Patients' Choices for Yoga Therapy: An Exploratory Cross-Sectional, Convenience-Sampling Survey from India.

In conventional healthcare, patients' preferences for their treatment are determined, though this practice has not been reported for yoga therapy. The present convenience sampling exploratory survey attempted to determine whether those seeking yoga therapy would report preferences for the way yoga therapy is implemented, the therapist's knowledge, and related aspects of yoga therapy. Responses from 426 people attending a yoga therapy institution in India were analyzed. Based on the chi-square test (p < 0.05) and Cramer's V (> 0.10), most people wished to receive yoga therapy in a group of others with a similar disease (42.25%), in a yoga institution (83.57%), and as in-person sessions (48.83%). Patients preferred yoga therapists to know about the principles of yoga (40.38%), to be well-informed generally (61.97%), and to be able to give suggestions for emotional well-being. For the majority of participants (59.4%), the reason for selecting yoga therapy was "a belief in yoga as therapy" (rather than as an add-on therapy or as a last resort). Patients' expectations of yoga therapy were positive, namely a cure of disease (79.34%) and improvement after 1 year (95.8%). Most patients (91.6%) wanted their conventional medicine practitioner to know that they were receiving yoga therapy. Although limited by the study design, survey design, and participant details available, overall results suggest that patients (1) reported specific preferences (for the implementation of yoga therapy and for yoga therapists' knowledge), (2) had expectations of yoga therapy, and (3) most often were interested in their conventional care physicians being informed about the yoga therapy they received.

Use of Yoga in India During the COVID-19 Pandemic: Results of a Patient Based Survey.

No Abstract available.

P300 Following Four Voluntarily Regulated Yoga Breathing Practices and Breath Awareness.

Attention was influenced by yoga breathing in previously published research. Each yoga breathing practice uniquely modifies specific breath characteristics. Differences in the study designs, assessment methods and interventions resulted in difficulty in comparing effects between yoga breathing practices. This study aimed (i) to compare four yoga breathing practices on attention using an auditory oddball task and (ii) to determine cardiac autonomic activity associated with attention using heart rate variability. P300 event related potential was recorded simultaneously with heart rate variability before and after 18-minute periods each of (i) high frequency yoga breathing (with increased breath frequency), (ii) bellows yoga breathing (with increased depth of respiration), (iii) alternate nostril yoga breathing (with alternate nostril patency), (iv) bumblebee yoga breathing (with prolonged exhale), (v) breath awareness (with attention to the breath) and (vi) quiet seated rest as control in 38 yoga experienced males (average age ± SD; 24.08 ± 4.01 years). The six sessions were on separate, randomly allocated days. The P300 peak amplitude recorded at Pz was significantly increased after four yoga breathing practices (Bonferroni adjusted post-hoc tests, repeated measures ANOVA). No significant changes were noted in heart rate variability following yoga breathing or control sessions. These findings suggest that the four yoga breathing practices increase the attentional neural resources engaged for this auditory oddball task, irrespective of the characteristic of breath uniquely regulated in the four yoga breathing practices.

Heartfulness Cleaning and Meditation: Short-Term Effects on Attention and Affect.

Heartfulness meditation (HM) trains the practitioner's attention as they progress towards reaching a super-conscious state. The process is supported by guided "Heartfulness cleaning," which helps clear the mind. This study aimed to examine the short-term effects of HM on affect and cognition and determine whether performing Heartfulness cleaning beforehand influenced the meditation outcome. Forty-eight experienced meditators (age range: 19-71 years and a male-to-female ratio: 27:21) were randomly assigned to 3 sessions: (i) HM, (ii) Heartfulness meditation preceded by cleaning, and (iii) quiet rest as a control. Mood state and emotional well-being were assessed before and after each intervention using established scales such as the Brief Mood Introspection Scale, Global Vigor and Affect Scale, Spielberger's State-Trait Anxiety Inventory, and the Digit Letter Substitution Test. After engaging in both HM and Heartfulness cleaning meditation (HCM) practices, there was a noticeable increase in feelings of pleasantness (7.3%, 7.0%, respectively) and positivity (7.5%, 7.8%, respectively), accompanied by a decrease in negative affect (14.4%, 16.5%, respectively). Additionally, HM and HCM increased in the net and total scores on a substitution test designed to measure associative learning. In contrast, there were no changes observed after 30 minutes of non-meditation. In summary, the findings of this study provide support for the positive impact of Heartfulness meditation and Heartfulness cleaning meditation on emotions, as well as their ability to enhance performance in tasks involving complex attention and associative learning. It should be noted that preceding Heartfulness meditation with 5 minutes of Heartfulness cleaning did not significantly alter the overall outcome of the meditation practice.

Yoga instructors' reported benefits and disadvantages associated with functioning online: A convenience sampling survey.

