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RESEARCHED EFFICACY OF YOGA
IN
BRONCHIAL ASTHMA & COPD
Yogacharya
Dr ANANDA BALAYOGI BHAVANANI
MBBS, ADY, PGDFH,PGDY,DSM,DPC, MD (AM), FIAY, C-IAYT
Chairman ICYER @ Ashram & Deputy Director, Centre for Yoga
Therapy, Education and Research (CYTER), Sri Balaji Vidyapeeth,
Pondicherry. Email: ananda@icyer.com
SBV AIM HIGH’s
Centre for Yoga Therapy, Education
and Research (CYTER)
Salutogenesis, our focus!
SBV AIM HIGH’s
Centre for Yoga Therapy, Education
and Research (CYTER)
Salutogenesis, our focus!
• The holistic science of Yoga is the best lifestyle
ever designed and is effective in managing
non-communicable lifestyle disorders
(Bhavanani, 2013).
• Modern research has focused on psycho-
physiological beneficial effects of Yoga which
is more than a mere physical exercise (Jeter et
al, 2015).
• Scientific basis of using Yoga as an adjunct
therapy in chronic obstructive pulmonary
disease (COPD) is well established with
significant improvements in lung function,
quality of life indices and bronchial
provocation responses coupled with
decreased need for regular and rescue
medicinal usage (Nagarathna & Nagendra,
1985; Vempati et al, 2009).
• Behera reported perceptible improvement in
dyspnoea and lung function in patients of
bronchitis after 4 weeks of Yoga therapy that
used a variety of postures and breathing
techniques (Behera, 1998).
• Yogic cleaning techniques such as dhauti kriya
(upper gastrointestinal cleaning with warm
saline or muslin cloth) and neti kriya (warm
saline nasal wash) remove excessive mucous
secretions, decrease inflammation and reduce
bronchial hypersensitivity thereby increasing
provocation threshold while kapalabhati
through forceful exhalations improves the
capacity to exhale against resistance
(Satyaprabha et al, 2001).
• A nonspecific broncho-protective or broncho-
relaxing effect has been also postulated
(Singh, 1987) while
• Improved exercise tolerance reported
following Yoga therapy in patients of chronic
severe airways obstruction (Tandon, 1978).
• It has been reported that well-performed slow
yogic breathing maintains better blood
oxygenation without increasing minute
ventilation,
• reduces sympathetic activation during
altitude-induced hypoxia (Bernardi et al, 2001)
and
• decreased chemoreflex sensitivity to hypoxia
and hypercapnia (Spicuzza et al, 2000).
• Asthmatic patients showed a statistically
significant improvement in Transfer factor of the
lung for carbon monoxide (TLCO), forced vital
capacity (FVC), forced expiratory volume in 1st
sec (FEV1), peak expiratory flow rate (PEFR),
maximum voluntary ventilation (MVV) and slow
vital capacity (SVC) after 2 months of Yoga
practice.
• Quality of life also increased significantly.
• It was concluded that pranayama and Yoga
postures may be used to increase respiratory
stamina, relax the chest muscles, expand the
lungs, raise energy levels, and calm the body
(Singh et al, 2012).
• A study to assess beneficial effects of Yoga in
exercise-induced broncho-constriction in
children aged 7-16y reported that all exercise-
response-positive asthmatics became exercise
response-negative asthmatics after 3 months
of bi-weekly Yoga training (Tahan et al, 2014).
• It was recommended that Yoga training can
supplement drug therapy to achieve better
control of asthma in children.
• In a recent study of 120 non-smoking male
and female patients of asthma in the age
group of 17-50 years, 8 weeks of Yoga
breathing exercises used adjunctively with
standard pharmacological treatment
significantly improved quality of life (Sodhi et
al, 2014).
• Which patients tend to respond to integrative medicine
interventions? (Kligler et al, 2012).
• Responders demonstrated an attitude of "change as
challenge;" a view of themselves as "independent" and
"leaders;" an ability to accept one's illness while still
maintaining a feeling of control over one's choices; a
connection to the deeper context or meaning of
complementary and alternative medicine (CAM)
interventions, as opposed to just "previous experience" of
CAM; and a sense of determination, commitment, and
"willingness to fight" for what one needs from the health
care system.
