TITLE: A review on effect of Suryanamaskar on physical fitness in children

ABSTRACT

Background: Suryanamaskar, a composite yogasana is known to provide a wide array of

benefits to the musculoskeletal, cardiovascular, neurological, gastrointestinal and endocrine

system. These benefits of Suryanamaskar have not been systematically reviewed in children.

Increasing physical inactivity in children necessitates exploration of activities such as

Suryanamaskar that can confer health benefits.

Objective: The purpose of this study was to review literature regarding benefits of

Suryanamaskar on physical fitness in children.

Methodology: Primary source articles published in English peer-reviewed journals were

included. Literature review was carried out using PubMed, Cochrane, Science Direct, and

Google Scholar from 1980-2020. Key word used was ‘Suryanamaskar’, ‘physical fitness’, ‘sun

salutation’, ‘yoga’, and ‘children’. Seven studies satisfied the inclusion criteria. All included

studies were randomized controlled trials. Methodological quality of studies was assessed by

using Physiotherapy Evidence Database (PEDro) scale. The effect of Suryanamaskar training on

physical fitness component such as flexibility, muscle strength, cardio-respiratory endurance and

cognition were reviewed.

Results: Seven studies matched the inclusion criteria. All seven studies were classified as fair

quality with high risk of bias. One study reported improvement in musculoskeletal strength and

endurance following Suryanamaskar. Two studies demonstrated increase in flexibility of hip

joint, wrist joint, hamstrings and Dorso-lumbar fascia. Improvement in cardio-respiratory

variables such as Systolic blood pressure, and Diastolic blood pressure, Peak Expiratory Flow
Rate, Forced Vital Capacity, Forced Expiratory volume, Heart rate and Vital capacity were

observed in three studies. Two studies reported improvement in cognition after performing well

in Digit Letter Substitution Task (DLST) following Suryanamasakar intervention.

Conclusion: Suryanamaskar training confers health benefits and improves physical fitness

components such as muscle strength, flexibility, cardio-respiratory endurance, and cognition.

Suryananamskar can emerge as a useful tool to promote physical fitness in children. High quality

longitudinal randomized control trials need to be undertaken to confirm the same.

Introduction

Yoga has been practiced for over 5000 years and is an ancient form of physical activity that

encompasses breathing techniques, postures, strengthening exercises and meditation. The

practice of yoga originated in India and has slowly gained popularity all over the world. [1]

Suryanamaskar is one of the ancient yogic practices which literally mean ‘to worship the sun. . In

Suryanamaskar ‘Surya’ denotes to Sun, and ‘namaskar’ denotes to salutation therefore this yogic
[2]
practice is known as the ‘salutation to the sun’ or ‘Suryanamskar’. Suryanamaskar is a set of

12 asanas or postures which include Pranamasana (prayer pose) 1st and 12th, Hasta uttanasana

(Raised arm pose) 2nd and 11th, Hastpadasana (Hand to foot) 3rd and 10th, Ashwa

sanchalanasana (Equestrian pose) 4th and 9th, Parvatasana (Mountain pose) 5th and 8th, Ashtang

namaskar (salutation with eight parts) 6th and 9th, and Bhujangasana (Cobra pose) 7th performed
[3, 4]
preferably in the morning facing the rising sun. It offers a wide array of benefits to the
[5]
musculoskeletal, cardiovascular, neurological, gastrointestinal and endocrinal system. It has

great benefits on health, stamina, mental and physical stability and strength. It is believed to

revitalize each and every cell of the body and give mental calmness. [6]

Regular practice of Suryanamaskar has been reported to improve blood circulation, maintain

health, increase strength, flexibility and general feeling of well-being. Physiological benefits

include increased blood circulation to brain and spinal mobility due to various 12 positions

achieved in Suryanasmaskar. It also helps to improve peristaltic movement of gut, increased

cardiac myocardial contractility. [7]

Simultaneously developing neuromuscular awareness (i.e. coordination and movement control)

maintain healthy body weight, preventing chronic illness such as (cancer, type-2 diabetes and

cardio-vascular diseases), maintaining good mental health, improving sleep and lowering

stress.[1]

