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INNOVATIVE ASPECTS OF CYTER

THE INNOVATIVE ASPECTS OF CYTER


Joseph and Lilian le Page, the founders of Integrative Yoga Therapy, USA were
recently in India on a mission to make a film on Yoga therapy and travelled
across the county recording therapeutic activities of premier Yoga centers.
After their visit to CYTER they commented,
There are many centers where you can get a Yoga degree, attend a Yoga
therapy session or find Yoga research being undertaken. However, to have all
three happening in one place is surely innovative. This center is indeed a role-
model that combines the best of the East with that of the West.
That is what we have here at CYTER. An integrated set up where we are
educating future Yoga therapists while simultaneously helping patients recover
from their illnesses and at the same time working towards developing an
understanding about the Hows & Whys of Yoga through scientific research.
Whereas Yoga is usually found in the Physical Education and Sports
Department of most universities, we at CYTER have it in a medical institution
thus enhancing the learning curve of our trainees as also enabling us to offer
holistic therapeutic benefits for all patients in our hospital. Yoga consultations
are part and parcel of all the Master Health checkups offered by our Hospital
services thus integrating the modern and the ancient even at the entry level
itself. Such quality of life enhancing benefits for nearly 6000 patients at
MGMCRI&RI are another truly innovative aspect of the work here at CYTER.
Our PG Diploma in Yoga Therapy (PGDYT) is one of the innovative courses in
the world as it is offered through a medical institution and brings together the
ancient wisdom of Yoga with the evidence based approach of modern
medicine. We have two batches of students enrolled in the course and classes
are going on regularly for first semester batch while the second semester batch
completed their examinations in August 2014. During our Deputy Directors
recent lecture tour down under many medical, paramedical and Yoga
professionals evidenced keen interest in attending such a course from the next
academic year, making its truly international in participation.
We have also given training to nursing students, faculty members, senior
citizens, special children and transgender participants and published 28 papers
and 9 abstracts on the short and long term, health enhancing benefits of such
training and therapeutic programmes. Current research studies are focusing on
obesity, computer vision syndrome and depression in the transgender
community. MBBS students have been exposed to Yoga through special
sessions and we suggest that the CYTER model be adopted by all innovative
medical colleges when the new MCI regulations on inclusion of Yoga in MBBS
curriculum are implemented.
The Govt of India, Ministry of Health &FW is currently promoting indigenous
systems of health in a strong manner through AYUSH. The limitations of
modern medicine in managing stress induced psychosomatic, chronic illnesses
are the strength of Yoga and hence a holistic integration of both systems
enables best quality of patient care. CYTER can be projected a nodal centre to
train medical educators and administrators for setting up such integrative
health centers in our country as we have the necessary infrastructure and man
power.
A successful Workshop-cum-Seminar was organized on Yoga for lifestyle
disorders and this was attended by more than 250 medical, paramedical, Yoga
professionals and students from all over the country with 25 international
delegates in November 2013. Regular awareness programmes are conducted in
the community at various schools, colleges, medical and social associations and
senior citizen welfare associations locally. CYTER also conducted a very well
received Yoga Therapy workshop during the 20th International Yoga Festival
organized by the Government of Pondicherry in January 2014.
It is imperative that Sri Balaji Vidyapeeth remain a Denovo University as it is
only in such a supportive and innovative milieu that the holistic art and science
of Yoga, our cultural heritage, has been able to reach both the classes and the
masses of our society optimally, effectively and holistically.











REPORT ON CYTER ACTIVITIES


CYTER Report- September 2014 Page 1

Sri Balaji Vidyapeeth
Mahatma Gandhi Medical College & Research Institute
Pillaiyarkuppam, Pondicherry - 607 402
CENTRE FOR YOGA THERAPY, EDUCATION AND RESEARCH (CYTER)

REPORT ON WORK DONE

Modern medical advancements provide the rationale for the integration of various
traditional healing techniques like Yoga to promote healing, health, and longevity.
Thanks to the foresight of Chairman and management of SBVU and MGMCRI,
CYTER was started on 1 November 2010 and was functioning adjacent to Blood bank
in Hospital Block.
Currently functioning in 1
st
floor, I block, adjacent to the main Hospital block,
MGMCRI since December 2013.

YOGA THERAPY (patient load):
CYTER is conducting a scientifically sound Yoga therapy programme through its Yoga
Therapy OPD in I Block from 9 am to 1 pm, Monday-Saturday.
Consultations are offered by Dr. Ananda Balayogi Bhavanani, Deputy Director
CYTER and Mrs Meena Ramanathan, Coordinator and Yoga Therapist. Qualified
Yoga instructors are imparting the schedules daily from 9.30am to 12.30 pm.
Individualised and group Yoga therapy sessions are being conducted for various
medical conditions such as diabetes, hypertension, musculoskeletal and psychiatric
disorders with excellent feedback from participants.
Yoga therapy and lifestyle consultations are offered daily as part of Basic, Superior,
Complete Cardiac and Deluxe Health Check packages of Master Heath Check-up in the
Corporate Services Wing of the hospital since October 2013.

Year Male Female TG Total Grand total
2010 31 28 - 59
5881
2011 440 750 27 1217
2012 210 542 10 763
2013 553 817 2 1372
2014
(Jan-Aug)
1135 1319 16 2470



CYTER Report- September 2014 Page 2

YOGA EDUCATION (courses):
A small but significant step was taken on the 30
th
J anuary 2014 with the inaugural of
the Post Graduate Diploma in Yoga Therapy (PGDYT) course at the CYTER in the
Mahatma Gandhi Medical College. The course was officially inaugurated ceremonially
by Dr Madanmohan, Director CYTER and then faculty members and the six students
of PGDYT course received blessings of the Vice chancellor Prof KR Sethuraman, Dean
(PG Studies &Research) Prof N Ananthakrishnan, Dean (Admin) Prof S Krishnan, and
the Registrar Prof AR Srinivasan. Holistic health, integrative treatment and mindbody
medicine are now buzz words. Integrating Yoga with modern medicine will enable us
to produce holistic physicians for health delivery of tomorrow as integrative medicine
becomes popular. This two semester (480 hr) part time course aims to produce
qualified Yoga therapists competent to impart a scientifically sound Yoga therapy
programme for patients of different conditions. The first batch of students completed
their 1
st
semester exams in August 2014 and second batch of students joined PGDYT at
CYTER on 10
th
September.
Yoga training has been given for nursing students of the Kasturba Gandhi Nursing
College on a regular basis since 2011. Nursing recruits visit CYTER during their
orientation programmes and are given special sessions highlighting benefits of Yoga.
Regular Yoga awareness programmes in MRD since September 2013.
Efforts to include Yoga in MBBS curriculum.
Regular talks as part of arthritis, obesity, back pain, diabetes awareness programmes
organized by various departments.
Capsule talks and lecture-demonstrations in Scientific Academic Forum (SAF)
Outreach programmes in educational institutions and other social organizations to
create awareness of Yoga and the functioning of CYTER at MGMCRI.
A CME-cum-Workshop on YOGA AND LIFESTYLE DISORDERS was organized by
CYTER and Department of Physiology at MGMC&RI on 22 November 2013. More
than 250 medical and paramedical professionals and students as well as Yoga
practitioners and enthusiasts took part in the CME that gave participants an overview of
the role Yoga can play in lifestyle disorders by inculcating a healthy lifestyle.
The CYTER team of Prof Madanmohan (Director), Dr Ananda Balayogi Bhavanani
(Deputy Director) and Smt. Meena Ramanathan (Coordinator - cum- Yoga therapist)
presented an invited Workshop on Yoga Therapy at the 20
th
International Yoga festival
organized by Department of Tourism, Government of Puducherry at Gandhi Tidal -
J anuary 4-7
th
2014.
Dr Ananda Balayogi Bhavanani (Deputy Director-CYTER) was invited to present
workshops, seminars and talks at various venues in Australia and New Zealand from
24
th
March to 14
th
April 2014. He presented highly successful programmes organized
by the Gitananda Yoga Association of Australia at IYTA-Wellington, Lotus Yoga
Centre-Paraparaumu in New Zealand and Anand Yoga Academy at Adelaide. He also
conducted intensive 3-day retreats at Tatum Park, NZ and Integral Yoga Academy of
Australasia at Adelaide. He presented a special 2-day workshop at the International
Yoga Teachers Association at Sydney, Australia and visited the Sivanna Integrative
Health Centre, Sydney to discuss further collaboration in Yoga therapy. He had special
personal meetings with Yogashri Dr Eric Dornekamp, the senior most Yoga authority
of New Zealand and the world famous authority on Yantra-Tantra, Dr. Swami
Anandakapila Saraswathi (J onn Mumford) of Sydney, Australia.

CYTER Report- September 2014 Page 3

Dr. Ananda was invited to attend Board of Studies meeting of GS College of Yoga and
Cultural Synthesis, at Kaivalyadhama in Lonavla. He has been nominated as the
chairperson for the subject, Anatomy and Physiology of the Human Body in the
Context of Yoga. This appointment is prestigious as Kaivalyadhama is one of the
oldest and premier Yoga institutions of India. He was also Chief Guest for the
inauguration of the Foundation Course in Yoga & Ayurveda at Kaivalyadhama. He was
an invited Resource Person for the National Seminar on "Dimensions of Yoga and its
dynamics" at MoP Vaishnav College for Women, Chennai. He delivered an invited
lecture on Diverse Dimensions of Yoga for the youth" in the event organized jointly
by the Krishnamacharya Yoga Mandiram and MoP Vaishnav College.
Smt. Meena Ramanthan, Coordinator and Yoga Therapist CYTER submitted her PhD
dissertation to the Tamil Nadu Physical Education and Sports University, Chennai. The
title of her 250 page dissertation is Effect of selected yogasanas and pranayama on
selected cardiorespiratory, psychological and psychomotor variables among low and
highly depressed geriatric women. She was invited to present an interactive session at
the CNE for nurses, staff and faculty of Indira Gandhi Government General Hospital
and Post Graduate Institute (IGGGH&PGI) Pondicherry. Mrs Meena Ramanathan gave
an interactive talk cum practical session on Stressa Curse; Yoga- a Boon; Yogic
Integration for Healthcare Givers with a demo by Sangeeta and Danush Apnadesh.
CYTER inaugurated a special Silver Citizens Yoga and Health Programme for Senior
Citizens of the Serene Pelican Belfort Township. More than 25 senior citizens attended
the sessions at CYTER. Dr Ananda gave an introduction and then the practice session
was led by Meena Ramanathan and supported by Latha and Dhanush, the Yoga
instructors. A special Silver Citizens Clinic is being organized from 11am to
12.30pm every Thursday at CYTER to benefit those who are above 60years of age.

YOGA RESEARCH (publications):
A. Published papers (28) :
1. Bhavanani AB. Yoga in health care. Annals of SBV 2012; 1 (2): 15-24.
2. Bhavanani AB, Ramanathan M, Balaji R and Pushpa D. Immediate effect of
suryanamaskar on reaction time and heart rate in female volunteers. Indian J Physiol
Pharmacol 2013; 57 (2): 199204.
3. Bhavanani AB. Modern Medicine, Meet Yoga. Integral Yoga Magazine USA. Fall
2013. pg 21-23.
4. Dinesh T, Sharma V K, Raja J eyakumar M, Syam Sunder A, Gopinath M, Bhavanani
AB. Effect of 8 weeks of pranav pranayama training on pulmonary function test
parameters in young healthy, volunteers of J IPMER population. Int Res J Pharm App
Sci 2013; 3 (4):116-18.
5. Dinesh T, Gaur G S, Sharma V K, Velkumary S, Bhavanani AB. Effect of 12 weeks of
kapalabhati pranayama training on cardio-respiratory parameters in young, healthy
volunteers of J IPMER population. International J ournal of Medical & Pharmaceutical
Sciences Research and Review 2013; 1 (4): 53-61.
6. Bhavanani AB, Ramanathan M, Madanmohan. Immediate cardiovascular effects of a
single yoga session in different conditions. Altern Integ Med 2013; 2: 144.

CYTER Report- September 2014 Page 4

7. Bhavanani AB, Ramanathan M, Madanmohan, Srinivasan AR. Hematological,
biochemical and psychological effects of a yoga training programme in nursing
students. Int Res J Pharm App Sci 2013; 3(6):17-23
8. Madanmohan. Integrating yoga and modern medicine. Annals of SBV 2013; 2 (2): 7.
9. Madanmohan. Yog for healthy lifestyle. Annals of SBV 2013; 2 (2): 20-23.
10. Bhavanani AB. Psychosomatic mechanisms of yoga. Annals of SBV 2013; 2 (2): 27-
31.
11. Bhavanani AB. Yoga practices for prevention and management of lifestyle disorders.
Annals of SBV 2013; 2 (2): 32-40.
12. Bhavanani AB, Ramanathan M, Balaji R, Pushpa D. Differential effects of uninostril
and alternate nostril pranayamas on cardiovascular parameters and reaction time. Int J
Yoga 2014; 7: 60-65.
13. Sharma VK, Raja J eyakumar M, Velkumary S, Subramanian SK, Bhavanani AB,
Madanmohan, Sahai A, Dinesh T. Effect of Fast and Slow Pranayama Practice on
Cognitive Functions in Healthy Volunteers. J ournal of Clinical and Diagnostic
Research 2014; 8 (1) : 10-13.
14. Bhavanani AB, Ramanathan M, Madanmohan. Immediate effect of alternate nostril
breathing on cardiovascular parameters and reaction time. Online International
Interdisciplinary Research J ournal 2014; 4; (Special Issue): 297-302.
15. Bhavanani AB. Yogic perspectives on mental health. International Light 2014. J an-
March: 14-17.
16. Bhavanani AB. Yoga. Clinical Roundup: Selected Treatment Options for Depression.
Alternative and Complementary Therapies 2014; 20: 54-55.
17. Madanmohan. Yoga for youth. Souvenir of the National Yoga Week 2014. MDNIY,
New Delhi, Feb 2014. Pg 52.
18. Bhavanani AB, Madanmohan, Meena Ramanathan, Srinivasan AR. Yoga improves
psychophysical health of nursing students. Souvenir of the National Yoga Week 2014.
MDNIY, New Delhi, Feb 2014. Pg 65-70.
19. Bhavanani AB. Introducing integral yoga education for the youth. Souvenir of the
National Yoga Week 2014. MDNIY, New Delhi, Feb 2014. Pg 84.
20. Meena Ramanathan, Bhavanani AB. Immediate effect of chandra and suryanadi
pranayamas on cardiovascular parameters and reaction time in a geriatric population.
International J ournal of Physiology 2014; 2 (1): 59-63.
21. Rajajeyakumar M, Amudharaj D, Bandi harikrishna, Madanmohan T, J eyasettiseloune,
Bhavanani AB. Immediate effect of different pranayam on short term heart rate
variability in health care students. A preliminary study. International J ournal of
Physiology 2014; 2 (1): 39-43.
22. Bhavanani AB. Yoga: A novel integrative therapy. Nisargopachar Varta 2014; 6 (5):
13-15.
23. Bhavanani AB, J ayasettiaseelon E, Sanjay Z, Madanmohan. Immediate effect of
chandranadi pranayam on heart rate variability and cardiovascular parameters in
patients of diabetes mellitus and hypertension. Yoga Mimamsa 2013; 45 (1&2): 1-13.

CYTER Report- September 2014 Page 5

24. Dinesh T, Gaur GS, Sharma VK, Bhavanani AB, Rajajeyakumar M, Sunder AS. Effect
of slow and fast pranayama training on handgrip strength and endurance in healthy
volunteers. J ournal of Clinical and Diagnostic Research 2014; 8 (5): BC01-03.
25. Bhavanani AB, Meena Ramanathan, Madanmohan. Yoga and mind body therapies in
health and disease: a brief review. Annals of SBV 2014; 3 (1): 29-41.
26. Bhavanani AB. Yogic perspectives on mental health. Annals of SBV 2014; 3 (1): 47-
52.
27. Bhavanani AB. The yoga of interpersonal relationships. Annals of SBV 2014; 3 (1):
53-60.
28. Bhavanani AB, Ramanathan M, Balaji R, Pushpa D. Comparative immediate effect of
different yoga asanas on heart rate and blood pressure in healthy young volunteers.
International J ournal of Yoga 2014; 7: 89-95.
In press:
1. Lee Majewski, Ananda Balayogi Bhavanani . A novel rejuvenation program for cancer
patients at Kaivalyadhama, India. Yoga Mimamsa (Ahead of print).
2. Ananda Balayogi Bhavanani. Diverse dimensions of Yoga. Yoga Mimamsa (Ahead of
print).
3. Ananda Balayogi Bhavanani. Role of yoga in health and disease. J ournal of Symptoms
and Signs.

B. Published abstracts (9):
1. Health, rejuvenation and longevity: an ayurvedic perspective. Madanmohan, Bhavanani
AB. Abstracts of Sanjeevita 2013, the First Annual Summit on Current Concepts in
Integrative Medicine organized by the Central Inter-Disciplinary Research Facility
(CIDRF) in collaboration with Sri Balaji Vidyapeeth, Puducherry. September 6th 2013,
MGMC&RI, Pondicherry. Pg. 48.
2. Yoga and modern medicine: need for integration. Madanmohan, Bhavanani AB.
Abstracts of Sanjeevita 2013, the First Annual Summit on Current Concepts in
Integrative Medicine organized by the Central Inter-Disciplinary Research Facility
(CIDRF) in collaboration with Sri Balaji Vidyapeeth, Puducherry. September 6th 2013,
MGMC&RI, Pondicherry. Pg. 48-49.
3. Effect of yoga training on cardiorespiratory health in obese subjects. Madanmohan,
Bhavanani AB, AR Srinivasan, S Balanehru. Abstracts of Sanjeevita 2013, the First
Annual Summit on Current Concepts in Integrative Medicine organized by the
Central Inter-Disciplinary Research Facility (CIDRF) in collaboration with Sri Balaji
Vidyapeeth, Puducherry. September 6th 2013, MGMC&RI, Pondicherry. Pg. 49.
4. Yoga works, but how? Bhavanani AB, Meena Ramanathan, Madanmohan. Abstracts of
Sanjeevita 2013, the First Annual Summit on Current Concepts in Integrative
Medicine organized by the Central Inter-Disciplinary Research Facility (CIDRF) in
collaboration with Sri Balaji Vidyapeeth, Puducherry. September 6th 2013,
MGMC&RI, Pondicherry. Pg. 49-50.
5. Immediate cardiovascular effects of pranayamas in patients of hypertension. Bhavanani
AB, Madanmohan. Abstracts of Sanjeevita 2013, the First Annual Summit on

CYTER Report- September 2014 Page 6

Current Concepts in Integrative Medicine organized by the Central Inter-Disciplinary
Research Facility (CIDRF) in collaboration with Sri Balaji Vidyapeeth, Puducherry.
September 6th 2013, MGMC&RI, Pondicherry. Pg. 50.
6. Effect of 12 weeks of pranayama training on basal physiological parameters in young,
healthy volunteers. Dinesh T, Gaur G S, Sharma V K, Bhavanani AB, Harichandra
Kumar KT. Poster No. A74. APPICON 2013.
7. Yoga for youth. Madanmohan. Abstracts of the National Yoga Week 2014. MDNIY,
New Delhi, Feb 2014. Pg 6.
8. Yoga improves psychophysical health of nursing students. Bhavanani AB,
Madanmohan, Meena Ramanathan, Srinivasan AR. Abstracts of the National Yoga
Week 2014. MDNIY, New Delhi, Feb 2014. Pg 21.
9. Introducing integral yoga education for the youth. Bhavanani AB. Abstracts of the
National Yoga Week 2014. MDNIY, New Delhi, Feb 2014. Pg 22.

C. Ongoing research projects (5):
1. Effect of 12-weeks of yoga training on cardiorespiratory, neurological and
psychological parameters in a geriatric population. Pre and test recordings have been
completed and 12 weeks Yoga training sessions conducted twice weekly in the Hospice
of St. Cluny, Pondicherry.
2. Intra ocular pressure variations in forward bending yoga postures. Collaborative project
with Department of Ophthalmology, MGMCRI. Proposal approved by IHEC in April
2014 and subjects are being recruited.
3. Effects of tratak and bhramari pranayama (yogic eye care module) on ocular muscle
balance and accommodation in computer vision syndrome. Collaborative project with
Department of Ophthalmology, MGMCRI. Proposal approved by IHEC in April 2014
and subjects are being recruited.
4. A study to assess the effectiveness of pranayama on level of depression among the
transgender. Collaborative project with KGMC. Proposal approved by IHEC, KGNC in
March 2014 and subjects are being recruited.
5. Effect of yoga training on cardiorespiratory health in obese subjects. Proposal
submitted to CCRYN, Deptt of AYUSH, Ministry of Health & FW, Govt of India after
clearance from IHEC.












PG DIPLOMA IN YOGA THERAPY

UNIQUE FEATURES OF PGDYT
There are many centers where you can get a Yoga degree, attend a Yoga
therapy session or find Yoga research being undertaken. However, to have all
three happening in one place is surely innovative. This center is indeed a role-
model that combines the best of the East with that of the West.
- Joseph le Page, founder- Integrative Yoga Therapy, USA
At CYTER we have an integrated set up where we are educating future Yoga
therapists, simultaneously helping patients recover from illnesses and at the
same time developing an understanding through scientific research.
Whereas Yoga is usually found in departments of Physical Education &
Sports in most universities, we at CYTER have it in a medical institution
thus enhancing the learning curve of our trainees as also enabling us to
offer holistic therapeutic benefits for all patients in our hospital.
Our PG Diploma in Yoga Therapy (PGDYT) is one of the innovative courses in
the country as it is offered through a medical institution and combines the
ancient wisdom with evidence based approach of modern medicine. The
course is conducted by experienced faculties who have Yoga and modern
medical training as well as a wealth of therapeutic and research experience
with more than 200 publications to their credit.
The syllabus includes topics dealing with teachings drawn from ancient
texts combined with modern medical advancements thus exposing students
to various clinical applications of Yoga as a therapy in a medical institution.
Internal assessment is given based on seminars and assignments and the
students participation in regular patient care and research activities of
CYTER in the hospital. A total 600 marks is allotted for theory including:
Foundations of yoga
Foundations of modern medicine
Foundations of yoga chikitsa (application of yoga as a therapy)
Application of yoga in different fields of human endeavor
Role of yoga in cardiovascular, respiratory, musculoskeletal and
digestive disorders
Yoga as a therapy for neurological, endocrine, metabolic, psychiatric
and other disorders
There is an extensive Practicum in both semesters (400 marks) that provides
training in extensive Yogic techniques that are then applied in different
conditions. Hands-on training in conducting sessions for healthy
participants as well as clinical experience in dealing with patients of various
conditions is provided.
We have two batches of students enrolled in the course and classes are
going on regularly. The first batch had a medical doctor attending while the
second has two nursing professionals amongst the students.
CYTER- SYLLABUS FOR PGDYT Page 1

Sri Balaji Vidyapeeth
Mahatma Gandhi Medical College & Research Institute
Pillaiyarkuppam, Pondicherry - 607 402
CENTRE FOR YOGA THERAPY, EDUCATION AND RESEARCH (CYTER)

POST GRADUATE DIPLOMA IN YOGA THERAPY (PGDYT)

1. NAME OF COURSE: PG DIPLOMA IN YOGA THERAPY (PGDYT)

2. DURATION OF COURSE: 12 months. The course will have two semesters of 6 months each.
Each semester will have 240 hours of teaching (theory: 80 hours, practicum: 120 hours,
assignment: 40 hours).

3. NUMBER OF SEATS & MANNER OF SELECTION: 25. Selection by entrance test and interview.
ELIGIBILITY: Modern medical and AYUSH doctors, dental surgeons, nursing professionals,
bachelor in physiotherapy, occupational therapy, PGDY, MSc Yoga.

4. ADVANTAGES OF THE COURSE, INNOVATIVE ASPECTS AND EMPLOYMENT OPPORTUNITIES:
Holistic health, integrative treatment and mindbody medicine are now buzz words.
Integrating Yoga with modern medicine will enable us to produce holistic physicians for
health delivery of tomorrow as integrative medicine becomes popular.

5. QUANTUM OF FEES: Rs 5,000/-

6. DETAILS OF TIMINGS FOR THE COURSE (EACH SEMESTER) :
i) Contact classes --------------------------------------------------------------- 200 hours
(2 hours / day, 5 days / week, 20 week/ semester = 200 hours)

ii) Assignment -------------------------------------------------------------------- 40 hours

Total 240 hours/sem


7. DETAILS OF SYLLABUS:


CYTER- SYLLABUS FOR PGDYT Page 2

SEMESTER I
1. FOUNDATIONS OF YOGA
UNIT 1: Meaning and definition of the term Yoga. Yoga as goal as well as the means.
Different connotations and meanings of Yoga. Misconceptions about Yoga. Comprehensive nature
and scope of Yoga. Aims and objectives of Yoga. A brief outline of the history of Yoga from
ancient to modern times. Modern developments and trends in Yoga. A brief introduction to the
vast literature on Yoga. Yoga as a lifestyle.
UNIT 2: Patanjalis Ashtanga Yoga. Ethical basis of Yoga. Different traditions and schools of Yoga.
Yogic concepts of pancha kosha, prana vayu, tattva, triguna, tridosha, klesha and antaraya.
Application of Yoga in various human activities like therapeutics, physical culture, education and
sports.
UNIT 3: Introduction to and scientific perspective of important Yogic techniques like asana,
pranayama, kriya, mudra, bandha, jathis and surya namaskar.
UNIT 4: Spanda-nishpanda concept of relaxation in Yoga. Dharana-dhyana (concentration and
meditation) in the yogic context. A scientific perspective of these techniques.
UNIT 5: Similarities and dissimilarities between Yogic practices and physical exercises. Asanas vs.
muscular exercises. Pranayama vs. deep breathing exercises. Role of various yogic techniques in
purification and fortification of the body-mind-spirit complex. Role of Yoga in management of
stress and maintenance of homeostasis.
2. FOUNDATIONS OF MODERN MEDICINE
UNIT 1: Human body as an integrated whole. Homeostasis and milieu interieur. Cells, tissues,
organs and systems of human body. Their mutually supportive and harmonious working
relationships in health and breakdown of these natural mechanisms in disease.
UNIT 2: Introduction to of anatomy and physiology of cardiovascular and respiratory systems.
Regulation of CVS, RS and body temperature. Bridging the autonomic and conscious activities
through Yoga and other mind-body therapies.
UNIT 3: Introduction to anatomy and physiology of musculo-skeletal and nervous systems.
Biomechanics of movement and important muscles used in Yoga practices. Introduction to the
functional areas of cerebral cortex. Neurophysiology of sleep-wakefulness and EEG. Limbic system,
pre-frontal lobe and physiology of emotions. Positive emotions.
UNIT 4: Introduction to anatomy and physiology of the endocrine, digestive and excretory systems.
Important aspects related to the shat kriyas (cleaning practices of Yoga).
UNIT 5: Homeostasis and stress: Psycho-neuro-endocrine and psycho- neuro-immune correlates.
Autonomic nervous system and its role in health and disease. Balancing the opposites (right and
left) energies through loma-viloma, ha-tha and surya-chandra. Balancing the right & left brain by
Yoga.
UNIT 6: Integrative physiology. Physiological responses to muscular exercise, gravity and
acceleration, high altitude hot and cold environment. Physiological effects of yogic practices.

CYTER- SYLLABUS FOR PGDYT Page 3

3. FOUNDATIONS OF YOGA CHIKITSA (APPLICATION OF YOGA AS A THERAPY)
UNIT 1: Yoga defined as samatvam (integration and harmony). Different aspects and meanings of
Yoga as related to health. Meaning of the term positive health. Yoga as a system that fosters
positive health. Cultivation of desirable psychological attitudes and reconditioning of the psycho-
physiological apparatus for positive health. Concepts of pancha-kosha and tri-sharira and their
special relationship to health and disease (adi-vyadhi). Yogic perspective of health and disease:
integration vs disintegration, sukha vs duhkha.
UNIT 2: Yoga as a therapy: its need and application in modern health care. Principles, mechanisms
and modalities of Yoga chikitsa. Vyuha model (heya-hetu,hana-upaya). Relationship of Yoga with
the AYUSH and CAM systems of medicine with emphasis on ayurveda, siddha and naturopathy. Yoga
chikitsa vs yogopathy: tracing the root cause of disease and applying the remedy, rather than
symptomatic management.
UNIT 3: Yoga as the original body mind medicine and ideal lifestyle. Concepts of ahar, vihar, achar
and vichar. Yogic principles of diet in relation to the dosha and guna concepts. Role and
importance attached to the mind in Yoga. Importance of right attitude (pratipaksha bhavanam) in
tackling common conflicts and frustrations. Role of yama-niyama (restraints and regulations) and
correct psychological attitudes (maitri-karuna et al) for psycho-somatic health.
UNIT 4: Importance of various techniques of hatha and jnana Yoga in the promotion of physical
health, mental clarity and emotional wellbeing. Role of mantra, japa, bhajan, chanting, yantra
and yatra in healing. Importance of faith and prayer in healing. Karma and its role in health and
disease. Role of music (nada yoga) and other alternative therapies.
UNIT 5: Research as the central feeder aspect of modern, evidence- based Yoga therapy. Modern
research findings and their applications in Yoga therapy. Need for modern methods of research in
understanding and evaluation of Yogic phenomena.
PRACTICUM
UNIT 1: Jathis and vyayama, surya namaskar, talasana, trikonasana, ardha kati chakrasana, ardha
utkat and utkatasana, sukhasana, vajrasana, padmasana, baddhakonasana, vakrasana, ardha
matsyendrasana, paschimottanasana.
UNIT 2: Shavasana, navasana, uttanpadasana, pavanmuktasana, sarvangasana, halasana,
matsyasana, shalabhasana, bhujangasana, dhanurasana, makarasana.
UNIT 3: Kriyas and Mudras: Jala neti, vamana dhauti, brahma mudra. Moola, uddiyana and
jalandhara bandha. Sethu, kaya and marmanasthanam kriyas.
UNIT 4: Vyagraha, vibhaga pranayama, pranava pranayama, nadishuddhi, surya and chandra nadi
and bhedana, ujjai and bhramari pranayama.
UNIT 5: Submission of 10 lesson plans as per assignments by each student that will consist of
lessons on one mudra, one bandha, two kriyas, four asanas and two pranayamas. Each student to
conduct 10 Yoga sessions in the classroom environment on the basis of their Lesson Plans.
CYTER- SYLLABUS FOR PGDYT Page 4

SEMESTER II

1. APPLICATION OF YOGA IN DIFFERENT FIELDS OF HUMAN ENDEAVOR
UNIT 1: Spiritual Yoga (adhyatmayoga) and applied Yoga (loukika Yoga). Scope and limitations
of applied Yoga. Introduction to the application of Yoga in different fields of human activity.
Empowering the individual through Yoga.
UNIT 2: Role of Yoga in enhancing quality of life of senior citizens and in the management of
various degenerative aspects of aging. Yoga for people with special needs, especially in children
with mental and physical disabilities.
UNIT 3: Yoga in rehabilitation. Role of Yoga in various addictions and in tackling social problems
(interpersonal and intrapersonal). Psycho-physiological improvements through Yoga in sporting
activities, both recreational and professional. Yoga sport competitions: benefits and drawbacks.
UNIT 4: Role of Yoga in enhancing productivity in the corporate sector. Stresses and strains of
executive jobs and their Yogic remedy. Yoga for self development, self motivation, to reduce
monotony and stress and enhance capacity of the individual as well as the corporate.
UNIT 5: Personality development through Yoga and its role in enhancing personal efficiency.
Managing the hectic lifestyle of medical and paramedical professionals. Regaining the art of
medicine, a healthy interpersonal doctor-patient relationship through Yoga. Code of conduct for
Yoga therapists.

2. ROLE OF YOGA IN CARDIOVASCULAR, RESPIRATORY, MUSCULOSKELETAL AND
DIGESTIVE DISORDERS
UNIT 1: Cardiovascular disorders: hypertension, atherosclerosis, CAD, stroke, heart failure,
arrhythmias. Yoga in a cardiac rehabilitation programme.
UNIT 2: Respiratory disorders: chronic obstructive airway diseases with emphasis on bronchial
asthma and bronchitis. Hathenas and shat kriyas in the managements of breathing disorders.
UNIT 3: Musculoskeletal conditions: lumbago, cervical spondylitis, arthritis, repetitive strain
injuries.
UNIT 4: Digestive disorders: peptic ulcer, IBS, liver disease, chronic constipation, hemorrhoids.
UNIT 5: Role of Yoga in management of cancer: adjunct and palliative role of Yoga. Pain and
fatigue relief. Improvement in QoL. Dealing with end life crisis. Care of the caregiver.

3. YOGA AS A THERAPY FOR NEUROLOGICAL, ENDOCRINE, METABOLIC,
PSYCHIATRIC AND OTHER DISORDERS

UNIT 1: Neurological: central, autonomic and peripheral neuropathies, Parkinsons disease,
dementia. Management of chronic pain.
UNIT 2: Endocrine: growth disorders, thyroid, reproductive disorders
CYTER- SYLLABUS FOR PGDYT Page 5

UNIT 3: Metabolic: obesity, diabetes mellitus, and metabolic syndrome
UNIT 4: Health issues in women and children, menarche, antenatal and postnatal care, menopause.
UNIT 5: Psychiatric disorders: BPAD, anxiety, depression. immune disorders.

PRACTICUM
UNIT 1: Ushtrasana, balasana, maha mudra 1&2, gomukhasana, mandukasana,
pashchimottanasana, purvottanasana. Trataka, kapalabhati, agnisara, nauli, viparitakarani,
ashwini mudra. Sitkari, sheetali, savitri and bhastrika pranayama.
UNIT 2 : Yoga schedules for musculoskeletal and digestive disorders.
UNIT 3 : Yoga schedules for cardiovascular and respiratory disorders.
UNIT 4: Yoga schedules for neurological, endocrine, metabolic, and other disorders.
UNIT 5: Submission of 10 complete Yoga therapy patient records of 5 different conditions. Hands
on evaluation in the class room of simulated mock Yoga therapy situations.

CYTER- SYLLABUS FOR PGDYT Page 6

8. SCHEME OF EXAMINATION: Both semesters will have 3 theory papers and 1 practicum.

Theory papers: Duration: 2 1/2 hours Max marks 80
Structured essay (8 x 10) = 80 marks
Internal assessment = 20 marks
Total = 100 marks
Practicum:
4 practicums based on unit 1-4 = 80 marks
Lesson plan based on unit 5 = 20 marks
Micro teaching/therapy session = 20 marks
Viva & evaluation of project work = 40 marks
Total = 160 marks
Internal assessment = 40 marks
Grand Total = 200 marks
SEMESTER I
Max marks
Paper 1: Foundations of yoga 80
Paper 2: Foundations of modern medicine 80
Paper 3: Foundations of yoga chikitsa (application of yoga as a therapy) 80
Practicum 160

SEMESTER II
Max marks
Paper 1: Application of yoga in different fields of human endeavor 80
Paper 2: Yoga as a therapy for cardio-vascular, respiratory, musculo-skeletal and
digestive disorders
80
Paper 3: Yoga as a therapy for neurological, endocrine, metabolic and psychiatric
and others Disorders
80
Practicum 160

Eligibility for appearing for the examination: Attendance : 80 %; internal assessment: 50%.
Project to be submitted 2 months before the 2
nd
semester examination.
Passing minimum: 50% of internal assessment + marks obtained (theory and practicum).

CYTER- SYLLABUS FOR PGDYT Page 7

Reference books and websites:
1. Understanding Medical Physiology. Bijlani RL & Manjunatha S. Jaypee Brothers. 2011
2. A Primer of Yoga Theory. Ananda Balayogi Bhavanani. Dhivyananda Creations, Pondicherry.
3. A Yogic Approach to Stress. Ananda Balayogi Bhavanani. Dhivyananda Creations,
Pondicherry.
4. Anatomy and Physiology of Yogic Practices. MM Gore, Lonavla
5. Applied Yoga. Meena Ramanathan. Arogya Yogalayam, Pondicherry.
6. Asana, Pranayama, Mudra and Bandha. Swami Satyananda, Bihar School of Yoga, Munger,
Bihar.
7. Asanas. Swami Kuvalayananda. Kaivalyadhama, Lonavla.
8. Asanas : Why? and How? O.P. Tiwari, Kaivalyadhama, Lonavla
9. Ashtanga Yoga of Patanjali . Swami Gitananda. Ananda Ashram, Pondicherry
10. Frankly Speaking. Swami Gitananda. Ananda Ashram, Pondicherry
11. Glimpses of The Human Body. Shirley Telles. VK Yogas, Bangalore
12. Hatha Yoga Practices of Gitananda Yoga. Ananda Balayogi Bhavanani. ICYER, Pondicherry.
13. History of Yoga from Ancient to Modern Times. Meenakshi Devi Bhavanani. ICYER at
Ananda Ashram, Pondicherry.
14. Notes for Yoga Practicals I & II. Ananda Balayogi Bhavanani. Dhivyananda Creations,
Pondicherry.
15. Principles and Methods of Yoga Practices. Ananda Balayogi Bhavanani. Dhivyananda
Creations, Pondicherry.
16. Scientific Basis of Yoga Education. Ananda Balayogi Bhavanani. Dhivyananda Creations,
Pondicherry.
17. Scientific Survey of Yoga Poses. Swami Kuvalayananda. Lonavla
18. The Yoga Tradition. George Feuerstein. Shambala Pub, USA
19. www.iayt.org
20. www.icyer.com
21. www.svyasa.org
22. www.kdham.org
23. Yoga and Sports. Swami Gitananda & Meenakshi Devi. Ananda Ashram, Pondicherry
24. Yoga: Asana, Pranayama, Mudra, Kriya. Vivekananda Kendra Prakashan, Chennai.
25. Yoga and Wellness. Ananda Balayogi Bhavanani. MDNIY, New Delhi.
26. Yoga Chikitsa: Application of Yoga as a Therapy. Ananda Balayogi Bhavanani. Dhivyananda
Creations, Pondicherry.
27. Yoga for a Wholistic Personality. Ananda Balayogi Bhavanani. MDNIY, New Delhi.
28. Yoga for Breathing Disorders. Swami Gitananda Giri and Ananda Balayogi Bhavanani.
Dhivyananda creations, Pondicherry.
CYTER- SYLLABUS FOR PGDYT Page 8

29. Yoga for Health and Healing. Ananda Balayogi Bhavanani. Dhivyananda creations,
Pondicherry.
30. Yoga for Weight Loss. Ananda Balayogi Bhavanani. Dhivyananda Creations, Pondicherry.
31. Yoga Life. Monthly Journal of Ananda Ashram, Pondicherry (Back issues)
32. Yoga Mimamsa. Quarterly Journal of Kaivalyadhama, Lonavla (Back issues)
33. Yoga: by Vivekananda Kendra Prakashan, Chennai.
34. Yogic Therapy. Swami Kuvalayananda and Dr. S.L. Vinekar. Kaivalyadhama, Lonavla.











PAPER PUBLICATIONS


PUBLICATIONS BY CYTER STAFF

A. Published papers (28) :
1. Bhavanani AB. Yoga in health care. Annals of SBV 2012; 1 (2): 15-24.
2. Bhavanani AB, Ramanathan M, Balaji R and Pushpa D. Immediate effect of
suryanamaskar on reaction time and heart rate in female volunteers. Indian J Physiol
Pharmacol 2013; 57 (2): 199204.
3. Bhavanani AB. Modern Medicine, Meet Yoga. Integral Yoga Magazine USA. Fall 2013.
pg 21-23.
4. Dinesh T, Sharma V K, Raja J eyakumar M, Syam Sunder A, Gopinath M, Bhavanani
AB. Effect of 8 weeks of pranav pranayama training on pulmonary function test
parameters in young healthy, volunteers of J IPMER population. Int Res J Pharm App Sci
2013; 3 (4):116-18.
5. Dinesh T, Gaur G S, Sharma V K, Velkumary S, Bhavanani AB. Effect of 12 weeks of
kapalabhati pranayama training on cardio-respiratory parameters in young, healthy
volunteers of J IPMER population. International J ournal of Medical & Pharmaceutical
Sciences Research and Review 2013; 1 (4): 53-61.
6. Bhavanani AB, Ramanathan M, Madanmohan. Immediate cardiovascular effects of a
single yoga session in different conditions. Altern Integ Med 2013; 2: 144.
7. Bhavanani AB, Ramanathan M, Madanmohan, Srinivasan AR. Hematological,
biochemical and psychological effects of a yoga training programme in nursing students.
Int Res J Pharm App Sci 2013; 3(6):17-23
8. Madanmohan. Integrating yoga and modern medicine. Annals of SBV 2013; 2 (2): 7.
9. Madanmohan. Yog for healthy lifestyle. Annals of SBV 2013; 2 (2): 20-23.
10. Bhavanani AB. Psychosomatic mechanisms of yoga. Annals of SBV 2013; 2 (2): 27-31.
11. Bhavanani AB. Yoga practices for prevention and management of lifestyle disorders.
Annals of SBV 2013; 2 (2): 32-40.
12. Bhavanani AB, Ramanathan M, Balaji R, Pushpa D. Differential effects of uninostril and
alternate nostril pranayamas on cardiovascular parameters and reaction time. Int J Yoga
2014; 7: 60-65.
13. Sharma VK, Raja J eyakumar M, Velkumary S, Subramanian SK, Bhavanani AB,
Madanmohan, Sahai A, Dinesh T. Effect of Fast and Slow Pranayama Practice on
Cognitive Functions in Healthy Volunteers. J ournal of Clinical and Diagnostic Research
2014; 8 (1) : 10-13.
14. Bhavanani AB, Ramanathan M, Madanmohan. Immediate effect of alternate nostril
breathing on cardiovascular parameters and reaction time. Online International
Interdisciplinary Research J ournal 2014; 4; (Special Issue): 297-302.
15. Bhavanani AB. Yogic perspectives on mental health. International Light 2014. J an-
March: 14-17.
16. Bhavanani AB. Yoga. Clinical Roundup: Selected Treatment Options for Depression.
Alternative and Complementary Therapies 2014; 20: 54-55.
17. Madanmohan. Yoga for youth. Souvenir of the National Yoga Week 2014. MDNIY,
New Delhi, Feb 2014. Pg 52.
18. Bhavanani AB, Madanmohan, Meena Ramanathan, Srinivasan AR. Yoga improves
psychophysical health of nursing students. Souvenir of the National Yoga Week 2014.
MDNIY, New Delhi, Feb 2014. Pg 65-70.
19. Bhavanani AB. Introducing integral yoga education for the youth. Souvenir of the
National Yoga Week 2014. MDNIY, New Delhi, Feb 2014. Pg 84.
20. Meena Ramanathan, Bhavanani AB. Immediate effect of chandra and suryanadi
pranayamas on cardiovascular parameters and reaction time in a geriatric population.
International J ournal of Physiology 2014; 2 (1): 59-63.
21. Rajajeyakumar M, Amudharaj D, Bandi harikrishna, Madanmohan T, J eyasettiseloune,
Bhavanani AB. Immediate effect of different pranayam on short term heart rate
variability in health care students. A preliminary study. International J ournal of
Physiology 2014; 2 (1): 39-43.
22. Bhavanani AB. Yoga: A novel integrative therapy. Nisargopachar Varta 2014; 6 (5): 13-
15.
23. Bhavanani AB, J ayasettiaseelon E, Sanjay Z, Madanmohan. Immediate effect of
chandranadi pranayam on heart rate variability and cardiovascular parameters in patients
of diabetes mellitus and hypertension. Yoga Mimamsa 2013; 45 (1&2): 1-13.
24. Dinesh T, Gaur GS, Sharma VK, Bhavanani AB, Rajajeyakumar M, Sunder AS. Effect
of slow and fast pranayama training on handgrip strength and endurance in healthy
volunteers. J ournal of Clinical and Diagnostic Research 2014; 8 (5): BC01-03.
25. Bhavanani AB, Meena Ramanathan, Madanmohan. Yoga and mind body therapies in
health and disease: a brief review. Annals of SBV 2014; 3 (1): 29-41.
26. Bhavanani AB. Yogic perspectives on mental health. Annals of SBV 2014; 3 (1): 47-52.
27. Bhavanani AB. The yoga of interpersonal relationships. Annals of SBV 2014; 3 (1): 53-
60.
28. Bhavanani AB, Ramanathan M, Balaji R, Pushpa D. Comparative immediate effect of
different yoga asanas on heart rate and blood pressure in healthy young volunteers.
International J ournal of Yoga 2014; 7: 89-95.

In press:
1. Lee Majewski, Ananda Balayogi Bhavanani . A novel rejuvenation program for cancer
patients at Kaivalyadhama, India. Yoga Mimamsa (Ahead of print).
2. Ananda Balayogi Bhavanani. Diverse dimensions of Yoga. Yoga Mimamsa (Ahead of
print).
3. Ananda Balayogi Bhavanani. Role of yoga in health and disease. J ournal of Symptoms
and Signs.

B. Published abstracts (9):
1. Health, rejuvenation and longevity: an ayurvedic perspective. Madanmohan, Bhavanani
AB. Abstracts of Sanjeevita 2013, the First Annual Summit on Current Concepts in
Integrative Medicine organized by the Central Inter-Disciplinary Research Facility
(CIDRF) in collaboration with Sri Balaji Vidyapeeth, Puducherry. September 6th 2013,
MGMC&RI, Pondicherry. Pg. 48.
2. Yoga and modern medicine: need for integration. Madanmohan, Bhavanani AB.
Abstracts of Sanjeevita 2013, the First Annual Summit on Current Concepts in
Integrative Medicine organized by the Central Inter-Disciplinary Research Facility
(CIDRF) in collaboration with Sri Balaji Vidyapeeth, Puducherry. September 6th 2013,
MGMC&RI, Pondicherry. Pg. 48-49.
3. Effect of yoga training on cardiorespiratory health in obese subjects. Madanmohan,
Bhavanani AB, AR Srinivasan, S Balanehru. Abstracts of Sanjeevita 2013, the First
Annual Summit on Current Concepts in Integrative Medicine organized by the Central
Inter-Disciplinary Research Facility (CIDRF) in collaboration with Sri Balaji
Vidyapeeth, Puducherry. September 6th 2013, MGMC&RI, Pondicherry. Pg. 49.
4. Yoga works, but how? Bhavanani AB, Meena Ramanathan, Madanmohan. Abstracts of
Sanjeevita 2013, the First Annual Summit on Current Concepts in Integrative
Medicine organized by the Central Inter-Disciplinary Research Facility (CIDRF) in
collaboration with Sri Balaji Vidyapeeth, Puducherry. September 6th 2013, MGMC&RI,
Pondicherry. Pg. 49-50.
5. Immediate cardiovascular effects of pranayamas in patients of hypertension. Bhavanani
AB, Madanmohan. Abstracts of Sanjeevita 2013, the First Annual Summit on Current
Concepts in Integrative Medicine organized by the Central Inter-Disciplinary Research
Facility (CIDRF) in collaboration with Sri Balaji Vidyapeeth, Puducherry. September
6th 2013, MGMC&RI, Pondicherry. Pg. 50.
6. Effect of 12 weeks of pranayama training on basal physiological parameters in young,
healthy volunteers. Dinesh T, Gaur G S, Sharma V K, Bhavanani AB, Harichandra
Kumar KT. Poster No. A74. APPICON 2013.
7. Yoga for youth. Madanmohan. Abstracts of the National Yoga Week 2014. MDNIY,
New Delhi, Feb 2014. Pg 6.
8. Yoga improves psychophysical health of nursing students. Bhavanani AB, Madanmohan,
Meena Ramanathan, Srinivasan AR. Abstracts of the National Yoga Week 2014.
MDNIY, New Delhi, Feb 2014. Pg 21.
9. Introducing integral yoga education for the youth. Bhavanani AB. Abstracts of the
National Yoga Week 2014. MDNIY, New Delhi, Feb 2014. Pg 22.


Page 15
Ann. SBV, July - Dec, 2012 1(2)
Annals of SBV
ABSTRACT: We are today faced with numerous debilitating chronic illnesses related to aging, environment, and
hedonistic lifestyle, such as cancer, diabetes, osteoporosis, and cardiovascular diseases as well as many incurable diseases
such as AIDS. Modern medical advancements provide the rationale for the integration of various traditional healing
techniques including Yoga to promote healing, health, and longevity. It is imperative that advances in medicine include
the wholistic approach of Yoga to face the current challenges in health care. Te antiquity of Yoga must be united with
the innovations of modern medicine to improve quality of life throughout the world. While modern medicine has a lot
to ofer humankind in its treatment and management of acute illness, accidents and communicable diseases, Yoga has a
lot to ofer in terms of preventive, promotive and rehabilitative methods in addition to many management methods to
tackle modern illnesses. While modern science looks outward for the cause of all ills, the Yogi searches the depth of his
own self. Tis two way search can lead us to many answers for the troubles that plague modern man. It is suggested that
a two way integration of the experimentally tempered modern science with the experientially modelled science of Yoga
can lead us to many answers for challenges plaguing modern humankind such as debilitating chronic illnesses related
to aging, environment, and hedonistic lifestyle. Modern medical advancements provide the rationale for the integration
of various traditional healing techniques including Yoga to promote healing, health, and longevity. It is imperative that
advances in medicine include the wholistic approach of Yoga to face the current challenges in health care. Te antiquity
of Yoga must be united with the innovations of modern medicine to improve quality of life throughout the world.
INTRODUCTION:
Yoga is the original mind-body medicine that has enabled individuals to attain and maintain sukha sthanam, a
dynamic sense of physical, mental and spiritual well being. Bhagavad-Gita defnes Yoga as samatvam meaning thereby
that Yoga is equanimity at all levels, a state wherein physical homeostasis and mental equanimity occur in a balanced
and healthy harmony. Yogamaharishi Dr Swami Gitananda Giri Guru Maharaj, the visionary founder of Ananda
Ashram at the International Centre for Yoga Education and Research (ICYER) in Pondicherry and one of the foremost
authorities on Yoga in the past century, has explained the concept of Yoga Chikitsa (Yoga as a therapy) in the following
lucid manner. Yoga Chikitsa is virtually as old as Yoga itself, indeed, the return of mind that feels separated from the
Universe in which it exists represents the frst Yoga therapy. Yoga Chikitsa could be termed as mans frst attempt at
unitive understanding of mind-emotions-physical distress and is the oldest wholistic concept and therapy in the world.
To achieve this Yogic integration at all levels of our being, it is essential that we take into consideration the all
encompassing multi dimensional aspects of Yoga that include the following: a healthy life nourishing diet, a healthy and
natural environment, a wholistic lifestyle, adequate bodywork through Asanas, Mudras and Kriyas, invigorating breath
work through the use of Pranayama and the production of a healthy thought process through the higher practices of
Jnana Yoga and Raja Yoga.
PSYCHOSOMATIC DISORDERS:
From the Yogic viewpoint of disease it can be seen that psychosomatic, stress related disorders appear to progress
through four distinct phases. Tese can be understood as follows:
1. Psychic Phase: Tis phase is marked by mild but persistent psychological and behavioural symptoms of stress like
irritability, disturbed sleep and other minor symptoms. Tis phase can be correlated with vijnanamaya and manomaya
koshas. Yoga as a mind body therapy is very efective in this phase.
2. Psychosomatic Phase: If the stress continues there is an increase in symptoms, along with the appearance of
generalized physiological symptoms such as occasional hypertension and tremors. Tis phase can be correlated with
manomaya and pranamaya koshas. Yoga as a mind body therapy is very efective in this phase.
3. Somatic Phase: Tis phase is marked by disturbed function of organs, particularly the target, or involved organ.
YOGA IN HEALTH CARE
Ananda Balayogi Bhavanani *
*
* Yogacharya Dr.Ananda Balayogi Bhavanani ,
Hon Advisor CYTER, MGMCRI
Ann. SBV, July - Dec, 2012 1(2)
Page 16 Annals of SBV
At this stage one begins to identify the diseased state. Tis phase can be correlated with pranamaya and annamaya
koshas. Yoga as a therapy is less efective in this phase and may need to be used in conjunction with other methods of
treatment.
4. Organic Phase: Tis phase is marked by full manifestation of the diseased state, with pathological changes such
as an ulcerated stomach or chronic hypertension, becoming manifest in their totality with their resultant complications.
Tis phase can be correlated with the annamaya kosha as the disease has become fxed in the physical body. Yoga as a
therapy has a palliative and quality of life improving efect in this phase. It also has positive emotional and psychological
efects even in terminal and end of life situations.
POTENTIALITIES OF YOGA:
Extensive research on Yoga being done all over the world has shown promise with regard to various disorders
and diseases that seem to be amiable to Yoga therapy (www.iayt.org, www.icyer.com, www.svyasa.org ). Tese include
psychosomatic, stress disorders such as bronchial asthma, diabetes mellitus, hypertension, irritable bowel syndrome,
gastro intestinal ulcer diseases, atherosclerosis, seizure disorder and headache. It also includes physical disorders such as
heart disease, lung disease, and mental retardation. Psychiatric disorders such as anxiety disorders, obsessive-compulsive
disorder, depression and substance abuse can also be managed along with other therapies. Musculoskeletal disorders
such as lumbago, spondylosis, sciatica and carpel tunnel syndrome can be tackled efectively with Yoga practices that
ofer a lot of hope in metabolic disorders such as thyroid and other endocrine disorders, immune disorders, obesity and
the modern metabolic syndrome.
According to Dr B Ramamurthy, eminent neurosurgeon, Yoga practice re-orients the functional hierarchy of the
entire nervous system. He has noted that Yoga not only benefts the nervous system but also the cardiovascular, respiratory,
digestive, endocrine systems in addition to bringing about general biochemistry changes in the yoga practitioners. Dr.
Dean Ornish, the eminent American doctor who has shown that Yogic lifestyle can reverse heart isease says, Yoga
is a system of perfect tools for achieving union as well as healing. Dr Swami Gitananda Giri says, Yoga is scientifc
and many of it practices can be measured by existing scientifc methods. As a science of mind it ofers a safe method
of concentration and meditation educing a practical application of the power of the human mind. Its entire process is
centered in awareness that is why I call it the science of awareness.
It is well established that stress weakens our immune system. Scientifc research in recent times has showed that
the physiological, psychological and biochemical efects of Yoga are of an anti-stress nature. Mechanisms postulated
included the restoration of autonomic balance as well as an improvement in restorative, regenerative and rehabilitative
capacities of the individual. A healthy inner sense of wellbeing produced by a life of Yoga percolates down through the
diferent levels of our existence from the higher to the lower producing health and wellbeing of a holistic nature. Streeter
Page 17
Ann. SBV, July - Dec, 2012 1(2)
Annals of SBV
et al (Med Hypotheses 2012;78: 571-9) recently proposed a theory to explain the benefts of Yoga practices in diverse,
frequently comorbid medical conditions based on the concept that Yoga practices reduce allostatic load in stress response
systems such that optimal homeostasis is restored. According to the theory proposed by Streeter and colleagues, the de-
creased parasympathetic nervous system and GABAergic activity that underlies stress-related disorders can be corrected
by Yoga practices resulting in amelioration of disease symptoms. HRV testing has a great role to play in our understand-
ing intrinsic mechanisms behind such potential efects of Yoga.
Innes et al had earlier (J Am Board Fam Pract 2005; 18: 491-519) also postulated two interconnected pathways
(given below) by which Yoga reduces the risk of cardiovascular diseases through parasympathetic (vagal) activation
coupled with reductions in per4ceived stress and decreased reactivity of sympathoadrenal system and HPA axis. Innes
and Vincent (eCAM 2007; 4: 469-86) also postulated similar mechanisms to be operating in reducing risk for Type 2
Diabetes mellitus (DM 2) and for complications related to DM 2.

