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Evidence based Yoga

02 Wednesday Jun 2021

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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. :yogrp

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.13 However, 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.

Meditation, Hypnosis, and Relaxation for Pain Treatment

28 Wednesday Oct 2020

Posted by in Meditation, Pain

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Stress and pain are intimately related. When being in pain causes stress or being stressed worsens pain, psychological therapies — including hypnosis, meditation, and relaxation — may help break the cycle.

For pain therapists, these treatments, which focus on the relationship between the mind and body, are considered mainstream. For other health professionals, they may be considered alternative or complementary therapies. Regardless of how they are labeled, there is evidence that for many people they work.

If you’re considering trying one of these approaches to pain relief, here’s what you need to know.

SONY DSC


Hypnosis

For many, hypnosis brings to mind a parlor game or nightclub act, where a man with a swinging watch gets volunteers to walk like a chicken or bark like a dog. But clinical, or medical, hypnosis is more than fun and games. It is an altered state of awareness used by licensed therapists to treat psychological or physical problems.

During hypnosis, the conscious part of the brain is temporarily tuned out as the person focuses on relaxation and lets go of distracting thoughts. The American Society of Clinical Hypnotists likens hypnosis to using a magnifying glass to focus the rays of the sun and make them more powerful. When our minds are concentrated and focused, we are able to use them more powerfully. When hypnotized, a person may experience physiologic changes, such as a slowing of the pulse and respiration, and an increase in alpha brain waves. The person may also become more open to specific suggestions and goals, such as reducing pain. In the post-suggestion phase, the therapist reinforces continued use of the new behavior.


Benefits of Hypnosis

Research has shown medical hypnosis to be helpful for acute andchronic pain. In 1996, a panel of the National Institutes of Health found hypnosis to be effective in easing cancer pain. More recent studies have demonstrated its effectiveness for pain related to burns, cancer, and rheumatoid arthritis and reduction of anxiety associated with surgery. An analysis of 18 studies by researchers at Mount Sinai School of Medicine in New York revealed moderate to large pain-relieving effects from hypnosis, supporting the effectiveness of hypnotic techniques for pain management.

If you want to try hypnosis, you can expect to see a practitioner by yourself for a course of 1-hour or half-hour treatments, although some practitioners may start with a longer initial consultation and follow up with 10- to 15-minute appointments. Your therapist can give you a post-hypnotic suggestion that will enable you to induce self-hypnosis after the treatment course is completed.

Alternatively, audio recordings exist that walk the listener through the steps necessary to achieve the benefits from hypnosis.

To find a hypnotherapist, speak to your doctor or contact the American Society of Clinical Hypnosis.

Meditation

Meditation involves using a number of awareness techniques to help quiet the mind and relax the body. The two most common techniques are:

      • Transcendental meditation . The patient repeats a single word or phrase, called a mantra, and is taught to allow other thoughts and feelings to pass.
      • Mindfulness Meditation. The person focuses all of his or her attention on thoughts and sensations. This form of meditation is often taught in stress-reduction programs.


Benefits of Meditation

Studies suggest that meditating can increase pain tolerance, activity levels, and self-esteem and decrease anxiety, stress, depression, and use of pain medications.

Mindfulness meditation has been used successfully in programs to reduce pain and improve mood in patients with chronic pain from a variety of conditions, including headache, low back pain, chest pain, and gastrointestinal pain.

There are varied forms of meditation and training certification organizations; for example, one can get certified in mindfulness-based stress reduction (MBSR), but if you’re not sure, speak to your doctor, who may be able to recommend a good teacher or teaching facility.

To practice meditation, repeated meetings with the instructor may not be necessary. A recent study examining the perception of pain and various mental training techniques has found that relatively short and simple mindfulness meditation training can have a significant positive and long-term effect on pain.


Relaxation Therapies

Relaxation therapies include a range of techniques with the goal of reducing stress. In addition to meditation, the major types of relaxation techniques are:

concept

Progressive muscle relaxation .Also known as systematic muscle relaxation and Jacobson relaxation, this technique involves slowly tensing, briefly holding, and then releasing each muscle group in a systematic fashion, starting with the muscles in the toes and moving upward. During this exercise, the person should notice the differences between tension and relaxation.

