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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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Nemeroff R, Harden A, Kowalsky B. Yoga classes as an early intervention for college students reporting high levels of stress and anxiety: A pilot study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:4-10. [PMID: 35157806 DOI: 10.1080/07448481.2021.2008401] [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: 03/15/2021] [Revised: 09/25/2021] [Accepted: 11/12/2021] [Indexed: 06/14/2023]
Abstract
Background:Today's college students are experiencing unprecedented rates of stress, anxiety, and mental health issues. As a result, college counseling centers are often overwhelmed by the demand for mental health services. Methods: The current study evaluated the potential for Hatha yoga classes to be used as an alternative to conventional psychotherapy for college students reporting high levels of stress and anxiety. Results: After 6 weeks of twice-weekly, hour-long yoga classes, significant reductions in stress, anxiety, pathological worry, and rumination were reported by 7 undergraduate college students. Conclusions: Results of this pilot study suggest that Hatha yoga classes may serve as a widely accessible, cost-effective early intervention that can be offered as a first-line recommendation to students who are struggling with heightened levels of stress and anxiety.
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Affiliation(s)
- Robin Nemeroff
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
| | - Alyson Harden
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
| | - Brianna Kowalsky
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
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Leisegang K, Opuwari CS, Moichela F, Finelli R. Traditional, Complementary and Alternative Medicines in the Treatment of Ejaculatory Disorders: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1607. [PMID: 37763726 PMCID: PMC10535559 DOI: 10.3390/medicina59091607] [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: 07/16/2023] [Revised: 09/02/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: Ejaculatory dysfunction (EjD) is a common male sexual disorder that includes premature ejaculation, delayed ejaculation, retrograde ejaculation, and anejaculation. Although psychological and pharmacological treatments are available, traditional, complementary, and alternative medicine (TCAM) is reportedly used. However, the clinical evidence for TCAM in EjD remains unclear. Therefore, this study aims to systematically review human clinical trials investigating the use of TCAM to treat EjD. Materials and Methods: A systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted by searching Scopus and PubMed databases. Controlled clinical trials investigating a cohort of male patients diagnosed primarily with EjD and undergoing any TCAM intervention compared to any comparison group were included. Quality of the studies was assessed using the Cochrane Risk of Bias tool for randomized controlled trials. Results: Following article screening, 22 articles were included. Of these, 21 investigated TCAM in premature ejaculation, and only 1 investigated TCAM in retrograde ejaculation. Different TCAM categories included studies that investigated lifestyle, exercise and/or physical activities (n = 7); herbal medicine supplements (n = 5); topical herbal applications (n = 4); acupuncture or electroacupuncture (n = 3); vitamin, mineral and/or nutraceutical supplements (n = 1); hyaluronic acid penile injection (n = 1); and music therapy (n = 1). Only 31.8% (n = 7) of the included studies were found to have a low risk of bias. The available studies were widely heterogenous in the TCAM intervention investigated and comparison groups used. However, the included studies generally showed improved outcomes intra-group and when compared to placebo. Conclusions: Different TCAM interventions may have an important role particularly in the management of PE. However, more studies using standardized interventions are needed.
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Affiliation(s)
- Kristian Leisegang
- School of Natural Medicine, University of the Western Cape, Bellville 7535, South Africa;
| | - Chinyerum Sylvia Opuwari
- Department of Medical Biosciences, University of the Western Cape, Bellville 7535, South Africa; (C.S.O.); (F.M.)
| | - Faith Moichela
- Department of Medical Biosciences, University of the Western Cape, Bellville 7535, South Africa; (C.S.O.); (F.M.)
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Franco Corso SJ, O'Malley K, Subaiya S, Mayall D, Dakwar E. The role of non-ordinary states of consciousness occasioned by mind-body practices in mental health illness. J Affect Disord 2023; 335:166-176. [PMID: 37150220 DOI: 10.1016/j.jad.2023.04.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/13/2023] [Accepted: 04/29/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Research with hallucinogens suggests that non-ordinary states of consciousness (NOSCs), particularly mystical-type experiences, predict improvements in various affective disorders and substance use disorders (SUDs). Little is known, however, about the therapeutic potential of NOSCs induced by mind-body practices such as meditation, yoga and breathwork. METHODS We conducted a literature review in online databases (PubMed, Scopus, Google Scholar) and preprint databases (SSRN, bioRxiv) to identify studies of NOSCs induced by mind-body practices and their effects in affective disorders and SUDs. RESULTS A wide variety of mind-body practices involving physical movement (i.e., shamanic drumming, yoga) and hyper-focused immersive mental experiences (i.e., meditation, breathwork) have been reported in the literature. Preliminary evidence, mostly from qualitative studies and open label studies, suggest that mind-body practices produce NOSCs. Such experiences have been associated with short-term reduced levels of anxiety and depression, increased motivation to quit addictive behaviors, and enhanced self-awareness and spiritual well-being. LIMITATIONS Findings are limited by the scarcity of literature in this field. Further rigorous and methodologically sound empirical research is needed, including comparative studies of NOSCs occasioned by different methods. CONCLUSIONS Mind-body practices may represent a promising approach for treating mental health disorders. The NOSCs induced by such practices may lead to beneficial shifts in perceptions, values, beliefs, and behaviors. Given the challenges with hallucinogen-based therapies, mind-body practices may represent a more accessible and acceptable way of eliciting potentially helpful NOSCs in clinical practice.
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Affiliation(s)
- Silvia J Franco Corso
- Department of Psychiatry, Columbia University Vangelos College of Physicians and Surgeons, New York, NY, United States of America; Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America.
| | - Kate O'Malley
- Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America
| | - Saleena Subaiya
- Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America
| | - Danielle Mayall
- Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America
| | - Elias Dakwar
- Department of Psychiatry, Columbia University Vangelos College of Physicians and Surgeons, New York, NY, United States of America; Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America
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Kedlaya MN, Karmakar S, Nayak N, Shanmugasundaram S, Rajagopal A, Puzhankara L. Yoga as an Integrated Holistic Approach to Oral Health: A Review. J Int Soc Prev Community Dent 2023; 13:106-113. [PMID: 37223445 PMCID: PMC10202256 DOI: 10.4103/jispcd.jispcd_221_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/04/2023] [Accepted: 03/20/2023] [Indexed: 05/25/2023] Open
Abstract
Objectives The association between various systemic diseases and periodontitis has been explored extensively. A sedentary lifestyle plays a significant role in systemic and periodontal disease progression. Therefore, lifestyle modification has been considered a component of therapeutic aspects for periodontal disease and systemic disease. This review focuses on how yoga may reduce chronic gingival inflammation by improving the body's defense, which can act more efficiently on periodontal bacteria and help maintain healthy gingiva. Materials and Methods A literature search was performed in PubMed/MEDLINE CINAHL, Web of Science, and Google Scholar for all the published articles related to yoga and its systemic benefits and potential role in reducing periodontal breakdown, and the findings were summarized. Results The practice of yoga therapy has been proven to show several benefits, such as reduced stress levels, anxiety and depression, increased antioxidant levels, reduced insulin resistance, and improved respiratory function. It also helps to improve the immune system. Conclusion Yoga can be used as a potential treatment modality adjunct to conventional periodontal therapy as it has been shown to have a potential benefit in controlling systemic risk factors.
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Affiliation(s)
- Madhurya N Kedlaya
- Department of Periodontology, Manipal College of Dental Sciences Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shaswata Karmakar
- Department of Periodontology, Manipal College of Dental Sciences Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Namratha Nayak
- Department of Periodontology, Manipal College of Dental Sciences Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shashikiran Shanmugasundaram
- Department of Periodontology, Manipal College of Dental Sciences Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anjale Rajagopal
- Department of Periodontology, Manipal College of Dental Sciences Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Lakshmi Puzhankara
- Department of Periodontology, Manipal College of Dental Sciences Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Carter A, Gilbert P, Kirby JN. A systematic review of compassion-based interventions for individuals struggling with body weight shame. Psychol Health 2023; 38:94-124. [PMID: 34694950 DOI: 10.1080/08870446.2021.1955118] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This systematic review investigated compassion-based interventions and the extent to which they can assist with addressing body weight shame. DESIGN The systematic review was pre-registered and conducted according to PRISMA guidelines. Seven electronic databases (PsycNET, Pubmed, Web of science, CINAHL, Scopus, ProQuest, Social Science Database) were searched. The methodological quality of studies was also assessed. MAIN OUTCOME MEASURES Main outcomes were body weight shame, and compassion. Secondary outcomes assessed were mental health, eating attitudes and behaviours, physical exercise and Body Mass Index and weight. RESULTS 25 studies (23 papers) met inclusion criteria and results indicated promise for compassion-based interventions for body weight shame, compassion, and health related behaviour. Mixed results were found for BMI and weight. The studies varied considerably in terms of populations targeted, the duration of interventions, and intervention delivery.Conclusion: Overall, compassion-based interventions were found to reduce body weight shame and improve levels of compassion. However, the impact of compassion-based interventions on BMI and weight is less promising. Recommendations for future research are provided.
