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Maity S, Abbaspour R, Bandelow S, Pahwa S, Alahdadi T, Shah S, Chhetri P, Jha AK, Nauhria S, Nath R, Nayak N, Nauhria S. The psychosomatic impact of Yoga in medical education: a systematic review and meta-analysis. MEDICAL EDUCATION ONLINE 2024; 29:2364486. [PMID: 38861675 PMCID: PMC11168339 DOI: 10.1080/10872981.2024.2364486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 05/31/2024] [Indexed: 06/13/2024]
Abstract
Non-clinical approaches such as meditation, yoga, and mindfulness are popular traditional therapeutical interventions adopted by many educational institutions to improve the physical and mental well-being of learners. This study aimed to evaluate the effectiveness of yoga intervention in improving cardiopulmonary parameters such as blood pressure, heart rate, pulmonary function tests and psychosomatic symptoms such as depression, anxiety and stress in medical and dental students. Using the PRISMA protocol, a search from databases such as PubMed, Scopus, and Embase resulted in 304 relevant articles. After screening the title and abstracts, 47 papers were analyzed thoroughly and included in the qualitative analysis. 18 articles with homogenous statistical data on physiology and psychological parameters were included for meta-analysis. In comparison to the control group, the study showed a significant reduction of systolic blood pressure (SBP: 6.82 mmHg, z = -3.06, p = 0.002), diastolic blood pressure (DBP: 2.92 mmHg, z = -2.22, p = 0.03), and heart rate (HR: 2.55 beats/min, z = -2.77, p = 0.006). Additionally, data from 4 studies yielded a significant overall effect of a stress reduction of 0.77 on standardized assessments due to the yoga intervention (z = 5.29, p < 0.0001). Lastly, the results also showed a significant (z = -2.52, p = 0.01) reduction of 1.2 in standardized anxiety tests in intervention group compared to the control. The findings offer promising prospects for medical educators globally, encouraging them to consider reformation and policymaking in medical curricula to enhance academic success and improve the overall quality of life for medical students worldwide.
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Affiliation(s)
- Sabyasachi Maity
- Department of Physiology, Neuroscience, and Behavioral Sciences, St. George’s University School of Medicine, True Blue, Grenada
| | - Raman Abbaspour
- Department of Electrical Engineering and Computer Science, York University, Toronto, Canada
| | - Stephan Bandelow
- Department of Physiology, Neuroscience, and Behavioral Sciences, St. George’s University School of Medicine, True Blue, Grenada
| | - Sehaj Pahwa
- Medical Student Research Institute, St. George’s University School of Medicine, True Blue, Grenada
| | - Taraneh Alahdadi
- Medical Student Research Institute, St. George’s University School of Medicine, True Blue, Grenada
| | - Sharan Shah
- Medical Student Research Institute, St. George’s University School of Medicine, True Blue, Grenada
| | - Praghosh Chhetri
- Department of Physiology, St. Matthew’s University School of Medicine, Georgetown, Cayman Islands
| | - Ameet Kumar Jha
- Department of Anatomical Sciences, St. Matthew’s University School of Medicine, Georgetown, Cayman Islands
| | - Shreya Nauhria
- Department of Child Protection, Cayman Islands Red Cross, Georgetown, Cayman Islands
| | - Reetuparna Nath
- Department of Education Service, St. George’s University School of Medicine, True Blue, Grenada
| | - Narendra Nayak
- Department of Microbiology, St. Matthew’s University School of Medicine, Georgetown, Cayman Islands
| | - Samal Nauhria
- Department of Pathology, St. Matthew’s University School of Medicine, Georgetown, Cayman Islands
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Nejadghaderi SA, Mousavi SE, Fazlollahi A, Motlagh Asghari K, Garfin DR. Efficacy of yoga for posttraumatic stress disorder: A systematic review and meta-analysis of randomized controlled trials. Psychiatry Res 2024; 340:116098. [PMID: 39191128 DOI: 10.1016/j.psychres.2024.116098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 04/24/2024] [Accepted: 07/21/2024] [Indexed: 08/29/2024]
Abstract
Yoga is an increasingly popular complementary intervention to reduce posttraumatic stress disorder (PTSD) symptoms and related comorbidities, but its safety and treatment efficacy are not firmly established. We conducted a systematic review and meta-analysis of existing randomized control trials (RCTs) of yoga interventions for PTSD and related secondary outcomes (e.g., depression). Initial search results found over 668 potential papers. Twenty met inclusion criteria (e.g., RCTs on adult participants with PTSD that evaluated safety or efficacy outcomes). Meta-analysis indicated that, compared to control interventions, participation in yoga interventions significantly improved self-report PTSD (standardized mean difference [SMD]: -0.51; 95 % confidence interval [CI]: -0.68, -0.35) and immediate (SMD: -0.39; 95 % CI: -0.56, -0.22) and long-term (SMD: -0.44; 95 % CI: -0.74, -0.13) depression symptoms. However, using clinician-reported assessments, yoga interventions were not associated with improved PTSD symptoms. Type of yoga differentially predicted outcomes. Sensitivity analysis showed consistent effect sizes when omitting each study from main analyses. Six studies reported whether any serious adverse events occurred. None were indicated. No publication bias was found, although individual intervention studies tended to be high in bias. Results suggest yoga is likely a safe and effective complementary intervention for reducing PTSD and depressive symptoms in individuals with PTSD. More rigorous RCTs are warranted.
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Affiliation(s)
- Seyed Aria Nejadghaderi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Systematic Review and Meta‑analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Seyed Ehsan Mousavi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran; Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asra Fazlollahi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kimia Motlagh Asghari
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Dana Rose Garfin
- Community Health Sciences, Fielding School of Public Health, University of California, 560 Charles E Young Drive South, Box 951772, Los Angeles, CA 90095, USA.
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Chen Q. Neurobiological and anti-aging benefits of yoga: A comprehensive review of recent advances in non-pharmacological therapy. Exp Gerontol 2024; 196:112550. [PMID: 39173784 DOI: 10.1016/j.exger.2024.112550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 08/12/2024] [Accepted: 08/19/2024] [Indexed: 08/24/2024]
Abstract
Aging is an unavoidable process marked by numerous physiological and psychological changes that profoundly impact overall health and quality of life. As the global population ages, there is a growing interest in non-pharmacological therapies that can mitigate the adverse effects of aging and promote longevity. This narrative review explores the broad spectrum of non-pharmacological mechanisms offering anti-aging benefits, with a special emphasis on holistic practices such as yoga, meditation, and lifestyle interventions. These therapies influence critical biological processes, including reducing oxidative stress, modulating chronic inflammation, enhancing immune function, and preserving telomere length-key markers of cellular aging. Additionally, these practices contribute to improved cardiovascular health, musculoskeletal strength, and mental well-being, fostering a comprehensive approach to healthy aging. Yoga, for instance, combines physical postures, breath control, and meditation to enhance physical flexibility, mental clarity, and emotional balance. Meditation practices are shown to reduce stress and improve cognitive function, further supporting healthy aging. Lifestyle modifications, such as diet and regular physical activity, complement these therapies by promoting overall vitality and reducing the risk of age-related diseases. This review underscores the potential of integrating these non-pharmacological strategies into daily routines to enhance resilience against aging, improve quality of life, and extend healthspan. Furthermore, it highlights the need for continued research to fully elucidate the mechanisms by which these therapies exert their anti-aging effects and to develop evidence-based guidelines for their implementation.
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Affiliation(s)
- Qiaoyan Chen
- Foundation Department, Zhe Jiang Tong Ji Vocational College of Science and Technology, Hangzhou, Zhejiang 311231, China.
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Ha WS, Chu MK. Advances in Exercise in the Clinical Trials of Migraine: A Scoping Review. Curr Pain Headache Rep 2024; 28:753-767. [PMID: 38761296 DOI: 10.1007/s11916-024-01269-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE OF REVIEW This review aimed to investigate emerging evidence regarding the effectiveness of exercise for migraines, focusing on the results of recent trials. Additionally, it explored the possibility of exercise as a treatment for migraines. RECENT FINDINGS Between 2020 and 2023, five, four, one, and two trials were conducted regarding the effect of aerobic exercise, anaerobic exercise, Tai Chi, and yoga, respectively, on migraine; all studies showed significant effects. Two trials on aerobic exercise showed that high-intensity exercise was similar to or slightly more effective than moderate-intensity exercise as a treatment for migraines. Three trials on anaerobic exercise reported its effectiveness in preventing migraines. Regarding efficacy, side effects, and health benefits, aerobic exercises and yoga are potentially beneficial strategies for the prevention of migraines. Further studies are needed to develop evidence-based exercise programs for the treatment of migraines.
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Affiliation(s)
- Woo-Seok Ha
- Department of Neurology, Severance Hospital Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
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Koroglu S, Durat G. The impact of mind-body therapies on the mental health of women victims of violence: A meta-analysis. Arch Womens Ment Health 2024:10.1007/s00737-024-01484-8. [PMID: 38958726 DOI: 10.1007/s00737-024-01484-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 06/11/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE Violence against women is a common public health problem and causes negative mental health outcomes. Mind-body therapies aim to positively affect a person's mental health by focusing on the interaction between mind, body, and behavior. Therefore, this study aims to evaluate the effect of mind-body therapies on women's mental health. METHODS Randomized controlled trials published in the last 20 years comparing mind-body therapies with active control or waiting lists in women victims of violence were included. Pubmed, Cochrane, Scopus, Web of Science, and CINAHL databases were searched until August 2023. The random effects model and fixed effects model were used for data analysis. The heterogeneity of the study was assessed using the I2 index, and publication bias was assessed using Egger's test and funnel plot. RESULTS Twelve eligible studies with a sample size of 440 women victims of violence were selected. Mind-body therapies led to a statistically significant reduction in anxiety scores (SMD: 1.95, 95% CI: 1.01, 2.89), depression scores (SMD: 1.68, 95% CI: 0.83, 2.52) and posttraumatic stress scores (SMD: 0.95, 95% CI: 0.73, 1.18). There was a high level of heterogeneity in the outcome for anxiety (I2 = 85.18), a high level of heterogeneity for depression (I2 = 88.82), and a low level of heterogeneity for PTSD (I2 = 19.61). Results of subgroup analysis based on the number of sessions showed that eight or fewer sessions reduced anxiety (SMD: 3.10, 95% CI: 1.37, 4.83) and depression scores (SMD: 3.44, 95% CI: 1.21, 5.68), while PTSD scores did not change. CONCLUSION Evidence suggests that mind-body therapies may reduce anxiety, depression, and PTSD in women victims of violence.
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Affiliation(s)
- Sevgi Koroglu
- Faculty of Health Sciences, Department of Psychiatric Nursing, Sakarya University, Sakarya, Turkey.
| | - Gülgün Durat
- Faculty of Health Sciences, Department of Psychiatric Nursing, Sakarya University, Sakarya, Turkey
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Mikkonen J, Luomajoki H, Airaksinen O, Goubert L, Pratscher S, Leinonen V. Identical movement control exercises with and without synchronized breathing for chronic non-specific low back pain:A randomized pilot trial. J Back Musculoskelet Rehabil 2024:BMR230413. [PMID: 39031339 DOI: 10.3233/bmr-230413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2024]
Abstract
BACKGROUND Exercise is a first-line treatment for chronic non-specific low back pain (CNSLBP). Exercise combined with specific breathing techniques have the potential to improve multifactorial outcomes. No previous studies, however, have compared outcomes between identical exercises with or without a specific breathing protocol in a uniform clinical study setting. OBJECTIVES 1) To investigate the feasibility of combining synchronized breathing with movement control exercises and evaluate eligibility criteria, randomization procedures, and dropout rates. 2) To study the preliminary efficacy of the interventions on multifactorial outcome measures. METHODS Thirty subjects with CNSLBP were randomized into two groups. Both groups had four contact clinic visits where they received personalized home movement control exercises to practice over two months. The experimental group included a movement control exercise intervention combined with synchronized breathing techniques. Trial registration number: NCT05268822. RESULTS Feasibility was demonstrated by meeting the recruitment goal of 30 subjects within the pre-specified timeframe with enrolment rate of 24.8% (30/121). Synchronized breathing techniques were successfully adhered by participants. Home exercise adherence was nearly identical between the groups without any adverse events. Preliminary efficacy findings on pain intensity, disability, and self-efficacy in the experimental group exceeded the minimal clinically important difference. No such findings were observed in any outcome measures within the control group. Overall, multifactorial differences were consistent because nine out of eleven outcome measures showed greater improvements for the experimental group. CONCLUSION The synchronized breathing with movement control exercises protocol was feasible and may be more beneficial for improving multifactorial outcomes compared to identical exercises alone. Results suggested progression to a full-scale trial.