Autogenic training . This technique uses visual imagery and body awareness to achieve relaxation. The person imagines being in a peaceful place and then focuses on different physical sensations, such as heaviness of the limbs or a calm heartbeat. People may practice on their own, creating their own images, or be guided by a therapist. Patients may also be encouraged to see themselves coping more effectively with stressors in their lives.

Breathing. Breathing techniques teach people to breathe effectively to relieve stress. While placing one hand on the chest and another on the belly, the person is instructed to take a slow, deep breath, taking in as much air as possible. During this, the belly should press against the hand. After holding their breath for a few seconds, patients are instructed to slowly exhale.

Benefits of Relaxing

While research is ongoing, there is evidence to suggest the effectiveness of relaxation techniques for reducing chronic pain related to a variety of medical conditions, including stress-related disorders. Other benefits may include reduced muscle tension and insomnia and increased activity level.

The best way to learn relaxation techniques is with the help of a trained practitioner. Usually, these techniques are taught in a group class and then practiced regularly at home.

There is no widely accepted license for practicing relaxation therapy. However, it is often practiced by therapists and psychologists. Ask your doctor for a recommendation.


Risks of Mind-Body Therapies

Although mind/body therapies don’t have the risks of medical or surgical therapies, there have been rare reports of adverse reactions from them.

If you have poorly controlled cardiovascular disease, experts recommend avoiding progressive muscle relaxation, because abdominal tensing can cause increased pressure in the chest cavity, slowing of the pulse, decreased return of blood to the heart, and increased venous pressure.

If you have a history of psychosis or epilepsy, you may wish to speak with your doctor before trying meditation. There have been reports of some people having further acute episodes following deep and prolonged meditation.

Hypnosis or deep relaxation can sometimes worsen psychological problems in people with post-traumatic stress disorders or a susceptibility to false memories. Its use should be avoided in patients with borderline personality disorder, dissociative disorders, or with patients who have histories of profound abuse. Because competent hypnotherapists are skilled in recognizing and referring patients with these conditions, only appropriately trained and experienced practitioners should undertake hypnosis.

Evidence based Yoga 2

01 Thursday Oct 2020

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:

Fitness and Health

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.

Evidence based Yoga

24 Thursday Sep 2020

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. 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. :

young woman excercising power yoga

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.13 However, 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.

Stressed?

02 Wednesday Sep 2020

Posted by in grounding, Handout, mindfulness, Relaxation, Stress, Wellness

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I’ve been teaching a stress less/relaxation class for years and below is one the handouts that participants report is most helpful.:0854f-feelings-54

Change the situation: Avoid – Alter. Change your reaction: Adapt – Accept

1. Avoid unnecessary stress

Not all stress can be avoided, and it’s not healthy to avoid a situation that needs to be addressed.

Learn how to say “no” – Know your limits and stick to them.

Avoid people who stress you out –Limit the amount of time you spend with people that cause you stress.

Take control of your environment – If the evening news makes you anxious, turn the TV off.

Avoid hot-button topics –If you repeatedly argue about the same subject with the same people, stop bringing it up or excuse yourself when it’s the topic of discussion.

Pare down your to-do list –If you’ve got too much on your plate, distinguish between the “shoulds” and the “musts.”

2. Alter the situation

If you can’t avoid a stressful situation, try to alter it. Figure out what you can do to change things so the problem doesn’t present itself in the future.

Express your feelings instead of bottling them up. If something or someone is bothering you, communicate your concerns in an open and respectful way.
Be willing to compromise. When you ask someone to change their behavior, be willing to do the same.

Be more assertive. Deal with problems head on, doing your best to anticipate and prevent them.

Manage your time better. Plan ahead and make sure you don’t overextend yourself.

3. Adapt to the stressor

If you can’t change the stressor, change yourself. You can adapt to stressful situations and regain your sense of control by changing your expectations and attitude.

