International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571

Review Article

Muslim - A New Form of Physical Activity: A Narrative Review

Dr Nabeela Nazish1, Dr Nidhi Kalra2

1Assistant Professor, Dr. B .R. Ambedkar Medical College, Bengaluru, Pincode-560043 2Assistant professor, BCIP, New Delhi.

Corresponding Author: Dr Nabeela Nazish

ABSTRACT

Aims and objectives: This review aims to discuss the relationship of Muslim Prayer with regular physical activity and its various medical benefits along with spiritual benefits. Methodology: For the present article, a literature search was performed using Google Scholar, Pubmed and Cochrane data base using the key words. Articles were searched and reviewed using the narrative approach. Outcome & Conclusion: There are numerous physical and physiological benefits of Salat because almost all the muscles of the body and joints are exercised during Salat. Different studies prove the medical benefits along with spiritual benefits of Salat. So Salat can be considered as a new form of physical activity due to its multiple dimension positive effect on overall health.

Key words- Muslim Prayer (Salat), Physical Activity, Health Benefits

INTRODUCTION depression, and fall-related injuries. Regular physical activity is Physical activity is considered as a leading important for living healthy lifestyle. health indicator. [5] To promote and maintain Physical activity is an essential human health, all healthy adults aged 18–65 yr need functions. [1] The human body has evolve as moderate-intensity aerobic physical activity a complex organism capable of performing for a minimum of 30 min on five days each different ranges of tasks, from large week or vigorous-intensity aerobic activity muscular activity to fine manual dexterity. for a minimum of 20 min on three days each [2] Daily physical activity can improve week. [6] Salat is a practice of formal prayer overall physical and musculoskeletal fitness. in which must be practiced by Numbers of evidences are there that showed . [7] Salat (Muslim Prayer) is the that enhanced musculoskeletal fitness is word for praying by Muslim associated with an improvement in overall worshippers and considered as second pillar health status and also decrease the risk of of the Islamic faith. [8] Salat is the Muslim chronic disease and disability. [3] Regular which involve performing some physical activity induces multiple spiritual along with certain physical adaptations within various system of body. postures. [9] Salat is performed by Muslim [4] worshippers five times a day and it is a Regular physical activity helps in spiritual and physical act in where, muscular reducing risk of different cardiovascular system of human body became active disease, neurological conditions, systemic without muscle fatigue and induces serenity diseases, musculoskeletal conditions, on body and soul. There are some scientific

International Journal of Health Sciences & Research (www.ijhsr.org) 337 Vol.8; Issue: 7; July 2018 Nabeela Nazish et al. Muslim Prayer-A New Form of Physical Activity: A Narrative Review evidences of long-term health benefits of spiritual act involving total obedience and performing moderate intensity activities submission to (God) and it is regularly. [10] Muslim prayer (Salat) can be obligatory for all Muslims to perform it. The called as Islamic yoga because of some method of praying is similar all over the common postures and benefits like Yoga. world. These are the following steps in Yoga consists of a number of „asana` or performing Salat. body positions, which is to be maintained Standing for Prayer for a desired length of time along with Starting position is standing and reciting „mantras` or breathing in a rhythmic worshippers should concentrate their minds manner. Salat (Islamic yoga) helps in on praying. in the comfortable standing promoting relaxation and emotional position, the center of pressure is usually wellness, enhance balance and coordination, midway between the in step of the two feet. and helps in enhancement of immune In a standing position, they raise their hands system. Relaxation effect reduces the mental up to the ear lobe and bring them down one stress and tension & enhances the memory. after another by holding the left wrist with Even each (Salat) positions is having some the right hand on the abdomen, above the similarity with corresponding yoga position navel, or on the chest. During voluntary and the positions together “activate” all clenching of the right hand, blood flow is seven “chakras” (energy fields) in the body- increased in the hand area of the left motor as per yoga practices. [11] cortex, and the corresponding sensory areas The present review aims to discuss various in the post-central gyrus. Worshippers utter physical and medical benefits of Muslim some versus in Arabic which also prayer with evidence based findings on contribute in activating speech muscles. proving Muslim prayer as a new form of physical activity After standing and uttering some Physical Activity verses from the Quran, bowing is done by Physical activity is one of the most forward movement of the vertebral column, basic human functions. The human body has resulting in activation of the back muscles evolved over millions of years for especially the Para spinal muscles and this performing an enormous range of tasks, movement is supported by two straight from walking; running or climbing to hands grasping the hyperextended knees. detailed actions involving fine manual After a few seconds, the worshipper dexterity. [2] Regular physical activity is gradually reverts to their normal standing being an important component of healthy position. lifestyle. Physical activity is one of the most basic human functions. [1] Routine physical The act of prostration is the activity can improve musculoskeletal fitness substance of Salat. It is done from the which results in improving overall health standing position to kneeling, putting the status and a reduction in the risk of chronic head down and touching the ground with the disease and disability. [3] Regular physical forehead, with the palms remaining parallel activity induces multiple adaptations within to the ears, and touching the ground with the musculoskeletal and cardiorespiratory flexed elbows for a few seconds system. [4] Sitting and Finishing Salat Muslim Prayer (Salat) After standing and bowing, and Salat is the Arabic word for prayers proceeding to prostration, sitting is done on offered by Muslim worshippers, and it is the left leg knee flexed with the inverted also considered as the second pillar of the Dorsi-flexed ankle and flexed right knee and Islamic faith. The procedure of the prayer metatarsophalangeal joint for a couple of ritual includes standing, bowing, prostration minutes. After that, Salat is concluded by and sitting. Salat is a physical as well as a

