Nagarathna Raghuram’s research while affiliated with Swami Vivekananda Yoga Anusandhana Samsthana and other places

Background People with visual impairment (VI) tend to face more psychological distress than normally sighted individuals due to mobility restrictions, fear of falling, and sleep disturbances. However, research to address these problems is rare. This study aims to investigate the effect of mindfulness-based yoga versus physical exercise on the psychological well-being of individuals with VI. Methods This study will be a single-blinded, three-armed, multicentered, randomized controlled trial (RCT). A total of 132 participants with VI (ages 15-25) will be recruited in the study and will be randomly assigned to either group 1 (mindfulness-based yoga), group 2 (physical exercise), or group 3 (wait-list control). Groups 1 and 2 will receive intervention for 40 hours (eight weeks, weekly five days, one hour/day), whereas group 3 will continue their daily activities as usual. The intervention will take place in the afternoon from Monday to Friday. The timing varies between 4-5 pm according to the different time schedules of the institutions of the blind. Three times, assessments will be conducted at T0 (baseline), T1 (eighth week at the completion of the intervention), and T2 (sixth month following the completion of the intervention). ANOVA will be used to find out the differences between groups; repeated measures ANOVA will be used to check within-group changes. Trial status The study was first screened in December 2021. The recruitment of participants has been completed in two centers covering 62 individuals with VI, and intervention started in August 2022. The data collection is still ongoing due to the nature of the study design, a specific demographic, complex logistics, and administrative bottlenecks. The study incorporates three different groups and a substantial sample size (n=132). The specific demographic, people with visual impairments, are rare and difficult to locate. In addition, a six-month follow-up assessment contributes to complex procedures while coordinating between various institutions and securing necessary authorizations. Discussion This study will be the first comprehensive RCT to investigate the psychological well-being of the VI population with various psychophysiological and hormonal parameters in multiple centers. The presence of physical exercise and a wait-list control group will further elucidate the potential mechanism of Mindfulness-based yoga. Mindfulness-based yoga can be integrated into educational and rehabilitation systems to enhance the well-being of individuals with VI.

Background: Health Care Professionals (HCPs) working on the frontlines of health care emergencies/pandemics often experience elevated anxiety, stress and reduced quality of sleep. Yoga is a mind-body practice that has been proven to effective in improving physical and mental health. Objective: To evaluate the effectiveness of integrated Yoga intervention on mental health measures and sleep quality among HCPs working during the COVID-19 pandemic. Methods: It was a quasi-experimental study on 110 HCPs, including Doctors and nursing staff, with an age range of 20 to 65 years who were recruited through a convenience sampling method and assigned to a Yoga group (n = 55) or a control group (n = 55).The Yoga group received a weekly one-hour Yoga session followed by a 30-minute self-practice three times a week at home for one month. The control group followed routine activity. Heart rate (HR), Blood Pressure, stress measures (Perceived Stress and visual analogue Scale for Stress), COVID-related anxiety, Sleep Quality, Quality of life and Preservative Thinking were assessed before and after the intervention. Results: A significant decrease in stress measures, COVID-19-related anxiety and fear, and perseverative thinking was noticed in the Yoga group. Sleep quality and quality of life also improved significantly. The control group showed no significant change. At one month, the Yoga group showed significantly greater improvement in stress measures, COVID-19-related anxiety and fear, perseverative thinking, sleep quality and quality of life compared to the control group. Conclusion: Yoga practice during the public health crisis would help reduce anxiety and stress and improve sleep among HCPs. Further, RCT studies are warranted.

