Greater improvements in the yoga group in Pain Self-Efficacy Questionnaire scores at 3, and 6 month follow-up
Yoga treatment studies of CLBP typically utilize some measure of physical functioning and disability as a primary outcome. Such outcomes can be tied to physiological performance, or validated questionnaires with specific behavioral items. Most yoga studies do demonstrate beneficial effects for adults suffering from CLBP ( Table 1 ).
A small randomized controlled trial, pilot study demonstrated trends for the yoga group in terms of improved balance and flexibility, and decreased disability and depression [ 28 ]. However, the study was weakened by the small sample size (n=22 participants) and a high dropout rate among the control group. As such, no statistical significance was observed.
The impact of Iyengar yoga therapy was assessed in a 16-week, randomized controlled trial involving subjects with non-specific CLBP compared to an educational control group [ 29 ]. The yoga subjects had less pain (Short Form-McGill Pain Questionnaire) and lower functional disability (Pain Disability Index) than the controls. Unfortunately there was a 30% drop-out rate in this study. Williams et al. conducted another 24-week study that showed significantly greater reductions in functional disability (Oswestry Disability Index), pain intensity (Visual Analog Scale) and depression (Beck Depression Inventory-Second Edition) among the subjects randomized to the yoga intervention group [ 30 ]. Both of these studies were limited by a reliance on self-report measures, a relatively healthy study population, and lack of controls for attention and physical activity between the treatment and control groups [ 29 ].
80 patients with CLBP participated in an intensive seven day long, residential yoga program. The effect of yoga on disability (Oswestry Disability Index), quality of life (World Health Organization Quality of Life-BREF) and flexibility was studied [ 31 , 32 ]. The intervention group practiced daily meditation, yoga exercise, chanting and went to lectures. The control group followed a daily routine of exercise, non-yogic breathing exercises, educational lectures and additionally filled their time watching nature programs. This control is different than the usual or no care control used in other studies. There was a significant difference in disability between groups, with the yoga group experiencing a greater improvement than the control group. The yoga group showed a greater increase in flexibility and reduction in pain (section 1 of the Oswestry Disability Index) than the control group [ 31 , 32 ].
Predictors of outcome were studied in 53 adults who were already involved either with yoga or a physical therapy intervention to treat CLBP. No significant differences in disability (Roland-Morris Disability Questionnaire) were seen at 6 weeks [ 33 ]. A major finding in both groups was that back pain self-efficacy was the most important predictor of pain, health status and disability. Self-efficacy refers to an individual’s belief in the capacity to change outcomes through their own actions, and was measured by the Back Pain Self-Efficacy Scale. A significant limitation of this study is the presence of self-selection bias because the participants were already enrolled/self-selected into the yoga or physical therapy groups prior to the study.
The effects of yoga on balance and gait were studied in an 8 week pilot study involving adult women (n=27) with musculoskeletal problems, such as osteoarthritis and low back pain [ 34 ]. The subjects’ balance and gait parameters were statistically improved compared to the pre-study values. The small sample size and lack of control group in this study make it difficult to attribute the improvements exclusively to the yoga intervention. Additionally the study failed to describe the nature of the relatively young (age 30–45 yrs) subjects’ musculoskeletal problems in any detail.
The effect of yoga on physical functioning has been described in two large randomized trials [ 35 , 36 ]. Sherman et al. studied yoga compared to stretching or a self-care book approach for patients with chronic low back pain [ 35 ]. In all the groups, function and symptoms improved over time. The yoga and stretching groups reported similarly improved results compared to the self-care group. The authors concluded that yoga benefits are due mainly to the benefits of physically stretching and strengthening the body, and not due to yoga’s mental aspect.
Tilbrook et al. studied the long-term effectiveness of a 12-week yoga program versus a back pain education booklet for low back pain patients [ 36 ]. The yoga group had significantly better back function (Roland-Morris Disability Questionnaire) than the usual care group at 3, 6, and 12 months follow-up. This study did not see any difference between interventions, in a secondary outcome, the Aberdeen Back Pain Scale for health related function and pain [ 37 , 38 ]. However this scale is noted to have significant weaknesses and is not suggested anymore for use [ 39 ].
A randomized dosing trial compared once versus twice-weekly yoga classes for CLBP in predominantly low income, racially diverse and more severely impaired populations [ 40 ]. Subjects (n=95) completed a 12-week intervention. Pain and back-related function improved in both groups, with no difference between the once and twice-weekly groups. There were several study limitations including the inability to blind participants, the use of self-reported measures, lack of a non-yoga control group, differential adherence between groups, high use of non study treatments, and no long-term follow up. The results suggest in an underserved population, weekly yoga classes do not increase benefit and present more difficult compliance issues.
A four-week, randomized control trial of a virtual reality-based Wii yoga program versus physical therapy and trunk stabilizing exercise in 30 middle-aged women with low back pain was presented [ 41 ]. Significantly improved outcomes were observed in both groups, for pain (visual analog scale), function (Oswestry low-back pain Disability Index, Roland-Morris Disability Questionnaire), and fear (fear avoidance beliefs questionnaire) scores. There were financial and time benefits provided to the middle aged women by the home, virtual reality based program. Limitations of this study included the lack of a traditional yoga control group, and the lack of frequency and dosing of exercise information in the control group. Another limitation is the specific age range and gender of the subjects, but as discussed by the authors the target group is middle aged women who have significant demands on their time and money for housekeeping and childrearing activities.
A number of studies demonstrate yoga’s effectiveness in reducing chronic low back pain. Williams et al. evaluated clinical levels of pain (using the Short Form-McGill Pain Questionnaire), pain-related fears to movement (Tampa Scale of Kinesiophobia), and pain beliefs (Survey of Pain Attitudes) [ 29 ]. The yoga intervention resulted in a two times greater reduction in pain, and reduced pain medication usage, compared to the educational control group. There was no significant difference in pain attitudes or movement fears, perhaps due to the study not having enough statistical power for these outcomes. Williams et al. further demonstrated the effectiveness of a 24 week Iyengar yoga program on improving chronic low back pain [ 30 ]. Individuals randomized to the yoga group showed greater improvements in pain intensity than in the control group.
A single group, pre-post study of military veterans who participated in a clinical yoga program at a large VA medical center showed improvement for pain between baseline and 10-weeks [ 42 ]. Pain was measured using a visual pain scale modification of the visual analog scale. Among the various indicators of the yoga “dosing” (i.e. amount of intervention), decreased pain was significantly correlated to the actual attendance. Additional analysis of this same study demonstrated that females experienced greater improvements in pain compared to the males [ 43 ]. The women had significantly greater improvements on depression, pain “on average”, energy, and Short-form 12 mental health. No gender difference was demonstrated for pain “at its worse”, total pain score, or Short-Form 12 physical health.
Saper et al. studied the effect of yoga on back pain among low income, racially diverse subjects [ 40 ]. The average low back pain intensity for the previous week (as measured by the Visual Analog Scale), was significantly reduced from 7 to 5 after the 12 week intervention, regardless of whether subjects attended once-or twice-weekly yoga classes [ 40 ].
