Eight months of integrated yoga, hydrotherapy and acupuncture on serum IgE levels and symptoms severity of a patient with chronic allergic rhinosinusitis: A case report.

A 27-year-old man with Allergic rhino sinusitis presented to our hospital in July 2020 with complaints of continuous sneezing, coughing while rising from bed for half an hour, and the same complaints repeated in the afternoon for half an hour, as well as a continuous dry cough for half an hour in the evening. He also had complaints of itching and skin rashes, particularly in his limbs. He underwent yoga (45 minutes, 5-6 days a week) including Jalaneti (a yogic cleansing technique, i.e. nasal irrigation with warm salt water for twice a week), hydrotherapy (enema using neem leaves paste mixed with water and steam bath on first day, followed by facial steam on alternate days) and Acupuncture (one session a week) for 8 months. Results showed a reduction in immunoglobulin E (IgE) levels and symptom severity suggesting that integrated yoga, hydrotherapy, and acupuncture are effective in the management of chronic allergic rhinosinusitis. All treatments were well tolerated without adverse effects. Though the result is encouraging, further studies are required with a larger sample size.

Yoga as Adjunct Therapy for Chronic Heart Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background Chronic heart failure (CHF) is a prevalent cardiovascular condition that can significantly impact the quality of life and increase mortality risk. Yoga is a mind-body therapy that has been studied as a potential complementary treatment for CHF. However, the effectiveness of yoga in improving outcomes in patients with CHF remains uncertain. Methods We conducted a systematic review of randomized controlled trials (RCTs) evaluating the effects of yoga on outcomes in patients with CHF. We searched the PubMed, Embase, Scopus, Cochrane Library, and IndMED databases from inception to March 2023. The outcomes of interest were left ventricular ejection fraction (LVEF), cardiac biomarkers, exercise capacity, quality of life, and cardiac function. Results We identified 11 RCTs that met our inclusion criteria, involving a total of 552 participants. The meta-analysis showed that yoga was associated with significant improvements in peak VO 2 (mean difference [MD]= 3.29; 95% Confidence Interval [CI]: 1.64 to 4.94; I 2 = 0%), exercise capacity (MD=101.54; 95% CI: 6.24 to 196.83; I 2 = 96%), quality of life (MD = -19.99; 95% CI: -25.76 to -14.22; I 2 = 43%), NT-proBNP (MD = -288.78; 95% CI: -492.20 to -85.37; I 2 = 94%), and 6-minute walk test (MD = 101.54; 95% CI: 6.24-196.83; I 2 = 96%), but not in the left ventricular ejection fraction (MD = 4.28; 95% CI: -1.14 to 9.70; I 2 = 93%). Subgroup analysis suggested that the effect of yoga on the quality of life is more pronounced in patients with the "New York Heart Association" (NYHA) class I and II CHF patients and in those who practiced yoga for longer durations. No serious adverse events related to yoga were reported. Most of the included studies were of "low" quality. Conclusion Current evidence suggests that yoga may be an effective complementary and integrative therapy for improving peak VO 2 exercise capacity, NT-proBNP, and quality of life in patients with CHF. However, the low-quality evidence does not render us to conclude anything beyond doubt or draw any firm clinical recommendation. Future high-quality studies are needed to explore the optimal duration and frequency of yoga practice and its effects on long-term outcomes in this population.

Effect of Ice Massage to Head and Spine on Blood Pressure and Heart Rate Variability in Patients with Hypertension: a Pilot Study.

BACKGROUND: Ice massage is one of the common hydrotherapeutic procedures. The current study is first of its kind, conducted to evaluate the effect of ice massage to head and spine on blood pressure and heart rate variability in patients with hypertension. MATERIALS AND METHODS: Fifteen hypertensive subjects with the mean ± standard deviation (SD) age of 48.87 ± 11.17 yrs were recruited and underwent only one session of ice massage to head and spine for 20 min. Blood pressure and heart rate variability were assessed before and immediately after the intervention. RESULTS: Results of this study showed a significant reduction in systolic blood pressure (p = <.001), diastolic blood pressure (p < .001) and heart rate (p = .012), and a significant increase in R-R Interval (the intervals between adjacent R waves in the electro cardiogram) (p = .001) in the post-test assessments compared to its respective pre-test assessments. CONCLUSION: Results suggest that 20 min of ice massage to head and spine may reduce blood pressure and heart rate in patients with hypertension. However, there is no evidence that this provides any significant clinical impact for the patient.

