Yoga as a support during Covid-19 lockdown

Sahni PS, Singh K, Sharma N, Garg R (2021)
Yoga an effective strategy for self-management of stress-related problems and wellbeing during COVID19 lockdown: A cross-sectional study.
PLOS ONE 16(2): e0245214

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FULL ARTICLE (PDF) 

OVERVIEW

Very few researches have been published so far investigating the therapeutic impact of yoga on the COVID-19 related stress and mental and emotional strain, and it is no surprise a first innovative one has been conducted in India.
The findings suggest that yoga practice may foster a better sense of control and understanding of COVID-19, fostering less stress and depression and promoting more wellbeing. Furthermore, a longer term yoga practice can nurture strong emotional regulation strategies.
Some limitations concern the fact that the recruitment happened via online yoga practitioner groups, thus all the respondents were somehow already interested in yoga, even the “non-practitioners”, which may have led to a bias. Furthermore, in India, individuals’ faith and spirituality play an important role in the society and it is therefore possible that, despite lacking a regular spiritual practice, non-practitioners may have had other support tools. Additionally, this study relied solely on self reporting, likely a requirement due to Covid-19 restrictions, but this may have also led to bias around opinions towards yogas effectiveness. By not including questions around other physical activity this study also neglected to consider the physical benefits of movement practices.
Though, this investigation is much welcomed as it addresses the role of yoga in the management of adversities and shows that practice can foster a chain of positive effects. The perception of lesser vulnerability and better sense of control over COVID-19, may in turn generate less stress and a higher sense of well-being. As the authors propose, less fear allows to view adversities with a more pragmatic approach and helps maintaining a peaceful disposition.
More studies are needed to examine the role of yoga as a complementary support tool during the COVID-19 lockdown and, more in general, during calamities, though this first study shows promising results.

This study notes that 2.6 billion people have been in lockdown due to Covid, and are therefore vulnerable to second form stress related disorders. Stress, anxiety and depression has been attributed to fear of contracting Covid-19. The authors cite previous studies around fear of other illnesses, such as AIDS and Diabetes, that have found negative effects on wellbeing. While there is previous research on the effectiveness of yoga as a complementary medicine for a host of mental health issues, there is little empirical research on its effectiveness on the self-management of stress and stress related problems. 

  • This was a cross-sectional study completed through an online survey of people in India. The study population was a convenient sample of individuals, contacted via online social networking yoga groups yoga group and email mailing lists.

  • 668 adults received the questionnaire, of which 643 (96.3%) chose to participate. 64.7% of participants were male, 34.7% were female and 4 participants did not specify gender. The age range of participants was 18-72 years old, with a mean age range of 28 years. 59% of the participants were students, of the other 41% non-student group 34.4% classified themselves as “working adults”.

  • The participants were broken into 3 categories based on their yoga and spirituality experience.
    • Practitioners”, those who reported they practiced some form of yoga (59.6% of the participants), were further categorized into “Long Term Practitioners” (>4 years of practice) “Middle Practitioners” (1-4 years of practice) and “Beginners” (having started during lockdown).
    • Other spiritual practitioners”, 17.6% of the total  respondents, those who reported another form of spiritual practice.
    • Non-practitioners”: the remaining 22.7% of participants.

The study was conducted via an online survey circulated through yoga practitioners online groups. The survey was designed for both Hindi and English speaking participants. Electronic consent was obtained before the survey was begun.

The researchers used a variety of tools to assess well being of participants.

  • The Brief Illness Perception (BIPQ) was adapted to rapidly assess the cognitive and emotional views of COVID-19:
    • Label of the disease: How the person viewed the symptoms of Covid-19
    • Consequences: How the person viewed the effect of Covid-19
    • Understanding: How well the person understood the illness
    • Timeline: How long the person thought affects of Covid-19 last
    • Cure or Control: How much control the person felt they had over recovering from or controlling the illness.

  • The Depression Anxiety and Stress Scale (DASS-9) was modified to measure the stress, anxiety and depression of participants, with participants asked to rate how much statements related to depression, anxiety and stress related to their current state.

  • Scale of General Well Being (SGWB) was used to measure well being through 14 common constructs of well-being, including happiness, calmness, self- acceptance and self-worth.

  • Brief Resilience Scale (BRS) was used to measure resilience through 6 items measuring the ability to bounce back from stress and difficulties.

  • Peace of Mind Scale (POMS) was used to measure peace of mind through a 5 item scale that measures affective well being through statement of internal peace and harmony. Participants were asked to indicate how often they felt the states described.

  • Emotional Regulation Questionnaire (ERQ) was used to assess commonly used emotional regulation strategies. Participants were asked to rate how much they responded to statements describing methods of ER.

Participants were also asked to fill out a yoga schedule, a consent form and demographic information.

Descriptive statistics describes the variables analyzed. Multivariate analysis was conducted to examine the significance of differences in the illness perception and well-being related measures among the 3 groups, as well as among the subgroups of Practitioners.

  • Yoga practitioners experienced significantly greater personal control and experienced lower emotional impact and higher preventative control than other spiritual practitioners and non-practitioners. This reflects the finding of numerous other studies on the physical and mental health benefits of yoga.

  • Lower rates of reported depression and stress were found in the yoga practitioner groups compared to the other practitioners and non practitioners groups. The yoga practitioner and other spiritual practitioner groups all had a higher sense of well being, than the non practitioner group, pointing to the effectiveness of other spiritual practices in creating peace of mind. No statistically significant difference was found in resilience, supporting the theory that resilience may be a trait construct.

  • Long term practitioners showed higher personal control and lower illness concerns than middle or beginner groups. Long Term practitioners were also found to have the highest peace of mind and lowest depression rates of all groups. Long term practitioners were shown to have higher rates of emotional regulation through use of reappraisal strategies compared to the other yoga practitioner groups.  Beginner practitioners (who had begun practicing during lockdown) were found to have the same levels of well-being and peace of mind as the mid-term practitioners.

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