To Assess the Efficacy of Bhujangasana and Shalabhasana in Katishool - A Clinical Comparative Study

Name: Dr. Ritu Raisinghani

PG Scholar: Department of Swasthvritta & Yoga

Guide Co-Guide
Dr. Mamata Tirankar Dr. Ravindra Patwardhan
M.D. Ayurved, Associate M.D. Ayurved, Professor,
Professor, Department of Department of Swasthvritta &
Swasthvritta & Yoga Yoga
Special Thanks To:

Respected Chairman Sir

Respected Principal Sir
Respected Director Sir
Introduction
The word Katishool is formed by binding of two words – “KATI” and “SHOOL”

1. KATI :-
• The word 'kati' is derived from the dhatu "kat + in" and it is considered as a 'sharira avayava
vishesha', a bodily part where the dress is tightened.
• Amarakaosha: Kati is a synonym of Shroni(pelvis)
• Shabdakalpa Druma : Kati is a body part situated near to Shroni and has circumference of
16 Angula (finger length).[1]
• According to Monier Monier Williams, Kati is the hollow space above the hip or the loins[2]

2. SHOOL:-
• Shool means pain. “शल रूगायाम”[3]
• The term shool is indicative of pain.

So, the term Katishoola collectively indicates a condition of the presence of pain at the kati
region (low back) is called as katishool
• Katishool as a seprate disease is explained in classical text “Bhela Samhita. [भे.सु.25,36 ,38]

• Aacharya Bhela has differentiated a vatavyadhi as sarvang roga and ekang roga. Katishool
has been included by him in ekang roga. [4]

• Aacharya Bhela has narrated that katiprishtagata vata is the main factor in the manifestation
of katishoola. [5]

• Acharya kashyapa has categorised the katishool as one of the disease occurs due to the
improper management of labour (dushprajata) [6]

• In the khilasthana there is a description of eight types of shoola, their etiology and pathology.
[7]
Yogasana
• Ayurveda specifically deals with mind body balance. The main part of it is Yoga and Asana. It
is essential to be healthy. Yoga provides us a simple remedies, skills and procedures of good
health and hygiene to gain physical and mental fitness in less time.

• Yoga and Asana effects the physiology of important anatomical structure during procedure
and steps. The definition of Asana is “Sthira Sukham Asanas” which means well balanced,
pleasant position of body. Asana are the “skillful exercises” that not only give physical and
mental power but also tone the body-mind for further exercises. Asana helps to synchronize
the mind with body.

• Yogasana aims to give flexibility to the body. By doing yogasana elasticity of limbs is
maintained.

• Yogasanas increases the elasticity of our body and make the body more active and suple.
The blood circulation smoothens and the body becomes more capable and efficient.[8]
Need of Study
• The prevalence of LBP in Indian population has been found to vary between 6.2% (in
general population) to 92% (in construction workers)*. At any given time, 2.4 million of the
world population are disabled because of low back pain, with 1.2 million on a chronic basis.**

• As in daily routine, students working on computers , housewives, daily commuters, people

with long duration sitting on office chair, sleep over abnormal mattress are trapped by
lifestyle disorders such as LOW BACK PAIN.

• People have no escape key from this vicious circle of money, work, health and stress. Low
back pain disorders are associated with age, back accident, cummulative whole body
vibration and postural overload.

• Hence an attempt will be made to assess the efficacy of a clinical comparartive study of
Bhujangasana and Shalabasana in Katishool.

*An International Journal of Research in AYUSH and Allied Systems ISSN: 2393-9583 (P)/ 2393-9591 (O)
**Von Korff M. Deyo RA, Cherkin D, Barlow W. Back pain in primary care: outcomes at 1 year, Spine, Jun 1
1993,18 (7):855-62. [Medline]
 Previous Work Done
S. Name Topic Year
No.

1 Dr. Aakash Mankar To assess the efficacy of 2004

Bhujangasana and Dhanurasana in
Katishool in Computer User
2 Dr. Vinod P.N. To assess the efficacy of 2005
Shalabhasana and Vajrasana in
Grudharsi

3 Dr. Amit Shingare To assess the efficacy of 2006

Matsyandrarasana in Katishool in Two-
Wheeler Users

4 Dr. Timsi Shrivastava To assess the efficacy of 2008

Bhujangasana and Shalabhasana in
Katishool in Two-Wheeler Users
Hypothesis
• Null Hypothesis [Ho] – As part of Yogasana, Shalabhasana and Bhujangasana don’t have
significant difference between the two in treating the lower back pain.

• Alternative Hypothesis

– H1 - The yogasana of Group A- Bhujangasana is more effective than the yogasana of

Group B- Shalabasana.
– H2 - The yogasana of Group B- Shalabasana is more effective than the yogasana of
Group A- Bhujangasana.
 Aims & Objectives

• Aim:
– The Efficacy of Bhujangasana and Shalabhasana in Katishool is to be
assessed through a clinical comparative study.

• Objectives:
– To study the effect of Bhujangasana and Shalabasana in katishool
– To assess the effect of Bhujangasana and Shalabasana in katishool
– To compare the effect of Bhujangasana and Shalabasana in katishool.
– To establish the efficacy of Bhujangasana and Shalabasana as costless,
effective external tool in katishool.
Materials and Methods
• Materials Used
• Source of Data
• Literature Source :
– Classical text books of Ayurveda.
– Articles And Journals.
– Classical Books of Yoga.

