Yoga

Improve Psychological Well-being in Coronary Artery Disease Patients with Mindfulness-Based Art Therapy

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Improve Psychological Well-being in Coronary Artery Disease Patients with Mindfulness-Based Art Therapy

 

By John M. de Castro, Ph.D.

 

“Given the proven role of stress in heart attacks and coronary artery disease, effective meditation would be appropriate for almost all patients with coronary artery disease.” – Joon Sup Lee

 

Cardiovascular disease is the number one killer, claiming more lives than all forms of cancer combined. “Heart disease is the leading cause of death for both men and women. About 610,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Every year about 735,000 Americans have a heart attack.” (Centers for Disease Control). “Coronary artery disease develops when the major blood vessels that supply your heart with blood, oxygen and nutrients (coronary arteries) become damaged or diseased. Cholesterol-containing deposits (plaque) in your arteries and inflammation are usually to blame for coronary artery disease.” – (Mayo Clinic)

 

A myriad of treatments has been developed for heart disease including a variety of surgical procedures and medications. But the safest effective treatments are lifestyle changes. These include quitting smoking, weight reduction, improved diet, physical activity, and reducing stresses. Safe and effective alternative treatments for cardiovascular disease are contemplative practices, such as meditation, tai chi, and yoga, have also been shown to be helpful for heart health. These practices have also been shown to be helpful for producing the kinds of lifestyle changes needed to prevent heart disease such as smoking cessation, weight reduction, and stress reduction.

 

In today’s Research News article “Effects of Mindfulness-Based Art Therapy on Psychological Symptoms in Patients with Coronary Artery Disease.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852419/ ), Jang and colleagues studied the effectiveness of Mindfulness-Based Art Therapy (MBAT) on the psychological states of patients with coronary artery disease. They recruited outpatients with coronary artery disease and randomly assigned them to either receive 12 weeks, once a week for 45 minutes, of Mindfulness-Based Art Therapy (MBAT) or a treatment as usual control. MBAT was based on the Mindfulness-Based Stress Reduction (MBSR) Program and included meditation, yoga, and body scan practices along with training in expressing their emotions through art and drawing. Patients were measured before and after training for anxiety, depression, and anger.

 

They found that the MBAT trained patients in comparison to baseline and the treatment as usual group had large and significant reduction in depression, anxiety and depression following treatment. In addition, there were large and significant decreases in experiences of anger and expressions of anger and also increases in anger control. Hence, the Mindfulness-Based Art Therapy (MBAT) program was successful in improving the psychological well-being of patients with coronary heart disease.

 

It should be noted that there wasn’t an active control conditions so the conclusions must be tempered with the understanding that there were considerable opportunities for bias and participant expectations to affect the results and there was no long-term follow-up to determine the durability of the effects. The findings, however, are encouraging and should provide encouragement for conducting a larger trial with active control conditions, e.g. aerobic exercise and long-term follow-up.

 

So, improve psychological well-being in coronary artery disease patients with mindfulness-based art therapy.

 

“15 minutes of meditation a day reduced the risk of death, heart attack, and stroke by 48 per cent” – British Heart Foundation

 

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

 

Jang, S.-H., Lee, J.-H., Lee, H.-J., & Lee, S.-Y. (2018). Effects of Mindfulness-Based Art Therapy on Psychological Symptoms in Patients with Coronary Artery Disease. Journal of Korean Medical Science, 33(12), e88. http://doi.org/10.3346/jkms.2018.33.e88

 

Abstract

Background

Mindfulness-based art therapy (MBAT) induces emotional relaxation in coronary artery disease (CAD) patients, and is a treatment known to improve psychological stability. The objective of this study was to evaluate the treatment effects of MBAT for CAD patients.

Methods

A total of 44 CAD patients were selected as participants, 21 patients belonged to a MBAT group, and 23 patients belonged to the control group. The patients in the MBAT group were given 12 sessions of treatments. To measure depression and anxiety, Beck Depression Inventory (BDI) and Trait Anxiety Inventory (TAI) were used. Anger and anger expression were evaluated using the State Trait Anger Expression Inventory (STAXI). The treatment results were analyzed using two-way repeated measures analysis of variance (ANOVA).

Results

The results showed that significant effects for groups, time, and interaction in the depression (interaction effect, [F(1,36) = 23.15, P < 0.001]; between groups, [F(1,36) = 5.73, P = 0.022]), trait anxiety (interaction effect, [F(1,36) = 13.23, P < 0.001]; between groups, [F(1,36) = 4.38, P = 0.043]), state anger (interaction effect, [F(1,36) = 5.60, P = 0.023]), trait anger (interaction effect, [F(1,36) = 6.93, P = 0.012]; within group, [F(1,36) = 4.73, P = 0.036]), anger control (interaction effect, [F(1,36) = 8.41, P = 0.006]; within group, [F(1,36) = 9.41, P = 0.004]), anger out (interaction effect, [F(1,36) = 6.88, P = 0.012]; within group, [F(1,36) = 13.17, P < 0.001]; between groups, [F(1,36) = 5.62, P = 0.023]), and anger in (interaction effect, [F(1,36) = 32.66, P < 0.001]; within group, [F(1,36) = 25.90, P < 0.001]; between groups, [F(1,36) = 12.44, P < 0.001]).

Conclusion

MBAT can be seen as an effective treatment method that improves CAD patients’ psychological stability. Evaluation of treatment effects using program development and large-scale research for future clinical application is needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852419/

 

Improve Functional Fitness with Yoga

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Improve Functional Fitness with Yoga

 

By John M. de Castro, Ph.D.

 

“All forms of exercise are important for the body. The right amount of it keeps us in shape, improves longevity, and certainly keeps me sane if nobody else. Yoga is so much more than simple stretches, and it’s certainly not just for flexible people who can already wrap their legs around their heads. Yoga is about creating balance, strength, flexibility and relaxation in the body through a series of postures, movements and breathing patterns.” – Victoria Adams

 

We celebrate the increasing longevity of the population. But, aging is a mixed blessing. The aging process involves a systematic progressive decline of the body and the brain. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. It is inevitable. In addition, many elderly experience withdrawal and isolation from social interactions. There is some hope as there is evidence that these declines can be slowed. For example, a healthy diet and a regular program of exercise can slow the physical decline of the body with aging. Also, contemplative practices such as meditation, yoga, and tai chi or qigong have all been shown to be beneficial in slowing or delaying physical and mental decline.

