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Phytotherapy in the German Medical AWMF S3 Guidelines - a Systematic OverviewIn Deutschland werden an die interdisziplinär, evidenz- und konsensbasiert erstellten S3-Leitlinien der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) höchste wissenschaftliche Ansprüche gestellt; sie prägen die Gestaltung der Patientenversorgung. Phytotherapeutika haben in der medizinischen Versorgung im deutschsprachigen Raum eine große Tradition. Zunehmend existiert Evidenz für ihre Wirksamkeit bei verschiedenen Erkrankungen. Die vorliegende Übersichtsarbeit untersucht, in welchem Ausmaß pflanzliche Arzneimittel in den aktuellen S3-Leitlinien Berücksichtigung finden. Mittels Überprüfung aller verfügbaren S3-Leitlinien der AWMF wurden die Empfehlungen/Statements zu phytotherapeutischen Therapieoptionen von 2 unabhängigen Experten identifiziert und in 3 Kategorien eingeteilt: positive, negative und offene. Darüber hinaus wurden Ausführungen zu Nebenwirkungen und Interaktionen recherchiert. In 40 (31,3%) der 128 Leitlinien wird Phytotherapie benannt. In 55 Leitlinien (42,9%), in denen grundsätzlich phytotherapeutische Therapieoptionen bestehen, werden pflanzlichen Arzneimittel nicht berücksichtigt. Von insgesamt 204 Empfehlungen zu Phytotherapeutika fallen 139 (68,1%) negativ aus oder bleiben ergebnisoffen. Phytotherapie wird in 27 Leitlinien (67,5%) im jeweiligen Kapitel zu komplementären und alternativen Verfahren und/oder unter Sonstiges eingeordnet, in 7 Leitlinien (17,5%) steht sie am Ende der Empfehlungen zur medikamentösen Therapie, in 8 Leitlinien (20%) zwischen den Empfehlungen zu konventionellen Verfahren. Hinweise zu Neben- und Wechselwirkungen finden sich zu 70 der 204 Empfehlungen (34,3%). Weit weniger als die Hälfte der verfügbaren AWMF-S3-Leitlinien beinhalten eine Recherche zu Phytotherapeutika, nur in 17 S3-Leitlinien finden sich aktuell positive Empfehlungen. Eine systematische Aufarbeitung der vorhandenen Evidenz ist notwendig, um die adäquate Berücksichtigung der Phytotherapie in den medizinischen Leitlinien zu gewährleisten.

Korrespondenz zu 10.1111/apt.14433

Background: Many cancer patients suffer from symptoms of anxiety, depression, and fatigue. Supportive treatments are increasingly used to alleviate distress in cancer. In this study, the effects of yoga on these symptoms are examined. Methods: We performed a randomized controlled study on cancer patients with mixed diagnoses comparing yoga therapy with a waiting list control group. We measured anxiety symptoms with the General Anxiety Disorder (GAD-7) scale, depressive symptoms with the Patient Health Questionnaire-2 (PHQ-2), and fatigue with the European Organisation for Research and Treatment of Cancer Fatigue scale (EORTC QLQ-FA13). Yoga therapy was carried out in weekly sessions of 60 min each for 8 weeks. The program provided restrained body and breathing exercises as well as meditation. The control group did not receive any yoga therapy while on the waiting list. Results: A total of 70 subjects participated in the study. Anxiety was significantly reduced by the yoga therapy in the intervention group compared to the control group (p = 0.005). However, yoga therapy did not show any significant effects on depression (p = 0.21) and fatigue (p = 0.11) compared to the control group. Conclusion: Yoga therapy may be used to alleviate anxiety symptoms in cancer patients and should be the subject of further research.

© 2019 the Author(s). Published by Wolters Kluwer Health, Inc. Background:Migraine and tension-type headache often occur comorbid with temporomandibular disorder; occlusal splint therapy is the most common treatment for temporomandibular disorder. The aim of this study was to assess the effects of occlusal splint therapy on headache symptoms in patients with migraine and/or tension-type headache comorbid with temporomandibular disorder.Methods:Sixty adult patients with migraine and/or tension-type headache and comorbid temporomandibular disorder were randomly assigned to individualized occlusal splint therapy applied during day- and nighttime plus usual care (n=30) or usual care alone (n=30). Primary outcome was the change in current pain intensity on a 100mm visual analogue scale from week 1 to week 12. Secondary outcomes included changes in headache days and headache hours assessed by headache diaries over a 2-week period, health-related quality of life (SF-36), and adverse events from week 1 to week 12 and (in the occlusal splint plus usual care group only) to week 24.Results:No group differences in changes in pain intensity from week 1 to week 12 were found. The number needed to treat was 3.8. Physical quality of life reduced stronger in the usual care group than in the occlusal splint plus usual care group. In the occlusal splint plus usual care group, headache intensity significantly decreased and physical quality of life significantly increased from week 1 to week 12 and to week 24 (all P

BACKGROUND: Mind-body medical interventions are commonly used to cope with depression and yoga is one of the most commonly used mind-body interventions. The aim of this review was to systematically assess and meta-analyze the effectiveness of yoga for depression. METHODS: Medline/PubMed, Scopus, the Cochrane Library, PsycINFO, and IndMED were searched through January 2013. Randomized controlled trials (RCTs) of yoga for patients with depressive disorders and individuals with elevated levels of depression were included. Main outcomes were severity of depression and remission rates, secondary outcomes were anxiety, quality of life, and safety. RESULTS: Twelve RCTs with 619 participants were included. Three RCTs had low risk of bias. Regarding severity of depression, there was moderate evidence for short-term effects of yoga compared to usual care (standardized mean difference (SMD) = -0.69; 95% confidence interval (CI) -0.99, -0.39; P Language: en

