Participation in a yoga intervention is associated with improved mental health among Latinx adolescents

Latinx youth with mental health disorders have worse outcomes when compared to their White (non-Hispanic) counterparts. Latinx youth also have less access to and lower utilization of mental health services. Emerging research supports the psychological and physical benefits of engaging in yoga and yoga may function as a complimentary treatment option for patients with mental health challenges. However, research assessing the efficacy of yoga and mindfulness is particularly sparse among Latinx youth, who may particularly benefit from mind body awareness activities given barriers to more traditional health approaches. The objective of this quasi-experimental study was to examine the effects of a 12-week Vinyasa flow-based yoga group intervention on anxiety, depression, empathy, and life satisfaction among adolescents receiving outpatient mental health treatment. Adolescents (n = 186; 12-17 years old) were recruited to an active intervention condition (Yoga); a subsequent group of participants (n = 91) were recruited in the same manner to an assessment-only comparison control condition (Comparison). The Yoga group participated in culturally and developmentally tailored group yoga classes for 12 weeks. Structural equation modelling was used to evaluate the main effect intervention response between participants in the two conditions. At the post-intervention assessment, after controlling for baseline levels of outcome variables (i.e., depression, anxiety, empathy, and life satisfaction), on average participants in the yoga condition reported: less depression symptoms (B = -1.54, p = 0.008), less anxiety symptoms (B = -0.75, p = 0.048), greater empathy (B = 1.32, p = 0.025) and greater life satisfaction (B = 0.30, p = 0.013) as compared to the Comparison condition. Yoga interventions can be an acceptable and feasible modality for promoting well-being and reducing mental health problems among Latinx youth.

Mechanisms Underlying Anti-Inflammatory and Anti-Cancer Properties of Stretching-A Review

Stretching is one of the popular elements in physiotherapy and rehabilitation. When correctly guided, it can help minimize or slow down the disabling effects of chronic health conditions. Most likely, the benefits are associated with reducing inflammation; recent studies demonstrate that this effect from stretching is not just systemic but also local. In this review, we present the current body of knowledge on the anti-inflammatory properties of stretching at a molecular level. A total of 22 papers, focusing on anti-inflammatory and anti-cancer properties of stretching, have been selected and reviewed. We show the regulation of oxidative stress, the expression of pro- and anti-inflammatory genes and mediators, and remodeling of the extracellular matrix, expressed by changes in collagen and matrix metalloproteinases levels, in tissues subjected to stretching. We point out that a better understanding of the anti-inflammatory properties of stretching may result in increasing its importance in treatment and recovery from diseases such as osteoarthritis, systemic sclerosis, and cancer.

A randomized controlled trial of the influence of yoga for women with symptoms of post-traumatic stress disorder

Background

Survivors in motor vehicle accident (MVA) may have posttraumatic stress disorder (PTSD). Yoga is a complementary approach for PTSD therapy.

Methods

This randomized controlled trial explored whether yoga intervention has effects on reducing the symptoms of PTSD in women survived in MVA. Participants (n = 94) were recruited and randomized into control group or yoga group. Participants attended 6 45-minuite yoga sessions in 12 weeks. Depression Anxiety Stress Scales (DASS) and Impact of Events Scale-Revised (IES-R) were used to assess psychological distress.

Results

Post-intervention IES-R total score of yoga group was significantly lower than that of control group (p = 0.01). At both post-intervention and 3-months post intervention, the DASS-21 total scores of yoga group were both significantly lower than those of control group (p = 0.043, p = 0.024). Yoga group showed lower anxiety and depression level compared to control group at both post-intervention (p = 0.033, p < 0.001) and post-follow-up (p = 0.004, p = 0.035). Yoga group had lower levels of intrusion and avoidance compared to control group after intervention (p = 0.002, p < 0.001).

Conclusion

Results illustrate that yoga intervention may alleviate anxiety and depression and improve the symptoms of PTSD in women with PTSD following MVA.

Effects of a Single Yoga Session on Cardiac Interoceptive Accuracy and Emotional Experience

BACKGROUND

There is an increasing body of research supporting the idea that cardiac interoceptive accuracy (IAc) can be improved by training. Findings concerning the effects of a single yoga session on IAc and the related construct emotional experience are sparse. The aim of this study was to examine if a single yoga session increases IAc and improves emotional experience.

METHODS

137 students were randomly assigned to a 20-min yoga session (n = 47), an endurance session (n = 46), or an inactive control condition (n = 44). IAc and emotional experience were assessed before and after the sessions.

RESULTS

There were no significant changes in IAc, or positive and negative affect. IAc at baseline and the change in positive effect were found as predictors for IAc after the yoga session.

CONCLUSION

A 20-min yoga session seems to be not applicable to improve IAc and emotional experience. Future studies should investigate long-term interventions and diverse healthy and clinical populations.

Yoga as an Integrative Therapy for Mental Health Concerns: An Overview of Current Research Evidence

Background: Because the prevalence of mental health concerns is high and access or full responsiveness to pharmacological or psychotherapeutic treatment for many individuals is low, there has been increased interest in yoga as a potential therapy for many mental health concerns. Approach: We synthesize and critique current research on the efficacy of yoga relative to pharmacological approaches for anxiety disorders, mood disorders, posttraumatic stress disorder, obsessive-compulsive disorder, and eating disorders. Results: Yoga has been tested mostly as a complementary treatment to standard psychiatric and psychotherapeutic approaches. Findings from efficacy trials largely support the notion that yoga can help reduce symptoms of many psychiatric conditions, including anxiety, depression, and PTSD symptoms, above and beyond the effects achieved by standard pharmacological treatments alone; however, most evidence is of poor to moderate quality. Plausible transdiagnostic bottom-up and top-down mechanisms of yoga’s therapeutic effects have been advanced but remain untested. Conclusions: While results should be considered preliminary until more rigorous evidence is available, yoga appears to have the potential to provide many people suffering with psychiatric symptoms additional relief at relatively little cost. Yoga may be a viable complementary therapy to psychiatric and psychotherapeutic approaches for people with mental health challenges.

