Papers by Prof Dr Meena Ramanathan
Yoga-Mimamsa, 2024
Objective: To develop a generic yoga therapy protocol for nonspecific chronic low back pain (NCLB... more Objective: To develop a generic yoga therapy protocol for nonspecific chronic low back pain (NCLBP) on the basis of previous research studies. Methods: A comprehensive PubMed search was done using keywords of "yoga" and "back pain" for English-language articles published till November 2022. PubMed showed 332 results for the keywords from 1977 to 2022. Twenty-nine studies were found eligible and the consolidation of yogic techniques were used in the studies. The study compiled 72 yogic techniques, including Asana and Pranayama, from 332 articles on yoga and back pain. Out of these, 151 were not relevant to yoga or back pain. After analyzing 181 articles, 33 were selected for review for a yoga therapy protocol, with four excluded due to inability to access full-text articles. The protocol was later validated by 14 eminent yoga therapy experts across the globe from countries including Australia,
Journal of Family Medicine and Primary Care
Introduction: Aging is becoming a major challenge for policymakers. Regular exercise helps keep e... more Introduction: Aging is becoming a major challenge for policymakers. Regular exercise helps keep elderly people mobile, enhances physical and mental abilities, and to some extent delays the effects of chronic illnesses. Objectives: To evaluate the effectiveness of a multimodal intervention to increase physical activity levels among sedentary elderly living in socially and economically constrained settings. Materials and Methods: A quasi-experimental study was conducted in selected old age homes in Puducherry, South India in 2022 for 3 months. Individuals aged ≥60 years, both genders residing in selected old-age homes were included through convenience sampling. The sample size was 36 subjects per arm [three arms namely E1, E2 (intervention arms), and C (control arm)]. Baseline data collection on physical activity was collected using a semi-structured questionnaire in all three arms. The intervention arms (E1 and E2) received a multimodal intervention to promote physical activity. In a...
Journal of Health Sciences, Mar 13, 2023
Introduction: The morbidity management and disability prevention (MMDP) strategy for elimination ... more Introduction: The morbidity management and disability prevention (MMDP) strategy for elimination of lymphatic filariasis (ELF) focuses on alleviating the sufferings of about 36 million filariasis patients living in 49 endemic countries. At present, available quality of life questionnaires are not adequate to address the stigma and stress of filarial lymphoedema (FLE) patients. Therefore, a comprehensive and a robust stigma and stress assessment tool needs to be developed. Methods: We developed 49 item SARI-FLE-Version-2 questionnaire for stigma assessment and 20 item PSS-FLE-Version-2 questionnaire for stress assessment and tested it among different grades of FLE patients. We followed the Likert scale scoring system and conducted a statistical analysis using SPSS IBM version 25.0. Results: Of the 80 lymphatic filariasis (LF) patients assessed, 35.0%, 42.5%, and 22.5% had grades 2, 3, and 4 LE of the lower extremity, respectively. The developed stigma tool had an excellent internal consistency, as indicated by high Cronbach alpha values for all six domains. There was a significant correlation (p < 0.05) between different stigma domains. In three domains (cognitive function, social stigma, and experienced stigma), the mean stigma scores were significantly higher for the grade 4 patients compared to grade 2 patients (p < 0.02). Conclusion: Stigma and stress assessment tools in the form of 49 item SARI-FLE-Version-2 and 20 item PSS-FLE-Version-2 questionnaires are reliable in quantifying the stigma and stress of LF patients. There is a scope to incorporate these tools in the MMDP component of the national ELF program in disease-endemic countries with finer modifications to the local situation.
