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YOGA RESEARCH:
Past, Present and Future……
Yogacharya
Dr. ANANDA BALAYOGI BHAVANANI
MBBS, ADY, PGDFH, PGDY, FIAY, MD (AM), DSc (Yoga)
Professor Yoga Therapy & Director
CYTER of Sri Balaji Vidyapeeth &
Chairman ICYER at Ananda Ashram, Pondicherry.
SRI BALAJI VIDYAPEETH
(Deemed University Accredited with “A” Grade by NAAC)
Centre for Yoga Therapy, Education
and Research (CYTER)
Salutogenesis, our focus!
Salutogenesis, our Focus
 Moving from pathogenesis, the focus on disease
towards salutogenesis, the focus on health!
 Under SBV AIM HIGH (Academy of Integrative
Medicine for Holistic Intervention towards General
Health), Faculty of Allied Health Sciences,
CYTER is striding forward on an innovative
path of promoting holistic health for one and all.
 Bringing together ancient experiential wisdom
of Yoga with evidence based approach of
modern medical science.
www.sbvu.ac.in/cyter
Prof MADANMOHAN
The Pioneer of
Integration of Yoga in
Modern Medicine
The AUM Team
 Origin of research in Yoga dates back to the pre-
historic origin of Yoga itself
 The ancient Rishis were truly searching and re-
searching for the answer to the all important
question, “Who am I ”?
 Scientific and philosophico-literary research is
essential to confirm, validate & enhance the
understanding and application of Yogic concepts
and practices for the benefit of humanity.
6,205
results for
“Yoga Therapy”
in PUBMED
 Swami Kuvalayananda & Kaivalyadhama
– ML Gharote, MV Bhole, PV Karambelkar, SL Vinekar
 Medical scientists at
– AIIMS, BHU, NIMHANS, JIPMER (BK Anand, GS Chinna, KN
Udupa, KS Gopal, RL Bijlani, Madanmohan, etc)
 Yoga Universities: sVYASA, PYP
 Mainly limited to the physical aspects
 Most researchers today however seem more
interested in proving themselves right than in really
researching Yoga as a whole
 Yoga in the “BOX” is NOT really Yoga!
Modern yoga research
Most Yogic phenomena are beyond the mere
physical manifestation of their effects
To conclude that Shavasana has
ONLY the physiological effect of
lowering BP & HR is to sight
merely the iceberg’s tip,
missing > 90%
The real effects of Shavasana as
the ultimate relaxation & true
renunciation may have more far-
reaching effects than we would
have been led to believe
Recent trends
 Yoga Research–now a global phenomenon
 Increased number of blinded, randomized and
controlled trials
 Improved planning and implementation
 Better understanding of the mechanisms by
which various practices cause their effects
 Increased number of research studies are being
published in indexed journals with peer review
– a better standard of research at least at the
physical level
 Greater funding available nowadays
 Do we have equipment to quantitatively
and qualitatively measure effects of Yoga?
 What to do in most aspects of Yoga that
are beyond our present day capacity?
 How to keep the “Yoga” in Yoga research?
 How to enable the knowledge gained of
modern research to percolate down into
clinical practice and Yoga education?
Some questions
 Is not just gathering information on Yoga
 Is not just the re-arranging of known facts on
Yoga
 Must be continual and expanding
– most modern research seems to be just repeating
ad-nauseam earlier works
 Must not be a sales pitch
– a lot of research today seems geared at attracting
people to specific techniques and institutions than
to benefiting Yoga as a whole
Yoga research
 True research is a quest driven by a specific
question which needs an answer leading to a
new question
 Most research in Yoga today however seems
either to be for curing diseases and disorders
that are rampant in modern world or to
publicize their own techniques.
 Basic research is lacking- not as attractive as
clinical trails and the publicity thereof
 Most researchers lack an ‘experience’ of Yoga –
are not living it, hence have no clue about what
they are studying.
 Need of the hour
– focus attention on core concepts of Yoga
– find newer methods to unravel its secrets
 Extensive basic research is required
– not much money in it !
 A lot of Yoga research today resembles
pharmaceutical companies trying to find
wonder drugs for newer diseases.
 Most modern Yoga researchers seem to be
trying to find out “a single Yoga pill for each
ill”.
• Comprehensive bibliometric analysis of Yoga therapy
research between 1967 & 2013 by Jeter PE, Slutsky J,
Singh N & Khalsa SB. (J Altern Complement Med
2015)
• Three-fold increase in number of publications seen
in the last decade, inclusive of all study designs.
• 45% RCTs, 18% controlled, and 37% uncontrolled.
• Most publications originated from India (n=258),
followed by USA (n=122) and Canada (n=13).
• Top three disorders addressed by Yoga interventions
were mental health, cardiovascular disease, and
respiratory disease.