Background: Office workers who need to use a computer while maintaining a static position for prolonged periods have more chance of having low back pain (LBP). Objective: The objective of the study is to investigate the effect of yoga on stress, anxiety, depression, and spinal mobility in computer users with chronic LBP (CLBP). Materials and Methods: In this randomized control trial, eighty computer users (42.6 ± 8.45 years of age; suffering from CLBP since 5.20 ± 3.01 years; 51 males and 29 females) who use a computer for their professional work, recruited from Bengaluru, India, were randomized into two groups: yoga group (n = 40) and physical exercise group (n = 40). The yoga group practiced an integrated module comprising yoga postures and mindfulness meditation, and the physical exercise group practiced physical exercise designed for LBP (1 h/day, 3 days/week for 16 weeks). Assessments of dial‑type goniometer and Depression Anxiety Stress Scale‑42 were performed at baseline, after 8 weeks, and after 16 weeks. Results: Stress, anxiety, and depression scores were significantly lower in the yoga group as compared to the physical exercise group at 16 weeks (P < 0.001), whereas spinal flexion (P < 0.001), spinal extension (P < 0.001), right lateral flexion (P = 0.001), and left lateral flexion (P = 0.007) scores were significantly higher in the yoga group as compared to the physical exercise group at 16 weeks. Conclusion: Yoga is more effective in reducing stress, anxiety, and depression and improving spinal mobility in computer users with CLBP than physical exercise designed for LBP. Keywords: Anxiety, back pain, depression, mindfulness, stress, yoga

Background and purpose Cerebral haemodynamics and cognitive performance may be adversely affected in type 2 diabetes mellitus (T2DM). Previous studies reported reduced cerebral blood flow (CBF) and altered cerebrovascular reactivity (CVR) in T2DM. Yoga, an ancient holistic health approach, is known to be beneficial for T2DM. We hypothesized that yoga practice may alter CBF and the flow resistance in the middle cerebral artery (MCA) and improve cognition in T2DM. Our secondary objective was to explore the relationship between changes in cerebral haemodynamics and cognition in T2DM. Materials and methods Participants were randomly allotted into the yoga and control groups based on the eligibility criteria. One hour of yoga intervention specific to type 2 diabetes was provided to the yoga group for three months, while conventional treatment was provided to the control group. A transcranial Doppler was used to evaluate longitudinal changes in cerebral haemodynamics in MCA. A Corsi block tapping test was used to assess visio-spatial working memory. Results There were 75 participants recruited, of whom 38 participated in yoga and 37 participated in a control group. Both intention to treat and per protocol analysis showed significant results. At day 90, intention-to-treat analysis showed significant changes in CBF velocities (mean difference −10.85%, 95% CI (−13.26, −6.15), p<0.001), cerebral vasodilatory reserve (mean difference −0.23%, 95% CI (−0.43, -0.03), p=0.02) and cognition (mean difference −12.13%, 95% CI (−17.48, -6.78), p≤0.001). There was no between-group effect. Also, the correlation between the CBF and cognition did not show any significant results. Conclusion The three-month yoga intervention was associated with an improvement in cerebral hemodynamics. The study also revealed an improvement in visio-spatial working memory among patients with T2DM. The study did not show any correlation between the improvement in cerebral haemodynamics and working memory. We recommend larger and longer studies on yoga intervention for T2DM patients to evaluate whether such benefits are sustained and improve their quality of life.

Background and purpose Cerebral haemodynamics and cognitive performance may be adversely affected in type 2 diabetes mellitus (T2DM). Previous studies reported reduced cerebral blood flow (CBF) and altered cerebrovascular reactivity (CVR) in T2DM. Yoga, an ancient holistic health approach, is known to be beneficial for T2DM. We hypothesized that yoga practice may alter CBF and the flow resistance in the middle cerebral artery (MCA) and improve cognition in T2DM. Our secondary objective was to explore the relationship between changes in cerebral haemodynamics and cognition in T2DM. Materials and methods Participants were randomly allotted into the yoga and control groups based on the eligibility criteria. One hour of yoga intervention specific to type 2 diabetes was provided to the yoga group for three months, while conventional treatment was provided to the control group. A transcranial Doppler was used to evaluate longitudinal changes in cerebral haemodynamics in MCA. A Corsi block tapping test was used to assess visio-spatial working memory. Results There were 75 participants recruited, of whom 38 participated in yoga and 37 participated in a control group. Both intention to treat and per protocol analysis showed significant results. At day 90, intention-totreat analysis showed significant changes in CBF velocities (mean difference −10.85%, 95% CI (−13.26,−6.15), p<0.001), cerebral vasodilatory reserve (mean difference −0.23%, 95% CI (−0.43, -0.03), p=0.02) and cognition (mean difference −12.13%, 95% CI (−17.48, -6.78), p≤0.001). There was no between-group effect. Also, the correlation between the CBF and cognition did not show any significant results. Conclusion The three-month yoga intervention was associated with an improvement in cerebral hemodynamics. Thestudy also revealed an improvement in visio-spatial working memory among patients with T2DM. The study did not show any correlation between the improvement in cerebral haemodynamics and working memory. We recommend larger and longer studies on yoga intervention for T2DM patients to evaluate whether such benefits are sustained and improve their quality of life.