Journal of Education Technology in Health Sciences, 2020
Aim and objective: All students enrolled in Health Professions Education (HPE) at Sri Balaji Vidy... more Aim and objective: All students enrolled in Health Professions Education (HPE) at Sri Balaji Vidyapeeth, Pondicherry, receive introductory yoga sessions during orientation programs conducted by their respective medical, dental and nursing colleges at the beginning of their first year of training. We conducted a pre-test-post-test study to evaluate initial yoga awareness amongst HPE students (pre-test) and to assess the changes after a single interactive session of yoga theory and practice (post-test). Material and Methods: 367 HPE students (196 F, 171 M) were divided into seven batches for participation in yoga sessions at the Centre for Yoga Therapy Education and Research (CYTER). The identical, validated Yoga Awareness Questionnaire (YAQ) was given to them before and after the sessions to evaluate the changes in understanding / knowledge about yoga and yoga therapy. Results: Post-test scores increased significantly (p < 0.001) over both pre-test scores. The differences were significant for all batches of the medical, dental and nursing students analysed separately, as well as for the overall comparisons of HPE students. Conclusion: Even a single interactive session of yoga theory and practice can result in significant improvements in the awareness and knowledge about yoga and yoga therapy, thus setting the stage for future short and long term studies on the benefits for such students.
Yoga Mimamsa, 2019
Background: Children with autism spectrum disorder (ASD) exhibit poor oral health due to lack of ... more Background: Children with autism spectrum disorder (ASD) exhibit poor oral health due to lack of manual dexterity. Regular training methods such as visual pedagogy and video modeling (VM) for developing the skill of toothbrushing do not address the core deficits which facilitate their effective and quick learning. Hence, there arises the need of an integrated therapy which can complement these regular training techniques. Aim: This study aimed to evaluate whether yoga can complement the regular training methods in teaching the brushing skill to children with ASD. Materials and Methods: Two groups of 36 children with ASD aged 7–15 years were imparted visual pedagogy and VM in Group I and additional yoga in Group II. Assessment of toothbrushing skill was done by parents and teachers independently using the perception and assessment forms, respectively. Results: By the end of 6 months, higher percentage of parents of children in Group II observed improvements in their child's brushing skill as compared to parents of children in Group I. Based on the teachers' observation, there was a statistically significant difference in the mean number of days the children watched the video completely (p = 0.001), with children in Group II watching the video for more number of days. Conclusion: Yoga has a positive and additive role along with the regular training methods for toothbrushing in children with ASD.
Alternative & Integrative Medicine, 2013
Aim and objective: This retrospective review of clinical data was done to determine cardiovascula... more Aim and objective: This retrospective review of clinical data was done to determine cardiovascular effects of a single yoga session in normal subjects as well as patients of different medical conditions. Methods: Data of 1896 patients (1229 female, 633 male and 34 transgender) with mean age of 36.28 ± 12.64 y who attended yoga therapy sessions at CYTER between November 2010 and September 2012 was used for analysis. Heart rate (HR), systolic (SP) and diastolic pressure (DP) had been recorded using non-invasive blood pressure (NIBP) apparatus before and after 60 minute yoga sessions at CYTER and indices like pulse pressure (PP), mean pressure (MP), rate-pressure product (RPP) and double product (DoP) were derived from recorded parameters. Participants were undergoing appropriate yoga therapy protocols as per their individual condition while normal subjects had a general schedule of practice. Typical yoga sessions included simple warm ups (jathis and surya namaskar), breath body movement coordination practices (kriyas), static stretching postures (asana), breathing techniques (pranayama), relaxation and chanting. Results: There were statistically significant (p<0.001) reductions in all the studied cardiovascular parameters following the yoga session. The magnitude of reductions differed in the groups, it being more significant in those having hypertension (n=505) and less significant in those having endocrine/skin (n=230) and musculoskeletal (n=120) conditions. It was moderately significant in the normal subjects (n=582) as well as patients having psychiatric (n=302) and respiratory (n=157) conditions. Conclusion: There is a healthy reduction in HR, BP and derived cardiovascular indices following a single yoga session. The magnitude of this reduction depends on the pre-existing medical condition as well as the yoga therapy protocol adopted. These changes may be attributed to enhanced harmony of cardiac autonomic function as a result of coordinated breath-body work and mind-body relaxation due to yoga.
