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A compilation of the abstracts
of research works done by ISCM of SBV
from 2010 to 2022.
Bridging Traditional
Healing Systems and
Modern Medical Science
Through Salutogenesis
©2023 by ISCM of SBV, All rights reserved, 1st Edition: 2023
Editor in-Chief:
Editor:
Yogacharya Dr. Ananda Balayogi Bhavanani
Director, ISCM of Sri Balaji Vidyapeeth,
Pondicherry, India. Email: iscm@sbvu.ac.in
Yogathilakam Dr. Meena Ramanathan
Vice Principal, School of Yoga therapy, ISCM
Sub-Editors: Yogachemmal Dayanidy G
Yogachemmal Dr. Balaji R
Asst. Professors, School of Yoga Therapy, ISCM
Published by:
ISBN :
Any material reproduced from this book may be done so only with prior
permission of the author and with due credit to the source. This is an important
aspect of Yogic culture and we request all readers to follow this request in the true
spirit of Yama and Niyama.
978-81-962215-0-8
Prof. Sobana R
Admin In-Charge, School of Music Therapy, ISCM
Mrs. Bhuvaneswari Ramesh
Ms. Jenita Caren Rajakumari
Asst. Professors, School of Music Therapy, ISCM
Institute of Salutogenesis & Complementary
Medicine (ISCM),
Sri Balaji Vidyapeeth (SBV),
Deemed to be University,
First Floor, I Block, SBV Campus,
Pillaiyarkuppam, Pondicherry – 607 402.
E-mail: iscm@sbvu.ac.in Phone : 0413 261549
Introduction
Role of Yoga and Music Therapy in
Promoting Salutogenesis
Role of Yoga and Music Therapy in
General Medicine
Role of Yoga and Music Therapy in
Pulmonology
Role of Yoga and Music Therapy in
Obstetrics and Gynecology
Role of Yoga and Music Therapy in
Pediatrics
Role of Yoga and Music Therapy in
Surgical conditions
Role of Yoga and Music Therapy in
Mental Health
Role of Yoga and Music Therapy in
Cardiology
Role of Yoga and Music Therapy in
Dentistry
Role of Yoga and Music Therapy in
Oncology
Role of Yoga and Music Therapy in
Community Settings
Copyrights from ISCM
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10
Chapter 11
Chaper 12
Chaper 13
CONTENTS
01
08
25
35
40
45
50
56
64
67
70
75
82
FOREWORD
Dr. DilipSarkar, MD, FACS, D.Litt (Yoga), C-IAYT, AYT-NAMA,
Past President, Board of Directors, American Heart Association,
VA and International Association of Yoga Therapists (IAYT)
Chairman, Center for Integrative Medicine and Yoga, Taksha Institute, USA
Faculty Member of VaYU (Vivekananda Yoga University, USA)
Associate Professor of Surgery (Retired), Eastern Virginia Medical School, USA
Fellow, American Association of Integrative Medicine, ACS
Life Member, National Ayurvedic Medical Association (NAMA)
Chairman of Board, Life in Yoga Institute (2011-2020)
In my j o u r n e y t o b r i ng Yoga
Therapy to promote health and healing of
ou r c o m m u nity, I m e t Dr. A n a n d a
Balayogi Bhavanani, the Director of
Institute of Salutogenesis (creation of
health SWASTHA) and Complementary
Medicine (ISCM) who acts and thinkslike
me, as my younger brother.
Both of us are promoting Yoga
Therapy as a primary, secondary and
I
tertiary pre vent ion o f the lifesty le related dis-eases throu gh
salutogenesis thus bridging traditional healing systems and modern
medical science.
It gives me great pleasure in writing the foreword for the book,
“Bridging Traditional Healing Systems and Modern Medical Science
through Salutogenesis”.
I congratulate the Management and Administration of Sri Balaji
Vidyapeeth, one of India's top healthcare universities for founding the
ISCM, an institute that amalgamates Yoga and music therapies into the
modern medical healthcare system. This is truly a one of a kind,
innovative institute in the world, a true example of 21 Century medicine.
The ISCM team of Sri Balaji Vidyapeeth (SBV) under the able
direction of Dr. Bhavanani has made a compilation of 76 abstracts
highlighting published research work done by themin the eld of Yoga
Therapy and Music Therapy from 2010 to 2022. This is commendable
output within a decade and I congratulate the whole team at the School
of Yoga Therapy and School of Music Therapy on their noble efforts.
All these 76 pioneering studiesprovide evidence for the
application of Yoga and Music Therapy in promoting Salutogenesis
(primary prevention) and as an adjuvant therapy for various medical
ailments (secondary and tertiary prevention). These have been done
with the highest of standards in line with the tenets of modern medical
science thus bridging the traditional systems of healing.
The term salutogenesis was coined by the Austrian sociologist
Prof. Aaron Antonovsky in 1979 and over the past two decades both Dr
Bhavanani and I, have been sharing extensively with modern medical
healthcare providers worldwide, methods to move from a pathogenic
orientation towards a salutogenic one through Yoga and Music Therapy.
As we both are trained as modern medical physicians, we are able
to build human bridges between the traditional concepts and bring them
into the consciousness of modern health care providers.
This is the main objective of this book that is a great addition to our
growing scientic literature on Yoga Therapy and Music Therapy.
I highly recommended this book to everyone who is interested in
integrative medicine. It will benet modern healthcare providers but at
the same time provides a great resource for medical professionals and
scientists interested in researching Yoga and Music Therapies.
Students of Yoga Therapy, Music Therapy, research scholars and
wellnessenthusiasts will nd themselves coming back to this text time
and time again for deeper study and practice.
Wishing team ISCM and SBV all the best, in their noble efforts to
bridge traditional and cultural wisdom with the modernity of medical
science.
II
Foreword
III
FOREWORD
Dr. Indra Selvarajah,
Medical Music Therapist,
Faculty of Human Ecology,
University Putra Malaysia.
Celebrating the Power of Music Therapy and Yoga Therapy
Music and yoga have long been recognized as powerful tools for
healing and transformation. Whether through the rhythms and
melodies of music or the physical and spiritual practices of yoga, these
modalities have the ability to access deep parts of ourselves and
facilitate healing on multiple levels. And when combined, the result is a
truly potent form of therapy.
As a music therapy clinician and educator with more than 15
years' experience in the eld, I have witnessedrst-hand the incredible
impact that music therapy practices can have on individuals facing a
wide range of challenges, from managing stress and anxiety to
overcoming trauma and addiction, evidence-based music therapy
hasbeen shown to be efcaciousat various levels of healing across
different settings. Through the exposure gained from my involvement
in ISCM, I have grown to greatly respect the all-encompassing holistic
benets of Yoga Therapy on all aspects of mindfulness and holistic
living.
Music therapy is a unique form of therapy that uses music as a
tool to facilitate change and promote healing. Through various
techniques such as playing instruments, singing, or listening to music,
individuals are able to express themselves and tap into their emotions in
a safe and supportive environment. The therapist then works with the
client to process and explore these emotions, using music as a bridge to
deeper levels of understanding and healing.
Similarly, yoga therapy is a holistic approach to healing that uses
the physical and spiritual practices of yoga to address a wide range of
physical, emotional, and mental health challenges. Through asana
(physical postures), pranayama (breathing techniques), meditation, and
other yogic practices, individuals are able to connect with their bodies
and minds in a deep and meaningful way, promoting overall wellness
and balance.
When music therapy and yoga therapy are combined, the result is
a powerful approach to healing that can address multiple levels of the
human experience radiating outwardly from the individual to the
community levels. Whether through using music to facilitate yoga
practice, or incorporating yoga practices into music therapy sessions, the
possibilities are endless.
In this book, we celebrate the power of music therapy and yoga
therapy to transform lives and promote healing. As you can see from the
sharing of evidence-based research, case studies, practical tips and
techniques, and personal stories,ISCM has achieved great strides in the
championing the salutogenic approach, breaking the glass ceiling to
explore the ways in which these modalities can be used together to create
a truly holistic preventative approach to wellness.
I invite you to explore the pages of this book with an open mind
and heart, and to embrace the transformative power of music therapy
and yoga therapy in your own life. I am condent that this wonderful
compilation will vividly demonstratehow Yoga Therapy working side
by side with Music Therapy will bring you deeper joy, healing, and
transformation.
Namaste.
IV
Foreword
CONTRIBUTORS OF THIS
COMPILATION OF ISCM ABSTRACTS
V
1. Abishek K, former Medical Student, MGMCRI, SBV
2. Ajmera S, Music Therapist
3. Amirtha Ganesh B, former Professor & Head, Dept. of
Cardiology, MGMCRI, SBV
4. Amudharaj D, Associate Professor, Dept. of Physiology, AIIMS,
Mangalagiri
5. Artchoudane S, Assistant Professor, CYS, AVMC & H
6. Arumugam P, former Principal, Sri Venkateshwara College of
Physiotherapy
7. Bakshi SS, Asso ciate Professor, Dept. of ENT, AIIMS,
Mangalagiri
8. Balachandran K, Associate Professor, Dept. of Endocrinology,
SRIHER
9. Balaji R, Assistant Professor, School of Yoga Therapy, ISCM, SBV
10. Balasundaram S, Professor & Head, Dept. of Psychiatry
MGMCRI, SBV
11. Bandihari Krishna, former Assistant Professor, Dept. of
Physiology, JIPMER
12. Bharathi P, former Professor & Head, Dept. of Physiology,
MGMCRI, SBV
13. Bhavanani AB, Professor & Director of ISCM, SBV
14. Bierski K, Institute of Social and Cultural Anthropology, Freie
Universität Berlin, Berlin, Germany
15. Chakravathy D, Professor & Head, Dept. of Conservative
Dentistry and Endodontics, IGIDS, SBV
VI
Contributors of Compilation of SYT & SMT Abstracts
16. Chandrashekar K, Physical Therapist, Ashraya Therapy Center,
Parrys
17. Das P, former Assistant Professor, Dept. of Pediatrics,
MGMCRI, SBV
18. Dayanidy G, Assistant Professor, School of Yoga Therapy,
ISCM, SBV
19. De Britto RLJ, Scientist 'F', ICMR,VCRC
20. Deivasigamani D, Assistant Professor, Dept. of Dermatology,
MGMCRI, SBV
21. Dhandapani G, Professor, Dept. of Pediatrics, JIPMER
22 Dhivya P, Assistant Professor, Dept. of General Medicine,
MGMCRI, SBV
23. Dinesh T, Assistant Professor, Dept. of Physiology, Government
Thiruvarur Medical College
24. Dixit P, Music Therapist
25. Dutta A, Assistant Professor, Dept. of General Medicine,
College of Medicine, JNM Hospital
26. Eswaran S, former Professor & Head, Dept. of Psychiatry,
MGMCRI, SBV
27. Eswari R, Senior Lecturer, Dept. of Pediatric & Preventive
Dentistry, IGIDS, SBV
28. Ezhumalai G, Senior Statistician and Research Consultant, SBV
29. Gaur G S, Professor, Dept. of Physiology, JIPMER
30. Ghose S, Professor, Dept. of OBGY & Dean, MGMCRI, SBV
31. Green SR, Associate Professor, Dept. of General Medicine,
MGMCRI, SBV
32. Gunasekaran D, Professor, Dept. of Pediatrics, JIPMER
33. Gupta K, former M. Phil Scholar, CYTER, SBV
34. Hanifah M, Professor & Head, Dept. of General Medicine,
MGMCRI, SBV
VII
35. Harichandra Kumar K T, Associate Professor, Dept. of Bio
Statistics, JIPMER
36. Harikrishnan E, Dept. of Pediatrics, Government Villupuram
Medical College.
37. Jagadevan M, Physical Therapist, JIPMER
38. Jaiganesh K, Professor, Dept. of Physiology, MGMCRI, &
Deputy Registrar, Regulatory Programmes, SBV
39. Jatiya L, Professor & Head, Dept. of Physiology, AVMC & H
40. Jayanthi Rajendran, Professor & Head, Dept. of Biochemistry,
MGMCRI, SBV
41. Jayapreeta R, Post-Graduate & Junior Resident, Dept. of
General Surgery, SVMCH & RC
42. Jayasettiaseelon E, former Senior Research Fellow, ACYTER,
JIPMER
43. Kannan V, Professor, Dept. of Surgery, MGMCRI, SBV
44. Karri Rama Reddy, Emeritus Professor of Psychiatry, Director-
Mansa Hospital, Rajamahendravanam
45. Karuppiah P, Assistant Professor, Dept. of Pediatrics,
MGMCRI, SBV
46. Kumar S, Assistant Professor, Dept. of Pyschiatry,
MGMCRI, SBV
47. Madanmohan T, Emeritus Professor of Physiology, Director,
CYS, AVMC & H, Honorary Advisor, ISCM, SBV
48. Madhavan C, Vice-Principal, Medical Education Chairman,
Meenakshi Medical College, MAHER
49. Mahendiran P, Assistant Professor, Dept. of Physical Education
and Sports Sciences, Annamalai University
50. Majewski L, Founding Director of Yoga for health Institute,
Toronto, Canada
51. Mangalagowri M, Research Scholar, Dept. of Biochemistry,
MGMCRI, SBV
Contributors of Compilation of SYT & SMT Abstracts
VIII
52. Mathew D, Dept. of Medicine, Aria Health System, USA
53. Mohana Krishnan B, Physical Therapist, JIPMER
54. Mopidevi VG, Professor & Head, Dept. of Psychiatry, G.S.L.
Medical College, Rajamahendravaram
55. Palanisamy S, Music Therapist
56. Parmar PN, Adjunct Faculty, School of Music Therapy, ISCM, SBV
57. Parthasarathy S, Professor, Dept. of Anaesthesia, MGMCRI,
SBV
58. Partheeban Muruganandam, Associate Professor, Dept. of
Psychiatry, MGMCRI, SBV
59. Perumal V, Additional Professor of Statistics & Demography,
Dept. of OBGY, AIIMS
60. P r abh u S M , A sso c ia t e P r of e ss o r , D ep t . o f M e di c a l
Gastroenterology, SRIHER
61. Pragasam S, Assistant Professor, Dept. of Dermatology,
MGMCRI, SBV
62. Prathima G S, Professor & Head, Dept. of Pediatric & Preventive
Dentistry, IGIDS, SBV
63. Punita P, Associate Professor, Dept. of Physiology, Meenakshi
Medical College and Research Institute
64. Pushpa D, former Yoga Instructer, CYTER, SBV
65. Raghul S, former Medical Student, MGMCRI, SBV
66. Raj JB, Professor & Head, Dept. of Physiology, MGMCRI, SBV
67. Radhakrishnan H, Professor, Dept. of Nephrology, MGMCRI,
SBV
68. Rajajeyakumar M, Assistant Professor, Dept. of Physiology,
SIMATS
69. Rajaramalingan V, Associate Professor, Dept. of Pediatrics,
MGMCRI, SBV
70. Rajasekaran A, Medical Director at Magil IVF Center, Anandraj
Speciality Hospital, ACE Fertility Solutions
Contributors of Compilation of SYT & SMT Abstracts
IX
71. Rajkumar M, Clinical Psychologist, Dept. of Psychiatry,
MGMCRI, SBV
72. Ramanathan M, Professor & Vice-Principal, School of Yoga
Therapy, ISCM, SBV
73. Ramesh B, Assistant Professor, School of Music Therapy, ISCM,
SBV
74. Ranganadin P, Professor & Head, Dept. of Respiratory
Medicine, MGMCRI, SBV
75. Reddy JRC, Dept. of Oral Medicine and Radiology, IGIDS, SBV
76. Ravikumar S, former MD Student, Dept. of Pediatrics,
MGMCRI, SBV
77. Renuka K. A, former Principal, KGNC, SBV
78. Sahai A, former Professor, Dept. of Bio-Chemistry, MGMCRI,
SBV
79. Samal S, Music Therapist
80. Sanguida. A, Professor, Dept. of Pediatric and Preventive
Dentistry, IGIDS, SBV
81. Sarkar S, Professor, Dept. of Psychiatry, AIIMS Kalyani.
82. Sekizhar V, Professor, Dept. of Oral Medicine & Radiology
IGIDS, SBV
83. Subramanian SK, Associate Professor, Dept. of Physiology,
AIIMS, Mangalgiri
84. Sharma V K , P r o f e s s o r , D e p t . of P h y s i ology, AIIMS,
Managalgiri
85. Shristhudhi D, Physical Therapist, Government Hospital,
Omandurar
86. Sobana R, Professor of Physiology & Admin in Charge, School
of Music Therapy, ISCM, SBV
87. Sreedevi A, former Professor & Head, Dept. of Dermatology,
MGMCRI, SBV
88. Srikanth S, Professor & Head, Dept. of Dermatology, MGMCRI,
SBV
Contributors of Compilation of SYT & SMT Abstracts
89. Srinivasan AR, Professor of Biochemistry, MGMCRI, &
Registrar, SBV
90. Subbiah B, Professor, Dept. of Physical Education, National
Institute of Technology
91. Subramaniam E, former Professor & Head, Dept. of Psychiatry,
MGMCRI, SBV
92. Sundar S, Founder & Director, Chennai School of Music
Therapy
93. Swaminathan RP, Emeritus Professor, Dept. of Medicine, PIMS
94. Swaminathan P, Professor, Dept. of Statistics, Saveetha Medical
Collage and Hospital
95. Thirusangu S, Assistant Professor, Dept. of Psychiatric Nursing,
Rama Nursing College
96. Thiruvalluvan A, former MDS Student, IGIDS, SBV
97. Udupa K, Professor, Dept. of Neurophysiology, NIMHANS
98. Vadlamudi H, former MD Student, Dept. of Pediatrics,
MGMCRI, SBV
99. Varathan K, Music Therapist
100. Varghese J K, Music Therapist & Psychologist
101. Vasanthan S, Assistant Professor, Dept. of Physiology,
MGMCRI, SBV
102. Vasundhara VR, Research Scholar, SYT, ISCM, SBV
103. Velkumary, Professor & Head, Dept. of Physiology, JIPMER
104. Venkatesh S, Associate Professor, Dept. of Pediatr ics,
MGMCRI, SBV
105. Vijaya Gopal, Professor, Dept. of Psychiatry, G.S.L. Medical
College, Rajamahendravaram.
106. Vijayalakshmi G, Research Scholar, Technical Ofcer 'C'
(Nursing), ICMR, VCRC.
X
Contributors of Compilation of SYT & SMT Abstracts
INTRODUCTION
Chapter 1
01
1.1. Prelude
Institute of Salutogenesis and Complementary Medicine (ISCM)
is the innovative brain child of Sri Balaji Vidyapeeth (SBV- A Deemed-
to-be-University in Pondicherry) that crosses boundaries of a regular
healthcare university that introduced Yoga and Music Therapy in 2010
as a Centers of Yoga Therapy Education and Research (CYTER) and
Music Therapy Education & Research (CMTER). Way before the concept
termed “Salutogenesis” was incorporated into the realms of SBV; the
practice of the underlying theory of transforming the focus from
pathogenesis to salutogenesis through various activities in realms of
patient care, health professionals' education and research has been
entrusted to these centers. In the years that followed, ample
infrastructure and facilities were provided, and eminent faculty
members were recruited to full the vision & mission of SBV.
It must be highlighted that SBV in the year 2018 brought forward
an administrative policy statement and SBV Policy on Salutogenesis
implementation and SBV Standard Operating Procedure for
Salutogenesis that has also been copyrighted. Such a policy by the
university reiterates its commitment towards the creation of a health
promoting environment that is supportive of wellness. In technical
terms, as suggested by Mittelmark et al (2022), this can be understood as
a salutatory extra-person factor that promotes positive health.
The equivalent concept to Salutogenesis in Indian tradition is
'Swastha' that implies a sense of being at ease with oneself. Acharya
Sushruta (~600 BC) dened this positive sense of wholesome wellness
as a 'dynamic balance of the elements and humors, normal metabolic
activity and efcient elimination coupled with a tranquil mind, senses
and contented soul.' Yoga may be understood as one of the best means to
02
achieve such a dynamic state of wholesome health and wellness at all
levels of existence. The application of Yoga and Music towards this has
been in regular practice in Indian tradition.
Healing in a holistic sense has faded from medical attention in
recent times and is rarely discussed in modern medicine especially in
therapeutics. To heal is to achieve or acquire wholeness as a person. The
whole some ness of personhood involves physical, emotional,
intellectual, social, and spiritual aspects of human experience.
1.2. Yoga Therapy in SBV
Modern medical advancements provide the rationale for
integration of various traditional healing techniques like Yoga,
Naturopathy, Ayurveda, Siddha and Music to promote health, healing
and longevity. “Government of India is currently promoting indigenous
systems of health in an active manner through Ministry of AYUSH. The
limitation of modern medicine in managing stress induced psychosomatic,
chronic illnesses is the strength of these traditional healing systems and hence a
holistic integration of both systems enables best quality of patient care”. In that
context, this may be the rst time around the globe that Yoga Therapy is
incorporated as a regular training practice for healthcare students of
medicine, dentistry and nursing colleges.
This pioneering innovation of integrating Yoga in medical
curriculum was initiated through 'Yogabhyasa'- a program especially
organised and conducted for the benet of medical students at SBV.
Since the integration has followed through with all students of Medical,
Dental, Nursing, Allied Health Sciences and recently with students of
pharmacy at SBV, who are provided with regular Yoga sessions, aimed
at the holistic wellbeing of students in general. Salutogenesis, the term
originally coined by the Austrian Sociologist Aaron Antonovsky,
describes the focus on well-being and health instead of disease. This
initiative would go a long way in stress management among students
besides enhancing the well-being of the mind and body and improving
the learning skills among the student community.
Introduction
03
Yoga Therapy at SBV has taken up the opportunity to introduce
Yoga in health care to foster a sense of wellness. It has also facilitated the
incorporation of Yoga Therapy education in Nursing Curriculum,
integrated Yoga in Health Professions Education and created Standard
Operating Procedure for Application of Yoga in Primary Health Care
Voyaging of Yoga Basics to Grass Roots — VYBGR with Department of
Community Medicine. It has also contributed to SBV Policy on
Salutogenesis implementation and SBV Standard Operating Procedure
for salutogenesis.
Prof KR Sethuraman, the Former VC of SBV must be credited
with introducing the concept of salutogenesis during his tenure and this
has become the focus of our efforts towards Integrative Medicine. This
step towards integrating Yoga as a curriculum enhanced the practice
with related research not only on their physical health, but also included
transformed personalities as well as a good sense of wellness, ability to
express feelings of being capable, respected, contented, condent,
composed, happy and peaceful. Following research, these regular
practices have been converted into best practices and nally into
copyrights.
1.3. Music Therapy in SBV
A Small team of Medical Professionals came together with a spark
of innovation to start a Music medicine unit along the lines of Yoga
Therapy in 2010. The main focus of the team was to create a positive and
holistic environment with Music for patients and healthcare workers.
The need to create evidence was also strongly integrated with a few
studies on students and faculty.
The Music Medicine Unit further evolved into Center for Music
Therapy, Education and Research (CMTER), adding education &
training for future Medical Music therapists. CMTER focussed on
building a team of credentialed, degree certied Medical Music
Therapists, looking forward to creating a base for a unique curriculum
Introduction
04
connecting global Music Therapy concepts to traditional healing
systems in India. The school of Music Therapy now proudly hosts a Post
Graduate diploma in Music Therapy, M.Sc in Medical Music Therapy
and a PhD program for Music Therapy under SBV. The practice of
introducing Music Therapy and its therapeutic uses to the students of
SBV has become a best practice and copyrighted as MEETS, started with
the MBBS students in 2015 has been continuing till present times and has
moved on to all other students of Nursing, Dental and AHS students.
Similarly the needs to accommodate culturally different students into
practice has created the clinical communication book and training is
built around intercultural learning concepts within teaching and
practice, regular clinical practice has evolved into a program for
pregnant women called “GarbhSanskar” and nally a protocol of
references and procedural support has all been copyrighted.
