Efficacy of Bhramari pranayama and Om chanting on asthma control, quality of life, and airway inflammation in asthmatic children: an open-label randomized controlled trial.

OBJECTIVES: To explore the efficacy of combination of Bhramari pranayama and om chanting as an adjunct to standard pharmacological treatment on asthma control, quality of life, pulmonary function, and airway inflammation in asthmatic children. METHODS: Children (n = 110; 8-15 years) with uncontrolled or partly controlled asthma were recruited from the Pediatric Chest Clinic of All India Institute of Medical Sciences, New Delhi. Eligible participants were randomized to either home-based online Bhramari pranayama and om chanting plus standard treatment (YI + ST) group, or standard treatment (ST) alone group. Primary outcome measures were 12-week change in level of asthma symptom control; asthma control questionnaire (ACQ) score, spirometry indices, impulse oscillometry parameters, and pediatric asthma quality of life questionnaire (PAQLQ) score. Secondary outcome was a change in fractional exhaled nitric oxide (FeNO) levels at 12 weeks. Beginning from the enrollment, every participant was evaluated at 0, 2, 6, and 12 weeks. RESULTS: After 12 weeks of intervention, higher proportion (68.2%) of children were found to have controlled asthma symptoms in the YI + ST group as compared to ST group (38.5%) according to per protocol analysis (p = 0.03). When compared to ST group, children in YI + ST group showed significantly lower ACQ score, higher PAQLQ score and reduced FeNO levels. No significant changes were observed for the lung function parameters. CONCLUSION: Children practicing Bhramari pranayama and om chanting for 12 weeks have better asthma symptom control, quality of life, and reduced airway inflammation than those taking standard pharmacotherapy alone.

Yoga for Migraine Prevention: An Ancient Practice with Evidence for Current Use.

PURPOSE OF REVIEW: The objective of this study is to review the recent literature on yoga for migraine prevention either as adjuvant or standalone therapy. Yoga is one of the most widely used complementary and integrative medicine (CIM) therapies; clinicians should be familiar with yoga practice so that they can best advise interested patients. It is also important to assess study design and types of yoga offered. Using PubMed and Litmaps, research published from 2018 to 2023 addressing yoga and migraine was assessed. RECENT FINDINGS: Two systematic reviews and six studies have recently been published on yoga as adjunctive migraine preventive treatment. There is class III evidence and a grade B recommendation for yoga as an adjunct migraine preventive treatment. Yoga has been shown to reduce headache frequency, disability, and likely also pain intensity and self-efficacy. Two studies (one in children and one in adults) suggested that yoga as standalone migraine preventive treatment reduces pain intensity, disability, and perceived stress. More research is needed on the long-term efficacy (including change in monthly migraine days specifically in addition to headache frequency) and adherence to yoga practice for the prevention of migraine. In addition, to our knowledge, there is no study evaluating yoga practice in the prodromal or headache phase of migraine as acute treatment.

Effect of pranayama on perceived stress, well-being and quality of life of frontline healthcare professionals on COVID-19 duty: A quasi-randomised clinical trial.

Healthcare professionals (HCPs) had to perform their duties under extremely trying circumstances during the COVID-19 pandemic. High expectations further increased HCP's stress, which had an adverse impact on their mental health. The present quasi-randomised clinical trial examined how a specially designed pranayama regimen practised for 4 weeks affected the mental health of frontline, exposed HCPs in terms of perceived stress, wellness and quality of life. A total of 280 frontline HCPs on COVID-19 duties in five public hospitals of Delhi, India participated in this study. The intervention (n = 123) and control (n = 127) groups were alternately allocated. Data on perceived, self-reported mental health of HCPs were collected at baseline and post-test at the end-line (after 28 days of practice). We report that the intervention group (n = 123) had a substantial lower perceived stress at post-test at the end-line in comparison to the control group (n = 127, p-value: .028). Their overall WHO Quality-of-Life score also improved, of which the score on psychological domain increased significantly (p-value: .019). Accordingly, we conclude that a 28-day practice of the pranayama by the frontline HCPs in COVID-19 hospitals significantly decreased their level of perceived stress and enhanced their psychological quality of life.