Ensuring Yoga Intervention Fidelity in a Randomized Preference Trial for the Treatment of Worry in Older Adults

Introduction: Yoga for treatment of worry in older adults is an intervention that is especially likely to translate into real-world practice. Assessing treatment fidelity improves confidence that effective interventions can be consistently applied and allows researchers to explore if any null results for effectiveness are indeed the result of a lack of intervention efficacy or lack of proper intervention implementation. Methods: This study describes treatment fidelity of a yoga intervention in a randomized preference trial that compared cognitive-behavioral therapy (CBT) and yoga for the treatment of worry, anxiety, and sleep in worried older (≥60 years) adults. Established methods for assessing treatment fidelity of CBT guided the procedure for ensuring that the yoga intervention was delivered as intended. The yoga intervention consisted of 20, 75-min, in-person, group, gentle yoga classes held twice weekly. Results: Six female instructors (mean age = 64 years) taught 660 yoga classes that were videotaped. Ten percent of these classes, stratified by instructor, were randomly selected for review. The average adherence score for yoga instructors was 6.84 (range 4-8). The average competency scores were consistently high, with an average score of 7.24 (range 6-8). Teaching content not included in the protocol occurred in 26 (38.1%) sessions and decreased over time. Observed ratings of instructor adherence were significantly related to ratings of competency. Instructor adherence was also significantly associated with lower participant attendance, but not with any of the other process or outcome measures. Conclusions: The larger range found in adherence relative to competence scores demonstrated that teaching a yoga class according to a protocol requires different skills than competently teaching a yoga class in the community, and these skills improved with feedback. These results may foster dialog between the yoga research and practice communities. Clinical Trial Registration No.: NCT02968238.

Feasibility, acceptability and preliminary impact of mindfulness-based yoga among Hispanic/Latinx adolescents

BACKGROUND

The Hispanic/Latinx population constitutes the fastest growing ethnic/racial minority group in the United States (U.S.). Compared to their non-Hispanic/Latinx White counterparts, Hispanic/Latinx youth experience more depression and anxiety, and have more unmet mental health needs (88% vs 76%). Emerging research supports the psychological and physical benefits of mind-body awareness training to enhance well-being and mental health, but almost no studies have recruited ethnic/racial minority samples.

PURPOSE

The current study examined the feasibility, acceptability and preliminary impact of a mindfulness-based yoga program among Hispanic/Latinx public high school students.

PROCEDURES

Participants (N = 187) were recruited from a local public high school in a large multi-ethnic urban school district in the Southeast U.S. and participated in 6 weekly hour-long sessions of mindfulness-based yoga. Participants completed assessments at pretest and one month after program completion.

MAIN FINDINGS

The sample was predominantly Hispanic/Latinx (95%) and female (64%), on average 15.2 years old (SD = 1.3), and 51% were born outside the U.S. Participants reported on average a 14.2% reduction in depressive symptoms (pretest mean = 5.51, posttest mean = 4.73, p = .032, Cohen's d = 0.2), a 14.9% reduction in anxiety symptoms (pretest mean = 9.90, posttest mean = 8.42, p = .005, Cohen's d = 0.2), and a 21.9% reduction in stress (pretest mean = 9.66, posttest mean = 7.54, p < .001, Cohen's d = 0.5).

CONCLUSION

These findings provide support for the effectiveness of a mindfulness-based yoga program for Hispanic/Latinx adolescents, a medically underrepresented group experiencing significant mental health disparities.

Online yoga to reduce post traumatic stress in women who have experienced stillbirth: a randomized control feasibility trial

BACKGROUND

About 1 in every 150 pregnancies end in stillbirth. Consequences include symptoms of post traumatic stress disorder (PTSD), depression, and anxiety. Yoga has been used to treat PTSD in other populations and may improve health outcomes for stillbirth mothers. The purpose of this study was to determine: (a) feasibility of a 12-week home-based, online yoga intervention with varying doses; (b) acceptability of a "stretch and tone" control group; and (c) preliminary efficacy of the intervention on reducing symptoms of PTSD, anxiety, depression, perinatal grief, self-compassion, emotional regulation, mindfulness, sleep quality, and subjective health.

METHODS

Participants (N = 90) were recruited nationally and randomized into one of three groups for yoga or exercise (low dose (LD), 60 min per week; moderate dose (MD), 150 min per week; and stretch-and-tone control group (STC)). Baseline and post-intervention surveys measured main outcomes (listed above). Frequency analyses were used to determine feasibility. Repeated measures ANCOVA were used to determine preliminary efficacy. Multiple regression analyses were used to determine a dose-response relationship between minutes of yoga and each outcome variable.

RESULTS

Over half of participants completed the intervention (n = 48/90). Benchmarks (≥70% reported > 75% satisfaction) were met in each group for satisfaction and enjoyment. Participants meeting benchmarks (completing > 90% of prescribed minutes 9/12 weeks) for LD and MD groups were 44% (n = 8/18) and 6% (n = 1/16), respectively. LD and MD groups averaged 44.0 and 77.3 min per week of yoga, respectively. The MD group reported that 150 prescribed minutes per week of yoga was too much. There were significant decreases in PTSD and depression, and improvements in self-rated health at post-intervention for both intervention groups. There was a significant difference in depression scores (p = .036) and grief intensity (p = .009) between the MD and STC groups. PTSD showed non-significant decreases of 43% and 56% at post-intervention in LD and MD groups, respectively (22% decrease in control).

CONCLUSIONS

This was the first study to determine the feasibility and preliminary efficacy of an online yoga intervention for women after stillbirth. Future research warrants a randomized controlled trial.

TRIAL REGISTRATION

ClinicalTrials.gov. NCT02925481. Registered 10-04-16.

Reducing Allostatic Load in Depression and Anxiety Disorders: Physical Activity and Yoga Practice as Add-On Therapies

The allostatic load (AL) index constitutes a useful tool to objectively assess the biological aspects of chronic stress in clinical practice. AL index has been positively correlated with cumulative chronic stress (physical and psychosocial stressors) and with a high risk to develop pathological conditions (e.g., metabolic syndrome, cardiovascular pathology, inflammatory disorders) and the so-called stress-related psychiatric disorders, including anxiety and depressive disorders. Chronic stress has negative effects on brain neuroplasticity, especially on hippocampal neurogenesis and these effects may be reversed by antidepressant treatments. Several evidences indicate that non-pharmacological interventions based on physical activity and yoga practice may add synergizing benefits to classical treatments (antidepressant and benzodiazepines) for depression and anxiety, reducing the negative effects of chronic stress. The aim of this review is to provide a general overview of current knowledge on AL and chronic stress in relation to depression and anxiety, physical activity and yoga practice.

An iterative design process to develop a randomized feasibility study and inform recruitment of minority women after stillbirth

BACKGROUND

Yearly, approximately 25,000 US women experience stillbirth and African American women have a 2.2 fold increased risk of stillbirth compared with white women. After stillbirth, women are subject to a sevenfold increased risk of post-traumatic stress compared with women after a live-birth. This paper presents findings from phase one of a National Institutes of Health funded, two-phase feasibility study to examine an online yoga intervention to reduce symptoms of post-traumatic stress in mothers after stillbirth. An iterative design was used to (1) inform the development of the online yoga intervention and (2) inform recruitment strategies to enroll minority women into phase two.

