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The role of yoga as a therapeutic intervention is increasingly being recognized in several clinical conditions, including psychiatric problems, as a means for alleviating symptoms, restoring good health and for successful rehabilitation. Research studies involving empirical approach is an important avenue that offers information on therapeutic effects of yoga both for health professionals and lay public. Yoga addresses the needs of the individual as a whole, rather than parts and this contribution becomes significant especially in conditions where these needs are only partially addressed by mainstream medicine. Epilepsy is one such chronic condition that carries with it the burden of several psychosocial problems that affect the quality of life and well being of the affected individual. Our work in the area of yoga therapy that spans over 3 decades has helped us understand the different dimensions in which yoga practice influences a person’s health and well being. This has encouraged us to apply the techniques of yoga for epileptic condition and assess the effects in scientific terms. The project was conceived by the Research Department of KYM and a grant was obtained from Central Council for Research in Yoga and Naturopathy (CCRYN), Government of India for this purpose.
The project formally commenced in June 2003 and we have completed the first phase of the study (pilot project) with sample strength of 31 in the experimental group (receiving yoga training) and 25 in the control group (only under medical management).
These persons were assessed on their clinical profile and on psychological parameters including anxiety, depression, quality o life and psychological well-being. A comprehensive neuropsychological assessment was carried out by a trained psychologist for these people individually. Except for neuropsychological assessment, the control group was assessed at baseline on clinical and psychological parameters. The neuropsychological status of the experimental group was compared with that of a normal control sample (persons without epilepsy/any neurological condition) matched or age, gender, education and socio-economic status.
The subjects in the experimental group were given individual yoga training every week. This constituted the practice of specific postures, pranayama, meditation, chanting etc., that was charted according to each person’s capacities and needs. Practice was not standardized, but the sessions were structured to include daily practice for 20 minutes to 30 minutes. Practice was monitored on a daily basis using monitor sheets, which also helped track their drug dosage and seizure frequency. The teachers in-charge also maintained a record of their observations and feedback from the students for every class. On an average, each participant received 20 individual sessions in 6 months (they would receive about 35 sessions during the 18 months’ study period).
Regular bi-monthly group sessions which involve presentations/discussions of important concepts in yoga, specific skills training, special lectures by resource persons have facilitated building a strong support group for epilepsy. We have completed 23 group sessions so far.
Regular assessments are done every 6 months for a period of 18 months. At the end of 6 months of training, the first post training assessment was done for 15 persons on the following parameters:
Psychological
Clinical
Subjective experiences related to practice
In April 2004 the results of the preliminary analysis were presented in front of a panel of experts for their critical evaluation.
The Panelists were:
Dr. Prithika Chary- (Neuropsychologist and Neurosurgeon), Apollo Hospitals)
(Dr. Prithika Chary has been supporting our project since its inception)
Mr. A V Balasubramaniam- (Director, Center for Indian Knowledge Systems)
Dr. R Sridharan-(Neurologist, Apollo Hospitals)
Dr. V D Swaminathan- (Reader, Dept. of psychology, University of Madras)
Dr. Sabiha Sultana- (Neuropsychologist, Apollo Hospitals)
Mr. S Sridharan- Yoga teacher, KYM, Chennai
Based on the suggestions and guidance obtained, we have started the second phase of the study – a randomized control trial that is considered the hallmark of scientific research.
On the basis of the assessments done so far, it has been found that there is significant reduction in the anxiety levels of the persons with epilepsy after yoga training.
There is significant improvement in anger expression, physical fatigue and physical quality of life.
Apart from the quantitative data, the study has generated a fund of qualitative data in the form of transcripts of group sessions, interaction with students, teachers’ reports and students’ subjective response to yoga practice.
Response to yoga varies from person to person, as also their compliance with the intervention and motivation to practice regularly. However, the results achieved so far are very positive and encouraging. While almost all the students report better self-confidence and better control over their health, some persons have consistently demonstrated the ability to even abort attacks by specific breathing practices.
This study has important implications for health and rehabilitation of persons with epilepsy. Yoga provides a crucial anchorage by addressing the person as a whole and not the condition per se. The yoga teacher plays an important role in the healing process by providing comprehensive care that is intensive and individual based. Yoga empowers a person with epilepsy to handle the condition better, develop a positive outlook of life and actively participate in his/her own healing and also support others with this condition.
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