 

Yoga practice has been shown to have a myriad of benefits for psychological and physical health. 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. It has been shown to improve balance and flexibility in older individuals.  It is safe and can be practiced by anyone from children to seniors. Recently, there have been a number of high profile athletes who have adopted a yoga practice to improve their athletic performance. But, the lack of exercise that is often associated with aging is a major problem. It is not known whether yoga practice is as good as traditional exercise programs in improving the overall functional fitness of sedentary older adults and slow the age related physical decline.

 

In today’s Research News article “Yoga Is as Good as Stretching–Strengthening Exercises in Improving Functional Fitness Outcomes: Results From a Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5864160/ ), Gothe and McAuley recruited older sedentary adults over 55 years of age and randomly assigned them to engage in either 8 weeks, 3 times per week, Hatha yoga practice or stretching–strengthening exercises. The Senior Fitness test was administered before and after training. It measured strength, agility, balance, endurance, flexibility, and gait speed.

 

They found that both the yoga and stretching–strengthening exercise practices produced significant improvements in the older participants’ functional fitness for all measured parameters. So, yoga practice produced as good improvements in fitness as more traditional exercise. In, addition, yoga practice was found to produce significantly better leg balance than stretching–strengthening exercise. This is important as problems with balance contributes to falls in the elderly which is a major contributor to poor health and mortality.

 

These are important and interesting results that suggest that older individuals can choose between yoga and more traditional exercise to improve their fitness and slow their physical decline. In general, yoga practice has been found to be safe and effective and if practiced with groups it can also be more fun and tend to offset the social isolation experienced by the elderly. Hence, yoga practice may be an excellent choice to maintain fitness during aging.

 

So, improve functional fitness with yoga.

 

“Yoga promotes physical health in multiple different ways. Some of them derive from better stress management. Others come more directly from the physical movements and postures in yoga, which help promote flexibility and reduce joint pain.” – Harvard Health

 

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

 

Gothe, N. P., & McAuley, E. (2016). Yoga Is as Good as Stretching–Strengthening Exercises in Improving Functional Fitness Outcomes: Results From a Randomized Controlled Trial. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 71(3), 406–411. http://doi.org/10.1093/gerona/glv127

 

Abstract

Background.

Despite yoga’s popularity, few clinical trials have employed rigorous methodology to systematically explore its functional benefits compared with more established forms of exercise. The objective of this study was to compare the functional benefits of yoga with the conventional stretching–strengthening exercises recommended for adults.

Methods.

Sedentary healthy adults ( N = 118; Mage = 62.0) participated in an 8-week (three times a week for 1 hour) randomized controlled trial, which consisted of a Hatha yoga group ( n = 61) and a stretching–strengthening exercise group ( n = 57). Standardized functional fitness tests assessing balance, strength, flexibility, and mobility were administered at baseline and postintervention.

Results.

A repeated measures multivariate analysis of variance showed a significant time effect for measures of balance [ F (3,18) = 4.88, p < .01, partial η 2 = .45], strength [ F (2,19) = 15.37, p < .001, partial η 2 = .62], flexibility [ F (4,17) = 8.86, p < .001, partial η 2 = .68], and mobility [ F (2,19) = 8.54, p < .002, partial η 2= .47]. Both groups showed significant improvements on measures of balance (left–right leg and four square step); strength (chair stands and arm curls); flexibility (back scratch and sit-and-reach); and mobility (gait speed and 8-feet up and go), with partial η 2 ranging from .05 to .47.

Conclusions.

These data suggest that regular yoga practice is just as effective as stretching–strengthening exercises in improving functional fitness. To our knowledge, this is the first study to examine functional benefits of yoga in comparison with stretching–strengthening exercises in sedentary, healthy, community-dwelling older adults. These findings have clinical implications as yoga is a more amenable form of exercise than strengthening exercises as it requires minimal equipment and can be adapted for individuals with lower levels of functioning or disabilities.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5864160/

 

Reduce Health Symptoms of Burnout with Yoga and Mindfulness

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Reduce Health Symptoms of Burnout with Yoga and Mindfulness

 

By John M. de Castro, Ph.D.

 

“Teachers who practice yoga say it has given them an outlet for the daily stresses and frustrations of teaching. It also equips them with strategies to stay calm during chaotic moments and helps them understand and reflect on both their mindset and that of their students.” – Madeline Will

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations burnout is all too prevalent. It frequently results from emotional exhaustion. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. Sleep disruption is an important consequence of the stress.  This exhaustion produces a loss of enthusiasm, empathy, and compassion. Regardless of the reasons for burnout or its immediate presenting consequences, it is a threat to the workplace. From a business standpoint, it reduces employee efficiency and productivity and increases costs. From the worker perspective, it makes the workplace a stressful, unhappy place, promoting physical and psychological problems that can become so severe as to result in sick leave. Hence, preventing burnout in the workplace is important.

 

Mindfulness techniques, including meditation, yoga, and Mindfulness-Based Cognitive Therapy (MBCT) are gaining increasing attention for the treatment of the symptoms of stress and burnout. They have been demonstrated to be helpful in reducing the psychological and physiological responses to stress and for treating and preventing burnout in a number of work environments. It is not known, however, which of the myriad of mindfulness training techniques is best for the treatment of burnout.

 

In today’s Research News article “Effect of traditional yoga, mindfulness–based cognitive therapy, and cognitive behavioral therapy, on health related quality of life: a randomized controlled trial on patients on sick leave because of burnout.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839058/ ), Grensman and colleagues recruited workers who were on sick leave for work-related burnout. They were randomly assigned to receive either traditional yoga (Ashtanga Yoga), Mindfulness-Based Cognitive Therapy (MBCT), or Cognitive Behavioral Therapy (CBT). Therapy included three hours of supervised group training per week and the participants practiced on their own for 1–1½ hours, 3–4 times a week, including homework. They were measured before and after treatment for health-related quality of life.

 

They found that all three interventions produced significant improvements in 12 of the 13 subscales of health-related quality of life; including physical well-being, emotional well-being, sleep, cognitive function, general health perceptions, satisfaction with family and with partner, and sexual function. The outcomes produced by the interventions containing mindfulness training (yoga and Mindfulness-Based Cognitive Therapy (MBCT)) were slightly, albeit significantly better than those produced by Cognitive Behavioral Therapy (CBT).

