Article

Effect of Short-Term Intensive Yoga Program on Pain, Functional Disability and Spinal Flexibility in Chronic Low Back Pain: A Randomized Control Study

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Abstract

The aim of this study was to compare the effect of a short-term intensive residential yoga program with physical exercise (control) on pain and spinal flexibility in subjects with chronic low-back pain (CLBP). This was a wait-list, randomized controlled study. The study was conducted at a residential integrative health center in Bangalore, South India. Eighty (80) subjects (females, n = 37) with CLBP, who consented were randomly assigned to receive yoga or physical exercise if they satisfied the selection criteria. Intervention: The intervention consisted of a 1-week intensive residential yoga program comprised of asanas (physical postures) designed for back pain, pranayamas (breathing practices), meditation, and didactic and interactive sessions on philosophical concepts of yoga. The control group practiced physical exercises under a trained physiatrist and also had didactic and interactive sessions on lifestyle change. Both of the groups were matched for time on intervention and attention. Pain-related outcomes were assessed by the Oswestry Disability Index (ODI) and by spinal flexibility, which was assessed using goniometer at pre and post intervention. Data were analyzed using repeated measures analysis of variance (RMANOVA). Data conformed to a Gaussian distribution. There was a significant reduction in ODI scores in the yoga group compared to the control group (p = 0.01; effect size 1.264). Spinal flexibility measures improved significantly in both groups but the yoga group had greater improvement as compared to controls on spinal flexion (p = 0.008; effect size 0.146), spinal extension (p = 0.002; effect size 0.251), right lateral flexion (p = 0.059; effect size 0.006); and left lateral flexion (p = 0.006; effect size 0.171). Seven (7) days of a residential intensive yoga-based lifestyle program reduced pain-related disability and improved spinal flexibility in patients with CLBP better than a physical exercise regimen.

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... Menggunakan pola gerakan yang ada pada Hatha Yoga yaitu setu bandhasana (pose jembatan) dan pranayama (pernapasan) menjadi salah satu gerakan untuk memberikan sensasi rileksasi secara fisiologisnya. Dengan hasil adanya penurunan nyeri yang signifikan pada ODI bagian 1 yang merupakan pengukuran nilai nyeri [13]. ...
... Dilihat dari tabel.3 penelitian ini selaras dengan hasil penelitian yang dilakukan oleh Tekur et al., (2008) yang mendapatkan hasil adanya peningkatan fleksibilitas lumbal pada kelompok yoga dengan efek yang lebih tinggi (1,305) pada gerak fleksi, (0,251) pada gerak ekstensi, dan lateral fleksi kanan meningkat dengan efek (0,006) [13]. ...
... Dilihat dari tabel.3 penelitian ini selaras dengan hasil penelitian yang dilakukan oleh Tekur et al., (2008) yang mendapatkan hasil adanya peningkatan fleksibilitas lumbal pada kelompok yoga dengan efek yang lebih tinggi (1,305) pada gerak fleksi, (0,251) pada gerak ekstensi, dan lateral fleksi kanan meningkat dengan efek (0,006) [13]. ...
... [2] Based on previous research studies, yoga therapy may offer us an integrated therapy for NCLBP. [10,[12][13][14][15][16][17][18] Yogic interventions may be a potent, scientific, nonsurgical, feasible, and cost-effective method, which can manage NCLBP effectively. Since yoga therapy includes the utility of the mindfulness component along with the Asanas (physical poses), it not only improves the adverse condition of the back but also develops a holistic positive approach to lifestyle which could help prevent the risk of recurrence. ...
... [25] Thus, there is a scope to improve Adjuvant Yoga Therapy for NCLBP. This could help approach NCLBP in a better way in Savasana [20,34] 66.67 Savasana [20,34] 100 Tadasana [4,20,[34][35][36]40,62] 61.90 Tadasana [4,30,[34][35][36]40,62] 85.7 Supta Pavanmuktasana [13,14,20,21,24,34,40,62] 59.52 Supta Pavanmuktasana [13,14,20,21,24,34,40,62] 78.6 Ardha-śhalabhasana [4,21,40] 57.14 Setubandhasana [4,21,40] 78.6 Setubandhasana [4,21,40] 54.76 Ardha-śhalabhasana [4,21,40] 71.4 Supta Tadasana [34] 54.76 Supta Tadasana [34] 71.4 Apanasana [63] 54.76 Apanasana [63] 71.40 Bhujangasana [13,21,24,37,62,64] 54.76 Marjariasana [62,64] 71.40 NadiShuddi Pranayama [41] 54.76 Makarasana [33] 71.40 Marjariasana [62,64] 52.38 AdhoMukhaVirasana [4,30,37,62,65] 71.40 Makarasana [33] 52.38 Shalabhasana [13,24] 71.40 AdhoMukhaVirasana [4,30,37,62,65] 52.38 Bhujangasana [13,21,24,37,62,64] 64.30 Vibhagiya Pranayama [41] 52.38 NadiShuddi Pranayama [41] 64.30 ...
... [25] Thus, there is a scope to improve Adjuvant Yoga Therapy for NCLBP. This could help approach NCLBP in a better way in Savasana [20,34] 66.67 Savasana [20,34] 100 Tadasana [4,20,[34][35][36]40,62] 61.90 Tadasana [4,30,[34][35][36]40,62] 85.7 Supta Pavanmuktasana [13,14,20,21,24,34,40,62] 59.52 Supta Pavanmuktasana [13,14,20,21,24,34,40,62] 78.6 Ardha-śhalabhasana [4,21,40] 57.14 Setubandhasana [4,21,40] 78.6 Setubandhasana [4,21,40] 54.76 Ardha-śhalabhasana [4,21,40] 71.4 Supta Tadasana [34] 54.76 Supta Tadasana [34] 71.4 Apanasana [63] 54.76 Apanasana [63] 71.40 Bhujangasana [13,21,24,37,62,64] 54.76 Marjariasana [62,64] 71.40 NadiShuddi Pranayama [41] 54.76 Makarasana [33] 71.40 Marjariasana [62,64] 52.38 AdhoMukhaVirasana [4,30,37,62,65] 71.40 Makarasana [33] 52.38 Shalabhasana [13,24] 71.40 AdhoMukhaVirasana [4,30,37,62,65] 52.38 Bhujangasana [13,21,24,37,62,64] 64.30 Vibhagiya Pranayama [41] 52.38 NadiShuddi Pranayama [41] 64.30 ...
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Objective: To develop a generic yoga therapy protocol for nonspecific chronic low back pain (NCLBP) on the basis of previous research studies. Methods: A comprehensive PubMed search was done using keywords of “yoga” and “back pain” for English‐language articles published till November 2022. PubMed showed 332 results for the keywords from 1977 to 2022. Twenty‐nine studies were found eligible and the consolidation of yogic techniques were used in the studies. The study compiled 72 yogic techniques, including Asana and Pranayama, from 332 articles on yoga and back pain. Out of these, 151 were not relevant to yoga or back pain. After analyzing 181 articles, 33 were selected for review for a yoga therapy protocol, with four excluded due to inability to access full‐text articles. The protocol was later validated by 14 eminent yoga therapy experts across the globe from countries including Australia, France, USA, Canada, Italy, Switzerland, and India, who had a minimum of 10 years’ experience in the field. The validation of the techniques was done based on a questionnaire that required classification under three categories: (1) not necessary, (2) useful but not essential, and (3) essential. All the three categories were then segregated in decreasing order of “Essential percentage” and “Weightage percentage” and the final list developed. The cutoff was that the yogic techniques must have ≥50% of acceptance by all experts. The practices were then sequenced in order of performance and cross referenced with traditional teachings. Results: The Generic Yoga Therapy Protocol for NCLBP that has been developed through this rational and logical mechanism has 18 yogic techniques selected on the basis of weightage and essential percentage. It includes 13 standing, sitting, prone, and supine postures (Asanas), four energy modulating breathing practices (Pranayamas), and one relaxation. The Shavasan relaxation received 100% approval by all experts. Conclusion: This generic yoga therapy protocol for NCLBP was developed through a comprehensive methodology that took into account the techniques used in previous research studies and was consolidated after a method of scientific validation by 14 eminent yoga therapy experts. Key Words: Asana, nonspecific chronic low back pain, Pranayama, yoga therapy protocol
... Regarding the applied interventions, 40% of studies compared an intervention related to lifestyle and a control group that that received no treatment or only advice and recommendations [31,42,44,45,[49][50][51][52], 35% of studies compared two groups with different interventions [43,48,[53][54][55][56][57][58] and the remaining 25% compared three groups (two interventions and one control) [31,46,47,59,60]. ...
... The duration of the intervention varied from 1 week [57,58] to 12 months [42,56], with the most frequent being 3 months, as was the case in 30% of the studies [43,49,54,55,59,60]. ...
... Functional disability was measured in 40% of studies [31,[44][45][46][47]54,55,57] with the ODI, with 10 questions, each evaluated between 0 and 5 points [62]. In total, 35% of the studies [45,48,[51][52][53]56,59] were evaluated with the RMDQ, made up of 24 questions [62]. ...
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Citation: Herrero, P.; Val, P.; Lapuente-Hernández, D.; Cuenca, N.; Calvo, S.; Gómez-Trullén, E.M. Effects of Lifestyle Interventions on the Improvement of Chronic Non-Specific Low Back Pain: A Systematic Review and Network Meta-Analysis. Healthcare 2024, 12, 505. https:// Abstract: Chronic non-specific low back pain (CNSLBP) is a highly prevalent musculoskeletal condition that has a great socioeconomic impact on health systems. Instead of focusing on mechanical causes and direct workload in the development of CNSLBP, genetics, psychosocial environment, lifestyle and quality of life are coming to the forefront in its approach. The main objective was to analyze whether interventions aimed at modifying lifestyle can be effective in improving pain intensity and functional disability in CNSLBP. A search in PubMed, Web of Science, Scopus and SportDiscus databases was performed. Both a univariate and a multivariate network meta-analysis were applied with the difference pre/post-treatment. A total of 20 studies were included for qualitative analysis, of which 16 were randomized clinical trials with a moderate-high methodological quality and were part of the quantitative analysis. The interventions that had the greatest effect in reducing pain intensity were cognitive therapy combined with functional exercise programs, lumbar stabilization exercise and resistance exercise; meanwhile, for functional disability, they were functional exercise programs, aerobic exercise and standard care. In conclusion, a multimodal intervention aimed at changing one's lifestyle that encompasses cognitive, behavioral, and physical aspects seems to be highly effective in improving pain intensity and functional disability caused by CNSLBP; however, it is not yet known if these improvements are maintained in the long term. Keywords: low back pain; lifestyle; sedentary behavior; pain intensity; functional disability; multi-variate network meta-analysis; non-specific low back pain
... The calculated sample size for each group was 24 based on earlier similar studies (power = 0.95 and alpha = 0.05). [23,24] Considering the possible attrition rate of up to 40%, the final sample size was set as 80: 40 in the yoga group and 40 in the physical exercise group. ...
... [31] Dial-type goniometer Spinal mobility was assessed using a dial-type goniometer manufactured by Anand Agencies, Pune, India. [24] The goniometer instrument has a dial with calibrations from 0° to 360° that is tied around the waist. The values for the ranges of movement for spinal flexion (SF), spinal extension (SE), right lateral flexion (RLF), and left lateral flexion (LLF) are read on the dial and noted in degrees. ...
... In an earlier similar study, the SF score improved by 28.30% within the yoga group after a 1-week residential yoga program, and the score improved by 15.91% within the physical exercise group after a 1-week physical exercise program. [24] Similarly, in the earlier study, the SE score improved by 51.52% within the yoga group and the score improved by 22.14% in the exercise group after 1 week of intervention. [24] The longer duration of physical exercise may be the reason for the significant improvement in the physical exercise group too in the current study. ...
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Full-text available
Background: Office workers who need to use a computer while maintaining a static position for prolonged periods have more chance of having low back pain (LBP). Objective: The objective of the study is to investigate the effect of yoga on stress, anxiety, depression, and spinal mobility in computer users with chronic LBP (CLBP). Materials and Methods: In this randomized control trial, eighty computer users (42.6 ± 8.45 years of age; suffering from CLBP since 5.20 ± 3.01 years; 51 males and 29 females) who use a computer for their professional work, recruited from Bengaluru, India, were randomized into two groups: yoga group (n = 40) and physical exercise group (n = 40). The yoga group practiced an integrated module comprising yoga postures and mindfulness meditation, and the physical exercise group practiced physical exercise designed for LBP (1 h/day, 3 days/week for 16 weeks). Assessments of dial‑type goniometer and Depression Anxiety Stress Scale‑42 were performed at baseline, after 8 weeks, and after 16 weeks. Results: Stress, anxiety, and depression scores were significantly lower in the yoga group as compared to the physical exercise group at 16 weeks (P < 0.001), whereas spinal flexion (P < 0.001), spinal extension (P < 0.001), right lateral flexion (P = 0.001), and left lateral flexion (P = 0.007) scores were significantly higher in the yoga group as compared to the physical exercise group at 16 weeks. Conclusion: Yoga is more effective in reducing stress, anxiety, and depression and improving spinal mobility in computer users with CLBP than physical exercise designed for LBP. Keywords: Anxiety, back pain, depression, mindfulness, stress, yoga
... The calculated sample size for each group was 24 based on earlier similar studies (power = 0.95 and alpha = 0.05). [23,24] Considering the possible attrition rate of up to 40%, the final sample size was set as 80: 40 in the yoga group and 40 in the physical exercise group. ...
