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Bikram Yoga Training and Physical Fitness in Healthy Young Adults

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Abstract

There has been relatively little longitudinal, controlled investigation of the effects of yoga on general physical fitness, despite the widespread participation in this form of exercise. The purpose of this exploratory study was to examine the effect of short-term Bikram™ yoga training on general physical fitness. Young healthy adults were randomized to yoga training (N=10, 29 ± 6 yrs, 24 sessions in eight weeks) or a control group (N=11, 26 ± 7 yrs). Each yoga training session consisted of 90 min of standardized, supervised postures performed in a heated and humidified studio. Isometric deadlift strength, handgrip strength, lower back/hamstring and shoulder flexibility, resting heart rate and blood pressure, maximal oxygen consumption (treadmill), and lean and fat mass (DEXA) were measured before and after training. Yoga subjects exhibited increased deadlift strength, substantially increased lower back/hamstring flexibility, increased shoulder flexibility, and modestly decreased body fat compared with Control. There were no changes in handgrip strength, cardiovascular measures, or maximal aerobic fitness. In summary, this short-term yoga training protocol produced beneficial changes in musculoskeletal fitness that were specific to the training stimulus.

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... A typical Bikram class is 90 min in duration, consists of a set series of 26 Hatha yoga postures and 2 breathing exercises, and is performed in a room heated to 41° C (105° F) with 40% humidity (5). Though Bikram Yoga is a rapidly growing fitness trend and booming business throughout the United States, only one research study was found that investigated the effects of Bikram yoga training on cardiovascular fitness (21), and no research has explored its effects on pulmonary function. Hence, the primary purpose of this study was to describe the resting hemodynamic, lung function, and cardiorespiratory fitness characteristics of Bikram yoga practitioners. ...
... To our knowledge, only one study has reported the effects of Bikram yoga on resting hemodynamics (21). Our cross-sectional data are consistent with the findings of Tracy and Hart (21) who showed no changes in cardiovascular measures. ...
... Our findings are again in agreement with Tracy and Hart (21). They found no significant improvement in VO 2 max following a period of Bikram yoga training. ...
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The effects of yoga training on health and fitness are unclear despite widespread participation. The primary purpose of this cross-sectional study was to describe the resting heart rate, blood pressure, lung function and aerobic fitness characteristics of long-term Bikram yoga practitioners. A secondary purpose was to examine the relationship between previous Bikram yoga experience and these physiological measures. Thirty-one Bikram yoga practitioners were placed into 2 groups according to years of experience (low = <3 months and high = =1 yr). All subjects completed a battery of tests to measure resting blood pressure and heart rate, pulmonary flow rates and capacities, and aerobic fitness. Unpaired t-tests demonstrated no significant differences between the two groups in any of the measured variables. A significant but weak correlation was detected between Bikram yoga experience and both percentage of predicted forced vital capacity (r = 0.38, P<0.05) and forced expiratory volume in the first second (r = 0.37, P<0.05). These results suggest that this form of yoga training does not provide an adequate stimulus to alter resting hemodynamics, pulmonary function or aerobic fitness.
... An ambient temperature between 35-40 o C with a relative humidity level between 40-60% must be held for the entirety of each Bikram yoga class offered. This style of yoga is believed to be more intense than the traditional option and involves rapid transitions between each of the 26 postures providing a considerable cardiovascular response and development of muscle fatigue (463). With its recent gain in popularity there remains limited inquiry towards the cardiovascular demands required. ...
... Bikram yoga's ability to positively influencing balance, muscular strength and steadiness in young adults (198). The single randomized control study in this review found no change in VO2max, resting heart rate and resting systolic blood pressure in both the control and intervention groups after an eight week intervention (463). Although the participants were young adults who had little to no experience with yoga and were considered sedentary; the implementation of 24 ...
... This practice of hot yoga was found to be more challenging than traditional hatha yoga due to the environmental conditions and its resulting influence on muscular and cardiovascular performance (463). Recently, far infrared sauna's (FIRS) have become a popular alternative to sauna heating when compared to mist or dry heat. ...
Thesis
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Background: The monitoring of an athlete’s training load and cardiac function have demonstrated to be valuable assessment tools in individual sporting events. Additionally, short term heat acclimation has shown to be effective for stimulating hypervolemia and augmenting cardiovascular performance. A gap in the literature exists indicating further research is required into both heat acclimation protocols and the monitoring of on-field training load and its cause and effect relationship with heart rate variability in team sport. Purpose: The purpose of this investigation was twofold; 1) identify a novel form of heat acclimation using hot yoga for augmenting cardiovascular and aerobic performance, and 2) identify an effective monitoring protocol suitable for team sport using internal training load and heart rate variability. Methods: The Canadian Women’s National Field Hockey team were participants for examining heat acclimation and the relationship between training load and autonomic modulation during the 2016 Olympic cycle. A maximal graded exercise test was completed prior to and following six hot yoga sessions to examine cardiovascular and aerobic performance measures. Results: In Chapter 4, six days of hot yoga developed hypovolemia that lead to trivial improvements in aerobic power, run time to exhaustion, and a small increase in running speed at each ventilatory threshold. A non-existent relationship between markers of exercise stress and alterations in plasma volume during and post hot yoga were observed. Chapter 5 identified a large relationship between the planned and achieved on field training load over a complete mesocycle. Additionally, a moderate relationship was observed between both time spent above anaerobic threshold, training load and alterations in the Ln rMSSD:R-R ratio.
... This form of yoga consists of a set of 26 held postures and breathing exercises practised in room heated to 40°C , and is proposed to have additional benefits over other yoga styles (Choudhury, 2007). For example, hot yoga has been reported to bring extra physical benefits, since practising in the heat improves blood flow (Hunter et al., 2013;Perrotta et al., 2016), metabolic rate (Larson-Meyer, 2016;Pate & Buono, 2014), and flexibility (Tracy & Hart, 2013). The sequence of movements is also designed to work through the whole body, which stimulates internal organs, the muscular-skeletal system, and general coordination (Choudhury, 2007). ...
... Some research efforts have been made to examine the relationship between hot yoga and psychological wellbeing, including its effects on mindfulness and perceived stress (Hewett et al., 2011), mood (Mace & Eggleston, 2016), positive-/ negative-affect and state-anxiety (Szabo et al., 2017), emotions and psychological resources (Park et al., 2020), as well as life satisfaction and core self-evaluation (Rissell et al., 2014). There are also studies that focus on the physical benefits of hot yoga, such as its effects on sleep quality (Kudesia & Bianchi, 2012), cardiovascular disease risk factors (Hunter et al., 2013), bone density (Sangiorgio et al., 2014), and general physical fitness (Tracy & Hart, 2013). Nonetheless, the sample size was small in most studies. ...
... Nonetheless, the sample size was small in most studies. Taking the above nine studies as an example, their sample sizes ranged from 9 to 157 participants (average = 55.38), with only one study (N = 21) following the RCT protocol (Tracy & Hart, 2013). Clearly, the correlational nature of most studies and their small sample sizes have limited the evidencebased and causal conclusions that can be drawn. ...
Article
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Practicing hot yoga may bring significant psychological benefits, but it is largely unstudied. We examined the effectsof hot yoga on multifaceted well-being indicators with 290 healthy yoga-naïve volunteers partaking in a six-weekrandomized controlled trial. Participants completed questionnaires pre- and post-intervention, and reported theiremotional experiences four times per day throughout an experience-sampling study. Results revealed that the hot yogagroup (n = 137) improved their well-being from pre- to post-treatment, comparing to the wait-list control group (n = 153).These improvements included life satisfaction, general health, mindfulness, peace of mind, and eudaimonic well-being(ΔR2 ranging from .01 to .08)—but not flourishing, which describes major aspects of social-psychological functioning.Multilevel analyses demonstrated that momentary positive emotional experiences increased significantly throughoutthe trial in the yoga group only (conditional R2 = .68), particularly when attending a yoga class (conditional R2 = .50).Interestingly, this increase in momentary positive emotion explained the improvement in post-intervention mindfulness,peace of mind, and general health by 21%, 31%, and 11%, respectively. Finally, the benefits of hot yoga were more notablein individuals with lower levels of baseline eudaimonic well-being (conditional R2 = .45), flourishing (conditional R2= .61), and mental well-being (conditional R2 = .65), even after ruling out any possible ceiling effects. To sum up, thisstudy demonstrated multiple psychological benefits of hot yoga and its potential to be an effective positive psychologyintervention. Future research—especially considering an active control group—is warranted.
... Of the 30 studies that were included, 15 originated from India (Bera and Rajapurkar, 1993;Harbans et al., 2011;Hegde et al., 2013;Kanojia et al., 2013;Mahajan et al., 1999;Manjunath and Telles, 2012;McDermott et al., 2014;Mooventhan and Khode, 2014;Ray et al., 2001;Shukla and Gehlot, 2014;Telles et al., 2014;Telles et al., 2013;Thiyagarajan et al., 2015;Khatri et al., 2007;Manchanda et al., 2013), 8 from the USA (Blumenthal et al., 1989;Cohen et al., 2008a;Elavsky and McAuley, 2007a;Kanaya et al., 2014;Stachenfeld et al., 1998;Tracy and (Chen et al., 2008;Chen et al., 2010), and one each from Japan (Sakuma et al., 2012) and China (Lu and Wang, 2007). Ten of the trials explicitly investigated overweight or obese individuals (Cohen et al., 2008a;Harbans et al., 2011;Kanaya et al., 2014;Lee et al., 2012;Seo et al., 2012;Shukla and Gehlot, 2014;Telles et al., 2014;Khatri et al., 2007;Kim et al., 2013;Manchanda et al., 2013); and three trials were conducted on children/adolescents (Bera and Rajapurkar, 1993;Seo et al., 2012;Telles et al., 2013). ...
... Two studies each used Silver yoga (Chen et al., 2008;Chen et al., 2010) and Hatha Yoga (Ray et al., 2001;Kim et al., 2013), one each used Restorative Yoga (Kanaya et al., 2014) Yogasana, (Sakuma et al., 2012), Bikram (Tracy and Hart, 2013), Vinyasa Yoga (Yang et al., 2011), and yogic lifestyle intervention (Mahajan et al., 1999), and 21 did not report the yoga style used (Appendix Table 1). Twenty-six studies reported using yoga postures while one used only breathing exercises; and the majority of trials also utilized breathing, meditation or relaxation exercises. ...
... Chen et al., 2010;Cohen et al., 2008a;DiPietro et al., 1998;Elavsky and McAuley, 2007a;Harbans et al., 2011;Hegde et al., 2013;Kanaya et al., 2014;Kanojia et al., 2013;Lee et al., 2012;Lu and Wang, 2007;Mahajan et al., 1999;Manjunath and Telles, 2012;McDermott et al., 2014;Mooventhan and Khode, 2014;Ray et al., 2001;Sakuma et al., 2012;Seo et al., 2012;Shukla and Gehlot, 2014;Stachenfeld et al., 1998;Telles et al., 2014;Telles et al., 2013;Thiyagarajan et al., 2015;Tracy and Hart, 2013;Van Puymbroeck et al., 2007;Yang et al., 2011;Khatri et al., 2007;Kim et al., 2013;Manchanda et al., 2013), while 127 of those full-texts were excluded (Table 1) (McIver, 2010;Cheung et al., 2012;Corey et al., 2014;LaCroix et al., 2012;Sharma et al., 2013;Singh et al., 2011;Hoogbruin et al., 2012;Lai et al., 2010;Trivedi and Mishra, 2014;Bock et al., 2010;Bock et al., 2014;Cheema et al., 2011;Cohen et al., 2013;Kandula et al., 2013; Neumark-Sztainer et al., 2011;Flaherty, 2014;Guarracino et al., 2006;Ades et al., 2003;Ankad Roopa et al., 2011;Armstrong and Scott Smedley, 2003;Bhutkar et al., 2011;Choudhary and Mishra, 2013;Hunter et al., 2013;Malhotra et al., 2005;Murthy et al., 2011;Nagarathna and Nagendra, 1987;Raj et al., 2011;Ramos-Jimenez et al., 2009;Sarvottam et al., 2013;Satyanarayana et al., 1992;Sivasankaran et al., 2006;Telles et al., 1993;Telles et al., 2010;Thomley et al., 2011;Villien et al., 2005;Yadav et al., 2012;Yadav et al., 2014;Yang and James, 2014;Begum et al., 2012;Cajka et al., 2013;Čajka et al., 2012;Ce et al., 2015;Chatterjee and Mondal, 2014;Chaya et al., 2006;Chaya et al., 2008;Dhananjai et al., 2013;Goncalves et al., 2011;Halder et al., 2015;Hegde et al., 2011;Herur et al., 2011;Kim et al., 2014;Krejci, 2011;Kubo et al., 2011;Madanmohan et al., 2008;Malhotra et al., 2010;Maninder et al., 2013;Miles et al., 2013;Santhi Sri et al., 2014;Singh et al., 2008;Sukhsohale and Phatak, 2012;Tyagi et al., 2014;Narendran et al., 2005a;Narendran et al., 2005b;Stein et al., 2014;Sprod et al., 2015;Emery and Blumenthal, 1990;Bar et al., 2014;Chu et al., 2014a;Cramer et al., 2014b;Hartley et al., 2014;Innes and Vincent, 2007;Jayasinghe, 2004;Liu et al., 2014;Manchanda and Madan, 2014;Patel et al., 2012;Brady, 2007;Ades et al., 2005;Manchanda et al., 2000;Pal et al., 2013;Pal et al., 2011;Raghuram et al., 2014;Cadmus-Bertram et al., 2013;Littman et al., 2012;Carei et al., 2010;McIver et al., 2009;Mitchell et al., 2007;Yurtkuran et al., 2007;Cade et al., 2010;McCaffrey et al., 2005;Murugesan et al., 2000;Rahnama et al., 2011;Cheung et al., 2014;Ebnezar et al., 2012;Sharma et al., 2015;Nidhi et al., 2012;Nidhi et al., 2013a;Nidhi et al., 2013b;Rakhshani et al., 2015;Innes and Selfe, 2012;Ikai et al., 2013;Amita et al., 2009;Gordon et al., 2008;Nishanth et al., 2011;Shantakumari et al., 2013;Skoro-Kondza et al., 2009;Visweswaraiah and Telles, ...
Article
Introduction: Overweight and obesity are among the most important modifiable risk factors for chronic diseases and premature death. The aim of this review was to systematically assess and analyze the effects of yoga on weight-related outcomes. Methods: Medline/PubMed, Scopus, and the Cochrane Library were screened through March 2015 for randomized controlled trials on yoga for weight-related outcomes in the general population or overweight/obese individuals. Risk of bias was assessed using the Cochrane risk of bias tool on the following domains: selection bias, performance bias, detection bias, attrition bias, reporting bias, and other bias. Results: Out of 445 records identified during literature search, 30 trials with a total of 2173 participants were included. No effects on weight, body mass index, body fat percentage or waist circumference were found. In studies with healthy adult participants an effect of yoga compared to usual care (SMD=-1.00; 95% CI=-1.44, -0.55; p<0.001) was found regarding waist/hip ratio. In studies with overweight/obese participants only, effects relative to usual care were found for body mass index (SMD=-0.99; 95% CI=-1.67, -0.31; p=0.004). Effects however were not robust against selection bias; and publication bias could not be ruled out. No intervention-related adverse events were reported. Conclusions: Despite methodological drawbacks, yoga can be preliminarily considered a safe and effective intervention to reduce body mass index in overweight or obese individuals.
... Heart rate variability can also be increased from via exercise-induced adaptation of the cardiovascular system. Research to date indicates that Bikram yoga does not elicit a strong enough cardiovascular training load in sedentary, apparently healthy adults to improve maximal oxygen update [29,44]. The null findings in the present study may be due to the lack of chronic adaptation of the cardiac muscle (i.e. ...
