Exploring the Effect of Trataka (A Yogic Cleansing Technique) and Cold Eye Pack on Eye Strain During COVID-19 Pandemic: A Randomized Three-Arm Trial

Objective: Computer vision syndrome is a major global public health concern affecting >60 million individuals globally. Yoga and naturopathy practices can reduce visual fatigue and strain. The present study attempted to explore the effect of trataka that is, a yogic cleansing technique and cold eye pack on visual strain and fatigue. Subjects: Three hundred volunteers from an IT company were recruited following inclusion and exclusion criteria. Intervention: The subjects were randomly distributed in three groups, that is, trataka, cold eye pack, and waitlist control group with an allocation ratio of 1:1:1. Outcome measure: Visual Fatigue Scale and Visual symptoms checklist (VSC) was administered at baseline and end of 2 weeks. Repeated measures analysis of variance (RM-ANOVA) with Bonferroni corrections was used to test the difference across the groups. Results: All the variables were similar at the baseline among the groups. Significant changes in the within-group analysis occurred in both the trataka and cold eye pack groups. The RM-ANOVA revealed significant differences in the VAS and VSC (p = 0.001) and the post hoc analysis suggested that there were significant differences in both the trataka and cold eye pack group when compared with the control group (p = 0.001); however, there was no differences between the trataka and cold eye pack group in both the scales (p = 1). Conclusions: The results of the present study suggest that a trataka and cold eye pack for 14 days improves self-rated visual strain and fatigue among IT professionals with computer vision syndrome. Clinical Trial registration number: CTRI/2020/11/029003.

Effect of Yoga-based breathing practices on depression, anxiety, stress, and fear of COVID-19 positive hospitalized patients: A randomized controlled trial

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.

Yoga for musculoskeletal pain, discomfort, perceived stress, and quality of sleep in industry workers: a randomized controlled trial

BACKGROUND AND OBJECTIVES

Work-related musculoskeletal pain and discomfort are due to repetitive, unnatural, continuous movements and postures. Yoga therapy is beneficial for pain and disability in occupational settings. The current study aims to investigate the effect of yoga on musculoskeletal pain, stress, and sleep quality among industry workers.

METHODOLOGY

The study was conducted as a parallel randomized controlled open-label trial. An allocation ratio of 1:1 was followed for randomization. A health survey was used to recruit 90 male workers in machinery manufacturing industries from Bengaluru. A specially designed yoga module was administered five days a week for eight weeks to yoga group. The waitlisted control group received lifestyle suggestions. Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), Perceived Stress Scale (PSS), and Pittsburgh Sleep Quality Index (PSQI) were administered at baseline, at the fourth week and eighth weeks. Repeated Measures Analysis of Variance (RM-ANOVA) was conducted to elicit the group*time interactions.

RESULTS

Ninety participants (Yoga = 45, Control = 45) with age 40.57 ± 6.85 were randomized. Significant interactions were found in CMDQ, VAS, PSS and PSQI scores. Further, between group comparison demonstrate significant difference between the groups at the end of 8 weeks for CMDQ, VAS and PSS scores.

CONCLUSIONS

Yoga can be used to reduce musculoskeletal pain, discomfort, perceived stress and improve sleep quality among industry workers.

TRIAL REGISTRATION NUMBER

CTRI/2022/03/040894.

Designing and validation of Yoga module for workers with prolonged standing

BACKGROUND

Prolonged standing is a part of several professions, which can have physical and psychosocial implications. Yoga as a mind-body therapy may be useful to prevent and manage such health issues. However, there is a lack of a standardized yoga module addressing the health issues of workers with prolonged standing.

OBJECTIVES

Thus, the present study was undertaken to design and validate a specific yoga module for the target population.

METHODS

A yoga module was prepared by reviewing yoga texts for the specific needs of the target population. This was validated for content validity for the experts on a Likert scale. 71 yoga experts validated the module. The content validity ratio (CVR) above 0.70 was considered to be valid.

RESULTS

The validated yoga module consists of joint loosening and strengthening exercises, asana, pranayama and relaxation techniques. The average CVR for the module was found to be 0.80.

CONCLUSION

The designed yoga module is found to be valid by the experts. The module needs to be assessed for feasibility and efficacy in the target population.

Immediate effect of a meditation technique on blood glucose, state anxiety and relaxation in patients with type 2 diabetes: a pilot randomized crossover study

OBJECTIVES

Type 2 diabetes mellitus (T2DM) is a major burden on global health and economy. Various Yogic techniques are found to be beneficial in the management of T2DM. Mind Sound Resonance Technique (MSRT) is one of the yoga-based meditation techniques observed to be effective in clinical settings.

