Yoga Therapy Research Research Articles

Development, Validation, and Feasibility of a Tele-Yoga Module for Patients with Hypothyroidism

BackgroundHypothyroidism is a deleterious non-communicable disease adversely affecting the metabolism, growth, and development of the individual. Yoga is a form of mind-body medicine that has shown a positive effect in managing the symptoms of hypothyroidism. This study aims to test the acceptability and viability of a Scientific Yoga Module (SYM) specific to hypothyroidism as a telehealth concept. MethodThe study was conducted in three phases. The first phase was to design and develop a yoga module post a thorough review of ancient and modern literature, suitable for the tele-mode of teaching and learning perspective; the second phase was to validate the module by the subject matter experts whereby 40 experts from various fields of yoga science, yoga therapy, and yoga research reviewed and endorsed the yoga module; in the third phase, a feasibility test through tele-mode for hypothyroidism patients living in the local community who volunteered to take part in the study was conducted with a sample size of 15 patients, were selected based on the inclusion and exclusion criteria of the study. The live session of tele-yoga intervention was imparted for 60minutes; 6 days a week; for 2 weeks by a certified yoga therapist with over five years of online teaching experience. A pretested questionnaire was used to assess the regularity and ease of practice; efficacy of the module; construct satisfaction and any adverse effects. ResultA total of 31 practices were suggested for hypothyroidism by the researchers. Out of which 24 practices were approved by the experts to be formulated as SYM with a content validity ratio (CVR) cut-off value ≥ 0.29. For the feasibility study, the mean age of the participants was 41.6±9.6 years. The result of the feasibility study was calculated in percentage whereby scores closer to 100% determine better feasibility of the module practice. The feasibility questionnaire was divided into 3 sections and shows the average percentage scores obtained within each section as follows – (a) ‘Regularity and ease of practice’ (93.3%); (b) ‘Efficacy of the module’ (91.1%); (c) ‘Construct satisfaction’ (81.9%). The overall feasibility of the module obtained an average of 88.7% with no adverse event attributed to the study. ConclusionTo the best of our knowledge, this study is the first attempt that designs, validates, and tests the feasibility of SYM as an adjunct therapy suitable for telehealth for treating hypothyroidism along with conventional medicine and found to be effective, safe, and feasible. It recommends tele-yoga as a potential tool for digital health for long-term practices to lead a healthy life. This study may be used as a preliminary study to further conduct large randomized controlled trials as a telehealth concept.

Yoga Therapy Research: A Narrative Review

Yoga Therapy Research: A Narrative Review

Methodological issues in yoga therapy research among psychiatric patients.

Yoga therapy has been widely accepted as part of the evidence-based modern healthcare system. Although research publications are growing in leaps and bounds, many methodological issues pose stumbling blocks. In this narrative review, various issues like standalone or add-on treatment, blinding, randomization, nature of dependent and intervening variables, duration of intervention, sustainability of effects, attrition bias, adherence and accuracy, all or none performance, diverse schools, heterogeneity and multidimensionality, assortment, permutations, and combinations of different components, neglect of essential ingredients, mindfulness, catch-22 situation, credentials of the instructors, cultural factors, naivety, multicentric studies, duration of collection of data, primary or standard treatment, interdisciplinary research, statistical lapses, qualitative research, biomedical research are discussed. There is a need to frame guidelines for conducting yoga therapy research and publication.

