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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 2  |  Issue : 2  |  Page : 78-85

Development and validation of vikrti measuring scale – A pilot study


1 Department of Yoga and Life Science, Swami Vivekananda Yoga Anusandhana Samsthana University, Bengaluru, Karnataka, India
2 Medical Director, Arogyadhama, VYASA, Bengaluru, Karnataka, India

Date of Submission26-Jul-2021
Date of Decision05-Oct-2021
Date of Acceptance07-Oct-2021
Date of Web Publication29-Nov-2021

Correspondence Address:
Suchitra S Patil
Swami Vivekananda Yoga Anusandhana Samsthana University, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijaim.ijaim_21_21

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  Abstract 


Objective: This is a preliminary report on the development of a scale to measure the pathology of tridoshas in a group of diseases by using the concepts of Āyurveda.
Design: The 97-item tridosha diagnosis scale (TDS) was developed based on the translation of Sanskrit verses describing vātaja (V), pittaja (P), and kaphaja (K) vikrti-vriddhi-kshaya and by taking the opinions of experts (fifteen Āyurveda experts, five psychiatrists, and five psychologists).
Settings: Arogyadhama holistic health hospital, VYASA, Bangalore, India.
Subjects: Thirty-five samples with a history of Diabetes, Back pain, Knee pain, Acidity, and cancer were included in the study. The patients with chronic illness and Cardiac diseases were excluded.
Results: The TDS was associated with excellent internal consistency. The Cronbach's alpha for V, P, and K vriddhi and kshaya scales were 0.939,0.945,0.853, 0.867,0.942,0.785 respectively. The Split-Half reliability for V, P, and K vriddhi, kshaya scales were 0.927, 0.962, 0.883, 0.848, 0.960, 0.688, respectively. Scores on vātaja, pittaja, and kaphaja scales were inversely correlated, suggesting that they are mutually exclusive. The three subgroups of back pain, acidity, diabetes had significantly high loadings on the vata vriddhi, pitta vriddhi, kapha vriddhi, respectively. While five cancer patients had significantly high loadings on vataja and kaphaja vriddhi, respectively. Factor analysis revealed that 70 items had good construct validity.
Conclusion: The TDS is a reliable and valid instrument. The scores on each of these doshas help in planning intervention.

Keywords: Kapha, pitta, tridosha, vikrti vāta


How to cite this article:
Patil SS, Singh A, Nagarathna R, Nagendra H R. Development and validation of vikrti measuring scale – A pilot study. Indian J Ayurveda lntegr Med 2021;2:78-85

How to cite this URL:
Patil SS, Singh A, Nagarathna R, Nagendra H R. Development and validation of vikrti measuring scale – A pilot study. Indian J Ayurveda lntegr Med [serial online] 2021 [cited 2022 Jan 19];2:78-85. Available from: http://www.ijaim.com/text.asp?2021/2/2/78/331491




  Introduction Top


Ayurveda, Vedic medical science, is fundamentally based on tridoshas_-Vata, Pitta, and Kapha. Metabolic principles control the function of Śarira and manas. Ayurveda proclaims– rogastu dosha vaishamyam, dosha samyam arogataa-vitiation of dosha is a disease, equilibrium of doshas gives health. Ayurveda pathology concept depends on the vitiation of tridoshas. According to Ayurveda scriptures vriddhi kshaya of tridoshas results in the manifestation of all the diseases. For example, Vata vriddhi is responsible for pain, Pitta vriddhi is responsible for acidity, Kapha vriddhi is responsible for diabetes and obesity. Moreover, in each disease based on the doshas are typologies are explained Accordingly, Ayurveda system of medicine adopts two lines of treatment: One is dosha pratyanika (pacifying the vitiated causative doshas) and another is vyadhi pratyanika (treating the disease symptoms). Based on tridosha vitiation, specific diet and daily regime for different types of vikrti are explained to regain health.[1],[2],[3],[4],[5],[6],[7],[8],[9] Which is comprehensive unlike personality concept of modern psychology.[10]