Evaluation of Cardiovascular Functions during the Practice of Different Types of Yogic Breathing Techniques.

INTRODUCTION: Yoga is the science of right living practice to promote health. Many studies have documented the cardiovascular effects of various yogic breathing techniques (YBTs), comparing the cardiovascular changes before and after the practice. However, there is a lack of study reporting the cardiovascular changes during the practice of YBT. MATERIALS AND METHODS: Twenty healthy individuals performed four different YBTs (Bhastrika, Bhramari, Kapalbhati, and Kumbhaka) in four different orders. Cardiovascular variables such as systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), stroke volume (SV), cardiac output (CO), pulse interval (PI), and total peripheral resistant (TPR) were assessed using a continuous noninvasive blood pressure monitoring system, before, during, and immediately after each YBT. Data were analyzed using repeated measures analysis of variance followed by post hoc analysis with Bonferroni adjustment for multiple comparisons using Statistical Package for the Social Sciences, Version 16.0. RESULTS: Results of this study showed a significant increase in DBP, MAP, HR, and CO along with a reduction in PI during Bhastrika; a significant increase in DBP, MAP, HR, and TPR with a reduction in SV, CO, and PI during Bhramari pranayama; a significant increase in SBP, DBP, MAP, HR, and CO with a reduction in PI during Kapalbhati; and a significant increase in SBP, DBP, MAP, and TPR with a reduction in SV and CO during Kumbhaka practice. CONCLUSION: In healthy individuals, cardiovascular changes during the practice of Bhastrika and Kapalbhati are more or less similar to each other and are different from those of Bhramari and Kumbhaka in most of the variables.

A Review on Role of Yoga in the Management of Patients with Cardiac Arrhythmias.

Evidence suggests that yoga is safe and effective in improving various risk factors, quality of life (QoL), and psychological burden that is related to arrhythmia. However, this is the first-ever systematic review performed to report the role of yoga in arrhythmia. We have performed a literature search using Cochrane Library, Medline/PubMed, Web of Science Core Collection, and IndMED electronic databases up to 3, January 2018. Of 240 articles, 6 potentially eligible articles were identified and included in the review. Results showed that yoga could be considered an efficient adjuvant in reducing arrhythmia (paroxysmal atrial fibrillation, ventricular tachyarrhythmia, and palpitation) related health problems; blood pressure, heart rate, depression and anxiety scores; and in improving health-related QoL of arrhythmia patients. However, there is a lack of randomized controlled trials and a clear mechanism behind the effect of yoga; studies had relatively a small sample size and different yoga protocols.

A randomized trial of the immediate effect of Bee-Humming Breathing exercise on blood pressure and heart rate variability in patients with essential hypertension.

OBJECTIVES: Bee-Humming Breathing (BHB) exercise is a simple yogic practice recommended for its favorable effect on cardiac physiology, including blood pressure (BP) and autonomic nervous system. However, strong evidence supporting its effectiveness is lacking. The present study was designed to evaluate the immediate effect of BHB exercise on blood pressure parameters and heart rate variability (HRV) in patients with essential hypertension. STUDY METHODS: We conducted a randomized control trial including 70 patients with essential hypertension, randomly allocated to perform either BHB exercise (n=35) or placebo slow breathing exercise (n = 35) for 5-minutes duration. Blood pressure and HRV were measured before, during, and after the practice. RESULTS: There was no significant decrease in systolic [effect size (95% CI): 2.22 (-13.20, 17.64); p 0.77], diastolic [4.54 (-17.40, 26.48); p 0.68] and mean blood pressures [1.37 (-8.78, 11.52); p 0.78] after BHB exercise in comparison to the control group in our study. The HRV analysis showed a significant increase in the HF power [6.8 (1.47, 12.12); p 0.01], and decrease in the LF power [-26.47 (-34.25, -18.68); p < 0.01] during the recovery phase of the 5-minute BHB exercise in comparison to the control group. CONCLUSIONS: This is the first randomized controlled trial to show that though a single short session of BHB exercise in hypertensive patients does not significantly reduce BP, it significantly augments the parasympathetic tone as indicated by a significant improvement in HRV parameters. CLINICAL TRIAL REGISTRATION NUMBER: CTRI/2018/08/015215.

Effect of bilateral needling at an acupuncture point, ST-36 (Zusanli) on blood glucose levels in type 2 diabetes mellitus patients: A pilot randomized placebo controlled trial.

