1 1867 160 RANDOMIZED TRIAL OF YOGA AS A COMPLEMENTARY THERAPY FOR PULMONARY TUBERCULOSIS. OBJECTIVE: THE PRESENT PROSPECTIVE, RANDOMIZED TRIAL COMPARED THE EFFICACY OF ANTI-TUBERCULOSIS TREATMENT (ATT) WITH TWO SEPARATE PROGRAMS (YOGA AND BREATH AWARENESS), ON LUNG CAPACITIES AND BACTERIOLOGICAL STATUS IN PULMONARY TUBERCULOSIS PATIENTS. METHODOLOGY: A TOTAL OF 1009 PULMONARY TUBERCULOSIS PATIENTS WERE SCREENED AND 73 WERE ALTERNATELY ALLOCATED, TO YOGA (N = 36) OR BREATH AWARENESS (N = 37) GROUPS, WITH 48 PATIENTS COMPLETING THE 2-MONTH TRIAL. PATIENTS AGED BETWEEN 20 AND 55 YEARS, WHO WERE SPUTUM-POSITIVE ON THREE CONSECUTIVE EXAMINATIONS, HAD NO PRIOR ATT, AND NO COMORBIDITIES OR EXTRAPULMONARY TUBERCULOSIS WERE INCLUDED. IN ADDITION TO ATT, ONE GROUP PRACTISED YOGA (N = 25) AND THE OTHER PRACTISED BREATH AWARENESS (N = 23) FOR 6 H PER WEEK, EACH SESSION BEING 60 MIN. THE MAIN OUTCOME MEASURES WERE: SYMPTOM SCORES, BODYWEIGHT, FVC, FEV(1), FEV(1)/FVC%, SPUTUM MICROSCOPY, SPUTUM CULTURE, AND POSTERO-ANTERIOR VIEW OF THE CXR. RESULTS: AT THE END OF 2 MONTHS, THE YOGA GROUP SHOWED A SIGNIFICANT REDUCTION IN SYMPTOM SCORES (88.1%), AND AN INCREASE IN WEIGHT (10.9%), FVC (64.7%) AND FEV(1) (83.6%) (P = 0.001, IN ALL COMPARISONS, PAIRED T-TEST). THE BREATH AWARENESS GROUP ALSO SHOWED A SIGNIFICANT (PAIRED T-TEST) REDUCTION IN SYMPTOM SCORES (16.3%, P= 0.02), AND AN INCREASE IN WEIGHT (2.1%, P= 0.003) AND FEV(1) (63.8%, P= 0.04). SIGNIFICANTLY MORE PATIENTS IN THE YOGA GROUP SHOWED SPUTUM CONVERSION BASED ON MICROSCOPY ON DAYS 30 AND 45 COMPARED TO THE BREATH AWARENESS GROUP (P = 0.045 AND P= 0.002, RESPECTIVELY, CHI(2) TEST). TEN OF 13 IN THE YOGA GROUP HAD NEGATIVE SPUTUM CULTURE AFTER 60 DAYS COMPARED WITH FOUR OF 19 IN THE BREATH AWARENESS GROUP (P = 0.005, CHI(2) TEST). IMPROVEMENT IN THE RADIOGRAPHIC PICTURE OCCURRED IN 16/25 IN THE YOGA GROUP COMPARED TO 3/22 IN THE BREATH AWARENESS GROUP ON DAY 60 (P = 0.001, CHI(2) TEST). CONCLUSIONS: THE IMPROVED LEVEL OF INFECTION, RADIOGRAPHIC PICTURE, FVC, WEIGHT GAIN AND REDUCED SYMPTOMS IN THE YOGA GROUP SUGGEST A COMPLEMENTARY ROLE FOR YOGA IN THE MANAGEMENT OF PULMONARY TUBERCULOSIS. 2004 2 2446 22 YOGA AND TAI CHI: A MIND-BODY APPROACH IN MANAGING RESPIRATORY SYMPTOMS IN OBSTRUCTIVE LUNG DISEASES. PURPOSE OF REVIEW: CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) IS CHARACTERIZED BY AIRFLOW LIMITATION BECAUSE OF AIRWAY AND/OR ALVEOLAR ABNORMALITIES. SYMPTOMS INCLUDE DYSPNEA, COUGH, CHRONIC SPUTUM PRODUCTION. AS THE THIRD-RANKED CAUSE OF DEATH AS WELL AS DISABILITY-ADJUSTED LIFE YEARS (DALYS), IT POSES A SIGNIFICANT BURDEN ON PATIENTS, FAMILIES, HEALTHCARE