***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: Fifty three patients with asthma underwent training for two weeks in an integrated set of yoga exercises , including breathing exercises , suryanamaskar , yogasana ( physical postures ) , pranayama ( breath slowing techniques ) , dhyana ( meditation ) , and a devotional session , and were told to practise these exercises for 65 minutes daily . They were then compared with a control group of 53 patients with asthma matched for age , sex , and type and severity of asthma , who continued to take their usual drugs . There was a significantly greater improvement in the group who practised yoga in the weekly number of attacks of asthma , scores for drug treatment , and peak flow rate . This study shows the efficacy of yoga in the long term management of bronchial asthma , but the physiological basis for this beneficial effect needs to be examined in more detail Objective To examine the prevalence of outcome reporting bias — the selection for publication of a subset of the original recorded outcome variables on the basis of the results — and its impact on Cochrane review s. Design A nine point classification system for missing outcome data in r and omised trials was developed and applied to the trials assessed in a large , unselected cohort of Cochrane systematic review s. Research ers who conducted the trials were contacted and the reason sought for the non-reporting of data . A sensitivity analysis was undertaken to assess the impact of outcome reporting bias on review s that included a single meta- analysis of the review primary outcome . Results More than half ( 157/283 ( 55 % ) ) the review s did not include full data for the review primary outcome of interest from all eligible trials . The median amount of review outcome data missing for any reason was 10 % , whereas 50 % or more of the potential data were missing in 70 ( 25 % ) review s. It was clear from the publications for 155 ( 6 % ) of the 2486 assessable trials that the research ers had measured and analysed the review primary outcome but did not report or only partially reported the results . For reports that did not mention the review primary outcome , our classification regarding the presence of outcome reporting bias was shown to have a sensitivity of 88 % ( 95 % CI 65 % to 100 % ) and specificity of 80 % ( 95 % CI 69 % to 90 % ) on the basis of responses from 62 trialists . A third of Cochrane review s ( 96/283 ( 34 % ) ) contained at least one trial with high suspicion of outcome reporting bias for the review primary outcome . In a sensitivity analysis undertaken for 81 review s with a single meta- analysis of the primary outcome of interest , the treatment effect estimate was reduced by 20 % or more in 19 ( 23 % ) . Of the 42 meta-analyses with a statistically significant result only , eight ( 19 % ) became non-significant after adjustment for outcome reporting bias and 11 ( 26 % ) would have overestimated the treatment effect by 20 % or more . Conclusions Outcome reporting bias is an under-recognised problem that affects the conclusions in a substantial proportion of Cochrane review s. Individuals conducting systematic review s need to address explicitly the issue of missing outcome data for their review to be considered a reliable source of evidence . Extra care is required during data extraction , review ers should identify when a trial reports that an outcome was measured but no results were reported or events observed , and contact with trialists should be encouraged PURPOSE Psychological interventions in the treatment of epilepsy have been developed and evaluated for many years but the amount of research has hardly made an impact on how epilepsy is treated . The purpose of this study was to develop and evaluate a psychological treatment program consisting of acceptance and commitment therapy ( ACT ) together with some behavioral seizure control technology shown to be successful in earlier research . METHODS The method consisted of a r and omized controlled trial group design with repeated measures ( n=27 ) . All participants had an EEG verified epilepsy diagnosis with drug refractory seizures . Participants were r and omized into one of two conditions , ACT or supportive therapy ( ST ) . Therapeutic effects were measured by examining changes in quality of life ( SWLS and WHOQOL ) and seizure index ( frequency x duration ) . Both treatment conditions consisted of only nine hours of professional therapy distributed in two individual and two group sessions during a four-week period . RESULTS The results showed significant effects over all of the dependent variables for the ACT group as compared to the ST group at six- and twelve-month follow-ups . CONCLUSIONS The results from this study suggest that a short-term psychotherapy program combined with anticonvulsant drugs may help to prevent the long-term disability that occurs from drug refractory seizures We determined the efficacy of progressive muscle relaxation in reducing seizure frequency .  