The Effect of Laughter Yoga on the Psychological Resilience and Sleep Quality of Nurses During the Pandemic: A Randomized Controlled Trial.

Background: During the COVID-19 pandemic, nurses frequently experienced psychological health problems such as anxiety, depression, insomnia, and stress. These problems have reduced the psychological health of nurses. Primary Objective: This study aims to reveal the effect of laughter yoga on the psychological resilience and sleep quality of nurses during the COVID-19 pandemic. Design: This randomized controlled trial study was carried out using an experimental research design with pre- and post-tests, including a control group. Setting: This study was conducted on nurses working in a hospital in Erzurum, located in the northeastern part of Turkey. Participants: The study involved 90 nurses, including 46 in the experimental group and 44 in the control group, between October and December 2021. Intervention: As an intervention, laughter yoga sessions were held online on Zoom for nurses in the experimental group. The experimental group was divided into three groups of 17, 17, and 16 individuals. Eight sessions of laughter yoga (two days a week for four weeks) were offered to nurses in the experimental group. Primary Outcome Measures: The Introductory Question Form, Connor-Davidson Resilience Scale, and Pittsburgh Sleep Quality Index were used for data collection. Results: Laughter yoga significantly improved the resilience levels and sleep quality of the experimental group (P < .05). Conclusion: Laughter yoga can be used to improve the resilience and sleep quality of nurses.

Satisfaction with Online Versus In-Person Yoga During COVID-19.

Introduction: During COVID-19 restrictions, yoga classes transitioned to online delivery. This report compares the perceived benefits and barriers to online and in-person yoga and determine the preferred format. A secondary aim was to compare how well each format was perceived to produce common benefits of yoga practice. Materials and Methods: A cross-sectional online survey of Australian participants. Results: In-person yoga scored highest for providing mental health/mood benefits, physical satisfaction, and feeling energized. Online yoga scored highest for convenience, mental health/mood benefits, and affordability (initial N = 156; follow-up N = 55). Conclusion: Online yoga was acceptable and perceived to provide improved mental health and mood.

Effect of Teleyoga Before COVID-19 and During Pandemic: A Narrative Review.

BACKGROUND: Yoga plays a beneficial adjunctive role in various disorders due to its physiological and psychological benefits. COVID-19 pandemic led to a paradigm shift in delivery of health interventions from on-site to online/ tele-intervention mode. Focus shifted to tele-yoga as a reasonable and feasible alternative to in-person yoga. Studies have evaluated its effect among patients suffering from various disorders, their care givers, healthcare workers, and the general public. We have assessed the effect of tele- Yoga, including its appropriateness, acceptability, and benefits, via this narrative review. METHODS: We searched PubMed data base using predefined keywords. Inclusion criteria included controlled trials and Randomized Controlled Trials (RCTs) which are completed and published in English language up to February 2022 with tele-yoga/online yoga as part of intervention. Exclusion criteria included articles in other language or articles whose full text is unavailable. RESULTS: After removing duplications and reviewing articles based on title, abstracts, and available full texts, seven studies with 391 participants were included. Majority of the trials took place in United States, with United Kingdom, Canada, and India following closely behind. Yoga can be safely administered via various online /tele interventions in both diseased and healthy individuls. Tele yoga or modules incorporating tele-yoga has been shown to improve symptoms like dyspnea, psychiatric/psychological burden including stress, anxiety and depression levels and may promote positive effects like spirituality. CONCLUSION: Tele-yoga is feasible and beneficial in healthy and diseased individuals. Larger well-designed RCTs comparing in-person yoga with tele-yoga are needed to ascertain their full benefits.

The Effect of Laughter Yoga on the Psychological Resilience and Sleep Quality of Nurses During the Pandemic: A Randomized Controlled Trial.