 

The study implies that the physical and psychological state of workers on sick leave for work-related burnout can be significantly improved by all of the three therapies tested. It is unfortunate that a no-treatment control or a non-effective treatment was included as without such comparison conditions it is impossible to tell if the treatment was effective or that the patients improved due to healing over time, spontaneous recovery, or participant expectancy effects.

 

But the fact that yoga and Mindfulness-Based Cognitive Therapy (MBCT) were slightly better than those produced by Cognitive Behavioral Therapy (CBT) suggests that the effects of these treatments that contained mindfulness training were not due to these potential confounding variables. This further suggests that mindfulness-based treatments are effective in reducing the symptoms of severe burnout. It appears that training in mindfulness is a very important component of any treatment for the symptoms of burnout.

 

So, reduce health symptoms of burnout with yoga and mindfulness.

 

“meditation helps in a number of ways. When you are forever on the go, you can easily disconnect from the fact that you’re ready to drop, your neck is crippled with tension or you haven’t breathed deeper than your upper chest for over 24 hours. Meditation provides an opportunity for you to check in with your body. It also provides a framework within which you can practice observing your thoughts and emotions rather than trying to tackle them. This gives you a new perspective on a very busy mind and far more space to make more rational decisions and reduce procrastination.” – Shona Mitchell

 

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

 

Grensman, A., Acharya, B. D., Wändell, P., Nilsson, G. H., Falkenberg, T., Sundin, Ö., & Werner, S. (2018). Effect of traditional yoga, mindfulness–based cognitive therapy, and cognitive behavioral therapy, on health related quality of life: a randomized controlled trial on patients on sick leave because of burnout. BMC Complementary and Alternative Medicine, 18, 80. http://doi.org/10.1186/s12906-018-2141-9

 

Abstract

Background

To explore if health related quality of life(HRQoL) increased after traditional yoga(TY), mindfulness based cognitive therapy(MBCT), or cognitive behavioral therapy(CBT), in patients on sick leave because of burnout.

Methods

Randomized controlled trial, blinded, in ninety-four primary health care patients, block randomized to TY, MBCT or CBT (active control) between September 2007 and November 2009. Patients were living in the Stockholm metropolitan area, Sweden, were aged 18–65 years and were on 50%–100% sick leave. A group treatment for 20 weeks, three hours per week, with homework four hours per week. HRQoL was measured by the SWED-QUAL questionnaire, comprising 67 items grouped into 13 subscales, each with a separate index, and scores from 0 (worse) to 100 (best). SWED-QUAL covers aspects of physical and emotional well-being, cognitive function, sleep, general health and social and sexual functioning. Statistics: Wilcoxon’s rank sum and Wilcoxon’s sign rank tests, Bonett-Price for medians and confidence intervals, and Cohen’s D.

Results

Twenty-six patients in the TY (21 women), and 27 patients in both the MBCT (24 women) and in the CBT (25 women), were analyzed. Ten subscales in TY and seven subscales in MBCT and CBT showed improvements, p < 0.05, in several of the main domains affected in burnout, e.g. emotional well-being, physical well-being, cognitive function and sleep. The median improvement ranged from 0 to 27 points in TY, from 4 to 25 points in CBT and from 0 to 25 points in MBCT. The effect size was mainly medium or large. Comparison of treatments showed no statistical differences, but better effect (small) of both TY and MBCT compared to CBT. When comparing the effect of TY and MBCT, both showed a better effect (small) in two subscales each.

Conclusions

A 20 week group treatment with TY, CBT or MBCT had equal effects on HRQoL, and particularly on main domains affected in burnout. This indicates that TY, MBCT and CBT can be used as both treatment and prevention, to improve HRQoL in patients on sick leave because of burnout, reducing the risk of future morbidity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839058/

 

Improve Arthritis in Older Adults with Seated Yoga

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Improve Arthritis in Older Adults with Seated Yoga

 

By John M. de Castro, Ph.D.

 

“Chair yoga may help to reduce pain in older adults suffering from arthritis. Based around the ancient form of exercise, it allows people with reduced mobility to also take part. It helps to boost the strength and flexibility of older people and could become an effective treatment for those with the debilitating condition.” Stephen Matthews

 

Osteoarthritis is a chronic degenerative joint disease that is the most common form of arthritis. It produces pain, swelling, and stiffness of the joints. It is the leading cause of disability in the U.S., with about 43% of arthritis sufferers limited in mobility and about a third having limitations that affect their ability to perform their work. Knee osteoarthritis effects 5% of adults over 25 years of age and 12% of those over 65. It is painful and disabling. Its causes are varied including, hereditary, injury including sports injuries, repetitive stress injuries, infection, or from being overweight.

 

There are no cures for knee osteoarthritis. Treatments are primarily symptomatic, including weight loss, exercise, braces, pain relievers and anti-inflammatory drugs, corticosteroids, arthroscopic knee surgery, or even knee replacement. Gentle movements of the joints with exercise and physical therapy appear to be helpful in the treatment of knee osteoarthritis. This suggests that alternative and complementary practices that involve gentle knee movements may be useful for treatment.

 

Mindfulness practices such as Tai Chi and Qigong  and yoga have been shown to reduce the physical symptoms of knee osteoarthritis. Yoga, has been shown to be a safe and effective treatment for a wide variety of physical and psychological conditions, including arthritis. But, people with lower extremity osteoarthritis have difficulty with balance making standing postures problematic. So, it would seem reasonable to look into the effectiveness of yoga practice performed while sitting in a chair in treating knee osteoarthritis.

 

In today’s Research News article “A Pilot Randomized Controlled Trial of the Effects of Chair Yoga on Pain and Physical Function Among Community-Dwelling Older Adults With Lower Extremity Osteoarthritis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357158/ ), Park and colleagues recruited older adults (>65 years of age) with osteoarthritis of the lower extremity joints; hip, knee; ankle, and foot. They were randomly assigned to either receive health education or seated Hatha yoga practice. Both Health Education and yoga was practiced for 45 minutes twice a week for 8 weeks and home practice was encouraged. The participants were measured before and after treatment and at a 1-month and 3-month follow-up for pain interference in everyday activities, fatigue, balance, walking speed, pain, and functional ability.

