Overview
According to a 2008 Centers for Disease Control and Prevention (CDC) health study, 7 percent of those surveyed engaged in what is considered exercise-based complementary and alternative medicine (CAM) activities. These activities are considered outside the scope of conventional exercise practices. Although pain relief was the most common reason for its use, exercise-based CAM is used throughout the spectrum of medical conditions. A survey of the medical literature revealed seven exercise-based CAM activities, namely yoga, Tai Chi, qigong, Pilates, the Alexander technique, the Feldenkrais method, and the Trager approach.
With an estimated twenty-one million adult participants in the United States in 2012, according to the survey conducted by the National Center for Complementary and Integrative Health and the CDC's National Center for Health Statistics, yoga is the most popular exercise-based CAM activity. A five-thousand-year-old practice that originated in India, yoga seeks to integrate the mind, body, and spirit through physical poses, breathing exercises, meditation, and spiritual philosophy. Pilates is another popular exercise system in the West. This one-hundred-year-old form of exercise is designed to strengthen core muscles while focusing on posture and proper breathing. Often, props and apparatus are used.
Tai
Chi, originally conceived as a martial art in China five
hundred years ago, is now practiced primarily for general physical fitness.
Although many forms exist, in the West, Tai Chi uses a series of slow, graceful
movements to enhance strength, stamina, and balance. Tai Chi is part of a larger,
five-thousand-year-old system of traditional Chinese mental, spiritual, and
physical training called qigong. Other components of qigong
include physical poses, meditation, and breathing exercises.
The Feldenkrais method, the Alexander
technique, and the Trager approach are lesser known
exercise-based CAM activities. These are movement therapies in which practitioners
are guided in their posture and physical actions to improve balance, reduce pain,
and increase emotional well-being.
Mechanisms of Action
Four of the seven forms of exercise-based CAM can be considered forms of
general physical exercise. Yoga, Pilates, Tai Chi, and qigong involve various
degrees of cardiovascular, strength, and flexibility training. Thus they promote
stamina, bone health, healthy weight, muscle tone, balance, and strength. Yoga,
Tai Chi, and qigong also involve meditation. Although scientific
research is ongoing, it appears that meditation decreases heart rate, increases
blood flow to the organs, and improves mood regulation because of changes in the
nervous system. No clinical data are available to determine the exact mechanism of
action of the Alexander technique, the Feldenkrais method, or the Trager
approach.
Uses and Applications
Exercise-based CAM is most commonly used to improve and maintain overall fitness. Other common therapeutic uses are to reduce stress, relieve pain, and improve flexibility. Exercise-based CAM experts claim, however, that these exercise systems are helpful in treating a variety of conditions, such as asthma, osteoporosis, menstrual pain, depression, cancer, high blood pressure, diabetes, arthritis, insomnia, neuromuscular disorders, fatigue, attention deficit disorder, gastrointestinal disorders, infertility, sinusitis, and heart disease.
Scientific Evidence
Determining whether exercise-based CAM is effective in the management and prevention of illness is challenging. A limited number of well-designed clinical trials are available. The wide variety of practices within these different styles makes obtaining a consensus difficult.
In 2010, several large, well-designed studies showed that Tai Chi and qigong
were beneficial in preventing osteoporosis in postmenopausal women and in treating
hypertension and heart disease. Additionally, these studies suggest that Tai Chi
may be effective in enhancing the immune system of the elderly.
A review of the medical literature reveals promising evidence that yoga may help treat a variety of medical conditions, including mood disorders, hypertension, insomnia, back pain, and osteoporosis, and may improve overall physical conditioning. In a 2008 randomized clinical trial in the journal Menopause, yoga reduced hot flashes in women by 30 percent. Furthermore, numerous studies have demonstrated that yoga diminishes sex performance anxiety and enhances female sexual desire. Many health practitioners use yoga in conjunction with conventional medicine in the treatment of cancer to reduce anxiety, pain, and insomnia, although scientists continue to debate the exact mechanisms of action involved.
A gap in the literature exists regarding the use of Pilates in treating medical conditions. Experts do agree that Pilates is effective in improving strength, flexibility, and balance. Although experts in the Feldenkrais method, the Alexander technique, and the Trager approach claim that their movement exercises reduce pain, prevent injury, and improve balance, no well-designed clinical trials have been conducted to determine their efficacy.
With regard to other medical claims about exercise-based CAM, no well-designed randomized controlled trials are available; a review of the medical literature did not support the claims.
Choosing a Practitioner
Hundreds of exercise-based CAM instructor-training programs have been established in the United States. None, however, include provider licensing requirements. Standards of certification for yoga instruction are largely based on the style of yoga studied and practiced. One program, the Yoga Alliance, is a nonprofit organization in the United States that maintains standards for yoga teacher-training programs. Teacher certification with this program requires a minimum of two hundred hours of training.
Several Tai Chi and qigong organizations provide teacher certification in the United States. Various levels of certification are offered based on hours of training and desired goals. Hundreds of Pilates training programs have been established in the United States too. Although licensing is not required, the Pilates Method Alliance offers a national teacher’s certification program through written examination. Instructors of the Feldenkrais method, the Alexander technique, and the Trager approach are required to complete two-to-four-year training programs that encompass four hundred to sixteen hundred hours of class and fieldwork for certification.
Safety Issues
Exercise-based CAM is generally considered safe for those without serious health conditions or injuries. Persons with spine or joint disease, uncontrolled blood pressure, or severe balance abnormalities should avoid some exercise-based CAM activities. Although uncommon, spine and joint injuries have occurred during CAM exercise activities. To avoid such injuries, participants should adhere to the directions of a certified instructor. Pregnant women, who should exercise caution when considering CAM, typically require modification of certain practices. All potential participants, especially if pregnant, looking into exercised-based CAM as a form of therapy should consult with their health care providers before joining any exercise-based program. It is advisable to choose a certified provider. Typically, a national association that confers the certification will have a list of qualified providers.
Bibliography
Barnes, P. M., B. Bloom, and R. L. Nahin. “Complementary and Alternative Medicine Use Among Adults and Children: 2007 United States.” National Health Statistics Reports 12: 1–23. Print.
Jahnke, R., et al. “A Comprehensive Review of Health Benefits of Qigong and Tai Chi.” American Journal of Health Promotion 24.6 (2010): 1–25. Print.
Nagel, Denise. "Health Benefits of Tai Chi and Qiqong." Huffington Post. TheHuffingtonPost.com, 23 June 2015. Web. 27 Jan. 2016.
"Nationwide Survey Reveals Widespread Use of Mind and Body Practices." National Center for Complementary and Integrative Health. Natl. Inst. of Health, 10 Feb. 2015. Web. 27 Jan. 2016.
Yang, K. “A Review of Yoga Programs for Four Leading Risk Factors of Chronic Diseases.” Evidence-Based Complementary and Alternative Medicine 4.4 (2007): 487–91. Print.
No comments:
Post a Comment