Background: During the COVID-19 pandemic, nurses frequently experienced psychological health problems such as anxiety, depression, insomnia, and stress. These problems have reduced the psychological health of nurses. Primary Objective: This study aims to reveal the effect of laughter yoga on the psychological resilience and sleep quality of nurses during the COVID-19 pandemic. Design: This randomized controlled trial study was carried out using an experimental research design with pre- and post-tests, including a control group. Setting: This study was conducted on nurses working in a hospital in Erzurum, located in the northeastern part of Turkey. Participants: The study involved 90 nurses, including 46 in the experimental group and 44 in the control group, between October and December 2021. Intervention: As an intervention, laughter yoga sessions were held online on Zoom for nurses in the experimental group. The experimental group was divided into three groups of 17, 17, and 16 individuals. Eight sessions of laughter yoga (two days a week for four weeks) were offered to nurses in the experimental group. Primary Outcome Measures: The Introductory Question Form, Connor-Davidson Resilience Scale, and Pittsburgh Sleep Quality Index were used for data collection. Results: Laughter yoga significantly improved the resilience levels and sleep quality of the experimental group (P < .05). Conclusion: Laughter yoga can be used to improve the resilience and sleep quality of nurses.

Clinician Perceptions of Incorporating Yoga into Therapeutic Practice.

Despite increased interest in mindfulness practices such as yoga as an adjunct for depression, anxiety, and other chronic health concerns, little research exists on the potential benefits of yoga in therapeutic settings. As a complementary therapy, yoga provides a value-added benefit to traditional clinical practices for (1) clinicians as a form of self-care in treating compassion fatigue caused by, for example, fallout from the COVID-19 pandemic, and (2) the patients they serve. The primary goal of the present study was to understand clinician perspectives of yoga as an intervention in the therapeutic setting for clinicians and clients. We conducted a qualitative study and surveyed therapists from a yoga teacher training program designed specifically for clinical therapists. Eight therapists completed a qualitative questionnaire designed to understand the effects of yoga on clinicians and patients in the therapeutic setting. Although the effects of COVID-19 had not been anticipated, survey results corroborate high rates of compassion fatigue for therapists and a decline in mental health for patients throughout the study. Yoga, specifically body awareness and breathwork, however, provided a baseline for navigating mental health for both patients and therapists amid the pandemic. Additionally, body awareness and breathwork were found to help therapists avoid burnout and compassion fatigue and facilitate a more positive therapy experience for patients and therapists. Yoga has the potential to be a positive adjunct in therapeutic settings and would benefit from further research into various applications.

Efficacy of Integrated Tele-Yoga Intervention on Physiological and Psychological Variables in Asymptomatic COVID-19 Positive Patients: A Confirmatory Randomized Control Trial.

BACKGROUND: A study was conducted on asymptomatic COVID-19 positive patients admitted in a COVID-19 hospital in Indore, India, during first wave of the pandemic. The objective of the study was to assess the efficacy of an integrated tele-yoga intervention as an adjunct to conventional management on physiological, psychological, and mindfulness variables. METHODS: In a confirmatory randomized control trial, 60 asymptomatic COVID-19 patients in hospital confinement were randomly allocated to experimental and control groups (n = 30). The tele-yoga intervention included breathing exercise, pranayama, and meditation delivered over 30 min for 7 days to the experimental group while the control group continued treatment as usual. Assessment of physiological variables and psychological variables was carried out before intervention and on day 7 immediately after intervention. Data were analyzed using SPSS (v.16.0). RESULTS: Mann-Whitney U test shows that there was a statistically significant difference between groups regarding all variables (p < 0.001). The physiological and psychological variables which included Oxygen saturation (2.07%), Heart rate (8.21%), Respiratory rate (10.04%), Systolic blood pressure (6.14%), Diastolic blood pressure (8.38%), Visual Analog Scale for stress (62.78%), COVID-19 Peritraumatic Distress Index (68.44%), and State Mindful Attention Awareness Scale (72.72%) showed significant changes in the experimental group compared to control group. CONCLUSION: The results of this study suggest that integrated tele-yoga might have therapeutic benefits in improving physiological, psychological, and mindfulness variables in asymptomatic COVID-19 patients.

Yoga Therapy in Cancer Care via Telehealth During the COVID-19 Pandemic.

