Muslims derive therapeutic and spiritual benefits starting from the Wudu to the physical movements in the Salat – Takbir, Qiyam, Ruku, Sajda, Jalsa, and Tasleems. Muslims perform five daily contact prayers (Salat) and voluntary prayers (Sunnah, Nafl) throughout the year and Taraweeh prayers during the month of Ramadan. This results in moderate physical exercise, particularly to every muscle in the body. Some muscles contract isometrically (same length) and some contract in approximation or isotonically (same tension). The energy needed for the muscle during exercise is met by a process known as glycogenolysis. The rate of muscle metabolism increases during the performance of Salat, resulting in a relative deficiency of oxygen and muscle nutrients. In turn, this deficiency causes vasodilation – and an increase in the calibre of blood vessels – thereby allowing blood to flow easily back to the heart. The temporarily increased load on the heart acts to strengthen the heart muscle and improve the circulation within the heart muscle.

During the month of Ramadan, additional prayers are performed after salatul Ishaa, called Taraweeh prayers which vary from 8 Rakat (unit of prayer) to 20 Rakat with a few minutes break after every 4 Rakat for chanting and extolling the Majesty of Allah. After Iftar (breaking of fast) the blood glucose level continues to rise from the food ingested. Just before the Iftar meals, the blood glucose and insulin levels are at their lowest level. After an hour or so after the Iftar meal, the blood glucose begins to rise and also plasma insulin. The liver and the muscles take up the circulating glucose. The blood sugar reaches high levels in an hour or two and the benefits of Taraweeh prayers come into effect. The circulating glucose is metabolised into carbon dioxide and water during the Taraweeh prayers.

Hence the Taraweeh prayers help in expending the extra calories and improve flexibility, and coordination, reduce stress-related autonomic responses in healthy persons, and relieve anxiety and depression.

Physical and Emotional Well-Being
The gentle exercises performed in Taraweeh prayers improve physical fitness, and emotional well-being and increase the longevity of the Namazi (one who performs the Salat or Namaz). When a little extra effort is made, as in performing the Taraweeh prayers, there will be a betterment in endurance, stamina, in flexibility and strength. It was noted that the five daily prayers (Salat) produce the same physiological changes without any undesirable side effects as those produced by jogging or walking at about three miles per hour. Recent research studies performed on 17,000 Harvard alumni who entered college between 1916-and 1950 give strong evidence that only moderate aerobic exercise, equivalent to jogging about 3 miles a day, promotes good health and may actually add years to life. Men who expended about 2000 kcal of energy on a weekly basis (equal to a daily 30-minute walk, run, cycle, swim, etc.,) had one-quarter to one-third lower death rates than classmates who did little or no exercise. In addition to the health-boosting qualities of the Salat, the Namazi will be trained to be ever ready for any unexpected physical exertion such as the sudden lifting of children, chairs, or catching a public transportation vehicle. The elderly will accomplish this more securely and efficiently. Hence this is an advantage for the elderly to maintain their physical fitness for a longer period of time. It has been observed that those who fast and perform the Taraweeh prayers report feeling much convalescing and robust.

The Elderly
As human beings grow older, their physiological activity diminishes, as a result, their bones become thinner and if not taken care of will suffer from osteoporosis (which causes the fractures of the bones when they fall in the elderly due to a loss of bone mineral content and consequent sponginess of the bones. The bone then becomes structurally unstable, brittle and susceptible to fractures). Primary osteoporosis is most common among postmenopausal (due to reduction in oestrogen) women or those who have undergone bilateral oophorectomy (both the ovaries removed).

Women are six times more likely than men to develop Type I osteoporosis. The three major prevention strategies of osteoporosis are a high dietary intake of calcium and vitamin D, regular exercise and oestrogen replacement in postmenopausal women. The skin also becomes fragile and crinkled. The repair processes of the body become slower and immune responses are decreased. In the elderly, their physical activity is reduced as a result they have lower levels of Insulin Growth Factor 1. Reserve functions of all vital organs decrease and the elderly are more susceptible to mishaps and ailments. Because of repeated and regular movements of the body during Salat muscle strength, tendon power, joint flexibility and cardiovascular reserve are improved. Hence Salat and Taraweeh prayers enable the elderly to enrich the quality of life and to meet with unforeseen difficulties such as falls that could injure their bodies. Therefore Taraweeh prayers will improve their endurance, self-respect and self-confidence in being self-reliant.

Adrenaline is secreted even by minor activity. The secretion outlasts the incitement.

