Fall Back!

On Sunday, November 6, 2022, at 2:00 a.m. (local time) clocks will be turned back one hour. Daylight saving time is ending … until March 2023.

We spring forward one hour in March and fall back one hour in November. Research suggests that even a one-hour change of the clock may impact health significantly, including strokes, heart attacks, accidents and changes in mood. Why? The answer is your circadian rhythm also known as your biological clock. 

Scientists believe ill health effects from time changes result from a mismatch between daylight saving time and our 24-hour biological clock. Ticking away at the molecular level, the biological clock is set by exposure to sunlight and darkness. Our biological clock regulates bodily functions such as metabolism, blood pressure and hormones that promote sleep and alertness. Time changes disturb our natural rhythms - messing with our sleep schedules and biological clock.

If you have ever experienced jet lag you are probably familiar with the symptoms of disturbed rhythms which include drowsiness; a tendency to fall asleep during the day; and an inability to fall asleep at night. Other symptoms include an inability to concentrate and think clearly, as well as disturbances in digestion and elimination. 

Many people find “falling back” easier than “springing forward.” In fact, numerous studies have linked the start of daylight saving time in the spring with a brief spike in car accidents, and with poor performance on tests of alertness, both likely due to sleep loss. However, many people still feel groggy after that extra hour of sleep in the fall.

3 Restorative Poses to Help You “Fall Back”

These poses are designed to relieve symptoms of disturbed natural rhythms and help you adapt to the time change more quickly.

Gather your props: 1 -3 blankets, a yoga bolster or pillows, wall space, and a timer (phone). Optional: chair.

 

1. Simple Supported Backbend (2-5 minutes)

Simple Supported Backbend

This pose improves breathing, reduces fatigue, and counters the effects of sitting, hunched forward for long periods.

You will need a bolster, pillow or two folded blankets to support your back and one folded blanket to support your neck.

Sit on the floor in front of the long side of your bolster (or pillows), knees bent, feet resting on the floor;

Move slowly – if lying back causes you discomfort, begin by lying on your side over the bolster (pillows) and then turning onto your back;

Place one hand under your neck for support and release it down onto a rolled blanket;

Lie over the bolster/pillows/blankets so that your middle back is supported and your shoulders rest comfortably on the floor. (2-5 minutes)

If your lower back feels uncomfortable, lift your hips and scoot your tailbone towards your feet, release your hips to the floor.

 

Coming out of the pose: Remove the blanket from under your neck and, on an exhale, push with your feet and slide toward your head. Rest for a few breaths with your lower back flat on the floor and your legs supported by the bolster. Roll to one side and, on an inhale, use your arms to gently press up into a sitting position. 

*Do not practice Simple Supported Backbend ...

if you experience sharp pain (vs. a stretching sensation) in your lower back; have spondylolisthesis, spondylolysis, or diagnosed disc disease; are more than 3 months pregnant; or during menstruation.

2. Knees Down Twist on the Wall (1-3 minutes per side):

Knees Down Twist on the Wall

Indian yoga master B.K.S. Iyengar describes twists as a "squeeze-and-soak" action: The organs are compressed during a twist, pushing out blood filled with metabolic by-products and toxins. When we release the twist, fresh blood flows in, carrying oxygen and the building blocks for tissue healing.

So breathe easily here, knowing that you are stimulating your natural healing process.

You will need a folded blanket(s) to place between your knees, one blanket to support your neck and a timer (phone).

Come down onto your back;

knees bent with feet flat on wall;

place folded blanket(s) between legs;

on an exhale, gently “walk” the feet down the wall to the right;

rest stacked knees on the floor and soles of the feet on wall (1-3 minutes).

Before switching to the left, “walk” the feet up the wall to the center and take 3 calm breaths.

Repeat to the left (1-3 minutes). 

 

Coming out of the pose: On an inhale, “walk” your feet up the wall to center. On an exhale, roll to your right side and remove the blankets from between your legs. On an inhale, use your arms to slowly press up into a seated position. Take 3 slow, calm breaths.

 

*Do not practice Knees Down Twist on the Wall ...

if you have a hiatal hernia or heart problems; are more than 3 months pregnant; or are menstruating.

 

3. Supported Fan Pose (2-5 minutes, switch cheeks halfway through):

Supported Fan Pose

This is a relaxing forward bend that opens up your inner thighs and gently stretches the lower back.  There are many options for this pose, choose the one that works best for you!

