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LIRA Week 4: Yoga
Michael Chiauzzi, Marissa Leoni, Christian Navarro, & Michael Scholz
Objectives
● Learn about current research regarding yoga and musculoskeletal
disorders
● Learn different yoga poses to promote strength, balance, flexibility, &
relaxation
● Learn about different meditation techniques and apps
● Review diaphragmatic breathing
● Yoga Resources
Current Research
Primary care physicians’ attitude and reported prescribing behavior for chronic low back pain: An exploratory cross-sectional study
● Background:○ Chronic LBP: Global prevalence ~20%, 33% recurrence within 1st year of exacerbation.
○ 533 Physicians in the French speaking portion of Switzerland were given the questionnaire.
● Methods: Questionnaire○ 79 Items
■ 4 parts: Socio-demographic data, PCP’s perceived usefulness of various conventional treatments for
chronic or recurrent LBP, PCP’s perceived usefulness of CM in general and of specific CM treatments,
PCP’s attitude towards and personal use of CM.
Primary care physicians’ attitude and reported prescribing behavior for chronic low back pain: An exploratory cross-sectional study
● Participants
Primary care physicians’ attitude and reported prescribing behavior for chronic low back pain: An exploratory cross-sectional study
● Results:○ Top 3 conventional treatments most often considered useful
■ PT (94.8%) NSAIDs (87.9%) Manual Therapy (822.5%)
○ Most prescribed conventional treatments
■ PT (99.2%) NSAIDs( 97.4%) Acetaminophen (94.4%) Osteopathic treatment (78.4%) yoga (69.3%)
therapeutic massage (63.9%)
○ Most recommended complementary medicine:
■ Osteopathic treatment (87.3%) acupuncture (69.3%) therapeutic massage (58.7%)
Yoga as a treatment for chronic low back pain: A systematic review of the literature
● Background: ○ Performed by US Dept of VA
○ Increasing prevalence of CLBP and increased report on the reduction in function being seen.
● Review of the literature until beginning of 2015 using PubMed as a database. ○ Included were randomized control trials using yoga as a treatment for CLBP
■ 27 articles of initial 128 that were found were used
● Discussion: ○ Common risk factors associated with CLBP
■ Previous back injury, high physical demands on job, low job satisfaction, age, back weakness, smoking.
○ Benefits to yoga:
■ Cost-effectiveness
■ Reducing functional disability
■ MAY have an effect on depression and other psychological disabilities. BDNF Levels
● Further research needed
Integrative effect of yoga practice in patients with knee arthritis. Wang et. al., 2018
● Background
○ Meta Analysis to quantify the efficiency of yoga exercise for patients
pain reduction, functional recovery and well-being.
● Methods
○ 13 studies included containing 1557 subjects
■ Subjects with OA, RA or suspected OA
○ 3 types of yoga
Visual analog scale (VAS)
Western Ontario and McMaster Universities Arthritis Index (WOMAC)
Health Assessment Questionnaire (HAQ)
Short Form 36 Health Survey (SF-36)
Integrative effect of yoga practice in patients with knee arthritis. Wang et. al., 2018
● Conclusion
○ Clinically significant pain alleviation and functional improvements
○ Stress reducing effects may be the effective mechanism for reducing
pain
○ Systemic effects such as lowered HR
○ Similar effects on low back pain and carpal tunnel
Effects of Yogasanas on osteoporosis in postmenopausal women. Motorwala et. al., 2016
● Background
○ Very common, increased risk of fracture
○ Can be measured with a DEXA scan
● Methods
○ 30 females ages 45-62 with t-score of ≤2.5
○ 6 month yoga program
○ Pre and post test analysis
Integrative effect of yoga practice in patients with knee arthritis. Wang et. al., 2018
● Results
Effects of yoga on cardiovascular disease risk factors: A systematic review and meta-analysis. Cramer et al., 2014
● Background
○ Assess the effects of yoga on modifiable cardiovascular risk factors in the general
population and high-risk disease groups
● Methods
○ 44 studies with a total of 3,168 participants
○ Yoga vs usual care or no treatment
● Limitations
○ Some studies contained a high-risk for bias
Effects of yoga on cardiovascular disease risk factors: A systematic review and meta-analysis. Cramer et al., 2014
● Results○ Systolic Blood Pressure -5.85 mmHg○ Diastolic Blood Pressure -4.12 mmHg○ Heart Rate -6.59 bpm○ Respiratory Rate -0.93 breaths per minute ○ Waist circumference -1.95 cm ○ Waist to hip ratio -0.02 ○ Total cholesterol -13.09 mg/dl○ HDL +2.94 mg/dl○ LDL -6.52 mg/dl○ VLDL -5.70 mg/dl○ Triglycerides -20.97 mg/dl○ Fasting blood glucose -14.11 mg/dl○ HbA1c -0.45%○ Insulin resistance -0.19
Conclusions● ~12 weeks is the sweet spot
for these effects● Should be used as an ancillary
treatment
Lower Extremity Strengthening Poses
Warrior I
● Strengthens: Glutes and Quads of front leg, Stretches opposite adductor
and hip flexor as well as chest and abdominals
● Step-by-step Guide:
○ https://www.yogajournal.com/poses/warrior-i-pose
Bridge Pose
● Strengthens:Hip Extensors, also hamstrings minimally
● Step-by-step Guide:
○ https://www.yogajournal.com/poses/bridge-pose
Chair Pose
● Strengthens: Glutes, Quads, Ankle stability. Also stretches chest, posterior
shoulders
● Step-by-step Guide:
○ https://www.yogajournal.com/poses/chair-pose
Upper Extremity Strengthening Poses
Downward Facing Dog
● Strengthens: Shoulder girdle, Lats
● Stretches: Triceps, Forearms, Hamstrings, Calves, arches
● Step-by-step Guide:
○ https://www.yogajournal.com/poses/downward-facing-dog
Also See...