Studies have discussed the importance of Ayurveda,[11] Tridoshas.[12],[13],[14],[15] A Statistical Model of Dosha Prakrti based on analysis of a questionnaire has been developed.[16] An analysis of Tridoshas physiology, linking it to the process of cellular physiology has been carried out.[17],[18] Similarly, a genetic basis of Tridosha constitution has been postulated.[19],[20],[21],[22] A study comparing the Āyurveda personality concepts and western psychology concepts is available.[23] Ayurveda Tridosha theory and four elements of Buddhist medicine, Chinese numerology have been compared.[24],[25] Importance of Prakrti in aging has been discussed.[26] The effect of isotonic exercise on the different types of Prakrti has been observed.[27] Differences in metabolism of different prakrti have been explained.[28] Left and right hemisphere chemical, dominance has been observed with a predominance of doshas.[29] A scale to measure tridoshas in psychotic patients has been developed.[30] Ayurveda Child Personality Inventory, a parent rating scale to measure tridoshas in children has been standardized.[31]

However, the scale to measure vikriti of doshas according to Āyurveda comprehensive concepts is not available. Measuring the vikrti of the doshas is an important step in the treatment of the diseases as it is different for Vata, Pitta, and Kapha doshas.

The objective of the present study was to develop an interviewing scale for measuring vitiation of tridoshas.


  Methods Top


The tridosha diagnosis scale (TDS) was developed based on hundred and ten Sanskrit characteristics from nine authoritative ancient Ayurveda texts describing characteristics typical of Vātaja, Pittaja, and Kaphaja vriddi, kshaya (characteristics of increased or decreased doshas). Item reduction was carried out by deleting the repeated items, ambiguous items, and by selecting those items specifically suitable for vikrti of the doshas.

One hundred and ten items in Sanskrit and, translation in English selected from the scriptures, were presented to ten Āyurveda experts for content validity. Which was the first step of the development. They were asked to judge the correctness of each statement and to check (1) if the items constructed represented acceptable translation of the Sanskrit in the original texts. (2) Whether any of the items were repeated or if any item should be added? (3) Whether the features of Vātaja, Pittaja, and Kaphaja vikrti selected for the scale are correct.

Based on their comments some of the items were selected, some items were removed, some were changed and refined. Finally, 97 questions of TDS were framed. The scale was again presented to five Āyurveda experts and one psychologist who reviewed the format of this scale and recommended a two-point scoring (0 and 1); this was adopted in the final TDS [Figure 1].
Figure 1: Describes the process of development and content validation of the scale

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The final TDS has 97 items-21 items for Vātaja vriddhi, 14 items for Vata kshya: 16 items for Pittaja vriddhi, 11 items for Pitta Kshaya: 20 items for Kaphaja vriddhi and 15 items for Kapha kshaya. The scale was to be filled by a physician [Appendix 1].

Data collection and analysis

The item difficulty level was analyzed by administering the scale on 10 samples of the age group of 28–42 years.

For testing the reliability and validity, the final scale of 97 items was administered on 30 subjects from Arogyadhama, Swami Vivekananda Yoga Anusandhana Samsthana of both sexes with an age range of 25–52 years. Samples with an early history of Diabetes, Back pain, Knee pain, and Acidity were included in the study. The patients with chronic illness, long duration of the history of diabetes, complications of diabetes cardiac diseases were excluded.

The Statistical Package for Social Sciences (SPSS, version 10, IBM Corp., Armonk, N.Y., USA) was used for data analysis. The data were analyzed for reliability. The split-half and Cronbach''s alpha tests were applied for reliability analysis. Pearson's correlation analysis was done to check the degree of association between vata, pitta, and kapha scores. Principal component analysis (factor analysis) was done to check the validity.


  Results Top


Content validity

Amongst the Ten experts, who served as judges 97 questions were agreed by all.