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Affiliation(s)
- Jani Mikkonen
- Private Practice, Helsinki, Finland
- Department of Surgery (Incl. Physiatry), Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Hannu Luomajoki
- ZHAW School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Olavi Airaksinen
- Department of Surgery (Incl. Physiatry), Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Steven Pratscher
- Department of Community Dentistry and Behavioral Sciences, University of Florida, Gainesville, FL, USA
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Ville Leinonen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurosurgery, Kuopio University Hospital, Kuopio, Finland
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O'Brien J, McIver S, Evans S, Trethewey E, O'Shea M. Yoga as an adjunct treatment for eating disorders: a qualitative enquiry of client perspectives. BMC Complement Med Ther 2024; 24:245. [PMID: 38915010 PMCID: PMC11194889 DOI: 10.1186/s12906-024-04514-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 05/22/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND This qualitative enquiry explores the experiences and perspectives of individuals with an eating disorder (ED) regarding their perceptions of yoga as an adjunct intervention to psychotherapy. It also explores the feasibility, acceptability, and safety of yoga from their perspectives. METHODS This study used a practice-based evidence framework and employed semi-structured interviews with 16 females with an ED. Participants were asked about their perspectives on the use of yoga as an adjunct intervention in ED recovery, perceived risks and what factors supported or hindered engagement. Thematic template analysis was used. RESULTS Three topic areas were elaborated. The first included participants' perceptions of how yoga enhanced their ED recovery. The second included how and when participants came to find yoga in their ED recovery. The final topic explored factors that supported participants with ED to engage in yoga. These resulted in the development of guiding principles to consider when designing a yoga intervention for EDs. CONCLUSIONS This study adds further to the emerging evidence that yoga can bring complementary benefits to ED recovery and provides a biopsychosocial-spiritual framework for understanding these. Findings provide an understanding of how yoga programs can be adapted to improve safety and engagement for people with an ED. Yoga programs for people with EDs should be co-designed to ensure that the physical, social, and cultural environment is accessible and acceptable.
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Affiliation(s)
- Jennifer O'Brien
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia.
| | - Shane McIver
- School of Health and Social Development, Deakin University, Melbourne, Australia
| | - Subhadra Evans
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia
| | - Eleanor Trethewey
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia
| | - Melissa O'Shea
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Australia
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Giridharan S, Kumar NV, Bhana R. The Impact of Kundalini Yoga on Cognitive Function and Memory: A Systematic Review of Randomized Controlled Trials. Cureus 2024; 16:e63161. [PMID: 39070487 PMCID: PMC11272664 DOI: 10.7759/cureus.63161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2024] [Indexed: 07/30/2024] Open
Abstract
Cognitive decline and dementia are significant public health challenges influenced by various modifiable and non-modifiable risk factors. Kundalini yoga (KY) has emerged as a promising non-pharmacological intervention to enhance cognitive function and memory in older adults at risk of cognitive decline. This systematic review aims to evaluate the effects of KY on cognitive function, memory impairment, and related neurobiological and psychological outcomes in older adults. A comprehensive literature search was conducted across PubMed, MEDLINE, Scopus, Web of Science, and the Cochrane Library, covering studies published from January 2000 to December 2023. Randomised controlled trials (RCTs) were included to compare KY with other cognitive enhancement strategies, such as memory enhancement training (MET) and psychoeducation. Five RCTs with 215 participants met the inclusion criteria. The studies varied in sample size (11 to 81 participants) and duration (12 to 24 weeks). The participants were older adults (≥55 years) with mild cognitive impairment (MCI) or subjective cognitive decline (SCD). The interventions compared KY with MET or psychoeducation. KY consistently improved memory performance and executive function. Significant mood enhancements, increased hippocampal volume, and better neural connectivity were observed. KY also reduced pro-inflammatory cytokines and altered ageing-related gene expression, demonstrating both cognitive and neurobiological benefits. KY appears to be a promising intervention for enhancing cognitive function, mood, and neurobiological health in older adults at risk of cognitive decline and dementia. While further research with more extensive, well-designed RCTs is needed to confirm these findings and optimise intervention strategies, the existing evidence supports the integration of KY into cognitive health programmes. Practitioners should ensure proper training and gradual progression to maximise benefits and minimise risks.
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Affiliation(s)
| | | | - Rajanee Bhana
- Oncology, University Hospitals North Midlands, Stoke-on-Trent, GBR
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Hossain MN, Lee J, Choi H, Kwak YS, Kim J. The impact of exercise on depression: how moving makes your brain and body feel better. Phys Act Nutr 2024; 28:43-51. [PMID: 39097997 PMCID: PMC11298280 DOI: 10.20463/pan.2024.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/02/2024] [Accepted: 05/07/2024] [Indexed: 08/06/2024] Open
Abstract
PURPOSE This study aimed to comprehensively explore and elucidate the intricate relationship between exercise and depression, and focused on the physiological mechanisms by which exercise influences the brain and body to alleviate depression symptoms. By accumulating the current research findings and neurobiological insights, this study aimed to provide a deeper understanding of the therapeutic potential of exercise in the management and treatment of depression. METHODS We conducted a systematic review of the scientific literature by selecting relevant studies published up to October 2023. The search included randomized controlled trials, observational studies, and review articles. Keywords such as "exercise," "depression," "neurobiology," "endocrinology," and "physiological mechanisms" were used to identify pertinent sources. RESULTS Inflammation has been linked to depression and exercise has been shown to modulate the immune system. Regular exercise can (1) reduce the levels of pro-inflammatory cytokines, potentially alleviating depressive symptoms associated with inflammation; (2) help in regulating circadian rhythms that are often disrupted in individuals with depression; and (3) improve sleep patterns, thus regulating mood and energy levels. CONCLUSION The mechanisms by which exercise reduces depression levels are multifaceted and include both physiological and psychological factors. Exercise can increase the production of endorphins, which are neurotransmitters associated with a positive mood and feelings of well-being. Exercise improves sleep, reduces stress and anxiety, and enhances self-esteem and social support. The implications of exercise as a treatment for depression are significant because depression is a common and debilitating mental health condition. Exercise is a low-cost, accessible, and effective treatment option that can be implemented in various settings such as primary care, mental health clinics, and community-based programs. Exercise can also be used as an adjunctive treatment along with medication and psychotherapy, which can enhance treatment outcomes.
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Affiliation(s)
- Md Najmul Hossain
- Department of Artificial Intelligence Convergence, Pukyong National University, Busan, Republic of Korea
| | - Jaeeun Lee
- Department of Artificial Intelligence Convergence, Pukyong National University, Busan, Republic of Korea
| | - Hongseok Choi
- Department of Artificial Intelligence Convergence, Pukyong National University, Busan, Republic of Korea
| | - Yi-Sub Kwak
- Department of Physical Education, College of Arts, Design and Sports Science, Dong-eui University, Busan, Republic of Korea
| | - Jongnam Kim
- Department of Artificial Intelligence Convergence, Pukyong National University, Busan, Republic of Korea
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Lenoir Dit Caron R, Verdun S, Triquenot-Bagan A, Tourny C, Coquart J. Yoga in the Rehabilitation of Post-Stroke Sequelae: A Non-Inferiority Randomized Controlled Trial. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:543-553. [PMID: 38011022 DOI: 10.1089/jicm.2023.0315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Introduction: Stroke survivors can experience various consequences that affect their physical and psychological balance. Yoga seems to be relevant for this population as it allows to work on both the body and the mind. The first objective of this study was to investigate the non-inferiority of yoga compared with conventional physical activity in improving physical function in patients with chronic post-stroke sequelae. The secondary objective was to investigate the superiority of yoga in improving the mental health of these patients. Methods: A randomized controlled trial was conducted. Thirty-six patients were randomized into two groups to practice a yoga program (YOG'AVC) or the Fitness and Mobility Exercise (FAME) program. Patients were assessed in a blinding mode pre- (T0) and post-program (T1) and 3-4 months after completion (T2). The physical assessments were the Berg Balance Scale, timed up and go test, 6-minute walk test, and quadriceps strength measured by hand-held dynamometer. Questionnaire assessments were: Activities-specific Balance Confidence Scale-Simplified, State-Trait Anxiety Inventory, Beck's Depression Inventory, and the Reintegration to Normal Living Index. Results: The YOG'AVC program was not inferior to the FAME program in improving balance, functional mobility and muscle strength. Both groups showed significant improvement (p < 0.05) between T0 and T1 in their anxiety, depression, and reintegration to normal life scores, with no significant difference between groups. Discussion: Both programs seem to be valuable in improving the physical abilities and psychological well-being of chronic post-stroke patients. However, further studies are required to confirm the difference between these programs.
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Affiliation(s)
- Rita Lenoir Dit Caron
- Univ Rouen Normandie, Normandie Univ, CETAPS UR 3832, Rouen, France
- Clinical Research Department, La Musse Hospital (Fondation La Renaissance Sanitaire), Saint-Sébastien-de-Morsent, France
| | - Stéphane Verdun
- Lille Catholic Hospitals, Biostatistics Department-Delegations for Clinical Research and Innovation, Lille Catholic University, Lille, France
| | | | - Claire Tourny
- Univ Rouen Normandie, Normandie Univ, CETAPS UR 3832, Rouen, France
| | - Jeremy Coquart
- Univ. Lille, Univ. Artois, Univ. Littoral Côte D'Opale, ULR 7369-Unité de Recherche Pluridisciplinaire Sport Santé Société (URePSSS), Lille, France
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Srinivasan R, Rodgers-Melnick SN, Rivard RL, Kaiser C, Vincent D, Adan F, Dusek JA. Implementing paper-based patient-reported outcome collection within outpatient integrative health and medicine. PLoS One 2024; 19:e0303985. [PMID: 38809886 PMCID: PMC11135778 DOI: 10.1371/journal.pone.0303985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 05/04/2024] [Indexed: 05/31/2024] Open
Abstract
OBJECTIVE To investigate the feasibility of pre- and post-encounter patient-reported outcome (PRO) measure collection within an outpatient integrative health and medicine (IHM) clinic and to characterize factors associated with successful completion. METHODS We conducted a retrospective review of 27,464 outpatient IHM encounters including 9,520 chiropractic; 8,237 acupuncture; 5,847 massage; 2,345 IHM consultation; and 1,515 osteopathic manipulation treatment encounters at four clinics offering IHM over 18 months. Patients were asked to complete paper questionnaires rating pain, anxiety, and stress from 0-10 immediately pre- and post-encounter. Generalized linear mixed effect regression models were used to examine the relationship between demographic, clinical, and operational covariates and completing (1) pre-encounter and (2) paired (i.e., pre and post) PROs. RESULTS Patients (N = 5587, mean age 49 years, 74% white, 77% female) generally presented for musculoskeletal conditions (81.7%), with a chief complaint of pain (55.1%). 21,852 (79.6%) encounters were among patients who completed pre-encounter PROs; 11,709/21,852 (53.6%) completed subsequent post-encounter PROs. Odds of PRO completion were more impacted by provider, operational, and clinical-level factors than patient factors. Covariates associated with increased odds of pre-encounter PRO completion included being female, having additional IHM encounters, and having a pain or anxiety complaint. Covariates associated with increased odds of paired PRO completion included being aged 31-40 vs. 51-60 years and having additional IHM encounters. CONCLUSION Implementing a paper-based PRO collection system in outpatient IHM is feasible; however, collecting post-encounter PROs was challenging. Future endeavors should leverage the electronic health record and patient portals to optimize PRO collection and engage patients and clinical providers.
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Affiliation(s)
- Roshini Srinivasan
- Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, United States of America
- Duke University School of Medicine, Durham, NC, United States of America
| | - Samuel N. Rodgers-Melnick
- Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, United States of America
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, United States of America
| | - Rachael L. Rivard
- Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, United States of America
- Center for Evaluation Survey and Research, HealthPartners Institute, Minneapolis, MN, United States of America
| | - Christine Kaiser
- Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, United States of America
| | - David Vincent
- Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, United States of America
| | - Francoise Adan
- Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH, United States of America
- Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, United States of America
| | - Jeffery A. Dusek
- Susan Samueli Integrative Health Institute, University of California Irvine, Irvine, CA, United States of America
- Department of Medicine, University of California Irvine, Irvine, CA, United States of America
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Lu J, Kang J, Huang H, Xie C, Hu J, Yu Y, Jin Y, Wen Y. The impact of Yoga on patients with knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials. PLoS One 2024; 19:e0303641. [PMID: 38753745 PMCID: PMC11098307 DOI: 10.1371/journal.pone.0303641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 04/29/2024] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVE The objective of this review is to conduct a comprehensive and systematic assessment of the efficacy of Yoga as an intervention for knee osteoarthritis (KOA). METHODS We searched PubMed, Cochrane Library, Embase, Web of Science, and PEDro as of January 3, 2024. Retrieved a total of 200 articles. Standardised mean differences (SMDs) and 95% confidence intervals (CI) were calculated. RESULTS The study included a total of 8 trials and involved 756 KOA patients. The results indicated that compared to the control group, Yoga exercise showed significant improvements in alleviating pain (SMD = -0.92; 95% CI = -1.64 ~ - 0.20; P = 0.01, I2 = 94%), stiffness (SMD = -0.51; 95% CI = -0.91 ~ -0.12; P = 0.01; I2 = 66%) and physical function (SMD = -0.53; 95% CI = -0.89 ~ -0.17; P = 0.004; I2 = 59%) among KOA patients. However, there was no significant improvement observed in terms of activities of activity of daily living (ADL) (SMD = 1.03; 95% CI = -0.01 ~ 2.07; P = 0.05; I2 = 84%), and quality of life (QOL) (SMD = 0.21; 95% CI = -0.33 ~ 0.74; P = 0.44; I2 = 83%) with the practice of Yoga. CONCLUSIONS In general, Yoga has been found to be effective in reducing pain and stiffness in KOA patients, it can also improve the physical function of patients. However, there is limited evidence to suggest significant improvements in terms of ADL and QOL.
