Category Archives: Research

From EmaxHealth

Patients with metastatic breast cancer might benefit from the practice of yoga, according to a new study presented at the 34th Annual San Antonio Breast Cancer Symposium (San Antonio, TX; December 6-10, 2011. A small randomized trial was collaboratively conducted by yogis and physicians, including S.K. Gopinath, MD, from the Department of Surgical, Medical and Radiation Oncology at the HCG-BIO Super Specialty Center in Bangalore, Karnataka, India. The researchers found that yoga might reduce psychological distress and modulate abnormal cortisol levels as well as immune responses in patients with metastatic breast cancer.

The randomized study was comprised of 45 women who underwent a daily yoga intervention and 46 who received standard supportive counseling. The subjects, with an average age of 50.5 years, were assessed at baseline and three months after the intervention.

The researchers found that the yoga intervention was markedly effective in improving psychosocial states. Following the study period, a statistically significant decrease was found in in anxiety, depression, perceived stress, fatigue severity, and fatigue interference in the yoga group, compared with the control group. Furthermore, the yoga group had a significant improvement in emotional function, role function, cognitive function, and global quality of life.

The investigators also evaluated biologic measures. At the beginning and the end of the intervention, daily saliva samples were collected at 9:00 a.m. and 10:00 p.m., and enzyme immune assay kits (Salimetrics) were used to evaluate cortisol levels. In addition, blood samples were collected for three consecutive days between 8:00 a.m. and 10:00 a.m. in order to enumerate the number of natural killer cells with flow cytometry. (Cytometry is a procedure that counts and examines microscopic particles, such as cells and chromosomes, by suspending them in a stream of fluid and passing them by an electronic detection apparatus.) Yoga was found to be of value in reducing cortisol levels.

A significant difference was found in the early morning (6:00 a.m.) cortisol levels. This finding means that cortisol, which is a measure of stress and naturally decreases when the body is at rest, was successfully modulated in the yoga group. Research has shown that patients with metastatic breast cancer whose diurnal (twice-daily) cortisol rhythms were flattened or abnormal have earlier mortality.

After the intervention, a significant increase in the percentage of natural killer cells was found in the yoga group, compared with the control group. Previous research has demonstrated that natural killer cells, which are naturally occurring cytotoxins (cell-killers), play a therapeutic role in the treatment of human cancers.

The study authors concluded that, in view of the foregoing laboratory values, yoga might improve overall quality of life in patients with metastatic breast cancer.

Psychosocial factors are much more difficult to quantify, compared to laboratory values such as cortisol levels. In order to define psychosocial outcomes, the researchers used a variety of common instruments to measure them: mood states (a hospital anxiety and depression scale), sleep quality (the Pittsburgh Insomnia Rating Scale), quality of life (the EORTC Core Quality of Life Questionnaire for breast cancer [QLQ-C30]), and perceived stress (a perceived stress scale). Data were analyzed using both parametric (analysis of covariance, with a respective baseline measure as a covariate) and nonparametric (the Mann–Whitney U test) tests to evaluate the effects of intervention on the outcome measures. In addition, data for salivary cortisol were log transformed, and area under the curve and cortisol slope were computed using a linear mixed-effects model.

The researcher noted that the cancer patients were most likely under great duress. They wrote: “Metastatic breast cancer patients experience tremendous psychological distress due to treatment, disease, and uncertainty of their survival.”

From The New York Times

By TARA PARKER-POPE

The news that the presidential candidate Michele Bachmann suffers from severe migraines has touched off a national discussion about a surprisingly common disorder that is little understood and often undertreated.

Migraine patients are coming forward with their stories. And while each one is different, they have two common threads: suffering and trying to cope.

For some, a migraine represents throbbing head pain and nausea so severe they retreat to a darkened room for a day or more. For others, it’s about a scary moment, driving on the highway when a migraine-induced aura or vision change forces them to pull over.

“Imagine someone having driven a nail straight through your head,” said Craig Partridge, 50, chief scientist for a high-tech research company in East Lansing, Mich., who began having migraines in his late teens. “And then they periodically tap on it to remind you it’s there. It’s that painful.”

More than 10 percent of adults and children suffer from migraine — which is three times as common in women and girls as in men and boys — and the Migraine Research Foundation reports that nearly a quarter of households are affected. The World Health Organization ranks migraine among the top 20 most debilitating health conditions; more than 90 percent of sufferers are unable to work or function normally during an attack, which can last for hours or even days.

