Yoga

Improve Chronic Fatigue Syndrome with Seated Yoga

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Improve Chronic Fatigue Syndrome with Seated Yoga

 

By John M. de Castro, Ph.D.

 

“The benefits of yoga, in general, include loosening up muscles, joints, and connective tissues, and improving strength and balance. But is it right for ME/CFS, with post-exertional malaise plus other problematic symptoms such as dizziness and muscle pain? We don’t have a lot of research on yoga for ME/CFS, but what we do have suggests that it just might be.” – Adrienne Dellwo

 

Chronic Fatigue Syndrome (CFS) occurs in about 0.2% of the population. It produces a profound, prolonged, and debilitating tiredness. When severe, it can produce a chronic and extreme tiredness, so severe that sufferers can become bed-bound or need to use a wheel-chair. It produces muscle pain, brain fog and dizziness, poor memory, disturbed sleep and trouble with digestion. Unfortunately, there are no known cures for CFS. The usual treatments for fatigue are targeted at symptom relief and include exercise and drugs. As an alternative to these traditional treatments, mindfulness training has been shown to reduce fatigue. The mindfulness practice of Yoga also includes exercise and it has been shown to be an effective treatment for the symptoms of Chronic Fatigue Syndrome (CFS). But the mechanism is not known of how yoga may be affecting the symptoms of CFS.

 

In today’s Research News article “The longitudinal effects of seated isometric yoga on blood biomarkers, autonomic functions, and psychological parameters of patients with chronic fatigue syndrome: a pilot study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836361/), Oka and colleagues recruited adults with Chronic Fatigue Syndrome (CFS) and randomly assigned them to receive either 20 minute, twice a week, for 2 months seated yoga practice with daily home practice or to no further treatment. Both groups continued to receive pharmacotherapy. They were measured before and after treatment for fatigue, anxiety, depression, and alexithymia. In addition, blood was drawn and assayed for DHEA-S, PRL, and TNF-α. Heart rate variability was also measured with and electrocardiogram (EKG).

 

They found that in comparison to baseline and the control group, the seated yoga group had a large and significant decrease in fatigue and depression. Further they found that the greater the decrease in fatigue for the seated yoga group, the greater the decrease in TNF-α, in the high frequency component of heartrate variability, and in alexithymia.

 

These results suggest that seated yoga is effective in reducing fatigue and depression in patients with Chronic Fatigue Syndrome (CFS). The correlation analysis suggests that the reduction in fatigue is associated with decreases in inflammation (TNF-α) and an increase in the ability to sense emotions (decreased alexithymia). The correlations do not indicate causation. So, it is not clear if the changes in fatigue produced the reductions in inflammation and alexithymia, or the reverse, or a third factor is responsible. But it is clear that seated yoga practice improves fatigue and depression in patients with CFS.

 

This is important as Chronic Fatigue Syndrome (CFS) is relatively common and debilitating and pharmacological treatments are most often ineffective. The fact that yoga practice can improve the symptoms of CFS is encouraging. In addition, the fact that the yoga practice was performed in a seated position makes it better suited to patients with fatigue who lack the energy for more intense yoga practice. The results of this small pilot study further provide justification for performing a large randomized controlled trial. Seated yoga practice may be able to at least in part reduce the physical and psychological problems produced by CFS.

 

So, improve chronic fatigue syndrome with seated yoga.

 

“isometric yoga together with conventional therapy was more effective in relieving fatigue than was conventional therapy alone in patients with CFS who did not respond adequately to conventional therapy.” – Takakazu Oka

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Oka, T., Tanahashi, T., Lkhagvasuren, B., & Yamada, Y. (2019). The longitudinal effects of seated isometric yoga on blood biomarkers, autonomic functions, and psychological parameters of patients with chronic fatigue syndrome: a pilot study. BioPsychoSocial medicine, 13, 28. doi:10.1186/s13030-019-0168-x

 

Abstract

Background

In a previous randomized controlled trial, we found that practicing seated isometric yoga regularly for 2 months improved the fatigue of patients with chronic fatigue syndrome (CFS) who are resistant to conventional therapy. The aim of this pilot study was to investigate the possible mechanisms behind this finding by comparing blood biomarkers, autonomic nervous function, and psychological indices before versus after an intervention period of seated isometric yoga practice.

Methods

Fifteen patients with CFS who did not show satisfactory improvements after at least 6 months of conventional therapy practiced seated isometric yoga (biweekly 20-min sessions with a yoga instructor and daily practice at home) for 2 months. The longitudinal effects of seated isometric yoga on fatigue, blood biomarkers, autonomic function, and psychological state were investigated by comparing the following parameters before and after the intervention period: Fatigue severity was assessed by the Chalder fatigue scale (FS) score. Levels of the blood biomarkers cortisol, DHEA-S, TNF-α, IL-6, prolactin, carnitine, TGF-β1, BDNF, MHPG, HVA, and α-MSH were measured. The autonomic nervous functions assessed were heart rate (HR) and HR variability. Psychological indices included the 20-item Toronto Alexithymia Scale (TAS-20) and the Hospital Anxiety and Depression Scale (HADS).

Results

Practicing seated isometric yoga for 2 months resulted in significant reductions in the Chalder FS (P = 0.002) and HADS-depression (P = 0.02) scores. No significant changes were observed in any other parameter evaluated. The change in Chalder FS score was not correlated with the change in HADS-depression score. However, this change was positively correlated with changes in the serum TNF-α levels (P = 0.048), the high frequency component of HR variability (P = 0.042), and TAS-20 scores (P = 0.001).

Conclusions

Regular practice of seated isometric yoga for 2 months reduced the fatigue and depressive symptom scores of patients with CFS without affecting any other parameters we investigated. This study failed to identify the markers responsible for the longitudinal fatigue-relieving effect of seated isometric yoga. However, considering that the reduced fatigue was associated with decreased serum TNF-α level and TAS-20 scores, fatigue improvement might be related to reduced inflammation and improved alexithymia in these patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836361/

 

Yoga Practice May Help Prevent the Development of Type II Diabetes

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Yoga Practice May Help Prevent the Development of Type II Diabetes

 

By John M. de Castro, Ph.D.

