Prolonged standing is one of the significant contributors to chronic venous insufficiency (CVI) in industry workers. Yoga is proven to be an effective therapy in treating occupational hazards. The current study aimed to investigate the effect of yoga on CVI among industry workers.
Methodology:
Male workers (n = 100) from machinery manufacturing industries in Bangalore meeting the inclusion and exclusion criteria were recruited for the study. The yoga group received a specifically designed yoga module for 6 days a week for 12 weeks, and the control group was offered lifestyle suggestions. Plasma homocysteine was used as the primary outcome variable, whereas Venous Clinical Severity Score, ankle brachial pressure index (ABPI), ankle and calf circumference, CVI questionnaire, and Chalder fatigue scale were assessed as secondary variables at baseline and the end of 12 weeks of intervention.
Results:
Eighty-eight participants (yoga = 43, control = 45) completed the study. A one-way analysis of covariates (ANCOVA) was used to determine the significant differences between groups in the post-values. A significant difference was found between groups in plasma homocysteine (partial eta squared = 0.34, p < 0.001). All variables, except for ABPI, calf circumference, and ankle circumference, had shown statistically significant differences between the yoga and control groups after 12 weeks of intervention, with moderate to high effect sizes. There were no significant adverse events associated with the intervention.
Conclusions:
Yoga practices can reduce the symptoms of CVI along with vascular inflammation as indicated by reduced plasma homocysteine. Overall, yoga practices are found to be safe and efficacious for managing CVI.
IEC Reference Number:
RES/IEC-SVYASA/184/2021
Trial Registration Number (If Clinical Trial):
CTRI/2021/02/030944
Get full access to this article
View all access options for this article.
References
1.
HalimI, OmarAR, SamanAM, et al.Assessment of muscle fatigue associated with prolonged standing in the workplace. Saf Health Work, 2012; 3(1):31–42; doi: 10.5491/SHAW.2012.3.1.31
TomeiF, BaccoloTP, TomaoE, et al.Chronic venous disorders and occupation. Am J Ind Med, 1999; 36(6):653–665; doi: 10.1002/(SICI)1097-0274(199912)36:6<653::AID-AJIM8>3.0.CO;2-P
4.
VandyF, WakefieldTW. Varicose veins: Evaluating modern treatments, with emphasis on powered phlebectomy for branch varicosities. Interv Cardiol (London), 2012; 4(5):527–536; doi: 10.2217/ica.12.48
5.
BradburyA, EvansC, AllanP, et al.What are the symptoms of varicose veins? Edinburgh vein study cross sectional population survey. Br Med J, 1999; 318(7180):353–356; doi: 10.1136/bmj.318.7180.353
MarolaS, FerrareseA, SolejM, et al.Management of venous ulcers: State of the art. Int J Sur, 2016; 33:S132–S134; doi: 10.1016/j.ijsu.2016.06.015
8.
LondonN, NashR. ABC of arterial and venous disease: Varicose veins. Br Med J, 2000; 320(7246):1391–1394; doi: 10.1136/bmj.320.7246.1391
9.
McCullyKS.Homocysteine and vascular disease. Nat Med, 1996; 2(4):386–389; doi: 10.1038/nm0496-386
10.
RandevaHS, LewandowskiKC, DrzewoskiJ, et al.Exercise decreases plasma total homocysteine in overweight young women with polycystic ovary syndrome. J Clin Endocrinol Metab, 2002; 87(10):4496–4501; doi: 10.1210/jc.2001-012056
11.
SamRC, BurnsPJ, HobbsSD, et al.The prevalence of hyperhomocysteinemia, methylene tetrahydrofolate reductase C677T mutation, and vitamin B12 and folate deficiency in patients with chronic venous insufficiency. J Vasc Surg, 2003; 38(5):904–908; doi: 10.1016/S0741-5214(03)00923-6
12.
DudmanNPB, TempleSE, GuoXW, et al.Homocysteine enhances neutrophil-endothelial interactions in both cultured human cells and rats in vivo. Circ Res, 1999; 84(4):409–416; doi: 10.1161/01.RES.84.4.409
13.
WooKS, ChookP, LolinYI, et al.Hyperhomocyst(e)inemia is a risk factor for arterial endothelial dysfunction in humans. Circulation, 1997; 96(8):2542–2544; doi: 10.1161/01.CIR.96.8.2542
O'DonnellTF, PassmanMA, MarstonWA, et al.Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum. J Vasc Surg, 2014; 60(2):3S–59S; doi: 10.1016/j.jvs.2014.04.049
16.
