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Yadav SS, Saoji AA, Somanadhapai S, Yadav NL, Upadhyay J, Rishi NN, Thapa R. Effect of Yoga-based breathing practices on depression, anxiety, stress, and fear of COVID-19 positive hospitalized patients: A randomized controlled trial. J Ayurveda Integr Med 2024; 15:100897. [PMID: 38527392 PMCID: PMC10982563 DOI: 10.1016/j.jaim.2024.100897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 01/18/2024] [Accepted: 01/30/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND COVID-19 infection has an impact on the mental state of patients and requires attention to mental health care. OBJECTIVE The aim of this study is to assess the effect of Yoga-based breathing practices on the mental state of patients with COVID-19. MATERIAL AND METHODS A randomized controlled trial was conducted with63 patients (male=46) who were RT-PCR positive for COVID-19 and hospitalized with asymptomatic (RT-PCR positive but no symptoms), mild (febrile, body ache, pharyngitis, nonproductive cough), and moderate (SpO2< 92%) symptoms assigned in the yoga (n=32) and control group (n=31). The study was conducted at Atharva Multispecialty Hospital and Research Center, North India. The yoga group received Yoga-based breathing practices twice a day for ten days in addition to conventional care, and the control group was advised not to do the practice. The Depression Anxiety and Stress scale (DASS-21) and fear of COVID-19 were assessed at baseline and after 10 days. Repeated measures ANOVA with Bonferroni correction was used to assess between and within subjects' effects. RESULTS The experimental group had better scores for depression, anxiety, stress, total DASS scores, and fear of COVID-19 (p<0.001) when compared with the control group. Within the group, analyses demonstrated improved scores in all domains in the yoga group (p<0.001) by the end of the intervention. In contrast, the control group improved only in stress scores (p=0.002), total DASS scores (p=0.012), and fear of COVID-19 (p=0.039). There are no adverse effects seen with Yoga-based breathing practices in these patients. CONCLUSION Yoga-based breathing practices have been found to have positive impact on mental health among COVID-19-positive patients during hospitalization. TRIAL REGISTRY NUMBER CTRI CTRI/2022/03/041071 Clinical Trials-Registry in India.
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Affiliation(s)
- Sunil Singh Yadav
- Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India; Faculty of Naturopathy and Yogic Sciences, SGT University, Gurgaon, India.
| | | | | | | | - Junu Upadhyay
- Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Niraj Nayan Rishi
- Maharishi Aurobindo Subharti College and Hospital of Naturopathy and Yogic Sciences, Swami Vivekanand Subharti University, Meerut, India
| | - Rita Thapa
- Maharishi Aurobindo Subharti College and Hospital of Naturopathy and Yogic Sciences, Swami Vivekanand Subharti University, Meerut, India
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Rain M, Puri GD, Bhalla A, Avti P, Subramaniam B, Kaushal V, Srivastava V, Mahajan P, Singh M, Pandey N, Malhotra P, Goel S, Kumar K, Sachdeva N, Maity K, Verma P, Dixit N, Gupta SJ, Mehra P, Nadholta P, Khosla R, Ahuja S, Anand A. Effect of breathing intervention in patients with COVID and healthcare workers. Front Public Health 2022; 10:945988. [PMID: 36249235 PMCID: PMC9561424 DOI: 10.3389/fpubh.2022.945988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/29/2022] [Indexed: 01/21/2023] Open
Abstract
Background Regulated breathing facilitates ventilation and reduces breathlessness. However, the effect of Yogic breathing on patients with COVID remains unclear. We aimed to evaluate the efficacy of two breathing protocols, i.e., short breathing technique (SBT) and long duration breathing technique (LBDT). Methods Three groups including COVID-positive patients, COVID-recovered patients, and healthcare workers (HCWs) were included in the study and segregated into Yoga and control groups. SBT was administered to COVID-positive patients. Both SBT and LBDT were administered to COVID-recovered patients and HCWs. A total of 18 biochemical parameters, a 6-min walk test (6MWT), and a 1-min sit-stand test (1MSST) were assessed on 0th, 7th, and 15th days, where biochemical parameters were the primary outcome. Pre-post estimation of neuropsychological parameters (nine questionnaires) and heart rate variability (HRV) were carried out. The paired t-test or Wilcoxon rank test was applied for pre-post comparison and the