 

“Yoga can do more than just relax your body in mind — especially if you’re living with diabetes. Certain poses may help lower blood pressure and blood sugar levels while also improving circulation, leading many experts to recommend yoga for diabetes management.” – Healthline

 

Diabetes is a major health issue. It is estimated that 30 million people in the United States and nearly 600 million people worldwide have diabetes and the numbers are growing. Type II Diabetes results from a resistance of tissues, especially fat tissues, to the ability of insulin to promote the uptake of glucose from the blood. As a result, blood sugar levels rise producing hyperglycemia. Diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.

 

Type 2 diabetes is a common and increasingly prevalent illness that is largely preventable. One of the reasons for the increasing incidence of Type 2 Diabetes is its association with overweight and obesity which is becoming epidemic in the industrialized world. A leading cause of this is a sedentary life style. Unlike Type I Diabetes, Type II does not require insulin injections. Instead, the treatment and prevention of Type 2 Diabetes focuses on diet, exercise, and weight control. Recently, mindfulness practices have been shown to be helpful in managing diabetes. A mindfulness practice that combines mindfulness with exercise is yoga and it has been shown to be helpful in the treatment of Type II Diabetes. Prevention is always better than treatments. So, it is important to investigate the ability of yoga practice to prevent Type II diabetes in at risk individuals.

 

In today’s Research News article “.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795440/), Ramamoorthi and colleagues reviewed, summarized, and performed a meta-analysis of the published controlled research studies of the effectiveness of yoga practice in improving prediabetic symptoms. The found 14 published studies with a total of 834 participants.

 

They report that the published research found that yoga practice significantly improved prediabetic symptoms. They included a significant reduction in fasting blood glucose levels and systolic blood pressure, and improved blood lipid profiles including low density lipoproteins, cholesterol, and triglycerides.

 

This meta-analysis suggests that yoga practice is a safe and effective practice that improves the metabolic signs predictive of future Type II diabetes. It appears to improve glycemic control, blood lipid profiles, and blood pressure. These are very encouraging results. It will be important to follow-up over the long-term to see if these improvements are lasting and if they reduce the transition from then prediabetic state to Type II diabetes.

 

So, yoga practice may help prevent the development of Type II Diabetes.

 

“yoga for diabetes provides unique benefits that can effectively restore the body to a state of natural health and proper function.” – Yoga U

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Ramamoorthi, R., Gahreman, D., Skinner, T., & Moss, S. (2019). The effect of yoga practice on glycemic control and other health parameters in the prediabetic state: A systematic review and meta-analysis. PloS one, 14(10), e0221067. doi:10.1371/journal.pone.0221067

 

Abstract

A systematic review and meta-analysis was conducted to investigate the effects of yoga on glycemic control, lipid profiles, body composition and blood pressure in people in the pre-diabetic state. Studies on the effectiveness of yoga on population groups under high risk for diabetes, called prediabetic or suffering from metabolic syndromes were extracted from a thorough search of PubMed, Scopus, Cochrane Library, EBSCO and IndMED databases. Both Randomised Controlled Trial (RCT) and non-RCT studies were included in the systematic review and meta-analysis. Studies published between Jan 2002 and Dec 2018 were included. Studies were considered for evaluation if they investigated a yoga intervention to prevent T2DM, against a control group, while also reporting glycemic control and other health parameters of T2DM management. Summary effect sizes and 95% confidence intervals (CI) were calculated using the Comprehensive Meta-Analysis software in addition to publication bias. Of the 46,500 identified studies, 14 studies with 834 participants of whom were 50% women, were found to be eligible for inclusion in our systematic review. Our quantitative synthesis included 12 randomized control trials and 2 non-randomized control trials, with the follow-up period ranging from 4 to 52 weeks. Compared to controls, yoga intervention improved fasting blood glucose (FBG) [Standard Mean Difference (SMD -0.064 mg/dL (95% CI -0.201 to 0.074)]; low density lipoprotein (LDL) [SMD-0.090 mg/dL (95% CI -0.270 to 0.090)]; triglycerides [SMD -0.148 mg/dL (95% CI -0.285 to -0.012)]; total cholesterol [SMD -0.058 mg/dL (95% CI -0.220 to 0.104)] and systolic blood pressure [SMD -0.058 mm Hg (95% CI -0.168 to 0.053)]. This meta-analysis uncovered clinically improved effects of yoga intervention on glycemic control, lipid profiles and other parameters of T2DM management in prediabetic population. These results suggest that yoga intervention may be considered as a comprehensive and alternative approach to preventing T2DM. Further adequately powered, well designed RCTs are needed to support our findings and investigate the long-term effects of yoga in T2DM patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795440/

 

Improve Attention Deficit Hyperactivity Disorder (ADHD) Symptoms in Children with Yoga

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Improve Attention Deficit Hyperactivity Disorder (ADHD) Symptoms in Children with Yoga

 

By John M. de Castro, Ph.D.

 

“research reports that yoga may help relieve attention-deficit hyperactivity disorder (ADHD) in children.” – Elaine Gavalas

 

Attention Deficit Hyperactivity Disorder (ADHD) is most commonly found in children, but for about half it persists into adulthood. It’s estimated that about 5% of the adult population has ADHD. Hence, this is a very large problem that can produce inattention, impulsivity, hyperactivity, and emotional issues, and reduce quality of life. The most common treatment is drugs, like methylphenidate, Ritalin, which helps reducing symptoms in about 30% of the people with ADHD. Unfortunately, the effectiveness of the drugs appears to be markedly reduced after the first year. In addition, the drugs often have troublesome side effects, can be addictive, and can readily be abused. So, drugs, at present, do not appear to be a good solution, only affecting some, only for a short time, and with unwanted side effects.

 

There are indications that mindfulness training may be an effective treatment for ADHD. It makes sense that it should be, as the skills and abilities strengthened by mindfulness training are identical to those that are defective in ADHD,  attention, impulse control, executive function, emotion control, and mood improvement. In addition, unlike drugs, it is a relatively safe intervention that has minimal troublesome side effects. Yoga is both an exercise and a mindfulness practice. This could be particularly attractive for kids with ADHD.

