Yoga for therapeutic purposes

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Therapeutic yoga workshop, Jakarta, 2016 Front split.jpg
Therapeutic yoga workshop, Jakarta, 2016

Yoga for therapeutic purposes is the use of yoga as exercise, consisting mainly of postures called asanas, as a gentle form of exercise and relaxation applied specifically with the intention of improving health. This form of yoga is widely practised in classes, and may involve meditation, imagery, breath work (pranayama) and music. [1]

Yoga as exercise

Yoga as exercise is a physical activity consisting mainly of postures (asanas), often connected by flowing sequences called vinyasas, sometimes accompanied by rhythmic breathing (pranayama), and often ending with relaxation or meditation. Yoga in this form has become familiar across the world, especially in America and Europe. Like other forms of modern yoga, it is derived from medieval Haṭha yoga, and is sometimes so named, but it is generally simply called "yoga". This is despite the existence of multiple older traditions of yoga within Hinduism dating back to the Yoga Sutras of Patanjali, some not involving asanas at all, and despite the fact that in no tradition was the practice of asanas central. Academics have given yoga as exercise a variety of names, including "modern postural yoga", "modern transnational yoga", and "transnational anglophone yoga".

Asana Postures in hatha yoga and modern yoga practice

An asana is a body posture, originally a sitting pose for meditation, and later in hatha yoga and modern yoga as exercise, adding reclining, standing, inverted, twisting, and balancing poses to the meditation seats. The Yoga Sutras of Patanjali define "asana" as "[a position that] is steady and comfortable". Patanjali mentions the ability to sit for extended periods as one of the eight limbs of his system. Asanas are also called yoga poses or yoga postures in English.

Exercise bodily activity that enhances or maintains physical fitness and overall health and wellness

Exercise is any bodily activity that enhances or maintains physical fitness and overall health and wellness. It is performed for various reasons, to aid growth and improve strength, preventing aging, developing muscles and the cardiovascular system, honing athletic skills, weight loss or maintenance, improving health and also for enjoyment. Many individuals choose to exercise outdoors where they can congregate in groups, socialize, and enhance well-being.

Contents

At least three types of health claim have been made for yoga: magical claims for medieval haṭha yoga, including the power of healing; unsupported claims of benefits to organ systems from the practice of asanas; and more or less well supported claims of specific medical and psychological benefits from studies of differing sizes using a wide variety of methodologies.

Siddhis are spiritual, paranormal, supernatural, or otherwise magical powers, abilities, and attainments that are the products of spiritual advancement through sādhanās such as meditation and yoga. The term ṛddhi is often used interchangeably in Buddhism.

Organ (anatomy) Collection of tissues

Organs are groups of tissues with similar functions. Plant and animal life relies on many organs that coexist in organ systems.

Systematic reviews have found beneficial effects of yoga on low back pain [2] and depression, [3] but despite much investigation little or no evidence for benefit for specific medical conditions. Study of trauma-sensitive yoga has been hampered by weak methodology. [4]

Low back pain disorder involving muscles, nerves, bones of the back

Low back pain (LBP) is a common disorder involving the muscles, nerves, and bones of the back. Pain can vary from a dull constant ache to a sudden sharp feeling. Low back pain may be classified by duration as acute, sub-chronic, or chronic. The condition may be further classified by the underlying cause as either mechanical, non-mechanical, or referred pain. The symptoms of low back pain usually improve within a few weeks from the time they start, with 40–90% of people completely better by six weeks.

Depression (mood) state of low mood and aversion to activity

Depression is a state of low mood and aversion to activity. It can affect a person's thoughts, behavior, motivation, feelings, and sense of well-being. It may feature sadness, difficulty in thinking and concentration and a significant increase/decrease in appetite and time spent sleeping, and people experiencing depression may have feelings of dejection, hopelessness and, sometimes, suicidal thoughts. It can either be short term or long term. Depressed mood is a symptom of some mood disorders such as major depressive disorder or dysthymia; it is a normal temporary reaction to life events, such as the loss of a loved one; and it is also a symptom of some physical diseases and a side effect of some drugs and medical treatments.

