Yoga in Medical Literature
Clinical trials and studies on a variety of kinds of yoga have appeared in Alternative Health Journals as well as Medical Journals such as Med Hypotheses, Journal of Gerontology Nursing, Journal of Affective Disorders, Appl Psychophysiol Biofeedback, Int J Cardiol, Psychooncology, Indian J Physiol Pharmacol and more.
In the last few years studies have verified the benefit of yoga for weight loss, chronic back pain, geriatric populations, depression, muscular dystrophy, alcoholism, epilepsy, breast cancer quality of life peripheral neuropathies, anxiety and joint, posture and musculoskeletal related injuries. Yoga can also enhance performances for musicians and athletes.
It has been used to shift blood chemistry, the effects of strokes and improve respiratory and cardiovascular function.
The postures and benefit of yoga have also been compared to Strain and Counterstrain from the field of Integrative Manual Therapy.
Among Complementary and Alternative (CAM) therapies for weight loss, Yoga is the most often used at 57.4% followed by meditation (8.2%), acupuncture (7.7%), massage (7.5%), and Eastern martial arts (5.9%). CAM users used CAM therapies on their own (62.6%), in a group setting (26.8%) or with a CAM practitioner (10.6%)."1 (Sharpe, Blanck, et al. 2007).
Low back pain is a significant public health problem and one of the most commonly reported reasons for the use of Complementary Alternative Medicine. In a randomized control trial comparing Iyengar yoga therapy to an educational control group, preliminary data indicated "the majority of self-referred persons with mild chronic low back pain will comply to and report improvement on medical and functional pain-related outcomes from Iyengar yoga therapy." 2 (Williams, Petronis, et al. 2005).
One study in Med Hypotheses found, integrating connective tissue and nervous system plasticity into the low back pain model potentially illuminates the mechanisms of a variety of treatments that may reverse these abnormalities by applying mechanical forces to soft tissues (e.g. physical therapy, massage, chiropractic manipulation, acupuncture), by changing specific movement patterns (e.g. movement therapies, yoga) or more generally by increasing activity levels (e.g. recreational exercise)."3 (Langevin & Sherman, 2007).
From the Journal of Gerontology Nursing, "An integrated approach of yoga including the mental and philosophical aspects in addition to the physical practices was useful for institutionalized older persons."4 (Krishnamurthy & Telles, 2007).
Exercises including Yoga are also recommended by Hatten, D. V. (2007). Exercise Your Options: Move it, stretch it, flex it, lift it, hit the water — just say YES to exercise from the Muscular Dystrophy Association.5
In a 2004 study, the Berg Balance Scale and Timed Movement Battery test improvements with yoga, leading researchers to conclude, "the results suggest that yoga may be beneficial to people who have had a stroke."6 (Bastille, 2004).
Another study hypothesized that yoga and meditation improves endothelial function. The endothelium is a layer of skin that lines the inside of the blood vessel. It is the layer between the blood flowing through the vessel and the rest of the blood vessel wall.
A course in yoga and meditation was given to 33 people with and without coronary artery disease for an hour and a half, three times a week for 6 weeks. The participants were encouraged to continue practicing at home. Researchers found, a significant reductions in blood pressure, heart rate, and Body Mass Index (BMI) in the total group with yoga.7 (Sivasankaran, 2006).
Another yoga related study looked at the short-term impact of a comprehensive but brief lifestyle intervention, based on yoga. The subjects had history of hypertension, coronary artery disease, diabetes mellitus, obesity, psychiatric disorders (depression, anxiety, 'stress'), gastrointestinal problems (non ulcer dyspepsia, duodenal ulcers, irritable bowel disease, Crohn's disease, chronic constipation) and thyroid disorders (hyperthyroidism and hypothyroidism) or were healthy without any of these conditions..
The intervention consisted of Asanas, Pranayama, relaxation techniques, group support, individualized advice, and lectures and films on philosophy of yoga, the place of yoga in daily life, meditation, stress management, nutrition, and knowledge about the illness.