International Journal of Health Sciences & Research (www.ijhsr.org) 338 Vol.8; Issue: 7; July 2018 Nabeela Nazish et al. Muslim Prayer-A New Form of Physical Activity: A Narrative Review looking over one‟s right and left shoulder wishing peace for mankind. [8]

i)standing for prayer ii)Bowing

iii) Prostation iv) Sitiing and finishing salat Fig-1 Steps of Muslim prayer [27]

Relationship of Muslim Prayer and and it is different from typical meditations. Physical Activity Salat is a physical movement as well as a According to definition of the World spiritual practice relating to the pure Health Organization one of the major obedience to god which is performed 5 aspects of health is physical health which is times in a day. Various movements easier to understand than other aspects of including standing, , sujood and sitting. health. Physical health is proper function of Joints involved in prayer contains shoulders, organs and cells biologically in wrist, elbow, metatarsophalangeal, proximal coordination. Medical and scientific and distal Interphalangeal, societies showed the interest in temporomandibular joint, jaw joint, spinal understanding impressions of religion on cord, pelvis, knee, ankle, subtalar, health. There is 350 to 400 studies found by metatarsophalangeal and atlantoaxial. [9] Matthews which shows that people having Salat is spiritual and physical act which strong religious beliefs, have more lifespan activates nearly all muscles of human body and a better quality of living rather than without muscle fatigue and induces serenity people with weak religious belief .World on body and soul. Scientific evidence shows Health Organization data shows 60% of that moderate intensity activities performed health and quality of life is depended on daily can have some long term health lifestyle. Islam guides the people in a right benefits. [10] way which helps them in problem solving Muslim prayer (called: Salat) is and stress release. The first and the foremost having similar effect like gentle exercise important duty in Islam after faith in god that makes muscles contracts isometrically and testify to the oneness of god is Prayer. and isotonically (Jing et al., 2012). Prayers Salat is an Arabic term which is used for have been shown to have a positive effect Muslim prayers and it is the second base of on the psychological as well as the physical Islamic faith which is usually done in a health of the human body (Yucel, 2008). quiet place and helps in better concentration There are two main movements during Salat of the mind which leads to relaxation effect which involve two flexion movements,