... [31] Dial-type goniometer Spinal mobility was assessed using a dial-type goniometer manufactured by Anand Agencies, Pune, India. [24] The goniometer instrument has a dial with calibrations from 0° to 360° that is tied around the waist. The values for the ranges of movement for spinal flexion (SF), spinal extension (SE), right lateral flexion (RLF), and left lateral flexion (LLF) are read on the dial and noted in degrees. ...
... In an earlier similar study, the SF score improved by 28.30% within the yoga group after a 1-week residential yoga program, and the score improved by 15.91% within the physical exercise group after a 1-week physical exercise program. [24] Similarly, in the earlier study, the SE score improved by 51.52% within the yoga group and the score improved by 22.14% in the exercise group after 1 week of intervention. [24] The longer duration of physical exercise may be the reason for the significant improvement in the physical exercise group too in the current study. ...
Article
Full-text available
Background: Office workers who need to use a computer while maintaining a static position for prolonged periods have more chance of having low back pain (LBP). Objective: The objective of the study is to investigate the effect of yoga on stress, anxiety, depression, and spinal mobility in computer users with chronic LBP (CLBP). Materials and methods: In this randomized control trial, eighty computer users (42.6 ± 8.45 years of age; suffering from CLBP since 5.20 ± 3.01 years; 51 males and 29 females) who use a computer for their professional work, recruited from Bengaluru, India, were randomized into two groups: yoga group (n = 40) and physical exercise group (n = 40). The yoga group practiced an integrated module comprising yoga postures and mindfulness meditation, and the physical exercise group practiced physical exercise designed for LBP (1 h/day, 3 days/week for 16 weeks). Assessments of dial-type goniometer and Depression Anxiety Stress Scale-42 were performed at baseline, after 8 weeks, and after 16 weeks. Results: Stress, anxiety, and depression scores were significantly lower in the yoga group as compared to the physical exercise group at 16 weeks (P < 0.001), whereas spinal flexion (P < 0.001), spinal extension (P < 0.001), right lateral flexion (P = 0.001), and left lateral flexion (P = 0.007) scores were significantly higher in the yoga group as compared to the physical exercise group at 16 weeks. Conclusion: Yoga is more effective in reducing stress, anxiety, and depression and improving spinal mobility in computer users with CLBP than physical exercise designed for LBP.
... Many randomized controlled trials have reported the effectiveness of yoga therapy on the improvement of pain, functional disability, and spinal flexibility in the general population with CLBP. [27][28][29][30][31] Recent systematic reviews reported Yoga Mīmāṃsā | Volume 54 | Issue 1 | January-June 2022 yoga to be more effective in pain, disability, depression, and other psychological comorbidities in CLBP compared to usual care or no care. [32][33][34] However, in comparison to physical exercise or physical therapy for CLBP and related disability, a recent systematic review and meta-analysis reported that yoga therapy had a similar effect. ...
... The calculated sample size for each group was 18 using the Oswestry Disability Index (ODI) score as a variable with an effect size of 1.26. [28] Similarly, the calculated sample size for each group was 24 using Quality of Life as a variable with an effect size of 1.09. [36] The power = 0.95 and alpha = 0.05 were set in both calculations. ...
... In an earlier similar study, the ODI score reduced significantly by 48.76% in the yoga group after a 1-week intensive residential yoga program comprising asanas (physical postures), Pranayamas (breathing practices), meditation, etc., with significant differences between groups, favoring yoga group. [28] In our study, the ODI score was reduced by 57.83% in 8 weeks and by 85.75% in 16 weeks in the YM group with significant between-group differences, favoring the yoga group. The result of the current study is in line with the earlier study. ...
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Introduction Chronic low back pain (CLBP) is two and a half times more prevalent in the working population than in nonworking population. The 1-year prevalence of low back pain (LBP) in working population ranges from 23% to 38%. However, the 1-year prevalence in computer professionals was found to be 31%–54%. Studies have demonstrated the vast mental and physiological health advantages associated with yoga. Objective We planned to investigate the effect of yoga and mindfulness meditation in computer users with CLBP. Methods Eighty computer users (42.6 ± 8.45 years of age; suffering from CLBP for 5.20 ± 3.01 years; 51 males and 29 females) were recruited from Bengaluru, Karnataka, India. Subjects were randomized into two groups; yoga and mindfulness meditation/YM group ( n = 40) and physical exercise/PE group ( n = 40). YM group practiced an integrated module comprising yoga practices and mindfulness meditation, while PE group practiced physical exercises designed for LBP (1 h per day, 3 days per week for 16 weeks). Assessments were done at baseline, after 8 weeks, and after 16 weeks. Results Seventy-seven participants (39 in YM and 38 in PE) completed the study. Oswestry Disability Index (ODI) scores and Numerical Rating Scale (NRS) scores decreased significantly, and the Sit and Reach Test (SRT) scores improved significantly in both groups after intervention ( p < 0.001). Between-group analyses demonstrated that there was a significant difference in ODI scores (YM = 7.28 ± 5.68, PE = 15.53 ± 8.13, P < 0.001), NRS scores (YM = 1.00 ± 0.89, PE = 1.82 ± 0.73, P < 0.001), and SRT scores (YM = 26.41 ± 5.03, PE = 22.82 ± 4.96, P = 0.002) between the YM group and PE group at 16 weeks, favoring the YM group. Conclusion A 16-week yoga & mindfulness meditation program appeared to be effective in reducing pain and functional disability, and in improving spinal flexibility in computer users with CLBP.
... Ten of the RCTs were conducted in the United States, 21,24,25,29,32,48,49,54,55,68,69 8 in India, [40][41][42][43][44]56,58,59,66 1 in Sweden, 1,5 2 in Germany, 38,61 2 in the United Kingdom, 8 1 in South Korea, 33 1 in Russia, 65 and 1 in Turkey. 17 One RCT did not report about its origin36. ...
... 8,32,41,62,66,68,69 Kundalini yoga style was used by one of the included RCTs, 1,5 and 2 studies used the Vini yoga style. 54,55 In 6 RCTs, the yoga style was described as a therapeutic approach 29,40,56,58,59,65 or an integrated approach. 43 One RCT offered their yoga intervention as a virtual course, but no style was stated. ...
... 68 Session length ranged from 30 minutes 33 to 120 minutes. 58,59 The median of program length was 10 weeks, and the median of session length was 60 minutes. ...
... 12,28 Duration and frequency of treatment and length of follow-up differ dramatically between studies. [11][12][13][14][18][19][20]23,[27][28][29][30][31][32][33][34][35][36][37][38][39][40] This variability belies the fact that there is no agreed on duration of treatment that provides a clinically meaningful result, as well as raises questions about the durability of the intervention. ...
... Neurosurgical forum efit is thought to be derived from changes in physiological, behavioral, and psychological factors, as well as from improvements in flexibility, strength, relaxation, and body awareness. 3,[11][12][13][14][15] There is evidence to suggest that yoga reduces oxidative stress and tissue inflammation, increases the release of certain neurotransmitters in the brain, and even results in brain remodeling that is correlated with decreased anxiety and increased pain tolerance. 11,[14][15][16][17][18][19][20][21][22][23][24][25][26] Longterm yoga practitioners also demonstrate significantly less cervical and lumbar degenerative disease on MRI compared with matched control groups. ...
... While the evidence is of variable certainty, given differences in interventions and inherent biases, one can conservatively posit that yoga is noninferior, at worst, and possibly more effective than nonyoga exercise interventions in relieving LBP and improving functional status. 3,11,13,19,23,29,31,37,39,40 Interestingly, while studies demonstrate a positive correlation between yoga practice compliance and treatment effect, yoga as an intervention appears to be relatively dose independent. 28,32,34 Additionally, it is important to note that yoga is not associated with any serious adverse events, and the risk of adverse events is not increased in comparison with nonyoga exercise. ...
... As already known from previous studies, this can be seen as a result consistent with the improvement of spinal flexibility, which is known as the main effect of Pilates [30]. In addition, previous studies have demonstrated that implementing a flexibility enhancement yoga program for individuals with spinal discomforts increases spinal flexibility alongside reduced back pain [31]. Concerning those insights, it is postulated that enhancing core flexibility through Pilates training among fencers may correlate with a reduction in spine-related discomfort and potential benefits in enhancing the integrity of the musculoskeletal system [31] (Fig. 3). ...
... In addition, previous studies have demonstrated that implementing a flexibility enhancement yoga program for individuals with spinal discomforts increases spinal flexibility alongside reduced back pain [31]. Concerning those insights, it is postulated that enhancing core flexibility through Pilates training among fencers may correlate with a reduction in spine-related discomfort and potential benefits in enhancing the integrity of the musculoskeletal system [31] (Fig. 3). ...
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PURPOSE: This study aimed to examine the effects of incorporating Pilates into the training regimen of elite fencers, focusing on enhancing flexibility and alleviating pain commonly experienced in the sport.METHODS: Twenty-five collegiate male elite fencers were stratified into two groups: a fencing training group (FT, n = 12, age = 18.92 ± 1.08, weight = 71.78 ± 7.43 kg, body mass index [BMI] = 22.32 ± 2.09 kg/m2) and a fencing-Pilates combined training group (FPT, n = 13, age = 19.92 ± 0.64, weight = 70.97 ± 9.14 kg, BMI = 22.61 ± 1.71 kg/m2). Evaluations, including body composition; physical fitness factors; shoulder strength; and joint range of motion in the upper extremities, lower extremities, neck, and spine, were conducted before and after 12 weeks of the intervention. Additionally, examinations of pain catastrophizing and anxiety levels during competitive engagements were performed.RESULTS: There were no statistical differences in body composition, physical fitness factors, or upper-limb strength between the FT and FPT groups. However, the FPT group exhibited a notable enhancement in shoulder abduction of the upper limb when holding a sword, in contrast to the unchanged metrics observed in the FT group. The positive impact of Pilates-combined treatment on flexibility extended to the neck; waist; and lower extremities, such as hip flexion, hip extension, hip abduction, medial rotation, and ankle dorsiflexion, coupled with significant improvements in psychological aspects, such as pain relief and related competition anxiety.CONCLUSIONS: This study confirmed that Pilates-combined treatment can have a beneficial effect on improving flexibility and pain in fencers, and verified the effectiveness of Pilates as an auxiliary training method for elite fencers.
... Yoga ranks 5th among Complementary and Alternative Medicine (CAM) treatments (Erik et al., 2013) and its bio-psychosocial approach is considered the gold standard for chronic pain treatment for CLBP (Gatchel et al., 2007) as endorsed by the American Pain Society and the American College of (Chou & Huffman, 2007). (Tekur et al., 2008). The perception of recovery and pain intensity is better with yoga than with conventional therapeutic exercises (Li et al., 2019). ...
... The sample size from a previous intervention study that compared the effect of Yoga on a visual analogue scale in CLBP was calculated (Tekur et al., 2008). The total sample size obtained was 32 by using the 'G power' software (alpha = 0.05, power = 0.96, and effect size =1.26). ...
Article
Full-text available
Background: Low back pain has an enormous societal and economic impact on the working-age population, and a large number of women are affected due to sedentary work environment. Treatment is often delayed as the symptoms are initially unclear and with progressive age, healthy ageing is compromised. Hence the study investigates the effects of the Integrated Approach of Yoga Therapy (IAYT) and Thai Massage (TM) on Non-Specific Low Back Pain (NSLBP). Method: We randomly allocated a total of 52 women employees from an Indian Garment Industry located in South Bangalore, into the IAYT group (n = 26, age 35.46 ± 7.78), and TM group (n = 26, age 34.23 ± 6.67). For the IAYT group, a yoga therapy module for 45 minutes for 5 days a week for 12 weeks was administered and for the TM group, a set of self-stretching exercises combined with Thai self-massage using a back massage stick for the same duration was administered. The assessment was done at baseline and after 12 weeks for both groups on the clinical parameters, back disability, depression, anxiety, stress, pain intensity, and biofield energies using Electro Photonic Imaging (EPI). Results: Statistical analysis was performed using Statistical Package for the Social Sciences, version 20.0 for Windows (SPSS Inc., Chicago, IL, USA). For within-group analysis, the Wilcoxon signed-rank test was used and for between-group analysis, Mann-Whitney U test was used. The IAYT group showed reduced back disability, and pain intensity at (75.24% and 66.92%) respectively, comparatively better than TM at (65.32% and 62.73%) respectively. The IAYT group showed a better improvement in depression, anxiety, and stress at (75.44%, 64.48%, and 63.35%) respectively as compared to the TM group at (55.75%, 57.03%, and 52.31%) respectively with P<0.001. Further, the IAYT group has shown considerable improvement in weight, waist-hip ratio, BMI, respiratory rate and pulse rate at (1.88%, 3.68%, 2.23%, 12.32%, and 4.06%) respectively as compared to TM group at (1.7%, 2.19%, 1.92%, 3.61% and, 1.67%) respectively with P<0.05. In the scores of EPI, the IAYT group demonstrated significant improvement in stress and lumbar spine energy area levels at (13.96%, and 44.02%) respectively as compared to the TM group at (5.42%, and 7.16%) respectively with P<0.05. Conclusions: IAYT seems to work more effectively for nonspecific low back pain than TM for female garment employees.
