Running head: YOGA AND PTSD

Yoga and PTSD:

Researching the Subjects
Ellie Wertheimer
University of South Florida

YOGA AND PTSD

Abstract
It is important to know how to look up articles, how to apply them to each other, and how to
evaluate the information the articles give the reader. First, this paper discussed the different
words used to find the articles, the use of the University of South Floridas search it engine, and
the use of PubMed with the key terms: Veterans with PTSD and yoga, and PTSD patients
doing yoga evidence based practice. Each article was examined concerning its aims, measures,
and statistics, and each had a p value of less than .05. This paper also showed how each article
was similar or different than the other articles. This is important because of how different the
studies were although they still all had a positive effect on the patients. Finally, the paper added
how the studies could have been different to get better results for the patients. In conclusion,
each randomized controlled study showed that performing yoga does help U.S. Veterans with
PTSD. It would be easier for Veterans with PTSD to perform yoga because it is affordable and
can be performed without great difficulty.

Yoga and PTSD:

Researching the Subjects
Post-traumatic stress disorder (PTSD) is a hard disability to live with, as many people do
not understand it and there are few therapies or medications to help cope with it. Yoga has been
studied multiple times with PTSD patients. It seems to have a strong correlation with their sleep,
anxiety levels, and stress levels, according to the articles that were evaluated. All of which have
a p value less than .05. PTSD patients have many difficulties with coping because of the

YOGA AND PTSD

flashbacks, making it hard to afford therapy or medications, which is why yoga is a better option
for them. It is important to answer the PICOT question: for Veterans with PTSD (P), will yoga
(I) compared to a group simply asked to meditate and with no intervention (C) improve quality
of sleep and decrease stress (O) within 8 weeks (T)? It is important to understand how the
articles were found and how yoga has an effect on Veterans with PTSD. According to Denniston
and Kennedy from National Guideline Clearninghouse, yoga is a great way to help with mental
illnesses, including PTSD. The purpose of this review of the literature is to understand the
differences in the studies and see how yoga effects Veterans with PTSD.
Literature Search
The University of South Florida Library Search It and PubMed were used to find the
articles about PTSD and yoga. Key terms used were Veterans with PTSD and yoga, and
PTSD patients doing yoga evidence based practice. It is important to make sure PTSD and
yoga were used in the search engine because that was the primary focus of the essay, even
though it did talk about Veterans with PTSD, other populations with PTSD studies could be
applied to the Veteran population. After it was put into the search engine, the dates were moved,
making the search between the years of 2010 and 2015, to make sure it is relevant to the current
day.
Literature Review
Three randomized-controlled trials were used for the paper, one of which the aim was to
test the hypothesis with U.S. Military Veterans with PTSD either performing breathing-based
meditation or in a control group (Seppala, & et.al, 2014). They were tested after one month and
after one year. It was hypothesized that the group performing the deep breathing would have
both less anxiety and decreased respiration rates. The article measured anxiety and respiration
rates in the patients before and after treatment with 21 U.S. Military Veterans with PTSD, with

YOGA AND PTSD

11 who performed the breathing, and with 10 who were in the control group. The outcomes of
the study were measured in one month (p> .001), and one year (p> .025), and were statistically
significant. A positive finding of the article is that they checked on the patients both one month
and one year after starting the therapy to see if long term was even better then short term effect.
However, it did not have enough patients to test and could have tried different types of deep
breathing as deep breathing is not specific.
In a second study by Staples, Hamilton and Uddo (2013), the aim was to test the
hypothesis that Veterans with PTSD would have overall better sleep and decreased hyperarousal
symptoms. They tested two groups; one performing yoga and a control group. It measured sleep
quality and hyperarousal symptoms before and after the study with 12 Veterans; six of whom
were performing yoga and six in the control group. In the study, when Veterans were asked to
perform yoga twice a week for six weeks, a p value of less than .05 was obtained, which shows
that the study was statistically significant. It was a good study because it measured how often
the patients performed the yoga and for how long. Also, it was the only study to check
hyperarousal symptoms. It would have been better if more patients were in the study, it should
have over 50, ideally over 100.
The last article reviewed (Jindani, Turner & Khhalsa, 2015), had the aim to test the
differences between the experimenters two different groups all with PTSD; ones who did
Kundalini yoga and a control group. It was hypothesized that the group that performed the yoga
would have better sleep, less stress, and less anxiety. The study was to measure the effects on
sleep, perceived stress, anxiety, and resilience as a result of doing yoga with a sample size of 80
people; 40 doing Kundalini yoga and 40 as the control. The statistics showed a p score less
than .05 when patients performed yoga, showing that the study was statically significant. The