... There was a null effect of Bikram yoga on secondary hemodynamic outcomes in the present study. Our findings in this cohort of normotensive adults ( Table 2) support those of previous studies (controlled and uncontrolled), which report unchanged blood pressure and resting heart rate in normotensive adults after 8 weeks of Bikram or non-Bikram hatha yoga performed one to three sessions per week [24,28,29,44]. Interestingly, a cross-sectional study reported that resting blood pressure of long-term Bikram yoga practitioners (1 year) was lower than the general United States population indicating that this practice may have a beneficial effect on hemodynamic health [48]. ...
... There was no significant adaptation of body weight, body composition, waist circumference or BMI in the present study. An RCT reported a trend in reduced body fat after 8-weeks of Bikram yoga, although no diet data was recorded during that 8-week trial [44]. Preliminary energy expenditure data from two studies indicates that Bikram yoga elicits a higher metabolic equivalent (MET) energy expenditure level compared to other forms of hatha yoga, and that it can be compared energetically to walking up to 3.7 METS [45,46,57]. ...
Article
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Objectives: The purpose of this study was to investigate the effect of 16 weeks of Bikram yoga on perceived stress, self-efficacy and health related quality of life (HRQoL) in sedentary, stressed adults. Design: 16 week, parallel-arm, randomised controlled trial with flexible dosing. Methods: Physically inactive, stressed adults (37.2±10.8 years) were randomised to Bikram yoga (three to five classes per week) or control (no treatment) group for 16 weeks. Outcome measures, collected via self-report, included perceived stress, general self-efficacy, and HRQoL. Outcomes were assessed at baseline, midpoint and completion. Results: Individuals were randomised to the experimental (n=29) or control group (n=34). Average attendance in the experimental group was 27±18 classes. Repeated measure analyses of variance (intention-to-treat) demonstrated significantly improved perceived stress (p=0.003, partial η(2)=0.109), general self-efficacy (p=0.034, partial η(2)=0.056), and the general health (p=0.034, partial η(2)=0.058) and energy/fatigue (p=0.019, partial η(2)=0.066) domains of HRQoL in the experimental group versus the control group. Attendance was significantly associated with reductions in perceived stress, and an increase in several domains of HRQoL. Conclusions: 16 weeks of Bikram yoga significantly improved perceived stress, general self-efficacy and HRQoL in sedentary, stressed adults. Future research should consider ways to optimise adherence, and should investigate effects of Bikram yoga intervention in other populations at risk for stress-related illness. Trial registration: Australia New Zealand Clinical Trials Registry ACTRN12616000867493. Registered 04 July 2016. URL: http://www.anzctr.org.au/ACTRN12616000867493.aspx.
... Several studies have investigated the effects of Bikram yoga practice on health using various study designs [3][4][5][6][7][8][9][10]; however, to our knowledge, these studies have never been synthesized and critiqued and, accordingly, there is no consensus in the scientific literature regarding the effectiveness of Bikram yoga on health. Therefore, the purpose of this review is twofold: (1) to summarize studies that have investigated the effect of Bikram yoga practice on health-related outcomes and (2) to provide recommendations for the development of more robust trials and novel research questions to address the limitations of the existing literature. ...
... Four studies to date have evaluated the effect of Bikram yoga training on measures of health-and/or skill-related physical fitness [3-5, 8, 9]. Hart and Tracy [3,4] examined the effects of an 8-week Bikram yoga intervention (3 classes/week) on body composition, flexibility, muscular strength and steadiness (neuromuscular control), cardiorespiratory fitness (VO 2max ), and balance in 21 apparently healthy adults. Thus far, this study is the only one to use an RCT design. ...
... Body composition is a health-related component of fitness and excess adiposity is a cardiovascular disease risk (CVD) factor. To date, no Bikram yoga study has reported significant changes in adiposity or lean muscle mass when measured using dual-energy X-ray absorptiometry (DEXA) [4,8,9]. Tracy and Hart [4] reported a trend toward reduced body adiposity in the yoga group ( = 0.069), which, despite randomisation, had higher baseline adiposity (28.4 ± 6% versus 20.8 ± 8.1%, = 0.03). ...
Article
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Bikram yoga is a style of hatha yoga involving a standarized series of asanas performed to an instructional dialogue in a heated environment (40.6°C, 40% humidity). Several studies evaluating the effect of Bikram yoga on health-related outcomes have been published over the past decade. However, to date, there are no comprehensive reviews of this research and there remains a lack of large-scale, robustly-designed randomised controlled trials (RCT) of Bikram yoga training. The purpose of this review is to contextualise and summarise trials that have evaluated the effects of Bikram yoga on health and to provide recommendations for future research. According to published literature, Bikram yoga has been shown to improve lower body strength, lower and upper body range of motion, and balance in healthy adults. Non-RCTs report that Bikram yoga may, in some populations, improve glucose tolerance, bone mineral density, blood lipid profile, arterial stiffness, mindfulness, and perceived stress. There is vast potential for further, improved research into the effects of Bikram yoga, particularly in unhealthy populations, to better understand intervention-related adaptations and their influence on the progression of chronic disease. Future research should adhere to CONSORT guidelines for better design and reporting to improve research quality in this field.
... Every posture is held for the same period, regardless of the instructor or the studio. The postures require prolonged, forceful and controlled contractions of the major muscle groups that, in conjunction with the hot environment, elicit both cardiorespiratory challenge and muscular fatigue (Tracy & Hart, 2013). Therefore, unlike Hatha yoga that was shown to represent low levels of exercise, akin to walking on a treadmill at 3.2 km/h (Hagins et al., 2007), this new form of hot yoga involves a greater physical challenge (Pate & Buono, 2014;Tracy & Hart, 2013). ...
... The postures require prolonged, forceful and controlled contractions of the major muscle groups that, in conjunction with the hot environment, elicit both cardiorespiratory challenge and muscular fatigue (Tracy & Hart, 2013). Therefore, unlike Hatha yoga that was shown to represent low levels of exercise, akin to walking on a treadmill at 3.2 km/h (Hagins et al., 2007), this new form of hot yoga involves a greater physical challenge (Pate & Buono, 2014;Tracy & Hart, 2013). ...
... The physiological and psychological benefits associated with Bikram yoga practicing were reported after shortduration research interventions lasting for only eight weeks (Hewett et al., 2011;Hunter et al., 2013;Tracy & Hart, 2013). From a physiological perspective, Bikram has reduced arterial stiffness in young -but not older adults and also reduced the insulin resistance index in the older -but not young adults (Hunter et al., 2013). ...
Article
Background: Bikram yoga is a relatively new, but an increasingly popular form of exercise. Its health benefits were demonstrated on physical and psychological measures. Aims: The current field study tested the acute effects of Bikram yoga on practitioners’ positive-/negative-affect and state-anxiety, and their link to the self-perceived stress, in Bikram yoga participants. Method: Field study, within-participants design, testing perceived stress and its relation to changes in positive-/negative-affect and state-anxiety in 53 habitual Bikram yoga participants. Results: Statistically significant positive changes emerged in all three psychological measures after the 90-min Bikram yoga session. The decrease in negative-affect and state-anxiety were significantly and positively related to the perceived stress. Estimated effort was unrelated to the magnitude of the changes recorded in the psychological measures. Heart rates and self-report measures indicated that physically Bikram yoga is only mildly challenging. Conclusions: The findings illustrate that, independently of the physical effort, Bikram yoga is a new mild form of exercise that reduces negative-affect and state-anxiety, and the reduction is directly related to the perceived stress. Therefore, Bikram yoga appears to be beneficial for all practitioners, but even more so for the individuals who experience substantial stress in the daily life.
... Heart rate variability can also be increased from via exercise-induced adaptation of the cardiovascular system. Research to date indicates that Bikram yoga does not elicit a strong enough cardiovascular training load in sedentary, apparently healthy adults to improve maximal oxygen update [29,44]. The null findings in the present study may be due to the lack of chronic adaptation of the cardiac muscle (i.e. ...
... There was a null effect of Bikram yoga on secondary hemodynamic outcomes in the present study. Our findings in this cohort of normotensive adults ( Table 2) support those of previous studies (controlled and uncontrolled), which report unchanged blood pressure and resting heart rate in normotensive adults after 8 weeks of Bikram or non-Bikram hatha yoga performed one to three sessions per week [24,28,29,44]. Interestingly, a cross-sectional study reported that resting blood pressure of long-term Bikram yoga practitioners (1 year) was lower than the general United States population indicating that this practice may have a beneficial effect on hemodynamic health [48]. ...
... There was no significant adaptation of body weight, body composition, waist circumference or BMI in the present study. An RCT reported a trend in reduced body fat after 8-weeks of Bikram yoga, although no diet data was recorded during that 8-week trial [44]. Preliminary energy expenditure data from two studies indicates that Bikram yoga elicits a higher metabolic equivalent (MET) energy expenditure level compared to other forms of hatha yoga, and that it can be compared energetically to walking up to 3.7 METS [45,46,57]. ...
Article
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Background Chronic activation of the stress-response can contribute to cardiovascular disease risk, particularly in sedentary individuals. This study investigated the effect of a Bikram yoga intervention on the high frequency power component of heart rate variability (HRV) and associated cardiovascular disease (CVD) risk factors (i.e. additional domains of HRV, hemodynamic, hematologic, anthropometric and body composition outcome measures) in stressed and sedentary adults. Methods Eligible adults were randomized to an experimental group (n = 29) or a no treatment control group (n = 34). Experimental group participants were instructed to attend three to five supervised Bikram yoga classes per week for 16 weeks at local studios. Outcome measures were assessed at baseline (week 0) and completion (week 17). ResultsSixty-three adults (37.2 ± 10.8 years, 79% women) were included in the intention-to-treat analysis. The experimental group attended 27 ± 18 classes. Analyses of covariance revealed no significant change in the high-frequency component of HRV (p = 0.912, partial η2 = 0.000) or in any secondary outcome measure between groups over time. However, regression analyses revealed that higher attendance in the experimental group was associated with significant reductions in diastolic blood pressure (p = 0.039; partial η2 = 0.154), body fat percentage (p = 0.001, partial η2 = 0.379), fat mass (p = 0.003, partial η2 = 0.294) and body mass index (p = 0.05, partial η2 = 0.139). ConclusionsA 16-week Bikram yoga program did not increase the high frequency power component of HRV or any other CVD risk factors investigated. As revealed by post hoc analyses, low adherence likely contributed to the null effects. Future studies are required to address barriers to adherence to better elucidate the dose-response effects of Bikram yoga practice as a medium to lower stress-related CVD risk. Trial registrationRetrospectively registered with Australia New Zealand Clinical Trials Registry ACTRN12616000867493. Registered 04 July 2016.
... Commonly referred to as hot yoga this unique and standardized practice sets itself apart from other forms of hot yoga. Bikram yoga involves 26 Hatha style postures that are standardized and led by certified Bikram yoga instructors who have completed a 9 week intensive training course through Bikram's Yoga College of India (Tracy and Hart, 2013). This style of yoga is performed in a specialized studio that controls its ambient temperature to the exact specifications required for all Bikram yoga classes. ...
... An ambient temperature between 35--40 o C with a relative humidity level between 40--60% must be held for the entirety of each Bikram yoga class offered. This style of yoga is believed to be more intense than the traditional option and involves rapid transitions between each of the 26 postures providing a considerable cardiovascular response and development of muscle fatigue (Tracy and Hart, 2013). With its recent gain in popularity there remains limited inquiry into the cardiovascular demands required. ...
... Each posture is repeated twice, held for a period of time that requires strong muscular contractions and calls upon each joint to be used in its full range of motion. This exclusive standardized style of hot yoga makes it unique and more suited for research purposes; potentially explaining why each of the six articles found in this review involved this licensed form of hot yoga (Tracy and Hart, 2013). A modified Downs and Black scoring system (Downs and Black, 1998) (Table 2) was utilized to assess the quality of the included articles. ...
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Background: Hatha yoga has become a popular form of exercise that has demonstrated to elicit marked increases in muscular strength and muscular flexibility. However, minimal inquiry towards its influence on cardiovascular health and performance is available. Methods: Published investigations including and preceding December 2016 were systematically reviewed and appraised. The terms, “Yoga”, “Yoga AND Exercise”, “Yoga AND Exercise Test” identified 337 articles, 6 of these articles were relevant and utilized in this review. Results: The cardiovascular demands on a Bikram yoga class appear to be light in nature while further demonstrating individual variation in metabolic cost and heart rate. The variations observed may have been a result of a diverse sample size with age, sex and fitness. Short term (ie. 8 wks) adaptions failed to demonstrate a significant difference in resting cardiovascular measurements with minimal support for enhancing aerobic power. Long term (ie. 1yr) Bikram yoga practice may elicit position adaptions in resting heart rate, systolic and diastolic blood pressure in obese individuals. There remained a lack of significant difference when examining cardiovascular performance measures between long term and novice Bikram yoga practitioners. Conclusions: Bikram yoga continues to increase in popularity as an alternative exercise option; however minimal evidence exists demonstrating its positive impact on cardiovascular health and performance. It appears this form of light exercise may be an effective and exciting means of activity for individuals looking to start an exercise program. Individuals wishing to pursue this form of exercise are encouraged to acquire approval and consent from a medical doctor and a certified exercise professional prior to starting
... Ushtrasana is one of the important Asana as described in ancient texts; it is also known as camel posture. It creates maximum compression of spines which stimulates the nervous system and also improves flexibility of neck and spine (Brian 2013). [4] Camel pose is posture that releases much stress and anxiety and helps to heal many different spinal ailments. ...
... It creates maximum compression of spines which stimulates the nervous system and also improves flexibility of neck and spine (Brian 2013). [4] Camel pose is posture that releases much stress and anxiety and helps to heal many different spinal ailments. ...
... Hatha yoga, is the most popular branch of yoga; consisting of physical postures (the asanas), controlled respiration (the pranayama), and deep relaxation (the meditation) [6]. There is strong scientific evidence demonstrating its beneficial effects on improvement of physical fitness including lower back/hamstring flexibility [7][8][9], handgrip strength [10][11][12][13], vital capacity [14,15] and psychological [6,16] variables in both healthy and non-healthy subjects. Furthermore, recent controlled studies of yoga for particular populations have used modified hatha yoga, with some poses modified by using props to support body regions, performed in seated positions or selected based on therapeutics' purpose, to meet the specific needs of subjects who are limited in their physical and functional abilities [10,11,[17][18][19]. ...
... Hand-grip strength increased significantly in HYG and this result may be derived from holding static postures in the asanas [26]. While a few investigators have found conflicting results [7,28], other studies are in agreement with the present findings and also reported significant improvement in hand-grip strength resulting from yoga training either in a healthy [12,13] or diseased populations [10,11,15,29]. In an earlier study a modified hatha yoga program which focused on simple stretching All values are presented as mean ± SD; n = 9 All values are presented as mean ± SEM; n = 9 * Significantly different from pre-assessment, p \ 0.05, Post-hoc analyses with Bonferroni adjustment comparing pre-and post-assessment J Occup Rehabil 123 and postural alignment improved in hand-grip strength in patients with carpal tunnel syndrome over an 8-week period [10]. ...
