Complementary Therapies in Clinical Practice 17(2011)1-8 Contents lists available at ScienceDirect CLINICAL PRACTICE Complementary Therapies in Clinical Practice ELSEVIER journal homepage:www.elsevier.com/locate/ctcp Yoga clinical research review Tiffany Field a.b.* Touch Research Institute,University of Miami School of Medicine,USA Fielding Graduate University.CA.USA ABSTRACT Keywords: In this paper recent research is reviewed on the effects of yoga poses on psychological conditions Yoga including anxiety and depression,on pain syndromes,cardiovascular,autoimmune and immune Cortisol Vagal activity conditions and on pregnancy.Further.the physiological effects of yoga including decreased heartrate and Pain blood pressure and the physical effects including weight loss and increased muscle strength are reviewed.Finally.potential underlying mechanisms are proposed including the stimulation of pressure receptors leading to enhanced vagal activity and reduced cortisoL.The reduction in cortisol,in turn,may contribute to positive effects such as enhanced immune function and a lower prematurity rate. 2010 Elsevier Ltd.All rights reserved. 1.Yoga research Many forms of yoga involving asanas have been described including,for example,Hatha yoga(Hatha meaning sun/moon). 1.1.Origins and practice of yoga which is considered the most relaxing form(see Table 1).Ashtanga is a programmed series of poses sometimes referred to as power Yoga comes from Sanskrit,and means to yoke or to join together. yoga,and Anasara is noted for its more free-flowing movements A description of the physical yoga postures was found in the Yoga called Vinyasa.lyengar involves holding poses longer and some Sutras,which was apparently written in 3000 BC by Patajali,who very strenuous positions such as headstands.Bikram is practiced in was a Sanskrit scholar and an Indian physician.'Although there are very high temperature rooms,a practice that is not recommended many types of yoga practices,yoga typically combines stretching for those with elevated blood pressure exercises and different poses with deep breathing and meditation. Yoga is designed to stretch and tone the muscles and to keep the spine and joints flexible.Some suggest that the bending.twisting 1.2.This research review and stretching movements also massage the internal organs and glands.Yoga poses are generally done with deep,diaphragmatic In this paper,recent research is reviewed on psychological,pain, breathing that is thought to increase oxygen flow to the brain. autoimmune and immune conditions and on physiological and phys- Yoga is typically practiced in loose clothing and bare feet on ical measures as well as potential underlying mechanisms for yoga a mat.A series of poses that are called Asanas in Sanskrit are effects(see Table 2).The literature search was focused on research that performed slowly and sequentially,concentrating each movement primarily assessed the effects of yoga poses (asanas)as opposed to on the deep abdominal breathing that accompanies each move- sessions that focused on breathing exercises (pranayamas)or medi- ment.Movements between poses are considered as important as tation.Although,of course because yoga classes often include all 3 maintaining a pose,and typically the poses are held for 4 or 5 elements,the effects of the physical postures are often confounded. breaths depending on the different teaching styles of yoga that are Although very little research has been conducted on potential popular today including Hatha,Ashtanga,Anasara,lyengar and underlying mechanisms for the effects of yoga,they may be similar Bikram.Many of the poses are named after animals,and the real to those of massage therapy,with yoga being a kind of self-massage yogis suggest that you mimic the animals when in the particular from the rubbing of limbs against each other and against the floor. pose such as feeling like a cat or a cobra while performing those In those ways.massage and yoga both appear to stimulate pressure poses. receptors under the skin which,in turn,leads to enhanced vagal activity and reduced cortisol.2 These physiological and biochemical changes would be expected to be accompanied by reduced *Touch Research Institute.University of Miami School of Medicine,PO Box depression and fewer pain syndromes and immune problems.3 016820.Miami.FL33101,USA.Tel:+3052436781. Yoga has been noted to reduce anxiety and depression.Studies E-mail address:tfield@med.miami.edu. have also shown that yoga can improve several conditions including 1744-3881/$-see front matter 2010 Elsevier Ltd.All rights reserved. doi:10.1016j.ctcp.2010.09.007Yoga clinical research review Tiffany Field a,b,* a Touch Research Institute, University of Miami School of Medicine, USA b Fielding Graduate University, CA, USA Keywords: Yoga Cortisol Vagal activity Pain abstract In this paper recent research is reviewed on the effects of yoga poses on psychological conditions including anxiety and depression, on pain syndromes, cardiovascular, autoimmune and immune conditions and on pregnancy. Further, the physiological effects of yoga including decreased heartrate and blood pressure and the physical effects including weight loss and increased muscle strength are reviewed. Finally, potential underlying mechanisms are proposed including the stimulation of pressure receptors leading to enhanced vagal activity and reduced cortisol. The reduction in cortisol, in turn, may contribute to positive effects such as enhanced immune function and a lower prematurity rate.