Other reviews by Kim Innes (2005, 2007 & 2012), Yang
(2007) and Sengupta (2012) have also highlighted role
of Yoga therapy.
A brief qualitative survey on the utilization of
Yoga research resources by Yoga teachers.
 This survey provided a basic picture of a
general lack of awareness of Yoga research
amongst practicing Yoga teachers and
therapists.
 Though a majority agree research is
important, few seriously update themselves
on this through scientific channels.
Bhavanani AB. J Intercult Ethnopharmacol. 2016; 5(2): 168-173
Student
Therapist
Patient
Researcher
Teacher
Key
players
© www.indeedcare.com/blog/tag/yoga-therapy
Yoga Practices
Postures, Breathing, Relaxation, Meditation
Fitness
↑Flexibility
↑Strength
↑Coordination/Balance
↑Respiratory Function
↑Self-Efficacy
Global Human Functionality
↑Physical & Mental Health, ↑Physical, Mental, Emotional Performance,
↑Positive Behavior Change, ↑Social Responsibility, Values, Relationships,
↑Quality of Life, ↑Life Purpose & Meaning, ↑Spirituality
Self-Regulation
↑Emotion Regulation
↑Stress Regulation
↑Resilience
↑Equanimity
↑Self-Efficacy
Awareness
↑Attention
↑Mindfulness
↑Concentration
↑Cognition
↑Meta-cognition
Spirituality
↑Transcendence
↑Unitive State
↑Flow
↑Transformation
↑Life Meaning/Purpose
Schmalzl L, Jeter P, Khalsa SBS. The Psychophysiology of Yoga: Characteristics of the Main Components and
Review of Research Studies. In: Newcombe S, O’Brien-Kop K, editors. Routledge Handbook of Yoga and
Meditation Studies.Oxon, UK: Routledge, Taylor and Francis Group, 2021, p. 440-59.
Potential Underlying Mechanisms
Innes KE and Selfe TK (2014) Meditation as a therapeutic intervention for adults at risk for Alzheimer’s disease –
potential benefits and underlying mechanisms. Front. Psychiatry 5:40. doi: 10.3389/fpsyt.2014.00040
SOME INTERESTING
YOGA RESEARCH IN
RECENT TIMES
Telles S, Desiraju T. IJMR 1991; 94: 357-63.
 Short kumbhak pranayamic breathing
 increase (52%) in the O2 consumption &
metabolic rate
 Long kumbhak pranayamic breathing
 lowering (19%) of the O2 consumption &
metabolic rate
Application of kumbhak may be different and
varied in potential cases accordingly
Shannahoff-Khalsa DS, Kennedy B. Int J
Neurosci. 1993 ; 73: 47-60
 Right UFNB increases HR compared to left.
 Stroke volume was higher in left UFNB
compensating for lower HR.
 Left UFNB significantly increased end diastolic
volume
 Demonstrated unique unilateral effect on
sympathetic stimulation of the heart that may
have therapeutic value.
 Recent studies by Raghuraj 2008, Rajajeyakumar 2014,
Bhavanani 2014 further substantiated these findings.
Telles S et al. IJPP 1994; 38 : 133-7.
 O2 consumption increased by
– 37% after right nostril pranayama
– 18% after alternate nostril pranayama
– 24% after left nostril pranayama
 Left nostril pranayama increased volar GSR
signifying reduction in sympathetic activity
 Breathing selectively through either nostril has
marked activating or relaxing effect on the
sympathetic nervous system.
Selvamurthy W et al. IJPP 1998; 42: 205-213
 Helped understand physiological mechanism
underlying effects of selected yogic exercises
in the treatment of essential hypertension
 3 weeks course of tilt and head down yogic
exercise (sarvangasan) clearly indicated gradual
improvement in baroreflex sensitivity
 Progressive attenuation of sympatho-adrenal
and renin-angiotensin activity
Raghuraj P et al. IJPP 1998 ; 42: 467-72
 Studied HRV in fast and slow breathing
techniques
– Kapalabhati and Nadishuddhi
 Kapalabhati modifies autonomic status
– increasing sympathetic activity
– with reduced vagal activity.
Kaviraja Udupa et al. IJPP 2003; 47 : 27-33
 Increased QS2, PEP, PEP/LVET & decreased
LVET, QT/QS2 indicate decreased adrenergic
tone
 Increased RRIV -enhanced parasympathetic
activity.
 Pranayam training produced subtle changes in
LV systolic performance probably by modulat-
ing cardiac autonomic tone.
Vijayalakshmi P et al. IJPP 2004; 48: 59-64.