SYSTEM AND SOCIETY. REGULAR PHYSICAL ACTIVITY IS LINKED TO DECREASE IN MORBIDITY AND MORTALITY ASSOCIATED WITH COPD, BUT IMPLEMENTATION REMAINS CHALLENGING. THERE IS A NEED FOR COMMUNITY-BASED INTERVENTIONS THAT PROMOTE PHYSICAL ACTIVITY. YOGA AND TAI CHI ARE WIDELY AVAILABLE IN THE COMMUNITY AND HAVE BEEN SHOWN TO BE BENEFICIAL IN PATIENTS WITH COPD AS WELL AS MANY OF THE CO-MORBID CONDITIONS ASSOCIATED WITH COPD. RECENT FINDINGS: YOGA AND TAI CHI HAVE BEEN FOUND TO BE MORE EFFECTIVE THAN USUAL CARE IN COPD WITH CLINICALLY MEANINGFUL IMPROVEMENTS IN 6-MIN WALK DISTANCE (6MWD), FORCED EXPIRATORY VOLUME IN 1 S (FEV1), AND HEALTH-RELATED QUALITY OF LIFE (HRQOL). THEY HAVE ALSO BEEN FOUND TO BE COMPARABLE TO PULMONARY REHABILITATION INTERVENTIONS. SUMMARY: YOGA AND TAI CHI PROVIDE COMMUNITY-BASED OPTIONS FOR PATIENTS WITH COPD TO IMPROVE THEIR PHYSICAL ACTIVITY, QUALITY OF LIFE, AND PULMONARY FUNCTION. 2020 3 2870 38 YOGA-BASED PULMONARY REHABILITATION FOR THE MANAGEMENT OF DYSPNEA IN COAL MINERS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: COAL MINE DUST EXPOSURE CAUSES CHRONIC AIRFLOW LIMITATION IN COAL MINERS RESULTING IN DYSPNEA, FATIGUE, AND EVENTUALLY CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). YOGA CAN ALLEVIATE DYSPNEA IN COPD BY IMPROVING VENTILATORY MECHANICS, REDUCING CENTRAL NEURAL DRIVE, AND PARTIALLY RESTORING NEUROMECHANICAL COUPLING OF THE RESPIRATORY SYSTEM. OBJECTIVES: TO EVALUATE THE EFFECTIVENESS OF INTEGRATED APPROACH OF YOGA THERAPY (IAYT) IN THE MANAGEMENT OF DYSPNEA AND FATIGUE IN COAL MINERS WITH COPD. MATERIALS AND METHODS: RANDOMIZED, WAITLIST CONTROLLED, SINGLE-BLIND CLINICAL TRIAL. EIGHTY-ONE COAL MINERS (36-60 YEARS) WITH STABLE STAGES II AND III COPD WERE RECRUITED. THE YOGA GROUP RECEIVED AN IAYT MODULE FOR COPD THAT INCLUDED ASANAS, LOOSENING EXERCISES, BREATHING PRACTICES, PRANAYAMA, CYCLIC MEDITATION, YOGIC COUNSELING AND LECTURES 90 MIN/DAY, 6 DAYS/WEEK FOR 12 WEEKS. MEASUREMENTS OF DYSPNEA AND FATIGUE ON THE BORG SCALE, EXERCISE CAPACITY BY THE 6 MIN WALK TEST, PERIPHERAL CAPILLARY OXYGEN SATURATION (SPO2%), AND PULSE RATE (PR) USING PULSE OXIMETRY WERE MADE BEFORE AND AFTER THE INTERVENTION. RESULTS: STATISTICALLY SIGNIFICANT WITHIN GROUP REDUCTIONS IN DYSPNEA (P < 0.001), FATIGUE (P < 0.001) SCORES, PR (P < 0.001), AND SIGNIFICANT IMPROVEMENTS IN SPO2% (P < 0.001) AND 6 MIN WALK DISTANCE (P < 0.001) WERE OBSERVED IN THE YOGA GROUP; ALL EXCEPT THE LAST WERE SIGNIFICANT COMPARED TO CONTROLS (P < 0.001). CONCLUSIONS: FINDINGS INDICATE THAT IAYT BENEFITS COAL MINERS WITH COPD, REDUCING DYSPNEA; FATIGUE AND PR, AND IMPROVING FUNCTIONAL PERFORMANCE AND PERIPHERAL CAPILLARY SPO2%. YOGA CAN NOW BE INCLUDED AS AN ADJUNCT TO CONVENTIONAL THERAPY FOR PULMONARY REHABILITATION PROGRAMS FOR COPD PATIENTS. 