Scientific Results of Yoga for Health of ladies.

 "Scientific Results: Yoga for Health and Well-being". The video features an introduction by Dr. Josephine Briggs, Director of the National Center for Complementary and Alternative Medicine, or NCCAM, and interviews with Dr. George Salem and Dr. Karen Sherman, researchers who are studying yoga. Following the interviews with Drs. Salem and Sherman are five brief tips for people interested in practicing yoga. The tips are accompanied by video footage of certified yoga instructors Yasmine Kloth and John Acton performing yoga techniques in an outdoor setting. Dr. Briggs speaks from an office at the National Institutes of Health in Bethesda, Maryland. Hello, I am Josie Briggs, director of the National Center for Complementary and Alternative Medicine, or NCCAM. NCCAM is one of 27 institutes and centers that make up the National Institutes of Health, the government's medical research agency. Our mission at NCCAM is to define, through rigorous scientific investigation, the usefulness and safety of complementary and alternative medicine interventions and their role in improving health and health care. In this video, we give you an introduction to yoga, a mind-body practice that has its origins in ancient Indian philosophy. 

Yoga is increasingly being integrated into our health care system. At NCCAM we are particularly interested in how health care providers are using yoga to improve the health of their patients. For example, to prevent falls in older adults, or to address persistent conditions such as chronic low back pain. This video will introduce you to some of the research that we are supporting to better understand the health benefits of yoga. We will highlight two of our researchers who are studying yoga, Dr. George Salem and Dr. Karen Sherman. Dr. Salem is at the University of Southern California. He is using innovative technology to examine how older people use their muscles and joints in certain yoga postures. As a researcher with a primary interest in the science of exercise, Dr. Salem focuses on the mechanics of the musculoskeletal system. How our bodies move. He will talk about why he chose to study yoga and some of the challenges in studying this mind-body practice. The second person you are going to hear from is Dr. Karen Sherman who conducts research at Group Health Cooperative in Seattle. Dr. Sherman has found yoga to be beneficial for people with low-back pain. In this video, she talks about low-back pain and the challenges of designing a rigorous yoga study that will explore the promise of this intervention. I hope you enjoy this presentation and that it piques your interest in learning more about integrative health practices like yoga. 

If you are considering practicing yoga, I encourage you to talk to your health care provider. Ask about the physical demands of the type of yoga you are interested in and learn more about what research has been done on this practice. Regardless of the type of integrative health practice you are considering, share information about what you do for your health with your health care providers. It will help ensure safe and coordinated care. Thank you for your interest, and I wish you good health. It is not intended to constitute or substitute for medical advice or for personal exercise instruction. We encourage you to discuss all questions and decisions about medical care or treatment with your health care provider before beginning any new exercise program, including the program featured in this video. Any reference to or appearance of any product, service, or therapy in this video is not intended as an express or implied endorsement by NCCAM or the Federal Government. Drs. Salem and Sherman were interviewed in their research labs in Los Angeles, California, and Seattle, Washington. My name is George Salem. I'm an associate professor and researcher in the division of bio kinesiology and physical therapy here at the University of Southern California. So, I am interested in exercise. 

I have been studying exercise for the past 30 years and using biomechanics force platforms, high-speed cameras to understand how exercise targets the musculoskeletal system. So, our primary objective in the current study, "Yoga Empowers Seniors Study", is to provide information for instructors who are going to be designing programs for seniors? However, this information is also going to be very useful for the clinician or therapist so that they can design individualized programs for their patients. Yes, we believe yoga is good and it has its place along with other forms of exercise, but what we want to do is make sure that the programs are tailored for the senior who may be participating in yoga for the very first time. To my knowledge, nobody has quantified the biomechanics, the forces, the muscle recruitment patterns, the joint movements, or torques that are created during yoga in healthy seniors. It's very innovative, it's very different. It's, it's creative and that's what makes it exciting. We recreate their poses and show them what their skeletal system would look like. 

Skeletons actually perform the yoga poses--asanas-- and they get to see their muscles light up and do different things. It's very exciting for our participants. The challenge is that If we work within a laboratory with lights, force plates. Our subjects have to be instrumented. We put reflective balls on their joints. We put wires across their muscles, they have tape and all kinds of electronics associated with them. And yet we need them to feel comfortable and so we always do our studies with a yoga instructor present. We always take them through an actual yoga program. They are not just standing there posing but rather they are performing yoga. They have a warm-up period. They have a cool-down period, we incorporate breathing and concentration, meditation techniques as well. We do have some preliminary results and what, what's fascinating and, and neat about the project is that many of those results were not intuitive. Poses we thought were targeting certain muscle groups actually are targeting completely different muscle groups. 

Poses we thought were relatively safe are actually generating rather large loads and joint torques at joints in which older adults can get into trouble. So, if I could I'd like to give you an example of a pose which we thought was going to be doing one thing but now we've learned it's doing something very different. And that would or those poses would be the warrior poses. And the warrior poses, it's often thought that these are very important poses for increasing balance in, in individuals and in fact it intuitively that makes sense. You're in a position with an extended base. Your legs are spread far apart. We call that an abducted position. And we always hypothesized that that pose would be targeting the outer muscles of the thighs the gluteus medius muscle or the abductor's muscles. We found that as opposed to targeting the abductor's muscles, they were actually targeting the inner muscles of the thigh the adductor muscles. A better pose for that might be the tree pose, for example, which we know from our biomechanical investigation does target the hip abductors. It's likely to increase one's balance control because those hip abductors are important for balance. One of the things we're learning is that some of these poses are really not intuitive. This information then will ultimately be disseminated perhaps in a book or perhaps online, and instructors can then go and bring down then take this information and design a program that is going to be safe and effective. 

