Effectiveness of Workplace Yoga Interventions to Reduce Perceived Stress in Employees: A Systematic Review and Meta-Analysis

The impact of yoga on occupational stress and wellbeing: exploring practitioners' experiences

Background

Workplace stress is a serious problem globally. It represents a major threat to the UN's sustainability goal of good health and wellbeing (SDG 3). The purpose of this article is to explore how yoga may be a tool for increased wellbeing and stress management at work and in everyday life.

Methods

To examine how yoga can facilitate employees' wellbeing and ability to cope with stress, we performed qualitative interviews with practitioners who did yoga regularly. We focused on how yoga was experienced by each of our interviewees and what practicing yoga meant to them. Our data material consists of 13 semi-structured lifeworld interviews. The sample consisted of 10 female and 3 male in the age range of 20-55 years old. The data were analyzed through a thematic analysis.

Results

The themes identified in the thematic analysis include: (1) yoga as a tool for increased wellbeing, (2) yoga for coping with stress and dealing with challenges, (3) the role of breathing, and (4) contextual factors. While confirming other research findings, this article elaborates on aspects informants described as induced by yoga, like self-awareness, calmness, balance, mood-lifting, focus, presence, self-care, and mastery. The reported positive outcomes of yoga constituted increased wellbeing, and also facilitated the ability to cope with stress and experience less stress. Informants also emphasized that yogic breathing was a central factor in inducing wellbeing and feeling less stressed. They also expressed that contextual factors, such as time, teacher, and location, influenced how practicing yoga was experienced and made sense of.

Conclusion

The study concludes that the interviewees experienced practicing yoga as positive, by reducing their occupational stress. Moreover, yoga increased their wellbeing, as well as their ability to cope with stress. These experienced changes were especially facilitated by yogic breathing, and influenced by contextual factors.

Randomized controlled trial investigating the role of yoga at workplace in improving fatigue, burnout, pain, strength, and quality of life among blue-collar workers

BACKGROUND

Due to the physical demands of work, blue-collar workers (BCW) frequently experience fatigue, musculoskeletal pain, and burnout. The purpose of this study was to determine the feasibility and utility of introducing yoga-based loosening exercises (YLE) at the workplace for improving fatigue, musculoskeletal pain, and burnout among BCW.

MATERIALS AND METHODS

One hundred and twenty-eight BCW were randomized into a yoga group that received 40 minutes of supervised YLE daily, 5 days a week, for 1 month, followed by 1 month of unsupervised practice at home or a waitlisted control group. The Chalder Fatigue Scale (CFS), Visual Analog Scale for pain, Oldenburg Burnout Inventory (OLBI), sit-and-reach test (SRT), handgrip strength dynamometer, and the Short Form-8 (SF-8) questionnaire were measured at baseline, at the end of the first month, and at follow-up after the first month.

RESULTS

All the participants adhered well to the YLE (≈86% at the workplace, ≈70% at home). Compared to the controls, the yoga group reported significant reductions in fatigue, pain, and burnout and significant improvements in flexibility, strength, and quality of life (P < 0.001) at all the time points.

CONCLUSION

Our findings demonstrate that workplace yoga programs for BCW are feasible and can considerably reduce fatigue, pain, and burnout and improve their quality of life.

Prevalence of stress and its relevance on psychological well-being of the teaching profession: A scoping review

Background

Well-being among teachers contributes toward quality work and better student support. Teachers' well-being persists to be a concern in school settings; there is a lacuna in understanding the concept of well-being among them. This scoping review identifies the stress factors and map their association with the psychological well-being of teachers employed in schools. Additionally, to identify the methodology and the interventions used in reducing teachers' stress and their relevance on their psychological well-being.

Methods

First, Pubmed, Web of Science, and Scopus databases were searched for eligible studies with MeSH terms for stress factors, well-being, and teachers from 2010 to 2022. Identified studies were screened thoroughly and excluded or included based on prior established criteria. Data from the included studies were extracted and summarized according to the study protocol.