 

In today’s Research News article “Effects of Yoga on Attention, Impulsivity, and Hyperactivity in Preschool-Aged Children with Attention-Deficit Hyperactivity Disorder Symptoms.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871620/), Cohen and colleagues recruited preschool children (3-5 years of age) who had at least 4 symptoms of Attention Deficit Hyperactivity Disorder (ADHD). They were randomly assigned to either 6 weeks of Yoga practice or a wait-list control condition. Yoga practice consisted of breathing exercises and poses and occurred twice a week at school in a group setting for 30 minutes and on other days at home guided by a DVD. Before and after the intervention and 6 weeks and 3 months later the parents and teachers completed measures of the children’s ADHD symptoms, emotional symptoms, conduct problems, peer problems, hyperactivity/inattention and prosocial behaviors. The children were also directly measured for attention in a computer-based test and for heart rate variability.

 

They found that for children with high Attention Deficit Hyperactivity Disorder (ADHD) symptom scores, yoga practice produced significant reductions in inattention and hyperactivity/inattention ratings by the parents. On the attention task, after the yoga intervention the children had significantly improved attention but also significantly higher distractibility. These findings were maintained at follow-up.

 

The results suggest that yoga practice is particularly beneficial for children who are high in Attention Deficit Hyperactivity Disorder (ADHD) symptoms improving their attentional ability and hyperactivity. These findings require further investigation to look closer at students with lower ADHD scores. But, they suggest that yoga practice may be beneficial in treating ADHD  in preschool children. Intervening this early in development may help to prevent ADHD development and/or prevent its transition into adulthood.

 

So, improve attention deficit hyperactivity disorder (ADHD) symptoms in children with yoga.

 

“Pairing a hyperactive child with a quiet, slow form of exercise may sound counterintuitive and even disastrous, but it turns out yoga can be incredibly helpful for children with attention deficit hyperactivity disorder (ADHD).” – Dennis Thompson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Cohen, S., Harvey, D. J., Shields, R. H., Shields, G. S., Rashedi, R. N., Tancredi, D. J., … Schweitzer, J. B. (2018). Effects of Yoga on Attention, Impulsivity, and Hyperactivity in Preschool-Aged Children with Attention-Deficit Hyperactivity Disorder Symptoms. Journal of developmental and behavioral pediatrics : JDBP, 39(3), 200–209. doi:10.1097/DBP.0000000000000552

 

Abstract

Objective

Behavioral therapies are first line treatments for preschoolers with ADHD. Studies support yoga as an intervention for school age children with ADHD; this study evaluated the effects of yoga in preschoolers on parent and teacher rated attention/challenging behaviors; attentional control (KiTAP); and heart rate variability (HRV).

Methods

This randomized waitlist-controlled trial tested a 6-week yoga intervention in preschoolers with ≥ 4 ADHD symptoms on the ADHD Rating Scale-IV Preschool Version. Group 1 (n=12) practiced yoga first; Group 2 (n=11) practiced yoga second. We collected data at four time points: baseline, T1 (6 wk), T2 (12 wk), follow-up (3 mo after T2).

Results

At baseline, there were no significant differences between Group 1 and 2 on any measure. At T1, Group 1 had faster reaction times on the KiTAP Go/No go task (p=.01, 95% CI: −371.1, −59.1, d=−1.7), fewer Distractibility errors of omission (p=.009, 95% CI: −14.2, −2.3, d=−1.5), but more commission errors (p=.02, 95% CI:1.4, 14.8, d=1.3) than Group 2. Children in Group 1 with more severe symptoms at baseline showed improvement at T1 not seen in Group 2 on parent-rated Strengths and Difficulties Questionnaire hyperactivity-inattention (β=−2.1, p=.04, 95% CI: −4.0, −0.1) and inattention on the ADHD Rating Scale (β=−4.4, p=.02, 95% CI: −7.9, −0.9). HRV measures did not differ between groups.

Conclusions

Yoga was associated with modest improvements on an objective measure of attention (KiTAP) and selective improvements on parent ratings. Yoga may be a promising treatment for ADHD symptoms in preschoolers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871620/

 

Improve the Symptoms of Myeloproliferative Neoplasm Patients with Online Yoga

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Improve the Symptoms of Myeloproliferative Neoplasm Patients with Online Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga classes specifically created for cancer patients offer more than a traditional support group. Yoga creates a sense of belonging, reduces feelings of stress and improves quality of life.” – Sara Szeglowski

 

“Myeloproliferative Neoplasms (MPNs) are blood cancers that occur when the body makes too many white or red blood cells, or platelets” (Cancer Support Community). It typically occurs in older adults and is fairly rare (1-2 cases/100,000 per year) and has a very high survival rate. It produces a variety of psychological and physical symptoms including fatigue, anxiety, pain, depression, and sleep disturbance, reduced physical, social, and cognitive functioning resulting. This produces a marked reduced in the patient’s quality of life.

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health including fatigue, anxiety, depression, pain, and sleep disturbance, and improves physical, social, and cognitive functioning as well as quality of life in cancer patients. Yoga practice also improves the physical and mental health of cancer patients. The vast majority of the yoga practice, however, requires a trained instructor. It also requires that the participants be available to attend multiple sessions at particular scheduled times that may be difficult for myeloproliferative neoplasm patients to attend and may or may not be compatible with their schedules and at locations that may not be convenient.

 

As an alternative, online yoga trainings have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the effectiveness of these online programs in relieving the psychological and physical symptoms of myeloproliferative neoplasm patients and improving their quality of life.

 

In today’s Research News article “Online yoga in myeloproliferative neoplasm patients: results of a randomized pilot trial to inform future research.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6556039/), Huberty and colleagues recruited adult myeloproliferative neoplasm patients and randomly assigned them to either receive online yoga training or to a wait-list control condition. Yoga training occurred via streamed videos for a total of 60 minutes training per week for 12 weeks. The individual training videos increased in duration from 5 minutes to 30 minutes over the 12 weeks. The participants were measured for adverse events and yoga participation by self-report and by clicking on the video links and over the training period. Before and after training they were measured for total symptoms, fatigue, pain intensity, anxiety, depression, sleep disturbance, sexual function, and quality of life. In, addition, blood was drawn and assayed for inflammatory cytokines.