 4 week yoga relaxation training for HT patients
 Response to IHG test subnormal initially
 Yoga relaxation training produced significant
decrease in BP, HR & RPP from 2nd week
onwards and peaked by 4 weeks
 Significant in BP, HR & RPP with IHG after
training indicated restoration of cardio-
vascular reflex mechanisms.
 Findings confirmed in later RCT by Punitha P
et al (Nat J Physiol Pharm Pharmacol, 2015).
Madanmohan et al. IJPP 2005; 49: 313-18.
 Slow Pranayama training
– Significant increase: MIP MEP, BHT & 40 mm Hg
test. Significant decrease in DP
 Fast Pranayam training
– Significant increase in HR, RPP & double product
(Do P).
 HR, RPP & Do P decreased (NS) in group I & increased
(NS) in group II
 Varied therapeutic applications
 Finding confirmed in later RCTs by Dinesh 2014 and
Sharma 2015
Manjunatha S et al. IJPP 2005; 49: 319-24.
 Do yoga asanas increase insulin secretion
from the pancreas?
 Serum insulin levels after asanas were lower
than those before the asanas
 Serum insulin level 0.5 h after post-asana oral
75 g-glucose challenge was higher
 The performance of asanas led to increased
sensitivity of the β cells of pancreas to the
glucose signal
Raghavendra Rao et al.Complementary
Therapies in Medicine 2009; 17: 1—8
 Compared anxiolytic effects of Yoga &
supportive therapy in Ca breast patients
undergoing conventional treatment.
 Overall decrease in both self-reported state
anxiety & trait anxiety in Yoga group
 Positive correlation between anxiety states and
traits with symptom severity and distress during
conventional treatment intervals.
 Yoga has a role in palliative care in terminal
cases too.
Bhavanani AB et al. Int J Yoga 2011; 4: 71-76.
 Effects of 6 months of training given in Slow Surya
Namaskar (SSN) at 6 rounds /30 min and Fast Surya
Namaskar (FSN) at 15 rounds ‘30 min for school
children.
 Cardiovascular (HR, BP) and muscular physiological
(HGS, HGE) effects studied.
 Effects of FSN are similar to physical aerobic exercises
whereas effects of SSN are similar to those of Yoga
training.
Kalyani BG et al. IJOY 2011; 4(1): 3-6.
 Neurohemodynamic correlates of audible ‘OM’
chanting were examined by functional MRI.
 Significant limbic deactivation observed during
‘OM’ chanting with bilateral changes in
orbitofrontal, anterior cingulate, para-hippocampal
gyri, thalami and hippocampi.
 As similar observations have been recorded with
vagus nerve stimulation used in depression and
epilepsy, the study findings argue for a potential
role of ‘OM’ chanting in clinical practice.
Streeter CC et al. Med Hypotheses 2012; 78: 571-9
 Stress induces autonomic imbalance
 Decreased para-sympathetic & increased
sympathetic activity, under activity of GABA
system, the primary inhibitory neuro-
transmitter, and increased allostatic load.
 Yoga helps correct the underactivity of para-
sympathetic nervous system and GABA systems
in part through stimulation of vagus nerves with
reduction in the allostatic load.
Ornish D et al. Lancet Oncol 2013; 14:1112-20
“Our genes, and our telomeres, are not
necessarily our fate,” - Dean Ornish
 Telomere shortness is a prognostic marker of
ageing, disease, and premature morbidity.
 Previous study (2008) showed association between
3 months of comprehensive lifestyle changes and
increased telomerase activity in immune cells.
 A comprehensive lifestyle intervention was
associated with increases in relative telomere
length after 5 years of follow-up.
But be careful!!
Some studies have
NO yoga in them at all !
Lana Skoro-Kondza et al. BMC Health
Services Research 2009; 9:33
 There was a small statistically insignificant fall in
HbA1c - not sustained > 6 months, no change in
other outcome measures.
 Around 2/3 of patients on GP diabetic registers
proved ineligible, & 90% of the remainder
declined to participate.
 Only 50% attendance at classes -Nobody did the
exercises regularly at home.
 Most participants -unsuitable for 'standard' Yoga
- limited flexibility, lack of basic fitness, co-
morbidity and lack of confidence.
Basically no yoga in the study at all!
Make sure it was done
in humans!!
Lateral Sleeping Position Influences Clean-
Up Of Brain's Metabolic Waste Products,
Halts Neurological Diseases
 Everyone started talking about all the
possible benefits of humans sleeping on their
side without even reading the full paper!
 Rodent models were used to examine the
glymphatic pathway — where CSF filters
through the brain and exchanges with
interstitial fluid to clear waste.
The Journal of Neuroscience, 5 August 2015, 35(31): 11034-11044
Some of our work in recent times
1. Randomized controlled trial of 12-week yoga therapy as lifestyle
intervention in patients of essential hypertension and cardiac autonomic
function tests. Natl J Physiol Pharm Pharmacol 2016; 6: 19-26.
