In modern times when the terms Yoga and Yoga therapy have become synonymous, this paper is but a small attempt to put into perspective what Yoga therapy can offer us as an integrative system of wholistic well being.
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Therapeutic Potential of Yoga
1. THERAPEUTIC
POTENTIAL OF YOGA
Yogacharya
Dr. ANANDA BALAYOGI BHAVANANI
MBBS, ADY, DSM, DPC, PGDFH, PGDY, FIAY
Deputy Director- CYTER
Centre for Yoga Education, Therapy and Research (CYTER),
MGMC & RI, SBVU, Puducherry.
2. YOGA & MODERN MEDICINE: MEETING POINTS
• Modern medical advancements provide the
rationale for the integration of various traditional
healing techniques including Yoga to promote
healing, health, and longevity
• Potential to provide us with a holistic health
science - a boon for psychosomatic health
• WHO : spiritual health in the “state of health’
• Modern medicine : accidents, acute illness,
emergencies and communicable diseases
• Yoga: preventive, promotive and rehabilitative
methods in addition to many management
methods to tackle modern illnesses
3. RELEVANCE TO MEDICAL PROFESSIONALS
• Yoga is an experiential science and a dynamic state
of health is a by-product of Yoga
• “Re-orients the functional hierarchy of the entire
nervous system” - Dr B Ramamurthy
• Effective in preventing and combating the modern
pandemic of stress borne disorders.
• Scientific evidence indicates that Yoga has
– promotive, preventive and curative potential,
– is a safe, non-pharmacological therapy and is
– an effective lifestyle adjunct to reduce drug
dosage and improve QOL of patients
4. • Psychosomatic and stress related disorders
– DM, hypertension, bronchial asthma, IBS, epilepsy, back
pain and functional disorders
• Reduce / eliminate drug dosage / dependence in
– DM, hypertension, epilepsy, anxiety, bronchial asthma,
constipation, dyspepsia, insomnia, arthritis, sinusitis
and dermatological disorders
• Yoga therapists must work in tandem with medical doctors
when treating patients on allopathic treatment
• “The treatment of the part shouldn’t be attempted without
a treatment of the entirety” - the treatment of the body
without treating the mind and soul is a useless waste of
time”- Plato
5. • LIFE STYLE MODIFICATIONS: “Yoga is a system of
perfect tools for achieving union as well as healing”-
Dr Dean Ornish
• REHABILITATION: “Modern medicine kept me alive,
Yoga gave me back my life”- Dr Swami Gitananda Giri
• COPING SKILLS: “Yoga may not be able to always cure
but it can surely help us to endure”- Sri BKS Iyengar
• HEALTHY DIET : biogenic, guna based diets
• RELAXATION: spanda -nishpanda concepts
• EXPENDITURE: cost effective, cost lowering
• AGING : anti-aging, regenerating, “young at heart”
• PSYCHOTHERAPY: the mind and beyond
• WOMEN’S HEALTH: puberty, pregnancy, menopause
• RESEARCH: Basic and applied scientific & literary
6. SOME THERAPEUTIC BENEFITS
• Yoga modifies coronary artery disease risk factors
and helps reverse heart disease
• Patients of respiratory disorders have shown
improvement with Yoga therapy
• Therapeutic tool for MR children -improvement in
IQ and social adaptation
• Has shown great potential in metabolic conditions-
diabetes, obesity, metabolic syndrome etc
• Psychiatry: OCD–improvement in Yale/Brown &
perceived stress scales , anxiety, depression
7. • A bibliometric analysis on biomedical literature
involving research on clinical application of Yoga
(Khalsa - IJPP 2004) revealed an increase in
publication frequency over past 3 decades with a
substantial and growing use of RCTs.
• The 3 types of disorders most evaluated have been
psychiatric conditions, CV disorders, & respiratory
disorders.
• Discrete disorders receiving most attention were
asthma, hypertension, diabetes, depression, heart
disease and anxiety.
• Recent reviews by Innes (2005, 2007 and 2012),
Yang (2007) and Sengupta (2012) have highlighted
role of Yoga as a therapy based on indexed reports.
10. Streeter CC et al. Med Hypotheses 2012; 78: 571-9
• Stress induces autonomic imbalance
• Decreased para-sympathetic & increased
sympathetic activity, under activity of GABA
system, the primary inhibitory neuro-
transmitter, and increased allostatic load.
• Yoga helps correct the underactivity of para-
sympathetic nervous system and GABA
systems in part through stimulation of vagus
nerves with reduction in the allostatic load.
11. Postulated mechanisms by which Yoga
reduces cardiovascular risk
Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and
possible protection with yoga: a systematic review. J Am Board Fam Pract 2005;18:491-519.
