Effects of an Integrated Yoga Program on Quality of Life, Spinal Flexibility, and Strength in Older Adults: A Randomized Control Trial.

Context: Aging can contribute to a decrease in physical activity as a result of metabolic dysfunction and hormonal imbalance that can cause degenerative joint disease and aging-related inflammation. As age advances, a decrease in muscle mass, muscle strength, and flexibility can impair physical function. Objective: The study intended to evaluate the effects of an integrated yoga module in improving the flexibility, muscle strength, and quality of life (QOL) of older adults. Design: This research team designed a prospective, two-arm, open-label, and parallel, randomized controlled trial. Setting: The study took place in an outpatient department at Divine Park, Yoga & Naturopathy Hospital, Udupi, Karnataka, India. Participants: Participants were 96 older adults, aged 60-75 years (64.1 ± 3.95 years) taking part in a yoga program in the department. Intervention: The program was a three-month, yoga-based lifestyle intervention. The participants were randomly allocated to the intervention group (n = 48) or to a waitlisted control group (n = 48). The intervention group underwent three one-hour sessions of yoga weekly, with each session including loosening exercises, asanas, pranayama, and meditation spanning. Outcome Measures: At baseline and post intervention, assessments were made: (1) for spinal flexibility using a sit and reach test, (2) for back and leg strength using a back leg dynamometer, (3) for handgrip strength (HGS) and endurance (HGE) using a hand-grip dynamometer, and (4) the Older People's Quality of Life (OPQOL) questionnaire. Analysis was performed employing Wilcoxon's Sign Rank tests and Mann Whitney Tests, using an intention-to-treat approach. Results: Compared to the control group, the intervention group experienced a significantly greater increase in spinal flexibility (P < .001), back leg strength (P < .001), HGE (P < .01), and QOL (P < .001) after three months of yoga. Conclusion: Yoga can be used safely for older adults to improve flexibility, strength, and functional QOL. Larger randomized controlled trials with an active control intervention are warranted.

Role of yoga therapy in improving digestive health and quality of sleep in an elderly population: A randomized controlled trial.

INTRODUCTION: Constipation and sleep disturbances commonly affect elderly population results in compromised physical and mental health. Mind-body interventions like yoga not only address the mental and physical health but also promote healthy ageing. This study evaluates the effect of 3 months yoga intervention on the sleep and constipation related quality of life (QoL) among the elderly. MATERIALS AND METHODS: Ninety six participants aged between 60 and 75 who did not had any history of yoga practice for past 1 year and having a zubrod score of 0-2 were randomized in to yoga (n = 48) or waitlisted control (n = 48). The yoga group received yoga interventions at a frequency of 3 sessions per week for 3 months. Pittsburg Sleep Quality Index (PSQI) and Patient Assessment of Constipation QoL (PAC-QOL) were used to assess the improvement. Intention to treat analysis method was used to include the drop-out participants. RESULTS: Eighty one participants (Yoga = 48, waitlisted control = 33) completed the study. Wilcoxon's sign rank test has shown that the yoga group had statistically significant changes in most of the parameters in PSQI and PAC-QOL (P ≤ 0.05). Mann Whitney test revealed that yoga group has better improvement in the sleep quality and constipation related QOL (P ≤ 0.05) compared to the controls. DISCUSSION: The results signify yoga can ease old age related issues like constipation and insomnia. This is encouraging for inclusion of yoga as a daily practice regimen to improve the constipation and sleep related quality of life in elderly population.

Performance on psychomotor tasks following two yoga-based relaxation techniques.

Previously cyclic meditation and supine rest have been shown to improve performance in a letter cancellation task requiring attention, visual scanning, and motor speed. The present study assessed the performance in 57 volunteers (all male, M age = 26.5 yr., SD = 4.6) in three tasks, viz., a digit-letter substitution task (DLST), a letter-copying task, and a circle-dotting task. The DLST assessed attention and speed of information processing, while the other 2 tests assessed motor speed. Each participant was assessed before and after three types of sessions: Cyclic Meditation, Supine Rest, and Control (no intervention). DLST scores and scores for letter-copying and circle-dotting tasks improved significantly after cyclic meditation; the same scores also improved after supine rest. There was no change after the no-intervention/Control session. From the results it was difficult to conclude whether improved DLST scores after cyclic meditation were due to better information processing speed or improved motor speed.

Evidence Base of Yoga Studies on Cardiovascular Health: A Bibliometric Analysis.

