Research - Yoga
Effectiveness of Hatha Yoga Versus Conventional Therapeutic Exercises for Chronic Nonspecific Low-Back Pain
Osama Neyaz, Lukram Sumila, Srishti Nanda, and Sanjay Wadhwe
Objective: To determine whether the effectiveness of Hatha yoga therapy is comparable to conventional therapeutic exercises (CTEs) for reducing back pain intensity and back-related dysfunction in patients with chronic nonspecific low-back pain (CNLBP).
Design: The study was a prospective randomized comparative trial, divided into two phases: an initial 6-weekly supervised intervention period followed by a 6-week follow-up period.
Settings: This study was conducted at Department of Physical Medicine and Rehabilitation and Centre for Integrative Medicine and Research of a tertiary care hospital.
Subjects: Patients between 18 and 55 years of age with complaint of CNLBP persisting ≥12 weeks with pain rating ≥4 on a numerical rating scale (0–10).
Intervention: A total of six standardized 35-min weekly Hatha yoga sessions (yoga group) and similarly 35-min weekly sessions of CTEs (CTE group), designed for people with CNLBP unaccustomed to structured yoga or CTE program. Participants were asked to practice on nonclass days at home.
Outcome measures: The primary outcome measures were Defense and Veterans Pain Rating Scale (DVPRS) (0–10) and 24-point Roland Morris Disability Questionnaire (RDQ). Secondary outcomes were pain medication usage per week and a postintervention Perceived recovery (Likert seven-point scale) of back-related dysfunction. Outcomes were recorded at the baseline, 6-week follow-up, and 12-week follow-up.
Results: Seventy subjects were randomized to either yoga (n = 35) or CTE group (n = 35). Data were analyzed using intention-to-treat, with last observation carried forward. Both yoga and the CTE group have shown significant improvement in back pain intensity and back-related dysfunction within both the groups at 6- and 12-week follow-ups compared to baseline. No statistically significant differences in the pain intensity (DVPRS; at 6 weeks: n = 35, difference of medians 1.0, 95% confidence interval [−5.3 to 3.0], p = 0.5; at 12 weeks: n = 35, 0.0 [−4.2 to 5.0], 0.7) and back-related dysfunction (RDQ; at 6 weeks: n = 35, 1.0 [−9.6 to 10.6], 0.4; at 12 weeks: n = 35, 0.0 [−8.8 to 10.6], 0.3) were noted between two groups. Improvements in pill consumption and perceived recovery were also comparable between the groups.
Conclusion: Yoga provided similar improvement compared with CTEs, in patients with CNLBP
Source : Journal Alternative and Complementary Medicine
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Impact of yoga based mind-body intervention on systemic inflammatory markers and co-morbid depression in active Rheumatoid arthritis patients: A randomized controlled trial
Gautam, Surabhia | Tolahunase, Madhuria | Kumar, Umab | Dada, Rimaa; *
Background:Recovery of the patients with rheumatoid arthritis (RA) depends on several physical and psychological factors, besides pharmacological treatment. Co-morbid depression adversely affects the outcome in RA. Usual medical therapies have a limited scope and fail to cure the psychological component of the disease. With advanced therapeutic options, achieving a state of remission has become the treatment goal, yoga based mind body intervention (MBI) may provide a holistic approach to its treatment dimension. Hence, MBIs become the need of hour as majority of diseases have a psychosomatic component.
Objective:To explore the effect of Yoga based MBI on disease specific inflammatory markers and depression severity in active RA patients on routine disease modifying anti-rheumatic drugs (DMARDs) therapy.
Methods:A total of 72 RA patients were randomized into 2 groups: yoga group (yoga with DMARDs) and control group (DMARDs only). Blood samples were collected pre and post intervention for primary outcome measurements of systemic biomarkers. Disease activity score 28 erythrocyte sedimentation rate (DAS28ESR) and health assessment questionnaire disability index (HAQ-DI) were used to assess disease activity and functional status respectively at pre and post intervention time-points. Secondary outcome, depression severity, was assessed by Beck Depression Inventory II scale (BDI-II) at 2 weekly intervals during 8 weeks of the study interventional plan.
Results:After 8 weeks of yoga based MBI, there was significant decrease in the severity of RA as seen by reduction in levels of various systemic inflammatory markers as well as in DAS28ESR (p-value <0.0001; effect size = 0.210) and HAQ-DI (p-value 0.001; effect size = 0.159). Also, yoga group experienced a statistically significant time dependent step-wise decline in depression symptoms over the period of 8 weeks as compared to control group (p-value <0.0001; effect size = 0.5). Regression analysis showed greater reduction in the scores of BDI-II with DAS28ESR (R2 = 0.426; p < 0.0001) and HAQ-DI (R2 = 0.236; p = 0.003) in yoga group.
Conclusions:Yoga, a mind body intervention re-established immunological tolerance by aiding remission at molecular and cellular level along with significant reduction in depression. Thus in this inflammatory arthritis with a major psychosomatic component, yoga can be used as a complementary/adjunct therapy.
Source : Restorative Neurology and Neuroscience
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Impact of Fast and Slow Pranayam on Cardio Vascular Autonomic Function among Healthy Young Volunteers: Randomized Controlled Study
Sharma VK1, Dinesh T2, Rajajeyakumar M3*, Grrishma B4 and Bhavanani AB
Background: Pranayama refers to the conscious manipulation of the breath in order to modulate the cosmic energy (prana) from the air in the environment. The techniques of Pranayam include practices that are performed in a slow or fast type.
Aim: Investigate and correlate the impact of three months practice of fast and slow pranayam on cardiovascular autonomic function among healthy young volunteer.
Materials and Methods: Total of 75 volunteer subjects were randomized into control group (Group1: n=25), fast pranayama group (Group 2: n=25) and slow pranayama group (Group 3: n=25). The pranayam practice (Slow Pranayam Group-Savitri, Pranav and Nadisodhana: Fast Pranayam Group-Bhastrika, Kukkuriya and Kapalabhati, were practiced 30 minutes per day, 3 days per week for 3 months either slow or fast pranayam by a certified yoga teacher. The recording of Short term Heart Rate Variability (HRV) was done at the before and after 3 months of study period.
Result: The LF/HF ratio which is the best indicator of Sympathovagal balance was reduced significantly in slow pranayam group showing a shifting of balance towards parasympathetic tone. The RMSSD which is considered to be the best predictor of parasympathetic tone significantly increased in slow pranayam group. A significant increase (HF) nu and decrease (LF) nu was noted in slow and fast pranayam respectively after yoga intervention.
Conclusion: Results of our study demonstrates that slow and fast pranayam practices are more effective to maintain sympatho-vagal balance by modulating sympathetic and parasympathetic division of autonomic nervous system.
Source : Journal Alternative & Integrative Medicine
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The benefits of yoga in children
Chandra Nanthakumar (Faculty of University Foundation Studies, HELP University, Bukit Damansara, 50490 Kuala Lumpur, Malaysia )
The number of children suffering from stress and anxiety in Malaysia is on the rise. Evidence shows that mind–body therapies such as mindfulness therapy, meditation and yoga have been practiced in many other countries to reduce and/or manage the psychological effects of stress and anxiety. This review article looks at the intervention of yoga as a meditative movement practice in helping school children manage stress and anxiety. Articles were retrieved using a combination of databases including PubMed/ MEDLINE, and PsycINFO. Not only peer-reviewed articles, but also those written in English language were included in this review. All studies reviewed had incorporated some form of meditative movement exercise. The intervention encompassed asanas (postures), pranayama (expansion of life force), dharana (concentration) and dhyana (meditation), which are the different paths in yoga. A total of eight articles met the inclusion criteria and were reviewed. The findings of this review reveal that the practice of yoga has brought about, among other things, improvement in managing and reducing stress and anxiety. Despite the limitations in most, if not all of the studies reviewed, in terms of heterogeneity and sample size, yoga appears to be an effective modality for helping children cope with stress and anxiety. It appears that if schools in Malaysia can incorporate yoga as part of the physical education curriculum, it will definitely benefit the students.
