Effects of Integrated Selected Yoga Practices on Physical and Mental Health Among Destitute Elderly Widows in Vrindavan: a Pilot Study

Effects of Integrated Selected Yoga Practices on Physical and Mental Health Among Destitute Elderly Widows in Vrindavan: a Pilot Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effects of Integrated Selected Yoga Practices on Physical and Mental Health Among Destitute Elderly Widows in Vrindavan: a Pilot Study Jyoti Varshney, Madhusudan Penna This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5226157/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Vrindavan has gained a reputation for harbouring many homeless elderly widows who confront tremendous physical, emotional, and financial hardships. These difficulties emphasize larger issues, such as poverty, social isolation, and poor healthcare for India's elderly. Yoga has recently gained recognition for its capacity to improve the health and well-being of these widows. Purpose This study aimed to test the effects of 4 weeks Integrated Selected Yoga Practices in improving Body pain, and decreasing Fatigue, Hypertension, Heart Rate, Stress, Anxiety and Depression in destitute elderly widows. Methods A quasi-experimental pre-test and post-test with a control group design was used. A convenience sample of 20 destitute elderly widows was divided into an Intervention Group (IG) (n = 10) and a control group (CG) (n = 10). The outcome measured of NRS, FAS, BP & HR by Digital Monitor, GAS, GDS and PSS were examined at baseline and the 4th week of the study. Results The Intervention Group (IG) showed a significant reduction in Body pain, Fatigue, Blood Pressure, Heart Rate, Anxiety, Depression and stress after 4 weeks compared to baseline. Conclusion It is recommended that Integrated Selected Yoga Practices be incorporated as a daily activity program in shelter homes or other long-term care facilities to improve Body pain and decrease Stress in destitute elderly widows. Integrated Yoga Destitute Elderly widows Physical Health Mental health 1. Introduction Every human being in the world should have the opportunity to have a long and healthy life (WHO, 2022).The process of getting older is a natural part of being human. which is followed by a decline in interrelated physical, mental, and social conditions. Elderly people are known as they are children where most of the decision used to be taken by others. They are considered to be dependent on others.(Jolanki, 2009) Elderly people change physiologically during their old age. Many psychological, behavioural, and mental changes are caused by these changes in them. As a person age, their physical strength and stamina decline more acutely and need to be treated systematically. The care and look after of the senior people have been limited at the level of global level. The encouragement for elderly participation in the active health care policy making need to be taken on priority. The provision for health care system in terms of success deliberation of services to this strata of society are matter of concern in present scenario.(Kolade et al., 2022) As elderly women have a longer life, they’re going to face more health problems. The such vulnerability would be even greater among elderly widows are caused by the truth that their widowhood id highly dependent on others owing to the loss of their spouse, are unable to earn income through economic activities and lack access to financial resources, in addition to having lower literacy and health awareness.(Hiremath, 2012) Based on the destitute women and widows welfare bill 2006 (Bill No XC of 2006) The word “Destitute” refers to any female who does not have an independent source of income or who is not being cared for by a family member or relative, and includes divorced women. They are all destitute women who live in shelter homes run by government authorities and non-governmental organisations, in their rented accommodations, and in other public places such as ghats and temples. (Vrindavan Report Page 146–165, n.d.). According to the UN Division for the Advancement of Women, 2000 reports, an estimated 20,000 widows struggle to survive in Vrindavan alone. For a woman, being destitute after becoming a widow is an extremely difficult condition. The loss of a spouse has been reported to harm widows’ health, making widowhood one of life’s most stressful situations(Anusic & Lucas, 2014). According to a case study conducted in Vrindavan, the majority of women suffering from major mental illnesses did not get any therapy. They are not only experience mental problems as they grow older age, but they also suffer physical issues as a result of not getting sufficient food and proper treatment(Ramanathan et al., 2017). Ageing is a natural process of decreasing health performance; abandonment following the husband’s death may increase health issues (Vrindavan Report Page 146–165, n.d.). Common conditions in destitute widows include hypertension, body pain, back and neck pain and osteoarthritis, hearing loss, cataracts and refractive errors, chronic obstructive pulmonary disease, stress, insomnia, depression and dementia. Yoga is a practice which includes relaxation, meditation, and a series of physical exercises with breathing to achieve physical, mental, social, and spiritual well-being(Ramanathan et al., 2017). Yoga promotes the regulation of autonomic functions, the relief of stress, and the improvement of psycho-physiological functions such as cardiovascular health and quality of life(Andharia, 2023). Yoga is considered a body-mind intervention that is increasingly being researched for its therapeutic possibilities in the elderly(Grover & Malhotra, 2015). Although several studies are proving the beneficial effects of yoga on the elderly, the majority of Indian studies in this area have focused on a specific population of the elderly, such as shelter home elderly, homeless population, and so on(Bansal & Patra, 2017). However, so far no study has been done on destitute elderly widows. Every human being is concealed with five layers of existence, viz., Annamaya (physical), Pranamaya (vital), Manomaya (Psychic), Vijnanamaya (Intellectual), and Anandamaya (Happiness), and Taitriya Upanishad contains a great overview of this Pancha Kosha concept(Dev et al., n.d.). Yoga conceptualises the human being as a multi-layered, conscious being, possessing three bodies or sharira (sthula-gros, sukshma-subtle, and kaa-causal) and having a five-layered existence (pancha kosha) consisting of our anatomical, physiological, psychological, intellectual, and universal existential layers(Jagannathan et al., 2014). The IAYT program, which is based on the Pancha Kosha concept mentioned above, includes several kinds of yogic practices at each level to assist patients with various diseases in addressing their issues. Among the Annamaya Kosha customs are: I. Asana : A steady, pleasant position that deeply relaxes internal organs by massaging them; all of the body's organs begin to function harmoniously, and the mind becomes peaceful. II. Diet : A healthy vegetarian diet that soothes the mind called as a Sattvic diet, is advised since it supports the human body and psyche's internal balance. III. Loosening exercises improve muscle strength, decrease joint stiffness, and boost physical endurance. Pranayama Kosha techniques include : breathing exercises and cleaning breath, which improve consciousness, clear the lungs, correct breathing patterns, and expand lung capacity. Pranayama: Reduces breathing rate and restores autonomic balance, calming the mind. Manomaya Kosha methods include : Cyclic meditation: methods with repeated stimulations and relaxations; Om