G.Yoga Theses PhD.
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Yoga Theses by Yoga PhD Students at SVYASA. These pages present some efforts at Scientific Validation of Yoga. You may receive full text of available yoga research papers
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Item EFFECT OF INTEGRATED YOGA IN NURSING PROFESSIONALS WITH CHRONIC LOW BACK PAIN – A RANDOMIZED CONTROL TRIAL(S-VYASA, 2018-11) PATIL, NEETINAKUMAR; Tekur, Padmini; Nagendra, H. R.; Monohar, P.V.Background: Chronic Low back pain (CLBP) adversely affects health-related quality of life in nursing professionals. Yoga has positive impact on LBP. Studies assessing the effects of Yoga on CLBP in nursing population are lacking. Aim: Present study is conducted to evaluate and compare the effect of integrated Yoga and physical exercises on pain, disability, psychological parameters and quality of life in nurses with CLBP. Methods: It is a prospective randomized control trail.88 female nursing professionals of age 33.77±3.44 years from a tertiary care hospital of South India were randomized in to yoga group (YG) (n=44; 31.45 ± 3.47 years) and control [exercise] group (CG) (n=44; 32.75 ± 3.71). YG was intervened with Integrated Yoga Therapy Module (IYTM) practices, one hour per day, five days week for six weeks. CG practiced a set of physical exercises for the same duration. All subjects were assessed using Numerical Rating Scale (NRS) for pain, Roland Morris Disability Questionnaire (RMDQ) for functional disability, Fear Avoidance Belief Questionnaire- physical (FABQpa), Fear Avoidance Belief Questionnaire - work (FABQw), State and Trait Anxiety Inventory (STAI), Beck’s Depression Inventory (BDI), and Perceived Stress Scale (PSS), Heart Rate Variability (HRV) [low frequency (LF), high frequency (HF), LF/HF ratio] and WHO quality of life questionnaire (WHOQOL-BREF) at baseline and end of six week intervention. Data were analyzed by paired samples t test and independent samples t test for within group and between group comparisons respectively by using SPSS version 22. Results: After six weeks of Yoga intervention, we found a significant decrease in NRS (p<0.001), RMDQ (p<0.001), FABQpa (p<0.001), FABQw (p<0.001), State Anxiety (p<0.001), Trait Anxiety (p<0.001), BDI (p<0.001), and PSS (p<0.001), LF/ HF ratio (p<0.001), WHOQOL-BREF [Physical (p<0.001), Psychological(p<0.001), Social(p<0.001)] but did not differ statistically for HF (p=0.24) and LF (p=0.103), environmental-QoL (p=0.078) variables compared to baseline in YG. After six weeks of physical exercise intervention, there was a significant decrease in NRS (p<0.001), RMDQ (p<0.001), FABQpa (p<0.001), FABQw (p<0.001), State Anxiety (p=0.031), BDI (p<0.001), and PSS (p<0.001), WHOQOL-BREF [Physical (p<0.001), Psychological(p<0.001), Social(p<0.001)] but did not differ statistically for Trait Anxiety (p=0.29), LF (p=0.513), HF (p=0.555) and LF/HF ratio (p=0.615), environmental- QoL (p=0.0957) variables compared to baseline in CG. On comparison between groups, YG showed a significant decrease in NRS (p<0.001), RMDQ (p<0.001), FABQpa (p<0.001), FABQw (p<0.001), State Anxiety (p<0.001), Trait Anxiety (p=0.025), BDI (p<0.001), and PSS (p<0.001), LF (p=0.01), LF/ HF ratio (p<0.001), WHOQOL-BREF [Physical (p<0.001), Psychological(p<0.001), Social(p<0.001)] but did not differ statistically for in HF (p=0.32) and environmental-QoL (p=0.25) variables compared to control group for post assessment. Conclusions: Integrated Yoga intervention was found to be more beneficial in improving pain, disability, anxiety, stress, fear avoidance, heart rate variability and quality of life among nursing professionals with chronic low back pain. There was a negative correlation between psychological parameters and quality of life at baseline.Item YOGA AND DIABETES: A MULTI-CENTRIC RESEARCH STUDY(SVYASA, 2021-01) Venkatrao, Muralidhar; Nagendra, H. R.; Nagarathna, RaghuramType 2 diabetes mellitus (T2DM) is a highly prevalent public health problem and a significant cause of morbidity and mortality in India. With over 77 million individuals diagnosed with T2DM, the burden of this disease is already huge. But there are two additional dimensions which make the potential public health burden of T2DM even greater: (a) studies indicate that about a third of the cases of diabetes remain undiagnosed and (b) the risk of progression from prediabetes to diabetes, and the pace of this progression, are both much higher among Indians as compared to other populations. Thus, there is urgent need to quantify the scale of the problem – that is, to get a robust estimate of the prevalence of diabetes – so that proper public policy can be shaped. Equally important is to implement preventative protocols for individuals at high-risk of progressing to diabetes. Aiming for prevention at prediabetes stage (which is the stage of increased diabetes risk) may be too late for the Indian population, given