Some migraine sufferers say the attacks are so debilitating they couldn’t imagine taking on a job with significant responsibility. But others note that years of experience and new drug treatments have helped them find ways to cope. Some say the condition forced them to take better care of themselves and adopt healthful behaviors, like getting enough sleep and learning to manage stress.

Mr. Partridge has learned to avoid caffeine and bright lights, and is vigilant about wearing sunglasses in strong sunlight. Years of taking ibuprofen to treat headaches led to an ulcer. Eventually, he learned that a magnesium supplement reduced the frequency of his headaches, and now he gets only about three a year.

“As far as I can tell, everyone is a little different,” he said. “Some people have auras, but I never had auras. I get tunnel vision. My tongue starts to get heavy and I have trouble talking.”

Kat Smith, a 47-year-old mother of three in Bryn Mawr, Pa., remembers her teenage brother suffering terribly from migraines, but she never experienced them until a bike accident in her 20s. Then, after the birth of her son, she had migraines “regularly and fiercely” about 12 times a month. She discovered that small amounts of alcohol and vigorous physical activity acted as a trigger.

“I was a fairly carefree person, but I became rigid, very disciplined with myself,” she said. “It seemed I had to eliminate things that other people associated with joy. I had to reconstruct my life as a person of migraine after accepting that these weren’t going to go away.”

She adapted, giving up ice hockey and aerobics and switching to yoga. But sometimes she pushes her limits. This weekend she took part in a vigorous dance class and was punished with a migraine.

“I’ll do something incredibly vigorous and physical, and it will feel so good,” she said. “That night I will get a massive migraine.”

For many patients, including Ms. Smith, a class of migraine drugs called triptans have been a godsend, helping to cut short the pain. Triptans work by causing blood vessels in the brain to constrict and change blood flow, and can often stop a migraine completely or reduce its severity if taken in the early minutes of an attack.

Other patients take daily treatments to prevent migraine from setting in. Barbara Thompson, a 59-year-old communications specialist in Manhattan, uses Topamax, a seizure drug that has been shown to prevent migraine. An attack sometimes “breaks through” despite the daily dose, and on those days she uses a triptan drug.

“Often I get them when I’m at work,” she said. “I find that I get more quiet, and I have to focus more intently on what I’m doing. It’s a more internal day — I don’t have a better way of putting it.”

In a video that went viral, the television reporter Serene Branson babbled gibberish last winter during a live report from the Grammy Awards. At first, it seemed as if she were having a stroke on live television, but her doctor later concluded that a complex migraine had rendered her unable to form words.

Some migraine sufferers, including Ms. Bachmann, experience pain so severe they go the emergency room. But a recent review of emergency room doctors in Ontario found that patients were rarely treated with the proper drugs for migraine, according to a report last month in the journal Pain Research & Management.

The data suggests that more education is needed.

“If it’s not well controlled with the right combination of preventative or acute therapy, it can be very disabling,” said Dr. Satnam Nijjar, the study’s lead author and an assistant professor of neurology at the Johns Hopkins Headache Center. “It’s probably the most common cause for time missed from work in the U.S.”

Robert Dalton, executive director of the National Headache Foundation in Chicago, says that while migraines can be impairing, the larger problem is that many sufferers aren’t getting proper medical care.

“What we want to make sure people understand,” he said, “is that it’s a debilitating disease when it’s not managed properly.”

From The New York Times
By PAM BELLUCK
Is there a way to prevent Alzheimer’s disease? Last week, a study presented at the Alzheimer’s Association International Conference in Paris suggested there might be, something that would give hope to millions who worry that one day they may be struggling with dementia.

The new study, by researchers at the University of California, San Francisco, estimated how many Alzheimer’s cases might be attributable to certain behaviors or conditions: physical inactivity, smoking, depression, low education, hypertension, obesity and diabetes.

The authors used a mathematical model to surmise that these behaviors and conditions, all of which can be modified, are responsible for about half of the roughly 5.3 million Alzheimer’s cases in the United States and 34 million cases worldwide.

And they calculated that if people addressed these risks — by exercising, quitting smoking, increasing their education or losing weight, for example — a significant number of Alzheimer’s cases could be prevented. Reducing the prevalence of these risk factors by 10 percent, the researchers estimated, could prevent 1.1 million cases worldwide; reducing these risk factors by 25 percent could prevent more than three million cases.

