A narrative review on yoga: a potential intervention for augmenting immunomodulation and mental health in COVID-19

Effect of Online Yoga on Child Health During COVID-19 Pandemic: A Qualitative Account from Parents

Background and Objectives: An individual develops socioemotional and cognitive abilities during childhood and adolescence. The COVID-19 pandemic has had a negative effect on the physical, psychological, social, and cultural health of children. Yoga has been observed to be helpful for children in enhancing their physical and mental health during the COVID-19 pandemic. The current article aims to understand the effect of yoga on children's health during the COVID-19 pandemic. Methods: The study used a qualitative method and an exploratory design. The data were collected through in-depth interviews using a semistructured interview guide. Results: Ten themes emerged from the thematic analysis. The major themes included the physical, psychological, and social benefits of yoga on children's health; physical, environmental, and cognitive barriers; and facilitators to practicing yoga. Conclusion: The parents felt that yoga was beneficial for children in various dimensions. Schools and academic organizations could develop online yoga programs tailored for children and also integrate them into the curriculum, allowing children to practice regularly.

Use of Complementary and Integrative Health Approaches in Adults with Long COVID in the US, a Nationally Representative Survey

Background: Long COVID is a serious, complex condition that has affected the lives of millions of people globally. Complementary and integrative health (CIH) approaches offer a wide range of potential therapies for the management of long COVID symptoms. However, there is limited information available about the utilization of CIH among long COVID patients. Methods: Nationally representative cross-sectional data from the United States 2022 National Health Interview Survey (NHIS, response rate 47.7%, n = 27,651) were used to investigate prevalence and predictors of CIH use in the past 12 months among individuals who experienced long COVID. The 12-month prevalence of CIH use was descriptively analyzed for those with long COVID versus those without using chi-squared tests or unpaired t-tests. Independent predictors of CIH use among individuals with long COVID were analyzed using a stepwise multiple logistic regression analysis. Results: A weighted total of 17,610,801 US adults (19.7%) who had a confirmed case of coronavirus disease 2019 (COVID-19) developed long COVID symptoms. A slightly greater proportion of individuals with long COVID (44.4%) than those without (40.9%) used CIH approaches in the past 12 months. The most used approaches were meditation, yoga, and massage therapy. CIH use by those with long COVID was significantly associated with younger age, female sex, higher education level, having health insurance coverage, higher household income level, receiving three or more COVID-19 vaccination doses, ever having asthma, and ever having an anxiety or depression diagnosis. Conclusions: Long COVID represents a major challenge for patients, health care providers, health care systems, economies, and global public health. CIH approaches may play an important role in symptom management for some patients, and additional research is needed to identify which modalities are most effective. Patients and health care providers may benefit from better information about the available options for treatment.

Humanistic and Holistic Strategies for Combating Mental Health Sequelae in the Elderly During the Post-COVID Era

Background

The elderly population is rapidly growing worldwide. By the year 2050, the elderly population will increase up to 2.1 billion. Among them, most of the elderly will be from low- to middle-income countries. India and China are the most populated countries in the world, and also they fall in the category of low- to middle-income countries. The elderly population in these two countries is also growing rapidly and creating an economic burden of geriatric care. On the other hand, the COVID-19 pandemic greatly affected the healthcare system. A higher mortality rate was documented among the elderly due to COVID-19; hence, it was a challenge for them to deal with a high load of the elderly population during the pandemic. These challenges never sublimate even during the post-COVID era. Mental health issues, such as stress, anxiety, and depression, are major drawbacks of COVID-19 among the elderly due to excessive fear of getting reinfection of COVID-19 and fear of social withdrawal. These factors are affecting healthy aging among the elderly. Even though WHO has taken few initiatives for healthy aging, proper interventional strategies are required to prevent mental illness and improve mental health among the elderly during the post-COVID era.

Summary

In this review, we have proposed a few mind-body strategies like Yoga, Exercise, Tai-Chi, and Qigong to improve mental health and holistic patient-centric implementation of those practices in the elderly during the post-COVID era.

Key message

Mind-body interventions can be used in a holistic patient-centric manner to prevent infectious diseases, and post-infection consequences. Further, it enhances immunomodulation along with mental health in the elderly.