Source : Journal of Integrative Medicine
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The Effects of Yoga on Pain, Mobility, and Quality of Life in Patients with Knee Osteoarthritis: A Systematic Review
Laidi Kan,1,2 Jiaqi Zhang,3 Yonghong Yang,1,2,4 and Pu Wang1,2,4
Objective. To systematically assess the effects of yoga on pain, mobility, and quality of life in patients with knee osteoarthritis.
Methods. Pubmed, Medline, EMBASE, the Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database (PEDro), and other sources were searched systematically in this study. Two reviewers identified eligible studies and extracted data independently. Downs and Black’s Quality Index were used to evaluate the methodological quality of the included studies.
Results. A total of 9 articles (6 studies) involving 372 patients with knee osteoarthritis met the inclusion criteria. The most common yoga protocol is 40~90 minutes/session, lasting for at least 8 weeks. The effect of yoga on pain relief and function improvement could be seen after two-week intervention.
Conclusion. This systematic review showed that yoga might have positive effects in relieving pain and mobility on patients with KOA, but the effects on quality of life (QOL) are unclear. Besides, more outcome measure related to mental health of yoga effects on people with KOA should be conducted.
Source : BMC Complementary and Alternative Medicine
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Yoga for Adult Women with Chronic PTSD: A Long-Term Follow-Up Study
Introduction: Yoga—the integrative practice of physical postures and movement, breath exercises, and mindfulness—may serve as a useful adjunctive component of trauma-focused treatment to build skills in tolerating and modulating physiologic and affective states that have become dysregulated by trauma exposure. A previous randomized controlled study was carried out among 60 women with chronic, treatment-resistant post-traumatic stress disorder (PTSD) and associated mental health problems stemming from prolonged or multiple trauma exposures. After 10 sessions of yoga, participants exhibited statistically significant decreases in PTSD symptom severity and greater likelihood of loss of PTSD diagnosis, significant decreases in engagement in negative tension reduction activities (e.g., self-injury), and greater reductions in dissociative and depressive symptoms when compared with the control (a seminar in women's health). The current study is a long-term follow-up assessment of participants who completed this randomized controlled trial.
Methods: Participants from the randomized controlled trial were invited to participate in long-term follow-up assessments approximately 1.5 years after study completion to assess whether the initial intervention and/or yoga practice after treatment was associated with additional changes. Forty-nine women completed the long-term follow-up interviews. Hierarchical regression analysis was used to examine whether treatment group status in the original study and frequency of yoga practice after the study predicted greater changes in symptoms and PTSD diagnosis.
Results: Group assignment in the original randomized study was not a significant predictor of longer-term outcomes. However, frequency of continuing yoga practice significantly predicted greater decreases in PTSD symptom severity and depression symptom severity, as well as a greater likelihood of a loss of PTSD diagnosis.
Conclusions: Yoga appears to be a useful treatment modality; the greatest long-term benefits are derived from more frequent yoga practice.
Source : The Journal of Alternative and Complementary Medicine
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Treating Depressive Symptoms in Psychosis: A Network Meta-Analysis on the Effects of Non-Verbal Therapies
The aim of this study was to examine whether non-verbal therapies are effective in treating depressive symptoms in psychotic disorders.
Material and Methods
A systematic literature search was performed in PubMed, Psychinfo, Picarta, Embase and ISI Web of Science, up to January 2015. Randomized controlled trials (RCTs) comparing a non-verbal intervention to a control condition in patients with psychotic disorders, whilst measuring depressive symptoms as a primary or secondary outcome, were included. The quality of studies was assessed using the ‘Clinical Trials Assessment Measure for psychological treatments’ (CTAM) scale. Cohen’s d was calculated as a measure of effect size. Using a Network Meta-analysis, both direct and indirect evidence was investigated.
10 RCTs were included, of which three were of high quality according to the CTAM. The direct evidence demonstrated a significant effect on the reduction in depressive symptoms relative to treatment as usual (TAU), in favor of overall non-verbal therapy (ES: -0.66, 95% C.I. = -0.88, -0.44) and music therapy (ES: -0.59, 95% C.I. = -0.85, -0.33). Combining both direct and indirect evidence, yoga therapy (ES: -0.79, 95% C.I. = -1.24, -0.35) had a significant effect on depressive symptoms, and occupational therapy (ES: 1.81, 95% C.I. = 0.81, 2.81) was less effective, relative to TAU. Exercise therapy did not show a significant effect on depressive symptoms in comparison to TAU (ES: -0.02 95% C.I. = -0.67, 0.62). Due to inconsistency of study evidence, the indirect effects should be interpreted cautiously.
Non-verbal therapies appear to be effective in reducing depressive symptomatology in psychotic disorders, in particular music therapy and yoga therapy.
Source : PLOSone
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Yoga to Reduce Trauma-Related Distress and Emotional and Behavioral Difficulties Among Children Living in Orphanages in Haiti: A Pilot Study
Kathryn A. Culver, MSc,1,* Kathryn Whetten, PhD,1,2,3 David L. Boyd, PhD,1 and Karen O'Donnell, PhD2,4,5
1Duke Global Health Institute, Duke University, Durham, NC.
2Center for Health Policy, Duke University, Durham, NC.
3Terry Sanford Institute of Public Policy, Duke University, Durham, NC.
4Departments of Psychiatry and Pediatrics, Duke University Medical Center, Durham, NC.
5Center for Child and Family Health, Duke University, Durham, NC.
Objectives: To measure trauma-related distress and evaluate the feasibility, acceptability, and preliminary efficacy of an 8-week yoga intervention (YI) in reducing trauma-related symptoms and emotional and behavioral difficulties (EBD) among children living in orphanages in Haiti.
Design: Case comparison with random assignment to YI or aerobic dance control (DC) plus a nonrandomized wait-list control (WLC) group.
Setting: Two orphanages for children in Haiti.
Participants: 76 children age 7 to 17 years.
Intervention: The YI included yoga postures, breathing exercises, and meditation. The DC group learned a series of dance routines. The WLC group received services as usual in the institutional setting. After completion of data collection, the WLC group received both yoga and dance classes for 8 weeks.
Outcome measures: The UCLA PTSD Reaction Index and the Strengths and Difficulties Questionnaire were used to indicate trauma-related symptoms and EBD, respectively. A within-subject analysis was conducted to compare pre- and post-treatment scores. A post-treatment yoga experience questionnaire evaluated acceptability of the YI.
Results: Analyses of variance revealed a significant effect (F[2,28]=3.30; p=0.05) of the YI on the trauma-related symptom scores. Regression analyses showed that participation in either 8 weeks of yoga or dance classes suggested a reduction in trauma-related symptoms and EBD, although this finding was not statistically significant (p>0.05). Respondents reported satisfaction with the yoga program and improved well-being.
Conclusions: Children with trauma-related distress showed improvements in symptoms after participation in an 8-week yoga program compared to controls. Yoga is a feasible and acceptable activity with self-reported benefits to child mental and physical health. Additional research is needed to further evaluate the effect of yoga to relieve trauma-related distress and promote well-being among children.
Source : Journal Alternative and Complementary Medicine
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A Yoga Intervention for Posttraumatic Stress: A Preliminary Randomized Control Trial
Farah Jindani,1 Nigel Turner,1 and Sat Bir S. Khalsa2
1Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON, Canada M5S 2S1
2Brigham and Women’s Hospital, Harvard Medical School, 900 Commonwealth Avenue, Boston, MA 02215, USA
Yoga may be effective in the reduction of PTSD symptomology. The purpose of this study was to evaluate the impact of a Kundalini Yoga (KY) treatment on PTSD symptoms and overall wellbeing. To supplement the current field of inquiry, a pilot randomized control trial (RCT) was conducted comparing an 8-session KY intervention with a waitlist control group. 80 individuals with current PTSD symptoms participated. Both groups demonstrated changes in PTSD symptomology but yoga participants showed greater changes in measures of sleep, positive affect, perceived stress, anxiety, stress, and resilience. Between-groups effect sizes were small to moderate (0.09–0.25). KY may be an adjunctive or alternative intervention for PTSD. Findings indicate the need for further yoga research to better understand the mechanism of yoga in relation to mental and physical health, gender and ethnic comparisons, and short- and long-term yoga practice for psychiatric conditions.
