If we offer,will they come: Perceptions of yoga among Hispanics

ObjectiveYoga is underutilized by the Hispanics. This study examined perceptions of benefits and barriers to yoga among Hispanic adults, to provide information that may increase their participation in this practice.SettingParticipants were recruited from a Community Center serving low-income Hispanics.DesignSelf-administered cross-sectional questionnaires assessing benefits and barriers to yoga were conducted in Spanish and English. Fisher’s exact test was used to examine perceptions of yoga by gender, age, and prior experience.ResultsParticipants (ages 18–85, 65 % women, n = 121) reported several benefits to yoga. Hispanic women, individuals 65 y or older, and those with prior experience, perceived more benefits. Barriers to yoga also differed by demographics. Men reported that time and the perception that they would have to do unrealistic pretzel-like poses as deterrents to yoga practice; younger individuals perceived yoga to be boring, and those with no experience perceived lack of flexibility and feeling like an outsider in class, as barriers to yoga. The most common barrier, across subgroups, was the cost associated with yoga practice. The majority of participants reported being willing to attend yoga classes if offered at a low cost.ConclusionPerceived barriers related to yoga reflect a lack of knowledge about yoga and what it entails and the cost of classes. Despite these barriers, Hispanic adults from a low-income population said they would be willing to attend yoga classes if offered at a low cost. Understanding and addressing these barriers can help researchers and health practitioners improve diversity in yoga classes and research.     

Qualitative study of yoga for Young adults in school sports

ObjectivesDistress and stress-related diseases are an increasing public health problem at schools. This qualitative study was nested in a non-randomized, controlled trial studying the effects of a 10-week yoga course as an alternative for regular school sports in two secondary schools in Germany.MethodsWe conducted a qualitative evaluation in 3 focus groups with 6 participants each. The focus groups were audio-recorded, transcribed verbatim, pseudonymised and analysed using qualitative content analysis. Furthermore open questions were asked in questionnaires.ResultsThe analysis of the participants’ interviews (mean age 19.6 ± 2.9 years, n = 10 female, n = 8 male) resulted in 4 key topics: 1. encountering yoga, 2. yoga practice, 3. effects and benefits of yoga, and 4. yoga in the school context.Yoga was very well accepted by most participants. They reported a variety of physical and psychological benefits as well as overall restorative effects. The relief of pain or other physical ailments, higher mobility and flexibility, improved posture and improved sleep were mentioned by the participants. Some participants used the new exercises and experiences (e.g. working with the breath) in their everyday life. The possibility for self-responsible action was a welcome change from the perceived pressure and heteronomy in normal (school) life. Controversial was the question of whether yoga - if it is part of school sport - should be assessed or graded, and whether it should be compulsory or voluntary.ConclusionYoga can offer both physical and psychological benefits in young adults as well as offer general regenerative effects. Yoga by sensitizing the participants to negative patterns of behaviour can encourage healthy behaviour.     

Perceived mechanisms of change in therapeutic yoga targeting psychological distress

IntroductionThis study was designed to investigate yoga teachers' and yoga therapists’ perceptions of the ways yoga is applied to treat symptoms of psychological distress, and identify the defining features, main components, and mechanisms of change in therapeutic practice.MethodsA qualitative design was employed. Six yoga teachers who had specific training and experience in teaching therapeutic yoga or practicing ‘yoga therapy’ took part in one-to-one interviews during which they gave accounts of their experiences of helping people cope with psychological distress through yoga. Participants' interviews were transcribed verbatim and were analysed using an integrative inductive-deductive thematic analysis.ResultsFour key themes were identified in relation to the benefits of therapeutic yoga: Awareness, Choice, Relationships, and Tailoring.ConclusionsThe findings support previous research which suggests that individualised yoga therapy is a promising intervention, and may help to form a theoretical rationale for the future treatment of psychological distress with yoga.     