Background Diabetes mellitus is one of the major current public health problems. Electro-acupuncture at ST-36 showed a significant reduction in plasma glucose levels in diabetic rats. There are lacks of studies reporting its hypoglycemic effect in humans and thus, the present study was conducted to evaluate the effect of needling at ST-36 (Zusanli) on blood glucose levels in patients with type 2 diabetes mellitus (T2DM). Methods Sixty T2DM participants were recruited and randomized into acupuncture group (n=30) and placebo control group (n=30). The participants of the acupuncture group received needling at ST-36 (one finger breadth lateral to the inferior border of the tibial tuberosity), and the participants those in the placebo control group received needling at placebo point (midpoint between the apex of the patella and tibial tuberosity). For both the groups, needles were retained for 30 min. Baseline and post-test assessments were performed prior to and after each intervention. Statistical analysis was performed using SPSS version 16. Results The present study showed a significant reduction in random blood glucose levels in the acupuncture group compared to the placebo control group. Conclusion This study suggests that 30 min of bilateral acupuncture needling at ST-36 with manual stimulation is effective in reducing blood glucose levels in T2DM patients.

Role of yoga in the prevention and management of various cardiovascular diseases and their risk factors: A comprehensive scientific evidence-based review.

Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels. CVDs are the leading cause of deaths worldwide. Though yoga is gaining popularity as a therapy, especially in CVD patients, there is a lack of a comprehensive review reporting its role in the management of various CVDs and their risk factors. Thus, we performed a comprehensive literature search in the PubMed/Medline electronic database. An aggregate of 603 articles published from inception were screened and 85 articles that are applicable were reported. This review suggests that yoga may play a role as an adjuvant in the management of various CVDs and their risk factors. However, many studies had a small sample size, different types and durations of the yoga interventions, and did not provide the details of mechanisms behind the improvements. Thus, further studies are warranted to explore the mechanisms of the impacts of yoga.

Effect of Moola Bandha (Perineum Contraction), A Yogic Lock on Cognitive Functions of College Students: An Exploratory Study.

Academic performance and excellence of college students are mainly depending on their cognitive functions. The purpose of this study was to examine the effectiveness of a yogic lock or hold, Moola bandha (perineum contraction) on cognitive functions of teacher training college students. Twenty-three healthy volunteers with the mean ± standard deviation age of 21.96 ± 1.64 years were recruited from a district institute of education and training (DIET) college, North India. All the subjects were asked to perform Moola bandha for the duration of 30 min a day (15 min in the morning and 15 min in the evening) for a period of 30 days. Assessments were taken before and after the intervention period. Results of this study showed a significant increase in the scores of d2 attention total number, digits span forward and backward test, Stroop tasks (neutral total and correct, congruent total and correct, and incongruent correct), and self-control scale along with a significant reduction in d2 attention (omission, commission, and timings), trail making text A and B duration, and positive and negative affective schedule's negative affect scores compared with its respective baseline. These results suggest that 30 min of daily practice of Moola bandha for 30 days is effective in improving the cognitive functions of teacher training college students.

Effect of a Yoga Based Meditation Technique on Emotional Regulation, Self-compassion and Mindfulness in College Students.

BACKGROUND: Emotion regulation is often a challenge for the college students. Yoga practice has been shown to reduce stress and improve mindfulness that is related to emotion regulation. Mastering emotions technique (MEMT) is one of the yoga-based meditation techniques that are designed to control emotions among practitioners. However, to the best of our knowledge, there is no known study reporting its scientific evidence-based effects on emotion and its related variables. Thus, this study was conducted to evaluate the effect of MEMT on emotion regulation, self-compassion, and mindfulness in college students. MATERIALS AND METHODS: Seventy-two subjects with the age varied from 18 to 25 years were recruited from a residential college. All the subjects underwent MEMT for the duration of 45 min a day for a period of 2 weeks. Assessments such as Emotional Regulation Questionnaire (ERQ), The Positive and Negative Affect Schedule (PANAS), Self-Compassion Scale (SCS), and Mindful Attention Awareness Scale (MAAS) were taken before and after the intervention. RESULTS: Results of this study showed a significant increase in the scores of cognitive reappraisal, positive affect, self-compassion, and MAAS along with a significant reduction in the scores of negative affect, and expressive suppression after the practice of MEMT compared to its respective baseline. CONCLUSIONS: Results of this study suggest that practice of MEMT is effective in improving emotion regulation, positive affects, self-compassion, and mindfulness while in reducing negative affects among college students.