2. Finding peace on a Psychiatric Ward with Yoga: Report on a pilot
anthropological study in Pondicherry, India. Annals of SBV 2016; 5(2): 14-
9.
3. Effect of yoga therapy on fasting lipid profile in chronic kidney disease: a
comparative study. Int J Adv Med 2018;5: 294-98.
4. Effects of overnight sleep deprivation on autonomic function and
perceived stress in young health professionals and their reversal through
yogic relaxation (Shavasana). Natl J Physiol Pharm Pharmacol 2018;8
5. Effect of adjuvant yoga therapy on pulmonary function and quality of life
among patients with Chronic Obstructive Pulmonary Disease: A
Randomized Control Trial. J Basic Clin Appl Health Sci. 2018; 2(3):117-22.
6. Immediate effect of Sukha Pranayama: A slow and deep breathing
technique on maternal and fetal cardiovascular parameters. Yoga
Mimamsa 2018; 50:49-52.
7. A comparative study on the effect of music therapy alone and a
combination of music and yoga therapies on the psycho-
physiological parameters of cardiac patients posted for
angiography. J Basic Clin Appl Health Sci. 2018; 2:163-8.
8. Yoga training enhances auditory & visual reaction time in
children with autism spectrum disorder: A case - control study. J
Basic Clin Appl Health Sci. 2019; 2:8-13.
9. Effectiveness of adjuvant yoga therapy in diabetic lung: A
randomized control trial. Int J Yoga 2019;12:96-102.
10. The efficacy of yogic breathing exercise Bhramari pranayama in
relieving symptoms of chronic rhinosinusitis. Int J Yoga
2019;12:120-3.
11. Yoga therapy as an adjunct to traditional tooth brushing
training methods in children with autism spectrum disorder.
Spec Care Dentist. 2019; 1–6.
12. Effect of adjunct yoga therapy in depressive disorders: Findings
from a RCT. Indian J Psychiatry 2019; 61:592-7.
13. Gupta K, Bhavanani A B, Ramanathan M, Rajasekar B, Sarkar S, Dayanidy
G. Effect of Adjuvant Yoga Therapy on Craving in Participants of an
Alcohol De-addiction Program: A Pilot Study. 2019; 2 (4):138-141.
14. Balaji R, Ramanathan M, Bhavanani AB. Nephroprotective Impact of
Adjuvant Yoga Therapy on Diabetes - A Randomised Controlled Trial. J
Clin Diagn Res.2020; 14(12): KC01-KC04.
15. Ramanathan M, Bhavanani AB. Yoga training enhances auditory and
visual reaction time in elderly woman inmates of a hospice: A pilot
randomized controlled trial. Yoga Mimamsa 2020;52:56-60.
16. Artchoudane S, Ramanathan M, Bhavanani AB, Muruganandam P, Jatiya
L. Effect of Yoga Therapy on Neuromuscular Function and Reduction of
Autism Severity in Children with Autism Spectrum Disorder: A Pilot
Study. International Journal of Health Systems and Translational
Medicine (IJHSTM). 2021; 1(1): 76-85.
17. Thiruvalluvan A, Sekizhar V, Ramanathan M, Bhavanani AB, Chakravathy
D, C. Reddy JR. Effect of pranayama techniques with Marmanasthanam
Kriya as yogic relaxation on biopsychosocial parameters prior to
endodontic therapy: A cross sectional study . Int J Yoga 2021;14:146-51
S W O T
analysis of yoga research
Udupa K, Ramanathan M, Bhavanani AB. SWOT Analysis in Yoga Research. J
Basic Clin Appl Health Sci 2021;4(1):26–30.
The New AUM Team
Various items/factors
 Strengths
 Weakness
 Opportunities
 Threats, risks/challenges
Internal factors: strengths and weakness
Strengths of yoga:
Cultural heritage
Time tested and effective in
various disorders
Life style entity with many facets
to training raising one’s
consciousness to higher levels so
as to unite with supreme
consciousness.
Weaknesses of yoga research:
Low scientific vigor
Not well validated, one cap
fitting all heads approach
Difficulties in conducting
blinded RCT, getting ethics
approval, funding and
publishing in high impact
journals
External
factors:
opportunities
and threats
(risks /
challenges)
Opportunities:
Conducting higher levels
and deeper studies with
proper design and
involving multiple
specialties
Strength & Opportunities (SO)
Strategies
Conducting yoga Research with
good design and in-depth studies
not just superficial benefits
Weakness & Opportunities
(WO) Strategies
Planning with proper control
group, double blind, unbiased
interpretation & convincing
reviewers of funding agencies
and journals with high quality
of scientific work
Threats:
Compliance issues to
carry out yoga training
by participants
Questionable data
collection, analysis &
interpretation.
