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2.  A selective review of dharana and dhyana in healthy participants 
Attention is an important part of the process of meditation. Traditional Yoga texts describe two stages of meditation which follow each other in sequence. These are meditative focusing (dharana in Sanskrit) and effortless meditation (dhyana in Sanskrit). This review evaluated eight experimental studies conducted on participants in normal health, who practiced dharana and dhyana. The studies included evaluation of autonomic and respiratory variables, eLORETA and sLORETA assessments of the EEG, evoked potentials, functional magnetic resonance imaging, cancellation task performance and emotional intelligence. The studies differed in their sample size, design and the method of practicing dharana and dhyana. These factors have been detailed. The results revealed differences between dharana and dhyana, which would have been missed if the two stages of meditation had not been studied separately.
doi:10.1016/j.jaim.2016.09.004
PMCID: PMC5192286  PMID: 27889426
Meditation; Yoga texts; Dharana–dhyana; Electrophysiology; Neuroimaging
3.  A Randomized Controlled Trial to Assess Pain and Magnetic Resonance Imaging-Based (MRI-Based) Structural Spine Changes in Low Back Pain Patients After Yoga Practice 
Background
The present study aimed at determining whether 12 weeks of yoga practice in patients with chronic LBP and MRI-based degenerative changes would result in differences in: (i) self-reported pain, anxiety, and spinal flexibility; and (ii) the structure of the discs or vertebrae.
Material/Methods
Sixty-two persons with MRI-proven degenerative intervertebral discs (group mean ±S.D., 36.2±6.4 years; 30 females) were randomly assigned to yoga and control groups. However, testing was conducted on only 40 subjects, so only their data are included in this study. The assessments were: self-reported pain, state anxiety, spinal flexibility, and MRI of the lumbosacral spine, performed using a 1.5 Tesla system with a spinal surface column. The yoga group was taught light exercises, physical postures, breathing techniques, and yoga relaxation techniques for 1 hour daily for 3 months. No intervention was given to the control group except for routine medical care. A repeated-measures analysis of variance (ANOVA) with post hoc analyses (which was Bonferroni-adjusted) was used. The Ethics Committee of Patanjali Research Foundation had approved the study which had been registered in the Clinical Trials Registry of India (CTRI/2012/11/003094).
Results
The yoga group showed a significant reduction in self-reported pain and state anxiety in a before/after comparison at 12 weeks. A few patients in both groups showed changes in the discs and vertebrae at post-intervention assessment.
Conclusions
Within 12 weeks, yoga practice reduced pain and state anxiety but did not alter MRI-proven changes in the intervertebral discs and in the vertebrae.
doi:10.12659/MSM.896599
PMCID: PMC5031167
Anxiety; Low Back Pain; Magnetic Resonance Imaging; Yoga
4.  Heart rate variability in chronic low back pain patients randomized to yoga or standard care 
Background
Chronic pain can alter the autonomic balance with increased sympathetic activity reflected in altered heart rate variability (HRV). It has been proposed that yoga can be useful to correct the autonomic imbalance in patients with chronic pain who have reduced HRV.
Methods and designs
In the present randomized controlled trial 62 patients with chronic low back pain associated with altered alignment of intervertebral discs (aged between 20 and 45 years, 32 males) were randomized to 2 groups. One group received yoga for 3 months while the other group carried out standard medical care based on the physician's advice. The duration was the same, i.e., 3 months. The heart rate variability and rate of respiration were assessed at baseline and at the end of 3 months.
Results
There was a significant difference in the baseline (pre) values between groups (p = 0.008) for respiration rate which was higher in the yoga group. The changes reported below are pre-post comparisons within each group. The yoga group showed a significant (p < 0.05; repeated measures ANOVA, post-hoc analyses) decrease in the LF power of HRV, rate of respiration and a significant increase in the HF power of HRV and in the pNN50.
Conclusion
The results suggest that yoga practice can shift the autonomic balance towards vagal dominance in patients with chronic low back pain associated with altered alignment of intervertebral discs.