meditation; and mind sound resonance technique (MSRT) for creating awareness and slowing down the mind. and Devotional Sessions: Practice "Bhakti Yoga" to cultivate emotional culture. Vijnanamaya Kosha Practices include lectures and yogic counselling that use yogic notions of fearlessness to alleviate stress. All of the techniques mentioned above are intended to help a person in reaching the ultimate level of self-knowledge. Anandamaya Kosha (Bliss) is a condition of blissful silence characterized by awareness, perfect balance, and freedom of choice, in which the mind is free of stress and anxiety. The IAYT model tackles imbalances at the physical, mental, and emotional levels(Balayogi et al., 2016). In theory, all IAYT components are mutually exclusive. To have the desired impact, all components must be integrated and offered at each of the five levels of life. Individual components cannot be considered the IAYT or have the same effects as the entire model(Balayogi et al., 2016). Integrated yoga practises based on an "Integrated Approach to Yoga Therapy" (IAYT) that covers all five levels of existence (Pancha Koshas, i.e., physical, Prana or subtle energies, mental, and intellectual levels) are a holistic approach to treating patients with mental health conditions(Dr R Nagarathna And Dr H R Nagendra, 2001). Integrated selected yoga practises (ISYP) based on IAYT The ISYP model incorporates varied yogic practises at each level of Pancha Kosha to help people with different health problems. 2. Materials and Methods This study followed a pre-test, post-test quasi-experimental approach with a control group for four weeks, in destitute elderly widows at Paramhansa Yogananda Ashram in Vrindavan between November 2022 to January 2023. Participants were not randomly assigned to the Intervention group (IG) and Control group (CG). Requisite approval was obtained from the University and Ashram’s Director. After obtaining informed consent and who were willing to participate in this study and able to perform the techniques in the Yoga intervention were recruited for the study. Participants who currently practice yoga were not willing to participate in the study and recommended surgery, hearing and vision problems were excluded from the study. The study had a total of 20 subjects. The convenience sampling method was followed and divided into two groups, the Intervention Group (IG) of 10 and the Control Group (CG) of 10 participants recruited. 2.1 Measures Assessments were conducted for the group at both the baseline and 4-week points. 2.1.1 Numerical Rating Scale The range of 0 to 10 is made up of the horizontal NRS in addition to the anchor word, such as “no pain” at one end, “moderate pain” in the middle of the graph, and “worst possible pain” at the opposite end. This rating system was determined to be a reliable and valid measure of pain severity when utilized with elderly people(Herr et al., 2004; Herr & Mobily, n.d.). 2.1.2 Fatigue Assessment Scale FAS assesses physical and mental aspects of fatigue signs. It is a 10-item reporting system that can be completed in about 2 min. Questions describes the personal feels (1 = Never, 2 = Sometimes; 3 = Regularly; 4 = Frequently; and 5 = Always). The 4th and 10th items were reversed scored (Shahid et al., 2011). 2.1.3 Blood Pressure & Heart rate Systolic, diastolic blood pressure and heart rate were monitored using an Omron automated blood pressure monitor (H-7121J) device (Instruction Manual 1 Automatic Upper Arm Blood Pressure Monitor M2 Basic (HEM-7121J-E), n.d.). 2.1.4 Geriatric Anxiety Scale A 10-item geriatric anxiety scale (GAS) instrument was used in this study to ascertain the status of anxiety in our participants. GAS can be self-administered or can be utilized as an interview tool as the questions are of (0) = Not at all, ( 1 ) = Sometimes, ( 2 ) = Most of the time and ( 3 ) = All of the time(Mueller et al., 2015). 2.1.5 Perceived Stress Scale Perceived Stress Scale (PSS) is one of the widely used stress scale used to determine the magnitude of situations that are perceived by individuals as unpredictable, uncontrollable and detrimental compared to previous month of their life. The latest version of PSS is a 10-item scale designed as a self-appraisal of the effects stressors on one’s life (Cohen, 1994). 2.1.6 Geriatric Depression Scale Depression was assessed using the Hindi Version of the Short Form of Geriatric Depression. This scale includes 15 questions related to depression in the elderly. A higher score indicates stronger symptoms of depression; specifically, a score of less than 5 indicates a normal state, a score of 6–9 indicates moderate depression, and a score of more than 10 indicates severe depression (Greenberg, n.d.). 2.2 Intervention The Integrated Selected Yoga Practices (ISYP) is an approach that not only deals with a physical lever but also includes using techniques to operate on different layers of our existence. The practices at the body level (annamaya kosha) Sukshma vyayama; at the subtle energy level (Pranayama kosha), include Anulom Vilom and Bhrahmri; and at the mind level (manomaya kosha), Om Japa, Yoga Nidra, Geeta Path, and Bhajan were implemented as interventions. After baseline data collection, a 45–50 minute session was delivered by a Yoga instructor. All IG participants ISYP for four weeks (6 days/week) for 45–50 minutes. All interventions were done on chairs due to elder women not being able to sit on the floor. Table 1 Socio demographic Characteristics of Participants at Baseline Age 60–70 7 70 3 30 70–80 3 30 7 70 Age (mean ± SD) 66.9 ± 5.27 71.6 ± 4.80 Education Illiterate 5 50 4 40 Primary 2 20 2 20 Middle 1 10 2 20 Matric 2 20 2 20 Nature of Husband's death Deaths from bites and stings of venomous animals 1 310 1 10 Heart attack/Brain Stroke 0 0 4 4 Liver/ kidney failure 0 0 1 1 Accident 1 10 4 4 Others 8 80 0 0 Duration of husband death 10–20 years 6 60 7 70 21–30 years 1 10 1 10 40–50 years 3 30 2 20 Number of Children 0 6 60 2 20 1–2 3 30 6 60 3–4 1 10 2 20 Reason to Home Leave Voluntarily 4 40 2 20 Abandoned by son 1 10 3 30 Ritual 2 20 1 10 Employment 3 30 2 20 Devotion 0 0 2 20 2. Data Analysis : The obtained data was expressed as mean and standard deviation. Comparison between pre and post scores was performed using the Wilcoxon signed rank test. Statistical significance was established at p < 0.05. Data analysis was performed using the statistical software IBM SPSS. 3. Results A total number of 20 participants completed the study (IG 10 participants, and the CG 10 participants). Sample characteristic information are given in Tables 1, 2 and 3 show the descriptive statistics for the pre- and post-test measures of the physical and mental health characteristics, both in the intervention group (IG) and in the control group (CG). The findings strongly suggest that implementing Integrated Selected Yoga Practices (ISYP) over four weeks leads to significant improvements in several physical and mental health parameters (body pain, fatigue, blood pressure, heart rate, anxiety, depression, and stress) among the destitute elderly widows in the intervention group. These findings suggest that ISYP can be an effective, safe, and low-cost intervention to improve the health and well-being of this vulnerable population. The control group, which did not receive the intervention, showed no significant improvements in the majority of these indicators, highlighting the efficacy of the yoga practices. 