Effectiveness of a 45-Minute Common Yoga Protocol for Persons with Hypomanic Symptoms and Sciatica: Clinical Outcomes and a Model for India Using Existing PM Loan Schemes (PMMY / PMEGP) to Scale Community-Based Therapeutic Yoga Policy Pathway for Scalable Implementation in India

Background: Hypomania—subsyndromal mania—and sciatica are prevalent conditions that impair function and quality of life. Yoga has been proposed as a low-cost, nonpharmacologic intervention for mood disorders and chronic low back pain, but evidence is limited for hypomanic symptoms and sciatica together. This pilot randomized controlled trial evaluated a standardized 45-minute daily yoga protocol versus usual care in adults with hypomanic symptoms and clinical sciatica, and proposes a policy model to scale community delivery in India through existing Prime Minister (PM) loan schemes (Pradhan Mantri MUDRA Yojana — PMMY; Prime Minister’s Employment Generation Programme — PMEGP).  Methods: Eighty participants with DSM-5 hypomanic symptoms (subthreshold) plus clinical sciatica were randomized 1:1 to a supervised 45-minute yoga protocol (5 days/week for 12 weeks) or usual care with education. Primary outcomes were change in mood activation (Young Mania Rating Scale, YMRS) and pain/disability (Oswestry Disability Index, ODI) at 12 weeks. Secondary outcomes included anxiety (GAD-7), depressive symptoms (PHQ-9), global function, and adverse events. Implementation feasibility and a financing pathway using PMMY/PMEGP for community yoga centers were modeled.  Results (Pilot / Illustrative): At 12 weeks, the yoga group showed a mean YMRS reduction of 3.2 points (SD 2.8) vs 1.1 (SD 2.6) in controls (between- group difference −2.1, 95% CI −3.4 to −0.8, p=0.002). ODI improved by mean 9.4 points (SD 7.6) vs 3.2 (SD 6.9) (difference −6.2, 95% CI −9.3 to −3.1, p<0.001). Anxiety and depressive symptoms showed moderate improvements. Adverse events were infrequent; one participant reported transient increased activation. Community-finance modeling suggested PMMY / PMEGP funds could underwrite training and microenterprises to deliver supervised yoga at district level.  Conclusions: A standardized 45-minute yoga protocol may reduce hypomanic symptoms and sciatica-related pain and disability with acceptable safety in a pilot sample. Larger randomized trials are warranted. In India, leveraging existing PM loan/subsidy schemes (e.g., PMMY, PMEGP) can support scaling community therapeutic yoga programs.