Internal consistency

An analysis of the data collected from 30 samples showed the Cronbach's alpha is at an acceptable range [Table 1] and [Table 2].[28]
Table 1: Reliability coefficients of the tridosha subscales

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Table 2: Split half reliability coefficients of the tridosha subscales

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Correlations amongst subscales

  • Vata vriddhi has negatively correlated with Kapha vriddhi--0.892 (significance-0.01)
  • Vata vriddhi has positively correlated with Kapha ksaya-0.375 (significance-0.05)
  • Pitta vriddhi has positively correlated with kapha kshaya-0.909 (significance-0.01)
  • These are the important significant correlations.
  • Vata vriddhi has positively correlated with pitta vriddhi (0.146)
  • Pitta vriddhi has negatively correlated with kapha vriddhi (−0.178).


Factor analysis

Factor analytic coefficient (by principal component analysis) was obtained for each item in the scale for all V, P, and K vriddhi and kshaya after removing the items which were not fitting into the model. Total 70 items had good factor loadings >0.4 and were retained in the final scale [Table 3] and [Table 4].
Table 3: Factor loadings of vriddhi subscales

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Table 4: Factor loadings of kshaya subscales

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  Discussion Top


The current study has illustrated the development and initial standardization of a scale TDS to measure vitiation-increase or decrease of tridoshas. It consists of 97 items. Moreover, it has also described the initial application of the scale on thirty subjects.

The reliability of subscales was supported by Cronbach's Alpha ranged from 0.785 to 0.945. And split-half reliability ranged from 0.688 to 0.962. This supported the fact of consistency of the scale.[29] [Table 2]. Co-relation between Vātaja, Pittaja, and Kaphaja scale scores was negative, suggesting discriminant validity[32],[33] [Table 3]. Correlation values ranging from 0.332 to 0.657, significance at 99% confidence for all correlations. This suggests that the three subscales measure different aspects of vikrti of an individual.

The construct validity of model fit 70 items was supported by principal component analysis.[34],[35],[36]

When the scale was administered to 14 patients with the symptoms of back pain, 6 patients with the symptoms of acidity, and 10 patients with an early history of diabetes. It was found that back pain patients scored more than 65% in the Vata vriddhi lakasha scale, acidity patients scored more than 65% on pitta vriddhi scale and diabetes patients scored more than 65% on Kapha vriddhi lakasha scale. Thus, convergent validity was proved as Back pain, Acidity, Diabetes, Cancer patients scored significantly high on Vata vriddhi, Pitta vriddhi, and kapha vriddhi, respectively.The results correlate with the explanation of the Ayurveda scriptures [Table 5].[1],[2],[3],[4]
Table 5: Disease and vikrti

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The Strength of the study was that it is the first attempt to standardize the interviewer–rating scale to measure the vikrti aspects of an individual, which is an important step to plan an intervention.[1],[2],[3],[4],[5],[6],[7],[8],[9] This scale was developed to check the vitiation of Vata, Pitta, and Kapha, TDS can be potentially used to measure the pathologic state because of predominant Dosha. Which can potentially aid in planning dosha pratyanika chikista based on the vikrti of the doshas.

Limitations of the study

Although TDS is a reliable valid instrument, it has not addressed inter-rater and test-retest reliability. Moreover, for the diagnosis, no objective parameters were used. The study should be done on more samples and norms should be established.


  Conclusions Top


A TDS is a reliable and valid instrument to measure the visitation of tridoshas. Researchers can employ this instrument to assess the effect of the intervention.

Acknowledgment

We thank, Dr. Kishore, Dr. Aarti Jagannathan, and Āyurveda experts in Hubli, Sushruta Ayurveda college, Bengaluru, for their support and participation in the study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.


  Appendix Top


Appendix 1: Vikrti scale

Tridosha diagnosis scale

Note: This is a symptom checklist of vitiation of Vata, Pitta, Kapha. The physician can ask direct or indirect questions to elucidate them.For example, varna upaghata they can ask whether patient has become black suddenly, earlier having white color.

Scoring is if the presence of the symptom-1, absence of symptom-0.