12. Yoga intervention:
Pathway 2
Yoga intervention:
Pathway 1
Inflammatory cytokines
Heart rate, blood pressure
Reduced risk for:
Type 2 diabetes and its complications
Improved coagulation
/ fibrinolytic profile
Oxidative stress
Endothelial function
Enhanced metabolic and
psychological profile
Insulin sensitivity
Glucose tolerance
Improved lipid profile
Visceral adiposity
Improved mood
Perceived stress
Activation/reactivity
of sympathoadrenal
system and HPA axis
Vagal
stimulation
Parasympathetic
activation
Innes KE, Vincent HK. The Influence of yoga-based programs on risk profiles in adults with type 2 diabetes
mellitus: A systematic review. eCAM 2007; 4: 469-86.
Postulated mechanisms of yoga in diabetes mellitus
13. Meditation: Potential Mechanisms
Innes KE and Selfe TK (2014) Meditation as a therapeutic intervention for adults at risk for Alzheimer’s disease
– potential benefits and underlying mechanisms. Front. Psychiatry 5:40. doi: 10.3389/fpsyt.2014.00040
14. Impact of stress on hypothalamic–pituitary–adrenal
(HPA) axis and sympathetic NS.
* Yoga has been shown to have significant beneficial effects in these
Sengupta P. Health Impacts of Yoga and Pranayama: A State-of-the-Art Review. Int J Prev Med 2012; 3:444–58.
15. Possible factors responsible for improvement of
physical performance by yoga
Ray US, Pathak A, Tomer OS. Hatha Yoga Practices: Energy Expenditure, Respiratory Changes and Intensity of
Exercise. Evid Based Complement Alternat Med. 2011; 2011: 241294.
PERFORMANCE IMPROVEMENT
BY YOGA
Cardio-respiratory reserve
Hemodynamic function
Respiratory function
Tidal volume
Respiratory rate
Body flexibility
Isometric nature of
asanas
Psycho-physiological functions
Local muscular Adaptation:
Lactate threshold
Perceived exertion
of exercise
Modulation of frequency and
duration of practices
16. Proposed relationships among dyspnea, benefits of yoga,
and outcomes of participation in a yoga program.
Donesky-Cuenco D, Nguyen HQ, Paul S, Carrieri-Kohlman V. Yoga Therapy Decreases Dyspnea-Related Distress and Improves
Functional Performance in People with Chronic Obstructive Pulmonary Disease: A Pilot Study. J Altern Complement Med
2009; 15: 225–234.
Mechanisms and
Correlates of Dyspnea
Proposed Benefits of
Yoga Training Proposed Outcomes
of Yoga Training
Hyperinflation
Hyperventilation
Hypoxemia
Hypercapnea
Work of breathing
Respiratory muscle
weakness
Deconditioning
Depression
Anxiety
Fatigue
Respiratory rate
Airway resistance
Respiratory muscle
strength
Autonomic arousal
Heart rate
Depression
Anxiety
Panic Attacks
Confidence in control
of breathing process
Muscle strength
Balance
Coordination
Flexibility
Dyspnea
Dyspnea – related
distress
Depression
Anxiety
HRQoL
Physical
perfromance
17. Postulated mechanisms for role of
yoga in pregnancy outcomes
Chuntharapat S, Petpichetchian W, Hatthakit U. Yoga during pregnancy: effects on maternal comfort, labor pain and
birth outcomes. Complement Ther Clin Pract 2008; 14(2): 105-15.
Yogasanas
Chanting AUM
Breathing awareness
Yoga nidra
Dhyana
Relaxation of body-
mind
Improved physical
strength
and flexibility
Body-mind calmness
Improved self-
awareness Birth outcomes scores
Maternal comfort
Labor pain
18. Yoga in cancer related fatigue
Bower JE, Garet D, Sternlieb B. Yoga for persistent fatigue in breast cancer survivors: results of a pilot study. Evid Based
Complement Alternat Med 2011; 2011:623168.
12-week Iyengar Yoga Programme
for Cancer Related Fatigue
Improved physical
performance
(chair stands)
Decreased severity and
duration of fatigue
Improvements in general
health quality of life and
reduction in depressive
symptoms
19. Yoga in chronic low back pain-mechanisms
Sherman et al., Comparison of yoga versus stretching for chronic low back pain: protocol for the Yoga Exercise Self-care
(YES) trial. Trials 2010; 11:36
YOGA
POSITIVELY IMPACTS COGNITIVE
APPRAISAL
(e.g., decreases fear avoidance & catastrophizing: increases
self efficacy & conscious awareness of the body)
REDUCES PHYSICAL
IMPAIRMENT
(e.g., increases strength & flexibility)
DECREASES BACK
PAIN/ DYSFUNCTION
POSITIVELY IMPACTS AFFECT AND STRESS
(e.g., decreases psychological distress & perceived stress;
increases positive affect)
IMPROVES NEUROENDOCRINE
FUNCTION
(e.g., normalizes HPA axis)
20. Interconnections between Inner Correspondence / Peaceful
Harmony (ICPH), mindful acceptance & mental /emotional
stabilization in response to mind-body interventions such as Yoga.