the much quicker progression to diabetes from this stage. It is more efficacious to aim preventative protocols at an earlier stage, before prediabetes. This points to the need for a simple, widely implementable, multi-variate risk score for identifying high-risk individuals, potentially even before the stage of prediabetes. The Indian Diabetes Risk Score (IDRS), which is widely used in India, needs to be validated at a nationwide level, and potentially improved to consider better measures of obesity. Once an individual is deemed to be in the high-risk category, there exist several preventative interventions including (but not limited to) Metformin therapy, increased physical activity, and dietary control. Another intervention is the ancient technique of Yoga. In ancient Yoga texts, repeated mention is made of the efficacy of Yogic practices to benefit diabetes risk factors such as reducing obesity, mitigating effects of chronic stress, fostering an active lifestyle and encouraging better dietary choices. This is especially the case with the practices of Haöha Yoga, including techniques that have made Yoga famous the world over: äsana (physical postures), ñaö-karma (purification practices), präìäyäma (breathing exercises), etc. A thorough examination of Haöha Yoga Pradépika reveals that these techniques reduce β cell dysfunction and increase insulin sensitivity via multiple pathways, thereby bringing about diabetes risk reduction and glycemic control. Existing scientific studies provide a preponderance of evidence to back the claims of Yogic texts. Specifically, we find studies reporting that (a) Yoga is effective in mitigating diabetes risk factors such as obesity and stress (b) Yoga effects glycemic control in individuals with diabetes and (c) the mind-body integrative aspect of Yoga fosters behavioral modifications that help one sustain better nutritional habits and a more active lifestyle. These findings hint strongly that a Yoga-based Lifestyle Protocol (YLP) can be a very effective adjunct to both prevention of diabetes and for glycemic control among individuals with diabetes. While YLP has been studied in smaller cohorts and/or in controlled circumstances where it is easier to ensure adherence to the protocol, it has not yet been studied in a large community setting to determine whether it has the necessary characteristics of simplicity, accessibility, and inexpensiveness so that it can be applied as a mitigation to a public health problem (diabetes risk reduction and glycemic control). AIMS AND OBJECTIVES The present study seeks to analyze data from Niyantrita Madhumeha Bharata Abhiyaan 2017 (Diabetes Free India Study 2017, hereinafter simply NMB-2017) to (a) improve the screening characteristics of the Indian Diabetes Risk Score (IDRS) by incorporating a better anthropometric measure of obesity, so that it can be used in the field to identify individuals who have a high risk of developing diabetes (b) test the potency of yoga-based lifestyle protocol (YLP) against diabetes risk reduction among high-risk individuals who are not yet in the prediabetes stage, in a large community setting and (c) test the efficacy of yoga as an adjunct to standard care for glycemic control among individuals with diabetes. METHODS PARTICIPANTS This study included three separate analyses: (a) Using a better measure of obesity to increase specificity of IDRS Using data from a nationwide randomized cluster sample survey (NMB-2017 Phase 2), 7496 adults at high risk for type 2 diabetes (as determined by IDRS ≥ 60) were analyzed. Waist Circumference (WC), Body Mass Index (BMI), and a composite obesity measure combining the two (BMIWC) were evaluated using Odds Ratio (OR), and Classification scores (Sensitivity, Specificity, and Accuracy). These were validated using Indian Diabetes Risk Score (IDRS) by replacing WC with BMI and BMIWC, and calculating Sensitivity, Specificity, and Accuracy. (b) YLP for diabetes risk reduction In a cluster randomized trial (NMB-2017 Phase 2) in 80 clusters from India, participants with normal HbA1c (< 5.7%) but screened for diabetes risk (IDRS ≥60) were randomly assigned in a 1:1 ratio to intervention and control groups, n=2316:2134, respectively. The primary outcome was conversion from normoglycemia to diabetes. Absolute and Relative risk reductions were estimated based on marginal probabilities. (c) YLP for glycemic control In a cluster randomized trial (NMB-2017 Phase 2) in 80 clusters from India, participants with prior diagnosis of diabetes and/or HbA1c levels in diabetes range (≥ 6.5%) were randomly assigned in a 1:1 ratio to intervention and control groups, n=1820:1572, respectively. Mean HbA1c reduction was calculated for each group, and independent samples t-test was used to test significance. Heterogeneity of treatment effects were calculated for subgroups with fair and poor glycemic control. DESIGN NMB-2017 was a pan-national, two-phased study. Phase 