World Health Organization (WHO) estimates that in developing countries more than 170 million

children, less than 18 years of age, are physically inactive. [8] Global recommendations proposed

by WHO for physical activity is 60 minutes of daily engagement in moderate to vigorous

physical activity for children aged 5-17 years. According to Center for Diseases Control (CDC)

only 17-39% of children from the United States are involved in organized physical activity for at
[8, 9]
least 60 min per day. Similar observations are reported from European and Asian countries.
[10, 11, 12]
In developing countries, like India, decline in the level of moderate to vigorous physical

activity pattern amongst urban school children is reported.[8, 13] Children engage in PA either

during PE classes in school hours or during recreational play time over weekends. Physical

training in Indian school is restricted to less than 30-60 minutes of physical education activity
[8]
period once or twice a week, which is inadequate and unstructured. Physical activity can

include structured play, games, sports, planned exercise or physical education activity and yoga.
[8, 14, 15]

Practice of regular physical activity promotes fitness and in order to carry out daily activities

without fatigue physical fitness is an essential requirement. [16] It modifies the sedentary life style
[17]
and also contributes to an active and healthy life beyond childhood and adolescence.

Industrialization has brought about changes in lifestyle with greater engagement of children in

sedentary activities. [13] Reduced physical fitness in children is associated with an elevated risk of

presenting increase in body mass index, elevated lipoproteins and cholesterol level and,
developing obesity and insulin resistance juvenile diabetes mellitus in school aged children. [18, 6,
19, 20]

Therefore, there is an urgent need to identify and promote physical activity in children through

incorporation of activities such as Suryanamaskar as a lifelong health behavior. However, yoga

has not been explored sufficiently for its health benefits in children. Thus a systematic review

was undertaken to identify the benefits of Suryanamaskar on physical fitness in order to include

this style of yogic practice (Suryanamaskar) in routine physical activity and promote health

behavior in children.
Figure 1.1 Suryanamaskar

Ashtang Hast uttanasana Hastpadasana Ashwa sanchalanasana

namaskar a

Ashtang namaskar Bhujangasana Ashwa sanchalanasana

Parvatasana Hastpadasana Pranamasana

Aim and Objectives

Aim: To review the effects of Suryanamaskar on physical fitness in children.

Objective: The purpose of this study was to review literature regarding benefits of

Suryanamaskar on physical fitness in children.

Methodology

Ethical approval: The study was commenced following ethical approval of research proposal by

Institution Ethical Review Committee, MGM Institute of Health Sciences, Kamothe, Navi-

Mumbai. A systematic review was carried out to review existing knowledge regarding benefits

of Suryanamaskar on physical fitness in children to enable prescription of Suryanamaskar as a

healthy lifestyle measure.

A review of literature was undertaken to identify healthy benefits of Suryanamaskar using the

Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines.

INFORMATION SOURCES

Studies were identified by searching databases: PubMed, Cochrane Library and, Science Direct

and Google Scholar. Key words used were ‘Suryanamaskar’ AND ‘Children’ AND ‘’Physical

fitness’’ OR ‘Yoga’ OR ‘Sun salutation’.

STUDY ELIGIBILITY

Inclusion criteria for the review were studies that included Suryanamaskar intervention in

healthy children, in the age group of 9 to 15 years, published in English language, in a peer

reviewed journal. Studies which included other yoga interventions along with Suryanamaskar

were not considered for inclusion.

ELIGIBILITY SCREENING

Studies were screened in 3 stages: title screening, abstract screening and full text screening.

Titles that did not meet eligibility criteria were excluded (n=15) Further abstract of eighteen

studies were screened. Three studies got excluded as they did not meet eligibility criteria. Full

text of remaining fifteen articles was then reviewed. Eight full text articles were excluded as they

did not meet the eligibility criteria. Finally, (n= 7) articles were included in this review.

DATA EXTRACTION

Following data were extracted from each study on the basis of Authors and Publication year,

objective of the study, age of the population included in the study, study design, outcome

variables (Physiological parameters, Flexibility, vital capacity, musculoskeletal strength and

endurance, and co-ordination.), assessment tools, and primary observations.