METHODS

Ten mothers (N = 5 stillbirth moms with no yoga experience, N = 5 nonstillbirth moms with yoga experience) participated in a series of online yoga videos (N = 30) and were assessed for self-compassion (SC) and emotional regulation (ER) before and after each video. An independent group of five minority women who had experienced stillbirth were interviewed about cultural barriers to recruitment and perceptions/opinions of yoga. A mean was calculated for SC and ER scores for each video at pre- and post-time points. The percent change of the mean difference between pre-post SC and ER scores were used to select videos for phase two. Videos with a negative change score or that had a 0% change on SC or ER were not used. A combination of deductive and inductive coding was used to organize the interview data, generate categories, and develop themes.

RESULTS

Five of the 30 tested yoga videos were not used. An additional 12 videos were developed, filmed, and used in the prescription for phase two. Topics from interview findings included perceived benefits/barriers of and interest in yoga, preferred yoga environment, suggested recruitment methods, content of recruitment material, and recommended incentives.

CONCLUSIONS

Online yoga may be beneficial for improving emotional regulation and self-compassion, but further testing is needed. Additionally, minority women express interest in online yoga but suggest that researchers apply culturally specific strategies regarding methods, content of material, and incentives to recruit minority women into a study.

The experience of mindful yoga for older adults with depression

WHAT IS KNOWN ON THE SUBJECT?: Mindful yoga combines yoga techniques with the mindfulness-based stress reduction approach. Previous studies on mindful yoga have reported improvements in depression for working-age adults, but no studies have been conducted with older people. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Mindful yoga may be a safe and acceptable intervention to improve the mental and physical health of older adults with depression. The beneficial therapeutic ingredients of mindful yoga, included calmness, being non-judgmental, letting go and seizing the day. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Single-sex mindful yoga groups may be more acceptable for some people. Well-conducted feasibility studies comparing mindful yoga with an alternative group-based approach are necessary. Abstract Introduction Mindful yoga combines yoga techniques with the mindfulness-based stress reduction approach. Previous studies on mindful yoga have reported improvements in depression for working-age adults, but no studies have been conducted with older people. Aims To explore the experiences of older adults with depression participating in a mindful yoga group to establish whether the approach has potential as a future intervention for this client group. Method This study adopted a qualitative descriptive method and used inductive content analysis. Eighteen in-depth individual interviews were conducted with nine participants (each participant had one interview following the programme and another four weeks later). Results Six main themes emerged: "improved physical status," "actively involved in the community," "positive psychological effects," "perceived therapeutic ingredients," "facilitators of practising mindful yoga" and "barriers to practising mindful yoga.". Discussion Most participants reported benefitting from the programme. Two male participants expressed that exercises were too challenging and more suited to women, suggesting single-sex groups may be more acceptable. Implications for practice Mindful yoga may be an acceptable/useful intervention for older adults with depression, but future studies are required to establish its feasibility and potential efficacy.

Yoga Education Program for Reducing Drug Dependency and Promoting Better Asthma Control for Chronic Asthmatic Children: A Multicity Experiment

This article reports a 1-year long yoga education program (YEP) experiment aimed at reducing drug dependency and promoting better asthma control for chronic asthmatic children. Participants were 450 chronic asthmatic children across 4 cities. Two measures were used: Pediatric Asthma Diary (PAD) and Childhood Asthma Control Test (C-ACT). Results indicated that intervention group children had better asthma control in terms of lower average PAD scores and higher C-ACT scores and reduced drug intake vis-à-vis the control group. Within the intervention cohort, asthma symptoms persistence was lower and control was higher for children from Asian cities, boys, Hindus, middle-class children, those whose mothers were their primary caregivers, who lived in standard family setups, who also attended the optional YEP rounds, and regularly self-practiced. The strongest predictor of lower posttest PAD scores and higher C-ACT scores was self-practice. The YEP can be used as an effective complementary treatment for chronic asthmatic children.

Role of Yoga and Mindfulness in Severe Mental Illnesses: A Narrative Review

Background:

Yoga has its origin from the ancient times. It is an integration of mind, body, and soul. Besides, mindfulness emphasizes focused awareness and accepting the internal experiences without being judgemental. These techniques offer a trending new dimension of treatment in various psychiatric disorders.

Aims:

We aimed to review the studies on the efficacy of yoga and mindfulness as a treatment modality in severe mental illnesses (SMIs). SMI includes schizophrenia, major depressive disorder (MDD), and bipolar disorder (BD).

Methods:

We conducted a literature search using PubMed, Google Scholar, and Cochrane Library with the search terms “yoga,” “meditation,” “breathing exercises,” “mindfulness,” “schizophrenia spectrum and other psychotic disorders,” “depressive disorder,” and “bipolar disorder” for the last 10-year period. We also included relevant articles from the cross-references.

Results:

We found that asanas and pranayama are the most commonly studied forms of yoga for schizophrenia. These studies found a reduction in general psychopathology ratings and an improvement in cognition and functioning. Some studies also found modest benefits in negative and positive symptoms. Mindfulness has not been extensively tried, but the available evidence has shown benefits in improving psychotic symptoms, improving level of functioning, and affect regulation. In MDD, both yoga and mindfulness have demonstrated significant benefit in reducing the severity of depressive symptoms. There is very sparse data with respect to BD.

Conclusion:

Both yoga and mindfulness interventions appear to be useful as an adjunct in the treatment of SMI. Studies have shown improvement in the psychopathology, anxiety, cognition, and functioning of patients with schizophrenia. Similarly, both the techniques have been established as an effective adjuvant in MDD. However, more rigorously designed and larger trials may be necessary, specifically for BD.

Relationship Between Mindfulness and Posttraumatic Stress in Women Who Experienced Stillbirth

OBJECTIVE

To explore the potential factors that mediate the relationship between mindfulness and symptoms of posttraumatic stress (PTS) in women who experienced stillbirth.

DESIGN

A cross-sectional analysis of baseline data before women's participation in an online mindfulness intervention (i.e., online yoga).

SETTING

This was a national study, and women participated in their own homes.

PARTICIPANTS

Women who experienced stillbirth (N = 74) within the past 2 years and resided in the United States.

METHODS

Women were recruited nationally, primarily through social media. Participants (N = 74) completed baseline assessments (self-report mental and physical health surveys) via a Web-based survey tool. We conducted an exploratory factor analysis of the COPE Inventory subscales to reduce the number of variables before entry into a mediation model. We then tested the mediation effects of sleep quality, self-esteem, resilience, and maladaptive coping on the relationship between mindfulness and PTS symptoms.

RESULTS

Through the exploratory factor analysis we identified a two-factor solution. The first factor included nine subscales that represented adaptive coping strategies, and the second factor included five subscales that represented maladaptive coping strategies. Results from multiple mediation analysis suggested that mindfulness had a significant inverse relationship to PTS symptoms mediated by sleep quality.

CONCLUSION

Mindfulness practices may have potential benefits for grieving women after stillbirth. Evidence-based approaches to improve sleep quality also may be important to reduce PTS symptoms in women after stillbirth.

