexibility at 17-18 years. Sports club participation was greater for boys at every age. Obese participants had the lowest physical fitness and sports club participation. Sports club participation increased physical fitness. Team sports seemed best for improving physical fitness, except flexibility. The study shows that sports club participation may be a key element for building health in adolescents. Preventive healthcare projects that promote sports club are needed to target sports club dropouts (obese adolescents and girls). Bridges should be built between physical education classes and sports clubs in adolescence to improve the health status of young people.

Predictions of the Distance Running Performances of Female Runners Using Different Tools.

This study examined the validity and compared the precision and accuracy of a distance-time linear model (DTLM), a power law and a nomogram to predict the distance running performances of female runners. Official rankings of French women ("senior" category: between 23 and 39 years old) for the 3000-m, 5000-m, and 10,000-m track-running events from 2005 to 2019 were examined. Performances of runners who competed in the three distances during the same year were noted (n=158). Mean values and standard deviation (SD) of actual performances were 11.28±1.33, 19.49±2.34 and 41.03±5.12 for the 3000-m, 5000-m, and 10,000-m respectively. Each performance was predicted from two other performances. Between the actual and predicted performances, only DTLM showed a difference (p<0.05). The magnitude of the differences in these predicted performances was small if not trivial. All predicted performances were significantly correlated with the actual ones, with a very high correlation coefficient (p<0.001; r>0.90), except for DTLM in the 3000-m, which showed a high correlation coefficient (p<0.001; r>0.895). Bias and 95% limits of agreement were acceptable because, whatever the method, they were≤-3.7±10.8% on the 3000-m, 1.4±4.3% on the 5000-m, and -2.5±7.4% on the 10,000-m. The study confirms the validity of the three methods to predict track-running performance and suggests that the most accurate and precise model was the nomogram followed by the power law, with the DTLM being the least accurate.

Evaluation of Age Based-Sleep Quality and Fitness in Adolescent Female Handball Players.

The present study aimed to examine the differences in sleep hygiene, balance, strength, agility, and maximum aerobic speed (MAS) between two groups of female handball players aged under 14 (U14) and under 17 (U17) years. Seventy-two female handball players participated and were divided into two groups according to age: U14 (n = 36, age: 13.44 ± 0.5 years) and U17 (n = 36, age: 15.95 ± 0.76 years). Sleep hygiene was evaluated using three questionnaires: Sleep quality and sleepiness via the Pittsburgh (PSQI) and Epworth (ESS) questionnaires, and the insomnia questionnaire via the measurement of the insomnia severity index (ISI). Physical fitness was evaluated with the stork balance tests with eyes open (OEB) and closed (CEB), the vertical jump (SJ), horizontal jump (SBJ), and five jump (FJT) tests, the agility (t-test) and the maximum aerobic speed (MAS) tests. No significant differences were shown between U14 and U17 players in all PSQI, ISI, and ESS scores, and balance and strength performances. Meanwhile, the U17 players' performances were significant better in agility quality (p = 0.003 < 0.01) and MAS (p = 0.05) compared to the U14 players. Biological gender specificity during the maturation phase may inhibit the improvement of balance, and strength performances between the age of 13 and 17 years, while agility and MAS performances are more affected by age alterations.

Prediction of Distance Running Performances of Female Runners Using Nomograms.

This study examined the validity, precision and accuracy of the predictions of distance running performances in female runners from three nomograms. Official rankings of French women for the 3000-m, 5000-m, and 10 000-m track-running events from 2005 to 2019 were examined. Only female runners who performed in the three distance events within the same year were included (n=158). Each performance over any distance was predicted using the three nomograms from the two other performances. The 3000-m, 5000-m and 10 000-m performances were 11min17 s±1min20 s, 19min29 s±2min20 s, 41min18 s±5min7 s, respectively. No difference was found between the actual and predicted running performances regardless of the nomogram (p>0.05). All predicted running performances were significantly correlated with the actual ones, with a very high correlation coefficient (p<0.001; r>0.90). Bias and 95% limits of agreement were acceptable because, whatever the nomogram, they were less than or equal to - 0.0±6.2% on the 3000-m, 0.0±3.7% on the 5000-m, and 0.1±9.3% on the 10 000-m. The study confirms the validity of the three nomograms to predict track-running performance with a high level of accuracy. The predictions from these nomograms are similar and may be used in training programs and competitions.