YOGA AND PTSD

study had a good sample size, randomly assigned people to the experimental and controlled
groups. They also used a particular yoga position that they performed. The study neglected to
explain how long the patients performed the yoga and how often they performed it.
Synthesis
All of the studies focused on either sleep or anxiety with the patients. These symptoms
can be hard to measure, although these symptoms are very common among people with PTSD.
Each one of the studies had a different type of yoga that they would do: general yoga (Staples et.
al., 2013), breathing exercises (Seppala et. al., 2014), and Kundalini yoga (Jindani et. al., 2015).
Each had a calming effect on the PTSD patients. All of the studies have a p value less than .05,
showing that the studies were all statistically significant and that yoga is effective on people with
PTSD. Only one study checked on the patients continually throughout the study (Seppala et. al.,
2014), while the other two only took results after about six weeks. All of the articles failed to
have an adequate sample size. There should at least be one hundred people to make sure it has a
therapeutic effect. It is not sure how yoga affects the brain to help people with PTSD yet, but it
does have beneficial effects on people with PTSD.
Clinical Recommendations
As just stated, most of the studies did not have enough people. It is usually
recommended to have at least 100 similar people from the population to make sure that the
treatment is effective for that population and can be used with other people with PTSD. The
amount of time patients spent performing yoga should have been measured. This would allow a
future study to determine if the amount of time spent practicing yoga had an effect. Perhaps 15
minutes has a small effect, while one hour might have a more significant effect should be
recommended for the new study.

YOGA AND PTSD

Only one study checked in with the patients at different intervals to see if long periods of
time were more or less effective. A better design would have more frequent check-ins.
Additionally it would be recommended, patients could have classes that are monitored
when and what exercises the patients do, so that treatments could be evaluated after each yoga
session. It would be important to have a pre-test and a post-test during the study to see how
patients feel about yoga and how it is affecting them in the new study. This would give a better
evaluation of the PICOT question. Finally, it would also be a good idea to do an
electroencephalogram (EEG) before and after treatment to see if there is a physical difference
between the scans. This would also help evaluate the PICOT question.

References
Jindani, F., Turner, N., & Khhalsa, S. B. (2015). A Yoga Intervention For Posttraumatic Stress: A
Preliminary Randomized Control Trial. Evidence-Based Complement and Alternative
Medicine, 2015, 351-746. doi: 10.1155/2015/351746
Seppala, E. M., Nitschke, JB., Tudorascu, DL., Hayes, A., Goldstein, MR., Nquyen, DT.,
Perlman, D., Davidson, RJ. (2014). Breathing-based Meditation Decreases
Posttraumatic Stress Disorder Symptoms in U.S. Military Veterans: A Randomized
Controlled Longitudinal Study. Journal of Traumatic Stress, 27(4), 397-405. doi:
10.1002/jts.21936

YOGA AND PTSD

Staples, J. K., Hamilton, M. F., Uddo, Madeline. (2013). A Yoga Program for the Symptoms of
Post-Traumatic Stress Disorders in Veterans. Military Medicine, 178(8), 854-860. doi:
10.7205/MILMED-D-12-00536
Denniston Jr., Philip L., Kennedy Jr., Charles, W. (2013). Mental illness and stress. National
Guideline Clearninghouse, Retrieved from: http://www.guideline.gov/content.aspx?
id=47588&search=yoga+and+ptsd