The Effect of Super Brain Yoga on Concentration, Memory, and Academic Progress in Nursing Students: A Quasi-Experimental Study.

Background: During university life, students often face significant changes in relationships and academic pressures. Given the stressors faced by nursing students and the importance of their academic success, the study aimed to assess the impact of Super Brain Yoga on nursing students' concentration, memory, and academic progress. Methods: This quasi-experimental study was conducted on 59 nursing students at Near East University in Cyprus from February to June 2023. The intervention group (N=29) performed Super Brain Yoga three times a week for two months, while the control group (N=30) continued the usual routines. Data were collected using the demographic questionnaire, Wechsler's memory test, Concentration test, and the semester grade point average. Data analysis was performed using independent and paired t-test, chi-square, and ANCOVA using SPSS software version 26, with a significance level of P˂0.05. Results: The study revealed a significant difference in total memory scores (P<0.001) and its subscales including personal and public information (P<0.001), orientation (P<0.001), mental control (P<0.001), logical memory (P=0.002), repeating numbers (P<0.001), visual memory (P<0.001), and learning associations (P=0.003) between the experimental and control groups after the intervention. Findings revealed a significant difference between the two groups in the reaction time (P=0.003) and the error of the reverse counting (P=0.021) following the intervention. After the intervention, based on ANCOVA test with adjusting the baseline values, there was no statistically significant difference in the semester mean of Grade Point Average between the two groups (95% confidence interval, P=0.657). Conclusion: Super Brain Yoga is a non-invasive intervention that can improve memory, concentration, and cognitive abilities in nursing students.

The Therapeutic Potential of Yoga for Alzheimer's Disease: A Critical Review.

Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, memory impairment, and behavioral changes, significantly impacting the quality of life of affected individuals and their caregivers. While pharmacological treatments offer limited relief, nonpharmacological interventions, like yoga, have gained attention for their potential therapeutic benefits. This critical review synthesizes findings from various studies on the feasibility, adherence, physical function, cognitive improvements, inflammatory markers, neuroprotection, and mood and behavioral changes associated with yoga interventions for older adults with AD. Despite these promising results, further research with randomized controlled trials, larger sample sizes, control groups, longitudinal follow-ups, standardized protocols, and diverse populations is necessary to confirm these benefits and understand the long-term effects of yoga on AD progression. This critical review highlights yoga's potential as a valuable nonpharmacological intervention in the holistic management of AD.

Study protocol for a multicentre randomised controlled trial evaluating the efficacy of an online yoga intervention in high-grade glioma patients and their caregivers: the YINOTA-O-trial.

INTRODUCTION: High-grade glioma patients and their caregivers often suffer from distress and a lower quality of life. Results from studies with patients with mixed cancer entities suggest that yoga can be an effective support. However, it is unclear whether this also applies to high-grade glioma patients and their caregivers. This study aims to investigate the effects of mindfulness-based online yoga for patients and their caregivers on emotional distress, quality of life and stress-associated physiological parameters compared with a waiting control group (WCG). METHODS & ANALYSIS: The study is designed as a multicentre randomised controlled trial. Adult glioma patients (central nervous system WHO grades 3 and 4) and their caregivers will be recruited. Examined yoga instructors deliver the intervention (1 hour per week) in a synchronous format over 8 weeks via video conferencing. The WCG will receive standard care during the 8-week waiting period. Data will be collected before and after the end of the intervention and another 3 months later using questionnaires as well as blood serum and hair samples to evaluate biochemical stress parameters. Primary outcome is self-reported generalised anxiety and secondary outcomes are self-reported fear of progression, depression and quality of life as well as brain-derived neurotrophic factor (BDNF), dehydroepiandrosterone (DHEA)/dehydroepiandrosterone sulfate (DHEAS), ferritin and hair cortisol. We hypothesise better outcomes in the intervention group compared with the WCG at all measurement points. 70 patients and 70 caregivers will be recruited consecutively. Primary endpoints are significant effect detections in the Generalised Anxiety Disorder scale-7 of patients and caregivers at the end of the intervention. Analyses of covariance will be performed to analyse the treatment effects. ETHICS AND DISSEMINATION: The Ethics Committee of the University of Würzburg approved the YINOTA-O (Yoga-Intervention bei Neuroonkologischen Tumorpatienten und deren Angehörigen - Online) study on 26 October 2021 (No.185/18-me). Results will be presented at conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: German Clinical Trials Register No. DRKS00029554.

[Summarising the efficiency of psychological interventions in the treatment of endometriosis]. / Az endometriózis pszichológiai ellátásában használatos beavatkozások hatékonyságának összegzése.