Objectives: The assessment of clinically meaningful differences in patients' self-reported outcomes has become increasingly important when interpreting the results of clinical studies. Although these assessments have become quite common there are hardly any data for nonspecific neck pain, especially in the context of complementary and alternative medicine. The aim of this analysis is the determination of minimal clinically important differences (MCID) and substantial clinical benefits (SCB) in patients with chronic nonspecific neck pain after cupping treatment. Methods: The data set comprised a total of 200 patients with chronic nonspecific neck pain participating in clinical trials on cupping therapy. The MCID and SCB for pain intensity (VAS), neck disability index (NDI) and the subscale bodily pain (SF-36-BP) as well as physical component summary (SF-36-PCS) of the SF-36 were determined using receiver operating characteristic (ROC) curve analysis with an adapted assessment of change in health status (SF-36), i.e. a 5-point Likert scale ranging from "much better" to "much worse", as anchor. MCID derived from the ROC was the score to distinguish "somewhat better" from "about the same", and the SCB was the score to distinguish "much better" from "somewhat better". Results: The calculated MCIDs were: -8. mm (-21%) for VAS, -3 points (-10.2%) for NDI, +10 points (+20.5%) for SF-36-BP and +2.6 points (+7.7%) for SF-36-PCS. The SCBs were: -26.5. mm (-66.8%) for VAS, -8.4 points (-29%) for NDI, +15.5 points (+43.1%) for SF-36-BP and +5.1 points (+12.9%) for SF-36-PCS. Accuracy of the estimations was good for MCID in general and for SCB regarding VAS and NDI. Conclusions: The results support the assumption that patients' perceptions of treatment benefits measured by VAS in these trials might be comparable to others in conventional therapies. For NDI and SF-36-PCS the estimated differences were smaller than in previous reports indicating that context factors such as patient characteristics and specific treatment conditions might play an important role. Further studies on MCIDS and SCBs for chronic nonspecific neck pain seem warranted. © 2013 Elsevier Ltd.

The aim of this systematic review and meta-analysis was to investigate the effectiveness of exercise for colorectal cancer patients. PubMed/Medline, Scopus and the Cochrane Library were searched through December 2012 without language restrictions. Randomised controlled trials (RCTs) comparing exercise interventions to control conditions were analysed when they assessed health-related quality of life, fatigue, physical fitness, survival and/or tumour-associated biomarkers in colorectal cancer patients. Risk of bias was assessed using the risk of bias tool recommended by the Cochrane Back Review Group. Literature search identified 342 non-duplicate records of which five RCTs with a total of 238 patients were included; three RCTs had low risk of bias. No evidence was found for short-term effects on quality of life [standardised mean difference (SMD) = 0.18; 95% confidence interval (CI) -0.39, 0.76; P = 0.53] or fatigue (SMD = 0.18; 95% CI -0.22, 0.59; P = 0.38). There was strong evidence for short-term improvements of physical fitness after aerobic exercise compared with controls (SMD = 0.59; 95% CI 0.25, 0.93; P < 0.01). One RCT each assessed immune parameters and oxidative DNA damage. No study reported survival rates or safety data. Given this insufficient evidence and the lack of safety data, no recommendation can be made regarding exercise interventions as a routine intervention for colorectal cancer patients.

Introduction: Integrative medicine inpatient treatment can improve health-related quality of life and mental health in chronically ill patients. This study aimed to explore the potential effect of a 14-day integrative inpatient treatment on chronically ill patients' self-management skills and resources; also focusing on gender specific effects. Materials and methods: A longitudinal prospective cohort study without a control group was conducted at the Department for Complementary and Integrative Medicine. The intervention consisted of individualized conventional and complementary medical treatments; the latter including mind/body techniques. The main outcomes were patients' self-management skills and resources according to the FERUS-questionnaire which measures motivation-to-change, coping, self-observation, self-efficacy, self-verbalization, hope and social support. FERUS data were compared before and after 14 days of hospital inpatient treatment, using repeated measurement ANOVA, with time as within-subject and gender as well as the amount of received mind/body interventions as between-subject factors. Results: Data from 73 patients between September and October 2007 (55 female, 51.5. ±. 13.5 years) were available. Statistical analyses showed significant overall increases in patients' self-management skills on the coping, self-observation, self-verbalization and social support FERUS sub-scales (. p

OBJECTIVES: Chronic neck pain is a significant public health problem with only very few evidence-based treatment options. There is growing evidence for the effectiveness of yoga for relieving musculoskeletal disorders. The aim of this study was to evaluate the effect of Iyengar yoga compared with exercise on chronic nonspecific neck pain. METHODS: Patients were randomly assigned to either yoga or exercise. The yoga group attended a 9-week yoga course and the exercise group received a self-care manual on home-based exercises for neck pain relief. The main outcome measure was the present neck pain intensity (100 mm visual analog scale). Secondary outcome measures included functional disability (Neck Disability Index), pain at motion (visual analog scale), health-related quality of life (Short Form-36 questionnaire), cervical range of motion, proprioceptive acuity, and pressure pain threshold. RESULTS: Fifty-one patients (mean age 47.8 y; 82.4% female) were randomized to yoga (n=25) and exercise (n=26) intervention. After the study period, patients in the yoga group reported significantly less neck pain intensity compared with the exercise group [mean difference:-13.9 mm (95% CI,-26.4 to-1.4), P=0.03]. The yoga group reported less disability and better mental quality of life. Range of motion and proprioceptive acuity were improved and the pressure pain threshold was elevated in the yoga group. DISCUSSION: Yoga was more effective in relieving chronic nonspecific neck pain than a home-based exercise program. Yoga reduced neck pain intensity and disability and improved health-related quality of life. Moreover, yoga seems to influence the functional status of neck muscles, as indicated by improvement of physiological measures of neck pain. Copyright © 2012 by Lippincott Williams &Wilkins.

In recent years, evidence has emerged regarding the effectiveness of osteopathic manipulative treatments (OMT). Despite growing evidence in this field, there is need for appropriate research designs that effectively reflect the person-centred system of care promoted in osteopathy and provide data which can inform policy decisions within the healthcare system. The purpose of this systematic review is to identify, appraise and synthesise the evidence from comparative effectiveness and economic evaluation research involving OMT. A database search was conducted using CINAHL, PubMed, PEDro, AMED, SCOPUS and OSTMED.DR, from their inception to May 2015. Two separate searches were undertaken to identify original research articles encompassing the economic evaluation and comparative effectiveness of OMT. Identified comparative effectives studies were evaluated using the Cochrane risk of bias tool and appraised using the Good Reporting of Comparative Effectiveness (GRACE) principles. Identified economic studies were assessed with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. Sixteen studies reporting the findings of comparative effectiveness (n = 9) and economic evaluation (n = 7) research were included. The comparative effectiveness studies reported outcomes for varied health conditions and the majority (n = 6) demonstrated a high risk of bias. The economic evaluations included a range of analyses and considerable differences in the quality of reporting were evident. Despite some positive findings, published comparative effectiveness and health economic studies in OMT are of insufficient quality and quantity to inform policy and practice. High quality, well-designed, research that aligns with international best practice is greatly needed to build a pragmatic evidence base for OMT. Refereed/Peer-reviewed

