Changes

== Complications of ativyayama ==

== Complications of ativyayama ==

<div style='text-align:justify;'>Excessive thirst (thrishna), emaciation (kshaya), dyspnoea with [[Jwara|fever]] and fainting (pratamaka), [[Raktapitta|bleeding disorders (raktapitta)]], fatigue (shrama), lethargy (klama), severe cough ([[Kasa Chikitsa|kasa]]), [[Jwara|fever (jwara)]], and [[Chardi Chikitsa|vomiting (chardi)]] are caused due to excess vyayama. [A.H.Sutra Sthana2/14; A.S.Sutra Sthana3/364].  <br/>Other health issues, in which over-exertion is the patho-physiological factor are [[Hikka Shwasa Chikitsa|hiccups (hikka shwasa)]] [Su.Sa.Uttara Tantar 50/3-4; Cha.Sa.Chikitsa Sthana 17/11; M.Ni12/1-2], especially that develop soon after food intake (kshudra hikka) [Cha.Sa.Chikitsa Sthana17/34]; [[Kasa Chikitsa|cough (kasa)]] [Su.Sa.Uttara Tantra 52/4, M.Ni11/1; A.H.Sutra Sthana 2/14; A.S.Sutra Sthana 3/64-65], [[Pandu Chikitsa|anaemia (pandu)]] [Cha.Sa.Chikitsa Sthana 16/8; M.Ni 8/2], obstructive jaundice (shakhashrita kamala) [Cha.Sa.Sutra Sthana16/125], [[Raktapitta|bleeding disorders (raktapitta)]] [A.S.Sutra Sthana-3/64-65; M.Ni 9/1], chest infections including tuberculosis (rajayakshma) [M.Ni 10/14], emaciation (shosha) [M.Ni 10/19], neurological and musculo-skeletal disorders (vatavyadhi) [Cha.Sa.Chikitsa Sthana 28/16-19; M. Ni 22/2], arthritis (vatarakta) [Su.Sa.Nidana Sthana-1/40-41], dysuria (mutrakrichra)  [M.Ni 30/1; Cha.Sa.Chikitsa Sthana 26/32], burning sensation while urinating (ushnavata) [Su.Sa.Uttara Tantra 58/22-23; M.Ni- 31/25], obstructed blood vessels (siragranthi) [Su.Sa.Nidana Sthana 11/8; A.H.Uttara Sthana 29/10; A.S.Uttara Sthana 34/11; M.Ni38/16], chest injury without external trauma (urakshata) [Cha.Sa.Nidana Sthana- 6/4), abdominal colic (shula roga) [M.Ni 26/2), suppuration of intestinal organs (antravidradhi) [Su.Sa.Nidana Sthana-9/16], headache over one side (ardhavabhedaka) [M.Ni60/11], polyp in female reproductive organ (yonikanda) [Ma..Ni 63/1], internal lumps due to [[Vata dosha|vata]] (vataja [[Gulma Nidana|gulma]]) [Cha.Sa.Nidana Sthana-3/6], haemorrhoids due to [[Vata dosha|vata]] (vatika arsha) [Cha.Sa.Chikitsa Sthana-14/13; M. Ni3/34; 5/4) and [[Pitta|pitta]] (pitta dominant arsha) [Madhava Nidana-5/5], cardiac disease due to [[Vata dosha|vata]] ([[Vata dosha|vata]] dominant hridroga) [Cha.Sa. Suta Sthana- 17/30; Cha.Sa.Chikita Sthana- 26/77], diarrhoea due to [[Vata dosha|vata]] (vatika atisara) [Cha.Sa.Chikitsa Sthana 19/5], vomiting due to [[Vata dosha|vata]] ([[Vata dosha|vata]] dominant  cchardi) [Cha.Sa.Chikitsa Sthana- 20/7], appearance of lipid in urine (vasa meha) [Cha.Sa.Nidana Sthana 4/36]. Ativyayama causes trauma in the thoracic region and it will result in traumatic cough (kshataja kasa). [Su.Sa.Uttara Tantra 52/11] <br/>By over exertion, the end-product of digestion/chyle (rasa dhatu) dries up and reduces its quality. Thus the person will become lean. [Su.Sa. Sutra Sthana 15/33]  </div>

