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OPEN MIND OPEN BODY Yoga Research |
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Summary and Interpretation of the Latest Published Research on Yoga and Health
Research shows that yoga interventions (particularly those that include not just postures, but also meditation, relaxation, breathing practices, and a yogic diet) can benefit a wide range of emotional and physical illnesses.
Each month, I post a summary of the latest peer-reviewed and published research on yoga and health. This page archives those summaries.
April
2006 Summaries
March 2006 Summaries
Yoga and pranayama help overweight teens lose weight. February 2006 Summaries
Physiological Responses to Iyengar Yoga Performed by Trained Practitioners. Author:
Blank, S.E.
This study measured the physiological responses of 15 female intermediate/advanced level Iyengar yoga practitioners (mean age 43.5 ± 6.9 yr), during an active Iyengar asana practice. In particular, the report focuses on cardiovascular and respiratory responses. During the 90 minute practice, practitioners expended an average of 149.4 ± 50.7 Kcal, which is equivalent to very mild exercise (walking might expend 300 Kcal, in comparison), and the practice did not meet the standards for sustained cardiovascular exercise. Backbends had the greatest cardiovascular response, compared to standing poses, inversions, and seated or supine poses. Interestingly, misalignment in poses influenced blood pressure responses in the pose. For example, misalignment in the warrior poses was associated with greater systolic blood pressure in the poses. Anyone interested in this data should access the full article online, as it includes a detailed list of asanas (including photos) and full statistics for every pose.
Authors:
Prasad, K.VV., Sunita, M., Raju, P.S., Reddy, M.V., Sahay, B.K., &
Murthy, K.J.Y.
Participants: 41 men and 23 women (ages 18-30 years) participating in a three months yoga certificate course at the Vemana Yoga Research Institute in Hyderabad, India. All volunteers were healthy, with no previous yoga experience. Yoga Instruction: For 30 days, the following pranayama sequence was practiced: Rechaka Puraka, Rechaka Puraka with Kumbhaka, Suryabedha Chandrabedha, Suryabedha Chandrabedha with Kumbhaka, and Kapalabhati, for 10 min each. Savasana was practiced for another 10 min at the end of the pranayama session. After 30 days, the pranayama practice was reduced to 20 min, and the following asanas were practiced for 40 min: Uttanasana, Mandukasana, Ustrasana, Yogamudra, Matsyendrasana, Paschimottanasana, Bhujangasana, Sarvangasana, Halasana, Uddiyana, Ardhamatsyendrasna, Dhanurasana, Shalabhasana, Sarpasana and Chakrasana. This combined pranayama and asana practice was continued for 60 days. Results: Women and men showed different metabolic responses to the pranayama and asana practices. However, in general, the responses of both women and men were positive (improvements/reductions in risk factors for metabolic and cardiovascular diseases). Men showed reduced levels of serum triglycerides and VLDL-cholesterol at the end of the first 30 days (pranayama practice only), and increased levels of HDL-cholesterol (the "good" cholesterol) and free fatty acids at the end of both the first 30 days (pranayama practice only) and at the end of the 3-month session. There was no change in LDL-cholesterol. Women showed reduced levels of serum free fatty acids at the end of both the first 30 days (pranayama only) and the 3-month session, and also showed reduced levels of total cholesterol, triglycerides, LDL-cholesterol and VLDL- cholesterol by the end of the 3-month session. There were no changes in HDL-cholesterol.
Authors:
Moolasarn, S., Sripa, S., Kuessirikiet, V., Sutawee, K., Huasary, J.,
Chaisila, C., Chechom, N., & Sankan, S. This randomized, controlled trial compared the benefits of six months of yoga, walking, and a wait-list control for 118 generally healthy seniors (65-85 years). The yoga and walking conditions included both group classes and a recommendation of home practice. Neither yoga nor walking improved cognitive function (including a an EEG measure of alertness). Participants in the yoga condition showed improvements in physical outcomes such as balance and flexibility, and quality of life outcomes such as energy and sense of well-being.
Authors:
Brazier, A., Mulkins, A., & Verhoef, M. This
randomized controlled trial examined the benefits of a residential
program, based on the Art of Living Course, for individuals living with
HIV/AIDS. The program teaches breathing, movement, and meditation
techniques. 47 out of 62 volunteers from community HIV/AIDS organizations
completed study. Participants who completed the Art of Living program
showed improvements in mental and physical well-being immediately
following the program, but these improvements were not maintained at later
follow-up points. Quantitative measures showed increases in daily stress
following the program, but qualitative interviews suggested that
participants had made positive changes in everyday life. This highlights
the one of the challenges of studying the benefits of an intervention: how
well do quantitative surveys capture the benefits of yoga and meditation? January 2006 Summaries
Comparing
yoga, exercise, and a self-care book for chronic low back pain: a
randomized, controlled trial. Source:
Annals of Internal Medicine, 143, 849-56. December 2005. Authors:
Sherman, K.J., Cherkin, D.C., Erro, J., Miglioretti, D.L., & Deyo, R.A.
