ORIGINAL ARTICLE
Year : 2022 | Volume
: 17 | Issue : 4 | Page : 911--914
Effect of 1-month structured yoga training program on perceived stress scale in adults
Parikshit Ashok Muley1, Pranjali Parikshit Muley2, Vishwas Vasant Mandlik3, Vidya Pravin Deshpande4,
1 Department of Physiology, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India
2 Department of Physiology, Datta Meghe Medical College and Shalinitai Meghe Hospital and Research Center, Nagpur, Maharashtra, India
3 Vice Chancellor, Yogavidya Gurukul, Nashik, Maharashtra, India
4 Consultant and Incharge of Arogyadham Yoga and Nisargopchar Kendra, Nashik, Maharashtra, India
Correspondence Address:
Dr. Parikshit Ashok Muley
N-20 Sneh-Nagar, Wardha Road, Nagpur, Maharashtra
India
Abstract
Background: Human health is primarily affected by stress leading to various noncommunicable diseases. The study was conducted to analyze whether yoga in daily routine improves perceived stress scores. Aim: The aim of this study was to examine the effect of yoga training on Perceived Stress Scale (PSS) in adult population. Objectives: The objective of this study was to analyze and compare stress scale during pre- and postyoga sessions. Materials and Methods: The study was conducted on 70 healthy adults of age group 18–50 years coming to Yoga center under Yoga Vidya Gurukul. PSS was administered in those subjects on two occasions that is before starting the yoga sessions (pre yoga) and after completing the 5 weeks of structured yoga protocol sessions (post yoga). Results: Our study showed significant improvement in perceived stress scores upon completion of 1 month of yoga training, which highlights the importance of yoga in stress management and possible mechanism of effect of yoga on psychological level.
How to cite this article:
Muley PA, Muley PP, Mandlik VV, Deshpande VP. Effect of 1-month structured yoga training program on perceived stress scale in adults.J Datta Meghe Inst Med Sci Univ 2022;17:911-914
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How to cite this URL:
Muley PA, Muley PP, Mandlik VV, Deshpande VP. Effect of 1-month structured yoga training program on perceived stress scale in adults. J Datta Meghe Inst Med Sci Univ [serial online] 2022 [cited 2023 Jun 7 ];17:911-914
Available from: https://journals.lww.com/dmms/pages/default.aspx/text.asp?2022/17/4/911/369493 |
Full Text
Introduction
Claude Bernard gave the concept milieu intérieur which means to keep our internal environment constant for maintenance of life. This was termed “Homeostasis” by Walter B. Cannon. The term “stress” was used by Selye which represents the effect of anything that seriously disturbs homeostasis. The actual or perceived threat is called the “stressor” and the response is “stress response.” Selye observed that severe, prolonged stress responses might lead to tissue damage and disease.[1]
In modern lifestyles, health is compromised largely due to stress. Stress primarily signifies the condition of disturbed normal functioning due to imbalance between individual's interactions with the environment. Stress is defined as structured series of physiological, neurohormonal, and psychological efforts of adaptation toward any real or anticipated situations that disturb homeostatic balance of the body and that require some kind of adjustments.[2] Stress is experienced in response to a range of physical, occupational, and emotional stimuli. Within manageable parameters, one's sense of well-being is maintained, but if these stimuli go beyond normal limits, then it becomes a stressor. Prolonged stress can cause adverse psychological and physical health effects, with an increased risk of premature mortality.
One of the steps which help to improve the ability to manage the stress is our traditional and cultural science – YOGA. Yoga is an ancient discipline which helps to bring balance and health to the physical, psychological, emotional, and spiritual dimensions of the individual. Yoga has provided a spiritual connection between mind and body, which helps in treatment of mental disorders such as stress.[3] The most central and common aspects of yoga practice today are different bodily postures (asanas) and breathing exercises (pranayamas) that aim to focus the mind, achieve relaxation, and increase wellness.[4] There are several studies which suggest that there is a positive effect of yoga on stress, but there are very few studies which are conducted on the perceived stress by an individual. Hence, we planned this study to see whether the yoga has any effect on the perceived stress.
The study analyzed and compared the levels of perceived stress in adults before and after completion of yoga training in adults. It helps to evaluate whether yoga is acting at the psychological level which affects the stress. Lifestyle changes could be suggested in people suffering from stress disorders by inculcating practice of yoga in daily life.
