Effects of yoga on mental and physical health: a short summary of reviews

Association between yoga and related contextual factors with moderate-to-vigorous physical activity among children and youth aged 5 to 17 years across five Indian states

Physical inactivity is one of the four key preventable risk factors, along with unhealthy diet, tobacco use, and alcohol consumption, underlying most noncommunicable diseases. Promoting physical activity is particularly important among children and youth, whose active living behaviours often track into adulthood. Incorporating yoga, an ancient practice that originated in India, can be a culturally-appropriate strategy to promote physical activity in India. However, there is little evidence on whether yoga practice is associated with moderate-to-vigorous physical activity (MVPA) accumulation. Thus, this study aims to understand how yoga practice is associated with MVPA among children and youth in India. Data for this study were obtained during the coronavirus disease lockdown in 2021. Online surveys capturing MVPA, yoga practice, contextual factors, and sociodemographic characteristics, were completed by 5 to 17-year-old children and youth in partnership with 41 schools across 28 urban and rural locations in five states. Linear regression analyses were conducted to assess the association between yoga practice and MVPA. After controlling for age, gender, and location, yoga practice was significantly associated with MVPA among children and youth (β = 0.634, p < 0.000). These findings highlight the value of culturally-appropriate activities such as yoga, to promote physical activity among children and youth. Yoga practice might have a particularly positive impact on physical activity among children and youth across the world, owing to its growing global prevalence.

Effect of yoga in medical students to reduce the level of depression, anxiety, and stress: pilot study (Goodbye Stress with Yoga GSY)

INTRODUCTION

Globally medical students reported high level of stress sensitivity, stress intensity and depression or anxiety. Yoga is proven to be a one of the most effective anxiolytic tools. The current study specifically designed to investigate the effect of yoga intervention on the level of stress, depression, and anxiety of medical student at the University of Pécs.

METHODS

Twenty-eight medical students from the University of Pécs, with an average age of 23.54 ± 4.36 years and a BMI of 22.42 ± 3.42 kg/m2, participated in a 10-week yoga intervention. In the current study, the DASS-21 was employed to gather information on stress, depression, and anxiety, while self-reported health and quality of life were assessed using the WHOQOL-BREF Questionnaire. The Shapiro-Wilk test was employed to examine the distribution of the data. The choice between the paired sampled T-test and the Wilcoxon signed test was determined based on the distribution of the data.

RESULTS

The intervention group exhibited a mean and standard deviation of depression pre- and post-yoga 10.14 ± 10.60 and 7.21 ± 8.56, similarly the values for anxiety were 8.57 ± 10.09 and 5.51 ± 7.42, and for stress values were 12.79 ± 10.73 and 9.64 ± 9.71 respectively. Notably, this outcome attribute to a significant in decreased depression (p = 0.019), anxiety (p = 0.049) among the participants.

CONCLUSIONS

Introduction of Yoga Intervention significantly decreased in levels of depression and anxiety. By this current study we were able to confirm the necessity of Yoga Intervention with our primary survey.

The role of exercise in aromatase inhibitor-induced arthralgia

Aromatase inhibitors are prescribed in breast cancer due to their associated lower rate of cancer recurrence compared to tamoxifen. However, aromatase inhibitor-induced arthralgia (AIIA) is one of the leading causes of treatment nonadherence, increasing the risk of cancer recurrence. The pathophysiology of AIIA is poorly understood, and although current recommendations for AIIA include lifestyle changes and analgesics depending on the severity of symptoms, there is no established effective treatment. The aim of this study is to explore the presentation and mechanism of AIIA and investigate the feasibility and efficacy of different exercise interventions (aerobic, resistance, aerobic and resistance combined, and yoga or tai chi) in patients with AIIA to guide the development of formal exercise prescription guidelines. Findings indicate that a mixed-modality regimen of aerobic and resistance exercises is feasible and safe and may serve the most benefit in improving joint pain, functionality, and quality of life. More specifically, the weekly regimen should consist of 150 min of aerobic exercise with two sessions of at least six resistance exercises, 8 to 12 repetitions, three sets each. Supplementary yoga and tai chi may be recommended twice a week depending on a patient's target symptoms. Yoga was associated with improved physical functionality, whereas tai chi was related to improvements in mental health. However, the feasibility and impact of combined aerobic and resistance exercise protocols with yoga or tai chi in our target population were not investigated in this review. The use of large, randomized controlled trials is recommended for future studies.

Impact of home quarantine on physical fitness of school-aged children in Xi'an during COVID-19 lockdown: a cross-sectional study

BACKGROUND

The emergence of the COVID-19 pandemic has sparked unprecedented global challenges. This study intends to investigate changes in the physical fitness of students aged 6-22 during the COVID-19 pandemic and to assess how the pandemic lockdown period affected these markers.

METHODS

According to the National Student Physical Health Standard, a stratified cluster sampling method was used to evaluate the body shape, body function, and physical fitness of children and adolescents (n = 8092) in Xi'an from 2019 to 2021. This study uses SPSS 26.0 (IBM, Chicago, IL, USA) for data statistics and analysis. The connection between physical fitness and years was measured using the one-variable analysis in the general linear model (GLM). Independent t-tests were used to determine the sex (male/female) and area (urban/rural) differences.

RESULTS

During the lockdown period, Body Mass Index (BMI) and flexibility showed an upward trend, while aerobic, strength, speed, and endurance showed a downward trend. In addition to the BMI of middle and high school students, almost all indicators show significant sex differences. There are urban-rural differences in some indicators, such as chin-ups.

CONCLUSION

During the pandemic of COVID-19, the physical fitness of children and adolescents in Xi'an did not change significantly, and there were slight differences among different grades. During the pandemic lockdown period, lifestyle changes and reduced outdoor activities for children and adolescents may be the reasons for the changing trend of various indicators.

Perceived delivery of essential yoga properties within in-person and remote weight loss maintenance interventions

OBJECTIVES

While previous research has utilized remote delivery of yoga interventions, no research has specifically interrogated the effectiveness of remote yoga intervention delivery. In this secondary analysis of weight-maintenance trial data, we examined participant perceptions of essential yoga properties across in-person and remote formats, hypothesizing that perceptions would not differ following remote delivery.

METHODS

24 women with overweight or obesity (34.6±4.1 kg/m2, 48.2±9.9 years) received a 12-week Iyengar yoga intervention (2x/week) following a 3-month behavioral weight loss program. Of 23 participants who completed follow-up questionnaires, 12 received the planned in-person intervention and 11 received a remote intervention (delivered live) due to the COVID-19 pandemic. The Essential Properties of Yoga Questionnaire (EPYQ) was completed online by participants and by the instructors to measure the perceptions of the relative emphasis placed on the essential components of the yoga intervention via 14 subscales. Linear regression models were used to compare perceptions of each EPYQ dimension across in-person and remote delivery methods, as well as between participants and instructors, independent of delivery method.

RESULTS

13 of the 14 subscales did not differ between delivery modalities (p>0.05). Participants perceived more individual attention within in-person yoga (p = 0.003). For both delivery methods, instructors perceived breathwork, restorative postures, and body locks to be incorporated to a lesser degree compared to participants (β = -1.28, p = 0.003; β = -1.57, p = 0.019; β = -1.39, p = 0.036; respectively). No other significant differences across the participant and instructor scores were observed.

CONCLUSIONS

Findings provide preliminary support for the use of live remote delivery of yoga, effectively communicating most essential yoga properties when compared to in-person classes. However, participants perceived more individual attention with in-person versus remote delivery; thus, future remote-based yoga interventions may benefit from providing additional individualized feedback.

Effects of a complex yoga-based intervention on physical characteristics

Empirical studies on yoga have shown that regular practice can have a beneficial effect on risk factors of cardiovascular diseases; also, it can decrease body weight, body fat and increase muscle mass. Positive effects on balance and flexibility were also reported. This study evaluated the impact of a 3-month complex yoga-based program, including physical exercises, education, and social support, with a quasi-randomized design in a middle-aged community sample. The intervention group consisted of 46 participants while the passive control group was 29 participants. The intervention group showed a significant increase in core muscle strength and hamstring flexibility and a decrease in body  fat. No significant changes were found concerning risk factors of cardiovascular diseases, body weight, muscle mass, balancing ability, and dietary habits. A 3-month yoga intervention cannot substantially impact the cardiovascular system and body weight control in middle-aged adults.

Holistic frailty prevention: The promise of movement-based mind-body therapies

Aging is characterized by fundamental cellular and molecular hallmarks that result in physiologic decline of most body systems. This may culminate in frailty, a state of decreased reserve. Because frailty is a state of multisystem dysregulation, multimodal interventions may be necessary to mitigate and prevent progression rather than interventions targeting a single system. Movement-based mind-body therapies, such as tai chi and yoga, are promising multimodal strategies for frailty prevention and treatment given their inherent multicomponent nature. In this review, we summarize the links between hallmarks of aging and frailty and how tai chi and yoga may impact these hallmarks. We review trial evidence for the impact of tai chi and yoga on frailty in older populations and discuss opportunities for future research.