Endometriosis is a common gynecological disease affecting 5-10% of women resulting in several psychological impacts. Regarding the high prevalence as well as extensive somatic symptoms, this has become a growing issue of psychological research in recent years. Thanks to its rising importance the negative effect on quality of life, mood, and anxiety symptoms has been proven. Thus we aimed to organize psychological interventions affecting the mentioned constructs and also examine their efficiency and scientific standards. Our inclusion criteria referred to studies based on randomized controlled trials, systematic reviews, and meta-analyses. We selected seven types of interventions, such as psychoeducation, cognitive behavioural therapy, mindfulness-based methods, progressive muscle relaxation, yoga, physical activity, and complex programs. Regarding the quality of life, mood, and anxiety cognitive behavioural therapy and progressive muscle relaxation were the most effective methods, however, other interventions had promising results either. Besides, there is a growing demand for psychological and mind-body interventions, which should get a more important place in the primary care of endometriosis next to medical treatment. We find inevitable further high-quality examinations, and from the point of practice, we consider it crucial to implement current evidence-based methods in the psychological care of endometriosis. Keywords: , , , , , , , , , , , .

Effectiveness of an interactive online group intervention based on pain neuroscience education and graded exposure to movement in breast cancer survivors with chronic pain: a randomised controlled trial.

PURPOSE: To evaluate the effectiveness, compared with usual care, of an interactive online group programme combining pain neuroscience education (PNE) and graded exposure to movement (GEM) for improving quality of life and pain experience in breast cancer survivors with chronic pain. METHODS: This single-blind randomised controlled trial included a sample of 49 breast cancer survivors who were randomly assigned to two groups (experimental: n = 22 and control: n = 27). The experimental group received a 12-week person-centred online programme based on pain neuroscience education and therapeutic yoga as gradual exposure to movement, while the control group continued with their usual care. The primary outcome was quality of life (FACT-B + 4); the secondary outcomes were related to the experience of chronic pain (pain intensity, pain interference, catastrophizing, pain self-efficacy, kinesiophobia, and fear avoidance behaviours). All variables were assessed at four time points (T0, baseline; T1, after PNE sessions; T2, after yoga sessions; T3, at 3-month follow-up). For data analysis, ANOVA (2 × 4) analysis of variance (95% CI) was used when outcomes were normally distributed. If not, within-group and between-group comparisons were calculated. RESULTS: Thirty-six participants were included in the analysis (control group, 22; experimental group, 14). A significant time * group effect was observed in favour of the experimental group regarding the global quality of life score (p = 0.010, ηp2 = 0.124). Significant differences in favour of the experimental group were observed for pain intensity, pain interference, catastrophizing, and pain self-efficacy. These differences persisted at follow-up. CONCLUSIONS: An online intervention based on PNE and GEM appears to be more effective than usual care for improving quality of life in breast cancer survivors with chronic pain, as a time per group interaction was reported. In addition, the intervention also significantly improved the participants' experience of chronic pain. However, due to the study limitations further research is needed. Trial record: NCT04965909 (26/06/2021).

Proof-of-Concept of an Integrated Yoga and Psychological Intervention in Mitigating Distress Among Diverse Women With Gynecologic, Gastrointestinal, and Thoracic Cancers.

Background: Fear of cancer recurrence (FCR), cancer-distress, depression, and anxiety are prevalent concerns among women with gynecologic and other understudied cancers, especially among women of color and lower socioeconomic status (SES). Evidence indicates that mind-body interventions are effective in reducing such distress. This study evaluates (1) proof-of-concept of an integrated group yoga and psychological intervention in alleviating distress among women with gynecologic, gastrointestinal, and thoracic cancers and (2) differences in efficacy across social and economic factors. Methods: One hundred twenty-five participants were enrolled in a 10-week, single-arm, integrated group intervention utilizing mindfulness meditation, psychotherapy skills, and yoga. They completed measures of FCR, cancer-distress, depression, and anxiety at baseline and following intervention. Mixed-linear models evaluated change in outcomes across the intervention and moderating effects of age, minority status, and SES among 51 participants with available data. Results: Reductions in total (b = -2.06, P = .012) and somatic depressive symptoms (b = -1.79, P = .002) and state anxiety (b = -6.21, P = .005) were observed across the sample. Higher SES was associated with greater reductions in psychosocial distress related to FCR (b = -0.74, P = .050), and in total (b = -1.06, P = .049) and affective depressive symptoms (b = -0.76, P = .006). Women of color experienced greater declines in somatic symptoms compared to non-Hispanic White women (b = -2.71, P = .031), with women of color experiencing lower SES exhibiting greatest reduction in these symptoms (b = 1.73, P = .026). Conclusions: This study demonstrates proof-of-concept that an integrated psychological and yoga intervention may reduce depressive symptoms and state anxiety among women with gynecologic, gastrointestinal, and thoracic cancers, with racial and/or ethnic minority status and SES moderating some of these effects. Future research should examine intervention feasibility and acceptability among diverse women with cancer and evaluate efficacy using a randomized controlled trial design.Trial registration: ClinicalTrials.gov NCT03385577.