PSYCHOSOMATIC MECHANISMS OF YOGA:
Yoga understands the infuence of the mind on the body as well as that of the body on the mind. Tis is the principle
of adhi-vyadhi elucidated in the Yoga Vasishta more than 5000 years ago! It is interesting that modern medicine has only
realised this connection in the last hundred years whereas Yogic of India were teaching and practising it for thousands
of years. No wonder Yoga may be considered as the original mind-body medicine.
We are what we think, yet we also start to think that which we do. Yogic concepts and techniques enable the
development of right attitudes towards life and enable us to correct the numerous internal and external imbalances
we sufer due to our wrong lifestyle/ genetic potential. Yoga enables us to take responsibility for our own health and
happiness and as Swami Gitananda Giri would say, If you want to be healthy do healthy things, if you want to be happy
do happy things.
Te following are just a few of the mechanisms through which Yoga can be said to work as an integrated mind-body
medicine:
1. Cleanses the accumulated toxins through various shuddi kriyas and generates a sense of relaxed lightness through
jathis and vyayama type activities. Free fow in all bodily passages prevents the many infections that may occur when
pathogens stagnate therein.
2. Adoption of a Yogic lifestyle with proper nourishing diet, creates positive antioxidant enhancement thus
neutralizing free radicals while enabling a rejuvenative storehouse of nutrients packed with life energy to work on
anabolic, reparative and healing processes .
3. Steadies the entire body through diferent physical postures held in a steady and comfortable manner without
strain. Physical balance and a sense of ease with oneself enhance mental / emotional balance and enable all physiological
processes to occur in a healthy manner.
4. Improves control over autonomic respiratory mechanisms though breathing patterns that generate energy and
enhance emotional stability. Te mind and emotions are related to our breathing pattern and rate and hence the slowing
down of the breathing process infuences autonomic functioning, metabolic processes as well as emotional responses.
5. Integrates body movements with the breath thus creating psychosomatic harmony. In Yoga the physical body is
related to annamaya kosha (our anatomical existence) and the mind to manomaya kosha (our psychological existence).
As the pranayama kosha (our physiological existence sustained by the energy of the breath) lies in between them, the
breath is the key to psychosomatic harmony.
6. Focuses the mind positively on activities being done, thus enhancing energy fow and resultant healthy circulation
to the diferent body parts and internal organs. Where the mind goes, there the prana fows!
7. Creates a calm internal environment through contemplative practices that in turn enable normalization of
homeostatic mechanisms. Yoga is all about balance or samatvam at all levels of being. Mental balance produces physical
balance and vice versa too.
8. Relaxes the body-emotion-mind complex through physical and mental techniques that enhance our pain
threshold and coping ability in responding to external and internal stressors. Tis enhances the quality of life as seen in
so many terminal cases where other therapies are not able to ofer any solace.
9. Enhances self confdence and internal healing capacities through the cultivation of right attitudes towards life
and moral-ethical living through yama-niyama and various Yogic psychological principles. Faith, self confdence and
Ann. SBV, July - Dec, 2012 1(2)
Page 18 Annals of SBV
inner strength are most essential if at all we wish for healing, repair, rejuvenation and re-invigoration.
10. Yoga works towards restoration of normalcy in all systems of the human body with special emphasis on the
psycho-neuro-immuno-endocrine axis. In addition to its preventive and restorative capabilities, Yoga also aims at
promoting positive health that will help us to tide over health challenges that occur during our lifetime. Tis concept
of positive health is one of Yogas unique contributions to modern healthcare as Yoga has both a preventive as well as
promotive role in the healthcare of our masses. It is also inexpensive and can be used in tandem with other systems of
medicine in an integrated manner to beneft patients.
INTEGRATING YOGA AND MODERN MEDICINE:
At frst glance, allopathic medicine and Yoga may seem to be totally incompatible and in some ways even antagonistic
to each other. Practitioners of either system are often found at loggerheads with one another in typical modern one-
upmanship. However it is my humble endeavor as a student of both these life giving, life changing and life saving
sciences, to fnd the similarities that exist between them and build a bridge between these two great sciences of todays
world. It would of course be much easier to build a bridge between Yoga and Ayurveda as both share many similarities
of concepts such as the Trigunas, Tridoshas, Chakras and Nadis. Tey also understand that a healthy balance between
body, mind and soul leads to total health. Diet and behavior are given importance in both systems and the ultimate goal
of both is the attainment of Moksha. Tough modern medicine may not share all of these concepts with Yoga, it is to be
seen that there are a great many meeting points for the construction of a healthy bridge between them. Both modern
medicine and Yoga understand the need for total health and even the Word Health Organization has recently added
a new dimension to the modern understanding of health by including spiritual health in its defnition of the state of
health. Spiritual health is an important element of Yoga and now that even the WHO has come around to understanding
this point of view, there is hope for a true unifcation of these two systems. Modern medicine has the ultimate aim and
goal of producing a state of optimum physical and mental health thus ultimately leadings to the optimum well being of
the individual. Yoga also aims at the attainment of mental and physical well being though the methodology does difer.
While modern medicine has a lot to ofer humankind in its treatment and management of acute illness, accidents and
communicable diseases, Yoga has a lot to ofer in terms of preventive, promotive and rehabilitative methods in addition
to many management methods to tackle modern illnesses. While modern science looks outward for the cause of all ills,
the Yogi searches the depth of his own self. Tis two way search can lead us to many answers for the troubles that plague
modern man.
Te potential and manifest integration of Yoga and modern medical science can be discussed under diferent sub
headings as follows:
PROMOTION OF POSITIVE HEALTH:
Yoga is an excellent tool of promotive health that can enrich modern medicine. Te practice of Yoga leads to the efcient
functioning of the body with homeostasis through improved functioning of the psycho-immuno-neuro-endocrine
system. A balanced equilibrium between the sympathetic and parasympathetic wings of the autonomic nervous system
leads to a dynamic state of health. Yogi Swatmarama in the Hathayoga Pradipika, one of the classical Yoga texts gives
us the assurance, One who tirelessly practises Yoga attains success irrespective of whether they are young, old decrepit,
diseased or weak. He gives us the guarantee that Yoga improves health of all alike and wards of disease, provided we
properly abide by the proper rules and regulations (yuvaa vrddho ativriddho vaa vyaadhito durbalo pi vaa abhyaasaat
siddhimaapnoti sarvayogeshvatandritah-Hathayoga Pradipika I:64). Te World Health Organization (WHO) defnes
health as a state of complete physical, mental, and social well being and not merely absence of disease or infrmity.
WHO has also in recent times suggested a fourth dimension of spiritual health but has fallen short of defning it without
confusing it with religion. From a Yogic perspective it is heartening that the WHO defnition gives importance to well
being that is a vital aspect of being healthy as well as feeling healthy. Tere is no use in a doctor telling patients that
all their investigations are normal when the patients themselves are not feeling well. Tis qualitative aspect of health
is something that Yoga and Indian systems of medicine have considered important for thousands of years. Te defnition
of asana given in the Yoga Sutra as sthira sukham implies this state of steady well being at all levels of existence (sthira
sukham asanam- Yoga Darshan II:46). Patanjali also tells us that through the practice of asana we can attain a state that
is beyond dualities leading to a calm and serene state of well being (tato dvandva anabhighata- Yoga Darshan II: 48).
Yoga aims at enabling the individual to attain and maintain a dynamic sukha sthanam that may be defned as a dynamic
sense of physical, mental and spiritual well being. Te Bhagavad Gita defnes Yoga as samatvam meaning thereby
that Yoga is equanimity at all levels. (yogasthah kurukarmani sangam tyaktva dhananjaya siddiyasidhyoh samobutva
samatvam yoga uchyate Bhagavad Gita II: 48) Tis may be also understood as a perfect state of health wherein physical
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homeostasis and mental equanimity occur in a balanced and healthy harmony.
One of the main lacunae of the WHO defnition lies in the use of the term state that implies health is something
to be achieved once and for all with no need for care about it thereafter! It is defnitely not so. We need to keep working
on our health with great vigour and dynamic enthusiasm for the entire span of our life. If health is to be understood as
a state, then it must be understood as a dynamic state that varies from day-to-day and often from minute-to-minute! It
is often actually more challenging to maintain this dynamic state of health than to even attain it in the frst place. Ask
any World No.1 sports champion and they will testify to this inherent truth that applies to sports as well as to life itself.
MANAGEMENT OF DISEASES AND DISORDERS:
Yoga doesnt negate the use of drugs and other methods of modern medicine. Maharishi Patanjali in his Avatar as
Charaka didnt shy away from the need to use medicinal herbs as well as surgical methods when necessary for the beneft
of the patient. Te system of Ayurveda is more in tune with the Yogic views of healing in this regard but defnitely
the modern antibiotic treatment of infectious diseases as well as the emergency medical and trauma management
techniques of modern medicine must be understood to be life-savers in times of need. No Yoga therapist in his or
her right mind should try to treat an acute myocardial infarction or an unconscious accident victim by Yoga alone. A
symbiotic relationship between the techniques of modern medicine and Yoga can help the patient more than a dogmatic
refusal to see the other side. Yoga has a lot to ofer in terms of psychosomatic disorders and in stress related disorders
such as diabetes, asthma, irritable bowel syndrome, epilepsy, hypertension, back pain and other functional disorders.
Yoga can help reduce and in some cases eliminate drug dosage and dependence in patients sufering from diabetes
mellitus, hypertension, epilepsy, anxiety, bronchial asthma, constipation, dyspepsia, insomnia, arthritis, sinusitis and
dermatological disorders.
To quote Dr Steven F Brena, Yoga is probably the most efective way to deal with various psychosomatic disabilities
along the same, time-honored, lines of treatment that contemporary medicine has just rediscovered and tested. Asanas
are probably the best tool to disrupt any learned patterns of wrong muscular eforts. Pranayama and Pratyahara are
extremely efcient techniques to divert the individuals attention from the objects of the outer environment, to increase
every persons energy potentials and interiorize them, to achieve control of ones inner functioning. Moreover, in
restoring human unity, the Yoga discipline is always increasing awareness and understanding of ourselves, adjusting our
emotions, expanding our intellect, and enabling us not only to function better in any given situation, but to perform
as spiritual beings with universal values. Yoga therapists must work in tandem with medical doctors when they are
treating patients who have been on allopathic treatment. Tere are many instances where the patient stops medical
treatment thinking that it no more necessary as they have started Yoga. Tis leads to many catastrophes that could be
easily avoided by tandem consultations with a medical specialist. Similarly many modern doctors tend to tell the patient
to take up Yoga or relaxation and forget to mention to the therapist what they actually want the patients to do. Most
allopathic medications need to be tapered of in a progressive manner rather than being stopped suddenly. We often fnd
this mistake in regard to corticosteroids as well as cardiac medications where sudden stoppage can be harmful. We must
remember Platos words when he said, Te treatment of the part shouldnt be attempted without a treatment of the
entirety, meaning that the treatment of the body without treating the mind and soul would be a useless waste of time.
REHABILITATION:
Yoga as a physical therapy has a lot to ofer patients of physical and mental handicaps. Many of the practices of
physiotherapy and other physical therapies have a lot in common with Yoga practices. Mentally challenged individuals
can beneft by an improvement in their IQ as well as in learning to relate to themselves and others better. As their
physiological functions improve with Yoga, the combination of Yoga and physical therapies can beneft such patients
as well as those with learning disabilities. Musculoskeletal problems can be treated by the combination to improve
function as well as range of movement, strength and endurance abilities. Balance and dexterity can also be improved by
the combination therapy. Te use of Yoga can help those recovering from accidents and physical traumas to get back on
their feet faster and with better functional ability. An example of this was Dr Swami Gitananda Giri who managed to
get back on his feet and function normally after a debilitating stay in a full body cast for more than six months. Swamiji
used to say, Modern medicine kept me alive, but Yoga gave me back my life as otherwise I may have been a cripple for
life. Yoga also has a lot to ofer those sufering from drug and substance abuse in assisting them to get back to a normal
life. Yoga helps develop their self-control and will power and also gives them a new philosophy of living. Tis is vital as
otherwise they will lapse into their old negative habits.
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HEALTHY DIET:
Tis is a place that modern medicine and Yoga can help give a patient as well as normal person the proper wholistic
values of a proper diet. Modern research shows us the benefts of the break-down study of foods on the basis of their
physical and chemical properties. Tis is important for the person to know how much of each constituent of food is to
be taken in the proper quantity. Yoga can help a person to learn the right attitude towards food as well as understand
concepts based on the Trigunas and Tridoshas for better health. Yoga teaches us that the cause of most disease is
through under (Ajjeranatvam), over (Atijeeranatvam) or wrong (Kujeeranatvam) digestion. Yoga also teaches us about
the approach to food, the types of food as well as the importance of timings and moderation in diet. A combination of
the modern aspects of diet with a dose of Yogic thought can help us eat not only the right things but also in the right way
and at the right time thus ensuing our good health and longevity. Yoga emphasizes the importance of not only eating
the right type of food but also the right amount and with the right attitude. Importance of not eating alone, as well as
preparation and serving of food with love are brought out in the Yogic scheme of right living. Guna (inherent nature) of
food is taken into consideration to attain and maintain good health. Modern dietary science of diet can learn a lot from
this ancient concept of classifcation of food according to inherent nature as it is a totally neglected aspect of modern
diet. We are what we eat! Te great Tamil poet-saint Tiruvalluvar ofers sane advice on right eating when he says, He
who eats after the previous meal has been digested, needs not any medicine. (marunthuena vaendaavaam yaakkaikku
arundiyathu atrathu poatri unnin-Tirukkural 942). He also says that life in the body becomes a pleasure if we eat food
to digestive measure (attraal alavuarinthu unga aghduudambu pettraan nedithu uikkum aaruTirukkural 943). He also
invokes the Yogic concept of Mitahara by advising that eating medium quantity of agreeable foods produces health and
wellbeing (maarupaaduillaatha undi marutthuunnin oorupaadu illai uyirkku -Tirukkural 943).
PSYCHOSOMATIC RELAXATION:
Most medical doctors understand that it is important to relax in order to get better. Te problem is that, though
the doctor tells the patient to relax, they dont tell them how to do so and maybe in fact they dont know the answer
themselves in the frst place. Hatha Yoga and Jnana Yoga Relaxation practices help relax the body, emotions and mind.
Relaxation is a key element of any Yoga therapy regimen and must not be forgotten at any cost. Shavasana has been
reported to help a lot in hypertensive patients and practices such as Savitri Pranayama, Chandra Pranayama, Kaya Kriya,
Yoga Nidra, Anuloma Viloma Prakriyas and Marmanasthanam Kriya are also available to the person requiring this state
of complete relaxation. It is important to remember that relaxation on its own is less efective than relaxation that follows
active physical exertion.
COPING SKILLS:
Yoga has a lot to ofer those who unable to cope with death and dying as well as those sufering from incurable
diseases. Te Yoga philosophy of living sees death as an inevitable aspect of life that cannot be wished away. Swami
Gitananda Giri used to tell us that the whole of life is, but a preparation for the moment of death, so that we can leave
the body in the right way. Tose who are taking care of the dying as well as those taking care of patients of incurable
diseases and major disabilities are under an extreme amount of stress and Yoga practice as well as its philosophy helps
them gain the inner strength necessary to do their duty. Yoga can help break the vicious spiral of pain-drug dosage-pain
and by doing so help reduce the drug dosage in patients sufering chronic pain. It has been reported that Yoga helps
improve the quality of life in patients sufering from cancer and also helps them cope better with the efects of treatment.
It relaxes them and helps them sleep better. As someone rightly said, Yoga may not be able to always cure but it can
surely help us to endure.
REDUCING EXPENDITURE:
Modern medicine is often criticized for the cost involved in its methods of treatment. Yoga ofers an inexpensive
method of health that can be added to the medical armory when required. Yoga only requires the patients own efort
and really doesnt need any paraphernalia. Of course the modern Yoga industry would rather have us believe that we
need tons of Yoga equipment to start Yoga, but they are awfully of the mark in this case. Reduction in drug dosage and
avoidance of unnecessary surgeries in many cases can also help reduce the spiraling cost of Medicare.
HEALTHY AGING:
Aging is inevitable and Yoga can help us to age gracefully. Modern medicine tries to help retard aging and help
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people look better by costly surgical methods that are only an external covering over the underlying aging process.
Healthy diet, regular exercise, avoidance of negative habits and cultivation of the positive habits and a healthy lifestyle
can help us to age with dignity. Yoga can also help our silver citizens retain their mental ability and prevent degenerative
disorders such as Parkinsons disease, Alzheimers and various other dementias. Physical accidents such as falls can be
minimized and many an artifcial hip, knee or shoulder replacement surgery can be avoided. My own revered father-
Guru Swami Gitananda Giri, Yogashri T Krishnamacharya, Sri Kannaiah Yogi, Swami Suddananda Bharathi, Sri
Yogeshwarji, Sri Yogendraji, Sri pattabi Jois and Padma Bhushan BKS Iyengarji are but a few of the Yogis who have
shown us that its is possible to grow old without losing any of the physical or mental faculties of youth.
PSYCHOTHERAPY:
In the feld of psychotherapy and psychoanalysis we can fnd a lot of ancient Yogic concepts being reiterated time
and again. Many modern psychotherapeutic concepts such as identifcation, projection, and transference are similar to
concepts in Yoga psychology. Yoga psychology integrates diverse principles within a single body. CG Jung had a great
interest in Yoga and the eastern thought and said, Chakras represent a real efort to give a symbolic theory of the
psyche. His Centre of Personality concept based on dream analysis is very similar to the Yogic concept of a central
psychic or spiritual personality. He also correlated Chakras to the archetypes that abound in the collective unconscious.
Yoga helps the psychotherapist in training self awareness, and in the self regulation of body, diet, breath, emotions,
habit patterns, values, will unconscious pressures and drives. It also helps in relating to the archetypal processes and to
a transient being. It ofers an integrated method rather than one that is found in isolation in many diferent therapies.
Te theory of Kleshas is an excellent model for psychotherapy while emotional therapies of Yoga include Swadhyaya,
Pranayama, Pratyahara, Dharana, Dhyana and Bhajans. Development of proper psychological attitudes is inculcated via
the concepts of Vairagya, Chitta Prasadanam as well as Patanjalis advise on adopting the attitudes of Maitri, Karuna,
Mudita and Upekshanam towards the happy, the sufering, the good and the evil minded persons. Yoga also has a lot to
ofer in terms of spiritual therapies such as Swadhyaya, Satsangha, Bhajans and Yogic counseling. It is also interesting to
note that both Yoga and psychoanalysis share common ground in understanding that symptoms of the disease are often
willed by the patients. While all psycho analysists must undergo psychoanalysis themselves, it is taught in Yoga that
one must frst undergo a deep Sadhana, before attempting to guide others on the path. However while psychoanalysis
searches the unconscious, Yoga attempts to understand and explore the super conscious.
LIFESTYLE CHANGES:
Yoga helps patients take their health in their own hands. Tey learn to make an efort and change their life style for
the better so that their health can improve. Life style modifcation is the buzzword in modern medical circles and Yoga
can play a vital role in this regard. Yogic diet, Asanas, Pranayamas, Mudras, Kriyas and relaxation are an important
aspect of lifestyle modifcation. To live a healthy life it is important to do healthy things and follow a healthy lifestyle.
Te modern world is facing a pandemic of lifestyle disorders that require changes to be made consciously by individuals
themselves. Yoga places great importance on a proper and healthy lifestyle whose main components are Achar (healthy
activities on a regular basis), Vichar (right thoughts and attitude towards life), Ahar (healthy, nourishing diet) and Vihar
(proper recreational activities to relax body and mind)
WOMENS HEALTH:
Women are the chosen ones blessed with the responsibility of the future of our human race. Healthy mothers give
birth to healthy babies and a healthy start has a great future ahead. Yoga has a lot to contribute in combination with
modern medicine to the health status of womankind. Puberty and menopause become easier transitions with the help
of Yoga and many eminent Yoginis have said that they were not even aware of a single menopausal symptom as they
went through this difcult period in a womans life. Similarly our young girls can vouch for the fact that their pubertal
changes and menarche has been relatively smoother than their counterparts who dont practice Yoga. Te benefts of
Yoga in terms of family planning are also an important aspect that needs further study, as they can be an efective part of
the contraceptive armory. Te risk of side efects is negated and the entire control restored to the individuals themselves.
Te Oli Mudras as practiced in the Gitananda Yoga tradition have great potential in this regard and also the Swara Yoga
theories of conception have a lot of exciting possibilities. Once conception occurs, Yoga helps the young mother to be,
to prepare herself physically and mentally for the upcoming childbirth. Yoga helps open the joints of the pelvis and hip
as well as strengthen the abdominal muscles for childbirth. Later, simple Pranayamas and relaxation techniques help
the new mother relax and enjoy the new experience of her life. Post partum introduction of simple practices along with
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breathing, relaxation and a lot of crawling helps her come back to normal earlier and this can be used in all maternity
hospitals along with allopathic management. Yoga practices can also help reduce the drug dosage in medical problems
that often complicate a normal pregnancy such as diabetes, asthma and hypertension.
RESEARCH:
Te positive benefts of Yoga research are of vital signifcance and an understanding of how the various practices
work in diferent conditions and in normal situations are of great value for both the science of Yoga as well as for the world
of medicine. Yoga therapists can beneft a lot by a scientifc understanding of Yoga postures and other techniques. Tis
will bring about a rational approach to Yoga therapy rather than a haphazard application of individualistic knowledge.
Under the department of AYUSH, Morarji Desai National Institute of Yoga has created advanced centers for Yoga
in JIPMER, NIMHANS, AIIMS and DIPAS to promote all aspects of Yoga in these premier medical institutions
of India. Various private institutions are running in our country and doing their best to propagate Yoga-Vidya. Yoga
therapy is being used both in conjunction with modern medicine or alternative systems of medicine as well as on
its own in various centers. Various conditions such as diabetes, hypertension, arthritis, mental depression, bronchial
asthma etc have been found to be relieved by Yoga Terapy and centers such as ICYER at Ananda Ashram, sVYASA,
Kaivalyadhama, Te Yoga Institute and Krishnamacharya Yoga Mandiram are doing a great deal of work in this feld.
Tough there is a lot of research on Yoga being done by medical doctors these days but it is important to remember
Swami Gitananda Giris words when he said, We must research Yoga and not the lack of Yoga. Many studies are badly
constructed and manya-time we fnd that the Yoga practices performed by the patients have no real relation to Yoga at
all. Te higher aspects of Yoga are still not in the researchable realm of modern science.
NEED FOR COORDINATION:
Te need of the modern age is to have an integrated approach towards therapy and to utilize Yoga therapy in
coordination and collaboration with other systems of medicine such as Allopathy, Ayurveda, Siddha and Naturopathy.
Physiotherapy and Chiropractic practices may be used with the Yoga if needed. Advice on diet and lifestyle is very
important irrespective of the mode of therapy that is employed for a particular patient.
PRESENT SCENARIO:
Te therapeutic potential of yoga has been recognized world over and studies have shown its benefcial efects in
numerous psychosomatic disorders like diabetes, hypertension, asthma, arthritis and other chronic diseases that are a
great burden on our health care delivery system. Te International Association of Yoga Terapists in the USA (www.
iayt.org) is doing a lot of work to make Yoga Terapy acceptable to the medical community worldwide. Tey have given
details of hundreds of research studies done all of over the world with regard to yoga as a novel and adjunct therapy to
be used along with modern medicine.
In India Yoga Terapy is under Dept of AYUSH in Ministry of Health and Family Welfare and through its Morarji
Desai National Institute of Yoga (www.yogamdniy.nic.in) fve Advanced Centers for Yoga have been set up in our
country. Te Advanced Centre for Yoga Terapy, Education and Research (ACYTER), a collaborative venture between
JIPMER and MDNIY is functioning since June 2008 and focusing primarily on the role of Yoga in the prevention
and management of cardiovascular disorders and diabetes mellitus. More than 30,000 patients have benefted from the
Yoga therapy consultations and practical sessions till date. Te centre also aims to popularize the science of yoga among
medical professionals (Yoga Vijnana 2008; 2: 71-78) and general public and has conducted workshops and awareness
programmes to this efect.
Central Council for Research in Yoga and Naturopathy in the Ministry of Health and Family Welfare (www.
ccryn.org) funds research studies in Yoga and ran a National Programme on Yoga and Naturopathy in 2010-2011. Yoga
therapists have been appointed under the NRHM programmes in government hospitals all over the country and most
major private medical hospitals have established Yoga and Healthy Living Centers.
Tough there are many private hospitals hosting Healthy Lifestyle Centers for their patients, it is only in recent
times that the Public Sector Hospitals have started such centers. AIIMS was one of the frst centers to have such a unit
(Indian J Physiol Pharmacol 2008; 52: 123-31) but today numerous units are functioning all over the country under the
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patronage of the Ministry of Health and Family Welfare, Government of India.
Te Centre for Yoga Terapy, Education and Research (CYTER) is running at MGMC&RI under the patronage of
Sri Balaji Vidyapeeth and a scientifcally sound Yoga therapy programme is running since 2010. Awareness programmes
have been conducted for medical and paramedical personnel and more than 5000 patients have benefted till date and
many studies under publication.
A WORD OF CAUTION:
A word of caution is also required. Tough Yoga and Yoga therapy are very useful in bringing about a state of total
health it is not a miracle cure for all problems. It needs a lot of discrimination on the part of both the therapist as well
as the patient. It may not be useful in emergency conditions and there is a strong need to consult a qualifed medical
doctor where in doubt. Each patient is diferent and so the therapy has to be molded to suit the individual needs rather
than relying on a specifc therapy plan for patients sufering the same medical condition. A very true problem is that
there is a diferent approach of the diferent schools of Yoga to the same condition. It is better to follow any one system
that one is conversant with, rather than trying to mix systems in a Yogic Cocktail. One must also be vigilant as there
is a strong presence of numerous quacks pretending to be Yoga therapists and this leads to a bad name for Yoga therapy
as well as Yoga in general.
CONCLUSION:
Te art and science of Yoga has infnite possibilities for providing answers to most health problems troubling
modern humankind. However we often misunderstand this science and want it to be a miracle pill. A pill that we
take only once, and want all the problems to vanish into thin air! Yoga is a wholistic science and must be learnt and
practiced with a holistic view. Te dedicated practice of Yoga as a way of life is no doubt a panacea for problems related
to psychosomatic, stress related physical, emotional and mental disorders and helps us regain our birthright of health
and happiness. It is only when we are healthy and happy that we can fulfll our destiny. With the adoption of a proper
attitude and lifestyle through the Yogic way of life, we can rise above our own circumstances and our life can blossom
as a time of variety, creativity, and fulfllment. Yoga helps us regain the ease we had lost through dis-ease (as implied
by sthira sukham asanam-PYS). It also produces mental equanimity (samatvam yoga uchyate-BG) where the opposites
cease to afect (tato dwandwa anabhigatha-PYS). Tis enables us to move from a state of illness and disease to one of
health and wellbeing that ultimate allows us to move from the lower animal nature to the higher human nature and
fnally the highest Divine Nature that is our birthright.
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Indian J Physiol Pharmacol 2013; 57(2) Suryanamaskar on Reaction Time and Heart Rate 199
SHORT COMMUNICATION
IMMEDIATE EFFECTS OF SURYANAMASKAR ON REACTION TIME
AND HEART RATE IN FEMALE VOLUNTEERS
ANANDA BALAYOGI BHAVANANI*, MEENA RAMANATHAN,
R. BALAJI AND D. PUSHPA
Centre for Yoga Therapy, Education and Research (CYTER),
MGMCRI, Pondicherry 607 402
( Received on November 5, 2012 )
Abstract : Suryanamaskar (SN), a yogic technique is composed of dynamic
muscular movements synchronised with deep rhythmic breathing. As it
may have influence on CNS, this study planned to investigate immediate
effects of SN on reaction time (RT) and heart rate (HR). 21 female volunteers
attending yoga classes were recruited for study group and 19 female
volunteers not participating in yoga were recruited as external-controls.
HR, auditory reaction time (ART) and visual reaction time (VRT) were
recorded before and after three rounds of SN in study group as well as 5
minutes of quiet sitting in both groups. Performance of SN produced
immediate decrease in both VRT and ART (P<0.001). This was significant
when compared to self-control period (P<0.001) and compared to external-
control group, it decreased significantly in ART (p=0.02). This was
pronounced when % was compared between groups (P<0.001). HR
increased significantly following SN compared with both self-control
(p=0.025) and external-control group (p=0.032). Faster reactivity may be
due to intermediate level of arousal by conscious synchronisation of dynamic
movements with breathing. Rise in HR is attributed to sympathetic arousal
and muscular exertion. We suggest that SN may be used as an effective
training means to improve neuro-muscular abilities.
Key words : yoga suryanamaskar reaction time heart rate
INTRODUCTION
Beneficial effects of Yoga have been
reported in peripheral and central neuronal
processing (1, 2, 3, 4). Reaction time (RT) is
simple and effective method of studying
central neuronal processing and is a simple
means of det ermi ni ng sensory- mot or
association, performance and cortical arousal
(3).
It has been reported that changes in
breathing period produced by voluntary
control of i nspi rati on are si gni fi cantl y
Indian J Physiol Pharmacol 2013; 57(2) : 199204
*Corresponding author : Dr. Ananda Balayogi Bhavanani, Honorary Advisor, Centre for Yoga Therapy,
Education and Research (CYTER), MGMCRI, Pondicherry 607 402
200 Bhavanani et al Indian J Physiol Pharmacol 2013; 57(2)
correlated to changes in RT (5). Some studies
on yoga have shown that regular practice of
yoga over a period of few weeks to a few
months can significantly decrease both visual
reaction time (VRT) and auditory reaction
time (ART) (2, 3, 6). Previous studies by
Bhavanani et al have reported a significant
and immediate decrease in RT following the
practice of nine rounds of mukha bhastrika,
a bellows type of pranayama in normal
school chi l dren as wel l as ment al l y
challenged adolescents (7, 8).
Suryanamaskar (SN) is a sequential
combination of yogic postures performed
dynamically in synchrony with the breath.
Energy cost and physiological changes during
the practice as well as after training have
been reported (9, 10, 11, 12).
Keeping the above in mind, this study
was planned to investigate the acute effects
of SN on RT and heart rate (HR) in trained
female volunteers.
METHODS
Twenty-one female volunteers (mean age
28.291.71 years) were recruited from those
attending regular yoga classes at CYTER in
Mahatma Gandhi Medi cal Col l ege and
Research Institute, Puducherry. Another
group of 19 female volunteers (mean age
32.111.41 years) not attending yoga classes
were recruited as external-controls. Informed
consent was obtained from all participants
and ethical clearance was obtained from
Institutional Human Ethics Committee.
Numerous vari ati ons of the SN are
taught and the one used in the present study
is known as Aruna SN. This is an integral
part of the Gitananda Tradition and involves
dynami c perf ormance of a sequent i al
combination of yogic postures in synchrony
with breathing (13). The speciality of this
variation is the usage of nasarga mukha
bhastrika, a bellows type of yogic breathing
done wi t h i nt ernal i zed awareness of
diaphragmatic actions.
The keywords for SN are stretch and
breathe and the breathing must be deep
and regular with the movements flowing with
the breath. From a standi ng posi ti on
(samasthiti asana) both arms are stretched
up breathing in, and the palms brought
together in anjali mudra. While exhaling,
stretch down with palms flat to the ground
and forehead to knees in pada hastha asana.
Lift the head while breathing in and then
blast out with a whoosh jumping back with
the whole body parallel to the ground in
chatur danda asana. On the next in-breath,
lift the head and bend back as much as
possible (kokila asana). Come into meru
asana by lifting the buttocks up, keeping the
knees tight and straight while pushing down
on the heels. In this position, inhale through
the nose and whoosh out forcefully through
the mouth (nasarga mukha bhastri ka).
Breathe in and jump forward bringing both
feet between the hands placed firmly on the
ground. Stretch the head up and feel a
stretch through the entire back. Breathe out
and lower the head down to knees. Breathe
in and lift back up to anjali mudra and finally
return and relax in samasthiti asana.
RT apparatus manufactured by Anand
Agencies, Pune was used with built in 4 digit
chronoscope and display accuracy of 1ms.
Simple ART was recorded for auditory beep
sound and simple VRT for red light. Subjects
Indian J Physiol Pharmacol 2013; 57(2) Suryanamaskar on Reaction Time and Heart Rate 201
were instructed to release response key with
dominant hand as soon as they perceived
the stimulus given from the front to avoid
effect of lateralised stimulus (14). All subjects
were gi ven adequat e exposure t o t he
equi pment on 2 di f f erent occasi ons to
familiarize them with the procedure. To
ensure objectivity, HR was recorded using
non-invasive semi-automatic BP monitor (CH
432, Citizen Systems, Tokyo, Japan) having
range from 40 to 180 beats/min and accuracy
5%.
For SN group, RT measurements and HR
recordings were done twice; before and after
a control period of 5 minutes of quiet sitting
and then before and after practice of SN.
Control period was 5 minutes, equivalent to
duration taken to perform SN. To avoid
influence of recording on different days and
order of recording, half subjects performed
sel f - cont rol recordi ngs on day- 1 and
others did SN recordings. This was reversed
on day-2. For external-control group, RT
measurements and HR recordings were done
before and after 5 minutes of quiet sitting
with half recording on day-1 and others on
day-2. Ten trials were recorded and average
of lowest three similar observations were
taken as single value (14).
Statistical analysis
Data are expressed as meanSEM.
Statistical analysis was done using GraphPad
InStat version 3.06 and all data passed
normality testing by Kolmogorov-Smirnov
Test and hence analyzed using Students t
t est f or pai red dat a f or i nt ra- group
comparisons and Students t test for unpaired
data between groups. P values less than 0.05
were accepted as indicating significant
differences.
RESULTS
Mean age of subjects in the SN group
was 28.291.71 and in external-control group
was 32.111.41 years and difference between
groups was not significant.
Comparison of self-control HR, ART and
VRT recordings in SN group showed no
si gni f i cant di f f erences ( P>0. 05) when
compared wi t h ext ernal - cont rol group
recordings both at baseline and after 5
minutes of quiet sitting.
The meanSEM values of HR, ART and
VRT recordi ngs and t hei r st at i st i cal
comparison between SN, self-control and
TABLE I : Immediate effect of suryanamaskar on heart rate (HR), auditory reaction time (ART) and
visual reaction time (VRT) in 21 female volunteers before (B) and immediately after (A)
three rounds of suryanamaskar and a self-control period of 5 minutes of quiet sitting.
Suryanamaskar (n=21) Self-Control period (n=19) Comparison (P value)
B A % B A % B A %
HR 76.712.04 80.522.47** 5.001.67 76.671.67 75.291.66 1.441.95 0.982 0.025 0.072
ART 225.048.23 193.448.66*** 14.281.75 236.639.06 234.148.78 0.940.68 0.012 < 0.001 < 0.001
VRT 245.806.93 213.726.80*** 13.081.03 249.525.49 244.695.83 1.881.13 0.359 < 0.001 < 0.001
Values are given as meanSEM. **P<0.01 by paired t test, ***P<0.001 by paired t test.
202 Bhavanani et al Indian J Physiol Pharmacol 2013; 57(2)
compared to both self-control period (p=0.025)
and external-control group (p=0.032). The %
difference in HR between SN and external-
control group was statistically significant
(p=0.004) and just missed significance with
self-control period (p=0.072). This rise in HR
can be attributed to sympathetic arousal as
well as muscular exertion and this is in
agreement with another report that average
i ntensi ty duri ng SN was 80% HRmax,
suffi ci ent to el i ci t a cardi o-respi ratory
training effect (12). It has been previously
reported that SN produces an increase in
VO2 max i ndi cati ng i mproved aerobi c
capacity and that it exerts only moderate
stress on cardio-respiratory system as it
keeps the practitioner within their lactate
and anaerobic threshold (9, 10).
Performance of SN produced immediate
and statistically significant decreases in VRT
and ART. The faster reactivity is in agreement
with previous studies on immediate effects
of mukha bhastrika and three weeks of
slow and fast pranayama training (7, 8, 14).
Decrease in RT signifies improvement in
central neuronal processing ability and this
may be attributed to greater arousal and
faster rate of information processing along
with improved concentration. RT is fastest
external-control groups are given in Tables
I and II.
The changes were significant with regards
to a rise in HR and fall in ART and VRT
following SN as compared with both self-
control and external-control group data. This
was more pronounced (P<0.001) in ART and
VRT data when the basel i ne adj usted
percentage changes (%) were compared
between groups.
DISCUSSION
To the best of our knowledge, this is the
first report on the immediate effects of SN
on RT. Previous studies on immediate/acute
effects of SN have focussed on energy cost
and cardio-respiratory changes during the
practice or cardiorespiratory and metabolic
responses to four rounds of the practice
(9, 12). Both these studies lacked control
groups whereas our present study analyses
immediate effects of RT with reference to
both self-control data as well as data from a
separate external-control group.
HR increased significantly following
performance of three rounds of SN (P<0.01).
This was statistically significant when
TABLE II : Immediate effect of suryanamaskar on heart rate (HR), auditory reaction time (ART)
and visual reaction time (VRT) in 21 female volunteers before (B) and immediately
after (A) three rounds of suryanamaskar and in an external- control group of 19
female volunteers performing 5 minutes of quiet sitting.
Suryanamaskar (n=21) External-Control period (n=19) Comparison (P value)
B A % B A % B A %
HR 76.712.04 80.522.47** 5.001.67 76.161.53 74.370.99 1.891.69 0.831 0.032 0.004
ART 225.048.23 193.448.66*** 14.281.75 223.8910.42 223.219.51 0.101.32 0.931 0.026 < 0.001
VRT 245.806.93 213.726.80*** 13.081.03 242.907.61 234.088.71* 3.741.38 0.779 0.070 < 0.001
Values are given as meanSEM. **P<0.01 by paired t test, ***P<0.001 by paired t test.
Indian J Physiol Pharmacol 2013; 57(2) Suryanamaskar on Reaction Time and Heart Rate 203
with an intermediate level of arousal and
deteriorates when subjects are either too
relaxed or too tensed. Exercise improves RT
and moderate muscular tension shortens pre-
contraction RT while isometric contraction
al l ows t he brai n t o work f ast er ( 15) .
Alternate forward and backward bending
movements as well as the jumping back and
forth movements in SN may have influenced
RT i n a manner si mi l ar t o i somet ri c
muscular exercise. Though RT shortening
effect of exercise is normally lost in post
exercise period as arousal diminishes (16),
in our subjects shortening of RT was carried
over into post SN period too. With the above
in mind, we attribute faster reactivity of our
subjects following SN to an intermediate
level of arousal brought about by conscious
synchroni sat i on of dynami c muscul ar
movements with slow, regular and deep
breathing.
Previous studies have demonstrated EEG
changes around somato-sensory and parietal
areas of cerebral cortex suggesting affective
arousal f ol l owi ng agni sara, naul i and
bhastrika and suggested such changes occur
through strong stimulation of somatic and
splanchnic receptors (17). The nasarga
mukha bhastrika in meru asana, involving
multiple forceful expirations done rapidly and
consecuti vel y may have prol onged and
residual neuro-muscular effect influencing
RT. It has been suggested that such forceful
expirations may alter afferent inputs from
abdominal and thoracic regions, in turn
modulating activity at ascending reticular
activating system and thalamo-cortical levels
(7, 8).
On the basis of the present study, it is
concluded that three rounds of SN produce
si gni fi cant shorteni ng of RT i n femal e
subjects as part of a generalised sympathetic
arousal as evidenced by significant rise in
HR. We suggest that SN may be used as an
effective training means to improve neuro-
muscular abilities. As our study is limited
by a small sample size, further studies with
larger sample sizes may help to understand
better underlying mechanisms involved in
bringing about such an immediate benefit.
ACKNOWLEDGMENTS
The authors thank management and
aut hori t i es of Sri Bal aj i Vi dyapeet h
University for setting up the Centre for Yoga
Therapy, Education and Research (CYTER)
in Mahatma Gandhi Medical College and
Research Institute (MGMCRI).
The authors are grateful to Yogacharini
Meenakshi Devi Bhavanani, Director ICYER
for her constant motivation, encouragement
and supportive guidance. We thank Miss
Subashana, ANM for assistance during
recording sessions and data entry.
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Int. Res J Pharm. App Sci., 2013; 3(4):116-118 ISSN: 2277-4149

Dinesh T et al., 2013 116

International Research Journal of Pharmaceutical and Applied
Sciences (IRJPAS)
Available online at www.irjpas.com
Int. Res J Pharm. App Sci., 2013; 3(4):116-118


EFFECT OF 8 WEEKS OF PRANAV PRANAYAMA TRAINING ON PULMONARY FUNCTION
TEST PARAMETERS IN YOUNG HEALTHY, VOLUNTEERS OF JIPMER POPULATION
Dinesh T
1
, Sharma V K
2
, Raja Jeyakumar M
3
, Syam Sunder A
4
, Gopinath M
5
Ananda Balayogi Bhavanani
6

1
Assistant Professor, Department of Physiology, Vinayaka Missions medical college, Karaikal- 609605,
2
Sharam V K Assistant Professor, Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education & Research,
Puducherry- 605006
3
Assistant Professor, Department of Physiology, Chennai Medical college hospital and research centre, Irungalur, Trichirappalli-
621105
4
PhD Scholar, Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry-
605006
5
Assistant Professor, Department of Physiology, Melmaruvathur Adhiparasakthi Institute of Medical Sciences and Research,
Melmaruvathur- 603319
6
Deputy Director, CYTER, Mahatma Gandhi Medical College and Research Institute, Puducherry - 607 402

Corresponding Author: Dinesh T, Email: arvindr84@gmail.com

Abstract: Background: Yoga is an ancient Indian science it has been practiced as a healthy way of life. Yoga consists of five
principles that include proper exercise, proper relaxation, proper breathing, proper diet, positive thinking and meditation.
Pranayama is a method of breathing and chest expansion exercise has been reported to improve respiratory function in healthy
individuals as well as in patients with respiratory diseases... The aim of the study is to find out the positive beneficial effects of
pranav pranayama training on pulmonary function parameters in young healthy, volunteers of both the genders. Materials and
methods: The present study was conducted on 12 healthy volunteers of both genders. Among them 6 were males subjects and 6
were females subjects. The mean age group of the subjects was 18.58+0.66 years. Pre and post pulmonary function parameters
such as FEV
1
, FVC, FEV
1
/ FVC, FEF
25-75
, MVV were taken using the spirometer at the end of 8 weeks pranayama training.
Results: Our results showed a significant difference in pulmonary function parameters. Before paranayma training FVC was
around 2.29+ 0.58, after it was 2.35+0.63, FEV1

was around 2.22+0.59 after it was 2.285+0.63, FEV1/FVC was around
97.11+3.83 after it was 97.45+3.36, FEF was around 3.35+1.01,after it was around 5.85+8.15, PEFR was around
266.83+72,after it was around 290.91+82.56, MVV was around 84.2+23.16 after it was around 85.90+ 23.59, from the above
results we concluded that PEFR was not statically significant P< 0.05. Other parameters showed a significantly high value in pre
and post data which is statistically significant P> 0.05.Conclusion: From our study we found that 8 weeks of pranav pranayama
training in the young, healthy volunteers showed increase in the commonly measured pulmonary function parameters, but the
increase was not statistically significant probably because of short duration of training. By increasing the duration of time the
reliable goal can be achieved by obtained maximal values of pulmonary function parameters which reflect directly on lung health
status.
Keywords: Pranav Pranayama, pulmonary function, healthy lungs, dead space, ventilatory function.

Introduction
Yoga, an ancient Indian science has been practiced
as a healthy way of life. Yoga emphasizes on controlled
breathing (pranayama), body posture (asana), relaxation of
mind (meditation) keeps a person energetic & healthy for
maintaining health and fitness and for treating diseases.
Pranayama is a method of yogic type of breathing and chest
expansion exercise, has been reported in previous studies as
it is known to improve respiratory function in healthy
individuals as well as in respiratory diseases. Pranayama,
the fourth step of ash tang yoga is an important component
of yoga training. Prana the vital life force that acts as a
catalyst in all our activities and Ayama is the expansion of
Pranayama can be defined as the science of controlled,
conscious expansion of Prana in our energy body sheath. As
a deep breathing technique, Pranayama reduces ventilation
and decreases work of breathing. It also refreshes air
throughout the lungs, in contrast with shallow breathing that
refreshes air only at the base of the lungs
(3)
. Spirometry is
the most commonly used technique to screen the respiratory
diseases. It includes the assessment of lung volumes and
flow-volume curves
(1, 2)
. Among the previous Studies
conducted at pranayama in several institutions in India have
reported impressive success in improving the lung functions
and has a positive effect and permanent relief from asthma.
It has also been proved that asthma attacks can usually be
prevented by Yoga methods without resorting to drugs.
Physicians have found that the addition of improved
concentration ability and yogic meditation together with the
practice of simple postures and pranayama makes treatment
more effective in patients who practice. Yoga has a better
chance of gaining the ability to control their breathing
problems. With the help of yogic breathing exercises, it is
possible to control an attack of severe shortness of breath
Research Article
Int. Res J Pharm. App Sci., 2013; 3(4):116-118 ISSN: 2277-4149

Dinesh T et al., 2013 117

without having to seek medical help. Various studies have
confirmed the beneficial effects of pranayama for patients
with respiratory problems
(2, 3)
.The ultimate goal of
traditional yogis was self realization or enlightenment, a
concept, which perhaps is quite esoteric to you and me. The
first step on this path is to reduce peripheral mental activity
through bringing awareness into the body, and then later
through relaxation and meditation to simply observe the
breath. This helps to quiet the mind and take us to a place of
peace. The reduction, and ultimately cessation of mental
activity is the goal or aim of meditation. On experiencing
this state we become aware of our unity with all things and
our essential nature of peace
(3)
.

Materials and methods
The present study was conducted on 12 young
healthy, volunteers of both the genders. Mean age was
18.58+0.66 years. After obtaining clearance from the
Institute Ethics Committee, subjects were motivated and
recruited for the study. Subjects with the history of active
sports training, previous experience of yoga, history of
chronic respiratory illness, history of major surgery in the
recent past, smoking, alcohol consumption were excluded
from the study. The subjects were familiarized with the aims
and objectives of the study as well as laboratory
environment. After giving detailed information about the
study, written consent was obtained from the volunteer
subjects.

Analysis of Parameters:
Baseline parameters (pre values) were recorded at
the beginning of the study. Height and weight were
measured using height scale and weighing scale
respectively. Using spirometer (Micro lab Version 1.32)
pulmonary function parameters were recorded. Pulmonary
Function Tests parameters analyzed are studied were
Forced Vital Capacity (FVC), Forced Expiratory Volume in
first second (FEV
1
), Ratio between FEV
1
and FVC (FEV
1
/
FVC), Peak Expiratory Flow Rate (PEFR), and Forced
Expiratory Flow at 25-75 (FEF
25-75
)

and Maximum
Voluntary Ventilation (MVV). The values of all tests were
taken as % predicted as per age, sex and height of each
subject according to standard equation .The subjects were
instructed to do the procedure in the sitting posture, with the
erect spine, without forward bending. The subject is asked to
keep the mouth piece inside the mouth with the lips closed
so as to make a seal, to avoid air leak while blowing; nose
was closed with the nose clips. They performed slow
expiratory vital capacity and forced vital capacity
maneuvers. These procedures were repeated for two more
times with of 3-5 minutes of interval in-between. The
subjects are instructed to give their maximal effort. The
above said PFT parameters such as FVC, FEV
1,
FEV
1
/
FVC, FEF
25-75,
PEFR and MVV were noted. Three readings
were taken and the best value out of them was recorded. The
same procure was followed while recording the post values
at the end of 8 weeks of pranayama training.

Pranayama training:
The subjects were given pranav pranayama training
and practiced the same under the guidance of a trained,
certified yoga instructor at Advanced Centre for Yoga
Therapy Education and Research (ACYTER), JIPMER,
Pondicherry. Practice sessions were conducted three days
per week (Monday, Wednesday and Friday) during the
evening time for 20-30 minutes for a total duration of eight
weeks. On rest of the days subjects were motivated to
practice at their home. Pranav pranayama is slow, deep and
rhythmic breathing in co ordination with A, U; M sounds
which were pronounced during expiration. They were asked
to assume Sukhasana (the comfortable posture). Deep
inhalation for 6 counts in co ordination with turning the
head to right side. This is followed by chanting ah in
coordination with the movement of head towards centre.
Deep inhalation for 6 counts in co ordination with turning
the head to left side. This is followed by chanting vu in
coordination with the movement of head towards centre.
Deep inhalation for 6 counts in co ordination with turning
the head and chin up. This is followed by chanting ma in
coordination with the movement of head towards
centre.Pranav pranayama was given for 3 cycles. At the end
subjects were made to lie down in Shavasana for 10
minutes.

Statistical analysis:
Graph pad software was used to analyze the data.
The values obtained from pre and post training period were
analyzed using Students paired t - t e s t. Data were
expressed as Mean SD.P value of less than 0.05 was
considered as significant.

Results:
Our results showed a significant difference in
pulmonary function parameters. Before paranayma training
FVC was around 2.29+ 0.58, after it was 2.35+0.63, FEV1

was around 2.22+0.59 after it was 2.285+0.63, FEV1/FVC
was around 97.11+3.83 after it was 97.45+3.36, FEF was
around 3.35+1.01,after it was around 5.85+8.15, PEFR was
around 266.83+72,after it was around 290.91+82.56, MVV
was around 84.2+23.16 after it was around 85.90+ 23.59,
from the above results we concluded that PEFR was not
statically significant P< 0.05. Other parameters showed a
significantly high value in pre and post data which is
statistically significant P> 0.05. The above values are coded
in table 1 as the pre and post data of our study which was
conducted on 12 healthy volunteers of both the genders of
age group around18.58+0.66 years. A positive result was
analyzed among the pulmonary function parameters from
our study.

Table 1: Effect of savitri pranayama training on
pulmonary function parameters before and after 8 weeks
of study period. Values are expressed as MeanSD
PFT Parameters BeforePranayama
training (n=12)
After pranayama
training (n=12)
FVC (L) 2.29+ 0.58 2.35+0.63
FEV
1
(L)

2.22+0.59 2.285+0.63
FEV
1
/FVC (%) 97.12+3.83 97.45+3.36
PEFR (L/m) 266.83+72 290.91+82.56 *
FEF
25-75
(L/s) 3.35+1.01 5.851.15**
MVV (L) 84.2+23.16 85.90+23.59
LEGEND -1 the values obtained before and after the
training period were compared using Students paired t - t e
Int. Res J Pharm. App Sci., 2013; 3(4):116-118 ISSN: 2277-4149

Dinesh T et al., 2013 118

s t *P< 0.05, **P < 0.01. Forced Vital Capacity (FVC),
Forced Expiratory Volume in first second (FEV
1
), Ratio
between FEV
1
and FVC (FEV
1
/ FVC), Peak Expiratory
Flow Rate (PEFR), Forced Expiratory Flow at 25-75 (FEF
25-
75
)

and Maximum Voluntary Ventilation (MVV).

Discussion
Yoga consists of different type of practices, most
common of which is pranayama. Different pranayama
produce different physiological effects. Madan Mohan et al
conducted a study on effect of slow and fast pranayama on
cardio- respiratory changes they concluded that pranayama
has a positive effect by improving the cardio respiratory
performance by minimizing the sympathetic effect on
circulatory pool
(1, 4)
. Another study conducted by Joshi et al
in which they found that yogic Asanas and pranayama
reduce the resting respiratory rate and increase vital
capacity, timed vital capacity, maximum voluntary
ventilation, breath holding time and maximal inspiratory and
expiratory pressures
(2)
. They concluded pranayama
sessions in young male volunteers. The results of the study
showed that there was a decrease in both expiratory and
inspiratory muscle strength, alveolar hypoventilation due to
depression of hypoxic and hypercapnoeic ventilatory drives
and decrease in maximal breathing and diffusing capacity
(5)

The decrease of oxygen uptake due to meditative practice
influenced the reduction of the total caloric expenditures
that, as a variable derived from VO2, also had a statistically
significant reduction of 35% which proves that oxygen
consumption increases with pranayama practice
(6, 7)
Results
of our study indicate that there was trend towards increase in
the ventilatory function parameters including FEV
1
, FVC,
FEV
1
/FVC, FEF
25-75
and MVV between time points,
although none of the parameters were statistically
significant. However PEFR parameter showed statistically
significant improvement. Improvement in the study subjects
may have occurred due to strength and endurance of
respiratory muscles and improvement in cardio, respiratory
parameters. Our findings are in congruence with the
previous studies of Udupa et al A in1975. In our study
the changes did not reach statistical significance probably
due to differences in the protocols, study design and lesser
number of subjects in our study
(9, 10)
. Our study further
substantiates the claim that yoga practice is beneficial on the
pulmonary function in normal subjects. In future we are
planning to extend this study further with more number of
subjects and duration of yoga training on healthy subjects as
well as patients
(11).

CONCLUSION
12 healthy volunteers between age group of
18.58+0.66 years years participated in this study. They were
given training of pranav pranayama. Pulmonary function
test parameters were recorded as pre and post sessions. Our
results showed significant increase in pulmonary function
parameters after regular practice of pranav pranayama .The
present study has shown that adding comprehensive yoga-
based breathing exercises (pranayama) to the daily life to
improve the lung function.
Acknowledgement
We acknowledge Mr. Dayanidy yoga instructor, ACYTER,
JIPMER. Dr.Velkumary, Assistant Professor, Mr. Shyam
Sundar Kiran PhD scholar, Department of Physiology,
JIPMER who helped us for the conduct of this project.
And a warm thanks to the volunteers who participated in our
study.

REFERENCES:
1. Madanmohan, Udupa K, Bhavanani AB,
Vijayalakshmi P, Surendiran A. Effect of slow and
fast pranayamas on reaction time and
cardiorespiratory variables. Indian J Physiol
Pharmacol 2005; 49: 313318.
2. Joshi LN, Joshi VD, Gokhale LV. Effect of short
term pranayamaa practice on breathing rate and
ventilatory functions of lung. Indian J Physiol
Pharmacol 1992; 36: 105-108.
3. Bijilani RL. The Yogic Practices: Asanas,
Pranayamas and Kriyas. Bijilani RL, editor,
Understanding medical physiology, Third edition.
New Delhi, India: Jaypee Brothers Medical
Publishers 2004; 883-889.
4. Fischberg S, Motamed S, Janssens JP. How to
perform and interpret spirometry in primary care.
Rev Med Suisse 2009; 5: 1882-9.
5. Khaidjapho K, Jaree P, and Pongnaratorn P,Yoga
exercise increases chest wall expansion and lung
volumes in young healthy thais, Thai journal of
physiological sciences, 2006; 19 (1):1-7.
6. N.k. Subbalakshmi1, s.k. Saxena, urmimala, and
urban j.a. Dsouza, Immediate effect of nadi -
shodhana pranayamaaOn some selected
parameters of cardiovascular,Pulmonary, and
higher functions of brain, Thai journal of
physiological sciences, 2005;18 (2):10-16
7. Madanmohan, Rai UC, Balavittal V, Thombre
DP,Swami Gitananda. Cardiorespiratory changes
during savitri pranayama and shavasan. The Yoga
Review 1983; 3: 2534.
8. Ganong WF. Review of Medical Physiology.
Boston: McGraw-Hill, 2003.
9. Udupa KN, Singh RH, and Settiwar RM. Studies
on the effect of some yogic breathing exercises
1975
(pranayamaa) in normal persons. Indian J Med Res,
1975; 63:1062-1065.
10. Anjum Sayyed1, Jyotsna Patil, Vilas Chavan,
Shrirang Patil,Sujeet Charugulla , Ajit Sontakke
and Neelima Kantak, Study of lipid profile and
pulmonary functions in subjects participated in
Sudarshan Kriya Yoga Al Ame en J Med ScI, 2010;
3(1):42-4 9
11. Ananda Balayogi Bhavanani, Madanmohan, Zeena
Sanjay And Ishwar V. Basavaraddi, Immediate
cardiovascular effects of pranava pranayama in
hypertensive patients. Indian J Physiol Pharmacol
2012; 56(3): 273278.

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International Journal of Medical & Pharmaceutical Sciences Research and Review Vol. 1 (4)
INTERNATIONAL J OURNAL OF MEDICAL &
PHARMACEUTICAL SCIENCES RESEARCH & REVIEW
Research Article..!
Received: 20-10-2013; Accepted: 11-11-2013
EFFECT OF 12 WEEKS OF KAPALABHATI PRANAYAMA TRAINING
ON CARDIO-RESPIRATORY PARAMETERS IN YOUNG, HEALTHY
VOLUNTEERS OF JIPMER POPULATION
Dinesh T
1
,Gaur G S
2
, Sharma V K
3
,Velkumary S
4
, Ananda Balayogi
Bhavanani
5

1
Department of Physiology, Vinayaka Missions Medical College, Karaikal
609605.
2
Department of Physiology, Jawaharlal Institute of Postgraduate Medical
Education & Research, Puducherry 605006.
3
Department of Physiology, Jawaharlal Institute of Postgraduate Medical
Education & Research, Puducherry 605006.
4
Department of Physiology, Jawaharlal Institute of Postgraduate Medical
Education & Research, Puducherry 605006
5
Deputy Director, CYTER, Mahatma Gandhi Medical College and Research
Institute, Puducherry - 607 402.
Corresponding Author: Dr. Dinesh T, Assistant Professor.
ABSTRACT
BACKGROUND
In the recent decades, interest has been increasing all over the world in the
applications of yogic techniques in the field of therapeutics and research.
Pranayama are breathing techniques that exert profound physiological effects on
pulmonary, cardiovascular and mental functions.

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OBJECTIVE
To study the effect of 12 weeks of Kapalabhati pranayama training on cardio-
respiratory parametersin healthy, young subjects.
KEYWORDS: Kapalabhati pranayama, Heart Rate, Blood Pressure, Respiratory
rate.
INTRODUCTION
Yogic system was developed by the sages of India which has been practiced
down the ages. In the recent decades, interest has been increasing all over the
world in the applications of yogic techniques in the field of therapeutics and
research. With increased awareness and interest in alternative and complementary
remedies, yogic techniques including pranayama are gaining importance and
becoming acceptable to the public as well as scientific community
(1)
. Pranayama
are breathing techniques that exert profound physiological effects on pulmonary,
cardiovascular and mental functions. The science of pranayama deals with the
knowledge, control and enrichment of this vital force which results in rhythmic
respiration, calm and alert state of mind. Pranayama has variable effect on cardio-
respiratory system
(2)
. Regular practice of pranayama improves cardio-vascular
and respiratory functions, improves autonomic tone towards parasympathetic
system, decreases the effect of stress and strain on the body and improves
physical and mental health
(1, 3, 5)
. The word kapalbhati is made up of two words:
kapal meaning 'skull' (here skull includes all the organs under the skull too) and
bhati meaning 'shining, illuminating'. The technique of Kapalabhati involves
short and strong forceful exhalations and inhalation happens automatically. The
aim of the study is to find out the beneficial effects of Kapalabhati pranayama
training on cardio-respiratory parameters in young, healthy, volunteers of both
genders.

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MATERIALS AND METHODS
The Present study was conducted in Department of Physiology, J IPMER on 62
healthy volunteers. The distribution was n=32 Pranayama training group and
control groups n=30. Kapalabhati pranayama started with 30 times for 1 min and
increased to 5 minutes/day, twice daily, thrice/ week for 12 weeks. Cardio-
respiratory parameters including resting heart rate (HR), systolic blood pressure
(SBP) and diastolic blood pressure (DBP) measured after 10 minutes of supine
rest.Respiratory rate (RR) was recorded before and after 12 weeks of study
period.
The Present study was conducted in Department of Physiology, J IPMER on 62
healthy volunteers of both genders, after obtaining clearance from the Institute
Ethics Committee. Subjects were randomized into pranayama (n=32) and control
groups (n=30), after getting informed, written consent. Mean age of the
volunteers was 18.54 +1.65 yrs. The subjects were familiarized with the aim and
objective of the study as well as laboratory environment.
PARAMETERS ANALYZED
Cardio-respiratory parameters including resting HR, SBP and DBP were
measured after 10 minutes of supine rest using digital BP monitor (Citizen- CH
432B, J apan) and respiratory rate (RR) was recorded passively by observing the
abdominal movements while recording the HR and BP. The same procedure was
followed while recording post values at the end of 12 weeks of pranayama
training.



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PRANAYAMA TRAINING
Supervised pranayama training was given to the study group by a certified yoga
instructor at Advanced Centre for Yoga Therapy Education and Research
(ACYTER), J IPMER, Puducherry according to the guidelines of Morarji Desai
National Institute of Yoga, New Delhi and they practiced Kapalabhati pranayama
started with 30 times or one minute and increased to 5 minutes/day, twice daily,
thrice/week for 12 weeks. Rests of the days, subjects were motivated to practice
at their home. Control group did not involve in any pranayama training during
this 12 weeks study period.
STATISTICAL ANALYSIS
Data for all parameters at baseline and post test were collected according to the
study protocol and computerized in Microsoft Excel database. Data were
summarized by using descriptive statistics such as percentage, mean and SD for
different parameters. Longitudinal changes in each group were compared by
using Students paired t-test. P<0.05 was considered statistical significant.
RESULTS
Pranayama training resulted in marginal decrease (P>0.05) in all basal
cardiovascular parameters while RR decreased significantly (P<0.01). On the
other hand, there was a significant (P<0.05) increase in RR.
Mean age of the volunteers was (18.54 +1.65). The analysis on the effect of 12
Weeks of Kapalbhati pranayama on cardio-respiratory parameters has been given
in Table No.1 that shows a significant decrease in RR from 17.34 2.09 to 16.41
0.61(P=0.03) and Marginaldecrease in other parameters (P>0.05) such as SBP,
DBP and HR.
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Table. 1 Effect of 12 weeks of Kapalabhati pranayama training (n=32) on cardio-
respiratory parameters: heart rate (HR), systolic blood pressure (SBP), diastolic
blood pressure (DBP) and respiratory rate (RR). Values are expressed as mean
SD.
Parameters Before pranayama training After pranayama training
HR(beats/min) 85.47 10.47 83.75 8.91**
SBP (mmHg) 112 11.71 110.68 10.74*
DBP (mmHg) 72.44 10.92 72.16 9.52*
RR(beats/min) 17.34 2.09 16.41 0.61***
Analysis done by Students paired t-test. *P<0.05, **P<0.01, ***P<0.001.
Table. 2 Changes in control group (n=30) after 12 weeks of study period
oncardio-respiratory parameters: heart rate (HR), systolic blood pressure (SBP),
diastolic blood pressure (DBP) and respiratory rate (RR). Values are expressed as
mean SD.
Parameters Before 12 weeks study period After 12 weeks study period
HR (beats/min) 86.33 9.65 87.47 7.78*
SBP (mmHg) 107.23 13.55
111.4 11.24**
DBP (mmHg) 71.45 6.791
73.73 9.239*
RR(beats/min) 17.23 1.22 18.33 1.81*
Analysis done by Students paired t-test. *P<0.05, **P<0.01, ***P<0.001.


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DISCUSSION
Pranayama involves manipulation of breath movement and the breath is a
dynamic bridge between the body and mind. The psychosomatic effects of
different pranayama are believed to derive from differences in duration of the
phases of the breathing cycle, tidal volume and other factors including the use of
mouth, nostrils, and constriction of the laryngeal muscles and position of the
glottis
(6)
. Resting HR is determined mainly by parasympathetic tone and
decrease in HR and BP indicates a decrease in sympathetic activity and / or
increase in parasympathetic activity
(7,8)
. Our results demonstrate that there was a
significant reduction in RR in pranayama group. On the contrary, there was a
significant increase in RR in the control group. There was statistically
insignificant, but definite trend towards decrease in HR, SBP and DBP in the
pranayama group. According to the traditional wisdom of yoga, pranayama is the
key for bringing about psychosomatic integration and harmony. By voluntarily
controlling breathing pattern, it is possible to influence ANS functions
(9)
. Very
few references are available on the effect of fast pranayama training on cardio-
respiratory parameters in individuals. Our results are in agreement with that of
Raghu raj et al in 1998 found practicing fast pranayama like Kapalabhati for 12
weeks lead to decrease in sympathetic activity and are not in agreement with
observations of few other studies. Madanmohan et al in 2005 evaluated short-
term effect of three weeks of fast pranayama (bhastrika) practice on cardio-
respiratory variables and reported an increase in sympathetic activity whereas Pal
et al in 2004 found no change in autonomic activity by the practice of 12 weeks
of Kapalabhati pranayama
(10,11)
. Another study conducted by Kullok et al in
1990 explained changes in autonomic activity by breathing exercises on the basis
of known anatomical asymmetries in the respiratory, cardiovascular and nervous
system and that the coupling mechanisms between each of these systems: lung-
heart, heart-brain and lungs-brain are also asymmetrical
(13)
. We propose that
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these changes may have occurred by pranayama practice due to improved
autonomic tone towards parasympathodominance resulting in hypo metabolic
state, relaxed state of mind and improved cardiac vagal tone. When the mind is
relaxed and resting, parasympathetic activity increases and RR decreases.
Increase in parasympathetic activity decreases resting HR and decrease in
sympathetic tone in skeletal muscle, blood vessels, decreases peripheral vascular
resistance and hence, decrease in DBP and improved tissue perfusion. Further our
study substantiates the claim that Kapalabhati pranayama practice is beneficial on
cardio-respiratory function in healthy, volunteers.

CONCLUSION
12 weeks of Kapalabhati pranayama training showed improvement in the cardio-
respiratory parameters with significant decrease in RR may be attributed to a
calm and stable mind-emotion complex in our subjects. Hence we conclude that
pranayama training is useful in reducing RR through psycho-somatic
mechanisms and that this enhances the health and well being of young subjects.

ACKNOWLEDGEMENT
we acknowledge programme director, coordinator, yoga instructors of ACYTER,
J IPMER. Author would like to thank Professors, Assistant Professors, Ph. D,
scholars of Department of Physiology, J IPMER who helped us for the conduct of
this project.






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REFERENCES
1. Udupa K, Madanmohan, Ananda AB, Vijayalakshmi P, Krishnamoorthy N.
(2003) Effect of pranayama training on cardiac function in normal young
volunteers. Indian J Physiology Pharmacology volume 47: PP27-33.
2. Veerabhadrappa SG, Baljoshi VS, Khanapure S, Herur A, Patil S, Ankad RB,
Chinagudi SJ . (2011) .Effect of yogic bellows on cardiovascular autonomic
reactivity. Cardiovascular Diseases research journal Volume ; 2(4): 223-27.
3. Udupa KN, Singh RH. (1972) The scientific basis of yoga. JAMA; volume
220(10): PP1365
4. Wallace RK, Benson H, Wilson AF. A wakeful hypo metabolic physiologic
state.( 1971) American J Physiology; volume 221(3): 795-99.
5. Bhargava R, Gogate MG, Mascarenhas J F. (1988 )Autonomic responses to
breath holding and its variations following pranayama. Indian J Physiology
Pharmacol; volume 32(4): PP 257-64.
6. Telles, Desiraju T. Heart rate alterations in different types of pranayama. (1992)
Indian J PhysiologyPharmacology; volume 36(4): PP 287-88.
7. Gopal KS, Bhatnagar OP, Subramanian N, Nishith SD. (1973); Effect of
yogasanas and pranayama on BP,pulse rate and some respiratory functions.
IndianJ Physiology Pharmacology volume17: PP 27376.
8. Upadhyay DK, Malhotra V, Sarkar D, (2008) Prajapati R. Effect of alternate
nostril breathing exercise on cardio respiratory functions. Nepal Med Coll J;
volume10(1): PP 25-27.
9. J erath R, Edry J W, Branes VA, J erath V. (2006) Physiology of long
pranayama breathing: Neural respiratory elements may provide a mechanism
that explains how slow deep breathing shifts the autonomic nervous system.
Med Hypotheses PP 67:5671.
10. Raghu raj P, Ramakrishna AG, Nagendra HR. (1998 )Effect of two related
yogic breathing techniques on heart rate variability. Indian J Physiology
Pharmacology volume; 42(4): PP 467-72.
11. Madanmohan, Udupa K, Bhavanani AB, Vijayalakshmi P, Surendiran A. (2005)
Effect of slow and fast pranayamas on reaction time and cardiorespiratory
variables. Indian J PhysiologyPharmacology volume; 49: PP 31318.
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12. Pal GK, Velkumary S, Madanmohan(2004). Effect of short- term practice of
breathing exercises on autonomic functions in normal human volunteers.
Indian J Med Research; volume 120:PP11521.
13. Kullok S, Maver C, Backon J , Kullok J . (1990 ) Interactions between non-
symmetric mechanical vector forces in the body and the autonomic nervous
system. Med Hypotheses; volume 32: PP17380.