 

They found that 79% of the patients in the yoga group completed participation averaging 42 minutes per week and there were no adverse events reported. Self-reports of yoga participation were over-reported by on average 10 minutes as assessed by actual clicks on the yoga video links. They found that in comparison to baseline and the wait-list group, the yoga group reported a moderate decrease in depression and small decreases in anxiety, pain intensity, sleep disturbance, and in TNF-α blood levels.

 

This was a pilot feasibility study and did not have a sufficient number of participants to detect small effects. It also lacked an active control, such as aerobic exercise. Nevertheless, the trial suggests that teaching yoga online is feasible and can successfully improve the psychological health of myeloproliferative neoplasm patients and reduce inflammation. This is potentially important as yoga treatment can be successfully employed remotely, inexpensively, and conveniently and can reduce the suffering of myeloproliferative neoplasm patients. A large randomized clinical trial with an active control condition is justified by these encouraging results.

 

So, improve the symptoms of myeloproliferative neoplasm patients with online yoga.

 

“Some people with cancer say it helps calm their mind so that they can cope better with their cancer and its treatment. Others say it helps to reduce symptoms and side effects such as pain, tiredness, sleep problems and depression.” – Cancer Research UK

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Huberty, J., Eckert, R., Dueck, A., Kosiorek, H., Larkey, L., Gowin, K., & Mesa, R. (2019). Online yoga in myeloproliferative neoplasm patients: results of a randomized pilot trial to inform future research. BMC complementary and alternative medicine, 19(1), 121. doi:10.1186/s12906-019-2530-8

 

Abstract

Background

Myeloproliferative neoplasm (MPN) patients suffer from significant symptoms, inflammation and reduced quality of life. Yoga improves these outcomes in other cancers, but this hasn’t been demonstrated in MPNs. The purpose of this study was to: (1) explore the limited efficacy (does the program show promise of success) of a 12-week online yoga intervention among MPN patients on symptom burden and quality of life and (2) determine feasibility (practicality: to what extent a measure can be carried out) of remotely collecting inflammatory biomarkers.

Methods

Patients were recruited nationally and randomized to online yoga (60 min/week of yoga) or wait-list control (asked to maintain normal activity). Weekly yoga minutes were collected with Clicky (online web analytics tool) and self-report. Those in online yoga completed a blood draw at baseline and week 12 to assess inflammation (interleukin-6, tumor necrosis factor-alpha [TNF-α]). All participants completed questionnaires assessing depression, anxiety, fatigue, pain, sleep disturbance, sexual function, total symptom burden, global health, and quality of life at baseline, week seven, 12, and 16. Change from baseline at each time point was computed by group and effect sizes were calculated. Pre-post intervention change in inflammation for the yoga group was compared by t-test.

Results

Sixty-two MPN patients enrolled and 48 completed the intervention (online yoga = 27; control group = 21). Yoga participation averaged 40.8 min/week via Clicky and 56.1 min/week via self-report. Small/moderate effect sizes were generated from the yoga intervention for sleep disturbance (d = − 0.26 to − 0.61), pain intensity (d = − 0.34 to − 0.51), anxiety (d = − 0.27 to − 0.37), and depression (d = − 0.53 to − 0.78). A total of 92.6 and 70.4% of online yoga participants completed the blood draw at baseline and week 12, respectively, and there was a decrease in TNF-α from baseline to week 12 (− 1.3 ± 1.5 pg/ml).

Conclusions

Online yoga demonstrated small effects on sleep, pain, and anxiety as well as a moderate effect on depression. Remote blood draw procedures are feasible and the effect size of the intervention on TNF-α was large. Future fully powered randomized controlled trials are needed to test for efficacy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6556039/

 

Improve Physical and Mental Health in Trauma Victims with Bikram Yoga

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Improve Physical and Mental Health in Trauma Victims with Bikram Yoga

 

By John M. de Castro, Ph.D.

 

“The steamy temps “allow you to increase their range of motion and stretch deeper within each pose,” since heat makes muscles more pliable, says Numbers. Unlike stretching it out in a standard cool yoga studio, the heat will have you feeling like a pro and extending further than you thought you could.” – Aryelle Siclait

 

Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. Trauma can produce troubling physical and psychological symptoms that need to be addressed. There are a number of therapies that have been developed to treat the effects of trauma. One of which, mindfulness training has been found to be particularly effective. Yoga practice is a mindfulness practice that has been shown to be helpful for trauma survivors.

 

Yoga is a mindfulness practice that has been shown to improve physical well-being and cardiovascular health. Bikram Yoga is somewhat unique yoga practice as it employs a set sequence of 26 poses (asanas) and two breathing exercises. It is practiced in a heated environment (105°F, 40.6°C, 40% humidity) and there is a unique programmed instructional dialogue. The hot environment is thought to soften the muscles making them more pliable and loosen the joints making them more flexible allowing the practitioner to go deeper into poses. The sweating that occurs is thought to help remove toxins and impurities.

 

In today’s Research News article “#MindinBody – feasibility of vigorous exercise (Bikram yoga versus high intensity interval training) to improve persistent pain in women with a history of trauma: a pilot randomized control trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6714085/), Flehr and colleagues recruited adult pre-menopausal women who had persistent pain and who had experienced trauma. They were randomly assigned to receive 8 weeks of 3 sessions per week of Bikram Yoga (90 minutes) or High Intensity Interval Training (45 minutes). The women were measured before and after training for pain severity, pain interference with quality of life, health, anxiety, depression, perceived stress, disorders of extreme stress, self-efficacy, life stressors, mindfulness, body size, and electrocardiogram (EKG) measures.

 

They found that pain significantly decreased for both groups. On the other hand, Bikram Yoga produced significantly greater improvements in physical functioning, mental health, and heart rate variability with moderate to large effect sizes. No intervention related injuries were reported. Heart rate variability has been shown to measure greater parasympathetic nervous system activity reflecting better overall health.