<div style='text-align:justify;'>Excessive thirst (thrishna), emaciation (kshaya), dyspnoea with [[Jwara|fever]] and fainting (pratamaka), [[Raktapitta|bleeding disorders (raktapitta)]], fatigue (shrama), lethargy (klama), severe cough ([[Kasa Chikitsa|kasa]]), [[Jwara|fever (jwara)]], and [[Chardi Chikitsa|vomiting (chardi)]] are caused due to excess vyayama. [A.H.Sutra Sthana2/14; A.S.Sutra Sthana3/364].  <br/>Other health issues, in which over-exertion is the patho-physiological factor are [[Hikka Shwasa Chikitsa|hiccups (hikka shwasa)]] [Su.Sa.Uttara Tantar 50/3-4; Cha.Sa.Chikitsa Sthana 17/11; M.Ni12/1-2], especially that develop soon after food intake (kshudra hikka) [Cha.Sa.Chikitsa Sthana17/34]; [[Kasa Chikitsa|cough (kasa)]] [Su.Sa.Uttara Tantra 52/4, M.Ni11/1; A.H.Sutra Sthana 2/14; A.S.Sutra Sthana 3/64-65], [[Pandu Chikitsa|anaemia (pandu)]] [Cha.Sa.Chikitsa Sthana 16/8; M.Ni 8/2], obstructive jaundice (shakhashrita [[Kamala|kamala]]) [Cha.Sa.Sutra Sthana16/125], [[Raktapitta|bleeding disorders (raktapitta)]] [A.S.Sutra Sthana-3/64-65; M.Ni 9/1], chest infections including tuberculosis ([[Rajayakshma Chikitsa|rajayakshma]]) [M.Ni 10/14], emaciation ([[Shosha Nidana|shosha]]) [M.Ni 10/19], neurological and musculo-skeletal disorders ([[Vatavyadhi Chikitsa|vatavyadhi]]) [Cha.Sa.Chikitsa Sthana 28/16-19; M. Ni 22/2], arthritis ([[Vatarakta Chikitsa|vatarakta]]) [Su.Sa.Nidana Sthana-1/40-41], dysuria (mutrakrichra)  [M.Ni 30/1; Cha.Sa.Chikitsa Sthana 26/32], burning sensation while urinating (ushnavata) [Su.Sa.Uttara Tantra 58/22-23; M.Ni- 31/25], obstructed blood vessels (siragranthi) [Su.Sa.Nidana Sthana 11/8; A.H.Uttara Sthana 29/10; A.S.Uttara Sthana 34/11; M.Ni38/16], chest injury without external trauma (urakshata) [Cha.Sa.Nidana Sthana- 6/4), abdominal colic (shula roga) [M.Ni 26/2), suppuration of intestinal organs (antravidradhi) [Su.Sa.Nidana Sthana-9/16], headache over one side (ardhavabhedaka) [M.Ni60/11], polyp in female reproductive organ (yonikanda) [Ma..Ni 63/1], internal lumps due to [[Vata dosha|vata]] (vataja [[Gulma Nidana|gulma]]) [Cha.Sa.Nidana Sthana-3/6], haemorrhoids due to [[Vata dosha|vata]] (vatika arsha) [Cha.Sa.Chikitsa Sthana-14/13; M. Ni3/34; 5/4) and [[Pitta|pitta]] (pitta dominant arsha) [Madhava Nidana-5/5], cardiac disease due to [[Vata dosha|vata]] ([[Vata dosha|vata]] dominant hridroga) [Cha.Sa. Suta Sthana- 17/30; Cha.Sa.Chikita Sthana- 26/77], diarrhoea due to [[Vata dosha|vata]] (vatika atisara) [Cha.Sa.Chikitsa Sthana 19/5], vomiting due to [[Vata dosha|vata]] ([[Vata dosha|vata]] dominant  cchardi) [Cha.Sa.Chikitsa Sthana- 20/7], appearance of lipid in urine (vasa meha) [Cha.Sa.Nidana Sthana 4/36]. Ativyayama causes trauma in the thoracic region and it will result in traumatic cough (kshataja kasa). [Su.Sa.Uttara Tantra 52/11] <br/>By over exertion, the end-product of digestion/chyle ([[Rasa dhatu|rasa dhatu]]) dries up and reduces its quality. Thus the person will become lean. [Su.Sa. Sutra Sthana 15/33]  </div>

