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Yoga for epilepsy.

BACKGROUND: Stress is considered an important precipitating factor for seizures. Yoga is believed to induce relaxation and stress reduction. The effect of yoga on the EEG and the autonomic nervous system have been reported. Yoga would be an attractive therapeutic option for epilepsy (if proved effective), in view of its nonpharmacological nature, minimal side effects and international acceptance. OBJECTIVES: To assess the efficacy of yoga in the treatment of patients with epilepsy. SEARCH STRATEGY: We searched the Cochrane Epilepsy Group trial register, the Cochrane Controlled Trials Register (The Cochrane Library Issue 4, 1998), MEDLINE for articles published up to the middle of 1998, and also registries of the research council for complimentary medicine were searched. In addition, we searched the references of all the identified studies. Finally, we contacted the members of the Neurological Society of India, several neurophysiology institutions and yoga institutes to seek any ongoing studies or studies published in nonindexed journals or unpublished studies. SELECTION CRITERIA: Randomized control trials and controlled clinical trials of treatment of epilepsy with yoga. DATA COLLECTION AND ANALYSIS: The data were extracted independently by both reviewers and any discrepancies were resolved by discussion. The main outcomes assessed were percentage of patients rendered seizure free, number of patients with more than 50% reduction in seizure frequency or seizure duration and the overall reduction in seizure frequency. Analyses were on an intention to treat basis. MAIN RESULTS: Only one study met the selection criteria, and recruited a total of 32 patients, 10 to sahaja yoga and 22 to control treatments. Antiepileptic drugs were continued in all. Randomization was by roll of a dice. The results of this study are as follows: (i) Four patients treated with yoga were seizure free for six months compared to none in the control groups. The Odds Ratio (OR) (95% Confidence Interval (CI)) for yoga versus sham yoga group was 14.5 (0.7, 316.7) and for yoga versus no treatment group 17.3 (0.8, 373.5). (ii) Nine patients in the yoga group had more than 50% reduction in seizure frequency compared to only one among the controls. The OR (95% CI) for yoga versus sham yoga group was 81 (4.4, 1504.5) and for the yoga versus no treatment group was 158.3 (5.8, 4335.9). (iii) There was a decline in the average number of attacks per month compared to the baseline frequency among the patients treated with yoga. The weighted mean difference ( 95% CI) between yoga versus sham yoga group was -2.1 (-3.1, -1.0) and for the yoga versus no treatment group -1.1 (-1.8, -0.4). (iv) More than 50% reduction in seizure duration was found in seven of the 10 patients treated with yoga, compared to none among the 22 controls. The OR (95%CI) for yoga versus sham yoga group was 45 (2.0, 1006.8) and for yoga versus no treatment group 53.57 (2.4, 1187.3). REVIEWER'S CONCLUSIONS: No reliable conclusions can be drawn regarding the efficacy of yoga as a treatment for epilepsy. Further studies are necessary to evaluate the efficacy of yoga in the treatment of epilepsy.

Complementary Therapies↗

Yoga MAT: A factorial randomized study using the Multiphase Optimization Strategy to develop a multicomponent yoga intervention for people with chronic pain taking medications for opioid use disorder.

BACKGROUND: People taking medications for opioid use disorder (MOUD) commonly experience chronic pain. Yoga interventions show promise for decreasing pain-related disability in other populations. More time spent in yoga practice may improve pain-related outcomes. METHODS: The Multiphase Optimization Strategy (MOST) provided the framework for developing an optimized yoga intervention package. In a 2x2x2x2 factorial experiment, we evaluated four candidate intervention components which, when added to a weekly yoga class, might increase yoga engagement. The primary outcome was minutes per week of yoga practice (classes and other yoga practice) over the 12-week intervention period. We sought to determine which combination of intervention components was associated with the most yoga practice for people with chronic pain taking buprenorphine or methadone as MOUD. RESULTS: We enrolled 192 adults. There was a significant main effect for Component "B" (having two private sessions with a yoga teachers; IRR = 1.10, 90%CI 1.02; 1.18), and a synergistic interaction between Components "B" and "D" (D was financial incentives for attending class; IRR = 1.11, 90%CI 1.02; 1.19). This combination of these two components (without other potential components) was associated with the second highest model-predicted mean minutes of yoga per week (157.1min; 90% CI = 120.1-194.0) which was only 4min less than the combination including all four components. CONCLUSIONS: We identified a combination of intervention components as the optimized intervention. A next step will be to test the effect of this optimized intervention on pain and substance use outcomes in a randomized controlled clinical trial.

