However, in situations where a patient is at risk of an illness but does not currently need more intensive therapy, introduction of yogic practices may forestall or prevent progression to the point where medical therapy is needed. Patients whose daily activities produce back strain or who have inherently stressful lives may benefit from yoga as a prophylactic strategy, thereby potentially avoiding more intensive interventions. Most certified yoga teachers, or instructors, have received some training in anatomy and physiology; however, this training can be quite varied and is not equivalent to the training required by the yoga therapist or healthcare practitioner.
As noted previously, yoga therapy, different from a yoga class, starts with a detailed history and physical examination and assessment from the health practitioner. Yoga brings the autonomic nervous system into healthy balance by stimulating the parasympathetic nervous system [ 11 , 12 ]. The parasympathetic system stimulates blood flow to the digestive system, brain, extremities and sexual organs [ 11 ]. Yogic practices work by decreasing physiologic arousal and quieting down this continual play of the autonomic system. Unfortunately, our bodies were not really set up in a way to handle these continual stressors [ 12 ].
Due to the continued excitation, one of the major neuroendocrine systems of the body, the hypothalamic-pituitary-adrenal HPA axis is set in motion. The axis is set in motion with release of corticotropin-releasing factor CRF from the hypothalamus. CRF then stimulates the anterior pituitary gland to release adrenocorticotropic hormone ACTH , which subsequently stimulates the adrenal cortex to produce and release cortisol [ 14 ]. In response to the stress, cortisol functions by aiding in the metabolism of fat, protein, and carbohydrates by converting them to glucose through gluconeogenesis.
This longer-term stress response subsequently raises blood glucose levels, suppresses the immune system, and causes retention of sodium and water by the kidneys, with subsequent increased blood volume and blood pressure. At a certain blood concentration, cortisol will exert a negative feedback to the hypothalamus and the pituitary gland with decreased discharging of both CRF and ACTH. At this point, homeostasis returns to the body and entire system. If, however, the body continues to be in a state of stress, real or perceived, this cycle perpetuates with subsequent sustained HPA axis activation [ 14 , 15 ].
Not all stress has unfavorable effects, of course. At this point, the body systems can become fatigued, causing multiple problems, both physically and emotionally [ 15 , 16 ]. When one is continually stressed, whether that stress is real or perceived, his or her nervous system can be shifted towards the state of sympathetic overdrive [ 11 , 12 ]. At this point, the actual activity of the sympathetic nervous system decreases with a decline in the release of epinephrine, but corticosteroid release continues to be activated at above-normal levels.
In such a case, the individual may no longer even recognize that they are in a stressful state. This state of high stress causing continuous sympathetic stimulation is epidemic in our society, from the corporate executive down to the young child on a busy school and activity schedule.
So stress is part of our lives—does it matter? In fact, the burden due to stress-related illness is quite concerning. These involve a wide spectrum of complaints, including headache, back pain, hypertension, arrhythmias, irritable bowel syndrome, insomnia, depression, anxiety, skin problems, fatigue, obesity, migraines, hyperlipidemia and accidents. Research has shown that continued and chronic stress can result in a generalized immunosuppressive effect that prevents the body to initiate a timely and appropriate immune reaction [ 16 , 18 , 19 , 20 ].
Acute stress increases levels of pro-inflammatory cytokines in the bloodstream [ 21 ]. Chronic stress, like acute stress, is associated with high levels of pro-inflammatory cytokines, but with potentially different health consequences [ 22 ]. Type 1 cytokine protective immune responses have been shown to be suppressed during times when the body is undergoing challenges of chronic stress, while pro-inflammatory and type-2 cytokine responses are activated [ 23 , 24 ].
Chronic or long-term stress can also suppress immunity by decreasing the number of immune cells as well as their function. Chronically high levels of cortisol can also be neurotoxic [ 14 ]. These high levels have been associated with accelerated aging, cognitive inhibition, impaired memory and the ability to learn, increased anxiety and fear, as well as depression and anhedonia [ 25 , 26 , 27 ]. Areas of the brain, including the hippocampus and the prefrontal cortex PFC , both with high cortisol receptors, can become impaired with high cortisol levels.
