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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

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

Effectiveness of Yoga and Combined Exercise in Female With Rheumatoid Arthritis: Randomized Controlled Trial.

BACKGROUND: Although exercise is beneficial for Rheumatoid Arthritis (RA), the comparative efficacy of different modalities for patients in clinical remission remains unclear. This study compared the short- and long-term effects of yoga versus a combined exercise programme on pain, balance, mobility, fatigue, depression, and quality of life in females with RA in remission. METHODS: In this single-blind, randomized controlled trial, 74 female participants were allocated to yoga (n&#xa0;=&#xa0;25), combined exercise (n&#xa0;=&#xa0;25), or a usual care control group (n&#xa0;=&#xa0;24). The intervention groups underwent an 8-week supervised programme. Clinical assessments, including the Visual Analogue Scale (pain), Berg Balance Scale, Timed Up and Go Test, Beck Depression Inventory, Fatigue Severity Scale, and Short Form-36, were conducted at baseline, post-intervention (8&#xa0;weeks), and follow-up (20&#xa0;weeks). RESULTS: Both intervention groups demonstrated significant improvements in all outcome measures compared with the control group at post-treatment and follow-up (p&#xa0;<&#xa0;0.05). Notably, the yoga group exhibited superior outcomes compared to the combined exercise group in reducing pain intensity (median reduction of 4.00 vs. 2.00 points; p&#xa0;<&#xa0;0.001, &#x3b7;2&#xa0;=&#xa0;0.724), as well as in physical function, balance, fatigue, depression, and quality of life at the 20-week follow-up. These benefits may be partly attributed to the incorporation of breathing and relaxation techniques inherent to yoga practice. CONCLUSIONS: Both 8-week yoga and combined exercise programs are effective in managing residual symptoms in females with RA in clinical remission. However, yoga appears to provide superior benefits in pain management and psychosocial well-being, supporting its integration into multidisciplinary RA management protocols, particularly for addressing psychosocial burden in patients achieving remission. TRIAL REGISTRATION: This study was retrospectively registered at NCT07072754 (clinicaltrials.gov).

Humans

Yoga as therapy in psychosomatic medicine.

Yoga as therapy with psychosomatic disorders has been practiced for many centuries in India, and only recently has become utilized for this purpose in other countries. The yoga system evolved as a 'system of liberation' to allow man to discriminate between his ego-self and pure consciousness, and as such, its medical benefits are really 'side-effects'. Integral yoga practice, however, with which many other self-regulatory somatopsychic approaches have much in common, consists of a holistic technology which functions to restore optimal homeostatis by a variety of special techniques not found in other approaches. Clinical observations of psychosomatic patients indicate that their distorted somatopsychic functioning necessitates their practice of yoga-like therapy. A review of the clinical evidence available indicates that yoga practice has proven most effective with a wide range of psychosomatic and psychiatric disorders. The effectiveness of yoga can be partially understood in terms of neurophysiological theory.

Humans

[Recent medical research on yoga and states of concentration].

Traditional oriental thinking attracts the growing scientific interest of occidental practitioners. Dr. Pierre Etévenon, head of the Department of Neuro-Psycho-Pharmacology at the French Institute for Health and Medical Research (INSERM), held several conversations and scientific exchanges with the author, and kindly provided copies of some of his works. They are at the basis of the present paper. M. A. Descamps (Paris) found that asanas--yoga postures-- are generators of dynamic action when there is an extension of the spinal column, whilst they lead to quiet states when there is a flexion of it. Claeys and Gones (Belgium) proved that overall global relaxation, as well as differential relaxation were far more effective and deep when obtained by yogis than those attempted by University students majoring in Physical Education. Lonsdorfer and Nussbaum (France) studied several parameters concerning hatha-yoga and concluded that it provides a regular functioning of the main bodily functions fostering thus a psycho-physical balance. Wallace and Benson (U.S.A.) proved that transcendental meditation increases aerobic metabolism, counteracting anaerobic metabolism which is related to mental distress. Etévenon (Paris) investigated neurophysiological effects of yoga in connection to ancient Indian concepts (Upanishads) on sleeping, meditation and degree of consciousness. Dr. Etévenon has studied the phylogenetic evolution of waking-sleeping cycles, focusing on phylogenetic and ontongenetic appearances of REM cycles (activated sleep). A correlation has been made with EEG studies during states of concentration (yoga, transcendental meditation, Zen). These states have been found to be specific brain activities, and different from deep sleep, in spite of certain similarities in the EEG. Several hypothesis are set forth to explain brain activities underlying sites of concentration. The possibilities of developing a conscious mastering of dreams are also under research, and special attention is paid to the works of Saint Denys (1867), and hindu tradition. This paper discusses also the psychological, therapeutic and anthropological implications of recent discoveries in the field.