This study aimed to test the efficacy of cupping therapy to improve symptoms and quality of life in patients diagnosed with the fibromyalgia syndrome. Participants were randomly assigned to cupping therapy, sham or usual care. Cupping was administered five times at twice weekly intervals on the upper and lower back. The primary outcome measure was pain intensity at day 18. Secondary outcomes included functional disability, quality of life, fatigue and sleep quality as well as pressure pain sensitivity, satisfaction and safety at day 18 and 6 months. Altogether 141 patients were included in this study (139 females, 55.8 ± 9.1 years). After 18 days patients reported significant less pain after cupping compared to usual care (difference −12.4; 95% CI: −18.9; −5.9, p

Emerging evidence suggests substantial health benefits from using meditation. While there are some indications that the popularity of meditation is increasing, little is known about the prevalence, patterns, and predictors of meditation use in the general population. In this secondary analysis of data from the 2012 US National Health Interview Survey (NHIS) (n = 34,525), lifetime and 12-month prevalence of meditation use were 5.2% and 4.1%, respectively. Compared to non-users, those who had used meditation in the past 12 months were more likely to be 40–64 years, female, non-Hispanic White, living in the West, at least college-educated, not in a relationship, diagnosed with one or more chronic conditions, smoking, consuming alcohol and physically active. Meditation was mainly used for general wellness (76.2%), improving energy (60.0%), and aiding memory or concentration (50.0%). Anxiety (29.2%), stress (21.6%), and depression (17.8%) were the top health problems for which people used meditation; 63.6% reported that meditation had helped a great deal with these conditions. Only 34.8% disclosed their use of meditation with a health provider. These findings indicate that about 9.3 million US adults have used meditation in the past 12 months; and that mental health problems were the most important reason for meditation use.

Background Abdominal obesity is a major risk factor for morbidity and mortality. The aim of this study was to investigate the effect of yoga on waist circumference and other anthropometric and self-reported variables in women with abdominal obesity.

Objectives To analyze whether yoga or meditation use is associated with body (dis)satisfaction and weight control methods in Australian women. Methods Women ages 34 to 39 y from the Australian Longitudinal Study on Women's Health were surveyed regarding body satisfaction, weight control behaviors, and yoga and meditation practice. Associations of body satisfaction and weight control methods with yoga/meditation practice were analyzed using chi-squared tests and multiple logistic regression modelling. Results Of the 8009 women, 49% were overweight or obese. Sixty-five percent of women with normal body mass index (BMI) and approximately 95% of women with overweight/obesity wanted to lose weight. At least one in four women with normal BMI was dissatisfied with body weight and shape, as were more than two in three women with overweight/obesity. The most common weight control methods included exercising (82.7%), cutting down meal sizes (76.8%), and cutting down sugars or fats (71.9%). Yoga/meditation was practiced frequently by 688 women (8.6%) and occasionally by 1176 women (14.7%). Yoga/meditation users with normal BMI were less likely dissatisfied with body weight and shape. All yoga/meditation users more likely exercised and followed a low glycemic diet or diet books; and women with obesity occasionally using yoga/meditation also more likely used fasting or smoking to lose weight. Conclusion Yoga/meditation users with normal BMI appear to be more satisfied with their body weight and shape than non-yoga/meditation users. While women with normal BMI or overweight tend to rely on healthy weight control methods, women with obesity occasional using yoga/meditation may more likely utilize unhealthy weight control methods.

Background: Vegetarian nutrition is gaining increasing public attention worldwide. While some studies have examined differences in motivations and personality traits between vegetarians and omnivores, only few studies have considered differences in motivations and personality traits between the 2 largest vegetarian subgroups: lacto-ovo-vegetarians and vegans. Objectives: To examine differences between lacto-ovo-vegetarians and vegans in the distribution patterns of motives, values, empathy, and personality profiles. Methods: An anonymous online survey was performed in January 2014. Group differences between vegetarians and vegans in their initial motives for the choice of nutritional approaches, health-related quality of life (World Health Organization Quality of Life-BREF (WHOQOL-BREF)), personality traits (Big Five Inventory-SOEP (BFI-S)), values (Portraits Value Questionnaire (PVQ)), and empathy (Empathizing Scale) were analyzed by univariate analyses of covariance; P values were adjusted for multiple testing. Results: 10,184 individuals completed the survey; 4,427 (43.5%) were vegetarians and 4,822 (47.3%) were vegans. Regarding the initial motives for the choice of nutritional approaches, vegans rated food taste, love of animals, and global/humanitarian reasons as more important, and the influence of their social environment as less important than did vegetarians. Compared to vegetarians, vegans had higher values on physical, psychological, and social quality of life on the WHOQOL-BREF, and scored lower on neuroticism and higher on openness on the BFI-S. In the PVQ, vegans scored lower than vegetarians on power/might, achievement, safety, conformity, and tradition and higher on self-determination and universalism. Vegans had higher empathy than vegetarians (all p < 0.001). Discussion: This survey suggests that vegans have more open and compatible personality traits, are more universalistic, empathic, and ethically oriented, and have a slightly higher quality of life when compared to vegetarians. Given the small absolute size of these differences, further research is needed to evaluate whether these group differences are relevant in everyday life and can be confirmed in other populations.

© 2016 Elsevier Inc. Introduction Overweight and obesity are among the most important modifiable risk factors for chronic diseases and premature death. The aim of this review was to systematically assess and analyze the effects of yoga on weight-related outcomes. Methods Medline/PubMed, Scopus, and the Cochrane Library were screened through March 2015 for randomized controlled trials on yoga for weight-related outcomes in the general population or overweight/obese individuals. Risk of bias was assessed using the Cochrane risk of bias tool on the following domains: selection bias, performance bias, detection bias, attrition bias, reporting bias, and other bias. Results Out of 445 records identified during literature search, 30 trials with a total of 2173 participants were included. No effects on weight, body mass index, body fat percentage or waist circumference were found. In studies with healthy adult participants an effect of yoga compared to usual care was found regarding waist/hip ratio (SMD =‐ − 1.00; 95% CI =‐ − 1.44, − 0.55; p