This has propelled the increase in research papers and copyrights
that showcase the uniqueness of Music Therapy and SBV. Evidence
based practice and strong conviction towards ethical practice has paved
the way in 2022, and we now have the rst module for Music Therapy in
nursing and the allied health science curriculum.
Music Therapy is still building its path to become stronger in
terms of accreditation, acceptance into Professional vacancies and
regular education programs through the central education portal of
India. We are humbly indebted to SBV for having given us the platform
to bring out a curriculum that has been accepted only through the
channels of regular board of studies and rigorous and meticulous
Academic council meetings to have a model that coincides with the UGC
norms for Higher education in Music Therapy.
1.4. Amalgamation of Yoga and Music Therapy at SBV into ISCM
This well-equipped Yoga and Music Therapy centres have now
been upgraded into the School of Yoga Therapy and School of Music
Therapy respectively, under the purview of Institute of Salutogenesis
Introduction
05
& Complementary Medicine since August 2022. The support provided
by the visionaries and the management of SBV have opened up avenues
for faculty and student and increase in patient care in almost all areas
including ICU and the operation theatres, apart from the plethora of
other Medical departments of OG, Pediatrics, Psychiatry, Surgery,
Cardiology, Palliative care, Orthopedics, ENT, Ophthalmology,
Neurosurgery and Neurology, with the recent increase in interest
shown from the Dental, Nursing and Allied Health science institutes
within SBV.
The Fundamental concepts of salutogenesis such as Sense of
Coherence (SOC) and Generalised Resistance Resources (GRR) have
been inculcated in all students through various orientation programs
and other student centric activities. A 'Salutogenic' approach is one that
focuses on factors that support health and wellbeing, beyond a more
traditional, 'pathogenic' focus on risk and problems. In this effort we
have consistently acknowledged the contributions of Professor
Antonovsky.
GRR support wellness and are found in the cultural, social and
environmental conditions of the individual, in early parts of life, in
socialisation experiences, as well as other idiosyncratic factors and
chance. We at SBV have attempted to explore Yoga Therapy and Music
Therapy as part of the GRR development through the YOGABHYASA
and MEETS (Musically Express your Emotions Thoughts for Success)
programs for our student community.
Furthermore both Yoga Therapy and Music Therapy have been
utilised extensively in the clinical setting of our hospitals as a part of
Specic Resistance Resources (SRR). Numerous research projects and
publications have documented these innovative efforts to integrate
traditional systems of healing and wellness with modern medical
approaches in patient care. Best practices such as PURNAM: CYTER
Model of Salutogenic Communication of Wholesomeness in a
Clinical Setting Salutogenic Approach of Yoga for the Third and
Introduction
06
Gender: The CYTER MODEL that introduce a Salutogenic orientation
in clinical practice have also been copyrighted.
Antonovsky proposed that the feeling of wellness is primarily
governed by the 'sense of coherence that may be considered the heart of
salutogenesis. This may be understood as a pervasive, long-lasting, and
dynamic feeling of condence that one's internal and external
environments are predictable and that there is a high probability that
things will work out as well as can be expected.' It has strong positive
correlation to perceived health, mental health, and quality of life as it
helps the 'diseased' to manage their condition and 'be well'.
The three components of SOC are based on a sense that -
1. One's life is comprehensible,
2. It is manageable and
3. It is meaningful.
The sense of life being comprehensible is a cognitive process
where the individual has the sense that my world is understandable.
The coping skill in the second component enables the individual to feel,
my world is manageable while the motivational aspect of life having a
sense of meaning fulness manifests in the individual feeling, my world
has meaning.
The comprehension, meaning fulness and manageability (SOC
approach) in chronic diseases keeps them 'well' despite any limitations
and is similar to 'physically disabled' becoming 'differently abled'. When
an individual has these three aspects manifesting in their life, they have a
sense of health, wellness, wellbeing and wholesomeness.
1.5 Gratitude Turns Denial into Acceptance, Chaos into Order, and
Confusion into Clarity…
Our gratitude extends unconditionally to Prof K R Sethuraman,
previously the vice chancellor of SBV for having given complete
freedom and propelling us into integrating holistic treatment practices
as well as introducing Salutogenesis to SBV.
Introduction
07
ISCM, owes a great debt of gratitude to Prof N Ananthakrishnan,
Dean of Faculty at SBV who has lovingly mentored CYTER right from its
inception and continues to motivate and guide us “To boldly go where
no man has gone before” reminding us the popular phrase from the Star
Trek science ction television series.
It is only because of the unconditional support of the management
and administrators of our deemed-to-be university, that we have been
able to tackle each and every challenge that has come up over the past
decade and a half.
We have done our best to make all activities lively and interactive
and the positive feedback from all stakeholders has been tremendous.
“May we be worthy of the blessings of such great humane
beings who strive for excellence in the humanistic aspects of modern
medicine”.
Introduction
Chapter 2
ROLE OF YOGA AND MUSIC THERAPY
IN PROMOTING SALUTOGENESIS
The terms general health and wellbeing have become a very
important topic, necessary nevertheless, for overall physical, mental,
social and spiritual dimensions. According to WHO “Healthy Living
requires a balance of responsible and smart health choices; eating right, daily
physical activity, promoting emotional and spiritual wellness, ensuring
adequate sleep, avoiding harmful drugs, alcohol, tobacco, illness, stress, &
safeguarding a good work-life balance”
Sri Balaji Vidyapeeth offers a salutogenic framework that leads to
th i s h e a lthy environme n t w i t h r e spect to students, f a culty,
administration and patient care. The inclusion of Yoga and Music
Therapy within a healthcare institution is one of a kind in India and
perhaps around the globe. This integration of holistic practices works
towards the creation of evidence through education, practice and
Research with healthy people through the concepts of learning coping
strategies for overall health and wellbeing. This chapter will showcase
Yoga and Music Therapy studies within that scope of view.
2.1. EVIDENCE BASED PRACTICE OF YOGA THERAPY
Immediate Effects of Suryanamaskar on Reaction Time and Heart
1
Rate in Female Volunteers.
Suryanamaskar (SN), a yogic technique is composed of dynamic
muscular movements synchronised with deep rhythmic breathing. As it
may have inuence on CNS, this study planned to investigate
immediate effects of SN on reaction time (RT) and heart rate (HR). 21
female volunteers attending Yoga classes were recruited for study group
and 19 female volunteers not participating in Yoga were recruited as
external-controls. HR, auditory reaction time (ART) and visual reaction
time (VRT) were recorded before and after three rounds of SN in study
group as well as 5 minutes of quiet sitting in both groups. Performance of
08
SN produced immediate decrease in both VRT and ART (P<0.001). This
was signicant when compared to self-control period (P<0.001) and
compared to external-control group, it decreased signicantly in ART
(p=0.02). This was pronounced when Δ% was compared between
groups (P<0.001). HR increased signicantly following SN compared
with both self-control (p=0.025) and external-control group (p=0.032).
Faster reactivity may be due to intermediate level of arousal by
conscious synchronisation of dynamic movements with breathing. Rise
in HR is attributed to sympathetic arousal and muscular exertion. We
suggest that SN may be used as an effective training means to improve
neuro-muscular abilities.
Effect of 12 Weeks of Kapalabhati Pranayama Training on Cardio-
Respiratory Parameters in Young Healthy Volunteers of JIPMER
2
Population.
In the recent decades, interest has been increasing all over the
world in the applications of yogic techniques in the eld of therapeutics
and research. Pranayama are breathing techniques that exert profound
physiological effects on pulmonary, cardiovascular and mental
functions. To study the effect of 12 weeks of Kapalabhati pranayama
training on cardio respiratory parameters in healthy, young subjects.
Differential Effects of Uninostril and Alternate Nostril Pranayamas
3
on Cardiovascular Parameters and Reaction Time.
Recent studies have reported the differential physiological and
psychological effects of yogic uninostril breathing (UNB) and alternate
nostril breathing (ANB) techniques. This study aims to determine
differential effects of these techniques on reaction time (RT), heart rate
(HR), and blood pressure (BP). Twenty Yoga-trained subjects came to
the lab on six different days and RT, HR, and BP were recorded
randomly before and after nine rounds of right UNB (suryanadi [SN]),
left UNB (chandranadi [CN]), right initiated ANB (suryabhedana [SB]),
left initiated ANB (chandrabhedana [CB]), nadishuddhi (NS), and
normal breathing (NB). Overall comparison of ∆ % changes showed
statistically signicant differences between groups for all parameters.
There was an overall reduction in HR- and BP-based parameters
09
Role of Yoga and Music Therapy in Promoting Salutogenesis
following CB, CN, and NS with concurrent increases following SB and
SN. The differential effects of right nostril initiated (SB and SN) and left
nostril initiated (CB, CN, and NS) UNB and ANB techniques were
clearly evidenced. Changes following NB were insignicant in all
respects. The overall comparison of ∆ % changes for RT showed
statistically signicant differences between groups t hat were
signicantly lowered following both SB and SN. Our study provides
evidence of sympathomimetic effects of right nostril initiated
pranayamas with sympatholytic/parasy mpathomimetic effect
following left nostril initiated pranayamas. We suggest that the main
effect of UNB and ANB techniques is determined by the nostril used for
inspiration rather than that used for expiration. We conclude that right
and left yogic UNB and ANB techniques have differential physiological
effects that are in tune with the traditional swara Yoga concept that air
ow through right nostril (SN and pingalaswara) is activatory in nature,
where as the ow through left nostril (CN and idaswara) is relaxatory.
Immediate Effect of Alternate Nostril Breathing on Cardiovascular
4
Parameters and Reaction Time.
This study evaluated immediate effects of 27 rounds of left nostril
initiated alternate nostril breathing (ANB) technique of nadishuddi (NS)
and right nostril initiated ANB of aloma viloma (AV) pranayama on
cardiovascular (CV) parameters and reaction time (RT) in a trained
population. 16 subjects attending regular Yoga sessions were recruited
and each subject performed 27 rounds of either technique, selected
randomly on different days. Heart rate (HR), systolic pressure (SP),
diastolic pressure (DP), auditory and visual reaction time (ART and
VRT) were recorded before and after pranayamas. NS was done by
breathing in through left nostril and out through right followed by
breathing in through right and out through left. AV was done by
breathing in through right nostril and out through left followed by
breathing in through left and out through right. All data passed
normality testing and statistical analysis was carried out using Student's
paired t test. HR, SP and DP reduced signicantly (p < 0.05 to 0.001) after
NS while they increased after AV. Post intervention differences as well
as ∆% between groups was signicant (p < 0.05 to 0.001) for HR, SP and
10
Role of Yoga and Music Therapy in Promoting Salutogenesis
DP. ART and VRT were signicantly (p < 0.05 to 0.001) shortened after
AV and signicantly prolonged after NS. Post intervention differences
as well as ∆% between groups was very signicant (p < 0.001) for both
ART and VRT. Signicant reductions of HR, SP and DP after NS and
their increase after AV may be attributed to modulation of autonomic
tone. Right nostril initiated ANB technique produces autonomic
arousal, whereas left nostril initiated ANB technique induces
relaxation/balance. These can be selectively applied in various
therapeutic settings. Further studies in various clinical conditions and
settings can enable us to understand their therapeutic applications
better.
Immediate Effect of Different Pranayam on Short Term Heart Rate
5
Variability in Health Care Students - A Preliminary Study.
Yoga produces consistent physiological changes and have sound
scientic basis. Heart rate variability (HRV) has come to be widely used
as a non-invasive tool to assess autonomic function in physiological as
well as disease states. In view of this, the present study was aimed to
study the effect of suryanadi (SNP) and chandra nadi pranayams (CNP)
on HRV in healthy young volunteers. 11 male volunteers aged between
20-30yrs were assigned to a sequence randomly. Each volunteer was
taught both SNP and CNP by trained Yoga teacher and made to practice
under direct supervision between 4-6.30 pm in ACYTER lab, JIPMER.
HRV was recorded by using BIOHARNESS Acknowledge 4.1 version
and analyzed by Kubios HRV 2.00 software. Basal resting parameters
and HRV were recorded for 5 minutes after that SNP was performed in
six cycles per minute for 5 minutes followed by 5 min rest. Three such
sessions (before, during and after) HRV were recorded. The same
procedure and recording ware followed for CNP. The time domain
analysis of SNP revealed an increased heart rate with a decreased
RMSSD, however the SDNN was increased. Frequency domain
analysis, increased LF power and decreased HF power and LF/HF ratio
increased after the intervention. In CNP, the time domain analysis,
showed decreased heart rate and an increased PNN50. The frequency
domain analysis revealed an increased HF power with decreased
11
Role of Yoga and Music Therapy in Promoting Salutogenesis
LF/HF ratio. SNP increase the sympathetic activity and CNP increases
the parasympathetic activity and these can be appropriately advocated
in many chronic cardiovascular diseases where the autonomic
imbalance is one of the primary derangements.
Comparative Immediate Effect of Different Yoga Asanas on Heart
6
Rate and Blood Pressure in Healthy Young Volunteers.
This study planned to compare immediate cardiovascular effects
of different Yoga asanas in healthy young volunteers. Heart rate (HR),
systolic pressure (SP), and diastolic pressure (DP), blood pressure (BP),
were recorded using the noninvasive blood pressure (NIBP) apparatus
in 22 healthy young subjects, before and after the performance of
Dhanurasana (DA), Vakrasana (VA) (both sides), Janusirasasana (JSA)
(both sides), Matsyasana and Shavasana for 130 secs. HR and BP were
further recorded during supine recovery at 2, 4, 6, 8, and 10 min. A
repeated measure of ANOVA was used for statistical analysis. There
were signicant changes in HR and BP both immediately after the
Asanas as well as during the recovery period. Overall comparisons of
∆% changes immediately after the performance of the Asanas revealed
signicant differences with regard to HR that increased signicantly
after DA. In the recovery phase, there were signicant intergroup
differences from 2 min onward in both SP and DP. The decrease of SP
after VA(right side) (VA-R) was signicantly greater than Shavasana
(4th, 6th, and 8th min) and JSA(left side) (JSA-L) at 6th and 8th min. DP
decreased signicantly after performing JSA-L compared to VA-R at the
6th and 8th min. The cardiovascular changes immediately after the
Asanas and during the recovery phase reveal inherent differences
between the selected postures. The rise of HR in DA may be attributed to
increased sympathetic response due to the relative difculty of the
posture as well as abdominal compression occurring in it. The effect of
supine relaxation is more pronounced after the performance of the
Asanas as compared to mere relaxation in Shavasana. This may be
attributed to a normalization and resultant homeostatic effect occurring
due to a greater, healthier de-activation of the autonomic nervous
system occurring towing to the presence of prior activation. There were
12
Role of Yoga and Music Therapy in Promoting Salutogenesis
also subtle differences between the right sided and left sided
performance of VA and JSA that may be occurring due to the different
internal structures being either compressed or relaxed on either side.
Our study provides initial evidence of differential cardiovascular effects
of Asanas and subtle differences between right and left sided
performance. Further, cardiovascular recovery is greater after the
performance of the Asanas as compared to shavasan; thus, implying a
better response when effort precedes relaxation.
7
Effect of Different Pranayamas on Respiratory Sinus Arrhythma.
Respiratory Sinus Arrhythmia (RSA) is the differential change of
Heart Rate (HR) in response to inspiration and expiration. This is a non-
invasive sensitive index of parasympathetic cardiac control. To evaluate
changes in RSA by utilizing a simple and cost-effective analysis of
electrocardiographic (ECG) tracings obtained during performance of
four pranayama techniques. Fifty-two trained volunteers performed the
following pranayamas with different ratios for inspiration and
expiration: sukha (1:1), traditional (1:2), pranava (1:3) and savitri
(2:1:2:1) and ECG was recorded while performing the techniques with
rest period of 5 minutes in-between. HR was calculated and maximum
HR during inspiration (Imax), minimum HR during expiration (Emin),
differences between Imax and Emin (∆), percentage differences between
Imax and Emin (∆%) practice by normalizing autonomic cardiovascular
rhythms as a result of increased vagal modulation and/or decreased
sympathetic activity and improved baroreex sensitivity. Respiratory
si nus arrhy t hmia (RSA ) i s a noninva sive sensi tive index of
parasympathetic cardiac control. It is based on variation of HR with
respiration wherein inspiration increases HR while expiration decreases
it. Factors modulating RSA are known to be the and expiration:
inspiration ratio (E: I) calculated by respective formulae. Statistical
analysis was carried out using repeated measures of ANOVA with
Tukey-Kramer multiple comparisons test. There were signicant
differences between groups in all ve aspects namely: p= 0.0093 for
mean Imax, p = 0.0009 for mean E min, and p < 0.0001 for ∆ HR (I-E), ∆%
HR (I-E) and E: I ratio. Pranava pranayama produced the greatest
13
Role of Yoga and Music Therapy in Promoting Salutogenesis
changes in all ve comparisons. We suggest that further short- and long-
term studies be undertaken with pranava pranayama in patients to
further qualitatively and quantitatively evaluate inherent mechanisms
of this simple technique. Addition of these cost-effective techniques to
the medical armory will help patients of rhythm disorders and other
cardiovascular conditions.
Comparative Study on the Effect of Yogic Relaxing Asanas and
Pranayamas On Cardiovascular Response in Healthy Young
8
Volunteers.
Cardiovascular morbidity is increasing recently in India. Stress
and autonomic dysfunction are associated with cardiovascular
morbidity. Yoga is the best lifestyle ever designed. Based on limited
scientic research, Yoga, meditation, asanas, and pranayamas including
relaxation) therapy is known to improve cardiovascular autonomic
functions. To study and compare the effect of 6 months of training in
relaxing asanas and pranayamas on blood pressure (BP), pulse pressure
(PP), heart rate (HR), and rate-pressure product (RPP) in young healthy
volunteers. A total of 109 healthy volunteers aged 20-25 years were
divided into 3 groups consisting of asan (n = 38), pranayam (n = 38), and
control group (n = 33). The Yoga training was given 25 min/day for 6
days/week for 6 months. Pranayam group received relaxing pranayam
(pranav, savitri, nadishuddhi and chandranadi), asana group received
relaxing asana (pawanmuktasana, balasan, dharmikasana, and
shavasan) and waiting list were kept as a control group. The results
were statistically compared between groups by analysis of variance and
intra-group pre-post comparisons by paired t-test. Results: Post training
analysis showed signicant decreases in systolic BP and diastolic BP as
well as PP, mean arterial pressure and RPP in both asana and pranayam
group as compared with control. There was, however, no signicant
difference between asan and pranayam group. Practising either relaxing
asana or pranayam enhances parasympathetic activity and decreases
sympathetic activity.
14
Role of Yoga and Music Therapy in Promoting Salutogenesis
Effect of Yogic Relaxing Asans And Pranayams on Heart Rate
Variability and Perceived Stress in Healthy Young Volunteers - A
9
Comparative Study.
The present study offers evidence of the cardiovascular
relaxation and harmonisation of the cardiac autonomic tone through
aspects of Yoga such as asan and pranayam. A total of 109 healthy
volunteers aged 20-25 years were randomly divided into asan,
pranayam and wait-listed group. Yoga training was given 25 min/day
for 6 days/week for 6 months, in which Pranayam group received
relaxing pranayam, asan group received relaxing asans and third group
was wait list control group. Pre and post HRV results of each group were
statistically compared by paired 't' test and between the group was
compared by One-way ANOVA. Pre-post analysis revealed that High
frequency (HF) signicantly increased (p<0.05) and Low frequency
component (LF), LF/HF ratio, PSS signicantly decreased (p<0.05) in
asan and pranayam group but no signicant difference was found in
control group (p>0.05). Inter group comparison analysis by ANOVA
revealed that LF, LF/HF ratio, PSS signicantly decreased and HF
signicantly increased in asan and pranayam group as compared to
controls. There was no signicant difference between asan and
pranayam groups.
Effects of Overnight Sleep Deprivation on Autonomic Function and
Perceived Stress in Young Health Professionals and their Reversal
10
Through Yogic Relaxation (Shavasana).
Extensive research has been done to demystify the effects of sleep
deprivation on cognitive functions, memory, and reasoning ability.
However, there is a lacuna in regard to the effects on autonomic function
and perceived stress as well as its modulation through yogic relaxation.
Healthcare professionals often work at night, and the effect of acute
overnight sleep deprivation on their performance is crucial. The present
study was undertaken to study the effects of overnight sleep
deprivation on autonomic function and perceived stress in health-care
professionals and to determine its modulation through yogic relaxation
(Shavasana). A total of 35 healthcare professionals, aged between 20 and
15
Role of Yoga and Music Therapy in Promoting Salutogenesis
25 years, were recruited from emergency services wing (casualty) of
MGMC and RI, Puducherry, and taught yogic relaxation. Heart rate
(HR), blood pressure (BP), and HR variability (HRV) were recorded and
Cohen's perceived stress scale (PSS) administered before the
commencement of day duty. Parameters were again recorded after
overnight sleep deprivation due to night shift work and then after they
practiced yogic relaxation (Shavasana). As data passed normality
testing, Student's paired t-test was used to compare the changes after
sleep deprivation and then after yogic relaxation. Overnight sleep
deprivation resulted in statistically signicant (P < 0.05) increases in
systolic BP (SBP), low frequency (LF), LF/high frequency (HF), diastolic
BP (DBP), PSS, and mean HR. This was coupled with signicant
decreases in mean RR, SDNN, pNN50, HF, and RMSSD. Following
yogic relaxation, these changes were reversed, and signicant decreases
were witnessed in LF, LF/HF, SBP, mean HR, DBP, and PSS with
signicant increases in mean RR, pNN50, HF, RMSSD, and SDNN. The
ndings of our study reiterate the negative effects of sleep deprivation
on cardiac autonomic status. Such deleterious effects may be partially
reversed by practicing yogic relaxation (Shavasana). Such conscious
relaxation may be able to help correct imbalance of autonomic nervous
system by enhancing parasympathetic tone and reducing sympathetic
overactivity.
Hematological, Biochemical and Psychological Effects of a Yoga
11
Training Programme in Nursing Students.
We were granted the opportunity to impart a 6-month
comprehensive course of Yoga training for nursing students. The aim of
this study was to analyse the effects of the training on the participants
health and quality of life (QoL) 60 healthy nursing students (12 M, 48 F)
aged 18.60 ± 0.67 (SD) were recruited, and 60 min of Yoga training was
given twic e weekly, for 6 months. Selected biochemical and
hematological parameters were recorded along with Ferrans and
Powers QoL index before and after the training period. QoL was also
tested at midterm. Because we were not able to establish a separate
control group, we correlated changes with the subjects frequency of
16
Role of Yoga and Music Therapy in Promoting Salutogenesis
attendance. Post-intervention statistical analysis (repeated measures of
ANOVA) revealed highly signicant and benecial changes in most
hematological and biochemical parameters. Major ndings are
enhanced bone marr ow function, reduced allergic tend ency ,
alkalization of urine, metabolic reconditioning (with special emphasis
on liver function) and improvement in all QoL indices. These changes
correlated positively with the subjects frequency of attendance, as
evidenced by Pearson's linear correlationtesting. There were also
signicant improvements in QoL index and its subscales, both at mid
training and post training. These improvements also correlated
positively with attendance. The present study provides evidence of the
benecial psychological and physical effects of Yoga training amongst
graduate nursing course students. We suggest that Yoga be made an
integral part of medical and paramedical collegiate education.
Effect of Fast and Slow Pranayama Practice on Cognitive Functions in
12
Healthy Volunteers.
To compare the cumulative effect of commonly practised slow
and fast pranayama on cognitive functions in healthy volunteers. 84
participants who were in self-reported good health, who were in the age
group of 18-25 years, who were randomized to fast pranayama, slow
pranayama and control group with 28 participants in each group. Fast
pranayama included kapalabhati, bhastrika and kukkuriya. Slow
pranayama included nadishodhana, Pranava and Savitri. Respective
pranayama training was given for 35 minutes, three times per week, for
a duration of 12 weeks under the supervision of a certied Yoga trainer.