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Purpose: The purpose of this study was to assess the effects of 8 weeks of modified hatha yoga training on physical fitness and stress level in injured workers. Methods: Eighteen male and female injured workers, age between 18 and 55 years, participated in this study. They were divided into two groups: an additive hatha yoga training to routine industrial rehabilitation program group (HYG: n = 9) and a control group with no yoga training (CG: n = 9). A modified hatha yoga protocol was designed for this population by two certified yoga instructors, approved by a physical therapist, and conducted for 1 h, three times weekly for 8 weeks. Physical fitness variables including flexibility of lower back and hamstrings, hand grip strength and lung capacity and scores of sensitivity to stress were evaluated at the time of recruitment and after 8 weeks of intervention. Results: The values of all physical fitness variables and stress scores were no significant difference between the two groups at baseline. Significant post-yoga improvements for HYG group were noted in flexibility, hand grip strength, and vital capacity (p < 0.05). In contrast, there was no significant change in the CG group. Stress scores did not change as a result of hatha yoga training. Conclusion: An 8-week modified hatha yoga training experience exerted therapeutic effects on physical fitness variables including flexibility of lower back and hamstrings, hand grip strength and vital capacity, but not on stress level in injured workers. These findings indicate that hatha yoga can be a beneficial adjunct to routine physical therapy treatment in industrial rehabilitation programs.
... Beneficial effects of yoga training on handgrip strength and handgrip endurance-as a measure of force fluctuation during isometric contraction-were shown for adults (Thangavel et al., 2014) and adolescents (Mandanmohan et al., 2003). However, no changes in handgrip strength were found in a study by Tracy and Hart (2013) in young adults. Differences in statistical approach may account for the diverging results. ...
... The results of Telles et al. (1993Telles et al. ( , 1994Telles et al. ( , 2006, Mandanmohan et al. (2003), and Thangavel et al. (2014) suggest that yoga training may improve relevant variables in motor function both of adults and older children. However, the effects may not be as strong as to withstand stricter statistical approaches (Tracy and Hart, 2013). What we do not know is whether yoga training improves motor abilities in younger children. ...
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The present pilot study investigated the effects of yoga training, as compared to physical skill training, on motor and executive function, physical self-concept, and anxiety-related behavior in junior primary school-aged children. Twenty-four participants with a mean age of 8.4 (±1.4) years completed either yoga or physical skill training twice a week for 6 weeks outside of regular school class time. Both forms of training were delivered in an individualized and child-oriented manner. The type of training did not result in any significant differences in movement and executive function outcomes. In terms of physical self-concept, significant group differences were revealed only for perceived movement speed such that yoga training resulted in perceptions of being slower while physical skill training resulted in perceptions of moving faster. Analysis of anxiety related outcomes revealed significant group effects only for avoidance behavior and coping strategies. Avoidance behavior increased following yoga training, but decreased following physical skill training. In addition, following yoga training, children showed an increased use of divergent coping strategies when facing problematic situations while after physical skill training children demonstrated a decrease in use of divergent coping strategies. Changes in overall physical self-concept scores were not significantly correlated with changes in avoidance behavior following yoga training. In contrast, following physical skill training increased physical self-concept was significantly correlated with decreases in avoidance behavior. In sum, exposure to yoga or physical skill training appears to result in distinct effects for specific domains of physical self-concept and anxiety-related behavior. Further studies with larger samples and more rigorous methodologies are required to further investigate the effects reported here. With respect to future studies, we address potential research questions and specific features associated with the investigation of the effects of yoga in a sample of school-aged children.
... There is evidence that short-term (8-weeks) yoga results in increased lower body strength and flexibility and improvements in arterial stiffness and glucose tolerance (Hunter et al., 2013a,b;Tracy and Hart, 2013). Most previous studies have focused on physical outcomes however, one uncontrolled study showed improvements in mindfulness scores after 8 weeks of yoga (Hewett et al., 2011). ...
... Our assessment of lower body strength revealed little difference in performance between the two groups. Results from one previous study investigating the effects of 8 weeks of yoga on fitness outcomes in young adults revealed significant changes in lower leg strength in the yoga group but not the control group (Tracy and Hart, 2013). We cannot rule out that the yoga intervention used in the current study was insufficient in volume to produce significant changes in lower body strength. ...
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Purpose Little is known about the effects of yoga training in adults with ADHD symptoms. This pilot study sought to determine the feasibility and selected psychological effects of 6 weeks of yoga training in women screening positive for adult ADHD compared to a wait-list control group. Methods A randomized trial was conducted with 32 adult women (18–24 years) who volunteered after screening positive for adult ADHD as assessed by the Adult ADHD Self-Report Scale (ASRS). Participants were randomized to 6 weeks of Bikram yoga training or to a wait-list control group. The yoga intervention consisted of two 90-min classes per week. Multilevel models were used to test hypothesized interactions of yoga-induced improvements compared to controls across time (baseline, 3 weeks, and 6 weeks). The primary outcomes assessed inhibitory control, cognitive flexibility and working memory using the NIH Toolbox. Separate models with trait mindfulness, trait anxiety and expectations for change in either attention or working memory as covariates tested whether these variables mediated the changes in the three measures of executive function. Secondary outcomes included mood, perceived functional impairment and motivation for, and hyperactivity during, the cognitive tests. Results No adverse events were observed. Attendance averaged 91.7% among the 69% of the sample that did not dropout. No significant Group X Time interactions were found for any of the psychological outcomes and the null executive function findings were unchanged when including the covariates. Conclusion Six-weeks of yoga training twice per week is potentially feasible for women experiencing ADHD symptoms, but an exercise stimulus of this duration and magnitude yields no beneficial cognitive or mood outcomes.
... The exercise intensity level of a typical Bikram yoga class has been classified as light to moderate. 19,20 Although this intensity level is not high enough to elicit an increase in cardiorespiratory fitness, 21 improvements in lower body strength, neuromuscular control (balance), and flexibility are evident. 21,22 However, there was significant sweat and water loss (1.1 kg/h in experienced yoga practitioners) due to the high temperature and humidity. ...
... 19,20 Although this intensity level is not high enough to elicit an increase in cardiorespiratory fitness, 21 improvements in lower body strength, neuromuscular control (balance), and flexibility are evident. 21,22 However, there was significant sweat and water loss (1.1 kg/h in experienced yoga practitioners) due to the high temperature and humidity. 19 We speculate that this large sweat loss is accompanied by a large salt and other electrolyte loss. ...
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It has been hypothesized that sweat loss during exercise causes a disruption in calcium homeostasis that activates bone resorption and over time leads to low bone mineral density. The purpose of this small pilot study was to determine whether dermal calcium loss from a bout of excessive sweating during light intensity physical activity triggers an increase in biomarkers of bone resorption. Biochemical markers related to bone homeostasis were measured before and after a 90 minute Bikram hot yoga practice performed in a room heated to 105 °F with 40 % humidity. Participants were five females with a mean age of 47.4 ± 4.7 years. Nude body weight, serum total calcium (Ca²⁺), free ionized calcium, albumin, parathyroid hormone (PTH) and CTX-I were measured before and after a Bikram hot yoga practice. Mean estimated sweat loss was 1.54 ± 0.65 L, which elicited a 1.9 ± 0.9 % decrease in participant’s body weight. Mean Ca²⁺ concentration in sweat was 2.9 ± 1.7 mg/dl and the estimated mean total calcium lost was 41.3 ± 16.4 mg. Serum ionized Ca²⁺ increased from 4.76 ± 0.29 mg/dl to 5.35 ± 0.36 mg/dl after the Bikram hot yoga practice (p = 0.0118). Serum PTH decreased from pre- 33.9 ± 3.3 pg/ml to post- 29.9 ± 2.1 pg/ml yoga practice (p = 0.0015) when adjusted for hemoconcentration (PTHADJ), implying a decrease in PTH secretion. We conclude that calcium loss in sweat during 90 minutes of Bikram hot yoga did not trigger an increase in PTH secretion and did not initiate bone resorption.
... Although yoga has become increasingly popular as a type of physical exercise (e.g. Ref. [20]), the various types of yoga were originally intended to influence body and mind together and its practice was considered a lifestyle. To this point and relevant to the present study, Srinivasan cautioned that yoga should be viewed as learning strategies "whereby we facilitate the control systems in the mind-body complex for proper functioning" ( [16], p.1). Yoga practice may influence one's being in a multitude of ways and the benefits to physical and behavioral health may be considered byproducts of a larger, interconnected process. ...
Article
This was an investigation of the feasibility and effectiveness of a brief yoga intervention (one session) within an intensive outpatient program (IOP) for service recipients diagnosed with various psychiatric disorders. Participants (N = 26) completed the Toronto Mindfulness Scale (TMS) and the Positive and Negative Affect Schedule (PANAS). Data was collected before and after one yoga session and follow-up data was collected via mail after discharge from the IOP. Scores indicated that negative affect significantly decreased and positive affect significantly increased from pre to post yoga session. Mindfulness scores significantly increased from pre to post yoga session. Though the results of this study supported that a yoga intervention is both feasible and effective within an IOP, collection of follow-up data after discharge via mail was not as feasible. The results of this preliminary investigation support a larger and longitudinal study to further examine yoga as a treatment modality with this clinical population.
... Nevertheless, some studies using subjective methods to study the effect of HY in BE demonstrate that systematic practice improves the yogi`s vitality and perception of its own physical condition, social functioning and quality of life. [24] Also, because of the nature of physical exercises (Asanas) performed in HY, it is common to find exceptional physical abilities in trained yogis especially in muscular flexibility, strength [25] and stress control. [4,26] Given the mystical-philosophical roots of HY, the contemporary yogi continues to strive for something more than merely physical and mental health. ...
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Yoga is an ancient oriental discipline that emerged from mystical and philosophical concepts. Today it is practiced in the west, partly due to the promotion of its benefits to improve the lifestyle and overall health. As compared to non‑Hatha Yoga (HY) practitioners, healthier and better-eating patterns have been observed in those who practice it. Agreement with the brought benefits, HY can be used as a therapeutic method to correct abnormal eating behaviors (AEB), obesity, and some metabolic diseases. However, the energy expenditure during traditional protocols of HY is not high; hence, it is not very effective for reducing or maintaining body weight or to improve cardiovascular conditioning. Even so, several observational studies suggest significant changes in eating behaviors, like a reduction in dietary fat intake and increments in that of fresh vegetables, whole grains and soy-based products, which in turn may reduce the risk for cardiovascular diseases. Given the inconsistency of the results derived from cross-sectional studies, more case–control studies are needed to demonstrate the efficacy of HY as an alternative method in the clinical treatment of disordered eating and metabolic diseases.
... Despite its promise as a restorative element of a total body wellness program, yoga may cause discomfort at the hip in some individuals [3][4][5]. Yoga postures often require forceful, sustained, and controlled muscular contractions, and may induce muscular fatigue [6]. Specifically, single leg tasks require increased knee and hip abductor forces, while common double leg poses, such as Warrior II, require an addiction moment greater than that elicited with walking [7]. ...
Article
Objective: Yoga is a popular form of exercise that promotes mind-body wellness and has recently been touted as a modality that may be well tolerated by patients with orthopaedic conditions. Paradoxically, yoga may exacerbate pain and dysfunction in certain populations, as poses often require prolonged activation of periarticular hip musculature to optimize stability, balance, and posture. The purpose of this study was to evaluate muscular activation patterns in subjects with hip pain during select yoga poses, hypothesizing that yoga participants with hip pain demonstrate poor ability to maintain muscular contractility necessary for pelvic stability. Methods: Women with and without hip pain, who regularly participate in yoga, were evaluated using surface electromyography (SEMG) while performing common yoga poses. Each participant performed 30 s holds of three poses. To introduce the element of fatigue, the three poses were repeated in the original order, immediately following 20 repetitions of side-lying hip abduction. Results: Subjects with hip pain demonstrated decreased muscular activation of the Gluteus Medius (p=0.0008), Gluteus Maximus (p<0.0001), Adductor Longus (p=0.0003) and External Obliques (p<0.0001). In healthy subjects, EMG activity of these muscles during yoga did not change (p=0.6387, 0.9954, 0.9740, 0.4878 respectively). Baseline amplitudes between groups were not significantly different (p=0.1725), although the Gluteus Medius amplitude was suggestive of a difference as it approached significance (p=0.0707). Conclusion: Patients with hip pain undergo more rapid periarticular muscular fatigue than control subjects. They demonstrate increased muscular dysfunction when performing weight bearing yoga poses, therefore, should be appropriately counselled regarding the potential risk of symptomatic exacerbation and possible counterproductive effects of participation.
... While often thought of as a flexibility enhancing exercise, yoga is a combination of both flexibility and isometric exercise (Miles et al., 2013) as evidenced by recent findings of increases in not only hamstring and shoulder flexibility, but also isometric deadlift and handgrip strength after 8 weeks of Bikram yoga practice in young adults (Tracy and Hart, 2013). Stretching has been shown to acutely enhance endothelial function in patients with myocardial infarction (Hotta et al., 2013). ...
Article
The purpose of this investigation was to determine if Bikram yoga, a style of heated hatha yoga, would improve endothelial function in young and middle-aged and older, healthy adults. This trial was performed in 36 young (n=17) and middle-aged and older adults (n=19) who completed 3 weekly Bikram yoga classes for 8 weeks. Height, body weight and body composition were determined and endothelial function was measured noninvasively using brachial artery flow-mediated dilation (FMD) before and after the intervention. No changes in body weight, BMI or body fat percentage occurred as a result of the intervention in either group. Brachial artery FMD was significantly increased in middle-aged and older (P<0.05) but not in young adults as a result of the intervention. The results demonstrate that a relatively short-term Bikram yoga practice might significantly improve vascular endothelial function in middle-aged and older adults. While apparently healthy individuals in this study experienced no adverse events, those with preexisting conditions should take caution and consult with a physician prior to engaging in this style of yoga.
... Several trials have indeed investigated the effects of yoga on balance and fall prevention in older adults or diseased patients; and most of them found beneficial effects [8][9][10][11]18]. The effects are considered results of increased postural awareness [19,20] and proprioception [19][20][21], as well as increased muscle strength [22][23][24]. Results of the trials however have to be Table 1 The bivariate association between practicing yoga or meditation often and four falls-related events, for 9822 Australian women aged 59-64 years. interpreted with care because of their often low quality and/or the underutilizing of appropriate measures of balance. ...
Article
Introduction: Falls are the leading cause of injuries in women across all ages. While yoga has been shown to increase balance, it has also been associated with injuries due to falls during practice. This study aimed to analyse whether regular yoga or meditation practice is associated with the frequency of falls and fall-related injuries in upper middle-aged Australian women. Methods: Women aged 59-64 years from the Australian Longitudinal Study on Women's Health (ALSWH) were queried regarding falls and falls-related injuries; and whether they regularly practiced yoga or meditation. Associations of falls and falls-related injuries with yoga or meditation practice were analysed using chi-squared tests and multiple logistic regression modelling. Results: Of 10,011 women, 4413 (44.1%) had slipped, tripped or stumbled, 2770 (27.7%) had fallen to the ground, 1398 (14.0%) had been injured as a result of falling, and 901 (9.0%) women had sought medical attention for a fall-related injury within the previous 12 months. Yoga or meditation was practiced regularly by 746 (7.5%) women. No associations of falls, fall-related injuries and treatment due to falls-related injury with yoga or meditation practice were found. Discussion: No association between yoga or meditation practice and falls or fall-related injuries have been found. Further studies are warranted for conclusive judgement of benefits and safety of yoga and meditation in relation to balance, falls and fall-related injuries.
... The rationale hypothesis to the cardiorespiratory improvement associated with yoga training is an expected physiological adaptation related to an increased oxygen delivery, decreased oxygen consumption and respiration rate, and decreased resting heart rate for a same effort level, resulting in improved exercise capacity (Raub, 2002). Similarly to our findings, Tracy and Hart (2013) have not found changes in VO 2 max in healthy young adults yoga practitioners, after eight weeks of intervention. The intensity of exercise performed in a traditional yoga class is low, as shown by Ray, Pathak, and Tomer (2011), who have found a range from 9.9% to 26.5% of VO 2 max during a full yoga practice session. ...