4. Discussion The purpose of the present research study was to observe how the 4-week Integrated Selected Yoga Practices intervention changed body pain, fatigue, hypertension, heart rate, stress, anxiety and depression in destitute elderly widows. Significant reduction in these parameters and improvement was observed as a result of 4 week of Integrated Selected Yoga Practices, with regard to the control group. As far as we are aware, the study is the first to investigate the effect of Integrated Selected Yoga Practices on body pain, fatigue, hypertension, heart rate, stress, anxiety and depression in destitute elderly widows. Previously a study by(Andharia, 2023) This study found significant improvements in both physical and mental health measures following a 12-week yoga intervention. In the current investigation, we also found significant changes in both the physical and mental health of elderly widows after four weeks of yoga practice (Shree Ganesh et al., 2022). The results showed significant improvements in the yoga group, including reduced perceived stress and depression, and enhanced quality of life. In our study also showed significant reductions in depression, and stress. The study found a higher participation rate among females (74.3%) compared to males (25.7%) and noted that anxiety levels were generally higher among females. Practicing yoga twice a week, particularly Laughter Yoga, correlated with better anxiety outcomes and promoted mental well-being among the elderly(Putu Eka Martina Heliasih Anak Agung Komang Suardana Euis Dewi Yuliana Made Yasna Wiguna, 2019). Similarly, in our investigation, elderly widows was a significant decrease in anxiety levels. After one month of Integrated Yoga, elderly participants with chronic health conditions saw significant improvements in vital signs, mental health, sleep quality, quality of life, and life satisfaction. Our study is similar to that one month of Integrated selected yoga practices showed significant reductions in anxiety, depression, and stress(Ashwini, Elderly Cardiac n Mental Health, n.d.). The study observed significant reductions in systolic and diastolic blood pressure, as well as pulse rate, following six months of Om chanting(Amin et al., 2016). Our study replicates these findings with a smaller sample size and a one-month intervention. The study showed significant improvements in psychological health among older adults who participated in a yoga intervention(Bonura & Tenenbaum, 2014). Our investigation supports this study, as we also found a notable reduction in body pain, fatigue, hypertension, and heart rate followed by Integrated Selected Yoga Practices. For several acute and chronic diseases, many classical yoga asanas and breathing techniques may be harmful. Particularly people who have certain injuries or bone issues are unable to sit on the floor. A modified yoga format works for some elderly individuals. Modified yoga practises can incorporate each and all of the essential components of a traditional yoga practice while also making changes for accessibility and safety. Yoga performed in a chair was adopted in the current study. In order to find the most efficient and secure practises and protocols, further study should identify the fundamental components of yoga, compare alternative models for modified yoga, and provide guidelines for modifying yoga practises safely for varied conditions and populations. The present study is limited to small sample size as it’s an pilot study. further studies should be performed with a larger sample size, duration should be increased and long-term intervention. Mechanism The mechanisms through which ISYP brought about these improvements are multifaceted: Physical Exercises (Annamaya Kosha) : The Sukshma Vyayama exercises aimed at improving physical flexibility, muscle strength, and overall physical conditioning, which helped in reducing body pain and fatigue. Breathing Techniques (Pranamaya Kosha) : Practices like Anulom Vilom and Bhrahmri Pranayama are known to enhance oxygenation, reduce stress hormones, and improve cardiovascular parameters, which contributed to the reductions in blood pressure and heart rate. Mental Exercises (Manomaya Kosha) : Techniques such as Om Japa, Yoga Nidra, Geeta Path, and Bhajan focus on calming the mind, reducing anxiety and depression, and improving overall mental health. These practices are designed to engage the mind in positive and soothing activities, thereby reducing stress and enhancing mental well-being. Holistic Integration : The integration of physical, respiratory, and mental practices in ISYP creates a comprehensive approach that addresses multiple layers of an individual's well-being, promoting a balance between body and mind. (Dr R Nagarathna And Dr H R Nagendra, 2001) 5. Conclusion This study is the first investigation into the impact of Integrated Selected Yoga Practices (ISYP) on the physical and mental health of destitute elderly widows, a highly neglected and vulnerable demographic. After a four-week ISYP intervention, major health indices such as body pain, fatigue, blood pressure, heart rate, anxiety, depression, and stress improved significantly. These findings emphasize ISYP's potential as a safe, cost-effective, holistic therapy alternative to conventional medical care. ISYP provides an accessible and practical option for improving the general well-being of elderly widows living in shelter homes. This study, as a pilot study, paves the way for further investigation into yoga's therapeutic benefits, suggesting that ISYP could play an important role in enhancing the quality of life of elderly populations experiencing similar socioeconomic and health issues. Abbreviations Abbreviations: IAYT- Integrated Approach to Yoga Therapy ISYP- Integrated Selected Yoga Practices MSRT- Mind Sound Resonance Technique NRS- Numeric Rating Scale BP & HR- Blood Pressure and Heart Rate GDS- Geriatric Depression Scale FAS- Fatigue Assessment Scale GAS- Geriatric Anxiety Scale PSS- Perceived Stress Scale IG- Intervention Group CG- Control Group Declarations Financial Support: Nil Statement of Ethics The study was approved by the university. The purpose and outcome as well as the methods of study were explained to the authority of the ashram, to ensure sustained cooperation. Informed written consent was obtained from each of the study participants. References WHO. (2022). 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Case Study Journal of Ayurvedic Herbal and Integrative Medicine , 1 , 41–57. https://doi.org/10.29121/jahim Jagannathan, A., Nagarathna, R., Ramakrsihna, J., & Villacres, M. D. (2014). Decoding the integrated approach to yoga therapy: Qualitative evidence based conceptual framework. International Journal of Yoga , 7 (1), 22. https://doi.org/10.4103/0973-6131.123475 Balayogi, A., Sri, B., Vidyapeeth, B., Ananda, Y., & Bhavanani, B. (2016). Cite this article: Balayogi Bhavanani.Mental Health and Wellbeing through Yoga. In J J Yoga (Vol. 2016, Issue 1). https://www.researchgate.net/publication/308889737 Dr R Nagarathna And Dr H R Nagendra. (2001). Integrated Approach of Yoga Therapy for Positive Health (First). Swami Vivekananda Yoga Prakashana. Herr, K. A., & Mobily, P. R. (n.d.). Comparison of Selected Pain Assessment Tools for Use With the Elderly . Herr, K. A., Spratt, K., Mobily, P. R., & Richardson, G. (2004). Pain Intensity Assessment in Older Adults Use of Experimental Pain to Compare Psychometric Properties and Usability of Selected Pain Scales With Younger Adults . Shahid, A., Wilkinson, K., Marcu, S., & Shapiro, C. M. (2011). Fatigue Assessment Scale (FAS). In STOP, THAT and One Hundred Other Sleep Scales (pp. 161–162). Springer New York. https://doi.org/10.1007/978-1-4419-9893-4_33 Instruction Manual 1 Automatic Upper Arm Blood Pressure Monitor M2 Basic (HEM-7121J-E) . (n.d.). Mueller, A. E., Segal, D. L., Gavett, B., Marty, M. A., Yochim, B., June, A., Coolidge, F. L., Pachana, N. A., & Oude