Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 54  |  Issue : 2  |  Page : 51-55

Suryanamaskar performed for a shorter duration matches the exercise intensity of a regular physical education session in adolescent children: A cross-over study


1 Community Physiotherapy Department, Seth GSMC and KEMH, Mumbai, Maharashtra, India
2 Physiotherapy School and Centre, Seth GSMC and KEMH, Mumbai, Maharashtra, India

Date of Submission27-Jun-2022
Date of Decision23-Aug-2022
Date of Acceptance24-Aug-2022
Date of Web Publication15-Dec-2022

Correspondence Address:
Dr. Apurv P Shimpi
Department of Community Physiotherapy, Sancheti College of Physiotherapy, 12, Thube Park, Shivajinagar, Pune - 411 005, Maharashtra,
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ym.ym_81_22

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  Abstract 


Context: Adolescent children are provided with lesser exercise duration and intensity due to academic priorities. Suryanamaskar (SN) may be a time-saving solution for their fitness enhancement.
Aim: To determine the duration and number of SN required by adolescent children to match the exercise intensity of their regular physical education (PE) session.
Materials and Methods: A cross-over study was conducted on 50 children, both genders, with a mean age of 13.9 ± 0.7 years, by a simple random sampling process. Their pulse rate (PR), respiratory rate (RR), and rate of perceived exertion (RPE) were measured pre- and immediately post participation in their routine PE session. After 24-h washout period, participants performed slow 12-step SN to match the PE session RPE post which their PR, RR, and number of SN performed were measured. Furthermore, their weekly duration of involvement in PE was documented. The PR, RR, and duration of PE/SN were compared using unmatched t-test with α set at ≤0.05 at 95% confidence interval.
Results: Adolescent children achieved RPE of 1.9 ± 1.4 post a 33.0 ± 9.0 min PE session which was matched in 9.4 ± 2.3 min of SN session (p < 0.05) at a similar PR (p = 0.25) and RR (p = 0.08). These children were found to be engaged in 75.6 ± 20.3 min of PE activity/week.
Conclusion: A 9-min session consisting of nine SN matches the exercise intensity of a routine 33-min PE session in adolescent children.

Keywords: Exercise intensity, physical activity, physical fitness, Suryanamaskar


How to cite this article:
Shimpi AP, Shetye JV, Kewlani MS. Suryanamaskar performed for a shorter duration matches the exercise intensity of a regular physical education session in adolescent children: A cross-over study. Yoga Mimamsa 2022;54:51-5

How to cite this URL:
Shimpi AP, Shetye JV, Kewlani MS. Suryanamaskar performed for a shorter duration matches the exercise intensity of a regular physical education session in adolescent children: A cross-over study. Yoga Mimamsa [serial online] 2022 [cited 2023 Feb 8];54:51-5. Available from: https://www.ym-kdham.in/text.asp?2022/54/2/51/363815




  Introduction Top


Regular physical activity is one of the most important steps to improve health condition and overall well-being. Participation in regular physical activity should include moderate to vigorous physical activities, particularly activities for enhancement of cardiovascular endurance, and muscle strength.[1],[2] Physical and mental health development is at its peak in adolescence age. Fitness and physical activity are the core components of development.[1],[3] School physical education (PE) is the primary societal institution for promoting physical activity in youth and 97% of elementary school students participate in PE sessions.[4],[5] Physical activity is in the form of a structured PE/training and it is defined as “A planned sequential standards-based program of curricula and instructions designed to develop motor skills, knowledge, and behaviors of healthy active living, physical fitness sportsmanship, self-efficacy, and emotional intelligence.”[1] It is an avenue for engaging in developmentally appropriate physical activities designed for children to develop their fitness, gross motor skills, and health. Physical training not only helps the child to be active and fit but also enhances academic performance, and children's social and emotional well-being.[1],[6] It also helps in the prevention of adult conditions such as heart disease, high blood pressure, and type 2 diabetes mellitus.[7],[8],[9] A minimum of 150 min of physical activity or training/week, i.e., 30 min/day for children in elementary schools and 225 min/week, i.e., 45 min/day in middle and high school is desired.[1],[3],[10]

