Yoga as therapy
Yoga as therapy is the use of yoga as exercise, consisting mainly of postures called asanas, as a gentle form of exercise and relaxation applied specifically with the intention of improving health. This form of yoga is widely practised in classes, and may involve meditation, imagery, breath work (pranayama) and calming music as well as postural yoga.[1]
At least three types of health claims have been made for yoga:
Systematic reviews have found beneficial effects of yoga on low back pain[2] and depression,[3] but despite much investigation, little or no evidence of benefit for specific medical conditions.[3][4] The study of trauma-sensitive yoga has been hampered by weak methodology.[5]
Context
The number of
Types of claims
At least three different types of claims of therapeutic benefit have been made for yoga from medieval times onwards, not counting the more general claims of good health made throughout this period: magical powers, biomedical claims for marketing purposes, and specific medical claims. Neither of the first two are supported by reliable evidence. The medical claims are supported by evidence of varying quality, from case studies to controlled trials and ultimately systematic review of multiple trials.[10][11]
Magical powers
Medieval authors asserted that
Biomedical claims for marketing purposes
Twentieth century advocates of some schools of yoga, such as B. K. S. Iyengar, have for various reasons made claims for the effects of yoga on specific organs, without citing any evidence. The yoga scholar Suzanne Newcombe argues that this was one of several visions of yoga as in some sense therapeutic, ranging from medical to a more popular offer of health and well-being.[15] The yoga scholar
...tone up the muscular, nervous and circulatory systems of the entire body. The spine receives a rich supply of blood, which increases the nervous energy in the chakras (the various nerve plexuses situated in the spine), the flywheels in the human body machine. These poses develop the chest and make the breathing fuller and the body firmer; they stop nervous trembling of the body and prevent the diseases which cause it; they also help to eliminate toxins by supplying pure blood to every part of the body and bringing the congested blood back to the heart and lungs for purification.[18]
The history of such claims was reviewed by
Types of activity
Remedial yoga
The
The history of remedial yoga goes back to the pioneers of modern yoga,
Newcombe argues that in Britain, yoga "largely avoided overt conflict with the medical profession by simultaneously
Sports medicine
From the point of view of
Research
Methodology
Much of the research on the therapeutic use of yoga has been in the form of preliminary studies or clinical trials of low methodological quality, including small sample sizes, inadequate control and blinding, lack of randomization, and high risk of bias.[34][4] Further research is needed to quantify the benefits and to clarify the mechanisms involved.[35]
For example, a 2010 literature review on the use of yoga for depression stated, "although the results from these trials are encouraging, they should be viewed as very preliminary because the trials, as a group, suffered from substantial methodological limitations."[4] A 2015 systematic review on the effect of yoga on mood and the brain recommended that future clinical trials should apply more methodological rigour.[3]
Mechanisms
The practice of asanas has been claimed to improve flexibility, strength, and balance; to alleviate stress and anxiety, and to reduce the symptoms of
Low back pain
Back pain is one reason people take up yoga, and since at least the 1960s some practitioners have claimed that it relieved their symptoms.[38]
A 2013 systematic review on the use of yoga for low back pain found strong evidence for short- and long-term effects on pain, and moderate evidence for long-term benefit in back-specific disability, with no serious adverse events. Ten randomised controlled trials were analysed, of which eight had a low risk of bias. The outcomes measured included improvements in "pain, back-specific disability, generic disability, health-related quality of life, and global improvement".[2] The review stated that yoga can be recommended as an additional therapy to chronic low back pain patients.[2] A 2022 Cochrane systematic review of yoga for chronic non-specific low back pain included 21 randomised controlled trials and found that yoga produced clinically unimportant improvements in pain and back-specific function. Improvements in back-specific function were similar to those obtained from other forms of therapeutic exercise, such as physical therapy.[39]
Mental disorders
Trauma-sensitive yoga has been developed by David Emerson and others of the Trauma Center at the Justice Resource Institute in Brookline, Massachusetts. The center uses yoga alongside other treatments to support recovery from traumatic episodes and to enable healing from post-traumatic stress disorder (PTSD). Workers including Bessel van der Kolk and Richard Miller have studied how clients can "regain comfort in their bodies, counteract rumination, and improve self-regulation through yoga."[40][41]
Systematic reviews indicate that yoga offers moderate benefit in the treatment of PTSD.[42][43][44] A 2017 systematic review of PTSD in post-9/11 veterans showed that participants in studies who had received mindfulness training, mind-body therapy, and yoga "reported significant improvements in PTSD symptoms".[45] Another systematic review on veterans the same year also found improvement in PTSD symptoms.[46] Other systematic reviews postulate that designing the style and instructions to the needs of the veterans leads to better results and a larger impact on PTSD symptoms.[47]
A 2013 systematic review on the use of yoga for
Cardiovascular health
A 2012 survey of yoga in Australia notes that there is "good evidence"
Other conditions
There is little reliable evidence that yoga is beneficial for specific medical conditions, and an increasing amount of evidence that it is not.
