***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 Adequate reporting of r and omized , controlled trials ( RCTs ) is necessary to allow accurate critical appraisal of the validity and applicability of the results . The CONSORT ( Consoli date d St and ards of Reporting Trials ) Statement , a 22-item checklist and flow diagram , is intended to address this problem by improving the reporting of RCTs . However , some specific issues that apply to trials of nonpharmacologic treatments ( for example , surgery , technical interventions , devices , rehabilitation , psychotherapy , and behavioral intervention ) are not specifically addressed in the CONSORT Statement . Furthermore , considerable evidence suggests that the reporting of nonpharmacologic trials still needs improvement . Therefore , the CONSORT group developed an extension of the CONSORT Statement for trials assessing nonpharmacologic treatments . A consensus meeting of 33 experts was organized in Paris , France , in February 2006 , to develop an extension of the CONSORT Statement for trials of nonpharmacologic treatments . The participants extended 11 items from the CONSORT Statement , added 1 item , and developed a modified flow diagram . To allow adequate underst and ing and implementation of the CONSORT extension , the CONSORT group developed this elaboration and explanation document from a review of the literature to provide examples of adequate reporting . This extension , in conjunction with the main CONSORT Statement and other CONSORT extensions , should help to improve the reporting of RCTs performed in this field Background Coal mine dust exposure causes chronic airflow limitation in coal miners result ing in dyspnea , fatigue , and eventually chronic obstructive pulmonary disease ( COPD ) . Yoga can alleviate dyspnea in COPD by improving ventilatory mechanics , reducing central neural drive , and partially restoring neuromechanical coupling of the respiratory system . Objectives To evaluate the effectiveness of Integrated Approach of Yoga Therapy ( IAYT ) in the management of dyspnea and fatigue in coal miners with COPD . Material s and methods R and omized , waitlist controlled , single-blind clinical trial . Eighty-one coal miners ( 36–60 years ) with stable Stages II and III COPD were recruited . The yoga group received an IAYT module for COPD that included asanas , loosening exercises , breathing practice s , pranayama , cyclic meditation , yogic counseling and lectures 90 min/day , 6 days/week for 12 weeks . Measurements of dyspnea and fatigue on the Borg scale , exercise capacity by the 6 min walk test , peripheral capillary oxygen saturation ( SpO2 % ) , and pulse rate ( PR ) using pulse oximetry were made before and after the intervention . Results Statistically significant within group reductions in dyspnea ( P < 0.001 ) , fatigue ( P < 0.001 ) scores , PR ( P < 0.001 ) , and significant improvements in SpO2 % ( P < 0.001 ) and 6 min walk distance ( P < 0.001 ) were observed in the yoga group ; all except the last were significant compared to controls ( P < 0.001 ) . Conclusions Findings indicate that IAYT benefits coal miners with COPD , reducing dyspnea ; fatigue and PR , and improving functional performance and peripheral capillary SpO2 % . Yoga can now be included as an adjunct to conventional therapy for pulmonary rehabilitation programs for COPD patients Background —It is well established that a depressed baroreflex sensitivity may adversely influence the prognosis in patients with chronic heart failure ( CHF ) and in those with previous myocardial infa rct ion . Methods and Results —We tested whether a slow breathing rate ( 6 breaths/min ) could modify the baroreflex sensitivity in 81 patients with stable ( 2 weeks ) CHF ( age , 58±1 years ; NYHA classes I [ 6 patients ] , II [ 33 ] , III [ 27 ] , and IV [ 15 ] ) and in 21 controls .  Slow breathing induced highly significant increases in baroreflex sensitivity , both in controls ( from 9.4±0.7 to 13.8±1.0 ms/mm Hg , P < 0.0025 ) and in CHF patients ( from 5.0±0.3 to 6.1±0.5 ms/mm Hg , P < 0.0025 ) , which correlated with the value obtained during spontaneous breathing ( r = + 0.202 , P = 0.047 ) . In addition , systolic and diastolic blood pressure decreased in CHF patients ( systolic , from 117±3 to 110±4 mm Hg , P = 0.009 ; diastolic , from 62±1 to 59±1 mm Hg , P = 0.02 ) . Conclusions —These data suggest that in patients with CHF  , slow breathing , in addition to improving oxygen saturation and exercise tolerance as has been previously shown , may be beneficial by increasing baroreflex sensitivity Background : In older adults , respiratory function may be seriously compromised when a marked decrease of respiratory muscle ( RM ) strength coexists with comorbidity and activity limitation . Respiratory muscle training has been widely studied and recommended as a treatment option for people who are unable to participate in whole-body exercise training ( WBET ) ;  however , the effects of inspiratory muscle training and yoga breathing exercises on RM function remain unknown , specifically in impaired older adults . Purpose : To evaluate the effects of inspiratory threshold training ( ITT ) and yoga respiratory training ( YRT ) on RM function in institutionalized frail older adults . Methods : Eighty-one residents ( 90 % women ; mean age , 85 years ) , who were