To study the effect of yoga asana and pranayama on pulmonary function test in chronic obstructive pulmonary disease (copd) patients

Rajkumar Prasad; Rinku Garg; Sanjay Sahay

doi:10.4103/sujhs.sujhs_26_22

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ORIGINAL ARTICLE

Year : 2022 | Volume : 8 | Issue : 2 | Page : 126-129

To study the effect of yoga asana and pranayama on pulmonary function test in chronic obstructive pulmonary disease (copd) patients

Rajkumar Prasad¹, Rinku Garg¹, Sanjay Sahay²
¹ Department of Physiology, Santosh Medical College and Hospital Ghaziabad, Uttar Pradesh, India
² Department of TB and Chest, Santosh Medical College and Hospital Ghaziabad, Uttar Pradesh, India

Date of Submission	14-May-2022
Date of Acceptance	24-Nov-2022
Date of Web Publication	11-Jan-2023

Correspondence Address:
Rajkumar Prasad
Department of Physiologys, Santosh Medical College and Hospital, NCR-Delhi, Ghaziabad, Uttar Pradesh
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sujhs.sujhs_26_22

Abstract

Background: Pranayama is an integral part of yoga training. Pranayama is a regulated breathing practice that improves airway responsiveness. Yoga asana and pranayama have been shown to reduce resting respiratory rate and enhance vital capacity, maximum voluntary ventilation, breath-holding time, maximal inspiratory pressure, and expiratory pressure.
Aim: This study aims to study the effect of yoga, asana, and pranayama on pulmonary function disease (chronic obstructive pulmonary disease [COPD]) patients.
Materials and Methods: This was a prospective observational study which was conducted in the Department of Physiology in association with the Department of Respiratory Medicine Santosh Medical College and Hospital, Ghaziabad, Uttar Pradesh, with a sample size of 55 participants on stable patients diagnosed (COPD) with aged between 40 and 65 years of either sex. Written informed consent and approval from the institutional ethics committee were taken before starting the study. The paired t-test was used to compare the mean and standard deviation of the quantitative variables. When the P < 0.05, the results are statistically significant. To conduct statistical analysis, SPSS 20.0 was used.
Results: We observed a statistically significant increase in forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FVC/FEV1 ratio, and peak expiratory flow rate after 8 and 12 weeks of yoga training compared to the first visit (0 week) baseline before yoga training.
Conclusion: The results of our study showed that the regular practice of yoga, asana, and pranayama for 45 min a day minimum of 3 days a week for 12 weeks showed improvement in pulmonary function tests of COPD patients. It was also concluded that yoga and asana along with pharmacological treatment for COPD patients showed improved breathing patterns and pulmonary function parameters. It was observed that yoga, asana, and pranayama had improved physical condition by reducing weight and body mass index which enhances pulmonary function.

Keywords: Chronic obstructive pulmonary disease, pranayama, pulmonary function test, yoga

How to cite this article:
Prasad R, Garg R, Sahay S. To study the effect of yoga asana and pranayama on pulmonary function test in chronic obstructive pulmonary disease (copd) patients. Santosh Univ J Health Sci 2022;8:126-9

How to cite this URL:
Prasad R, Garg R, Sahay S. To study the effect of yoga asana and pranayama on pulmonary function test in chronic obstructive pulmonary disease (copd) patients. Santosh Univ J Health Sci [serial online] 2022 [cited 2023 May 30];8:126-9. Available from: http://www.sujhs.org/text.asp?2022/8/2/126/367561

Introduction

The term “yoga” refers to the concept of unity. The Sanskrit word “yuj” is the root of the term. To achieve enlightenment, self-realization, and eventually the achievement of God and happiness, it is a path of personal and spiritual growth through meditation. The original purpose of yoga was to achieve samadhi or self-realization.^[1]

The practice of yoga entails pranayama and asana are two yoga practices that work together to keep the body and mind in a stable state. The practice of yoga has been demonstrated to produce long-lasting alterations in the body.

The two words, prana and ayama, make up the word pranayama, which means “the art of controlling.” Prana means “the ability to keep the body alive through the air,” which is another way of saying “breath,” and ayama means “expansion, extension, and control of breath.” In pranayama, breathing exercises such as inhaling, holding your breath, and exhaling are often done along with “Dhyana” (meditation) and “Asana” (physical posture).^[2]

Pranayama is one of the most important parts of yoga training. Pranayama is a form of controlled breathing that helps asthmatics open their airways more easily.^[3]

Yogic asana and pranayama have been shown to slow down breathing at rest, increase vital capacity, and increase maximal voluntary ventilation, breath-holding time, maximal inspiratory pressure, and maximal expiratory pressure. Many studies have shown that long-term yoga practice is good for the way the lungs work.^[4],[5] When people did yoga regularly, their breathing rate went down.

