Yoga research review

Acute changes in urinary metabolites: vinyasa yoga compared to cycle ergometer exercise

Introduction

Increased interest in unconventional exercise such as vinyasa yoga has outpaced our understanding of the physiological response to yoga exercise. The objective of the current study was to evaluate changes in urinary metabolites (i.e., alanine, phenylalanine, glycine, choline, taurine, creatinine, creatine, dimethylamine, citrate, pyruvate, acetate, and beta-hydroxybutyrate) elicited by vinyasa yoga compared to moderate intensity aerobic exercise in young healthy adults.

Methods

Twelve participants, six women and six men, completed a vinyasa yoga exercise session (VY) and a moderate intensity cycle ergometer exercise session (ME) in a sequential fashion. The intensity of the ME was matched to heart rate and rating of perceived exertion elicited during the initial VY. Urine samples were collected at baseline and following the completion of each of VY and ME. Metabolite concentrations after each exercise were normalized to their baseline levels to obtain a relative exercise-induced change in concentration. We hypothesized that activation of large muscle groups in the lower extremities would foster greater ME-induced alterations in metabolites.

Results

Exercise-induced changes in urinary concentrations of phenylalanine, creatinine, creatine, glycine, choline, taurine, dimethylamine, citrate, pyruvate, alanine, and beta-hydroxybutyrate were greater in ME compared to VY (P < 0.05). There was no difference between the exercise-induced changes in lactate between groups (P < 0.05).

Discussion

The results of this study demonstrate that ME promotes more robust changes in urinary metabolites compared to VY. These differences may be due to a greater localized workload on the large muscle groups of the lower extremities during ME, and potentially highlight the distributed metabolic demand of VY.

Impact of 10 Weeks of Yoga Intervention on Mental Health and Overall Well-Being Among Medical Students: GSY Study

BACKGROUND

the purpose of this study was to explore the effect of 10 weeks of yoga intervention on the mental health outcomes (stress, anxiety, and depression), quality of life, emotional regulation, and quality of sleep of medical students.

METHOD

In the current experimental study, 220 medical students, with a mean age of 21.36 ± 2.20 years, participated in a 10-week yoga intervention at the University of Pécs. Data were collected before and after the intervention using the validated questionnaires DASS-21, WHOQOL-BREF, PSQI, and DERS. The distribution of data was checked using the Kolmogorov-Smirnov test. A paired sample T-test was used to compare the mean of the continuous variable. Stepwise linear regression was used to assess the association between mental health outcomes and quality-of-life variables.

RESULTS

The present study shows a significant reduction in (p < 0.001), depression (p < 0.001), and anxiety (p < 0.001) for participants, and overall quality of life (p < 0.001), quality of sleep (p < 0.001), and emotional regulation (p < 0.001) significantly improved after the intervention. The stepwise linear regression shows a strong association between higher levels of anxiety (β = 0.608, R2 = 0.366) and depression (β = 0.608, R2 = 0.392), with higher stress levels and improvement in environmental conditions being associated with a decrease in stress levels (β = -0.392, R2 = 0.087).

CONCLUSIONS

the current study shows that yoga significantly improved the mental health and well-being of medical students, improving quality of life, quality of sleep, and emotional regulation.

REGISTERED CLINICAL TRIAL

NCT06661603.

Stress-related psychiatric disorders

Stress is a natural human emotion that motivates us to face difficulties and risks. Everyone experiences stress to some extent, but when it becomes chronic or reaches a level that cannot be managed, its effects begin to manifest. It is a common condition that most individuals confront, and its effects on the body and brain have become more obvious in recent years. Social and environmental interactions activate systemic reactions primarily controlled by the brain via immunological, neuroendocrine, and metabolic pathways. Long-term stress disrupts homeostasis, activating stress mediators that attempt to restore balance but frequently cause cumulative damage, particularly to the hippocampus, amygdala, and hypothalamus. Furthermore, persistent stress can have a direct and indirect effect on initiating psychiatric illnesses such as depression, anxiety, ADHD, and schizophrenia. Studies on neuroimaging show anatomical and functional alterations in stress-affected regions such as the prefrontal cortex and the hippocampus, which are linked to emotional dysregulation and cognitive decline. To better understand how stress affects psychiatric disorders and exacerbates their symptoms, this chapter will first discuss the molecular mechanism and neurobiological changes it can cause. It will then demonstrate various neuroimaging techniques for studying the effects of stress and offer potential treatments to mitigate these negative effects.

Complementary Approaches to Postoperative Pain Management: A Review of Non-pharmacological Interventions

Postoperative pain significantly affects many surgical patients. While opioids are crucial for pain management, they come with unwanted side effects. Alternatives like nonsteroidal anti-inflammatory drugs, N-methyl-D-aspartate (NMDA) receptor antagonists, and regional anesthesia techniques such as nerve blocks are utilized, but these also have limitations. This underscores the need for complementary non-pharmacological interventions to enhance postoperative pain control and reduce opioid dependence. This study aimed to synthesize evidence on the efficacy of nondrug approaches for managing postoperative pain. The study examined the effects of non-pharmacological interventions such as preoperative patient education, mind-body modalities, and physical therapies. Findings suggest that these approaches can reduce pain intensity, decrease opioid consumption, and enhance recovery outcomes. The study also highlighted the pivotal role of healthcare professionals in implementing these strategies. However, it identified workload constraints and insufficient training as barriers to effective utilization in clinical practice. Integrating non-pharmacological interventions into multimodal pain management regimens can improve postoperative pain control and reduce reliance on opioids. Further research is crucial to definitively establish the efficacy of individual interventions and optimize their combined use in clinical practice. Additionally, enhanced training programs for nurses and initiatives to facilitate the implementation of these strategies are necessary for their successful adoption.

The Effects of Yoga on Fall-Related Physical Functions for Older Women: A Systematic Review of Randomized Controlled Trials

Introduction: The evidence showed that the risk of falls was higher in women, and yoga was considered an effective rehabilitation method for preventing falls. However, there had been no previous attempts to synthesize the evidence specifically for the use of yoga in preventing falls among older women. Objectives: This systematic review aimed to strengthen the existing body of evidence by focusing exclusively on the impact of yoga in improving fall-related physical functions among older women. Methods: A systematic review was conducted following the PRISMA guidelines. The protocol was developed in advance of the study and registered on PROSPERO (Registration number: CRD42024506550). Results: The effects of yoga on balance, gait, and lower-limb strength were inconsistent. It showed that yoga programs designed to prevent falls in older women might not demonstrate the same effectiveness as those identified in previous systematic reviews for the general older adult population. Conclusions: This systematic review is the first to exclusively explore the impact of yoga on fall-related physical functions in older women. However, this review did not directly observe a definitive effect of yoga on fall prevention in older women. Future studies should delve deeper into identifying appropriate yoga postures and determining the optimal dose required to enhance physical function and prevent falls.

A Systematic Review of Yoga Interventions on the Mental Health of Nursing Professionals and Students

This systematic review aimed to evaluate the impact of yoga interventions on preventing and alleviating mental health issues, including stress, anxiety, burnout, depression, and other related factors among nursing professionals and students. The review adhered to the PRISMA guidelines and was registered in PROSPERO (CRD42024512366). A comprehensive literature search was conducted in Google Scholar and PubMed using keywords such as "nursing students," "nursing professionals," "yoga interventions," and "mental health." Eligible studies were randomized controlled trials (RCTs) published from 1st January 2014 to 31st December 2024, involving nursing population and yoga-based interventions targeting mental health outcomes. The risk of bias was assessed using the CASP tool. The search identified 14 RCTs (967 participants, predominantly female, age range - 18 to 69 years) that met the eligibility criteria. The yoga intervention varied in duration (10 minutes to 1 hour per session), frequency (once to five times weekly), and protocols (Laughter yoga being the most common). Mental health outcomes such as stress, anxiety, burnout, mindfulness, depression, quality of sleep, and life satisfaction were assessed. Most studies reported significant improvements in these outcomes in the yoga intervention groups compared to control groups. Nine studies showed a significant stress reduction, and 3 studies found a decrease in anxiety. No adverse effects were reported, and dropout rates varied between 0% to 52.1%. Yoga was found to be effective in improving mental health and well-being among nursing professionals and students. Yoga mainly reduced stress, anxiety, burnout, and depression, suggesting its potential as a low-cost, accessible intervention for mental health management in this population. Future studies should focus on refining protocols and exploring long-term effects to establish yoga as an integral part of mental health care for nursing professionals and students.