This
randomized controlled trial compared the benefits of yoga, conventional
therapeutic exercise, and a self-care book for chronic low back pain. Participants:
101 adults (66% women, mean age of 44) with chronic low back pain, the
majority of whom had experienced pain for longer than one year, and had
experienced pain for more than 45 of the past 90 days prior to entering
the study. Interventions:
Participants were randomly assigned to either a 12-week yoga intervention,
a 12-week exercise intervention, or a home study/educational book
intervention. IAYT
Advisors Gary Kraftsow and Robin Rothenberg designed the 75-minute group
classes and home practice guides for participants. The classes followed a
gentle viniyoga approach specifically designed for back pain. Each class
had a specific focus (such as relaxation, strengthening the hip muscles,
or customizing a personal practice), and included a question-and-answer
period, an opening and closing breathing exercise, 5 to 12 postures, and a
guided deep relaxation. Postures were repeated rather than held, and
included: cobra, bridge, knees to chest, reclining leg stretches and hip
openers, modifications of warrior and chair, standing forward bend, and
kneeling forward bend (child's pose). The therapeutic exercise
intervention was designed by a physical therapist, and included education
about biomechanics and both aerobic and strength-building exercise. The
self-care book was The Back Pain Helpbook by J. Moore et al., an
evidence-based book that teaches a comprehensive fitness and strength
program, lifestyle changes, and guidelines for managing pain. Results:
Participants in the yoga group showed the greatest improvements in back
function at 12 weeks (the end of the intervention). At 26 weeks, the yoga
group also showed greater improvements in symptoms/less use of pain
medication than the other two groups. At 26 weeks, the yoga group and
therapeutic exercise group showed similar improvements in back function,
and both groups showed greater improvements than the education book group.
An educational handout summarizing this study was written for the public and is available at: http://www.annals.org/cgi/summary_pdf/143/12/849.pdf Note:
An interview with author Karen Sherman and yoga teacher Robin Rothenberg,
discussing the yoga program used in this study and the challenges of
running the study, was published in the 2005 International
Journal of Yoga Therapy. A
pilot study of yoga for breast cancer survivors: physical and
psychological benefits. Source:
Psycho-Oncology. E-published ahead of print on December 23 2005. Authors:
Culos-Reed, S.N., Carlson L.E., Daroux L.M., & Hately-Aldous, S. This
pilot study examined the physical and psychological benefits of a 7-week
yoga program for cancer survivors. Study volunteers were randomly assigned
to either the yoga intervention
(n=20) or to a wait-list control group with no intervention (n=18).
Participants completed pre- and post-intervention assessments, including
both self-report of psychosocial and physical well-being, and
physiological measurements (i.e. of weight, blood pressure, and grip
strength). Participants:
Participants had a mean age of 50, and were on average more than 4 1/2
years past initial cancer diagnosis. 95% of participants were female, and
85% were survivors of breast cancer. Intervention:
The yoga classes began with 10 minutes of gentle breathing, laying supine,
with legs flexed at the hip and supported by a wall, followed by 50
minutes of 6–10 modified gentle asanas (which varied over the course of
7 weeks as participants’ flexibility and strength improved) and 15
minutes in savasana (relaxation). The classes are described as
Iyengar-influenced, with special attention to kinesiology and an emphasis
on "moving mindfully and in [a] pain-free range of motion". Yoga
group participants were divided into two waves, so that only 10
participants were in each class. Results:
Following the intervention, significant improvements were seen in both
psychosocial well-being (i.e., mood, quality of life, and stress) and in
physical fitness (i.e., healthy weight gain and flexibility). However,
significant differences between the yoga group and control group were seen
only in psychosocial well-being. Participants in the yoga group showed
greater improvements in psychosocial well-being, compared to members of
the control group. Both groups showed similar improvements in physical
fitness. The authors point out that many participants in the control group
reported beginning their own physical fitness activities when they were
not assigned to the yoga intervention. Therefore, it is difficult to
interpret the lack of difference in improved fitness between yoga and
control groups. These
authors conclude that the findings of this pilot study "suggest that
yoga has significant potential and should be further explored as a
beneficial physical activity option for cancer survivors."
Integrative
review of research related to meditation, spirituality, and the elderly. Source:
Geriatric Nursing, 26, 372-7. November-December 2005. Author:
Lindberg, D.A. This article reviews the last 25 years of research on the benefits of meditation for the elderly. The authors defined meditation broadly, to include formal mindfulness meditation, other mindfulness practices, guided imagery, and meditative prayer. The review summarizes a wide range of benefits supported by studies, including: reduced anxiety, increased self-esteem, increased restfulness and alertness, decreased impatience, decreased agitated behavior, increased group participation, improved self-control, and increased relaxation. These benefits were seen in participants with a wide range of problems associated with aging, including physical disease and cognitive problems such as memory loss and dementia. According to the authors, "This review supports the hypothesis that meditation can be taught to the elderly, even those with dementia. The results also support the hypothesis that meditation and spiritual practices could promote significant social and emotional benefits for those in social isolation." The authors also point out the general importance of a spiritual framework for aging, to support and honor the elderly.