Parameters were recorded before and after 12 weeks of intervention:
Perceived stress scale (PSS), BMI, waist to hip ratio and cognitive
parameters-letter cancellation test, trail making tests A and B, forward
and reverse digit spans and auditory and visual reaction times for red
light and green light. Inter-group comparison was done by one-way
ANOVA and intra-group comparison was done by paired t-test.
Executive functions, PSS and reaction time improved signicantly in
both fast and slow pranayama groups, except reverse digit span, which
17
Role of Yoga and Music Therapy in Promoting Salutogenesis
showed an improvement only in fast pranayama group. In addition,
percentage reduction in reaction time was signicantly more in the fast
pranayama group as compared to that in slow pranayama group. Both
types of pranayamas are benecial for cognitive functions, but fast
pranayama has additional effects on executive function of manipulation
in auditory working memory, central neural processing and sensory-
motor performance.
13
Yoga Improves Psychophysical Health of Nursing Students.
60 healthy nursing students were recruited, and 60 min Yoga
training was given twice weekly, for 6 months. Selected biochemical and
hematological parameters were recorded along with Ferrans and
Powers QoL index before and after the training period. Because we were
not able to establish a separate control group, we correlated changes
with the subjects´ frequency of attendance. Post-intervention statistical
analysis (repeated measures of ANOVA) revealed highly signicant
and benecial changes in most hematological and biochemical
parameters. Major ndings are enhanced bone marrow function,
re d u c e d allergic t e ndency, a l kalization of u r i n e , metabolic
reconditioning (with special emphasis on liver function) and
improvement in all QoL indices. These changes correlated positively
with the subjects´ frequency of attendance, as evidenced by Pearson's
linear correlation testing. There were also signicant improvements in
QoL index and its subscales, both at mid training and post training.
These improvements also correlated positively with attendance. The
present study provides evidence of the benecial psychophysical effects
of Yoga training amongst nursing students. We suggest that Yoga be
made an integral part of medical and paramedical collegiate education.
Effect of Slow and Fast Pranayama Training on Handgrip Strength
14
and Endurance in Healthy Volunteers.
Background: Pranayama has been assigned very important role
in yogic system of exercises and is said to be much more important than
Yogasanas for keeping sound health. Also, different pranayamas
produce divergent physiological effects. Aim: To study the effect of 12
18
Role of Yoga and Music Therapy in Promoting Salutogenesis
weeks training of slow and fast pranayama on handgrip strength and
endurance in young, healthy volunteers of JIPMER population. Settings
and Design: Present study was conducted in the Department of
Physiology, JIPMER in 2011-12 (1.06.11 to 1.04.12). Materials and
Methods: Total of 91 volunteer subjects were randomised into slow
pranayama (SPG) (n=29), fast pranayama (FPG) (n=32) and control
groups ( CG) (n=3 0). Super vised pranay ama training (SPG -
Nadisodhana, Pranav pranayama and Savitri pranayama; FPG -
Kapalabhati, Bhastrika and Kukkuriya pranayama) was given for 30
minutes thrice a week for 12 weeks to both slow and fast pranayama
groups by certied Yoga trainer. Hand grip strength (HGS) and
endur ance (HGE) para mete rs were recorded usin g handgrip
dynamometer (Rolex, India) at baseline and after 12 weeks of
pranayama training. Statistical Analysis Used: Longitudinal changes in
each group were compared by using Student's paired t-test. Delta
changes in each group were analysed by ANOVA with Tukey post-hoc
analysis. Results: In SPG signicant improvement occurred only in HGE
parameter from 83.95±45.06 to 101.62±53.87 (seconds) (p0.05).
Conclusion: Pranayama training decreases sympathetic activity,
resulting in mental relaxation and decreased autonomic arousal
thereby, decreasing force uctuations during isometric contraction.
This is reected as improvement in HGS and HGE.
A Comparative Study of the Differential Effects of Short-Term Asana
15
and Pranayama Training on Reaction Time.
Numerous studies have reported long and short-term effects of
Yoga training on reaction time (RT), but few have evaluated differential
effects of training in asana and pranayama. Hence the present study was
done to elucidate effects of such differential training on RT in health
professions students attending Yoga training. 134 healthy young adults
studying BSc Nursing at KGNC were recruited for the study and
informed consent obtained from them. 89 from 1st year were randomly
divided into two groups and 44 of them received one week of training in
asana while 45 received parallel training in pranayama. 45 control
19
Role of Yoga and Music Therapy in Promoting Salutogenesis
subjects were recruited from 2nd year that didn't receive Yoga training
but were coming to CYTER for clinical posting. Auditory and visual RT
(ART and VRT) were measured before and after the one-week study
period and appropriate statistical methods applied for intra and inter
group comparisons. Both asana and pranayama training resulted in
signicant (p<0.001) shortening of ART and VRT, while ART was
signicantly (p<0.05) prolonged in controls with no signicant change
in VRT. Intergroup comparisons revealed that these changes were more
pronounced following pranayama training especially with regard to
VRT. The present study provides evidence that even a short term, one
week training in asana and pranayama can shorten RT in novices and
that this is more pronounced in case of pranayama training. These
changes may be attributed to enhanced central processing ability
resulting from better sense of perception, sensitivity, alertness and
awareness occurring as a result of Yoga practice. As pranayama practice
tends to be more introspectional (with eyes closed), this may have more
pronounced effects than asana where awareness is more externalized in
novices. It is also plausible that the conscious alterations of respiratory
patterns may inuence ascending pathways resulting in more
pronounced changes after pranayama. It is suggested that Yoga training
of even a short duration can enhance central processing ability and that
such training especially in pranayama may be utilized to enhance
learning capabilities in students of health professions education.
Enhancing Awareness of Yoga in Health Professions Education
Students Through a Single Interactive Session: A Pre-Test-Post-Test
16
Study.
All students enrolled in Health Professions Education (HPE) at
Sri Balaji Vidyapeeth, Pondicherry, receive introductory Yoga sessions
during orientation programs conducted by their respective medical,
dental and nursing colleges at the beginning of their rst year of
training. We conducted a pretest-posttest study to evaluate initial Yoga
awareness amongst HPE students (pre-test) and to assess the changes
after a single interactive session of Yoga theory and practice (post-test).
20
Role of Yoga and Music Therapy in Promoting Salutogenesis
367 HPE students (196 F, 171 M) were divided into seven batches for
participation in Yoga sessions at the Centre for Yoga Therapy Education
and Research (CYTER). The identical, validated Yoga Awareness
Questionnaire (YAQ) was given to them before and after the sessions to
evaluate the changes in understanding / knowledge about Yoga and
Yoga Therapy. Post-test scores increased signicantly (p < 0.001) over
both pre-test scores. The differences were signicant for all batches of
the medical, dental and nursing students analysed separately, as well as
for the overall comparisons of HPE students. Even a single interactive
session of Yoga Theory and practice can result in signicant
improvements in the awareness and knowledge about Yoga and Yoga
Therapy, thus setting the stage for future short- and long-term studies
on the benets for such students.
Impact of Fast and Slow Pranayama on Cardio Vascular Autonomic
Function among Healthy Young Volunteers: Randomized Controlled
17
Study.
Pranayama refers to the conscious manipulation of the breath in
order to modulate the cosmic energy (prana) from the air in the
environment. The techniques of Pranayama include practices that are
performed in a slow or fast type. The study aimed to investigate and
correlate the impact of three months practice of fast and slow pranayama
on cardiovascular autonomic function among healthy young volunteer.
A total of 75 volunteer subjects were randomized into control group
(Group1: n=25), fast pranayama group (Group 2: n=25) and slow
pranayama group (Group 3: n=25). The pranayama practice (Slow
Pranayama Group-Savitri, Pranav and Nadisodhana: Fast Pranayama
Group-Bhastrika, Kukkuriya and Kapalabhati, were practiced 30
minutes per day, 3 days per week for 3 months either slow or fast
pranayama by a certied Yoga teacher. The recording of Short-term
Heart Rate Variability (HRV) was done at the before and after 3 months
of study period. The LF/HF ratio which is the best indicator of
Sympathovagal balance was reduced signicantly in slow pranayama
group showing a shifting of balance towards parasympathetic tone. The
21
Role of Yoga and Music Therapy in Promoting Salutogenesis
RMSSD which is considered to be the best predictor of parasympathetic
tone signicantly increased in slow pranayama group. A signicant
increase (HF) nu and decrease (LF) nu was noted in slow and fast
pranayama respectively after Yoga intervention. Conclusion: Results of
our study demonstrates that slow and fast pranayama practices are
more effective to maintain sympatho-vagal balance by modulating
sympathetic and parasympathetic division of autonomic nervous
system.
Immediate Effect of Pranava Pranayama on Oxygen Saturation and
Heart Rate in Healthy Volunteers: A Single-Blinded, Randomized
18
Controlled Trial.
Yoga is known to promote health and wellness in all. Pranava
Pranayama is a useful sound based yogic breathing technique with
reported benets such as potentiating vagal tone. This single blinded
randomized self-controlled cross-over study was done with 58
participants. The immediate effect of Pranava Pranayama on saturation
of oxygen in the blood (SpO2) and heart rate (HR) was determined
before and after intervention using pulse oximeter. To avoid extraneous
inuences due to recording on different days, one half of the subjects
were randomized to perform quiet sitting on day 1 while other half did
Pranava Pranayama which was then reversed on day 2. Intra group
comparison showed signicant changes (p < 0.001) in both SpO2 and HR
following Pranava Pranayama whereas in the quiet sitting group, there
was an insignicant fall in the SpO2 readings but HR was found
signicant (p < 0.001). Intergroup comparison showed signicant
differences between groups (p-0.032). Cardiovascular changes
following Pranava Pranayama may be as a result of audible chanting
improving baroreex sensitivity along with increased endogenous
nitric oxide production. This promotes vasodilatation resulting in
reduction of BP. The decrease in vascular resistance and an increase in
capillary perfusion results in increased oxygen saturation with lesser
demand on the heart. This study provides evidence that Pranava
Pranayama is an effective technique in enhancing SpO2 and our
22
Role of Yoga and Music Therapy in Promoting Salutogenesis
ndings may have therapeutic applications especially in the current
pandemic situation.
2.2. EVIDENCE BASED PRACTICE IN MUSIC THERAPY
A Study on the Relationship of Music Therapy and the Personality
19
Traits of Neuroticism and Agreeableness.
Music has emotional, cognitive and social impacts on the listener.
The magnitude of response is associated with the Big Five personality
traits (Neuroticism, E x t r a v e r s i o n , Openness t o E x p e r i e n c e ,
Agreeableness, and Conscientiousness). The aim of the study was to
determine the association between the Big Five personality traits and
response to Music Therapy based on Indian classical ragas as evaluated
by the improvements in self-rated anxiety and depression scores before
and after Music administration. 28 engineering college students (15
males, 13 females) with signs of clinical anxiety and depression,
evaluated by the Self- Rating Scale for Anxiety and depression (SAS and
SDS) devised by Zung, were recruited for the study. The anxiety and
depression scores before and after 21 days of Music administration
(Music in Rag Bilaskhani Todi for 30 minutes twice a day through head
phones) were compared. The personality traits of the students were
assessed using the NEO-FFI of Costa & Mc Crae. Association between
the personality traits and the difference in anxiety and depression scores
before and after Music administration was analyzed. The results
indicate that response to Music Therapy is associated with the
personality traits. A Signicant positive correlation (r=0.3 for anxiety
scores) is found to exist between those with high Neuroticism scale and
improvement in the anxiety indices after Music Therapy. A negative
correlation exists between those with low Agreeableness scale and
indices for anxiety and depression (r= -0.3 for anxiety scores, r= -0.2 for
depression scores). Thus, Music alleviates stress and the response is
associated with the inherent personality traits, namely Agreeableness
and Neuroticism.
23
Role of Yoga and Music Therapy in Promoting Salutogenesis
A Survey of The Musical Preferences of Young Adolescents Newly
20
Admitted to The Medical School.
To explore the association between Musical preferences and the
stress- relieving and/or enhancing reading ability of the preferred class
of Musical items. 60 adolescents (30 males and 30 females of I MBBS
students of a private medical college in Puducherry) were given a single
exposure of Rag Bilahari in folk style for 20 minutes, after which they
were asked to describe their subjective feelings evoked on listening
Music which was analyzed with their individual Musical preferences.
The majority among the adolescent group felt that the Musical piece
would “reduced their stress” prefer folk tune (“reective & complex”
Musical dimension of Rentfrow & Gosling) As most of the females felt
the Music is relaxing is signicantly greater than males, we can presume
females use Music for emotional purpose. Majority of participants
belong to the “reective & complex” Musical dimension and feel the
Music reduces their stress and would enhance their reading ability.
2.3. ONGOING STUDIES AT ISCM
Effect of Yoga on Wellbeing in undergraduate healthcare
students: A Salutogenic approach
1.
24
Role of Yoga and Music Therapy in Promoting Salutogenesis
Chapter 3
ROLE OF YOGA AND MUSIC
THERAPY IN GENERAL MEDICINE
General Medicine also called internal medicine involves the
diagnosis, prevention, and treatment of adult diseases. The speciality
has a wide range of acute and chronic diseases that affect various body
parts. Some of the areas that falls under general medicine diabetes,
hypertension, heart disease, cholesterol, thyroid malfunctions, liver
diseases, among many others. General medicine may also include
preventative care such as sports physicals, counselling related to health
and heart diseases.
Yoga & Music Therapies has been found to have great benets
when it comes to prevention of diseases if practiced on regular basis.
More scientic studies published role of Yoga as an adjuvant therapy in
controlling glycemic proles, systolic & diastolic blood pressure,
dyslipidemia and the anthropometric parameters. Most importantly it
helps to increases the efcacy of drugs and sustain reductions in side
effects caused by the drugs. Maintain better blood oxygenation without
increasing minute ventilation while reducing sympathetic activation. It
also helps healthier blood pressure, perfusion pressure and renal artery
blood ow, through these mechanisms it helps to prevent the
progression of disease and its complications.
Keywords: Diabetes mellitus, hypertension, general medicine,
Yoga, Music.
3.1. EVIDENCE BASED PRACTICE IN YOGA THERAPY
Immediate Cardiovascular Effects of a Single Yoga Session in
21
Different Conditions.
This retrospective review of clinical data was done to determine
cardiovascular effects of a single Yoga session in normal subjects as well
as patients of different medical conditions. Data of 1896 patients (1229
female, 633 male and 34 transgender) with mean age of 36.28 ± 12.64 y
25
who attended Yoga Therapy sessions at CYTER between November
2010 and September 2012 was used for analysis. Heart rate (HR), systolic
(SP) and diastolic pressure (DP) had been recorded using non-invasive
blood pressure (NIBP) apparatus before and after 60 minute Yoga
sessions at CYTER and indices like pulse pressure (PP), mean pressure
(MP), rate-pressure product (RPP) and double product (DoP) were
derived from recorded parameters. Participants were undergoing
appropriate Yoga Therapy protocols as per their individual condition
while normal subjects had a general schedule of practice. Typical Yoga
sessions included simple warm ups (jathis and surya namaskar), breath
body movement coordination practices (kriyas), static stretching
postures (asana), breathing techniques (pranayama), relaxation and
chanting. There were statistically signicant (p<0.001) reductions in all
the studied cardiovascular parameters following the Yoga session. The
magnitude of reductions differed in the groups, it being more signicant
in those having hypertension (n=505) and less signicant in those
having endo crine/ski n (n=23 0) and muscu loskeleta l (n=12 0)
conditions. It was moderately signicant in the normal subjects (n=582)
as well as patients having psychiatric (n=302) and respiratory (n=157)
conditions. There is a healthy reduction in HR, BP and derived
cardiovascular indices following a single Yoga session. The magnitude
of this reduction depends on the pre-existing medical condition as well
as the Yoga Therapy protocol adopted. These changes may be attributed
to enhanced harmony of cardiac autonomic function as a result of
coordinated breath-body work and mind-body relaxation due to Yoga.
Immediate Effect of Chandra Nadi Pranayam on Heart Rate
Variability and Cardiovascular Parameters in Patients of Diabetes
22
Mellitus and Hypertension.
Diabetes mellitus (DM) and hypertension (HT) are widely
prevalent psychosomatic lifestyle disorders that often coexist.
Chandranadi pranayama (CNP), an exclusive left nostril breathing
technique, has been reported to be useful in reducing heart rate (HR)
and blood pressure (BP) in normal subjects as well as hypertensives and
is part of Yoga Therapy schedules for patients of HT and DM. This study
26
Role of Yoga and Music Therapy in General Medicine
investigated the immediate effects of 5 minutes of CNP on HR, BP and
heart rate variability (HRV) in patients of HT, DM and in those having
both (DMHT). Thirty-nine participants receiving standard medical care
from the department of medicine, JIPMER were recruited. HR, BP and
short-term supine HRV were recorded before and after 5 minutes of
CNP. Analysis showed signicant (p < 0.05) fall of HR and BP indices in
all three groups with no difference between groups. However, in short
term HRV analysis, there were differences between the responses of DM
and HT patients with regard to mean RR and mean HR. Pre-existing
intergroup differences with regard to SDNN, RMSSD, HF power and
total power were negated after the performance of CNP. Pre-post intra
group comparisons showed signicant increases in Mean RR and Mean
HR in both HT and HTDM groups while there were signicant increases
in LFnu and LF/HF ratio with signicant decrease in Hfnu in DM group.
The post CNP responses of DM group in Mean RR, SDNN, Mean HR,
RMSSD, LF power and total power were contrary to responses in the
other groups. This is the rst report comparing immediate effects of
CNP in patients of HT and DM. The reduction in HR and BP indices in all
three groups may be attributed to an overall normalization of autonomic
cardiovascular rhythms along with improvement in baroreex
sensitivity irrespective of the disorder. The HRV ndings are more
complicated but show a trend towards a normalization of the
autonomic differences between groups that is typical of Yoga
techniques. HRV changes in DM patients were contrary to HT and
DMHT patients in many parameters and this may be due to a greater
degree of cardiac autonomic neuropathy in them. Further studies are
required to enable better understanding of mechanisms involved as well
as to determine how long such effects persist. We recommend the
addition of this simple and cost-effective technique to regular
management protocols of HT and DM.
Effect of Yoga Therapy on Fasting Lipid Prole in Chronic Kidney
23
Disease: A Comparative Study.
Lipid abnormalities are common among patients with chronic
kidney disease (CKD) and it tends to persist/worsen even after
27
Role of Yoga and Music Therapy in General Medicine
initiating treatment. The cardiovascular mortality and morbidity remain
signicantly high in this population. The present study was carried out
to assess the effect of Yoga Therapy on fasting lipid prole in CKD
patients. It was an interventional case control study on CKD patients
with and without Yoga in a tertiary care hospital. About 60 CKD patients
aged >18 years were enrolled for the study and were divided into 2
groups of 30 each. Subjects in Group 1 who underwent Yoga Therapy.
Group 2 subjects did not do Yoga and they served as controls. Serum
lipid prole, RFT and BP were estimated for all patients. Chi-square test,
Paired and unpaired t test, mean and delta change were used for
comparison. A p-value of <0.05 was considered statistically signicant.
Out of 60 patients, males were predominant. There was signicant
reduction in Triglycerides, LDL and VLDL in the Yoga group. Total
cholesterol also reduced but was not statistically signicant. HDL also
increased but insignicant statistically. Yoga therapy can be a new
added adjuvant and cost effective to the standard lipid lowering agent to
reduce the lipid levels in CKD patients.
Proposed Yoga Protocol Based on Glycemic Control, Insulin
Re s is t an c e a n d A n th r op o me tr y -S p ec i e d Pa ra m et e rs : A
24
Retrospective Study on Clinically Euthyroid Type II Diabetics.
Inclusion of Yoga in the daily routine would haemoglobin
moderate glycemic control, alleviate insulin resistance (IR), besides
reducing the risk of complications in people with long-standing diabetes
and comorbidity. The body mass index (BMI) cut-off criteria are
different as per the Asian Indian and WHO standards. Accordingly,
overweight range of 23–24.9 in the Asian Indian category will fall under
the nonobese category. Obese range of ≥25 BMI in the Asian Indian
group will come under the overweight category as per the WHO
standards. To devise a unique Yoga protocol based on anthropometry
and biochemical assessment, has been proposed with reference to
specic parameters in insulin-resistant, clinically euthyroid type II
diabetics with special reference to Asian Indian and WHO standards. A
retrospective study was conducted in the Department of Biochemistry
with inputs from the diabetic clinic of a tertiary care teaching hospital as
well as a designated center for Yoga Therapy, following acceptance from
28
Role of Yoga and Music Therapy in General Medicine
the research advisory committee. The study subjects were clinically
euthyroid type II diabetics (both genders) in the age group 35–70 years
who were on diabetic diet and oral hypoglycemic agents (OHAs). Data
from clinically euthyroid type II diabetics (n = 101) (adult males and
females in the age group 35–70) were utilized for the study. The Pearson
correlation coefcient and multivariate analysis were enabled and p <
0.05 was considered signicant. Results: Statistically signicant
associations were observed between IR (dependent variable) and other
independent variables, namely HbA1c, TAG/HDL (surrogate marker of
small dense LDL), and thyroid hormones. With reference to BMI, based
on Asian Indian standards, TAG/HDL depicted association with
homeostasis model assessment-Insulin resistance (HOMA-IR) (p =
0.011) and TSH was negatively associated with HbA1c (p = 0.027) in
overweight; HbA1c and TSH exhibited positive association with p =
0.001 and 0.04, respectively, in obese as per the Asian Indian criteria for
BMI. Keeping BMI as per the WHO, TAG/HDL (p = 0.008) in nonobese
and in overweight HbA1c with p = 0.001 were associated with HOMA-
IR. Signicant association was not found in the obese subjects, as per the
WHO standards. There is a need for a unique Yoga protocol to address
clinically euthyroid type II diabetics. Hitherto, such a protocol has not
been developed, especially with reference to BMI, as per the Asian
Indian and WHO standards. Practicing this proposed Yoga protocol on
the basis of anthropometry might prove benecial in glycemic control,
alleviating IR, besides reducing complications of type II diabetics in
euthyroid population who may later be candidates for frank thyroid
comorbidity.
Nephroprotective Impact of Adjuvant Yoga Therapy on Diabetes-A
25
Randomised Controlled Trial.
Recent studies have provided abundant evidence about benets
of Yoga in various chronic disorders. Diabetes Mellitus (DM) is a group
of metabolic diseases characterised by chronic hyperglycaemia and
renal complications of the disease are especially notable. It is estimated
that 10% to 40% cases of Type 2 DM (T2DM) eventually end up having
kidney failure. Yoga Therapy may help to prevent progression of kidney
damage in diabetic patients. The study aimed to evaluate the effect of
29
Role of Yoga and Music Therapy in General Medicine
adjuvant Yoga Therapy on renal prole in diabetic patients. This single
blind Randomised Controlled Trial (RCT) was designed as an
interdisciplinary collaborative work between Centre for Yoga Therapy,
Education and Research (CYTER) and Department of Endocrinology of
Mahatma Gandhi Medical College and Research Institute, Sri Balaji
Vidyapeeth, Puducherry, India. A total of 72 diabetic patients with
HbA1c, more than 7% were recruited and pre study evaluation of
Fasting Blood Sugar (FBS), Postprandial Blood Sugar (PPBS), HbA1c,
blood urea and serum creatinine were done. They were then
randomised into control group (n=36) who received only standard
medical management and Yoga group (n=36) who received Yoga
Therapy thrice weekly for 4 months along with standard medical
management. Post study evaluation of all parameters was done at end of
study period and data were analysed by Student's paired and unpaired
t-test for intra and intergroup comparisons. Postinterventional
comparisons revealed statistically signicant reductions (p<0.001) in all
glycaemic and renal parameters in the group receiving Yoga Therapy
when compared with control group who didn't receive the Yoga
intervention. Intragroup comparisons revealed signicant reduction of
all parameters in Yoga group. It is concluded from the present RCT that
Yoga has a denite role as an adjuvant therapy as it enhances standard
medical care and hence, can be recommended in routine clinical
management of diabetes to prevent progression into complications that
are part of the natural history of the disease.