Voshaar, R. C. (2015). Geriatric Anxiety Scale: item response theory analysis, differential item functioning, and creation of a ten-item short form (GAS-10). International Psychogeriatrics , 27 (7), 1099–1111. https://doi.org/10.1017/S1041610214000210 Greenberg, S. A. (n.d.). The Geriatric Depression Scale (GDS) . www.ConsultGeriRN.org. Cohen, S. (1994). PERCEIVED STRESS SCALE . www.mindgarden.com Shree Ganesh, H., Subramanya, P., Rao, Mr., Vadhiraj, H., & Udupa, V. (2022). Impact of yoga therapy in improving perceived stress, depression, and quality of life in elderly population: A randomized controlled trial. Journal of Applied Consciousness Studies , 10 (1), 62. https://doi.org/10.4103/ijoyppp.ijoyppp_26_21 Putu Eka Martina Heliasih Anak Agung Komang Suardana Euis Dewi Yuliana Made Yasna Wiguna, N. I. (2019). GAP GYAN-THE RELATIONSHIP BETWEEN THE DURATION OF FOLLOWING YOGA PRACTICE AND LEVEL OF ANXIETY IN ELDERLY IN YOGA GROUP PAKRAMAN VILLAGE, KETEWEL, GIANYAR . https://www.gapjournals.org/ Ashwini, elderly cardiac n mental health . (n.d.). Amin, A., Kumar, S. S., Rajagopalan, A., Rajan, S., Mishra, S., Reddy, U. K., & Mukkadan, J. K. (2016). Beneficial effects of OM chanting on depression, anxiety, stress and cognition in elderly women with hypertension. Indian Journal of Clinical Anatomy and Physiology , 3 (3), 253. https://doi.org/10.5958/2394-2126.2016.00056.6 Bonura, K. B., & Tenenbaum, G. (2014). Effects of yoga on psychological health in older adults. Journal of Physical Activity and Health , 11 (7), 1334–1341. https://doi.org/10.1123/jpah.2012-0365 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5226157","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":365331308,"identity":"d2396e88-7037-4cf2-8ce7-294e2a552baa","order_by":0,"name":"Jyoti Varshney","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3klEQVRIiWNgGAWjYBAC9gYgkQDEBgzJhxkbiNECVMXYANGSlkyCFgawlhxjIrXMSD7+4GEbQ545e85nwxl/DjPwSx+/QEBLWmJDYhtDsWXP282JG9sOM0j25RQQ0JJj2JBwhiFxw43czQcfNhxmMDjDk0CslpzHBx/8IUKLIFhLBVgLc+IGNpAW9gN4tUjzPEucAdRSbHDmmbHhzLZ0HskeHrw6GPjYkw98/GHAkGdwPPmxZM8fazl+HvYH+PUIgB3+H+58oBU8Bvi18EMcnoAkRMiWUTAKRsEoGGkAAOqATnQFJSLMAAAAAElFTkSuQmCC","orcid":"","institution":"Kavikulaguru Kalidas Sanskrit University","correspondingAuthor":true,"prefix":"","firstName":"Jyoti","middleName":"","lastName":"Varshney","suffix":""},{"id":365331309,"identity":"cf85c3a0-c327-4caa-8a6a-48759379e246","order_by":1,"name":"Madhusudan Penna","email":"","orcid":"","institution":"Kavikulaguru Kalidas Sanskrit University","correspondingAuthor":false,"prefix":"","firstName":"Madhusudan","middleName":"","lastName":"Penna","suffix":""}],"badges":[],"createdAt":"2024-10-08 14:23:37","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5226157/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5226157/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107844634,"identity":"171685c5-2991-469d-8bfe-6f7df42554f5","added_by":"auto","created_at":"2026-04-26 21:23:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":318353,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5226157/v1/2d77b038-ae8d-4945-8973-fb3fe1484b86.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eEffects of Integrated Selected Yoga Practices on Physical and Mental Health Among Destitute Elderly Widows in Vrindavan: a Pilot Study\u003c/p\u003e","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eEvery human being in the world should have the opportunity to have a long and healthy life (WHO, 2022).The process of getting older is a natural part of being human. which is followed by a decline in interrelated physical, mental, and social conditions. Elderly people are known as they are children where most of the decision used to be taken by others. They are considered to be dependent on others.(Jolanki, 2009) Elderly people change physiologically during their old age. Many psychological, behavioural, and mental changes are caused by these changes in them. As a person age, their physical strength and stamina decline more acutely and need to be treated systematically. The care and look after of the senior people have been limited at the level of global level. The encouragement for elderly participation in the active health care policy making need to be taken on priority. The provision for health care system in terms of success deliberation of services to this strata of society are matter of concern in present scenario.(Kolade et al., 2022) As elderly women have a longer life, they\u0026rsquo;re going to face more health problems. The such vulnerability would be even greater among elderly widows are caused by the truth that their widowhood id highly dependent on others owing to the loss of their spouse, are unable to earn income through economic activities and lack access to financial resources, in addition to having lower literacy and health awareness.(Hiremath, 2012)\u003c/p\u003e\n\u003cp\u003eBased on the destitute women and widows welfare bill 2006 (Bill No XC of 2006) The word \u0026ldquo;Destitute\u0026rdquo; refers to any female who does not have an independent source of income or who is not being cared for by a family member or relative, and includes divorced women. They are all destitute women who live in shelter homes run by government authorities and non-governmental organisations, in their rented accommodations, and in other public places such as ghats and temples. (Vrindavan Report Page 146\u0026ndash;165, n.d.).\u003c/p\u003e\n\u003cp\u003eAccording to the UN Division for the Advancement of Women, 2000 reports, an estimated 20,000 widows struggle to survive in Vrindavan alone. For a woman, being destitute after becoming a widow is an extremely difficult condition. The loss of a spouse has been reported to harm widows\u0026rsquo; health, making widowhood one of life\u0026rsquo;s most stressful situations(Anusic \u0026amp; Lucas, 2014). According to a case study conducted in Vrindavan, the majority of women suffering from major mental illnesses did not get any therapy. They are not only experience mental problems as they grow older age, but they also suffer physical issues as a result of not getting sufficient food and proper treatment(Ramanathan et al., 2017). Ageing is a natural process of decreasing health performance; abandonment following the husband\u0026rsquo;s death may increase health issues (Vrindavan Report Page 146\u0026ndash;165, n.d.). Common conditions in destitute widows include hypertension, body pain, back and neck pain and osteoarthritis, hearing loss, cataracts and refractive errors, chronic obstructive pulmonary disease, stress, insomnia, depression and dementia.\u003c/p\u003e\n\u003cp\u003eYoga is a practice which includes relaxation, meditation, and a series of physical exercises with breathing to achieve physical, mental, social, and spiritual well-being(Ramanathan et al., 2017). Yoga promotes the regulation of autonomic functions, the relief of stress, and the improvement of psycho-physiological functions such as cardiovascular health and quality of life(Andharia, 2023). Yoga is considered a body-mind intervention that is increasingly being researched for its therapeutic possibilities in the elderly(Grover \u0026amp; Malhotra, 2015). Although several studies are proving the beneficial effects of yoga on the elderly, the majority of Indian studies in this area have focused on a specific population of the elderly, such as shelter home elderly, homeless population, and so on(Bansal \u0026amp; Patra, 2017). However, so far no study has been done on destitute elderly widows.