Chapter 7 Yoga and Heart Rate Variability (HRV): a Systematic Review
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PSYCHOPHYSIOLOGICAL AND METABOLIC CHANGES WITH YOGA PRACTICES A thesis submitted in fulfillment of the requirements for the degree of Doctor of Philosophy Anupama Tyagi MA (Yogic Science) School of Health Sciences College of Science, Engineering and Health RMIT University, Australia November 2014 Psychophysiological and Metabolic Changes with Yoga Practices Declaration by Candidate I hereby certify that: (a) Except where due acknowledgment has been made, the work embodied in this thesis is the result of original research done by the candidate alone; (b) The work has not been submitted previously, in part or as whole, to qualify for any other academic award; (c) The content of this thesis is a result of work which has been carried out since the commencement date of the approval program; (d) Any editorial work paid or unpaid, made third party acknowledged; (e) Ethics procedures and guidelines have been followed; Anupama Tyagi Date: 25.11.2014 II पूजामूलं गु셁पदू म ्। ूﴃ् ध्यानमूलं गु셁मूरू मन्त्रमूलं गु셁셍ाू啍यं मोक्षमूलं गु셂셍ूक पा ॥ The Root of Meditation is the Form of the Guru; The Root of Worship is the Feet of the Guru; The Root of Mantra is the Words of Guru; The Root of Liberation is the Grace of Guru. III LIST OF PUBLICATION ARISING FROM THIS THESIS Peer Reviewed Publications Tyagi A, Cohen M (2013). Oxygen Consumption Changes with Yoga Practices: A systematic Review, Journal of Evidence-Based Complementary & Alternative Medicine, 18(4), 290-308. Tyagi A, Cohen M (2014). Yoga and Hypertension: A systematic Review, Alternative Therapies, 20(2), 32-59. Tyagi A, Cohen M, Reece J, Telles S (2014). An Explorative Study of Metabolic Responses to Mental Stress and Yoga Practices in Yoga Practitioners, Non-yoga Practitioners and individuals with Metabolic Syndrome, BMC Complementary and Alternative Medicine 14(1), 445 Under Peer Review Tyagi A, Cohen M, Reece J, Linda J, Telles S. Heart Rate Variability ‘HRV’ During Yoga Practices and Mental Stress in Yoga Practitioners, Non-Yoga Practitioners, and People with Metabolic Syndrome ‘MetS’, Evidence-Based Complementary and Alternative Medicine. Tyagi A, Cohen M, Linda J, Yoga and Heart Rate Variability: A Systematic Review, Applied Psychophysiology and Biofeedback. IV Oral and Poster Presentation Tyagi A, Cohen M (2009), Oral Presentation, Flow and Psychophysiological Correlates of Yoga, 15th International Holistic Health Conference, Melbourne Victoria. Tyagi A, Cohen M (2010), Poster Presentation, Stress and Psychophysiological Correlates of Yoga, HDR Conference, RMIT University, Melbourne, Victoria. Tyagi A, Cohen M, John R, Telles S (2012), Poster presentation, Oxygen consumption During Different Yoga Practices in Regular Yoga Practitioners, Non Practitioners and Metabolic Syndrome Patients, HDR Conference, RMIT University, Melbourne, Victoria. V Dedication The long journey of completing this thesis originated from the fascination with diligent yoga practices and yoga experience that came initially from my first Yoga guru, my mother Sheela Rani Gupta. I would therefore like to dedicate this thesis to my mother. VI Acknowledgement I would never have been able to accomplish this milestone without extended support and sincere endeavors of my supervisors, Prof Marc Cohen, Dr. Shirley Telles and Dr. Linda Jones. First and foremost, I express my deepest gratitude to my senior supervisor Prof. Marc Cohen, for extending continual support throughout my candidature academically and emotionally. I thank him for all my publications, encouragement of my project and his interest in promoting yoga research. I appreciate all his contributions of time, guidance and making my PhD experience productive and stimulating. I feel honor to thank Dr. Shirley Telles, for being her research student, for the guidance in collecting research data and granting me permission to use the well equipped laboratory at Patanjali Yoga Research Center, Haridwar, India. Dr. Linda Jones, you are fabulous, therefore I extend my heartfelt gratitude for your extended help in my research, guidance for thesis structure, for proof reading, for your patience and unwavering support. Thanks for the joy and enthusiasm you gave me. To the editors and reviewers of the journals to which I submitted the various manuscripts, I feel deep gratitude. Their editorial comments and suggestions always resulted in a better, manuscript and their input slowly trained me in the craft of scientific writing. The success and final production of this project required a lot of support, guidance, assistance and encouragement along the way and I am very fortunate to have received all of this. Words cannot express how grateful I am to my mother-in-law Usha Tyagi for all the sacrifices