BACKGROUND: Mind-body practices such as yoga are widely popular, but little is known about how such exercises impact health-related quality of life.
OBJECTIVE: To measure changes in health-related quality of life associated with 3 months of mind-body training as practiced in community-based settings.
DESIGN: Prospective cohort study.
SETTING: Eight centers for practice of mind-body training.
PARTICIPANTS: One hundred ninety-four English-speaking adults who had taken no more than 10 classes at the centers prior to enrollment in the study. One hundred seventy-one (88%) returned the 3-month follow-up questionnaire.
INTERVENTION: Administration of the SF-36 questionnaire at the start of training and after 3 months.
MEASUREMENTS AND MAIN RESULTS: At baseline, new participants in mind-body training reported lower scores than U.S. norms for 7 of 8 domains of the SF-36: mental health, role emotional, social, vitality, general health, body pain, and role physical (P<.002 for all comparisons). After 3 months of training, within-patient change scores improved in all domains (P<.0001), including a change of +15.5 (standard deviation ±21) in the mental health domain. In hierarchical regression analysis, younger age (P=.0003), baseline level of depressive symptoms (P=.01), and reporting a history of hypertension (P=.0054) were independent predictors of greater improvement in the SF-36 mental health score. Five participants (2.9%) reported a musculoskeletal injury.
CONCLUSIONS: New participants in a community-based mind-body training program reported poor health-related quality of life at baseline and moderate improvements after 3 months of practice. Randomized trials are needed to determine whether benefits may be generalizable to physician-referred populations.
alternative medicine behavioral health promotion disease prevention patient involvement quality of life
Young DR, Appel LJ, Jee SH, Miller ER. Effects of aerobic exercise and tai chi on blood pressure in older people: results of a randomized trial. J Am Geriatr Soc. 1999;47:277–84.PubMedGoogle Scholar
Hartman CA, Manos TM, Winter C, et al. Effects of tai chi training on function and quality of life indicators in older adults with osteoarthritis. J Am Geriatr Soc. 2000;48:1553–9.PubMedGoogle Scholar
Wolf SL, Barnhart HX, Kutner N, et al. Reducing frailty and falls in older persons: an investigation of tai chi and computerized balance training. J Am Geriatr Soc. 1996;44:489–97.PubMedGoogle Scholar
Garfinkel MS, Schumacher HR, Husain A, Levy M, Reshetar RA. Evaluation of a yoga based regimen for treatment of osteoarthritis of the hands. J Rheumatol. 1994;21:2341–3.PubMedGoogle Scholar
Janakiramaiah N, Gangadhar BN, Naga Venkatesha Murthy PJ, Harish MG, Subbakrishna DK, Vedamurthachar A. Antidepressant efficacy of Sudarshan Kriya Yoga (SKY) in melancholia: a randomized comparison with electroconvulsive therapy (ECT) and imipramine. J Affect Disord. 2000;57:255–9.PubMedCrossRefGoogle Scholar
Naga Venkatesha Murthy PJ, Janakiramaiah N, Gangadhar BN, Subbakrishna DK. P300 amplitude and antidepressant response to Sudarshan Kriya Yoga (SKY). J Affect Disord. 1998;50:45–8.PubMedCrossRefGoogle Scholar
Khumar SS, Kaur P, Kaur S. Effectiveness of shavasana on depression among university students. Indian J Clin Psychol. 1993;20:82–7.Google Scholar
Malathi A, Damodaran A, Shah N, et al. Psychophysiological changes at the time of examination in medical students before and after the practice of yoga and relaxation. Indian J Psychiatry. 1998;40:35–40.Google Scholar
Malathi A, Damadoran A, Shah N, et al. Effect of yogic practices on subjective well-being. Indian J Physiol Pharmacol. 2000;44:202–6.PubMedGoogle Scholar
Craft LL, Landers DM. Effect of exercise on clinical depression and depression resulting from mental illness: a meta-analysis. J Sport Exer Psychol. 1998;20:339–57.Google Scholar
Mannerkorpi K, Nyberg B, Ahlmen M, Ekdah C. Pool exercise combined with an education program for patients with fibromyalgia syndrome: a prospective, randomized study. J Rheumatol. 2000;27:2473–81.PubMedGoogle Scholar
Painter P, Carlson L, Carey S, Paul SM, Myll J. Physical functioning and health-related quality-of-life changes with exercise training in hemodialysis patients. Am J Kidney Dis. 2000;35:482–92.PubMedGoogle Scholar
Singh NA, Clements KM, Fiatarone MA. A randomized controlled trial of progressive resistance training in depressed elders. J Gerontol A Biol Sci Med Sci. 1997;52A:M27–35.Google Scholar
Wallace JI, Buchner DM, Grothaus L, et al. Implementation and effectiveness of a community-based health promotion program for older adults. J Gerontol A Biol Sci Med Sci. 1998;53A:M301–6.Google Scholar
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.PubMedCrossRefGoogle Scholar
