Impact of Yoga on anxiety, stress and sleep quality among health care professionals during public health crisis.

BACKGROUND: Health Care Professionals (HCPs) working on the frontlines of health care emergencies/pandemics often experience elevated anxiety, stress and reduced quality of sleep. Yoga is a mind-body practice that has been proven to effective in improving physical and mental health. OBJECTIVE: To evaluate the effectiveness of integrated Yoga intervention on mental health measures and sleep quality among HCPs working during the COVID-19 pandemic. METHODS: It was a quasi-experimental study on 110 HCPs, including Doctors and nursing staff, with an age range of 20 to 65 years who were recruited through a convenience sampling method and assigned to a Yoga group (n = 55) or a control group (n = 55).The Yoga group received a weekly one-hour Yoga session followed by a 30-minute self-practice three times a week at home for one month. The control group followed routine activity. Heart rate (HR), Blood Pressure, stress measures (Perceived Stress and visual analogue Scale for Stress), COVID-related anxiety, Sleep Quality, Quality of life and Preservative Thinking were assessed before and after the intervention. RESULTS: A significant decrease in stress measures, COVID-19-related anxiety and fear, and perseverative thinking was noticed in the Yoga group. Sleep quality and quality of life also improved significantly. The control group showed no significant change. At one month, the Yoga group showed significantly greater improvement in stress measures, COVID-19-related anxiety and fear, perseverative thinking, sleep quality and quality of life compared to the control group. CONCLUSION: Yoga practice during the public health crisis would help reduce anxiety and stress and improve sleep among HCPs. Further, RCT studies are warranted.

Impact of workplace yoga on pain measures, mental health, sleep quality, and quality of life in female teachers with chronic musculoskeletal pain: A randomized controlled study.

BACKGROUND: Chronic pain conditions such as low back pain, knee pain and cervical pain are highly prevalent among female teachers. Chronic pain significantly affects the mental health, sleep and quality of life among teachers. OBJECTIVE: This study is intended to investigate the impact of a workplace yoga intervention on musculoskeletal pain, anxiety, depression, sleep, and quality of life (QoL) among female teachers who had chronic musculoskeletal pain. METHOD: Fifty female teachers aged between 25-55 years with chronic musculoskeletal pain were randomized to either the yoga group (n = 25) or the control group (n = 25). The yoga group received a 60-minute structured Integrated Yoga intervention (IY) four days a week for six consecutive weeks at school. The control group received no intervention. OUTCOME MEASURES: Pain intensity, anxiety, depression, stress, fatigue, self-compassion, sleep quality, and quality of life were assessed at the baseline and six weeks. RESULTS: A significant (p < 0.05) reduction in pain intensity and pain disability in the yoga group was observed after 6-week compared to baseline. Anxiety, depression, stress, sleep scores and fatigues also improved in the yoga group after six weeks. The control group showed no change. Post score comparison showed a significant difference between the groups for all the measures. CONCLUSION: Workplace yoga intervention is found to be effective in improving pain, pain disability, mental health, sleep quality among female teachers with chronic musculoskeletal pain. This study strongly recommends yoga for the prevention of work-related health issues and for the promotion of wellbeing among teachers.

Long-Term Effects of Hatha Yoga on Heart Rate Variability In Healthy Practitioners: Potential Benefits For Cardiovascular Risk Reduction.

Hatha yoga is commonly practiced in Western countries and is claimed to reduce risk of cardiovascular disease. The purpose of this study was to evaluate and compare time-domain and frequency-domain metrics of heart rate variability (HRV) in Hatha yoga practitioners and healthy controls. This cross-sectional study, which was conducted at a regional university and community wellness center, included convenience sampling of 19 Hatha yoga practitioners and 8 healthy controls. Using a lead II ECG system, 10 minutes of electrocardiogram (ECG) recording was collected for each participant. Artifact-free, 5-minute signals were used to derive time-domain and frequency-domain measures of HRV. The mean duration of Hatha yoga practice among practitioners was 11.47 ± 8 years. Demographic and anthropometric characteristics did not differ significantly between groups. Compared with the control group, the yoga group had significantly greater mean high frequency (HF) power (859.2 ± 1342.1 vs 175.5 ± 121.1; P = .04) and mean HF normalized units (nu) (57.0 ± 16.6 vs 36.7 ± 13.4; P = .02) and a significantly lower low frequency (LF)/HF ratio (1.1 ± 0.5 vs 2.2 ± 1.1; P = .01). No significant intergroup differences were observed for LF power, LF nu, or any time-domain measures of HRV. These results lack generalizability due to small sample size and lack of blinded assessment of outcome measures. Hatha yoga practitioners showed parasympathetic predominance compared with healthy controls. Analyzing frequency-domain HRV metrics enables detecting changes in cardiac autonomic function earlier than by analysis of time-domain metrics. Parasympathetic predominance demonstrated in the yoga group suggests Hatha yoga practitioners may be at lower risk for stress-related comorbidities.