ARCHIVES
Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: a systematic review.
This article reviews research (published between 1970 and 2004) on the effects of yoga on insulin resistance and cardiovascular disease.
70 studies were identified, including 1 observational study, 26 uncontrolled clinical trials, 21 nonrandomized controlled clinical trials, and 22 randomized controlled clinical trials. Yoga for anxiety: a systematic review of the research evidence. Yoga
reduces stress and anxiety among distressed women.
Meditation experience is associated with increased cortical thickness.
This study compared the brain structure of 20 long-term meditators and 15
non-meditators. Magnetic resonance imaging was used to assess cortical thickness.
The meditators had, on average, 9 years of meditation experience and practiced daily. 5 of these participants were meditation or yoga teachers. The study matched meditators and controls by important variables, such as age, gender, and education, that could influence brain structure.
A randomized controlled trial of meditation and massage effects on quality of life in people with late-stage disease: a pilot study. Researchers at the Yale Prevention Research Center conducted a randomized, controlled pilot study of Metta meditation, with and without massage, to investigate the independent and synergistic effects on quality of life among patients with AIDS. The two-year study was conducted at a 40-bed nonprofit, skilled nursing facility dedicated to HIV/AIDS care. The authors note that these two interventions - which both foster a sense of connection to others - may be particularly helpful for individuals with AIDS, a disease that is often accompanied by social stigma and isolation. In particular, the authors hypothesized that physical, healing touch can make individuals more receptive to the practice and benefits of meditation. Over the course of the study, 58 residents (43% women) nearing end-of-life were randomly assigned to either: a) 1 month of meditation, which included a 90-minute introductory instruction, and daily practice to a 15-minute meditation audiocassette, b) 1 month of Swedish massage therapy, 30 minutes per day, 5 days per week, c) 1 month of both meditation and massage, or d) standard care (no intervention).
The following Metta (lovingkindness and forgiveness) meditation was used: Phrases
offering loving-kindness to self: May
I be free from danger May
I be well May
I be happy May
I be peaceful Phrases
offering loving-kindness to others: Just
as I wish to be free from danger, may you be free from danger Just
as I wish to be well, may you be well Just
as I wish to be happy, may you be happy Just
as I wish to be peaceful, may you be peaceful Phrases
offering forgiveness to self: For
all of the ways I have hurt or harmed myself, knowingly or unknowingly,
I offer forgiveness. Phrases
offering forgiveness to others: I
forgive you for whatever you have done, intentionally or
unintentionally— through
your actions, words, even through your thoughts. Through what you
did, and what you failed to do. However the pain came to me through you,
I forgive you. Phrases
asking forgiveness of others: I
ask that you forgive me for whatever I may have done, intentionally or unintentionally,
through my words, my actions, or even through my thoughts.
However I may have hurt or injured you—I ask your forgiveness. Importantly, the study provided ongoing access to the meditation instructor, so that participants could ask questions about the meditation process, or discuss their experiences. The study measured five dimensions of well-being at three time points: 1) before the intervention, 2) 8 weeks (one month following the intervention), and 3) 68 weeks (long-term follow-up for those participants still living). 41 residents completed full study; the other 17 participants experienced a decline in mental status, left the facility for more intensive care or to prepare for death, or died while in care at the center. Results: Only the combined intervention group (meditation plus massage) showed significant improvements in well-being at the 8-week follow-up. In particular, the combined intervention group showed improvement in function, interpersonal well-being, and spiritual well-being. These benefits seemed to persist at the longest follow-up (68 weeks). Both the meditation-only and massage-only groups maintained or improved function, while the standard-care control group showed a decline. These results suggest that meditation and touch therapy complement each other in end-of-life and advanced-illness care. This is an important idea for both individual yoga therapists, who may be able to supplement instruction with manual/touch therapies or collaborate with other therapists, and for program development at hospitals, hospice centers, and other healing centers.
Authors:
Williams, A.L., Selwyn, P.A., Liberti, L., Molde, S., Njike, V.Y.,
McCorkle, R., Zelterman, D.,
& Katz, D.L. Source: Journal of Palliative Medicine, 5, 939-52. October 2005.