High-intensity interval training vs. yoga in improving binge eating and physical fitness in inactive young females.

Yoga is effective in binge eating disorder (BED) treatment, but it does not seem effective enough to improve low physical fitness. In contrast, high-intensity interval training (HIIT) is effective in improving physical fitness but has never been studied in the context of BED. In the study, 47 young inactive females with mild to moderate BED were recruited and randomly assigned to a HIIT group (HIIT), a Yoga group (YG), or a control group (CG; age, 19.47 ± 0.74, 19.69 ± 0.874, and 19.44 ± 0.63 years; BMI, 21.07 ± 1.66, 21.95 ± 2.67, and 20.68 ± 2.61 kg/m2, respectively). The intervention groups participated in 8-week specific exercises, while the CG maintained their usual daily activity. Before and after the training, participants were evaluated for BED using the binge eating scale (BES) and for physical fitness. The obtained data were compared within groups and between groups, and a correlation analysis between BES and physical fitness parameters was performed. After the training, the YG presented significant improvements in BES (- 20.25%, p = 0.006, ηp2 = 0.408), fat mass (FM, - 3.13%, p = 0.033, ηp2 = 0.269), and maximal oxygen consumption (VO2max, 11.51%, p = 0.000, ηp2 = 0.601), whereas the HIIT showed significant improvements in body weight (BW, - 1.78%, p = 0.006, ηp2 = 0.433), FM (- 3.94%, p = 0.033, ηp2 = 0.285), and BMI (- 1.80%, p = 0.006, ηp2 = 0.428), but not in BES. Comparisons between groups revealed that both HIIT and YG had significantly higher VO2max levels than CG (HIIT 12.82%, p = 0.006, ηp2 = 0.088; YG: 11.90%, p = 0.009, ηp2 = 0.088) with no difference between HIIT and YG. Additionally, YG presented significantly lower BES than both HIIT (15.45%, p = 0.02, ηp2 = 0.03) and CG (11.91%, p = 0.022, ηp2 = 0.03). In conclusion, Yoga is an effective treatment for BED, but HIIT is not, despite its high efficacy in improving physical fitness.

Yoga as an Adjunctive Treatment for Chronic Low Back Pain: A Narrative Review.

BACKGROUND: Yoga has been recognized for its many mental and physical health benefits. A growing body of literature supports yoga's indication in chronic low back pain (CLBP) management. CLBP is a major public health concern, given its high rates of associated disabilities and large healthcare costs. A biopsychosocial approach has been deemed the most effective and appropriate management strategy for this condition. When alternative and comprehensive approaches for managing the complexity of CLBP are considered, yoga poses a safe, accessible adjunctive treatment option. OBJECTIVES: The goal of this review is to demonstrate, by highlighting yoga's benefits on mental and physical health and the pathophysiology associated with CLBP, that yoga is an effective form of CLBP management. Our other goal is to establish that yoga encompasses a biopsychosocial approach to managing CLBP. STUDY DESIGN AND METHODS: After thorough examination of the available published literature, this narrative review evaluated 24 articles examining yoga's benefits to CLBP patients. RESULTS: CLBP is associated with high rates of anxiety, depression, chronic stress, and pain catastrophizing. Numerous studies support yoga as an effective intervention for depression, anxiety, chronic stress, and pain catastrophizing, given yoga's effects on the sympathetic nervous system, endocrine system, and various neurotransmitters and brain regions, and improvements in these areas may ameliorate the clinical symptoms experienced by CLBP patients. Physically, symptoms experienced by those with CLBP include pain, impaired function and mobility, disability, fatigue, and medication dependence, all of which, according to the literature, yoga has been shown to improve. Additionally, the chronicity and persistence of low back pain are related to central and peripheral sensitization, and yoga may intervene in these pathways to minimize symptom propagation. LIMITATIONS: This review is not without limitations. The current literature lacks standardization regarding which yoga poses are safe, appropriate, and effective for CLBP patients, which limits the generalizability of yoga therapy. Additionally, few existing prospective trials study yoga in the management of CLBP. Though numerous randomized controlled trials (RCTs) are included in this review, most of the current literature details other reviews or analyses of RCTs, includes smaller sample sizes, and lacks long-term follow-up data. Furthermore, many of these studies include patients who have volunteered or self-selected to trial yoga therapy for their back pain, indicating inherent selection bias. CONCLUSION: Overall, the current management strategies for CLBP do not encompass an effective biopsychosocial approach, and an intervention such as yoga is a promising adjunctive treatment for the condition.

Development of a Comprehensive Cough Therapy Program (CCTP) for chronic cough in India: a qualitative study.