A randomized preference trial of cognitive-behavioral therapy and yoga for the treatment of worry in anxious older adults

Background

Worry is a common problem among older adults. Cognitive-behavioral therapy is the most studied nonpharmacological intervention and it has demonstrated efficacy in reducing late-life worry and anxiety. Although the evidence-base is smaller, yoga has been shown to reduce anxiety and stress. However, little is known about the relative effectiveness of these two nonpharmacological interventions. Further, the impact of patient preference on outcomes is unknown.

Purpose: The purpose to this study is to compare the effectiveness of cognitive-behavioral therapy (CBT) with yoga for improving late-life worry, anxiety, and sleep. We will also examine the effects of preference and selection on outcomes, adherence, and attrition.

Methods

We are conducting a two-stage randomized preference trial comparing CBT and yoga for the reduction of worry in a sample of anxious older adults. Five hundred participants will be randomized to either the preference trial (participants choose the intervention; N = 250) or to the randomized trial (participants are randomized to one of the two interventions; N = 250) with equal probability. CBT consists of 10 telephone-based sessions with an accompanying workbook. Yoga consists of 10 weeks of group yoga classes (twice a week) that is modified for use with older adults.

Conclusions

The study design is based on feedback from anxious older adults who wanted more nonpharmacological options for intervention as well as more input into the intervention they receive. It is the first head-to-head comparison of CBT and yoga for reducing late-life worry and anxiety. It will also provide information about how intervention preference affects outcomes.

Trial registration

ClinicalTrials.gov NCT02968238.

The physical postures of yoga practices may protect against depressive symptoms, even as life stressors increase: a moderation analysis

Yoga contains sub-components related to its physical postures (asana), breathing methods (pranayama), and meditation (dhyana). To test the hypothesis that specific yoga practices are associated with reduced psychological distress, 186 adults completed questionnaires assessing life stressors, symptom severity, and experience with each of these aspects of yoga. Each yoga sub-component was found to be negatively correlated with psychological distress indices. However, differing patterns of relationship to psychological distress symptoms were found for each yoga sub-component. Experience with asana was negatively correlated with global psychological distress (r = -.21, p < .01), and symptoms of anxiety (r = -.18, p = .01) and depression (r = -.17, p = .02). These relationships remained statistically significant after accounting for variance attributable to Social Readjustment Rating Scale scores (GSI: r = -.19, p = .01; BSI Anxiety: r = -.16, p = .04; BSI Depression: r = -.14, p = .05). By contrast, the correlations between other yoga sub-components and symptom subscales became non-significant after accounting for exposure to life stressors. Moreover, stressful life events moderated the predictive relationship between amount of asana experience and depressive symptoms. Asana was not related to depressive symptoms at low levels of life stressors, but became associated at mean (t[182] = -2.73, p < .01) and high levels (t[182] = -3.56, p < .001). Findings suggest asana may possess depressive symptom reduction benefits, particularly as life stressors increase. Additional research is needed to differentiate whether asana has an effect on psychological distress, and to better understand potential psychophysiological mechanisms of action.

Adjunctive yoga v. health education for persistent major depression: a randomized controlled trial

BACKGROUND

The objective of this study was to determine whether hatha yoga is an efficacious adjunctive intervention for individuals with continued depressive symptoms despite antidepressant treatment.

METHOD

We conducted a randomized controlled trial of weekly yoga classes (n = 63) v. health education classes (Healthy Living Workshop; HLW; n = 59) in individuals with elevated depression symptoms and antidepressant medication use. HLW served as an attention-control group. The intervention period was 10 weeks, with follow-up assessments 3 and 6 months afterwards. The primary outcome was depression symptom severity assessed by blind rater at 10 weeks. Secondary outcomes included depression symptoms over the entire intervention and follow-up periods, social and role functioning, general health perceptions, pain, and physical functioning.

RESULTS

At 10 weeks, we did not find a statistically significant difference between groups in depression symptoms (b = -0.82, s.e. = 0.88, p = 0.36). However, over the entire intervention and follow-up period, when controlling for baseline, yoga participants showed lower levels of depression than HLW participants (b = -1.38, s.e. = 0.57, p = 0.02). At 6-month follow-up, 51% of yoga participants demonstrated a response (⩾50% reduction in depression symptoms) compared with 31% of HLW participants (odds ratio = 2.31; p = 0.04). Yoga participants showed significantly better social and role functioning and general health perceptions over time.

CONCLUSIONS

Although we did not see a difference in depression symptoms at the end of the intervention period, yoga participants showed fewer depression symptoms over the entire follow-up period. Benefits of yoga may accumulate over time.

A study protocol of a three-group randomized feasibility trial of an online yoga intervention for mothers after stillbirth (The Mindful Health Study)

BACKGROUND

In the USA, stillbirth (in utero fetal death ≥20 weeks gestation) is a major public health issue. Women who experience stillbirth, compared to women with live birth, have a nearly sevenfold increased risk of a positive screen for post-traumatic stress disorder (PTSD) and a fourfold increased risk of depressive symptoms. Because the majority of women who have experienced the death of their baby become pregnant within 12-18 months and the lack of intervention studies conducted within this population, novel approaches targeting physical and mental health, specific to the needs of this population, are critical. Evidence suggests that yoga is efficacious, safe, acceptable, and cost-effective for improving mental health in a variety of populations, including pregnant and postpartum women. To date, there are no known studies examining online-streaming yoga as a strategy to help mothers cope with PTSD symptoms after stillbirth.

METHODS

The present study is a two-phase randomized controlled trial. Phase 1 will involve (1) an iterative design process to develop the online yoga prescription for phase 2 and (2) qualitative interviews to identify cultural barriers to recruitment in non-Caucasian women (i.e., predominately Hispanic and/or African American) who have experienced stillbirth (N = 5). Phase 2 is a three-group randomized feasibility trial with assessments at baseline, and at 12 and 20 weeks post-intervention. Ninety women who have experienced a stillbirth within 6 weeks to 24 months will be randomized into one of the following three arms for 12 weeks: (1) intervention low dose (LD) = 60 min/week online-streaming yoga (n = 30), (2) intervention moderate dose (MD) = 150 min/week online-streaming yoga (n = 30), or (3) stretch and tone control (STC) group = 60 min/week of stretching/toning exercises (n = 30).

DISCUSSION

This study will explore the feasibility and acceptability of a 12-week, home-based, online-streamed yoga intervention, with varying doses among mothers after a stillbirth. If feasible, the findings from this study will inform a full-scale trial to determine the effectiveness of home-based online-streamed yoga to improve PTSD. Long-term, health care providers could use online yoga as a non-pharmaceutical, inexpensive resource for stillbirth aftercare.

