***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND There has been limited study of yoga training as a complementary exercise strategy to manage the symptom of dyspnea in patients with chronic obstructive pulmonary disease ( COPD ) . PURPOSE The primary purpose of this pilot study was to evaluate a yoga program for its safety , feasibility , and efficacy for decreasing dyspnea intensity ( DI ) and dyspnea-related distress ( DD ) in older adults with COPD . METHODS Clinical ly stable patients with COPD ( n = 29 ; age 69.9 + /- 9.5 ; forced expiratory volume in 1 second ( FEV(1 ) ) 47.7 + /- 15.6 % predicted ; female = 21 ) were r and omized to a 12-week yoga program specifically design ed for people with COPD or usual-care control  ( UC ) . The twice-weekly yoga program included asanas ( yoga postures ) and visama vritti pranayama ( timed breathing ) . Safety measure outcomes included heart rate , oxygen saturation , dyspnea , and pain . Feasibility was measured by patient-reported enjoyment , difficulty , and adherence to yoga sessions . At baseline and at 12 weeks , DI and DD were measured during incremental cycle ergometry and a 6-minute walk ( 6MW ) test . Secondary efficacy outcomes included physical performance , psychologic well-being , and health-related quality of life ( HRQoL ) . RESULTS Yoga training was safe and feasible for patients with COPD . While yoga training had only small effects on DI after the 6MW test ( effect size [ ES ] , 0.20 ; p = 0.60 ) , there were greater reductions in DD in the yoga group compared to UC ( ES , 0.67 ; p = 0.08 ) . Yoga training also improved 6MW distance ( + 71.7 + /- 21.8 feet versus -27.6 + /- 36.2 feet ; ES = 0.78 , p = 0.04 ) and self-reported functional performance ( ES = 0.79 , p = 0.04 ) compared to UC . There were small positive changes in muscle strength and HRQoL. CONCLUSIONS Elderly patients with COPD participated safely in a 12-week yoga program especially design ed for patients with this chronic illness . After the program , the subjects tolerated more activity with less DD and improved their functional performance . These findings need to be confirmed in a larger , more sufficiently powered efficacy study BACKGROUND Despite recent advances in pharmacologic and device therapy , morbidity and mortality from heart failure ( HF ) remain high . Yoga combines physical and breathing exercises that may benefit patients with HF . We hypothesized that an 8-week regimen of yoga in addition to st and ard medical therapy would improve exercise capacity , inflammatory markers , and quality of life ( QoL ) in patients with HF . METHODS AND RESULTS New York Heart Association Class I-III HF patients were r and omized to yoga treatment ( YT ) or st and ard medical therapy ( MT ) .  Measurements included a grade d exercise test ( GXT ) to V O(2Peak ) and the following serum biomarkers : interleukin-6 ( IL-6 ) , high-sensitivity C-reactive protein ( hsCRP ) , and extracellular superoxide dismutase ( EC-SOD ) . The Minnesota Living with Heart Failure Question naire ( MLHFQ ) was administered to assess changes in QoL. A total of 19 patients were enrolled after the initial screening . Of the 19 patients , 9 were r and omized to YT and 10 to MT . Patients had a mean EF of 25 % .  GXT time and V O(2Peak ) were significantly improved in the YT versus MT groups ( + 18 % in the YT and -7.5 % in MT ; P = .03 vs. control and + 17 in YT and -7.1 in MT ; P = .02 , respectively ) . There were statistically significant reductions in serum levels of IL-6 and hsCRP and an increase in EC-SOD in the YT group ( all P < .005 vs. MT ) . MLHFQ scores improved by 25.7 % in the YT group and by 2.9 % in the MT group . CONCLUSIONS Yoga improved exercise tolerance and positively affected levels of inflammatory markers in patients with HF , and there was also a trend toward improvements in Background and Purpose — Balance impairment is common after stroke ; modified yoga may be able to improve balance and other important poststroke variables . Scientific- evidence is needed to support such treatment interventions . The purpose of this study was to assess the impact of a yoga-based rehabilitation intervention on balance , balance self-efficacy , fear of falling ( FoF ) , and quality of life after stroke . Methods — This was a prospect i ve , r and omized , pilot study of yoga-based rehabilitation for people with chronic stroke . All yoga sessions were taught by a registered yoga therapist , occurred twice per week for 8 weeks and included seated , st and ing , and floor postures with relaxation and meditation .  