Volume 2 Issue 9 1000144
Altern Integ Med
ISSN: 2327-5162 AIM, an open access journal
Open Access Research Article
Alternative & Integrative Medicine
Bhavanani et al., Altern Integ Med 2013, 2:9
http://dx.doi.org/10.4172/2327-5162.1000144
Keywords: Yoga therapy; Cardiovascular efects; Psycho-somatic
harmony
Introduction
Humanity is today faced with numerous debilitating chronic
illnesses related to aging, environment and an increasingly hedonistic
lifestyle. Tese illnesses include cancer, diabetes, osteoporosis, and
cardiovascular disease, as well as incurable diseases such as AIDS.
While modern medicine has much to ofer in its treatment of acute
illness, accidents and communicable diseases, it cannot provide all the
solutions for the many ills that plague 21
st
century (woman). Yoga, as
a complement to modern medicine, can be especially useful in helping
to fll in the gaps in the felds of disease prevention, management and
rehabilitation. When combined, modern medicine and yoga turn out to
be more than the sum of their parts. What is the source of this synergy
between modern and ancient science? While modern science looks
outward for the cause of all ills, the yogi searches the depths of their
own self, fnding therein many of the answers he needs to maintain a
vital equilibrium. Te combination of the outward and inward search
proves to be more efective than either alone.
Dr. Dean Ornish, the renowned American physician and author
who has shown that a yogic lifestyle can reverse heart disease, says,
Yoga is a system of perfect tools for achieving union as well as healing
[1]. Dr. B. Ramamurthy, the eminent neurosurgeon, has observed that
yoga practice reorients the functional hierarchy of the entire nervous
system [1]. He has also noted that yoga benefts the cardiovascular,
respiratory, digestive, and endocrine systems, in addition to bringing
about other positive biochemical changes. For humanity to take full
advantage of its birthright of health and happiness, it is imperative
that modern, science-based medicine integrate the holistic approach of
traditional healing techniques like yoga. Only in this way can medical
practitioners provide true health care, as opposed to merely caring for
the sick. Te result will be an improvement in the quality of health, and
life, around the world.
Numerous studies have been done in the past few decades on
psycho-physiological and biochemical changes occurring following
practice of yoga [2-9]. A few clinical trials have also shown promise
despite yoga not being ideally suited for the scientifc gold standard
of double-blind clinical trials [10,11] and though we are truly yet to
research and understand subtler efects of yoga [12]. Evidence is also
growing that yoga practice is a relatively low-risk, high-yield approach
to improving overall health and wellbeing [13]. It has been rightly
pointed out that yoga is qualitatively diferent from any other mode of
physical activity in that it consists of a unique combination of isometric
*Corresponding author: Ananda Balayogi Bhavanani, CYTER, Mahatma Gandhi
Medical College & Research Institute, Pillayarkuppam, Pondicherry 607402, India,
Tel: 91-413-2622902; E-mail: yognat@gmail.com
Received September 28, 2013; Accepted November 11, 2013; Published
November 13, 2013
Citation: Bhavanani AB, Ramanathan M, Madanmohan (2013) Immediate
Cardiovascular Effects of a Single Yoga Session in Different Conditions. Altern
Integ Med 2: 144. doi:10.4172/2327-5162.1000144
Copyright: 2013 Bhavanani AB, et al. This is an open-access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original author and source are credited.
Immediate Cardiovascular Effects of a Single Yoga Session in Different
Conditions
Ananda Balayogi Bhavanani
1
*, Meena Ramanathan
1
and Madanmohan
2
1
Centre for Yoga Therapy, Education and Research, Mahatma Gandhi Medical College & Research Institute, Pillayarkuppam, Pondicherry, India
2
Department of Physiology, Mahatma Gandhi Medical College & Research Institute, Pondicherry, India
Abstract
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 signifcant (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 signifcant in those
having hypertension (n=505) and less signifcant in those having endocrine/skin (n=230) and musculoskeletal
(n=120) conditions. It was moderately signifcant 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.
Citation: Bhavanani AB, Ramanathan M, Madanmohan (2013) Immediate Cardiovascular Effects of a Single Yoga Session in Different Conditions.
Altern Integ Med 2: 144. doi:10.4172/2327-5162.1000144
Page 2 of 4
Volume 2 Issue 9 1000144
Altern Integ Med
ISSN: 2327-5162 AIM, an open access journal
muscular contractions, stretching exercises, relaxation techniques, and
breathing exercises [14].
Tere are only a few studies that have focused on the immediate
efects of a single yoga session and these include one that investigated
the efectiveness of a single 90-minute hatha yoga class and concluded
that it can signifcantly reduce perceived stress [15]. Another recent
study showed that cognitive performance afer a yoga session was
signifcantly superior as compared with an aerobic session [16]. A
recent report on the acute efects of one session of hatha yoga practice
on blood pressure and other cardiovascular responses in healthy
volunteers has showed that systolic (SP), mean (MP), and diastolic
(DP) blood pressures increased signifcantly during the yoga practice
[14]. However they have not compared the pre-post efects of the
entire session and only focused on the individual techniques during
the session.
With the above in mind, this retrospective review of data was done
to determine cardiovascular efects of a single 60-minute yoga session
in normal subjects as well as patients of diferent medical conditions.
Materials and Methods
Tis retrospective review of clinical data was conducted at the Center
for Yoga Terapy Education and Research (CYTER) functioning in
Mahatma Gandhi Medical College and Research Institute, Puducherry,
India. CYTER is conducting regular yoga therapy sessions daily for
patients of diferent conditions as well as normal subjects. 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.
Tese sessions were carried out in CYTER Yoga hall between 10 AM
and 12 noon on weekdays in a quiet environment, with a comfortable
temperature and subdued lighting. Te participants had been advised
to fnish their breakfast at least 2 hours earlier and come afer emptying
bowel and bladder.
Heart rate (HR), SP and DP had been recorded before and afer the
60 minute yoga sessions at CYTER. To ensure objectivity, all recordings
were performed using non-invasive semi-automatic BP monitor (CH-
432, Citizen Systems, Tokyo, Japan) with an instrumental accuracy of
5% for HR and 3 mm Hg for BP. Pre intervention HR and BP
was recorded afer 5 min of supine rest while the post-intervention
recordings were taken at the end of the session in supine position.
Cardiovascular indices like pulse pressure (PP), MP, rate-pressure
product (RPP) and double product (DoP) were derived from the
recorded parameters.
Te participants were undergoing appropriate yoga therapy
protocols as per their individual condition (Table 1) while normal
Yogic technique Normal
subjects
Endocrine and
skin disorders
Respiratory
disorders
Hypertension &
CV disorders
Musculo-skeletal
disorders
Psychiatric
disorders
Jathis & kriyas (loosening techniques)
Aruna surya namaskar (slow, breath coordinated)
Standing asanas
Trikona asana
Veera asana 1 & 2
Tada asana
Ardhakati & kati chakra asana
Mehru asana & nasarga mukha bhastrika
Ardha utkat asana
Sitting asanas
Vakra asana
Paschimottana/purvottana asana
Matsya asana
Chatuspada kriya/vyagraha pranayama
Danda kriya
Ashwini mudra/moola bandha
Face prone asanas
Bhujanga asana/ bhujangini mudra
Ardha shalaba asana
Makara asana
Supine asanas
Pawanamukta series
Pada uttana series
Sethu kriya
Relaxation
Savitri pranayama in shava asana
Marmanasthanam/kaya kriya
Pranayamas
Mukha bhastrika
Chandra nadi/bhedana
Surya nadi/bhedana
Pranava
Bhramari
Nadi shuddhi
Table 1: Yoga therapy protocols adopted for different groups with minor individual variations as per their psycho-physical condition and abilities.
Citation: Bhavanani AB, Ramanathan M, Madanmohan (2013) Immediate Cardiovascular Effects of a Single Yoga Session in Different Conditions.
Altern Integ Med 2: 144. doi:10.4172/2327-5162.1000144
Page 3 of 4
Volume 2 Issue 9 1000144
Altern Integ Med
ISSN: 2327-5162 AIM, an open access journal
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.
At our centre, we are using the yoga therapy methods and schedules
as elucidated in Yoga Chikitsa: Te Application of Yoga as a Terapy
authored by Yogacharya Dr. Ananda Balayogi Bhavanani, published by
Dhivyananda Creations, Pondicherry, India 2013.
Data were assessed for normality using GraphPad InStat version
3.06 for Windows 95, (GraphPad Sofware, San Diego California
USA, www.graphpad.com). As all data passed normality testing by
Kolmogorov-Smirnov Test, statistical analysis was carried out using
Students paired t test and p values less than 0.05 were accepted as
indicating signifcant diferences for pre-post comparisons (Tables 1
and 2).
Results
Te results are given in Tables 2 and 3. Tere were statistically
signifcant (p<0.001) reductions in all the studied cardiovascular
parameters following the yoga session in the overall analysis. Te
magnitude of reductions difered in the groups, it being more
signifcant in those having hypertension (n=505) and less signifcant
in those having endocrine/skin (n=230) and musculoskeletal (n=120)
conditions. It was moderately signifcant in the normal subjects
(n=582) as well as patients having psychiatric (n=302) and respiratory
(n=157) conditions.
Discussion
Tere is a healthy reduction in HR, BP and derived cardiovascular
indices following a single yoga therapy session. Te magnitude of this
reduction appears to depend on the pre-existing medical condition as
well as the yoga therapy protocol adopted.
Reductions in various cardiovascular parameters following a
single session of yoga implies better autonomic regulation of the heart
in our subjects. Tis can be attributed to either an overall increase of
parasympathetic tone and/or a reduction in sympathetic tone. RPP and
Do P are indirect indicators of myocardial O
2
consumption and load on
the heart, thereby signifying a lowering of strain on the heart [17,18].
Sympathetic activation is known to increase HR and RPP and decrease
overall heart rate variability (HRV). RPP provides a simple measure of
HRV in hypertensive patients and is a surrogate marker in situations
where HRV analysis is not available [19]. It has also been shown that
SDNN and total power of HRV are inversely correlated with mean HR
and RPP [17].
Groups HR SP DP
B A B A B A
Normal subjects
(n=582)
79.93 8.33 77.14 7.40*** 115.35 10.42 114.45 9.36* 74.37 9.46 73.48 7.11*
Endocrine/skin
(n=230)
80.05 9.46 78.06 8.54*** 111.65 10.64 112.51 10.04 70.77 9.00 71.88 7.40 *
Respiratory
(n=157)
78.55 7.76 76.36 6.35 ** 112.32 6.75 111.18 5.57* 72.94 6.52 72.79 5.97
Hypertension
(n=505)
78.50 7.38 75.84 6.71*** 129.04 14.65 124.98 11.35*** 80.59 9.96 79.10 8.39***
Musculo-skeletal
(n=120)
77.78 7.25 75.80 6.49 * 112.98 12.14 112.03 9.13 72.59 9.12 73.30 7.31
Psychiatry
(n=302)
81.53 9.81 78.66 9.06 *** 115.06 11.54 112.86 10.56 *** 74.01 9.18 73.50 8.02
Total
(n=1896)
79.55 8.44 77.00 7.61*** 118.13 13.58 116.39 11.29 *** 75.3 9.85 74.76 8.04 ***
*p<0.05
**p<0.01
***p<0.001 by Students paired t test of pre-post comparisons.
Table 2: Heart rate (HR), systolic pressure (SP) and diastolic pressure (DP) before (B) and after (A) a single session of yoga therapy in different groups.
Groups PP MP RPP DoP
B A B A B A B A
Normal subjects
(n=582)
40.98 9.70 40.97 8.03 88.03 8.66 87.14 6.97** 92.23 13.11 88.37 11.84*** 70.43 10.77 67.32 9.18***
Endocrine/skin
(n=230)
40.88 7.94 40.63 8.16 84.39 8.82 85.42 7.44 * 89.25 12.98 87.90 13.04 67.47 10.22 66.74 9.77
Respiratory
(n=157)
39.38 7.32 38.39 5.84 86.07 5.62 85.59 5.15 88.33 11.12 84.91 8.46** 67.67 8.46 65.33 6.49**
Hypertension
(n=505)
48.45 12.46 45.88 10.59*** 96.74 10.6 94.39 8.06*** 101.59 17.08 94.91 12.99*** 76.19 12.55 71.71 9.80***
Musculo-skeletal
(n=120)
40.39 9.77 38.73 6.28* 86.06 9.13 86.21 7.39 87.99 13.34 85.00 10.76* 67.08 10.18 65.43 8.57*
Psychiatry
(n=302)
41.05 7.70 39.36 8.65** 87.69 9.35 86.62 7.96** 93.90 15.33 88.82 13.53*** 71.55 11.92 68.16 10.22***
Total
(n=1896)
42.83 10.50 41.63 9.08*** 89.58 10.8 88.63 8.20*** 94.03 15.28 89.66 12.76*** 71.33 11.64 68.30 9.63***
*p<0.05
**p<0.01
***p<0.001 by Students paired t test of pre-post comparisons.
Table 3: Pulse pressure (PP), mean pressure (MP), rate-pressure product (RPP) and double product (DoP) before (B) and after (A) a single session of yoga therapy in
different groups.
Citation: Bhavanani AB, Ramanathan M, Madanmohan (2013) Immediate Cardiovascular Effects of a Single Yoga Session in Different Conditions.
Altern Integ Med 2: 144. doi:10.4172/2327-5162.1000144
Page 4 of 4
Volume 2 Issue 9 1000144
Altern Integ Med
ISSN: 2327-5162 AIM, an open access journal
A previous report on the acute efects of one session of hatha yoga
practice on blood pressure and other cardiovascular responses in
healthy volunteers showed that SP, MP and DP increased signifcantly
during the yoga practice [14]. Te elevation in blood pressure due to
yoga practice was associated with increases in cardiac output and HR,
which are responses similar to those observed in isometric exercise.
However it is to be noted that for each posture during the yoga practice,
that study continuously measured HR, SP, DP, MP, stroke volume, and
cardiac output. On the other hand we have only evaluated the pre-post
efects and hence are commenting on the overall efects of the yoga
sessions rather than individual practices. Te conscious self-efort
made in asana practice may be understood as the spanda (tension)
component whereas the relaxation of efort (prayatna shaithilya)
may be understood as the nishpanda (relaxation) component. Even
Maharishi Patanjali tells us that the pair of opposites (dwandwa) is
transcended (dwandanabigata) when one perfects the state of asana.
Hence, it is essential to physiologically evaluate not only the actual
performance of an asana, but also the period of recovery following it.
A study by Telles et al. [20] studied O
2
consumption and respiration
following four yoga postures interspersed with relaxation and supine
relaxation alone, and concluded that the combination of stimulating
and relaxing techniques reduced physiological arousal better than the
mere practice of relaxation techniques alone [20]. Tey also pointed
out that though the practical performance of yoga techniques seem
to be stimulatory in nature, their physiological efects are in fact
more relaxatory. Tis is corroborated by a previous study reporting
that shavasana relaxation is enhanced with the addition of savitri
pranayama thus decreasing O
2
consumption by 26% [21].
All the yoga therapy protocols adopted at CYTER have a major
component of pranayama and yogic relaxation. We hypothesize that
this may be the main factor that is producing cardiac autonomic balance
in most of our subjects irrespective of their initial condition. We also
noticed that the reductions were greater in those who had abnormal
readings in the initial testing as opposed to those in whom the initial
readings were within normal range. It is traditionally taught that yoga
is the state of balance (samatvam yoga uchyate-Bhagavad Gita) and this
restoration of physical, mental, emotional and spiritual balance may be
the prime factor behind the changes seen across groups.
Te above fndings of our retrospective data analysis are in
agreement with a previous suggestion that yoga appears to modulate
stress response systems by reducing perceived stress and anxiety, which
in turn, decreases physiological arousal with decreases in HR and BP
and respiration [13].
Conclusion
Tere is a healthy reduction in HR, BP and derived cardiovascular
indices following a single yoga session. Te magnitude of this
reduction depends on the pre-existing medical condition as well as
the yoga therapy protocol adopted. Tese 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.
Acknowledgments
The authors thank the management and authorities of Sri Balaji Vidyapeeth
University for setting up the Centre for Yoga Therapy, Education and Research
(CYTER) in Mahatma Gandhi Medical College and Research Institute (MGMCRI).
We are grateful to Yogacharini Meenakshi Devi Bhavanani, Director ICYER for her
constant motivation and supportive guidance. Thanks are due to Yoga instructors
Mrs D Pushpa and Dr. R Balaji for conducting the therapy sessions and for their
valuable assistance during recording sessions and data entry.
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on executive function. J Phys Act Health 10: 488-495.
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Citation: Bhavanani AB, Ramanathan M, Madanmohan (2013) Immediate Cardiovascular
Effects of a Single Yoga Session in Different Conditions. Altern Integ Med 2: 144.
doi:10.4172/2327-5162.1000144
Int. Res J Pharm. App Sci., 2013; 3(6):17-23 ISSN: 2277-4149

Bhavanani AB et al., 2013 17

International Research Journal of Pharmaceutical and Applied
Sciences (IRJPAS)
Available online at www.irjpas.com
Int. Res J Pharm. App Sci., 2013; 3(6):17-23



HEMATOLOGICAL, BIOCHEMICAL AND PSYCHOLOGICAL EFFECTS OF A YOGA
TRAINING PROGRAMME IN NURSING STUDENTS
Ananda Balayogi Bhavanani
1*
, Meena Ramanathan
2
, Madanmohan
3
, Srinivasan Ar
4

1
Deputy Director, CYTER, MGMCRI, Pillayarkuppam, Pondicherry 607402.
2
Co-ordinator and Yoga therapist, CYTER, MGMCRI, Pondicherry.
3
Professor and Head, Department of Physiology, MGMCRI, Pondicherry.
4
Professor, Department of Biochemistry, MGMCRI and Registrar, Sri Balaji Vidyapeeth University, Pondicherry.

Corresponding Author: Ananda Balayogi Bhavanani; Email: yognat@gmail.com
Abstract: Background: We were granted the opportunity to impart a 6 month comprehensive course of yoga training for
nursing students. The aim of this study was to analyse the effects of the training on the participants health and quality of life
(QoL) Materials and Methods: 60 healthy nursing students (12 M, 48 F) aged 18.60 0.67 (SD) y were recruited, and 60 min of
yoga training was given twice weekly, for 6 months. Selected biochemical and hematological parameters were recorded along
with Ferrans and Powers QoL index before and after the training period. QoL was also tested at mid term. Because we were not
able to establish a separate control group, we correlated changes with the subjects frequency of attendance.Results: Post-
intervention statistical analysis (repeated measures of ANOVA) revealed highly significant and beneficial changes in most
hematological and biochemical parameters. Major findings are enhanced bone marrow function, reduced allergic tendency,
alkalization of urine, metabolic reconditioning (with special emphasis on liver function) and improvement in all QoL indices.
These changes correlated positively with the subjects frequency of attendance, as evidenced by Pearsons linear correlation
testing. There were also significant improvements in QoL index and its subscales, both at mid training and post training. These
improvements also correlated positively with attendance. Conclusion: The present study provides evidence of the beneficial
psychological and physical effects of yoga training amongst graduate nursing course students . We suggest that yoga be made an
integral part of medical and paramedical collegiate education.
Key words: psycho-physical health, quality of life, yoga

INTRODUCTION
Holistic health, integrative treatment and mind
body medicine are some of the current buzz words in health
care. Integrative medicine is gaining in popularity and, here,
yoga has the potential to make a significant contribution.
The art and science of yoga has been practised for thousands
of years. Recently, numerous scientists have studied its
effects and reported consistent, beneficial physiological and
psychological changes.
(1-10)
Yoga may be considered the
original mind-body medicine; its philosophy and practice
are highly effective in producing psycho-somatic and
somato-psychic re-integration. Yoga improves mood and
reduces stress by emphasizing every-moment body
awareness involving attentional focus on ones breathing,
emotions, thoughts or specific parts of the body.
(11)
These
responses may be mediated by frontal lobe structures, whose
physiological markers, such as reaction time, have shown
improvement in short-term and long-term yoga training
programmes.
(1,5,10)

Practitioners of yoga claim that it provides one of
the best means for self-improvement and enables the
manifestation of ones highest physical, mental, emotional
and spiritual potential.

Such improvements in mental and
emotional well-being enhance ones ability to manage
stress. This has been documented in normal volunteers and
patients suffering from lifestyle disorders.
(12,13)
It has been
suggested that yoga enhances mood, balances emotions and
modulates activity of hypothalomo-pituitary-adrenal (HPA)
axis.
(3,4,14)

)
It reduces allostatic load in stress response
systems, restoring optimal homeostasis by normalizing
parasympathetic nervous system and GABA under-
activity.
(15)
Another

recent study detailed the
psychophysiological benefits of Yoga training in a
paramedical student population, reporting improvements in
anthropometric, cardiovascular and neurological parameters,
coupled with positive changes in heart rate variability
(HRV) and Quality of Life (QoL) indices, signifying a
healthier state of body and mind.
(16)


Authorities of Kasturba Gandhi Nursing College
requested the authors to impart yoga training to students
enrolled in their Bachelor of Nursing course. This
opportunity was used to study hematological, biochemical
and QoL indices, in order to help students understand the
effects of their yoga training and to scientifically validate
those effects.

MATERIALS AND METHODS
Sixty apparently healthy nursing students (12 M, 48 F),
aged 18.60 0.67 (SD) years, who were novices to yoga
took part in the present study after granting informed
Research Article
Int. Res J Pharm. App Sci., 2013; 3(6):17-23 ISSN: 2277-4149

Bhavanani AB et al., 2013 18

consent. Because yoga training was part of their co-
curricular activity, we devised a 6-month comprehensive
training programme. The programme was delivered in
twice-weekly, 60 min sessions and included the following
components:
1. Brief theory of yoga and its practices and their
benefits.
2. Jathis (loosening practices) and kriyas (breath-
body coordination practices).
3. Surya namaskar (sun salutation) with breath
awareness.
4. Yogasanas (postures): trikona (triangle), nataraja
(cosmic dancer), veeraI, II & III (warrior), vriksha
(tree), pashchimottana (posterior stretch),
purvottana (anterior stretch), chatushpada (four
footed), ushtra (camel), matsya (fish), janushirasa
(head to knee), vakra (twist), ardhamatsyendra
(half twist), makara (crocodile), bhujanga (cobra),
shalabha (locust), dhanura (bow), pada-uttana (leg
lift), pavana mukta (wind releasing), viparitakarani
(topsy-turvy), hala (plough), sarvanga (pan limb)
and shava (corpse) asanas.
5. Pranayamas (breathing techniques): mukha
bhastrika (oral bellows), vyagraha (tiger), surya
nadi (sun channel), chandra nadi (moon channel),
pranava (AUM chanting breath), nadishuddhi
(alternate nostril-I), aloma viloma (alternate nostril-
II) and sadanta pranayamas (cooling breath).
6. Relaxation: shavasana with savitri pranayama (2:1
ratio breathing in corpse posture), kayakriya
(dynamic body relaxation), marmanasthanam kriya
(sequential relaxation) and yoga nidra (yogic
sleep).

The following hematological and biochemical
parameters were tested by qualified technicians in the
Central Laboratory of the hospital before and after the 6
month training period:
1. Total and differential leucocyte (WBC) counts,
ESR at and 1hr, erythrocyte (RBC) count,
platelet count, hemoglobin (Hb) and hematological
indices.
2. Urine pH.
3. Random blood sugar, urea, creatinine, total
cholesterol (TC), triacylglycerols (TG), high
density lipoprotein (HDL), low density lipoprotein
(LDL), very low density lipoprotein (VLDL ) and
ratios calculated for TC / HDL, TC / LDL, HDL /
LDL, LDL / HDL.
4. Blood electrolytes: sodium, potassium and
chloride.
5. Liver function test (LFT): total protein, albumin,
globulin, AG ratio, bilurubin (direct), SGOT,
SGPT and alkaline phosphatase.

The Ferrans and Powers QoL Index: Generic III version
was used to evaluate total QoL Score.
(16)
The QoL was
tested before training, at mid-term (3 months) and after
completion of training (6 months). Part I (33 questions)
evaluated the subjects satisfaction with different aspects of
life and Part II (33 questions) evaluated the importance of
those aspects in the subjects life.
1. The health and functioning subscale was evaluated
by 13 questions dealing with health, pain, worries
etc
2. The social and economic subscale was evaluated by
8 questions dealing with friends, neighborhood,
education etc.
3. The psychological and spiritual subscale was
evaluated by 7 questions dealing with peace of
mind, faith in god, happiness etc.
4. The family subscale was evaluated by 5 questions
dealing with family health, family happiness and
emotional support from family etc.

Statistical analysis of pre and post intervention data was
done using GraphPad InStat version 3.06 for Windows 95
(GraphPad Software, San Diego California USA,
www.graphpad.com). All data passed normality testing by
Kolmogorov-Smirnov Test and, hence, was analyzed using
Students t test for paired data. Repeated measures ANOVA
with Tukey-Kramer Multiple Comparisons testing was
applied for QoL indices comparing pre, mid and post
changes. Percent changes (%) were tested for correlation
with attendance in training sessions using Pearsons
correlation coefficient. P values less than 0.05 were
accepted as indicating significant differences between pre
and post intervention data.


RESULTS
The results are given in Tables 1-5. Post-
intervention statistical analysis revealed a highly significant
and beneficial change in all parameters that correlated
positively with attendance of the subjects.

There was a highly significant (p< 0.001) increase
in total WBC, RBC and platelet count, urine pH, TC, HDL,
HDL/LDL and chloride levels and a decrease in eosinophils,
monocytes, creatinine, LDL, TC/HDL and LDL/HDL. The
Neutrophils and AG ratio increased significantly (p<0.01)
with a concurrent significant increase (p<0.05) in basophils,
urea, sodium, albumin and bilurubin.

There was a significant improvement in QoL for
both mid-training (3 months) and post-training (6 months)
comparisons, and this correlated positively (p< 0.001 to p<
0.05) with the attendance of the subjects. The improvements
of QoL were highly significant (p <0.001) for pre-mid and
pre-post comparisons. It was highly significant (p< 0.001)
for pre-mid comparisons of health function and psycho-
spiritual as well as for pre-post of socio-economic subscales.
The improvement was significant (p< 0.01) for pre-post of
health function, psycho-spiritual and family subscales and
for pre-mid comparison of family subscale. It was p< 0.05
for pre-mid comparisons in socio-economic subscale.

There were insignificant changes in the other
parameters like random blood sugar, potassium, total
protein, globulin, SGOT, SGPT, alkaline phosphatase,
basophils, monocytes, urea, keratinize, ESR and RBC
indices like PCV, MCV, MCH and MCHC.

DISCUSSION
Int. Res J Pharm. App Sci., 2013; 3(6):17-23 ISSN: 2277-4149

Bhavanani AB et al., 2013 19

The improvement in the hematological,
biochemical and psychological profiles of our subjects may
be attributed primarily to yoga training, since these changes
were significantly correlated to the frequency of their
attendance. Since yoga training was part of the curriculum
of our host institute, it was not possible to establish a
separate control group. To overcome this limitation, we
correlated changes in all parameters with attendance, and a
majority of them were significantly positive. This
strengthens the direct correlation between the observed
changes and yoga training, and, rules out the possibility that
these were due to other normal, extraneous or growth-
related factors such as nutrition or other forms of physical
activity training.

Hematological and biochemical parameters: Hb
and blood components (WBC, RBC and platelets) showed
significant increases that were positively correlated to the
students frequency of attendance in classes (Table 1). We
hypothesize that this may be attributed to either asanas
exercising limbs or pranayamas stimulating erythropoiesis,
or both. Our hypothesis is based on the fact that a natural
response to hypoxia (which can occur during aerobic
exercise or changes in altitude) is endogenous erythropoietin
(eEpo) synthesis, which stimulates erythropoiesis.
(17)
An
earlier report by Malshe has suggested that benefits of
pranayama may be due to daily self-administered brief,
intermittent hypoxia causing release of eEpo and Vascular
Endothelial Growth Factor (VEGF), thus offering a
multitude of benefits in health and a variety of disease
conditions.
(18 )
Our hypothesis is also supported by another
recent study that reported

rapid gene expression changes in
peripheral blood lymphocytes upon practice of a
comprehensive yoga program.
(19 )
They speculated that the
increased expression of Nuclear Factor Erythroid 2 (NFE2)
induced by the yoga program may have favorable effects on
megakaryocyte maturation and platelet production.

The increase in leukocyte count signifies an
improvement in immune function, since these cells play a
crucial role in inflammatory processes and in defending
against pathogens. In this context, the insignificant rise of
ESR in our subjects does not indicate an inflammatory
event, but suggests that ESR is playing the role of
modulator, as proposed by Carranquea.
(20)
Carranquea also
proposed that this rise is due to the metabolic activity of
blood cells and is a consequence of a reduction in oxidation
processes due to yogas anti-stress effect and the release of
free radicals at the erythrocyte level. As oxidative activity
has a complex duality in terms of benefit, this facet needs to
be explored further before definite conclusions can be made.

The decrease in eosinophils is evidence of a
reduction in allergic tendencies. This provides a scientific
basis for using yoga in allergic conditions where
eosinophilia is implicated. Erythrocytes contain hemoglobin,
which is involved in the transport of oxygen from the lungs
to the tissues and in the buffering of hydrogen ions. Hence,
the increase in RBC and Hb is evidence of the health-
promoting aspects of yoga even at the cellular level. Such
changes are further seen in the significant rise of platelets or
thrombocytes, which provide the first hemostatic plug
following tissue injury. The biochemical changes in urea
and bilurubin levels indicate increased cellular metabolism
with a resultant increase in cellular waste products for
excretion (Tables 2 and 3). The alkalization of urine (Table
2) is a positive sign, as medical management of urinary tract
infections and calculi usually aims to promote alkalization
of urine. The post yoga decreases in the number of pus cells
and epithelial cells in the urine also indicates a healthier
urinary tract and excretory system.

The lipid profile showed a healthy response, with
an increase in HDL and decreases in LDL and VLDL (Table
2). All cholesterol ratios also showed positive changes
including total cholesterol whose increase (within normal
levels) may be attributed to the significant increase in HDL.
Normally, the safe TC/HDL ratio is less than 4. It was
initially 4.57 0.83 in our subjects, but decreased to a safe
level of 3.88 0.87 following the training programme.
Similarly, a healthy LDL/HDL ratio is less than 3. Although
the initial pre-training level in our subjects was a higher
normal value (2.95 0.86), it also fell to a lower normal
value (2.25 0.80). The HDL/LDL ratio should normally be
more than 0.3, but it is preferable to maintain it above 0.4.
This ratio also increased from a lower normal value of 0.37
0.15 to a higher normal value of 0.49 0.19, implying a
better prognosis for cardiovascular health. HDL, or good
cholesterol, is involved in transporting cholesterol from
tissues to the liver. Its increased presence, along with
positive changes in all cholesterol ratios, is a sign of the
anti-atherogenic effects of yoga. A similar conclusion is also
found in the review by Innes
(7,8)
and in recent reports on
healthy volunteers and patients of hypertension and diabetes
mellitus.
(21, 22, 23)
.


The TG/HDL ratio decreased significantly from
2.60 0.53 to 2.050.60, a healthy fall of more than 20%.
This finding has positive prognosis as the TG/HDL ratio is
an indicator of insulin resistance and a ratio > or =3.5 has
been reported to provide a simple means of identifying
insulin-resistant, dyslipidemic patients, likely to be at
increased risk of cardiovascular disease.
(24)
Five of our
subjects had initial values more than 3.5 and 6 had values
more than 3. All of them except for one had reductions in
the ratio on post training analysis. This implies a possible
breakdown of insulin resistance that is of great health
enhancing value in the prevention and management of
metabolic conditions such as diabetes and the syndrome X.


The increase in bilurubin in our subjects correlates
positively with their attendance. Bilurubin is a major
intravascular product of heme catabolism and is a potent
antioxidant. A preliminary meta-analytic study
demonstrated an unambiguous, inverse relationship between
serum bilurubin levels and atherosclerosis, thus indicating
its preventive potential in oxidative, stress-mediated
diseases.
(25)
In fact it was recently stated in the editorial of a
research topic forum that bilurubin is now recognized as an
endogenous cytoprotective compound at low
(physiological) concentrations.
(26)
Hence, its increase
within normal limits in the present study may be interpreted
Int. Res J Pharm. App Sci., 2013; 3(6):17-23 ISSN: 2277-4149

Bhavanani AB et al., 2013 20

as a physiological change that indicates the health-
promoting effects of yoga.

These health-promoting changes in our subjects
may be attributed to improved metabolic activity due to the
regular practice of yoga techniques. These techniques have
been reported to help yoga practitioners attain ideal body
weight and improve their cardiovascular endurance and
anaerobic power.
(27)
Innes and Vincent have suggested that
Yoga reduces the cardiovascular risk profile by decreasing
activation of the sympatho-adrenal system and
hypothalamic-pituitary-adrenal axis and by promoting a
feeling of well-being, along with direct enhancement of
parasympathetic activity via the vagus nerve.
(8)


Quality of life index scores: There was a significant
improvement in QoL both at mid training (3 months) and
post training (6 months), and this correlated positively with
attendance in the yoga sessions (Tables 4 and 5).
Improvements appeared in all subscales, including the
health function, psycho-spiritual, family and socio-economic
categories. Our findings are in line with those of Sharma and
Michelson, who reported that a short lifestyle modification
and stress management educational programme leads to
remarkable improvement in subjective well-being scores.
Such interventions can therefore make an appreciable
contribution to both primary prevention and management of
lifestyle diseases.
(13, 28)
This is supported by

Innes and
Vincent, who suggest that yoga-based training programmes
provide a source of social support that may be a factor in
reducing risk for cardiovascular diseases.
(8)
According to
Madanmohan, 60 hour, comprehensive yoga training
programme for medical students at JIPMER showed
improvements in psychological well-being, as well as in the
subscales of anxiety, depressive mood, positive well-being,
self control, general health and vitality.
(29)
Another recent
study on yoga for paramedical students used the Ferrans and
Powers QoL index and reported improvements in total QoL
and positive changes in all subscales.
(16)
Although there
were 8-12% changes in % scores, these changes did not
reach statistical significance due to the smaller sample size
and shorter duration of training (3 months). Nevertheless,
our present study confirms those findings.

Our findings are similar to those of Malathi and
Damodaran, who reported decreased anxiety levels in
MBBS students following yoga training.
(12)
The authors also
reported improvements in their subjects sense of well-
being, their feeling of relaxation, and the quality of their
interpersonal relationships, as well as improved
concentration, efficiency, self-confidence and, attentiveness,
along with lowered irritability levels and a more optimistic
outlook on life. They concluded that yoga had reduced basal
anxiety levels and attenuated the increase in anxiety scores
in stressful states. They postulated that the decrease in
anxiety led to better adjustment adaptability towards
environmental and internal stressors, which thus enabled
participants to better and more calmly perform their routine
duties.

Harinath et al reported improvements in both
cardiorespiratory performance and psychological profile
after three months of yoga. These changes were
accompanied by increases in plasma melatonin.
(30)
A recent
review by Sengupta et al suggested that yoga triggers
neurohormonal mechanisms that reduce stress and anxiety
and acts as a psychophysiological stimulus to increase
endogenous secretion of melatonin. This, in turn, improves
the sense of well-being.
(4)
Another large-scale study in the
USA reported that mind-body interventions showed
significantly greater improvements on perceived stress,
sleep quality, and the heart rhythm coherence ratio of HRV.

(31)
Here, the authors concluded that both mindfulness-based
and therapeutic yoga programs may provide effective
interventions to target high stress levels, sleep disturbances,
and autonomic imbalances in employees. These results are
applicable to our study population, a group of nursing
students exposed to numerous stressors.

The potential benefits of the various practices in
our study may be hypothesized as follows: suryanamaskar
improves metabolic function and tones up the
musculoskeletal system; trikona, nataraja and veera asanas
evoke a sense of stability and balance both physically and
mentally; vakra, ardhamatsyendra, paschimottana,
pavanamukta, bhujanga and dhanura asanas, by virtue of
their twisting and compression-relaxation actions, may be
stimulating intra-abdominal organs such as the liver and
pancreas, resulting in improvements in hematological,
biochemical and lipid profiles; sarvangasana, halasana and
viparitakarani may be harmonizing psycho-neuro-endocrine
function, as reflected in the biochemical parameters; aloma
viloma, suryanadi and chandranadi pranayamas may be
normalizing emotional and autonomic balance; pranava and
savitri pranayama in shavasana may contribute toward a
sense of inner calmness, thus enhancing inherent
homeostatic mechanisms; and kaya kriya, marmanasthanam
kriya and yoga nidra create a sense of mind-body harmony
that facilitates psycho-somatic re-integration.

CONCLUSION
The present study substantiates the psychological
and physical benefits of yoga training. All the tested
parameters showed desirable changes and most were
statistically significant. The major findings are enhanced
bone marrow function, reduced allergic tendency,
alkalization of urine, metabolic reconditioning with special
emphasis on liver function and improved QoL indices. This
may be attributed to an improved functioning of the body-
mind complex, which is facilitated by breath-body
coordination in the yoga practices. On the basis of the
present study, we recommend that yoga be made an integral
part of medical and paramedical collegiate education.




Int. Res J Pharm. App Sci., 2013; 3(6):17-23 ISSN: 2277-4149

Bhavanani AB et al., 2013 21

Table 1. Hematological parameters before and after 6 months of yoga training.

Parameters are given as Mean SD for n subjects. * p < 0.05, ** p < 0.01 and *** p < 0.001 by paired t test between pre and
post training values. Correlation coefficient (r) and p values are given after applying Pearson linear correlation between pre-post
% with the respective attendance in the classes.

Table 2. Biochemical parameters before and after 6 months of yoga training.

Parameters are given as Mean SD for n subjects. * p < 0.05, ** p < 0.01 and *** p < 0.001 by paired t test between pre and
post training values. Correlation coefficient (r) and p values are given after applying Pearson linear correlation between pre-post
% with the respective attendance in the classes.









n Before After % r p
Total Count
(/ mm
3
)
58 6570.69
1478.38
7591.38
1395.01 ***
18.24
22.10
0.2853 0.03
Neutrophils
(%)
58 54.88
7.24
57.71
6.08 **
6.21
12.80
0.1362 0.3081
Lymphocytes
(%)
58 39.71
7.51
39.66
5.54
3.47
24.91
0.1011 0.4502
Eosinophils
(%)
57 4.61
2.63
2.26
1.84 ***
-47.53
36.65
0.401 0.0018
ESR -1/2hr
(mm)
57 6.79
4.33
7.56
2.92
33.05
60.16
0.01026 0.9391
ESR-1hr
(mm)
57 15.26
8.75
15.30
6.73
14.70
50.14
0.1089 0.4201
Erythrocytes( RBC)
(million/ mm
3
)
56 4.33
0.43
4.58
0.52***
5.83
7.64
0.2743 0.0372
Hemoglobin (Hb)
(gm %)
11.82
1.90
12.19
1.73***
3.58
5.75
0.3048 0.0200
Platelet
(lakhs/ mm
3
)
57 2.38
0.43
2.72
0.47***
16.41
21.62
0.3514 0.0068
n Before After % r p
Urine pH 57 6.18
0.24
6.42
0.35***
3.95
6.34
0.429 0.0008
Total cholesterol (TC)
(mg/dL)
53 147.96
28.08
154.87
31.27***
4.69
7.98
0.2846 0.0303
Triacylglycerols (TG)
(mg/dL)
53 83.87
21.02
80.94
22.52
-2.54
15.56
0.2376 0.0725
High density lipoprotein (HDL)
(mg/dL)
53 32.25
4.01
40.04
5.45***
24.91
16.50
0.5096 0.0001
Low density lipoprotein (LDL)
(mg/dL)
53 93.68
25.05
88.11
25.56***
-5.60
11.83
0.2652 0.0443
Very low density lipoprotein (VLDL)
(mg/dL)
53 17.68
4.52
16.55
4.54
-3.44
24.40
0.3396 0.0091
TG / HDL 53
2.60
0.53
2.05
0.60***
-20.84
15.83
0.4362 0.0011
TC / HDL 53 4.57
0.83
3.88
0.87***
-15.04
10.99
0.3801 0.0033
TC / LDL 53 1.64
0.56
1.84
0.68***
12.23
14.48
0.4385 0.0006
HDL / LDL 53 0.37
0.15
0.49
0.19***
34.85
27.88
0.4876 0.0001
Int. Res J Pharm. App Sci., 2013; 3(6):17-23 ISSN: 2277-4149

Bhavanani AB et al., 2013 22

Table 3. Liver function parameters before and after 6 months of yoga training.

Parameters are given as Mean SD for n subjects. * p < 0.05, ** p < 0.01 and *** p < 0.001 by paired t test between pre and
post training values. Correlation coefficient (r) and p values are given after applying Pearson linear correlation between pre-post
% with the respective attendance in the classes.

Table 4: Ferrans and Powers Quality of Life Index scores: pre, mid and post six months of yoga training.

pre mid post p value
Overall QoL 18.37 3.07 20.35 2.49 *** 20.13 2.30

< 0.0001
Health and function 18.54 3.60 21.17 2.96 *** 20.46 3.14

<0.0001
Socio-economic 19.29 3.71 20.65 3.47 * 21.54 2.90

0.0001
Psycho-spiritual 19.26 4.70 21.93 3.91 *** 21.51 3.12

<0.0001
Family subscale 19.29 5.87 21.66 4.34 ** 21.56 4.80

0.0024
Values given as mean SD for 60 subjects. P values are given for intergroup compassions done by repeated measures of ANOVA
with Tukey-Kramer Multiple Comparisons Test.
* = p < 0.05, ** = p < 0.01 and *** = p < 0.001 between pre and mid values.

= p < 0.01 and

= p < 0.001 between pre and post values.

Table 5: Correlation of various parameters of Ferrans and Powers QoL Index, with attendance of the subjects during pre-
post, pre-mid and mid-post periods of the six months yoga training.
Values given as mean SD for 60 subjects. Correlation coefficient (r) and p values are given after applying Pearson linear
correlation between pre-post, pre-mid and mid-post % with the respective attendance in the classes.

ACKNOWLEDGMENTS:
The authors thank the management of Sri Balaji
Vidyapeeth University for setting up the Centre for Yoga
Therapy, Education and Research (CYTER) in Mahatma
Gandhi Medical College and Research Institute (MGMCRI).
We are grateful to Yogacharini Meenakshi Devi Bhavanani,
n Before After % r p
Total Protein
(g/dL)
23 7.36
0.44
7.37
0.33
0.38
5.38
0.1906 0.1518
Albumin
(g/dL)
25 4.29
0.51
4.52
0.34*
6.51
14.76
0.4312 0.0007
Globulin
(g/dL)
22 3.08
0.43
2.90
0.38
-5.06
13.92
0.1058 0.4293
AG ratio 22 1.40
0.29
1.60
0.38**
16.73
30.40
0.3868 0.0027
Bilurubin total
(mg/dL)
24 0.82
0.42
0.91
0.43*
22.78
40.40
0.3371 0.0097
Parameter Comparison Attendance % r value p value
Overall QoL
pre-post 19.48 8.27 12.1119.87 0.4868 < 0.0001
pre-mid 11.90 5.59 13.53 22.18 0.5273 < 0.0001
mid-post 7.58 5.03 0.1015.29 0.5617 < 0.0001
Health and function
pre-post 19.48 8.27 14.7430.02 0.3936 0.0019
pre-mid 11.90 5.59 18.58 29.42 0.4019 0.0015
mid-post 7.58 5.03 -1.6920.02 0.5668 < 0.0001
Socio-economic
pre-post 19.48 8.27 15.4025.46 0.3778 0.0029
pre-mid 11.90 5.59 10.39 25.97 0.5143 < 0.0001
mid-post 7.58 5.03 6.6520.54 0.3312 0.0098
Psycho-spiritual
pre-post 19.48 8.27 17.9932.92 0.2582 0.0464
pre-mid 11.90 5.59 20.12 36.06 0.3992 0.0016
mid-post 7.58 5.03 1.6226.50 0.3935 0.0019
Family subscale
pre-post 19.48 8.27 27.9671.22 0.3149 0.0143
pre-mid 11.90 5.59 32.07 83.28 0.3998 0.0016
mid-post 7.58 5.03 1.3521.89 0.3412 0.0076
Int. Res J Pharm. App Sci., 2013; 3(6):17-23 ISSN: 2277-4149

Director ICYER for her constant motivation and
supportive guidance. Thanks are due to Yoga instructors
Miss D Pushpa and Dr. R Balaji for conducting the
training programme and for their valuable assistance
during recording sessions and data entry. For help in
improving the language of this paper, our thanks go to
Billy Uber of Baden-Baden, Germany.

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Bhavanani AB et al., 2013 23
Ann. SBV, July - Dec, 2013 2(2)
Page 7 Annals of SBV
Health for all by 2000 AD has remained a pipedream. And can we achieve health for all even by 3000 AD?
Unlikely. Unless we adopt an efective and integrative approach to the problem. Te present health scenario is dismal.
With increasing elderly population, the incidence of already prevalent chronic lifestyle disorders is on a steady rise.
Antibiotic resistance is staring us in the face. Expensive high-tech modern medicine is beyond the reach of even the
upper middle class. Public hospitals are over-crowded, under-stafed and fund-starved. Millions die of chronic diseases
while they are on life-long drug treatment. It is clear that allopathy does not have all the answers and there is an urgent
need to adopt an integrative and holistic approach to the problem. Tere are gems in alternative treatment modalities
which are simple, bio-eco-friendly and inexpensive. We need to shed our ego and get rid of holier-than-thou attitude.

Yoga can efectively augment modern medicine. Being holistic, it is ideal for integrated development of our body,
mind as well as soul. Mind, body and soul are intricately inter-related and mind-body dichotomy is at the root of our
problems and disease. Health as well as ill health have physical, mental-emotional as well as spiritual dimensions.
Elderly persons are more happy and healthy if spiritually active. However, spiritual domain has been outside the scope
of modern medicine. Yoga can efectively fll this lacuna. Yoga has promotive and preventive potential and can play
an important role before the disease manifests itself. Yoga has many advantages. Being non-pharmacological, it is free
from negative, harmful side efects of drugs. In contrast, it has positive, side benefts in terms of improvement of
psychosomatic health of the patient. Even if drugs have to be given along with yoga therapy, decrease in drug dosage will
bring down the cost of medicare & limit the side efects of drugs. Another advantage of yoga therapy is that treatment
of one disease is associated with simultaneous beneft in other diseases as well as improvement in quality of life. Yogic
relaxation and breathing techniques can be of immense value in pre-operative relaxation and post-operative recovery. It
is clear that inexpensive and holistic yoga therapy can be great boost to our health care delivery system.
Great ventures are bound to face great challenges. The principle of duality (dvand) is inherent in our world.
Change is always resisted due to uncertainty, even fear of unknown. We have to deal with status quo-ists who
lack motivation and love laziness. Who has time? Well meaning professionals are busy in administrative work or
private practice. The curriculum is already loaded, how to add new content? Another challenge is to identify and
exclude unscientific, untested and potentially harmful methods. Powerful drug companies have vested interest
in tutoring and pleasing physicians. They are quite smart in modulating even the research findings! The task is
stupendous, but worthy and achievable. We need to rope in competent, authentic and well meaning persons. We
need visionaries who are scientists by training and action-oriented karmayogis. Use of internet will make the
effort more effective, open and respectable. And Divine Grace will make the whole effort fruitful and enjoyable.
INTEGRATING YOGA AND MODERN MEDICINE : OPPORTUNITIES AND CHALLENGES
Madan Mohan *
*
* Prof. Madan Mohan ,Director, Center for Yoga Terapy,
Education and Research, Puducherry
Page 20
Ann. SBV, July - Dec, 2013 2(2)
Annals of SBV
Healthy lifestyle: a holistic view: Who does not want good health and long life ? However, there is no free lunch
and one has to earn it by living a disciplined and healthy lifestyle. Health is the best wealth, so says the samskrit verse
Labhanam shreshtham arogyam. If you possess good health, feel blessed, give thanks and preserve it at all costs. If
not, do your best to achieve it, at any cost since our body is a temple of the Divine (Deho devalayah) and the means for
performing all righteous deeds (Sharir madyam khalu dharm sadhanam). Vedic rishis have prayed for a full, enjoyable
and independent life not just for 100 years, but even beyond (AUM tachchakshur devahitam bhooyashch sharadah
shatat. Yajurved, 36: 14). Many warriors of Mahabharat war ( 3000 BC ) were of venerable age and the great warrior
Bhishma Pitamah was absolutely healthy and strong at 186 years. Te secret of their long and healthy life was disciplined
lifestyle in tune with the laws of Mother Nature. Tese universal Divine laws of nature are called as Rit in Vedic
language. Yog and ayurved which belong to the Vedic tradition are rooted in nature. In spite of spectacular advances
in medical science, modern man is a victim of a host of chronic health problems like hypertension, diabetes, chronic
pains and insomnia. Te primary cause of these problems is our artifcial lifestyle that is away from and against the laws
of nature.
What does being healthy mean? Health is difcult to defne, easy to appreciate and a joy to enjoy. Positive health
means perfect functioning of body and mind and ability to enjoy healthy life in its various dimensions. WHO defnition
of health is A state of complete physical, mental and social wellbeing and not merely an absence of disease or infrmity.
It is a condition or quality expressing adequate functioning of the organism in a given situation. To this defnition, WHO
has added spiritual wellbeing also. However, it is not clear what spirituality means. Spirituality should not be confused
with religion and this point has been discussed in the section on Spiritual Health and Healing: a Yogic Perspective.
Physiological approach to the question of health is in terms of measurable, objective values. A person is healthy if his
blood pressure, heart rate, body temperature, blood glucose and other parameters are within normal physiological range.
A healthy person is able to meet adequately the demands of his profession / work, i.e. as a teacher, a soldier or a farm hand.
In a healthy person, dynamically interacting homeostatic (regulatory) mechanisms of unimaginable complexity maintain
various body functions and parameters within normal physiological range. Tese mechanisms are less developed and
easily taxed in newborn (especially premature) babies and the elderly. In ayurved, the term for health is swasth, i.e. one
who is established and comfortable in his own being, a state of being whole and feeling whole. Acharya Sushrut (~ 600
BC) has given poetically beautiful and philosophically holistic defnition of health thus: Health is a state of balance of
elements, optimum digestion and elimination and happy senses, mind and soul (Samadoshah samagnishcha. Sushrut
Samhita, Sutrasthanam, 15:41).
Lifestyle is the way people live and this has immense infuence on the status of health or disease. Since ones lifestyle
is developed early in life, it is advisable to cultivate healthy lifestyle in early childhood. Many factors determine ones
lifestyle. Economic status determines incidence of under-nutrition in poor and obesity in the rich. Cultural values of
the society dictate the incidence of vegetarianism in the population. Sedentary life is a major factor for coronary artery
disease while personal habits like smoking and alcoholism determine the incidence of heart disease and cirrhosis of liver.
Exercise, healthy diet and rest and relaxation are important components of lifestyle. From the yogic point of view, proper
posture and brahmacharya are very important components of ones lifestyle. Yog is the most perfect lifestyle module as
it is comprehensive and holistic in its nature.
Yog for healthy lifestyle: Yog is a scientifcspiritual discipline and conscious evolution of our physical, mental and
spiritual aspects. Its ultimate aim is to become divine by achieving unity with the all- pervading Divine Consciousness.
According to Sri Aurobindo, All life is yog because yog is a philosophy that can be applied to everyday activities of our
daily life. Te ancient marvel of yog which is the most precious gem of our cultural heritage has been preserved despite
centuries of stagnation and suppression due to brutal foreign invasions. And now it is our duty to promote and propagate
YOG FOR HEALTHY LIFESTYLE
Madanmohan *
*
* Prof Madanmohan MBBS, MD (Physiology), PG Diploma in Yoga, MSc Yoga, DSc (Yoga), FIAY
CYTER, MGMCRI, Puducherry
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it for the beneft of entire humanity. Yog is holistic and its relevance is universal. It is the best means for improving
our health as well as preventing and managing stress and stress disorders which are unmanageable by our health care
delivery system.
According to materialistic view, we are essentially a body that has a mind. On the other hand, from the spiritual and
yogic point of view, we are spiritual beings having human experience. In other words, we are an individual soul that has
two beautiful instruments, body and mind. Tese three entities, i.e. soul, body and mind continuously and dynamically
interact with, and infuence each other. Yog has profound infuence on our total health and personality because it has
desirable efect on all the three aspects of our being. Yog is holistic in nature since it is science, philosophy as well as art.
It has promotive, preventive as well as curative potential. Its efect is augmentative as it improves our physical, mental as
well as spiritual health. Yog is a time-tested and safe tradition. Compared to other modes of health intervention, it has
many advantages. It is economical in terms of time, energy and resources. Being holistic, it is ideal for our horizontal,
in-depth as well as vertical development. For prevention as well as management of stress and stress disorders, there is
no method as efective and as far-reaching as yog. Tat is why Yogeshwar Krishn describes the superiority of a yogi in
unambiguous terms (Tapasvibhyo adhiko yogi. Bhagavadgita, 6:46).
Proper posture: From yogic point of view, proper posture and movement are important components of healthy
lifestyle. Posture is a manifestation of physical and mental balance and has powerful infuence on physical aging and
mental mood. Good posture is very important for energetic and active life. When you are stooped, you look old and
feel old. Do not think that slumped posture is natural to old age. So, lift yourself against the physical weight of gravity
and mental weight of aging. Whether sitting or standing, maintain a good, frmly upright but comfortable and relaxed
posture as asan should be frm but comfortable (Sthir sukham asanam. Yog Darshan). Stand and move with grace and
vigor and do not tighten your muscles stif in unwanted and awkward position. Of the 700 muscles that we have, good
posture needs only 5 key muscles. Yogic posture is ergonomically appropriate and physiologically sound. Terefore, avoid
poor posture and slouching in a chair as it:
i) Distorts alignment of bones and creates more pressure on lower back.
ii) Tenses muscles resulting in muscle pain and stifness of joints.
iii) Interferes with breathing and decreases vital capacity.
iv) Interferes with circulation and oxygen delivery to brain resulting in poor concentration and drowsiness.
v) Results in poor digestion and constipation.
vi) Decreases productivity and accelerates aging.
Yog improves physiological functions: Human body is a beautifully robust mechanism capable of taking care of itself.
Yog assists this process and improves our physiological functions and health. Scientifc research has shown that yogic
techniques produce consistent and benefcial physiological changes and have sound scientifc basis (Wallace RK. Science,
167: 1751, 1970; Madanmohan et al. Indian J Physiol Pharmacol, 36: 229, 1992). Even a few weeks of yog training can
improve physiological and psychological functions. Practice of asans and pranayams results in overall improvement in
physical ftness and cardio-respiratory functions. We have reported that yog training for 3 months produces a signifcant
increase in respiratory pressures, breath holding times and hand-grip strength (Madanmohan et al. Indian J Physiol
Pharmacol, 36: 229, 1992). Tis indicates an improved physical strength and cardio-respiratory function. In the same
study, we also found a signifcant decrease in visual and auditory reaction times after the yog training. Tis indicates a
faster and more efcient information processing by the brain. We have also reported that after yog training, exercise-
induced stress to cardio- vascular system in less severe (Madanmohan et al. Indian J Physiol Pharmacol, 48:461,2004
). Tis means that yog training can enable one to tolerate more severe exercise load. Other workers have found that yog
training produces a signifcant improvement in dexterity scores and motor speed (Manjunath & Telles, Indian J Physiol
Pharmacol, 43: 225, 1999; Dash & Telles, Ibid, 43: 458, 1999). Yogis are capable of remarkable feats of endurance (Vakil
RJ. Te Lancet, 2: 871, 1950) and control of their autonomic functions (Chhina GS, Proc International Union Physiol
Sci, 10: 103, 1974).
Yog for mental health: Just as our body requires physical exercise, balanced diet and bathing for good health, our
mind requires inner discipline for mental health. Ordinary mind is a clutter of uncontrolled thoughts. Meditation
(dhyan) is the ideal way to calm the mind. Meditation is the inner (antarang) yogic discipline in which there is a
continuous fow of thought towards a higher spiritual ideal in a higher spiritual center of our consciousness. It makes the
mind one-pointed and produces psychosomatic relaxation. Meditation is not an ordinary concentration. It is a special
kind of concentration based on the frst two steps of ashtang yog. Tess two steps are i) yam or fve moral virtues and
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ii) niyam or fve spiritual discipline. Jap or repetition of holy name is very efective in achieving success in meditation.
Jap should be done in a spirit of love and adoration as mystic worship and not in a mechanical way. Tus performed, jap
and dyan are higher forms of worship to which our body, mind and soul, the whole being respond with better health
and healing power. Tat is the secret of the power of yog. For success in dyan and to get attached to the universal
Divine Consciousness, we have to create proper mood and loosen our worldly attachments. Tis attainment of unity and
realization of identity is the goal of yog. In this state, our inner soul is freed from the thralldom of ego, mind and senses.
Ten problems of the world do not disturb our inner harmony. Tis is the basis of sound mental health, a distinguishing
characteristic of a yog sadhak. Yog is equanimity (Samatvam yog uchyate. Bhagavadgita, 2: 48) and evenness of temper
is the essential feature of mental health.
Spiritual health and healing: a yogic perspective: Human body is the highest and best creation of the Divine and
an instrument for performing noble deeds (Sharir madyam khalu dharm sadhanam). Tat is why Vedic Rishis have
called this body has Devapuri and Ayodhya (Asht chakra navadwara devanam poorvayodhya. Atharvaved, 10: 2: 31).
Our body-mind-soul complex is the real temple of the Divine. By yog sadhana, we should keep it ft, clean and pure and
seek the Divine within. Spiritual healing is curing a disease by non-physical means, i.e. through powers outside medical
intervention. By prayer, meditation and therapeutic touch, the healer channels Divine healing energy that improves
patients life force (pran shakti). Tere are claims that spiritual healing hastens recovery and even hopelessly ill patients
can recover miraculously.
Faith, i.e. belief in a higher universal Divine power is the basis of the spirituality. Faith is what your heart tells
you is true when you intellect cannot prove it. One can have faith in a religion or in eternal universal Truth called as
Rit in Vedic language. It may be noted that spirituality is distinct from religion. Religion is a particular belief system
and mode of worship. Religions are many, but spirituality is one. Religion may nurture spirituality, but spirituality
does not depend on it. Prayer is another important component of spiritual life. Prayer can lift the mind and soothe the
soul. Prayer enhances health and promotes healing of self and others. It is a medical secret - prayer heals. Performing
actions and ones duty with a spirit of selfess service (Nishkam karmyog of Bhagavadgita) is an important component of
spiritual life. A person who believes in all-pervading universal Divine power feels connected not only to everyone, but
to all forms of life and the whole creation. Tis promotes universal love which is distinct from selfsh romantic love. A
person who has these spiritual qualities is an asset to the whole society.
Health benefts of spirituality are signifcant. Faith in higher Spiritual power relieves one of cares, anxieties
and stress and promotes calmness and tranquility. Consequently, his heart rate, blood pressure, muscle tone, oxygen
consumption and carbon dioxide production decrease. Even his cholesterol decreases over a period of time. Spiritually-
oriented people get sick less often. Tey recover faster in case they fall sick. It is claimed that patients recover better if
family and friends pray for them. Spirituality also decreases the incidence of stroke and death from heart disease and
increases survival after surgery. Spirituality helps to prevent / overcome bad habits because spirituality is considered
to be bigger than these. As a result, there is increase in longevity and quality of life. Here it is interesting to note that
Benson (New England Journal of Medicine, 281: 1133, 1969) has reported that transcendental meditation (TM) can
help one to kick of drug addiction, which is a serious problem among the modern youth.
Power of pranayam: It needs to be emphasized that slow and deep pranayam breathing has a powerful infuence
on our wellbeing. A simple exercise to relieve stress and promote wellbeing is to straighten and mildly arch your spine
as you inhale (purak) slowly and sequentially and then exhale (rechak) as you bend forward and round your back. It is
claimed that pranayam reduces obesity and purifes the body. According to Patanjali, pranayam destroys the covering of
inner light and the mind gains the power concentration (Yog Darshan, 2: 52-53). Manusmriti (6: 71) says that pranayam
purifes the impurities of senses and the mind.
From the physiological point of view, slow and deep breathing (as in mahat yog pranayam) has the following
advantages:
i) It is economical as it reduces dead space ventilation.
ii) All the muscles of respiration are strengthened.
iii) Diferent parts of the chest and lungs are stretched, improving their fexibility.
iv) Abdominal viscera are gently massaged by the descending diaphragm.
v) Venous return (blood fow) to heart is improved.
vi) Mind-body coordination (thereby health) is improved.
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Tere is evidence that pranayam has therapeutic potential. In an interesting work from our laboratories, we have
demonstrated that subjects trained in yog can achieve a state of deep psychosomatic relaxation and signifcant decrease
in oxygen consumption within 5 minutes of practicing savitri pranayam (Madanmohan et al. Te Yoga Review, 3:
25,1983). Savitri pranayam is a slow, deep and rhythmic breathing in which the ratio between purak, kumbhak, rechak
and shunyak (bahya kumbhak) is 2:1:2:1. Telles and Desiraju ( Indian Journal of Medical Research, 94: 357, 1991) also
have demonstrated that pranayam can decrease oxygen consumption signifcantly. More recently, we have demonstrated
the benefcial efect of pranayam in patients having premature ventricular complexes and palpitation (Prakash et al.
International Journal of Cardiology, 111: 450, 2006; Ravindra et al. Ibid, 108: 124, 2006). It is clear that the power of
pranayam is available to us freely. Let us use it for the beneft of the humanity.
Yog for prevention and management of stress: Te all- pervasive stress and stress disorders are the bane of modern
society. Te main cause of stress among the afuent sections is material progress without a parallel development of inner,
spiritual resources and this results in deep rooted conficts and disharmony. Healthy balance between worldly enjoyment
(bhog) and detachment (tyag) is good for mental health. Tis point is beautifully taught in a Vedic verse thus: Tis
whole universe is pervaded by Ishwar. Enjoy this world with a sense of detachment and do not covet the wealth of others
(Ishavasyam idam sarvam. Yajurved, 40: 1). Chronic stress results in disturbance of mental and physical equilibrium.
Te consequence is a host of chronic disorders like hypertension, angina, diabetes mellitus, peptic ulcer, irritable bowel,
chronic pains, insomnia and cancers. It is alarming that the incidence of these lifestyle diseases is increasing in India.
Te problem is more marked in urban areas where people are living a routine of daily rat race. Over-ambitious, ever-
struggling and restless persons (type A personality) are more prone to stress disorders. Tey can be screened in their
early life by psychophysiological tests and taught yog relaxation techniques as a preventive measure.
Yog has a comprehensive and holistic approach to health and is the best treatment for stress and stress disorders.
A judicious combination of simple stretching asans, slow rhythmic pranayams, yog nidra and dhyan is most efective
and ideal for prevention and management of stress. Mantr (e.g. AUM) chanting, jap and bhajan singing, especially in a
dedicated group (satsang) are very efective for managing stress and improving mental health. Yogeshwar Krishn gives
a very high place to jap and bhajan singing when he says Among the oferings, I am the ofering of jap (Yajnanam jap
yajnosmi, Bhagavadgita, 10: 25) and He is the best yogi who worships Me by bhajan singing (Shraddhavan bhajate yo
maam, Bhagavadgita, 6: 47).
Many workers have demonstrated the efectiveness of yogic techniques in the control of blood pressure and
hypertension ( Selvamurthy et al. Ind J Physiol Pharmacol, 42: 205, 1998: Datey et al. Angiology, 20: 325, 1969).
Yog lays great stress on proper diet, a distinctive feature of which is emphasis on purity (satvik ahar) and moderation
(mitahar). Overeating is a form of malnutrition that results in conditions like obesity, diabetes mellitus, and arthritis.
Yogeshwar Krishn emphasizes the importance of regulation in diet, recreation, sleep-wakefulness and other activities
for the yog sadhak (Yuktahar viharasya. Bhagavadgita, 6: 17). Chhandogya Upanishd emphasizes the importance of
purity of diet for our inner purity (Ahar shuddhou satva shuddhi. 7: 26: 2). Purity of mind results in improved mental
health and freedom from psycho-somatic disorders. It is clear that yogic lifestyle is very efective for prevention as well
as management of stress and stress disorders.
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Yoga is the original mind-body medicine that has enabled individuals to attain and maintain sukha sthanam, a
dynamic sense of physical, mental and spiritual well being. Bhagavad-Gita defnes Yoga as samatvam meaning thereby
that Yoga is equanimity at all levels, a state wherein physical homeostasis and mental equanimity occur in a balanced
and healthy harmony.
Yogamaharishi Dr Swami Gitananda Giri Guru Maharaj, the visionary founder of Ananda Ashram at the
International Centre for Yoga Education and Research (ICYER) in Pondicherry and one of the foremost authorities on
Yoga in the past century, has explained the concept of Yoga Chikitsa (Yoga as a therapy) in the following lucid manner.
To achieve this Yogic integration at all levels of our being, it is essential that we take into consideration the all
encompassing multi dimensional aspects of Yoga that include the following: a healthy life nourishing diet, a healthy and
natural environment, a wholistic lifestyle, adequate bodywork through Asanas, Mudras and Kriyas, invigorating breath
work through the use of Pranayama and the production of a healthy thought process through the higher practices of
Jnana Yoga and Raja Yoga.
Psychosomatic Disorders:
Te Nirvana Prakarana of the Laghu Yoga Vashishta, one of the ancient Yoga Texts describes in detail the origin
and destruction of mental and bodily diseases. Sage Vashishta teaches Lord Rama that there are two major classifcations
of disease. Tose that are caused by the mind are primary (adhija vyadhi, the psychosomatic, stress disorders) while those
that afict the body directly are secondary (anadhija vyadhi, infectious disease, accidents etc). Te primary disease has
two sub divisions. Tese are the samanya (ordinary physical diseases) and the Sara (the essential disorder of rebirth that
may only be destroyed by atma jnana or knowledge of the Divine Self). Samanya diseases are the ones that afect us
physically and may be destroyed by the correction of the mind-body disharmony. It is in these psychosomatic disorders
that the actual practical application of Yoga practices as a mode of therapy can be very useful.
From the Yogic viewpoint of disease it can be seen that psychosomatic, stress related disorders appear to progress
through four distinct phases. Tese can be understood as follows:
1. Psychic Phase: Tis phase is marked by mild but persistent psychological and behavioural symptoms of stress like
irritability, disturbed sleep and other minor symptoms. Tis phase can be correlated with vijnanamaya and manomaya
koshas. Yoga as a mind body therapy is very efective in this phase.
2. Psychosomatic Phase: If the stress continues there is an increase in symptoms, along with the appearance of
generalized physiological symptoms such as occasional hypertension and tremors. Tis phase can be correlated with
manomaya and pranamaya koshas. Yoga as a mind body therapy is very efective in this phase.
3. Somatic Phase: Tis phase is marked by disturbed function of organs, particularly the target, or involved organ.
At this stage one begins to identify the diseased state. Tis phase can be correlated with pranamaya and annamaya
koshas. Yoga as a therapy is less efective in this phase and may need to be used in conjunction with other methods of
treatment.
PSYCHOSOMATIC MECHANISMS OF YOGA
Ananda Balayogi Bhavanani *
Yoga Chikitsa is virtually as old as Yoga itself, indeed, the return of mind that feels separated from the
Universe in which it exists represents the frst Yoga therapy. Yoga Chikitsa could be termed as mans frst
attempt at unitive understanding of mind-emotions-physical distress and is the oldest wholistic concept
and therapy in the world.
*
* Yogacharya Dr. Ananda Balayogi Bhavanani, MBBS, ADY, DPC, DSM, PGDFH, PGDY, FIAY, MD (Alt.Med)
Deputy Director, CYTER, MGMCRI, SBVU and Chairman ICYER at Ananda Ashram, Pondicherry.
Email: yoga@mgmcri.ac.in and yognat@gmail.com
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4. Organic Phase: Tis phase is marked by full manifestation of the diseased state, with pathological changes such
as an ulcerated stomach or chronic hypertension, becoming manifest in their totality with their resultant complications.
Tis phase can be correlated with the annamaya kosha as the disease has become fxed in the physical body. Yoga as a
therapy has a palliative and quality of life improving efect in this phase. It also has positive emotional and psychological
efects even in terminal and end of life situations.
Potentialities:
Extensive research on Yoga being done all over the world has shown promise with regard to various disorders
and diseases that seem to be amiable to Yoga therapy (www.iayt.org, www.icyer.com, www.svyasa.org ). Tese include
psychosomatic, stress disorders such as bronchial asthma, diabetes mellitus, hypertension, irritable bowel syndrome,
gastro intestinal ulcer diseases, atherosclerosis, seizure disorder and headache. It also includes physical disorders such as
heart disease, lung disease, and mental retardation. Psychiatric disorders such as anxiety disorders, obsessive-compulsive
disorder, depression and substance abuse can also be managed along with other therapies. Musculoskeletal disorders
such as lumbago, spondylosis, sciatica and carpel tunnel syndrome can be tackled efectively with Yoga practices that
ofer a lot of hope in metabolic disorders such as thyroid and other endocrine disorders, immune disorders, obesity and
the modern metabolic syndrome.
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It is well established that stress weakens our immune system. Scientifc research in recent times has showed that
the physiological, psychological and biochemical efects of Yoga are of an anti-stress nature. Mechanisms postulated
included the restoration of autonomic balance as well as an improvement in restorative, regenerative and rehabilitative
capacities of the individual. A healthy inner sense of wellbeing produced by a life of Yoga percolates down through the
diferent levels of our existence from the higher to the lower producing health and wellbeing of a holistic nature.
Streeter et al (2012) recently proposed a theory to explain the benefts of Yoga practices in diverse, frequently
comorbid medical conditions based on the concept that Yoga practices reduce allostatic load in stress response systems
such that optimal homeostasis is restored.
Tey hypothesized that stress induces an:
1. Imbalance of the ANS with decreased parasympathetic and increased sympathetic activity,
2. Under activity of the gamma amino-butyric acid (GABA) system, the primary inhibitory neurotransmitter
system, and
3. Increased allostatic load.
Tey further hypothesized that Yoga-based practices
1. Correct underactivity of the parasympathetic nervous system and GABA systems in part through stimulation
of the vagus nerves, the main peripheral pathway of the parasympathetic nervous system, and
2. Reduce allostatic load.
According to the theory proposed by Streeter and colleagues, the decreased parasympathetic nervous system and
GABAergic activity that underlies stress-related disorders can be corrected by Yoga practices resulting in amelioration
of disease symptoms. HRV testing has a great role to play in our understanding intrinsic mechanisms behind such
potential efects of Yoga.
Innes et al had earlier (2005) also postulated two interconnected pathways (given below) by which Yoga reduces the
risk of cardiovascular diseases through mechanisms of parasympathetic activation coupled with decreased reactivity of
sympathoadrenal system and HPA axis.