• Clinical Source
– It is a clinical study. Patients suffering from katigrah and fulfill the criteria will selected
from OPD and randomly screened from various health camps held by the Institution,
Department of Swasthvritta & Yoga along with the support of other departments of Rani
Dullaiya Smriti Ayurved P.G Mahavidyalaya and Hospital, Barkhedi Kalan, Bhopal.

• Instrument Required
– Yoga Mat.
– A well ventilated area – Yoga Hall.
Method:-

Study Design ->

Method
• Sample Size:
Total 60 Patients (30 patients in each group)

• Grouping :

Group A: This will be trial group; 30 patients of this group will perform Bhujangasana and
the efficacy will be noted.
Group B: This will be trial group; 30 patients of this group will perform Shalabasana and the
efficacy will be noted.

• Study Center :
Patients will be randomly selected from OPD of department of Swasthavritta & Yoga of Rani
Dullaiya Smriti Ayurved P.G Mahavidyalaya Evam chikitsalaya Bhopal (M.P)
• Treatment Duration:
45 days

• Follow up:
After the completion of 45 days of treatment of performing asana :-
• 1st Follow up – 7th day
• 2nd Follow up – 15th day
• 3rd Follow up – 30th day
• 4th Follow up – 45th day

• Total Study Duration:

90 days – 3 months
Inclusion and Exclusion Criteria:
• Inclusion Criteria :
– Ideal gender.
– Age Group – 25 years to 60 years.
– Patients presenting with classical signs and symptoms – pain, stiffness, tenderness,
numbness or restricted movements.
– No Diagnosed Pathology involved.

• Exclusion Criteria :
– Handicapped Patients.
– Cases with low back pain as accident and other spinal injuries.
– Cases with history of severe orthopaedic condition as Lumbar spondylitis etc.
– Pregnancy and Lactating mothers.
– Congenital Deformities.
Criteria of Assessment*
• Subjective Parameters
– Kati Shool – Pain in Kati.
– Kati Stambha – Stiffness present in Kati.
– Kati Suptata – Numbness in Kati.

• Objective Parameters
– VAS : Visual Analogue Scale
– SLR Test : Straight Leg Raising Test

*Research Article International Ayurvedic Medical Journal ISSN:2320 5091

*International Journal of Ayurvedic Medicine, Vol 11 (2), 310-313 ISSN No: 0976-5921
Subjective Parameters
• Katishool (Pain)
Parameters Score

No Pain 0

Mild Pain 1
(Pain while Walking)

Moderate Pain 2
(Pain in Movement and Rest Both)

Severe Pain 3
(Intolerable Pain)
• Katistambha (Stiffness)
Parameters Score

No Stiffness 0

Mild Stiffness 1
(Stiffness in Rest Only)

Moderate Stiffness 2
(Frequent Spells of Stiffness in Daily Routine)

Severe Stiffness 3
(Stiffness affecting Routine Activities)
Objective Parameters
• Visual Analogue Scale

Severity Index VAS

No Pain 0
Mild Pain 1- 3
Moderate Pain 4-5
Severe Pain 5-6
Very Severe Pain 7-9
Worst Possible Pain 10
• SLR Test – Straight Leg Raise Test

– Ask the patient lie flat in a supine position.

– One should observe the patient's face while raising one leg, and he should stop when the
patient expresses pain.
– Take note of the extent to which the patient elevated his leg.
– Verify that his complaints are related to leg and back pain rather than tight hamstrings.

Marking (in degree) Grade

Leg Raise upto 90 Degree 0

Leg Raise upto 60 - 90 Degree 1
Leg Raise upto 45 - 60 Degree 2
Leg Raise upto 0 – 40 Degree 3
Yoga Module Adopted in Study – Standard Operative
Procedure
• Total Duration – 22 minutes avg.
• Level :- Basic
• Style :- Ashtang Yoga
• Strengthens :- Vertebral Column
• Place :- Yogasana should be performed in well ventilated room or yoga hall of institution or
herbal garden of institution.

• Procedure for Performing Yogasana for the study

– Pre-Procedure
– Procedure
– Post Procedure
• Pre Procedure:
– For Relaxation of muscles, sukshma vyayam is to be performed.
– It is performed to give movement to all the joints.
– It takes around 5 minutes

• Procedure:
– Initially, 5 times the asana will be asked perform by the patient.
– Later on increase up to 7 – 10 times as per capability of the patient.
– Time : 5 – 7 minutes of each session.
– Kaal : Morning (empty stomach) – 6:00 AM
Evening (2-3 hours after lunch) – 6:00 PM
Yogasana (Group A) :-
Bhujangasana

2/41, 42

Yogasana (Group B) :-
Shalabhasana

2/38
• Post Procedure
– Om Chanting - 5 Minutes

– Relaxation - 5 Minutes
Chapters To be included
• Introduction
• Aims & Objectives
• Review Of Literature
• Material & Methods
• Observation & Result
• Discussion
• Conclusion
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