Prolonged stress, both physiological and psychological, with continued high levels of blood cortisol can induce lowered metabolic rates and decreased synaptic densities in the hippocampus and the PFC [ 25 , 28 , 29 , 30 ]. Even perceived stress has been shown to negatively correlate with overall PFC volume, specifically in white matter volume of the PFC, specifically in the ventrolateral and dorsolateral PFC [ 31 ]. An enlarged and hyperactive amygdala is often observed during stressful conditions placed on the body [ 14 , 32 , 33 , 34 , 35 ].
Of interest, studies performed on decreasing stress revealed that following stress-reduction interventions, where patients reported significantly reduced perceived stress, decreases basolateral amygdala gray matter density, as seen on Magnetic Resonance Imaging MRI scans [ 32 , 36 ]. Dysregulation of the HPA axis is often seen and reported in those with depressive disorders.
In addition, both the dopaminergic and serotonergic systems are thought to be involved in the development of depression if they become dysfunctional or dysregulated [ 43 ]. Studies done in rats have shown that chronic stress can induce a depressive state, along with notable dysregulation of both their HPA axes and their dopaminergic and serotonergic systems in the PFC. Release of GABA has also shown to be impaired in these rats as well [ 40 , 43 ]. Other mood disorders, including anxiety, are also thought to be aggravated by stress-induced modifications of the PFC.
Of note, stress may impact the prefrontal GABA pathways. This type of mindful movement with slow, rhythmic breathing is more likely to promote parasympathetic and vagal tone compared to other forms of exercise [ 1 , 11 , 46 , 47 ]. Improved vagal tone is reflected by increased heart rate variability HRV , which is the variation in the time interval between heartbeats. This physiologic phenomenon can be predictive of how readily the heart rate returns to normal, or quiets down, after increasing in response to a stressor. Decreased HRV is associated with poorer myocardial function, often seen after a myocardial infarction, and is seen with increased sympathetic activity.
Increased HRV with high frequency activity is associated with increased parasympathetic activity. Yogic breathing techniques—in particular, alternate nostril breathing, which involves breathing through the left and right nostril alternately—has been associated with increased parasympathetic activity, increased HRV and decreased systolic blood pressure [ 48 ].
Slow and rhythmic breathing has also been shown to promote the release of prolactin and the hormone oxytocin, which can foster feelings of friendship, calmness and bonding to others released during childbirth which may help the mother relax and bond with her newborn during a very painful process [ 1 , 49 ]. These yoga practices also reduce circulating levels of cortisol and have been demonstrated to reduce the manifestations of stress.
With practice, there is decreased firing from the locus coeruleus, which is the principal site in the brain for synthesis of norepinephrine in response to stress and panic. This decreased norepinephrine output helps the body to relax and quiet down with reduced respiratory rates and heart rates. The decreased sympathetic output decreases the release of corticotropin releasing factor, with resultant decrease in cortisol output [ 50 , 51 , 52 ]. An open-label study from performed on a cohort of 54 outpatients with clinical depression at a tertiary care psychiatric hospital revealed that, as a group, this cohort had higher levels of serum cortisol compared to healthy controls [ 50 ].
These 54 subjects were offered yoga classes as adjunctive therapy for their depressive symptoms. A G4 group was used as healthy controls N In the total sample, with good adherence, and irrespective of treatment method, the cortisol levels were found to be decreased significantly at the end of treatment in all subjects. It appears that formal meditation practice can change both brain structure and function [ 53 ]. It has been found that people who do more meditation practice develop more robust brain structures in certain areas. Multiple studies have shown that yogic practices such as mindful meditation can increase both cortical thickness and gray matter, particularly in areas controlling emotional regulation and executive functioning.
These regions notably include the insula, the ventromedial pre-frontal cortex and anterior cingulate cortex ACC [ 53 , 54 ].
