Abstract
Objective:
The aim was to study the effect of short-term Yoga therapy program on quality of life in patients suffering from psychosomatic ailments.
Methods:
Sample size and Study period: All the subjects coming to SVYASA AROGYADHAMA in month of July 2011 for Yoga therapy for various psychosomatic ailments and were free of any primary psychiatric illness and volunteering to participate were enrolled in the study after taking informed consent. Their physical condition was healthy enough to practice Yoga as judged clinically. All subjects (n = 94) who were enrolled in the study underwent Integrated Approach to Yoga Therapy, which included Asanas, Pranayamas, meditation, Kriyas and lectures on practice of Yoga and derived special techniques in their respective sections. The quality of life was assessed by SF-12 questionnaire and thereby calculating Physical and Mental Composite Scores (PCS and MCS) before and after 1 week of Yoga therapy. Data thus obtained was analyzed using paired t-test.
Results:
A significant improvement (P < 0.001) was seen in the study group in both PCS (from mean ± SD of 37.50 ± 9.58 to 43.7 ± 8.73) and MCS (from 45.87 ± 9.57 to 53.35 ± 7.9.) with minor variations in patients of various departments.
Conclusion:
A short-term Yoga therapy program leads to a remarkable improvement in the quality of life of the subjects and can contribute favorably in the management of psychosomatic disorders.
Keywords: Pshychosomatic disorder, quality of life, SF-12, yoga
INTRODUCTION
In the Yoga Sutras, Yoga is defined as “union” of mind, body and spirit. Classically, Yoga is understood as the science of the mind.[1] These days it is assuming importance in improving mental health and quality of life in the treatment of a number of disorders.[2]
Several diseases affect a person's biopsychosocial functioning to a greater or lesser degree.[3] These diseases are known as psychosomatic diseases. Psychosomatic means mind (psyche) and body (soma). A psychosomatic disorder is a disease which involves both mind and body. There is a mental aspect to every physical disease. How one reacts to and copes with disease varies greatly from person to person. For example, a rash of psoriasis may not bother some people while it may make some feel depressed and more ill. There can be physical effects from mental illness. For example, with some mental illnesses one may not eat, or take care of oneself, and this can cause physical problems.[4]
WHO defines quality of life as individuals’ perceptions of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. Hence, definition focuses on respondents’ “perceived” quality of life.[3]
Quality of life means a good physical and mental condition, consisting of two elements: The ability to cope with everyday tasks (the biopsychosocial level) and the patient's satisfaction from his activities at all levels as well as control over the disease and symptoms connected with the treatment method being applied.[5]
The most important and frequently used generic health-related quality of life assessment is the SF-36 comprising of 36 questions providing functional health and well-being scores.[6] The SF-12 is a multipurpose short-form survey with 12 questions, all selected from the SF-36. The questions are combined, scored, and weighted to create mental and physical functioning and overall health-related-quality of life.
The present study evaluates the changes in quality of life following short-term lifestyle modifications based on Yoga.
AIMS AND OBJECTIVES
To study the effect of short-term Yoga therapy program on quality of life in patients suffering from psychosomatic ailments.
METHODS
Subjects
The study was done in SVYASA AROGYADHAMA, Bangalore in the month of July 2011. It was based on the data collected on 94 subjects who were diagnosed for psychosomatic ailments based on history and previous investigations and who attended Integrated Approach to Yoga Therapy (IAYT). Ethical clearance was obtained from Institutional ethical committee of SVYASA and written informed consent was obtained from all subjects. All subjects, more than 18 years of age and who understood English were included. Subjects from psychiatry section of AROGYADHAMA, who came for rehabilitation and who were severely ill, with complications and uncontrolled disease were excluded from the study. The subjects were a heterogeneous group, having hypertension, bronchial asthma coronary artery disease, diabetes mellitus, obesity, neurological disorder, chronic backache and arthritis and they were divided into different departments according to their ailments. In no subject, the physical condition prevented from participation in Yoga therapy.
