YOGA IN STRESS RELATED DISEASES
Negative emotions and psychosocial pathology are found to be related to severe asthma (Friedman, 1984; Carswell, 1985; Carson and Schauer, 1992). Self-rated hostility and depression (Schmaling et al. 1997) and higher degree of frustrating situations in their life (Berezin et al. 1997) were found to be associated with decreased pulmonary function, blood immunoglobulin levels and clinical state of the disease.
Goyeche (1982) published his work on the integrated yoga approach to asthma with beneficial results. Singh et al (1990) studied 18 subjects with mild bronchial asthma after Two weeks of practice of yogic Pranayama by the use of a breathing device called pink city lung exerciser (PCL). Vedanthan et al (1998) studied the effect of yoga practices on 17 students in the age group of 19-52 years in an university set up. Daily symptom score, medication score, AM and PM PEFR, weekly questionnaires and lung functions were measured. The subjects in yoga group reported significant degree of relaxation, positive attitude and tendency for lesser usage of inhalers. We followed up 53 pairs of bronchial asthmatics in a controlled study and also 570 asthmatics in a prospective study for 3 to 54 months. There was 80% reduction in meditation & symptom scores with improved lung function in yoga group and not in control group (38). Further, regular practitioner stood to gain the best (41).
Yoga in Anxiety Neurosis
Norton & Johnson (1983), DeLuca & Holborn (1984), Tarrier & Main (1986) have demonstrated the comparative efficacy of different types of muscle relaxation therapies (taped instructions or applied relaxations) in different types of anxiety of both cognitive and somatic type such as snake phobia, nail biting, hair pulling, panic attacks as well as general anxiety. Tyrer et al (1988) in their randomized control study on 210 subjects demonstrated that self help group fared better than the diazepam group and consumed less psychotropic drugs. Crisan (1988) observed reduction in scores on Max Hamilton's a anxiety scale, general health questionnaire, heart rate, urinary level of VMA and a rise in galvanic skin resistance in 19 patients with generalized anxiety neurosis after 8 weeks of Pranayama practice.
Yoga in diabetes
In both IDDM and NIDDM physiologically demanding stressful situations like infection, pregnancy etc. are known to increase the demand for insulin. Similarly emotional stresses also contribute to the irregular control of diabetes. Jobson et al (1991) in a well planned controlled study showed that although there was demonstrable physiological rest (reduced muscle activity and skin resistance) the progressive relaxation training and biofeedback given once a week did not help in improving diabetic control in 20 patients with type II diabetes.
Monro et al (1992) carried out a controlled trial on 21 subjects with NIDDM. Fasting blood glucose and glyco-sylated hemoglobin reduced significantly (p<0.05) in the group of 11 who practiced the integrated program of yoga as compared to a matched control group of 10 who did not practice yoga. Several other studies (Sahay et al 1986, Jain et al 1993) have shown the beneficial effects of yoga in NIDDM through reduction in hyperglycemia and the need for oral hypoglycemic agents. Rice et al (1992) observed increased peripheral blood circulation in lower extremities as measured through toe temperature and blood volume pulse in 40 diabetes in the age range of 17 to 73 years after biofeedback assisted relaxation training.
Yoga in Hypertension
Datey & his co-workers (1969) showed the beneficial effect of shavasana in mild hyper-tensives who were not taking medication. Patel (1973,75) has shown the beneficial effects of shavasana in hypertension in her year long follow-up control study. In an open study comprising 23 hyper-tensive patients Sachdeva et al (1994) observed reduction in systolic blood pressure and diastolic blood pressure.
Yoga in Coronary Heart Disease
Greenwood et al (1996) reviewed the literature and showed that both social support and life stresses influence the incidence and mortality of coronary heart disease, the latter more so than the former. The emotion support had the largest effect. Orth Gomer et al (1997) analyzed the heart rate variability from a halter record during transient myocardial ischeamia and observed suppression of the efferent vagal activity and suggested that this vagal blockage may be a fore-runner to onset of ischaemia.
The work of Ornish et al has become a major land mark on this path of preventive cardiology. Gould, Ornish and coworkers (1995) studied the changes in myocardial perfusion by positron emission tomography (PET) after 5 years of intense risk factor modification. The experimental group of 20 followed a program of very low fat vegetarian diet, mild to moderate exercise, stress management and group support. Although there was a significant degree of improvement observed in the percent diameter stenosis on coronary angiography in the experimental group as compared to control group, greater degree of changes were observed in ventricular perfusion and the measurement of area of LV with less than 60% activity in PET.
Yoga in Rheumatoid Arthritis
Stress could be a major triggering or aggravating factor for the autoimmune inflammation in rheumatoid arthritis has been understood. Haslock (1994) reported the beneficial effect on grip strength and Stanford health assessment questionnaire disability index in 10 severe rheumatoid arthritis subjects, as compared to 10 matched controls who participated in a program of IAYT. Role of yoga in mechanical back pain, carpel tunnel syndrome, cervical spondylitis, fibro-myalgia and chronic pain have been studied by many workers.