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Affiliation(s)
- Junyue Lu
- School of Rehabilitation Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Jiliang Kang
- School of Rehabilitation Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Haoyuan Huang
- The Third Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Chen Xie
- School of Rehabilitation Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Jiaxuan Hu
- School of Rehabilitation Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Yan Yu
- School of Rehabilitation Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Yu Jin
- School of Rehabilitation Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Youliang Wen
- School of Rehabilitation Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
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Begasse de Dhaem O, Bernstein C. Yoga for Migraine Prevention: An Ancient Practice with Evidence for Current Use. Curr Pain Headache Rep 2024; 28:383-393. [PMID: 38502436 DOI: 10.1007/s11916-024-01234-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE OF REVIEW The objective of this study is to review the recent literature on yoga for migraine prevention either as adjuvant or standalone therapy. Yoga is one of the most widely used complementary and integrative medicine (CIM) therapies; clinicians should be familiar with yoga practice so that they can best advise interested patients. It is also important to assess study design and types of yoga offered. Using PubMed and Litmaps, research published from 2018 to 2023 addressing yoga and migraine was assessed. RECENT FINDINGS Two systematic reviews and six studies have recently been published on yoga as adjunctive migraine preventive treatment. There is class III evidence and a grade B recommendation for yoga as an adjunct migraine preventive treatment. Yoga has been shown to reduce headache frequency, disability, and likely also pain intensity and self-efficacy. Two studies (one in children and one in adults) suggested that yoga as standalone migraine preventive treatment reduces pain intensity, disability, and perceived stress. More research is needed on the long-term efficacy (including change in monthly migraine days specifically in addition to headache frequency) and adherence to yoga practice for the prevention of migraine. In addition, to our knowledge, there is no study evaluating yoga practice in the prodromal or headache phase of migraine as acute treatment.
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Affiliation(s)
- Olivia Begasse de Dhaem
- Department of Neurology, University of Connecticut, Hartford HealthCare, 300 Post Road West Suite 102, Westport, CT, 06880, USA.
| | - Carolyn Bernstein
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
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Brandão T, Martins I, Torres A, Remondes-Costa S. Effect of online Kundalini Yoga mental health of university students during Covid-19 pandemic: A randomized controlled trial. J Health Psychol 2024; 29:567-580. [PMID: 38230561 PMCID: PMC11075415 DOI: 10.1177/13591053231220710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024] Open
Abstract
University students were at an increased risk for psychological distress during the COVID-19 pandemic. Using a randomized controlled trial, we examined the efficacy of an online Kundalini Yoga intervention on students' psychological functioning. Healthy university students (N = 106) were randomly assigned to a Kundalini Yoga group, an active control group, or a passive control group in a 1:1:1 ratio. The experimental group attended six Yoga sessions over 6 weeks and the active control group attended to six autogenic relaxation sessions over 6 weeks. All participants completed the study protocol, which involved answering questionnaires related to psychological distress, emotion regulation, self-compassion, self-concept, spiritual well-being, and subjective happiness at three different time points: baseline, at the end of the intervention, and at 1-month follow-up. Results showed that Yoga contributed to improving self-compassion, extrinsic affect improving, and personal and communal spiritual well-being, in comparison to the control groups.
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Affiliation(s)
- Tânia Brandão
- William James Center for Research Ispa—Instituto Universitário, Portugal
| | - Inês Martins
- Departamento de Educação e Psicologia, Escola de Ciências Humanas e Socias, Universidade de Trás-os-Montes e Alto Douro, Portugal
| | - Ana Torres
- Department of Psychology and Education, Faculty of Social Sciences, University of Beira Interior, Portugal
- Center for Health Technology and Services Research of the Health Research Network (CINTESIS@RISE), Department of Education and Psychology, University of Aveiro, Portugal
| | - Sónia Remondes-Costa
- Departamento de Educação e Psicologia, Escola de Ciências Humanas e Socias, Universidade de Trás-os-Montes e Alto Douro, Portugal
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15
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Abiç A, Yilmaz Vefikuluçay D. The Effect of Yoga on Menopause Symptoms: A Randomized Controlled Trial. Holist Nurs Pract 2024; 38:138-147. [PMID: 38709129 DOI: 10.1097/hnp.0000000000000646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
The research was conducted as a randomized controlled study with the aim of determining the effect of yoga on menopause symptoms. Menopausal women between the ages of 40 and 60 years were included in the research. There were 31 menopausal women in each of 2 groups, making a total of 62. A Descriptive Characteristics Form and the Menopause Rating Scale (MRS) were used to collect data. In the research, the yoga group practiced yoga for 60 minutes twice a week for 10 weeks. In the final lesson of the 10 weeks of yoga training, the women were again given the MRS. No intervention was performed on the control group. The median score on the MRS of the women in the yoga group was 16 (11-21) in the pretest, and 5 (3-9) in the posttest (P < .05). The median score on the subscale of psychological complaints of the women in the yoga group was 6 (3-8) in the pretest, and 1 (1-2) in the posttest (P < .05). The median score on the subscale of urogenital complaints of the women in the yoga group was 3 (3-5) in the pretest, and 1 (0-2) in the posttest (P < .05). The median score on the subscale of somatic complaints of the women in the yoga group was 7 (4-10) in the pretest, and 1 (1-3) in the posttest (P < .05). It was concluded from the research that 60 minutes of yoga 2 days a week for 10 weeks may reduce the psychological, somatic, and urogenital symptoms experienced in menopause.
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Affiliation(s)
- Arzu Abiç
- Author Affiliations: Department of Obstetrics and Gynecology Nursing, Eastern Mediterranean University Department of Nursing, Famagusta, Turkish Republic of Northern Cyprus (Dr Abiç); and Department of Obstetrics and Gynecology Nursing, Mersin University Faculty of Nursing, Mersin, Turkey (Dr Yilmaz Vefikuluçay)
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16
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Zok A, Matecka M, Bienkowski A, Ciesla M. Reduce stress and the risk of burnout by using yoga techniques. Pilot study. Front Public Health 2024; 12:1370399. [PMID: 38699423 PMCID: PMC11064875 DOI: 10.3389/fpubh.2024.1370399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 03/01/2024] [Indexed: 05/05/2024] Open
Abstract
Introduction This article examines the effectiveness of yoga in managing stress, with a particular focus on work-related stress. Yoga combines physical postures, breath control, and meditation, and has gained recognition for its potential to relieve stress. Purpose This study aimed to investigate the motivating factors behind individuals adopting yoga exercises and to assess the effects of regular yoga practice, with a particular focus on age-related differences. Additionally, we aimed to compare participants' expectations with the actual results of their yoga practice. Methods To achieve this, we conducted a comprehensive survey using an online form, which was completed by 520 yoga practitioners. Participants were surveyed about their motivation, the effects they experienced, and the type of yoga they practiced. Results The results showed that the most common motivation for individuals practicing yoga was stress reduction. Additionally, the analysis of the effects of regular yoga practice demonstrated a significant reduction in stress levels, with experienced practitioners reporting lower stress levels compared to beginners. In conclusion, the study suggests that regular yoga practice can be an effective way to reduce stress levels. Conclusion Dynamic forms of yoga, which incorporate fluid movements and synchronized breathing techniques, are highly effective approaches to stress management and relief. These findings highlight the value of yoga as a tool for individuals of all ages seeking stress relief and overall well-being. Another advantage of yoga practice is its affordability and lack of negative side effects.
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Affiliation(s)
- Agnieszka Zok
- Department of Philosophy of Medicine and Bioethics, Poznan University of Medical Sciences, Poznan, Poland
| | - Monika Matecka
- Department of Occupational Therapy, Poznan University of Medical Sciences, Poznań, Poland
| | - Artur Bienkowski
- Department of Philosophy of Medicine and Bioethics, Poznan University of Medical Sciences, Poznan, Poland
| | - Magdalena Ciesla
- Department of Philosophy of Medicine and Bioethics, Poznan University of Medical Sciences, Poznan, Poland
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17
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Ahuja N, Bhardwaj P, Pathania M, Sethi D, Kumar A, Parchani A, Chandel A, Phadke A. Yoga Nidra for hypertension: A systematic review and meta-analysis. J Ayurveda Integr Med 2024; 15:100882. [PMID: 38484438 PMCID: PMC10950755 DOI: 10.1016/j.jaim.2023.100882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/05/2023] [Accepted: 12/15/2023] [Indexed: 03/24/2024] Open
Abstract
BACKGROUND Hypertension is a prevalent chronic condition that affects a substantial proportion of the world's population. Medications are commonly prescribed for hypertension management, but non-pharmacological interventions like yoga are gaining popularity. OBJECTIVE The purpose of this systematic review and meta-analysis is to assess the efficacy of Yoga Nidra (YN) for the management of hypertension. METHODS A systematic review and meta-analysis of clinical trials, i.e., non-randomized and randomized controlled trials (RCTs) was conducted to investigate the effects of YN on hypertension. PubMed, the Cochrane Library, SCOPUS, and EBSCO were searched for relevant studies published up to September 2022. The quality of the included studies was assessed using the Cochrane risk of bias tool. The primary outcome measure was the change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) after YN intervention, analyzed as weighted mean difference (WMD), in comparison to control groups. The random-effects model was used for the meta-analysis. Risk of bias was assessed for RCTs and non-RCTs using Cochrane's RoB-2 and ROBINS-I tools, respectively. RESULTS Five RCTs and three Non-RCTs involving a total of 482 participants (239 for YN vs 243 for controls) were included in this review. The meta-analysis indicated that YN significantly reduced SBP (WMD = 12.03 mm Hg, 95% CI [7.12, 16.93], Z = 4.80, p < 0.00001) and DBP (WMD = 6.32 mm Hg, 95% CI [3.53, 9.12], Z = 4.43, p < 0.00001) compared to control groups. The overall risk of bias for the three RCTs was high, whereas for the five non-RCTs, one had an overall moderate risk while the other four had an overall serious risk of bias. DISCUSSION This systematic review and meta-analysis provides evidence supporting the efficacy of YN as a complementary therapy for hypertension management. YN is a safe, cost-effective, and easily accessible intervention that primarily relies on interoception and induces a deep relaxation response in practitioners, aiding them in coping with various components of high blood pressure, such as stress, vascular inflammation, peripheral vascular resistance, etc. Our understanding of the mechanisms of YN is constantly evolving, and there is a need for further research to fully explore and appreciate the significance of this ancient science and its potential efficacy on BP. Considering the results and the multifactorial role of YN, it can act as a safe and reliable adjuvant therapy to complement the pharmacological treatment of hypertension. However, further studies with larger sample sizes, longer follow-up periods, and homogenous populations are warranted. CONCLUSION This meta-analysis suggests that YN is effective in reducing SBP and DBP, particularly in individuals with hypertension. The results highlight the potential of YN as a complementary therapy for hypertension management. Healthcare providers may consider recommending YN to patients with hypertension as an adjuvant therapy to medication. Further studies are required to identify standardized optimal forms and durations of YN best suited for hypertension management.
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Affiliation(s)
- Navdeep Ahuja
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Praag Bhardwaj
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Monika Pathania
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
| | - Dilasha Sethi
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana - SVYASA, Bangaluru, Karnataka, India
| | - Arjun Kumar
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ashwin Parchani
- Dept. of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Akshita Chandel
- Dept. of General Medicine, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India
| | - Aashish Phadke
- Division of Endocrine and Metabolic Disorders - Lifestyle Modulations and Yoga Modules, Kasturba Health Society - Medical Research Centre, Mumbai, Maharashtra, India
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18
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Baishya A, Metri K. Effects of yoga on hypothyroidism: A systematic review. J Ayurveda Integr Med 2024; 15:100891. [PMID: 38507967 PMCID: PMC10966165 DOI: 10.1016/j.jaim.2024.100891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/31/2023] [Accepted: 01/18/2024] [Indexed: 03/22/2024] Open
Abstract
Evidence from clinical trials has shown positive effects of yoga on hypothyroidism. To date, there is no review of these studies. This systematic review evaluates the efficacy of yoga as a therapeutic intervention for hypothyroidism. PubMed, Medline, PsycINFO, and Science Direct databases were searched to identify relevant literature. The review included clinical studies that evaluated the effects of yoga on hypothyroidism. Studies that were not conducted inenglish, unavailable, non-experimental, or those that were reviews, case studies, case reports, not based on yoga, involved yoga as a intervention, or included a mixed population were excluded. Eleven studies (n = 516) met the eligibility criteria. Of these, four studies were RCTs, two non-RCTs and five were pretest-posttest studies. The duration of the yoga intervention varied from 1 to 6 months. Most of these studies adopted a combination of suryanamaskar, asana, pranayama and meditation. On quality assessment, one study had a low risk of bias (1 RCT), six studies had a moderate risk of bias (3 RCTs, one non-RCT and two pretest-posttest studies), and four studies had a high risk of bias (1 non-RCT and three pretest-posttest studies). The outcome measures assessed were TSH, T3, T4, and thyroid medication usage, lipid indices, BMI, heart rate variability, pulmonary measures, blood glucose, anxiety, depression, self-esteem, quality of life and sleep. The majority of the studies reported significant improvements in these outcomes following yoga intervention. This systematic review reports evidence for effects of yoga on various outcome measures in hypothyroidism, suggesting its possible role in the management of hypothyroidism. However, there is a need for adequately powered, high-quality RCT studies in the future to draw a definitive conclusion.