Results

Among the 60 studies that met our inclusion criteria, the majority were quantitative, with cross-sectional studies. Several studies focused on emotional exhaustion, depersonalization, and diminished personal accomplishment aspect among teachers. Almost half of the included studies focused on organizational and social pressures such as administration workload, classroom management issues, lack of supervisor and team support, students' behaviour, and pressure from parents. The most used interventions to overcome stress were coping strategies and mindfulness training intervention tools.

Conclusions

The findings from the current scoping review will reveal the different stressors which impact psychological well-being. Focus on the most used interventions to overcome stress among schoolteachers. This will also provide recommendations to regulators and management to identify the factors causing stress among teachers and their relevance to their psychological well-being, overcome employee turnover and absenteeism issues. Also, different alternatives available to reduce the stress may benefit the stakeholders and policymakers to confirm a suitable intervention that will benefit the teaching profession.

Impact of 10-Min Daily Yoga Exercises on Physical and Mental Discomfort of Home-Office Workers During COVID-19

OBJECTIVE

Evaluate the effects of 10 min/day of yoga for 1 month on musculoskeletal discomfort and mood disturbance of home-office workers.

BACKGROUND

The COVID-19 pandemic forced many people to switch to teleworking. The abrupt change from an office setting to an improvised home-office may negatively affect the musculoskeletal and emotional health of workers. By providing mental and physical exercises, yoga may be effective in reducing adverse effects.

METHOD

Fifty-four participants (42 women, 12 men) followed a 1-month yoga program, while 40 participants (26 women, 14 men) continued with their common work routine. The Cornell Musculoskeletal Discomfort Questionnaire was used to evaluate severity, interference with work and frequency of pain, and to obtain a total discomfort score for 25 body areas. Mood disturbance was evaluated with the Profile of Mood States questionnaire. Both groups completed both questionnaires, before and after the experimentation period.

RESULTS

After 1 month, for the yoga group only, significant reductions were observed in the discomfort of eyes, head, neck, upper and lower back, right wrist, and hips/buttocks, as well as reductions in discomfort severity, frequency and interference for the neck, upper and lower back. Total mood disturbance was also significantly reduced for the yoga group only. No favorable changes occurred for the control group.

CONCLUSION

The yoga intervention program appears to reduce musculoskeletal discomfort and mood disturbance of home-office workers.

APPLICATION

Sedentary workers may benefit from 10 min/day of yoga during the workday to attenuate potential physical and emotional discomfort during the current pandemic and beyond.

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.

Incorporation of yoga in pharmacy education

BACKGROUND

The well-being of pharmacists is critical to support personal and professional health. Identifying and integrating a variety of practices that promote wellness is prudent for schools/colleges of pharmacy so students may form habits before entering the profession as practitioners. Yoga, a practice that combines muscular activity with mindfulness, can be incorporated with minimal resources via numerous mechanisms within and outside of the curriculum.

METHODS

The objective was to provide a summary of various strategies incorporating yoga in pharmacy professional curricula as well as detail various approaches to integrating yoga into pharmacy curricula. Literature was evaluated across professional pharmacy programs pertaining to yoga knowledge, beliefs, approaches, and benefits.

RESULTS

Ten articles about yoga awareness, knowledge, beliefs, and benefits in professional pharmacy curricula were identified. Improvement in mental health and decreased stress were recognized as benefits. Within schools/colleges of pharmacy, yoga programming has been included in required as well as elective courses, co-curriculum programming, extracurricular activities, and post-graduate training.

IMPLICATIONS

Schools of pharmacy can consider incorporation of yoga practice into curricula as a tool to promote well-being and resiliency.

Mindfulness-based stress reduction combined with early cardiac rehabilitation improves negative mood states and cardiac function in patients with acute myocardial infarction assisted with an intra-aortic balloon pump: a randomized controlled trial

Objective

To investigate the clinical effects of mindfulness-based stress reduction (MBSR) intervention combined with early cardiac rehabilitation (CR) on patients with acute myocardial infarction (AMI) assisted with an intra-aortic balloon pump (IABP).