Noncommunicable diseases including coronary artery disease contribute to approximately 50% of global mortality. Pharmacological treatment alone may not be a panacea for such diseases since it may be associated with various other adverse effects. Hence, strategies such as Yoga involving healthy lifestyle and stress management are widely sought by the patient population. MATERIALS AND METHODS: An electronic search of PubMed as a standard bibliographic database was performed through February 2015 using the keywords "Yoga" and "Cardiovascular." Studies with Yoga as the independent variable and parameters related to cardiac health as the dependent variable were included and exclusion criteria were applied. RESULTS: A total of 149 publications were identified which met the inclusion criteria for analysis. Of the total publications, 44% were clinical trials of which 19% were randomized controlled trials which may be categorized as high-quality ones. An upward trend in the overall research in this area is evident. Major work has been accomplished by researchers of the United States (38%) and India (29%). CONCLUSION: The survey indicates that the number of publications in the field of "Yoga" and "Cardiovascular" health has increased rapidly in the late years. Analysis comprising the nation/state helps define its status with regard to its counterparts and helps understand science priorities and disease control strategies in an effort to provide cost-effectiveness and quality control. There is a need for further high-quality studies in the field of "Yoga" and "Cardiovascular" diseases to validate the effects of Yoga on health parameters.

Yoga practice to improve sleep quality and body composition parameters of obese male - a randomized controlled trial.

Background Globally obesity increase is a big challenge. Obesity causes many non-communicable diseases. Options to control obesity are in search. Aim: To assess the outcome of 3 months follow-up period, after 14 weeks yoga intervention, for body composition and sleep quality parameters on obese male in urban setting. Materials and methods Design: Parallel group RCT (randomized controlled trial) on obese male. The two groups were yoga and control groups, with yoga (n = 37, age 40.03 ± 8.74), control (n = 35, age 42.20 ± 12.06). The IAYT (integrated approach of yoga therapy) training was given to yoga group for 14 weeks, and the unsupervised yoga practice was continued by the subjects at their home, for further 3 months. Training was 1.5 hour daily for 5 days in a week, which included the IAYT module of Suryanamaskara Asana Pranayama and relaxation. No yoga activity but walking etc. for the same time, was given to control group. Body composition parameters were assessed through BIA (bioelectrical impedance) method using InBody R 20 model. The sleep quality was assessed using PSQI (Pittsburgh sleep quality index). Within group and between group analysis were performed, using SPSS version 21. The correlation analysis was carried out on the difference in pre follow-up values. Results During the follow-up period within the group, the body composition parameters improved and the parameters of quality of sleep showed trends of improvement. Also some of the gain obtained during 14 weeks intervention was lost during follow-up period. Conclusions The changes observed may indicate the long-term benefits of yoga practice for control of obesity in urban setting for males.

Sleep Quality and Body Composition Variations in Obese Male Adults after 14 Weeks of Yoga Intervention: A Randomized Controlled Trial.

BACKGROUND: Obesity is a big challenge all over the world. It is associated with many noncommunicable diseases. Yoga known to be add-on treatment may be effective for obesity control. AIM: To assess the effect of integrated approach of yoga therapy (IAYT) for body composition and quality of sleep in adult obese male. SUBJECTS AND METHODS: A randomized controlled trial was conducted for 14 weeks on obese male of urban setting. Eighty individuals were randomly divided into two groups, i.e., yoga group (n = 40; age; 40.03 ± 8.74 years, body mass index [BMI] 28.7 ± 2.35 kg/m2) and control group (age; 42.20 ± 12.06 years, BMI 27.70 ± 2.05 kg/m2). The IAYT was imparted to yoga group for 1½ hour for 5 days in a week for 14 weeks. The control group continued their regular activities. The body composition by InBody R20 and sleep quality by Pittsburgh Sleep Quality Index (PSQI) were assessed. Statistical analysis was done for within and between groups using SPSS version 21. The correlation analysis was done on the difference in pre-post values. RESULTS: The results showed that weight (P = 0.004), BMI (P = 0.008), bone mass (P = 0.017), obesity degree (P = 0.005), and mineral mass (P = 0.046) were improved in yoga group and no change in control group (P > 0.05). The global score of PSQI improved (P = 0.017) in yoga group alone. CONCLUSION: The results indicate the beneficial effects of IAYT on body composition and sleep quality in obese males. The yoga practice may reduce obesity with the improvement in quality of life.

Effect of Integrated Approach of Yoga Therapy on Male Obesity and Psychological Parameters-A Randomised Controlled Trial.