The Deadly Duo of Hypertension and Diabetes in India: Further Affirmation from a New Epidemiological Study.

INTRODUCTION: Hypertension is highly prevalent in patients with type II diabetes mellitus. India has some of the highest rates of diabetes and hypertension worldwide, but there is a lack of local data on the coexistence of these two risk factors. This study determined the prevalence of hypertension in patients with, or at high risk of, type II diabetes mellitus from across India. METHODS: Data came from a nationwide trial evaluating the effects of yoga-based lifestyle modification for the prevention/management of type II diabetes. Participants were recruited based on randomized house-to-house screening in urban and rural areas from 65 districts of 29 states/union territories. Eligible individuals were aged 20-80 years and had diabetes or were at high risk of diabetes (IDRS ≥ 60). Anthropometric and demographic data were obtained, and resting blood pressure and blood glucose levels were recorded. RESULTS: This analysis included data from 14,135 individuals. Of these, 25% had self-reported diabetes, 19% were diagnosed with diabetes during the trial, and 26.8% were at high risk for type II diabetes. In these three patient groups, hypertension prevalence rates were 58%, 41.0%, and 35.8%, respectively. The prevalence of hypertension was highest in the North East region and lowest in the North West. CONCLUSION: The high prevalence of hypertension in patients with, or at risk of diabetes, highlights the urgent need for policies to manage this population, who are at high risk of cardiovascular disease and death.

A Comprehensive Review of Yoga Research in 2020.

Objectives: Accumulated evidence garnered in the last few decades has highlighted the role of yoga in health and disease. The overwhelming mortality and morbidity mediated by noncommunicable epidemics such as heart disease and cancer have fostered a search for mechanisms to attenuate them. Despite overwhelming success in acute care, the efficacy of modern medicines has been limited on this front. Yoga is one of the integrative therapies that has come to light as having a substantial role in preventing and mitigating such disorders. It thus seems trite to analyze and discuss the research advancements in yoga for 2020. The present review attempts to distill recent research highlights from voluminous literature generated in 2020. Methods: This review was conducted on the articles published or assigned to an issue in 2020. The authors searched the PubMed database for clinical studies published in the English language, using yoga (including meditation) as the intervention, and having an adequate description of the intervention. Then, they extracted data from each study into a standardized Google sheet. Results: A total of 1149 citations were retrieved in the initial search. Of these, 46 studies met eligibility criteria and were finally included. The studies were predominantly on mental health and neuropsychology, addressing various issues such as anxiety, postural balance, migraine, academic performance, and childhood neglect. Anxiety, stress, and depression were other common denominators. Eight studies were on cardiorespiratory systems, including exercise capacity, cardiac rehabilitation, myocardial infarction, and hypertension. Three studies were on diabetes, evaluating the effect of yoga. Five studies focused on cognition, health status, and autonomic regulation and few others included cancers, infertility, ulcerative colitis, urinary incontinence, restless leg syndrome, rheumatoid arthritis, chronic pain, and metabolic syndrome. Finally, most studies were on noncommunicable diseases with one exception, human immunodeficiency virus; two randomized controlled trials were dedicated to it. Conclusions: Yoga has been studied under a wide variety of clinicopathological conditions in the year 2020. This landscape review intends to provide an idea of the role of yoga in various clinical conditions and its future therapeutic implications.

Potential Role of Yoga in the Management of Ankylosing Spondylitis: A Retrospective Study.

