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  • My Most Listened to Songs of 2022: OVSKY – Time [NCS Release]

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  • Watch “Understanding Opioid Overdose: Causes, Signs and When to Seek Help”

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  • Evidence based Yoga 2

    Yoga is a mind and body practice in complementary medicine with origins in ancient Indian philosophy. Part two of evidence based Yoga:

    Carpal tunnel syndrome A randomized, single-blind controlled trial of 42 patients with carpal tunnel syndrome assigned subjects to either a yoga treatment group or a wrist splint group, each 8 weeks in duration. Twice a week, the yoga group practiced postures specifically designed to strengthen and stretch each joint in the upper body. Yoga participants showed improvement in grip strength, pain levels, and Phalen’s sign when compared to the wrist splint group. Nerve conduction studies were not performed.15 A Cochrane review of 21 trials that evaluated the clinical outcome of nonsurgical treatment of carpal tunnel syndrome reported that 8 weeks of yoga practice significantly reduced pain as compared to wrist splinting. The yoga was described as having a “significant short-term benefit,” though the duration of this benefit is unknown.16

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    Depression A 2004 review of five RCTs that evaluated yoga-based interventions for depression and depressive disorders showed some positive outcomes and no adverse effects on patients’ mild to severe depressive disorders. However, poor study design and incomplete methodologic reporting makes this interpretation preliminary.17 An RCT studying 7 weeks of yoga training in a group of breast cancer survivors showed positive changes in emotional function, depression, and mood disturbance.18 “Yoga and stress management” (in the online version of this article) provides more information on this study and others involving the effects of yoga on stress.

    Irritable bowel syndrome In an RCT, treatment with loperamide (Imodium) was compared to treatment with a series of 12 yoga postures practiced twice a day for 2 months in a small sample of patients with clinically diagnosed irritable bowel syndrome. Patients underwent measurement of surface electrogastrography, and trait and state anxiety tests were administered before, during, and up to 2 months after treatment. Both intervention groups demonstrated a decrease in bowel symptoms and state anxiety.19

    Menopausal symptoms In a recent pilot study, 14 postmenopausal women reported via interview and questionnaire a decrease in the severity and frequency of hot flushes after 8 weeks of 90-minute “restorative yoga” classes. Although this initial finding sounds encouraging, this trial had no control group or objective parameter measurements.20 An RCT studying postmenopausal sleep quality divided 164 women into groups who participated in either 4 months of low-intensity yoga, a moderate-intensity walking program, or a wait-list control group. This study reported no statistically significant interventional effects of any treatment on total sleep quality or on any individual sleep quality domain.21

    Multiple sclerosis An RCT of 57 subjects with clinically defined multiple sclerosis were assigned to weekly Iyengar yoga class plus home practice, a cycling program, or a wait-list control group for 6 months. Results showed that both active interventions produced significant improvement in perceived levels of energy and reduced fatigue; however, the specific effects of the yoga practice were not isolated.22 Osteoarthritis In a pilot study, 11 deconditioned, yoga naive subjects with a clinical diagnosis of knee osteoarthritis showed improvements in pain and knee stiffness after 8 weeks of yoga training. The group performed modified Iyengar yoga sessions once a week.23

    Seizure disorders In 2000, a systematic review of the published literature revealed that only one study was able to meet the selection criteria for reliable research design. The reviewers concluded that no available evidence pointed to yoga therapy as an efficacious treatment for epilepsy.24

    Strength and flexibility In a recent study on the fitness related effects of hatha yoga, 10 yoga-naïve and previously untrained subjects aged 18 to 27 years participated in 85 minutes of pranayama and hatha yoga practice twice a week for 8 weeks. These subjects showed significant improvement in upper and lower body muscular strength, endurance, and flexibility. No statistically significant change in body composition or pulmonary function was observed.13
    In a partial RCT with a longer time frame, 54 subjects aged 20 to 25 years participated in either 5 months of yoga instruction or no activity. After that time period, both groups practiced yoga for an additional 5 months. The group practicing 10 months of yoga showed significant improvements in shoulder, trunk, hip, and neck flexibility, as well as a reported improved performance during submaximal exercise testing.25
    A well-executed study compared subjects who underwent 24 hours of hatha yoga classes over 8 weeks with a control group. The yoga training group showed a 13% to 35% improvement in flexibility, balance, and muscular endurance. The authors concluded that hatha yoga practice has significant effects on balance and flexibility.26