that she made on my behalf and her prayers have sustained me so far. Of course I would not have completed this doctorate research without the extended support and unfailing confidence of my VII husband Pankaj, my son Suryansh and my daughter Srishti. I thank you all for motivating me to strive towards my goal. Pankaj, you are amazing, without your outstanding contribution, I would seriously not have accomplished this task. I wish to thank my aunt Rita Taneja for her divinest input in my life. I am so much grateful to my loveliest sister-in-law Geetu Gupta who continuously sweetened my life and helped me in practical ways. The kindest support came to me from my son’s friend Daniel Tasmakis, who reread my work and provided me suggestion despite being busy with his own university studies. I would absolutely fail in my duty if I do not mention my little dog Stricker, who was always there cheering me with his nicest cuddles. I wish to extend my thankfulness to my priest Achrya Raj Tripathi for his profound mental support that did not let my faith down from Almighty Lord Shiva. His inspirational words and teachings always lit the way out of several murky holes during all the downturns of my life. I am thankful for the academic and financial support that I have been fortunate enough to receive from the RMIT University. I would like to extend my sincere thanks to the staff for their endless efforts and professionalism. I appreciate Dr. John Reece for his statistical support and advices in my manuscripts. Finally, I would express my special appreciation and thanks to Swami Ramdev and Achraya Blakrishna for their extended interest in the yoga research, and for permitting me to conduct my research and collect research data at Patanjali Yoga research Foundation. I thank all research laboratory staff for their assistance and the research participants. VIII Table of Contents Page Declaration by Candidate …………………………………………………………………………………………………………II Picture of Lord Shiva………………………………………………………………………………………………………………. III List of Publication Arising from this Thesis…………………………………………………………………………….. IV Dedication………………………………………………………………………………………………………………………………… VI Acknowledgement………………………………………………………………………………………………………………….. VII Table of Contents…………………………………………………………………………………………………………………….. IX List of Figures………………………………………………………………………………………………………………………… XIV List of Tables…………………………………………………………………………………………………………………………. XIV List of Abbreviations………………………………………………………………………………………………………………. .XV Thesis Abstract …………………………………………………………………………………………………………………………..1 CHAPTER 1- Background…………………………………………………………………………………………… 3 1.1. Mind-Body Medicine: Historical and Modern Perspective…………………………………………….. 3 1.2. Objectives of the Thesis………………………………………………………………………………………………… 6 1.3. Evolution of Research Questions…………………………………………………………………………………… 7 1.4. Organisation of Chapters……………………………………………………………………………………………....9 CHAPTER 2- Stress and Mind- Body Balance…………………………………………………………. 12 2.1. Introduction………………………………………...……………………………………………………………………….12 2.2. Concept of Stress………………………………………………………………………………………………………… 13 2.2.1. Balance and Homeostasis……………………………………………………………………………………... 13 2.2.2. Allostasis……………………………………………………………………………………………………………………14 2.2.3. Classification of Stress Acute and Chronic……………………………………………………………...16 2.3. Stress as viewed by the Different Disciplines………………………………………………………………16 2.3.1. Stress as Stimulus………………………………………………………………………………………………….. 17 2.3.2. Stress as Process……………………………………………………………………………………………………. 18 2.3.3. Stress as Response…………………………………………………………………………………………………. 19 2.4. Integrative Model of Stress…………………………………………………………………………………………. 22 2.4.1. Stress Exposure………………………………………………………………………………………………………. 23 2.4.2. Stress Reactivity……………………………………………………………………………………………………… 24 2.4.3. Stress Recovery………………………………………………………………………………………………………. 25 2.4.4. Stress Restoration…………………………………………………………………………………………………… 25 2.5. Modelling Stress in Laboratory (Mental Arithmetic Stress Test)……………………………….. 26 2.6. Stress Metabolism and Oxygen Consumption……………………………………………………………. 27 IX 2.7. Stress Autonomic Control and Heart Rate Variability………………………………………………… 28 2.8. Non-Invasive Physiological Measures of Stress…………………………………………………………. 29 2.8.1. Measurement of Oxygen Consumption…………………………………………………………………… 31 2.8.1.1. Measuring Oxygen Consumption through Dilution Technique…………………………..31 2.8.1.2. Standard Conditions for Oxygen Consumption Measurement…………………………. 32 2.8.2. Measurement of Quantification of HRV………………………………………………………………….. 32 2.8.3. Psychological Measures………………………………………………………………………………………….. 33 2.8.3.1. Profile of Mood State………………………………………………………………………………………….. 33 2.8.3.2. Flow Scale………………………………………………………………………………………………………….. 34 2.9. Stress Regulatory System…………………………………………………………………………………………… 34 2.9.1. Sympathetic