Reframe problems. Try to view stressful situations from a more positive perspective.

Look at the big picture. Will it matter in a month, or a year?

Adjust your standards. Set reasonable standards for yourself and others, and learn to be okay with “good enough.”

Focus on the positive. When stress is getting you down, take a moment to reflect on all the things you appreciate in your life, including your own positive qualities and gifts.

4. Accept what you can’t change

Some sources of stress are unavoidable, in such cases; the best way to cope with stress is to accept things as they are. Acceptance may be difficult, but in the long run, it’s easier than railing against a situation you can’t change.

Don’t try to control the uncontrollable. Focus on the things you can control such as the way you choose to react to problems.

Look for the upside. As the saying goes, “What doesn’t kill us makes us stronger.” When facing major challenges, try to look at them as opportunities for personal growth.

Share your feelings. Talk to a trusted friend or make an appointment with a therapist.

Learn to forgive. Accept the fact that we live in an imperfect world and that people make mistakes.

Meditation Reduces Anxiety

16 Thursday Jul 2020

Posted by in brain, Meditation, mindfulness, Psychoeducation, Relaxation, Research, Stress, Wellness

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Scientists at Wake Forest Baptist Medical Center have identified the brain functions involved in how meditation reduces anxiety.

The team wrote in the journal Social Cognitive and Affective Neuroscience about how they studied 15 healthy volunteers with normal levels of everyday anxiety. They said these individuals had no previous meditation experience or anxiety disorders.

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The participants took four 20-minute classes to learn a technique known as mindfulness meditation. In this form of meditation, people are taught to focus on breath and body sensations and to non-judgmentally evaluate distracting thoughts and emotions.

“Although we´ve known that meditation can reduce anxiety, we hadn´t identified the specific brain mechanisms involved in relieving anxiety in healthy individuals,” said Dr. Fadel Zeidan, Ph.D., postdoctoral research fellow in neurobiology and anatomy at Wake Forest Baptist and lead author of the study. “In this study, we were able to see which areas of the brain were activated and which were deactivated during meditation-related anxiety relief.”

The researchers found that meditation reduced anxiety ratings by as much as 39 percent in the participants.

“This showed that just a few minutes of mindfulness meditation can help reduce normal everyday anxiety,” Zeidan said.

Fadel and colleagues were also able to reveal that meditation-related anxiety relief is associated with activation of the anterior cingulate cortex and ventromedial prefrontal cortex, which are areas of the brain involved with executive-level function.

“Mindfulness is premised on sustaining attention in the present moment and controlling the way we react to daily thoughts and feelings,” Zeidan said. “Interestingly, the present findings reveal that the brain regions associated with meditation-related anxiety relief are remarkably consistent with the principles of being mindful.”

He said the results of this neuroimaging experiment complement that body of knowledge by showing the brain mechanisms associated with meditation-related anxiety relief in healthy people.

Scientists wrote in the journal Frontiers in Human Neuroscience in November 2012 about how meditation has lasting emotional benefits. They found that participating in an eight-week meditation training program could have measurable effects on how the brain functions, even when someone is not actively meditating. The team used two forms of meditation training and saw some differences in the response of the amygdala, which is the part of the brain known to be important for emotion.

Stress and movement

30 Thursday Jan 2020

Posted by in creative arts therapy, Dance Movement Therapy, Health, mental health, Relaxation, Stress

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Stress can be indicated when a person becomes stuck/frozen or stopped in a bodily movement that can be described as either gestural, ( movements isolated to parts or part of the body) or postural ( movements carried constantly through the whole body). When  there is a continuous flow of movement from gesture to posture and vice versa than the person is considered moving in balance and not not indicated to be in stress. one example of this is something that has come up in the last 20 years of leading stress reduction exercises with groups. I ask the participants how they know they are stressed out and the top answers are:

I notice I am gripping the steering wheel- I notice I am making a fist- I am clenching my teeth-I am clenching my butt.