1 was a nationwide cross sectional survey using a multi-level stratified cluster sampling technique with random selection among urban and rural populations, with the objective of collecting data on diabetes status and diabetes risk. Phase 2 was a sub-sample of phase-1 participants who were deemed high-risk (as determined by IDRS ≥ 60) or had a previous diagnosis of diabetes. Phase 2 participants went through further assessments in the form of blood tests and more detailed questionnaire. ASSESSMENTS i. Anthropometric measures (ordinal): Height (in cm), Weight (in kg), and Waist Circumference (in cm) ii. Derived measures (ordinal): BMI [Weight(in kg)/Height(in m)2 ] iii. Blood HbA1c levels (in DCCT %) (Ordinal) iv. Via questionnaire (Categorical): Age, Family history of Diabetes, and levels of physical activity. Note: The questionnaire collected more information than detailed here (see Appendix 5), but they were not used in this analysis. INTERVENTION Intervention included practice of yoga-based lifestyle modification protocol (YLP) for 9 consecutive days, followed by daily home and weekly supervised practices for 3 months. In the diabetes risk reduction study, the control-cluster received standard of care advice for diabetes prevention. In the glycemic control study, the control-cluster received standard care for T2DM. RESULTS Study 1 BMIWC had higher OR (2·300) compared to WC (1·87) and BMI (2·26). WC, BMI, and BMIWC were all highly Sensitive (0·75, 0·81, 0·70 resp.). But BMIWC had significantly higher Specificity (0.36) when compared to WC and BMI (0.27 each). IDRSWC, IDRSBMI, and IDRSBMIWC were all highly Sensitive (0·87, 0·88, 0·82 resp.). But IDRSBMIWC had significantly higher Specificity (0·39) compared to IDRSWC and IDRSBMI (0·30, 0·31 resp.). Study 2 Among individuals at high risk for diabetes (as determined by IDRS ≥ 60) but with normal glycemic levels at baseline, the YLP was found to be significantly effective in halting progression to diabetes as compared to standard of care (RRR 68.64%, 95% CI 64.73 – 73.48). Study 3 Among individuals with diabetes, YLP showed a significantly greater reduction in HbA1c levels (µ=1.31, σ=1.40) compared to control arm (µ=0.45, σ=0.55); t(∞) = 22.68, p < 0.001. This effect was even more pronounced in individuals with poor glycemic control at baseline, with the difference in mean reduction of HbA1c levels between yoga and control being significantly higher (µ=1.61, σ=1.29) compared to individuals with fair glycemic control at baseline (µ=0.35, σ=0.83); t(∞) = 15.73, p < 0.001. COLCULSIONS Both WC and BMI are good predictors of risk for T2DM, but BMIWC is a better predictor, with higher Specificity; this may indicate that Indians with high values of both central (high WC)and general (BMI> 23) obesity carry higher risk for type 2 diabetes than either one in isolation. Using BMIWC in IDRS improves its performance on Accuracy and Specificity. Substantive influence of yoga-based lifestyle intervention was observed against diabetes risk reduction on the high-risk Indian cohort. Among individuals with diabetes, YLP reduced glycemic levels, with the effect being more significant in people who had poor glycemic control to begin with. This might indicate that YLP can be very valuable clinically as an adjunct to standard treatment for individuals whose serum glucose levels are not responsive to standard care. Overall, our findings point to the efficacy of YLP as an effective strategy to combat the epidemic of diabetes from both preventative and treatment perspectives.Item Empirical evidence for increased creative cognition and associated EEG Synchrony following experience of self during low default mode network activity in youth(S-VYASA, 2018) Shetkar, Reshma M.; Hankey, Alex; Nagendra, H. R.Background: Western science divides the creative process into four stages: preparation, incubation, illumination and verification. The scientific study of creativity now focuses on brain function studying how different brain regions are involved, suggesting that process depends on coordinated use of the frontal, parietal and temporal lobes of the brain. Brain studies indicate that EEG coherence is a bio-marker signature, suggesting that creativity involves increased integration between different brain regions. Traditional Indian approaches to understanding creativity are based on expanded states of mind described in Vedic literature. They suggest that ‘expansion of mind’ is the key step, achieved by practice of deep meditations. The disparity between the two approaches western and eastern, suggests that considering both together may bring deeper insights. Deep meditation is known to bring illumination, which is important. Brain mechanisms suggest themselves as illumination correlates with brain coherence and synchrony. Eastern wisdom may help resolve problems in the scientific approach. Eastern Literature: Certain Upaniñat, Çikñä, Yoga, and Alaìkära Çästra