The operative word was “could.” As the researchers pointed out, there is not yet scientific proof that any of these risk factors in fact cause Alzheimer’s. Only if they are shown to do so could the new analysis be considered a practical recipe for preventing the disease.

“These things are not definitive,” said one author, Dr. Kristine Yaffe, a professor of psychiatry, neurology and epidemiology. “We’re assuming that these are sort of causally related to the risk of dementia and Alzheimer’s, but unless you have a great trial, you just don’t know.”

But while experts may have understood that distinction, not everyone else did. Some headlines made things sound more certain: “7 Things You Can Do to Fight Alzheimer’s” or “7 Steps to Prevent Alzheimer’s.”

In an editorial accompanying the study, both published in the journal Lancet Neurology, Dr. Laura Fratiglioni, director of the Aging Research Center at the Karolinska Institute in Sweden, suggested that the report was valuable, but said that the estimates “could be regarded as only theoretical” until more rigorous research is done.

“We have been able to identify some possible preventive factors,” Dr. Fratiglioni said, “but we do not have the final answer because we do not have the experimental studies.”

Indeed, research on prevention of Alzheimer’s is in its infancy. It has only been since the 1980s that dementia has not been considered a symptom of normal aging. And studies on preventing Alzheimer’s can be complicated and costly, especially the randomized controlled trials that provide the strongest evidence. Such trials have to follow people for years, and isolating individual risk factors — separating obesity from hypertension, diabetes, nutrition and physical inactivity, for instance — is challenging.

Last year, a National Institutes of Health panel of experts with no vested interest in Alzheimer’s research concluded that “no evidence of even moderate scientific quality exists to support the association of any modifiable factor (such as nutritional supplements, herbal preparations, dietary factors, prescription or nonprescription drugs, social or economic factors, medical conditions, toxins or environmental exposures) with reduced risk of Alzheimer’s disease.”

Most research, the panel found, involved observational studies, showing that people who did or did not get Alzheimer’s had certain characteristics beforehand, but not whether the characteristics were causal.

The panel found the strongest evidence for only one conclusion: that the herb gingko biloba does not prevent Alzheimer’s. There was moderate evidence that neither vitamin E nor drugs called cholinesterase inhibitors, used to treat dementia symptoms, decrease risk of Alzheimer’s. And there was moderate evidence that the gene ApoE4 significantly increases Alzheimer’s risk, as does menopause therapy with estrogens and progestins.

Evidence for or against any other causal factor was poor, often because studies were small, used vague or changing definitions, or did not rigorously monitor what subjects were doing.

“We debated for hours and hours and hours how to write the report, because certainly we didn’t want it to be the carrier of bad news,” said Dr. Martha Daviglus, the panel’s chairwoman and a preventive medicine expert at Northwestern University. But “we wanted the public to realize that at this point nothing that people can sell to them is proven to work.”

Many members of the Alzheimer’s community were stung, considering the panel’s conclusions a “glass half empty,” said William Thies, the Alzheimer’s Association’s chief medical and scientific officer. “We would agree that we haven’t proven any of these risk factors, but there’s data that are pretty good for some of them. And in a world where we have lots of Alzheimer’s disease and no definitive medical intervention, prevention strategies that are based on lifestyle changes are certainly attractive.”

Dr. Yaffe and her colleague Deborah Barnes excluded risk factors like nutrition or brain exercise because they believed research was not solid enough. They used a more elastic threshold to evaluate research than the N.I.H. panel because, Dr. Yaffe said, the panel “didn’t quite do the field justice.”

Their model weighed the strength of existing research and how widespread the risk factors were. In the United States, they estimated that 1.1 million Alzheimer’s cases, or 21 percent, may be linked to physical inactivity. Fifteen percent may owe to depression, 11 percent to smoking, 8 percent to midlife hypertension, 7 percent to obesity, 7 percent to low education and 3 percent to diabetes.

Their estimates for the risk factors worldwide differed because some behaviors and conditions are more common than in the United States. So low education accounted for 19 percent, or 6.5 million cases, worldwide, while physical inactivity accounted for 13 percent and obesity 2 percent.

Dr. John W. Williams Jr., a professor of medicine at Duke University who led an analysis of Alzheimer’s prevention research for the N.I.H. panel, said studies like Dr. Yaffe’s can be informative “when we don’t have other evidence” and can help shapers of public policy “make decisions about where to invest to reduce risk.”