Indian journal of experimental biology, 2009
The present work was carried out to elucidate the role of NSAIDs, PPARg agonist and HMG CoA inhib... more The present work was carried out to elucidate the role of NSAIDs, PPARg agonist and HMG CoA inhibitor on cholesterol and lipopolysaccharide (LPS) induced neurodegeneration. The cerebellar, neuronal cells were exposed to cholesterol (10 and 50 microg/ml), LPS (1 ng/ml) or both. Neuroprotective effect of ibuprofen, rofecoxib, simvastatin and pioglitazone was assessed by measuring the neuronal loss, MTT dye assay, nitric oxide, LDH and lipid peroxide measurement. The results indicated that incubation of cholesterol and LPS showed less synaptic connections, neurite outgrowth and cell shrinkage as compared to normal cerebellar cells. Significantly decreased survival cells count along with increased LDH, lipid peroxide and nitrite levels were observed in the cells that confirmed neurodegeneration with cholesterol and LPS challenge. In comparison to individual toxins (LPS or cholesterol), combination of LPS and cholesterol produced more deleterious effect indicated synergistic effect of to...
Introduction: Alcohol-related disorders have disrupted the everyday life of the consumer graduall... more Introduction: Alcohol-related disorders have disrupted the everyday life of the consumer gradually and led to a rise in alcohol-related diseases, violence, including homicide, suicide, sexual assault, and intimate partner violence. Long-term diseases, such as high blood pressure, heart disease, stroke, liver disease, and digestive problems are also rising due to excessive alcohol intake. Moreover, social problems, including lost productivity, family problems, unemployment are due to excessive alcohol intake. Aim: To study the effects of adjuvant yoga therapy on stress, anxiety, and depression in patients undergoing an alcohol de-addiction program at de-addiction clinic, department of Psychiatry, Mahatma Gandhi Medical College & Research Institute (MGMC&RI) in Pondicherry. Settings and design: Seventy-one male patients undergoing an alcohol de-addiction program were recruited as subjects and randomly divided into Group A, who received Yoga therapy as per the CYTER protocol, daily cou...
Stress is an inevitable part of modern day lifestyle and this has been implicated in various medi... more Stress is an inevitable part of modern day lifestyle and this has been implicated in various medical disorders including psychosomatic, cardiovascular, psychiatric, and neurological conditions. All these non-communicable disorders (NCD) are constantly on an upscale (CVD is the most common cause of mortality and disability, WHO 2011) after the effective control of communicable disorders with antibiotics and hygiene practices. The increasing stress could be attributed to “competitive” modern day life, the perception of this stress and its subsequent biological effects on various systems and this has been investigated ever since the days of Cannon. He provided the classic 3 F’s response to stress in terms of fright (having fear and other emotions to decide on subsequent course of action) which would be either flight (moving away from the threat) or fight (face the threat) and face that challenge effectively. Thus stress could be any challenge to well-being or homeostasis of the system which the individual would face or run away based on the level of threat and his ability to face the challenge effectively that would lead to the consequences of stress.