© Copyright 2016, Mary Ann Liebert, Inc. 2016. Objective: This study examined the prevalence, patterns, and predictors of t'ai chi and qigong use in the U.S. general population. Design: Cross-sectional survey. Methods: Data from the 2012 National Health Interview Survey (n = 34,525). Weighted frequencies were used to analyze lifetime and 12-month prevalence and patterns of use. Independent predictors of practice were analyzed by using logistic regression models. Analyzes were conducted in 2015. Results: The lifetime and 12-month prevalence of t'ai chi/qigong practice were 3.1% and 1.2%, respectively. The 12-month prevalence was associated with age older than 30 years; being African American, Asian, or other ethnic origin; living in the West; being college educated and single; and being a light to heavy alcohol consumer. Almost 39% of users attended formal classes. T'ai chi/qigong was practiced for wellness/disease prevention and to improve energy, immune function, athletic performance, or memory/concentration. Stress, arthritis, and joint problems were the most frequent specific health problems for practice. Conclusions: Despite an only marginal increase of t'ai chi/qigong practice in the United States over the past 10 years, the proportion of minorities among practitioners has increased significantly. Gaps between clinical application and research are discussed.

Supplemental Digital Content is available in the text, Available systematic reviews showed uncertainty on the effectiveness of using acupuncture and related therapies for palliative cancer care. The aim of this systematic review and meta-analysis was to summarize current best evidence on acupuncture and related therapies for palliative cancer care. Five international and 3 Chinese databases were searched. Randomized controlled trials (RCTs) comparing acupuncture and related therapies with conventional or sham treatments were considered. Primary outcomes included fatigue, paresthesia and dysesthesias, chronic pain, anorexia, insomnia, limb edema, constipation, and health-related quality of life, of which effective conventional interventions are limited. Thirteen RCTs were included. Compared with conventional interventions, meta-analysis demonstrated that acupuncture and related therapies significantly reduced pain (2 studies, n = 175, pooled weighted mean difference: −0.76, 95% confidence interval: −0.14 to −0.39) among patients with liver or gastric cancer. Combined use of acupuncture and related therapies and Chinese herbal medicine improved quality of life in patients with gastrointestinal cancer (2 studies, n = 111, pooled standard mean difference: 0.75, 95% confidence interval: 0.36–1.13). Acupressure showed significant efficacy in reducing fatigue in lung cancer patients when compared with sham acupressure. Adverse events for acupuncture and related therapies were infrequent and mild. Acupuncture and related therapies are effective in reducing pain, fatigue, and in improving quality of life when compared with conventional intervention alone among cancer patients. Limitations on current evidence body imply that they should be used as a complement, rather than an alternative, to conventional care. Effectiveness of acupuncture and related therapies for managing anorexia, reducing constipation, paresthesia and dysesthesia, insomnia, and limb edema in cancer patients is uncertain, warranting future RCTs in these areas.

Introduction The purpose of this study was to investigate the prevalence, patterns, and predictors of yoga use in the U.S. general population. Methods Using cross-sectional data from the 2012 National Health Interview Survey Family Core, Sample Adult Core, and Adult Complementary and Alternative Medicine questionnaires (N=34,525), weighted frequencies for lifetime and 12-month prevalence of yoga use and patterns of yoga practice were analyzed. Using logistic regression analyses, sociodemographic predictors of lifetime yoga use were analyzed. Analyses were conducted in 2015. Results Lifetime and 12-month prevalence of yoga use were 13.2% and 8.9%, respectively. Compared with nonpractitioners, lifetime yoga practitioners were more likely female, younger, non-Hispanic white, college educated, higher earners, living in the West, and of better health status. Among those who had practiced in the past 12 months, 51.2% attended yoga classes, 89.9% used breathing exercises, and 54.9% used meditation. Yoga was practiced for general wellness or disease prevention (78.4%), to improve energy (66.1%), or to improve immune function (49.7%). Back pain (19.7%), stress (6.4%), and arthritis (6.4%) were the main specific health problems for which people practiced yoga. Conclusions About 31 million U.S. adults have ever used yoga, and about 21 million practiced yoga in the past 12 months. Disease prevention and back pain relief were the most important health reasons for yoga practice. Yoga practice is associated with age, gender, ethnicity, SES, and health status.

A reasonable estimation of expected dropout rates is vital for adequate sample size calculations in randomized controlled trials (RCTs). Underestimating expected dropouts rates increases the risk of false negative results while overestimating rates results in overly large sample sizes, raising both ethical and economic issues. To estimate expected dropout rates in RCTs on yoga interventions, MEDLINE/PubMed, Scopus, IndMED, and the Cochrane Library were searched through February 2014; a total of 168 RCTs were meta-analyzed. Overall dropout rate was 11.42% (95% confidence interval [CI] = 10.11%, 12.73%) in the yoga groups; rates were comparable in usual care and psychological control groups and were slightly higher in exercise control groups (rate = 14.53%; 95% CI = 11.56%, 17.50%; odds ratio = 0.82; 95% CI = 0.68, 0.98;p=0.03). For RCTs with durations above 12 weeks, dropout rates in yoga groups increased to 15.23% (95% CI = 11.79%, 18.68%). The upper border of 95% CIs for dropout rates commonly was below 20% regardless of study origin, health condition, gender, age groups, and intervention characteristics; however, it exceeded 40% for studies on HIV patients or heterogeneous age groups. In conclusion, dropout rates can be expected to be less than 15 to 20% for most RCTs on yoga interventions. Yet dropout rates beyond 40% are possible depending on the participants’ sociodemographic and health condition.

© European Society of Cardiology. Background Metabolic syndrome is the most important risk factor for developing cardiovascular disease and type 2 diabetes. The aim of this review was to systematically assess and perform a meta-analysis of the effects of yoga on the parameters of metabolic syndrome. Methods MEDLINE/PubMed, Scopus, the Cochrane Central Register of Controlled Trials and IndMED were searched and screened from their inception through to 8 March 2016 for randomised controlled trials on yoga for patients with metabolic syndrome. Risk of bias was assessed using the Cochrane risk of bias tool. Results Seven trials with a total of 794 participants were included. No effects of yoga on resolution of metabolic syndrome, diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol and fasting plasma glucose were found, but yoga was superior to usual care for waist circumference (standardised mean difference (SMD) = '0.35; 95% confidence interval (CI) = '0.57 to '0.13; p < 0.01) and systolic blood pressure (SMD = '0.29; 95% CI = '0.51 to '0.07; p = 0.01). However, these effects were not robust against selection bias. No intervention-related adverse events were reported. Conclusion Based on the results of this meta-analysis, no recommendation can be made for or against yoga in order to influence the parameters of metabolic syndrome. Despite methodological drawbacks, and until further research is undertaken, yoga can be preliminarily considered as a safe and effective intervention for reducing waist circumference and systolic blood pressure in individuals with metabolic syndrome who are not adhering to conventional forms of exercise.