Even after the Taraweeh prayers are over the effects of adrenaline and noradrenaline are manifest. (Adrenaline also called epinephrine is produced by the adrenal glands. The middle part of these glands, the adrenal medulla, secretes the hormone, which is chemically almost identical to the transmitter substance noradrenaline produced at the ends of sympathetic nerves. Adrenaline secretion into the bloodstream during stress causes acceleration of the heart, constriction of arterioles, and dilation of the pupils. In addition, adrenaline produces a marked increase in metabolic rate thus preparing the body for an emergency.) Even the thought of the intention of performing the Taraweeh prayers is sufficient to activate the sympathetic nervous system. The sympathetic nervous system (thoracolumbar nervous system) is one of the two divisions of the autonomic nervous system, which supplies motor nerves to the smooth muscles of internal organs and to the heart muscle. Sympathetic nerve fibres arise via spinal nerves in the thoracic and lumbar regions. Their endings release mainly adrenaline, which increases heart rate and breathing rate, raises blood pressure and slows digestive processes, thereby preparing the body for “fight or flight” and antagonising the effects of the sympathetic nervous system. The adrenaline would redistribute the blood in the body to the active muscles, would mobilise liver glycogen if necessary in order to provide glucose for the active tissues, would diminish fatigue in skeletal muscles and would facilitate alveolar ventilation relax the bronchiolar muscle, and would initiate cardiovascular changes. Exercise induces a more effective functioning of beta-adrenoreceptors located on cell membranes.

Beneficial effects of Gentle Exercise
The Taraweeh prayer is considered to be a gentle exercise. The beneficial effects of gentle exercise on the body are many which are elaborated on here.

Effects on Skeletal Muscle
Once muscles atrophy in spite of the availability of ample proteins. During the Salat and Taraweeh, every muscle in the body contracts ironically and others isometrically. This gentle exercise also enhances endurance and diminishes tiredness. It helps the incapacitated to make the most of their remnant capabilities. The blood flow in strung muscles is low. During the prayers, the blood flow is greatly increased to the muscles. Blood flow sometimes increases even before the start of Taraweeh prayers, with just the thought of performing the Taraweeh prayers. In addition to needing fats, proteins, and carbohydrates, the human body requires minerals such as Potassium for nerve and muscle activity. It is found in fruits, meats, seafood and milk. Potassium deficiency leads to muscular and neurologic disorders. Potassium is also important in the transmission of nerve impulses and is a major positive ion in intracellular fluids. Potassium is involved in cellular enzyme activities, and it helps regulate the chemical reactions by which carbohydrates are converted to energy and amino acids are converted to protein. Also, Potassium ions cause vasodilation of arterioles. During the Taraweeh prayers, systolic Blood pressure may rise (the larger number in B.P.) a little and the diastolic Blood Pressure(the lower number in B.P.) may remain unchanged or even fall. However after the Taraweeh prayers are over, the B.P. may drop to just below normal levels which is a welcome sign. Taraweeh prayers improve respiratory efficiency; circulation in the capillaries surrounding the alveoli, or air sacs, is increased, and this brings about enhanced gas exchange and deeper breathing. The increase in the maximal consumption of oxygen is what makes the Namazi feel better. Those who perform the Taraweeh prayers, apart from the prescribed Salat, are more alert and active than those who do not perform the

Taraweeh prayers, even after the age of retirement. Taraweeh prayers improve physical strength and joint stability and reduce the risk of injury to the tendons and connective tissues. After age 40, the bone mineral density falls with age. Taraweeh prayers increase bone mineral density in both menopausal and elderly women and prevent osteoporosis and maintain normalcy in bone structures. Osteoporosis results in hip fractures in women after menopause and in elderly men. The risk of osteoporosis is substantially reduced by regular Salat and Taraweeh prayers. The prayers improve lubrication of joints, and movement, and maintain flexibility. Deep vein thrombosis (the most common cause of ulceration of the legs in the elderly) is prevented by performing Salat and Taraweeh prayers.

Metabolic Effects
Salat improves body weight control and expends calories without a proportionate increase in appetite. A combination of moderate dietary restriction, both at the Iftar and Sahur (early morning breakfast before the start of fast) meals, accompanied by the Taraweeh prayers, should achieve weight reduction. This will also reduce both fat and body weight, but the fat-free weight will remain constant or may even increase slightly. Hence during Ramadan, one should not overeat the Sahur and Iftar meals and continue to perform Salat and Taraweeh prayers in order to lose some of the excess weight.