Balance was assessed with the Berg Balance Scale , balance self-efficacy with the Activities-specific Balance Confidence Scale , FoF with a dichotomous yes/no question , and quality of life with the Stroke Specific Quality of Life scale . Results — There were no significant differences between wait-list control ( n=10 ) and yoga ( n=37 ) groups in baseline or follow-up scores . However , using within-group comparisons , yoga group data demonstrated significant improvement in balance ( Berg Balance Scale , 41.3±11.7 vs 46.3±9.1 ; P<0.001 ) and FoF ( 51 % vs 46 % with FoF ; P<0.001 ) . Conclusions — A group yoga-based rehabilitation intervention  for people with chronic stroke has potential in improving multiple poststroke variables . Group yoga may be complementary to rehabilitation , may be possible in medical-based and community-based setting s , and may be cost-effective . Further testing of group yoga-based rehabilitation interventions is warranted . Clinical Trial Registration — URL : http:// clinical trials.gov . Unique Identifier : NCT01109602 Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more BACKGROUND The number of African American ( AA ) patients living with heart failure ( HF ) has been increasing , especially among the economically disadvantaged . Yoga therapy has been found to improve physical and psychological parameters among healthy individuals , but its effect in patients with HF remains unknown . The purpose of this study was to examine the effects of yoga therapy on cardiovascular endurance ( VO2peak ) , flexibility , quality of life ( QoL ) , and inflammatory markers on medically stable HF patients . METHODS Forty patients ( 38 AA , 1 Asian , and 1 Caucasian ) with systolic or diastolic HF were r and omized to the yoga group ( YG , n = 21 ) or the control group ( CG , n = 19 ) . All patients were asked to follow a home walk program . Premeasurement and postmeasurement included a treadmill stress test to peak exertion , flexibility , interleukin-6 ( IL-6 ) , C-reactive protein ( CRP ) , and extracellular superoxide dismutase ( EC-SOD ) . QoL was assessed by the Minnesota Living with Heart Failure Question naire ( MLwHFQ ) . RESULTS The statistical analyses ( assessed by ANOVA and t-tests ) were significant for favorable changes in the YG , compared with those in the CG , for flexibility ( P = 0.012 ) , treadmill time ( P = 0.002 ) , VO2peak ( P = 0.003 ) , and the biomarkers ( IL-6 , P = 0.004 ; CRP , P = 0.016 ; and EC-SOD , P = 0.012 ) . Within the YG , pretest to posttest scores for the total ( P = 0.02 ) and physical subscales ( P < 0.001 ) of the MLwHFQ were improved . CONCLUSIONS Yoga therapy offered additional benefits to the st and ard medical care of predominantly AA HF patients by improving cardiovascular endurance , QoL , inflammatory markers , and flexibility Aim . This paper reports a systematic review and critical appraisal of the evidence on the effectiveness of behavioral therapies such as yoga and mindfulness practice s for stroke rehabilitation . Background . The experience of stroke can have a negative impact on both psychological and physical health and on quality of life . Yoga and relevant practice s are promising therapies that have been used with patients with a variety of conditions . In order to draw conclusions on effectiveness for stroke patients , the evidence requires systematic assessment . Methods . A comprehensive search of major biomedical and complementary medicine data bases was conducted . Relevant research was categorized by study type and appraised according to study design . Results . Five r and omized controlled clinical trials and four single case studies were found . Additionally , one qualitative research study was identified . Studies reported positive results , including improvements in cognition , mood , and balance and reductions in stress . Modifications to different yoga practice s make comparison between studies difficult , and a lack of controlled studies precludes any firm conclusions on efficacy . Conclusion . Yoga and mindfulness could be clinical ly valuable self-administered intervention options for stroke rehabilitation . Further research is needed to evaluate these specific practice s and their suitability in stroke rehabilitation Our aim was to determine the minimal important difference ( MID ) for 6-min walk distance ( 6MWD ) and maximal cycle exercise capacity ( MCEC ) in patients with severe chronic obstructive pulmonary disease ( COPD ) . 