But he said: “What should individuals do with it? Probably not much.”

Among the limitations, he said, was that some risk factors, like physical inactivity and obesity, “are darn hard to change.”

And does a risk factor like depression cause Alzheimer’s — or is it the other way around?

Still, everyone agrees these risks merit attention for other reasons: preventing cancer or heart disease, improving overall health.

“It’s good if you can do it, but not in the name of Alzheimer’s,” Dr. Daviglus said. “But maybe we will find out that by doing this for other diseases, we are also doing it for Alzheimer’s.”

From CNN
By Elizabeth Cohen, Senior Medical Correspondent

When Dr. Carolyn LaFleur was in a car accident six years ago, she couldn’t move her neck for a year and a half, she had terrible pain in her hip, and she would get headaches at her temples.

Frequent icing, physical therapy and massage therapy helped her neck and hip, but didn’t do much for the pain in her head.

Then just last year LaFleur discovered yoga. While it didn’t get rid of her headaches, it did make the pain much more manageable.

“Yoga has given me strength,” says LaFleur, 66, an anesthesiologist who practices in Hudson, New York.

She has her yoga “prescribed” by Dr. Loren Fishman, a rehabilitative medicine specialist at Columbia University’s New York-Presbyterian hospital in Manhattan.

“Yoga lowers your tension. It relaxes the basic tone of your muscle,” he says. “And the minute you notice that yoga helps, it raises your confidence that you can help yourself. It gives you the feeling of ‘I can do it.’ “

Fishman and others have done studies showing yoga can help all sorts of medical ailments, from depression to sexual dysfunction to rotator cuff injuries.

“People often have a hard time believing they can get such powerful change from yoga, but they do,” says Dr. Dean Ornish, who has studied the health benefits of yoga.

Ornish, a clinical professor of medicine at the University of California San Francisco, says yoga works by bringing down stress levels, which relaxes everything in your body, including blood vessels.

“Your arteries begin to relax so there’s more blood flow everywhere, so everything is better,” says Ornish, president of the Preventive Medicine Research Institute.

Here are 10 ailments where yoga can make a difference.

1. Headaches

Fishman suggested to LaFleur that she do the camel pose, the bridge pose and the wheel pose for headaches. He says these poses stretch the muscles in the front of the chest, which help control the head. The Yoga Journal has more information on yoga for headaches.

2. Asthma

Several studies, including one published in the “Indian Journal of Physiology and Pharmacology,” show yoga can help asthma sufferers. Livestrong and Women Fitness list poses that seem to help.

3. Sexual dysfunction in women

A study in the “Journal of Sexual Medicine” shows yoga improved women’s desire, satisfaction and orgasms. Health magazine suggests a sequence of wide leg squat to lizard lunge to frog pose to improve a woman’s sex life. Harvard Medical School also has suggestions (added) for yoga poses to enhance sexual function.

4. Sexual dysfunction in men

Doctors in India have successfully used yoga to treat men with premature ejaculation; there are more details in an article in the “Journal of Sex & Marital Therapy.” Men’s Health suggests certain poses to help men improve their sex lives, including something called “horndog pose.”

5. Sleep problems

Researchers at the M.D. Anderson Cancer Center found lymphoma patients who did yoga slept better than those who didn’t. About.com’s yoga guide suggests trying the happy baby pose or the goddess pose before you go to bed.

6. Menstrual pain

According to a study published in the “North American Society for Pediatric and Adolescent Gynecology,” the cobra, cat and fish poses helped teens and young women with menstrual pain.

7. Rotator cuff injuries

Fishman published a study earlier this year showing a chair-assisted headstand can help people with rotator cuff tears. See Figure 2 for how to do it.

8. Osteoporosis

Fishman also published a study showing a regimen of 10 yoga poses helps build bone mineral density after menopause.

9. Pain sensitivity

According to the “Harvard Mental Health Letter,” a study at the University of Utah showed people who practice yoga had a higher pain tolerance than those who didn’t.

10. Depression and anxiety

A German study mentioned in the same Harvard publication showed that emotionally distressed women became less depressed and anxious after they took two 90-minute yoga classes a week for three months. This yoga journal article suggests camel pose, bridge pose and wheel pose.

Follow @ElizCohenCNN and @CNNHealth on Twitter.