Sherman et al. measured pain “bothersomeness” instead of pain severity because of the complex nature of pain [ 44 ]. Subjects rated their back pain during the previous week on an 11-point scale, from “not at all” to “extremely” bothersome, in response to a 12-week yoga, exercise or book education intervention. All interventions were helpful, but the yoga and exercise groups improved
Back pain “bothersomeness” was studied in individuals already involved either with yoga or a physical therapy intervention [ 33 ]. Both interventions helped, and there were no significant group differences between yoga and physical therapy after 6 weeks of treatment. However, the baseline characteristics of the yoga group were such that they demonstrated less back pain and disability to begin with.
A randomized control trial evaluated the impact of Iyengar yoga on pain intensity (Visual Analog Scale) and health related quality of life in subjects with nonspecific chronic low back pain [ 45 ]. The study compared yoga therapy to conventional exercise therapy, with 6 month follow up. Both interventions resulted in significant benefits, with the yoga intervention having the greater impact.
Yoga’s effect on psychological health has not been well characterized in the scientific literature to date. Galantino et al. conducted a pilot study of depression and a Hatha yoga intervention [ 28 ]. As mentioned, this study had a small sample size and a high dropout rate. They demonstrated a non-significant trend towards decreased depression in their yoga intervention group.
Groessl et al. studied the effect of yoga on depression and quality of life (Short-Form 12 version 2) in veterans with back pain [ 42 ]. They found significant improvements in depression, and a trend towards significant improvements for the Mental Health Scale of the SF-12. The improvement in depression tended to be associated with the subjects’ self-reported amount of home practice.
The impact of Iyengar yoga on depression (Beck Depression Inventory) was studied in subjects with CLBP [ 30 ]. The subjects randomized to the yoga group showed greater improvements in depression than those in the control group. One limit of the study was that yoga group received more attention than the self-directed control group. Another limit was the lack of controls for physical activity between the groups.
Tekur et al. found their yoga group experienced significantly greater improvements in the psychological subscale of their quality of life scale (World Health Organization Quality of Life-BREF) compared with the controls [ 32 ]. However, this residential-based study involved additional elements (i.e. 8 hours a day of interactive lectures, chanting, meditation sessions) than typical Hatha or Iyengar yoga interventions. Furthermore, this was only a short-term (i.e. 1 week follow up) study.
One randomized controlled trial [ 36 ] and an affiliated pilot study [ 46 ]studied yoga versus “usual care” with the mental health ShortForm 12. The pilot study found no significant difference, but it was under-powered (n =20) [ 46 ]. Their follow-up study was adequately powered. They still found no significant difference in mental health function at the 3-, 6- and 12 month assessments (although the 3- and6-month assessments demonstrated a trend towards improvement)[ 36 ].
A few studies have explored the mechanisms by which yoga might affect back pain. Sherman et al. and Lee et al. investigated several possible mediators, including serotonin, cortisol, dehydroepiandrosterone (DHEA), and brain derived neurotrophic factor (BDNF) [ 47 , 48 ]. Additionally Sherman et al. investigated psychological factors that may mediate the effect of yoga on back pain.
These factors included cognitive appraisal measures (fear avoidance, self-efficacy and self-awareness), affect and stress (psychological distress, perceived stress and positive states of mind), physical activity, and neuroendocrine function [ 47 ]. Neuroendocrine function was measured with cortisol and DHEA levels from saliva samples. The goal was to identify which measure had the biggest effect on back-related dysfunction (Roland-Morris Disability Questionnaire) in the yoga versus stretching versus self-care groups. Self-efficacy, and hours of back exercise were the most significant contributors to the effect of yoga. Sleep disturbance also played a small role. No effect was seen from cortisol or DHEA levels. Yoga and stretching had similar effects. One limit was the fairly healthy study population.
Lee et al. investigated the effect of yoga on pain, BDNF, and serotonin in premenopausal women with chronic low back pain [ 48 ]. The yoga group had decreased pain, increased BDNF and unchanged serotonin. The untreated control group had increased pain, decreased BDNF and decreased serotonin. This suggested that the beneficial effects of yoga are associated with elevated serum BDNF levels and maintained serotonin levels. There were several limitations including small sample size, gender bias, and a control group that could better account for group socialization effects. It’s also not clear why the control group exhibited increased pain after the intervention.
Low back pain itself is a persistent condition with a known high rate of recurrence and a high rate of incomplete resolution [ 8 , 49 ]. Therefore in studying subjects with back pain, it would not be surprising to see occasional adverse events. Overall, however, it does not appear that yoga presents a significantly increased risk for normal individuals or patients with back pain. In one study, among 30 subjects randomized to yoga, one adverse event was reported [ 29 ]. That subject had symptomatic osteoarthritis and was diagnosed with a herniated disc during the study. Medical review of the adverse event by the Institutional Review Board determined it was unrelated to the yoga postures.
No serious adverse events were reported among 101 subjects in yoga versus exercise trial [ 44 ]. One yoga participant discontinued class due to migraine headaches, one exercise participant ‘strained’ her back and sought care from a chiropractor. More recently, Sherman et al. found an equal number of mild to moderate adverse events (mostly temporarily increased back pain) among the subjects in both the yoga and a more traditional stretching intervention [ 35 ]. One of the 87 yoga class subjects experienced a serious event, a herniated disc. One in the self care control group reported increased pain. Despites these adverse events, overall the yoga and stretching groups had moderately improved outcomes.
8% of 156 yoga participants and 1% of 157 usual care participants reports adverse events in the study by Tilbrook et al. [ 36 ]. In the yoga group, 11 events were nonserious and related to temporarily increased pain. 1 event was serious, and occurred in an individual with a history of severe pain after any physical activity. In the usual care group there was actually a death, and also an injury unrelated to the intervention.
In a comprehensive review of non-pharmacological and non-invasive therapies for chronic low back pain, there were discovered only rare reports of serious adverse events [ 50 ]. However, better reporting of harms was suggested as a need.
Low back pain risk factors include previous back pain episodes, high physical demands of work, low job satisfaction, age, back weakness, and smoking [ 51 – 53 ]. Care seeking and disability due to chronic low back pain depend more on psychosocial issues than on individual clinical features or workplace physical demands [ 53 ]. Identifying and addressing these psychosocial factors helps improve outcomes and limit costs [ 20 ].
Among the treatments for CLBP, there is variable evidence to support effectiveness of non-pharmacologic [ 50 ], and medication [ 54 ]management. Yoga, in comparison to spinal manipulation, physical therapy, and acupuncture, may be more cost effective because it can be delivered in a group format and self-administered at home. However, actual cost analysis of yoga interventions is needed.
This literature review suggests that yoga is effective in reducing pain and disability, and improving both physical and mental function. The Sherman et al. study employ used a three-arm intervention, and thus, provides important “comparative effectiveness” data by comparing yoga to a conventional stretching program led by physical therapists and a self-care book from primary care providers [ 35 ]. A few key points derive from their work, which is supported also by other research [ 33 ]. Yoga was not superior in effectiveness compared to conventional stretching. Self-efficacy and hours of back exercise may be the most important factors for both conventional exercise therapy and yoga.