Effects of yoga on eating disorders—A systematic review

BackgroundThe question of whether yoga practice ameliorates or even aggravates eating disorders is currently under debate. The aim of this review was to systematically assess and the effectiveness and safety of yoga in patients with eating disorders.MethodsMedline/PubMed, PsycINFO, and the Psychological and Behavioral Science Collection were screened through July 2018 for randomized controlled trials, non-randomized controlled trials and longitudinal observational studies on yoga for patients with eating disorders and other individuals with disordered eating and/or body dissatisfaction. Risk of bias was assessed using the Cochrane risk of bias tool and the Newcastle-Ottawa Quality Assessment Scale.ResultsEight randomized trials and four uncontrolled trials involving a total of 495 participants were included. Risk of bias was mixed. Comparing yoga to untreated control groups, effect sizes ranged from negligible effects of d = 0.02 to very large effects of d = 2.15. However, most effects were small to moderately sized and in most cases not significant. No safety-related data were reported.ConclusionsThere is limited evidence on the effectiveness and safety of yoga in patients with eating disorders. Yoga can be preliminarily considered as an additional treatment option in multimodal psychiatric treatment programs.     

Associations of yoga practice,health status,and health behavior among yoga practitioners in Germany—Results of a national cross-sectional survey

BackgroundWhile yoga can improve health-related variables and health behavior, different yoga styles and practice components appear to be associated with specific health outcomes. The aim of this study was to explore the connection between yoga use, health, and health behaviors across different yoga styles.MethodsA cross-sectional anonymous online survey (n = 1,702; 88.9% female; 93.3% German nationality; mean age 47.2 ± 10.8 years; 58.2% yoga teachers) assessed yoga practice characteristics, health-related variables and health behavior. The survey was distributed in Germany only but not limited to German participants.ResultsAshtanga yoga (15.7%), Hatha yoga (14.2%), and Sivananda yoga (22.4%) were the most commonly practiced yoga styles; participants practiced for a mean of 12.7 ± 10.0 years. Most participants had good to excellent (96.1%) overall health; 87.7% reported improved health since starting yoga. Controlling for sociodemographic and clinical factors, health-related variables were mainly associated with frequency of yoga postures practice (p < 0.05), health behaviors also with yoga philosophy study (p < 0.05). The various yoga styles were associated with specific health-related variables (p < 0.05).ConclusionYoga practitioners generally have a good overall health and a healthy lifestyle. While health variables are mainly associated with practice of yoga postures, health behaviors are also associated with the study of yoga philosophy. Yoga interventions targeting prevention or health promotion should include yoga philosophy to modify health behaviors. The specific yoga style employed may also influence health outcomes.     

Impact of yoga on psychopathologies and quality of life in persons with HIV: A randomized controlled study

BackgroundEvidence suggests that individuals with human immunodeficiency virus (HIV) often exhibit poor physical and mental health, which contributes to a reduced Quality of Life (QoL). Yoga is a form of alternative therapy that has positive influences on general health and QoL.ObjectivesThis study examined the effects of yoga on i) anxiety, depression, and psychological well-being and ii) QoL among individuals with an HIV positive status.MethodologySixty individuals with HIV-positive (aged 30–50 years) from rehabilitation centres across Bangalore were randomly assigned to the yoga intervention group (n = 30; 11 men) or the wait-listed control group (n = 30; 10 men). Participants in the yoga group underwent 8 weeks of intense yoga practice performed an hour a day for 5 days a week. The yoga practice consisted of physical postures, breathing practices, relaxation techniques, and meditation. Participants in the wait-listed control group followed their normal routine. Anxiety, fatigue, depression, and QoL were assessed twice for all subjects in each group – once at the start of the study to establish a baseline and once more at the end of the 2-month study period to assess any changes. Data analysis was performed on the assessments using SPSS software version 10.ResultsBetween group analysis demonstrated that a significantly different reduction in anxiety (p < 0.001), depression (p < 0.001), and fatigue (p < 0.001) was observed in the yoga group compared to the control group, as well as significant improvements in well-being (p < 0.001) and all domains of QoL (p < 0.001) in the yoga group compared to the control group.ConclusionThis study indicates that yoga intervention appears to improve the psychological health and QoL of individuals who are HIV-positive. Therefore, based on these findings, yoga may be recommended as a complementary therapy to enhance conventional HIV care.     