Trauma-sensitive yoga is yoga as exercise, adapted from 2002 onwards for work with individuals affected by psychological trauma. The goal of trauma-sensitive yoga is for trauma survivors to develop a greater sense of mind-body connection, ease their physiological experiences of trauma, gain a greater sense of ownership over their bodies, and augment their overall well-being.

Context

Different schools teach yoga with emphasis on aerobic exercise (such as Bikram Yoga), precision in the asanas (like Iyengar Yoga), or spirituality (like Sivananda Yoga). Unbranded "hatha yoga" (not to be confused with medieval hatha yoga) may teach any combination of these. Yoga dimensions.svg
Different schools teach yoga with emphasis on aerobic exercise (such as Bikram Yoga), precision in the asanas (like Iyengar Yoga), or spirituality (like Sivananda Yoga). Unbranded "hatha yoga" (not to be confused with medieval haṭha yoga) may teach any combination of these.

Yoga classes used as therapy usually consist of asanas (postures used for stretching), pranayama (breathing exercises), and relaxation in savasana (lying down). [6] The physical asanas of modern yoga are related to medieval haṭha yoga tradition, but they were not widely practiced in India before the early 20th century. [7]

Pranayama practice of breath control in Yoga

Prāṇāyāma is the Hatha yoga practice of breath control.

The number of schools and styles of yoga in the Western world has grown rapidly from the late 20th century. By 2012, there were at least 19 widespread styles from Ashtanga Vinyasa Yoga to Viniyoga. These emphasise different aspects including aerobic exercise, precision in the asanas, and spirituality in the haṭha yoga tradition. [5] [8] These aspects can be illustrated by schools with distinctive styles. Thus, Bikram Yoga has an aerobic exercise style with rooms heated to 105 °F (41 °C) and a fixed sequence of 2 breathing exercises and 26 asanas performed in every session. Iyengar Yoga emphasises correct alignment in the postures, working slowly, if necessary with props, and ending with relaxation. Sivananda Yoga focuses more on spiritual practice, with 12 basic poses, chanting in Sanskrit, pranayama breathing exercises, meditation, and relaxation in each class, and importance is placed on vegetarian diet. [5] [8]

Viniyoga is the individualised style of yoga as exercise, also called Vinyasa Krama Yoga, developed by Tirumalai Krishnamacharya and taught by his son T. K. V. Desikachar. The American Viniyoga Institute was founded and is directed by Gary Kraftsow.

Aerobic exercise

Aerobic exercise is physical exercise of low to high intensity that depends primarily on the aerobic energy-generating process. "Aerobic" means "relating to, involving, or requiring free oxygen", and refers to the use of oxygen to adequately meet energy demands during exercise via aerobic metabolism. Generally, light-to-moderate intensity activities that are sufficiently supported by aerobic metabolism can be performed for extended periods of time. What is generally called aerobic exercise might be better termed "solely aerobic", because it is designed to be low-intensity enough so that all carbohydrates are aerobically turned into energy.

Bikram Yoga system of yoga

Bikram Yoga is a hot system of yoga as exercise that Bikram Choudhury synthesized from traditional hatha yoga techniques. It became popular in the early 1970s. All Bikram Yoga Beginning Series classes run for 90 minutes and consist of the same series of 26 postures, including two breathing exercises.