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Affiliation(s)
- Alicia Carter
- Compassionate Mind Research Group, School of Psychology, The University of Queensland, St Lucia, Australia
| | - Paul Gilbert
- Compassionate Mind Research Group, School of Psychology, The University of Queensland, St Lucia, Australia.,Psychology, Derby University, Derby, UK
| | - James N Kirby
- Compassionate Mind Research Group, School of Psychology, The University of Queensland, St Lucia, Australia
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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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Dülger E, Mut M, Erbas T, Sahiner L, Vardar Yağlı N, Bilgin S. Effects of combined aerobic-strength training and yoga on quality of life and related parameters in women with pituitary adenoma after surgery: a randomized crossover study. Eur J Endocrinol 2022; 186:667-675. [PMID: 35380988 DOI: 10.1530/eje-22-0031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/05/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The pituitary gland is responsible for hormonal balance in the body, and disruption of hormonal balance in patients with pituitary adenoma (PA) indirectly affects the quality of life. This study aimed to examine the effects of yoga and combined aerobic and strength training (A+ST) on quality of life and related parameters such as sleep, fatigue, emotional state, sexual function, and cognitive status in women with PA. DESIGN Ten women with PA were included in this randomized crossover study. Group 1 (n = 5, mean age: 52 ± 13.5 years) received A+ST for the first 6 weeks, a 2-week washout period, and yoga for the second 6 weeks. Group 2 (n = 5, mean age: 41.8 ± 14 years) received the yoga program first, followed by the A+ST program. METHODS Participants were assessed using the following tools before and after each exercise intervention: Functional Assessment of Cancer Therapy-Brain (FACT-Br) (quality of life), Pittsburg Sleep Quality Index, Fatigue Severity Scale (FSS), Female Sexual Function Index (FSFI), Hospital Anxiety and Depression Scale (HADS), and Montreal Cognitive Assessment Scale (MOCA). RESULTS FACT-Br scores were higher after the yoga program, HADS anxiety score was lower after the A+ST program, and MOCA scores increased after both exercise programs (P < 0.05). FSS score decreased after both exercise programs, but not significantly. In addition, nonsignificant decreases in HADS anxiety and depression scores and increased FSFI scores were observed after the yoga program. CONCLUSION A+ST and yoga have positive effects on the quality of life in PA. We recommend yoga and A+ST as a supportive therapy for this population that may face comorbidities after surgical and medical treatment. Our results indicate these patients may benefit from physiotherapist-guided exercise programs.
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Affiliation(s)
- Esra Dülger
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Melike Mut
- Department of Neurosurgery, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Tomris Erbas
- Department of Endocrinology and Metabolism, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Levent Sahiner
- Department of Cardiology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Naciye Vardar Yağlı
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Sevil Bilgin
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Faculty of Medicine, Ankara, Turkey
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Role of Yoga practices on cognitive functions. Int J Health Sci (Qassim) 2022. [DOI: 10.53730/ijhs.v6ns3.6341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Yoga is the science of conditioning one's mind and body via the practise of shatkarma, asana, pranayama, mudra, and meditation. The aim of this review of literature is to give theoretical rationale for identifying
(a) the specific attributes of yoga poses that have been used in yoga protocols of various studies but have not been explicitly explored, & (b) the minimum time necessary to keep a posture to bring about a corresponding change in performance among the aforementioned cognitive functions (s) In humans, The most prevalent and under-treated problems are cognitive decline & psychological health problems. Different studies have been carried out to determine the influence of Yoga on human cognitive and psychological health indices. However, no comprehensive examination of the effects of yoga-based therapy on human cognitive and mental health has been undertaken to far. Yoga is an ancient science that places a premium on disease prevention and treatment, as well as the percentage of health. Yoga is recognized to delay the effects of aging and has been found to be effective in the therapy of aging-related disorders. Yoga is a centuries-old discipline that is said to improve both physical and emotional well-being.
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Cole AK, Pearson T, Knowlton M. Comparing Aerobic Exercise with Yoga in Anxiety Reduction: An Integrative Review. Issues Ment Health Nurs 2022; 43:282-287. [PMID: 34436979 DOI: 10.1080/01612840.2021.1965269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Anxiety is a common mental health disorder that affects many Americans yet often goes unrecognized or undertreated. The purpose of this article is to review the current literature to assist in determining which alternative and complimentary therapy, aerobic exercise or yoga, is most beneficial in reducing anxiety symptoms. The literature search process resulted in a total of 14 articles included in the review. Results indicate that yoga is more effective in decreasing anxiety symptoms than aerobic exercise. Health care providers can use this information to help recommend an alternative form of therapy for patients.
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Affiliation(s)
- Amanda K Cole
- School of Nursing, Western Carolina University, Cullowhee, North Carolina, USA
| | - Tamera Pearson
- School of Nursing, Western Carolina University, Cullowhee, North Carolina, USA
| | - Mary Knowlton
- School of Nursing, Western Carolina University, Cullowhee, North Carolina, USA
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Estevao C. The role of yoga in inflammatory markers. Brain Behav Immun Health 2022; 20:100421. [PMID: 35199049 PMCID: PMC8842003 DOI: 10.1016/j.bbih.2022.100421] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 01/03/2023] Open
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Nayar D, Mahapatro M, Nayar P. Role of Yoga as an Adjunct in the Management of Migraine Headache-Current Status and Future Indications. Int J Yoga 2022; 15:12-18. [PMID: 35444373 PMCID: PMC9015090 DOI: 10.4103/ijoy.ijoy_173_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 11/04/2022] Open
Abstract
Migraine headache is a painful, disabling condition afflicting 7% of the population. The long-term effort of coping with a chronic headache disorder predisposes the individual to other psychiatric illnesses, ischemic cerebrovascular disease as well as medicine overuse headache. The use of nonpharmacological methods to reduce the stress and pain associated with headache can improve the overall quality of life and reduce the burden of the disease. To examine the utility of yoga as an adjunct to pharmacological treatment of migraine headache. The review article is based on the secondary literature collected through the Google Scholar database between the years 2010 and 2020. Several themes were identified regarding the burden of migraine/headache and the need for the integration of yoga into the existing healthcare system. Despite the limitations and the need for greater scientific rigor, there have been consistent reports of the beneficial effects of yoga in the reduction of stress, anxiety, depression, and an enhanced quality of life, as well as better pain management in chronic diseases. Studies on the role of yoga in the treatment of migraine have been few in number. They have consistently shown that yoga can be a valuable adjunct to the existing pharmacological interventions in the management of migraine headache. In recent years, the Indian government has made enormous strides in establishing yoga outreach programs throughout the country. The need of the hour is to integrate evidence-based yoga with the wellness centers and noncommunicable diseases treatment plan. It can help to reduce the burden on the existing health care resources.
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Affiliation(s)
- D Nayar
- MBBS Intern, Kasturba Medical College, Manipal, Karnataka, India
| | - M Mahapatro
- Department of Social Sciences, National Institute of Health and Family Welfare, New Delhi, India
| | - P Nayar
- Department of Psychiatry, Mata Chanan Devi Hospital, New Delhi, India,Address for correspondence: Dr. Nayar P, A3/7, JanakPuri, New Delhi - 110 058, India. E-mail:
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Nourollahimoghadam E, Gorji S, Gorji A, Khaleghi Ghadiri M. Therapeutic role of yoga in neuropsychological disorders. World J Psychiatry 2021; 11:754-773. [PMID: 34733640 PMCID: PMC8546763 DOI: 10.5498/wjp.v11.i10.754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/28/2021] [Accepted: 08/02/2021] [Indexed: 02/06/2023] Open
Abstract
Yoga is considered a widely-used approach for health conservation and can be adopted as a treatment modality for a plethora of medical conditions, including neurological and psychological disorders. Hence, we reviewed relevant articles entailing various neurological and psychological disorders and gathered data on how yoga exerts positive impacts on patients with a diverse range of disorders, including its modulatory effects on brain bioelectrical activities, neurotransmitters, and synaptic plasticity. The role of yoga practice as an element of the treatment of several neuropsychological diseases was evaluated based on these findings.
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Affiliation(s)
| | - Shaghayegh Gorji
- Epilepsy Research Center, Münster University, Münster 48149, Germany
| | - Ali Gorji
- Epilepsy Research Center, Münster University, Münster 48149, Germany
- Department of Neuroscience, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran
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14
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Ho TTQ. Stress and the development of depressive symptoms among Facebook users: A moderated mediation model of poor sleep quality and anxiety. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02383-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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15
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Abstract
This study was conducted to evaluate the effect of yoga on pain levels in female students with primary dysmenorrhea. This study is a randomized experimental study with control group and pretest post-test practice. This study included 60 volunteer female students (30 experimental and 30 control groups). The patients in the experimental group took part in the yoga program a total of 12 sessions, once per week for 12 weeks. "Personal Information Form", "Visual Analog Skala (VAS)" and "Dysmenorrhea Monitoring Form (DMF)" were used in data collection process. To measure dysmenorrhea pain, the students were requested to mark a number between 1 and 10 on the VAS scale according to the severity of their pain on the menstruation starting date. The yoga applications were used for three menstrual cycles. The mean age of the students in the experimental group was 20.30 ± 0.46, while the mean age of the students in the control group was 20.46 ± 0.50. The difference between the pain levels of the students in the experimental group in the first, second, third and fourth measurements was found to be statistically significant (p < 0.001). It was determined that the difference between the pain levels of the students in the control group in the first, second, third and fourth measurements was not statistically significant (p > 0.05). Yoga can be used as an effective intervention in reducing menstrual pain in women with primary dysmenorrhea.