To this point, compared to traditional exercise programs derived physical therapy, yoga could provide superior compliance and benefit in the long term. Yoga poses, once learned, might be more easily remembered by patients because the poses and their associated names tend to have universal recognition. Yoga programs, even ‘adaptive’ or ‘senior’ classes, are accessible in most cities, at studios, local gyms, recreation centers and hotel wellness centers. In contrast, patients finishing a physical therapy program may receive a variety of suggested exercises with no standardization, and little similar to what another physical therapist might dispense. Patients can lose, forget or not even receive a home exercise program from their therapists at the conclusion of a formal physical therapy prescription. Long term outcome studies are needed to explore this hypothesis because most yoga studies to date have lasted less than 26 weeks, with the exception of the study by Tilbrook et al. [ 36 ].
Yoga, with its spiritual and psychological underpinnings, potentially might provide greater mental health benefits compared to traditional physical therapy. However, the impact of yoga on depression has been evaluated in only a small number of studies. Significant effects on depression were found in two studies [ 30 , 42 ], but only non-significant trends were found for the Mental Health Scale SF-12 [ 42 ]. Sherman et al. found that self-efficacy and also sleep were important psychological benefits of yoga on low back pain [ 47 ]. With the high rates of depression among sufferers of CLBP, further research in this area is needed [ 20 ]. To what extent yoga may impact other mental health conditions (e.g. anxiety disorders, which are not as well measured by the SF-12) is also an important research direction.
Lastly, safety data from the largest and most recent trials suggest about a 10–15% incidence of temporarily increased low back pain, and two identified cases of herniated disc. It appears that yoga participation is not without risks. However, the great majority of participants do appear to experience considerable benefits without many problems.
Overall, yoga is an intervention which appears to be well positioned, as the healthcare system shifts from caring mostly for patients with acute illness to caring mostly for patients with chronic disease, and where healthcare providers seek to design preventative strategies against the chronic conditions of modern society. More specifically, because it is a reflective activity, yoga may find particular application among military veterans who must live with the long term effects of wartime trauma [ 55 ].
Yoga appears as effective as other non-pharmacologic treatments in reducing the functional disability of back pain. It appears to be more effective in reducing pain severity or “bothersomeness” of CLBP when compared to usual care or no care. Yoga may have a positive effect on depression and other psychological co-morbidities, with maintenance of serum BDNF and serotonin levels. Yoga appears to be an effective and safe intervention for chronic low back pain.
This research was partly supported by the grant, NIH/VA RRDC RX000474
At the request of Jasmine Chehrazi, Founder of YogaActivist.org , a group of nine graduate students enrolled in the Master of Public Health (M.P.H.) program at The George Washington University conducted a literature review on the health benefits of yoga. The review provides YogaActivist.org with information needed to further develop its network of studio-supported yoga outreach programs to diverse communities, both locally and nationally. Specifically, the review highlights the dynamic interplay between stress, weight, and other disease indicators—all of which can be addressed, if not mitigated, through routine participation in yoga.
The group of M.P.H. students searched for relevant articles in academic, peer-reviewed journals, including, but not limited to, the Journal of General Internal Medicine, Journal of Psychiatric Practice, Alternative Therapies in Health and Medicine, International Journal of Nursing Studies, Journal of Affective Disorders, Rehabilitation Oncology, and Topics in Clinical Nutrition. The search was by no means exhaustive, but the group found and summarized 19 different articles demonstrating the effectiveness of yoga in promoting physiological and mental health, as well as in controlling disease and disease indicators. While the 19 studies differ in study type, design, purpose, sample size, target population, yoga method(s) and technique(s), length of follow-up, and overall findings, they together demonstrate the widespread applicability of yoga to diverse populations, irrespective of gender, age, race/ethnicity, weight, or health status.
Through the literature review, the nine students found documentation of yoga’s effectiveness in treating musculoskeletal conditions, improving mental health, reducing stress and anxiety, increasing cortisol levels (associated with self-esteem and tenacity and lower levels of nervousness and depression), improving pulmonary function among asthmatic children, increasing exercise self-efficacy, reducing and/or controlling blood pressure, slowing weight gain, controlling diabetes mellitus, and improving overall mood. Such benefits extend to individuals across the life span. While yoga alone is insufficient to reverse disease or substantially improve health status, the literature suggests that yoga, when combined with other intervention measures, can reap significant physiological and mental health benefits for diverse populations. Yoga is a personal, non-competitive physical activity. When practiced correctly and routinely, yoga provides individuals of all ages with the motivation and self-efficacy needed to live and maintain healthier lifestyles.
Below is a summary of each of the 19 articles regarding the effectiveness of yoga interventions in promoting health. The summaries are categorized by the primary health or behavioral objective of each study.
Yoga and Mental Health
1) Lee SW, Mancuso CA, Charlson ME. Prospective study of new participants in a community-based mind-body training program. J Gen Intern Med. 2004;19(7):760-5.
FINDING: A 3-month yoga program improved mental health scores and other quality of life measures. Yoga Type: Dahn-hak. 1) stretching exercises for large muscle groups and shoulders, neck,hips, back, and knees, 2) postures are held for “energy accumulation 3) 5- to 10-minute meditation intended to facilitate “energy awareness”, 4) repetition of the large muscle group stretches. Yoga Frequency/Duration : 1-hour class offered 2-to-3 times per week for 3 months.
OBJECTIVE: To measure changes in health-related quality of life associated with 3 months of mind-body training as practiced in community-based settings.
METHODS: A prospective cohort study was done in eight centers for the practice of mind-body training in the metropolitan New York City area with 194 adults, and 171 completed the follow-up survey. Participants typically attended a 1-hour class two to three times per week. They were given a questionnaire before the classes began and 3 months later with questions about mental and physical health from validated survey instruments.
RESULTS: At baseline, new participants reported lower scores than U.S. norms for 7 of 8 domains of the Medical Outcomes Study SF-36 general health questionnaire. After 3 months of training, within patient change scores improved in all domains (P< .0001), including a change of +15.5 in the mental health domain. In hierarchical regression analysis, younger age, baseline level of depressive symptoms and a history of hypertension were independent predictors of greater improvement in the SF-36 mental health score. Five participants (2.9%) reported a musculoskeletal injury.
2) Uebelacker LA, Epstein-Lubow G, Gaudiano, BA. Hatha. Yoga for depression: critical review of the evidence for efficacy, plausible mechanisms of action, and directions for future research. J Psychiatr Pract. 2010;16:22–33.
FINDING: A review of eight clinical trials showed the yoga may help treat depression. Note: Methodological concerns with most trials. Yoga Type : Some asana-focused, some meditation-focused Yoga Frequency/Duration : Varied in length from 3 days to 12 weeks and in intensity from daily to once per week.