Humans↗

The effects of yoga training and a single bout of yoga on delayed onset muscle soreness in the lower extremity.

The purpose of this study was to determine the effects of yoga training and a single bout of yoga on the intensity of delayed onset muscle soreness (DOMS). 24 yoga-trained (YT; n = 12) and non-yoga-trained (CON; n = 12), matched women volunteers were administered a DOMS-inducing bench-stepping exercise. Muscle soreness was assessed at baseline, 24, 48, 72, 96, and 120 hours after bench-stepping using a Visual Analog Scale (VAS). Groups were also compared on body awareness (BA), flexibility using the sit-and-reach test (SR), and perceived exertion (RPE). Statistical significance was accepted at p </= 0.05. A 2 x 2 mixed factorial ANOVA with repeated measures at 24 and 48 hours revealed a significant (p < 0.05) group main effect with VAS scores greater for CON than YT. Paired t-tests revealed that in YT, VAS scores were higher before yoga class than after yoga class at 24 hours (21.4 [+/- 6.9] mm vs. 11.1 [+/- 4.1] mm; p = 0.02). The SR was greater in YT than in CON (65.0 [+/- 7.9] cm vs. 33.3 [+/- 7.0] cm; p < 0.01); however, no differences were found between yoga and control in BA (94.0 [+/- 4.4] units vs. 83.8 [+/- 3.7] units; p = 0.21) or in RPE at 5-minute intervals (2.9 [+/- 0.3], 5.3 [+/- 0.8], 5.8 [+/- 0.9], and 5.2 [+/- 0.8] vs. 2.5 [+/- 0.3], 4.0 [+/- 0.5], 4.2 [+/- 0.3], and 4.9 [+/- 0.4]. Yoga training and a single bout of yoga appear to attenuate peak muscle soreness in women following a bout of eccentric exercise. These findings have significant implications for coaches, athletes, and the exercising public who may want to implement yoga training as a preseason regimen or supplemental activity to lessen the symptoms associated with muscle soreness.

Adult↗

Asthma: the yoga perspective. Part II: Yoga therapy in the treatment of asthma.

The integral yoga approach to asthma (and other psychosomatic disorders) is briefly outlined as meeting all of the requirements for an optimal, holistic, somatopsychic therapy (as outlined in Part I), including correction of distorted posture and faulty breathing habits, teaching a system of general muscle relaxation, techniques for the release of suppressed emotion and for reducing anxiety and self-conscious awareness, as well as special methods for the expectoration of mucus. Yoga practices are described in detail and the available psychophysiological research on yoga practice, as well as clinical-therapeutic studies on yoga as asthmatic therapy, are reviewed. It can therefore be concluded that yoga therapy is most effective with asthma.

Asthma↗

Beneficial effects of yoga lifestyle on reversibility of ischaemic heart disease: caring heart project of International Board of Yoga.

OBJECTIVES: Yoga based lifestyle modifications have been earlier shown to be beneficial in coronary artery disease in a small number of patients. We evaluated the role of lifestyle modification based on Yoga techniques, stress management and dietary modifications in retardation of coronary artery disease. METHODS: This prospective, controlled, open trial included angiographically proven coronary artery disease patients (71 patients in study group and 42 patients in control group). They were assessed clinically, by biochemical parameters, stress myocardial perfusion and function studies and coronary angiography and on psychological parameters. The study group patients were given a family based Yoga Programme which included, control of risk factors, dietary modifications and stress management for a period of one year. The patients were assessed at baseline, at frequent intervals and at the end of one year. RESULTS: At the end of one year of yoga training, statistical significant changes (P<0.05) were found in serum total cholesterol (reduction by 23.3% in study group patients as compared to 4.4% in controls); serum LDL cholesterol (reduction of 26% in study group patients as compared to 2.6% in the control group), regression of disease (43.7% of study group patients v/s 31% control group on MPI and 70.4% of study group v/s 28% of control group on angiography) arrest of progression (46.5% study group v/s 33.3% control group on MPI) and progression (9.9% of study group vs 35.7% of controls on MPI, 29.6% of study group v/s 60.0% of controls on angiography). At the end of the study improvement in anxiety scores was concordant with the improvement seen in the MPI. No untoward effects of the therapy were observed. CONCLUSION: Yoga based lifestyle modifications help in regression of coronary lesions and in improving myocardial perfusion. This is translated into clinical benefits and symptomatic improvement.