International Journal of Yoga
Context: Intraocular pressure (IOP) increases during “sirasasana” and may be a risk factor for th... more Context: Intraocular pressure (IOP) increases during “sirasasana” and may be a risk factor for the progression of glaucoma. Other “head below heart” asanas may also cause increase in IOP. Aims: To determine the change in IOP following three “head below the heart” postures-“meruasana”, “viparithakarni,” and “sarvangasana”. Settings and Design: Prospective observational study conducted in a tertiary care hospital over 3 weeks. Materials and Methods: Willing, regular yoga practitioners recruited by purposive sampling performed “meruasana”, “viparithakarni,” and “sarvangasana” in random order according to a 3 × 3 periods cross over study design after baseline measurement of IOP, blood pressure (BP), and pulse rate. Each asana was held for 30 s. Within 15–30 s of completion of asana, IOP, BP, and pulse rate were recorded. There was an interval of 30 min between the asanas. Statistical Analysis Used: Normality of data was tested using the Kolmogorov–Smirnov test. Repeated measures of ANOVA with Tukey-Kramer multiple comparisons was used to compare changes in IOP, BP, pulse rate following asana. P ≤ 0.05 was accepted as statistically significant. Results: There were 33 participants with a mean age of 29.6 ± 10.5 years (95% confidence interval [CI]: 26.02, 33.18). The mean baseline IOP was 15.5 ± 3.4 mm Hg (95% CI: 14.34, 16.66) in the right eye and 16.7 ± 3.4 mm Hg (95% CI: 15.54, 17.86) in the left eye. IOP showed a significant reduction following each of the three asanas (P &lt; 0.0001). However, neither pulse rate (P = 0.53) nor BP (P = 0.27) showed any change following the asanas. Conclusions: “Meruasana,” “viparithakarni,” and “sarvangasana” when held for 30 s by healthy yoga practitioners resulted in post-asana drop in IOP with no significant change in pulse rate or BP.
Journal of Ayurveda and Integrative Medicine
Functional Dyspepsia (FD), commonly called chronic indigestion, comes under the umbrella of &... more Functional Dyspepsia (FD), commonly called chronic indigestion, comes under the umbrella of &#39;Disorders of Gut–Brain Axis&#39;. It manifests as a cluster of upper gastrointestinal symptoms including epigastric pain or burning, postprandial fullness and early satiety. Since the pathophysiology is complex, it is often difficult to effectively manage and significantly impacts the patient&#39;s quality of life. This case series aims to elucidate the role of Yoga as an adjuvant therapy to modern medicine in providing relief of dyspeptic symptoms in such patients. Yoga is an ancient Indian mind-body practise that has the potential to be used for various brain-gut disorders. Apart from treating the gut disorders from top down (mind-gut) pathway, it may have more direct physiological effects as well. Researches on IBS and one research on abdominal pain related FGID have shown Yoga therapy to be effective in ameliorating the symptoms. In this study, we present three such cases (1 male and 2 female) having a clinical diagnosis of FD in detail. These patients were initially non-responsive to medications but later showed remarkable improvement in symptoms within one month of added Yoga therapy intervention. This study was conducted as a part of a larger study conducted at a tertiary hospital in Pondicherry in collaboration between its Yoga department and Medical Gastroenterology Department. Yoga therapy protocol was given along with their regular medical management for a month. Gastrointestinal Symptom Rating Scale (GSRS) and Dyspepsia Symptom Score questionnaires were used to assess symptoms before and after the intervention period. All three patients showed marked reductions in symptom scores both in the GSRS and Dyspepsia Questionnaire. The present case series suggests effect of adjuvant Yoga therapy in reducing symptoms of functional dyspepsia. Future studies may clarify the psycho-physiological basis of the same.
International journal of life science and pharma research, Mar 1, 2023
With increased urbanization and industrialization, there is an emerging global epidemic of obesit... more With increased urbanization and industrialization, there is an emerging global epidemic of obesity which is a forerunner of metabolic syndrome. The most significant underlying cause of the metabolic syndrome is insulin resistance and its consequences. The metabolic syndrome causes lipogenesis and fat deposition. It is one of the most important risk factors for the development of catastrophic health consequences such as coronary artery disease, myocardial infarction, diabetes mellitus Type II, fatty liver, and malignant diseases. While most of these patients are treated by pharmacotherapy, there is a growing interest in studying the effectiveness of alternative therapies, including Yoga. Yoga has been practiced in India for thousands of years. Yoga, particularly Asana and Pranayama, is effective not only in improving the overall health and well-being of an individual but also reported to be effective in managing chronic medical conditions such as hypertension, diabetes, and autoimmune disorders. Various studies have found Yoga to be not only preventive but also of therapeutic value. Yoga not only has physical elements but also consists of breathing techniques, mindfulness, meditation, and relaxation techniques; hence it not only strengthens the body (secondary to physical exercise) but also positively impacts the psychosocial well-being of individuals practicing Yoga regularly. We undertook this review to determine the effectiveness of Yoga in patients with metabolic syndrome and to know whether Yoga has therapeutic benefits in patients with metabolic syndrome. Moreover, an attempt was also made to determine whether there was a significant reduction in the risk of secondary cardiovascular complications in these patients.