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Each one of these actions is a frozen gesture and they generally use the most “force”, muscle, blood flow of any other component of the body while they are active.  Think about it, if you clench your fist the blood flow increases due to the sudden contraction of the muscles, a part of your attention is brought to the area because its being engaged, the rest of the body begins to respond to the clenched fist starting with the arm, shoulders, spine, abdominal muscles and so on ad so on. Suddenly your attention increases to the area dramatically and you realize; “oh I’m clenching my fist….”

The first step to releasing this body stress is the breath. When stressed we tend to hold our breath and/or it becomes shallow breathing. Taking a big breath in and a big breath out begins to increase the oxygen to the brain (and the rest if the body). That big breath also automatically signals to the body on a primal level that the stressor is less and the body begins to relax its muscular contractions. Also when we consciously are taking in a big breath we are exerting voluntary control over our bodies which is the opposite of the stress response which is a involuntary response. This voluntary and controlled breath also signals to the brain on a primal level that the stressor is lessen, resulting in the muscles lessening their contradiction.

Of course simply breathing does not seem like much of an answer for someone who experiences chronic stress/anxiety. But it is one more tool that one can use. Like mindfulness, visualizations, and other techniques, breathing is something that needs to be practiced and the more you practice the more effective it becomes.

Stressed?

06 Wednesday Nov 2019

Posted by in grounding, Handout, mindfulness, Relaxation, Stress, Wellness

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I’ve been teaching a stress less/relaxation class for years and below is one the handouts that participants report is most helpful.:

Change the situation: Avoid – Alter. Change your reaction: Adapt – Accept

1. Avoid unnecessary stress

Not all stress can be avoided, and it’s not healthy to avoid a situation that needs to be addressed.

Learn how to say “no” – Know your limits and stick to them.

Avoid people who stress you out –Limit the amount of time you spend with people that cause you stress.

Take control of your environment – If the evening news makes you anxious, turn the TV off.

Avoid hot-button topics –If you repeatedly argue about the same subject with the same people, stop bringing it up or excuse yourself when it’s the topic of discussion.

Pare down your to-do list –If you’ve got too much on your plate, distinguish between the “shoulds” and the “musts.”

2. Alter the situation

If you can’t avoid a stressful situation, try to alter it. Figure out what you can do to change things so the problem doesn’t present itself in the future.

Express your feelings instead of bottling them up. If something or someone is bothering you, communicate your concerns in an open and respectful way.
Be willing to compromise. When you ask someone to change their behavior, be willing to do the same.

Be more assertive. Deal with problems head on, doing your best to anticipate and prevent them.

Manage your time better. Plan ahead and make sure you don’t overextend yourself.

3. Adapt to the stressor

If you can’t change the stressor, change yourself. You can adapt to stressful situations and regain your sense of control by changing your expectations and attitude.

Reframe problems. Try to view stressful situations from a more positive perspective.

Look at the big picture. Will it matter in a month, or a year?

Adjust your standards. Set reasonable standards for yourself and others, and learn to be okay with “good enough.”

Focus on the positive. When stress is getting you down, take a moment to reflect on all the things you appreciate in your life, including your own positive qualities and gifts.

4. Accept what you can’t change

Some sources of stress are unavoidable, in such cases; the best way to cope with stress is to accept things as they are. Acceptance may be difficult, but in the long run, it’s easier than railing against a situation you can’t change.

Don’t try to control the uncontrollable. Focus on the things you can control such as the way you choose to react to problems.

Look for the upside. As the saying goes, “What doesn’t kill us makes us stronger.” When facing major challenges, try to look at them as opportunities for personal growth.

Share your feelings. Talk to a trusted friend or make an appointment with a therapist.

Learn to forgive. Accept the fact that we live in an imperfect world and that people make mistakes.

Stress and movement

09 Wednesday Oct 2019

Posted by in creative arts therapy, Dance Movement Therapy, Health, Mental Health, Relaxation, Stress

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Stress can be indicated when a person becomes stuck/frozen or stopped in a bodily movement that can be described as either gestural, ( movements isolated to parts or part of the body) or postural ( movements carried constantly through the whole body). When  there is a continuous flow of movement from gesture to posture and vice versa than the person is considered moving in balance and not not indicated to be in stress. one example of this is something that has come up in the last 20 years of leading stress reduction exercises with groups. I ask the participants how they know they are stressed out and the top answers are:

I notice I am gripping the steering wheel- I notice I am making a fist- I am clenching my teeth-I am clenching my butt.

