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Yoga meditation-medicine (1)


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Yoga meditation-medicine (1)

  1. 1. Yoga and Medicine
  2. 2. 3 Questions • What is Yoga? • What is the evidence that Yoga has health benefits? • How do I use and prescribe Yoga as a physician?
  3. 3. Yoga • 5000 years old • founded in India • The word “Yoga” means “yoke” or “unity” translated from Sanskrit, the classical language of India. • It also means “discipline” or “effort.”
  4. 4. Yoga • Yoga requires you to make an effort to unify your body and mind. • You do this by concentrating your awareness on your physical body through breathing and postures.
  5. 5. Meditation is part of Yoga • Meditation is a technique in which the meditator seeks not only to reach a deep state of relaxation, but to quiet the mind. • The mind is a chattering monkey that one tries to make quiet with meditation.
  6. 6. Meditation seeks a state of enlightenment, a freedom from the tyranny of our worries.
  7. 7. Types of Yoga The approach to Yoga that focuses on postures is called Hatha (haht-hah) Yoga. • Ananda • Ashthanga • Bikram • Iyengar • Kundalini • Sivananda • Viniyoga
  8. 8. Yoga breathing • Abdominal breathing • Sends a fax to the brain to relax • Close your eyes • Put your hand on your belly • Imagine …..
  9. 9. Yoga postures (Asanas) • Asanas are the heart of Hatha Yoga • Stretching that maintains and enhances flexibility • Many poses are a form of isometric strengthening exercise, which involve the contraction of muscles without moving the joint. • Isometric exercise is often used in physical therapy for the rehabilitation of injured joints.
  10. 10. Meditation techniques • Focused • Mantra • Walking
  11. 11. Focused Meditation • is a technique in which you direct your awareness onto something. – a picture or statue of a deity – a universal principle such as compassion or forgiveness – or the syllable OM, the famous Hindu mantra.
  12. 12. Mantra meditation • In Sanskrit, the “man” in mantra means “to think,” and “tra” suggests instrumentality. • Mantra literally means an instrument of thought. • You repeat a word, phrase or sound in order to transcend the constant distractions of the mind.
  13. 13. Transcendental Meditation (TM) • movement founded by Maharshi Mahesh Yogi of India.
  14. 14. Functional Mapping of Meditation • Meditation is a conscious mental process that induces a set of integrated physiologic changes termed the “relaxation response” by Herbert Benson. • Functional magnetic resonance imaging (fMRI) was used to identify and characterize the brain regions that are active during a simple form of meditation.
  15. 15. Results • Significant signal increases were observed in the dorsolateral prefrontal and parietal cortices, hippocampus/parahippocampus, temporal lobe, pregenual anterior cingulate cortex, striatum, and pre- and post-central gyri during meditation. • This indicates that the practice of meditation activates neural structures involved in attention and control of the autonomic nervous system. – Neuroreport. 2000 May 15;11(7):1581-5. Functional brain mapping of the relaxation response and meditation. Lazar SW,…, Benson H.
  16. 16. Decrease in Beta-wave activity after meditation
  17. 17. Question • What is the evidence that Yoga/meditation have health benefits?
  18. 18. There is good scientific evidence that exercise: • Increases muscle and bone strength • Increases lean muscle and decreases body fat • Helps control weight • Enhances your psychological wellbeing, reduces depression • Reduces symptoms of anxiety and improves your general mood
  19. 19. Yoga is exercise • Stretching for flexibility • Improved Strength • Improved Balance
  20. 20. Evidence for Health Benefits of Yoga • HTN – Relaxation Response • Carpal Tunnel Syndrome • Asthma and improved vital capacity • Stress reduction to diminish the many conditions caused or made worse by stress.
  21. 21. Relaxation Response • Herbert Benson, MD • founding President of the Mind/Body Medical Institute • Associate Professor of Medicine, Harvard Medical School
  22. 22. Relaxation Response • Sit comfortably with your eyes closed. • Pay attention to your breathing, and repeat a word or phrase or prayer silently to yourself as you exhale. • When you notice your mind wandering (It will) just notice it and passively bring your attention back to your breathing. – A form of meditation.
  23. 23. Autonomic NS • Sympathetic NS • Parasympathetic NS
  24. 24. Fight or Flight • Whether you fight or run, your sympathetic nervous system will be on overdrive pumping out nor-epinephrine. • What are the physiological effects of this process? • Why would you not want this to be a chronic state of existence?