Source : eCAM
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Effects of a 12-Week Hatha Yoga Intervention on Cardiorespiratory Endurance, Muscular Strength and Endurance, and Flexibility in Hong Kong Chinese Adults: A Controlled Clinical Trial
Caren Lau, Ruby Yu, and Jean Woo
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Sha Tin, Hong Kong
Objective. To examine the effects of a 12-week Hatha yoga intervention on cardiorespiratory endurance, muscular strength and endurance, and flexibility in Chinese adults. Methods. 173 adults (aged 52.0 ± 7.5 years) were assigned to either the yoga intervention group (n=87) or the waitlist control group (n=86). 19 dropped out from the study. Primary outcomes were changes in cardiorespiratory endurance (resting heart rate (HR) and maximal oxygen uptake (VO2max)), muscular strength and endurance (curl-up and push-up tests), and lower back and hamstring flexibility (the modified back-saver sit-and-reach (MBS) test). Results. Compared to controls, the yoga group achieved significant improvements in VO2max (P<0.01), curl-up (P<0.05) and push-up (P<0.001) tests, and the MBS left and right leg tests (both P<0.001) in both genders. Significant change was also found for resting HR between groups in women (P<0.05) but not in men. Further analysis comparing participants between younger and older subgroups yielded similar findings, except that the older participants in the yoga group failed to improve resting HR or the curl-up test versus control. Adherence (89%) and attendance (94%) were high. No serious adverse events occurred. Conclusion. A 12-week Hatha yoga intervention has favorable effects on cardiorespiratory endurance, muscular strength and endurance, and flexibility in Chinese adults.
Source : Evidence Based Complementary and Alternative Medicine
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Yoga and chronic pain have opposite effects on brain gray matter
Chronic pain is known to cause brain anatomy changes and impairments, but yoga can be an important tool for preventing or even reversing the effects of chronic pain on the brain, according to a National Institutes of Health (NIH) official speaking at the American Pain Society's annual meeting.
M. Catherine Bushnell, PhD, scientific director, Division of Intramural Research, National Center for Complementary and Integrative Health, NIH, explained in a plenary session address that many chronic pain patients show associated anxiety and depression as well as deficits in cognitive functions. In addition, brain imaging studies in rats and humans have shown alterations in gray matter volume and white matter integrity in the brain caused by the effects of chronic pain.
"Imaging studies in multiple types of chronic pain patients show their brains differ from healthy control subjects," said Bushnell. "Studies of people with depression show they also have reduced gray matter, and this could contribute to the gray matter changes in pain patients who are depressed. Our research shows that gray matter loss is directly related to the pain when we take depression into account," said Bushnell.
Gray matter is brain tissue with numerous cell bodies and is located in the cerebral cortex and subcortical areas. The impact of gray matter loss depends on where it occurs in brain. Decreased gray matter can lead to memory impairment, emotional problems and decreased cognitive functioning.
Bushnell said there is compelling evidence from studies conducted at NIH/NCCIH and other sites that mind-body techniques, such as yoga and meditation, can counteract the brain anatomy affects of chronic pain. "Practicing yoga has the opposite effect on the brain as does chronic pain," said Bushnell.
She said the studies show yoga practitioners have more gray matter than controls in multiple brain regions, including those involved in pain modulation. "Some gray matter increases in yogis correspond to duration of yoga practice, which suggests there is a causative link between yoga and gray matter increases," Bushnell noted.
Assessing the impact of brain anatomy on pain reduction, Bushnell said gray matter changes in the insula or internal structures of the cerebral cortex are most significant for pain tolerance. "Insula gray matter size correlates with pain tolerance, and increases in insula gray matter can result from ongoing yoga practice," said Bushnell.
"Brain anatomy changes may contribute to mood disorders and other affective and cognitive comorbidities of chronic pain. The encouraging news for people with chronic pain is mind-body practices seem to exert a protective effect on brain gray matter that counteracts the neuroanatomical effects of chronic pain," Bushnell added.
Source : Science Daily
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The effectiveness of yoga in modifying risk factors for cardiovascular disease and metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials
- 1Department of Health Policy, Harvard University, MA, USA
- 2Center for Health Decision Science, Harvard School of Public Health, MA, USA
- 3Department of Epidemiology, Erasmus MC, the Netherlands
- 4Department of Radiology, Erasmus MC, the Netherlands
- 5Division of General Medicine and Primary Care, Harvard Medical School, MA, USA
- 6Department of Health Policy and Management, Harvard School of Public Health, MA, USA
- MG Myriam Hunink, Departments of Radiology and Epidemiology, Room Na 2818, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, the Netherlands.
Background Yoga, a popular mind-body practice, may produce changes in cardiovascular disease (CVD) and metabolic syndrome risk factors.
Design This was a systematic review and random-effects meta-analysis of randomized controlled trials (RCTs).
Methods Electronic searches of MEDLINE, EMBASE, CINAHL, PsycINFO, and The Cochrane Central Register of Controlled Trials were performed for systematic reviews and RCTs through December 2013. Studies were included if they were English, peer-reviewed, focused on asana-based yoga in adults, and reported relevant outcomes. Two reviewers independently selected articles and assessed quality using Cochrane’s Risk of Bias tool.
Results Out of 1404 records, 37 RCTs were included in the systematic review and 32 in the meta-analysis. Compared to non-exercise controls, yoga showed significant improvement for body mass index (−0.77 kg/m2 (95% confidence interval −1.09 to −0.44)), systolic blood pressure (−5.21 mmHg (−8.01 to −2.42)), low-density lipoprotein cholesterol (−12.14 mg/dl (−21.80 to −2.48)), and high-density lipoprotein cholesterol (3.20 mg/dl (1.86 to 4.54)). Significant changes were seen in body weight (−2.32 kg (−4.33 to −0.37)), diastolic blood pressure (−4.98 mmHg (−7.17 to −2.80)), total cholesterol (−18.48 mg/dl (−29.16 to −7.80)), triglycerides (−25.89 mg/dl (−36.19 to −15.60), and heart rate (−5.27 beats/min (−9.55 to −1.00)), but not fasting blood glucose (−5.91 mg/dl (−16.32 to 4.50)) nor glycosylated hemoglobin (−0.06% Hb (−0.24 to 0.11)). No significant difference was found between yoga and exercise. One study found an impact on smoking abstinence.
Conclusions There is promising evidence of yoga on improving cardio-metabolic health. Findings are limited by small trial sample sizes, heterogeneity, and moderate quality of RCTs.
Source : EU Journal of Preventative Cardiology
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The Effect of a Yoga Intervention on Alcohol and Drug Abuse Risk in Veteran and Civilian Women
with Posttraumatic Stress Disorder
Shivani Reddy, MD,1,2 Alexandra M. Dick, MA, 3 Megan R. Gerber, MD, MPH, 1,2
and Karen Mitchell, PhD 4,5
Individuals with posttraumatic stress disorder (PTSD) often exhibit high-risk substance use behaviors.
Complementary and alternative therapies are increasingly used for mental health disorders, although
evidence is sparse.
Investigate the effect of a yoga intervention on alcohol and drug abuse behaviors in women with
PTSD. Secondary outcomes include changes in PTSD symptom perception and management and initiation of
Materials and Methods:
The current investigation analyzed data from a pilot randomized controlled trial comparing a 12-session
yoga intervention with an assessment control for women age 18 to 65 years with PTSD.
The Alcohol Use Disorder Identification Test (AUDIT) and Drug Use Disorder Identification Test (DUDIT)
were administered at baseline, after the intervention, and a 1-month follow-up. Linear mixed models were used
to test the significance of the change in AUDIT and DUDIT scores over time. Treatment-seeking questions were
compared by using Fisher exact tests.
The mean AUDIT and DUDIT scores decreased in the yoga group; in the control group, mean AUDIT
score increased while mean DUDIT score remained stable. In the linear mixed models, the change in AUDIT
and DUDIT scores over time did not differ significantly by group. Most yoga group participants reported a
reduction in symptoms and improved symptom management. All participants expressed interest in psycho-
therapy for PTSD, although only two participants, both in the yoga group, initiated therapy.