Psychosomatic Mechanisms Of Yoga:
Yoga understands the infuence of the mind on the body as well as that of the body on the mind. Tis is the principle
of adhi-vyadhi elucidated in the Yoga Vasishta more than 5000 years ago! It is interesting that modern medicine has only
realised this connection in the last hundred years whereas Yogic of India were teaching and practising it for thousands
of years. No wonder Yoga may be considered as the original mind-body medicine.
We are what we think, yet we also start to think that which we do. Yogic concepts and techniques enable the
development of right attitudes towards life and enable us to correct the numerous internal and external imbalances
we sufer due to our wrong lifestyle/ genetic potential. Yoga enables us to take responsibility for our own health and
happiness and as Swami Gitananda Giri would say, If you want to be healthy do healthy things, if you want to be happy
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do happy things.
Te following are just a few of the mechanisms through which Yoga can be said to work as an integrated mind-body
medicine:
1. Cleanses the accumulated toxins through various shuddi kriyas and generates a sense of relaxed lightness through
jathis and vyayama type activities. Free fow in all bodily passages prevents the many infections that may occur when
pathogens stagnate therein.
2. Adoption of a Yogic lifestyle with proper nourishing diet, creates positive antioxidant enhancement thus
neutralizing free radicals while enabling a rejuvenative storehouse of nutrients packed with life energy to work on
anabolic, reparative and healing processes .
3. Steadies the entire body through diferent physical postures held in a steady and comfortable manner without
strain. Physical balance and a sense of ease with oneself enhance mental / emotional balance and enable all physiological
processes to occur in a healthy manner.
4. Improves control over autonomic respiratory mechanisms though breathing patterns that generate energy and
enhance emotional stability. Te mind and emotions are related to our breathing pattern and rate and hence the slowing
down of the breathing process infuences autonomic functioning, metabolic processes as well as emotional responses.
5. Integrates body movements with the breath thus creating psychosomatic harmony. In Yoga the physical body is
related to annamaya kosha (our anatomical existence) and the mind to manomaya kosha (our psychological existence).
As the pranayama kosha (our physiological existence sustained by the energy of the breath) lies in between them, the
breath is the key to psychosomatic harmony.
6. Focuses the mind positively on activities being done, thus enhancing energy fow and resultant healthy circulation
to the diferent body parts and internal organs. Where the mind goes, there the prana fows!
7. Creates a calm internal environment through contemplative practices that in turn enable normalization of
homeostatic mechanisms. Yoga is all about balance or samatvam at all levels of being. Mental balance produces physical
balance and vice versa too.
8. Relaxes the body-emotion-mind complex through physical and mental techniques that enhance our pain
threshold and coping ability in responding to external and internal stressors. Tis enhances the quality of life as seen in
so many terminal cases where other therapies are not able to ofer any solace.
9. Enhances self confdence and internal healing capacities through the cultivation of right attitudes towards life
and moral-ethical living through yama-niyama and various Yogic psychological principles. Faith, self confdence and
inner strength are most essential if at all we wish for healing, repair, rejuvenation and re-invigoration.
10. Yoga works towards restoration of normalcy in all systems of the human body with special emphasis on the
psycho-neuro-immuno-endocrine axis. In addition to its preventive and restorative capabilities, Yoga also aims at
promoting positive health that will help us to tide over health challenges that occur during our lifetime. Tis concept
of positive health is one of Yogas unique contributions to modern healthcare as Yoga has both a preventive as well as
promotive role in the healthcare of our masses. It is also inexpensive and can be used in tandem with other systems of
medicine in an integrated manner to beneft patients.
Need For Coordination:
Te need of the modern age is to have an integrated approach towards therapy and to utilize Yoga therapy in
coordination and collaboration with other systems of medicine such as Allopathy, Ayurveda, Siddha and Naturopathy.
Physiotherapy and Chiropractic practices may be used with the Yoga if needed. Advice on diet and lifestyle is very
important irrespective of the mode of therapy that is employed for a particular patient.
A Word Of Caution:
A word of caution is also required. Tough Yoga and Yoga therapy are very useful in bringing about a state of total
health it is not a miracle cure for all problems. It needs a lot of discrimination on the part of both the therapist as well
as the patient. It may not be useful in emergency conditions and there is a strong need to consult a qualifed medical
doctor where in doubt. Each patient is diferent and so the therapy has to be molded to suit the individual needs rather
than relying on a specifc therapy plan for patients sufering the same medical condition.
A very true problem is that there is a diferent approach of the diferent schools of Yoga to the same condition. It is
better to follow any one system that one is conversant with, rather than trying to mix systems in a Yogic Cocktail. One
must also be vigilant as there is a strong presence of numerous quacks pretending to be Yoga therapists and this leads to
a bad name for Yoga therapy as well as Yoga in general.
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Conclusion:
Te dedicated practice of Yoga as a way of life is no doubt a panacea for problems related to psychosomatic, stress
related physical, emotional and mental disorders and helps us regain our birthright of health and happiness. It is only
when we are healthy and happy that we can fulfll our destiny. With the adoption of a proper attitude and lifestyle
through the Yogic way of life, we can rise above our own circumstances and our life can blossom as a time of variety,
creativity, and fulfllment.
Yoga helps us regain the ease we had lost through dis-ease (as implied by sthira sukham asanam-PYS). It also produces
mental equanimity (samatvam yoga uchyate-BG) where the opposites cease to afect (tato dwandwa anabhigatha-PYS).
Tis enables us to move from a state of illness and disease to one of health and well being that ultimate allows us to move
from the lower animal nature to the higher human nature and fnally the highest Divine Nature that is our birthright.
References And Recommended Reading:
1.Ananda Balayogi Bhavanani. A Primer of Yoga Teory. Dhivyananda Creations, Iyyanar Nagar, Pondicherry. 2008. www.rishiculture.org
2.Back issues of International Journal of Yoga Terapy. Journal of the International Association of Yoga Terapists, USA. www.iayt.org
3.Back issues of Yoga Life, Monthly Journal of ICYER at Ananda Ashram, Pondicherry. www.icyer.com
4.Back issues of Yoga Mimamsa. Journal of Kaivalyadhama, Lonavla, Maharashtra, USA. www.kdham.com
5. Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible
protection with yoga: a systematic review. J Am Board Fam Pract 2005;18: 491-519.
6. Srimad Bhagavad Gita by Swami Swarupananda. Advaita Ashrama, Kolkata. 2007
7.Streeter CC, Gerbarg PL, Saper RB, Ciraulo DA, Brown RP. Efects of yoga on the autonomic nervous system, gamma-aminobutyric-acid,
and allostasis in epilepsy, depression, and post-traumatic stress disorder. Med Hypotheses 2012; 78:571-9.
8.Te Supreme Yoga: Yoga Vashista. Swami Venkatesananda. Motilal Banarsidass Publishers Pvt Ltd.Delhi. 2007
9.Ananda Balayogi Bhavanani. Yoga for health and healing. Dhivyananda Creations, Iyyanar Nagar, Pondicherry. 2008.
10.Anantharaman TR. Ancient Yoga and Modern Science. Mushiram Manoharlal Publishers Pvt Ltd, New Delhi. 1996
11. Ananda Balayogi Bhavanani. Yoga Chikitsa-Application of Yoga as a Terapy Dhivyananda Creations, Iyyanar Nagar, Pondicherry. 2013.
www.rishiculture.org
12. Yoga: Step-by-Step. A 52 lesson Correspondence Course by Yogamaharishi Dr. Swami Gitananda Giri. Ananda Ashram at ICYER,
Pondicherry. www.icyer.com
13. Te Forceful Yoga (being the translation of the Hathayoga Pradipika, Gheranda Samhita and Siva Samhita). Translated into English by
Pancham Sinh, Rai Bahadur Srisa Chandra Vasu and Romanized and edited by Dr GP Bhatt. Mothilal Banarsidas Publishers Private
Limited, Delhi. 2004.
14. Yoga the Science of Holistic Living. Vivekananda Kendra Patrika. Vol. 17- 2. 1988.
15. Taimni IK. Te Science of Yoga. Te Teosophical Publishing House, Chennai.1961
16. Meena Ramanathan. Tiruvalluvar on Yogic Concepts. Aarogya Yogalayam, Venkateswara Nagar, Saram, Pondicherry-13.2007
17. Swami Satyananda Saraswathi. Four Chapters on Freedom. Bihar School of Yoga, Munger, India. 1999
18. Nagarathna R and Nagendra HR. Integrated approach of Yoga therapy for positive health. Swami Vivekananda Yoga Prakashana,
Bangalore, India. 2001.
19. Healthy mind, healthy body. Sri Ramakrishna Math, Chennai, India.1997.
20. Feuerstein Georg. Te Shambala Guide to Yoga. Shambala Publications Inc, Boston, Massachusetts, and USA.1996.
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Stress is inevitable in the modern world because of the imbalance between the demands of ones environment and
ones capabilities. In fact, it is the distress, which causes the problem and can be defned as every physical and mental
tension that we experience as unpleasant. Te environment today is more demanding. From childhood onwards, the
development of capacities and capabilities of the individual is not able to keep pace with the increase of demands on
them. Tis gap in most cases goes on widening. Te huge crowds at Temples, churches and mosques in some way or the
other are related to this imbalance. Everyone seems to be going there in order to beg or bribe the almighty to perform
the balancing act.
When we talk of stress we must also remember that some amount of stress is necessary in order to bring out the best
in us. However it is vital to learn how to manage stress and keep it under our control. It is important to also remember
the words of Epictetus in 60 A.D. who said, Men are not disturbed by things, but the views, they take of them. As
Swamiji Gitananda Giri Guru Maharaj jocularly used to say You dont have problemsyou are the problem! A
positive frame of mind will help us to be cheerful and unstressed. Maharishi Patanjalis advise in this regard to cultivate
Pratipaksha Bhavanam (Te Opposite View) is vital to achieve balance of the emotions and mind. It is also worth
trying to follow his advice of Maitri-Sukha (Friendliness towards the happy), Karuna-Dukha (Compassion towards the
sufering), Mudhita-Punya (Cheerfulness towards the virtuous) and Upekshanam-Apunya (Indiference towards the
wicked).
Te most common causes of stress are the Shat Ripus or the six enemies of the spirit. Tese are Kama (Uncontrolled
passion), Krodha (Senseless Anger), Lobha (Greed), Moha (Blind infatuation), Mada (Massive Ego) and Matsarya
(Malice / envy). Corruption of character, conduct, thought and interpersonal dealing is another cause of stress.
An environment where sadistic pleasure gives satisfaction, where ethics have little or scant regard, where self-interest
is more important and where under cutting and backbiting are a common feature, will surely lead to the development
of extreme stress. It is important to realise these facts and be aware of them in our life. Unless we develop awareness
and consciousness of what we think, feel and do, there cannot be a lasting solution to stress. We must strive to become
persons of Equal mindedness in all situations that is described as Stitha Prajna or Samabhava in the Srimad Bhagavad
Gita.
Tough stress probably cannot be avoided, it can, however, be managed. Te following actions may help reduce/
eliminate the stress.
1. Awareness: It is important that we frst become aware of the stress and then try to let it go. Sharing your tension
with a friend and/or a family member may solve the problem to a great extent. You cannot wish away problems by non-
acknowledgement of them.
2. Movement: Movement helps in reducing tension. Tis can mean walking, jumping, making noise, swimming
and playing. Stress tends to accumulates in the joints and movement helps to dissipate it. Rotation of the neck and
shoulders in many cases helps a lot. Some corporates have even established stress-relieving chambers where employees
may shout, screams or hit a hanging pillow to relieve the pent up tension.
3. Yoga techniques: Te regular practice of various Yoga techniques and inculcating the Yogic values in daily life
will go a long way towards not only reducing the stress levels bit also in giving us that elusive Peace of Mind. Yogic
relaxation practices such as Shavasana and Yoga Nidra help to create a sense of awareness and relaxation in the whole
body as well as the mind.
4. Hobby: A hobby can help to relieve tension because it helps us to divert our mind from an unpleasant occurrence.
Music, dance, painting, cooking and gardening are efective ways to take our mind to a diferent Zone. Playing with
your pet can also help relieve tension and many people have Tera-pets or pets that help them therapeutically!
5. Breathing: Breathing is one of the easiest ways of relieving stress. Whenever you feel tension rising, take a few
YOGA PRACTICES FOR PREVENTION AND MANAGEMENT OF LIFESTYLE DISORDERS
Ananda Balayogi Bhavanani *
*
* Yogacharya Dr. Ananda Balayogi Bhavanani, MBBS, ADY, DPC, DSM, PGDFH, PGDY, FIAY, MD (Alt.Med)
Deputy Director, CYTER, MGMCRI, SBVU and Chairman ICYER at Ananda Ashram, Pondicherry.
Email: yoga@mgmcri.ac.in and yognat@gmail.com
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deep breaths and you will immediately feel the diference.
6. Attitude: It is important to Let things lie for sometime when facing problems and many situations resolve on
their own. Other situations may appear smaller and less stressful after some time. Development of a detached attitude
can also help us to have a better perception of situations and this in turn helps us to face them better.
7. Visualization: Visualization of a pleasant solution to the problems can also help a lot. Tis is quite diferent
from daydreaming. Tis is widely adopted by players and athletes for improving their performance. After a stressful
encounter, coolly sit in your chair, close your eyes and visualize the episode as an act of an ignorant person and excuse
him for the incident.
8. Auto-Suggestion: Another mental technique is Positive self-suggestion. Te negative thoughts are to be replaced
with positive ones and an attitude of I can and I will is to be developed.
9. Self efort: Stress is related to the individuals environment and their tolerance capacity. As both of these are
diferent in diferent people, each individual has to settle for their own method for managing their day-to-day problems.
It must be clearly understood that we are responsible for our health and happiness and have a duty to take care of these
Divine gifts. Swami Gitananda Giri used to often say, Health and happiness are your birthright. It is through our own
eforts and will power that we can ultimately solve the problem of stress and achieve our birthrights.
Yoga is an integrated way of life in which awareness and consciousness play a great part in guiding our spiritual
evolution through life in the social system itself by understanding that Yoga is the science and art of right-use-ness of
body, emotions and mind.
Basic Warming Up Practices
Jattis are basic movements of the body parts that help to release pent up tensions in those parts. Tey increase
circulation to the part and also the fow of Pranic energy is increased due to the movements. A few of these practices
will be described now.
Take up a comfortable standing position such as the Samasthiti Asana. Stand on one leg and shake the other leg.
Repeat on the other side and then alternate a few times between right and left. Stand on both legs and start to shake
your hands one at a time. Alternate between the right and left a few times and then start to shake both hands at the
same time.
Shake your hands and move them up, down, to the left and to the right. Shake your hands all around you in a
circular movement. Tis helps to energize the Pranamaya Kosha, our energy sheath or subtle body. Come back to the
standing position.
Open the legs two feet apart and keep the hands on the hip. Move the torso in all four directions clock-wise and
anti clock-wise in a grinding action. Ten do it in a continuous manner. Bend forward and perform some toe touching
with a bouncing action. Bounce to the front, and then move to your left. Move to your right and then come back to the
front. Come back to the standing position.
Spread your feet a bit and lift both your arms to the side. Start to twist your torso from side to side a few times.
Feel the stretch in your hip region and back. Come back to the standing position and relax with deep breathing for some
time.
Sit down with both legs stretched out in front of you. Draw your right knee up to your chest and then kick out with
a whooshing sound. Perform the same action on the left side. Continue to alternate legs for some time. Draw up both
your knees and do the same action with a whooshing sound as you release the feet. Relax with your feet stretched out
in front.
Surya Namaskar
Rishikesh Surya Namaskar, the Yogic sun salutation is a series of twelve physical postures. Tese alternating
backward and forward bending postures fex and stretch the spinal column through their maximum range giving a
profound stretch to the whole body. Te basic breathing principle is to inhale during upward and backward bending
postures and exhale during forward bending postures.
Stand erect with your feet close together. Perform Namaskar Mudra by joining your palms together in front of your
chest.
Breathe in and stretch your arms over your head into the Anjali Mudra and then arch your back. Feel the healthy
stretch in your whole body.
Breathe out and bend forward while keeping your arms and back in one line and as straight as possible. Perform the
Pada Hasta Asana by bringing your head to your knees while keeping your hands on either side of your feet.
Breathe in and extend your right leg back until it is straight as possible and you are balanced on your toes and hands.
Your left leg should be bent with the sole fat on the ground. Lift your head and bend back and open up your chest. Tis
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is the Ashwa Sanchalana Asana, the equestrian posture.
While breathing out bring your left leg back towards the right and keep the feet just a foot apart with your heels
fat to the ground. Simultaneously raise your buttocks and lower your head between your arms, so that your body forms
a triangle with the ground. Tis is the Mehru Asana or mountain posture. While maintaining the posture, take a deep
inhalation.
While breathing out drop both knees to the ground and slowly slide the body down at an angle and bring your
chest and chin to the ground. Eight parts of your body namely your toes, knees, chest, hands and chin should touch the
ground while the buttocks are kept up. Youre your breath while performing this Ashtanga Bhumi Sparsha, the eight
limbed prostration.
Breathe out and come into Bhujanga Asana, the Cobra posture. Focus your awareness at the base of your spine and
feel a healthy stretch in your back and neck.
Exhale and come back to the Mehru Asana, the mountain posture. Tis strengthens the arms and legs as well as the
spinal column. Inhale and bring your right leg forward in-between your hands while keeping your left leg in its original
position to perform the Ashwa Sanchalana Asana. Breathe out and bring your left foot forward to come into the Pada
Hasta Asana. Breathe in and come up and perform the Anjali Mudra and bend backward. Breathe out and come back
to the standing while bringing your hands back to the chest in Namaskar Mudra.
To perform the Rishikesh Surya Namaskar on the opposite side perform the practice again with a slight modifcation.
To complete the other half the same movements are repeated except that the left leg is brought back while performing
the Ashwa Sanchalana the frst time. Te other postures such as Mehru Asana, Ashtanga Bhumi Sparsha and Bhujanga
Asana are done in the same manner. When coming back to the Ashwa Sanchalana the left foot is brought forward and
then the Pada Hasta is performed by joining right foot to the left before completing the practice with the Anjali Mudra
and fnally relaxing in the Sama Sthithi with deep breathing.
One full round consists of the 12 poses done twice in sequence. Practice 3 to 9 rounds of the Surya Namaskar daily
for maximum beneft. When the exercises are done little quickly the gain is more physical and when they are done slowly
with breath awareness the gain is more mental and spiritual.
Yoga Asanas
TALA KRIYA
Te term, Tala refers to a Palmyra tree and you should try to stretch yourself as tall
as that tree while performing this practice. Take up a comfortable and stable Samasthiti
Asana. Breathe in and lift both arms up over your head until they are parallel to each other.
Let the palms of both hands face inward and then go up onto your toes and stretch up as
high as possible. Hold the breath and feel the healthy stretch along your whole body from
toes to fnger tips. Breathe out and relax your arms back to your sides while coming back
to the fat foot posture. Repeat the practice two more times at each session for maximum
beneft. With practice the posture can be held for a longer time and normal breathing done
while holding the posture for 30 to 45 seconds.
HASTHA KONA KRIYA
Stand in a steady Samastiti Asana with your arms by your side. Breathe in and lift your right arm over your head.
Try to extend the arm over your head towards the left as far as possible without bending it. Tis gives a good stretch to
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the entire right side of the body. Slowly start to breathe out and lower your arm slowly back
to the side. Repeat the practice a few more times.
Make sure that you lift your arm on the in breath and lower it on the out breath.
Perform the practice on the opposite side by lifting your left arm over your head while
breathing in. Extend it as far towards the right as possible without bending it. Feel the
excellent stretch on the entire left side of your body. Lower your arm back to your side while
breathing out. Repeat the practice a few more times.
Te Hastha Kona Kriya helps to stretch and tone up the musculature of the arms,
shoulders and the Para-spinal area in a way not done in day-to-day life. Tis helps trigger
the relaxation response in these tissues that are normally tensed due to disuse, misuse and
abuse. A sense of profound relaxation is obtained after the practice of this activity that is
also known as the Ardha Kati Chakrasana.
TRIKONA ASANA
Stand in Samasthiti Asana. Place your feet two to three feet apart facing forwards.
Stretch your arms to the sides so that they are pulling the chest in opposite directions.
Turn your head and right foot to the right side and slowly bring your right hand down
to the right foot and place the palm of the right hand on the ground in front of the right
foot. Look up at the middle fnger of the left hand. Let the entire torso get a good twist
and stretch. Hold the position for 30 seconds while performing deep breathing. Release
and come back up to the open arm position and then do the opposite side by placing
your left hand down in front of the left foot. Hold the position for 30 seconds while
performing deep breathing. When ready come back up to the Samasthiti Asana and
relax with a few rounds of deep breathing.
VAKRA ASANA
Sit erect with your legs stretched out in the Uttana Asana. Bend your right knee
and place the right foot by the side of the left knee. Turn to your right and place your
right hand on the ground behind you to support your erect position. Bring your left
arm round the outer side of the right knee and catch hold of the right big toe. Turn
your head and look back over your right shoulder. Te erect knee acts as a fulcrum
for getting maximum twist of the spine. Keep your torso as straight as possible. Hold
the posture for 30 seconds with soft breathing.
Release the posture and come back to the Uttana Asana. Tis posture gives an
excellent massage to the abdominal organs and is very useful for those sufering from
diabetes as well as digestive disorders. It is also useful for neck and back problems.
Repeat the practice on the opposite side in a similar manner. Hold the posture for 30
seconds with soft breathing. Release the posture and come back to the Uttana Asana
and relax with deep breathing for some time.
ARDHA MATSYENDRA ASANA
Sit erect with both legs stretched out in front and your palms gently pressing on the ground by your sides in Uttana
Asana. Fold your right knee and place the heel tight in against the perineum. Place your left foot by the side of your right
thigh by crossing it over the knee. Bring your right hand round the outer side of the left knee
passing between the chest and the knee and catch hold of the left big toe. Your right shoulder
blade rests on the outer side of your left knee.
Take your left hand round your back and try to get a grip on your right thigh. Look back
over your left shoulder. Te erect knee acts as a fulcrum for getting maximum twist of the
spine. Keep your trunk vertical. Hold the posture for 30 seconds with soft breathing. Tis
posture gives an excellent massage to all the abdominal organs and is very useful for those
sufering from diabetes as well as digestive disorders.
Release and come back to the Uttana Asana.
Repeat on the opposite side by folding your left knee with the heel tight in against the
perineum. Place your right foot by the side of your left thigh by crossing it over the knee.
Bring your left hand round the outer side of the right knee passing between the chest and the
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knee and catch hold of the right big toe. Your left shoulder blade rests on the outer side of your right knee.
Take your right hand round your back and try to get a grip on your left thigh. Look back over your right shoulder.
Te erect knee acts as a fulcrum for getting maximum twist of the spine. Keep your trunk vertical. Hold the posture
for 30 seconds with soft breathing. When you are ready slowly release the posture and come back to the Uttana Asana.
CHATUS PADA ASANA AND VYAGRAHA PRANAYAMA
Take up the Chatus Pada Asana with your weight evenly
distributed between your hands and knees. Start breathing in
and out for an equal count of six. While breathing in slowly
lift your head and arch your back downwards. Ten breathe out
slowly and lower your head while arching your back upwards.
Breathe in while lifting your head and arch your back down.
Breathe out while lowering your head and arching your
back up. Repeat this excellent practice at least nine times at each
session. Vyagraha Pranayama helps us to utilize all sections of
our lungs in a balanced and controlled manner thus energizing
the whole body with healing Pranic energy.
When ready slowly relax back to the Vajrasana for a period
of quiet contemplation.
BHUJANGINI MUDRA
To perform the Cobra gesture, take up the Unmukha Asana
which is a prone position with your entire body in a straight line.
In this technique the emphasis is on the breathing pattern and
the production of a mighty hissing sound through the clenched
teeth. Slowly bring your arms forward and keep your palms on the
ground alongside your shoulders. Take in a deep breath. While
making a mighty hissing sound, fare back into the Bhujanga
Asana. Slowly relax back onto the foor while breathing in and
then again fare back with a mighty hiss. Repeat this Mudra at
least three to six times at each session. Tis technique helps release
the pent up stress that accumulates in our system from our daily
life and provides great emotional and mental relief.
It is an excellent stress-buster and is a must for all in this day and age. After completing the practice come back
down to the face prone pose. Place your arms alongside your body and turn your head to the side. Relax for a few
minutes and let the beneft of this Mudra seep into each and every cell of your body.
PAWAN MUKTA ASANA
Lie down in a comfortable Shavasana and start to breathe in and
out for an equal count of six or eight. To perform the single legged Eka
Pada Pawan Mukta Asana bend and lift your right knee while breathing
in and simultaneously also lift your head of the ground. Catch hold of
your knee with your arms and try to touch your knee to your forehead.
Hold the position a few seconds and then while breathing out slowly
release the position and lower your head while at the same time bringing
your foot back to the ground.
Repeat this at least two more times to complete a set of three rounds
of the practice. Relax a few seconds in the Shavasana and then perform
the practice on the left side. Relax in Shavasana for a few minutes with
deep and rhythmic breathing while concentrating on your abdominal
area that will help to relax you further.
To perform the double legged Dwi Pada Pawan Mukta Asana bend
and lift both your knees while breathing in. Bring them as close to your
forehead as possible while simultaneously raising your head to meet the
knees. Hold a few seconds and then while breathing out, lower your
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head and simultaneously bring your feet back to the ground. Repeat this two more times to complete a set of three
rounds at each session.
Relax in Shavasana for a few minutes with deep and rhythmic breathing while concentrating on your abdominal
area. Tis will help you to relax even further as the emotional tensions tend to tighten up the abdominal area leading to
a feeling of butterfies in the stomach.
EKA PADA UTTANPADA ASANA
From Shava Asana lift your right leg up towards the sky on the in breath.
Try not to bend the knee if possible. On the out breath lower the leg back to the
ground. Use a breath cycle of in and out for a count of six or eight.
Repeat this two more times. Perform the same practice on the left side.
Lift your left leg up towards the sky on the in breath. Try not to bend the knee
if possible. On the out breath lower the leg back to the ground. Use a breath
cycle of in and out for a count of six or eight. Repeat this two more times. After
performing the practice at least three times on each side relax in Shava Asana
with deep breathing.
DWI PADA UTTANPADA ASANA
From Shava Asana lift both legs up towards the sky on the in breath. Try not to
bend the knees if possible. On the out breath lower the legs back to the ground. Use
a breath cycle of in and out for a count of six or eight. Repeat this two more times
and then relax in Shava Asana with deep breathing. Tose who have back problems
should not do straight leg lifting and should do it with bent knees instead to avoid
increasing the strain on the back.
SARVANGA ASANA
Lie down in Shava Asana. Breathe in and lift both legs at a time until you are in the Dwi
Pada Uttanpada Asana. Continue the upward motion and lift your back of the ground using both
arms to support the lower back. Keep your trunk and legs in a straight line by supporting the entire
trunk on the shoulders. Breathe in a shallow manner while concentrating on the healthy pressure
at the throat region.
Release the posture after 10 to 15 seconds and while breathing out slowly come back to the
Shava Asana. Roll your head from side to side to ease away any pressure that may have accumulated
in the neck. After a short relaxation, repeat the practice two more times.
VIPARITA KARANI
Viparita Karani is the shoulder stand-like Mudra where the weight of the body
is supported by the elbows while the hands are placed against the pelvic girdle. From
the supine Shavasana slowly lift both your legs up as if performing the Sarvangasana.
However the weight of your body should be balanced on your elbows and arms and
not on your shoulders.
Hold the posture in a comfortable manner and then start to perform the
incomplete and complete actions of this Mudra.
Perform the incomplete action by taking a deep inhalation and bringing your
straightened legs towards your head so that your body makes an acute angle. Ten
perform the completed action by pushing your legs away while exhaling the breath.
Make sure that your feet are extended in a rigid position making an obtuse angle.
Breathe in bringing your feet towards your head 1-2-3-4-5-6. Breathe out pushing your feet away 1, 2, 3,4,5,6.
Continue the practice for a minimum of three to nine rounds of this alternation between the incomplete and
complete postures with the breath cycle at every session.
Tis Mudra promotes a healthy metabolic function by stimulating the pancreas and the uptake of insulin by cells of
the body. It is highly recommended for the prevention, control and possible cure of conditions such as Diabetes Mellitus
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and imbalances of the thyroid gland. When ready slowly bring your legs down to the ground in a phased manner and
enjoy a quiet period of relaxation in the Shavasana.
SHAVASANA WITH SAVITRI PRANAYAMA
Lie supine on the ground with your head preferably to the north enabling your body to be in alignment with the
earths electromagnetic feld. Make sure that your head and body are in a straight line while hands are kept relaxed by
side with palms facing upwards. Bring your feet together and let forefeet fall away into a v shape with heels as close
together as possible.
Start to consciously watch your breath by letting your awareness settle in the
abdominal area. Feel the abdominal movements as your abdomen rises as you breathe
in and falls as you breathe out. After a few rounds of this practice, slowly let your
awareness settle at the tip of your nose. Feel the cool inspired air fowing into your
nostrils as you breathe in and become aware of the warm expired air fowing out of
the nostrils when you breathe out.
Consciously regulate your breath so that the duration of the incoming and
outgoing breathes are equal. Te inspiration and expiration can be for a count of 4 or
6 initially and then with practice elongated to a count of 8 or 10. Perform at least nine
rounds of this conscious deep breathing and enjoy the relaxed sensation that spreads
throughout your body.
Relaxation in Shavasana can be further deepened by utilizing Savitri Pranayama to relax and rejuvenate your body,
emotions and mind. Breathe in through your nose for a count of 6. Hold in the breath for a count of 3. Breathe out
through your nose for a count of 6. Finally hold the breath out for a count of 3. Make sure that you are breathing in
and out through both nostrils and that you are using the complete Yogic breathing. Perform at least 9 rounds of this
combination practice that heightens the relaxation to a very deep level.
After performing 10 to 15 minutes of the Shavasana slowly start to move your fngers and toes. Perform conscious
stretching and make a smooth transition from the relaxed to the active state. Lift your left arm over your head and
turn over onto your left side. Continue the turning action until you come into the face-prone posture. Perform Makara
Asana by placing your right hand on the left while the left is placed palm down on the ground in front of you. Keep your
forehead or chin on your right hand while keeping your legs a foot apart. Bring your hands forward near your shoulders
and push yourself back into the Bhujanga Asana. Continue the back bending movement and go into the four footed
Chatus Pada Asana. Relax into the Shashanga Asana with your arms stretched out in front and then fnally come back
to the Vajrasana. With your palms on your thighs sit quietly for some time and enjoy the efects of the deep relaxation
that has spread to every part of your body.
SPANDA NISHPANDA KRIYA
Tis practice is done from Shavasana using the yogic concept of Shpanda Nishpanda, which means the coupling of
tension and relaxation. We consciously tense diferent parts of our body as much as possible and then relax them to the
maximum in a step-by-step manner. Tis produces a better relaxation response than the mere attempt to relax without
putting in the initial efort of tension.
Lie down in a comfortable supine Shavasana with your entire body in a singe straight line. After a few seconds of
relaxation in this position, start to tense your entire body part-by-part from your toes up to the top of your head until
every part of your body is as tense as possible. Hold this 100% tension state of Spandha for a few seconds. Let all the
muscles of your entire body be as tense as possible. At the peak of the tension, just let go and immediately relax your
entire body 100%. Tis is the state of Nishpanda. Enjoy this relaxed state and with conscious awareness continue to
watch your breath as it comes in and goes out of your nose.
Repeat this practice again by tensing up your entire musculoskeletal system to the state of Spandha and hold it for
a few seconds. When ready let go completely and enjoy the Nishpanda state for a few minutes.
To complete the practice repeat the Spandha Nishpanda Kriya a third time by tensing up your entire musculoskeletal
system from your toes to the top of your head. Hold the complete tension for a few seconds. When ready let go completely
and enjoy the complete relaxation that ensures. Be aware of how all your muscles relax in this practice because the
relaxation is deepened when it is contrasted with tension.
Tis practice is a boon for those sufering psychosomatic, stress induced and stress aggravated life disorders such as
hypertension, diabetes, asthma, insomnia, peptic ulcers and bowel disorders.
Ann. SBV, July - Dec, 2013 2(2)
Page 39 Annals of SBV
MARMANASTHANAM KRIYA
Te twenty-two sensitive parts of the body are known by the collective Sanskrit
term Marmanasthanam. To concentrate upon these parts in a particular order or to
command these areas to relax in a particular way while concentrating, gives a very
satisfactory, deep relaxation that has been found by tested experiments to give relief
even to compulsive dreaming. Tis is an excellent Kriya to do at the end of a strenuous
session of Asanas and Pranayamas. Te relaxation should be preceded by at least nine
rounds of Savitri Pranayama, the Rhythmic Breath, to create the proper atmosphere.
Tis technique (Kriya) can be done in two ways, one for relaxation the other for deep
concentration. For relaxation the technique is done from feet to the head. For deep
concentration from head to feet. While concentrating upon twenty-two body parts,
each part is commanded (by mind) to relax or a thought of peace or serenity directed
to the areas.
For relaxation, concentrate upon the (1) toes and command the toes to relax (2) feet
(3) lower legs to knees (4) upper legs to hips (5) buttocks (6) base of spine (7) pelvic area
(8) abdomen (9) chest and (10) shoulders. Now take your concentration down to the (11)
fngers, and command the fngers to relax then (12) hands (13) lower arms to elbows
(14) upper arms to shoulders where your concentration joins with body concentration
(15) throat (neck) (16) around the mouth and chin (17) around the nose and cheeks (18)
eyes (19) back around the ears (20) back of the head (21) top of the head (22) Cavernous
Plexus in the middle of the forehead. All the while you should command relaxation.
Perform Jyoti Dharana and Jyoti Dhyana (concentration and meditation on the Divine
light) at the Bhrumadhya Bindu (Midpoint between the eyebrows). Visualize the
Divine Jyoti to be having the brilliance equal to 1000 suns but without the glare. Absorb
yourself into this Divine Jyoti.
PRANAYAMA PRACTICES
PRANAVA PRANAYAMA
Tasya vachakah pranavaha, the sacred sound of the Divine is the Pranava says
Maharishi Patanjali. Tis develops abdominal, thoracic and clavicular regions of the
lungs to their maximum capacity. Tis Pranayama has unlimited healing potential and
brings about harmony of body, emotions and mind. It is an important part of Rishiculture
Ashtanga Yoga tradition as taught by Yogamaharishi Dr Swami Gitananda Giri Guru
Maharaj.
Adham Pranayama, the abdominal or lower chest breathing. Put the fngers into the
Chin Mudra with the index and thumb fngers touching each other at the tips. Keep the
other three fngers straight and united. Take a deep breath into the lower chest and abdominal regions and then let it
out with the sound aaa.
To perform thoracic or mid-chest breathing, the Madhyam Pranayama, curl your fngers inward to form Chinmaya
Mudra. Take a deep breath into the mid chest and thoracic regions and then breathe out with the sound ooo.
Adyam Pranayama is the clavicular or upper chest breathing and utilises Adhi Mudra. Clench your fsts with your
thumb in the centre. Keep the Adhi Mudra on your thighs and breathe deeply into the upper chest and clavicular regions
and then exhale with the sound mmm.
Joining the earlier three parts of the breath in a complete Yogic breath is the fourth stage, known was Mahat Yoga
Pranayama. Put the Adhi Mudra with knuckles of your right and left hands touching in front of the navel. Tis is now
known as the Brahma Mudra. Take a deep breath into the low, mid and upper chest regions. Now let the breath out with
the sounds of aaaooommm. Relax and enjoy the feeling of potent healing energy fow through the entire body.
NASARGA MUKHA BHASTRIKA
Nasarga Mukha Bhastrika is a forceful expulsion of the breath through the mouth that can accompany diferent
movements to relieve our pent up stress.
Take up a comfortable standing position and then start to shake your hands as vigorously as possible to help loosen
up the accumulated tensions of your daily life. Visualize all the tensions that have accumulated in your wrist and elbow
joints getting a good shake up by this action. When you have got the tensions loosened up, take in a deep breath through
your nose and clench your fst as if catching hold of all your tensions and stress. Now with a powerful blast through your
Page 40
Ann. SBV, July - Dec, 2013 2(2)
Annals of SBV
mouth whoosh away all your accumulated tensions and stress as forcibly as possible.
Again shake your hands as fast as possible. Breathe in and catch hold of the tension in
your fst. Trow it all away with a blast. Make sure that you are using your diaphragm muscle
vigorously while blasting out the breath in this practice.
Perform this practice 3, 6 or 9 times as necessary. After performing 3 to 9 rounds of this
practice, relax in the standing position and enjoy the feeling of relief that sweeps through your
arms as you relax with some deep breathing.
CHANDRA PRANAYAMA
Sit in Vajrasana and perform Nasarga Mudra with your right hand. Close your right nostril with your thumb.
Inhale slowly through your left nostril for a count of four. Now exhale through the same left nostril for a count of eight.
Keep your right nostril closed throughout the duration of the practice. Repeat the Chandra Pranayama for a
minimum of nine rounds at each session.
Patients of lifestyle disorders such as anxiety, hypertension, insomnia, diabetes and other stressful conditions can
beneft by practising this Pranayama 27 times before breakfast, lunch, dinner and before going to bed at night.
BHRAMARI PRANAYAMA
Sit on the heels in the Vajrasana with the spine erect. Perform the Shanmuki Mudra with the thumbs of the hands
closing the external auditory canal. Te frst two fngers are then placed over the closed eyelids while the ring fngers
regulate the fow of air through the nostrils. Te little fngers are placed over the closed lips. Tis Mudra helps in joining
together the nerves of the hands with the facial and trigeminal nerves on the face.
Take a slow and deep breath in for six counts. Let out the breath very slowly while making a sound in the nasal
passages like the high-pitched sound of a female bee. Tis buzzing sound is very much like the Anuswarah sound of
mmm of the Pranava AUM. Repeat this at least nine times.
Bhramari is one of the Swara Pranayamas and stimulates the secretions and tones up nerve centres. Tis helps relive
Pitta conditions and rejuvenates the skin. It also creates a beautiful voice. It is a contemplative prelude to Nada Yoga.
CONTEMPLATIVE PRACTICES
PRANA DHARANA -BREATH AWARENESS: Sit in Vajrasana or lie down in Shava Asana. Begin to be
aware of your breathing and how the air passes down from the nostrils into the lungs and then back out the nostrils.
Feel the abdominal movements as the abdomen rises with the in breath and falls with the out breath. Let your awareness
settle in the abdomen. Feel the cool inspired air fowing into the nostrils and the warm expired air fowing out of the
nostrils. Let your awareness settle at the tip of the nose. Consciously regulate the breath so that the ratio of insp: exp is
equal. It can be a 4,6,8 or 10 count. Perform nine rounds of this practice.
MINDFULNESS BASED MEDITATION: One of the most productive of the many forms of quiet sitting,
popularly grouped under the heading of meditation is the mindfulness based awareness of ones thoughts. Tis is to be
done without identifying with the thoughts and without either justifying or condemning them. Take up a straight back
sitting position and sit facing to the North or East in the early morning. Keep your mind as placid as possible, as this is
the important feature of the early morning meditation. Breathe slowly and rhythmically, but very quietly. Do not upset
the peace. Hold your mind concentrated inside your head at a point in line with the eyebrows. Relax. Dont attempt to
force visualization, simply be alert and expectant. Presently, you will have the sensation of movement within the head, as
though watching a ticker tape of your thoughts. Te thoughts will be in extreme slow motion. Observe the thoughts.
Dont get emotionally involved with them, just watch them. You will actually be able to see your thoughts, as well as
hear them. Usually, the thoughts are quite mundane, but benign. Simply observe them, passively and dispassionately.
OM JAPA: Take up any meditative posture and start to perform the Savitri Pranayama in a 6 by 3 or 8 by 4
rhythm. Make an audible Pranava OM in the Bindu Nadi. With Japa-Ajapa, make silent intonation of the Pranava OM
concentrating at this same point. Do not let the mind waver away from either a conscious repetition of the Mantra OM,
as Japa, or as the silent Ajapa.
AJAPA JAPA: Take up any meditative posture and start to perform the Savitri Pranayama in a 6 by 3 or 8 by
4 rhythm. As you breathe in listen to the sound of SAH made as the breath enters your respiratory passages. As you
breathe out listen to the sound of HUM that is made as the breath leaves your respiratory passages. Concentrate on this
Ajapa Japa of HAMSA SOHAM in tune with the breath.
International Journal of Yoga Vol. 7 Jan-Jun-2014
60
Differential effects of uninostril and alternate nostril
pranayamas on cardiovascular parameters and reaction time
Ananda Balayogi Bhavanani, Meena Ramanathan
1
, Balaji R
2
, Pushpa D
2
Deputy Director,
1
Co-ordinator and Yoga Therapist,
2
Yoga Instructor, Centre for Yoga Therapy, Education, and Research, Mahatma Gandhi
Medical College and Research Institute, Puducherry, India
Address for correspondence: Dr. Ananda Balayogi Bhavanani,
Deputy Director, Centre for Yoga Therapy, Education, and Research,
Mahatma Gandhi Medical College and Research Institute, Pillaiyarkuppam, Puducherry India.
E-mail: yognat@gmail.com
human life and one such example is swarodaya vigyan, the
ultradian nasal cycle as codified in the Shiva swarodaya,
wherein differential effects of different phases of the nasal
cycle are given in great detail.
[2]
A group of pranayama, namely chandra and surya
nadi (CN and SN, respectively) and chandra bhedana and
surya bhedana (CB and SB, respectively) have uninostril
breathing (UNB) and alternate nostril breathing (ANB)
patterns using left and/or right nostrils, respectively. This
type of yogic nostril manipulation is also furthered in nadi
shuddhi (NS), a specific technique involving alternate use
of both nostrils in a specific pattern.
These yogic UNB and ANB techniques have captured
the imagination of researchers worldwide and recent
studies have reported their differential physiological and
INTRODUCTION
Pranayama, the fourth limb of classical ashtanga yoga is
an essential part of yogabhyasa and is increasingly being
used as a tool of yoga chikitsa or the application of yoga as
a therapy. There are a multitude of pranayama techniques
and it is traditionally taught that each of them has different
psycho-physiological benefits.
[1]
The ancient rishis, the
seers of India have intuitively analyzed all aspects of
Access this article online
Website:
www.ijoy.org.in
Quick Response Code
DOI:
10.4103/0973-6131.123489
Background: Recent studies have reported the differential physiological and psychological effects of yogic uninostril
breathing (UNB) and alternate nostril breathing (ANB) techniques. This study aims to determine differential effects of these
techniques on reaction time (RT), heart rate (HR), and blood pressure (BP).
Materials and Methods: Twenty yoga-trained subjects came to the lab on six different days and RT, HR, and BP were recorded
randomly before and after nine rounds of right UNB (surya nadi [SN]), left UNB (chandra nadi [CN]), right initiated ANB (surya
bhedana [SB]), left initiated ANB (chandra bhedana [CB]), nadi shuddhi (NS), and normal breathing (NB).
Results: Overall comparison of % changes showed statistically signifcant differences between groups for all parameters. There
was an overall reduction in HR- and BP-based parameters following CB, CN, and NS with concurrent increases following SB and
SN. The differential effects of right nostril initiated (SB and SN) and left nostril initiated (CB, CN, and NS) UNB and ANB techniques
were clearly evidenced. Changes following NB were insignifcant in all respects. The overall comparison of % changes for RT
showed statistically signifcant differences between groups that were signifcantly lowered following both SB and SN.
Discussion and Conclusion: Our study provides evidence of sympathomimetic effects of right nostril initiated pranayamas
with sympatholytic/parasympathomimetic effect following left nostril initiated pranayamas. We suggest that the main effect of
UNB and ANB techniques is determined by the nostril used for inspiration rather than that used for expiration. We conclude
that right and left yogic UNB and ANB techniques have differential physiological effects that are in tune with the traditional
swara yoga concept that air fow through right nostril (SN and pingala swara) is activatory in nature, whereas the fow through
left nostril (CN and ida swara) is relaxatory.
Key words: Blood pressure; heart rate; pranayama; reaction time.
ABSTRACT
Short Communication
Bhavanani, et al.: Immediate differential effects of pranayamas
61
International Journal of Yoga Vol. 7 Jan-Jun-2014
psychological effects including effects on O
2
consumption,
metabolism and body weight,
[3]
blood glucose,
[4]
involuntary
blink rates
[4]
and intraocular pressure,
[5]
heart rate (HR),
stroke volume and end diastolic volume
[6]
as well as skin
resistance, digit pulse volume, and blood pressure (BP).
[7]

ANB (as done in NS pattern) has been reported to rapidly
alter cardiopulmonary responses and improve simple
problem solving.
[8]
Raghuraj and Telles have suggested
that yogic breathing through the right, left, or through
both nostrils alternately produces distinct autonomic
changes.
[9]
They reported that right UNB increased systolic
pressure (SP) and diastolic pressure (DP), whereas left
UNB resulted in significant reduction in SP and mean
pressure (MP).
However, none have studied the immediate effect of these
UNB and ANB techniques on reaction time (RT), a sensitive
and simple indicator of central neuronal processing. RT
is the interval between the onset of a signal (stimulus)
and the initiation of a movement response and is an
indirect index of central neuronal processing as well as a
simple means of determining sensory-motor association,
performance, and cortical arousal. Though RT shortening
effects of pranayama as well as comprehensive yoga
training of different durations have been reported,
[10-12]

earlier none have studied the immediate effects. Previous
studies by Bhavanani et al. have reported significant and
immediate decrease in auditory reaction time and visual
reaction time (ART and VRT, respectively) following nine
rounds of mukha bhastrika, a bellows type of pranayama
in normal school children as well as mentally challenged
adolescents.
[13,14]
With the above in mind, we have studied the immediate
effects of UNB and ANB on cardiovascular (CV) parameters
and RT. The aim of the study is to determine the differential
effects of these techniques if any and understand the
mechanisms behind their physiological effects. It is
hypothesized that right/left UNB, ANB performed by right
in and left out/left in and right out methods as well as NS
will have different effects. Keeping all of this in mind,
this study was planned to investigate the acute effects
of different UNB and ANB pranayamas on resting CV
parameters and RT.
MATERIALS AND METHODS
Twenty subjects (13 females and 7 males) regularly attending
yoga sessions at the Centre for Yoga Therapy, Education, and
Research (CYTER) thrice weekly for more than 3 months
were recruited for the study by convenience sampling. Their
mean age and Body mass index (BMI) were 34.10 13.62
standard deviation (SD) and 25.28 7.65 (SD), respectively.
All of them were right handed. Eight of them reported
normal health status, whereas the other 12 reported that they
were undergoing regular treatment for one or more medical
conditions such as hypertension,
[6]
hypothyroidism,
[3]
type 2
diabetes mellitus,
[2]
polycystic ovary syndrome,
[2]
bipolar
affective disorder,
[1]
sinusitis,
[1]
psoriasis,
[1]
and uterine
prolapse.
[1]
None were receiving autonomic modifying
agents like - or -blocking drugs.
Each subject came to the CYTER lab on six different days.
They were instructed to have a light breakfast before 8 a.m.
and report for the study between 10 a.m. and 12 noon. On
each of the 6 days, they performed nine rounds of any one
of the six techniques selected by random selection of both
subject and technique so as to avoid any bias or influence
of different days on the group.
The subjects were instructed to sit in any comfortable
posture and relax for 5 min before the pre-intervention
recordings of resting HR, BP, and RT were taken. They then
performed nine rounds of the following techniques after
which the post-recordings of HR, BP, and RT were repeated.
Right UNB (SN) using nasika mudra wherein the ring
finger was used to occlude left nostril by pressing on
the outside of the nostril
Left UNB (CN) using nasika mudra wherein the thumb
was used to occlude right nostril by pressing on the
outside of the nostril
Breathing in through right nostril and out through the
left (SB) using nasika mudra to regulate flow through
respective nostrils
Breathing in through left nostril and out through the
right (CB) using nasika mudra to regulate flow through
respective nostrils
Breathing in through left nostril and out through right
followed by breathing in through right and out through
left (NS) using nasika mudra to regulate flow through
respective nostrils
Performance of normal breathing (NB) through both
nostrils with nasika mudra (just performed as a placebo
but not closing either nostril).
Participants were instructed to focus their mind on their
breath and ensure it was slow, deep, and regular while
attempting to utilize all sections of their lungs. Respiratory
rate for all techniques was maintained at 5-6 breaths
per min (BPM) and this was regulated by one of the
investigators providing an audible count of six for both
inspiration and expiration. As they were all attending
regular yoga sessions, none reported any difficulty in doing
the techniques in this manner.
To ensure objectivity in measuring HR and BP, the
recordings were done using non-invasive semi-automatic
BP monitor (CH 432, Citizen Systems, Tokyo, Japan) with
an instrumental accuracy of 5% for HR and 3 mm Hg
for BP. Pulse pressure (PP) was calculated as SP-DP, MP as
Bhavanani, et al.: Immediate differential effects of pranayamas
International Journal of Yoga Vol. 7 Jan-Jun-2014
62
DP + 1/3 PP, rate-pressure product (RPP) as HR SP/100,
and double product as HR MP/100.
RT apparatus manufactured by Anand Agencies, Pune
was used for the study. The instrument has a built in
4-digit chronoscope with a display accuracy of 1 ms. It
features four stimuli, two response keys, and a ready
signal. Switches for selecting right or left response key for
any stimulus are provided. In this study, simple ART was
recorded for auditory beep sound stimulus and simple
VRT for red light stimulus. The subjects were instructed
to release the response key as soon as they perceived the
stimulus. The signals were given from the front of the
subjects to avoid the effect of lateralized stimulus and
they used their dominant hand while responding to the
signal. All subjects were given adequate exposure to the
equipment on two different occasions to familiarize them
with the procedure of RT measurement as this is found
to be more consistent when subjects have had adequate
practice. For statistical analysis of RT, more than 8-10 trials
were recorded and the average of the lowest three similar
observations was taken as a single value.
[11-14]
Data were assessed for normality using GraphPad InStat
and passed normality testing by Kolmogorov-Smirnov
Test. Statistical analysis was done using analysis
of variance (ANOVA) with Tukey-Kramer Multiple
Comparisons Test for data with identical SDs and Kruskal-
Wallis (non-parametric ANOVA) with Dunns Multiple
Comparisons Test for data with non-identical SDs.
Students t (paired) test was done and P values less than
0.05 were accepted as significant differences in pre-post,
intra-group comparisons.
RESULTS
The overall comparison of % changes showed
statistically significant differences between groups for
all parameters [Tables 1 and 2]. As seen in Table 1, HR
reduced significantly following both CB and CN, whereas
SP fell significantly following CB and NS and a significant
rise was seen in DP following SB. PP fell significantly
following NS, MP reduced significantly following CB,
while it increased following SB and there was significant
reduction in RPP and Double product (DoP) following CB
and CN, while only RPP decreased significantly following
NS. Inter-group differences were statistically significant for
HR, DP, MP, RPP, and DoP comparisons between CB and SB,
as well as SB and CN. The comparisons were significant for
RPP and DoP between CN and SN as well as CB and SN.
The inter-group differences were statistically significant
Table 1: Overall comparison of % changes in heart rate, systolic pressure, diastolic pressure, pulse pressure, mean
pressure, rate-pressure product, and double product in 20 subjects following a control period of nine rounds of normal
breathing as well as nine rounds of chandra bhedana, surya bhedana, chandra, surya nadi and nadi shuddhi pranayamas
(%) % after NB % after CB % after SB % after CN % after SN % after NS P value
HR 0.194.79 4.615.99 2.226.42* 4.787.17

1.138.05 0.308.41 0.0017


SP 0.905.05

2.295.58 1.235.33

1.285.13 1.495.17

5.044.97 <0.0001
DP 0.365. 91 2.426.94 4.176.46** 2.057.59

0.506.36 0.596.98 0.0089


PP 0.5718.84

1.2613.14 2.7013.95 1.1613.42

6.1211.70

12.8315.04 0.0008
MP 0.343.85 2.405.62 2.804.98** 1.765.70

0.335.36 2.024.86

0.0027
RPP 1.037.83 6.847.25 3.6410.25** 5.909.74

2.7410.65

4.828.70

<0.0001
DoP 0.477.11 6.93***7.52 5.209.77 6.3310.15

1.5610.70

1.828.46 <0.0001
Values are given as meanSD. P values are given for intergroup compassions done by repeated measures of analysis of variance with Tukey-Kramer Multiple
Comparisons Test. For HR: *P<0.05 for CB versus SB;

P<0.05 for SB versus CN; For SP:

P<0.001 for SB versus NS;

P<0.001 for SN versus NS;

P<0.05
for NB versus NS; For DP: **P<0.01 for CB versus SB;

P<0.05 for SB versus CN; For PP:

P<0.05 for CN versus NS;

P<0.001 for SN versus NS;

P<0.05
for NB versus NS; For MP: **P<0.01 for CB versus SB;

P<0.05 for SB versus CN;

P<0.05 for SB versus NS; For RPP: **P<0.01 for CB versus SB;

P<0.01
for CB versus SN;

P<0.01 for SB versus CN;

P<0.05 for CN versus SN;

P<0.05 for SB versus NS;

P<0.05 for SN versus NS; For DoP: ***P<0.001 for


CB versus SB;

P<0.05 for CB versus SN;

P<0.001 for SB versus CN;

P<0.05 for CN versus SN; For all other comparisons, P>0.05. HR = Heart rate;
SP = Systolic pressure; DP = Diastolic pressure; PP = Pulse pressure; MP = Mean pressure; RPP = Rate-pressure product; Dop = Double product; NB = Normal
breathing; CB = Chandra bhedana; SB = Surya bhedana; CN = Chandra nadi; SN = Surya nadi; NS = Nadi shuddhi
Table 2: Overall comparison of % changes in auditory reaction time and visual reaction time in 20 subjects
following a control period of nine rounds of normal breathing as well as nine rounds of chandra bhedana, surya
bhedana, chandra nadi, Surya nadi, nadi shuddhi pranayamas
(%) % after NB % after CB % after SB % after CN % after SN % after NS P value
ART 2.62
(7.35,7.23)
4.73
(6.88, 7.43)
4.84
(12.75,8.40)***
3.95
(9.42,10.67)

6.596
(15.05,4.82)

1.09
(8.38,8.97)

<0.0001
VRT 1.40
(4.09, 5.18)
2.02
(6.86,9.89)
6.05
(13.04,6.64)**

2.83
(9.31,10.17)

6.67
(0.89,10.94)

1.28
(7.58,10.66

<0.0001
Values are given as median (range).P values are given for intergroup compassions done by Kruskal Wallis (nonparametric analysis of variance) with Dunns Multiple
Comparisons Test. For ART:***P<0.001 for CB versus SB;

P<0.001 for CB versus SN;

P<0.01 for SB versus CN;

P<0.001 for CN versus SN;

P<0.05
for SN versus NB;

P<0.01 for SN versus NS; For VRT: **P<0.01 for CB versus SB;

P<0.001 for CB versus SN;

P<0.01 for SB versus CN;

P<0.05 for SB
versus NB;

P<0.01 for SB versus NS;

P<0.001 for CN versus SN;

P<0.001 for SN versus NB;

P<0.001 for SN versus NS; For all other comparisons,


P>0.05. ART = Auditory reaction time; VRT = Visual reaction time; NB = Normal breathing CB = Chandra bhedana; SB = Surya bhedana;
CN = Chandra nadi; SN = Surya nadi; NS = Nadi shuddhi
Bhavanani, et al.: Immediate differential effects of pranayamas
63
International Journal of Yoga Vol. 7 Jan-Jun-2014
for comparisons between NS and SB, SN and NB for SP;
between NS and CN, SN and NB for PP; between NS and
SB for MP; and between NS and SB and SN for RPP. In
contrast to all of this, there were no significant changes
following NB.
ART and VRT shortened significantly following SB and
SN [Table 2]. There was a significant prolongation of ART
and VRT following CB while only ART was prolonged
following CN. The overall comparison of % changes for
RT showed statistically significant differences between
groups for ART and VRT that were significantly lowered
following both SB and SN with no apparent differences
between SB and SN or CB and CN and no significant
changes following NB and NS.
DISCUSSION
Resting CV parameters
There was an overall reduction in majority of CV
parameters following CB, CN, and NS with concurrent
increases following SB and SN [Table 1]. The differential
effects of right nostril initiated (SB and SN) and left nostril
initiated (CB, CN, and NS) UNB and ANB techniques
were clearly evidenced by statistically significant
differences between them. The changes following NB were
insignificant in all respects.
The significant reductions in HR, RPP, and DoP following
CB and CN as well as the significant fall in SP following
CB and the same coupled with decrease of RPP following NS
may be attributed to reduction in sympathetic activity
and/improvement of vagal tone as supported by previous
studies.
[3,6,9,15]
The significant decrease in PP following NS
may be attributed to the combination of the significant fall
in SP coupled with a small and insignificant rise in DP.
Interestingly, there was a significant rise in DP and MP
and a small insignificant rise in SP following SB. There
was also a small but insignificant rise in HR, RPP, and DoP
following SB and all of these changes may be attributed to
an enhanced sympathetic activity as reported by previous
studies.
[3,7,9,16]
RPP and DoP are indirect indicators of myocardial O
2

consumption and load on the heart, thereby signifying a
lowering of strain on the heart.
[15,17]
Sympathetic activation
is known to increase HR and RPP and decrease overall heart
rate variability (HRV). RPP provides a simple measure of
HRV in hypertensive patients and is a surrogate marker in
situations where HRV analysis is not available. It has also
been shown that standard deviation of normal to normal
beats and total power of HRV are inversely correlated
with mean HR and RPP.
[17]
Hence, the reduction in HR and
RPP following CB, CN, and NS implies better autonomic
regulation of the heart in our subjects with decreased O
2

consumption and load. This can be attributed to either an
overall increase of parasympathetic tone and/or a reduction
in sympathetic tone as it has also been previously reported
that sympathetic activity is lower during left UNB.
[18]
Raghuraj and Telles
[9]
reported significant decreases in
SP and MP following 30 min of left UNB, while the small
reduction in DP in that study also missed significance as in
this study. Though they reported a significant increase in
HR, we have found a significant decrease in HR following
both CB and CN in this study where the fall in SP was
significant only following CB and NS and not after CN.
These changes may be attributed to changes in cardiac
output (CO), peripheral vascular resistance, and humoral
factors.
[9]
As the HR reduced significantly following CB
and CN in this study, it is plausible that the coexisting
fall in SP is related to CO. It has been recently suggested
that there is an immediate increase in cardiac autonomic
modulation following ANB and paced breathing at five
BPM without a shift in autonomic balance in individuals
inexperienced with yogic breathing.
[19]
Breathing at the rate of six BPM is known to increase
vagal modulation of sinoatrial (SA) and atrioventricular
nodes and enhances baroreceptor sensitivity.
[15]
This may
be responsible for reduction in HR and the BP indices
following CB, CN, and NS in this study as it may have
harmonized respiratory and CV Meyer rhythms. This
may have potentially limited the otherwise influential
sympathomimetic effects of SB and SN; it has been
earlier suggested that sympathetic activation produced
by right UNB may be masked by vagally mediated lung
baroreceptor activity due to voluntary breathing efforts.
[20]
Srivastava et al. have earlier reported a tilt toward
parasympathetic dominance after just 15 min of ANB.
[21]

It is to be noted that this type of ANB (NS) involves a two
breath cycles for each round of the practice as opposed to
the one breath cycle as done in SB and CB. It is possible
that the significant changes seen in SP, PP, and RPP
following NS are a result of the longer duration and double
the number of breaths compared to the other techniques.
Our study provides evidence of sympathomimetic effects
as manifested by increases in all resting CV parameters
following the right nostril pranayamas. This is in
agreement with previous studies suggesting that right
UNB has sympathomimetic effects including increase
in metabolism, baseline O
2
consumption, and enhanced
cardio-sympathetic activity.
[6,3,7,9,16]
These effects have
been demonstrated after a month-long training
[3]
as well
as immediately after 45 min of the practice.
[7]
A recent
study also has reported significant increase in SP, DP,
and MP after 30 min of the practice.
[9]
Earlier studies in
normal subjects
[3,6,7,16]
have reported significant increases
Bhavanani, et al.: Immediate differential effects of pranayamas
International Journal of Yoga Vol. 7 Jan-Jun-2014
64
in HR and/or BP following right UNB though Jain et al.
conversely reported no significant change in HR and a
significant reduction in BP in healthy male subjects with
no significant changes in female subjects after 15 min
of SN.
[20]
A month of right UNB practice compared to
ANB resulted in a significant increase in the HR and O
2

consumption and a decrease in the body weight.
[3]
Another
study, which compared the immediate effects of right UNB
with NB, both practiced for 45 min, showed a reduction
in skin resistance, digit pulse volume with an increase in
SP following right UNB.
[7]
Studies on the dog by Levi et al. have reported considerable
right left asymmetry in the distribution of sympathetic
fibers to the heart with right-sided stellate ganglion
stimulation having greater chronotropic effects while
the left produced greater inotropic effects.
[4]
It is to be
noted that there are differences between the right and
left vagus nerves too with the right vagus having greater
cardiac deceleratory effect compared to the left and the
right vagus exerting greater restraint on the SA node
than the left.
[4]
Shannahoff-Khalsa and Kennedy have
suggested that ultradian rhythms of HR may be also
governed by alternating rhythmic influences of the right
and left branches of the autonomic nervous system with
increased HR resulting from right sympathetic with left
parasympathetic dominance.
[6]
Despite the above findings, it is to be noted that there are no
significant differences between right nostril initiated UNB
and ANB techniques (SB and SN). Similarly, there are no
significant differences between left nostril initiated UNB
and ANB techniques (CB and CN). Most of the significant
changes seemed to be following SB rather than SN where
the changes were on the similar lines but statistically
insignificant. The picture was not so demarcated with
regard to CN and CB as both seemed to be producing
equivalent changes in all parameters. The changes in
NS were more on the lines similar to left nostril initiated
techniques. On the basis of these findings, we suggest that
the main effect of the various UNB and ANB techniques is
determined more by the nostril used for inspiration rather
than that used for expiration.
Reaction time
Both ART and VRT shortened significantly following SB
and SN [Table 2]. There was a significant prolongation of
ART following both CB and CN, while VRT was prolonged
following CB. These changes were significantly lower
following both SB and SN as compared to NB, NS, CN,
and CB but there were no apparent differences between SB
and SN or CB and CN and no significant changes following
NB and NS. All the ART values were significantly shorter
than respective VRT values, and this is in agreement with
previous reports.
[10-14]
It has been previously suggested that the faster reactivity
seen post-pranayama may be due to a modulation of
activity at ascending reticular activating system and
generalized alteration in information processing at
the primary thalamo-cortical level occurring during
pranayama.
[13,14]
Changes in breathing period produced by
voluntary control of inspiration have been reported to be
significantly correlated to changes in RT.
[22]
According to
the traditional wisdom of yoga, pranayama is the key to
bringing about psychosomatic integration and harmony.
It may be easily understood that a calm mind will be able
to process information much better and react appropriately
than an agitated one. A previous study from JIPMER
reported a reduction in RT following 3 weeks of training
in both slow and fast pranayamas.
[12]
Decrease in RT signifies an improvement in central
neuronal processing ability of the special children.
This may be due to (1) greater arousal and faster rate
of information processing; (2) improved concentration;
and/or (3) ability to ignore or inhibit extraneous stimuli.
RT tends to improve as arousal increased and it has been
reported that RT is fastest with an intermediate level of
arousal and deteriorates when the subject is either too
relaxed or too tensed. An enhancement of contralateral
hemisphere function has been reported with selective
nostril breathing,
[23]
while Werntz et al. reported relatively
greater integrated electro encephalogram (EEG) value in one
hemisphere that correlated with predominant airflow in
the contralateral nostril, defining a new inter-relationship
between cerebral dominance and peripheral autonomic
nervous function.
[24]
It has also been suggested that forced
ANB has a balancing effect on functional activity of left
and right hemispheres.
[4]
It has been previously suggested that right nostril dominance
in the nasal cycle as well as right UNB may be correlated
with the activity phase of the basic rest-activity cycle, the
time during which sympathetic activity in general exceeds
parasympathetic activity throughout the body.
[4]
Another
study suggested that the lowering of intraocular pressure
by right UNB indicated sympathetic stimulation.
[6]
Various
mechanisms have been postulated to explain differential
physiological and psychological changes due to right and
left nostril breathing. Shannahoff-Khalsa suggested that
mechanical receptors in the nasal mucosa register flow of
air across membranes (unilaterally) and transmit this signal
ipsilaterally to the hypothalamus, the highest center for
autonomic regulation.
[4]
Even alternating leftright levels
of catecholamines have been found to occur in peripheral
circulation of resting humans with rhythms coupled to the
nasal cycle.
[25]
It is possible that the right nostril initiated
techniques are producing such a state of autonomic
arousal, whereas left nostril initiated techniques are
inducing autonomic relaxation/balance in our subjects.
Bhavanani, et al.: Immediate differential effects of pranayamas
65
International Journal of Yoga Vol. 7 Jan-Jun-2014
A major limitation of this study as well as the past studies
in UNB and ANB is that most researchers have not taken
into account the pre-intervention nasal dominance pattern
of the subjects before initiating their study protocol. As
the flow of air in the subjects dominant/non-dominant
nostril will already be having its own effects on autonomic
function, this is a major lacuna that needs to be addressed
in future studies.
CONCLUSION
We conclude that right and left yogic UNB and ANB
techniques have differential physiological effects. Right
nostril initiated UNB and ANB techniques (SB and SN)
induce a state of arousal through sympathetic activation
and/through increased ascending reticular activity and/or
by central action at the primary thalamo-cortical level.
On the other hand, left nostril initiated UNB and ANB
techniques (CB, CN, NS) delay reactivity of the subjects by
inducing a sense of inert lethargy and may induce a state
of parasympathetic dominance as seen in CV parameters.
This finding is in tune with the traditional swara yoga
concept that air flow through right nostril (SN and pingala
swara) is activatory in nature, whereas the flow through
left nostril (chandra nadi and ida swara) is relaxatory.
[2]

Further studies in different populations and in patients
of different conditions, as well as over different periods
of time, may provide a more detailed understanding of
the therapeutic potential of these simple and effective
pranayama techniques.
ACKNOWLEDGMENTS
The authors thank the management and authorities of Sri Balaji
Vidyapeeth University for setting up the Centre for Yoga Therapy,
Education and Research (CYTER) in Mahatma Gandhi Medical
College and Research Institute (MGMCRI). The authors are grateful
to Yogacharini Meenakshi Devi Bhavanani, Director ICYER and
Dr Madanmohan, Professor and Head Department of Physiology,
MGMCRI for their constant motivation, encouragement and
supportive guidance. We thank Miss Subashana, ANM for her
valuable assistance during the recording sessions and data entry.
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How to cite this article: Bhavanani AB, Ramanathan M, Balaji
R, Pushpa D. Differential effects of uninostril and alternate nostril
pranayamas on cardiovascular parameters and reaction time. Int J
Yoga 2014;7:60-5.
Source of Support: Nil, Confict of Interest: None declared
Journal of Clinical and Diagnostic Research. 2014 Jan, Vol-8(1): 10-13 10 10
DOI: 10.7860/JCDR/2014/7256.3668
Original Article

Keywords: Pranayama, Cognitive functions, Reaction time
ABSTRACT
Objectives: To compare the cumulative effect of commonly
practised slow and fast pranayama on cognitive functions in
healthy volunteers.
Settings and Design: 84 participants who were in self-reported
good health, who were in the age group of 18-25 years, who
were randomized to fast pranayama, slow pranayama and
control group with 28 participants in each group.
Material and Methods: Fast pranayama included kapalabhati,
bhastrika and kukkuriya. Slow pranayama included nadishodhana,
Pranav and Savitri. Respective pranayama training was given for
35 minutes, three times per week, for a duration of 12 weeks
under the supervision of a certied yoga trainer. Parameters
were recorded before and after 12 weeks of intervention:
Perceived stress scale (PSS), BMI, waist to hip ratio and
cognitive parameters-letter cancellation test, trail making tests
A and B, forward and reverse digit spans and auditory and visual
reaction times for red light and green light.
Statistical Analysis: Intergroup comparison was done by one way
ANOVA and intra group comparison was done by paired t-test.
Results and Conclusion: Executive functions, PSS and
reaction time improved signicantly in both fast and slow
pranayama groups, except reverse digit span, which showed
an improvement only in fast pranayama group. In addition,
percentage reduction in reaction time was signicantly more
in the fast pranayama group as compared to that in slow
pranayama group. Both types of pranayamas are benecial for
cognitive functions, but fast pranayama has additional effects on
executive function of manipulation in auditory working memory,
central neural processing and sensory-motor performance.