Effects of yoga compared with health promotion on health-related quality of life in adults with post-COVID-19 condition: protocol for a randomised controlled trial

INTRODUCTION

Post-COVID-19 condition (post COVID, also known as long COVID) is a global public health issue estimated to affect over 100 million people. Common symptoms include fatigue, dyspnoea and cognitive dysfunction ('brain fog'). Over time, these symptoms have an adverse effect on mental health, physical activity and quality of life (QoL). The condition requires innovative and feasible treatment approaches that can be effective and self-managed. Physical activity is essential for good health; however, aerobic exercise or weightlifting may not be suitable for post COVID patients who experience fatigue or breathlessness. The benefits of yoga include improved flexibility, mobility, body strength and balance. It is also shown to reduce symptoms of fatigue and improve breathing efficiency, mental health and QoL. This study protocol describes the rationale and methods for a randomised controlled trial (RCT) of a yoga-based intervention designed for adults with post COVID.

METHODS AND ANALYSIS

A two-group, parallel, RCT with blinded follow-up assessments. Participants will be randomised with a 1:1 allocation to either a 12-week yoga-based intervention or a 12-week health promotion (active comparison) intervention. In total, 88 participants aged 30-65 years will be recruited and randomised. The primary outcome is health-related QoL (36-item Short-Form). Secondary outcomes are dyspnoea, fatigue, sleep quality, cognitive functions, mental fatigue, depression, anxiety, physical activity, demographic data and physical health measures. Data will be analysed as intention-to-treat basis, using linear mixed modelling. All assessments are conducted at Karolinska Institutet in Stockholm, Sweden. The yoga-based intervention will take place at a yoga studio centrally located in Stockholm city.

ETHICS AND DISSEMINATION

The study is approved by the Swedish Ethical Review Authority, reference number 2023/06518-01. All participants must sign written informed consent before enrolment and are free to withdraw from the study at any point. Key results will be available through research articles and seminars.

TRIAL REGISTRATION NUMBER

German Clinical Trials Register, DRKS00032837.

Tracking Studies on the Effects of Qi Gong Fitness on Stress, Anxiety, and Depression Among Underprivileged Working Youth

OBJECTIVE

This study aimed to evaluate the effectiveness of Qi Gong fitness in alleviating stress, anxiety, and depression among underprivileged working youth with a follow-up study.

METHODS

Eighty subjects were randomly assigned to normal groups (NG) and treatment groups (TG), with 40 participants in each group. The Perceived Stress Scale (PSS), Generalized Anxiety Disorder 7 (GAD-7), and 24-Item Hamilton Rating Scale for Depression (HAMD-24) were used to evaluate the effect of Qi Gong fitness on alleviating stress, anxiety, and depression symptoms in underprivileged working youth.

RESULTS

There was no significant difference in demographic outcome indicators between NG and TG. The main analytic results showed significant differences (P < .05) in the intra- and inter-group comparisons of NG and TG in stress, anxiety, and depression before and after intervention. When compared with prior intervention, NG and TG after intervention showed more favorable scores in PSS, GAD-7, and HAMD-24, among which PSS (NG: 51.61 ± 4.32 vs. 29.80 ± 3.08; TG: 55.21 ± 5.41 vs. 15.85 ± 2.25; P < .01), GAD-7 (NG: 10.83 ± 2.45 vs. 9.85 ± 2.52; TG: 12.23 ± 1.90 vs. 7.84 ± 1.57; P < .01), and HAMD-24 (NG: 10.83 ± 2.45 vs. 9.85 ± 2.52; TG: 25.63 ± 3.94 vs. 11.40 ± 3.82; P < .01); These results indicate that NG and TG have significant effects on alleviating occupational stress, anxiety, and depression in young underprivileged people.

CONCLUSION

The study indicates that Qi Gong fitness had a positive effect on reducing and alleviating stress, anxiety, and depression among young underprivileged professionals. This highlights the potential benefits of incorporating Qi Gong fitness into treatment plans.

Mind-body practices in chronic inflammatory arthritis

Mind-body practices are complementary approaches recognized by the World Health Organization (WHO). While these practices are very diverse, they all focus on the interaction between mind and body. These include mindful meditation, yoga, Tai Chi, sophrology, hypnosis and various relaxation techniques. There is growing interest in incorporating these strategies in the management of chronic rheumatic diseases including rheumatoid arthritis. The aim of this review is to describe the main mind-body practices and analyze the existing evidence in chronic rheumatic diseases. In rheumatoid arthritis, the Mindfulness-Based Stress Reduction program, yoga, Tai Chi and relaxation may improve patient-reported outcomes, but the benefit on inflammation and structural progression is unclear. In spondyloarthritis, very few studies are available but similar evidence exist. Further evaluations of these practices in chronic rheumatic diseases are needed since their risk/benefit ratio appears excellent.