It is well known that exercise prevents coronary heart disease (CHD), increases high-density lipoproteins (HDL or healthy Cholesterol), increases maximum oxygen uptake, slows the heart, lowers the B.P. slightly, decreases ventricular ectopic activity, enlarges the lumen of the coronary arteries and increases cardiac output.

Exercise also improves carbohydrate tolerance and improves late-onset diabetes, and helps cases of chronic respiratory diseases. Beneficial changes have been recorded in the lipid profile, B.P., clotting factors, weight reduction and insulin sensitivity of muscles and other tissues in persons who exercise regularly. Growth Hormone secretion is elevated by fasting and it is further elevated by Taraweeh prayers. As Growth Hormone is necessary for collagen formation, this may be an important factor as to why the skin of those who fast regularly during Ramadan and perform the Taraweeh prayers do not get wrinkled, even when they grow old.

Mental Health
It is a known fact that exercise improves mood, thought and behaviour. Exercise improves the quality of life, induces a greater sense of well-being and energy, reduces anxiety and depression, influences mood favourably and contributes to self-esteem and an aura of confidence; improves memory in the elderly, especially with constant repetition of the Ayaat (verses) from the Glorious Quran and other Ayaat which exalt His Glory. This constant repetition of the Quranic Ayaat would help to screen the mind from incoming thoughts. It has been found by a Harvard University researcher, Dr Herbert Benson that repetition of a prayer, Ayaat of the Quran or remembrance (Dhikr) of Allah or muscular activity coupled with passive disregard of intensive thoughts causes a “relaxation response” that leads to the lowering of Blood Pressure and decreases in oxygen consumption and a reduction in heart and respiratory rates. All these are combined in the Taraweeh prayer which is an ideal condition for “relaxation response.” It combines repeated muscular activity with repetition of Salat, chanting of words of glorification of Allah and of supplications. The Taraweeh prayer puts the mind in a relaxed state. This calm state of the mind may be partly due to the release of encephalins, beta-endorphins (endogenous morphine) and others into the blood circulation. Endorphins are any one of the neuropeptides composed of many amino acids, elaborated by the pituitary gland and acting on the central and peripheral nervous systems to reduce pain. Endorphins are categorised as alpha-endorphin, beta-endorphin, and gamma-endorphin which produce pharmacologic effects similar to morphine. Beta-endorphin found in the brain and GI(gastrointestinal) tract is the most potent of the endorphins and is a powerful analgesic(pain killer) in humans and animals. For example, during childbirth many women release endorphins reducing a woman’s sensation of pain. The release of endorphins is associated with euphoria. During childbirth, women who give birth with little or no medication sometimes label this euphoria a “birth climax.”

Conclusion
Islam is the only religion where physical movements of Salat and Taraweeh prayers are combined with spiritual exercise. When Salat and Taraweeh prayers are practised throughout a person’s life, recurring every few hours or so, trains a person to undertake the difficult task of meditation during physical manoeuvres of Salat and Taraweeh prayers so that the Namazi(one who performs the Salat) benefits both from spiritual as well as physical exercise. Salat and Taraweeh prayers are unique in that tension builds up in the muscles during physical manoeuvres on the one hand, while tension is relieved in the mind due to the spiritual ingredient, on the other hand. The following benefits have been noted among those who perform the Taraweeh prayers: burning off calories and losing weight, maintaining muscle tone and body composition, joint flexibility (stiff joints are often the result of disuse, not arthritis), increasing metabolic rate, improving circulation, improving heart and lung function and aerobic capacity, decreasing heart disease risk profile, increasing your sense of self-control, reducing your level of stress, increasing your ability to concentrate, improving your appearance, reducing depression and resistance to depression, helping you sleep better and suppressing your appetite. Evidence is also accumulating that those who perform regular Salat along with voluntary prayers can conserve and actually retard the loss of bone mass in the elderly, thus staving off the ravages of osteoporosis that afflicts both men and women. It is also possible to retard the ageing process and confer some protection to health in later life. Those who have performed Salat (Fard and Wajib), Sunnah and Nafl and Taraweeh prayers throughout life get protection and a positive effect in terms of health and longevity. They reverse the life-shortening effects of cigarette smoking and excess body weight. Even people with high blood pressure (a primary heart disease risk) reduced their death rate by one-half and their risk of dying from any of the major diseases is reduced. They also counter genetic tendencies toward an early death.

Hence Salat (Fard, Wajib), Sunnah, Nafl and Taraweeh prayers are necessary for Muslims to preserve life and their desirable qualities into old age.