BACKGROUND: Ankylosing spondylitis (AS) is a chronic autoimmune inflammatory spondyloarthropathy with unclear pathogenesis. The inflammatory pain in AS leads to restricted spinal mobility and significant disability. Yoga is a nonpharmacological intervention that has positive effects on various musculoskeletal-related problems. However, its role in AS is unknown. OBJECTIVE: The present retrospective study assessed the efficacy of a two-week residential yoga intervention on spinal flexibility among AS patients. METHODS: The records for 24 male AS patients within the age range 30 to 50 years (average age 38.3 ± 10.5 years) who underwent a two-week residential yoga retreat between 2015 and 2020 were obtained from a yoga center located in South India. Yoga intervention consisted of yoga postures, breathing practices, meditation, a healthy diet, and devotional sessions. Pre and Post data of the sit-and-reach test, blood pressure, heart rate, and symptom score were analyzed using Statistical Package for Social Sciences (SPSS). RESULTS: Compared to the baseline, the post scores of the sit-and-reach test, systolic blood pressure and heart rate were found to be significantly (P < .05) lower. The symptom score and analgesic medication score also showed significant improvement after two-weeks compared to the baseline. CONCLUSION: This retrospective study indicates the positive impact of on and analgesic use among AS patients. However, additional studies using robust research designs are warranted.

Effects of yoga on stress, fatigue, musculoskeletal pain, and the quality of life among employees of diamond industry: A new approach in employee wellness.

BACKGROUND: Diamond industry employees often experience musculoskeletal pain, fatigue, and stress, contributing to a low quality of life (QoL). Yoga is an ancient discipline of mind-body practice Yoga has numerous health benefits. OBJECTIVE: This study investigated the efficacy of workplace yoga in improving stress, musculoskeletal pain, fatigue, and QoL among employees of the diamond industry. METHODS: One-hundred sixty-six employees of the diamond industry between the ages of 20 and 60 participated in the study. Participants were assigned to either yoga (n = 84) or waitlist (n = 82) groups. The yoga group received one hour of yoga, four days a week for three consecutive months. Participants in the waitlist group followed their daily routines. Musculoskeletal pain, fatigue, stress, and QoL were assessed at baseline and after three months. RESULTS: One-hundred fifty-five employees completed the study. The yoga group showed significant (p < 0.05) improvement in pain, perceived stress, fatigue, and QoL domains after three months compared to baseline. The waitlist group showed no significant improvement in any of the measures. In the post scores comparison between the groups revealed a significant difference between the groups. CONCLUSION: Workplace yoga found to be a useful, cost-effective and feasible intervention in improving stress, musculoskeletal pain, fatigues and quality of life among employees of the diamond industry. Yoga may be implemented in the workplace as a wellness program at the workplace.

Effect of yoga on depression in hypothyroidism: A pilot study.

BACKGROUND: The prevalence of hypothyroidism among Indian women is 15.8%. Depression is frequently reported in hypothyroidism. Yoga is an effective intervention for depression. However, the influence of yoga on depression in patients with hypothyroidism has not been studied. AIM: The present study investigated the effect of a 3-month integrated yoga intervention (3-IY) on depression, lipid indices, and serum thyroid-stimulating hormone (sTSH) levels among female patients having hypothyroidism, and mild-to-moderate depression. METHOD: The present single-arm pre-post design study was conducted in thirty-eight women (average age 34.2 ± 4.7 years). Participants received a 3-IY comprising asanas, pranayama, and relaxation techniques for 60 min daily (5 days a week). Depression, sTSH, lipid profile indices, Body Mass Index (BMI), fatigue, anxiety, and stress were assessed at baseline and after 12 weeks. Thyroid medication was kept constant during the study period. Data were analysed using R Studio software. RESULT: A significant (P < 0.05) reduction in depression (58%), sTSH (37%), BMI (6%), fatigue (64%), anxiety (57%), lipid profile indices (HLD increased significanty), and stress (55%) levels was observed after 3 months, compared with the corresponding baseline levels. CONCLUSION: The 3-IY is useful for reducing depression, dyslipidemia, and sTSH in women with hypothyroidism and depression. Further studies with a larger sample size and a robust research design using objective variables must be conducted to strengthen the study findings.

Impact of Yoga on Mental Health and Sleep Quality Among Mothers of Children With Intellectual Disability.