Methods

A total of 100 AMI patients with IABP assistance due to hemodynamic instability at Wuhan Asia Heart Hospital were enrolled in the study. The participants were divided into two groups using the random number table method (n = 50 each group). Patients receiving routine CR were assigned to the CR control group, while patients receiving MBSR plus CR were assigned to the MBSR intervention group. The intervention was performed twice a day until the removal of the IABP (5-7 days). Each patient's level of anxiety/depression and negative mood state were evaluated before and after intervention using the self-rating anxiety scale (SAS), self-rating depression scale (SDS), and profiles of mood state scale (POMS). The results of the control and intervention groups were compared. IABP-related complications and left ventricular ejection fraction (LVEF), measured with echocardiography, were also assessed and compared between the two groups.

Results

The SAS, SDS, and POMS scores were lower in the MBSR intervention group than in the CR control group (P < 0.05). There were also less IABP-related complications in the MBSR intervention group. LVEF was significantly improved in both groups, but the degree of LVEF improvement was more significant in the MBSR intervention group than in the CR control group (P < 0.05).

Conclusions

MBSR combined with early CR intervention can assist in alleviating anxiety, depression, and other negative mood states, reduce IABP-related complications, and further improve cardiac function in AMI patients with IABP assistance.

The eSports Medicine: Pre-Participation Screening and Injuries Management-An Update

Recently, electronic sports (eSports) became one of the growing forms of new media due to the wide diffusion of games and online technologies. Even if there is still a debate about the definition and characterization of eSports, eAthletes train heavily, compete in tournaments, must abide by competition, association, and governing body rules, just like all other athletes. Furthermore, as in any other competitive discipline, there can be injuries. Aberrant sitting posture, repetitive movements, screen vision, prolonged playing hours, and a sedentary lifestyle can lead to several medical hazards in musculoskeletal, ophthalmology, neurological, and metabolic systems. Moreover, several cardiovascular changes occur in eAthletes. This paper aims to explore the different injuries that can occur in a professional eAthlete, suggesting how every high-level gamer could benefit from a pre-participation evaluation and a correct injury prevention strategy.

The Effects of Yoga Exercise on Blood Pressure and Hand Grip Strength in Chronic Stroke Patients: A Pilot Controlled Study

BACKGROUND

We investigated the beneficial effect of add-on yoga with rehabilitation on blood pressure (BP) and hand grip strength in patients with chronic stroke (more than 90 days).

METHODS

The study included patients 30-80 years of age who could stand independently for 1 min. Patients with psychiatric diseases or undergoing other therapies (like acupuncture) were excluded. The yoga group received training (1 h session twice weekly) with standard rehabilitation for 8 weeks. The control group received standard rehabilitation only. There were no differences in age, gender, hand grip strength, or BP between the two groups (16 subjects in each group) at baseline.

RESULTS

The systolic BP (p = 0.01) decreased significantly, and the diastolic BP also decreased but not significantly in the yoga group (p = 0.11). For hand grip strength, both the unaffected hand (p = 0.00025) and the affected hand (p = 0.027) improved significantly. The control group showed no significant change in systolic or diastolic BP, nor did the grip strength change in both hands. Gender and age also affected the results of overall rehabilitation in that women benefited more from a decrease in BP, while men and young people (lower than the mean age of 60) benefited from hand grip strength improvement.

CONCLUSIONS

Combining yoga with rehabilitation in chronic stroke patients can improve hand grip strength and decrease systolic BP.

Effect of Om chanting and Yoga Nidra on depression anxiety stress, sleep quality and autonomic functions of hypertensive subjects - a randomized controlled trial

INTRODUCTION

Hypertension (HTN) is a common and growing public health challenge with severe risk factors. Hence, this study aimed to assess the effect of Om chanting and Yoga Nidra on depression, anxiety, stress, sleep quality and autonomic functions on individuals with hypertension.