Effect of Yoga Therapy on Cardiovascular Parameters in Patients with
26
Psoriasis: A Randomized Control Trial — Pilot Study.
This study was done at the Centre for Yoga Therapy, Education
and Research (CYTER) of Sri Balaji Vidyapeeth (SBV) to determine
cardiovascular (CV) parameters in patients with psoriasis. Data of 20
patients (12 female, 8 male) with a mean age of 44.40 ± 15.2 y who were
referred by Dept. of Dermatology and attended Yoga Therapy sessions
at CYTER was used for analysis. Supervised Yoga training was given to
the participants who were randomized into the Yoga group. Heart rate
(HR), systolic and diastolic pressure (SP and DP) was recorded using
non-invasive blood pressure (NIBP) apparatus before and after the
30
Role of Yoga and Music Therapy in General Medicine
study period of 12 weeks. CV indices such as Pulse pressure (PP), mean
pressure (MP), rate-pressure product (RPP), and double product (DoP)
were derived using appropriate formulae. The inter-group comparison
showed signicant change (p<0.05) in SP. The derived CV indices such
as PP, RPP &DoP also showed signicant changes. (p<0.05) after 12
weeks of Yoga training. The intragroup comparison in the control group
showed a signicant increase in SP and DP (p<0.05). There is a healthy
reduction in SP and derived CV indices following 12 weeks of Yoga
training. The magnitude of this reduction depends on the pre-existing
medical condition and intensity of the disease in each individual. These
changes may be attributed to enhanced harmony of cardiac autonomic
function as a result of coordinated breath-body work and mind-body
relaxation due to Yoga resulting in a signicant reduction in the
perceived stress.
Role of Yoga as an Adjuvant Therapy in the Management of Metabolic
27
Syndrome – A Randomized Control Pilot Study.
Metabolic syndrome (MetS) is a public health threat rising
globally at an alarming rate. Yoga as a therapy is becoming increasingly
popular and its applications are increasing in various clinical conditions.
Yoga is an integrated system of self-culturing, aimed at coordinated
development of body and mind leading to enhanced physical health,
spiritual harmony, positive thinking, happiness and peace. This study
aimed to study the role of Yoga as adjuvant therapy in the clinical
management of MetS. The study was done an interdisciplinary
collaborative work between Center for Yoga Therapy and Department
of General Medicine of MGMCRI, Sri Balaji Vidyapeeth, Puducherry.
Thirty newly diagnosed MetS patients were recruited; prestudy
evaluati o n s of b o dy ma s s i n dex, w a i st ci r c u m ference , h i p
circumference, pulse rate, systolic blood pressure (SP), diastolic blood
pressure (DP), fasting blood sugar, postprandial blood sugar,
glycosylated haemoglobin, and fasting lipid prole were done. By the
method of simple randomization, subjects were allocated to Yoga
Therapy group (n = 15), who received Yoga Therapy thrice weekly for 3
months along with standard medical management and to control group
(n = 15) who received only standard medical management. Post study
evaluation of all parameters was done at the end of the study period.
31
Role of Yoga and Music Therapy in General Medicine
Data were analyzed by Student's paired 't' test, as all data passed
normality. There was a statistically signicant (p < 0.05) reduction in all
the above parameters in Yoga group compared to control group.
Changes seen in control group were missing signicance. It may be
concluded from the present pilot study that adjuvant Yoga Therapy is
benecial in maintaining good health and reducing metabolic risk
factors. This may have impact on utilization of Yoga Therapy as a secure
and cost-effective add-on therapeutic modality in combating MetS.
Impact of an Integrated Yoga Therapy Protocol on Insulin Resistance
28
and Glycemic Control in Patients with Type 2 Diabetes Mellitus.
Diabetes mellitus (DM), characterized by chronic hyperglycemia,
is attributed to relative insulin deciency or resistance, or both. Studies
have shown that Yoga can modulate parameters of insulin resistance.
The present study explored the possible benecial effects of integrated
Yoga Therapy with reference to glycemic control and insulin resistance
(IR) in individuals with diabetes maintained on standard oral medical
care with Yoga Therapy, compared to those on standard oral medical
care alone. In this study, the subjects on Yoga intervention comprised 35
type 2 diabetics, and an equal number of volunteers constituted the
control group. Subjects ranged in age from 30 to 70 years, with hemo-
globin A1c (HbA1c) test more than 7%, and were maintained on diabetic
diet and oral hypoglycemicagents. Blood samples were drawn prior to
and after 120 days of integrated Yoga Therapy intervention. Fasting
blood glucose (FBG), post-prandial blood glucose (PPBG), HbA1c,
insulin, and lipid prole were assessed in both the intervention and
co ntrol group s. T he interven tion group r evealed signic a nt
improvements in body mass index (BMI) (0.7 kg/m2 median decrease;
P=0.001), FBG (20 mg/dL median decrease; P<0.001), PPBG (33 mg/dL
median decrease; P<0.001), HbA1c (0.4% median decrease; P<0.001),
homeostatic model assessment for insulin resistance (HOMA-IR) (1.2
median decrease; P<0.001), cholesterol (13 mg/dL median decrease,
P=0.006), triacylglycerol (22 mg/dL median decrease; P=0.027), low-
density lipoprotein (6 mg/dL median decrease; P=0.004), and very-low-
density lipoprotein levels (4 mg/dL median decrease; P=0.032).
Increases in high-density lipoprotein after 120 days were not signicant
(6 mg/dL median increase; P=0.15). However, when compared to
32
Role of Yoga and Music Therapy in General Medicine
changes observed in patients in the cont rol group, all these
improvements proved to be signicant. Administration of integrated
Yoga Therapy to individuals with diabetes leads to a signicant
improvement in glycemic control, insulin resistance, and key
biochemical parameters.
3.2. EVIDENCE BASED PRACTICE IN MUSIC THERAPY
Role of Rag Ahir Bhairav as Complementary and Alternative
29
Medicine (CAM) On Blood Pressure in Prehypertensive Adults.
Pre-hypertension is the preliminary stage of hypertension with
high normal blood pressure, which is a major risk factor for cardio
vascular, renal and neurological complications. Music Therapy is
considered as an important complementary and alternative medicine
(CAM) to treat pre-hypertension. The aim of this study was to nd out
the efcacy of Music on blood pressure in pre-hypertensive adults. Sixty
male pre-hypertensive subjects, who are not on any antihypertensive
therapy, were divided randomly into 2 groups (the experimental and the
control groups). The experimental group received 40 days of Music
Therapy, while the control group did not receive Music Therapy. The
systolic and diastolic blood pressures of the subjects were recorded
before and after 40 days in both the groups and statistically analyzed.
There was a signicant reduction in the blood pressure in the
experimental group when compared to the control group. We conclude
that Music plays an effective role as complementary therapy for treating
the patients with pre-hypertension.
Effect of Music Therapy on Pain Perception, Fatigue Level and
30
Physiological Variables in Patients Under Going Haemodialysis
Chronic renal failure (CRF) is a severe and chronic illness that can
signicantly impact a person's quality of life. It is caused by various
pathologies and can lead to multiple complications, including fatigue
and chronic pain. Haemodialysis is a standard and lifesaving treatment
for patients with CRF, but the prolonged immobilization required
during this procedure can exacerbate fatigue and pain. Music Therapy is
a non-invasive treatment that has positively impacted patients
undergoing haemodialysis. In the study we have done, the therapy
consisted of passive listening and active participation in the form of deep
33
Role of Yoga and Music Therapy in General Medicine
34
breathing for eight weeks. To provide Music Therapy based on client
preference to patients undergoing haemodialysis for chronic renal
failure. To observe the fatigue and subjective pain perception level after
eight weeks of Musical intervention. The sessions began with a warm-
up session of OM chanting, which was used to set the atmosphere and
bring attention to the subject. Then, devotional songs were played for 10
minutes based on the patient's preferences, followed by 20 minutes of
Indian classical Veena Music. The therapy sessions were administered
every third day, twice a week when the patients underwent
haemodialysis. Each session lasted around 3 hours. Subjective
parameters of fatigue and pain perception were assessed before the
intervention, after four weeks, and after eight weeks of Musical
intervention. The results indicated that Music Therapy lowered these
patients' fatigue and pain perception. The fatigue level, estimated by the
CIS (Checklist Individual Strength) score, was reduced by 30%, and the
pain perception score dropped from 8 to 6.5. The ndings of this study
suggest that Music Therapy can be an effective complementary
treatment for patients undergoing haemodialysis, as it can help to
reduce fatigue and pain perception. It is essential because these
symptoms can signicantly impact patients' quality of life and may
impact adherence to treatment regimens. However, it's also worth
noting that this study only assesses the effect in a small sample size. For
a short period, more research is needed in a larger population with a
longer duration. Exploring different Music or other therapeutic
techniques is also benecial to nd the most effective approach for
3.3. ONGOING STUDIES AT ISCM
Effect of Yoga Therapy in modifying stress in patients with
psoriasis: A randomized control trial
Role of Yoga as an adjuvant therapy in management of metabolic
syndrome: A Randomized Control Trial
Effect of adjuvant Yoga Therapy on non-ulcer dyspepsia among
patients in a tertiary care hospital: a randomised controlled trial
Effectiveness of integrated Yoga - Siddha module for the
management of type 2 diabetes mellitus.
1.
2.
3.
4.
Role of Yoga and Music Therapy in General Medicine
Chapter 4
ROLE OF YOGA AND MUSIC
THERAPY IN PULMONOLOGY
Respiratory Medicine plays a key role in diagnosis most common
conditions like Bronchial Asthma, Chronic Obstructive Pulmonary
Disease (COPD), tuberculosis, diseases caused through airborne &
occupational hazards like byssinosis, bagassosis, & cancers most of them
have poor prognosis. They also play a key role in smoking cessation.
Yoga Therapy through the most important technique Pranayama
aimed at increasing lung expansion as well as conscious breath work
improving elasticity and compliance. Increased oxygenation, opening of
airspaces and recruitment of alveoli. Practicing Pranayama has been
reported to maintain better blood oxygenation without increasing
minute ventilation while reducing sympathetic activation. Yogic
techniques enable reexogenic feedback through various nerves in the
body corresponding to the parts of the lungs to be enlarged, expanded,
reconditioned or rejuvenated. Music Therapy has been found to be
useful in pulmonology as it acts as a distraction to the discomfort that
comes with using various procedures that are prescribed to them for
improvement in lung power. They also go through a great deal of
psychological and social disturbances due their physical state that often
results in losing hope. Music Therapy has been found to have positive
outcomes that improve patient cooperation towards treatment.
Keywords: COPD, asthma, diabetic lung, respiration, lung
function
4.1 EVIDENCE BASED PRACTICE IN YOGA THERAPY
Effectiveness of Adjuvant Yoga Therapy in Diabetic Lung:
31
A Randomized Control Trial.
Recent studies provide ample evidence of the benets of Yoga in
various chronic disorders. Diabetes mellitus is a group of metabolic
diseases characterized by chronic hyperglycemia and Sandler coined the
35
term “Diabetic Lung" for the abnormal pulmonary function detected in
diabetic patients due underlying pulmonary dysfunction. Yoga
Therapy may help in achieving better pulmonary function along with
enhanced glycaemic control and overall health benets. Aim: To study
the effect of adjuvant Yoga Therapy in diabetic lung through
spirometry. Settings and Design: Randomized control trial was made as
interdisciplinary collaborative work between departments of Yoga
Therapy, Pulmonary Medicine and Endocrinology, of MGMC & RI, Sri
Balaji Vidyapeeth Puducherry. 72 patients of diabetic lung as conrmed
by spirometry (<70% of expected) were randomized into control group
(n=36) who received only standard medical treatment and Yoga group
(n=36) who received Yoga training thrice weekly for 4 months along
with standard medical management. Yoga Therapy protocol included
yogic counseling, preparatory practices, Asanas or static postures,
Pranayama or breathing techniques and relaxation techniques.
Hathenas of the Gitananda Yoga tradition were the main practices used.
Spirometry was done at the end of the study period. Data was analysed
by Student's paired and unpaired 't' test as it passed normality. There
was a statistically signicant (P < 0.05) reduction in weight, and BMI
along with a signicant (P < 0.01) improvement in pulmonary function
(FEV1, FVC) in Yoga group as compared to control group where
parameters worsened over study period. It is concluded from the
present RCT that Yoga has a denite role as an adjuvant therapy as it
enhances standard medical care and hence is even more signicant in
routine clinical management of diabetes, improving physical condition
and pulmonary function.
Comparative Effect of 12 weeks of Slow and Fast Pranayama Training
on P ulmonary Functio n i n Y o u ng, H ealthy Volunteer s : A
32
Randomized Controlled Trial.
Pranayamas are breathing techniques that exert profound
physiological effects on pulmonary, cardiovascular, and mental
functions. Previous studies demonstrate that different types of
Pranayamas produce divergent effects. Aim: The aim was to compare
the effect of 12 weeks of slow and fast pranayama training on
36
Role of Yoga and Music Therapy in Pulmonology
pulmonary function in young, healthy volunteers. This study was
carried out in Departments of Physiology and ACYTER, Jawaharlal
Institute of Postgraduate Medical Education and Research, Puducherry
in 2011. Subjects and Methods: Ninety-one healthy volunteers were
randomized into slow pranayama group (SPG), n =29, fast pranayama
group (FPG), n = 32 and control groups (CG) (n = 30). Supervised
pranayama training (SPG: Nadisodhana, Pranav pranayama and Savitri
pranayama; FPG: Kapalabhati, Bhastrika and Kukkriya pranayama)
was given for 30 min/day, thrice/week for 12 weeks by certied Yoga
instructors. Pulmonary function parameters (PFT) such as forced vital
capacity (FVC), forced expiratory volume in rst second (FEV 1 ), ratio
between FEV 1 and FVC (FEV 1 /FVC), peak expiratory ow rate
(PEFR), maximum voluntary ventilation (MVV), and forced expiratory
ow 25-75 (FEF 25-75 ), were recorded at baseline and after 12 weeks of
pranayama training using the computerized spirometer (Micro
laboratory V1.32, England). Results: In SPG, PEFR, and FEF 25-75
improved signicantly (P < 0.05) while other parameters (FVC, FEV 1,
FEV 1 /FVC, and MVV) showed only marginal improvements. In FPG,
FEV 1 /FVC, PEFR, and FEF 25-75 parameters improved signicantly (P
< 0.05), while FVC, FEV 1, and MVV did not show signicant (P > 0.05)
change. No signicant change was observed in CG. Twelve weeks of
pranayama training in young subjects showed improvement in the
commonly measured PFT. This indicates that pranayama training
improved pulmonary function and that this was more pronounced in
the FPG.
Effect of Adjuvant Yoga Therapy on Pulmonary Function and Quality
of Life Among Patients with Chronic Obstructive Pulmonary Disease:
33
A Randomized Control Trial.
Previous studies have suggested that Yoga positively impacts
lung function and quality of life (QoL). The present prospective two-
arm, single-blinded and controlled study evaluated the effect of
adjuvant Yoga Therapy on pulmonary function and QoL in patients of
Chronic Obstructive Pulmonary Disease (COPD). Material and
Methods: Seventy-two COPD patients were recruited and randomized
37
Role of Yoga and Music Therapy in Pulmonology
to Yoga group who received adjuvant Yoga Therapy in addition to
standard medical management and control group who received only
medical management. Yoga Therapy protocol included loosening
exercises, postures, breathing techniques and relaxation. Forced vital
capacity (FVC), forced expiratory volume in rst second (FEV1) and
FEV1/FVC were measured using computerized pulmonary function
test 'Trueow (ndd)'. Saint George Respiratory Questionnaire (SGRQ)
was used to asses QoL. Changes in parameters were correlated with
symptom s, activ ity, impa cts and qualit y s cores . I ntra-g roup
comparisons were done using Student's paired 't' test and intergroup
comparisons using unpaired 't' test. Results: There was signicant
improvement (p < 0.001) in FVC and FEV1 after four weeks of adjuvant
Yoga Therapy while controls showed decline in all parameters. QoL
scores, namely: symptoms,activity, impacts and quality improved
signicantly in Yoga group with no signicant changes in controls.
Signicant correlation was found between pulmonary function and QoL
in Yoga group. Conclusion: Signicant improvements of lung function
with adjuvant Yoga Therapy can be attributed to comprehensive Yoga
Therapy package administered to participants resulting in decreased
airway resistance and better lung compliance attributed to nonspecic
broncho-protective / broncho-relaxing effect. Signicant improvement
in QoL scores can be attributed to improved vital capacity as well as
enhanced self-condence /self-reliance. We conclude that there is a
positive and additive role of adjuvant therapy with standard medical
management of COPD.
4.2. EVIDENCE BASED PRACTICE IN MUSIC THERAPY
Music Therapy for Pulmonary Rehabilitation in Chronic Obstructive
34
Pulmonary Disease [COPD] Patients An Interventional Trial.
Complementary therapies such as Musical interventions are used
as adjuncts in the rehabilitation of chronic illnesses. Patients who
attended the Pulmonology OPD of a south Indian medical university
and diagnosed as moderate asthmatics as per American Thoracic Society
classication were recruited. They were given Music Therapy in the
form of vocal exercise and monotone OM chanting, by qualied Music
38
Role of Yoga and Music Therapy in Pulmonology
therapist 20 minutes a day for 21 days. The pulmonary functions- FVC
(Forced Vital Capacity) and FEV1/FVC (Forced Expiratory Volume 1
second), dyspnoea level by Visual Dyspnoea Assessment Scale (VDAS)
and stress level by Cohen's perceived stress scale were recorded during
the recruitment and after completion of the entire Music Therapy
sessions. Statistical analysis of pre and post Music Therapy data by
paired t-test (p≤0.01) showed there was a signicant improvement of
pulmonary functions, reduction of dyspnoea and perceived stress levels
of our study population.
4.3 ONGOING STUDIES
39
Comparison of the impact of Music Therapy intervention VS
incentive spirometer on peak expiratory ow rate, dyspnea and
quality of life in hospitalized Chronic Obstructive Pulmonary
Disease patients.
1.
Role of Yoga and Music Therapy in Pulmonology
Chapter 5
ROLE OF YOGA AND MUSIC THERAPY
IN OBSTETRICS & GYNECOLOGY
One of the most unique, challenging & blessed department to play
a vital role keeping both the mother & baby healthy from the time
conception to till the time of delivering the baby, they not only provide
medical treatments but also support patients emotionally.
Adjuvant Yoga Therapy helps to psychosomatic health of the
maternal foetus as they induce the relaxation response in the expectant
mother. Toning cardiac autonomic reduces the anxiety and stress and
improves the pain tolerance during labour.
Inuence of Music has been found to be useful in regulating vitals,
increase milk volume and provide comfort pre, peri and post-delivery.
Musical interventions with mothers who go through anxiety as their
babies are admitted in NICU and providing support during their stay in
the hospital has been well documented.
Keywords: Yoga, Music, Psychosomatic, cardiac , relaxation, pain
tolerance , labour, milk volume, maternal breast feeding satisfaction.
5.1. EVIDENCE BASED PRACTICE OF YOGA THERAPY
Immediate Effect of Sukha Pranayama: A Slow and Deep Breathing
35
Technique on Maternal and Fetal Cardiovascular Parameters.
This pilot study was done to evaluate the immediate effect of
Sukha Pranayama, a slow and deep breathing technique on maternal
and fetal cardiovascular parameters. Single session pre-post comparison
was done for 10 min of Sukha Pranayama in 12 pregnant women in their
3rd trimester. The study participants were guided to breathe in and out
in a slow and regular manner for a count of 4 s each. Maternal
cardiovascular parameters, namely mean heart rate (MHR), systolic
pressure (SP), and diastolic pressure (DP), were measured before and
after the session and rate-pressure product (RPP) derived with the
40
formulae. Fetal heart rate (FHR) was derived from the nonstress test
tracing. Results: SP, MHR, FHR, and RPP reduced signicantly after
single session of Sukha Pranayama. The mothers reported that they felt
more relaxed and also sensed active fetal movement while performing
the pranayama. Discussion: Reduction in maternal cardiovascular
parameters may be attributed to reduced sympathetic activity coupled
with enhanced vagal parasympathetic tone. Reduction in RPP signies
reduced myocardial oxygen consumption and load on the heart as
evidenced by previous studies. These changes in cardiac autonomic
status may enhance placental circulation, leading to healthier fetal
development. The present study reiterates the importance of Yoga for
the psychosomatic health of maternal-fetal unit as an add-on relaxation
technique. We plan to develop this pilot study into a full-edged
evaluation of maternal and fetal wellbeing through Yoga.
Immediate Effect of Pranava Pranayama on Fetal and Maternal
36
Cardiovascular Parameters.
Maternal stress responses play an important role in the etiology of
fetal and maternal disorders other than biomedical risks. The surge of
emergency evidence that Yoga as adjuvant therapy can have signicant
benecial effects in the prenatal period and in the fetus. The aim of this
study was to evaluate the immediate effect of Pranava Pranayama on
maternal and fetal cardiovascular parameters. Three-way cross-over
rd
study was done on 3 consecutive days in 60 pregnant women (3
trimester) with 10 min of breath awareness, listening to OM, and
performing Pranava Pranayama. Maternal heart rate (MHR) and
systolic and diastolic pressures were measured before and after each
session, and cardiovascular indices were derived with formulae. Fetal
heart rate (FHR) was obtained from nonstress test tracing. Data were
assessed using GraphPad InStat version 3.06. Student's t-test was used
for intragroup comparisons while repeated measured ANOVA with
Tukey–Kramer multiple comparison tests were done for intergroup
comparison. Signicant changes (P < 0.001) were found in MHR and
FHR immediately after all three interventions. Delta% changes showed
the greatest fall in MHR (P = 0.03) after Pranava as compared to the other
41
Role of Yoga and Music Therapy in Obstetrics & Gynecology
two while in FHR, both OM group and Pranava were signicant (P <
0.001). There were signicant changes found in MHR, FHR, and
cardiovascular responses rate-pressure product and double product
after a single session of intervention. Yogic breathing techniques
Pr a nava may enhance cardiova s cular hemodyn a mics of the
maternal–fetal unit. Reduction in maternal and fetal cardiovascular
parameters attributed to reduced sympathetic activity coupled with
enhanced vagal parasympathetic tone. Such changes in cardiac
autonomic status may enhance placental circulation and lead to
healthier fetal development.
5.2. EVIDENCE BASED PRACTICE IN MUSIC THERAPY
Evaluating the Effect of Music Therapy on the Establishment of
37
Lactogenesis and Maternal Breast Feeding Satisfaction Levels.
Establishment of lactogenesis is an important determinant for a
successful breastfeeding journey of rst-time mothers. Breastfeeding is
essent ial for provision of immunity and neu rodev elopment.
Primigravids commonly encounter issues with the initiation of lactation
process. Music has been documented to have an impact on reducing
anxiety, stress as well as pain perception during labour there by
beneting lactating mothers. This current study had evaluated the effect
of Music Therapy aiding on process of lactogenesis and breastfeeding in
primigravids The study was done to evaluate the effect of active Music
listening and singing lullabies on the establishment of lactogenesis and
maternal breastfeeding satisfaction in new mothers. This is an
exploratory randomized controlled trial with primigravids (n=62)
randomized and allocated into two groups i.e. (Music Therapy/group
A; n=33) and (control group/ group B; n=29) respectively. Music
therapy intervention was provided to group A, while standard medical
care was commonly given to both groups. The UNICEF breast feeding
checklist and Maternal Breast-Feeding Evaluation Scale (MBFES) was
used to evaluate initiation of lactation time and maternal breastfeeding
satisfaction levels respectively. There was statistically signicant
improvement in the initiation of lactation time, time of each feed and
maternal breastfeeding satisfaction levels with a steady rise in time of
42
Role of Yoga and Music Therapy in Obstetrics & Gynecology
each feed in Music Therapy group. There was also a signicant
difference in increase in time of feeds between the Music Therapy and
control groups. Hence, it can be said that Music Therapy may be helpful
as an effective coping strategy for rst-time mothers and help them in
establishing lactogenesis and may also be helpful in enhancing the
maternal breast-feeding satisfaction levels.