You will need a bolster or several folded blankets and a timer (phone). Optional for variation: a chair.

Sit on the floor:

open your legs into a comfortable “fan” position, you may want to place a folded blanket under your hips;

place your bolster or pillow(s) lengthwise on the floor in front of you, between your legs;

on an exhale, release forward, resting your torso and head on the bolster/pillow(s);

if you feel any strain, increase the height of the bolster with folded blankets so that you are releasing down rather than stretching and straining towards the bolster ;

rest your forehead on the bolster or turn your head to one side and rest your cheek on it;

rest your arms on each side of the bolster or drape them over the bolster;

close your eyes and breathe normally, let your body be supported by the props (2-5 minutes, switch cheeks halfway through).

OPTIONAL CHAIR VARIATIONS:

Lean forward and rest your folded arms and forehead on the chair seat. Add folded blankets to the chair seat until your are comfortable. Add a folded blanket under your hips for added comfort.  If this is too stressful, turn the chair around and rest your folded arms against its back. 

Supported Fan Pose with Chair Seat

Supported Fan Pose with Chair Back

Leg options include: open in “fan” - like above;

OR: cross-legged (change the cross of the legs halfway through the pose); and one leg straight in front under the chair, and one knee bent, with the foot folded towards your pelvis - like below.

 

Supported Fan Pose with Chair and Crossed Legs

Supported Fan Pose with Chair and Leg Under

Coming out of the pose: Place your hands on the bolster or chair, inhale, and using your arms, press slowly up into a seated position. Exhale. Inhale, exhale and place your hands behind you and lean back to relieve your back. Take 3 slow, calm breaths.

Do not practice Supported Fan Pose ...

if you have sacroiliac pain. This is most often experienced as a circle of pain about the size of a quarter over the left or right side of the sacrum. Seek the advice of your health care provider regarding your sacroiliac alignment.

BONUS POSE: My favorite anytime pose … Legs Up the Wall

Legs Up the Wall Pose

The restorative nature of this pose gets blood flowing to parts of the body that need it, making it good for most any ailment including disturbed natural rhythms. The accumulated fluid in your legs flows down, toward the main lymphatic duct in your abdomen. Fluids are shifted from your legs and feet, releasing lactic acid, which relieves tired muscles and gently stretches the back of the legs. 

 

You will need a blanket(s), wall space and a timer (phone). Optional for variation: a chair.

 

Legs Up the Wall: (7-10 minutes):

Have a blanket handy to place under your neck and head;

sit with one shoulder near the wall and your thighs parallel to the wall;

roll back as you swing your legs up the wall;

once you are in position, make sure your tailbone and buttocks are not lifted off the floor – if so, move your hips away from the wall;

place a blanket or pillow under your neck and head if needed for comfort;

your arms can be in any position that is comfortable for you (7-10 minutes).

 

Variation with Chair: 

Coming out of the pose: Bend your knees towards your chest. On an exhale, roll to one side. Pause for a breath, then use your arms to press up into a seated position. Take 3 slow, calm breaths.

Do not practice Legs Up the Wall ...

if you have a hiatal hernia; are menstruating; are more than 3 months pregnant or at risk of miscarriage; or you have sciatica.

 

As you "fall back" this year, remember to breathe ...

 

Breathing in, you touch the fact that you are alive, that you are in rhythm with the flow of life. 

Breathing out, you know that life is a miracle, that you are living that miracle … here and now.

 

Omm ... Ouch!

 

Many people believe yoga is a source only of healing and never harm. Glenn Black, a yoga teacher for 40 years, has a cautionary tale: “In India, a yogi came to study at Iyengar’s school and threw himself into a spinal twist. I watched in disbelief as three of the man’s ribs gave way – pop, pop, pop.” He goes on to say, “Never do headstand, shoulder stand, or plow.”

Black should know, he had spinal fusion and has screws in his lower lumbar spine to stabilize herniated discs and spondylolisthesis. How did his injuries come about? Black explains, “Yoga. Extreme back bends, and twisting coming up from my hands on my ankles. I overstretched my ligaments and destabilized my spine.”

You may want to think twice about these “impressive” yoga poses … and some of their associated injuries!

Thoracic outlet syndrome – compression of nerves passing from the neck into the arms

Degenerative arthritis of the cervical spine

Retinal tears – increased eye pressure causes the delicate retinal tissue to pull away from the back lining of the eye.

