International Journal of Yoga
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    Table of Contents - Current issue
Coverpage
January-April 2019
Volume 12 | Issue 1
Page Nos. 1-88

Online since Tuesday, December 11, 2018

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EDITORIAL  

Sustaining honesty takes center stage in science publishing p. 1
Govindasamy Agoramoorthy
DOI:10.4103/ijoy.IJOY_69_18  
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NARRATIVE REVIEW Top

Role of yoga and mindfulness in severe mental illnesses: A narrative review p. 3
Gopinath Sathyanarayanan, Ashvini Vengadavaradan, Balaji Bharadwaj
DOI:10.4103/ijoy.IJOY_65_17  
Background: Yoga has its origin from the ancient times. It is an integration of mind, body, and soul. Besides, mindfulness emphasizes focused awareness and accepting the internal experiences without being judgemental. These techniques offer a trending new dimension of treatment in various psychiatric disorders. Aims: We aimed to review the studies on the efficacy of yoga and mindfulness as a treatment modality in severe mental illnesses (SMIs). SMI includes schizophrenia, major depressive disorder (MDD), and bipolar disorder (BD). Methods: We conducted a literature search using PubMed, Google Scholar, and Cochrane Library with the search terms “yoga,” “meditation,” “breathing exercises,” “mindfulness,” “schizophrenia spectrum and other psychotic disorders,” “depressive disorder,” and “bipolar disorder” for the last 10-year period. We also included relevant articles from the cross-references. Results: We found that asanas and pranayama are the most commonly studied forms of yoga for schizophrenia. These studies found a reduction in general psychopathology ratings and an improvement in cognition and functioning. Some studies also found modest benefits in negative and positive symptoms. Mindfulness has not been extensively tried, but the available evidence has shown benefits in improving psychotic symptoms, improving level of functioning, and affect regulation. In MDD, both yoga and mindfulness have demonstrated significant benefit in reducing the severity of depressive symptoms. There is very sparse data with respect to BD. Conclusion: Both yoga and mindfulness interventions appear to be useful as an adjunct in the treatment of SMI. Studies have shown improvement in the psychopathology, anxiety, cognition, and functioning of patients with schizophrenia. Similarly, both the techniques have been established as an effective adjuvant in MDD. However, more rigorously designed and larger trials may be necessary, specifically for BD.
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ORIGINAL ARTICLES Top