Trial registration
The study is registered with the Clinical Trials Registry of India (CTRI/2012/11/003094) and can be accessed at.
doi:10.1186/s12906-016-1271-1
PMCID: PMC4982400  PMID: 27514611
Heart rate variability; Rate of respiration; Yoga; Standard care; Chronic low back pain
5.  A Functional Near-Infrared Spectroscopy Study of High-Frequency Yoga Breathing Compared to Breath Awareness 
Background
High-frequency yoga breathing (breath rate of 2.0 Hz) has been associated with changes in oxy-hemoglobin in the prefrontal region of the brain. The present study assessed the effects of high-frequency yoga breathing (HFYB) at 1.0 Hz on frontal oxy-hemoglobin (oxy-Hb) and deoxy-hemoglobin (deoxy-Hb).
Material/Methods
Forty healthy male participants were recruited for the study. The experimental group consisted of 20 participants 23–40 years old (group mean ±S.D., 26.4±4.7 years) with at least 3 months of experience performing HFYB (group mean ±S.D., 16.3±9.8 months). The control group consisted of 20 participants ages 23–38 years (group mean age ± S.D., 27.4±4.1 years), who were seated quietly for the same duration and their average experience of yoga practice was (±S.D.) 4.3±2.7 months. Each participant in the experimental group was assessed at 2 sessions (HFYB and breath awareness [BAW]) on alternate days. Hemodynamic changes were assessed using a functional near-infrared spectroscopy sensor placed over the forehead. Data were analyzed using repeated-measures analyses of variance followed by post hoc Bonferroni adjustment.
Results
A significant reduction was observed in oxy-Hb during and after HFYB on the left and right sides compared to values before. We also found a significant reduction in deoxy-Hb during and after the quiet sitting control session compared to pre-session values on left and right sides.
Conclusions
The decrease in oxy-Hb during and after HFYB suggests that there was no frontal activation during HFYB when practiced at the rate of 1.0 Hz.
doi:10.12659/MSMBR.899516
PMCID: PMC4946388  PMID: 27351626
Cerebral Arteries; fNIRs; Hemodynamics; Meditation; Yoga
6.  School-based Yoga Programs in the United States: A Survey 
Advances in mind-body medicine  2015;29(4):18-26.
Context
Substantial interest has begun to emerge around the implementation of yoga interventions in schools. Researchers have found that yoga practices may enhance skills such as self-regulation and prosocial behavior, and lead to improvements in students’ performance. These researchers, therefore, have proposed that contemplative practices have the potential to play a crucial role in enhancing the quality of US public education.
Objective
The purpose of the present study was to provide a summary and comparison of school-based yoga programs in the United States.
Design
Online, listserv, and database searches were conducted to identify programs, and information was collected regarding each program’s scope of work, curriculum characteristics, teacher-certification and training requirements, implementation models, modes of operation, and geographical regions.
Setting
The online, listserv, and database searches took place in Boston, MA, USA, and New Haven, CT, USA.
Results
Thirty-six programs were identified that offer yoga in more than 940 schools across the United States, and more than 5400 instructors have been trained by these programs to offer yoga in educational settings. Despite some variability in the exact mode of implementation, training requirements, locations served, and grades covered, the majority of the programs share a common goal of teaching 4 basic elements of yoga: (1) physical postures, (2) breathing exercises, (3) relaxation techniques, and (4) mindfulness and meditation practices. The programs also teach a variety of additional educational, social-emotional, and didactic techniques to enhance students’ mental and physical health and behavior.
Conclusions
The fact that the present study was able to find a relatively large number of formal, school-based yoga programs currently being implemented in the United States suggests that the programs may be acceptable and feasible to implement. The results also suggest that the popularity of school-based yoga programs may continue to grow.
PMCID: PMC4831047  PMID: 26535474
7.  Metabolic and Ventilatory Changes During and After High-Frequency Yoga Breathing 
Background
Practicing high-frequency yoga breathing (HFYB) induced a hypermetabolic state in a single subject during the practice but the effect has not been studied in multiple practitioners.