Preoperative Rehabilitation in Lung Cancer Patients: Yoga Approach.

Lung cancer is one of the leading causes of cancer death worldwide. Surgical removal remains the best option for most tumors of this type. Reduction of cigarette consumption in patients with lung cancer candidates for the surgery could limit the impact of tobacco on postsurgical outcomes. Breathing exercises appear to help combat cigarette cravings. Yoga exercise benefits have been studied in lung cancer survivors, rather than in the preoperative setting. In this study, we have recruited 32 active smokers affected by lung cancer and being candidates for pulmonary surgery. The patients were randomly assigned to two groups: one treated by standard breathing and the other treated by yoga breathing (YB). The groups were evaluated at times T0 (baseline) and T1 (after 7 days of treatment) to compare the effects of the two breathing treatments on pulmonary performance in a presurgery setting. Pulmonary and cardiocirculatory functions have been tested using a self-calibrating computerized spirometer and a portable pulse oximetry device. The findings demonstrate appreciable short-term improvement in lung function assessed by spirometry. We conclude that yoga breathing can be a beneficial preoperative support for thoracic surgery.

Randomized controlled trial on the effectiveness of a multicomponent intervention on migraine: A study protocol.

AIM: To describe a randomized controlled trial protocol that evaluates the effectiveness of a multicomponent intervention in improving the outcomes (quality of life, disability, intensity, frequency and duration) of patients with migraine. BACKGROUND: Migraine affects various facets of Quality of Life and results in moderate to high levels of disability among migraineurs. Migraine pain can be intense and unremitting that can interfere with the daily routine and reduce the ability to think and function normally. Many people can lower their risk of a migraine by simply avoiding stress, getting enough sleep, eating regularly and by avoiding triggers. Hence, the present study aims at evaluating the effectiveness of a multicomponent intervention in managing migraine headaches. The multicomponent intervention includes behavioural lifestyle modification program and sessions of pranayama (a form of yogic breathing exercise). DESIGN: The study is a prospective, randomized, controlled, single-blinded trial with parallel arms. METHODS: The study participants are randomized to intervention and control arms. The participants randomized to the intervention arm would receive the specific multicomponent intervention based on the protocol. The participants in the control arm would receive routine care. They are followed up for 24 weeks and the outcomes are assessed. DISCUSSION: Various studies report that non-pharmacological therapies and integrative therapies play a major role in the management of migraine headaches. The findings of the study are expected to open up new horizons in health care arena emphasizing the use of non-pharmacological therapy for less focused areas of primary care health problems such as migraine. TRIAL REGISTRATION: The trial is registered with the Clinical Trials Registry India (CTRI). The CTRI India is one of the primary registries in the WHO registry network (Ctri.nic.in, ). CTRI reference ID: CTRI/2015/10/006282.

Cerebrovascular Hemodynamics During the Practice of Bhramari Pranayama, Kapalbhati and Bahir-Kumbhaka: An Exploratory Study.

Various pranayama techniques are known to produce different physiological effects. We evaluated the effect of three-different pranayama techniques on cerebrovascular hemodynamics. Eighteen healthy volunteers with the mean ± standard deviation age of 23.78 ± 2.96 years were performed three-different pranayama techniques: (1) Bhramari, (2) Kapalbhati and (3) Bahir-Kumbhaka in three-different orders. Continuous transcranial Doppler (TCD) monitoring was performed before, during and after the pranayama techniques. TCD parameters such as peak systolic velocity, end diastolic velocity (EDV), mean flow velocity (MFV) and pulsatility index (PI) of right middle cerebral artery were recorded. Practice of Kapalbhati showed significant reductions in EDV and MFV with significant increase in PI while, Bahir-Kumbhaka showed significant increase in EDV and MFV with significant reduction in PI. However, no such significant changes were observed in Bhramari pranayama. Various types of pranayama techniques produce different cerebrovascular hemodynamic changes in healthy volunteers.

Yoga and physical exercise - a review and comparison.

