1. Explain what is yoga.
2. Discuss the benefits of practicing Yoga (at least 3).
3. Have you ever practiced yoga?
4. Discuss your experience?
The answer should be based on the knowledge obtained from the attached called ” YOGA” added to the post Question in word (attached from the Book and online literature/references included.) not just your opinion.
· There are 4 questions in the discussion, you must answer all of them completely
· APA Format Time New Roman 12 font. strictly enforced.
· I am expecting a minimum of 400 words.
Book. “Complementary and Alternative Therapies for Nursing Practice (4th Edition). Author: Karen Lee Fontaine RN MSN- Edition: 4
Approved Online Resources: NOT OLDER THAN 5 years.
· American Yoga Association www.americanyogaassociation.org.
· The Canadian Yoga Institute www.yogacanada.org
· Center for Mindfulness in Medicine, Health Care, and Society
· National Center for Complementary and Alternative Medicine. Yoga for health.
References are used in addition to the book must have:
· Serial/journal articles
· Volume number, in italics.
· Issue number. This is bracketed immediately after the volume number but not italicized.
· Month, season or other designation of publication if there is no volume or issue number.
· Include all page numbers. Ex: 7(1),24 Sergiev, P. V., Dontsova, O. A., & Berezkin, G. V. (2015).
Yoga, part of Ayurvedic medicine, has been practiced for thousands of years in India, where it is a way of life that includes ethical models for behavior and mental and physical exercises aimed at producing spiritual enlightenment. Although yoga developed from Hinduism, it is not a religion but rather a journey of the body, mind, and spirit on a path toward unity. It is a method for life that can complement and enhance any system of religion, or it can be practiced completely apart from religion. The Western approach to yoga tends to be more fitness
oriented, whereas the Eastern approach to yoga is to prepare people for the experience of self-realization. Most Westerners begin yoga with the goal of managing their stress, learning to relax, and increasing their vitality and well-being. After learning yoga, many become more interested in the underlying principles of physical fitness and keeping the mind focused, calm, and clear. Yoga is meant to prepare the body and mind for a useful, dedicated life.
The word yoga means to direct and concentrate one’s attention and comes from the Sanskrit word yuj, meaning “to yoke” or “to join.” Yoga was first described by Patanjali, an Indian sage who, thousands of years ago, wrote the Yoga Sutra, which recorded information that had been passed down orally for many years. This text has helped define and shape the modern practice of yoga. Yoga first came to the United States in the 1890s, when Swami Vivekananda became a popular teacher and guide. In the 1960s, the Maharishi Mahesh Yogi, the developer of Transcendental Meditation, became a popular figure for the U.S. “hippie generation,” and interest in it has continued to grow since then (Smith, Hall, & Gibbs, 2013). The various methods of yoga all have the same goal: to attain a state of pure bliss and oneness with the universe. Raja yoga emphasizes control of the intellect to attain enlightenment, accomplished through meditation, concentra- tion, and breath control. Kriya yoga is the practice of quieting the mind through scriptural study, breath control, mantras, and meditation. Karma yoga focuses on service to all beings as the path to enlightenment. Bhakti yoga emphasizes devotion to the divine. Inana yoga’s goal is wisdom and the direct knowledge of the divine. Tantra yoga involves the study of sacred writings and rituals. Mantra yoga is the study of sacred sounds. Kundalini yoga is the study of energy movement along the spine. Iyengar yoga, a form of hatha yoga, strives for perfec- tion in the postures using props such as belts or ropes. Silver yoga and chair yoga are designed to accommodate those with reduced body flexibility such as older people or those with physical challenges. Restorative yoga is usually done in a lying or sitting position, which causes less physical strain. Props such as blan- kets, pillows, towels, balls, or straps support the poses and provide a gentle prolonged stretch. When combined with physical therapy the benefits are improved strength, flexibility, and range of motion for individuals recovering from illness or injury or for those experiencing physical or emotional stress (Ramacharaka, 2012; Smith et al., 2013). Although these many branches of yoga exist, this chapter focuses on hatha yoga as the form of yoga most frequently practiced by Westerners. In this particular type of yoga, the path to enlightenment is through control over the physical body as the key to control of the mind and freedom of the spirit. Physical exercises, breath control, and meditation tone and strengthen the whole person—body, mind, and spirit.