2016 4 2787 38 YOGA THERAPY DECREASES DYSPNEA-RELATED DISTRESS AND IMPROVES FUNCTIONAL PERFORMANCE IN PEOPLE WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A PILOT STUDY. BACKGROUND: THERE HAS BEEN LIMITED STUDY OF YOGA TRAINING AS A COMPLEMENTARY EXERCISE STRATEGY TO MANAGE THE SYMPTOM OF DYSPNEA IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). PURPOSE: THE PRIMARY PURPOSE OF THIS PILOT STUDY WAS TO EVALUATE A YOGA PROGRAM FOR ITS SAFETY, FEASIBILITY, AND EFFICACY FOR DECREASING DYSPNEA INTENSITY (DI) AND DYSPNEA-RELATED DISTRESS (DD) IN OLDER ADULTS WITH COPD. METHODS: CLINICALLY STABLE PATIENTS WITH COPD (N = 29; AGE 69.9 +/- 9.5; FORCED EXPIRATORY VOLUME IN 1 SECOND (FEV(1)) 47.7 +/- 15.6% PREDICTED; FEMALE = 21) WERE RANDOMIZED TO A 12-WEEK YOGA PROGRAM SPECIFICALLY DESIGNED FOR PEOPLE WITH COPD OR USUAL-CARE CONTROL (UC). THE TWICE-WEEKLY YOGA PROGRAM INCLUDED ASANAS (YOGA POSTURES) AND VISAMA VRITTI PRANAYAMA (TIMED BREATHING). SAFETY MEASURE OUTCOMES INCLUDED HEART RATE, OXYGEN SATURATION, DYSPNEA, AND PAIN. FEASIBILITY WAS MEASURED BY PATIENT-REPORTED ENJOYMENT, DIFFICULTY, AND ADHERENCE TO YOGA SESSIONS. AT BASELINE AND AT 12 WEEKS, DI AND DD WERE MEASURED DURING INCREMENTAL CYCLE ERGOMETRY AND A 6-MINUTE WALK (6MW) TEST. SECONDARY EFFICACY OUTCOMES INCLUDED PHYSICAL PERFORMANCE, PSYCHOLOGIC WELL-BEING, AND HEALTH-RELATED QUALITY OF LIFE (HRQOL). RESULTS: YOGA TRAINING WAS SAFE AND FEASIBLE FOR PATIENTS WITH COPD. WHILE YOGA TRAINING HAD ONLY SMALL EFFECTS ON DI AFTER THE 6MW TEST (EFFECT SIZE [ES], 0.20; P = 0.60), THERE WERE GREATER REDUCTIONS IN DD IN THE YOGA GROUP COMPARED TO UC (ES, 0.67; P = 0.08). YOGA TRAINING ALSO IMPROVED 6MW DISTANCE (+71.7 +/- 21.8 FEET VERSUS -27.6 +/- 36.2 FEET; ES = 0.78, P = 0.04) AND SELF-REPORTED FUNCTIONAL PERFORMANCE (ES = 0.79, P = 0.04) COMPARED TO UC. THERE WERE SMALL POSITIVE CHANGES IN MUSCLE STRENGTH AND HRQOL. CONCLUSIONS: ELDERLY PATIENTS WITH COPD PARTICIPATED SAFELY IN A 12-WEEK YOGA PROGRAM ESPECIALLY DESIGNED FOR PATIENTS WITH THIS CHRONIC ILLNESS. AFTER THE PROGRAM, THE SUBJECTS TOLERATED MORE ACTIVITY WITH LESS DD AND IMPROVED THEIR FUNCTIONAL PERFORMANCE. THESE FINDINGS NEED TO BE CONFIRMED IN A LARGER, MORE SUFFICIENTLY POWERED EFFICACY STUDY. 