unable to perform WBET ( inability to independently walk more than 10 m ) , were r and omly assigned to a control group or one of the  2 experimental groups ( ITT or YRT ) . Experimental groups performed a supervised interval-based training protocol , either through threshold inspiratory muscle training device or yoga breathing exercises , which lasted 6 weeks ( 5 days per week ) . Outcome measures were collected at 4 time points ( pretraining , intermediate , posttraining , and follow-up ) and included the maximum respiratory pressures ( maximum inspiratory pressure [ MIP ] and maximum expiratory pressure [ MEP ] ) and the maximum voluntary ventilation ( MVV ) . Results : Seventy-one residents completed the study : control ( n = 24 ) ; ITT ( n = 23 ) ; YRT ( n = 24 ) . The treatment on had a significant effect on MIP YRT ( F6,204 = 6.755 , P < .001 , & eegr;2 = 0.166 ) , MEP ( F6,204 = 4.257 , P < .001 , & eegr;2 = 0.111 ) , and MVV ( F6,204 = 5.322 , P < .001 , & eegr;2 = 0.135 ) . Analyses showed that the YRT group had a greater increase of RM strength ( MIP and MEP ) and endurance ( MVV ) than control and /or ITT groups . Conclusion : Yoga respiratory training appears to be an effective and well-tolerated exercise regimen in frail older adults and may therefore be a useful alternative to ITT or no training , to improve RM function in older population , when WBET is not possible Context : Psychological comorbidities are prevalent in coal miners with chronic obstructive pulmonary disease ( COPD ) and contribute to the severity of the disease reducing their health status . Yoga has been shown to alleviate depression and anxiety associated with other chronic diseases but in COPD not been fully investigated . Aim : This study aim ed to evaluate the role of yoga on health status , depression , and anxiety in coal miners with COPD . Material s and Methods : This was a r and omized trial with two study arms ( yoga and control ) , which enrolled 81 coal miners , ranging from 36 to 60 years with stage II and III stable COPD . Both groups were either on conventional treatment or combination of conventional care with yoga program for 12 weeks . Results : Data were collected through st and ardized question naires ; COPD Assessment Test , Beck Depression Inventory and State and Trait Anxiety Inventory at the beginning and the end of the intervention . The yoga group showed statistically significant ( P < 0.001 ) improvements on all scales within the group , all significantly different ( P < 0.001 ) from changes observed in the controls . No significant prepost changes were observed in the control group ( P > 0.05 ) . Conclusion : Yoga program led to greater improvement in physical and mental health status than did conventional care . Yoga seems to be a safe , feasible , and effective treatment for patients with COPD . There is a need to conduct more comprehensive , high- quality , evidence -based studies to shed light on the current underst and ing of the efficacy of yoga in these chronic conditions and identify unanswered questions BACKGROUND In chronic heart failure ( CHF ) , impaired pulmonary function can independently contribute to oxygen desaturation and reduced physical activity . We investigated the effect of breathing rate on oxygen saturation and other respiratory indices . METHODS  Arterial oxygen saturation ( SaO2 ) and respiratory indices  were recorded during spontaneous breathing ( baseline ) and during controlled breathing at 15 , six , and three breaths per min in 50 patients with CHF and in 11 healthy volunteers ( controls ) . 15 patients with CHF were r and omly allocated 1 month of respiratory training to decrease their respiratory rate to six breaths per min . Respiratory indices  were recorded before training , at the end of training , and 1 month after training . FINDINGS During spontaneous breathing , mean SaO2 was lower in CHF patients than in controls ( 91 - 4 % [ SD 0.4 ] vs 95.4 % [ 0.2 ] , p<0.001 ) . Controlled breathing increased SaO2 at all breathing rates in patients with CHF . Compared with baseline , minute ventilation increased at 15 breaths per min ( + 45.9 % [ 9.8 ] , p<0.01 ) , did not change at six breaths per min , and decreased at three breaths per min ( -40.3 % [ 4.8 ] , p<0.001 ) . In the nine CHF patients who had 1 month of respiratory training , resting SaO2 increased from 92.5 % ( 0.3 ) at baseline to 93.2 % ( 0.4 ) ( p<0.05 ) , their breathing rate per min decreased from 13.4 ( 1.5 ) to 7.6 ( 1.9 ) ( p<0.001 ) , peak oxygen consumption increased from 1157 ( 83 ) to 1368 ( 110 ) L/min ( p<0.05 ) , exercise time increased from 583 ( 29 ) to 615 ( 23 ) min/s ( p<0.05 ) , and perception of dyspnoea reduced from a score of 19.0 ( 0.4 ) to 17.3 ( 0.9 ) on the Borg scale ( p<0.05 ) . There were no changes in the respiratory indices in the patients who 
    Output:
    
Only the effects on exercise capacity and pulmonary function were robust against method ological bias .
Effects were only present in breathing-focused yoga interventions but not in interventions including yoga postures .
Adverse events were reported infrequently .
Conclusion : This meta- analysis found robust effects of yoga on exercise capacity and pulmonary function in patients with COPD .
Yoga , specifically yoga breathing techniques , can be an effective adjunct intervention for patients with COPD .