The Effect of Yoga on Premenstrual Distress, Quality of Life, and Stress Level

The study aims to evaluate the effect of yoga on the premenstrual syndrome, perceived stress level and the quality of life. The study was conducted as a randomized controlled trial at a university in Turkey. A yoga group = 39, a control group = 41, total of n = 80 female students participated in the study. In the study, firstly, the preview was made, then the yoga group was applied two days a week for eight weeks, the second follow-up was made after the application, and lastly, the last follow-up was made in the 24th week. Four questionnaire surveys were applied on students. When the yoga group compared with the control group in terms of premenstrual syndrome, the quality of life and perceived stress level in the 2nd follow-up, a statistically significant decrease was found in the mean between the menstrual and premenstrual period, and the quality of life increases in the yoga group compared to the control group students. Practicing yoga in university students with premenstrual syndrome reduced premenstrual symptoms and raised quality of life. Yoga can be recommended to girls with premenstrual syndrome (PMS) to reduce PMS and improve quality of life.

Exploring the Effects of Qigong, Tai Chi, and Yoga on Fatigue, Mental Health, and Sleep Quality in Chronic Fatigue and Post-COVID Syndromes: A Systematic Review with Meta-Analysis

Background/Objectives: Chronic fatigue syndrome (CFS) and post-COVID syndrome (PCS) pose a substantial socioeconomic burden. The aim of this systematic review was to assess current evidence regarding the effect of the most popular forms of movement-based mindful exercises, i.e., qigong, tai chi, and yoga, on fatigue and associated symptoms in CFS and PCS. Methods: CINAHL, Embase, PsycINFO, PubMed, Scopus, and the Cochrane Library were searched from inception to October 2023. Randomized controlled trials (RCTs) where qigong, tai chi, or yoga were compared with waitlist, no intervention, or active controls were included. Independent reviewers participated in data extraction, and evaluated risk of bias, spin of information, completeness of intervention description, and certainty of the evidence (GRADE). Meta-analyses were conducted. The primary outcome was the level of fatigue. Secondary measures were the severity of anxiety and depressive symptoms and sleep quality. Results were expressed as mean difference (MD) or standardized mean difference (SMD) with a 95% confidence interval (CI). Results: Thirteen RCTs with 661 participants were included, with most studies presenting a moderate or high risk of bias. Mindful exercises were more effective than control interventions to alleviate fatigue: SMD (95%CI) = -0.44 (-0.63 to -0.25), I2 = 48%, p < 0.0001. Positive effects were also observed for secondary outcomes. The certainty of the evidence was low or very low. Conclusions: Qigong, tai chi, and yoga may be effective to reduce fatigue and improve anxiety, depression, and sleep quality in adults with CFS or PCS. However, serious methodological concerns limit the clinical applicability of these findings.

Customizing Yoga for Global Diversity: A Comparative Study of Eastern and Western Practices for Effective Integration Into Complementary Healthcare

INTRODUCTION

 This cross-sectional study aimed to examine differences in yoga practices to enhance the validity and comparability of yoga research findings. It addresses the "black-box" approach to yoga interventions by highlighting various delivery components that can impact the validity of outcomes. By moving away from the generalization of yoga outcomes, this study provides deeper insights into yoga practices across culturally diverse populations. These insights are crucial for improving the reliability of outcomes and facilitating the integration of yoga into global complementary healthcare.

METHODS

 The study included 2,619 participants, with a balanced representation from India (1,296) and the United States (1,323). The participants were diverse, with 47.5% being yoga masters, gurus, therapists, and experts. The study utilized the 14 subscales of the Essential Properties of Yoga Questionnaire (EPYQ) to assess four factors of yoga practice: region (India/United States), sex (male/female), delivery mode (remote/in-person), and participation status (instructor/practitioner). The EPYQ demonstrated strong internal consistency (Cronbach's alpha = 0.928).

RESULTS

 The total EPYQ score was higher in India than in the United States. Significant differences (p < 0.05) were observed for the 14 subscales across all four factors: region, sex, delivery mode, and participation status. Notable observations include that, by region, the United States sample scored higher than the Indian sample on the subscales of body awareness and acceptance/compassion (mean differences of -0.06 and -0.03, respectively), while the Indian sample scored higher on the spirituality and social aspects subscales (mean differences of 0.54 and 0.57, respectively). The remote delivery mode scored higher for the subscales of yoga philosophy and health benefits (mean differences of 0.17 and 0.13, respectively), and lower for the subscales of individual attention and active postures (mean differences of -0.17 and -0.04, respectively). By sex, the scores on the subscales of social aspects and yoga philosophy were higher for men than for women (mean differences of -0.26 and -0.24, respectively), whereas women scored higher for the subscales of body awareness and restorative postures (mean differences of 0.19 and 0.17, respectively). By participation status, practitioners showed higher scores for the subscales of physicality and active postures (mean differences of -0.05 and -0.02, respectively), whereas instructors scored higher on the subscales of yoga philosophy and meditation/mindfulness (mean differences of 0.37 and 0.32, respectively).

CONCLUSIONS

 This study emphasizes the importance of recognizing variations in yoga practices and highlights the need for customization to enhance its integration into healthcare. To address the challenges posed by global diversity and practice heterogeneity, the study suggests moving from "black box" evaluations of yoga interventions toward data-driven analysis of macro- and micro-level factors. These insights can guide developers, healthcare providers, and researchers in creating culturally sensitive, user-friendly solutions and inform future cross-cultural research. Further related research will help create robust standards for yoga practices and delivery, applying the same rigor as that applied to conventional healthcare practices.

Does Self-Reported Trait Mindfulness Contribute to Reducing Perceived Stress in Women Who Practice Yoga and Are Physically Active?

(1) Background: This study aimed to investigate whether yoga practice and physical activity level play an essential role in trait mindfulness and perceived stress reduction. Moreover, the study examined the differences in trait mindfulness and perceived stress between women who practiced yoga and those who engaged in other physical activities or were physically inactive, taking into account the time spent on physical activity in accordance with the World Health Organization recommendations. (2) Methods: A sample of 201 women participated in a cross-sectional online-based study, including 96 yoga practitioners and 105 non-practitioners of yoga (including physically active and inactive individuals). The average age of the participants was 36 years (range, 18-72 years; M = 36.19, SD = 11.64). Respondents completed the Mindful Attention Awareness Scale (MAAS) and the Perceived Stress Scale (PSS-10). (3) Results: Women who practiced yoga and were physically active had a significantly higher level of trait mindfulness and lower perceived stress levels than women who did not practice yoga and were physically inactive. An indirect effect of physical activity on perceived stress through mindfulness was shown only for women practicing yoga for at least 150 min per week. (4) Conclusions: This study revealed the importance of frequent yoga practice in reducing perceived stress and improving mindfulness traits. These findings may serve as a basis for implementing preventive actions in women experiencing high levels of everyday stress.