Yoga is a multifaceted spiritual tool with enhanced health and well-being as one of its positive effects. The components of yoga which are very commonly applied for health benefits are asanas (physical postures), pranayama (regulated breathing) and meditation. In the context of asanas, yoga resembles more of a physical exercise, which may lead to the perception that yoga is another kind of physical exercise. This article aims at exploring the commonalities and differences between yoga and physical exercise in terms of concepts, possible mechanisms and effectiveness for health benefits. A narrative review is undertaken based on traditional and contemporary literature for yoga, along with scientific articles available on yoga and exercise including head-to-head comparative trials with healthy volunteers and patients with various disease conditions. Physical exercises and the physical components of yoga practices have several similarities, but also important differences. Evidence suggests that yoga interventions appear to be equal and/or superior to exercise in most outcome measures. Emphasis on breath regulation, mindfulness during practice, and importance given to maintenance of postures are some of the elements which differentiate yoga practices from physical exercises.

Yogic breathing when compared to attention control reduces the levels of pro-inflammatory biomarkers in saliva: a pilot randomized controlled trial.

BACKGROUND: Self-report measures indicate that Yoga practices are perceived to reduce stress; however, molecular mechanisms through which YB affects stress are just beginning to be understood. While invasive sampling such as blood has been widely used to measure biological indicators such as pro-inflammatory biomarkers, the use of saliva to measure changes in various biomolecules has been increasingly recognized. As Yoga practice stimulates salivary secretion, and saliva is considered a source of biomarkers, changes in salivary cytokines before and after Yogic breathing exercise as specified in an ancient Tamil script, Thirumanthiram, were examined using a Cytokine Multiplex to compare to Attention Control (AC) group. METHODS: Twenty healthy volunteers were randomized into two groups stratified by gender (N = 10 per YB and AC groups); The YB group performed two YB exercises, each for ten minutes, for a total of twenty minutes in a single session as directed by a trained Yoga instructor. The AC group read a text of their choice for 20 min. Saliva was collected immediately after YB training at 0, 5, 10, 15 and 20 min and analyzed by Multiplex enzyme linked immunosorbent assay (ELISA). RESULTS: The levels of interleukin (IL)-1ß, IL-8, and monocyte chemotactic protein -1 (MCP-1) were significantly reduced in YB group when compared to AC group. The level of reduction of IL-8 was significant at all time points tested, whereas IL-1ß showed reduction at 15 and 20 min time points (p < 0.05), and MCP-1 level was marginally different at 5-20 min. There were no significant differences between YB and AC groups in the salivary levels of IL-1RA, IL-6, IL-10, IL-17, IP-10, MIP-1b, and TNF-α. CONCLUSIONS: These data are the first to demonstrate the feasibility of detecting salivary cytokines using multiplex assay in response to a Yoga practice. This study was registered in Clinical Trials.gov # NCT02108769.

Heart Rate Variability, Flow, Mood and Mental Stress During Yoga Practices in Yoga Practitioners, Non-yoga Practitioners and People with Metabolic Syndrome.

Heart Rate Variability (HRV) and respiratory sinus arrhythmia are directly associated with autonomic flexibility, self-regulation and well-being, and inversely associated with physiological stress, psychological stress and pathology. Yoga enhances autonomic activity, mitigates stress and benefits stress-related clinical conditions, yet the relationship between autonomic activity and psychophysiological responses during yoga practices and stressful stimuli has not been widely explored. This experimental study explored the relationship between HRV, mood states and flow experiences in regular yoga practitioners (YP), non-yoga practitioners (NY) and people with metabolic syndrome (MetS), during Mental Arithmetic Stress Test (MAST) and various yoga practices. The study found that the MAST placed a cardio-autonomic burden in all participants with the YP group showing the greatest reactivity and the most rapid recovery, while the MetS group had significantly blunted recovery. The YP group also reported a heightened experience of flow and positive mood states compared to NY and MetS groups as well as having a higher vagal tone during all resting conditions. These results suggest yoga practitioners have a greater homeostatic capacity and autonomic, metabolic and physiological resilience. Further studies are now needed to determine if regular yoga practice may improve autonomic flexibility in non-yoga practitioners and metabolic syndrome patients. Clinical Trial No 'ACTRN 2614001075673'.