METHODS

This prospective randomized controlled study was conducted in patients with hypertension at Little Flower Medical Research Center. A total of 80 patients with diagnosed hypertension were recruited and randomized equally to either the experimental group or control group. The experimental group received a combination of Om chanting and Yoga Nidra for five days a week for two months. The control group participants continued with their regular conventional medications. Depression anxiety stress scale (DASS), Pittsburgh sleep quality index (PSQI) and heart rate variability (HRV) scores were assessed at baseline, 30 and 60 day for both the groups.

RESULTS

A total of 34 subjects in the experimental group and 31 subjects in the control group were included in the analysis. There was a significant (p<0.001) reduction in depression, anxiety, stress, and a significant (p<0.001) improvement in PSQI and HRV parameters in the experimental group was observed as compared to the control group. No adverse events were reported during the trial period.

CONCLUSIONS

The current study validates the effectiveness of Om chanting and Yoga Nidra in reducing depression, anxiety, stress and improving sleep quality and autonomic functions in hypertensive patients. These interventions could thus be considered a safer form of complementary therapy in managing stress and hypertension.

Impact of workplace yoga on pain measures, mental health, sleep quality, and quality of life in female teachers with chronic musculoskeletal pain: A randomized controlled study

BACKGROUND

Chronic pain conditions such as low back pain, knee pain and cervical pain are highly prevalent among female teachers. Chronic pain significantly affects the mental health, sleep and quality of life among teachers.

OBJECTIVE

This study is intended to investigate the impact of a workplace yoga intervention on musculoskeletal pain, anxiety, depression, sleep, and quality of life (QoL) among female teachers who had chronic musculoskeletal pain.

METHOD

Fifty female teachers aged between 25-55 years with chronic musculoskeletal pain were randomized to either the yoga group (n = 25) or the control group (n = 25). The yoga group received a 60-minute structured Integrated Yoga intervention (IY) four days a week for six consecutive weeks at school. The control group received no intervention.

OUTCOME MEASURES

Pain intensity, anxiety, depression, stress, fatigue, self-compassion, sleep quality, and quality of life were assessed at the baseline and six weeks.

RESULTS

A significant (p < 0.05) reduction in pain intensity and pain disability in the yoga group was observed after 6-week compared to baseline. Anxiety, depression, stress, sleep scores and fatigues also improved in the yoga group after six weeks. The control group showed no change. Post score comparison showed a significant difference between the groups for all the measures.

CONCLUSION

Workplace yoga intervention is found to be effective in improving pain, pain disability, mental health, sleep quality among female teachers with chronic musculoskeletal pain. This study strongly recommends yoga for the prevention of work-related health issues and for the promotion of wellbeing among teachers.

Stress Reduction by Yoga versus Mindfulness Training in Adults Suffering from Distress: A Three-Armed Randomized Controlled Trial including Qualitative Interviews (RELAX Study)

Distress is a growing public health concern. In this three-armed randomized controlled trial, n = 102 adults with elevated stress levels and stress-related symptoms were randomly assigned to (1) “integrative” yoga classes which combined physical exercises, mindfulness training, and ethical/philosophical aspects of traditional yoga; to (2) Iyengar yoga classes which entailed primarily physical exercises; or to (3) mindfulness training without physical training. We hypothesized the synergistic effects of physical yoga exercises, mindfulness, and ethical/philosophical aspects. The primary outcome was the group difference on Cohen’s Perceived Stress Scale (PSS) after 12 weeks. Secondary outcomes included burnout, quality of life, physical complaints, depression, anxiety, mindfulness, interoceptive awareness, self-regulation, spirituality, mysticism, and posttraumatic stress. All outcomes were evaluated at baseline (V0), after 12 weeks (V1), and after 24 weeks (V2). A subset of participants took part in qualitative interviews. A lasting and clinically relevant stress reduction was observed within all groups (PSS ΔV0−V1Integrative Yoga = −6.69 ± 6.19; ΔV0−V1Iyengar Yoga = −6.00 ± 7.37; ΔV0−V1Mindfulness = −9.74 ± 7.80; all p < 0.00). Effect sizes were also statistically large at the end of the follow-up period (Cohen’s d Integrative Yoga = 1.41; d Iyengar Yoga = 1.37; d Mindfulness = 1.23). There were no significant group differences or evidence of relevant synergistic effects from combining mindfulness and physical yoga exercises. All three interventions were found to be equally effective methods of stress reduction. Their use in practice should be based on availability and patient preference.