• Non-responders were more often uncertain and anxious in
their relationship to their asthma, tending to fall back on
denial, and lacking a connection to the deeper context or
philosophy of CAM interventions.
• All of these mechanisms can help bring about
both objective and subjective improvements
in the condition of patients with COPD.
• Yoga as a therapy is also cost effective,
relatively simple and carries minimal risk and
hence should be advocated as an adjunct,
complementary therapy in our search for an
integrated system of medicine capable of
producing health and well being for all.
• However all this optimism needs to be tempered with
the negative findings from a recent systematic review
and meta-analysis that reviewed 14 RCTs with 824
patients (Cramer et al, 2014).
• They concluded that there was no evidence for effects
of Yoga compared with sham Yoga or breathing
exercises and that no effect was robust against all
potential sources of bias.
• They ended by saying, "Yoga cannot be considered a
routine intervention for asthmatic patients at this
point. It can be considered an ancillary intervention or
an alternative to breathing exercises for asthma
patients interested in complementary interventions."
References:
1. Behera D. Yoga therapy in chronic bronchitis. J Assoc Physicians India 1998; 46: 207-8.
2. Bernardi L, Passino C, Wilmerding Vetal. Breathing patterns and cardiovascular autonomic modulation during hypoxia
induced by simulated altitude. J Hypertens 2001; 19 : 947-58
3. Bhavanani AB. Yoga Chikitsa: The application of Yoga as a therapy. Pondicherry, India: Dhivyananda Creations, 2013.
4. Cramer H, Posadzki P, Dobos G, Langhorst J. Yoga for asthma: a systematic review and meta-analysis. Ann Allergy
Asthma Immunol 2014;112(6):503-510.
5. Jeter PE, Slutsky J, Singh N, Khalsa SB. Yoga as a therapeutic intervention: A bibliometric analysis of published
research studies from 1967 to 2013. J Altern Complement Med. 2015;21:586–92.
6. Kligler B, McKee MD, Sackett E, Levenson H, Kenney J, Karasz A. An integrative medicine approach to asthma: who
responds? J Altern Complement Med 2012; 18 (10): 939-45.
7. Nagarathna R, Nagendra HR. Yoga for bronchial asthma: a controlled study. BMJ 1985; 291: 1077-79.
8. Satyaprabha TN, Murthy H, Murthy BTC. Efficacy of naturopathy and Yoga in bronchial asthma - a self controlled
matched scientific study. IJPP 2001; 45: 80-6.
9. Singh S, Soni R, Singh KP, Tandon OP. Effect of Yoga practices on pulmonary function tests including transfer factor of
lung for carbon monoxide (TLCO) in asthma patients. Indian J Physiol Pharmacol 2012; 56 (1):63-8.
10. Singh V. Effect of respiratory exercises on asthma. The Pink City lung exerciser. Journal of Asthma 1987; 24: 355-359.
11. Sodhi C, Singh S, Bery A. Assessment of the quality of life in patients with bronchial asthma, before and after Yoga: a
randomised trial. Iran J Allergy Asthma Immunol 2014;13 (1) :55-60.
12. Spicuzza L, Gabutti A, Porta C, Montano N, Bernardi L. Yoga and chemoreflex response to hypoxia and hypercapnia.
Lancet 2000 ; 356: 1495-96.
13. Tahan F, Eke Gungor H, Bicici E. Is Yoga training beneficial for exercise-induced bronchoconstriction? Altern Ther
Health Med 2014;20 (2):18-23.
14. Tandon M K. Adjunct treatment with Yoga in chronic severe airways obstruction. Thorax 1978; 33: 514-517
15. Vempati R, Bijlani RL, Deepak KK. The efficacy of a comprehensive lifestyle modification programme based on Yoga in
the management of bronchial asthma: a randomized controlled trial. BMC Pulm Med 2009 ; 30; 9:37.