Cerebrovascular Hemodynamics During the Practice of Bhramari Pranayama, Kapalbhati and Bahir-Kumbhaka: An Exploratory Study.

Various pranayama techniques are known to produce different physiological effects. We evaluated the effect of three-different pranayama techniques on cerebrovascular hemodynamics. Eighteen healthy volunteers with the mean ± standard deviation age of 23.78 ± 2.96 years were performed three-different pranayama techniques: (1) Bhramari, (2) Kapalbhati and (3) Bahir-Kumbhaka in three-different orders. Continuous transcranial Doppler (TCD) monitoring was performed before, during and after the pranayama techniques. TCD parameters such as peak systolic velocity, end diastolic velocity (EDV), mean flow velocity (MFV) and pulsatility index (PI) of right middle cerebral artery were recorded. Practice of Kapalbhati showed significant reductions in EDV and MFV with significant increase in PI while, Bahir-Kumbhaka showed significant increase in EDV and MFV with significant reduction in PI. However, no such significant changes were observed in Bhramari pranayama. Various types of pranayama techniques produce different cerebrovascular hemodynamic changes in healthy volunteers.

Evidence based effects of yoga practice on various health related problems of elderly people: A review.

More than 50% of the elderly above 60 years of age suffer from chronic medical conditions, the prevalence of which increases with age. Though Yoga has been reported as an effective modality in improving various physical and psychological aspects of elderly populations, a comprehensive review of Yoga and its effects on various health related problems of elderly populations has not yet been reported. Hence, we performed PubMed/Medline search to review relevant articles, using keyword "yoga and elderly". Relevant articles published since inception till 6th October 2016 were included for the review. Based on the available scientific literature, this review suggests that the regular practice of Yoga can be considered as an effective intervention in improving physical (reduces heart rate, blood pressure, blood glucose, oxidative damage, fatigue, weakness, fear of fall, and improve heart rate variability, baroreflex sensitivity, insulin sensitivity, physical functions, mobility, flexibility, and urinary incontinence), mental (reduces depression, anxiety), emotional (reduces anger, stress, tension and improve self-efficacy), social (improve life satisfaction), and vital (improved vitality) planes of elderly individuals, offering a better quality of sleep and quality of life.

Evidence based effects of yoga in neurological disorders.

Though yoga is one of the widely used mind-body medicine for health promotion, disease prevention and as a possible treatment modality for neurological disorders, there is a lack of evidence-based review. Hence, we performed a comprehensive search in the PubMed/Medline electronic database to review relevant articles in English, using keywords "yoga and neurological disorder, yoga and multiple sclerosis, yoga and stroke, yoga and epilepsy, yoga and Parkinson's disease, yoga and dementia, yoga and cerebrovascular disease, yoga and Alzheimer disease, yoga and neuropathy, yoga and myelopathy, and yoga and Guillain-Barre syndrome". A total of 700 articles published from 1963 to 14th December 2016 were available. Of 700 articles, 94 articles were included in this review. Based on the available literature, it could be concluded that yoga might be considered as an effective adjuvant for the patients with various neurological disorders.

Heart Rate Variability Changes During and after the Practice of Bhramari Pranayama.

BACKGROUND: Yoga is an ancient Indian science as well as the way of life. Pranayama is one of the most important yogic practices. Bhramari pranayama was shown to produce a reduction in blood pressure after the practice and thus reported to produce parasympathetic activity. However, there are no known studies reported the heart rate variability (HRV) changes either during or after the practice of Bhramari. Hence, this study aims at evaluating the HRV changes during and after the practice. MATERIALS AND METHODS: Sixteen (9 males, 7 females) healthy volunteers with the mean ± standard deviation age of 23.50 ± 3.01 years were recruited. All the subjects performed Bhramari pranayama for the duration of 5 min. Assessments were taken before, during, and immediately after the practice of pranayama. Statistical analysis was performed using students paired samples t-test, Wilcoxon signed-ranks test and repeated measures of analysis of variance and Post-hoc analysis with Bonferroni adjustment for multiple comparisons. RESULTS: Results of this study showed a significant increase in HR and low frequency spectrum of HRV and a significant reduction in high frequency spectrum of HRV during the practice of Bhramari which revert to normal after the practice. CONCLUSION: Results of this study suggests that there might be a parasympathetic withdrawal during the practice of Bhramari. However, further studies are required to warrant the findings of this study.