BACKGROUND: Yoga is an evidence-based mind-body practice known to improve physical and mental health in cancer patients. We report on the processes and patient-reported outcomes of one-on-one yoga therapy (YT) consultations delivered via telehealth. METHODS: For patients completing a YT consultation between March 2020 and October 2021, we examined demographics, reasons for referral, and self-reported symptom burden before and after one YT session using the Edmonton Symptom Assessment Scale (ESAS). Changes in ESAS symptom and subscale scores [physical distress (PHS), psychological distress (PSS), and global distress (GDS)] were evaluated by Wilcoxon signed-rank test. Descriptive statistics summarized the data. RESULTS: Ninety-seven initial YT consults were completed, with data evaluated for 95 patient encounters. The majority were women (83.2%) and white (75.8%), The mean age for females was 54.0 and for males was 53.4; the most common diagnosis was breast cancer (48%), 32.6% had metastatic disease, and nearly half (48.4%) were employed full-time. Mental health (43.0%) was the most common reason for referral, followed by fatigue (13.2%) and sleep disturbances (11.7%). The highest symptoms at baseline were sleep disturbance (4.3), followed by anxiety (3.7) and fatigue (3.5). YT lead to clinically and statistically significant reductions in PHS (mean change = -3.1, P < .001) and GDS (mean change = -5.1, P < .001) and significant reductions in PSS (mean change = -1.6, P < .001). Examination of specific symptom scores revealed clinically and statistically significant reductions in anxiety (mean change score -1.34, P < .001) and fatigue (mean change score -1.22, P < .001). Exploratory analyses of patients scoring ≥1 for specific symptoms pre-YT revealed clinically and statistically significant improvements in almost all symptoms and those scoring ≥4 pre-YT. CONCLUSIONS: As part of an integrative oncology outpatient consultation service, a single YT intervention delivered via telehealth contributed to a significant improvement in global, physical, and psychosocial distress. Additional research is warranted to explore the long-term sustainability of the improvement in symptoms.

Yoga for COVID-19: An ancient practice for a new condition - A literature review.

A substantial proportion of people with acute COVID-19 develop post-COVID-19 condition (previously known as long-COVID) characterized by symptoms that persist for months after the initial infection, including neuropsychological sequelae. Post-COVID-19 condition frequency varies greatly according to different studies, with values ranging from 4 to 80% of the COVID-19 patients. Yoga is a psycho-somatic approach that increases physical, mental, emotional and spiritual strength, and connection. Yoga practice enhances innate immunity and mental health, so it can be used as complementary therapy in the COVID-19 treatment, namely the post-COVID-19 condition. In this article, we conducted a literature review on yoga and COVID-19, finding that an intervention comprising asana, pranayama, and meditation may be a strategy of choice for these patients' recovery. However, further studies are needed to show its effectiveness in this, still unknown, context.

Perceived usefulness of yoga to maintain well-being and in relation to COVID-19 cases among Hungarian yoga practitioners.

BACKGROUND: The present COVID-19 epidemic has had a considerable impact on the mental health of individuals worldwide. Research projects suggests potential benefits of yoga practice for prevention, or as medical supplementation in relation to the present pandemic. This study investigated the association between yoga and health status, and how the frequency of yoga practice affected the mental well-being (MWB) of the respondents. METHODS: Hungarian yoga practitioners (N.=379) aged 20 to 75 years (93.4% female) were asked about their personal health, perceived usefulness of yoga practice for COVID-19 cases and their MWB. Data were collected between April 17 and May 17, 2021. The measurement tool used was an online questionnaire including sociodemographic data, characteristics of yoga practice, COVID-19 and health related questions, and WHO Well-being Index (WBI-5). Associations were examined through ANOVA and χ2 tests. RESULTS: There was a significant difference among the yoga practice groups by weekly frequency (once a week, 2-3 times a week, 4-5 times a week, daily) on the total mean score of well-being (WBI-5), F (3, 373) =12.97, P<0.001, ηp2=0.094. The daily practice of yoga showed the highest MWB. CONCLUSIONS: According to our findings, it can be stated that regular yoga practice is associated with higher level of MWB which can be successful in dealing with COVID-19 issues such as stress and depression.

Effect of Yoga and Mindfulness Intervention on Symptoms of Anxiety and Depression in Young Adolescents Attending Middle School: A Pragmatic Community-Based Cluster Randomized Controlled Trial in a Racially Diverse Urban Setting.