Accredited with ‘A’ grade by NAAC

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RESEARCHED EFFICACY OF YOGA IN BRONCHIAL ASTHMA & COPD

  • 1. RESEARCHED EFFICACY OF YOGA IN BRONCHIAL ASTHMA & COPD Yogacharya Dr ANANDA BALAYOGI BHAVANANI MBBS, ADY, PGDFH,PGDY,DSM,DPC, MD (AM), FIAY, C-IAYT Chairman ICYER @ Ashram & Deputy Director, Centre for Yoga Therapy, Education and Research (CYTER), Sri Balaji Vidyapeeth, Pondicherry. Email: ananda@icyer.com
  • 2. SBV AIM HIGH’s Centre for Yoga Therapy, Education and Research (CYTER) Salutogenesis, our focus!
  • 3. SBV AIM HIGH’s Centre for Yoga Therapy, Education and Research (CYTER) Salutogenesis, our focus!
  • 4. • The holistic science of Yoga is the best lifestyle ever designed and is effective in managing non-communicable lifestyle disorders (Bhavanani, 2013). • Modern research has focused on psycho- physiological beneficial effects of Yoga which is more than a mere physical exercise (Jeter et al, 2015).
  • 5. • Scientific basis of using Yoga as an adjunct therapy in chronic obstructive pulmonary disease (COPD) is well established with significant improvements in lung function, quality of life indices and bronchial provocation responses coupled with decreased need for regular and rescue medicinal usage (Nagarathna & Nagendra, 1985; Vempati et al, 2009).
  • 6. • Behera reported perceptible improvement in dyspnoea and lung function in patients of bronchitis after 4 weeks of Yoga therapy that used a variety of postures and breathing techniques (Behera, 1998).
  • 7. • Yogic cleaning techniques such as dhauti kriya (upper gastrointestinal cleaning with warm saline or muslin cloth) and neti kriya (warm saline nasal wash) remove excessive mucous secretions, decrease inflammation and reduce bronchial hypersensitivity thereby increasing provocation threshold while kapalabhati through forceful exhalations improves the capacity to exhale against resistance (Satyaprabha et al, 2001).
  • 8. • A nonspecific broncho-protective or broncho- relaxing effect has been also postulated (Singh, 1987) while • Improved exercise tolerance reported following Yoga therapy in patients of chronic severe airways obstruction (Tandon, 1978).
  • 9. • It has been reported that well-performed slow yogic breathing maintains better blood oxygenation without increasing minute ventilation, • reduces sympathetic activation during altitude-induced hypoxia (Bernardi et al, 2001) and • decreased chemoreflex sensitivity to hypoxia and hypercapnia (Spicuzza et al, 2000).
  • 10. • Asthmatic patients showed a statistically significant improvement in Transfer factor of the lung for carbon monoxide (TLCO), forced vital capacity (FVC), forced expiratory volume in 1st sec (FEV1), peak expiratory flow rate (PEFR), maximum voluntary ventilation (MVV) and slow vital capacity (SVC) after 2 months of Yoga practice. • Quality of life also increased significantly. • It was concluded that pranayama and Yoga postures may be used to increase respiratory stamina, relax the chest muscles, expand the lungs, raise energy levels, and calm the body (Singh et al, 2012).
  • 11. • A study to assess beneficial effects of Yoga in exercise-induced broncho-constriction in children aged 7-16y reported that all exercise- response-positive asthmatics became exercise response-negative asthmatics after 3 months of bi-weekly Yoga training (Tahan et al, 2014). • It was recommended that Yoga training can supplement drug therapy to achieve better control of asthma in children.
  • 12. • In a recent study of 120 non-smoking male and female patients of asthma in the age group of 17-50 years, 8 weeks of Yoga breathing exercises used adjunctively with standard pharmacological treatment significantly improved quality of life (Sodhi et al, 2014).