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The insula is involved with proprioception, self-awareness and emotional regulation. The ACC is the self-regulatory process center, giving one the ability to monitor attention conflicts and allow for more cognitive flexibility [ 55 , 56 , 57 , 58 ]. Meditation has been shown to increase the thickness of the left hippocampus, the region of the brain that functions in the formation of long-term memory, emotional regulation and cognition, as well as being a critical area of the brain that plays a vital role in the resiliency to chronic stress and depressive states, possibly due to expression of hippocampal neurotrophic protein brain-derived neurotropic factor or BDNF [ 59 ].
Resiliency to stress, stress-related depression and post-traumatic stress are housed in the hippocampus—multiple studies have shown that increased hippocampal activation correlated negatively with post-traumatic stress disorder PTSD and depression symptoms, and positively with resilience [ 25 , 55 , 60 , 61 , 62 ]. PTSD patients show considerable reduction in volume of the hippocampus, decreased ventromedial PFC activity and insufficient inhibition of the amygdala, all resulting in increased fear, persistent negative emotions, impulsivity, anxiety and depressive rumination.
Mindfulness meditation, particularly in long-term expert meditators, has been shown to diminish activity and size in anxiety-related areas of the brain such as the amygdala, as well as to increase the size of the PFC and insular cortex, both controlling emotional regulation. These meditators have also been shown to have diminished functional connections between the amygdala and the PFC, allowing for less reactivity to stressors [ 55 , 63 , 64 ]. Meditation also appears to be effective for PTSD and depression symptoms, although more high-quality studies are needed [ 65 , 66 ]. A recent study suggested that hatha yoga postures asanas alone can also improve stress and increase relaxation dispositions.
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This randomized controlled trial performed in among college students with high psychological stress assessed the effects of sun salutations or suryanamaskar defined as a series of 12 physical postures on relaxation dispositions R-dispositions. Suryanamaskar is a traditional asana sequence that is a well-known yogic exercise; however, there are few studies on the physiologic effects of regular suryanamaskar practice [ 67 , 68 ]. In this study, the intervention group was to practice a daily suryanamaskar session for 14 days, which was composed of a short warm up, 13 rounds of suryanamaskar with mantras and breathing, followed by a cool down in a sitting position.
The set of exercises took approximately 20 min to complete daily. No specific activity was given for the control arm to perform. After 14 days, the experimental group scored higher on multiple aspects on the surveys with increased points compared to the control group for: physical relaxation, mental calmness, feeling at ease and peace, being more well-rested and refreshed, improved strength, awareness and joy.
In addition, the intervention group scored lower on fatigue, somatic stress, worry, and negative emotional feelings when compared with the control group [ 69 ]. Yoga practices can increase multiple neurotransmitters and hormones such as GABA, serotonin, and dopamine—all natural anti-depressants [ 11 ]. Lower-than-normal levels of GABA in the brain have been associated with schizophrenia, depression, anxiety, post-traumatic stress disorder, epilepsy and sleep disorders [ 73 ]. Multiple kinds of both anxiolytic and anti-depressant medications work by increasing GABA levels in the central nervous system.
As mentioned earlier, yoga practices seem to be effective by bringing the parasympathetic and sympathetic systems into balance often by increasing parasympathetic tone and decreasing sympathetic firing , and does this in large part by increasing GABA activity [ 75 ]. Studies have shown that GABAergic inhibitory interneurons result in cortical inhibition which has been implicated in improved cognitive performance and enhanced emotional regulation capabilities [ 76 ].
Multiple studies have shown that the practice of yoga and meditation may work as well as other therapies in increasing GABA levels in the brain [ 77 , 78 , 79 ]. As meditation, mindfulness practices and yoga have been moving more and more into the mainstream, it is becoming more apparent that these practices may work to keep our minds and bodies from withering with age by potentially stabilizing, and even lengthening telomeres. Telomeres are small, repetitive, chromosomal sequences found at the end of chromosomes which protect the chromosome from deterioration and cell death.
