Yoga

Namaste. I honor the place in you in which the entire universe dwells. I honor the place in you which is of love, of peace, of light, and of truth. When you are in that place in you, and I am in that place in me, We are One.

Bulleted columns represent those characteristics that have been associated with yoga in the research literature. Please note that only evidence from experimental research levels A and B are included. Level C evidence (nonquantifiable) is not included in the table but is described in the text. Please see the User’s Guide Section: 3 for a detailed description of research levels.

Neuromusculoskeletal Functions
Flexibility Strength: Upper Body Strength: Lower Body Bone Development Muscle Relaxation Posture

Movement Functions
Coordination Motor Skills Fine Motor Control Visuomotor

Sensory Functions
Balance Sensory Development Proprioception/Kinesthetics

Systems Function
Metabolic Changes Cardiorepiratory Health

Mental Functions
Psychosocial Development Cognition Body Image/Self-Esteem Socialization

Traditional Yoga
Originates in East Indian philosophy Emphasizes self-actualization and the union of mind and spirit Karma yoga, emphasizing action Bhakti yoga, emphasizing emotion Inana yoga, emphasizing knowledge and wisdom Raja yoga, emphasizing mental and physical control

Children’s yoga: modified form incorporating storytelling, drama, music, games, and group poses

Functional Skill Examples
Sit, stand, kneel, four point, transfers

Advantages
Requires no special equipment or clothing May be practiced individually at home May be safe alternative to higher energy activities for those at risk for coronary events

Hatha Yoga
Popular subform of traditional Raja yoga Composed of three primary elements: pranayama (breathwork), asanas (physical postures), and shavasana (meditation) Viniyoga, restorative/therapeutic yoga, and integral yoga: gentle forms promoting relaxation and coordination of breath with movement Iyengar yoga and Ashtanga/power yoga: relatively vigorous forms emphasizing strengthening and flexibility

Precautions
Ashtanga yoga and select Iyengar poses may be contraindicated for individuals with cardiac conditions Select yoga poses may be contraindicated for specific orthopedic conditions Children should not practice select forms of pranayama Yoga practice by individuals under 16 years of age is not endorsed by the American Yoga Association

note: American Yoga Association is independent and is not a governing organization for yoga teachers

Individuals should consult their doctors before initiating new activities or when increasing activity level

Physical and Psychosocial Outcomes
SUMMARY OF THE LITERATURE
A significant body of research exists regarding the potential role yoga practice may play in the treatment of various diseases and ailments, including heart disease, asthma, epilepsy, and carpal tunnelNEUROMUSCULAR FUNCTIONS syndrome, among others. Although the most Flexibility signficant body of literature related to yoga B Increased hand range of motion in practice documents the cardio-pulmonary novice practitioners with osteoarthritis benefits associated with participation, strong (Garfinkle et al 1994) evidence also documents improvements in C Described as improving flexibility in metabolic profiles and in upper extremity practitioners with cognitive impairments strength. A small but remarkable body of (Fields 1991) evidence documents improvements in cognitive function in children and adolescents who Posture practice yoga. There is surprisingly little written in the research literature regarding the impact of C Described as improving posture in practitioners with visual impairments yoga practice on flexibility and balance. (Hider 1983) Fourteen articles included in this review are related to the benefits of yoga participation for Strength: Upper Body individuals with disabilities or potentially A Improved grip strength in Iyengar yoga disabling conditions; five of these articles are practitioners with carpal tunnel syndrome specific to children with disabilities. Four (Garfinkle et al 1998) studies included in this review used children A Increased muscular efficiency and without disabilities as subjects. endurance of upper extremity muscles in Although yoga practice is traditionally novice hatha yoga practitioners considered a whole lifestyle that incorporates (Ray et al 1986) a vegetarian diet, the most common practice B Increased hand grip strength in novice of yoga in the United States does not Iyengar yoga practitioners with necessarily incorporate vegetarianism. osteoarthritis Consequently, studies that included a (Garfinkle et al 1994) vegetarian diet in the intervention were excluded from this review. As meditation is an MOVEMENT FUNCTIONS integral part of any yoga practice, articles documenting the effects of meditation practice, which may or may not have Coordination included other yoga practices, were included C Described as improving coordination in in this review. practitioners with cognitive impairments Specific examples of the documented (Fields 1991) outcomes of participation in yoga are listed below. Motor Skills B Improved performance on static motor