MeissnerMH, MonetaG, BurnandK, et al.The hemodynamics and diagnosis of venous disease. J Vasc Surg, 2007; 46(6):S4–S24; doi: 10.1016/j.jvs.2007.09.043
17.
HowardDPJ, HowardA, KothariA, et al.The role of superficial venous surgery in the management of venous ulcers: A systematic review. Eu J Vasc Endo Surg, 2008; 36(4):458–465; doi: 10.1016/j.ejvs.2008.06.013
18.
SwathiPS, RaghavendraBR, SaojiAA. Health and therapeutic benefits of Shatkarma: A narrative review of scientific studies. J Ayurveda Integr Med, 2021; 12(1):206–212; doi: 10.1016/j.jaim.2020.11.008
19.
SaojiAA, RaghavendraBR, ManjunathNK. Effects of yogic breath regulation: A narrative review of scientific evidence. J Ayurveda Integr Med, 2019; 10(1):50–58; doi: 10.1016/j.jaim.2017.07.008
RajbhojP, PathakS, PatilS. The effects of yoga practice on lung function and sIL-2R biomarkers in individuals working and living in the lonavala industrial area: A randomized controlled trial. Indian J Occup Environ Med, 2023; 27(2):159; doi: 10.4103/ijoem.ijoem_220_22
23.
PravalikaB, YamunaU, SaojiAA. Yoga for musculoskeletal pain, discomfort, perceived stress, and quality of sleep in industry workers: A randomized controlled trial. Int Arch Occup Environ Health, 2023; 96(10):1349–1360; doi: 10.1007/s00420-023-02013-3
24.
PravalikaB, YamunaU, SaojiAA. Effect of Yoga on musculoskeletal pain and discomfort, perceived stress, and quality of sleep in industrial workers: Study protocol for a randomized controlled trial. Adv Integr Med, 2022; 9(4):224–229; doi: 10.1016/j.aimed.2022.11.003
25.
CushingRE, BraunKL, AldenS. A qualitative study exploring yoga in veterans with PTSD symptoms. Int J Yoga Therap, 2018; 28(1):63–70; doi: 10.17761/2018-00020
26.
Ciezar-AndersenSD, HaydenKA, King-ShierKM. A systematic review of yoga interventions for helping health professionals and students. Complement Ther Med, 2021; 58:102704; doi: 10.1016/j.ctim.2021.102704
27.
SaojiAA.Yoga: A strategy to cope up stress and enhance wellbeing among medical students. N Am J Med Sci, 2016; 8(4):200–202; doi: 10.4103/1947-2714.179962
28.
HakkedCS, BalakrishnanR, KrishnamurthyMN. Yogic breathing practices improve lung functions of competitive young swimmers. J Ayurveda Integr Med, 2017; doi: 10.1016/j.jaim.2016.12.005
29.
TellesS, DashM, NaveenKV. Effect of yoga on musculoskeletal discomfort and motor functions in professional computer users. Work, 2009; 33(3):297–306; doi: 10.3233/WOR-2009-0877
30.
SaojiAA, SwathiP, BhatR, et al.Exploring the effect of Trataka (a yogic cleansing technique) and cold eye pack on eye strain during COVID-19 pandemic: A randomized three-arm trial. J Integr Complement Med, 2023. [Epub ahead of print]; doi: 10.1089/jicm.2023.0175
31.
Kiecolt-GlaserJK, ChristianL, PrestonH, et al.Stress, inflammation, and yoga practice. Psychosom Med, 2010; 72(2):113–121; doi: 10.1097/PSY.0b013e3181cb9377
32.
ParkJ, ShermanDG, AgogoG, et al.Frailty modifies the intervention effect of chair yoga on pain among older adults with lower extremity osteoarthritis: Secondary analysis of a nonpharmacological intervention trial. Exp Gerontol, 2020; 134:110886; doi: 10.1016/j.exger.2020.110886
33.
LaiYT, HsiehCC, HuangLS, et al.The effects of upper limb exercise through yoga on limb swelling in Chinese breast cancer survivors—A pilot study. Rehabilitation Nursing, 2017; 42(1):46–54; doi: 10.1002/rnj.217
34.
NarahariS, AggithayaM, ThernoeL, et al.Yoga protocol for treatment of breast cancer-related lymphedema. Int J Yoga, 2016; 9(2):145; doi: 10.4103/0973-6131.183713
35.
NaragattiS, GuptaR. Case study on patient with varicose veins. Int J Curr Adv Res, 2019; 8(10B):20198–20200; doi: 10.24327/ijcar.2019.20200.3938
36.
ChauhanS, PatraS, SinghSP, et al.Combined effect of yoga and naturopathy in uncomplicated varicose vein disease—A prospective randomized controlled trial. J Ayurveda Integr Med, 2023; 14(3):100718; doi: 10.1016/j.jaim.2023.100718
37.