Yoga also has an inner dimension that emphasizes its key purpose. Detachment, concentration, and meditation together form a single process toward the development of pure consciousness (Smith et al., 2013). Box 16.1 lists the eight limbs of yoga.
BOX 16.1 The Eight Limbs of Yoga: Guidelines for Living
1. Abstinences (yamas) Nonviolence (ahimsa) Truthfulness (satya) Nonstealing (asteya) Chastity or nonlust (brahmacharya) Nongreed (aparigraha)
2. Personal Disciplines (niyamas) Purity (shauca) Contentment ( samtosa) Self-discipline (tapas) Self-study (svadhyaya) Centering on the divine (ishvara-pranidhana)
3. Body Control (asanas)
4. Breath Control (pranayama)
5. Detachment (pratyahara)
6. Concentration (dharana)
7. Meditation (dhyana)
8. Pure Consciousness (samadhi) right living (abstinence and personal discipline), right care of the body (body control), and enhancement of vital energy (breath control).
Abstinences concern what not to do in life. The first abstinence pertains to nonviolence. Nonviolence means not only not physically hurting others but also having nonviolent words and nonviolent thoughts. Truthfulness, the second abstinence, results in personal integrity and strength of character. Non- stealing, the third abstinence, includes not stealing others’ material belongings as well as not taking credit for things one has not done, not stealing the center of attention, and so forth. The fourth abstinence, chastity or nonlust, means holding people in high esteem and loving and respecting others. The fifth abstinence is nongreed, which means living simply and viewing possessions as tools to use in life. Nongreed leads to the avoidance of jealousy and envy (Gupta & Fox, 2012).
Personal disciplines concern what to do in life. Purity, the first discipline, is achieved through the practice of the five abstinences. The abstinences clear away negative ways of being, leading one straight to purity. Purity also relates to cleanliness and respect for all life. Contentment, the second discipline, means finding happiness with who one is and with what one has. The third discipline, self-discipline, means being able to make a commitment and adhere to it. The fourth discipline, self-study, means studying oneself through introspection. Centering on the divine, the fifth discipline involves devotion. These disciplines work with any religion because individuals are encouraged to focus on how the divine is in them, part of them, and all around them (Gupta & Fox, 2012).
Body control, an important part of hatha yoga, is attained through a number of poses or asanas. These body positions are what most Western people think of when they hear the word yoga (see Figure 16.1). These poses help people learn to control their bodies, making them stronger, more flexible, better functioning, and more resistant to disease and other problems. Poses are also meant to facilitate meditation. The poses are frequently classified into the following groups: standing poses, inverted poses, twists, backward-bending poses, forward bends, and poses for restoration. Another way of classifying poses is according to balance, strength, flexibility, and relaxation. The belief in nonviolence also applies to the poses, which means that physical exercise is never done to the point of pain because pain is indicative of doing violence to the body (Lysycia, 2013.)
Breath control teaches people to direct energy or prana for optimal physical and mental benefit. When air is inhaled, so is vital energy that flows into the body to nourish and enliven. The purpose of balancing the breath is to make respiratory rhythm more regular, which in turn has a soothing effect on the entire nervous system. It is the best antecedent to meditation because it focuses attention inward and reduces scattered thinking (Babooa, 2012).
The practice of detachment is related to the senses. It is the withdrawal of the senses from everything that stimulates them. The goal of detachment is to gain mastery over external influences. This detachment can occur during breathing exercises, during meditation, and while doing the poses. The process of detachment can also be an effective technique for pain control (Babooa, 2012).