Figure 2.1 PRISMA Flow Diagram-

Records identified through

Identification

database searching
(n = 35)

Records after duplicates removed

Screening

(n = 20)

Records screened on Records excluded

basis of abstract (n =3)
(n =18) Abstract didn’t meet
the inclusion criteria
Eligibility

Full-text articles
Full-text articles
excluded
assessed for eligibility
(n = 15) Didn’t meet the
inclusion criteria
(n =8)

Studies included in
Included

quantitative synthesis
(n = 7)
 Authors Study type Population Intervention Primary Outcome
and Sample outcome measures
size
1) Interventiona School Group 1- Fast Slow Isometric hand
Bhavanani l study children, 12- surynamaskar suryanamskar grip, Respiratory
et al, n = 42 16 year of age was performed reduced diastolic pressure such as
2011.[7] two groups in such a way pressure, whereas Maximum
with 21 that all 12 fast inspiratory
children in postures were Suryanamaskar pressure, and
each group completed in 2 increased systolic Maximum
min, and to pressure. expiratory pressure
Group1 complete 15 Both types measured by –
prformed rounds of increased Mercury
Fast Suryanamaskar isometric hand manometer
suryanamask it took 30-40 grip strength and
ar min. endurance, Pulmonary
increased function test Peak
Group2 Group 2- Slow maximal expiratory flow
performed suryanamaskar inspiratory rate, Forced vital
Slow was performed pressure and peak capacity, and
suryanamask such that each flow rate. Forced expiratory
ar of the 12 volume, were
postures was measured by –
held for 30 Computerized
seconds. Each Spirometer
rounds was
completed in 6 Cardiovascular
min, five parameters-
rounds were Blood pressure was
performed in measured using
30-40 min. Semi-automatic
Duration of blood pressure
intervention- 6 (BP) monitor.
months.
2)Javadek Intervention School Experimental Suryanamaskar DLST – digit
ar et al, al Study children, 12 group group showed letter substitution
2012. [16] n = 64, to 14 years underwent 16.7% task visual
32 in each Suryanamask improvement scanning, mental
group ar Practice Physical flexibility,
exercise group sustained
Control group showed 13.2% attention,
underwent improvement in psychomotor
routine Digit Letter speed of
physical Substitution information
exercises for Task. No processing
30 days difference was
observed
between the two
activities

3) Intervention School Suryanamask Increase in Forced Vital

S.Kumar al study children, 10 ar was Forced Vital Capacity was
et al, n = 115 to 14 years of performed for Capacity and measured by
2011.[13] age 45 days. Peak Expiratory spirometer,
Cardio- Flow Rate was Peak Expiratory
respiratory observed. Flow Rate by
parameters - Reduction in using Mini-
blood heart rate, Wright peak flow
pressure, diastolic meter, Blood
heart rate, pressure, pressure (BP)
respiratory respiratory rate using a
rate, Forced was reported sphygmomanome
Vital after practice of ter
Capacity and Suryanamaskar and Respiratory
Peak rate by manual
Expiratory method.
Flow Rate
were
measured pre
and post
intervention.
4) Pal et Intervention School Experimental Participants who Hip joint
al, al study children, 14 group followed flexibility was
2014.[11] n = 30, to 16 years performed Vinyasa sun measured using
15 in each Vinyasa salutation goniometry.
group training for training
45 minutes in improved their
Experiment the morning, hip joint
al group 3days a week flexibility higher
performed for 8 weeks. than participants
Vinyasa sun in control group.
salutation Control group
continued
Control routine daily
group was activities.
given no
intervention
5) Pal et Intervention 14 to 16 Experimental Increase in vital Vital capacity
al, 2014. al study years student group capacity was (VC) was
[14]
n = 30, performed observed measured by Dry
15 in each Vinyasa following spirometer and
group training for a Vinayasa recorded in liters
period of 45 training.
Experiment minutes in the
al group- morning 5
performed days a week
Vinyasa sun for 8 weeks.
salutation
Control group
Control continued
group- was routine daily
given no activities.
training
protocol
6) Pal et Intervention School Experimental Significant Flexibility for
al, 2014. al study children, 14 group difference was wrist joint was
[12]
n = 30, to 16 years performed seen in measured using
15 in each Vinyasa experimental goniometer in
group training for a group who degrees.
period of 45 followed
Experiment minutes in the Vinyasa sun
al group- morning, 3 salutation poses
performed times a week which improved
vinyasa sun for 8 weeks. wrist joint
salutation Control group flexibility
continued among school
Control basic daily going children.
group- was routine.
given no
training
protocol

7) V.K. School Group1 – No difference DLST- digit

Sharma et children.,13 performed was observed letter
al, 2017. to 15 years Suryanamask on digit letter substitution task
[15]
of age ar with substitution involves
mantra task between visual scanning,
chanting the mantras mental
and breathing flexibility,sustai
Group2 – group and ned attention,
performed breathing and psychomotor
Suryanamask control group speed of
ar with fixed following information
breathing intervention processing
pattern