Subjects were 24 people with epilepsy attending an urban neurology clinic . The experimental design consisted of an 8-week baseline period , a treatment period of six sessions of progressive relaxation training ( PRT , n = 13 ) or quiet sitting ( QS , n = 11 ) and an 8-week follow up . In the PRT group , 11 subjects reported a decrease in seizure frequency ( p less than 0.01 ) , and in the QS group , 7 reported a decrease ( p greater than 0.05 ) . The mean decrease in seizure frequency was 29 % for the PRT group ( p less than 0.01 ) but only 3 % for the QS group ( p greater than 0.05 ) . This is the fifth recent report of a controlled study documenting the success of progressive relaxation therapy in seizure reduction . PRT is inexpensive and noninvasive and facilitates patient participation . Such a technique should be incorporated into clinical practice The effects of two pranayama yoga breathing exercises on airway reactivity , airway calibre , symptom scores , and medication use in patients with mild asthma were assessed in a r and omised , double-blind , placebo-controlled , crossover trial . After baseline assessment over 1 week , 18 patients with mild asthma practised slow deep breathing for 15 min twice a day for two consecutive 2-week periods . During the active period , subjects were asked to breathe through a Pink City lung ( PCL ) exerciser -- a device which imposes slowing of breathing and a 1:2 inspiration : expiration duration ratio equivalent to pranayama breathing methods ; during the control period , subjects breathed through a matched placebo device .  Mean forced expiratory volume in 1 s ( FEV1 ) , peak expiratory flow rate , symptom score , and inhaler use over the last 3 days of each treatment period were assessed in comparison with the baseline assessment period ; all improved more with the PCL exerciser than with the placebo device , but the differences were not significant . There was a statistically significant increase in the dose of histamine needed to provoke a 20 % reduction in FEV1 ( PD20 ) during pranayama breathing but not with the placebo device . The usefulness of controlled ventilation exercises in the control of asthma should be further investigated Hatha-Yoga has become increasingly popular in western countries as a method for coping with stress . However , little is known about the physiological and psychological effects of yoga practice . We measured heart rate , blood pressure , the hormones cortisol , prolactin and growth hormone and certain psychological parameters in a  yoga practicing group and a control group of young female volunteers reading in a comfortable position during the experimental period . There were no substantial differences between the groups concerning endocrine parameters and blood pressure . The course of heart rate was significantly different , the yoga group had a decrease during the yoga practice . Significant differences between both groups were found in psychological parameters . In the personality inventory the yoga group showed markedly higher scores in life satisfaction and lower scores in excitability , aggressiveness , openness , emotionality and somatic complaints . Significant differences could also be observed concerning coping with stress and the mood at the end of the experiment . The yoga group had significant higher scores in high spirits and extravertedness Three children with very frequent refractory epileptic seizures underwent a behavioral intervention consisting of symptom discrimination , counter measures , contingent relaxation , and positive reinforcement for correct responses in a systematic replication series . The studies involved a 6-h nonintervention base rate , a 6-h treatment phase , and a 6-h nonintervention follow-up under laboratory conditions for each child . Neurophysiologic and behavioral measures of the effects of treatment were made using electroencephalogram (EEG)-video equipment . Effects of treatment were assessed by using a r and om sample of EEG-video sequences in base rate and follow-up . Results showed that no significant reduction of either seizure behavior or paroxysmal EEG activity was found subsequent to training in discrimination of early paroxysmal activity and /or sensations preceding seizures . Both seizure behavior and paroxysmal activity were significantly reduced in all three cases following intervention with an adapted countermeasure technique . No additional effects could be noted subsequent to the application of either contingent relaxation or positive reinforcement for correct responses . Paroxysmal EEG changes and seizure behavior were highly correlated . Reduction of the clinical manifestation or seizure response by behavioral manipulation was accompanied by a reduction of the total amount of paroxysmal activity as measured by the EEG The effect of Sahaja yoga meditation on 32 patients with primary idiopathic epilepsy on regular and maintained antiepileptic medication was studied . The patients were r and omly divided into 3 groups : group I practice d Sahaja Yoga meditation twice daily for 6 months under proper guidance ; group II practice d postural exercises mimicking the meditation for the same duration ; and group III was the control group .  