Our appreciation to the University of North Carolina Center for Development and Learning and The North Carolina Office on Disability and Health for their support of this publication. For more information on the benefits of participation in recreation contact your local physical, occupational, or recreation therapist or your local community recreation provider.
Hunter, K. 2/02

activities requiring hand steadiness and visuomotor coordination in children practicing yoga (Telles et al 1993) C Described as improving orientation and mobility skills in practitioners with visual impairments (Hider 1983)

B

Improved vital lung capacity in novice hatha yoga practitioners (Birkel and Edgren 2000) B Improved utilization of oxygen in novice pranayama and shavasana practitioners (Raju et al 1994) B Increased heart rate during meditation in Brahmakumaris Raja yoga practitioners (Telles and Desiraju 1993) B Improved pulmonary function in novice adolescent practitioners with asthma (Jain et al 1991)

SENSORY FUNCTIONS Proprioception and Kinesthetics
C Described as improving kinesthetic awareness and spatial orientation in practitioners with visual impairments (Hider 1983) B Decreased systolic and diastolic blood pressure in novice practitioners (Sundar et al 1984) B Decreased hypertensive drug requirements in novice shavasana practitioners with hypertension (Sundar et al 1984)

Sensory Development
A Improved visual contrast sensitivity in Sahaja yoga meditation practitioners with epilepsy (Panjwani et al 2000) A Decreased pain and select other symptoms associated with carpal tunnel syndrome in Iyengar yoga practitioners (Garfinkle et al 1998)

Metabolic Changes
A/B Decreased cortisol levels in meditation and yoga practitioners (MacLean et al 1997; Kamel and Toriumi 2000) A Decreased body weight in novice hatha yoga practitioners (Ray et al 1986) A Increased plasma norepinephrine levels at venipuncture in meditation practitioners (Morrell and Hollandsworth 1986) B Increased melatonin levels in experienced meditation practitioners (Tooley et al 2000) B Increased levels of corticotropinreleasing hormone in experienced meditation practitioners (Harte et al 1995) B Decreased blood lactate levels and increased pyrvate/lactate ratio in novice pranayama and shavasana practitioners (Raju et al 1994) B Decreased blood cholesterol levels in novice practitioners (Joseph et al 1981) B Decreased fasting blood glucose levels

SYSTEMS FUNCTIONS Cardiorespiratory Health
A Decreased heart rate in adolescent yoga practitioners (Telles et al 1997) A/B Decreased respiration rate in yoga, pranayama, and shavasana practitioners (Telles et al 1997; Raju et al 1994) A Improved airway reactivity in pranayama practitioners with asthma (Singh et al 1990) A Decreased diastolic blood pressure in meditation practitioners (Morrell and Hollandsworth 1986) A/B Improved asthma control in novice yoga practitioners with asthma (Nagendra and Nagarathna 1986; Nagarathna and Nagendra 1985; Jain et al 1991)

Our appreciation to the University of North Carolina Center for Development and Learning and The North Carolina Office on Disability and Health for their support of this publication. For more information on the benefits of participation in recreation contact your local physical, occupational, or recreation therapist or your local community recreation provider.
Hunter, K. 2/02

in novice practitioners (Joseph et al 1981)

Psychosocial Development
B Increased alpha wave predominance in experienced and inexperienced yoga practitioners (Kamel and Toriumi 2000; Joseph et al 1981) B Enhanced perception of relaxation and increased levels of positive affect in experienced meditation practitioners (Harte et al 1995) B Enhanced mental and physical energy in novice pranayama practitioners (Wood 1993)

Other
A Decreased seizure frequency in practitioners with epilepsy (Panjwani et al 1996)