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Malipeddi S, Mehrotra S, John JP, Kutty BM. Practice and proficiency of Isha Yoga for better mental health outcomes: insights from a COVID-19 survey. Front Public Health 2024; 12:1280859. [PMID: 38371236 PMCID: PMC10869487 DOI: 10.3389/fpubh.2024.1280859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/11/2024] [Indexed: 02/20/2024] Open
Abstract
Introduction The COVID-19 pandemic has brought about unparalleled suffering on a global scale, affecting both physical and mental well-being. In such challenging times, it becomes crucial to identify interventions that can alleviate negative mental health outcomes, such as stress, while promoting positive mental health outcomes, like well-being. We report the effectiveness of a mind-body practise, Isha Yoga, in promoting well-being. Methods We conducted an online survey, during the COVID-19 pandemic, with Yoga practitioners (n = 1,352) from the Isha Yoga tradition in Karnataka, India. We evaluated stress and well-being attributes using conventional psychometric questionnaires. Subsequently, we requested the Isha Yoga practitioners to share another survey with their friends and family members, assessing similar outcomes. From the respondents of this shared survey (n = 221), we identified individuals who currently did not engage in any form of Yoga or meditation, constituting the non-Yoga control group (n = 110). To enhance the reliability and validity of our study and minimize the limitations commonly associated with online surveys, we adhered to the CHERRIES guidelines for reporting survey studies. Results Isha Yoga practitioners had significantly lower levels of stress (p < 0.001, gHedges = 0.94) and mental distress (p < 0.001, gHedges = 0.75) while reporting significantly higher levels of well-being (p < 0.001, gHedges = 0.78) and affective balance (p < 0.001, gHedges = 0.80) compared to the control group. Furthermore, expertise-related improvements were observed in these outcomes, and a dose-response relationship was found between regularity of Isha Yoga practice and outcome changes. A minimum 3-4 days of weekly practice showed significant differences with the control group. In addition, we investigated the effect of Isha Yoga on stress and well-being among the healthcare workers (HCWs) in our sample and observed better mental health outcomes. Discussion These findings collectively underscore the benefits of Mind and Body practices like Isha Yoga on various aspects of mental health and well-being, emphasizing its potential as an effective and holistic approach for promoting a healthy lifestyle among diverse populations, including healthcare workers, even in difficult circumstances such as the COVID-19 pandemic.
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Affiliation(s)
- Saketh Malipeddi
- Centre for Consciousness Studies, Department of Neurophysiology, NIMHANS, Bengaluru, Karnataka, India
| | - Seema Mehrotra
- Department of Clinical Psychology, NIMHANS, Bengaluru, Karnataka, India
| | - John P. John
- Multi-modal Brain Image Analysis Laboratory, Department of Psychiatry, NIMHANS, Bengaluru, Karnataka, India
| | - Bindu M. Kutty
- Centre for Consciousness Studies, Department of Neurophysiology, NIMHANS, Bengaluru, Karnataka, India
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20
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Loewenthal J, Berning MJ, Wayne PM, Eckstrom E, Orkaby AR. Holistic frailty prevention: The promise of movement-based mind-body therapies. Aging Cell 2024; 23:e13986. [PMID: 37698149 PMCID: PMC10776124 DOI: 10.1111/acel.13986] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023] Open
Abstract
Aging is characterized by fundamental cellular and molecular hallmarks that result in physiologic decline of most body systems. This may culminate in frailty, a state of decreased reserve. Because frailty is a state of multisystem dysregulation, multimodal interventions may be necessary to mitigate and prevent progression rather than interventions targeting a single system. Movement-based mind-body therapies, such as tai chi and yoga, are promising multimodal strategies for frailty prevention and treatment given their inherent multicomponent nature. In this review, we summarize the links between hallmarks of aging and frailty and how tai chi and yoga may impact these hallmarks. We review trial evidence for the impact of tai chi and yoga on frailty in older populations and discuss opportunities for future research.
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Affiliation(s)
- Julia Loewenthal
- Division of Aging, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | | | - Peter M. Wayne
- Division of Preventive MedicineBrigham and Women's HospitalBostonMassachusettsUSA
- Osher Center for Integrative Medicine, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Elizabeth Eckstrom
- Division of General Internal Medicine & GeriatricsOregon Health & Science UniversityPortlandOregonUSA
| | - Ariela R. Orkaby
- Division of Aging, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- New England Geriatric Research, Education, and Clinical Center (GRECC)VA Boston Healthcare SystemBostonMassachusettsUSA
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21
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Richard D, Rousseau D, Umapathy K, Pandya H, Rousis G, Peeples P. Exploring the Impact of a Trauma-informed Yoga and Mindfulness Curriculum for Multiple Populations: A Pilot Study. Explore (NY) 2024; 20:54-61. [PMID: 37365081 DOI: 10.1016/j.explore.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 05/11/2023] [Accepted: 05/31/2023] [Indexed: 06/28/2023]
Abstract
Individuals with trauma experience negative mental health impacts and are at risk of poor cardiovascular outcomes. Unmanaged, these conditions may worsen, compromising healing and wellbeing. Yoga, particularly trauma-informed, may improve outcomes. The current pilot study explores the impact of a novel trauma-informed yoga and mindfulness curriculum on wellbeing in two parts. The first examined mental health (stress, mood) outcomes in four trauma-impacted populations: adults who were incarcerated (INC), individuals in recovery from substance use disorders (SU), veterans (VA), and vulnerable youth (YTH) assessing both the impact of individual class participation and impact of attending at least four curriculum sessions. For the subgroup of incarcerated individuals, impact by theme was examined. After curriculum sessions, stress was reduced, and mood improved. Across multiple sessions both the largest decreases in stress and greatest increase in mood occurred after participant in the first session. Further, a specific exploration of curriculum class impact by theme for participants who were incarcerated indicated no difference in impact by theme. The second part of this study explored cardiovascular outcomes for the population of those in recovery from substance use. Reductions in systolic blood pressure occurred immediately after the first curriculum session, and diastolic blood pressure reduced over three consecutive sessions.
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Affiliation(s)
- D Richard
- University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, United States.
| | - D Rousseau
- Boston University, 1010 Commonwealth Avenue, Rm 510, Boston, MA 02215, United States.
| | - K Umapathy
- University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, United States.
| | - H Pandya
- SS&C Technologies, 9000 Southside Blvd, Building 700, Jacksonville FL 32256, United States
| | - G Rousis
- University of South Florida, 4202 E., Fowler Avenue, PCD 4118 G, Tampa, FL 33620, United States.
| | - P Peeples
- The Peeples Collaborative, 1327 Walnut Street, Jacksonville, FL, United States
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22
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Apoorva HM, Jayaram M, Patil NJ. Usefulness of Yoga in the management of tinnitus during COVID-19: A narrative review. J Ayurveda Integr Med 2024; 15:100822. [PMID: 38157657 PMCID: PMC10787241 DOI: 10.1016/j.jaim.2023.100822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 06/24/2023] [Accepted: 10/26/2023] [Indexed: 01/03/2024] Open
Abstract
The emergence of Coronavirus disease 2019 (COVID- 19) has resulted in an unprecedented global health crisis. Tinnitus is the most commonly reported symptom when the COVID-19 impacts the auditory-vestibular system. There are a variety of management strategies for amelioration of tinnitus including Yoga. The present review deals with three issues: one, occurrence of tinnitus in persons affected by COVID-19; two, the impact of COVID-19 situation on tinnitus severity; and three, the potential of Yoga as an intervention strategy. Literature search was carried out through search engines like PubMed, Cochrane, Web of Science and Google scholar using keywords like 'tinnitus', 'COVID-19' and 'Yoga'. The relevant studies were identified and the findings summarized in a narrative manner. Based on the evidence obtained in the present review, the authors propose that yoga can be used as an effective strategy in overcoming the psychosocial factors associated with COVID-19 particularly in this pandemic and related lockdown situation. It is also proposed here that teleyoga can serve as a practical, feasible and safe mode for providing therapeutic services for tinnitus-related issues particularly in the present pandemic situation.
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Affiliation(s)
- H M Apoorva
- Department of Speech Pathology & Audiology, Sri Devaraj Urs Academy of Higher Education & Research, Kolar, India
| | - M Jayaram
- Department of Speech Pathology & Audiology, Sri Devaraj Urs Academy of Higher Education & Research, Kolar, India.
| | - N J Patil
- Department of Integrative Medicine, Sri Devaraj Urs Academy of Higher Education & Research, Kolar, India
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Sahoo U, Sharma SK, Chari H, Nayak SR, Ali W, Muhammad T. Examining the rural-urban differentials in yoga and mindfulness practices among middle-aged and older adults in India: secondary analysis of a national representative survey. Sci Rep 2023; 13:22095. [PMID: 38087012 PMCID: PMC10716390 DOI: 10.1038/s41598-023-49388-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023] Open
Abstract
Physical activity and mental well-being play an important role in reducing the risk of various diseases and in promoting independence among older adults. Appropriate physical activity, including yoga and mindfulness practices, can help rectify the loss of independence due to aging and have a positive influence on physical health and functional activities. This study assessed rural-urban differences in yoga and mindfulness practices and their associated factors among middle-aged and older Indian adults. The total sample size considered for the current analysis was 72,250 middle-aged and older adults (aged ≥ 45 years). Bivariate and multivariable logistic regression analyses were used to estimate the prevalence of yoga and mindfulness practices and examine the associations of selected variables with yoga and mindfulness practices among the participants. Further, we used the Fairley decomposition technique to determine the factors contributing to rural-urban differences in the prevalence of yoga and mindfulness practices among middle-aged and older adults. More than 9% of middle-aged and older adults in rural areas and 14% in urban areas reported practicing yoga and mindfulness activities more than once per week. Adults aged ≥ 65 years were more likely to practice yoga and mindfulness activities than those who age 45-54 years were. Those with an education of ten years and above were 2.3 and 2.1 times higher likely to practice yoga in rural (AOR: 2.28; CI: 2.07-2.52) and urban (AOR: 2.13; CI: 1.91-2.37) areas compared to their uneducated peers, respectively. The largest contributors in diminishing the gap in yoga practice among participants were education (44.2%), caste (2.5%), chronic diseases such as hypertension (4.53%), diabetes (1.71%), high cholesterol (3.08%), self-reported pain (5.76%), and difficulties in instrumental activities of daily living (1.22%). The findings suggest that middle-aged and older adults in urban areas practice yoga and mindfulness activities more than their peers in rural areas do. Education level, household characteristics, and health outcomes such as chronic conditions, pain, and functional difficulties explain the observed differences in yoga and mindfulness practices across rural and urban areas. Age-appropriate healthy practices such as yoga and mindfulness should be encouraged to enhance the physical and mental well-being of middle-aged and older adults, especially in rural areas.
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Affiliation(s)
- Umakanta Sahoo
- Department of Statistics, Sambalpur University, Jyoti Vihar, Burla, Odisha, India
| | | | - Harshita Chari
- Gokhale Institute of Politics and Economics, Pune, India
| | | | - Waad Ali
- Department of Geography, Sultan Qaboos University, Muscat, Oman
| | - T Muhammad
- International Institute for Population Sciences, Mumbai, India.
- Center for Healthy Aging, The Pennsylvania State University, University Park, USA.
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Parkman S, Olausson J. Efficacy of yoga for caregivers of persons with dementia: An integrative review. Scand J Caring Sci 2023; 37:980-990. [PMID: 37070342 DOI: 10.1111/scs.13172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 03/25/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND The progressive nature of dementia leaves the person vulnerable and dependent on others for care. While persons with dementia often have better outcomes when cared for at home, it can lead to personal challenges and self-neglect of the caregiver. Mindfulness-based interventions such as yoga can lessen the potential negative effects encountered by caregivers of persons with dementia. AIM The aim of this review was to synthesise available empirical research related to the role of yoga on the biopsychosocial health outcomes for caregivers of persons with dementia population. METHOD A systematic search of the databases Academic Search Complete, CINAHL Plus, Medline and PsychINFO was done using the terms "yoga" AND "caregivers or family members or informal caregivers" AND "dementia or Alzheimer's." Using the selection process outlined by the PRISMA framework, thirty-six studies met the initial criteria and were potentially relevant to the topic. A methodological check was performed using the critical appraisal tool of Melnyk and Fineout-Overholt and the GRADE system of recommendation. This process led to the inclusion of four articles. FINDINGS Four studies were included for this review: two randomised controlled trials, a non-randomised intervention study with a waitlist and a pilot cohort study. Three studies focused on informal caregivers and one study involved professional caregivers. In all studies, yoga practices included asanas, pranayama, relaxation and meditation. This integrative review recommended that yoga may be useful in reducing stress, depression and anxiety while increasing quality of life indicators, vitality indicators, self-compassion scores, mindfulness attention, sleep quality and diastolic blood pressure. Outcomes that were not significantly changed were caregiver burden, systolic blood pressure and heart rate. However, the level of evidence was moderate with small sample sizes suggesting additional research is needed to include well-designed randomised controlled trials with larger sample sizes.
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Affiliation(s)
- Suzanne Parkman
- University of Southern Maine, 96 Falmouth St, Portland, Maine, 04103, USA
| | - Jill Olausson
- University of Southern Maine, 96 Falmouth St, Portland, Maine, 04103, USA
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Bentley TGK, D’Andrea-Penna G, Rakic M, Arce N, LaFaille M, Berman R, Cooley K, Sprimont P. Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature. Brain Sci 2023; 13:1612. [PMID: 38137060 PMCID: PMC10741869 DOI: 10.3390/brainsci13121612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 12/24/2023] Open
Abstract
Anxiety and stress plague populations worldwide. Voluntary regulated breathing practices offer a tool to address this epidemic. We examined peer-reviewed published literature to understand effective approaches to and implementation of these practices. PubMed and ScienceDirect were searched to identify clinical trials evaluating isolated breathing-based interventions with psychometric stress/anxiety outcomes. Two independent reviewers conducted all screening and data extraction. Of 2904 unique articles, 731 abstracts, and 181 full texts screened, 58 met the inclusion criteria. Fifty-four of the studies' 72 interventions were effective. Components of effective and ineffective interventions were evaluated to develop a conceptual framework of factors associated with stress/anxiety reduction effectiveness. Effective breath practices avoided fast-only breath paces and sessions <5 min, while including human-guided training, multiple sessions, and long-term practice. Population, other breath paces, session duration ≥5 min, and group versus individual or at-home practices were not associated with effectiveness. Analysis of interventions that did not fit this framework revealed that extensive standing, interruptions, involuntary diaphragmatic obstruction, and inadequate training for highly technical practices may render otherwise promising interventions ineffective. Following this evidence-based framework can help maximize the stress/anxiety reduction benefits of breathing practices. Future research is warranted to further refine this easily accessible intervention for stress/anxiety relief.