Condition | Study | Date | Findings |
---|---|---|---|
rheumatic diseases | Systematic review | 2013 | Weak support in terms of pain and disability, no evidence on safety[51] |
epilepsy or menopause-related symptoms | Systematic review | 2015 | No evidence of benefit[52][53] |
Cancer | American Cancer Society's opinion | 2019 | Can improve strength and balance; is "unlikely to cause harm", does not "interfere with cancer treatment"; randomised controlled trial of women who had had breast cancer. Measured outcomes included fatigue, depression, and sleep quality.[55][56]
|
Dementia | Systematic review | 2015 | "Promising" evidence that exercise helps with activities of daily living; no evidence of benefit to cognition, neuropsychiatric symptoms, or depression; yoga was not distinguished from other forms of exercise.[57] |
Attention deficit hyperactivity disorder | Systematic review | 2010 | No effect, measured by teacher rating on the ADHD overall scale.[34] |
Female urinary incompetence | Systematic review | 2019 | Insufficient evidence[58] |
Safety
Although relatively safe, yoga is not a risk-free form of exercise. Sensible precautions can usefully be taken, such as avoiding advanced moves by beginners, not combining practice with psychoactive drug use, and avoiding competitiveness.[59]
A small percentage of yoga practitioners each year suffer physical injuries analogous to
See also
- Exercise is Medicine
- Neurobiological effects of physical exercise
- Yoga foot drop
References
- ^ Feuerstein, Georg (2006). "Yogic Meditation". In Jonathan Shear (ed.). The Experience of Meditation. St. Paul, Minnesota: Paragon House. p. 90.
While not every branch or school of yoga includes meditation in its technical repertoire, most do.
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- ^ a b c Anon (13 November 2012). "What's Your Style? Explore the Types of Yoga". Yoga Journal.
- ^ Forbes, Bo. "Yoga Therapy in Practice: Using Integrative Yoga Therapeutics in the Treatment of Comorbid Anxiety and Depression". International Journal of Yoga. 2008: 87.
- ^ Singleton 2010, p. 4.
- ^ a b c Beirne, Geraldine (10 January 2014). "Yoga: a beginner's guide to the different styles". The Guardian. Retrieved 1 February 2019.
- ^ a b Mallinson & Singleton 2017, p. 108.
- ^ a b c Broad 2012, pp. 39 and whole book.
- ^ Mallinson & Singleton 2017, pp. 108–111.
- ^ Mallinson & Singleton 2017, pp. 359–361.
- ^ Mallinson & Singleton 2017, pp. 385–387.
- ^ Newcombe 2019, pp. 203–227, Chapter "Yoga as Therapy".
- ^ a b c d Jain 2015, pp. 82–83.
- ^ Gourley, Bernie (1 June 2014). "Book Review: Light on Yoga by BKS Iyengar". The !n(tro)verted yogi. Retrieved 20 November 2018.
- ^ a b Iyengar 1979, p. 302, and whole book.
- ^ "Contemporary Definitions of Yoga Therapy". International Association of Yoga Therapists. Retrieved 10 December 2021.
- ^ a b Newcombe 2019, p. 215.
- ^ Goldberg 2016.
- ^ Newcombe 2019, p. 216.
- ^ Newcombe 2019, p. 217.
- ^ Newcombe 2019, p. 221.
- ^ Mehta, Mehta & Mehta 1990, pp. 185–187.
- ^ Newcombe 2019, p. 219.
- ^ Newcombe 2019, p. 206.
- ^ Newcombe 2019, p. 189.
- ^ Newcombe 2019, p. 209.
- ^ Newcombe 2019, p. 211.
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- ^ "The Truth About Alternative Medical Treatments". American Cancer Society. 30 January 2019. Retrieved 4 September 2019.
- ^ a b "Say Yes to Yoga". American Cancer Society. 23 August 2018. Retrieved 4 September 2019.
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Sources
- ISBN 978-1-4516-4142-4.
- Goldberg, Elliott (2016). OCLC 926062252.
- ISBN 978-1855381667.
- OCLC 878953765.
- OCLC 928480104.
- Mehta, Silva; Mehta, Mira; Mehta, Shyam (1990). Yoga the Iyengar Way: The new definitive guide to the most practised form of yoga. ISBN 978-0863184208.
- ISBN 978-1-78179-661-0.
- OCLC 318191988.
External links
- International Association of Yoga Therapists
- Vox: I read more than 50 scientific studies about yoga. Here's what I learned by Julia Belluz