EFFECT OF YOGIC PRACTICES ON SYSTOLIC BLOOD PRESSURE AND HEADACHE FREQUENCY AMONG MIDDLE AGED WOMEN SUFFERING WITH MIGRAINE

*NALINI.G,**Dr. R. Elangovan, *Full-Time Ph.D Scholar, Faculty of Yoga Sciences and Therapy, Meenakshi Academy of Higher Education and Research (Deemed to be University), No.24, Vembuliamman Koil Street, West K.K.Nagar, Chennai-78, Tamil Nadu, India. E- Mail ID: ngovin123@gmail.com, **Professor & Head, Faculty of Yoga Sciences and Therapy, Meenakshi Academy of Higher Education and Research (Deemed to be University), No.24, Vembuliamman Koil Street, West K.K.Nagar, Chennai-78, Tamil Nadu, India. E-Mail ID: relangovantnpesu@gmail.com.

ABSTRACT

Migraine is a neurovascular and endocrine disorder which can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. There is much research which relates that hypertensed women will have more frequency of migraine attack than the normal migraine women. The purpose of the random group experimental design was to find out the effect of yogic practices on systolic blood pressure and headache frequency among middle aged women suffering with migraine. For the purpose of the study, 45 middle aged women suffering only with migraine were selected randomly by random sampling design from Chennai city and they were divided into three groups I, II and III with 15 subjects in each group. It was hypothesized that there would be significant differences on systolic blood pressure and migraine frequency among middle aged women suffering with migraine than the control group due to yogic practices. It was also hypothesized that there would be significant differences on systolic blood pressure and headache frequency between hypertensed middle aged women suffering with migraine and the middle aged women suffering with migraine only due to yogic practices. Preliminary test was taken for all the Groups (I, II and III) on systolic blood pressure and headache frequency before the start of the training program. Group I (hypertensed middle aged women with migraine), Group II (middle aged women only with migraine) was given Yogic Practices for six days a week about 60 minutes a day for a total period of 24 weeks. Group III (Control Group) were in active rest. After the experimental period, all the three groups were retested again on the same selected dependent variables. Analysis of co-variance (ANCOVA) was used to find out the mean differences among the experimental group I and II and the control group. The Scheffe’s post hoc test was used to find out the paired mean differences between the experimental groups. The test of significance was fixed at 0.05 level of confidence. The results of the study showed that systolic blood pressure (decreased) and headache frequency (reduced) were significantly decreased than the Control Group due to yogic practices and it was proved again that there were significant differences due to yogic practices on Systolic blood pressure (decreased) and headache frequency (reduced) of hypertensed middle aged women suffering with migraine than the middle aged women suffering with migraine only. Hence it was concluded that yogic practices are beneficial mainly to hypertensed middle aged women suffering with migraine.

KEYWORDS: Hypertension, Migraine, Systolic, Blood Pressure, Headache frequency, Yogic Practices.

INTRODUCTION

Migraine is a neurovascular and endocrinal disorder. It is the painful headache due to fluctuation in blood flow to the brain or the fluctuations of hormones such as serotonin and estrogen often play a role in pain sensitivity for migraine sufferers. Migraine n women are often associated with the fluctuations of estrogen hormone which in turn cause the nerves to more sensitive to pain and blood vessel to contract. Vasoconstriction and Vaso dilation are more common among migraine people, but not the same to all migraine sufferers. Hypertensed middle aged women are more prone to severe headache rather the women with migraine only.

Inflammation of the blood vessels and the overproduction of Nitric oxide (NO) is also one of the reasons for migraine sufferers. The two major categories of migraine are migraine with aura ( classical migraine) and migraine without aura (common migraine).Symptoms of the migraine include acute, frequent headache ,sensitivity to light, distorted vision, dizziness, light headedness, nasal congestion, sensitivity to sound, etc

Yoga is the perfect restorative practices which can be followed easily by the hypertensed middle aged women with migraine at the body and mind level. It is more effective since the yogic practices are based on the individual rather the practice specific. It is not only for physical and mental fitness, it promotes the total well being. Yoga therapy is the specific set of yogic practices using props according to the individual and the stage of the illness. The main focus of the yoga therapy for middle aged women with migraine is to balance nitric oxide secretion, the blood flow, hormones and nervous activity in the brain by promoting more oxygen and stimulating the vagus nerve.