Proposed physiological mechanisms of pranayama: A discussion.

BACKGROUND: Pranayama, or yogic breathing technique, is now well-known worldwide by ordinary people, doctors, and scientific communities for its immediate and long-term physiological effect. However, no comprehensive physiological mechanisms explained pranayama. The present study proposed these physiological mechanisms to interpret the underlying science behind pranayama. METHOD: The author searches PubMed/Medline internet sources for authentic scientific data and articles to acquire evidence following specific keywords. The author reviewed a total of seventy-three papers, following PRISMA guidelines. 17 full articles, including seven systematic reviews, five clinical trials, two observational studies, and three randomized control trials, have been selected to discuss proposed physiological mechanisms. DISCUSSION: This study proposes physiological mechanisms of pranayama. It is commenced from Step 1. Activation of mechanoreceptors and chemoreceptors in the respiratory system; then Step 2. Activation of mechanoreceptors and chemoreceptors in the circulatory system, followed by Step 3. Activation of brain respiro-circulatory control centre; Step 4. Activation of the cerebellum; Step 5. Activation of the limbic system and finally end with; Step 6. Activation of the cerebral cortex. The physiological adjustment and adaptation mechanisms due to pranayama of all these six proposed areas have been discussed. Authentic scientific evidence has also been presented to support these proposed physiological mechanisms of pranayama. The author stated the study's limitations and suggested future specific scientific experiments in this area of proposed physiological mechanisms of pranayama. CONCLUSION: These prospective proposed physiological mechanisms of pranayama in the future may provide the best scientific background for therapeutic rehabilitation and for the healthy population to maintain their general wellness.

Effect of Right Nostril Breathing on Cardiorespiratory Parameters and Reaction Time in Young, Healthy Humans: An Interventional Study.

Background and Objective: Yogic breathing helps in reduction of stress and strain in the body. Right and left nostril breathings (RNB and LNB, respectively) have different effects on cardiorespiratory parameters. The study was performed to examine the effect of RNB exercise on cardiorespiratory parameters and reaction time in young, healthy human volunteers. Materials and Methods: In this prospective, interventional study, 110 young healthy volunteers underwent systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR), respiratory rate (RR), vital capacity (VC), peak expiratory flow rate (PEFR), and reaction time (RT) examination before and after 2 weeks of performing 45 min of RNB exercise daily. Results: There was notable increment in SBP (113.39 ± 17.72 vs. 117.74 ± 10.83 mmHg, P = 0.002) and DBP (67.64 ± 10.32 vs. 71.27 ± 8.68 mmHg, P = 0.002). PR increased nonsignificantly (86.44 ± 12.65/min vs. 87.32 ± 13.43/min, P = 0.476). Significant decrease in RR (14.40 ± 2.48/min vs. 12.31 ± 2.23/min, P < 0.0001) was observed. VC (3.57 ± 0.57 vs. 3.82 ± 0.55 L/min, P < 0.0001) and PEFR (441.36 ± 50.22 vs. 468.91 ± 53.66 L/min, P < 0.0001) also increased significantly. Substantial reduction in auditory reaction time (ART) (165.58 ± 32.18 vs. 147.42 ± 23.39 ms, P < 0.0001) and visual reaction time (VRT) (191.04 ± 37.94 vs. 165.86 ± 28.74 ms, P < 0.0001) was seen. After engaging in cardiorespiratory exercise, the maximal heart rate (MHR) remained unchanged (P = 0.929). Conclusion: RNB results in increase in blood pressure, heart rate, VC, and PEFR and decrease in ART and VRT. Further studies in patients with cardiorespiratory diseases are necessary to understand its clinical utility.

Effects of yoga on hypothyroidism: A systematic review.