Harnessing the Potential of Artificial Intelligence in Yoga Therapy

Integrating artificial intelligence (AI) into yoga therapy represents a transformative paradigm shift in holistic health management. This article explores the evolving landscape of AI in yoga therapy, encompassing recent advancements, potential applications, ethical considerations, and implications for well-being. Recent advancements in AI have enabled real-time monitoring and personalized interventions during yoga practice, offering unprecedented customization and efficacy. AI-powered virtual assistants and telehealth platforms extend the reach of yoga therapy interventions, enhancing accessibility and inclusivity. However, ethical considerations surrounding privacy, autonomy, equity, transparency, and cultural sensitivity must be carefully addressed to ensure responsible deployment and safeguard the well-being of individuals. By prioritizing ethical principles and values, stakeholders can harness AI's transformative potential to advance the yoga therapy field and promote holistic well-being for individuals and communities worldwide.

An Intervention to Improve Mental and Physical Health of Undergraduate Nursing Students

BACKGROUND

Nursing students experience poorer mental and physical health relative to students in other health-related disciplines and young adults of similar age outside post-secondary school. Compromised mental and physical health has numerous negative impacts on nursing students and can result in burnout and development of chronic diseases.

PURPOSE

To determine whether an asynchronous online yoga intervention would improve mental and physical health of students.

METHODS

An asynchronous online 6-week yoga intervention was carried out between January and December 2021, using a pre/post design. Participants' symptoms of depression, anxiety, stress, and self-compassion were assessed using the Depression, Anxiety, and Stress Scale and Self-Compassion Scale and core endurance was assessed using the Mackenzie Core Endurance Test prior to commencement and at the conclusion of the program.

RESULTS

Of 114 participants, 68 completed the online program and pre and post measures showed that the mean depression, anxiety, stress, self-compassion and core endurance scores improved significantly (p<0.001) between baseline and study completion.

CONCLUSION

A six-week virtual yoga program significantly improved mental and physical health of undergraduate nursing students. Targeted modifications to the yoga program might enhance participant retention.

Effect of Yoga in Industrial Workers with Chronic Venous Insufficiency: A Randomized Controlled Trial

Background and objective: Prolonged standing is one of the significant contributors to chronic venous insufficiency (CVI) in industry workers. Yoga is proven to be an effective therapy in treating occupational hazards. The current study aimed to investigate the effect of yoga on CVI among industry workers. Methodology: Male workers (n = 100) from machinery manufacturing industries in Bangalore meeting the inclusion and exclusion criteria were recruited for the study. The yoga group received a specifically designed yoga module for 6 days a week for 12 weeks, and the control group was offered lifestyle suggestions. Plasma homocysteine was used as the primary outcome variable, whereas Venous Clinical Severity Score, ankle brachial pressure index (ABPI), ankle and calf circumference, CVI questionnaire, and Chalder fatigue scale were assessed as secondary variables at baseline and the end of 12 weeks of intervention. Results: Eighty-eight participants (yoga = 43, control = 45) completed the study. A one-way analysis of covariates (ANCOVA) was used to determine the significant differences between groups in the post-values. A significant difference was found between groups in plasma homocysteine (partial eta squared = 0.34, p < 0.001). All variables, except for ABPI, calf circumference, and ankle circumference, had shown statistically significant differences between the yoga and control groups after 12 weeks of intervention, with moderate to high effect sizes. There were no significant adverse events associated with the intervention. Conclusions: Yoga practices can reduce the symptoms of CVI along with vascular inflammation as indicated by reduced plasma homocysteine. Overall, yoga practices are found to be safe and efficacious for managing CVI. IEC Reference Number: RES/IEC-SVYASA/184/2021 Trial Registration Number (If Clinical Trial): CTRI/2021/02/030944.

Beyond the Badge: A Scoping Review Among Police Personnel in South India Exploring the Impact of Yoga and Health Education on Cardiovascular Health

Communicable diseases have been the primary cause of morbidity and mortality, affecting populations for decades. However, in recent times, noncommunicable diseases (NCDs) have emerged as the primary cause of illness and premature death due to factors such as urbanization, longer life expectancy, and unhealthy lifestyles. In recent years, noncommunicable illnesses have emerged as the primary cause of morbidity and premature mortality, replacing infectious diseases as the leading cause of illness and death. Among the top five causes of NCD, cardiovascular disease (CVD) is the most important factor, comprising the major diseases with maximum mortality and morbidity. The burden of CVD is greatly increased by modifiable risk factors, such as smoking, high blood pressure, type 2 diabetes, low-density lipoprotein cholesterol, and excess body weight. CVD occurs particularly in certain occupational risk groups, such as doctors, police personnel, and persons working for prolonged hours, predisposing them to unhealthy dietary practices, improper sleeping patterns, and increased psychological stress. As members of this occupational group, police personnel are particularly at risk for cardiovascular diseases, making it imperative to implement preventive measures to reduce the burden of these diseases in this population. The primary objective was to assess the impact of yoga and health education interventions on cardiovascular health outcomes among police personnel in South India, and the secondary objective was to examine the changes in blood pressure levels and lipid profiles following yoga and health education programs among police personnel.

Yoga-Based Interventions in Low-Income Populations: A Scoping Review

Introduction: The popularity of yoga has surged in recent years; however, yoga practitioners have remained a largely homogenous population. Research reflects that most practitioners are of a higher socioeconomic status. There are access barriers to yoga for lower income individuals, likely due to factors such as financial constraints and logistical challenges. The primary goal of this review was to synthesize literature on yoga research among low-income populations and better understand the feasibility and acceptability of such interventions. A secondary goal was to assess the consistency of metrics for reporting feasibility and acceptability across such studies using the CheckList Standardizing the Reporting of Interventions for Yoga (CLARIFY) guidelines as a framework. Third, the authors sought to propose additional standardized CLARIFY guidelines that may enhance reporting on the diversity of yoga research populations, adherence, and retention. Methods: The electronic databases PubMed, PsycINFO, Cochrane Central Register of Controlled Trials, and Google Scholar were searched in May 2022 using a prespecified search string. Articles assessing a yoga intervention in predominantly low-income adult populations were deemed eligible for inclusion. Results: The search resulted in 512 potential articles. Eleven were deemed eligible for inclusion. The included studies reported mostly positive effects of yoga on the target outcome (i.e., pain/disability, quality of life/wellness, and psychiatric symptoms). Recruitment and retention data showed generally good attendance and high study completion rates. Common study design components included recruitment embedded within preexisting medical settings, proximal yoga locations, and mitigation of yoga-related costs. Finally, the authors noted inconsistency in the reporting of adherence, retention, and other sociodemographic characteristics of participants and yoga instructors (e.g., race, ethnicity, and income). Discussion: Yoga may promote physical and mental health for low-income individuals. Important facilitators to access are noted, such as proximal study settings, as well as barriers such as the need for childcare that can be addressed in future research. In addition, several study design considerations could help address the specific needs of low-income participants in yoga research, such as compensating participants, recruiting within existing medical settings, and providing yoga-related equipment at no cost. Finally, the authors suggest specific ways to enhance reporting of study metrics related to socioeconomic diversity, by adding to the preexisting CLARIFY guidelines.

Eight-week stress management exercise program improves mental health and autonomic nervous system of adults exposed to chronic stress

BACKGROUND

This study investigated a stress management exercise program's effect on mental health, muscle pain, and autonomic nervous system activity in adults exposed to chronic stress.

METHODS

Thirty mothers between 40 to 59 years old raising children with disabilities were equally allocated into the yoga (YG) or control group (CG). The YG participated in 16 prop-assisted yoga sessions twice weekly for eight weeks, focusing on relaxing and strengthening neck, shoulder, back, and waist stress-related muscles. The Beck Depression Inventory, State-Trait Anxiety Inventory, Parenting Stress Scale, Stress Response Inventory, and Brief Resilience Scale assessed mental health variable changes. Visual Analog Scales (VAS) were used to self-report neck, shoulders, back, and waist pain and assess stress, anxiety, relaxation, and confidence. We also measured pain, psychological VAS, and Heart Rate Variability (HRV) immediately before and after each yoga session.