Global initiative for lung disease 2021 defines chronic obstructive pulmonary disease (COPD) as a common, preventable, and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is caused by airway or alveolar abnormalities, which are usually caused by significant exposure to noxious particles or gases and are influenced by host factors, such as abnormal lung development. There is no cure for COPD, which causes permanent blockage of airflow, deterioration of lung function, loss of lung tissue, diminished well-being, and a high death rate.

It has been shown that yoga therapy has a positive impact on lung function and exercise capacity when utilized as an adjuvant to a pulmonary rehabilitation program for COPD patients.^[6] Respiratory function has been the focus of yogic practice research for decades. Yoga helps prevent, treat, and rehabilitate numerous respiratory disorders by enhancing pulmonary ventilation and gas exchange, as well as increasing ventilatory performance. In the 18^th and 19^th centuries,

Yogic breathing exercises are known as pranayama. It is a type of bodily stimulation, in that sense. Adaptation to a recurring stimulus is achieved by consistent pranayama practice. When the sympathetic and parasympathetic neural systems are in balance, breathing is the sole autonomic function that can be consciously regulated. The involuntary neurological system can only be influenced by breathing, i.e., by establishing rhythmic breathing patterns with our voluntary nerves and muscles.^[7] Lung function testing^[8] is a straightforward screening technique that may be conducted using basic equipment.

Materials and Methods

The study design was a prospective observational study which was conducted in the Department of Physiology with the collaboration of the Department of Respiratory Medicine at Santosh Medical College and Hospital in Ghaziabad, Uttar Pradesh, India. The aim was to study the effect of yoga asana and pranayama on pulmonary function test (PFT) in COPD patients with an objective to record and compare the changes in PFT-forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, peak expiratory flow rate (PEFR) in COPD patients before and after the practice of yoga, asana, and pranayama at 0 week (first visit), 8 weeks, and 12 weeks, respectively.

A convenience sample of 55 patients with COPD from the Santosh Medical College Department of Respiratory Medicine was selected by simple random sampling in this research. Written informed consent was acquired from the individuals who agreed to participate in the study. The patients were advised to continue taking their current medication regimen. The benefits of yoga had been discussed with the patient. The patient had a thorough physical examination, including the measurement of their height, weight, and body mass index (BMI). On recruitment of participants, basal PFT was recorded at the first visit followed by 8 weeks and 12 weeks after the practice of yoga. SPSS (statistical package for social sciences version20.0 IBM, USA Developer) was used to examine the data. (COMPUTERISED MEDISOFT EXP'AIR 1.2901 SPIROMETER) was used for conducting PFT before and after yoga therapy. Spirometry is an apparatus for measuring the volume of air inspired and expired by the lungs. A spirometer measures ventilation and the movement of air into and out of the lungs. The spirogram will identify two different types of abnormal ventilation patterns, obstructive and restrictive.
Participants were advised not to smoke 1 h before a spirometry test and also not to wear tight cloth which would have restricted his/her breathing. The participant was made seated in a chair in the examination room and a nose clip was placed on the patient's nose to keep both nostrils closed and cup-like breathing mask was placed around the patient mouth and was instructed to take a deep breath in, hold breath for a few seconds, and then exhale as hard as into the breathing mask.

The test was repeated at least three times to make sure that the results are consistent, if there was a lot of variation between the test's results, the highest value from the three test's readings was used as a result.

Results

The FVC reported as mean standard deviation (SD) at 0 week (first visit) before yoga training improved from 2.48 ± 0.86–2.55 ± 0.85 at 8 weeks (P < 0.001) and 2.56 ± 0.85 at 12 weeks (P < 0.001), which is statistically significant. Similarly, the P value increases from 8 weeks (P < 0.001) to 12 weeks (P < 0.023) after yoga practice as shown in [Table 1].

Table 1: Comparison of the mean and standard deviation of forced vital capacity at 0 week (first visit), at 8 weeks, and at 12 weeks of yoga training

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As depicted in [Table 2], there is a statistically significant rise in FEV1 at 0 week (first visit) before yoga training from 1.70 ± 0.59–1.79 ± 0.61 at 8 weeks (P < 0.001) and to 1.81 ± 0.61 at 12 weeks (P < 0.001). Similarly, the P value after 12 weeks is < 0.001 when compared to 8 weeks.