TRIAL REGISTRATION

NCT02925481.

Perceptions of hatha yoga amongst persistently depressed individuals enrolled in a trial of yoga for depression

OBJECTIVES

To understand depressed individuals' experiences in a 10-week hatha yoga program.

DESIGN

In a randomized controlled trial, participants were assigned to either 10 weeks of hatha yoga classes or a health education control group. This report includes responses from participants in yoga classes. At the start of classes, average depression symptom severity level was moderate.

MAIN OUTCOME MEASURES

After 10 weeks of yoga classes, we asked participants (n=50) to provide written responses to open-ended questions about what they liked about classes, what they did not like or did not find helpful, and what they learned. We analyzed qualitative data using thematic analysis.

RESULTS AND CONCLUSIONS

Elements of yoga classes that may increase acceptability for depressed individuals include having instructors who promote a non-competitive and non-judgmental atmosphere, who are knowledgeable and able to provide individualized attention, and who are kind and warm. Including depression-related themes in classes, teaching mindfulness, teaching breathing exercises, and providing guidance for translating class into home practice may help to make yoga effective for targeting depression. Participants' comments reinforced the importance of aspects of mindfulness, such as attention to the present moment and acceptance of one's self and one's experience, as potential mechanisms of action. Other potential mechanisms include use of breathing practices in everyday life and the biological mechanisms that underlie the positive impact of yogic breathing. The most serious concern highlighted by a few participants was the concern that the yoga classes were too difficult given their physical abilities.

Yoga stretching for improving salivary immune function and mental stress in middle-aged and older adults

Protection against age-related immune suppression is important in elderly individuals. This study determined the effect of yoga on mucosal immune function and mental stress. Saliva samples were collected from 23 adult women (age: 60.4 ± 10.4 years) before and after 90 minutes of yoga stretching or rest to measure secretory immunoglobulin A (SIgA), cortisol, and testosterone. The SIgA concentration and secretion rate were significantly higher after yoga than before (p < .05). The cortisol concentration and secretion rate were lower and testosterone secretion rate higher after yoga (p < .05). Yoga stretching can reduce stress and enhance mucosal immune function in elderly women.

INDIVIDUALIZED YOGA FOR REDUCING DEPRESSION AND ANXIETY, AND IMPROVING WELL-BEING: A RANDOMIZED CONTROLLED TRIAL

BACKGROUND

Depression and anxiety are leading causes of disability worldwide. Current treatments are primarily pharmaceutical and psychological. Questions remain about effectiveness and suitability for different people. Previous research suggests potential benefits of yoga for reducing depression and anxiety. The aim of this study is to investigate the effects of an individualized yoga intervention.

METHODS

A sample of 101 people with symptoms of depression and/or anxiety participated in a randomized controlled trial comparing a 6-week yoga intervention with waitlist control. Yoga was additional to usual treatment. The control group was offered the yoga following the waitlist period. Measures included Depression Anxiety Stress Scale (DASS-21), Kessler Psychological Distress Scale (K10), Short-Form Health Survey (SF12), Scale of Positive and Negative Experience (SPANE), Flourishing Scale (FS), and Connor-Davidson Resilience Scale (CD-RISC2).

RESULTS

There were statistically significant differences between yoga and control groups on reduction of depression scores (-4.30; 95% CI: -7.70, -0.01; P = .01; ES -.44). Differences in reduced anxiety scores were not statistically significant (-1.91; 95% CI: -4.58, 0.76; P = .16). Statistically significant differences in favor of yoga were also found on total DASS (P = .03), K10, SF12 mental health, SPANE, FS, and resilience scores (P < .01 for each). Differences in stress and SF12 physical health scores were not statistically significant. Benefits were maintained at 6-week follow-up.

CONCLUSION

Yoga plus regular care was effective in reducing symptoms of depression compared with regular care alone. Further investigation is warranted regarding potential benefits in anxiety. Individualized yoga may be particularly beneficial in mental health care in the broader community.

Validation of the Behavioral Activation for Depression Scale (BADS)-Psychometric properties of the long and short form

With the development of the Behavioral Activation for Depression Scale (BADS) by Kanter, et al. [1], different behavioral aspects of depression like activation, rumination or avoidance, and functional impairment can be measured. The long and the short versions of the BADS, however, show differences in the quality of psychometric properties. We wanted to validate the short and long forms of the BADS. We therefore evaluated the factor structure, the psychometric properties, and the construct validity of the long version and the subscales in a clinically depressed German sample (n=258) in study 1. In study 2, we explored the factor structure and the psychometric properties of the short version of the BADS in a subsyndromal sample with elevated depressive symptoms (n=406). In study 1, our results replicated the four factor solution of the BADS-25 original version and showed good psychometric properties. However, with regard to the BADS-9 only the French factor solution of the short BADS-9 demonstrated acceptable fit with low internal consistency of the subscale Avoidance. Thus, only the total score of the short form can be recommended.

Mindfulness-based yoga intervention for women with depression

OBJECTIVES

The purpose of this study was to examine the efficacy of a 12-week mindfulness-based yoga intervention on depressive symptoms and rumination among depressed women.

DESIGN

Prospective, randomized, controlled 12 week intervention pilot study. Depressive symptoms were assessed at baseline, post-intervention (12 weeks), and one-month follow-up.

SETTING

Women with a history of diagnosed depression and currently depressed were randomized to a mindfulness-based yoga condition or a walking control.

INTERVENTIONS

The mindfulness-based yoga intervention consisted of a home-based yoga asana, pranayama and meditation practice with mindfulness education sessions delivered over the telephone. The walking control condition consisted of home-based walking sessions and health education sessions delivered over the phone.

MAIN OUTCOME MEASURES

The Beck Depression Inventory (BDI) and Ruminative Responses Scale (RRS).

RESULTS

Both groups reported decreases in depressive symptoms from baseline to post-intervention, f(1,33)=34.83, p<0.001, and from baseline to one-month follow-up, f(1,33)=37.01, p<0.001. After controlling for baseline, there were no significant between group differences on depression scores at post-intervention and the one-month follow-up assessment. The mindfulness-based yoga condition reported significantly lower levels of rumination than the control condition at post-intervention, after controlling for baseline levels of rumination, f(1,31)=6.23, p<0.01.

CONCLUSIONS

These findings suggest that mindfulness-based yoga may provide tools to manage ruminative thoughts among women with elevated depressive symptoms. Future studies, with larger samples are needed to address the effect of yoga on depression and further explore the impact on rumination.