Strength & Threats (ST)
Strategies
Designing study countering all
the threats/risks
Weaknesses & Threats (WT)
Strategies
Designing study countering all
the weakness, threats/risks
Gratitude
is the
highest
attitude.
Thank You!

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Yoga Research: Past, Present and Future

  • 1. YOGA RESEARCH: Past, Present and Future…… Yogacharya Dr. ANANDA BALAYOGI BHAVANANI MBBS, ADY, PGDFH, PGDY, FIAY, MD (AM), DSc (Yoga) Professor Yoga Therapy & Director CYTER of Sri Balaji Vidyapeeth & Chairman ICYER at Ananda Ashram, Pondicherry.
  • 2.
  • 3. SRI BALAJI VIDYAPEETH (Deemed University Accredited with “A” Grade by NAAC) Centre for Yoga Therapy, Education and Research (CYTER) Salutogenesis, our focus!
  • 4. Salutogenesis, our Focus  Moving from pathogenesis, the focus on disease towards salutogenesis, the focus on health!  Under SBV AIM HIGH (Academy of Integrative Medicine for Holistic Intervention towards General Health), Faculty of Allied Health Sciences, CYTER is striding forward on an innovative path of promoting holistic health for one and all.  Bringing together ancient experiential wisdom of Yoga with evidence based approach of modern medical science. www.sbvu.ac.in/cyter
  • 5. Prof MADANMOHAN The Pioneer of Integration of Yoga in Modern Medicine The AUM Team
  • 6.  Origin of research in Yoga dates back to the pre- historic origin of Yoga itself  The ancient Rishis were truly searching and re- searching for the answer to the all important question, “Who am I ”?  Scientific and philosophico-literary research is essential to confirm, validate & enhance the understanding and application of Yogic concepts and practices for the benefit of humanity.
  • 8.  Swami Kuvalayananda & Kaivalyadhama – ML Gharote, MV Bhole, PV Karambelkar, SL Vinekar  Medical scientists at – AIIMS, BHU, NIMHANS, JIPMER (BK Anand, GS Chinna, KN Udupa, KS Gopal, RL Bijlani, Madanmohan, etc)  Yoga Universities: sVYASA, PYP  Mainly limited to the physical aspects  Most researchers today however seem more interested in proving themselves right than in really researching Yoga as a whole  Yoga in the “BOX” is NOT really Yoga! Modern yoga research
  • 9. Most Yogic phenomena are beyond the mere physical manifestation of their effects To conclude that Shavasana has ONLY the physiological effect of lowering BP & HR is to sight merely the iceberg’s tip, missing > 90% The real effects of Shavasana as the ultimate relaxation & true renunciation may have more far- reaching effects than we would have been led to believe
  • 10. Recent trends  Yoga Research–now a global phenomenon  Increased number of blinded, randomized and controlled trials  Improved planning and implementation  Better understanding of the mechanisms by which various practices cause their effects  Increased number of research studies are being published in indexed journals with peer review – a better standard of research at least at the physical level  Greater funding available nowadays
  • 11.  Do we have equipment to quantitatively and qualitatively measure effects of Yoga?  What to do in most aspects of Yoga that are beyond our present day capacity?  How to keep the “Yoga” in Yoga research?  How to enable the knowledge gained of modern research to percolate down into clinical practice and Yoga education? Some questions
  • 12.  Is not just gathering information on Yoga  Is not just the re-arranging of known facts on Yoga  Must be continual and expanding – most modern research seems to be just repeating ad-nauseam earlier works  Must not be a sales pitch – a lot of research today seems geared at attracting people to specific techniques and institutions than to benefiting Yoga as a whole Yoga research
  • 13.  True research is a quest driven by a specific question which needs an answer leading to a new question  Most research in Yoga today however seems either to be for curing diseases and disorders that are rampant in modern world or to publicize their own techniques.  Basic research is lacking- not as attractive as clinical trails and the publicity thereof  Most researchers lack an ‘experience’ of Yoga – are not living it, hence have no clue about what they are studying.
  • 14.  Need of the hour – focus attention on core concepts of Yoga – find newer methods to unravel its secrets  Extensive basic research is required – not much money in it !  A lot of Yoga research today resembles pharmaceutical companies trying to find wonder drugs for newer diseases.  Most modern Yoga researchers seem to be trying to find out “a single Yoga pill for each ill”.