RESULTS

The YG exhibited significant reductions in muscle pain, depression, stress response, fatigue, and frustration, whereas the CG expressed no change. Prop-assisted yoga immediately improved pain and psychological VAS. HRV analyses revealed instantly reduced heart rates and an R-R interval and standard deviation normal to normal (SDNN) increase.

CONCLUSIONS

Prop-assisted yoga may serve as a viable, safe, and efficient alternative therapeutic modality for managing chronic stress-related conditions.

Preliminary effects of a yoga intervention for lung cancer dyads: benefits for care partners

PURPOSE

Lung cancer is a disease with high mortality and morbidity, impacting both the patient and their closest contact, referred to in this paper as their care partner. There is limited evidence on how to support mental health and quality of life (QOL) for patient-care partner dyads during cancer treatment. This pilot study examines yoga as an intervention to improve well-being for the dyad.

METHODS

A single-group, 12-week pilot trial of yoga for patients and their care partners recruited from two hospitals during cancer treatment (N = 23 patient-partner dyads or 46 individuals). Most care partners were spouses (70%), with the remainder being adult children (22%), a sibling (4%), or a friend (4%). Descriptive statistics, Cohen's d effect sizes, and paired t-tests for validated psychosocial measures were calculated at baseline and 12 weeks.

RESULTS

Sixty-five percent of dyads (N = 13) completed the study, with withdrawals mostly due to disease progression. Among care partners, there was a decrease in depression symptomology on the PHQ-8 (p = 0.015, Cohen's d = 0.96) and improvement in QOL on the Caregiver QOL-Cancer scale (p = 0.001, Cohen's d = 0.61). Fifty percent of dyads experienced concordant improvement in depressive symptoms and 77% in QOL.

CONCLUSION

Patient-partner yoga is a promising intervention for improving mental health and QOL for patient-partner dyads among lung cancer survivors. This study demonstrates yoga to be acceptable, feasible, and with high concordance within patient-partner dyads for improvements in QOL. Yoga shows promise for patients and care partners to alleviate the negative psychosocial impacts of lung cancer, though more research is needed to confirm effects.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT03649737, 12/9/2020.

Effects of a Yoga Program Combined with a Mediterranean Diet on Nutritional Status and Functional Capacity in Community-Dwelling Older Adults: A Randomized Controlled Clinical Trial

(1) Background: With the aging population, effective interventions are needed to enhance the health of older adults. This study investigated the combined effects of yoga and the Mediterranean diet on various health outcomes in community-dwelling older adults; (2) Methods: The study employed a randomized controlled trial design with a total of 116 older adults randomized to an experimental group (n = 57) that underwent a combined yoga and Mediterranean diet program and a control group (n = 59) that did not receive any intervention. Nutritional status was assessed using the Mini Nutritional Assessment, flexibility with the Back Scratch Test and the Chair Sit-and-Reach Test, balance, gait, and fall risk with the Tinetti Scale, and muscle strength with a dynamometer and the 30 s Chair Stand Test; (3) Results: Regarding nutritional status, there were significant differences between the experimental group and the control group (Cohen's d = 0.02). The participants in the experimental group showed greater balance (11.12 ± 3.01 vs. 10.03 ± 2.35, Cohen's d = 0.41 and gait (7.63 ± 1.96 vs. 6.69 ± 2.50, Cohen's d = 0.44) with respect to the control group. In terms of flexibility, the experimental group showed statistically significant improvements in the right arm (Cohen's d = 0.43), left arm (Cohen's d = 0.64), right perineum (Cohen's d = 0.42), and left leg (Cohen's d = 0.37) Finally, in terms of strength, participants in the experimental group experienced statistically significant improvements in grip strength and lower body strength (Cohen's d = 0.39 and 0.81, respectively); (4) Conclusions: The study highlights the potential benefits of a 12-week intervention combining yoga with a Mediterranean diet to improve the health and functional capacities of community-dwelling older adults.

Perceived delivery of essential yoga properties within in-person and remote weight loss maintenance interventions

OBJECTIVES

While previous research has utilized remote delivery of yoga interventions, no research has specifically interrogated the effectiveness of remote yoga intervention delivery. In this secondary analysis of weight-maintenance trial data, we examined participant perceptions of essential yoga properties across in-person and remote formats, hypothesizing that perceptions would not differ following remote delivery.

METHODS

24 women with overweight or obesity (34.6±4.1 kg/m2, 48.2±9.9 years) received a 12-week Iyengar yoga intervention (2x/week) following a 3-month behavioral weight loss program. Of 23 participants who completed follow-up questionnaires, 12 received the planned in-person intervention and 11 received a remote intervention (delivered live) due to the COVID-19 pandemic. The Essential Properties of Yoga Questionnaire (EPYQ) was completed online by participants and by the instructors to measure the perceptions of the relative emphasis placed on the essential components of the yoga intervention via 14 subscales. Linear regression models were used to compare perceptions of each EPYQ dimension across in-person and remote delivery methods, as well as between participants and instructors, independent of delivery method.

RESULTS

13 of the 14 subscales did not differ between delivery modalities (p>0.05). Participants perceived more individual attention within in-person yoga (p = 0.003). For both delivery methods, instructors perceived breathwork, restorative postures, and body locks to be incorporated to a lesser degree compared to participants (β = -1.28, p = 0.003; β = -1.57, p = 0.019; β = -1.39, p = 0.036; respectively). No other significant differences across the participant and instructor scores were observed.

CONCLUSIONS

Findings provide preliminary support for the use of live remote delivery of yoga, effectively communicating most essential yoga properties when compared to in-person classes. However, participants perceived more individual attention with in-person versus remote delivery; thus, future remote-based yoga interventions may benefit from providing additional individualized feedback.

Exploring the Impact of a Trauma-informed Yoga and Mindfulness Curriculum for Multiple Populations: A Pilot Study

Individuals with trauma experience negative mental health impacts and are at risk of poor cardiovascular outcomes. Unmanaged, these conditions may worsen, compromising healing and wellbeing. Yoga, particularly trauma-informed, may improve outcomes. The current pilot study explores the impact of a novel trauma-informed yoga and mindfulness curriculum on wellbeing in two parts. The first examined mental health (stress, mood) outcomes in four trauma-impacted populations: adults who were incarcerated (INC), individuals in recovery from substance use disorders (SU), veterans (VA), and vulnerable youth (YTH) assessing both the impact of individual class participation and impact of attending at least four curriculum sessions. For the subgroup of incarcerated individuals, impact by theme was examined. After curriculum sessions, stress was reduced, and mood improved. Across multiple sessions both the largest decreases in stress and greatest increase in mood occurred after participant in the first session. Further, a specific exploration of curriculum class impact by theme for participants who were incarcerated indicated no difference in impact by theme. The second part of this study explored cardiovascular outcomes for the population of those in recovery from substance use. Reductions in systolic blood pressure occurred immediately after the first curriculum session, and diastolic blood pressure reduced over three consecutive sessions.