International Journal of Yoga
Introduction: Maternal stress responses play an important role in the etiology of fetal and mater... more Introduction: Maternal stress responses play an important role in the etiology of fetal and maternal disorders other than biomedical risks. The surge of emergency evidence that yoga as adjuvant therapy can have significant beneficial effects in the prenatal period and in the fetus. Aim: The aim of this study was to evaluate the immediate effect of Pranava Pranayama on maternal and fetal cardiovascular parameters. Materials and Methods: Three-way cross-over study was done on 3 consecutive days in 60 pregnant women (3rd trimester) with 10 min of breath awareness, listening to OM, and performing Pranava Pranayama. Maternal heart rate (MHR) and systolic and diastolic pressures were measured before and after each session, and cardiovascular indices were derived with formulae. Fetal heart rate (FHR) was obtained from nonstress test tracing. Data were assessed using GraphPad InStat version 3.06. Student&#39;s t-test was used for intragroup comparisons while repeated measured ANOVA with Tukey–Kramer multiple comparison tests were done for intergroup comparison. Results: Significant changes (P &lt; 0.001) were found in MHR and FHR immediately after all three interventions. Delta% changes showed the greatest fall in MHR (P = 0.03) after Pranava as compared to the other two while in FHR, both OM group and Pranava were significant (P &lt; 0.001). Conclusion: There were significant changes found in MHR, FHR, and cardiovascular responses rate-pressure product and double product after a single session of intervention. Yogic breathing techniques Pranava may enhance cardiovascular hemodynamics of the maternal–fetal unit. Reduction in maternal and fetal cardiovascular parameters attributed to reduced sympathetic activity coupled with enhanced vagal parasympathetic tone. Such changes in cardiac autonomic status may enhance placental circulation and lead to healthier fetal development.
Indian Journal of Psychiatry
Yoga therapy has been widely accepted as part of the evidence-based modern healthcare system. Alt... more Yoga therapy has been widely accepted as part of the evidence-based modern healthcare system. Although research publications are growing in leaps and bounds, many methodological issues pose stumbling blocks. In this narrative review, various issues like standalone or add-on treatment, blinding, randomization, nature of dependent and intervening variables, duration of intervention, sustainability of effects, attrition bias, adherence and accuracy, all or none performance, diverse schools, heterogeneity and multidimensionality, assortment, permutations, and combinations of different components, neglect of essential ingredients, mindfulness, catch-22 situation, credentials of the instructors, cultural factors, naivety, multicentric studies, duration of collection of data, primary or standard treatment, interdisciplinary research, statistical lapses, qualitative research, biomedical research are discussed. There is a need to frame guidelines for conducting yoga therapy research and publication.
Medical Journal of Dr. D.Y. Patil Vidyapeeth
Introduction: Yoga is known to promote health and wellness in all. Pranava Pranayama is a useful ... more Introduction: Yoga is known to promote health and wellness in all. Pranava Pranayama is a useful sound based yogic breathing technique with reported benefits such as potentiating vagal tone. Subjects and Methods: This single blinded randomized self-controlled cross-over study was done with 58 participants. The immediate effect of Pranava Pranayama on saturation of oxygen in the blood (SpO2) and heart rate (HR) was determined before and after intervention using pulse oximeter. To avoid extraneous influences due to recording on different days, one half of the subjects were randomized to perform quiet sitting on day 1 while other half did Pranava Pranayama which was then reversed on day 2. Results: Intra group comparison showed significant changes (p &lt; 0.001) in both SpO2 and HR following Pranava Pranayama whereas in the quiet sitting group, there was an insignificant fall in the SpO2 readings but HR was found significant (p &lt; 0.001). Intergroup comparison showed significant differences between groups (p-0.032). Discussion: Cardiovascular changes following Pranava Pranayama may be as a result of audible chanting improving baroreflex sensitivity along with increased endogenous nitric oxide production. This promotes vasodilatation resulting in reduction of BP. The decrease in vascular resistance and an increase in capillary perfusion results in increased oxygen saturation with lesser demand on the heart. Conclusion: This study provides evidence that Pranava Pranayama is an effective technique in enhancing SpO2 and our findings may have therapeutic applications especially in the current pandemic situation.