OBJECTIVE: Review the literature of studies evaluating the efficacy of yoga for the treatment of depression and possible mechanisms .
METHODS: Studies were included in the review if they were clinical trials with one of the intervention arms involving a predominantly yoga intervention and a requirement for participants to have a diagnosed depressive disorder or elevated depression symptoms.
RESULTS: Eight trials were found. The number of participants ranged from 28 to 89. Of the five studies that compared yoga to no/minimal treatment, four found some evidence that yoga was superior to the control group, and the final one did not directly compare the two groups. Studies varied in length of intervention from 3 days to 12 weeks and in intensity from daily to once per week, and different types of yoga were used (some asana-focused and some meditation-focused). Effect sizes of differences varied widely, and methodological differences and flaws threatening internal validity make it difficult to draw generalizable conclusions.
3) Birdee GS, Legedza, AT, Saper RB. Characteristics of yoga users: results of a national survey. J Gen Intern Med . 2008;23(10):1653-1658.
FINDING: A national survey of yoga users showed it to be helpful for overall health and well being, mental health, and musculoskeletal conditions. Yoga Type: N/A Yoga Frequency/Duration : Self-report that person had practiced yoga during past 12 months (and not tai chi or qi gong)
OBJECTIVE: To characterize yoga users, medical reasons for use, perceptions of helpfulness, and disclosure of use to medical professionals.
METHODS: A cross-sectional study was done using data from the National Health Interview Survey Alternative Medicine Supplement with 31,044 respondents. Survey participants were asked if they had practiced yoga during the past 12 months. If they had practiced yoga, but not tai chi or qi gong, they were asked whether they practiced yoga for medical conditions and if it helped their condition and also how important yoga was in maintaining their general health and well-being.
RESULTS: The prevalence of yoga use for health in the U.S. was 5.1percentwith a mean age of 39.5. Most yoga users (58%) felt that yoga was an important part of maintaining their health and well-being. A smaller percentage of yoga users reported using yoga to treat specific medical conditions (16%). Among medical conditions, 10.5percentand 3.3percentof yoga users reported using yoga to specifically treat musculoskeletal and mental health conditions, respectively. A majority of these yoga users reported yoga as helpful for their mental health (83%) and musculoskeletal condition (76%).
4) Woolery A, Myers H, Sternlieb B, Zeltzer L. A yoga intervention for young adults with elevated symptoms of depression. Alter Ther Health Med . 2004;10(2):60-63.
FINDING: A 5-week program of yoga showed reductions in depression and anxiety among young adults. Yoga Type : Iyengar Yoga Frequency/Duration : Two 1-hour classes per week for 5 weeks
OBJECTIVE: To determine the short-term effect of yoga on mood in mildly depressed young adults.
METHODS: Twenty-eight 18-29 year olds with mild depression were randomly assigned to an intervention group or a wait-list control group. The intervention group participated in a 5-week yoga program of two 1-hour classes per week. Measurements of depression and anxiety levels were made using the Beck Depression Inventory (BDI), State Trait Anxiety Inventory (STAI), and Profile of Mood States (POMS) survey instruments before classes began, midway through the program and at the program’s completion. Morning cortisol levels were also taken at the same time points.
RESULTS: The yoga group showed a significantly greater reduction in depression compared to the control group (p<.001). A similar pattern was seen for trait anxiety (p<.001) Significant pre- to post-class reductions were seen in depression-dejection, tension-anxiety, anger-hostility, fatigue-inertia, confusion-bewilderment, and total mood disturbance. Yoga participants also showed higher morning cortisol levels, which are associated with self-esteem, hardiness, and tenacity, and lower levels of nervousness and depression.
5) Chen KM, Chen MH, Chao HC, Hung HM Lin, HS, et al. Sleep quality, depression state, and health status of older adults after silver yoga exercises: cluster randomized trial. Inter J Nurs Stud. 2008;4:154-163.
FINDING: A 6-month yoga program improved sleep quality, depression, and perceived health status among older adults who reside in the community. Yoga Type : Warm up, hatha yoga gentle stretching, relaxation, and guided-imagery meditation. Yoga Frequency/Duration : 70 minutes three times per week for six months.
OBJECTIVE: To test the effects of six months of silver yoga exercises in promoting the mental health of older adults in senior activity centers, especially among the indicators of sleep quality, depression, and self-perception of health status.
METHODS: A cluster randomized trial was conducted in eight senior citizen activity centers in southern Taiwan. Participants were randomly assigned into either the experimental (n = 62) or the control (n = 66) group based on their attendance at selected senior activity centers. A 70-minute silver yoga exercise program was implemented three times per week for six months as the intervention for the participants in the experimental group.
RESULTS: The mental health indicators of the participants in the experimental group were significantly improved in comparison to the participants in the control group after the silver yoga interventions (all p < .05). Many of the indicators improved after three months of the intervention and were maintained throughout the six month study. These indicators included subjective sleep quality (as measured by the Pittsburgh Sleep Quality Index (PSQI) score), daytime dysfunction, physical and mental health perception, and depression state.Silver yoga exercise sessions were taught 3 times per week, for 70 minutes each session, over 6 months. Each 70-minute session included a warm up, hatha yoga gentle stretching, relaxation, and guided-imagery meditation. No additional details regarding postures or sequence are provided. For consistency over the course of the intervention, yoga instructors followed a pre-recorded tape made by the principal investigator which verbally guided them through the sequence of postures for each session.
6 ) Gupta N, Khera S, Vempati RP, Sharma R, Bijlani RL. Effect of yoga based lifestyle intervention on state and trait anxiety. Indian J Physiol Pharmacol. 2006;50(1): 41-47.
FINDING: Short educational program for stress management and lifestyle modification based on yoga leads to reduction in anxiety. Yoga Type : Asanas and pranayama Yoga Frequency/Duration : 8-day outpatient course, 3-4 hours/day, over 10 days (with a 2-day weekend break)
OBJECTIVES: To study the short-term impact of a comprehensive, yet brief, lifestyle intervention based on yoga in diseased and normal individuals.
METHODS: The research subjects had a history of hypertension, coronary artery disease, diabetes mellitus, obesity, psychiatric disorders and thyroid disorders. The intervention consisted of asanas, pranayanama, relaxation techniques, group support, individualized advice, lectures and films on philosophy of yoga, and the place of yoga meditation in daily life, meditation, and stress management.
RESULTS: Outcome measures were anxiety scores taken on the first and last days of the course. Among diseased individuals, improvement was seen in anxiety levels.
7) Galantino ML, Cannon N, Hoelker T, Iannaco J, Quinn L. Potential benefits of walking and yoga on perceived levels of cognitive decline and persistent fatigue in women with breast cancer. Rehab Oncol. 2007;25(3):3-12.
FINDING: Exercise, specifically walking and yoga, have been proven effective in enhancing quality of life and decreasing fatigue in breast cancer populations. Yoga Type : variable Yoga Frequency/Duration : variable
OBJECTIVE: To investigate available evidence for the effect of walking and yoga on breast cancer survival following chemotherapy.