    REFERENCES

    1. Tindle HA, Davis RB, Phillips RS, Eisenberg DM. Trends in use of complementary and alternative medicine by US adults: 1997-2002. Altern Ther Health Med. 2005;11(1):42-49.
    2. Carrico M. Yoga Journal’s Yoga Basics: The Essential Beginner’s Guide to Yoga for a Lifetime of Health and Fitness. New York, NY: Henry Holt and Company; 1997.
    3. Nayak NN, Shankar K. Yoga: a therapeutic approach. Phys Med Rehabil Clin N Am. 2004;15(4): 783-798, vi.
    4. Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: a systematic review.J Am Board Fam Pract. 2005;18(6):491-519.
    5. Raub JA. Psychophysiologic effects of Hatha yoga on musculoskeletal and cardiopulmonary function: a literature review. J Altern Complement Med. 2002;8(6):797-812.
    6. Luskin FM, Newell KA, Griffith M, et al. A review of mind-body therapies in the treatment of musculoskeletal disorders with implications for the elderly. Altern Ther Health Med. 2000;6(2): 46-56.
    7. Jensen PS, Kenny DT. The effects of yoga on the attention and behavior of boys with attentiondeficit/ hyperactivity disorder (ADHD). J Atten Disord. 2004;7(4):205-216.
    8. Kirkwood G, Rampes H, Tuffrey V, et al. Yoga for anxiety: a systematic review of the research evidence. Br J Sports Med. 2005;39(12):884-891.
    9. Krisanaprakornkit T, Krisanaprakornkit W, Piyavhatkul N, Laopaiboon M. Meditation therapy for anxiety disorders. Cochrane Database Syst Rev. 2006;(1):CD004998.
    10. Sabina AB, Williams AL, Wall HK, et al. Yoga intervention for adults with mild-to-moderate asthma: a pilot study. Ann Allergy Asthma Immunol. 2005;94(5):543-548.
    11. Vendanthan PK, Kesavalu LN, Murthy KC, et al. Clinical study of yoga techniques in university students with asthma: a controlled study. Allergy Asthma Proc. 1998;19(1):3-9.
    12. Sherman KJ, Cherkin DC, Erro J, et al. Comparing yoga, exercise, and a self-care book for chronic low back pain: a randomized, controlled trial. Ann Intern Med. 2005;143(12):849-856.
    13. Tran MD, Holly RG, Lashbrook J, Amsterdam EA. Effects of Hatha yoga practice on the healthrelated aspects of physical fitness. Prev Cardiol. 2001;4(4):165-170.
    14. Clay CC, Lloyd LK, Walker JL, et al. The metabolic cost of Hatha yoga. J Strength Cond Res. 2005;19(3):604-610.
    15. Garfinkel MS, Singhal A, Katz WA, et al. Yoga-based intervention for carpal tunnel syndrome: a randomized trial. JAMA. 1998;280(18):1601-1603.
    16. O’Connor D, Marshall S, Massy-Westropp N. Nonsurgical treatment (other than steroid injection) for carpal tunnel syndrome. Cochrane Database Syst Rev. 2003(1):CD003219.
    17. Pilkington K, Kirkwood G, Rampes H, Richardson J. Yoga for depression: the research evidence. J Affect Disord. 2005;89(1-3):13-24.
    18. Culos-Reed SN, Carlson LE, Daroux LM, Hately-Aldous S. A pilot study of yoga for breast cancer survivors: physical and psychological benefits. Psycho Oncol. 2006;15(10):891-897.
    19. Taneja I, Deepak KK, Poojary G, et al. Yogic versus conventional treatment in diarrheapredominant irritable bowel syndrome: a randomized control study. Appl Psychophysiol Biofeedback. 2004;29(1):19-33.
    20. Cohen BE, Kanaya AM, Macer JL, et al. Feasibility and acceptability of restorative yoga for treatment of hot flushes: a pilot trial. Maturitas. 2007;56(2):198-204.
    21. Elavsky S, McAuley E. Lack of perceived sleep improvement after 4-month structured exercise programs. Menopause. 2007;14(3, pt 1):535-540.
    22. Oken BS, Kishiyama S, Zajdel D, et al. Randomized controlled trial of yoga and exercise in multiple sclerosis. Neurology. 2004;62(11):2058-2064.
    23. Kolasinski SL, Garfinkel M, Tsai AG, et al. Iyengar yoga for treating symptoms of osteoarthritis of the knees: a pilot study. J Altern Complement Med. 2005;11(4):689-693.
    24. Ramaratnam S, Sridharan K. Yoga for epilepsy. Cochrane Database Syst Rev. 2000(3):CD001524.
    25. Ray US, Mukhopadhyaya S, Purkayastha SS, et al. Effect of yogic exercises on physical and mental health of young fellowship course trainees. Indian J Physiol Pharmacol. 2001;45(1):37-53.
    26. Boehde D, Porcari JP, Greany J, et al. The physiological effects of 8 weeks of yoga training. J Cardiopulm Rehabil. 2005;25(5):290.