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Affiliation(s)
- Tanya G. K. Bentley
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Gina D’Andrea-Penna
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
- Neurosciences Graduate Program, University of California San Diego, La Jolla, CA 92093, USA
| | - Marina Rakic
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Nick Arce
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Michelle LaFaille
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Rachel Berman
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Katie Cooley
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Preston Sprimont
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
- Department of Kinesiology, California State University Fullerton, Fullerton, CA 92831, USA
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Martínez-Calderon J, Casuso-Holgado MJ, Muñoz-Fernandez MJ, Garcia-Muñoz C, Heredia-Rizo AM. Yoga-based interventions may reduce anxiety symptoms in anxiety disorders and depression symptoms in depressive disorders: a systematic review with meta-analysis and meta-regression. Br J Sports Med 2023; 57:1442-1449. [PMID: 37369553 DOI: 10.1136/bjsports-2022-106497] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVE To summarise the effect of mind-body exercises on anxiety and depression symptoms in adults with anxiety or depressive disorders. DESIGN Systematic review with meta-analysis and meta-regression. DATA SOURCES Five electronic databases were searched from inception to July 2022. Manual searches were conducted to explore clinical trial protocols, secondary analyses of clinical trials and related systematic reviews. ELIGIBILITY CRITERIA Randomised clinical trials evaluating qigong, tai chi or yoga styles with anxiety or depression symptoms as the outcomes were included. No intervention, waitlist or active controls were considered as control groups. The risk of bias and the certainty of the evidence were assessed. Meta-analyses, meta-regressions and sensitivity analyses were performed. RESULTS 23 studies, comprising 22 different samples (n=1420), were included. Overall, meta-analyses showed yoga interventions were superior to controls in reducing anxiety symptoms in anxiety disorders. Furthermore, yoga-based interventions decreased depression symptoms in depressive disorders after conducting sensitivity analyses. No differences between groups were found in the rest of the comparisons. However, the certainty of the evidence was judged as very low for all outcomes due to concerns of high risk of bias, indirectness of the evidence, inconsistency and imprecision of the results. In addition, there was marked heterogeneity among yoga-based interventions and self-reported tools used to evaluate the outcomes of interest. CONCLUSION Although yoga-based interventions may help to improve mental health in adults diagnosed with anxiety or depressive disorders, methodological improvements are needed to advance the quality of clinical trials in this field. PROSPERO REGISTRATION NUMBER CRD42022347673.
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Affiliation(s)
- Javier Martínez-Calderon
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| | - María Jesús Casuso-Holgado
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
| | - Maria Jesus Muñoz-Fernandez
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
- Department of Physiotherapy, University School Francisco Maldonado, Sevilla, Spain
| | - Cristina Garcia-Muñoz
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, Cadiz, Spain
| | - Alberto Marcos Heredia-Rizo
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, Sevilla, Spain
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Acar Y, Ilçin N, Sarı İ. The Effects of Tele-Yoga in Ankylosing Spondylitis Patients: A Randomized Controlled Trial. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:727-737. [PMID: 37257184 DOI: 10.1089/jicm.2023.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Objective: This randomized controlled trial aimed at investigating the effects of tele-yoga on physical function, disease activity, spinal mobility, flexibility, muscular endurance, exercise capacity, balance, sleep quality, stress, depression, anxiety, quality of life (QoL), and mindfulness in patients with ankylosing spondylitis (AS). Methods: Sixty patients with AS were randomly assigned to the tele-yoga group (TYG) or wait-list control group (CG). In addition to their medical treatments, TYG participants attended online yoga classes three times per week for 8 weeks. The CG continued their standard medical treatment. Data were collected at baseline and after 8 weeks. The primary outcome measure was physical function as assessed by the Bath AS Functional Index (BASFI). Secondary outcome measures included the Bath AS Disease Activity Index (BASDAI), Bath AS Patient Global Score (BAS-G), Assessment of SpondyloArthritis International Society Health Index (ASAS HI), Bath AS Metrology Index (BASMI), sit-and-reach test, sit-up test, push-up test, incremental shuttle walk test, Balance Master test, Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), 36-Item Short Form Health Survey (SF-36), and Mindful Attention Awareness Scale (MAAS). Results: Compared with the CG (n = 27), participants in the TYG (n = 28) demonstrated significant improvements in BASFI (p = 0.001). The TYG also showed significant improvements in disease activity, spinal mobility, flexibility, muscular endurance, balance, sleep quality, stress, depression, and QoL compared with the CG (p < 0.05). Conclusions: Tele-yoga practice appears to be a safe and promising intervention for patients with AS and should be considered as a part of holistic disease management because of its potential physical and psychological benefits. Clinical Trial Registration: NCT04803383.
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Affiliation(s)
- Yasemin Acar
- Institute of Health Sciences, Department of Physical Therapy and Rehabilitation, Dokuz Eylül University, İzmir, Turkey
| | - Nursen Ilçin
- Faculty of Physical Therapy and Rehabilitation, Geriatric Physiotherapy Department, Dokuz Eylül University, İzmir, Turkey
| | - İsmail Sarı
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Dokuz Eylül University, İzmir, Turkey
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O'Brien J, Evans S, McIver S, O'Shea M. A scoping review of integrated yoga and psychological approaches for the treatment of eating disorders. J Eat Disord 2023; 11:152. [PMID: 37684706 PMCID: PMC10492346 DOI: 10.1186/s40337-023-00845-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/14/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Eating disorders are serious mental health conditions that significantly impact the social and economic burden of mental ill health in Australia. Best practice treatment for eating disorders includes a multi-axial approach, including medical, psychiatric, and psychological approaches. More recently, complementary and alternative therapy approaches, such as yoga, are used to support eating disorder recovery. METHODS This scoping review identified and examined current research exploring the use of yoga alongside psychological approaches for the treatment and management of eating disorders across the lifespan. RESULTS Results highlighted the lack of available research, with only four studies identified. Three of these studies piloted programs and identified promising results with a reduction of eating disorder symptomatology. However, these results remain tentative due to methodological limitations and the overall lack of available evidence. In the future, researchers are encouraged to clearly articulate the theoretical concepts that underpin their yoga programs and focus on adequately powered and designed trials, such as RCTs, to accurately compare treatment effects between interventions combining yoga with psychological interventions and standard psychological treatment. Qualitative enquiry is also recommended to provide further insights regarding what makes interventions successful. CONCLUSIONS Current evidence suggests further guidance and pragmatic recommendations to guide researchers and clinicians alike are required, ultimately improving outcomes for people experiencing an eating disorder across the lifespan.
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Hoge EA, Simon NM, Szuhany K, Feldman B, Rosenfield D, Hoeppner S, Jennings E, Khalsa SB, Hofmann SG. Comparing Kundalini Yoga, cognitive behavioral therapy, and stress education for generalized anxiety disorder: Anxiety and depression symptom outcomes. Psychiatry Res 2023; 327:115362. [PMID: 37598625 DOI: 10.1016/j.psychres.2023.115362] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 07/14/2023] [Accepted: 07/21/2023] [Indexed: 08/22/2023]
Abstract
Increasingly, individuals with anxiety disorders are seeking mind-body interventions (e.g., yoga), but their effectiveness is unclear. This report summarizes seven additional, secondary outcomes measuring anxiety and depression symptoms from a study of 226 adults with generalized anxiety disorder who were randomized to 12-week Kundalini Yoga, Cognitive-Behavior Therapy (CBT) or stress education (control). At post-treatment, participants receiving CBT displayed significantly lower symptom severity, compared to those in the control group, on 6 of the 7 measures. Participants who received Yoga (vs. those in the control group) displayed lower symptom severity on 3 of the 7 measures. No significant differences were detected between participants receiving CBT vs those receiving Yoga. At the 6-month follow-up, participants from the CBT continued to display lower symptoms than the control group.
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Affiliation(s)
- Elizabeth A Hoge
- Georgetown University Medical Center, Department of Psychiatry, 2115 Wisconsin Ave, NW, Suite 200, Washington, DC, 20007, USA.
| | - Naomi M Simon
- New York University Grossman School of Medicine, Department of Psychiatry, New York NY 10016, USA
| | - Kristin Szuhany
- New York University Grossman School of Medicine, Department of Psychiatry, New York NY 10016, USA
| | - Benjamin Feldman
- New York University Grossman School of Medicine, Department of Psychiatry, New York NY 10016, USA
| | - David Rosenfield
- Department of Psychology, Southern Methodist University, Expressway Tower 1100N, Dallas, Texas, USA
| | - Susanne Hoeppner
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Richard B. Simches Research Center, 185 Cambridge St., Suite 2000, Boston MA, USA
| | - Emma Jennings
- New York University Grossman School of Medicine, Department of Psychiatry, New York NY 10016, USA
| | - Sat Bir Khalsa
- Departments of Medicine and Neurology, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston MA, USA
| | - Stefan G Hofmann
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Avenue, Boston, MA 02215, USA; Department of Clinical Psychology, Philipps-University Marburg, Schulstrasse 12, 35037 Marburg, Germany
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Liu Z, Lemus J, Smirnova IV, Liu W. Rehabilitation for non-motor symptoms for patients with Parkinson's disease from an α-synuclein perspective: a narrative review. EXPLORATION OF NEUROPROTECTIVE THERAPY 2023; 3:235-257. [PMID: 37920444 PMCID: PMC10621781 DOI: 10.37349/ent.2023.00049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/22/2023] [Indexed: 11/04/2023]
Abstract
Parkinson's disease (PD) is a common neurodegenerative disorder affecting aged population around the world. PD is characterized by neuronal Lewy bodies present in the substantia nigra of the midbrain and the loss of dopaminergic neurons with various motor and non-motor symptoms associated with the disease. The protein α-synuclein has been extensively studied for its contribution to PD pathology, as α-synuclein aggregates form the major component of Lewy bodies, a hallmark of PD. In this narrative review, the authors first focus on a brief explanation of α-synuclein aggregation and circumstances under which aggregation can occur, then present a hypothesis for PD pathogenesis in the peripheral nervous system (PNS) and how PD can spread to the central nervous system from the PNS via the transport of α-synuclein aggregates. This article presents arguments both for and against this hypothesis. It also presents various non-pharmacological rehabilitation approaches and management techniques for both motor and non-motor symptoms of PD and the related pathology. This review seeks to examine a possible hypothesis of PD pathogenesis and points to a new research direction focus on rehabilitation therapy for patients with PD. As various non-motor symptoms of PD appear to occur earlier than motor symptoms, more focus on the treatment of non-motor symptoms as well as a better understanding of the biochemical mechanisms behind those non-motor symptoms may lead to better long-term outcomes for patients with PD.
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Affiliation(s)
- Zhaoyang Liu
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS 66160, USA
- Department of Orthopedic Surgery and Sports Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Jessica Lemus
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Irina V. Smirnova
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Wen Liu
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS 66160, USA
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Yatham P, Chintamaneni S, Stumbar S. Lessons From India: A Narrative Review of Integrating Yoga Within the US Healthcare System. Cureus 2023; 15:e43466. [PMID: 37711938 PMCID: PMC10498999 DOI: 10.7759/cureus.43466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/14/2023] [Indexed: 09/16/2023] Open
Abstract
The ancient practice of yoga has gained worldwide popularity as a way for people to improve their overall health and well-being. This manuscript reviews and examines the history of yoga, its physical and mental health benefits, its incorporation into the Indian healthcare system, and the public perception of yoga in India. Many initiatives for yoga exist, including promoting research on yoga, providing education and information on its benefits, and developing evidence-based standardized yoga therapy guidelines. With this in mind, this narrative review article explores the potential benefits of incorporating yoga into the United States (US) healthcare system and the possible challenges of doing so. It also provides valuable insights for policymakers and healthcare professionals.
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Affiliation(s)
- Puja Yatham
- Internal Medicine, Herbert Wertheim College of Medicine, Miami, USA
| | | | - Sarah Stumbar
- Family Medicine, Herbert Wertheim College of Medicine, Miami, USA
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Mikkonen J, Luomajoki H, Airaksinen O, Goubert L, Leinonen V. Protocol of identical exercise programs with and without specific breathing techniques for the treatment of chronic non-specific low back pain: randomized feasibility trial with two-month follow-up. BMC Musculoskelet Disord 2023; 24:354. [PMID: 37147638 PMCID: PMC10161472 DOI: 10.1186/s12891-023-06434-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/15/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Chronic low back pain (CLBP) is a leading cause of disability globally. Exercise therapies are one of the commonly prescribed treatment options for CLBP. The specific exercise therapies for CLBP most commonly target movement dysfunction, but seldom brain-based pain modulation. Exercise therapies with specific breathing techniques (SBTs) have been shown to influence and enhance brain-based structural and functional pain modulation. AIMS AND OBJECTIVES To assess the feasibility of the SBTs protocol, eligibility criteria, randomization, and dropout rates. To quantify the changes in patient outcome measures and choose the most relevant measure for larger-scale study. To quantify self-adherence levels to home exercise and monitor and record possible pain medication and other treatment modality usage, and adverse events during exercise. DESIGN A parallel randomised analyst-blinded feasibility trial with two-month follow-up. OUTCOME MEASURES Feasibility related to aims and objectives. Multiple pain- and health-related patient-reported outcome measures of pain intensity, disability, central sensitization, anxiety, kinesiophobia, catastrophising, self-efficacy, sleep quality, quality of life, and health and well-being status. Exercise adherence, pain medication and other treatment modality usage, and possible adverse events related to exercises will be monitored and recorded. METHODS Thirty participants will be randomized to movement control exercise with SBTs (15 subjects in experimental group) or movement control exercise without SBTs (15 subjects in control group) in private chiropractic practice setting with two-month follow-up. Trial registration number; NCT05268822. DISCUSSION The clinical difference in effectiveness between practically identical exercise programs in uniform study settings with or without SBTs has not been studied before. This study aims to inform feasibility and help determine whether progression to a full-scale trial is worthwhile.
