The physiotherapy profession has undergone a paradigmatic shift in recent years.  In response to mounting research evidence that psychosocial issues cannot be disentangled from biomechanical factors, a conceptual ‘biopsychosocial’ model has been developed [1].  

The current research suggests that better patient outcomes are achieved when a broader view of a patients symptoms is used to contextualise the patient therapist interaction [1].

Subsequently, the emerging research has encouraged therapists to engage in a multifaceted process that acknowledges input from various specialists like psychologists, sociologists, occupational therapists and nurses [2].

As a result, it has been recognised that basic similarities exist between yoga and physiotherapy in terms of mutidisciplinarity and complexity of holistic care [3]. The enrichment and cross-fertilisation of physiotherapy with yoga offers an evidence based approach to overall patient care, and enhances the treatment of recalcitrant chronic conditions often complicated by complex biopsychosocial entanglements [3].

Brief Characteristics of Yoga

Yoga offers a philosophical system for approaching health holistically. It is estimated that yoga has been developing for four to five thousand years, mainly in Asia.  An extensive renaissance of yoga is now being observed across the world.

Yoga creates inner physical and emotional balance through the use of postures that are combined with breathing techniques that are based mainly on isometric muscle contractions [4]. Yoga emphasizes that physical self-control and can be regarded as a way of harmonizing the balance between catabolic and anabolic reactions within the body [5, 6]. The yoga practice is related to high levels of concentration and emotion control [7].

Yoga also offers guidance in relation to the dietary habits and a self-regulated life-style, as well as general ethical and moral principles [8]. Overall, the main objective of yoga is the achievement of balanced health and well-being optimal fitness and increased body resistance.

 

Physiological Benefits of Yoga

Practicing yoga exercises leads to the autonomic nerve plexuses and the endocrine system stimulation by an increased pressure in the abdominal wall. Thus, it is suggested that yoga postures improve the performance of the cardio-respiratory system [9], enhance lung function together with increased strength and endurance of respiratory muscles [10, 11] leading to increased vital capacity [12]. It also normalizes blood pressure and improves immunity [13], reduces heart rate, respiratory rate and increases red blood cell volume [14]. A significant reduction in the amount of oxygen consumed with decreased breath rate and increased breath volume has also been found [15, 16].

Yoga may also significantly decrease fatigue [17]. More precisely, yoga "intervention" increases regression of coronary atherosclerosis and coronary lesions in patients with severe coronary artery disease, whilst simultaneously improving myocardial perfusion [18]. Yoga also improves symptomatic status, functional class and risk factor profile [19]. In this study, patients performing yoga exercises required revascularisation procedures (coronary angioplasty or bypass surgery) less frequently.

From the physiotherapy point of view, yoga may be regarded as an appropriate way of using body postures that offers enhanced cardio-pulmonary function i.e. improved breathing patterns or blood vessel contraction as well as various physiological benefits.

Neuropsychological Benefits of Yoga

Yoga seems to stimulate the right brain hemisphere and increase alpha wave frequencies [20]. Patients practicing yoga may also show a significant reduction in the number of errors during static motor performance [21] as well as improvement in sensory-motor performance and enhanced processing ability of the central nervous system [22] and eye-hand coordination [21].

 References:

1.       Sanders, T., Foster, N. E., Bishop, A., & Ong, B. N. (2013). Biopsychosocial care and the physiotherapy encounter: physiotherapists’ accounts of back pain consultations. BMC musculoskeletal disorders, 14(1), 65.

  1. Foster NE, Delitto A: Embedding psychosocial perspectives within clinical management of low back pain: integration of psychosocially informed management principles into physical therapist practice–challenges and opportunities. Phys Ther 2011, 91(5):790-803

  2. Posadzki, P., & Parekh, S. (2009). Yoga and physiotherapy: a speculative review and conceptual synthesis. Chinese journal of integrative medicine, 15(1), 66-72.

  3. Kogler A. Yoga. Jelenia Gora: Psychosomatic Hygiene Publishing; 1990:67.

  4. Michalska M. Influence of Hathayoga exercises on health’s integrative component. Lider 2004 (2):20–23 (Article in Polish).

  5. Mlotkowski J. Yoga for you. Poznan: National Publishing Agency; 1990:14.

  6. Javalgekar r. Medical yoga. Warsaw: Comes Publishing Agency; 1992:47.

  7. Grochmal S. Relaxation and concentration exercises. Warsaw: National Medical Publishing; 1993:245.

  8. Harinath K, Malhotra AS, Pal K, Prasad R, Kumar R, Kain TC, et al. Effects of Hatha yoga and Omkar meditation on cardiorespiratory performance, psychologic profile, and melatonin secretion. J Altern Complement Med 2004;10:261–268.

  9. Dash M, Telles S. Improvement in hand grip strength in normal volunteers and rheumatoid arthritis patients following yoga training. Indian J Physiol Pharmacol 2001;45:355–360.

  10. Mandanmohan, Jatiya L, Bhavanani AB. Effect of yoga training on hand grip, respiratory pressures and pulmonary function. Indian J Physiol Pharmacol 2003;47:387–392.

  11. Savic K, Pfau D, Skoric S, Pfau J, Spasojevic N. The effect of Hatha yoga on poor posture in children and the psychophysiologic condition in adults. Med Pregl 1990;43:268–272.

  12. Szyszko-Bohusz A. Yoga-Indian philosophical, therapeutical and education system. Krakow: Barbara Publishing; 1996:87.

  13. Manjunath NK, Telles S. Effects of sirsasana (headstand) practice on autonomic and respiratory variables. Indian J Physiol Pharmacol 2003;47:34–42.

  14. Arambula P, Peper E, Kawakami M, Gibney KH. The physiological correlates of Kundalini yoga meditation: a study of a yoga master. Appl Psychophysiol Biofeedback 2001;26:147–153. 

  15. Telles S, Reddy SK, Nagendra HR. Oxygen consumption and respiration following two yoga relaxation techniques. Appl Psychophysiol Biofeedback 2000;25:221–227

  16. Oken BS, Kishiyama S, Zajdel D, Bourdette D, Carlsen J, Haas M, et al. Randomized controlled trial of yoga and exercise in multiple sclerosis. Neurology 2004;62:2058–2064.

  17. Yogendra J, Yogendra HJ, Ambardekar S, Lele RD, Shetty S, Dave M, et al. Beneficial effects of yoga lifestyle on reversibility of ischaemic heart disease: caring heart project of International Board of Yoga. J Assoc Physicians Indian 2004;52:283–289.