Results from this pilot study suggest that a specialized yoga therapy may play a role in attenuating
the symptoms of PTSD, reducing risk of alcohol and drug use, and promoting interest in evidence-based
psychotherapy. Further research is needed to confirm and evaluate the strength of these effects.
Source : Journal Alternative and Complementary Medicine
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Yoga Relieves Multiple Sclerosis Symptoms, Rutgers Study Finds
Specialized program improved quality of life, decreased pain and fatigue
Paula Meltzer was only 38 when out of nowhere everything she looked at was blurry. For the single mother, who had a lucrative career as a gemologist and spent hours examining valuable pieces of jewelry, it seemed as if – in a split second – her life changed.
At first doctors thought Meltzer had a brain tumor. What they determined after further tests, however, was that she had multiple sclerosis, an autoimmune disease that affects the brain and central nervous system and was causing optic neuritis, an inflammation of the optic nerve that can cause a partial or complete loss of vision.
“I was living independently, doing my job, taking care of my child – and then I had to look to my parents to take care of me,” Meltzer said.
Almost two decades later, Meltzer, out of a wheelchair and walking without a cane, was one of 14 women with moderate disability due to MS who participated in a pilot trial conducted by the Rutgers School of Health Related Professions. A specially-designed yoga program for these MS patients not only improved their physical and mental well-being but also enhanced their overall quality of life.
“I felt like I became steadier and stronger in my core,” Meltzer said. Prior to yoga, she described herself as a “wall walker,” someone who felt safer holding onto the wall in order to get around. “To be able to stand on one leg and feel balanced is amazing.”
Susan Gould Fogerite, director of research for the Institute for Complementary and Alternative Medicine in the School of Health Related Professions, said that although there is widespread evidence that yoga is being used as a form of exercise by those with MS, much of the feedback has been anecdotal and there isn’t much empirical data regarding its safety and efficacy.
This is why she and her colleagues, Evan Cohen and David Kietrys, physical therapists and associate professors in the School of Health Related Professions at Stratford, decided to undertake the small pilot study, believing that a specialized yoga program for MS patients – which incorporates mind, body and spirit – would be beneficial to everyday living.
What they discovered at the end of the eight-week trial was that those who participated were better able to walk for short distances and longer periods of time, had better balance while reaching backwards, fine motor coordination, and were better able to go from sitting to standing. Their quality of life also improved in perceived mental health, concentration, bladder control, walking, and vision, with a decrease in pain and fatigue.
“Yoga is not just exercise, it is a whole system of living,” said Fogerite, an associate professor, who, along with Kietrys, will present the results on September 26 at the Symposium on Yoga Research at the Kripalu Institute in Massachusetts. “The panel of experts who advised us on the trial wanted to make sure that we provided a fully integrated program that included philosophy, breathing practices, postures, relaxation and meditation.”
The yoga pilot trial was held at Still Point Yoga Center in Laurel Springs, a southern New Jersey town close to Philadelphia. Of the 72 individuals who were interested in participating, only 16 were eligible based on medical and other criteria and availability. Of those, 15 were enrolled and 14 completed the program after one person had to withdraw because of an unrelated health problem.
Meltzer and the other women who participated in the trial ranged in age from 34 to 64. Some had been diagnosed with MS within the last two years while others had been living with the illness for up to 26 years. For 90 minutes, twice a week for two months, they practiced techniques and exercises that would improve their posture, help to increase stamina, and teach them how to relax and focus.
“This study, I hope, is one of many that will give us the clinical information we need,” said Fogerite. “Yoga is not currently being widely prescribed for people with MS, although it might turn out to be a very helpful treatment.”
The yoga practices were done by the women in the study sitting, standing, or lying on yoga mats, and using metal folding chairs situated close to the wall to provide them with more support.
“What was so nice about this experience was that although everyone was at a different level of the disease, we felt like we were all together, so I think the camaraderie helped,” said Meltzer. “And it wasn’t just about gaining more mobility and balance in our legs but our arms and necks felt stronger as well.”
Fogerite said a larger randomized controlled trial would be needed to determine whether yoga could be used as a prescribed treatment for individuals with moderate disability due to MS. More than 2.3 million people – two to three times more women than men – throughout the world are diagnosed with this disease which can cause poor coordination, loss of balance, slurred speech, tremors, numbness, extreme fatigue and problems with memory and concentration.
“When I was first diagnosed I no longer felt safe in my own body,” Meltzer said. "I didn’t trust my body at all. What the program did was really bring that trust back.”
Source : University of New Jersey
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Exploring the Benefits of Unilateral Nostril Breathing Practice Post-Stroke: Attention, Language, Spatial Abilities, Depression, and Anxiety
Marshall Rebecca Shisler, Basilakos Alexandra, Williams Tiffany, and Love-MyersKim.
AbstractObjective: Unilateral nostril breathing (UNB) is a yogic pranayama technique that has been shown to improve verbal and spatial cognition in neurologically intact individuals. Early study of UNB in healthy individuals has shown benefits for attention and memory. This preliminary study explored whether UNB influenced various measures of attention, language, spatial abilities, depression, and anxiety in post-stroke individuals, both with and without aphasia.
Design: A within-subjects repeated-measures design was used to determine whether UNB improved cognitive, linguistic, and affect variables in post-stroke individuals. Within-subjects comparisons determined UNB's effects over time, and between-subjects comparison was used to determine whether changes in these variables differed between post-stroke individuals with and without aphasia.
Setting: Athens and Atlanta, Georgia.
Participants: Eleven post-stroke individuals participated in a 10-week UNB program. Five individuals had stroke-induced left hemisphere damage with no diagnosis of aphasia (left hemisphere damage control group; LHD), and six individuals experienced left hemisphere damage with a diagnosis of aphasia (individuals with aphasia group; IWA).
Measures: Individuals were assessed on measures of attention, language, spatial abilities, depression, and anxiety before, during, and after UNB treatment.
Results: UNB significantly decreased levels of anxiety for individuals in both groups. Performance on language measures increased for the individuals with aphasia.
Conclusions: Significant findings for language and affect measures indicate that further investigation regarding duration of UNB treatment and use of UNB treatment alongside traditional speech-language therapy in post-stroke individuals is warranted.
Source : Journal Alternative and Complementary Medicine
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The Effects of Pranayama, Hatha and Raja Yoga on Physical Pain and the Quality of Life of Women with Multiple Sclerosis
Shahla Najafi Doulatabad, Khirollah Nooreyan, Ardavan Najafi Doulatabad, and Zinat Mohebbi Noubandegani
In a clinical trial carried out on 60 women with multiple sclerosis, the researchers obtained data using survey questionnaires. In addition to demographic data, the Multiple Sclerosis Quality of Life-54 (MSQoL-54) instrument was used to determine how multiple sclerosis influences the quality of life of the studied women. Within the frame of this randomized controlled trial, the participants were divided into two equally sized groups (the case and the control group) in which the level of pain and the quality of life were evaluated. The case group exercised pain-managing Yoga methods for three months, keeping the pace of eight 90 minute - sessions per month. The control participants were subjected to no intervention. One month after the Yoga therapy, the level of pain and the quality of life were evaluated in both groups and compared to the baseline data. Data were analyzed using SPSS software and paired t-tests. After the Yoga therapy, the case group showed a significant improvement in physical pain management (P=0.007) and the quality of life (P=0.001) as compared to the control group. The results showed that Yoga techniques can alleviate physical pain and improve the quality of life of multiple sclerosis patients.
Source : Afr J Tradit Complement Altern Med. 2013; 10(1): 49–52.
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Complementary and Alternative Approaches Relieve the Burden of Atrial Fibrillation
By Mark L. Fuerst
Newer nonpharmacologic treatment options for atrial fibrillation (AF), including advances in radiofrequency catheter ablation and AF surgery, have led to substantial improvements in the treatment of the disease. However, AF can still cause disabling and bothersome symptoms that adversely affect a patient’s quality of life. One way to help manage the disease and improve quality of life may be to add adjunctive complementary and alternative therapies, such as yoga, meditation, acupuncture, therapeutic hypnosis, or tai chi into routine care.
