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Medizinische Fakultät Der Universität Duisburg-Essen Medizinische Fakultät der Universität Duisburg-Essen aus der Klinik für Naturheilkunde und Integrative Medizin Einfluss von Übungshäufigkeit und Yogastil auf die Gesundheit, den Lebensstil und die Sicherheit von Yogaübenden eine Onlineumfrage I n a u g u r a l - D i s s e r t a t i o n zur Erlangung des Doktorgrades der Medizin durch die Medizinische Fakultät der Universität Duisburg-Essen Vorgelegt von Daniela Quinker aus Olpe 2020 Diese Dissertation wird via DuEPublico, dem Dokumenten- und Publikationsserver der Universität Duisburg-Essen, zur Verfügung gestellt und liegt auch als Print-Version vor. DOI: 10.17185/duepublico/74549 URN: urn:nbn:de:hbz:464-20210728-081112-0 Alle Rechte vorbehalten. Dekan: Herr Univ.-Prof. Dr. med. J. Buer 1. Gutachter: Herr Priv.-Doz. Dr. rer. medic. Dipl.-Psych. H. Cramer 2. Gutachter: Frau Univ.-Prof. Dr. rer. nat. S. Moebus Tag der mündlichen Prüfung: 16. Juni 2021 2 Publikationen: Aus dieser Dissertation entstanden drei Publikationen: Cramer, H., Quinker, D., Pilkington, K., Mason, H., Adams, J., Dobos, G. (2019): Associations of yoga practice, health status, and health behavior among yoga practitioners in Germany - Results of a national cross-sectional survey. Complementary Therapies in Medicine. 42: 19-26. Cramer, H., Quinker, D., Schumann, D., Dobos, G., Lauche, R. (2019): Adverse effects of yoga: a national cross-sectional survey. BMC Complementary and Alternative Medicine. 19:190. Park, C., Quinker, D., Dobos, G., Cramer, H. (2019): Motivations for adopting and maintaining a yoga practice: a national cross-sectional survey. Journal of Alternative and Complementary Medicine. 25:1009-1014. 3 Inhaltsverzeichnis 1 Einleitung ................................................................................................................. 7 1.1 Yoga ................................................................................................................... 8 1.1.1 Terminologie und Definition ...................................................................... 8 1.1.2 Historische Ursprünge ................................................................................ 9 1.2 Yogastile .......................................................................................................... 14 1.2.1 Ashtanga-/Vinyasa-Yoga.......................................................................... 15 1.2.2 Hatha-Yoga ............................................................................................... 16 1.2.3 Iyengar-Yoga ............................................................................................ 17 1.2.4 Kundalini-Yoga ........................................................................................ 18 1.2.5 Krishnamacharya Tradition/Viniyoga ...................................................... 20 1.2.6 Power-Yoga .............................................................................................. 20 1.2.7 Sivananda-Yoga/Yoga Vidya ................................................................... 21 1.3 Aktuelle Gesetzeslage ...................................................................................... 22 1.4 Stand der Forschung ........................................................................................ 23 1.4.1 Aktuelle Studienlage: Auswirkungen von Yoga auf die Gesundheit ....... 23 1.4.2 Aktuelle Studienlage: Verletzungshäufigkeit beim Yoga ........................ 27 2 Fragestellung ......................................................................................................... 29 3 Material und Methoden ........................................................................................ 30 3.1 Design und Teilnehmer .................................................................................... 30 3.1.1 Studiendesign ........................................................................................... 30 3.1.2 Stichprobengröße ...................................................................................... 30 3.1.3 Teilnehmer ................................................................................................ 30 3.1.4 Zeitraum ................................................................................................... 31 3.2 Datenerhebung ................................................................................................. 31 3.3 Zielparameter ................................................................................................... 32 3.3.1 Hauptzielparameter ................................................................................... 32 3.3.2 Nebenzielparameter .................................................................................. 33 3.4 Messinstrumente .............................................................................................. 33 3.4.1 Charakteristika der Yogapraktizierenden ................................................. 34 4 3.4.2 Soziodemografische Daten ....................................................................... 35 3.4.3 Ermittlung des Gesundheitsstatus ............................................................. 36 3.4.4 Gesundheitsverhalten................................................................................ 37 3.4.5 Yoga und Verletzungen ............................................................................ 38 3.5 Statistische Auswertung ................................................................................... 39 4 Ergebnisse .............................................................................................................. 41 4.1 Teilnehmer ....................................................................................................... 41 4.2 Charakteristika der Yogapraxis........................................................................ 46 4.3 Gesundheitszustand und Gesundheitsverhalten ............................................... 52 4.4 Assoziationen zwischen Yogapraxis und Gesundheitsstatus ........................... 59 4.5 Assoziationen zwischen der Yogapraxis und dem Gesundheitsverhalten ....... 65 4.6 Verletzungshäufigkeit beim Yoga ................................................................... 68 5 Diskussion .............................................................................................................. 80 5.1 Zusammenfassung der Ergebnisse ................................................................... 80 5.2 Interpretation der Ergebnisse ........................................................................... 80 5.2.1 Soziodemografie ....................................................................................... 80 5.2.2 Hauptzielparameter ................................................................................... 82 5.2.3 Nebenzielparameter .................................................................................. 87 5.3 Grenzen dieser Studie ...................................................................................... 92 5.4 Fazit ................................................................................................................. 93 6 Zusammenfassung ................................................................................................. 96 7 Literaturverzeichnis .............................................................................................. 97 8 Anhang ................................................................................................................. 116 8. 1 Online-Fragebogen ........................................................................................ 116 8.2 Angeschriebene Teilnehmer .......................................................................... 142 8.2.1 Berufsverbände ....................................................................................... 142 8.2.2 Facebook ................................................................................................. 142 8.2.3 E – Mail .................................................................................................. 148 8.3 Abkürzungsverzeichnis .................................................................................. 153 5 8.4 Abbildungsverzeichnis ................................................................................... 154 8.5 Tabellenverzeichnis ....................................................................................... 155 8.6 Zusätzliche Tabellen ...................................................................................... 157 9 Danksagung ......................................................................................................... 178 10 Lebenslauf ............................................................................................................ 179 6 1 Einleitung Yoga entstammt der indischen Philosophie und existiert seit über 1000 Jahren. In den Europa und den USA (im weiteren als westliche Länder bezeichnet) hat Yoga seit ca. sechs Jahrzehnten eine zunehmende Bedeutung erlangt. Inzwischen praktizieren laut Schätzungen 250 Millionen Menschen weltweit Yoga (Herbst, M. 2017). In den USA gaben 13,2 % der Erwachsenen im Jahr 2012 an, Yoga zu praktizieren oder bereits einmal praktiziert zu haben (Cramer, H. et al. 2016b). Hiervon führten 6 % (14 Millionen Amerikaner1) an, dass Yoga ihnen von ihrem Therapeuten oder Arzt empfohlen wurde (Macy, D. 2008). In Deutschland praktizieren ca. 15,7 Millionen Menschen Yoga oder sind an Yoga interessiert (Cramer, H. 2015b). Dies entspricht ungefähr 18 % der Bevölkerung in Deutschland. Yoga entwickelt
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