Effectiveness of yoga on arterial stiffness: A systematic review

ObjectivesArterial stiffness is a major cardiovascular (CV) risk and an independent strong predictor of CV morbidity and mortality. The aim of this systematic review is to evaluate the clinical or interventional studies that assessed the effectiveness of yoga on arterial stiffness in participants of any age or sex, healthy or with any conditions.DesignSystematic review of clinical trials or interventional studies.Data sourcesCochrane Library, Medline/PubMed, Scopus, and Google Scholar databases.Review methodsDatabases were searched till July 2019 for clinical trials or interventional studies whether controlled or uncontrolled, randomized or non-randomized studies assessing the effects of yoga on arterial stiffness. Quality of the studies was assessed by using Physiotherapy Evidence Database (PEDro) Scale.ResultsSeven full-text articles (total number of participants = 362) that evaluated the effect of yoga on arterial stiffness were included in this review. There were three randomized controlled studies and four were non-controlled studies (single group studies). Four studies have shown significant reduction in arterial stiffness, while three studies did not find any significant change in arterial stiffness. The beneficial effects of yoga intervention on arterial stiffness in young adults and elderly hypertensive patients are encouraging. Methodological quality was good for one study, moderate for two studies and poor for four studies.ConclusionsThis review shows that yoga practice is effective in preventing or reducing the arterial stiffness in young healthy and obese, and elderly hypertensive patients. As the methodology of many studies is of low quality and safety measures were not reported, there is a need of quality randomized controlled trials of yoga effects on arterial stiffness among high risk individuals.     

Yoga for secondary prevention of coronary heart disease: A systematic review and meta-analysis

ObjectivesYoga has been widely practiced and has recently shown benefits in patients with coronary heart disease (CHD), however, evidence is inconsistent.MethodsWe conducted a systematic review and meta-analysis by searching PubMed/Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE and Web of Science from inception to May 31, 2020 for randomised controlled trials (RCTs) comparing yoga with usual care or non-pharmacological interventions in patients with CHD. The primary outcomes were all-cause mortality and health related quality of life (HR-QoL). Secondary outcomes were a composite cardiovascular outcome, exercise capacity and cardiovascular risk factors (blood pressure, lipid profiles and body mass index).ResultsSeven RCTs with a total of 4671 participants were included. Six RCTs compared yoga with usual care and one compared yoga with designed exercise. The mean age of the participants ranged from 51.0–60.7 years and the majority of them were men (85.4 %). Pooled results showed that compared with usual care, yoga had no effect on all-cause mortality (RR, 1.02; 95 % CI, 0.75–1.39), but it significantly improved HR-QoL (SMD, 0.07; 95 % CI, 0.01 - 0.14). A non-significant reduction of the composite cardiovascular outcome was observed (133 vs. 154; RR, 0.63; 95 % CI, 0.15–2.59). Serum level of triglyceride and high density lipoprotein cholesterol, blood pressure and body mass index were also significantly improved. The study comparing yoga with control exercise also reported significantly better effects of yoga on HR-QoL (85.75 vs. 75.24, P < 0.001). No severe adverse events related to yoga were reported.ConclusionsYoga might be a promising alternative for patients with CHD as it is associated with improved quality of life, less number of composite cardiovascular events, and improved cardiovascular risk factors.     

Exploring how different types of yoga change psychological resources and emotional well-being across a single session