Evidence that yoga may be beneficial comes from a recent small cohort study showing that the regular practice of yoga improves symptoms, arrhythmia burden, heart rate, blood pressure, anxiety and depression scores, and several domains of quality of life among patients with paroxysmal AF.1 Three months of yoga training reduced both symptomatic and asymptomatic AF episodes and improved quality-of-life parameters, including physical functioning, general health, vitality, social functioning, and mental health. This is not the first study to test the effects of yoga in the management of cardiovascular disease, but it is the first one to evaluate the role of yoga in AF.
The authors propose several possible physiologic explanations for their findings: an increase in parasympathetic tone; enhanced balance between the 2 autonomic nervous system components; reduced systemic inflammation and oxidative stress; and decreased progression of arrhythmia by preventing or attenuating atrial remodeling. They also suggest patients benefit from the emotionally supportive atmosphere at yoga centers and the caring relationships formed there, as well as changes in diet and lifestyle modification often associated with yoga practice.
Previous research has evaluated other noninvasive strategies, such as meditation, which has been associated with a significant reduction in the risk of all-cause mortality, myocardial infarction, or stroke in patients with documented coronary heart disease.2
Acupuncture has proven to be effective in decreasing AF recurrences after electrical cardioversion in persistent AF and also in reducing the burden of AF among patients with paroxysmal AF.3 In addition, therapeutic hypnosis can lead to a statistically significant lower incidence of AF after coronary artery bypass graft surgery.4
Many patients with AF also suffer from chronic heart failure. Researchers have shown that patients who completed 12 weeks of tai chi training demonstrated a significantly improved heart failure-related quality of life, greater exercise tolerance (walked farther on a 6-minute test), and had greater decreases in blood levels of B-type natriuretic protein when compared to a usual-care group.5 In a larger follow-up study, the investigators found tai chi led to clinically significant improvements in quality of life.
These researchers believe that tai chi is a safe, adaptable form of aerobic exercise, can reduce stress and improve psychological well-being, improves breathing efficiency, may improve the confidence to exercise and motivate healthy behavior, and is associated with higher levels of social support.5 Importantly, about 90% of the participants in the heart failure and tai chi studies regularly came to the classes and practiced tai chi at home as well, which suggests that tai chi can be safely incorporated into regular activities, even for patients with chronic heart disease.Other studies support including tai chi in the treatment of heart failure patients. A randomized controlled trial demonstrated that adding tai chi to endurance training for heart failure patients resulted in greater improvements in exercise tolerance (as assessed by the 6-minute walk test), systolic blood pressure, quality of life, and lower extremity strength, as compared to the control group.6
Although larger randomized controlled trials are needed to establish the relationship between adjunctive complementary and alternative therapies and AF, the current evidence suggests that these types of nonpharmacologic treatments may be safely incorporated into comprehensive management strategies for AF.
- Lakkireddy D, Atkins D, Pillarisetti J, et al. Effect of yoga on arrhythmia burden, anxiety, depression, and quality of life in paroxysmal atrial fibrillation: The YOGA My Heart Study. J Am Coll Cardiol. 2013 Jan 25. [Epub ahead of print]
- Schneider RH, Grim CE, Rainforth MV, et al. Stress reduction in the secondary prevention of cardiovascular disease: randomized, controlled trial of transcendental meditation and health education in blacks. Circ Cardiovasc Qual Outcomes. 2012;5:750-758.
- Lombardi F, Belletti S, Battezzati PM, et al. Acupuncture for paroxysmal and persistent atrial fibrillation: an effective non-pharmacological tool? World J Cardiol. 2012;4:60-65.
- Novoa R, Hammonds T. Clinical hypnosis for reduction of atrial fibrillation after coronary artery bypass graft surgery. Cleve Clin J Med. 2008;75(suppl 2):S44-S47.
- Yeh GY, Wood MJ, Lorell BH, et al. Effects of tai chi mind-body movement therapy on functional status and exercise capacity in patients with chronic heart failure: a randomized controlled trial. Am J Med. 2004;117:541-548.
- Caminiti G, Volterrani M, Marazzi G, et al. Tai chi enhances the effects of endurance training in the rehabilitation of elderly patients with chronic heart failure. Rehabil Res Pract. 2011;2011:761958
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Exercise During Pregnancy Gives Newborn Brain Development a Head Start
As little as 20 minutes of moderate exercise three times per week during pregnancy enhances the newborn child’s brain development, according to researchers at the University of Montreal and its affiliated CHU Sainte-Justine children’s hospital. This head-start could have an impact on the child's entire life. “Our research indicates that exercise during pregnancy enhances the newborn child’s brain development,” explained Professor Dave Ellemberg, who led the study. “While animal studies have shown similar results, this is the first randomized controlled trial in humans to objectively measure the impact of exercise during pregnancy directly on the newborn’s brain. We hope these results will guide public health interventions and research on brain plasticity. Most of all, we are optimistic that this will encourage women to change their health habits, given that the simple act of exercising during pregnancy could make a difference for their child’s future.” Ellemberg and his colleagues Professor Daniel Curnier and PhD candidate Élise Labonté-LeMoyne presented their findings today at the Neuroscience 2013 congress in San Diego.
Not so long ago, obstetricians would tell women to take it easy and rest during their pregnancy. Recently, the tides have turned and it is now commonly accepted that inactivity is actually a health concern. “While being sedentary increases the risks of suffering complications during pregnancy, being active can ease post-partum recovery, make pregnancy more comfortable and reduce the risk of obesity in the children,” Curier explained. “Given that exercise has been demonstrated to be beneficial for the adult’s brain, we hypothesized that it could also be beneficial for the unborn child through the mother's actions.”
To verify this, starting at the beginning of their second trimester, women were randomly assigned to an exercise group or a sedentary group. Women in the exercise group had to perform at least 20 minutes of cardiovascular exercise three times per week at a moderate intensity, which should lead to at least a slight shortness of breath. Women in the sedentary group did not exercise. The brain activity of the newborns was assessed between the ages of 8 to 12 days, by means of electroencephalography, which enables the recording of the electrical activity of the brain. “We used 124 soft electrodes placed on the infant's head and waited for the child to fall asleep on his or her mother's lap. We then measured auditory memory by means of the brain’s unconscious response to repeated and novel sounds,” Labonté-LeMoyne said. “Our results show that the babies born from the mothers who were physically active have a more mature cerebral activation, suggesting that their brains developed more rapidly.”
The researchers are now in the process of evaluating the children’s cognitive, motor and language development at age 1 to verify if these differences are maintained.
Source : Newswise
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A 20-Minute Bout of Yoga Stimulates Brain Function Immediately After
Researchers report that a single, 20-minute session of Hatha yoga significantly improved participants' speed and accuracy on tests of working memory and inhibitory control, two measures of brain function associated with the ability to maintain focus and take in, retain and use new information. Participants performed significantly better immediately after the yoga practice than after moderate to vigorous aerobic exercise for the same amount of time.
The 30 study subjects were young, female, undergraduate students. The new findings appear in the Journal of Physical Activity and Health.
"Yoga is an ancient Indian science and way of life that includes not only physical movements and postures but also regulated breathing and meditation," said Neha Gothe, who led the study while a graduate student at the University of Illinois at Urbana-Champaign. Gothe now is a professor of kinesiology, health and sport studies at Wayne State University in Detroit. "The practice involves an active attentional or mindfulness component but its potential benefits have not been thoroughly explored."
"Yoga is becoming an increasingly popular form of exercise in the U.S. and it is imperative to systematically examine its health benefits, especially the mental health benefits that this unique mind-body form of activity may offer," said Illinois kinesiology and community health professor Edward McAuley, who directs the Exercise Psychology Laboratory where the study was conducted.
The yoga intervention involved a 20-minute progression of seated, standing and supine yoga postures that included isometric contraction and relaxation of different muscle groups and regulated breathing. The session concluded with a meditative posture and deep breathing.
Participants also completed an aerobic exercise session where they walked or jogged on a treadmill for 20 minutes. Each subject worked out at a suitable speed and incline of the treadmill, with the goal of maintaining 60 to 70 percent of her maximum heart rate throughout the exercise session.