International Journal of Health Sciences & Research (www.ijhsr.org) 339 Vol.8; Issue: 7; July 2018 Nabeela Nazish et al. Muslim Prayer-A New Form of Physical Activity: A Narrative Review namely Ruku (bowing 90 degree forward concluded by rotation of the head and neck flexion with both hands on knees) and Sujud to the right and to the left. Such regular (flexion with the hands and forehead flat on repeated movements for years strengthen the floor). [12] An interesting statistic the overall body muscular system. All the revealed that Arabians who follow the flexors and extensors of weight bearing Muslim faith have a range of motion of joints are involved during various salat 139.5° in comparison to non-Arabic patients positions and these muscles bear the burden, who do not follow Muslim faith have 102.5º of extending the knee joints against most of of range. The act of sitting on the floor and the body weight on getting up from kneeling for daily religious activities from prostration or deep squatting position. These an early age may improve the flexibility of gentle movements are helpful in muscles. [13] maintaining joint mobility and elasticity of Muslim prayer is also a form of a mild its surrounding structures.1-7 and act as a exercise. It involves movements of all body form of endurance exercise which help to parts 5 times daily at regular intervals which protect the joints from osteoarthritis (OA). helps to maintain the body round the clock [15] without causing any strain or tiredness. [14] One study done that investigated the Benefits of Muslim Prayer muscle activity of the neck extensors (NE), The major function of rehabilitation sternocleidomastoids (SCM) and biceps is to provide the proper therapy that helps in brachii (BB) muscles in healthy subjects improving the physical activities of during Salat and specified exercises using impaired and disabled persons through surface electromyography (EMG). A group improvement in their muscle strength. The of undergraduates aged between 19 to 25 rehabilitation team should always take heed years voluntarily participated in this study. of the social and mental well-being of such For the assessment of the NE and SCM, the patients. When the different aspects of Salat subjects were asked to perform Salat were studied, it shows improvement in (salam‟s position) and exercise [neck heart, spine, memory, concentration, and rotation exercise]. Subjects were asked to cognitive functions, in fact the whole body perform ‟s position and biceps gets benefitted by the cumbersome dumbbell curl (BDC) to access BB. The beneficial effects of different postures of EMG and the motion signals of the muscles Salat. Salat activity can helps in the were recorded. The findings indicate that rehabilitation process of various there were contractions of the muscles musculoskeletal and neurological during the Salat and exercise with difference conditions. [10] EMG level. Therefore, Salat may be useful Musculoskeletal Benefits in warm up exercise or in rehabilitation Islamic prayers include several programs. [16] physical activities while performing One study done on Muslim patients Raq‟aas. Each includes standing erect, presenting with advanced degenerative bowing to a right angle position, standing arthritis of the knee, the movements of the again, prostrating from standing position, affected joint are often preserved because of then squatting with the knee joints the traditional Arabic way of sitting and the maximally flexed and shins lying in parallel Muslim way of praying force the knees into on ground, i.e., deep squatting, prostrating deep flexion for long periods many times a again, then deep squatting again. Raq'aas are day. Arabic patient was having significantly no less than two and no more than four in better range of flexion than that of non- each of the five main daily prayers. Each Arabic patients with knee osteoarthritis. Raq'aa after the first has to start by standing There was also a statistically significant up from either the position of prostration or difference between the mean extension from deep squatting position and it

International Journal of Health Sciences & Research (www.ijhsr.org) 340 Vol.8; Issue: 7; July 2018 Nabeela Nazish et al. Muslim Prayer-A New Form of Physical Activity: A Narrative Review deficit of the two groups with osteoarthritis. significantly better dynamic balance than [17] the non-practicing healthy subjects. The One research was done to investigate results of this study support the hypothesis the activity of the gastrocnemius (Gas) that Muslim prayers benefits and improves muscle in healthy subjects during salat the human physiological function, (ruku‟ position) and specific exercise especially balance. [19] [Unilateral Plantar Flexion Exercise Another study investigated the effect (UPFE)] using electromyography (EMG). of Muslim prayer (Salat) on the relative Both lateral and medial Gas muscles were power (RPa) of electroencephalography assessed in a group of undergraduates aged (EEG) and autonomic nervous activity and between 19 to 25 years who voluntarily the relationship between them by using participated in this study and the spectral analysis of EEG and heart rate myoelectric activity of the muscles were variability (HRV). Thirty healthy Muslim recorded and analyzed. The finding showed men participated in the study and Their that there were same EMG level electrocardiograms and EEGs were contractions of the muscles during the salat continuously recorded before, during, and and exercise. Therefore, salat may be after Salat practice with a computer-based considered useful for strengthening data acquisition system which shows during exercises and rehabilitation programs for Salat, a significant increase (p < .05) was lower limb activities. [18] observed in the mean RPa in the occipital Another study was done to assess the and parietal regions and in the normalized effectiveness of Muslim Prayer movements unit of high-frequency (nuHF) power of on strength of lower back muscles (LBM) in HRV (as a parasympathetic index). This relation to some common LBM exercises. A study concludes that regular Salat practices cross-sectional study was conducted at King may help promote relaxation, minimize Abdul Aziz University, in anxiety, and reduce cardiovascular risk. [20] October, 2012. They analyzed surface One study was done to identify the effects electromyogram data of 15 men and 15 of the Muslim prayer, known as Salat, on women aged (21.4±2.2 years) to compare heart rate (HR) and blood pressure (BP) the strength of LBM contraction in while performing or mime the different Muslim‟s prayers movements with that of postures of Salat i.e.:; standing, bowing, three chosen LBM exercises. Their study prostrating and sitting. The results showed showed that there were no significant that there was a significant difference in the differences between Muslim‟s four prayers HR of the subjects between performing and movements and two of the LBM exercises miming Salat. The standing and prostration included in the study (p≥0.05.The positions of Salat produced the highest and conclusion of the study was that major the lowest HR, respectively. The systolic movements of Muslim‟s prayers is having and the diastolic BP decreased significantly similar effects as LBM exercises. [12] after performance and mime of Salat, and a Neurological and Cardiovascular benefits greater reduction in BP was observed during One study was done to determine the performance of Salat. [21] effect of the Islamic prayer regime on balance. Sixty healthy male subjects were Psychological Benefits divided into two groups: one group who is the formal prayer of Islam that is a practiced Islamic prayer, and another group physically demanding practice that helps in includes non-practicing subjects. The adjusting the rhythm of the body. One study dynamic balance was assessed by using a done on the muscle activity of the right and Balance Master. Group performing Islamic left external upper trapezius muscles to prayer regimes were having statistically assess the level of muscle activity during