Material/Methods
Healthy male volunteers (n=47, group mean age ±S.D., 23.2±4.1 years) were recruited as an experimental group and another twenty volunteers were recruited as a control group. The experimental group practiced either HFYB (Breath rate 1.0 Hz) or breath awareness (BAW) on two separate days. The sequence was reversed for alternate participants. The control group was assessed under similar conditions while sitting at ease. The breath rate (RR), tidal volume (VT), ventilation (VE), VO2, VCO2, arterial PCO2 and energy expenditure (EE Kcal/day) were assessed for 35 minutes using an open circuit oxygen consumption analyzer. The assessment period was divided into before, during and after conditions. Repeated measures analyses of variance (ANOVA) were used to compare data recorded during and after the two practices with data recorded before. Before-After comparisons in the control group were with paired t-tests.
Results
The most relevant significant changes were increases in VE, VO2, VCO2 and EE during HFYB, while the same variables decreased during the control period. However after HFYB there was no change in VO2 or EE, although VE decreased as it did after the control period.
Conclusions
HFYB induces a hypermetabolic state for the duration of the practice which returns to baseline after HFYB suggesting a possible application for HFYB in hypometabolic states.
doi:10.12659/MSMBR.894945
PMCID: PMC4547545  PMID: 26270968
High-Frequency Ventilation; Metabolism; Oxygen Consumption; Respiration; Ventilation; Yoga
8.  Physiological Effects of Mind and Body Practices 
BioMed Research International  2015;2015:983086.
doi:10.1155/2015/983086
PMCID: PMC4478368  PMID: 26171397
9.  Neurophysiological Effects of Meditation Based on Evoked and Event Related Potential Recordings 
BioMed Research International  2015;2015:406261.
Evoked potentials (EPs) are a relatively noninvasive method to assess the integrity of sensory pathways. As the neural generators for most of the components are relatively well worked out, EPs have been used to understand the changes occurring during meditation. Event-related potentials (ERPs) yield useful information about the response to tasks, usually assessing attention. A brief review of the literature yielded eleven studies on EPs and seventeen on ERPs from 1978 to 2014. The EP studies covered short, mid, and long latency EPs, using both auditory and visual modalities. ERP studies reported the effects of meditation on tasks such as the auditory oddball paradigm, the attentional blink task, mismatched negativity, and affective picture viewing among others. Both EP and ERPs were recorded in several meditations detailed in the review. Maximum changes occurred in mid latency (auditory) EPs suggesting that maximum changes occur in the corresponding neural generators in the thalamus, thalamic radiations, and primary auditory cortical areas. ERP studies showed meditation can increase attention and enhance efficiency of brain resource allocation with greater emotional control.
doi:10.1155/2015/406261
PMCID: PMC4475567  PMID: 26137479
10.  Ayurvedic Doshas as Predictors of Sleep Quality 
Background
The 3 Ayurvedic constitutional types or Doshas – vata, pitta, and kapha – are responsible for homeostasis and health. The doshas determine various functions, including sleep. According to the Ayurvedic texts, sleep is caused by increased kapha and insomnia by increased vata or pitta, which may follow physical or mental exertion, or disease. The present study was carried out to determine whether this relationship could be found using contemporary standardized questionnaires.
Material/Methods
In this cross-sectional single-group study, 995 persons participated (646 males; group average age ±S.D., 49.1±15.2 years). Participants were attending a 1-week residential yoga program in northern India. Participants were assessed for dosha scores using a Tridosha questionnaire and the quality of sleep in the preceding week was self-rated using a sleep rating questionnaire.
Results
Multiple linear regression analyses were used to determine if each dosha acted as a predictor of quality and quantity of sleep. Vata scores significantly predicted the time taken to fall asleep [p<0.01], and the feeling of being rested in the morning [p<0.001]; with higher vata scores being associated with a longer time to fall asleep and a lesser feeling of being rested in the morning. Kapha scores significantly predicted day-time somnolence [p<0.05] and the duration of day-time naps in minutes [p<0.05], with higher kapha scores being associated with longer day-time naps.
