Context and Aims: Migraine is an episodic disabling headache requiring long-term management. Migraine management through Yoga therapy would reduce the medication cost with positive health benefits. Yoga has shown to improve the quality of life, reduce the episode of headache and medication. The aim of the present study was to evaluate the efficacy of Yoga as an adjuvant therapy in migraine patients by assessing clinical outcome and autonomic functions tests. Subjects and Methods: Migraine patients were randomly given either conventional care (n = 30) or Yoga with conventional care (n = 30). Yoga group received Yoga practice session for 5 days a week for 6 weeks along with conventional care. Clinical assessment (frequency, intensity of headache and headache impact) and autonomic function test were done at baseline and at the end of the intervention. Results: Yoga with conventional care and convention care groups showed significant improvement in clinical variables, but it was better with Yoga therapy. Improvement in the vagal tone along with reduced sympathetic activity was observed in patients with migraine receiving Yoga as adjuvant therapy. Conclusions: Intervention showed significant clinical improvement in both groups. Headache frequency and intensity were reduced more in Yoga with conventional care than the conventional care group alone. Furthermore, Yoga therapy enhanced the vagal tone and decreased the sympathetic drive, hence improving the cardiac autonomic balance. Thus, Yoga therapy can be effectively incorporated as an adjuvant therapy in migraine patients.

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Context: Relationships between mind and body have gradually become accepted. Yogic practices cause modulation of the immune system. Transcendental meditation (TM) is a specific form of mantra meditation. We reported previously different plasma levels of catecholamines and pituitary hormones in TM practitioners comparing with a control group, and patterns of the daytime secretion of these hormones different from those normally described. Aims: The aim of the following study is to evaluate the immune system in these meditation practitioners, by determining leukocytes and lymphocytes subsets. Methods: TM group consisted of 19 subjects who regularly practice either TM or the more advanced Sidhi-TM technique. A control group consisted of 16 healthy subjects who had not previously used any relaxation technique. Total leukocytes, granulocytes, lymphocytes and monocytes were counted by an automated quantitative hematology analyzer, whereas lymphocytes subsets were determined by flow cytometry. Samples were taken from each subject at 0900 h after an overnight fast. Results: The results indicated that the TM group had higher values than the control group in CD3+CD4−CD8+ lymphocytes (P < 0.05), B lymphocytes (P < 0.01) and natural killer cells (P < 0.01), whereas CD3+CD4+CD8− lymphocytes showed low levels in meditation practitioners (P < 0.001). No significant differences were observed in total leukocytes, granulocytes, monocytes, total lymphocytes or CD3+ lymphocytes comparing both groups. Conclusions: The technique of meditation studied seems to have a significant effect on immune cells, manifesting in the different circulating levels of lymphocyte subsets analyzed. The significant effect of TM on the neuroendocrine axis and its relationship with the immune system may partly explain our results.

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Background / Aim: Yoga is an ancient Indian science as well as the way of life. Pranayama is a part of yoga, which improves pulmonary function in combination of many pranayama, but the aim of our study is to evaluate the effect of only Bhramari pranayama and OM chanting on pulmonary function in healthy individuals. Materials and Methods: A total of 82 subjects were randomized into the study group (SG) (n = 41) and control group (CG) (n = 41). Baseline assessment was performed before intervention for both groups. SG practiced Bhramari pranayama and OM chanting for the duration of 10 min (5 min for each practice)/day for the period of 6 days/week for 2 weeks and CG did not practice so. After intervention post-assessment was performed for SG (n = 40) and CG (n = 39). Statistical analysis was performed by Independent samples t-test and Student's paired t-test with the use of Statistical Package for the Social Sciences version 16 (2007, USA). Results: The result showed a significant improvement in peak expiratory flow (PEF), forced expiratory flow (FEF) _25% and maximal voluntary ventilation (MVV) along with a significant reduction in weight in SG compared with CG in independent samples t-test. Significant improvement in slow vital capacity (SVC), forced expired volume in 1 s (FEV ₁ ) along with PEF, FEF _25% and MVV; Significant reduction in weight and body mass index were observed in SG unlike in CG in Student's paired t-test. No significant changes were found in forced vital capacity, FEV ₁ /SVC and FEF _50% , between and within the group analysis of SG and CG. Conclusion: Bhramari pranayama and OM chanting are effective in improving pulmonary function in healthy individuals.