MENTAL FUNCTIONS Body Image/Self-esteem
A Improved body satisfaction in novice children practicing yoga (Clance et al 1980) B Decreased anxiety, panic, and depressive B Improved body awareness in hatha symptoms in meditation and yoga yoga practitioners practitioners (Rani and Rao 1994; Engelman et al 1982) (Kabat-Zinn et al 1992; Berger and Owen B Improved self-cathexis in novice hatha 1988) yoga practitioners B Decreased tension, confusion, and (Engelman et al 1982) aggression in yoga practitioners C Described as improving body awareness (Berger and Owen 1988) in practitioners with disabilities C Described as encouraging positive group (Fields 1991; Hider 1983) identity in practitioners with cognitive C Described as improving self esteem in impairments practitioners with visual impairments (Fields 1991) (Hider 1983) C Described as improving sleeping habits in practitioners with visual impairments Cognition (Hider 1983) A Improved intellectual function, including intelligence quotient and mental age, in Socialization child and adolescent practitioners with A Improved social adaptation skills in mental retardation novice child and adolescent practitioners (Uma et al 1989) with mental retardation B Improved spatial memory in adolescent (Uma et al 1989) pranayama practitioners B Improved social interaction in novice (Naveen et al 1997) child practitioners B Improved academic performance in (Clance et al 1980) novice child yoga practitioners C Described as promoting social (Clance et al 1980) independence and competence in C Described as improving ability to follow practitioners with visual impairments verbal directions in practitioners with visual (Hider 1983) impairments (Hider 1983)
Our appreciation to the University of North Carolina Center for Development and Learning and The North Carolina Office on Disability and Health for their support of this publication. For more information on the benefits of participation in recreation contact your local physical, occupational, or recreation therapist or your local community recreation provider.
Hunter, K. 2/02

but emphasize poses incorporating a posterior pelvic tilt, such as Angry Cat pose

Motor Memory
Use visual representations of pose sequences or components (e.g. picture schedule)

Vision
Provide precise, verbal explanations Provide tactile cues and hands-on assistance, particularly when individual is first learning pose Demonstrate poses in a bright clothes Incorporate group chanting to foster group identification

Selected Resources Modifications
GENERAL MODIFICATION EXAMPLES
Modify poses with pillows, wedges, bolsters, blocks, scarves, and belts Use a wall, chair, parallel bars, or inclusion aide to provide additional support Use an inclusion aide to assist in performing poses Perform upper extremity/trunk components of standing poses while sitting against a wall, sitting in a chair, or in high kneel If in a group, practice in a circle formation Break individual poses down into subcomponents
Note: Resources selected are not comprehensive and are not endorsed by authors.

Articles
Galas J. The breath that refreshes. Paraplegia News. 1996;50(3):46-51.

Books
Brosnan B. Yoga for Handicapped People. 1982. Souvenir Press Fontana D. Teaching Meditation to Children. 1997. Element Books. Luby T. Children’s Book of Yoga: Games & Exercises Mimic Plants & Animals & Objects. 1998. Clear Light Publishers. Stewart M, Phillips K. Yoga for Children. 1992. Simon & Schuster, Inc. Sumar S. Translator: Jeffrey Volk, Adriana Marusso. Yoga for the Special Child: A Therapeutic Approach for Infants and Children with Down Syndrome, Cerebral Palsy, and Learning Disabilities. 1998. Special Yoga.

SPECIFIC MODIFICATION EXAMPLES
For children Incorporate group poses, storytelling, drama, and music Use a candle/flame or a sand hourglass as a focus for meditation activities For individuals with difficulties in:

Websites
Yoga for the Special Child www.specialyoga.com Yogakids www.yogakids.com You and Me Yoga www.youandme-yoga.org

Flexibility or Range of Motion
Modify individual poses and pose sequences to accomodate individual needs e.g. individuals with loridosis may choose not to move to end ranges of motion in spinal extension poses, such as Bow pose,

Our appreciation to the University of North Carolina Center for Development and Learning and The North Carolina Office on Disability and Health for their support of this publication. For more information on the benefits of participation in recreation contact your local physical, occupational, or recreation therapist or your local community recreation provider.
Hunter, K. 2/02

Equipment
Floor Point Yoga videotape www.floorpointyoga.com The Yoga Garden Game www.theyogagarden.com

National and Local Foundations and Organizations
American Yoga Association www.americanyogaassociation.org Conscious Wave program: Gaiam Yoga for Life in the schools yogaforlife@gaiam.com

Our appreciation to the University of North Carolina Center for Development and Learning and The North Carolina Office on Disability and Health for their support of this publication. For more information on the benefits of participation in recreation contact your local physical, occupational, or recreation therapist or your local community recreation provider.
Hunter, K. 2/02

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