They keep the chromosome stable. Telomere shortening, or unraveling, affects how quickly cells age. Telomere length has been found to be a prognostic marker of aging, disease and premature morbidity in humans. Telomere shortening is prevented by the enzyme telomerase.
Of note, chronic stress may potentially speed up the aging process through decreased telomerase activity and telomere shortening [ 80 ]. In , Dean Ornish found a significant association between comprehensive lifestyle changes including yoga, meditation, breathing, stress management and a healthy whole-food, plant-based diet , and increased telomerase activity in human peripheral blood mononuclear cells.
Of interest, the participants of this study also showed significant reductions in psychological distress and low-density lipoprotein cholesterol [ 81 ]. In , a five-year follow-up study was completed on the same participants and controls. The participants were found to have persistently increased telomere length and telomerase activity over their age-matched controls. The study also compared blood samples from and , evaluating both relative telomere length RTL and telomerase enzymatic activity per cell.
Of interest, after five years, RTL was found to have increased in the lifestyle intervention group and to have decreased in the control group with the difference between the two groups as statistically significant [ 82 ]. This was the first controlled trial to show that any lifestyle intervention might lengthen telomeres over time.
Meditation has also been shown to be potentially protective regarding RTL. An intriguing study from evaluated a group of 15 subjects practicing Loving-Kindness Meditation LKM compared to a control group of non-meditators n LKM, or Metta bhavana from the Buddhist tradition, is a method of developing compassion by directing well-wishes towards others. It can be practiced by anyone, regardless of religious affiliation.
It is a meditation of care, concern, friendship and compassion for oneself and others. Peripheral blood leukocytes were then measured for RTL in both groups. Although this study was limited by its small sample size, these results are exciting as they suggest that meditation—in particular, LKM practice—might increase RTL, a biomarker associated with aging and longevity [ 83 ].
However, inflammation can have serious health implications when it becomes prolonged and chronic. Chronic systemic inflammation may not be as apparent as acute inflammation, and can persist undetected at low levels for years. As previously discussed, yoga is beneficial for decreasing both acute and chronic stress levels. In multiple studies, yoga has been found to decrease inflammatory markers such as C-reactive protein and other inflammatory cytokines in the blood, while increasing levels of multiple immunoglobulins and natural killer cells [ 11 , 84 , 85 , 86 ].
Recent research has also shown that those who practice yoga regularly have higher levels of leptin and adiponectin in their bodies, both natural chemicals that work to alleviate inflammation in the body. Adiponectin has been found to be a key component of endothelial function and is cardioprotective [ 1 , 87 , 88 ]. A very interesting recent discovery is that even a small amount of practice may make a significant difference. A notable study by Yadav et al. Another randomized, controlled clinical trial from also showed that practicing yoga for as little as three months can not only lower markers of inflammation, but can also make big differences in symptoms of fatigue in breast cancer survivors [ 90 ].
In this trial, women were recruited and randomly assigned to either 12 weeks of min hatha yoga classes twice per week, or a wait-list control. Breast cancer treatments were fully completed before the onset of the study. Multiple inflammatory markers were evaluated as part of the outcome of this trial as well as multiple different surveys assessing both fatigue and depression.
Of particular interest, this study also showed that the more yogic practices that the women did, the better their outcomes. This suggests that yogic practices can continue to make significant sustained differences in signs and symptoms of inflammation even months later. The American College of Rheumatology states that exercise and physical activity is a necessary part of an effective treatment program for patients with both osteoarthritis and rheumatoid arthritis [ 91 , 92 ]. In these patients, exercise has been shown to have a vital role in promoting joint health without worsening disease.
Patients suffering from arthritis who exercise regularly have less joint pain, more vitality, better sleep, reduced morning joint stiffness and improved daily living function.
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In particular, yoga incorporates important elements of body awareness such as proprioception, coordination, balance and postural alignment, all of which are particularly important in individuals with joint disease [ 93 ]. A comprehensive review of randomized controlled trials that evaluated yoga as an intervention for chronic low back pain CLBP supported the practices and found them to be efficacious on short-term improvements in functional disability [ 94 ]. In fact, yoga therapy has been shown to improve pain, back function, spinal mobility, depression and anxiety in patients with CLBP to a greater degree than physical therapy [ 95 , 96 ].