Association between cyclic meditation and creative cognition: Optimizing connectivity between the frontal and parietal lobes p. 29
Reshma Madhukar Shetkar, Alex Hankey, HR Nagendra, Balaram Pradhan
DOI:10.4103/ijoy.IJOY_26_17  
Background: Important stages of creativity include preparation, incubation, illumination, and verification. Earlier studies have reported that some techniques of meditation promote creativity but have not specified which stage is enhanced. Here, we report the influence of cyclic meditation (CM) on creative cognition measured by a divergent thinking task. Our aim was to determine the degree of association between the two. Methods: Twenty-four university students were randomly assigned to an experimental group (CM) and controls (Supine Rest), 35 min/day for 7 days. Creativity performance was assessed pre and post using Abbreviated Torrance Test for Adults (ATTA), while 64-channel electroencephalography (EEG) was used to measure brain activity during both CM/SH and the creativity test. Results: Results indicated that CM training improved creativity performance, producing a shift to predominant gamma activity during creativity compared controls who showed delta activity. Furthermore, the experimental group showed more activation of frontal and parietal regions (EEG leads F3, F4 and P3, P4) than controls, i.e., the regions of the executive network responsible for creative cognition, our particular regions of interest where specialized knowledge is being stored. Conclusion: Improvement on creativity test performance indicates that CM increases association and strengthens the connectivity between frontal and parietal lobes, the major nodes of default mode network and executive attention network, enhancing the important stages of creativity such as preparation, incubation, and illumination.
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Effects of online yoga and tai chi on physical health outcome measures of adult informal caregivers p. 37
Andi-Céline Martin, Darren Candow
DOI:10.4103/ijoy.IJOY_5_18  
Aims: This study aimed to investigate the effects of online Vinyasa Yoga (VY) and Taijifit™ (12 weeks) in informal caregivers (≥18 years of age). Methods: Twenty-nine participants were randomized to two groups: VY (n = 16, 55.87 ± 12.31 years) or Taijifit™ (n = 13, 55.07 ± 12.65 years). Main Outcome Measures: Prior to and following the study, assessments were made for muscle strength (1-RM leg press, chest press, and handgrip), muscle endurance (leg press and chest press; maximal number of repetitions performed to fatigue at 80% and 70% baseline 1-RM, respectively), abdominal endurance (maximum number of consecutive curl-ups to fatigue), tasks of functionality (dynamic balance and walking speed), and flexibility (sit and reach). Results: There was a significant increase over time for muscle strength, muscle endurance, tasks of functionality, and flexibility (P = 0.001). The VY group experienced a greater improvement in chest press endurance (VY: pre 19.25 ± 5.90, post 28.06 ± 7.60 reps; Taijifit™ pre 15.69 ± 4.49, post 21.07 ± 5.85 reps; P = 0.019) and abdominal endurance (VY: pre 37.12 ± 31.26, post 68.43 ± 55.07 reps; Taijifit™ pre 19.23 ± 19.00, post 32.07 ± 20.87 reps; P = 0.034) compared to the Taijifit™ group. Conclusions: VY and Taijifit™ are effective for improving muscle strength and endurance, tasks of functionality, and flexibility in informal caregivers. VY led to greater gains in chest press endurance and abdominal curl-ups.
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Breath rate variability: A novel measure to study the meditation effects p. 45
Rahul Soni, Manivannan Muniyandi
DOI:10.4103/ijoy.IJOY_27_17  
Context: Reliable quantitative measure of meditation is still elusive. Although electroencephalogram (EEG) and heart rate variability (HRV) are known as quantitative measures of meditation, effects of meditation on EEG and HRV may well take long time as these measures are involuntarily controlled. Effect of mediation on respiration is well known; however, quantitative measures of respiration during meditation have not been studied. Aims: Breath rate variability (BRV) as an alternate measure of meditation even over a short duration is proposed. The main objective of this study is to test the hypothesis that BRV is a simple measure that differentiates between meditators and nonmeditators. Settings and Design: This was a nonrandomized, controlled trial. Volunteers meditate in their natural habitat during signal acquisition. Subjects and Methods: We used Photo-Plythysmo-Gram (PPG) signal acquisition system from BIO-PAC and recorded video of chest and abdomen movement due to respiration during a short meditation (15 min) session for 12 individuals (all males) meditating in a relaxed sitting posture. Seven of the 12 individuals had substantial experience in meditation, while others are controls without any experience in meditation. Respiratory signal from PPG signal was derived and matched with that of the video respiratory signal. This derived respiratory signal is used for calculating BRV parameters in time, frequency, nonlinear, and time-frequency domain. Statistical Analysis Used: First, breath-to-breath interval (BBI) was calculated from the respiration signal, then time domain parameters such as standard deviation of BBI (SDBB), root mean square value of SDBB (RMSSD), and standard deviation of SDBB (SDSD) were calculated. We performed