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Regular physical activity has been shown to improve overall physical fitness. The long-term adherence to physical activity is a big challenge for health maintenance; so, pleasure activities, as Hatha Yoga (yoga), may represent a good alternative on both individual and public contexts. Yoga is an ancient activity designated to both health and unhealthy individuals. It integrates physical, mental, and spiritual components and may improve aspects of health. The aim of the present study was to evaluate the effects of a 12-week systematized yoga intervention on health-related physical fitness components assessed by body mass, body mass index (BMI), waist circumference (WC), relative body fat, abdominal endurance, upper body endurance, hamstring flexibility, and cardiorespiratory fitness. The study was performed at University of Brasilia, Faculty of Physical Education, Distrito Federal, Brazil. Twenty-five young healthy yoga novices (22.36 ± 2.40 years), both gender, volunteered to participate in this study. The intervention was based on 50 minutes yoga class, twice a week for 12 weeks, involving physical poses, meditation, and relaxation. Measurements were performed one week prior to and one week after the yoga intervention. Collecting data included age, gender, height, body mass, body fat estimates and physical fitness tests. Body fat percentage was determinated by the measure of skinfolds at seven sites. Muscle strength/endurance was evaluated by push-up and sit-up tests. Hamstring flexibility was assessed using sit-and-reach test protocol. The 12-minutes Cooper test was performed to estimate cardiorespiratory fitness. Participants that attended at least 75% of the total sessions were included in the study results. The results showed 1.3 (1.0 - 4.0) cm decrease in WC and 0.7 (0.9 - 1.5) decrease in body fat percentage, and 7.8 (2.0 - 5.0) cm increase in hamstring flexibility and 3.0 (1.0 - 4.0) in abdominal endurance, after the yoga intervention (p
... In this study, one month of yogic practices significantly reduced resting heart rate along with systolic, diastolic and mean arterial blood pressure. Previously, eight weeks of Bikram yoga practices in sedentary, normotensive young adults were found helpful in this regard with increased physical functions [24] . These observations were quite similar to previous scientific studies those reported reductions in arterial blood pressure after 10 weeks of yoga practices [4,12] . ...
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Background: There is paucity in published scientific work addressing effect of yoga training on healthy individual at altitude above sea level. Thus, this study was aimed to observe effects of one month yogic intervention on perceived stress and other responses of healthy Indian men at moderate altitude. Methods: Twenty two healthy Indian men aged 29.7 ± 4.3 years (Mean ± SD) participated in an one month yoga training program for 6 days in a week, during 6-7am in the morning, at an altitude of 1600m (5052ft). Their perceived stress score (PSS), resting heart rate (RHR), arterial blood pressure (SBP, DBP) and peripheral capillary oxygen saturation (SpO2%) were measured at baseline and after one month yoga practices. Metabolic analyzer was used to measure resting oxygen consumption (V̇O2rest), carbon dioxide production (V̇CO2rest), and energy expenditure (EEm). Graphpad prism 6 and IBM SPSS 21 were used to perform statistical tests as applicable to analyze the within subject changes for all the variables except age and height. Correlation coefficients of changes in between V̇O2rest, V̇CO2rest and EEm were also calculated. Results: Most of the variables decreased significantly post one month yogic intervention and trends of reduction was observed for V̇O2rest (p=0.06), R (p=0.127) and EEm (p=0.058) after one month yoga training. Reduction in EEm was found to be significantly correlated with V̇O2rest and V̇CO2rest (p<0.001) respectively. Conclusion: One month yoga training at moderate altitude may reduce perceived stress, resting metabolism, and improve cardiovascular functions of healthy Indian men. Keywords: altitude, blood pressure, metabolism, stress, yoga
... For instance it is said of Bikram Yoga that while a regular session can improve muscle strength, there is no effect on aerobic fitness. [6] A very recent study finds that the high ambient temperature of the Bikram yoga session provides no added benefits over and above other forms of hatha yoga. [7] All the studies on resting heart rate and systolic and diastolic blood pressure have reported that Bikram yoga delivers no significant change over time. ...
... A further 20 met all selection criteria, apart from the reporting of SD change . The authors of these papers were contacted, but only four responses were received, and full data were not provided in these instances (35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54). Contact was made by email. ...
Article
Previous reports of substantial inter‐individual differences in weight change following an exercise intervention are often based solely on the observed responses in the intervention group. Therefore, we aimed to quantify the magnitude of inter‐individual differences in exercise‐mediated weight change. We synthesized randomized controlled trials (RCTs) of structured, supervised exercise interventions. Fourteen electronic databases were searched for relevant studies published up to March 2017. Search terms focused on structured training, RCTs and body weight. We then sifted these results for those RCTs (n = 12, 1500 participants) that included relevant comparator group data. Standard deviations (SDs) of weight change were extracted, thereby allowing the SD for true inter‐individual differences in weight loss to be calculated for each study. Using a random effects meta‐analysis, the pooled SD (95% CI) for true individual responses was 0.8 (−0.9 to 1.4) kg. The 95% prediction interval (based on 2SDs) for true inter‐individual responses was −2.8 to 3.6 kg. The probability (% chance) that the true individual response variability would be clinically meaningful (>2.5 kg) in a future study in similar settings was 23% (‘unlikely’). Therefore, we conclude that evidence is limited for the notion that there are clinically important individual differences in exercise‐mediated weight change.
... It is more difficult to explain why aerobic capacity did not increase after 22 hot yoga sessions as reported by Tracy and Hart. [38] The majority of participants in the study ranged between 2.18 and 3.40 yoga sessions per week, which may have created a large variance in the aerobic capacity outcome. All participants in the current study were 100% compliant at 3 sessions per week. ...
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Context: Chronic heat exposure promotes cardiovascular and cellular adaptations, improving an organism's ability to tolerate subsequent stressors. Heat exposure may also promote neural adaptations and alter the neural-hormonal stress response. Hot-temperature yoga (HY) combines mind-body exercise with heat exposure. The added heat component in HY may induce cardiovascular and cellular changes, along with neural benefits and modulation of stress hormones. Aims: The purpose of the present study is to compare the cardiovascular, cellular heat shock protein 70 (HSP70), neural, and hormonal adaptations of HY versus normal-temperature yoga (NY). Settings and design: Twenty-two subjects (males = 11 and females = 11, 26 ± 6 years) completed 4 weeks of NY (n = 11) or HY (n = 11, 41°C, 40% humidity). Yoga sessions were performed 3 times/week following a modified Bikram protocol. Subjects and methods: Pre- and posttesting included (1) hemodynamic measures during a heat tolerance test and maximal aerobic fitness test; (2) neural and hormonal adaptations using serum brain-derived neurotrophic factor (BDNF) and adrenocorticotropic hormone (ACTH), along with a mental stress questionnaire; and (3) cellular adaptations (HSP70) in peripheral blood mononuclear cells (PBMCs). Statistical analysis: Within- and between-group Student's t-test analyses were conducted to compare pre- and post-VO2 max, perceived stress, BDNF, HSP70, and ACTH in HY and NY groups. Results: Maximal aerobic fitness increased in the HY group only. No evidence of heat acclimation or change in mental stress was observed. Serum BDNF significantly increased in yoga groups combined. Analysis of HSP70 suggested higher expression of HSP70 in the HY group only. Conclusions: Twelve sessions of HY promoted cardiovascular fitness and cellular thermotolerance adaptations. Serum BDNF increased in response to yoga (NY + HY) and appeared to not be temperature dependent.
... K. Cramer 2013). In addition, pre-designed studies reporting on adverse reactions have mostly focused healthy young adults and have not included detailed accounts of the pre-existing health conditions of the sample (Tracy andHart 2013, H. K. Cramer 2013). ...
Article
Introduction: The number of individuals practicing hot yoga across the United States has increased over the past decade, though the risks of hot yoga practice are not yet fully understood. The American population in general has a high prevalence of a number of chronic health conditions including heart disease, asthma, and diabetes. However, the risks for individuals with these pre-existing health conditions have not yet been identified. Methods: A large cross-sectional study (n=700) was conducted via online survey. Results: A Chi-squared analysis was conducted to examine the relationship between various pre-existing health conditions and the incidence of an adverse outcome related to participation in hot yoga practice. Discussion: Every pre-existing health condition recorded in this study was a risk factor for at least one adverse outcome resulting from hot yoga practice. Further study is required to verify populations most at risk and preventing injury or illness resulting from hot yoga participation. Conclusion: Little is known about the risks of hot yoga practice for those with various health conditions. This paper outlines the associations between hot yoga injuries and adverse outcomes and pre-existing health conditions. Keywords: Hot Yoga, Risks, Injuries, Pre-existing Conditions, Safety
... The enhancement of physical fitness and improvement of body composition in the older adults following yogic practice has been reported [7]. Bikram yoga associated with increased head lift strength, substantially increased lower back/ hamstring flexibility, increased shoulder flexibility, and modestly decreased body fat, while no changes reported in handgrip strength, cardiovascular measures, or maximal aerobic fitness [57]. A recent review summarized that yoga may engender improvements in some components of fitness in older adults also suggesting that more evidence is required to determine its effectiveness as an alternative exercise to promote fitness in older adults [41] Oxidative Stress and Other Age-Related Biochemical Variables Studies [6,52,58] showed that yoga can decrease oxidative stress and improve antioxidant and redox status. ...
Chapter
Yoga is an ancient Indian system of philosophy, culture, tradition, and way of maintaining better life, established in India thousands of years ago. The Sanskrit word Yoga means union of body and mind through breath control methods, asanas and meditation. The ashtang yogic practices, very popularly known today, are derived from Patanjali’s Yoga Sutra. Asana (postural exercises), pranayama (breathing maneuver), and dhyana (meditation) are mostly practiced in different combinations for physical and mental well being. It gradually develops the spiritual harmony of the individual through the control of mind and body. The practice of yoga uses eight methods, known as “limbs,” thus being known as “Ashtanga Yoga”: yama (restraint), niyama (observance), asana (posture), pranayama (breath control), pratyahara (sensory deprivation), dharana (contemplation), dhyana (fixing the attention), and samadhi (absolute concentration). Regular yogic practices endow perfect physical and mental health to its practitioner. It improves aerobic capacity, anaerobic capacity, joint flexibility, and muscle strength. Evidence shows that the regular execution of these practices provides the practitioner with more physical flexibility, muscle strengthening, increased vitality, delineated psychological stress, and reduced cardiovascular risks. Yogic techniques are known to improve one’s overall performance and work capacity. During yoga session, the postural maneuvers are executed without repetition and are connected to each other by passages that establish links between the exercises in a sequence. Yoga is not only a discipline to be practiced by saints or spiritual aspirants but also has relevance to the spirit of military activities.
... In another randomized study, no significant change in VO2max was observed after 8 weeks yoga practice (n=10) compared to control group 317 Therefore, increase in VO2max in yoga practitioner is may be due to reduction in weight and BMI. ...
Thesis
Objective: We intended to evaluate the efficacy of yogic exercise on cardio-respiratory fitness; memory, stress, mental health and plasma nitric oxide level in healthy adult subjects. We also aimed to find out the correlation between change in cardiorespiratory fitness & mental health and nitric oxide level due to yoga practice. Methods: In this yoga interventional study, the most prevalent yoga exercise model (Asanas, Pranayama and Meditation) was used. The study samples (n=200) were healthy male (n=120) and female (n=80) adults (mean age=39.95 years) were recruited by taking written consent. Subjects with any systemic and/or psychological disorders or under specific medications, pregnant women were excluded. Subjects who have never practiced or practicing yoga or other type of physical exercise and willing to practice yoga (1 hr per day; 6 days per week for 6 months) were included in the study. Data was collected at baseline (pre-yogic exercise) and after 6-months of yoga training (post-yogic exercise). The following parameters were measured at baseline and after yoga practice for 6 months: Cardio-respiratory parameters and fitness: Resting HR, resting BP, HR and BP after Harvard Step Test (HST), vital capacity, FEV1, PEFR, VO2max, physical fitness index (PFI); Mental health: memory, perceived stress (PSS), anxiety, depression, emotional balance, loss of behavioral or emotional control, general positive affect, life satisfaction, psychological distress & well-being, mental health index (MHI); and plasma nitric oxide level (NOx). The collected data was statistically analyzed with SPSS (24th version). Paired t-test was applied to determine the significance difference between baseline and post-yogic data values. The p-value was established at 5% level of significance. vii Results: We found significant decrease in resting heart rate (p<0.0001) and resting SBP and DBP (p<0.0001); significant increase vital capacity (p<0.0001), FEV1 (p<0.0001), PEFR (p<0.0001) and increase in VO2max (p<0.0001) by 14.43%, NOx (p<0.001) after yoga regimen. We found significant increase (p<0.0001) in physical fitness index by 56%. Yogic exercise for 6 months resulted in significant increase in memory score ((p<0.0001) and significant reduction in perceived stress score (PSS); anxiety (p<0.0001), depression (p<0.0001), and loss of behavioral or emotional control (p<0.0001) and psychological distress (p<0.0001) scores. Further, we found significant increase in general positive affect (p<0.0001), emotional ties (p<0.0001), life satisfaction (p<0.0001) scores. Regular practice of yoga for 6 months have resulted in significant increase in mental health index (p<0.0001). Conclusion: Significant improvement in cardio-respiratory fitness and mental health due to yoga practice suggests the extremely positive health benefits on physiological as well as psychological health. The results indicate the effectiveness of yoga as mind and body work out modality to improve the cardio-respiratory and mental health, if practiced regularly.
... In line with our hypothesis, performing the yoga session in a heated environment (HY) commonly used in hot yoga practice (105°F / 41.5°C) did not significantly increase the aerobic requirements or energy cost of exercise compared to performing the session at room temperature (RTY). Per our findings presented in Table 1, neither condition achieved VO2 or caloric consumption thresholds for improving aerobic fitness (26,56) or producing chronic improvements in body composition (19). Notably however, our present results do suggest an increase in fat metabolism indicated by our measurements of gas exchange (Table 1) and acute alterations in IL-6 ( Table 3). ...
Article
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International Journal of Exercise Science 13(3): 802-817, 2020. Performing yoga in a heated environment (HY) is a popular exercise mode purported to improve range of motion (ROM), body composition, and aerobic fitness. The purpose of this investigation was to compare a session of HY to room temperature yoga (RTY) with regards to ROM, oxygen consumption, caloric expenditure, and biomarkers of acute stress and inflammation. Sixteen experienced yoga practitioners (F14, M2; 40 ± 11yr; 22.6 ± 1.8 kg/m2) completed a 1-hour standardized Bikram sequence in HY (105°F, 40°C) and RTY (74°F, 23.3°C) conditions (order of conditions randomized, humidity standardized at 40%). Intra-exercise metabolic gas exchange and heart rate (HR) was monitored using a metabolic cart. ROM measures were taken pre and post-exercise at the elbow, shoulder, hip, and knee. Cytokines interleukin 6,10 (IL-6, IL-10) and tumor-necrosis-factor alpha (TNF-α) were analyzed from blood samples collected pre- and 30-minutes post-exercise. Intra-exercise metabolic gas exchange and heart rate (HR) was monitored using a metabolic cart. Both bouts elicited similar acute changes in ROM although HY elicited a greater increase in hip abduction (RTYΔ° = 2.3 ± 1.3|HYΔ° = 6.6 ± 1.5; p < 0.05). Mean VO2, peak VO2, %VO2max, HR, and kcal expenditure did not differ between conditions. RER was lower during the HY (RTY = 0.95 ± 0.02| HY = 0.89 ± 0.02; p < 0.05) with a concomitant elevation in fat oxidation (RTY = 0.05 ± 0.01|HY = 0.09 ± 0.01, g·min-1; p < 0.05) and decrease in carbohydrate oxidation (RTY = 0.51 ± 0.04|HY = 0.44 ± 0.03, g·min-1; p < 0.05). Serum IL-6 was increased (15.5 ± 8.0-fold) following HY only (p < 0.05). HY does not significantly elevate aerobic energy cost compared to RTY but may acutely increase fat substrate utilization and hip ROM. Future studies remain needed to establish dose-response relationships for including HY or RTY into well-rounded fitness programs.
