Dr Ananda Balayogi Bhavanani's invited talk at the 23rd International Conference on Frontiers in Yoga Research & its Applications. 3 - 6 January 2020. S-VYASA Deemed to be University, Bangalore, India
Integrating Yoga Therapy within the Modern Medical System
1. Integrating Yoga Therapy
within the
Modern Medical System
Yogacharya
Dr ANANDA BALAYOGI BHAVANANI
MBBS, MD (AM), ADY, DSM, DPC, PGDFH, PGDY, FIAY, C-IAYT, DSc (Yoga)
Director CYTER of Sri Balaji Vidyapeeth & Chairman ICYER at
Ananda Ashram, Puducherry, India. yognat@gmail.com
Presented at the 23rd International Conference on Frontiers in Yoga Research & its
Applications. 3 - 6 January 2020. S-VYASA Deemed to be University, Bangalore, India
2. SRI BALAJI VIDYAPEETH
(Deemed University Accredited with “A” Grade by NAAC)
Ranked 72 in NIRF 2018
Centre for Yoga Therapy, Education
and Research (CYTER)
Salutogenesis, our focus!
3. From CAM to TCI medicine: The journey
Alternative
CAM: Complementary & Alternative Medicine
TCI : Traditional, Complementary & Integrative medicine
4. From CAM to TCI medicine: The journey
Alternative
Complementary
CAM: Complementary & Alternative Medicine
TCI : Traditional, Complementary & Integrative medicine
5. From CAM to TCI medicine: The journey
Alternative
Complementary
Integrative
CAM: Complementary & Alternative Medicine
TCI : Traditional, Complementary & Integrative medicine
12. Bridging the experiential wisdom of Yoga with
empirical modern medical science @CYTER of SBV.
Yoga is usually found in Physical Edu
& Sports deptts of universities
We at CYTER, have it in a medical
institution since 2010
– quality of life enhancing benefits
for ~ 65,000 participants
– educating future Yoga therapists
(PGDYT, M.Phil, PhD),
– creating awareness amongst
medical, dental and nursing
students & professionals
– scientifically researching Yoga,
– 110 publications & 9 CMEs.
– IDY celebrations since 2015
13. Our Team
Honorary Advisor: Prof. Madanmohan
MBBS, MD, MSc, DSc (Yoga), FIAY
Director:
Dr. Ananda Balayogi Bhavanani
MBBS, ADY, PGDY, MD (AM), C-IAYT, DSc (Yoga)
Deputy Director:
Dr. Meena Ramanathan
MA, CYT, DYNS, PGDY, MSc, PhD (Yoga), C-IAYT
Assistant Professor: Sri.G Dayanidy,
MCA, MSc (Yoga), PGDYE, CYT, PGDYT
Yoga Instructors:
P Danushapnadeesh, MCA, MTech, DYEd, PGDYT
G Sarulatha, Dip Yoga and Bharatanatyam
• Director is an international authority
on yoga and yoga therapy and a
medical doctor with vast experience in
Yoga education, therapy and research.
Member National Board of Y&N-
Ministry of AYUSH, International Day of
Yoga, National DM & Yoga prog, ICH &
CCRYN. EC of IYA & Advisor IAYT &
AAYT. >250 papers & abstracts, 30
books and compilations, 19 DVDs &
~2000 citations with h-index 22 & i10-
index 39. 1st C- IAYT certified in India.
• Deputy Director is first Pondicherrian
to complete her PhD in Yoga. Extensive
experience in Yoga for geriatric
population and special children. She is
Yogathilakam awardee of PYA, C-IAYT
certified & Examiner for IYA PrCB.
• Assistant Professor is Yogachemmal
awardee from PYA, UGC Net qualified &
examiner for IYA PrCB.
14. Salutogenesis, our Focus
• Moving from pathogenesis, the focus on disease
towards salutogenesis, the focus on health!
• CYTER is striding forward on an innovative path of
promoting holistic health for one and all.
Pathogenesis
Salutogenesis
www.sbvu.ac.in/cyter
15.
16. Relevance to health care professionals
• Yoga is an experiential science and a dynamic state
of health is a by-product of Yoga
• “Re-orients the functional hierarchy of the entire
nervous system” - Dr B Ramamurthy
• Effective in preventing and combating the modern
pandemic of stress borne disorders.