Conclusions
The results suggest that the doshas can influence the quality and quantity of sleep.
doi:10.12659/MSM.893302
PMCID: PMC4448595  PMID: 25982247
Linear Models; Medicine, Ayurvedic; Sleep
11.  Augmenting brain function with meditation: can detachment coincide with empathy? 
doi:10.3389/fnsys.2015.00141
PMCID: PMC4597130  PMID: 26500514
meditation; detachment; empathy; dmPFC; vmPFC
12.  Role of Respiration in Mind-Body Practices: Concepts from Contemporary Science and Traditional Yoga Texts 
doi:10.3389/fpsyt.2014.00167
PMCID: PMC4243490  PMID: 25505427
ancient yoga texts; psychosomatic disease; respiratory regulation; affect; relaxation; inner awareness
13.  Blood Pressure and Heart Rate Variability during Yoga-Based Alternate Nostril Breathing Practice and Breath Awareness 
Background
Previous research has shown a reduction in blood pressure (BP) immediately after the practice of alternate nostril yoga breathing (ANYB) in normal healthy male volunteers and in hypertensive patients of both sexes. The BP during ANYB has not been recorded.
Material/Methods
Participants were 26 male volunteers (group mean age ±SD, 23.8±3.5 years). We assessed (1) heart rate variability, (2) non-invasive arterial BP, and (3) respiration rate, during (a) ANYB and (b) breath awareness (BAW) sessions. Each session was 25 minutes. We performed assessments at 3 time points: Pre (5 minutes), during (15 minutes; for ANYB or BAW) and Post (5 minutes). A naïve-to-yoga control group (n=15 males, mean age ±SD 26.1±4.0 years) were assessed while seated quietly for 25 minutes.
Results
During ANYB there was a significant decrease (repeated measures ANOVA) in systolic BP and respiration rate; while RMSSD (the square root of the mean of the sum of squares of differences between adjacent NN intervals) and NN50 (the number of interval differences of successive normal to normal intervals greater than 50 ms) significantly increased. During BAW respiration rate decreased. In contrast, respiration rate increased during the control state. ANYB and BAW were significantly different (2-factor ANOVA) in RMSSD and respiration rate. BAW and control were different with respect to respiration rate.
Conclusions
The results suggest that vagal activity increased during and after ANYB, which could have contributed to the decrease in BP and changes in the HRV.
doi:10.12659/MSMBR.892063
PMCID: PMC4247229  PMID: 25408140
Arterial Pressure; Heart Rate; Yoga
14.  An explorative study of metabolic responses to mental stress and yoga practices in yoga practitioners, non-yoga practitioners and individuals with metabolic syndrome 
Background
Stress places a metabolic burden on homeostasis and is linked to heightened sympathetic activity, increased energy expenditure and pathology. The yogic state is a hypometabolic state that corresponds with mind-body coherence and reduced stress. This study aimed to investigate metabolic responses to stress and different yoga practices in regular yoga practitioners (YP), non-yoga practitioners (NY) and metabolic syndrome patients (MS).
Methods
YP (n = 16), NY (n = 15) and MS (n = 15) subjects underwent an experimental protocol that comprised of different 5-minute interventions including mental arithmetic stress test (MAST), alternate nostril breathing (ANB), Kapabhati breathing (KB) and meditation (Med) interspersed with 5 minutes of quiet resting (neutral condition (NC)). During the intervention periods continuous body weight adjusted oxygen consumption (VO2ml/min/kg) was measured using open circuit indirect calorimetry with a canopy hood.
Results
This is the first study to report oxygen consumption (OC) in yoga practitioners during and after MAST and the first to report both within and between different populations. The results were analysed with SPSS 16 using 3X9 mixed factorial ANOVAs. The single between-subject factor was group (YP, NY and MS), the single within-subject factor was made up of the nine intervention phases (NC1, MAST, NC2, ANB, NC3, KB, NC4, Med, NC5). The results demonstrated that the regular YP group had significantly less OC and greater variability in their OC across all phases compared to the MS group (p = .003) and NY group (p = .01). All groups significantly raised their OC during the mental arithmetic stress, however the MS group had a significantly blunted post-stress recovery whereas the YP group rapidly recovered back to baseline levels with post stress recovery being greater than either the NY group or MS group.