... [2] Due to the strict format of 26 postures in the same sequence, with certified instructors using standardized scripts, all conducted in a climate-controlled environment, Bikram Yoga is uniquely suited for scientific research. [3] However, it is unknown why someone is motivated to participate in long-term Yoga practice to maintain health benefits over time. ...
Article
Background: In our modern society, physical activity is a lifestyle choice. Bikram Yoga is a low impact; moderate exercise and the understanding of motivation and adherence to the practice is unknown. This study aimed to evaluate the effect of 90 min Bikram Yoga practice on basic psychological needs of competence (the sense of skill mastery), autonomy (volitionally performing a task), and relatedness (a connection with others) as postulated in self-determination theory for motivation. Methods: The sample included Bikram Yoga practitioners in the Southwestern United States (n = 126) averaged between the age group of 35 and 64, predominately female, and highly educated. Responses to the Psychological Need Satisfaction in Exercise Scale were analyzed using multivariate analysis of variance. Results: Results showed a statistically significant effect of frequency of Yoga attendance on the satisfaction of basic psychological needs (i.e., competence, autonomy, and relatedness); (P = 0.025); specifically, Yoga practitioners who attended four or more classes per week had higher satisfaction levels of Basic Psychological Need for competence (P = 0.013) and relatedness (P = 0.034). A statistically significant effect of the level of experience on the satisfaction of basic psychological needs (i.e., competence, autonomy, and relatedness) (P = 0.014) found in experienced Bikram Yoga practitioners, specifically for competence (P = 0.013) and relatedness (P = 0.023) compared to novice counterparts. Conclusion: The study provides some evidence of an individual's motivation for a 90 min Bikram Yoga practice and possible adherence. Future investigation of Bikram Yoga practice adopting self-determination theory appears worthwhile.
... Nevertheless, some studies that use subjective methods to study the effect of hatha yoga on bio energy show that systematic practice improves yogi's vitality and perception of their own physical condition, social functioning and quality of life (7). Also, due to the nature of the physical exercises carried out in hatha yoga, there are often exceptional physical abilities in the yoga exercises, especially in muscular flexibility, strength (8)and stress control (9,10). ...
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Objectives: Yoga is one of the alternatives that attract the attention of a large number of people in the hope of positive changesin health. The purpose of this study is to assess the influence of diet and yoga exercises on the body mass and various functional parameters. Methods: Eleven subjects practicing yoga and 11 healthy, non-yoga participated in the study. Body composition was determined with Body Composition Analyzer, model IoI 353. The energy value of the usual diet is calculated through a simple food questionnaire. The assessment of physical development and functional training was done by several indices. Results: The main results are that diet containing less fat and protein and more carbohydrates leads to lower body mass index and there is no relationship between muscle mass and the amount proteins in the diet. Yoga affects the breath holding during inhalation in comparison with the control group (p = 0.019), but does not affect the breath holding during exhalation. Conclusion: Yoga could significantly improve the general condition of a person, with the main benefits of maintaining a healthy weight.
... High temperature yoga, originating in Thailand (the training temperature is as high as 40°C), has a clear demand for ambient temperature. Its theory proposes that the most effective and, therefore, the most ideal way to lose weight and keep fit are to practice yoga at a high temperature [3,4]. But the relevant confirmatory studies are lacking which are about the therapeutic effect of high temperature yoga on the well-being of overweight middle-aged and young women. ...
Article
To explore the effect of high temperature yoga exercise on improving physical and psychological well-being of overweight middle-aged and young women. 50 overweight middle-aged and young women from yoga clubs were selected. The indexes of their constitution, physiological functions, psychological adaptation were measured and compared before and after one year of uninterrupted high temperature yoga exercise. The indexes of the subjects' constitution and physiological functions were remarkably uplifted (P < 0.05); their psychological adaptation was improved as well. Aerobics represented by high temperature yoga can improve body shape, lower lipid, reduce weight, and exert an evident therapeutic effect on improving physiological functions and boosting psychological well-being.
... [43]. Bikram yoga classes are undertaken in a room held at a constant heat of 40 degrees Celsius and humidity of 40% [43,44]. Bikram yoga postures are classified as light-tomoderate by the American College of Sports Medicine [45], however, Bikram yoga intensities (although highly dependent on posture) have been reported to reach up to 6.0 metabolic equivalence of task [46], the threshold for vigorous activity intensity. ...
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Background: The neurobiology of persistent pain shares common underlying psychobiology with that of traumatic stress. Modern treatments for traumatic stress often involve bottom-up sensorimotor retraining/exposure therapies, where breath, movement, balance and mindfulness, are used to target underlying psychobiology. Vigorous exercise, in particular Bikram yoga, combines many of these sensorimotor/exposure therapeutic features. However, there is very little research investigating the feasibility and efficacy of such treatments for targeting the underlying psychobiology of persistent pain. Methods: This study was a randomized controlled trail (RCT) comparing the efficacy of Bikram yoga versus high intensity interval training (HIIT), for improving persistent pain in women aged 20 to 50 years. The participants were 1:1 randomized to attend their assigned intervention, 3 times per week, for 8 weeks. The primary outcome measure was the Brief Pain Inventory (BPI) and further pain related biopsychosocial secondary outcomes, including SF-36 Medical Outcomes and heart rate variability (HRV), were also explored. Data was collected pre (t0) and post (t1) intervention via an online questionnaire and physiological testing. Results: A total of 34 women were recruited from the community. Analyses using ANCOVA demonstrated no significant difference in BPI (severity plus interference) scores between the Bikram yoga (n = 17) and the HIIT (n = 15). Women in the Bikram yoga group demonstrated significantly improved SF-36 subscale physical functioning: [ANCOVA: F(1, 29) = 6.17, p = .019, partial eta-squared effect size (ηp2) = .175 and mental health: F(1, 29) = 9.09, p = .005, ηp2 = .239; and increased heart rate variability (SDNN): F(1, 29) = 5.12, p = .013, ηp2 = .150, scores compared to the HIIT group. Across both groups, pain was shown to decrease, no injuries were experienced and retention rates were 94% for Bikram yoga and 75% for HIIT . Conclusions: Bikram yoga does not appear a superior exercise compared to HIIT for persistent pain. However, imporvements in quality of life measures and indicator of better health were seen in the Bikram yoga group. The outcomes of the present study suggest vigorous exercise interventions in persistent pain cohorts are feasible. Trial registration: Australian New Zealand Clinical Trials Registry ( ACTRN12617001507370 , 26/10/2017).
... Even though yoga is a popular trend in professional sports, less is known in the scientific literature about its real effects in the matter of strength and conditioning for elite athletes. However, many studies indicate the avenues of exploration: 24 yoga sessions through 8 weeks of Bikram yoga improves strength of the lower limbs; 29 measured with kinematic, kinetic, and biomechanical data, Hatha yoga postures showed that they can engender an appreciable range of joint angles through the ankle, knee, and hip, and elicited a qualitative rectus abdominis activity. 30 The effects on flexibility are also noticed in many positives ways, as well as the delayed onset of muscle soreness in the lower extremity. ...
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In preparation for a short track speed skating season, eight men and seven women were given yoga sessions during an 8-week high volume training cycle. The sessions were planned according to the postural aspects specific to short track speed skating technical requirements. Three specific goals were selected for the intervention: 1) to observe whether the practice of yoga as postural training could improve the efficiency and the athlete's repertoire along the muscular synergies solicited in the short track speed skating specific technique; 2) to enhance and diversify the motor time-on-task of athletes without changing the prescription of other training stimulus; and 3) to lower the risk of injury during periods with high volumes of training. A total of 36 sessions of yoga were given. Three postural tests were administered before and after the intervention with 14 angles analyzed. Non-parametric Wilcoxon test was used to compare angles' variations. The 36 yoga sessions totalized 986 minutes of motor time-on-task, registering a proportion of 30% of the global motor time-on-task of the training cycle. Improvements were found in eleven of the 14 angles measured when comparing pre- and post-postural tests (P-value from 0.01 to 0.005). During the 8 weeks, excepting traumatic injuries due to short track speed skating accidents, no skaters suffered injuries linked to the high volume of training. Following the intervention, coaches noticed, following their on-ice feedbacks, an adjustment in the efficiency of the skating technique, in particular regarding hip dissociation. These results suggest that yoga could be inserted into out-of-season training cycles, even in a high volume training cycle. Planned with the decision training tools, it allows athletes to diversify their motor time-on-task by integrating a new functional range of generic movements with the solicitation of neuromuscular synergies related to the specificity of their sport.
... 10 Four studies have investigated the medium-term (8 weeks to 1 year) effects of Bikram yoga practice on resting HR and blood pressure (BP) in normotensive adults and none of them reported significant changes over time. 7,[11][12][13] However, in nonheated yoga, where the literature is more extensive and includes more subjects, several studies reported that yoga effectively reduced BP in both normotensive and hypertensive subjects. 14 In the short term, physical activity produces an increase in HR and oxygen consumption. ...
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Introduction: Main cardiovascular parameters such as heart rate (HR), blood pressure, and myocardial oxygen consumption (MOC) are tightly regulated by a multifactorial, nonlinear control system. Increased HR because of physical activity is often accompanied by an increase in blood pressure. Postural changes have an effect on the baroreceptors, and stretching exercises and isometric contractions modulate muscle mechanoreceptors eliciting increases in blood pressure. However, a hot environment increases the core temperature inducing vasodilation and plasma volume changes that might contribute to a drop in blood pressure. During the practice of Bikram yoga, all these factors converge and little is known about the resulting changes in blood pressure and MOC. Methods: Sixteen apparently healthy female volunteers, regular practitioners of Bikram yoga, were evaluated during a 90 min session. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured immediately after each posture and HR was measured continuously during the practice. Results: HR and estimated MOC increased significantly over baseline during the exercise (+62.3% and +63.6%, respectively). HR mean value across the entire Bikram yoga session was 126.6 ± 14.3 bpm reaching a maximum of 168.1 ± 20.2 bpm. SBP was not significantly increased over baseline at any time during the practice with a mean value of 117.0 ± 10.1 mmHg and DBP was significantly decreased over baseline most of the time (-10.1%, mean 71.2 ± 7.3 mmHg) with particular decline toward the end of the practice during the floor postures. Conclusions: DBP during the practice of Bikram yoga was significantly different from that previously reported for nonheated Hatha yoga for normotensive subjects. Further studies evaluating the same group at both conditions are needed to better characterize the magnitude of the changes in HR, SBP, DBP, and MOC.
... structural alignment, use of props, and sequencing of poses. Bikram yoga [21] is a specific type of physical practice, which is trademarked and strictly standardised across instructors and studios. Vinyasa yoga [22] is a more vigorous style of yoga and requires the subject to move continuously through poses versus holding poses. ...
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Understanding the motivation and satisfaction of yoga consumers is of critical importance for both leisure service providers and leisure researchers to enhance the sustainability of personal lives in terms of physical wellness and mental happiness. For this purpose, this study investigated 25,120 pairs of online ratings and reviews from 100 yoga centres in Shanghai, China using latent Dirichlet allocation (LDA)-based text mining, and successfully established the relationship between rating and review. Findings suggest that Chinese yogis are motivated by improving physical condition, improving psychological condition, gracing appearance, establishing social connection, and creating social isolation. In addition to teaching mainstream yoga, yoga centres also provide additional courses. From a consumer perspective, yogis are relatively satisfied with teachers, courses, and the environment, but complain about the supporting staff, membership price, and reservation service. Managerially, yoga centres are encouraged to continue attending to the motivations of yogis, specialising their guidance, and fostering strengths and circumventing weaknesses in their service. This study also contributes by verifying, elaborating on, and tentatively extending the framework of the Physical Activity and Leisure Motivation Scale (PALMS).
... 0 (0.0%) 0 (0.0%) Ashtanga yoga [12][13][14][15] 4 3 (75.0%) 1 (25.0%) 0 (0.0%) Bikram yoga 16,17 2 2 (100.0%) 0 (0.0%) 0 (0.0%) Broota relaxation technique 18 1 1 (100.0%) ...
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Objective: To determine whether the odds of positive conclusions in randomized controlled trials (RCTs) of yoga, differ between yoga styles. Design: Systematic review of yoga RCTs. Medline/PubMed, Scopus, the Cochrane Library, IndMED and the tables of content of specialist yoga journals, not listed in medical databases, were screened up to 12 February, 2014 for RCTs comparing yoga interventions to non-yoga interventions. The RCTs' conclusions were classified as positive (yoga is helpful for a respective condition) or not positive; and these were compared between different yoga styles using the Chi squared test and multiple logistic regression analysis. Results: A total of 306 RCTs were included. These applied 52 different yoga styles, the most commonly used of which were: hatha yoga (36 RCTs), Iyengar yoga (31 RCTs), pranayama (26 RCTs), and the integrated approach to yoga therapy (15 RCTs). Positive conclusions were reached in 277 RCTs (91%); the proportion of positive conclusions did not differ between yoga styles (p=0.191). Conclusion: RCTs with different yoga styles do not differ in their odds of reaching positive conclusions. Given that most RCTs were positive, the choice of an individual yoga style can be based on personal preferences and availability.
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Yoga, a popular mind-body practice, may produce changes in cardiovascular disease (CVD) and metabolic syndrome risk factors. This was a systematic review and random-effects meta-analysis of randomized controlled trials (RCTs). Electronic searches of MEDLINE, EMBASE, CINAHL, PsycINFO, and The Cochrane Central Register of Controlled Trials were performed for systematic reviews and RCTs through December 2013. Studies were included if they were English, peer-reviewed, focused on asana-based yoga in adults, and reported relevant outcomes. Two reviewers independently selected articles and assessed quality using Cochrane's Risk of Bias tool. Out of 1404 records, 37 RCTs were included in the systematic review and 32 in the meta-analysis. Compared to non-exercise controls, yoga showed significant improvement for body mass index (-0.77 kg/m(2) (95% confidence interval -1.09 to -0.44)), systolic blood pressure (-5.21 mmHg (-8.01 to -2.42)), low-density lipoprotein cholesterol (-12.14 mg/dl (-21.80 to -2.48)), and high-density lipoprotein cholesterol (3.20 mg/dl (1.86 to 4.54)). Significant changes were seen in body weight (-2.32 kg (-4.33 to -0.37)), diastolic blood pressure (-4.98 mmHg (-7.17 to -2.80)), total cholesterol (-18.48 mg/dl (-29.16 to -7.80)), triglycerides (-25.89 mg/dl (-36.19 to -15.60), and heart rate (-5.27 beats/min (-9.55 to -1.00)), but not fasting blood glucose (-5.91 mg/dl (-16.32 to 4.50)) nor glycosylated hemoglobin (-0.06% Hb (-0.24 to 0.11)). No significant difference was found between yoga and exercise. One study found an impact on smoking abstinence. There is promising evidence of yoga on improving cardio-metabolic health. Findings are limited by small trial sample sizes, heterogeneity, and moderate quality of RCTs. © The European Society of Cardiology 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
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Background A growing number of randomized controlled trials (RCTs) have investigated the therapeutic value of yoga interventions. This bibliometric analysis aimed to provide a comprehensive review of the characteristics of the totality of available randomized yoga trials. Methods All RCTs of yoga were eligible. Medline/PubMed, Scopus, the Cochrane Library, IndMED, and the tables of content of yoga specialty journals not listed in medical databases were screened through February 2014. Bibliometric data, data on participants, and intervention were extracted and analyzed descriptively. Results Published between 1975 and 2014, a total of 366 papers were included, reporting 312 RCTs from 23 different countries with 22,548 participants. The median study sample size was 59 (range 8–410, interquartile range = 31, 93). Two hundred sixty-four RCTs (84.6%) were conducted with adults, 105 (33.7%) with older adults and 31 (9.9%) with children. Eighty-four RCTs (26.9%) were conducted with healthy participants. Other trials enrolled patients with one of 63 varied medical conditions; the most common being breast cancer (17 RCTs, 5.4%), depression (14 RCTs, 4.5%), asthma (14 RCTs, 4.5%) and type 2 diabetes mellitus (13 RCTs, 4.2%). Whilst 119 RCTs (38.1%) did not define the style of yoga used, 35 RCTs (11.2%) used Hatha yoga and 30 RCTs (9.6%) yoga breathing. The remaining 128 RCTs (41.0%) used 46 varied yoga styles, with a median intervention length of 9 weeks (range 1 day to 1 year; interquartile range = 5, 12). Two hundred and forty-four RCTs (78.2%) used yoga postures, 232 RCTs (74.4%) used breath control, 153 RCTs (49.0%) used meditation and 32 RCTs (10.3%) used philosophy lectures. One hundred and seventy-four RCTs (55.6%) compared yoga with no specific treatment; 21 varied control interventions were used in the remaining RCTs. Conclusions This bibliometric analysis presents the most complete up-to-date overview on published randomized yoga trials. While the available research evidence is sparse for most conditions, there was a marked increase in published RCTs in recent years.