Types of claim

At least three different types of claim of therapeutic benefit have been made for yoga from medieval times onwards, not counting the more general claims of good health made throughout this period: magical powers, biomedical claims for marketing purposes, and specific medical claims. Neither of the first two are supported by reliable evidence. The medical claims are supported by evidence of varying quality, from case studies to controlled trials and ultimately systematic review of multiple trials. [9] [10]

Magical powers

Medieval authors asserted that Haṭha yoga brought physical (as well as spiritual) benefits, and provided magical powers including of healing. The Hatha Yoga Pradipika (HYP) states that asanas in general, described as the first auxiliary of haṭha yoga, give "steadiness, good health, and lightness of limb." (HYP 1.17) [9] Specific asanas, it claims, bring additional benefits; for example, Matsyendrasana awakens Kundalini and helps to prevent semen from being shed involuntarily; (HYP 1.27) Paschimottanasana "stokes up the digestive fire, slims the belly and gives good health"; (HYP 1.29) Shavasana "takes away fatigue and relaxes the mind"; (HYP 1.32) while Padmasana "destroys all diseases" (HYP 1.47). [11] These claims lie within a tradition across all forms of yoga that practitioners can gain supernatural powers. [12] Hemachandra's Yogashastra (1.8–9) lists the magical powers, which include healing and the destruction of poisons. [13]

Biomedical claims for marketing purposes

Styles of yoga differ in their approach to the asanas. Iyengar Yoga emphasises correctness, seen here as a practitioner uses a yoga brick to attain correct alignment in Utthitha Trikonasana. Uttitha Trikonasana.jpg
Styles of yoga differ in their approach to the asanas. Iyengar Yoga emphasises correctness, seen here as a practitioner uses a yoga brick to attain correct alignment in Utthitha Trikonasana.

Twentieth century advocates of some schools of yoga, such as B. K. S. Iyengar, have for various reasons made claims for the effects of yoga on specific organs, without adducing any evidence. The yoga scholar Andrea Jain describes such claims in terms of "elaborating and fortifying his yoga brand" [14] and "mass-marketing", [14] calling Iyengar's 1966 book Light on Yoga "arguably the most significant event in the process of elaborating the brand". [14] The yoga teacher Bernie Gourley notes that the book neither describes contraindications systematically, nor provides evidence for the claimed benefits. [15] Jain suggests that "Its biomedical dialect was attractive to many." [14] For example, in the book, Iyengar claims that the asanas of the Eka Pada Sirsasana cycle [16]

...tone up the muscular, nervous and circulatory systems of the entire body. The spine receives a rich supply of blood, which increases the nervous energy in the chakras (the various nerve plexuses situated in the spine), the flywheels in the human body machine. These poses develop the chest and make the breathing fuller and the body firmer; they stop nervous trembling of the body and prevent the diseases which cause it; they also help to eliminate toxins by supplying pure blood to every part of the body and bringing the congested blood back to the heart and lungs for purification. [16]

The history of such claims was reviewed by William J. Broad in his 2012 book The Science of Yoga. Broad argues that while the health claims for yoga began as Hindu nationalist posturing, it turns out that there is ironically [10] "a wealth of real benefits". [10]

Evidence-based medical claims

Researchers have studied the medical and psychological effects of yoga as exercise in a wide range of trials and observational studies, sometimes with careful controls, providing evidence of differing quality about yoga's possible benefits. [10] The various types of claim, and the evidence for them, are discussed below.

Research

Methodology

Much of the research on the therapeutic use of yoga has been in the form of preliminary studies or clinical trials of low methodological quality, including small sample sizes, inadequate control and blinding, lack of randomization, and high risk of bias. [17] [18]

For example, a 2010 literature review on the use of yoga for depression stated, "although the results from these trials are encouraging, they should be viewed as very preliminary because the trials, as a group, suffered from substantial methodological limitations." [18] A 2015 systematic review on the effect of yoga on mood and the brain recommended that future clinical trials should apply more methodological rigour. [3]

Mechanisms

A yoga class relaxing in Supta Baddha Konasana. There is evidence that yoga relieves stress by multiple mechanisms. YogaClass.jpg
A yoga class relaxing in Supta Baddha Konasana. There is evidence that yoga relieves stress by multiple mechanisms.