Neuroimmune recognition and regulation in the respiratory system

Neuroimmune recognition and regulation in the respiratory system is a complex and highly coordinated process involving interactions between the nervous and immune systems to detect and respond to pathogens, pollutants and other potential hazards in the respiratory tract. This interaction helps maintain the health and integrity of the respiratory system. Therefore, understanding the complex interactions between the respiratory nervous system and immune system is critical to maintaining lung health and developing treatments for respiratory diseases. In this review, we summarise the projection distribution of different types of neurons (trigeminal nerve, glossopharyngeal nerve, vagus nerve, spinal dorsal root nerve, sympathetic nerve) in the respiratory tract. We also introduce several types of cells in the respiratory epithelium that closely interact with nerves (pulmonary neuroendocrine cells, brush cells, solitary chemosensory cells and tastebuds). These cells are primarily located at key positions in the respiratory tract, where nerves project to them, forming neuroepithelial recognition units, thus enhancing the ability of neural recognition. Furthermore, we summarise the roles played by these different neurons in sensing or responding to specific pathogens (influenza, severe acute respiratory syndrome coronavirus 2, respiratory syncytial virus, human metapneumovirus, herpes viruses, Sendai parainfluenza virus, Mycobacterium tuberculosis, Pseudomonas aeruginosa, Staphylococcus aureus, amoebae), allergens, atmospheric pollutants (smoking, exhaust pollution), and their potential roles in regulating interactions among different pathogens. We also summarise the prospects of bioelectronic medicine as a third therapeutic approach following drugs and surgery, as well as the potential mechanisms of meditation breathing as an adjunct therapy.

Recommendations and guidelines of integrative medicine for COVID-19 care: The APEC project outcome

This article - Recommendations and Guidelines of Integrative Medicine (IM) for COVID-19 Care - was one of the outcomes from an Asia-Pacific Economic Cooperation (APEC) Project (Integrative Medicine (IM) and COVID -19 Care) during the time between May 2022 and March 2023. With the efforts from care providers, researchers, health policy makers and healthcare administrative leaders among APEC economies, the purpose of this file was to provide comprehensive IM systems for COVID-19 care as recommendations and suggestive guidelines including care methods, tools, procedures, symptom conditions and targets selections, and points need to be considered during care applications. All cited COVID-19 care practices have confirmed their efficacy and usefulness either used alone or combined with conventional medicine. This article provides current useful medical information on IM for COVID-19 care which could benefit APEC economies and world health communities on their healthcare system.

Yoga for COVID-19: An ancient practice for a new condition - A literature review

A substantial proportion of people with acute COVID-19 develop post-COVID-19 condition (previously known as long-COVID) characterized by symptoms that persist for months after the initial infection, including neuropsychological sequelae. Post-COVID-19 condition frequency varies greatly according to different studies, with values ranging from 4 to 80% of the COVID-19 patients. Yoga is a psycho-somatic approach that increases physical, mental, emotional and spiritual strength, and connection. Yoga practice enhances innate immunity and mental health, so it can be used as complementary therapy in the COVID-19 treatment, namely the post-COVID-19 condition. In this article, we conducted a literature review on yoga and COVID-19, finding that an intervention comprising asana, pranayama, and meditation may be a strategy of choice for these patients' recovery. However, further studies are needed to show its effectiveness in this, still unknown, context.

Evidence-based integration of yoga in psychiatric practice

Yoga has been put to test in clinical medicine to build evidence. There has been a steep rise in yoga research through 2010, threefold in the next decade. Despite challenges, clinicians have explored yoga intervention in several disorders. The available data have been examined using meta-analysis when there are more studies. Psychiatric disorders treated with yoga have attracted more research. Some examples include depression, schizophrenia, anxiety, obsessive-compulsive disorder (OCD), somatoform pain, addiction, mild cognitive impairment, and elderly and childhood disorders. Current manuscript focuses on highlighting the major steps towards generating evidence that have led to integration of yoga into psychiatry practice. It also discusses various challenges and the way forward.