== Concept of avyayama ==

== Concept of avyayama ==

<div style='text-align:justify;'>Avyayama is the lack/ reduced physical exertion yielding in aggravation of [[Kapha dosha|kapha dosha]] [Cha.Sa Nidana Sthana 1/25] and vitiation of channels of transportation of lipids (medovaha srotodushi). [Cha.Sa.Vimana Sthana -5/16] <br/>The condition is encountered in [[Vyadhi|diseases]] due to deranged lipids (medoroga) [Ma.Ni 34/1], obesity (atisthaulya) [Cha.Sa.Sutra Sthana 21/4; Su.Sa.Sutra Sthana-15/32], obstinate urinary [[Vyadhi|diseases]] including diabetes ([[Prameha Nidana|prameha]]) [Su.Sa.Nidana Sthana 6/3], [[Prameha Nidana|diabetes]] due to [[Kapha dosha|kapha]] (kaphaja prameha) [Cha.Sa Nidana Sthana-4/5], chronic stage of [[Prameha Nidana|diabetes]] with aggravated [[Vata dosha|vata]] (madhumeha) [Cha.Sa.Sutra Sthana 17/79-80], worm- infestation (krimiroga) [Su.Sa.Uttara Tantra 54/3; M. Ni7/4], oedema due to [[Kapha dosha|kapha]] ([[Kapha dosha|kapha]] dominant shopha) [Cha.Sa.Sutra Sthana18/7-8], abdominal disorders due to [[Kapha dosha|kapha]] (kaphaja udara) [Cha.Sa.Chikitsa Sthana 13/29], hemorrhoids due to [[Kapha dosha|kapha]] (kaphaja arsha) [Cha.Sa. Chikitsa Sthana 14/18-19; Ma.Ni 5/7], and a type of erysipelas (granthi visarpa). [Cha. Sa. Chikitsa Sthana 21/39] </div>

<div style='text-align:justify;'>Avyayama is the lack/ reduced physical exertion yielding in aggravation of [[Kapha dosha|kapha dosha]] [Cha.Sa Nidana Sthana 1/25] and vitiation of channels of transportation of lipids (medovaha srotodushi). [Cha.Sa.Vimana Sthana -5/16] <br/>The condition is encountered in [[Vyadhi|diseases]] due to deranged lipids (medoroga) [Ma.Ni 34/1], obesity (atisthaulya) [Cha.Sa.Sutra Sthana 21/4; Su.Sa.Sutra Sthana-15/32], obstinate urinary [[Vyadhi|diseases]] including diabetes ([[Prameha Nidana|prameha]]) [Su.Sa.Nidana Sthana 6/3], [[Prameha Nidana|diabetes]] due to [[Kapha dosha|kapha]] (kaphaja prameha) [Cha.Sa Nidana Sthana-4/5], chronic stage of [[Prameha Nidana|diabetes]] with aggravated [[Vata dosha|vata]] ([[Prameha Chikitsa|madhumeha]]) [Cha.Sa.Sutra Sthana 17/79-80], worm- infestation (krimiroga) [Su.Sa.Uttara Tantra 54/3; M. Ni7/4], oedema due to [[Kapha dosha|kapha]] ([[Kapha dosha|kapha]] dominant [[Shvayathu Chikitsa|shopha]]) [Cha.Sa.Sutra Sthana18/7-8], abdominal disorders due to [[Kapha dosha|kapha]] (kaphaja udara) [Cha.Sa.Chikitsa Sthana 13/29], hemorrhoids due to [[Kapha dosha|kapha]] (kaphaja arsha) [Cha.Sa. Chikitsa Sthana 14/18-19; Ma.Ni 5/7], and a type of erysipelas (granthi visarpa). [Cha. Sa. Chikitsa Sthana 21/39] </div>

