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Therapies

yoga

 

What Is It?
How Does It Work?
What You Can Expect
Health Benefits
How To Choose a Practitioner
Cautions
References

Evidence Based Rating Scale
 

 

What Is It?

Yoga is an ancient philosophy of life as well as a system of exercises that encourages the union of mind, body, and spirit. In fact, the word yoga is derived from the Sanskrit word meaning "yoke" or "union." The ultimate goal of yoga is to achieve a state of balance and harmony between mind and body.

There is evidence that yoga was practiced as early as 5,000 years ago, although the first written description is found in the Yoga Sutras, a book from the second century B.C. that is partially attributed to the Indian physician and Sanskrit scholar Patanjali. The Yoga Sutras describe a multi-fold path to spiritual enlightenment that includes Hatha yoga, the system of physical exercises, breathing techniques, and meditation that is most often followed by Western yoga practitioners today. (Other forms of yoga include Bhakti, Jnana, Karma, Laya, and Raja.) All types of yoga subscribe to the belief that the body and mind are seamlessly connected, and that, for optimal health, they must be in a state of balance.

How Does It Work?

What sets Hatha yoga apart from some other forms of yoga and general exercise programs is that it places an equal emphasis on mental and physical fitness. This mind-body integration, proponents believe, is what helps Hatha yoga practitioners feel calmer and more "centered," and is why it's often recommended for stress reduction.

Hatha yoga concentrates on three areas: pranayama (breathing), asanas (postures), and dhyana (meditation). The controlled breathing of pranayama helps to focus the mind and is important for relaxation and meditation. Its deep, slow breathing patterns have a beneficial effect on the respiratory system: Studies show that people who do yoga regularly have lowered breathing rates and increased lung capacity. The postures, which include standing, balancing, forward and backward bends, and twists, strengthen the body, increase flexibility, and encourage relaxation. In addition, Hatha yoga has been shown to improve posture and increase circulation. Dhyana, the meditative aspect of yoga, calms and focuses the mind. All three practices build on and complement one another.

Although scientists don’t know exactly how yoga produces its physiological benefits, some speculate that it does so primarily by reducing stress. It may also promote the release of endorphins, the body's natural painkillers.

What You Can Expect

Hatha yoga can be learned from books or videotapes, and easily lends itself to practice at home. However, beginners initially will be better served by taking classes with a trained yoga teacher. A good teacher can help you learn proper breathing and meditation techniques and specific postures, and can help you address your particular needs and physical limitations. Classes generally last 60 to 90 minutes, and beginners usually take one or two classes weekly.

A Hatha yoga class may begin with a period of quiet. The teacher will then take you through gentle warm-up exercises and into a series of postures, which are each held anywhere from a few seconds to several minutes. As your abilities improve, you will be taught progressively more difficult postures. Movement throughout the class should always be gentle, never painful.

Proper breathing, through the nostrils, is emphasized throughout the classes, and the teacher may suggest that you focus on exhaling during certain postures and on inhaling during others. A class generally ends with a period of deep relaxation, with students lying comfortably on the floor.

Whether you attend classes or practice yoga at home, it is important to work in a warm, quiet room. Be sure to wear loose, comfortable clothing so you can move easily. While classes often provide a special "sticky mat," which helps prevent slipping, you can use a blanket or towel for the same purpose. It is also recommended that you practice yoga barefoot.

There are no hard and fast rules about how often to do yoga, but regular practice will help you achieve the full benefits. Many teachers recommend a 20- to 30-minute routine every day. For comfort's sake, always practice on an empty stomach. Many people prefer a yoga session upon awakening in the morning; others find that doing yoga before bed helps them to fall asleep.

Health Benefits

A substantial amount of research has been conducted on the health benefits of yoga, and further studies are ongoing. In addition to improving the body's strength, flexibility, coordination, and range of motion, yoga has been shown to decrease blood pressure, slow respiratory rate, improve the fitness of the heart and other muscles, and reduce stress and anxiety.

Studies have shown yoga to be particularly helpful for musculoskeletal ailments. Yoga has been shown to be a beneficial treatment for carpal tunnel syndrome and osteoarthritis of the hands. In the treatment of carpal tunnel syndrome yoga not only increases grip strength, but also results in greater pain reduction than conventional wrist splinting (1-4). Similar effects have been shown on the pain, tenderness, and loss of range of motion associated with osteoarthritis of the hands (5). Yoga’s emphasis on controlled stretching and increased flexibility make it an attractive aid in the short term management of many musculoskeletal ailments. Further studies are needed to assess yoga’s long term benefit on these conditions.

