Effect of a 12-week yoga therapy program on mental health status in elderly women inmates of a hospice.

AIM AND OBJECTIVES: This study was undertaken to evaluate the effectiveness of yoga on the mental health status of elderly women inmates residing in a hospice in Puducherry. MATERIALS AND METHODS: Forty elderly women were randomly divided into yoga and wait-listed control group. A yoga therapy program of 60 min was given twice a week for 12 weeks. This protocol was specially designed for senior citizens, keeping in mind their health status and physical limitations that included simple warm-up and breath-body movement coordination practices (jathis and kriyas), static stretching postures (asanas), breathing techniques (pranayamas), and relaxation. Hamilton anxiety scale for measuring anxiety, Hamilton rating scale for depression, and Rosenberg self-esteem scale to measure self-esteem were administered to both groups before and after the 12-week study period. Data were assessed for normality, and appropriate parametric and nonparametric statistical methods were applied for intra- and inter-group comparisons. RESULTS: Overall, intra- and inter-group comparison of prepost data showed statistically significant (P < 0.001) differences for all three parameters. There was an overall improvement in the scores indicating decreased levels of depression and anxiety coupled with an increase in the level of self-esteem after the yoga therapy program. DISCUSSION: The influence of yoga in the reduction of depression and anxiety scores and improvement in self-esteem scores in elderly women subjects is evident from this study. As reported in earlier studies, this may be attributed to changes in central neurotransmitters such as gamma-aminobutyric-acid coupled with increased parasympathetic tone and decreased sympatho-adrenal activity. CONCLUSION: It is recommended that yoga should be a part of health-care facilities for elderly as it can enhance the quality of life by improving their overall mental health status. It could provide a healthy and positive alternative from depressing negative thoughts, and give them a sense of purpose and hope.

Effect of Different Pranayamas on Respiratory Sinus Arrhythmia.

INTRODUCTION: Respiratory Sinus Arrhythmia (RSA) is the differential change of Heart Rate (HR) in response to inspiration and expiration. This is a noninvasive sensitive index of parasympathetic cardiac control. AIM: To evaluate changes in RSA by utilizing a simple and cost-effective analysis of electrocardiographic (ECG) tracings obtained during performance of four pranayama techniques. MATERIALS AND METHODS: Fifty two trained volunteers performed the following pranayamas with different ratios for inspiration and expiration: sukha (1:1), traditional (1:2), pranava (1:3) and savitri (2:1:2:1) and ECG was recorded while performing the techniques with rest period of 5 minutes in-between. HR was calculated and maximum HR during inspiration (Imax), minimum HR during expiration (Emin), differences between Imax and Emin (Δ), percentage differences between I(max) and Emin (Δ%) and expiration: inspiration ratio (E:I) calculated by respective formulae. Statistical analysis was carried out using repeated measures of ANOVA with Tukey-Kramer multiple comparisons test. RESULTS: There were significant differences between groups in all five aspects namely: p= 0.0093 for mean Imax, p = 0.0009 for mean Emin, and p < 0.0001 for Δ HR (I-E), Δ% HR (I-E) and E:I ratio. Pranava pranayama produced the greatest changes in all five comparisons. CONCLUSION: We suggest that further short and long term studies be undertaken with pranava pranayama in patients to further qualitatively and quantitatively evaluate inherent mechanisms of this simple technique. Addition of these cost-effective techniques to the medical armory will help patients of rhythm disorders and other cardiovascular conditions.

Measuring Respiratory Pressures with Mercury Manometer in Low Economic Health Care Settings- An Analytical Study.

INTRODUCTION: Health care economics restricts many health centers from using hi-tech diagnostics equipment. Mercury manometers are used for calibration of pressure transducers. If standardized it would be a cost effective, simple alternative to transducers in low economic settings. AIM: To analyse the feasibility of mercury manometer usage in respiratory pressure measurement. MATERIALS AND METHODS: The experimental study was conducted with 30 healthy volunteers of age group 17-19 yrs. They were recruited by using simple random sampling method. The volunteers were made familiarized to lab environment, instrument and techniques of maximum inspiratory (Pimax) and expiratory pressures (Pemax). Then parameters were recorded using mercury manometer connected to different syringes as mouth piece (2.5 ml, 10 ml, and 20 ml) and with sphygmomanometer. Statistical analysis was done by using IBM SPSS statistics version 21. RESULTS: The Pimax was 111.07 ± 6.53 with a 2.5 ml syringe as mouth piece. With 20 ml syringe it was 61.47 ± 9.98. PEmax with 2.5 ml syringe was 70.33 ± 8.19 with a confidence limit of 2.93 and with sphygmomanometer was 99.33 ± 8.16 with a confidence limit of 2.92. There was a change in recorded pressure and the correlation analysis result showed a significant difference from both above and below 10 ml mouth piece range. CONCLUSION: Mercury manometers could be used for recording respiratory pressures in low economic facilities once standardized. Size of syringe to be used as mouth piece needs further more works although this study finds 10 ml syringe as suitable.