Group3 –
performed
general
Suryanamask
ar

For 45 to 50
minutes for
5 day a week
for 6 weeks
Quality Assessment:
The internal validity of each article was independently assessed by using Physiotherapy

Evidence Database (PEDro) score for Randomized Control Trial (RCT) studies. The tool

assesses the ability of each study too make conclusion about the link between eligibility criteria

and physical parameters of the study. Flaws in the design and methodology of the study can

increase risk of bias and decrease the internal validity of the article. The reviewer scored each of

the 11 items of the quality assessment tool as ‘YES’ (√), ‘NO’ (×). In order to compare the risk

of bias across studies, the answers weighted as ‘YES’ was assigned score 1 and ‘NO’ was

assigned score 0. The total score for each study was used to classify the quality of the study and

risk of bias. Score < 4 was considered as ‘poor’, 4 to 5 were considered ‘fair’, 6 to 8 were

considered ‘good’ and 9 to 10 were considered ‘excellent’. [21, 22]

Table.2.1 Pedro score quality assessment scale (PEDro scale)

Bhavnani V.K. S.Kumar Javadekar Pal et Pal et Pal et

et al, Sharma et al, et al, al,2014. al,2014. al,2014.
2011. et al, 2011. 2012.
2017.
Eligibility √ √ √ √ × × ×
criteria.
Randomized × √ √ √ √ √ √
allocation.
Concealed × × × × × × ×
allocation.
Comparable √ √ √ √ √ √ √
at baseline.
Blinded × × × × × × ×
subjects.
Blinded × × × × × × ×
therapist.
Blinded × × × × × × ×
assessors.
Adequate × × × × × × ×
follow-up.
Intention to × × × × × × ×
treat
analysis.
Between √ √ × √ √ √ √
group
Comparisons
.
Point √ √ √ √ √ √ √
estimate and
variability.
Total Score 4/10 5/10 4/10 5/10 4/10 4/10 4/10

Fair Fair Fair Fair Fair Fair Fair

Quality Quality Quality Quality Quality Quality Quality
Results

Quality Assessment interpretation:

As per PEDro scale, all studies reported fair quality with no blinding of participants or

researchers therefore introducing a risk of bias. All included studies had clearly defined their

eligibility criteria, objectives, inclusion-exclusion criteria, and variables. All participants were

randomized to Suryanamsakar or a control condition.

The individual characteristics of the study group, gender classification, duration of intervention,

type of Suryanamaskar, clinical variables studied are described in the further sections.

Characteristics of the study group: Studies included school going children in the age group of

9-15 years. Both male as well as female children were included in three studies (n=221), four

studies included only male children (n=126). In this review total seven studies were included, the

gender distribution in this review was a total of 53% boys and 47% girls participated in various

studies. The studies included school-going children in the age group 9-15 years of age.

Duration of Suryanamaskar intervention for all the studies ranged between 8 to 12 weeks.

Types of Suryanamaskar: The various studies included variations in types of Suryanamaskar

studied. The forms used were Slow Suryanamaskar, Fast Suryanamaskar, Hatha Suryanamaskar,

Vinyasa Sun salutation, Mantra chanting with Suryanamaskar, and breathing control with

Suryanamaskar.

In Slow Suryanamskar, participants performed all twelve poses in slow and rhythmic manner in

which all twelve postures was held for 30 seconds. In Fast Suryanamaskar participants were

instructed to perform all twelve postures in rapid manner without any holds. Vinyasa Sun
salutation focused on dynamic connecting posture which created link between Suryanamaskar

poses and breathing. These postures are performed at quicker pace than other forms of

Suryanamaskar. [23] In one study, one group of children performed Mantra chanting and another
[24, 18, 25]
group performed breathing control with twelve Suryanamskar poses. Hatha

Suryanamaskar consisted of twelve spinal poses performed with emphasis on breathing pattern

and was the commonest form practiced. Poses included were Pranamasana, Hasta uttanasana,

Hastpadasana, Ashwa sanchalanasana, Parvatasana, Ashtang namaskar, and Bhujangasana

Performed in a cyclic manner. [3, 4]

Muscle Strength and endurance

Improvement in muscle strength and endurance was reported following Suryanmaskar

intervention. Isometric hand grip strength endurance and time for 33% of isometric hand grip i.e.