© 2016 Elsevier GmbH Introduction The needle stimulation mat, also known as fakirs mat or acupressure pad has regularly been advertised as an effective means to reduce chronic back pain, however little is known about the effectiveness of such device. This study aimed to test the effects of the needle stimulation pad for chronic or recurrent low back pain. Methods In this prospective, single-armed trial patients with non-specific chronic or recurrent low back pain were selected from a health insurance company database and advised to use the pad daily for two weeks; outcomes were assessed at baseline, weeks 2 and 14. Primary outcome measure was pain intensity at week 2; secondary outcome measures included disability, health-related quality of life, fear avoidance beliefs, analgesic medication and safety. Results 91 patients were included (50 males, 52.3 ± 10.5years). No significant differences were found for pain intensity between weeks 0, 2 and 14, however immediate pain relief was detected after the application (p

Pflanzliche Arzneimittel haben in der medizinischen Versorgung im deutschsprachigen Raum eine lange Tradition, werden aber bei der Erstellung medizinischer Leitlinien selten berücksichtigt. In einer Vorstudie wurde von unserer Arbeitsgruppe aufgearbeitet, in welchem Ausmaß sie in den aktuellen interdisziplinär, evidenz- und konsensusbasiert erstellten S3-Leitlinien der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) Beachtung gefunden haben. Ziel der jetzigen Studie war es, zu analysieren, inwieweit Neben- bzw. Wechselwirkungen von pflanzlichen Arzneimitteln in diesen S3-Leitlinien diskutiert werden. Im Januar 2015 wurden 134 S3-Leitlinien gezählt und analysiert. 27,6% (n = 37) weisen insgesamt 194 Statements unter dem Begriff «Phytotherapie» auf. Hinweise zu Neben- und Wechselwirkungen finden sich in 28,4% der Statements (n = 55), die bei 13,9% (n = 27) durch Literatur belegt werden. 14 dieser Statements betreffen Nahrungsergänzungsmittel und Ähnliches, 11 sind pauschale Aussagen zur Phytotherapie, 7 fassen mindestens 2 Arzneipflanzen pauschal zusammen. Damit weisen nur 23 Statements auf Neben- bzw. Wechselwirkungen von einzelnen Arzneipflanzen hin, 14 davon sind mit Literaturstellen belegt. Diese Ergebnisse entsprechen bei Weitem nicht den geforderten Standards der AWMF. Dafür verantwortlich sind insbesondere unpräzise Begrifflichkeiten sowie eine unzureichende Systematik bei der Suche nach wissenschaftlicher Evidenz für die Unbedenklichkeit von Arzneipflanzen-Zubereitungen. Die Gesellschaft für Phytotherapie kann hier einen wichtigen Beitrag zur Qualitätsverbesserung leisten.

Neck pain is a significant public health problem with 1 in 2 people experiencing neck pain at least once in their lifetime.1 Neck pain is often recurrent, of nonspecific nature, and associated with disability in both social and occupational life.2–4 For the treatment of chronic courses, evidence is still limited, as only therapeutic exercises, acupuncture, and manual therapies were recommended in recent clinical practice guidelines.5–7 On asking manual therapists about their perception and use of complementary and alternative medicine for the treatment of chronic pain conditions, one repeatedly mentioned treatment was craniosacral therapy (CST).8 CST is thought to be a noninvasive, mindfulness-based treatment approach using gentle manual palpation techniques to release fascial restrictions between the cranium and the sacrum.9 The craniosacral system anatomically encompasses the structures of the central nervous system including the skull, the cranial sutures, the cerebrospinal fluid, and the membranes of the brain and the spinal cord. It is influenced by and linked to the musculoskeletal system,10 and presumably to the vascular and endocrine system as well as to the sympathetic and parasympathetic nervous system.11 In the craniosacral theory, fascial restrictions within the craniosacral system lead to abnormal, arrhythmic motion of the cerebrospinal fluid. This craniosacral rhythm is assessable by palpation and quantifiable by encephalogram, myelogram, and magnetic resonance imaging.12 There is also growing evidence for fascial involvement in pain chronification. Studies have shown increased activity of fascial nociceptors within restricted connective tissue, which can contribute to remodeling processes of inflammation and fibrosis, increased tissue stiffness, muscle tension, and chronic pain.13,14 However, research on craniosacral diagnostic and treatment mechanisms revealed very heterogenous results,11,12 with only preliminary evidence supporting inherent processes of peripheral and descending pain inhibition due to gentle fascial palpation techniques.11,15,16 The effectiveness of craniosacral treatment on health outcomes has been shown for a number of chronic pain syndromes, but it is limited to observational designs and randomized controlled trials with low to moderate methodological quality.17–19 Efficacy studies and studies on musculoskeletal pain have not been conducted to date,20 although neck and back pain were the most frequent symptoms for which CST was requested.21 Therefore, this study aimed at investigating the efficacy of CST in chronic nonspecific neck pain in comparison with a manual sham control intervention.

Background: Homeopathy use continues to grow in many European countries, and some studies have examined the characteristics of patients using homeopathy within the general population. The aim of this study was to identify predictors for homeopathy use among internal medicine patients. Patients and Methods: A cross-sectional analysis was conducted among all patients being referred to the Department of Internal and Integrative Medicine at Essen, Germany, over a 3-year period. The analysis examined whether patients had used homeopathy for their primary medical complaint before, the perceived benefit, and the perceived harm of homeopathy use. Odds ratios with 95% confidence intervals were calculated using multiple logistic regression analysis. Results: Of 2,045 respondents, 715 (35.0%) reported having used homeopathy for their primary medical complaint (diagnosis according to the International Statistical Classification of Diseases and Related Health Problems), with 359 (50.2%) reporting perceived benefits and 15 (2.1%) reporting harm. Homeopathy use was positively associated with female gender, high school level education, suffering from fibromyalgia or subthreshold depression, and being fast food abstinent, while patients with osteoarthritis, spinal or other pain, smokers, and patients with a high external-social health locus of control were less likely to use homeopathy. Conclusion: Personal characteristics and health status may impact on the use and the perceived helpfulness of homeopathy.