Efficacy
of frequent mantram repetition on stress, quality of life, and spiritual
well-being in veterans: a pilot study. A central goal of this study was to consider an intervention that specifically addresses spirituality and spiritual coping. The authors note that many stress-reduction interventions offer strategies for relaxation, emotional coping, and cognitive change, but fail to address spiritual concerns. 62 outpatient veterans (90% men, with a mean age of 62) participated in the full study, which consisted of a 5-week, 90-min per week intervention, with pre-intervention and post-intervention self-report measures of stress, anxiety, anger, quality of life, and spiritual well-being. The
intervention included 5 classes:1) How to Choose a Mantram, 2) How to Use
and Track Mantram Practice, 3) Developing One-Pointed Attention, 4)
Slowing Down, and 5) Putting It All Together. Participants choose a
mantram from a recommended list that included several major spiritual
traditions. Below are a few examples from that list: Buddhist:
Om Mani Padme Hum (Ohm Mah-nee Pod-may Hume), an invocation to the jewel
(Self) in the lotus of the heart Christian:
Kyrie Eleison (Kir-ee-ay Ee-lay-ee-sone), Lord have mercy, or the Lord is
risen. Hindu:
Rama (Rah-mah), eternal joy within. Jewish:
Shalom, Peace Muslim:
Bismallah Ir-rahman Ir-rahim (Beesemah-lah ir-rah-mun ir-rah-heem), in the
name of Allah, the merciful, the compassionate Native
American: O Wakan Tanka Oh, Great Spirit Participants
were taught how to use their mantram in everyday life and activities,
rather than as practice limited to seated meditation. Participants
reported an average of 8.7 (SD=7.32)
daily mantram sessions. Authors:
Bormann, J.E., Smith, T.L., Becker, S., Gershwin, M., Pada, L., Grudzinski,
A.H., & Nurmi, E.A. Source: Journal of Holistic Nursing, 23(4), 395-414. December 2005.
Yoga
for depression: The research evidence. This article reviews both published and ongoing research on Yoga-based interventions for the treatment of depression, up to June 2004. Interestingly, the authors excluded studies that involved interventions based solely on meditation and those involving complex or multiple interventions (i.e. the well-known mindfulness-based stress reduction program). 5 randomized controlled trials were identified. Most interventions focused on younger adults (mean ages 18-35), and clinical status varied from mild depression to severe depression. All five trials reported positive outcomes, and only one reported any adverse outcomes (fatigue and breathlessness). Breathing practices were an important part of the interventions, and three of the five interventions included only breathing and relaxation practices (no asana). Both asana practices included backbending, which traditionally has been thought to relieve depression. The authors of the review did not discuss in detail the benefits of various asanas. The authors caution that variations among the study designs, yoga interventions, and study participants make it difficult to draw strong general conclusions. However, the overall positive results suggest that yoga has potential as a therapeutic intervention for yoga.
Authors:
Pilkington, K., Kirkwood, G., Rampes, H., & Richardson, J. Research
Council for Complementary Medicine, London, UK
Each group session included yoga postures and breathing exercises adapted for beginners and seniors. Yoga postures included: surya namaskar (modified sun salutations using a chair and props), virasana (hero pose), vajrasana (thunderbolt pose), tadasana (mountain pose), table pose (including leg-lifts), parsvotanasana (flank stretch), virabhadrasana (warrior pose), salabasana (locust pose), padangusthasana (holding the big toe pose), supta padangusthana (holding the big toe lying down pose), uttitha hasta padangustasana (extended holding the big toe pose), supta baddha konasana (lying down bound angle pose), eka pada bhekasana (one-leg frog pose), raja kapotasana (pigeon or hip stretch pose), and shavasana (corpse pose). Consistent with an Iyengar asana practice, props (blankets, chairs, blocks) were used in many postures.
Researchers
examined pre- and post-intervention changes in peak hip extension, average
anterior pelvic tilt, and stride length at comfortable walking speed. Peak
hip extension and stride length significantly increased, and there was a
marginally-significant trend toward reduced average pelvic tilt.
Participants who completed the home yoga practices were more likely to
show this improvement Both the frequency and duration of
yoga home practice predicted changes in hip extension and average pelvic
tilt, suggesting that home practice is an important part of yoga
interventions. Authors:
DiBenedetto, M., Innes, K.E., Taylor, A.G., Rodeheaver, P.F., Boxer, J.A.,
Wright, H.J., & Kerrigan, D.C. Source: Archives of Physical Medicine and Rehabilitation, 86, 1830-1837.
Intracerebral pain processing in a Yoga Master who claims not to feel pain during meditation. Kelly's note: These findings are particularly fascinating because of their "completeness". Rather than finding reduced activity in one pain center of the brain, there was a reduction in the thalamus (which relays sensory information), the sensory cortex (which receives and processes sensory information), and the insula and cingulate cortex (which interprets the emotional aspects of pain). I think that this study has important implications for treating chronic pain, although it is not clear from this study whether these brain changes are available through basic meditation training, or whether they could be used in everyday life.
Source: European Journal of Pain, 9, 581-589.
Iyengar
yoga for treating symptoms of osteoarthritis of the knees: a pilot study. Authors:
Kolasinski, S.L., Garfinkel, M., Tsai, A.G., Matz, W., Dyke, A.V., &
Schumacher, H.R.. Source: Journal of Alternative and Complementary Medicine, 11, 689-93.
The
metabolic cost of hatha yoga.