METHODS

Thirty-two patients with T2DM were randomized to either MSRT or supine rest (SR) sessions on two separate days separated by a washout period of one day. Fasting blood glucose levels were measured before and immediately after the sessions. State anxiety and subjective feeling of relaxation were assessed using Spielberg's state anxiety inventory (STAI) and Visual Analogue Scale (VAS) respectively.

RESULTS

There were significant differences between MSRT and SR groups in fasting blood glucose (p=0.019), STAI scores (p<0.001) and subjective relaxation (p<0.001). Within group analyses revealed significant reductions (p<0.001) in fasting blood glucose and STAI scores, along with an increase in subjective relaxation following the practice of MSRT, whereas, non-significant changes were found following the SR session.

CONCLUSIONS

A single session of MSRT was found to reduce blood glucose levels and state anxiety along with enhanced relaxation when compared to SR.

Effects of Nadishodhana and Bhramari Pranayama on heart rate variability, auditory reaction time, and blood pressure: A randomized clinical trial in hypertensive patients

BACKGROUND

Hypertension (HTN) is a chronic elevation of arterial blood pressure (BP) due to environmental and lifestyle factors. The lifelong treatment protocol causes poor adherence to anti-hypertensive drugs. Nadi Shodhana and Bhramari pranayama are the most effective yogic treatment for the management of HTN.

OBJECTIVES

This study was done to assess and compare the immediate effect of Nadi Shodhana and Bhramari Pranayama on HRV and ART in hypertensive individuals. Thus, to understand the effectiveness of specific pranayama on hypertension.

METHODOLOGY

This study is a randomized, comparative study design. The hundred participants were recruited into two groups 1 (n = 50) and 2 (n = 50). The study was conducted on pre-diagnosed patients with HTN, from the inpatient department of SDM Nature Cure Hospital, Shanthivana. Group 1 was asked to practice Nadi Shodhana Pranayama and Group-2 was asked to practice Bhramari Pranayama for 20 min. The patients were assessed for Heart Rate Variability & Auditory Reaction Time before and immediately after the intervention.

RESULTS

Nadi Shodhana Pranayama showed a significant decrease in ART (p = 0.01) and Bhramari Pranayama showed a highly significant decrease in ART (p < 0.00001). Whereas there was no statistically significant difference in both the groups in HRV parameters.

CONCLUSION

The study showed that both Nadi Shodhana and Bhramari Pranayama can be effective in balancing the sympathovagal tone. Thus, Nadi Shodhana and Bhramari Pranayama can be practised for the management of essential hypertension.

The role of trataka in ameliorating visual strain and promoting psychological well-being during prolonged use of digital displays: A randomized controlled trial

BACKGROUND: The prolonged usage of digital displays leads to visual strain and, in turn, impairs psychological well-being. The practice of Yoga is said to enhance psychological functions and reduce visual strain. OBJECTIVE: The present study assessed the effect of the trataka (Yogic visual concentration) practice on the visual strain, mind-wandering, and mindfulness. METHODS: One hundred six volunteers equally distributed in the experimental and control groups completed the study. Visual Fatigue Scale (VFS), visual symptoms checklist (VSC), mind-wandering questionnaire (MWQ), and State Mindfulness Attention Awareness Scale (SMAAS) were administered at baseline and at the end of two weeks. RESULTS: All variables were similar at the baseline in both groups, and significant differences were noted at the end of two weeks between both groups. There was a significant reduction in VFS and VSC scores, MWQ, along with an increase in SMAAS scores in the experimental group. Although there were significant changes in VFS, MWQ, and SMAAS in the control group, the magnitude of change was minimal. CONCLUSIONS: The practice of trataka was found to reduce the visual strain, mind wandering while improving the state mindfulness. The practice can be implemented to mitigate visual strain and associated psychological implications due to prolonged exposure to digital displays, which has increased during the COVID-19 pandemic.