© 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved. Background: Low back pain and pelvic girth pain are common in pregnancy and women commonly utilize complementary manual therapies such as massage, spinal manipulation, chiropractic, and osteopathy to manage their symptoms. Objective: The aim of this systematically review was to critically appraise and synthesize the best available evidence regarding the effectiveness of manual therapies for managing pregnancy-related low back and pelvic pain. Methods: Seven databases were searched from their inception until April 2015 for randomized controlled trials. Studies investigating the effectiveness of massage and chiropractic and osteopathic therapies were included. The study population was pregnant women of any age and at any time during the antenatal period. Study selection, data extraction, and assessment of risk of bias were conducted by 2 reviewers independently, using the Cochrane tool. Separate meta-analyses were conducted to compare manual therapies to different control interventions. Results: Out of 348 nonduplicate records, 11 articles reporting on 10 studies on a total of 1198 pregnant women were included in this meta-analysis. The therapeutic interventions predominantly involved massage and osteopathic manipulative therapy. Metaanalyses found positive effects for manual therapy on pain intensity when compared to usual care and relaxation but not when compared to sham interventions. Acceptability did not differ between manual therapy and usual care or sham interventions. Conclusions: There is currently limited evidence to support the use of complementary manual therapies as an option for managing low back and pelvic pain during pregnancy. Considering the lack of effect compared to sham interventions, further high-quality research is needed to determine causal effects, the influence of the therapist on the perceived effectiveness of treatments, and adequate dose-response of complementary manual therapies on low back and pelvic pain outcomes during pregnancy.

© 2016 AGA Institute Background & Aims This review aims to systematically survey the effects of yoga on symptoms of irritable bowel syndrome (IBS), pain, quality of life, mood, stress, and safety in patients with IBS. Methods MEDLINE/Pubmed, Scopus, the Cochrane Library, CAM-QUEST, CAMbase, and IndMED were screened through November 2015. Randomized controlled trials comparing yoga with usual care, nonpharmacologic, or pharmacologic interventions were analyzed for patients with IBS. Primary outcomes included gastrointestinal symptoms, quality of life, and pain. Anxiety, mood, and safety were defined as secondary outcomes. Risk of bias was assessed according to the Cochrane Collaboration recommendations. Results Six randomized controlled trials with a total of 273 patients were included in the qualitative analysis. There was evidence for a beneficial effect of a yogic intervention over conventional treatment in IBS, with significantly decreased bowel symptoms, IBS severity, and anxiety. Furthermore, there were significant improvements in quality of life, global improvement, and physical functioning after yoga compared with no treatment. Two randomized controlled trials reported safety data stating that no adverse events occurred. Overall, risk of bias of the included studies was unclear. Conclusions The findings of this systematic review suggest that yoga might be a feasible and safe adjunctive treatment for people with IBS. Nevertheless, no recommendation can be made regarding yoga as a routine intervention for patients with IBS because of major flaws in study methods. More research is needed with respect to a high-quality study design and consensus in clinical outcome measurements in IBS. ClinicalTrials.gov number, NCT02721836.

Introduction: Chronic diseases are one of the biggest challenges for future medicine. Empowering patients to adopt a health promoting lifestyle and to learn effective coping strategies seems essential for successful therapy. Integrative medicine might provide such strategies to promote healthy lifestyle changes by means of Mind/Body therapies. Concept: The Department for Internal and Integrative Medicine at Kliniken Essen-Mitte, academic teaching Hospital of the University Duisburg-Essen, offers an Integrative Day Care Clinic with the focus on lifestyle management as part of standard care. The program utilizes Mind/Body therapies and components from cognitive therapy to increase patient's coping. Case reports: Three cases, attending the Integrative Day Care Clinic, are presented here. Cases reveal that the Integrative Day Care Clinic may be effective for all patients who do contribute to the program and make necessary lifestyle changes. The most frequently reported changes do not concern symptom severity, but acceptance, coping and self-efficacy, especially in stressful situations. Satisfaction with the therapy is high. Conclusion: An Integrative Day Care Clinic group program appears to indicate positive effects for patients with chronic diseases. These results are supported by the results of several randomized controlled trials in patients with chronic diseases. Further superior quality trials and qualitative approaches are necessary to provide reliable results and more insight into the nature of the effects. © 2012 Elsevier GmbH.

Background: In conditions such as phantom limb pain and low back pain body image is distorted. This qualitative study investigates body image in patients with chronic non-specific neck pain (CNP), its influence on their everyday life and any changes linked to traditional cupping therapy. Methods: The study was conducted with a convenience sample of 6 patients with CNP from a larger randomised controlled trial (RCT) on cupping. The data came from body image drawings and semi-structured interviews. The latter were analysed using Mayring's content analysis techniques. Results: The patients' drawings showed apparent body image distortions with elements that were missing or deformed. The interviews showed that pain was the predominant perception, influencing patients' body perception. Patients saw their pain as beyond their control, using mostly passive strategies to cope. After cupping, patients reported less pain and improved pain perception. These changes were reflected in their drawings. Conclusion: Patients with CNP experienced apparent body image distortions, which traditional cupping therapy appeared to improve. Additional research is needed to further explore this link. © 2012 S. Karger GmbH, Freiburg.

Prof. Dr. med. Jost LanghorstKlinik fur Naturheilkunde und Integrative MedizinKliniken Essen-Mitte, Knappschafts-KrankenhausAm Deimelsberg 34a, 45276 Essen, Deutschlandj.langhorst@kliniken-essen-mitte.de© 2012 S. Karger GmbH, Freiburg1661-4119/12/0196-0280$38.00/0Accessible online at: www.karger.com/fokFax +49 761 4 52 07 14Information@Karger.dewww.karger.com