hand grip endurance improved in children performing fast and slow Suryanamaskar with greater

increase in fast Suryanamaskar group. Hand grip strength was measured with the dominant hand

gripping the inflated cuff of mercury and sustaining the gripped cuff measured the hand grip

endurance. [24, 36, 37]

Flexibility

Two studies observed significant improvement in flexibility of children following Suryanmaskar

intervention. [18, 9] Flexibility of hip and wrist joint was observed to increase after eight week of

vinyasa Suryanamaskar training. Flexibility was assessed by recording joint range of motion

using a standard goniometer [9]

Cardio-Respiratory variables

Three studies observed significant improvement in the cardio-respiratory variables post

Suryanamaskar intervention. Significant improvement was observed in systolic blood pressure

and diastolic blood pressure with Suryanamaskar training. Resting cardiovascular variables like

heart rate and diastolic blood pressure decreased significantly following Suryanamaskar training

for 6 months. [24, 26, 27]

Studies reported significant improvement in Peak Expiratory Flow Rate (PEFR), Forced Vital
[24, 26, 27]
Capacity (FVC) and decrease in Respiratory Rate (RR) after Suryanamaskar practice.

Peak Expiratory Flow Rate and Forced Vital Capacity were measured using Spirometer.[26]

Change in lung volumes was observed following both slow and fast Suryanamaskar. Similarly

pulmonary functions such as Peak Expiratory Flow Rate, Forced Vital Capacity, and Forced

Expiratory Volume observed significant improvement in both Fast Surya Namaskar and Slow

Surya Namaskar groups. Same researchers reported increase in respiratory muscle strength

evaluated using Maximum Inspiratory Pressure (MIP) and Maximum Expiratory Pressure (MEP)

after Suryanamaskar intervention. Greater increase in Maximum Inspiratory Pressure was

observed following Fast Suryanamaskar compared to Slow Suryanamaskar. Whereas, greater

increase in Maximum Expiratory Pressure was observed in Slow Suryanamaskar group

compared to Fast Suryanamaskar. These values were measured using mercury manometer. [24]

Cognition

Two studies observed significant improvement in the cognition and reaction time in children
[25, 28]
after Suryanamaskar intervention. Significant difference was reported between children

performing Suryanamaskar with mantra chanting compared to control group children who did
not perform any intervention performance in Digit Letter Substitution Test (DLST) in school

children after 6 week training of Suryanamaskar. The authors concluded that mantra chanting

during practice of suryanamaskar had significant improvement in sustained attention with

improved performance on DSLT which involved: visual scanning, mental flexibility, sustained

attention and psychomotor speed of information processing. [28, 29]

Discussion

This systematic review was undertaken to identify the benefits of Suryanamaskar on physical

fitness in order to include this style of yogic practice (Suryanamaskar) in routine physical

activity and promote health behavior in children. Based on literature review inclusive of 7

studies, benefits of Suryanamaskar on physical fitness and mental health are discussed further.

Most of the reviewed studies included school going children in the age group 9-15 years.

Children younger than 9 years were not included in any of the reviewed studies. All interventions

were carried out during the school hours, indicating that inclusion of Suryanamaskar into the

physical education curriculum is a feasible option for health promotion of school children.

Children of both genders were included in the studies reflecting on the application of common

physiological benefits to both genders

Firstly, muscle strength and endurance were reported to improve following Suryanamaskar

intervention in children. Performing the 12 asanas included in Suryanamaskar demands both

isotonic muscle activation whereas maintenance of the postures requires isometric contraction

during the steady state of different postures in Suryanamaskar. Suryanamaskar is a well

sequenced posture designed in such a way that involuntary muscles and joints undergo various

degree flexion and extension moments of different parts. In Hastauttanasana major muscle

activity observed are Erector Spinae, Lattismus dorsi, Lower Trapezius, and Gastrocnemius it

also provides strength to abdominal muscle where in Hastpadasana muscle activity observed

were, erector spinae and lower trapezius it also provides strength to hip, knee, quadriceps,

hamstrings and calves. In Ashwasanchalanasana major muscle activity observed are Erector

Spinae, Gluteus Maximus, Vastus lateralis, Latismus Dorsi, and Rectus Abdominius.

