“One new approach for treating mood and anxiety disorders is hatha yoga, a form of yoga that uses physical postures in combination with breathing and/or meditation practices,”(Vollbehr et al. 2018). The leading cause of long-term disabilities within the older adult demographic is osteoarthritis which affects approximately 33.6% of people above the age of 65 years (Park et al. 2017). In the past twenty years, metabolic syndrome (MetS) has become a pandemic, which is rapidly increasing (Lau et al., 2015). Metabolic syndrome has become a growing problem across the globe. The research on how yoga can benefit one’s health is a significant finding even though it is not fully understood. Yoga can improve the client’s mobility by maintaining and improving their range of motion, circulation, and bone strength (Wolter’s Kluwer, 2020). Along with this, yoga can improve one’s health by lowering their waist line, blood pressure, and stress(McEwee, 2020).
Review of Literature
Caren Lau, Ruby Yu*, Jean Woo (2015). Effects of a 12-Week Hatha Yoga Intervention on Metabolic Risk and Quality of Life in Hong Kong Chinese Adults with and without Metabolic Syndrome
This randomized control, which tested a two- armed, non blinded control trial. It analyzed the effect that a twelve week Hatha yoga program would have on 173 Chinese men and women, from Hong Kong, with and without MetS. Metabolic syndrome is an amalgamation of conditions that occur simultaneously. This condition increases your risk of heart disease, stroke and type 2 diabetes. Consequently, these clients tend to have a raised blood pressure, increased blood sugar, a higher percentage of body fat around the waist, and abnormal cholesterol or triglyceride levels.
Eighty- seven of the participants were assigned to the yoga group and eighty- six were assigned to the control group. The mean age of the study population was between the ages of thirty- one and seventy- one years old. They created a hypothesis that those who participated in the yoga group would have an improved metabolic risk than those in the control group. The control group was asked to keep their routine activities the same and not began any new exercise regimens. The research demonstrated that the program had significant benefits on metabolic risk factors, MetS Z score and HRQoL compared to the control group. This also included waist circumference, fasting glucose, and triglycerides. Their findings demonstrated a minor favorable effect of the yoga program on the non-MetS. The authors stated that anti-hypertensive medication use in MetS yoga participants had potential benefits on their blood pressure. The reduction in the fasting glucose of the entire group, confirms the results from twenty- five other studies on the benefits of yoga. The underlying relationship between yoga and its influence of fasting glucose are not fully understood. The authors stated that it is possible that by lowering the activity of the sympathoadrenal system (SAS) and the hypothalamic pituitary adrenal (HPA) axis, yoga can enhance a client’s health and well- being. Along with this, yoga can reduce oxidative stress and improve their levels of antioxidants, thus creating a protective effect on type 2 diabetes. However, the beneficial effects of the yoga program for fasting glucose was not concluded in MetS participants; further studies are needed in order to clarify the glucose- lowering effect (Lau et al. 2015).
Bastille, J. V., & Gill-Body, K. M. (2004). A Yoga-Based Exercise Program for People With Chronic Poststroke Hemiparesis. Physical Therapy, 84(1), 33–48.
This single-case study conducted in 2004 evaluated the effects of yoga on people with poststroke hemiparesis. Yoga may be used as an alternative form of rehabilitation therapy instead of standard exercise programs. The four subjects from Keene, New Hampshire met the following four conditions necessary for this study: (1) they have experienced a stroke more than nine months ago, (2) they have moderately impaired motor function in lower-extremities according to the Fugl-Meyer-Sensimotor Assessment, (3) able to walk without assistance, (4) completed rehabilitation. The yoga session therapy included various activities. First the subjects were educated on the musculoskeletal, nervous, and circulatory structures of the body as well as yoga concepts. The goal of this activity was to inform and develop a better understanding of the mind and body. The second activity was to increase body awareness. The goal was to promote awareness of body sensation, position, and activity of the mind. The third activity involved voluntary breathing. The goal of this activity was to increase awareness of breath throughout the body and how it affects movement and concentration. The following activity involves physical poses. The goal of this activity was to develop better flexibility, muscle force, endurance, balance, and coordination. The next activity was guided imagery. The goal of this activity was to encourage relaxation. The following activity was a seated silent meditation. The goal of this activity was to encourage mental clarity. The last activity was expression. The goal was to share their experiences and encourage awareness of any changes to mind or body (Bastille et al., 2004).
