Objective. To examine the effects of a 12-week Hatha yoga intervention on cardiorespiratory endurance, muscular strength and endurance, and flexibility in Chinese adults. Methods. 173 adults (aged 52.0  7.5 years) were assigned to either the yoga intervention group (n = 87) or the waitlist control group (n = 86). 19 dropped out from the study. Primary outcomes were changes in cardiorespiratory endurance (resting heart rate (HR) and maximal oxygen uptake (VO2max)), muscular strength and endurance (curl-up and push-up tests), and lower back and hamstring flexibility (the modified back-saver sit-and-reach (MBS) test). Results. Compared to controls, the yoga group achieved significant improvements in VO2max (P < 0.01), curl-up (P < 0.05) and push-up (P < 0.001) tests, and the MBS left and right leg tests (both P < 0.001) in both genders. Significant change was also found for resting HR between groups in women (P < 0.05) but not in men. Further analysis comparing participants between younger and older subgroups yielded similar findings, except that the older participants in the yoga group failed to improve resting HR or the curl-up test versus control. Adherence (89%) and attendance (94%) were high. No serious adverse events occurred. Conclusion. A 12-week Hatha yoga intervention has favorable effects on cardiorespiratory endurance, muscular strength and endurance, and flexibility in Chinese adults.

Increasing evidence suggests that complementary and alternative approaches that encourage increased physical activity and reduce sedentary behaviours might confer health benefits. Originated in India, yoga has become increasingly popular in western countries [21] as a means of exercise primarily using gentle static stretching postures with minimal physical exertion and conscious breathing to promote flexibility and relaxation. Of the various branches of yoga (such as Hindu, Hatha, Raja, and Mantra), Hatha yoga is perhaps the most widely practiced, which consists of elements of physical postures, conscious breathing, and meditation [22]. Hatha yoga appears safe and easy to learn and does not require any complicated or expensive equipment or specific training venue and thus could be suggested as an alternative form of exercise associated with high exercise adherence [23].


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In addition to improving resting HR, the yoga intervention increased VO2max in both men and women compared with the control group. When comparing participants between younger and older subgroups, the yoga intervention was similarly effective in increasing VO2max in both subgroups. Prior studies showed improved VO2peak for healthy untrained adults [26] and people with chronic heart failure who completed an 8-week yoga training program [50]. We add to these prior studies by showing an improved VO2max for apparently healthy adults assigned to a 12-week yoga training program. While the mechanisms responsible for the change cannot be directly determined in this study, the increased muscular endurance resulting from yoga practice may have achieved a better control of intercostal muscles that would subsequently improve VO2max.

Previous studies have reported that yoga exercise improved truck dynamic muscular strength and endurance as well as abdominal muscles muscular strength [27, 29]. Similar data were observed with a significant improvement in lower limb muscular endurance in older adults [28]. Our study also demonstrated significant favorable effects of the yoga intervention on muscular strength and endurance of upper body muscles and abdominal muscles in both men and women. The mechanisms by which yoga provides beneficial effects on muscular strength and endurance still need to be determined but it is reasonable to believe that the benefit may be mediated by some yoga postures, which may have achieved optimal intensity for increasing muscular strength and endurance. A previous electromyographic (EMG) analysis in 20 older adults showed that some selected yoga postures including the Chair and Warrior Front postures had generated relatively large knee extensor joint moments of force and quadriceps EMG activity [51]. In addition, yoga may help to maintain proper posture and spinal alignment, thereby exerting beneficial effects on muscular strength and endurance. However, abdominal muscular strength failed to improve in the yoga group versus the control group within older participants. It is possible that the intensity of yoga was not sufficiently high to provide observable improvements in this measure in older adults who tend to have weak abdominal muscles. However, we did not measure muscle mass in this study.

An additional benefit of the yoga intervention was improvement in flexibility, which can determine the efficiency of muscles. Our findings demonstrated significant favorable effects of the yoga program on lower back and hamstring flexibility in both genders and age groups. These results are in accordance with previous research that found yoga significantly improved ankle flexibility, shoulder elevation, trunk extension, and trunk flexion in healthy untrained adults [26] and spinal flexibility in people with chronic low back pain [52]. The findings of the increased flexibility are not unexpected, given the static stretching nature of yoga postures (involving holding the stretched position using the strength of the agonist muscle) [26], which exert their beneficial effects on flexibility by increasing the length of both connective and muscle tissue [53], thus engendering a range of joint angles.