As we analyze our current results we will be expanding our studies to include other groups of individuals, both healthy individuals and those with disabilities. As yoga participation has increased in recent years though, we understand that this is an area that really is under-researched, and in discussing and working with my colleague at UCLA, Gail Greendale, we really decided that, hey, here is an opportunity for us to use these very unique tools, these, this very tech, high tech tools to better understand what yoga is actually doing? how it's targeting the physiology the biological processes of our body. My name is Karen Sherman, and I'm a senior scientific investigator at Group Health Research Institute. I started researching yoga because I actually was quite interested in complementary medicine treatments for back pain. Back pain, as you know, is the number one reason why people search outside of the conventional med, medical area for some relief, and at the time that I began my work here at Group Health, there were actually no formal studies that had been published on yoga. No solid research out there at that time, and I thought, wow, this is a natural kind of thing to do, so I jumped on it. So, we started our first yoga study was funded in 2005 and the first thing that we did before we even did the clinical trial is we had to sort of design it. So, one of the things that we had to ask ourselves is what should the yoga intervention look like? And we chose to focus on postures and breathing with some of the relaxation elements explicitly added. We chose to use a style of yoga called Vini yoga. The idea of Vini yoga is that you adopt the posture of the person. So, how are you going to design your study? What are you going to compare it to? We said there are really two things we're very interested in. One is, "how does it compare to usual care?" That is to say what people would normally do? And we augmented our usual care with a self-care book. And that was sort of a basic standard of comparison.

And then we were just curious, how is yoga different from a sort of conventional exercise? I have to say that back pain researchers often find that nothing works so I was actually surprised that yoga did work. It was clearly superior to usual care at all-time points and it was better than the exercise at a couple of time points. Not enormously better but statistically significant and intriguing. We've moved on to do two things. One is to try to confirm those results in a much larger population. Secondly, to try to understand, what's really going on? How is yoga working? Is it simply lots of stretching and strengthening or are there other elements that are really important the relaxation kind of stress reduction sorts of things. In thinking about how this research is actually going to help the clinician and the patient, I do think research is very important for people with back pain. There are over a hundred treatments for back pain out there, most of them have not been tested and what's the poor clinician or what's the poor patient to do? Caring for people with low-back pain is actually quite challenging for the conventional physician. Turns out that most people don't have an identifiable lesion on x-ray and so docs don't have a really great idea of what to give people other than drugs or maybe a referral to physical therapy and those aren't terribly effective. So what happens is the patient is often frustrated, and the doctor feels bad because they can't really help the patient very well, and so it's not a pleasant situation. I think that's one of the values of complementary therapies is that patients report at least subjectively, that they're quite helpful and that's the value of doing this research is to really find out how helpful they are from a more objective perspective. It's very interesting that we actually have found people do continue to practice their yoga. In fact, at the very last inter, an interview which is about 3 months after the classes are over, about two-thirds of the people in both of our studies reported that they had practiced yoga in the prior week so that's a very nice confirmation that for many people it's quite accessible. 

It's very interesting that people want to know what the magic pose is, but it turns out that a sequence of poses is actually quite important in the Vini yoga tradition. And also the poses that can be most helpful might differ from person to person. For example, if somebody needs to learn to relax, the wheel pose and associated very gentle relaxing poses would be extremely important. If a person is weak in some area, they'll need to have some more strengthening kinds of poses, for example. The ones that strengthen the hip muscles so it just depends on the individual. Our posture sequence was designed to provide all of that so people could get an idea of what would be helpful for them. Narrator: Five tips for people who are interested in practicing yoga Yasmine Kloth and John Acton demonstrate various yoga techniques at Brookside Gardens in Wheaton, Maryland. Millions of people in the U.S. practice yoga. Scientists are studying how yoga may be used to help improve health and to learn more about its safe use.
 Yoga and other mind and body therapies are being integrated into conventional health care settings. Interest in these practices often is based on results from research that has been conducted over the past decade. Recent studies in people with chronic low-back pain suggest that a carefully adapted set of yoga poses can help reduce pain and improve function. Other studies also suggest that practicing yoga (as well as other forms of regular exercise) might have other health benefits such as reducing heart rate and blood pressure and may also help relieve anxiety and depression. 

Studies show that some other health conditions may not benefit from yoga. For example, research suggests that yoga is not helpful for asthma, and studies looking at yoga and arthritis have had mixed results. Yoga is generally considered to be safe in healthy people when practiced appropriately. However, people with high blood pressure, glaucoma, or sciatica, and women who are pregnant should modify or avoid some yoga poses. Everyone's body is different, and yoga postures should be modified based on individual abilities. Carefully selecting an instructor who is experienced and is attentive to your needs is an important step toward helping you practice yoga safely. Inform your instructor about any medical issues you have, and ask about the physical demands of yoga. If you're thinking about practicing yoga, also be sure to talk to your health care providers. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.