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Evidence based Yoga 2

08 Wednesday May 2019

Posted by in Health, Wellness, Yoga

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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

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.

5 steps to get you motivated to Exercise

13 Wednesday Mar 2019

Posted by in Exercise, Health, Wellness

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You know you should do it. And you know why: Exercising — simply put, moving instead of sitting — is critical for safeguarding your health and setting a good example for your kids. So why does it seem so hard to get yourself moving?

The truth is: You can. But knowing how and why to exercise isn’t enough. You need to develop the right mind-set to get and stay motivated.

“Change is hard!” says certified health behavior coach Shelly Hoefs, fitness supervisor at the Mutch Women’s Center for Health Enrichment in Sioux Falls, S.D. “When we try to start exercising, we think of all the excuses for not doing it and all the things that have gotten in the way before. Getting fit starts to seem overwhelming. And that makes it feel stressful. Before long, we don’t want to do it anymore.”

Here are five steps to get you moving in the right direction — and keep you going.

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  1. Find Personal Motivation to Exercise

What you need to get you up off the couch is a reason that’s important to you. At first, that may be some external factor, says Cal Hanson, director of the Sanford Wellness Center in Sioux Falls, S.D. It could be a number on the scale that surprises you or your doctor’s recommendation that you need to move more to stay healthy.

There are all kinds of benefits to getting fit. Which matters most to you? Something as simple as taking a walk after dinner every night helps to:

  • control your weight
  • strengthen your bones
  • enhance your muscles
  • reduce your risk for heart disease, type 2 diabetes, and some types of cancer

Plus, by becoming active, you’re being a good role model for your children.

These benefits may get you started, but they may not cut it when it comes to keeping you moving day after day, Hanson says. To keep up your motivation to exercise over time, you also need to find your internal motivators. Maybe taking a yoga class leaves you feeling more energized or less stressed. Maybe a run or walk every day helps you let go of stress. Hanson says these are the kind of rewards that are meaningful to you on a personal level and that can help keep you motivated.

 

  1. Set Realistic Goals to Get Fit

CDC guidelines call for adults to do 2 1/2 hours of moderate-intensity aerobic exercise a week. That’s a 30-minute walk five days a week. If you kick it up a notch — jogging or running, for example – it can be 15 minutes a day, five days a week.

You can aim for these exercise guidelines, but don’t try to meet them at the start. “People lose their motivation to exercise when they try to do too much too soon,” says Hanson.

So instead of walking for 30 minutes a day right off the bat, start out doing 15 minutes a day, two or three days a week.

Set weekly goals, gradually adding more time and intensity. At the end of each week, take a look at how you did. If you reached your goal, celebrate! “And if you didn’t reach your goal,” Hanson says, “think about what went wrong and how you’re going to respond differently next time.”

 

  1. Stop Thinking of It as Exercise — Do Something You Enjoy

You don’t have to go to the gym to get a good workout. It’s all about moving more — however you do it. For some people, going to the gym provides structure that helps them focus and a sense of accomplishment when they’re done. For others, it’s a chore — one they wind up avoiding as often as they can.

What else can you do? Almost anything that gets you — and your family — moving:

  • Walk the dog, or walk a neighbor’s dog. They’ll be grateful for the help!
  • Have dance contests with the kids instead of watching TV.
  • Go to the park and play hide-and-seek.
  • Shoot hoops with the kids.
  • Walk or bike to the store instead of driving, or park far away from the entrance.
  • Get off the train a stop early and walk the rest of the way to your office.

If you think about it, you’re surrounded by opportunities to get more active. Find the ones that you get excited about. You’re more likely to keep doing them if you’re having fun.

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  1. Plan How to Fit Exercise Into a Hectic Schedule

For busy parents, a major obstacle to getting fit is lack of time. If you wait for time to open up, chances are you won’t be able to squeeze in a walk or a dance class very often. To avoid getting sidetracked by the daily demands of life, try these tips:

  • “Sit down with your schedule and really carve out blocks of time,” says psychologist Susan Bartell, PsyD, author of  Susan’s Fit and Fun Family Action Plan.Put it in your calendar like any other appointment.
  • Add physical activity to things you already do. For example, pedal a stationary bike while reading or watching TV. Or take a walk with a friend to catch up instead of calling each other on the phone.
  • Plan activities you can do with your kids, such as going for bike rides or skating. Not only will you find more time for fitness, you’ll help inspire your kids to move more.

If you plan ahead for potholes on the road to fitness, you’re more likely to stay on course, Bartell says. “When you think through solutions to problems in advance, you’re less likely to give up when a pothole comes along.”

 

  1. Bounce Back from Setbacks

You’ve set a reasonable fitness goal. You’ve prepared for potential problems. Yet somehow you still didn’t make it to the gym today as you had planned. Don’t let that be your downfall.

“For many people, this is a slippery slope,” Hanson says. “It reminds them of times when they failed before, and they begin to think of themselves as exercise failures.”

When this happens, it’s time for an attitude adjustment so you don’t completely lose your motivation to exercise. If you miss the gym on Monday, that doesn’t mean your whole week is shot, Hanson says. It simply means you need to hit the gym on Tuesday or take the dog for an extra-long walk tonight.

Knowing how to exercise isn’t just a matter of learning how to use your body to hold a yoga pose or swing a racquet. It also involves learning how to use your mind to propel yourself into action and stick with a fitness routine.

“Start thinking of yourself as someone who exercises,” says Hoefs. “Eventually, that will become your identity”.

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