OBJECTIVES OF THE STUDY

The objectives of the study was to find out whether there would be any significant difference on systolic blood pressure and headache frequency due to yogic practices among hypertensed middle aged women suffering with migraine

PURPOSE OF THE STUDY

The purpose of the study was to find out the effect of yogic practices on systolic blood pressure and headache frequency among hypertensed middle aged women suffering with migraine

 

 

 

 

 

HYPOTHESIS

• . It was hypothesized that there would be significant differences on systolic blood pressure and headache frequency among middle aged women suffering with migraine due to Yogic practices than the control group.
• It was hypothesized that there would be significant differences on systolic blood pressure and headache frequency between hypertensed middle aged women suffering with migraine and the middle aged women suffering with migraine only due to yogic practices.

DELIMITATIONS

• The study was confined to middle age women only.
• The age of the subject was ranged from 40 to 50 years only.
• The study was confined to yogic practices as independent variable only
• The study was confined to systolic blood pressure and migraine frequency as dependent variables only.

LIMITATIONS

• The factors like Socio-Economical status were not taken into consideration.
• The climatic conditions were not considered.
• Factors like Life style habits were not taken into consideration.
• Subject’s day to day activities were not taken into account.
• Diet and Medications followed by subjects was not controlled.

REVIEW OF RELATED LITERATURE

Anand Kumar et.al., (2020) conducted a randomized clinical trial on effect of yoga as add-on therapy in migraine at a single tertiary care academic hospital in New Delhi, India. Patients enrolled were aged 18-50 years with a diagnosis of episodic migraine and were randomized into medical and yoga groups (1:1). Randomization was computer-generated with a variable block size and concealed. A predesigned yoga intervention was given for 3 months. Outcomes were recorded by a blinded assessor. The primary endpoint was a decrease in headache frequency, headache intensity, and Headache Impact Test (HIT)-6 score. Secondary outcomes included change in Migraine Disability Assessment (MIDAS) score, pill count, and proportion of headache free patients. 60 patients with episodic migraine were randomly assigned to medical and yoga groups. A total of 114 patients completed the trial. Baseline measures were comparable except for a higher mean headache frequency in the yoga group. Compared to medical therapy, the yoga group showed a significant mean delta value reduction in headache frequency (delta difference 3.53. Yoga as an add-on therapy in migraine is superior to medical therapy alone. It may be useful to integrate a cost-effective and safe intervention like yoga into the management of migraine.

Mahsa Zamani Boroujeni et.al., (2015) conducted a study on the effect of yoga intervention on blood NO in female migraineurs. Thirty-two female patients with migraine took part and were randomly divided into two groups. The control group (n = 14) received medication and the yoga group (n = 18) participated in 12 weeks yoga training in addition to receiving the same medication as that of the control group. Frequency and duration of headache were assessed by a questionnaire. Visual Analogue Scale was used to measure the severity of headache, and the metabolite of NO also was measured by Griess reaction. Headache Impact Test (HIT-6) was also used to assess the impact of headache on patients’ lives. Data were analyzed by t-test mean variance. When comparing yoga and control groups after 12 weeks, the results showed a

reduction in headache severity, frequency, and headache impact on patients’ lives after the intervention in the yoga group however, the changes in the control group were not significant. Duration of headache also reduced after 12 weeks in the yoga group, but the results were not significant A non-significant increase was seen in blood NO level in both groups after treatment

METHODOLOGY

To achieve the purpose of the study, 80 came forward, 60 were screened and 45 middle aged women suffering with migraine were selected randomly from Chennai city, between the age group of 40 and 50 years and they were divided into three groups I, II and III with 15 subjects in each group. Preliminary test was conducted for all the three groups (I, II and III) on the selected dependent variables before the start of the training program. Group I and II subjects were given Yogic practices for 60 minutes, six days in a week for a total period of 24 weeks.

