Relaxation training combined with increased physical activity lowers the psychophysiological activation in community-home boys

Systematic Review of Yoga Interventions for Anxiety Reduction Among Children and Adolescents

OBJECTIVE. Anxiety disorders are the most prevalent psychological disorders among children and youths. There is growing interest in intervention options for anxiety. Yoga is widely used in clinical, school, and community settings, but consolidated sources outlining its effectiveness in reducing anxiety are limited.

METHOD. This systematic review examined the evidence base (1990–2014) for yoga interventions addressing anxiety among children and adolescents (ages 3–18 yr).

RESULTS. We identified 2,147 references and found 80 articles that were eligible for full-text review. The final analysis included 16: 6 randomized controlled trials, 2 nonrandomized preintervention–postintervention control-group designs, 7 uncontrolled preintervention–postintervention studies, and 1 case study.

CONCLUSION. Nearly all studies indicated reduced anxiety after a yoga intervention. However, because of the wide variety of study populations, limitations in some study designs, and variable outcome measures, further research is needed to enhance the ability to generalize and apply yoga to reduce anxiety.

Managing Mental Health Disorders Resulting from Trauma through Yoga: A Review

There are many and varied types of trauma. The extent to which trauma influences the mental health of an individual depends on the nature of trauma, as well as on the individual's coping capabilities. Often trauma is followed by depression, anxiety, and PTSD. As the pharmacological remedies for these conditions often have undesirable side-effects, nonpharmacological remedies are thought of as a possible add-on treatment. Yoga is one such mind-body intervention. This paper covers eleven studies indexed in PubMed, in which mental health disorders resulting from trauma were managed through yoga including meditation. The aim was to evaluate the use of yoga in managing trauma-related depression, anxiety, PTSD and physiological stress following exposure to natural calamities, war, interpersonal violence, and incarceration in a correctional facility. An attempt has also been made to explore possible mechanisms underlying benefits seen. As most of these studies were not done on persons exposed to trauma that had practiced yoga, this is a definite area for further research.

Therapeutic effects of yoga for children: a systematic review of the literature

PURPOSE

We completed a systematic review of the literature on the effect of yoga on quality of life and physical outcome measures in the pediatric population. We explored various databases and included case-control and pilot studies, cohort and randomized controlled trials that examined yoga as an exercise intervention for children.

SUMMARY OF KEY POINTS

Using the Sackett levels of evidence, this article reviews the literature on yoga as a complementary mind-body movement therapy. We address the research through three practice patterns according to the Guide to Physical Therapist Practice and provide considerations for the inclusion of yoga into clinical practice.

STATEMENT OF CONCLUSIONS AND RECOMMENDATIONS FOR CLINICAL PRACTICE

The evidence shows physiological benefits of yoga for the pediatric population that may benefit children through the rehabilitation process, but larger clinical trials, including specific measures of quality of life are necessary to provide definitive evidence.

Zur Wirksamkeit körperorientierter Therapieverfahren bei der Behandlung hyperaktiver Störungen: Ergebnisse einer kontrollierten Pilotstudie