The complex relationship between physical activity and diabetes: an overview

Diabetes mellitus (DM) is a widespread condition, representing a challenging disease to manage. Exercise is being increasingly recommended as part of the therapeutic regimen for DM but the management of different forms of physical activity is difficult for individuals with diabetes, trainers, and physicians. Regular exercise can improve health and well-being, helping individuals to achieve their target lipid profile, body composition, cardio-respiratory fitness, and glycemic goals. People with diabetes tend to be as inactive as the general population, with a large percentage of individuals not achieving the minimum amount of recommended physical activity levels. Indeed, several barriers to exercise exist for persons with diabetes, including sports eligibility, multi-modality management of diabetic athletes, and inadequate knowledge about adequate type and intensity of exercise. The aim of the present review is to provide the current understanding of mechanisms, recommendations, and beneficial effects of different modalities of exercise for the treatment of DM.

Impact of mental toughness on athlete's performance and interventions to improve

Mental toughness is the ability to handle pressure, adversity, and stress by overcoming failures. It is also the state of persisting without refusing to quit, with the possession of superiority in mental skills. This review aimed to describe the effect of mental toughness on the performance of athletes and also to have an insight into the various interventions to improve mental toughness. For this, PubMed was searched using the appropriate keywords till December 2021 and a narrative synthesis was performed. Mental tightness was evident to be correlated with many important aspects such as better performance, goal progress, withholding stress, coping, optimism and self-reflection. It also helps in a better level of confidence, constancy, control, positive cognition, visualization and challenges than the opponent team. Many interventional strategies have been adopted in previous years which mainly focused on personalized programs including psychological skills training, coping and optimism training, mindfulness, yoga, general relaxation, imagery, and a combination of both, and many more other aspects were observed to be effective in improving mental toughness. However, physical training alone did not observe to be beneficial. The current evidence indicates the important role of mental toughness on the sports performance of athletics and the role of various interventional strategies focusing on mindfulness and psychological interventions in improving mental toughness. All these interventional strategies need to be implemented in the actual practice.

High-intensity interval training for chronic pain conditions: a narrative review

Chronic pain is defined as pain that persists past the normal healing time. Physical activity and exercise programs are increasingly being promoted and used for a variety of chronic pain conditions. Evidence suggests that physical exercise is an intervention with few adverse events that may improve pain severity and physical function, thus improving the quality of life. High-intensity interval training (HIIT) has been shown to improve physical outcome measures and to decrease disorder-related disability in people with chronic disorders. Since an overview of the benefits of HIIT on chronic pain conditions has not been published yet, this review aims to report the effects of HIIT alone or in combination with other forms of training on different kind of chronic pain conditions. A search in the main scientific electronic databases was performed. The results of the studies included in this review showed that HIIT is beneficial for several chronic pain conditions, improving pain and physical function. Since HIIT could represent a valid help to conventional drug therapies, it could improve the quality of life of these subjects. The actual quality of evidence remains very low, and further high evidence studies are needed to confirm the promising outcomes reported in this review.

Systematic Review for the Medical Applications of Meditation in Randomized Controlled Trials

Background: Meditation has been increasingly adapted for healthy populations and participants with diseases. Its beneficial effects are still challenging to determine due to the heterogeneity and methodological obstacles regarding medical applications. This study aimed to integrate the features of therapeutic meditation in randomized controlled trials (RCTs). Methods: We conducted a systematic review of RCTs with meditation for populations with diseases using the PubMed database through June 2021. We analyzed the characteristics of the diseases/disorders, participants, measurements, and their overall benefits. Results: Among a total of 4855 references, 104 RCTs were determined and mainly applied mindfulness-based (51 RCTs), yoga-based (32 RCTs), and transcendental meditation (14 RCTs) to 10,139 patient-participants. These RCTs were conducted for participants with a total of 45 kinds of disorders; the most frequent being cancer, followed by musculoskeletal and connective tissue diseases and affective mood disorder. Seven symptoms or signs were frequently assessed: depressive mood, feeling anxious, quality of life, stress, sleep, pain, and fatigue. The RCTs showed a higher ratio of positive outcomes for sleep (73.9%) and fatigue (68.4%). Conclusions: This systematic review produced the comprehensive features of RCTs for therapeutic meditation. These results will help physicians and researchers further study clinical adaptations in the future as reference data.