 

They found that after the 8-weeks of practice and at the 1- and 3-month follow-ups, the yoga group had significantly greater reductions in pain, pain interference in daily activities, fatigue, and walking speed. There were no significant adverse events observed. Hence, practicing yoga while seated was well tolerated and safe and produced significant improvements in the symptoms of lower extremity osteoarthritis in elderly adults. This suggests that seated yoga practice may be a welcome, safe and effective alternative to pharmacologic or surgical treatment for osteoarthritis in the elderly.

 

So, improve arthritis in older adults with seated Yoga.

 

“The potential impact of this study on public health is high, as this program provides an approach for keeping community-dwelling elders active even when they cannot participate in traditional exercise that challenges their balance,” – Patricia Liehr

 

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

 

Park, J., McCaffrey, R., Newman, D., Liehr, P., & Ouslander, J. G. (2017). A Pilot Randomized Controlled Trial of the Effects of Chair Yoga on Pain and Physical Function Among Community-Dwelling Older Adults With Lower Extremity Osteoarthritis. Journal of the American Geriatrics Society, 65(3), 592–597. http://doi.org/10.1111/jgs.14717

 

Abstract

Objectives

To determine effects of Sit ‘N’ Fit Chair Yoga, compared to a Health Education program (HEP), on pain and physical function in older adults with lower extremity osteoarthritis (OA) who could not participate in standing exercise

Design

Two-arm randomized controlled trial

Setting

One HUD senior housing facility and one day senior center in south Florida

Participants

Community-dwelling older adults (N = 131) were randomly assigned to chair yoga (n = 66) or HEP (n = 65). Thirteen dropped after assignment but prior to the intervention; 6 dropped during the intervention; 106 of 112 completed at least 12 of 16 sessions (95% retention rate).

Interventions

Participants attended either chair yoga or HEP. Both interventions consisted of twice-weekly 45-minute sessions for 8 weeks.

Measurements

Primary: pain, pain interference; secondary: balance, gait speed, fatigue, functional ability measured at baseline, after 4 weeks of intervention, at the end of the 8-week intervention, and post-intervention (1 and 3 months).

Results

The chair yoga group showed greater reduction in pain interference during the intervention (p = .01), sustained through 3 months (p = .022). WOMAC pain (p = .048), gait speed (p = .024), and fatigue (p = .037) were improved in the yoga group during the intervention (p = .048) but improvements were not sustained post intervention. Chair yoga had no effect on balance.

Conclusion

An 8-week chair yoga program was associated with reduction in pain, pain interference, and fatigue, and improvement in gait speed, but only the effects on pain interference were sustained 3 months post intervention. Chair yoga should be further explored as a nonpharmacologic intervention for older people with OA in the lower extremities.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357158/

 

Improve College Students Responses to Stress with Yoga

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Improve College Students Responses to Stress with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga is a practice of uniting the mind and physical body as one. It combines breathing exercise, meditation, and physical positions. This combination is believed to reduce many physical and mental ailments that are caused by stress.” – Rebecca Chasar

 

In the modern world education is a key for success. Where a high school education was sufficient in previous generations, a college degree is now required to succeed in the new knowledge-based economies. There is a lot of pressure on students to excel so that they can be admitted to the best universities and there is a lot of pressure on university students to excel so that they can get the best jobs after graduation. As a result, parents and students are constantly looking for ways to improve student performance in school. The primary tactic has been to pressure the student and clear away routine tasks and chores so that the student can focus on their studies. But, this might in fact be counterproductive as the increased pressure can actually lead to stress and anxiety which can impede the student’s mental health, well-being, and school performance.

 

It is, for the most part, beyond the ability of the individual to change the environment to reduce stress, so it is important that methods be found to reduce the college students’ responses to stress; to make them more resilient when high levels of stress occur. Contemplative practices including meditation, mindfulness training, and yoga practice have been shown to reduce the psychological and physiological responses to stress. In, addition, exercise if also know to reduce responses to stress. But, nearly half of college students are physically inactive. So, yoga, which is both a mindfulness practice and a physical activity should be particularly effective.

 

In today’s Research News article “Psychophysiological effects of yoga on stress in college students.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5868218/  ), Tripathi and colleagues review the published research literature on the effectiveness of yoga practice to reduce the physiological and psychological responses to stress in college students.

 

They report yoga training has been found to reduce autonomic arousal, reducing sympathetic nervous system activity and increasing parasympathetic nervous system activity. Since, physiological arousal is characteristic of stress responding, yoga practice reduces this physiological marker of stress. Yoga practice reduces perceived stress, tension, sleepiness, worry, and negative emotions and increases relaxation, mental quiet, peace, rest, strength, awareness and joy, thereby improving psychological well-being. Hence, the existing research suggests that yoga practice may be valuable in helping college students cope with the physical and mental consequences of stress and thereby improve their performance in school.

 

So, improve college students responses to stress with yoga.

 

“As science continues to understand the negative effects of stress on our mental and physical bodies, techniques like meditation and yoga that were once considered fringe are becoming prolifically mainstream.  If we can begin to understand and utilize these techniques before stress becomes an issue, then these tools can be even more valuable.” – Kelly Golden

 

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

 

Tripathi, M. N., Kumari, S., & Ganpat, T. S. (2018). Psychophysiological effects of yoga on stress in college students. Journal of Education and Health Promotion, 7, 43. http://doi.org/10.4103/jehp.jehp_74_17

 

Abstract

College students are vulnerable to a critical period in developmental maturation, facing rigorous academic work, and learning how to function independently. Physical activities such as running and bicycling have been shown to improve mood and relieve stress. However, college students often have low levels of physical activity. Yoga is an ancient physical and mental activity that affects mood and stress. However, studies examining the psychophysiological effects of yoga are rare in peer-reviewed journals. The aim of this study is to establish preliminary evidence for the psychophysiological effects of yoga on stress in young-adult college students. The present study suggests that yoga has positive effects on a psychophysiological level that leads to decreased levels of stress in college student. Further research is needed to examine the extent to which different types of yogic practices address the needs of different college subpopulations (e.g., overweight, sedentary, and smokers).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5868218/

Improve Psychological and Physical Health During Cancer Treatment with Yoga

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Improve Psychological and Physical Health During Cancer Treatment with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga for cancer patients—what better way to manage anxiety, gain strength, increase flexibility, and create feelings of well-being! A growing body of research points to the potential of yoga for supporting cancer patients, both during and after treatment.” – Tari Prinster

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Yoga practice is a form of mindfulness training that has been shown to be beneficial for cancer patients. In today’s Research News article “Review of Yoga Therapy During Cancer Treatment.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5777241/ ), Danhauer and colleagues review and summarize the published research studies on the application of yoga practice to the treatment of cancer patients undergoing treatment. They identified 12 non-randomized and 13 randomized published clinical trials.