Recommendations to the primary care practitioners and the patients for managing pelvic pain, especially in painful bladder syndrome for early and better prognosis

Painful bladder syndrome (PBS) is a common disease presenting with chronic pelvic pain and discomfort with at least one urinary symptom with no identifiable cause. The etiology is still unknown, and the medication has limited effects on pelvic pain or other urinary symptoms. This article presents advanced insight regarding the approach to PBS, particularly pelvic pain for primary care practitioners and patients. We suggest six tips for medical staff and suspected patients for easy diagnosis and proper treatment of pelvic pain. These six tips cover: Self-awareness of the disease; immediate urine culture test; specifying the location of pain urinary incontinence; frequency, or urgency without functional disorder of an overactive bladder helpful dietary control; complementary, and alternative medicine, and finding an expert. These tips might be helpful in advancing the schematic approach and in achieving better prognosis of PBS. Further study should be conducted to achieve better treatment for this disease, including development of a definitive test and diagnosis.

Efficacy of yoga for depressed postpartum women: A randomized controlled trial

BACKGROUND

Up to 20% of women experience postpartum depression (PPD). PPD is associated with anxiety and poor health-related quality of life (HRQOL). Efficacious treatments are critical; many women with PPD prefer complementary therapies. Thus, the current study examined yoga as a complementary therapy for PPD.

METHODS

Fifty-seven postpartum women with scores ≥12 on the Hamilton Depression Rating Scale were randomly assigned to a yoga (N = 28) or wait-list control (N = 29) group. The yoga intervention consisted of 16 classes over 8 weeks. Outcomes were depression, anxiety, and HRQOL.

RESULTS

The yoga group experienced significantly greater rate of improvement in depression, anxiety, and HRQOL, relative to the control group with moderate to large effects. Reliable Change Index analyses revealed that 78% of women in the yoga group experienced clinically significant change.

CONCLUSION

These findings support yoga as a promising complementary therapy for PPD, and warrant large-scale replication studies.

TRIAL REGISTRATION

http://clinicaltrials.gov/NCT02213601.

Establishing key components of yoga interventions for reducing depression and anxiety, and improving well-being: a Delphi method study

BACKGROUND

Previous research suggests benefits of yoga in reducing depression and anxiety. However, common concerns in reviews of the research include lack of detail, rationale and consistency of approach of interventions used. Issues related to heterogeneity include amount, types and delivery of yoga interventions. This study aims to document consensus-based recommendations for consistency of yoga interventions for reducing depression and anxiety.

METHODS

The Delphi method was used to establish consensus from experienced yoga teachers. Thirty-three eligible teachers were invited to participate, from four different countries. Two rounds of an online survey were sent to participants. The first round sought initial views. The second round sought consensus on a summary of those views. Survey questions related to frequency and duration (dosage) of the yoga, approaches and techniques to be included or avoided, and training and experience for yoga teachers.

RESULTS

Twenty-four teachers agreed to participate. Eighteen completed the second round (n = 18). General consensus (>75% of participants in agreement) was achieved on parameters of practice (dosage): an average of 30 to 40 minutes, to be done 5 times per week, over a period of 6 weeks. Numerous recommendations for yoga techniques to include or avoid were collected in the first round. The second round produced a consensus statement on those recommendations. Breath regulation and postures were considered very important or essential for people with depression; and relaxation, breath regulation and meditation being very important or essential for people with anxiety. Other recommended components also achieved consensus. There was also general consensus that it is very important or essential for teachers to have a minimum of 500 training hours over 2 years, at least 2 years teaching experience, training in developing personalised yoga practices, training in yoga for mental health, and professional supervision or mentoring.

CONCLUSIONS

The Delphi process has achieved a consensus statement on the application of yoga for reducing anxiety and depression. This consensus provides a checklist for identification of commonalities and evaluation of past research. Future research can proceed to develop and evaluate consensus-based yoga intervention protocols for the reduction of anxiety and depression, and improvements in well-being.

Protocol to evaluate the impact of yoga supplementation on cognitive function in schizophrenia: a randomised controlled trial

BACKGROUND

Schizophrenia (SZ) is a chronic illness that is treated symptomatically. Cognitive dysfunction is a core feature of SZ that is relatively intractable to pharmacotherapy. Yoga can improve cognitive function among healthy individuals. A recent open trial indicated significant benefits of yoga training (YT) in conjunction with conventional pharmacotherapy among patients with SZ.

AIMS

To describe the protocol for an ongoing randomised controlled trial designed to test whether the reported beneficial effects of YT on cognitive function among SZ patients can be replicated. Secondarily, the effects of YT on daily functioning living skills are evaluated.

METHODS

Consenting patients with SZ receive routine clinical treatment and are randomised to adjunctive YT, adjunctive physical exercise (PE) or treatment as usual (proposed N = 234 total, N = 78 in each group). The trial involves YT or PE 5 days a week and lasts 3 weeks. Participants are evaluated thrice over 6 months. Cognitive functions measured by Trail Making Test, University of Pennsylvania Neurocognitive Computerised Battery were primary outcome measures while clinical severity and daily functioning measured by Independent Living Skills Survey were secondary outcome measures.

RESULTS

A total of 309 participants have been randomised as of 31 August 2013, which exceeded beyond 294 proposed after attrition. Once participants begin YT or PE they generally complete the protocol. No injuries have been reported.

CONCLUSIONS

Short term YT is feasible and acceptable to Indian SZ patients. If beneficial effects of YT are detected, it will provide a novel adjunctive cognitive remediation strategy for SZ patients.

A conceptual framework of stress vulnerability, depression, and health outcomes in women: potential uses in research on complementary therapies for depression

BACKGROUND

Depression is a chronic mental health condition that affects millions of individuals worldwide. It is well-established that psychological stress plays an integral role in depression and that depression has numerous negative health outcomes. However, a closer look at components of stress vulnerabilities and depression is required to allow for the development and testing of appropriate interventions.

AIMS AND DISCUSSION

This article describes a conceptual framework about the complex and bidirectional relationship between stress vulnerability, depression, and health outcomes in women. The authors elucidate how the framework can be applied in clinical research about cellular aging and on the mechanisms of complementary and alternative medicine (CAM) for depression, using yoga as an example of a CAM modality.

CONCLUSION

The proposed conceptual framework may be helpful for adding depth to the body of knowledge about the use of mind-body therapies for individuals at high risk of stress vulnerability and/or depression.

Decoding the integrated approach to yoga therapy: Qualitative evidence based conceptual framework

Aim:

The aim of this study was to define, decode, and append to the conceptual frame-work of the integrated approach to yoga therapy (IAYT).

Materials and Methods:

Four stakeholders who followed two in-patients with depression over a period of 2 weeks in the residential center Arogyadhama (of Swami Vivekananda Yoga Anusandana Samsthana, Bangalore, India) were interviewed before the start of the IAYT treatment and prior to discharge of the patient. The patients were also interviewed pre and post and were observed once during their session. The data from the audio recordings from eight in-depth interviews were transcribed manually and qualitative analysis was conducted.