  • 15. • Comprehensive bibliometric analysis of Yoga therapy research between 1967 & 2013 by Jeter PE, Slutsky J, Singh N & Khalsa SB. (J Altern Complement Med 2015) • Three-fold increase in number of publications seen in the last decade, inclusive of all study designs. • 45% RCTs, 18% controlled, and 37% uncontrolled. • Most publications originated from India (n=258), followed by USA (n=122) and Canada (n=13). • Top three disorders addressed by Yoga interventions were mental health, cardiovascular disease, and respiratory disease. Other reviews by Kim Innes (2005, 2007 & 2012), Yang (2007) and Sengupta (2012) have also highlighted role of Yoga therapy.
  • 16.
  • 17. A brief qualitative survey on the utilization of Yoga research resources by Yoga teachers.  This survey provided a basic picture of a general lack of awareness of Yoga research amongst practicing Yoga teachers and therapists.  Though a majority agree research is important, few seriously update themselves on this through scientific channels. Bhavanani AB. J Intercult Ethnopharmacol. 2016; 5(2): 168-173
  • 20. Yoga Practices Postures, Breathing, Relaxation, Meditation Fitness ↑Flexibility ↑Strength ↑Coordination/Balance ↑Respiratory Function ↑Self-Efficacy Global Human Functionality ↑Physical & Mental Health, ↑Physical, Mental, Emotional Performance, ↑Positive Behavior Change, ↑Social Responsibility, Values, Relationships, ↑Quality of Life, ↑Life Purpose & Meaning, ↑Spirituality Self-Regulation ↑Emotion Regulation ↑Stress Regulation ↑Resilience ↑Equanimity ↑Self-Efficacy Awareness ↑Attention ↑Mindfulness ↑Concentration ↑Cognition ↑Meta-cognition Spirituality ↑Transcendence ↑Unitive State ↑Flow ↑Transformation ↑Life Meaning/Purpose Schmalzl L, Jeter P, Khalsa SBS. The Psychophysiology of Yoga: Characteristics of the Main Components and Review of Research Studies. In: Newcombe S, O’Brien-Kop K, editors. Routledge Handbook of Yoga and Meditation Studies.Oxon, UK: Routledge, Taylor and Francis Group, 2021, p. 440-59.
  • 21. Potential Underlying Mechanisms Innes KE and Selfe TK (2014) Meditation as a therapeutic intervention for adults at risk for Alzheimer’s disease – potential benefits and underlying mechanisms. Front. Psychiatry 5:40. doi: 10.3389/fpsyt.2014.00040
  • 23. Telles S, Desiraju T. IJMR 1991; 94: 357-63.  Short kumbhak pranayamic breathing  increase (52%) in the O2 consumption & metabolic rate  Long kumbhak pranayamic breathing  lowering (19%) of the O2 consumption & metabolic rate Application of kumbhak may be different and varied in potential cases accordingly
  • 24. Shannahoff-Khalsa DS, Kennedy B. Int J Neurosci. 1993 ; 73: 47-60  Right UFNB increases HR compared to left.  Stroke volume was higher in left UFNB compensating for lower HR.  Left UFNB significantly increased end diastolic volume  Demonstrated unique unilateral effect on sympathetic stimulation of the heart that may have therapeutic value.  Recent studies by Raghuraj 2008, Rajajeyakumar 2014, Bhavanani 2014 further substantiated these findings.
  • 25. Telles S et al. IJPP 1994; 38 : 133-7.  O2 consumption increased by – 37% after right nostril pranayama – 18% after alternate nostril pranayama – 24% after left nostril pranayama  Left nostril pranayama increased volar GSR signifying reduction in sympathetic activity  Breathing selectively through either nostril has marked activating or relaxing effect on the sympathetic nervous system.
  • 26. Selvamurthy W et al. IJPP 1998; 42: 205-213  Helped understand physiological mechanism underlying effects of selected yogic exercises in the treatment of essential hypertension  3 weeks course of tilt and head down yogic exercise (sarvangasan) clearly indicated gradual improvement in baroreflex sensitivity  Progressive attenuation of sympatho-adrenal and renin-angiotensin activity
  • 27. Raghuraj P et al. IJPP 1998 ; 42: 467-72  Studied HRV in fast and slow breathing techniques – Kapalabhati and Nadishuddhi  Kapalabhati modifies autonomic status – increasing sympathetic activity – with reduced vagal activity.
  • 28. Kaviraja Udupa et al. IJPP 2003; 47 : 27-33  Increased QS2, PEP, PEP/LVET & decreased LVET, QT/QS2 indicate decreased adrenergic tone  Increased RRIV -enhanced parasympathetic activity.  Pranayam training produced subtle changes in LV systolic performance probably by modulat- ing cardiac autonomic tone.