2009 5 1139 24 EFFICACY OF YOGA TRAINING IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS. OBJECTIVES: TO EVALUATE THE IMPACT OF YOGA TRAINING IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). METHOD: A LITERATURE SEARCH WAS PERFORMED IN PUBMED, COCHRANE LIBRARY, EMBASE, CINAHL, AND WEB OF SCIENCE FOR RELEVANT STUDIES PUBLISHED BEFORE JUNE 2017. QUALITY ASSESSMENT, SENSITIVITY ANALYSIS AND HETEROGENEITY WERE PERFORMED. STATA12.0 SOFTWARE WAS USED FOR STATISTICAL ANALYSIS. RESULTS: TEN STUDIES WERE ELIGIBLE FOR THIS ANALYSIS. THERE WERE SIGNIFICANTLY GREATER IMPROVEMENTS IN 6MWD (P = 0.000), BORG SCALE SCORES (P = 0.018), FEV1 VALUE (P = 0. 013), PACO2 (P = 0.037), SGRQ SCORES (P = 0. 000) AND CAT SCORES (P = 0.009) IN YOGA TRAINING PATIENTS. NO STATISTICALLY SIGNIFICANT DIFFERENCE WAS OBSERVED IN THE FEV1/FVC (P = 0.75), FEV1 PREDICTED VALUE (P = 0.057) AND FVC (P = 0.05). CONCLUSIONS: THIS META-ANALYSIS INDICATES THAT YOGA TRAINING CAN BE AN ACCEPTABLE AND APPROPRIATED ADJUNCTIVE REHABILITATION PROGRAM FOR COPD PATIENTS. 2018 6 214 34 A STUDY OF THE EFFECT OF YOGA TRAINING ON PULMONARY FUNCTIONS IN PATIENTS WITH BRONCHIAL ASTHMA. THE ROLE OF YOGA BREATHING EXERCISES, AS AN ADJUNCT TREATMENT FOR BRONCHIAL ASTHMA IS WELL RECOGNIZED. ONE HUNDRED TWENTY PATIENTS OF ASTHMA WERE RANDOMIZED INTO TWO GROUPS I.E GROUP A (YOGA TRAINING GROUP) AND GROUP B (CONTROL GROUP). EACH GROUP INCLUDED SIXTY PATIENTS. PULMONARY FUNCTION TESTS WERE PERFORMED ON ALL THE PATIENTS AT BASELINE, AFTER 4 WEEKS AND THEN AFTER 8 WEEKS. MAJORITY OF THE SUBJECTS IN THE TWO GROUPS HAD MILD DISEASE (34 PATIENTS IN GROUP A AND 32 IN GROUP B). GROUP A SUBJECTS SHOWED A STATISTICALLY SIGNIFICANT INCREASING TREND (P < 0.01) IN % PREDICTED PEAK EXPIRATORY FLOW RATE (PEFR), FORCED EXPIRATORY VOLUME IN THE FIRST SECOND (FEV1), FORCED VITAL CAPACITY (FVC), FORCED MID EXPIRATORY FLOW IN 0.25-0.75 SECONDS (FEF25-75) AND FEV1/FVC% RATIO AT 4 WEEKS AND 8 WEEKS AS COMPARED TO GROUP B. THUS, YOGA BREATHING EXERCISES USED ADJUNCTIVELY WITH STANDARD PHARMACOLOGICAL TREATMENT SIGNIFICANTLY IMPROVES PULMONARY FUNCTIONS IN PATIENTS WITH BRONCHIAL ASTHMA. 2009 7 1059 43 EFFECTS OF YOGA ON EXERCISE CAPACITY IN PATIENTS WITH LYMPHANGIOLEIOMYOMATOSIS: A NONRANDOMIZED CONTROLLED STUDY. OBJECTIVE: TO EVALUATE THE EFFECTS OF YOGA ON EXERCISE CAPACITY AND QUALITY OF LIFE IN PATIENTS WITH LYMPHANGIOLEIOMYOMATOSIS (LAM), A RARE CYSTIC LUNG DISEASE IN WOMEN. PATIENTS AND METHODS: THIS WAS A NONRANDOMIZED, CONTROLLED STUDY CONDUCTED IN BEIJING, CHINA (AUGUST 27, 2017 - APRIL 26, 2018). TWENTY-SIX PARTICIPANTS WERE ALLOCATED TO THE INTERVENTION (YOGA) GROUP (N = 13) OR CONTROL GROUP (N = 13). THE YOGA INTERVENTION INVOLVED A 24-WEEK PROGRAM OF YOGA CLASS TRAINING FOR 90 MIN ONCE A WEEK AND NO FEWER THAN 2 AT-HOME SESSIONS PER WEEK (AT LEAST 15 MIN PER SESSION). THE 6-MIN WALKING