INTRODUCTION: Obesity is a growing global epidemic and cause of non-communicable diseases. Yoga is one of the effective ways to reduce stress which is one of the causes of obesity. AIM: To assess the effect of Integrated Approach of Yoga Therapy (IAYT) yoga module on adult male obesity in an urban setting. MATERIALS AND METHODS: RCT (Randomized Controlled Trial) was conducted for 14 weeks on obese male subjects with yoga and control groups. Total number of subjects were 72 and they were randomized into two groups (Yoga n=37, Control n=35). The subjects were from an urban setting of Mumbai and were doing yoga for the first time. Special yoga training of IAYT was given to yoga group for one and half hour for 5 days in a week for 14 weeks. The control group continued regular physical activities and no specific physical activity was given. The assessments were anthropometric parameters of weight, Body Mass Index (BMI), MAC (Mid Upper Arm Circumferences) of Left and Right Arm, Waist Circumference (WC), HC (Hip Circumference), WHR (Waist Hip Ratio), SKF(Skin Fold Thickness of Biceps, Triceps, Sub scapular, suprailiac and cumulative), Percentage body fat based on SKF and Psychological Questionnaires of Perceived Stress Scale (PSS) and AAQW (Acceptance and Action Questionnaire for Weight Related Difficulty). These were taken before and after intervention for both yoga and control groups. Within and between group analysis & correlation of differences from post to pre readings among the variables, were carried out using SPSS 21. RESULTS: The anthropometric and psychological parameters were improved in both the groups but changes were significant in yoga group. CONCLUSION: Incorporating the IAYT for obese male in urban setting will be effective for obesity treatment and for reducing the obesity related problems.

Yoga Practice for Reducing the Male Obesity and Weight Related Psychological Difficulties-A Randomized Controlled Trial.

INTRODUCTION: Obesity is a health disorder and increasing all over the world. It is also a cause for many non-communicable diseases. Yoga practice reduces the stress level which may improve the eating habits and help in weight reduction. AIM: To assess the final outcome of the effects after 3 months of the 14 weeks yoga training on obesity of adult male in an urban setting. MATERIALS AND METHODS: This was a randomized controlled trial with parallel groups (Yoga and Control groups) on male obese. Total 80 subjects with Body Mass Index (BMI) between 25 to 35 kg/cm2 were enrolled and randomized into two equal groups in which 72 subjects (yoga n = 37 and control n=35) completed the trial. Yoga group mean age ± SD was 40.03±8.74 and Control group mean age±SD was 42.20±12.06. A 14 weeks special IAYT (Integrated Approach of Yoga Therapy) yoga training was given to the Yoga group and no specific activity was given to Control group. The interim results of this study at 14 weeks were covered in another article which is under process. After the 14 weeks of yoga training the Yoga group was asked to continue the yoga practice for the next 3 months and the Control group was not given any physical activity. The final outcome is covered in this paper. The assessments were anthropometric parameters of body weight (Wt), BMI (Body Mass Index), MAC (Mid-upper Arm Circumferences of left and right arm), WC (Waist Circumference), HC (Hip Circumference), WHR (Waist Hip Ratio), SKF (Skin Fold Thickness) of biceps, triceps, sub scapular, suprailiac and cumulative skin fold thickness value), Percentage body fat based on SKF and Psychological questionnaires of PSS (Perceived Stress Scale) and AAQW (Acceptance and Action Questionnaire for Weight related difficulty). Assessments were taken after 3 months of yoga training, for both Yoga and Control groups. Within group, between group and correlation analyses were carried out using SPSS 21. RESULTS: Improvement in anthropometric and psychological parameters such as Wt, Percentage body fat, PSS were observed in the final outcome. Also, some of the improvements such as AAQW score were lost in the final outcome, compared to interim results. CONCLUSION: The yoga practice is effective for obesity control for adult male in an urban setting.

Influence of Yoga-Based Personality Development Program on Psychomotor Performance and Self-efficacy in School Children.

Selective attention and efficacy are important components of scholastic performance in school children. While attempts are being made to introduce new methods to improve academic performance either as part of curricular or extracurricular activities in schools, the success rates are minimal. Hence, this study assessed the effect of yoga-based intervention on psychomotor performance and self-efficacy in school children. Two hundred ten school children with ages ranging from 11 to 16 years (mean age ± SD; 13.7 ± 0.8 years) satisfying the inclusion and exclusion criteria were recruited for the 10-day yogä program. An equal number of age-matched participants (n = 210; mean ± SD; 13.1 ± 0.8 years) were selected for the control group. Participants were assessed for attention and performance at the beginning and end of 10 days using trail making task (TMT) A and B, and self-efficacy questionnaire. The yoga group showed higher self-efficacy and improved performance after 10 days of yoga intervention. The performance in TMT-A and -B of the yoga group showed a significantly higher number of attempts with a reduction in time taken to complete the task and a number of wrong attempts compared with control group. Results suggest that yoga practice enhances self-efficacy and processing speed with fine motor coordination, visual-motor integration, visual perception, planning ability, and cognitive performance.