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Affiliation(s)
- Jani Mikkonen
- Private Practice, Mikonkatu 11, 00100, Helsinki, Finland.
- Department of Surgery (Incl. Physiatry), Institute of Clinical Medicine, University of Eastern Finland, 70211, Kuopio, Finland.
| | - Hannu Luomajoki
- ZHAW School of Health Professions, Zurich University of Applied Sciences, CH-8401, Winterthur, Switzerland
| | - Olavi Airaksinen
- Department of Surgery (Incl. Physiatry), Institute of Clinical Medicine, University of Eastern Finland, 70211, Kuopio, Finland
| | - Liesbet Goubert
- Department of Experimental-Clinical and Health Psychology, Ghent University, 9000, Ghent, Belgium
| | - Ville Leinonen
- Department of Neurosurgery, Institute of Clinical Medicine, University of Eastern Finland, 70211, Kuopio, Finland
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Smit C, Cartwright T. Recommending yoga for health: A survey of perceptions among healthcare practitioners in the UK. Complement Ther Clin Pract 2023; 52:101765. [PMID: 37172418 DOI: 10.1016/j.ctcp.2023.101765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/14/2023] [Accepted: 05/01/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Yoga has the potential to support patients across various health conditions. It is slowly being integrated into healthcare worldwide. While healthcare practitioners (HCPs) are critical to integration, there are currently no studies investigating their perceptions of yoga for health, their openness to recommending yoga to patients, and barriers to doing so. This novel UK study aims to address this. METHOD An online survey was conducted among practising UK HCPs. Recruitment was through multi-modal convenience sampling. The COM-B model was used as a framework. Regression analysis examined predictors of HCPs' likelihood to recommend yoga. Open-end responses were analysed through thematic analysis. RESULTS 198 HCPs were included in the analysis, including general practitioners (GPs, 18.8%), psychologists (18.3%), and nurses/health visitors (14.7%). A high proportion (68.8%) practised yoga at least monthly. The likelihood of recommending yoga to patients was high (M = 4.03, SD = 0.94; 5-point scale). Older age, not being a GP, and greater capability and motivation significantly predicted a greater likelihood of recommending yoga, explaining 41.4% of the variance (p < 0.001). Barriers to recommending yoga were mostly related to the lack of opportunity. CONCLUSIONS HCPs in this study had high levels of personal engagement with yoga and were open to recommending yoga to patients, but still faced several barriers. Workplace support, particularly for GPs, and information about how patients can access appropriate and affordable yoga instruction would facilitate referral. Further research with a representative sample is warranted to understand perceptions of HCPs less engaged with yoga.
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Affiliation(s)
- Carryn Smit
- Psychology, School of Social Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, United Kingdom.
| | - Tina Cartwright
- Psychology, School of Social Sciences, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, United Kingdom.
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Halappa NG. Integration of yoga within exercise and sports science as a preventive and management strategy for musculoskeletal injuries/disorders and mental disorders - A review of the literature. J Bodyw Mov Ther 2023; 34:34-40. [PMID: 37301554 DOI: 10.1016/j.jbmt.2023.04.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/06/2023] [Accepted: 04/12/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Exercise-induced musculoskeletal injuries/disorders and associated mental disorders are prevalent among athletes. The main objective of this review is to analyze the prospects of Yoga practices as a preventive and management strategy for musculoskeletal injuries/disorders and associated mental disorders often encountered in exercise and sports activities. METHODS A review of the literature was performed using electronic databases such as MEDLINE/PubMed and google scholar published between January 1991 and December 2021 which yielded 88 research articles. The keywords used were yoga OR exercise AND musculoskeletal injuries OR disorders, yoga OR exercise AND mental disorders, yoga AND sports injuries, yoga AND stress, yoga OR exercise AND oxidative stress, yoga OR exercise AND inflammation, yoga OR exercise AND diet. RESULTS The moderate and regular exercises are beneficial to health. However, high intensity and overtraining physical activities lead to immune suppression, oxidative stress, muscle damage/fatigue, coronary risk, psychiatric disorders and so on due to enormous strain on various physiological functions. Yoga seems to undermine these adverse activities through up-regulating the functions of the parasympathetic nervous system (PNS) and down-regulating the activities of hypothalamohypophysial axis (HPA) which are conducive to healing, recovery, regeneration, reduction in stress, relaxation of mind, better cognitive functions, promotion of mental health, reduction in inflammation and oxidative stress, and so on. CONCLUSION Literature suggests that Yoga should be integrated within exercise and sports sciences mainly to prevent & manage musculoskeletal injuries/disorders and associated mental disorders.
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Affiliation(s)
- Naveen G Halappa
- School of Public Health & School of Buddhist Studies, Philosophy and Comparative Religions, Nalanda University, Bihar, India.
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Wu Y, Yan D, Yang J. Effectiveness of yoga for major depressive disorder: A systematic review and meta-analysis. Front Psychiatry 2023; 14:1138205. [PMID: 37032928 PMCID: PMC10077871 DOI: 10.3389/fpsyt.2023.1138205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/23/2023] [Indexed: 04/11/2023] Open
Abstract
Objective Major depressive disorder (MDD) has a relapse rate that cannot be ignored and places a tremendous burden on the patient in the prevention and treatment process. Yoga, a combination of physical and mental exercises, is effective and acceptable for the adjunctive treatment of MDD. This study aimed to explore further the evidence of yoga's efficacy for patients with MDD. Methods PubMed, Embase, Cochrane library, PsycINFO, SinoMed, CNKI, Wanfang, and VIP databases from their inception to 13 October 2022 were searched by a pre-defined search strategy. RCTs of patients with MDD who met diagnostic criteria for yoga treatment were included. RoB2.0 was used to evaluate the quality of the literature. Improvement in depressive symptoms was assessed by the Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HAMD), or other scales were used as primary outcome indicators, and improvement in anxiety was assessed by the Hamilton Anxiety Scale (HAMA) and State-Trait Anxiety Inventory (STAI) scale as secondary outcome indicators. RR and Cohen's d at 95% CI were used as effect size estimates, and Q and I2 were used to evaluate the size of heterogeneity, with a p-value less than 0.05 indicating statistical significance. Results Thirty-four RCT studies, including 1,269 patients in the treatment group and 1,072 patients in the control group, 48.4% of whom were women, were included in the study. Compared to the control group, the BDI-II results yielded a moderate effect of yoga on the improvement of depressive symptoms (Cohen's d = -0.60; 95% CI: -1.00 to -0.21; p < 0.01), the HAMD results yielded a moderate improvement of yoga on the severity of depressive symptoms (Cohen's d = -0.64; 95% CI: -0.98 to -0.30; p < 0.01), and the STAI results can be concluded that yoga had a negligible effect on the improvement of the level of anxiety (Cohen's d = -0.26; 95% CI: -0.48 to -0.04; p = 0.02). No adverse events occurred in the yoga group during the treatment. Conclusion Yoga can improve depressive symptoms and anxiety in patients with MDD and has a safe and wide patient acceptance. Systematic review registration [https://www.crd.york.ac.uk/prospero/], identifier [PROSPERO, CRD42022373282].
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Affiliation(s)
| | | | - Jianli Yang
- Department of Psychology, Tianjin Medical University General Hospital, Tianjin, China
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Loewenthal J, Innes KE, Mitzner M, Mita C, Orkaby AR. Effect of Yoga on Frailty in Older Adults : A Systematic Review. Ann Intern Med 2023; 176:524-535. [PMID: 36913687 DOI: 10.7326/m22-2553] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Yoga, a multicomponent mind-body practice, improves several domains of physical and psychological health and may affect frailty in older adults. PURPOSE To evaluate the available trial evidence on the effect of yoga-based interventions on frailty in older adults. DATA SOURCES MEDLINE, EMBASE, and Cochrane Central from their inception to 12 December 2022. STUDY SELECTION Randomized controlled trials evaluating the effect of yoga-based interventions, including at least 1 session of physical postures, on a validated frailty scale or single-item markers of frailty in adults aged 65 years or older. DATA EXTRACTION Two authors independently screened articles and extracted data; 1 author assessed risk of bias with review from a second author. Disagreements were resolved through consensus and as-needed input from a third author. DATA SYNTHESIS Thirty-three studies (n = 2384 participants) were identified in varied populations, including community dwellers, nursing home residents, and those with chronic disease. Yoga styles were primarily based on Hatha yoga and most often included Iyengar or chair-based methods. Single-item frailty markers included measures of gait speed, handgrip strength, balance, lower-extremity strength and endurance, and multicomponent physical performance measures; no studies included a validated definition of frailty. When compared with education or inactive control, there was moderate-certainty evidence that yoga improved gait speed and lower-extremity strength and endurance, low-certainty evidence for balance and multicomponent physical function measures, and very low-certainty evidence for handgrip strength. LIMITATION Heterogeneity in study design and yoga style, small sample sizes, and reporting deficiencies leading to concerns for selection bias. CONCLUSION Yoga may affect frailty markers that are associated with clinically meaningful outcomes in older adult populations but may not offer benefit over active interventions (for example, exercise). PRIMARY FUNDING SOURCE None. (PROSPERO: CRD42020130303).
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Affiliation(s)
- Julia Loewenthal
- Division of Aging, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts (J.L.)
| | - Kim E Innes
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, West Virginia (K.E.I.)
| | - Margalit Mitzner
- Renaissance School of Medicine at Stony Brook University, Stony Brook, New York (M.M.)
| | - Carol Mita
- Countway Library, Harvard Medical School, Boston, Massachusetts (C.M.)
| | - Ariela R Orkaby
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, and New England Geriatric Research, Education, and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts (A.R.O.)
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Systematic review to explore the effect of yoga on anxiety in adults. Ment Health (Lond) 2023. [DOI: 10.56508/mhgcj.v6i1.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
Introduction: The National Health Service cannot chronically sustain the overwhelming demands being placed on it due to financial cuts, staff numbers and recent presence of Covid-19. As a result, anxiety levels are on the rise thus increasing the need for effective first-line treatment.
Purpose: The purpose of this systematic review was to examine the efficacy of yoga as a first-line treatment for anxiety. Previous systematic reviews have produced mixed results.
Methodology: The inclusion criteria followed the PICO research statement. The population (P) were either healthy or diagnosed with anxiety and the intervention (I) was yoga. The comparison (C) was a control group, or CBT, or used a pre-and post-intervention design. The outcome (O) was the change in the level of anxiety post-intervention.
Results and Discussion: After the review of 64 studies, 7 studies fit the inclusion criteria: four randomized controlled studies, one longitudinal study, and two pre- and post-intervention comparisons. All the studies included provided statistically significant results for the beneficial effect of yoga on anxiety.
Conclusion: This study adds to preceding literature on the current anxiety levels of adults and the potential utility of yoga as a first-line treatment for self-management of anxiety levels. This review stresses the issue of heterogeneity, mode of yoga and calls for more robust randomised controlled trials to pioneer the subject matter to help, if not prevent, to slow down the rising cases of anxiety and ill mental health worldwide.
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Welford P, Östh J, Hoy S, Rossell SL, Pascoe M, Diwan V, Hallgren M. Effects of Yoga and Aerobic Exercise on Verbal Fluency in Physically Inactive Older Adults: Randomized Controlled Trial (FitForAge). Clin Interv Aging 2023; 18:533-545. [PMID: 37021083 PMCID: PMC10069432 DOI: 10.2147/cia.s359185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/20/2022] [Indexed: 03/31/2023] Open
Abstract
Purpose To compare the effects on verbal fluency of a supported yoga-based exercise intervention to an aerobic exercise intervention and a wait-list control group. Participants and Methods Eighty-two physically-inactive but otherwise healthy adults (mean age 72.5 years, range 65-85, 77% female) were recruited into a 12-week, three-group, parallel randomized controlled trial. Participants were supported to complete ≥3 Hatha yoga classes per/week or ≥3 structured aerobic exercise sessions/week. A wait-list control group continued usual daily activities only. Verbal fluency, including total-FAS, animals, and verbs, was assessed before and after interventions. Group effects were assessed using analysis of covariance (ANCOVA). Results Twenty-seven participants were randomized to yoga, 29 to aerobic exercise and 26 to a waitlist. At 12-week follow-up, compared to baseline, there were increases in mean total-FAS in the yoga (+5.0 words, p=0.002) and aerobic exercise groups (+6.6 words, p=0.004). Mean total-FAS in the wait-list control group remained stable (-0.5 words, p=0.838). There were medium-magnitude estimated treatment effects on total-FAS for yoga versus wait-list control and aerobic exercise versus wait-list control: Hedges' g=0.51 (p=0.213) and 0.57 (p=0.098) respectively. In addition, small-to-medium magnitude estimated treatment effects were seen on animals and verbs for yoga versus wait-list control and aerobic exercise versus wait-list control: g=0.28 (p=0.155), 0.19 (p=0.766) and 0.50 (p=0.085), 0.59 (p=0.233) respectively. Conclusion Participation in yoga or aerobic exercise was associated with estimated improvements in verbal fluency compared to a non-active control group. Yoga and aerobic exercise may be promising approaches by which to promote cognitive function among older adults. Trial Registration DRKS00015093, U1111-1217-4248.