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  • My Most Listened to Songs of 2022: JUNGLE – GOOD TIMES / PROBLEMZ

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  • Watch “Dan Flores: On the History of Bison in the American West” on YouTube

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  • Evidence based Yoga

    Yoga is a mind and body practice in complementary medicine with origins in ancient Indian philosophy. The various styles of yoga that people use for health purposes typically combine physical postures, breathing techniques, and meditation or relaxation. There are numerous schools of yoga. Hatha yoga, the most commonly practiced in the United States and Europe, emphasizes postures (asanas) and breathing exercises (pranayama).

    Since the 1020’s researchers have been studying and publishing articles on the results of a Yoga practice. Listed below are some of the research results of Hatha Yoga and specific medical conditions. :

    Utthita Trikonasana

    ADHD Eighteen boys with diagnosed attention-deficit/hyperactivity disorder (ADHD) were randomly assigned to either a yoga treatment or a cooperative activities group. After 20 sessions of yoga, the boys showed improvement on a variety of indices, including oppositional behavior, emotional lability, and restlessness or impulsivity. The subjects exhibited a dose/ response curve, with those subjects who participated in additional home practice showing a greater response. The control group showed superior scores on measures of hyperactivity, anxiety, and shyness, as well as social function measures.7

    Anxiety A meta-analysis of the research involving yoga interventions for anxiety and related disorders reviewed eight studies conducted during 2004. Overall, this research reported positive results, especially in cases of obsessive-compulsive disorder. However, the authors were quick to point out a generally poor quality of research techniques, inadequacies in methodology, and difficulty comparing studies.8 A Cochrane review of two RCTs that investigated the effectiveness of meditation and yoga on patients with diagnosed anxiety disorders stated that based on the available research, no distinct conclusions can be drawn on the ability of meditation and yoga to be effective for anxiety disorders.9

    Asthma To determine the efficacy of Iyengar yoga practice on symptoms and perceived quality of life of people living with asthma, 62 patients with mild to moderate asthma were randomized and divided into two groups. The treatment group performed Iyengar yoga for 4 weeks, and the control group enrolled in a “stretching” program. Both groups underwent spirometry testing and recorded their bronchodilator use, symptoms, and quality of life assessments. At no point in the study did the yoga intervention group show a measured benefit in clinical indices.10

    Another small RCT divided 17 subjects into a yoga treatment and a control group. The yoga group engaged in relaxation pranayama (mindful breathing) techniques, yoga postures, and meditation 3 times per week for 16 weeks. Spirometry testing showed little difference between the two groups; however, the yoga group showed improved exercise tolerance and reported relaxation as well as a more positive attitude as measured by questionnaire. This study also showed a trend toward less use of short-acting bronchodilator medication in the yoga group.11

    Back pain A 12-week RCT compared viniyoga practice with conventional therapeutic back exercises or a self-help book for 101 patients with chronic low back pain. The yoga group met with one instructor for a weekly 75-minute viniyoga practice. Patients were also encouraged to practice at home daily and were given handouts and an audio CD guide. This group showed greater improvement in functional status, decreased activity restriction, and increased general health compared to the conventional exercise group or the self-help book group at 12 weeks. At 26 weeks post treatment, the conventional exercise and yoga therapy group did not show a significant difference in outcome, though at all points in time, viniyoga therapy appeared to be more effective than the self- care book. The viniyoga benefit also lasted for months after the intervention.12