Arndt B¨ussing et al. Inner Correspondence and peacefulness with practices among participants in Eurythmy Therapy &
Yoga: A Validation Study. Evid Based Complement Alternat Med 2011; 2011: 329023.
Mindful
acceptance
Mental
stabilization
Stress reduction
blood pressure
Symptoms
Life satisfaction
Quality of Life
Inner Correspondence
/ Peaceful Harmony
(ICPH)
21. Bhavanani AB et al. IJPP 2003: 47:297-300 and IJPP 2012; 56 : 174–180.
Improved
concentration
power
Greater
arousal and
faster rate
of information
processing
Ability to
ignore
or Inhibit
extraneous
stimuli
Mukha
Bhastrika
(a yogic
bellows type
breathing
technique)
Enhanced
central
neuronal
processing
and
sensory-
motor
performance
22. Improved baroreflex
sensitivity
Normalization of autonomic
cardiovascular rhythms
Enhanced cardiac
autonomic regulation
Integrated relaxation
response with
decreased after load
Pranava
pranayama
Sukha
pranayama
Mild ‘Valsalva like’ effect
with decreased pre- load
↓
HR
↓
DP
↓
SP
↓
MP
↓
RPP
Savitri
pranayama
Chandranadi
pranayama
Clinically
valuable
in
HT & DM
Bhavanani AB et al. Int J Yoga Ther 2011; 21: 73-76 & Yoga Mimamsa 2012; 44: 101-112. Indian J
Physiol Pharmacol 2012; 56: 273–78 & Biomed Human Kin 2012: 4: 66 – 69. Int J Yoga 2012; 5: 108-11
24. LIMITATIONS OF YOGA THERAPY
• Not a miracle cure for all problems
• Use discernment (Viveka)
• Not for emergencies
• Consult a doctor where in doubt
• Each patient is different
• Different approaches of different traditions
• Don’t be a quack !
25. AN INTEGRATED APPROACH
• The need of the modern age is to have an integrated
approach towards therapy and to utilize Yoga therapy
with coordination and collaboration with other
systems of medicine such as Allopathy, Ayurveda,
Siddha and Naturopathy
• Physiotherapy, osteopathy and chiropractic practices
may be used with the Yoga if needed
• Advise on diet and life style is very important
• Adoption of right attitudes through Yogic counselling
26. IN CONCLUSION
• The ancient art and science of Yoga has infinite
possibilities of solutions for the health related issues
faced by modern humankind.
• We however want it to be a miracle pill, that we take
only once - immediate solution to all problems!
• Yoga is a wholistic science and must be learnt and
practiced with a holistic view.
• The dedicated practice of Yoga as a way of life is no
doubt a panacea for psychosomatic, stress related
disorders helping us to regain our birthright of
natural health and universal happiness.
• The integration of Yoga and modern medicine can
help create a healthier and happier world.
27. “Health and happiness are your birthright.
Do not forsake your golden culture for the
plastic playthings of the modern world.
Learn and live Yoga for then you will know
true health and happiness”
Yogamaharishi
Dr Swami Gitananda Giri
Guru Maharaj
Founder: ICYER at Ananda
Ashram, Pondicherry
(1907-1993)
Notas del editor
Sengupta P. Health Impacts of Yoga and Pranayama: A State-of-the-Art Review. Int J Prev Med 2012; 3: 444–458.
Ray US, Pathak A, Tomer OS. Hatha Yoga Practices: Energy Expenditure, Respiratory Changes and Intensity of Exercise. Evid Based Complement Alternat Med. 2011; 2011: 241294.
Donesky-Cuenco D, Nguyen HQ, Paul S, Carrieri-Kohlman V. Yoga Therapy Decreases Dyspnea-Related Distress and Improves Functional Performance in People with Chronic Obstructive Pulmonary Disease: A Pilot Study. J Altern Complement Med 2009; 15: 225–234.
Chuntharapat S, Petpichetchian W, Hatthakit U. Yoga during pregnancy: effects on maternal comfort, labor pain and birth outcomes. Complement Ther Clin Pract 2008; 14(2): 105-15.