Mental health conditions in childhood and adolescence are increasing in the U.S. population and require early intervention, as highlighted by a recent Surgeon General's Advisory on Protecting Youth Mental Health. These health issues, which have been exacerbated by the COVID-19 pandemic, impair functioning, and may lead to longer term reductions in quality of life. Young adolescents are likely to experience stressors including academic pressure, feelings of loneliness and isolation, and excessive exposure to social media, all of which have been made worse by the pandemic and associated disruptions. Universal preventive programs at school serve as an important strategy for equipping youth with coping skills to address current and future social and emotional challenges. Yoga and mindfulness programs have emerged as a promising preventive approach for schools and have proven feasible and acceptable. The current study evaluated a universal, school-based mindfulness and yoga program among youth aged 11-14 in a racially diverse, urban setting in the United States. Outcomes of interest included symptoms of anxiety and depression. Anxiety and depression symptoms decreased in the intervention group, although these differences were not statistically significant. In the control group, anxiety symptoms decreased but depression symptoms increased. The resulting time effect indicated a significant decrease in anxiety symptoms, while the time by group effect revealed a strong trend in depression symptoms. Future research should investigate the utility of yoga and mindfulness interventions for early adolescents in a larger population, and the differences in intervention effect among subgroups, with attention to longer term outcomes.

Perceived Stress, Resilience, and Wellbeing in Seasoned Isha Yoga Practitioners Compared to Matched Controls During the COVID-19 Pandemic.

Background: Yoga practices, including breathing, meditation, and posture protocols (asanas), have been shown to facilitate physical and mental wellbeing. Methods: Seasoned yoga practitioners were recruited from the Isha Foundation. Recruitment of the comparison group was achieved using snowball sampling and were not yoga practitioners. Participants in the non-yoga group were randomized to a 3-min Isha practice or a comparator group asked to perform 15-min of daily reading. Participants completed a series of web-based surveys (REDCap) at baseline, 6, and 12 weeks. These surveys include validated scales and objective questions on COVID-19 infection and medical history. The validated questionnaires assess for: perceived stress (PSS), mood states [anxiety and depression (PHQ-4), joy (DPES-Joy subscale)], mindfulness attention and awareness (MAAS), resilience (BRS), mental wellbeing (WEMWBS) and recovery from traumatic event (PTGI). Weekly activity diaries were employed as a tool for collecting compliance information from study participants. Perceived stress scale scores were identified as primary outcome for this study. Findings: The median Perceived Stress Scale (PSS) score for the yoga practitioners compared to the active and placebo comparators was significantly lower at all time-points: baseline: 11 [IQR 7-15] vs. 16 [IQR 12-21] in both the active and placebo comparators (p < 0.0001); 6 weeks: 9 [IQR 6-13] vs. 12 [IQR 8-17] in the active comparator and 14 [IQR 9-18] in the placebo comparator (p < 0.0001); and 12 weeks: 9 [IQR 5-13] vs. 11.5 [IQR 8-16] in the active comparators and 13 [IQR 8-17] in the placebo comparator (p < 0.0001). Among the randomized participants that were compliant for the full 12 weeks, the active comparators had significantly lower median PSS scores than the placebo comparators 12 weeks [10 (IQR 5-14) vs. 13 (IQR 8-17), p = 0.017]. Further, yoga practitioners had significantly lower anxiety at all three-time points (p < 0.0001), lower depression at baseline and 6 weeks (p < 0.0003), and significantly higher wellbeing (p < 0.0001) and joy (p < 0.0001) at all three-time points, compared to the active and placebo comparator groups. Interpretation: The lower levels of stress, anxiety, depression, and higher level of wellbeing and joy seen in the yoga practitioners compared to the active and placebo comparators illustrate the impact of regular yoga practices on mental health even during the pandemic. Trial Registration: ClinicalTrials.gov, identifier: NCT04498442.

Effect of Yoga on the Stress, Anxiety, and Depression of COVID-19-Positive Patients: A Quasi-Randomized Controlled Study.