International Journal of Health Sciences & Research (www.ijhsr.org) 341 Vol.8; Issue: 7; July 2018 Nabeela Nazish et al. Muslim Prayer-A New Form of Physical Activity: A Narrative Review

Islamic prayer. The EMG showed more in the Islamic, however, hospital researchers significant decrease and relaxation have concluded that patients benefit from compared with non-training tasks of clients. even a simplified version of Yoga i.e. Salat augments the behavioral interventions Islamic postures (Karima Burns, 2012; Roaf because it helps develop internal awareness et al.,2014). The Muslim Prayer positions is and enhance health status and reduce the similar as some Yoga position, and the risk of shoulder problems. [22] One study positions together 'activate' all seven was done to find out the mental health and 'chakras' (energy fields) in the human body. self concept among Muslim those Who The idea of activating a chakra may means Practice Regular Namaz and Tilawat -E- thinking about how the 'feeling' sense Quran and Muslim those Who Do Not functions (Roaf et al.,2014). [11] Practice Regular Namaz and Tilawat -E- Quran. The result of this study conclude that DISCUSSION Muslim those who Practice Regular Namaz This review focuses on evidence and Tilawat -E- Quran have significantly based various benefits of Muslim prayer. high mental health than Muslim those who There are numerous physical, physiological do Not Practice Regular Namaz and Tilawat and psychological benefits of Salat because -E- Quran. [23] almost all the muscles of the body and joints Muslim prayer is the meditation of are exercised during Salat. In the prostration Islam. One pilot study was done with EEG movement of Muslim prayer besides the analysis in twenty-five trials of Muslim limb, back and perineal muscles are prayer was reported. Some of the findings exercised repeatedly. Prayer is a kind of are consistent with the majority of the psychological therapy that helps in calming previous meditation studies (alpha rhythm and soothing the soul as well as relieving all slowing, increased alpha rhythm coherence). tension. It was found that prayer is However, Muslim prayer does not show an distinguished by a wonderful measure of increase in alpha and/or theta power like smoothness, harmony and coordination, most of the results of other meditation represented in standing, kneeling (ruku), studies. [24] prostration (sujud) and sitting between Similarity between Yoga and Namaz every two . Consequently, the Muslim Prayer can be called Islamic risks of varicose vein reduced affects in Yoga because of the similar benefits like those, who perform prayers regularly and regular practice of Yoga .Yoga as 'one of properly. Also Sujud which is one of the the oldest systems of personal development action of Salat in which the head is in a encompassing body, mind and spirit'. Yoga position lower than the heart and therefore, is now became the fastest growing health receives increased blood supply and due to trend for its curative powers of movement. surge in blood supply, this phenomenon has Yogic Asanas comprises of a different of a positive effect on memory, concentration, body postures, while reciting 'Mantras' or psyche and other cognitive abilities and also breathing in a rhythmic manner. Medical it helps in drainage of sinuses, as a result of schools like Harvard and foundations such which person has less chances of getting as Menninger Foundation have researched sinusitis. Sujud position also helps in the various benefits of Yoga and now maintaining the respiratory functions, and recommend it to their patients. Interestingly keeps lungs in good shape also. [25] Islamic also have similarity in postures with One study was done to assess the yoga. This simple form of Yoga provides an effect of Salat and mimicking salat individual physical, mental and spiritual movements and postures on subjects with benefits five times a day as Muslims assume erectile dysfunction. In that study Ten certain positions while reciting Quran. Of volunteers were recruited and were divided course, not all the Yoga positions are found into two groups- one group who were