Alpha Rhythm

Randomised controlled trial of yoga and bio-feedback in management of hypertension.

34 hypertensive patients were assigned at random either to six weeks' treatment by yoga relaxation methods with bio-feedback or to placebo therapy (general relaxation). Both groups showed a reduction in blood-pressure (from 168/100 to 141/84 mm. Hg in the treated group and from 169/101 to 160/96 mm Hg in the control group). The difference was highly significant. The control group was then trained in yoga relaxation, and their blood-pressure fell to that of the other group (now used as controls).

Adult

Adjunct treatment with yoga in chronic severe airways obstruction.

Eleven patients with severe chronic airways obstruction were given training in yogic breathing exercises and postures. A matched group of 11 patients were given physiotherapy breathing exercises. Both groups of patients were followed up at monthly intervals for nine months with pulmonary function tests, tests of exercise tolerance, and inquiry into their symptoms. After training in yoga the mean maximum work increased significantly by 60.55 kpm; whereas no such rise occurred after training in physiotherapy. This objective improvement was associated with symptomatic improvement in a significantly higher number of patients given training in yoga.

Aged

Psychophysiological correlates of the practice of Tantric Yoga meditation.

Autonomic and electroencephalographic (EEG) correlates of Tantric Yoga meditation were studied in three groups of subjects as they progressed from normal consciousness into meditation. Groups differed in their level of meditation proficiency. Measures of skin resistance, heart rate, respiration, autonomic orienting responses, resting EEG, EEG alpha and theta frequencies, sleep-scored EEG, averaged evoked responses, and subjective experience were employed. Unlike most previously reported meditation studies, proficient meditators demonstrated increased autonomic activation during meditation while unexperienced meditators demonstrated autonomic relaxation. During meditation, proficient meditators demonstrated increased alpha and theta power, minimal evidence of EEG-defined sleep, and decreased autonomic orienting to external stimulation. An episode of sudden autonomic activation was observed that was characterized by the meditator as an approach to the Yogic ecstatic state of intense concentration. These findings challenge the current "relaxation" model of meditative states.

Adult

Biological significance of piezoelectricity in relation to acupuncture, Hatha Yoga, osteopathic medicine and action of air ions.

Piezoelectric properties of biological macromolecules such as proteins, nucleic acids and mucopolysaccharides are reviewed in this paper. It is indicated that the structural elements of the human body composed of these piezoelectric substances are capable of transducing a mechanical energy into an electric current. Such a transduction may be brought about by movements of an acupuncture needle, osteopathic manipulations; Hatha Yoga postures or action of negatively charged air irons. It is postulated that electric current induced by stimulation of the specific sites on the surface of human body flows towards the internal organs along the semiconductive channels of biologic macromolecules. Electric current induced either by the piezoelectric transduction or directly applied from an external source may in turn stimulate individual cells in the target organ. Involvement of electrical phenomena in regulatory mechanisms on cellular and molecular levels is discussed.

Acupuncture Therapy

12-month follow-up of yoga and bio-feedback in the management of hypertension.

Twenty hypertensive patients treated by psychophysical relaxation exercises were followed up monthly for 12 months. Age and sex matched hypertensive controls were similarly followed up for 9 months. Statistically significant reductions in blood-pressure (BP) and antihypertensive drug requirements were satisfactorily maintained in the treatment group. Mere repetition of B.P. measurements and increased medical attention did not in themselves reduce B.P. significantly in control patients.

Adult

Yoga and biofeedback in the management of 'stress' in hypertensive patients.

1. Psychophysical relaxation exercises based on yogic principles and reinforced by biofeedback instruments were used for behaviour modification in sixteen hypertensive subjects. 2. Preliminary studies indicated that their pressor response to emotional and physical stimuli became less exaggerated and less protracted compared with controls.

Adult

'Positive and 'negative' aspects of the 'altered states of consciousness' induced by autogenic training, Zen and yoga.

As practices of altered states of consciousness (ASC) have become more widely used among psychotherapists who have become aware of the limitations of psychoanalytic, educational and behavioral approaches, negative aspects ('Makyo') of ASC have drawn their special attention. For the purpose of controlling or preventing these side-effects, (1) the problem of indication is most important, (2) and evaluation of the patient's personality is indispensable, (3) preparatory education about ASC methods and (4) guidance by experienced leaders are most helpful, (5) appropriate use of tranquilizers and (6) the mere presence of a supportive therapist at the place of practice can also be helpful.

Autogenic Training