Conclusions
Yoga practitioners have greater metabolic variability compared to non-yoga practitioners and metabolic syndrome patients with reduced oxygen requirements during resting conditions and more rapid post-stress recovery. OC in metabolic syndrome patients displays significantly blunted post-stress recovery demonstrating reduced metabolic resilience. Our results support the findings of previous randomised trials that suggest regular yoga practice may mitigate against the effects of metabolic syndrome.
Clinical trial number
ACTRN12614001075673; Date of Registration: 07/10/2014.
doi:10.1186/1472-6882-14-445
PMCID: PMC4247158  PMID: 25398263
Yoga; Meditation; Breathing; Metabolic syndrome; Oxygen consumption; Energy Expenditure; Metabolic rate; Stress reactivity; Stress recovery
15.  Research on Traditional Medicine: What Has Been Done, the Difficulties, and Possible Solutions 
Traditional medicine (TM) is being used more frequently all over the world. However most often these are choices made by the patient. Integrating TM into mainstream health care would require research to understand the efficacy, safety, and mechanism of action of TM systems. This paper describes research done on TM and difficulties encountered in researching TM, especially when an attempt is made to conform to the model for conventional medicine. The research articles were PubMed searched and categorized as experimental, quasiexperimental, reviews, descriptive, historical, interviews, case histories, and abstract not available. The last part of the report provides suggestions to make research on TM more acceptable and useful, with the ultimate goal of integrating TM into mainstream healthcare with sufficient knowledge about the efficacy, safety, and mechanism of action of TM systems.
doi:10.1155/2014/495635
PMCID: PMC4074945  PMID: 25013445
16.  A comparative controlled trial comparing the effects of yoga and walking for overweight and obese adults 
Background
Walking and yoga have been independently evaluated for weight control; however, there are very few studies comparing the 2 with randomization.
Material/Methods
The present study compared the effects of 90 minutes/day for 15 days of supervised yoga or supervised walking on: (i) related biochemistry, (ii) anthropometric variables, (iii) body composition, (iv) postural stability, and (v) bilateral hand grip strength in overweight and obese persons. Sixty-eight participants, of whom 5 were overweight (BMI ≥25 kg/m2) and 63 were obese (BMI ≥30 kg/m2; group mean age ±S.D., 36.4±11.2 years; 35 females), were randomized as 2 groups – (i) a yoga group and (ii) a walking group – given the same diet.
Results
All differences were pre-post changes within each group. Both groups showed a significant (p<0.05; repeated measures ANOVA, post-hoc analyses) decrease in: BMI, waist circumference, hip circumference, lean mass, body water, and total cholesterol. The yoga group increased serum leptin (p<0.01) and decreased LDL cholesterol (p<0.05). The walking group decreased serum adiponectin (p<0.05) and triglycerides (p<0.05).
Conclusions
Both yoga and walking improved anthropometric variables and serum lipid profile in overweight and obese persons. The possible implications are discussed.
doi:10.12659/MSM.889805
PMCID: PMC4051462  PMID: 24878827
Yoga; Walking; Obesity; Adipokines; Lipid Profile; Anthropometry
17.  Changes in Autonomic Variables Following Two Meditative States Described in Yoga Texts 
Abstract
Objectives
In ancient yoga texts there are two meditative states described. One is dharana, which requires focusing, the second is dhyana, during which there is no focusing, but an expansive mental state is reached. While an earlier study did show improved performance in an attention task after dharana, the autonomic changes during these two states have not been studied.
Methods
Autonomic and respiratory variables were assessed in 30 healthy male volunteers (group mean age±SD, 29.1±5.1 years) during four mental states described in traditional yoga texts. These four mental states are random thinking (cancalata), nonmeditative focusing (ekagrata), meditative focusing (dharana), and effortless meditation (dhyana). Assessments were made before (5 minutes), during (20 minutes), and after (5 minutes), each of the four states, on four separate days.