Application of mobility training methods in sporting populations: A systematic review of performance adaptations

This systematic review investigates influences of mobility training in sporting populations on performance outcomes. The search strategy involved Embase, MEDLINE Complete, Sports Discus and manual search from inception to March 2022. Mobility training studies with a minimum three-week, or 10-session duration in healthy sporting populations of any age were included. Twenty-two studies comprising predominantly young adult or junior athletes were analysed from 319 retrieved articles. Performance outcomes were strength, speed, change of direction, jumping, balance, and sport-specific skills. Fifteen studies randomized participants with only four indicating systematic allocation concealment and blinding of outcomes assessors in only one study. In 20 of 22 studies mobility training was of some benefit or helped to maintain sports performance to a larger degree than control conditions. Control conditions, which were generally no activity conditions, were primarily non-significant. The majority of evidence suggests that a range of mobility training methods may improve key sports performance variables or are unlikely to impair performance over time. Therefore, coaches can consider the potential benefits of including comprehensive mobility programmes with minimal risk of impairing performance. Higher-quality studies in homogenous populations are necessary to confirm performance changes.

Effect of tele-yoga on aerobic capacity, respiratory muscle strength, and cognitive performance in patients with obstructive sleep apnea syndrome

BACKGROUND

Obstructive sleep apnea syndrome (OSAS) causes a decrease in aerobic capacity, respiratory muscle strength, and cognitive function, negatively affecting health-related quality of life.

OBJECTIVES

This study aimed to compare aerobic capacity, respiratory muscle strength, cognitive performance, functional capacity, sleep quality and daytime sleepiness in OSAS patients practicing and not practicing tele-yoga (TY).

METHODS

44 OSAS patients (40 M, 4F) were randomized into TY and control groups. TY group underwent live synchronous group-based TY sessions, 60 min/day, three days/week, for 12 weeks. Control group performed unsupervised thoracic expansion exercises at home 4 times daily for 12 weeks. The following were evaluated at baseline and at the end of the 6th and 12th weeks: inspiratory and expiratory respiratory muscle strength (MIP, MEP), cardiopulmonary exercise test, Corsi Block Tapping Test (CBTT) and Stroop TBAG test, six-minute walk test (6MWT), Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS).

RESULTS

TY significantly improved MIP, and exercise test parameters (VE, HRmax,%HR, heart rate recovery in the first minute and RQmax), CBTT (forward) and Stroop TBAG test scores (parts of 3,4,5) compared to the controls (p<0.05). There were no significant changes 6MWT in the TY group compared to the control group (p > 0.05). Sleep duration (min), sleep efficiency, sleep quality of PSQI and ESS score improved significantly in the TY group compared to the control group (p < 0.05).

CONCLUSION

We suggest including TY intervention as a method of exercise in addition to CPAP treatments since it improves the health-related parameters of OSAS patients.

Complementary Health Approaches and Integrative Health in Occupational Therapy

This AOTA Position Statement describes the use of complementary and integrative health approaches in occupational therapy practice and presents ethical and pragmatic matters, including diversity, equity, inclusion, cultural humility, continuing competence, standards of practice, and supporting evidence.

Effect of yoga on adipokine levels among overweight and obese people: A systematic review

BACKGROUND

Adipokines have an important role in the pathophysiology of overweight and obesity and associated inflammatory diseases.

OBJECTIVE

The present review aims to evaluate the role of Yoga on adipokines among people with overweight and obesity.

METHODS

Authors performed a systematic search for relevant research studies as per the PRISMA guidelines in Google Scholar, Medline/Pubmed, Scopus, Web of Science, PsychInfo electronic databases. Two independent authors conducted the selection of articles, data extraction, assessment of the risk of bias for individual studies. Any disagreements were resolved by discussion with the third author.

RESULTS

Eight randomized trials and four uncontrolled trials involving a total of 1054 participants were included. Yoga with varying frequencies was administered for different durations. The studied adipokines among overweight and obese were leptin, adiponectin, interleukin-6 (IL-6), Tumor necrosis factor-alpha (TNF-α), chemerin, visfatin, plasminogen activator inhibitor-1 (PAI-1), and transforming growth factor-beta (TGF-β). The methodological quality of the included studies was low to moderate on the Cochrane risk of bias tool and Newcastle-Ottawa Quality Assessment Scale. The higher the frequency and duration of Yoga practice, the more significant changes in the adipokine levels were seen.

CONCLUSION

The present review indicates that Yoga practices positively impacts adipokines among people with overweight and obesity. However, the present study precludes the generalizability of results due to the methodological heterogeneity, the type of Yoga intervention, and settings.

Recommending yoga for health: A survey of perceptions among healthcare practitioners in the UK

BACKGROUND

Yoga has the potential to support patients across various health conditions. It is slowly being integrated into healthcare worldwide. While healthcare practitioners (HCPs) are critical to integration, there are currently no studies investigating their perceptions of yoga for health, their openness to recommending yoga to patients, and barriers to doing so. This novel UK study aims to address this.

METHOD

An online survey was conducted among practising UK HCPs. Recruitment was through multi-modal convenience sampling. The COM-B model was used as a framework. Regression analysis examined predictors of HCPs' likelihood to recommend yoga. Open-end responses were analysed through thematic analysis.

RESULTS

198 HCPs were included in the analysis, including general practitioners (GPs, 18.8%), psychologists (18.3%), and nurses/health visitors (14.7%). A high proportion (68.8%) practised yoga at least monthly. The likelihood of recommending yoga to patients was high (M = 4.03, SD = 0.94; 5-point scale). Older age, not being a GP, and greater capability and motivation significantly predicted a greater likelihood of recommending yoga, explaining 41.4% of the variance (p < 0.001). Barriers to recommending yoga were mostly related to the lack of opportunity.

CONCLUSIONS

HCPs in this study had high levels of personal engagement with yoga and were open to recommending yoga to patients, but still faced several barriers. Workplace support, particularly for GPs, and information about how patients can access appropriate and affordable yoga instruction would facilitate referral. Further research with a representative sample is warranted to understand perceptions of HCPs less engaged with yoga.

Increased Effect Sizes in a Mindfulness- and Yoga-Based Intervention After Adjusting for Response Shift with Then-Test

Objectives

Response shift refers to variations in self-reported evaluations at different times from changes in one’s internal standards, values, and meanings. The current study explored the utility of the then-test to detect a potential mindfulness-based response shift occurrence during a mindfulness- and yoga-based intervention for student musicians, and to ascertain to what extent effect sizes could differ when adjusting for it.

Method

Participants (n = 31) completed the Five Facet Mindfulness Questionnaire (FFMQ) halfway through the intervention (Time 1-FFMQ), post-intervention (Time 2-FFMQ), and immediately after Time 2-FFMQ with a then-test approach that asked participants to rate the FFMQ based on retrospective reflections on their mindfulness at Time 1 (then-test-FFMQ). Paired t-tests and Hedges’ g effect sizes were computed to estimate three potential effects: response shift (Time 1-FFMQ minus then-test-FFMQ), the conventional intervention effect (Time 2-FFMQ minus Time 1-FFMQ), and the effect after adjusting for response shift (i.e., actual intervention effect = Time 2-FFMQ minus then-test-FFMQ).

Results

Response shift was significant for the FFMQ Observe subscale (g = 0.41) and total scale (g = 0.37). The adjusted scores in all subscales (Observe, g = 0.47; Describe, g = 0.25; Act Aware, g = 0.40; Non-judge, g = 0.28; Non-react, g = 0.57) and total scale (g = 0.60) achieved significance and yielded larger effect sizes than the conventional results, for which only Act Aware (g = 0.28), Non-react (g = 0.36), and total scale (g = 0.28) were significant.

Conclusions

Notwithstanding some methodological limitations, this study lends support to the utility of the then-test to quantify response shift. When adjusting for it, effect sizes from a mindfulness- and yoga-based intervention were generally amplified.

Preregistration

This study was not preregistered.