    Cardiovascular disease A systematic literature review of 70 studies published over the past two decades showed a trend toward beneficial changes in metabolic syndrome risk factors such as insulin resistance, lipid profiles, BP, and anthropomorphic indices. The author noted that by controlling risk factors for metabolic syndrome, a regular yoga practice might possibly reduce the risk of cardiovascular disease (CVD). It is important to note that approximately one-third of the reviewed studies were RCTs and that the majority of the others were uncontrolled or nonrandomized controlled clinical trials.4 A 2002 comprehensive review of the literature on the psychophysiological effects of hatha yoga concluded that regular hatha yoga practice and a “yoga lifestyle” have the potential to benefit CVD risk indices.5

    Cardiovascular fitness A 50-minute hatha yoga routine burns 2.2 to 3.6 kcal/min, the equivalent a very slow walk. Except in persons who are very deconditioned, this type of yoga practice alone is unlikely to have a significant training effect on cardiovascular fitness, pulmonary function, body composition, or fat metabolism.13 More vigorous forms of power or vinyasa yoga require a higher energy output, depending on the method of teaching and selection of asanas (postures). One recent study demonstrated a 7% increase in VO2 max after previously sedentary subjects practiced 8 weeks of yoga training.13However, the general consensus is that yoga does not provide the significant cardiovascular stimulus necessary to enhance cardiovascular function.14

    REFERENCES

    1. Tindle HA, Davis RB, Phillips RS, Eisenberg DM. Trends in use of complementary and alternative medicine by US adults: 1997-2002. Altern Ther Health Med. 2005;11(1):42-49.

    2. Carrico M. Yoga Journal’s Yoga Basics: The Essential Beginner’s Guide to Yoga for a Lifetime of Health and Fitness. New York, NY: Henry Holt and Company; 1997.

    3. Nayak NN, Shankar K. Yoga: a therapeutic approach. Phys Med Rehabil Clin N Am. 2004;15(4): 783-798, vi.

    4. Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: a systematic review.J Am Board Fam Pract. 2005;18(6):491-519.

    5. Raub JA. Psychophysiologic effects of Hatha yoga on musculoskeletal and cardiopulmonary function: a literature review. J Altern Complement Med. 2002;8(6):797-812.

    6. Luskin FM, Newell KA, Griffith M, et al. A review of mind-body therapies in the treatment of musculoskeletal disorders with implications for the elderly. Altern Ther Health Med. 2000;6(2): 46-56.

    7. Jensen PS, Kenny DT. The effects of yoga on the attention and behavior of boys with attentiondeficit/ hyperactivity disorder (ADHD). J Atten Disord. 2004;7(4):205-216.

    8. Kirkwood G, Rampes H, Tuffrey V, et al. Yoga for anxiety: a systematic review of the research evidence. Br J Sports Med. 2005;39(12):884-891.

    9. Krisanaprakornkit T, Krisanaprakornkit W, Piyavhatkul N, Laopaiboon M. Meditation therapy for anxiety disorders. Cochrane Database Syst Rev. 2006;(1):CD004998.

    10. Sabina AB, Williams AL, Wall HK, et al. Yoga intervention for adults with mild-to-moderate asthma: a pilot study. Ann Allergy Asthma Immunol. 2005;94(5):543-548.

    11. Vendanthan PK, Kesavalu LN, Murthy KC, et al. Clinical study of yoga techniques in university students with asthma: a controlled study. Allergy Asthma Proc. 1998;19(1):3-9.

    12. Sherman KJ, Cherkin DC, Erro J, et al. Comparing yoga, exercise, and a self-care book for chronic low back pain: a randomized, controlled trial. Ann Intern Med. 2005;143(12):849-856.

    13. Tran MD, Holly RG, Lashbrook J, Amsterdam EA. Effects of Hatha yoga practice on the healthrelated aspects of physical fitness. Prev Cardiol. 2001;4(4):165-170.