Cobra Pose

Cerebral damage – hyper-flexion of the neck wounds the vertebral arteries, producing clots, swelling and constriction

Wheel Pose

Horner’s syndrome – disruption of a nerve pathway from the brain to the head and neck which causes constricted pupil, drooping of the upper eyelid, absence of sweating of the face, and sinking of the eyeball into the bony cavity that protects the eye.

Hero Pose

“Yoga foot drop” – nerves are deprived of oxygen below the knee causing difficulties walking and climbing stairs, foot drags while walking

Hand-to-Big-Toe Pose

Strains, sprains, and dislocations – overstretching that causes muscle damage and torn cartilage. 

 

Injuries happen to yoga teachers, too. Some teachers have practiced downward-facing dog so strenuously that they have torn their Achilles tendon. Many yoga teachers have had to have hip replacement surgery and “bad backs” are also common.

Yikes! Black goes on to say, “The vast majority of people should give up ‘yoga’ altogether. It’s simply too likely to cause harm.”

Don’t give up, yet! In yoga, like running, the vast majority of injuries are caused by “overdoing” it. Many people simply rush through a series of postures just to say they’ve done them – similar to runners adding “junk” miles just to add X number of miles to their training logs. Also, many people push themselves past stabbing pain in a yoga pose because they don’t want to be seen as weak, or inflexible - similar to runners tying to run through pain so they won’t seen as a “wimp.” Many people become frustrated with their bodies for “not keeping up” with their expectations so they overdo it to the point of injury.

Most people have underlying physical weaknesses or problems that make injury all but inevitable. Instead of practicing yoga poses for a specific range of motion that makes sense for their body, they attempt to force their bodies to do what the teacher’s or classmates’ bodies are doing.

You need to be aware of YOUR body and not push past your God-given limitations!

Black explains, “Most people have a limited view of yoga and approach it as a physical discipline, … Awareness and consciousness are no longer emphasized, and yoga somehow became relegated to physical exercise. It is a myth that it's safe to do asana without awareness and consciousness.”

Five Ways to Avoid Yoga Injuries ...

1. Be willing to get in touch with your body and accept its limits.

2. Move with care, listen to your pain signals. Sharp, stabbing pain? Stop! Be willing to adapt poses, use props or skip poses.

3. Be in the present moment; focus on what you can do now, not what you used to do, or what you think you should be doing a month from now. Your practice will change over the years – that’s normal, that’s natural.

4. Have goals, but be realistic and honor your body. Don’t expect to do too much too soon when learning a new pose. Pushing your body to new extremes will undoubtedly cause injury.

5. Balance yoga with the rest of your lifestyle. If you are already performing high-intensity activities such as running, swimming, cycling, etc., choose a gentle or restorative practice to avoid injuries. If you are basically sedentary, begin with chair, restorative or gentle practices and then, over time, move into a more active hatha or vinyasa practice.

References:

Broad, W. J. (2013). The Science of Yoga: The Risks and Rewards. Simon & Schuster.

Burkhardt, Laura. 10 Ways to Get Real About Your Body’s Limitations & Avoid Yoga Injuries. Yoga Journal. January 10, 2018

Cramer H, Quinker D, Schumann D, Wardle J, Dobos G, Lauche R. Adverse effects of yoga: a national cross-sectional survey. BMC Complement Altern Med. 2019 Jul 29;19(1):190. doi: 10.1186/s12906-019-2612-7. PMID: 31357980; PMCID: PMC6664709.

Fromberg, Eden. Glenn Black Responds to New York Times Article on Yoga. Huffpost. January 12, 2012.

McCrary, Meagan. Inside My Injury: A Yoga Teacher’s Journey from Pain to Depression to Healing. Yoga Journal. May 7, 2018.

Sfeir JG, Drake MT, Sonawane VJ, Sinaki M. Vertebral compression fractures associated with yoga: a case series. Eur J Phys Rehabil Med 2018;54:947-51. DOI: 10.23736/S1973-9087.18.05034-7

Swain TA, McGwin G. Yoga-Related Injuries in the United States From 2001 to 2014. Orthopaedic Journal of Sports Medicine. November 2016. doi:10.1177/2325967116671703

Spring Forward!

Twice a year, we experience daylight saving time by springing forward in March and falling back in November. Research has found this changing of clocks impacts people differently based on their tendency to be either an “early bird” or a “night owl.”

In the study, researchers assessed changes in participants’ sleep schedules the week before, during, and after “springing forward” in March 2019. They found that people whose genes make them more likely to be early birds adapt to the time change in a few days, while night owls could take more than a week to return to their normal sleep schedule.