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Background: Trataka, a type of yoga practice is considered to improve cognitive functions. The aim of this study was to test the effect of trataka on cognitive functions of the elderly. Materials and Methods: Elderly subjects were recruited based on inclusion and exclusion criteria (n = 60) and randomly divided using randomized block design into two groups: Trataka and wait list control group. Trataka (a visual cleansing technique) was given for a period of 1 month (26 days). The subjects in both groups were assessed on day 1 (pre- and postintervention in trataka group and after quiet sitting in control group) and on day 30 on Digit Span Test, Six Letter Cancellation Test (SLCT), and Trail Making Test-B (TMT-B). Results: Friedman's test and Wilcoxon signed-rank test showed that at the 2 ^nd follow-up there was significant improvement in digit span scores (z = −3.35, P < 0.01) in the trataka group. SLCT scores (t = 5.08, P < 0.01) and TMT-B scores (t = −4.26, P < 0.01) improved immediately after the practice of trataka (when baseline compared to first follow-up). At 1 month follow-up, trataka group showed significantly better performance in the SLCT test compared to baseline (t = −3.93, P < 0.01) and TMT-B scores (t = 7.09, P < 0.01). Repeated measure analysis of variance (RM ANOVA) results also reiterated that there was significant interaction effect at the end of 1 month of trataka intervention as compared to control group on TMT-B and SLCT scores. Conclusions: The results of this study establish that Trataka can be used as a technique to enhance cognition in the elderly.

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Background: Studies have shown that Integrated Yoga reduces pain, disability, anxiety and depression and increases spinal flexibility and quality-of-life in chronic low back pain (CLBP) patients. Objective: The objective of this study was to compare the effect of two yoga practices namely laghu shankha prakshalana (LSP) kriya, a yogic colon cleansing technique and back pain specific asanas (Back pain special technique [BST]) on pain, disability, spinal flexibility and state anxiety in patients with CLBP. Materials and Methods: In this randomized control (self as control) study, 40 in-patients (25 were males, 15 were females) between 25 and 70 years (44.05 ± 13.27) with CLBP were randomly assigned to receive LSP or BST sessions. The measurements were taken immediately before and after each session of either of the practices (30 min) in the same participant. Randomization was used to decide the day of the session (3 ^rd or 5 ^th day after admission) to ensure random distribution of the hang over effect of the two practices. Statistical analysis was performed using the repeated measures analysis of variance. Results: Significant group * time interaction (P < 0.001) was observed in 11 point numerical rating scale, spinal flexibility (on Leighton type Goniometer) and (straight leg raise test in both legs), Oswestry Disability Index, State Anxiety (XI component of Spieldberger's state and trait anxiety inventory. There was significantly (P < 0.001, between groups) better reduction in LSP than BST group on all variables. No adverse effects were reported by any participant. Conclusion: Clearing the bowel by yoga based colon cleansing technique (LSP) is safe and offers immediate analgesic effect with reduced disability, anxiety and improved spinal flexibility in patients with CLBP.

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Introduction: This study planned to compare immediate cardiovascular effects of different yoga asanas in healthy young volunteers. Materials and Methods: Heart rate (HR), systolic pressure (SP), and diastolic pressure (DP), blood pressure (BP), were recorded using the non invasive blood pressure ( NIBP) apparatus in 22 healthy young subjects, before and after the performance of Dhanurasana (DA), Vakrasana (VA) (both sides), Janusirasasana (JSA) (both sides), Matsyasana and Shavasana for 30 s. HR and BP were further recorded during supine recovery at 2, 4, 6, 8, and 10 min. A repeated measure of ANOVA was used for statistical analysis. Results: There were significant changes in HR and BP both immediately after the Asanas as well as during the recovery period. Overall comparisons of ∆% changes immediately after the performance of the Asanas revealed significant differences with regard to HR that increased significantly after DA. In the recovery phase, there were significant intergroup differences from 2 min onward in both SP and DP. The decrease of SP after VA (right side) (VA-R) was significantly greater than Shavasana (4 ^th , 6 ^th , and 8 ^th min) and JSA (left side) (JSA-L) at 6 ^th and 8 ^th min. DP decreased significantly after performing JSA-L compared to VA-R at the 6 ^th and 8 ^th min. Discussion: The cardiovascular changes immediately after the Asanas and during the recovery phase reveal inherent differences between the selected postures. The rise of HR in DA may be attributed to increased sympathetic response due to the relative difficulty of the posture as well as abdominal compression occurring in it. The effect of supine relaxation is more pronounced after the performance of the Asanas as compared to mere relaxation in Shavasana. This may be attributed to a normalization and resultant homeostatic effect occurring due to a greater, healthier de-activation of the autonomic nervous system occurring towing to the presence of prior activation. There were also subtle differences between the right sided and left sided performance of VA and JSA that may be occurring due to the different internal structures being either compressed or relaxed on either side. Conclusion: Our study provides initial evidence of differential cardiovascular effects of Asanas and subtle differences between right and left sided performance. Further, cardiovascular recovery is greater after the performance of the Asanas as compared to shavasan; thus, implying a better response when effort precedes relaxation.