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Affiliation(s)
- Nurcan Kirca
- Faculty of Nursing, Department of Obstetrics & Gynecological Nursing, Akdeniz University, Antalya, Turkey
| | - AslıSis Celik
- Faculty of Nursing, Department of Obstetrics & Gynecological Nursing, Ataturk University, Erzurum, Turkey
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16
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Mathersul DC, Dixit K, Avery TJ, Schulz-Heik RJ, Zeitzer JM, Mahoney LA, Cho RH, Bayley PJ. Heart rate and heart rate variability as outcomes and longitudinal moderators of treatment for pain across follow-up in Veterans with Gulf War illness. Life Sci 2021; 277:119604. [PMID: 33984356 DOI: 10.1016/j.lfs.2021.119604] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 10/21/2022]
Abstract
AIMS Accumulating evidence suggests Gulf War illness (GWI) is characterised by autonomic nervous system dysfunction (higher heart rate [HR], lower heart rate variability [HRV]). Yoga - an ancient mind-body practice combining mindfulness, breathwork, and physical postures - is proposed to improve autonomic dysfunction yet this remains untested in GWI. We aimed to determine (i) whether HR and HRV improve among Veterans with GWI receiving either yoga or cognitive behavioural therapy (CBT) for pain; and (ii) whether baseline autonomic functioning predicts treatment-related pain outcomes across follow-up. MAIN METHODS We present secondary analyses of 24-hour ambulatory cardiac data (mean HR, square root of the mean squared differences between successive R-R intervals [RMSSD], high frequency power [HF-HFV], and low-to-high frequency ratio [LF/HF] extracted from a 5-min window during the first hour of sleep) from our randomised controlled trial of yoga versus CBT for pain among Veterans with GWI (ClinicalTrials.govNCT02378025; N = 75). KEY FINDINGS Veterans who received CBT tended towards higher mean HR at end-of-treatment. Better autonomic function (lower mean HR, higher RMSSD/HF-HRV) at baseline predicted greater reductions in pain across follow-up, regardless of treatment group. Better baseline autonomic function (mid-range-to-high RMSSD/HF-HRV) also predicted greater pain reductions with yoga, while worse baseline autonomic function (higher mean HR, lower RMSSD/HF-HRV) predicted greater pain reductions with CBT. SIGNIFICANCE To our knowledge, this is the first study to suggest that among Veterans with GWI, HR may increase with CBT yet remain stable with yoga. Furthermore, HR and HRV moderated pain outcome across follow-up for yoga and CBT.
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Affiliation(s)
- Danielle C Mathersul
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, United States of America; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, United States of America; Discipline of Psychology, Murdoch University, Murdoch, WA 6150, Australia.
| | - Kamini Dixit
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, United States of America
| | - Timothy J Avery
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, United States of America; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, United States of America; National Centre for Posttraumatic Stress Disorder (NCPTSD), Veterans Affairs Menlo Park Health Care System, Menlo Park, CA 94025, United States of America
| | - R Jay Schulz-Heik
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, United States of America
| | - Jamie M Zeitzer
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, United States of America; Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, United States of America
| | - Louise A Mahoney
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, United States of America
| | - Rachael H Cho
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, United States of America
| | - Peter J Bayley
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, United States of America; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, United States of America
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Bakshi N, Cooley A, Ross D, Hawkins L, Sullivan M, Astles R, Sinha C, Katoch D, Peddineni M, Gee BE, Lane PA, Krishnamurti L. A pilot study of the acceptability, feasibility and safety of yoga for chronic pain in sickle cell disease. Complement Ther Med 2021; 59:102722. [PMID: 33892094 DOI: 10.1016/j.ctim.2021.102722] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/12/2021] [Accepted: 04/15/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES To determine the acceptability, feasibility and safety of yoga for chronic pain in sickle cell disease. DESIGN AND SETTING In Part A of this two-part study, adolescents with SCD and chronic pain (Group 1) and their parent (Group 2) completed a survey designed to capture pain characteristics, attitudes and practices related to yoga, and potential acceptability of a yoga program. In Part B, the study assessed the feasibility and safety of an instructor-led group yoga program. The study was registered on clinicaltrials.gov (NCT03694548). INTERVENTION Eight instructor-led group yoga sessions. MAIN OUTCOME MEASURES Feasibility and safety outcomes were chosen a priori, as follows: 1) Proportion of adolescent patients with SCD and chronic pain approached that consent to participate in Part A, 2) Proportion of adolescent participants enrolled in Part A that consent to participate in Part B, 3) Proportion of participants enrolled in Part B that attend at least 6 of 8 yoga sessions, 4) Proportion of participants enrolled in Part B with an ED visit or a hospitalization for pain within 24 h of completion of each yoga session, 5) Proportion of participants in Part B who complete all study assessments before, and at the end of the yoga program, 6) Adherence to submission of pain diary. RESULTS The median age of 15 patient participants in Part A was 16 (IQR 14-17), and 14 parents was 43.5 (IQR 42-51). Most participants were female. Most participant responses indicated a positive opinion of yoga. Nine adolescents (60 %) from Part A participated in Part B of the study. The median age of 9 participants in Part B was 17 (IQR 15-18), and 5 of the 9 participants were female (53.3 %). Only one participant was able to attend 3 of the 8 yoga sessions offered, and did not experience any ED visits or hospitalizations following the yoga sessions. None of the other feasibility endpoints were met in this study. CONCLUSIONS Patients with SCD and chronic pain overall have a positive opinion of yoga, but there are challenges with recruitment and retention of participants in a clinical trial of yoga, and barriers to feasibility of an in-person group yoga intervention.
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Affiliation(s)
- Nitya Bakshi
- Division of Pediatric Hematology-Oncology-BMT, Department of Pediatrics, Emory University, Atlanta, GA, USA; Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Atlanta, GA, USA.
| | - Anthony Cooley
- Division of Hospital Medicine, Department of Pediatrics, Emory University, USA
| | - Diana Ross
- Division of Pediatric Hematology-Oncology-BMT, Department of Pediatrics, Emory University, Atlanta, GA, USA
| | - Lauren Hawkins
- Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, USA
| | | | - Rachel Astles
- Division of Pediatric Hematology-Oncology-BMT, Department of Pediatrics, Emory University, Atlanta, GA, USA
| | - Cynthia Sinha
- Division of Pediatric Hematology-Oncology-BMT, Department of Pediatrics, Emory University, Atlanta, GA, USA
| | - Deeksha Katoch
- Department of Pediatrics, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Manasa Peddineni
- NOVA Southeastern University College of Osteopathic Medicine, Fort Lauderdale, FL, USA
| | - Beatrice E Gee
- Division of Pediatric Hematology-Oncology-BMT, Department of Pediatrics, Emory University, Atlanta, GA, USA; Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Peter A Lane
- Division of Pediatric Hematology-Oncology-BMT, Department of Pediatrics, Emory University, Atlanta, GA, USA; Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Lakshmanan Krishnamurti
- Division of Pediatric Hematology-Oncology-BMT, Department of Pediatrics, Emory University, Atlanta, GA, USA; Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Atlanta, GA, USA
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Kochuvilayil T, Fernandez RS, Moxham LJ, Lord H, Alomari A, Hunt L, Middleton R, Halcomb EJ. COVID-19: Knowledge, anxiety, academic concerns and preventative behaviours among Australian and Indian undergraduate nursing students: A cross-sectional study. J Clin Nurs 2021; 30:882-891. [PMID: 33434378 PMCID: PMC8013450 DOI: 10.1111/jocn.15634] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/10/2020] [Accepted: 12/31/2020] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To compare knowledge, anxiety, academic concerns and preventative behaviours between undergraduate nursing students in Australia and India during the COVID-19 pandemic. BACKGROUND Based on the World Health Organization's direction for containment of the novel coronavirus (COVID-19), countries implemented varying levels of restrictions including closure of university campuses and providing on line undergraduate education. METHODS Students in NSW, Australia and Kerala, India completed an online survey assessing their (a) knowledge and source of information about COVID-19; (b) anxiety; and coping strategies; (c) academic concerns; and (d) preventative behaviours. Descriptive and inferential statistics were used to summarise the data. RESULTS Data from 99 Australian and 113 Indian undergraduate nurses were analysed. Greater number of Indian students indicated having sufficient knowledge of COVID-19 (OR 0.22; 95% CI 0.08, 0.63), getting information about COVID-19 from social media (OR 0.03; 95% CI 0.01, 0.07) and being concerned about 'attending clinical placement' (MD-1.08; 95% CI -1.94, -0.23). Australian students reported significantly higher levels of anxiety (MD 1.99 95% CI 1.21, 2.78), difficulty sleeping (OR 18.00; 95% CI 6.76, 47.96), concentrating (OR 33.22; 95% CI 13.85, 79.67) and eating (OR 14.05; 95% CI 3.19, 61.84). Greater number of Australian students indicated that they would go to the University if they needed to meet with other students (OR 9.21; 95% CI 3.08, 27.55), had to access the library (OR 7.20; 95% CI 3.26, 15.90) or had a group assignment (OR 2.93; 95% CI 1.26, 6.77). CONCLUSIONS Wide variations were present in knowledge, anxiety, academic concerns and preventative behaviours among undergraduate nursing students in two countries. RELEVANCE TO CLINICAL PRACTICE Undergraduate students may benefit from additional support from the University and staff in the clinical setting with online learning and resources in order to adjust to the 'new normal' and enable them to achieve academic success.