● Plank and Side Plank
● Strengthens: Shoulder Girdle, Triceps, Core
Core Poses
Boat Pose
● Strengthens: abdominals and deep hip flexors and requires
good sitting balance
● Step-by-step guide:
○ https://www.yogajournal.com/poses/full-boat-pose
Plank Pose
● Strengthens: core and upper extremities
● Step-by-step guide:
○ https://www.yogajournal.com/poses/plank-pose
Cat-Cows
● Spinal mobility
● Step-by-step guide cat pose:
○ https://www.yogajournal.com/poses/cat-pose
● Step-by-step guide cow pose:
○ https://www.yogajournal.com/poses/cow-pose
Balance Poses
Tree Pose
● Single Leg Balance, Hip Stability esp. Abductors
● Step-by-step guide:
○ https://www.yogajournal.com/poses/tree-pose
Side Plank Pose
● Arm balance, strengthens arms and wrists
● Step-by-step guide:
○ https://www.yogajournal.com/poses/side-plank-pose
Warrior III Pose
● Step-by-step guide:
○ https://www.yogajournal.com/poses/warrior-iii-pose
● 23 Minute Video For Improving Balance:
○ https://www.yogajournal.com/videos/balancing-poses
Flexibility Poses
Legs-Up-The-Wall Pose
● Stretches: Back of Legs- Hip Extensors (Glutes), Knee Flexors (Hamstrings)
● Step-by-step Guide:
○ https://www.yogajournal.com/poses/legs-up-the-wall-pose
High Lunge Pose
● Stretches: Hip Extensors (Glutes), Opposite Hip Flexors
● Step-by-step Guide:
○ https://www.yogajournal.com/poses/high-lunge
Big Toe Pose
● Stretches: Hip Extensors (Glutes), Knee Flexors (Hamstrings), Low Back
● Step-by-step Guide:
○ https://www.yogajournal.com/poses/big-toe-pose
Extended Triangle Pose
● Stretches: Adductors (inner thighs), Opposite Abductors (Gluteus
Medius/Minimus), Lateral Trunk
● Step-by-step Guide:
○ https://www.yogajournal.com/poses/extended-triangle-pose
Relaxation & Meditation
Restorative Poses● Corpse Pose
○ Step-by-step guide:
https://www.yogajournal.com/poses/corpse-pose
● Child’s Pose
○ Step-by-step guide:
https://www.yogajournal.com/poses/child-s-pose
● Reclining Bound Angle Pose
○ Step-by-step guide:
https://www.yogajournal.com/poses/reclining-bound-angle-pose
Meditation and Mental Imagery ● https://www.youtube.com/watch?v=e1qHRZGd82k
Meditation Apps
● The Mindfulness App
● Calm
● Headspace
● Mindbody
Yoga Resources
● Yoga with Adriene
○ https://www.youtube.com/user/yogawithadriene
○ Meditation, Weight Loss, Flexibility, Beginners
● Yoga Journal
● Different styles of yoga
○ https://www.mindbodygreen.com/articles/the-11-major-types-of-yo
ga-explained-simply
○
References ● Chang DG, Holt JA, Sklar M, Groessl EJ. Yoga as a treatment for chronic low back pain: A systematic review of
the literature. Journal of orthopedics & rheumatology. 2016;3(1):1-8.
● Cramer, H., Lauche, R., Haller, H., Steckhan, N., Michalsen, A., & Dobos, G. (2014). Effects of yoga on
cardiovascular disease risk factors: A systematic review and meta-analysis. International Journal of Cardiology,
173(2), 170-183. doi:10.1016/j.ijcard.2014.02.017
● https://www.healthline.com/health/mental-health/top-meditation-iphone-android-apps
● https://www.yogajournal.com
● Rodondi, P., Dubois, J., Bill, A., Koutaïssoff, D., Ros, J., Aveni, E., . . . Burnand, B. (2018). Primary care physicians’
attitude and reported prescribing behavior for chronic low back pain: An exploratory cross-sectional study.
Plos One, 13(9). doi:10.1371/journal.pone.0204613
● Wang Y, Lu S, Wang R, et al. Integrative effect of yoga practice in patients with knee arthritis: A
PRISMA-compliant meta-analysis. Tusconi. M, ed. Medicine. 2018;97(31):e11742.
doi:10.1097/MD.0000000000011742.