contain insights into the nature of creativity. The Upaniñat have deep implications for workings of the mind. Çikñä identifies four levels of speech: transcendental, ideas, linguistic thoughts, and speech. Ideas form the basis for cognition. Yoga brings access to the deepest level of consciousness Samädhi, the ‘blank’ state of mind held to be necessary for incubation; and Åtambharä Prajïä, the state where creativity arises. The works of Vyasa, Kälidäsa, and Saint Jïäneçvara, all experts in Alaìkära Çästra, offer examples of profound processes of cognition and creativity. The Upaniñat offer insights and patterns of thought that guide disciples of Masters to their own realization of illumination, and abilities to help solve humanity’s problems.Item Yoga for working memory in adolescents(S-VYASA, 2015) Babu, Natesh; Nagendra, H. R.The current education system’s focus has been on logical and scientific thinking right from the primary level. During this process, the vital part of education: detachment has been ignored. Concentration and detachment are the key processes of education for the comprehensive development of personality in the teenagers as per Swami Vivekananda. Yoga, an ancient science, in its original form consists of diverse practices, such as physical postures (äsanas), regulated breathing (präëayäma), meditation, understanding the spiritual basis of life and ethical practices. Recent studies have shown Yoga based add-on programs in Modern education, enhance psychological well-being. LITERARY RESEARCH In this chapter of literary research, attempts were made to understand prajïa (awareness), from ancient Indian scriptures. This chapter elucidates the role of prajïa in development of mind and its different aspects (antaùkaraëa), and removal of impurities (småtimala) leading to a state of mastery over the mind (sthithaprajïa sthithi). Relevant slokas are presented text-wise, and a coherent discussion has provided for the same. Finally, with the theoretical model which depicts the whole concept to understand the process of the cognitive refinement was summarized. REVIEW OF SCIENTIFIC LITERATURE Review of scientific literature enumerates working memory, yoga, mindfulness and its relevance to adolescents. Evidence shows that working memory skills are closely linked to performance on scholastic tests. Further working memory is highly predictive measures of literacy, mathematics, and language comprehension. Yoga has been found to be beneficial for even mentally challenged and healthy adolescents on cognitive function. Cyclic Meditation (CM) is a unique practice which incorporates mind and body movements, along with awareness is a potential for prevention of clinical levels of psychopathology and improving overall psychological well-being in healthy individuals. Further mindfulness-based intervention has shown significant enhancement of mental health and well-being. More research is needed to understand the influence of yoga practices on the working memory in adolescents. Further to our knowledge outshoot of a yoga-based intervention, the mindfulness has not explored over working memory. AIM The primary aim was to explore the efficacy of yoga on working memory among adolescents. OBJECTIVES 1. To establish normative data for working memory task in Indian adolescents. 2. To explore the relationship between yoga related psychological states and working memory in healthy adolescents. 3. To evaluate the effect of intense yoga based personality development program on psychological domains and working memory in healthy adolescents. 4. To examine the immediate outcome of cyclic meditation on working memory and state anxiety in healthy adolescents.Item Use of integrated approach of yoga therapy and ayurveda in the management of migraine headache(S-VYASA, 2019) Sharma, Vasudha M.; Nagendra, H. R.Background: There is a rise in the need for Complementary and Integrative medicine to provide long-term healing solutions in non-communicable diseases in general and Migraine Headache in particular. Knowing the limitations of conventional medical approach, the present study therefore evaluated the influence of the two Indian traditional systems of medicine, i.e., Ayurveda and Yoga as an integrative medical intervention. Changes following the use of Ayurveda and Yoga therapy were studied on symptoms, migraine-related disability, perceived stress, autonomic variables, muscle activity and quality of life in patients with migraine headache without aura. Aims and Objective: • To compile and understand the concept of migraine headache according to Ayurveda and Yoga texts. • To scientifically validate the use of Ayurveda and Yoga in the management of migraine headache without aura. Methodology: This study was a Prospective, Open labelled, matched control trial comparing an Ayurveda- Yoga group (AY) with a Control group (CT) on symptomatic conventional treatment. 