Congress also acknowledges the impact of “springing forward” and “falling back.” They are considering The Sunshine Protection Act of 2021 (H.R. 69), which would make daylight saving time the new, permanent standard time. It was introduced into Congress on January 4, 2021 and was referred to the House Subcommittee on Consumer Protection and Commerce. Once out of committee, the bill will possibly be sent on to the House or Senate. In other words, until Congress passes this bill, early birds and night owls must learn to deal with the time change.

Can Restorative Yoga Help Early Birds? Night Owls?

Adjusting to time changes and different time zones often disturbs our natural (circadian) body rhythms. If you have ever experienced jet lag you are probably familiar with the symptoms of disturbed rhythms which include drowsiness; a tendency to fall asleep during the day; and an inability to fall asleep at night. Other symptoms include an inability to concentrate and think clearly, as well as disturbances in digestion and elimination.

Recovery from disturbed rhythms is tied to your individual physiology. Simply put, some people adapt more quickly to the new time but both early birds and night owls may benefit from restorative yoga.

soulveda.com

3 Restorative Poses to Help You “Spring Forward”

As you calm your body with these 3 simple poses, bring your awareness to your breath. When you bring your awareness to your breath, you realize you are living, present here and now – regardless of daylight savings time.

6-3 days before the time change & on Saturday evening: When "springing forward", a 10 p.m. bedtime is really an 11 p.m. bedtime, prior to the switch. So, to help your body adjust to this change, practice these poses two hours before your preferred bedtime. So if you normally go to bed at 10 p.m., practice these poses at 8 p.m.

6-3 days after the time change: Practice the poses one hour before your bedtime (9 p.m. for a 10 p.m. bedtime).

You will need: 1 or 2 blankets, yoga bolster or pillows, wall space, and a timer (phone). 

 

1. Knees Down Twist on the Wall

 

Knees Down Twist on the Wall

Indian yoga master B.K.S. Iyengar describes twists as a "squeeze-and-soak" action: The organs are compressed during a twist, pushing out blood filled with metabolic by-products and toxins. When we release the twist, fresh blood flows in, carrying oxygen and the building blocks for tissue healing.

So breathe easily here, knowing that you are stimulating your natural healing process.

1. Knees Down Twist on the Wall (1-3 minutes per side):

Come down onto your back;

knees bent with feet flat on wall;

place folded blanket(s) between legs;

on an exhale, gently “walk” the feet down the wall to the right;

rest stacked knees on the floor and soles of the feet on wall.

Before switching to the left, “walk” the feet up the wall to the center and take 3 calm breaths.

Repeat to the left.

*Do not practice this pose

if you have a hiatal hernia or heart problems; are more than 3 months pregnant; or are menstruating.

Coming out of the pose: On an inhale, “walk” your feet up the wall to center. On an exhale, roll to your right side and remove the blankets from between your legs. On an inhale, use your arms to slowly press up into a seated position. Take 3 slow, calm breaths. 

 

2. Child's Pose 

Child's Pose

This pose brings awareness to the breathing in the back of your body. 60 percent of our lungs are in the back and only 40 percent in the front, so don’t neglect moving your breath into your back. Spread your back ribs to the sides as you inhale ... then ride the exhalation back to neutral on the exhale.

2. Child’s Pose (5-8 minutes, switch cheeks halfway through):

place your bolster or pillow(s) on the floor in front of you;

kneel with your knees hip-width apart;

sit back on your heels;

place a blanket(s) under your knees/shins/ankles if needed for comfort;

separate your knees wide enough to place the bolster/pillow(s) between your thighs;

on an exhale, release forward, resting your torso on the bolster/pillow(s);

rest on your left cheek, turn to your right cheek halfway through

*Do not practice this pose

if you have a chronic back condition or are more than 3 months pregnant.

Coming out of the pose: Place your hands on the floor under your shoulders, inhale, and press slowly up onto your heels. Exhale. Inhale, exhale and untangle your legs and come to a seated position. Take 3 slow, calm breaths.

 

3. Legs Up the Wall

 

Legs Up the Wall

While in this pose take several long, slow breaths. As you do, imagine the accumulated fluid in your legs flowing down, toward the main lymphatic duct in your abdomen. Fluids are shifted from your legs and feet, releasing lactic acid, which relieves tired muscles and gently stretches the back of the legs. Feel your entire spine supported by the floor. Welcome the opportunity to be still.