"Among the diseased subjects significant improvement was seen in the anxiety levels of patients of hypertension, coronary artery disease, obesity, cervical spondylitis and those with psychiatric disorders. The observations suggest that a short educational program for lifestyle modification and stress management leads to remarkable reduction in the anxiety scores within a period of 10 days."8(Gupta, 2006).
Another study found that Yoga lifestyle intervention slows or stops the progression of damage to the heart blood vessels in people with severe coronary artery disease. It also improves symptoms, what the person is able to do and some of the risk factors important in preventing another circulation related event.9 Manchanda, 2000).
"The majority of study subjects (93%) completed the trial. Of those who completed the trial, 92% attended seven or more of the eight yoga sessions. The majority of the subjects were satisfied with the study and 75% continued to practice yoga 3 months after the study. Mean number of hot flushes per week decreased by 30.8% and mean hot flush score decreased 34.2% from baseline to week 8. No adverse events were observed.."10 (Cohen,2006).
"Oxidative stress contributes to the process of aging as well as a variety of chronic degenerative diseases. There are indications that psychological stress increases oxidative stress whereas relaxation decreases it.
The yoga-based lifestyle modification program (YLMP) consisted of a nine-day educational out-patient course on the theory and practice of yoga and included, besides a daily one-hour practice of physical postures (asanas) and breathing exercises (pranayama), lecture and films on yoga, stress management and nutrition, practice of meditation and shavasana (a relaxation technique), and individual counseling.
The study suggests that a brief low cost lifestyle intervention based on yoga reduces oxidative stress."11 (Yadav, Ray, et al. 2005).
In 2006, Zwick looked at ways to adapt yoga for specific populations in "Integrating Iyengar yoga into rehab for spinal cord injury." Nursing12 (Zwick, 2006).
"Sudarshana Kriya Yoga (SKY) has demonstrable antidepressant effects. SKY was tested for this effect in inpatients of alcohol dependence. Results extend the antidepressant effects of SKY in alcohol dependence subjects. Reduction in stress-hormone levels (cortisol and ACTH) along with BDI reductions possibly support a biological mechanism of Sudarshana Kriya Yoga in producing beneficial effects."13 (Vedamurthachar, Janakiramaiah, et al. (2006).
Results suggest that professional hatha yoga practitioners have less sensitivity to high levels of CO2 in the blood because their practice has allowed them to adapt to "low arterial pH and high levels of CO2 for long periods."14(Miyamura, 2002).
"Cyclic meditation (CM) is a technique which combines "stimulating" and "calming" practices, based on a statement in ancient yoga texts suggesting that such a combination may be especially helpful to reach a state of mental equilibrium. The results support the idea that a combination of yoga postures with supine rest (in Cyclic meditation) reduces the oxygen consumption more than resting supine alone does."15 (Sarang, & Telles, 2006).
In a study of yoga meditation and drug resistant chronic epilepsy, researchers found, "at 3 months, a reduction in seizure frequency was noted in all except 1 patient, six of whom had greater or equal to 50% seizure reduction."16 (Rajesh, & Jayachandran, et al. 2006).
In a study of the "potential benefits of mind-body techniques on cognitive function, researchers found, "those in the yoga group showed significant improvement in quality-of-life and physical measures compared to exercise and wait-list control groups."17 (Oken, Zajdel, et al. 2006).
"Physical activity provides a number of physical and psychological benefits to cancer survivors, including lessening the impact of detrimental cancer-related symptoms and treatment side-effects (e.g. fatigue, nausea), and improving overall well-being and quality of life. The purpose of the present pilot study was to examine the physical and psychological benefits afforded by a 7-week yoga program for cancer. Researcher concluded, "these initial findings suggest that yoga has significant potential and should be further explored as a beneficial physical activity option for cancer survivors."18 (Nicole Culos-Reed, Carlson, et al. 2006).