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Context: Response inhibition is a key executive control processes. An inability to inhibit inappropriate actions has been linked to a large range of neurologic and neuropsychiatric disorders. Aims: Examine the effect of Bhramari Pranayama (Bhpr) on response inhibition in healthy individuals. Settings and Design: Thirty-one male students age ranged from 19-31 years from a residential Yoga University, Bengaluru, India were recruited for this study. We used a randomized self as control within-subjects design. Participants were counterbalanced randomly into two different experimental conditions (Bhpr and deep breathing (DB)). Materials and Methods: Response inhibition has been measured using a standard tool Stop Signal Task (SST). Each session lasted for 50 min with 10 min for the experimental conditions, preceded and followed by 20 min of assessment. The primary outcome measure was stop signal reaction time (SSRT), an estimate of the subject's capacity for inhibiting prepotent motor responses. Additional measures of interest were the probability of responding on stop signal trials, P (r,s) and mean RT to go stimuli. Results: The mean probability of responding on stop signal trials (p (r,s)) during Bhpr and DB are close to 50%, indicating reliable SSRT. Paired sample t-tests showed a significant decrease (P = 0.024) in SSRT after Bhpr session, while the DB group did not show any significant change. Further, t-tests show that the go RT increased significantly after Bhpr (P = 0.007) and no other changes/differences were observed. Conclusions: Bhpr enhanced response inhibition and cognitive control in nonclinical participants.

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Background: A good body balance requires a proper function of vestibular, visual, and somatosensory systems which can be reach with exercise practice and/or yoga. Aim: To determine the effects of a 5-month hatha yoga training program on body balance in young adults. Materials and Methods: This study used a controlled, nonrandomized design, where the experimental group underwent a 5-month training program and were then compared with the control group that had a sedentary lifestyle. A convenience sample of 34 out of 40 men aged 25-55 years old (34.0 ± 0.9) were deemed eligible for this study. They were randomly divided into two groups: Experimental and control groups. Subjects in the experimental group were engaged in 60 min sessions of hatha yoga three times a week for 5 months. We evaluated postural control by measuring the limit of stability and velocity of oscillation (VOS) in three conditions of the balance rehabilitation unit (BRU) and through field procedures (four position, plane, flamingo, hopscotch, and dynamic test). Results: We observed differences (P < 0.05) in postintervention scores between the groups regardless of BRU parameters and field procedures (except for flamingo) even after adjusting for preintervention scores, suggesting that these changes were induced by hatha yoga training. The partial eta squared on BRU parameters ranged from 0.78 (VOS1)-0.97 (COP2), and from 0.00 (flamingo)-0.94 (four position) for the field procedures. Conclusions: Our results provide substantial evidence that postural control in healthy young adults can be improved through practicing hatha yoga.

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Context: Yoga-related injuries are of increasing concern as the use of yoga continues to rise. Aims: The aim of the following study is to examine whether a national sample of yoga practitioners would report discontinued use of yoga due to injury from the practice, assess what injuries resulted in discontinued use, determine what injuries were most common and identify injuries requiring medical attention. Methods: Secondary data analysis of a nationally representative sample of adults in the United States (n = 23,393). Results: Less than 1% of individuals who had ever practiced yoga (n = 2230) reported an injury from yoga that led to discontinued use. Of those reporting injury, less than one-third (n = 4) reported seeking medical attention. The most common side-effect was back pain. Approximately, half of those reporting back pain sought medical attention. Conclusions: Injury due to yoga is an infrequent barrier to continued practice and severe injury due to yoga is rare.