Enhancing awareness of yoga in health professions education students through a single interactive session: A pretest-post test study

Aim and objective: All students enrolled in Health Professions Education (HPE) at Sri Balaji Vidyapeeth, Pondicherry, receive introductory yoga sessions during orientation programs conducted by their respective medical, dental and nursing colleges at the beginning of their first year of training. We conducted a pre-test-post-test study to evaluate initial yoga awareness amongst HPE students (pre-test) and to assess the changes after a single interactive session of yoga theory and practice (post-test). Material and Methods: 367 HPE students (196 F, 171 M) were divided into seven batches for participation in yoga sessions at the Centre for Yoga Therapy Education and Research (CYTER). The identical, validated Yoga Awareness Questionnaire (YAQ) was given to them before and after the sessions to evaluate the changes in understanding / knowledge about yoga and yoga therapy. Results: Post-test scores increased significantly (p < 0.001) over both pre-test scores. The differences were significant for all batches of the medical, dental and nursing students analysed separately, as well as for the overall comparisons of HPE students. Conclusion: Even a single interactive session of yoga theory and practice can result in significant improvements in the awareness and knowledge about yoga and yoga therapy, thus setting the stage for future short and long term studies on the benefits for such students. Keywords: Yoga, Health professions education, Pretest-post test.

What Is Our "Epistemic Responsibility"? Reflections on Social Work's Orientation in Yoga Therapy Research.

The purpose of this article is to explore how the social work discipline could provide a complementary lens through which yoga therapy can be analyzed and evaluated by engaging in knowledge-creation practices and procedures that prioritize the "epistemic responsibility" described by philosopher Lorraine Code. More specifically, by seeking to strategically include often-subjugated types of knowledge and by focusing on redistributing epistemic power to agents that typically have been excluded from epistemic participation in contemporary yoga therapy research, the social work discipline, with its strong commitment to social justice, has the potential to contribute to filling an important gap in scientific literature. We begin by presenting the relevance of the social work perspective in relation to the field of yoga therapy. We next offer a reserved critical analysis of the dominant technical knowledge base that currently informs yoga therapy practice. This analysis highlights the social parameters that may be rendered invisible or left aside when adopting a positivist epistemological lens and justifies how the conceptual apparatus of epistemic responsibility serves as a potential platform for rethinking social work's position and future contributions to the field of yoga therapy. Finally, we mobilize the concept of cultural appropriation to illustrate how striving for epistemic responsibility provides an entry point for addressing the multilevel, complex social processes embedded in yoga therapy practice and research while aiming to capture the many voices-and hence the various truths-implicated in a democratic, reflexive, and inclusive research process.

조현병 치료에 활용되는 요가치료 - 요가치료 프로그램 개발을 위한 예비 연구 -

The purpose of this study was to investigate yoga treatments currently used in the health care field, especially in the psychological and mental health fields, before our future development of the yoga treatment program. The article explored how the broad notion of classic yoga’s healing has been minimized into a narrow range of yoga therapy. This study is thought to be a necessary process for developing a psychotherapy program that utilizes both yoga’s original healing theory and contemporary scientific method of revealing psychological effects of yoga therapy. In Korea, yoga therapy has not yet been used in psychotherapy and medical fields. Therefore, this study was carried out mainly on the results of foreign studies using yoga therapy for the treatment of psychosis. In particular, the US and Indian healthcare professionals focused on how to treat mental disorders through yoga therapy. As a result, it was found that there are some issues to be considered in developing an independent yoga treatment program for the improvement of symptoms. Particularly, it is necessary to exclude meditation and establish a short-term program that focuses on posture, breathing, and relaxation in accordance with the yoga theory. To be used for a meta-analysis in future, measurement of randomized control study or experimental plan for random crossover study should be planned. As well, scientific experiments based on the selection of appropriate scales for evaluation of the program’s feasibility will help in the ongoing yoga therapy research.

Effect of Modified Slow Breathing Exercise on Perceived Stress and Basal Cardiovascular Parameters.