Teaching the mind to focus on one thing instead of many is the goal of concentration. Concentration means sustaining attention while quieting the mind and relaxing the breathing. Frequently, people focus on one object such as a candle flame, the figure of a circle, or a single sound. The purpose is to learn to push away many thoughts that usually float around in one’s mind. Concentration works directly on the body, allowing each yoga pose to accomplish the maximum possible benefit (Kabat-Zinn, 2011).
Breath control, detachment, and concentration lead to the state of meditation. Meditation occurs when people become absorbed into the object on which they are concentrating. At this point, nothing else exists. It is through the process of meditation that individuals are able to clear their minds of clutter and thus think more quickly and see things more clearly in daily life (Kabat-Zinn, 2011). Meditation is covered as a separate topic in Chapter 17.
The other seven limbs of yoga lead to pure consciousness, which means a total merging with the object of meditation and thus becoming one with the universe. Generally speaking, pure consciousness is “mind without thought.” Many religions throughout history include pure consciousness as part of their tradition. Christianity refers to it as “pure love,” and Judaism, as the “divine nothingness” or “the naught.” It is more than a mental or emotional experience. Physically, breathing slows drastically, the heart rate drops, and EEGs demonstrate unique patterns unlike those in any of the other three common states of consciousness—waking, sleeping, and dreaming. Pure consciousness is an ideal state, a state of pure bliss that is elusive for most people. A few rare and diligent yogis have been able to maintain this state for extended periods of time. Most others get occasional glimpses of it while meditating (Kabat-Zinn, 201
VIEW OF HEALTH AND ILLNESS
In yoga, health is related to the five sheaths of existence. The first sheath is the physical body; the second is the vital body, life force, or prana; the third sheath is the mind, including thoughts and emotions; the fourth sheath is the higher intellect; and the fifth sheath is bliss, filled with positive energy and inner peace. It is believed that imbalances in any of these sheaths can result in illness. For example, intense anger, a disturbance in the third sheath, disrupts one’s breathing pattern, which leads to an imbalance in prana or life force. The disrupted breathing allows the invasion of a virus, leading to a disruption in the first sheath, manifesting as a cold. Living one’s life in moderation is thought to keep all five sheaths in balance, which contributes to health and well-being (Smith et al., 2013). Yogic thought places food or ahara on three levels. The first is the physical food that nourishes the body. The second is impressions or the sensations of sound, touch, sight, taste, and smell that nourish the mind. The third level is associations or the people who nourish the soul. Health and well-being are withdrawal from wrong food, wrong impressions, and wrong associations while simultaneously opening up to the right food, right impressions, and right associations. Just as a healthy body resists tox- ins and pathogens, a healthy mind resists the negative influences around it (Smith et al., 2013).
The yogic perspective of health and illness is related to internal and external balance. Although it is recognized that viruses, bacteria, genetics, and accidents can cause illness, disorders can also be brought on by:
· insufficient prana, or life force.
· blocked prana.
· inappropriate diet.
· lack of cleanliness.
· pessimism and negativity.
Healthy habits, maintenance of the body, peacefulness of mind, and calmness of spirit protect people from ill health. Yoga is a great preventive medicine. It helps the body cleanse itself of toxins by removing obstacles to the proper flow of the lymphatic system. Lymph is pumped through the body by movement—musculoskeletal movement, respiratory movement,
circulatory movement, gastrointestinal movement, and so forth, all of which are part of yoga. Yoga also increases the flow of vital energy throughout the body by opening up and increasing the flexibility of body joints, considered to be minor chakras. Yoga poses and breathing techniques allow energy and lymph to flow freely throughout the entire body, resulting in a body that works better, feels better, and fights disease more effectively. Health, from a yogic perspective, can be described as the body easeful, the mind peaceful, and the life useful (Gupta & Fox, 2012).