 

They found that the research reports that yoga practice improves the psychological and physical health of cancer patients undergoing treatment. These include psychological improvements in anxiety, depression, mood, negative affect, relaxation, overall mental health, cognition, spiritual well-being, social support, self-efficacy, and coping, and physical improvements in overall health, physical quality of life, fatigue, invigoration, sleep, most-bothersome symptom, and upregulation of genes involved in immunity.

 

These are impressive results that strongly suggest that yoga practice is of great benefit to cancer patients undergoing treatment. It appears to be safe, with few if any negative side effects, be acceptable for patients undergoing treatment, and to improve the patients’ mental and physical health.

 

Yoga practice is generally complex, involving a number of components including, postures, meditation, breathing exercises, and chanting. It is unclear from the research which ones or which combinations of these components are responsible for the benefits. It remains for future research to better clarify how yoga functions to produce these remarkable benefits for cancer patients. Such a clarification could lead to improved and more targeted practices.

 

So, improve psychological and physical health during cancer treatment with yoga.

 

“Cancer patients who practice yoga as therapy during their treatment often refer to their yoga practice as a life-saver. The healing power of yoga helps both cancer patients and cancer survivors. No matter how sick from treatments and no matter how little energy, many find that the one thing that would bring relief were a gentle set of therapeutic yoga poses geared for cancer patients.” – 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

 

Danhauer, S. C., Addington, E. L., Sohl, S. J., Chaoul, A., & Cohen, L. (2017). Review of Yoga Therapy During Cancer Treatment. Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, 25(4), 1357–1372. http://doi.org/10.1007/s00520-016-3556-9

 

Abstract

Purpose

Reviews of yoga research that distinguish results of trials conducted during (versus after) cancer treatment are needed to guide future research and clinical practice. We therefore conducted a review of non-randomized studies and randomized controlled trials of yoga interventions for children and adults undergoing treatment for any cancer type.

Methods

Studies were identified via research databases and reference lists. Inclusion criteria: (1) children or adults undergoing cancer treatment; (2) intervention stated as yoga or component of yoga; and (3) publication in English in peer-reviewed journals through October 2015. Exclusion criteria: (1) samples receiving hormone therapy only; (2) interventions involving only meditation; and (3) yoga delivered within broader cancer recovery or mindfulness-based stress reduction programs.

Results

Results of non-randomized (adult: n=8, pediatric: n=4) and randomized controlled trials (adult: n=13, pediatric: n=0) conducted during cancer treatment are summarized separately by age group. Findings most consistently support improvement in psychological outcomes (e.g., depression, distress, anxiety). Several studies also found that yoga enhanced quality of life, though further investigation is needed to clarify domain-specific efficacy (e.g., physical, social, cancer-specific). Regarding physical and biomedical outcomes, evidence increasingly suggests that yoga ameliorates sleep and fatigue; additional research is needed to advance preliminary findings for other treatment sequelae and stress/immunity biomarkers.

Conclusions

Among adults undergoing cancer treatment, evidence supports recommending yoga for improving psychological outcomes, with potential for also improving physical symptoms. Evidence is insufficient to evaluate the efficacy of yoga in pediatric oncology. We describe suggestions for strengthening yoga research methodology to inform clinical practice guidelines.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5777241/

 

Relieve Major Depression with Yoga

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Relieve Major Depression with Yoga

 

By John M. de Castro, Ph.D.

 

“for many patients dealing with depression, anxiety, or stress, yoga may be a very appealing way to better manage symptoms. Indeed, the scientific study of yoga demonstrates that mental and physical health are not just closely allied, but are essentially equivalent. The evidence is growing that yoga practice is a relatively low-risk, high-yield approach to improving overall health.” – Harvard Mental Health Letter

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. It is also generally episodic, coming and going. Some people only have a single episode but most have multiple reoccurrences of depression.  Depression can be difficult to treat. It is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But, drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Even after remission some symptoms of depression may still be present (residual symptoms).

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.  Another effective alternative treatment is exercise. But it is difficult to get depressed people, who lack energy, to engage in regular exercise. Yoga is a contemplative practice that is both a mindfulness practice and an exercise. It has been shown to be effective in the treatment of depression and even yogic breathing alone has been found to be effective. So, the combination of yoga practice with breathing exercises should be particularly effective.

 

In today’s Research News article “Adjunctive yoga vs. health education for persistent major depression: a randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548599/ ), Uebelacker and colleagues recruited patients with Major Depressive Disorder (MDD) who were being treated with antidepressant medications and randomly assigned them to receive either 10 weeks of Hatha Yoga or a Health Education Workshop. Yoga classes included breathing exercises, meditation, and postures, and met for 80 minutes, twice a week for 10 weeks. Participants were encouraged to also practice at home. Health education classes included presentations on alcohol, nicotine, and caffeine; being a smart patient; brain diseases; cancer prevention; diabetes; nutrition; germs, colds, and the flu; physical activity; sleep; physical pain, prevalence and causes of depression; and protecting your heart and met for 60 minutes, twice a week for 10 weeks. Participants were encouraged to also study at home. Participants were measured before and after treatment and 3 and 6 months later for depression, physical health, and physical activity.

 

They found that at the end of training there was no significant difference between the groups in depression, but over the following 3 and 6 months, the yoga practice group significantly decreased in depression levels with moderate effect size while the health education group did not. In addition, over the 3 and 6 months follow-up period a greater percentage of participants in the yoga group no longer met the criterion for clinical depression. There were no significant changes in physical health and no adverse events recorded. So, yoga practice was found to be a safe and effective for major depression even in combination with antidepressant medication.

 

It is important to note that the yoga group continued to practice at home after the 10 week training period averaging 36 and 34 minutes of practice per week over the 3 and 6 months follow-up periods. It is not known but suspected that the improvements in depression over this period may have been due to the continued practice. It is also important to note that this study was of excellent quality with an equivalent control condition. This is rare in this kind of research and greatly strengthens the conclusions. Hence, it appears that yoga practice helps to relieve depression in patients with Major Depressive Disorder (MDD) even with continued antidepressant medication.