Going within, between and beyond: An exploration of regular Ashtanga Yoga practitioners' conceptualizations of five dimensions of wellbeing

Yoga is an embodied practice underpinned by philosophical elements, seeking to evolve different dimensions of human existence for optimal functioning in relation to oneself, others and beyond. This mixed-methods research focused on 137 regular Ashtanga Yoga practitioners (AYPs) by investigating their conceptualizations of five dimensions of wellbeing (i.e., physical, emotional, psychological, social, spiritual). Conceptualizations were analysed through word count analysis and Reflexive Thematic Analysis separately for each dimension, yielding four themes in each case, which partly aligned with existing wellbeing and yoga models, and partly extended on the existing literature. Further higher level analysis identified shared meanings across these five dimensions, expressed in themes grouped within five topics (i.e., freedom from and managing suffering, a positive and integrated sense of self, a sense of equanimity and steadiness, the self in relation to others and the world, meta-awareness). Furthermore, it also portrayed each dimension as multileveled, represented in three levels of human functioning. The foundational level encompassed the absence and managing suffering, representing functioning in coping and recovery mode. The optimal functioning level included a positive and integrated sense of self, a sense of equanimity and steadiness, and the self in relation to others and the world, representing functioning in personal development and growth mode. The contemplative and transcendental level involved meta-awareness in every dimension of wellbeing, representing functioning in transpersonal mode. As a result, we propose a preliminary model informed both by this empirical work and previous theories. While the continuousness of themes across dimensions reinforces the importance of embodiment and transcendence in wellbeing frameworks, the notion of the self as a multi-level system could be further explored in relation to knowing about and cultivating wellbeing.

Physical exercise interventions for perinatal depression symptoms in women: A systematic review and meta-analysis

Background

The previous meta-analysis indicated that physical exercise could play a crucially therapeutic role in reducing perinatal depression symptoms in women. However, the efficacy varies across different exercise types, forms, intensities, and duration.

Aim

The purpose of this study was to review and evaluate the effects of different types, forms, intensities, and duration of exercise for improving perinatal depressive symptoms.

Design

A systematic review and meta-analysis.

Methods

Randomized controlled trials until December 2021 were searched from seven databases, including PubMed, EMBASE, Medline, CINAHL, Web of Science, Cochrane Library, and PsycINFO. The risk of bias in eligible trials was evaluated using the Cochrane Risk of Bias tool. When high heterogeneity was tested, we used random-effects models. A funnel plot was used to assess the publication bias. This review was performed under the PRISMA guidelines, Consensus on Exercise Reporting (CERT) checklist and Cochrane Handbook. The certainty of the body of evidence was assessed using the GRADE method.

Results

Of 1,573 records, 20 trials were identified in this study. The results of this review revealed that women with perinatal depression symptoms gained benefits from physical exercise [OR = 0.62, 95% CI (0.45, 0.86), P = 0.004; MD = -0.57, 95% CI (-0.83, -0.30), P < 0.0001]. Type of walking [SMD = -1.06, 95% CI (-1.92, -0.19), P < 0.00001], form of "Individual + group-based"exercise [SMD = -0.91, 95% CI (-0.80, -0.03), P = 0.04], intensity of ≥150 min per week [SMD = -0.84, 95% CI (-1.53, -0.15), P = 0.02], and ≥12 weeks duration [SMD = -0.53, 95% CI (-0.75, -0.31), P < 0.00001] seemed to generate more prominent improvement on perinatal depression symptoms.

Conclusion

Physical exercise showed a significant effect on reducing perinatal depressive symptoms. This meta-analysis provides an important update on exercise's efficacy in treating perinatal depression. Further higher quality and large-scale trials are needed to substantiate our findings.

Systematic review registration

[https://www.crd.york.ac.uk/prospero/], identifier [CRD42022296230].

Bibliometric and visualized analysis of exercise and osteoporosis from 2002 to 2021

Background

Bibliometric analysis was designed to investigate a systematic understanding of developments in exercise and osteoporosis research over the past 20 years.

Methods

Relevant publications from the Web of Science Core Collection were downloaded on April 26, 2022. CiteSpace, VOSviewer, and the online bibliometric analysis platform were used to conduct this scientometric study.

Results

A total of 5518 publications were in 1202 academic journals with 137405 co-cited references in by 5637 institutions from 98 countries/regions. The country leading the research was the USA. The University of Melbourne was the most active institution. Osteoporosis International was the most productive journal concerning exercise and osteoporosis research. According to the burst references, "low-level vibration," "high-frequency" and "resistance exercise" have been recognized as the hotspots research in the domain. The keywords co-occurrence analysis identified "skeletal muscle," "sarcopenia" and "mesenchymal stem cell" as the important future research directions.

Conclusion

This study was the first comprehensive metrological and statistical analysis of exercise and osteoporosis research over the past 20 years. Our findings would provide guidance to understand the research frontiers and hot directions in the near future.

Effects of vibrotactile feedback on yoga practice

Participating in physical exercise using remote platforms is challenging for people with vision impairment due to their lack of vision. Thus, there is a need to provide nonvisual feedback to this population to improve the performance and safety of remote exercise. In this study, the effects of different nonvisual types of feedback (verbal, vibrotactile, and combined verbal and vibrotactile) for movement correction were tested with 22 participants with normal vision to investigate the feasibility of the feedback system and pilot tested with four participants with impaired vision. The study with normal-vision participants found that nonvisual feedback successfully corrected an additional 11.2% of movements compared to the no-feedback condition. Vibrotactile feedback was the most time-efficient among other types of feedback in correcting poses. Participants with normal vision rated multimodal feedback as the most strongly preferred modality. In a pilot test, participants with impaired vision also showed a similar trend. Overall, the study found providing vibrotactile (or multimodal) feedback during physical exercise to be an effective way of improving exercise performance. Implications for future training platform development with vibrotactile or multimodal feedback for people with impaired vision are discussed.

Introduction to Traditional Medicine and Their Role in Prevention and Treatment of Emerging and Re-Emerging Diseases

Infectious diseases have been a threat to human health globally. The relentless efforts and research have enabled us to overcome most of the diseases through the use of antiviral and antibiotic agents discovered and employed. Unfortunately, the microorganisms have the capability to adapt and mutate over time and antibiotic and antiviral resistance ensues. There are many challenges in treating infections such as failure of the microorganisms to respond to the therapeutic agents, which has led to more chronic infections, complications, and preventable loss of life. Thus, a multidisciplinary approach and collaboration is warranted to create more potent, effective, and versatile therapies to prevent and eradicate the old and newly emerging diseases. In the recent past, natural medicine has proven its effectiveness against various illnesses. Most of the pharmaceutical agents currently used can trace their origin to the natural products in one way, shape, or form. The full potential of natural products is yet to be realized, as numerous natural resources have not been explored and analyzed. This merits continuous support in research and analysis of ancient treatment systems to explore their full potential and employ them as an alternative or principal therapy.

Yoga Module Development and Validation: A Systematic Review with Methodological Guidelines

In the past decades, more than fifty different yoga styles have been implemented in the therapeutic context to manage various diseases. Yet, not all of these yoga styles have been validated or standardized as a program. The aim of this article is to review the different methodologies used for yoga module development and to assess their quality. Three databases (PubMed, Web of Science, and Scopus) were searched using the following keywords and Boolean operators: (validation OR development OR design) AND (yoga OR mind-body) AND (module OR protocol OR program). Three thousand six hundred and seventy-one articles were enlisted, and based on the inclusion and exclusion criteria, 37 articles were narrowed down for review. Since no checklist exists to assess the quality of yoga modules, the authors designed a 23-item checklist to categorize each having low, medium, or high quality. As per the yoga module quality checklist, only 21.6% of the studies had high quality, while 75.3% of the articles had medium quality and 8.11% had low quality. A commonly used development method was literature review, while for validation, experts' scoring of the Likert scale was the preferred means. The feasibility of the module was carried out only by half of the studies. Few diseases such as cardiovascular disease, diabetes mellitus, obesity, Parkinson's disease, and obesity had more than one yoga module developed. The findings of this systematic review have shed some light on the growing need for standardized methods of yoga module development. The 23-item checklist can guide researchers in the homogeneous development strategies when designing yoga interventions in the future.