Parvatasana pose had major muscle activity of Erector spinae and it also builds strength and
endurance of shoulder, arm and wrist with strengthening especially lower back. Astangasana

pose included major muscle activity of Erector Spinae, Lower Trapezius, Gluteus Maximus,

Vastus Lateralis and Latismus Dorsi. Bhujangasana pose included major muscle activity of

Erector spinae, Lower Trapezius and Lattismus Dorsi. All 12 pose involved in Suryanamaskar

practice improves posture of the body. [3, 30] Sun salutation training improves the muscle strength
[31]
and general body endurance. Particularly, Bhujangasana results in improvement in trunk

muscle strength in students. [32]

Thus, increase in lower limb and trunk muscle strength, power and endurance is an important

health benefit following Suryanamaskar training.[8] Further, on comparison between fast and

slow Suryanamaskar, studies indicated greater increase in muscle strength following fast

Suryanamaskar which may lead to delayed onset of muscle fatigue which reduces the lactate

built-up within the muscle .[24] In a study it was observed that motor units are recruited in order

of size during voluntary contraction with respect to the increase in force and effort, further the

author suggested that during intense exercise there is recruitment of the large motor units which

produce greater muscle contraction. These findings can be correlated with the study of Bhavnani

et al, as fast suryananamsakr is an intense exercise which causes recruitment of larger motor

units and therefore increases the muscle strength. [33]

Secondly, Suryanamaskar involves 12 asanas which demand alternate flexion and extension

postures of the spine and extremities. These alternate postures improve stretch ability of muscles

of the lower limb, back, thorax, and gluteal group of muscle. It has also shown to increase

flexibility of hip joint, knee joint, ankle joint and wrist joint. [9, 26, 23] It was also hypothesized that

Suryanamaskar training with other physical activity exercises should have significant

improvement in Dorso-lumbar fascia and lower limb flexibility. [6] Asanas like the Hastpadasana
stretches hamstring and calves muscles while bringing about complete flexion of the spine and

hips. Whereas bhujangasana brings about complete extension of the spine and hips [3, 6] Thus, an

overall improvement in body flexibility is observed following regular practice of Suryanamaskar

Thirdly, improvement in cardio-respiratory function component is reported after Suryanamasakar

training. [24, 27, 25] Resting cardiovascular variables like Heart rate decrease with increase training

of Suryanamaskar. Systolic blood pressure was observed to increase and diastolic blood pressure

decreased significantly with increased Suryanamaskar training. SN is a dynamic aerobic activity

that activates large muscles of the trunk and lower extremity thus placing a volume overload on

the body. The dynamic muscle contractions help to increase venous return and cardiac output

during exercise. Long duration training leads to conditioning of the skeletal muscles with

enhance mitochondrial oxygen extraction and aerobic enzymatic activity, thus reducing the O2

demand following training. [24]

Significant improvement was observed in Peak Expiratory Flow Rate (PEFR), Forced Vital
[27]
Capacity (FVC) and decrease in Respiratory Rate (RR). Also respiratory pressures such as

MIP and MEP show significant improvement which increases endurance and strength of

respiratory and expiratory muscles. In pulmonary functions, Functional Vital Capacity (FVC)
[24]
and Forced Expiratory Volume (FEV1) increased significantly. VO2max value was also

hypothesized to have significant improvement after practicing Suryanamasakar with physical

[8]
activity exercise. Suryanamaskar asanas such as Hastuttanasana, Bhujagasana and

Ashtangasana stretch the respiratory and intercostals muscles, thus facilitating respiratory

muscle contraction. This concept can be related to the Frank Starlings law which suggests that

greater stretch of the muscle leads to forceful muscular contraction. Similarly, compression of

the abdominal contents with a consequent diaphragm stretch during Ashwasanchalanasana can
increases tidal breathing and subsequently the vital capacity following long duration training.

Further, breathing co-ordination with exhalation during trunk flexion and inspiration during

trunk extension along with mantra chanting, improves total lung capacity as it improves the

strength of respiratory muscle which leads to adequate inflation and deflation of the lungs as the

respiratory muscle work to their maximal extent. [3, 34]

Lastly, Cognition was observed to be improved significantly after suryanamaskar training, in the

parameters such as Digit Letter Substitution Task. [28, 29]

This review summarizes the benefits offered by Suryanamaskar in children in age group of 10-16

years, on Health related physical fitness domains such as muscular strength and endurance,

flexibility, cardiovascular and respiratory endurance cognition and reaction time. Existing studies

were methodologically of fair quality. Thus, better quality randomized control trials with low

level of bias need to be undertaken to establish the role of Yoga and Suryanamaskar as a life

style practice and health promotion strategy in school-going children.

