Dosage of Yoga: Researching Yoga in the Schools. Catherine Cook-Cottone, Ph.D., R.Y.T University at Buffalo, SUNY

Transcription

1 Dosage of Yoga: Researching Yoga in the Schools Catherine Cook-Cottone, Ph.D., R.Y.T University at Buffalo, SUNY

2 Dosage The amount of a medicine, drug, or vitamin that should be taken at one time or regularly during a period of time (Webster). MINIMAL THERAPUETIC DOSAGE Dosage below which yoga will not have a significant, measureable effect (see Cook-Cottone, 2013).

3 Attunement Model

4 Disordered Self

5 Exercise Science In the field of exercise science, studies show significant dose-response outcomes including: physical functioning, mental health, emotional well-being, social functioning, general health, and vitality with lowest dosages often showing no effects (e.g., Martin, Church, Thompson, Earnest, & Blair, 2009).

6 Why Explore Dosage? To control for dosage as a confounding variable in efficacy studies. Translation to practice- recommended therapeutic dosage. To better understand the key mechanisms of change.

7 Dosage and the Yoga Sutra Practice becomes firmly grounded when well attended to for a long time without break and in all earnestness" 1:14, Pantanjali, Yoga Sutras (Satchidananda, 2012)

8 School Data Dosages included (a few examples): Asana, breathing, meditation, relaxation; 60-minutes, 1/week, 12 weeks Asana, relaxation, reflection, massage; 30- minutes, 3/week, 3 weeks Asana, breathing, role-playing, guided imagery, discussion, music, visual aides; 30-miutes, 3/week, 8 weeks Poses, relaxation, breathing, internal cleansing, songs; 75-minutes, 7/week, 1 month. (Cook-Cottone, 2013; Serwacki & Cook-Cottone, 2012).

9 Yoga and Life Skills Program Yoga, life skills work, journaling, guided relaxation; 90-minutes, 1/week, 14 weeks (e.g., Scime & Cook-Cottone, 2008).

10 Africa Yoga Project Citation- Cook-Cottone, C. P., Klein, J., Giambrone, C., Cottone, J., Easton, B., Fain, S., Herron, N., & Procknal, S. (Preliminary Results Report, 4/14). The Africa Yoga Project Concept Mapping Teacher Data Analysis: A report for fundraisers and AYP. Submitted 4/17/14. To be finalized for Jessalyn Klein s Dissertation at University at Buffalo, State University of New York under the supervision of Catherine Cook-Cottone Ph.D.Associate Professor. Preparation for submission for publication in process. What is Mechanism of Change?

11 Dosage: What Matters?

12 Dosage: How Often? Classes per month/days per month (Ross et al., 2012). Control and measurement of home practice (Ross et al., 2012; Sherman, 2012). Are they teaching? (AYP data) Do they practice when they teach? (AYP data) Were participants in attendance? (Serwacki & Cook-Cottone, 2012) Consistency of Practice (Sherman, 2012) See Cook-Cottone, 2013.

13 Dosage: How Long? Duration of yoga intervention; how many weeks in length? (Uebelacker et al., 2010; Sherman, 2012). Minutes per session (Klein & Cook-Cottone, 2013). Previous yoga interventions. Years of practice prior to intervention. See Cook-Cottone, 2013.

14 Dosage: Composition Content of session affecting dosage (i.e., 45 minute session with 30 minutes asana and 15 minutes meditation; Klein & Cook-Cottone, 2013). Which limbs of yoga? How much of each limb? Other physical activity (Ross et al., 2012). See Cook-Cottone, 2013.

15 Dosage: Integrity Quality of practice or treatment integrity (Sherman, 2012) School variables affecting integrity (e.g., Scime & Cook-Cottone, 2008) Attendance- late arrival, early exit. See Cook-Cottone, 2013.

16 Current Recommendations A regular practice would be comprised of 2-3 sessions per week for at least one hour per session. (Uebelacker et al.,2010) There is trend for western studies to report twice weekly sessions from 60 to 90 minutes in length Sherman (2012). moderate to higher doses would include session lengths at 90 minutes or more and/or frequency of greater than 3 sessions per week. See Cook-Cottone, 2013.

17 Current Recommendations There is still a dearth of recommendations for minimum duration. Efficacy across studies of various mental and physical issues trending at over one month of practice with intervals of 4, 6, 9, 12, 16, and 32 weeks of practice. shorter durations would fall below 6 weeks, moderate at 6-12 weeks, longer duration studies at 13 to 32 weeks. Sherman (2012) observed a median duration across yoga studies reviewed was at 8 weeks. These categories are somewhat arbitrary cutoffs. Researchers should provide of previous literature to support dosage conditions used in current study (Sherman, 2012).

18 Last Thoughts. Rhetorical questions Is yoga an intervention (with a discrete beginning and end) or a lifelong practice? Should our answer to this question be reflected in how we describe and study outcomes?

19 Contact Information Catherine Cook-Cottone, Ph.D., RYT Web: k-cottone Blog:

20 References Cook-Cottone, C. P. (2013). Dosage as a critical variable in yoga research. International Journal of Yoga Therapy, 23, Kirkwood, G., Rampes, H., Tuffrey, V. Richardson, J., Pilkington, K. (2005). Yoga for anxiety: A systematic review of the research. British Journal of Sports Medicine, 39, Klein, J., & Cook-Cottone, C. P. (2013). A systematic review of yoga for the treatment of eating disorders. International Journal of Yoga Therapy, 23, Martin, C. K., Chruch, T. S., Thompson, A. M., Earnest, C. P., & Blair, S. N. (2009). Exercise dose and quality of life, Archives of Internal Medicine, 3, Ross, A., Friedmann, E., Bevans, M., & Thomas, S. (2012). Frequency of yoga practice predicts health: Results from a national survey of yoga practice. Evidenced-based Complementary and Alternative Medicine, pp. 10. Doi /2012/983258

21 References Satchidananda, S. (2012). The yoga sutras of Patanjali. Buckingham, VA: Integral Publications. Scime, M., & Cook-Cottone, C. P. (2008). Primary prevention of eating disorders: A constructivitstic integration of mind and body strategies. International Journal of Eating disorders, 14, Sherman, K. J. (2012). Guidelines for developing yoga interventions for randomized trials. Evidenced-based Complementary and Alternative Medicine, pp 16. DOI: /2012/ Uebelacker, L., Epstein-Lubow, G., Gaudiano, B. A., Tremont, G., Battle, C. L., & Miller, I. W., (2010). Hatha yoga for depression: Critical review of the evidence for efficacy, plausible mechanism of action, and directions for future research. Journal of Psychiatric Practice, 16,