  • 29. Vijayalakshmi P et al. IJPP 2004; 48: 59-64.  4 week yoga relaxation training for HT patients  Response to IHG test subnormal initially  Yoga relaxation training produced significant decrease in BP, HR & RPP from 2nd week onwards and peaked by 4 weeks  Significant in BP, HR & RPP with IHG after training indicated restoration of cardio- vascular reflex mechanisms.  Findings confirmed in later RCT by Punitha P et al (Nat J Physiol Pharm Pharmacol, 2015).
  • 30. Madanmohan et al. IJPP 2005; 49: 313-18.  Slow Pranayama training – Significant increase: MIP MEP, BHT & 40 mm Hg test. Significant decrease in DP  Fast Pranayam training – Significant increase in HR, RPP & double product (Do P).  HR, RPP & Do P decreased (NS) in group I & increased (NS) in group II  Varied therapeutic applications  Finding confirmed in later RCTs by Dinesh 2014 and Sharma 2015
  • 31. Manjunatha S et al. IJPP 2005; 49: 319-24.  Do yoga asanas increase insulin secretion from the pancreas?  Serum insulin levels after asanas were lower than those before the asanas  Serum insulin level 0.5 h after post-asana oral 75 g-glucose challenge was higher  The performance of asanas led to increased sensitivity of the β cells of pancreas to the glucose signal
  • 32. Raghavendra Rao et al.Complementary Therapies in Medicine 2009; 17: 1—8  Compared anxiolytic effects of Yoga & supportive therapy in Ca breast patients undergoing conventional treatment.  Overall decrease in both self-reported state anxiety & trait anxiety in Yoga group  Positive correlation between anxiety states and traits with symptom severity and distress during conventional treatment intervals.  Yoga has a role in palliative care in terminal cases too.
  • 33. Bhavanani AB et al. Int J Yoga 2011; 4: 71-76.  Effects of 6 months of training given in Slow Surya Namaskar (SSN) at 6 rounds /30 min and Fast Surya Namaskar (FSN) at 15 rounds ‘30 min for school children.  Cardiovascular (HR, BP) and muscular physiological (HGS, HGE) effects studied.  Effects of FSN are similar to physical aerobic exercises whereas effects of SSN are similar to those of Yoga training.
  • 34. Kalyani BG et al. IJOY 2011; 4(1): 3-6.  Neurohemodynamic correlates of audible ‘OM’ chanting were examined by functional MRI.  Significant limbic deactivation observed during ‘OM’ chanting with bilateral changes in orbitofrontal, anterior cingulate, para-hippocampal gyri, thalami and hippocampi.  As similar observations have been recorded with vagus nerve stimulation used in depression and epilepsy, the study findings argue for a potential role of ‘OM’ chanting in clinical practice.
  • 35. Streeter CC et al. Med Hypotheses 2012; 78: 571-9  Stress induces autonomic imbalance  Decreased para-sympathetic & increased sympathetic activity, under activity of GABA system, the primary inhibitory neuro- transmitter, and increased allostatic load.  Yoga helps correct the underactivity of para- sympathetic nervous system and GABA systems in part through stimulation of vagus nerves with reduction in the allostatic load.
  • 36. Ornish D et al. Lancet Oncol 2013; 14:1112-20 “Our genes, and our telomeres, are not necessarily our fate,” - Dean Ornish  Telomere shortness is a prognostic marker of ageing, disease, and premature morbidity.  Previous study (2008) showed association between 3 months of comprehensive lifestyle changes and increased telomerase activity in immune cells.  A comprehensive lifestyle intervention was associated with increases in relative telomere length after 5 years of follow-up.
  • 37. But be careful!! Some studies have NO yoga in them at all !
  • 38. Lana Skoro-Kondza et al. BMC Health Services Research 2009; 9:33  There was a small statistically insignificant fall in HbA1c - not sustained > 6 months, no change in other outcome measures.  Around 2/3 of patients on GP diabetic registers proved ineligible, & 90% of the remainder declined to participate.  Only 50% attendance at classes -Nobody did the exercises regularly at home.  Most participants -unsuitable for 'standard' Yoga - limited flexibility, lack of basic fitness, co- morbidity and lack of confidence. Basically no yoga in the study at all!
  • 39. Make sure it was done in humans!!