METHODS: Authors searched randomized clinical controlled trials, systematic reviews, cohort studies, and case series for information regarding the effect of walking and yoga on quality of life, persistent fatigue, and perceived levels of cognitive decline in breast cancer populations.
RESULTS: Yoga proved to be beneficial in breast cancer populations, leading to improvements in sleep quality, strength, flexibility, and quality of life. The three main components of yoga—asanas (yoga physical postures), pranayama (breathing exercises/patterns), and dhyana (meditation)—have been shown to decrease fatigue and improve perceptions of vitality.
8 ) Janakiramaiah N, Gangadhar BN, Naga Venkatesha Murthy PJ, Harish MG, Subbakrishna DK, et al. Antidepressant efficacy of Sudarshan Kriya yoga (SKY) in melancholia: a randomized comparison with electroconvulsive therapy (ECT) and imipramine. J Affect Disord. 2000;57(1-3):255-259.
FINDING: Once daily practice of Sudarshan Kriya yoga (SKY) was found to be equally effective to medication and nearly as effective as electro-shock therapy in the remission of depression among patients. Yoga Type : Sudarshan Kriya yoga was used with some changes. To make it widely acceptable to patients and the medical profession, some of the adventitious components (e.g., briefing about positive attitudes to life ‘living in the present’, etc.) were dropped as were the meditative aspects. The physiological technique consisting of only specified rhythms of breathing. This adaptation for clinical purposes was designated Sudarshan Kriya Yoga. There were three sequential components interspersed with normal breating while sitting with eyes closed. The procedure closed with 10-15 minutes of Yoga Nidra (tranquil state) in supine position. Yoga Frequency/Duration : Six 45-minute sessions during mornings per week. For patients with marked diurnal retardation, afternoon sessions were also recommended. Mean number of sessions was 20.
OBJECTIVE: To investigate the efficacy of yoga practice as it compares to traditional treatments of clinical depression.
METHODS: Randomized, control study of 45 patients hospitalized with severe depression (as defined by the Beck Depression Inventory and Hamilton Rating Scale for Depression). The patients were divided into three groups with the first receiving electroconvulsive therapy three times weekly for four weeks. The second group was administered imiprimine, an antidepressant medication, at typical dosing. The last group was trained in SKY and encourages to practice it daily. Pre/Post test surveys focused on depressive effects.
RESULTS: Patients practicing SKY were noted to have a 67percentremission rate of their symptoms showed it to be as effective as imiprimine and nearly as effective as electroconvulsive therapy. Though compelling, the findings are subject to possible selection bias due to inadequate group sizes for statistical validity. However, they are highly suggestive that further investigation into the clinical efficacy of yoga practice is warranted and could present itself as a low-risk/high-reward alternative to traditional depression treatments.
9) Vedamurthachar A, Janakiramaiah N, Hegde JM, Shetty TK, Subbakrishna DK, et al. Antidepressant efficacy and hormonal effects of Sudarshan Kriya Yoga (SKY) in alcohol dependent individuals. J Affect Disord. 2006;94:249-253.
FINDING: Practice of yoga was found to demonstrate antidepressant effects in a randomized control trial among consenting patients participating in alcohol detoxification programs. Measures of cortisol, ACTH and prolactin revealed a possible biological mechanism for yoga’s effects. Yoga Type : The SKY consisted of three distinctive breathing periods (Pranayama):1. Ujjayi pranayama: Consists of slowdeep breathing. Each cycle includes breathing in, holding, breathing out and holding.2. Bhastrika pranayama consists of forced inhalation and exhalation 20 times. Ujjayi and Bhastrika pranayama requires about 12–15 min.3. Cyclical breathing consists of slow, medium, and fast cycles of breathing practiced for a total duration of 30min.These three procedures are done in sitting posture (Sukhasana) with eyes closed. This was followed by Yoga Nidra (lying in a tranquil state) for about 20 min. Yoga Frequency/Duration : One 65-minute session once per day for two weeks.
OBJECTIVE: To determine the effectiveness of yoga practice in the treatment of depression among individuals participating in alcohol dependence detoxification.
METHODS: After a week of detoxification management, subjects were recruited to participate in a randomized-control study. There were a total of 60 subjects who participated in a two-week study. The control group was provided standard detoxification, while the intervention group practiced daily sessions of breathing exercises and yoga practice. Effects were measured with the use of the Beck Depression Inventory (BDI) pre/post each session and morning plasma cortisol, ACTH and prolactin measures were taken prior to and following the two-week intervention.
RESULTS: Both the control and intervention groups displayed a reduction in self-reported depression symptoms according to the BDI. Additionally, there was a noted correlation between depression symptom reduction and reduction of morning plasma cortisol levels among the intervention group participants. Physical measures of cortisol suggest a biological pathway for the observed results among program participants. The small group size is a possible confounder of these results. Also, it was noted by those administering the study that depression symptoms declined in all patients over that same period. However, the level of reduction and the effects on cortisol measures suggest a biological pathway of depression reduction in those practicing yoga.
Yoga and Stress in Children
10) Mendelson T, Greenberg, MT, Dariotis, JK, Gould, LF, Rhoades, BL, et al. Feasibility and preliminary outcomes of a school-based mindfulness intervention for urban youth. J Abnorm Child Psychol. May 4, 2010; DOI:10.1007/s10802-010-9418-x.
FINDING: A 12-week intensive yoga program improved involuntary stress responses in 4 th and 5 th graders. Yoga Type : Yoga-inspired postures and movement series, including bending, stretching, and fluid movement. Poses were selected to enhance muscle tone and flexibility, and students were taught the health benefits of the poses. Students also practiced breathing, starting with beginner exercises and gradually moving to more advanced ones. These exercises trained the youths to use their breath to center and calm themselves. At the end of each class, youth lay on their backs with their eyes closed while the instructors guided them through a mindfulness practice, which involved attending to a specific focus for several minutes, such as paying attention to each breath or sending out positive energy to others. The brief period of discussion prior to the guided mindfulness practice in which instructors offered didactic information about topics such as identifying stressors, using mindfulness techniques to respond to stress, cultivating positive relationships with others, and keeping one’s mind and body healthy. This information was oftenwoven into the subsequent guided mindfulness practice (e.g., using the breath to create calm if something stressful has happened). Yoga Frequency/Duration : Four 45-minute session per week for 12 weeks.
OBJECTIVE: To assess the feasibility, acceptability, and preliminary outcomes of a school-based mindfulness and yoga intervention.
METHODS: Ninety-seven 4 th and 5 th graders in the inner city of Baltimore participated in a 4-day per week 12-week yoga and mindfulness program at school. Each yoga session lasted 45 minutes and occurred during a non-academic time period. Students were given a questionnaire to assess their stress response, depressive symptoms, and relations with peers and school, all of which used validated instruments.
RESULTS: Many students were eager to join the program, and a focus group showed that participants had a positive experience with the program. The intervention group’s survey responses showed significant improvements in involuntary stress responses as compared to controls (p<.001). Significant different were also seen on three subscales, including rumination, intrusive thoughts, and emotional arousal (p<.01).