Application of mobility training methods in sporting populations: A systematic review of performance adaptations

This systematic review investigates influences of mobility training in sporting populations on performance outcomes. The search strategy involved Embase, MEDLINE Complete, Sports Discus and manual search from inception to March 2022. Mobility training studies with a minimum three-week, or 10-session duration in healthy sporting populations of any age were included. Twenty-two studies comprising predominantly young adult or junior athletes were analysed from 319 retrieved articles. Performance outcomes were strength, speed, change of direction, jumping, balance, and sport-specific skills. Fifteen studies randomized participants with only four indicating systematic allocation concealment and blinding of outcomes assessors in only one study. In 20 of 22 studies mobility training was of some benefit or helped to maintain sports performance to a larger degree than control conditions. Control conditions, which were generally no activity conditions, were primarily non-significant. The majority of evidence suggests that a range of mobility training methods may improve key sports performance variables or are unlikely to impair performance over time. Therefore, coaches can consider the potential benefits of including comprehensive mobility programmes with minimal risk of impairing performance. Higher-quality studies in homogenous populations are necessary to confirm performance changes.

Effect of tele-yoga on aerobic capacity, respiratory muscle strength, and cognitive performance in patients with obstructive sleep apnea syndrome

BACKGROUND

Obstructive sleep apnea syndrome (OSAS) causes a decrease in aerobic capacity, respiratory muscle strength, and cognitive function, negatively affecting health-related quality of life.

OBJECTIVES

This study aimed to compare aerobic capacity, respiratory muscle strength, cognitive performance, functional capacity, sleep quality and daytime sleepiness in OSAS patients practicing and not practicing tele-yoga (TY).

METHODS

44 OSAS patients (40 M, 4F) were randomized into TY and control groups. TY group underwent live synchronous group-based TY sessions, 60 min/day, three days/week, for 12 weeks. Control group performed unsupervised thoracic expansion exercises at home 4 times daily for 12 weeks. The following were evaluated at baseline and at the end of the 6th and 12th weeks: inspiratory and expiratory respiratory muscle strength (MIP, MEP), cardiopulmonary exercise test, Corsi Block Tapping Test (CBTT) and Stroop TBAG test, six-minute walk test (6MWT), Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS).

RESULTS

TY significantly improved MIP, and exercise test parameters (VE, HRmax,%HR, heart rate recovery in the first minute and RQmax), CBTT (forward) and Stroop TBAG test scores (parts of 3,4,5) compared to the controls (p<0.05). There were no significant changes 6MWT in the TY group compared to the control group (p > 0.05). Sleep duration (min), sleep efficiency, sleep quality of PSQI and ESS score improved significantly in the TY group compared to the control group (p < 0.05).

CONCLUSION

We suggest including TY intervention as a method of exercise in addition to CPAP treatments since it improves the health-related parameters of OSAS patients.

The Relationship Between Yoga Practice Dosage and Perceived Stress, Anxiety, and Self-reported Health Among Breast Cancer Survivors Who Practice Yoga

The aim of this anonymous online study was to explore the yoga practice of breast cancer survivors to determine if yoga dosage (frequency and duration of practice) was related to stress, anxiety, and self-reported health in female survivors. Participants were recruited from online breast cancer support groups during a 3-month period (June-September 2019). Demographic information, stage and treatment of breast cancer, and frequency of yoga participation, including a home yoga practice were reported. Measures include the Perceived Stress Scale, State-Trait Anxiety Inventory, and self-reported health. Cumulative yoga dosage was calculated. Thirty-five women participated (mean age = 55 years) and were divided into low and high yoga dosage groups based on the sample distribution. Low dosage of yoga was operationally defined as a cumulative dosage that fell within the lowest quartile (≤25%). Findings indicated no difference between the low-dosage group compared with the high-dosage group for perceived stress and self-reported health; but the high dosage yoga group had lower state anxiety scores (P < .05). All participants reported good self-reported health. These findings contribute to our knowledge of the psychosocial aspects of breast cancer survivorship and raise questions for further research quantifying the therapeutic dosing of yoga practice.

The influence of hatha yoga on stress, anxiety, and suppression: A randomized controlled trial

Engaging in yoga may mitigate stress and anxiety in individuals while potentially enhancing one's capacity to manage distractions. Our research aimed to explore the relation between these two outcomes: Can an eight-week yoga program foster distraction suppression, thereby reducing stress and discomfort? To answer this question, we used Hatha Yoga, the most commonly practiced form of yoga. We tested if the intervention improved participants' ability to suppress distractions and selectively decrease self-reported stress and stress reactivity. In Addition, we investigated whether such an intervention would increase participants' mindfulness. Our study included 98 healthy yoga novices between 18 and 40 years who were randomly assigned to either an experimental or a waitlist condition, with each participant completing pre- and post-intervention assessments, including questionnaires, as well as electrophysiological and behavioral measures. After eight weeks of yoga practice, significant reductions in self-reported stress and stress reactivity levels, as well as increased mindfulness, were observed among those participating in the intervention relative to those in the waitlist control group. There were, however, no significant changes in state or trait anxiety due to the intervention. Changes in stress measures could not be explained by changes in participants' ability to suppress distractors, which was not affected by the intervention. Overall, our findings suggest that regular participation in Hatha Yoga can improve mental health outcomes without impacting cognitive functioning directly related to distractor suppression. CLINICAL TRIAL REGISTRATION NUMBER: NCT05232422.

Health status of aged women with or without the experience of practicing yoga

BACKGROUND

Yoga is a popular training practice that enhances women's physical activity level and modifies the major risk factors contributing to noncommunicable diseases. This study aimed to compare general health and cardiovascular health, musculoskeletal health, psychological health, and health-related quality of life between aged women with and without long-term yoga practice.

METHODS

Thirty-two female yoga practitioners (mean age 56 years) with ≥ 2 years experience in regular yoga practice and 32 age-matched women without yoga experience participated in the study. Between-group comparisons was performed to explore the differences in various health outcomes, including body build indices, exercise endurance, blood pressure, and heart rate variability; hamstring flexibility, upper-limb muscle strength, shoulder range of motion, and upper-limb function; and the symptoms of anxiety and depression, sleep quality, and fatigue.

RESULTS

Our findings revealed that yoga practitioners demonstrated greater hamstring flexibility, shoulder ROM on the non-dominant side, and hand-grip strength; a higher heart rate variability parameter value (RMSSD); and shorter sleep latency than those who did not practice yoga.

CONCLUSIONS

In view of the encouraging results of the long-term benefits of yoga practice, it warrants being promoted among aged women to enhance their physical and mental well-being.

A randomized trial examining the effect of yoga on dietary lapses and lapse triggers following behavioral weight loss treatment

Background

Dietary lapses can hinder weight loss and yoga can improve self-regulation, which may protect against lapses. This study examined the effect of yoga on dietary lapses, potential lapse triggers (e.g., affective states, cravings, dietary temptations), and reasons for initiating eating following weight loss treatment.

Methods

Sixty women with overweight/obesity (34.3 ± 3.9 kg/m2) were randomized to a 12 week yoga intervention (2x/week; YOGA) or contact-matched control (cooking/nutrition classes; CON) following a 12-week behavioral weight loss program. Participants responded to smartphone surveys (5x/day) over a 10-day period at baseline, 12, and 24 weeks to assess lapses and triggers.

Results

At 24 weeks, YOGA and CON differed on several types of lapses (i.e., less eating past full, eating more than usual, loss of control when eating, self-identified overeating, difficulty stopping eating in YOGA), and YOGA was less likely to eat to feel better or in response to stress (ps < 0.05). YOGA also reported less stress and anxiety and more positive affect (ps < 0.01); dietary temptations and cravings did not differ from CON.

Conclusion

Yoga resulted in fewer dietary lapses and improved affect among women with overweight/obesity following weight loss. While preliminary, findings suggest that yoga should be considered as a potential component of weight loss treatment to target dietary lapses.