Determining the effect of yoga on job satisfaction and burnout of nurse academicians

PURPOSE

This study was conducted to determine the effect of yoga on burnout and job satisfaction of nursing academicians.

DESIGN AND METHODS

The research is an experimental clinical trial conducted as pretest-posttest with control groups between March and August 2019 in a Nursing Faculty. Participants in the experimental group were given yoga practice (n = 33) twice a week for 8 weeks. Data were collected by using MBI and MSQ.

FINDINGS

The experimental group's mean posttest Personal Achievement, Extrinsic Satisfaction and General Satisfaction scores were higher than that of control group participants, and a highly significant difference was found between the groups.

PRACTICE IMPLICATIONS

Yoga practice is effective in reducing the burnout and increasing job satisfaction of nursing academicians.

Stress, psychological distress and support in a health care organization during Covid-19: A cross-sectional study

AIM

The main aim of this study was to understand what health and wellbeing initiatives are helpful for health care workers' stress and psychological distress during the Covid-19 pandemic.

BACKGROUND

Health care workers are at increased risk of poor mental health during health emergencies; understanding support required for health care workers is of paramount importance.

METHODS

Participants were health care workers at a health and social care organization (N = 159). The study included an online questionnaire including an evaluation of health and wellbeing initiatives and measures of perceived stress and psychological distress.

RESULTS

The highest rated resources were counselling, personal protective equipment (PPE) and Covid-19 testing. Those who accessed yoga reported significantly less stress and psychological distress than those who did not access yoga.

CONCLUSIONS

Health care workers with higher stress and psychological distress felt less supported by their organization, less listened to and less involved in organizational decisions.

IMPLICATIONS FOR NURSING MANAGEMENT

Practical implications are discussed such as forward planning for health emergencies (e.g., PPE supply), accessible Covid-19 testing as well as budgeting for counselling services and exercise classes. In addition, targeted support for those diagnosed with Covid-19 is recommended, alongside involvement of staff members in organizational decisions.

How does yoga practice and therapy yield psychological benefits? A review and model of transdiagnostic processes

Interest in yoga as an intervention for psychological wellbeing has increased in recent years, with literature investigating beneficial effects in a variety of presentations and settings. The theoretical understanding of this benefit has previously focused on physiological changes involved in yoga practice, however interest has turned to the potential psychological mechanisms eliciting psychological wellbeing. The current paper builds on previous theory and argues that yoga practice targets transdiagnostic psychological processes; mechanisms that feature commonly across a wide range of presentations, thus reducing distress and increasing wellbeing across clinical and non-clinical populations. Features of yoga practice are discussed in relation to these transdiagnostic processes and the features of modern talking therapies. A new model is proposed positing specific aspects of yoga practice correlate with specific transdiagnostic processes to elicit psychological change and argues that the mechanisms by which change occurs are directly compared with the changes observed in talking therapies. The implications for future research and the potential for this to support the commissioning of holistic approaches in clinical practice are discussed.

Effects of yoga on stress, fatigue, musculoskeletal pain, and the quality of life among employees of diamond industry: A new approach in employee wellness

BACKGROUND

Diamond industry employees often experience musculoskeletal pain, fatigue, and stress, contributing to a low quality of life (QoL). Yoga is an ancient discipline of mind-body practice Yoga has numerous health benefits.

OBJECTIVE

This study investigated the efficacy of workplace yoga in improving stress, musculoskeletal pain, fatigue, and QoL among employees of the diamond industry.