Importance Treatment of chronic low back pain (LBP) in older adults is limited by the adverse effects of analgesics. Effective nonpharmacologic treatment options are needed. Objective To determine the effectiveness of a mind-body program at increasing function and reducing pain in older adults with chronic LBP. Design, setting, and participants This single-blind, randomized clinical trial compared a mind-body program (n = 140) with a health education program (n = 142). Community-dwelling older adults residing within the Pittsburgh metropolitan area were recruited from February 14, 2011, to June 30, 2014, with 6-month follow-up completed by April 9, 2015. Eligible participants were 65 years or older with functional limitations owing to their chronic LBP (≥ 11 points on the Roland and Morris Disability Questionnaire) and chronic pain (duration ≥ 3 months) of moderate intensity. Data were analyzed from March 1 to July 1, 2015. Interventions The intervention and control groups received an 8-week group program followed by 6 monthly sessions. The intervention was modeled on the Mindfulness-Based Stress Reduction program; the control program, on the ”10 Keys” to Healthy Aging. Main outcomes and measures Follow-up occurred at program completion and 6 months later. The score on the Roland and Morris Disability Questionnaire was the primary outcome and measured functional limitations owing to LBP. Pain (current, mean, and most severe in the past week) was measured with the Numeric Pain Rating Scale. Secondary outcomes included quality of life, pain self-efficacy, and mindfulness. Intent-to-treat analyses were conducted. Results Of 1160 persons who underwent screening, 282 participants enrolled in the trial (95 men [33.7%] and 187 women [66.3%]; mean [SD] age, 74.5 [6.6] years). The baseline mean (SD) Roland and Morris Disability Questionnaire scores for the intervention and control groups were 15.6 (3.0) and 15.4 (3.0), respectively. Compared with the control group, intervention participants improved an additional –1.1 (mean, 12.1 vs 13.1) points at 8 weeks and –0.04 (mean, 12.2 vs 12.6) points at 6 months (effect sizes, –0.23 and –0.08, respectively) on the Roland and Morris Disability Questionnaire. By 6 months, the intervention participants improved on the Numeric Pain Rating Scale current and most severe pain measures an additional –1.8 points (95% CI, –3.1 to –0.05 points; effect size, –0.33) and –1.0 points (95% CI, –2.1 to 0.2 points; effect size, –0.19), respectively. The changes in Numeric Pain Rating Scale mean pain measure after the intervention were not significant (–0.1 [95% CI, –1.1 to 1.0] at 8 weeks and –1.1 [95% CI, –2.2 to –0.01] at 6 months; effect size, –0.01 and –0.22, respectively). Conclusions and relevance A mind-body program for chronic LBP improved short-term function and long-term current and most severe pain. The functional improvement was not sustained, suggesting that future development of the intervention could focus on durability.

Objectives The Department of Internal and Integrative Medicine, Kliniken-Essen-Mitte, is known for its complementary healing methods, such as Meditation, Taiji, Qigong, and Yoga etc. With the above-mentioned „randomized clinical trial: yoga vs. written self-care advice” H. Cramer et al. aim to assess the efficacy and safety of yoga for improving qualitive of life with ulcerative colitis. Methods A total of randomly chosen 77 patients (75 % women) in clinical remission but impaired quality of life were assigned to 12 supervised weekly yoga sessions of respectively 90 minutes or written self-care advice in form of handbooks, the latter group without engaging in yoga practice (supervised as well as at home). The authors explain their procedure referring to the current methodological claims of obviously good scientific practice (s. pp. 1380) relying on both subjective reports as well as lab examinations (blood sedimentation, bowel movement …). Results Yoga is definitely a safe and effective supplemental intervention for patients with ulcerative colitis and impaired quality of life. 21 patients in the yoga group and 12 patients in the self-care handbook group realized a clinical relevant increase in quality of life at week 12, i. e. immediately after the yoga intervention! While at week 24, i. e. three months after the weekly supervised yoga practice 27 and 17, respectively, still realized an increased quality of life. 3 and 1 patients, respectively, experienced serious adverse events, and 7 and 8 non-serious adverse events – thus being almost equally distributed.

Die aktuelle Leitlinie «Diagnostik und Therapie der Colitis ulcerosa» wurde im September 2011 unter Federfuhrung der Deutschen Gesellschaft fur Verdauungsund Stoffwechselkrankheiten (DGVS) und Mitarbeit der Deutschen Gesellschaft fur Pathologie (DGP), der Deutschen Gesellschaft fur Allgemeinund Viszeralchirurgie (DGVC), der Gesellschaft fur padiatrische Gastroenterologie und Ernahrung (GPGE) sowie der Deutschen Gesellschaft fur Ernahrungsmedizin (DGEM) vorgelegt. Die nachste Aktualisierung ist fur September 2016 avisiert; die gegebenen Empfehlungen werden also noch eine geraume Weile den Goldstandard in der Therapie der Colitis ulcerosa darstellen [1]. Fur eine Reihe komplementarmedizinischer Verfahren enthielt die Leitlinie evidenzbasierte positive Empfehlungen, die einen hinreichenden Konsens in der Leitlinienkonferenz fanden (Tab. 1). So wurden abgeschwacht positive Empfehlungen fur das Phytotherapeutikum Plantago ovata gegeben, das sich in einer klinischen Studie Mesalazin in der remissionserhaltenden Behandlung als ebenburtig erwies (Empfehlung 10.16); ebenso fur Curcumin, das in der remissionserhaltenden Behandlung komplementar zu 5-ASA empfohlen wird (Empfehlung 10.15). Ein Problem in der Anwendung von Curcumin in Deutschland ergibt sich allerdings daraus, dass in der japanischen Studie [2], auf der die Empfehlung beruht, Curcumin in einer Dosis von 2 × 1 g/Tag eingesetzt wurde, wahrend die in Deutschland verfugbaren Praparate deutlich geringere Dosierungen enthalten. Daneben gibt die Leitlinie eine abgeschwacht positive Empfehlung fur Akupunktur in Kombination mit Moxibustion als komplementare Therapie im leichten bis moderaten Schub (Empfehlung 10.18) sowie fur eine multimodale komplementare Mind-Body-Therapie zur Verbesserung der Lebensqualitat (Empfehlung 10.17). Letztere Empfehlung ist bisher nahezu einzigartig in Deutschland; erstmals wird hier eine multimodale MindBody-Therapie empfohlen, wie sie in Deutschland in integrativmedizinischen Kliniken angeboten wird [3]. Die Empfehlung basiert unter anderem auf einer deutschen randomisierten Studie [4, 5], die zeigen konnte, dass ein multimodales Lebensstilmodifikationsprogramm mit Elementen der Mind-Body-Medizin die Lebensqualitat von Patienten in Remission oder mit geringer Krankheitsaktivitat in klinisch relevantem Umfang steigern kann. Weitere komplementarmedizinische Verfahren, inklusive weiterer Phytotherapeutika und einzelner Verfahren der Mind-Body-Medizin wie Yoga oder Qigong, konnten aufgrund der unzureichenden Datenlage nicht empfohlen werden (Empfehlung 10.20). Ein potenzieller Kandidat fur zukunftige Aktualisierungen der Leitlinie scheint die Behandlung mit Eiern des Schweinepeitschenbandwurms (Trichuris suis ovata) zu sein, die in einer randomisierten Studie im leichten bis moderaten Schub die Krankheitsaktivitat signifikant starker senken konnte als Placebo, derzeit aber – vor dem Hintergrund der fehlenden Zulassung in Deutschland – nicht generell empfohlen wird (Empfehlung 10.19). Aktuell wird je eine europaische und eine nordamerikanische Multicenterstudie zur Effektivitat von Trichuris suis ovata bei chronisch entzundlichen Darmerkrankungen durchgefuhrt – allerdings nur bei Patienten mit Morbus Crohn. Die Empfehlung einer Anzahl komplementarmedizinischer Verfahren in der Therapie der Colitis ulcerosa bietet denjenigen Behandlern Sicherheit, die diese Verfahren aufgrund klinischer Erfahrungen und positiver Studienergebnisse bereits anwenden oder eine Anwendung erwagen, und kann auch konventionell arbeitende Kollegen ermutigen, sich intensiver mit diesen Verfahren zu beschaftigen. Die Leitlinie geht jedoch noch einen deutlichen Schritt weiter und kann hier als