The population-based approach of childhood obesity prevention of World Health Organization (WHO) estimates that more than 170 million children of <18 years in upper middle income (developing) countries are obese.[1],[10],[11] The studies evaluating their PE curriculum comment that their present PE system does not achieve the standards required for the maintenance of optimal physical fitness in children.[1],[11],[12] Furthermore, the observations revealed that even in the presence of PE specialist, students were provided with only 3 min of moderate to vigorous physical activity per PE class; that is <10% of their class time and adolescent children, therefore, do not obtain 30 min of moderate to vigorous physical activity/day.[1],[13] Studies have shown that childhood obesity is increasing. Obesity being more of lifestyle problem, it is of utmost importance to bring about lifestyle modifications and environmental modifications. Hence as this is a great challenge for the 21st century, especially in the pressing times of lockdowns and closures of schools due to COVID-19, evaluating the intensity and time of physical training in school children becomes important.[14] Studies have proven that physical activity recommendations cannot be met only through PE alone, so the development of specialized programs to promote generalization must be developed and evaluated.[5],[15]

Yoga is an ancient discipline practiced in India for ages. Yoga brings balance between health to the physical, mental, emotional, and spiritual dimensions of the individual.[16],[17] Yoga benefits physical and mental health through the downregulation of hypothalamic-pituitary-adrenal axis.[18],[19] Yoga training is associated with the improvement of muscle strength and respiratory endurance in prepubertal children as well.[20] Suryanamaskar (SN) is a component of yoga and is a set of sequential yogic postures called Asanas. A review suggests that SN may be equally effective or better than exercise at improving variety of health-related outcome measures such as body composition, blood glucose, blood lipids, and oxidative stress.[19],[21] SN has been researched to be an effective and useful tool for health and fitness enhancement and also it provides economic and time factor advantages.[21],[22] Hence, it becomes necessary to understand the training regime by SN in regards to its dosage and duration of intervention in today's competitive era of our future generation.


  Materials and Methods Top


The study was conducted after an approval obtained from the Institutional Ethical Committee (IRB-SIOR/Agenda 052).

Subjects

Written informed consent was obtained from the guardians and assent was obtained from all subjects before enrolment in the study. Healthy school-going children from 10 different urban secondary co-ed schools were recruited by a simple random sampling from a particular region of the city. These children were within the age group of 13–15 years studying in private or government schools and participated regularly in PE sessions. Adolescent children with acute trauma, orthopedic condition restricting physical activity, or uncontrolled metabolic systemic disease or any illness that would limit the ability to perform necessary asanas were excluded from the study.[23]

Study design

A cross-over study was conducted by recruiting participants with a simple random technique. The sample size was determined using G-power software considering the time duration utilized for the completion of the PE activity versus the SN activity by the subjects as independent groups. The assumptions made were for a 30 min of PE session while it was hypothesized that the same intensity of exercises will be completed by the SN group in 25 min with a standard deviation (SD) of 7 min each. The obtained effect size was 0.71 at α = 0.05 at 95% confidence interval. A sample size of 52 per group was obtained.

Assessments

The outcome measures were assessed at the baseline and immediately after performing PE session and SN session. Manual measurement of the pulse rate (PR) was done using the palpatory method of the radial artery in the forearm while respiratory rate (RR) was assessed manually by observing the number of chest rises in 1 min.[24] The rate of perceived exertion (RPE) was assessed using the Modified Borg Scale of RPE post-PE and SN. Baseline assessments were taken with the child sitting in the comfortable and supported position after a 5 min rest.[25]