Context:Different types of breathing exercises have varied effects on cardiovascular parameters and the stress levels in an individual.Aim:The aim of this study was to assess the effect of a modified form of isolated alternate nostril, slow breathing exercise on perceived stress, and cardiovascular parameters in young, male volunteers.Settings and Design:This was a randomized control study carried out at Advanced Centre for Yoga Therapy Education and Research, Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry in 2014.Subjects and Methods:Hundred healthy male volunteers were randomized into control group, n = 50 and slow breathing group (study), n = 50. Slow breathing exercise training was given to study group for 30 min a day, 5 times/week for 12 weeks, under the supervision of certified yoga trainers. Perceived Stress Scale (PSS) using Cohen's questionnaire, anthropometric parameters such as body mass index (BMI), waist-hip ratio (WHR), and cardiovascular parameters such as heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were recorded at baseline and after 12 weeks. The control group did not receive any intervention. Slow breathing exercise training was provided for the study group. During the study period, one volunteer opted out of the study group due to personal reasons.Results:HR, SBP, DBP, and PSS decreased significantly (P < 0.05) in the study group following 12 weeks slow breathing exercise training, while no significant change (P > 0.05) was observed in BMI and WHR. There was no significant change in the control group.Conclusion:Twelve weeks of modified slow breathing exercise reduced perceived stress and improved the cardiovascular parameters. The above results indicate that our modified slow breathing exercise is effective in reducing stress and improving the cardiovascular parameters.

Yoga Therapy in Japan.

This perspective piece gives an overview of the current situation of yoga therapy in Japan today. Traditional yoga in Japan suffered a serious setback in 1995 with a nerve gas terrorist attack on the Tokyo subway, which was carried out by a cult that recruited members through yoga classes. But with the increase in popularity with modern forms of yoga such as Iyengar yoga, Ashtanga yoga and hot yoga in the West, the general public in Japan today is forgetting its aversion to yoga and considers it to be something that can contribute to good health. In 2012, the Japan Yoga Therapy Society (JYTS) conducted a study on adverse events in yoga classes throughout Japan with the University of Kyushu School of Medicine, with support from the Ministry of Health, Labour and Welfare. This study indicated that more than half of people attending yoga classes have some form of chronic illness, with 42.3% receiving outpatient care. This survey was the beginning of growing interest from both the government and universities in yoga therapy. JYTS is beginning to make inroads into bringing yoga therapy into cancer and palliative care, senior citizen homes, alcohol and drug addiction rehabilitation, cardiovascular rehabilitation, and research on trauma and schizophrenia. While there are still limited opportunities for yoga therapists to work in mainstream healthcare services, there is growing interest among medical professionals in both physical and mental health. JYTS is beginning to make inroads into bringing yoga therapy into cancer and palliative care, senior citizen homes, alcohol and drug addiction rehabilitation, cardiovascular rehabilitation, and research on trauma and schizophrenia. While there are still limited opportunities for yoga therapists to work in mainstream healthcare services, there is growing interest among medical professionals in both physical and mental health. This perspective piece introduces some of the developments in yoga therapy research and practice in Japan.

Yoga Therapy in Japan

This perspective piece gives an overview of the current situation of yoga therapy in Japan today. Traditional yoga in Japan suffered a serious setback in 1995 with a nerve gas terrorist attack on the Tokyo subway, which was carried out by a cult that recruited members through yoga classes. But with the increase in popularity with modern forms of yoga such as Iyengar yoga, Ashtanga yoga and hot yoga in the West, the general public in Japan today is forgetting its aversion to yoga and considers it to be something that can contribute to good health. In 2012, the Japan Yoga Therapy Society (JYTS) conducted a study on adverse events in yoga classes throughout Japan with the University of Kyushu School of Medicine, with support from the Ministry of Health, Labour and Welfare. This study indicated that more than half of people attending yoga classes have some form of chronic illness, with 42.3% receiving outpatient care. This survey was the beginning of growing interest from both the government and universities in yoga therapy. JYTS is beginning to make inroads into bringing yoga therapy into cancer and palliative care, senior citizen homes, alcohol and drug addiction rehabilitation, cardiovascular rehabilitation, and research on trauma and schizophrenia. While there are still limited opportunities for yoga therapists to work in mainstream healthcare services, there is growing interest among medical professionals in both physical and mental health. JYTS is beginning to make inroads into bringing yoga therapy into cancer and palliative care, senior citizen homes, alcohol and drug addiction rehabilitation, cardiovascular rehabilitation, and research on trauma and schizophrenia. While there are still limited opportunities for yoga therapists to work in mainstream healthcare services, there is growing interest among medical professionals in both physical and mental health. This perspective piece introduces some of the developments in yoga therapy research and practice in Japan.