Zusammenfassung: Fragestellung: Zur Effektivität körperorientierter Therapieverfahren bei hyperkinetischen Störungen liegen bisher kaum methodisch gut kontrollierte Studien vor. Ziel der Arbeit war die Prüfung der differentiellen Wirksamkeit eines an kindliche Bedürfnisse angepassten Yoga Trainings im Vergleich zu einem herkömmlichen Bewegungstraining. Methodik: Bei 19 Kindern mit klinischer Diagnose einer hyperkinetischen Störung (nach ICD-10) wurden nach randomisierter Gruppenzuordnung im 2×2 cross-over Design die Trainingseffekte (Yoga vs. Bewegungstraining) anhand von Varianzanalysen mit Messwiederholung geprüft. Ergebnisse: Es zeigte sich eine deutliche Überlegenheit des Yoga Trainings sowohl hinsichtlich der Verbesserungen der Testleitungen im Dortmunder Aufmerksamkeitstest (DAT) als auch bei der Reduktion der hyperkinetischen Symptomatik im standardisiert erhobenen Elternurteil mit Effektstärken (ES) im mittleren bis hohen Bereich (ES = 0.60-0.97). Bei Trainingsende lagen die Gruppenmittelwerte im unauffälligen Bereich und unterschieden sich nicht bedeutsam von den Werten einer repräsentativen Vergleichsstichprobe. Kinder mit Methylphenidat Behandlung profitierten mehr vom Training und zeigten aufgrund höherer Ausgangswerte zu Studienbeginn deutlichere Symptomverbesserungen als Kinder ohne pharmakologische Unterstützung. Schlussfolgerungen: Die Befunde der Pilotstudie legen nahe, dass Yoga als Intervention oder begleitende Therapie bei hyperkinetischen Störungen erfolgreich eingesetzt werden kann. Sie fordern dazu auf, die Wirksamkeit körperorientierter Therapieverfahren bei der Behandlung hyperaktiver Störungen in weiteren Studien systematisch zu prüfen.

Impact of meditation on resting and ambulatory blood pressure and heart rate in youth

OBJECTIVE

The purpose of this study was to evaluate the impact of a meditation program on resting and ambulatory blood pressure and heart rate in youth.

METHODS

Data from 73 middle school students (age 12.3 +/- 0.6 years) randomly assigned by classroom to either meditation (N = 34) or health education control (N = 39) groups were analyzed. The meditation groups engaged in 10-minute sessions at school and at home after school each day for 3 months. Resting (seated) systolic blood pressure, diastolic blood pressure, and heart rate measurements were obtained pretest and posttest on three consecutive school days using Dinamap 1846SX monitors. Ambulatory systolic blood pressure, ambulatory diastolic blood pressure, and ambulatory heart rate were recorded over 24-hour periods at pretest and posttest every 20 minutes during self-reported normal waking hours and every 30 minutes during self-reported normal sleep hours using Spacelabs 90207 monitors.

RESULTS

Significant (p < .05) differences in average change from pretest to posttest were found between the meditation and health education control groups for resting systolic blood pressure (-2.7 vs. 1.1 mm Hg), daytime ambulatory systolic blood pressure after school (-2.0 vs. 3.6 mm Hg), daytime ambulatory diastolic blood pressure after school (0.1 vs. 4.3 mm Hg), and daytime ambulatory heart rate after school (-5.3 vs. 0.3 bpm).

CONCLUSION

These findings demonstrate the potential beneficial impact of meditation on blood pressure and heart rate in the natural environment in healthy normotensive youth.

The effects of yoga on the attention and behavior of boys with Attention-Deficit/ hyperactivity Disorder (ADHD)

Boys diagnosed with ADHD by specialist pediatricians and stabilized on medication were randomly assigned to a 20-session yoga group (n = 11) or a control group (cooperative activities; n = 8). Boys were assessed pre- and post-intervention on the Conners' Parent and Teacher Rating Scales-Revised: Long (CPRS-R:L & CTRS-R:L; Conners, 1997), the Test of Variables of Attention (TOVA; Greenberg, Cormna, & Kindschi, 1997), and the Motion Logger Actigraph. Data were analyzed using one-way repeated measures analysis of variance (ANOVA). Significant improvements from pre-test to post-test were found for the yoga, but not for the control group on five subscales of the Conners' Parents Rating Scales (CPRS): Oppositional, Global Index Emotional Lability, Global Index Total, Global Index Restless/Impulsive and ADHD Index. Significant improvements from pre-test to post-test were found for the control group, but not the yoga group on three CPRS subscales: Hyperactivity, Anxious/Shy, and Social Problems. Both groups improved significantly on CPRS Perfectionism, DSM-IV Hyperactive/ Impulsive, and DSM-IV Total. For the yoga group, positive change from pre- to post-test on the Conners' Teacher Rating Scales (CTRS) was associated with the number of sessions attended on the DSM-IV Hyperactive-Impulsive subscale and with a trend on DSM-IV Inattentive subscale. Those in the yoga group who engaged in more home practice showed a significant improvement on TOVA Response Time Variability with a trend on the ADHD score, and greater improvements on the CTRS Global Emotional Lability subscale. Results from the Motion Logger Actigraph were inconclusive. Although these data do not provide strong support for the use of yoga for ADHD, partly because the study was under-powered, they do suggest that yoga may have merit as a complementary treatment for boys with ADHD already stabilized on medication, particularly for its evening effect when medication effects are absent. Yoga remains an investigational treatment, but this study supports further research into its possible uses for this population. These findings need to be replicated on larger groups with a more intensive supervised practice program.