ObjectivesYoga demonstrates beneficial effects in many populations, yet our understanding of how yoga brings about these effects is quite limited. Among the proposed mechanisms of yoga are increasing psychological resources (mindfulness, body consciousness, self-transcendence, spiritual peace, and social connectedness) that may bring about salutary effects on emotional wellbeing. Further, yoga is a complex practice comprising meditation, active and restorative postures, and breathwork; however little is known about how different components may affect mechanisms. We aimed to determine how an acute session of yoga (and its specific components) related to pre- to post- session changes in proposed mechanisms (psychological resources) and whether those changes were associated with positive changes in emotions.Design144 regular yoga practitioners completed measures of mindfulness, body consciousness, self-transcendence, social connectedness, spiritual peace, and exercise-induced emotions (positive engagement, revitalization, tranquility, exhaustion) immediately before and after a yoga session (N = 11 sessions, each a different type of yoga). Perceived properties of each yoga session, exercise exertion and engagement with the yoga teacher were assessed immediately following the session.ResultsPre-to post- yoga, levels of positive emotions (engagement, tranquility and revitalization) increased while exhaustion decreased. Further, all psychological resources increased and closely tracked improved emotions. Additionally, aspects of the yoga session correlated with changes in psychological resources (mechanisms) and emotions.ConclusionsYoga may influence multiple psychological mechanisms that influence emotional well-being. Further, different types of yoga may affect different mechanisms. Results can inform yoga interventions aiming to optimize effects through specific mechanisms such as mindfulness or spirituality.     

Impact of yoga in facilitating muscular functioning among asymptomatic male cricket players: Longitudinal randomized controlled study

BackgroundCricket is one of the prominent global team sports. With an emergence of Twenty20 tournaments, the physical preparation of elite cricket players has become complex with high match injury incidence. Yoga as a body-mind training is associated with having positive effects on a person's physical and psychological conditions, bringing in better mind-body equilibrium.ObjectivesEvaluating the impact of yoga in facilitating muscular functioning and mindfulness among asymptomatic male cricket players.MethodFirst-class domestic male cricket players in the age group of 18–35 years were randomized into yoga group n=42 and wait-list control group n=40. Players received the yoga module for five days per week for a duration of six weeks. Primary outcome measures of muscular functioning were core stability, flexibility, range of motion, static balance, dynamic balance and proprioception of the ankle. Assessments were held at baseline, immediate post-intervention, and a follow-up after six months of intervention.ResultsA statistical significance with p < .001 was observed for most of the variables at T2 and T3. Comparison of the model fit shows a highly significant p < 0.001 difference between the model as compared to the baseline model among most of the variables.ConclusionThis yoga module was appropriate for enhancing muscular functioning variables of this study. Continuous practice of this yoga module can reinforce sustainable benefits for male cricket players.     

Role of yoga therapy in improving digestive health and quality of sleep in an elderly population: A randomized controlled trial

IntroductionConstipation and sleep disturbances commonly affect elderly population results in compromised physical and mental health. Mind-body interventions like yoga not only address the mental and physical health but also promote healthy ageing. This study evaluates the effect of 3 months yoga intervention on the sleep and constipation related quality of life (QoL) among the elderly.Materials and methodsNinety six participants aged between 60 and 75 who did not had any history of yoga practice for past 1 year and having a zubrod score of 0–2 were randomized in to yoga (n = 48) or waitlisted control (n = 48). The yoga group received yoga interventions at a frequency of 3 sessions per week for 3 months. Pittsburg Sleep Quality Index (PSQI) and Patient Assessment of Constipation QoL (PAC-QOL) were used to assess the improvement. Intention to treat analysis method was used to include the drop-out participants.ResultsEighty one participants (Yoga = 48, waitlisted control = 33) completed the study. Wilcoxon's sign rank test has shown that the yoga group had statistically significant changes in most of the parameters in PSQI and PAC-QOL (P ≤ 0.05). Mann Whitney test revealed that yoga group has better improvement in the sleep quality and constipation related QOL (P ≤ 0.05) compared to the controls.DiscussionThe results signify yoga can ease old age related issues like constipation and insomnia. This is encouraging for inclusion of yoga as a daily practice regimen to improve the constipation and sleep related quality of life in elderly population.     

