For people with epilepsy, doing yoga may help reduce feelings of stigma about the disease along with reducing seizure frequency and anxiety, according to new research published in the November 8, 2023, online issue of Neurology, the medical journal of the American Academy of Neurology.

“People with epilepsy often face stigma that can cause them to feel different than others due to their own health condition and that can have a significant impact on their quality of life,” said study author Manjari Tripathi, MD, DM, of All India Institute of Medical Sciences in New Delhi. “This stigma can affect a person’s life in many ways including treatment, emergency department visits and poor mental health. Our study showed that doing yoga can alleviate the burden of epilepsy and improve the overall quality of life by reducing this perceived stigma.” 

For the study, researchers looked at people with epilepsy with an average age of 30 in India.

Researchers measured stigma based on participants’ answers to questions such as: “Do you feel other people discriminate against you?” “Do you feel you cannot contribute anything in society?” and “Do you feel different from other people?”

Researchers then identified 160 people who met the criteria for experiencing stigma. Participants had an average of one seizure per week and on average took at least two anti-seizure medications.

Researchers then randomly assigned participants to receive yoga therapy or sham yoga therapy. Yoga therapy included exercises in loosening muscles, breathing, meditation and positive affirmations. Sham yoga consisted of exercises that mimic the same yoga exercises, but participants were not given instructions on two key components of yoga believed to induce a relaxation response: slow and synchronized breathing, and attention to the body movements and sensations during practice.

Each group received seven supervised group sessions of 45 to 60 minutes over three months. Participants were also asked to practice sessions at home at least five times a week for 30 minutes. They tracked seizures and yoga sessions in a journal. After the three months of therapy, participants were followed for another three months.

Researchers found when compared to people who did sham yoga, people who did yoga were more likely to reduce their perceived stigma of the disease. People who did yoga had an average score of seven at the start of the study and an average score of four at the end of the study, while people who did sham yoga had an increase from an average score of six at the start of the study to an average score of seven at the end.

Researchers also found that people who did yoga were more than four times as likely to have more than a 50% reduction in their seizure frequency after six months than the people who did sham yoga.

In addition, people who did yoga were more than seven times more likely to no longer have seizures than those who did sham yoga.

There was also a significant decrease in anxiety symptoms for people who did yoga versus people who did not. They saw improvements in quality of life measures and mindfulness.

“These study findings elevate the need to consider alternative therapies and activities for people with epilepsy facing stigma,” said Tripathi. “Yoga may not only help reduce stigma, but also improve quality of life and mindfulness. Plus, yoga can be easily prerecorded and shared with patients online using minimal resources and costs.”

Physical activity has positive effects on mental health and yet, activity rates are declining. This is particularly worrying because the mental well-being of teenagers continues to deteriorate. In the US, one in six school children is diagnosed with some type of mental disorder.

Riding bikes is a promising approach to introduce school-aged children to physical activity. Now, researchers in the US have investigated how adolescents’ psychosocial well-being changed after participating in a school-based cycling program.

“Participation in a school cycling education program during the Covid-19 pandemic was associated with improved psychosocial well-being among middle schoolers,” said Dr Esther Walker, research director at the non-profit organization Outride. “While we saw promising increases in some student subgroups, certain groups had higher levels of self-reported mental well-being both before and after participating in the program.”

“It was really encouraging to see such a positive student response to a cycling-specific physical education program,” said Fletcher Dementyev, a research assistant at Loma Linda University and first author of the study published in Frontiers in Sports and Active Living. “This motivates us, and hopefully others, to continue investigating and developing cycling as a pathway to improved health and well-being in adolescents.”

Riding out for better mental health

Outride is a not-for-profit organization partnering with schools to provide cycling programs. “The Riding for Focus (R4F) program aims to equip students with basic cycling knowledge and experience, so that they may ride safely and confidently,” Walker explained.

“A bicycle can be used for leisure activities, competition, and transportation. Thus, not only are students participating in an activity that improves their health and wellbeing, but also one that empowers them to explore the world,” said Dr Sean Wilson, a researcher at Loma Linda University and the study’s senior author.