Evidence from clinical trials has shown positive effects of yoga on hypothyroidism. To date, there is no review of these studies. This systematic review evaluates the efficacy of yoga as a therapeutic intervention for hypothyroidism. PubMed, Medline, PsycINFO, and Science Direct databases were searched to identify relevant literature. The review included clinical studies that evaluated the effects of yoga on hypothyroidism. Studies that were not conducted inenglish, unavailable, non-experimental, or those that were reviews, case studies, case reports, not based on yoga, involved yoga as a intervention, or included a mixed population were excluded. Eleven studies (n = 516) met the eligibility criteria. Of these, four studies were RCTs, two non-RCTs and five were pretest-posttest studies. The duration of the yoga intervention varied from 1 to 6 months. Most of these studies adopted a combination of suryanamaskar, asana, pranayama and meditation. On quality assessment, one study had a low risk of bias (1 RCT), six studies had a moderate risk of bias (3 RCTs, one non-RCT and two pretest-posttest studies), and four studies had a high risk of bias (1 non-RCT and three pretest-posttest studies). The outcome measures assessed were TSH, T3, T4, and thyroid medication usage, lipid indices, BMI, heart rate variability, pulmonary measures, blood glucose, anxiety, depression, self-esteem, quality of life and sleep. The majority of the studies reported significant improvements in these outcomes following yoga intervention. This systematic review reports evidence for effects of yoga on various outcome measures in hypothyroidism, suggesting its possible role in the management of hypothyroidism. However, there is a need for adequately powered, high-quality RCT studies in the future to draw a definitive conclusion.

Comparison of Yoga with exercise in ankylosing spondylitis on mobility and functional capacity.

AIM: To compare the effects of Yoga with traditional exercise on the mobility and functional capacity of individuals with ankylosing spondylitis (AS). METHODS: The participants of the study were recruited at the rheumatology department, adhering to the study's inclusion and exclusion criteria. Participants were randomized into two groups (Group A - Yoga, and Group B - exercise).The candidates participated in an 8-week intervention consisting of 3 weekly sessions of either Yoga or Exercise intervention. Outcomes were collected at pre-treatment, at 8 weeks, and at 12 weeks. RESULTS: The within-group comparison showed an improvement in all outcome measures with p < .05 between post-treatment and the follow-up. In the yoga group, there was an improvement in the measures of BASMI (p = .001), BASFI (p = .005), PSQI (p = .021), CE (p = .053) and NPRS (p = .001). Similarly, in the exercise group, there was an improvement in BASMI (p = .002), BASFI (p = .003), PSQI (p = .010), CE (p = .004) and NPRS (p = .001). In the between group comparison at post-treatment, there were no statistically significant differences in BASMI (yoga = 3.0 ± 1.50, exercise = 2.3 ± 1.38), PSQI (yoga = 5.3 ± 1.50, exercise = 4.9 ± 1.17) and NPRS (yoga = 1.3 ± 2.22, exercise = 0.4 ± 0.50) CE (yoga = 4.0 ± 1.18, exercise = 3.4 ± 0.96), BASFI (yoga = 1.8 ± 2.14, exercise = 2.1 ± 1.87). CONCLUSION: The results demonstrated a statistically significant improvement in within-group scores of mobility, functional capacity, sleep quality and pain in AS patients of both intervention programs but there were no significant differences between the groups.

Effects of Pranayama on Cancer Patients: A Narrative Review of Clinical Outcomes.

Pranayama, a set of yogic breathing techniques, is being studied as a potential supportive care option for cancer patients. This review intends to evaluate the effectiveness of Pranayama in enhancing the quality of life and well-being of cancer patients based on evidence from randomized controlled trials. We thoroughly searched databases for studies published between 2013 and 2023. We focused on randomized controlled trials that compared Pranayama interventions with non-yoga control groups. We assessed the primary outcomes, including psychological well-being, quality of life, physiological parameters, and treatment-related side effects. The review indicates that practicing Pranayama can lead to significant improvements in antioxidant levels, stress, anxiety, sleep quality, and overall quality of life for cancer patients. However, the evidence comes from a limited number of studies, which vary in sample sizes and methodologies. Pranayama shows promise as a complementary therapy for cancer patients, potentially enhancing their well-being and quality of life. Nonetheless, the current evidence base is limited, necessitating further research with larger sample sizes and more rigorous study designs to confirm these findings and elucidate the underlying mechanisms.

Therapeutic role of yoga in hypertension.

