YOKING TOGETHER YOGA RESEARCH,

THERAPY & EDUCATION

Yogacharya Dr. ANANDA BALAYOGI BHAVANANI

MBBS, ADY, DSM, DPC, PGDFH, PGDY, FIAY, MD (AM)Deputy Director CYTER, Sri Balaji Vidyapeeth andChairman ICYER at Ananda Ashram, Pondicherry.

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Student

Therapist

PatientResearcher

TeacherKey

players

Requirements for the yoking

Yoga instructors & therapists must be up-to-dateon modern research and its findings.

Must be able to understand the actual findingsthrough the methodology adopted and notmerely “read” general news items that are oftenmisleading and only highlight ‘news’.

Must bring the knowledge so gained into theiractual clinical practice and class room teachingthus empowering next generation of instructorsand therapists.

To be a competent yoga instructor and therapist,

We require intelligence and empathy,be willing to share, need to understand our limitations, realize we are not perfect and be willing to embark on a continuously

expanding learning curve.

The day we stop learning is the day we stop living!

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 importantquestion, “Who am I ”?

More than a 100 years ago Swami Vivekananda gavea dynamic call to rid Yoga and spirituality of thecobwebs of hidden mysteries.

Scientific and philosophico-literary research isessential to confirm, validate & enhance theunderstanding and application of Yogic concepts andpractices for the benefit of humanity.

Swami Kuvalayananda & Kaivalyadhama– ML Gharote, MV Bhole, PV Karambelkar, SL Vinekar

Medical scientists at – AIIMS, BHU, 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 reallyresearching 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 and 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 quantitativelyand qualitatively measure effects of Yoga?

What to do in most aspects of Yoga thatare beyond present day capacity?

How to keep the “Yoga” in Yoga research? How to enable the knowledge gained of

modern research to percolate down intoclinical 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 specificquestion which needs an answer leading to anew question

Most research in Yoga today however seemseither to be for curing diseases and disordersthat are rampant in modern world or topublicize 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”.

SOME INTERESTING YOGA RESEARCH IN

RECENT TIMES

Selvamurthy W et al. IJPP 1998; 42: 205-213

Helped understand physiological mechanismunderlying effects of selected yogic exercisesin the treatment of essential hypertension

3 weeks course of tilt and head down yogicexercise (sarvangasan) clearly indicated gradualimprovement in baroreflex sensitivity

Progressive attenuation of sypatho-adrenal andrenin-angiotensin 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.

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 GSRsignifying reduction in sympathetic activity

Breathing selectively through either nostril hasmarked activating or relaxing effect on thesympathetic nervous system.

Raghuraj Pet al. IJPP 1998 ; 42: 467-72

Studied HRV in fast and slow breathingtechniques– Kapalabhati and Nadishuddhi

Kapalabhati modifies autonomic status– increasing sympathetic activity– with reduced vagal activity.

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 mayhave therapeutic value.

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 weekonwards and peaked by 4 weeks

Significant ↑in BP, HR & RPP with IHG aftertraining indicated restoration of cardio-vascular reflex mechanisms.

Findings confirmed in recent RCT by PunithaP 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 recent RCTs by Dinesh T and

Sharma VK (JCDR 2014, IJOY 2015).

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 rateApplication of kumbhak may be different and varied in potential cases accordingly

Bhavanani AB et al. Int J Yoga 2011; 4: 71-76.

Effects of 6 months of training given in Slow SuryaNamaskar (SSN) at 6 rounds /30 min and Fast SuryaNamaskar (FSN) at 15 rounds ‘30 min for schoolchildren.

Cardiovascular (HR, BP) and muscular physiological(HGS, HGE) effects studied.

Effects of FSN are similar to physical aerobic exerciseswhereas effects of SSN are similar to those of Yogatraining.

Manjunatha S et al. IJPP 2005; 49: 319-24.

Do yoga asanas increase insulin secretionfrom the pancreas?