Training protocol

Post informed consent and assent, participants were asked to perform their routine PE activity under the supervision of their PE teacher which consisted of a sequence of the combination of general mobility exercises, plyometric jumping, twisting and bending motions of the trunk, squatting, lunging, and spot marching a set of 16–20 repetitions. Rarely, it consisted of unstructured games that the children played at their leisure. After the completion of a 30-min session (with the exception of one school which conducted a 60 min PE session with adequate breaks), their PR, RR, and RPE were assessed within 2 min, before obtaining a baseline recovery. After a 24-h washout period, participants performed SN at the speed of one SN/min on the same RPE as with their physical training session. PR, RR, number of SN, and time taken to reach the exercise intensity were measured. SN consisted of a total of 12 steps/asanas performed with the following instructions:[21],[26],[27]

Step 1: Pranamasan: Stand straight. Look straight. Place the feet together, pull in knees, thigh muscles, and belly. Expand the chest. Fold hands. Palms pressed against each other to perform namaskar.

Step 2: Hastauttanasan: Raise arms above head. Grow taller. Then bend back. Stretch abdomen.

Step 3: Padahastasan (Hastapadasan): Bend forward. Don't bend knees. Go down and place your hands on the floor besides your foot.

Step 4: Ashwasanchalanasan: Take the right leg back and stretch it while balancing it on the toe and keep the left leg in front of your body. Keep palms straight on both sides of the foot and look upward.

Step 5: Parvatasan: Take back the left leg as well and keep both the feet together while raising the hip from the ground and balancing on all fours.

Step 6: Ashtangnamaskar (or Chaturnamaskar): Slowly come down and bring your shoulders near your hands. Knees may touch the ground and the waist and hip should be slightly raised above the ground or may touch the ground in the female participants (Shashtangnamaskar) if the upper body strength is lower.

Step 7: Bhujangasan: Lower waist and raise torso, make arms straight and balance. Feel a bend of the spine and stretch of the abdomen.

Step 8: Parvatasan: Same as position 5.

Step 9: Ashwasanchalanasana: Same as position 4.

Step 10: Padahastasan (Hastapadasana): Same as position 3.

Step 11: Hastauttanasan: Same as position 2.

Step 12: Pranamasan: Same as position 1.

Exercise compliance and supervision: PE session was conducted under the supervision of their PE teacher. SN was conducted under the supervision of a physical therapist trained and certified in Yoga. Loose and comfortable clothing were worn by the participants in both sessions as per their choice ensuring that they did not hinder with the performance of the movements. Compliance was considered as completing the SN till RPE equivalent to that achieved at the end of PE in the previous session was reached.

Statistical analysis

All data are presented as mean ± SD. Within-group comparison to study the difference between pre- and postintervention was done using unmatched t-test using the Statistical Package for the Social Sciences (IBM Inc., Chicago, Illinois, USA). The difference was considered statistically significant with α set at p ≤ 0.05 at 95% confidence interval.


  Results Top


Of the 78 children approached, 56 were found eligible and were recruited. Only 50 children who completed the study were considered for final analysis [Table 1]. The baseline PR and RR of the study samples were found to be within the normative parameter.[24] These urban adolescent children were engaged in 75.6 ± 20.3 min of PE/week. Their exercise intensity at the end of a 33.0 ± 9.0-min session, as measured by RPE, was 1.9 ± 1.4 (fairly light) [Table 2]. The same exercise intensity was obtained with an average of 9.4 ± 2.3 SN within 9.4 ± 2.3 min which was matched by their PR (p = 0.25) and RR (p = 0.08) [Table 3].
Table 1: Demographic data

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Table 2: Dose of exercises (physical education activities) performed by adolescent school children

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Table 3: Comparison of heart rate, respiratory rate, and session duration postphysical education activity and post Suryanamaskar at a constant rate of perceived exertion of mean 1.9