Materials and Methods
The study was performed on 70 adult populations (male and female) of age 18–50 years coming for Yoga Pravesh class at Yoga Vidya Dham, Nashik, under Yoga Vidya Gurukul. The class consists of 1 month in which there was daily 1-h yoga training and the structured yoga protocol [Table 1] was followed on each day. After taking valid consent from the subjects, they were asked to solve Perceived Stress Scale (PSS) questionnaire consisting of 14 items on two occasions, i.e., before yoga (pre yoga) and after yoga sessions (post yoga). The questionnaire was available in English and Marathi languages.{Table 1}
The stress test was done with the help of PSS.[5] PSS is associated with direct changes to both physiologic and psychological processes. This scale helps to measure the perception of stress by an individual. The scale includes a number of different questions about present levels of experienced stress. In this scale, there are 14 items which are easy to understand, and the response alternatives are simple to understand. The questions ask about feelings and thoughts during the last month. Out of the 14 items, 7 items (item number on PSS as 1, 2, 3, 8, 11, 12, and 14) are neutrally stated questions which indicate that if the stress score is more then more is the stress perceived by the subject. The remaining 7 questions (item number on PSS as 4, 5, 6, 7, 9, 10, and 13) are positively stated questions means scores get reversed, i.e., more is score, less is the severity of stress perceived.[5] The average score of each item of 70 subjects was calculated during pre- as well as postyoga sessions.
In asanas, following postures were obtained:
Sleeping position: Sarvangasana, Vipritkarni, Halasana, Pawanmuktasana, ShavasanaProne position: Bhujangasana, Shalbhasana, Dhanurasana, Naukasana, MakarasanaSitting position: Padmasana, Paschimottanasana, Padmasana Yogmudra, Vajrasana Yogmudra, Ardha Matsyendrasana, Akarna DhanurasanaStanding position: Veerasana, Trikonasana, VrukshasanaPranayama: Sslow breathing 1:2 – in this type of breathing ratio, the count of 1 means the duration of 4 s. So in this type of breathing, subject was inhaling for 4 s followed by exhalation for 8 s.
Fast breathing; in this, the speed of breathing is increased. These included six types of breathing types:
Type 1: By keeping both the nostrils open, fast breathing is performedType 2: With the help of pranayama mudra close right nostril and fast breathing by left nostrilType 3: Same as Type 2, but in this, close left nostril and fast breathing by right nostrilType 4: Close right nostril, inhale through left nostril and immediately close left nostril, and exhale through right nostrilType 5: Close left nostril, inhale through right nostril and immediately close right nostril, and exhale through left nostrilType 6: Combination of Type 4 and 5. Inhale through left nostril and exhale through right, then inhale through right nostril and exhale with left. This completes the one cycle.
In addition to the above protocol, four lectures were conducted on the diet control, self-study of yoga, science of yoga, and its perspectives.
Ethical clearance
Ethical approval for this study was provided by the Ethical Committee of Datta Meghe medical college & Shalinitai Meghe Hospital and Research Center, Nagpur, on 18 November 2021.
Results
All item forms (70 pre and 70 post yoga) were evaluated and found complete and included in analysis. Statistical analysis was done with the help of Wilcoxon signed-rank test to study the effect of yoga training on stress scores. It was observed from [Table 2] and [Chart 1] (for neutrally stated questions) that perceived stress scores significantly decreased in postyoga sessions in all items except 12. This indicates that there is a decrease in the perceived stress score. [Table 3] and [Chart 2] (for positively stated questions) show that the stress scores were significantly higher which suggest that the perceived stress was lower after yoga sessions. [Table 4] shows a comparison of mean PSS scores between pre and post yoga. It was observed that the mean PSS score in pre yoga was 28.73 and in post yoga was 19.49. When the two scores were compared with the help of paired t-test, it was observed that the difference between the mean PSS score was highly significant in pre- versus postyoga score (P < 0.0001).{Table 2}{Table 3}{Table 4}[INLINE:1][INLINE:2]
[Table 2] shows the item number as per the PSS with an average score of pre and post yoga sessions. The observations in the result [Table 2] shows decrease in the stress score significantly in the post yoga session except for the item number 12 which shows same score.
[Table 3] shows the stress scores for positively stated questions. In these, scores get reversed, i.e., more is score, less is the severity of stress perceived. It is observed that in each item except at item number 6, the score increases.