Adult↗

The physiological correlates of Kundalini Yoga meditation: a study of a yoga master.

This study explores the physiological correlates of a highly practiced Kundalini Yoga meditator. Thoracic and abdominal breathing patterns, heart rate (HR), occipital parietal electroencephalograph (EEG), skin conductance level (SCL), and blood volume pulse (BVP) were monitored during prebaseline, meditation, and postbaseline periods. Visual analyses of the data showed a decrease in respiration rate during the meditation from a mean of 11 breaths/min for the pre- and 13 breaths/min for the postbaseline to a mean of 5 breaths/min during the meditation, with a predominance of abdominal/diaphragmatic breathing. There was also more alpha EEG activity during the meditation (M = 1.71 microV) compared to the pre- (M = .47 microV) and postbaseline (M = .78 microV) periods, and an increase in theta EEG activity immediately following the meditation (M = .62 microV) compared to the pre-baseline and meditative periods (each with M = .26 microV). These findings suggest that a shift in breathing patterns may contribute to the development of alpha EEG, and those patterns need to be investigated further.

Electroencephalography↗

A yoga intervention for young adults with elevated symptoms of depression.

CONTEXT: Yoga teachers and students often report that yoga has an uplifting effect on their moods, but scientific research on yoga and depression is limited. OBJECTIVE: To examine the effects of a short-term Iyengar yoga course on mood in mildly depressed young adults. DESIGN: Young adults pre-screened for mild levels of depression were randomly assigned to a yoga course or wait-list control group. SETTING: College campus recreation center. PARTICIPANTS: Twenty-eight volunteers ages 18 to 29. At intake, all participants were experiencing mild levels of depression, but had received no current psychiatric diagnoses or treatments. None had significant yoga experience. INTERVENTION: Subjects in the yoga group attended two 1-hour Iyengar yoga classes each week for 5 consecutive weeks. The classes emphasized yoga postures thought to alleviate depression, particularly back bends, standing poses, and inversions. MAIN OUTCOME MEASURES: Beck Depression Inventory, State-Trait Anxiety Inventory, Profile of Mood States, morning cortisol levels. RESULTS: Subjects who participated in the yoga course demonstrated significant decreases in self-reported symptoms of depression and trait anxiety. These effects emerged by the middle of the yoga course and were maintained by the end. Changes also were observed in acute mood, with subjects reporting decreased levels of negative mood and fatigue following yoga classes. Finally, there was a trend for higher morning cortisol levels in the yoga group by the end of the yoga course, compared to controls. These findings provide suggestive evidence of the utility of yoga asanas in improving mood and support the need for future studies with larger samples and more complex study designs to more fully evaluate the effects of yoga on mood disturbances.

Adult↗

Prevalence and patterns of adult yoga use in the United States: results of a national survey.

BACKGROUND: Although yoga appears to be popular in the United States, there are no published studies on yoga's prevalence or patterns of use. METHODS: In 1998 we surveyed by telephone a nationally representative sample of 2055 English-speaking U.S. adults (60% weighted response rate) regarding yoga use. RESULTS: Of the respondents, 7.5% used yoga at least once in their lifetime and 3.8% used yoga in the previous 12 months. Respondents who used yoga at least once were more likely than non-users to be female (68% vs. 51%), college educated (68% vs. 45%), and urban dwellers (93% vs. 74%). Factors independently associated with yoga use at least once included female gender (OR 2.5 [95% CI 1.7-3.8]), baby boomer age group (ages 34-53) compared to pre-baby boomers (> or = 54 (2.3 [1.4-4.0]), education beyond high school (2.2 [1.4-3.5]), residing in large and small metropolitan areas compared to non-metropolitan areas (3.8 [1.8-7.8] and 2.7 [1.3-5.8], respectively), and use of other CAM therapies (5.3 [2.7-10.5]). Of respondents using yoga in the previous 12 months, 64% reported using yoga for wellness, 48% for health conditions, and 21% specifically for back or neck pain. Ninety percent felt yoga was very or somewhat helpful and 76% did not report spending money related to their yoga. CONCLUSIONS: In 1998 an estimated 15.0 million American adults had used yoga at least once in their lifetime and 7.4 million during the previous year. Yoga was used for both wellness and specific health conditions often with perceived helpfulness and without expenditure.