Results
During dhyana there was a significant increase in the skin resistance level (p<0.001; post hoc analysis following ANOVA, during compared to pre) and photo-plethysmogram amplitude (p<0.05), whereas there was a significant decrease in the heart rate (p<0.001) and breath rate (p<0.001). There was a significant decrease in the low frequency (LF) power (p<0.001) and increase in the high frequency (HF) power (p<0.001) in the frequency domain analysis of the heart rate variability (HRV) spectrum, on which HF power is associated with parasympathetic activity. There was also a significant increase in the NN50 count (the number of interval differences of successive NN intervals greater than 50 ms; p<0.001) and the pNN50 (the proportion derived by dividing NN50 by the total number of NN intervals; p<0.001) in time domain analysis of HRV, both indicative of parasympathetic activity.
Conclusions
Maximum changes were seen in autonomic variables and breath rate during the state of effortless meditation (dhyana). The changes were all suggestive of reduced sympathetic activity and/or increased vagal modulation. During dharana there was an increase in skin resistance. The changes in HRV during ekagrata and cancalata were inconclusive.
doi:10.1089/acm.2011.0282
PMCID: PMC3546358  PMID: 22946453
19.  Effect of yoga or physical exercise on physical, cognitive and emotional measures in children: a randomized controlled trial 
Background
Previous studies have separately reported the effects of physical exercise and yoga in children, showing physical, cognitive and emotional benefits.
Objectives
The present randomized controlled trial assessed the effects of yoga or physical exercise on physical fitness, cognitive performance, self-esteem, and teacher-rated behavior and performance, in school children.
Methods
98 school children between 8 to 13 years were randomized as yoga and physical exercise groups {n = 49 each; (yoga: 15 girls, group mean age 10.4 ± 1.2 years), (physical exercise: 23 girls, group mean age 10.5 ± 1.3 years)}. Both groups were blind assessed after allocation, using: (i) the Eurofit physical fitness test battery, (ii) Stroop color-word task for children, (iii) Battle’s self-esteem inventory and (iv) the teachers’ rating of the children’s obedience, academic performance, attention, punctuality, and behavior with friends and teachers. After assessments the yoga group practiced yoga (breathing techniques, postures, guided relaxation and chanting), 45 minutes each day, 5 days a week. During this time the physical exercise group had jogging-in-place, rapid repetitive movements and relay races or games. Both groups were assessed at the end of 3 months. Data were analyzed with RM ANOVA and post-hoc tests were Bonferroni adjusted.
Results
There was one significant difference between groups. This was in social self-esteem which was higher after physical exercise compared to yoga (p < 0.05). All the changes reported below are based on after-before comparisons, within each group. Both groups showed an increase in BMI, and number of sit-ups (p < 0.001). Balance worsened in the physical exercise group, while plate tapping improved in the yoga group (p < 0.001). In the Stroop task both groups showed improved color, word- and color-word naming (p < 0.01), while the physical exercise group showed higher interference scores. Total, general and parental self-esteem improved in the yoga group (p < 0.05).
Conclusion
Yoga and physical exercise are useful additions to the school routine, with physical exercise improving social self-esteem.
Trial registration
The study was registered in the Clinical Trials Registry of India (CTRI/2012/11/003112).
doi:10.1186/1753-2000-7-37
PMCID: PMC3826528  PMID: 24199742
Yoga; Physical exercise; Physical fitness; Cognitive performance; Self-esteem; School children
21.  Changes in P300 following alternate nostril yoga breathing and breath awareness 
This study assessed the effect of alternate nostril yoga breathing (nadisuddhi pranayama) on P300 auditory evoked potentials compared to a session of breath awareness of equal duration, in 20 male adult volunteers who had an experience of yoga breathing practices for more than three months. Peak amplitudes and peak latencies of the P300 were assessed before and after the respective sessions. There was a significant increase in the P300 peak amplitudes at Fz, Cz, and Pz and a significant decrease in the peak latency at Fz alone following alternate nostril yoga breathing. Following breath awareness there was a significant increase in the peak amplitude of P300 at Cz. This suggests that alternate nostril yoga breathing positively influences cognitive processes which are required for sustained attention at different scalp sites (frontal, vertex and parietal), whereas breath awareness brings about changes at the vertex alone.
doi:10.1186/1751-0759-7-11
PMCID: PMC3679963  PMID: 23721252
Alternate nostril yoga breathing; P300; Breath awareness; Cognitive processes
23.  Yoga on Our Minds: A Systematic Review of Yoga for Neuropsychiatric Disorders 
Background: The demand for clinically efficacious, safe, patient acceptable, and cost-effective forms of treatment for mental illness is growing. Several studies have demonstrated benefit from yoga in specific psychiatric symptoms and a general sense of well-being.