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  Discussion Top


PE and activities regarding PE have been studied by researchers globally and all of them have generally narrowed down to the component that the time devoted to PE is extremely less in children as compared to the minimum criteria being laid down by global bodies such as WHO and CDC.[1],[3],[10] The current study involved 27 boys and 23 girls with a mean age of 13.9 ± 0.7 years. It was observed that these children performed 75.6 min ± 20.3 min of physical activity/week as they had only 2–3 days of PE class/week, i.e., an average of 2.3 ± 0.4 days and each session with an average time of 33.0 min ± 9.0 min. Furthermore, the mean RPE at the end of PE class was 1.96 ± 1.42 which is “fairly light” as per Modified Borg's scale and the mean of PR was 98.6 bpm ± 12.2 bpm which is 49.7% of age-predicted HRmax[28] and considered to be a low-intensity activity.[29] Present authors observed that there were days where the PE class was cancelled to complete the pending syllabus of other subjects. Hence, due to increased competition and academic pressures, the time and intensity of physical activity were compromised.

Various authors have laid down the importance of a structured PE program for health enhancement in children and also stated that PE program can be modified to obtain better results in the fitness of children.[1],[2],[3],[4],[5] However, in country like India, questions have been raised not only on the acceptance of the policy-makers to be actively involved in the induction of such programs, but also on the financial requirements that will be encountered while trying to introduce PE in the form of sports at school levels.[11],[12],[13] SN has been evidenced to be an effective and useful tool for health and fitness enhancement and it also is economical and time-saving as well.[21],[22],[26],[27],[30] In the present study, SN was considered only by virtue of its rhythmic asanas and breathing components of inhalation (purak), exhalation (rechak), and hold (kumbhak) without recitation of the mantras.[31],[32] Hence, no consideration of spiritual benefits/concentration and memory benefits or academic benefits were considered in the present study. Furthermore, the intensity and speed of SN were controlled by performing them till same PR, RR, and RPE level as that recorded at the end of PE session was reached. It was performed at the speed of one SN/minute, i.e., one asana held for 5 s.[26] Around nine SNs were required to reach the same intensity as that of the physical session. Thus, only 9.4 min ± 2.3 min were required as compared to 30-min physical exercise sessions to match the same intensity. Hence, it becomes important to introduce economical, time-saving, and effective intervention such as SN in the exercise regime of adolescent children to enhance their overall health and fitness in the limited time provided in school for physical exercises session. SN not only helps in the enhancement of the aerobic capacity by the maintenance of the exercise intensity but it also helps in the improvement of the other domains of fitness including body composition, flexibility, upper and lower limbs strength, and endurance[21] and hence proving to be a complete exercise.[27]

Although the findings of the present study show that a 9-min SN session is adequate to compensate for the benefits for a 30 min PE session, the authors, by no means, are recommending a reduction of the duration of the PE session but are merely suggesting it as an alternative exercise activity to fulfill the physical activity demands of these children, who, in their competitive aspects, neglect being involved in any physical activity, play or structured exercise program. Often, schools are also responsible for canceling PE sessions to give priority to other academic sessions which may further lead to a reduction in physical activity and predisposition to ill effects of a sedentary lifestyle.[33] Furthermore, the authors observed that the PE sessions were performed at a very low intensity of 1.9 of 10 on a modified Borg scale and for a very short duration of 75.6 min ± 20.3 min/week. The WHO, in its 2020 guidelines, recommends a duration of 150 min/week of moderate-to-severe intensity physical activity for children of 5–17 years,[10] and hence, there is a need to increase the same. In an era of COVID and academic challenges where health and fitness are getting a setback,[14],[34] performing SN, even for a shorter duration of 15–20 min, can be looked-up as a viable solution for maintaining the health and fitness in adolescent children. Furthermore, it may be worthwhile to estimate if SN at a moderate to vigorous intensity can further help in reducing this duration of recommended activity while still offering similar or higher benefits to the study population.


  Conclusion Top


The authors conclude that a 9-min session consisting of nine SN matches the exercise intensity of a routine 30-min PE session in adolescent children.

Acknowledgments

The authors wish to acknowledge all the participants from the various schools who participated in the present study and their parents and principals who permitted to conduct the study in their schools. The authors also express their gratitude to the PE teachers who helped with the PE sessions in the study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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  [Table 1], [Table 2], [Table 3]



 

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