 

So, relieve major depression with yoga.

 

“yoga classes dramatically reduced levels of depression—so much so that afterward most of the research subjects wouldn’t have qualified as depressed enough to participate in the study in the first place.” – Jessica Berger Gross

 

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

 

Uebelacker, L. A., Tremont, G., Gillette, L. T., Epstein-Lubow, G., Strong, D. R., Abrantes, A. M., … Miller, I. W. (2017). Adjunctive yoga vs. health education for persistent major depression: a randomized controlled trial. Psychological Medicine, 47(12), 2130–2142. http://doi.org/10.1017/S0033291717000575

 

Abstract

Background

The objective of this study was to determine whether hatha yoga is an efficacious adjunctive intervention for individuals with continued depressive symptoms despite antidepressant treatment.

Methods

We conducted a randomized controlled trial of weekly yoga classes (n = 63) vs. health education classes (Healthy Living Workshop, or HLW; n = 59) in individuals with elevated depression symptoms and antidepressant medication use. HLW served as an attention-control group. The intervention period was 10 weeks, with follow-up assessments 3 and 6 months afterwards. The primary outcome was depression symptom severity assessed by blind rater at 10 weeks. Secondary outcomes included depression symptoms over the entire intervention and follow-up periods, social and role functioning, general health perceptions, pain, and physical functioning.

Results

At 10 weeks, we did not find a statistically significant difference between groups in depression symptoms (b=−0.82, SE=0.88, p=0.36). However, over the entire intervention and follow-up period, when controlling for baseline, yoga participants showed lower levels of depression than HLW participants (b = −1.38, SE = 0.57, p = 0.02). Fifty-one percent of yoga participants demonstrated a response (≥ 50% reduction in depression symptoms) at 6 month-follow-up, compared to 31% of HLW participants (OR = 2.31; p = 0.04). Yoga participants showed significantly better social and role functioning and general health perceptions over time.

Conclusions

Although we did not see a difference in depression symptoms at the end of the intervention period, yoga participants showed fewer depression symptoms over the entire follow-up period. Benefits of yoga may accumulate over time.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548599/

 

Reduce Substance Abuse with Yoga

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Reduce Substance Abuse with Yoga

By John M. de Castro, Ph.D.

 

“When people take substances, they’re seeking a certain experience, whether it’s escapist or transcendental or just wanting a different psychological state, to get away from whatever is making them unhappy. Yoga is an alternative, a positive way to generate a change in consciousness that, instead of providing an escape, empowers people with the ability to access a peaceful, restorative inner state that integrates mind, body, and spirit.” – Sat Bir Khalsa

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. In the U.S. about 17 million people abuse alcohol. Drunk driving fatalities accounted for over 10,000 deaths annually. “Tobacco use remains the single largest preventable cause of death and disease in the United States. Cigarette smoking kills more than 480,000 Americans each year, with more than 41,000 of these deaths from exposure to secondhand smoke. In addition, smoking-related illness in the United States costs more than $300 billion a year. In 2013, an estimated 17.8% (42.1 million) U.S. adults were current cigarette smokers.”  (Centers for Disease Control and Prevention).

 

Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse. Hence, it is important to find an effective method to both treat substance abuse disorders and to prevent relapses. Mindfulness practices have been shown to improve recovery from various addictions. Yoga is a mindfulness practice that has documented benefits for the individual’s psychological and physical health and well-being. There has been a paucity of studies, however, on the use of yoga practice to treat substance abuse.

 

In today’s Research News article “Role of Yoga in Management of Substance-use Disorders: A Narrative Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812135/ ), Kuppili and colleagues review and summarize the published research literature on the application of yoga practice for the treatment of substance abuse. They found 16 studies, 12 of which were randomized controlled trials.

 

There were 9 studies of yoga practice as a treatment for nicotine (smoking) addiction. These studies reported that yoga practice increased the desire to quit smoking, reduced cravings for cigarettes, and assisted in quitting. There were, however, mixed findings on the duration of these effects. There were 3 studies of yoga practice as a treatment for alcohol use disorders. These studies reported that yoga practice was helpful in reducing alcohol intake and depression. There were 3 studies of yoga practice as a treatment for opioid use disorders. These studies reported that yoga practice for patients undergoing treatment improved mood states and quality of life. There was only 1 study of yoga practice as a treatment for cocaine use disorder and reported improvements in perceived stress and quality of life.

 

The studies reviewed suggest that yoga practice may be of use in the treatment of substance use disorders particularly in improving the psychological state of patients under treatment and perhaps reducing cravings. There is obviously, though, a need for more studies with larger samples and with long-term follow-up. Yoga practice does not appear to a magical cure for substance abuse but may be helpful to the patient in kicking the habit. Clearly yoga practice has substantial psychological and physical benefits for practitioners and these in combination with its helpfulness for the treatment of substance abuse make it a reasonable choice for improving he well-being of patients with these disorders.

 

“Yoga is a complementary, or adjunct, health practice that is often considered a natural form of medicine. Adjunct means “in addition to,” and not “in place of.” Yoga is often beneficial when used in tandem with other traditional substance abuse treatment methods.” – American Addiction Centers

 

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

 

Pooja Patnaik Kuppili, Arpit Parmar, Ankit Gupta, Yatan Pal Singh Balhara. Role of Yoga in Management of Substance-use Disorders: A Narrative Review. J Neurosci Rural Pract. 2018 Jan-Mar; 9(1): 117–122. doi: 10.4103/jnrp.jnrp_243_17

 

Abstract

Substance use disorders are comparable to chronic medical illnesses and have a chronic relapsing course. Despite being significant contributors to morbidity and mortality, limited treatment options exist. The current narrative review was aimed at providing an overview of yoga therapy in substance-use disorders and discuss the relevant methodological issues. Articles published in English language till May 2017 indexed with PubMed, PubMed central, and Google Scholar were searched using search terms “Yoga,” “Substance use,” “Drug dependence,” “Nicotine,” “Tobacco,” “Alcohol,” “Opioids,” “Cannabis,” “Cocaine,” “Stimulants,” “Sedative hypnotics,” “Inhalants,” and “Hallucinogens” for inclusion in the review. A total of 314 studies were found fulfilling the stated criteria. Out of which, 16 studies were found to fulfill the inclusion and exclusion criteria and 12 were randomized control trials. The majority of studies were available on the role of yoga in management of nicotine dependence. Sample size of these studies ranged from 18 to 624. The majority of studies suggested the role of yoga in reducing substance use as well as substance-related craving (especially in nicotine-use disorders) in short term. However, more studies are required for demonstrating the long-term effects of yoga therapy in substance-use disorder.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812135/

 

Relieve Tinnitus with Yoga

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Relieve Tinnitus with Yoga

 

By John M. de Castro, Ph.D.