3. Legs Up the Wall: (7 – 10 minutes):

Have a blanket handy to place under your neck and head;

sit with one shoulder near the wall and your thighs parallel to the wall;

roll back as you swing your legs up the wall;

once you are in position, make sure your tailbone and buttocks are not lifted off the floor – if so, move your hips away from the wall;

place a blanket under your neck and head if needed for comfort;

your arms can be in any position that is comfortable for you.

Do not practice this pose

if you have a hiatal hernia; are menstruating; are more than 3 months pregnant or at risk of miscarriage; or you have sciatica.

Coming out of the pose: Bend your knees towards your chest. On an exhale, roll to one side. Pause for a breath, then use your arms to press up into a seated position. Take 3 slow, calm breaths.

Breathing in, you touch the fact that you are alive, that you are in rhythm with the flow of life. 

Breathing out, you know that life is a miracle, that you are living that miracle … here and now.

 

Don't Be a "Sissy!"

quotesgram.com

 We thought growing old would never happen to us! Yet, as our bodies begin to age, we might believe we have become “sissies.” Which, according to Wikipedia, “implies a lack of courage, strength, athleticism, or coordination.” In other words, we think we are “too old.”

The worst thing you think about yourself is, “I’m too old.” Becca Levy, at the Yale School of Public Health, examined data from the Ohio Longitudinal Study of Aging and Retirement that examined more than 1,000 participants since 1975. Participants (average age of 63 when they joined the study), were asked if they agreed or disagreed with statements like: “As you get older, you become useless.”

Levy found the average person with a more positive attitude lived for 22.6 years after the study started, while the average person who agreed with negative statements about aging, survived for just 15 years. That link remained even after Levy had controlled for their actual health status at the start of the survey, as well as other known risk factors, such as socioeconomic status or feelings of loneliness, which could influence longevity.

For many scientists, the link between beliefs about aging and long-term health and longevity is... “very well established,” says Dr. David Weiss, who studies the psychology of aging at Martin Luther University of Halle-Wittenberg in Germany. “Behavior is undoubtedly important. If you associate age with frailty and disability, you may be less likely to exercise as you get older and that lack of activity is certainly going to increase your predisposition to many illnesses, including heart disease and Alzheimer’s.”

Yet, in order to grow old with a positive attitude, we must come to terms with the aging process and the losses we will probably endure. Our vision and hearing fades; we become weaker and less flexible; our skin wrinkles; and we experience memory glitches. 60–80 % of people aged 60 or older, suffer from at least one non-communicable, chronic disease. (1) In addition, the “60 +” group often experience sleep disturbances and, if that wasn’t enough, we are predisposed to infections because of age related immune-suppression. Indeed, “old age ain’t no place for sissies!” But there is ...

We have never before had so much information available to us that explains how we can use self-care practices, like yoga, to maintain health, a positive attitude and a greater quality-of-life as we grow older. A survey of recent research is extremely encouraging, no matter your age!

Physical Health:

Yoga promotes physical well being by improving muscle strength and endurance, postural stability, balance, and reduction in fatigue and the risk of falls for elderly people. (2,3)

Non-infectious/Chronic Diseases:

There are also multiple reports suggesting the favorable effect of yoga on older adults with age-related, chronic conditions, including:

cardiovascular diseases, (4)

diabetes, (5)

chronic obstructive pulmonary disease, (6)

osteoarthritis and chronic low back pain. (3)

Mental Health:

Yoga enhances positive mood states and decreases mood disturbances like anxiety and depression. (7, 2) Also, practicing yoga appears to be therapeutically effective in improving sleep quality and enhancing cognitive function among people aged 60 years or older. (8)

Systematic reviews of randomized controlled studies demonstrate that a regular yoga practice results in improvement in both physical quality-of-life and mental well-being in people aged 60 years or above. (3) A regular yoga practice helps us to remain flexible, strong, and balanced, with a relaxed mind, sharp brain, and good mood. And there’s ...

1. You have choices.

Yoga is not about competing or comparing yourself to anyone else, especially to younger people or the person you once were! It is okay to choose yoga practices like chair, gentle, or restorative rather than hot yoga or vinyasa. Gentler yoga practices are effective, too! Slow, controlled movements and holding poses build strength.

The key is to accept yourself as you are, today - tomorrow could be different. Your body can improve—incrementally, over time with regular practice. Rather than choosing the kind of practice you think you should be able to do, choose one that works for your body. You are more likely to stick with a yoga practice if you feel comfortable, safe, and happy!