“We really need this”: Trauma-informed yoga for Veteran women with a history of military sexual trauma

ObjectivesUp to 70% of women service members in the United States report military sexual trauma (MST); many develop post-traumatic stress disorder (PTSD) and co-occurring disorders. Trauma-informed yoga (TIY) is suggested to improve psychiatric symptoms and shown feasible and acceptable in emerging research, yet no work has evaluated TIY in MST survivors. The current quality improvement project aimed to examine TIY’s feasibility, acceptability, and perceived effects in the context of MST.DesignCollective case series (N = 7).SettingNew England Vet Center.InterventionsExtant TIY program (Mindful Yoga Therapy) adapted for Veteran women with MST in concurrent psychotherapy.Main outcome measuresAttrition and attendance; qualitative exit interview; validated self-report measure of negative affect pre/post each yoga class, and symptom severity assessments and surveys before (T1; Time 1) and after the yoga program (T2; Time 2).ResultsFeasibility was demonstrated and women reported TIY was acceptable. In qualitative interviews, women reported improved symptom severity, diet, exercise, alcohol use, sleep, and pain; reduced medication use; and themes related to stress reduction, mindfulness, and self-compassion. Regarding quantitative change, results suggest acute reductions in negative affect following yoga sessions across participants, as well as improved affect dysregulation, shame, and mindfulness T1 to T2.ConclusionsTIY is both feasible and acceptable to Veteran women MST survivors in one specific Vet Center, with perceived behavioral health benefits. Results suggest TIY may target psychosocial mechanisms implicated in health behavior change (stress reduction, mindfulness, affect regulation, shame). Formal research should be conducted to confirm these QI project results.     

Is one yoga style better than another? A systematic review of associations of yoga style and conclusions in randomized yoga trials

ObjectiveTo determine whether the odds of positive conclusions in randomized controlled trials (RCTs) of yoga, differ between yoga styles.DesignSystematic review of yoga RCTs. Medline/PubMed, Scopus, the Cochrane Library, IndMED and the tables of content of specialist yoga journals, not listed in medical databases, were screened up to 12 February, 2014 for RCTs comparing yoga interventions to non-yoga interventions. The RCTs’ conclusions were classified as positive (yoga is helpful for a respective condition) or not positive; and these were compared between different yoga styles using the Chi squared test and multiple logistic regression analysis.ResultsA total of 306 RCTs were included. These applied 52 different yoga styles, the most commonly used of which were: hatha yoga (36 RCTs), Iyengar yoga (31 RCTs), pranayama (26 RCTs), and the integrated approach to yoga therapy (15 RCTs). Positive conclusions were reached in 277 RCTs (91%); the proportion of positive conclusions did not differ between yoga styles (p = 0.191).ConclusionRCTs with different yoga styles do not differ in their odds of reaching positive conclusions. Given that most RCTs were positive, the choice of an individual yoga style can be based on personal preferences and availability.     

Teens’ perspectives on yoga as a treatment for stress and depression

ObjectiveTo understand adolescents’ experiences and attitudes toward yoga, with a particular focus on acceptability and feasibility of a yoga intervention for depressed adolescents.DesignQualitative analysis of data from three focus groups and eight individual interviews, for a total of 22 teen participants.SettingOutpatient setting in a psychiatric hospital in the U.S.Main outcome measuresTeens were asked about their own and their peers’ attitudes toward, and experiences with, hatha yoga; reactions to a study-created yoga video; and opinions on class logistics.ResultsTeens had both positive and negative attitudes toward, and experiences with, hatha yoga. They commented on “who does yoga;” many responses suggested a limited group (e.g., moms; people with money and time). Participants agreed that yoga could be potentially beneficial for depressed or stressed teens. Self-consciousness while being in a yoga class was a major concern. Overall, teens reacted favorably to the study-created yoga video. Teens had varied opinions about class logistics including class duration and size. Teens cited barriers to class, such as transportation, as well as barriers to home yoga practice.ConclusionsKey points for developing a yoga class that might be appealing to depressed or stressed teens include: creating a class with variety that teens will find interesting; taking concrete steps to decrease teen self-consciousness; incorporating messages relevant for teens and consistent with yoga philosophy; and actively countering stereotypes about who practices yoga. Limitations of this study include the lack of data from male teens.     