Individuals can do as much or as little yoga as they wish. Some start with all three practices—poses, breath control, and meditation. Others start with the poses and may or may not develop interest in breathing and meditation. As practiced in the United States, a typical yoga session lasts 20 minutes to an hour. Some spend 30 minutes doing poses and another 30 minutes doing breathing practices and meditation. Others spend the majority of the time doing poses and end with a short meditation or relaxation procedure. Some people practice one to three times a week in a class, while others practice daily at home. Yoga should not be done within 1 to 2 hours after a heavy meal for sake of abdominal comfort when doing the poses. Caffeine and other
stimulants should be avoided because they may interfere with the goal of relaxation.
Yoga should never be done under the influence of alcohol or recreational drugs because they may decrease concentration, coordination, and strength, thus increasing the risk of physical injury. Yoga is best done in comfortable, loose clothing using a nonslippery surface such as a rug, mat, or blanket. Because it is important that the process have one’s full attention, the room should be void of all extraneous noise, even soft background music.
Yoga is tailored to the individual and can be done with great benefit at the beginner level as well as at the most advanced level. Participants must remember that yoga is not a competitive sport, and thus a person’s level does not matter. If people are stiff and out of shape, sick, or weak, sets of easy exercises help loosen the joints and stimulate circulation. If practiced regularly, these simple exercises alone make a great difference in people’s health and well-being.
Poses can be slow and careful or more vigorous. Beginning poses are used to relax tension in the muscles and joints and center the mind. Attention is paid to how the body feels and what it is doing. Every movement is made gently and slowly. Strain or force is to be avoided because yoga is a nonviolent approach that is done comfortably. Strength training is isometric because the muscles are tensed in opposition to each other. After assuming a pose, one holds it for as long as can be done comfortably, usually about six breaths. Each pose in a well-structured workout includes a pose and its opposite, such as a forward bend and a backward bend, so the body stays physically balanced. Breathing should be easy, fluid, and continuous and used to facilitate the poses (Lysycia, 2013).
Every yoga session should end with a few minutes of complete and total relaxation. This period is an important part of bringing the mind and body together to maximize the benefits. Some people end the session with chanting to reach a deeper state of relaxation. The instructor ends the session with the word namaste: “The divine in me bows to the divine in you.” Yoga offers a number of health benefits.
The physical and psychological benefits include the following:
· Increases flexibility of muscles and joints
· Improves range of motion
· Tones and strengthens muscles
· Improves endurance
· Increases circulation
· Lowers blood pressure
· Increases lymph circulation
· Improves digestion and elimination
· Promotes deeper breathing
· Increases brain endorphins, enkephalins, and serotonin
· Increases mental acuity
· Augments alpha and theta brain wave activity
· Promotes relaxation
· Manages stress (Li & Goldsmith, 2012; National Center for Complementary and Alternative Medicine [NCCAM], 2013.
Yoga is not a cure-all for disease. It can help, however, to relieve symptoms, decrease pain, and improve the quality of life. It helps prevent disease by reinforcing lifestyle changes such as positive health habits and attitudes. Overall, yoga is safe. If individuals have a weak link—whether it is the lower back, knees, or shoulders, they are at higher risk of injury and need to be more careful when doing yoga. The two main causes of yoga-related injuries are unqualified teachers and overzealous students. Poorly trained instructors teach improper form. Overzealous students see yoga as a competition and push themselves beyond their physical limits.
The National Institutes of Health (NIH) has three current clinical trials in progress: evaluation of yoga for sleep disturbances in posttraumatic stress disorder (PTSD, efficacy of yoga for treatment-resistant PTSD, and development of a translational tool to study yoga therapy. The Joanna Briggs Institute has published two evidence summaries regarding yoga:
The evidence summary for yoga as a treatment for people with epilepsy found no clear research results. Thus, the recommendation for the use of yoga in the treatment of people with epilepsy should be based on clinical judgment (Rathnayake, 2011a).
• The evidence summary for yoga as one type of exercise for older adults who suffer from sleep problems found that yoga is recommended to improve the sleep status of older adults (Rathnayake, 2011b).
The following is a small selection of current reported research:
• A systematic review of yoga for musculoskeletal disorders found that yoga was equal to or superior to exercise or usual care in decreasing pain and decreasing pain medication use. More studies with larger samples and precise descriptions of the yoga intervention are needed for more vigorous evidence (McCaffrey & Park, 2012).