VIVEK KUMAR SHARMA
1
, RAJAJEYAKUMAR M.
2
, VELKUMARY S.
3
, SENTHIL KUMAR SUBRAMANIAN
4
,
ANANDA B. BHAVANANI
5
, MADANMOHAN
6
, AJIT SAHAI
7
, DINESH THANGAVEL
8
INTRODUCTION
Anxiety, stress and mental tensions have become almost inevitable
companions of human life at all cross sections of populations [1].
Studies have reported higher perceived stress among students
in healthcare courses, including dental, medical and nursing
courses [2-5], as compared to students from other elds. Yoga
and pranayama are ancient sciences which originated in India,
which can be practised to combat stress [6]. Pranayama involves
manipulation of the breath and it consists of three phases:
puraka (inhalation); kumbhaka (retention) and rechaka
(exhalation) [7,8]. Pranayama can be practised as either fast or
slow pranayamas. Both fast and slow pranayamas are benecial
[9-11], but their physiological responses are different in healthy
participants [12]. Executive functions refer to cognitive processes
that regulate, control, and manage other cognitive processes [13].
Executive functions include working memory, concentration span,
scanning and retrieval of stored information and mental exibility,
i.e. the ability to shift from one criterion to another in sorting or
matching tasks [14,15]. Perceived stress has a negative impact
on executive functions [16,17]. There is a paucity of data on
evaluation of the cumulative effect of commonly practised slow and
fast pranayamas on cognitive parameters such as attention span,
executive functions, perceived stress and reaction time. Therefore,
the current study aimed to compare the effects of twelve weeks
of fast and slow pranayama training on these parameters in young
healthcare students.
MATERIAL AND METHODS
This study was conducted in the Department of Physiology,
JIPMER, Pondicherry India, during May 2011 to December 2011.
Yoga training was given at the Advanced Centre for Yoga Therapy
Education and Research (ACYTER), JIPMER, Pondicherry. The
P
h
y
s
i
o
l
o
g
y

S
e
c
t
i
o
n
study was commenced after obtaining approval from the institutes
scientic advisory committee and human ethics committee.
Participants
We considered volunteers who were in the age group of [18-
25] years, who were in self-reported good health, who were
undergoing various healthcare courses (medical, nursing and allied
medical sciences). We excluded volunteers who had practised
yoga in the past one-year and those with current or previous
mental or neurological diseases. We explained the study design to
the volunteers and made them aware that their participation would
remain anonymous and that they had the freedom to withdraw
from the study at any time.We included only those who gave their
written informed consents to participate in the study (n=84).
Parameters Measured
1. Height
2. Weight
3. Cognitive Functions Test Battery [19]
Letter Cancellation Test (LCT)
Trail Making Test A (TTA)
Trail Making Test B (TTB)
Forward digit span (FDS)
Reverse digit span (RDS)
4. Reaction time (RT)
Reaction time for the detection of auditory (ART) and visual
signals (red and green lights) (VRT- R and VRT G respectively)
was recorded on apparatus supplied by Ananda agencies (Pune,
India). RT is an indirect index of the processing capacity of the
central nervous system, and it is a simple and inexpensive method
Effect of Fast and Slow Pranayama
Practice on Cognitive Functions
in Healthy Volunteers
www.jcdr.net Vivek Kumar Sharma et al., Effect of Fast and Slow Pranayama Practice on Cognitive Functions in Healthy Volunteers
Journal of Clinical and Diagnostic Research. 2014 Jan, Vol-8(1): 10-13 11 11

Keywords: Pranayama, Cognitive functions, Reaction time
size was adequate and that the strength of the study was good.
There were no signicant differences in age, height or weight
between the three groups [Table/Fig-1]. There was no signicant
difference in gender distribution between the groups. The 3 groups
were comparable in executive functions and attention span before
the intervention [Table/Fig-2]. There was a signicant decrease in
LCT (time) (p<0.001), number of omissions in LCT (p<0.001), total
time taken for TTA (p<0.001), total time taken for TTB (p<0.001),
ART (p<0.001) and VRT (both green and red light) (p<0.005) in
both the study groups but not in the control group after the study
period (12 weeks). We have also observed that practice of fast
and slow pranayama lead to siginicant decrease in Perceived
stress scale scores [18]. In addition, a signicant improvement
was seen among participants of both fast pranayama group and
slow pranayama group in FDS (p<0.001), whereas a change in
RDS was seen only in fast pranayama group participants.
There were no signicant differences in the percentage of change
from pre- to post-test between fast and slow pranayama groups
in stress scores and in all of the executive function parameters.
However, the fast pranayama group showed a signicantly
improved performance as compared to the slow pranayama group
of determining sensorimotor performance [20].
Study design
The persons involved in the recording of the parameters and the
analysis of data were blind to the experimental conditions (i.e. the
group that the participants belonged to).
We familiarized the participants with the test batteries and gave
them adequate practice on the reaction time apparatus on two
separate occasions, to produce results that were more consistent.
On the day of assessment, participants reported to the Department
of Physiology, JIPMER, between 9 and 10 AM, at least two
hours after eating a light breakfast. Then, the above-mentioned
parameters were recorded. We administered these tests in the
same order as are given here, to all the participants.
Then, the participants (n=84) were randomly assigned into three
groups:
Fast pranayama group (n = 28): 1. Kapalabhati, Bhastrika and
Kukkriya.
Slow pranayama group (n = 28): 2. Nadishodhana, Pranava
and Savitri.
Control group (n = 28): 3. No pranayama intervention. All
the parameters were recorded again after 12 weeks of
intervention.
Intervention
We trained the participants in their respective pranayama technique
for one week, before the start of the intervention period. Pranayama
intervention was carried out for about thirty-ve minutes a day,
three times per week, for a duration of 12 weeks. A certied yoga
trainer at ACYTER gave the Pranayama training and intervention.
Participants practised the pranayama in a quiet room which was
maintained at a comfortable temperature (25 2C). We followed
pranayama techniques followed in ACYTER, JIPMER 21. Typical
sessions of fast and slow pranayamas were as follows:
Fast Pranayama: Each cycle (6 minutes) consisted of practising
one minute of Kapalabhati, one minute of Bhastrika and one minute
of Kukkriya pranayamas, interspersed with one minute of rest
between each pranayama. Participants were asked to complete 4
cycles in each session (24 minutes).
Slow Pranayama: Each cycle (9 minutes) consisted of practising
two minutes of Nadishodhana, two minutes of Pranava and two
minutes of Savitri pranayamas which were interspersed with one
minute of rest between each pranayama. While they were sitting
in a comfortable posture (sukhasana), participants were asked to
perform three rounds per session (27 minutes).
STATISTICAL ANALYSIS
Power and sample size software, version 3.0 was used to calculate
the adequate sample size (at assumed power of 90%) which
was required for the study and to analyze the posttest power
of the study. Analysis of the data was done by using IBM SPSS,
version 19. The normality of the data was tested by Kolmogorov
Smirnov test. Intergroup comparison was done using one way
ANOVA, followed by Tukey Krammer posthoc test for pair wise
comparisons. Intragroup comparisons were done by using paired
t-test for parametric measures and Wilcoxon signed rank test was
used for non-parametric measures. Chi-square test was used
to compare intergroup gender distributions. The Mann Whitney
U-test was used to compare the percentage change between
groups. A p value less than 0.05 was considered to be statistically
signicant.
RESULTS
A post-test analysis, revealed that the lowest power of the study
with a mean RDS difference of 0.36 (SD=1.13) between fast and
slow pranayama groups was 85%, which showed that the sample
Parameters Fast pranayama
group (n=28)
Slow pranayama
group (n=28)
Control group
(n=28)
LCT
(time in sec)
Pre 114.03 17.13 104.89 19.20 111.36 18.74
Post 104.17 114.15*** 89.32 19.37*** 109.36 24.05
LCT
(omissions)
Pre 2.64 2.52 1.36 1.54 0.86 0.97
Post 0.71 1.08*** 0.42 0.69** 0.70 1.08
LCT
(commission)
Pre 0.035 0.18 0.03 0.18 0.06 0.25
Post 0.071 0.62 0.07 0.26 003 0.18
TTA
(in sec)
Pre 73.60 23.4 65.12 14.96 74.10 11.64
Post 58.67 21.62*** 51.89 13.14*** 72.10 12.95
TTB
(in sec)
Pre 104.57 26.50 97.05 24.36 106.73 34.45
Post 83.96 18.94*** 85.39 25.47*** 98.46 33.47
FDS Pre 6.03 0.83 6.00 0.94 5.93 1.36
Post 6.75 1.07*** 6.42 0.71* 5.73 1.25
RDS Pre 4.14 0.80 4.21 0.95 3.83 1.14
Post 4.50 1.07* 4.57 1.13 3.80 1.32
ART
(msec)

Pre 188.99 30.36 186.61 30.43 189.54 28.08
Post 154.89 29.10*** 167.58 23.99*** 189.76 26.61
VRTR
(msec)

Pre 219.79 35.21 208.11 37.02 221.88 34.45
Post 177.85 22.22*** 189.32 40.19* 222.0 27.79
VRT-G
(msec)

Pre 240.70 39.44 226.53 41.67 222.68 31.69
Post 186.31 28.02*** 206.32 39.02* 223.21 30.04
PSS Pre 19.21 4.33 19.21 4.38 20.57 3.17
Post 14.42 4.14*** 13.89 2.94*** 19.82 3.41
Parameters Fast pranayama
group (n=28)
Slow pranayama
group (n=28)
Control group
(n=28)
Age (years) (Mean SD) 18.39 1.133 19.28 1.82 19.0 1.56
Height (cm) (Mean SD) 158.46 7.30 157.33 9.42 157.25 8.86
Weight (Kg) (Mean SD) 49.63 6.12 51.82 11.65 50.21 9.26
Gender
Male 5 4 5
Female 23 24 23
[Table/Fig-1]: Comparison of subjects characteristics amongst three
groups. *P<0.05; **P<0.01; ***P<0.001. One way ANOVA test for intergroup
comparison of Age, Height & Weight. Chi-square test for comparison of intergroup gender
distribution
[Table/Fig-2]: Comparison of pre test and post test values of cognitive
test parameters and reaction time in three groups (Mean S.D). LCT- letter
cancellation test, TTA Trial test A, TTB Trial test A , FDS- Forward digit span, RDS- Reverse digit
span, ART Auditory reaction time, VRTR Visual reaction time for red, VRT-G Visual reaction time
for green, PSS- Perceived stress score. *P<0.05; **P<0.01; ***P<0.001; Pre-Post analysis was done by
wilcoxon signed rank test.

Pre-Post analysis was done by Students paired t test;


#
P<0.05;
##
P<0.01;
###
P<0.001;
#
Intergroup analysis of pre values between groups was done by One way ANOVA
Vivek Kumar Sharma et al., Effect of Fast and Slow Pranayama Practice on Cognitive Functions in Healthy Volunteers www.jcdr.net
Journal of Clinical and Diagnostic Research. 2014 Jan, Vol-8(1): 10-13 12 12
Parameters Fast pranayama group
(n=28)
Slow pranayama group
(n=28)
LCT (time in sec) 7.82 10.91 13.24 15.10
LCT (omissions) 52.45 43.32 35.57 52.36
LCT (commission) 3.57 18.98 -0.035 0.188
TTA (in sec) 18.47 19.92 15.87 23.06
TTB (in sec) 17.65 17.25 7.23 28.66
FDS -13.1 20.32 -9.29 14.83
RDS -9.52 19.74 -10.62 32.94
ART (msec) 16.72 16.38* 8.31 15.27
VRTR (msec) 17.33 14.91* 8.42 16.32
VRT-G (msec) 20.72 16.80** 7.89 12.75
PSS 23.47 20.38 23.04 18.31
in ART, VRT-R (P<0.05) and VRT-G (P<0.01) [Table/Fig-3].
DISCUSSION
According to the traditional wisdom of yoga, pranayama is the key
to bringing about psychosomatic integration and harmony.
Specically, we observed a signicant reduction in perceived
stress and improvement in the following cognitive domains:
attention, visuo-motor speed and memory retention capacity in
both fast and slow pranayama groups. Prefrontal cortex regulates
physiological functions by integrating information from ongoing
cognitive processes, emotional processes and current stress
level [14,22]. Chronic (perceived) stress alters normal patterns
of prefrontal cortex activation during cognitive tasks, resulting in
enhanced autonomic arousal [14,22]. The reduced stress in both
pranayama groups could have enabled their improved cognitive
functions. Our results were consistent with those of previous
studies, which found signicant improvement in various cognitive
domains with the practice of different yoga breathing techniques
[10,23-25].
In the present study, it was not possible to determine the mechanism
of action of pranayama techniques, but we hypothesized that the
improvements in cognitive functions in pranayama groups may have
occurred due to reduced stress and improved parasympathetic tone.
The particular contribution of pranayama to stress reduction might
be mediated by the bidirectional vagal system. Vagal afferents
from peripheral receptors are connected with the nucleus tractus
solitarius from which bres ascend to the thalamus, limbic areas
and anterior cortical areas. The descending projections then
modulate autonomic, visceral, and stress arousal mechanisms at
the different levels of the neuraxis [26]. The bottom-up mechanisms
of pranayama practice may be induced through the stretch of
respiratory muscles, specically the diaphragm [14,26]. During
above tidal inhalation (as was seen in Hering Breuers reex),
stretch of lung tissue produces inhibitory signals in the vagus
nerve, which ultimately shifts the autonomic nervous sytem into
parasympatho-dominance, that results in a calm and alert state
of mind [27].
During both fast and slow types of pranayama practice,
when participants intentionally focus on breathing at different
frequencies of respiration and intend to relax, attention is drawn
away from extraneous distracting stimuli. With continuous
pranayama practice, the participants ability to concentrate is
enhanced and the changes in mental processing (e.g., focused
attention and reduced stress) are rapidly expressed in the body
via the autonomic and neuro endocrine systems. This reorganizes
neural representation within the CNS and improves bidirectional
communication between the cerebral cortex and the limbic,
autonomic, neuro endocrine, emotional, and behavioural activation
[22]. Also, generalized alteration in information processing at
thalamo-cortical level induces modication in neural mechanisms
which regulate the respiratory system [28].
The shortening of auditory and visual RT in our pranayama
groups represents greater arousal, better concentration and faster
responsiveness [12]. The improvement was signicantly greater in
the fast pranayama group as compared to that in slow pranayama
group. One previous study found insignicant decreases in ART
and VRT, with a shorter (three weeks) training period of Savitri
(slow breathing) and Bhastrika (fast breathing) pranayamas [12].
Our study, on the other hand, demonstrated that a prolonged
practice (12 weeks) of pranayama could be benecial in reducing
RT.
LIMITATIONS OF THE STUDY
There was a difference in training times between the fast and slow
pranayama groups (24 vs. 27 minutes), since the participants in
the fast pranayama group found it difcult to do more than four
rounds in a session. Also, there was a difference in the number
of male and female participants in the study. Nevertheless, the
male and female participants were equally distributed between the
groups, i.e. the gender ratio was almost similar. Since this study
was conducted only on healthy participants, future studies should
broaden the current research and include clinical populations such
as patients with psychiatric disorders, whose cognitive functions
are adversely compromised.
CONCLUSION
Slow and rapid types of pranayama are benecial for stress
reduction and for improving cognitive functions, but fast pranayama
has additional effects on sensori-motor performance (i.e. faster
auditory and visual RT).
DECLARATION FROM THE AUTHORS:
The ndings discussed in this research article are a part of the
bigger study to evaluate the effect of fast and slow pranayama on
various physiological parameters in adolescents. Part of the study
has earlier been published in Int J Yoga 2013;6:104-10. [29]
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[10] Telles S, Raghuraj P, Arankalle D, Naveen KV. Immediate effect of high-frequency
yoga breathing on attention. Indian J Med Sci. 2008 Jan; 62(1):20-2.
[11] Udupa K, Madanmohan, Bhavanani AB, Vijayalakshmi P, Krishnamurthy N.
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Indian J Physiol Pharmacol. 2003 Jan; 47(1): 27-33.
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of slow and fast pranayams on reaction time and cardiorespiratory variables.
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[Table/Fig-3]: Comparison of percentage difference between groups.
LCT- letter cancellation test, TTA Trial test A, TTB Trial test A , FDS- Forward
digit span, RDS- Reverse digit span, ART Auditory reaction time, VRTR Visual
reaction time for red, VRT-G Visual reaction time for green, PSS- Perceived stress
score. Analysis was done using Mann Whitney U test. *P<0.05; **P<0.01; ***<0.001
www.jcdr.net Vivek Kumar Sharma et al., Effect of Fast and Slow Pranayama Practice on Cognitive Functions in Healthy Volunteers
Journal of Clinical and Diagnostic Research. 2014 Jan, Vol-8(1): 10-13 13 13

PARTICULARS OF CONTRIBUTORS:
1. Assistant Professor, Department of Physiology, JIPMER, Puducherry, India.
2. Assistant Professor, Department of Physiology, Chennai Medical College Hospital & Research Centre, Irungalur, Trichy, Tamilnadu, India.
3. Assistant Professor, Department of Physiology, JIPMER, Pondicherry, India.
4. Senior Resident, Department of Physiology, JIPMER, Pondicherry, India.
5. Deputy Director, CYTER, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
6. Professor and Head, Department of Physiology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
7. Professor & Head, Department of Biostatistics, JIPMER, India.
8. Assistant Professor, Department of Physiology, Vinayaka Missions Medical College & Hospital, Keezhakasakudi, Karaikal, Puducherry, India.
NAME, ADDRESS, E-MAIL ID OF THE CORRESPONDING AUTHOR:
Dr. Senthil Kumar Subramanian,
Senior Resident, Department of Physiology, Jawaharlal Institute of Post-Graduate
Medical Education and Research, Pondicherry-605 006, India.
Phone: 91+ 9962267560, E-mail: drsenthilkumar83@gmail.com
FINANCIAL OR OTHER COMPETING INTERESTS: None.
Date of Submission: Aug 04, 2013
Date of Peer Review: Sep 10, 2013
Date of Acceptance: Oct 28, 2013
Date of Publishing: Jan 12, 2014
[13] Elliott R. Executive functions and their disorders: Imaging in clinical neuroscience.
British Medical Bulletin. 2003 Mar 1;65(1):49-59.
[14] M Marsel Mesulam. Aphasia, memory loss and other focal cerebral disorders.
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[15] Monsell S. Task switching. Trends in cognitive sciences 2003 Mar;7(3):134-40.
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memory and motivation for reward without disrupting motor ability and
motivation to explore. Behav Neurosci. 2006 Aug;120(4):842-51.
[17] Ohman L, Nordin S, Bergdahl J, Slunga BL, Stigsdotter NA. Cognitive function
in outpatients with perceived chronic stress. Scand J Work Environ Health.
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[18] Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J
Health Soc Behav. 1983 Dec;24(4):385-96.
[19] Lezak MD, Howieson DB, Loring DW. Orientation and attention.
Neuropsychological assessment. 4 ed. New York: Oxford University Press;
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[20] Madanmohan, Udupa K, Bhavanani AB, Vijayalakshmi P, Surendiran A. Effect
of slow and fast pranayams on reaction time and cardiorespiratory variables.
Indian J Physiol Pharmacol. 2005 Jul;49(3):313-8.
[21] Gitananda Swami. Pranayama: The fourth limb of Ashtanga yoga. Satya press;
2008.
[22] Taylor AG, Goehler LE, Galper DI, Innes KE, Bourguignon C. Top-down and
bottom-up mechanisms in mind-body medicine: development of an integrative
framework for psychophysiological research. Explore (NY) 2010 Jan;6(1):29-
41.
[23] Jella SA, Shannahoff-Khalsa DS. The effects of unilateral forced nostril breathing
on cognitive performance. Int J Neurosci. 1993 Nov; 73(1-2):61-8.
[24] Joshi M, Telles S. Immediate effects of right and left nostril breathing on verbal
and spatial scores. Indian J Physiol Pharmacol. 2008 Apr;52(2):197-200.
[25] Telles S, Raghuraj P, Maharana S, Nagendra HR. Immediate effect of three yoga
breathing techniques on performance on a letter-cancellation task. Percept Mot
Skills. 2007 Jun;104(3 Pt 2):1289-96.
[26] Brown RP, Gerbarg PL. Sudarshan Kriya yogic breathing in the treatment
of stress, anxiety, and depression: part I-neurophysiologic model. J Altern
Complement Med. 2005 Feb;11(1):189-201.
[27] Jerath R, Edry JW, Barnes VA, Jerath V. Physiology of long pranayamic breathing:
neural respiratory elements may provide a mechanism that explains how slow
deep breathing shifts the autonomic nervous system. Med Hypotheses. 2006;
67(3):566-71.
[28] Telles S. Alterations of auditory middle latency evoked potentials during yogic
consciously regulated breathing and attentive state of mind. 1993 May.
[29] Sharma Vivek, Trakroo Madanmohan, Subramaniam Velkumary, Rajajeyakumar
M, Bhavanani Anand, Sahai Ajit. Academic journal article. Int J Yoga.
2013;6:104-10.

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Page 297
Immediate Effect of Alternate Nostril Breathing On Cardiovascular
Parameters and Reaction Time

Ananda Balayogi Bhavanani
a
, Meena Ramanathan
b
, Madanmohan
c
a
Deputy Director, CYTER, MGMCRI, Pillayarkuppam, Pondicherry 607402, India
b
Co-ordinator and Yoga therapist, CYTER, MGMCRI, Pondicherry, India
c
Professor and Head, Department of Physiology and Director CYTER, MGMCRI,
Pondicherry, India
Corresponding author:
Ananda Balayogi Bhavanani
Deputy Director, CYTER, MGMCRI, Pillayarkuppam, Pondicherry 607402, India


Background: This study evaluated immediate effects of 27 rounds of left nostril initiated
alternate nostril breathing (ANB) technique of nadi shuddi (NS) and right nostril initiated
ANB of aloma viloma (AV) pranayama on cardiovascular (CV) parameters and reaction time
(RT) in a trained population.
Materials and methods: 16 subjects attending regular yoga sessions were recruited and each
subject performed 27 rounds of either technique, selected randomly on different days. Heart
rate (HR), systolic pressure (SP), diastolic pressure (DP), auditory and visual reaction time
(ART and VRT) were recorded before and after pranayamas. NS was done by breathing in
through left nostril and out through right followed by breathing in through right and out
through left. AV was done by breathing in through right nostril and out through left followed
by breathing in through left and out through right. All data passed normality testing and
statistical analysis was carried out using Students paired t test.
Results: HR, SP and DP reduced significantly (p < 0.05 to 0.001) after NS while they
increased after AV. Post intervention differences as well as % between groups was
significant (p < 0.05 to 0.001) for HR, SP and DP. ART and VRT were significantly (p < 0.05
to 0.001) shortened after AV and significantly prolonged after NS. Post intervention
differences as well as % between groups was very significant (p < 0.001) for both ART and
VRT.
Discussion: Significant reductions of HR, SP and DP after NS and their increase after AV
may be attributed to modulation of autonomic tone. Right nostril initiated ANB technique
produces autonomic arousal, whereas left nostril initiated ANB technique induces
relaxation/balance. These can be selectively applied in various therapeutic settings. Further
studies in various clinical conditions and settings can enable us to understand their therapeutic
applications better.
KEYWORDS: alternate nostril breathing, pranayama, reaction time, yoga
INTRODUCTION:
Shiva Swarodaya, a classical yogic text describes the ultradian nasal cycle as
Swarodaya Vigyan and highlights differential effects of its phases that reflect the
lunar cycles
(1)
Yogic

teachings reiterate that breathing exclusively through the left
nostril potentiates ida nadi, the lunar channel while breathing exclusively through
the right activates pingala nadi, the solar channel.
Abstract
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In the past few decades scientific studies on uni-nostril breathing (UNB) and alternate
nostril breathing (ANB) have reported physiological and psychological effects of
pranayama techniques

such as right UNB (surya nadi), left UNB (chandra nadi),
right initiated ANB (surya bhedana), left initiated ANB (chandra bhedana) and nadi
shuddhi (NS).
(2, 3, 4, 5, 6)
Performance of

ANB has been reported to rapidly alter
cardiopulmonary responses and improve simple problem solving
(7)
and a tilt toward
parasympathetic dominance has been demonstrated after even just 15 min of ANB
involving two breath cycles for each round of the practice.
(5)
It is important to scientifically validate specific differential effects of various ANB
techniques and to the best of our knowledge no study has compared NS and aloma
viloma (AV) pranayama. Both of them are two breath cycle ANB techniques, but
the breathing is initiated through left nostril in NS (left in-right out-right in-left out)
while it is initiated through right nostril in AV (right in-left out-left in-right out).
With the above in mind, this study planned to evaluate immediate effects of 27 rounds
of NS and AV on cardiovascular (CV) parameters and reaction time (RT) in a trained
population. For CV parameters we selected heart rate (HR) as well as systolic
pressure (SP) and diastolic pressure (DP) as these indicate changes in cardiac
autonomic regulation while for RT that is an index of processing ability of central
nervous system and a simple, non invasive means of determining sensorimotor co-
ordination and performance we selected auditory and visual RT (ART and VRT
respectively).
(8, 9)
MATERIALS AND METHODS:
Sixteen subjects (11 females, 5 males) attending regular yoga sessions at the Centre
for Yoga Therapy, Education, and Research (CYTER) twice / thrice weekly for more
than 2 months were recruited for this self-controlled study by convenience sampling.
Their mean age was 31.06 8.96 (SD) years and all were right handed. Three
reported normal health status, whereas others reported that they were on regular
treatment for one or more medical conditions like hypertension (2), type 2 diabetes
mellitus (1), arthritis (1), bronchial asthma (1), poly cystic ovarian disorder (6) and
stress (2). None were receiving autonomic modifying agents like - or blockers.
Each subject came to the CYTER lab on two different days. They were instructed to
have a light breakfast before 8 am and report for the study between 10 am and 12
noon. On each of the days, they performed 27 rounds of either technique, selected
randomly so as to avoid any bias or influence of the different days of recording.
The subjects were instructed to sit in any comfortable posture and relax for 5 min
before taking pre-intervention recordings of HR, SP, DP, ART and VRT. They then
performed the selected technique and all parameters were recorded immediately after
performance of 27 rounds. The entire sequence of recording was randomised to avoid
any bias.
Both techniques were performed in an erect sitting posture using a hand gesture
(nasika mudra) wherein ring finger of the right hand was used to occlude left nostril
by pressing on the outside of the nostril and the thumb to occlude right nostril as
required. The left hand was held in jnana mudra and placed on the left thigh in both
techniques. The alternate nostril breathing sequence for one round of the technique
was as follows:
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NS was done by breathing in through left nostril and out through right
followed by breathing in through right and out through left.
AV was done by breathing in through right nostril and out through left
followed by breathing in through left and out through right.
Participants were instructed to focus their mind on their breath and ensure it was slow,
deep, and regular while attempting to utilize all sections of their lungs. Respiratory
rate for both techniques was maintained at approximately 5-6 breaths per min (BPM)
and this was regulated by one of the investigators providing an audible count of six
for both inspiration and expiration. As they were all attending regular yoga sessions,
none reported any difficulty in performing 27 rounds of the techniques as given
above.
To ensure objectivity in measuring HR and BP, the recordings were done using non-
invasive automatic BP monitor (HEM 7203, Omron Healthcare Co. Ltd, Kyoto,
Japan) with an instrumental accuracy of 5% for HR and 3 mm Hg for BP. RT
apparatus (Anand Agencies, Pune) with a built in 4 digit chronoscope and display
accuracy of 1 ms was used for the study. Auditory beep sound stimulus was used for
ART and red light stimulus for VRT. The subjects were instructed to release the
response key as soon as they perceived the stimulus. Signals were given from the
front to avoid effect of lateralized stimulus and they used dominant hand while
responding to signals.
(3, 4)
All subjects were given adequate exposure to the equipment
on two different occasions to familiarize them with the procedure as RT is more
consistent when subjects have had adequate practice.
(6)
More than ten trials were
recorded and the mean of three similar observations was taken as a single value for
purpose of statistical analysis.
(10, 11)
Data were assessed for normality using GraphPad InStat version 3.06 for Windows
95, (GraphPad Software, San Diego California USA). All data passed normality
testing by Kolmogorov-Smirnov Test and hence intra and inter group analysis was
carried out using Students paired t test.
RESULTS:
The results are given in Table 1. HR, SP and DP reduced significantly (p < 0.05 to
0.001) after NS while they increased after AV. The post intervention differences as
well as % between groups was significant (p < 0.05 to 0.001) for HR, SP and DP.
ART and VRT were significantly (p < 0.05 to 0.001) shortened after AV and
significantly prolonged after NS. The post intervention differences as well as %
between groups was very significant (p < 0.001) for both ART and VRT.
DISCUSSION:
The significant reductions of HR, SP and DP after NS and their increase after AV
may be attributed to modulation of the resting autonomic tone. Previous reports
support our finding that right nostril initiated UNB and ANB techniques induce a state
of arousal through sympathetic activation and / through increased ascending reticular
activity and / by central action at the primary thalamo-cortical level.
(4, 6, 12, 13)
This
autonomic arousal may also explain faster reactivity seen after AV and signifies an
enhancement of central neuronal processing ability. This may be due to a faster rate of
information processing as well as improved concentration that enables selective
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Page 300
inhibition of extraneous stimuli. The slower reactivity after NS on the other hand,
may be attributed to the induction of a more relaxed state of parasympathetic
dominance in our subjects, as evidenced by reductions in all CV parameters.
(13)

Some researchers have tried to explain the differential physiological and
psychological changes due to right and left nostril breathing and have postulated
various mechanisms. Shannahoff-Khalsa suggested that mechanical receptors in the
nasal mucosa register flow of air across membranes (unilaterally) and transmit this
signal ipsilaterally to the hypothalamus, the highest center for autonomic regulation.
(2)
He also suggested that right nostril dominance in the nasal cycle as well as right UNB
may be correlated with the activity phase of the basic rest-activity cycle, the time
during which sympathetic activity in general exceeds parasympathetic activity
throughout the body.
(2)
Differences between right and left vagus nerves have been
reported with right vagus having greater cardiac deceleratory effect compared to left
and right vagus exerting greater restraint on SA node than left.
(2)
Another study
suggested that ultradian rhythms of HR may be also governed by alternating rhythmic
influences of the right and left branches of the autonomic nervous system with
increased HR resulting from right sympathetic with left parasympathetic
dominance.
(12)
Kennedy reported alternating leftright levels of catecholamines in
peripheral circulation of resting humans with rhythms coupled to the nasal cycle.
(14)

As the present study provides more supporting evidence to these earlier reports, we
can plausibly conclude that right nostril initiated ANB techniques produce autonomic
arousal, whereas left nostril initiated ANB techniques induce autonomic
relaxation/balance. These techniques can be selectively applied in various therapeutic
settings with NS benefiting those who require relaxation, reduction of stress, anxiety
and hypertension while AV can be applied in patients of depression, narcolepsy and
learning disorders. Further studies in various clinical conditions and settings can
enable us to understand their therapeutic applications better.
ACKNOWLEDGMENTS:
The authors thank the management of Sri Balaji Vidyapeeth University for setting up
and supporting the Centre for Yoga Therapy, Education and Research (CYTER) in
Mahatma Gandhi Medical College and Research Institute (MGMCRI). We are
grateful to Yogacharini Meenakshi Devi Bhavanani, Director ICYER for her constant
motivation and supportive guidance. Thanks are due to D Pushpa, G Sarulatha and M
Sangeeta for their valuable assistance during training, recording sessions and data
entry. We thank all the subjects for their wholehearted cooperation during the training
and recording sessions.
REFERENCES:
1. Bhavanani AB, Swarodaya Vigjnan- A Scientific Study of the Nasal Cycle.
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4. Raghuraj P, Telles S. Immediate effect of specific nostril manipulating yoga
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Table 1: Immediate effect of nadi shuddi and aloma viloma pranayamas on heart
rate (HR), systolic pressure (SP), diastolic pressure (DP), auditory reaction time
(ART) and visual reaction time (VRT) in the same subjects before (B) and
immediately after (A) performance of 27 rounds of the respective technique.

Nadi shuddi
Pranayama
Aloma viloma
Pranayama
Comparison
(p value)
B A % B A % B A %
HR
(beats/min)
86.67
9.41
78.67
7.31 ***
-8.89
4.89
82.69
10.36
85.77
12.16
3.72
7.36
0.13 0.032 <0.001
SP
(mmHg)
119.42
11.24
113.58
10.44***
-4.76
3.76
117.17
11.27
120.16
8.91*
2.82
4.45
0.07 <0.001 <0.001
DP
(mmHg)
74.92
8.15
73.00
5.05*
-1.98
4.74
75.67
7.05
79.76
7.26***
5.55
5.28
0.66 <0.001 <0.001
ART
(msec)
193.75
16.44
204.08
14.86***
5.51
3.12
190.35
18.79
178.65
19.26***
-6.17
3.15
0.50 <0.001 <0.001
VRT
(msec)
213.68
16.44
221.75
15.46 **
3.94
3.87
211.31
17.83
203.69
18.08**
-3.51
4.82
0.64 0.002 <0.001

Values are given as mean SD for 16 subjects. * p < 0.05, ** p < 0.01 and *** p <
0.001 by paired t test for intra group comparisons. Actual p values are given for
paired t test for intergroup comparisons. % comparisons were done by paired t test.
52

DOI: 10.1089/act.2014.20110 MARY ANN LIEBERT, INC. VOL. 20 NO. 1 ALTERNATIVE AND COMPLEMENTARY THERAPIES
FEBRUARY 2014
CAM Therapies
Estimates indicate that > 350 million people are affected
by depression worldwide.
1
While conventional medicine de-
fines depression as a neurochemical disequilibrium disorder,
treating it with psychoactive drugs, such as neurotransmitter
reuptake inhibitors,
2
complementary and alternative medicine
(CAM) finds different causes for depression and, therefore, its
treatment. Approximately 10%20% of patients conditions
respond poorly to conventional therapy or the conditions are
nonresponsive.
3
Thus, we report some CAM interventions
with which we have seen good results in our clinical practice
by combining them in an individualized way according to each
patients needs.
AcupunctureA significant beneficial effect of acupunc-
ture is that it can reduce the severity of depression. One meta-
analysis showed that acupuncture and electroacupuncture as
monotherapies had similar effects, compared to usual medica-
tion,
4
although when either of these therapies were combined
with antidepressants, the results were no better than medica-
tion alone.
5
Vitamin DResearch shows that elderly people with vita-
min D deficiency have an increased risk of depression, with an
association between the severity of symptoms and decreased
serum 25OHD
3
levels.
6
A trial of 600 international units
(IU)/day supplementation for 6 months produced significant
improvement in the well-being of subjects.
7
Although the ideal
dose recommended has not been determined yet, higher doses
seem to produce better results; thus, we usually recommend
600800 IU/day.
HomeopathyA rapid, gentle and permanent restoration
of the health,
8
proposed by Hahnemann, may be achieved
by using an individualized homeopathic medicine selected
according to the similitude to the patients symptoms. In
one trial, homeopathy was not considered to be an inferior
treatment, compared to fluoxetine, for acute treatment of pa-
tients with depression
9
; however, inconclusive results were
obtained when comparing individualized homeopathic treat-
ment with placebo.
10
Polyunsaturated fatty acids (PUFAs)A high proportion
of PUFAs are found in brain lipids. n-3 PUFAs may affect
serotoninergic and dopaminergic transmissions,
11
which are
involved in depression. Observational data have shown an as-
sociation between lower levels of n-3 PUFAs and depression.
3

Although the ideal dose is still debated, we have seen positive
results with 2 g/day of flaxseed oil, a precursor of the n-6 and
n-3 PUFAs.
References
1. World Health Organization: Depression. 2012. Online document at: www.
who.int/mediacentre/factsheets/fs369/en Accessed December 10, 2013.
2. Bondy B. Pathophysiology of depression and mechanisms of treatment.
Dialogues Clin Neurosci 2002;4:720.
3. Ortega RM, Rodrguez-Rodrguez E, Lpez-Sobaler AM. Effects of omega
3 fatty acids supplementation in behavior and non-neurodegenerative neuro-
psychiatric disorders. Br J Nutr 2012;107(suppl2):261270.
4. Stub T, Alrk T, Liu J. Acupuncture treatment for depressiona systematic
review and meta-analysis. Eur J Integr Med 2011;3:e259e270.
5. Zhang ZJ, Chen HY, Yip KC, et al. The effectiveness and safety of acupunc-
ture therapy in depressive disorders: Systematic review and meta-analysis. J
Affect Disord 2010;124:921.
6. Eyles DW, Burne TH, McGrath JJ. Vitamin D, effects on brain develop-
ment, adult brain function and the links between low levels of vitamin D and
neuropsychiatric disease. Front Neuroendocrinol 2013;34:4764.
7. Leedahl DD, Cunningham JL, Drake MT, et al. Hypovitaminosis D in psy-
chiatric inpatients: Clinical correlation with depressive symptoms, cogni-
tive impairment, and prescribing practices. Psychosomatics 2013;54:257
262.
8. Hahnemann S; OReilly WB, Decker S, transl. Organon of the Medical Art,
6th ed. Redmond, WA: Birdcage Books, 1996.
9. Adler UC, Paiva NM, Cesar AT, et al. Homeopathic individualized Q-Po-
tencies versus fluoxetine for moderate to severe depression: Double-blind,
randomized non-inferiority trial. Evid Based Complement Alternat Med 2011;
2011:520182.
10. Adler UC, Krger S, Teut M, et al. Homeopathy for depression: A ran-
domized, partially double-blind, placebo-controlled, four-armed study (DEP-
HOM). PLoS One 2013;8:e74537.
Clinical Roundup
Selected Treatment Options for Depression
All comments, opinions, and recommendations in the Clinical Roundup
are those of the authors and do not constitute those of the Journal, its Pub-
lisher, or its editorial staff.
20.1 ACT_pages.indd 52 2/14/14 12:51:27 PM
54
ALTERNATIVE AND COMPLEMENTARY THERAPIES FEBRUARY 2014
MARY ANN LIEBERT, INC. VOL. 20 NO. 1
To enhance the treatment effect, the pellets are applied to the
reactive region of each identified acupoint as detected by an acu-
point detector. The effect of the treatment is evaluated using the
Hamilton Depression Rating Scale and the Subjective Happiness
Scale. Based on my and my colleagues clinical experiences au-
ricular acupuncture provides a holistic, convenient, nonpainful,
hygienic, and risk-free therapy to help patients with depression.
References
1. Tsang HWH, Cheung L, Lak DCC. Qigong as a psychosocial interven-
tion for depressed elderly with chronic physical illnesses. Int J Geriatr Psych
2002;17:11461154.
2. Suen LKP, Wong TKS, Leung AWN. Is there a place for auricular therapy in
the realm of nursing? Complement Ther Nurs Midwifery 2001;7:132139.
3. Oleson T. Auriculotherapy Manual: Chinese and Western Systems of Ear
Acupuncture, 3rd ed. Los Angeles: Health Care Alternatives, 2003.
4. Bao AM, Ruhe HG, Gao SF et al. Neurotransmitters and neuropeptides in
depression [review]. Handb Clin Neurol 2012;106:107136.
Lorna Suen, BN, MPH, DipClinAcup, PhD
School of Nursing
The Hong Kong Polytechnic University
HungHom, Hong Kong
Yoga I
Yoga can enhance ones spiritual life and perspective beyond
the physical life regardless of ones particular religion.
1
It en-
ables people to attain and maintain a balance between exertion
and relaxation, and this produces a healthy and dynamic state
of homeostatic equilibrium.
2
Recent studies have shown that
yoga improves mood
3
and reduces depression scores.
4
These
changes have been attributed to an increased secretion of thal-
amic g-aminobutyric acid
5
with a greater capacity for emotional
regulation.
4
Even a 10-day yoga-based lifestyle modification
program has been reported to improve subjective well-being
scores of patients.
6
There has been extensive work done on Sudarshan Kriya
Yoga and depression at the National Institute of Mental Health
and Allied Sciences in India. This technique has been recom-
mended as a potential alternative to drugs for melancholia as a
first-line treatment.
7

In addition to its benefits for patients themselves, yoga also
has a great role for managing depression manifesting in fam-
ily caregivers of patients with dementia.
8
Researchers also
support the promising role of yoga as an intervention for de-
pression because the intervention is cost-effective and easy to
implement.
4
In the yoga therapy practice where I work, at the
Centre for Yoga Therapy, Education and Research (CYTER)
in Pondicherry, the principles used are
2
:
(1) Becoming one with the breathBody movement and
breath are synchronized particularly in the use of kriya or
structured movements, such as the sun salutation. We use
forceful breath patterns, such as bhastrika and kapalbhathi
for activation.
Table 1. Eight Specific Auricular Points for
Treating Depression
Auricular points Rationale
Shenmen Used to calm the mind
Liver Liver is associated with emo-
tion from the TCM perspective
Occiput Also known as the Antidepres-
sant point
3
Subcortex Also known as the Excitement
point, to relieve depression & is
used to calm the mind.
3
Anterior ear lobe Also known as Master Cerebral
(lower portion) & is near the Be happy point,
which is located on the back
of the ear.
3,a
Center of ear Also known as Point zero, for
achieving general homeostatic
balance
3
Brainstem Also known as the Brain
3
Lower tragus Also known as the Pineal Gland
3
(lower portion)
a
Huang LC. Auricular Treatment: Formulae and Prescriptions. Orlando: Auricular
Medicine International Research and Training Centre, 2001.
TCM, Traditional Chinese Medicine.
Figure 1. Location of auricular points for depression.
20.1 ACT_pages.indd 54 2/14/14 12:51:28 PM
55
ALTERNATIVE AND COMPLEMENTARY THERAPIES FEBRUARY 2014
MARY ANN LIEBERT, INC. VOL. 20 NO. 1
(2) Shifting from individuality to universalityYogic coun-
seling aims to help the participant understand the bigger
picture and improve self-esteem.
(3) Holistic approach of yoga as a lifestyleUse of early
morning sunlight for healing and rejuvenating activities,
use of water for internal and external cleansing, and care-
ful attention to diet. Gentle stretching and strengthening
static practices (sans) are introduced in a graded man-
ner, depending on the physical ability of the patient.
References
1. Nespor K. Twelve years of experience with yoga in psychiatry. Int J Psy-
chosom 1993;40:105107.
2. Bhavanani AB. Yoga Chikitsa: The application of yoga as a therapy. Pondi-
cherry, India: Dhivyananda Creations, 2013.
3. Lavey R, Sherman T, Mueser KT, et al. The effects of yoga on mood in
psychiatric inpatients. Psychiatr Rehabil J 2005;28:399402.
4. Shapiro D, Cook IA, Davydov DM, et al. Yoga as a complementary treat-
ment of depression: Effects of traits and moods on treatment outcome. Evid
Based Complement Alternat Med 2007;4:493502.
5. Streeter CC, Whitfield TH, Owen L, et al. Effects of yoga versus walking on
mood, anxiety, and brain GABA levels: A randomized controlled MRS study.
J Altern Complement Med 2010;16:11451152.
6. Sharma R, Gupta N, Bijlani RL. Effect of yoga based lifestyle intervention
on subjective well-being. Indian J Physiol Pharmacol 2008;52:123131.
7. Janakiramaiah N, Gangadhar BN, Naga Venkatesha Murthy PJ, et al. An-
tidepressant efficacy of Sudarshan Kriya Yoga (SKY) in melancholia: A ran-
domized comparison with electroconvulsive therapy (ECT) and imipramine. J
Affect Disord 2000;57:255259.
8. Waelde LC, Thompson L, Gallagher-Thompson D. A pilot study of a
yoga and meditation intervention for dementia caregiver stress. J Clin Psy-
chol 2004;60:677687.
Ananda Balayogi Bhavanani, MBBS, ADY, FIAY, MD (AM)
Centre for Yoga Therapy, Education and Research
Mahatma Gandhi Medical College & Research Institute
Pillayarkuppam, Pondicherry, India
Yoga II
Depression, a significant contributor to the global burden of
disease, is estimated to affect 350 million people worldwide.
1

The World Health Organization estimates that depression will
be the number-one health concern in both developed and de-
veloping nations by 2030.
2
Yoga is cost-effective; easy to implement; and produces
beneficial emotional, psychologic, and biologic effects. Thus,
it appears to be a promising intervention for depression.
3
In a
study, it was found that yogsans featuring backbends of long
duration, both passive and active, along with vigorous hand
balancing and, finally, restful supported backbending relax-
ation, were beneficial in depression.
4
Iyengar yoga also places
a great deal of emphasis on postures that involve opening of
the chest, such as backbends, as they may have direct effects
on the blood circulation, thus elevating mood and psychologic
well-being.
5
A study of 28 young adults with depression, who were
randomly divided into two groups (yoga and wait-list con-
trol), showed that two classes of Iyengar yoga per week
for 5 weeks led to a significant reduction in self-reported
symptoms of depression, negative mood, and fatigue.
6
Yoga
postures emphasized in this study were backbends, stand-
ing and inverted postures with brief periods of relaxation,
and breathing exercises in between.
6
In another study,
Shavsana was examined as a therapeutic technique for de-
pression, which revealed this type of yogas effectiveness
for alleviating depression.
7
In a randomized clinical trial, 45 untreated patients with
depression were divided into three groups who received (1)
antidepressant medication (i.e., imipramine), (2) electrocon-
vulsive therapy, or (3) Sudarshana Kriy Yoga (SKY). Assess-
ments were made at baseline and performed every week for 4
weeks. All three groups had reductions in depression scores
(based on the Beck Depression Inventory and the Hamilton
Rating Scale for Depression). In the third week, the SKY
group and the group taking imipramine had similar scores, but
the SKY group had higher scores than the electroconvulsive
therapy group.
8
The practice of Sahaja Yoga meditation produced additional
improvement in executive functions. These included manipu-
lation of information in verbal working memory and added
improvement in attention span and visualmotor speed of pa-
tients with depression.
9
The following yogic practices
10
(60 minutes daily for 3
months) may be useful for managing depressive disorders:
(1) Loosening practices
11
Shithilikarana vyyma for ~ 15
minutes:
(A) Standing practices are jogging, jumping, hip twist-
ing, forward and backward bending, alternate toe
touching, and side bending
(B) Sitting practices are Tiger stretch and Halsana-
Paschimottnsan stretch
(C) Supine practices are straight leg raising, both legs
raising, and cycling
(2) Breathing practices
10
Prnyma for ~ 8 minutes in-
volves forceful exhalation (Kaplbhti for 2 minutes),
right nostril breathing (Surynuloma Viloma prnyma
for 2 minutes), Bellow breathing (Bhastrik for 2 min-
utes); or SKY and Oceanic breathing (Ujjayi for 2 min-
utes).
(3) Physical postures
10
sanas for a total of ~ 12 minutes:
(A) Standing sanas are Sun Salutation (Surya Nama-
skra for 5 minutes) and Half wheel pose
(Ardha Chakrsana; 1 minute for each side)
(B) Sitting sanas are Camel pose (Ustrsana for 1
minute), and Posterior Stretching Pose
(Paschimottnsana for 1 minute)
(C) A prone sana is the Cobra pose (Bhujangsana for
1 minute)
20.1 ACT_pages.indd 55 2/14/14 12:51:28 PM
International Journal of Physiology, January-June 2014, Vol. 2, No. 1 59
DOI Number: 10.5958/j.2320-608X.1.2.001
INTRODUCTION
Ageing is a progressive, generalised impairment
of function, resulting in a loss of adaptive response to
stress and in a growing risk of age-related disease.
(1)
It
is a natural process characterised by declining physical
performance, slower speed of reaction, inadequate
working of various systems with poor motor and
sensory conduction. The process of aging is
Immediate effect of Chandra and Suryanadi Pranayamas
on Cardiovascular Parameters and Reaction Time in a
Geriatric Population
Meena Ramanathan
1
, Ananda Balayogi Bhavanani
2
1
Co-ordinator and Yoga Therapist, Centre for Yoga Therapy, Education and Research,
2
Deputy Director, CYTER,
MGMCRI, Pillayarkuppam, Pondicherry
ABSTRACT
Previous studies have reported differential physiological and psychological effects of exclusive right
and left nostril breathing. Though potential health benefits have been postulated, further clinical
research is required to prove immediate and sustained efficacy of these techniques. This study
evaluated immediate effects of exclusive right (SNP) and left (CNP) nostril breathing on cardiovascular
(CV) parameters and reaction time (RT) in a geriatric population. 26 subjects attending regular yoga
sessions at a senior citizen hospice, were recruited for this self-controlled study. They were instructed
to sit in any comfortable posture and relax for 5 min before taking the pre-intervention recordings of
Heart rate (HR), blood pressure (BP), auditory and visual RT (ART and VRT respectively). They then
performed the selected technique and parameters were recorded immediately after performance of 9
rounds of either SNP or CNP. The entire sequence of recordings was randomised to avoid any bias.
Intra and inter group statistical analysis was carried out using Student's paired t test for data that
passed normality testing and Wilcoxon matched-pairs signed-ranks test applied for the others. Overall
intra-group comparison of pre-post data and inter-group % comparisons showed statistically
significant (p < 0.05) differences for all parameters. There was an overall reduction in HR and BP-
based parameters following both SNP and CNP. However, inter-group % comparisons revealed a
significantly greater reduction after CNP for all parameters. Inter-group comparisons revealed highly
significant decreases (p < 0.001) in VRT and ART after SNP. In conclusion, our study sheds new light
on the physiological changes occurring after SNP and CNP in a geriatric population. While both
techniques reduce HR and BP, CNP does it more significantly. There is shortening of RT following
SNP and this may be attributed to enhance sensory motor function that is of great significance in the
elderly. We suggest that Yoga should be part of the heath care facilities for the elderly as it can enhance
their quality of life and improve their overall health status.
Keywords: Cardiovascular, Geriatrics, Pranayama, Reaction Time, Yoga
characterised by progressive and generalised
impairment of homeostasis resulting in declining
ability to respond to external or internal stresses and
increased risk of diseases.
(2)
Yoga is a conventional long-established and time-
tested art and therapeutic science that has positive
contribution to make in maintenance of general
wellbeing and happiness. According to the
Hathapradipika, one of the traditional Yoga texts, it is
a safe and reliable practice that can be done at any age
(Yuva vrddhothivrddho va vyadhito durbalopi va abhyasat
siddimapnoti sarvayogeshvatandritah. Whether young,
Corresponding author:
Ananda Balayogi Bhavanani
Deputy Director
CYTER, MGMCRI, Pillayarkuppam, Pondicherry
13. Yognat --59--.pmd 3/20/2014, 7:26 AM 59
60 International Journal of Physiology, January-June 2014, Vol. 2, No. 1
old or very old, sick or debilitated, one who is vigilant
attains success in all yoga, by means of practice,
provided they abide to the rules and regulations
properly- Hathapradipika I:64).
(3)
Yoga has preventive,
curative as well as rehabilitative potential and this may
be explained on the basis of its ability to modulate
autonomic functions, relieve stress, improve
physiological functions including cardio-respiratory
fitness and improve quality of life.
(4,5,6)
Swarodaya vigyan, the science of understanding
the ultradian nasal cycle has been traditionally codified
in Shiva Swarodaya wherein differential effects of
different phases of the nasal cycle are given in great
detail
(7)
It is traditionally taught that breathing
exclusively through the left nostril or chandra nadi
pranayama (CNP) potentiates ida nadi, the lunar
channel while breathing exclusively through the right
in surya nadi pranayama (SNP), activates the pingala
nadi, the solar channel.
There is some evidence that the practice of
Pranayama (the fourth limb of Ashtanga Yoga) can
significantly lower dangerous free radicals while
increasing the bodys intrinsic potential to produce
protective antioxidants.
(8)
This may be one of the
intrinsic mechanisms by which it helps improve
psycho-physiological wellbeing in patients suffering
from chronic degenerative diseases that are more
common in the elderly.
Previous studies have reported differential
physiological and psychological effects of exclusive
right and left nostril breathing.
(9,10,11)
Though potential
health benefits have been postulated, further clinical
research is required to prove immediate and sustained
efficacy of these techniques especially in a geriatric
population.
With the above in mind, this study planned to
evaluate immediate effects of SNP and CNP on
cardiovascular (CV) parameters and reaction time (RT)
in a geriatric population. We selected heart rate (HR)
and blood pressure (BP) as these indicate changes in
cardiac autonomic regulation while RT is an index of
processing ability of central nervous system and a
simple, non invasive means of determining
sensorimotor co-ordination and performance.
(12, 13)
MATERIALS AND METHOD
Twenty six subjects (21 females, 5 males) attending
regular yoga sessions at a senior citizen hospice, twice
weekly for more than 3 months were recruited for this
self-controlled study by convenience sampling. Their
mean age and body mass index (BMI) were 61.38
3.61 (SD) years and 25.26 6.33 units respectively. All
of them were right handed. Three of them reported
normal health status, whereas others reported that they
were on regular treatment for one or more medical
conditions like hypertension (14), hypothyroidism (3),
type 2 diabetes mellitus (15), knee pain (4), low back
pain (3),