PURPOSE: Chronic Cough (CC) is an emerging area of practice in speech language pathology. Behavioral treatment for managing CC has gained attention in the recent past. This study aimed to devise a comprehensive behavioural therapy program for CC by involving allied health professionals (AHPs), who are typically involved in management of CC. METHODS: A qualitative methodology was used to devise a behavioral treatment module for CC. Practice patterns of medical professionals, AHPs and yoga practitioners for CC were gathered through semi-structured interviews. A constant comparative framework was used to recruit participants until data saturation was achieved. The interview transcripts were analyzed to identify relevant components for the module. A post-interview survey was conducted to finalize the module through a consensus-based approach. RESULTS: Three themes and respective sub-themes were identified from analysis. The module was developed based on the treatment strategies followed by professionals and was labeled 'Comprehensive Cough Therapy Program (CCTP)'. This comprised four components - similar to what is available in literature - patient education, breathing exercises, laryngeal hydration, and cough control strategies. This was devised using inputs from the interviews and evidence in the literature. CONCLUSION: In line with global guidelines, this behavioral treatment module can serve as a possible management option for CC.

Integrated Yoga and Naturopathy Intervention on Glycemic Profile and Autonomic Variables in Co-Existence of Diabetes Mellitus with Hypertension: A Two-Arm Observational Study.

Background: Diabetes Mellitus coexisting with hypertension has received significant global attention and remains a public health challenge in the past two decades. The states of hyperinsulinemia and insulin resistance have been postulated as causes or consequences of hypertension. Evidence shows that alternative systems of medicine can play a significant role in achieving glycemic control. This study aimed to compare and evaluate the impact of yoga and naturopathy-based lifestyles on patients with diabetes mellitus and diabetes mellitus with hypertension. Methods: Sixty subjects were recruited into two groups, group 1 (diabetes mellitus with hypertension) and group 2 (diabetes mellitus) based on the inclusion and exclusion criteria. Both the groups underwent naturopathy and yoga intervention for ten days. The glycemic profile and heart rate variability (HRV) of the patients were assessed at the baseline and 10 days after the intervention. Results: Study resulted in a significant change in both time domain and frequency domain variables (HRV, FBS, and PPBS) in both group 1 and group 2 (P < .05, for all) but the mean difference was more in group 2 with a significant difference between the two groups, P < .05. The diastolic blood pressure significantly decreased only in group 2, whereas the systolic blood pressure decreased in both groups without any difference between the two groups. Conclusion: The results of the present study show that integrated yoga and naturopathy management significantly help in glycemic control and autonomic functions in both groups.

Comprehensive In-Patient Neuro-rehabilitation: Harnessing Yoga's Potential - A Pilot Study in Germany.

Background: Neurological diseases require rehabilitation due to the disabling effects they induce, yet cost and therapist availability make long-term therapy difficult. However, innovative, cost-effective strategies that cater to patients' physical and mental requirements are vital to address this gap in care. Incorporating Yoga into in-patient neuro-rehabilitation holds promise as a complementary approach to enhance physical and mental recovery for individuals in a German neurological rehabilitation hospital. This study explores the potential benefits of integrating Yoga within the multimodal care framework, shedding light on its role in improving patient outcomes and overall well-being. Objectives: To study the effect of integrated yoga therapy and multimodal rehabilitation techniques in the neuro-rehabilitation of Multiple Sclerosis, Stroke, and others in an in-patient setting. Design and Setting: A single group pre-post study was conducted at a neurological rehabilitation centre- KWA-Klinik, Stift Rottal, Bad Griesbach, Germany. Twenty patients (11 female and nine male, age 54.4 ± 9.50 years) with different neurological diseases (12-Multiple Sclerosis, 3-Stroke, 5- others) volunteered to participate in the study. Intervention: The integrated yoga intervention was designed by experts from Yoga and neurology to suit neuro-rehabilitation patients. Yoga intervention included Breathing practices, yogic loosening practices, Rapid breathing (Kapalabhati), Alternate nostril breathing (Nadishuddi Pranayama), Physical postures (Asanas), and Relaxation techniques. Participants underwent yoga training for one hour daily, five days a week, for three weeks, along with other conventional rehabilitation procedures. Outcome Measures: The Pain Analog Scale and Spasticity Analog Scale were used to determine the extent of the problem. Barthel Index, Timed up and go Test, and Hand Grip Strength were used to determine the baseline functioning of a patient. Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression symptoms in patients.WHOQOL-BREF questionnaire used to assess QoL. Results: There was a significant reduction in pain (66.97%, P = .001), spasticity (64.47%, P = .001), and anxiety scores (29.05%, P = .02). There is no significant decrease in depression scores (21.86%, P = .065). Improvement in Barthel index (10.38%, P < .001), timed up and go Test (11.63%, P = .001), and physical (4.92%, P = .031), psychological (4.79%, P = .036) and environmental domains (9.12%, P = .001) of WHOQOL-BREF. The results indicate that yoga therapy can effectively address common and debilitating symptoms associated with neurological disorders. Along with the improvement in daily living activities, mobility, and overall quality of life for patients with neurological conditions. Conclusion: Incorporating Yoga into the neuro-rehabilitation regimen for in-patients at a German neurological rehabilitation hospital has proven both achievable and advantageous. The seamless inclusion of yoga sessions within the structured rehabilitation schedules demonstrates the practicality of this integration. Future studies should focus on exploring the long-term effects of Yoga in comparison with other complementary therapies in neuro-rehabilitation.