 

“With this new research we now know that regular yoga practice can reduce these symptoms and tinnitus without medication.” – Barry Keate

 

Tinnitus is one of the most common symptoms to affect humanity. People with tinnitus live with a phantom noise that can range from a low hiss or ringing to a loud roar or squeal which can be present constantly or intermittently. It can have a significant impact on people’s ability to hear, concentrate, or even participate in everyday activities. The vast majority of people with tinnitus have what is known as subjective tinnitus. This is caused by unknown problems somewhere in the auditory system; the inner, middle, or outer ear, the part of the brain that translates nerve signals as sounds, or the auditory nerves.

 

Approximately 25 million to 50 million people in the United States experience it to some degree. Approximately 16 million people seek medical attention for their tinnitus, and for up to two million patients, debilitating tinnitus interferes with their daily lives. There are a number of treatments for tinnitus including, counseling, sound therapy, drugs, and even brain stimulation. Unfortunately, none of these treatments is very effective. Mindfulness practices have been shown to be effective in treating Tinnitus. Hence there is a need to further explore the various forms of mindfulness practices as alternative treatments for tinnitus.

 

In today’s Research News article “The Effects of Yoga in Patients Suffering from Subjective Tinnitus.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786150/ ), Köksoy and colleagues recruited tinnitus patients and provided them with yoga instruction for an hour once a week for 12 weeks. The practice consisted of postures, breathing exercises, meditation, and relaxation. The participants were instructed to practice as often as possible at home. They were measured before and after yoga practice for tinnitus severity, the everyday and emotional handicap produced by tinnitus, and stress symptoms produced by tinnitus.

 

They found that after the yoga practice there was a large, 58%, and significant reduction in tinnitus severity, a 44% reduction in the handicap produced by tinnitus, and a 21% reduction in the stress produced by tinnitus, including the psychological, physical, and pain facets of tinnitus produced stress. Hence the yoga practice was very effective in improving the symptoms of tinnitus.

 

It should be noted that there wasn’t a comparison (control) condition present in the study. So, the results should be viewed as preliminary and a proof of concept. In addition, 1//3 of the original patient sample dropped out during the study. Nevertheless, the results provide a clear rationale for the performance of a large randomized controlled clinical trial of yoga for tinnitus. Tinnitus is such a widespread problem with few treatment options that a non-invasive and non-drug treatment that is safe and effective, would be a great step forward in relieving the suffering produced by this mysterious disease.

 

So, relieve tinnitus with yoga.

 

“Tinnitus sufferers will definitely be able to benefit from this type of yoga because of how relaxing it is and also beneficial in terms of overall health. When people who have tinnitus are more relaxed and less tense, they have a tendency to not perceive the ringing or buzzing sounds which they usually hear as much. Although this may not be a definitive cure for tinnitus, it is a rather good treatment option to explore.” – Ramdev Yoga

 

 

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

 

Sümbüle Köksoy, Can Mehmet Eti, Meltem Karataş, Yusuf Vayisoglu. The Effects of Yoga in Patients Suffering from Subjective Tinnitus. Int Arch Otorhinolaryngol. 2018 Jan; 22(1): 9–13. Published online 2017 Apr 3. doi: 10.1055/s-0037-1601415

 

Abstract

Introduction  Tinnitus is a perception of sound in the absence of an external source and it is a distressing issue. Yoga is a system of mind-body practices with the goal of uniting the body, mind and soul. It has been shown to reduce anxiety and stress, as well as improving the quality of life.

Objective  The aim of this study is to investigate the effects of yoga in patients suffering from chronic subjective tinnitus.

Methods  Twelve subjects previously diagnosed with chronic subjective tinnitus were selected for the study. The patients were asked to attend to yoga classes once a week and to practice yoga at home using a worksheet for 3 months. Each yoga class consisted of body exercises (asana), breathing (pranayama) and meditation (shavasana and yoga nidra). Tinnitus scores before and after the yoga classes were compared using the Wilcoxon test.

Results  Among the 12 patients, there were 4 men and 8 women and their mean age was 52.5 years. The median duration of tinnitus among the group was 5.4 years. There were statistically significant differences in the stress ( p  = 0.01), handicap ( p  = 0.004) and severity ( p  = 0.007) questionnaires scores.

Conclusion  This study indicated that yoga practices may reduce life stress and symptoms of subjective tinnitus.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786150/

Reduce Low Back Pain with Yoga

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Reduce Low Back Pain with Yoga

 

By John M. de Castro, Ph.D.

 

“For most of our lives, we take our backs for granted. But at some point in just about everyone’s life, our backs revolt and remind us that they need love and attention too. Thankfully, for many of us, the pain is only temporary. But for others, it can be much more debilitating—and much more frustrating. In severe cases, medical attention may be necessary, but if your pain is less severe, yoga may be able to help by strengthening the back, stretching it and improving circulation to the spine and nerves.” – Liz Rosenblum

 

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.

 

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. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, 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. So, it makes sense to further explore the effectiveness of yoga therapy for chronic low back pain.

 

In today’s Research News article “Yoga treatment for chronic non-specific low back pain.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5294833/ ), Wieland and colleagues review and summarize the published research studies that examined the effectiveness of yoga practice for the treatment of chronic low back pain. They discovered only 12 published research studies on the subject. They reported that the studies found that yoga practice in comparison to no-exercise control conditions produced small but significant improvements in pain and back function that were maintained for 6 months. This demonstrates that yoga practice is effective for back pain but does not allow for a determination of whether exercise in general or yoga specifically was effective. So, they looked at studies of yoga practice in comparison to other forms of exercise and found that yoga practice produced small but significantly better improvements than other exercises in pain but equivalent improvements in back function. When yoga practice was combined with other exercises it did not produce significantly greater benefits than exercise alone.