Designing, validation, and feasibility of integrated yoga therapy module for chronic low back pain.

CONTEXT: Chronic low back pain (CLBP) is a significant public health problem that has reached epidemic proportions. Yoga therapy has emerged as one of the complementary and alternative therapies for CLBP. AIM: The present study reports the development, validation, and feasibility of an integrated yoga therapy module (IYTM) for CLBP. SETTINGS AND DESIGN: This study was carried out at the SVYASA Yoga University, Bengaluru, South India. The IYTM for CLBP was designed, validated, and later tested for feasibility in patients with CLBP. MATERIALS AND METHODS: In the first phase, IYTM for CLBP was designed based on the literature review of classical texts and recently published research studies. In the second phase, designed IYTM (26 yoga practices) was validated by thirty subject matter (yoga) experts. Content validity ratio (CVR) was analyzed using Lawshe's formula. In the third phase, the validated IYTM (20 yoga practices) was tested on 12 patients for pain, disability and perceived stress at baseline and after 1-month of this intervention. RESULTS: A total of 20 yoga practices with CVR ≥0.33 were included, 6 yoga practices with CVR ≥0.33 were excluded from the designed IYTM. The feasibility study with validated IYTM showed significant reduction in numerical pain rating scale (P = 0.02), Oswestry disability scale (P = 0.02), and Perceived Stress Scale (P = 0.03). CONCLUSION: The designed IYTM was validated by thirty yoga experts and later evaluated on a small sample. This study has shown that the validated IYTM is feasible, had no adverse effects and was useful in alleviating pain, disability, and perceived stress in patients with CLBP. However, randomized control trials with larger sample are needed to strengthen the study.

Job satisfaction, job stress and psychosomatic health problems in software professionals in India.

This questionnaire based study investigates correlation between job satisfaction, job stress and psychosomatic health in Indian software professionals. Also, examines how yoga practicing Indian software professionals cope up with stress and psychosomatic health problems. The sample consisted of yoga practicing and non-yoga practicing Indian software professionals working in India. The findings of this study have shown that there is significant correlation among job satisfaction, job stress and health. In Yoga practitioners job satisfaction is not significantly related to Psychosomatic health whereas in non-yoga group Psychosomatic Health symptoms showed significant relationship with Job satisfaction.

Changes in autonomic variables following two meditative states described in yoga texts.

OBJECTIVES: In ancient yoga texts there are two meditative states described. One is dharana, which requires focusing, the second is dhyana, during which there is no focusing, but an expansive mental state is reached. While an earlier study did show improved performance in an attention task after dharana, the autonomic changes during these two states have not been studied. METHODS: Autonomic and respiratory variables were assessed in 30 healthy male volunteers (group mean age ± SD, 29.1 ± 5.1 years) during four mental states described in traditional yoga texts. These four mental states are random thinking (cancalata), nonmeditative focusing (ekagrata), meditative focusing (dharana), and effortless meditation (dhyana). Assessments were made before (5 minutes), during (20 minutes), and after (5 minutes), each of the four states, on four separate days. RESULTS: During dhyana there was a significant increase in the skin resistance level (p<0.001; post hoc analysis following ANOVA, during compared to pre) and photo-plethysmogram amplitude (p<0.05), whereas there was a significant decrease in the heart rate (p<0.001) and breath rate (p<0.001). There was a significant decrease in the low frequency (LF) power (p<0.001) and increase in the high frequency (HF) power (p<0.001) in the frequency domain analysis of the heart rate variability (HRV) spectrum, on which HF power is associated with parasympathetic activity. There was also a significant increase in the NN50 count (the number of interval differences of successive NN intervals greater than 50 ms; p<0.001) and the pNN50 (the proportion derived by dividing NN50 by the total number of NN intervals; p<0.001) in time domain analysis of HRV, both indicative of parasympathetic activity. CONCLUSIONS: Maximum changes were seen in autonomic variables and breath rate during the state of effortless meditation (dhyana). The changes were all suggestive of reduced sympathetic activity and/or increased vagal modulation. During dharana there was an increase in skin resistance. The changes in HRV during ekagrata and cancalata were inconclusive.