... Yoga ranks 5th among Complementary and Alternative Medicine (CAM) treatments (Erik et al., 2013) and its bio-psychosocial approach is considered the gold standard for chronic pain treatment for CLBP (Gatchel et al., 2007) as endorsed by the American Pain Society and the American College of (Chou & Huffman, 2007). (Tekur et al., 2008). The perception of recovery and pain intensity is better with yoga than with conventional therapeutic exercises (Li et al., 2019). ...
... The sample size from a previous intervention study that compared the effect of Yoga on a visual analogue scale in CLBP was calculated (Tekur et al., 2008). The total sample size obtained was 32 by using the 'G power' software (alpha = 0.05, power = 0.96, and effect size =1.26). ...
Article
Full-text available
Background: Low back pain has an enormous societal and economic impact on the working-age population, and a large number of women are affected due to sedentary work environment. Treatment is often delayed as the symptoms are initially unclear and with progressive age, healthy ageing is compromised. Hence the study investigates the effects of the Integrated Approach of Yoga Therapy (IAYT) and Thai Massage (TM) on Non-Specific Low Back Pain (NSLBP). Method: We randomly allocated a total of 52 women employees from an Indian Garment Industry located in South Bangalore, into the IAYT group (n = 26, age 35.46 ± 7.78), and TM group (n = 26, age 34.23 ± 6.67). For the IAYT group, a yoga therapy module for 45 minutes for 5 days a week for 12 weeks was administered and for the TM group, a set of self-stretching exercises combined with Thai self-massage using a back massage stick for the same duration was administered. The assessment was done at baseline and after 12 weeks for both groups on the clinical parameters, back disability, depression, anxiety, stress, pain intensity, and biofield energies using Electro Photonic Imaging (EPI).
... Seven trials, which supported stabilizing exercise for pain relief (which included two trials) and two clinical guidelines for aquatic and supervised exercise therapy were noted [3,5,34,46,[65][66][67][68][69][70][71]. Moreover, one higher-quality trial, one meta-analysis, and two clini- cal guidelines found that yoga was an effective treatment [3,6,72,73]. However, several of these treatments were not supported by trials or analysis. ...
... One systemic review together with two clinical guidelines were included in the review of heat and cold therapy for acute LBP [4,6,49]. For chronic LBP, one higher-quality randomized trial supported pain improvement from general physical modalities [3,6,72,73,98]. Higher-quality trials, a SR, and three clinical guidelines that supported acupuncture for treating chronic LBP were observed [3,4,6,112,113]. Nevertheless, there was insufficient evidence for a majority of treatment methods for chronic LBP. ...
Article
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We aimed to determine the recommendation level for the treatment of acute and chronic low back pain (LBP). A systematic review (SR) of the literature was performed and all English-language articles that discuss acute and chronic LBP, including MEDLINE and the Cochrane Database of Systematic Reviews, were searched. Of the 873 searched literature reports, 259 articles, including 131 clinical trials, 115 SRs, nine meta-analyses, and four clinical guidelines were analyzed. In these articles, high-quality randomized controlled trials, SRs, and used well-written clinical guidelines were reviewed. The results indicated multiple acute and chronic LBP treatment methods in the literature, and these reports when reviewed included general behavior, pharmacological therapy, psychological therapy, specific exercise, active rehabilitation and educational interventions, manual therapy, physical modalities, and invasive procedures. The Trial conclusions and SRs were classified into four categories of A, B, C, and D. If there were not enough high-quality articles, it was designated as "I" (insufficient). This review and summary of guidelines may be beneficial for physicians to better understand and make recommendations in primary care.
... These results are in line with Alter (2004), Sadler, Spink, Ho, de Jonge & Chuter (2017) and many researchers who have found that tightened hamstrings muscles restrictions and lumbar lordosis movement are related to low back pain and restricted functioning. These results are also in line with other low intensive intervention programs such as Yoga, breathing and meditation practice and proprioceptive exercises, which improved flexibility, dynamic balance and health components (Kellis & Kofotolis, 2006;Tekur, Singphow, Nagendra & Raghuram, 2008). ...
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Background. Physical activity (PA) is highly recommended for older adults in order to improve physical functioning, health and well-being. Aims. The purposes of this pilot research were: to investigate the influence of Harmonic Gymnastics (HG) on flexibility, dynamic balance, health and well-being of older adults, and to verify the feasibility of the research tools. Methods. In this pilot research 15 healthy men and women, mean age 58.7 (6.5), from Tel Aviv, Israel, volunteered to participate in the research program, which included 50 min. of HG practice, three times a week, for six weeks. Three questionnaires – SF-36 Health and quality of life questionnaire, The Global Physical Activity Questionnaire (GPAQ) and the Mindfulness Awareness Assessment Scale (MAAS) – and two physical skills testing equipment – Y Balance Test (YBT) and the Back Saver Sit and Reach test (BSSR) – were used to assess the subjects. Results. Post-test results showed significant improvements of total score of health and well-being by SF-36 (p < 0.05) and body awareness by MAAS (p <0.0001), but no significant results for SF-36 (0.0629) subscales nor for the global PA measured by GPAQ (p= 0.391). Participants improved hamstring flexibility (p < 0.05) and dynamic balance of right leg (p < 0.001) and left leg (p = 0.00001). Conclusions. This pilot research indicates the feasibility of YBT, BSSR, MAAS and SF-36. HG was found to be tailored for older adults. Older adults improved functioning capabilities, body awareness, health and well-being after the program.
... Tailored Yoga therapy may offer the flexibility to address individual patient needs, recognizing the diverse spectrum of neurological conditions and the opportunity for personalized therapy plans. Several studies have shown similar beneficial effect of Yoga in reducing anxiety, depression, 26 imporving the QoL, and psychological wellbeing 5 in other non communicable diseases such as chronic low back pain, 27 neck pain, rheumatoid arthritis, 28 diabetes, 29 patient empowerment is in line with conventional healthcare objectives. Further efforts should be encouraged for implementation of yoga in neuro-rehabilitation settings. ...
... Both styles of yoga are rich in asanas, and ashtanga also focuses on breathing control during practice (12). Research from other authors confirms the pleiotropic effect of yoga on the human body, including the circulatory system, and alleviates the effects of diseases of the musculoskeletal system (13)(14)(15)(16)(17)(18). Yoga improves lung function, strength of respiratory and expiratory muscles as well as skeletal muscle strength and endurance (19). ...
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Introduction Recreational physical activity is becoming more popular due to the increased public awareness about the beneficial effects on health status and quality of life. The aim of the study was to assess the nutritional status and health behaviors of women who regularly practice yoga as a form of physical recreation and to compare them with those who had not practiced before and had just signed up for yoga classes. A total of 143 women took part in this study. Methods The nutritional status was assessed based on the obtained anthropometric measurements. The following indicators were calculated: Body Mass Index (BMI) and waist-to-hip ratio (WHR), determining the visceral accumulation of fat tissue. Health behaviors were assessed using a standardized five-point scale Health Behavior Inventory (HBI). Results There were significant differences in the value of the general health behavior index, the sten scale, and the subscale regarding proper eating habits in the study groups compared to women who had not practiced yoga before (control group). Health behaviors indicators, particularly proper eating habits, are significantly higher in women participating regularly in yoga exercises, indicating a higher awareness among yoga practitioners. Conclusion It can be suggested that yoga participation as a recreational physical activity can be an appropriate option for pursuing healthy habits.
... [5] In participants with persistent low back pain, it was observed that yoga practice reduced pain-related impairment and improved spinal flexibility. [6] Regular yoga practice for 3 months reduces blood pressure, heart rate, and autonomic function, as well as emotional arousal, and moves practitioners toward parasympathetic dominance. [7] Therefore, it is beyond a shadow of a doubt that yogic science is incredibly beneficial in treating specific ailments and helping preserve and improve normal physical and mental health. ...
Article
A BSTRACT Fibromyalgia (FM) is characterized by widespread pain, fatigue, stiffness, sleep irregularities, and tenderness of joints and muscles due to dysregulation of neurophysiological functions. It is more common in women compared to men. Till now, there is no specific treatment available for FM. The review aimed to review the literature on the effect of yogic practices on FM. The search was done in the following databases: Google Scholar and PubMed. The articles were searched using the keywords, FM, FM syndrome, Yoga, Pranayama, Yogic practices, and alternative therapy, without date restrictions which yielded 28 results, and eight articles were included in the final review. A review of the included articles showed the significant role of yogic practices in managing symptoms of FM, including stiffness, pain, sleep disturbance, fatigue, and depression. The yogic interventions such as asanas, Surya Namaskar, Nadi Shodhana Pranayama, and mindfulness meditation of specific duration were helpful in relieving the symptoms of FM. Yogic practices are helpful in the management of FM symptoms. Future randomized controlled trials contrasting various forms of yoga or exercise, however, will enable the identification of the most efficient treatments for FM and allow for more precise targeting of the patients who will benefit most from them.
... Among the interventions that have been shown to be effective both psychologically and physically are those that include yoga. Yoga training interventions have been proven to improve spinal flexibility in people affected by CLBP (Tekur et al., 2008), both in elderly women and men (Brems, 2015;Buttner et al., 2015). Such interventions improve the physical status by stimulating the release of various hormones related to bodily well-being (Sherman et al., 2013;Lee et al., 2014) and brain-derived neurotrophic factor, suggesting that the potential decrease in pain level may arise from yoga exercise (Posadzki and Ernst, 2011). ...
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Objective The present study aims to examine whether combining hatha yoga practice with self-compassion meditation could influence kinesiophobia, emotions, perceived stress, and perceived disability among individuals with chronic low back pain when compared with hatha yoga alone. Methods The randomized controlled study included 70 participants with chronic low back pain (CLBP) who were randomly assigned to a Hatha yoga group (HY; n = 35) or a Hatha yoga group plus self-compassion meditation (HYSCM; n = 35). Participants followed a protocol for 8 weeks, and the assessments were carried out before and after the intervention, with a follow-up evaluation conducted after one month. The participants completed the PANAS, PSS, TSK, and RMQ questionnaires. A Generalized Estimating Equation was used to explore the effect of interventions. Results Both HY and HYSCM groups improved kinesiophobia, perceived disability, and stress at the follow-up. However, the HYSCM group shown a more significant reduction in kinesiophobia compared to the HY group. Moreover, significant improvement in positive affect and a reduction in negative affect over time in the HYSCM group were observed. Conclusion Hatha yoga practice when combined with self-compassion meditation led to extra benefits by exhibiting a prolonged effect, especially on kinesiophobia positive and negative effects.
... Chronic pain is a common issue for individuals recovering from spinal injuries. Yoga asanas can help manage and alleviate pain by releasing endorphins, the body's natural painkillers [4]. The gentle stretching and strengthening of the spine and surrounding muscles can reduce tension and provide relief from pain, promoting a more comfortable recovery process without relying solely on medication [5]. ...
... Yoga practices involve physical postures, breathing practices, meditation, and a healthy lifestyle. It has been effectively used for managing musculoskeletal health issues such as low back pain [20,21], lower limb pain [22], and fatigue [23]. Yoga is known to reduce stress and enhance well-being in the workplace [24]. ...
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Background Prolonged standing is a part of several professions, which can have physical and psychosocial implications. Yoga as a mind-body therapy may be useful to prevent and manage such health issues. However, there is a lack of a standardized yoga module addressing the health issues of workers with prolonged standing. Objectives Thus, the present study was undertaken to design and validate a specific yoga module for the target population. Methods A yoga module was prepared by reviewing yoga texts for the specific needs of the target population. This was validated for content validity for the experts on a Likert scale. 71 yoga experts validated the module. The content validity ratio (CVR) above 0.70 was considered to be valid. Results The validated yoga module consists of joint loosening and strengthening exercises, asana, pranayama and relaxation techniques. The average CVR for the module was found to be 0.80. Conclusion The designed yoga module is found to be valid by the experts. The module needs to be assessed for feasibility and efficacy in the target population.
... Yoga has been proven as an effective means of managing chronic low back pain (LBP) (Cramer et al., 2013;Saper et al., 2014;Sherman et al., 2011;Tekur et al., 2008;Williams et al., 2005). Yoga is an extensive science that includes many asanas or physical exercises, breathing exercises, meditation, and mindfulness. ...
... Mindfulness training has also been found beneficial. [21] Benefits of yoga practice are not limited to asthma, they have also demonstrated benefits for back pain, [22] cardiometabolic, [23] and mental health [24,25] and other pathologies. [26][27][28] In these studies, dropout rates have been high enough to detract from the clinical efficacy of the protocols. ...
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Background: Bronchial asthma afflicts many millions of people worldwide, with multinational studies finding over 4% of young adults on asthma medication. Prescribed medication may alleviate symptoms but does not cure. The complementary system of yoga therapy has developed yoga practice modules that improve symptoms, but are cumbersome, and lead to high dropout rates. Results: We report the development of a new, shorter yoga module that achieved zero dropouts over a 90-day randomized controlled trial. Discussion: All yoga breathing exercises could be done standing or sitting in a chair, making the module suitable not just for young adults, but for all ages.