Additional benefit of yoga to standard lifestyle modification on blood pressure in prehypertensive subjects: a randomized controlled study.

High blood pressure (BP) is a known risk factor for cardiovascular disease morbidity. Considering the growing evidence of nonpharmacological interventions in the management of high BP, we designed a randomized, parallel active-controlled study on the effect of yoga and standard lifestyle modification (LSM) on BP and heart rate in individuals with prehypertension (systolic BP 120-139 mm Hg and/or diastolic BP 80-89 mm Hg). Volunteers (20-60 years) of both genders without any known cardiovascular disease were randomized into either LSM group (n = 92) or LSM+yoga group (n = 92). Before the intervention, age, waist circumference, physical activity, BP and fasting plasma glucose and lipids were comparable between the groups. After 12 weeks of intervention, we observed a significant reduction in the BP and heart rate in both the groups. Further, the reduction in systolic BP was significantly more in LSM+yoga group (6 mm Hg) as compared with LSM group (4 mm Hg). In addition, 13 prehypertensives became normotensives in LSM+yoga group and four in LSM group. The results indicate efficacy of nonpharmacological intervention and the additional benefit of yoga to standard LSM. Further research in this field may add to the level of evidence on the benefit of yoga, in the reduction of BP in high BP subjects, in the scientific literature.

A comparative study of the effects of asan, pranayama and asan-pranayama training on neurological and neuromuscular functions of Pondicherry police trainees.

BACKGROUND: Though neurological benefits of yoga training have been reported, lacunae still exists in understanding neurophysiological effects of such training. Hence, the present study was conducted to find the effect of yogasanas and pranayams on neurological and neuromuscular functions in healthy human volunteers and also determined differential effects of training in asan, pranayama and their combination. MATERIALS AND METHODS: Eighty male trainees from Pondicherry Police Training School were randomly divided into asan, pranayama, and asan-pranayama groups who received a training of 4 days a week for 6 months and a control group. Electroencephalogram (EEG), nerve conduction (NC), electromyogram (EMG), visual evoked potentials (VEP), and auditory reaction time (ART) were recorded before and after the study period. NC, EMG, and VEP data were obtained from 28 subjects; EEG data from 48 subjects; and RT from 67 subjects. Intergroup differences were assessed by AVOVA/Kruskal-Wallis and intragroup differences by Student's t-test. RESULTS AND DISCUSSION: Police trainees showed beneficial effects of yoga training, although they were undergoing intensive police training and the yoga training was relatively less intense. Alpha, theta, and total power of EEG increased as a result of asan training. A shortening of visual reaction time and a decrease in red-green discriminatory reaction time signifies an improved and faster processing of visual input. They also showed a decrease in resting EMG voltage, signifying better muscular relaxation following pranayama training. Beta, theta and total power of EEG increased. ART and red-green discriminatory reaction times decreased in the trainees, signifying a more alert state as well as improved central neural processing. A combination of asan and pranayama training for 6 months produced an improvement in motor and sensory nerve conduction. Total power of EEG, alpha and theta power as well as delta % increased, while reaction time decreased signifying an alert and yet relaxed state of the neuromuscular system. SUMMARY AND CONCLUSION: The present study has shown that 6 months training in asan, pranayama as well as their combination is effective in improving physiological functions of police trainees. They showed beneficial effects of yoga training, although they were undergoing intensive police training and the yoga training was relatively less intense. Hence, we recommend that yoga training be introduced in police training curricula.

Effect of fast and slow pranayama on perceived stress and cardiovascular parameters in young health-care students.