Each one of these actions is a frozen gesture and they generally use the most “force”, muscle, blood flow of any other component of the body while they are active.  Think about it, if you clench your fist the blood flow increases due to the sudden contraction of the muscles, a part of your attention is brought to the area because its being engaged, the rest of the body begins to respond to the clenched fist starting with the arm, shoulders, spine, abdominal muscles and so on ad so on. Suddenly your attention increases to the area dramatically and you realize; “oh I’m clenching my fist….”

The first step to releasing this body stress is the breath. When stressed we tend to hold our breath and/or it becomes shallow breathing. Taking a big breath in and a big breath out begins to increase the oxygen to the brain (and the rest if the body). That big breath also automatically signals to the body on a primal level that the stressor is less and the body begins to relax its muscular contractions. Also when we consciously are taking in a big breath we are exerting voluntary control over our bodies which is the opposite of the stress response which is a involuntary response. This voluntary and controlled breath also signals to the brain on a primal level that the stressor is lessen, resulting in the muscles lessening their contradiction.

Of course simply breathing does not seem like much of an answer for someone who experiences chronic stress/anxiety. But it is one more tool that one can use. Like mindfulness, visualizations, and other techniques, breathing is something that needs to be practiced and the more you practice the more effective it becomes.

Relaxation to Reduce Stress, Anxiety, & Depression

31 Wednesday Jul 2019

Posted by in Handout, Health, Meditation, mindfulness, Relaxation, Stress, Wellness

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Here is another handout that I often give to clients/patients. I should add that I do all of the ideas in my handouts. No point talking about something if you can walk it too.

The body’s natural relaxation response is a powerful antidote to stress. Relaxation techniques such as deep breathing, visualization, progressive muscle relaxation, meditation, and yoga can help you activate this relaxation response. When practiced regularly, these activities lead to a reduction in your everyday stress levels and a boost in your feelings of joy and serenity. What’s more, they also serve a protective quality by teaching you how to stay calm and collected in the face of life’s curveballs.

The relaxation response is not: The relaxation response is:
laying on the couch

sleeping

being lazy

 a mentally active process that leaves the body relaxed

best done in an awake state

trainable and becomes more profound with practice

Starting a relaxation practice

A variety of relaxation techniques help you achieve the relaxation response. Those whose stress-busting benefits have been widely studied include deep breathing, progressive muscle relaxation, meditation, visualization, yoga, and tai chi. feelings-40

Learning the basics of these relaxation techniques isn’t difficult. But it takes practice to truly harness their stress-relieving power: daily practice, in fact. Most stress experts recommend setting aside at least 10 to 20 minutes a day for your relaxation practice. If you’d like to get even more stress relief, aim for 30 minutes to an hour.

Getting the most out of your relaxation practice

Set aside time in your daily schedule. The best way to start and maintain a relaxation practice is by incorporating it into your daily routine. Schedule a set time either once or twice a day for your practice. You may find that it’s easier to stick with your practice if you do it first thing in the morning, before other tasks and responsibilities get in the way.

Don’t practice when you’re sleepy. These techniques can relax you so much that they can make you very sleepy, especially if it’s close to bedtime. You will get the most out of these techniques if you practice when you’re fully awake and alert.

Choose a technique that appeals to you. There is no single relaxation technique that is best. When choosing a relaxation technique, consider your specific needs, preferences, and fitness level. The right relaxation technique is the one that resonates with you and fits your lifestyle.

Do you need alone time or social stimulation?

If you crave solitude, solo relaxation techniques such as meditation or progressive muscle relaxation will give you the power to quiet your mind and recharge your batteries. If you crave social interaction, a class setting will give you the stimulation and support you’re looking for. Practicing with others may also help you stay motivated.