The program
All subjects underwent IAYT, which included physical postures (Asanas), voluntary breathing (Pranayamas), meditation, internal cleansing processes (Kriyas) and lectures on practice of Yoga and derived special techniques in their respective sections. These procedures were offered daily and each session lasted for 1 h.
Study design
All subjects were given self-administered SF-12 questionnaire with no time limit and their doubts were cleared then and there on the first day of their admission and again after 1 week of Yoga practice at AROGYADHAMA. The quality of life was assessed by SF-12 questionnaire and thereby calculating Physical and Mental Composite Scores (PCS and MCS) before and after the Yoga therapy.[7] PCS and MCS were computed using the rating on 12 questions from 0 to 100, where a 0 score indicates the lowest level of health and 100 indicates the highest level. PCS and MCS scores were assessed using SF-12 Health Survey Scoring database.[7]
Data thus obtained were analyzed by paired t-test using SPSS version 20.
RESULTS
The mean ± SD of age of the study group was 46.18 ± 16.58 years. About 55.3% of the subjects were females and rest 44.7% were males.
In the whole study group, there was a statistically significant improvement in both PCS (P < 0.001) and MCS (P < 0.001) with minor variations in patients of various departments [Table 1] which are as follows:
Table 1.
Comparison of PCS and MCS before and after 1-week yoga in different departments
A significant improvement was seen in PCS in patients of all departments-neurology/spinal disorders (P < 0.001), pulmonology/cardiology (P < 0.001), metabolic disorders (P < 0.001), endocrinology (P < 0.001), others (rheumatology/gastroenterology/promotion to positive health) (P < 0.001). Similar results were observed in MCS with statistically significant improvement seen in patients of neurology/spinal disorders (P < 0.001), pulmonology/cardiology (P < 0.001), metabolic disorders (P < 0.001), endocrinology (P < 0.001), others (rheumatology/gastroenterology/promotion to positive health) (P < 0.001).
DISCUSSION
The study intervention was a short-term; IAYT comprised of daily practice of Asanas, Pranayamas, meditation, Kriyas and lectures on practice of Yoga and derived special techniques and diet. The results showed that even a short-term that is, just 7 days of Yoga practice showed a significant improvement in both PCS and MCS. This implies that Yoga improved not only the physical wellbeing of the subjects but also improved the mental state. These benefits were observed over a wide range of chronic diseases, which implies that Yoga intervention has an effect regardless of the diagnosis.
According to Yoga sutra, the body and mind cannot be separated. This logic indicates that all physical benefits resulting from the practice of Yoga are coupled with mental benefits such as development of inner consciousness, positivity, awareness, and appreciation of nature, combining to offer a whole-body therapy.[1]
The physical benefits of Yoga are linked to the release of β-endorphins and the shift caused in neurotransmitter levels linked to emotions such as dopamine and serotonin and implicit dominance of the parasympathetic nervous system.[8]
Yoga stimulates an under active parasympathetic nervous system and increases the inhibitory action of a hypoactive GABA system in brain pathways and structures that are critical for threat perception, emotion regulation, and stress reactivity.[9]
The results of the present study are comparable with other studies. A 30 min session of yogic stretching and breathing exercises produces a marked augmentation in perceptions of physical and mental energy. Such exercises also increase feelings of alertness and enthusiasm, and make subjects feel distinctly less sluggish and sleepy than before the session began.[10] A simple and inexpensive essentially educational intervention based on Yoga improves subjective well-being.[2]
As the study does not have a control group, the effect of Yoga therapy on quality of life cannot be generalized.
CONCLUSION
The present study suggests that a short-term integrated Yoga therapy can improve the overall general well-being of subjects irrespective of their disease. Hence, daily practice of Yoga on regular basis will improve the quality of life. To conclude, Yoga could be prescribed as a supplement to conventional therapy of a psychosomatic disease.
ACKNOWLEDGMENT
The authors acknowledge the support of SVYASA, Bangalore for allowing us to conduct the present study.
Footnotes
Source of Support: The authors acknowledge the support of SVYASA, Bangalore for allowing us to conduct the present study
Conflict of Interest: None declared
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