Adult↗

Factors influencing changes in tweezer dexterity scores following yoga training.

Yoga has already been shown to improve perceptual-motor skills, but the factors which influence its effects are not well defined. This study correlates age, gender, and motivation to learn yoga with the performance in a dexterity task following yoga. Tweezer dexterity was recorded in eighty subjects belonging to four groups. Two groups were given a month of yoga training. One group consisted of subjects who had volunteered to join for the training and the other group were deputed for the training as part of their job. The two remaining groups did not receive yoga training and were selected to match the respective groups receiving yoga, for age and sex, but not for their motivation to learn yoga. The test involved using a tweezer to place metal pins in evenly spaced holes in a metal plate within four minutes. Following yoga the scores of the volunteers who learnt yoga increased significantly, whereas there was no change in scores of deputed subjects and non-yoga groups. For reasons described in detail, factors such as age and gender did not appear to contribute to the difference in performance. Hence motivation to learn yoga appeared to influence the magnitude of increase.

Adult↗

The impact of modified Hatha yoga on chronic low back pain: a pilot study.

PURPOSE: The purpose of this randomized pilot study was to evaluate a possible design for a 6-week modified hatha yoga protocol to study the effects on participants with chronic low back pain. PARTICIPANTS: Twenty-two participants (M = 4; F = 17), between the ages of 30 and 65, with chronic low back pain (CLBP) were randomized to either an immediate yoga based intervention, or to a control group with no treatment during the observation period but received later yoga training. METHODS: A specific CLBP yoga protocol designed and modified for this population by a certified yoga instructor was administered for one hour, twice a week for 6 weeks. Primary functional outcome measures included the forward reach (FR) and sit and reach (SR) tests. All participants completed Oswestry Disability Index (ODI) and Beck Depression Inventory (BDI) questionnaires. Guiding questions were used for qualitative data analysis to ascertain how yoga participants perceived the instructor, group dynamics, and the impact of yoga on their life. ANALYSIS: To account for drop outs, the data were divided into better or not categories, and analyzed using chi-square to examine differences between the groups. Qualitative data were analyzed through frequency of positive responses. RESULTS: Potentially important trends in the functional measurement scores showed improved balance and flexibility and decreased disability and depression for the yoga group but this pilot was not powered to reach statistical significance. Significant limitations included a high dropout rate in the control group and large baseline differences in the secondary measures. In addition, analysis of the qualitative data revealed the following frequency of responses (1) group intervention motivated the participants and (2) yoga fostered relaxation and new awareness/learning. CONCLUSION: A modified yoga-based intervention may benefit individuals with CLB, but a larger study is necessary to provide definitive evidence. Also, the impact on depression and disability could be considered as important outcomes for further study. Additional functional outcome measures should be explored. This pilot study supports the need for more research investigating the effect of yoga for this population.

Adult↗

Effect of a gentle Iyengar yoga program on gait in the elderly: an exploratory study.