Analysis of Retinal Blood Vessel Diameters in Pregnant Women Practicing Yoga: A Feasibility Study

Studies have shown that practicing yoga during pregnancy beneficially affects maternal and neonatal outcomes. The objective of this study was to determine the effect of prenatal yoga on the microvascular circulatory system via non-invasive measurements of retinal blood vessels. We included 29 women who practiced prenatal yoga in the study. There were no statistically significant differences in arteriolar and venular diameters pre- vs. post-90 min yoga practice (150.5 ± 11.4 μm pre- vs. 151.2 ± 10.2 μm post-yoga; p = 0.53 for arteriolar and 221.8 ± 16.1 μm pre- vs. 223.2 ± 15.7 μm post-yoga; p = 0.51 for venular diameters). The current study demonstrated the feasibility of the setup. More extensive studies are needed to determine the potential microvascular effects of practicing yoga throughout pregnancy.

Yoga and Qigong for Health: Two Sides of the Same Coin?

Yoga and qigong are ancient mind–body practices used in the East for thousands of years to promote inner peace and mental clarity. Both share breathing techniques and slow movements and are being used as alternative/complementary approaches to the management of disease, especially chronic problems with no effective conventional treatments. However, information comparing the health benefits of both approaches is scarce, and the choice between yoga or qigong practice may only depend on patients’ preferences or practice availability. The aim of the present paper was to overview yoga and qigong use for health benefits under different pathological conditions. Yoga and qigong seem to have similar effects, which might be expected, since both are similar mind–body approaches with the same concept of vital life-force energy and the practice of meditative movements. Problematic research issues within the literature on yoga and qigong are the small sample sizes, use of different styles, significant variance in practice duration and frequency, short duration of intervention effects, and the usage of a non-active control group, thus emphasizing the need for further high-quality randomized trials. Studies comparing yoga and qigong are warranted in order to assess differences/similarities between the two approaches for health benefits.

Methodological issues in conducting yoga- and meditation-based research: A narrative review and research implications

Yoga and meditation-based interventions have been extensively utilized in the field of contemporary complementary and alternative medicine for various physical and mental health conditions. Ongoing COVID-19 pandemic has rekindled the interest of researchers in yoga and meditation for its preventive and therapeutic utilities. However, the available literature in this area has several methodological concerns, limiting formers’ clinical utility. A comprehensive literature on this topic would stimulate researchers and guide them to conduct research on this topic with robust methodologies. The current review highlights the methodological issues with the yoga and meditation-based Research (henceforth, MBR), discusses some of the contentious issues, and provides future directions. The PubMed, Medline, and google scholar databases were searched to screen records dealing with the methodological issues on MBR. The search yielded 299 records, upon screening, only 24 articles were found suitable for the current study. Common methodological issues with MBR: lack of the consensus definitions of the yoga and meditations, interventions lacking theoretical framework of meditation; inadequate description of the study design; difficulty with participants recruitment, setting up the control groups, and blinding; difficulty in assessing the baseline characteristics of the participants, and validity issues with the outcome measures. A few research, however, have also highlighted the potential measures to overcome these methodological challenges. Yoga and meditation-based interventions are promising for several health conditions. However, literature suffers from considerable methodological issues, thus, limiting its utility in modern clinical practice. The study findings can stimulate and guide future research on this topic.

A systematic review of in vivo stretching regimens on inflammation and its relevance to translational yoga research

OBJECTIVE

To conduct a systematic review evaluating the impact of stretching on inflammation and its resolution using in vivo rodent models. Findings are evaluated for their potential to inform the design of clinical yoga studies to assess the impact of yogic stretching on inflammation and health.

METHODS

Studies were identified using four databases. Eligible publications included English original peer-reviewed articles between 1900-May 2020. Studies included those investigating the effect of different stretching techniques administered to a whole rodent model and evaluating at least one inflammatory outcome. Studies stretching the musculoskeletal and integumentary systems were considered. Two reviewers removed duplicates, screened abstracts, conducted full-text reviews, and assessed methodological quality.

RESULTS

Of 766 studies identified, 25 were included for synthesis. Seven (28%) studies had a high risk of bias in 3 out of 10 criteria. Experimental stretching protocols resulted in a continuum of inflammatory responses with therapeutic and injurious effects, which varied with a combination of three stretching parameters--duration, frequency, and intensity. Relative to injurious stretching, therapeutic stretching featured longer-term stretching protocols. Evidence of pro- and mixed-inflammatory effects of stretching was found in 16 muscle studies. Evidence of pro-, anti-, and mixed-inflammatory effects was found in nine longer-term stretching studies of the integumentary system.

CONCLUSION

Despite the overall high quality of these summarized studies, evaluation of stretching protocols paralleling yogic stretching is limited. Both injurious and therapeutic stretching induce aspects of inflammatory responses that varied among the different stretching protocols. Inflammatory markers, such as cytokines, are potential outcomes to consider in clinical yoga studies. Future translational research evaluating therapeutic benefits should consider in vitro studies, active vs. passive stretching, shorter-term vs. longer-term interventions, systemic vs. local effects of stretching, animal models resembling human anatomy, control and estimation of non-specific stresses, development of in vivo self-stretching paradigms targeting myofascial tissues, and in vivo models accounting for gross musculoskeletal posture.

Hot Yoga Leads to Greater Well-being: A Six-week Experience-sampling RCT in Healthy Adults

Practicing hot yoga may bring significant psychological benefits, but it is largely unstudied. We examined the effects of hot yoga on multifaceted well-being indicators with 290 healthy yoga-naïve volunteers partaking in a six-week randomized controlled trial. Participants completed questionnaires pre- and post-intervention, and reported their emotional experiences four times per day throughout an experience-sampling study. Results revealed that the hot yoga group (n = 137) improved their well-being from pre- to post-treatment, comparing to the wait-list control group (n = 153). These improvements included life satisfaction, general health, mindfulness, peace of mind, and eudaimonic well-being (ΔR2 ranging from .01 to .08)-but not flourishing, which describes major aspects of social-psychological functioning. Multilevel analyses demonstrated that momentary positive emotional experiences increased significantly throughout the trial in the yoga group only (conditional R2 = .68), particularly when attending a yoga class (conditional R2 = .50). Interestingly, this increase in momentary positive emotion explained the improvement in post-intervention mindfulness, peace of mind, and general health by 21%, 31%, and 11%, respectively. Finally, the benefits of hot yoga were more notable in individuals with lower levels of baseline eudaimonic well-being (conditional R2 = .45), flourishing (conditional R2 = .61), and mental well-being (conditional R2 = .65), even after ruling out any possible ceiling effects. To sum up, this study demonstrated multiple psychological benefits of hot yoga and its potential to be an effective positive psychology intervention. Future research-especially considering an active control group-is warranted.

Integration of hatha yoga and evidence-based psychological treatments for common mental disorders: An evidence map

BACKGROUND

Interest in the use of yoga to enhance engagement with and augment the benefits of psychological treatment has grown. However, a systematic approach to reviewing existing research examining the use of yoga with psychological treatment is lacking.

MATERIALS AND METHODS

This mapping review identified and synthesised research trialling yoga as an integrated or adjunct therapy with evidence-based psychological interventions for the treatment of anxiety, depression, PTSD, and eating disorders.

RESULTS

Overall, the review identified ten published and three unpublished studies, representing either single group or small quasi-experimental research designs.

DISCUSSION

Limited but promising findings were shown for yoga with CBT for anxiety and depression, and the integration of yoga within intensive treatment models for PTSD.