• Scientific evidence indicates that Yoga has
– promotive, preventive and curative potential,
– is a safe, non-pharmacological therapy and is
– an effective lifestyle adjunct to reduce drug
dosage and improve QOL of patients
17. • Preventing and managing psychosomatic - stress
related disorders
– DM, hypertension, bronchial asthma, IBS,
epilepsy, back pain and functional disorders
• Reduce / eliminate drug dosage / dependence in
– DM, hypertension, epilepsy, anxiety, bronchial
asthma, constipation, dyspepsia, insomnia,
arthritis, sinusitis and dermatological disorders
• Yoga therapists must work in tandem with medical
doctors when managing patients on medical
treatment.
• “Collaboration” is the key word
18. “The treatment of the
part shouldn’t be
attempted without a
treatment of the entirety.
The treatment of the
body without treating
the mind and soul is a
useless waste of time”
- Plato
(428 – 348 BC)
19. • LIFE STYLE MODIFICATIONS: “Yoga is a system of
perfect tools for achieving union as well as healing”
-Dr Dean Ornish
• REHABILITATION: “Modern medicine kept me alive,
Yoga gave me back my life”- Dr Swami Gitananda Giri
• COPING SKILLS: “Yoga may not be able to always cure
but it can surely help us to endure”- Sri BKS Iyengar
• HEALTHY DIET : biogenic, guna based diets
• RELAXATION: spanda -nishpanda concepts
• EXPENDITURE: cost effective, cost lowering
• AGING : anti-aging, regenerating, “young at heart”
• PSYCHOTHERAPY: the mind and beyond
• WOMEN’S HEALTH: puberty, pregnancy, menopause
• RESEARCH: Basic and applied scientific & literary
20. SOME THERAPEUTIC BENEFITS
• Yoga modifies coronary artery disease risk factors
and helps reverse heart disease
• Patients of respiratory disorders have shown
improvement with Yoga therapy
• Therapeutic tool for MR children -improvement in
IQ and social adaptation
• Has shown great potential in metabolic conditions-
diabetes, obesity, metabolic syndrome etc
• Psychiatry: OCD–improvement in Yale/Brown &
perceived stress scales , anxiety, depression
21. • 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.
26. Impact of stress on hypothalamic–pituitary–adrenal
(HPA) axis and sympathetic NS.
* Yoga has been shown to have significant beneficial effects in these
Sengupta P. Health Impacts of Yoga and Pranayama: A State-of-the-Art Review. Int J Prev Med 2012; 3:444–58.
27. 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.
29. Relaxation is the key to healing!
• An essential prerequisite for healing.
• We cannot heal when we are stressed.
• Conscious relaxation facilitates self-healing
• All about educing the “Relaxation Response”
• Yoga’s greatest contribution
to modern healthcare!
30. 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
* Concept and image courtesy of Sat Bir S Khalsa, PhD USA
31. Postulated mechanisms by which Yoga
reduces cardiovascular risk
Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and
possible protection with yoga: a systematic review. J Am Board Fam Pract 2005;18:491-519.
32. Possible factors responsible for improvement of
physical performance by yoga
Ray US, Pathak A, Tomer OS. Hatha Yoga Practices: Energy Expenditure, Respiratory Changes and Intensity of
Exercise. Evid Based Complement Alternat Med. 2011; 2011: 241294.
PERFORMANCE IMPROVEMENT
BY YOGA
Cardio-respiratory reserve
Hemodynamic function
Respiratory function
Tidal volume
Respiratory rate
Body flexibility
Isometric nature of
asanas
Psycho-physiological functions
Local muscular Adaptation:
Lactate threshold
Perceived exertion
of exercise
Modulation of frequency and
duration of practices
33. Proposed relationships among dyspnea, benefits of yoga,
and outcomes of participation in a yoga program.
Donesky-Cuenco D, Nguyen HQ, Paul S, Carrieri-Kohlman V. Yoga Therapy Decreases Dyspnea-Related Distress and Improves
Functional Performance in People with Chronic Obstructive Pulmonary Disease: A Pilot Study. J Altern Complement Med
2009; 15: 225–234.