"This range was chosen to replicate previous findings that have shown improved cognitive performance in response to this intensity," the researchers reported.
Gothe and her colleagues were surprised to see that participants showed more improvement in their reaction times and accuracy on cognitive tasks after yoga practice than after the aerobic exercise session, which showed no significant improvements on the working memory and inhibitory control scores.
"It appears that following yoga practice, the participants were better able to focus their mental resources, process information quickly, more accurately and also learn, hold and update pieces of information more effectively than after performing an aerobic exercise bout," Gothe said. "The breathing and meditative exercises aim at calming the mind and body and keeping distracting thoughts away while you focus on your body, posture or breath. Maybe these processes translate beyond yoga practice when you try to perform mental tasks or day-to-day activities."
Many factors could explain the results, Gothe said. "Enhanced self-awareness that comes with meditational exercises is just one of the possible mechanisms. Besides, meditation and breathing exercises are known to reduce anxiety and stress, which in turn can improve scores on some cognitive tests," she said.
"We only examined the effects of a 20-minute bout of yoga and aerobic exercise in this study among female undergraduates," McAuley said. "However, this study is extremely timely and the results will enable yoga researchers to power and design their interventions in the future. We see similar promising findings among older adults as well. Yoga research is in its nascent stages and with its increasing popularity across the globe, researchers need to adopt rigorous systematic approaches to examine not only its cognitive but also physical health benefits across the lifespan."
Source : Science Daily
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The Effects of Regular Yoga Practice on Pulmonary Function in Healthy Individuals: A Literature Review
Allison N. Abel, BEd, Lisa K. Lloyd, PhD, and James S. Williams, PhD
Department of Health and Human Performance, Texas State University–San Marcos, San Marcos, TX.
Objectives: Yoga is a popular form of exercise in the Western world, and yoga's effects on pulmonary function have been investigated previously. The purpose of this article is to review this research systematically and determine if regular yoga training improves pulmonary function in apparently healthy individuals.
Methods: Using the Alternative Health Watch, the Physical Education Index, Medline,® and the SPORTdiscus databases; and the keywords yoga, respiration, and pulmonary function, a comprehensive search was conducted that yielded 57 studies. Of these studies selections were made to include only experimental studies written in English, published in peer-reviewed journals after 1980, and investigating the effects of regular yoga practice on pulmonary function in healthy individuals participating in the studies.
Results: Yoga improved pulmonary function, as measured by maximum inspiratory pressure, maximum expiratory pressure, maximum voluntary ventilation, forced vital capacity, forced expiratory volume in 1 second, and peak expiratory flow rate, in all (N=9), but 1, study.
Conclusions: Overall, pulmonary function appears to improve with a minimum of 10 weeks of regular yoga practice, and the magnitude of this improvement is related to fitness level and/or the length of time the subjects spend practicing pranayama (i.e., breathing exercises). In other words, greater improvements in pulmonary function are more likely to be seen in less-fit individuals and/or those that engage in longer periods of pranayama. Additional studies examining various yoga practices are warranted to gain a more comprehensive understanding of the effects of yoga techniques on pulmonary functions.
Source : the Journal of Alternative and Complementary Medicine
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Yoga May Calm Afib
Patients with paroxysmal atrial fibrillation may see some relief from doing yoga, a small, proof-of-concept study suggested.
After 3 months of yoga training, patients had fewer symptoms and less atrial fibrillation measured on cardiac nonlooping event monitors compared with a pre-training control period, according to Dhanunjaya Lakkireddy, MD, of the University of Kansas Cardiovascular Research Institute in Kansas City, and colleagues.
Yoga was also associated with a continuation of declines in heart rate and both systolic and diastolic blood pressure observed during the control phase (P<0.001 for all), the researchers reported online in the Journal of the American College of Cardiology.
"These findings underscore the therapeutic value of a low-cost non-invasive therapy such as yoga to effectively complement the conventional treatment strategies in improving atrial fibrillation patient care," they wrote. "Given the high prevalence of [the condition] and costs of conventional therapy, the public health relevance of these findings is very pertinent."
Although yoga has been shown to have some beneficial effects on cardiovascular health, it had not been studied in patients with atrial fibrillation.
The Yoga My Heart Study was a single-center, before-and-after study of 49 patients with symptomatic paroxysmal atrial fibrillation. An initial 3-month observation period during which yoga was not performed was followed by 3 months of yoga training, which took place in 60-minute sessions twice a week. The participants were given educational DVDs and encouraged to practice at home.
The average age of the patients was 61, and atrial fibrillation had lasted an average of 5.3 years at baseline.
From the observation period to the end of the yoga period, there were reductions in events associated with both self-reported symptoms and findings of atrial fibrillation on the event monitors (average 2.1 versus 3.8), events associated with symptoms but no findings on the monitors (1.4 versus 2.9), and events associated with findings on the monitor but no symptoms (0.04 versus 0.12). All differences were statistically significant at P<0.001.
Eleven patients (22% of the cohort) had an atrial fibrillation episode during the control phase but not during the yoga phase.
In general, quality of life, depression, and anxiety did not change during the control phase, but all showed significant improvements following the yoga phase. Specifically, there were significant gains in the quality-of-life domains of physical functioning, general health, vitality, social functioning, and mental health (P<0.02 for all).
There were no major adverse effects of complications associated with yoga therapy.
The mechanisms underlying the apparent benefits of yoga therapy remain unclear, according to Lakkireddy and colleagues, who provided some possible explanations.
"Yoga may prevent the atrial fibrillation initiation and perpetuation through its pleiotropic effects such as: increasing the baseline parasympathetic tone, suppressing extreme fluctuations in the two autonomic nervous system components, and decreasing the progression of the arrhythmia by preventing or minimizing atrial remodeling," they wrote.
The improvement in quality of life, anxiety, and depression "is likely explained by yoga-related attenuation of neurohormonal response to triggers of stress," they added.
However, they wrote, "the benefit from the emotionally supportive atmosphere at yoga training centers, and the positive impact by the caring relationships, change in diet, and lifestyle modification associated with yoga practice on physiological parameters cannot be underestimated."
The researchers acknowledged some limitations of the study, including the lack of information on variations in autonomic tone, systemic inflammatory markers, and endothelial function, the possibility that atrial fibrillation episodes were underestimated because of the low sampling rates of the event recorders, and the inability to determine whether the initiation of atrial fibrillation episodes was vagally mediated.
Source : MedPage Today
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Yoga Reduces Depression in Pregnant Women, Boosts Maternal Bonding
University of Michigan study the first to show evidence that mindfulness yoga may offer effective treatment for depressed new mothers to be. Prenatal yoga may help women cope with depression.
It's no secret that pregnancy hormones can dampen moods, but for some expectant moms, it's much worse: 1 in 5 experience major depression.
Now, new research shows that an age-old recommended stress-buster may actually work for this group of women: yoga.
Pregnant women who were identified as psychiatrically high risk and who participated in a 10-week mindfulness yoga intervention saw significant reductions in depressive symptoms, according to a University of Michigan Health System pilot feasibility study. Mothers-to-be also reported stronger attachment to their babies in the womb.
The findings were published in Complementary Therapies in Clinical Practice.
"We hear about pregnant women trying yoga to reduce stress but there's no data on how effective this method is," says lead author Maria Muzik, M.D., M.S., assistant professor of psychiatry and assistant research scientist at the Center for Human Growth and Development. "Our work provides promising first evidence that mindfulness yoga may be an effective alternative to pharmaceutical treatment for pregnant women showing signs of depression.
"This promotes both mother and baby wellbeing."
Mental health disorders during pregnancy, including depression and anxiety, have become a serious health concern. Hormonal changes, genetic predisposition and social factors set the stage for some expectant moms to experience persistent irritability, feelings of being overwhelmed and inability to cope with stress.
Untreated, these symptoms bear major health risks for both the mom and baby, including poor weight gain, preeclampsia, premature labor and trouble bonding with the new baby.
While antidepressants have proven to effectively treat these mood disorders, Muzik says, previous studies show that many pregnant women are reluctant to take these drugs out of concern for their infant's safety.