© 2016 J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York. Hypertension is a major public health problem and one of the most important causes of premature morbidity and mortality. Yoga is a traditional Indian practice that has been adapted for use in complementary and alternative medicine and mainly includes physical postures, breathing techniques, and meditation. The impact of yoga as a complementary intervention for hypertension has been investigated in a number of randomized controlled trials; with an overall effect of about 10 mmHg reduction in systolic and about 8 mmHg reduction in diastolic blood pressure. Yoga seems to be effective only for hypertension but not for prehypertension; and only as an adjunct to antihypertensive pharmacological treatment but not as an alternative therapy. Breathing and meditation rather than physical activity seem to be the active part of yoga interventions for hypertensive patients. These practices can increase parasympathic activity and decrease sympathetic activity, arguably mainly by increasing GABA activity; thus counteracting excess activity of the sympathetic nervous system which has been associated with hypertension. Although yoga has been associated with serious adverse events in single case reports, population-based surveys as well as clinical trials indicate that yoga is a relatively safe intervention that is not associated with more adverse events than other forms of physical activity. Yoga can thus be considered a safe and effective intervention for managing hypertension. Given the possibly better risk/benefit ratio, it may be advisable to focus on yogic meditation and/or breathing techniques.

Yoga is increasingly used as a therapeutic and preventive method worldwide. The aim of this nationally representative survey was to assess prevalence and patterns of yoga practice in Germany.Between August and September 2014, a nationally representative sample of 2,041 individuals of at least 14 years of age was interviewed regarding actual and prior yoga practice. Differences between socioeconomic subgroups were analyzed using chi-squared tests.Lifetime prevalence of yoga practice was 15.1%, point prevalence 3.3%. Higher prevalence was associated with female gender (p0.001), higher education (p0.001), employment (p = 0.047), and living in a major city (p0.001). Mean duration of yoga practice was 48.2 months; 61.7% practiced at least once weekly. The main reasons for yoga practice were improved physical (62.8%) and mental well-being (56.9%) as well as physical (54.4%) and mental capacity (50.0%). Positive changes due to yoga were reported by 89.7% of practitioners, mainly increased inner balance (58.8%). Another 16.1% of those who were not currently practicing could imagine practicing yoga in the next 12 months.An estimated 15.7 million Germans are currently practicing yoga or are at least interested in starting to practice, most commonly women, metropolitans, and those with a higher education as well as employed persons. Almost 90% practitioners report positive changes due to their yoga practice.

Coronary heart disease (CHD) is one of the most widespread diseases. It has a lifetime prevalence of 9.3% in 40- to 79-year-olds (1) and is the most common cause of death in Germany (2). According to data from the World Health Organization (WHO), around 80% of the risk factors for CHD can be influenced by the patient’s behavior; this applies above all to lack of exercise, poor nutrition, overweight, and chronic subjective stress (3, 4). Correspondingly, the German National Disease Management Guideline on chronic CHD recommends secondary prevention as an integral component of the comprehensive long-term care of patients with cardiac disease (5). The preventive measures should cover the areas of nutrition, exercise/sport, and stress reduction/relaxation. Particularly in the USA, intensive mind–body medicine (MBM) programs for lifestyle modification have been developed that integrate these components into standardized secondary preventive interventions (6). MBM focuses on achieving self-regulation by means of preventive and curative interactions between the brain, the rest of the body, the mind, and behavior (6– 9). In contrast to many other programs for lifestyle modification, MBM interventions include not only nutritional advice and exercise/sport, but also relaxation techniques and psychological motivational elements (6, 7, 9). While the effects of single components or interventions (10– 12) and of less intensive lifestyle modification programs (13– 15) h ave been repeatedly studied, no meta-analyses of the effectiveness of complex MBM interventions have yet been published. The aim of this review was to perform a systematic analysis of the evidence from randomized trials on the effect of MBM interventions on cardiac events and mortality in comparison with standard treatment in patients with CHD.

Introduction Falls are the leading cause of injuries in women across all ages. While yoga has been shown to increase balance, it has also been associated with injuries due to falls during practice. This study aimed to analyse whether regular yoga or meditation practice is associated with the frequency of falls and fall-related injuries in upper middle-aged Australian women. Methods Women aged 59–64 years from the Australian Longitudinal Study on Women's Health (ALSWH) were queried regarding falls and falls-related injuries; and whether they regularly practiced yoga or meditation. Associations of falls and falls-related injuries with yoga or meditation practice were analysed using chi-squared tests and multiple logistic regression modelling. Results Of 10,011 women, 4413 (44.1%) had slipped, tripped or stumbled, 2770 (27.7%) had fallen to the ground, 1398 (14.0%) had been injured as a result of falling, and 901 (9.0%) women had sought medical attention for a fall-related injury within the previous 12 months. Yoga or meditation was practiced regularly by 746 (7.5%) women. No associations of falls, fall-related injuries and treatment due to falls-related injury with yoga or meditation practice were found. Discussion No association between yoga or meditation practice and falls or fall-related injuries have been found. Further studies are warranted for conclusive judgement of benefits and safety of yoga and meditation in relation to balance, falls and fall-related injuries.