\u003c/p\u003e\n\u003cp\u003eEvery human being is concealed with five layers of existence, viz., Annamaya (physical), Pranamaya (vital), Manomaya (Psychic), Vijnanamaya (Intellectual), and Anandamaya (Happiness), and Taitriya Upanishad contains a great overview of this Pancha Kosha concept(Dev et al., n.d.). Yoga conceptualises the human being as a multi-layered, conscious being, possessing three bodies or sharira (sthula-gros, sukshma-subtle, and kaa-causal) and having a five-layered existence (pancha kosha) consisting of our anatomical, physiological, psychological, intellectual, and universal existential layers(Jagannathan et al., 2014). The IAYT program, which is based on the Pancha Kosha concept mentioned above, includes several kinds of yogic practices at each level to assist patients with various diseases in addressing their issues.\u003c/p\u003e\n\u003cp\u003eAmong the Annamaya Kosha customs are:\u003c/p\u003e\n\u003cp\u003e\u003cspan\u003e\u003cstrong\u003eI. Asana\u003c/strong\u003e: A steady, pleasant position that deeply relaxes internal organs by massaging them; all of the body\u0026apos;s organs begin to function harmoniously, and the mind becomes peaceful.\u003cbr\u003e\u003c/span\u003e\u003cspan\u003e\u003cstrong\u003eII. Diet\u003c/strong\u003e: A healthy vegetarian diet that soothes the mind called as a Sattvic diet, is advised since it supports the human body and psyche\u0026apos;s internal balance.\u003cbr\u003e\u003c/span\u003e\u003cspan\u003e\u003cstrong\u003eIII. Loosening exercises\u003c/strong\u003e improve muscle strength, decrease joint stiffness, and boost physical endurance.\u003cbr\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePranayama Kosha techniques include\u003c/strong\u003e: breathing exercises and cleaning breath, which improve consciousness, clear the lungs, correct breathing patterns, and expand lung capacity. Pranayama: Reduces breathing rate and restores autonomic balance, calming the mind.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eManomaya Kosha methods include\u003c/strong\u003e: Cyclic meditation: methods with repeated stimulations and relaxations; Om meditation; and mind sound resonance technique (MSRT) for creating awareness and slowing down the mind. and Devotional Sessions: Practice \u0026quot;Bhakti Yoga\u0026quot; to cultivate emotional culture.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eVijnanamaya Kosha Practices include\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003electures and yogic counselling that use yogic notions of fearlessness to alleviate stress. All of the techniques mentioned above are intended to help a person in reaching the ultimate level of self-knowledge.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAnandamaya Kosha (Bliss)\u003c/strong\u003e is a condition of blissful silence characterized by awareness, perfect balance, and freedom of choice, in which the mind is free of stress and anxiety. The IAYT model tackles imbalances at the physical, mental, and emotional levels(Balayogi et al., 2016).\u003c/p\u003e\n\u003cp\u003eIn theory, all IAYT components are mutually exclusive. To have the desired impact, all components must be integrated and offered at each of the five levels of life. Individual components cannot be considered the IAYT or have the same effects as the entire model(Balayogi et al., 2016).\u003c/p\u003e\n\u003cp\u003eIntegrated yoga practises based on an \u0026quot;Integrated Approach to Yoga Therapy\u0026quot; (IAYT) that covers all five levels of existence (Pancha Koshas, i.e., physical, Prana or subtle energies, mental, and intellectual levels) are a holistic approach to treating patients with mental health conditions(Dr R Nagarathna And Dr H R Nagendra, 2001). Integrated selected yoga practises (ISYP) based on IAYT The ISYP model incorporates varied yogic practises at each level of Pancha Kosha to help people with different health problems.\u003c/p\u003e"},{"header":"2. Materials and Methods","content":"\u003cp\u003eThis study followed a pre-test, post-test quasi-experimental approach with a control group for four weeks, in destitute elderly widows at Paramhansa Yogananda Ashram in Vrindavan between November 2022 to January 2023. Participants were not randomly assigned to the Intervention group (IG) and Control group (CG). Requisite approval was obtained from the University and Ashram\u0026rsquo;s Director. After obtaining informed consent and who were willing to participate in this study and able to perform the techniques in the Yoga intervention were recruited for the study. Participants who currently practice yoga were not willing to participate in the study and recommended surgery, hearing and vision problems were excluded from the study. The study had a total of 20 subjects. The convenience sampling method was followed and divided into two groups, the Intervention Group (IG) of 10 and the Control Group (CG) of 10 participants recruited.\u003c/p\u003e\n\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003e2.1 Measures\u003c/h2\u003e\n \u003cp\u003eAssessments were conducted for the group at both the baseline and 4-week points.\u003c/p\u003e\n \u003cdiv id=\"Sec4\" class=\"Section3\"\u003e\n \u003ch2\u003e2.1.1 Numerical Rating Scale\u003c/h2\u003e\n \u003cp\u003eThe range of 0 to 10 is made up of the horizontal NRS in addition to the anchor word, such as \u0026ldquo;no pain\u0026rdquo; at one end, \u0026ldquo;moderate pain\u0026rdquo; in the middle of the graph, and \u0026ldquo;worst possible pain\u0026rdquo; at the opposite end. This rating system was determined to be a reliable and valid measure of pain severity when utilized with elderly people(Herr et al., 2004; Herr \u0026amp; Mobily, n.d.).\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e\n \u003ch2\u003e2.1.2 Fatigue Assessment Scale\u003c/h2\u003e\n \u003cp\u003eFAS assesses physical and mental aspects of fatigue signs. It is a 10-item reporting system that can be completed in about 2 min. Questions describes the personal feels (1\u0026thinsp;=\u0026thinsp;Never, 2\u0026thinsp;=\u0026thinsp;Sometimes; 3\u0026thinsp;=\u0026thinsp;Regularly; 4\u0026thinsp;=\u0026thinsp;Frequently; and 5\u0026thinsp;=\u0026thinsp;Always). The 4th and 10th items were reversed scored (Shahid et al., 2011).\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e\n \u003ch2\u003e2.1.3 Blood Pressure \u0026amp; Heart rate\u003c/h2\u003e\n \u003cp\u003eSystolic, diastolic blood pressure and heart rate were monitored using an Omron automated blood pressure monitor (H-7121J) device (Instruction Manual 1 Automatic Upper Arm Blood Pressure Monitor M2 Basic (HEM-7121J-E), n.d.).\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e\n \u003ch2\u003e2.1.4 Geriatric Anxiety Scale\u003c/h2\u003e\n \u003cp\u003eA 10-item geriatric anxiety scale (GAS) instrument was used in this study to ascertain the status of anxiety in our participants. GAS can be self-administered or can be utilized as an interview tool as the questions are of (0)\u0026thinsp;=\u0026thinsp;Not at all, (\u003cspan class=\"CitationRef\"\u003e1\u003c/span\u003e)\u0026thinsp;=\u0026thinsp;Sometimes, (\u003cspan class=\"CitationRef\"\u003e2\u003c/span\u003e)\u0026thinsp;=\u0026thinsp;Most of the time and (\u003cspan class=\"CitationRef\"\u003e3\u003c/span\u003e)\u0026thinsp;=\u0026thinsp;All of the time(Mueller et al., 2015).\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e\n \u003ch2\u003e2.1.5 Perceived Stress Scale\u003c/h2\u003e\n \u003cp\u003ePerceived Stress Scale (PSS) is one of the widely used stress scale used to determine the magnitude of situations that are perceived by individuals as unpredictable, uncontrollable and detrimental compared to previous month of their life. The latest version of PSS is a 10-item scale designed as a self-appraisal of the effects stressors on one\u0026rsquo;s life (Cohen, 1994).