Evidence base for yoga practice
Everyone should practice yoga, said Rodney Yee and Colleen Saidman Yee, founders of Urban Zen Integrative Therapy, and recipients of the Visionary Award, at the 2019 Integrative Healthcare Symposium in New York City.
It’s not putting your legs around your head in a pretzel position, or bowing to mind-controlling guru, said Colleen Yee, speaking to some of the assumptions of the practice. Yoga is simply movement, focus, and breath, she said.
The Sanskrit definition of yoga translates to, “the cessation of the fluctuations of the mind,” which, in reality, is not really possible. Instead, the Yees say practitioners and patients should focus on coming back to the breath, coming back to the Earth.
According to studies published by the National Center for Complementary and Integrative Health, use of yoga in the U.S. grew by over 50 percent in adults and more than doubled in children from 2012 to 2017.
The Centers for Disease Control and Prevention’s 2012 National Health Interview Survey found that 94 percent of adults practiced yoga for general wellness and disease prevention, or to improve energy. In addition, 18 percent used yoga to treat a specific health condition, and many said it reduced stress, improved their sleep, and helped them feel better emotionally, among other benefits.
When it comes to chronic diseases, conditions that have been studied for potential yoga intervention include stress management and wellness, asthma, cancer, cardiovascular disease, chronic obstructive pulmonary disease, diabetes, irritable bowel syndrome, menopause, mental health conditions, pain, sleep problems, smoking cessation, and weight control.
Yoga research has also focused heavily on benefits for mental wellbeing. Two randomized controlled trials at Johns Hopkins University in Baltimore Maryland, found that patients who practiced hatha yoga over eight weeks experienced a clinically significant reduction in depression severity. Another 10-week study at Brown University in Providence, Rhode Island found that yoga participants had lower levels of depression and, at a six-month follow-up, 51 percent of yoga participants showed a greater than 50 percent reduction in depression symptoms.
Other studies looking at prenatal anxiety and depression found an 8-week yoga course reduced both subjective and physiological measures of anxiety, while treatment as usual led to higher postnatal depression. A meta-analysis of 17 studies showed hatha yoga had a meaningful effect on anxiety that was correlated with total number of hours practiced. Those with higher levels of anxiety benefited the most, the Boston University study said.
Yoga also has an opportunity in supportive cancer care. The Society for Integrative Oncology recommends integrative therapies during and after breast cancer treatment through a study conducted by researchers at Columbia University in New York City. A combination of meditation, yoga, stress management, relaxation, music therapy, and massage were recommended for anxiety and stress reduction, depression and mood disorders, and to improve general quality of life.
For cardiovascular disease, a randomized controlled trial assessed the effects of 12 weeks of lyengar yoga versus enhanced usual care in untreated prehypertension or Stage 1 hypertension. Yoga produced clinically meaningful improvements in 24 hour systolic and diastolic blood pressure. In a systematic review of 44 randomized controlled trials yoga improved systolic and diastolic blood pressure, heart rate and respiratory rate, waist circumference, total and high-density lipoprotein cholesterol and triglycerides, and insulin resistance.
In diabetes patients, a systemic review and meta-analysis examined the effects of yoga and blood sugar control in adults with type 2 diabetes. Researchers looked at 23 studies with 2,473 participants. Compared with controls, yoga participants improved their blood glucose levels. Yoga was also associated with significant improvements in lipid profile, blood pressure, body mass index, cortisol levels, and risk factors for complications in adults with type 2 diabetes.
There’s clearly the science backing yoga practice as supportive care in chronic disease management, said the Yees, which inspired them to develop Urban Zen Integrative Therapy. This care technique combines five core healing modalities:
- Yoga therapy
“We have a lot more research to do,” he said, “but most of what we’re bringing to the table has been in practice thousands of years.”
Colleen Yee stresses that the scope of practice is to add to conventional medical care and improve quality of life, not treat or cure disease.
“We’re not claiming that we’re healing anyone,” she says. “What we can do is add this human-to-human element [to patient care].”
Loneliness is a huge problem, and often neglected in disease management.
“We should go in and say ‘we see you, we feel you,’ and approach it as I’m a human relating to another human,” said Colleen Yee. “That’s the integrative therapy we’re offering.”
The Yees work with patients through what they refer to as the pain, anxiety, nausea, insomnia, constipation, and exhaustion (PANIC) model, using the five core healing modalities.
“It doesn’t just have to be in the hospital bed,” said Rodney Yee. “These modalities can apply to everyone. The healing can happen on its own when you allow it to.”
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