International Journal of Health Sciences & Research (www.ijhsr.org) 342 Vol.8; Issue: 7; July 2018 Nabeela Nazish et al. Muslim Prayer-A New Form of Physical Activity: A Narrative Review

Muslims (Group I) were asked to perform concentric and eccentric muscle actions their daily Salat and a new intervention of which play an important role in postural an additional 12 movement cycles of Salat stability and balance. [19] Namaz is a for three sessions a week. Non-Muslim haemodynamic exercise which overall subjects (Group II) were taught to mimic improved circulation, coordination, Good Salat movements, and were asked to Posture, balance and wellbeing which burn perform a total of 12 movement cycles off the calories and helps in losing weight without reading the recitation for three and maintaining and body composition and sessions a week. An International Index for increased aerobic capacity & reduces Erectile Function 5 (IIEF-5) questionnaire incidence of brain hemorrhage & stroke. [14] was given to the subjects before and after the intervention of performing Salat or CONCLUSION mimicking Salat movements and postures. A sound body with sound mind is The results showed that all measured essential for every man to achieve the goal. parameters improved significantly, with the Muslim prayer coordinates the actions of largest change observed in the maximum body & mind of people. Different studies percent volumetric change over the baseline prove the medical benefits along with (from 138 to 222%). This study concludes spiritual benefits. So, by these evidence that the alternative approach of Salat and based researches Muslim prayer postures mimicking Salat movements and postures, can be taken as a new form exercise for may have beneficial effects for ED patients. treating different musculoskeletal and [26] neurological conditions. Salat as a physical exercise is quite similar to the tai chi and yoga as it also REFERENCES 1. Pate RR, Pratt M, Blair SN, Haskell WL, involves the movements of the whole body Macera CA, Bouchard C, Buchner D, Ettinger and promotes physical fitness. Recent W, Heath GW, King AC, Kriska A. Physical studies of yoga show that a decrease in the activity and public health: a recommendation systolic pressure is observed when an from the Centers for Disease Control and individual performs yogic relaxation and Prevention and the American College of Sports Medicine. Jama. 1995 Feb 1;273(5):402-7. meditation. One study showed that Salat 2. Cavill N, Kahlmeier S, Racioppi F, editors. decreased systolic BP and also reduces the Physical activity and health in Europe: evidence sympathetic discharge resulting in and for action. World Health Organization; 2006. predominance of the parasympathetic 3. Warburton DE, Nicol CW, Bredin SS. Health system. A study covering 17,000 Harvard benefits of physical activity: the evidence. Canadian medical association journal. 2006 Mar alumni provides strong evidence that 14;174(6):801-9. moderate aerobic exercise is equivalent to 4. Chaput JP, Klingenberg L, Rosenkilde M, jogging about 3 miles a day. Ibrahim et al. Gilbert JA, Tremblay A, Sjödin A. Physical suggests that subjects who perform Salat activity plays an important role in body weight regularly, five times a day, would have a regulation. Journal of obesity. 2010 Aug 12;2011. healthy body composition, increase the 5. Kahn EB, Ramsey LT, Brownson RC, Heath basal metabolic rate and reduced body fat GW, Howze EH, Powell KE, Stone EJ, Rajab [21] mass. MW, Corso P. The effectiveness of interventions Studies on the benefits of „Salat‟ to increase physical activity: A systematic have revealed that when it performed review1, 2. American journal of preventive medicine. 2002 May 1;22(4):73-107. correctly and with the right postures along 6. Haskell WL, Lee IM, Pate RR, Powell KE, Blair with the spiritual well-being; it is also SN, Franklin BA, Macera CA, Heath GW, improving mental and physical health, Thompson PD, Bauman A. Physical activity and improving muscle strength, joint mobility public health: updated recommendation for and blood circulation. A study reported that adults from the American College of Sports Medicine and the American Heart Association. the different postures of salat provide Circulation. 2007;116(9):1081.

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How to cite this article: Nazish N, Kalra N. Muslim prayer- a new form of physical activity: a narrative review. Int J Health Sci Res. 2018; 8(7):337-344.

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International Journal of Health Sciences & Research (www.ijhsr.org) 344 Vol.8; Issue: 7; July 2018