Effects of Culture-Based Chants on Labour Pain During the Latent
Stage of Labour in Primigravidae Mothers: A Randomized Controlled
38
Trial.
Labour is a complex and very painful experience. Poorly relieved
pain results in prolonged and stressful labour, maternal impatience in
opting for caesarean section and postpartum complications. A positive
childbirth experience has a lasting impact on the postpartum health and
wellbeing of the new mothers. Music Therapy (MT) has been studied to
reduce labour pain perception and behaviours and to provide a positive
childbirth experience. The study aimed in to determine the effect of MT
on labour pain and pain behavioural symptoms during the latent stage
of labour of primiparous women. A total of 120 primiparous women in
the latent stage of labour with regular contractions and dilatations less
than 4 cms were included in the study and randomly divided into two
groups. Music group (n=60) received MT in the form of deep breathing
and chanting exercises for one hour between each and every contraction
and the control group (n=60) received only standard treatment. A 10-
point visual analogue pain scale (VAS) and Behavioural Pain Rating
Scale (BPRS) were measured and recorded by the investigators. MT
intervention resulted in statistically signicant reduction in pain and
total BPRS scores between the Music and the control group with
(p=0.001). Also, the BPRS domain scores in facial expression,
restlessness, consolation, and vocalization indicated signicant
reduction due to MT intervention with (p=0.001). The domain of BPRS –
muscle tone did not make a signicant impact with Music. Chanting and
deep breathing experiences as Music Therapy during the latent stage of
labour may reduce pain perception and pain behaviours. Such Music
Therapy interventions may provide positive experiences during
43
Role of Yoga and Music Therapy in Obstetrics & Gynecology
childbirth, it could be a safe and dependable method adopted for an
effective labour pain management.
Effect of Relaxing Music on Blood Pressure and Heart Rate in
Hospitalized Pre-Hypertensive Women in The Third Trimester of
39
Pregnancy: A Randomized Control Study.
Music Therapy has been found to have a positive inuence on
hypertension and pre-hypertension. The same can be said of the benets
of in pre, peri and post-natal women. This study was to observe effect of
relaxing Music on systolic blood pressure (BP), diastolic BP and heart
rates in hospitalized pre-hypertensive pregnant women in the third
trimester of pregnancy. Sixty hospitalized pre-hypertensive pregnant
women in the third trimester of pregnancy were included in the study.
They were divided into experiment (n=30) and control (n=30) groups by
randomization. Experiment group received three, 15 minutes sessions of
receptive Music Therapy in form of non-rhythmic instrumental Music.
The control group did not receive Music Therapy intervention. BP and
heart rates were measured before and after each session. Experiment
group showed signicant reduction in systolic BP, diastolic BP and heart
rate after each session of receptive Music Therapy. In comparison
between two groups, systolic BP showed signicant reduction. No
subject experienced any adverse effect. Listening to relaxing Music can
reduce BP and heart rates in hospitalized pre-hypertensive pregnant
women during third trimester. The BP lowering effect of relaxing Music
listening is more signicant for systolic BP. Receptive Music Therapy
seems to be safe in pregnant women
5.3. ONGOING STUDIES AT ISCM
44
Effect of live Music Therapy during episiotomy repair procedure:
A randomized controlled trial.
Effect of Music Therapy on the oxidative stress and hormonal
markers of breastmilk secretion in primigravida mothers after
normal delivery: a randomised controlled trial.
Music Therapy in Utero
1.
2.
3.
Role of Yoga and Music Therapy in Obstetrics & Gynecology
Chapter 6
ROLE OF YOGA AND MUSIC
THERAPY IN PEDIATRICS
The Pediatrics department requires a range of skills that is
required to interact, identify, diagnosis & treat not only the child but the
whole family. The department maintains the immunization and
wellbeing of a child until 17 years of age.
Prevention is better than cure. Likewise, the same concept adopted
in Yoga & Music Therapies is Heyam Dukham Anangatham (Prevent those
miseries yet to happen). It helps strengthen children's growing bodies
and helps them improve their exibility, which can reduce their chance
of injury. Most importantly it regulates emotions of children.
Many scientic studies report Yoga & Music Therapies help to
increase attention span, concentration, memory & awareness. Music has
found its place from the time a baby is born, whether at home or during
their need to stay in the NICU, during immunization and creates a
positive environment in their need to stay in a paediatric ward. The need
for family Music Therapy is a theory well established in the NICU of
pediatrics department. This chapter showcases the use of Yoga Music
Therapy in various pediatric settings within a hospital environment and
with children with special needs by ISCM, SBV.
Keywords: Pediatrics, Yoga and Music Therapies, exibility,
environment, attention span, focus, memory and awareness, NICU,
immunization, ASD, raga
6.1. EVIDENCE BASED PRACTICE OF YOGA THERAPY
Yoga Training Enhances Auditory and Visual Reaction Time in
40
Children with Autism Spectrum Disorder: A Case-Control Study.
Autism is a neuro-developmental disorder leading to multiple
problems including academic difculties and impaired skills.
Informationprocessing is abnormal in children with Autism Spectrum
Disorder (ASD) and theircentral nervous system (CNS) is either over or
45
under aroused. Reaction time (RT) is a useful marker to study the ability
of CNS. This study planned to investigate thechanges in RT before and
after 12 weeks of Yoga training. 72 ASD children were divided equally
into control group(Group I) who did not undergo Yoga training and
Yoga group (Group II) who received 60 minutes' Yoga training, ve
days a week, for 12 weeks. Components of Yoga protocol included
jathis, kriyas, asanas, pranayamas and yogic relaxation. Auditory RT
(ART) and Visual RT (VRT) were recorded before and after 12 weeks'
Yogatraining using RT apparatus. Data was assessed for normality
using GraphPad InStat version 3.06 for Windows 95. Wilcoxon
matched-pairs signed-ranks test wasused for intragroup comparison
and Mann–Whitney test for intergroup comparison.P <0.05 was
accepted as indicating signicance.Intra-group comparisons showed a
highly signicant increase in ART ingroup I (p < 0.001) whereas both
ART and VRT decreased signicantly in groupII (p < 0.001) with Yoga
training. Intergroup comparisons showed highly signicantdifferences
in ART and VRT values (P< 0.0001). Delta % changes were also
highlysignicant for both ART and VRT (P< 0.0001).Yoga training may
be utilized to reduce dependency on others and enhance learning
capabilities and social skills in ASD children.
Effect of Yoga Therapy on Neuromuscular Function and Reduction of
Autism Severity in Children with Autism Spectrum Disorder: A Pilot
41
Study.
Autism is characterized by dysfunction in motor execution and
sensory perception that are linked with neuromuscular function (fN) for
children with autism spectrum disorder (ASD). This article aims to
evaluate effectiveness of Yoga Therapy (YT) on fN and autism severity
in children with ASD. Sixty children were screened (age 6 to 18) using
childhood autism rating scale (CARS); 40 were allocated randomly
(n=20) into Yoga (YG) and control (CG) groups; both followed regular
school routine, and YG received 10 YT sessions (60 min/session). Visual
reaction time (VRT), handgrip strength (HGS), and CARS were
measured. YG showed signicant changes in VRT and CARS after YT
and intergroup comparisons revealed signicant differences between
46
Role of Yoga and Music Therapy in Pediatrics
groups at the end of the study (VRT,p=0.008; CARS,p=0.011). YT
resulted in small but statistically signicant changes in CARS and
signicant improvement in VRT. This implies that YT can be used as an
adjuvant modality for children with ASD, reducing co-morbidities with
regard to the neuromuscular function.
6.2. EVIDENCE BASED PRACTICE IN MUSIC THERAPY
Vestibular Stimulation with Indian Hammock Versus Music
Intervention in the Prevention of Infantile Colic in term Infants: An
42
Open-Labelled, Randomized Controlled Trial.
Infantile colic is a common condition worldwide: about one in ve
infants younger than three months develops colic. It is one of the most
common causes of emergency department visit in the early infancy.An
ideal colic treatment modality must be able to console the infant quickly
as well as alleviate the parental stress. This study was done to determine
whether vestibular stimulation offered by Indian hammock and Music
intervention are useful in reducing the occurrence of infantile colic in
term infants. This open-labelled randomized clinical trial was
conducted among 465 term neonates who were randomly assigned to
one of three groups: Music group, hammock group and control group.
The Music intervention was given for a cumulative duration of at least
4 h a day with one stretch of at least 1 h. In the hammock group, babies
were put to sleep inside the Indian hammock and were swung gently
until they sleep, and were allowed to sleep in it, until they wake up. For
the control group, routine predischarge counselling was given. All
parents were provided a cry log and were instructed to record the log of
cry events and duration. The primary outcome measure was occurrence
of infantile colic episode as dened by ROME IV criteria. The infants
were followed up from birth until the age of 3.5 months, and the cry log
was collected during each follow-up visit. Results: Of the 435 term
neonates who completed follow-up, 59 infants developed infantile colic
(13.6%). The prevalence of infantile colic in the control group, Music
group and the Indian hammock group was 25.6%, 5.4% and 9.6%
respectively; there was a signicant reduction in the prevalence of
infantile colic in the intervention groups as compared to the control
47
Role of Yoga and Music Therapy in Pediatrics
group. Vestibular stimulation by Indian hammock and Music
intervention individually reduced the occurrence of infantile colic.
The Effectiveness of Music and Mother's Voice on Pain Reduction
43
During Venepuncture in Neonates- A Randomized Control Trial.
Neonates in NICU undergo painful procedures as a part of
therapeutic and diagnostic intervention. Previous literatures show that
pain management during procedures is still below optimal level. This
study determines the effectiveness of Music and mother's voice on pain
reduction in neonates during venepuncture using Neonatal Pain
Agitation Sedation Score (NPASS) pre-validated scale. These 3 arms
open randomized control study conducted in a tertiary care hospital in
Puducherry included 300 neonates undergoing venepuncture. Music
group received pre-recorded lullabies and mother's voice group
received pre-recorded mother's voice during venepuncture. The control
group received no intervention. NPASS was documented before, during
and after the venepuncture. The NPASS was statistically signicant
(p<0.001) between the Music (4.52 ± 2.23) and control group (7.16 ± 2.19)
and also between mother's voice (5.88 ± 1.924) and control group (7.16 ±
2.19). Music and mother's voice help in pain reduction in neonates and
Music is better than mother's voice.
Live Music Therapy as an Active Focus of Attention for Pain and
44
Behavioral Symptoms of Distress During Pediatric Immunization.
Immunization procedures can be painful and frightening
experiences for children and can cause a lot of distress and lasting
negative outcomes. These outcomes may be minimized if taken care of at
the time of pediatric immunization. This study aimed at using Music
Therapy as an active focus of attention. A total of 100 children coming for
routine immunization to pediatric outpatient department were
included and were divided into experiment (n = 50) and control (n = 50)
groups. Experiment group received live Music Therapy during
immunization procedure. Control group received no intervention. The
Modied Behaviour Pain Scale (MBPS),10-point pain levels, and 10-
point distress levels were documented by parents. Duration of crying
was recorded by investigators. Pre- and postimmunization blood
pressures and heart rates of parents holding the children were also
measured and recorded by investigators. Independent and paired t tests
were used for analysis. All 3 domains of the Modied Behaviour Pain
48
Role of Yoga and Music Therapy in Pediatrics
Scale and duration of crying showed signicant improvement (P < .05)
in the experiment group. Pain and distress levels also showed
statistically nonsignicant improvement in experiment group. Blood
pressure and heart rate of parents showed no difference. Music Therapy
could be helpful to children, parents, and health care providers by
reducing discomfort of the child during paediatric immunization.
Effect of Rag Neelambari on Certain Physiological and Behavioral
45
Parameters of Preterm Infants.
It has been established by several authors that premature babies
immensely from lullaby-style Music exposure. Most lullabies in south
India are sung in a melodic mode known as Neelambari, and it is widely
accepted traditionally for its sleep -promoting effects. The present Study
was designed to elicit the effects of Neelambari on Heart rate, respiratory
rate, O2 saturation and behavioural score of medically healthy
premature infants admitted in the neonatal intensive care unit (NICU).
Thirteen stable infants received pre-recorded Music at 70 dB through
free eld delivery for 30 minutes for three consecutive days. All the
physiological and behavioural parameters were recorded every ve
minutes, before, during and after therapy, allowing 30 minutes for each
interval. It was found that Neelambari has a benecial effect on all the
above physiological parameters. Behavioural score demonstrated
decreased arousal and a state of progression towards deep sleep about
20 minutes after exposure to this rag. These ndings refute those of an
earlier study conducted in Puducherry, which concluded that anecdotal
references to the sleep promoting effects of Neelambari reect a
conditional response. Several authors have stated that it is difcult to
elicit conditioned responses in premature infants, due to cortical
immaturity. Since, all the infants demonstrated decreased arousal,
drowsiness and a state of deep sleep following Neelambari exposure, we
can infer that Neelambari does possess sleep inducing qualities
6.3. ONGOING STUDIES AT ISCM
49
Efcacy of combined live Music Therapy and tactile stimulation
on neonatal pain management: A mixed method
1.
Role of Yoga and Music Therapy in Pediatrics
Chapter 7
ROLE OF YOGA AND MUSIC THERAPY
IN SURGICAL CONDITIONS
One of last option of treatment where there is no role of drugs and
surgery becomes treatment of choice starting from Hernia to many
cancers. Yoga and Music Therapies plays an integral part in surgical
patients, because its roles start from pre op by accepting it & prepares
towards the procedure & reducing the stress and anxiety, during
surgery maintain the cardio-respiratory-autonomic balance & after
surgery helps facilitate wound healing optimally, increase the pain
tolerance & immunity to prevent from post- operative infections & there
by reducing hospital stay.
Keywords: Pre & Post op, pain tolerance, hospital stay, surgery,
healing
7.1. EVIDENCE BASED PRACTICE OF YOGA THERAPY
Effect of Yoga on Cognitive Function in Filarial Lymphoedema
46
Patients.
Background: Lymphatic lariasis (LF) is a neglected tropical
vector borne disease that affects people of low- and middle-income
groups. The larial lymphoedema is classied into four grades (grades I,
II, III and IV) based on the severity and external manifestation of the
disease. Grade I is reversible whereas grades II, III and IV are persistent
oedema and there is no pharmacological cure. Most of the Grade IV
lymphoedema patients suffer due to the physical disability which affects
their daily activities and quality of life (QoL), besides causing very low
cognitive function, which may be due to the economic burden caused by
their disability. Therefore, the study of the impact of Yoga on cognitive
function in larial lymphoedema patients was undertaken with the
noble cause of alleviating the distress of these patients. To know the
effect of Yoga on cognitive function among larial lymphoedema
patients, we carried out a study consisting of two arms ie. One study and
50
one control group. Morbidity Management Disability Prevention
(MMDP) measures include maintaining leg hygiene by washing the
limb, trimming the nail, practicing suitable leg exercises, elevation of the
limb, and regular usage of crepe bandages. This package of MMDP was
given to both arms and in addition to this, the study Group was given
Yoga training (Selective asana and pranayama for 60 minutes, including
warm-up and relaxation. We evaluated the impact assessment by
testing the mean differences of pre and post measure. We assessed the
effect size using the method Cohens d for the signicant mean
differences. We randomized 80 patients (1:1 ratio) into two groups.
Regular practice of Yoga along with routine MMDP measures for six
months showed a large effect size (>=0.8) in cognitive function. The
results were consistent with respect to grades and duration of
lymphoedema, and age of the patients. Yoga practices have a good,
favourable effect on larial lymphoedema patients' s cognitive function.
Effect of Yoga on Lower Extremity Function Among Filarial
47
Lymphoedema Patients.
Lymphatic lariasis (LF) is a neglected mosquito born tropical
disease that affects people of low socio-economic group. Filarial
lymphoedema has been classied into 4 grades by WHO. Except Grade-
1 all o t h e r grades 2 , 3 ,4 are p e r s istent edem a . T h e r e i s n o
pharmacological treatment to cure the disease completely. But leg
hygiene is important to prevent progression of disease. If left untreated
it may lead to grade 4 and disability will occur, there by mobility of limb
is also affected. This disability leads to stress, mental depression and
patients lose interest to do any work. Their mobility is restricted, and
they complain of pain and difculty in walking. Therefore, we decided
to assess if Yoga can be curative and help to improve them physical
mobility (Lower extremity function) since Yoga is already being used as
a cure for many diseases. Hence by practicing selective asana and
pranayama may prove to be a worthy trial in the case of larial
lymphoedema disability. To know the effect of Yoga on lower extremity
function among larial lymphoedema patients, we carried out two arms
randomized control trial. Group-1 Experimental group received Yoga
51
Role of Yoga and Music Therapy in Surgical Conditions
training (Selective asana and pranayama for 60 minutes, including
warm-up and relaxation) along with routine Morbidity Management
and Disabi lity P reven tion (MMDP) measures whic h includ e
maintaining leg hygiene by washing the limb, trimming the nail,
practicing suitable leg exercises, elevation of the limb, and regular usage
of crepe bandages. On the other hand, Group-2 control group received
only MMDP measures. We evaluated the impact assessment by testing
the mean differences of pre and post measures. We assessed the effect
size using the method Cohens d for the signicant mean differences.
Regular practice of Yoga along with routine MMDP measures for six
months showed betterment in lower extremity function. The results
were consistent with respect to grades and duration of edema, and age
of the patients. Yoga practices have a good, favorable effect on larial
lymphoedema patients' lower extremity functions.
The Efcacy of Yogic Breathing Exercise Bhramari Pranayama in
48
Relieving Symptoms of Chronic Rhinosinusitis.
A multitude of modalities are available for the treatment of
chronic rhinosinusitis; however, each has its side effects and compliance
issues. Bhramari pranayama, which is a breathing exercise in the
practice of Yoga, offers an inexpensive and free from side effect
modality in this regard. The objective of this study was to evaluate the
efcacy of Bhramari pranayama in relieving the symptoms of chronic
sinusitis. A total of 60 patients with chronic sinusitis were randomly
divided into two groups, one received conventional treatment of
chronic sinusitis and the other group was in addition taught to practice
yogic breathing exercise Bhramari pranayama. The patients were
advised to practice this breathing exercise twice a day and were
followed up at 1, 4, and 12 weeks using the Sino-Nasal Outcome Test
(SNOT-22 score). Results The mean SNOT-22 score in the group
following the Bhramari pranayama breathing exercise using the
ANOVA test improved from 39.13 ± 9.10 to 24.79 ± 8.31 (P = 0.0002), this
improvement was seen by the end of 4 weeks itself and continued until
the 12th week of assessment. Integrating regular practice of Bhramari
pranayama along with the conventional management of chronic
rhinosinusitis is more effective than conventional management alone.
52
Role of Yoga and Music Therapy in Surgical Conditions
Additive Effect of “Brahma Mudra” on Pain, Proprioception and
49
Functional Abilities in Non-Specic Mechanical Neck Pain.
Being the second highest musculoskeletal problem irrespective of
age, gender and occupation, the etiology of neck pain is predominantly
mechanical in nature. This can lead to dysfunction with time and
recurrence. Altered joint position sense (JPS) from soft tissues can alter
the cervical biomechanics by compromising the cephalo spatial
orientation, which depends on the visual, vestibular and proprioceptive
cues. This study was done to observe the additive effect of “Brahma
mudra” (BM) a yogic tool on non-specic mechanical neck pain and its
clinical implication on pain, proprioception and functional abilities.
Methods: It was a quasi-experimental pre epost study design involving
30 individuals from a software rm between the age group of 18e45
ye a rs. The convent i onal treatme n t g r oup received standard
physiotherapy regime and in the BM group BM was incorporated in
addition to standard physiotherapy regime. Independent sample
student t-test/Mann Whitney test were used to compare continuous
variables between two groups. Paired sample test/Wilcoxon signed
rank test were used for within groups. Results: There was a signicant
reduction in pain, improved functional abilities and proprioception in
BM group when compared to conventional treatment group with 0.01
level of statistical signicance. Conclusion: It may be concluded that
practice of BM had an added effect to conventional standard
physiother apy regime in reduction of pain, impr ovement of
proprioception and functional abilities among individuals with chronic
non-specic mechanical neck pain.
53
7.2. EVIDENCE BASED PRACTICE IN MUSIC THERAPY
Evaluation of Music Interventions for Anxiety During Dermatosurgery
50
Under Local Anesthesia.
Music is a safe, non-invasive and affordable adjunct to ofce
surgery with several studies based on the effect of Music on anxiety
levels in varying age groups proving benecial. The main aim of the
current study was to evaluate the effect of Music intervention on the
anxiety levels of patients going through dermato-surgery under local
Role of Yoga and Music Therapy in Surgical Conditions
anesthesia. Participants (n=150) undergoing dermato-surgery were
divided equally as control (no Music intervention) and experimental
group (Music intervention). The demographic data, physiological
parameters (blood pressure (BP), heart rate (HR) and respiratory rate
(RR)) at varying time intervals (baseline, 10 minutes after the
commencement of surgery and 20 minutes after the end of surgery)
along with the psychological parameter (anxiety) were recorded.
Participants listened to the Music of their interest during surgery. The
anxiety levels decreased signicantly within both the experimental and
control groups at varying time intervals (p<0.001). Within each group,
BP, HR, and RR at all time intervals were statistically signicant
(p<0.0001). On comparing the control and experimental groups, only
systolic BP at all time intervals was statistically signicant (p<0.05). A
negative correlation was observed in RR at 10 minutes with respect to
interest in Music and social avoidance; at 20 minutes only with interest
in Music (p<0.05)
A Study on the Effects of Music Therapy in Patients Posted For Upper
51
Gastrointestinal Endoscopy.
Apprehension of undergoing an interventional procedure such as
endoscopy makes the patient anxious and hampers their cooperation to
the procedure. Music Therapy has been documented to be useful in
improving tolerance of patients during procedure by regulating blood
pressure and oxygen saturation of blood thereby reducing the duration
of the procedure. The aim of this study was to document the effects of
MT in patients posted for upper Gastrointestinal Endoscopy. 60 subjects
of age 30 to 50 years posted for Upper GI endoscopy were divided into
two groups GI and GII of 30 each. Group I heard Music which they
selected through Headphones for 10 minutes and Group II calmly rested
before the diagnostic procedure. Physiological parameters (Blood
pressure, Heart rate, Respiratory rate) and Psychological parameters
(Spielberger's State Anxiety Inventory STAI) were assessed before and
after Music Therapy. The behavioural parameter (Cooperation level to
the procedure) was recorded after the endoscopy procedure.
Statistically signicant reduction in Systolic Blood Pressure, Respiratory
Rate was observed in the Group I in the post Music Therapy
54
Role of Yoga and Music Therapy in Surgical Conditions
interventional recording compared to pre Music Therapy readings.
Diastolic pressure did not show signicant change whereas Heart Rate
mildly raised. STAI scores markedly reduced in Group I indicating they
have calmed down. The cooperation level was substantially better in
Group I where 60% were highly cooperative compared to 20% of the
control group. We can conclude from our study results that Music
Therapy could be employed as a mode of Complementary & Alternate
Medicine (CAM) in alleviating the preoperative anxiety and Musical
preference of the subject has to be considered to obtain better responses.
Estimation of the Effects of Music Therapy on the Anxiety and
Patient's Perception During an Upper Gastrointestinal Endoscopy
52
Procedure: A Randomised Controlled Trial.