\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e\n \u003ch2\u003e2.1.6 Geriatric Depression Scale\u003c/h2\u003e\n \u003cp\u003eDepression was assessed using the Hindi Version of the Short Form of Geriatric Depression. This scale includes 15 questions related to depression in the elderly. A higher score indicates stronger symptoms of depression; specifically, a score of less than 5 indicates a normal state, a score of 6\u0026ndash;9 indicates moderate depression, and a score of more than 10 indicates severe depression (Greenberg, n.d.).\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\n \u003ch2\u003e2.2 Intervention\u003c/h2\u003e\n \u003cp\u003eThe Integrated Selected Yoga Practices (ISYP) is an approach that not only deals with a physical lever but also includes using techniques to operate on different layers of our existence. The practices at the body level (annamaya kosha) Sukshma vyayama; at the subtle energy level (Pranayama kosha), include Anulom Vilom and Bhrahmri; and at the mind level (manomaya kosha), Om Japa, Yoga Nidra, Geeta Path, and Bhajan were implemented as interventions. After baseline data collection, a 45\u0026ndash;50 minute session was delivered by a Yoga instructor. All IG participants ISYP for four weeks (6 days/week) for 45\u0026ndash;50 minutes. All interventions were done on chairs due to elder women not being able to sit on the floor.\u0026nbsp;\u003c/p\u003e\u0026nbsp;\u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eSocio demographic Characteristics of Participants at Baseline\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e60\u0026ndash;70\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e70\u0026ndash;80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e66.9\u0026thinsp;\u0026plusmn;\u0026thinsp;5.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e71.6\u0026thinsp;\u0026plusmn;\u0026thinsp;4.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEducation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMiddle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMatric\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNature of Husband\u0026apos;s death\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDeaths from bites and stings of venomous animals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e310\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHeart attack/Brain Stroke\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLiver/ kidney failure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAccident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDuration of husband death\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10\u0026ndash;20 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21\u0026ndash;30 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e40\u0026ndash;50 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNumber of Children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u0026ndash;2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u0026ndash;4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eReason to Home Leave\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVoluntarily\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAbandoned by son\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRitual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEmployment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDevotion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e2. Data Analysis\u003c/strong\u003e: The obtained data was expressed as mean and standard deviation. Comparison between pre and post scores was performed using the Wilcoxon signed rank test. Statistical significance was established at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Data analysis was performed using the statistical software IBM SPSS.\u003cspan\u003e\u003c/span\u003e\u003c/p\u003e\n\n\u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003eA total number of 20 participants completed the study (IG 10 participants, and the CG 10 participants). Sample characteristic information are given in Tables 1, 2 and 3 show the descriptive statistics for the pre- and post-test measures of the physical and mental health characteristics, both in the intervention group (IG) and in the control group (CG). The findings strongly suggest that implementing Integrated Selected Yoga Practices (ISYP) over four weeks leads to significant improvements in several physical and mental health parameters (body pain, fatigue, blood pressure, heart rate, anxiety, depression, and stress) among the destitute elderly widows in the intervention group. These findings suggest that ISYP can be an effective, safe, and low-cost intervention to improve the health and well-being of this vulnerable population. The control group, which did not receive the intervention, showed no significant improvements in the majority of these indicators, highlighting the efficacy of the yoga practices.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cimg 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\"\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cdiv\u003e\u003cbr\u003e\u003c/div\u003e\n\u003cp\u003e\u003cimg src=\"https://myfiles.space/user_files/122228_c8a1650c59388082/122228_custom_files/img1728973637.png\"\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cimg src=\"https://myfiles.space/user_files/122228_c8a1650c59388082/122228_custom_files/img1728973636.png\"\u003e\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThe purpose of the present research study was to observe how the 4-week Integrated Selected Yoga Practices intervention changed body pain, fatigue, hypertension, heart rate, stress, anxiety and depression in destitute elderly widows. Significant reduction in these parameters and improvement was observed as a result of 4 week of Integrated Selected Yoga Practices, with regard to the control group. As far as we are aware, the study is the first to investigate the effect of Integrated Selected Yoga Practices on body pain, fatigue, hypertension, heart rate, stress, anxiety and depression in destitute elderly widows. Previously a study by(Andharia, 2023) This study found significant improvements in both physical and mental health measures following a 12-week yoga intervention. In the current investigation, we also found significant changes in both the physical and mental health of elderly widows after four weeks of yoga practice (Shree Ganesh et al., 2022). The results showed significant improvements in the yoga group, including reduced perceived stress and depression, and enhanced quality of life. In our study also showed significant reductions in depression, and stress. The study found a higher participation rate among females (74.3%) compared to males (25.7%) and noted that anxiety levels were generally higher among females. Practicing yoga twice a week, particularly Laughter Yoga, correlated with better anxiety outcomes and promoted mental well-being among the elderly(Putu Eka Martina Heliasih Anak Agung Komang Suardana Euis Dewi Yuliana Made Yasna Wiguna, 2019). Similarly, in our investigation, elderly widows was a significant decrease in anxiety levels. After one month of Integrated Yoga, elderly participants with chronic health conditions saw significant improvements in vital signs, mental health, sleep quality, quality of life, and life satisfaction. Our study is similar to that one month of Integrated selected yoga practices showed significant reductions in anxiety, depression, and stress(Ashwini, Elderly Cardiac n Mental Health, n.d.). The study observed significant reductions in systolic and diastolic blood pressure, as well as pulse rate, following six months of Om chanting(Amin et al., 2016). Our study replicates these findings with a smaller sample size and a one-month intervention. The study showed significant improvements in psychological health among older adults who participated in a yoga intervention(Bonura \u0026amp; Tenenbaum, 2014). Our investigation supports this study, as we also found a notable reduction in body pain, fatigue, hypertension, and heart rate followed by Integrated Selected Yoga Practices.