Article
Studies have demonstrated positive results for people who practice traditional yoga, specifically in body mass index, depression, cancer, sleeping patterns, and diabetes. Most forms of traditional yoga are held in a temperate climate between 293 Kelvin (K) to 295 K; a temperature that is calming and places little stress on the body. Bikram yoga, however, is a more intense form of yoga performed in a hotter climate, typically at 314 K with 40% humidity. The purpose of this study was to determine how Bikram yoga affected blood pressure, body composition, and sleep patterns in beginner and intermediate/experienced practitioners. Participants (N=16) completed 8 weeks of sessions, ranging between 2 to 7 classes per week in a local Bikram yoga program conducted by certified instructors. All participants were assessed prior to the study and again at the end of the eight weeks. A BOD POD (an air displacement plethysmography) was used for body composition assessments, while a digital blood pressure cuff was used to assess blood pressure. In addition, participants were also surveyed on sleep parameters pre and post yoga participation. In combining all subjects, results showed there was a significant improvement (p=0.054) in faster time to fall asleep (27.66 min pre and 23.967 min post), and a trend (p=0.057) towards improved mean arterial pressure (92.20 mmHg pre and 88.33 mm Hg post). There were no differences in weight loss or percent body fat in subjects. This study indicates that there is a trend towards improved blood pressure and significant improvement in sleep parameters after 8 weeks of Bikram yoga for both intermediate/experienced and beginners, but no differences in body composition.
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The purpose of this study was to find out the impact of adapted yoga with recreational games practice on selected bio-motor variables of intellectually challenged children. For this study, 20 male intellectually challenged children were selected from Faculty of Disability Management and Special Education unit and TAT Kalanilayam Middle School, Coimbatore. The selected subjects were considered as two groups,10subjects in each group. TAT Kalanilayam Middle School boys were treated as experimental group. These 10 subjects hadunder gone adapted yoga with recreational games training designed by the researcher, five days a week for eight weeks. Faculty of Disability Management and Special Education unit boys were treated as control group. The control group did not participate in any specific training programme. The following variables were selected for the study such as biomotor variables namely flexibility and agility.All subjects were tested prior to training and after completion of eight weeks of training on the selected variables. To analyze the collected data investigator used dependent 't' ratio to find out the significant difference between the mean of pre and posttest. Analysis of covariance (ANCOVA) was applied to determine the significance of mean difference between the two groups. The experimental group showed significant difference than the control group after eight weeks ofadapted yoga with recreational games training in all the selected variables.
Article
BACKGROUND: Yoga's benefits on various aspects of health for sighted children is substantially supported by the literature. This study aimed to extend those fidings to children with visual impairment. OBJECTIVE: The aim of the study was to measure changes in upper extremity strength and motor speed in children with visual impairment following 16-weeks of yoga training. METHODS: This was a two arm pre post, single blind, waitlist-controlled study. Eighty-three (yoga [n = 41], control [n = 42]) participants (aged 9-16 years) enrolled, 6 dropped out from the trial. Demographic characteristics were not significantly different between the two groups. The following variables: upper extremity muscle strength; elbow flexion and elbow extension, pinch strength and motor speed were evaluated bilaterally using a handheld dynamometer, pinch dynamometer and finger tapping board respectively at baseline and after the 16-week intervention. SPSS-20 was used for statistical analysis. RESULTS: Significant improvements in all variables (P < 0.05) were observed in the yoga group for both limbs but no significant changes were observed in the control group. CONCLUSION: The study suggests that yoga may be considered an effective option to improve muscle strength and motor function in children with visual impairment.
Article
Purpose: To characterize yoga's impact on WBPU, body composition and functional measures in healthy (50-65y) women. Methods: WBPU and functional measures were compared between women who routinely practiced yoga (YOGA; n=7) and non-active counterparts (CON; n=8). Results: Q (0.61±0.06 vs. 0.78±0.07, p=0.04), PS (3.07±0.37 vs. 4.17±0.40, p=0.03), PB (2.59±0.48 vs. 3.80±0.48, p=0.05) were lower, and lean body mass higher (64±1 vs. 58±2%, p≤0.01) for YOGA vs. CON, respectively. WBPB, and functional measures were similar. Conclusions: Routine yoga practice influenced WBPU in healthy older women. Study findings are novel and provide a basis for future investigations evaluating long-term benefits of yoga as an alternative mode of exercise for maintaining muscle mass in support of active aging.
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Yoga is an increasingly popular activity, perhaps because of its association with stress reduction and relaxation – an association that is generally supported by empirical evidence. Understanding of the mediating variables is, however, limited. Given that, the purpose of this paper is to present a theoretical perspective that encourages systematic research regarding the relationship between yoga, stress, and musculoskeletal activity. This embodied perspective parallels popular interest in the mind-body connection and emphasizes the influence of body position on thinking as well as emotion. Those influences take on added meaning in the context of the Cognitive Appraisal Theory and the Biopsychosocial Model of Challenge and Threat. Investigations of embodied cognition suggest that yoga may reduce stress by affecting the way individuals appraise stressors. The combination of body position and common components of yoga practice may also contribute to that effect, particularly when considering thoughts about the self and feelings of confidence. Findings regarding embodied emotion make a similar contribution to understanding the implications of previous research findings and common yoga practices. Considering yoga and stress from an embodied perspective also highlights the role of the musculoskeletal system in the stress process, leading to the question of whether yoga influences stress by directly influencing the musculoskeletal system, indirectly by influencing awareness of that system, or through a combination of the two. Those questions, in turn, highlight the importance of expanding investigations of psychological processes, body position, musculoskeletal activity during yoga, and the interactions between those variables.
Article
The primary aim of this research was to quantify the degree to which the upper airway temperature changes with singing warm-up. Based on prior upper airway thermoregulation research it was hypothesized that upper airway temperature would not significantly increase during singing warm up when compared to prewarm up and recovery phases. Ten participants completed a short singing warm-up of their choice until they felt sufficiently warmed up while upper airway temperature was measured at 1 second intervals via a transnasal thermistor placed against the posterior pharyngeal wall, just above the larynx. Descriptive statistics and statistical modeling were used for comparison of pre-warm-up, warm-up, and recovery phases of a short singing warm-up. Results indicated a physiologically-significant increase (≥0.5°C) of upper airway temperature during the singing warm-up when compared to the prewarm up average. Significant differences (P < 0.0001) were identified between all pairwise comparisons analyzed for the three phases of data collected (baseline, warm-up, and recovery). These findings support an upper airway tissue temperature increase in response to the singing warm-up. The extent to which these findings can be generalized to the intrinsic laryngeal muscles is still unknown given the technical difficulty of obtaining intramuscular laryngeal temperature measures.
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Bikram yoga is practiced in a room heated to 105°F with 40% humidity for 90 min. During the class a large volume of water and electrolytes are lost in the sweat, specifically, sodium is lost, the main cation of the extracellular fluid. There is little known about the volume of sweat and the amount of sodium lost in sweat during Bikram yoga or the optimum quantity of fluid required to replace these losses. The participants who took part in this small feasibility study were five females with a mean age of 47.4 ± 4.7 years and 2.6 ± 1.6 years of experience at Bikram yoga. The total body weight, water consumed, serum sodium concentration, serum osmolality, and serum aldosterone levels were all measured before and after a Bikram yoga practice. Sweat sodium chloride concentration and osmolality were measured at the end of the practice. The mean estimated sweat loss was 1.54 ± 0.65 L, while the amount of water consumed during Bikram yoga was 0.38 ± 0.22 L. Even though only 25% of the sweat loss was replenished with water intake during the Bikram yoga class, we did not observe a change in serum sodium levels or serum osmolality. The sweat contained 82 ± 16 mmol/L of sodium chloride for an estimated total of 6.8 ± 2.1 g of sodium chloride lost in the sweat. The serum aldosterone increased 3.5‐fold from before to after Bikram yoga. There was a decrease in the extracellular body fluid compartment of 9.7%. Sweat loss in Bikram yoga predominately produced a volume depletion rather than the dehydration of body fluids. The sweating‐stimulated rise in serum aldosterone levels will lead to increased sodium reabsorption from the kidney tubules and restore the extracellular fluid volume over the next 24 hr.
Article
Background Cricket is one of the prominent global team sports. With an emergence of Twenty20 tournaments, the physical preparation of elite cricket players has become complex with high match injury incidence. Yoga as a body-mind training is associated with having positive effects on a person's physical and psychological conditions, bringing in better mind-body equilibrium. Objectives Evaluating the impact of yoga in facilitating muscular functioning and mindfulness among asymptomatic male cricket players. Method First-class domestic male cricket players in the age group of 18-35 years were randomized into yoga group n=42 and wait-list control group n=40. Players received the yoga module for five days per week for a duration of six weeks. Primary outcome measures of muscular functioning were core stability, flexibility, range of motion, static balance, dynamic balance and proprioception of the ankle. Assessments were held at baseline, immediate post-intervention, and a follow-up after six months of intervention. Results A statistical significance with p<.001 was observed for most of the variables at T2 and T3. Comparison of the model fit shows a highly significant p<0.001 difference between the model as compared to the baseline model among most of the variables. Conclusion This yoga module was appropriate for enhancing muscular functioning variables of this study. Continuous practice of this yoga module can reinforce sustainable benefits for male cricket players.
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Background: Overweight is a big problem for sportspersons. Excess body weight affects sportsperson's skills and performances. Excess body fat in sportspersons also increases the risk of heart disease, diabetes, liver disease, arthritis, and allied problems. Objectives: This study was designed to assess the impact of yoga–Preksha meditation on obesity in sportspersons. Materials and Method: The participants were selected randomly from the Physical Education Department of Chaudhary Devi Lal University, Sirsa. Totally seventy students were incorporated in the study. They were divided into two groups of 35 each. Group I was termed as “experimental” and Group II was considered as “control” group. The experimental group was progressively introduced to the selected yogic exercises and Preksha meditation. The practice session was conducted for 60 min on all weekdays except Sundays for a period of 4 months. Control group was not given any such training. Pre data (0 day) and Post data (after 4 months) of both groups i.e. height, weight and body mass index (BMI) was taken. The difference in the percentage of participants improving in the experimental group and the corresponding control group was tested for significance of difference by computing Student's t-test. Results: The results showed that there was a significant reduction in body weight and BMI in experimental group which may be attributed to the dominance of parasympathetic component of autonomic nervous system and simultaneous balance in the stimulatory activity of sympathetic components too. This might have caused alteration in fat mobilization which resulted in reduction in body weight and BMI. Conclusion: The regular practice of yoga–Preksha meditation is helpful in managing the problem of obesity in sportspersons and improves their performance.
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Overweight and obesity affects more than 66% of the adult population and is associated with a variety of chronic diseases. Weight reduction reduces health risks associated with chronic diseases and is therefore encouraged by major health agencies. Guidelines of the National Heart, Lung, and Blood Institute (NHLBI) encourage a 10% reduction in weight, although considerable literature indicates reduction in health risk with 3% to 5% reduction in weight. Physical activity (PA) is recommended as a component of weight management for prevention of weight gain, for weight loss, and for prevention of weight regain after weight loss. In 2001, the American College of Sports Medicine (ACSM) published a Position Stand that recommended a minimum of 150 min wk(-1) of moderate-intensity PA for overweight and obese adults to improve health; however, 200-300 min wk(-1) was recommended for long-term weight loss. More recent evidence has supported this recommendation and has indicated more PA may be necessary to prevent weight regain after weight loss. To this end, we have reexamined the evidence from 1999 to determine whether there is a level at which PA is effective for prevention of weight gain, for weight loss, and prevention of weight regain. Evidence supports moderate-intensity PA between 150 and 250 min wk(-1) to be effective to prevent weight gain. Moderate-intensity PA between 150 and 250 min wk(-1) will provide only modest weight loss. Greater amounts of PA (>250 min wk(-1)) have been associated with clinically significant weight loss. Moderate-intensity PA between 150 and 250 min wk(-1) will improve weight loss in studies that use moderate diet restriction but not severe diet restriction. Cross-sectional and prospective studies indicate that after weight loss, weight maintenance is improved with PA >250 min wk(-1). However, no evidence from well-designed randomized controlled trials exists to judge the effectiveness of PA for prevention of weight regain after weight loss. Resistance training does not enhance weight loss but may increase fat-free mass and increase loss of fat mass and is associated with reductions in health risk. Existing evidence indicates that endurance PA or resistance training without weight loss improves health risk. There is inadequate evidence to determine whether PA prevents or attenuates detrimental changes in chronic disease risk during weight gain.
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Sarcopenia, the age-associated loss of skeletal muscle mass and function, has considerable societal consequences for the development of frailty, disability, and health care planning. A group of geriatricians and scientists from academia and industry met in Rome, Italy, on November 18, 2009, to arrive at a consensus definition of sarcopenia. The current consensus definition was approved unanimously by the meeting participants and is as follows: Sarcopenia is defined as the age-associated loss of skeletal muscle mass and function. The causes of sarcopenia are multifactorial and can include disuse, altered endocrine function, chronic diseases, inflammation, insulin resistance, and nutritional deficiencies. Although cachexia may be a component of sarcopenia, the 2 conditions are not the same. The diagnosis of sarcopenia should be considered in all older patients who present with observed declines in physical function, strength, or overall health. Sarcopenia should specifically be considered in patients who are bedridden, cannot independently rise from a chair, or who have a measured gait speed less that 1 m/s(-1). Patients who meet these criteria should further undergo body composition assessment using dual energy x-ray absorptiometry with sarcopenia being defined using currently validated definitions. A diagnosis of sarcopenia is consistent with a gait speed of less than 1 m·s(-1) and an objectively measured low muscle mass (eg, appendicular mass relative to ht(2) that is ≤ 7.23 kg/m(2) in men and ≤ 5.67 kg/m(2) in women). Sarcopenia is a highly prevalent condition in older persons that leads to disability, hospitalization, and death.
