REVIEW OF RELATED LITERATURE

Transcription

1 REVIEW OF RELATED LITERATURE The researcher will attempt to review the earlier studies in relation to yogic exercises and allied areas. Malhotra et al. (2005) condected the study of the beneficial effect of yoga in diabetes on a 40 days yoga asana regime under the supervision of a yoga expert. 13 specific Yoga asanas done by Type 2 Diabetes Patients included. SuryaNamaskar, Trikonasana, Tadasana, Sukhasana, Padmasana, Bhastrika Pranayama, Pashimottanasana, Ardhmatsyendrasana, Pawanmuktasana, Bhujangasana, Vajrasana, Dhanurasana and Shavasana are beneficial for diabetes mellitus. Serum insulin, plasma fasting and one hour postprandial blood glucose levels and anthropometric parameters were measured before and after yoga asanas. The results indicate that there was significant decrease in fasting glucose levels from basal to mg/dl and one hour postprandial blood glucose levels decreased from to mg/dl. A significant decrease in waist-hip ratio and changes in insulin levels were also observed, suggesting a positive effect of yoga asanas on glucose utilisation and fat redistribution in NIDDM. Yoga asanas may be used as an adjunct with diet and drugs in the management of Type 2 diabetes. Amita et al. (2009) The study was conducted effect of yog-nidra on glucose leval in diabetic patient on 41, middle aged, type-2 diabetic patients, who were on oral hypoglycaemic. These patients were divided in to two groups: (a) 20 patients on oral hypoglycaemic with yoga-nidra, and (b) 21 were on oral hypoglycaemic alone. Yoganidra practiced for 30 minutes daily up to 90 days, parameters were recorded every. 30th day. Results of this study showed that most of the symptoms were subsided (P < 0.004, significant), and fall of mean blood glucose level was significant after 3-month of Yoga-nidra. This fall was 21.3 mg/dl, P < , (from to ,) in fasting and mg/dl, P = 0.02, (from to ) in post prandial glucose level. Results of this study suggest that subjects on Yoga-nidra with drug regimen had better control in their fluctuating blood glucose and symptoms associated with diabetes, compared to those were on oral hypoglycaemics alone.

2 Gore (1994) examined that yogic treatment was given to 9(nine) diabetics for five weeks. The mental relaxation and tranquilization were emphasized more. This was special approach than the usual concept of physical exercises in the yogic treatment. The diet was regulated in terms of their calorie requirement. Fasting as well as postprandial blood sugar reduced significantly from to mg/100ml blood and to mg/100 ml. bloods respectively after the yogic treatment. Glucose tolerance increased Psychological make up and the general feeling of all being also improved. The medicinal doses were reduced. Follow of study on 4 (four) patients after 6 (six) months, showed further improvement was to continued yogic treatment. Since the diabetes is a stress disorder, the above approach seems to be appropriate, on the basis of the results. Bhat et al. (1994) conducted a study role of yogic practices on effective control of diabetes. It is one of the major health problems affecting about 5 % of Indian population. Complications involved in management of diabetes and increasing prevalence of diabetes every year, have been emphasized on the need for efficient control. Diet control, exercises and meditation with insulin and/or antiglycemic drug are the presently available treatment procedures. Stress management is also important in preventing the onset as well as controlling diabetes. Yoga includes moderate exercise, diet restriction, relaxation techniques etc. is a very good stress management system. Yoga brings harmony in body and mind, and keeps the person healthy, both physically and mentally. Literature survey indicates that effective control of diabetes, both IDDM and NIDDM can be achieved by the yoga practice. This can be explored by further experimental researches. Desai (1984) conducted a study an influence of yogic treatment of serum lipase activity in diabetics. Eight diabetic of both the sexes in age group of years (adult diabetics) undergoing yogic treatment for seven weeks in S.A.D.T. Gupta Yogic Hospital, Kaiwalya Dhama, Lonavala in two different batches. Their basal serum lipase activity were recorded and repeated after seven week of yogic training. During treatment period various yogic practices comprising of kriyas, asanas and pranayamas were daily given for one hour in the morning and also in the evening. Over the period of