The largest, most rigorously conducted randomized controlled trial RCT of yoga and arthritis to date was published in by Moonaz et al. Most importantly, this trial examined the safety, efficacy and feasibility of yoga for sedentary patients with both rheumatoid and osteoarthritis, with significant outcomes revealing important physical and mental health benefits in these individuals with regular yoga practice. Of great interest, almost all benefits that were seen were still observable nine months after study completion [ 97 ].
Cardiovascular disease CVD encompasses a broad spectrum of syndromes, including atherosclerosis, stroke, arrhythmia, hypertension, hyperlipidemia, heart disease and peripheral vascular disease, and is the leading cause of mortality, morbidity and disability worldwide [ 1 ]. Although there have been tremendous advancements in medications, treatment plans and programs for both the prevention and treatment of CVD, there are still a number of challenges in implementation of these programs, and limitations of the treatments. Multiple risk factors are known to cause oxidative stress, leading to endothelial disruption and dysfunction.
These include dyslipidemia, diabetes, hypertension, obesity, smoking and psychological stress, which can in turn start a cascade of events involving inflammatory and vasoactive mediators, in particular, interleukin-6, fibrinogen, C-reactive protein and tumor necrosis factor-alpha, that lead to the development of CVD [ 1 ]. Yoga therapy may be a significant and cost-effective therapy for CVD by interrupting a number of these different events along this cascade [ 1 , 11 , 88 , 98 , 99 , ]. Of interest is a study done by Sarvottam et al.
In this trial, a ten-day yoga intervention program was found to significantly reduce the body mass indices and systolic blood pressures in 51 overweight and obese men. These men were also found to have significant changes in certain inflammatory markers with decreases in IL-6 and elevation of adiponectin [ 88 ].
According to the American Heart Association, yoga practices can help to lower blood pressure, increase lung capacity, improve respiratory function and heart rate, improve circulation and boost muscle tone [ ]. By decreasing both of these pathways, yoga can interrupt multiple different inflammatory events on the cascade toward CVD and enhance cardiovagal function [ ]. An intriguing study by Krishna et al. Parameters including heart rate, blood pressure, heart rate variability HRV and rate pressure product RPP were measured before and after yoga intervention.
As mentioned above, increased HRV is predictive of how readily the heart rate returns to normal, or quiets down, after increasing in response to a stressor—a sign of parasympathetic tone—and RRP is an index of myocardial O 2 consumption and load on the heart. Both of these are measures of cardiac autonomic function. In this trial of heart failure patients, randomly assigned to receive either a yoga intervention program or standard medical therapy alone, heart rate HR , blood pressure BP , and measures of cardiac autonomic function were assessed before and after the week intervention.
Sympathetic nervous system modulation measured by Lfnu—low-frequency normalized unit decreased significantly and parasympathetic nervous system modulation measured by Hfnu—high frequency normalized unit increased significantly as well in the intervention compared to the controls—both signs indicating improved HRV [ ]. This study suggests that there could be a great benefit of yoga therapy as an adjunct to medical treatment in patients with heart failure.
As a complementary and integrative therapy, yoga for the management of hypertension has been studied in numerous randomized controlled trials. On average, the overall effect of yoga therapy results in a reduction of systolic BP of approximately 10 mmHg and approximately an 8 mmHg reduction in diastolic BP [ 75 , ]. Of note, yoga seems to be efficacious only for hypertension, not for pre-hypertension.
It is also important to recognize that at this time yoga therapy can only be recommended as an adjunct to antihypertensive pharmacological treatment, not as an alternative therapy alone. Breathing and meditation seem to be the important components of the yoga interventions as well rather than physical yoga asanas for hypertensive patients.