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Interest in yoga is growing, especially among older adults. This review critically summarizes the current literature to investigate whether physical fitness and function benefits are engendered through the practice of yoga in older adults. A comprehensive search yielded 507 studies; 10 studies with 544 participants (69.6 ± 6.3 yr, 71% female) were included. Large variability in yoga styles and measurement outcomes make it challenging to interpret results across studies. Studies reported moderate improvements for gait (ES = 0.54, 0.80), balance (ES = 0.25-1.61), upper/lower body flexibility (ES = 0.25, 0.70), lower body strength (ES = 0.51), and weight loss (ES = 0.73, 0.99).Yoga may engender improvements in some components of fitness in older adults. However, more evidence is needed to determine its effectiveness as an alternative exercise to promote fitness in older adults. Further investigation into yoga as an exercise activity for older adults is warranted.
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To obtain estimates of time to recruit the study sample, retention, facility-based class attendance and home practice for a study of yoga in breast cancer survivors, and its efficacy on fatigue, quality of life (QOL), and weight change. Sixty-three post-treatment stages 0-III borderline overweight and obese (body mass index ≥ 24 kg/m(2)) breast cancer survivors were randomly assigned to a 6-month, facility- and home-based viniyoga intervention (n = 32) or a waitlist control group (n = 31). The yoga goal was five practices per week. Primary outcome measures were changes in QOL, fatigue, and weight from baseline to 6 months. Secondary outcomes included changes in waist and hip circumference. It took 12 months to complete recruitment. Participants attended a mean of 19.6 classes and practiced at home a mean of 55.8 times during the 6-month period. At follow-up, 90% of participants completed questionnaires and 87% completed anthropometric measurements. QOL and fatigue improved to a greater extent among women in the yoga group relative to women in the control group, although no differences were statistically significant. Waist circumference decreased 3.1 cm (95% CI, -5.7 and -0.4) more among women in the yoga compared with the control group, with no difference in weight change. This study provides important information regarding recruitment, retention, and practice levels achieved during a 6-month, intensive yoga intervention in overweight and obese breast cancer survivors. Yoga may help decrease waist circumference and improve quality of life; future studies are needed to confirm these results.
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Several studies suggest yoga may be effective for chronic low back pain; however, trials targeting minorities have not been conducted. PRIMARY STUDY OBJECTIVES: Assess the feasibility of studying yoga in a predominantly minority population with chronic low back pain. Collect preliminary data to plan a larger powered study. Pilot randomized controlled trial. Two community health centers in a racially diverse neighborhood of Boston, Massachusetts. Thirty English-speaking adults (mean age 44 years, 83% female, 83% racial/ethnic minorities; 48% with incomes < or = $30,000) with moderate-to-severe chronic low back pain. Standardized series of weekly hatha yoga classes for 12 weeks compared to a waitlist usual care control. Feasibility measured by time to complete enrollment, proportion of racial/ethnic minorities enrolled, retention rates, and adverse events. Primary efficacy outcomes were changes from baseline to 12 weeks in pain score (0=no pain to 10=worst possible pain) and back-related function using the modified Roland-Morris Disability Questionnaire (0-23 point scale, higher scores reflect poorer function). Secondary efficacy outcomes were analgesic use, global improvement, and quality of life (SF-36). Recruitment took 2 months. Retention rates were 97% at 12 weeks and 77% at 26 weeks. Mean pain scores for yoga decreased from baseline to 12 weeks (6.7 to 4.4) compared to usual care, which decreased from 7.5 to 7.1 (P=.02). Mean Roland scores for yoga decreased from 14.5 to 8.2 compared to usual care, which decreased from 16.1 to 12.5 (P=.28). At 12 weeks, yoga compared to usual care participants reported less analgesic use (13% vs 73%, P=.003), less opiate use (0% vs 33%, P=.04), and greater overall improvement (73% vs 27%, P=.03). There were no differences in SF-36 scores and no serious adverse events. A yoga study intervention in a predominantly minority population with chronic low back pain was moderately feasible and may be more effective than usual care for reducing pain and pain medication use.
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The effectiveness and efficacy of Iyengar yoga for chronic low back pain (CLBP) were assessed with intention-to-treat and per-protocol analysis. Ninety subjects were randomized to a yoga (n = 43) or control group (n = 47) receiving standard medical care. Participants were followed 6 months after completion of the intervention. This study aimed to evaluate Iyengar yoga therapy on chronic low back pain. Yoga subjects were hypothesized to report greater reductions in functional disability, pain intensity, depression, and pain medication usage than controls. CLBP is a musculoskeletal disorder with public health and economic impact. Pilot studies of yoga and back pain have reported significant changes in clinically important outcomes. Subjects were recruited through self-referral and health professional referrals according to explicit inclusion/exclusion criteria. Yoga subjects participated in 24 weeks of biweekly yoga classes designed for CLBP. Outcomes were assessed at 12 (midway), 24 (immediately after), and 48 weeks (6-month follow-up) after the start of the intervention using the Oswestry Disability Questionnaire, a Visual Analog Scale, the Beck Depression Inventory, and a pain medication-usage questionnaire. Using intention-to-treat analysis with repeated measures ANOVA (group x time), significantly greater reductions in functional disability and pain intensity were observed in the yoga group when compared to the control group at 24 weeks. A significantly greater proportion of yoga subjects also reported clinical improvements at both 12 and 24 weeks. In addition, depression was significantly lower in yoga subjects. Furthermore, while a reduction in pain medication occurred, this was comparable in both groups. When results were analyzed using per-protocol analysis, improvements were observed for all outcomes in the yoga group, including agreater trend for reduced pain medication usage. Although slightly less than at 24 weeks, the yoga group had statistically significant reductions in functional disability, pain intensity, and depression compared to standard medical care 6-months postintervention. Yoga improves functional disability, pain intensity, and depression in adults with CLBP. There was also a clinically important trend for the yoga group to reduce their pain medication usage compared to the control group.
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Chronic back pain affects a large proportion of both the general population and of military veterans. Although numerous therapies exist for treating chronic back pain, they can be costly and tend to have limited effectiveness. Thus, demonstrating the efficacy and cost-effectiveness of additional treatment alternatives is important. The purpose of our study was to examine the benefits of a yoga intervention for Veterans Administration (VA) patients. SUBJECTS/INTERVENTION: VA patients with chronic back pain were referred by their primary care providers to a yoga program as part of clinical care. Before starting yoga, a VA physician trained in yoga evaluated each patient to ensure that they could participate safely. The research study consisted of completing a short battery of questionnaires at baseline and again 10 weeks later. Questionnaires included measures of pain, depression, energy/fatigue, health-related quality of life, and program satisfaction. Paired t-tests were used to compare baseline scores to those at the 10-week follow-up for the single group, pre-post design. Correlations were used to examine whether yoga attendance and home practice were associated with better outcomes. Baseline and follow-up data were available for 33 participants. Participants were VA patients with a mean age of 55 years. They were 21% female, 70% white, 52% married, 68% college graduates, and 44% were retired. Significant improvements were found for pain, depression, energy/fatigue, and the Short Form-12 Mental Health Scale. The number of yoga sessions attended and the frequency of home practice were associated with improved outcomes. Participants appeared highly satisfied with the yoga instructor and moderately satisfied with the ease of participation and health benefits of the yoga program. Preliminary data suggest that a yoga intervention for VA patients with chronic back pain may improve the health of veterans. However, the limitations of a pre-post study design make conclusions tentative. A larger randomized, controlled trial of the yoga program is planned.
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Twelve normal healthy volunteers (6 males and 6 females) undergoing yoga training for 90 days were studied for the effect of yoga on exercise tolerance. Their ages ranged from 18 to 28 years. The volunteers were taught only Pranayama for the first 20 days and later on yogic asanas were added. Sub-maximal exercise tolerance test was done on a motorized treadmill by using Balke's modified protocol, initially, after 20 days (Phase-I) and after 90 days of yoga training (Phase-II). Pyruvate and lactate in venous blood and blood gases in capillary blood were estimated immediately before and after the exercise. Minute ventilation and oxygen consumption were estimated before and during the test. Post exercise blood lactate was elevated significantly during initial and Phase-I, but not in Phase-II. There was significant reduction of minute ventilation and oxygen consumption only in males in Phase-I and II at the time when the volunteers reached their 80% of the predicted heart rate. Female volunteers were able to go to higher loads of exercise in Phase-I and II.
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A finger tapping task was used to assess motor speed (MS) of both hands in 53 adults and 152 children before and after yoga training and in 38 adults of a non-yoga (control) group. All subjects were right hand dominant. The 30-second tapping speed (TS) test was considered as three time intervals, i.e. 0-10 second (TS1), 10-20 seconds (TS2) and 20-30 seconds (TS3). There was a significant (Student's t-test) increase in all three TS values following 10 days of yoga in children and 30 days of yoga in adults. However for both groups at baseline and final assessments, TS2 and TS3 were significantly lower than TS1. Hence the TS was increased after yoga training during the first 10-seconds of the test but not during the next 20 seconds. These results suggest an increase in motor speed for repetitive finger movements following yoga training, but not in strength or endurance, as the increase was not sustained over 30 sec.
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The present study aimed at assessing the effects of a set of yoga practices on normal adults (n = 37), children (n = 86), and patients with rheumatoid arthritis (n = 20). An equal number of normal adults, children, and patients with rheumatoid arthritis who did not practice yoga were studied under each category, forming respective control groups. Yoga and control group subjects were assessed at baseline and after varying intervals, as follows, adults after 30 days, children after 10 days and patients after 15 days, based on the duration of the yoga program, which they attended, which was already fixed. Hand grip strength of both hands, measured with a grip dynamometer, increased in normal adults and children, and in rheumatoid arthritis patients, following yoga, but not in the corresponding control groups, showing no re-test effect. Adult female volunteers and patients showed a greater percentage improvement than corresponding adult males. This gender-based difference was not observed in children. Hence yoga practice improves hand grip strength in normal persons and in patients with rheumatoid arthritis, though the magnitude of improvement varies with factors such as gender and age.
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Reports on the effect of yogic exercises on aerobic capacity are few. There is also no literature available on the effect of yogic exercise on perceived exertion (PE) after maximal exercise. In this study the effect of training in Hatha yogic exercises on aerobic capacity and PE after maximal exercise was observed. Forty men from the Indian army (aged 19-23 yr) were administered maximal exercise on a bicycle ergometer in a graded work load protocol. The oxygen consumption, carbon dioxide output, pulmonary ventilation, respiratory rate, heart rate (HR) etc., at maximal exercise and PE score immediately thereafter were recorded. The subjects were divided into two equal groups. Twelve subjects dropped out during the course of study. One group (yoga, n = 17) practiced Hatha yogic exercises for 1 h every morning (6 days in a week) for six months. The other group (PT, n = 11) underwent conventional physical exercise training during the same period. Both groups participated daily in different games for 1 h in the afternoon. In the 7th month, tests for maximal oxygen consumption (VO2Max) and PE were repeated on both groups of subjects. Absolute value of VO2Max increased significantly (P < 0.05) in the yoga group after 6 months of training. The PE score after maximal exercise decreased significantly (P < 0.001) in the yoga group after 6 months but the PT group showed no change. The practice of Hatha yogic exercises along with games helps to improve aerobic capacity like the practice of conventional exercises (PT) along with games. The yoga group performed better than the PT group in terms of lower PE after exhaustive exercise.
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To compare isokinetic strength of leg muscles and foot center of pressure (COP) as a measure of sway between long-term Tai Chi practitioners and controls. Cross-sectional study. Community setting. Twenty subjects in the Tai Chi group and 19 subjects in the control group (age, >55 y). Subjects in Tai Chi group had practiced Tai Chi for a minimum of 3 years. Concentric and eccentric strength of knee extensors and flexors at 60 degrees/s and 120 degrees/s, and foot COP displacement during quiet stance with eyes open or closed. People in the Tai Chi group had significantly higher knee extensor strength at all speeds tested (P<.013), and smaller foot COP excursions for both eyes open and eyes closed conditions (P<.05) than people in control group. No significant difference existed in knee flexors between the 2 groups (P<.713). The COP excursions correlated significantly with the eccentric strength of knee extensors (P<.07) but not with the concentric strength of knee extensors (P<.14) or with the isokinetic strength of knee flexors at most of the speeds (P<.27). These findings support the hypothesis that the maintenance of eccentric strength of postural muscles in the lower extremities, which is beneficial for maintaining good postural stability, is helped through the long-term practice of Tai Chi.
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The purpose of this study was to examine the effects of Taiji training on knee extensor strength and force control in older individuals. Twenty-six healthy older adults (71.9 +/- 1.8 years) participated in the study. Sixteen of the older adults (70.2 +/- 1.8 years) underwent Taiji training for 20 weeks (experimental group), whereas the other 10 (74.6 +/- 1.2 years) served as the control group. For both groups, strength and force control of the knee extensors was assessed twice with an isokinetic dynamometer. Strength was assessed with a maximum voluntary isometric contraction (MVC). Force control was measured as the standard deviation (SD) and coefficient of variation (CV) of force during a constant isometric knee extension task at 2%, 30%, 60%, and 90% MVC. For the experimental group, MVC significantly increased (19.5 +/- 4.9%) and the CV of force decreased (18.9 +/- 3.3%) following Taiji training. Improvements in the CV of force were primarily due to decreases in the SD of force (R(2) =.86) rather than increases in strength (R(2) =.12). Furthermore, decreases in SD of force were independent of improvements in strength. For the control group, strength, SD, and CV of force were not different for the 2 tests. The overall findings suggest that Taiji training improves knee extensor strength and force control in older adults.
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Although there are a number of reports on the effect of yoga training on pulmonary functions, very few studies have been undertaken on the effect of yoga training on respiratory pressures and handgrip endurance. Hence the present work was planned to study the effect of yoga training on hand grip strength (HGS), hand grip endurance (HGE), maximum expiratory pressure (MEP), maximum inspiratory pressure (MIP), forced expiratory volume (FEV), forced expiratory volume in first second (FEV1) and peak expiratory flow rate (PEFR). 20 school children in the age group of 12 to 15 years were given yoga training (asans and pranayams) for 6 months. 20 age and gender-matched students formed the control group. Yoga training produced statistically significant (P < 0.05) increase in HGS and HGE. MEP, MIP, FEV, FEV1 and PEFR also increased significantly (P < 0.001) after the yoga training. In contrast, the increase in these parameters in the control group was statistically insignificant. Our study shows that yoga training for 6 months improves lung function, strength of inspiratory and expiratory muscles as well as skeletal muscle strength and endurance. It is suggested that yoga be introduced at school level in order to improve physiological functions, overall health and performance of students.
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To conduct a systematic review of published literature regarding the effects of yoga, a promising mind-body therapy, on specific anthropometric and physiologic indices of cardiovascular disease (CVD) risk and on related clinical endpoints. We performed a literature search using 4 computerized English and Indian scientific databases. The search was restricted to original studies (1970 to 2004) evaluating the effects of yoga on CVD or indices of CVD risk associated with the insulin resistance syndrome (IRS). Randomized controlled trials (RCTs), nonrandomized controlled trials, uncontrolled (pre and post) clinical trials, and cross-sectional (observational) studies were included if they met specific criteria. Data were extracted regarding study design, setting, population size and characteristics, intervention type and duration, comparison group or condition, outcome assessment, data analysis and presentation, follow-up, and key results, and the quality of each study was evaluated according to specific predetermined criteria. We identified 70 eligible studies, including 1 observational study, 26 uncontrolled clinical trials, 21 nonrandomized controlled clinical trials, and 22 RCTs. Together, the reported results of these studies indicate beneficial changes overall in several IRS-related indices of CVD risk, including glucose tolerance and insulin sensitivity, lipid profiles, anthropometric characteristics, blood pressure, oxidative stress, coagulation profiles, sympathetic activation, and cardiovagal function, as well as improvement in several clinical endpoints. Collectively, these studies suggest that yoga may reduce many IRS-related risk factors for CVD, may improve clinical outcomes, and may aid in the management of CVD and other IRS-related conditions. However, the methodologic and other limitations characterizing most of these studies preclude drawing firm conclusions. Additional high quality RCTs are needed to confirm and further elucidate the effects of standardized yoga programs on specific indices of CVD risk and related clinical endpoints.