CONTEXT: Perceived stress is higher for students in various healthcare courses. Previous studies have shown that pranayama practice is beneficial for combating stress and improve cardiovascular functions but both fast and slow pranayama practice produce different physiological responses. AIM: Present study was conducted to compare the effects of commonly practiced slow and fast pranayama on perceived stress and cardiovascular functions in young health-care students. MATERIALS AND METHODS: Present study was carried out in Departments of Physiology and Advanced Centre for Yoga Therapy Education and Research, JIPMER, Pondicherry. Ninety subjects (age 18-25 years) were randomized to fast pranayama (Group 1), slow pranayama (Group 2) and control group (Group 3). Group 1 subjects practiced Kapalabhati, Bhastrika and Kukkuriya Pranayama while Group 2 subjects practiced Nadishodhana, Savitri and Pranav Paranayama. Supervised pranayama training was given for 30 min, 3 times a week for the duration of 12 weeks to Groups 1 and 2 subjects by certified yoga trainer. Following parameters were recorded at the baseline and after 12 weeks of training; perceived stress scale (PSS), heart rate (HR), respiratory rate, systolic blood pressure and diastolic blood pressure (DBP), mean arterial pressure (MAP), rate pressure product (RPP), and double product (Do P). RESULTS: There was a significant decrease in PSS scores in both Group 1 and Group 2 subjects but percentage decrease was comparable in these groups. Significant decrease in HR, DBP, RPP, and Do P was seen in only Group 2 subjects. CONCLUSION: This study demonstrates that both types of pranayama practice are beneficial in reducing PSS in the healthy subjects but beneficial effect on cardiovascular parameters occurred only after practicing slow pranayama.

Cardiovagal modulation, oxidative stress, and cardiovascular risk factors in prehypertensive subjects: cross-sectional study.

BACKGROUND: Hypertension, one of the modifiable risk factors for cardiovascular disease (CVD), is known to be associated with increased oxidative stress and reduced cardiovagal modulation. Similar to hypertension, prehypertension is associated with increased risk of adverse cardiovascular (CV) events. We planned this study to find the association between prehypertension, cardiovagal modulation, oxidative stress, and associated CV risk factors. METHODS: We recruited 178 subjects through hypertension screening camps conducted in Puducherry, India. Subjects were grouped into prehypertensive (n = 97) and normotensive (n = 81) groups. They were further subdivided, based on age, as young (20-39 years) and middle-aged (40-60 years) adults. We measured basal physiological parameters, heart rate variability, oxidative stress (thiobarbituric acid reactive substance and total antioxidant capacity (TAC)), and CV risk factors. RESULTS: We found significant increase in oxidative stress in prehypertensive subjects of both age groups but the cardiovagal modulation decreased significantly in young prehypertensive subjects when compared with normotensive subjects. Correlation of TAC with root mean square of the sum of successive R wave to R wave (RR) interval differences (RMSSD), a cardiovagal modulation parameter (r = 0. 437; P < 0.001), and mean arterial pressure (MAP) (r = -0.318; P < 0.001) was significant even after adjusting for CV risk factors. The correlation between MAP and RMSSD (r = 0.199; P = 0.009) was reduced after adjusting for CV risk factors. CONCLUSIONS: Prehypertension in young adults is associated with increased oxidative stress and altered cardiovagal modulation. The risk factors for CVDs in prehypertensive young adults were found to be equivalent to that of middle-aged adults who are in the twilight zone for developing CV dysfunctions.

Handgrip strength and endurance as a predictor of postoperative morbidity in surgical patients: can it serve as a simple bedside test?

Postoperative morbidity is related to preoperative nutritional status. Current methods of assessing this are cumbersome, lack sufficient accuracy to completely separate all those at risk from others, and require a laboratory backup. This study was done to evaluate handgrip manometry, a simple bedside test as an indicator of preoperative nutritional status to predict risk of postoperative complications. Normal values for maximal grip strength and endurance times were established in 496 controls. Similar values were recorded in 100 patients undergoing elective surgery preoperatively. Postoperative variables studied included complication rate and hospital stay. The efficacy of four parameters, serum albumin, clinical nutritional score based on subjective global assessment, maximal grip strength (MGS), and grip endurance time, in predicting complications were studied. It was found that age and presence of co-morbidity increased risk of complications. Of the four predictive parameters studied, it was found that MGS is better than serum albumin. Clinical scoring was superior to MGS in predicting risk of complications. MGS is a simple bedside test, which can be easily performed. It can be used as a complimentary test to clinical scoring in identifying patients at risk of complications after surgery. Patients with abnormal MGS require urgent preoperative correction to reduce the risk of complications.