An upper gastrointestinal (GI) endoscopy procedure is an
invasive medical procedure that is used in diagnosis and treatment of
various intestinal disorders. Patients posted for upper GI endoscopy
procedures often experience signicant levels of pre-procedural fear,
anxiety and discomfort during the procedure which can negatively
affect cooperation levels during the procedure with the attending
doctor. A very few studies have explored the benecial effects of Music
Therapy in this regard and so our study was planned. A prospective
randomised controlled trial was conducted with a sample of 54 patients
who were enrolled for this study. They were randomly divided into two
groups - group 1 consisting of 27 patients, receiving a Music Therapy
intervention and group 2 consisting of 27 patients who served as a
control group. Group 1 received a receptive Music Therapy intervention
in the form vocal, relaxing, improvisational Music with patient
preferred chants for fteen minutes before and during the endoscopy
procedure. Group 2 did not receive a Music Therapy intervention. The
results indicated that the post intervention, state-anxiety levels was
signicantly lower in the Music Therapy group compared to the control
group with (p=0.001). Patients' cooperation levels during the procedure
with the attending doctor was signicantly higher in the Music Therapy
group than in the control group (p=0.001). Repeated Music Therapy
intervention is highly benecial in reducing state anxiety levels and
improving cooperation levels during the GI endoscopy procedure.
55
Role of Yoga and Music Therapy in Surgical Conditions
ROLE OF YOGA AND MUSIC
THERAPY IN MENTAL HEALTH
Chapter 8
Mental Health is maintaining balance at physical, mental,
spiritual, emotional & social aspects. Both Yoga & Music therapies plays
a vital role in maintain Mental health at optimum level as a
complementary medicine. Studies shows that & Yoga & Music
Therapies supports stress management, mental health, mindfulness,
healthy eating, weight loss and quality sleep. Yoga has been shown to
lower stress hormones in our bodies while simultaneously increasing
benecial brain chemicals like endorphins and GABA (gamma-
aminobutyric acid). It also helps t he induvial to do hea lthy
communication with others and thereby improving the Inter & Intra
personal relationships.
Keywords: Mental Health, Stress hormones, brain chemicals,
interpersonal relationships, mindfulness, sleep.
8.1. EVIDENCE BASED PRACTICE OF YOGA THERAPY
Finding Peace on A Psychiatric Ward with Yoga: Report on A Pilot
53
Anthropological Study in Pondicherry, India.
This article explores how patients and their families engage with
Yoga practice offered at a psychiatric ward of MGMC&RI in the Sri Balaji
Vidyapeeth in Pondicherry, India. The material collected during
participant observation-based research in form of detailed eld notes,
photography and video focused on patients' experiences, hopes and
limitations as well clinical staff's expectations and opinions on
providing Yoga as a therapeutic activity. Participants in the study found
Yoga to be a benecial practice through which they could release
tensions, relax and care for themselves. However, patients also felt that
they would not be able to continue with their practice once discharged
from the hospital. In addition to therapeutic interventions, then, there is
a burning need to introduce Yoga in patients as a long-term skilled
56
practice. Yoga could be brought out of the psychiatric ward into the
patients' day-to-day lives by encouraging families to practice together.
Furthermore, we suggest that using personalized videos could support
patients in maintaining regular practice and to enhance adherence.
Effect of Adjunct Yoga Therapy in Depressive Disorders: Findings
54
from a Randomized Controlled Study.
Depression causes signicant burden both to the individual and
to society, and its treatment by anti depr essants has various
disadvantages. There is preliminary evidence that adds on Yoga
Therapy improves depression by impacting the neurotransmitters
involved in the regulation of mood, motivation, and pleasure. Our study
aimed to nd the effect of adjunctive Yoga Therapy on outcome of
depression and comorbid anxiety. A randomized controlled study
involving patients with major depressive disorder (n = 80) were
allocated to two groups, one received standard therapy (antidepressants
and counselling) and the other received adjunct Yoga Therapy along
with standard therapy. Ratings of depression and anxiety were done
using Montgomery–Asberg Depression Rating Scale and Hospital
Anxiety and Depression Scale at baseline, 10th and 30th day. Clinical
Global Impression (CGI) Scale was applied at baseline and 30th day to
view the severity of illness and clinical improvement. By the 30th day,
individuals in the Yoga group had signicantly lower scores of
depression, anxiety, and CGI scores, in comparison to the control group.
The individuals in the Yoga group had a signicant fall in depression
scores and signicant clinical improvement, compared to the control
group, from baseline to 30th day and 10th to 30th day. In addition, the
individuals in the Yoga group had a signicant fall in anxiety scores
from baseline to 10th day. Anxiety starts to improve with short-term
Yoga sessions, while long-term Yoga Therapy is likely to be benecial in
the treatment of depression.
Effect of Adjuvant Yoga Therapy on Craving in Participants of an
55
Alcohol De-addiction Program: A Pilot Study.
This study was conducted to nd the effects of adjuvant Yoga
Therapy on craving in participants undergoing alcohol de-addiction
57
Role of Yoga and Music Therapy in Mental Health
program at a residential de-addiction center. Thirty male patients
undergoing a residential alcohol de-addiction program at the mother
care de-addiction center (MCF) in Puducherry were recruited as
subjects, were randomly divided into group I (15 subjects), who received
Yoga Therapy as per the Centre for Yoga Therapy, Education and
Research (CYTER) protocol, and group II (15 subjects), who received
only standard medical management, 6 days a week for 2 weeks along
wi t h their standard medical m a nagement. Alcohol C raving
Qu e stionnair e –Short Form–R e v ised was administ e red t o a l l
participants before and after study period. Data were analyzed using
Student's paired and unpaired t tests for the intra- and intergroup
comparisons, respectively. The intragroup comparison showed a
signicant reduction (p < 0.001) in the craving scale in group I, whereas
there was a statistically insignicant reduction in group II. The
intergroup comparisons showed a signicant reduction (p < 0.01) in the
craving scale between groups. The delta (change) and delta% values also
showed a statistically signicant reduction after 2 weeks of Yoga
therapy (p < 0.05 and p < 0.01, respectively). The ndings of this study
give us an indication of the positive role of adjuvant Yoga Therapy in
reducing craving, thus enhancing the management of alcohol
dependence. We recommend that Yoga Therapy could be made a
regular feature in such de-addiction clinics.
Effect of Adjuvant Yoga Therapy on Craving in Patients of Alcohol
56
Dependence Syndrome (ADS).
Alcohol consumption is widely gaining attention owing to its
potential for addiction and health implications. There is a high
pervasiveness of alcoholism in Pondicherry, Union Territory, India.
Alcohol misuse leads to numerous social, economic, and health
problems. Besides, motor vehicle accidents, dementia, depression,
homicide, and suicide are alcohol use disorders. A signicant block to
recovery from alcoholism is substantial alcohol craving and its chronic
relapsing nature. The study aimed to understand the brief and daily
adjuvant Yoga Therapy's effects on craving in patients undergoing an
alcohol de-addiction program at de-addiction clinic, department of
Psychiatry, Mahatma Gandhi Medical College & Research Institute
58
Role of Yoga and Music Therapy in Mental Health
(MGMC&RI) in Pondicherry. 71 male patients undergoing an alcohol
de-addiction program were recruited as subjects and randomly divided
into Group A, who received Yoga Therapy as per the CYTER protocol
for a minimum of 7 daily sessions of 1.5 hours each session, daily
counseling, warm-ups (Jathis) and standard medication, and Group B,
who only received standard medical management. Methods and
ma t e r i a l s: A l c o h ol C r a v i n g Q u e s t i o nnaire ( ACQ S F - R ) was
administered to all patients before and after the intervention. Statistical
analysis used: Statistical analysis was carried out using JASP-0.9.2.0
software. Wilcoxon test was performed for intragroup comparisons,
and the Mann-Whitney test was performed for intergroup comparison
to arrive at the p values. Results: The scores in the intergroup
comparisons were as follows: Craving-Compulsivity (p=0.0892),
Craving-Expectancy (p=0.0069), Craving-Purposefulness (p<0.0001),
Craving-Emotionality (p=0.0126), Craving-General craving (p<0.0001).
Whereas, in the intragroup comparisons, the scores were as follows:
Craving-Compulsivity (p<0.001), Craving-Expectancy (p<0.001),
Craving-Purposefulness (p<0.001), Craving-Emotionality (p<0.001),
Craving-General craving (p<0.001) Conclusion: The present study
supports previous studies on benets of Yoga and concludes that Yoga
Therapy helps in managing craving levels of patients of Alcohol
Dependence Syndrome (ADS).
Effect of Adjuvant Yoga Therapy on Quality of Life in the Participants
57
of an Alcohol De- Addiction Program.
ADS is not a static condition, described in absolute terms, but a
life-long illness. It is a phenomenon that depends on the interaction of
biological, social, and cultural factors, e.g., religion and the symbolic
value of alcohol in each culture, that determines how the person can
relate to the substance in the individual and social process of learning
how to consume alcohol, thereby affecting the quality of life in the
process. Aim: To study adjuvant Yoga Therapy's effects on Quality of
life (QOL) in patients undergoing alcohol de-addiction program at de-
addiction clinic, department of Psychiatry, Mahatma Gandhi Medical
College and Research Institute (MGMC&RI) in Pondicherry. 71 male
59
Role of Yoga and Music Therapy in Mental Health
patients undergoing an alcohol de-addiction program were recruited as
subjects and randomly divided into Group A, who received Yoga
Therapy as per the CYTER protocol along with standard medication for
daily sessions of up to 1.5 hours each, including daily counseling
sessions, for up to two weeks and Group B, who only received standard
medical management. Methods and materials: Administration of World
Health Organization (WHO) Quality of Life Bref version WHO 2004:
WHOQOL Bref to all patients before and after the intervention.
Statistical analysis used: JASP-0.9.2.0 software was used for Statistical
analysis. Wilcoxon test was performed for intragroup comparisons, and
the Mann-Whitney test was performed for intergroup comparison to
arrive at the p values. Results: The scores in the intergroup comparisons
were as follows: QOL- Physical health (p=0.0002), QOL- Psychological
health (p=0.0053), QOL- Social relationship (p=0.2321), QOL-
Environment (p=0.0212), QOL- Total Quality of life (p=0.0046). Whereas
in the intragroup comparisons, the scores were as follows: QOL-
Physical health (p<0.001), QOL- Psychological health (p<0.001), QOL-
Social relationship (p<0.05), QOL- Environment (p<0.001), QOL- Total
Quality of life (p<0.001). Conclusions: The present study supports
previous studies on the benets of Yoga and concludes that Yoga
Therapy helps in spiritually improving the Quality of life of patients
with Alcohol Dependence Syndrome (ADS).
Methodological Issues in Yoga Therapy Research Among Psychiatric
58
Patients.
Yoga Therapy has been widely accepted as part of the evidence-
based modern healthcare system. Although research publications are
growing in leaps and bounds, many methodological issues pose
stumbling blocks. In this narrative review, various issues like
standalone or add-on treatment, blinding, randomization, nature of
dependent and intervening variables, duration of intervention,
sustainability of effects, attrition bias, adherence and accuracy, all or
n o ne pe r fo rm a nc e , d iv e rs e sc ho o ls , he te r og en e it y an d
multidimensionality, assortment, permutations, and combinations of
different components, neglect of essential ingredients, mindfulness,
60
Role of Yoga and Music Therapy in Mental Health
catch-22 situation, credentials of the instructors, cultural factors,
naivety, multicentric studies, duration of collection of data, primary or
standard treatment, interdisciplinary research, statistical lapses,
qualitative research, biomedical research are discussed. There is a need
to frame guidelines for conducting Yoga Therapy research and
8.2. EVIDENCE BASED PRACTICE IN MUSIC THERAPY
Effect of Adjunctive Music Listening Intervention on Craving and
Withdrawal Symptoms in Patients with Alcohol Dependence: A Pilot
59
Study.
Music listening intervention seems to be a suitable treatment
option for patients with alcohol dependence. Researchers have
indicated the positive role of Music listening in addictive behavior
treatment. The effect of Music listening on the neurological processes by
effecting mesolimbic structural changes which is responsible for reward
processing has been explored. Listening to pleasurable Music is studied
to help the addicts to recover soon. However, there are not many studies
which conclusively indicate the benecial effects of listening to Music on
the recovery of the biological aspects of craving and withdrawal
symptoms in patients with alcoholic dependence. This pilot study was
conducted on 10 male patients with Alcoholic Dependency Syndrome
(ADS) in the age group of 18 to 64 with an aim to arrive at a suitable
research methodology and to detect any limitations relating to
recruitment of patients for the study, randomization, period of
intervention and compliance to interventional procedures to do a PhD
dissertation on the effect of Music listening on the craving and
withdrawal symptoms of patients with ADS. All the ten patients
registered for de-addiction treatment aged between with the diagnosis
of ADS and hospitalized received Music listening intervention in the
form of relaxation Music for two weeks on all the days for duration of
half an hour. Music used for the intervention was pre-recorded,
relaxing, non-lyrical, instrumental Music having soft timbre and slow
tempo with the properties of predictability and short melodic phrases.
Patients completed the assessment of Alcohol Craving Questionnaire –
Short Form - Revised (ACQ - SF - R), to assess the level of craving and
61
Role of Yoga and Music Therapy in Mental Health
Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised
(CIWA-Ar) to assess the level of withdrawal symptoms before the Music
listening intervention commenced, on the 7th day, on the 14th day when
the study was completed and when the patients came for follow-up after
one week of discharge. The results indicated that the methodology was
robust and the study proved to be feasible. Some limitations were
indicated regarding recruitment, follow ups and relapse situations. The
ndings also indicated that Music listening may support de-addictive
treatment by reducing the withdrawal and craving symptoms in
patients diagnosed with ADS. The presentation will detail on the results
of the pilot study.
Effect of Adjuvant Music Therapy on Anxiety, Depressive Symptoms,
and Cognitive Functions of Patients Receiving Electroconvulsive
60
Therapy: A Preliminary Study.
Electro convulsive Therapy (ECT) is one of the most commonly
used treatments for severe psychiatric disorders. Prior and during the
ECT treatment, patients may experience varied degrees of anxiety,
depressive symptoms, and cognitive impairments. Music Therapy (MT)
as an adjuvant psychiatric intervention has been successfully employed
in many elds of medicine and psychiatry but unexplored in ECT
indicative patient group. This study evaluated the effect of MT on
anxiety, depression, and cognitive functions of patients receiving ECT.
A sample of 29 patients who received ECT as per diagnostic and
treatment needs were randomized into cases (n = 14; receiving adjuvant
MT) and controls (n = 15; no MT intervention) after subjecting to set
criteria. Hospital Anxiety and Depression Scale (HADS) and Montreal
Cognitive Assessment (MoCA) were recorded a day before and 15 days
after scheduled four sessions of ECTs were over. Music Therapy
intervention in the form of Ahir Bhairav raga improvisation, imagery of
journey of good health, recovery, and relaxation was administered for
cases. Paired t tests and independent t tests were used for intragroup
and intergroup comparisons, respectively. Music Therapy intervention
resulted in within-the-group signicant reduction in anxiety,
depression, and improvement in cognitive functioning scores (p ≤ 0.05).
62
Role of Yoga and Music Therapy in Mental Health
Music Therapy group also recorded a signicant reduction in total
HADS composite scores during the period of intervention. An
intergroup comparison between the MT and the control groups resulted
in a signicant improvement in anxiety and total HADS scores. The
study results support that MT intervention can be used in clinical
settings as an adjunct with ECT, to control anxiety, depression, and
cognitive functions in mentally ill patients. More studies with larger
sample size are needed to conrm these ndings.
8.3. ONGOING STUDIES AT ISCM
63
Efcacy of Different Yoga Techniques on Negative and Cognitive
Symptoms of Schizophrenia – Comparative Study
The effect of adjunctive Music in the management of craving and
withdrawal symptoms in patients with alcohol dependence: a
randomized controlled trial and a post qualitative analysis.
1.
2.
Role of Yoga and Music Therapy in Mental Health
ROLE OF YOGA AND MUSIC
THERAPY IN CARDIOLOGY
Chapter 9
Cardiovascular diseases are the leading cause of deaths, in this
85% deaths are due to Myocardial infractions & Cerebrovascular
accidents. Yoga & Music Therapies play a vital role in maintain the
cardio autonomic balance and also one of key therapies in cardiac
rehabilitation. Mechanism of Yoga Therapy is like Valsalva manoeuvre
which positively impacts the baroreceptors there by it plays huge role in
normalising the blood pressures, most pranayama techniques helps to
decrease pre & after load in heart and helps maintain it in a healthy way.
Suryanamaskar, Asanas & Kriyas helps to reduce the fat by utilisation of
glucose deposited peripherally and this result in not only reducing the
weight and improve the glycemic prole and prevents the macro &
microvascular complications of Metabolic syndromes. Yoga & Music
Therapies are safe, cost- effective & cardio friendly adjuvant therapies
Keywords: Myocardial Infraction, Cerebrovascular accidents,
Valsalva manoeuvre, baroreceptors, pre & after load, micro &
macrovascular complications.
9.1. EVIDENCE BASED PRACTICE OF YOGA THERAPY
Randomized Controlled Trial of 12-Week Yoga Therapy as Lifestyle
Intervention in Patients of Essential Hypertension and Cardiac
61
Autonomic Function Tests.
In the Indian subcontinent, 118 million people are with
hypertension, and this gure is anticipated to double by 2025. Yoga has
been widely claimed to play a role in the prevention and management of
psychosomatic, stress-induced, and lifestyle disorders such as
hypertension. To study the effect of 12 weeks of Yoga Therapy as a
lifestyle intervention on cardiac autonomic functions in patients of
essential hypertension. Materials and Methods: Subjects with
hypertension from the Medicine Outpatient Department of the
64
Jawaharlal Institute of Postgraduate Medical Education and Research
were randomized into control and Yoga groups. The control group was
treated only with the allopathic medicines. The Yoga group was given
12 weeks of Yoga Therapy module designed by JIPMER Institute
Advanced Center for Yoga Therapy Education and Research along with
the routine medical treatment. The participants' blood pressure and
cardiac autonomic function were recorded before and after the 12 weeks
of the study period. No signicant change was observed in the body
weight (BW), body mass index (BMI), abdominal circumference, and
waist–hip ratio (WHR) in both the control and Yoga groups at the end of
the 12 week-study period. There was a signicant decrease in the resting
systolic pressure (SP), diastolic pressure (DP), rate pressure product
(RPP), and mean arterial pressure (MAP) in the Yoga group. In contrast,
there was no signicant change in the SP, DP, RPP, and MAP of the
control group. High frequency (HF) power, total spectral power, and HF
normalized units (nu) showed a signicant increase in the Yoga group.
Low frequency (LF) power, HF power, and LF (nu) showed a signicant
(p o 0.05) decrease in the Yoga group at the end of the 12-week Yoga
Therapy. Twelve weeks of Yoga Therapy reduced both the SP and DP in
the Yoga group. Furthermore, Yoga Therapy increased the heart rate
variability and vagal tone and decreased the sympathetic tone in the
subjects with hypertension. At the same time, it increased both the
parasympathetic and sympathetic reactivity.
9.2. EVIDENCE BASED PRACTICE IN MUSIC THERAPY
A Comparative Study on The Effect of Music Therapy Alone and A
Combinat ion of Music and Yoga T herapies on The Psyc ho
Phys i o logi c a l P a r amet e r s o f C a rdia c P atie n t s P o s ted f or
62
Angiography.
Patients undergoing cardiac catheterization and coronary
angiography often experience high levels of anxiety and physiological
disturbances. Music Therapy and Music interventions have been found
to be effective in bringing down the anxiety and reducing the
physiological disturbances for these patients. However, the efcacy of
combination of Music and Yoga therapies for preprocedural anxiety and
65
Role of Yoga and Music Therapy in Cardiology
physiological disturbances needs to be studied. We aimed in this study
to compare the effect of Music Therapy with the combination of Music
and Yoga Therapies to impact the psycho-physiological responses like
anxiety, blood pressure, pulse rate and respiratory rate of patients who
were posted for coronary angiography. A total of 45 patients who were
posted for coronary angiography were included in the study and
randomly divided into three groups. Music therapy group(n=16)
received Music listening intervention in the form listening to pre-
recorded, patient-preferred, relaxing raga improvisational Music for 15
minutes 1) on the previous day of angiography and 2) 15 minutes before
being taken to the catheterization lab on the day of the angiography. The
combination of Music and the Yoga group received both Music Therapy
and Yoga Therapy in the form of pranava pranayama together for 15
minutes. The control group received only the standard medical
treatment. The state of anxiety was measured by a ve-point single item
Likert scale and the physiological measures such as systolic blood
pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR) and
respiratory rate (RR) were also recorded for the study. Both Music
Therapy alone and the combination of Music and Yoga Therapies
resulted in within the group signicant reduction in anxiety and
respiratory rate and Music Therapy group recorded additionally
signicant reduction in SBP, DBP and PR scores during the period of
intervention. Our ndings indicate that Music Therapy alone can bring
down the anxiety levels and reduce the physiological disturbances of
patients posted for angiography. Also, combination of Music and Yoga
Therapies can bring down the anxiety levels and improve the deep
breathing pattern for these patients posted for angiography. More
studies are needed to conrm these ndings.
9.3. ONGOING STUDIES AT ISCM
66
A comparative study on the effect of live Music Therapy and
Music medicine on cardiac surgery patients
1.
Role of Yoga and Music Therapy in Cardiology
ROLE OF YOGA AND MUSIC
THERAPY IN DENTISTRY
Chapter 10
Dental procedures often cause discomfort and pain which in turn
increases anxiety in patients. This reduces compliance of treatment and
post treatment visits. Musical interventions help in reducing anxiety and
pain in patients during dental procedures. Actions along musical songs
are being used to teach children with special needs on oral hygiene and
learning to brush their teeth. This also inuences these children to
improve eye hand coordination. In prosthodontics, patients who come
for months of treatment often deal with depressive symptoms. Music
plays a positive role in improving their compliance towards the
procedures. Yoga Therapy has an anti-inammatory and anti-anxiety
effect which helps people undergo minor dental procedures by reducing
their anxiety and also quickens wound healing. Various Yoga
techniques improve the anti-oxidant status, enhance immune function
and reduce chronic gingival inammation. By facilitating enhanced
learning ability, Yoga enables children with special needs to maintain
better oral hygiene.
Keywords: Oral Medicine, Dental Hygiene, oxidative stress,
inammation, healing
10.1. Evidence Based practice in Yoga Therapy
Yoga Therapy as an Adjunct to Traditional Tooth Brushing Training
63
Methods in Children with Autism Spectrum Disorder.
The Study was conducted to evaluate if Yoga could be an adjunct
to regular training methods in training brushing skill to children with
autism spectrum disorder (ASD). Methods: Seventy-two children with
ASD aged 7-15 years were selected and divided into two groups (N = 36).
Children in Group I received visual pedagogy and video modelling and
children in Group II received visual pedagogy and video modelling with
Yoga. Plaque and gingival indices (PI and GI) were recorded at baseline
67
and at the end of rst, second, third, and sixth month. The scores were
summarized as mean and standard deviation and inter-group
comparison was done using independent t-test. Results: Inter-group
comparison of mean plaque and gingival indices scores were
statistically signicant at second month (P = .039 for PI and P = .009 for
GI). The scores were statistically signicant even at third month (P = .001
for PI and P = .002 for GI) and sixth month (P = .001 PI and GI), with
children in Group II demonstrating better oral hygiene. Yoga training
can be used as an adjunct to enhance tooth brushing learning
capabilities of children with ASD in addition to visual modeling and
pedagogy.
Integrated Yoga Therapy for Teaching Tooth Brushing Skills to
Children with Autism Spectrum Disorder: A Qualitative Study of
64
Parents' Perceptions.
Children with autism spectrum disorder (ASD) exhibit poor oral
health due to lack of manual dexterity. Regular training methods such as
visual pedagogy and video modelling (VM) for developing the skill of
toothbrushing do not address the core decits which facilitate their
effective and quick learning. Hence, there arises the need of an
integrated therapy which can complement these regular training
techniques. This study aimed to evaluate whether Yoga can
complement the regular training methods in teaching the brushing skill
to children with ASD. Two groups of 36 children with ASD aged 7–15
years were imparted visual pedagogy and VM in Group I and additional
Yoga in Group II. Assessment of toothbrushing skill was done by
parents and teachers independently using the perception and
assessment forms, respectively. By the end of 6 months, higher
percentage of parents of children in Group II observed improvements in
their child's brushing skill as compared to parents of children in Group I.
