Behere 2011.
Methods | Allocation: randomised. Blinding: single blind (raters blind to group status). Duration: 4 months, assessed at baseline, 2 months and 4 months. Design: parallel. Setting: outpatient services of the Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India. | |
Participants | Diagnosis: schizophrenia (DSM IV).
History: patients on stabilised antipsychotic medications for 6 weeks or longer before recruitment.
N = 91.
Age: 18 ‐ 60 years.
Sex: 32M,12F
Inclusion criteria: CGI score less than or equal to 3 as assessed by treating psychiatrist. Exclusion criteria: any comorbid psychiatric disorder, medical or neurological illness. |
|
Interventions | 1.Yoga: 1 month yoga training from a trained yoga instructor developed from a particular school (Swami Vivekananda Yoga Anusandhana Samsthana), followed by 3 months of self practice at home. The techniques consisted of the following components: (i) shithileekarana vyayama (loosening exercises) for 10 minutes, (ii) yoga postures (asanas) for approximately 20 minutes, (iii) breathing exercises for 18 minutes, (iv) quick relaxation techniques for 3 minutes, meditation was not included. (N = 34). 2. Standard‐care control: participants did not receive any add‐on intervention. (N = 26) 3. Exercise: 1 month exercise training from a trained yoga instructor followed by 2 months practice of exercises at home. This consisted of brisk walking, jogging, and exercises in standing and sitting postures and relaxation. No meditation included. Therapist: participant ratio not detailed. (N = 31)* Participants in all the 3 groups continued to receive stable dose of antipsychotic medications until the end of the study. |
|
Outcomes | Mental state: PANSS. Social functioning: SOFS, emotional recognition (TRACS). Leaving the study early. |
|
Notes | Same yoga intervention as Jayaram 2013 * Included only data from intervention groups 1 and 2. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: ''Using computer‐generated random numbers, 91 patients were allocated to three treatment groups''. Response: Low risk. |
Allocation concealment (selection bias) | High risk | Quote: "The randomization was performed by one of the authors in the study (Dr JT)." Response: This could potentially be high risk as the order of allocation could be known, which could influence the allocation of participants to either intervention. |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Participants and personnel delivering the yoga intervention will be aware they are undertaking or delivering the yoga intervention. |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Quote: ''The raters were blind to the status, and the raters were not involved in imparting yoga therapy or exercise''. Response: Low risk. |
Incomplete outcome data (attrition bias) All outcomes | High risk | Quote: ''The number of patients who completed the study and included in the final analysis was 27 in the Yoga group, 17 in the Exercise group and 22 in the Waitlist group''. Response: Extent of withdrawal broadly similar between yoga and control group, but rated as high risk as not all participants randomised were included in the final analysis (7 in Yoga group, 14 in Exercise group, and 4 in Waitlist group ‐ 27.5% overall). |
Selective reporting (reporting bias) | Low risk | All stated outcomes were reported. |
Other bias | High risk | Funding: not stated. One of the authors may be invested in intervention due to affiliation with Swami Vivekananda Yoga Anusandhana Samsthana. Yoga for this study was developed from this school. |