Vāta vrddhi lakshana:

  1. Bala varna sukha upaghāta – destruction of strength, colour, happiness
  2. Mano vyaharsha- confused mind
  3. Sarvendriyanyupahanti- Impaired sense and motor organs
  4. Bhaya-fear
  5. Śoka-grief
  6. Moha-fainting
  7. Dainya-miserable state
  8. Ati pralapa-excessive talking
  9. Karśya-leanness, emaciation
  10. Gatra kampa-Tremors in whole body
  11. Sphurana- Convulsions in single part of the body
  12. Ushna kāmita- desiring hot-stuffs
  13. Sanjnanasha-loss of awareness
  14. Nidranasha-loss of sleep
  15. Asthishula-pain in bones
  16. Malasanga-constipation
  17. Ādhmāna- Flatulence
  18. Ātopa-Distention of abdomen
  19. Vākpārushya—harsh voice
  20. Alpa balatvam- Loss of enthusiasm
  21. Gādha varchasvam-Deep lusture.


Vāta kshaya lakshana:

  1. Arochaka- dislike towards food
  2. Apāka-indigestion
  3. Sadanam- exhaustion, fatigue
  4. Gauravam-heaviness
  5. Hrllasa- Vomiting sensation
  6. Āsyasravanam-salivation
  7. Duyanam-distress
  8. Virekasya vaishamyam-irregular bowel movements
  9. Vaishamayamanalsya-Improper digestive fire.
  10. Sanjnamoha- Confused intellect, mind
  11. Alpavāk- less speech
  12. Alpa cheshtata- reduced activity
  13. Apraharsha- dissatisfaction
  14. Angasāda- pain.


Pitta vrddhi lakshana:

  1. Glani- exhaust or fatigue
  2. Indriya dourbalya- Weakness of sense or motor organs
  3. Trishna- excessive thirst
  4. Murcha- Fainting
  5. Kriyakshayam-Reduced activity
  6. Bhaya-fear
  7. Krodha-anger
  8. Harsha-state of joy
  9. Moha-Confusion
  10. Pitatvam- yellowish ness of body
  11. Shitabhilasha- desire for cold stuffs
  12. Daha- Burning sensation in body
  13. Tiktasyata- Feeling of bitter taste
  14. Alpa nidrata- reduced sleep
  15. Santapa- fever
  16. Pita vinmutra- yellow bowels and urine.


Pitta kshaya lakshana:

  1. Apakti- indigestion
  2. Bhaktashradhha- dislike for food
  3. Stambha- stiffness.numbness, motionless, insensibility
  4. Shaitya- coldness
  5. Toda-pricking pain
  6. Gauravam- heaviness
  7. Nakhadinam shouklyatvam- white nails
  8. Gātrapārushya-roughness in body
  9. Kampa- Tremors
  10. Mandoshma- Reduced temperature
  11. Nishprabhatvam-loss of lusture.


Kapha vriddhi lakshana:

  1. Cheshta pranasham- reduced activity
  2. Murchaa- delusion
  3. Vāksanga- obstruction in speech
  4. Ālasya-lazyness
  5. Vrshata-increased sexual vigour
  6. Klibata-Weak mindedness
  7. Shvaitya- whiteness of the body
  8. Shaitya- Coldness
  9. Sthoulya- obesity
  10. Angasāda- pain
  11. Tandra-drowsiness
  12. Nidraa- excessive sleep
  13. Shwāsa- breathlessness
  14. Kāsa- cough
  15. Praseka- vomiting
  16. Hrllasa- vomting sensation
  17. Agnisāda- loss of digestive fire
  18. Sandhi vishlesha- dislocation of joint
  19. Sthairya- firmness, stiffness
  20. Asthi vishlesha- dislocation of bones.


Kapha kshaya lakshana:'

  1. Bhrama- giddiness
  2. Udveshtana-pain in buttocks and back of body
  3. Toda-Pricking sensation
  4. Dāha- burning sensation
  5. Sphutana- cracking of skin
  6. Angamarda-grinding pain in body
  7. Parishosha-dryness
  8. Duyana- distress
  9. Dhupana-fragrance
  10. Anidra- loss of sleep
  11. Snadhi shaithilya- loosening of joints
  12. Hrddrava- palpitations
  13. Shleshmashya shunyata- emptiness in chest, throat
  14. Trishna- excessive thirst
  15. Dourbalya- weakness.




 
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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