From Inner Balance to Visual Health: Unraveling the Therapeutic Role of Yoga in Optic Neuropathy and Ocular Manifestations - Narrative Review

The optic nerve comprises approximately 1.2 million axons of retinal ganglion cells and is vulnerable to degeneration due to a myriad of causes. While traditional treatments have been the cornerstone of ocular care, emerging evidence highlights the benefits of integrative approaches, which can be used as an adjunct in the management of optic neuropathy. Yoga is a mind-body energy medicine encompasses physical postures, breath control, and meditation. Currently, it has gained attention for its holistic effects on well-being, by promoting health, preventing onset of diseases, adjunct in disease management, and for its rehabilitative potential. In addition, the underlying mechanisms through which yoga exerts its therapeutic influence, evaluates clinical outcomes, and explores potential synergistic effects with conventional treatments remain largely unexplored. Neuroprotective mechanisms of yoga, such as enhancing retinal ganglion cell function, reducing oxidative stress, coupled with its ability to modulate inflammatory processes and improve circulation, contribute to its potential benefits in visual health. Analysis of clinical studies reveals promising outcomes, including improvements in visual acuity, visual fields, quality of life, and functional outcomes in individuals with optic neuropathy and ocular manifestations who undergo yoga intervention (especially dhyaan) with awareness of breath. Furthermore, the integration of yoga with conventional treatments and complementary modalities unveils the possibilities of multidisciplinary approaches in ocular care that need evaluation. By unraveling the role of yoga intervention in ocular health, this review provides valuable insights for clinicians and researchers, fostering a deeper understanding of the mind-body connection and paving the way for enhanced visual health outcomes. Embracing yoga as an adjunctive therapy may has the potential to revolutionize the management of optic neuropathy and ocular manifestations, offering individuals a holistic approach to optimize visual well-being, reduce comorbid depression and caregiver burden, and improve overall quality of life.

Review of self-efficacy assessment scales for geriatric patients with urinary incontinence

Urinary incontinence is a common condition in the elderly, which can be improved with rehabilitation. However, compliance with the rehabilitation regimen is influenced by the level of self-efficacy. Self-efficacy of elderly patients in dealing with urinary incontinence can be clinically assessed and understood by using a suitable scale, to implement specific improvement measures. At present, the tools used for assessing the self-efficacy of elderly patients with urinary incontinence include the General Self-Efficacy Scale (GSES), the Pelvic Floor Muscle Self-efficacy Scale, the Geriatric Self-efficacy Index for Urinary Incontinence, and the Yoga Self-Efficacy Scale. Most of these tools are suitable for female patients with urinary incontinence, but lack relevance to the disease characteristics of geriatric patients. In this study, we reviewed the self-efficacy assessment tools for geriatric patients with urinary incontinence, to provide a reference for related research. It is important to accurately assess the self-efficacy of patients with geriatric UI to effectively enhance their level of self-efficacy, so that patients with geriatric UI can avail early help and quickly reintegrate with family and society.

Lessons From India: A Narrative Review of Integrating Yoga Within the US Healthcare System

The ancient practice of yoga has gained worldwide popularity as a way for people to improve their overall health and well-being. This manuscript reviews and examines the history of yoga, its physical and mental health benefits, its incorporation into the Indian healthcare system, and the public perception of yoga in India. Many initiatives for yoga exist, including promoting research on yoga, providing education and information on its benefits, and developing evidence-based standardized yoga therapy guidelines. With this in mind, this narrative review article explores the potential benefits of incorporating yoga into the United States (US) healthcare system and the possible challenges of doing so. It also provides valuable insights for policymakers and healthcare professionals.

Role of Meditation in Ameliorating Examination Stress Induced Changes in Cardiovascular and Autonomic Functions

Background

Examination stress is a very well-known model of psychological stress in students. It induces changes in systolic (SBP) and diastolic blood pressure (DBP), along with changes in heart rate variability (HRV) and baroreflex sensitivity (BRS), due to autonomic perturbations.

Purpose

To find out if Raj Yoga meditation (RYM) practice affects autonomic and cardiovascular function in healthy young subjects during periods of examination stress. Our primary objective was to evaluate the effect of one month of supervised RYM practice on ameliorating examination-induced changes in cardiovascular and autonomic function. The secondary objective was to measure the stress levels of medical students before and after RYM.

Methods

Pre-training measurements of SBP, DBP, HRV, and BRS were done, and the Medical Student Stressor Questionnaire (MSSQ) was administered to 80 participants one month before examinations. They were then trained in RYM. Post-training assessment of the same parameters was done after examinations and also after two months.

Results

In our study, RYM training decreased DBP (p = 0.01) but not SBP. BRS showed a trend towards an increase after RYM practice, but it was not statistically significant (p = 0.44). The standard deviation of the NN interval (SDNN) (p = 0.03), low-frequency (LF) nu (0.003), and high-frequency (HF) nu (0.04) showed a statistically significant change. Average RR, median RR, average rate, square root of the mean squared differences of successive NN intervals (RMSSD), pRR, total power, LF (µs2), and LF/HF ratio were not statistically significantly different between the three groups. There was a statistically significant decline in MSSQ scores for MSSQ I (p = 0.04), MSSQ II (p = 0.04), and MSSQ IV (p = 0.03).

Conclusion

Short-term practice of supervised RYM during stressful periods is protective for the cardiovascular and autonomic systems and decreases stress in medical students.

Effects of yoga on depressive symptoms, anxiety, sleep quality, and mood in patients with rheumatic diseases: Systematic review and meta-analysis

OBJECTIVE

To investigate the effects of yoga on depressive symptoms, anxiety, sleep quality, and mood of patients with rheumatic diseases through a systematic literature review with meta-analysis.

LITERATURE SURVEY

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement and the Cochrane recommendations and risk of bias tool. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO). Studies were selected using the PICOS (participants, intervention, comparison, outcome, and study) strategy. Searches were carried out until March 2022 and performed in Web of Science, PubMed, SportDiscus, Scopus, Cochrane, and EBSCO databases.

METHODOLOGY

Data were extracted to identify the differences between yoga and control and exercise groups and effect sizes.

SYNTHESIS

In total, 27 studies were included for qualitative analysis and 18 for meta-analysis. The studies found investigated yoga in patients with osteoarthritis, fibromyalgia, rheumatoid arthritis, and chronic fatigue syndrome. Regarding the risk of bias, the majority of studies showed a high risk or uncertain risk of bias in several criteria. Regarding the meta-analysis, yoga was favored to decrease depressive symptoms (standard mean difference [SMD]:-0.88; 95% confidence interval [CI]:-1.42; -0.34), anxiety (SMD: -0.51; 95% CI = -0.81 to -0.20), and improve sleep quality SMD = -0.96; 95% CI = -1.36 to -0.56). No differences were found between yoga and other exercise modalities in depression (p < .01).

CONCLUSIONS

Yoga is effective in improving depression, anxiety, and sleep quality of patients with rheumatic diseases. However, research in this field still needs further studies, because of methodological issues in the studies and a reduced number of studies conducted on each rheumatic disease and on the effects of yoga on each variable.

Impact of Yoga Intervention in Lower Limb Amputees following Trauma in Relation to Behavior and Quality of Life: A Randomized Controlled Trial

Background

Yoga is an emerging intervention causing improvement in physical, mental, and spiritual well-being. Its role in improving outcomes in patients with amputation was investigated.

Methodology

Patients with traumatic lower limb amputation (n = 50) were enrolled and randomized to the Yoga group (n = 26) against control (n = 24). Sociodemographic details, quality of life (QOL) (World Health Organization QOL-BREF), Depression anxiety stress scale (DASS), Rosenberg self-esteem scale, and amputee body image score were applied at baseline, 6,-18 weeks of amputation.

Results

Sociodemographic and clinical variables were comparable between groups. At 18 weeks, the Yoga group had better QOL (P = 0.005) than the control group. Symptoms of depression (0.02) and anxiety (<0.001) reduced, and self-image (P = 0.015) improved significantly at 6 weeks, while stress (P = 0.003) reduced at 18 weeks in the yoga group. Despite comparable body image scores, the prosthesis usage (hours/day) was more (P = 0.005) in the Yoga (6.9 ± 3.2) group against the control (12 ± 2.7).

Conclusion

Yoga improves QOL and self-esteem and reduces depression, anxiety, and stress symptoms in patients with traumatic amputation.

Beyond the Mat: Exploring the Potential Clinical Benefits of Yoga on Epigenetics and Gene Expression: A Narrative Review of the Current Scientific Evidence

Yoga, an ancient practice rooted in Indian philosophy, has gained widespread popularity for its numerous physical and mental health benefits. In the recent years, there has been growing interest in understanding how yoga influences gene expression and epigenetic modifications. This narrative review investigates the molecular mechanisms, by which yoga influences gene expression, focusing on deoxyribonucleic acid (DNA) methylation, and histone modifications. Research literature was sourced from various databases to select randomized clinical trials and comparative cohort studies examining yoga's impact on gene expression and epigenetic changes. Our findings suggest that yoga could exert anti-inflammatory effects, as it downregulates pro-inflammatory cytokines, soluble interleukin IL-2 receptor gene expression, and transcription factors. Yoga also boosts the innate antiviral response and brain health by enhancing natural defense genes and microRNA-29c expression. Notably, it activates telomerase, linked with cellular longevity, and promotes nitric oxide synthetase and neuroprotective gene expression, implying benefits for ocular health. In addition, yoga fosters DNA repair and cellular integrity maintenance by increasing oxoguanine glycosylase one protein and p53 gene expression. However, the diversity of yoga interventions in these studies complicates direct comparisons and broader application. The current research primarily focuses on short-term outcomes, offering a limited understanding of yoga's long-term epigenetic impacts. Future research should address these gaps by studying the enduring effects of Yoga, personalizing interventions, and contrasting techniques.

