Minding the Mat: Moving the Yoga Field Forward

I n this issue of Global Advances in Health and Medicine, Cheung et al report their findings from a mixed-methods study of adherence to yoga practice for older women with knee osteoarthritis. 1 These women completed an 8-week yoga intervention for osteoarthritis 6 months prior to completing a survey, face-to-face interviews, and vid-eotaping of their practice. Adherence at 6 months was analyzed 3 different ways to determine (1) whether the participant was practicing any yoga (yes/no); (2) average minutes of yoga practice per day; and (3) average days of yoga practice per week. Sixty-one percent of participants reported continuing to practice at least some yoga. Practicing yoga on average 21 to 30 minutes per day was most common (32% of participants). Almost half reported doing yoga 3 to 4 days per week. Qualitative analyses of interview data explored facilitators and barriers to ongoing yoga practice. Facilitators included perceived physical and mental benefits of yoga (eg, less pain and greater calmness, respectively) and setting aside a specific time for practice. Barriers included other health problems interfering with yoga practice, pain, and difficulty finding the time. Yoga research like this study is timely. In 10 years, use of yoga by the public has grown almost 2-fold: In 2002, 5.1% of US adults used yoga at least once in the previous year compared to 9.5% in 2012. 2 Correspondingly , yoga research has increased substantially. A Medline search using the term yoga found 57 entries in 2002 and 400 entries in 2014. Randomized controlled trials have been conducted or are in process for common chronic conditions such as osteoarthritis, low back pain, anxiety, and depression. Fair to good evidence is emerging that yoga may be moderately effective for some conditions, particularly chronic pain. 3,4 Terms such as yoga therapy, therapeutic yoga, and medical yoga are becoming more common. As yoga experts, researchers, and healthcare providers try to better understand what yoga is helpful for, the issue of assuring adherence to yoga practice becomes critical. Adherence to a daily medication and specified dosage regimen is a straightforward concept, albeit with its own challenges to measure. For example, a person with high blood pressure adheres to his medication regimen by taking his antihypertensive pills daily as instructed. This definition presumes that the maximum beneficial effect of the hypertension medicine will occur if the participant is adherent to taking it daily at the specified dose. For …