 

The results suggest that although both programs produced decreased pain intensity, Bikram Yoga was superior to a comparable high intensity exercise in improving the physical and mental health of trauma survivors with persistent pain. A strength of the study is that the Bikram Yoga intervention was compared to another high intensity exercise program, thus reducing the likelihood of participant expectancy effects. Hence Bikram Yoga appears to be a safe and effective treatment for women who have experienced trauma. It would be interesting in the future to compare the Bikram Yoga program to a comparable yoga program practiced at room temperature.

 

So, improve physical and mental health in trauma victims with Bikram Yoga.

 

“Hot yoga addresses all aspects of physical fitness including muscular strength, endurance, flexibility and weight loss. . . . There is no other style of yoga that addresses the overall health of the body in such a comprehensive way.” – Peter Mason

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Flehr, A., Barton, C., Coles, J., Gibson, S. J., Lambert, G. W., Lambert, E. A., … Dixon, J. B. (2019). #MindinBody – feasibility of vigorous exercise (Bikram yoga versus high intensity interval training) to improve persistent pain in women with a history of trauma: a pilot randomized control trial. BMC complementary and alternative medicine, 19(1), 234. doi:10.1186/s12906-019-2642-1

 

Abstract

Background

The neurobiology of persistent pain shares common underlying psychobiology with that of traumatic stress. Modern treatments for traumatic stress often involve bottom-up sensorimotor retraining/exposure therapies, where breath, movement, balance and mindfulness, are used to target underlying psychobiology. Vigorous exercise, in particular Bikram yoga, combines many of these sensorimotor/exposure therapeutic features. However, there is very little research investigating the feasibility and efficacy of such treatments for targeting the underlying psychobiology of persistent pain.

Methods

This study was a randomized controlled trail (RCT) comparing the efficacy of Bikram yoga versus high intensity interval training (HIIT), for improving persistent pain in women aged 20 to 50 years. The participants were 1:1 randomized to attend their assigned intervention, 3 times per week, for 8 weeks. The primary outcome measure was the Brief Pain Inventory (BPI) and further pain related biopsychosocial secondary outcomes, including SF-36 Medical Outcomes and heart rate variability (HRV), were also explored. Data was collected pre (t0) and post (t1) intervention via an online questionnaire and physiological testing.

Results

A total of 34 women were recruited from the community. Analyses using ANCOVA demonstrated no significant difference in BPI (severity plus interference) scores between the Bikram yoga (n = 17) and the HIIT (n = 15). Women in the Bikram yoga group demonstrated significantly improved SF-36 subscale physical functioning: [ANCOVA: F(1, 29) = 6.17, p = .019, partial eta-squared effect size (ηp2) = .175 and mental health: F(1, 29) = 9.09, p = .005, ηp2 = .239; and increased heart rate variability (SDNN): F(1, 29) = 5.12, p = .013, ηp2 = .150, scores compared to the HIIT group. Across both groups, pain was shown to decrease, no injuries were experienced and retention rates were 94% for Bikram yoga and 75% for HIIT .

Conclusions

Bikram yoga does not appear a superior exercise compared to HIIT for persistent pain. However, imporvements in quality of life measures and indicator of better health were seen in the Bikram yoga group. The outcomes of the present study suggest vigorous exercise interventions in persistent pain cohorts are feasible.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6714085/

 

High Frequency of Yoga Practice Produces Greater Benefits

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High Frequency of Yoga Practice Produces Greater Benefits

 

By John M. de Castro, Ph.D.

 

“Regular yoga practice creates mental clarity and calmness; increases body awareness; relieves chronic stress patterns; relaxes the mind; centers attention; and sharpens concentration. Body- and self-awareness are particularly beneficial, because they can help with early detection of physical problems and allow for early preventive action.” – Natalie Nevins

 

Yoga practice has been shown to have a myriad of benefits for psychological and physical health, social, and spiritual well-being. It is both an exercise and a mind-body practice that stresses both mental attention to present moment movements, breath control, and flexibility, range of motion, and balance. There has, however, not been much attention paid to the characteristics of practice that are important for producing maximum benefits.

 

In today’s Research News article “Effects of Yoga Asana Practice Approach on Types of Benefits Experienced.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746050/), Wiese and colleagues emailed a questionnaire to a large sample of yoga practitioners. They were asked for demographic information and to describe their yoga practice and physical, mental, emotional, spiritual, and relational benefits of yoga.

 

They found that the higher the frequency of practice the greater the physical, mental, emotional, spiritual, and relational benefits. Weaker relationships were found between consistency of practice, teaching yoga, and teacher experience and the benefits. In addition, there was a relationship between the frequency of practice without a teacher and self-confidence. Evening practice was found to be a negative predictor of benefits.

 

These findings suggest, as has been previously reported, that yoga practice produces myriad of benefits for psychological and physical health, social, and spiritual well-being. The characteristic of practice that was most highly related to these benefits was how many times per week yoga was practiced, particularly when the practice occurred 5 or more times per week; the more practice, the greater the benefits. Also associated with benefits were consistency of practice, teaching yoga, and teacher experience, while evening practice was associated with less benefit.

 

It should be noted that these results are correlations and caution must be exercised in assigning causation. But the findings are consistent with finding from controlled studies, suggesting that yoga practice produces great benefit.

 

So, practice frequently to obtain the greatest benefits from yoga practice.

 

“Multiple studies have confirmed the many mental and physical benefits of yoga. Incorporating it into your routine can help enhance your health, increase strength and flexibility and reduce symptoms of stress, depression and anxiety. Finding the time to practice yoga just a few times per week may be enough to make a noticeable difference when it comes to your health.” – Rachel Link

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Wiese, C., Keil, D., Rasmussen, A. S., & Olesen, R. (2019). Effects of Yoga Asana Practice Approach on Types of Benefits Experienced. International journal of yoga, 12(3), 218–225. doi:10.4103/ijoy.IJOY_81_18

 

Abstract

Context:

Modern science and the classic text on hatha yoga, Hatha Yoga Pradipika, report physical, mental, emotional, spiritual, and relational benefits of yoga practice. While all have specific suggestions for how to practice, little research has been done to ascertain whether specific practice approaches impact the benefits experienced by practitioners.