 

The summary suggests that yoga practice and other exercises are safe and effective treatments for chronic low back pain that can produce lasting improvements in pain and back function. They found evidence that yoga practice may be slightly better than other exercises in reducing pain, but there is no additional benefit of combining yoga with other exercises. Hence, yoga practice is an acceptable, safe, and effective alternative to drug and surgical treatments that has small but significant benefits for the relief to the suffering of people with chronic low back pain.

 

So, reduce low back pain with Yoga.

 

“a structured yoga program may be an alternative to physical therapy for people with chronic low-back pain, depending on individual preferences, availability, and cost.” – NCCIH

 

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

 

Wieland, L. S., Skoetz, N., Pilkington, K., Vempati, R., D’Adamo, C. R., & Berman, B. M. (2017). Yoga treatment for chronic non-specific low back pain. The Cochrane Database of Systematic Reviews, 1, CD010671. http://doi.org/10.1002/14651858.CD010671.pub2

 

Abstract

Background

Non-specific low back pain is a common, potentially disabling condition usually treated with self-care and non-prescription medication. For chronic low back pain, current guidelines state that exercise therapy may be beneficial. Yoga is a mind-body exercise sometimes used for non-specific low back pain.

Objectives

To assess the effects of yoga for treating chronic non-specific low back pain, compared to no specific treatment, a minimal intervention (e.g. education), or another active treatment, with a focus on pain, function, and adverse events.

Search methods

We searched CENTRAL, MEDLINE, Embase, five other databases and four trials registers to 11 March 2016 without restriction of language or publication status. We screened reference lists and contacted experts in the field to identify additional studies.

Selection criteria

We included randomized controlled trials of yoga treatment in people with chronic non-specific low back pain. We included studies comparing yoga to any other intervention or to no intervention. We also included studies comparing yoga as an adjunct to other therapies, versus those other therapies alone.

Data collection and analysis

Two authors independently screened and selected studies, extracted outcome data, and assessed risk of bias. We contacted study authors to obtain missing or unclear information. We evaluated the overall certainty of evidence using the GRADE approach.

Main results

We included 12 trials (1080 participants) carried out in the USA (seven trials), India (three trials), and the UK (two trials). Studies were unfunded (one trial), funded by a yoga institution (one trial), funded by non-profit or government sources (seven trials), or did not report on funding (three trials). Most trials used Iyengar, Hatha, or Viniyoga forms of yoga. The trials compared yoga to no intervention or a non-exercise intervention such as education (seven trials), an exercise intervention (three trials), or both exercise and non-exercise interventions (two trials). All trials were at high risk of performance and detection bias because participants and providers were not blinded to treatment assignment, and outcomes were self-assessed. Therefore, we downgraded all outcomes to ‘moderate’ certainty evidence because of risk of bias, and when there was additional serious risk of bias, unexplained heterogeneity between studies, or the analyses were imprecise, we downgraded the certainty of the evidence further.

For yoga compared to non-exercise controls (9 trials; 810 participants), there was low-certainty evidence that yoga produced small to moderate improvements in back-related function at three to four months (standardized mean difference (SMD) −0.40, 95% confidence interval (CI) −0.66 to −0.14; corresponding to a change in the Roland-Morris Disability Questionnaire of mean difference (MD) −2.18, 95% −3.60 to −0.76), moderate-certainty evidence for small to moderate improvements at six months (SMD −0.44, 95% CI −0.66 to −0.22; corresponding to a change in the Roland-Morris Disability Questionnaire of MD −2.15, 95% −3.23 to −1.08), and low-certainty evidence for small improvements at 12 months (SMD −0.26, 95% CI −0.46 to −0.05; corresponding to a change in the Roland-Morris Disability Questionnaire of MD −1.36, 95% −2.41 to −0.26). On a 0–100 scale there was very low- to moderate-certainty evidence that yoga was slightly better for pain at three to four months (MD −4.55, 95% CI −7.04 to −2.06), six months (MD −7.81, 95% CI −13.37 to −2.25), and 12 months (MD −5.40, 95% CI −14.50 to −3.70), however we pre-defined clinically significant changes in pain as 15 points or greater and this threshold was not met. Based on information from six trials, there was moderate-certainty evidence that the risk of adverse events, primarily increased back pain, was higher in yoga than in non-exercise controls (risk difference (RD) 5%, 95% CI 2% to 8%).

For yoga compared to non-yoga exercise controls (4 trials; 394 participants), there was very-low-certainty evidence for little or no difference in back-related function at three months (SMD −0.22, 95% CI −0.65 to 0.20; corresponding to a change in the Roland-Morris Disability Questionnaire of MD −0.99, 95% −2.87 to 0.90) and six months (SMD −0.20, 95% CI −0.59 to 0.19; corresponding to a change in the Roland-Morris Disability Questionnaire of MD −0.90, 95% −2.61 to 0.81), and no information on back-related function after six months. There was very low-certainty evidence for lower pain on a 0–100 scale at seven months (MD −20.40, 95% CI −25.48 to −15.32), and no information on pain at three months or after seven months. Based on information from three trials, there was low-certainty evidence for no difference in the risk of adverse events between yoga and non-yoga exercise controls (RD 1%, 95% CI −4% to 6%).

For yoga added to exercise compared to exercise alone (1 trial; 24 participants), there was very-low-certainty evidence for little or no difference at 10 weeks in back-related function (SMD −0.60, 95% CI −1.42 to 0.22; corresponding to a change in the Oswestry Disability Index of MD −17.05, 95% −22.96 to 11.14) or pain on a 0–100 scale (MD −3.20, 95% CI −13.76 to 7.36). There was no information on outcomes at other time points. There was no information on adverse events.

Studies provided limited evidence on risk of clinical improvement, measures of quality of life, and depression. There was no evidence on work-related disability.

Authors’ conclusions

There is low- to moderate-certainty evidence that yoga compared to non-exercise controls results in small to moderate improvements in back-related function at three and six months. Yoga may also be slightly more effective for pain at three and six months, however the effect size did not meet predefined levels of minimum clinical importance. It is uncertain whether there is any difference between yoga and other exercise for back-related function or pain, or whether yoga added to exercise is more effective than exercise alone. Yoga is associated with more adverse events than non-exercise controls, but may have the same risk of adverse events as other back-focused exercise. Yoga is not associated with serious adverse events. There is a need for additional high-quality research to improve confidence in estimates of effect, to evaluate long-term outcomes, and to provide additional information on comparisons between yoga and other exercise for chronic non-specific low back pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5294833/