Prefrontal oxygenation and working memory in patients with type 2 diabetes mellitus following integrated yoga: a randomized controlled trial

AIMS

Type 2 diabetes mellitus (T2DM) alters brain functional and structural connectivity leading to cognitive dysfunction. This study examined the effect of a 12-week yoga intervention on prefrontal cortex (PFC) oxygenation and working memory in patients with T2DM.

METHODS

Fifty participants were randomized into yoga and waitlist control groups. The yoga protocol specific to T2DM was followed. The pre- (day 1), mid- (6 weeks) and post-intervention (12 weeks) assessments included measurement of PFC oxygenation while performing working memory tasks (n-back) using functional near-infrared spectroscopy.

RESULTS

Following a 12-week intervention, the yoga group showed improved performance in working memory [accuracy (geometric mean difference of 3.15%, 95% CI [2.33,3.96], p = 0.001) and reaction time (mean difference of 100.8 milliseconds,95% CI [- 166.6, - 35.1], p = 0.002] in the high task load (2-back) associated with higher oxygenation in dorsolateral PFC (β coefficient mean difference of 95.6, 95% CI [0.23,191], p = 0.049) and ventrolateral PFC (β coefficient mean difference of 53.4, 95% CI [7.8,98.9], p = 0.018) regions. Higher oxygenation in dorsolateral PFC during 2-back task was positively correlated with accuracy (r(23) = 0.65, p < 0.001) and negatively correlated with reaction time (r(23) =  - 0.47,p = 0.017).

CONCLUSION

Integrated yoga practice may improve working memory performance associated with higher PFC oxygenation in patients with T2DM. As 12 weeks of yoga intervention improved working memory performance, the regular practice of yoga may have the potential to prevent decline of cognitive functions in clinical conditions.

Exploring the Effect of Yoga on Exercise Endurance As Assessed by Cardiorespiratory Efficiency Tests in Exercise Physiology Laboratory: A Pilot Study

Background Today's world of cut-throat competition is boggling with stress as the most common problem among the modern generation, and reduction in stress demands a radical solution. Yoga comes as a rescuer that focuses on improving one's physical and spiritual well-being. It can increase one's strength and flexibility. Yoga practitioners have asserted the effect of physical exercise involved in it on balancing physical and spiritual health for decades, but only recently has there been a move to substantiate these claims through research. This study aimed at assessing the effect of yogic practice on exercise endurance and physical fitness as assessed by important physical fitness parameters through cardiorespiratory efficiency tests in an Exercise Physiology Laboratory. Methodology A total of 60 Bachelor of Medicine, Bachelor of Surgery (MBBS) students from a rural medical college in central India were recruited for the study. Thirty MBBS students who had undergone yogic training for six months comprised the trained or the case group, and another group of 30 students comprising the untrained group were recruited for the study from different levels of the course within the age group of 17-25 years. Body mass index (BMI) and body surface area (BSA) were calculated. Resting pulse rate and blood pressure, resting respiratory rate, maximal oxygen consumption (VO₂ max), physical fitness index (PFI), breath holding time (BHT), and 40 mm Hg endurance test time was measured.  Results The mean PFI (%) in males was 88.82±5.56 and 96.05±7.44, and that in females was 82.06±8.95 and 96.55±6.47 in the control and case groups, respectively. The mean 40 mm Hg endurance test (in seconds) in males was 36.47±8.45 and 48.88±8.64 and in females was 29.79±10.30 and 38.4±10.69 in the control and test groups, respectively. The mean BHT (in seconds) in males was 44.80±14.18 and 58.91±12.35, and that in females was 42.29±15.37 and 54.60±13.36 as in control and case groups, respectively. The VO₂ max evaluated by the modified Harvard step test was 2.41±0.58 L/min in control males and 3.6±0.90 L/min in the case group of males, and it was 2.14±0.49 L/min in the control group of females, and 3.76±0.69 L/min in case group of females. Conclusion By studying the dynamics of the various cardiorespiratory responses, we have determined the values of fitness parameters in the case group. It was found that the yoga group had statistically significantly higher VO₂ max per minute and better PFI, BHT, and 40 mm Hg endurance values (p<0.05).

The effects of a complex yoga-based intervention on healthy psychological functioning

Background

Yoga based interventions were found to have a positive impact on various indicators of psychological functioning, such as perceived stress, satisfaction with life, positive and negative affectivity. Additionally, such interventions improved bodily or interoceptive awareness and spirituality.

Methods

The present study assessed the effects of a 3-month long complex yoga-based intervention compared to a passive control group in a Hungarian community sample. The final sample consisted of 44 intervention (Mage = 47.5, SD = = 8.76) and 29 control participants (Mage = 47.4, SD = 9.47). The aforementioned constructs were measured 1 week before and after the intervention.

Results

The intervention reduced participants’ perceived stress (p = &lt;0.001, ηp2 = 0.153) and negative affectivity (p = 0.019, ηp2 = 0.113), improved spirituality (p = 0.048, ηp2 = 0.054) and various aspects of interoceptive awareness such as noticing (p = &lt;0.001, ηp2 = 0.169) attention regulation (p = &lt;0.001, ηp2 = 0.211), self-regulation (p = 0.002, ηp2 = 0.190) body listening (p = 0.010, ηp2 = 0.097), trusting (p = 0.026, ηp2 = 0.070), but did not impact positive affectivity and satisfaction with life.

Conclusion

A 3-months long complex yoga-based intervention has a positive impact on many aspects of healthy psychological functioning.

Effect of Yoga on Frailty in Older Adults : A Systematic Review

BACKGROUND

Yoga, a multicomponent mind-body practice, improves several domains of physical and psychological health and may affect frailty in older adults.

PURPOSE

To evaluate the available trial evidence on the effect of yoga-based interventions on frailty in older adults.

DATA SOURCES

MEDLINE, EMBASE, and Cochrane Central from their inception to 12 December 2022.

STUDY SELECTION

Randomized controlled trials evaluating the effect of yoga-based interventions, including at least 1 session of physical postures, on a validated frailty scale or single-item markers of frailty in adults aged 65 years or older.

DATA EXTRACTION

Two authors independently screened articles and extracted data; 1 author assessed risk of bias with review from a second author. Disagreements were resolved through consensus and as-needed input from a third author.

DATA SYNTHESIS

Thirty-three studies (n = 2384 participants) were identified in varied populations, including community dwellers, nursing home residents, and those with chronic disease. Yoga styles were primarily based on Hatha yoga and most often included Iyengar or chair-based methods. Single-item frailty markers included measures of gait speed, handgrip strength, balance, lower-extremity strength and endurance, and multicomponent physical performance measures; no studies included a validated definition of frailty. When compared with education or inactive control, there was moderate-certainty evidence that yoga improved gait speed and lower-extremity strength and endurance, low-certainty evidence for balance and multicomponent physical function measures, and very low-certainty evidence for handgrip strength.

LIMITATION

Heterogeneity in study design and yoga style, small sample sizes, and reporting deficiencies leading to concerns for selection bias.

CONCLUSION

Yoga may affect frailty markers that are associated with clinically meaningful outcomes in older adult populations but may not offer benefit over active interventions (for example, exercise).

PRIMARY FUNDING SOURCE

None. (PROSPERO: CRD42020130303).

Effects of Yoga and Aerobic Exercise on Verbal Fluency in Physically Inactive Older Adults: Randomized Controlled Trial (FitForAge)

Purpose

To compare the effects on verbal fluency of a supported yoga-based exercise intervention to an aerobic exercise intervention and a wait-list control group.

Participants and Methods

Eighty-two physically-inactive but otherwise healthy adults (mean age 72.5 years, range 65-85, 77% female) were recruited into a 12-week, three-group, parallel randomized controlled trial. Participants were supported to complete ≥3 Hatha yoga classes per/week or ≥3 structured aerobic exercise sessions/week. A wait-list control group continued usual daily activities only. Verbal fluency, including total-FAS, animals, and verbs, was assessed before and after interventions. Group effects were assessed using analysis of covariance (ANCOVA).

