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. 2015 Oct 21;2015(10):CD010554. doi: 10.1002/14651858.CD010554.pub2

Ikai 2014.

Methods Allocation: randomised.
 Blinding: single blind (raters blind to group status).
 Duration: 8‐week intervention with 8‐week follow‐up.
 Design: parallel.
 Setting: Department of Neuropsychiatry, Yamanashi Prefectural Kita Hospital, Yamanashi, Japan.
Participants Diagnosis: schizophrenia (F20‐F29 according to the International Classification of Diseases, 10th edition).
 History: outpatients receiving the same medication for the previous 8 weeks, registered in the day‐care centre.
 N = 50.
 Age: > 18 years.
 Sex: 32M, 17F.
 Inclusion criteria: 18 years or older, receiving the same medication for the previous 8 weeks, and registered in the day‐care centre.
Exclusion criteria: incapable of providing consent, current substance or alcohol abuse/dependence.
Interventions 1. Yoga therapy: 8 weeks hatha yoga in the hospital gymnasium training from ''one of the investigators who held a master's degree of Hatha yoga''. The techniques consisted of the following components: (i) warming‐up and loosening‐up exercises for 7 minutes (including guided meditation for 3 minutes), (ii) yoga postures (asanas) for 28 minutes, (iii) relaxation for 7 minutes, (iv) breathing exercises for 8 minutes; participants were asked to self practice at home (n = 25).
2. Standard care: a weekly regular day‐care programme consisting of social‐skills training and psycho‐education.
Both yoga and standard‐care groups were registered in the regular day‐care programme and could avail ''ambulatory treatment'' that consisted of non‐structured clinical management such as pharmacotherapy, and very brief psychotherapy by participant's treating psychiatrist (from personal communication with study author 6 August 2015).
Medications were kept constant by participants' treating psychiatrists throughout the study period unless a change was clinically indicated.
Outcomes Mental State: 25‐Item Resilience Scale, PANSS
Social functioning: FACT‐Sz
Quality of life: EQ‐5D
Leaving the study early
Unable to use:
Blood markers, DIEPSS ‐ not specified in protocol.
Notes Note: same study location and procedure and a number of common authors as Ikai 2013, but the current study took place between November 2012 and April 2013. Follow‐up was at 16 weeks, but as no data were reported for the standard‐care group and the FACT‐Sz and PANSS in the yoga group, only the 8‐week follow‐up data was included.
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Quote: ''A simple randomization list with no special stratification or blocks was made by using a computer program''.
Response: Likely to be adequate.
Allocation concealment (selection bias) Low risk Quote: ''the randomization was performed by using sealed envelopes prepared by physicians at Yamanashi Prefectural Kita Hospital who were not involved in this study''
Response: Likely to be adequate.
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.
Response: Unclear risk.
Blinding of outcome assessment (detection bias) 
 All outcomes Unclear risk Quote: ''All assessments were performed by trained psychiatrists who were blind to the patients' allocations and were not involved in the yoga therapy''.
Response: Low risk.
Incomplete outcome data (attrition bias) 
 All outcomes High risk Follow‐up was at 16 weeks, but no data reported for the standard‐care group and the FACT‐Sz and PANSS in the yoga group.
Response: High risk.
Selective reporting (reporting bias) Low risk All outcomes listed were reported.
Other bias Unclear risk Adherence of groups to day‐care programme and ''ambulatory treatment'' is not specified.