3 study he was observed a significant reduction in serum lipase activity in eight diabetic patients due to continuation of yogic treatment for seven weeks. Subjects were studied to see the influence of seven weeks of yogic training-cum treatment. Their basal serum lipase activity were recorded and repeated after seven weeks of yogic training. Over the period of study he was observed a significant reduction in serum lipase activity in eight diabetic patients. Moorthy (1987) undertook a study, effect of selected yogic practices on blood sugar levels of the diabetic patients. Twenty three diabetic patients were selected for the study. The yogic training programs were performed for three months. Their basal blood sugar level was measured and repeated after three months of yoga training program. He was observed that the significant improvement in 23 (twenty three) diabetic patients in respect of blood sugar level. Brown (1988) conducted the effects of educational interventions in diabetes care. Forty-seven studies on the effect of patient teaching on knowledge, self-care behaviors, and metabolic control were analyzed using meta-analysis. Variables, such as type of patient instruction, type of research design, and overall quality of the study, also were analyzed. The 236 (two hundred thirty six) effect sizes had an un-weighted mean of 0.91 and a weighted mean of The weighted mean effect size for studies with control groups (N=27) was and the weighted mean effect size for studies using the one group pretest-post-test design (N=20) was. Homogeneity analyses resulted in weighted mean effect size estimates for knowledge sub-variables ranging from 0.41 to 0.91; for skill performance, 0.25 to 0.38; for compliance, 0.24 to 1.01; and for metabolic control, 0.06 to Experimental mortality was the only variable significantly correlated with the overall weighted mean effect size, r =.52, p =.002. The results of this study clearly support the notion that patient teaching has positive outcomes in diabetic adults. Furthermore, methodological issues were important factors which influenced these findings.. Sahay et al. (1988) under took a study the role of yoga in the control of diabetes mellitus. Fasting & Post lunch blood sugar levels came down significantly. The patients

4 develop a sense of well being within 10 days, with lowering of the dosage of drugs and diminished incidence of acute complications like infections and ketosis. There were significant changes in the Insulin kinetics and those of counter-regulatory hormones like cortical. We identified specific practices for diabetes. They have carried our long-term follow up studies in 30 (thirty) patients for periods ranging from 2-7 years. There was a smooth and sustained control of diabetes in these patients as assessed by periodic blood sugar values and estimation of HbAIc. The incidences of long term complication as well as acute complications were significantly low. It was concluded that I.D.D.M. cases showed a normalization of blood sugar with significant changes in the wide day to day fluctuations in the blood sugar values and attacks of hypoglycemia and ketosis. Varandani et al. (1988) administrated 286 (two hundred eighty six) patients with diabetes of different degrees of severity took part in a 3(three) months yoga therapy course (Hatha Yoga cleansing Process and Exercises), with a strict diet and no drugs. 25% had a normal blood sugar level at the end and 27% had an improved blood and urine chemistry without reaching normal values. The 25% who did not react to the therapy consisted mainly of persons who have diabetes since their childhood or who had needed large quantities of insulin before. Perry et al. (1997) investigated the impact of intensive lifestyle education on dietary practices, exercise and metabolic measurements in people with insulindependent diabetes mellitus (IDDM). Sixty-one volunteer subjects with IDDM were randomized to intensive (Group 1) or standard (Group 2) education programmes for six months. During a second six month period of observation Group 1 subjects received routine surveillance for their condition and those in Group 2 were given intensive advice (phase 2). Current insulin regimens were modified to optimize glycaemic control before the start of the intervention phase. Nutrient intakes, weight, blood pressure, glycated hemoglobin (HbA1), plasma lipids, lipoproteins and maximal oxygen consumption (VO2 max) were measured at the time of recruitment and at three monthly intervals during the

5 trial and phase 2. The result of the study shown that glycated hemoglobin decreased significantly in both groups between recruitment and randomization, the improvement being sustained during the six months of the randomized trial and for group 1 during the six months of post trial observation. Comparable changes were seen with total and low density lipoprotein (LDL) cholesterol in Group 1 during the trial, but significant decreases were only seen in Group 2 in association with intensive intervention (phase 2). It was observed that a lifestyle programme for people with IDDM results in modest changes in diet and exercise habits sufficient to improve measures of glycaemic control and lipoprotein mediated risk of coronary heart disease independent of changes in insulin regime. Kinmonth et al. (1998) administrated to assess the effect of additional training of practice nurses and general practitioners in patient centered care on the lifestyle and psychological and physiological status of patients with newly diagnosed type 2 diabetes. 250 (two hundred fifty) patients (aged 30-70) diagnosed with type 2 diabetes and completing follow up at one year (42 in intervention group, 108 in comparison group) It was concluded that compared with patients in the C group, those in the intervention group reported better communication with the doctors and greater treatment satisfaction and wellbeing. However, their body mass index was significantly higher as were triglyceride concentrations, whereas knowledge scores were lower. Differences in lifestyle and glycaemic control were not significant. Kerr et al. (2002) investigated an Eastern art form for a Western disease randomized controlled trail of yoga in patients with poorly controlled insulin-treated diabetes. There is increasing interest in the use of complimentary therapies. A paucity of data examined the effectiveness of such therapies in patients with diabetes. They have examined the influence of providing yoga for patients with diabetes that is poorly controlled despite the best efforts of the multidisciplinary team. After obtaining ethical approval; 37 (thirty seven) patients with poorly controlled diabetes were randomized to a traditional intensive education programme and simple exercises or a 16 (sixteen) weeks Hatha Yoga Plan.