Systemic hypertension is an established risk factor for coronary artery disease and cerebrovascular accident and control of blood pressure reduces the risk of a major cardiovascular event. Both non-pharmacological and pharmacological treatment options are available to treat hypertension. Yoga, recently received more attention as a treatment modality for various lifestyle disorders, even though practiced in India since ancient times. In this review, we are analyzing the role of yoga in the treatment of systemic hypertension.

Breathing Right or Left! The Effects of Unilateral Nostril Breathing on Psychological and Cognitive Wellbeing: A Pilot Study.

The impact of controlled breathing on cognitive and affective processing has been recognized since ancient times, giving rise to multiple practices aimed at achieving different psychophysical states, mostly related to mental clarity and focus, stress reduction, and relaxation. Previous scientific research explored the effects of forced unilateral nostril breathing (UNB) on brain activity and emotional and cognitive functions. Some evidence concluded that it had a contralateral effect, while other studies presented controversial results, making it difficult to come to an unambiguous interpretation. Also, a few studies specifically addressed wellbeing. In the present study, we invited a pilot sample of 20 participants to take part in an 8-day training program for breathing, and each person was assigned to either a unilateral right nostril (URNB) or left nostril breathing condition (ULNB). Then, each day, we assessed the participants' wellbeing indices using their moods and mind wandering scales. The results revealed that, after the daily practice, both groups reported improved wellbeing perception. However, the effect was specifically related to the nostril involved. URNB produced more benefits in terms of stress reduction and relaxation, while ULNB significantly and increasingly reduced mind-wandering occurrences over time. Our results suggest that UNB can be effectively used to increase wellbeing in the general population. Additionally, they support the idea that understanding the effects of unilateral breathing on wellbeing and cognition requires a complex interpretive model with multiple brain networks to address bottom-up and top-down processes.

Effects of the Brief Simha Kriya Breathing Practice for Health Care Workers During the COVID-19 Pandemic.

Introduction: During the COVID-19 pandemic, health care workers (HCWs) experienced increased anxiety, depression, loneliness, and other mental health issues. HCWs need additional resources to cope with the mental health impact of their work. Yoga techniques could be helpful strategies to manage different stressors during times of uncertainty. Methods: This prospective, single-arm, trial examined the effects of a brief pranayama yoga practice on the wellbeing of HCWs during the height of COVID-19. HCWs were recruited through announcements and institutional websites at a large major cancer center in the southern United States. A short, prerecorded, 5-min breathwork video intervention called "Simha Kriya" was provided to participants, and they were encouraged to practice one to two times daily for 4 weeks. Participants completed self-report instruments at baseline and weeks 1 and 4, including: (1) Perceived Stress Scale (PSS); (2) Brief Resilient Coping Scale (BRCS); and (3) a questionnaire assessing the experience of COVID-19 among HCWs that had five subscales. HCWs also conducted a measure of breath holding time. Paired sample t-tests and mixed-effects analysis of variance models examined changes over time. Results: One hundred participants consented to the study, with 88 female, 60 white, 39 worked remotely, and 27 were clinical staff. Sixty-nine participants provided data at week 1 and 56 at week 4. Participants' adherence to the breathing exercises between weeks 1 and 4 was similar, with a mean of six times per week. At week 4, there were significant decreases in the COVID-19 Distress score (p < 0.0001) and COVID-19 Disruption (p = 0.013), yet no changes in the PSS. There were also significant increases in COVID-19 Stress Management (p = 0.0001) and BRCS scores (p = 0.012), but no changes in Perceived Benefits of COVID-19 and no changes in breath holding time. Discussion: Brief yoga-based breathing practices helped reduce pandemic-specific stress, improved resilience, and stress management skills in HCWs. Trial Registration Number: NCT04482647.

Effect of Meditation, Mindfulness-Based Stress Reduction, and Relaxation Techniques as Mind-Body Medicine Practices to Reduce Blood Pressure in Cardiac Patients: A Systematic Review and Meta-Analysis.