With its focus on controlled breathing (pranayama) it is not surprising that yoga has been investigated as an alternative treatment for the management of asthma. However, firm conclusions cannot be drawn about yoga’s possible beneficial effect on the treatment of asthma at this time. This uncertainty is due to the small sample sizes and small number of controlled trials on yoga for this condition (6). Preliminary study data shows that yoga may have a beneficial effect on the subjective consequences of asthma such as: degree of relaxation, positive attitude, and better yoga exercise tolerance (7, 8). Because of these conflicting findings, yoga is recommended only as a useful adjunct in the medical management of asthma. 

Yoga not only displays a calming effect on the respiratory system, but has also shown promise in the alleviation of neurological complaints. A study conducted by Woolery et al showed suggestive evidence that yoga postures (asanas) may alleviate mild depression (9). Other research has shown limited evidence that the regulated breathing of yoga (pranayama) may help alleviate depression (10). One study found that Sudarshan Kriya Yoga may even be a potential alternative to conventional anti-depressant drugs in treating mild depression (11). However, these studies are limited in scope. More studies are needed on larger and more heterogenous populations to determine yoga’s effect on depression.

Researchers are also studying yoga’s effect on epilepsy. Currently, there is not a persuasive amount of evidence that yoga is of benefit in the treatment of epilepsy (12). At this time, a few small scale trials have shown that Sahaja yoga may modulate the physiological responses of epileptic patients and lead to seizure reduction (13, 14). Again more research is needed clarify yoga’s direct role in management of epilepsy.

The circulatory system is also influenced by the healing power of yoga. Yoga has been shown to be effective in controlling the symptoms of hypertension (15). Even more impressive, yoga can actually help reverse many of the causes of coronary heart disease. A study conducted by Manchanda et al. demonstrated significant decrease in anginal episodes per week, improved exercise capacity, decreased body weight, and lower cholesterol and triglyceride levels when subjects were treated with a yogic lifestyle intervention (16). These results lasted up to at least a year after the start of intervention. Other studies have confirmed that yoga is not only a preventive but, also therapeutic approach to the maintenance of a healthy heart (17).

These benefits of yoga extend not only to persons with health conditions, but also benefit the perfectly healthy. Researchers have demonstrated improved mobility, less anxiety and depression, and better performance on memory and problem solving tests in groups participating in yogic interventions (18, 19, 20).

Because it promotes relaxation, yoga also aids sleep and digestion. While yoga on its own is not a cure for any condition, it is often recommended as a complementary therapy for cancer, arthritis, asthma, diabetes, depression, fibromyalgia, and migraines. It can also be beneficial during pregnancy.

How To Choose a Practitioner

Most health clubs, YMCAs, YWCAs, and community centers offer Hatha yoga classes. Among the more popular types of Hatha yoga classes are:

·  Iyengar, which stresses precision and uses props.

·  Astanga (or "power yoga"), which is strenuous and for those who seek an aerobic workout in addition to yoga's other benefits. It's not for those out of shape.

·  Kundalini, which emphasizes breathing and chanting.

·  Viniyoga, the precursor of Iyengar and Astanga, which stresses harmonious sequences of postures.

To find classes, ask for references from friends who study yoga and don't be afraid to shop around. Many centers allow prospective students to take a first class for free. Others offer "sampler" days when new students can try out shorter versions of regular yoga classes.

Because yoga instructors are not medical professionals, no licensing is required. Certification can be obtained through some yoga schools, however. Look for a teacher who has at least several years of experience and who continues to study and practice yoga actively.

While classes are recommended for beginners, there are also many yoga books and videotapes available to guide you.

Cautions

·  Before starting a yoga class, be sure to tell your teacher about any concerns or physical limitations you may have.

·  Always warm up gradually and work at your own pace. While some stiffness may occur after the first classes, you should not feel pain.

·  Avoid upside-down postures, such as shoulderstands or headstands, if you have high blood pressure, glaucoma, or a hernia.

·  If you are pregnant, tell your instructor, so he or she can modify postures for you. If you prefer, there are special yoga classes available for expectant mothers. Avoid postures that put pressure on the uterus.

·  Avoid or alter back-bending postures if you have disk or other back problems.

·  If you’re not in good athletic shape, think twice before you enroll in currently popular Astanga or "power yoga" classes, which can be physically challenging.