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Affiliation(s)
| | - Ritin S. Fernandez
- Faculty of Science, Medicine and HealthSchool of NursingUniversity of WollongongWollongongNSWAustralia
- Centre for Research in Nursing and HealthSt George HospitalKogarahNSWAustralia
| | - Lorna J. Moxham
- Faculty of Science, Medicine and HealthSchool of NursingUniversity of WollongongWollongongNSWAustralia
| | - Heidi Lord
- Centre for Research in Nursing and HealthSt George HospitalKogarahNSWAustralia
| | - Albara Alomari
- School of Nursing and MidwiferyWestern Sydney UniversityLiverpoolNSWAustralia
| | - Leanne Hunt
- School of Nursing and MidwiferyWestern Sydney UniversityLiverpoolNSWAustralia
| | - Rebekkah Middleton
- Faculty of Science, Medicine and HealthSchool of NursingUniversity of WollongongWollongongNSWAustralia
| | - Elizabeth J. Halcomb
- Faculty of Science, Medicine and HealthSchool of NursingUniversity of WollongongWollongongNSWAustralia
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Joyce C, Roseen EJ, Keysor JJ, Gross KD, Culpepper L, Saper RB. Can Yoga or Physical Therapy for Chronic Low Back Pain Improve Depression and Anxiety Among Adults From a Racially Diverse, Low-Income Community? A Secondary Analysis of a Randomized Controlled Trial. Arch Phys Med Rehabil 2021; 102:1049-1058. [PMID: 33556352 DOI: 10.1016/j.apmr.2021.01.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/12/2021] [Accepted: 01/19/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To determine and compare the effect of yoga, physical therapy (PT), and education on depressive and anxious symptoms in patients with chronic low back pain (CLBP). DESIGN Secondary analysis of a randomized controlled trial. SETTING Academic safety net hospital and 7 community health centers. PARTICIPANTS A total of 320 adults with CLBP. INTERVENTION Yoga classes, PT sessions, or an educational book. OUTCOME MEASURE Depression and anxiety were measured using the Patient Health Questionnaire and Generalized Anxiety Disorder 7-item Scale, respectively, at baseline, 12, and 52 weeks. We identified baseline and midtreatment (6-wk) factors associated with clinically meaningful improvements in depressive (≥3 points) or anxious (≥2 points) symptoms at 12 weeks. RESULTS Participants (female=64%; mean age, 46.0±10.7 years) were predominantly non-White (82%), low-income (<$30,000/year, 59%), and had not received a college degree (71%). Most participants had mild or worse depressive (60%) and anxious (50%) symptoms. At 12 weeks, yoga and PT participants experienced modest within-group improvements in depressive symptoms (mean difference [MD]=-1.23 [95% CI, -2.18 to -0.28]; MD=-1.01 [95% CI, -2.05 to -0.03], respectively). Compared with the education group, 12-week differences were not statistically significant, although trends favored yoga (MD=-0.71 [95% CI, -2.22 to 0.81]) and PT (MD= -0.32 [95% CI, -1.82 to 1.18]). At 12 weeks, improvements in anxious symptoms were only found in participants who had mild or moderate anxiety at baseline. Independent of treatment arm, participants who had 30% or greater improvement in pain or function midtreatment were more likely to have a clinically meaningful improvement in depressive symptoms (odds ratio [OR], 1.82 [95% CI, 1.03-3.22]; OR, 1.79 [95% CI, 1.06-3.04], respectively). CONCLUSIONS In our secondary analysis we found that depression and anxiety, common in this sample of underserved adults with CLBP, may improve modestly with PT and yoga. However, effects were not superior to education. Improvements in pain and function are associated with a decrease in depressive symptoms. More research is needed to optimize the integration of physical and psychological well-being in PT and yoga.
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Affiliation(s)
- Christopher Joyce
- Department of Rehabilitation Science, Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts, United States; School of Physical Therapy, Massachusetts College of Pharmacy and Health Sciences University, Worcester, Massachusetts, United States.
| | - Eric J Roseen
- Department of Rehabilitation Science, Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts, United States; Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, United States
| | - Julie J Keysor
- Department of Rehabilitation Science, Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts, United States; Department of Physical Therapy, Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts, United States
| | - K Douglas Gross
- Department of Rehabilitation Science, Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts, United States; Department of Physical Therapy, Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts, United States
| | - Larry Culpepper
- Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, United States
| | - Robert B Saper
- Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, United States
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Simon NM, Hofmann SG, Rosenfield D, Hoeppner SS, Hoge EA, Bui E, Khalsa SBS. Efficacy of Yoga vs Cognitive Behavioral Therapy vs Stress Education for the Treatment of Generalized Anxiety Disorder: A Randomized Clinical Trial. JAMA Psychiatry 2021; 78:13-20. [PMID: 32805013 PMCID: PMC7788465 DOI: 10.1001/jamapsychiatry.2020.2496] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE Generalized anxiety disorder (GAD) is common, impairing, and undertreated. Although many patients with GAD seek complementary and alternative interventions, including yoga, data supporting yoga's efficacy or how it compares to first-line treatments are lacking. OBJECTIVES To assess whether yoga (Kundalini yoga) and cognitive behavioral therapy (CBT) for GAD are each more effective than a control condition (stress education) and whether yoga is noninferior to CBT for the treatment of GAD. DESIGN, SETTING, AND PARTICIPANTS For this randomized, 3-arm, controlled, single-blind (masked independent raters) clinical trial, participants were recruited from 2 specialty academic centers starting December 1, 2013, with assessment ending October 25, 2019. Primary analyses, completed by February 12, 2020, included superiority testing of Kundalini yoga and CBT vs stress education and noninferiority testing of Kundalini yoga vs CBT. INTERVENTIONS Participants were randomized to Kundalini yoga (n = 93), CBT for GAD (n = 90), or stress education (n = 43), which were each delivered to groups of 4 to 6 participants by 2 instructors during twelve 120-minute sessions with 20 minutes of daily homework. MAIN OUTCOMES AND MEASURES The primary intention-to-treat outcome was acute GAD response (Clinical Global Impression-Improvement Scale score of much or very much improved) after 12 weeks as assessed by trained independent raters. RESULTS Of 538 participants who provided consent and were evaluated, 226 (mean [SD] age, 33.4 [13.5] years; 158 [69.9%] female) with a primary diagnosis of GAD were included in the trial. A total of 155 participants (68.6%) completed the posttreatment assessment. Completion rates did not differ (Kundalini yoga, 60 [64.5%]; CBT, 67 [74.4%]; and stress education, 28 [65.1%]: χ2 = 2.39, df = 2, P = .30). Response rates were higher in the Kundalini yoga group (54.2%) than in the stress education group (33.%) (odds ratio [OR], 2.46 [95% CI, 1.12-5.42]; P = .03; number needed to treat, 4.59 [95% CI, 2.52-46.19]) and in the CBT group (70.8%) compared with the stress education group (33.0%) (OR, 5.00 [95% CI, 2.12-11.82]; P < .001; number needed to treat, 2.62 [95% CI, 1.91-5.68]). However, the noninferiority test did not find Kundalini yoga to be as effective as CBT (difference, 16.6%; P = .42 for noninferiority). CONCLUSIONS AND RELEVANCE In this trial, Kundalini yoga was efficacious for GAD, but the results support CBT remaining first-line treatment. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01912287.
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Affiliation(s)
- Naomi M. Simon
- Department of Psychiatry, New York University Grossman School of Medicine, New York, New York
| | - Stefan G. Hofmann
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - David Rosenfield
- Department of Psychology, Southern Methodist University, Dallas, Texas
| | - Susanne S. Hoeppner
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Elizabeth A. Hoge
- Department of Psychiatry, Georgetown University Medical Center, Washington, DC
| | - Eric Bui
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Sat Bir S. Khalsa
- Departments of Medicine and Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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Jonsson G, Franzén L, Nyström MBT, Davis PA. Integrating yoga with psychological group-treatment for mixed depression and anxiety in primary healthcare: An explorative pilot study. Complement Ther Clin Pract 2020; 41:101250. [PMID: 33113486 DOI: 10.1016/j.ctcp.2020.101250] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 08/29/2020] [Accepted: 10/20/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Yoga has shown promise as a treatment for depression and anxiety. The present pilot study investigated the feasibility of an eight-week grouptreatment integrating emotion-focused psychoeducation, compassion-focused therapy, and Virya yoga for depression and anxiety in primary healthcare. MATERIALS AND METHODS Patients seeking treatment for depression and anxiety in a primary healthcare centre completed either an integrative group-treatment (N = 14) or treatment as usual (TAU, N = 17). Outcome measures were analysed pre- and posttreatment. Correlations in the intervention group were investigated between treatment outcomes and amount of yoga practice between sessions. RESULTS Large within-group effect sizes on all outcome measures were found at posttreatment. Symptom reduction did not differ between groups (p = 0.155). Improvement in alexithymia correlated significantly (p < 0.05) with amount of yoga practice between sessions. CONCLUSION Integrating yoga with a psychological group-treatment is a somewhat feasible approach to treatment for depression and anxiety in primary healthcare.
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Affiliation(s)
- Gustav Jonsson
- Department of Psychology, Umeå University, 901 87, Umeå, Sweden.
| | - Lisa Franzén
- Department of Psychology, Umeå University, 901 87, Umeå, Sweden.
| | | | - Paul A Davis
- Department of Psychology, Umeå University, 901 87, Umeå, Sweden.
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Integrating complementary and alternative therapies into professional psychological practice: An exploration of practitioners' perceptions of benefits and barriers. Complement Ther Clin Pract 2020; 41:101238. [PMID: 32932216 DOI: 10.1016/j.ctcp.2020.101238] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 08/18/2020] [Accepted: 08/27/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND PURPOSE Although Complementary and Alternative Therapies (CATs) are currently incorporated into psychotherapy, scepticism remains among professional and practicing psychologists about integration of CATs into professional practice. This research explored perceived benefits and barriers to integrating CATs into psychology practice with individual clients. MATERIALS AND METHODS We used a qualitative framework informed by Transpersonal Psychology to explore benefits and barriers to integrative psychology practice. We conducted semi-structured interviews with six practitioners trained or training in psychology and CATs and analysed verbatim transcripts using thematic analysis. RESULTS Participants reported personal, career-based, and epistemological benefits and barriers to integrative psychology practice. Benefits were improved therapeutic relationships, specialisation options, and a time reflective psychology. Barriers included stigma and bias, regulations, and dominance of the scientist-practitioner model. Superordinate themes were holism, connectedness, and governance. CONCLUSION Results activate conversation about the importance of a transpersonally oriented integrative psychological practice for the 21st century.
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Fradkin C. Colleen E. Carney: Goodnight Mind for Teens: Skills to Help You Quiet Noisy Thoughts and Get the Sleep You Need. J Youth Adolesc 2020. [DOI: 10.1007/s10964-020-01296-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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A Comparison of the Acute Effects of Different Forms of Yoga on Physiological and Psychological Stress: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176090. [PMID: 32825677 PMCID: PMC7503485 DOI: 10.3390/ijerph17176090] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 08/18/2020] [Indexed: 11/17/2022]
Abstract
Yoga is a frequently recommended stress management strategy; however, the acute stress response to varying types of yoga are not fully clear. Thus, the purpose of this study was to compare the acute effects of meditative and power yoga on indices of physiological and psychological stress. In a crossover counterbalanced design, physically active females (n = 13; age = 20.8 yrs ± 0.8, height = 164.5 cm ± 6.1, body mass = 65.0 kg ± 13.8) who did not regularly participate in yoga or mindful training enrolled in this study. Participants completed two visits each, with a standardized instructional-video 30-min yoga session with either A) meditative (Hatha style) yoga or B) power (Vinyasa style) yoga. Prior to and immediately after each yoga bout, psychological stress was assessed using the State–Trait Anxiety Inventory (STAI) questionnaire, and salivary cortisol samples were obtained to measure indices of physiological stress. State anxiety scores were significantly lower following meditative yoga (p = 0.047) but were not different following power yoga (p = 0.625). Salivary cortisol levels were significantly lower following meditative yoga (p = 0.020) but not following power yoga (p = 0.242). Results indicate that acute engagement in meditative yoga decreases markers of psychological and physiological stress, while power yoga does not impart a significant stress-relieving benefit. Findings indicate that differing types of yoga may have various stress-relieving capabilities and should be considered by individuals seeking anxiolytic benefits.