Impact of transcendental meditation on ambulatory blood pressure in African-American adolescents

The objective of this study was to determine the impact of stress reduction on blood pressure (BP) in adolescents by the Transcendental Meditation (TM) program. African-American adolescents (aged 16.2 +/- 1.3 years) with high normal systolic BP were randomly assigned to either 4-month TM (n = 50) or health education control (n = 50) groups. Ambulatory 24-h BP measures were recorded at pretest, 2- and 4-month post-tests, and 4-month follow-up. Greater decreases in daytime systolic BP (P < .04) and diastolic BP (P < .06) in the TM group compared with the control group across the visits demonstrate a beneficial impact of the TM program in youth at risk for the development of hypertension.

Impact of Transcendental Meditation on cardiovascular function at rest and during acute stress in adolescents with high normal blood pressure

OBJECTIVE

This study examined the impact of the Transcendental Meditation (TM) program on cardiovascular (CV) reactivity in adolescents with high normal BP.

METHOD

Thirty-five adolescents [34 African Americans (AAs), 1 Caucasian American (CA); ages 15-18 years] with resting systolic blood pressure (SBP) between the 85th and 95th percentile for their age and gender on three consecutive occasions, were randomly assigned to either TM (n=17) or health education control (CTL, n=18) groups. The TM group engaged in 15-min meditation twice each day for 2 months including sessions during school lunch break. Primary CV outcome measures were changes in blood pressure (BP), heart rate (HR), and cardiac output (CO) at rest and in response to two laboratory stressors, a simulated car driving stressor and an interpersonal social stressor interview.

RESULTS

The TM group exhibited greater decreases in resting SBP (P<.03) from pre- to postintervention, compared to the CTL group. The TM group exhibited greater decreases from pre- to postintervention in SBP, HR, and CO reactivity (P's<.03) to the simulated car driving stressor, and in SBP reactivity (P<.03) to the social stressor interview.

CONCLUSION

The TM program appears to have a beneficial impact upon CV functioning at rest and during acute laboratory stress in adolescents at-risk for hypertension.

Comparison of changes in autonomic and respiratory parameters of girls after yoga and games at a community home

The heart rate, breathing rate, and skin resistance were recorded for 20 community home girls (Home group) and for 20 age-matched girls from a regular school (School group). The former group had a significantly higher rate of breathing and a more irregular breath pattern known to correlate with high fear and anxiety, than the School group. Skin resistance was significantly lower in the School group, which may suggest greater arousal, 28 girls of the Home group formed 14 pairs, matched for age and duration of stay in the home. Subjects of a pair were randomly assigned to either yoga or games groups. For the former emphasis was on relaxation and awareness, whereas for the latter increasing physical activity was emphasized. At the end of an hour daily for six months both groups showed a significant decrease in the resting heart rate relative to initial values (Wilcoxon paired-sample rest), and the yoga group showed a significant decrease in breath rate, which appeared more regular but no significant increase in the skin resistance. These results suggest that a yoga program which includes relaxation, awareness, and graded physical activity is a useful addition to the routine of community home children.