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Chronic low back pain is a common problem that has only modestly effective treatment options. To determine whether yoga is more effective than conventional therapeutic exercise or a self-care book for patients with chronic low back pain. Randomized, controlled trial. A nonprofit, integrated health care system. 101 adults with chronic low back pain. 12-week sessions of yoga or conventional therapeutic exercise classes or a self-care book. Primary outcomes were back-related functional status (modified 24-point Roland Disability Scale) and "bothersomeness" of pain (11-point numerical scale). The primary time point was 12 weeks. Clinically significant change was considered to be 2.5 points on the functional status scale and 1.5 points on the bothersomeness scale. Secondary outcomes were days of restricted activity, general health status, and medication use. After adjustment for baseline values, back-related function in the yoga group was superior to the book and exercise groups at 12 weeks (yoga vs. book: mean difference, -3.4 [95% CI, -5.1 to - 1.6] [P < 0.001]; yoga vs. exercise: mean difference, -1.8 [CI, -3.5 to - 0.1] [P = 0.034]). No significant differences in symptom bothersomeness were found between any 2 groups at 12 weeks; at 26 weeks, the yoga group was superior to the book group with respect to this measure (mean difference, -2.2 [CI, -3.2 to - 1.2]; P < 0.001). At 26 weeks, back-related function in the yoga group was superior to the book group (mean difference, -3.6 [CI, -5.4 to - 1.8]; P < 0.001). Participants in this study were followed for only 26 weeks after randomization. Only 1 instructor delivered each intervention. Yoga was more effective than a self-care book for improving function and reducing chronic low back pain, and the benefits persisted for at least several months.
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Little is known about the metabolic and heart rate responses to a typical hatha yoga session. The purposes of this study were 1) to determine whether a typical yoga practice using various postures meets the current recommendations for levels of physical activity required to improve and maintain health and cardiovascular fitness; 2) to determine the reliability of metabolic costs of yoga across sessions; 3) to compare the metabolic costs of yoga practice to those of treadmill walking. In this observational study, 20 intermediate-to-advanced level yoga practitioners, age 31.4 +/- 8.3 years, performed an exercise routine inside a human respiratory chamber (indirect calorimeter) while wearing heart rate monitors. The exercise routine consisted of 30 minutes of sitting, 56 minutes of beginner-level hatha yoga administered by video, and 10 minutes of treadmill walking at 3.2 and 4.8 kph each. Measures were mean oxygen consumption (VO2), heart rate (HR), percentage predicted maximal heart rate (%MHR), metabolic equivalents (METs), and energy expenditure (kcal). Seven subjects repeated the protocol so that measurement reliability could be established. Mean values across the entire yoga session for VO2, HR, %MHR, METs, and energy/min were 0.6 L/kg/min; 93.2 beats/min; 49.4%; 2.5; and 3.2 kcal/min; respectively. Results of the ICCs (2,1) for mean values across the entire yoga session for kcal, METs, and %MHR were 0.979 and 0.973, and 0.865, respectively. Metabolic costs of yoga averaged across the entire session represent low levels of physical activity, are similar to walking on a treadmill at 3.2 kph, and do not meet recommendations for levels of physical activity for improving or maintaining health or cardiovascular fitness. Yoga practice incorporating sun salutation postures exceeding the minimum bout of 10 minutes may contribute some portion of sufficiently intense physical activity to improve cardio-respiratory fitness in unfit or sedentary individuals. The measurement of energy expenditure across yoga sessions is highly reliable.
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Family and friends who provide unpaid care to an individual with a disease or disability (known as informal caregivers) experience numerous threats to their physical health as a result of providing care. In spite of evidence that participation in physical and leisure activities can be health promoting, informal caregivers have reported diminished or completely absent leisure participation. Hatha yoga has documented therapeutic benefits, including reduced anxiety, as well as improved muscle strength and endurance and flexibility. The purpose of this study was to determine the feasibility of conducting an 8-week yoga program with informal caregivers, and to gather pilot data on the effects of yoga on the physical fitness and coping of informal caregivers. Caregivers were randomized into a yoga intervention (n = 8) or control group (n = 9). The yoga sessions were 2.5 hours/week for 8 weeks and consisted of a variety of pranayama (breathing) and asana (postures) activities and were led by a certified yoga instructor. Four caregivers (two in each group) dropped out of the study. After the conclusion of the 8-week yoga program, lower body strength increased significantly for those in the yoga group and other notable trends occurred in terms of coping, upper body strength and aerobic endurance. Caregivers in the control group experienced an unexpected increase in lower body flexibility. These findings indicate that caregivers in a yoga program may receive some benefits. Future studies are encouraged to test the efficacy of yoga as an intervention for caregivers.
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OBJECTIVE: To evaluate the effects of two exercise approaches, Tai Chi (TC) and computerized balance training (BT), on specified primary outcomes (biomedical, functional, and psychosocial indicators of frailty) and secondary outcomes (occurrence of falls).DESIGN: The Atlanta FICSIT (Frailty and Injuries: Cooperative Studies of Intervention Techniques), a prospective, randomized, controlled clinical trial with three arms (TC, BT, and education [ED]). Intervention length was 15 weeks, with primary outcomes measured before and after intervention and at 4-month follow-up. Falls were monitored continuously throughout the study.SETTING: Persons aged 70 and older living in the community.PARTICIPANTS: A total of 200 participants, 162 women and 38 men; mean age was 76.2.MEASUREMENTS: Biomedical (strength, flexibility, cardiovascular endurance, body composition), functional (IADL), and psychosocial well-being (CES-D scale, fear of falling questionnaire, self-perception of present and future health, mastery index, perceived quality of sleep, and intrusiveness) variables.RESULTS: Grip strength declined in all groups, and lower extremity range of motion showed limited but statistically significant changes. Lowered blood pressure before and after a 12-minute walk was seen following TC participation. Fear of falling responses and intrusiveness responses were reduced after the TC intervention compared with the ED group (P = .046 and P = .058, respectively). After adjusting for fall risk factors, TC was found to reduce the risk of multiple falls by 47.5%.CONCLUSIONS: A moderate TC intervention can impact favorably on defined biomedical and psychosocial indices of frailty. This intervention can also have favorable effects upon the occurrence of falls. Tai Chi warrants further study as an exercise treatment to improve the health of older people.
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The civilization of India has produced a great variety of systems of spiritual beliefs and practices. Ancient seers used yoga as a means to explore the exterior and interior world and, perhaps, ultimately to achieve wisdom and knowledge of the sacred Indian texts: the Vedas, Upanishads, and Shastras.6 These great teachers, or gurus, did not equate yoga with religion but more as an art of living at the highest level in attunement with the larger life–reality. The emphasis in yoga was on personal verification rather than on belief. The practice of yoga was a way to inner joy and outer harmony.The Sanskrit word “yoga” comes from the root yug (to join), or yoke (to bind together or to concentrate). Essentially, however, the word “yoga” has come to describe a means of uniting or a method of discipline: to join the body to the mind and together join to the self (soul), or the union between the individual self and the transcendental self. Yoga comes from an oral tradition in which teaching was transmitted from teacher to student. The Indian sage Patanjali, called “The Father of Yoga, ” collated this oral tradition in his classic work The Yoga Sutras, a 2000-year-old treatise on yogic philosophy. He defines yoga as “that which restrains the thought process and makes the mind serene.” Patanjali suggests that ethics (yama and niyama) is the way to cleanse the mind, body, and spirit. He emphasizes a more psychological approach to healing and self-realization. The body's organs and systems are to be cleansed first through asanas (postures) and pranayama (controlling the breath).13 The Sutras provide guidance on how to gain mastery over the mind and emotions and how to achieve spiritual growth. The code of conduct includes the practice of the highest human virtues like ahimsa (noninjury) and satya (truth), and the promotion of the noblest feelings like amity and compassion.2Initially, the discipline of hatha yoga used in the studies described later was developed as a means for meditation: preparing the body and the nervous system for stillness. Physical strength and stamina developed by asanas and pranayama allowed the mind to remain calm. The word “hatha” can be divided into two words: ha (sun) and tha (moon). The common interpretation of hatha yoga is a union of the pairs of opposites. Hatha yoga, the yoga of activity, addresses the body and mind and requires discipline and effort. It is through hatha yoga that most Westerners are introduced to the philosophy. Many people believe that this is yoga and are unaware of the totality of yoga as a philosophy of life.Along with meditation, yoga asanas and pranyama have become popular in the West, and yoga has become “westernized.” Postures are taught as ends in themselves merely to heal an illness, reduce stress, or look better. The fact that these postures are a foundation for self-realization is generally ignored. Yoga is often thought of as calisthenics, epitomized by the headstand, the lotus posture, or another pretzel-like pose. Many think of yoga as a system of meditation or religion. Yoga, however, is meant to be practiced in the larger context of conscious spiritual discipline. The Hatha Yoga Pradipika is considered to be the classic manual on hatha yoga. The first chapter reminds the student that hatha yoga is used as a vehicle in self-realization.25 This goal should be kept in sight. Yoga is proposed to be a preventive as well as curative system of the body, mind, and spirit.14Recently, large numbers of Americans are practicing yoga for its proposed health benefits. Some health professionals are referring their patients to yoga teachers for help in managing a variety of stress-related ailments. Yoga is regarded as a holistic approach to health that not only increases flexibility, strength, and stamina but also fosters self-awareness, emotional stability, and peace of mind. Yoga has become a household word in the West. Millions of men and women read books about yoga, attend classes or seminars, and do the physical exercises for which yoga is famous. Many have tried meditation or some other form of yoga on a regular basis. Clearly, yoga is alive in Western society today.There are various styles of hatha yoga, and each has specific characteristics that reflect a particular approach to the yoga asanas such as Iyengar, Kundalini, Kripalu, and Sivananda. Iyengar, a popular style in the West, is based on the teachings of living yoga master named B.K.S. Iyengar. The method is orderly and progressive. Postures are adjusted to meet the needs and physical conditions of the student. There are specific anatomic guidelines in the execution of the asanas and pranayama.12 As a therapy, yoga is a system designed to refine human physiology. Asanas, or postures, if done properly, are believed to affect every gland and organ in the body. Postures have to be adjusted so that the various organs, joints, and bones are properly positioned so that physiologic changes may occur. Distribution of body weight has to be even on the joints and muscles so that there is no injury. Therapeutic yoga is the performance of postures for treating medical disorders. A key development in this application of yoga is Iyengar's use of props (e.g., chairs, belts, blankets, blocks) to assist the patient in assuming the posture without strain. It is said that each posture has a specific shape to which the body must be adapted and not the asana to the body.23In a disease like osteoarthritis (OA) of the finger joints, asanas are proposed to realign the skeletal structure and loosen stiff joints. Effects may be the result of the geometry of the asana. Many musculoskeletal problems may be mechanical and have to be mechanically considered. Realignment of muscles is proposed to remove the altered stresses and strains and to re-establish anatomic relationships.8
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The objective of this study was to evaluate the effect of Tai Chi Chuan (TCC) on health fitness in older individuals. Methods: Thirty-eight community-dwelling persons aged 58 to 70 yr completed this study. The TCC group included 9 men and 11 women; the control group included 9 men and 9 women. The TCC group practiced TCC for 11.2+/-1.4 months, with the attendance of 4.6+/-1.3 times x wk(-1). Each session included 20 min of warm-up, 24 min of TCC practice, and 10 min of cooldown. The exercise intensity was 52-63% of the heart rate range. Cardiorespiratory function, strength, flexibility, and percent of body fat were evaluated before and at the end of this study. The male TCC group showed 16.1% increase in VO2max (P < 0.01), 11 degrees increase in thoracic/lumbar flexibility (P < 0.05), 18.1% increase in muscle strength of knee extensor (P < 0.01), and 15.4% increase of knee flexor (P < 0.05). The female TCC group showed 21.3% increase in VO2max (P < 0.01), 8.8 degrees increase in flexibility (P < 0.05), 20.3% increase in muscle strength of knee extensor (P < 0.05), and 15.9% increase of knee flexor (P < 0.05). The control group showed no significant change in these variables. The results indicate that a 12-month Tai Chi Chuan program is effective for improving health fitness of the elderly.
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The aim of this study was to assess the levels of flexibility, functional autonomy and QoL in elderly yoga practitioners. The subjects were divided into a yoga group (YG; n = 52; age = 66.79 ± 3.30 years; BMI = 24.77 ± 3.18) and control group (CG; n = 31; age = 69.33 ± 4.84 years; BMI = 24.32 ± 3.71) and submitted to flexibility tests through goniometry, the LADEG autonomy protocol and QoL, using the WHOQOL-Old questionnaire. Repeated measures ANOVA showed increases in articular range of motion in shoulder abduction (Δ%SA = 14.11%; p = 0.0001), horizontal shoulder extension (Δ%HSE = 33.90%; p = 0.0001), lumbar spine flexion (Δ%LSF = 50.74%; p = 0.0001), hip flexion (Δ%HF = 35.75%; p = 0.0001), hip extension (Δ%HE = 10.93%; p = 0.021) and knee flexion (Δ%KF = 3.90%; p = 0.001) and in the GDLAM autonomy index (Δ%AI = -13.67%; p = 0.0001) in the YG compared to the CG. The Mann-Whitney test revealed increases in QoL scores in Facet 1 (Δ%Fac1 = 9.04%; p=0.043), Facet 5 (Δ%Fac5 = 51.06%; p = 0.0001) and in overall QoL (Δ%OqoL = 8.13%; p = 0.046) in the YG compared to the CG. The remaining variables showed no significant intergroup modifications. Thus, the study suggests that the regular practice of yoga may lead to improved range of motion in the performance of activities of daily living in elderly women.
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Individuals with osteoarthritis can experience difficulty walking and poor strength, possibly leading to falls and fractures. Exercise has been found to increase strength and bone mineral density. The purpose of this study was to determine the effects of 6 months of t'ai chi on knee muscle strength, bone mineral density, and fear of falling in older women with osteoarthritis. Eighty-two (82) women with osteoarthritis, recruited from outpatient clinics and community health centers, were randomly assigned to either a t'ai chi group and took part in a t'ai chi program, or a control group. Of these, 30 subjects (mean age = 63 years) in the t'ai chi group and 35 (mean age = 61 years) in the control group completed post-test measures at 6 months. After the 6-month study period, subjects in the t'ai chi program had significantly greater knee extensor endurance (pre- to post-test mean increase = 36.4 W/kg, versus 1.1 W/kg for the controls), and significantly greater bone mineral density in the neck of the proximal femur (mean change = 0.09, versus -0.10 for the controls), Ward's triangle (mean change = 0.04, versus -0.04 for the controls), and trochanter (mean change = 0.07, versus -0.05 for the controls) than the controls. However, knee extensor and flexor strength did not differ significantly between the groups. The fear of falling during daily activities reduced significantly more in the t'ai chi group (mean change = -2.40, versus 0.66 for the controls). T'ai chi increased knee extensor muscle endurance and bone mineral density in older women with osteoarthritis, and decreased their fear of falling during daily activities. Further study with long-term follow-up is needed to substantiate the role of t'ai chi exercise in the prevention of fall and its related fracture.