Aims:

Our aim was to relate the experience level of the practitioner, the context of practice approaches (time of day, duration of practice, frequency of practice, etc.), and experience level of the teacher, to the likelihood of reporting particular benefits of yoga.

Methods:

We conducted a cross-sectional descriptive survey of yoga practitioners across levels and styles of practice. Data were compiled from a large voluntary convenience sample (n = 2620) regarding respondents’ methods of practice, yoga experience levels, and benefits experienced. Multiple logistic regression was used to identify approaches to yoga practice that positively predicted particular benefits.

Results:

Frequency of practice, either with or without a teacher, was a positive predictor of reporting nearly all benefits of yoga, with an increased likelihood of experiencing most benefits when the practitioner did yoga five or more days per week. Other aspects of practice approach, experience level of the practitioner, and the experience level of the teacher, had less effect on the benefits reported.

Conclusions:

Practice frequency of at least 5 days per week will provide practitioners with the greatest amount of benefit across all categories of benefits. Other practice approaches can vary more widely without having a marked impact on most benefits experienced.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746050/

 

Improve Chronic Low Back Pain in Low Income Patients with Yoga

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Improve Chronic Low Back Pain in Low Income Patients with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga’s focus on balance and steadiness encourages your body to develop defenses against the causes of back pain, which include weak abdominal and pelvic muscles, as well lack of flexibility in the hips. When you strengthen these muscles, you improve your posture, which reduces the load on your back, and thus reduces the aches you feel. In addition, stretching can increase flexibility by increasing blood flow to tight muscles.” – Annie Hauser

 

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years and opiate pain killers are dangerous and can lead to abuse, addiction, and fatal overdoses.

 

Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects. Mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain. Yoga practice has been shown to have a myriad of health benefits. These include relief of chronic pain. Yoga practice has also been shown to be effective for the relief of chronic low-back pain.  Many forms of yoga focus on the proper alignment of the spine, which could directly address the source of back and neck pain for many individuals. The majority of the research, though, has focused on relatively affluent populations. There is a need to study the effectiveness of yoga practice for low back pain in low-income populations.

 

In today’s Research News article “Physical and Physiological Effects of Yoga for an Underserved Population with Chronic Low Back Pain.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746048/), Colgrove and colleagues recruited adult low-income minority group members who had chronic low back pain and assigned them to a wait-list control condition or to receive yoga training twice a week for 60 minutes for 12 weeks. They were measured before and after training for pain, disability, muscle strength, and flexibility. Blood was drawn and the inflammatory marker TNF-α was measured. Finally, they underwent Magnetic Resonance Imaging (MRI) of their brains.

 

They found that in comparison to baseline and the wait-list control group, the yoga group had significantly lower levels of pain, improved abdominal strength, and improved spinal and hip flexibility. Although trends were present there were too few participants to detect significant changes in TNF-α levels or in the brain scans.

 

This was a pilot study assessing feasibility and as such enrolled only a small number of patients. Nevertheless, the results showed that yoga practice improves the pain levels, core strength, and flexibility of low-income minority patients with chronic low back pain. These results are similar to those seen with affluent non-minority populations. These encouraging results support conducting a large randomized controlled clinical study.

 

So, improve chronic low back pain in low income patients with yoga.

 

“Yoga is one of the more effective tools for helping soothe low back pain. The practice helps to stretch and strengthen muscles that support the back and spine, such as the paraspinal muscles that help you bend your spine, the multifidus muscles that stabilize your vertebrae, and the transverse abdominis in the abdomen, which also helps stabilize your spine.” – Matthew Sloan

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Colgrove, Y. M., Gravino-Dunn, N. S., Dinyer, S. C., Sis, E. A., Heier, A. C., & Sharma, N. K. (2019). Physical and Physiological Effects of Yoga for an Underserved Population with Chronic Low Back Pain. International Journal of Yoga, 12(3), 252–264. doi:10.4103/ijoy.IJOY_78_18

 

Abstract

Background:

Yoga has been shown useful in reducing chronic low back pain (CLBP) through largely unknown mechanisms. The aim of this pilot study is to investigate the feasibility of providing yoga intervention to a predominantly underserved population and explore the potential mechanisms underlying yoga intervention in improving CLBP pain.

Methods:

The quasi-experimental within-subject wait-listed crossover design targeted the recruitment of low-income participants who received twice-weekly group yoga for 12 weeks, following 6–12 weeks of no intervention. Outcome measures were taken at baseline, preintervention (6–12 weeks following baseline), and then postintervention. Outcome measures included pain, disability, core strength, flexibility, and plasma tumor necrosis factor (TNF)-α protein levels. Outcomes measures were analyzed by one-way ANOVA and paired one-tailed t-tests.

Results:

Eight patients completed the intervention. Significant improvements in pain scores measured over time were supported by the significant improvement in pre- and post-yoga session pain scores. Significant improvements were also seen in the Oswestry Disability Questionnaire scores, spinal and hip flexor flexibility, and strength of core muscles following yoga. Six participants saw a 28.6%–100% reduction of TNF-α plasma protein levels after yoga, while one showed an 82.4% increase. Two participants had no detectable levels to begin with. Brain imaging analysis shows interesting increases in N-acetylaspartate in the dorsolateral prefrontal cortex and thalamus.

Conclusion:

Yoga appears effective in reducing pain and disability in a low-income CLBP population and in part works by increasing flexibility and core strength. Changes in TNF-α protein levels should be further investigated for its influence on pain pathways.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746048/

 

Improve Emotion Regulation with Exercise and Mindfulness

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Improve Emotion Regulation with Exercise and Mindfulness

 

By John M. de Castro, Ph.D.

 

“When we engage in mindful practices, we can bring greater awareness, clarity, and equanimity to our day to day experiences. This leads to greater balance and less of the intense swings in mood that can throw us off kilter for days at a time.” – Sean Fargo

 

Mindfulness practice has been shown to improve emotions and their regulation. Practitioners demonstrate more positive and less negative emotions and the ability to fully sense and experience emotions, while responding to them in appropriate and adaptive ways. In other words, mindful people are better able to experience yet control their responses to emotions. The ability of mindfulness training to improve emotion regulation is thought to be the basis for a wide variety of benefits that mindfulness provides to mental health and the treatment of mental illness especially depression and anxiety disorders. Aerobic exercise can also improve emotions and their regulation. So, it makes sense to study the relationship between exercise and mindfulness in effecting emotion regulation.