Results

Twenty-seven participants were randomized to yoga, 29 to aerobic exercise and 26 to a waitlist. At 12-week follow-up, compared to baseline, there were increases in mean total-FAS in the yoga (+5.0 words, p=0.002) and aerobic exercise groups (+6.6 words, p=0.004). Mean total-FAS in the wait-list control group remained stable (-0.5 words, p=0.838). There were medium-magnitude estimated treatment effects on total-FAS for yoga versus wait-list control and aerobic exercise versus wait-list control: Hedges' g=0.51 (p=0.213) and 0.57 (p=0.098) respectively. In addition, small-to-medium magnitude estimated treatment effects were seen on animals and verbs for yoga versus wait-list control and aerobic exercise versus wait-list control: g=0.28 (p=0.155), 0.19 (p=0.766) and 0.50 (p=0.085), 0.59 (p=0.233) respectively.

Conclusion

Participation in yoga or aerobic exercise was associated with estimated improvements in verbal fluency compared to a non-active control group. Yoga and aerobic exercise may be promising approaches by which to promote cognitive function among older adults.

Trial Registration

DRKS00015093, U1111-1217-4248.

A cross-sectional analysis of yoga experience on variables associated with psychological well-being

Introduction

Previous research has identified numerous physical, psychological, and spiritual benefits associated with the practice of yoga. Indeed, yoga has been linked with improved quality of life, reduced stress, and numerous markers of psychological well-being. In the current research, a cross-sectional design was used to examine whether the psychological benefits associated with yoga only apply to long-term practitioners or whether more "casual," intermittent yoga experience could produce positive outcomes.

Methods

An American population of long-term practitioners (n = 129), intermittent practitioners (n = 161), and non-practitioners (n = 164) completed online self-report measures of emotional regulation, trait mindfulness, self-compassion, interoceptive awareness, and spiritual intelligence variables.

Results

The results indicated that long-term (LT) practitioners scored higher than intermittent experience (IE) practitioners on measures of mindfulness (M_LT  = 137.3; M_IE  = 127.6), interoceptive awareness (M_LT  = 3.4; M_IE  = 3.1), self-compassion (M_LT  = 3.4; M_IE  = 3.1), and spiritual intelligence (M_LT  = 63.5; M_IE  = 55.5; all p-value < 0.05). Intermittent practitioners scored higher than no-experience (NE) group on interoceptive awareness (M_IE  = 3.1; M_NE  = 2.7) and spiritual intelligence (M_IE  = 55.5; M_NE  = 46.6; both p-value < 0.05). Contrary to our hypotheses, yoga experience had no effect on depression, anxiety, or stress levels. Separate mediation analyses demonstrated that interoceptive awareness, spiritual intelligence, mindfulness, and self-compassion each mediated the relationship between yoga experience and emotion dysregulation. Furthermore, emotion dysregulation mediated the relationship between yoga experience and depression, anxiety, and stress.

Discussion

Taken together, the results of this study suggest that long-term practitioners experience more benefits compared to intermittent and non-practitioners, and that the mechanisms underlying these benefits are multi-faceted.

Interest in and Barriers to Practicing Yoga among Family Caregivers of People with Cancer

Background

Family caregivers of people with cancer report high levels of psychological distress. Yoga, with well-documented mental health benefits, could be a useful intervention to address distress in this population. However, little is known about yoga practices among cancer caregivers. The present study evaluates their interest in and barriers to yoga practice.

Methods

We conducted a cross-sectional survey study of family caregivers of cancer patients at five suburban satellite locations of an academic cancer center. Survey items and statistical analyses focused on yoga usage as well as interest in and barriers to yoga practice.

Results

Among 539 participants, most were females (64.8%), white (84.2%), and caring for a spouse or partner (54.7%). Interest in practicing yoga among study participants was 42.3%. Increased interest was independently associated with being females (odds ratio [OR] = 3.30, 95% confidence interval [CI] = 1.98-5.51, P < 0.001) and employed (part-time: OR = 2.58, 95% CI = 1.1-6.18, P = 0.03; full-time: OR = 1.77, 95% CI = 1.1-2.01, P = 0.02). Few participants (6.3%) were currently practicing yoga, although 31% had done so in the past. Sixty-one percent of those who had practiced before their loved one's diagnosis stopped practicing yoga afterward. Commonly cited barriers to yoga practice included time constraints (37.3%) and psychological obstacles (33.6%). About a quarter of those who had never practiced yoga lacked awareness of yoga's benefits (26.6%).

Conclusion

Despite the low use of yoga, interest in practicing was moderately high, especially among women and employed caregivers. As caregivers face numerous barriers to yoga practice, strategies are needed to overcome these barriers and help them access yoga's health benefits.

Effect of Yoga involvement on mental health in times of crisis: A cross-sectional study

Background

Yoga involvement can be understood as a degree of immersion in the philosophical/spiritual teachings of Yoga. Previous research has shown a positive association between Yoga involvement and mental health. This study further investigates the effect of Yoga involvement on several parameters of psychological well-being and distress amidst a global crisis precipitated by the COVID-19 pandemic.

Methods

A total sample of 246 participants (216 females; 118 Yoga versus 128 age-matched Pilates practitioners) were included in the study. Via an online-survey the following questionnaires were completed: the WHO-Five Well-Being Index, the Multidimensional Inventory for Religious/Spiritual Well-Being short version, the Leipzig Short Scale of Sense of Coherence, the Brief Symptom Inventory and the Yoga Immersion Scale which was adapted for the control group to Pilates Immersion Scale.

Results

When controlling for occupation and psychiatric disorder, involvement in general was higher for Yoga practitioners than for Pilates controls. Furthermore, Yoga practice was associated with increased religious/spiritual well-being and decreased sense of coherence, but neither with psychological well-being nor with psychological distress. Involvement, in general, positively predicted psychological well-being, religious/spiritual well-being and sense of coherence, but there was no connection with psychological distress. Lastly, involvement mediated the positive relationship between Yoga practice and religious/spiritual well-being and suppressed the negative effect of Yoga practice on sense of coherence.

Conclusion

Our findings suggest that involvement in a certain relaxation practice has a positive impact and might be a key component in understanding Yoga's influence on mental health. Further randomized controlled research, including clinical groups, is necessary to explain how involvement changes and how it effects well-being more specifically.

Weight-related Self-monitoring App Use Among Emerging Adults is Cross-sectionally Associated With Amount and Type of Physical Activity and Screen Time

Weight-related self-monitoring (WRSM) apps are often used by emerging adults to assist in behavior change. However, little is known about the relationship between WRSM among the general population of emerging adults and various physical activity and screen time behaviors. This paper examines associations between WRSM app use and various forms of physical activity and screen time among a population-based sample of emerging adults. Data come from EAT 2018 (N = 1,568, mean age = 22.0 ± 2.0 years), a population-based sample of emerging adults from Minneapolis/St. Paul, Minnesota. Participants reported on the types of WRSM apps used (physical activity and/or dietary focused), in addition to how much time they spent doing physical activity, whether they practiced yoga, compulsive exercise, recreational screen time, social media use, and whether they viewed dieting/weight loss materials. Linear and logistic regressions were used to assess adjusted means and prevalences of outcomes. We found that physical activity-focused WRSM app users engaged in more hours of total (8.7 vs 7.2, P < .001), and moderate-to-vigorous (5.1 vs 4.3, P = .002) physical activity compared to non-users. Similar results were found for dietary WRSM app users compared to non-users. However, WRSM app users had higher levels of compulsive exercise and were more likely to view dieting/weight loss materials (Ps < .001). Findings suggest that although physical activity is higher among WRSM users, the types of physical activity and screen time behaviors WRSM users are engaging in may be harmful.

Effect of yoga on cardiovascular functions and psychological aspects of people on public service-related work: an exploratory study

OBJECTIVES

Yoga is increasingly being introduced in workplace settings to improve health and well-being. However, there is a lack of studies reporting the effect of yoga in people on public service-related work, who are at high risk for various health-related problems. Thus, the objective of this study was to find the effect of yoga on cardiovascular functions and psychological (stress, anxiety, and depression) aspects of people on public service-related work.

METHODS

A single-group pre-test and post-test experimental study design was adopted. Eighty-two participants aged 41.52 ± 7.44 years who are working in the Tamil Nadu Public Service Commission were undergone 1-h of yoga (under the supervision of a yoga & naturopathy doctor) a day, 5-days a week for a period of 1-month at their office. Cardiovascular functions such as systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate (PR) were measured using an automatic BP monitor. Psychological variables such as stress, anxiety, and depression were measured using Depression Anxiety and Stress Scales (DASS) before and after the intervention.