... было показано, что 4-недельный курс йога-терапии привел к значительному снижению интенсивности боли, сокращению времени нетрудоспособности, уменьшению проявлений депрессии, улучшению качества жизни по сравнению с применением лечебной физкультуры, физиотерапевтического лечения и когнитивно-поведенческой терапии [17]. По данным исследования P. Tekur, показана более значимая эффективность недельного курса йоги по сравнению с физическими упражнениями [18]. ...
Article
Lower back pain is an urgent global problem. Often it is combined with metabolic disorders, which leads to mutual aggravation of both pathological conditions. The aim of the study was a comparative assessment of the complex therapy of patients with exacerbation of chronic vertebrogenic dorsalgia using various methods. Materials and methods. We examined 60 patients with concomitant metabolic disorders in the form of obesity. Results. The effectiveness of the use of non-drug methods, namely therapeutic exercises with elements of yoga practice and reflexology in the complex therapy of patients with chronic pain in the lower back in combination with metabolic disorders, has been proven. Conclusion. The use of these methods allows to achieve a positive effect, which manifests itself in reducing the intensity of the pain syndrome and improving the functionality of patients, as well as correction of concomitant metabolic disorders.
... Several RCTs have demonstrated the benefits of integrated yoga in CLBP (Hartfiel et al., 2012;Sherman et al., 2005;P. Tekur et al., 2012;Tekur et al., 2008;Telles et al., 2009); however, studies seeing the effect of yoga on CLBP with long-term follow-ups are limited. Similarly, studies demonstrated yoga to be more effective in CLBP as compared to usual care or no care (Chang et al., 2016;Goode et al., 2016;Whitehead, 2018); however, there are limited studies that demonstrate the effectiveness of long-term yoga intervention as compared to physical exercise (PE). ...
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Background Computer professionals are more prone to chronic low back pain (CLBP) as compared to the normal population. It has been reported that the 1-year prevalence of low back pain (LBP) was 23%38% in the normally active population, while it was 31%54% in computer users. Objective To investigate the effect of yoga and mindfulness meditation on the quality of life (QOL) of computer users with CLBP. Materials and Methods Eighty computer users (42.6 ± 8.45 years of age; suffering from CLBP since 5.20 ± 3.01 years; 51 males and 29 females) were recruited from Bengaluru, India. Participants were randomized into two groups: Yoga and mindfulness meditation/YM group ( n = 40) and physical exercise/PE group ( n = 40). The YM group practiced an integrated module comprising yoga postures and mindfulness meditation, and the PE group practiced PE designed for LBP. Both groups practiced 1 hour daily, 3 days a week for 16 weeks. WHO QOL-BREF and spinal flexibility (Straight Leg Raising [SLR]) were assessed at baseline and after 8 and 16 weeks. Results Results of repeated measures-analysis of variance test showed that the scores on QOL physical health (diff = 12.43%, P < 0.001), psychological health (diff = 11.9%, P < 0.001), social relationships (diff = 15.66% P < 0.001), and environment (diff = 17.37% P < 0.001) were significantly higher in YM group as compared to PE group at the end of 16 weeks. Similarly, the scores on the SLR right leg (diff = 12.97%, P < 0.001) and SLR left leg score (diff = 11.71%, P < 0.001) were significantly higher in the YM group as compared to the PE group at the end of 16 weeks. Conclusion Yoga with mindfulness meditation is significantly more effective in improving QOL and spinal flexibility in computer users with CLBP as compared to PE designed for LBP.
... Previous studies on yoga have reported improved chronic pain [44,45], mental health domains, sleep quality, and quality of life [46][47][48] following yoga intervention. ...
Article
Background: Chronic pain conditions such as low back pain, knee pain and cervical pain are highly prevalent among female teachers. Chronic pain significantly affects the mental health, sleep and quality of life among teachers. Objective: This study intended to investigate the impact of a workplace yoga intervention on musculoskeletal pain, anxiety, depression, sleep, and quality of life (QoL) among female teachers who had chronic musculoskeletal pain. Method: Fifty female teachers aged between 25-55 years with chronic musculoskeletal pain were randomized to either the yoga group (n = 25) or the control group (n = 25). The yoga group received a 60-minute structured Integrated Yoga intervention (IY) four days a week for six consecutive weeks at school. The control group received no intervention. Outcome measures: Pain intensity, anxiety, depression, stress, fatigue, self-compassion, sleep quality, and quality of life were assessed at the baseline and six weeks. Results: A significant (p < 0.05) reduction in pain intensity and pain disability in the yoga group was observed after 6-week compared to baseline. Anxiety, depression, stress, sleep scores and fatigues also improved in the yoga group after six weeks. The control group showed no change. Post score comparison showed a significant difference between the groups for all the measures. Conclusion: Workplace yoga intervention is found to be effective in improving pain, pain disability, mental health, sleep quality among female teachers with chronic musculoskeletal pain. This study strongly recommends yoga for the prevention of work-related health issues and for the promotion of wellbeing among teachers.
... A vállöv csökkent mozgástartománya fájdalmat és testtartási instabilitást is okozhat (Macedo & Magee, 2008), és feltételezik, hogy jelentős fogyatékosságot okoz a 65 éves kort betöltött egészséges felnőttek 30%-ánál (Chakravarty és Webley, 1993). A hosszú távú rendszeres, de a rövid távú testmozgás és fizikai tevékenységek is lelassíthatják ezt a negatív következményt (Tekur, Nagendra, & Raghuram, 2008;Bates, Donaldson, Lloyd, Castell, Krolik & Coleman, 2009). Az alsótest ereje elengedhetetlen az olyan tevékenységekhez, mint a lépcsőzés, a nagy távolságok megtétele, a székből való felkelés vagy a fürdőkádból való kiemelkedés. ...
Article
A népesség elöregedése a modern társadalom egyik legnagyobb kihívása, ami a világ közösségének problémáit és növekvő érdeklődését eredményezi a népesség egészségével, életminőségével és működőképességével kapcsolatban. Számos evolúcióbiológus egyetért azzal a tézissel, hogy az öregedés a szervezet funkcionális képességeinek „csökkenését” jelenti. A tanulmány célja az volt, hogy meghatározza a 12 hetes, erősítő gumiszalagokkal végzett alacsony terhelésű erősítő edzések hatását idős nők fizikai fittségére, egészségi mutatóira, hetente kettő, illetve hetente három edzéssel. Az adatok elemzése után egyértelműen elmondható, hogy az idősödő (60–75 éves) generáció még jelentős fizikai és szellemi tartalékokkal rendelkezik. Az öregedő társadalom egészségi, fizikai állapota nagymértékben a krónikus betegségek prevenciójától és gondozásától függ. A tudatos egészségmegőrzés, a fizikai állóképesség és a szellemi aktivitás edzése a betegségek megelőzésének leghatásosabb módszerei.
... Asanas (static postures) are designed to engage all targeted and supporting muscle groups while maintaining a regular and steady breathing rhythm (15) . Yoga has been demonstrated to significantly increase the flexibility of the lower extremities and lower back compared to static stretching exercises (16) . The body's muscles are stretched and strengthened through yoga, which calms the mind and soul. ...
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Background: Athletes’ flexibility and strength endurance improve through regular yoga practice. If plyometric exercises combine with yoga asanas in training programs, it may enhance performance in sports that demand these fitness components. Objectives: To determine the effect of eight weeks of plyometric training alone and in combination with asanas on adolescent volleyball players’ flexibility and strength endurance. Methods: Forty-five male adolescent volleyball players were randomly selected for two experimental groups and a control group for eight weeks. An ANCOVA was used to compare the modified post-test means to the initial test means. Findings: The study’s findings indicate that plyometric exercise, both alone and in combination with asanas, has a substantial effect on flexibility (F = 15.90, p = 0.00) and strength endurance (F = 2.366, p = 0.0027). Furthermore, the paired means of plyometric combined with asanas and plyometric (0.743, p = 0.03), plyometric combined with asanas and control (1.268, p = 0.00), and plyometric and control (0.525, p = 0.029) had a statistically significant mean difference in flexibility. Among the paired means, the differences in strength endurance between plyometric combined with asanas and plyometric (0.276, p = 0.853); plyometric combined with asanas and control (2.911, p = 0.055); and plyometric and control (2.635, p = 0.082) were not statistically significant. Novelty: Plyometric training alone improved the players’ flexibility by 14.25%, and plyometric training combined with asanas improved it by 28.64% compared to the control group. The combined exercise was 16.78% more effective than plyometric training alone. Post-testing data on strength endurance demonstrate an improved trend, despite the absence of statistically significant differences. Keywords: Adolescent; Asanas; Flexibility; Plyometric; Strength Endurance
... it has been hypothesized that by increasing GaBa activity, yoga can reduce allostatic load within stress response systems such that optimal homeostasis is restored. 39 tekur et al. 41 demonstrated favorable results after an intensive oneweek course, for people with busy lifestyles, including normalized cortisol stress markers with a faster returned to work. Similarly with the other trials, participants performed varying amounts of exercise dependent on class adherence and home practice, thus no firm conclusions can yet be drawn. ...
... Yoga has its impact on musculoskeletal pain in various workplace settings like hygiene profession [19], diamond industry [20], professional computer users [21,42], nursing population in hospital settings [22], home-office workers [23], metallurgic company [12], etc. Previous studies on Yoga have shown its association with a reduction in pain-related disability [24], improvement in flexibility [25], functional capacity and mobility [26], muscular strength [27] and quality of life [28] in individuals with different musculoskeletal disorders. ...
Article
Background and Objectives Musculoskeletal pain and discomfort at the workplace are closely associated with prolonged, repetitive, continuous, and unnatural movements. Yoga as mind-body medicine has been shown to reduce pain and disability. The current study aims to assess the effect of yoga on musculoskeletal pain and discomfort among industry workers. Materials and Methods Ninety industrial workers with self-reported pain symptoms will be randomly assigned to Yoga and wait-list control groups following an equal allocation ratio. Yoga group will receive a specially designed Integrated Yoga module five days a week for eight weeks. The control group will be given lifestyle suggestions, and they will be offered the same Yoga module after the post-assessment. Musculoskeletal pain and discomfort scores, perceived stress, and quality of sleep will be assessed at baseline, after four and eight weeks. Statistical Analyses Normality and appropriate statistical tests will be done after data collection to assess the differences between and within the groups. Expected Outcomes Specifically designed Yoga module will help reduce subjective pain, stress and improve sleep quality in industrial workers.
... Yoga practice is a commonly used integrative therapy across the world, with reported use to improve health and relieve pain nearly doubling over the past decade in many countries [25]. A growing number of randomized controlled trials (RCTs) [26][27][28][29][30][31][32][33] support yoga's effectiveness for reducing pain and improving function in adults with cLBP. Reviews, meta-analyses [34,35], and practice guidelines from the American Pain Society and the American College of Physicians [20] support yoga as an evidence-based treatment for cLBP with at least moderate benefit. ...
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Introduction Yoga has been shown to reduce pain and improve function in populations with chronic low back pain (cLBP), yet the underlying molecular mechanisms remain elusive. This study examined the feasibility and acceptability of a yoga research protocol, including recruitment, retention, and data collection, and investigated the preliminary effects of yoga on psychological and neurophysiological functions, including gene expression and DNA methylation profiles, in participants with cLBP. Methods A one-arm trial was conducted with 11 participants with cLBP who enrolled in a 12-week yoga intervention. Data on subjective pain characteristics, quantitative sensory testing, and blood for analysis of differentially expressed genes and CpG methylation was collected prior to the start of the intervention and at study completion. Results Based on pre-determined feasibility and acceptability criteria, the yoga intervention was found to be feasible and highly acceptable to participants. There was a reduction in pain severity, interference, and mechanical pain sensitivity post-yoga and an increase in emotion regulation and self-efficacy. No adverse reactions were reported. Differential expression analysis demonstrated that the yoga intervention induced increased expression of antisense genes, some of which serve as antisense to known pain genes. In addition, there were 33 differentially hypomethylated positions after yoga (log2 fold change ≥ 1), with enrichment of genes involved in NIK/NF-kB signaling, a major pathway that modulates immune function and inflammation. Discussion/conclusions The study supports the feasibility and acceptability of the proposed protocol to test a specific mechanism of action for yoga in individuals with cLBP. These results also support the notion that yoga may operate through our identified psychological and neurophysiologic pathways to influence reduced pain severity and interference.
... This is followed by holding certain yogic poses, including flexion, extension, adduction, abduction and rotation, which engage the muscles in isometric contraction [36][37][38]. The movement of joints increases flexibility, whereas standing yogic poses improve balance and coordination by strengthening major muscle groups (e.g., hamstring muscles and quads) [39][40][41]. This might lead to a reduction in pain and stiffness and improved function [41][42][43]. ...
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The global burden of osteoarthritis among adults is rising. Yoga might be a potential solution for the management of osteoarthritis. This systematic review aims to synthesise the content, structure and delivery characteristics of effective yoga interventions for the management of osteoarthritis. The JBI methodology for systematic reviews of effectiveness and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines will be followed. Randomised controlled trials (RCTs) assessing the effectiveness of yoga interventions for the management of osteoarthritis in adults will be included in this review. We aim to search the following databases to find published and unpublished studies: MEDLINE, EMBASE, CINAHL, PsycInfo, SPORTDiscus, AMED, Web of Science, CENTRAL, TRIP, AYUSH Research Portal, ABIM, CAM-QUEST, PeDro, OpenGrey, EthOS, ProQuest Dissertations and Theses and DART-Europe-e-theses portal. No date or language restrictions will be applied. A narrative synthesis will be conducted with the help of tables. A meta-regression will be conducted to explore the statistical evidence for which the components (content, structure and delivery characteristics) of yoga interventions are effective.