Based on the teachers' observation, there was a statistically signicant
difference in the mean number of days the children watched the video
completely (p = 0.001), with children in Group II watching the video for
more number of days. The results of the current study may explain that
Yoga has a positive and additive role along with the regular training
methods for toothbrushing in children with ASD.
68
Role of Yoga and Music Therapy in Dentistry
Effect of Pranayama Techniques with Marmanasthanam Kriya as
Yogic Relaxation on Biopsychosocial Parameters Prior to Endodontic
65
Therapy: A Cross Sectional Study.
The root canal treatment is one of the common dental or
endodontic therapies associated with high levels of patient anxiety.
Yoga therapy (YT) is reported in medical literature as an effective
modality in bringing down anxiety in clinical scenarios; however, the
reports of the same for dental settings are fewer. The current study
aimed to evaluate the effect of YT on biopsychosocial parameters in
patients undergoing root canal therapy. A cross sectional study was
conducted on 50 participants who underwent dental root canal therapy.
The sample was divided into two groups: Yoga group (Group A; n = 25)
who received YT and control group (Group B; n = 25) who were
subjected to self-relaxation during dental procedure. The state of anxiety
was measured b y a 5-poi nt single-item Likert scal e and the
cardiovascular (CV) parameters (systolic blood pressure [SBP], diastolic
blood pressure [DBP], heart rate [HR]) and CV indices (pulse pressure
[PP], mean arterial pressure [MAP], rate-pressure product [RPP], and
double product [DoP]) were derived and compared between both the
groups. The intergroup comparison showed statistically signicant
differences in anxiety score (P < 0.001), SBP (P < 0.001), MAP (P < 0.001),
RPP (P < 0.001), DoP (P < 0.001), HR (P < 0.029), DBP (P < 0.003), and PP
(P < 0.116). A signicant reduction was recorded in terms of anxiety and
primary and derived CV parameters in the Yoga group. The YT can be
adopted as an interventional tool for anxiety management in patients
indicated for dental root canal therapy. Evaluation of Music as
interventional Therapy in promoting oral health in children with autism
spectrum disorder- a randomised clinical trial.
10.2. ONGOING STUDIES
69
Evaluation of Music as Interventional Therapy in promoting oral
health in children with autism spectrum disorder- A Randomized
Control Trial
Effects of Pranayama on anxiety and perception of pain in patients
undergoing surgical extraction of mandibular impacted third
molar
1.
2.
Role of Yoga and Music Therapy in Dentistry
ROLE OF YOGA AND MUSIC
THERAPY IN ONCOLOGY
Chapter 11
70
The Media worldwide is reporting the rise of the cases of cancer
and the 5-year global cancer prevalence was estimated to be 28.8 million
in 2008 with half the burden in areas of very high human development
comprising only one-sixth of the world's population. Yoga and music
therapy may help people with cancer to enhance their wellbeing both
mentally and physically as they reduce many side effects of both the
disease and its myriad treatments. Typically patients of cancer undergo
extensive chemotherapy with or without surgery, followed often by
radiation. After such intensive treatment schedules provided by
modern medicine patients are physically exhausted. Their bodies have
be en subjec ted to a w ide array of chemic al poisons , w hich
indiscriminately attack all generative cells resulting in physical
exhaustion. However, the toll on the physical body is only one side of the
coin as many enter various degrees of depression after completion of
inte n siv e t rea t m ent s . L o n g t e rm c hemo t her a p y r e sul t s i n
chemotherapy-induced cognitive dysfunction or “chemo brain” that
may be due to restriction in blood supply to the brain, manifesting as
depression, mental confusion, inability to focus and loss of short-term
memory. Music therapy improves emotional expression, acceptance,
and cooperation during treatment, thus reducing pain perception and
discomfort. A study reported even reduced emesis after chemotherapy.
The patients have an existential crisis when diagnosed with cancer and
the negative effects of anger, fear, sadness, embarrassment, shame, and
guilt which manifests in them. Music therapy plays a supportive role
that brings about reduction with negative emotions. Participating in
musical activities provides a sense of control, improving their ability to
communicate and express themselves. It has been found to be extremely
useful in rehabilitation of cancer survivors as well. Studies have also
71
reported effectiveness of Yoga, meditation and mindfulness as a
rehabilitative and palliative therapy in various types of cancer.
Keywords: Quality of life, stress, physical & mental support, pain,
anxiety, oncology
11.1 EVIDENCE BASED PRACTICE OF YOGA THERAPY
A Novel Rejuvenation Program for Cancer Patients at Kaivalyadhama,
66
India.
The modern intensive treatment for cancer leaves the patients
physically and mentally exhausted by the end of it. There is great
potential for Yoga, the original mind–body medicine, in such a situation
as it conjointly emphasizes body, mind, and spirit, which may be
particularly useful for enhancing patients' social and spiritual wellbeing.
Some studies have reported the effectiveness of Yoga, meditation, and
mindfulness as a rehabilitative and palliative therapy in various types of
cancer. With the above background in mind, we created a 3- week
residential program for cancer patients to empower them in their
journey, “back to health.” The curriculum was geared specially for those
who had undergone chemotherapy and/or radiation. The program
utilized the sister life sciences of Yoga and Ayurveda with a healthy dose
of self-education to assist patients in their recovery from the devastation
of cancer and its modern treatment. The modes ofreintegration used in
this program were designed to specially address the physical, mental,
and psychic (spiritual) needs of the participants. The curriculum
included various asanas, kriyas, pranayama, mudras, and bandha, as
well as chanting. Ayurvedic treatment based on panchkarma science
was designed and applied according to each patient's disposition. An
educational component was included to inform patients of potential
carcinogenic factors in their life and to change their mindset and
attit udes from vict imhood to self-empowerment. In order to
scientically validate the program, physiological, biochemical,
psychological, and Ayurvedic assessment of tridoshas was carried out.
Our special Cancer Rehabilitation Yoga program is expected to have
several benecial effects for those recovering from the aftermath of anti-
Role of Yoga and Music Therapy in Oncology
72
cancer therapies even at 3-month follow-up. Subjective observations so
far reveal that the program led to overall empowerment of the
participants.
Effects of an Intensive 3 - Week Yoga Retreat on Sense of Well Being in
67
Cancer Survivors.
Introduction: Cancer survivors are often severely affected
physically, mentally and emotionally after passing through modern
medical treatments. As Yoga conjointly emphasizes body-mind-spirit
thus enhancing physical, mental, social and spiritual well-being,
Kaivalyadhama Yoga Institute in Lonavla, India initiated a three-week
residential intensive retreat for cancer survivors to empower them in
their journey, “back to health and wellbeing”. The aims and objectives of
the present study is to evaluate the effects of this residential program for
cancer patients on their psychological wellbeing, and determine if or not
these effects were sustained at follow up after three months. The modes
of reintegration used in this program were designed to specially address
the multidimensional needs of cancer survivors and incorporated
various Yogic techniques including Asana, Pranayama, Mudra, Bandha,
relaxation, silent meditation and chanting as well as education given in a
group setting. Three standard psychological evaluation tools were used:
WHO Quality of Life-BREF (WHOQOLBREF), Prole of Mood States
(POMS) and Hospital Anxiety and Depression Score (HADS). These
were administered on rst (D1) and last days (D20) of the program and
repeated at follow up three months later (3M). Pre and post retreat (D1-
D20) data was analysed for 26 subjects using Students paired t-test while
RMANOVA was used tocompare pre-post retreat and follow up data of
19 subjects. Signiant improvements were seen in all domains of QOL
with signicant reduction in all negative psychological states and
improvement in vigour and total POMS score. There was Signiant
decrease in anxiety, depression and overall rating on HADS with
marked decrease in anxiety compared to depression. In pre-post and
follow-up (D1, D20 and 3M) comparisons for 19 subjects, all components
showed Signiant changes except social QOL. Though some of the
Role of Yoga and Music Therapy in Oncology
benets of the retreat are lost during follow up, none of the values
reached level of signicant except in anger subscale and even that was
still lower than at start of retreat. The present study offers evidence of the
benecial psychological changes occurring after a three-week intensive
retreat for cancer survivors. This is in tune with previous reports. One of
the biggest benets may actually lie in the empowerment of the
participants as they are given tools, which make them feel in control of
their health and wellbeing. Changes are maintained in those who
continue the practices even at three months follow up but are lost slowly
in those who discontinued them. Even then, all parameters at three
months follow up are still positive as compared to pre-retreat values.
More rigorous and randomized controlled studies are required to
validate these results in the future.
68
Enhancing Quality of Life in Cancer Survivors Through Yoga.
This is a small introduction to our 3-week residential program for
cancer patients to empower them in their journey, “back to health”. The
curriculum was geared specically for those who had undergone
chemotherapy and/or radiation, and the program utilized the life
sciences of Yoga with a healthy dose of self-education to assist patients in
their recovery from the devastation of cancer and its modern treatment.
The rst of these programs was held in 2013 at Kaivalyadhama Yoga
Institute in Lonavla, India. The biggest benet of the program lies in the
empowerment of the participants. They are given the yogic tools, which
make them feel in control of their health and wellbeing. They arrive with
long drawn faces, often with a lot of pain and suffering. In the 3 weeks of
the program their faces slowly light up, the moods change and their
outlook on life becomes optimistic. They leave as different people with
new, health enhancing attitudes and often new values. The advantage of
such program is that in most cases it is very effective and with proper
training of Yoga teachers it can be conducted in any medical facility,
which has an in-patient's department. The program is completely
transferable and adaptable to any setting providing the patients stay at
the facility continuously for 3 weeks, have common space in which the
73
Role of Yoga and Music Therapy in Oncology
group can perform group activities 4 – 6 hrs per day. It is our hope that
soon such healing programs will be available at every facility dealing
with cancer patients.
11.2 EVIDENCE BASED PRACTICE OF MUSIC THERAPY
Effect of the Indian Raga Bageshri on the Body Temperature of Cancer
69
Patients on Chemotherapy.
It is well known that hyperthermia is one of the adverse reactions
produced by chemotherapy in cancer patients. We aimed to see the
benet of Indian Music i.e. listening to raga Bageshri in cancer patients
undergoing chemotherapy. In this randomized, single blinded study of
24 patients divided into two groups, the patients of Music group listened
to raga bageshri through a compact disc player for three days twice
daily. Temperature measurements pre and post chemotherapy were
observed by a blinded observer. The temperature changes were
subjected to suitable statistical analyses and noted. The patients of both
the groups were similar with respect to marital status, education, source
of health information, stage of illness, psychological support and site of
cancer. All patients satised the inclusion criteria and no patient was
excluded from the study. There was a signicant decrease in the body
temperature of patients subjected to post- chemotherapy Music
intervention 40 after minutes of Music exposure. There were no side
effects. To conclude, listening to Music, i.e. raga bageshri decreased
body temperature signicantly in patients with cancer undergoing
chemo therapy.
74
Role of Yoga and Music Therapy in Oncology
ROLE OF YOGA AND MUSIC THERAPY
IN COMMUNITY SETTINGS
Chapter 12
A place where lots of misunderstandings about Yoga & Music
Therapies. Place where diagnosis, treatment is not up to the mark. The
aim of Yoga & Music Therapies is creating more awareness in the
population how it can be tackled in cost effective manner. Communities
are rich in resources, and pooling together collective skills makes us
stronger together. It plays important role in substance abuse by
stimulating the prefrontal cortex the part of the brain responsible for self-
control. Healthy environmental group can be created by these therapies
to promote support and healing in the community
Keywo rds: Community, Healthy environment , supp ort,
substance abuse, self- control, resources
12.1. EVIDENCE BASED PRACTICE IN YOGA THERAPY
Immediate Effect of Chandra and Surya [nadi Pranayamas on
Cardiovascular Parameters and Reaction Time in A Geriatric
70
Population.
Previous studies have reported differential physiological and
psychological effects of exclusive right and left nostril breathing.
Though potential health benets have been postulated, further clinical
research is required to prove immediate and sustained efcacy of these
techniques. This study evaluated immediate effects of exclusive right
(SNP) and left (CNP) nostril breathing on cardiovascular (CV)
parameters and reaction time (RT) in a geriatric population. 26 subjects
attending regular Yoga sessions at a senior citizen hospice, were
recruited for this self-controlled study. They were instructed to sit in any
comfortable posture and relax for 5 min before taking the pre-
intervention recordings of Heart rate (HR), blood pressure (BP),
auditory and visual RT (ART and VRT respectively). They then
performed the selected technique and parameters were recorded
75
immediately after performance of 9 rounds of either SNP or CNP. The
entire sequence of recordings was randomised to avoid any bias. Intra
and inter group statistical analysis was carried out using Student's
paired t test for data that passed normality testing and Wilcoxon
matched-pairs signed-ranks test applied for the others. Overall intra-
group comparison of pre-post data and inter-group Δ % comparisons
showed statistically signicant (p < 0.05) differences for all parameters.
There was an overall reduction in HR and BP based parameters
following both SNP and CNP. However, inter-group Δ % comparisons
revealed a signicantly greater reduction after CNP for all parameters.
Inter-group comparisons revealed highly signicant decreases (p <
0.001) in VRT and ART after SNP. In conclusion, our study sheds new
light on the physiological changes occurring after SNP and CNP in a
geriatric population. While both techniques reduce HR and BP, CNP
does it more signicantly. There is shortening of RT following SNP and
this may be attributed to enhance sensory motor function that is of great
signicance in the elderly. We suggest that Yoga should be part of the
heath care facilities for the elderly as it can enhance their quality of life
and improve their overall health status.
Single Session of Integrated “Silver Yoga” Program Improves
71
Cardiovascular Parameters in Senior Citizens.
This Pilot Study was carried out to determine cardiovascular
effects of a single session of an integrated “silver Yoga” program in
senior citizens of Serene Pelican Township, Pondicherry. Heart rate
(HR) and blood pressure (BP) measurements were recorded in 124
senior citizens (75 female, 49 male) with mean age of 67.19 ± 10.61 year
who attended an integrated “Silver Yoga” program at Centre for Yoga
Therapy, Education and Research from August to October 2014.
Participants practiced the protocol that was specially designed for
senior citizens, keeping in mind their health status and physical
limitations.This included simple warm-ups (jathis), breath body
movement coordination practices (kriyas), static stretching postures
(asanas), breathing techniques (pranayamas), relaxation and simple
chanting. Non-invasive BP apparatus was used to record the HR,
76
Role of Yoga and Music Therapy in Community Settings
systolic (SP) and diastolic pressure (DP) before and after the 60 min
sessions. Pulse pressure (PP), mean pressure (MP), rate-pressure
product (RPP) and double product (DoP) indices were derived from the
recorded parameters. Student's paired t-test was used to compare data
that passed normality testing by Kolmogorov–Smirnov Test and
Wilcoxon matched-pairs signed-ranks test for those that did not. P < 0.05
were accepted as indicating signicant differences for pre-post
comparisons. Results: All parameters witnessed a reduction following
the single session. This was statistically more signicant (P < 0. 0001) in
HR, RPP and DoP while it was also signicant (P < 0.01 and P < 0.05) in
SP and PP, respectively. The decrease in MP just missed signicance (P =
0.054) while it was not signicant in DP. Conclusion: There is a healthy
reduction in HR, BP and derived cardiovascular indices following a
single Yoga session in geriatric subjects. These changes may be
attributed to enhanced harmony of cardiac autonomic function as a
result of coordinated breath-body work and mind-body relaxation due
to an integrated “Silver Yoga” program.
Effects of A Single Session of Yogic Relaxation on Cardiovascular
72
Parameters in A Transgender Population.
This pilot study was done to determine effects of a single session
of yogic relaxation on cardiovascular parameters in a transgender
population. Heart rate (HR) and blood pressure (BP) measurements
were recorded in 106 transgender participants (mean age of 23.86 ± 7.87
y) at ending a yogic relaxation program at CYTER, MGMCRI.
Participants practised a series of techniques consisting of quiet sitting,
om chanting, mukhabhastrika, nadishuddhi, brahma mudra, pranava
pranayama in sitting posture and avitri pranayama in shavasana. HR,
systolic (SP) and diastolic pressure (DP) were recorded before and after
the 60-minute session using non-invasive blood pressure (NIBP)
apparatus. Pulse pressure (PP), mean pressure (MP), rate-pressure
product (RPP) and double product (DoP) indices were derived from
recorded parameters. Student's paired t test was used to compare data
that passed normality testing and Wilcoxon matched pairs signed-ranks
test for others. P values less than 0.05 were accepted as indicating
77
Role of Yoga and Music Therapy in Community Settings
signicant differences for pre-post comparisons. All recorded
cardiovascular parameters witnessed a reduction following the session.
This was statistically more signicant (p < 0. 0001) in HR, MP, RPP and
DoP and signicant (p = 0.002) in SP. There is a healthy reduction in HR,
BP and derived cardiovascular indices following a single yogic
relaxation session in a transgender population. These changes may be
attributed to enhanced harmony of cardiac autonomic function as a
result of mind-body relaxation program. It is suggested that an open and
non-hostile environment is conducive for obtaining such a state of
psychosomatic relaxation and that such opportunities for transgender
participants should be created in all healthcare facilities.
Effect of a 12 ‐ Week Yoga Therapy Program on Mental Health Status
73
in Elderly Women Inmates of a Hospice.
This study was undertaken to evaluate the effectiveness of Yoga
on the mental health status of elderly women inmates residing in a
hospice in Puducherry. Forty elderly women were randomly divided
into Yoga and wait-listed control group. A Yoga Therapy program of 60
min was given twice a week for 12 weeks. This protocol was specially
designed for senior citizens, keeping in mind their health status and
physical limitations that included simple warm-up and breath–body
movement coordination practices (jathis and kriyas), static stretching
postures (asanas), breathing techniques (pranayamas), and relaxation.
Hamilton anxiety scale for measuring anxiety, Hamilton rating scale for
depression, and Rosenberg self-esteem scale to measure self-esteem
were administered to both groups before and after the 12-week study
period. Data were assessed for normality, and appropriate parametric
and nonparametric statistical methods were applied for intra- and inter-
group comparisons. Overall, intra‐ and inter‐group comparison of
prepost data showed statistically signicant (P < 0.001) differences for all
three parameters. There was an overall improvement in the scores
indicating decreased levels of depression and anxiety coupled with an
increase in the level of self-esteem after the Yoga Therapy program. The
inuence of Yoga in the reduction of depression and anxiety scores and
improvement in self‐esteem scores in elderly women subjects is evident
78
Role of Yoga and Music Therapy in Community Settings
from this study. As reported in earlier studies, this may be attributed to
changes in central neurotransmitters such as gamma-aminobutyric-acid
coupled with increased parasympathetic tone and decreased sympatho-
adrenal activity. It is recommended that Yoga should be a part of health-
care facilities for elderly as it can enhance the quality of life by improving
their overall mental health status. It could provide a healthy and positive
alternative from depressing negative thoughts, and give them a sense of
purpose and hope.
A 12-Week “Silver Yoga” Program Enhances Lung Function in Elderly
74
Women Residents of a Hospice.
“Silver Yoga” program has been devised by Centre for Yoga
Therapy, Education and Research (CYTER) of Sri Balaji Vidyapeeth,
Pondicherry. Participants practiced the protocol that was specially
designed for senior citizens, keeping in mind their health status and
physical limitations. The present study was planned to evaluate possible
changes in lung functioning assessed through Pulmonary Function Test
(PFT) in senior citizens following 12 weeks of an integrated Silver Yoga
programme. In this comparative pre-post study, 40 elderly women
inmates of the hospice were randomised into two groups of 20 each.
Yoga group (Group A) received training in the integrated Silver Yoga
programme while control group (Group B) did not receive any Yoga
training. Both the groups however participated in all the routine
activities of the Hospice. Anthropometric data, respiratory rate and lung
function parameters were recorded before and after the 12-week study
period. Intra-group and inter-group comparisons of pre and post study
data were done using Student's paired and unpaired t-test respectively.
A p-value less than 0.05 was considered to indicate signicant
differences between means. After the 12 weeks of Silver Yoga, both
weight and BMI showed signicant reduction (p<0.05) in Group A,
whereas there was an insignicant increase in Group B. Lung function
tests such as FVC, FEV1, PEFR, and FIVC increased signicantly
(p<0.05) after Yoga training, whereas FVC decreased signicantly
(p<0.05) in the Group B. Group A showed signicant decrease in both
RespiratoryRate (RR) (p<0.01) and Lung Age (p<0.001) while FEF25-75
79
Role of Yoga and Music Therapy in Community Settings
increased signicantly in both groups. Results of this pilot study give
preliminary evidence that incorporation of Yoga as part of senior's
lifestyle can help in promoting health thereby, modifying age related
disorders. It is however, limited by the smaller sample size, also limited
to a single centre. Further multi-centric studies with larger populations
can deepen understanding of intrinsic mechanisms by which these
changes are occurring in Silver Yoga.
12.2. EVIDENCE BASED PRACTICE IN MUSIC THERAPY
Live Music Therapy in Waiting Area of Intensive Care Units: A Novel
75
Concept for Betterment of Close Relatives of ICU Patients.
Family members of ICU patients experience high levels of stress
and anxiety. We explored a novel concept of live Music Therapy for
relatives of ICU patients. Weekly 1-hour sessions of live Music Therapy
consisting of devotional songs and prayers were performed in waiting
area of ICU in a tertiary care hospital. Responses of 100 rst degree
relati ves of ICU patients wer e documented using an 8-it em
questionnaire. 69% of the subjects rated live Music Therapy sessions as
“excellent”; 50% of the subjects reported that they felt “excellent” after a
single session. Such sessions were reported as a felt need by 77% of the
subjects; 92% of the subjects reported that there were high chances that
they would recommend such sessions in the hospital in future. In our
study, we found our concept to be feasible, acceptable, and highly
appreciated as well as encouraged rst degree relatives of ICU patients.
Music Therapy as Group Singing Improves Geriatric Depression
Scale Score and Loneliness in Institutionalized Geriatric Adults with
76
Mild depression: A Randomized Controlled Study.
This study was conducted with an aim to evaluate the effect of
group Music Therapy in the form of group singing, led by a Music
Therapist, on depressive symptoms and loneliness in institutionalized
geriatric individuals having mild depression. The study was conducted
as a randomized control trial at St.Mary's Home for the aged,
Cuddalore, Tamil Nadu. The study was conducted as a randomized
control trial. The experiment group (n = 40) received daily Music
Therapy in the form of group singing lead by a Music Therapist for 3
80
Role of Yoga and Music Therapy in Community Settings
weeks. The control group (n = 40) did not receive any specic
intervention. Baseline and weekly Geriatric Depression Scale-Short
Form (GDS-SF) and UCLA Loneliness Scale scores were recorded in
both groups. Measures of Central Tendency, Mann–Whitney U-test, and
Wilcoxon W value. Statistically signicant improvement (P < 0.05) was
seen in both the scores at the end of 3 weeks in the experiment group as
compared to the control group. On intra group comparison, both scores
showed statistically signicant improvement (P < 0.001) in the
experiment group at the end of 3 weeks as compared to baseline but not
in the control group. No adverse event was reported. Group singing
signicantly improves GDS-SF scores and loneliness in institutionalized
geriatric adults having mild depression at the end of 3 weeks. Further
research in this area is desirable which could contribute to the
well-being of the aged population.
12.3. ONGOING STUDIES
81
Exploring the effect of Music Therapy on life skills, among
adolescent students.
Effect of Yoga Therapy on Neuromuscular and Cardiovascular
Functions and Reduction of Autism Severity in Children with
Autism Spectrum Disorder: A Randomized Controlled Trial
Effect of Yoga Therapy on psychological Variables among care
givers of special children: A Randomized Control Trial
1.
2.
3.
Role of Yoga and Music Therapy in Community Settings
COPYRIGHTS OBTAINED
BY ISCM
Chapter 13
1. SBV's model of Music Therapy patient care services
2. Standard operating protocol (SOP) for Music Therapy services
procedural support
3. SBV's model of enculturated approach to Music Therapy
practice
4. Clinical Communication in Tamil Vernacular Language for
Music Therapists in International Phonetic Alphabets (IDA)
5. Center for Music Therapy Education and Research Model of
Song Writing Technique with patients who have had an
abortion.