The importance of research literacy for yoga therapists.

Evidence-Informed Practice (EIP) utilizes the three components of expert opinion, research evidence, and client values. It is a recommended training competency for integrative health practitioners in diverse fields, such as acupuncture and massage therapy. Research Literacy (RL) is a necessary pre-requisite to EIP. Many yoga therapists have limited training in these skills, which negatively impacts inter-professional communication and collaboration, as well as further advancement of yoga therapy research and practice. In this article, we propose inclusion of RL and EIP in the training of yoga therapists. Benefits for client care, collaborative care, and the field of yoga therapy are discussed.

The importance of research literacy for yoga therapists.

Evidence-Informed Practice (EIP) utilizes the three components of expert opinion, research evidence, and client values. It is a recommended training competency for integrative health practitioners in diverse fields, such as acupuncture and massage therapy. Research Literacy (RL) is a necessary pre-requisite to EIP. Many yoga therapists have limited training in these skills, which negatively impacts inter-professional communication and collaboration, as well as further advancement of yoga therapy research and practice. In this article, we propose inclusion of RL and EIP in the training of yoga therapists. Benefits for client care, collaborative care, and the field of yoga therapy are discussed.

Gesture Analysis For Yoga Alignment

INTRODUCTION: Yoga Therapy research has recently become the focus of rigorous scientific inquiry in the interest of understanding and quantifying its benefits for a wide variety of medical conditions. There remains a disparity between segments of the population who can readily access yoga classes and therapies. For difficult to reach individuals, Yoga in an exergame format could be utilized in clinical or home environments. The purpose of this study was to analyze Yoga posture alignment using a gesture analysis program in order to produce a yoga exergame using the Microsoft Kinect. We captured six yoga postures demonstrated by an advanced yoga teacher, as a gold standard for comparison purposes. METHODS: Six yoga postures were selected for the basis of the training set using Microsoft Visual Gesture Builder (VGB). Programs utilized were included in Kinect version 2 SDK and ran on a PC. RESULTS: Three 3D video clips of the six yoga postures were captured from the yoga teacher, two for VGB training and one for validation. We found that adding the second training clip increased performance accuracy for four out of the six postures. The forward bend and arms up postures might improve with additional training clips. Our prior research has shown that the Kinect skeleton algorithms become confused with yoga postures that change the usual orientation of the head. A convenience sample of undergraduate students with various levels of yoga experience, were recorded executing the same 6 postures before, at the mid-point and at the conclusion of a 10-week yoga class series. We assessed the longitudinal correlation points between yoga experience level and VGB posture accuracy. CONCLUSION: Gesture analysis for yoga alignment training may be a useful tool for the development of home and clinical yoga therapy for hard to reach populations. The Kinect sensor provides a tool that could score the performance of yoga therapy and provide quantitative measures of posture adherence and improvement.

Credentialing and Policy Update for Yoga Teachers and Yoga Therapists: Implications for Yoga Research and Yoga Therapy Research

In January 2016, Yoga Journal and Yoga Alliance (YA) released the 2016 Yoga in America Study [1]. According to this study, the number of people participating in yoga in the United States has surged from 20.4 million in 2012 to over 36 million at the beginning of 2016. For the 2,021 persons over the age of 18 who were surveyed, the top three reasons given for participating in yoga practice were enjoyment, health benefits, and stress relief. The surge in the popularity of yoga and its use to enhance health and reduce stress begs the question, “What oversight exists to assure the safety and welfare of the more than 36 million yoga practitioners?” The answer comes in the form of self-regulation of the industry by YA and the International Association of Yoga Therapists (IAYT) and the voluntary participation by yoga teachers and yoga therapists.