... b AU0 Despite its widespread practice, there is a paucity of research conducted on Essentrics. While Pilates, [14][15][16][17][18][19] Yoga, [20][21][22][23][24][25][26][27][28][29] and Tai Chi [30][31][32][33][34][35][36] have all had significant effects on the improvement of strength, body composition and flexibility, there are no published studies on the effects of Essentrics as a guided exercise program. The purpose of this study is to determine the effect of Essentrics on muscular strength, flexibility and body composition among young adults. ...
... The primary analysis showed that compared with physiotherapy care, cognitive behavioural therapy delivered with physiotherapy care was not significant for reducing pain intensity at short term follow-up (SMD 0.47, 95% confidence interval −0. 66 Based on the SUCRA values and mean rank (supplementary L), the most highly ranked intervention at post-intervention (SUCRA 91.2%, mean rank 2.4), short term (96.7%, 1.4), and mid-term (96.6%, 1.5) follow-up was behavioural therapy delivered with physiotherapy care. At long term follow-up, cognitive behavioural therapy delivered with physiotherapy care was the highest ranked intervention (69.2%, 3.8). ...
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Objective To determine the comparative effectiveness and safety of psychological interventions for chronic low back pain. Design Systematic review with network meta-analysis. Data sources Medline, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, SCOPUS, and CINAHL from database inception to 31 January 2021. Eligibility criteria for study selection Randomised controlled trials comparing psychological interventions with any comparison intervention in adults with chronic, non-specific low back pain. Two reviewers independently screened studies, extracted data, and assessed risk of bias and confidence in the evidence. Primary outcomes were physical function and pain intensity. A random effects network meta-analysis using a frequentist approach was performed at post-intervention (from the end of treatment to <2 months post-intervention); and at short term (≥2 to <6 months post-intervention), mid-term (≥6 to <12 months post-intervention), and long term follow-up (≥12 months post-intervention). Physiotherapy care was the reference comparison intervention. The design-by-treatment interaction model was used to assess global inconsistency and the Bucher method was used to assess local inconsistency. Results 97 randomised controlled trials involving 13 136 participants and 17 treatment nodes were included. Inconsistency was detected at short term and mid-term follow-up for physical function, and short term follow-up for pain intensity, and were resolved through sensitivity analyses. For physical function, cognitive behavioural therapy (standardised mean difference 1.01, 95% confidence interval 0.58 to 1.44), and pain education (0.62, 0.08 to 1.17), delivered with physiotherapy care, resulted in clinically important improvements at post-intervention (moderate quality evidence). The most sustainable effects of treatment for improving physical function were reported with pain education delivered with physiotherapy care, at least until mid-term follow-up (0.63, 0.25 to 1.00; low quality evidence). No studies investigated the long term effectiveness of pain education delivered with physiotherapy care. For pain intensity, behavioural therapy (1.08, 0.22 to 1.94), cognitive behavioural therapy (0.92, 0.43 to 1.42), and pain education (0.91, 0.37 to 1.45), delivered with physiotherapy care, resulted in clinically important effects at post-intervention (low to moderate quality evidence). Only behavioural therapy delivered with physiotherapy care maintained clinically important effects on reducing pain intensity until mid-term follow-up (1.01, 0.41 to 1.60; high quality evidence). Conclusions For people with chronic, non-specific low back pain, psychological interventions are most effective when delivered in conjunction with physiotherapy care (mainly structured exercise). Pain education programmes (low to moderate quality evidence) and behavioural therapy (low to high quality evidence) result in the most sustainable effects of treatment; however, uncertainty remains as to their long term effectiveness. Although inconsistency was detected, potential sources were identified and resolved. Systematic review registration PROSPERO CRD42019138074.
... Padmini Tekur and others [51] found that short-term intensive comprehensive yoga training reduced pain and dysfunction, and increased spinal flexibility, in patients with CLBP. ...
... [12][13][14] It is effective in improving spinal flexibility and pain management in chronic low back pain patients. 15 Yoga is effective in various chronic inflammatory conditions, such as multiple sclerosis and rheumatoid arthritis. Yoga practice was found to be associated with a decrease in inflammatory markers. ...
Article
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Background Ankylosing spondylitis (AS) is a chronic autoimmune inflammatory spondyloarthropathy with unclear pathogenesis. The inflammatory pain in AS leads to restricted spinal mobility and significant disability. Yoga is a nonpharmacological intervention that has positive effects on various musculoskeletal-related problems. However, its role in AS is unknown. Objective The present retrospective study assessed the efficacy of a two-week residential yoga intervention on spinal flexibility among AS patients. Methods The records for 24 male AS patients within the age range 30 to 50 years (average age 38.3 ± 10.5 years) who underwent a two-week residential yoga retreat between 2015 and 2020 were obtained from a yoga center located in South India. Yoga intervention consisted of yoga postures, breathing practices, meditation, a healthy diet, and devotional sessions. Pre and Post data of the sit-and-reach test, blood pressure, heart rate, and symptom score were analyzed using Statistical Package for Social Sciences (SPSS). Results Compared to the baseline, the post scores of the sit-and-reach test, systolic blood pressure and heart rate were found to be significantly ( P < .05) lower. The symptom score and analgesic medication score also showed significant improvement after two-weeks compared to the baseline. Conclusion This retrospective study indicates the positive impact of on and analgesic use among AS patients. However, additional studies using robust research designs are warranted.
... [7]Yoga, a mind-body medicine, has been observed to curtail chronic pain, functional disability, improve joint mobility, reduce inflammation, improve mental health and the overall quality of life. [8][9][10] [11]However, the evidence for the effectiveness of Yoga-based intervention in patients is sparse. The present study is designed to impede this gap and depict the feasibility and efficacy of Yoga as a potent treatment modality for Ankylosing spondylitis amidst the COVID-19 Pandemic. ...
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Background Amidst the adversities of the COVID 19 pandemic, the health care system has seen a new paradigm shift towards e-health services. In the advent of catering to the geometrically increasing health care needs of the patients suffering from various chronic health conditions when in social isolation, the need for the shift seems to be paramount. Patients with Ankylosing spondylitis under immunosuppressants and variable degrees of disabilities are at higher risk. This study aims to assess the efficacy of e-Yoga as a treatment option for these patients in need. Methods This is a single-center, parallel-group prospective randomized, open-blinded end-point trial. Patients aged between 30 to 50 years will be recruited from the members of Antardhwani: A society of ankylosing spondylitis, Ahmedabad, Gujarat. The yoga experts will administer a scientifically developed and validated Yoga module via e-Yoga modalities. A total of 135 patients will be recruited and randomly allocated to Yoga and control groups. Data will be recorded at baseline and three months on disease activity, degree of functional limitations in patients, quality of life, inflammatory biomarkers, depression, and anxiety using Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index(BASFI), AS Quality of Life index(ASQOL), C reactive protein (CRP), Erythrocyte sedimentation rate (ESR), Physical health questionnaire-4 (PHQ-4), respectively. Discussion The study will report the efficacy of e-Yoga in catering to the physical and mental insufficiencies of inpatients with Ankylosing spondylitis amidst Covid 19 pandemic. The study is prospectively registered in the Clinical Trial Registry of India (CTRI/2020/08/027215)
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Aims This trial investigates the effects of Sphinx Pose Yoga therapy on psychophysiological outcomes in healthcare professionals (HCPs) suffering from chronic low back pain (CLBP). By examining the changes in key biomarkers (Substance P, beta-endorphins, and cortisol), this study aims to compare yoga therapy to standard care in terms of improvement in pain intensity, disability, stress levels, and quality of life. Settings and Design Koohi Goth Women’s Hospital, Randomized Controlled Trial. Subjects and Methods A total of 221 HCPs (nurses and midwives) with CLBP were enrolled. Out of these, 140 were randomly assigned to either Group A (Sphinx Yoga therapy) or Group B (usual care) for 12 weeks. The study assessed pain relief, disability, quality of life (QoL), and physical stress using psychophysiological biomarkers, and social and physical parameters. Evaluations were conducted at baseline and postintervention (after 12 weeks) to measure the impact of the interventions. Statistical Analysis Used Baseline data were analyzed using χ² tests and independent sample t -tests. Paired sample t -tests were used for pre- and postintervention comparisons. One-way analysis of variance identified differences between groups at follow-up, and analysis of covariance adjusted for potential confounders. Results Our findings support the hypothesis that the Sphinx Yoga Pose reduces pain, disability, physical stress, and improves the QoL among HCPs with CLBP. A significant variation was observed in psychophysiological biomarkers, with a decline in substance P and cortisol levels and elevated β-endorphin levels among Group A subjects compared to those in Group B after 12 weeks of yoga therapy. The assessed parameters, disability, quality of life, and stress scores significantly improved post-intervention in Group A. No serious adverse events were reported during the study. Although some participants experienced minor and temporary discomfort during the initial sessions, these issues were manageable. Hence, no participant withdrew from the study due to these issues. Conclusions Offering a 12-week Yoga therapy to HCPs with CLBP significantly reduced pain, increased functional ability, and improved QoL. Sphinx Yoga Pose emerged as an effective alternative therapy for managing CLBP among healthcare professionals.
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Background: Low back pain is common. For patients with mechanic or non-specific chronic LBP (cLBP), the current guidelines suggest conservative, nonpharmacologic treatment as a first-line treatment. Among the available strategies, physiotherapy represents a common option offered to patients presenting with cLBP. The present systematic review investigates the prognostic factors of patients with mechanic or non-specific cLBP undergoing physiotherapy. Methods: In September 2024, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase. All the randomised controlled trials (RCTs) which evaluated the efficacy of a physiotherapy programme in patients with LBP were accessed. All studies evaluating non-specific or mechanical LBP were included. Data concerning the following PROMs were collected: the pain scale, Roland Morris Disability Questionnaire (RMQ), and Oswestry Disability Index (ODI). A multiple linear model regression analysis was conducted using the Pearson Product–Moment Correlation Coefficient. Results: Data from 2773 patients were retrieved. The mean length of symptoms before the treatment was 61.2 months. Conclusions: Age and BMI might exert a limited influence on the outcomes of the physiotherapeutic management of cLBP. Pain and disability at baseline might represent important predictors of health-related quality of life at the six-month follow-up. Further studies on a larger population with a longer follow-up are required to validate these results.
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A BSTRACT This systematic review is aimed to evaluate the effect of yoga therapy on lumbar intervertebral disc prolapse (LIVDP) also known as lumbar disc herniation (LDH). Databases such as PubMed/Medline, Cochrane Library, Science Direct, and search engine Google Scholar were searched from 2007 to 2024. Randomized control trials (RCTs), case studies, and quasi-experimental studies involving yoga therapy and LIVDP/LDH were included in the study. The PRISMA guidelines were followed to extract the 10 articles for the study. The primary outcomes included disability scores, pain intensity, nerve conduction, and structural changes. 10 studies involving 546 patients were included in the study. The average sample size of the studies was 54.6 patients. The length of intervention varied from 3 weeks to 4 months with an average of 2 sessions/week. This study demonstrated that yoga therapy is an effective, affordable, and preventive treatment for LIVDP and low back pain. However, additional high-quality, large-scale RCTs and studies are needed for clinically significant results.
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Introduction Low back and neck pain are common musculoskeletal disorders with multiple treatment options. India’s traditional medical systems, known as Ayush (Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa and Homoeopathy) offer range of interventions and are widely used. In view of limited documentation of adverse events following Ayush interventions for lumbar and cervical spondylosis, we synthesized evidence and estimated proportion of studies reporting adverse events. Methods We systematically searched all published documents from biomedical and multidisciplinary abstract and citation databases and Ayush-specific repositories from their inception to April 2021. We selected studies as per inclusion criteria and extracted information, adhering to PRISMA guidelines. We systematically reviewed the qualitative evidence form the selected studies. Results Majority (94%) of the selected 113 studies were interventional studies and included 77 (68.1%) journal articles and 35 (31%) academic dissertations. Among the Ayush systems, considerable proportion was from Ayurveda (32.7%), followed by Siddha (24.8%), Yoga (22.1%), Unani (15.9%) and Homoeopathy (4.4%). Almost three-fourths of the studies were on lumbar spondylosis (65%; n = 74), followed by cervical spondylosis (31%; n = 35), and the remaining four included both. Thirteen percent of the 113 studies described adverse events [Yoga = 9.7%; Unani = 1.8% and Homoeopathy = 1.8%]. More adverse events were reported among the studies on lumbar (9.7%) than cervical spondylosis (2.7%). The nature of interventions were non-pharmacological (10.6%; n = 12), pharmacological (n = 2; 1.8%) or combined (n = 1; 0.9%). Conclusions Only one in eight studies reported any adverse event following Ayush interventions for cervical and lumbar spondylosis. There could be certain degree of underreporting of adverse events and requires further exploration. PROSPERO Registration ID CRD42020167433.