Researchers
concluded that a basic yoga practice of varied poses is "a very light
intensity" form of exercise, and "may be too low to provide a
training stimulus for improving cardiovascular fitness". Researchers
also stated that "these data demonstrate that hatha yoga may have
little, if any, cardiovascular benefit." Kelly's
comments:
This article should be considered in the broader context of yoga's
cardiovascular and cardiorespiratory health benefits. A study summarized
last month reported that low-intensity yoga helps to prevent weight gain,
through some mechanism other than creating large metabolic
demands during the practice. Obesity plays a
large role in cardiovascular diseases, and yoga may play a role in
maintaining a healthy weight. Also, breath-centered yoga trains the
cardiorespiratory systems, even without creating large metabolic demands,
and the variety of asanas in a balanced yoga practice can improve general
circulation. Finally, yoga's greatest contribution to cardiovascular
health may be reducing stress, which takes a major toll on the CV system. Authors:
Clay, C.C., Lloyd, L.K.,
Walker, J.L., Sharp, K.R., & Pankey, R.B. Source: Journal of Strength and Conditioning Research, 19, 604-610.
Yoga for cancer patients and survivors: A review. Researchers
at the UCLA's Cousins Center for Psychoneuroimmunology reviewed published,
peer-reviewed research on the benefits of yoga for cancer patients and
survivors. The studies reviewed found that yoga was associated with
"modest improvements in sleep quality, mood, stress, cancer-related
distress, cancer-related symptoms, and overall quality of life." You can access the full text of this review for free. Source: Cancer Control, 12(3):165-71. Authors: Bower JE, Woolery A, Sternlieb B, Garet D.
Yoga practice is associated with attenuated weight gain in healthy, middle-aged men and women. Researchers from the Division of Public Health Sciences at the Fred Hutchinson Cancer Research Center in Seattle conducted a major study of the association between regular yoga practice and weight gain after age 45. 15,550 adults, aged 53 to 57 years, provided retrospective reports of their physical activity (including yoga) during the past 10 years, as well as their current weight and their weights at ages 30 and 45. Researchers analyzed the results separately for individuals of a healthy weight (BMI < 25) and overweight individuals. Healthy-weight individuals who reported practicing yoga for four or more years gained an average of 3.1 lbs less than healthy-weight individuals who did not practice yoga for four or more years (9.5 lbs weight gain versus 12.6 lbs). Overweight individuals showed a more dramatic 18.5 lb difference (5.0 lbs weight loss for who individuals who reported practicing yoga for four or more years, versus 13.5 lbs weight gain among those who did not.) The authors conclude: "Although causal inference from this observational study is not possible, results are consistent with the hypothesis that regular yoga practice can benefit individuals who wish to maintain or lose weight." Authors:
Kristal AR, Littman AJ, Benitez D, White E.
Is
Spirituality a Critical Ingredient of Meditation? Comparing the Effects of
Spiritual Meditation, Secular Meditation, and Relaxation on Spiritual,
Psychological, Cardiac, and Pain Outcomes.
Authors: Wachholtz AB, Pargament KI. Source: Journal of Behavioral Medicine, Jul 28 2005 (online).
Loving-kindness
meditation for chronic low back pain: results from a pilot trial. Authors: Carson JW, Keefe FJ, Lynch TR, Carson KM, Goli V, Fras AM, Thorp SR. Source: Journal of Holist Nursing, 23(3):287-304.
The relationship of yoga, body awareness, and body responsiveness to self-objectification and disordered eating.
This study, which received a lot of media attention, found that yoga practice is associated with greater body awareness, lower self-objectification, greater body satisfaction, and fewer disordered eating attitudes, compared to aerobics exercise and no exercise. It is important to note that the study used a survey design, rather than a yoga intervention with random assignment. The author compared three groups of women who reported engaging in yoga (43 women), aerobic exercise (43 women), and neither yoga nor aerobic exercise (51 women). Because the study used questionnaires rater than interventions, it is unclear whether women with greater body awareness and satisfaction are more likely to practice yoga, or whether yoga (as hypothesized) actually improved body awareness and satisfaction.
Author: Daubenmier, J.J. Source:
Psychology of Women Quarterly, 29: 207.
Meditation
reduces sympathetic activation and improves the quality of life in elderly
patients with optimally treated heart failure: a prospective randomized
study.
Authors: Curiati, J.A., Bocchi, E., Freire, J.O., Arantes, A.C., Braga, M.R., Garcia, Y., Guimaraes, G., & Fo, W.J. Source: Journal of Alternative and Complementary Medicine, 11(3):465-72.
Yoga
intervention for adults with mild-to-moderate asthma: a pilot study. Authors: Sabina, A.B., Williams, A.L., Wall, H.K., Bansal, S., Chupp, G., & Katz, D.L. Source: Annals of Allergy, Asthma, and Immunology, 94(5):543-8.
Cardiorespiratory
synchronization during Zen meditation. Researchers
at the University of Witten/Herdecke in Herdecke, Germany studied the effects of
meditation on a specific aspect of breathing: (respiratory sinus arrhythmia, RSA).
RSA is a natural pattern of heart rate variability - the heart beats faster
during inhalation and slower during exhalation. Researchers measured this
pattern of heart rate variability as 9 inexperienced meditators practiced two
kinds of meditation: seated Zen meditation (breath and thought awareness), and
Kinhin (walking) meditation. During
both types of meditation, breathing rate lowered, the highest heart rate (during
inhalation) lowered, and the lowest heart rate (during exhalation) increased,
but the basic pattern of RSA was strengthened. This outcome is potentially
interesting because reduced RSA has been associated with depression, the
physical changes of aging, and even predicts death; higher RSA is often
considered a sign of cardiovascular health. Authors: Cysarz, D., & Bussing, A. Source: European Journal of Applied Physiology. 2005 Jun 7 [Epub ahead of print]
Effect
of Iyengar yoga therapy for chronic low back pain.