Effect of Vakrasana on Blood Glucose Levels in Type 2 Diabetes Mellitus: A Randomized Controlled Study.

Background: Diabetes mellitus is one of the most prevalent metabolic diseases. Literature suggests that yoga including a group of asanas reduces blood glucose and glycated hemoglobin levels in type 2 diabetes mellitus (T2DM). However, to the best of our knowledge, no known study evaluated the effects of a single asana (i.e., Vakrasana) in T2DM. Objective: This study aimed to determine the effect of Vakrasanana on blood glucose levels in T2DM patients. Materials and Methods: Sixty T2DM patients aged 51.12 ± 6.43 years were randomly (1:1 ratio) allocated to yoga group (YG) and control group (CG). YG was asked to perform only one session of Vakrasana, while the CG was on rest in a sitting posture for 10 minutes. Random blood glucose (RBG) levels were assessed before and after the intervention. Results: Within-group analysis showed a significant reduction in RBG levels in YG (P < .001; Effect size (d) = 0.203), while a significant increase in RBG was observed in CG (P < .001; Effect size (d) = 0.077), compared to the respective pre-test assessments. Whereas the between-groups analysis did not show a significant difference in RBG levels between the two groups (z = 1.597; P = 0.110). However, YG had a small effect size (Effect size (d) = 0.288) in reducing RBG levels compared to CG. Conclusion: Ten minutes of Vakrasana has some positive effect in reducing blood glucose levels, unlike rest in sitting posture in patients with T2DM. However, further studies are required to validate the findings of this study.

Patients' Expectations of Yoga and Associated Therapies Influence Treatment Outcome: A Convenience Sampling Pre-Post Study from India.

An association between expectations of treatment and treatment outcome has been reported for conventional medical and surgical treatments. However, this association has not been described for yoga therapy. The present study recruited patients (154 males and 145 females, n = 299; age 48.8 ± 14.7 years) who had been admitted to a residential wellness center, most commonly with diseases of the musculoskeletal system or connective tissue; endocrine, nutritional, or metabolic diseases; and digestive system disorders (all based on ICD-11). Assessments included: (1) expectations of yoga and associated therapies at baseline using two questionnaires (Treatment Expectation Questionnaire and Expectation for Treatment Scale); and (2) treatment outcome at baseline and after 7 days of yoga and associated therapies using the Physical Health Questionnaire and Global Perceived Effect scale. The intervention included yoga and additional therapies (e.g., hydrotherapy and ayurveda for approximately 40% of the time). Multivariable regression analyses (controlled for variation due to age, gender, education, and baseline Physical Health Questionnaire scores) demonstrated that expectations of (1) positive outcomes of all aspects of treatment significantly predicted better overall perceived effect of treatment; (2) symptom resolution (positive expectations) significantly predicted higher total Physical Health Questionnaire scores, with better digestion; and (3) low adverse outcomes significantly predicted better sleep. The findings support the premise that higher positive expectations and lower negative expectations of yoga therapy predict better treatment outcomes. These findings suggest that people should be well-informed about the reported benefits and the less-frequent negative outcomes of yoga therapy so that their expectations may be positive yet realistic, optimally influencing treatment outcomes.

Participant Experiences from a Randomized Controlled Trial of Heated Yoga for Depression.