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Chronic low back pain (cLBP) is a major cause of disability and healthcare expenditure worldwide. Its prevalence is increasing globally from somatic and psychosocial factors. While non-pharmacological management, and in particular physiotherapy, has been recommended as a first-line treatment for cLBP, it is not clear what type of physiotherapeutic approach is the most effective in terms of pain reduction and function improvement. This analysis is rendered more difficult by the vast number of available therapies and a lack of a widely accepted classification that can effectively highlight the differences in the outcomes of different management options. This study was conducted according to the PRISMA guidelines. In January 2024, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase. All the randomised controlled trials (RCTs) which compared the efficacy of physiotherapy programs in patients with cLBP were accessed. Studies reporting on non-specific or mechanical cLPB were included. Data concerning the Visual Analogic Scale (VAS) or numeric rating scale (NRS), Roland Morris Disability Questionnaire (RMQ) and Oswestry Disability Index (ODI). Data from 12,773 patients were collected. The mean symptom duration was 61.2 ± 51.0 months and the mean follow-up was 4.3 ± 5.9 months. The mean age was 44.5 ± 9.4 years. The mean BMI was 25.8 ± 2.9 kg/m². The Adapted Physical Exercise group evidenced the lowest pain score, followed by Multidisciplinary and Adapted Training Exercise/Complementary Medicine. The Adapted Physical Exercise group evidenced the lowest RMQ score followed by Therapeutic Exercises and Multidisciplinary. The Multidisciplinary group evidenced the lowest ODI score, followed by Adapted Physical Exercise and Physical Agent modalities. Within the considered physiotherapeutic and non-conventional approaches to manage nonspecific and/or mechanic cLBP, adapted physical exercise, physical agent modalities, and a multidisciplinary approach might represent the most effective strategy to reduce pain and disability.
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Purpose Chronic low back pain (CLBP) is an aging and public health issue that is a leading cause of disability worldwide and has a significant economic impact on a global scale. Treatments for CLBP are varied, and there is currently no study with high-quality evidence to show which treatment works best. Exercise therapy has the characteristics of minor harm, low cost, and convenient implementation. It has become a mainstream treatment method in clinics for chronic low back pain. However, there is insufficient evidence on which specific exercise regimen is more effective for chronic non-specific low back pain. This network meta-analysis aimed to evaluate the effects of different exercise therapies on chronic low back pain and provide a reference for exercise regimens in CLBP patients. Methods We searched PubMed, EMBASE, Cochrane Library, and Web of Science from inception to 10 May 2022. Inclusion and exclusion criteria were used for selection. We collected information from studies to compare the effects of 20 exercise interventions on patients with chronic low back pain. Results This study included 75 randomized controlled trials (RCTs) with 5,254 participants. Network meta-analysis results showed that tai chi [standardized mean difference (SMD), −2.11; 95% CI, −3.62 to −0.61], yoga (SMD, −1.76; 95% CI −2.72 to −0.81), Pilates exercise (SMD, −1.52; 95% CI, −2.68, to −0.36), and sling exercise (SMD, −1.19; 95% CI, −2.07 to −0.30) showed a better pain improvement than conventional rehabilitation. Tai chi (SMD, −2.42; 95% CI, −3.81 to −1.03) and yoga (SMD, −2.07; 95% CI, −2.80 to −1.34) showed a better pain improvement than no intervention provided. Yoga (SMD, −1.72; 95% CI, −2.91 to −0.53) and core or stabilization exercises (SMD, −1.04; 95% CI, −1.80 to −0.28) showed a better physical function improvement than conventional rehabilitation. Yoga (SMD, −1.81; 95% CI, −2.78 to −0.83) and core or stabilization exercises (SMD, −1.13; 95% CI, −1.66 to −0.59) showed a better physical function improvement than no intervention provided. Conclusion Compared with conventional rehabilitation and no intervention provided, tai chi, toga, Pilates exercise, sling exercise, motor control exercise, and core or stabilization exercises significantly improved CLBP in patients. Compared with conventional rehabilitation and no intervention provided, yoga and core or stabilization exercises were statistically significant in improving physical function in patients with CLBP. Due to the limitations of the quality and quantity of the included studies, it is difficult to make a definitive recommendation before more large-scale and high-quality RCTs are conducted.
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Aim and background: Chronic back pain is a prevalent condition for which various management methods, including participation in sports rehabilitation programs, have been proposed to reduce pain. The aim of this study was to investigate the effectiveness of specialized yoga exercises on pain, functional capacity, and range of motion in women with non-specific chronic back pain. Material and Methods: The study included a sample of 50 women with non-specific chronic low back pain in Amol city, selected through convenience sampling and randomly assigned to two experimental groups (n=25) and a control group (n=25). The research tools used were the McGill Pain Questionnaire, the 6-minute fast walking functional test, and waist flexion range measurement using Kinovea software. These measurements were taken before and 48 hours after the final session of yoga exercises. The experimental group underwent 24 sessions of specialized yoga exercises, each lasting 60 minutes. The study design was a pre-test-post-test with a control group, and the data were analyzed using univariate covariance analysis (ANCOA). Results: The results showed that the specialized yoga training program significantly reduced the pain in women with chronic low back pain (p≤ 0.05), improved functional capacity (p ≤ 0.001), and increased back range of motion (p ≤ 0.001). Conclusion: Due to the integration of mental and strengthening exercises, specialized yoga exercises can positively impact psychological factors such as fear of movement and fear of pain, leading to improved back range of motion and functional capacity in patients.
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Background: Non-specific low back pain is a common, potentially disabling condition usually treated with self-care and non-prescription medication. For chronic low back pain, current guidelines recommend exercise therapy. Yoga is a mind-body exercise sometimes used for non-specific low back pain. Objectives: To evaluate the benefits and harms of yoga for treating chronic non-specific low back pain in adults compared to sham yoga, no specific treatment, a minimal intervention (e.g. education), or another active treatment, focusing on pain, function, quality of life, and adverse events. Search methods: We used standard, extensive Cochrane search methods. The latest search date was 31 August 2021 without language or publication status restrictions. Selection criteria: We included randomized controlled trials of yoga compared to sham yoga, no intervention, any other intervention and yoga added to other therapies. Data collection and analysis: We followed standard Cochrane methods. Our major outcomes were 1. back-specific function, 2. pain, 3. clinical improvement, 4. mental and physical quality of life, 5. depression, and 6. Adverse events: Our minor outcome was 1. work disability. We used GRADE to assess certainty of evidence for the major outcomes. Main results: We included 21 trials (2223 participants) from the USA, India, the UK, Croatia, Germany, Sweden, and Turkey. Participants were recruited from both clinical and community settings. Most were women in their 40s or 50s. Most trials used iyengar, hatha, or viniyoga yoga. Trials compared yoga to a non-exercise control including waiting list, usual care, or education (10 trials); back-focused exercise such as physical therapy (five trials); both exercise and non-exercise controls (four trials); both non-exercise and another mind-body exercise (qigong) (one trial); and yoga plus exercise to exercise alone (one trial). One trial comparing yoga to exercise was an intensive residential one-week program, and we analyzed this trial separately. All trials were at high risk of performance and detection bias because participants and providers were not blinded to treatment, and outcomes were self-assessed. We found no trials comparing yoga to sham yoga. Low-certainty evidence from 11 trials showed that there may be a small clinically unimportant improvement in back-specific function with yoga (mean difference [MD] -1.69, 95% confidence interval [CI] -2.73 to -0.65 on the 0- to 24-point Roland-Morris Disability Questionnaire [RMDQ], lower = better, minimal clinically important difference [MCID] 5 points; 1155 participants) and moderate-certainty evidence from nine trials showed a clinically unimportant improvement in pain (MD -4.53, 95% CI -6.61 to -2.46 on a 0 to 100 scale, 0 no pain, MCID 15 points; 946 participants) compared to no exercise at three months. Low-certainty evidence from four trials showed that there may be a clinical improvement with yoga (risk ratio [RR] 2.33, 95% CI 1.46 to 3.71; assessed as participant rating that back pain was improved or resolved; 353 participants). Moderate-certainty evidence from six trials showed that there is probably a small improvement in physical and mental quality of life (physical: MD 1.80, 95% CI 0.27 to 3.33 on the 36-item Short Form [SF-36] physical health scale, higher = better; mental: MD 2.38, 95% CI 0.60 to 4.17 on the SF-36 mental health scale, higher = better; both 686 participants). Low-certainty evidence from three trials showed little to no improvement in depression (MD -1.25, 95% CI -2.90 to 0.46 on the Beck Depression Inventory, lower = better; 241 participants). There was low-certainty evidence from eight trials that yoga increased the risk of adverse events, primarily increased back pain, at six to 12 months (RR 4.76, 95% CI 2.08 to 10.89; 43/1000 with yoga and 9/1000 with no exercise; 1037 participants). For yoga compared to back-focused exercise controls (8 trials, 912 participants) at three months, we found moderate-certainty evidence from four trials for little or no difference in back-specific function (MD -0.38, 95% CI -1.33 to 0.62 on the RMDQ, lower = better; 575 participants) and very low-certainty evidence from two trials for little or no difference in pain (MD 2.68, 95% CI -2.01 to 7.36 on a 0 to 100 scale, lower = better; 326 participants). We found very low-certainty evidence from three trials for no difference in clinical improvement assessed as participant rating that back pain was improved or resolved (RR 0.97, 95% CI 0.72 to 1.31; 433 participants) and very low-certainty evidence from one trial for little or no difference in physical and mental quality of life (physical: MD 1.30, 95% CI -0.95 to 3.55 on the SF-36 physical health scale, higher = better; mental: MD 1.90, 95% CI -1.17 to 4.97 on the SF-36 mental health scale, higher = better; both 237 participants). No studies reported depression. Low-certainty evidence from five trials showed that there was little or no difference between yoga and exercise in the risk of adverse events at six to 12 months (RR 0.93, 95% CI 0.56 to 1.53; 84/1000 with yoga and 91/1000 with non-yoga exercise; 640 participants). Authors' conclusions: There is low- to moderate-certainty evidence that yoga compared to no exercise results in small and clinically unimportant improvements in back-related function and pain. There is probably little or no difference between yoga and other back-related exercise for back-related function at three months, although it remains uncertain whether there is any difference between yoga and other exercise for pain and quality of life. Yoga is associated with more adverse events than no exercise, but may have the same risk of adverse events as other exercise. In light of these results, decisions to use yoga instead of no exercise or another exercise may depend on availability, cost, and participant or provider preference. Since all studies were unblinded and at high risk of performance and detection bias, it is unlikely that blinded comparisons would find a clinically important benefit.
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Background: Meditation has been increasingly adapted for healthy populations and participants with diseases. Its beneficial effects are still challenging to determine due to the heterogeneity and methodological obstacles regarding medical applications. This study aimed to integrate the features of therapeutic meditation in randomized controlled trials (RCTs). Methods: We conducted a systematic review of RCTs with meditation for populations with diseases using the PubMed database through June 2021. We analyzed the characteristics of the diseases/disorders, participants, measurements, and their overall benefits. Results: Among a total of 4855 references, 104 RCTs were determined and mainly applied mindfulness-based (51 RCTs), yoga-based (32 RCTs), and transcendental meditation (14 RCTs) to 10,139 patient-participants. These RCTs were conducted for participants with a total of 45 kinds of disorders; the most frequent being cancer, followed by musculoskeletal and connective tissue diseases and affective mood disorder. Seven symptoms or signs were frequently assessed: depressive mood, feeling anxious, quality of life, stress, sleep, pain, and fatigue. The RCTs showed a higher ratio of positive outcomes for sleep (73.9%) and fatigue (68.4%). Conclusions: This systematic review produced the comprehensive features of RCTs for therapeutic meditation. These results will help physicians and researchers further study clinical adaptations in the future as reference data.
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Background Ankylosing spondylitis (AS) is a chronic inflammatory disease that causes significant disability and reduced quality of life. Scientific studies on yoga have revealed its various health benefits in chronic conditions, including autoimmune diseases. However, whether yoga is feasible for AS patients or not is not studied. Further, no validated yoga module is available for AS patients. Objective(s) This study intended to develop a yoga module for AS patients and investigated its feasibility of use. Materials and methods The study was completed in three phases. In Phase I, six yoga experts prepared a list of 64 yoga practices based on the classical and contemporary yogic literature review. Of these practices, 41 were included in the designed yoga module. In Phase II, 41 experts with a minimum of five years of experience in yoga therapy were invited for yoga module validation. The usefulness of the practices was rated by experts on a 3-point scale (1: not at all useful, 2: moderately useful, and 3: very much useful). The Lawshe content validity ratio (CVR) method was used for the content validity of the yoga module. Practices with a CVR score of > 0.3 were retained in the final yoga module. In Phase III, a certified yoga instructor administered the validated yoga module to 19 AS patients (average age: 35.5 ± 10.7 years) thrice weekly for a month. Feasibility was assessed on the basis of the attrition rate, retention rate, attendance of the participants, and the subjective response on practical sessions using a structured checklist. Results Of the 41 practices in the module, 31 had a CVR score of > 0.3 and were included in the final yoga module. Of the 25 participants, 19 (76%) completed the study while six dropped out (24%). Nineteen patients reported greater improvement in pain and flexibility. They found yoga relaxing and easy to practice. Most participants (65%) were able to practice a minimum of 30 min/day. Conclusion The present study offers a validated yoga module consisting of 31 practices for AS patients. The results of the pilot suggested that the module is feasible, acceptable, and easy to practice for AS patients. We recommend that AS patients should practice this yoga module for a minimum of 30 min every day under the supervision of a yoga expert.