Serum insulin levels after asanas were lowerthan those before the asanas

Serum insulin level 0.5 h after post-asana oral75 g-glucose challenge was higher

The performance of asanas led to increasedsensitivity of the β cells of pancreas to theglucose signal

Streeter CC et al. Med Hypotheses 2012; 78: 571-9

Stress induces autonomic imbalance Decreased para-sympathetic & increased

sympathetic activity, under activity of GABAsystem, the primary inhibitory neuro-transmitter, and increased allostatic load.

Yoga helps correct the underactivity of para-sympathetic nervous system and GABA systemsin part through stimulation of vagus nerves withreduction in the allostatic load.

Raghavendra Rao et al.ComplementaryTherapies in Medicine 2009; 17: 1—8

Compared anxiolytic effects of Yoga &supportive therapy in Ca breast patientsundergoing conventional treatment.

Overall decrease in both self-reported stateanxiety & trait anxiety in Yoga group

Positive correlation between anxiety states andtraits with symptom severity and distress duringconventional treatment intervals.

Yoga has a role in palliative care in terminalcases too.

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.

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 inHbA1c - not sustained > 6 months, no change inother outcome measures.

Around 2/3 of patients on GP diabetic registersproved ineligible, & 90% of the remainderdeclined to participate.

Only 50% attendance at classes -Nobody did theexercises 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 thepossible benefits of humans sleeping on theirside without even reading the full paper!

Rodent models were used to examine theglymphatic pathway — where CSF filtersthrough the brain and exchanges withinterstitial fluid to clear waste.

The Journal of Neuroscience, 5 August 2015, 35(31): 11034-11044

The Journal of Neuroscience, 5 August 2015, 35(31): 11034-11044

Comprehensive bibliometric analysis of Yoga therapyresearch 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 inthe last 10 years, 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). The top three disorders addressed by yoga

interventions were mental health, cardiovasculardisease, and respiratory disease.

Other recent reviews by Kim Innes (2005, 2007 and2012), Yang (2007) and Sengupta (2012) have alsohighlighted role of Yoga therapy.

Unless we aim to treat the individual’s underlyingpsycho-somatic disassociation and ignorant,jaundiced perception of reality, we are not practicingreal yoga chikitsa.

Thiruvalluvar, the Dravidian saint advises us to lookfor the disease, look for its root cause, search theremedy and apply it (noi naadi noi mudhal naadiathuthanikkum vaai naadi vaippach cheyal -Tirukkural 948).

Managing and suppressing manifest symptoms usingYoga techniques without trying to find and correctthe ‘underlying’ cause is better described asYOGOPATHY!

The vital and living, experiential link in the chainof Yoga seems to be missing in today’s Yogaeducation, research and therapy.

This link is the individual’s personal sadhana. Unless we ourselves know what to do, how to

do it, why we do it, and what it feels like whenit´s done, how can we intelligently “prescribe”,or “ teach” it to others?

Isn’t it against the very spirit of yama-niyama torecommend/ teach a practice without personalexperience of the nature of the practice itself?

The above caveat also holds true for researchersstudying the effects of Yoga techniques.

They try to fit the grand design of Yoga into thelimited box of their methodology and end up notstudying “Yoga” at all.

If we don’t have the ‘experience’ of thetechnique and its ‘state of being’, what are wegoing to research, and report?

Papers are published that are excellent from ascientific perspective, but truly very limited froma Yogic perspective.

When we acknowledge that Yoga demandsconsciousness in every moment, this conundrumbecomes even thicker, deeper, and more difficultto sort out.

Unless we live a life of Yoga, or at least attemptto do so, how can we understand the inherentspirit of ‘wholesomeness’ that yokes everything?

A good teacher teaches more by example thanwords, and so does a good therapist, who healsmore by ‘being’ the therapy than by justprescribing techniques galore.

It’s not just about mere qualifications or the lackof them.

The need of the hour is a symbiotic relationshipbetween Yoga and modern science.

Living, human bridges combining the best of bothworlds need to be cultivated.

Yoga is all about becoming "one“, an integrated“state of being”.

Yogopathy, in contrast, is more about "doing"than "being".

We, as Yoga practitioners, teachers, researchers,and therapists, must make a sincere anddetermined attempt to strengthen that oneimportant link in the chain of Yoga - the link ofour personal, ‘every moment sadhana’.

THANK YOU

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