Despite decades of research on yoga and depression, subjective experiences of participants in these studies have rarely been reported, and never in individuals receiving heated yoga for depression. We examined patient-reported qualitative findings from an 8-week randomized controlled trial of heated yoga for depression. Eighty medically healthy participants with moderate-to-severe depression were randomized to 8 weeks of at least twice-weekly heated yoga classes, derived from Bikram yoga, or a waitlist control. Fifty-seven participants received a clinician-administered exit interview at intervention completion/study withdrawal. The exit interview assessed: (1) how participants felt immediately following the heated yoga sessions (acute effects), (2) what they liked or found helpful about heated yoga over the 8-week intervention (positive effects), and (3) what they disliked/did not find helpful over the 8-week intervention (negative effects). Qualitative data were analyzed using thematic analysis. Acute improvements in depressive symptoms (i.e., immediately following yoga) were the most commonly reported (n = 44, 77.2%), followed by overall positive effects on depressive symptoms (i.e., over the course of the 8-week intervention; n = 33, 57.9%), including improvements in sleep (n = 10, 17.5%), energy (n = 13, 22.8%), mood (n = 18, 31.6%), motivation (n = 2, 3.5%), and concentration/decision-making (n = 5, 8.8%). Overall negative effects (i.e., over the course of the 8-week intervention) included dislike of various aspects of the intervention (n = 19, 33.3%), such as instruction (n = 7, 12.3%), difficulty (n = 7, 12.3%), repetitiveness (n = 3, 5.3%), class length (n = 2, 3.5%), and boredom (n = 7, 12.3%). Most participants reported both overall positive and negative effects (n = 37, 64.9%). Of the rest, 19 (33.3%) reported only overall positive effects, and 1 (1.8%) reported only overall negative effects. Most participant experiences were positive. Negative effects were less common and primarily involved dislike of different aspects of the heated yoga. The findings support strong acceptability and subjective improvement in depressive symptoms in depressed individuals.

The effects of acupressure, laughter yoga, and a mindfulness-based stress reduction program applied to postmenopausal women for menopause symptoms and quality of life.

OBJECTIVE: This research was conducted to determine the effects of acupressure, laughter yoga, and a mindfulness-based stress reduction program applied to postmenopausal women for menopause symptoms and quality of life. METHODS: A randomized controlled design was used. The study was conducted with a total of 146 women, including 41 acupressure, 31 laughter yoga, 37 mindfulness-based stress reduction, and 37 control group women. The women in the acupressure group were administered acupressure twice a week, which accounted for 16 sessions in total. Women in the laughter yoga and mindfulness-based stress reduction groups received a total of eight sessions of the related intervention, which was performed once a week. Study data were collected using a participant information form, the Menopause Rating Scale (MRS), and the Menopause-Specific Quality of Life Scale (MENQOL). Descriptive statistics, paired-samples t test, χ 2 test, analysis of variance test, and intention to treat analysis were used to analyze the data. Before the intention to treat analysis was performed, the multiple imputation method was employed to deal with missing data. RESULTS: In the study, it was found that there was a decrease in the MRS total score after the intervention in women in all three intervention groups compared to the control group ( P < 0.05). In the laughter yoga group, total MRS scores decreased by 3.16 points ( P < 0.05). In the acupressure group, total MRS scores decreased by 5.46 points ( P < 0.05). In the mindfulness-based stress reduction (MBSR) program group, total MRS scores decreased by 4.65 points ( P < 0.05). It was determined that the mean scores of women in the laughter yoga and acupressure groups on all subscales of the MENQOL decreased after the intervention compared to the control group ( P < 0.05). The comparison of the MBSR group and the control group showed that there was a decrease only in the psychosocial domain subdimension of the MENQOL ( P < 0.05). CONCLUSIONS: In conclusion, it was determined that laughter yoga, acupressure, and MBSR could be effective in reducing menopause symptoms and improving quality of life, although findings require further testing in a rigorously controlled study and in a study with only a single prespecified outcome.

Co-creating a yoga program for women diagnosed with gynecologic cancer: a consensus study.

PURPOSE: Yoga may be uniquely suited to address bio-psycho-social concerns among adults with gynecologic cancer because it can be tailored to individuals' needs and can help shift focus inward towards self-reflection, body appreciation, and gratitude. This study describes the collaborative process guided by the Knowledge-to-Action framework used to develop a yoga program for adults diagnosed with gynecologic cancer and inform a feasibility trial. METHODS: In 3 collaborative phases, yoga instructors and women diagnosed with gynecologic cancer formulated recommendations for a yoga program and evaluated the co-created program. RESULTS: The program proposed is 12 weeks in length and offers two 60-min group-based Hatha yoga classes/week to five to seven participants/class, online or in person, with optional supplemental features. Overall, participants deemed the co-created program and instructor guidebook to be reflective of their needs and preferences, though they provided feedback to refine the compatibility, performability, accessibility, risk precautions, and value of the program as well as the instructor guidebook. CONCLUSION: The feasibility, acceptability, and benefits of the program are being assessed in an ongoing feasibility trial. If deemed feasible and acceptable, and the potential for enhancing patient-reported outcomes is observed, further investigation will focus on larger-scale trials to determine its value for broader implementation.

Chair-based yoga programme for older adults with multimorbidity: RCT with embedded economic and process evaluations.