6 Participation in regular yoga exercises did not improve glycaemic control but insulin requirements remained stable in the yoga group and increased in the controls. Although quality of life was not altered, all but one subject in the yoga group opted to continue with yoga long after completion of the study. Malhotra et al. (2002) conducted a study of certain yoga asanas if practiced regularly are known to have beneficial effects on human body. These yoga practices might be interacting with various, somato-neuro-endocrine mechanisms to have therapeutic effects. They under took twenty four NIDDM patients of 30 to 60 year old, provides metabolic and clinical evidence of mprovement in glycaemic control and pulmonary functions. These middle-aged subjects were type II diabetics on antihyperglycaemic and dietary regimen. Their baseline fasting and postprandial blood glucose and glycosylated Hb wee monitored along with pulmonary function studies. The expert gave these patients training in yoga asanas and was pursed min/day for 40 days under guidance. These asanas consisted of 13 (thirteen) well known postures, done in a sequence. After 40 (forty) days of yoga asanas regimen, the parameters were repeated. The results indicate that there was significant decrease in fasting blood glucose levels (basal /-90.8 in mg/dl to /-79.8 in mg/dl) The postprandial blood glucose levels also decreased ( / in mg/dl to / in mg/dl), glycosylated hemoglobin showed a decease. The FEV1, FVC, PEFR, MVV increased significantly. These findings suggest that better glycaemic control and pulmonary functions can be obtained in NIDDM cases with yoga asana and pranayama. Krook et al.(2003) investigated lifestyle modification programme to reduce risk factors in subjects with type-ii diabetes mellitus. Three hundred and four individuals participated in a life style modification program, involving three residential visits (2 weeks, 1 week and one 3 - days visit) spaced over 31 weeks. Participants received information and practical guidance regarding exercise training, nutrition as well as tress management and psychological counseling. Clinical parameters were determined at each visit. After completion of the program, subjects showed significant improvement in

7 glycaemic control (P<0.0001), oxygen uptake and blood pressure, body mass index and serum cholesterol was significantly reduced, while HDL cholesterol (P<0.05) was significantly increased but no changes in LDL cholesterol values. Subjects also reported increased well being and reduced stress. It was concluded that a 31 weeks lifestyle modification program results in marked improvements in glycaemic control, blood pressure and well-being in subject with type-ii diabetes. Singh et al. (2004) investigated the effect of 40 (forty) days of yogic exercises on cardiac functions, blood glucose level and glycosylated hemoglobin. They studied 24 type-ii DM cases provides metabolic and clinical evidence of improvement in glycemic control autonomic functions. Middle aged subjects were type-ii diabetics on antihyperglycemic and dietary regimen. Fasting and postprandial blood glucose and glycosylated H6 were monitored along with autonomic function studies. The expert gave these patients training in Yoga asanas (13 asanas) for min/day for 40 days under guidance. After 40 (forty) days of yoga asanas regimen, the parameters were repeated. The result indicated that there was significant +decrease in fasting blood glucose and postprandial glucose levels from basal / in mg/dl to /-16.3 in mg/dl and / in mg/dl to / in mg/dl respectively after yoga regimen. Glycosylated hemoglobin also decreased form 9.03+/-0.29% to 7.83+/-0.53%, the pulse rate, systolic and diastolic blood pressure decreased significantly. These finding suggested that better glycaemic control and stable autonomic functions can be obtained in type-ii DM cases with yoga asanas and pranayama. Tudor et al. (2004) designed to conduct a randomized trial of a physical activity intervention. The first step program for adults with type-ii diabetes. Total 47 (forty seven) overweight/obese, sedentary individuals (age= /-5.2 y; BMI=33.3+/-5.6 kg/m2) recruited through a diabetes education centre, for 16 (sixteen) weeks intervention study and 24 (twenty four) weeks follow-up assessment. Primary outcome: daily physical activity (PA) assessed by pedometer (steps/day). Secondary outcomes: anthropometric measures (weight, BMI, waist girth, hip girth) indicators of cardiovascular health (resting heart rate and blood pressure) glycemic control and plasma lipid status. Results: Relative to the control group, Fast step program