The spread of COVID-19 has resulted in reports of increase in stress, anxiety, and depression across society, especially in people who have tested positive for COVID-19, which affects their mental health and well-being. This article reports a quasi-randomized controlled study conducted in the COVID wards of a hospital to examine the efficacy of add-on yoga intervention in reducing stress, anxiety, and depression in COVID-affected patients under quarantine. The peripheral capillary oxygen saturation level and heart rate of the COVID-19-affected patients were also measured. A total of 62 COVID-19-positive patients participated in the study. The participants were randomized into a control group (n = 31), which received conventional medical treatment alone, and a yoga intervention group (n = 31), which received 50 minutes of yoga intervention along with the conventional medical treatment. Standardized Hospital Anxiety and Depression Scale, Generalized Anxiety Disorder-7 Item, Patient Health Questionnaire-9, and Perceived Stress Scale were administered at the beginning and end of the quarantine period. A significant decrease in stress, anxiety, and depression was observed in the patients who undertook the add-on yoga intervention. There was also a significant decrease in anxiety in the control group, but the intervention group had a larger decrease compared to the control group. Further significant improvements in oxygen saturation and heart rate levels were observed in the group of patients who were practicing yoga, but no significant improvement was observed in the control group. Findings of this study suggest that yoga intervention can be an effective add-on practice in reducing stress, anxiety, and depression levels of COVID-19 patients.

How junior doctors perceive personalised yoga and group exercise in the management of occupational and traumatic stressors.

OBJECTIVES: Junior doctors are exposed to occupational and traumatic stressors, some of which are inherent to medicine. This can result in burnout, mental ill-health and suicide. Within a crossover pilot study comparing personalised, trauma-informed yoga to group-format exercise, qualitative interviews were conducted to understand the experience of junior doctors and whether such interventions were perceived to help manage these stressors. METHODS: Twenty-one doctors, 76% female, were order-randomised to consecutive 8-week yoga and exercise programmes. Fifty-two interviews were recorded before and after each programme. RESULTS: Many participants reported being time poor, sleep-affected, frequently stressed and occasionally in physical pain/distress. Major stressor themes were workplace incivility, death/human suffering and shift work with minimal support. Both interventions were acceptable for different reasons. Personalised yoga offered a therapeutic alliance, time to check-in and reduced anxiety/rumination. Group exercise provided energy and social connection. One participant found yoga beneficial following an acute workplace trauma: 'It was really eye opening how much I felt my body just needed to detox … I wouldn't have gone to a group fitness the next day … I just wanted to relax and breathe …We still had a big debrief which was great … (but) I almost felt like … I dealt with it physically and emotionally before going into it (P20).' CONCLUSION: Junior doctors found both interventions useful for stress management adjunctive to other organisational programmes though for different and complementary reasons, possibly related to delivery mode. Personalised, trauma-informed yoga provided a confidential therapeutic alliance whereas group exercise offered social connection.

Potential benefits of Yoga in pregnancy-related complications during the COVID-19 pandemic and implications for working women.

BACKGROUND: Pregnancy is a vulnerable period of growth and enrichment along with many physiological and psychological challenges. These changes can lead to complications if compounded by external stress and anxiety. COVID-19 has emerged as a chief stressor among the general population and is a serious threat among vulnerable populations. Therefore, there is a need for stress management tools, such as Yoga and physical exercises, both at home and at work. These can be adopted during the pandemic with proper maintenance of social distancing. OBJECTIVE: To evaluate and compile literature that has reported the health outcomes of Yoga intervention on pregnancy at the workplace and analyzes both the restrictions as well as advantages of its beneficial effects in comparison to physical exercises. METHODOLOGY: A comprehensive literature review was conducted utilizing PubMed and Google Scholar. The keywords used for the search include "Yoga", "work", "complications", "physical exercise", "drugs" and "COVID" indifferent permutations and combinations with "pregnancy". We compiled the literature with respect to pregnancy complications and the effects of drugs, physical activity and Yoga for preventing these complications. RESULTS: We noted that pregnancy-related complications are becoming more prevalent because of a sedentary lifestyle, restricted physical activity and growing stress. In such situations, a home or workplace Yoga protocol can combine both exercise and mindfulness-based alleviation of anxiety for both working and non-working women. CONCLUSION: Yoga can be effective for combating stress and anxiety besides boosting immunity in pregnant working women confronted with the COVID-19 pandemic.

The role of trataka in ameliorating visual strain and promoting psychological well-being during prolonged use of digital displays: A randomized controlled trial.