RESULTS

Results of this study showed a significant reduction in body mass index, SBP, DBP, PR, mean arterial pressure, rate pressure product, and double product. Though results showed insignificant (just missed the statistical significance [p=0.056]) reduction in anxiety, it showed clinical improvement (i.e. the mean anxiety score has reduced from moderate category to mild category). However, there is neither statistically significant nor clinical difference in stress and depression. None of the participants reported any untoward events during the study period.

CONCLUSIONS

Results suggest that yoga might improve the cardiovascular functions and anxiety of people in public service-related work. However, no such significant improvement was noted in their stress and depression levels. However, a randomized controlled trial is required to warrant the results of this study.

The Impact of a Yoga-Based Mindfulness Intervention versus Psycho-Educational Session for Older Adults with Mild Cognitive Impairment: The Protocol of a Randomized Controlled Trial

BACKGROUND

There is a global agreement in the medical community that a significant proportion of dementia cases could be prevented or postponed. One of the factors behind this agreement comes from scientific evidence showing that mind-body interventions such as mindfulness and yoga for the elderly have been related to a range of positive outcomes, including improved cognition performance in seniors with mild cognitive impairment (MCI).

OBJECTIVE

This study aims to evaluate the effectiveness of a yoga-based mindfulness intervention (YBM) versus psychoeducational sessions for older adults with MCI attending Hospital Clinic Universidad de Chile in Santiago.

METHOD

Two-arm, individually randomized controlled trial (RCT) will be carried out at Clinical Hospital Universidad de Chile in Santiago. Older people over 60 years with any type of MCI using a score < 21 in the Montreal Cognitive Assessment (MoCA) test and a score of 0.05 in the Clinical Dementia Rating (CDR) Scale; and with preserved activities of daily living will be randomly assigned with an allocation ratio of 1:1 in either the yoga-based mindfulness intervention or the active control group based on the psycho-educational program. People who have performed yoga and/or mindfulness in the last 6 months or/and people with a psychiatric clinical diagnosis will be excluded from the study. Montreal Cognitive Assessment, the Lawton Instrumental Activities of Daily Living Scale (IADL), the Barthel Index (BI), the Pemberton happiness index, the Geriatric Anxiety Inventory (GAI) as well as the Geriatric Depression Scale (GDS-5) will be administered by blinded outcomes assessors before random assignment (Pre-test), the week following the last session of the intervention (post-test), and then after 3- and 6-months follow-up.

RESULTS

The YBM intervention protocol based on a video recording has been adapted and designed. This is the first RCT to examine the effects of a yoga-based mindfulness intervention in improving cognitive and physical functions and mental health outcomes for Chilean elderly diagnosed with MCI. It is expected to be implemented as an acceptable and effective non-pharmacological option for older people with MCI.

CONCLUSION

Providing evidence-based programs such as preventive therapy for Alzheimer's disease has relevant implications for public mental health services in Chile.

Psychophysiological Adaptations to Yoga Practice in Overweight and Obese Individuals: A Topical Review

Physical activity has been documented as a foundational approach for weight management and obesity, improving several cardiometabolic and mental health indices. However, it is not clear whether yoga practice can induce beneficial improvements in anthropometric and body composition parameters, performance, metabolic health, and well-being among overweight/obese people. The aim of this topical review was to catalog training studies examining the psychophysiological responses to yoga interventions in order to detect which outcomes have been investigated, the research methods applied, and the conclusions. The inclusion/exclusion criteria were met by 22 published articles involving 1178 (56% female) overweight/obese participants. This brief review on yoga-induced adaptations demonstrates that this widely used meditative movement activity can meaningfully improve the vast majority of the selected markers. These beneficial alterations are focused mostly on various anthropometric and body composition variables, cardiovascular disease risk factors, physical fitness parameters, quality of life, and stress in previously inactive overweight/obese individuals. Instead, yoga-based physical exercise interventions investigating anxiety, depression, mood state, exercise enjoyment, affect valence, and adherence were limited. Further research should focus on the yoga intervention configuration and potential mechanisms behind favorable changes in various psychophysiological indices through large-scale, rigorously designed randomized controlled trials implementing long-term interventions in overweight/obese individuals.

Effects of vibrotactile feedback on yoga practice

Participating in physical exercise using remote platforms is challenging for people with vision impairment due to their lack of vision. Thus, there is a need to provide nonvisual feedback to this population to improve the performance and safety of remote exercise. In this study, the effects of different nonvisual types of feedback (verbal, vibrotactile, and combined verbal and vibrotactile) for movement correction were tested with 22 participants with normal vision to investigate the feasibility of the feedback system and pilot tested with four participants with impaired vision. The study with normal-vision participants found that nonvisual feedback successfully corrected an additional 11.2% of movements compared to the no-feedback condition. Vibrotactile feedback was the most time-efficient among other types of feedback in correcting poses. Participants with normal vision rated multimodal feedback as the most strongly preferred modality. In a pilot test, participants with impaired vision also showed a similar trend. Overall, the study found providing vibrotactile (or multimodal) feedback during physical exercise to be an effective way of improving exercise performance. Implications for future training platform development with vibrotactile or multimodal feedback for people with impaired vision are discussed.

Quality of Life and Stress Management in Healthcare Professionals of a Dental Care Setting at a Teaching Hospital in Rome: Results of a Randomized Controlled Clinical Trial

In the healthcare environment, more and more people experience work-related stress. The Faculty of Medicine and Dentistry of Sapienza University of Rome, having observed the need to take care of healthcare professionals, has set itself the objective of providing useful tools such as additional and necessary personal protective equipment for healthcare professionals.

OBJECTIVE

To promote health through better management, skills, and the use of strategies and solutions to identify, decompress, and neutralize those responsible for work-related stress mechanisms in order to take care of those who care (CURARE CURANTES).

MATERIALS AND METHODS

A randomized controlled clinical trial was conducted. The participants were enrolled by three departments of the Department of Dental and Maxillofacial Sciences of Rome; in consideration of emotional involvement of health professionals who work there. A motivational program was offered.

RESULTS

There were 17 and 16 healthcare professionals in the intervention and control groups, respectively. Levels of the mental composite score (MCS) varied both in the pre-post phase of the intervention group (p = 0.002), and between the intervention group and control group in the post phase (p = 0.006). No significant differences were observed for the physical composite score (PCS). Similarly, there were no significant differences regarding the positivity scale (PS) and the two dimensions of work-related stress (job demand and decision latitude).

CONCLUSION

This study demonstrates the efficacy of yoga training practiced directly in the workplace and wearing work clothes, entering the work context, not weighing further on the healthcare workload, and being a way to carry out physical activity even in those cases in which professionals do not have the time to do it in their free time.

Manual development for a multi-modal, dyadic intervention for persistent pain: A Qualitative Study

Background

People who experience persistent pain often require help from a family member, partner, or friend. These caregivers frequently have pain but are often not included in interventions. Caregivers and care receivers who both experience pain are more likely to be socially isolated, and experience communication conflict and decreased quality of life. Interventions should target caregiving dyads to help them manage their pain together. However, there are few intervention manuals or research protocols developed to support the dyad.

Objective

The purpose of this qualitative study was to explore the needs of caregiving dyads, including input from dyads and medical and allied health experts to inform the development of an intervention manual for dyads with persistent pain.

Method

A total of 16 caregiving dyads experiencing persistent pain, one care receiver (caregiver could not participate), and 8 health experts, recruited from the community, participated in focus groups. Data were transcribed verbatim, uploaded into NVivo software, and analyzed using constant comparison qualitative methods.

Results

Findings identified the importance of a new intervention to focus on modifiable approaches to managing pain as a dyad, addressing the emotional and psychological effects of experiencing pain as a dyad, and careful consideration of logistics to implement an intervention with dyads in persistent pain.

Conclusion

These results highlight important considerations to meet the needs of caregiving dyads with pain. This study informed the development of the MY-Skills intervention, a novel program that merges self-management education with adaptive yoga to treat persistent pain in caregiving dyads.

Effect of Prenatal Yoga on Heart Rate Variability and Cardio-Respiratory Synchronization: A Prospective Cohort Study

The objective was to assess the effects of prenatal yoga on heart rate variability (HRV) and cardio-respiratory synchronization, used as proxies of autonomic nervous system activity. Sixty-nine healthy pregnant women were included; 33 in a yoga group attending at least one 90-min yoga class weekly throughout pregnancy, and 36 controls not involved in formal pregnancy exercise programs. Measurements of the time domain (SDNN, standard deviation of regular R-R intervals, and RMSSD, square root of mean squared differences of successive R-R intervals) and frequency domain (ln(LF/HF), natural logarithm of low-frequency to high-frequency power) HRV indices, as well as cardio-respiratory synchronization indexes were performed once per trimester before and after yoga or 30-min moderate-intensity walk. A statistical comparison was performed using a three-way analysis of the variance (p < 0.05 significant). Both the time domain and frequency domain HRV indices showed significant shifts towards parasympathetic dominance following yoga when compared to the controls throughout pregnancy (p = 0.002 for SDNN, p < 0.001 for RMSSD, and p = 0.006 for ln(LF/HF), respectively). There was a statistically non-significant trend towards higher synchronization between respiratory frequency and heart rate following yoga vs. controls (p = 0.057). Regular prenatal yoga was associated with enhanced parasympathetic activation persisting throughout pregnancy.