\u003c/p\u003e \u003cp\u003eFor several acute and chronic diseases, many classical yoga asanas and breathing techniques may be harmful. Particularly people who have certain injuries or bone issues are unable to sit on the floor. A modified yoga format works for some elderly individuals. Modified yoga practises can incorporate each and all of the essential components of a traditional yoga practice while also making changes for accessibility and safety. Yoga performed in a chair was adopted in the current study. In order to find the most efficient and secure practises and protocols, further study should identify the fundamental components of yoga, compare alternative models for modified yoga, and provide guidelines for modifying yoga practises safely for varied conditions and populations. The present study is limited to small sample size as it\u0026rsquo;s an pilot study. further studies should be performed with a larger sample size, duration should be increased and long-term intervention.\u003c/p\u003e \u003cp\u003e \u003cb\u003eMechanism\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe mechanisms through which ISYP brought about these improvements are multifaceted:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003ePhysical Exercises (Annamaya Kosha)\u003c/b\u003e: The Sukshma Vyayama exercises aimed at improving physical flexibility, muscle strength, and overall physical conditioning, which helped in reducing body pain and fatigue.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eBreathing Techniques (Pranamaya Kosha)\u003c/b\u003e: Practices like Anulom Vilom and Bhrahmri Pranayama are known to enhance oxygenation, reduce stress hormones, and improve cardiovascular parameters, which contributed to the reductions in blood pressure and heart rate.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eMental Exercises (Manomaya Kosha)\u003c/b\u003e: Techniques such as Om Japa, Yoga Nidra, Geeta Path, and Bhajan focus on calming the mind, reducing anxiety and depression, and improving overall mental health. These practices are designed to engage the mind in positive and soothing activities, thereby reducing stress and enhancing mental well-being.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eHolistic Integration\u003c/b\u003e: The integration of physical, respiratory, and mental practices in ISYP creates a comprehensive approach that addresses multiple layers of an individual's well-being, promoting a balance between body and mind. (Dr R Nagarathna And Dr H R Nagendra, 2001)\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eThis study is the first investigation into the impact of Integrated Selected Yoga Practices (ISYP) on the physical and mental health of destitute elderly widows, a highly neglected and vulnerable demographic. After a four-week ISYP intervention, major health indices such as body pain, fatigue, blood pressure, heart rate, anxiety, depression, and stress improved significantly. These findings emphasize ISYP\u0026apos;s potential as a safe, cost-effective, holistic therapy alternative to conventional medical care. ISYP provides an accessible and practical option for improving the general well-being of elderly widows living in shelter homes. This study, as a pilot study, paves the way for further investigation into yoga\u0026apos;s therapeutic benefits, suggesting that ISYP could play an important role in enhancing the quality of life of elderly populations experiencing similar socioeconomic and health issues.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAbbreviations:\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIAYT-\u003c/strong\u003e Integrated Approach to Yoga Therapy\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eISYP-\u003c/strong\u003e Integrated Selected Yoga Practices\u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMSRT-\u003c/strong\u003e Mind Sound Resonance Technique\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNRS-\u003c/strong\u003e Numeric Rating Scale\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBP \u0026amp; HR-\u003c/strong\u003e Blood Pressure and Heart Rate\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGDS-\u003c/strong\u003e Geriatric Depression Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFAS-\u003c/strong\u003e Fatigue Assessment Scale\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGAS-\u003c/strong\u003e Geriatric Anxiety Scale\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePSS-\u003c/strong\u003e Perceived Stress Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIG-\u003c/strong\u003e Intervention Group\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCG-\u003c/strong\u003e Control Group\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFinancial Support:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNil\u003cstrong\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatement of Ethics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the university. The purpose and outcome as well as the methods of study were explained to the authority of the ashram, to ensure sustained cooperation. Informed written consent was obtained from each of the study participants.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWHO. (2022). \u003cem\u003eWHO clinical consortium on healthy ageing 2022\u003c/em\u003e (Issue December).\u003c/li\u003e\n\u003cli\u003eJolanki, O. H. (2009). Agency in talk about old age and health. \u003cem\u003eJournal of Aging Studies\u003c/em\u003e, \u003cem\u003e23\u003c/em\u003e(4), 215\u0026ndash;226. https://doi.org/10.1016/j.jaging.2007.12.020\u003c/li\u003e\n\u003cli\u003eKolade, O., Porat-Dahlerbruch, J., van Achterberg, T., \u0026amp; Ellen, M. (2022). Strategies for engaging senior citizens and their informal caregivers in health policy development: a scoping review protocol. \u003cem\u003eBMJ Open\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e(10), e064505. https://doi.org/10.1136/bmjopen-2022-064505\u003c/li\u003e\n\u003cli\u003eHiremath, S. S. (2012). The Health Status of Rural Elderly Women in India: A Case Study. \u003cem\u003eInternational Journal of Criminology and Sociological Theory\u003c/em\u003e, \u003cem\u003e5\u003c/em\u003e(3), 960\u0026ndash;963.\u003c/li\u003e\n\u003cli\u003e\u003cem\u003eStudy On Widows at Vrindavan\u003c/em\u003e. (2009).\u003c/li\u003e\n\u003cli\u003eAnusic, I., \u0026amp; Lucas, R. E. (2014). Do social relationships buffer the effects of widowhood? A prospective study of adaptation to the loss of a spouse. \u003cem\u003eJournal of Personality\u003c/em\u003e, \u003cem\u003e82\u003c/em\u003e(5), 367\u0026ndash;378. https://doi.org/10.1111/jopy.12067\u003c/li\u003e\n\u003cli\u003eRamanathan, M., Bhavanani, A., \u0026amp; Trakroo, M. (2017). Effect of a 12-week yoga therapy program on mental health status in elderly women inmates of a hospice. \u003cem\u003eInternational Journal of Yoga\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e(1), 24. https://doi.org/10.4103/0973-6131.186156\u003c/li\u003e\n\u003cli\u003eAndharia, C. (2023). EFFECTIVENESS OF YOGIC INTERVENTION ON PHYSICAL AND MENTAL HEALTH AMONG THE GERIATRIC PATIENTS. \u003cem\u003eVidya - A Journal\u003c/em\u003e, \u003cem\u003e2\u003c/em\u003e(1). http://vidyajournal.org\u003c/li\u003e\n\u003cli\u003eGrover, S., \u0026amp; Malhotra, N. (2015). Depression in elderly: A review of Indian research. \u003cem\u003eJournal of Geriatric Mental Health\u003c/em\u003e, \u003cem\u003e2\u003c/em\u003e(1), 4. https://doi.org/10.4103/2348-9995.161376\u003c/li\u003e\n\u003cli\u003eBansal, B., \u0026amp; Patra, S. (2017). Annamaya Kosha-From the Viw Point of Ancient and Modern Science. In \u003cem\u003eInternational Journal of Yoga and Allied Sciences\u003c/em\u003e (Issue 6).