Paffenbarger RS, Wing AL, Hyde RT. Physical activity as an index of heart attack risk in college alumni. Am J Epidemiol. 1978;108:161–75.PubMedGoogle Scholar
Stewart AL, Hays RD, Wells KB. Long-term functioning and well-being outcomes associated with physical activity and exercise in patients with chronic conditions in the medical outcomes study. J Clin Epidemiol. 1994;47:719–30.PubMedCrossRefGoogle Scholar
Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey: Manual and Interpretation Guide. Boston, Mass: Health Institute; 1993.Google Scholar
Simon GE, Revicki DA, Grothaus L, Vonkorff M. SF-36 summary scores: are physical and mental health truly distinct? Med Care. 1998;36:567–72.PubMedCrossRefGoogle Scholar
Radloff LS. The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.CrossRefGoogle Scholar
Spielberger CD. Manual for the State-trait Anxiety Inventory. Redwood City, Calif: Mindgarden; 1983.Google Scholar
Schwarzer R, Jerusalem M. Generalized self-efficacy scale. In: Weinman J, Wright S, Johnston M, eds. Measures in Health Psychology: A User’s Portfolio. Windsor, UK: NFER-NELSON; 1995.Google Scholar
U.S. Department of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General. Atlanta, Ga: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, International Medical Publishing; 1996.Google Scholar
Scholz U, Gutiérrez-Doña B, Sud S, Schwarzer R. Is perceived self-efficacy a universal construct? Psychometric findings from 25 countries. Eur J Psychol Assess. 2002;18:242–51.CrossRefGoogle Scholar
Al-Windi A, Dag E, Kurt S. The influence of perceived well-being and reported symptoms on health care utilization: a population-based study. J Clin Epidemiol. 2002;55:60–6.PubMedCrossRefGoogle Scholar
Knanudt PR, Connor KM, Weisler RH, Churchill LE, Davidson JR. Alternative therapy use by psychiatric outpatients. J Nerv Ment Dis. 1999;187:692–5.CrossRefGoogle Scholar
Druss BG, Rosenheck RA. Use of practitioner-based complementary therapies by persons reporting mental conditions in the United States. Arch Gen Psychiatry. 2000;57:708–14.PubMedCrossRefGoogle Scholar
Unutzer J, Klap R, Sturm R, et al. Mental disorders and the use of alternative medicine: results from a national survey. Am J Psychiatry. 2000;157:1851–7.PubMedCrossRefGoogle Scholar
Kessler RC, Soukup J, Davis RB, et al. The use of complementary and alternative therapies to treat anxiety and depression in the United States. Am J Psychiatry. 2001;158:289–94.PubMedCrossRefGoogle Scholar
Burstein HJ, Gelber S, Guadagnoli E, Weeks JC. Use of alternative medicine by women with early-stage breast cancer. N Engl J Med. 1999;340:1733–9.PubMedCrossRefGoogle Scholar
Furnham A, Bhagrath R. A comparison of health beliefs and behaviors of clients of orthodox and complementary medicine. Br J Clin Psychol. 1993;32:237–46.PubMedGoogle Scholar
Furnham A, Forey J. The attitudes, behaviors, and beliefs of patients of conventional vs. complementary (alternative) medicine. J Clin Psychol. 1994;50:458–69.PubMedCrossRefGoogle Scholar
MacLean CRK, Walton KG, Wenneberg SR, et al. Effects of the Transcendental Meditation program on adaptive mechanisms: changes in hormone levels and responses to stress after 4 months of practice. Psychoneuroendocrinology. 1997;22:277–95.PubMedCrossRefGoogle Scholar
McGrady A, Woerner M, Argueta Bernal GA, Higgins JT. Effect of biofeedback-assisted relaxation on blood pressure and cortisol levels in normotensives and hypertensives. J Behav Med. 1987; 10:301–10.PubMedCrossRefGoogle Scholar
Sudsuang R, Chentanez V, Veluvan K. Effect of buddhist meditation on serum cortisol and total protein levels, blood pressure, pulse rate, lung volume, and reaction time. Physiol Behav. 1991;50:543–8.PubMedCrossRefGoogle Scholar
McKinney CH, Antoni MH, Kumar M, Tims FC, McCabe PM. Effects of guided imagery and music therapy on mood and cortisol in healthy adults. Health Psychol. 1997;16:390–400.PubMedCrossRefGoogle Scholar
Schmidt T, Wijga A, Von Zur Muhlen A, Brabant G, Wagner TO. Changes in cardiovascular risk factors and hormones during a comprehensive residential three month kriya yoga training and vegetarian nutrition. Acta Physiol Scand Suppl. 1997;640:158–62.PubMedGoogle Scholar
McEwen BS, Seeman T. Protective and damaging effects of mediators of stress: elaborating and testing the concepts of allostasis and allostatic load. Ann NY Acad Med. 1999;896:30–47.CrossRefGoogle Scholar
Meyer SE, Chrousos GP, Gold PW. Major depression and the stress system: a life span perspective. Dev Psychopath. 2001;13:565–80.CrossRefGoogle Scholar
Stokes PE. The potential role of excessive cortisol induced by HPA hyperfunction in the pathogenesis of depression. Eur Neuropsychopharmacol. 1995;5 suppl:77–82.PubMedCrossRefGoogle Scholar