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Baumel A, Torous J, Edan S, Kane JM. There is a non-evidence-based app for that: A systematic review and mixed methods analysis of depression- and anxiety-related apps that incorporate unrecognized techniques. J Affect Disord 2020; 273:410-421. [PMID: 32560936 DOI: 10.1016/j.jad.2020.05.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/05/2020] [Accepted: 05/08/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Recent studies have utilized available online data to examine the impact of depression- and anxiety-related apps that incorporate evidence-based techniques; however, the impact of apps incorporating non-evidence-based techniques is unknown. Understanding this impact is important in order to assess the potential benefits or harm from their use. METHODS We systematically reviewed apps incorporating relevant techniques aimed at depression- and anxiety-related conditions, found through Google Play search. We conducted quantitative and qualitative analyses of user reviews, and analyzed app usage utilizing an independent user panel. RESULTS Compared to apps incorporating evidence-based techniques (n = 14), user ratings of apps classified as non-evidence-based (n = 27) were lower (4.0 versus 4.5, p=.001, η2=0.24) and a smaller percentage of users found these apps to be beneficial for mental health (76.2% versus 100%, p=.003, η2=0.23). Users found apps incorporating non-evidence-based techniques to be mostly helpful in providing in-the-moment relief; however, some users described these apps as containing content that could be harmful for a person in such a mental state. LIMITATIONS The data do not enable the differentiation of user experiences based on user groups (e.g. according to the severity of symptoms), which should be examined in future studies. CONCLUSIONS This study indicates that depression and anxiety apps incorporating non-evidence-based techniques are viewed less favorably and have more potential to cause harm. However, many users found them helpful mostly in providing in-the-moment relief. Examining user experiences with these apps is an important way to learn about unmet user needs and potential benefits or harm.
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Affiliation(s)
- Amit Baumel
- Department of Community Mental Health, University of Haifa, Haifa, Israel.
| | - John Torous
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Stav Edan
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - John M Kane
- Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
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Erdoğan Yüce G, Muz G. Effect of yoga-based physical activity on perceived stress, anxiety, and quality of life in young adults. Perspect Psychiatr Care 2020; 56:697-704. [PMID: 32037569 DOI: 10.1111/ppc.12484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/03/2020] [Accepted: 02/02/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study, conducted at a public university in Turkey, sought to determine the effects of yoga-based physical activity on perceived stress, anxiety, and quality of life in young adults. DESIGN AND METHODS This study was planned as a semiexperimental nonrandomized study with a control group. FINDINGS Yoga-based physical activity decreased the perceived stress and state anxiety levels, but had no effect on trait anxiety levels and quality of life. PRACTICAL IMPLICATIONS It is recommended that yoga-based treatment can be included in nursing interventions for reducing stress and anxiety levels in young adults.
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Affiliation(s)
| | - Gamze Muz
- Department of Internal Nursing, Nevsehir Haci Bektas Veli University, Nevsehir, Turkey
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Saxena K, Verrico CD, Saxena J, Kurian S, Alexander S, Kahlon RS, Arvind RP, Goldberg A, DeVito N, Baig M, Grieb A, Bakhshaie J, Simonetti A, Storch EA, Williams L, Gillan L. An Evaluation of Yoga and Meditation to Improve Attention, Hyperactivity, and Stress in High-School Students. J Altern Complement Med 2020; 26:701-707. [PMID: 32551827 DOI: 10.1089/acm.2020.0126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: Problems with attention and stress are common in children and predict academic difficulties and other behavioral and emotional problems. Mind-body interventions such as yoga and meditation improve attention and reduce stress. In this study, we examined the impact of Hatha yoga on attention and stress in ninth graders. Design: A total of 174 ninth graders from a Texas high school were enrolled in the study. Teachers assigned students to a yoga group (YG) or control group (CG) based on their class schedule. The YG participated in 25-min Hatha yoga classes twice weekly over 12 weeks (n = 123). The CG included 51 students. Student self-reports on measures of inattention and hyperactivity (the strengths and weaknesses of ADHD [attention-deficit/hyperactivity disorder] symptoms and normal behavior rating scale for ADHD) and stress (perceived stress scale) were obtained at baseline and at 12 weeks. Results: There were no significant differences in baseline levels of inattention (p = 0.86), hyperactivity (p = 0.25), and perceived stress (p = 0.28) between the YG and CG. Regarding inattention scores, there was a significant interaction of group and time (b = -1.09, standard error [SE] = 0.30, p < 0.001). Pairwise t-tests showed a significant reduction in inattention for the YG (d = 0.27) but a significant increase in inattention for the CG. Regarding hyperactivity, there was no significant interaction of group and time (b = -0.43, SE = 0.26, p = 0.1). Pairwise t-tests demonstrated a significant reduction in hyperactivity for the YG (d = 0.22), but not the CG. The interaction of group and time was not significant in predicting the slope of change in perceived distress (b = -0.93, SE = 1.19, p = 0.43). Pairwise t-tests did not show a significant reduction in perceived distress for either group. Conclusion: These findings suggest that Hatha yoga may improve attention and hyperactivity in high school students.
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Affiliation(s)
- Kirti Saxena
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Christopher D Verrico
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Johanna Saxena
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Sherin Kurian
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Stefanie Alexander
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ramandeep Singh Kahlon
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Ruchir P Arvind
- Department of Psychiatry, University of Texas Health-McGovern Medical School, Houston, TX, USA
| | - Adam Goldberg
- Department of Psychiatry, University of Texas Health-McGovern Medical School, Houston, TX, USA
| | - Nicholas DeVito
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Mirza Baig
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Anastasia Grieb
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Jafar Bakhshaie
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Alessio Simonetti
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Laurel Williams
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Lex Gillan
- Institute for Spirituality and Health, Houston, TX, USA
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Mathersul DC, Eising CM, DeSouza DD, Spiegel D, Bayley PJ. Brain and Physiological Markers of Autonomic Function Are Associated With Treatment-Related Improvements in Self-Reported Autonomic Dysfunction in Veterans With Gulf War Illness: An Exploratory Pilot Study. Glob Adv Health Med 2020; 9:2164956120922812. [PMID: 32426178 PMCID: PMC7218338 DOI: 10.1177/2164956120922812] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 02/25/2020] [Accepted: 04/01/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Gulf War Illness (GWI) is a poorly understood condition characterized by a constellation of mood, cognitive, and physical symptoms. A growing body of evidence demonstrates autonomic nervous system (ANS) dysfunction. Few published treatment studies exist for GWI. METHOD We recently completed a randomized controlled trial comparing a 10-week group yoga intervention to 10-week group cognitive behavioral therapy (CBT) for veterans with GWI. Here, we present exploratory data on ANS biomarkers of treatment response from a small pilot exploratory neurophysiological add-on study (n = 13) within that larger study. RESULTS Findings suggest that veterans with GWI receiving either yoga or CBT for pain improved following treatment and that changes in biological ANS-especially for the yoga group-moved in the direction of healthy profiles: lower heart rate, higher square root of the mean squared differences between successive R-R intervals (RMSSD), greater parasympathetic activation/dominance (increased high-frequency heart rate variability [HF-HRV], decreased low-frequency/high-frequency [LF/HF] ratio), reduced right amygdala volume, and stronger amygdala-default mode/amygdala-salience network connectivity, both immediately posttreatment and at 6-month follow-up. Biological mechanisms of CBT appeared to underlie improvements in more psychologically loaded symptoms such as self-reported fatigue and energy. Higher tonic arousal and/or more sympathetic dominance (higher skin conductance, lower RMSSD, lower HF-HRV, higher LF/HF ratio) pretreatment predicted greater treatment-related improvements in self-reported ANS for both the yoga and CBT group. CONCLUSION These exploratory pilot data provide preliminary support for the suggestion that treatment (yoga, CBT) is associated with improvements in both biological and self-reported ANS dysfunctions in GWI. The major limitation for these findings is the small sample size. Larger and more controlled studies are needed to replicate these findings and directly compare biomarkers of yoga versus CBT.
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Affiliation(s)
- Danielle C Mathersul
- War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Carla M Eising
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
- Department of Clinical Psychology Science, Maastricht University, Maastricht, the Netherlands
| | - Danielle D DeSouza
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California
| | - David Spiegel
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Peter J Bayley
- War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
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Trkulja V, Barić H. Current Research on Complementary and Alternative Medicine (CAM) in the Treatment of Anxiety Disorders: An Evidence-Based Review. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:415-449. [PMID: 32002940 DOI: 10.1007/978-981-32-9705-0_22] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Complementary and alternative medicine (CAM) encompasses a wide range of different nonmainstream therapies that have been increasingly used for treatment or adjunctive treatment of various ailments with anxiety/anxiety disorders being one of the commonly CAM (self)-medicated conditions. Thousands of published papers refer to use of CAM in various psychiatric disorders or in healthy or medically ill patients with mood or anxiety difficulties. In this chapter we focus specifically on clinically diagnosed (in line with the standard criteria) anxiety disorders and overview evidence of efficacy/safety of a range of CAM modalities: biologically based therapies (typically herbal preparations and less so nutraceuticals); manipulative and body-based therapies (acupuncture, aerobic exercise, massage, therapeutic touch, repetitive transcranial magnetic stimulation, balneotherapy, and others); mind-body therapies (yoga, Morita therapy, Tai Chi, reiki, Chinese cognitive therapy, religious and spiritual interventions, relaxation, mediation, and mindfulness-based interventions); and alternative medical systems (Ayurveda, homeopathy). We focus exclusively on randomized controlled trials and attempt to evaluate the existing body of evidence in the same manner that is applied to mainstream treatments.