Student's t-test or Mann-Whitney U test was used for group comparison. Repeated measures test was applied for data recorded at three time points. Results A significant elevation in white blood cell (WBC) count was observed in COVID-positive intervention (p < 0.001) and control groups (p = 0.003), indicating no role of intervention on change in WBC number. WBC count (p = 0.002) and D-dimer (p = 0.002) significantly decreased in the COVID-recovered intervention group. D-dimer was also reduced in HCWs practicing Yogic breathing as compared to controls (p = 0.01). D-dimer was the primary outcome, which remained below 0.50 μg/ml (a cutoff value to define severity) in the COVID-positive yoga group (CYG) and decreased in the COVID-recovered yoga group (RYG) and the HCW yoga group (HYG) after intervention. A 6-min walk test (6MWT) showed an increase in distance covered among the COVID-positive patients (p = 0.01) and HCWs (p = 0.002) after intervention. The high-frequency power (p = 0.01) was found to be reduced in the COVID-positive intervention group. No significant change in neuropsychological parameters was observed. Conclusion Yogic breathing lowered D-dimer, which is helpful in reducing thrombosis and venous thromboembolism in patients with COVID-19 besides lowering the chances of vaccine-induced thrombotic thrombocytopenia in vaccinated individuals. The breathing intervention improved exercise capacity in mild to moderate cases of COVID-19. Further studies can show if such breathing techniques can influence immunity-related genes, as reported recently in a study. We suggest that Yogic breathing may be considered an integrative approach for the management of patients with COVID. Trial registration http://ctri.nic.in/Clinicaltrials/login.php, identifier: CTRI/2020/10/028195.
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Affiliation(s)
- Manjari Rain
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Goverdhan Dutt Puri
- Department of Anesthesia, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Aashish Bhalla
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pramod Avti
- Department of Biophysics, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Pramod Avti
| | | | - Vipin Kaushal
- Department of Hospital Administration, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vinod Srivastava
- College of Health and Behavioral Sciences, Fort Hays State University, Hays, KS, United States
| | - Pranay Mahajan
- Department of Hospital Administration, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Mini Singh
- Department of Virology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Navin Pandey
- Department of Hospital Administration, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Malhotra
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sonu Goel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Krishan Kumar
- Department of Psychiatry, Post Graduate 30 Institute of Medical Education and Research, Chandigarh, India
| | - Naresh Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kalyan Maity
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Prashant Verma
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Interdisciplinary Centre for Swami Vivekananda Studies, Panjab University, Chandigarh, India
| | - Nishant Dixit
- Department of Psychology, Panjab University, Chandigarh, India
| | - Sheetal Jindal Gupta
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Priya Mehra
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Department of Biotechnology, Panjab University, Chandigarh, India
| | - Pooja Nadholta
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Radhika Khosla
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Akshay Anand
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Centre of Phenomenology and Cognitive Sciences, Panjab University, Chandigarh, India,CCRYN-Collaborative Center for Mind Body Intervention Through Yoga, Post Graduate Institute of Medical Education and Research, Chandigarh, India,*Correspondence: Akshay Anand
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Chang TFH, Ley BL, Ramburn TT, Srinivasan S, Hariri S, Purandare P, Subramaniam B. Online Isha Upa Yoga for student mental health and well-being during COVID-19: A randomized control trial. Appl Psychol Health Well Being 2022; 14:1408-1428. [PMID: 35064741 DOI: 10.1111/aphw.12341] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 01/07/2022] [Indexed: 12/22/2022]
Abstract