Randomized controlled trial of 12-week yoga therapy as lifestyle intervention in patients of essential hypertension and cardiac autonomic function tests

Background: In the Indian subcontinent, 118 million people are with hypertension, and this figure is anticipated to double by 2025. Yoga has been widely claimed to play a role in the prevention and management of psychosomatic, stress-induced, and lifestyle disorders such as hypertension. Aims and Objective: To study the effect of 12 weeks of yoga therapy as a lifestyle intervention on cardiac autonomic functions in patients of essential hypertension. Materials and Methods: Subjects with hypertension from the Medicine Outpatient Department of the Jawaharlal Institute of Postgraduate Medical Education and Research were randomized into control and yoga groups. The control group was treated only with the allopathic medicines. The yoga group was given 12 weeks of yoga therapy module designed by JIPMER Institute Advanced Center for Yoga Therapy Education and Research along with the routine medical treatment. The participants’ blood pressure and cardiac autonomic function were recorded before and after the 12 weeks of the study period. Result: No significant change was observed in the body weight (BW), body mass index (BMI), abdominal circumference, and waist–hip ratio (WHR) in both the control and yoga groups at the end of the 12 week-study period. There was a significant decrease in the resting systolic pressure (SP), diastolic pressure (DP), rate pressure product (RPP), and mean arterial pressure (MAP) in the yoga group. In contrast, there was no significant change in the SP, DP, RPP, and MAP of the control group. High frequency (HF) power, total spectral power, and HF normalized units (nu) showed a significant increase in the yoga group. Low frequency (LF) power, HF power, and LF (nu) showed a significant (p < 0.05) decrease in the yoga group at the end of the 12-week yoga therapy. Conclusion: Twelve weeks of yoga therapy reduced both the SP and DP in the yoga group. Furthermore, yoga therapy increased the heart rate variability and vagal tone and decreased the sympathetic tone in the subjects with hypertension. At the same time, it increased both the parasympathetic and sympathetic reactivity.

Yoga as a Therapeutic Intervention: A Bibliometric Analysis of Published Research Studies from 1967 to 2013.

A comprehensive bibliometric analysis was conducted on publications for yoga therapy research in clinical populations. Major electronic databases were searched for articles in all languages published between 1967 and 2013. Databases included PubMed, PsychInfo, MEDLINE, IndMed, Indian Citation Index, Index Medicus for South-East Asia Region, Web of Knowledge, Embase, EBSCO, and Google Scholar. Nonindexed journals were searched manually. Key search words included yoga, yoga therapy, pranayama, asana. All studies met the definition of a clinical trial. All styles of yoga were included. The authors extracted the data. A total of 486 articles met the inclusion criteria and were published in 217 different peer-reviewed journals from 29 different countries on 28,080 study participants. The primary result observed is the three-fold increase in number of publications seen in the last 10 years, inclusive of all study designs. Overall, 45% of the studies published were randomized controlled trials, 18% were controlled studies, and 37% were uncontrolled studies. Most publications originated from India (n=258), followed by the United States (n=122) and Canada (n=13). The top three disorders addressed by yoga interventions were mental health, cardiovascular disease, and respiratory disease. A surge in publications on yoga to mitigate disease-related symptoms in clinical populations has occurred despite challenges facing the field of yoga research, which include standardization and limitations in funding, time, and resources. The population at large has observed a parallel surge in the use of yoga outside of clinical practice. The use of yoga as a complementary therapy in clinical practice may lead to health benefits beyond traditional treatment alone; however, to effect changes in health care policy, more high-quality, evidence-based research is needed.

Yoga Therapy Research: A Whole-Systems Perspective on Comparative Effectiveness and Patient-Centered Outcomes.