"Previous research has suggested that yoga and meditation practices are effective in stress management, alleviating anxiety and musculoskeletal problems and improving mood and cognitive and physical performance. Musicians experience a number of challenges in their profession including high levels of stress, performance anxiety and performance-related musculoskeletal conditions. The results from this preliminary study suggest that yoga and meditation may be beneficial as a routine practice to reduce performance anxiety in musicians."19 (Khalsa & Cope, 2006).
"Considerable evidence exists for the place of mind body medicine in the treatment of anxiety disorders. Excessive anxiety is maladaptive.
The intervention consisted of asanas, pranayama, relaxation techniques, group support, individualized advice, and lectures and films on philosophy of yoga, the place of yoga in daily life, meditation, stress management, nutrition, and knowledge about the illness. The observations suggest that a short educational program for lifestyle modification and stress management leads to remarkable reduction in the anxiety scores within a period of 10 days."20 (Gupta, Khera, et al., 2006).
Another study on Kundalini yoga found, "the results indicate that both cognitive behavior therapy and yoga are promising stress management techniques."21 (Granath,2006).
"This study found that there has been a dramatic increase in overall use of CAM in adults with diabetes; diabetes was not an independent predictor of overall use of CAM; and people with diabetes were more likely to use prayer, but less likely to use herbs, yoga, or vitamins compared to persons without diabetes."22 (Garrow & Egede 2006).
"Peripheral neuropathy, associated with diabetes, neurotoxic chemotherapy, human immunodeficiency virus (HIV)/antiretroviral drugs, alcoholism, nutrient deficiencies, heavy metal toxicity, and other etiologies, results in significant morbidity. In the realm of physical medicine, acupuncture, magnetic therapy, and yoga have been found to provide benefit."23 (Head, 2006).
The objective of this study was, "to examine the efficacy of two preparatory interventions on one mile run performance in 90 high school long distance runners. Motivational and yoga interventions designed to improve long distance running performance were equally acceptable to the participants, but the former had a greater effect."24 (Donohue,2006).
Describing Strain and Counterstrain developed by American Osteopath Lawrence Jones, DO and then Advanced Strain and Counterstrain developed by Sharon W. Giammatteo25. David Pinto noted it is a positional technique for the musculoskeletal and smooth muscle system, "I believe an argument could be made for these positions having the effect of mudras or asanas: yogic positions intended to free up and enhance energy flow and balance. Perhaps these are a kind of polarity yoga that directly improves both energy flow and structure."26 (Pinto, 2003).
References
1. Sharpe, P. A., H. M. Blanck, et al. (2007). "Use of complementary and alternative medicine for weight control in the United States." J Altern Complement Med 13(2): 217-22.
2. Williams, K. A., J. Petronis, et al. (2005). "Effect of Iyengar yoga therapy for chronic low back pain." Pain 115(1-2): 107-17.
3. Langevin, H. M. and K. J. Sherman (2007). "Pathophysiological model for chronic low back pain integrating connective tissue and nervous system mechanisms." Med Hypotheses 68(1): 74-80.
4.Krishnamurthy, M. N. and S. Telles (2007). "Assessing depression following two ancient Indian interventions: effects of yoga and ayurveda on older adults in a residential home." J Gerontol Nurs 33(2): 17-23.
5. Hatten, D. V. (2007). Exercise Your Options: Move it, stretch it, flex it, lift it, hit the water — just say YES to exercise, Muscular Dystrophy Association: http://www.mda.org/publications/Quest/q143exercise.html.
6. Bastille, J. V. and K. M. Gill-Body (2004). "A yoga-based exercise program for people with chronic poststroke hemiparesis." Phys Ther 84(1): 33-48 [Full Text] http://www.ptjournal.org/cgi/content/full/84/31/33.