• Eighty-four pregnant women living with depression were randomly assigned to yoga, massage therapy, or standard prenatal care control groups. Both therapy groups had a greater improvement in depression, anxiety, and somatic symptoms compared with the control group. The yoga and massage therapy groups also had longer gestational ages and higher birth weights than the control group (Field, Diego, Hernandez- Reif, et al., 2012).
• Ninety-two pregnant women living with depression were randomly assigned at 22 weeks’ gestation to yoga or to a social support control group. The yoga group reported a more rapid improvement in depression, anxiety, and somatic symptoms, but at the end of the treatment period both groups demonstrated the same degree of improvement (Field, Diego, Delgado, & Medina, 2012).
• A randomized controlled single-blind study of 80 people with chronic low back pain found that those in a yoga program as opposed to those in a physical therapy control group had significantly better improvement in pain, anxiety, depression, and spinal mobility (Tekur, Nagarathna, Chametcha, Hankey, & Nagendra, 2012).
• Thirty people with simple fractures were randomly assigned to a yoga group or to a control group. Twenty-one days post fracture, the yoga group had significant improvement in pain reduction and tenderness and a significant increase in fracture line density compared with the control group (Oswal, Nagarathna, Ebnezar, & Nagendra, 2011).
INTEGRATED NURSING PRACTICE
The regular practice of yoga builds and tones muscles, increases flexibility, improves endurance, and promotes a state of relaxation. The physiologic responses are the opposite of the fight-or-flight stress response. Stretching and deep breathing bring on a profound sense of relaxation. Gentle stretching and range-of-motion joint exercises decrease muscle tension and joint stiffness. The mindful focus on awareness of self, breath, and energy minimizes anxiety associated with stress. Just getting the body down
on the floor tends to clear the mind, perhaps because being on the floor is so unusual that it changes people’s attitudes toward and awareness of the body (Kabat-Zinn, 2011).
Hatha yoga is designed by and for healthy, flexible people. Even when experiencing a serious illness, however, most people can work on breath control even if they do not feel up to doing the poses. The breathing exercises and relaxation response nourish the body, quiet the mind, and contribute to a more balanced state. Individuals should be encouraged to check with their primary care practitioner if they have recently had surgery, have a debilitating physical handicap, or have cancer, diabetes, epilepsy, heart disease, high blood pressure, HIV, multiple sclerosis, or any other serious condition. Yoga, combined with a low-fat diet and moderate aerobic exercise, can significantly reduce blockages in coronary arteries (Ornish, 2008). Other studies have shown yoga to be effective in treating arthritis, diabetes, mood disorders, asthma, hypertension, menstrual cramps, back pain, and chronic fatigue.
Yoga can benefit people of any age, from children to older adults. Chil- dren take naturally to yoga and usually find it to be much fun. Getting the whole family involved is one way to maintain the routine. Some adults find yoga complements their aerobic routine, while others engage in yoga as a great nonaerobic conditioner. It is possible to learn yoga from books or com- pact disks (see the Resources section at the end of this chapter), but it is easier to learn from a teacher. Yoga classes are available in many places, such as health clubs, community centers, universities, and hospitals.
As a nurse, you can encourage people to utilize yoga as a way to start on the path of taking responsibility for their well-being. Consistent practice of yoga changes people’s attitudes about their body and their beliefs about what they can do to take care of themselves, both of which are crucial to well-being. For some, the physical exercise may be a way to attain a specific goal such as improving flexibility, improving muscle tone, or losing weight. Others have no specific goal other than the exercise itself and becoming aware of their self, breath, and energy. The relaxation that accompanies yoga can stimulate self- healing and contribute to a sense of inner peace.