Results:

The conceptual frame-work of IAYT depicts that patient related factors (“co-operation of patient”, “patients awareness of his/her condition”), therapist related factors (“ability to guide”, “the assistance to the patients”, “explanation of the exercises”) and treatment related factors (“combination of psychiatric or Ayurvedic medication with yoga”, “counseling during the IAYT treatment”, duration of treatment), play an integrated role in reaching the “aim of IAYT” and experiencing “improvements and changes”.

Conclusion:

The IAYT is a holistic program and the ability of the patient to cooperate with and integrate the available factors (therapist related and treatment related) could enable best results.

The effectiveness of yoga for depression: a critical literature review

In the United States, the prevalence of depression is quite high-9% in the general population-with women, young adults, and seniors particularly vulnerable. In recent years, increasing numbers of people are turning to complementary and alternative medicine (CAM) for relief from depression and other mental health problems. One form of CAM, yoga, has been growing in popularity; this rise in popularity has, in part, been driven by interest in how this practice, with its mindfulness and meditation aspects, may decrease depression. This critical literature review examines six recent studies on yoga as an intervention; specifically, this review focuses on yoga styles in which the practice of yoga poses, called asanas, is the core component. Although the significant positive findings are promising, the studies had methodological limitations; identification of these limitations can inform future studies.

A pilot study of a randomized controlled trial of yoga as an intervention for PTSD symptoms in women

Posttraumatic stress disorder (PTSD) is a debilitating condition that affects approximately 10% of women in the United States. Although effective psychotherapeutic treatments for PTSD exist, clients with PTSD report additional benefits of complementary and alternative approaches such as yoga. In particular, yoga may downregulate the stress response and positively impact PTSD and comorbid depression and anxiety symptoms. We conducted a pilot study of a randomized controlled trial comparing a 12-session Kripalu-based yoga intervention with an assessment control group. Participants included 38 women with current full or subthreshold PTSD symptoms. During the intervention, yoga participants showed decreases in reexperiencing and hyperarousal symptoms. The assessment control group, however, showed decreases in reexperiencing and anxiety symptoms as well, which may be a result of the positive effect of self-monitoring on PTSD and associated symptoms. Between-groups effect sizes were small to moderate (0.08-0.31). Although more research is needed, yoga may be an effective adjunctive treatment for PTSD. Participants responded positively to the intervention, suggesting that it was tolerable for this sample. Findings underscore the need for future research investigating mechanisms by which yoga may impact mental health symptoms, gender comparisons, and the long-term effects of yoga practice.

Current evidence regarding the management of mood and anxiety disorders using complementary and alternative medicine

This article is an updated review on the potential uses of complementary and alternative medicine (CAM) approaches for the management of patients with mood and anxiety disorders. We have focused this current paper on the different types of disorders and the CAM intervention which might be useful. This is in distinction to the prior paper which focused on the CAM interventions. In addition, we have provided a discussion of more recent studies that help to further inform practitioners about CAM interventions in these disorders. Mood and anxiety disorders are among the most prevalent mental health issues affecting people today and there are many approaches towards their management. CAM interventions can include supplements, botanical remedies, meditation and spiritual practices, acupuncture, and dietary practices. There are a growing number of research studies on the effectiveness of CAM interventions in mood and anxiety disorders, and this review evaluates and critiques such data.

Complementary and alternative therapies as add-on to pharmacotherapy for mood and anxiety disorders: a systematic review

BACKGROUND

Depressed and anxious patients often combine complementary and alternative medicine (CAM) therapies with conventional pharmacotherapy to self-treat symptoms. The benefits and risks of such combination strategies have not been fully evaluated. This paper evaluates the risk-benefit profile of CAM augmentation to antidepressants in affective conditions.

METHODS

PubMed was searched for all available clinical reports published in English up to December 2012. Data were evaluated based on graded levels of evidence for efficacy and safety.

RESULTS

Generally, the evidence base is significantly larger for depression than for anxiety disorder. In unipolar depression, there is Level 2 evidence for adjunctive sleep deprivation (SD) and Free and Easy Wanderer Plus (FEWP), and Level 3 for exercise, yoga, light therapy (LT), omega-3 fatty acids, S-adenosylmethionine and tryptophan. In bipolar depression, there is Level 1 evidence for adjunctive omega-3s, Level 2 for SD, and Level 3 for LT and FEWP. In anxiety conditions, exercise augmentation has Level 3 support in generalized anxiety disorder and panic disorder. Though mostly well-tolerated, these therapies can only be recommended as third-line interventions due to the quality of available evidence.

LIMITATIONS

Overall, the literature is limited. Studies often had methodological weaknesses, with little information on long-term use and on potential drug-CAM interactions. Many CAM studies were not published in English.

CONCLUSIONS

While several CAM therapies show some evidence of benefit as augmentation in depressive disorders, such evidence is largely lacking in anxiety disorders. The general dearth of adequate safety and tolerability data encourages caution in clinical use.

Effects of yoga exercise on salivary beta-defensin 2

PURPOSE

Yoga stretching can be done comfortably and easily by beginners and older adults to compensate for lack of exercise or poor health maintenance. The aim of this study was to determine the effect of yoga stretching on mucosal immune functions, primarily human β-defensin 2 (HBD-2) in saliva.

METHODS

Fifteen healthy adults (age, 60.4 ± 8.0 years) participated in the study. Participants rested for 90 min on the first day and performed yoga for 90 min on the second day. Measurements were carried out before and after rest or yoga. Saliva samples were collected by chewing a sterile cotton at a frequency of 60 cycles per min. Salivary HBD-2 concentration was measured using an enzyme-linked immunosorbent assay.

RESULTS

HBD-2 concentration after yoga stretching (165.4 ± 127.1 pg/mL) was significantly higher than that before yoga stretching (84.1 ± 63.4 pg/mL; p < 0.01). HBD-2 expression rate after yoga stretching (232.8 ± 192.9 pg/min) was significantly higher than that before yoga stretching (110.7 ± 96.8 pg/min; p < 0.01). HBD-2 concentration (p < 0.05) and HBD-2 expression rate (p < 0.01) at post on the second day (yoga) was significantly higher than that on the first day (rest). POMS score of anger-hostility was lower after yoga than before.

CONCLUSIONS

Yoga stretching for 90 min can increase salivary HBD-2 expression in older adults. Therefore, yoga stretching might be useful for older adults and athletes to maintain their health.