7. Sivasankaran, S., S. Pollard-Quintner, et al. (2006). "The effect of a six-week program of yoga and meditation on brachial artery reactivity: do psychosocial interventions affect vascular tone?" Clin Cardiol 29(9): 393-8.
8. Gupta, N., S. Khera, et al. (2006). "Effect of yoga based lifestyle intervention on state and trait anxiety." Indian J Physiol Pharmacol 50(1): 41-7.
9. Manchanda, S. C., R. Narang, et al. (2000). "Retardation of coronary atherosclerosis with yoga lifestyle intervention." J Assoc Physicians India 48(7): 687-94.
10. Cohen, B. E., A. M. Kanaya, et al. (2006). "Feasibility and acceptability of restorative yoga for treatment of hot flushes: A pilot trial." Maturitas.
11. Yadav, R. K., R. B. Ray, et al. (2005). "Effect of a comprehensive yoga-based lifestyle modification program on lipid peroxidation." Indian J Physiol Pharmacol 49(3): 358-62.
12. Zwick, D. (2006). "Integrating Iyengar yoga into rehab for spinal cord injury." Nursing 36 Suppl Pt Insider: 18-22.
13. Vedamurthachar, A., N. Janakiramaiah, et al. (2006). "Antidepressant efficacy and hormonal effects of Sudarshana Kriya Yoga (SKY) in alcohol dependent individuals." J Affect Disord 94(1-3): 249-53.
14. Miyamura, M., K. Nishimura, et al. (2002). "Is man able to breathe once a minute for an hour?: the effect of yoga respiration on blood gases." Jpn J Physiol 52(3): 313-6.
15. Sarang, P. S. and S. Telles (2006). "Oxygen consumption and respiration during and after two yoga relaxation techniques." Appl Psychophysiol Biofeedback 31(2): 143-53.
16. Rajesh, B., D. Jayachandran, et al. (2006). "A pilot study of a yoga meditation protocol for patients with medically refractory epilepsy." J Altern Complement Med 12(4): 367-71.
17. Oken, B. S., D. Zajdel, et al. (2006). "Randomized, controlled, six-month trial of yoga in healthy seniors: effects on cognition and quality of life." Altern Ther Health Med 12(1): 40-7.
18. Nicole Culos-Reed, S., L. E. Carlson, et al. (2006). "A pilot study of yoga for breast cancer survivors: physical and psychological benefits." Psychooncology 15(10): 891-7.
19. Khalsa, S. B. and S. Cope (2006). "Effects of a yoga lifestyle intervention on performance-related characteristics of musicians: a preliminary study." Med Sci Monit 12(8): CR325-31.
20. Gupta, N., S. Khera, et al. (2006). "Effect of yoga based lifestyle intervention on state and trait anxiety." Indian J Physiol Pharmacol 50(1): 41-7.
21. Granath, J., S. Ingvarsson, et al. (2006). "Stress management: a randomized study of cognitive behavioural therapy and yoga." Cogn Behav Ther 35(1): 3-10.
22. Garrow, D. and L. E. Egede (2006). "National patterns and correlates of complementary and alternative medicine use in adults with diabetes." J Altern Complement Med 12(9): 895-902.
23. Head, K. A. (2006). "Peripheral neuropathy: pathogenic mechanisms and alternative therapies." Altern Med Rev 11(4): 294-329.
24. Donohue, B., A. Miller, et al. (2006). "Effects of brief yoga exercises and motivational preparatory interventions in distance runners: results of a controlled trial." Br J Sports Med 40(1): 60-3; discussion 60-3.
25. Giammatteo, Thomas, D.C., P.T. and Weiselfish-Giammatteo, Sharon, Ph.D., P.T., Integrative Manual Therapy for the Autonomic Nervous System and Related Disorders: Utilizing Advanced Strain and Counterstrain Technique, Berkeley: North Atlantic, 1997, 154 pp.
26. Pinto, D. (2003). "Doorways to structure: Strain/Counterstrain." Energy Currents: Journal of Polarity Therapy.