College students experienced increased stress and anxiety during the COVID-19 pandemic. This study evaluated the effect of brief online Isha Upa Yoga modules on undergraduates' mental health and well-being. Randomized control trial (RCT) with waitlist control crossover (N = 679). The intervention group was instructed to learn and practice the modules daily for 12 weeks. At the end of the 4-week RCT, the control group was instructed to learn and practice the modules for the remaining 8 weeks. Primary outcomes included stress and well-being. Secondary outcomes included anxiety, depression, resilience, positive affect and negative affect. Linear mixed-effects models were used for analyses. Isha Upa Yoga significantly reduced stress (Group [intervention, control] × Time [baseline, Week 4] interaction, p = .009, d = .27) and increased well-being (Group × Time interaction p = .002, d = .32). By the study's end, the intervention and control groups experienced significant improvements in well-being (p < .001, p < .001), stress (p < .001, p < .001), anxiety (p < .001, p < .001), depression (p < .001, p = .004), positive affect (p = .04, p < .001), and negative affect (p < .001, p < .001). Online Isha Upa Yoga shows promise for mitigating the pandemic's negative impact on undergraduates' mental health and improving their well-being.
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Affiliation(s)
- Tracy F H Chang
- School of Management and Labor Relations, Rutgers University, Piscataway, New Jersey, USA
| | - Barbara L Ley
- Departments of Women & Gender Studies and Communication, University of Delaware, Newark, Delaware, USA
| | - Triya T Ramburn
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | | | - Sepideh Hariri
- Sadhguru Center for a Conscious Planet, Beth Israel Deaconess Medical Center, Harvard Medical University, Boston, Massachusetts, USA
| | | | - Balachundhar Subramaniam
- Sadhguru Center for a Conscious Planet, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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El Hayek S, Kassir G, Zalzale H, Gonzalez-Diaz JM, Bizri M. Emerging Psychiatric Themes in Post-COVID-19 Patients on a Psychiatry Consultation-liaison Service. Psychiatr Q 2021; 92:1785-1796. [PMID: 34463904 PMCID: PMC8405712 DOI: 10.1007/s11126-021-09944-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2021] [Indexed: 01/19/2023]
Abstract
The need for consultation-liaison psychiatry on COVID-19 wards has substantially increased since the start of the pandemic. In this cross-sectional study, we aimed to summarize the characteristics of patients admitted to the post-COVID-19 ward of the American University of Beirut Medical Center who received a psychiatric consultation. We collected relevant sociodemographic and medical data, information about past psychiatric history, psychiatry consultation details, hospital course, and disposition outcome. We also conducted chi-square and binary logistic regression analyses to assess the association between the different variables and disposition outcome. A total of 52 patients (mean age 57.33 years; equal gender distribution) were seen by the psychiatry consult-liaison team. Most had medical comorbidities and 21.2% required intubation. The most prevalent psychiatric diagnoses were delirium (30.8%), major depressive episode (15.4%), and other anxiety disorder (15.4%). Pharmacological management was implemented in 90.4% of cases and mainly included second-generation antipsychotics (36.5%). Non-pharmacological interventions consisted of those related to delirium and therapy for anxiety. Only intubation was significantly associated with disposition outcome (p = 0.004). This study highlights the various psychiatric themes emerging during the acute and post-acute periods of hospitalization for COVID-19. Hospitalized individuals recovering from the infection should be diligently screened and referred to the psychiatry consultation-liaison team to ensure the implementation of appropriate interventions.
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Affiliation(s)
- Samer El Hayek
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ghida Kassir
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Hussein Zalzale
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Jairo M Gonzalez-Diaz
- UR Center for Mental Health - CERSAME, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
- Clínica Nuestra Señora de La Paz, Bogota, Colombia
- Barcelona Clínic Schizophrenia Unit, Neurosciences Institute, Barcelona University, Barcelona, Spain
| | - Maya Bizri
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon.
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