Participants were self-referred from the community, and reported experiencing back pain for an average of 11.2 years. Participants were randomly assigned to either a 16-week yoga group, or a 16-week educational control group. 42 of the 60 participants who enrolled in the study completed the study. Participants reported on a variety of outcomes at baseline, the end of the 16-week intervention, and at a 3-month follow-up. The Iyengar yoga practice was associated with significant reductions in pain intensity, functional disability, and the use of pain medication, at both the 16-week point and the 3-month follow-up.
Note: A full report of the methodology of this study will be published in the upcoming (October 2005) International Journal of Yoga Therapy. This article will provide details about the study and yoga practice that will be of interest to yoga professionals interested in adopting the back pain protocol or conducting their own research. Authors: Williams, K.A., Petronis, J., Smith, D., Goodrich, D., Wu, J., Ravi, N., Doyle, E.J. Jr, Gregory Juckett, R., Munoz Kolar, M., Gross, R., & Steinberg, L. Source: Pain, 115(1-2), 107-17.
Yoga
helps chronic fatigue: A prospective observational study of treatments for
unexplained chronic fatigue.
Participants were not assigned to use any specific therapy, but reported the therapies that they tried over the course of two years. Participants reported a wide variety of therapies, including: prescribed medications, non-prescribed supplements and herbs, lifestyle changes, alternative therapies (including yoga), and psychological support.
Yoga was associated with reduced fatigue at the two-year follow-up. The authors identified yoga as the most promising alternative therapy for chronic fatigue.
Authors: Bentler, S.E., Hartz, A.J., & Kuhn, E.M. Source: Journal of Clinical Psychiatry, 66(5), 625-32.
Influence
of Yoga & Ayurveda on self-rated sleep in a geriatric population.
This study should be recognized for its excellent design and large sample size.
Authors: Manjunath, N.K., & Telles, S. Source: Indian Journal of Medical Research, 121(5), 683-90.
Don't Fall Asleep in a Yoga Pose?
Physicians at the Department of Neurology of the University of Washington Medical Center and the Veterans Affairs Puget Sound Health Care System in Seattle, Washington, report an interesting case study. A women taking several prescription pain, sleep, and anti-depressant medications fell asleep in a straight-leg seated forward bend (paschimottanasana). When she woke up, she experienced profound lower extremity weakness and sensory abnormality. At a three-month follow-up, she was still experiencing symptoms. The authors write, "The pathophysiology of the lesion could be related to either stretch injury or proximal compression/infarct of the nerve in the gluteal region (distal to the sciatic notch), or a combination of both."
Authors: Walker, M, Meekins, G, & Hu, SC. Source: Neurologist, 11(3), 176-8. May 2005.
Efficacy
of Yoga on Pregnancy Outcomes Researchers from the Vivekananda Yoga Research Foundation in Bangalore, India, investigated the effects of yoga practice during pregnancy on several birth outcomes: birthweight, preterm labor, and pregnancy complications. Three hundred thirty five (335) women attending the antenatal clinic at Gunasheela Surgical and Maternity Hospital in Bangalore, India, were enrolled between 18 and 20 weeks of pregnancy in a prospective, matched, observational study. 169 women were assigned to practice yoga for one hour daily; 166 women, in the control group, were assigned to walk 30 minutes twice a day . Women in the yoga group and control group were matched for age, parity, body weight, and Doppler velocimetry scores of umbilical and uterine arteries. The yoga practice included asanas, breathing, and meditation. Both groups engaged in their activity from the date of entry into the study until delivery. Participation by women in both groups was montiored by frequent telephone calls and activity diaries.
The authors conclude: "An integrated approach to yoga during pregnancy is safe. It improves birth weight, decreases preterm labor, and decreases IUGR either in isolation or associated with PIH, with no increased complications."
Authors: Narendran, S, Nagarathna, R, Narendran, V, Gunasheela, S, & Nagendra, HR. Source: Journal of Alternative and Complementary Medicine, 11(2), 237-44. April 2005.
Aryuveda, Yoga, & Cardiovascular Disease This article reviews research on the use of Ayurvedic treatments (including Yoga practice) for cardiovascular diseases. The authors conclude that there is sufficient evidence to support the use of Yoga in treating heart disease and hypertension. The authors conclude that there is not sufficient empirical evidence to support the use of any Ayurvedic herbal treatment for heart disease or hypertension. However, the authors believe that many herbs used by Ayurvedic practitioners show promise and could be appropriate for larger randomized clinical trials.
Authors: Mamtani, Ravinder, & Mamtani, Ronac Source: Cardiology
in Review, 13(3), 155-162. 2005 Complementary Therapies for Pain, Anxiety, and Mood Disturbance
How can complementary medicine assist conventional cancer therapy? Authors Deng and Cassileth provide an excellent review of research and clinical trials of a wide variety of complementary therapies, including massage, meditation, acupuncture, and nutritional supplements. You can access the full report for free.