The current review identified a lacuna in information regarding benefits of Suryanamaskar on

performance measures such as balance, speed and agility. Hence, further work in this area is

required to study the comprehensive health benefits of Suryanamaskar in children. Studies had

found that most studies have been undertaken to include healthy children, therefore the benefits

of Suryanamaskar can be explored in children with attention disorders and in children with

developmental disorders
Conclusion:

Based on the current review, it can be concluded that Suryanamaskar training improves muscle

strength and endurance, flexibility, cardio-respiratory function, cognition and reaction time in

children. Inclusion of Suryanamaskar into the regular physical education curriculum at school

emerges as a feasible plan to increase physical fitness and deter physical inactivity in school-

going children.
References

1. Li AW, Goldsmith CA. The effects of yoga on anxiety and stress. Alternative Medicine

Review. 2012 Mar 1; 17(1).

2. Bryant T, Edwin F, A. Sūtras of Patañjali: Edition, Translation and Commentary. New

York North Point Press ISBN 0865477361. 2009.

3. Nikam VM. A Role of ‘Surya Namaskara’ For Good Health. Aayushi International

Interdisciplinary Research Journal (AIIRJ). 2020 Feb; 7(2):2349-638.

4. Vaibhav A, Shukla S, Singh OP. Surya Namaskar (Sun Salutation): A Path to Good

Health. IJPR. 2016;6(7):44

5. Saraswati S. Suryanamaskar-A technique of solar vitalization. Munger Yoga Publications

Trust. 1983.

6. Kumar G, Monga G, Gothi N. Measuring impact of Surya Namaskar and Pranayama for

management of child obesity in India. International Journal of Contemporary Pediatrics.

2019 Mar;6(2):352.

7. Vaibhav A, Shukla S, Singh OP. Surya Namaskar (Sun Salutation): A Path to Good

Health. International Journal of Pharmaceutical Research. 2016;6(7):44.

8. Shimpi A, Shetye J, Mehta A. Comparison between effect of equal intensity training with

Suryanamaskar or Physical Education activity or combination of both on Physical fitness

in Adolescent Urban School children–A Randomized Control Trial: A Hypothesis.

Journal of Medical Thesis. 2014 May;2(2):35-8.

9. Pal D. Effect of Vinyasa Sun salutation on Wrist joint flexibility in school going children.

Journal of Educational Chronicle. 2014 Dec;5(2):98.

10. Peltzer K, Pengpid S. Leisure time physical inactivity and sedentary behaviour and

lifestyle correlates among students aged 13–15 in the association of Southeast Asian

nations (ASEAN) member states, 2007–2013. International Journal of Environmental

Research and Public Health. 2016 Feb;13(2):217.

11. Santaliestra-Pasías AM, Mouratidou T, Verbestel V, Bammann K, Molnar D, Sieri S,

Siani A, Veidebaum T, Mårild S, Lissner L, Hadjigeorgiou C. Physical activity and

sedentary behaviour in European children: the IDEFICS study. Public Health Nutrition.

2014 Oct;17(10):2295-306.

12. Riddoch CJ, Andersen LB, Wedderkopp N, Harro M, Klasson-Heggebø L, Sardinha LB,

Cooper AR, Ekelund UL. Physical activity levels and patterns of 9-and 15-yr-old

European children. Medicine & Science in Sports & Exercise. 2004 Jan 1;36(1):86-92.

13. Karkera, Anupama, et al. "Physical fitness and activity levels among urban school

children and their rural counterparts." The Indian Journal of Pediatrics 81.4 (2014).

14. Sharma B, Chavez RC, Nam EW. Prevalence and correlates of insufficient physical

activity in school adolescents in Peru. Revista de saude publica. 2018 May 21;52:51.

15. Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, Hergenroeder

AC, Must A, Nixon PA, Pivarnik JM, Rowland T. Evidence based physical activity for

school-age youth. The Journal of pediatrics. 2005 Jun 1;146(6):732-7.

16. Malina RM, Katzmarzyk PT. Physical activity and fitness in an international growth

standard for preadolescent and adolescent children. Food and Nutrition Bulletin. 2006

Dec;27(4_suppl5):S295-313.
17. Hussey J, Bell C, Bennett K, O’dwyer J, Gormley J. Relationship between the intensity

of physical activity, inactivity, cardiorespiratory fitness and body composition in 7–10-

year-old Dublin children. British journal of sports medicine. 2007 May 1;41(5):311-6.