OBJECTIVES: Caring for a child with Intellectual Disability Disorder (IDD) is a tremendously stressful task for any mother, leading to poor mental health and compromised quality of life. Anxiety, depression, stress, and poor sleep quality are frequently observed in mothers with Intellectual Disability Disorder child. This study assessed the impact of a 1-month yoga intervention on anxiety, depression, stress and sleep quality in mothers of children with intellectual disabilities. METHODS: We selected 53 mothers of children with intellectual disabilities between the age of 30 and 50 years (mean age, 40.2 ± 7.1 years). Of these mothers, 28 received 1.5 hours of integrated yoga practice consisting of physical postures, breathing techniques, relaxation techniques and meditation every other day for 1 month. The remaining 25 mothers, who served as the control group, participated in a group discussion session twice a week for 1 month. MAIN OUTCOME MEASURES: All mothers were assessed for anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), stress with the Perceived Stress Scale (PSS), and sleep quality with the Pittsburgh Sleep Quality Index (PSQI) at baseline and at 1 month. RESULTS: Significant improvements in anxiety (-24.8%; P < .001), depression (-15.9%; P < .001), sleep quality (-25.1%; P < .05) and stress (-11.4%; P < .001) were observed after 1 month compared with baseline in the yoga group. In a similar fashion, a significant decrease in anxiety (-12.3%; P < .001), depression (-8.6%; P < .001) and sleep quality (-5.6%; P < .001) was seen in the control group as well. The between-group comparison of post-intervention scores revealed a significantly better improvement in anxiety (P <.001), depression (P < .001), perceived stress (P < .001) and sleep quality (P = .012) in the yoga group compared with the control group. CONCLUSIONS: Our study indicates that yoga can be used as an effective intervention to improve psychopathology and sleep quality in mothers of children with intellectual disabilities. We recommend future randomized controlled trials with larger sample sizes and of longer duration to study the long-term effects of yoga.

Immediate effect of mind sound resonance technique (MSRT - a yoga-based relaxation technique) on blood pressure, heart rate, and state anxiety in individuals with hypertension: a pilot study.

Background Mind sound resonance technique (MSRT) is a yoga-based relaxation technique. Previous studies on MSRT demonstrated its potential health-benefiting effects in both clinical and nonclinical population. Present study intended to assess the acute effect of MSRT intervention on blood pressure, heart rate (HR), and state anxiety in patients with essential hypertension (HTN). Methods Thirty participants (13 females) with HTN, within the age range 30-60 years (with mean±SD: 57.23±11.3 years), who visited SVYASA University campus to attend 1-week residential yoga program for HTN treatment, were considered for this study based on inclusion and exclusion criteria. All participants received a 4-day MSRT orientation sessions prior to the study. Each participant underwent 30-min session of both MSRT and supine rest (SR) on 2 successive days. Systolic and diastolic blood pressures, pulse rate, and state anxiety were measured before and immediately after both MSRT and SR sessions. Data were analyzed using SPSS version 16. Repeated-measure analysis of variance was applied to assess within-subjects changes. Results After MSRT session, significant decrease in systolic blood pressure (SBP), diastolic blood pressure (DBP), HR, and state anxiety was observed compared to baseline. Similarly, after SR session, significant changes were found in HR and state anxiety. No significant change was seen in SBP and DBP following SR compared to SR session; MSRT session showed significantly better improvement in SBP, DBP, HR, and state anxiety. Conclusion Present study demonstrated the usefulness of single session of MSRT in reducing blood pressure, HR, and state anxiety among individuals with HTN as compared to SR. These findings encourage the further studies with larger sample size and long-term intervention with a robust research design.

Effect of 1-Week Yoga-Based Residential Program on Cardiovascular Variables of Hypertensive Patients: A Comparative Study.