Aims: Type 2 diabetes mellitus (T2DM) alters brain functional and structural connectivity leading to cognitive dysfunction. This study examined the effect of a 12-week yoga intervention on prefrontal cortex (PFC) oxygenation and working memory in patients with T2DM. Methods: Fifty participants were randomized into yoga and waitlist control groups. The yoga protocol specific to T2DM was followed. The pre- (day 1), mid- (6 weeks) and post-intervention (12 weeks) assessments included measurement of PFC oxygenation while performing working memory tasks (n-back) using functional near-infrared spectroscopy. Results: Following a 12-week intervention, the yoga group showed improved performance in working memory [accuracy (geometric mean difference of 3.15%, 95% CI [2.33,3.96], p = 0.001) and reaction time (mean difference of 100.8 milliseconds,95% CI [- 166.6, - 35.1], p = 0.002] in the high task load (2-back) associated with higher oxygenation in dorsolateral PFC (β coefficient mean difference of 95.6, 95% CI [0.23,191], p = 0.049) and ventrolateral PFC (β coefficient mean difference of 53.4, 95% CI [7.8,98.9], p = 0.018) regions. Higher oxygenation in dorsolateral PFC during 2-back task was positively correlated with accuracy (r(23) = 0.65, p < 0.001) and negatively correlated with reaction time (r(23) = - 0.47,p = 0.017). Conclusion: Integrated yoga practice may improve working memory performance associated with higher PFC oxygenation in patients with T2DM. As 12 weeks of yoga intervention improved working memory performance, the regular practice of yoga may have the potential to prevent decline of cognitive functions in clinical conditions.

Background Computer professionals are more prone to chronic low back pain (CLBP) as compared to the normal population. It has been reported that the 1-year prevalence of low back pain (LBP) was 23%38% in the normally active population, while it was 31%54% in computer users. Objective To investigate the effect of yoga and mindfulness meditation on the quality of life (QOL) of computer users with CLBP. Materials and Methods Eighty computer users (42.6 ± 8.45 years of age; suffering from CLBP since 5.20 ± 3.01 years; 51 males and 29 females) were recruited from Bengaluru, India. Participants were randomized into two groups: Yoga and mindfulness meditation/YM group ( n = 40) and physical exercise/PE group ( n = 40). The YM group practiced an integrated module comprising yoga postures and mindfulness meditation, and the PE group practiced PE designed for LBP. Both groups practiced 1 hour daily, 3 days a week for 16 weeks. WHO QOL-BREF and spinal flexibility (Straight Leg Raising [SLR]) were assessed at baseline and after 8 and 16 weeks. Results Results of repeated measures-analysis of variance test showed that the scores on QOL physical health (diff = 12.43%, P < 0.001), psychological health (diff = 11.9%, P < 0.001), social relationships (diff = 15.66% P < 0.001), and environment (diff = 17.37% P < 0.001) were significantly higher in YM group as compared to PE group at the end of 16 weeks. Similarly, the scores on the SLR right leg (diff = 12.97%, P < 0.001) and SLR left leg score (diff = 11.71%, P < 0.001) were significantly higher in the YM group as compared to the PE group at the end of 16 weeks. Conclusion Yoga with mindfulness meditation is significantly more effective in improving QOL and spinal flexibility in computer users with CLBP as compared to PE designed for LBP.