18. Pal D. Effect of Vinyasa Sun salutation on flexibility in school going children. 2014

Dec;5(2):98.

19. Meena G, Venkatesan R. Effects Of Resistance, Suryanamaskar And Combined Training

With Almond Supplementation On Selected Serum Electrolytes Among Obese School

Children. Indian Federation of Computer Science in sports www. ijhpecss. org and www.

ifcss. in under the auspices of International Association of Computer Science.;5:55.

20. Raj M, Sundaram KR, Paul M, Deepa AS, Kumar RK. Obesity in Indian children: time

trends and relationship with hypertension. National Medical Journal of India. 2007 Nov

1;20(6):288.

21. Joseph S. Effect of Yoga practice, Suryanamaskar and Meditation on psychological well-

being of female school basket ball player. Ganesar college of Arts and Science. 2018 Mar

3:13.

22. De Morton NA. The PEDro scale is a valid measure of the methodological quality of

clinical trials: a demographic study. Australian Journal of Physiotherapy. 2009 Jan

1;55(2):129-33.

23. Kumar BS, Pal D, Gaurav P. Voga Mimāņsā, Vol. XLII No. 2: 109-116July, 200 Effect

of Vinyasa Sun salutation on flexibility among school children.

24. Kumar BS, Pal D, Gaurav P. Voga Mimāņsā, Vol. XLII No. 2: 109-116July, 200 Effect

of Vinyasa Sun salutation on flexibility among school children.

25. Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, Hergenroeder

AC, Must A, Nixon PA, Pivarnik JM, Rowland T. Evidence based physical activity for

school-age youth. The Journal of pediatrics. 2005 Jun 1;146(6):732-7.

26. Kumar S. Effects of suryanamaskar on cardio vascular and respiratory parameters in

school students. Recent research in Science and Technology. 2011 May 28;3(10).

27. Pal D. Effect of Vinyasa Sun salutation on Vital capacity among school going children.

Journal of Educational Chronicle. 2014 Jun;5(1):100.

28. Javadekar P, Manjunath NK. Effect of Surya namaskar on sustained attention in school

children. J Yoga Phys Ther. 2012;2(110):2.

29. Cashin AG, McAuley JH. Clinimetrics: Physiotherapy Evidence Database (PEDro) Scale.

Journal of Physiotherapy. 2019 Sep 11;66(1):59-.

30. Peltzer K, Pengpid S. Leisure time physical inactivity and sedentary behaviour and

lifestyle correlates among students aged 13–15 in the association of Southeast Asian

nations (ASEAN) member states, 2007–2013. International Journal of Environmental

Research and Public Health. 2016 Feb;13(2):217.

31. Sinha B, Ray US, Pathak A, Selvamurthy W. Energy cost and cardiorespiratory changes

during the practice of Surya Namaskar. Indian Journal of Physiology and Pharmacology.

2004 Apr;48(2):184-90.

32. Vigneshwaran G. Influence of Suryamamaskar Practices on back strength among male

college students. International Journal of Advance Research and Innovative Ideas in

Education. 2016;2(6):1808-10.

33. Sale DG. Influence of exercise and training on motor unit activation. Exercise and sport

sciences reviews. 1987 Jan 1;15:95-151.

34. Chandrasekhar M, Ambareesha K, Nikhil C. Effect of pranayama and suryanamaskar on

pulmonary functions in medical students. Journal of clinical and diagnostic research:

JCDR. 2014 Dec;8(12):BC04.

35. Drenowatz C, Greier K, Ruedl G, Kopp M. Association between club sports participation

and physical fitness across 6-to 14-year-old Austrian youth. International journal of

environmental research and public health. 2019 Jan;16(18):3392.

36. Bhutkar MV, Bhutkar PM, Taware GB, Surdi AD. How effective is sun salutation in

improving muscle strength, general body endurance and body composition? Asian J

Sports Med. 2011 Dec;2(4):259-66. doi: 10.5812/asjsm.34742. PMID: 22375247;

PMCID: PMC3289222.

37. Mohanty S, Murty PV, Pradhan B, Hankey A. Yoga practice increases minimum

muscular fitness in children with visual impairment. Journal of caring sciences. 2015

Dec;4(4):253.