The practice of asanas has been claimed to improve flexibility, strength, and balance; to alleviate stress and anxiety, and to reduce the symptoms of lower back pain, without necessarily demonstrating the precise mechanisms involved. [20] A review of five studies noted that three psychological (positive affect, mindfulness, self-compassion) and four biological mechanisms (posterior hypothalamus, interleukin-6, C-reactive protein and cortisol) that might act on stress had been examined empirically, whereas many other potential mechanisms remained to be studied; four of the mechanisms (positive affect, self-compassion, inhibition of the posterior hypothalamus and salivary cortisol) were found to mediate yoga's effect on stress. [19]

Low back pain

A 2013 systematic review on the use of yoga for low back pain found strong evidence for short- and long-term effects on pain, and moderate evidence for long-term benefit in back-specific disability, with no serious adverse events. Ten randomised controlled trials were analysed, of which eight had a low risk of bias. The review stated that yoga can be recommended as an additional therapy to chronic low back pain patients. [2]

Mental disorders

A 2013 systematic review on the use of yoga for depression found moderate evidence of short-term benefit over "usual care" and limited evidence compared to relaxation and aerobic exercise. Only 3 of 12 randomised controlled trials had a low risk of bias. The diversity of the studies precluded analysis of long-term effects. [21]

A 2015 systematic review on the effect of yoga on mood and the brain concluded that "yoga is associated with better regulation of the sympathetic nervous system and hypothalamic-pituitary-adrenal system, as well as a decrease in depressive and anxious symptoms in a range of populations." [3]

Trauma-sensitive yoga has been developed by David Emerson and others of the Trauma Center at the Justice Resource Institute in Brookline, Massachusetts. The center uses yoga alongside other treatments to support recovery from traumatic episodes and to enable healing from PTSD. Workers including Bessel van der Kolk and Richard Miller have studied how clients can "regain comfort in their bodies, counteract rumination, and improve self-regulation through yoga." [22] [23] A 2018 systematic review of 12 studies, that had individually found positive effects compared to their control groups, was unable to find strong evidence of benefit from yoga for post-traumatic stress disorder, depression, or anxiety following traumatic experiences, and called for more rigorous study design. [4]

Other conditions

There is little reliable evidence that yoga is beneficial for specific medical conditions, and an increasing amount of evidence that it is not. A systematic review in 2013 found weak evidence for the use of yoga for rheumatic diseases, with no evidence of its safety. [24] A 2015 systematic review found no evidence of benefit in treatment of epilepsy or menopause-related symptoms. [25] [26] Practice of yoga had no effect on the underlying mechanisms of cancer. [27] Another systematic review in 2015 found little evidence that yoga helps people with dementia perform their daily activities. [28] A 2010 systematic review showed no effect of yoga on attention deficit hyperactivity disorder. [17] A systematic review in 2019 concluded that there was not enough evidence to be able to assess the effectiveness of yoga for treating women with urinary incontinence. [29]

Safety

Although relatively safe, yoga is not a risk-free form of exercise. Sensible precautions can usefully be taken – for example the avoidance of advanced moves by beginners, not combining practice with psychoactive drug use, and avoiding competitiveness. [30]

A small percentage of yoga practitioners each year suffer physical injuries analogous to sports injuries. [31] The practice of yoga has been cited as a cause of hyperextension or rotation of the neck, which may be a precipitating factor in cervical artery dissection. [32]

See also

Related Research Articles

Lotus position cross-legged sitting position, commonly used for meditation

Padmasana or lotus position is a cross-legged sitting asana originating in meditative practices of ancient India, in which each foot is placed on the opposite thigh. It is an ancient asana, predating hatha yoga, and is commonly used for meditation, in the Yoga, Hindu, Tantra, Jain, and Buddhist contemplative traditions.

Hatha yoga branch of yoga, focusing on physical techniques

Haṭha yoga is a branch of Yoga. The Sanskrit word हठ haṭha literally means "force" and thus alludes to a system of physical techniques.

Salamba Shirshasana, often shortened to Shirshasana,, or Yoga Headstand is an inverted asana in modern yoga as exercise; it was described as both an asana and a mudra in classical hatha yoga.