DISTANCE (6MWD), LUNG FUNCTION, SERUM VASCULAR ENDOTHELIAL GROWTH FACTOR-D (VEGF-D) LEVELS, QUALITY OF LIFE, AND SYMPTOMS OF ANXIETY AND DEPRESSION WERE MEASURED AT BASELINE, 12-WEEK AND 24-WEEK FOLLOW-UP. AN INCREMENTAL CARDIOPULMONARY EXERCISE TEST WAS CONDUCTED AT BASELINE AND THE 24-WEEK FOLLOW-UP. RESULTS: ELEVEN PATIENTS COMPLETED THE YOGA TRAINING PROGRAM. THE YOGA GROUP EXHIBITED IMPROVEMENTS IN THE FOLLOWING OUTCOMES VERSUS THOSE OF THE CONTROL GROUP: 6MWD (+ 55 +/- 29 M VS + 18 +/- 49 M, P = 0.04), ANAEROBIC THRESHOLD (3.4 +/- 2.4 ML/MIN/KG VS 1.6 +/- 1.4 ML/MIN/KG, P = 0.035) AND PEAK WORK LOAD (11.7 +/- 14.6 W VS 0.2 +/- 9.1 W, P = 0.027). THERE WAS NO SIGNIFICANT DIFFERENCE IN PEAK OXYGEN CONSUMPTION (VO2PEAK), LUNG FUNCTION, VEGF-D LEVEL, AND QUALITY OF LIFE BETWEEN THE YOGA AND CONTROL GROUPS. NO ADVERSE EFFECTS WERE FOUND IN THE YOGA GROUP. CONCLUSION: YOGA IS A FEASIBLE AND SAFE INTERVENTION FOR PULMONARY REHABILITATION AND POTENTIALLY IMPROVES EXERCISE CAPACITY IN PATIENTS WITH LAM. TRIAL REGISTRATION: (CLINICAL TRIAL REGISTRATION NUMBER AT WWW.CHICTR.ORG.CN: CHICTR-OON-1701274). 2020 8 786 40 EFFECT OF YOGA BREATHING (PRANAYAMA) ON EXERCISE TOLERANCE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A RANDOMIZED, CONTROLLED TRIAL. OBJECTIVE: PULMONARY REHABILITATION IMPROVES EXERCISE TOLERANCE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD). HOWEVER, MANY PATIENTS DO NOT HAVE ACCESS TO PULMONARY REHABILITATION PROGRAMS. WE HYPOTHESIZED THAT AN ALTERNATIVE TO PULMONARY REHABILITATION TO IMPROVE EXERCISE TOLERANCE IS THE PRACTICE OF PRANAYAMA, OR YOGA BREATHING, WHICH COULD BE DONE INDEPENDENTLY AT HOME. WE ALSO SOUGHT TO DETERMINE WHETHER YOGA NONPROFESSIONALS COULD ADEQUATELY TEACH PRANAYAMA TO PATIENTS. DESIGN: PROOF-OF-CONCEPT, RANDOMIZED, DOUBLE-BLIND, CONTROLLED PILOT TRIAL. SETTINGS/LOCATION: TWO ACADEMIC PULMONARY PRACTICES. SUBJECTS: FORTY-THREE PATIENTS WITH SYMPTOMATIC, MODERATE-TO-SEVERE COPD. INTERVENTIONS: TWELVE WEEKS OF PRANAYAMA PLUS EDUCATION VERSUS EDUCATION ALONE. TWO YOGA PROFESSIONALS TRAINED THE RESEARCH COORDINATORS TO CONDUCT ALL PRANAYAMA TEACHING AND MONITORED THE QUALITY OF THE TEACHING AND THE PRACTICE OF PRANAYAMA BY STUDY PARTICIPANTS. OUTCOME MEASURES: THE PRIMARY OUTCOME WAS A CHANGE IN THE 6-MIN WALK DISTANCE (6MWD). SECONDARY OUTCOMES INCLUDED CHANGES IN LUNG FUNCTION, MARKERS OF OXIDATIVE STRESS AND SYSTEMIC INFLAMMATION, AND MEASURES OF DYSPNEA AND QUALITY OF LIFE. RESULTS: THE 6MWD INCREASED IN THE PRANAYAMA GROUP (LEAST SQUARE MEAN [95% CONFIDENCE INTERVAL] = 28 M [-5 TO 61]) AND DECREASED IN THE CONTROL GROUP (-15 M [-47 TO 16]), WITH A NEARLY