arthritis (1), asthma (2), dyslipidemia (4) and
insomnia (2). None were receiving autonomic
modifying agents like - or -blocking drugs.
The study was conducted on four different days
between 4pm and 5.30 pm. To avoid any confounding
effects of recording on different days, subjects were
randomly assigned to do one of the techniques on two
days of their recording. One half of the subjects
performed CNP, while the others performed SNP and
this was reversed on the next day. The subjects were
instructed to sit in any comfortable posture and relax
for 5 min before taking the pre-intervention recordings
of HR, systolic pressure (SP), diastolic pressure (DP),
auditory and visual RT (ART and VRT respectively).
They then performed the selected technique and the
parameters were recorded immediately after the
performance of 9 rounds of either the SNP or CNP.
The entire sequence of recordings was randomised to
avoid any bias.
SNP was performed using nasika mudra wherein
the ring finger of the right hand was used to occlude
the left nostril by pressing on the outside of the nostril.
CNP was performed using nasika mudra wherein the
thumb was used to occlude right nostril by pressing
on the outside of the nostril. The left hand was held in
Jnana Mudra on both the occasions. Participants were
instructed to focus their mind on their breath and
ensure it was slow, deep, and regular while attempting
to utilize all sections of their lungs. Respiratory rate
for all techniques was maintained at 5-6 breaths per
min (BPM) and this was regulated by providing an
audible count of six for both inspiration and expiration.
As they were all attending regular Yoga sessions, none
reported any difficulty in doing the techniques.
HR, SP and DP were recorded using non-invasive
semi-automatic BP apparatus (CH 432, Citizen
Systems, Tokyo, Japan) having range from 40 to 180
beats/min and accuracy 5%. Mean pressure (MP),
pulse pressure (PP), rate-pressure product (RPP) and
double product (Do P) were calculated by respective
formulae.
RT apparatus (Anand Agencies, Pune) with a built
in 4 digit chronoscope and display accuracy of 1 ms
was used for the study. Simple ART was recorded for
auditory beep sound stimulus and simple VRT for red
13. Yognat --59--.pmd 3/20/2014, 7:26 AM 60
International Journal of Physiology, January-June 2014, Vol. 2, No. 1 61
light stimulus. The subjects were instructed to release
response key as soon as they perceived stimulus.
Signals were given from the front to avoid effect of
lateralized stimulus and they used dominant hand
while responding to signals.
(10,11)
All subjects were
given adequate exposure to the equipment on two
different occasions to familiarize them with the
procedure as RT is more consistent when subjects have
had adequate practice.
(14)
More than ten trials were
recorded and the mean of three similar observations
was taken as a single value for purpose of statistical
analysis.
(15, 16)
Data were assessed for normality using GraphPad
InStat version 3.06 for Windows 95, (GraphPad
Software, San Diego California USA). Intra and inter
group statistical analysis was carried out using
Students paired t test for data that passed normality
testing by Kolmogorov-Smirnov Test. Wilcoxon
matched-pairs signed-ranks test was applied for other
data. P values less than 0.05 were accepted as indicating
significant differences for pre-post and intergroup
comparisons.
RESULTS
The results are given in Table 1. Overall intra-group
comparison of pre-post data and inter-group %
comparisons showed statistically significant (p < 0.05)
differences for all parameters. There was an overall
reduction in HR and BP-based parameters following
both SNP and CNP. However, inter-group %
comparisons revealed a significantly greater reduction
after CNP for all parameters except DP and HR (that
just missed statistical significance). Inter-group
comparisons revealed highly significant decreases (p
< 0.001) in VRT and ART after SNP.
Table 1: Immediate effect of chandra nadi pranayama (CNP) and surya nadi pranayama (SNP) on heart rate (HR),
systolic pressure (SP), diastolic pressure (DP), mean arterial pressure (MAP), pulse pressure (PP), rate pressure
product (RPP), double product (DoP), auditory reaction time (ART) and visual reaction time (VRT) in a geriatric
population before (B) and immediately after (A) nine rounds of the technique.
Parameters CNP SNP Comparison
(n = 26) (n = 26) (p value)
B A % B A % B A %
HR 79.19 74.46 -4.64 79.81 77.65 -1.69 0.408 0.047 0.0889
(beats/min) 12.52 7.54** 11.13 12.75 8.59 9.26
SP 142.42 132.85 -6.31 142.12 138.65 -2.17 0.7593 0.0097 0.0032
(mmHg) 18.61 13.7*** 6.05 18.51 15.28* 4.27
DP 83.46 79.73 -3.77 83.85 80.35 -3.56 0.4836 0.5779 0.7222
(mmHg) 11.09 7.25** 7.58 11.19 8.24** 7.21
MP 103.12 97.44 -5.05 103.27 99.78 -3.05 0.7531 0.0313 0.0182
(mmHg) 11.81 7.77*** 5.78 11.89 9.21** 4.63
PP 58.96 53.12 -7.91 58.27 58.31 2.03 0.5113 0.0248 0.0254
(mmHg) 16.13 12.94** 17.71 15.91 13.13 14.66
RPP 112.99 99 -10.44 113.79 107.83 -3.76 0.6476 0.0057 0.0101
(units) 23.86 5.34** 13.78 25.12 17.64* 10.62
DoP 81.81 72.58 -9.24 82.66 77.48 -4.63 0.2999 0.007 0.029
(Units) 16.28 9.70** 13.90 17.17 11.01** 10.63
ART 297.83 292.03 -1.12 293.28 279.73 -4.59 0.0215 0.0003 0.0038
(ms) 56.21 37.48 5.67 52.9 50.18*** 2.81
VRT 315.05 316.89 0.82 307.65 296.21 -3.68 0.0132 <0.0001 <0.0001
(ms) 68.7 64.82 2.7 54.06 51.38*** 2.12
Values are given as mean SD for 26 subjects. * p < 0.05, ** p < 0.01 and *** p < 0.001 by paired t test for intra group comparisons of HR,
SP (SNP), DP, MP, PP, RPP and DoP and Wilcoxon matched-pairs signed-ranks test for SP (CNP), ART and VRT. Actual p values are given
for paired t test (HR, DP, MP, PP, RPP and DoP) and Wilcoxon matched-pairs signed-ranks test (SP, ART and VRT.) are given for the
intergroup comparisons. % comparisons were done by paired t test for PP and RPP and by Wilcoxon matched-pairs signed-ranks test
for the rest.
13. Yognat --59--.pmd 3/20/2014, 7:26 AM 61
62 International Journal of Physiology, January-June 2014, Vol. 2, No. 1
DISCUSSION
In the present study we have found a reduction in
all CV parameters following 9 rounds of both CNP
and SNP, but these changes were more significant
following CNP. This may be due to the fact that slow
and deep breathing at the rate of 5-6 BPM has been
reported to enhance cardiac autonomic regulation.
(17)
A normalization of autonomic CV rhythms as a result
of increased vagal modulation and/ or decreased
sympathetic activity and improved baroreflex
sensitivity have been suggested in an earlier report on
CNP in hypertensive patients
(18)
It has been however
reported that yogic breathing through right, left, or
through both nostrils in normal subjects produces
distinct autonomic changes and that SNP increased SP
and DP, whereas CNP resulted in significant reduction
in SP and MP.
(11)
Jain et al suggested that sympathetic
activation produced by right nostril breathing may be
masked by vagally mediated lung baroreceptor
activity enhanced by voluntary breathing efforts.
(19)
Hence changes following CNP may be

attributed to a
parasympatho-mimetic effect as the nasal cycle is
dependent upon tonic activity of limbic autonomic
nervous system with hypothalamus as control centre,
as well as levels of circulating catecholamines and
other neuro-hormones.
(20, 21)
Interestingly in our geriatric population, even right
nostril breathing decreased CV parameters. This seems
to be a contradiction to concepts of swara yoga but a
recent report has found that SNP is safe in
hypertensives and attributed this to in-built safety
mechanisms of yoga that enhances homeostatic
normalcy.
(22)
The goal of Yoga is to restore homeostasis,
hence, if sympathetic reactivity of a subject is already
higher than normal, it is suggested that yogic
techniques will not further increase such a hyper
reactivity but rather bring it back to normal. Hence,
we suggest that SNP may be practiced safely by the
geriatric population though CNP has greater benefits.
Changes in the RPP and DoP signify a reduced work
load on the heart with reduced O
2
consumption, and
this is indeed a positive finding in the geriatric
population.
The RT changes following CNP and SNP were
however very divergent with significant reduction
being seen in SNP and no such changes in CNP. The
activation following SNP may be attributed to an
improved central neuronal processing ability due to
greater arousal and faster rate of information
processing.
(15)
This is usually attributed to an alert state
produced by sympathetic activation, but in the present
study, as CV parameters havent shown such a change,
it must be due to other mechanisms. Earlier studies
by the authors have reported shortened RT following
mukha bhastrika in both normal and mentally
challenged children and also after surya namaskar.
(16,
23)
It has been previously suggested that right nostril
dominance in the nasal cycle as well as right uninostril
forced breathing, may be correlated with the activity
phase of the basic rest-activity cycle, the time during
which sympathetic activity in general exceeds
parasympathetic activity throughout the body.
(24)
Werntz et al have also reported relatively greater
integrated electro encephalogram (EEG) value in one
hemisphere correlating with predominant airflow in
contralateral nostril, defining the inter-relationship
between cerebral dominance and peripheral
autonomic nervous function.
(25)
In this study, the wider
variation in RT values may be attributed to reduced
sensory awareness and attention span in the elderly.
This may also be why there were significant differences
in pre-test values too.
In conclusion, our study sheds new light on
physiological changes occurring after SNP and CNP
in a geriatric population. While both techniques reduce
HR and BP, CNP does it more significantly. There is
shortening of RT following SNP and this may be
attributed to enhanced sensory motor function of great
significance in the elderly. We suggest that Yoga should
be part of heath care facilities for elderly as it can
enhance quality of life and improve overall health
status.
Conflict of Interest: None
Source of Funding: Mahatma Gandhi Medical College
and Research Institute (MGMCRI), Sri Balaji
Vidyapeeth Deemed University, Pondicherry.
Ethical clearance: IHEC of MGMCRI approved the
research study at the meeting held on 13
th
December
2011. (FAC/2011/05)
ACKNOWLEDGMENTS
The authors thank Mrs D Pushpa, Miss G Sarulatha,
Miss Imma Sivaraj and Miss Visalakshi

for their
valuable assistance during recording sessions and data
entry. We thank the inmates and authorities of the
Hospice of Saint Cluny for their wholehearted
cooperation during the training and recording sessions.
13. Yognat --59--.pmd 3/20/2014, 7:26 AM 62
International Journal of Physiology, January-June 2014, Vol. 2, No. 1 63
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2. Sircar S. Apoptosis and Aging. In: Sircar S, ed.
Medical Physiology. New Delhi: CBS publication;
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3. The Forceful Yoga (being the translation of the
Hathayoga Pradipika, Gheranda Samhita and
Siva Samhita). Translated into English by
Pancham Sinh, Rai Bahadur Srisa Chandra Vasu
and Romanized and edited by GP Bhatt. Mothilal
Banarsidas Publishers Private Limited, Delhi.
2004.
4. Madanmohan, Udupa K, Bhavanani AB,
Vijayalakshmi P, Surendiran A. Effect of slow and
fast pranayams on reaction time and cardio
respiratory variables. Indian J Physiol
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5. Innes KE, Bourguignon C, Taylor AG.
Risk indices associated with the insulin resistance
syndrome, cardiovascular disease, and possible
protection with yoga: a systematic review. J Am
Board Fam Pract 2005; 18: 491-519.
6. Sengupta P. Health Impacts of Yoga and
Pranayama: An art-of-the-state review. Int J Prev
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7. Bhavanani AB, Swarodaya Vigjnan- A Scientific
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8. Bhattacharya S, Pandey US, Verma NS.
Improvement in oxidative status with yogic
breathing in young healthy males. Indian J
Physiol Pharmacol 2002; 46: 349-54.
9. Shannahoff-Khalsa DS, Kennedy B. The effects
of unilateral forced nostril breathing on the heart.
Int J Neurosci 1993; 73: 47-60.
10. Mohan SM. Svara (Nostril dominance) and
bilateral volar GSR. Indian J Physiol Pharmacol
1996; 40: 5864.
11. Raghuraj P, Telles S. Immediate effect of specific
nostril manipulating yoga breathing practices on
autonomic and respiratory variables. Appl
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12. Lofthus GK. Sensory motor performance and
limb preference. Percepts Motor Skills 1981; 52:
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Premenstrual stress on Audiovisual reaction time
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15. Madanmohan, Thombre DP, Balakumar B,
Nambinarayanan TK, Thakur S, Krishnamurthy
N, et al. Effect of yoga training on reaction time,
respiratory endurance and muscle
strength. Indian J Physiol Pharmacol 1992; 36:
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16. Bhavanani AB, Ramanathan M,
Harichandrakumar KT. Immediate effect of
mukha bhastrika (a bellows type pranayama) on
reaction time in mentally challenged adolescents.
Indian J Physiol Pharmacol 2012; 56: 174-80.
17. Bhavanani AB, Sanjay Z, Madanmohan.
Immediate effect of sukha pranayama on
cardiovascular variables in patients of
hypertension. Int J Yoga Therap 2011; 21: 73-76.
18. Bhavanani AB, Madanmohan, Sanjay Z .
Immediate effect of chandra nadi pranayama (left
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cardiovascular parameters in hypertensive
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19. Jain N, Srivastava RD, Singhal A. The effects of
right and left nostril breathing on
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20. Deshmukh VD. Limbic autonomic arousal: Its
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21. Eccles R. Nasal airflow in health and disease. Acta
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22. Bhavanani AB, Sanjay Z, Madanmohan.
Suryanadi pranayama (right unilateral nostril
breathing) may be safe for hypertensives. J Yoga
and Phys Ther 2012; 2: 118.
23. Bhavanani AB, Ramanathan M, Balaji R, Pushpa
D. Immediate effects of suryanamaskar on
reaction time and heart rate in female volunteers.
Indian journal of physiology and
pharmacology 2013; 57: 199-204.
24. Shannahoff-Khalsa DS. Unilateral forced nostril
breathing: Basic science, clinical trials, and
selected advanced techniques. Subtle Energies
and Energy Med J 2002; 12: 79-106.
25. Werntz DA, Bickford RG, Bloom FE, Shannahoff-
Khalsa DS. Alternating cerebral hemispheric
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nervous function. Hum Neurobiol 1983; 2: 39-43.
13. Yognat --59--.pmd 3/20/2014, 7:26 AM 63
International Journal of Physiology, January-June 2014, Vol. 2, No. 1 39
DOI Number: 10.5958/j.2320-608X.1.2.001
INTRODUCTION
The ancient Indian science of Yoga makes use of
voluntary regulation of the breathing to make
Immediate effect of Different Pranayam on Short Term
Heart Rate Variability in Health Care Students - A
Preliminary Study
Rajajeyakumar M
1
, Amudharaj D
2
, Bandi harikrishna
3
, Madanmohan T
4
, Jeyasettiseloune
5
, Bhavanani AB
6
1
Assistant Professor, Department of Physiology, Chennai Medical College Hospital & Research Centre, Trichy,,
2
Assistant Professor, Department of Physiology, Aarupadai Veedu Medical College & Hospital Pondicherry,
3
PhD Scholar, Department of Physiology, JIPMER), Pondicherry,
4
Professor & Head, Department of Physiology,
Mahatma Gandhi Medical College & Research Centre, Pondicherry,
5
Senior Research Fellow, Department of ACYTER
(JIPMER), Pondicherry,
6
Deputy Director, CYTER, Mahatma Gandhi Medical College & Research Centre Pondicherry
ABSTRACT
Introduction: Yoga produces consistent physiological changes and have sound scientific basis. Heart
rate variability (HRV) has come to be widely used as a non-invasive tool to assess autonomic
function in physiological as well as disease states. In view of this, the present study was aimed
to study the effect of suryanadi(SNP) and chandranadi pranayams(CNP) on HRV in healthy young
volunteers.
Methodology: 11male volunteers aged between 20-30yrs were assigned to a sequence randomly.
Each volunteer was taught both SNP and CNP by trained yoga teacher and made to practice under
direct supervision between 4-6.30 pm in ACYTER lab, JIPMER. HRV was recorded by using
BIOHARNESS AcqKnowledge 4.1 version and analyzed by Kubios HRV 2.00 software. Basal resting
parameters and HRV were recorded for 5 minutes after that SNP was performed in six cycles per
minute for 5 minutes followed by 5 min rest. Three such sessions (before, during and after) HRV
were recorded. The same procedure and recording ware followed for CNP.
Results: The time domain analysis of SNP revealed an increased heart rate with a decreased RMSSD,
However the SDNN was increased. Frequency domain analysis, increased LF power and decreased
HF power and LF/HF ratio increased after the intervention. In CNP, the time domain analysis, showed
decreased heart rate and an increased pNN50. The frequency domain analysis revealed an increased
HF power with decreased LF/HF ratio.
Discussion: SNP increase the sympathetic activity and CNP increases the parasympathetic activity
and these can be appropriately advocated in many chronic cardiovascular diseases where the
autonomic imbalance is one of the primary derangements.
Keywords: Suryanadi Pranayam, Chandranadi Pranayam , Heart Rate Variability
Corresponding author:
M Rajajeyakumar
Assistant Professor
Department of Physiology, Chennai Medical College
Hospital & Research Centre, Irungalur, Trichy
Email id: rajakumar60@ gmail.com.
Contact No: 09751382650
respiration rhythmic and to calm the mind
1, 8
. This
practice is called Pranayama. Nadisuddhi pranayama
means purification of subtle energy paths, inhalation
and exhalation are through alternative nostrils for
successive respiratory cycles.
Surya Anuloma Viloma Pranayama means heat
generating breathing particle when the respiratory
cycle of inhalation and exhalation is completed
through the right nostril exclusively. When completed
through the left nostril alone the practice is called
9. Rajajeykumar--39--.pmd 3/20/2014, 7:26 AM 39
40 International Journal of Physiology, January-June 2014, Vol. 2, No. 1
Chandra Anuloma Viloma Pranayam which means
a heat dissipating or cooling liberating practice
2,3
Heart rate variability (HRV) has come to be widely
used as a non-invasive tool to assess autonomic
function in a variety of physiologic as well as
disease states
4
. However, there is paucity of literature
on immediate effect of suryanadi and Chandranadi
pranayam on HRV.In view of this, the present study
was aimed to study the immediate effect of suryanadi
and chandranadi pranayams on HRV in healthy young
volunteers.
MATERIALS AND METHOD
Materials
HRV was recorded by using BIOHARNESS
AcqKnowledge 4.1 version and analyzed by Kubios
HRV 2.00 software. Blood pressure and heart rate were
recorded with the subject seated comfortably, using
the noninvasive automated BP monitor (NIBP).
Methods & procedure
Study involves human subjects only
Inclusion criteria
Subjects aged between 20-30years males
Willing for learning pranayam technique
Exclusion criteria
Subjects with history of previous or current organic
diseases.
Subjects currently receiving yoga therapy
including meditation & biofeedback.
The present study was conducted on 11male
volunteers 20-30yrs. after obtaining ethical clearance
from the institutional Human Ethics Committee. All
consenting subjects meeting inclusion and exclusion
criteria of the study will be selected and informed
written consent will be obtained after thoroughly
explaining the procedure.
Their height, weights were recorded and BMI was
calculated. Each volunteer was taught both suryanadi
(SNP) and chandranadi pranayam (CNP) by trained
yoga teacher and made to practice under direct
supervision until they were familiar. The procedures
and recordings were carried out in lying down posture
for all volunteers between 4-6.30 pm in ACYTER lab,
JIPMER.Basal resting parameters and HRV were
recorded for five minutes followed by
Day 1: SNP (only right nostril breathing) was
performed in six cycles per minute (each cycle consists
of five seconds for each inspiration and expiration) for
five minutes followed by five min rest. Three such
sessions (before, during and after) HRV were recorded.
Day 2: The same procedure and parameters were
recorded for CNP (left nostril breathing only).
Statistical analysis:
Statistical analysis was done using SPSS version
16 (Repeated measures of ANOVA followed by post
hoc analysis with Benferroni adjustment) and the level
of statistical significance is considered at a p value <
0.05.
RESULTS
The results of our study were much in accordance
with the previous studies. The time domain analysis
of SNP revealed an increased heart rate with a
decreased RMSSD, the index of short term HRV.
However the SDNN which is considered the index of
long term HRV increased. Also, in the frequency
domain analysis there is an increased LF power and
decreased HF power.
The index of sympathovagal balance as reflected
by LF/HF ratio increased i.e. from 1.8 to 2.2 after the
intervention. All the observation showed that SNP is
sympathomimetic. In CNP, the time domain analysis
of HRV revealed a decreased heart rate and an
increased pNN50. The frequency domain analysis
revealed an increased HF power with decreased LF/
HF ratio i.e. from 2.1 to 1.5. The observations of CNP
clearly indicated that CNP is an activator of the
parasympathetic activity.
9. Rajajeykumar--39--.pmd 3/20/2014, 7:26 AM 40
International Journal of Physiology, January-June 2014, Vol. 2, No. 1 41
Table 1: Shows the effect of Suryanadi pranayam on short term heart rate variability parameters before, during &
immediate after the procedure.
Parameters Before During After P Value F/df
Time domain
Mean RR 867.1621.262 826.0418.264** 868.1719.798 0.007 6.361/(2,10)
SDNN 27.76731.386 40.9182.088*** 29.6090.976 0 20.964/(2,10)
Mean HR* 69.791.758 73.271.644** 69.701.618 0.004 7.310/(2,10)
STD HR 2.956 0.189 4.159 0.289** 3.331 0.281 0.005 6.989/(2,10)
RMSSD 26.7361.276 22.3270.870** 25.2001.165* 0.005 6.926/(2,10)
NN50 23.4553.987 13.3641.557** 18.3643.336** 0.021 4.728/(2,10)
pNN50 6.755 1.179 3.655 0.460* 5.20 0.941** 0.013 5.496/(2,10)
RR triangular index 8.096 0.365 11.246 0.657** 8.677 0.266 0 11.552/(2,10)
TINN 139.096.634 194.5412.293** 147.7275.367 0 12.373/(2,10)
Frequency domain
VLF (0"0.04 Hz) 119.2747.703 115.0936.784 148.7232.618 0.811 0.212/(2,10)
LF (0.04"0.15 Hz) 406.7285.557 1415 170.840*** 468.44562.848 0 24.56/(2,10)
HF (0.15"0.4 Hz) 271.90934.034 122.90934.784** 267..90940.423 0.002 8.760/(2,10)
Total power 797.909113.806.557 1653 143.30** 885.0981.267 0 18.321/(2,10)
LF/HF ratio 1.886 0.458 32.878 15.796 2.287 0.512 0.041 3.765/(2,10)
Percentage power
PVLF (0"0.04 Hz) 12.127 3.340 7.755 2.829 15.236 2.742 0.231 1.579/(2,10)
PLF (0.04"0.15 Hz) 48.155 4.950 81.264 5.662*** 51.527 4.632 0 16.462/(2,10)
PHF (0.15"0.4 Hz) 39.70 6.425 10.99 5.439** 33.245 5.615 0.002 8.247/(2,10)
Normalized units
NLF (0.04"0.15 Hz) 56.09 6.195 88.382 5.680** 61.51 5.755 0.001 10.711/(2,10)
NHF (0.15"0.4 Hz) 43.90 6.195 11.618 5.680** 38.482 5.755 0.001 10.711/(2,10)
Values are expressed as Mean SEM. . *P d 0.05 **P d 0.01 ***P d 0.001
* comparison of during the technique with before SNP
* Comparision of after the technique with before
comparison of after the technique with during
Changes during the test and after the test were both compared with pretest values by Students pairedt test. The two P values reported
are for the pretest vs. during and pretest vs. after comparisons respectively.
Table 2: Shows the effect of Chandranadi pranayam on short term heart rate variability parameters before, during
& immediate after the procedure.
Parameters Before During After P Value F/df
Time domain
Mean RR 853.5821.564 816.1425.84 852.9823.05 0.026 4.426/(2,10)
SDNN 28.391.38 43.121.608*** 29.200.951 0 32.645/(2,10)
Mean HR* 70.991.835 74.6292.409 71.062.014 0.016 5.136/(2,10)
STD HR 3.33 0.228 4.615 0.376 3.156 0.150 0.002 8.748/(2,10)
RMSSD 26.660.799 23.040.877* 26.491.165 0.004 7.324/(2,10)
NN50 22.272.78 14.091.988 24.094.303 0.025 4.455/(2,10)
pNN50 6.155 0.825 3.809 0.579 6.755 1.298 0.024 4.51/(2,10)
RR triangular index 8.386 0.241 10.769 0.437*** 8.390 0.280 0 20.134/(2,10)
TINN 140.007.717 221.8116.614** 145.904.662 0 13.895/(2,10)
Frequency domain
VLF (0"0.04 Hz) 140.0944.05 123.5441.908 74.2713.163 0.419 0.419/(2,10)
LF (0.04"0.15 Hz) 427.1890.69 1460 83.51*** 434.4540.127 0 85.351/(2,10)
HF (0.15"0.4 Hz) 244.0925.208 131.0916.017** 305..0936.914 0 20.190/(2,10)
Total power 811.182119.583 1714 113.450*** 813.9067.840 0 29.026/(2,10)
LF/HF ratio 2.166 0.630 13.659 2.317** 1.582 0.171 0 25.214/(2,10)
9. Rajajeykumar--39--.pmd 3/20/2014, 7:26 AM 41
42 International Journal of Physiology, January-June 2014, Vol. 2, No. 1
Table 2: Shows the effect of Chandranadi pranayam on short term heart rate variability parameters before, during
& immediate after the procedure. (Contd.)
Parameters Before During After P Value F/df
Percentage power
PVLF (0"0.04 Hz) 12.127 3.340 6.482 1.702 9.273 1.756 0.074 2.978/(2,10)
PLF (0.04"0.15 Hz) 48.155 4.950 85.627 1.419*** 53.60 2.183 0 41.374/(2,10)
PHF (0.15"0.4 Hz) 39.70 6.425 7.900 1.038*** 37.136 3.159 0 33.244/(2,10)
Normalized units
NLF (0.04"0.15 Hz) 56.09 6.195 91.655 1.024*** 59.44 2.896 0 41.908/(2,10)
NHF (0.15"0.4 Hz) 43.90 6.195 8.345 1.024*** 40.536 2.897 0 41.823/(2,10)
Values are expressed as Mean SEM. *P d 0.05 **P d 0.01 ***P d 0.001
* comparision of during with before
* comparision of after with before
comparison of after with during
Changes during the test and after the test were both compared with pre-test values by Students pairedt test. The two P values reported
are for the pre-test vs. during and pre-test vs. after comparisons respectively.
DISCUSSION
The present study evaluated the effect of SNP and
CNP on HRV in three different sessions (before, during
& after). Heart rate variability has come to be widely
used as a non-invasive tool to assess autonomic
function in a variety of physiologic as well as
disease states
4
. HF component predominately a
consequence of vagal activity. LF component probably
due to combination of sympathetic and
parasympathetic activity.
LF/HF ratio has been used as a non-invasive index
of sympathovagal balance. Our studies show that SNP
revealed an increased heart rate with a decreased
RMSSD, the index of short term HRV. Frequency
domain analysis there is an increased LF power and
decreased HF power. The index of sympathovagal
balance as reflected by LF/HF ratio increased. All the
observation showed that SNP is sympathomimetic.
CNP, the time domain analysis of HRV revealed a
decreased heart rate and an increased pNN50. The
frequency domain analysis revealed an increased HF
power with decreased. The observations of CNP
clearly indicated that CNP is an activator of the
parasympathetic activity. It seems possible that
mechanical receptors in the nasal mucosa are activated
with air flow in to the nostril and this signal is
unilaterally transmitted to the hypothalamus
5
.This
indicates that the practice of slow breathing exercise
improves vagal activity. Practice of pranayam has been
known to modulate cardiac autonomic status with an
improvement in cardio-respiratory functions
6.
A long-term improvement in autonomic balance
as well as in respiratory, cardiovascular and brain
function can be achieved if mechanical forces are
applied to the body with the aim of reducing existing
imbalances of mechanical force vectors. This technique
implies continually Controlling the body functions for
precise timings like in Pranayamic breathing
techniques.
7
The hypothalamus is considered the highest center
for autonomic regulation. SNP increase the
sympathetic activity and CNP increases the
parasympathetic activity and these can be
appropriately advocated in many chronic
cardiovascular diseases where the autonomic
imbalance is one of the primary derangements. The
beneficial effect of SNP and CNP can be applied to all
school children to improve the physical health and
sports activities of the students.
Limitation
All participants were right hand dominant used to
manipulate the nostrils. There was no separate control
for this study.
Recommendation
Sample size has to be increased
Female can be include to find out the gender
difference.
To compare the immediate effect with long term
training.
9. Rajajeykumar--39--.pmd 3/20/2014, 7:26 AM 42
International Journal of Physiology, January-June 2014, Vol. 2, No. 1 43
ACKNOWLEDGMENT
The authors thank Dr. E.S.Prakash, Associate
Professor of Physiology, Division of Basic Medical
Sciences, Mercer University School of Medicine, USA,
for helping me to write the manuscript.
Conflict of Interest: No Conflict of interest applicable
for this study.
Source of Funding: Not applicable
Ethical Clearance: Enclosed (Human ethical
committee certificate -JIPMER).
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arjuna. The bhagavad gita royal science of god-
realization. The immortal dialogue between soul
and spirit. A new translation and commentary
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2. Bhargava R, Gogate MG,& Mascarchas JF.
Autonomic responses to breath holding and its
variations following pranayama. Indian J
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3. Keuning J. On the nasal cycle. J Int Rhinol
(1968);6:99-135.
4. Task Force of the European Society of Cardiology
and the North American Society of Pacing and
Electrophysiology. Heart rate variability.
Standards of measurement, physiological
interpretation, and clinical use. Eur Heart J (1996);
17: 354381.
5. Shannahoff-khalsa, D.S. Lateralized rhythms of
the central and autonomic nervous
systems. International Journal of Neuroscience:
(1991) ; 11: 222-251.
6. Pal GK, Velkumary S,& Madanmohan. Effect
of short term practice of breathing exercises on
autonomic functions in normal human
volunteers. Indian J Med Res( 2004); 120:
115-121.
7. Sharma VK, Trakroo M, Subramaniam V,
Rajajeyakumar M, Bavavani AB, Sahai A.
Effect of fast and slow pranayam on perceived
stress and cardiovascular parameters in young
health-care students. Int J Yoga 2013; 6:104-10.
8. Dinesh T, Sharma V K, Rajajeyakumar M, Syam
Sunder A, Gopinath M Ananda Balayogi
Bhavanani. Effect of 8 weeks of Pranav
Pranayama Training on Pulmonary Function Test
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9. Rajajeykumar--39--.pmd 3/20/2014, 7:26 AM 43
Bhavanani et al. Yoga Mimamsa 2013; 45 (1&2): 1-13
1

IMMEDIATE EFFECT OF CHANDRANADI PRANAYAM ON HEART RATE
VARIABILITY AND CARDIOVASCULAR PARAMETERS IN PATIENTS OF
DIABETES MELLITUS AND HYPERTENSION

ANANDA BALAYOGI BHAVANANI
1*
,

E

J AYASETTIASEELON
2
, ZEENA SANJ AY
3
,
MADANMOHAN
4


PRESENT AFILIATIONS:
1
Deputy Director, Centre for Yoga Therapy, Education and Research (CYTER), MGMCRI,
Puducherry.. Email: yognat@gmail.com
2
Senior Research Fellow, ACYTER, J IPMER, Puducherry- 6. Email: jss8yoga@gmail.com
3
Senior Research Fellow, ACYTER, J IPMER, Puducherry-6. Email: zeesanj@gmail.com
4
Director, CYTER, MGMCRI, Puducherry. Email: drmadanmohan999@rediffmail.com

*Corresponding author


ACKNOWLEDGEMENTS:
The authors thank Sri G Dayanidy and Selvi L Vithiyalakshmi, yoga instructors at ACYTER for
their assistance during the study. We also thank the Director, MDNIY and Director, J IPMER for
their support as this study was possible because ACYTER has been established as a
collaborative venture between the Morarji Desai National Institute of Yoga, New Delhi and
J IPMER, Puducherry with funding from Department of AYUSH, Ministry of Health and Family
Welfare, Government of India.
Bhavanani et al. Yoga Mimamsa 2013; 45 (1&2): 1-13
2
ABSTRACT:
Diabetes mellitus (DM) and hypertension (HT) are widely prevalent psychosomatic lifestyle
disorders that often coexist. Chandranadi pranayama (CNP), an exclusive left nostril breathing
technique, has been reported to be useful in reducing heart rate (HR) and blood pressure (BP) in
normal subjects as well as hypertensives and is part of yoga therapy schedules for patients of HT
and DM. This study investigated the immediate effects of 5 minutes of CNP on HR, BP and
heart rate variability (HRV) in patients of HT, DM and in those having both (DMHT). Thirty
nine participants receiving standard medical care from the department of medicine, J IPMER
were recruited. HR, BP and short-term supine HRV were recorded before and after 5 minutes of
CNP. Analysis showed significant (p <0.05) fall of HR and BP indices in all three groups with
no difference between groups. However in short term HRV analysis, there were differences
between the responses of DM and HT patients with regard to mean RR and mean HR.
Preexisting intergroup differences with regard to SDNN, RMSSD, HF power and total power
were negated after the performance of CNP. Pre-post intra group comparisons showed
significant increases in Mean RR and Mean HR in both HT and HTDM groups while there were
significant increases in LFnu and LF/HF ratio with significant decrease in HFnu in DM group.
The post CNP responses of DM group in Mean RR, SDNN, Mean HR, RMSSD, LF power and
total power were contrary to responses in the other groups. This is the first report comparing
immediate effects of CNP in patients of HT and DM. The reduction in HR and BP indices in all
three groups may be attributed to an overall normalization of autonomic cardiovascular rhythms
along with improvement in baroreflex sensitivity irrespective of the disorder. The HRV findings
are more complicated but show a trend towards a normalization of the pre existing autonomic
differences between groups that is typical of Yoga techniques. HRV changes in DM patients
were contrary to HT and DMHT patients in many parameters and this may be due to a greater
degree of cardiac autonomic neuropathy in them. Further studies are required to enable better
understanding of mechanisms involved as well as to determine how long such effects persist.
We recommend the addition of this simple and cost effective technique to regular management
protocols of HT and DM.

Key words: chandra nadi pranayama, heart rate variability, diabetes mellitus, hypertension
Bhavanani et al. Yoga Mimamsa 2013; 45 (1&2): 1-13
3
INTRODUCTION:
Heart rate variability (HRV), the beat-to-beat alterations in heart rate, is a simple noninvasive
measurement for investigating autonomic influence on the cardiovascular system.
(1)
Low HRV
and baroreflex sensitivity reflect impaired cardiovagal adaptability and suggest excessive
sympathetic and/or insufficient parasympathetic tone that are, in turn, strong independent
predictors of cardiovascular morbidity and mortality.
(2)
Streeter et al recently proposed a theory to explain the benefits of Yoga practices in diverse,
frequently comorbid medical conditions based on the concept that Yoga practices reduce
allostatic load in stress response systems such that optimal homeostasis is restored.
(3)
They

hypothesized that stress induces an imbalance of the autonomic nervous system (ANS) with
decreased parasympathetic and increased sympathetic activity, under activity of the gamma
amino-butyric acid (GABA) system, the primary inhibitory neurotransmitter system, and
increased allostatic load. They further hypothesized that Yoga-based practices correct
underactivity of the parasympathetic nervous system and GABA systems in part through
stimulation of the vagus nerves, the main peripheral pathway of the parasympathetic nervous
system, and reduce allostatic load. According to their theory the decreased parasympathetic
nervous system and GABAergic activity that underlies stress-related disorders can be corrected
by Yoga practices resulting in amelioration of disease symptoms. HRV testing has a great role to
play in our understanding intrinsic mechanisms behind such potential effects of Yoga.
Diabetes mellitus (DM) and hypertension (HT) are widely prevalent psychosomatic lifestyle
disorders that often coexist and in whom factors such as sedentary habits and physical,
emotional and mental stress play a major role. They also probably have synergistic detrimental
effects on the cardiovascular system especially with regard to the cardiac autonomic function.
Various reviews have suggested that Yogic practices may have a role in prevention and
management of diabetes as well as co-morbid conditions like HT and dyslipidemia
(2, 4, 5)
. It is
interesting to note that even a short lifestyle modification and stress management education
program based on yoga reduces risk factors for cardiovascular disease and DM within a period
of 9 days.
(6)

Chandranadi pranayama (CNP), an exclusive left nostril breathing technique, has been reported
to be useful in reducing heart rate (HR) and blood pressure (BP) in normal subjects as well as
hypertensives and is part of yoga therapy schedules for patients of HT and DM. Potential health
benefits of unilateral forced nostril breathing (UFNB) have been postulated and many studies
done on normal subjects.
(7, 8, 9 )
Further clinical research is however needed to establish the
Bhavanani et al. Yoga Mimamsa 2013; 45 (1&2): 1-13
4
efficacy of these techniques in various psychosomatic conditions such as HT and DM and we
have recently reported beneficial HR and SP reducing effects of CNP in hypertensive patients on
regular standard medical management.
(10)
This was attributed to a normalization of autonomic
cardiovascular rhythms with increased vagal modulation and / or decreased sympathetic activity
along with improvement in baroreflex sensitivity.
With the above in mind, the present study planned to investigate immediate effects of 5 minutes
of CNP on HR, BP and HRV in established patients of HT, DM and in those having both
(DMHT).
Table 1: Demographic characteristics of the different study groups of patients of
hypertension (HT), diabetes mellitus (DM) and both hypertension and diabetes mellitus
(DMHT).

HT DM DMHT
Number 14 12 13
Age 50.14 12.04 41.08 9.73 56.15 8.49
Gender 8 M / 6 F 8 M / 4 F 9 M / 4 F
BMI 27.21 3.21 25.00 2.05 26.62 3.66
Respiratory rate during
basal recording
18.43 2.68 19.31 5.88 18.00 3.34
Respiratory rate during CNP 8.29 4.10 7.62 4.17 6.62 1.26
Respiratory rate during post
CNP recording
18.14 3.46 * 17.77 5.10 16.15 4.04 **
Medications Amlodipine,
Enalopril
Atorvastatin and
Aspirin
Glimipride,
Glibenclamide
Metformin,
Rosaglitazone
Proglitazone,
Insulin
Amlodipine,
Enalopril
Atorvastatin,
Glimipride
Glibenclamide,
Metformin
Rosaglitazone,
Progiltazone
Insulin and Aspirin


, p =0.0143 for inter group comparisons of age by ANOVA with * for DM vs DMHT.
* p <0.05, ** p<0.01 by paired t test for comparisons between pre and post CNP RR during
HRV recordings.

Bhavanani et al. Yoga Mimamsa 2013; 45 (1&2): 1-13
5
MATERIALS AND METHODS:
This study was conducted at the Advanced Centre for Yoga Therapy Education and Research
(ACYTER) that has been established as a collaborative venture between the Morarji Desai
National Institute of Yoga, New Delhi and J IPMER, Puducherry with funding from Department
of AYUSH in the Ministry of Health and Family Welfare, Government of India. Ethical
approval has been obtained by ACYTER from the Institutional Ethics Committee for studies on
the effect of yoga therapy on HT and DM. The present study was conducted as a pilot study as
part of this larger study.
Thirty nine participants were recruited from those attending regular Yoga therapy sessions at
ACYTER, J IPMER by convenience sampling. All were receiving standard medical care for
more than 3 years on outpatient in the department of medicine, J IPMER. Demographic
characteristics of the participants are given in Table 1.
All tests were carried out in ACYTER Yoga Research laboratory between 9 and 11 am. The
environment was quiet, with comfortable temperature and subdued lighting. The subjects were
briefed about the study protocol and written informed consent was obtained from them. They
were advised to come at least one hour after light breakfast, with empty bowel and bladder,
refrain from smoking and alcohol on the day of test and take their morning dosage of
antihypertensive agent after the procedure to avoid interference with cardiac autonomic
functions.
Anthropometric parameters such as height (cm) and body weight (Kg) were recorded and BMI
calculated using Quetlet formula. Height was measured by a wall mounted stadiometer and
weight with spring balance avoiding zero and parallax errors. The subjects were then asked to lie
in a comfortable supine posture on the couch and relax for 5 minutes.
HR and BP were measured using non-invasive semi-automatic BP monitor (CH 432, Citizen
Systems, Tokyo, J apan) apparatus and short-term supine HRV was recorded using Zephyr
TM
BioHarness
TM
USA and analyzed using Kubio software V 2.0 Finland. The following frequency
and time domain indices were calculated from the HRV recordings.
Time domain indices:
1. Mean RR in milliseconds (ms).
2. SDNN- standard deviation of normal to normal intervals in ms.
3. Mean heart rate (1/min)
Bhavanani et al. Yoga Mimamsa 2013; 45 (1&2): 1-13
6
4. RMSSD- root mean square of successive standard deviations in ms.
Frequency domain indices:
1. LF Power (ms
2
): Power in low frequency range ( 004015 Hz)
2. HF (ms
2
): Power in high frequency range 01504 Hz
3. LF norm (nu): LF power in normalised units - LF / (Total PowerVLF)*100
4. HF norm (nu): HF power in normalised units - HF / (Total PowerVLF)*100
5. Total power (ms
2
): LF power +HF power
6. LF / HF Ratio: LF [ms
2
] / HF [ms
2
]
The subjects were then instructed to close their right nostril with their right thumb and use gentle
pressure to occlude the right nostril. They then performed the pranayama by breathing in and out
though the unblocked left nostril in a calm and regular manner for a total duration of 5 minutes.
They were instructed to use a conscious effort to breathe in low, mid and upper parts of their
lungs in a sequential manner for both inspiration and expiration. Post test HR and BP
measurements were recorded again at the end of the 5 minutes of CNP. Pulse pressure (PP) was
calculated as SP-DP, mean pressure (MP) as DP +1/3 PP, rate-pressure product (RPP) as HR
SP / 100 and double product (Do P) as HR MP / 100.
Statistical analysis of pre and post intervention data was done using GraphPad InStat version
3.06 for Windows 95, GraphPad Software, San Diego California USA, www.graphpad.com.
Wilcoxon matched-pairs signed-ranks test was used for intra group comparisons while inter
group comparisons were done using ANOVA with Tukey-Kramer Multiple Comparisons Test
for data with identical SDs and Kruskal Wallis with Dunns Multiple Comparisons Test for data
with non identical SDs. P values less than 0.05 were accepted as indicating significant
differences between pre and post test data.

RESULTS:
The results are given in Table 2 and 3. CNP resulted in a significant (p <0.05) fall of HR and
BP indices in all three groups of patients with no difference between groups (Table 3). However
in short term HRV analysis, there were differences between the responses of DM and HT
patients with regard to mean RR and mean HR. Preexisting intergroup differences with regard to
SDNN, RMSSD, HF power and total power were negated after the performance of CNP (Table
2). Pre-post intra group comparisons showed significant increases in Mean RR and Mean HR in
Bhavanani et al. Yoga Mimamsa 2013; 45 (1&2): 1-13
7
both HT and DMHT groups while there were significant increases in LFnu and LF/HF ratio with
significant decrease in HFnu in DM group. The post CNP responses of DM group in Mean RR,
SDNN, Mean HR, RMSSD, LF power and total power were contrary to responses in the other
groups.

Table 2: Resting HRV analysis of patients of hypertension (HT), diabetes mellitus (DM)
and both hypertension and diabetes mellitus (DMHT) before (B) and after (A) the
performance of 5 minutes of chandra nadi pranayama (left uninostril breathing).

HT (n=14) DM (n=12) DMHT (n=13) ANOVA

B A B A B A B A
Mean
RR
(ms)
852.21

105.57
880.67

109.86
**
774.24

83.77
769.77

97.48
774.22

134.76
786.83

127.29
*
P =0.1219
P=0.0187
with * for
D vs HT
SDNN
(ms)
30.44
16.33
34.14
15.62
33.16
15.21
29.12
14.70
20.30
10.32
23.31
12.91
P =0.0224
with * for
DM vs DMHT
P =0.0782
Mean
HR
(1/min)
71.56
8.68
69.40
8.84**
78.53
7.89
79.24
9.07
79.40
11.23
77.93
10.31
*
P =0.0724
P =0.0184
with * for
DM vs HT
RMSS
D (ms)
35.51
23.92
36.45
18.38
39.16
19.84
29.17
14.50
23.15
12.08
24.35
9.75
p =0.0087
with ** for
DM vs DMHT
P =0.1145
LF
Power
(ms
2
)
407.00

493.854
615.143

638.313
507.33

750.13
475.00

613.00
163.15

170.29
331.85

396.50
P=0.0675
P=
0.3237
HF
Power
(ms
2
)
576.93

1092.44
379.79

580.14
536.83

483.83
372.58

429.20
212.77

339.50
301.85

478.96
P=0.0125
with * for
DM vs DMHT
P=
0.4891
LF
(n.u)
47.19

23.61
58.03

20.60
45.36

19.46
59.13

21.00*
46.38

15.65
52.39

16.95
P =0.9731 P =0.6499
HF
(n.u)
52.81

23.61
41.97

20.60
54.64

19.46
40.88

21.00*
53.62

15.65
47.61

16.95
P =0.9731 P =0.6499
Total
Power
(ms
2
)
984.29

1501.74
994.86

1105.56
1044.0

1143.18
848.00

867.43
376.00

494.36
633.69

774.61
P=0.0115
with * for
DM vs DMHT
and * for HT vs
DMHT
P =0.2979
LF/HF
1.44
1.44
2.02
1.52
1.03
0.64
2.06
1.42*
1.09
0.92
1.39
0.93
P =0.9994 P =0.3614
Values are given as mean SD. * p <0.05, ** p <0.01, *** p <0.001 by Wilcoxon matched-
pairs signed-ranks test for intra group comparisons. Inter group comparisons by ANOVA with
Tukey-Kramer Multiple Comparisons Test for data with identical SDs and Kruskal Wallis with
Dunns Multiple Comparisons Test for data with non identical SDs. * p <0.05 for intergroup
post hoc comparisons.

Bhavanani et al. Yoga Mimamsa 2013; 45 (1&2): 1-13
8
Table 3: Heart rate (HR), systolic pressure (SP), diastolic pressure (DP), pulse pressure
(PP), mean pressure (MP), rate-pressure product (RPP) and double product (Do P) in of
patients of hypertension (HT), diabetes mellitus (DM) and both hypertension and diabetes
mellitus (DMHT) before (B) and after (A) the performance of 5 minutes of chandra nadi
pranayama (left uninostril breathing).

HT
(n=14)
DM
(n=12)
DMHT
(n=13)
ANOVA

B A B A B A B A
HR (beats/min)
70.86

11.18
67.86

9.80 *
74.67

6.62
71.08

7.49 **
74.69

11.31
71.92

10.07 **
P=0.6415 P=0.4894
SP (mm Hg)
137.00

14.54
130.50

13.53 *
126.00

12.48
123.25

12.75 *
130.85

8.19
128.00

12.27
P=0.0804 P=0.2332
DP (mm Hg)
83.71

8.42
80.86

8.37 *
80.08

8.58
78.67

9.36
82.00

7.78
79.08

6.93 *
P=0.5412 P=0.7686
PP (mm Hg)
53.29

14.54
49.64

9.20
45.92

6.60
44.58

6.99
48.85

10.60
48.92

12.12
P=0.2555 P=0.2440
MP (mm Hg)
101.48

8.41
97.40

9.43 **
95.39

9.55
93.53

10.09 **
98.28

6.14
95.38

7.04
P=0.1762 P=0.5478
RPP (units)
97.47

20.57
89.27

19.14 **
94.03

11.70
87.32

10.14 **
97.48

14.46
91.46

11.68 **
P=0.8306 P=0.7747
DoP (units)
72.35

15.22
66.66

14.02**
71.13

8.42
66.25

7.86***
73.50

12.38
68.41

9.45**
P=0.8938 P=0.8693
Values are given as mean SD. * p <0.05, ** p <0.01, *** p <0.001 by Wilcoxon matched-
pairs signed-ranks test for intra group comparisons. Inter group comparisons by ANOVA with
Tukey-Kramer Multiple Comparisons Test for data with identical SDs and Kruskal Wallis with
Dunns Multiple Comparisons Test for data with non identical SDs. * p <0.05 for intergroup
post hoc comparisons.

DISCUSSION AND CONCLUSION:
This is the first report of the immediate cardiovascular effects of CNP in patients of HT and DM
utilizing HRV analysis. We have also measured resting cardiovascular parameters, thus
enabling us to understand the resultant effects and also to confirm previous reports on
cardiovascular effects of CNP.
There was a significant fall of HR and BP indices in all three groups of patients and this
reduction may be attributed to an overall normalization of autonomic cardiovascular rhythms
along with improvement in baroreflex sensitivity irrespective of the underlying disorder. It has
been previously reported that sympathetic activity is lower during left nostril breathing.
(11)
This
Bhavanani et al. Yoga Mimamsa 2013; 45 (1&2): 1-13
9
is also supported by Innes et al who had earlier postulated two interconnected pathways by
which Yoga reduces the risk of cardiovascular diseases through the mechanisms of
parasympathetic activation coupled with decreased reactivity of sympathoadrenal system and
HPA axis.
(2)


The cardiovascular effects with regard to the RPP and Do P are more significant (p<0.01 to p<
0.001) and this can be attributed to the cumulative benefits from a reduction in HR as well as
BP. RPP and Do P are especially important in patient care as they are indirect indicators of
myocardial oxygen consumption and load on the heart, and hence this reduction implies a
lowering of the strain on the heart.
(12)
As RPP is also a surrogate marker of overall HRV, its
reduction implies an improved cardiac autonomic regulation in our subjects.
(13)
As the HR also
reduced significantly in our study, the fall in SP can be attributed to a reduction in cardiac output
due to decreased venous return as well as decreased HR. Slow and deep regular breathing is
known to harmonize respiratory and cardiovascular Meyer rhythms that then result in changes in
HR as well as BP. Increased vagal modulation of SA and AV nodes along with enhancement of
baroreceptor sensitivity may be responsible for reduction in HR and subsequent fall in SP in our
subjects irrespective of their condition.
The HRV findings in all three groups are more complicated but show a trend towards a
normalization of the pre existing autonomic differences between groups that is typical of Yoga
techniques. Preexisting intergroup differences with regard to SDNN, RMSSD, HF power and
total power were negated after the performance of CNP.
Significant increases in Mean RR with conversely significant decreases in Mean HR in both the
HT and DMHT groups may be explained by the factors discussed above and strengthen the
possibility of an enhanced harmonization of cardiac autonomic function. This seems to be more
evident in the patients of HT and DMHT as LF power and total power also increased in these
groups while it reduced in DM group. Increases in LF power are traditionally interpreted as an
index of enhanced sympathetic activity but recent understanding is that LF power reflects
baroreflex function and not cardiac sympathetic innervation. Moak et al reported that LF power
derived from the interbeat interval spectrogram predominantly reflects baroreflex-mediated,
phasic changes in cardiovagal and sympathetic noradrenergic outflows.
(14)
They concluded that
in the setting of baroreflex failure, baseline LF power is reduced, regardless of the status of
cardiac sympathetic innervation.

Changes in all three groups following CNP suggests that an improvement is occurring in the
cardiac autonomic modulation irrespective of the increase or decrease in different HRV
Bhavanani et al. Yoga Mimamsa 2013; 45 (1&2): 1-13
10
parameters. This implies a healthier heart, capable of responding to external and internal
changes in an adequate manner. Our hypothesis is supported by a recent report that the period
immediately following alternate nostril breathing as well as paced breathing is marked by
elevated autonomic modulation of the heart.
(15)
It is to be noted that in virtually all of the short term HRV analysis, there were differences
between the responses of DM and HT patients with regard to mean RR and mean HR. This may
be attributed to a greater degree of cardiac autonomic neuropathy that is known to occur in
patients of DM. Pre-post intra group comparisons showed significant increases in Mean RR and
Mean HR in both HT and DMHT groups while there were significant increases in LFnu and
LF/HF ratio with significant decrease in HFnu in DM group. The post CNP responses of DM
group in Mean RR, SDNN, Mean HR, RMSSD, LF power and total power were contrary to
responses in the other groups.
HRV is known to be lower in patients of DM and HT and in our study, SDNN, RMSSD, LF
power, HF power and total power were much lower in the DMHT group compared to the other
groups and this may be attributed to a synergetic detrimental effect on the cardiac autonomic
nervous system due to concurrent DM and HT. a previous study by Sridar et al has also reported
reduced baseline HRV in patients having DMHT as compared to those having only DM
(16)
This
can be attributed to the cardiac aautonomic neuropathy in DM and HT resulting in impaired
regulation of BP and HRV due to a shift in cardiac autonomic balance towards sympathetic
dominance. Improvements in all HRV parameters following CNP in our patients may be
attributed to a balancing of the autonomic function with a shift from the sympathetic dominant
state to one of parasympathetic balance. Sridar et all had also reported that the degree of
increase in HRV was greater in hypertensive diabetic patients as opposed to normotensive
diabetic patients
(16)
and our findings are similar to some extent as there was a greater % change
in DMHT group.
A recent study from J IPMER assessing sympathovagal imbalance by spectral analysis of HRV
reported that that autonomic imbalance in pre-hypertensives was due to proportionate increased
sympathetic activity and vagal inhibition, whereas in hypertensives, vagal withdrawal was more
prominent than sympathetic over activity.
(17)
This may explain the major differences between
the groups at baseline and also the changes in DMHT group as the cardiac autonomic imbalance
was of a greater degree of severity. Increased sympathetic activity, enhanced cardiovascular
reactivity and reduced parasympathetic tone have been strongly implicated in the pathogenesis
of insulin resistance syndrome, atherosclerosis and cardiovascular diseases. Innes and Vincent

Bhavanani et al. Yoga Mimamsa 2013; 45 (1&2): 1-13
11
have suggested that yoga reduces this risk profile by decreasing activation of the sympatho-
adrenal system and the hypothalamic-pituitary-adrenal axis and also by promoting a feeling of
wellbeing along with direct enhancement of parasympathetic activity via vagus nerve.
(18)

Although decreased HRV is the most powerful predictor of cardiac mortality, there are a few
limitations in any study using HRV as a tool for research. It is still unclear as to which is the best
HRV variable to measure as none provides significant, consistent and accurate outcome.
(19)

Since HRV deals with RR interval variations, its measurement is limited to subjects with sinus
rhythm and to those with low number of ectopic beats.
(20)

As the present study lacked an appropriate paired control group of patients, further controlled
studies are planned to ascertain a deeper understanding of the mechanisms involved. Such
studies can also determine how long such an autonomic modifying effect persists in clinical
situations. It is recommended that this simple and cost effective technique be added to the
regular management protocol of HT and DM and utilized when immediate reduction of HR and
BP are required in day-to-day as well as clinical situations.


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Journal of Clinical and Diagnostic Research. 2014 May, Vol-8(5): BC01-BC03 11
DOI: 10.7860/JCDR/2014/7452.4390
Original Article
Effect of Slow and Fast Pranayama
Training on Handgrip Strength and
Endurance in Healthy Volunteers
P
h
y
s
i
o
l
o
g
y

S
e
c
t
i
o
n

DINESH THANGAVEL
1
, GIRWAR SINGH GAUR
2
, VIVEK KUMAR SHARMA
3
,
ANANDA BALAYOGI BHAVANANI
4
, RAJAJEYAKUMAR M.
5
, SYAM SUNDER A.
6

Keywords: Pranayama, Physiological parameters
ABSTRACT
Background: Pranayama has been assigned very important
role in yogic system of exercises and is said to be much more
important than yogasanas for keeping sound health. Also different
pranayamas produce divergent physiological effects.
Aim: To study the effect of 12 weeks training of slow and fast
pranayama on handgrip strength and endurance in young,
healthy volunteers of JIPMER population.
Settings and Design: Present study was conducted in the
Department of Physiology, JIPMER in 2011-12 (1.06.11 to
1.04.12).
Materials and Methods: Total of 91 volunteer subjects were
randomised into slow pranayama (SPG) (n=29), fast pranayama
(FPG) (n=32) and control groups (CG) (n=30). Supervised
pranayama training (SPG - Nadisodhana, Pranav pranayama and
Savitri pranayama; FPG - Kapalabhati, Bhastrika and Kukkuriya
pranayama) was given for 30 minutes thrice a week for 12 weeks
to both slow and fast pranayama groups by certied yoga trainer.
Hand grip strength (HGS) and endurance (HGE) parameters were
recorded using handgrip dynamometer (Rolex, India) at baseline
and after 12 weeks of pranayama training.
Statistical Analysis Used: Longitudinal changes in each group
were compared by using Students paired t-test. Delta changes
in each group were analysed by ANOVA with Tukey post-hoc
analysis.
Results: In SPG signicant improvement occurred only in HGE
parameter from 83.9545.06 to 101.6253.87 (seconds) (p<0.001)
whereas in FPG, signicant improvement was observed in HGS
from 33.319.83 to 37.99.41 (Kilograms) (p=0.01) as well as in
HGE from 92.7841.37 to 116.5658.54 (seconds) (p=0.004).
Using Students unpaired t-test difference between the groups in
HGS is found to be 1.175.485 in SPG and in FPG is 4.597.26
(p=0.39); HGE difference in SPG is 1.7721.17 and in FPG is
2.3843.27 (p>0.05).
Conclusion: Pranayama training decreases sympathetic
activity, resulting in mental relaxation and decreased autonomic
arousal thereby, decreasing force uctuations during isometric
contraction. This is reected as improvement in HGS and HGE.
INTRODUCTION
The spiritual-scientic discipline of yoga incorporates a wide
variety of practices and many scientic researches conclusively
document its preventive, therapeutic and excelling powers in the
individuals [1,2].
The versions of pranayama vary from single nostril breathing to
bellow breathing and it consists of three phases: purak (inhalation),
kumbhak (retention) and rechak (exhalation) and these phases can
be practised in either slow or fast manner [3]. Hand grip strength
(HGS) is an indicator of muscle function and nutritional status.
It has been used as an objective clinical measure in a variety of
situations including assessing the general strength in order to
determine work capacity [4]. HGS is inuenced by effort, skeletal
muscle bulk and contractility. Regular practice of pranayama has
shown improvement in HGS of both hands [5]. One previous
study has compared the effect of six months practice of fast
(FSN) and slow (SSN) practice of Suryanamaskar (SN) (type of
yogasana) on adolescents and found out that both types of SN
had positive physiological benets but the effects of FSN were
similar to physical aerobic exercises, whereas the effects of SSN
were similar to those of yoga training [6]. As different types of
pranayamas have also been demonstrated to produce different
physiological benets in the subjects [79], the present study
was planned to study the effect of 12 weeks of slow and fast
pranayama training on handgrip strength and handgrip endurance
in young adult subjects of JIPMER population.
SUBJECTS AND METHODS
Present study was conducted in the Department of Physiology,
JIPMER, Puducherry. The subjects were recruited from the students
of various courses conducted in JIPMER, Puducherry as well as
staff, friends and relatives of them. The study involved less than
minimal risk.
Inclusion criteria
Healthy volunteers of both gender in the age group of 18-30
years.
Exclusion criteria
History of chronic respiratory illness.
Subjects receiving medication for any chronic ailment.
Smokers and alcoholics.
Athletes.
Any history of previous yoga or bio feedback techniques
training in last one year.
The purpose of the study, procedures and benets were briefed to
them. The willing participants were randomised into SPG (n=29),
FPG (n=32) and CG (n=30) after getting informed written consent,
by simple randomisation method using random numbers generated
through computer. Average age of the volunteers was average age
of 18.58 2.27 (mean SD) were considered for analysis. Among
these 91 volunteers, 72 were females and the remaining 19 were
Vivek Kumar Sharma et al., Effect of Slow and Fast Pranayama Training on Handgrip Strength and Endurance in Healthy Volunteers www.jcdr.net
Journal of Clinical and Diagnostic Research. 2014 May, Vol-8(5): BC01-BC03 22
Control Group: consisted of group of volunteers who were not
included in 12 week training of pranayama.
RESULTS
The comparison of parameters between baseline and post test
amongst the groups on hand grip dynamometry parameters are
given in [Table/Fig-1]. The details on the comparison of handgrip
dynamometry parameters considered for the study at baseline were
comparable (p>0.05).
The analysis on the effect of 12 weeks of slow pranayama on HGS
and HGE parameters shows a statistically signicant improvement
(p<0.001) for HGE and statistically insignicant change (p>0.05)
for HGS parameter. The analysis on the effect of 12 weeks of
fast pranayama on HGS and HGE shows statistically signicant
improvement in both HGS and HGE (p=0.01 and p=0.004,
respectively).
In CG there was no signicant change observed in both HGS and
HGE parameters (p>0.05) after 12 weeks of study period. In HGS
parameter, longitudinal changes amongst the groups were not
statistically signicant (p>0.05). In HGE parameter, changes
amongst the groups were statistically signicant (p=0.003).An
average increase of 2.38 43.27in FPG and 1.77 21.17in SPG
was observed (P=0.003 and P=0.03 respectively) compared to
the CG.
Also, [Table/Fig-2] demonstrates that on comparing HGS and HGE
parameters, there was no signicant difference between SPG and
FPG groups. Therefore, our study demonstrates that the effect of
slow and fast pranayama groups can be considered comparable on
handgrip dynamometer parameters (HGS & HGE).
DISCUSSION
Since pranayama can be practiced in either slow or fast manner
[3], the benecial effects obtained by the practice of different prana-
yamas may be derived from the differences in duration of the phases
of the breathing cycle, tidal volume and other factors including the
use of mouth, nostrils, constriction of the laryngeal muscles and
position of the glottis [10].
Results of our study demonstrate that there was no signicant differ-
ence in the baseline values of handgrip dynamometry parameters.
Therefore, all the three groups can be considered comparable for
the present study. There was signicant improvement in HGS and
HGE in fast pranayama group whereas in slow pranayama group,
there was signicant improvement in only HGE parameter (p<0.001)
along with statistically non signicant but denite trend towards
increase in HGS. However, on comparing longitudinal changes
males. The study did not involve invasive procedures at any stage.
Hand grip strength (HGS) and endurance (HGE) parameters were
recorded at baseline and after 12 weeks of pranayama training
using handgrip dynamometer (Rolex, India). The subjects were
asked to sit comfortably and proper instructions were given to them.
They were asked to perform maximum voluntary contraction (MVC)
using the handgrip dynamometer. The test was repeated three
times with a gap of two minutes and the highest value was recorded
as HGS. Following HGS, the subjects were instructed to maintain
one-third of HGS for as long as possible. Duration in seconds was
noted as HGE using the stop watch. Supervised pranayama training
(SPG - Nadisodhana, Pranav pranayama and Savitri pranayama;
FPG - Kapalabhati, Bhastrika and Kukkuriya pranayama) was given
for 30 minutes/ day, thrice/week for the duration of 12 weeks by
certied yoga trainer as per the guidelines of Morarji Desai National
Institute of Yoga, New Delhi. The details of pranayama training are
as follows:
1. Fast Pranayama: Each cycle consisted of practicing one minute
of Kapalabhati, Bhastrika and Kukkriya pranayama interspersed
with one minute of rest between each pranayama. Subjects
were asked to complete three or more cycles in each session.
Kapalabhati pranayama: The subjects forcefully expelled during
the expiration but the inhalation was passive. One hundred
and twenty rounds per sitting was the maximum allowed.
Bhastrika pranayama (Bellows): Subjects were instructed to
take deep inspiration followed by rapid expulsion of breath
following one another in rapid succession. This is called as
bellow type of breathing. Each round consisted of 10 such
bellows.
Kukkriyapranayama (Dog Pant): The subjects sat in vajrasana
with both palms on the ground in front with wrists touching
knees and ngers pointing forward. With wide open mouth and
the tongue pushed out as far as possible subjects breathed in
and out at a rapid rate with their tongue hanging out of their
mouth. The whole practice was repeated for three rounds.
2. Slow Pranayama: Each round (seven minutes) of session
consisted of practicing two minutes of nadishodhana, pranava
and savitri pranayama interspersed with one minute of rest
between each pranayama done in comfortable posture
(sukhasana). Subjects were asked to perform nine or more
rounds according to their capacity.
Nadishodhana pranayama: is rhythmic and slow alternate
nostril breathing. One round consisted of inhaling through one
nostril, exhaling through other nostril and repeating the same
procedure through other nostril.
Savitri pranayama is a slow, deep and rhythmic breathing,
each cycle having a ratio of 2:1:2:1 between inspiration
(purak), held-in breath (kumbhak), expiration (rechak), and held
out breath (shunyak) phases of the respiratory cycle.
Pranava pranayama is slow, deep and rhythmic breathing
where emphasis is placed on making the sound AAA, UUU
and MMM while breathing out for duration of two to three
times the duration of the inhaled breath.
At the end of session, all SPG and FPG subjects were instructed to
lie down in shavasana and relax for 10 minutes.
Parameters
SPG(n=29) FPG (n=32) CG (n=30)
Baseline Post test Baseline Post test Baseline Post test
HGS (Kg) 32.83 11.33 34 11.90 33.31 9.83 37.9 9.41* 30.43 10.15 32.40 9.25
HGE (s) 83.95 45.06 101.62 53.87*** 92.78 41.37 116.56 58.54** 71.83 40.86 65.80 34.06
[Table/Fig-1]: Comparison of handgrip dynamometry parameters between baseline and post test amongst the study groups (Mean SD)
SPG - slow pranayama group, FPG - fast pranayama group,CG - control group. Handgrip strength (HGS) in Kilograms and handgrip endurance (HGE) in seconds. Analysis
done by Students paired t-test. *p<0.05, **p<0.01, ***p<0.001.
Parameters SPG (n=29) FPG (n=32) CG (n=30)
HGS (Kg) 1.17 5.28 4.59 7.26 1.97 7.42
HGE (s) 1.77 21.17 2.38 43.27 -6.03 35.53*
, ##
[Table/Fig-2]: Comparison of the delta changes (difference between post test &
baseline) amongst the studygroups on handgrip strength (HGS) and endurance
(HGE) parameters (Mean SD).
SPG - slow pranayama group, FPG - fast pranayama group, CG - control group.
*with respect to slow pranayama group,
#
with respect to fast pranayama group.
Analysis done by one way ANOVA with Tukey post-hoc analysis .*p<0.05, **p<0.01,
***p<0.001.
#
p<0.05,
##
p<0.01,
###
p<0.001.
Journal of Clinical and Diagnostic Research. 2014 May, Vol-8(5): BC01-BC03 33
www.jcdr.net Vivek Kumar Sharma et al., Effect of Slow and Fast Pranayama Training on Handgrip Strength and Endurance in Healthy Volunteers
between fast and slow pranayama groups, there was no statistically
signicant difference between these groups. Therefore, our study
demonstrates that both slow and fast pranayamas are benecial
on the handgrip dynamometer parameters (HGS & HGE) and the
benecial effect of the two groups can be considered comparable.
To the best of our knowledge, there is no previous study which
compared the effect of slow and fast pranayamas on HGE and
HGS. However, many previous studies had shown benecial effect
of integrated yoga practices which included various pranayama
techniques. A study by Madanmohan et al., observed 21 percent
increase in HGS on healthy volunteers with 12 weeks of yoga training
[11]. Another study done by Raghuraj et al. on school children aged
1118 years found that 10 days of pranayama training signicantly
improved HGS ranging from 4.1 percent to 6.5 percent without
lateralised effect [5].
The improvement in HGS & HGE after pranayama training can be
ascribed to the state of calm alertness, better subjective wellbeing
and hypo metabolic state in the subjects which may have resulted
in better concentration on the task. This may be due to improved
autonomic tone resulting in increased parasympathetic drive,
calming of stress responses, neuroendocrine release of hormones
and thalamic generators [12]. Improved autonomic tone may reduce
oxygen requirement by pranayama practice, as the availability of
energy and oxidation of glucose is believed to inuence the HGS [13].
Also, cognitive components and non specic arousal can be
the possible factors for the improvement in HGS [14]. Ray et al.,
reported that yogic exercises produce signicant increase in muscle
endurance and delay in onset of fatigue [15]. Raju et al., also reported
that yoga training resulted in a signicant increase in maximal work
output with a signicantly reduced level of oxygen consumption per
unit work [16].
To conclude, our results demonstrate that both slow and fast
pranayamas are benecial on handgrip dynamometry parameters
and fast pranayama was more effective than slow pranayama.
KEY MESSAGES
Different pranayamas produce different physiological effects.
Especially fast pranayama training when practiced regularly for
longer duration, it produces parasympatho dominance in contrast
to the short duration training which evokes sympathetic activity.
ACKNOWLEDGEMENT
Special thanks are due to the Advanced Centre for Yoga Therapy
Education and Research (ACYTER) team of Mr. Dayanidy G and
Ms. Vithiyalakshmi L, Yoga Instructors, for an excellent conduct of
pranayama training sessions. We are also grateful to the subjects
for cooperating during the study in all possible aspects.
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[3] Chodzinski J. The effect of rhythmic breathing on blood pressure in hypertensive
adults. J Undergrad Res. 2000; 1(6).
[4] Gilbert JC, Knowlton RG. Simple method to determine sincerity of effort during a
maximal isometric test of grip strength. Am J Phys Med. 1983; 62(3): 13544.
[5] Raghuraj P, Nagarathna R, Nagendra HR, Telles S. Pranayama increases
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[10] Telles, Desiraju T. Heart rate alterations in different types of pranayamas. Indian J
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krishnamurthy N, Chandrabose A. Effect of yoga training on reaction time,
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22933.
[12] Brown RP, Gerbarg PL. SudarshanKriya yogic breathing in the treatment of stress,
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[13] Mohinder P, Malik SL. Effect of smoking on anthropometric somatotype and grip
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[14] Peynirciolu ZF, Thompson JL, Tanielian TB: Improvement strategies in free-throw
shooting and grip-strength tasks. J Gen Psychol. 2000; 127(2): 14556.
[15] Ray US, Hegde KS, Selvamurthy W. Improvement in muscular efciency as
related to a standard task after yogic exercises in middle aged men. Indian J Med
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[16] Raju PS, Madhavi S, Prasad KV, Reddy MV, Reddy ME, Sahay BK, Murthy KJ.
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PARTICULARS OF CONTRIBUTORS:
1. Assistant Professor, Department of Physiology, Vinayaka Missions Medical College, Karaikal-609605, India.
2. Additional Professor, Department of Physiology, JIPMER, Puducherry-605006, India.
3. Assistant Professor, Department of Physiology, JIPMER, Puducherry-605006, India.
4. Deputy Director, CYTER, Mahatma Gandhi Medical College and Research Institute, Puducherry-607 402, India.
5. Assistant Professor, Department of Physiology, Chennai Medical College Hospital and Research Centre,Tiruchirappalli, Tamilnadu-621105, India.
6. Phd Scholar, Department of Physiology, JIPMER, Puducherry-605006, India.
NAME, ADDRESS, E-MAIL ID OF THE CORRESPONDING AUTHOR:
Dr. Vivek Kumar Sharma,
Assistant Professor, Department of Physiology, JIPMER, Puducherry-605006, India.
Phone: 9442529673, E-mail: drviveksharma@yahoo.com
FINANCIAL OR OTHER COMPETING INTERESTS: None.
Date of Submission: Aug 25, 2013
Date of Peer Review: Jan 17, 2014
Date of Acceptance: Mar 12, 2014
Month of Publishing: May, 2014
Ann. SBV, Jan - Jun 2014;3(1)
Page 29 Annals of SBV
Introduction
Oh, East is East, and West is West, and never
the twain shall meet, said Rudyard Kipling. Tis
dichotomy however seems to have been overcome
in recent times, as many eastern healing traditions
have slowly and steadily percolated the health care
system worldwide. Tis is especially true of mind
body therapies that focus on the health promotive
intrinsic connections that exist between the human
brain, mind, body, and individual behaviour.
Tis includes techniques of meditation (mantra
meditation, mindfulness meditation, and others), qi
gong, tai chi, and yoga.
1
In the USA, reported use
of deep breathing, meditation, and yoga increased
between 2002 and 2007 with 12.7% of adults
using deep-breathing exercises, 9.4% practicing
meditation, and 6.1% taking up yoga.
2,3
Pain
related issues were the top usage statistics while
more than 40% of adults with neuropsychiatric
symptoms were drawn to the usage of various
mindbody therapies.
4