Shavasana A relaxing reclining posture in hatha yoga

Shavasana, or Corpse Pose is an asana in hatha yoga and modern yoga as exercise, often used for relaxation at the end of a session.

Viparita Karani An inverted posture in hatha yoga

Viparita Karani or legs up the wall pose is considered either as an asana or a mudra in haṭha yoga. In modern yoga as exercise, it is commonly a fully supported pose using a wall and sometimes a pile of blankets.

Virasana A kneeling posture in modern yoga

Virasana or Hero Pose is a kneeling asana in modern yoga as exercise. Medieval hatha yoga texts describe a cross-legged meditation asana under the same name.

Simhasana A kneeling posture in hatha yoga

Simhasana or Lion Pose is an asana in hatha yoga and modern yoga as exercise.

Kukkutasana A hand-balancing posture in hatha yoga

Kukkutasana, Cockerel Pose, or Rooster Posture is an asana in hatha yoga and modern yoga as exercise.

Modern yoga consists of a range of techniques including asanas (postures) and meditation derived from some of the philosophies, teachings and practices of Hinduism, and organised into a wide variety of schools and denominations. It has been described by Elizabeth de Michelis as having four types, namely: Modern Psychosomatic Yoga, as in The Yoga Institute; Modern Denominational Yoga, as in Brahma Kumaris; Modern Postural Yoga, as in Iyengar Yoga; and Modern Meditational Yoga, as in early Transcendental Meditation. The yoga scholar Mark Singleton however does not subscribe to De Michelis's framework, considering the categories to "subsume detail, variation, and exception". In the 21st-century, modern yoga has become the subject of academic study.

The Joga Pradīpikā is a hatha yoga text by Ramanandi Jayatarama written in 1737 in a mixture of Hindi, Braj Bhasa, Khari Boli and forms close to Sanskrit. It presents 6 cleansing methods, 84 asanas, 24 mudras and 8 kumbhakas. The text is illustrated in an 1830 manuscript with 84 paintings of asanas, prepared about a hundred years after the text.

Gorakshasana A seated posture in hatha yoga

Gorakshāsana is a seated asana in hatha yoga. It has been used for meditation and in tantric practice.

Mark Singleton is a scholar of yoga and Senior Research Fellow at SOAS, University of London, where he works on the European Research Council-funded Hatha Yoga Project. He is the author of the widely-read study of modern postural yoga Yoga Body : the Origins of Modern Posture Practice (2010), based on his PhD thesis; it argued that certain posture-based forms of modern yoga represent, in large part, a radical break from haṭha yoga tradition, with different goals, and an unprecedented emphasis on āsanas. His 2017 book Roots of Yoga is an extensive collection of translations of yoga practice texts. He has written many academic articles and edited three collections of scholarship on yoga.

<i>Yoga Body</i>

Yoga Body : the Origins of Modern Posture Practice is a 2010 book on yoga as exercise by Mark Singleton. It is based on his PhD thesis, and argues that the yoga known worldwide is, in large part, a radical break from hatha yoga tradition, with different goals, and an unprecedented emphasis on asanas, many of them acquired in the 20th century. By the 19th century, asanas and their ascetic practitioners were despised, and the yoga that Vivekananda brought to the West in the 1890s was asana-free. Yet, from the 1920s, an asana-based yoga emerged, with an emphasis on its health benefits, and flowing sequences (vinyasas) adapted from the gymnastics of the physical culture movement. This was encouraged by Indian nationalism, with the desire to present an image of health and strength.

<i>Hatha Yoga: The Report of a Personal Experience</i>

Hatha Yoga: The Report of a Personal Experience is a 1943 book by Theos Casimir Bernard describing what he learnt of hatha yoga while in India. It is one of the first books in English to describe and illustrate a substantial number of yoga poses (asanas); it describes the yoga purifications (shatkarmas), yoga breathing (pranayama), yogic seals (mudras), and meditative union (samadhi) at a comparable level of detail.