\u003c/li\u003e\n\u003cli\u003eDev, T., Vishwavidyalaya, S., \u0026amp; Tripathy, M. (n.d.). Evaluation of Integrated Approach of Psycho and Yoga Therapy in Management of Anxiety Neurosis: A Case Study. \u003cem\u003eCase Study Journal of Ayurvedic Herbal and Integrative Medicine\u003c/em\u003e, \u003cem\u003e1\u003c/em\u003e, 41\u0026ndash;57. https://doi.org/10.29121/jahim\u003c/li\u003e\n\u003cli\u003eJagannathan, A., Nagarathna, R., Ramakrsihna, J., \u0026amp; Villacres, M. D. (2014). Decoding the integrated approach to yoga therapy: Qualitative evidence based conceptual framework. \u003cem\u003eInternational Journal of Yoga\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e(1), 22. https://doi.org/10.4103/0973-6131.123475\u003c/li\u003e\n\u003cli\u003eBalayogi, A., Sri, B., Vidyapeeth, B., Ananda, Y., \u0026amp; Bhavanani, B. (2016). Cite this article: Balayogi Bhavanani.Mental Health and Wellbeing through Yoga. In \u003cem\u003eJ J Yoga\u003c/em\u003e (Vol. 2016, Issue 1). https://www.researchgate.net/publication/308889737\u003c/li\u003e\n\u003cli\u003eDr R Nagarathna And Dr H R Nagendra. (2001). \u003cem\u003eIntegrated Approach of Yoga Therapy for Positive Health\u003c/em\u003e (First). Swami Vivekananda Yoga Prakashana.\u003c/li\u003e\n\u003cli\u003eHerr, K. A., \u0026amp; Mobily, P. R. (n.d.). \u003cem\u003eComparison of Selected Pain Assessment Tools for Use With the Elderly\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eHerr, K. A., Spratt, K., Mobily, P. R., \u0026amp; Richardson, G. (2004). \u003cem\u003ePain Intensity Assessment in Older Adults Use of Experimental Pain to Compare Psychometric Properties and Usability of Selected Pain Scales With Younger Adults\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eShahid, A., Wilkinson, K., Marcu, S., \u0026amp; Shapiro, C. M. (2011). Fatigue Assessment Scale (FAS). In \u003cem\u003eSTOP, THAT and One Hundred Other Sleep Scales\u003c/em\u003e (pp. 161\u0026ndash;162). Springer New York. https://doi.org/10.1007/978-1-4419-9893-4_33\u003c/li\u003e\n\u003cli\u003e\u003cem\u003eInstruction Manual 1 Automatic Upper Arm Blood Pressure Monitor M2 Basic (HEM-7121J-E)\u003c/em\u003e. (n.d.).\u003c/li\u003e\n\u003cli\u003eMueller, A. E., Segal, D. L., Gavett, B., Marty, M. A., Yochim, B., June, A., Coolidge, F. L., Pachana, N. A., \u0026amp; Oude Voshaar, R. C. (2015). Geriatric Anxiety Scale: item response theory analysis, differential item functioning, and creation of a ten-item short form (GAS-10). \u003cem\u003eInternational Psychogeriatrics\u003c/em\u003e, \u003cem\u003e27\u003c/em\u003e(7), 1099\u0026ndash;1111. https://doi.org/10.1017/S1041610214000210\u003c/li\u003e\n\u003cli\u003eGreenberg, S. A. (n.d.). \u003cem\u003eThe Geriatric Depression Scale (GDS)\u003c/em\u003e. www.ConsultGeriRN.org.\u003c/li\u003e\n\u003cli\u003eCohen, S. (1994). \u003cem\u003ePERCEIVED STRESS SCALE\u003c/em\u003e. www.mindgarden.com\u003c/li\u003e\n\u003cli\u003eShree Ganesh, H., Subramanya, P., Rao, Mr., Vadhiraj, H., \u0026amp; Udupa, V. (2022). Impact of yoga therapy in improving perceived stress, depression, and quality of life in elderly population: A randomized controlled trial. \u003cem\u003eJournal of Applied Consciousness Studies\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e(1), 62. https://doi.org/10.4103/ijoyppp.ijoyppp_26_21\u003c/li\u003e\n\u003cli\u003ePutu Eka Martina Heliasih Anak Agung Komang Suardana Euis Dewi Yuliana Made Yasna Wiguna, N. I. (2019). \u003cem\u003eGAP GYAN-THE RELATIONSHIP BETWEEN THE DURATION OF FOLLOWING YOGA PRACTICE AND LEVEL OF ANXIETY IN ELDERLY IN YOGA GROUP PAKRAMAN VILLAGE, KETEWEL, GIANYAR\u003c/em\u003e. https://www.gapjournals.org/\u003c/li\u003e\n\u003cli\u003e\u003cem\u003eAshwini, elderly cardiac n mental health\u003c/em\u003e. (n.d.).\u003c/li\u003e\n\u003cli\u003eAmin, A., Kumar, S. S., Rajagopalan, A., Rajan, S., Mishra, S., Reddy, U. K., \u0026amp; Mukkadan, J. K. (2016). Beneficial effects of OM chanting on depression, anxiety, stress and cognition in elderly women with hypertension. \u003cem\u003eIndian Journal of Clinical Anatomy and Physiology\u003c/em\u003e, \u003cem\u003e3\u003c/em\u003e(3), 253. https://doi.org/10.5958/2394-2126.2016.00056.6\u003c/li\u003e\n\u003cli\u003eBonura, K. B., \u0026amp; Tenenbaum, G. (2014). Effects of yoga on psychological health in older adults. \u003cem\u003eJournal of Physical Activity and Health\u003c/em\u003e, \u003cem\u003e11\u003c/em\u003e(7), 1334\u0026ndash;1341. https://doi.org/10.1123/jpah.2012-0365\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Integrated Yoga, Destitute Elderly widows, Physical Health, Mental health","lastPublishedDoi":"10.21203/rs.3.rs-5226157/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5226157/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eVrindavan has gained a reputation for harbouring many homeless elderly widows who confront tremendous physical, emotional, and financial hardships. These difficulties emphasize larger issues, such as poverty, social isolation, and poor healthcare for India's elderly. Yoga has recently gained recognition for its capacity to improve the health and well-being of these widows.\u003c/p\u003e\u003ch2\u003ePurpose\u003c/h2\u003e \u003cp\u003eThis study aimed to test the effects of 4 weeks Integrated Selected Yoga Practices in improving Body pain, and decreasing Fatigue, Hypertension, Heart Rate, Stress, Anxiety and Depression in destitute elderly widows.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA quasi-experimental pre-test and post-test with a control group design was used. A convenience sample of 20 destitute elderly widows was divided into an Intervention Group (IG) (n\u0026thinsp;=\u0026thinsp;10) and a control group (CG) (n\u0026thinsp;=\u0026thinsp;10). The outcome measured of NRS, FAS, BP \u0026amp; HR by Digital Monitor, GAS, GDS and PSS were examined at baseline and the 4th week of the study.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe Intervention Group (IG) showed a significant reduction in Body pain, Fatigue, Blood Pressure, Heart Rate, Anxiety, Depression and stress after 4 weeks compared to baseline.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eIt is recommended that Integrated Selected Yoga Practices be incorporated as a daily activity program in shelter homes or other long-term care facilities to improve Body pain and decrease Stress in destitute elderly widows.\u003c/p\u003e","manuscriptTitle":"Effects of Integrated Selected Yoga Practices on Physical and Mental Health Among Destitute Elderly Widows in Vrindavan: a Pilot Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-10-15 06:36:50","doi":"10.21203/rs.3.rs-5226157/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6143c943-7eb1-4ea6-b42e-ff3a5756527e","owner":[],"postedDate":"October 15th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-26T21:23:16+00:00","versionOfRecord":[],"versionCreatedAt":"2024-10-15 06:36:50","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5226157","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5226157","identity":"rs-5226157","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}