== Contemporary approach ==

== Contemporary approach ==

===Difference between physical exercise and vyayama: ===

===Difference between physical exercise and vyayama: ===

<div style='text-align:justify;'>The WHO definition of   physical activity is any bodily movement produced by skeletal muscles that requires energy expenditure<ref name="ref4">WHO. Physical activity [Internet]. 2022 [cited 2022 Dec 13]. Available from: https://www.who.int/news-room/fact-sheets/detail/physical-activity</ref>. It can be household work, moving from one place to other, lifting an object etc. Exercise is a subcategory of physical activity that is planned, structured, repetitive, and purposefully focused on improvement or maintenance of one or more components of physical fitness<ref name="ref5">Dasso NA. How is exercise different from physical activity? A concept analysis. Nurs Forum [Internet]. 2019 Jan 1 [cited 2022 Dec 14];54(1):45–52. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/nuf.12296</ref>. Vyayama is of three types- physical, verbal or mental, among them only physical exercise is meant for health maintenance, and it must be implemented at right amounts, with due precautions. Mental exertion has a tiring effect and therefore it cannot be considered as a healthy practice.<ref name="ref6">Silva-Júnior FL e, Emanuel P, Sousa J, Silva M, Teixeira S, Oliveira Pires F, et al. Prior Acute Mental Exertion in Exercise and Sport. Clin Pract Epidemiol Ment Heal. 2016;12(1):94–107.</ref> Vyayama is an anabolic/ constructive activity as per [[Ayurveda|Ayurveda]], with benefits like ability to perform activities, increased digestion, reduction of unwanted fat deposits, fitness etc. It is recommended to be practiced, along with an adequate lipid diet in moderate quantity, and therefore burn-out is not a goal of vyayama. Hence, it is a conducive physical exertion. There is a clear-cut difference between vyayama, ayasa (exertion) and shrama (fatigue), where the latter two are catabolic in nature, which results in exhaustion and burn-out. Both these are dangerous to health. On the other hand, vyayama should be stopped prior to exhaustion. </div>

<div style='text-align:justify;'>The WHO definition of physical activity is any bodily movement produced by skeletal muscles that requires energy expenditure<ref name="ref4">WHO. Physical activity [Internet]. 2022 [cited 2022 Dec 13]. Available from: https://www.who.int/news-room/fact-sheets/detail/physical-activity</ref>. It can be household work, moving from one place to other, lifting an object etc. Exercise is a subcategory of physical activity that is planned, structured, repetitive, and purposefully focused on improvement or maintenance of one or more components of physical fitness<ref name="ref5">Dasso NA. How is exercise different from physical activity? A concept analysis. Nurs Forum [Internet]. 2019 Jan 1 [cited 2022 Dec 14];54(1):45–52. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/nuf.12296</ref>. Vyayama is of three types- physical, verbal or mental, among them only physical exercise is meant for health maintenance, and it must be implemented at right amounts, with due precautions. Mental exertion has a tiring effect and therefore it cannot be considered as a healthy practice.<ref name="ref6">Silva-Júnior FL e, Emanuel P, Sousa J, Silva M, Teixeira S, Oliveira Pires F, et al. Prior Acute Mental Exertion in Exercise and Sport. Clin Pract Epidemiol Ment Heal. 2016;12(1):94–107.</ref> Vyayama is an anabolic/ constructive activity as per [[Ayurveda|Ayurveda]], with benefits like ability to perform activities, increased digestion, reduction of unwanted fat deposits, fitness etc. It is recommended to be practiced, along with an adequate lipid diet in moderate quantity, and therefore burn-out is not a goal of vyayama. Hence, it is a conducive physical exertion. There is a clear-cut difference between vyayama, ayasa (exertion) and shrama (fatigue), where the latter two are catabolic in nature, which results in exhaustion and burn-out. Both these are dangerous to health. On the other hand, vyayama should be stopped prior to exhaustion. </div>