  • 40. Lateral Sleeping Position Influences Clean- Up Of Brain's Metabolic Waste Products, Halts Neurological Diseases  Everyone started talking about all the possible benefits of humans sleeping on their side without even reading the full paper!  Rodent models were used to examine the glymphatic pathway — where CSF filters through the brain and exchanges with interstitial fluid to clear waste. The Journal of Neuroscience, 5 August 2015, 35(31): 11034-11044
  • 41. Some of our work in recent times 1. Randomized controlled trial of 12-week yoga therapy as lifestyle intervention in patients of essential hypertension and cardiac autonomic function tests. Natl J Physiol Pharm Pharmacol 2016; 6: 19-26. 2. Finding peace on a Psychiatric Ward with Yoga: Report on a pilot anthropological study in Pondicherry, India. Annals of SBV 2016; 5(2): 14- 9. 3. Effect of yoga therapy on fasting lipid profile in chronic kidney disease: a comparative study. Int J Adv Med 2018;5: 294-98. 4. Effects of overnight sleep deprivation on autonomic function and perceived stress in young health professionals and their reversal through yogic relaxation (Shavasana). Natl J Physiol Pharm Pharmacol 2018;8 5. Effect of adjuvant yoga therapy on pulmonary function and quality of life among patients with Chronic Obstructive Pulmonary Disease: A Randomized Control Trial. J Basic Clin Appl Health Sci. 2018; 2(3):117-22. 6. Immediate effect of Sukha Pranayama: A slow and deep breathing technique on maternal and fetal cardiovascular parameters. Yoga Mimamsa 2018; 50:49-52.
  • 42. 7. A comparative study on the effect of music therapy alone and a combination of music and yoga therapies on the psycho- physiological parameters of cardiac patients posted for angiography. J Basic Clin Appl Health Sci. 2018; 2:163-8. 8. Yoga training enhances auditory & visual reaction time in children with autism spectrum disorder: A case - control study. J Basic Clin Appl Health Sci. 2019; 2:8-13. 9. Effectiveness of adjuvant yoga therapy in diabetic lung: A randomized control trial. Int J Yoga 2019;12:96-102. 10. The efficacy of yogic breathing exercise Bhramari pranayama in relieving symptoms of chronic rhinosinusitis. Int J Yoga 2019;12:120-3. 11. Yoga therapy as an adjunct to traditional tooth brushing training methods in children with autism spectrum disorder. Spec Care Dentist. 2019; 1–6. 12. Effect of adjunct yoga therapy in depressive disorders: Findings from a RCT. Indian J Psychiatry 2019; 61:592-7.
  • 43. 13. Gupta K, Bhavanani A B, Ramanathan M, Rajasekar B, Sarkar S, Dayanidy G. Effect of Adjuvant Yoga Therapy on Craving in Participants of an Alcohol De-addiction Program: A Pilot Study. 2019; 2 (4):138-141. 14. Balaji R, Ramanathan M, Bhavanani AB. Nephroprotective Impact of Adjuvant Yoga Therapy on Diabetes - A Randomised Controlled Trial. J Clin Diagn Res.2020; 14(12): KC01-KC04. 15. Ramanathan M, Bhavanani AB. Yoga training enhances auditory and visual reaction time in elderly woman inmates of a hospice: A pilot randomized controlled trial. Yoga Mimamsa 2020;52:56-60. 16. Artchoudane S, Ramanathan M, Bhavanani AB, Muruganandam P, Jatiya L. Effect of Yoga Therapy on Neuromuscular Function and Reduction of Autism Severity in Children with Autism Spectrum Disorder: A Pilot Study. International Journal of Health Systems and Translational Medicine (IJHSTM). 2021; 1(1): 76-85. 17. Thiruvalluvan A, Sekizhar V, Ramanathan M, Bhavanani AB, Chakravathy D, C. Reddy JR. Effect of pranayama techniques with Marmanasthanam Kriya as yogic relaxation on biopsychosocial parameters prior to endodontic therapy: A cross sectional study . Int J Yoga 2021;14:146-51
  • 44. S W O T analysis of yoga research Udupa K, Ramanathan M, Bhavanani AB. SWOT Analysis in Yoga Research. J Basic Clin Appl Health Sci 2021;4(1):26–30. The New AUM Team
  • 45. Various items/factors  Strengths  Weakness  Opportunities  Threats, risks/challenges Internal factors: strengths and weakness Strengths of yoga: Cultural heritage Time tested and effective in various disorders Life style entity with many facets to training raising one’s consciousness to higher levels so as to unite with supreme consciousness. Weaknesses of yoga research: Low scientific vigor Not well validated, one cap fitting all heads approach Difficulties in conducting blinded RCT, getting ethics approval, funding and publishing in high impact journals External factors: opportunities and threats (risks / challenges) Opportunities: Conducting higher levels and deeper studies with proper design and involving multiple specialties Strength & Opportunities (SO) Strategies Conducting yoga Research with good design and in-depth studies not just superficial benefits Weakness & Opportunities (WO) Strategies Planning with proper control group, double blind, unbiased interpretation & convincing reviewers of funding agencies and journals with high quality of scientific work Threats: Compliance issues to carry out yoga training by participants Questionable data collection, analysis & interpretation. Strength & Threats (ST) Strategies Designing study countering all the threats/risks Weaknesses & Threats (WT) Strategies Designing study countering all the weakness, threats/risks
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