spectral analysis to calculate frequency domain parameters (power spectral density [PSD], power of each band, peak frequency of each band, and normalized frequency) using Burg, Welch, and Lomb–Scargle (LS) method. We calculated nonlinear parameters (sample entropy, approximate entropy, Poincare plot, and Renyi entropy). We calculated time frequency parameters (global PSD, low frequency-high frequency [LF-HF] ratio, and LF-HF power) by Burg LS and wavelet method. Results: The results show that the mediated individuals have high value of SDSD (+24%), SDBB (+29%), and RMSSD (+26%). Frequency domain analysis shows substantial increment in LFHF power (+73%) and LFHF ratio (+33%). Nonlinear parameters such as SD1 and SD2 were also more (>20%) for meditated persons. Conclusions: As compared to HRV, BRV can provide short-term effect on anatomic nervous system meditation, while HRV shows long-term effects. Improved autonomic function is one of the long-term effects of meditation in which an increase in parasympathetic activity and decrease in sympathetic dominance are observed. In future works, BRV could also be used for measuring stress.
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Effect of yoga as an add-on therapy in the modulation of heart rate variability in children with duchenne muscular dystrophy p. 55
Dhargave Pradnya, Atchayaram Nalini, Raghuram Nagarathna, Trichur R Raju, Ragupathy Sendhilkumar, Adoor Meghana, Talakad N Sathyaprabha
DOI:10.4103/ijoy.IJOY_12_18  
Background: Duchene muscular dystrophy (DMD) is a progressive muscular disorder. Cardiac disorder is the second-most common cause of death in children with DMD, with 10%–20% of them dying of cardiac failure. Heart rate variability (HRV) is shown to be a predictor of cardio-autonomic function. Physiotherapy (PT) is advised for these children as a regular treatment for maintaining their functional status. The effect of yogic practices on the cardio-autonomic functions has been demonstrated in various neurological conditions and may prove beneficial in DMD. Materials and Methods: In this study, 124 patients with DMD were randomized to PT alone or PT with yoga intervention. Home-based PT and yoga were advised. Adherence was serially assessed at a follow-up interval of 3 months. Error-free, electrocardiogram was recorded in all patients at rest in the supine position. HRV parameters were computed in time and frequency domains. HRV was recorded at baseline and at an interval of 3 months up to 1 year. Repeated-measures ANOVA was used to analyze longitudinal follow-up and least significant difference for post hoc analysis and P < 0.05 was considered statistically significant. Results: In our study, with PT protocol, standard deviation of NN, root of square mean of successive NN, total power, low frequency, high-frequency normalized units (HFnu), and sympathovagal balance improved at varying time points and the improvement lasted up for 6–9 months, whereas PT and yoga protocol showed an improvement in HFnu during the last 3 months of the study period and all the other parameters were stable up to 1 year. Thus, it is evident that both the groups improved cardiac functions in DMD. However, no significant difference was noted in the changes observed between the groups. Conclusion: The intense PT and PT with yoga, particularly home-based program, is indeed beneficial as a therapeutic strategy in DMD children to maintain and/or to sustain HRV in DMD.
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Positive effects of yoga on physical and respiratory functions in healthy inactive middle-aged people p. 62
Kuniko Yamamoto-Morimoto, Shuji Horibe, Rikio Takao, Kunihiko Anami
DOI:10.4103/ijoy.IJOY_10_18  
Context: Yoga improves physical and respiratory functions in healthy inactive middle-aged people. Aim: This study aimed to assess the effects of 8 weeks of asana and asana with pranayama lessons in order to clarify the influence of two different combinations of yoga practice on physical and respiratory functions in healthy inactive middle-aged people. Subjects and Methods: A total of 28 participants (mean age: 52.7 years) were divided into a yoga asana (YA) group and YA with pranayama (YAP) group. Participants attended a 70-min session once a week for 8 weeks. The YA group practiced basic asana without specific breathing instructions, while the YAP group practiced basic asana with specific breathing instructions (pranayama). Respiratory function was measured with an autospirometer. Physical function assessments included the 30-s chair stand test and upper and lower extremity flexibility. All tests were assessed at baseline and after 8 weeks of intervention. Statistical Analysis: Changes in scores were analyzed with the paired t-test for each group. Pre-post results were compared for all the measured values. P < 0.05 was considered statistically significant. Results: Both groups showed significant improvements in physical and overall respiratory functions after the 8-week yoga intervention. However, the maximal inspiratory pressure and lower extremity flexibility improved only in the YAP group. Conclusions: The 8-week yoga intervention for healthy inactive middle-aged people improved the overall respiratory and physical functions, and the inclusion of pranayama had the added benefit of improving inspiratory muscle strength and global body flexibility.
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PERSPECTIVE Top