METHODS

One-hundred sixty-six employees of the diamond industry between the ages of 20 and 60 participated in the study. Participants were assigned to either yoga (n = 84) or waitlist (n = 82) groups. The yoga group received one hour of yoga, four days a week for three consecutive months. Participants in the waitlist group followed their daily routines. Musculoskeletal pain, fatigue, stress, and QoL were assessed at baseline and after three months.

RESULTS

One-hundred fifty-five employees completed the study. The yoga group showed significant (p < 0.05) improvement in pain, perceived stress, fatigue, and QoL domains after three months compared to baseline. The waitlist group showed no significant improvement in any of the measures. In the post scores comparison between the groups revealed a significant difference between the groups.

CONCLUSION

Workplace yoga found to be a useful, cost-effective and feasible intervention in improving stress, musculoskeletal pain, fatigues and quality of life among employees of the diamond industry. Yoga may be implemented in the workplace as a wellness program at the workplace.

Feasibility and outcome of an online streamed yoga intervention on stress and wellbeing of people working from home during COVID-19

BACKGROUND

The outbreak of COVID-19 and its associated measures has resulted in a sizeable working population transitioning to working from home (WFH), bringing additional challenges, and increasing work-related stress. Research has indicated that yoga has promising potential in reducing stress in the workplace. However, there are very few studies exploring the impact of online streamed yoga on stress management for people-WFH.

OBJECTIVE

To investigate the feasibility and outcome of an online streamed yoga intervention on stress and wellbeing of people-WFH during COVID-19.

METHODS

A six-week pilot randomized controlled trial (RCT) yoga intervention was designed with yoga (n = 26) and a wait-list control group (n = 26). A mixed two-way ANOVA was used to assess changes in standardised outcome measures at baseline and post-intervention. Likert and open-ended questions assessed enjoyment, acceptability and perceived benefits of the program, which were analysed thematically.

RESULTS

Compared with the control, the yoga group reported significant improvements in perceived stress, mental wellbeing, depression and coping self-efficacy, but not stress and anxiety. Participants experienced physical and mental health benefits and reported high acceptability and enjoyment of the intervention.

CONCLUSIONS

An online yoga intervention can help people WFH manage stress and enhance wellbeing and coping abilities.

Prevalence of Balance Impairment and Factors Associated with Balance among Patients with Stroke. A Cross Sectional Retrospective Case Control Study

Stroke is a major cause of disability worldwide, and balance impairments are common disabling factors in patients with stroke, leading to falls. Thus, the study objectives were as follows: (i) To find the prevalence of balance impairment among patients with stroke. (ii) To find out the factors associated with balance impairment in patients with stroke. This cross-sectional retrospective case control study involved eighty-one post stroke patients with a mean age of 58.36 ± 14.06, recruited from six hospitals, who underwent an assessment of balance, walking speed, depression and isometric strength of the ankle and knee. These patients were later categorized into subjects with good balance (<45) in the Berg balance scale (BBS) and those with poor balance (≥45), as cases and controls, to assess the factors associated with balance impairment using binary logistic regression. The prevalence of balance impairment among patients with stroke was 48.1%. The reduction in power of knee flexors (OR = 0.858), knee extensors (OR = 0.880) and ankle dorsiflexors (OR = 0.820) was found to be significantly associated with balance impairment, along with speed (OR = 1.187 (95% CI = 1.100, 1.280)), depression (OR = 1.331 (95% CI = 1.055-1.679)) and activities of daily living (OR = 0.313 (95% CI = 0.150-0.650)). In summary, around half of the patients with stroke exhibited balance impairments, with females being more prone.

Development and Feasibility Testing of a Brief Yoga Module on Well-being and Cognition of Postgraduate Mental Healthcare Students in Tertiary Settings

BACKGROUND

Mental health-care students experience stress and burnout during their training period. Yoga has been found to be helpful in improving one's mental health and well-being.

AIM

The aim of this study is to develop and test the feasibility of a brief yoga module for postgraduate mental health-care students.