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Affiliation(s)
- Paul Welford
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Josefine Östh
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Sara Hoy
- Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden
| | - Susan L Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Victoria, Australia
| | - Michaela Pascoe
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Vinod Diwan
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Mats Hallgren
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Correspondence: Mats Hallgren, Department of Global Public Health, Karolinska Institutet, Level 6, 1e Solnavägen, Solna, 11365, Sweden, Tel +46852480000, Email
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Baklouti S, Fekih-Romdhane F, Guelmami N, Bonsaksen T, Baklouti H, Aloui A, Masmoudi L, Souissi N, Jarraya M. The effect of web-based Hatha yoga on psychological distress and sleep quality in older adults: A randomized controlled trial. Complement Ther Clin Pract 2023; 50:101715. [PMID: 36521407 PMCID: PMC9744484 DOI: 10.1016/j.ctcp.2022.101715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/09/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND To date, there has been very limited experimental research on the impact of Yoga on older adults' mental health during the COVID-19 crisis. We aimed to explore the effect of a web-based Hatha yoga program on psychological and quality of sleep in older adults who self-isolated at home during the initial stage of the COVID-19 outbreak. METHODS Two hundred volunteers of both sexes were split into experimental (Yoga group, YG) and control (Control group, CG) groups, in a web-based randomized controlled study. All participants were administered the Depression, Anxiety and Stress Scales (DASS-21) and the Pittsburgh sleep quality index (PSQI); at baseline and following an eight-week online Hatha yoga intervention. RESULTS The YG showed significant reductions in depression (-56.1%; Z = 5.67, p < 0.01, r = 0.70) anxiety (-64.3%; Z = 5.27, p < 0.01, r = 0.65) and stress (-68.2%; Z = 5.86, r = 0.73) scores, while the CG showed a significant increase in depression. In addition, the total PSQI score of the YG was considerably lower during follow-up (3.38 ± 2.02, p < 0.05) than at baseline (4.8 ± 32, p < 0.05), which indicates an improvement of the quality of sleep. The proportion of individuals experiencing good sleep from the YG increased from 63% to 85% after the Hatha yoga intervention. CONCLUSION The use of a web-based Hatha Yoga intervention program was associated with a beneficial effect on the mental health and quality of sleep in older adults.
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Affiliation(s)
- Souad Baklouti
- Physical Activity, Sport and Health Research Unit (UR18JS01), National Sport Observatory, Tunis, Tunisia,High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, 3000, Tunisia
| | - Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia,Department of Psychiatry Ibn Omrane, Razi Hospital, Manouba, Tunisia,Corresponding author. Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Noomen Guelmami
- Department of Human and Social Sciences, Higher Institute of Sport and Physical Education of Kef, University of Jendouba, Jendouba, Tunisia,Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Tore Bonsaksen
- Department of Health and Nursing Science, Faculty of Social and Health Science, Inland Norway University of Applied Sciences, Elverum, Norway,Department of Health, Faculty of Health Studies, VID Specialized University, Sandnes, Norway
| | - Hana Baklouti
- Physical Activity, Sport and Health Research Unit (UR18JS01), National Sport Observatory, Tunis, Tunisia
| | - Asma Aloui
- Physical Activity, Sport and Health Research Unit (UR18JS01), National Sport Observatory, Tunis, Tunisia,High Institute of Sport and Physical Education, University of Gafsa, Gafsa, Tunisia
| | - Liwa Masmoudi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, 3000, Tunisia
| | - Nizar Souissi
- Physical Activity, Sport and Health Research Unit (UR18JS01), National Sport Observatory, Tunis, Tunisia
| | - Mohamed Jarraya
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, 3000, Tunisia
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Meditation and Yoga for Irritable Bowel Syndrome: A Randomized Clinical Trial. Am J Gastroenterol 2023; 118:329-337. [PMID: 36422517 PMCID: PMC9889201 DOI: 10.14309/ajg.0000000000002052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/09/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Delivered in person, yoga is effective in managing irritable bowel syndrome (IBS) symptoms. The evidence for efficacy, feasibility, and safety of virtually delivered yoga for patients with IBS is unknown. METHODS Adults diagnosed with IBS were randomized to either Hatha yoga intervention of 8 weekly online classes delivered virtually or an advice-only control group and assessed at baseline and postintervention. We used an unadjusted ANOVA to determine differences between and within groups on the primary outcome (decrease of ≥50 points in IBS Symptom Severity Scale [IBS-SSS]) and secondary outcomes (quality of life, anxiety and depression, fatigue, somatic symptoms, perceived stress, COVID-19 stress, and self-compassion). We assessed feasibility through recruitment and attrition rates, adherence, participant satisfaction, and safety (i.e., adverse events). RESULTS Seventy-nine people participated (mean age 45.4 years [SD = 14.0], 92% women, 20% attrition rate). IBS-SSS decreased significantly in the treatment group (Δ change = 54.7, P = 0.028), but not in the control group (Δ change = 22.6, P = 0.277). Fourteen patients (37%) in the yoga group reached a clinically relevant decrease of ≥50 points on the IBS-SSS postintervention compared with 8 patients (20%) in the control group ( P = 0.242). No significant difference was found between groups in IBS-SSS score postintervention ( P = 0.149), but significant differences in favor of the treatment group for quality of life ( P = 0.030), fatigue ( P = 0.035), and perceived stress ( P = 0.040) were identified. The yoga program demonstrated feasibility. Intention to practice yoga decreased significantly in both groups from baseline to postintervention ( P < 0.001). However, the decline in intention did not correlate with practice minutes. DISCUSSION Virtually delivered yoga is safe and feasible, and effective in reducing IBS symptoms. Based on the primary end point, the intervention was not superior to an advice-only control group.
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Chopra D, Stern E, Bushell WC, Castle RD. Yoga and pain: A mind-body complex system. FRONTIERS IN PAIN RESEARCH 2023; 4:1075866. [PMID: 36910253 PMCID: PMC9996306 DOI: 10.3389/fpain.2023.1075866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/05/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction The human body's response to pain is indicative of a complex adaptive system. Therapeutic yoga potentially represents a similar complex adaptive system that could interact with the pain response system with unique benefits. Objectives To determine the viability of yoga as a therapy for pain and whether pain responses and/or yoga practice should be considered complex adaptive systems. Methods Examination through 3 different approaches, including a narrative overview of the evidence on pain responses, yoga, and complex system, followed by a network analysis of associated keywords, followed by a mapping of the functional components of complex systems, pain response, and yoga. Results The narrative overview provided extensive evidence of the unique efficacy of yoga as a pain therapy, as well as articulating the relevance of applying complex systems perspectives to pain and yoga interventions. The network analysis demonstrated patterns connecting pain and yoga, while complex systems topics were the most extensively connected to the studies as a whole. Conclusion All three approaches support considering yoga a complex adaptive system that exhibits unique benefits as a pain management system. These findings have implications for treating chronic, pervasive pain with behavioral medicine as a systemic intervention. Approaching yoga as complex system suggests the need for research of mind-body topics that focuses on long-term systemic changes rather than short-term isolated effects.
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Affiliation(s)
| | - Eddie Stern
- Vivekananda Yoga University, Los Angeles, CA, United States
| | | | - Ryan D Castle
- Chopra Foundation Institute, Honolulu, HI, United States
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Karri RR, Bhavanani AB, Ramanathan M, Mopidevi VG. Methodological issues in yoga therapy research among psychiatric patients. Indian J Psychiatry 2023; 65:12-17. [PMID: 36874523 PMCID: PMC9983453 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_464_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/21/2022] [Accepted: 11/21/2022] [Indexed: 01/13/2023] Open
Abstract
Yoga therapy has been widely accepted as part of the evidence-based modern healthcare system. Although research publications are growing in leaps and bounds, many methodological issues pose stumbling blocks. In this narrative review, various issues like standalone or add-on treatment, blinding, randomization, nature of dependent and intervening variables, duration of intervention, sustainability of effects, attrition bias, adherence and accuracy, all or none performance, diverse schools, heterogeneity and multidimensionality, assortment, permutations, and combinations of different components, neglect of essential ingredients, mindfulness, catch-22 situation, credentials of the instructors, cultural factors, naivety, multicentric studies, duration of collection of data, primary or standard treatment, interdisciplinary research, statistical lapses, qualitative research, biomedical research are discussed. There is a need to frame guidelines for conducting yoga therapy research and publication.
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Affiliation(s)
- Rama Reddy Karri
- Centre for Yoga Therapy, Education and Research (CYTER), Sri Balaji Vidyapeeth (S.B.V.), Pillaiyarkuppam, Puducherry, India
| | - Ananda B Bhavanani
- Centre for Yoga Therapy, Education and Research (CYTER), Sri Balaji Vidyapeeth (S.B.V.), Pillaiyarkuppam, Puducherry, India
| | - Meena Ramanathan
- Centre for Yoga Therapy, Education and Research (CYTER), Sri Balaji Vidyapeeth (S.B.V.), Pillaiyarkuppam, Puducherry, India
| | - Vijaya Gopal Mopidevi
- Department of Psychiatry, G.S.L. Medical College, Rajamahendravaram, Andhra Pradesh, India
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Bös C, Gaiswinkler L, Fuchshuber J, Schwerdtfeger A, Unterrainer HF. Effect of Yoga involvement on mental health in times of crisis: A cross-sectional study. Front Psychol 2023; 14:1096848. [PMID: 37034922 PMCID: PMC10074601 DOI: 10.3389/fpsyg.2023.1096848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 02/28/2023] [Indexed: 04/11/2023] Open
Abstract
Background Yoga involvement can be understood as a degree of immersion in the philosophical/spiritual teachings of Yoga. Previous research has shown a positive association between Yoga involvement and mental health. This study further investigates the effect of Yoga involvement on several parameters of psychological well-being and distress amidst a global crisis precipitated by the COVID-19 pandemic. Methods A total sample of 246 participants (216 females; 118 Yoga versus 128 age-matched Pilates practitioners) were included in the study. Via an online-survey the following questionnaires were completed: the WHO-Five Well-Being Index, the Multidimensional Inventory for Religious/Spiritual Well-Being short version, the Leipzig Short Scale of Sense of Coherence, the Brief Symptom Inventory and the Yoga Immersion Scale which was adapted for the control group to Pilates Immersion Scale. Results When controlling for occupation and psychiatric disorder, involvement in general was higher for Yoga practitioners than for Pilates controls. Furthermore, Yoga practice was associated with increased religious/spiritual well-being and decreased sense of coherence, but neither with psychological well-being nor with psychological distress. Involvement, in general, positively predicted psychological well-being, religious/spiritual well-being and sense of coherence, but there was no connection with psychological distress. Lastly, involvement mediated the positive relationship between Yoga practice and religious/spiritual well-being and suppressed the negative effect of Yoga practice on sense of coherence. Conclusion Our findings suggest that involvement in a certain relaxation practice has a positive impact and might be a key component in understanding Yoga's influence on mental health. Further randomized controlled research, including clinical groups, is necessary to explain how involvement changes and how it effects well-being more specifically.
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Affiliation(s)
- Christiane Bös
- Institute of Psychology, University of Graz, Graz, Austria
| | - Lisza Gaiswinkler
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria
| | - Jürgen Fuchshuber
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria
- Department of Philosophy, University of Vienna, Vienna, Austria
- *Correspondence: Jürgen Fuchshuber,
| | | | - Human-Friedrich Unterrainer
- Institute of Psychology, University of Graz, Graz, Austria
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
- Department of Religious Studies, University of Vienna, Vienna, Austria
- Faculty of Psychotherapy Science, Sigmund Freud University, Vienna, Austria
- Human-Friedrich Unterrainer,
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Gangadhar BN. Evidence-based integration of yoga in psychiatric practice. Indian J Psychiatry 2023; 65:5-11. [PMID: 36874516 PMCID: PMC9983454 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_813_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 12/17/2022] [Indexed: 01/13/2023] Open
Abstract
Yoga has been put to test in clinical medicine to build evidence. There has been a steep rise in yoga research through 2010, threefold in the next decade. Despite challenges, clinicians have explored yoga intervention in several disorders. The available data have been examined using meta-analysis when there are more studies. Psychiatric disorders treated with yoga have attracted more research. Some examples include depression, schizophrenia, anxiety, obsessive-compulsive disorder (OCD), somatoform pain, addiction, mild cognitive impairment, and elderly and childhood disorders. Current manuscript focuses on highlighting the major steps towards generating evidence that have led to integration of yoga into psychiatry practice. It also discusses various challenges and the way forward.