Background: A study was conducted on asymptomatic COVID-19 positive patients admitted in a COVID-19 hospital in Indore, India during first wave of the pandemic. The objective of the study was to assess the efficacy of an integrated tele-yoga intervention as an adjunct to conventional management on physiological, psychological and mindfulness variables. Methods: In a confirmatory randomized control trial, 60 asymptomatic COVID-19 patients in hospital confinement were randomly allocated to experimental and control groups (n=30). The tele-yoga intervention included breathing exercise, pranayama and meditation and delivered over 30 minutes for 7 days to the experimental group while, the control group continued treatment as usual. Assessment of physiological variables & psychological variables was carried out before intervention and on day seven immediately after intervention. Data was analyzed using SPSS (V.16.0). Results: Mann Whitney U test shows that there was a statistically significant difference between groups regarding all variables (p<0.001). The physiological and psychological variables which included Oxygen Saturation (2.07%), Heart Rate (8.21%), Respiratory Rate (10.04%), Systolic Blood Pressure (6.14%), Diastolic Blood Pressure (8.38%), Visual Analog Scale for Stress (62.78 %), Covid-19 Peritraumatic Distress Index (68.44 %), and State Mindful Attention Awareness Scale (72.72 %) showed significant changes in the experimental group compared to control group. Conclusion: The results of this study suggest that integrated tele-yoga might have therapeutic benefits in improving physiological, psychological, and mindfulness variables in asymptomatic COVID- 19 patients.

Introduction Chronic low back pain (CLBP) is two and a half times more prevalent in the working population than in nonworking population. The 1-year prevalence of low back pain (LBP) in working population ranges from 23% to 38%. However, the 1-year prevalence in computer professionals was found to be 31%–54%. Studies have demonstrated the vast mental and physiological health advantages associated with yoga. Objective We planned to investigate the effect of yoga and mindfulness meditation in computer users with CLBP. Methods Eighty computer users (42.6 ± 8.45 years of age; suffering from CLBP for 5.20 ± 3.01 years; 51 males and 29 females) were recruited from Bengaluru, Karnataka, India. Subjects were randomized into two groups; yoga and mindfulness meditation/YM group ( n = 40) and physical exercise/PE group ( n = 40). YM group practiced an integrated module comprising yoga practices and mindfulness meditation, while PE group practiced physical exercises designed for LBP (1 h per day, 3 days per week for 16 weeks). Assessments were done at baseline, after 8 weeks, and after 16 weeks. Results Seventy-seven participants (39 in YM and 38 in PE) completed the study. Oswestry Disability Index (ODI) scores and Numerical Rating Scale (NRS) scores decreased significantly, and the Sit and Reach Test (SRT) scores improved significantly in both groups after intervention ( p < 0.001). Between-group analyses demonstrated that there was a significant difference in ODI scores (YM = 7.28 ± 5.68, PE = 15.53 ± 8.13, P < 0.001), NRS scores (YM = 1.00 ± 0.89, PE = 1.82 ± 0.73, P < 0.001), and SRT scores (YM = 26.41 ± 5.03, PE = 22.82 ± 4.96, P = 0.002) between the YM group and PE group at 16 weeks, favoring the YM group. Conclusion A 16-week yoga & mindfulness meditation program appeared to be effective in reducing pain and functional disability, and in improving spinal flexibility in computer users with CLBP.

This study with aim of development and validation of a yoga program for patients with T2DM was carried in view of emerging evidence of yoga as an alternative and/or complementary treatment. Classical and contemporary yoga texts were reviewed for identification of yoga practices. After reviewing research papers and yoga texts a THREE-step yoga program, in order of increasing difficulty level for T2DM was prepared. For validation of yoga program, mixed methods approach integrating qualitative and quantitative inputs was considered. Eighteen experts over three rounds of iteration contributed toward validation of yoga program. A final set of three-step yoga program was obtained which further needs to be tested in standardized randomized controlled trials. Trial Registration With Indian Council of Medical Research: Clinical Trial Registry of India; ICMR-CTRI: Development and Validation study: CTRI/2013/11/004163.