Yoga is for every (able) body: A content analysis of disability themes within mainstream yoga media p. 68
Erin Vinoski Thomas, Jan Warren-Findlow, Jennifer B Webb
DOI:10.4103/ijoy.IJOY_25_18  
Yoga is increasingly being recommended as a health self-management strategy for people with a range of disabilities. Mainstream yoga media have been criticized for limited representation of racial/ethnic, gender, age, and body size diversity within their publications; however, it is not known how these media outlets include visual representations of or textual information relevant for people with disabilities (PWDs). The purpose of this research was to understand if and how mainstream yoga media visually represent and include information for PWDs. We conducted a content analysis of the “Yogapedia” section of each Yoga Journal magazine published in 2015 and 2016 (n = 17). Two independent coders rated all of the images and text in these sections. Data were analyzed using a thematic approach informed by a prominent theoretical model of disablement. Results suggest that images contained no representation of disability. In contrast, magazine text included an abundance of references to disability; however, these mentions predominately aligned with constructs found early in the disablement process and strongly focused on physical and mobility limitations. These findings expand upon previous research examining the underrepresentation of marginalized groups within yoga media and illuminate a paucity of relevant information for individuals with disabilities who are interested in and may benefit from yoga practice.
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SHORT COMMUNICATIONS Top

Effect of yoga intervention on short-term heart rate variability in children with autism spectrum disorder p. 73
HM Vidyashree, K Maheshkumar, L Sundareswaran, G Sakthivel, PK Partheeban, Ravindran Rajan
DOI:10.4103/ijoy.IJOY_66_17  
Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairment in social interactions, communication, restricted, and repetitive behaviors. Evidence-based treatment options for ASD are limited. Yoga is practiced by over 20 million people worldwide, and multiple studies have investigated yoga as a possible effective intervention for children with ASD. Aim: The aim of this study is to investigate the effect of yoga intervention on short-term heart rate variability (HRV) in children with ASD. Methodology: In this study, 50 children (38 boys and 12 girls) with ASD were recruited from Swabhimaan Trust, Palavakkam, Chennai. They were randomly grouped into ASD with yoga intervention group (n = 25) and ASD without yoga intervention group (n = 25) by simple lottery method. Yoga group children underwent yoga training for 3 months, and the control group did not receive any such training. For short-term HRV, 15 min electrocardiogram recording in sitting posture was recorded in lead II using a simple analog amplifier. Results: In HRV, time domain parameters such as mean RR interval (0.72 [0.74] to 0.94 [0.92]), standard deviation of the NN intervals (52.04 [54.23] to 74.48 [72.80]), and root of the mean squared differences of successive NN interval (32.60 [34.40] to 40.83 [42.90]) significantly increased in ASD children after yoga intervention. In frequency-domain parameters, high frequency (HF) in n. u (48.08 [47.24] to 58.37 [59.22]) shows a significant increase and low frequency (LF) in n. u (52.4 [51.82] to 40.51 [40.12]), and LF/HF ratio (1.29 [1.31] to 0.78 [0.79]) shows a significant decrease in ASD with yoga intervention group children after 3 months of yoga training. Conclusion: Yoga interventions have been successful in bringing parasympathetic dominance in ASD children, and the greater advantage is being a noninvasive way of intervention to support children with ASD and help them to achieve physiological as well as psychological balance.
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Yogic breathing instruction in patients with treatment-resistant generalized anxiety disorder: Pilot study p. 78
Nupur Tiwari, Michelle Sutton, Matthew Garner, David S Baldwin
DOI:10.4103/ijoy.IJOY_22_18  
Aim: This study aims to evaluate the feasibility and effects of instruction in yogic breathing techniques (Pranayama) in patients with treatment-resistant generalized anxiety disorder (GAD) in UK secondary mental health services settings. Materials and Methods: Participants were adult primary or secondary care patients with a primary diagnosis of GAD (with or without comorbidity) and persistent anxiety symptoms of at least moderate intensity, despite prior treatment with two or more medications of proven efficacy. Patients participated in group-delivered yogic breathing training and practice for 12 weeks. Structured assessments were performed at baseline, after 1, 2, and 6 weeks of instruction, and at end-point. Participants also completed the antisaccade (emotional variant) task and startle response task at baseline and end-point. Results: At baseline, participating patients (n = 9) had moderate-to-severe anxiety symptoms and mild-to-moderate depressive symptoms, they attended 84% of offered sessions and provided positive feedback on the content and delivery of treatment. Symptom severity reduced significantly from baseline to end-point. There were greater errors on negative trials compared to neutral trials in the antisaccade task at baseline, and a significant reduction in antisaccade errors for negative stimuli as compared to neutral stimuli between baseline and end-point: but there were no significant differences in either mean heart rate or startle response between baseline and end-point. Limitations: The absence of a control group and small sample size. Conclusion: Yogic breathing techniques proved simple to learn and may be beneficial in reducing anxiety and depressive symptoms in patients with treatment-resistant GAD. Yogic breathing had no effect on autonomic arousal, but the reduction in errors to negative stimuli in the antisaccade task suggests an improvement in attention control during the intervention accompanying the reduction in symptoms.
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CASE REPORT Top

Prevention of chronic migraine attacks with acupuncture and Vamana Dhauti (yogic therapeutic self-induced emesis) interventions p. 84
Naveen Gowrapura Halappa
DOI:10.4103/ijoy.IJOY_11_18  
Chronic migraine is a prevalent neurological disorder. Conventional treatment has been providing symptomatic relief by reducing the symptoms of pain and vomiting. In addition, there are side effects associated with these medications. A 53-year-old male presented with chronic migraine with aura. He was treated for acute symptoms for 10 days with the following acupuncture points at the EM 6 (Qiuhou), ST 8 (Touwei), GB-8 (Shuaigu), LI 4 (Hegu), and ST 44 (Neiting). In addition, Vamana Dhauti (VD) (self-induced emesis) was taught once followed by VD practice once a week as part of a long-term follow-up for 10 years. Results suggest that acupuncture is beneficial to reduce the acute symptoms of migraine and the possible frequency of migraine attacks. However, VD has shown to be beneficial in reducing the frequency of migraine attacks over a period of time and eventually led to the complete cessation of migraine attacks. In conclusion, randomized controlled trials are required for testing the efficacy in managing migraine.
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