These are the components of the yogic practice that can increase parasympathetic activity and decrease sympathetic tone, which counteracts the surplus of sympathetic activity associated with hypertension. An interesting study conducted in on the effects of Iyengar yoga supports this theory. The exact mechanisms as to the potential benefits of yoga in controlling blood pressure remain unknown at this time. Additional rigorously controlled trials are needed to further investigate the potential benefits of yoga for improving blood pressure in those individuals with both pre-hypertension and hypertension to help determine optimal yogic practices, yoga program design and treatment plan [ 1 , 75 , , ].
Yoga therapy may also be quite useful as a complementary therapy for atrial fibrillation AF. It is well known that the autonomic nervous system plays a pivotal role in the pathophysiology of AF, and it has been proposed that an imbalance in both the sympathetic and parasympathetic nervous systems contribute to the disease entity [ , ].
In a trial performed in by Lakkireddy et al. Both symptomatic and asymptomatic AF episodes were assessed for a three-month control period prior to the intervention, and during the intervention. Of interest, feelings of both depression and anxiety were also found to be reduced significantly in study subjects as well as improvements on several measures of quality of life including general health, physical functioning, vitality, social functioning and mental health [ ].
Yoga as Medicine—for the World
The benefits of yoga therapy in these patients with AF are thought to be due to restoration of sympathetic and parasympathetic balance at the level of HPA axis as well as decreasing both inflammation and oxidative stress, resulting in the suppression of atrial remodeling, micro-reentry circuits and triggers for AF; however, the exact mechanism remains unknown [ 1 , ]. In a society exploding with technology, children now are confronted with many daily distractions and temptations, with resultant overstimulation and pressures from their peers. There are more stresses on families with reduced downtime and quiet time caused by the overscheduling of activities, overvaluing productive time and greater pressure to succeed academically.
Not only are children and young adults under more stress, but they also have fewer coping skills to manage these stressors. As with adults, when children internalize stress, it is often manifested physically, resulting in health issues such as insomnia, chronic abdominal pain, headaches, depression, anxiety and mood swings [ , ]. For the past number of years, schools have been cutting programs such as life skills courses and physical education classes.
When these stress management skills are not learned at an early age, it only becomes harder to learn them as the children get older. Yoga may help children, adolescents and young adults cope with stress by teaching them self-regulation skills to control emotions and stress at a young age. These practices would, in turn, help their well-being and mental health, improve overall resiliency and help to positively keep their lives in balance. Yogic practices help the body to connect to the mind by helping one to focus on the present moment and clearing the mind of overwhelming thoughts.
Even very young children can learn to benefit from yogic breathing techniques, which can help to calm and distract toddlers from a temper tantrum or help them to sleep. According to the National Institutes of Health, children who practice yoga have an increased sense of self-awareness and self-confidence. Concentration skills are enhanced [ , ]. These learned mind-body skills can also help a child reexamine a difficult, or even painful, experience into one that bolsters their sense of resiliency [ , ].
This, in turn, may contribute to improved attention, self-esteem, empowerment and good mental health [ , , ]. According to the National Health Interview Survey NHIS , mind-body therapies, including yoga, were the most favored complementary and alternative medicine CAM practices among children with behavioral, emotional or mental health problems. Per the NHIS, the use of yoga and yoga therapy in children had increased since from 2. Of note, older children between the ages of 13 and 17 were noted to use these mind-body therapies more often, and were more commonly used by female patients versus male patients 5.
Compared to research performed in adults, there is unfortunately a lack of good RCTs on the safety and efficacy of yoga among the pediatric population. In , Galantino et al.
Although this review concluded that there was certainly positive evidence regarding the use of yoga in the pediatric population, more research is imperative [ , ]. Since then, there have been no recent systematic reviews of pediatric therapeutic yoga [ ]; however, a growing number of RCTs are being performed. In a recent bibliometric analysis of yoga studies published between and , there were studies found with 31 of the studies 9. In , Kaley-Isley et al. The majority of these studies showed benefit as well as very few adverse effects.