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Affiliation(s)
- Vladimir Trkulja
- Department of Pharmacology, Zagreb University School of Medicine, Zagreb, Croatia.
| | - Hrvoje Barić
- Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia
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Papp ME, Nygren-Bonnier M, Gillerius J, Wändell P, Lindfors P. Effects of hatha yoga on self-reported health outcomes in a randomized controlled trial of patients with obstructive pulmonary disorders. NORDIC PSYCHOLOGY 2019. [DOI: 10.1080/19012276.2019.1653220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Marian E. Papp
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels allé 23, Huddinge, SE-14183, Sweden
| | - Malin Nygren-Bonnier
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden and Allied Health Professionals, Function Area Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, 23100, SE-141 83, Sweden
| | - Janni Gillerius
- Department of Psychology, Stockholm University, Frescati hagväg 14, Stockholm, SE-106 91, Sweden
| | - Per Wändell
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels allé 23, Huddinge, SE-14183, Sweden
| | - Petra Lindfors
- Department of Psychology, Stockholm University, Frescati hagväg 14, Stockholm, SE-106 91, Sweden
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Papp ME, Nygren-Bonnier M, Gullstrand L, Wändell PE, Lindfors P. A randomized controlled pilot study of the effects of 6-week high intensity hatha yoga protocol on health-related outcomes among students. J Bodyw Mov Ther 2019; 23:766-772. [PMID: 31733760 DOI: 10.1016/j.jbmt.2019.05.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 03/20/2019] [Accepted: 05/11/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Modern hatha yoga exercises (YE) provide an alternative form of physical activity which may reduce stress, facilitate recovery and improve health. This study investigated the short-term effects of high intensity hatha yoga exercises (HIY) on health-related outcomes. METHODS A 6-week randomized controlled study was performed to compare HIY with a control group not changing their exercise behavior. Healthy students (N = 44; median age: 25 years, range 20-39 years; HIY: n = 21, including 3 men; control group: n = 23, including 3 men) novice to yoga participated in the intervention which included one weekly class and recommended home training. Participants provided self-reports in questionnaires before and after the intervention. Self-reports included anxiety and depression (Hospital Anxiety and Depression Scale), stress (Perceived Stress Scale), sleep quality (Pittsburgh Sleep Quality Index), insomnia (Insomnia Severity Index), subjective health complaints (Common Symptoms in General Practice Index) and self-rated health (single-item). RESULTS After the 6-week intervention, there were no between-group differences in anxiety, depression, stress, sleep or self-rated health. However, when investigating associations within the HIY-group, a higher HIY-dose was related to less depression (r = 0.47; p = 0.03), improved sleep quality (r = 0.55; p = 0.01), and less insomnia (r = 0.49; p = 0.02). CONCLUSIONS There were no short-term between-group effects of HIY on mental distress, sleep or self-rated health. However, within the HIY-group, a higher dose was associated with improved mental health in terms of depression and with improved sleep. Although future studies with larger samples are needed, these preliminary findings suggest short-term positive effects of HIY on health-related outcomes among students. TRIAL REGISTRATION NUMBER NCT01305096.
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Affiliation(s)
- Marian E Papp
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care Sweden.
| | - Malin Nygren-Bonnier
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Lennart Gullstrand
- University of Gothenburg, Department of Nutrition, Health and Sport Science, SE 405 30, Gothenburg, Sweden
| | - Per E Wändell
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care Sweden
| | - Petra Lindfors
- Department of Psychology, Stockholm University, Frescati Hagväg 14, SE-106 91, Stockholm, Sweden
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Mathersul DC, Tang JS, Schulz-Heik RJ, Avery TJ, Seppälä EM, Bayley PJ. Study protocol for a non-inferiority randomised controlled trial of SKY breathing meditation versus cognitive processing therapy for PTSD among veterans. BMJ Open 2019; 9:e027150. [PMID: 30948610 PMCID: PMC6500221 DOI: 10.1136/bmjopen-2018-027150] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/11/2018] [Accepted: 12/18/2018] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Post-traumatic stress disorder (PTSD) is a debilitating, highly prevalent condition. Current clinical practice guidelines recommend trauma-focused psychotherapy (eg, cognitive processing therapy; CPT) as the first-line treatment for PTSD. However, while these treatments show clinically meaningful symptom improvement, the majority of those who begin treatment retain a diagnosis of PTSD post-treatment. Perhaps for this reason, many individuals with PTSD have sought more holistic, mind-body, complementary and integrative health (CIH) interventions. However, there remains a paucity of high-quality, active controlled efficacy studies of CIH interventions for PTSD, which precludes their formal recommendation. METHODS AND ANALYSES We present the protocol for an ongoing non-inferiority parallel group randomised controlled trial (RCT) comparing the efficacy of a breathing meditation intervention (Sudarshan Kriya Yoga [SKY]) to a recommended evidence-based psychotherapy (CPT) for PTSD among veterans. Assessors are blinded to treatment group. The primary outcome measure is the PTSD Checklist-Civilian Version and a combination of clinical, self-report, experimental and physiological outcome measures assess treatment-related changes across each of the four PTSD symptom clusters (re-experiencing, avoidance, negative cognitions or mood and hyperarousal/reactivity). Once the RCT is completed, analyses will use both an intent-to-treat (using the 'last observation carried forward' for missing data) and a per-protocol or 'treatment completers' procedure, which is the most rigorous approach to non-inferiority designs. ETHICS AND DISSEMINATION To the best of our knowledge, this is this first non-inferiority RCT of SKY versus CPT for PTSD among veterans. The protocol is approved by the Stanford University Institutional Review Board. All participants provided written informed consent prior to participation. Results from this RCT will inform future studies including larger multi-site efficacy RCTs of SKY for PTSD and other mental health conditions, as well as exploration of cost-effectiveness and evaluation of implementation issues. Results will also inform evidence-based formal recommendations regarding CIH interventions for PTSD. TRIAL REGISTRATION NUMBER NCT02366403; Pre-results.
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Affiliation(s)
- Danielle C Mathersul
- War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Julia S Tang
- War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - R Jay Schulz-Heik
- War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Timothy J Avery
- War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Emma M Seppälä
- Center for Compassion and Altruism Research and Education, Stanford University School of Medicine, Stanford, California, USA
- Yale Center for Emotional Intelligence, Yale University, New Haven, Connecticut, USA
| | - Peter J Bayley
- War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
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Brenes GA, Sohl S, Wells RE, Befus D, Campos CL, Danhauer SC. The Effects of Yoga on Patients with Mild Cognitive Impairment and Dementia: A Scoping Review. Am J Geriatr Psychiatry 2019; 27:188-197. [PMID: 30413292 PMCID: PMC6541218 DOI: 10.1016/j.jagp.2018.10.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 10/03/2018] [Accepted: 10/18/2018] [Indexed: 01/22/2023]
Abstract
Yoga is an ancient mind body practice. Although yoga has been used as a complementary health approach for enhancing wellness and addressing a variety of health issues, little is known about the impact of yoga on cognitive functioning in adults with mild cognitive impairment (MCI) and dementia. We conducted a literature review to examine the impact of yoga on persons with MCI and dementia. Eight studies were identified that reported on yoga as either the primary intervention or one component of a multi-component intervention in samples of persons with MCI or dementia. Results suggest that yoga may have beneficial effects on cognitive functioning, particularly on attention and verbal memory. Further, yoga may affect cognitive functioning through improved sleep, mood, and neural connectivity. There are a number of limitations of the existing studies, including a lack of intervention details, as well as variability in the frequency/duration and components of the yoga interventions. A further complicating issue is the role of various underlying etiologies of cognitive impairment. Despite these limitations, providers may consider recommending yoga to persons with MCI or dementia as a safe and potentially beneficial complementary health approach.
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Affiliation(s)
- Gretchen A. Brenes
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine
| | - Stephanie Sohl
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine
| | | | - Deanna Befus
- Department of Family and Community Medicine, Wake Forest School of Medicine
| | - Claudia L. Campos
- Department of Internal Medicine, Section on General Internal Medicine, Wake Forest School of Medicine
| | - Suzanne C. Danhauer
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine
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Abstract
Background Despite the wide array of health benefits that have been evidenced with yoga, a clear gap exists examining how yoga impacts connections with oneself and to others. Aims The objectives of the present study were twofold: (1) to describe the day-to-day (in)variability in daily yoga practice and relational outcomes and (2) to examine the direct and indirect effects of yoga practice on relational outcomes. Methods Community-dwelling yoga practitioners (n = 104, age range: 18-76 years) with a yoga practice of at least once a week were recruited for a 21-day daily diary study. Practitioners were asked to complete daily Internet surveys at the end of the day which included questions with respect to one's yoga practice and relational domains (i.e., mindfulness, [self-]compassion, and social connectedness). Results Multilevel analyses revealed yoga and relational outcomes to be dynamic phenomena, indicated by substantial variation (intraclass correlations = 0.34-0.48) at the within-person level. On days when an individual practiced more yoga than their usual, greater mindfulness (b = 2.93, standard error [SE] = 0.39, P < 0.05) and self-compassion (b = 1.45, SE = 0.46, P < 0.05) were also reported. 1-1-1 multilevel mediation models demonstrated that yoga has an indirect effect on both compassion and social connectedness through increases in mindfulness at the within- and between-person levels. In models testing self-compassion as the mediator, the indirect effect of daily yoga practice on compassion was significant, although limited to the within-person level. Conclusions These findings suggest that a routine yoga practice could positively impact how a practitioner relates to theirselves and to others, both on a day-to-day basis, and with accumulated practice.