Elevated blood pressure is one of the major risk factors for cardiovascular diseases. Available evidence on mind-body medicine (MBM) techniques on blood pressure is inconclusive and provides conflicting results. The objective of the current systematic review and meta-analysis is to evaluate the effect of MBM techniques on blood pressure in patients with cardiovascular disease. Randomized control trials (RCTs) done between the years 2000 and 2020 on cardiovascular disease, using MBM techniques such as meditation, mindfulness-based stress reduction and relaxation techniques were searched through electronic databases such as PubMed, Cumulative Index to Nursing & Allied Health (CINAHL), EMBASE and Cochrane Library. Three authors independently performed article selection, data extraction and validation. Meta-analysis was performed using a random effect model and standardized mean difference (SMD) with 95% confidence interval (CI) estimated for the effect size. Fifteen RCTs with 927 patients were included in the meta-analysis. Heterogeneity among the studies was very high for all analyses (I2>94%). For studies comparing systolic blood pressure, MBM interventions show a significant (p=0.01) effect when compared to conventional treatment, an overall estimated effect size of SMD - 0.78 (95% CI: -1.36, -0.20). For studies comparing the diastolic blood pressure, MBM intervention did not show any significant effect when compared to the conventional treatment, an overall effect size of SMD -0.26 (95% CI: -0.91, 0.39). The findings of the meta-analysis suggest that MBM interventions may improve systolic blood pressure alone in patients with cardiac diseases. With high heterogeneity and low quality of the included studies, more robust evidence is required before suggesting MBM as an effective treatment modality for reducing blood pressure in cardiovascular diseases.

Visual respiratory biofeedback to improve visuospatial cognition and cardiac interoception in migraineurs: a study protocol for a randomized controlled trial.

Objectives: Migraine is a complex neurological disorder that typically presents with unilateral cephalgia associated with cognitive impairment and reduced interoception. These symptoms result in socio-economic repercussions due to reduced productivity, efficiency, and work performance. Therefore, along with headache management, improving cognition and interoception should also be significant therapeutic targets to effectively manage migraine. To achieve this, we propose to explore the role of a yoga-based visual respiratory biofeedback (VRB) as a possible therapeutic strategy. Methods and analysis: At least 64 participants will be recruited for the trial after screening for eligibility criteria, using the migraine screening questionnaire and Montreal cognitive assessment test. They will be randomly allocated (1:1) to either the experimental group receiving a 20-min session of yoga-based VRB or the control group who will be asked to watch a documentary film for the same duration. Visuospatial cognition will be assessed by the Corsi block-tapping task, and cardiac interoceptive accuracy will be assessed by the heartbeat counting task at baseline and immediately after the intervention. Based on the distribution and variance of the data obtained, analysis will be conducted based on linear mixed models using SPSS version 28.0.1.0, with a two-sided p-value of < 0.05 considered to be statistically significant. Discussion: To the best of our knowledge, this is the first study to design and assess the effects of yoga-based biofeedback therapy on cognition and cardiac interoception in migraineurs. Furthermore, we postulated that pranayama's therapeutic effects might be enhanced by using visual yogic respiratory biofeedback. Considering the socio-economic burden of migraine, if found effective, VRB investigated in the trial could be considered as a therapeutic strategy. Clinical trial registration: ClinicalTrials.gov CTRI, CTRI/2023/03/050430.

Effect of a single session of yoga and meditation on stress reactivity: A systematic review.

This systematic review synthesises the evidence for the effectiveness of a single session of yoga or its components including meditation and breathing techniques in reducing acute stress reactivity in healthy adults. Following the PRISMA guidelines, we searched Medline, EMBASE, Cochrane, CINAHL, and PsycINFO on 30th July 2023 for randomised controlled or crossover trials of yoga components and reporting physiological and/or psychological outcome measure(s) related to stress reactivity. Risk of bias (ROB) was assessed using the Cochrane ROB 2 tool. Data were synthesised narratively. Twenty-one out of 28 eligible studies (n = 2574) relating to 31 interventions (meditation [n = 22], breathing [n = 4] and yoga [n = 5]) reported outcomes in favour of the intervention. Stress reactivity was reported to be reduced by 71% of studies measuring physiological outcomes and 65% of studies measuring psychological outcomes. These studies show that a single session of yoga components is effective in reducing acute stress reactivity in adults and could be recommended for stress management. Future studies with larger populations and a more equal representation of genders and age groups are warranted.