6. “Indian Classical Music and Guided Imagery-assisted
Relaxation as Procedural Support for Invasive Medical
Procedures”
7. Therapeutic Secular Chanting for use in Operation Theatres in
SBV
8. SBV Model of Credit based Medical Music Therapy Internship
Program
9. SBV model of Development and Implementation of a
curriculum of M.Sc. Medical Music Therapy
10. MEETS –“Musically Express your Emotions & Thoughts for
Success”
11. Incorporation of Yoga Therapy Education in Nursing
Curriculum – Sri Balaji Vidyapeeth (SBV) Model
82
12. Choice Based Credit Courses in Yoga Therapy
13. CYTER Yoga Therapy Educational Videos
14. Administrative policy statement and SBV Policy on
salutogenesis implementation and SBV Standard Operating
procedure for Salutogenesis
15. “Divyanga Yoga”: The CYTER Model
16. “Salutogenic Approach of Yoga for the Third Gender: The
CYTER model
17. Standard Operating Procedure for Application of Yoga in
Primary Health Care (Voyaging of Yoga Basics to Grass Roots –
VYBGR)
18. Integrating Yoga in Health Professions Education
19. MYFSC - Making Yoga Fun for Special Children
20. Purnam : CYTER Model of Salutogenic Communication of
Wholesomeness in a Clinical Setting
21. Yoga ChikitsaAnukrama : CYTER Model
22. “SILVER YOGA”: The CYTER Model
23. Promoting wellness through focus on salutogenesis - an SBV
best practice
SUBMITTED
01. KPJ Musical Cardence for Toddlers
02. KPJ Symphonic Drama
03. KPJ Rhythmic Dental Anxiety Song
83
Copyrights Obtained by ISCM
84
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2. Dinesh T, Gaur G S, Sharma V K, Velkumary S, Bhavanani AB.
Effect of 12 weeks of kapalabhati pranayama training on cardio-
respiratory parameters in young, healthy volunteers of JIPMER
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12. Sharma VK, RajaJeyakumar M, Velkumary S, Subramanian SK,
Bhavanani AB, Madanmohan T, Sahai A, Dinesh T. Effect of Fast
and Slow Pranayama Practice on Cognitive Functions in
Healthy Volunteers. Journal of Clinical and Diagnostic
Research 2014; 8 (1): 10-13
13. Bhavanani AB, Madanmohan T, Ramanathan M, Srinivasan
AR. Yoga improves psychophysical health of nursing students.
Souvenir of the National Yoga Week 2014. MDNIY, New Delhi,
Feb 2014. Pg 65-70.
References
86
14. Dinesh T, Gaur GS, Sharma VK, Bhavanani AB, Rajajeyakumar
M, Sunder AS. Effect of slow and fast pranayama training on
handgrip strength and endurance in healthy volunteers. journal
of Clinical and Diagnostic Research 2014; 8 (5): BC01-03
15. Bhavanani AB, Ramanathan M, Dayanidy G, Madanmohan T
Renuka K. A comparative study of the differential effects of
short-term asana and pranayama training on reaction time. Ann
Med Health Sci Res. 2017; 7: 80-83
16. Dayanidy G,Bhavanani AB,Ramanathan M. Enhancing
awareness of Yoga in health professions education students
through a single interactive session: A pretest-post-test study.
Jo urnal of Educat ion Techno logy in Heal th Scienc es,
2018;5(1):20-24
17. Sharma VK, Dinesh T, Rajajeyakumar M, Grrishma B,
Bhavanani AB. Impact of fast and slow pranayam on cardio
vascular autonomic function among healthy young volunteers:
randomized controlled study. alternIntegr Med 2018; 7: 1000265
18. Ramanathan M, Bhavanani AB. Immediate effect of pranava
pranayama on oxygen saturation and heart rate in healthy
volunteers: A single-blinded, randomized controlled trial. Med
J DY Patil Vidyapeeth [Epub ahead of print] [cited 2023 Feb 13].
19. Sobana R, Jaiganesh K, Bharathi P. A study on the relationship
of Music Therapy and personality traits of neuroticism and
agreeableness Nat.J.Res.Com.Med 2013;2(1), 1 – 78
20. Sobana R, Jaiganesh K, Bharathi P. A survey of the musical
preferences of young adolescents newly admitted to The
medical school Int.J.Pharm.Bio.Sci.2013 (7) 4 (3); (B) 654-658
21. Bhavanani AB, Ramanathan M, MadanmohanT . Immediate
cardiovascular effects of a single Yoga session in different
conditions. Altern Integ Med 2013; 2: 144.
22. Bhavanani AB, Jayasettiaseelon E, Sanjay Z, Madanmohan T.
Immediate effect of chandranadipranayam on heart rate
variability and cardiovascular parameters in patients of
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87
diabetes mellitus and hypertension. Yoga Mimamsa 2013; 45
(1&2): 1-13
23. Dutta A, Green SR, Bhavanani AB, Hemachandar R, Dhivya P,
Mathew KT. Effect of Yoga Therapy on fasting lipid prole in
chronic kidney disease: a comparative study. Int J Adv Med
2018;5: 294-98.
24. Mangalagowri M, Jayanthi R, Srinivasan AR, Bhavanani AB,
Ramanathan M. Proposed Yoga protocol based on glycemic
control, insulin resistance and anthropometry-specied
parameters: A retrospective study on clinically euthyroid Type
II Diabetics. J Basic Clin Appl Health Sci 2020;3(3):107–114.
25. Balaji R, Ramanathan M, Bhavanani AB. Nephroprotective
impact of adjuvant Yoga Therapy on diabetes – A randomised
controlled trial. J Clin Diagn Res.2020; 14(12): KC01-KC04.
26. Dayanidy G, Bhavanani AB, Ramanathan M, Srikanth S. Effect
of Yoga Therapy on cardiovascular parameters in patients with
psoriasis: A randomized control trial — pilot study. IP J
NutrMetab Health Sci 2021;4(2):61-63
27. Balaji R, Ramanathan M, Bhavanani AB. Role of Yoga as an
adjuvant therapy in the management of metabolic syndrome –
A randomized control pilot study. Yoga Mimamsa 2021; 53:116-21
28. Mangala Gowri M, Jayanthi R, Srinivasan AR, Bhavanani AB,
Ramanathan M. Impact of an integrated Yoga Therapy protocol
on insulin resistance and glycemic control in patients with Type
2 diabetes mellitus. rambam maimonides Med J 2022;13 (1):
e0005. DOI: 10.5041/RMMJ.1046
29. Sobana R, Jaiganesh K, Barathi P. Role of Rag Ahir Bhairav as
complementary and alternative medicine (CAM) on blood
pressure in prehypertensive adults. Jour of Med Sci & Tech 2013;
2(2); 66- 70
30. Sobana. R, Jaiganesh. K and Parthasarathy. S , Effect of Music
Therapy on pain perception, fatigue level, and physiological
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variables in patients under going hemodialysis - A prospective
randomized interventional trial. (2023). Int.J. Life Sci.Pharma
Res.13(2),L89-L89L94
31. Balaji R, Ramanathan M, Bhavanani AB, Ranganadin P,
Balachandran K. Effectiveness of adjuvant Yoga Therapy in
diabetic lung: A randomized control trial. Int J Yoga 2019; 12:96-
102.
32. Dinesh T, Gaur G S, Sharma V K, Madanmohan T, Harichandra
Kumar K T, Bhavanani A B. Comparative effect of 12 weeks of
slow and fast pranayama training on pulmonary function in
young, healthy volunteers: A randomized controlled trial. Int J
Yoga 2015; 8: 22-26.
33. Artchoudane S, Ranganadin P, Bhavanani AB, Ramanathan M,
Madanmohan T. Eff ect of adjuvant Yoga The rapy on
pulmonary function and quality of life among patients with
chronic obstructive pulmonary disease: A randomized control
trial. J basic clin appl Health Sci. 2018; 2(3):117-22
34. Sobana R, Sundar S, Jaiganesh K. Music therapy for pulmonary
rehabilitation in chronic obstructive pulmonary disease [COPD]
patients-An interventional trial. Int J Cur Res Rev. 2020
Jun;12(12):26.
35. Vasundhara VR, Bhavanani AB, Ramanathan M, Ghose S,
Dayanidy G. Immediate effect of Sukha Pranayama: A slow and
deep breathing technique on maternal and fetal cardiovascular
parameters. Yoga Mimamsa 2018; 50:49-52.
36. Vasundhara VR, Ramanathan M, Ghose S, Bhavanani AB.
Immediate effect of Pranava Pranayama on fetal and maternal
cardiovascular parameters. Int J Yoga 2022; 15:240-5
37. Ramesh B, Sundar S, Ghose S, Damodaran G, Balasubramanian
S, Govindasamy E. Evaluating the effect of Music Therapy on
the establishment of lactogenesis and maternal breast feeding
satisfaction levels. Int.J.Med.Health Res. 2020;6;05-09
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38. Ramesh B, Sundar S, Jayapreeta R, Samal S, Ghose S. Effects of
culture-based chants on labour pain during the latent stage of
labour in primigravidae mothers: A randomized controlled
trial. journal of basic, clinical and applied health sciences.
2018;2(1):16-19
39. Sundar S, Ramesh B, Rajasekaran A. Effect of relaxing Music on
blood pressure and heart rate in hospitalized pre-hypertensive
women In 3rd trimester of pregnancy: A randomized control
study. asian journal of pharmaceutical and clinical research.
2015;8(5): 179-181
40. Ramanathan M, Eswari R, Bhavanani AB, Prathima GS,
Sanguida A. Yoga training enhances auditory and visual
reaction time in children with autism spectrum disorder: A case
– control study. J Basic Clin Appl Health Sci. 2019; 2:8-13.
41. A rt ch o u d an e S , R am a n a th a n M , B ha v an a n i A B ,
Muruganandam P, Jatiya L. Effect of Yoga Therapy on
neuromuscular function and reduction of autism severity in
children with autism spectrum disorder: A pilot study.
international journal of health systems and translational
medicine (IJHSTM). 2021; 1(1): 76-85.
42. Ravikumar S, Srinivasan AR, Dhandapany G, Sundar S,
Soundararajan P. Vestibular stimulation with Indian hammock
versus Music intervention in the prevention of infantile colic in
term infants: An open-labelled, randomized controlled trial. Int
J PediatrAdolesc Med. 2020 Jan 22.
43. Vadlamudi H, Palanisamy S, Sundar S, Rajaramalingam,
Dhandapani G, Karuppiah P. The effectiveness of Music and
mother's voice on pain reduction during venepuncture in
neonates- A randomized control trial. J. Adv. Res. 2017;5(2),
2575-2579
44. Sundar S, Ramesh B, Dixit , Venkatesh S, Das P, Gunasekaran D.
Live Music Therapy as an active focus of attention for pain and
behav i o u ral s y mptom s o f di s t ress d uring p e d iatri c
immunization. Clinical paediatrics. 2016 Jul;55(8):745-8.
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90
45. Bharath P, Sobana J, Jaiganesh K, Parthasarathy S, Vadivel S.
Effect of rag neelambari on certain physiological and behavioral
parameters of preterm infants. asian journal of paediatric
practice, Vol. 16, No. 2, 2012
46. Vijayalakshmi G, Mahendiran P, Ramanathan M, Perumal V,
De Britto RLJ. Effect of Yoga on cognitive function in Filarial
lymphoedema patients. international journal of enhanced
research in educational development (IJERED) 2021; 9 (6): 1-7.
47. Vijayalakshmi G, Mahendiran P, Ramanathan M, Perumal V,
De Britto RLJ. Effect of Yoga on lower extremity function among
filarial lymphoedema patients. IJRAR 2021; 8 (4): 717-26
48. Abishek K, Bakshi SS, Bhavanani AB. The efcacy of yogic
breathing exercise Bhramari pranayama in relieving symptoms
of chronic rhinosinusitis. Int J Yoga 2019; 12:120-3.
49. Jagadevan M, Mohanakrishnan B, Bhavanani AB, Shristhudhi
D, Arumugam P, Subbiah B, et al. Additive effect of “Brahma
Mudra” on pain, proprioception and functional abilities in non-
specic mechanical neck pain. J Body Mov Ther 2021; 27: 717-
722.
50. Deivasigamani D, Sreedevi A, Sundar S, Balasundaram S,
Pragasam S. Evaluation of Music interventions for anxiety
during dermatosurgery under local anesthesia. Int J Res
Dermatol 2020; 6:376-82.
51. Sobana R, Sundar S, Dixit P. A study on the effects of Music
Therapy in pati ents posted for upper gastrointestinal
endoscopy. Int J Pharm Bio Sci. 2015 Apr;6(2):307-13.
52. Kannan V, Sundar S, Prabhu SM, Ezhumalai G. Estimation of
the effects of Music Therapy on the anxiety and patient's
perception during an upper gastrointestinal endoscopy
procedure: a randomised controlled trial. Int J Res Med Sci 2020;
8:2594-600.
53. Bierski K, Bhavanani AB, Eswaran S, Madanmohan T. Finding
peace on a psychiatric ward with Yoga : report on a pilot
anthropological study in pondicherry, india. Annals of SBV
2016; 5 (2): 14-19.
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54. Kumar S, S u b r a m a n i am E , B h a v a nani A B , S a rkar S ,
Balasundaram S. Effect of adjunct Yoga Therapy in depressive
disorders: Findings from a randomized controlled study.
Indian J Psychiatry 2019; 61:592-7.
55. Gupta K, Bhavanani AB, Ramanathan M, Balaji R, Sarkar S,
Dayanidy G. Effect of adjuvant Yoga Therapy on craving in
participants of an alcohol de-addiction Program: A pilot study.
2019; 2 (4):138-141.
56. Gupta K, Bhavanani AB, Sarkar S, Ramanathan M, Balaji R
Effect of adjuvant Yoga Therapy on craving in patients of
alcohol dependence syndrome (ADS). International Journal of
Creative Research Thoughts. 2021;9(1):1087-1096.
57. Gupta K, Bhavanani AB, Sarkar S, Ramanathan M, Balaji R
Effect of adjuvant Yoga Therapy on quality of life in the
participants of an alcohol de addiction program. International
Journal of Creative Research thoughts. 2021;9(2):1429-1438.
58. Karri RR, Bhavanani AB, Ramanathan M, Mopidevi VG.
Methodological issues in Yoga Therapy research among
psychiatric patients. Indian Journal of Psychiatry 2023; 65(1):
12-17.
59. Rajkumar M, Balasundaram S, Subramanian K, Sumathy S,
Adkoli BV. “Music listening intervention on craving and
withdrawal symptoms in patients with alcohol dependence: A
randomized controlled trial.”IOSR journal of dental and
medical sciences (IOSR-JDMS), 20(05), 2021, pp. 10-12
60. Varghese J K, Sundar S, Sarkar S, Ezhumalai G. Effect of
adjuvant Music Therapy on anxiety, depressive symptoms, and
cognitive functions of patients receiving electroconvulsive
therapy: A preliminary study. J basic clin Appl Health Sci 2019;
XX(X): 1–4.
61. Punita P, Madanmohan T, Palamalai SR, Subramanian S,
Bhavanani AB, Madhavan C. Randomized controlled trial of 12-
week Yoga Therapy as lifestyle intervention in patients of
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essential hypertension and cardiac autonomic function tests.
Natl J Physiol Pharm Pharmacol 2016; 6: 19-26.
62. Ajmera S, Sundar S, Amirtha Ganesh B, Bhavanani AB,
Dayanidy G, Ezhumalai G. A comparative study on the effect of
Music Therapy alone and a combination of Music and Yoga
therapies on the psycho-physiological parameters of cardiac
patients posted for angiography. J Basic Clin Appl Health Sci.
2018; 2:163-8.
63. Esw ari R, Prathima GS, Sanguida A, Ramanathan M,
Harikrishnan E, Ezhumalai G. Yoga therapy as an adjunct to
traditional tooth brushing training methods in children with
autism spectrum disorder. Spec Care Dentist. 2019; 1–6.
64. Eswari R, Prathima G S, Sanguida A, Ramanathan M,
Bhavanani AB, Harikrishnan E. Integrated Yoga Therapy for
teaching toothbrushing skills to children with autism spectrum
disorder: A qualitative study of parents' perceptions. Yoga
Mimamsa 2019; 51:43-7.
65. Thiruvalluvan A, Sekizhar V, Ramanathan M, Bhavanani AB,
Chakravathy D, C. Reddy JR. Effect of pranayama techniques
wi t h Marmanasth a n a m K r i ya a s yogic relaxation o n
biopsychosocial parameters prior to endodontic therapy: A
cross sectional study. Int J Yoga 2021; 14:146-151.
66. Majewski L, Bhavanani AB. A novel rejuvenation program for
cancer patients at Kaivalyadhama, India. Yoga Mimamsa 2014;
46:20-4
67. Bhavanani AB, Majewski L, Tiwari S. Effects of an intensive 3-
week Yoga retreat on sense of well being in cancer survivors. J
Alt Med Res 2016; 2(2): 116.
68. Majewski L, Bhavanani AB. Enhancing quality of life in cancer
survivors through Yoga. Annals of SBV 2016; 5 (2): 7-13.
69. Bharathi P, Jaiganesh K, Sobana R, Parthasarathy S. Effect of the
indian raga. Bageshri on the body temperature of cancer
patients on chemotherapy. Int J Cur Sci Res. 2012; 2(1): 243-245.
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reaction time in a geriatric population. International Journal of
Physiology 2014; 2 (1): 59-63.
71. Bhavanani AB, Ramanathan M, Madanmohan T. Single session
of integrated "silver Yoga" program improves cardiovascular
parameters in senior citizens. J IntercultEthnopharmacol. 2015
Apr-Jun;4(2):134-7.
72. Bhavanani AB, Ramanathan M, Madanmohan T, Thirusangu S.
Effects of a single session of yogic relaxation on cardiovascular
parameters in a transgender population. International Journal of
Physiology 2016; 4 (1): 27-31.
73. Ramanathan M, Bhavanani AB, Madanmohan T. Effect of a 12-
week Yoga Therapy program on mental health status in elderly
women inmates of a hospice. Int J Yoga. 2017 Jan-Apr;10(1):24-
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Lung Function in Elderly Women. J Clin Diagn Res.2018; 12(8):
KC01-KC04.
75. Sundar S, Ramesh B, Varathan K. Live Music Therapy in the
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betterment of close relatives of ICU patients. Int J Res Med Sci.
2016; 4(3): 950-952.
76. Mathew D, Sundar S, Subramaniam E, Parmar PN. Music
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References
Dr. Barbara Wheeler
USA
Dr. Helen Odell-Miller
OBE, UK
Dr. Jorg Fachner
UK
Dr. Suzanne Hanser
USA
Dr. Cheryl Dileo
USA
Dr. Gerhard Tucek
Austria
Prof. Sumathy Sundar
India
Dr. Rajshri Sripathy
India
Dr. Tarun Kumar Patel
India
Dr. Parin N Parmar
India
Dr. Luciano Bernadi
Finland
Yogacharya
Leigh Blashki
Australia
Yogacharini
Cathy Davis
UK
Yogachemmal
Dr Lori Rubenstein
Fazzio, USA
Yogaratna Paramahamsa
Svami Yogananda Giri
Italy
Dr Sat Bir Singh
Khalsa, USA
Yogacharya
Eric Doornekamp
ZEELAND
Yogacharini Latha
Germany
Yogacharini
Kalavathi Devi
UK
Dr Stephen Parker
USA
Dr Larry Payne
USA
Dr Dilip Sarkar
USA
Yogacharya
Joseph Le Page
USA
Dr Arpan Bhatt
India
Dr Amy Wheeler
USA
Dr Mathew J Taylor
USA
Yogacharini
Menaka Desikachar
India
Ammaji Yogacharini
Meenakshi Devi
Bhavanani, India
Prof. Madanmohan
India
Dr Chinmay Pandya
India
Dr W Selvamurthy
India
Dr BR Sharma
India
Dr Manjunath Sharma
India
Dr Hamsaji Yogendra
India
Sri Subadh Tiwari
India
Yogacharya
S Sridharan
India
ACADEMIC PROGRAMS OFFERED AT ISCM
We are humbly indebted to SBV for having given us the platform
to bring out a curriculum that has been accepted only through the
channels of regular board of studies and rigorous and meticulous
Academic council meetings to have a model that coincides with the UGC
norms for Higher Education in Yoga and Music Therapy.
The major highlight of the academic programs at ISCM is the
adoption of the Choice Based Credit System (CBCS) recommended by
the NAAC and UGC as per the New Education of Policy (NEP)as a major
reform in higher education. As a corollary to this system, a competency-
based approach has been proposed for the new programs wherein there
is a lateral entry and exit options in the programs.
DOCTOR OF PHILOSOPHY IN YOGA THERAPY (PhD YT)
As per UGC norms
MASTERS IN YOGA THERAPY (MSc YT)
Course duration: Two academic years (96 weeks) with four semesters
including time for assessment.
Number of seats: A maximum of 5 students may be admitted for MSc
(YT) course every year.
Number of credits for MSc: 80 credits (40 + 40 credits)
Lateral entry will be offered to those candidates who possess
PGD Y T f rom S BV o r c an d ida t es w i th P G DY T f r o m o th e r
institutes/university if that syllabus fulls equivalence as determined
by a committee duly to be constituted for the same.
Lateral exit option will also be available for the candidates after
completion of rst year (40 credits) of the MSc and the student can exit
with a PGDYT.
XIII
Academic Programs Offered at ISCM
PG DIPLOMA IN YOGA THERAPY (PGDYT)
Course duration: One academic year (48 weeks) with two semesters
including time for assessment.
Number of seats: Maximum of 10 candidates will be admitted for each of
the certicate courses.
Number of credits for PGDYT: 40 credits
PG CERTIFICATE PROGRAMS IN YOGA THERAPY
Course duration: Each certicate course is of approximately 12 weeks
(3 months) duration including time for assessment.
Number of seats: Maximum of 10 candidates will be admitted for each of
the certicate courses.
Number of credits for each course: 10 credits
Four courses are being offered.
1. Certicate in Foundation of Yoga (CFY)
2. Certicate in Foundations of Yoga therapy (CFYT)
3. Certicate in Applications of Yoga (CAY)
4. Certicate in Clinical Applications of Yoga Therapy (CCAYT)
Eligibility Criteria for MSc (YT), PGDYT & PGCYT Courses:
ŸModern medical and AYUSH doctors, dental surgeons, nursing
professionals, bachelor in physiotherapy, occupational therapy,
PGDY, MA or MSc Yoga/ Yoga therapy or equivalent
certication in Yoga from institutions of repute with any
bachelor degree.
ŸThe candidates will be shortlisted based on their aptitude for
teaching as determined by written test and/or interview.
XIV
DOCTOR OF PHILOSOPHY IN MUSIC THERAPY (PhD MT)
As per UGC norms
MASTER IN MEDICAL MUSIC THERAPY(MSC MMT)
Course duration: Two academic years (96 weeks) with four semesters
including time for assessment.
Number of seats: 10
Number of credits for MSc: 80 credits (40 + 40 credits)
Lateral entry into Master's program is offered after writing an
eligibility test to those who have a post graduate diploma in Music
therapy(with an equivalent credit course).
POST GRADUATE DIPLOMA IN MUSIC THERAPY (PGDMT)
Course duration: Two academic years (48 weeks) with two semesters
including time for assessment.
Number of seats: 10
Number of credits for PGDMT: 40 credits
Eligibility Criteria for MSc (MMT) & PGDMT Courses:
ŸAny undergraduate with commendable skills in Music (with a
certicate or degree in Music and/or instruments)
ŸThe candidates will be shortlisted based on the aptitude for
teaching as determined by a written test and/or Interview.
INTERNSHIP TRAINING PROGRAMME
Course duration: 6 months for Music Therapy & 3 months for Yoga
Therapy
OBSERVERSHIP PROGRAMME IN MUSIC THERAPY
Course duration: 15 days to 2 months
Academic Programs Offered at ISCM
XV