More than 1,200 middle schoolers, aged 11 to 14 years, participated in the program’s surveys. Before and after cycling, they completed two surveys that included measures of current mental well-being and psychological functioning. Given the improvement in teenagers’ mental well-being scores, short term physical activity programs hold promise of having a positive influence on mental health and well-being in adolescents, the team said.

Privilege determines well-being

Next to overall well-being, the scientists examined social risk factors that influenced well-being pre- and post-program participation. “We focused on a number of key risk factors that affect mental health and well-being in middle school aged children in the US, including socio-economic status, gender, and race,” Wilson explained.

Relative risk assessments indicated that males, white students, and those from high socio-economic status families still had reduced relative risk of developing psychosocial disorders post-intervention. For example, female students’ well-being improved significantly; male students, however, still had higher well-being scores compared to females after the program. There also was a significant post-program increase in the well-being of non-white students. This positive impact is supported by studies showing that physical activity programs can positively influence the psychosocial well-being of ethnic minorities, particularly those from low-income families.

“While participating can certainly contribute positively to one’s day-to-day life, ultimately, to see large scale improvements, changes in policy, reductions in systematic disparities in access to nutrition, health services, safe environments, and beyond need to be put in motion,” said Walker.

The authors also pointed to limitations of their study, one being a study population that is different from the countrywide student population. “This means that our results, though insightful, aren’t fully reflective of the national youth physical education context,” said Dementyev. “We see this study as the beginning of a national dialogue surrounding investment in cycling education and its potential returns.”

Want the health benefits of exercising, but aren’t too keen on pounding the pavement or pumping iron every day?

Edith Cowan University (ECU) may be able to clarify how many times per week you need to exercise to make it worth your while.

A new study saw participants perform a single three-second, maximum-effort eccentric bicep contraction — similar to slowly lowering a heavy dumbbell, from a bent arm to a straight arm.

Previous ECU research showed this can significantly improve muscle strength when it’s performed daily for five days a week (Monday – Friday), for four weeks.

Participants in the new study were split into two groups, with the first group performing a single three-second contraction two days per week, and the other performing the same exercise on three days per week.

After four weeks, researchers compared the participants’ bicep strength.

Those who performed the exercise two-days per week saw no significant changes, however the three-day group saw small but significant increases in concentric strength (2.5 per cent) and eccentric strength (3.9 per cent).

Study lead Professor Ken Nosaka said the results helped to further improve our understanding of how our body responds to exercise — and how people can then put that knowledge to good use.

“Our previous work has shown regular, shorter exercise is more beneficial than a one or two big training sessions in a week,” Professor Nosaka said. “Now, we have a clearer idea of where the tipping point is where you start to see meaningful benefits from such a minimal exercise. These new results suggest at least three days a week are required, at least for the single three-second eccentric contraction training.”

Three is good… but five is better

While the findings showed three days per week will have an impact, finding the willpower to put in a couple of extra days of exercise per week will produce better results.

The previous study’s participants who performed the exercise five days a week saw greater improvements in strength — more than 10% increases — than the three-day group.

However, Professor Nosaka stressed this didn’t mean exercising every day would improve results even further.

“Muscle adaptations occur when we are resting, so muscles need rest to improve their strength and their muscle mass,” he said. “It should be noted that the exercise was only three seconds, so the rest between exercises in the study was close to 28,800 times more than the exercise time. But muscles do appear to like to be stimulated more frequently, especially for the small volume of muscle strengthening exercise.”

Applying it to real life

Professor Nosaka said more research was needed to see if the study’s findings apply to other types and volumes of exercise.

“Muscles enjoying frequent stimulation may not necessarily be the case for a greater volume of aerobic exercise to improve cardiovascular function, or muscle strengthening exercise such as working out at a gym,” he said.

“However, it may be that exercising once a week for 2 hours is less effective than exercising every day for 20 minutes.

“If it is not possible to have 20 minutes a day for exercise, even five minutes a day makes a difference for fitness and health.

“Of course, more studies are needed to confirm this, but our recent studies show the importance of accumulating small amount of exercise as frequently as possible in a week.

“It is important to note that even a very small amount of exercise can make a difference to our body, if it is performed regularly.”

‘Weekly minimum frequency of one maximal eccentric contraction to increase muscle strength of the elbow flexors’ was published in the European Journal of Applied Physiology.