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Yoga is an ancient Indian science and way of life, which influences the functioning of the brain and the rest of the body. Several studies have shown that the practice of yoga has a definite role in the promotion of positive health, including mental health, characterized by improved cardio-respiratory efficiency, autonomic responses to stressors, sleep, muscular endurance, and 'higher’ brain functions. With an increase in the incidence of stress-related ailments, related to the rapid pace of life today, yoga has been evaluated as a treatment for such disorders in several controlled trials. The disorders, which were most likely to respond to yoga, with reduced symptoms and need for medication, were bronchial asthma, non-insulin dependent diabetes mellitus, anxiety neurosis, and rheumatoid arthritis.
THE CONCEPT OF HEALTH Scientific studies on yoga
According to the World Health Organization (WHO) the state of health is defined as a state of complete physical, mental, social and spiritual well being and not merely an absence of disease or infirmity. It is clear from this definition that health and ill-health are not two discrete entities as commonly understood but health should be conceived as a continuous function indicating the state of well being.
The ancient Indian science, Yoga, has its origin in the Sankhya philosophy of Indian culture, which is about 8000 years old (Nagarathna, 2001).
Yoga includes a wide range of techniques (e.g., physical postures, regulated breathing, cleansing techniques, meditation, philosophical principles, and devotional sessions, surrendering to the Supreme).
These techniques bring about a calm and balanced state of mind, and are expected to help the spiritual evolution of the individual. However, yoga has more pragmatic applications in medicine. In order to understand these, it is important to know the concepts of ‘health’ and ‘disease’ in Yoga texts.
According to yoga, man is in perfect health and homeostasis at his subtle levels of existence. All diseases are classified as (i) stress-related (adhija) and (ii) not stress related, e.g., injuries (anadhija) (Vasudeva, 1937).
Yoga has been considered especially useful in the management of stress related disorders by getting mastery over the excessive speed of the mind. The technique to reducing the rate of flow of thoughts with deep internal awareness is yoga. This review will describe the therapeutic applications of yoga in the management of arthritis.
Physical activity is an essential part of the effective treatment of osteoarthritis (OA) and rheumatoid arthritis (RA), according to treatment guidelines published by the American College of Rheumatology (Hochberg, 1995; Newsome, 2002).
In persons with arthritis, exercise is safe and does not exacerbate pain or worsen disease (Ettinger,1997; Minor,1999; O'Grady,2000;Bearne,2002). In fact, exercise may play a key role in promoting joint health (Forrest,1994) , since those who do not exercise often suffer more joint discomfort than those who do (Nordemar,1981). However, regular physical activity is especially important for people with arthritis, who often have decreased muscle strength, physical energy, and endurance (Lyngberg,1988).
The psychological benefits of exercise such as stress reduction, fewer depressive symptoms, improved coping and well-being and enhanced immune functioning (Taylor,1985;Scully,1998;Fox,1999 Paluska,2000) also contribute to greater overall health.
Yoga has been used in the management of a wide range of diverse ailments. While there is a great deal of anecdotal evidence of the benefits of yoga, to date only a handful of scientific studies have been conducted on persons with OA and RA (though several more are currently underway). The study conducted in England demonstrated that hand grip strength significantly improved following yoga in rheumatoid arthritis patients (Haslock,1994).
It was subsequently proven that yoga resulted in similar benefits in rheumatoid arthritis patients in an Indian population (Dash, 2001). Studies in osteoarthritis of the hands and carpal tunnel syndrome show greater improvement in pain during activity, tenderness and finger range of motion (Garfinkel, 1994).
These above studies have shown promising results with some improvement in joint health, physical functioning, and mental/emotional well-being. Perhaps most importantly, yoga has an important positive effect on quality of life. People with arthritis may also enjoy yoga more than traditional forms of exercise, and exercise enjoyment is an important predictor of adherence(Ryan,1997;Trost,2003).This is particularly important considering that, on average, 50% of sedentary individuals will drop out of exercise within 6 months (Dishman,1990).
In summary, yoga can be a meaningful and enjoyable alternative to traditional forms of exercise such as aerobics or aquatic exercise with important health benefits. Yoga can play an important role in reducing stress and frustration that results from pain and disability, and increasing positive feelings and wellbeing. Drug treatments for OA and RA have improved markedly in the last few years. Despite this, arthritis cannot be cured, and even the best medications and medical care can only help a little. There is a great need for additional activities patients can do to reduce pain, disability, and take control of the overall impact arthritis may have on their lives. Thus, the evidence suggests that, when combined with a program of good medical care, yoga may provide important additional physical and psychological health benefits for arthritis patients.
Finally, it has to be emphasized that while yoga has important therapeutic benefits, the practice of yoga is very important in the promotion of positive health and human potential in body, mind, and spirit (Scott, 1999).
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