The result in [Table 4] shows that the difference between the mean score of PSS in pre and post yoga is statistically highly significant (P < 0.0001).
Discussion
The present study investigated the health benefits of practicing yoga in reducing perceived stress in adult population. It was observed that the stress score was altered in postyoga sessions and that the individuals' perceived lesser stress as compared with the preyoga readings.
Stress leads to activation of hypothalamic–pituitary–adrenal (HPA) axis and the sympathetic nervous system (SNS) which leads to a cascade of physiologic, behavioral, and psychologic effects as a result of the release of cortisol and catecholamines. The constant state of hypervigilance results in repeated firing of the HPA axis and SNS which leads to imbalance and dysregulation of the system. This ultimately results in diseases such as obesity, diabetes, anxiety, and cardiovascular disease.[6],[7] There is growing evidence that perceived stress has a major impact on the initiation and progression of disease.[8]
The marked reduction in perceived stress in our study appears to be of clinical importance.
Yoga is the science of human development, which helps to bring balance and health to the physical, mental, emotional, and spiritual dimensions of the individual.[8] The perceived stress is often exaggerated by the thoughts coming to our mind. Yoga is a science which stops fluctuations in your mind and makes it stable, which helps you to realize truth to a greater extent. Once there is a realization of truth, the undue perceived stress gets reduced and that may be the reason for feeling of less perceived stress after yoga sessions in our study.
The structured yoga protocol practiced in Yoga Pravesh class[9] offers maximum benefit to the participants. The warm-up exercise (purak halchali), Sun Salutation (Surya Namaskar), and yogic postures (asanas) cause stretching and strengthening of muscles, which improve the balance that helps to build physical flexibility.[9] The breathing exercise offers a state of quietness and tranquility which stabilizes the mental and emotional disturbances and fluctuations. While the practice of prayer and meditation reduces the distractions of mind and helps to concentrate on the activity. The feeling of calmness helps to tone sympathetic and parasympathetic nervous system to give it flexibility to activate whatever is needed in a particular situation. Yoga is a series of practices that allow you to steadily gain discipline, strength, self-control while cultivating relaxation and awareness. In addition to this, the yoga protocol had four lectures which provided the participants the details about the expected practice of yoga, the diet to follow, and proper self-practice of yoga at home.[9] Thus, yoga protocol followed in this study gives a holistic approach in achievement toward health which helps to cope up with perceived stress in a better way to the participants.
The present study is in conformity with several other studies which reported beneficial effects of yoga on stress reduction and general well-being. Malathi and Damodaran randomized 50 medical students to yoga or to a nonintervention control group. A significant reduction in anxiety scores and high positive feedback score was noted in the yoga participants.[10] Shankarpillai et al. found that yogic intervention group had significantly reduced visual analog scale and state trait anxiety than other groups.[4] Satyapriya et al. in their study on pregnant women concluded that yoga reduces perceived stress and improves adaptive autonomic response to stress in healthy pregnant women.[11] In a study conducted by West et al., it was found that both African dance and hatha yoga reduced perceived stress and negative effect.[12]
The precise mechanism of action of yoga is not yet determined, but it is postulated that yoga may lower the stress response by down regulating the HPA and SNS axis which act as a primary effectors of stress.[7],[13] Yoga may be having inhibitory action on paraventricular nucleus (PVN) of the hypothalamus.[14] Major mechanism responsible for inhibition of HPA axis is the direct neural inhibition of PVN neurons by neurotransmitter GABA.[15] Some of the studies have proposed that yoga shifts autonomic nervous system balance to parasympathetic by vagus stimulation.[8] Yoga appears to stimulate dermal and subdermal pressure receptors under the skin which leads to increase vagal activity.[16]
Thus, yoga with its physical, emotional, mental, personality development, and holistic understanding offers to cope with stressful states. Thus, yoga can be beneficial in achieving a tranquil state of mind during routine activities and yet providing the concentration and arousal essential in demanding or stressful situations.
Conclusion
The study concludes that yoga plays a very important role in reducing perceived stress and that the practice of yoga in daily routine may improve the condition of disease associated with stress. Future research is needed to examine the therapeutic effects of individual interventions. Furthermore, studies with larger samples and longer periods of follow-up with the possible inclusion of biochemical parameters as objective measures of health to determine an outcome endpoint for mind–body treatments are needed in future.
Acknowledgment
We would like to thank Yogavidyadham, Nashik, for providing help for research study.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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