Mindfulness (Vipassana) meditation: effects on P3b event-related potential and heart rate variability.

The concept of mindfulness is based on Vipassana, a Buddhist meditation technique. The present study examines the physiological indices of attention and autonomic regulation in experienced Vipassana meditators to test the claim that mindfulness is an effective therapeutic tool due to its effects on increasing awareness of present experience and emotional self-regulation. Ten male experienced Vipassana meditators underwent two assessment sessions, one where they practiced Vipassana meditation and another where they rested with no meditation (random thinking). Each meditation/no-meditation session lasted 30 min and was preceded and followed by an auditory oddball task with two tones (standard and target). Event-related potentials to the tones were recorded at the Fz, Cz, and Pz locations. Heart rate variability, derived from an EKG, was recorded continuously during the meditation/no-meditation sessions and during a 5-minute baseline before the task. The Vipassana experts showed greater P3b amplitudes to the target tone after meditation than they did both before meditation and after the no-meditation session. They also showed a larger LF/HF ratio increase during specific Vipassana meditation. These results suggest that expert Vipassana meditators showed increased attentional engagement after meditation and increased autonomic regulation during meditation supporting, at least partially, the two claims concerning the clinical effectiveness of mindfulness.

Mid-latency auditory evoked potentials in 2 meditative states.

Mid-latency auditory evoked potentials (MLAEPs) were assessed in 60 participants during 4 mental states described in traditional yoga texts. These 4 mental states are random thinking, nonmeditative-focused thinking, meditative focusing, and meditation. Assessments were made before (5 minutes), during (20 minutes), and after (5 minutes) each of the 4 states, on 4 separate days. There were prolonged latencies of 2 MLAEPs components, the Na and Pa waves during meditation (P < .05, post hoc analyses following analysis of variance [ANOVA]), suggesting that auditory information transmission at the level of the medial geniculate and primary auditory cortex (ie, the neural generators corresponding to the Na and Pa waves) was delayed. Hence, meditation influenced MLAEPs, while meditative focusing did not.

Changes in midlatency auditory evoked potentials following two yoga-based relaxation techniques.

Practicing meditation while focusing on a sound or a symbol influenced midlatency auditory evoked potentials (MLAEPs). Cyclic meditation (CM) is a technique combining yoga postures with meditation while supine, which has influenced the P300 event-related potential. The effects of CM on MLAEPs have not been previously studied. The MLAEPs were studied before and after the practice of CM compared to an equal duration of supine rest (SR) in 47 male volunteers (group mean age 26.5 +/- 4.4 years), recorded from the vertex referenced to linked earlobes. The sessions were one day apart and subjects were randomly assigned to each session. The Pa wave peak latency and Nb wave peak latency significantly increased following CM compared to before CM (repeated measures ANOVA, post-hoc analysis with least significant difference, p<0.05). There was a significant increase in the peak amplitude of the Nb wave (p<0.05) compared to before CM. Post SR there was a significant increase in the peak latency of the Na wave (p<0.05) compared to before SR. In conclusion following CM the latencies of neural generators corresponding to cortical areas is prolonged, whereas following SR a similar change occurs at mesencephalic-diencephalic levels.

Effect of two yoga-based relaxation techniques on memory scores and state anxiety.

BACKGROUND: A yoga practice involving cycles of yoga postures and supine rest (called cyclic meditation) was previously shown to improve performance in attention tasks more than relaxation in the corpse posture (shavasana). This was ascribed to reduced anxiety, though this was not assessed. METHODS: In fifty-seven male volunteers (group average age +/- S.D., 26.6 +/- 4.5 years) the immediate effect of two yoga relaxation techniques was studied on memory and state anxiety. All participants were assessed before and after (i) Cyclic meditation (CM) practiced for 22:30 minutes on one day and (ii) an equal duration of Supine rest (SR) or the corpse posture (shavasana), on another day. Sections of the Wechsler memory scale (WMS) were used to assess; (i) attention and concentration (digit span forward and backward), and (ii) associate learning. State anxiety was assessed using Spielberger's State-Trait Anxiety Inventory (STAI). RESULTS: There was a significant improvement in the scores of all sections of the WMS studied after both CM and SR, but, the magnitude of change was more after CM compared to after SR. The state anxiety scores decreased after both CM and SR, with a greater magnitude of decrease after CM. There was no correlation between percentage change in memory scores and state anxiety for either session. CONCLUSION: A cyclical combination of yoga postures and supine rest in CM improved memory scores immediately after the practice and decreased state anxiety more than rest in a classical yoga relaxation posture (shavasana).