BACKGROUND: Among numerous changes in response to the COVID-19 pandemic, most yoga classes have repositioned online. However benefits, difficulties and satisfaction of teaching yoga online remain to be studied. With this background the present survey aimed to determine: (i) benefits, disadvantages and satisfaction of teaching yoga online and (ii) their association with characteristics related to (a) socio-demographic, (b) online yoga teaching experience and (c) yoga practice. METHODS: Three hundred and five yoga instructors were invited to take part in the online survey. Of these, 181 (m:f = 98:83) responded to the survey satisfactorily and were included. RESULTS: The three most common benefits of teaching yoga online were: (i) a sense of safety from risk of COVID-19 (93.92%), (ii) cost saving (82.87%) and (iii) wider access to trainees within India (77.90%). The three most common disadvantages were: (i) technical difficulties (74.03%), (ii) missing in-person contact (63.90%) and (iii) concern that online instructions can lead to injury (59.16%). Around 66.30% respondents were satisfied with the monitoring of trainees during online yoga classes while 70.16% respondents were satisfied with the level of attention they could pay to the topic they were teaching during online yoga class. The benefits and disadvantages of teaching yoga online varied with the characteristics of yoga instructors (p < 0.05, χ2 test). CONCLUSIONS: The benefits and disadvantages of teaching yoga online are of relevance during and beyond the pandemic. Characteristics related to (i) socio-demographics, (ii) online yoga teaching and (iii) yoga practice influence reported benefits and disadvantages of teaching yoga online.

Volitional Yoga Breathing Influences Attention and Anxiety: An Exploratory Randomized Crossover Study.

BACKGROUND: Previous studies assessed yoga breathing practices individually. This exploratory, randomized crossover study assessed attention and anxiety following four yoga breathing practices, breath awareness, and quiet seated rest. MATERIALS AND METHODS: Thirty-eight male volunteers between 20 and 37 years (group mean age ± SD; 24.08 ± 4.01 years) were assessed in six sessions in random order (www.randomizer.org) on separate days. The sessions were: (i) alternate nostril yoga breathing, (ii) bellows yoga breathing, (iii) bumblebee yoga breathing, (iv) high-frequency yoga breathing, (v) breath awareness, and (vi) quiet seated rest. The sessions were for 18 min each. Six letter cancellation test (SLCT) and Spielberger's State Trait Anxiety Inventory-state (STAI-s) were administered pre and post each session. Data analysis used general linear mixed model analysis, with fixed effect of states (pre and post) and sessions. RESULTS: A significant main effect of states was observed on total attempted (F1,407 = 5.374, p = 0.021) and net attempted scores (F1,407 = 6.178, p = 0.013) of the SLCT, with a significant increase in scores following high-frequency yoga breathing (padj = 0.031 for total attempted scores; padj = 0.029 for net attempted scores). Also, a significant main effect of states on STAI-s scores was observed (F1,407 = 33.979, p < 0.001), with a significant decrease in scores following alternate nostril yoga breathing (padj = 0.001), bellows yoga breathing (padj = 0.008), bumblebee yoga breathing (padj = 0.002), and high-frequency yoga breathing (padj = 0.042) compared to the corresponding pre state. There was a significant main effect of sessions (F5,407 = 3.043, p = 0.010) on STAI-s scores, with scores post alternate nostril yoga breathing significantly lower than post breath awareness (padj = 0.037). CONCLUSION: Following high-frequency yoga breathing sustained attention was better than before while state anxiety decreased in post-pre comparisons of alternate nostril yoga breathing, bellows yoga breathing, bumblebee yoga breathing, and high-frequency yoga breathing. The differences between breathing practices may be due to differences in degree of volitional regulation of breathing and in the breath patterns modified volitionally. The generalizability of the findings was limited by including an all male, yoga experienced sample. Future research should include participants of both genders and could include different levels of yoga experience, with assessments including objective measures of attention and anxiety.

Benefits and adverse effects associated with yoga practice: A cross-sectional survey from India.

OBJECTIVE: Benefits and adverse effects of yoga were reported in surveys from different countries. The present study aimed to (i) determine the benefits and adverse effects of yoga in yoga experienced persons in India and (ii) correlate these effects of yoga with factors related to the individual and their yoga practice. DESIGN AND SETTING: This convenience sampling in-person survey reports benefits and adverse effects of yoga in 3135 yoga experienced persons. RESULTS: The benefits of yoga were reported by 94.5 percent of the respondents. The three most common benefits were improvement in: (i) physical fitness, (ii) mental state and (iii) cognitive functions. An adverse effect of yoga was reported by 1.9 percent of the respondents. The three most common adverse effects reported were: (i) soreness and pain, (ii) muscle injuries and (iii) fatigue. The following factors showed a significant association (in all cases p < 0.05 Chi square test; Cramer's V > 0.10) with reported benefits of yoga: (i) experience of yoga in months, (ii) time spent practicing yoga in a week, (iii) number of yoga techniques practiced, and (iv) whether awareness was maintained during the yoga practice or not. CONCLUSION: Benefits of yoga practice to physical health were the most common, with soreness and pain the most common adverse effect of yoga. Yoga practice related factors influence the benefits of yoga.

