Effect of Yoga as an Adjunctive Therapy on the Respiratory Function of COPD Patients with mild to Severe Grades of Severity in a Tertiary Care Centre in Kerala

Introduction: Chronic obstructive pulmonary disease(COPD) being a major public health problem, pulmonaryrehabilitation along with pharmacotherapy can give betterresults while managing COPD. Almost no studies have beendone to assess the relationship between effect of yoga as anadjunctive therapy on respiratory function in COPD patientsespecially in south India. This study was an attempt to knowthe effect of selected Yogic practices on improving respiratoryfunction.Material and methods: A total of 30 cases of mild, moderateand severe grades of COPD defined as per Global Initiative forobstructive lung disease (GOLD) guidelines were recruitedin this study. The sample size was taken as 30. All selectedsubjects were assessed for spirometric evaluation, Maximuminspiratory pressure MIP (or PImax) and Maximal expiratorypressure MEP (or PEmax). Patients were taught selected yogaexercises for 1 hour, thrice a week for one month by a certifiedyoga therapist. Thereafter, patients were asked to practice athome in the morning for two months.Statistical analysis was performed using a statistical softwarepackage SPSS version 20.0. Comparison of pre-yoga andpost-yoga assessment of respiratory function at the end of eachmonth for two months was done. Continuous variables wereexpressed as Mean±SD. Effect of yoga on selected parametersat different interval of time were assessed by paired t test.P<0.05 was taken to be statistically significant.Results: FEV1%, PEFR, FVC, FEV1/FVC, showed anincreasing trend over time from pre-yoga to 1 month and preyoga to 2 month, among which FEV1% and FEV1/FVC wasstatistically significant at p <0.05. Likewise, variables PEFRalso showed a significant increase from pre- yoga to end of2nd month (p<0.05).Conclusion: yoga practices is suggestive of improvingrespiratory function in COPD patients when used adjunctivelywith standard pharmacological treatment.

Immediate cardiovascular effects of pranava pranayama in hypertensive patients.

Slow, deep, pranayama - based breathing training has been shown to be effective in reducing blood pressure (BP). The present study was undertaken to determine immediate effects of performing pranava pranayama on cardiovascular parameters in hypertensive patients. 29 hypertensive patients who were on medical treatment and also attending yoga sessions were recruited for the present study. Supine heart rate (HR) and BP were recorded before and after performance of pranava pranayama for five minutes. Post intervention statistical analysis revealed a significant (P<0.05) reduction in systolic pressure (SP) and a more significant (P<0.01) reduction in HR, pulse pressure and double product (Do P). The reduction in rate-pressure product (RPP) was highly significant (P<0.001). Pranava pranayama is effective in reducing HR and SP in hypertensive patients within five minutes of the practice. This may be due to a normalization of autonomic cardiovascular rhythms as a result of increased vagal modulation and/or decreased sympathetic activity and improved baroreflex sensitivity along with an augmentation of endogenous nitric oxide production. Our findings have potential therapeutic applications in day-to-day as well as clinical situations where blood pressure needs to be brought down at the earliest. The significant fall in RPP and Do P signifies a reduction in oxygen consumption and work done by the heart. It is concluded that pranava pranayama, a simple and cost effective technique can be used in the management of hypertensive patients in addition to the regular medical management. Further studies are required to enable a deeper understanding of the mechanisms involved and its usefulness in the long- term management of hypertension.

Integrated approach to yoga therapy and autism spectrum disorders.

A specially designed Integrated Approach to Yoga Therapy module was applied to Autism Spectrum Disorders over a period of two academic years. Despite low numbers (six in each arm), consistency and magnitude of effects make the findings significant. Parental participation, allowing firm guidance to be given to each child, resulted in significant improvements in imitation and other skills, and in behavior at home and family relationships. We hypothesize that guided imitation of therapist body positions stimulated mirror neuron activation, resulting in improved sense of self.