Among these studies, the areas for which yoga was used for therapy in children include physical fitness, cardiac and respiratory symptoms, mental and behavioral health, developmental syndromes, irritable bowel syndrome, eating disorders including obesity, anorexia and bulimia, cancer and prenatal effects on birth outcomes [ 1 ]. In , 14 individual controlled studies were evaluated, showing that yoga, as a CAM treatment and approach, appears to be an encouraging therapy and stress management intervention for children and adolescents, again with a very low rate of reported adverse effects.
Yoga therapy can have significantly favorable effects on psychological and cognitive functioning, particularly in patients with emotional, mental and behavioral disorders [ ]. Of note, many of the studies reviewed had methodological limitations, small sample sizes, lack of randomization and much variability between yoga practice intervention methods so that clear conclusions were not possible, and it was suggested that to obtain the most benefits from therapeutic yoga in children, more regulated research efforts are warranted [ , ].
There has been increasing interest in the use of mind-body techniques and therapies for children and adolescents with focusing, concentration and attention disorders. If yoga and mindfulness helps one to focus inward and pay attention, it would be only natural to assume that these types of therapies would be of great benefit to those who have difficulty with inattentiveness. Ideally, this increased focus would potentially increase attention naturally, even in children with challenging attention disorders. In , a systematic review of trials examining the evidence for efficacy of yoga in the treatment of a number of different pediatric psychiatric disorders, of which 16 met appropriate criteria for the final review, showed emerging evidence Grade B to support a role for yoga in treating children with Attention Deficit and Hyperactivity Disorder ADHD in two RCTs [ ].
Among these two RCTs was an intriguing randomized trial from , published in the Journal of Attention Disorders , which showed that boys diagnosed with ADHD, on appropriate medication, reduced their symptoms in inattentiveness and behavior when practicing yoga regularly.
In this trial, 16 boys with ADHD were randomized to receive either yoga therapy YG or cooperative activities CG in addition to their previously prescribed medications for a total of 20 weeks.
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The YG received one hour of hatha yoga per week along with breathing and relaxation techniques. Although there was improvement in both groups, the YG group showed significant improvement on five subscales of the CPRS. Positive changes on the CTRS were also seen in those who attended more yoga sessions and who engaged in more home practice. Although this was a small study, the trial did suggest that yoga may be a useful CAM therapy for adjunctive management, along with medical management, in children with ADHD.
Another trial from by Haffner et al. The YG received 2 h of hatha yoga weekly for a period of 34 weeks. Outcome measures here included test scores on a task requiring focused attention, as well as both parent and teacher ratings of ADHD symptoms. Results from this trial revealed that the yoga training was superior to the conventional motor training. This pilot study also demonstrated that yoga can be an impressive adjunctive treatment for ADHD, though again limited by its small sample size.
These researchers advocate for further research into the impact of yoga on children with ADHD [ ]. What about the possibilities of yoga entering the school curriculum? It has become increasingly commonplace for large companies and offices to incorporate yoga and meditation facilities for their employees as a means to help improve concentration, refresh focus, improve motivation and counteract prolonged sitting at a desk orworkbench all work-day long.
Schoolchildren, who also spend hours working and sitting all day, may benefit to the same degree. There have been a few RCTs have evaluated the effects yoga within a school curriculum particularly in the prevention of mental health problems and enhancement of psychosocial well-being.
One RCT from by Khalsa et al. In this trial, students were asked to self-report measures of mental health parameters including mood, anxiety, stress, and resilience both at baseline and post-intervention. Of note, this is one of a few trials that compares the effects of yoga to that of another form of exercise in this case, physical education as an exercise control group.
More studies comparing the yoga with standard exercise are warranted as benefits can certainly be seen for both. Another interesting study from examined a school-based mindfulness and yoga intervention program in four inner city public schools in Baltimore, MD. Mental health parameters were also assessed in the trial including stress responses, feelings of depression, emotional arousal, control of thoughts and student social interactions.