Body Temperature and Energy Expenditure During and After Yoga Breathing Practices Traditionally Described as Cooling.

BACKGROUND In traditional yoga texts, sheetali and sitkari pranayamas are described as cooling. The present study was aimed at recording the surface body temperature, oxygen consumed, and carbon dioxide eliminated before, during, and after performance of sheetali and sitkari pranayamas. MATERIAL AND METHODS Seventeen healthy male volunteers with ages between 19 to 25 years (average age 20.7±1.8 years) were assessed in 4 sessions, viz. sheetali pranayama, sitkari pranayama, breath awareness and quiet lying, on 4 separate days, in random sequence. The axillary surface body temperature (TRUSCOPE II, Schiller, China) and metabolic variables (Quark CPET, COSMED, Italy) were recorded in 3 periods: before (5 minutes), during (18 minutes), and after (5 minutes), in each of the 4 sessions. The heat index was calculated in the before and after periods, based on recordings of ambient temperature and humidity. Data were analyzed using SPSS (Version 24.0). RESULTS Body temperature increased significantly during sheetali and sitkari (p<0.05, p<0.01; respectively) while it decreased after breath awareness and quiet lying down (p<0.01, p<0.001; respectively) when compared with respective post-exercise states. Oxygen consumption increased by 9.0% during sheetali (p<0.05) and by 7.6% during sitkari (p<0.01) while it decreased significantly during (p<0.05) and after (p<0.01) quiet lying down compared to respective pre-exercise states. CONCLUSIONS The results do not support the description of these yoga breathing practices as cooling. These yoga breathing practices may be used to induce a mild hypermetabolic state.

The impact of yoga on teachers' self-rated emotions.

OBJECTIVES: To assess (i) if teachers' age or gender could predict their baseline levels of mental well-being and anxiety and any change after yoga. (ii) Whether mental well-being or anxiety changed following 15 days of yoga in primary school teachers. Primary school teachers took part in this single group longitudinal trial (n = 302, group mean age ± SD; 41.8 ± 5.90 years). They received 240 min of yoga practice and 120 min of yoga theory each day. At baseline and after 15 days of yoga the assessments were (i) mental well-being (Warwick-Edinburgh scale) and (ii) state anxiety (Spielberger's State Trait Anxiety Inventory). RESULTS: Gender acted as a significant predictor for mental well-being scores (P = 0.001) and state anxiety (P = 0.005) in the group at baseline. Females showed higher anxiety scores and lower mental well-being scores. Following yoga the teachers showed a significant increase in mental well-being by 5.84% and a decrease in state anxiety by 4.48%. Trial registration The trial was registered retrospectively (August 15, 2019; Trial Registration Number: ISRCTN90253431).

Quality of Life in Yoga Experienced and Yoga Naïve Asian Indian Adults with Obesity.

Background: Obesity adversely affects quality of life which then acts as a barrier to weight loss and weight loss maintenance. Hence, those interventions which positively influence the quality of life along with weight reduction are considered useful for sustained weight loss in persons with obesity. An earlier study showed better quality of life in obese adults who had experience of yoga compared to yoga naïve obese adults. However, the main limitation of the study was the small sample size (n=20 in each group). Objective: The present study aimed to determine whether with larger sample sizes the quality of life would differ in yoga experienced compared to yoga naïve adults with obesity. Methods: There were 596 Asian Indian obese adults (age range 20 to 59 years; group mean age ± SD; 43.9 ± 9.9 years): of whom (i) 298 were yoga experienced (154 females; group mean age ± SD; 44.0 ± 9.8 years) with a minimum of 1 month of experience in yoga practice and (ii) 298 were yoga naïve (154 females; group mean age ± SD; 43.8 ± 10.0 years). All the participants were assessed for quality of life using the Moorehead-Ardelt quality of life questionnaire II. Data were drawn from a larger nationwide trial which assessed the effects of yoga compared to nutritional advice on obesity over a one-year follow-up period (CTRI/2018/05/014077). Results: There were higher participant-reported outcomes for four out of six aspects of quality of life in the yoga experienced compared to the yoga naïve (p < 0.008, based on t values of the least squares linear regression analyses, Bonferroni adjusted, and adjusted for age, gender, and BMI as covariates). These were enjoyment in physical activities, ability to work, self-esteem, and social satisfaction. Conclusion: Obese adults with yoga experience appear to have better quality of life in specific aspects, compared to yoga naïve persons with a comparable degree of obesity.