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Affiliation(s)
- Moé Kishida
- College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Jacqueline Mogle
- College of Nursing, The Pennsylvania State University, Pennsylvania, USA
| | - Steriani Elavsky
- Department of Human Movement Studies, University of Ostrava, Ostrava, Czech
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Cramer H, Lauche R, Anheyer D, Pilkington K, de Manincor M, Dobos G, Ward L. Yoga for anxiety: A systematic review and meta-analysis of randomized controlled trials. Depress Anxiety 2018; 35:830-843. [PMID: 29697885 DOI: 10.1002/da.22762] [Citation(s) in RCA: 125] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 02/11/2018] [Accepted: 02/17/2018] [Indexed: 12/11/2022] Open
Abstract
Yoga has become a popular approach to improve emotional health. The aim of this review was to systematically assess and meta-analyze the effectiveness and safety of yoga for anxiety. Medline/PubMed, Scopus, the Cochrane Library, PsycINFO, and IndMED were searched through October 2016 for randomized controlled trials (RCTs) of yoga for individuals with anxiety disorders or elevated levels of anxiety. The primary outcomes were anxiety and remission rates, and secondary outcomes were depression, quality of life, and safety. Risk of bias was assessed using the Cochrane tool. Eight RCTs with 319 participants (mean age: 30.0-38.5 years) were included. Risk of selection bias was unclear for most RCTs. Meta-analyses revealed evidence for small short-term effects of yoga on anxiety compared to no treatment (standardized mean difference [SMD] = -0.43; 95% confidence interval [CI] = -0.74, -0.11; P = .008), and large effects compared to active comparators (SMD = -0.86; 95% CI = -1.56, -0.15; P = .02). Small effects on depression were found compared to no treatment (SMD = -0.35; 95% CI = -0.66, -0.04; P = .03). Effects were robust against potential methodological bias. No effects were found for patients with anxiety disorders diagnosed by Diagnostic and Statistical Manual criteria, only for patients diagnosed by other methods, and for individuals with elevated levels of anxiety without a formal diagnosis. Only three RCTs reported safety-related data but these indicated that yoga was not associated with increased injuries. In conclusion, yoga might be an effective and safe intervention for individuals with elevated levels of anxiety. There was inconclusive evidence for effects of yoga in anxiety disorders. More high-quality studies are needed and are warranted given these preliminary findings and plausible mechanisms of action.
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Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Romy Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Dennis Anheyer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Karen Pilkington
- School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, United Kingdom
| | - Michael de Manincor
- National Institute of Complementary Medicine (NICM), Western Sydney University (WSU), Sydney, Australia
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Lesley Ward
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia.,Centre for Rehabilitation Research in Oxford (RRIO), Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
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Mocanu E, Mohr C, Pouyan N, Thuillard S, Dan-Glauser ES. Reasons, Years and Frequency of Yoga Practice: Effect on Emotion Response Reactivity. Front Hum Neurosci 2018; 12:264. [PMID: 30022932 PMCID: PMC6039555 DOI: 10.3389/fnhum.2018.00264] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/08/2018] [Indexed: 01/23/2023] Open
Abstract
Yoga practice, even in the short term, is supposed to enhance wellbeing and counteract psychopathology through modification of emotion reactivity. Yoga teaches that emotional responses may be less pronounced with longer and more frequent practice, and potentially when people perform yoga for mental rather than physical reasons. We tested 36 yoga practitioners of varying experience (between 6 months and 11 years of practice). We assessed participants’ self-reported emotional experience and peripheral physiological reactions (heart rate, skin conductance, respiration) when seeing positive and negative pictures. Results were analyzed as a function of the years of, frequency of, and reasons for yoga practice. We found a heart rate increase with the degree participants performed yoga for mental reasons. In addition, years of yoga practice were significantly associated with reduced abdominal respiratory rate when facing negative pictures, speaking in favor of reduced arousal with yoga experience. Finally, regarding frequency of practice, a higher frequency in the last month was linked to less negative and positive experiences as well as a reduced abdominal respiratory amplitude when viewing positive pictures. Altogether, these results demonstrate that intense short-term yoga practice might relate to a (i) decrease in the intensity of self-reported emotional experiences and (ii) deepened respiration. Short-term effects might be shaped by what participants expect as practice benefits. However, several years of practice might be needed to decrease respiratory arousal in the face of negative situations, which likely is a manifestation of an evolution in the emotion regulation process.
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Affiliation(s)
- Elisabeth Mocanu
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Christine Mohr
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Niloufar Pouyan
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Simon Thuillard
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
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Kuvačić G, Fratini P, Padulo J, Antonio DI, De Giorgio A. Effectiveness of yoga and educational intervention on disability, anxiety, depression, and pain in people with CLBP: A randomized controlled trial. Complement Ther Clin Pract 2018; 31:262-267. [DOI: 10.1016/j.ctcp.2018.03.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/07/2018] [Accepted: 03/14/2018] [Indexed: 12/13/2022]
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Sullivan MB, Erb M, Schmalzl L, Moonaz S, Noggle Taylor J, Porges SW. Yoga Therapy and Polyvagal Theory: The Convergence of Traditional Wisdom and Contemporary Neuroscience for Self-Regulation and Resilience. Front Hum Neurosci 2018; 12:67. [PMID: 29535617 PMCID: PMC5835127 DOI: 10.3389/fnhum.2018.00067] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 02/06/2018] [Indexed: 12/21/2022] Open
Abstract
Yoga therapy is a newly emerging, self-regulating complementary and integrative healthcare (CIH) practice. It is growing in its professionalization, recognition and utilization with a demonstrated commitment to setting practice standards, educational and accreditation standards, and promoting research to support its efficacy for various populations and conditions. However, heterogeneity of practice, poor reporting standards, and lack of a broadly accepted understanding of the neurophysiological mechanisms involved in yoga therapy limits the structuring of testable hypotheses and clinical applications. Current proposed frameworks of yoga-based practices focus on the integration of bottom-up neurophysiological and top-down neurocognitive mechanisms. In addition, it has been proposed that phenomenology and first person ethical inquiry can provide a lens through which yoga therapy is viewed as a process that contributes towards eudaimonic well-being in the experience of pain, illness or disability. In this article we build on these frameworks, and propose a model of yoga therapy that converges with Polyvagal Theory (PVT). PVT links the evolution of the autonomic nervous system to the emergence of prosocial behaviors and posits that the neural platforms supporting social behavior are involved in maintaining health, growth and restoration. This explanatory model which connects neurophysiological patterns of autonomic regulation and expression of emotional and social behavior, is increasingly utilized as a framework for understanding human behavior, stress and illness. Specifically, we describe how PVT can be conceptualized as a neurophysiological counterpart to the yogic concept of the gunas, or qualities of nature. Similar to the neural platforms described in PVT, the gunas provide the foundation from which behavioral, emotional and physical attributes emerge. We describe how these two different yet analogous frameworks-one based in neurophysiology and the other in an ancient wisdom tradition-highlight yoga therapy's promotion of physical, mental and social wellbeing for self-regulation and resilience. This parallel between the neural platforms of PVT and the gunas of yoga is instrumental in creating a translational framework for yoga therapy to align with its philosophical foundations. Consequently, yoga therapy can operate as a distinct practice rather than fitting into an outside model for its utilization in research and clinical contexts.
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Affiliation(s)
- Marlysa B. Sullivan
- Integrative Health Sciences, Maryland University of Integrative Health, Laurel, MD, United States
| | - Matt Erb
- The Center for Mind-Body Medicine, Washington, DC, United States
| | - Laura Schmalzl
- College of Science and Integrative Health, Southern California University of Health Sciences, Whittier, CA, United States
| | - Steffany Moonaz
- Director of Clinical and Academic Research, Maryland University of Integrative Health, Laurel, MD, United States
| | | | - Stephen W. Porges
- Kinsey Institute, Indiana University, Bloomington, IN, United States
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Peterson CT, Bauer SM, Chopra D, Mills PJ, Maturi RK. Effects of Shambhavi Mahamudra Kriya, a Multicomponent Breath-Based Yogic Practice ( Pranayama), on Perceived Stress and General Well-Being. J Evid Based Complementary Altern Med 2017; 22:788-797. [PMID: 29228793 PMCID: PMC5871312 DOI: 10.1177/2156587217730934] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Stress-induced disorders such as anxiety represent the leading causes of adult disability worldwide. Previous studies indicate that yoga and other contemplative practices such as pranayama, or controlled yogic breathing techniques, may be effective in the treatment of mood disorders and stress. In this study, 142 individuals (mean age = 43 years; SD = 13.90) participated in a 3-day retreat program during which they learned Shambhavi Mahamudra kriya, which is a yogic practice that includes both deep breathing and meditation techniques. Participants were instructed to practice the kriya each day for 21 minutes. After 6 weeks of daily practice, participants reported subjectively lower levels of perceived stress (Perceived Stress Scale) and higher levels of general well-being (General Well-Being Scale) compared to baseline. These results support the notion that Shambhavi Mahamudra kriya may represent a natural treatment for stress reduction.