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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.
Article
35 male volunteers with ages ranged from 20 to 46 yrs were studied in two sessions, of yoga based guided relaxation and supine rest. Assessments of autonomic parameters were made in 15 subjects, before, during and after the practices, whereas oxygen consumption and breath volume were recorded in 25 subjects, before and after both types of relaxation. A significant decrease in oxygen consumption and increase in breath volume were recorded after guided relaxation (paired t test). There were comparable reductions in heart rate and skin conductance level during both types of relaxation. During guided relaxation the power of the low frequency component of the heart rate variability spectrum reduced, whereas the power of the high frequency component increased, suggesting reduced sympathetic activity. Also subjects with a base line ratio of LF/HF >0.5 showed a significant decrease in the ratio after guided relaxation, while subjects with a ratio < 0.5 at baseline showed no such change. The results suggest that sympathetic activity decreased after guided relaxation based on yoga, depending on the base line levels. A number of reports have described the physiological changes associated with diverse relaxation techniques (Harding, 1996; Smith, Amutio, Anderson, & Aria, 1996; Broms, 1999). Relaxation guided by instructions has been shown to be more effective in reducing physiological arousal than a control session of supine rest (Sakakibara, Takeuchi, & Hayano, 1994). Also, after exercise the heart rate and blood pressure returned to the baseline level sooner, when subjects practiced guided relaxation compared with recovery after rest while supine or seated (Bera, Gore, & Oak, 1998). Specific relaxation techniques may be more effective for certain persons, based on their psychophysiological characteristics (Weinstein & Smith, 1992), and isometric "squeeze" relaxation has been found to be more likely to induce relaxation compared to meditation, for individuals who have difficulty focusing and less developed stress coping strategies (Weinstein & Smith, 1992). However, most reports describe post relaxation effects on a group level, regardless of individual differences at base line. Also, most instructions to relax make use of imagery (Rickard, Collier, McCoy, Crist, & Weinberger, 1993) and breathing (Toivanen, Lansimies, Jokela, & Hanninen, 1993). With this background, the present study was conducted to assess whether the present subjects who had a group mean of 30.2 months experience of yoga practice, showed greater reduction in physiological arousal after "Guided relaxation" (with instructions) as compared to "Supine Rest" (without instructions). This was considered interesting as both practices (i.e., relaxation with instructions and rest in the supine position are considered to be relaxing by yoga practitioners). Also yoga practice is believed to help reach a state in which external instructions to relax are no longer necessary. Guided relaxation was based on yoga, with breath awareness and chanting, as is usual in yoga practice (Nagendra & Nagarathna, 1988). (ii) As a second aim, subjects were categorized as two groups, based on their baseline levels of LF/HF ratio of the heart rate variability components, which indicate the cardiac autonomic control, and the changes of the two categories of subjects after guided relaxation are presented separately.
Article
This immensely practical volume describes the rationale, development, and utilization of cognitive-behavioral techniques in promoting health, preventing disease, and treating illness, with a particular focus on pain management. An ideal resource for a wide range of practitioners and researchers, the book's coverage of pain management includes theoretical, research, and clinical issues, and includes illustrative case material.
Article
Adult asthmatics, ranging from 19 to 52 years from an asthma and allergy clinic in a university setting volunteered to participate in the study. The 17 students were randomly divided into yoga (9 subjects) and nonyoga control (8 subjects) groups. The yoga group was taught a set of breathing and relaxation techniques including breath slowing exercises (pranayama), physical postures (yogasanas), and meditation. Yoga techniques were taught at the university health center, three times a week for 16 weeks. All the subjects in both groups maintained daily symptom and medication diaries, collected A.M. and P.M. peak flow readings, and completed weekly questionnaires. Spirometry was performed on each subject every week. Analysis of the data showed that the subjects in the yoga group reported a significant degree of relaxation, positive attitude, and better yoga exercise tolerance. There was also a tendency toward lesser usage of beta adrenergic inhalers. The pulmonary functions did not vary significantly between yoga and control groups. Yoga techniques seem beneficial as an adjunct to the medical management of asthma.
Article
Fifty three patients with asthma underwent training for two weeks in an integrated set of yoga exercises, including breathing exercises, suryanamaskar, yogasana (physical postures), pranayama (breath slowing techniques), dhyana (meditation), and a devotional session, and were told to practise these exercises for 65 minutes daily. They were then compared with a control group of 53 patients with asthma matched for age, sex, and type and severity of asthma, who continued to take their usual drugs. There was a significantly greater improvement in the group who practised yoga in the weekly number of attacks of asthma, scores for drug treatment, and peak flow rate. This study shows the efficacy of yoga in the long term management of bronchial asthma, but the physiological basis for this beneficial effect needs to be examined in more detail.
Article
There is increasing interest in the fact that breathing exclusively through one nostril may alter the autonomic functions. The present study aimed at checking whether such changes actually do occur, and whether breathing is consciously regulated. 48 male subjects, with ages ranging from 25 to 48 years were randomly assigned to different groups. Each group was asked to practice one out of three pranayamas (viz. right nostril breathing, left nostril breathing or alternate nostril breathing). These practices were carried out as 27 respiratory cycles, repeated 4 times a day for one month. Parameters were assessed at the beginning and end of the month, but not during the practice. The 'right nostril pranayama' group showed a significant increase, of 37% in baseline oxygen consumption. The 'alternate nostril' pranayama group showed an 18% increase, and the left nostril pranayama group also showed an increase, of 24%. This increase in metabolism could be due to increased sympathetic discharge to the adrenal medulla. The 'left nostril Pranayama' group showed an increase in volar galvanic skin resistance, interpreted as a reduction in sympathetic nervous system activity supplying the sweat glands. These results suggest that breathing selectively through either nostril could have a marked activating effect or a relaxing effect on the sympathetic nervous system. The therapeutic implications of being able to alter metabolism by changing the breathing pattern have been mentioned.
Article
To determine whether chronic pain patients' beliefs and attributions about pain control are amenable to change in a short-term inpatient multidisciplinary pain management program. Non-randomized consecutive sample with prospective, before-after treatment. Pain-management, tertiary care center in a major U.S. city. All adult patients (n = 50) who were treated in an inpatient multidisciplinary pain management center were contrasted with those of a control group of 46 adult patients who were treated in an outpatient pain center. Pain Locus of Control Scale, the Pain Beliefs and Perceptions Inventory, subjective pain intensity, and medication usage were measured before and after treatment. Statistically significant posttreatment changes were found for the treatment group, but not the control group. Patients who completed the inpatient pain management program reported significant decreases in subjective pain intensity despite discontinuation of narcotic analgesics. Patients in the treatment group showed an increased sense of personal control over their pain and substantial decreases in attributions of pain control to powerful others and chance. Patients in the treatment group also showed a significant reduction in their endorsement of the belief that their pain was a mysterious phenomenon. Chronic non-terminal pain patients' beliefs about pain and attributions of pain control are amenable to change in a short-term inpatient multidisciplinary pain management program. These results suggest that an intensive multidisciplinary program involving psychotherapy might be more effective in treating chronic pain patients similar to those in this study than outpatient treatment without psychotherapy.
Article
The autonomic and respiratory variables were studied in seven experienced meditators (with experience ranging from 5 to 20 years). Each subject was studied in two types of sessions--meditation (with a period of mental chanting of "OM") and control (with a period of non-targetted thinking). The meditators showed a statistically significant reduction in heart rate during meditation compared to the control period (paired 't' test). During both types of sessions there was a comparable increase in the cutaneous peripheral vascular resistance. Keeping in mind similar results of other authors, this was interpreted as a sign of increased mental alertness, even while being physiologically relaxed (as shown by the reduced heart rate).
Article
This is the second of two papers that systematically review available scientific evidence on the causes of disability from occupational low back pain, and the effectiveness of interventions to prevent it after its onset (secondary prevention). This paper reviews the national history of how back pain and the risk factors for its extension into chronic disability, followed by a critical summary of intervention studies attempting to reduce the duration of this disability, and to evaluate the results.
Article
Cognitive behavioral treatment has been incorporated into standard medical treatment procedures in German pain centers. Acceptance of the treatment by patients and outcome in terms of pain, coping, and disability was investigated. Components of the psychological treatment are education, relaxation and imagery, modifying thoughts and feelings, enhancement of pleasant activities, and training of good postural habits. The program was conducted in a group setting in accordance with a treatment manual and consists of 12 weekly 2.5-h sessions. A two-factor experiment with repeated measures on one factor was applied. Ninety-four consecutive patients with low-back pain were randomly assigned to an experimental group having a combined medical and cognitive-behavioral treatment, or to a control group with medical treatment only. Assessments were taken pre-treatment, post-treatment, and--in the treated group only--at a 6-months follow-up. At each assessment, patients kept a pain diary over a period of 4 weeks, and filled in self-report questionnaires. The sample consisted of 36 experimental and 40 control subjects at post-treatment. Experimental subjects reported less pain, better control over pain, more pleasurable activities and feelings, less avoidance and less catastrophizing. In addition, disability was reduced in terms of social roles, physical functions and mental performance. The results were maintained at follow-up. Patients who only received medical treatment showed little improvement. Data indicate that the program meets the needs of the patients and should be continued.
Article
Carpal tunnel syndrome is a common complication of repetitive activities and causes significant morbidity. To determine the effectiveness of a yoga-based regimen for relieving symptoms of carpal tunnel syndrome. Randomized, single-blind, controlled trial. A geriatric center and an industrial site in 1994-1995. Forty-two employed or retired individuals with carpal tunnel syndrome (median age, 52 years; range, 24-77 years). Subjects assigned to the yoga group received a yoga-based intervention consisting of 11 yoga postures designed for strengthening, stretching, and balancing each joint in the upper body along with relaxation given twice weekly for 8 weeks. Patients in the control group were offered a wrist splint to supplement their current treatment. Changes from baseline to 8 weeks in grip strength, pain intensity, sleep disturbance, Phalen sign, and Tinel sign, and in median nerve motor and sensory conduction time. Subjects in the yoga groups had significant improvement in grip strength (increased from 162 to 187 mm Hg; P = .009) and pain reduction (decreased from 5.0 to 2.9 mm; P = .02), but changes in grip strength and pain were not significant for control subjects. The yoga group had significantly more improvement in Phalen sign (12 improved vs 2 in control group; P = .008), but no significant differences were found in sleep disturbance, Tinel sign, and median nerve motor and sensory conduction time. In this preliminary study, a yoga-based regimen was more effective than wrist splinting or no treatment in relieving some symptoms and signs of carpal tunnel syndrome.
Article
On the basis of medical officers diagnosis, thirty three (N = 33) hypertensives, aged 35-65 years, from Govt. General Hospital, Pondicherry, were examined with four variables viz, systolic and diastolic blood pressure, pulse rate and body weight. The subjects were randomly assigned into three groups. The exp. group-I underwent selected yoga practices, exp. group-II received medical treatment by the physician of the said hospital and the control group did not participate in any of the treatment stimuli. Yoga imparted in the morning and in the evening with 1 hr/session. day-1 for a total period of 11-weeks. Medical treatment comprised drug intake every day for the whole experimental period. The result of pre-post test with ANCOVA revealed that both the treatment stimuli (i.e., yoga and drug) were effective in controlling the variables of hypertension.
Article
The Oswestry Disability Index (ODI) has become one of the principal condition-specific outcome measures used in the management of spinal disorders. This review is based on publications using the ODI identified from the authors' personal databases, the Science Citation Index, and hand searches of Spine and current textbooks of spinal disorders. To review the versions of this instrument, document methods by which it has been validated, collate data from scores found in normal and back pain populations, provide curves for power calculations in studies using the ODI, and maintain the ODI as a gold standard outcome measure. It has now been 20 years since its original publication. More than 200 citations exist in the Science Citation Index. The authors have a large correspondence file relating to the ODI, that is cited in most of the large textbooks related to spinal disorders. All the published versions of the questionnaire were identified. A systematic review of this literature was made. The various reports of validation were collated and related to a version. Four versions of the ODI are available in English and nine in other languages. Some published versions contain misprints, and many omit the scoring system. At least 114 studies contain usable data. These data provide both validation and standards for other users and indicate the power of the instrument for detecting change in sample populations. The ODI remains a valid and vigorous measure and has been a worthwhile outcome measure. The process of using the ODI is reviewed and should be the subject of further research. The receiver operating characteristics should be explored in a population with higher self-report disabilities. The behavior of the instrument is incompletely understood, particularly in sensitivity to real change.
Article
The present study was conducted to evaluate a statement in ancient yoga texts that suggests that a combination of both "calming" and "stimulating" measures may be especially helpful in reaching a state of mental equilibrium. Two yoga practices, one combining "calming and stimulating" measures (cyclic meditation) and the other, a "calming" technique (shavasan), were compared. The oxygen consumption, breath rate, and breath volume of 40 male volunteers (group mean +/- SD, 27.0 +/- 5.7 years) were assessed before and after sessions of cyclic meditation (CM) and before and after sessions of shavasan (SH). The 2 sessions (CM, SH) were 1 day apart. Cyclic meditation includes the practice of yoga postures interspersed with periods of supine relaxation. During SH the subject lies in a supine position throughout the practice. There was a significant decrease in the amount of oxygen consumed and in breath rate and an increase in breath volume after both types of sessions (2-factor ANOVA, paired t test). However, the magnitude of change on all 3 measures was greater after CM: (1) Oxygen consumption decreased 32.1% after CM compared with 10.1% after SH; (2) breath rate decreased 18.0% after CM and 15.2% after SH; and (3) breath volume increased 28.8% after CM and 15.9% after SH. These results support the idea that a combination of yoga postures interspersed with relaxation reduces arousal more than relaxation alone does.