"Unfortunately, few women suffering from perinatal health disorders receive treatment, exposing them and their child to the negative impact of psychiatric illness during one of the most vulnerable times," Muzik says. "That's why developing feasible alternatives for treatment is critical."
Evidence suggests women are more comfortable with nontraditional treatments, including herbal medicine, relaxation techniques and mind-body work.
Yoga continues to grow in popularity but in the United States, many classes concentrate on yoga as "exercise," omitting the practice of being fully present in the moment and aware, authors say.
Meanwhile, mindfulness yoga -- which combines meditative focus with physical poses -- has proven to be a powerful method to fight stress and boost energy.
For the U-M research study, women who showed signs of depression and who were between 12-26 weeks pregnant participated in 90-minute mindfulness yoga sessions that focused on poses for the pregnant body, as well as support in the awareness of how their bodies were changing to help their babies grow.
Funding for follow up work on this subject was recently provided by a grant from the Institute for Research on Women and Gender.
"Research on the impact of mindfulness yoga on pregnant women is limited but encouraging," Muzik says. "This study builds the foundation for further research on how yoga may lead to an empowered and positive feeling toward pregnancy."
Source : Science Daily
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Siginificant Benefits of Yoga in People With Rheumatoid Arthritis, Study Shows
Individuals with rheumatoid arthritis who practice yoga showed statistically significant improvements in disease activity, according to a small study presented at the EULAR 2011 Annual Congress.
The results of the study conducted in the United Arab Emirates (UAE) among 47 patients (26 yoga patients and 21 controls) demonstrate that patients who completed 12 sessions of Raj yoga which is one of the gentler styles of yoga, combining exercise and breathing techniques showed significant improvements in disease activity scores (DAS28) of p=0.021 and health assessment questionnaire's (HAQ†) of p=0.0015. However there was no statistically significant improvement on the quality of life scale (QoL).
"Most patients with RA do not exercise regularly despite the fact that those who do report less pain and are therefore more physically active," said Dr Humeira Badsha MD Rheumatologist and founder of the Emirates Arthritis Foundation, Dubai, UAE. "While our study has been conducted in a small group of patients the results show clear benefits for patients who regularly practice Raj yoga. We believe that practicing yoga longer term could in fact result in further significant improvements and hope our study drives further research into the benefits of yoga in RA."
Patients were recruited by email through the Emirates Arthritis Foundation RA database (mean age of yoga group 44 years, mean age of control group 46.2 years, 80% female). Demographic data, disease activity indices, health assessment questionnaire (HAQ) and SF-36 (a standard patient survey commonly used to calculate patient quality of life) were documented at enrolment and after completion of 12 sessions of yoga.
Results of a separate study show the positive effects of yoga on the quality of life in patients with Fibromyalgia, a long-term condition which causes extreme pain all over the body.
Results of one further study investigating the effects of yoga on the QoL of patients with fibromyalgia, demonstrated that QoL scores, after an eight session classical yoga program which combines gentle yoga postures, breathing techniques and meditation, were better than scores obtained before the program (p<0.05) along with a significant decrease in the anxiety levels of patients (p<0.05). As anxiety is often a key symptom in patients with this condition, this study represents a positive step in improving the lives of people suffering from fibrolmyalgia.
Source : Science Daily
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Yoga May Help Stroke Survivors Improve Balance
Group yoga can improve balance in stroke survivors who no longer receive rehabilitative care, according to new research in the American Heart Association journal Stroke.
In a small pilot study, researchers tested the potential benefits of yoga among chronic stroke survivors -- those whose stroke occurred more than six months earlier.
"For people with chronic stroke, something like yoga in a group environment is cost effective and appears to improve motor function and balance," said Arlene Schmid, Ph.D., O.T.R., lead researcher and a rehabilitation research scientist at Roudebush Veterans Administration-Medical Center and Indiana University, Department of Occupational Therapy in Indianapolis, Ind.
The study's 47 participants, about three-quarters of them male veterans, were divided into three groups: twice-weekly group yoga for eight weeks; a "yoga-plus" group, which met twice weekly and had a relaxation recording to use at least three times a week; and a usual medical care group that did no rehabilitation.
The yoga classes, taught by a registered yoga therapist, included modified yoga postures, relaxation, and meditation. Classes grew more challenging each week.
Compared with patients in the usual-care group, those who completed yoga or yoga-plus significantly improved their balance.
Balance problems frequently last long after a person suffers a stroke, and are related to greater disability and a higher risk of falls, researchers said.
Furthermore, survivors in the yoga groups had improved scores for independence and quality of life and were less afraid of falling.
"For chronic stroke patients, even if they remain disabled, natural recovery and acute rehabilitation therapy typically ends after six months, or maybe a year," said Schmid, who is also an assistant professor of occupational therapy at Indiana University-Purdue University in Indianapolis and an investigator at the Regenstrief Institute.
Improvements after the six-month window can take longer to occur, she said, "but we know for a fact that the brain still can change. The problem is the healthcare system is not necessarily willing to pay for that change. The study demonstrated that with some assistance, even chronic stroke patients with significant paralysis on one side can manage to do modified yoga poses."
The oldest patient in the study was in his 90s. All participants had to be able to stand on their own at the study's outset.
Yoga may be more therapeutic than traditional exercise because the combination of postures, breathing and meditation may produce different effects than simple exercise, researchers said.
"However, stroke patients looking for such help might have a hard time finding qualified yoga therapists to work with," Schmid said. "Some occupational and physical therapists are integrating yoga into their practice, even though there's scant evidence at this point to support its effectiveness."
Researchers can draw only limited conclusions from the study because of its small number of participants and lack of diversity. The study also didn't have enough participants to uncover differences between the yoga and control groups. The scientists hope to conduct a larger study soon.
Researchers also noticed improvements in the mindset of patients about their disability. The participants talked about walking through a grocery store instead of using an assistive scooter, being able to take a shower and feeling inspired to visit friends.
"It has to do with the confidence of being more mobile," Schmid said. Although they took time to unfold, "these were very meaningful changes in life for people."
Source : Science Daily
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Yoga Reduces Stress; Now It’s Known Why
Six months ago, researchers at UCLA published a study that showed using a specific type of yoga to engage in a brief, simple daily meditation reduced the stress levels of people who care for those stricken by Alzheimer’s and dementia. Now they know why. As previously reported, practicing a certain form of chanting yogic meditation for just 12 minutes daily for eight weeks led to a reduction in the biological mechanisms responsible for an increase in the immune system’s inflammation response. Inflammation, if constantly activated, can contribute to a multitude of chronic health problems.
Reporting in the current online edition of the journal Psychoneuroendocrinology, Dr. Helen Lavretsky, senior author and a professor of psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior, and colleagues found in their work with 45 family dementia caregivers that 68 of their genes responded differently after Kirtan Kriya Meditation (KKM), resulting in reduced inflammation.
Caregivers are the unsung heroes for their yeoman’s work in taking care of loved ones that have been stricken with Alzheimer’s and other forms of dementia, said Lavretsky, who also directs UCLA’s Late-Life Depression, Stress and Wellness Research Program. But caring for a frail or demented family member can be a significant life stressor. Older adult caregivers report higher levels of stress and depression and lower levels of satisfaction, vigor and life in general. Moreover, caregivers show higher levels of the biological markers of inflammation. Family members in particular are often considered to be at risk of stress-related disease and general health decline.
As the U.S. population continues to age over the next two decades, Lavretsky noted, the prevalence of dementia and the number of family caregivers who provide support to these loved ones will increase dramatically. Currently, at least five million Americans provide care for someone with dementia.
"We know that chronic stress places caregivers at a higher risk for developing depression," she said "On average, the incidence and prevalence of clinical depression in family dementia caregivers approaches 50 percent. Caregivers are also twice as likely to report high levels of emotional distress." What's more, many caregivers tend to be older themselves, leading to what Lavretsky calls an "impaired resilience" to stress and an increased rate of cardiovascular disease and mortality.