 

References

  1. Muller M, et al. Effectiveness of hand therapy interventions in primary management of carpal tunnel syndrome: a systematic review. J Hand Ther. 2004; 17(2)210-28.
  2. O’Connor D, et al. Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome. Cochrane Database Syst Rev. 2003; (1):CD003219.
  3. Garfinkel MS, Singhal A, Katz WA, Allan DA, Reshetar R, Schumacher HR Jr. Yoga-based intervention for carpal tunnel syndrome: a randomized trial. JAMA. 1999; 281(22): 2087.
  4. Goodyear-Smith F, et al. What can family physicians offer patients with carpal tunnel syndrome other than surgery? A systematic review of nonsurgical management. Ann Fam Med. 2004; 2(3):267-73.
  5. Garfinkel MS, Schumacher HR Jr, Husain A, Levy M, Reshetar RA. Evaluation of a yoga based regimen for treatment of osteoarthritis of the hands. J Rheumatol. 1994; 21(12): 2341-3.
  6. Steurer-Stey C, et al. Complementary and alternative medicine in asthma: do they work? Swiss Med Wkly. 2002: 132(25-26):338-44.
  7. Vedanthan PK, Kesavalu LN, Murthy KC, Duvall K, Hall MJ, Baker S, Nagarathna S. Clinical study of yoga techniques in university students with asthma: a controlled study. Allergy Asthma Proc. 1998; 19(1):3-9.
  8. Manocha R, Marks GB, Kenchington P, Peters D, Salome CM. Sahaja yoga in the management of moderate to severe asthma: a randomized controlled trial. Thorax. 2002; 57(2):110-5.
  9. Woolery A, Myers H, Sternlieb B, Zeltzer I. A yoga intervention for young adults with elevated symptoms of depression. Altern Ther Health Med. 2004;10(2):60-3.
  10.  Jorm AF et al. Effectiveness of complementary and self-help treatments for depression. Med J Aust. 2002;176 Suppl:S84-96.
  11.  Janakiramaiah N, Gangadhar BN, Naga Venkatesha Murthy PJ, Harish MG, Subbakrishna DK, Vedamurthachar A. Antidepressant efficacy of Sudarshan Kriya Yoga (SKY) in melancholia: a randomized comparison with electroconvulsive therapy (ECT) and imipramine. J Affect Disord. 2000;57(1-3):255-9.
  12.  Ramaratnam S, et al. Yoga for epilepsy. Cochrane Database Syst Rev. 2000;(3):CD001524.
  13. Pajwani U, Selvamurthy W, Singh SH, Gupta HL, Mukhopadhyay S, Thakur L. Effect of Sahaja yoga meditation on auditory evoked potentials (AEP) and visual contrast sensitivity (VCS) in epileptics. Appl Psychophysiol Biofeedback. 200;25(1):1-12.
  14. Panjwani U, Selvamurthy W, Singh SH, Gupta HL, Thakur L, Rai UC. Effect of Sahaja yoga practice on seizure control & EEG changes in patients of epilepsy. Indian J Med Res. 1996;103:165-72.
  15.  Murugesan R, Govindarajulu N, Bera TK. Effect of selected yogic practices on the management of hypertension. Indian J Physiol Pharmacol. 2000; 44(2):207-10.
  16. Manchanda SC, Narang R, Reddy KS, Sachdeva U, Prabhakaran D, Dharmanand S, Rajani M, Bijlani R. Retardation of coronary atherosclerosis with yoga lifestyle intervention. J Assoc Physicians India. 2000;48(7):687-94.
  17.  Mahajan AS, Reddy KS, Sachdeva U. Lipid profile of coronary risk subjects following yogic lifestyle interventions. Indian Heart J. 1999;51(1):37-40.
  18.  Ray US, Mukhopadhyaya S, Purkayastha SS, Asnani V, Tomer OS, Prashad R, Thakur L, Selvamurthy W. Effect of yogic exercises on physical and mental health of young fellowship course trainees. Indian J Physiol Pharmacol. 2001; 45(1):37-53.
  19. Manjunath NK, Telles S. Improved performance in the Tower of London test following yoga. Indian J Physiol Pharmacol. 2001; 45(3):351-4.
  20. Naveen KV, Nagarathna R, Nagendra HR, Telles S. Yoga Breathing through a particular nostril increases spatial memory scores without lateralized effects. Psychol Rep. 1997; 81(2):555-61.
  21. Mahajan AS, Reddy KS, Sachdeva U. Lipid profile of coronary risk subjects following yogic lifestyle interventions. Indian Heart J. 1999;51(1):37-40.
  22. Manchanda SC, Narang R, Reddy KS, Sachdeva U, et al. Retardation of coronary atherosclerosis with yoga lifestyle intervention. J Assoc Physicians India. 2000;48(7):687-94.
  23.  Khalsa HK. Yoga: an adjunct to infertility treatment. Fertil Steril. 2003 Oct;80 Suppl 4:46-51.

     

     


Evidence Based Rating Scale 

The Evidence Based Rating Scale is a tool that helps consumers translate the findings of medical research studies with what our clinical advisors have found to be efficacious in their personal practice. This tool is meant to simplify which supplements and therapies demonstrate promise in the treatment of certain conditions. This scale does not take into account any possible interactions with any medication/ condition/ or therapy which you may be currently undertaking. It is therefore advisable to ask your doctor before starting any new treatment regimen.

Condition

Rating

Explanation

 Angina  


Date Published: 09/08/2005
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