The Science of Yoga and it’s benefits in a Palliative Setting
– Dr. Bindu Menon, Hyderabad
Yoga is a mind-body practice which originated in India thousands of years ago, that aims to create inner harmony and integrate the physical, mental, and spiritual dimensions of life. What yoga can offer in palliative care is a holistic approach in which the ‘individual’ is focused on, not just the disease. In addition to emphasizing better quality of life, it incorporates a patient-centered, broader view on health with the goal of providing relief from symptoms, discomfort, physical challenges, and mental stress caused due to the illness.
Yoga is widely acknowledged and practiced across the globe because of its scientific basis in enhancing health and well-being. The eight limbs of yoga, as described in Patanjali’s Ashtanga Yoga, shares valuable insights on living a meaningful life. The first two limbs, Yama and Niyama, are moral and social guidelines that provide us with a code of behavior and establish the groundwork for a life filled with ideals and values. The third limb, Asana, explains the postures that bring stability to the body and mind. The fourth limb, Pranayama, includes breathing exercises to purify the body channels, bestowing the mind with clarity and calmness. The remaining four limbs, the Pratyahara, Dharana, Dhyana and Samadhi are the mind related meditation practices that help us to connect with the higher self, and attain moksha, or salvation. Thus, Yoga is ancient science that focuses on uplifting mankind from a basic level to attain a higher self, or self-actualization.
The following are examples of some yoga practices useful in Palliative Care, which can be practiced under the guidance of a certified yoga instructor.
1. Gentle yoga poses (asanas)
A palliative atmosphere is a better fit for restorative yoga, which uses props to modify traditional poses, or asanas. Consequently, stretching, support, and relaxation are all facilitated by utilizing a cushion or towel. Stretching that is adapted and supported to meet the needs of each patient is advised in a palliative context.
2. Regulated breathing techniques (pranayama)
Stress and anxiety can be managed by deep, yogic breathing that involves prolonged exhalation, which relaxes most skeletal muscles. Anybody, wherever, even in a hospital bed, can do this, regardless of age or physical restrictions. By lowering sympathetic activity and balancing vagal activity, diaphragmatic breathing successfully lowers anxiety levels. Breathing slowly and deeper and breathing through alternate nostrils (Nadi Shodan pranayama) purifies the channels and relaxes the body and mind.
3. Meditation Practices (dhyana)
Through the practice of meditation, one learns to focus their attention on one item at a time and prevent mental distractions. By using this technique, one can eliminate thoughts that are taking over their head, therefore, lowering tension and calming the mind. Improved emotional and psychological wellness, as well as adaptive stress management and ‘self-awareness’, are all facilitated by meditation.
Yoga Nidra (conscious, dynamic, yogic sleep)
‘Yoga Nidra’ or ‘yogic sleep’ is a ‘Pratyahara technique’ in which the distraction of mind is constrained, and the mind goes to a deep relaxed state, induces a calming effect on body and mind and has profound benefits in treating chronic illness, psychological disorders, and psycho somatic diseases. ‘Yoga Nidra’, a psychotherapeutic practice that involves a specific set of steps for the guided meditation and visualisation. The ‘sankalpa technique’ is the most crucial way to train the mind when practicing Yoga Nidra. Sankalpa, which translates as ‘intention’ or ‘determination’ aids in the creation of positive affirmations and shifts an individual’s entire identity in a good direction. This can be used in a palliative care context to achieve total calm and relaxation as well as to lessen anger, anxiety, and emotional reactivity.
Nada Yoga
Singing or chanting a mantra is known as nada yoga, and it is said to have enormous therapeutic advantages. It reduces anxiety and positively increases the EEG Alpha and general well-being.
Gestures (mudra)
Everyone can get comfort through balancing and relaxing mudras, which are gentle bodily gestures. For yoga therapy at the end of life, hasta mudras such as the adhi, padma, and anjali mudras are advised. In order to restore inner harmony and balance, the Varuna and Chinn mudras are helpful.
Mindfulness
Mindfulness teaches to focus living on the present moment, and this can be practiced anytime, anywhere, and suitable for even the most disabled patient. Mindfulness-based practice can aid in coping with the stress and assist them in acceptance to face the realities of sickness, pain and death.
Do’s and Dont’s
Individuals from any age can practice yoga, and it can be done practically in any place, including on a hospital bed. As they say, “If you can breathe, you can do yoga”. A comprehensive assessment of the patient’s health guarantees a tailored yoga regimen to enhance one’s personal health status and prevent negative consequences. Thus, it is advised to seek the advice of a certified yoga instructor.
It is best to avoid poses that put stress on the bones in advanced metastatic malignancies that have affected your bones. In patients receiving radiation therapy for lung lesions, hyperventilation techniques like Kapalabhati (forceful exhalation and automatic inhalation) and Bhastrika (bellows breath) are prohibited because they increase the risk of pneumothorax. One needs to pay attention to the underlying pathology, and this is crucial in the management of chronic illnesses, and other medical emergencies.
Conclusion
It appears that incorporating the age-old spiritual and yogic knowledge into traditional palliative care settings is a viable, affordable, and time-tested holistic strategy that provides patients with an all-encompassing treatment. There are some common misunderstandings regarding yoga, such as the idea that it’s just for those who are flexible as an activity. The public and healthcare professionals need to be made aware of the advantages of yoga for managing symptoms and attending to a patient’s psychological and spiritual requirements.