The subjects’ improvements were evaluated using the Berg Balance Scale (BBS) and Timed Movement Battery (TMB). BBS involved 14 activities that tested the subject’s balance and was graded on a scale from 0 to 4 with a maximum score of 56. TMB involved 11 mobility tasks that were performed at 2 speeds: self-selected speed (SS) and maximum movement (MM). The difference between SS and MM is referred to as reserve speed (RS), which helps measure the ability to do activities safely at speeds faster than normal. Another indicator called Stroke Impact Scale (SIS), helped evaluate the quality of life. It was used prior to the intervention period and after the intervention period (Bastille et al., 2004).
Subject 1 showed improvements in total TMB SS scores, but not in BBS or total TMB MM scores. It is important to note that Subject 1 had a low adherence to the program. Subject 2 showed the most number of changes which may be due to his/her consistent adherence to the program. The TMB SS and MM tests resulted in a 14 second improvement. The results of Subject 3 did not reflect any improvements in TMB tasks. Subject 3 had difficulty participating in the program due to complaints of pain and fear of worsening her condition. However, she has shown improvements in the BBS tests. Subject 4 was not consistent with the yoga program due to complaints of fatigue. However, Subject 4 had also shown improvements during the BBS tests, which indicate an improvement in balance abilities (Bastille et al., 2004).
Some possible barriers and weaknesses of this study include the small sample size and adherence to the program. The results of this study may indicate that yoga is beneficial to those who are consistent with the activities of the program.
Wieland L.S., Skoetz N., Pilkington K., Vempati R., D’Adamo C.R., Berman B.M. (2017). Yoga treatment for chronic non-specific low back pain. Cochrane Database of Systematic Reviews
Yoga Treatment for chronic non-specific low back pain: Low back pain is a common problem for many people. Some people may have chronic back pain. Yoga could be a treatment for low back pain (Wieland et al., 2017).
The systematic review on the randomized control study was to analyze the effects of yoga for treating chronic non-specific low back pain, compared to no or minimal treatment. The study included 12 trials (1080 participants) that occurred in the USA (seven trials), India(three trials), and the UK(two trials). The trials compared yoga to no intervention or a non-exercise intervention such as education (seven trials), an exercise intervention(three trials), or both exercise and non-exercise interventions(two trials). Yoga, compared to non-exercise controls, resulted in low-certainty evidence that yoga produced small to moderate improvement in back-related pain at three to four months. For yoga compared to back-centered exercise, there was insufficient certainty evidence that there may be little or no difference between yoga and non-yoga exercise in improving back pain at three and six months. Also, interestingly moderate-certainty evidence was found in the study that there was a high risk of increased back pain in yoga than in non-exercise. Overall, the study does provide evidence that yoga does provide small-moderate improvement compared to non-exercise. Still, compared to other forms of exercise, there is no real difference in evidence of back pain improvement (Wieland et al. 2017).
Nursing Implications: Yoga does show improvement in back pain compared to no exercise. However, with yoga compared to other back activities, there was no real difference in the improvement of pain. Yoga combined with specific back exercises/stretches, should be the best method to improve back pain. Also, the exercises and yoga have to be performed with proper form to ensure that there will not be an actual inadvertent effect of increased back pain. The nursing implication is to advise patients with back pain to do yoga and to stretch. Yoga can be beneficial for rehabilitation (Wieland et al., 2017).
Yoga is a very beneficial exercise for the mind, body, and soul. In this particular study, the focus was on how yoga can benefit the body in improving back pain, metabolic function, and musculoskeletal motor function
Bastille, J. V., & Gill-Body, K. M. (2004). A yoga-based exercise program for people with
chronic poststroke hemiparesis. Physical Therapy, 84(1), 33–48.
Lau, C., Yu, & Woo (2015). “Effects of a 12-Week Hatha Yoga Intervention on Metabolic Risk and Quality of Life in Hong Kong Chinese Adults with and without Metabolic Syndrome.” Plos One, vol. 10, no. 6, 2015, doi:10.1371/journal.pone.0130731.
McElwee, T. (2020). N213 Evidence Based Practice. Topic Five: Conducting Evidence-Based Practice [PowerPoint slides].
Taylor C., Lynn P., & Bartlett (2019). Taylor’s Fundamentals of Nursing (9th ed.). Philadelphia,
PA: Wolters Kluwer.
Wieland L.S., Skoetz N., Pilkington K., Vempati R., D’Adamo C.R., Berman B.M. (207). Yoga treatment for chronic non-specific low back pain. Cochrane Database of Systematic Reviews doi: 10.1002/14651858.CD010671.pub2.
Wolters Kluwer, (2020). Concept Definitions with Exemplars.