Authors:
Deng, G., & Cassileth, B.R.
Treatment
of Chronic Insomnia with Yoga: A Preliminary Study with Sleep-wake Diaries.
"(1) long, slow, abdominal breathing with meditation on long, slow abdominal breathing for 1–3 min; (2) arms extended upwards at a 60◦ degree angle with the palms flat and facing upwards with meditation on the breath for 1–3 min; (3) arms extended horizontally to the sides with the wrists bent upwards and the palms facing away with meditation on the breath for 1–3 min; (4) hands clasped together at the sternum with the arms pushing the palms together with meditation on the breath for 1–3 min; (5) a breathing meditation called “Shabad Kriya.” Palms are resting in the lap facing upward with right over left and the thumbs touching. Eyes are 1/10 open and gaze is downwards past the tip of the nose. The inhale is in 4 segments or “sniffs,” followed by breath retention for 16 counts, and an exhale in 2 segments, so that the ratio of inhale:hold:exhale is 4:16:2. During the inhale, the mantra “Sa, Ta, Na, Ma” is mentally recited with each segment. During the breath retention, this mantra is mentally repeated four times. During the exhale the mantra “Wahe Guru” is mentally recited concurrently with each exhale segment. Participants are encouraged to maintain the overall breathing frequency as slow as is comfortable, while maintaining the specified ratio of inhale:hold:exhale for up to 11 min."
Participants kept
track of the sleep time, sleep quality, and sleep disruptions in sleep-wake
diaries. The yoga intervention was associated with improvements in atotal sleep
time, total wake time, sleep efficiency, sleep onset latency, and wake time
after sleep onset.
Author: Khalsa, S.B. Source: Applied Psychophysiology and Biofeedback, 29,:269-78. Dec 2004.
Ujjayi
Breath Training Changes Everyday Breathing Patterns. Researchers at the Universite de la Mediterranee in France studied the effects of ujjayi breath training on everyday breathing patterns. Researchers measured the resting breathing patterns of participants before and after a two-month yoga respiration training program. The training program focused on slow, deep ujjayi breathing, with breath retention after both the inhalation and exhalation. After the training, participants showed a significant increase in exhalation duration (how long the exhale takes) and a modest increase in tidal volume (how much air is inhaled with each breath). These two findings are probably not independent; a deeper, more complete exhalation creates the space for a larger inhalation.
Authors:
Villien F, Yu M, Barthelemy P, Jammes Y.
Effect of Zen
Meditation on Serum Nitric Oxide Activity and Lipid Peroxidation. Of all of the physiological risk factors for cardiovascular disease, and other diseases, ones you don't often read about are nitric oxide activity and lipid peroxidation. However, research suggests that nitric oxide is an important regulator of heart beat, blood flow, and blood vessel constriction. Lipid peroxidation is a process associated with cellular damage in the body. The following study - conducted by researchers at the Department of Psychiatry, College of Medicine, and Institute of Natural Medicine at Hallym University, in South Korea - examined the effect of Zen meditation on these risk factors for cardiovascular and other diseases.
These findings suggest that regular Zen meditators may be at reduced risk for certain diseases. However, this was not a randomized clinical trial, so researchers could not rule out other factors that may have accounted for the observed differences.
Authors: Kim D.H., Moon Y.S., Kim H.S., Jung J.S., Park H.M., Suh H.W., Kim Y.H., & Song D.K. Source:
Prog Neuropsychopharmacol Biol Psychiatry, 29,:327-31. Feb 2005
Meditation and Yoga Reduce Emotional Stress of Chronic Pain
Chronic pain, which affects more than 100 million Americans, is
notoriously difficult to treat. Traditional Western medical approaches often fail to reduce the physical and emotional suffering associated with
chronic pain. Meditation and yoga have long been used to reduce the physical symptoms of chronic pain. Now, a study shows that meditation and
yoga can also help individuals deal with the emotional side of chronic pain. Chronic pain can put close relationships under a great deal of stress, make work and other everyday tasks impossible, and challenge even the strongest self-image. These psychological losses can be more stressful than the physical pain itself. For this reason, chronic pain is often associated with depression and anxiety.
What might account for these changes? Researchers found that the
meditation and yoga group also reported a decrease in maladaptive coping strategies (such as avoidance or pessimism) over the course of the study.
Meditation and yoga may help individuals face, and come to terms with, the emotional and practical losses associated with chronic pain. Researchers
concluded that mindfulness practices can be an important part of chronic pain treatment. These findings are consistent with other studies that have shown
meditation and yoga to be helpful at reducing anxiety and depression. By showing us how to accept the present moment, mindfulness practices may reduce the psychological costs of any major loss. Authors:
Sagula, D., & Rice, K.G.
Tai
Chi: improving functional balance and predicting subsequent falls in older
persons. Researchers at the Oregon Research Institute examined whether Tai Chi training reduces falls in an elderly population.