OBJECTIVE: To determine if a tailored yoga program could improve age-related changes in hip extension, stride length, and associated indices of gait function in healthy elders, changes that have been linked to increased risk for falls, dependency, and mortality in geriatric populations. DESIGN: Single group pre-post test exploratory study. A 3-dimensional quantitative gait evaluation, including kinematic and kinetic measurements, was performed pre- and postintervention. Changes over time (baseline to postintervention) in primary and secondary outcome variables were assessed using repeated-measures analysis of variance. SETTING: Yoga exercises were performed in an academic medical center (group classes) and in the subjects' homes (yoga home-practice assignments). Pre- and postassessments were performed in a gait laboratory. PARTICIPANTS: Twenty-three healthy adults (age range, 62-83 y) who were naive to yoga were recruited; 19 participants completed the program. INTERVENTION: An 8-week Iyengar Hatha yoga program specifically tailored to elderly persons and designed to improve lower-body strength and flexibility. Participants attended two 90-minute yoga classes per week, and were asked to complete at least 20 minutes of directed home practice on alternate days. MAIN OUTCOME MEASURES: Peak hip extension, average anterior pelvic tilt, and stride length at comfortable walking speed. RESULTS: Peak hip extension and stride length significantly increased (F1,18=15.44, P<.001; F1,18=5.57, P=.03, respectively). We also observed a trend toward reduced average pelvic tilt (F1,18=4.10, P=.06); adjusting for the modifying influence of frequency of home yoga practice strengthened the significance of this association (adjusted F1,17=14.30, P=.001). Both the frequency and duration of yoga home practice showed a strong, linear, dose-response relationship to changes in hip extension and average pelvic tilt. CONCLUSIONS: Findings of this exploratory study suggest that yoga practice may improve hip extension, increase stride length, and decrease anterior pelvic tilt in healthy elders, and that yoga programs tailored to elderly adults may offer a cost-effective means of preventing or reducing age-related changes in these indices of gait function.

Accidental Falls↗

The metabolic cost of hatha yoga.

To determine the metabolic and heart rate (HR) responses of hatha yoga, 26 women (19-40 years old) performed a 30-minute hatha yoga routine of supine lying, sitting, and standing asanas (i.e., postures). Subjects followed identical videotaped sequences of hatha yoga asanas. Mean physiological responses were compared to the physiological responses of resting in a chair and walking on a treadmill at 93.86 m.min(-1) [3.5 miles per hour (mph)]. During the 30-minute hatha yoga routine, mean absolute oxygen consumption (Vo(2)), relative Vo(2), percentage maximal oxygen consumption (%Vo(2)R), metabolic equivalents (METs), energy expenditure, HR, and percentage maximal heart rate (%MHR) were 0.45 L.min(-1), 7.59 ml.kg(-1).min(-1), 14.50%, 2.17 METs, 2.23 kcal.min(-1), 105.29 b.min(-1), and 56.89%, respectively. When compared to resting in a chair, hatha yoga required 114% greater O(2) (L.min(-1)), 111% greater O(2)(ml.kg(-1).min(-1)), 4,294% greater %Vo(2)R, 111% greater METs, 108% greater kcal.min(-1), 24% greater HR, and 24% greater %MHR. When compared to walking at 93.86 m.min(-1), hatha yoga required 54% lower O(2)(L.min(-1)), 53% lower O(2)(ml.kg(-1).min(-1)), 68% lower %Vo(2)R, 53% lower METs, 53% lower kcal.min(-1), 21% lower HR, and 21% lower %MHR. The hatha yoga routine in this study required 14.50% Vo(2)R, which can be considered a very light intensity and significantly lighter than 44.8% Vo(2)R for walking at 93.86 m.min(-1) (3.5 mph). The intensity of hatha yoga may be too low to provide a training stimulus for improving cardiovascular fitness. Although previous research suggests that hatha yoga is an acceptable form of physical activity for enhancing muscular fitness and flexibility, these data demonstrate that hatha yoga may have little, if any, cardiovascular benefit.

Adult↗

Rapid stress reduction and anxiolysis among distressed women as a consequence of a three-month intensive yoga program.