A View Independent Classification Framework for Yoga Postures

Yoga is a globally acclaimed and widely recommended practice for a healthy living. Maintaining correct posture while performing a Yogasana is of utmost importance. In this work, we employ transfer learning from human pose estimation models for extracting 136 key-points spread all over the body to train a random forest classifier which is used for estimation of the Yogasanas. The results are evaluated on an in-house collected extensive yoga video database of 51 subjects recorded from four different camera angles. We use a three step scheme for evaluating the generalizability of a Yoga classifier by testing it on (1) unseen frames, (2) unseen subjects, and (3) unseen camera angles. We argue that for most of the applications, validation accuracies on unseen subjects and unseen camera angles would be most important. We empirically analyze over three public datasets, the advantage of transfer learning and the possibilities of target leakage. We further demonstrate that the classification accuracies critically depend on the cross validation method employed and can often be misleading. To promote further research, we have made key-points dataset and code publicly available.

Effect of Practicing Meditation, Pranayama, and Yoga on the Mental Health of Female Undergraduate Medical Students: An Interventional Study

Background

Medical education is a rigorous formal education with a vast syllabus. Burnout and stresses are common among medical students and more prominent in females. Female medical students suffer from a higher level of stress than male medical students. For the improvement of physical and mental health, meditation, pranayama, and yoga are some of the ancient techniques. Meditation is a technique of focusing the mind on a target like an object, activity, or any thought. Pranayama is an ancient yogic practice focusing on the breath. Yoga is a combination of physical, mental, and spiritual dimensions that has the potential to improve mental and physical health.

Objective

This study aimed to find the effect of meditation, pranayama, and yoga on the improvement of mental health among female undergraduate medical students.

Materials and methods

This was an interventional study. A total of 105 females with a median age of 19 years (first quartile - third quartile: 18-20) first-year undergraduate medical students were recruited for this study. They were randomly allocated to control, meditation, pranayama, and yoga groups. The control group did not practice any form of meditation, pranayama, or yoga. The rest of the group practiced a designated program for their group, six days a week for 12 weeks. The anxiety, depression, anger, and sense of well-being were assessed by a validated self-administered questionnaire developed by the Defence Institute of Physiology and Allied Sciences, New Delhi before starting the study, at six weeks, and at 12 weeks after the intervention. Inter-group levels of anxiety, depression, anger, and well-being were compared by the Kruskal-Wallis test with Dunn’s posthoc test. Intra-group parameters at baseline, at six weeks, and at 12 weeks after the intervention was tested by Friedman’s test.

Result

The age (years) (p = 0.07), height (cm) (p = 0.98), and weight (kg) (p = 0.26) of participants among groups were similar. Anxiety, depression, and anger significantly decreased after six weeks in all three intervention groups. A further decrement was seen after 12 weeks of meditation, pranayama, and yoga. The maximum effect was seen in the yoga group. A sense of well-being was improved after practicing all types of interventions. However, meditation was found to increase a sense of well-being to the highest level compared to pranayama and yoga.

Conclusion

Introduction and sustainment of meditation, pranayama, and yoga programs for first-year female undergraduate medical students may help reduce anxiety, depression, and anger and promote a sense of well-being. Although a six-week program helps to improve mental health, a 12-week program helps in further improvement. A yoga program is more effective for improving the mental health of the students in comparison with pranayama and meditation.

Transcriptional modulation of inflammation, and aging in Indian obese adults following a 12-week yoga-based lifestyle intervention: A randomized controlled trial

Introduction

Obesity is one of the major global problems in today's world, both in children, and the adult age group. Current evidence suggests obesity alters the expression of various genes related to oxidative stress, inflammation, and aging. In recent times complementary therapy like yoga-based lifestyle intervention (YBLI) is used as an adjunct therapy to modern medicine. This study examines the efficacy of 12 weeks of yoga-based lifestyle intervention with standard care (SC) on the expression of genes related to oxidative stress, inflammation, and aging in obese adults.

Methods

This was a two-arm parallel randomized control trial implemented at Integral Health Clinic (IHC), an outpatient facility that regularly conducted YBLI programs for the prevention of lifestyle diseases like obesity and diabetes in the Department of Physiology, All India Institute of Medical Sciences (AIIMS), New Delhi. Blood samples at baseline and weeks 2,4, and 12 were collected from 72 adults (male n = 21; female n = 51) of age 20–45 years with a body–mass index (BMI) of 25–35 kg/m² who were randomized to receive either a 12-week SC (n = 36) or YBLI (n = 36). SC included recommendations for the management of obesity as per Indian guidelines including a low-calorie individualized diet and physical activity. Asana (physical postures), pranayama (breathing exercises), and meditation were all part of the YBLI. Primary outcomes were relative fold change in the expression of genes associated with oxidative stress [Nuclear factor-kappa B (NF-Kappa B)], inflammation [Tumor necrosis factor-α (TNFα), interleukin-6 (IL-6)], and aging [human telomerase reverse transcriptase (TERT)] in peripheral blood mononuclear cells between the two groups at week-12.

Results

There were no significant changes in fold change of TERT, IL-6, and NF-kappa B between the groups at week 12. The relative fold change of TERT was significantly greater in the YBLI group (p = <0.0001) vs the SC group at 2 weeks. The relative fold change of TNF α was significantly lower at week 12 in YBLI though the change was not continuous and reliable. Within both groups, TERT expression was significantly increased at week 2 though the change was greater in the YBLI group (p < 0.0001). TNF α gene expression was significantly lower at weeks 2 and 4, compared to baseline level, in the SC group but it increased at week 12.

Conclusion

The results while did not confirm our hypothesis, are important to share with the scientific society, to be able to improve prospective study designs and find optimal time/intervention/biological marker settings for this highly important scientific field. The results are suggestive of a positive impact of YBLI and SC on the fold change of aging-related TERT gene in obesity, though the benefit was not evident till week 12. However, the results should be evaluated with caution and in light of other published studies. To better understand the positive effects of YBLI on oxidative stress, inflammation, and aging-related gene expression in obesity, larger studies are recommended.

The Effects of Yoga on Bipolar Disorder: A Systematic Review

Bipolar disorder (BD) is a mood disorder characterized by severe mood swings and or periods of depression. This study examined the role that practicing yoga has on the symptoms of BD. One of the main goals was to identify if patients with BD believe that yoga is a viable treatment option. Six research databases were searched using the keywords "yoga" AND "therapy" AND "BD" AND "bipolar depression." Articles published in 2005 and later were included in the search. After duplicates were removed, and inclusion and exclusion criteria were applied, five articles were analyzed and included in this literature review. Results of this review indicate that yoga has been shown to be associated with both benefits and risks for the treatment of BD. Studies have shown that yoga might relieve some symptoms of BD and depression. However, due to the lack of research on the impact of yoga on BD and the small number of studies included in this review, results should be approached with caution. Overall, yoga was well-tolerated in the studies reviewed in this article. Yoga may relieve the symptoms of depression. Future research should analyze the long-term impact of yoga on bipolar depression. Yoga instructional standards should also be considered.

Yoga and Qigong for Health: Two Sides of the Same Coin?

Yoga and qigong are ancient mind–body practices used in the East for thousands of years to promote inner peace and mental clarity. Both share breathing techniques and slow movements and are being used as alternative/complementary approaches to the management of disease, especially chronic problems with no effective conventional treatments. However, information comparing the health benefits of both approaches is scarce, and the choice between yoga or qigong practice may only depend on patients’ preferences or practice availability. The aim of the present paper was to overview yoga and qigong use for health benefits under different pathological conditions. Yoga and qigong seem to have similar effects, which might be expected, since both are similar mind–body approaches with the same concept of vital life-force energy and the practice of meditative movements. Problematic research issues within the literature on yoga and qigong are the small sample sizes, use of different styles, significant variance in practice duration and frequency, short duration of intervention effects, and the usage of a non-active control group, thus emphasizing the need for further high-quality randomized trials. Studies comparing yoga and qigong are warranted in order to assess differences/similarities between the two approaches for health benefits.

