Role of Yoga and its possible mechanism behind the psychophysiological outcomes in elderly - A Randomized control trial

Abstract

BACKGROUND The ageing process is a biological reality which has its own dynamic progression, usually associated with degenerative changes, loss of role and functionality and an increasing prevalence for chronic non communicable diseases such as diabetes, heart disease, arthritis, cancer, dementia, Parkinson’s etc. Lifestyle approaches such as yoga would therefore mitigate disability and prevent NCD’s. This study aims to evaluate the effects of yoga in reducing stress and improving performance in elderly. AIMS AND OBJECTIVES Aim: To evaluate the effects on possible mechanism behind the integrated yoga practice on psychophysiological outcomes in elderly population. Objectives: To evaluate the effects of yoga on perceived stress, quality of life, sleep, mood, heart rate variability, spinal flexibility, muscle strength in elderly. METHODS Participants Elderly subjects willing to undergo yoga class for three months conducted by Divine Park Trust, Saligrama, Udupi and Kundapura. Subjects will be referred from both primary care physicians and bill board flyers inviting participants to enrol in a lifestyle program to improve their health. Design The proposed study design is a parallel, prospective, waitlisted, randomized controlled trial with 1:1 allocation ratio. Patients will be randomized into intervention arm and control arm. vii Assessments: Primary Outcomes: 1. Quality of Life using older people’s quality of life questionnaire 2. Changes in Heart rate variability Secondary Outcomes 1. Spinal flexibility assessed by Sit and Reach Test 2. Calf muscle strength assessed using and Back and leg dynamometer 3. Hand Grip strength assessed using Hand grip Dynamometer 4. Self-reported depression using Geriatric Depression Scale 5. Insomnia using Pittsburg Sleep Quality Index 6. Stress level using Perceived Stress Scale 7. Constipation using Patient Assessment of Constipation Quality of Life Intervention: The Yoga intervention comprises of Physical postures, Pranayama (controlled breathing), Meditation & Relaxation & will be given under the guidance of an institutionally certified Yoga therapist. The physical postures consist of preliminary stretching exercises followed by breathing practices and asana in four categories (standing, sitting, prone, and supine). RESULTS: Yoga group showed significant reduction (expressed as significance) in all the variables of frequency domain of heart rate variability, LF, HF and LF/HF (p<0.05). All the domains of quality of life were depicted to have a significant improvement in yoga group after a 12 week intervention when compared to control group. (p=0.001). viii Also, perceived stress, depression, spinal flexibility and calf muscle strength was improved in when compared with control group in both between and within group analysis (p=0.001). All the domains of sleep quality and constipation related Quality of life, Hand grip strength and VAS scores depicted an improvement in the yoga group (p<0.05). CONCLUSION: The improvement in the quality of life and autonomic function in elderly was mediated by reduction in stress and improvement in their physical and psychological well-being