Yogic practices such as Ardha Uttanasana, Adhomukha Svanasana, Sashankasana, ,

Sethubandhasan, Marjariasana, Viparita Karani, Matsyasana, Simhasana, Janu Sirasasana, Shavasan and Pranayama practices such as Anulom Viloma, Sectional Breathing, Bhrammari, Shambavi mudra, Khechari mudra, followed by Yoga Nidra and Mindful meditation were given in restorative mode to group I and group II subjects.

Group III (Control Group) subjects were permitted to undergo their routine and normal lifestyle during the course of experiment without any specific training.

After 24 weeks, the three groups were retested again on the same selected dependent variables such as Systolic blood pressure and headache frequency (Headache Disability Questionnaire). The scores were statistically measured using Analysis of Co-Variance (ANCOVA) to find out the significant mean differences between the three groups (Group I, II and III). The Scheffe’s post hoc test would be used to find out the paired mean differences between the experimental groups. The test of significance was fixed at 0.05 level of confidence.

RESULTS AND DISCUSSIONS

 

The data pertaining to the variable collected from the three groups before and after the training period were statistically analyzed by using Analysis of Co-variance (ANCOVA) to determine the significant mean difference. The Scheffe’s post hoc test would be used to find out the paired mean differences between the experimental groups and the hypothesis was tested at 0.05 level of confidence. These are shown in the tables below.

RESULTS ON SYSTOLIC BLOOD PRESSURE TABLE I ANALYSIS OF COVARIANCE OF THE MEANS OF EXPERIMENTAL GROUP1, GROUP II AND THE CONTROL GROUP ON SYSTOLIC BLOOD PRESSURE(SCORES IN mmHg)

TEST	EX-GP1 (HYPERTENSION WITH MIGRAINE)	EX-GP2 (MIGRAINE ONLY)	CONTROL GROUP	sv	ss	df	MS	F
Pre test	136.47	128.6	126.73	between	800.53	2	400.27	63.14
				within	266.27	42	6.34
Post test	126.8	127.07	130	between	94.58	2	47.29	4.08*
				within	487.33	42	11.6
Adjusted	122.49	128.54	132.84	between	238.56	2	119.28	14.24*
				within	343.35	41	8.37
Mean gain	-9.67	-1.53	3.27

*Significant at 0.05 level of confidence. Table F ratio (0.05) (2,42 =3.22 and 2, 41 = 3.23).

This proved that the differences between the post test means of the subjects were significant. Taking into consideration the pre and post test scores among the groups, adjusted mean scores were calculated and subjected to statistical treatment. The obtained F value 4.08 was greater than the required F value of 3.23. This proved that there was a significant difference among the means due to 24 weeks of yogic practices on Systolic blood pressure and in line with the study conducted by Mahsa Zamani Boroujeni et.al., (2015).

Since significant improvements were recorded, the results were subjected to post hoc analysis using Scheffe's Confidence Interval test. The results were presented in Table II

TABLE II

SCHEFFE’S POST-HOC TEST SYSTOLIC BLOOD PRESSURE

EX-GRP 1 (HYP-M)	EX-GRP 2 (M)	CG	MEAN DIFFERENCE	CD at 5% Level
122.49	128.54		6.05*	3.29
122.49		132.84	10.35*
	128.54	132.84	4.30*

*significant at 0.05 level of confidence

The difference of paired mean difference value of the two experimental groups is greater than the C.I value. Hence it is concluded that there is significant difference in Systolic blood pressure between Group I and Group II

The pre-test, post-test and adjusted post-test mean values of Systolic blood pressure for the

Group I, II and the control group on Systolic blood pressure were graphically presented in Figure

Figure 1 BAR DIAGRAM SHOWING THE MEAN DIFFERENCES AMONG THE GROUPS ON SYSTOLIC BLOOD PRESSURE (Scores in mmHg)

 

 

 

RESULTS ON HEADACHE FREQUENCY TABLE III ANALYSIS OF COVARIANCE OF THE MEANS OF EXPERIMENTAL GROUP1, GROUP II AND THE CONTROL GROUP ON HEADACHE FREQUENCY (SCORES IN NO. OF DAYS)