INTRODUCTION: Hypertension (HTN) is an important public health concern and a leading cause of morbidity and mortality worldwide. Yoga is a form of mind-body medicine shown to be effective in controlling blood pressure (BP) and reduces cardiac risk factors in HTN. Integrated approach of Yoga therapy (IAYT) is a residential yoga-based lifestyle intervention proven to be beneficial in several health conditions. Aim: To study the efficacy of 1 week of residential IAYT intervention on cardiovascular parameters in hypertensive patients. METHODOLOGY: Twenty hypertensive individuals (7 females) within age range between 30 and 60 years (average; 46.62 ± 9.9 years), who underwent 1 week of IAYT treatment for HTN, were compared with age- gender-matched non-IAYT group (5 females; average age; 47.08 ± 9.69 years) in terms of systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), cardiac output (CO), stroke volume (SV), baroreflex sensitivity (BRS), and total peripheral vascular resistance (TPVR), IAYT program consisted of sessions of asanas, breathing practices, meditation and relaxation techniques, low salt, low-calorie diet, devotional session, and counseling. Individuals in non-IAYT group followed their normal routine. All the variables were assessed before and after one week. Data were analyzed using SPSS version 16. RM-ANOVA was applied to assess within group and between group changes after intervention. RESULTS: There was a significant improvement in SBP (P = 0.004), DBP (P = 0.008), MAP (0.03), BRS (P < 0.001), and TPVR (P = 0.007) in IAYT, group whereas in control group, we did not find significant difference in any of the variables. Between-group comparison showed a significant improvement in SBP (P = 0.038), BRS (P = 0.034), and TPVR (P = 0.015) in IAYT group as compared to non-IAYT group. CONCLUSION: One-week IAYT intervention showed an improvement in baroreflex sensitivity, systolic BP, and total peripheral vascular resistance in hypertensive patients. However, further randomized control trials need to be performed to confirm the present findings.

Development and validation of a yoga module for Parkinson disease.

Background Parkinson's disease (PD), a progressive neurodegenerative disease, affects motor and nonmotor functions, leading to severe debility and poor quality of life. Studies have reported the beneficial role of yoga in alleviating the symptoms of PD; however, a validated yoga module for PD is unavailable. This study developed and validated an integrated yoga module(IYM) for PD. Methods The IYM was prepared after a thorough review of classical yoga texts and previous findings. Twenty experienced yoga experts, who fulfilled the inclusion criteria, were selected validating the content of the IYM. A total of 28 practices were included in the IYM, and each practice was discussed and rated as (i) not essential, (ii) useful but not essential, and (iii) essential; the content validity ratio (CVR) was calculated using Lawshe's formula. Results Data analysis revealed that of the 28 IYM practices, 21 exhibited significant content validity (cut-off value: 0.42, as calculated by applying Lawshe's formula for the CVR). Conclusions The IYM is valid for PD, with good content validity. However, future studies must determine the feasibility and efficacy of the developed module.

Effects of Mind Sound Resonance Technique (Yogic Relaxation) on Psychological States, Sleep Quality, and Cognitive Functions in Female Teachers: A Randomized, Controlled Trial.

Context • Several studies have revealed a high rate of physical and psychological problems from stress among schoolteachers. Yoga is one of the mind-body interventions known to alleviate stress and effects. The mind sound resonance technique (MSRT), a yoga-based, mindfulness relaxation is recognized as having a positive influence on physical and psychological health. Objectives • The study intended to examine the effects of an MSRT intervention for 1 mo on perceived stress, quality of sleep, cognitive function, state and trait anxiety, psychological distress, and fatigue among female teachers. Design • The study was a randomized, controlled trial. Setting • The study occurred at 2 primary schools in Bangalore City, India. Participants • Sixty female teachers, aged between 30 and 55 y, from the 2 schools were enrolled in the study. Intervention • The participants were randomly divided into an MSRT group (n = 30) and a control group (n = 30). Participants in the MSRT group participated in MSRT for 30 min/d, 5 d/wk, for the duration of 1 mo. The participants in the control group followed their normal daily routines. Outcome measures • Perceived stress, sleep quality, cognitive function, anxiety, psychological distress, fatigue, and self-esteem were assessed using standardized assessment tools at baseline and after 1 mo of the intervention. Results • In the MSRT group, a significant reduction occurred for 5 variables: (1) 47.01% for perceived stress (P < .001), (2) 28.76% for state anxiety (P < .001), (3) 13.35% for trait anxiety (P < .001), (4) 32.90% for psychological distress (P < .001), and (5) 44.79% for fatigue (P < .001). A significant improvement occurred for that group for 2 variables: (1) 44.94% for quality of sleep (P < .001), and (2) 12.12% for self-esteem (P < .001). An 11.88% increase occurred for the group for cognitive function, but the change was not significant (P = .111). On the other hand, the control group showed significant increases in 5 variables: (1) 55.56% for perceived stress (P < .001), (2) 13.32% for state anxiety (P < .001), (3) 21.28% for trait anxiety (P < .001), (4) 20.95% for psychological distress (P = .103), and (5) 16.44% for fatigue (P < .001). The group also showed significant decreases in 3 variables: (1) 3.51% for self-esteem (P < .001), (2) 21.39% for quality of sleep (P = .003), and (3) 17.60% for cognitive function (P = .002). A comparison between the 2 groups showed significant differences in 7 variables: (1) perceived stress (P < .001), (2) quality of sleep (P < .001), (3) state anxiety (P < .001), (4) trait anxiety (P < .001), (5) psychological distress (P = .006), (6) fatigue (P = .005), and (7) self-esteem (P < .001). No significant differences existed between the groups in cognitive function (P = .083). Conclusions • In the current study, the practice of MSRT facilitated a reduction in the levels of stress, anxiety, fatigue, and psychological distress. The relaxation technique also enhanced the levels of self-esteem and quality of sleep among female teachers working in primary schools.