 

In today’s Research News article “How Does Exercise Improve Implicit Emotion Regulation Ability: Preliminary Evidence of Mind-Body Exercise Intervention Combined With Aerobic Jogging and Mindfulness-Based Yoga.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6718717/), Zhang and colleagues recruited healthy female postgraduate students who did not have meditation experience and who did not engage in exercise. They were randomly assigned to a wait-list control condition or to engage in exercise 3 times per week over 8 weeks. The exercise alternated between jogging for 40 minutes and yoga practice for 60 minutes. The yoga practice consisted of postures, breathing exercises, and meditation. They were measured before and after the intervention for emotion regulation, negative emotions, aerobic fitness, and mindfulness.

 

They found that in comparison to baseline and the wait-list control group, the aerobic exercise and yoga group had significant increases in emotion regulation, aerobic fitness, and mindfulness and decreases in negative emotions. They also found that increases in aerobic fitness were associated with increases in emotion regulation. But this association was only significant with participants who had high or moderate increases in their levels of mindfulness. At low levels of improvements in mindfulness there was no significant relationship between aerobic fitness and emotion regulation.

 

These findings are interesting and suggest that aerobic exercise and yoga improves the individual’s ability to regulate their emotions. But mindfulness is required for aerobic exercise to be effective. The increases in mindfulness would be expected as the exercise intervention contained yoga and meditation components. Aerobic exercise is known to improve mood. It is new to show that it also improves emotion regulation. Perhaps that’s the reason for the improvements in mood. But in order for the emotion regulation to be improved by exercise, it must be accompanied by improvements in mindfulness. This suggests that the ability to pay attention in the present moment nonjudgmentally to one’s emotions is required for the exercise to affect the ability to regulate the emotions. Here mindfulness plays a permissive role allowing the exercise to have its effect on the participants ability to regulate their emotions.

 

So, Improve Emotion Regulation with Exercise and Mindfulness.

 

“By acting mindfully, people are not only aware of their own feelings but become able to distance from it, avoiding feeling overpowered and acting out.” – Joan Swart

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Zhang, Y., Fu, R., Sun, L., Gong, Y., & Tang, D. (2019). How Does Exercise Improve Implicit Emotion Regulation Ability: Preliminary Evidence of Mind-Body Exercise Intervention Combined With Aerobic Jogging and Mindfulness-Based Yoga. Frontiers in psychology, 10, 1888. doi:10.3389/fpsyg.2019.01888

 

Abstract

Purpose: The primary aim of the present study is to examine the effect of 8-week mind-body exercise intervention combining aerobic jogging and mindfulness-based yoga on implicit emotion regulation ability. The secondary aim is to explore the specific potential pathways by which the mind-body exercise intervention fosters implicit emotion regulation. This may help us to understand how the key components of exercise intervention contribute to emotional benefits.

Methods: Sixty participants were randomly allocated to one of two parallel groups: (1) the intervention group (n = 29) and (2) the waitlist control group (n = 31). Participants were asked to fill out scales measuring mindfulness and instructed to complete an emotion regulation task to assess implicit emotion regulation ability as well as the PWC 170 Test to evaluate aerobic fitness before and after the intervention.

Results: The results of the two-way repeated ANOVA revealed that 8 weeks of intervention improved implicit emotion regulation, mindfulness, and aerobic fitness levels. Path analysis showed that only improved aerobic fitness mediated the intervention effect on implicit emotion regulation ability, controlling for change in negative affect. Notably, the relationship between the effects on implicit emotion regulation ability and aerobic fitness was moderated by improved mindfulness.

Conclusion: Eight weeks of mind-body exercise intervention improves implicit emotion regulation ability. The aerobic fitness may be an essential pathway which mediates the efficacy on implicit emotion regulation ability. Furthermore, different components, such as aerobic fitness and mindfulness, may interactively contribute to such emotional benefits.

Keywords: mind-body exercise, aerobic jogging, mindfulness-based yoga, implicit emotion regulation ability, aerobic fitness, mindfulness, potential pathway

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6718717/

 

Improve Coping with Chronic Pain with Yoga

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Improve Coping with Chronic Pain with Yoga

 

By John M. de Castro, Ph.D.

 

“By first understanding chronic pain as a mind-body experience and then using yoga’s toolbox of healing practices—including breathing exercises and restorative poses—you can find true relief from pain and begin to reclaim your life.” – Kelly McGonigal

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

Pain involves both physical and psychological issues. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. There is an accumulating volume of research findings to demonstrate that mind-body therapies have highly beneficial effects on the health and well-being of humans. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices, in general, are effective in treating pain and specific practices such as yoga can be effective for the relief of chronic pain.

 

In today’s Research News article “Yoga for People With Chronic Pain in a Community-Based Setting: A Feasibility and Pilot RCT.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6689911/), Schmid and colleagues recruited adult pain patients from a pain clinic who had chronic pain for at least 6 months. They received treatment as usual but half were randomly assigned to receive an additional program of yoga practice for 60 minutes, twice a week, for 8 weeks, including both seated and standing poses. They were measured before and after training for pain severity, pain interference with daily activities, mental and physical quality of life, self-efficacy, and body responsiveness.

 

They found that after treatment the yoga group had significant improvements in pain interference with daily activities, self-efficacy surrounding pain management, physical function, and coping with symptoms, confidence to address pain and chronic disease, and body responsiveness. Hence, it appears that yoga practice, while not altering pain severity itself, does improve the patients’ ability to manage the pain and prevent it from interfering with their daily activities and thereby improve their quality of life. Chronic pain produces suffering, which interferes with the conduct of the patients’ lives. Relief is critical. Yoga practice appears to produce a modicum of that relief.

 

So, improve coping with chronic pain with yoga.