=== Types of exercise: ===

=== Types of exercise: ===

<div style='text-align:justify;'>There are mainly four types of exercises namely:<br/> a) Endurance, strength, balance and flexibility<ref name="ref7">NIH. Four Types of Exercise Can Improve Your Health and Physical Ability | National Institute on Aging [Internet]. National Institute on Aging NIA. 2021 [cited 2022 Dec 14]. Available from: https://www.nia.nih.gov/health/four-types-exercise-can-improve-your-health-and-physical-ability</ref>. Endurance exercises otherwise known as aerobic exercises, improve heart rate and respiratory rate. They help in preventing [[Vyadhi|diseases]] due to wear and tear. Swimming, dancing, brisk walking etc. are some examples of endurance exercises. Strengthening exercises increase muscle strength, prevent falls and improve [[Sharira|body]] balance. They include weight training, wall push-ups, lifting the [[Sharira|body]] weight etc. Balance exercises enhance [[Sharira|body]] balance and thereby prevent falls (eg: yoga, heel to toe walking). Flexibility exercises are stretching itself.<br/>'''Over-exertion (ativyayama):''' Magnitude and duration of exercise are to be determined prior to designing the schedule considering the physique, age, health status, amount of physical activity etc. In order to   gain a fascinating physical appearance in a short period many people, especially celebrities follow unhealthy aggressive exercise protocol. Recent alarming events, of celebrity death in their 40’s and 50’s point towards the illogical  unhealthy exercise schedule. <br/>'''Contemporary approach:''' Exercise and work-out  has become a part of a  popular lifestyle  measure in addition of being health promotion tool. Group exercises like dance, zumba etc. are mainly meant for fun   gathering methods. Intention of such activities are relaxation, shaping the [[Sharira|body]], and in most cases, an a lacunae surfaces in an analytical approach in implementing these activities   based on the individual’s needs. Additionally, self-exercise/ work-out, using social media is very common which also shares, the same drawback. <br/>'''Personalization of exercise:''' Physique, physical activity, age, dietary intake, etc. of each individual is variable, so exercise must be designed in accordance with the needs of the person. <br/>'''Combined effect of diet and exercise:''' In order to achieve fitness and health, diet restriction or exercise alone is not very beneficial. Combined and wise execution of these two are the key to achieve the expected results<ref name="ref8">Magkos F, Hjorth MF, Astrup A. Diet and exercise in the prevention and treatment of type 2 [[Prameha Nidana|diabetes]] mellitus. Nat Rev Endocrinol. 2020 Oct;16(10):545-555. doi: 10.1038/s41574-020-0381-5. Epub 2020 Jul 20. PMID: 32690918.</ref><ref name="ref9">Johns DJ, Hartmann-Boyce J, Jebb SA, Aveyard P; Behavioural Weight Management Review Group. Diet or exercise interventions vs combined behavioral weight management programs: a systematic review and meta-analysis of direct comparisons. J Acad Nutr Diet. 2014 Oct;114(10):1557-68. doi: 10.1016/j.jand.2014.07.005. PMID: 25257365; PMCID: PMC4180002.</ref>. Vyayama is hence, included in daily regimen (dinacharya) with an optimal magnitude. <br/>'''Role of prajna and prajnaparadha in exercise adherence:''' Awareness regarding one’s health status, bad habits, health behavior (dhi) are the key for initiating action- (dhriti). Both these bring forth enthusiasm and endurance towards exercise (maintenance/ adherence). When the individual lacks enthusiasm (dhriti bhramsha/ prajnaparadha), the adherence to exercise fades. Thus, continuous loop of prajna installation and prajnaparadha installation (relapse) play in cyclical adherence and non-adherence to exercise, which is the core theme behind ‘dushchikitsya atisthoola’ concept. <br/>Fit India Movement: An Indian government initiative aimed at improving the health of citizens by daily exercise. It was launched on the National sports day 2019 (August 29). It includes age appropriate fitness protocol for 5-18 years, 18-65 years and above 65. </div>