1,218 patients enrolled in the National Emphysema Treatment Trial completed exercise tests before and after 4–6 weeks of pre-trial rehabilitation  , and 6 months after r and omisation to surgery or medical care .  The St George 's Respiratory Question naire ( domain and total scores ) and University of California San Diego Shortness  of Breath Question naire ( total score ) served as anchors for anchor-based MID estimates . In order to calculate distribution-based estimates , we used the st and ard error of measurement , Cohen 's effect size and the empirical rule effect size . Anchor-based estimates for the 6MWD were 18.9 m ( 95 % CI 18.1–20.1 m ) , 24.2 m ( 95 % CI 23.4–25.4 m ) , 24.6 m ( 95 % CI 23.4–25.7 m ) and 26.4 m ( 95 % CI 25.4–27.4 m ) , which were similar to distribution-based MID estimates of 25.7 , 26.8 and 30.6 m. For MCEC , anchor-based estimates for the MID were 2.2 W ( 95 % CI 2.0–2.4 W ) , 3.2 W ( 95 % CI 3.0–3.4 W ) , 3.2 W ( 95 % CI 3.0–3.4 W ) and 3.3 W ( 95 % CI 3.0–3.5 W ) , while distribution-based estimates were 5.3 and 5.5 W. We suggest a MID of 26±2 m for 6MWD and 4±1 W for MCEC for patients with severe COPD AIMS AND OBJECTIVES Promoting physical fitness of young-older adults is essential in reducing healthcare expenditures which would occur in the future for those with chronic health problems . The silver yoga exercise programme was developed to accommo date the reduced body flexibility experienced by many older adults and was critically review ed by experts and pilot-tested with community-dwelling older adults . This study aim ed to test older adults ' physical fitness after a 24-week silver yoga exercise programme and to examine whether the programme could be further shortened to fit senior activity centres ' programme design s. DESIGN A quasi-experimental , pre-post tests design was used : baseline , at 12-week and at 24-week periods . METHODS Convenience sample s of 204 subjects were recruited from eight senior activity centres and 176 subjects completed the study . Subjects were r and omly assigned into three groups based on the centres : ( 1 ) Experiment I : complete silver yoga with stretching and meditation , ( 2 ) Experiment II : shortened silver yoga without the guided-imagery meditation and ( 3 ) Wait-list control . The interventions were conducted three times per week for 24 weeks . Physical fitness indicators included body compositions , cardiovascular-respiratory functions , physical functions and the range of motion . RESULTS At the end of the 24-week period , the physical fitness of subjects in Experiments I and II had significantly improved whether or not guided-imagery meditation was used and all had better physical fitness than subjects in the control group ( all p < 0.05 ) . CONCLUSIONS The physical fitness of older adults in both the 70-minute complete silver yoga group and the 55-minute shortened silver yoga group had significantly improved after the interventions . It was recommended that the silver yoga programme be shortened by eliminating the guided-imagery meditation . RELEVANCE TO CLINICAL PRACTICE The shortened silver yoga exercise programme is recommended to be incorporated as an activity programme in community- setting s to promote the physical fitness of older adults CONTEXT Mood disorders are prevalent in people after stroke , and 
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Symptoms of anxiety were reduced after yoga in individuals with stroke , although this was not observed in individuals with COPD .
The effect of yoga  on symptoms of depression varied across studies with no significant effects compared with usual care .
Conclusions : Yoga programs have similar design s and components across chronic disease population s. Compared with usual care , yoga result ed in significant improvements in exercise capacity and a mean improvement in HRQL  .