THERAPEUTIC POTENTIAL OF YOGA

Yogacharya

Dr. ANANDA BALAYOGI BHAVANANIMBBS, ADY, DSM, DPC, PGDFH, PGDY, FIAY

Deputy Director- CYTERCentre for Yoga Education, Therapy and Research (CYTER),

MGMC & RI, SBVU, Puducherry.

YOGA & MODERN MEDICINE: MEETING POINTS

• Modern medical advancements provide therationale for the integration of various traditionalhealing techniques including Yoga to promotehealing, health, and longevity

• Potential to provide us with a holistic healthscience - 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 rehabilitativemethods in addition to many managementmethods to tackle modern illnesses

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

• Psychosomatic and stress related disorders

– DM, hypertension, bronchial asthma, IBS, epilepsy, backpain and functional disorders

• Reduce / eliminate drug dosage / dependence in

– DM, hypertension, epilepsy, anxiety, bronchial asthma,constipation, dyspepsia, insomnia, arthritis, sinusitisand dermatological disorders

• Yoga therapists must work in tandem with medical doctorswhen treating patients on allopathic treatment

• “The treatment of the part shouldn’t be attempted withouta treatment of the entirety” - the treatment of the bodywithout treating the mind and soul is a useless waste oftime”- Plato

• LIFE STYLE MODIFICATIONS: “Yoga is a system ofperfect 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 curebut 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

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

• A bibliometric analysis on biomedical literatureinvolving research on clinical application of Yoga(Khalsa - IJPP 2004) revealed an increase inpublication frequency over past 3 decades with asubstantial and growing use of RCTs.

• The 3 types of disorders most evaluated have beenpsychiatric conditions, CV disorders, & respiratorydisorders.

• Discrete disorders receiving most attention wereasthma, hypertension, diabetes, depression, heartdisease and anxiety.

• Recent reviews by Innes (2005, 2007 and 2012),Yang (2007) and Sengupta (2012) have highlightedrole of Yoga as a therapy based on indexed reports.

PSYCHO-NEURO-IMMUNO-ENDOCRINOLOGICAL CORRELATES OF STRESS

NERVOUS

SYSTEM

ENDOCRINE

SYSTEM

IMMUNE

SYSTEM

MENTAL & PHYSICAL ILLNESS

HEALTH

Overexposure to stress

DISEASE

Streeter CC et al. Med Hypotheses 2012; 78: 571-9

• Stress induces autonomic imbalance

• Decreased para-sympathetic & increasedsympathetic activity, under activity of GABAsystem, the primary inhibitory neuro-transmitter, and increased allostatic load.

• Yoga helps correct the underactivity of para-sympathetic nervous system and GABAsystems in part through stimulation of vagusnerves with reduction in the allostatic load.

Postulated mechanisms by which Yogareduces cardiovascular risk

Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, andpossible protection with yoga: a systematic review. J Am Board Fam Pract 2005;18:491-519.

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 diabetesmellitus: A systematic review. eCAM 2007; 4: 469-86.

Postulated mechanisms of yoga in diabetes mellitus

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

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.

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 ofExercise. 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

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 ImprovesFunctional Performance in People with Chronic Obstructive Pulmonary Disease: A Pilot Study. J Altern Complement Med2009; 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

Postulated mechanisms for role of yoga in pregnancy outcomes

Chuntharapat S, Petpichetchian W, Hatthakit U. Yoga during pregnancy: effects on maternal comfort, labor pain andbirth 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

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

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)

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)

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 Inhibitextraneous

stimuli

Mukha

Bhastrika(a yogic

bellows type

breathing

technique)

Enhanced central

neuronal processing

andsensory-

motor performance

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 JPhysiol Pharmacol 2012; 56: 273–78 & Biomed Human Kin 2012: 4: 66 – 69. Int J Yoga 2012; 5: 108-11

SOME DISORDERS AMIABLE TO YOGA THERAPY

• C.V.S : Essential HT, CAD

• Respiratory : Asthma, COAD

• Stress : Tension headache

• M.S : Backache, RA, spondilitis

• Metabolic : DM, thyroid disorders, obesity

• G.I.T : IBS, dyspepsia, ulcerative colitis

• Psychiatric : Anxiety, depression, phobias

• C.N.S : Mental retardation, epilepsy, migraine

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 !

AN INTEGRATED APPROACH

• The need of the modern age is to have an integratedapproach towards therapy and to utilize Yoga therapywith coordination and collaboration with othersystems of medicine such as Allopathy, Ayurveda,Siddha and Naturopathy

• Physiotherapy, osteopathy and chiropractic practicesmay be used with the Yoga if needed

• Advise on diet and life style is very important

• Adoption of right attitudes through Yogic counselling

IN CONCLUSION

• The ancient art and science of Yoga has infinitepossibilities of solutions for the health related issuesfaced by modern humankind.

• We however want it to be a miracle pill, that we takeonly once - immediate solution to all problems!

• Yoga is a wholistic science and must be learnt andpracticed with a holistic view.

• The dedicated practice of Yoga as a way of life is nodoubt a panacea for psychosomatic, stress relateddisorders helping us to regain our birthright ofnatural health and universal happiness.

• The integration of Yoga and modern medicine canhelp create a healthier and happier world.

“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)