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Affiliation(s)
- B N Gangadhar
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Psychophysiological Adaptations to Yoga Practice in Overweight and Obese Individuals: A Topical Review. Diseases 2022; 10:diseases10040107. [PMID: 36412601 PMCID: PMC9680480 DOI: 10.3390/diseases10040107] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/10/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
Physical activity has been documented as a foundational approach for weight management and obesity, improving several cardiometabolic and mental health indices. However, it is not clear whether yoga practice can induce beneficial improvements in anthropometric and body composition parameters, performance, metabolic health, and well-being among overweight/obese people. The aim of this topical review was to catalog training studies examining the psychophysiological responses to yoga interventions in order to detect which outcomes have been investigated, the research methods applied, and the conclusions. The inclusion/exclusion criteria were met by 22 published articles involving 1178 (56% female) overweight/obese participants. This brief review on yoga-induced adaptations demonstrates that this widely used meditative movement activity can meaningfully improve the vast majority of the selected markers. These beneficial alterations are focused mostly on various anthropometric and body composition variables, cardiovascular disease risk factors, physical fitness parameters, quality of life, and stress in previously inactive overweight/obese individuals. Instead, yoga-based physical exercise interventions investigating anxiety, depression, mood state, exercise enjoyment, affect valence, and adherence were limited. Further research should focus on the yoga intervention configuration and potential mechanisms behind favorable changes in various psychophysiological indices through large-scale, rigorously designed randomized controlled trials implementing long-term interventions in overweight/obese individuals.
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Soulé I, Littzen-Brown C, Vermeesch AL, Garrigues L. Expanding the Mind-Body-Environment Connection to Enhance the Development of Cultural Humility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13641. [PMID: 36294221 PMCID: PMC9602847 DOI: 10.3390/ijerph192013641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/23/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
The unique health care needs of diverse individuals and communities are complex. To meet these needs, healthcare professionals are being called upon to alter traditional ways of thinking, perceiving, and acting in order to create more inclusive environments. Research shows that using mindsight, a process that increases both insight and empathy, can enhance an individual's mind-body-environment connection, increase self-awareness, and promote the development of cultural humility. This paper will discuss the current perspectives on the mind/body/environment connection from a Western lens that may impact the enactment of cultural humility for healthcare providers. Two evidence-based approaches, yoga and forest therapy, are recommended as effective intervention tools in fostering mindsight and cultural humility. Blending traditional cognitive learning with techniques anchored in the physical body may hold promise in supporting the development of mindsight and cultural humility in healthcare education and practice.
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Affiliation(s)
- Isabelle Soulé
- School of Nursing & Health Innovations, University of Portland, Portland, OR 97203, USA
| | - Chloé Littzen-Brown
- School of Nursing & Health Innovations, University of Portland, Portland, OR 97203, USA
| | - Amber L. Vermeesch
- Department of Family and Community Nursing, School of Nursing, University of North Carolina Greensboro, Greensboro, NC 27412, USA
| | - Layla Garrigues
- School of Nursing & Health Innovations, University of Portland, Portland, OR 97203, USA
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Welford P, Gunillasdotter V, Andréasson S, Hallgren M. Effects of physical activity on symptoms of depression and anxiety in adults with alcohol use disorder (FitForChange): Secondary outcomes of a randomised controlled trial. Drug Alcohol Depend 2022; 239:109601. [PMID: 35994841 DOI: 10.1016/j.drugalcdep.2022.109601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/05/2022] [Accepted: 08/06/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE To compare the effects of yoga, aerobic exercise, and usual care on anxiety and depressive symptoms in non-treatment seeking adults with AUD. METHOD Parallel, three-group, open-label randomised (1:1:1) controlled trial with blinded follow-up assessment. Non-treatment seeking adults (aged 18-75 years) were recruited via advertisements in a free newspaper in Stockholm, Sweden. All participants had clinician-diagnosed AUD prior to randomisation. This trial excluded those who were physically active, or for whom supervised physical activity was contraindicated. Participants were randomly assigned to 12-weeks of aerobic exercise, yoga, or usual care (telephone counselling). The secondary outcome of interest was the Hospital Anxiety and Depression Scale (HADS), assessed at baseline and 12-week follow-up. Primary analyses consisted of linear regression models and followed intention-to-treat (ITT) principals. RESULTS In total, 140 participants (mean age 53.7 years, SD=11.8) were recruited. Follow-up was completed for 42/45 participants randomised to TAU, 42/49 to aerobic exercise and 43/46 to yoga. ITT analyses included 126 trial participants. There were statistically significant within-group improvements in total HADS in all three intervention groups. Effect sizes for usual care and aerobic exercise were small (Hedges' g=0.48, 95% CI=0.16, 0.80 and g=0.41, 95% CI=0.09, 0.72, respectively), while yoga was associated with a large treatment effect (g=1.06, 95% CI=0.69, 1.43). There were significant between-group differences in these improvements favouring yoga (B=-2.15, 95% CI=-4.16, -0.15, p = .035) relative to usual care, but no significant differences between yoga and aerobic exercise. No injuries were reported. CONCLUSIONS Findings support the recommendation of yoga for non-treatment seeking adults with AUD.
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Affiliation(s)
- Paul Welford
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Victoria Gunillasdotter
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden; Centre for Psychiatry Research, Sweden, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Services, 114 35 Stockholm, Sweden
| | - Sven Andréasson
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden; Centre for Psychiatry Research, Sweden, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Services, 114 35 Stockholm, Sweden
| | - Mats Hallgren
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden.
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Xie X, Li C, Tiggelaar S, Simbulan F, Falk L, Brophy JM. Developing a cross-validation tool for evaluating economic evidence in rapid literature reviews. J Comp Eff Res 2022; 11:1151-1160. [PMID: 36170031 DOI: 10.2217/cer-2021-0274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Rapid economic reviews efficiently summarize economic evidence. However, reporting main findings without assessing quality and credibility can be misleading. The objective of this study was to develop a rapid cross-validation screening tool to evaluate economic evidence when conducting rapid economic literature reviews. Methods: This article outlines our reasoning and the theoretical concepts for developing the screening tool. Results: This cross-validation tool is a qualitative approach under a Bayesian framework that uses prior health economic evidence to gauge the credibility of the rapid economic review's findings. This article describes an application of this tool and highlights practical considerations for its development and deployment. Conclusion: This tool can provide a valuable screening instrument to evaluate the quality and credibility of the economic evidence.
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Affiliation(s)
- Xuanqian Xie
- Health Technology Assessment Program, Ontario Health, Toronto, ON M5S 1N5, Canada
| | - Chunmei Li
- Health Technology Assessment Program, Ontario Health, Toronto, ON M5S 1N5, Canada
| | - Sean Tiggelaar
- Health Technology Assessment Program, Ontario Health, Toronto, ON M5S 1N5, Canada
| | - Frances Simbulan
- Health Technology Assessment Program, Ontario Health, Toronto, ON M5S 1N5, Canada
| | - Lindsey Falk
- Health Technology Assessment Program, Ontario Health, Toronto, ON M5S 1N5, Canada
| | - James M Brophy
- Departments of Medicine & Epidemiology, Biostatistics, & Occupational Health, McGill University, Montreal, QC H3A 0G4, Canada
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49
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Martinez-Calderon J, de-la-Casa-Almeida M, Matias-Soto J. The Effects of Mind-Body Exercises on Chronic Spinal Pain Outcomes: A Synthesis Based on 72 Meta-Analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912062. [PMID: 36231365 PMCID: PMC9564899 DOI: 10.3390/ijerph191912062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 05/12/2023]
Abstract
An umbrella review of systematic reviews with a meta-analysis was developed to summarize the evidence on the effectiveness of qigong, tai chi, and yoga in chronic spinal pain outcomes. The CINAHL, Cochrane Library, Embase, PsycINFO, PubMed and SPORTDiscus databases were searched. Pain, psychological factors, and quality of life (QOL) were the outcomes of interest. The methodological quality of the reviews was evaluated using the AMSTAR-2 tool. The overlap was calculated using the corrected covered area. A total of 72 meta-analyses drawn from 20 systematic reviews were included and often were rated at a critically low quality. The effects of qigong on chronic low back and neck pain (CLBP and CNP, respectively) were inconsistent, although it improved the physical component of QOL after 12 weeks for CNP. Tai chi was superior to the controls in reducing CLBP; no reviews of interest were found on CNP. Yoga was superior to multiple controls in reducing CLBP, but no relevant effects on depression or QOL were found. QOL, anxiety, depression, and general mood improved with yoga for CNP. Inconsistencies arose related to yoga and CNP. Our findings mainly supported the potential effects of yoga and tai chi on pain-related outcomes, psychological factors, and QOL in populations with CLBP and NP. Clinical and methodological considerations were discussed.
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Affiliation(s)
- Javier Martinez-Calderon
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Avicena s/n, 41009 Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, University of Seville, 41004 Seville, Spain
| | - Maria de-la-Casa-Almeida
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Avicena s/n, 41009 Sevilla, Spain
- Correspondence: ; Tel.: +34-954-486-520
| | - Javier Matias-Soto
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, University of Seville, 41004 Seville, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Peñalosa, 3, 29071 Malaga, Spain
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50
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Szuhany KL, Adhikari S, Chen A, Lubin RE, Jennings E, Rassaby M, Eakley R, Brown ML, Suzuki R, Barthel AL, Rosenfield D, Hoeppner SS, Khalsa SB, Bui E, Hofmann SG, Simon NM. Impact of preference for yoga or cognitive behavioral therapy in patients with generalized anxiety disorder on treatment outcomes and engagement. J Psychiatr Res 2022; 153:109-115. [PMID: 35810600 PMCID: PMC9969964 DOI: 10.1016/j.jpsychires.2022.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 05/11/2022] [Accepted: 07/01/2022] [Indexed: 11/18/2022]
Abstract
There is some, but inconsistent, evidence to suggest that matching patient treatment preference enhances treatment engagement and outcome. The current study examined differential preferences and factors associated with treatment preference for 12-week group cognitive behavioral therapy (CBT), yoga, or stress education in 226 adults with generalized anxiety disorder (GAD; 70% female, Mean age = 33 ± 13.5). In a subsample of 165 patients who reported an intervention preference and were randomized to yoga or CBT, we further examined whether match to preferred intervention improved the primary treatment outcome (responder status on Clinical Global Impressions Scale) and engagement (dropout, homework compliance). Preferences for CBT (44%) and yoga (40%) were similar among patients. Women tended to prefer yoga (OR = 2.75, p = .01) and CBT preference was associated with higher baseline perceived stress (OR = 0.92, p = .04) and self-consciousness meta-cognitions (OR = 0.90, p = .02). Among those not matched to their preference, treatment response was higher for those receiving CBT than yoga (OR = 11.73, p = .013); there were no group differences for those matched to their treatment preference. In yoga, those who received their preference were more likely to drop than those who did not (OR = 3.02, 95% CI = [1.20, 7.58], p = .037). This was not the case for CBT (OR = 0.37, 95% CI = [0.13, 1.03], p = .076). Preference match did not predict homework compliance. Overall, results suggest that treatment preference may be important to consider to optimize outcome and engagement; however, it may vary by treatment modality. Future research incorporating preference, especially with yoga for anxiety, is aligned with personalized medicine. TRIAL REGISTRATION: clinicaltrials.gov: NCT01912287; https://clinicaltrials.gov/ct2/show/NCT01912287.
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Affiliation(s)
- Kristin L Szuhany
- Anxiety, Stress and Prolonged Grief Program, Department of Psychiatry, New York University Grossman School of Medicine, 1 Park Avenue, 8th Floor, New York, NY, 10016, USA.
| | - Samrachana Adhikari
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, 4th Floor, New York, NY, 10016, USA.
| | - Alan Chen
- Division of Biostatistics, Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, 4th Floor, New York, NY, 10016, USA.
| | - Rebecca E Lubin
- Department of Psychological & Brain Sciences, Boston University, 900 Commonwealth Ave, 2nd Floor, Boston, MA, 02215, USA.
| | - Emma Jennings
- Anxiety, Stress and Prolonged Grief Program, Department of Psychiatry, New York University Grossman School of Medicine, 1 Park Avenue, 8th Floor, New York, NY, 10016, USA.
| | - Madeleine Rassaby
- Anxiety, Stress and Prolonged Grief Program, Department of Psychiatry, New York University Grossman School of Medicine, 1 Park Avenue, 8th Floor, New York, NY, 10016, USA.
| | - Rachel Eakley
- Anxiety, Stress and Prolonged Grief Program, Department of Psychiatry, New York University Grossman School of Medicine, 1 Park Avenue, 8th Floor, New York, NY, 10016, USA.
| | - Mackenzie L Brown
- Department of Psychological & Brain Sciences, University of Louisville, Life Sciences Building, Louisville, KY, 40292, USA.
| | - Rebecca Suzuki
- Department of Psychology, University of Denver, 2155 S. Race St, Denver, CO, 80210, USA.
| | - Abigail L Barthel
- Department of Psychological & Brain Sciences, Boston University, 900 Commonwealth Ave, 2nd Floor, Boston, MA, 02215, USA.
| | - David Rosenfield
- Department of Psychology, Southern Methodist University, Expressway Tower 1100N, Dallas, TX, USA.
| | - Susanne S Hoeppner
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Richard B. Simches Research Center, 185 Cambridge St., Suite, 2000, Boston, MA, USA.
| | - Sat Bir Khalsa
- Departments of Medicine and Neurology, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, USA.
| | - Eric Bui
- Department of Psychiatry, University of Caen Normandy & Caen University Hospital, Avenue de la Cote de Nacre, Caen, France.
| | - Stefan G Hofmann
- Department of Psychological & Brain Sciences, Boston University, 900 Commonwealth Ave, 2nd Floor, Boston, MA, 02215, USA; Department of Clinical Psychology, Philipps-University Marburg, Germany, Schulstrasse 12, 35037, Marburg, Germany.
| | - Naomi M Simon
- Anxiety, Stress and Prolonged Grief Program, Department of Psychiatry, New York University Grossman School of Medicine, 1 Park Avenue, 8th Floor, New York, NY, 10016, USA.
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