<div style='text-align:justify;'>There are mainly four types of exercises namely:<br/> a) Endurance, strength, balance and flexibility<ref name="ref7">NIH. Four Types of Exercise Can Improve Your Health and Physical Ability | National Institute on Aging [Internet]. National Institute on Aging NIA. 2021 [cited 2022 Dec 14]. Available from: https://www.nia.nih.gov/health/four-types-exercise-can-improve-your-health-and-physical-ability</ref>. Endurance exercises otherwise known as aerobic exercises, improve heart rate and respiratory rate. They help in preventing [[Vyadhi|diseases]] due to wear and tear. Swimming, dancing, brisk walking etc. are some examples of endurance exercises. Strengthening exercises increase muscle strength, prevent falls and improve [[Sharira|body]] balance. They include weight training, wall push-ups, lifting the [[Sharira|body]] weight etc. Balance exercises enhance [[Sharira|body]] balance and thereby prevent falls (eg: yoga, heel to toe walking). Flexibility exercises are stretching itself.<br/>'''Over-exertion (ativyayama):''' Magnitude and duration of exercise are to be determined prior to designing the schedule considering the physique, age, health status, amount of physical activity etc. In order to gain a fascinating physical appearance in a short period many people, especially celebrities follow unhealthy aggressive exercise protocol. Recent alarming events, of celebrity death in their 40’s and 50’s point towards the illogical  unhealthy exercise schedule. <br/>'''Contemporary approach:''' Exercise and work-out  has become a part of a  popular lifestyle  measure in addition of being health promotion tool. Group exercises like dance, zumba etc. are mainly meant for fun gathering methods. Intention of such activities are relaxation, shaping the [[Sharira|body]], and in most cases, an a lacunae surfaces in an analytical approach in implementing these activities based on the individual’s needs. Additionally, self-exercise/ work-out, using social media is very common which also shares, the same drawback. <br/>'''Personalization of exercise:''' Physique, physical activity, age, dietary intake, etc. of each individual is variable, so exercise must be designed in accordance with the needs of the person. <br/>'''Combined effect of diet and exercise:''' In order to achieve fitness and health, diet restriction or exercise alone is not very beneficial. Combined and wise execution of these two are the key to achieve the expected results<ref name="ref8">Magkos F, Hjorth MF, Astrup A. Diet and exercise in the prevention and treatment of type 2 diabetes mellitus. Nat Rev Endocrinol. 2020 Oct;16(10):545-555. doi: 10.1038/s41574-020-0381-5. Epub 2020 Jul 20. PMID: 32690918.</ref><ref name="ref9">Johns DJ, Hartmann-Boyce J, Jebb SA, Aveyard P; Behavioural Weight Management Review Group. Diet or exercise interventions vs combined behavioral weight management programs: a systematic review and meta-analysis of direct comparisons. J Acad Nutr Diet. 2014 Oct;114(10):1557-68. doi: 10.1016/j.jand.2014.07.005. PMID: 25257365; PMCID: PMC4180002.</ref>. Vyayama is hence, included in daily regimen (dinacharya) with an optimal magnitude. <br/>'''Role of prajna and prajnaparadha in exercise adherence:''' Awareness regarding one’s health status, bad habits, health behavior (dhi) are the key for initiating action- ([[Dhriti|dhriti]]). Both these bring forth enthusiasm and endurance towards exercise (maintenance/ adherence). When the individual lacks enthusiasm (dhriti bhramsha/ [[Prajnaparadha|prajnaparadha]]), the adherence to exercise fades. Thus, continuous loop of prajna installation and [[Prajnaparadha|prajnaparadha]] installation (relapse) play in cyclical adherence and non-adherence to exercise, which is the core theme behind ‘dushchikitsya atisthoola’ concept. <br/>Fit India Movement: An Indian government initiative aimed at improving the health of citizens by daily exercise. It was launched on the National sports day 2019 (August 29). It includes age appropriate fitness protocol for 5-18 years, 18-65 years and above 65. </div>

== Current researches ==

== Current researches ==