Effects of yoga and aerobic exercise on wellbeing in physically inactive older adults: Randomized controlled trial (FitForAge)

ObjectiveTo compare the effects of yoga and aerobic exercise (AE) on wellbeing in physically inactive, but otherwise healthy older adults. A secondary objective was to assess and compare the frequency of adverse events associated with yoga and AE.DesignTwelve-week, three-group, parallel randomized controlled trial with blinded follow-up assessment.InterventionsParticipants were supported to complete ≥ 3 Hatha yoga classes/week or ≥ 3 AE sessions/week. A wait-list control (WLC) group continued usual daily activities.Main outcome measureChange in wellbeing, assessed using the Satisfaction with Life Scale (SWLS) and Life Satisfaction Index-Z (LSI),at baseline and at 12-week follow up.ResultsIn total, 82 adults (mean age 72.5 years, range 65–85, 77% female) were recruited. Of these, 27 were randomized to yoga, 29 to aerobic exercise and 26 to wait-list control. Medium-magnitude treatment effects (Hedges’ g) were seen for yoga versus WLC and AE versus WLC(SWLS, g = 0.65 and 0.56; LSI, g = 0.54 and 0.54, respectively). In per-protocol analyses, larger effect sizes were found (SWLS, g = 0.72 and 0.66; LSI, g = 0.76 and 0.76, respectively). Adverse events were less frequent in the yoga group (6/27; 22%) compared to AE (10/27; 37%).ConclusionsAmong physically inactive older adults, participation in yoga or AE was associated with beneficial effects on subjective wellbeing when compared to a non-active control group. Yoga was associated with fewer injuries and may be especially suitable for older adults (DRKS 00015093).     

Yoga versus home exercise program in children with enthesitis related arthritis: A pilot study

PurposeThe aim was to compare the effects of yoga and home exercise program on lower extremity functional status, pain, and quality of life in children with enthesitis related arthritis (ERA).MethodsTwenty-one children with ERA were divided into two groups as yoga (n = 11) and home exercise (n = 10). Yoga group performed supervised yoga exercises twice a week for eight weeks. Home exercise group performed video-based exercises for the same period. Pain in rest and activity, lower extremity functional status, and quality of life were evaluated at baseline and following eight weeks.ResultsThe groups were similar at baseline (p > 0.05). All the parameters, except parent reported quality of life, significantly improved in yoga group (p < 0.05), where only stair climb test times significantly improved in home exercise group (p < 0.05).ConclusionsYoga seems promising for improving lower extremity functional status, pain, and quality of life as an exercise intervention in rehabilitation programs of children with ERA.     

What are the known effects of yoga on the brain in relation to motor performances,body awareness and pain? A narrative review

ObjectiveThe current body of literature was reviewed to evaluate the effects of yoga on the brain in relation to motor performance, body awareness and pain.BackgroundYoga has been increasingly popular in the Western countries especially for its unique integration of the mind and body. Yoga has been studied more intensely in the last decade. Although it has been shown to improve cognitive functions, few studies have looked into the effects of yoga on improving motor performance, body awareness or pain and the possible underlying brain mechanisms associated with them.MethodsA search of the current literature was made using keywords such as: “yoga brain motor”, “yoga brain pain”, “effects yoga brain” and “effects yoga brain motor performance”. The findings were then discussed in relation to motor performance, body awareness and pain and their reported mechanisms of action on the brain.ResultsA total of 61 articles were selected, out of which 29 were excluded because they did not meet our criteria. A total of thirty-two articles were included in this review, which we further subdivided by focus: motor performance (n = 10), body awareness (n = 14) and pain (n = 8).DiscussionOur review shows that yoga has a positive effect on learning rate, speed and accuracy of a motor task by increasing attention and decreasing stress through a better control of sensorimotor rhythms. Yoga also seems to improve sensory awareness and interoception, regulate autonomic input, increase parasympathetic activity and promote self-regulation. Yoga was also shown to reduce the threat signal, increase pain tolerance, decrease pain unpleasantness and decrease the anxiety and distress associated with pain. Those changes are associated with the recruitment of specific brain areas such as the insula, the amygdala and the hippocampus.ConclusionBased on the studies reviewed in this report, we found that the practice of yoga seems to facilitate motor learning, to increase body awareness and to decrease pain. These are associated with a wide variety of changes in terms of brain activity and structure. Further studies are necessary to reveal its precise mechanism of action on the brain and to validate its wider application in clinical settings.