The limitations of this study include the lack of randomization, which may have led to selection bias and decreased comparability between groups with various confounding factors. Other limitations include nonblinded assessment of outcomes and the possible lack of measures of confounding factors such as diet and sleep quality. In addition, the participants were a highly motivated group that was willing to volunteer for a research study, and the yoga class was adapted for beginners; therefore findings may not be directly generalizable to a typical community yoga class. Finally, because the yoga classes were offered to participants once per week, the frequency of sessions may be different from that of other intervention studies, which makes comparison between studies difficult. However, our study has several notable strengths including the use of an expert yoga practitioner to design a program specifically for middle-aged to older adults, a sex-balanced stratified sample, and the inclusion of multiple outcome variables.

Until date, studies reporting effect of yoga package, comprising of selected shuddhi kriyas, asanas, pranayamas and meditation, on physiological health of volunteers of a particular age group are available. A systematic study considering physiological effect of a specific yoga package on the populace of different age groups from similar occupational background is still a virgin area to undertake.

Body weight is an important parameter for the determination of nutritional requirements, drug dose administration, pulmonary tidal volume estimation and hemodynamic assessments. As gaining or reduction of body weight above or below normal is associated with many lifestyle related diseases, maintenance of proper body weight is important irrespective of age and sex. In the present study body, weight of all the volunteers decreased and also in different age groups, with highest reduction was observed in the age group of 30-39 years (7.2%) [Figure 2]. This decrement was likely contributed by reduction in total body fat in all volunteers. Ray et al., also reported that body weight of middle aged men was lowered after practicing yoga. [5] Yogic sukshma and sthulavyama, suryanamaskar and practice of different asanas help in the reduction of body weight of the participants. [20]

Skinfold thickness of the volunteers was reduced after yoga training in all age groups. Triceps SKT of the participants was lowered by 17.2% in all volunteers and 7.9%, 16.3% and 20.7% in the age group 20-29 years, 30-39 years and 40-49 years respectively [Figure 3]. After practicing yoga suprailiac SKT was lowered by 22% in all after 12-weeks and group wise 19.4%, 19.4% and 22.5% respectively. Rush et al., in their study have reported that in Asian Indians, abdominal fat increased with increasing age. [23] We also observed suprailliac skinfold thickness and waist circumference was highest in senior age participants. Subscapular skinfold thickness was lowered by 14.1% in all volunteers after yogic intervention. Reduction in this skinfold thickness was also observed in Gr. - I, II and III by 5.5%, 13% and 16.7% respectively. It was also observed that reduction of suprailiac skinfold thickness was higher among all skinfold thicknesses [Figure 3]. This might be due to different forward and backward bending asanas and suryanamaskara, which gives more activity in the trunk region and thereby reduces the excessively deposited fat in that region. [24] Central skin fold thickness which is a sum of subscapular and suprailiac skin fold thickness was reduced by 17.5% in all volunteers and 11.1%, 15.7% and 18.9% in the participants of age group 20-29 years, 30-39 years and 40-49 years respectively. Peripheral SKT which is a sum of biceps and triceps skinfold thickness was also decreased to 13.7% after yogic practice. Sum of all skinfold thickness was decreased by 14%, 14.5% and 18% in all, 30-39 years and 40-49 years age group respectively after HYT. Bera and Rajapurkar showed a significant improvement in body density in male high school students after practicing yoga for 1 year. [11] In our study, we also found body density increased significantly in all and in senior age group (30-39 and 40-49 years) participants after 12-weeks which might be due to lowered total body fat. But body density of younger age group (20-29 years) did not show any change. Higher amount of body fat is associated with increased risk of adverse health events and greater mortality. [25] Fat% and total body fat were increased with age and highest in the volunteers of age group of 40-49 years. Body fat% and thus total body fat was reduced after 12-weeks Hatha yoga practice in all volunteers with highest reduction observed in the age group 40-49 years (10.5% and 15.9% respectively). Thus, HYT for 12 weeks preferentially reduces the body fat% and absolute fat weight and thereby significantly lowered the body weight and increased body density. Our findings of weight loss complemented with reduction in total body fat signpost that HYT is a potential adjunct for management of obesity in adult. 006ab0faaa

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