Effect of Trataka (Yogic Visual Concentration) on the Performance in the Corsi-Block Tapping Task: A Repeated Measures Study

Background and Objective: Attention and memory are essential aspects of cognitive health. Yogasanas, pranayama, and meditation have shown to improve cognitive functions. There has been no assessment of Trataka (yogic visual concentration) on working or on spatial memory. The present study was planned to assess the immediate effects of Trataka and of eye exercise sessions on the Corsi-block tapping task (CBTT). Methods: A total of 41 healthy volunteers of both genders with age 23.21 ± 2.81 years were recruited. All participants underwent baseline assessment, followed by 2 weeks of training in Trataka (including eye exercise). Each training session lasted for 20 min/day for 6 days a week. After completion of the training period, a 1-week washout period was given. Each participant then was assessed in two sessions in Trataka and in eye exercise on two separate days, maintaining the same time of the day. Repeated measure analysis of variance with Holm's adjustment was performed to check the difference between the sessions. Results: Significant within-subjects effects were observed for forward Corsi span andforward total score (p < 0.001), and also for backward Corsi span (p < 0.05) and backward total score (p < 0.05). Post hoc analyses revealed Trataka session to be better than eye exercises and baseline. The eye exercise session did not show any significant changes in the CBTT. Conclusion: The result suggests that Trataka session improves working memory, spatial memory, and spatial attention.

Yoga therapy as an adjunct to conventional management of systemic sclerosis: A case series

Systemic sclerosis (SSc) is an autoimmune disorder leading to significant disability and loss of Quality of Life (QoL). Yoga has become popular in recent times for its potential therapeutic benefits. Since there are no scientific reports on the use of Yoga for SSc, we present two female cases (aged 49 and 29 respectively) of limited SSc (duration of illness 4 and 3 years respectively) who underwent Yoga therapy as an adjunct to conventional management in a residential setting for a period of five and four weeks, respectively. During their stay, they underwent a specifically designed Yoga module. After their discharge, they were followed-up for four weeks, during which they were asked to continue practicing Yoga for 1 h every day. Both of them reported a reduction in pain, stiffness, symptom scores, and improved QoL on discharge and at the follow-up compared to the values on admission. Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP), as biomarkers of inflammation, reduced on the discharge when compared to the baseline. No adverse events were noted during the stay and the follow-up. Thus, the present case series indicate a possible beneficial role of Yoga as an adjunct therapy to conventional management of SSc. Further studies in the area are warranted to ascertain the efficacy of Yoga for SSc.

Health and therapeutic benefits of Shatkarma: A narrative review of scientific studies

Shatkarma, also known as Shatkriya are a set of six yogic cleansing techniques described in the Hatha Yoga texts. Several health benefits of these procedures are indicated in the traditional texts of Yoga. However, there is no comprehensive literature about the scientific evidence on Shatkriya. Hence, we searched in PubMed, PubMed Central and Google Scholar databases to review relevant articles in English. The search yielded a total 723 references, published from 1976 to April 2020. Based on the inclusion and exclusion criteria, 37 articles were included in this review. We found scientific studies on four out of six cleansing techniques. The limited evidence on Shatkriya suggests positive effects on various physiological and clinical domains. The practice of dhauti was found to enhance respiratory functions and was useful in digestive disorders. Nasal cleansing, neti was particularly found beneficial in managing the rhinosinusitis in age groups ranging from children to adults. Although trataka practice was found to enhance cognition and bring a state of relaxation, but there was no evidence supporting its role in eye disorders. Kapalabhati practice appears to have a beneficial role in the activation of sympathetic nervous system, enhance cognition, and improve overall metabolism. Further large-scale clinical trials with robust designs are warranted to evaluate the effects of Shatkriya in health and disease.

Effect of Mind Sound Resonance Technique (MSRT - A yoga-based relaxation technique) on psychological variables and cognition in school children: A randomized controlled trial

OBJECTIVE

School children undergo stress, which could impact their psychological functions and cognitive abilities. Yoga practices have been found useful in enhancing psychological functions and performance. The current study was planned to evaluate a yoga-based relaxation technique's efficacy as an extracurricular activity on psychological state and cognitive function.

DESIGN AND SETTING

This study was a parallel-group randomized controlled trial conducted at a government school in south India.

PARTICIPANTS

Sixty students with age ranging between 14-16 years (mean age ± SD; 15.3 ± 0.71 years) satisfying the inclusion and exclusion criteria were randomized to experimental and control groups with an allocation ratio of 1:1.

INTERVENTION

Experimental group received Mind Sound Resonance Technique (MSRT), whereas the control group performed supine rest (SR) for two-weeks.

OUTCOME MEASURES

Participants were assessed with State trait anxiety inventory - short form, Mind Wandering Questionnaire, State Mindfulness Attention Awareness Scale, and Trail making task at baseline and post-intervention.

RESULTS

Experimental group showed a reduction in state anxiety and mind wandering with improvement in state mindfulness and performance in the Trail-making task compared to the control group.

CONCLUSION

Results of the current trial indicate the beneficial role of MSRT in enhancing psychological and cognitive functions in children. Further, large-scale trials are warranted to ascertain the usefulness of the technique.