Yoga for women

Modern yoga as exercise has often been taught by women to classes consisting mainly of women. This continued a tradition of gendered physical activity dating back to the early 20th century, with the Harmonic Gymnastics of Genevieve Stebbins in America and Mary Bagot Stack in Britain. One of the pioneers of modern yoga, Indra Devi, a pupil of Krishnamacharya, popularised yoga among American women using her celebrity Hollywood clients as a lever.

Science of yoga

The science of yoga is the scientific basis of modern yoga as exercise in human sciences such as anatomy, physiology, and psychology. Yoga's effects are to some extent shared with other forms of exercise, though it differs in the amount of stretching involved, and because of its frequent use of long holds and relaxation, in its ability to reduce stress. Yoga is here treated separately from meditation, which has effects of its own, though yoga and meditation are combined in some schools of yoga.

References

  1. ↑ Feuerstein, Georg (2006). "Yogic Meditation". In Jonathan Shear (ed.). The Experience of Meditation. St. Paul, Minnesota: Paragon House. p. 90. While not every branch or school of yoga includes meditation in its technical repertoire, most do.
  2. 1 2 Cramer, Holger; Lauche, Romy; Haller, Heidemarie; Dobos, Gustav (2013). "A Systematic Review and Meta-analysis of Yoga for Low Back Pain". The Clinical Journal of Pain. 29 (5): 450–460. doi:10.1097/AJP.0b013e31825e1492.
  3. 1 2 3 Pascoe, Michaela C.; Bauer, Isabelle E. (1 September 2015). "A systematic review of randomised control trials on the effects of yoga on stress measures and mood". Journal of Psychiatric Research. 68: 270–282. doi:10.1016/j.jpsychires.2015.07.013. PMID   26228429.
  4. 1 2 Nguyen-Feng, Viann N.; Clark, Cari J.; Butler, Mary E. (August 2019). "Yoga as an intervention for psychological symptoms following trauma: A systematic review and quantitative synthesis". Psychological Services. 16 (3): 513–523. doi:10.1037/ser0000191.
  5. 1 2 3 YJ Editors (13 November 2012). "What's Your Style? Explore the Types of Yoga". Yoga Journal.CS1 maint: Extra text: authors list (link)
  6. ↑ Bo, Forbes. "Yoga Therapy in Practice: Using Integrative Yoga Therapeutics in the Treatment of Comorbid Anxiety and Depression". International Journal of Yoga. 2008: 87.
  7. ↑ Singleton 2010, p. 4.
  8. 1 2 3 Beirne, Geraldine (10 January 2014). "Yoga: a beginner's guide to the different styles". The Guardian . Retrieved 1 February 2019.
  9. 1 2 Mallinson & Singleton 2017, p. 108.
  10. 1 2 3 4 Broad 2012, pp. 39 and whole book.
  11. ↑ Mallinson & Singleton 2017, pp. 108–111.
  12. ↑ Mallinson & Singleton 2017, pp. 359–361.
  13. ↑ Mallinson & Singleton 2017, pp. 385–387.
  14. 1 2 3 4 Jain 2015, pp. 82–83.
  15. ↑ Gourley, Bernie (1 June 2014). "Book Review: Light on Yoga by BKS Iyengar". The !n(tro)verted yogi. Retrieved 20 November 2018.
  16. 1 2 Iyengar 1979, p. 302, and whole book.
  17. 1 2 Krisanaprakornkit, T.; Ngamjarus, C.; Witoonchart, C.; Piyavhatkul, N. (2010). "Meditation therapies for attention-deficit/hyperactivity disorder (ADHD)". Cochrane Database of Systematic Reviews (6): CD006507. doi:10.1002/14651858.CD006507.pub2. PMID   20556767.