Positive outcomes were again seen in the intervention group compared to the controls in a number of these different psychological variables. Both of these studies are significant in that they suggest that mindfulness-based programs may be of great benefit for youths, especially in helping them to cope with daily stressors.
A landmark study was recently performed in , again in two inner-city public schools in Baltimore, MD. The two groups were comparable at baseline: average age was 12 years, These outcomes suggested that underprivileged, vulnerable and disadvantaged youths could significantly benefit from mindfulness-based programs in school, particularly with negative psychological symptoms and developing improved coping mechanisms for stress.
Of great significance is the impact that these positive outcomes may have as children mature—it is a well-appreciated fact that many adult diseases have their genesis in childhood, especially those due to high exposure to stress and trauma [ ]. In a research review from , Hagen et al. The authors suggested that these school-based programs may help students improve self-regulation of emotions, stress-coping skills, resiliency and overall mood. They concluded that for young people to start practicing mind-body techniques from an early age may prevent future generations from experiencing more stress in their adult lives.
Ongoing research into yoga and mindfulness-based practices continues to reveal and uncover health benefits, supporting its use in health management. It also should be noted that the field of yoga research encompasses the inherent dilemma of the wide variety of yogic practices used as interventional therapies.
Larger, multi-centered studies using standardized yoga programs and uniform methodologies with long-term follow-up and outcomes are needed. The practice of yoga is not as easy or as quick as taking medication, but mounting evidence suggests it is worth the effort and investment. Yoga helps one to reconnect with oneself. The practice can help one to see how they may be reacting to the world around them, and may help them learn to respond from a different perspective. Slowing down, quieting our minds and connecting with our inner selves all help to bring one into the present moment. This can ultimately help to relieve one from the pressures and stressors from the hustle and bustle of this very busy world.
National Center for Biotechnology Information , U. Journal List Children Basel v. Children Basel. Published online Feb Ina Stephens. Hilary McClafferty, Academic Editor. Author information Article notes Copyright and License information Disclaimer. Received Dec 27; Accepted Feb 3.
Abstract Medical yoga is defined as the use of yoga practices for the prevention and treatment of medical conditions. Keywords: yoga, yogic practice, anxiety, depression, mindfulness, meditation, arthritis, ADHD, cardiovascular disease, inflammation.
Yoga as Medicine - Full Programme
Introduction Within the past decade, yoga has infiltrated not only Western culture, but also Western medicine. Prescription: Yoga Medical yoga is defined as the use of yoga practices for the prevention and potential treatment of medical conditions. What Is Yoga Yoga is not a particular denomination or religion, but an age-old practice based on a harmonizing system for the body, mind, and spirit to attain inner peace and liberation [ 9 , 10 ]. How Do Yogic Practices Work? Meditation It appears that formal meditation practice can change both brain structure and function [ 53 ].
Yoga and Neurotransmitters Yoga practices can increase multiple neurotransmitters and hormones such as GABA, serotonin, and dopamine—all natural anti-depressants [ 11 ]. Yoga and Telomeres As meditation, mindfulness practices and yoga have been moving more and more into the mainstream, it is becoming more apparent that these practices may work to keep our minds and bodies from withering with age by potentially stabilizing, and even lengthening telomeres.
Yoga and Cardiac Disease Cardiovascular disease CVD encompasses a broad spectrum of syndromes, including atherosclerosis, stroke, arrhythmia, hypertension, hyperlipidemia, heart disease and peripheral vascular disease, and is the leading cause of mortality, morbidity and disability worldwide [ 1 ]. Conclusions Ongoing research into yoga and mindfulness-based practices continues to reveal and uncover health benefits, supporting its use in health management. Conflicts of Interest The author declares no conflict of interest. References 1. Khalsa S. This might frustrate readers seeking a formula, but those willing to experiment have access to many diverse tools and practices.
No doubt McCall's fine articulation of yoga's healing potential will appeal to a large audience of instructors, students, physicians and their patients. View Full Version of PW. Buy this book. Zeebra Books. Show other formats. Discover what to read next. The Most Anticipated Books of Fall
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