Yoga in the Management of Overweight and Obesity

Although yoga may help manage conditions comorbid with overweight and obesity, such as low back pain, whether yoga helps with weight loss or maintenance beyond that which can be achieved with diet and exercise remains unclear. A search of multiple databases through September 2012 was undertaken identifying peer-reviewed studies on yoga, meditation, mindfulness, obesity, and overweight. Studies on yoga and weight loss are challenged by small sample sizes, short durations, and lack of control groups. In addition, there is little consistency in terms of duration of formal group yoga practice sessions, duration of informal practices at home, and frequency of both. Studies do however suggest that yoga may be associated with weight loss or maintenance. Mechanisms by which yoga may assist with weight loss or maintenance include the following: (a) energy expenditure during yoga sessions; (b) allowing for additional exercise outside yoga sessions by reducing back and joint pain; (c) heightening mindfulness, improving mood, and reducing stress, which may help reduce food intake; and (d) allowing individuals to feel more connected to their bodies, leading to enhanced awareness of satiety and the discomfort of overeating. Thus, yoga appears promising as a way to assist with behavioral change, weight loss, and maintenance.

Feasibility, acceptability, and effects of gentle Hatha yoga for women with major depression: findings from a randomized controlled mixed-methods study

Major depressive disorder (MDD) is a common, debilitating chronic condition in the United States and worldwide. Particularly in women, depressive symptoms are often accompanied by high levels of stress and ruminations, or repetitive self-critical negative thinking. There is a research and clinical imperative to evaluate complementary therapies that are acceptable and feasible for women with depression and that target specific aspects of depression in women, such as ruminations. To begin to address this need, we conducted a randomized, controlled, mixed-methods community-based study comparing an 8-week yoga intervention with an attention-control activity in 27 women with MDD. After controlling for baseline stress, there was a decrease in depression over time in both the yoga group and the attention-control group, with the yoga group having a unique trend in decreased ruminations. Participants in the yoga group reported experiencing increased connectedness and gaining a coping strategy through yoga. The findings provide support for future large scale research to explore the effects of yoga for depressed women and the unique role of yoga in decreasing rumination.

"A feeling of connectedness": perspectives on a gentle yoga intervention for women with major depression

Major depressive disorder (MDD) is one of the most common and debilitating health conditions in women in the United States and worldwide. Many women with MDD seek out complementary therapies for their depressive symptoms, either as an adjunct or alternative to the usual care. The purpose of this study is to understand the experiences of women who participated in a yoga intervention for their depression. The findings from this interpretive phenomenological study are derived from interviews with and daily logs by 12 women with MDD who took part in an 8-week gentle yoga intervention as part of a larger parent randomized, controlled trial. Results show that the women's experience of depression involved stress, ruminations, and isolation. In addition, their experiences of yoga were that it served as a self-care technique for the stress and ruminative aspects of depression and that it served as a relational technique, facilitating connectedness and shared experiences in a safe environment. Future long-term research is warranted to evaluate these concepts as potential mechanisms for the effects of yoga for depression.

The Efficacy of Yoga as an Intervention for Chronic Low Back Pain

Chronic low back pain (cLBP) is common and has a tremendous economic impact. With the prevalence and incidence of low back pain (LBP) on the rise, individuals often seek alternative treatments. Yoga is a widely used complementary and alternative medicine treatment for LBP. However, its efficacy as an intervention for LBP has not been thoroughly investigated. Therefore the purpose of this study was to systematically review the current literature for randomized controlled trials that assess the outcomes of Yoga as an intervention for individuals with cLBP. An electronic database search was performed for studies related to the efficacy of yoga in treatment for cLBP. Studies included were randomized control trials, published in English, from a peer-reviewed journal that identified yoga as the primary treatment focus for LBP in at least one group and included participants with at least a 12-week (3-month) history of symptoms. Our search revealed 185 articles. Of these, 10 met the inclusion criteria. We concluded Yoga intervention appears to be an efficacious intervention in alleviating cLBP. Yoga was demonstrated to significantly improve quality of life and reduce disability, stress, depression, and medication usage associated with cLBP in 8 of the 10 analyzed trials when compared with usual care, self-care book, or exercises. However, more research is necessary before recommendations can be made.

The influence of a yoga exercise program for young adults with intellectual disabilities

BACKGROUND

Individuals with intellectual disabilities (ID) have an increased risk of obesity and are significantly less likely to engage in physical activity compared to their nondisabled peers. A growing body of research supports the physical and mental health benefits of yoga. While the benefits of yoga have been studied across a host of populations with varying ages and physical disabilities, no studies could be identified investigating the benefits of yoga for young adults with ID.

AIMS

This study investigated the impact of participating in yoga classes on the amount of exercise behavior and perception of physical exertion when compared to non-structured exercise sessions between two young adults with ID in a post-secondary education setting.

MATERIALS AND METHODS

A single subject multiple baseline research design was implemented across two young adults with mild ID to determine the effects of a yoga exercise class on frequency of exercise behavior and perception of physical exertion when compared to non-structured exercise sessions. Partial interval recording, the Eston-Parfitt curvilinear rating of perceived exertion scale, and the physical activity enjoyment scale were implemented to collect data on dependent variables and consumer satisfaction during each non-structured exercise session and each yoga class.

RESULTS

indicated that percentage of exercise behavior and perceived exertion levels during yoga group exercise sharply increased with large effect sizes when compared to non-structured exercise sessions.

Yoga on our minds: a systematic review of yoga for neuropsychiatric disorders

BACKGROUND

The demand for clinically efficacious, safe, patient acceptable, and cost-effective forms of treatment for mental illness is growing. Several studies have demonstrated benefit from yoga in specific psychiatric symptoms and a general sense of well-being.

OBJECTIVE

To systematically examine the evidence for efficacy of yoga in the treatment of selected major psychiatric disorders.

METHODS

Electronic searches of The Cochrane Central Register of Controlled Trials and the standard bibliographic databases, MEDLINE, EMBASE, and PsycINFO, were performed through April 2011 and an updated in June 2011 using the keywords yoga AND psychiatry OR depression OR anxiety OR schizophrenia OR cognition OR memory OR attention AND randomized controlled trial (RCT). Studies with yoga as the independent variable and one of the above mentioned terms as the dependent variable were included and exclusion criteria were applied.

RESULTS

The search yielded a total of 124 trials, of which 16 met rigorous criteria for the final review. Grade B evidence supporting a potential acute benefit for yoga exists in depression (four RCTs), as an adjunct to pharmacotherapy in schizophrenia (three RCTs), in children with ADHD (two RCTs), and Grade C evidence in sleep complaints (three RCTs). RCTs in cognitive disorders and eating disorders yielded conflicting results. No studies looked at primary prevention, relapse prevention, or comparative effectiveness versus pharmacotherapy.

CONCLUSION

There is emerging evidence from randomized trials to support popular beliefs about yoga for depression, sleep disorders, and as an augmentation therapy. Limitations of literature include inability to do double-blind studies, multiplicity of comparisons within small studies, and lack of replication. Biomarker and neuroimaging studies, those comparing yoga with standard pharmaco- and psychotherapies, and studies of long-term efficacy are needed to fully translate the promise of yoga for enhancing mental health.