11) Stueck M, Gloeckner N. Yoga for children in the mirror of science: working spectrum and practice fields of the training of relaxation with elements of yoga for children. Early Child Dev Care. 2005;175:371-377.
FINDING: In a small study, a 15-week program of yoga and relaxation training improved stress responses in preteens. Yoga Type : 1) Relaxation. Used technique called ‘journey through the body’, which consists of different concentration tasks on single body parts. Other used first relaxation techniques are breathing techniques from yoga (ujjayi, nadhi shodana, alternating breathing). 2) Yoga exercises. a) 23 different yoga exercises (based on Shivananda-Yoga, Rishikesh/India) b) individual complex of yoga exercises c) participants can develop their own complex yoga and instruct others. 3) Series of activities such as massage techniques (partner massage, ball massage), meditation (candle meditation), sensory exercises (discovering of objects by touching and smelling), and interactive exercises (‘trust game’, ‘jumping lotus flower’) as well as six different imagery techniques. Yoga Frequency/Duration : One 1-hour session per week for 15 weeks.
OBJECTIVE: To determine whether yoga can assist in reducing stress responses in preteens.
METHODS: Forty-eight 11-12-year olds with abnormal exam anxiety participated in the study with 21 students assigned to the experimental group to participate in a 15-session program of relaxation, yoga, and other meditation and social interaction exercises. Each session lasted one hour. A questionnaire with stress-related items was given to students before the sessions began, immediately after the 15-week program, and three months after the program ended.
RESULTS: Students involved in the program showed improvement in several stress measures. Significant effects were seen in a comparison immediately after the training: decreased aggression, decreased helplessness in school, decreased physical complaints, improved stress coping abilities. In a comparison 3-months later, the following effects were seen: improvements in emotional balance, decreased anxiety, decreased shyness in social contacts, and decreased impulsiveness. In the first post-test measurement, parents also reported their students as being calmer and more balanced (71.4%), less impulsive, aggressive and hot-tempered (38.1%), more concentrated (38.1%), and having fewer complaints (38.1%). Comparisons to the control group were not statistically measured.
Yoga and Attention Problems in Children
12) P eck HL, Kehle TJ, Bray MA, Theodore LA. Yoga as an intervention for children with attention problems. School Psych Rev. 2005;34z:415-424.FINDING: A small study showed an improvement in “time on task” for elementary school students with attention problems. Yoga Type : “Yoga Fitness for Kids” DVD by Gaiam (2003). Deep breathing, postures, and relaxation exercises. Poses included frog, downward dog and bridge. Movement in a gamelike manner interspersed between poses. Ended with guided imagery while lying on their backs. Yoga Frequency/Duration : Two 30-minute sessions per week for 3 weeks.
OBJECTIVE: To investigate the effectiveness of yoga for improving time on task in children with attention problems.
METHODS: Ten students ages 6-10 with attention problems (but not diagnosed with Attention Deficit Hyperactivity Disorder (ADHD)) participated in a 30-minute yoga videotape program twice per week for 3 weeks. Measurements were made of children’s “time on task”, defined as the percentage of intervals observed where the students had eye contact with the teacher or assigned task and performed the requested classroom assignments in 10-minute observations. Measurements occurred twice per week as follows: baseline for 3-7 weeks (varying by grade level), intervention for 3 weeks, and follow-up for 3 weeks. Measurements occurred at the same time each day, and a child of the same gender (for each child in the program) in each classroom was chosen as a comparison.
RESULTS: An improvement in the mean “time on task” was seen both immediately following the intervention (effect size 1.5 to 2.7) and in the follow-up period (effect size 0.77 to 1.95). No change was seen in the comparison group.
Yoga and Asthma in Children
13) Jain SC, Rai L, Valecha A, Jha, UK, Bhatnagar SO , Ram K . Effect of yoga training on exercise tolerance in adolescents with childhood asthma. J Asthma . 1991;28(6):437-442.
FINDING: Yoga training improved pulmonary function and exercise capacity in children and teens with asthma. Yoga Type : Yogic cleansing procedures, postures, and breathing. Yoga Frequency/Duration : Daily for 90 minutes in morning and 1 hour in evening for 40 days.
OBJECTIVE: To determine if yoga can improve pulmonary function and exercise capacity in children with asthma.
METHODS: A study of 46 children with a mean age of 15.8 years and a history of asthma was performed. Children participated in 40 days of yoga training, and measurements were made of forced expiratory volume, distance walked in a 12-minute time period and overall physical fitness as assessed by a modified Harvard Step Test. Twenty-six patients were followed for up to two years and asthma symptoms and medication requirements were measured.
RESULTS: Improvements were seen in expiratory volume, distance walked in a 12-minute time period and overall physical fitness. Of patients followed for up to two years, children showed a continued reduction in asthma symptoms and less need for medication. Fourteen of the children with mild asthma who continued yoga every day for 15-30 minutes remained asymptomatic.NOTE: This article was not available through GWU. The data were obtained from the abstract and from a review article: Galantino ML, Galbavy R, Quinn L. Therapeutic effects of yoga for children: a systematic review of the literature. Pediatr Phys Ther . 2008;20(1):66-80.
Yoga and Obesity, Diabetes, and Cardiovascular Disease
14) Kristal AR, Littman AJ, Benitez D, White E. Yoga practice is associated with attenuated weight gain in healthy, middle-ages men and women. Altern Ther Health Med. 2005;11(4):28-33.
FINDING: Practicing yoga for four or more years slowed weight gain in middle-ages adults. Yoga Type : N/A Yoga Frequency/Duration : Self-report of number of days per week and minutes per day they practiced yoga and the number of years. Yoga practice was grouped into three categories of increasing intensity.
OBJECTIVE: To examine whether yoga practice is associated with a lower mean 10-year weight gain after age 45.
METHODS: 15,550 adults ages 53 to 57 were recruited into the Vitamin and Lifestyle cohort study between 2000 and 2002. A validated physical activity questionnaire was given to the participants, which asked about a variety of activities including yoga. Participants reported the number of years in the last 10 years that they did each activity and the number of days per week and minutes per day. Yoga practice was grouped into three categories of increasing intensity. Self-reported weight and height were used to calculate participants’ current BMI, and the weight change was calculated from the difference between their current weight and their weight at age 45 (also by self-report).
RESULTS: Individuals with a BMI less than 25 who practiced yoga for four or more years had a 3.1 lb. lower weight gain than those who had not practiced yoga. Individuals who were overweight and practiced yoga for four or more years showed an 18.5 lb. lower weight gain. All models were adjusted for other physical activity, dietary factors, and other obesity-related variables.
15) Sahay BK. Role of yoga in diabetes. J Assoc of Physicians India . 2007; 55 :121-126.
FINDING: Yoga has a role in diabetes control and prevention. Yoga Type : Pranayama Yoga Frequency/Duration : N/A
OBJECTIVE: To assess the role of yoga on glycemic control, insulin kinetics, body composition, exercise tolerance, and co-morbidities including hypertension and dyslipidemia.