Effect of Integrated Yoga (IY) on psychological states and CD4 counts of HIV-1 infected patients: A randomized controlled pilot study.

BACKGROUND: Human immunodeficiency virus (HIV) infected individuals frequently suffer from anxiety and depression. Depression has been associated with rapid decline in CD4 counts and worsened treatment outcomes in HIV-infected patients. Yoga has been used to reduce psychopathology and improve immunity. AIM: To study the effect of 1-month integrated yoga (IY) intervention on anxiety, depression, and CD4 counts in patients suffering from HIV-1 infection. METHODS: Forty four HIV-1 infected individuals from two HIV rehabilitation centers of Manipur State of India were randomized into two groups: Yoga (n = 22; 12 males) and control (n = 22; 14 males). Yoga group received IY intervention, which included physical postures (asanas), breathing practices (pranayama), relaxation techniques, and meditation. IY sessions were given 60 min/day, 6 days a week for 1 month. Control group followed daily routine during this period. All patients were on anti-retroviral therapy (ART) and dosages were kept stable during the study. There was no significant difference in age, gender, education, CD4 counts, and ART status between the two groups. Hospital anxiety and depression scale was used to assess anxiety and depression, CD4 counts were measured by flow cytometry before and after intervention. Analysis of variance - repeated measures was applied to analyze the data using SPSS version 10. RESULTS: Within group comparison showed a significant reduction in depression scores (F [1, 21] =4.19, P < 0.05) and non-significant reduction in anxiety scores along with non significant increment in CD4 counts in the yoga group. In the control group, there was a non-significant increase in anxiety and depression scores and reduction in CD4 counts. Between-group comparison revealed a significant reduction in depression scores (F [1, 21] =5.64, P < 0.05) and significant increase in CD4 counts (F [1, 21] =5.35, P < 0.05) in the yoga group as compared to the control. CONCLUSION: One month practice of IY may reduce depression and improve immunity in HIV-1 infected adults.

Effect of Yoga on anxiety, depression and self-esteem in orphanage residents: A pilot study.

INTRODUCTION: There has been an increase in a number of orphanages and children living in orphanages in last few years. The children living in orphanages often have psychological problems among which anxiety, depression, and low self-esteem are considered to be most prominent. Yoga is a noninvasive, cost-effective, and safe intervention among complementary and alternative medicine which is known to have a positive impact on psychological problems. AIMS: The present pilot study intended to assess the effect of a two week Yoga intervention on anxiety, depression, and self-esteem of adolescents and young adults living in an orphanage. MATERIALS AND METHODS: Adolescent and young adults participants who were the permanent residents of an orphanage (n = 34; males = 27, females = 7) between age ranges of 12-20 years underwent 2 week of Yoga intervention. Yoga intervention comprised Asana (Yogic postures), Pranayama (Yogic breathing practices), and Dharana-Dhyana (Yogic relaxation techniques) for 1 h daily over 15 days. Hospital anxiety and depression and Rosenberg self-esteem scale were administered at baseline and after the intervention to assess anxiety, depression, and self-esteem, respectively. RESULTS: There was a significant reduction (P = 0.001) in anxiety, depression, and significant improvement in self-esteem (P = 0.001) at the end of 2 weeks Yoga intervention. CONCLUSIONS: This pilot study suggests that 2 weeks of Yoga practice potentially reduced anxiety and depression and improved self-esteem of orphanage adolescents and young adults. These findings need confirmation from studies with a larger sample size and randomized controlled design, which are implicated in the future.