YamunaU, MajumdarV, SaojiAA. Effect of Yoga on homocysteine level, symptomatology and quality of life in industrial workers with Chronic Venous Insufficiency: Study protocol for a randomized controlled trial. Adv Integr Med, 2022; 9(2):119–125; doi: 10.1016/j.aimed.2022.02.002
38.
YamunaU, MadleK, MajumdarV, et al.Designing and validation of Yoga module for workers with prolonged standing. J Ayurveda Integr Med, 2023; 14(5):100788; doi: 10.1016/j.jaim.2023.100788
39.
MelnykS, PogribnaM, PogribnyI, et al.A new HPLC method for the simultaneous determination of oxidized and reduced plasma aminothiols using coulometric electrochemical detection. J Nutr Biochem, 1999; 10(8):490–497; doi: 10.1016/S0955-2863(99)00033-9
40.
MeissnerMH, NatielloC, NichollsSC. Performance characteristics of the venous clinical severity score. J Vasc Surg, 2002; 889–895; doi: 10.1067/mva.2002.128637
41.
ThurstonB, DawsonJ. Ankle brachial pressure index: An update for the vascular specialist and general practitioner. Vascular, 2019; 27(5):560–570; doi: 10.1177/1708538119842395
42.
WuSC, CrewsRT, SkratskyM, et al.Control of lower extremity edema in patients with diabetes: Double blind randomized controlled trial assessing the efficacy of mild compression diabetic socks. Diabetes Res Clin Pract, 2017; 127:35–43; doi: 10.1016/j.diabres.2017.02.025
BiemansAAM, Velden SK VanDer, BruijninckxCMA, et al.Validation of the chronic venous insufficiency quality of life questionnaire in dutch patients treated for varicose veins. Eur J Vasc Endovasc Surg, 2011; 42(2):246–253; doi: 10.1016/j.ejvs.2011.04.007
45.
KohnoK, NiiharaH, HamanoT, et al.J-curve association between alcohol intake and varicose veins in Japan: The Shimane CoHRE Study. J Dermatol, 2019; 46(10):902–906; doi: 10.1111/1346-8138.15022
46.
AlmutiriBM, AlshammariAM, AlharbiSB, et al.Evaluating the prevalence and risk factors of varicose veins in surgeons and operating room staff at Buraidah Center Hospital. Cureus, 2024; 16(1):e51706; doi: 10.7759/cureus.51706
47.
KohnoK, NiiharaH, HamanoT, et al.Standing posture at work and overweight exacerbate varicose veins: Shimane CoHRE study. J Dermatol, 2014; 41(11):964–968; doi: 10.1111/1346-8138.12643
48.
MillanSB, GanR, TownsendPE. Venous ulcers: Diagnosis and treatment. Am Fam Physician, 2019; 100(5):298–305.
KrijnenRM, de BoerEM, AdèrHJ, et al.Compression stockings and rubber floor mats: do they benefit workers with chronic venous insufficiency and a standing profession?. J Occup Environ Med, 1997; 39(9):889–894; doi: 10.1097/00043764-199709000-00013
51.
ParavastuSCV, HorneM, DoddPDF. Endovenous ablation therapy (laser or radiofrequency) or foam sclerotherapy versus conventional surgical repair for short saphenous varicose veins. Cochrane Database Syst Rev, 2016; 2016(11):CD010878; doi: 10.1002/14651858.CD010878.pub2
ChienLW, ChangHC, LiuCF. Effect of yoga on serum homocysteine and nitric oxide levels in adolescent women with and without dysmenorrhea. J Altern Complement Med, 2013; 19(1):20–23; doi: 10.1089/acm.2011.0113
54.
O'MearaS, CullumN, NelsonEA, et al.Compression for venous leg ulcers. Cochrane Database Syst Rev, 2012; 2012(11):CD000265; doi: 10.1002/14651858.CD000265.pub3
55.
OrrL, KlementKA, McCrossinL, et al.A systematic review and meta-analysis of exercise intervention for the treatment of calf muscle pump impairment in individuals with chronic venous insufficiency. Ostomy Wound Manage, 2017; 63(8):30–43; doi: 10.25270/owm.2017.08.3043
56.
ZegarraTI, TadiP.CEAP Classification of Venous Disorders. StatPearls Publishing: Treasure Island, FL; 2023.
57.
YamunaU, MajumdarV, SaojiAA. Effect of yoga in workers with chronic venous insufficiency. Mendeley Data, 2023; V2; doi: 10.17632/kbmcrczj58.2
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