Yoga As A Terapy
Yoga as a mode of therapy (yoga chikitsa) has
become extremely popular, and a great number
of studies and systematic reviews ofer scientifc
evidence of its potential in treating a wide range of
psychosomatic conditions. Yoga understands health
and well-being as a dynamic continuum of human
nature and not merely a state to be reached and
maintained. Yoga helps the individual to establish
sukha sthanam, which may be defned as a dynamic
sense of physical, mental, and spiritual well-being.
Yogamaharishi Dr. Swami Gitananda Giri Guru
Maharaj, the visionary founder of Ananda Ashram
at the ICYER, Pondicherry (www.icyer.com) and
one of the foremost authorities on Yoga in the past
century exclaimed lucidly, Yoga chikitsa is virtually
as old as yoga itself, indeed, the return of mind that
feels separated from the Universe in which it exists
represents the frst yoga therapy. Yoga chikitsa
could be termed as mans frst attempt at unitive
understanding of mind-emotions-physical distress
and is the oldest wholistic concept and therapy in
the world.
5

To achieve this yogic integration at all
levels of our being, it is essential that we take
into consideration the all encompassing multi
dimensional aspects of yoga that include the
following: a healthy life-nourishing diet, a healthy
and natural environment, a wholistic lifestyle,
adequate bodywork through asana, mudra-bandha
and kriya, invigorating breath work through
pranayama and the cultivation of a healthy thought
process through jnana yoga and raja yoga.
Te International Association of Yoga
Terapists (IAYT), USA has taken this idea into
account in defning Yoga therapy as follows
6
: Yoga
therapy is the process of empowering individuals
to progress toward improved health and well-being
through the application of the philosophy and
practice of yoga. Tis has been further elabourated
by the IAYT in its Recommended Educational
Standards for the Training of Yoga Terapists,
published on 1 July, 2012
.7
Tis is one of the best
documents on standards in yoga therapy and is a
path breaking efort covering comprehensively all
aspects of yoga as a holistic therapy.
Te need of the hour is for a symbiotic
relationship between yoga and modern science. To
satisfy this need, living, human bridges combining
the best of both worlds need to be cultivated. It
is important that more dedicated scientists take
up yoga and that more yogis study science, so that
we can build a bridge between these two great
evolutionary aspects of our civilization. Te process
as well as the goal of yoga is all about becoming
one with an integrated state of being.
8

YOGA AND MIND BODY THERAPIES IN HEALTH AND DISEASE: A BRIEF REVIEW
Ananda Balayogi Bhavanani
*
, Meena Ramanathan
**
, Madanmohan
***
* Ananda Balayogi Bhavanani , Deputy Director, E mail: yognat@gmail.com
** Meena Ramanathan, Co-ordinator and Yoga therapist, E mail: saineema@yahoo.com
*** Madanmohan, Director, Prof & Head, Dept. of Physiology, E mail: drmadanmohan999@rediffmail.com
Centre for Yoga Therapy, Education and Research (CYTER)
Mahatma Gandhi Medical College and Research Institute, Puducherry 607402, India
Ann. SBV, Jan - Jun 2014;3(1)
Page 30 Annals of SBV
Promotes Positive Health
Healthy life can be considered as a by-product
of practicing yogic techniques since it has been
observed that Yoga practitioners are physically and
mentally healthier and have better coping skills to
stressors than the normal population. Knowledge
of inexpensive, efective and easily administrable
yogic techniques by health professionals will go
a long way in helping us achieve the goal of the
World Health Organisation to provide physical,
mental, spiritual and social health for all sections
of human society.
Some of the important documented health
promoting benefts of mind-body practices such as
yoga and meditation include:
1. Improvement in cardio-respiratory efciency
9,
10, 11, 12
2. Improvement in exercise tolerance
13, 14, 15, 16
3. Harmonious balance of autonomic function
17,
18, 19, 20
4. Improvement in dexterity, strength, steadiness,
stamina, fexibility, endurance, and neuro-
musculo-skeletal coordination
13, 21, 22, 23, 24, 25, 26
5. Increase in alpha rhythm, inter-hemispheric
coherence and homogeneity in the brain
27, 28,
29, 30
6. Improved sleep quality
31
7. Improved cognitive functions
9, 32, 33, 34, 35, 36, 37, 38
8. Alteration in brain blood fow and brain
metabolism
39, 40, 41, 42
9. Modulation of the neuro-endocrine axis
43, 44, 45,
46, 47, 48
We can say that the eastern mind-body
techniques afect every cell of the human
body. Tey bring about better neuro-efector
communication, improve strength, and enhance
optimum functioning of all organ-systems while
increasing resistance against stress and diseases
with resultant tranquillity, balance, positive attitude
and equanimity.
Figure1: Possible Factors Responsible For Physical Performance Improvement By Yoga
(Ray US, Pathak A, Tomer OS. Hatha Yoga Practices: Energy Expenditure, Respiratory Changes And Intensity Of
Exercise. Evid based complement alternat med. 2011; 2011: 241294.)
Managing Stress
It is well established that stress weakens our
immune system. Scientifc research in recent times
has shown that the physiological, psychological and
biochemical efects of yoga are of an anti-stress nature.
A majority of studies have described benefcial efects
of yoga interventions in stress with an Agency for
Healthcare Research and Quality (AHRQ) report
stating that Yoga helped reduce stress.
49
Reductions
in perceived stress following yoga are reported to be
as efective as therapies such as relaxation, cognitive
behavioural therapy and dance therapy.
Ann. SBV, Jan - Jun 2014;3(1)
Page 31 Annals of SBV
Mechanisms postulated include the restoration
of autonomic balance as well as an improvement
in restorative, regenerative and rehabilitative
capacities of the individual. A healthy inner sense
of wellbeing produced by a life of yoga percolates
down through the diferent levels of our existence
from the higher to the lower levels producing health
and wellbeing of a holistic nature. Streeter et al
recently proposed a theory to explain the benefts
of yoga practices in diverse, frequently co-morbid
medical conditions based on the concept that yoga
practices reduce allostatic load in stress response
systems so that optimal homeostasis is restored.
50
Tey hypothesized that stress produces an:
Imbalance of the autonomic nervous
system with decreased parasympathetic
and increased sympathetic activity,
Under activity of the gamma amino-
butyric acid (GABA) system, the primary
inhibitory neurotransmitter system, and
Increased allostatic load.
Tey further hypothesized that yoga-
based practices i) correct under activity of the
parasympathetic nervous system and GABA
systems in part through stimulation of the vagus
nerves, the main peripheral pathway of the
parasympathetic nervous system, and ii) reduce
allostatic load.
According to the theory proposed by them,
decreased parasympathetic nervous system and
GABAergic activity that underlies stress-related
disorders can be corrected by yoga practices
resulting in amelioration of disease symptoms. A
review by Bhavanani concluded that heart rate
variability (HRV) testing has a great role to play
in our understanding of the intrinsic mechanisms
behind such potential autonomic balancing efects
of yoga.
51
Innes et al had earlier postulated two
interconnected pathways by which yoga reduces
the risk of cardiovascular diseases through the
mechanisms of parasympathetic activation coupled
with decreased reactivity of sympathoadrenal
system and HPA axis.
52
It is notable that one of the newer applications
of yoga has been in managing the aftermaths of
natural disasters. Studies have shown that yoga
signifcantly reduces symptoms of posttraumatic
stress disorder (PTSD), self-rated symptoms of
stress (fear, anxiety, disturbed sleep, and sadness)
and respiration rate.
53
Figure 2: Impact Of Stress On HypothalamicPituitaryAdrenal (Hpa) Axis And Sympathetic Nervous System.
(Sengupta P. Health Impacts of Yoga and Pranayama: A State-of-the-Art Review.Int J Prev Med 2012; 3:44458.
* Yoga has signifcant benefcial efects at these levels)
Ann. SBV, Jan - Jun 2014;3(1)
Page 32 Annals of SBV
Mental Health
Yoga can enhance ones spiritual life and
perspective beyond the physical life regardless
of ones particular religion.
54
It enables people to
attain and maintain a balance between exertion
and relaxation, and this produces a healthy and
dynamic state of homeostatic equilibrium.
5
Recent
studies have shown that yoga improves mood
and reduces depression scores.
55,56
Tese changes
have been attributed to an increased secretion
of thalamic GABA with greater capacity for
emotional regulation.
56,57
Even a 10 day yoga-based
lifestyle modifcation program has been reported to
improve subjective wellbeing scores of patients.
20
Tere has been extensive work done on
Sudarshan Kriya Yoga and depression at the
National Institute of Mental Health and Neuro
Sciences (NIMHANS) in India. Tis technique
has been recommended as a potential alternative
to drugs for melancholia as a frst-line treatment.
58
A review by Carim-Todd et al on yoga and
smoking cessation, reported positive benefts of
mindbody interventions.
59
Tese interventions
produced changes in smoking behaviour/in
predictors of smoking behaviour such as abstinence,
decreased number of cigarettes smoked, lower
intensity of cravings and attitudinal changes
regards smoking. However, defnite conclusions
on their benefts for smoking cessation couldnt be
drawn due to scarcity of papers, low quality of some
publications, and numerous limitations of these
studies like inadequate sample size, limitations of
study design, lack of adherence monitoring, lack of
objective measures, inadequate or absent control
conditions and absence of blinding.
A large number of studies show that the
practice of yoga can produce signifcant decrease
in the basal anxiety scores in diferent populations.
60, 61, 62, 63, 64, 65
Tese reports have shown signifcant
improvements in perceived stress, state and trait
anxiety, subjective well-being, vigour and decrease
in salivary cortisol, fatigue and depression. Physical
well-being also increased, and those subjects
sufering from headache or back pain reported
marked pain relief. We can conclude that yoga and
other mind body therapies do have a potential role
in management of depressive and anxiety disorders.
In addition to its benefts for patients themselves,
yoga also has a great role for managing depression
manifesting in family caregivers of patients with
dementia.
66
Researchers also support the promising
role of yoga as an intervention for depression
because it is cost-efective and easy to implement.61
However a point to consider is that all the mind-body
interventions do seem to be efective when compared
to passive controls but reports are less conclusive
when compared with active controls.
67
Figure 3: Interconnections Between Inner Correspondence / Peaceful Harmony (Icph), Mindful Acceptance &
Mental /Emotional Stabilization In Response To Mind-Body Interventions Such As Yoga.
(Arndt Bussing et al. Inner Correspondence and peacefulness with practices among participants in Eurythmy
Therapy & Yoga: A Validation Study. Evid Based Complement Alternat Med 2011; 2011: 329023.)
Ann. SBV, Jan - Jun 2014;3(1)
Page 33 Annals of SBV
Cardiovascular Conditions
Many studies have tried to explore the
mechanisms by which yoga modifes coronary
artery disease risk factors. Manchanda et al
68
,
Ornish et al
69
and Yogendra et al
70
have conducted
prospective, randomized and controlled trials on
angiographically proven coronary artery disease
patients with yoga intervention and demonstrated
that yoga based lifestyle modifcation helps in
regression of coronary lesions and improvement in
myocardial perfusion. Te efect of yogic lifestyle on
some of the modifable risk factors could probably
explain the preventive and therapeutic benefcial
efect observed in coronary artery disease.
A review of 70 eligible studies investigating the
efects of yoga on risk indices associated with the
insulin resistance syndrome, cardiovascular disease,
and possible protection with yoga, reported that
most had a reduction of systolic and/or diastolic
pressure. However, the reviewers also noted that
there were several noted potential biases and
limitations that made it difcult to detect an efect
specifc to yoga.
52
Another literature review reported
signifcant improvements in overall cardiovascular
endurance of young subjects who were given
varying periods of yoga training.
71
Physical ftness
increased as compared to other forms of exercise
and longer duration of yoga practice produced
better cardiopulmonary endurance. In fact a
detailed review of yoga in cardiac health concluded
that it can be benefcial in the primary and
secondary prevention of cardiovascular disease and
that it can play a primary or a complementary role
in this regard.
72
Respiratory Disorders
Scientifc basis of using yoga as an adjunct
therapy in chronic obstructive pulmonary diseases
is well established with signifcant improvements in
lung function, quality of life indices and bronchial
provocation responses coupled with decreased need
for regular and rescue medicinal usage.
73,74
Behera
reported perceptible improvement in dyspnea and
lung function in patients of bronchitis after 4 weeks
of yoga therapy that used a variety of postures and
breathing techniques.
75
Yogic cleaning techniques
such as dhautikriya (upper gastrointestinal cleaning
with warm saline or muslin cloth) and netikriya
(warm saline nasal wash) remove excessive mucous
secretions, decrease infammation and reduce
bronchial hypersensitivity thereby increasing
provocation threshold while kapalabhati through
forceful exhalations improves the capacity to
exhale against resistance.
76
A nonspecifc broncho
protective or broncho relaxing efect has been also
postulated
77
while improved exercise tolerance has
been reported following yoga therapy in patients
of chronic severe airways obstruction.
78
It has
been reported that well-performed slow yogic
breathing maintains better blood oxygenation
without increasing minute ventilation, reduces
sympathetic activation during altitude-induced
hypoxia
79
and decreased chemorefex sensitivity
to hypoxia and hypercapnia
80
. Tese help bring
about both objective and subjective improvements
in the condition of patients with bronchitis. Yoga
as a therapy is also cost efective, relatively simple
and carries minimal risk and hence should be
advocated as an adjunct, complementary therapy
in our search for an integrated system of medicine
capable of producing health and wellbeing for all.
Metabolic/Endocrine Conditions
A few RCTs have suggested that yoga and
meditation practices act on the hypothalamic
pituitaryadrenal axis (HPA) axis to reduce
cortisol levels in plasma,
81, 82, 83, 84
as well as reduce
sympathetic nervous system tone, increase vagal
activity,
85,86
and elevate brain GABA levels
62
.
Major systematic reviews of the efects of yoga
on risk indices associated with insulin resistance
syndrome and risk profles in adults with type 2
diabetes have been done in recent times.
52,87
Tey
reported post-intervention improvement in various
indices but with results varying by population and
study design. Another systematic review addressed
the management of type 2 diabetes and concluded
that the reviewed trials suggest favourable efects of
yoga on short-term parameters related to diabetes
but not necessarily for long-term outcome.
88
Te
AHRQ cites two studies comparing yoga versus
medication which reported a large and signifcant
reduction of fasting glucose in individuals with type
2 diabetes in one, and a smaller but still signifcant
improvement in the other.
49
Ann. SBV, Jan - Jun 2014;3(1)
Page 34 Annals of SBV
Figure 4: Proposed Relationships Among Dyspnea, Benefts of Yoga, and Outcomes of Participation In A Yoga
Program. (Donesky-Cuenco D, Nguyen Hq, Paul S, Carrieri-Kohlman V. Yoga Therapy Decreases Dyspnea-Related
Distress and Improves Functional Performance In People With Chronic Obstructive Pulmonary Disease: A Pilot Study.
J Altern Complement Med 2009; 15: 225234).
Figure 5 Postulated Mechanisms By Which Yoga Can Help Reduce Risk For Type 2 Diabetes Mellitus And Its
Complications (Innes Ke, Vincent Hk. The Infuence Of Yoga-Based Programs On Risk Profles In Adults With Type 2
Diabetes Mellitus: A Systematic Review. Ecam 2007; 4: 469-86.)
Ann. SBV, Jan - Jun 2014;3(1)
Page 35 Annals of SBV
A recent systematic review of yoga on
menopausal symptoms reported small efects
on psychological symptoms with no efects on
total menopausal symptoms, somatic symptoms,
vasomotor symptoms, or urogenital symptoms.
89
Musculoskeletal Conditions
A review by Posadzki et al
90
found that 10 of 11
RCTs reported signifcantly greater efects in favor
of Yoga when compared to standard care, self-care,
therapeutic exercises, relaxing yoga, touch and
manipulation, or no intervention. Yoga was more
efective for chronic back pain than the control
interventions such as usual care or conventional
therapeutic exercises though some studies
showed no between group diferences.
91
Recently
two well designed trials of yoga for back pain
reported clinically meaningful benefts over usual
medical care but not over an intensive stretching
intervention.
92,93
Figure 6: Mechanisms Underlying Efectiveness Of Yoga For Chronic Low Back Pain. (Sherman et al., Comparison
of yoga versus stretching for chronic low back pain: protocol for the Yoga Exercise Self-care trial. Trials 2010; 11:36
Cancer
According to the fndings of a comprehensive
meta-analysis of role of yoga in cancer, improvements
in psychological health were seen in yoga groups when
compared to waitlist or supportive therapy groups.
94

With respect to overall quality of life, there was a
trend towards improvement. To explain the positive
outcomes, Smith and Pukall suggested various
complex pathways which may involve relaxation,
coping strategies, acceptance, and self-efcacy.
95

Kochupillai et al reported increase in natural killer
cells in cancer patients who had completed their
standard therapy after practicing Sudarshan Kriya
Yoga and pranayam breathing techniques.
96

A systematic review and meta-analysis of RCTs
on the physical and psychosocial benefts of yoga in
cancer patients and survivors by Bufart and colleagues
concluded that yoga may be a feasible intervention as
benefcial efects on several physical and psychosocial
symptoms were reported.
97
Tey showed that it
has strong benefcial efects on distress, anxiety and
depression, moderate efects on fatigue, general
HRQoL, emotional function and social function, small
efects on functional well-being, and no signifcant
efects on physical function and sleep disturbances. It
was suggested that yoga can be an appropriate form
of exercise for cancer patients and survivors who are
unable or unwilling to participate in other traditional
aerobic or resistance exercise programs.
Ann. SBV, Jan - Jun 2014;3(1)
Page 36 Annals of SBV
Pregnancy
Preliminary evidence from various scientifc studies
supports yogas potential efcacy, particularly if
started early in the pregnancy. Women practicing
yoga in their second trimester reported signifcant
reductions in physical pain from baseline to post
intervention compared with women in the third
trimester whose pain increased.
98
Women in
their third trimester showed greater reductions in
perceived stress and trait anxiety. Another study
reported signifcantly fewer pregnancy discomforts
at 38-40 weeks of gestation.
99
Subjects who
participated in the yoga programme exhibited
higher outcome and self-efcacy expectancies
during active and second stage of labour. Provision
of booklets and videos on yoga during pregnancy
may contribute to a reduction in pregnancy
discomforts and improved childbirth self-efcacy.
Satyapriya et al concluded that yoga reduces
perceived stress and improves adaptive autonomic
response to stress in healthy pregnant women
100

while Chuntharapat et al
101
concluded that yoga
produced higher levels of maternal comfort during
labour and 2 hour post-labour with a decrease in
subject evaluated labour pain. Tey also reported
shorter duration of the frst stage of labour, as well
as total time of labour in subjects practicing yoga.
A study by Narendran et al reported a
lower trend in the occurrence of complications
of pregnancy such as pregnancy-induced
hypertension, intrauterine growth retardation and
pre-term delivery in subjects who practiced yoga.
102

Tey concluded that an integrated approach to yoga
during pregnancy is safe and that it improved birth
weight, decreased preterm labour, and reduced
IUGR either in isolation or associated with PIH,
with no increased complications.
A review by Field reported that alternative
therapies have been found efective for reducing
pregnancy-related back and leg pain and nausea
and for reducing depression and cortisol levels and
the associated prematurity rate.
103
It also noted
that alternative therapies reduce pain and thereby
the need for medication.
Figure 7: Postulated Mechanisms of Benefts of Yoga In Pregnancy. Chuntharapat S, Petpichetchian W, Hatthakit U.
Yoga during pregnancy: efects on maternal comfort, labor pain and birth outcomes. Complement Ther Clin Pract
2008; 14(2): 105-15.
Paediatric Population
Clinical applications of Yoga have been studied in
paediatric and young adult populations with focus
on physical ftness, cardio-respiratory efects, mental
health, behaviour and development, irritable bowel
syndrome, eating disorders, and prenatal efects on
birth outcomes. Tough a large majority of studies
are positive, due to methodological limitations,
evidence provided is still in its infancy.
104
Yoga has
been suggested as an option for children to increase
physical activity and ftness and that yoga may be
a gateway for adopting a healthy active lifestyle in
sedentary children who are intimidated by more
vigorous forms of exercise. Tey recommended
Ann. SBV, Jan - Jun 2014;3(1)
Page 37 Annals of SBV
that further research is necessary to identify
clinical applications of yoga for children and that
such research needs to be conducted with rigorous
methodology in RCTs with detailed description of
protocols and reporting of results. Methodological
issues specifc to mind-body interventions should
be addressed including adequate description of the
intervention and control group, and single blinding
of the outcome assessor.
A review by Galantino et al concluded that the
evidence shows physiological benefts of yoga for
the paediatric population that may beneft children
through the rehabilitation process, but larger
clinical trials, including specifc measures of QOL
are necessary to provide defnitive evidence.
105

Tey rightly suggested that the type and intensity
of yoga, the specifc postures for the intended
outcome, and the measurement of adherence
beyond the clinic have to be determined. Teir
review showed that yoga may beneft children with
mental challenges by improving their mental ability,
along with motor coordination and social skills and
that restoration of some degree of functional ability
is possible in those having physical disabilities.
It was suggested that physical therapists might
apply these fndings in the neuromuscular areas
of learning, motor control, and coordination.
A notable point mentioned by them was that,
Regardless of the goal, yoga appears to be a
multitasking modality that simultaneously treats
both physical impairments as well as more global
issues such as stress, anxiety, or hyperactivity.
In Conclusion
All of the above studies and reviews suggest a
number of areas where mind-body therapies such
as yoga may be benefcial, but more research is
required for virtually every one of them to establish
their benefts conclusively. Tis is true in the
process of introducing any new therapy into the
modern health care system and is not surprising
when we realize that the proper studies on yoga
as a therapeutic modality are not older than a few
decades.
Some of the major issues highlighted by these
studies and reviews include:
1. Individual studies on yoga for various
conditions are small
2. Poor-quality trials in general with multiple
instances for bias
3. Substantial heterogeneity with regards to the
populations studied,
yoga interventions,
duration and frequency of yoga practice,
comparison groups, and
outcome measures.
4. Compliance was not routinely noted, thus
preventing an understanding of the apt dosage
requirements with regard to the mind-body
interventions
5. Yoga requires active participation and
motivation that requires active eforts from
both the researcher as well as the participants.
6. Changes in attitudes and behavior need to be
documented and understood better, especially
in the lifestyle, stress induced psychosomatic
conditions.
7. It is not clear which patients may beneft
from the mind-body interventions, and which
aspects of the interventions or which specifc
styles were more efective than others.
It has been suggested that yoga may help
improve patient self-efcacy, self-competence,
physical ftness, and group support, and may well
be efective as a supportive adjunct to mitigate
medical conditions. Bssing et al concluded that
yoga may have potential to be implemented as a
safe and benefcial supportive/adjunct treatment
that is relatively cost-efective, may be practiced
at least in part as a self-care behavioral treatment,
provides a life-long behavioral skill, enhances self-
efcacy and self-confdence, and is often associated
with additional positive side efects.
106
It is important to develop objective measures of
various mind-body therapies and their techniques
while including them in intervention trials. It has
also been suggested that the publication of specifc
interventions used in future studies in manual
form can allow reliable replication and future
implementation. It is also important to develop tools
to monitor objectively the participants self-practice,
compliance, and adherence to the interventions. Yoga
has preventive, promotive as well as curative potential
and a yogic lifestyle confers many advantages to
Ann. SBV, Jan - Jun 2014;3(1)
Page 38 Annals of SBV
the practitioner. Since lifestyle related diseases are
alarmingly on the rise in our modern society, yogic
lifestyle should be given a special place in preventing
and managing these diseases.
As suggested by Bussing et al, Yoga may well
be efective as a supportive adjunct to mitigate some
medical conditions, but not yet a proven stand-alone,
curative treatment. Larger-scale and more rigorous
research with higher methodological quality and
adequate control interventions is highly encouraged
because yoga may have potential to be implemented
as a benefcial supportive/adjunct treatment that is
relatively cost-efective, may be practiced at least in
part as a self-care behavioural treatment, provides a
life-long behavioural skill, enhances self-efcacy and
self-confdence and is often associated with additional
positive side efects.
106
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Introduction:
Yoga is frst and foremost a moksha shastra meant
to facilitate the individual to attain the fnal
freedom, liberation or emancipation. One of the
important by-products of the Yogic way of living is
attainment of health and well being. Tis is brought
about by right-use-ness of the body, emotions and
mind with awareness and consciousness. Tis must
be understood to be as healthy a dynamic state
that may be attained in spite of the individuals
sabija karma that manifests as their genetic
predispositions and the environment into which
they are born. Yoga also helps maintain and sustain
this dynamic positive state of health after it has
been attained through disciplined self efort.
Te central theme of Yoga is the golden
mean, fnding the middle path, a constant search
for moderation and a harmonious homoeostatic
balance. Yoga is the unitive impulse of life, which
always seeks to unite diverse streams into a single
powerful force. Proper practice produces an inner
balance of mind that remains stable and serene
even in the midst of chaos. Tis ancient science
shows its adherents a clear path to the eye of the
storm and ensures a stability that endures within,
even as the cyclone rages externally.
Causation of Psychosomatic Disorders:
Yogamaharishi Dr Swami Gitananda Giri, founder
of Ananda Ashram at Pondicherry (www.icyer.
com) has written extensively about the relationship
between health and disease. He says, Yoga views
the vast proliferation of psychosomatic diseases as
a natural outcome of stress and strain created by
desire fostered by modern propaganda and abuse
of the body condoned on all sides even by religion,
science and philosophy. Add to this the synthetic
junk food diet of modern society and you have
the possibility of endless disorders developing
even the extinction of man by his own ignorance
and misdeeds.
He explains the root cause of disease as follows.
Yoga, a wholistic, unifed concept of oneness,
is adwaitam or non-dual in nature. It suggests
happiness, harmony and ease. Dis-ease is created
when duality or dwaitam arises in the human
mind. Tis false concept of duality has produced all
conficts of human mind and the vast list of human
disorders. Duality (dis-ease) is the primary cause
of mans downfall. Yoga helps return man to his
pristine, whole nature.
All diseases, maladies, tensions, are
manifestations of divisions of what should be mans
complete nature, the atman or Self . Tis Self is
ease. A loss of ease creates dis-ease. Duality is
the frst insanity, the frst disease, the unreasonable
thought that I am diferent from the whole. I
am unique. I am me. Te ego is a manifestation
of disease. Only a distorted ego could feel alone,
sufer from the lonely disease, in a Universe, a
Cosmos totally flled with the Self .
Interestingly, he points out that one of the oldest
words for man is insan. Man is insane. A return
to sanity, going sane, is the subject of real Yoga
Sadhana and Yoga Abhyasa. Yoga Chikitsa is one of
the methods to help insane man back onto the path
of sanity. A healthy man or woman may be known by
the term-Yogi. A very strongly worded yet very true
statement indeed from the Lion of Pondicherry!
Yogic Perspective of Depression:
According to the Yoga Darshan codifed by Maharishi
Patanjali, depression or rather daurmanasya is
one of the four vikshepa sahabhuvah that are
the manifestations that accompany the obstacles
to yoga sadhana, the nava antaraya. Te other
sahabhuvah are duhkha or sufering, angamejayatva
or tremors and shvasaprasvasa or irregular respiration.
(duhkhadaurmanasya angamejayatva shvasaprasvasa
vikshepasahabhuvah Yoga Darshan -1:31). When we
analyze this sutra deeply we fnd that they are very
true refections of our inner state.
YOGIC PERSPECTIVES ON MENTAL HEALTH
Dr Ananda Balayogi Bhavanani *
* Dr Ananda Balayogi Bhavanani, Deputy Director, CYTER, Mahatma Gandhi Medical College and Research
Institute, Puducherry 607402, India, Email: yognat@gmail.com
Ann. SBV, Jan - Jun 2014;3(1)
Page 48 Annals of SBV
Duhkha or painful sufering at the physical,
emotional and mental level can drive us to despair.
Sufering is an excellent trick our mind plays as
very few can overcome the moment of sufering.
Very few are capable of realizing what is really
happening in the process of their evolutionary
journey. Te moment sufering is felt, most people
give up, and the lower mind survives to fght
another day.
Daurmanasya refers to dejection and despair.
We must remember that depression is not just in
the mind but has many physical aspects too. A
state of depression is another tool by which the
lower mind tries to halt the spiritual progress of a
sadhaka. However we must realise that the greatest
teachings are often given at moments of great
despair. Te art and science of Yoga understands
that this may be the best teachable moment and
hence we fnd the highest teachings of the Bhagavad
Gita and Ramayana coming at this point.
Our Guru Swami Gitananda Giri Guru
Maharaj used to say, A nervous breakdown is
actually an opportunity for a spiritual breakthrough
if we can realise the positive implications in our
moment of despair and dejection. Te teachings
of the Yoga Vasishtha and the Bhagavad Gita
which may be said to be the frst and second
recorded psychological counseling sessions in
human history were delivered when both Lord
Rama and Arjuna respectively were at the depths
of their depression. If we realise that this is indeed
a window of opportunity for growth, success will
come to us the soonest. But if we miss this golden
chance, then even the Divine will struggle to help
us out of our own deep pit of self pity.
Angamejayatva are the physical tremors of the
body. Te practice of asana helps us to attain to a
state of physical control over our body. Tis enables
us to go beyond the dwandwa, the pair of opposites
that are the cause of these tremors. Tremors are an
externalized manifestation of internal imbalances
of our emotions and mind. Imbalance at the higher
level causes the imbalance in the neuro-chemical
transmitters and psycho-physiological pathways of
the body, resulting in these physical tremors. When
confronted with such a frightening manifestation,
many aspirants get scared whether they are harming
themselves and stop their Sadhana out of fear.
Shvasaprasvasa refers to the irregularity in
breathing patterns. One of the main physical
manifestations of mental and emotional upsets
is the haphazardness of respiration. Ancient
Yogis contemplated this deeply and found that
mental disturbances cause irregularity and
instability of respiration. Though their jnana
drishti (perspective of wisdom) they realised
that by stabilizing the breath, we can conversely
produce a stability of emotions and mind. This
knowledge is used even today in the practice
of pranayama, when it is used as a means of
altering the higher (mind) through the lower
(body). This is one of the best examples of the
numerous somato-psychic applications found in
the practices of hatha yoga, the physical science
of balancing equal and opposite energies.
Yogic Methods To Attain and Maintain
Health:
Te science of Yoga has numerous practical
techniques as well as advice for proper life style in
order to attain and maintain health and well being.
Bahiranga practices such as yama, niyama, asana
and pranayama help produce physical health while
antaranga practices of dharana and dhyana work
on producing mental health along with pratyahara.
Yoga works towards restoration of normalcy in all
systems of the human body with special emphasis
on the psycho-neuro-immuno-endocrine axis.
In addition to its preventive and restorative
capabilities, Yoga also aims at promoting positive
health that will help us to tide over health challenges
that occur during our lifetime. Just as we save
money in a bank to tide over fnancial crises, so also
we can build up our positive health balance to help
us manage unforeseen health challenges with faster
recovery and recuperation. Tis concept of positive
health is one of Yogas unique contributions to
modern healthcare as Yoga has both a preventive
as well as promotive role in the healthcare of our
masses. It is also inexpensive and can be used in
tandem with other systems of medicine in an
integrated manner to beneft patients.
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Becoming One With Te Breath:
In the science of Yoga, body movement and
breath must be synchronized. Te breath pattern
is important. Particularly in the use of kriya or
structured movements like Surya namaskar, the
body is normally lifted on an incoming breath and
lowered on an outgoing breath. Some of the breath
patterns such as the bhastrika strengthen the whole
solar plexus area as well as the diaphragm, building
up stamina while producing internal cleansing
of organs and the blood stream. Kapalbhathi
is another dynamic technique that enables us
to break out of the deep hole of depression by
creating a sense of activation. Surya nadi and ujjayi
pranayama can also help in activating those who
need the activation for healthy well being. Te
bandha trayam as well as the aswini mudra are both
a God-send for those sufering from depression as
they revitalise the entire psycho-neuro-endocrine
system. Te pranava and bhramari pranayama work
towards creating an inner harmony that results in
the attainment of a state of mental calmness.
According to Dr Swami Gitananda Giri, one
of the foremost exponents of Yoga in the 20th
century, the inherent message of Pranayama can be
summarised as follows:
Tere is an absolute and direct correlation
between the way an organism breathes and
its energy level.
Tere is an absolute and direct correlation
between the way a man breathes and the
length of his life span.
Tere is an absolute and direct correlation
between the way a man breathes and the
state of mind and clarity of thought, which
he enjoys.
Tere is an absolute correlation between
the way a man breathes and the quality of
emotions, which he experiences.
Tere is an absolute and direct correlation
between the way a man breathes and
the subtlety of the thoughts, which pass
through his mind.
Shifting From Individuality To Universality:
Yoga, which emphasizes the universal, is a perfect
foil to those human activities, which glorify the
personal. Te ego which is fxated only on its own
shallow self will soon run into the blank wall of
depression and despair, overwhelmed by its own
superfciality. Tat striving spirit which looks
within at the universal aspect of its own nature and
sees the oneness of the whole of creation will fnd
an endless fountain of inspiration and joy. In short
it may be safely said that the practice of Yoga as
a unifed whole helps the individual shift from an
I-centric approach to a we-centric approach.
Te Srimad Bhagavad Gita says, yogaha karmasu
koushalam meaning thereby that Yoga is skill in
action (BG 2:50). Te real Yogi, immensely conscious
and aware at the physical, mental and emotional
levels gains great control through that consciousness
over all aspects of life thus developing a real skill in
living. Part of that skill springs from his cultivated
detachment, his ability to work for works sake,
and not for the sake of the reward. He realizes that
his duty is to do his best but that the ultimate result
is not in his hands. Te Yogi performs the needed
action not for the sake of the fruits of that action, but
because it is good and necessary to do so.
Such an attitude of mind produces consummate
skill in whatever action the Yogi undertakes.
Consummate concentration, consummate controls
are all ofshoots of good Yoga Sadhana. Tis
belies the age-old belief that the competitive
spirit produces the highest skill. To this the
Yogic answer is: detachment from the fruits of the
action produces the greatest efciency, for one is
then emotions connected with goal-oriented,
competitive thinking. Te beauty of Yoga is that
these abstract principles become concrete in the
daily practice of the techniques available in the
Yoga system. Once the seed of Yoga fnds fertile
soil, these concepts grow naturally, slowly but surely
taking root in all aspects of life.
Wholistic Approach of Yoga:
Te Yogic wholistic approach to life that everything
is important and everything has its efect could do
much to improve the mind, body and emotional
states of well being. Tese practical approaches to
health include:
Te use of early morning sunlight for
healing and rejuvenative activities
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Te use of water for internal and external
cleansing
Careful attention to diet of a sattvic nature
Realising the necessity for balance between
exertion and relaxation as all tension must be
balanced using concept of spanda nishpanda
or exertion-relaxation-exertion-relaxation
in an alternating rhythm of activity,
Learning how to unwind through the
many relaxation techniques available in
the Yoga science which can balance the
immense amount of stress and strain that
are part and parcel of day to day life
Realising the need for clean air, water and
food
Becoming aware of the efect of modern
modes of entertainment and addictive
habits in general debilitation of the physical,
emotional and mental nature
Providing a working philosophy which
will sustain one in triumph and defeat
Learning to be sensitive to ones own bio-
rhythms, ones own physical, mental and
emotional cycles
Being aware of the efects of the seasons
and the various unnatural life styles to
which the modern man is exposed
In short, all of these aspects of Yoga as a way
of natural living can provide relief for many of
the psychosomatic ailments afecting humankind
today.
Cultivation of Positive Health:
According to Yogacharini Meenakshi Devi
Bhavanani, Director ICYER at Ananda Ashram
in Pondicherry, Yoga has a step-by-step method
for producing and maintaining perfect health at all
levels of existence. She explains that social behaviour
is frst optimized through an understanding and
control of the lower animal nature (pancha yama)
and development and enhancement of the higher
humane nature (pancha niyama).
Te body is then strengthened, disciplined,
purifed, sensitized, lightened, energized and
made obedient to the higher will through asana.
Universal pranic energy that fows through body-
mind-emotions-spirit continuum is intensifed and
controlled through pranayama using breath control
as a method to attain controlled expansion of the
vital cosmic energy. Te externally oriented senses
are explored, refned, sharpened and made acute,
until fnally the individual can detach themselves
from sensory impressions at will through
pratyahara.
Te restless mind is then purifed, cleansed,
focused and strengthened through concentration
(dharana). If these six steps are thoroughly
understood and practiced then the seventh, dhyana
or meditation (a state of union of the mind with
the object of contemplation) is possible. Intense
meditation produces samadhi, or the enstatic
feeling of Union, Oneness with the Universe. Tis
is the perfect state of integration or harmonious
health.
Yogic Tools For Positive Mental Health:
In order to create an environment conducive to the
development of positive mental health as also to
prevent and manage the psychosomatic lifestyle
disorders that are threatening humankind, Yoga
ofers us many practical day-to-day methods of
action. Some of these tools for positive health are
as follows.
1. Become aware of your body, emotions and
mind: Without awareness there cannot be health or
healing. Awareness of body implies conscious body
work that needs to be synchronized with breath to
qualify as a psychosomatic technique of health and
healing. Psychosomatic disorders cannot be tackled
without awareness.
2. Improve your dietary habits: Most disorders
are directly or indirectly linked to improper dietary
patterns that need to be addressed in order to fnd
a permanent solution to health challenges. One of
the most important lifestyle changes that needs
be implemented in management of any lifestyle
disorder is diet.
3. Relax your whole body: Relaxation is
most often all that most patients need in order
to improve their physical condition. Stress is the
major culprit and may be the causative, aggravating,
or precipitating factor in so many psychosomatic
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disorders. Doctors are often found telling their
patients to relax, but never tell them how to do it!
Te relaxation part of every Yoga session is most
important for it is during it that beneft of practices
done in the session seep into each and every cell
producing rest, rejuvenation, reinvigoration and
reintegration.
4. Slow down your breath making it quiet and
deep: Rapid, uncontrolled, irregular breathing is
a sign of ill health whereas slow, deep and regular
controlled breathing is a sign of health. Breath is
the link between body and mind and is the agent
of physical, physiological and mental unifcation.
When breath is slowed down, metabolic processes
are also slowed and anabolic activities begin the
process of healing and rebuilding. If breath is calm,
mind is calm and life is long!
5. Calm down your mind and focus it
inwardly: Te mind is as disturbed as a drunken
monkey bitten by a scorpion say our scriptures. To
bring that wayward agitated mind under control,
and take it on a journey into our inner being is
fundamental in fnding a way out of the disease
maze in which we are entangled like a fy in the
spiders web. Breath work and sensory control
are the base on which mind training can occur;
hence much importance is given to pranayama and
pratyahara. It is only after this that concentration
practices leading to meditation can have any use.
Just sitting and thinking about something is not
meditation!
6. Improve the fow of healing Pranic Life
Energy: Improve the fow of healing Pranic Life
Energy to all parts of the body, especially to those
diseased parts, thus relaxing, regenerating and
reinvigorating ourselves. Prana is life and without
it there cannot be healing. Te diferent prana and
upa prana vayu that are energies driving diferent
physiological functions of the body need to be
understood and applied as per needs of the patient.
7. Fortify yourself against omnipresent
stressors: Decrease your stress level by fortifying
yourself against the various omnipresent stressors
in your life. When face to face with the innumerable
thorns in a forest, one may either choose to spend
all their time picking them up one by one while
other thorns continue falling or choose to wear
a pair of shoes and walk through the forest. Te
diference is in attitude. Choosing the right attitude
can change everything and bring about a resolution
of the problem by healing the core. Stress is more
about how you react to the stressor than about the
nature of the stressor itself !
8. Increase your self reliance and self
confdence: Life is full of challenges that are there
only to make us stronger and better. Te challenges
should be understood as opportunities for change
and faced with confdence. We must understand we
have the inner power to overcome each and every
challenge that is thrown at us by life. Te Divine is
not a sadist to give us challenges that are beyond
our capacity!
9. Facilitate natural emanation of wastes:
Facilitate natural emanation of waste from the body
by practicing shuddi kriyas like dhauti, basti and neti.
Accumulation and stagnation of waste materials
either in inner or outer environment always causes
problems. Yogic cleaning practices help wash out
impurities (mala shodhana) thus helping the process
of regeneration and facilitating healing.
10. Take responsibility for your own health:
Remember that ultimately it is YOU who are
responsible for your own health and well being and
must take the initiative to develop positive health
to tide you over challenging times of ill health.
Yoga fxes responsibility for our health squarely
upon our own shoulders. If we do healthy things
we are healthy and if we do unhealthy things we
become sick. No use complaining that we are not
well when we have been the cause of our problem.
As Swamiji Gitananda Giri would say, You dont
have problems-you are the problem!
11. Health and happiness are your birthright:
Health and happiness are your birthright, claim
them and develop them to your maximum potential.
Tis message of Swamiji is a frm reminder that the
goal of human existence is not health and happiness
but is moksha (liberation). Most people today are
so busy trying to fnd health and happiness that
they forget why they are here in the frst place.
Yoga helps us regain our birthright and attain the
goal of human life.
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Conclusion:
Te dedicated practice of Yoga as a way of life
is no doubt a panacea for problems related to
psychosomatic, stress related physical, emotional
and mental disorders and helps us regain our
birthright of health and happiness. It is only when
we are healthy and happy that we can fulfl our
destiny.
Recommended Reading:
1. Yoga Chikitsa: Te application of Yoga as a Terapy.
Dr. Ananda Balayogi Bhavanani. Dhivyananda Creations,
Iyyanar Nagar, Pondicherry. 2013.
2. Ancient Yoga and Modern Science. TR
Anantharaman. Mushiram Manoharlal Publishers Pvt Ltd,
New Delhi. 1996
3. Back issues of International Journal of Yoga Terapy.
Journal of the International Association of Yoga Terapists,
USA. www.iayt.org
4. Back issues of Yoga Life, Monthly Journal of
ICYER at Ananda Ashram, Pondicherry. www.icyer.com
5. Four Chapters on Freedom. Commentary on Yoga
Sutras of Patanjali by Swami Satyananda Saraswathi, Bihar
School of Yoga, Munger, India. 1999
6. Srimad Bhagavad Gita by Swami Swarupananda.
Advaita Ashrama, Kolkata. 2007
7. Yoga and Sport. Dr Swami Gitananda Giri and
Meenakshi Devi Bhavanani. Satya Press. Pondicherry. 1991.
www.icyer.com
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Introduction:
All aspects of our human personality are cultured
through the process of Yoga helping us evolve
towards perfection until we are One with the
Divine Self. Yoga helps destroy the Kleshas, the
psychological afictions that warp our vision, as well
as eradicates Karma Bandha that prevents us from
realizing our potential Divinity. Our great Rishis
like Veda Vyasa and Maharishi Patanjali have given
us a clear road map for this evolutionary journey
with vital clues towards understanding both the
internal and external culturing processes of Yoga.
Te cultural teachings of Yoga help us become All
One by losing our sense of individuality to gain an
unparalleled sense of universality.
In our day-to-day personal and inter-personal
social life, Yoga has given us multitudes of tools,
concepts, attitudes and techniques through which we
can attain inner contentment leading to happiness
and spiritual realization while simultaneously
creating harmony in all relationships. All psycho-
social qualities essential for healthy inter-personal
relationships are cultivated when we live a life of
Yoga that is in tune with the eternal Dharma. Tese
humane qualities include loving understanding,
innate sensibility that sees others perspectives,
compassion, empathy, respect, gratitude, fdelity
and responsibility. In fact the Srimad Bhagavad
Gita delineates very similar qualities of a spiritually
healthy person in Chapter XVI. Tese include:
fearlessness (Abhayam), purity of inner being
(Sattva Samshuddhih), steadfastness in the path
of knowledge ( Jnanayoga Vyavasthitih), charity
(Danam), self control (Dama), spirit of sacrifce
(Yajna), self analysis (Svadhyaya), disciplined
life (Tapa), uprightness (Arjavam), non violence
(Ahimsa), truthfulness (Satyam), freedom from
anger (Akrodhah), spirit of renunciation (Tyagah),
tranquility (Shanti), aversion to defamation
(Apaishunam), compassion to all living creatures
(Daya Bhutesv), non covetedness (Aloluptvam),
gentleness (Maardavam), modesty (Hrir
Acaapalam), vigor (Tejah), forgiveness (Kshama),
fortitude (Dhritih), cleanliness of body and mind
(Saucam), freedom from malice (Adroho), and
absence of pride (Naa Timaanita). One who is
blessed with these qualities is indeed a divine
blessing to the social life of their immediate family,
friends, relatives and their society itself.
Te Four Pronged Approach:
Our ancient Indian culture, a vibrant living culture
till even today, has a lot to ofer in every sphere
of life. Te elevated spiritual, psychological and
metaphysical concepts of our great Maharishis
hold true even today and it is up to us to delve into
them and reap benefts of psycho-physiological
health, happiness as well as intra-personal and
inter-personal social harmony. Our Rishis were
visionary seers who codifed innumerable concepts
that produce physically, emotionally and mentally
healthy individuals who are valuable for betterment
of society.
Our ancients in their infnite wisdom realised
that we need to deal with diferent people diferently.
Some people can be held close whereas with others
an arms length or often a six feet poles length is
required. Sensitive, sensible people may respond
to a soft carrot approach while the arrogant who
are usually dull and inert may only respond to a
heavy and strong stick. Te Rishis have codifed a
four pronged approach to deal with diferent types
of human personalities at diferent times and in
diferent ways. Saint Tiyagaraja in his composition
sarasa sama dana bheda danda chatura describes
Lord Rama as the perfect example of a human
possessing these qualities of Kingship and kinship.
Te frst of these four methods is known as
Sama and is the dealing with people using a sense
of equanimity and treating them as equals in the
search for truth. Tis can only be applied with the
noble ones and will be misused by others as seen in
THE YOGA OF INTERPERSONAL RELATIONSHIPS
Dr Ananda Balayogi Bhavanani *
* Dr Ananda Balayogi Bhavanani, Deputy Director, CYTER, Mahatma Gandhi Medical College and Research
Institute, Puducherry 607402, India and Chairman: International Centre for Yoga Education and Research,
and Yoganjali Natyalayam Puducherry. www.rishiculture.org and www.icyer.com
Ann. SBV, Jan - Jun 2014;3(1)
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todays chaotic environment. Te second method is
Dana, which implies the afording of concessions
towards those who are truly needy. Tis may be in
the material, physical, mental or emotional form
and is the giving of a bit of leeway that can help
those who are in trouble to come up to par with
others and then slowly develop into one who can
be treated at the Sama level. Bheda is the third
method and is a separation from troublesome
elements in order to reduce the extent of the
problem. When used in a proper and judicious
manner this can help many situations to normalize
and prevent them from going from bad to worse.
When things get really bad or worse, then Danda
or minimal deterrent action through judicious
punishment can be of use when we considering the
holistic picture.
In modern times the spare the rod mentality
is prevalent and we do seem to end up spoiling
our children and youth by making them weaker
in all aspects. We take away their ability to be
responsible citizens by teaching then indirectly
that anything that happens is not your fault- you
are the victim. I reiterate clearly that I am not a
supporter of any form of corporal punishment, but
I do realize the need for a determent in order for
the betterment of the whole. One rotten apple is all
that we need to spoil a barrel and the same can be
said of the repeated ofenders. Such situations need
to be nipped in the bud and the Danda method
has its uses too in such situations. Of course this
requires a lot of Viveka on the part of the parent,
teacher or person in authority and also needs safety
precautions so that it is not misused by ignorant
egotistical persons who want to be the star of the
show at the cost of the others. Te most basic
qualities required for a good parent, teacher and
leader in any feld of endeavor are intelligence and
empathy. Yet how many of our people have these
qualities today?
Evolutionary Quirks of the Human Brain:
Ammaji, Kalaimamani Meenakshi Devi Bhavanani
often talks about the fve quirks of the human
brain and quotes the Ken Keyes Jr who in his book
Your Road Map to Lifelong Happiness argues
that there is an essential lack of communication
between the old (reptilian - mammalian) and the
new (conscious, neo-cortex) parts of the human
brain. As the old brain developed over 60 to 375
million years it is powerful and well-set in its ways.
Its habitual responses to environmental survival
challenges are strong and automatic kill or be
killed. On the other hand, the New Brain of
human consciousness is only 40 to 100 thousand
years old and hence the new boy on the block.
Te lack of communication between the old and
new brains produces the Five Quirks that are the
major causes behind innumerable problems we face
in all interpersonal relationships. Tese quirks are:
1. Te Object Quirk the animal brain sees
objects only in a very vague, hazy, general sense and
not in a specifc sense. It views objects and classifes
them as to how they may fulfll its needs or in what
way they may threaten its safety. Tus, it confuses
diferent people and things. It sees everything
generally as friend or foe, provider of food or as a
sexual possibility. It does not need to see any object
with specifc characteristics. For example, it does
not choose a mate on personal charm or elevated
character but simply as a means to gratify sex drive.
Other objects and other creatures are important
only as means to satisfy basic needs.
2. Te Time Quirk Keyes says the Old
Brain has no time sense. It does not perceive past
or future. It lives only in the present moment. It
eats or is eaten. Tere is no sense of tomorrow
or yesterday. Everything is immediate, now, urgent.
At that lower level of life, every experience is in the
Now of survival.
3. Te Unsafe Stranger Quirk Te Old
Brain views all strangers with suspicion. Te
unknown stranger is a possible threat to survival or
a competitor for resources. Any creature diferent
from oneself and ones species is a potential threat.
4. Te Unchanging Entity Quirk To the
Old Brain incapable of perceiving subtleties,
everything remains the same a tree is always a
tree. It does not perceive the various changes,
which all things pass through. It sees all things
as unchanging as the perception of intricate
subtleties of change is not necessary for survival.
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5. Adaptable Memory Quirk Te animal
does not need memory. Te only memory
necessary is what enables it to survive. Hence, what
it remembers can be adjusted to whatever best
helps it to survive. Tere is no objective truth. Te
only Truth to the animal brain is survival of the
fttest.
Te manner in which animals and reptiles
perceive the world is a much dimmer, less precise,
less clear, survival-oriented perception totally geared
to survival. Tis is much less than that available
to the conscious mind. Te Old Brain is fuelled
by emotional responses. Te basic motivating
emotion is fear. Te other important drives-sex,
survival instinct, herd mentality, dominance, power
struggles, nurturing and being nurtured-are all tied
to the organisms basic need to survive at all costs
and fear of death or extinction.
For example, the Object Quirk manifests
in human experience when a person in the past
was abused by a red-haired woman and hence, in
future, always has a dislike for red-haired women.
Te Old Brain cannot see the possibility that all
red-haired women will not abuse it. Similarly the
Time Quirk manifests itself in human behavior in
this manner: when one experiences unhappiness,
one feels one is always unhappy. Tis may cause
one to perceive another person as always angry,
even though the person may only be angry at that
moment. Witness how many husband-wife or
parent-child quarrels begin with the words You
always do this
Te Unsafe Stranger Quirk is evidenced in
the suspicion that people feel when a foreigner
enters their circle, or someone of a diferent religion
a diferent race, a diferent culture etc comes into
their social circle. Tere is an instinctual fear, even
though that person may be perfectly harmless. Tis
is highly visible in todays society where everyone
wants their country, state, language, religion
etc to be the best. Linguistic, religious and
regional fanaticism springs forth from such old
conditioned responses that are so deeply ingrained
in the animal brain that people lose all sense and
do things that they would never do in even their
wildest dreams.
Te Unchanging Entity Quirk manifests
when people cannot see that those around them are
constantly changing, that they are not what they
were yesterday. A thief may have reformed himself,
but others may always perceive him as a thief. Te
husband may have overcome his bad habit, but the
wife cannot see him anew. Tis is carried further by
the Adjustable Memory Quirk that occurs when
people deliberately or unconsciously re-arrange
their memories to support or justify their emotions
or desires. For example, a couple who wish to
divorce may adjust their memories to remember
only the bad times or the bad characteristics
of their partners. Tis is very common in most
relationships and cannot be overcome without
awareness and consciousness that springs from
introspectional self analysis of Swadyaya.
Animals are prisoners of their genes. Tey are
incarnated into a conditioned, stimulus-response
programming and they have no choice, but to
follow their instincts. Man, the new being, the frst
Conscious Organism has the power of choice.
He / she may now act, and choose to respond in
a dignifed and adequate manner, rather than re-
act in an uncontrolled and totally inappropriate
manner. Te human being has the power to think,
to recall past situations and compare them to
the present reality. Man has the power of reason
which frees him from the instinctive responses to
challenge which is the mode of behavior of the
reptilian and mammalian kingdom. But the power
of the unconscious emotions and instincts rising
from the Old Brain in a kind of evolutionary lag
sometimes overpowers the Rational Brain and
causes Te New Being to react in an irrational
manner. Man as a social, conscious being has lifted
himself from the jungle environment with its
moment to moment dangers and constant life and
death challenges. He no longer faces challenges
to his very survival on a constant basis. His life
is relatively secure on the physical level (barring
wars and other unusual circumstance). Yet, his
Old Brain is hard wired to react as though every
threat (physical or psychological) is a life and death
matter. Hence, even psychological challenges, or
innocuous frictions trigger of Old Brain extreme
responses, especially on the emotional level.
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We can witness in so many human relationships
that the old, animal and reptilian autonomic
responses and reactions cloud the human or
conscious perception. Te Old Brain reacts out
of past conditioning. It is heavily loaded with
emotions which are part of the mammalian complex,
and hence, unconscious. Te animal-reptile
(Pashu) is not free to choose as it is bound by the
tight noose (Pasha) of its conditioned stimulus-
response mechanism. If it is threatened, it will fee
or fght. Tese are the only options open to it. We
must remember that on the other hand, the New
Brain has the power to act after considering the
reality of the present situation. We have the choice
of using discernment, rationality and deliberation
to choose consciously our actions and responses
in any given circumstance. Tis power of choice
is concomitant to the event of consciousness. Te
multiple million dolor question is however, Are we
ready and willing to be real human beings?
Importance of Adhikara Yoga:
Te Pancha Yama and Pancha Niyama are considered
as Adhikara Yoga by Dr TR Anantharaman as they
give us the self resplendent authority and inner
resolve for spiritual realizations. Tey provide
a strong moral and ethical foundation for our
personal and social life. Tey guide our attitudes
with regard to the right and wrong in our life and
in relation to our self, our family unit and the entire
social system.
Te higher, conscious power to refect, to perceive
the current situation freed of all past conditioning,
and then to consciously choose an appropriate
response is the essence of Yama-Niyama, the
moral and ethical system of Rishiculture Ashtanga
Yoga. Yama may be understood to be a conscious
restraint of primitive instincts and impulses rising
from the Old Brain. Yama is thus the control
of our unconsciousness tendencies, our Vasanas
and the deeply ingrained habitual patterns of our
Samskaras. Niyama may be on the other hand said
to be a positive and conscious reinforcement of the
higher consciousness, those Divine characteristics
that propel ones evolution into more advanced
states of being. Niyama is the cultivation of
consciousness. Pujya Swamiji, Gitananda Giri
called the Yama and Niyama as No-Option Yoga
for they are the sarvabhauma mahavratam of
Maharishi Patanjali. If we want to grow, to evolve
out of our reptilian mammalian past into the
truly human, humane and divine nature, we must
restrain the primordial instincts through Yama and
consciously reinforce our Divine nature through
the observances and practice of Niyama.
Te Pancha Yamas are Ahimsa (Non violence),
Satya (truthfulness), Asteya (non-stealing),
Brahmacharya (control of the creative impulse)
and Aparigraha (non covetedness). Tese are the
DO NOTS in a Yoga Sadhakas life. Do not kill,
do not be untruthful, do not steal, do not waste
your god given creativity and do not covet that
which does not belong to you. Tese guide us to say
a big NO to our lower self and the lower impulses
of violence etc. When we apply these to our life
we can defnitely have better personal and social
relationships as social beings.
Te Pancha Niyamas are Soucha (cleanliness),
Santhosha (contentment), Tapa (discipline),
Swadyaya (study of ones-self ) and Ishwar
Pranidhana (gratitude to the Divine). Te Pancha
Niyamas guide us with DOS - do be clean, do
be contented, do be disciplined, do self - study
(introspection) and do be thankful to the divine
for all of his blessings. Tey help us to say a big
YES to our higher self and the higher impulses.
Defnitely a person with such qualities is a God-
send to humanity.
We must remember that even if we are
unable to live the Yama-Niyama completely, the
attempt by us to do so will bear fruit and make us
a better person, of value to those around us and
a valuable person within our family and society.
These are values which need to be introduced to
our children and youth, making them aware and
conscious of these wonderful concepts of daily
living. These are indeed qualities that are to be
imbibed in a natural and Sahaja manner and not
learnt under the threat of fear or compulsion.
The parents and teachers can by example show
their children the importance of these qualities
and when the children see the good examples of
their parents and teachers living there principles
they will surely follow suit sooner than later.
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Other Important Yogic Concepts:
Tere are many important Yogic concepts that
help guide us in shaping our personal lives as well
as helping us to create harmonious interpersonal
relationships that make up our daily social life.
Some examples of these spiritually uplifting
concepts that transform all aspects of our social life
include:
Vasudeiva Kudumbakam: Te whole
world is one family. Tis is an excellent concept
which helps one to understand that division on
the basis of class, creed, religion and geographical
distribution are all man made obstructions
towards oneness. One can then look upon all as
his own and can bond with everyone irrespective
of any barrier. All the great Yogic saints such as
Tirumoolar, Tiruvalluvar, Basava, Periyalvar and
Tirunavukkarasar have reminded us again and
again in so many lovely verses of the singular
teachings that there is only One Humanity and
One God.
Chaturvidha Purusharthas: Te four
legitimate goals of life tell us how we can set
legitimate goals in this life and work towards
attaining them in the right way, following our
dharma to attain Artha (material prosperity), Kama
(emotional prosperity) and fnally the attainment
to the real goal of our life, Moksha (spiritual
prosperity). Tese four are termed as Aram, Porul,
Inbam and Veedu respectively in Nannool, an
ancient Dravidian text and the great life enhancing
teachings in the Tirukkural of Tiruvalluvar deal
directly with the frst three and hints at the fourth.
Pancha Klesha: Avidya (ignorance), Asmita
(ego), Raaga (attraction), Dwesha (repulsion) and
Abinivesha (urge to live at any cost) are the fve
Kleshas or mental afictions with which we are
born into this human life. Trough Yoga we can
understand how these control our life and see their
efects on our behavior. Tese Kleshas hinder
our personal and social life and must be destroyed
through the practice of Patanjalis Kriya Yoga
which is Tapa, Swadyaya and Ishwar Pranidhana.
Jiva Karunya: Empathic compassion
towards all living beings is extolled in the
teachings of Tirumoolar, Tiruvalluvar and Vallalar
Ramalinga Adigalar. Tirumoolar says that the most
important aspects of right living are the devoted
loving ofering to the Divine while in daily life
the feedings of other human beings and animals
with loving compassion. He also stresses the need
of speaking good and kind words to others as the
means to spiritual upliftment. Tiruvalluvar asks us
the poignant question, Of what use is intelligence
if one cannot empathize with the pain of others
and help them
Chatur Bhavana: Te four attitudes that
Patanjali advises us to cultivate are given in the
33rd Sutra of the Samadhi Pada. Tese attitudes
that help us to control our mental processes are:
friendliness towards those who are happy (Maitri
Sukha); compassion towards those who are
miserable (Karuna Dukha); cheerfulness towards
the virtuous (Mudhita Punya); and indiference
towards the wicked (Upekshanam Apunya).
Tese help us create a Yogic attitude of Sama
Bhava or equal mindedness in all situations. Tey
also help us to overcome the Kleshas, and provide
us with answers on how to live a Yogic life. Tey
make us humane and help us to live within the
social structure in a healthy and happy manner.
Pratipaksha Bhavanam: Te concept of
Pratipaksha Bhavanam is an amazing teaching
and must be inculcated in our Sadhana of day-
to-day living as we face it so many times each
day. Even if we cannot replace negative thoughts
with emotion-laden positive reinforcements, we
must at least make an attempt to stop them in
their troublesome track! I have personally found
that a strong STOP statement works wonders
in helping block out the negative thoughts that
otherwise lead us into the quicksand-like cesspool
of deeper and greater trouble. Tiruvalluvar advises
us to repay negative actions done to us by others
with positive selfess actions towards them.
Karma Yoga: Selfess action and the
performance of our duty without any motive are
qualities extolled by the Bhagavad Gita which
is one of the main Yogic texts. Performing ones
duty for the sake of the duty itself and not with
any other motive helps us to develop detachment
(Vairagya) which is a quality vital for a good
life. Karma Yoga includes important concepts of
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action-reaction and teaches us the importance of
right action. Tis includes the concepts of selfess
action (Nishkama Karma) as well as skill in action
(Karmasu Koushalam). Selfess action and the
performance of our duty without any motive are
qualities extolled by the Bhagavad Gita which is
one of the main yogic texts. Performing ones duty
for the sake of the duty itself and not with any other
motive helps us to develop detachment (Vairagya)
which is a quality vital for a good life. Yoga is skill
in action according to Yogeshwar Krishna in the
Bhagavad Gita. To do our best and leave the rest is
how Pujya Swamiji Gitananda Giri Guru Maharaj
used to describe the best way of life. Even if we
dont practice the other aspects of Yoga, we can be
living Yoga, by performing all our duties skill fully
and to the best of our ability. A great teacher can
be a true Yogi by performing doing their duty to
perfection and without care for the rewards of the
action, even if they do not practice any Asanas or
Pranayama.
Samatvam: Yoga is equanimity says
the Bhagavad Gita. Development of a complete
personality who is neither afected by praise
nor blame through development of Vairagya
(detachment) leads to the state of Stitha Prajna
or Sama Bhava. Tis is a state of mind which is
equally predisposed to all that happens, be it good
or bad. Such a human is a boon to society and a
pleasure to live and work with.
Bhakti Yoga: Te self efacing, loving path
of Bhakti enables us to realize the greatness of the
Divine and understand our puniness as compared
to the power of the Divine or nature. We realize
that we are but puppets on a string following his
commands on the stage of the world and then
perform our activities with the intention of them
being an ofering to the Divine and gratefully
receive HIS blessings. It is only with the blessings
of the Divine, that we can even worship his holy
feet (avanarulal avan thal vanangi) says the Shiva
Puranam, a Shaivite Dravidian classic.
Shifting From Individuality To
Universality:
Yoga, which emphasizes the universal, is a perfect
foil to those human activities, which glorify the
personal. Te ego which is fxated only on its own
shallow self will soon run into the blank wall of
depression and despair, overwhelmed by its own
superfciality. Tat striving spirit which looks
within at the universal aspect of its own nature and
sees the oneness of the whole of creation will fnd
an endless fountain of inspiration and joy. In short
it may be safely said that the practice of Yoga as
a unifed whole helps the individual shift from an
I-centric approach to a we-centric approach.
Tirumoolar stresses the importance of cutting the
ego sense (Anava Mala) in countless verses of the
3000 versed classic Tirumandiram.
Yoga not only considers the importance of
attaining a dynamic state physical health but
also more importantly mental health. Qualities
of a mentally healthy person (Stitha Prajna) are
enumerated in the Bhagavad Gita as follows:
Beyond passion, fear and anger (veeta raga
bhaya krodhah- II.56)
Devoid of possessiveness and egoism
(nirmamo nirahamkarah- II.7)
Firm in understanding and un bewildered
(sthira buddhir asammudhah- V.20)
Engaged in doing good to all creatures
(sarva bhutahiteratah- V.25)
Friendly and compassionate to all ( maitrah
karuna eva ca- XII.13)
Pure hearted and skilful without expectation
(anapekshah sucir daksah- XII.16)
Maharishi Patanjali tells us that we can gain
unexcelled happiness, mental comfort, joy and
satisfaction by practicing and attaining a state of
inner contentment (santoshat anuttamah sukha
labhah- PYS II: 42). Tis link is quite apparent once
we think about it, but not too many associate the
need for contentment in their greed for anything
and everything in this material world. Te Srimad
Bhagavad Gita says, yogaha karmasu koushalam
meaning thereby that Yoga is skill in action (II.50).
Te real Yogi, immensely conscious and aware at
the physical, mental and emotional levels gains
great control through that consciousness over
all aspects of life thus developing a real skill in
living. Part of that skill springs from his cultivated
detachment, his ability to work for works sake,
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and not for the sake of the reward. He realizes that
his duty is to do his best but that the ultimate result
is not in his hands. Te Yogi performs the needed
action not for the sake of the fruits of that action,
but because it is good and necessary to do so. Such
an attitude of mind produces consummate skill in
whatever action the Yogi undertakes. Consummate
concentration, consummate controls are all
ofshoots of good Yoga Sadhana. Tis belies the
age-old belief that the competitive spirit produces
the highest skill. To this the Yogic answer is:
detachment from the fruits of the action produces
the greatest efciency, for one is then emotions
connected with goal-oriented, competitive
thinking. Te beauty of Yoga is that these abstract
principles become concrete in the daily practice of
the techniques available in the Yoga system. Once
the Seed of Yoga fnds fertile soil, these concepts
grow naturally, slowly but surely taking root in all
aspects of life.
Regaining Our Health And Happiness
Trough Yoga:
Health and happiness are your birthrights,
Moksha is your goal. Reclaim your birthrights
and attain your goal though Yoga roared the
Lion of Modern Yoga, Yogamaharishi Dr Swami
Gitananda Giri. Living a happy and healthy
life on all planes is possible through the unifed
practice of Hatha Yoga Asanas and Pranayamas,
Dharana, Dhyana and Bhakti Yoga especially
when performed consciously and with awareness.
Asanas help to develop strength, fexibility, will
power, good health, and stability and thus when
practiced as a whole give a person a stable and
unifed strong personality. Pranayama helps us to
control our emotions which are linked to breathing
and the Pranamaya Kosha (the vital energy sheath
or body). Slow, deep and rhythmic breathing helps
to control stress and overcome emotional hang-
ups. Dharana and Dhyana help us to focus our
mid and dwell in it and thus help us to channel
our creative energy in a wholistic manner towards
the right type of evolutionary activities. Tey help
us to understand our self better and in the process
become better humans in this social world.
Te true Yogic life involves a sustained struggle
against past conditioning, an attempt to control
ones inner environment in order to focus inward.
Yoga is isometric, pitting one part of the body
against the other and the Yogi strives to be more
perfect today, than he/she was yesterday. It is
practically impossible for classical Yoga Sports,
Pranayamas and other Yoga practices to harm the
practitioner when they are performed in the proper
manner.
Yoga is not just performing some contortionist
poses or hufng and pufng some Pranayama or
sleeping our way through any so-called meditation.
It is an integrated way of life in which awareness
and consciousness play a great part in guiding
our spiritual evolution through life in the social
system itself and not in some remote cave in the
mountains or hut in the forest. Yoga can be rightly
said to be the science and art of right-useness of
body, emotions and mind.
Tiruvalluvar says, Te loving ones live for
the sake of others while the unloving live only
for themselves. Yogis have immense love and
compassion for all beings and wish peace and
happiness not only for themselves, but for all
living beings. Tey are not individualists seeking
salvation for themselves but on the contrary are
universalists seeking to live life in the proper
evolutionary manner to the best of their ability
and with care and concern for their fellow human
brethren and those beings living at all planes of
existence. Tis is well exemplifed by Yogic prayers
such as, Om, loka samasta sukhino bhavanthu
sarve janaha sukhino bhavanthu Om shanti, shanti,
shanti Om.
May we all become true Yogis as extolled by
Yogeshwar Sri Krishna when he says, tasmad yogi
bhavarjuna become thou a Yogi, Oh Arjuna. Hari
Om Tat Sat- May that be the reality!
Suggested Reading:
1. A Primer of Yoga Teory. Dr. Ananda Balayogi
Bhavanani. Dhivyananda Creations, Iyyanar Nagar,
Pondicherry. 2008.
2. A Yogic Approach to Stress. Dr Ananda Balayogi
Bhavanani.. Dhivyananda Creations, Iyyanar Nagar,
Pondicherry. (2nd edition) 2008.
3. Ancient Yoga and Modern Science. Dr. TR
Ann. SBV, Jan - Jun 2014;3(1)
Page 60 Annals of SBV
Anantharaman. Mushiram Manoharlal Publishers Pvt Ltd,
New Delhi. 1996
4. Ashtanga Yoga of Patanjali. Dr Swami Gitananda
Giri. Edited by Meenakshi Devi Bhavanani. Satya Press,
Pondicherry.1995
5. Culturing ones self though Yoga. Ananda Balayogi
Bhavanani. Yoga Mimamsa 2011; 43 (1): 84-94.
6. Evolutionary quirks, yama niyama & the human
brain. Meenakshi Devi Bhavanani. Yoga Vijnana 2009; 2 (3
&4): 1-8.
7. Frankly speaking. Dr Swami Gitananda Giri. Edited
by Meenakshi Devi Bhavanani. Satya Press, Pondicherry.1995
8. Srimad Bhagavad Gita. Swami Swarupananda.
Advaita Ashrama, Kolkata. 2007
9. Tiruvalluvar on Yogic Concepts. Meena
Ramanathan, Aarogya Yogalayam, Venkateswara Nagar,
Saram, Pondicherry-13.2007
10. Tirumandiram: A Tamil Scriptural Classic.
Translated by Dr. B. Natarajan, Sri Ramakrishna Math,
Chennai. 2006
11. Understanding the Yoga Darshan. An Exploration
of the Yoga Sutras of Maharishi Patanjali by Ananda Balayogi
Bhavanani. Dhivyananda Creations, Pondicherry. 2011
12. Yoga for Health and Healing. Dr Ananda Balayogi
Bhavanani. Dhivyananda Creations, Iyyanar Nagar,
Pondicherry. 2007
13. Yoga Terapy Notes. Dr Ananda Balayogi Bhavanani.
Dhivyananda Creations, Iyyanar Nagar, Pondicherry. 2007
14. Yoga: Step by Step. Dr Swami Gitananda Giri.
Satya Press, Pondicherry. 1975
Volume 7 | Issue 2 | J uly-December | 2014
Official Publication of
Swami Vivekananda Yoga Anusandhana Samsthana University
Online full text at
http://www.ijoy.org.in
IJ Y O
International J ournal of Yoga
Guest Editorial
Original Articles
Comparative immediate effect of different yoga asanas on heart rate and blood pressure in healthy young volunteers
Effect of trataka on cognitive functions in the elderly
Effect of Bhramari pranayama and OM chanting on pulmonary function inhealthy individuals: A prospective randomized control trial
Effect of yogic colon cleansing (Laghu Sankhaprakshalana Kriya) on pain, spinal flexibility, disability and state anxiety in chronic low back pain
Toward building evidence for yoga
Contents
ISSN 0973-6131
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International Journal of Yoga Vol. 7 Jul-Dec-2014
Comparative immediate effect of different yoga asanas on
heart rate and blood pressure in healthy young volunteers
Ananda Balayogi Bhavanani, Meena Ramanathan, Balaji R, Pushpa D
Centre for Yoga Therapy, Education and Research, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
Address for correspondence: Dr. Ananda Balayogi Bhavanani,
Centre for Yoga Therapy, Education and Research,
Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
E-mail: yognat@gmail.com
Original Article
of studies documenting various facets of this art and
science.
[1-4]
However, though many studies have elucidated
applied aspects of Yoga in different health conditions,
very few have focused on the basic research needed to
understand the intricate mind-body mechanisms involved
in the different yogic techniques.
[5]
The different Yogic psychophysiological techniques are
bound to have different effects on each and every cell
of the human body and this in turn will depend on the
various body systems, organs, and tissues involved in the
performance of such practices.
[6]
As the role of the spinal
INTRODUCTION
Yoga has truly captured the imagination of scientists
in recent times with a dramatic increase in the number
Introduction: This study planned to compare immediate cardiovascular effects of different yoga asanas in healthy young
volunteers.
Materials and Methods: Heart rate (HR), systolic pressure (SP), and diastolic pressure (DP), blood pressure (BP), were
recorded using the non invasive blood pressure (NIBP) apparatus in 22 healthy young subjects, before and after the performance
of Dhanurasana (DA), Vakrasana (VA) (both sides), Janusirasasana (JSA) (both sides), Matsyasana and Shavasana for 30 s.
HR and BP were further recorded during supine recovery at 2, 4, 6, 8, and 10 min. A repeated measure of ANOVA was used
for statistical analysis.
Results: There were signifcant changes in HR and BP both immediately after the Asanas as well as during the recovery period.
Overall comparisons of % changes immediately after the performance of the Asanas revealed signifcant differences with regard
to HR that increased signifcantly after DA. In the recovery phase, there were signifcant intergroup differences from 2 min onward in
both SP and DP. The decrease of SP after VA (right side) (VAR) was signifcantly greater than Shavasana (4
th
, 6
th
, and 8
th
min) and
JSA (left side) (JSA-L) at 6
th
and 8
th
min. DP decreased signifcantly after performing JSAL compared to VAR at the 6
th
and 8
th
min.
Discussion: The cardiovascular changes immediately after the Asanas and during the recovery phase reveal inherent differences
between the selected postures. The rise of HR in DA may be attributed to increased sympathetic response due to the relative
diffculty of the posture as well as abdominal compression occurring in it. The effect of supine relaxation is more pronounced
after the performance of the Asanas as compared to mere relaxation in Shavasana. This may be attributed to a normalization
and resultant homeostatic effect occurring due to a greater, healthier de-activation of the autonomic nervous system occurring
towing to the presence of prior activation. There were also subtle differences between the right sided and left sided performance
of VA and JSA that may be occurring due to the different internal structures being either compressed or relaxed on either side.
Conclusion: Our study provides initial evidence of differential cardiovascular effects of Asanas and subtle differences between
right and left sided performance. Further, cardiovascular recovery is greater after the performance of the Asanas as compared
to shavasan; thus, implying a better response when effort precedes relaxation.
Key words: Asana; cardiovascular effects; research; Yoga.
ABSTRACT
Access this article online
Website:
www.ijoy.org.in
Quick Response Code
DOI:
10.4103/0973-6131.133870
Bhavanani, et al.: Differential effects of Asanas
International Journal of Yoga Vol. 7 Jul-Dec-2014
90
column is emphasized in Yoga, it follows logically that the
effects of forward bending postures would be different than
those of back bending ones and that these in turn may be
different from the physiological effects of twisting postures.
As both intra thoracic and intra-abdominal pressure-volume
changes affect the cardiovascular system, it is plausible that
these Asanas will produce changes in the heart rate (HR)
and blood pressure (BP). The conscious self-effort made in
Asana practice may be understood as the Spanda (tension)
component whereas the relaxation of effort (Prayatna
shaithilya) may be understood as the Nishpanda (relaxation)
component. Even Maharishi Patanjali tells us that the pair
of opposites (Dwandwa) is transcended (Dwandanabigata)
when one perfects the state of Asana. Hence, it is essential
to physiologically evaluate not only the actual performance
of an Asana, but also the period of recovery following it.
However, there is a lacuna of studies on such effects
and there is only one study
[7]
comparing cardiovascular
effects of some Asanas and that too was carried out in
untrained subjects with only a single recording without
pre-post comparisons. That study had evaluated only the
BP during the performance of Sukhasana, Vajrasana, and
Dhanurasana (DA) by 25 medical students and compared
these findings with the supine, sitting, and standing
positions. As a pre-post comparison was lacking in that
study, no concrete conclusion could be inferred about the
actual effects of performing Asanas or about the recovery
following their performance.
The Swara Yoga tradition
[8]
also emphasizes the subtle
differences existing between energy flows on the right and
left sides (Pingala and Ida nadi respectively) manifesting
through the ultradian rhythmicity of right or left nostril
dominance (Surya and Chandra Swara respectively).
Autonomic function is affected by right-left brain
activity
[9,10]
and as there is a sensory-motor crossover
relationship between right and left sides of the body and
the contralateral hemispheres, this leads to speculation
to differences in autonomic function depending on
techniques performed utilizing either right/left sides.
With the above rational in mind, this study was planned to
compare the immediate cardiovascular effects of different
Yoga Asanas in healthy young volunteers. In addition
to studying the immediate effect of the Asanas, we also
studied the post posture supine recovery period for ten
min. Hence, Shavasana also served as a control to the
supine rest being carried out after the performance of the
other Asanas.
MATERIALS AND METHODS
This study was conducted at the Center for Yoga Therapy
Education and Research (CYTER) functioning in Mahatma
Gandhi Medical College and Research Institute, Puducherry,
India. Ethical clearance was obtained from the Institutional
Human Ethics Committee and 22 students (16 female,
6 male), aged 19.05 0.79 standard deviation (SD) years,
with body mass index of 20.54 3.15 (SD) undergoing
the B Sc., Nursing course at Kasthurba Gandhi Nursing
College, Sri Balaji Vidyapeeth, Puducherry were recruited
for the study by convenience sampling. CYTER staff was
conducting regular Yoga training sessions twice weekly
for 6 months for nursing students and these participants
were selected as they could perform the required set of
Asanas with an adequate level of proficiency. Asanas
selected for the study were: DA, Vakrasana (VA) (both
sides), Janusirasasana (JSA) (both sides), Matsyasana, and
Shavasana [Figure 1].
We selected these Asanas as they manipulated the spinal
column indifferent positions. The human spine is given
great importance in the Yoga tradition (Brahma Danda
or Meru Danda). The forward bending (JSA), backward
bending (DA from the prone position and Matsyasana
from supine position) and twisting VA nature of the
Asanas was taken into consideration and also the fact
that the effects of two of them (VA and JSA) could be
evaluated on both right and left sides. These Asanas were
also part of the syllabus of Yoga training the subjects
had received earlier and hence an adequate level of
proficiency in performance of the postures was also
ensured.
Each subject came to CYTER on seven different days and
the entire study took 3 weeks for its completion as all
subjects couldnt be studied on the same day due to the
lack of space and manpower. On each of the days, they
performed one of the Asanas that was selected by random
selection of both subject and technique so as to avoid any
bias or influence of different days on the group. All tests
were carried out in CYTER between 10 and 12 noon. The
environment was quiet, with a comfortable temperature
and subdued lighting. The subjects were briefed about the
study protocol and written informed consent was obtained
from them. They were advised to finish their breakfast
at least 2 h earlier and come after emptying bowel and
bladder.
To ensure objectivity in measuring HR and BP, the
recordings were performed using non-invasive
semi-automatic BP monitor (CH 432, Citizen Systems,
Tokyo, Japan) with an instrumental accuracy of 5% for
HR and 3 mm Hg for BP. Pre intervention HR and BP
was recorded after 5 min of supine rest. The subjects then
performed one of the Asanas for 30 s, following which
the post-intervention recordings were taken. HR and BP
were further recorded during the supine recovery period
at 2,4,6,8 and 10 min.
Bhavanani, et al.: Differential effects of Asanas
91
International Journal of Yoga Vol. 7 Jul-Dec-2014
Data were assessed for normality using GraphPad InStat
version 3.06 for Windows 95, (GraphPad Software, San
Diego California USA, www.graphpad.com). As all data
passed normality testing by Kolmogorov-Smirnov Test,
statistical analysis was carried out using repeated measures
of ANOVA with Tukey-Kramer multiple comparisons test to
compare differences between groups at each point of time.
Students paired t test and P values less than 0.05 were
accepted as indicating significant differences for pre-post
and recovery period intra-group comparisons.
RESULTS
There were significant changes in HR and BP both
immediately after performing asanas as well as during
the recovery period [Tables 1-3 and Figures 2-4].
Overall comparisons of changes immediately after the
performance of the Asanas revealed significant differences
with regard to HR that increased significantly after
DA [Table 1, Figure 2]. In the recovery phase, there were
significant intergroup differences from 2 min onward in
both systolic pressure (SP) and diastolic pressure (DP) as
given in Tables 2 and 3 and Figures 3 and 4. The decrease
of SP after VA (right side) (VA-R) was significantly greater
than Shavasana (4
th
, 6
th
, and 8
th
min) and JSA-L at 6
th
and
8
th
min [Table 2 and Figure 3]. DP decreased significantly
after performing JSA-L compared to VA-R at the 6
th
and
8
th
min [Table 3 and Figure 4]. The plot of % changes
during the recovery period showed greater fall in SP and
DP after all the other Asanas as compared to that following
Shavasana [Figures 3 and 4].
DISCUSSION
The cardiovascular changes immediately after performing
the Asanas and during the recovery phase as evidenced in
this study reveal inherent differences between the selected
postures [Tables 1-3, Figures 2-4]. Differences between
Figure 1: Asanas performed by participants in the study: Janusirasasana (right), Janusirasasana (left), Vakrasana (right), Vakrasana (left), Dhanurasana, Matsyasana,
and Shavasana
Bhavanani, et al.: Differential effects of Asanas
International Journal of Yoga Vol. 7 Jul-Dec-2014
92
the selected Asanas were especially significant for HR
immediately after performing DA [Table 1 and Figure 2].
There was a higher stress response to DA as opposed
to the other Asanas and this may be attributed to an
increased sympathetic response due in part to the relative
difficulty of the posture as well as the intense abdominal
compression occurring while performing it.
Each of the Asanas had its own pattern and through there
were overall similarities, some differences can be made out
in a detailed examination. VA-R had the greatest fall in HR
during the recovery period while JSA-R had the greatest
fall of both SP and DP by the end of the 10 min recovery
period [Tables 1-3, Figures 2-4]. There were significant
differences between the selected Asanas mainly during
the recovery period after 2 min and this finding helps us
to understand that the effects of the Asanas is quite similar
after 2 min. This also implies that a rest of 2 min should
be given in between the Asanas if one is to attain the best
relaxatory effect of Yoga practices.
A previous study on individual Asanas evaluated the
BP while 25 medical students performed Sukhasana,
Vajrasana and DA and also compared these findings
with the supine, sitting, and standing positions.
[7]
DA
had the highest BP as compared to all other postures in
that study too. The main difference between our present
study and that study is that they had measured the BP
while the subjects were in the posture, whereas we
have measured before and after the posture along with
a 10 min recovery period. They had only recorded a
single value and thus there was no pre-post comparison
in their study. It is also to be noted that their subjects
were not regular practitioners of Yoga while our subjects
Table 1: Immediate HR response to the performance of DA, JSA-R, JSA-L, VA-R, VA-L, MA and SA for 30 s followed
by subsequent HR recovery at 2,4,6,8 and 10 min
Time
frame
DA JSA-R JSA-L VA-R VA-L MA SA P
Pre 73.9110.01 74.277.64 76.4111.49 80.098.27 75.5510.31 72.2312.34 73.5010.19 0.1367
Zero 89.1411.21***