METHODS: Individuals with diabetes and without diabetes were randomized to different groups and performed yogic practices for 45 minutes each day, which was followed by relaxation practices.
RESULTS: The studies confirmed that yoga has a useful role in the control of diabetes mellitus. Fasting and postprandial blood glucose levels decreased significantly. There were significant changes in insulin kinetics and those of counter-regulatory hormones such as cortisol. There was a decrease in fatty acids. There was an increase in lean body mass and a decrease in body fat percentage. The number of insulin receptors was increased, and there was an improvement in insulin sensitivity and a decline in insulin resistance.
16) Yang K, Bernardo LM, Sereika SM, Conroy MB, Balk J, et al. Utilization of a 3-month yoga program for adults at high risk for type 2 diabetes: a pilot study. Evid Based Complement Alternat Med . Published on-line: August 18, 2009 doi:10.1093/ecam/nep117. 1-7.
FINDING: Yoga may help to lower adult risk for type 2 diabetes, reduce cardio-metabolic risk factors, and increase exercise self-efficacy. Yoga Type : Vinyasa Yoga Frequency/Duration : 1-hour sessions, 2 times per week, for 3 months. Each session began with a 5-7 min warm-up and ended with a 10 min relaxation period.
OBJECTIVE: To conduct a pilot study to assess the feasibility of implementing a 12-week yoga program among adults at high risk for type 2 diabetes.
METHODS: Twenty-three adults were randomly assigned to either a yoga intervention group, which participated in a 3-month yoga intervention with 1-hour Vinyasa style yoga sessions twice per week, or an educational group, which received general health educational materials every 2 weeks. Participants had to: (1) be between 45 and 65 years of age; (2) be non-exercisers (no more than 30 minutes twice per week) for the previous year; (3) have a family history of type 2 diabetes, and; (4) have at least one cardio-metabolic risk factor. All participants completed questionnaires and had blood tests at baseline and at the end of the 3-month program to measure blood pressure, blood glucose, insulin, lipid levels, and body weight, as well as to assess exercise self-efficacy.
RESULTS: Compared with the education group, the yoga group experienced improvements in weight, blood pressure, insulin, triglycerides, and exercise self-efficacy. Findings suggest that a yoga program would possibly help to lower adults’ risk for type 2 diabetes, as well as reduce cardio-metabolic risk factors for adults at high risk for type 2 diabetes.
17) Guarracino JL, Savino S, Edelstein S. Yoga participation is beneficial to obesity prevention, hypertension control, and positive quality of life. Top Clin Nutr . 2006;21(2):108-113.
FINDING: Yoga may be beneficial in controlling weight, blood pressure, and mood. Yoga Type : Hatha and relaxation yoga. Yoga Frequency/Duration : The majority of study participants (55.7%) had practiced yoga for less than 1 year, followed next by those who had practiced yoga for more than 5 years (31.4%). The majority of participants (57.1%) practiced yoga for 1-2 hours per week, followed by those who spent less than 1 hour per week practicing yoga (24.3%).
OBJECTIVE: To evaluate the effects of hatha and relaxation yoga on obesity, blood pressure, and quality of life.
METHODS: Seventy healthy women and men ages 18 years or older were recruited from 3 fitness centers in Massachusetts after completing a 1-hour yoga class and were asked to complete a survey. The survey was used to measure how the participants felt after the yoga class, and questions included those related to yoga frequency and duration, other physical activity and duration, past and present medication use, food consumption behavior, demographic information, and data related to height, weight, blood pressure, tricep skinfold, and waist and mid-arm circumference.
RESULTS: According to survey results of the 70 participants, hatha and relaxation yoga had a statistically significant role in controlling weight, hypertension, and mood. Of the participants, those who had practiced yoga for less than 1 year had a significantly higher systolic blood pressure (mean 117.13) than those who had practiced yoga for 1-4 years (mean 107.56). However, the survey participants’ mean BMI (24.41) was significantly different from the BMI used as a cutoff for determining obesity (30.0), thus suggesting that individuals who practice hatha and relaxation yoga may not generally be obese.
18) Yang K. A review of yoga programs for four leading risk factors of chronic diseases. Evid Based Complement Alternat Med . 2007;4(4):487-491.
FINDING: Yoga programs may be effective in reducing body weight, blood pressure, blood glucose, and cholesterol. Yoga Type : Other than duration and frequency, most articles did not describe the yoga sessions in detail. Of the few articles that did identify the type of yoga studied, the most common was Hatha yoga. Yoga Frequency/Duration : The most common duration and frequency of yoga sessions in the studies were 30-60 min per session, with sessions meeting daily for 4-10 weeks. Many studies also used sessions meeting 2-3 times per week for 8-12 weeks.
OBJECTIVE: To review published studies of yoga programs and to determine the effect of yoga interventions on chronic disease risk factors, such as overweight, hypertension, high glucose level, and high cholesterol.
METHODS: A systemic search was conducted, yielding 32 articles from electronic databases published between 1980 and 2007. Of the 32 articles reviewed, 12 described experimental studies, 18 described quasi-experimental studies, and 2 described observational studies. Only 7 of the studies were conducted in the United States, and only 16 of the studies focused on subjects with diabetes, hypertension, or cardiovascular disease.
RESULTS: In analyzing the 32 articles, the authors found that yoga interventions are generally effective in reducing body weight, blood pressure, blood glucose level, and cholesterol level. However, only a few studies examined long-term effects.
Yoga and other Health Issues
19) Pullen PR, Thompson WR, Benardot D, Brandon LJ, Mehta PK, et al. The Benefits of yoga for African American heart failure patients. Med Sci Sports and Exerc. 2010:42(4): 651-657.
FINDING: Yoga improves cardiovascular endurance for African Americans who have suffered from heart failure. Yoga Type : Pranayama and Asanas. Yoga Frequency/Duration : 5 minute warm-up, including breathing exercises a 40 minute period of postures, ending with a 15 minute relaxation phase. Patients attended a total of 16 supervised sessions over an 8-10 week period.
OBJECTIVE: To see if yoga can improve physical and psychological parameters (cardiovascular endurance (VO2peak), flexibility, quality of life (QoL) and inflammatory markers) among patients with heart failure (HF), particularly among African Americans.
METHODS: Forty patients (38 AA, 1 Asian, 1 Caucasian) with systolic or diastolic HF were randomized to the yoga group (YG, N=21) or the control group (CG, N=19). All patients were asked to follow a home walking program. Pre- and post-measurements included a treadmill stress test to peak exertion, flexibility, interleukin-6 (IL-6), C- reactive protein (CRP), and extra cellular-super oxide dismutase (EC-SOD). QoL was assessed by the Minnesota Living with Heart Failure Questionnaire (MLwHFQ).
RESULTS: Yoga therapy offered additional benefits to the standard medical care of predominantly AA HF patients by improving cardiovascular endurance, QoL, inflammatory markers and flexibility.