Naturopathy and Yoga for improving quality of life in Pemphigus vulgaris and managing co-morbid type 2 diabetes: A case report

A 57 years old male patient was admitted to an inpatient Naturopathy and Yoga (N&Y) hospital, diagnosed with pemphigus vulgaris (PV) for one year and co-morbid type 2 diabetes (T2DM) for 10 years, associated with poor quality of life (QoL). He was administered N&Y therapies for 10 days, along with conventional medicines. There was improved QoL and reduced dosage of insulin, along with reduction in body weight. These changes were sustained and improved further during the 60-day follow-up period. Although there was no improvement in the skin lesions, the improvement in QoL indicate a possible role of N&Y in management of PV and T2DM. This case report also warrants further studies for N&Y in the management of dermatological conditions as well as metabolic syndrome.

Immediate Effects of Yoga Breathing with Intermittent Breath Holding on Response Inhibition among Healthy Volunteers

Background:

There is very little evidence available on the effects of yoga-based breathing practices on response inhibition. The current study used stop-signal paradigm to assess the effects of yoga breathing with intermittent breath holding (YBH) on response inhibition among healthy volunteers.

Materials and Methods:

Thirty-six healthy volunteers (17 males + 19 females), with mean age of 20.31 ± 3.48 years from a university, were recruited in a within-subject repeated measures (RM) design. The recordings for stop signal task were performed on three different days for baseline, post-YBH, and post yogic breath awareness (YBA) sessions. Stop-signal reaction time (SSRT), mean reaction time to go stimuli (go RT), and the probability of responding on-stop signal trials (p [r/s]) were analyzed for 36 volunteers using RM analysis of variance.

Results:

SSRT reduced significantly in both YBH (218.33 ± 38.38) and YBA (213.15 ± 37.29) groups when compared to baseline (231.98 ± 29.54). No significant changes were observed in go RT and p (r/s). Further, the changes in SSRT were not significantly different among YBH and YBA groups.

Conclusion:

Both YBH and YBA groups were found to enhance response inhibition in the stop-signal paradigm. YBH could be further evaluated in clinical settings for conditions where response inhibition is altered.

Effects of yogic breath regulation: A narrative review of scientific evidence

Pranayama or breath regulation is considered as an essential component of Yoga, which is said to influence the physiological systems. We present a comprehensive overview of scientific literature in the field of yogic breathing. We searched PubMed, PubMed Central and IndMed for citations for keywords “Pranayama” and “Yogic Breathing”. The search yielded a total of 1400 references. Experimental papers, case studies and case series in English, revealing the effects of yogic breathing were included in the review. The preponderance of literature points to beneficial effects of yogic breathing techniques in both physiological and clinical setups. Advantageous effects of yogic breathing on the neurocognitive, psychophysiological, respiratory, biochemical and metabolic functions in healthy individuals were elicited. They were also found useful in management of various clinical conditions. Overall, yogic breathing could be considered safe, when practiced under guidance of a trained teacher. Considering the positive effects of yogic breathing, further large scale studies with rigorous designs to understand the mechanisms involved with yogic breathing are warranted.

Yoga as a Therapeutic Intervention in the Management of Dysfunctional Uterine Bleeding: A Controlled Pilot Study

BACKGROUND

Dysfunctional uterine bleeding (DUB) is one of the most common gynecological disorders encountered in women during the reproductive age. Yoga therapy has shown promising benefits in several gynecological disorders.

METHODS

Thirty women between the ages of 20 and 40 years with primary DUB were randomly assigned to a yoga (n = 15) and a waitlist control group (n = 15). Participants in the yoga group received a 3-month yoga module and were assessed for hemoglobin values, endometrial thickness (ET), pictorial blood loss assessment chart (PBAC), State-Trait Anxiety Inventory, perceived stress scale, and Pittsburgh Sleep Quality Index (PSQI) before and after a 3-month follow-up period.

RESULTS

At the end of 3 months of intervention, the yoga group, unlike the control group, reported a significant reduction in the anxiety scores (P < 0.05) and perceived stress (P < 0.05). The PSQI scores indicated a reduction in sleep disturbances (P < 0.001) and the need for sleep medications (P < 0.01) and higher global scores (P < 0.001). However, there were no changes in PBAC and ET in both the groups.

CONCLUSION

The results indicate that yoga therapy positively impacts the outcome of DUB by reducing the perceived stress and state anxiety and improving the quality of sleep. This warrants larger clinical trials to validate the findings of this pilot study.