70.959.23 72.8610.07** 73.917.08*** 73.5910.55 72.149.54 68.147.88* <0.0001


2 min 68.9110.06** 67.239.58*** 67.8211.13*** 70.237.43*** 66.367.78*** 66.6410.40*** 67.419.67** 0.7718
4 min 68.369.66*** 66.739.58*** 68.239.71*** 69.279.09*** 66.097.43*** 67.099.96** 65.738.22*** 0.7713
6 min 66.648.35*** 65.8211.22*** 68.1411.86*** 66.597.46*** 65.059.25*** 65.9110.19** 64.597.11*** 0.8621
8 min 67.328.91*** 67.3211.16** 67.6810.50*** 66.778.35*** 65.007.60*** 65.3210.25*** 63.509.66*** 0.6125
10 min 67.959.52** 65.9512.14*** 66.5010.21*** 67.556.88*** 65.0910.24*** 65.0910.70*** 63.950.11*** 0.7844
HR = Heart rate, DA = Dhanurasana; JSA-R = Janusirasasana-R; JSA-L = Janusirasasana-L; VA-R = Vakrasana; VA-L = Vakrasana-L; MA = Matsyasana; SA =
Shavasana; *P<0.05, **for P<0.01 and *** for P<0.001 for comparison with pre values by Students paired t test,

P<0.001 for DA versus all other Asanas at


zero min by RMANOVA with Tukey-Kramer Multiple comparisons test
Table 2: Immediate SP response to the performance of DA, JSA-R, JSA-L, VA-R, VA-L, MA and SA for 30 s followed
by subsequent HR recovery at 2,4,6,8 and 10 min
Time
frame
DA JSA-R JSA-L VA-R VA-L MA SA P
Pre 108.5511.38 109.507.86 111.4111.29 105.7711.26 110.3611.78 109.6811.54 109.8614.08 0.5865
Zero 106.2711.92 107.3210.16 108.2710.41* 104.188.74 107.149.24* 105.9512.66* 105.1811.61** 0.7473
2 min 101.5510.15*** 100.238.79*** 104.0910.23*** 98.917.85** 103.64009.26*** 100.459.31*** 105.2312.13** 0.0574
4 min 100.0911.01*** 99.597.52*** 103.367.82*** 97.737.98***

102.829.76*** 100.279.18*** 105.6812.05 0.0140


6 min 98.4110.64*** 99.097.75*** 102.5910.00***

96.328.23***

102.099.43*** 99.828.38*** 103.4510.66*** 0.0064


8 min 98.419.79*** 98.598.23*** 103.097.98***

96.688.23***

101.739.32*** 98.869.49*** 102.9110.46*** 0.0079


10 min 98.279.56*** 98.058.40*** 102.327.46*** 97.328.58*** 102.919.69*** 99.149.69*** 102.689.06*** 0.0146
SP = Systolic; DA = Dhanurasana; JSA-R = Janusirasasana-R; JSA-L = Janusirasasana-L; VA-R = Vakrasana; VA-L = Vakrasana-L; MA = Matsyasana;
SA = Shavasana; HR = Heart rate; *P<0.05, **For P<0.01 and ***for P<0.001 for comparison with pre values by Students paired t test;

P<0.05 for VA-R


versus SA at 4, 6 and 8 min and

P<0.05 for JSA-L versus VA-R at 6 and 8 min by RMANOVA with Tukey-Kramer Multiple comparisons test
Table 3: Immediate DP response to the performance of DA, JSA-R, JSA-L, VA-R, VA-L, MA and SA for 30 s followed
by subsequent HR recovery at 2,4,6,8 and 10 min
Time
frame
DA JSA-R JSA-L VA-R VA-L MA SA P
Pre 64.827.03 69.4111.93 68.186.49 67.277.9 68.097.62 68.418.25 64.186.48 0.2195
Zero 62.8211.75 61.918.69** 63.828.15* 60.326.18*** 64.418.2 59.236.47*** 60.556.16** 0.2150
2 min 57.094.75*** 57.005.03*** 59.557.18*** 55.867.17*** 58.324.61*** 57.145.66*** 60.866.87* 0.0438
4 min 56.554.91*** 57.004.84*** 59.955.74*** 56.646.08***

57.735.03*** 57.234.77*** 60.506.46* 0.0254


6 min 56.774.53*** 57.775.52*** 59.326.18*** 55.866.19***

58.324.78*** 57.864.58*** 60.646.57** 0.0427


8 min 56.274.57*** 57.955.38*** 59.505.19***

54.916.04***

58.363.67*** 58.455.96*** 59.366.87*** 0.0234


10 min 56.865.34*** 57.504.90*** 59.418.24*** 57.327.42*** 58.554.79*** 57.554.96*** 60.365.83** 0.3520
DP = Diastolic; DA = Dhanurasana; JSA-R = Janusirasasana-R; JSA-L = Janusirasasana-L, VA-R = Vakrasana; VA-L = Vakrasana-L; MA = Matsyasana;
SA = Shavasana; HR = Heart rate; *P<0.05, **for P<0.01 and *** for P<0.001 for comparison with pre values by Students paired t test,

For VA-R versuss SA


at 4,6 and 8 min and

P<0.05 for JSA-L versus VA-R at 8 min by RMANOVA with Tukey-Kramer Multiple comparisons test
Bhavanani, et al.: Differential effects of Asanas
93
International Journal of Yoga Vol. 7 Jul-Dec-2014
Figure 2: Heart rate response in % immediately following performance of Dhanurasana, JanusirasasanaR, JanusirasasanaL, VakrasanaR, VakrasanaL, Matsyasana,
and Shavasana for 30 s and at 2,4,6,8, and 10 min
-20
-15
-10
-5
0
5
10
15
20
Pre mmediate 2 min 4 min 6min 8 min 10min
DA JSA-R JSA-L VA-R VA-L MA SA
-13
-11
-9
-7
-5
-3
-1
Pre mmediate 2 min 4 min 6min 8 min 10min
DA JSA-R JSA-L VA-R VA-L MA SA
Figure 3: Systolic pressure response in % immediately following performance of Dhanurasana, JanusirasasanaR, JanusirasasanaL, VakrasanaR, VakrasanaL,
Matsyasana and Shavasana for 30 s and at 2, 4, 6, 8 and 10 min
were undergoing a Yoga training program and had been
practicing the techniques for more than 3 weeks at the
time of the study.
Previous studies have reported the energy expenditure
and ventilatory responses of Yogic standing (Virasana)
and sitting (Siddhasana) postures.
[11,12]
They reported
that Virasana induces temporarily a hyper metabolic
state characterized by enhance sympathetic activity
that gets inhibited upon the adoption of Shavasana.
[11]

Siddhasana was reported to be a mild type of exercise
as it had higher energy expenditure and ventilatory
responses as compared to supine and chair sitting
postures.
[12]
Bhavanani, et al.: Differential effects of Asanas
International Journal of Yoga Vol. 7 Jul-Dec-2014
94
The effect of supine relaxation is more pronounced
after the performance of the Asanas as compared to just
relaxing in Shavasana [Figures 2-4]. This may be attributed
to a normalization and resultant homeostatic effect
occurring towing to a greater, healthier de-activation of the
autonomic nervous system occurring due to the presence
of prior activation.
A study by Telles et al. studied O
2
consumption and
respiration following four Yoga postures interspersed with
relaxation and supine relaxation alone, and concluded that
the combination of stimulating and relaxing techniques
reduced physiological arousal better than the mere practice
of relaxation techniques alone.
[13]
They also pointed out
that though the practical performance of Yoga techniques
seem to be stimulatory in nature, their physiological
effects are in fact more relaxatory. This is corroborated by
a previous study from JIPMER reporting that Shavasana
relaxation is enhanced with the addition of Savitri
Pranayama thus decreasing O
2
consumption by 26%.
[14]
Manjunatha et al. studied the effects of selected Yogic
postures on fasting and postprandial glycaemia and
insulinemia in healthy young subjects and concluded
that the performance of Asanas led to increased
sensitivity of the cells of the pancreas to the glucose
signal.
[15]
It was found in that study that the performance
of four different sets of Asanas had similar effects of
reducing fasting and postprandial glycaemia and that
blood insulin levels also fell after the performance of the
Asanas. However, when oral glucose tolerance test ( GTT)
was administered, there was a greater insulin response
that may be interpreted as an enhanced sensitivity of
pancreatic cells to the glucose challenge too. At the
metaphysical level, this may be taken to imply a dynamic
state of balance where one is balanced, yet ready to face
any challenge that may occur.
One of the extra findings of this study is the revelation of
subtle differences between the right sided and left sided
performance of VA and JSA that may be occurring as a
result of the different internal structures being either
compressed or relaxed on either side. This requires further
exploration and studies with a greater number of subjects
and doing the Asanas in different positions may help
unravel the scientific basis of such differences.
The aim of Yoga is harmony or homeostatic balance at all
levels of existence (Samatvam yogah uchyate) as elucidated
in the Bhagavad Gita
[16]
and the psychophysiological
nature of Yoga Asanas may be producing such a
balance even if they initially have a hyper metabolic
or cardio-respiratory stimulatory action. This is well
evidenced by the cardiovascular responses to all the
Asanas in our study, as the post postural HR and BP both
fell below the initial values during the recovery period
and this was consequently seen to be even lower than the
responses to supine relaxation in Shavasana. This has been
corroborated by recent reports that both the sympathetic
and parasympathetic limbs of the autonomic nervous
-20
-18
-16
-14
-12
-10
-8
-6
-4
-2
0
Pre mmediate 2 min 4 min 6min 8 min 10min
DA JSA-R JSA-L VA-R VA-L MA SA
Figure 4: Diastolic pressure response in % immediately following performance of Dhanurasana, JanusirasasanaR, JanusirasasanaL, VakrasanaR, VakrasanaL,
Matsyasana, and Shavasana for 30 s and at 2, 4, 6, 8 and 10 min
Bhavanani, et al.: Differential effects of Asanas
95
International Journal of Yoga Vol. 7 Jul-Dec-2014
system activity were enhanced in hypertensives following
Yoga training.
[17,18]
In conclusion, our study provides initial evidence of
differential cardiovascular effects of Asanas and subtle
differences between right and left sided performance.
Further, cardiovascular recovery is greater after the
performance of the Asanas as compared to Shavasana;
thus, implying a better response when effort precedes
relaxation.
ACKNOWLEDGMENTS
The authors thank the management and authorities of Sri
Balaji Vidyapeeth University for setting up the Centre for
Yoga Therapy, Education and Research (CYTER) in Mahatma
Gandhi Medical College and Research Institute (MGMCRI).
The authors are grateful to Yogacharini Meenakshi Devi
Bhavanani, Director ICYER and Dr. Madanmohan, Professor
and Head Department of Physiology, MGMCRI for their constant
motivation, encouragement and supportive guidance. We thank
Miss Subashana, ANM for her valuable assistance during the
recording sessions and data entry.
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Source of Support: Nil, Confict of Interest: None declared
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ONGOING PROJECTS






ONGOING RESEARCH PROJECTS

1. EFFECT OF 12-WEEKS OF YOGA TRAINING ON CARDIO-
RESPIRATORY, NEUROLOGICAL AND PSYCHOLOGICAL
PARAMETERS IN A GERIATRIC POPULATION. Pre and post test
recordings have been completed and 12 weeks Yoga training sessions
conducted twice weekly in the Hospice of St. Cluny, Pondicherry.
2. INTRA OCULAR PRESSURE VARIATIONS IN FORWARD
BENDING YOGA POSTURES. Collaborative project with Department
of Ophthalmology, MGMCRI. Proposal approved by IHEC in April 2014
and subjects are being recruited.
3. EFFECTS OF TRATAK AND BHRAMARI PRANAYAMA
(YOGIC EYE CARE MODULE) ON OCULAR MUSCLE
BALANCE AND ACCOMMODATION IN COMPUTER VISION
SYNDROME. Collaborative project with Department of Ophthalmology,
MGMCRI. Proposal approved by IHEC in April 2014 and subjects are
being recruited.
4. A STUDY TO ASSESS THE EFFECTIVENESS OF PRANAYAMA
ON LEVEL OF DEPRESSION AMONG THE TRANSGENDER.
Collaborative project with KGMC. Proposal approved by IHEC, KGNC
in March 2014 and subjects are being recruited.
5. EFFECT OF YOGA TRAINING ON CARDIORESPIRATORY
HEALTH IN OBESE SUBJECTS. Proposal submitted to CCRYN,
Deptt of AYUSH, Ministry of Health & FW, Govt of India after
clearance from IHEC.










CHRONOLOGICAL REPORT

Sri Balaji Vidyapeeth
Mahatma Gandhi Medical College & Research Institute
Pillaiyarkuppam, Pondicherry - 607 402
CENTRE FOR YOGA THERAPY, EDUCATION AND RESEARCH (CYTER)

CHRONOLOGY OF IMPORTANT EVENTS
MONTH DATE EVENTS M F TG Total
2010
NOVEMBER 1.11.2010 Inaugural function: lamp lighted by
Yogacharya Dr. Ananda Balayogi
Bhavanani, Hon Advisor CYTER in presence
of Yoga Therapy and Music Therapy unit
members.

3 5 - 8
DECEMBER





15.12.2010









Chairman visited CYTER, had a discussion
and asked for our suggestions to improve
therapy unit.

MCI team visited CYTER


25

25

-

50
2011
JANUARY 25.1.2011 CYTER unit shifted to deluxe ward. 38 25 - 63

FEBRUARY

Regular therapy, consultation and classes.


65

63

6

134


MARCH
10.3.2011


11.3.2011
Shifted back into the renovated therapy
unit.

A team of doctors from Royal College of
London visited the therapy unit.

42

52

-

94

APRIL 5.4.2011



29.4.2011
Yoga therapy unit members participated in
the CAM seminar conducted by SAF team
of MGMC&RI.

Yogacharini Kalaimamani Smt. Meenakshi
Devi Bhavanani (Ammaji) visited CYTER,
with her students from ICYER.

41

71

3

115
MAY 25.5.2011 A group of students along with their
professor and ethical committee members
visited the dept. a yoga demonstration
was given to them and the students also
participated and did the practices.

45

51

-

96
JUNE Regular therapy consultation and classes 30 92 - 122
JULY Regular therapy consultation and classes 29 105 - 134

AUGUST

Regular therapy, consultation and classes


24

82

-

106

SEPTEMBER

9.11.2011

A team of faculty members from Glasgow
University visited the therapy unit and
Yoga demonstration was given to them.

26

38

-

64

OCTOBER
Regular therapy consultation and classes 33

39 7 79
NOVEMBER Regular therapy consultation and classes 37

61 7 105
DECEMBER 7.12.2011

9.12.2011


23.12.2011
MCI team visited our department.

Inaugural Yoga session for 2
nd
year nursing
students of KGNC (Kasturuba Gandhi
Nursing College) by CYTER team.

A write up about CYTER was published in
the Tamil daily, Dinakaran and
Tamilmurasu.


32

69

4

105






2012
JANUARY


Regular therapy consultation and classes
23 35 2 60
FEBRUARY


Regular therapy consultation and classes
26


57


- 84

MARCH


Regular therapy consultation and classes

31

65

96
APRIL

Regular therapy consultation and classes
20 76 96
MAY 14.5.2012 Visitors from United Kingdom High
Commission visited the department.
29 42 8 79
JUNE Regular therapy consultation and classes 11 39 50
JULY 06.7.2012



27.7.2012
Valedictory function of Yoga training for
2
nd
year nursing students of KGNC
(Kasturuba Gandhi Nursing College)

CME/workshop on synergistic effect of
yoga and music-CYTER gave a presentation
and demonstration.

5

46

51
AUGUST
Regular therapy consultation and classes

21

25

46
SEPTEMBER Regular therapy consultation and classes 8 44 52
OCTOBER

26.10.2012
Regular therapy, consultation and classes.

Awareness programme for obesity -
presentation & demonstration

15 32 47






NOVEMBER Regular therapy, consultation and classes. 6 33 39
DECEMBER Regular therapy, consultation and classes.

15 48 63
2013
JANUARY Regular therapy, consultation and classes.

5 55 2 62

FEBRUARY


25.2.13
Regular therapy, consultation and classes.

A team of international music therapists
visited and discussed on the various
modalities of Yoga as a form of therapy


3 50

53
MARCH 9.3.13 The yoga instructors of the yoga therapy
unit participated in the workshop medical
student well being conducted on March
9
th,
under the guidance of dr.
Madanmohan, Professor & Head Dept of
Physiology, on Stress and its Management
by Yoga,(Lecture Demonstration).

6 64 70
27.3.2013 Members of Yoga therapy unit
attended/participated/conducted the
workshop ZENFORIANS, conducted by
the MSc Nursing students of KGNC,
MGMCRI, on 27.3.13, as part of their
Staff/Faculty welfare programme.
Workshop was conducted on Yoga and
lifestyle modification to combat stress
followed by a practice session for
alleviating STRESS. All the participants
enjoyed the sessions.

APRIL Regular therapy, consultation and classes. 17 76 93
MAY

19.5.2013
Regular therapy, consultation and classes.

An interactive session was conducted on
19.5.2013 by CYTER as a CNE for nurses,
staff and faculty of Rajiv Gandhi
Government Women and Children
Hospital, Ellapillaichavadi, Pondicherry.
Mrs Meena Ramanathan gave an
interactive talk cum practical session on
Stress destructs- yoga constructs with a
demo by Sangeeta.

59 57 116
JUNE Regular therapy consultation and classes.

Yoga Instructor Ms. Sarulatha gave classes
for the Nursing students more than two
weeks as part of Phd study for the
Mr.Vasantham and Dr. Prem.

37 54 91
JULY


5.7.2013




Regular therapy consultation and classes.

Yoga therapy unit members participated in
the programme conducted by SAF
(Scientific Academic Forum) of MGMC&RI
on 5.7.2013.
A presentation was given by the
coordinator Meena Ramanathan on Yoga
29 105 134




11.7.2013
& Psychosomatic Ailments, following
which an interactive demonstration was
conducted with demo by Ms. Sarulatha.

Dr. Ananda Balayogi Bhavanani joined as
Deputy Director CYTER (Department of
Yoga and Music Medicine), MGMC & RI on
11
th
July 2013. He had been previously
associated with the centre as Honorary
Advisor since its inception in 2010.

Proposal for a RCT on Effect of yoga
training on cardio-respiratory health in
obese subjects was prepared for
submission to CCRYN, Ministry of Health &
FW, New Delhi.

Detailed syllabus for a PG Diploma in Yoga
therapy for medical professionals was
prepared and submitted to Dean, PG
Studies.
AUGUST

7.8.2013




18.8.2013
Regular therapy, consultation and classes.

Proposal for a RCT on Effect of yoga
training on cardiorespiratory health in
obese subjects was presented in the IHEC
for its approval.

A research paper entitled, Hematological,
biochemical and psychological effects of a
yoga training programme in nursing
students was submitted to Biomedical
Human Kinetics.

Five posters and abstracts were prepared
for presentation in Sanjeevita 2013.

20 50 70
SEPTEMBER


6.9.2013







Regular therapy consultation and classes.


Dr. Madanmohan (Professor & Head,
Department of Physiology and Director
CYTER) was an invited speaker in the panel
discussion on medical pluralism during
Sanjeevita 2013, Annual Summit organized
by CIDRF at MGMC&RI on 6
th
September
2013. Dr. Madanmohan, Dr. Ananda
Balayogi Bhavanani (Deputy Director
54 109 - 163

















4, 18 & 25
September








13.9.2013

CYTER) and Mrs. Meena Ramanathan
(Coordinator and Yoga Therapist) also
presented five posters and abstracts on
behalf of CYTER.
Topics presented included:
1. Health, rejuvenation and longevity:
an Ayurvedic perspective,
2. Yoga and modern medicine: need
for integration,
3. Yoga works, but how?
4. Immediate cardiovascular effects
of pranayamas in patients of
hypertension,
5. Effect of Yoga training on
cardiorespiratory health in obese
subjects.

Yoga Awareness and Counselling
Programmes are being held in the MRD of
MGMC & RI from 10AM to 12 noon every
Wednesday since 4
th
September 2013 with
good response from patients to this
initiative. The programme was conducted
on 4, 18 & 25

September and 63 patients
benefited from the consultation and
cessing sessions.

Two new books namely, Yoga Chikitsa: the
Application of Yoga as a Therapy and
Saraswatis Pearls: Dialogues on the Yoga
of Sound authored by Dr. Ananda Balayogi
Bhavanani (Deputy Director CYTER) were
released on September 13
th
2013 by
Kalaimamani Yogacharini Meenakshi Devi
Bhavanani, Director, ICYER at Ananda
Ashram, Pondicherry. The book on Yoga
Chikitsa also has chapters contributed by
Dr. Madanmohan (Professor & Head,
Department of Physiology and Director
CYTER) and Mrs. Meena Ramanathan
(Coordinator and Yoga Therapist) while
Saraswatis Pearls is a series of
conversations between Dr. Ananda
Balayogi Bhavanani and Dr. Sangeeta Laura
Biagi of Italy who is visiting professor in
Italian Folklore and Music at New York
University and Vassar College (NY).
OCTOBER

1.10.2013





6.10.2013





10.10.2013







15.10.2013
and
16.10.2013








29.10.2013






9,16, 23 &
30.10.2013






Regular therapy consultation and classes.

Paper entitled, Immediate cardiovascular
effects of a single yoga session in different
conditions based on a review of data at
CYTER was submitted to the Journal of
Alternative & Integrative Medicine.

An article entitled, Modern Medicine,
Meet Yoga! by Dr Ananda Balayogi
Bhavanani was published in the Fall 2013
issue (Pg 21-23) of the prestigious Integral
Yoga Magazine, USA.

A group of Yoga teachers and students
from Yoga Academy of Berlin, Germany led
by Yogacharya Ananda Leone, visited
CYTER and expressed appreciation of the
good work being done and admired the
management for this novel integration of
yoga with modern medicine.

CYTER participated in the Orthopedic
Awareness Week conducted by the
orthopedic department, MGMCRI in MRD.
Meena Ramanathan gave a talk on
Importance of Yoga for maintaining the
Spinal health, and a presentation on Yoga
for Arthritis and Yoga for Low Back Pain on
15
th
and 16
th
along with demonstration by
Yoga Instructors M. Sangeetha and G.
Sarulatha.

CYTER participated in the Obesity
Awareness conducted by the MGMCRI in
MRD Meena Ramanathan gave a talk on
Importance of Yoga for obesity with
demonstration by Yoga Instructors
M.Sangeetha and G.Sarulatha.

Yoga Awareness and Counselling
Programmes are being held in the MRD of
MGMC & RI from 10AM to 12 noon every
Wednesday with good response from
patients to this initiative. 58 patients
benefited from the programme.


102 75 - 177
30.10.2013 Paper entitled, Immediate effect of
chandra and suryanadi pranayamas on
cardiovascular parameters and reaction
time in a geriatric population was
submitted to the International Journal of
Physiology and accepted for publication.

NOVEMBER










14.11.2013










22.11.2013




Regular therapy consultation and classes.


Orientation session was conducted by Dr
Ananda and Mrs Meena for 20 newly
joined nursing staff members who visited
CYTER supervised by Mrs Deepa, Nursing
educator, MGMCRI.

Department of Medicine with Dietetics
and Yoga in association with Department
of Corporate Health Services organized a
public awareness programme on 14th
November 2013, at 9 am in MRD ,
MGMCRI in view of WORLD DIABETIC DAY
celebration. Meena Ramanathan gave a
talk on Importance of Yoga for diabetes
mellitus with demonstration by Yoga
Instructor G. Sarulatha.

CME cum Workshop on Yoga & Lifestyle
Disorders was organized by CYTER and
Dept of Physiology at MGMCRI. More than
250 delegates participated and CYTER
Phase-II was officially inaugurated by Prof
KR Sethuraman, VC, SBVU.

Research paper entitled, Immediate
cardiovascular effects of a single yoga
session in different conditions was
published in the journal of Alternative and
Integrative Medicine. It also received wide
publicity through news coverage in The
Hindu newspaper.

127 51 - 178
DECEMBER







2.12.2013



Regular therapy consultation and classes.

Health Awareness camp for Senior Citizen
at the Serene Pelican Belfort Township as
part of the Out-reach program of CYTER.
Consultation and Yoga Therapy advice was
95 70 - 165

















3.12.2013
given to 15 senior citizens during this
occasion.

CYTER was part of the Team from
MGMCRI, who attended the Health
Awareness camp at NCR, a company in
Pillayar Kuppam- consultation , Yoga
Therapy and dietary advice was given to
more than 35 staff members there at their
office as part of the CYTER Out-reach Prog.

Paper entitled, Differential effects of
uninostril and alternate nostril
pranayamas on cardiovascular parameters
and reaction time was published in
International Journal of Yoga.
A research paper entitled, Hematological,
biochemical and psychological effects of a
yoga training programme in nursing
students was published in International
Research Journal of Pharmacological and
Applied Sciences.

Immediate effect of chandra and
suryanadi pranayamas on cardiovascular
parameters and reaction time in a geriatric
population was submitted to the
International Journal of Physiology and
accepted for publication.

2014
JANUARY

4.1.2014 to
7.1.2014










8.1.2014

Regular therapy consultation and classes.

The CYTER team of Prof Madanmohan
(Director), Dr Ananda Balayogi Bhavanani
(Deputy Director) and Smt. Meena
Ramanathan (Coordinator - cum- Yoga
therapist) presented a special Workshop
on Yoga Therapy and Yoga awareness
programme was conducted via a CYTER
stall at the 20
th
International Yoga festival
organized by the Department of Tourism,
Government of Pondicherry at Gandhi
Tidal.

CYTER received wide publicity through
coverage in national editions of The Times
90 74 164


21.1.2014


27
th
& 28
th

Jan 2014



30.1.2014
of India newspaper.

Orientation visit by nursing students from
Pauls Nursing college.

Introductory Yoga session conducted by
CYTER for 150 students of 1
st
MBBS at
MGMCRI by Dr Madanmohan, Dr Ananda
and Smt Meena.

Inauguration of PGDYT course.
FEBRUARY 1,8,15 &
22.2.2014


2.2.2014




6.2.2014


20, 22, &
26-2-2014













24 and 26,
2.2014
Regular therapy consultation and classes.
Regular classes for the students of PGDYT
course from 9am to 2pm

Presentation on Yoga for pediatricians
by Meena Ramanathan during CME for
Pondy Pediatric Forum at Annamalai
International.

A group of 20 Nurses of MGMC&RI
attended a orientation session at CYTER

The well-known Yoga therapists and
directors of Integrative Yoga Therapy (IYT),
USA & Enchanted Mountain Center for
Yoga and Well-Being in Brazil, Joseph and
Lilian le Page visited CYTER. They
interacted and interviewed the VC-SBVU,
Dean (PG&R) and Director CYTER and
observed the various yoga therapy
sessions and PGDYT classes at CYTER. They
were making an educational video on Yoga
Therapy in India and interviewed
recipients of yoga therapy, students of
PGDYT as well as Dr Ananda and Smt.
Meena on the novel, integrative approach
to yoga therapy adopted at CYTER.
Dr Ananda gave an introductory session on
Yoga for health for senior teachers of
Pondicherry at State training Centre,
Directorate of School Education,
Pondicherry.
100 93 193
MARCH

1,8,15,22&
29.3.2014

7.3.2014





21.3.2014


23
.
3.2014





24.3.2014
Regular therapy consultation and classes.

Regular classes for the students of PGDYT
course from 9am to 2pm

Smt. Meena gave a special presentation on
Yoga for women at the VCRC,
Pondicherry during the International
Womens Day celebrations organised on
7
th
March 2014.

An inspector from MCI (Psychiatry) visited
CYTER and inspected the proceedings.

Smt Meena directed a special
demonstration by the SADAY students at
Gandhi Tidal as part of the Womens day
celebration of ARUMAI rehabilitation
organization.

Dr Ananda was invited to present
workshops, seminars and talks at various
venues in Australia and New Zealand from
24
th
March to 14
th
April 2014. He
presented highly successful programmes
organized by the Gitananda Yoga
Association of Australia at IYTA-
Wellington, Lotus Yoga Centre-
Paraparaumu in New Zealand and Anand
Yoga Academy at Adelaide. He also
conducted intensive 3-day retreats at
Tatum Park, NZ and Integral Yoga
Academy of Australasia at Adelaide. He
presented a special 2-day workshop at the
International Yoga Teachers Association at
Sydney, Australia and visited the Sivanna
Integrative Health Centre, Sydney to
discuss further collaboration in Yoga
therapy. He had special personal meetings
with Yogashri Dr Eric Dornekamp, the
senior most Yoga authority of New
Zealand and the world famous authority
on Yantra-Tantra, Dr. Swami Anandakapila
Saraswathi (Jonn Mumford) of Sydney,
Australia.
153 179 --
















332













APRIL

5,12.19&
26.4.2014

8.4.14




15.4.14














16.4.14
Regular therapy consultation and classes.

Regular classes for the students of PGDYT
course from 9am to 2pm

Nine TG members from the SCHOD
(Sagodaran Community Health
Development Society) attended Yoga
sessions @CYTER

IHEC meeting approved the following
studies from CYTER.
1. Effect of 12-weeks yoga training on
cardiorespiratory, neurological &
psychological parameters in a geriatric
population.
2. Effect of tratak and bhramari
pranayama on ocular muscle balance
and accommodation in computer
vision syndrome.
3. Intra ocular pressure variations in
head below the heart yoga postures.

Dr Ananda rejoined duty after successful
tour down under.
200 179 9 388
MAY

3, 10, 24
and 31

19.5.14
Regular therapy consultation and classes.

Regular classes for the students of PGDYT
course from 9am to 2pm.

Dr. Ananda was nominated to the Editorial
Board of Yoga Mimamsa, the bimonthly
Yoga journal of Kaivalyadhama, Lonavla.
He has previously served as an advisor to
the journal since 2010. This appointment is
prestigious as Yoga Mimamsa is one of the
oldest and premier Yoga journals of India
having been founded by the legendary
Swami Kuvalayananda.
155 216 - 371
JUNE




14
th
&15
th



Regular therapy consultation and classes.

Regular classes for the students of PGDYT
course from 9am to 2pm

Dr. Ananda was invited to attend the
Board of Studies meeting of the GS College
of Yoga and Cultural Synthesis, at
123 177 - 300











16.6.2014











25.6.2014
Kaivalyadhama in Lonavla. He has been
nominated as the chairperson for the
subject, Anatomy and Physiology of the
Human Body in the Context of Yoga. This
appointment is prestigious as
Kaivalyadhama is one of the oldest and
premier Yoga institutions of India. He was
also Chief Guest for the inauguration of
the Foundation Course in Yoga & Ayurveda
at Kaivalyadhama.

Smt. Meena Ramanthan, Coordinator and
Yoga Therapist CYTER submitted her PhD
dissertation to the Tamil Nadu Physical
Education and Sports University, Chennai.
The title of her 250 page dissertation is
Effect of selected yogasanas and
pranayama on selected cardiorespiratory,
psychological and psychomotor variables
among low and highly depressed geriatric
women.

Dr. Ananda attended the Governing Body
Meeting of the South Zone Cultural Centre
at Chennai that was presided by the
Governor of Tamil Nadu who is also
Chairman of the SZCC. Dr. Ananda was
nominated by Pondicherry Govt
Department of Art and Culture to the
Governing Body of the South Zone Cultural
Centre, Tanjavur under Ministry of Culture,
Govt of India in 2013. He has also served
as member in the Expert committee of
SZCC to select Young Talented Artistes
awardees for 2013-14.

JULY




2.7.2014




Regular therapy consultation and classes.

Regular classes for the students of PGDYT
course from 9am to 2pm

A group of 11 staff nurses who joined duty
in MGMCRI from July visited CYTER and
had an interactive pranayama / relaxation
session.

124 217 - 341
4.7.2014










29.7.2014













28, 30 and
31
st
July
Dr. Ananda Balayogi Bhavanani was invited
to be Resource Person for the One Day
National Seminar on "Dimensions of Yoga
and its dynamics" at MoP Vaishnav College
for Women, Chennai. He delivered an
invited lecture on Diverse Dimensions of
Yoga for the youth" in the event organized
jointly by the Krishnamacharya Yoga
Mandiram and MoP Vaishnav College.

Dr. Ananda Balayogi Bhavanani was invited
to be a peer reviewer for BioPsychoSocial
Medicine, an open access, peer-reviewed
online journal that is the official journal of
the Japanese Society of Psychosomatic
Medicine, and publishes research on
psychosomatic disorders and diseases that
are characterized by objective organic
changes and/or functional changes that
could be induced, progressed, aggravated,
or exacerbated by psychological, social,
and/or behavioral factors and their
associated psychosomatic treatments.

Model/send-up theory examinations were
conducted for students of PGDYT course
from 10am to 12.30pm.

AUGUST

2.8.2014




3.8.2014










Regular therapy consultation and classes.

Model/send-up practical examination
conducted for students of PGDYT course
from 10am to 1pm.


An interactive session was conducted by
CYTER as a CNE for nurses, staff and
faculty of Indira Gandhi Government
General Hospital and Post Graduate
Institute (IGGGH&PGI) Pondicherry. Mrs
Meena Ramanathan gave an interactive
talk cum practical session on Stressa
Curse; Yoga- a Boon; Yogic Integration for
Healthcare Givers with a demo by
Sangeeta and Danush Apnadesh.

190 184 7 381
7.8.2014












2,5,7,9 &
12 August

18,19 & 20
August


21 August










25 August



28 August
Yoga Awareness programme was
conducted by Smt Meena Ramanathan,
Coordinator-cum-Yoga therapist CYTER for
Senior Citizens at the Serene Pelican
Belfort Township as part of Out-reach
programs of CYTER. Consultation and Yoga
Therapy advice was given to more than 25
senior citizens on the occasion. Smt Latha,
the Yoga instructor from CYTER gave a
demonstration and then Smt Meena led a
practical session on simple practices for
seniors.

Revision classes for the students of PGDYT
course from 9am to 2pm.

Final theory examinations conducted for
students of PGDYT course from 10am to
12.30pm.

CYTER inaugurated a special Silver Citizens
Yoga and Health Programme for Senior
Citizens of the Serene Pelican Belfort
Township. More than 25 senior citizens
attended the sessions at CYTER. Dr Ananda
gave an introduction and then the practice
session was led by Meena Ramanthan and
supported by Yoga instructors Latha and
Dhanush.


Practical examination was conducted for
students of PGDYT course from 10am to
12.30pm.

Silver Citizens Yoga and Health Programme
SEPTEMBER

4
th
Sept

10
th
Sept
Regular therapy consultation and classes.

Silver Citizens Yoga and Health Programme

Inauguration of classes for 1
st
and 2
nd

batches of PGDYT.














PHOTO GALLERY


INTERNATIONAL YOGA FESTIVAL 2014
Department of Tourism, Government of Pondicherry -


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M MB BB BS S S ST TU UD DE EN NT TS S O OF F
M MG GM MC C& &R RI I, , S SB BV VU U- -2 20 01 14 4
4/25/2014 Lowering pressure without medicine no longer a stretch - The Hindu
http://www.thehindu.com/todays-paper/tp-national/tp-tamilnadu/lowering-pressure-without-medicine-no-longer-a-stretch/article4388329.ece?css=print 1/1
Today's Paper NATIONAL TAMIL NADU
Published: February 7, 2013 00:00 IST | Updated: February 7, 2013 06:01 IST
Lowering pressure without medicine no longer a stretch
Kavita Kishore
Expert advises simple yoga and chanting for decreasing ones blood pressure
Calming chantsA study conducted at the Advanced Centre for Yoga Therapy, Education and Research, showed that pranava pranayama , a yogic
technique with chanting, could significantly blood pressure
If you are suffering from hypertension, new research shows that a certain yoga posture could help you significantly
lower your blood pressure fairly rapidly. The results can be seen with a very simple aasana and just involves basic
chanting, the study has found.
According to a study conducted at the Advanced Centre for Yoga Therapy, Education and Research (ACYTER), by Dr.
Anandan Balayogi Bhavanani, pranava pranayama , when performed in the supine position, could significantly
reduce systolic pressure, pulse pressure and mean pressure (diastolic pressure + 1/3 pulse pressure). These results
were not observed when the subjects underwent what Dr. Bhavanani terms sham relaxation a technique where
they were asked to lie down and relax various parts of their bodies.
According to Dr. Bhavanani, pranava pranayama is the practice of taking three slow and deep breaths followed by
making a prolonged aaa ooo mmm sound when exhaling. This pranayama is typically done in a seated posture, but
for the sake of this research he decided to experiment with it in a supine position to see if it was more effective.
For the purpose of the study, 29 subjects (15 male and 14 female), with the average age of 57 years, were chosen. All
the subjects were undergoing treatment for hypertension and diabetes for more than three years. They were then
divided into two groups. One group was asked to practice the pranava pranayama , while the other group underwent
sham relaxation. Both these groups were asked to do the exercise for 10 minutes a day.
The pranava group was asked to practice shavasana simple conscious resting for the first two and the last two
minutes and for the remaining six minutes they were asked to perform pranava pranayama in the supine position.
The pre-relaxation and post-relaxation heart rate and blood pressure was taken from all of the patients and the
required variables were calculated.
For the patients that underwent the sham relaxation, the results were not as striking as for those who performed the
pranava relaxation, he said.
The ACYTER group is now conducting a similar research on the effect of pranava pranayama on patients who have
suffered from stroke, he said.
Printable version | Apr 25, 2014 5:49:14 PM | http://www.thehindu.com/todays-paper/tp-national/tp-
tamilnadu/lowering-pressure-without-medicine-no-longer-a-stretch/article4388329.ece
The Hindu
4/25/2014 Yoga could reduce cardiovascular markers - The Hindu
http://www.thehindu.com/todays-paper/tp-national/tp-tamilnadu/yoga-could-reduce-cardiovascular-markers/article5438837.ece?css=print 1/1
Today's Paper NATIONAL TAMIL NADU
Published: December 9, 2013 00:00 IST | Updated: December 9, 2013 05:53 IST
Yoga could reduce cardiovascular markers
Kavita Kishore
CYTERs study concludes one yoga session can reduce heart rate, BP
For the study, data of 1896 patients, from the ages of 24 to 48, was analysed. Yoga session in progress at CYTER
A new study by the Centre of Yoga Therapy, Education and Research, Mahatma Gandhi Medical College & Research
Institute reveals that a single session of yoga can significantly reduce heart rate and blood pressure
According to the conclusion of the study, a single yoga session can reduce the heart rate, blood pressure and derived
cardiovascular indices. The magnitude of the reduction depends on the pre-existing medical conditions, as well as the
protocol of yoga therapy that is adopted.
The changes in cardiovascular could be attributed to an enhanced harmony in cardiac autonomic functions, resulting
from the coordinated breath-body work, as well as the relaxation of mind and body, Deputy Director (Yoga) of CYTER
Ananda Balayogi Bhavanani told The Hindu .
For the study, data of 1896 patients 1229 women, 633 men and 34 transgender from the ages of 24 to 48 was
analysed. These people attended yoga sessions between November 2010 and September 2012 and heart rate, systolic
and diastolic pressure were measured after a 60 minute yoga session. Pulse pressure, mean pressure, rate pressure
product and double produce were derived from the data.
In patients with hypertension, there was a significant reduction in cardiovascular parameters following the session.
People with skin problems and musculoskeletal problems, the reduction was less significant, while in patients with no
health conditions as well as those with psychiatric and respiratory conditions, there was a moderate change in the
cardiovascular markers, the study indicates.
According to Dr. Bhavanani, although there have been several studies on the physiological, psychological and
biochemical changes following yoga practice, only very few have focussed on the effect of a single session. CYTER also
conducted a one day CME to discuss papers on Lifestyle Diseases and Yoga recently.
Printable version | Apr 25, 2014 5:50:09 PM | http://www.thehindu.com/todays-paper/tp-national/tp-
tamilnadu/yoga-could-reduce-cardiovascular-markers/article5438837.ece
The Hindu