These findings suggest that a yoga program that focuses on improving balance - through standing poses and mindful vinyasa - may also prevent falls in an elderly population. However, whenever osteoperosis is suspected, great care must be taken to prevent falls during the training!
Authors:
Li, Harmer, Fisher, & McAuley.
Action
Observation and Acquired Motor Skills: An fMRI Study with Expert Dancers. Researchers studied the brain activity associated with watching movement (ballet and capoeira), and compared the brain activity of individuals trained in the movement form with the brain activity of individuals not trained in the movement form. Although the researchers did not study yoga, I think that the results of the study are useful for teachers of any movement form.
These findings can remind teachers that beginners in any movement form - including yoga- cannot learn as quickly from demonstrations as experienced students. We develop expertise that allows us to easily learn from demonstration, as we study a movement form.
Authors:
Calvo-Merino, Glaser, Grezes, Passingham, & Haggard.
Standing
and supine hamstring stretching are equally effective. Researchers at the New Hampshire Musculoskeletal Institute compared the effectiveness of standing and supine (reclining) hamstring stretching.
While not earth-shattering, this study is a good reminder that there is no one perfect pose for any given intention.
Authors:
Decoster, Scanlon, Horn, & Cleland.
Evidence
underlying breathing retraining in people with stable chronic obstructive
pulmonary disease. Researchers from the Physical Therapy Department of Husson College in Bangor, Maine, reviewed the usefulness of two yogic breathing techniques for individuals with chronic obstructive pulmonary disease (COPD).
Pursed breathing is an excellent technique to practice anytime you want to lower breathing rate; it is recommended not just for breathing disorders, but for panic attacks, insomnia, and hyperventilation.
Authors: Dechman & Wilson. Source: Physical Therapy, Vol 84. Dec 2004.
Researchers at the Medical College of Georgia, in Augusta, GA, investigated the effects of meditation on blood pressure and heart rate in youth.
Authors:
Barnes, Davis,
Murzynowski, & Treiber. The effects of yoga training and a single bout of yoga on delayed onset muscle soreness in the lower extremity.
Researchers at the Department of Exercise Science and Sports Studies at Springfield College Allied Health Sciences in Springfield, Massachusetts, examined whether yoga influences muscles soreness after exertion.
Authors:
Boyle, Sayers, Jensen, Headley, & Manos.
November 2004: Although not a research report, "Breathing Lessons" by Mary P. Guerrera, MD is a thoughtful essay on the role of breathing exercises in clinical medicine and teaching. It appears in the November 2004 volume of the journal Family Medicine.
Effects
of hatha yoga and african dance on perceived stress, affect, and salivary
cortisol. Researchers from Reed College, the University of California (San Francisco), and Oregon Health Sciences University examined the psychological and neuroendocrine effects of yoga and dance.
Elevated cortisol is associated with a number of psychological (i.e., depression) and physical (i.e., immune suppression) illnesses. Yoga may improve well-being by lowering cortisol; however, cortisol measurements alone do not support a strong argument. These results also remind me of a theory that I've long had about why many people seek yoga and meditation. I've suspected that many people who find benefit in yoga and meditation are looking for an end to some suffering, rather than a "high" or pleasure. These results suggest that yoga is primarily working on reducing negative experiences, rather than boosting intense positive states.
Authors: West, Otte, Geher, Johnson, & Mohr Source: Annals of Behavioral Medicine, Vol 28, October 2004.
Does yoga speed healing for patients with low back pain?
Researchers at the University of Texas Southwestern Medical Center reviewed previously published studies on the the effectiveness of yoga for low back pain.
Authors: Graves, Krepcho, Mayo, & Hill. Source:
J Fam Pract, Vol 53(8):661-2. August
2004. Prospective study of new participants in a
community-based mind-body training program.
Researchers at the Center for Complementary and Integrative Medicine, Weill Medical College of Cornell University investigated changes in emotional and physical well-being after 171 participants completed a mind-body training program that included yoga.
Authors: Lee, Mancuso, & Charlson. Source: J Gen Intern Med. Vol 19(7):760-5. July 2004.
A pilot study of a yoga and meditation intervention for
dementia caregiver stress.
Researchers at the Pacific Graduate School of Psychology examined the effects of a six-session yoga-meditation program (called Inner Resources) designed to help caregivers cope with stress.
Authors: Waelde, Thompson, & Gallagher-Thompson. Source: J Clin Psychol, Vol 60(6):677-87. June 2004.
Randomized
controlled trial of yoga and exercise in multiple sclerosis.
Researchers in the Department of Neurology at Oregon Health & Science University examined the effects of yoga and aerobic exercise on cognitive function, fatigue, mood, and quality of life in individuals with multiple sclerosis:
Authors: Oken, Kishiyama, Zajdel, Bourdette, Carlsen, Haas, Hugos, Kraemer, Lawrence, & Mass. Source: Neurology, Vol 62(11):2058-64. June 2004.
I began this monthly update in June 2004. You can search for earlier studies at the free online database of published medical research: http://www.pubmed.org
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