8 participants increased their PA >3000 steps/day (approximately 30 min./day) during the intervention. Waist and hip girth decreased (approximately 2.3 cm.), but did not differ significantly between groups. Significant changes did not emerge for any of the other variables. Bijlani et al (2005) examined the short-term impact of a brief life style intervention based on yoga on some of the biochemical indicators of risk for cardiovascular disease and diabetes measured. The variables of interest were measured at the beginning (day 1) and end (day 10) of the intervention using a pre-post design. The study based on data collected on 98 (ninety eight) subjects (67 male, 31 female), ages years, who attended one of their program. The subjects were a heterogeneous group of patients with hypertension, coronary artery disease, diabetes mellitus and variety of other illnesses. The study carried out in integral health clinic which conducts 8 days life style modification programs based on yoga for prevention and management of chronic disease. Fasting plasma, glucose and serum lipoprotein profile were measured on the first and last day of the course. Results depicted that fasting plasma glucose, serum total cholesterol, low-density lipoprotein cholesterol, the ratio of total cholesterol to high density lipoprotein cholesterol and total triglycerides were significantly lower, and HD1 cholesterol significantly higher. It was concluded that a short life style modification and stress management education program leads to favorable metabolic effects within a period of 9(nine) days Teaching Effectiveness: Review Hermanson et al. (1990) assessed Research has not elucidated a strong significant statistical relationship between the effectiveness of teachers in the classroom and their scholarly productivity. There are some weak correlations between certain teaching attributes and scholarly productivity, including intelligence, subject knowledge, and preparation. The studies do not show a negative correlation between teacher s effectiveness and scholarly productivity. The problems with elucidating a statistically significant relationship between teachers classroom ability and scholarly productivity are probable the result of measurement problems and a positive relationship likely does

9 exist. It seems apparent that the increased knowledge gained through scholarly makes teachers more effective in the classroom. Stivers et al. (1991) examined extent to which findings from research on teacher s effectiveness are represented on the national teacher s examination test of professional knowledge was studied through Delphi investigations. Phase I identified and rated seven research reviews. Phase II with 12 (twelve) panelist-examined the relationship of test items to research findings from 1 review. Zounhia et al. (2002) the purpose of their study was to explore differences in instructional and pedagogical effectiveness among Greek secondary school teachers of different subjects, as perceived by pupils. In this study 165 pupils (aged years) from 33 (thirty three) secondary schools in Athens, Greece, completed questionnaires regarding the effectiveness of 253 (two hundred fifty three) teachers. Within the framework of teacher preparation at university, the results indicated no significant differences in instructional and pedagogical effectiveness between those who attended courses in pedagogy, psychology and instructional knowledge (didactics) and those who did not however, pupils perceived the instructional role of teachers to be higher than the pedagogical role. Moreover, in teachers of different subjects, instructional and pedagogical effectiveness were associated and correlated to each other. Matteucci et al. (2003) the purpose of the study was evaluation of a teaching program on both type- I and type- II diabetes. They recruited 77 (seventy seven) types-i (TIDM) and 154 (one hundred fifty four) types-ii (T2DM) diabetic patients as well as 87 (eighty seven) matched control subjects on the basis of medical interview, questionnaires concerning diabetes knowledge, diabetes quality of life, state-trait anxiety, depression and general perceived self-efficiency, biochemical examination. Out of 231 (two hundred thirty one) diabetic patients, only 101 (one hundred one) patients (37 TIDM and 64 T2DM) completed intervention group due to organizational barriers. Intervention and reference (non participant patients) group received identical medical care, except that the educational group met with the educator during five teaching sessions. Three to six months after the completion of the course, they underwent a final

10 assessment. Prospective result were showed in TIDM, a reduction in HBALc levels and an increase in plasma DHL cholesterol with no change in drug treatment (the reference group showed no change in HBALc values despite an increased insulin dose), improved technical skill, knowledge, quality of life and self-efficiency in T2DM, a reduction in fasting plasma glucose and on improvement in knowledge and quality of life. The same levels of anxiety, depression and general self-efficiency in diabetic patients compared with healthy control subjects, lower diabetes. Specific quality of life associated with established insulin treatment in T2DM.