TEST	EX-GP1 (HYPERTENSION WITH MIGRAINE)	EX-GP2 (MIGRAINE ONLY)	CONTROL GROUP	sv	ss	df	MS	F
Pre test	6.67	4.93	4.93	between	30.04	2	15.02	8.62
				within	73.2	42	1.74
Post test	4.0	4.07	6.07	between	41.38	2	20.69	13.19*
				within	65.87	42	1.57
Adjusted	3.26	4.44	6.44	between	63.78	2	31.89	36.81*
				within	35.52	41	0.87
Mean gain	-2.67	-0.87	1.13

*Significant at 0.05 level of confidence. Table F ratio (0.05) (2,42 =3.22 and 2, 41 = 3.23).

This proved that the differences between the post test means of the subjects were significant. Taking into consideration the pre and post test scores among the groups, adjusted mean scores were calculated and subjected to statistical treatment. The obtained F value 13.19 was greater than the required F value of 3.23. This proved that there was a significant difference among the means due to 24 weeks of yogic practices on headache frequency and the result is in line with the study conducted by Anand Kumar et.al., (2020).

Since significant improvements were recorded between the group I and group II, the results were subjected to post hoc analysis using Scheffe's Confidence Interval test. The results were presented in Table IV

 

TABLE IV

SCHEFFE’S POST-HOC TEST HEADACHE FREQUENCY

EX-GRP 1 (HYP-M)	EX-GRP 2 (M)	CG	MEAN DIFFERENCE	CD at 5% Level
3.26	4.44		1.18*	1.06
3.26		6.44	3.18*
	4.44	6.44	2.00*

*significant at 0.05 level of confidence

The difference of paired mean difference value of the two experimental groups is greater than the C.I value. Hence it is concluded that there is significant difference in headache frequency between Group I and Group II

The pre-test, post-test and adjusted post-test mean values of headache frequency for the Group I,

II and the control group on headache frequency were graphically presented in Figure 2

Figure 2

 

BAR DIAGRAM SHOWING THE MEAN DIFFERENCES AMONG THE GROUPS ON HEADACHE FREQUENCY (Scores in Number of days)

 

DISCUSSION ON HYPOTHESIS

• It was hypothesized that there would be significant differences on systolic blood pressure and migraine frequency among middle aged women suffering with migraine due to Yogic practices than the control group.
• The results proved that there were significant differences on Systolic blood pressure (decreased) and headache frequency( reduced) due to yogic practices among middle aged women suffering with migraine than the control group
• It was hypothesized that there would be significant differences on systolic blood pressure and headache frequency of hypertensed middle aged women suffering with migraine and the middle aged women suffering with migraine only due to yogic practices.
• The results proved that there were significant differences due to yogic practices on Systolic blood pressure (decreased) and headache frequency (reduced) between hypertensed middle aged women suffering with migraine than the middle aged women suffering with migraine only

CONCLUSION

• It is concluded that yogic practices significantly decreased Systolic blood pressure and reduced the headache frequency among middle aged women suffering with migraine than the control group.
• It is concluded that yogic practices significantly decreased Systolic blood pressure and reduced the headache frequency of hypertensed middle aged women suffering with migraine than the middle aged women suffering with migraine only. Hence yoga is highly powerful and cost effective adjuvant therapy to hypertensed middle aged women suffering with migraine.

 

REFERENCES:

• Anand Kumar, Rohit Bhatia, Gautam Sharma, Dhanlika Dhanlika, Sreenivas Vishnubhatla, Rajesh Kumar Singh, Deepa Dash, Manjari Tripathi, M.V. Padma Srivastava (2020). A randomized clinical trial on Effect of yoga as add-on therapy in migraine ,American academy of neurology, PMID: 32376640,DOI: https://doi.org/10.1212/WNL.0000000000009473
• Mahsa Zamani Boroujeni, Seyed Mohamad Marandi,1 Fahimeh Esfarjani,1 Mina Sattar,1 Vahid Shaygannejad,2 and Shaghayegh Haghjooy Javanmard (2015). Yoga intervention on blood NO in female migraineurs, Advanced Biomedical Research, PMID: 26918241, PMCID: PMC4746941