After battling and surviving stage III colon cancer, Jean Di Carlo-Wagner was inspired to share with other cancer patients and survivors the healing powers of yoga practice.
Jena Duncan has been involved in supporting and coordinating queer and trans yoga for several years, and began teaching in 2017. Jena uses they/them pronouns. “Yoga has given me the opportunity to live a more vibrant, free, and connected life. Queer and trans yoga has given me the chance to be fully seen for all […]
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Affiliation.
Objective: The objective of this research was to examine the evidence for delivering yoga-based interventions in schools.
Methods: An electronic literature search was conducted to identify peer-reviewed, published studies in which yoga and a meditative component (breathing practices or meditation) were taught to youths in a school setting. Pilot studies, single cohort, quasi-experimental, and randomized clinical trials were considered.
Research: quality was evaluated and summarized.
Results: Twelve published studies were identified. Samples for which yoga was implemented as an intervention included youths with autism, intellectual disability, learning disability, and emotional disturbance, as well as typically developing youths.
Conclusion: Although effects of participating in school-based yoga programs appeared to be beneficial for the most part, methodological limitations, including lack of randomization, small samples, limited detail regarding the intervention, and statistical ambiguities curtailed the ability to provide definitive conclusions or recommendations. Findings speak to the need for greater methodological rigor and an increased understanding of the mechanisms of success for school-based yoga interventions.
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COMMENTS
Our review of the yoga-imaging literature suggests that behavioral mind-body interventions such as yoga practice can affect the anatomy of the brain. Yoga practice appears to be linked to anatomical changes in the frontal cortex, hippocampus, anterior cingulate cortex and insula. Throughout the studies reviewed, yoga practice showed a ...
Conclusions: Yoga has been studied under a wide variety of clinicopathological conditions in the year 2020. This landscape review intends to provide an idea of the role of yoga in various clinical ...
Yoga is one of the integrative therapies that has come to light as having a substantial role in preventing and mitigating such disorders. It thus seems trite to analyze and discuss the research advancements in yoga for 2020. The present review attempts to distill recent research highlights from voluminous literature generated in 2020.
INTRODUCTION. A 3,000 year old tradition, yoga, is now regarded in the Western world as a holistic approach to health and is classified by the National Institutes of Health as a form of Complementary and Alternative Medicine (CAM).[] The word "yoga" comes from a Sanskrit root "yuj" which means union, or yoke, to join, and to direct and concentrate one's attention.[2,3] Regular practice ...
We reviewed 11 studies examining the effects of yoga practice on the brain structures, function and cerebral blood flow. Collectively, the studies demonstrate a positive effect of yoga practice on the structure and/or function of the hippocampus, amygdala, prefrontal cortex, cingulate cortex and brain networks including the default mode network ...
Methods/design: A systematic literature review was conducted to identify articles that assess the effect of yoga and yoga-related interventions on stress reduction in nonclinical populations. Studies were classified according to the length of the intervention, yoga type, and measures of outcome. The studies were selected throughout last 5 years ...
To examine the empirical evidence regarding the mechanisms through which yoga reduces stress, we conducted a systematic review of the literature, including any yoga intervention that measured stress as a primary dependent variable and tested a mechanism of the relationship with mediation. Our electronic database search yielded 926 abstracts, of ...
For example, the Cochrane review of yoga for epilepsy published in 2017 is an update of the review originally published in protocol form in 1998 and as a completed systematic review in 1999. ... making these broader reviews covering yoga easier to identify in the literature. ...
Yoga is one of the integrative therapies that has come to light as having a substantial role in preventing and mitigating such disorders. It thus seems trite to analyze and discuss the research advancements in yoga for 2020. The present review attempts to distill recent research highlights from voluminous literature generated in 2020.
Yoga research in medical health literature continues to increase. ... (5 reviews), audio-led yoga (4 reviews), and video-led yoga in one review. No review evaluates the effect of yoga by type or delivery mechanism for a specific health condition. Twenty reviews report the duration and frequency of yoga sessions.
Yoga is the most popular complementary health approach practiced by adults in the United States. It is an ancient. mind and body practice with origins in Indian philosophy.Yoga combines physical ...
A number of systematic reviews of yoga interventions in a broad range of healthy and chronically ill populations, reported that yoga practice results in decreased stress, anxiety, and depression. 14, 15, 17, 58 Similarly, a 2016 bibliographic review concluded that yoga has beneficial effects on a variety of psychiatric and medical conditions.
A key limitation to this review, and the yoga literature as a whole, is the inherent difficulty in comparing findings across heterogeneous yoga interventions and styles. Although much of modern yoga practiced in the Western world falls under the umbrella of Hatha yoga, including physical postures, meditation, and breath work, stylistic ...
reduces stress, we conducted a systematic review of the literature. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for conducting systematic reviews (Moher, Liberati, Tetzlaff, Altman, & The PRISMA Group, 2009). For this review, the inclusion criteria were: any study of a yoga
D Kanchana. Vivekanandhan S. This study aims to analyze the yoga research publications from the Scopus database between 2008 - 2021 with 9723 research publications and 149619 citations. From the ...
This paper is a narrative review on yoga research published during the last few years (2016-2019). The review includes summaries of papers on prevalence of yoga and the use of yoga for physical and mental health. Most of the studies in the current literature have addressed yoga effects
2.2. Fatigue. We found one systematic review/meta-analysis evaluating the effects of yoga on fatigue in a variety of medical conditions. The review included 19 RCTs and included healthy persons as well as patients with cancer, multiple sclerosis, dialysis, chronic pancreatitis, fibromyalgia, and asthma [].Overall, a small positive effect with an SMD of 0.28 [0.24-0.33] was found.
improve physical fitness, relieve stress, and enhance quality of life. In addition, they may be. addressing specific health conditions, such as back pain, neck pain, arthritis, and anxiety ...
This literature review focuses on 94 college-based studies utilizing yoga interventions published in peer-reviewed journals from 2000 to 2016. Studies from these publications primarily come from India (45%) and the United States (39%). This review article addresses variation in yoga intervention protocols, mainly methodology and duration.
This literature review suggests that yoga is effective in reducing pain and disability, and improving both physical and mental function. The Sherman et al. study employ used a three-arm intervention, and thus, provides important "comparative effectiveness" data by comparing yoga to a conventional stretching program led by physical ...
Through the literature review, the nine students found documentation of yoga's effectiveness in treating musculoskeletal conditions, improving mental health, reducing stress and anxiety, increasing cortisol levels (associated with self-esteem and tenacity and lower levels of nervousness and depression), improving pulmonary function among ...
The studies comparing the effects of yoga and exercise seem to indicate that, in both healthy and diseased populations, yoga may be as effective as or better than exercise at improving a variety of health-related outcome measures. ... (SNS). The purpose of this article is to provide a scholarly review of the literature regarding research ...
Abstract. Objective: The objective of this research was to examine the evidence for delivering yoga-based interventions in schools. Methods: An electronic literature search was conducted to identify peer-reviewed, published studies in which yoga and a meditative component (breathing practices or meditation) were taught to youths in a school ...