  25. 25. Fight or Flight • Yoga and meditation decrease this sympathetic tone and reduce feelings of stress and anxiety • Many modern health problems are worsened by stress and anxiety • Yoga works to decrease sympathetic tone
  26. 26. Relaxation Response • Significantly greater reductions in psychological distress, anxiety, and perceived stress were found in the experimental group who had learned the relaxation response. – The evaluation of a mind/body intervention to reduce psychological distress and perceived stress in college students. – Deckro GR, …, Benson H. – J Am Coll Health. 2002 May;50(6):281-7.
  27. 27. Yoga can prevent Seizures • More than 50% reduction in seizure frequency and duration compared with the control groups. – Cochrane Database Systematic Rev. 2000;(3)
  28. 28. Yoga for Poststroke Rehabilitation • A yoga-based exercise program for people with chronic poststroke hemiparesis. – Pilot study with four patients • Gentle exercise program adapted for people who have had a stroke. • Yoga showed some benefit. – Bastille JV, Gill-Body KM. Phys Ther. 2004 Jan;84(1):33-48.
  29. 29. Yoga to improve quality of life of patients with cancer • Persons with breast or prostate cancer were taught to use Yoga. • Significant improvements were seen in overall quality of life, symptoms of stress, and sleep quality. • Carlson LE, et al. Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress … in breast and prostate cancer outpatients. • Psychoneuroendocrinology. 2004 May;29(4):448-74
  30. 30. Pain in the hands • Evaluation of a yoga based regimen for treatment of osteoarthritis of the hands. • The Yoga program was effective in providing relief in hand osteoarthritis. Garfinkel MS, et al. J Rheumatol. 1994 Dec;21(12):2341-3.
  31. 31. Carpal Tunnel Syndrome
  32. 32. Carpal Tunnel Syndrome • “Current evidence shows significant shortterm benefit from oral steroids, splinting, ultrasound and yoga.” • Cochrane review, Issue 1, 2004. • Garfinkel, et al. Yoga-Based Intervention for Carpal Tunnel Syndrome. A Randomized Trial. JAMA. 1998
  33. 33. Eczema Story
  34. 34. Health Conditions in which Yoga may help heal or treat • • • • • • • • • Arthritis Allergies Asthma Hypertension Coronary Artery Disease Irritable Bowel Syndrome Heartburn (GERD) Constipation Tension Headaches and Migraines • PMS and Menstrual Discomfort • Menopause • Pain of the Back, Hips, Knees • Depression & Anxiety • Substance Abuse • Skin Disorders • Chronic Fatigue Syndrome • Overweight • Sleep Problems
  35. 35. Yoga and Meditation to stay healthy • Exercise and relaxation can reduce feelings of stress and keep the body and mind healthy
  36. 36. Question • How do I use and prescribe Yoga as a physician?
  37. 37. Treating Back Pain with Yoga • Similarities to PT – Williams flexion exercises – McKenzie extension exercises • Addition of breathing and relaxation
  38. 38. Yoga and Meditation • As forms of medical treatments do Yoga and Meditation meet standards for being safe and effective? • Safer than most medications – No adverse effects such as allergic reactions, liver or kidney damage as seen with some medications.
  39. 39. Safety • Safe from musculoskeletal injuries if you listen to your own body • No pain and a lot of gain • Avoid postures that you can’t handle • Can continue in to older age – 80 year old yoga teacher in San Antonio
  40. 40. Effective • We have reviewed some studies showing effectiveness for certain conditions • More studies are being done • People only continue Yoga when they find that it works for them • Built in effectiveness meter • People often continue medications when they see or feel no benefit and are subject to real side effects • Can be free – cost effective
  41. 41. Yoga and Meditation • Best when they are practiced as part of an overall healthy lifestyle: – Good diet – Aerobic exercise – No smoking – Safe drinking – Wearing seatbelts
  42. 42. How to get started • Books - hundreds • Videos - many • Classes – all over San Antonio •
  43. 43.
  44. 44. Conclusion • Yoga can be valuable to: – You – Your patients • WE can write prescriptions for healthy lifestyles (not just medications) – Diet and exercise – Smoking cessation – Yoga