Visual Contrast Sensitivity ( VCS ) , Auditory Evoked Potentials ( AEP ) , Brainstem Auditory Evoked Potentials ( BAEP ) , and Mid Latency Responses ( MLR ) were recorded initially ( 0 month ) and at 3 and 6 months for each group . There was a significant improvement in VCS following meditation practice in group I participants . Na , the first prominent negative peak of MLR and Pa , the positive peak following Na did not register changes in latency . The Na-Pa amplitude of MLR also showed a significant increase . There were no significant changes in the absolute and interpeak latencies of BAEP . The reduced level of stress following meditation practice may make patients more responsive to specific stimuli . Sahaja Yoga meditation appears to bring about changes in some of the electrophysiological responses studied in epileptic patients OBJECTIVE Yoga and relaxation techniques have traditionally been used by nonmedical practitioners to help alleviate musculoskeletal symptoms . The objective of this study was to collect controlled observations of the effect of yoga on the h and s of patients with osteoarthritis ( OA ) . METHODS Patients with OA of the h and s were r and omly assigned to receive either the yoga program or no therapy . Yoga techniques were supervised by one instructor once/week for 8 weeks . Variables assessed were pain , strength , motion , joint circumference , tenderness , and h and function using the Stanford H and Assessment question naire . RESULTS The yoga treated group improved significantly more than the control group in pain during activity , tenderness and finger range of motion . Other trends also favored the yoga program . CONCLUSION This yoga derived program was effective in providing relief in h and OA . Further studies are needed to compare this with other treatments and to examine longterm effects 34 hypertensive patients were assigned at r and om either to six weeks ' treatment by yoga relaxation methods with bio-feedback or to placebo therapy ( general relaxation ) . Both groups showed a reduction in blood-pressure ( from 168/100 to 141/84 mm . Hg in the treated group and from 169/101 to 160/96 mm Hg in the control group ) . The difference was highly significant . The control group was then trained in yoga relaxation , and their blood-pressure fell to that of the other group ( now used as controls ) BACKGROUND More than 30 percent of patients with epilepsy have inadequate control of seizures with drug therapy , but why this happens and whether it can be predicted are unknown . We studied the response to antiepileptic drugs in patients with newly diagnosed epilepsy to identify factors associated with subsequent poor control of seizures . METHODS We prospect ively studied 525 patients ( age , 9 to 93 years ) who were given a diagnosis , treated , and followed up at a single center between 1984 and 1997 . Epilepsy was classified as idiopathic ( with a presumed genetic basis ) , symptomatic ( result ing from a structural abnormality ) , or cryptogenic ( result ing from an unknown underlying cause ) . Patients were considered to be seizure-free if they had not had any seizures for at least one year . RESULTS Among the 525 patients , 333 ( 63 percent ) remained seizure-free during antiepileptic-drug treatment or after treatment was stopped . The prevalence of persistent seizures was higher in patients with symptomatic or cryptogenic epilepsy than in those with idiopathic epilepsy ( 40 percent vs. 26 percent , P=0.004 ) and in patients who had had more than 20 seizures before starting treatment than in those who had had fewer ( 51 percent vs. 29 percent , P<0.001 ) . The seizure-free rate was similar in patients who were treated with a single established drug ( 67 percent ) and patients who were treated with a single new drug ( 69 percent ) . Among 470 previously untreated patients , 222 ( 47 percent ) became seizure-free during treatment with their first antiepileptic drug and 67 ( 14 percent ) became seizure-free during treatment with a second or third drug . In 12 patients ( 3 percent ) epilepsy was controlled by treatment with two drugs . Among patients who had no response to the first drug , the percentage who subsequently became seizure-free was smaller ( 11 percent ) when treatment failure was due to lack of efficacy than when it was due to intolerable side effects ( 
    Output:
    
The yoga group showed significant improvement in their quality of life according to the Satisfaction With Life Scale ( SWLS ) ( P < 0.05 ) , while the ACT group had significant improvement in the World Health Organization Quality of Life-BREF ( WHOQOL-BREF ) scale ( P < 0.01).Overall , we assessed the quality of evidence as low ; no reliable conclusions can be drawn at present regarding the efficacy of yoga as a treatment for epilepsy .
Results of the overall efficacy analysis show that yoga treatment was better when compared with no intervention or interventions other than yoga ( postural exercises mimicking yoga ) .
There was no difference between yoga and Acceptance and Commitment Therapy .
Physician blinding would normally be taken to be the person delivering the intervention , whereas we think the ' physician ' would in fact be the outcome assessor ( who could be blinded ) , so that would be a reduction in detection bias rather than performance bias .