BACKGROUND: The prolonged usage of digital displays leads to visual strain and, in turn, impairs psychological well-being. The practice of Yoga is said to enhance psychological functions and reduce visual strain. OBJECTIVE: The present study assessed the effect of the trataka (Yogic visual concentration) practice on the visual strain, mind-wandering, and mindfulness. METHODS: One hundred six volunteers equally distributed in the experimental and control groups completed the study. Visual Fatigue Scale (VFS), visual symptoms checklist (VSC), mind-wandering questionnaire (MWQ), and State Mindfulness Attention Awareness Scale (SMAAS) were administered at baseline and at the end of two weeks. RESULTS: All variables were similar at the baseline in both groups, and significant differences were noted at the end of two weeks between both groups. There was a significant reduction in VFS and VSC scores, MWQ, along with an increase in SMAAS scores in the experimental group. Although there were significant changes in VFS, MWQ, and SMAAS in the control group, the magnitude of change was minimal. CONCLUSIONS: The practice of trataka was found to reduce the visual strain, mind wandering while improving the state mindfulness. The practice can be implemented to mitigate visual strain and associated psychological implications due to prolonged exposure to digital displays, which has increased during the COVID-19 pandemic.

Online Isha Upa Yoga for student mental health and well-being during COVID-19: A randomized control trial.

College students experienced increased stress and anxiety during the COVID-19 pandemic. This study evaluated the effect of brief online Isha Upa Yoga modules on undergraduates' mental health and well-being. Randomized control trial (RCT) with waitlist control crossover (N = 679). The intervention group was instructed to learn and practice the modules daily for 12 weeks. At the end of the 4-week RCT, the control group was instructed to learn and practice the modules for the remaining 8 weeks. Primary outcomes included stress and well-being. Secondary outcomes included anxiety, depression, resilience, positive affect and negative affect. Linear mixed-effects models were used for analyses. Isha Upa Yoga significantly reduced stress (Group [intervention, control] × Time [baseline, Week 4] interaction, p = .009, d = .27) and increased well-being (Group × Time interaction p = .002, d = .32). By the study's end, the intervention and control groups experienced significant improvements in well-being (p < .001, p < .001), stress (p < .001, p < .001), anxiety (p < .001, p < .001), depression (p < .001, p = .004), positive affect (p = .04, p < .001), and negative affect (p < .001, p < .001). Online Isha Upa Yoga shows promise for mitigating the pandemic's negative impact on undergraduates' mental health and improving their well-being.

Feasibility and Effectiveness of the Web-Based WeActive and WeMindful Interventions on Physical Activity and Psychological Well-Being.

This study is aimed at examining the feasibility and effectiveness of aerobic and resistance training (WeActive) and mindful exercise (WeMindful) interventions in improving physical activity (PA), psychological well-being (PWB), and subjective vitality among college students. Participants in this study were 77 college students who were randomly assigned to either the WeActive group (n = 43) or the WeMindful group (n = 28). The WeActive group attended two 30-minute aerobic and resistance training sessions per week, and the WeMindful group attended two 30-minute yoga and mindful exercise sessions per week for eight weeks. All participants completed the International Physical Activity Questionnaire, the World Health Organization-Five Well-Being Index, and the Subjective Vitality Scale before and after the intervention, as well as the Assessing Feasibility and Acceptability Questionnaire at the end of the intervention. The primary study outcome measures were PA, PWB, and subjective vitality. A repeated-measures ANCOVA indicated a significant main effect of time for total PA (F = 7.89, p = 0.006, η 2 = 0.049), vigorous PA (F = 5.36, p = 0.024, η 2 = 0.022), and walking (F = 7.34, p = 0.009, η 2 = 0.042) in both intervention groups. There was a significant interaction effect of time and group for PWB (F = 11.26, p = 0.001, η 2 = 0.022), where the WeActive group experienced a decrease in PWB scores while participants in the WeMindful group experienced an increase in PWB scores over time. There was a main effect of group for subjective vitality (F = 8.91, p = 0.007, η 2 = 0.088), indicating that the WeMindful group experienced a greater increase in subjective vitality than the WeActive group. Further, the participants in both groups indicated that the synchronized and asynchronized Zoom-based WeActive and WeMindful interventions were acceptable, appropriate, and feasible for participants. This study demonstrated that mindful exercise is effective in increasing PA, PWB, and subjective vitality while aerobic and resistance training may only be effective in increasing PA.

Physical relaxation for occupational stress in healthcare workers: A systematic review and network meta-analysis of randomized controlled trials.