Article
Yoga has potential for benefit for patients with coronary artery disease though objective, angiographic studies are lacking. We evaluated possible role of lifestyle modification incorporating yoga, on retardation of coronary atherosclerotic disease. In this prospective, randomized, controlled trial, 42 men with angiographically proven coronary artery disease (CAD) were randomized to control (n = 21) and yoga intervention group (n = 21) and were followed for one year. The active group was treated with a user-friendly program consisting of yoga, control of risk factors, diet control and moderate aerobic exercise. The control group was managed by conventional methods i.e. risk factor control and American Heart Association step I diet. At one year, the yoga groups showed significant reduction in number of anginal episodes per week, improved exercise capacity and decrease in body weight. Serum total cholesterol, LDL cholesterol and triglyceride levels also showed greater reductions as compared with control group. Revascularisation procedures (coronary angioplasty or bypass surgery) were less frequently required in the yoga group (one versus eight patients; relative risk = 5.45; P = 0.01). Coronary angiography repeated at one year showed that significantly more lesions regressed (20% versus 2%) and less lesions progressed (5% versus 37%) in the yoga group (chi-square = 24.9; P < 0.0001). The compliance to the total program was excellent and no side effects were observed. Yoga lifestyle intervention retards progression and increases regression of coronary atherosclerosis in patients with severe coronary artery disease. It also improves symptomatic status, functional class and risk factor profile.
Article
35 male volunteers whose ages ranged from 20 to 46 years were studied in two sessions of yoga-based guided relaxation and supine rest. Assessments of autonomic variables were made for 15 subjects, before, during, and after the practices, whereas oxygen consumption and breath volume were recorded for 25 subjects before and after both types of relaxation. A significant decrease in oxygen consumption and increase in breath volume were recorded after guided relaxation (paired t test). There were comparable reductions in heart rate and skin conductance during both types of relaxation. During guided relaxation the power of the low frequency component of the heart-rate variability spectrum reduced, whereas the power of the high frequency component increased, suggesting reduced sympathetic activity. Also, subjects with a baseline ratio of LF/HF > 0.5 showed a significant decrease in the ratio after guided relaxation, while subjects with a ratio < or = 0.5 at baseline showed no such change. The results suggest that sympathetic activity decreased after guided relaxation based on yoga, depending on the baseline levels.
Article
Yoga teachers and students often report that yoga has an uplifting effect on their moods, but scientific research on yoga and depression is limited. To examine the effects of a short-term Iyengar yoga course on mood in mildly depressed young adults. Young adults pre-screened for mild levels of depression were randomly assigned to a yoga course or wait-list control group. College campus recreation center. Twenty-eight volunteers ages 18 to 29. At intake, all participants were experiencing mild levels of depression, but had received no current psychiatric diagnoses or treatments. None had significant yoga experience. Subjects in the yoga group attended two 1-hour Iyengar yoga classes each week for 5 consecutive weeks. The classes emphasized yoga postures thought to alleviate depression, particularly back bends, standing poses, and inversions. Beck Depression Inventory, State-Trait Anxiety Inventory, Profile of Mood States, morning cortisol levels. Subjects who participated in the yoga course demonstrated significant decreases in self-reported symptoms of depression and trait anxiety. These effects emerged by the middle of the yoga course and were maintained by the end. Changes also were observed in acute mood, with subjects reporting decreased levels of negative mood and fatigue following yoga classes. Finally, there was a trend for higher morning cortisol levels in the yoga group by the end of the yoga course, compared to controls. These findings provide suggestive evidence of the utility of yoga asanas in improving mood and support the need for future studies with larger samples and more complex study designs to more fully evaluate the effects of yoga on mood disturbances.
Article
One of the diagnostic characteristics of the manipulable spinal lesion--a musculoskeletal disturbance detected by manual palpation and corrected with manipulation--is said to be altered segmental tissue texture. Various manual therapy authors have speculated on the possible nature of this tissue change, with some authors hypothesizing that it represents deep segmental muscle overactivity. To review the literature relating to the detection and nature of altered paraspinal tissue texture, proposed explanations for altered tissue texture, evidence for the plausibility of paraspinal muscle spasm, and evidence of muscle dysfunction associated with low back pain (LBP). MEDLINE and CINAHL databases were searched using various combinations of the keywords paraspinal, muscle, palpation, EMG, spine, low back pain, pain, myofascial, hardness, manipulation, reliability, and somatic dysfunction, along with searching the bibliographies of selected articles and textbooks. All relevant data were used. Little direct evidence exists for the nature of abnormal paraspinal tissue texture detected by palpation. Palpation for tenderness is more reliable than palpation for tissue texture change. Indirect evidence from animal studies and experimental muscle inflammation support the plausibility of protective paraspinal muscle contraction. Increased paraspinal electromyographic (EMG) activity observed in subjects with LBP appears to be a result of voluntary and nonvoluntary changes in motor control, modified by psychophysiological responses to perceived stress rather than a simple protective reflex. Although little direct evidence exists of the nature of clinically detected paraspinal tissue texture change, the concept of reactive muscle contraction appears plausible. Increased paraspinal EMG activity associated with LBP does not appear to be mediated by a simple protective reflex.
Article
Low back pain is a significant public health problem and one of the most commonly reported reasons for the use of Complementary Alternative Medicine. A randomized control trial was conducted in subjects with non-specific chronic low back pain comparing Iyengar yoga therapy to an educational control group. Both programs were 16 weeks long. Subjects were primarily self-referred and screened by primary care physicians for study of inclusion/exclusion criteria. The primary outcome for the study was functional disability. Secondary outcomes including present pain intensity, pain medication usage, pain-related attitudes and behaviors, and spinal range of motion were measured before and after the interventions. Subjects had low back pain for 11.2+/-1.54 years and 48% used pain medication. Overall, subjects presented with less pain and lower functional disability than subjects in other published intervention studies for chronic low back pain. Of the 60 subjects enrolled, 42 (70%) completed the study. Multivariate analyses of outcomes in the categories of medical, functional, psychological and behavioral factors indicated that significant differences between groups existed in functional and medical outcomes but not for the psychological or behavioral outcomes. Univariate analyses of medical and functional outcomes revealed significant reductions in pain intensity (64%), functional disability (77%) and pain medication usage (88%) in the yoga group at the post and 3-month follow-up assessments. These preliminary data indicate that the majority of self-referred persons with mild chronic low back pain will comply to and report improvement on medical and functional pain-related outcomes from Iyengar yoga therapy.
Article
The objective of the study was to study the short-term impact of a brief lifestyle intervention based on yoga on some of the biochemical indicators of risk for cardiovascular disease and diabetes mellitus. The variables of interest were measured at the beginning (day 1) and end (day 10) of the intervention using a pre-post design. The study is the result of operational research carried out in our Integral Health Clinic (IHC). The IHC is an outpatient facility which conducts 8-day lifestyle modification programs based on yoga for prevention and management of chronic disease. A new course begins every alternate week of the year. The study is based on data collected on 98 subjects (67 male, 31 female), ages 20-74 years, who attended one of our programs. The subjects were a heterogeneous group of patients with hypertension, coronary artery disease, diabetes mellitus, and a variety of other illnesses. The intervention consisted of asanas (postures), pranayama (breathing exercises), relaxation techniques, group support, individualized advice, lectures and films on the philosophy of yoga and the place of yoga in daily life, meditation, stress management, nutrition, and knowledge about the illness. The outcome measures were fasting plasma glucose and serum lipoprotein profile. These variables were determined in fasting blood samples, taken on the first and last day of the course. Fasting plasma glucose, serum total cholesterol, low-density lipoprotein (LDL) cholesterol, very- LDL cholesterol, the ratio of total cholesterol to high density lipoprotein (HDL) cholesterol, and total triglycerides were significantly lower, and HDL cholesterol significantly higher, on the last day of the course compared to the first day of the course. The changes were more marked in subjects with hyperglycemia or hypercholesterolemia. The observations suggest that a short lifestyle modification and stress management education program leads to favorable metabolic effects within a period of 9 days.
Article
The surgery for herniated disc is the most common operation at the level of the lumbar spine. The failed surgery rates range between 10% and 40%, conforming what is known as Failed Back Surgery Syndrome (FBSS). Return to work after surgery occurs in 70-85% of the cases. There are a few studies analysing the quality of life after the operation. The aims of this study are to know the incidence of the herniated disc lumbar failed surgery in our area, identify those factors influencing its development, and study behavioural parameters as the return to work and the quality of life at a middle term after surgery, also its relation with the success or failure surgery. A descriptive transversal study of 117 patients operated for herniated lumbar disc during the first six months of the year 2003 is reported. In order to evaluate the incidence of failed surgery and the related factors, the clinical records were retrospectively analyzed. Ninety one patients were interviewed by phone using the Health Questionnaire SF-36, in order to analyze the non clinical factors related to FBSS, such as labour reincorporation, satisfaction with surgery, realization of rehabilitation treatment and quality of life after surgery. For the statistical analysis of the results, we used the program SPSS 11.01. In a sample in which the proportion between both sexes was 1/1, and the middle age was over 45 years [35-54], in which the most frequent clinical symptom was right sciatica, lasting more than 6 months, correlated to disc herniation at L5-S1 level, 37.9% of the patients presented FBSS. Although there were a few patients with reoperation in our study, the incidence of FBSS in these patients was higher (52.9%) than in patients who suffered this surgery for first time (32%). The predictive clinical factors of an unfavourable result in patients operated on for first time were bilateral sciatica, the presence of stenosis associated to herniated disc and comorbidity factors. On the other hand the sociolabor factors identified were a low culture level and those working as drivers, building and service sectors. Return to work occurred in the 64% of the active workers before surgery. Only around 10% of patients were dissatisfied with surgical result and there was a significant relationship between this and the physical function, pain, vitality and emotional status in the SF-36 with the FBSS. One out of three patients operated of herniated lumbar disc in our area presented failed disc surgery and the return to work occurred in 2 out of three patients active before the operation. The failed surgery patient suffers from pain, that interferes and limits the labour and home activities. Furthermore, the patient presents frequent sensation of fatigue and exhaustion and also emotional problems that contribute to interfere with work and activities of the daily life.
Disability resulting from occupational low back pain: A review of scientific evidence on prevention before disability begins
  • Jw Franks
  • Kerr
  • As Brooker
  • Demano
Franks JW, Kerr MS, Brooker AS, Demano SE. Disability resulting from occupational low back pain: A review of scientific evidence on prevention before disability begins. Spine 1996;21:2908–2917.
Effects of yoga practices in nonspecific low back pain The impact of modified Hatha yoga on chronic low back pain: A pilot study
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  • V Reddy
Vidyasagar JVS, Prasad BN, Reddy V, et al. Effects of yoga practices in nonspecific low back pain. Clin Proc NIMS 1989;4:160–164. 19. Galantino ML, Bzdewka TM, Eissler-Russo JL, et al. The impact of modified Hatha yoga on chronic low back pain: A pilot study. Altern Ther Health Med 2004;10:56–59.
New Perspectives in Stress Management
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Nagendra HR, Nagarathna R. New Perspectives in Stress Management. Bangalore: Vivekananda Kendra Prakashana, 1997.
Effects of yoga practices in nonspecific low back pain
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Vidyasagar JVS, Prasad BN, Reddy V, et al. Effects of yoga practices in nonspecific low back pain. Clin Proc NIMS 1989;4:160–164.
Yoga for the promotion of positive health
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Nagarathna R, Nagendra HR. Yoga for the promotion of positive health. Bangalore: Swami Vivekananda Yoga Prakashana, 2000.
student, for their help with scoring the results and with preparing the manuscript; to all the staff members of SVYASA for their cooperation in conducting the program; to the Jubilee Camdarac Institute for taking the X-rays
  • D Ph
Ph.D. student, for their help with scoring the results and with preparing the manuscript; to all the staff members of SVYASA for their cooperation in conducting the program; to the Jubilee Camdarac Institute for taking the X-rays; and John Ebnezar, M.B.B.S., D.Ortho, D.N.B. student, who gave his second opinion on the X-rays.
Mind Sound Resonance Technique. Banga-lore: Swami Vivekananda Yoga Prakashana
  • Hr Nagendra
Nagendra HR. Mind Sound Resonance Technique. Banga-lore: Swami Vivekananda Yoga Prakashana, 1998.
Yoga for Back Pain. Banga-lore: Swami Vivekananda Yoga Prakashana
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Nagarathna R, Nagendra HR. Yoga for Back Pain. Banga-lore: Swami Vivekananda Yoga Prakashana, 2001.
Pranayama:—the Art and Science. Bangalore: Swami Vivekananda Yoga Prakashana
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Nagendra HR. Pranayama:—the Art and Science. Bangalore: Swami Vivekananda Yoga Prakashana, 2000.
Disordered sleep, pain, fatigue and gastrointestinal symptoms in fibromyalgia, chronic fatigue and irritable bowel syndromes Basic and Clinical Aspects of Chronic Abdominal Pain
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