2010 Elsevier Ltd. All rights reserved. 1. Yoga research 1.1. Origins and practice of yoga Yoga comes from Sanskrit, and means to yoke or to join together. A description of the physical yoga postures was found in the Yoga Sutras, which was apparently written in 3000 BC by Patajali, who was a Sanskrit scholar and an Indian physician.1 Although there are many types of yoga practices, yoga typically combines stretching exercises and different poses with deep breathing and meditation. Yoga is designed to stretch and tone the muscles and to keep the spine and joints flexible. Some suggest that the bending, twisting and stretching movements also massage the internal organs and glands. Yoga poses are generally done with deep, diaphragmatic breathing that is thought to increase oxygen flow to the brain. Yoga is typically practiced in loose clothing and bare feet on a mat. A series of poses that are called Asanas in Sanskrit are performed slowly and sequentially, concentrating each movement on the deep abdominal breathing that accompanies each move￾ment. Movements between poses are considered as important as maintaining a pose, and typically the poses are held for 4 or 5 breaths depending on the different teaching styles of yoga that are popular today including Hatha, Ashtanga, Anasara, Iyengar and Bikram. Many of the poses are named after animals, and the real yogis suggest that you mimic the animals when in the particular pose such as feeling like a cat or a cobra while performing those poses. Many forms of yoga involving asanas have been described including, for example, Hatha yoga (Hatha meaning sun/moon), which is considered the most relaxing form (see Table 1). Ashtanga is a programmed series of poses sometimes referred to as power yoga, and Anasara is noted for its more free-flowing movements called Vinyasa. Iyengar involves holding poses longer and some very strenuous positions such as headstands. Bikram is practiced in very high temperature rooms, a practice that is not recommended for those with elevated blood pressure. 1.2. This research review In this paper, recent research is reviewed on psychological, pain, autoimmune and immune conditions and on physiological and phys￾ical measures as well as potential underlying mechanisms for yoga effects (see Table 2). The literature search was focused on research that primarily assessed the effects of yoga poses (asanas) as opposed to sessions that focused on breathing exercises (pranayamas) or medi￾tation. Although, of course because yoga classes often include all 3 elements, the effects of the physical postures are often confounded. Although very little research has been conducted on potential underlying mechanisms for the effects of yoga, they may be similar to those of massage therapy, with yoga being a kind of self-massage from the rubbing of limbs against each other and against the floor. In those ways, massage and yoga both appear to stimulate pressure receptors under the skin which, in turn, leads to enhanced vagal activity and reduced cortisol.2 These physiological and biochemical changes would be expected to be accompanied by reduced depression and fewer pain syndromes and immune problems.3 Yoga has been noted to reduce anxiety and depression. Studies have also shown that yoga can improve several conditions including * Touch Research Institute, University of Miami School of Medicine, PO Box 016820, Miami, FL 33101, USA. Tel.: þ305 243 6781. E-mail address: tfield@med.miami.edu. Contents lists available at ScienceDirect Complementary Therapies in Clinical Practice journal homepage: www.elsevier.com/locate/ctcp 1744-3881/$ e see front matter
2010 Elsevier Ltd. All rights reserved. doi:10.1016/j.ctcp.2010.09.007 Complementary Therapies in Clinical Practice 17 (2011) 1e8