Background: Older adults with multimorbidity experience impaired health-related quality of life and treatment burden. Yoga has the potential to improve several aspects of health and well-being. The British Wheel of Yoga's Gentle Years Yoga© programme was developed specifically for older adults, including those with chronic conditions. A pilot trial demonstrated feasibility of using Gentle Years Yoga in this population, but there was limited evidence of its effectiveness and cost-effectiveness. Objective: To determine the effectiveness and cost-effectiveness of the Gentle Years Yoga programme in addition to usual care versus usual care alone in older adults with multimorbidity. Design: Pragmatic, multisite, individually randomised controlled trial with embedded economic and process evaluations. Setting: Participants were recruited from 15 general practices in England and Wales from July 2019 with final follow-up in October 2022. Participants: Community-dwelling adults aged 65 years and over with multimorbidity, defined as two or more chronic health conditions from a predefined list. Interventions: All participants continued with any usual care provided by primary, secondary, community and social services. The intervention group was offered a 12-week programme of Gentle Years Yoga. Main outcome measures: The primary outcome and end point were health-related quality of life measured using the EuroQol-5 Dimensions, five-level version utility index score over 12 months. Secondary outcomes were health-related quality of life, depression, anxiety, loneliness, incidence of falls, adverse events and healthcare resource use. Results: The mean age of the 454 randomised participants was 73.5 years; 60.6% were female, and participants had a median of three chronic conditions. The primary analysis included 422 participants (intervention, n = 227 of 240, 94.6%; usual care, n = 195 of 214, 91.1%). There was no statistically or clinically significant difference in the EuroQol-5 Dimensions, five-level version utility index score over 12 months: the predicted mean score for the intervention group was 0.729 (95% confidence interval 0.712 to 0.747) and for usual care it was 0.710 [95% confidence interval (CI) 0.691 to 0.729], with an adjusted mean difference of 0.020 favouring intervention (95% CI -0.006 to 0.045, p = 0.14). No statistically significant differences were observed in secondary outcomes, except for the pain items of the Patient-Reported Outcomes Measurement Information System-29. No serious, related adverse events were reported. The intervention cost £80.85 more per participant (95% CI £76.73 to £84.97) than usual care, generated an additional 0.0178 quality-adjusted life-years per participant (95% CI 0.0175 to 0.0180) and had a 79% probability of being cost-effective at the National Institute for Health and Care Excellence threshold of £20,000 per quality-adjusted life-year gained. The intervention was acceptable to participants, with seven courses delivered face to face and 12 online. Limitations: Self-reported outcome data raise the potential for bias in an unblinded trial. The COVID-19 pandemic affected recruitment, follow-up and the mode of intervention delivery. Conclusions: Although the Gentle Years Yoga programme was not associated with any statistically significant benefits in terms of health-related quality of life, mental health, loneliness or falls, the intervention was safe, acceptable to most participants and highly valued by some. The economic evaluation suggests that the intervention could be cost-effective. Future work: Longer-term cost-effectiveness modelling and identifying subgroups of people who are most likely to benefit from this type of intervention. Trial registration: This trial is registered as ISRCTN13567538. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 17/94/36) and is published in full in Health Technology Assessment; Vol. 28, No. 53. See the NIHR Funding and Awards website for further award information.

It is common for older adults to have two or more long-term health conditions. These conditions affect quality of life differently, with some people feeling well and others needing healthcare support. The Gentle Years Yoga programme was developed to improve quality of life for older adults, including those with long-term health conditions. We wanted to see how well the programme worked and if it offered good value for money for the NHS. We tested whether offering a 12-week course of Gentle Years Yoga improved the quality of life and reduced anxiety, depression, loneliness and falls for people aged 65 years and over who had two or more long-term health conditions. We recruited 454 people through general practices across England and Wales, with 240 people selected at random to be invited to take part in the Gentle Years Yoga programme and the other 214 to continue with their usual care and not be offered Gentle Years Yoga. The average age of participants was 74 years, nearly two-thirds were female and the number of long-term health conditions participants had ranged from two to nine (average was three). They completed four questionnaires over a 12-month period. We also interviewed some of the participants and the yoga teachers to find out how the approach worked in practice. The yoga was delivered either face to face or online. We did not find any significant benefits in terms of quality of life, anxiety, depression, loneliness or falls. At interview, some yoga participants noted no or a modest impact on their health or lifestyle, while others described Gentle Years Yoga as transformative, having substantial impacts and improvements on their physical health and emotional well-being. Because running the yoga classes was relatively inexpensive and some insignificant benefits were seen, the Gentle Years Yoga programme may be good value for money.

Yoga for Veterans with PTSD: Intervention Feasibility, Changes in PTSD Symptom Severity, and Psychological and Physiological Health-Related Fitness Outcomes.