Alternate-Nostril Yoga Breathing Reduced Blood Pressure While Increasing Performance in a Vigilance Test.

BACKGROUND Reports suggest that vigilance or sustained attention increases sympathetic activity. A persistent increase in sympathetic activity can lead to an increase in blood pressure. Alternate-nostril yoga breathing has been shown to be useful to (i) improve attention and (ii) decrease the systolic and diastolic blood pressure. Earlier studies did not report simultaneous recordings of the blood pressure and performance in vigilance tests after alternate-nostril yoga breathing. With this background, the present study was planned to determine if 15 minutes of alternate nostril yoga breathing could improve the performance in a vigilance test without an increase in blood pressure. MATERIAL AND METHODS Fifteen healthy male volunteers participated in the study (group mean age ±SD, 22.4±2.4 years). Participants were assessed on 3 separate days in 3 different sessions. These were (i) alternate nostril yoga breathing, (ii) breath awareness, and (iii) sitting quietly as a control. Blood pressure and the digit vigilance test were simultaneously assessed before and after each session. RESULTS Systolic blood pressure (p<0.01), mean arterial blood pressure (p<0.05), and the time taken to complete the digit vigilance test (p<0.05) significantly decreased following alternate-nostril yoga breathing. The time taken to complete the digit vigilance test differed significantly between sessions (p<0.05). The time taken to complete the digit vigilance test was also significantly decreased after sitting quietly (p<0.01). CONCLUSIONS Alternate-nostril yoga breathing appears to improve performance in the digit vigilance test, along with a reduction in systolic blood pressure. This is suggestive of better vigilance without sympathetic activation.

Heart rate variability in chronic low back pain patients randomized to yoga or standard care.

BACKGROUND: Chronic pain can alter the autonomic balance with increased sympathetic activity reflected in altered heart rate variability (HRV). It has been proposed that yoga can be useful to correct the autonomic imbalance in patients with chronic pain who have reduced HRV. METHODS AND DESIGNS: In the present randomized controlled trial 62 patients with chronic low back pain associated with altered alignment of intervertebral discs (aged between 20 and 45 years, 32 males) were randomized to 2 groups. One group received yoga for 3 months while the other group carried out standard medical care based on the physician's advice. The duration was the same, i.e., 3 months. The heart rate variability and rate of respiration were assessed at baseline and at the end of 3 months. RESULTS: There was a significant difference in the baseline (pre) values between groups (p = 0.008) for respiration rate which was higher in the yoga group. The changes reported below are pre-post comparisons within each group. The yoga group showed a significant (p < 0.05; repeated measures ANOVA, post-hoc analyses) decrease in the LF power of HRV, rate of respiration and a significant increase in the HF power of HRV and in the pNN50. CONCLUSION: The results suggest that yoga practice can shift the autonomic balance towards vagal dominance in patients with chronic low back pain associated with altered alignment of intervertebral discs. TRIAL REGISTRATION: The study is registered with the Clinical Trials Registry of India ( CTRI/2012/11/003094 ) and can be accessed at.

Blood pressure and heart rate variability during yoga-based alternate nostril breathing practice and breath awareness.

BACKGROUND: Previous research has shown a reduction in blood pressure (BP) immediately after the practice of alternate nostril yoga breathing (ANYB) in normal healthy male volunteers and in hypertensive patients of both sexes. The BP during ANYB has not been recorded. MATERIAL/METHODS: Participants were 26 male volunteers (group mean age ±SD, 23.8±3.5 years). We assessed (1) heart rate variability, (2) non-invasive arterial BP, and (3) respiration rate, during (a) ANYB and (b) breath awareness (BAW) sessions. Each session was 25 minutes. We performed assessments at 3 time points: Pre (5 minutes), during (15 minutes; for ANYB or BAW) and Post (5 minutes). A naïve-to-yoga control group (n=15 males, mean age ±SD 26.1±4.0 years) were assessed while seated quietly for 25 minutes. RESULTS: During ANYB there was a significant decrease (repeated measures ANOVA) in systolic BP and respiration rate; while RMSSD (the square root of the mean of the sum of squares of differences between adjacent NN intervals) and NN50 (the number of interval differences of successive normal to normal intervals greater than 50 ms) significantly increased. During BAW respiration rate decreased. In contrast, respiration rate increased during the control state. ANYB and BAW were significantly different (2-factor ANOVA) in RMSSD and respiration rate. BAW and control were different with respect to respiration rate. CONCLUSIONS: The results suggest that vagal activity increased during and after ANYB, which could have contributed to the decrease in BP and changes in the HRV.