Effect of lifestyle intervention in Type II diabetes

Introduction and Aim: Sedentary habits, unhealthy dietary patterns and psychological stress are the major potential problems for the advancements of a various life style disorders like Diabetes mellitus. Yoga is a lifestyle intervention, an effort to keep the condition under control and ameliorate overall quality of life. The idea of this research study among Type II diabetics is to assess the effectiveness of metabolic control with life style intervention (yoga) for 6 months.   Materials and Methods: 200 subjects aged 30–60 years of either gender recently diagnosed with Type II diabetes were randomized into 4 groups and were given 6 months intervention which included supervised regular yoga practice, diet and educational sessions. Weight, BMI, glucose, HbA1c, Insulin and lipid profile were measured before commencement, and after 6 months of the intervention. The statistical methods‘t’ test and ANOVA were applied to assess the “mean and difference” at p value 0.05.   Results: Alterations in the life style of Type II diabetics with the intervention of  yoga, diet and educational sessions showed a significant profitable impact on weight, BMI, fasting glucose,  insulin, HbA1c, and lipid profile.   Conclusion: Short term interventions produced positive modest changes in metabolic control. These lifestyle modifications with the intervention of yoga and diet counselling is effective in the management of  weight loss, glycemic control, plasma  Insulin and lipid profile levels which on longer duration may yield a better effective result along with constant motivation.

Potential Role of Yoga Intervention in the Management of Chronic Non-malignant Pain

Pain is an unpleasant and upsetting experience. Persistent pain has an impact on an individual's quality of life which causes stress and mood disorders. There are currently no pain-relieving techniques available that can eliminate pain and offer relief without causing any adverse effects. These factors draw attention to traditional treatments like yoga and meditation, which can reduce biological stress and hence increase immunity, as well as alleviate the psychological and emotional suffering produced by pain. Yoga reduces the stress response and the pain cascade via the downregulation of the hypothalamus-pituitary-adrenal (HPA) axis and vagal stimulation. Yoga is a cost-effective growing health practice that, unlike pharmaceuticals, has no side effects and can help patients stay in remission for longer periods of time with fewer relapses. Yoga not only reduces stress and depression severity but also improves functional status and reduces pain perception. This article highlights the impact of yoga on pain management and on a malfunctioning immune system, which leads to improved health, pain reduction, disease management, and improvement in overall quality of life.

Content, Structure, and Delivery Characteristics of Yoga Interventions for Managing Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objectives

This systematic review aimed to synthesize the content, structure, and delivery characteristics of effective yoga interventions used for managing hypertension and to compare these characteristics with ineffective interventions.

Design and Method

The JBI and the PRISMA guidelines were followed in this systematic review. RCTs conducted among hypertensive adults were included. RCTs reporting at least one of the major components of yoga (i.e., asana, pranayama, and dhyana and relaxation practices) and comparing them with no intervention or any intervention were eligible. Sixteen databases were searched for published and unpublished studies without any date and language restrictions till March 15, 2021.

Results

The literature search yielded 13,130 records. 34 RCTs (evaluating 38 yoga interventions) met the inclusion criteria. Overall, included studies had low methodological quality mostly due to inadequate reporting. Yoga reduced SBP and DBP compared to a control intervention (MD -6.49 and -2.78; 95CI% -8.94- -4.04 and -4.11- -1.45, respectively). Eighteen, 14 and 20 interventions were effective in improving SBP, DBP, or either, respectively. 13 out of 20 effective interventions incorporated all the 3 major components of yoga and allocated similar durations to each component whereas ineffective interventions were more focused on the asana and duration of asana practice was longer. The most common duration and frequency of effective interventions were 45 min/session (in 5 interventions), 7 days/week (in 5 interventions), and 12 weeks (in 11 interventions) whereas the most common session frequency was 2 days a week (in 7 interventions) in ineffective interventions. Effective interventions were mostly center-based (in 15 interventions) and supervised (in 16 interventions) and this was similar with ineffective interventions.

Conclusion

Despite the low quality and heterogeneity of included studies, our findings suggest yoga interventions may effectively manage hypertension. The differences between the effective and ineffective interventions suggest that effective yoga interventions mostly incorporated asana, pranayama, and dhyana and relaxation practices and they had a balance between these three components and included regular practice. They were mostly delivered in a center and under supervision. Future studies should consider developing and evaluating an intervention for managing hypertension using the synthesized findings of the effective interventions in this review.

Systematic Review Registration

[PROSPERO], identifier [CRD42019139404].

Combating the psychological impact of COVID-19 pandemic through yoga: Recommendation from an overview

Globally, the psychological health of the people is being affected due to the COVID-19 pandemic. Given the fact that numerous systematic reviews already exist on yoga and mental health, it becomes vital to undertake an overview on the same. The objective of the overview was to summarise the evidence from different systematic reviews of distinct yoga interventions used to improve mental health and recommend yoga practices for the same. The protocol was registered on PROSPERO (CRD42020185221). MEDLINE via Pubmed, Cochrane Database of Systematic Reviews and Google Scholar were searched for relevant literature. Search terms used were "Yoga practice, mental health and systematic review". Reviews from earliest possible date till May 2020, including those examining the effects of any single or combination of yoga interventions on mental health reported on children, youth and adults were selected. The Assessment of Multiple Systematic Reviews (AMSTAR) tool was used to evaluate the evidence of the included reviews. Out of the 90 reviews found, eight unique reviews were selected for the overview. Overall, 243 studies were analyzed, with an overlap of only 6 studies across the reviews. Out of 8 reviews, only 2 were of high quality and the rest were of moderate quality. Owing to heterogeneity of the included studies, only descriptive analysis was possible. The results of the review indicate moderate to positive effects of yoga on the mental health parameters. Practicing yoga (physical postures, Bhramary Pranayam, mindfulness meditation, sahaj yoga and laughter therapy) can be beneficial to improve psychological health of the people during the COVID-19 pandemic.

[Welche Behandlungs-Optionen wurden von COVID-19 infizierten Yoga-Übenden als hilfreich empfunden? - Ergebnisse einer Querschnittsanalyse]

Einführung: Die meisten COVID-19 Infizierten machen die Infektion im häuslichen Umfeld durch und werden vermutliche Maßnahmen zur Symptomlinderung anwenden, die aus dem Bereich der Selbstverordnung kommen. Von Interesse ist daher, welche Maßnahmen von COVID-19 Infizierten genutzt werden. Methoden: Anonyme Querschnittsanalyse, bei der die eigenen Behandlungsoptionen in Bezug zu acht Hauptsymptomen mit Hilfe von Freitextfeldern erfasst und kategorisiert werden. Einbezogen wurden Datensätze von Yoga-Übenden als spezifische Zielgruppe, die sich in den Zeiträumen der drei dominanten Virus-Varianten infiziert hatten (n=208: 89% Frauen; Altersmittel 49 ± 11). Die Aussagen wurden deskriptiv dargestellt und die Inhalte der Freitextfelder nach inhaltsanalytischen Gesichtspunkten kategorisiert und den jeweiligen Hauptsymptomen einer COVID-19 Infektion zugeordnet. Ergebnisse: In Bezug auf die acht Symptomgruppen ergab sich ein differenziertes Bild der als hilfreich empfundenen Behandlungsoptionen. Die meisten Nennungen hatte die Kategorie Zeit/Ruhe/Schlaf, insbesondere bei Schwäche/Erschöpfung und Rumpf-/Gliederschmerzen, gefolgt von Atemübungen (Pranayama), die insbesondere bei Atemnot/Kurzatmigkeit und Husten zur Anwendung kamen. Yoga-Übungen wurden insbesondere bei Rumpf-/Gliederschmerzen sowie Schwäche/Erschöpfung genutzt. Die konventionelle Schmerzmedikation stand bei Kopfschmerzen sowie Rumpf-/Gliederschmerzen im Vordergrund. Bewegung an der frischen Luft und Spaziergänge zur Regeneration waren relevant bei Schwäche/Erschöpfung, Atemnot/Kurzatmigkeit sowie Husten. Phytotherapeutische Anwendungen waren insbesondere bei Husten bedeutsam. Ätherische Öle und Riechtraining hatten ihren Schwerpunkt bei Geruchs-/Geschmacksstörungen und Husten. Schlussfolgerungen: In Bezug auf das angewendete Spektrum der unterstützenden Therapieoptionen im Sinne des Selbstmanagements wurden einige sehr häufig und differenziert angewendet. Hier könnte man eine subjektiv empfundene "Nützlichkeit" annehmen. In der Literatur lassen sich für einige dieser Optionen auch Hinweise für eine mögliche Wirksamkeit finden, für andere nicht ohne weiteres. Diese unterstützenden Therapieoptionen könnten außerdem eine Möglichkeit sein, um einer abwartenden Hilflosigkeit proaktiv entgegenzuwirken.