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Background: The Pulmonary Function Tests are important for measuring the fitness of an individual from a physiological point of view. Lung function parameters tend to have a relationship with lifestyle such as regular yoga, an ancient system of Indian Philosophy. Yoga is probably the best lifestyle ever devised in the history of mankind. Hence the present analytical study was undertaken to assess the effects of yoga on respiratory system when compared with sedentary subjects. Objective: To compare the pulmonary function test among the yogic and sedentary groups. Materials and Methods: The present study was conducted on 50 subjects practicing yoga and 50 sedentary subjects in the age group of 20-40 years. They were assessed for pulmonary function test in which sedentary group acted as controls. The tests which were recorded as per standard procedure using Medspiror as determinants of pulmonary function were FVC, FEV1, FEV3, PEFR and FVC/FEV1 ratio. Results: Pulmonary Functions were compared between the yoga practitioners and sedentary group. Yoga exercise significantly increased chest wall expansion as observed by higher values of pulmonary functions compared with sedentary controls. The study group were having higher mean of percentage value of FVC 109.1 ± 18.2%, FEV1 of 116.3 ± 15.9%, FEV3 of 105.7 ± 14.9 %, PEFR of 109.2 ± 21.3% and FEV1/FVC ratio of 111.3 ± 6.9% as compared to sedentary group. Conclusions: Regular Yoga practice increases the vital capacity, timed vital capacity, maximum voluntary ventilation, breath holding time and maximal inspiratory and expiratory pressures.

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Context: Mindfulness forms an important component of meditation practice and has been increasingly popular around the world. There has been growing interest in studying the mindful component of various meditation techniques. One of the various forms of mindfulness is the practice of a unique technique called cyclic mediation (CM). We aimed at ascertaining the level of mindfulness in experienced practitioners of CM using a Mindfulness Attention Awareness Scale (MAAS). Materials and Methods: MAAS was administered anonymously in a classroom setup and two of the project coordinators were present to supervise the administration and to assist the participants where necessary. We executed a cross sectional design. One hundred and thirty-three (n = 133) healthy male volunteers (66 meditators and 67 non-meditators) with ages ranging from 25 to 35 years participated in the study. Meditators had a minimum 3 years experience of meditation. Results: Data were analyzed using IBM SPSS 20. The data were checked for normality and an independent samples t-test was employed to compare the means of both the groups. MAAS scores were significantly higher in meditators as compared with the non-meditators (P < 0.001). We found a positive correlation (r = 0.620) between the years of meditation practice and the levels of trait mindfulness. Conclusions: CM can lead to development of higher levels of mindfulness and may have the ability to positively impact mental states and attention, thereby offering the potential for prevention of clinical levels of psychopathology and improving overall psychological well-being in healthy individuals.

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OA Knee is the most common arthritis. Knee replacement Surgeries are being done increasingly in the present times. This has led to the violation of the standard indications and when knees are replaced ignoring other co - musculoskeletal conditions it results in the surgery failing early. This is about a patient who encountered a failed TKR due to improper selection as patient had bilateral OA Hip that was ignored in the initial stages. To overcome the problem she was advised bilateral hip replacement which would leave her with four replacements in the lower limb. She refused surgery and was told there are no alternative treatment options. This patient underwent a 3 week integrated course of IAYT at our center and she made a remarkable recovery. IAYT is a good non-surgical treatment that can be affective both before and after knee replacement and it should be considered as the first choice of treatment before surgery.

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Context: The implicit association test (IAT), a new tool for yoga research is presented. Implicit measures could be used in those situations where (1) The construct is difficult to self-report, (2) there is a threat of social desirability. Clinically, we can assess cognitive dissonance by evaluating incongruence between implicit and explicit measures. Explicit preferences are self-reported. Implicit preferences are what we inherently believe, often without our conscious awareness. Aims: The primary objective of this study is to provide a bird's eye view of the field, implicit cognition, with emphasis on the IAT and the secondary objective is to illustrate through an example of our study to develop an implicit tool to assess implicit preference toward yoga. Settings and Design: A total of 5 independent samples of total 69 students undergoing short and long-term yoga courses in a Yoga University were assessed for their implicit and explicit preferences towards yoga. Materials and Methods: The yoga-IAT (Y-IAT), explicit self-rating scale was administered through computers using the Inquisit program by Millisecond Software. Experimental and scoring materials are provided. Statistical Analysis Used: Data were extracted using recommended scoring algorithm and descriptive statistics highlighting basic psychometric properties of Y-IAT are presented along with its congruence with explicit self-measure. Results: A moderate preference toward yoga was detected, with a lower implicit-explicit congruence, reflecting possible confound of social desirability in the self-report of preference toward yoga. Conclusions: Implicit measures may be used in the yoga field to assess constructs, which are difficult to self-report or may have social desirability threat. Y-IAT may be used to evaluate implicit preference toward yoga.

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