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Yoga and Medicine 3 Questions What is Yoga? What is the evidence that Yoga has health benefits? How do I use and prescribe Yoga as a physician? Yoga 5000 years old founded in India The word “Yoga” means “yoke” or “unity” translated from Sanskrit, the classical language of India.

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Yoga and Medicine

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Yoga and Medicine


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3 Questions

  • What is Yoga?

  • What is the evidence that Yoga has health benefits?

  • How do I use and prescribe Yoga as a physician?


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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.”


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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.


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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.


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Meditation seeks a state of enlightenment, a freedom from the tyranny of our worries.


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Types of Yoga

The approach to Yoga that focuses on postures is called Hatha (haht-hah) Yoga.

  • Ananda

  • Ashthanga

  • Bikram

  • Iyengar

  • Kundalini

  • Sivananda

  • Viniyoga


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Yoga breathing

  • Abdominal breathing

  • Sends a fax to the brain to relax

  • Close your eyes

  • Put your hand on your belly

  • Imagine …..


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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.


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Meditation techniques

  • Focused

  • Mantra

  • Walking


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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.  


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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.


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Transcendental Meditation (TM)

  • movement founded by Maharshi Mahesh Yogi of India.


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Beatles


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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.


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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.


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Decrease in Beta-wave activity after meditation


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Question

  • What is the evidence that Yoga/meditation have health benefits?


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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 well-being, reduces depression

  • Reduces symptoms of anxiety and improves your general mood


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Yoga is exercise

  • Stretching for flexibility

  • Improved Strength

  • Improved Balance


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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.


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Relaxation Response

  • Herbert Benson, MD

  • founding President of the Mind/Body Medical Institute

  • Associate Professor of Medicine, Harvard Medical School


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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.


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Autonomic NS

  • Sympathetic NS

  • Parasympathetic NS


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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?


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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


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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.


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Yoga can prevent Seizures

  • More than 50% reduction in seizure frequency and duration compared with the control groups.

    • Cochrane Database Systematic Rev. 2000;(3)


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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.


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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


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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.


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Carpal Tunnel Syndrome


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Carpal Tunnel Syndrome

  • “Current evidence shows significant short-term 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


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Eczema Story


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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

Health Conditions in which Yoga may help heal or treat


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Yoga and Meditation to stay healthy

  • Exercise and relaxation can reduce feelings of stress and keep the body and mind healthy


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Question

  • How do I use and prescribe Yoga as a physician?


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Treating Back Pain with Yoga

  • Similarities to PT

    • Williams flexion exercises

    • McKenzie extension exercises

  • Addition of breathing and relaxation


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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.


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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


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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


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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


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How to get started

  • Books - hundreds

  • Videos - many

  • Classes – all over San Antonio

  • http://www.texasyoga.com/directories/san_antonio_yoga.html


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http://www.santosha.com/asanas/index.html


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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


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