30 subjects who were recruited to Ayurveda and Yoga (AY) group underwent traditional Pañcakarma (Bio-purification) using Virecana (therapeutic purgation) followed by Yoga therapy, while 30 subjects matched for age and gender belonging to the Control (CT) group continued on symptomatic treatment (NSAID's) for 90 days. The subjects of both groups were administered the Suśruta Prakṛti Inventory on day 1 to understand individual body constitution. A Comprehensive Headache-related Quality of life Questionnaire (CHQQ) and Visual analogue scale (VAS) were administered on day 1 and day 90 of the study. The symptom checklist, migraine disability assessment score, perceived stress, heart rate variability and surface electromyography of Frontalis muscle were measured on Day 1, Day 30 and Day 90 in both groups. Data were analysed using Repeated Measures of ANOVA followed by a post-hoc analysis with Bonferroni correction. Results: Out of the 60 subjects belonging to both groups, 46 (76.6%) had Pitta based Prakṛti either as pravara (primary) or as madhyama (secondary)). Following 90 days of intervention the AY group showed significant reduction in the migraine related symptoms viz., number of attacks, duration of each attack, associated with nausea and vomiting, severity of headache and analgesic requirements. The pain intensity reduced significantly (p<.001). There was a significant reduction in migraine disability and perceived stress scores were seen in AY group (P<.001). The low-frequency component of the heart rate variability decreased significantly, the high-frequency component increased and their ratio showed improved sympatho-vagal balance. The root mean square of the electromyography signal and integral electromyography of the frontalis muscle decreased in the AY group compared to the control group. There was a significant improvement in the total score of headache related Quality of Life (p<.001). Conclusion: An Integrated Yoga therapy and Ayurveda based intervention reduces symptoms, intensity of pain, migraine related disability and perceived stress. It also reduces the sympathetic arousal and muscle tension therefore improving the quality of life in migraine patients.Item FIELD REG STUDIES IN MYSORE DASARĀ AND SOMAYAJÑA EVENTS(S-VYASA, 2017-10) Divya, B. R.; Nagendra, H. R.The existence of the psychokinetic potential of the human consciousness through the interactions between the man and the physical systems has explored the ability of the mind to collapse the randomness of a physical system. Performance of sacrificial rituals is harmonious to all living beings of the Cosmos. The life process governed by proper combination of Agni and Soma is very well demonstrated in our Vedic Rituals such as Yāga/Homa. Chanting of mantras, ingredients, and rituals involved in Yāga have already proved the positive impact of performing Yāga on human beings, animal and plant life through many studies. The use of Soma establishes a link between the consciousness and the processes of creation. It`s ceremonies with specific herbal mixtures act medicinally on the body and psycho actively on the mind directly effecting the ontological status of a person. Yajñas and Cultural programs are a participatory act thru which human beings create and maintain their existence in the world. Harmonious company with similar focused attention are motivation towards togetherness and mutual support creating Collective Consciousness Fields.Item BENEFITS OF YOGA EDUCATION IN HIGH SCHOOL CURRICULUM FOR ANGER MANAGEMENT; A RANDOMIZED CONTROL STUDY(S-VYASA, 2017-12) T. L., Alaka mani; Nagendra, H. R.; Omkar, S. N.; Sharma, Manoj KumarIntroduction: Adolescent anger is one of the key contributors of adolescent mortality and many negative developmental outcomes. Research studies indicate, escalated anger issues in schools and colleges across the globe including India. Anger being multidimensional construct, assessment of anger and its management remains a significant challenge. Despite a number of studies done on anger, it is still an emotion that is very much misunderstood. While, the available adolescent anger theories and inventories provide considerable direction towards the way forward, they lack clarity in terms of providing a comprehensive approach in assessment and management of anger. Considering negative developmental outcomes and the far reaching consequences of adolescent anger, there is a growing consensus among researchers, educators and health professionals to develop effective school based anger management programs. Indian Classical texts, mainly Vedic science provides immense conceptual resources to understand the concept of anger and its dynamics. There is an increasing trend of adopting spiritual concepts and practices for promoting mental health. Yogic Science having its strong roots in spirituality as well as evidence based approaches acceptable to modern science will be able to provide holistic approach to anger assessment and anger management.