OBJECTIVES: Work related stress is a major occupational health problem that is associated with adverse effects on physical and mental health. Healthcare workers are particularly vulnerable in the era of COVID-19. Physical methods of stress relief such as yoga and massage therapy may reduce occupational stress. The objective of this systematic review and network meta-analysis is to determine the effects of yoga, massage therapy, progressive muscle relaxation, and stretching on alleviating stress and improving physical and mental health in healthcare workers. METHODS: Databases were searched for randomized controlled trials on the use of physical relaxation methods for occupational stress in healthcare workers with any duration of follow-up. Meta-analysis was performed for standard mean differences in stress measures from baseline between subjects undergoing relaxation vs non-intervention controls. Network meta-analysis was conducted to determine the best relaxation method. RESULTS: Fifteen trials representing 688 healthcare workers were identified. Random-effects meta-analysis shows that physical relaxation methods overall reduced measures of occupational stress at the longest duration of follow-up vs baseline compared to non-intervention controls (SMD -0.53; 95% CI [-0.74 to -0.33]; p < .00001). On network meta-analysis, only yoga alone (SMD -0.71; 95% CI [-1.01 to -0.41]) and massage therapy alone (SMD -0.43; 95% CI [-0.72 to -0.14]) were more effective than control, with yoga identified as the best method (p-score = .89). CONCLUSION: Physical relaxation may help reduce occupational stress in healthcare workers. Yoga is particularly effective and offers the convenience of online delivery. Employers should consider implementing these methods into workplace wellness programs.

Videoconferenced Yoga Interventions for Cancer Patients and their Caregivers during the COVID-19 Pandemic: A Report from a Clinician's Perspective.

BACKGROUND: The acceptability of videoconferencing delivery of yoga interventions in the advanced cancer setting is relatively unexplored. The current report summarizes the challenges and solutions of the transition from an in-person (ie, face-to-face) to a videoconference intervention delivery approach in response to the Coronavirus Disease pandemic. METHOD: Participants included patient-family caregiver dyads who were enrolled in ongoing yoga trials and 2 certified yoga therapists who delivered the yoga sessions. We summarized their experiences using recordings of the yoga sessions and interventionists' progress notes. RESULTS: Out of 7 dyads participating in the parent trial, 1 declined the videoconferenced sessions. Participants were between the ages of 55 and 76 and mostly non-Hispanic White (83%). Patients were mainly male (83%), all had stage III or IV cancer and were undergoing radiotherapy. Caregivers were all female. Despite challenges in the areas of technology, location, and setting, instruction and personal connection, the overall acceptability was high among patients, caregivers, and instructors. Through this transition process, solutions to these challenges were found, which are described here. CONCLUSION: Although in-person interventions are favored by both the study participants and the interventionists, videoconference sessions were deemed acceptable. All participants had the benefit of a previous in-person experience, which was helpful and perhaps necessary for older and advanced cancer patients requiring practice modifications. In a remote setting, the assistance of caregivers seems particularly beneficial to ensure practice safety. CLINICALTRIALS.GOV: NCT03948100; NCT02481349.

Yoga and music intervention to reduce depression, anxiety, and stress during COVID-19 outbreak on healthcare workers.

AIM: To investigate impact of Yoga and Music Intervention on anxiety, stress, and depression levels of health care workers during the COVID-19 outbreak. METHODS: This study was conducted to assess psychological responses of 240 healthcare workers during COVID-19 outbreak. We used Yoga and Music Intervention in normal and abnormal subjects based on Depression Anxiety and Stress Scale-42 (DASS-42). RESULTS: Of all 209 participants, 105 (50.23%) had symptoms of depression (35.88%), anxiety (40.19), and stress (34.92%) alone or in combination. The data suggest that there is significant improvement in test scores after intervention. Majority of persons with abnormal score exhibited improved DASS-42 score on combined interventions of Yoga and music compared to control group. Even subjects without abnormalities on DASS-42 score also showed improved DASS-42 scores in intervention (n = 52) group compared to nonintervention (n = 52) group. CONCLUSIONS: Our findings highlighted the significance of easily available, simple, inexpensive, safe nonpharmacological interventions like Yoga and Music therapy to overcome stress, anxiety, and depression in present times.