Posttraumatic stress disorder (PTSD) is a burdensome disorder associated with lower quality of life and increased morbidity and mortality. Veterans are particularly at risk for PTSD resulting from experiencing traumatic events during military service. Current treatments for PTSD often fail to remediate symptoms and are associated with high dropout rates; therefore, complementary and integrative health approaches, such as yoga, are being considered to treat PTSD-related symptoms. The present study investigated the feasibility of a 12-week, 1-hour/week, in-person, trauma-informed mindful resilience yoga intervention for improving PTSD symptom severity and secondary psychological outcomes (e.g., physical and mental health, sleep, mindfulness, and self-efficacy), physiological health-related fitness outcomes (e.g., body composition and muscular strength), and physical activity outcomes (e.g., accelerometry) in a sample of veterans with PTSD. Results demonstrated the intervention to be feasible, with 12 participants (9 male, 3 female; mean age 50.3) completing the program (10 participants completed ≥ 75% of the 12 sessions). Statistically significant improvement was demonstrated in the "nonjudging of inner experience" aspect of mindfulness (p = 0.005, d = 1.280). Although not considered statistically significant (p > 0.008), the majority of outcomes demonstrated trending improvement from pre- to postintervention, with small to large Cohen's d effect sizes. The novelty of this study is represented by the trending improvements in physiological health-related fitness outcomes, with lean mass and handgrip strength demonstrating small effect sizes (d = 0.243 and d = 0.267, respectively). Our results extend the existing literature on the feasibility and potential effectiveness of yoga as a complementary or integrative therapy for PTSD in the veteran population.

Effects of One-to-One Trauma Center Trauma-Sensitive Yoga Sessions on Psychological Symptoms and Interoception over 6 Months.

Posttraumatic stress disorder (PTSD) is a serious health condition that adversely affects the mind and body. Current first-line treatment for PTSD tends to focus on the mind and overlook the impacts of trauma on the body. Trauma Center Trauma-Sensitive Yoga (TCTSY) is an evidence-based adjunctive therapy for complex trauma and PTSD that uses a body-based approach to trauma healing. Although designed to be used in group or individual contexts, previous studies have focused only on TCTSY facilitated in groups. The present study examined the effects of one-to-one TCTSY (i.e., one participant receiving TCTSY services, not in a group TCTSY context) on anxiety, depression, posttraumatic stress, interoception, substance use, and sleep over time. Using an observational approach, all certified TCTSY facilitators received the study invitation to share with clients who were enrolled in one-to-one TCTSY services. Ten clients participated in the study across four countries (women n = 8; mean age 44.80 ± 11.91; PTSD diagnosis n = 9). Clients completed Qualtrics surveys at TCTSY sessions in June-December 2022. Linear mixed-model analyses found that anxiety, depression, posttraumatic stress symptoms, attention regulation, self-regulation, and body listening significantly improved over time. There were no significant changes in sleep or substance use from pre- to post-study. TCTSY is a somatic approach for managing trauma symptoms and enhancing interoceptive awareness. Extensions of the present study are warranted to further understand the effects of one-to-one TCTSY for trauma care.

Effects of yoga compared with health promotion on health-related quality of life in adults with post-COVID-19 condition: protocol for a randomised controlled trial.

INTRODUCTION: Post-COVID-19 condition (post COVID, also known as long COVID) is a global public health issue estimated to affect over 100 million people. Common symptoms include fatigue, dyspnoea and cognitive dysfunction ('brain fog'). Over time, these symptoms have an adverse effect on mental health, physical activity and quality of life (QoL). The condition requires innovative and feasible treatment approaches that can be effective and self-managed. Physical activity is essential for good health; however, aerobic exercise or weightlifting may not be suitable for post COVID patients who experience fatigue or breathlessness. The benefits of yoga include improved flexibility, mobility, body strength and balance. It is also shown to reduce symptoms of fatigue and improve breathing efficiency, mental health and QoL. This study protocol describes the rationale and methods for a randomised controlled trial (RCT) of a yoga-based intervention designed for adults with post COVID. METHODS AND ANALYSIS: A two-group, parallel, RCT with blinded follow-up assessments. Participants will be randomised with a 1:1 allocation to either a 12-week yoga-based intervention or a 12-week health promotion (active comparison) intervention. In total, 88 participants aged 30-65 years will be recruited and randomised. The primary outcome is health-related QoL (36-item Short-Form). Secondary outcomes are dyspnoea, fatigue, sleep quality, cognitive functions, mental fatigue, depression, anxiety, physical activity, demographic data and physical health measures. Data will be analysed as intention-to-treat basis, using linear mixed modelling. All assessments are conducted at Karolinska Institutet in Stockholm, Sweden. The yoga-based intervention will take place at a yoga studio centrally located in Stockholm city. ETHICS AND DISSEMINATION: The study is approved by the Swedish Ethical Review Authority, reference number 2023/06518-01. All participants must sign written informed consent before enrolment and are free to withdraw from the study at any point. Key results will be available through research articles and seminars. TRIAL REGISTRATION NUMBER: German Clinical Trials Register, DRKS00032837.