METHODS

Amixed method design was used. Phase 1 involved development and validation of the yoga module using the qualitative exploratory method. Phase II tested the feasibility of the module on a sample of 28 first-year postgraduate students. These students participated in a 15-day (30 min/day) brief yoga module for improving their well-being and cognition (mirror neuron activation [MNA] and tower of London task as assessed on day 0, day 15 (2 weeks), and day 30 (4 weeks). Qualitative feedback of the student volunteers was also recorded.

RESULTS

Significant improvement in the well-being scores was observed in the students who adhered to the yoga practice after 2 weeks and 4 weeks. Functional near infra-red spectroscopy (fNIRS) data indicated that adherents showed significant activation of left somatosensory region of the brain and deactivation in the right primary somatosensory region during the static and active phase of the MNA task, respectively. Adherent group showed significant improvement in reaction time during "Zero-Moves" tasks of Tower of London. The qualitative thematic analysis showed that the module helped improve the well-being and mental health of the students.

CONCLUSION

The yoga program was found to have high need and medium to high feasibility. A systemic integration of student well-being-oriented interventions including yoga in the curriculum of postgraduate mental health-care courses is advocated.

Physical relaxation for occupational stress in healthcare workers: A systematic review and network meta-analysis of randomized controlled trials

OBJECTIVES

Work related stress is a major occupational health problem that is associated with adverse effects on physical and mental health. Healthcare workers are particularly vulnerable in the era of COVID-19. Physical methods of stress relief such as yoga and massage therapy may reduce occupational stress. The objective of this systematic review and network meta-analysis is to determine the effects of yoga, massage therapy, progressive muscle relaxation, and stretching on alleviating stress and improving physical and mental health in healthcare workers.

METHODS

Databases were searched for randomized controlled trials on the use of physical relaxation methods for occupational stress in healthcare workers with any duration of follow-up. Meta-analysis was performed for standard mean differences in stress measures from baseline between subjects undergoing relaxation vs non-intervention controls. Network meta-analysis was conducted to determine the best relaxation method.

RESULTS

Fifteen trials representing 688 healthcare workers were identified. Random-effects meta-analysis shows that physical relaxation methods overall reduced measures of occupational stress at the longest duration of follow-up vs baseline compared to non-intervention controls (SMD -0.53; 95% CI [-0.74 to -0.33]; p < .00001). On network meta-analysis, only yoga alone (SMD -0.71; 95% CI [-1.01 to -0.41]) and massage therapy alone (SMD -0.43; 95% CI [-0.72 to -0.14]) were more effective than control, with yoga identified as the best method (p-score = .89).

CONCLUSION

Physical relaxation may help reduce occupational stress in healthcare workers. Yoga is particularly effective and offers the convenience of online delivery. Employers should consider implementing these methods into workplace wellness programs.

Effect of Video Observation and Motor Imagery on Simple Reaction Time in Cadet Pilots

Neuromotor training can improve motor performance in athletes and patients. However, few data are available about their effect on reaction time (RT). We investigated the influence of video observation/motor imagery (VO/MI) on simple RT to visual and auditory stimuli. The experimental group comprised 21 cadets who performed VO/MI training over 4 weeks. Nineteen cadets completed a sham intervention as control. The main outcome measure was RT to auditory and visual stimuli for the upper and lower limbs. The RT to auditory stimuli improved significantly post-intervention in both groups (control vs. experimental mean change for upper limbs: -40 ms vs. -40 ms, p = 0.0008; for lower limbs: -50 ms vs. -30 ms, p = 0.0174). A trend towards reduced RT to visual stimuli was observed (for upper limbs: -30 ms vs. -20 ms, p = 0.0876; for lower limbs: -30 ms vs. -20 ms, p = 0.0675). The interaction term was not significant. Only the specific VO/MI training produced a linear correlation between the improvement in the RT to auditory and visual stimuli for the upper (r = 0.703) and lower limbs (r = 0.473). In conclusion, VO/MI training does not improve RT when compared to control, but it may be useful in individuals who need to simultaneously develop a fast response to different types of stimuli.