BACKGROUND: Emotional distress is an increasing public health problem and Hatha yoga has been claimed to induce stress reduction and empowerment in practicing subjects. We aimed to evaluate potential effects of Iyengar Hatha yoga on perceived stress and associated psychological outcomes in mentally distressed women. MATERIAL/METHODS: A controlled prospective non-randomized study was conducted in 24 self-referred female subjects (mean age 37.9+/-7.3 years) who perceived themselves as emotionally distressed. Subjects were offered participation in one of two subsequential 3-months yoga programs. Group 1 (n=16) participated in the first class, group 2 (n=8) served as a waiting list control. During the yoga course, subjects attended two-weekly 90-min Iyengar yoga classes. Outcome was assessed on entry and after 3 months by Cohen Perceived Stress Scale, State-Trait Anxiety Inventory, Profile of Mood States, CESD-Depression Scale, Bf-S/Bf-S' Well-Being Scales, Freiburg Complaint List and ratings of physical well-being. Salivary cortisol levels were measured before and after an evening yoga class in a second sample. RESULTS: Compared to waiting-list, women who participated in the yoga-training demonstrated pronounced and significant improvements in perceived stress (P<0.02), State and Trait Anxiety (P<0.02 and P<0.01, respectively), well-being (P<0.01), vigor (P<0.02), fatigue (P<0.02) and depression (P<0.05). Physical well-being also increased (P<0.01), and those subjects suffering from headache or back pain reported marked pain relief. Salivary cortisol decreased significantly after participation in a yoga class (P<0.05). CONCLUSIONS: Women suffering from mental distress participating in a 3-month Iyengar yoga class show significant improvements on measures of stress and psychological outcomes. Further investigation of yoga with respect to prevention and treatment of stress-related disease and of underlying mechanism is warranted.

Adult↗

Effectiveness of Mobile-Delivered Exercise and Yoga Programs on Depressive Symptom Reduction in Employees: Randomized Controlled Trial.

BACKGROUND: Mental health challenges such as stress and depression are prevalent among employees. Mobile health platforms that deliver exercise or yoga interventions offer a promising approach to improve mental health outcomes in this population. OBJECTIVE: This study aimed to assess the effectiveness of 12-session adaptive moderate-intensity exercise and yoga programs delivered via a motion-detecting digital platform in reducing stress and depressive symptoms among employees. METHODS: This was an unblinded, 3-arm, parallel-group, randomized controlled trial conducted at Seoul National University Bundang Hospital and Boramae Medical Center between November 2023 and January 2024. Eligible participants were full-time employees. Seventy-five participants were randomly assigned to an exercise, a yoga, or a cognitive behavioral therapy-based self-care control group using computer-generated randomization. The exercise and yoga groups engaged in motion-detecting, adaptive physical activity training, whereas the control group accessed mobile-based, self-directed stress management educational materials. The intervention was largely automated, with no individualized therapeutic guidance provided. Allocation was concealed until trial entry. All recruitment and outcome assessments were conducted in person at the hospitals. The primary outcomes were perceived stress and depressive symptoms, whereas the secondary outcomes included posttraumatic stress, insomnia severity, cognitive stress response, occupational stress, and burnout. Physiological outcomes were assessed using heart rate variability and electroencephalography. Measurements were collected at baseline, immediately after the intervention, and at 4-week follow-up. Data were analyzed using a multivariate linear model to evaluate the main effects of time, group, and time&#xd7;group interactions. RESULTS: Of the 75 randomized participants (exercise: n=24, 32%; yoga: n=25, 33.3%; and control: n=26, 34.7%), 71 (94.7%) who completed at least 9 of the 12 sessions (&#x2265;40 min each) were included in the outcome analysis (exercise: n=21, 29.5%; yoga: n=24, 33.8%; and control: n=26, 36.6%). For the coprimary outcomes, the group&#xd7;time interaction for depressive symptoms (Patient Health Questionnaire-9) approached but did not reach the Bonferroni-corrected threshold (F4,136=2.71; P=.03; adjusted &#x3b1;=.025); however, planned pairwise comparisons revealed significantly greater improvement in the yoga group compared to the control group at 4-week follow-up (&#x3b2;=-3.67; adjusted P<.001). For the Perceived Stress Scale, the interaction was not significant (P=.29), although a significant main effect of time (P<.001) indicated overall stress reduction across all groups. For secondary outcomes, a significant group&#xd7;time interaction was found for the Cognitive Stress Responses Scale (P=.003), indicating differential trajectories of improvement. The yoga group showed a consistent linear decrease, whereas the exercise group showed immediate but less sustained gains. CONCLUSIONS: Digitally delivered adaptive yoga programs demonstrated superior and sustained improvements in depressive symptoms and Cognitive Stress Responses Scale scores compared with the active cognitive behavioral therapy-based self-care control group. However, the exercise program showed more modest and less sustained effects, warranting further investigation using larger samples.

Adult↗