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Affiliation(s)
- Christine Tara Peterson
- 1 University of California San Diego, La Jolla, CA, USA.,2 Chopra Foundation, Carlsbad, CA, USA
| | - Sarah M Bauer
- 3 Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.,4 Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Deepak Chopra
- 1 University of California San Diego, La Jolla, CA, USA.,2 Chopra Foundation, Carlsbad, CA, USA
| | - Paul J Mills
- 1 University of California San Diego, La Jolla, CA, USA
| | - Raj K Maturi
- 5 Indiana University School of Medicine, Indianapolis, IN, USA
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Shepherd-Banigan M, Goldstein KM, Coeytaux RR, McDuffie JR, Goode AP, Kosinski AS, Van Noord MG, Befus D, Adam S, Masilamani V, Nagi A, Williams JW. Improving vasomotor symptoms; psychological symptoms; and health-related quality of life in peri- or post-menopausal women through yoga: An umbrella systematic review and meta-analysis. Complement Ther Med 2017; 34:156-164. [PMID: 28917368 DOI: 10.1016/j.ctim.2017.08.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 06/05/2017] [Accepted: 08/17/2017] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Vasomotor symptoms (VMS), commonly reported during menopausal transition, negatively affect psychological health and health-related quality of life (HRQoL). While hormone therapy is an effective treatment, its use is limited by concerns about possible harms. Thus, many women with VMS seek nonhormonal, nonpharmacologic treatment options. However, evidence to guide clinical recommendations is inconclusive. This study reviewed the effectiveness of yoga, tai chi and qigong on vasomotor, psychological symptoms, and HRQoL in peri- or post-menopausal women. DESIGN MEDLINE, Cochrane Database of Systematic Reviews, EMBASE, CINAHL and the Allied and Complementary Medicine Database were searched. Researchers identified systematic reviews (SR) or RCTs that evaluated yoga, tai chi, or qigong for vasomotor, psychological symptoms, and health-related quality of life (HRQoL) in peri- or post-menopausal women. Data were abstracted on study design, participants, interventions and outcomes. Risk of bias (ROB) was assessed and updated meta-analyses were performed. RESULTS We identified one high-quality SR (5 RCTs, 582 participants) and 3 new RCTs (345 participants) published after the SR evaluating yoga for vasomotor, psychological symptoms, and HRQoL; no studies evaluated tai chi or qigong. Updated meta-analyses indicate that, compared to controls, yoga reduced VMS (5 trials, standardized mean difference (SMD) -0.27, 95% CI -0.49 to -0.05) and psychological symptoms (6 trials, SDM -0.32; 95% CI -0.47 to -0.17). Effects on quality of life were reported infrequently. Key limitations are that adverse effects were rarely reported and outcome measures lacked standardization. CONCLUSIONS Results from this meta-analysis suggest that yoga may be a useful therapy to manage bothersome vasomotor and psychological symptoms.
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Affiliation(s)
- M Shepherd-Banigan
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA.
| | - K M Goldstein
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center 6301 Herndon Road, Durham, NC, USA
| | - R R Coeytaux
- Duke Clinical Research Institute, 2400 Pratt Street, Durham, NC 27705, USA
| | - J R McDuffie
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center 6301 Herndon Road, Durham, NC, USA
| | - A P Goode
- Department of Physical Therapy, Duke University Medical Center 2200 W. Main Street Durham, NC 27705, USA
| | - A S Kosinski
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, 8 Duke University Medical Center, Durham, MC 27703, USA
| | - M G Van Noord
- Duke University Medical Center Library, Durham, NC 27708, USA
| | - D Befus
- Duke University School of Nursing, 307 Trent Drive, Durham, NC 27710, USA
| | - S Adam
- Department of Medicine, Division of Hematology Oncology, Duke University Medical Center, 8 Duke University Medical Center, Durham, NC 27703, USA
| | - V Masilamani
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA
| | - A Nagi
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA
| | - J W Williams
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center 6301 Herndon Road, Durham, NC, USA
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Cramer H, Anheyer D, Lauche R, Dobos G. A systematic review of yoga for major depressive disorder. J Affect Disord 2017; 213:70-77. [PMID: 28192737 DOI: 10.1016/j.jad.2017.02.006] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/01/2017] [Accepted: 02/05/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND The purpose of this review was to investigate the efficacy and safety of yoga interventions in treating patients with major depressive disorder. METHODS MEDLINE, Scopus, and the Cochrane Library were screened through December 2016. Randomized controlled trials (RCTs) comparing yoga to inactive or active comparators in patients with major depressive disorder were eligible. Primary outcomes included remission rates and severity of depression. Anxiety and adverse events were secondary outcomes. Risk of bias was assessed using the Cochrane tool. RESULTS Seven RCTs with 240 participants were included. Risk of bias was unclear for most RCTs. Compared to aerobic exercise, no short- or medium-term group differences in depression severity was found. Higher short-term depression severity was found for yoga compared to electro-convulsive therapy; remission rates did not differ between groups. No short-term group differences occurred when yoga was compared to antidepressant medication. Conflicting evidence was found when yoga was compared to attention-control interventions, or when yoga as an add-on to antidepressant medication was compared to medication alone. Only two RCTs assessed adverse events and reported that no treatment-related adverse events were reported. LIMITATIONS Few RCTs with low sample size. CONCLUSIONS This review found some evidence for positive effects beyond placebo and comparable effects compared to evidence-based interventions. However, methodological problems and the unclear risk-benefit ratio preclude definitive recommendations for or against yoga as an adjunct treatment for major depressive disorder. Larger and adequately powered RCTs using non-inferiority designs are needed.
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Affiliation(s)
- Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany; Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - Dennis Anheyer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Romy Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Brosseau L, Taki J, Desjardins B, Thevenot O, Fransen M, Wells GA, Imoto AM, Toupin-April K, Westby M, Gallardo ICÁ, Gifford W, Laferrière L, Rahman P, Loew L, Angelis GD, Cavallo S, Shallwani SM, Aburub A, Bennell KL, Van der Esch M, Simic M, McConnell S, Harmer A, Kenny GP, Paterson G, Regnaux JP, Lefevre-Colau MM, McLean L. The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part one: introduction, and mind-body exercise programs. Clin Rehabil 2017; 31:582-595. [PMID: 28183188 DOI: 10.1177/0269215517691083] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To identify effective mind-body exercise programs and provide clinicians and patients with updated, high-quality recommendations concerning non-traditional land-based exercises for knee osteoarthritis. METHODS A systematic search and adapted selection criteria included comparative controlled trials with mind-body exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+, D-) was used, based on statistical significance ( P < 0.5) and clinical importance (⩾15% improvement). RESULTS The four high-quality studies identified demonstrated that various mind-body exercise programs are promising for improving the management of knee osteoarthritis. Hatha Yoga demonstrated significant improvement for pain relief (Grade B) and physical function (Grade C+). Tai Chi Qigong demonstrated significant improvement for quality of life (Grade B), pain relief (Grade C+) and physical function (Grade C+). Sun style Tai Chi gave significant improvement for pain relief (Grade B) and physical function (Grade B). CONCLUSION Mind-body exercises are promising approaches to reduce pain, as well as to improve physical function and quality of life for individuals with knee osteoarthritis.
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Affiliation(s)
- Lucie Brosseau
- 1 Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Jade Taki
- 2 Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Brigit Desjardins
- 3 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Odette Thevenot
- 3 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Marlene Fransen
- 4 Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - George A Wells
- 5 School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Karine Toupin-April
- 7 Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, Faculty of Medicine and School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Marie Westby
- 8 Mary Pack Arthritis Program, Vancouver Coastal Health, Department of Physical Therapy, University of British Columbia, Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | | | - Wendy Gifford
- 10 School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Lucie Laferrière
- 11 Canadian Forces Health Services Group Headquarters, National Defense, Ottawa, Ontario, Canada
| | - Prinon Rahman
- 12 Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Laurianne Loew
- 13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Gino De Angelis
- 13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Sabrina Cavallo
- 13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Ala' Aburub
- 13 School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Kim L Bennell
- 14 Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Martin Van der Esch
- 15 Department of Rehabilitation, Reade Centre for Rehabilitation and Rheumatology, Amsterdam, Netherlands, Faculty of Health. ACHIEVE, Centre of Applied Research and School of Physiotherapy, University of Applied Sciences, Amsterdam, Netherlands
| | - Milena Simic
- 16 Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Sara McConnell
- 17 Department of Medicine, St. Joseph's Health Care Centre, Toronto, Ontario, Canada
| | - Alison Harmer
- 18 Faculty of Health Sciences, Clinical and Rehabilitation Sciences Research Group, University of Sydney, Sydney, Australia
| | - Glen P Kenny
- 3 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Gail Paterson
- 19 The Arthritis Society, Ottawa Office, Ontario Division, Ottawa, Ontario, Canada
| | - Jean-Philippe Regnaux
- 20 Centre de recherche Epidémiologie et Biostatistique, Hôpital Hôtel-Dieu, Paris, France
| | | | - Linda McLean
- 1 Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Yonglitthipagon P, Muansiangsai S, Wongkhumngern W, Donpunha W, Chanavirut R, Siritaratiwat W, Mato L, Eungpinichpong W, Janyacharoen T. Effect of yoga on the menstrual pain, physical fitness, and quality of life of young women with primary dysmenorrhea. J Bodyw Mov Ther 2017; 21:840-846. [PMID: 29037637 DOI: 10.1016/j.jbmt.2017.01.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 01/15/2017] [Accepted: 01/31/2017] [Indexed: 11/26/2022]
Abstract
The aim of the present study was to investigate effect of specially designed yoga program on the menstrual pain, physical fitness, and quality of life (QOL) of non-athlete women with primary dysmenorrhea (PD) aged 18-22 years. Thirty-four volunteers were randomly assigned into control and yoga groups. Menstrual pain, physical fitness, and QOL were evaluated at baseline and at the end of the 12-week study period. The yoga group was asked to practice yoga for 30 min per day, twice a week, for 12 weeks at home, while the control group did not receive any form of exercise over the study period. There were significant improve in menstrual pain, physical fitness, and QOL in the yoga group more than the control group. Therefore, this specially designed yoga program may be a possible complementary treatment for PD.
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Affiliation(s)
- Ponlapat Yonglitthipagon
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Somruthai Muansiangsai
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Wilanee Wongkhumngern
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Wanida Donpunha
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Raoyrin Chanavirut
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Wantana Siritaratiwat
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Lukana Mato
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Wichai Eungpinichpong
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Taweesak Janyacharoen
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand.
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