Relationships between sports club participation and physical fitness and Body Mass Index in childhood.

BACKGROUND: Physical fitness (PF) is a powerful determinant of health. The aim of this study was to examine the relationships between sports club (SC) participation and PF, and Body Mass Index (BMI) in children. METHODS: The population included 15,625 children (8029 boys and 7596 girls) 5 to 10 years old divided into three aged groups. PF was assessed with the Diagnoform® Kid (IRFO, Loos, France) from 5 tests measuring different components: cardiorespiratory endurance, muscular strength, speed, coordination, agility, and flexibility. BMI was calculated. SC participation was documented. The sports were classified into four categories based on the educational goal (C1, C2, C3, C4). The relationships between sex, age, BMI class and SC participation were tested. RESULTS: The children who practiced in SC had better PF than those who did not. C1 (track and field, swimming, triathlon, and cycling) and C4 (team, combat, and racket sports) sports seemed to be associated with a better PF. CONCLUSIONS: This study showed that SC participation may be an element for building health. Preventive healthcare projects for SC dropouts (obese children and girls) are needed.

The Effects of Sporting and Physical Practice on Visual and Kinesthetic Motor Imagery Vividness: A Comparative Study Between Athletic, Physically Active, and Exempted Adolescents.

The interest of motor imagery practice on performance and motor learning is well-established. However, the impact of sporting and physical practice on motor imagery vividness is currently unclear, especially in youth. Two-hundred-and-forty adolescents were recruited to form different groups. For each age group (age-group 1, A-G1 with 13years≤age≤14years 6months vs. age-group 2, A-G2 with 14years 6months

Sport-Related Affective Benefits for Teenagers Are Getting Greater as They Approach Adulthood: A Large-Scale French Investigation.

The present investigation examined how sports club membership is related to adolescents' daily negative and positive affects as they age. Robust prior results demonstrated that sports club membership is positively related to positive affect and negatively related to negative affect. However, surprisingly, no prior studies examined whether these benefits are consistently present throughout the teenage years or there are certain critical periods when teenagers can affectively profit more from being members of a sports club. The present cross-sectional investigation examined these questions on a comprehensive sample of French adolescents (N=17,337, female=7,604, aged between 10 and 18, M age=12.45years, SD age=1.94years). Besides the expected affective benefits of a sports club membership, there was no interaction between age and negative affect. However, late adolescents reported greater daily positive affective benefits of sports club membership than early adolescents. These results suggest that late adolescents can use the extra affective benefits of sports club membership to gain advantages for the first steps of their adult life, such as coping with career start or transition to higher education. These results can provide guidelines for future studies to prioritize late adolescents with heightened positive sport-related affective benefits. It can also be useful information to promote sport among late adolescents.

Effect of yoga on health-related quality of life in central nervous system disorders: A systematic review.

OBJECTIVE: Investigate the effect of yoga on health-related quality of life (HRQoL) in patients with central nervous system disorders. METHODS: A systematic search was conducted on the PubMed-NCBI, EBSCO Host, Cochrane Library, Scopus and ScienceDirect databases until 05 April 2021. Only randomized control trials published in English or French were included and had to compare yoga to another intervention group or a control group. They also had to clearly measure HRQoL. Methodological quality was assessed with the revised Cochrane risk-of-bias tool for randomized trials and the quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. RESULTS: Sixteen studies were found, including six for multiple sclerosis, five for Parkinson's disease, two for stroke, one for dementia, one for epilepsy and one for brain tumour. Only 12 studies performed between-group statistics and 8 found a significant difference between groups after treatment. When yoga was compared to no intervention, the results were generally in favour of the yoga group, but when yoga was compared to another intervention programme, there was generally no significant difference between groups. There were many different HRQoL questionnaires, even within the same disease, which reduces the comparability of studies. CONCLUSIONS: With low to moderate quality of the evidence, yoga seems effective to improve HRQoL in people with Parkinson's disease. For multiple sclerosis, stroke, dementia, epilepsy and brain tumour, the quality of the evidence is still insufficient to conclude of the effectiveness of yoga.