CONCLUSIONS

Future research is encouraged to focus on controlled trials that enable examination of the component effect of yoga when applied with evidence-based psychological treatment and acceptability and feasibility data to further knowledge regarding a role for yoga in clinical practice.

When Eastern Meets Western Medicine to Manage SARS-CoV-2/COVID-19 Patient: a Case Report

Psychological and psychosocial issues are one of the prime areas to be focused on in SARS-CoV-2/COVID-19. However, those patients' mental, social, and emotional parts are still not being focused on while treating the SARS-CoV-2/COVID-19. Thus, we integrated both eastern and western medicine to discuss its impact on the mental and psychological issues of the patient. We treated a 52-year-old man who was infected with COVID-19/SARS-CoV-2 and had a sign and symptoms of fever, sore throat, running nose, cough, and tiredness. The patient was treated with integrated medicine, where we combined both eastern and western medicine to treat all aspects of health, i.e., physical, mental, emotional, and social. With the intervention we applied, his health was getting better day by day, and on the 16th day, his SARS-CoV-2 came negative. In addition, his mental health was also much better than the initial days of intervention. The integrated medicine therapeutic strategy effectively treats COVID-19 patients in all dimensions of health.

Effect of Trataka (Yogic Visual Concentration) on the Performance in the Corsi-Block Tapping Task: A Repeated Measures Study

Background and Objective: Attention and memory are essential aspects of cognitive health. Yogasanas, pranayama, and meditation have shown to improve cognitive functions. There has been no assessment of Trataka (yogic visual concentration) on working or on spatial memory. The present study was planned to assess the immediate effects of Trataka and of eye exercise sessions on the Corsi-block tapping task (CBTT). Methods: A total of 41 healthy volunteers of both genders with age 23.21 ± 2.81 years were recruited. All participants underwent baseline assessment, followed by 2 weeks of training in Trataka (including eye exercise). Each training session lasted for 20 min/day for 6 days a week. After completion of the training period, a 1-week washout period was given. Each participant then was assessed in two sessions in Trataka and in eye exercise on two separate days, maintaining the same time of the day. Repeated measure analysis of variance with Holm's adjustment was performed to check the difference between the sessions. Results: Significant within-subjects effects were observed for forward Corsi span andforward total score (p < 0.001), and also for backward Corsi span (p < 0.05) and backward total score (p < 0.05). Post hoc analyses revealed Trataka session to be better than eye exercises and baseline. The eye exercise session did not show any significant changes in the CBTT. Conclusion: The result suggests that Trataka session improves working memory, spatial memory, and spatial attention.

Practice or performance? A content analysis of yoga-related videos on Instagram

Representations of yoga within media have become increasingly idealised, depicting typical practitioners as young, thin, and physically competent. While previous content analyses of yoga have focused on still images, social media platforms such as Instagram encourage the use of video to enhance viewer engagement. Video may contain features which reflect a more nuanced view of the body, and therefore the current study analysed 400 women in yoga-related videos on Instagram for appearance characteristics, body conceptualisation, yoga pose type, risk, and perceived intention. The vast majority of women were perceived to be in their 20s and thin or athletic. Only 13.2 % of women showed average visible levels of body fat, while more than a third displayed visible muscularity across multiple muscle groups. There was little presence of objectification with the majority of women in active poses, though more than 60 % of poses/sequences were advanced and potentially risky. The vast majority of videos appeared to be for the purpose of demonstrating skill rather than instructing the viewer. The findings show that videos on Instagram perpetuate unrealistic appearance ideals in yoga and also provide a platform for content creators to engage viewers by representing yoga as a highly performative, predominantly advanced physical activity.

Is Weekly Frequency of Yoga Practice Sufficient? Physiological Effects of Hatha Yoga Among Healthy Novice Women

Beneficial physical and physiological health outcomes of yoga practice are well-supported by empirical data. However, whether weekly frequency of training is sufficient to evoke positive changes, is still an open question. The present intervention study investigated the effects of 10 weekly sessions of beginner level hatha yoga with respect to indicators of physical fitness and physiological markers. 82 young women (mean age of 22.0 ± 3.83 years) participated in the study. The yoga group (N = 49) attended a yoga course consisting of 10 sessions (1.5 h each) on a weekly basis. The control group (N = 33) did not receive any intervention. BMI, body fat percentage, balance (one-leg-stand test with open and closed eyes, functional reach test), flexibility (side bend test, modified sit and reach test) core muscle strength (plank test) as well as resting heart rate (HR), and heart rate variability (HRV) were assessed 1 week before and after the course. Both frequentist and Bayesian analysis showed an improvement in flexibility and balance in the yoga group compared to the control group. The yoga group showed also increased core muscle strength. No changes with respect to BMI, body fat percentage, resting HR and HRV were found. Ninety minute beginner level hatha yoga classes were characterized by 93.39 HR and 195 kcal energy consumption on average. The present findings suggest that weekly setting of a 10-session long hatha yoga training leads to improvements in balance, flexibility and core muscle strength among healthy young women. However, for changes in BMI, body fat percentage, resting HR and HRV longer, and/or more intense interventions are needed.

The necessity of integrated medicine to treat SARS-Cov-2/COVID-19 patient: A case report

Health policymakers and clinicians should also prioritize mental, emotional and social health while treating SARS-CoV-2/COVID-19, and for this, different treatment varieties of eastern medicine would be a better option to integrate into western medicine so that we could have a better result in all dimensions of health.

The prevalence and characteristics of yoga or meditation users in Iceland: Results of a national health survey

BACKGROUND

Use of yoga or meditation has increased decisively in recent years. Factors associated with the use of yoga and meditation are not well understood. The aim was to focus on the relationship of yoga and meditation to sociodemographic background, religiosity, healthcare-related attitudes, mental and physical health, and physician visits.

MATERIALS AND METHODS

This study builds on data from a national health survey of a random sample of Icelandic adults, aged 18-75 (n = 1599; response rate of 58%).

RESULTS

The overall use of yoga or meditation reached 19.3% in 2015. This is an increase of 12.5% points over a nine-year period. The increase was much greater for women. Yoga or meditation use was positively related to the female gender, younger age, higher levels of education, and not belonging to a religious denomination. It was also positively related to higher anxiety, previous visits to a physician, and a positive attitude toward CAM services, but it was negatively related to having chronic medical conditions.

CONCLUSION

Increased use of yoga or meditation may reflect public interest in Icelander's self-care and health promotion. Further studies are needed to better understand the predictors and effects of yoga and meditation.

Diversification of Physical Activities: An Exploration of Provision Characteristics of Holistic Movement Practices in a Large Australian City

Holistic movement practices (HMPs) are an emerging category of physical activity, contributing to the diversification of physical activity opportunities. Purposefully incorporating not only physical but also mental, social, and/or spiritual elements, HMPs have received limited research attention with respect to participation parameters. The purpose of this study was to begin to map HMPs' participation potential by exploring the provision features of HMPs in Melbourne. Data were collected via internet searches, with a focus on events offered. Event features, including type, cost, duration, venue address, and target groups, were recorded. Associated neighbourhood characteristics were also explored by linking venue locations to selected census information. Provision was documented for Yoga and Pilates in central Melbourne (1011 events), for Tai Chi and Qigong (323 events), and for a range of smaller HMPs (149 events) across Greater Melbourne. Results indicated a wide range in provision features. Affinities with the holistic nature of HMPs were noticeable in venue choices and neighbourhood socio-demographics. Mention of specific target groups was infrequent. Results are discussed in light of implications for uptake. HMPs exemplify the increasing diversity of physical activity opportunities in modern-day societies. Further research to elucidate their place in the landscape of physical activities is warranted.