For the yoga research community to capitalize on its current momentum, it is critical to consider certain developments in research theory and innovative methodologies. The concept of model validity must be incorporated in yoga therapy research so that explanatory constructs employed and outcome measures chosen reflect the principles of traditional yogic science. Focusing on effectiveness research will ensure maximum generalizability of study results and reflect real-world therapy delivery settings, thereby increasing the relevance of outcomes. Whole systems of healing require research methodologies that address complex relationships between multi-target therapies with multiple potential treatment results. Complex, dynamic systems theory provides the theoretical and methodological innovations necessary to design studies, choose outcomes, and analyze data in a way that can account for charting complex, cyclical, therapeutic trajectories across time. Emphasizing patient-centered outcomes is aligned with the patent-oriented and tailored natured of yoga therapy delivery. Increasing the quality and quantity of comparative effectiveness research to analyze the harms and benefits of contrasting therapies can provide an infrastructure for designing studies that can have significant practical impact. The creation of practice-based research networks within the yoga research community will incentivize links between mainstream clinical researchers and yoga therapy delivery settings, ultimately developing collaborative networks. Yoga therapy centers can facilitate patient recruitment for studies and inform standards for yoga researchers. Collaborative efforts between the yoga and ayurvedic research communities will streamline efforts, solidify expertise, cross-pollinate theoretical and methodological innovation, and consolidate efforts to secure research funding and increase publication and dissemination of study findings.

Protocol for a Feasibility Study of Restorative Yoga for Symptom Management in Fibromyalgia

Objective: Increasingly, yoga is among the therapies included in recommended multimodal treatment approaches for persons with fibromyalgia. Given the numerous yoga lineages, styles, practice components, and the relatively scant empirical evidence of the effectiveness of yoga therapy for persons diagnosed with fibromyalgia, rigorous studies are needed to support these recommendations. The development of sound methodological designs and protocols to ensure study rigor, enhance replication potential, and synthesize results across studies for establishing evidence-based best practices is needed. Thus, this article presents the design and protocol used in an 8-week intervention study aimed at determining the feasibility of restorative yoga as an appropriate intervention for persons diagnosed with fibromyalgia. A secondary aim was to collect preliminary data on the perceived effects of restorative yoga to inform future fibromyalgia yoga therapy research. Method: Using a prospective, mixed-methods, single-arm design, the investigators assessed the feasibility of an 8-week restorative yoga intervention for persons diagnosed with fibromyalgia. Twelve (12) persons with physiciandiagnosed fibromyalgia took part in twice weekly, 90-minute restorative yoga group classes and a 20-minute home practice on the five non-class evenings. The Theory of Planned Behavior informed the study design. Quantitative findings for feasibility included recruitment, study completion, and adherence rates during the 8-week intervention and at a 1-month follow-up. These findings were corroborated by qualitative findings from semi-structured pre- and post-intervention interviews. Data regarding the perceived effects of restorative yoga were collected using self-report questionnaires at intervention baseline and at weeks 4 and 8. Discussion: The study protocol provides a template for future feasibility studies of restorative yoga for persons diagnosed with musculoskeletal conditions, and one that can inform future yoga intervention studies aimed at identifying the most efficacious and feasible yoga style(s) for persons diagnosed with fibromyalgia.

Yoga Therapy Research, Individualized Yoga Therapy and Call It Yoga Therapy

Three independent perspectives on Yoga therapy research, Individualized yoga therapy and the current controversy over nomenclature for our field, i.e., yoga therapy vs. medical yoga.

Table of Contents &amp; Editorial

Yoga therapy continues to flourish, thanks in part to the growing body of research evidence supporting its effectiveness in a variety of settings. This issue of IJYT advances the trend through articles that demonstrate the value of yoga therapy in improving the physical and psychological status of individuals with Parkinson's disease, in easing the transition of teenage girls from incarceration to participation in society, and in improving the flexibility of elderly individuals. As with the majority of articles accepted (and, alas, rejected) for acceptance into the Journal, the bulk of yoga therapy research has focused on the use of asana to address challenges ranging from the physical to the psychological.

Yoga for Psychiatry and Mental Health: An Ancient Practice with Modern Relevance

Yoga for Psychiatry and Mental Health: An Ancient Practice with Modern Relevance