    14. Clay CC, Lloyd LK, Walker JL, et al. The metabolic cost of Hatha yoga. J Strength Cond Res. 2005;19(3):604-610.

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  • My Most Listened to Songs of 2022: Tank And The Bangas – Stolen Fruit

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  • Watch “Improving Access to Care for People with Developmental Disabilities”

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  • Addiction Hijacks the Brain

    You’ve probably heard of the brain’s reward network. It’s activated by basic needs — including food, water and sex — and releases a surge of the feel-good neurotransmitter dopamine when those needs are met. But it can also be hijacked by drugs, which lead to a greater dopamine release than those basic needs.

    But the reward network isn’t the only brain network altered by drug use. A new review concluded that drug addiction affects six main brain networks: the reward, habit, salience, executive, memory and self-directed networks.

    In 2016, a total of 20.1 million people ages 12 and older in the U.S. had a substance-use disorder, according to the National Survey on Drug Use and Health, an annual survey on drug use. And drug addiction, regardless of the substance used, had surprisingly similar effects on the addicted brain, said the review, published in the journal Neuron.

    The review looked at more than 100 studies and review papers on drug addiction, all of which studied a type of brain scan called functional magnetic resonance imaging (fMRI).

    More than half of the studies out there look at the effects of drug use on the reward network, said Anna Zilverstand, lead author of the new review and an assistant professor of psychiatry at the Icahn School of Medicine at Mount Sinai in New York City.

    “Because we showed that the effects are very distributed across the six different networks … [we can conclude that] an approach that only looks at one of these networks isn’t really justified,” Zilverstand told Live Science. “This [finding] will hopefully lead other researchers to look beyond the reward network.”

    For example, the memory network is pretty much ignored in research on substance-use disorders, Zilverstand said. This network allows humans to learn non-habit-based things, such as a new physics concept or a history lesson. Some research has suggested that in people with substance-use disorders, stress shifts the person’s learning and memory away from the memory network to the habit network, which drives automatic behavior, such as seeking and taking drugs.

    Another less-studied network is the self-directed network, which is involved in self-awareness and self-reflection, the review said. In people with addictions, this network has been associated with increasing craving.

    Two other networks are involved in substance-use disorders: The executive network is normally responsible for goal-maintaining and execution, but drugs can alter this network as well, reducing a person’s ability to inhibit their actions. The salience network picks up important cues in a person’s environment and redirects the individual’s attention to them. (In people with drug addiction, attention is redirected toward drugs, increasing craving and drug-seeking.)

    Which comes first, the brain activity or the drug use?

    “For me, the most surprising [finding] was how consistent the effects were across addictions,” Zilverstand said. What’s more, “the fact that the effects are quite independent of the specific drug use points to them being something general that might actually precede drug use rather than be a consequence of drug use.”

    Zilverstand said she hopes that more studies will look at whether some people have abnormal brain activity in these six networks naturally and if that activity just gets exacerbated if they begin drug use. It’s important to know if some of these traits precede drug use; if that’s the case, it might be possible to identify people who are prone to addiction and intervene before an addiction begins, she said.

    Some research has pointed toward this possibility already. For example, studies have shown that some people have “difficulties … inhibiting impulsiveness before drug use,” Zilverstand said. “Some of these impairments precede drug use, and they may become worse with more drug use, but they exist before the problem escalates.”

    The good news, however, is that activity in four of these networks — executive, reward, memory and salience — moves back toward “normal” once drug use ends. “We know that four of the networks (partially — not fully) recover but not yet what happens to the other two networks,” Zilverstand said in an email.

    Zilverstand added that she’s particularly excited about an ongoing study called the Adolescent Brain Cognitive Development (ABCD) Study, which is tracking 10,000 children across the U.S. from around ages 9 or 10 to age 20 (the children are now around 13). Some of these individuals will inevitably become addicted to drugs, most likely marijuana or alcohol, Zilverstand said.

    “We’ll be able to see if the effects that we found [in the review] exist in youth who have not yet abused drugs,” she said, and she predicted that researchers will be able to find a lot of the effects identified in the review in the six brain networks.

    The authors noted that because some regions of the brain are very small — for example, the amygdala, which is found toward the center of the brain — the studies can’t identify strong signals from those areas on brain scans. So, it’s possible that drugs affect additional networks in the brain that are hidden because of the limitations of our technologies, Zilverstand said.

    “We don’t want to conclude that [those effects] don’t exist,” she said.

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  • My Most Listened to Songs of 2022: WEDNESDAY CAMPANELLA – Edison

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