Research has suggested for some time that psychosocial interventions like meditation reduce the adverse effects of caregiver stress on physical and mental health. However, the pathways by which such psychosocial interventions impact biological processes are poorly understood.
In the study, the participants were randomized into two groups. The meditation group was taught the 12-minute yogic practice that included Kirtan Kriya, which was performed every day at the same time for eight weeks. The other group was asked to relax in a quiet place with their eyes closed while listening to instrumental music on a relaxation CD, also for 12 minutes daily for eight weeks. Blood samples were taken at the beginning of the study and again at the end of the eight weeks.
"The goal of the study was to determine if meditation might alter the activity of inflammatory and antiviral proteins that shape immune cell gene expression," said Lavretsky. "Our analysis showed a reduced activity of those proteins linked directly to increased inflammation.
"This is encouraging news. Caregivers often don’t have the time, energy, or contacts that could bring them a little relief from the stress of taking care of a loved one with dementia, so practicing a brief form of yogic meditation, which is easy to learn, is a useful too."
Source : Newswise
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Effects of Yoga Versus Walking on Mood, Anxiety, and Brain GABA Levels: A Randomized Controlled MRS Study
Chris C. Streeter, MD,1 Theodore H. Whitfield, ScD,2 Liz Owen, BArch,3 Tasha Rein, BA,1 Surya K. Karri, MD, MPH,4 Aleksandra Yakhkind, MS,5 Ruth Perlmutter, MA,6 Andrew Prescot, PhD,7 Perry F. Renshaw, MD, PhD,8 Domenic A. Ciraulo, MD,1 and J. Eric Jensen, PhD9
1Division of Psychiatry, Boston University School of Medicine, Boston, MA.
2Division of Actuarial Science, Boston University, Boston, MA.
3Liz Owen Yoga, Arlington, MA.
4Department of Neurosurgery, Harvard University, Boston, MA.
5Medicine/Hematology-Oncology, Children's Hospital Boston, Boston, MA.
6School of Medicine, University of Massachusetts, Boston, MA.
7Department of Radiology, University of Utah, Salt Lake City, UT.
8Department of Psychiatry, University of Utah, Salt Lake City, UT.
9Department of Psychiatry, Harvard University, Belmont, MA.
Objectives: Yoga and exercise have beneficial effects on mood and anxiety. γ-Aminobutyric acid (GABA)-ergic activity is reduced in mood and anxiety disorders. The practice of yoga postures is associated with increased brain GABA levels. This study addresses the question of whether changes in mood, anxiety, and GABA levels are specific to yoga or related to physical activity.
Methods: Healthy subjects with no significant medical/psychiatric disorders were randomized to yoga or a metabolically matched walking intervention for 60 minutes 3 times a week for 12 weeks. Mood and anxiety scales were taken at weeks 0, 4, 8, 12, and before each magnetic resonance spectroscopy scan. Scan 1 was at baseline. Scan 2, obtained after the 12-week intervention, was followed by a 60-minute yoga or walking intervention, which was immediately followed by Scan 3.
Results: The yoga subjects (n = 19) reported greater improvement in mood and greater decreases in anxiety than the walking group (n = 15). There were positive correlations between improved mood and decreased anxiety and thalamic GABA levels. The yoga group had positive correlations between changes in mood scales and changes in GABA levels.
Conclusions: The 12-week yoga intervention was associated with greater improvements in mood and anxiety than a metabolically matched walking exercise. This is the first study to demonstrate that increased thalamic GABA levels are associated with improved mood and decreased anxiety. It is also the first time that a behavioral intervention (i.e., yoga postures) has been associated with a positive correlation between acute increases in thalamic GABA levels and improvements in mood and anxiety scales. Given that pharmacologic agents that increase the activity of the GABA system are prescribed to improve mood and decrease anxiety, the reported correlations are in the expected direction. The possible role of GABA in mediating the beneficial effects of yoga on mood and anxiety warrants further study.
Source : The Journal of Complementary and Alternative Medicine
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Acupuncture Appears Linked With Improvement in Patients With Chronic Obstructive Pulmonary Disease
According to a small clinical trial reported by investigators from Japan, acupuncture appears to be associated with improvement of dyspnea (labored breathing) on exertion, in patients with chronic obstructive pulmonary disease (COPD), according to a study published Online First by Archives of Internal Medicine, a JAMA Network publication.
he management of dyspnea is an important target in the treatment of COPD, a common respiratory disease characterized by irreversible airflow limitation. COPD is predicted to be the third leading cause of death worldwide by 2020, according to the study background. Masao Suzuki, L.Ac., Ph.D., of Kyoto University and Meiji University of Integrative Medicine, Kyoto, Japan, and colleagues conducted a randomized controlled trial from July 2006 through March 2009. A total of 68 patients diagnosed with COPD participated, and 34 were assigned to a real acupuncture group for 12 weeks, plus daily medication. The other 34 were assigned to a placebo acupuncture group in which the needles were blunt (and appeared to, but did not enter the skin). The primary measure was the evaluation of a six-minute walk test on a Borg scale where 0 meant "breathing very well, barely breathless" and 10 signified "severely breathless."
"We demonstrated clinically relevant improvements in DOE [dyspnea on exertion] (Borg scale), nutrition status (including BMI), airflow obstruction, exercise capacity and health-related quality of life after three months of acupuncture treatment," the authors note.
After 12 weeks of treatment, the Borg scale score after the six-minute walk test improved from 5.5 to 1.9 in the real acupuncture group. No improvement was seen in the Borg scale score in the placebo acupuncture group before and after treatment (4.2 and 4.6, respectively), according to the study results.
"Randomized trials with larger sample sizes and longer-term interventions with follow-up evaluations are necessary to confirm the usefulness of acupuncture in COPD treatment," the authors conclude.
Invited Commentary: Reevaluating Acupuncture Research Methods
In an invited commentary, George T. Lewith, M.A., M.D., F.R.C.P., M.R.C.G.P, and Mike Thomas, Ph.D., F.R.C.P., of the University of Southampton, Hampshire, England, write: "Where does this study lead us? The authors note that acupuncture must be used in addition to conventional care, and although this is undoubtedly correct, it may have significant economic implications."
They continue: "Evaluating traditional interventions, such as acupuncture, that are widely available has many implications, including the fact that best practice and dose response have rarely been evaluated scientifically as would be the case for a new pharmaceutical agent."
"This study points to an important potential role for acupuncture in COPD management. These findings demand larger but equally methodologically rigorous confirmatory studies if we are to consider integrating this approach into our management strategy," they conclude.
Source : Science Daily
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Yoga for Persistent Fatigue in Breast Cancer Survivors: Results of a Pilot Study
Julienne E. Bower,1,2,3,4 Deborah Garet,3 and Beth Sternlieb5
1Department of Psychology, UCLA, Los Angeles, CA 90095, USA
2Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, UCLA, Los Angeles, CA 90095, USA
3Cousins Center for Psychoneuroimmunology, Semel Institute, UCLA, Los Angeles, CA 90095, USA
4Division of Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA 90095, USA
5Pediatric Pain Program, Mattel Children's Hospital, UCLA, Los Angeles, CA 90095, USA
Approximately one-third of breast cancer survivors experiences persistent fatigue for months or years after successful treatment completion. There is a lack of evidence-based treatments for cancer-related fatigue, particularly among cancer survivors. This single-arm pilot study evaluated the feasibility and preliminary efficacy of a yoga intervention for fatigued breast cancer survivors based on the Iyengar tradition. Iyengar yoga prescribes specific poses for individuals with specific medical problems and conditions; this trial emphasized postures believed to be effective for reducing fatigue among breast cancer survivors, including inversions and backbends performed with the support of props. Twelve women were enrolled in the trial, and 11 completed the full 12-week course of treatment. There was a significant improvement in fatigue scores from pre- to post-intervention that was maintained at the 3-month post-intervention followup. Significant improvements were also observed in measures of physical function, depressed mood, and quality of life. These results support the acceptability of this intervention and suggest that it may have beneficial effects on persistent post-treatment fatigue. However, results require replication in a larger randomized controlled trial.
Source Evidence-Based Complementary and Alternative Medicine Volume 2011 (2011), Article ID 623168, 8 pages
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