IP Journal of Nutrition, Metabolism and Health Science, 2021
This study was done at the Centre for Yoga Therapy, Education and Research (CYTER) of Sri Balaji ... more This study was done at the Centre for Yoga Therapy, Education and Research (CYTER) of Sri Balaji Vidyapeeth (SBV) to determine cardiovascular (CV) parameters in patients with psoriasis.Data of 20 patients (12 female, 8 male) with a mean age of 44.40 ± 15.2ywho were referred by Dept. of Dermatology and attended yoga therapy sessions at CYTER was used for analysis. Supervised yoga training was given to the participants who were randomized into the yoga group. Heart rate (HR), systolic and diastolic pressure (SP and DP) was recorded using non-invasive blood pressure (NIBP) apparatus before and after the study period of 12 weeks. CV indices such as Pulse pressure (PP), mean pressure (MP), rate-pressure product (RPP), and double product (DoP) were derived using appropriate formulae.The inter-group comparison showed significant change (p<0.05) in SP. The derived CV indices such as PP, RPP & DoP also showed significant changes. (p<0.05) after 12 weeks of Yoga training. The intragroup...
Rambam Maimonides Medical Journal, 2022
Objective Diabetes mellitus (DM), characterized by chronic hyperglycemia, is attributed to relati... more Objective Diabetes mellitus (DM), characterized by chronic hyperglycemia, is attributed to relative insulin deficiency or resistance, or both. Studies have shown that yoga can modulate parameters of insulin resistance. The present study explored the possible beneficial effects of integrated yoga therapy with reference to glycemic control and insulin resistance (IR) in individuals with diabetes maintained on standard oral medical care with yoga therapy, compared to those on standard oral medical care alone. Methods In this study, the subjects on yoga intervention comprised 35 type 2 diabetics, and an equal number of volunteers constituted the control group. Subjects ranged in age from 30 to 70 years, with hemoglobin A1c (HbA1c) test more than 7%, and were maintained on diabetic diet and oral hypoglycemic agents. Blood samples were drawn prior to and after 120 days of integrated yoga therapy intervention. Fasting blood glucose (FBG), post-prandial blood glucose (PPBG), HbA1c, insulin,...
Research-Based Perspectives on the Psychophysiology of Yoga, 2018
Asana (posture) is usually defined as a body posture held with stability and ease by Patanjali. H... more Asana (posture) is usually defined as a body posture held with stability and ease by Patanjali. Hathayoga Pradipika emphasises that asana helps bring about stability in health and suppleness of body. As intra-thoracic, intra-abdominal pressure-volume changes affect internal organs and systems, it is plausible that asanas produce changes through mechanisms both local as well as general. This chapter takes a look at various studies that have explored human physiology in relation to asana. Some examples are glucose metabolism, changes in energy expenditure, ventilatory responses, oxygen consumption as well as respiratory, neuromuscular and cardiovascular parameters. It also explores the neuromuscular reflex arcs dynamics that position asana as an excellent system to restore psychosomatic harmony and balance. It needs to be stressed that the actual efforts being made in asana are of a somato-psychic nature while benefits that accrue are of a psychosomatic nature. It is suggested that Ha...
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Papers by Prof Dr Meena Ramanathan