Table 2: Comparison of forced expiratory volume at 1 s at 0 week (first visit), 8 weeks, and 12 weeks after yoga training

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As shown in [Table 3], there is a substantial rise in the FEV1/FVC ratio reported as the mean SD from 69.98 ± 9.46–70.77 ± 8.86 at 8 weeks and 71.55 ± 8.97 at 12 weeks following yoga training. It is also worth noting that the P value at 12 weeks is lower than at 8 weeks.

Table 3: Mean and standard deviation of forced expiratory volume at 1 s/forced vital capacity at first visit, 8 weeks, and 12 weeks after yoga training

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As depicted in [Table 4] when compared to 0 week, the rise in PEFR represented as a mean SD rose from 4.13 ± 2.03 at the first visit to 4.41 ± 2.03 at 8 weeks (P < 0.029) and 4.46 ± 2.01 at 12 weeks (P = 0.029). When compared to the 8-week mark, the P = 0.029 remains unchanged after 12 weeks.

Table 4: Comparison of peak expiratory flow rate at first visit (0 week), 8 weeks, and 12 weeks after yoga training

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Discussion

COPD is a chronic progressive illness that is one of the top causes of death globally, particularly in India. As the disease advances, the patient's lung function declines, causing inactivity. Inactivity causes COPD to worsen by weakening the body's muscles.^[9] The psychophysiological advantage of pranayama is increased stress management and decreased autonomic arousal variables.^[10] Yoga promotes parasympathetic over sympathetic autonomic balance. Yoga reduces sympathetic reactivity (blood pressure, heart rate, and respiration) by readjusting autonomic imbalance and controlling breathing.^[11]

Pranayama is the art of controlling one's breathing; anulom vilom pranayama is an act of focusing on one's breathing that leads to concentration. These actions of focus divert the individual's attention away from worry and tension. This stress-free mental state produces calm responses.^[12],[13] There are several techniques to change breathing in pranayama, including varying the pace and depth, holding the breath, breathing through the mouth, and alternating breathing through one or both nostrils. In Sanskrit, these consciously controlled yoga breathing methods are known as pranayama. The use of oxygen increases during pranayama.^[14]

We examined the impact of 12 weeks of yoga instruction on PFTs in COPD patients. The research included 55 patients, 29 male and 26 female, aged 40–65 years. Participants returned to out patient department (OPD) for PFT after 8 and 12 weeks of yoga practice. After the baseline PFT (FVC, FEV1, FEV1/FVC, and PEFR) recording, individuals were treated to yoga asanas and pranayama practice. Participants learned shavasana, shashankasana, and bhramari, anulom vilom, and kapalabhati. The following asanas and pranayamas were done for 45 min, 3 times a week, for 12 weeks. The lung function test was compared 8 weeks and 12 weeks after yoga. Yoga training may enhance FVC, FEV1, FEV1/FVC, and PEFR by statistically significant amounts. The current study's findings were compared to earlier findings.

Although COPD cannot be cured, it may be managed. Pulmonary rehabilitation has been shown to enhance lung function and quality of life in patients with COPD. Yogic breathing patterns may be altered and respiratory symptoms improved when used in conjunction with standard pharmaceutical treatment. After 4 weeks of adjunct yoga treatment, the FVC and the FEV1 of 72 COPD patients studied by Soccalingam et al. in 2018 improved significantly.^[15]

According to Venugopal et al., improvements in the FEV1 percent, FVC, and FEV1/FVC across the preyoga to 1-month and preyoga to 2-month periods were statistically significant at P = 0.05.^[16]

It was also shown that yoga therapy had a significant impact on FEV1 (P = 0.001). Rehabilitation facilities at the hospital, regardless of specialty, are essential.^[17]

According to the current research, adding yoga asana and pranayama as a supplemental treatment improves the physical condition by lowering weight and bmi, and therefore, improves pulmonary function through FVC, FEV1/FVC, and PEFR. We found a statistically significant increase in FVC, FEV1, FVC/FEV1 ratio, and PEFR following 8 and 12 weeks of yoga training compared to the baseline record before yoga training at 0 week (first visit).

Conclusion

Following has been concluded from the study

The practice of yoga asana and pranayama for 45 min, three times a week for 12 weeks showed to improve the various PFT parameters FVC, FEV1, FEV1/FVC, and PEFR
Yoga, asana, and pranayama exercises, when used adjunctively with standard pharmacological treatment and pulmonary rehabilitation had improved breathing pattern and pulmonary function parameters FVC, FEV1, FEV1/FVC, and PEFR in COPD patients
The complementary therapy of yoga, asana, and pranayama showed improvement in physical condition by reducing weight and BMI which enhanced pulmonary function through parameters.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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