Mechanisms and
Correlates of Dyspnea
Proposed Benefits of
Yoga Training Proposed Outcomes of
Yoga Training
Hyperinflation
Hyperventilation
Hypoxemia
Hypercapnea
Work of breathing
Respiratory muscle
weakness
Deconditioning
Depression
Anxiety
Fatigue
Respiratory rate
Airway resistance
Respiratory muscle
strength
Autonomic arousal
Heart rate
Depression
Anxiety
Panic Attacks
Confidence in control
of breathing process
Muscle strength
Balance
Coordination
Flexibility
Dyspnea
Dyspnea – related
distress
Depression
Anxiety
HR
QoL
Physical performance
34. Postulated mechanisms for role of yoga in
pregnancy outcomes
Chuntharapat S, Petpichetchian W, Hatthakit U. Yoga during pregnancy: effects on maternal comfort, labor pain and
birth outcomes. Complement Ther Clin Pract 2008; 14(2): 105-15.
Yogasanas
Chanting AUM
Breathing awareness
Yoga nidra
Dhyana
Relaxation of body-
mind
Improved physical
strength
and flexibility
Body-mind calmness
Improved self-
awareness Birth outcomes scores
Maternal comfort
Labor pain
35. Yoga in cancer related fatigue
Bower JE, Garet D, Sternlieb B. Yoga for persistent fatigue in breast cancer survivors: results of a pilot study. Evid Based
Complement Alternat Med 2011; 2011:623168.
12-week Iyengar Yoga Programme
for Cancer Related Fatigue
Improved physical
performance
(chair stands)
Decreased severity and
duration of fatigue
Improvements in general
health quality of life and
reduction in depressive
symptoms
36. Yoga in chronic low back pain-mechanisms
Sherman et al., Comparison of yoga versus stretching for chronic low back pain: protocol for the Yoga Exercise Self-care
(YES) trial. Trials 2010; 11:36
YOGA
POSITIVELY IMPACTS COGNITIVE
APPRAISAL
(e.g., decreases fear avoidance & catastrophizing: increases
self efficacy & conscious awareness of the body)
REDUCES PHYSICAL
IMPAIRMENT
(e.g., increases strength & flexibility)
DECREASES BACK
PAIN/ DYSFUNCTION
POSITIVELY IMPACTS AFFECT AND STRESS
(e.g., decreases psychological distress & perceived stress;
increases positive affect)
IMPROVES NEUROENDOCRINE
FUNCTION
(e.g., normalizes HPA axis)
37. Improved baroreflex
sensitivity
Normalization of autonomic
cardiovascular rhythms
Enhanced cardiac
autonomic regulation
Integrated relaxation
response with
decreased after load
Pranava
pranayama
Sukha
pranayama
Mild ‘Valsalva like’ effect
with decreased pre- load
↓
HR
↓
DP
↓
SP
↓
MP
↓
RPP
Savitri
pranayama
Chandranadi
pranayama
Clinically
valuable
in
HT & DM
Bhavanani AB et al. Int J Yoga Ther 2011; 21: 73-76 & Yoga Mimamsa 2012; 44: 101-112. Indian J
Physiol Pharmacol 2012; 56: 273–78 & Biomed Human Kin 2012: 4: 66 – 69. Int J Yoga 2012; 5: 108-11
43. 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.
44. Some of our work in recent times (contd..)
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.
45.
46.
47.
48. “Path breaking innovation
indeed. Much needed for the
modern world. Congrats SBV!”
Ammaji
“CYTER is such a huge
inspiration. There should be
many more projects like
this.”- Yogacharini Kalavathi,
Wales, UK
“CYTER is balancing the
difficult path of staying true to
tradition on one hand, and
adapting it to the modern
world on the other .
Dr Ramesh Bijlani, AIIMS
CYTER is engaged in spreading
awareness about traditional Yoga
and its benefit for the welfare of
society, in addition to carrying out
research in yoga to establish strong
scientific foundation for Yoga, which
is most needed of the hour.
-Dr HR Nagendra, Chancellor
S-Vyasa Yoga University
49. CYTER is doing the perfect seva,
with a strong knowledge base.
-Dr Shirley Telles, Patanjali
Research Foundation
Haridwar
“CYTER is not just a centre, it
is the medicine of the future.
Joseph Le Page, Integrative
Yoga Therapy, USA.
“CYTER will surely be one
of the torch bearers in
Yoga Therapy worldwide in
time to come.”
Sri S Sridharan, KYM
“A great opportunity to train
‘hands on’ in the application
of Yoga in medicine.
Excellent training in a yoga
therapy department within a
modern medical hospital
with a unique team!” -
Nathalie Cazach,
Student PGDYT, France.
51. “Yoga therapy is the process of
empowering individuals to
progress toward improved health
and wellbeing through the
application of the teachings and
practices of Yoga”. – IAYT