 

“Yoga can be helpful in pain management with both physical and mental benefits, but yoga is not a quick fix solution. Yoga has many of the same benefits as mindfulness practice, due to the common focus on breath, body and present moment awareness. Because yoga is also a physical practice many people find yoga more accessible than traditional meditation practices, which are undertaken in stillness.” – PainHealth

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Schmid, A. A., Fruhauf, C. A., Sharp, J. L., Van Puymbroeck, M., Bair, M. J., & Portz, J. D. (2019). Yoga for People With Chronic Pain in a Community-Based Setting: A Feasibility and Pilot RCT. Journal of evidence-based integrative medicine, 24, 2515690X19863763. doi:10.1177/2515690X19863763

 

Abstract

The purpose of this feasibility pilot study was to assess benefits of 8 weeks of yoga in people with chronic pain. Participants completed baseline assessments and were randomized to yoga or usual care. Yoga was offered twice a week for 8 weeks. We assessed feasibility and the Brief Pain Inventory (BPI) was the primary outcome, assessing pain-severity and pain interference on daily activities. Eighty-three people were recruited; 67 people completed the study and were included in the analyses. Average age of participants was 50.78 ± 10.43 years and most participants had pain >10 years. The intervention appeared feasible and there were significant improvements (P < .05) in multiple measures for the yoga group, including a decrease in BPI interference scores from 7.15 ± 1.70 to 6.14 ± 2.21 (P = .007). There was a significant difference in body responsiveness and pain management scores between groups at 8 weeks. It appears that yoga was feasible and positively influenced multiple outcome measures for people with chronic pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6689911/

 

Improve Chronic Low Back Pain with Yoga

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Improve Chronic Low Back Pain with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga is great for working on flexibility and core stability, correcting posture, and breathing—all of which are necessary for a healthy back.” – Sasha Cyrelson

 

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years and opiate pain killers are dangerous and can lead to abuse, addiction, and fatal overdoses. Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects.

 

Mindfulness practices have been found to be effective in treating pain and have been shown to be safe and effective in the management of low back pain. Yoga practice has been shown to have a myriad of health benefits. These include relief of chronic pain. Yoga practice has also been shown to be effective for the relief of chronic low-back pain.  Many forms of yoga focus on the proper alignment of the spine, which could directly address the source of back and neck pain for many individuals. So, it makes sense to further explore the effectiveness of yoga practice for chronic low back pain.

 

In today’s Research News article “Yoga, Physical Therapy, or Education for Chronic Low Back Pain: A Randomized Noninferiority Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392183/), Saper and colleagues recruited adult patients with low back pain lasting at least 12 weeks and randomly assigned them to receive yoga, physical therapy, or education. Yoga training consisted of 12 weekly, 75 minute classes with 30 minutes of daily practice at home including relaxation, breathing exercises, meditation, and poses. Drop-in yoga classes were available during the subsequent 40 weeks. Physical therapy occurred in 15 60-minute session of graded exercise over 12 weeks. Booster classes were offered during the subsequent 40 weeks. Education included information on chronic low back pain self-management, stretching, strengthening, and the role of emotions and fear avoidance. They were measured before and after training and at 14, 28, and 40 weeks later for back-related function, pain intensity, global improvement, patient satisfaction, and health related quality of life.

 

They found that in comparison to baseline both the yoga and physical therapy groups had improvements in back-related function and pain intensity and were less likely to use pain medication at the end of training. These improvements were maintained 40 weeks later. Hence, both yoga practice and physical therapy were equivalently safe and effective treatments for low back pain and the improvements produced were enduring.

 

So, improve chronic low back pain with yoga.

 

“Yoga is one of the more effective tools for helping soothe low back pain. The practice helps to stretch and strengthen muscles that support the back and spine, such as the paraspinal muscles that help you bend your spine, the multifidus muscles that stabilize your vertebrae, and the transverse abdominis in the abdomen, which also helps stabilize your spine.” – Matthew Solan

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Saper, R. B., Lemaster, C., Delitto, A., Sherman, K. J., Herman, P. M., Sadikova, E., … Weinberg, J. (2017). Yoga, Physical Therapy, or Education for Chronic Low Back Pain: A Randomized Noninferiority Trial. Annals of internal medicine, 167(2), 85–94. doi:10.7326/M16-2579

 

Abstract

Background:

Yoga is effective for mild to moderate chronic low back pain (cLBP), but its comparative effectiveness with physical therapy (PT) is unknown. Moreover, little is known about yoga’s effectiveness in underserved patients with more severe functional disability and pain.

Objective:

To determine whether yoga is noninferior to PT for cLBP.

Design:

12-week, single-blind, 3-group randomized noninferiority trial and subsequent 40-week maintenance phase. (ClinicalTrials.gov: NCT01343927)

Setting:

Academic safety-net hospital and 7 affiliated community health centers.

Participants:

320 predominantly low-income, racially diverse adults with nonspecific cLBP.

Intervention:

Participants received 12 weekly yoga classes, 15 PT visits, or an educational book and newsletters. The maintenance phase compared yoga drop-in classes versus home practice and PT booster sessions versus home practice.

Measurements:

Primary outcomes were back-related function, measured by the Roland Morris Disability Questionnaire (RMDQ), and pain, measured by an 11-point scale, at 12 weeks. Prespecified noninferiority margins were 1.5 (RMDQ) and 1.0 (pain). Secondary outcomes included pain medication use, global improvement, satisfaction with intervention, and health-related quality of life.

Results:

One-sided 95% lower confidence limits were 0.83 (RMDQ) and 0.97 (pain), demonstrating noninferiority of yoga to PT. However, yoga was not superior to education for either outcome. Yoga and PT were similar for most secondary outcomes. Yoga and PT participants were 21 and 22 percentage points less likely, respectively, than education participants to use pain medication at 12 weeks. Improvements in yoga and PT groups were maintained at 1 year with no differences between maintenance strategies. Frequency of adverse events, mostly mild self-limited joint and back pain, did not differ between yoga and PT.

Limitations:

Participants were not blinded to treatment assignment. The PT group had disproportionate loss to follow-up.

Conclusion:

A manualized yoga program for nonspecific cLBP was noninferior to PT for function and pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392183/