Objective: To systematically examine the evidence for efficacy of yoga in the treatment of selected major psychiatric disorders.
Methods: Electronic searches of The Cochrane Central Register of Controlled Trials and the standard bibliographic databases, MEDLINE, EMBASE, and PsycINFO, were performed through April 2011 and an updated in June 2011 using the keywords yoga AND psychiatry OR depression OR anxiety OR schizophrenia OR cognition OR memory OR attention AND randomized controlled trial (RCT). Studies with yoga as the independent variable and one of the above mentioned terms as the dependent variable were included and exclusion criteria were applied.
Results: The search yielded a total of 124 trials, of which 16 met rigorous criteria for the final review. Grade B evidence supporting a potential acute benefit for yoga exists in depression (four RCTs), as an adjunct to pharmacotherapy in schizophrenia (three RCTs), in children with ADHD (two RCTs), and Grade C evidence in sleep complaints (three RCTs). RCTs in cognitive disorders and eating disorders yielded conflicting results. No studies looked at primary prevention, relapse prevention, or comparative effectiveness versus pharmacotherapy.
Conclusion: There is emerging evidence from randomized trials to support popular beliefs about yoga for depression, sleep disorders, and as an augmentation therapy. Limitations of literature include inability to do double-blind studies, multiplicity of comparisons within small studies, and lack of replication. Biomarker and neuroimaging studies, those comparing yoga with standard pharmaco- and psychotherapies, and studies of long-term efficacy are needed to fully translate the promise of yoga for enhancing mental health.
doi:10.3389/fpsyt.2012.00117
PMCID: PMC3555015  PMID: 23355825
yoga; meditation; depression; schizophrenia; cognition; ADHD; clinical trials; alternative medicine
24.  Blood pressure and purdue pegboard scores in individuals with hypertension after alternate nostril breathing, breath awareness, and no intervention 
Background
Previously alternate nostril yoga breathing (anuloma-viloma pranayama) was shown to reduce the blood pressure (BP) in people with hypertension. An elevated BP has been associated with poor performance in certain tasks requiring attention and co-ordination. The Purdue pegboard task assesses manual dexterity and eye-hand co-ordination.
Material/Methods
In the present study there were ninety participants with essential hypertension. Their ages ranged from 20 to 59 years (group average age ±S.D., 49.7±9.5 years; sixty males). Participants were randomized as three groups, with thirty participants in each group. One group practiced alternate nostril yoga breathing for 10 minutes, the second group practiced breath awareness for the same duration and the third group was given a control intervention (i.e., reading a magazine with neutral content). Assessments were taken before and after the interventions for participants of the three groups. Assessments included the blood pressure and performance in the Purdue pegboard task. Data were analyzed with a repeated measures ANOVA and post-hoc analyses were Bonferroni adjusted.
Results
Following alternate nostril breathing (ANYB) there was a significant decrease in systolic and diastolic blood pressure (p<0.001 and p<0.05), and an improvement in Purdue pegboard task scores for both hands (p<0.05), and for the right hand (p<.001). Breath awareness (the control session) also showed a significant decrease in systolic blood pressure (p<0.05). The right hand scores improved in the group reading a magazine (p<0.05).
Conclusions
The results suggest that the immediate effect of ANYB is to reduce the BP while improving the performing in a task requiring attention, bimanual dexterity and visuo-motor co-ordination.
doi:10.12659/MSM.883743
PMCID: PMC3628802  PMID: 23334063
hypertension; alternate nostril yoga breathing; blood pressure; Purdue pegboard task; attention; visuo-motor co-ordination; bi-manual dexterity

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