ScienceDaily (May 28, 2011) — Individuals with rheumatoid arthritis who practice yoga showed statistically significant improvements in disease activity, according to a small study presented at the EULAR 2011 Annual Congress.

The results of the study conducted in the United Arab Emirates (UAE) among 47 patients (26 yoga patients and 21 controls) demonstrate that patients who completed 12 sessions of Raj yoga which is one of the gentler styles of yoga, combining exercise and breathing techniques showed significant improvements in disease activity scores (DAS28) of p=0.021 and health assessment questionnaire’s (HAQ†) of p=0.0015. However there was no statistically significant improvement on the quality of life scale (QoL).

“Most patients with RA do not exercise regularly despite the fact that those who do report less pain and are therefore more physically active,” said Dr Humeira Badsha MD Rheumatologist and founder of the Emirates Arthritis Foundation, Dubai, UAE. “While our study has been conducted in a small group of patients the results show clear benefits for patients who regularly practice Raj yoga. We believe that practicing yoga longer term could in fact result in further significant improvements and hope our study drives further research into the benefits of yoga in RA.”

Patients were recruited by email through the Emirates Arthritis Foundation RA database (mean age of yoga group 44 years, mean age of control group 46.2 years, 80% female). Demographic data, disease activity indices, health assessment questionnaire (HAQ) and SF-36 (a standard patient survey commonly used to calculate patient quality of life) were documented at enrolment and after completion of 12 sessions of yoga.

Results of a separate study show the positive effects of yoga on the quality of life in patients with Fibromyalgia, a long-term condition which causes extreme pain all over the body.

Results of one further study investigating the effects of yoga on the QoL of patients with fibromyalgia, demonstrated that QoL scores, after an eight session classical yoga program which combines gentle yoga postures, breathing techniques and meditation, were better than scores obtained before the program (p<0.05) along with a significant decrease in the anxiety levels of patients (p<0.05). As anxiety is often a key symptom in patients with this condition, this study represents a positive step in improving the lives of people suffering from fibrolmyalgia.

From WebMD

Study Shows Yoga Classes May Help Prevent Falls in Older Stroke Patients

By Jennifer Warner

WebMD Health NewsReviewed by Laura J. Martin, MD June 6, 2011 —

Practicing yoga after a stroke may help rebuild balance and prevent potentially disabling falls among the elderly, a study shows.

The study shows stroke survivors who participated in a specialized post-stroke yoga class improved their balance by up to 34%.

Researchers say the participants also experienced a big boost in their own self-confidence after their yoga practice and became more physically active in their communities.

“It also was interesting to see how much the men liked it,” says researcher Arlene A. Schmid, assistant professor of occupational therapy in the School of Health and Rehabilitation Sciences at Indiana University-Purdue University, Indianapolis, in a news release.

Schmid says many of the participants wanted to continue their yoga practice at home after the study ended.

“They enjoyed it so much partly because they weren’t getting any other treatment. They had already completed their rehabilitation but felt there still was room for improvement,” Schmid says.

Previous research shows the risk of falls and breaking a hip increase significantly after a stroke and also increase with age.

A Visual Guide to Understanding Stroke

Yoga for Balance
In this small, preliminary study, researchers looked at the effects of yoga on balance and overall fitness and confidence in a group of 20 veterans who had survived a stroke.

The participants, 19 men and one woman with an average age of 66, attended an hour-long yoga class twice a week for eight weeks. The yoga therapist modified the typical yoga poses to meet the veterans’ needs.

For example, the participants initially performed the yoga poses while seated in chairs and then progressed to standing poses. Eventually, all the participants were able to perform poses on the floor.

“Everything was modified because we wanted them to be successful on day one,” Schmid says. “Everyone could be successful at some level.”

By the end of the study, researchers found the participants’ balance had improved by 17% on the Berg Balance Scale and by 34% on the Fullerton Balance scale. In particular, the average score on the Berg Balance Scale improved from 40 to 47, which indicates they were no longer at high risk for a fall.

The study also shows that the stroke survivors experienced improvements in endurance and self-confidence in their ability to be physically active.

Researchers say the results are preliminary and further study with a larger group of participants is needed. The results suggest that specialized yoga classes for stroke survivors may provide significant benefits in reducing the risk of falls.

The study was presented at the American College of Sports Medicine Annual Meeting in Denver.

This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the “peer review” process, in which outside experts scrutinize the data prior to publication in a medical journal.