  • 13. • Which patients tend to respond to integrative medicine interventions? (Kligler et al, 2012). • Responders demonstrated an attitude of "change as challenge;" a view of themselves as "independent" and "leaders;" an ability to accept one's illness while still maintaining a feeling of control over one's choices; a connection to the deeper context or meaning of complementary and alternative medicine (CAM) interventions, as opposed to just "previous experience" of CAM; and a sense of determination, commitment, and "willingness to fight" for what one needs from the health care system. • Non-responders were more often uncertain and anxious in their relationship to their asthma, tending to fall back on denial, and lacking a connection to the deeper context or philosophy of CAM interventions.
  • 14. • All of these mechanisms can help bring about both objective and subjective improvements in the condition of patients with COPD. • Yoga as a therapy is also cost effective, relatively simple and carries minimal risk and hence should be advocated as an adjunct, complementary therapy in our search for an integrated system of medicine capable of producing health and well being for all.
  • 15. • However all this optimism needs to be tempered with the negative findings from a recent systematic review and meta-analysis that reviewed 14 RCTs with 824 patients (Cramer et al, 2014). • They concluded that there was no evidence for effects of Yoga compared with sham Yoga or breathing exercises and that no effect was robust against all potential sources of bias. • They ended by saying, "Yoga cannot be considered a routine intervention for asthmatic patients at this point. It can be considered an ancillary intervention or an alternative to breathing exercises for asthma patients interested in complementary interventions."
  • 16. References: 1. Behera D. Yoga therapy in chronic bronchitis. J Assoc Physicians India 1998; 46: 207-8. 2. Bernardi L, Passino C, Wilmerding Vetal. Breathing patterns and cardiovascular autonomic modulation during hypoxia induced by simulated altitude. J Hypertens 2001; 19 : 947-58 3. Bhavanani AB. Yoga Chikitsa: The application of Yoga as a therapy. Pondicherry, India: Dhivyananda Creations, 2013. 4. Cramer H, Posadzki P, Dobos G, Langhorst J. Yoga for asthma: a systematic review and meta-analysis. Ann Allergy Asthma Immunol 2014;112(6):503-510. 5. Jeter PE, Slutsky J, Singh N, Khalsa SB. Yoga as a therapeutic intervention: A bibliometric analysis of published research studies from 1967 to 2013. J Altern Complement Med. 2015;21:586–92. 6. Kligler B, McKee MD, Sackett E, Levenson H, Kenney J, Karasz A. An integrative medicine approach to asthma: who responds? J Altern Complement Med 2012; 18 (10): 939-45. 7. Nagarathna R, Nagendra HR. Yoga for bronchial asthma: a controlled study. BMJ 1985; 291: 1077-79. 8. Satyaprabha TN, Murthy H, Murthy BTC. Efficacy of naturopathy and Yoga in bronchial asthma - a self controlled matched scientific study. IJPP 2001; 45: 80-6. 9. Singh S, Soni R, Singh KP, Tandon OP. Effect of Yoga practices on pulmonary function tests including transfer factor of lung for carbon monoxide (TLCO) in asthma patients. Indian J Physiol Pharmacol 2012; 56 (1):63-8. 10. Singh V. Effect of respiratory exercises on asthma. The Pink City lung exerciser. Journal of Asthma 1987; 24: 355-359. 11. Sodhi C, Singh S, Bery A. Assessment of the quality of life in patients with bronchial asthma, before and after Yoga: a randomised trial. Iran J Allergy Asthma Immunol 2014;13 (1) :55-60. 12. Spicuzza L, Gabutti A, Porta C, Montano N, Bernardi L. Yoga and chemoreflex response to hypoxia and hypercapnia. Lancet 2000 ; 356: 1495-96. 13. Tahan F, Eke Gungor H, Bicici E. Is Yoga training beneficial for exercise-induced bronchoconstriction? Altern Ther Health Med 2014;20 (2):18-23. 14. Tandon M K. Adjunct treatment with Yoga in chronic severe airways obstruction. Thorax 1978; 33: 514-517 15. Vempati R, Bijlani RL, Deepak KK. The efficacy of a comprehensive lifestyle modification programme based on Yoga in the management of bronchial asthma: a randomized controlled trial. BMC Pulm Med 2009 ; 30; 9:37.
  • 17. Accredited with ‘A’ grade by NAAC