Cerebrovascular hemodynamics during pranayama techniques.

BACKGROUND: Pranayama techniques are known to produce variable physiological effects on the body. We evaluated the effect of the two commonly practiced Pranayama techniques on cerebral hemodynamics. MATERIALS AND METHODS: Fifteen healthy male volunteers, trained in Yoga and Pranayama, were included in the study. Mean age was 24 years (range 22-32 years). Study participants performed 2 Pranayamas in 2 different orders. Order 1 (n = 7) performed Bhastrika (bellows breaths) followed by Kumbhaka (breath retention) while order 2 (n = 8) performed Kumbhaka followed by Bhastrika. Both breathing techniques were performed for 1 min each. Continuous transcranial Doppler (TCD) monitoring was performed during the breathing techniques. TCD parameters that were recorded included peak systolic velocity (PSV), end-diastolic velocity (EDV), mean flow velocity (MFV), and pulsatility index (PI) of the right middle cerebral artery at baseline, 15, 30, 45, and 60 s. RESULTS: Significant reductions in EDV (3.67 ± 6.48; P < 0.001) and MFV (22.00 ± 7.30; P < 0.001) with a significant increase in PI (2.43 ± 0.76; P < 0.001) were observed during Bhastrika. On the contrary, a significant increase in PSV (65.27 ± 13.75; P < 0.001), EDV (28.67 ± 12.03; P < 0.001), and MFV (43.67 ± 12.85; P < 0.001) with a significant reduction in PI (0.89 ± 0.28; P < 0.01) was observed only during Kumbhaka. CONCLUSION: Bhastrika and Kumbhaka practices of Pranayama produce considerable and opposing effects on cerebral hemodynamic parameters. Our findings may play a potential role in designing the Pranayama techniques according to patients' requirements.

Effects of ice massage of the head and spine on heart rate variability in healthy volunteers.

OBJECTIVE: Ice massage (IM) is one of the treatment procedures used in hydrotherapy. Though its various physiological/therapeutic effects have been reported, effects of IM of the head and spine on heart rate variability (HRV) have not been studied. Thus, this study evaluated the effects of IM of the head and spine on HRV in healthy volunteers. METHODS: Thirty subjects were randomly divided into 3 sessions: (1) IM, (2) tap water massage (TWM) and (3) prone rest (PR). Heart rate (HR) and HRV were assessed before and after each intervention session. RESULTS: A significant increase in the mean of the intervals between adjacent QRS complexes or the instantaneous HR (RRI), square root of mean of sum of squares of differences between adjacent normal to normal (NN) intervals (RMSSD), number of interval differences of successive NN intervals greater than 50 milliseconds (NN50), proportion derived by dividing NN50 by total number of NN intervals along with significant reduction in HR after IM session; significant increase in RRI along with significant reduction in HR after TWM, and a significant increase only in RMSSD after PR were observed. However, there was no significant difference between the sessions. CONCLUSION: Results of this study suggest that 20 min of IM of the head and spine is effective in reducing HR and improving HRV through vagal dominance in healthy volunteers.

Effects of Various Pranayama on Cardiovascular and Autonomic Variables.

Cardiovascular functions are controlled by neural factors, temperature, hormones, etc., Of these, neural factors primarily concern the autonomic nervous system, which plays a major role in maintaining and regulating cardiac functions, e.g., blood pressure and heart rate. Pranayama is one of the most important yogic practices. There are various review articles on Yoga and its effects but, though Pranayama is a part of yoga, there is lack of review articles. To the best of our knowledge there is no known review article on effect of various Pranayama on cardiovascular and autonomic variables. To provide a general overview about the effect of various pranayama (breathing techniques) on cardiovascular and autonomic variables. A narrative review was performed based on the available scientific literature. An electronic data search was performed in Medline/PubMed database to review relevant articles, using keywords such as "Pranayama, Yogic breathing techniques, Unilateral nostril breathing, Alternate nostril breathing, Kapalbhati, Bhastrika and Bhramari Pranayama". All the relevant articles published from 1988 to 06-04-2016 were included in this review. Slow type of yogic breathing technique was reported to produce beneficial effect on cardiovascular and autonomic variables while fast breathing techniques do not produce such effects. There is lack of consistency in the results of specific nostril yogic breathing techniques and the mechanisms behind the effects of various pranayama. This review suggests that different types of Pranayama techniques produce different effects and the mechanisms behind these effects are not fully understood.