2. You can adapt poses and use props.

Use a wall or a chair to steady yourself, especially during balancing poses. Using blocks, straps, and bolsters will make postures more achievable and safe. Use a pillow to raise your hips in seated poses and meditation. Props are tools to keep you active!

Unwind @ the Wall; a Strap Practice; or Blanket Bliss are examples of prop practices. They can also give you ideas on how to incorporate props into your yoga practice.

3. You can try something new!

Try chair yoga. If getting up and down off the floor is a challenge, chair yoga is a great option that gives you the same benefits as you’d get in a standing yoga practice. For people with mobility issues or knee, hip, or back pain, chair yoga is accessible and helpful. After I fell while running, I practiced chair yoga with the “Relax into Yoga” DVD while my skinned and bruised knee healed. I still rotate this DVD into my practice even though my knee is healed. (You may be able to check out this DVD and as well as other yoga DVDs, from your public library, for free!)

Try restorative yoga – especially if you engage in regular athletic activities. “Rest” or days of light activity are essential to avoiding injuries and allow your muscles to replenish. In restorative yoga, you use props to support your body and promote healing, relaxation and rest. Restorative yoga is for everyone at any age but is especially is helpful if you are dealing with a chronic condition; sleep disturbances; recovering from an injury; or as a rest day from athletics.

Learn about the 5 types of restorative poses, then explore a Mindful Breathing Practice, or a one- pose video practice: (each video is approximately 15 minutes of guided practice)

Basic Relaxation Pose

Supported Child’s Pose

Mountain Brook Pose

“Old age ain’t no place for sissies!” Old age is for the place for maintaining a healthy body and mind. Old age is the time to accept the changes growing old brings by embracing where you are right now, not where you were in the past. Old age is living now, today with “courage, strength, and athleticism.”

See also:

Are You Aging Well?

Cultivate Your Core

Are Your Hips Healthy?

 

References

 

1. Gong, J.B., Yu, X.W., Yi, X.R., Wang, C.H., Tuo, X.P., 2018. Epidemiology of chronic

noncommunicable diseases and evaluation of life quality in elderly. Aging Med. 1,

64–66. https://doi.org/10.1002/agm2.12009.

2. Kraemer, J.M., Marquez, D.X., 2009. Psychosocial correlates and outcomes of yoga or

walking among older adults. J. Psychol. 143, 390–404. https://doi.org/10.3200/JRLP.143.4.390-404.

3. Tulloch, A., Bombell, H., Dean, C., Tiedemann, A., 2018. Yoga-based exercise improves

health-related quality of life and mental well-being in older people: a systematic

review of randomised controlled trials. Age Ageing 47, 537–544. https://doi.org/10.1093/ageing/afy044.

4. Chu, P., Gotink, R.A., Yeh, G.Y., Goldie, S.J., Hunink, M.M., 2016. The effectiveness of

yoga in modifying risk factors for cardiovascular disease and metabolic syndrome: a

systematic review and meta-analysis of randomized controlled trials. Eur. J. Prev.

Cardiol. 23, 291–307. https://doi.org/10.1177/2047487314562741.

5. Hewston, P., Deshpande, N., 2018. Fear of falling and balance confidence in older adults

with type 2 diabetes mellitus: a scoping review. Can. J. Diabetes 42, 664–670.

https://doi.org/10.1016/j.jcjd.2018.02.009.

6. Wu, L.-L., Lin, Z.-K., Weng, H.-D., Qi, Q.-F., Lu, J., Liu, K.-X., 2018. Effectiveness of

meditative movement on COPD: a systematic review and meta-analysis. Int. J. Chron.

Obstruct. Pulmon. Dis. 13, 1239–1250. https://doi.org/10.2147/COPD.S159042.

7. de Manincor, M., Bensoussan, A., Smith, C., Fahey, P., Bourchier, S., 2015. Establishing

key components of yoga interventions for reducing depression and anxiety, and im-

proving well-being: a Delphi method study. BMC Complement. Altern. Med. 15, 85.

https://doi.org/10.1186/s12906-015-0614-7.

8. Zhang, Y., Li, C., Zou, L., Liu, X., Song, W., 2018. The effects of mind-body exercise on

cognitive performance in elderly: a systematic review and meta-analysis. Int. J.

Environ. Res. Public Health 15, 2791. https://doi.org/10.3390/ijerph15122791.