Almost anyone can be taught the Mountain Pose, which is a standing position of postural awareness. When this pose is practiced well, the body is prepared for almost all daily movement: standing, sitting, walking, and run- ning. Like the mountain poised between heaven and earth, this pose estab- lishes grounding through the legs and feet and encourages the lift of the spine. Instruct people to stand sideways near a full-length mirror so they can check their alignment, which may feel strange at first (see Figure 16.2). Once people are in alignment, they should notice their physical sensations. Is weight bal- anced evenly between the feet? Are the legs firm but not tight? Are shoulders relaxed? Does the spinal cord feel light and the head feel balanced on the torso? Is breathing comfortable and easy? Encourage people to practice the Mountain Pose several times a day. Standing well reduces strain on the joints, ligaments, and muscles, especially those of the spinal column and lower extremities. It also aids respiration, digestion, and elimination. The Mountain Pose conveys a sense of poise and self-esteem.
Benefits from any fitness program, including yoga, can occur only with continued practice. Try some of these suggestions to help people develop a regular pattern:
• Encourage clients to make time for yoga practice every day, to give themselves permission to take care of themselves and take time to relax. They may find that doing a few poses before bedtime or early in the morning works best. Even if they practice for only 5 minutes, a daily practice is the foundation on which to build.
• To maintain their practice, many people find it helpful to go to a yoga class at least once a week. The support of practicing with others and the information they get from teachers help strengthen their commitment to yoga.
• Suggest that they create a dedicated yoga space. They may have to temporarily push things aside to have enough space for their practice. Or they may simply choose a place to spread their yoga mat on the floor. Having a regular space for practice helps people focus on the poses without being distracted by their surroundings.
• Have people start with the poses they like. If they like a pose, they will do it even if it is difficult. You may suggest that they take one pose they like from each class and practice it at least once a day, which takes only a few moments. They can then gradually begin to combine the poses to form their own yoga session.
One of the many applications of yoga is in pregnancy and childbirth. In fact, many of the techniques taught in childbirth classes, such as focus, relaxation, and systematic breathing, have their roots in yoga. The gentle stretching of the poses helps ease the muscle aches of pregnancy and strengthens the muscles that will be used during delivery. The breathing techniques may lessen the shortness of breath that often accompanies advanced pregnancy.
Yoga practiced while pregnant is slightly different from regular yoga in that some poses are contraindicated. These poses are the extreme stretching positions and any position that puts pressure on the uterus. Full forward bends will probably be uncomfortable for both woman and baby. Because her center of balance has shifted completely, she must be careful with balance poses. A pregnant woman should never lie on the stomach for any pose. After the 20th week, she should lie on her left side rather than her back. If any pose feels uncomfortable, the woman should stop at once. If a pregnant woman experiences dizziness, sudden swelling, extreme shortness of breath, or vaginal bleeding, she should see her midwife or doctor immediately (Lee & Attwood, 2013).
With midwife or doctor approval, most women can usually start gentle yoga poses 2 weeks after delivery or a few weeks later if they have had a cesarean section. They should start with a few poses and gradually work back to their regular routine. If their postpartum bleeding gets heavier or brighter red, they must stop and call their midwife or doctor. Filling their body with energy through breathing exercises may promote self-healing after childbirth.
As people learn yoga, they will find that each sequence of poses helps them focus on something specific; for example, one sequence can improve
balance, while another may release anger and negative feelings; some sequences will tone internal organs, increase lung capacity, or build upper-body strength. People choose the sequences that are right for them. It is most important to remind people that it is not a matter of being a beginning, intermediate, or advanced student but rather that they keep practicing, doing as much as they can whenever they can. Yoga moves at their pace; in the time they have.
· Sit comfortably and close your eyes.
· Simply notice your breathing without trying to change it. Pay attention to your in- breath and your out-breath.
· Now imagine that the breath is pouring into your heart with each inhalation and flowing out of your heart with each exhalation. Just feel the breath flowing in and out of your heart. Imagine the breath is pure love.
· Do this breath awareness for 5 to 10 minutes.
· Now let your attention return to your environment, slowly open your eyes, get up, and move on.
· Think about the feeling throughout the day.