  18. 1 2 Uebelacker, L. A.; Epstein-Lubow, G.; Gaudiano, B. A.; Tremont, G.; Battle, C. L.; Miller, I. W. (2010). "Hatha yoga for depression: critical review of the evidence for efficacy, plausible mechanisms of action, and directions for future research". Journal of Psychiatric Practice. 16 (1): 22–33. doi:10.1097/01.pra.0000367775.88388.96. PMID   20098228.
  19. 1 2 Riley, Kristen E.; Park, Crystal L. (2015). "How does yoga reduce stress? A systematic review of mechanisms of change and guide to future inquiry". Health Psychology Review. 9 (3): 379–396. doi:10.1080/17437199.2014.981778.
  20. ↑ Hayes, M.; Chase, S. (March 2010). "Prescribing Yoga". Primary Care. 37 (1): 31–47. doi:10.1016/j.pop.2009.09.009. PMID   20188996.
  21. ↑ Cramer, Holger; Lauche, Romy; Langhorst, Jost; Dobos, Gustav (2013). "Yoga for Depression: A Systematic Review and Meta-Analysis". Depression and Anxiety. 30 (11): 1068–1083. doi:10.1002/da.22166.
  22. ↑ Jackson, Kate. "Trauma-Sensitive Yoga". Social Work Today.
  23. ↑ Nolan, Caitlin R. (2016). "Bending without breaking: A narrative review of trauma-sensitive yoga for women with PTSD". Complementary Therapies in Clinical Practice. 24: 32–40. doi:10.1016/j.ctcp.2016.05.006.
  24. ↑ Cramer, H.; Lauche, R.; Langhorst, J.; Dobos, G. (November 2013). "Yoga for rheumatic diseases: a systematic review". Rheumatology (Oxford). 52 (11): 2025–30. doi:10.1093/rheumatology/ket264. PMID   23934220.CS1 maint: Uses authors parameter (link)
  25. ↑ Panebianco, Mariangela; Sridharan, Kalpana; Ramaratnam, Sridharan (2 May 2015). "Yoga for epilepsy". The Cochrane Database of Systematic Reviews (5): CD001524. doi:10.1002/14651858.CD001524.pub2. PMID   25934967.
  26. ↑ Lee, M. S.; Kim, J. I.; Ha, J. Y.; Boddy, K.; Ernst, E. (2009). "Yoga for menopausal symptoms: a systematic review". Menopause . 16 (3): 602–608. doi:10.1097/gme.0b013e31818ffe39. PMID   19169169.
  27. ↑ "Yoga". American Cancer Society. 1 November 2008. Retrieved 1 April 2014.
  28. ↑ Forbes, Dorothy; Forbes, Scott C.; Blake, Catherine M.; Thiessen, Emily J.; Forbes, Sean (15 April 2015). "Exercise programs for people with dementia". The Cochrane Database of Systematic Reviews (4): CD006489. doi:10.1002/14651858.CD006489.pub4. PMID   25874613.
  29. ↑ Wieland, L. Susan; Shrestha, Nipun; Lassi, Zohra S.; Panda, Sougata; Chiaramonte, Delia; Skoetz, Nicole (2019). "Yoga for treating urinary incontinence in women". The Cochrane Database of Systematic Reviews. 2: CD012668. doi:10.1002/14651858.CD012668.pub2. PMC   6394377 . PMID   30816997.
  30. ↑ Cramer, H.; Krucoff, C.; Dobos, G. (2013). "Adverse events associated with yoga: a systematic review of published case reports and case series". PLoS ONE. 8 (10): e75515. doi:10.1371/journal.pone.0075515. PMC   3797727 . PMID   24146758.CS1 maint: Uses authors parameter (link)
  31. ↑ Penman, S.; Cohen, M.; Stevens, P.; Jackson, S. (July 2012). "Yoga in Australia: Results of a national survey". International Journal of Yoga. 5 (2): 92–101. doi:10.4103/0973-6131.98217. PMC   3410203 . PMID   22869991.CS1 maint: Uses authors parameter (link)
  32. ↑ Caso, V.; Paciaroni, M.; Bogousslavsky, J. (2005). "Environmental factors and cervical artery dissection". Frontiers of Neurology and Neuroscience. 20: 44–53. doi:10.1159/000088134. PMID   17290110.CS1 maint: Uses authors parameter (link)

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