SIGNIFICANT TREATMENT EFFECT (P = 0.06) IN FAVOR OF PRANAYAMA. PRANAYAMA ALSO RESULTED IN SMALL IMPROVEMENTS IN INSPIRATORY CAPACITY AND AIR TRAPPING. BOTH GROUPS HAD SIGNIFICANT IMPROVEMENTS IN VARIOUS MEASURES OF SYMPTOMS, BUT NO OVERALL DIFFERENCES IN RESPIRATORY SYSTEM IMPEDANCE OR MARKERS OF OXIDATIVE STRESS OR SYSTEMIC INFLAMMATION. CONCLUSION: THIS PILOT STUDY SUCCESSFULLY DEMONSTRATED THAT PRANAYAMA WAS ASSOCIATED WITH IMPROVED EXERCISE TOLERANCE IN PATIENTS WITH COPD. LAY PERSONNEL WERE ABLE TO ADEQUATELY TEACH PATIENTS TO PRACTICE PRANAYAMA. THESE RESULTS SUGGEST THAT PRANAYAMA MAY HAVE SIGNIFICANT CLINICAL BENEFITS FOR SYMPTOMATIC PATIENTS WITH COPD, A CONCEPT THAT NEEDS TO BE CONFIRMED IN FUTURE, LARGER CLINICAL TRIALS. 2017 9 792 35 EFFECT OF YOGA IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE. YOGA IS ADJUNCTIVELY UTILIZED OUTSIDE THE UNITED STATES IN THE TREATMENT OF A VARIETY OF DISEASES, INCLUDING CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), BUT THERE ARE NO STUDIES ASSESSING ITS ADJUNCTIVE EFFICACY IN THE UNITED STATES. WE PROSPECTIVELY EVALUATED THE EFFECTS OF YOGA TRAINING ON THE QUALITY OF LIFE (QOL) AND THE PARAMETERS OF LUNG FUNCTION IN PATIENTS WITH COPD. THIRTY-THREE PATIENTS WITH DOCUMENTED COPD, PER GLOBAL INITIATIVE FOR OBSTRUCTIVE LUNG DISEASE CRITERIA, WERE RECRUITED. ALL PATIENTS RECEIVED STANDARD COPD CARE. THE QOL WAS ASSESSED BY THE ST. GEORGE RESPIRATORY QUESTIONNAIRE. STANDARD SPIROMETRY AND MAXIMUM INSPIRATORY (MAXIMAL INSPIRATORY PRESSURE) AND EXPIRATORY PRESSURE (MAXIMAL EXPIRATORY PRESSURE) WERE MEASURED. PATIENTS WERE TAUGHT SELECTED YOGA EXERCISES INCLUDING BREATHING EXERCISES, MEDITATION, AND YOGA POSTURES FOR 1 HOUR, THRICE A WEEK FOR 6 WEEKS BY A CERTIFIED YOGA THERAPIST. THE QUALITY OF LIFE AND LUNG FUNCTION WERE AGAIN ASSESSED AT THE END OF 6 WEEKS. TWENTY-TWO PATIENTS COMPLETED THE STUDY. DIFFERENCES IN PREYOGA VERSUS POSTYOGA SCORES WERE EVALUATED USING PAIRED T-TESTS. STATISTICALLY SIGNIFICANT IMPROVEMENTS (P < 0.05) WERE OBSERVED FOR THE ST. GEORGE RESPIRATORY QUESTIONNAIRE [95% CONFIDENCE INTERVAL (CI) 43.13-58.47], VITAL CAPACITY (95% CI 2.53-7.65), MAXIMAL INSPIRATORY PRESSURE (95% CI 6.62-23.64), AND MAXIMAL EXPIRATORY PRESSURE (95% CI 1.63-13.81). YOGA WHEN PRACTICED BY PATIENTS WITH COPD RESULTS IN IMPROVEMENT IN THE QOL AND LUNG FUNCTION ON A SHORT-TERM BASIS. ADDITIONAL RESEARCH IS NEEDED TO CONFIRM THESE FINDINGS IN A RANDOMIZED CONTROLLED TRIAL AND IN THE LONGER TERM. 2012 10 190 35 A RANDOMIZED STUDY OF YOGA THERAPY FOR THE PREVENTION OF RECURRENT REFLEX VASOVAGAL SYNCOPE. AIMS: VASOVAGAL SYNCOPE (VVS) IS A COMMON CARDIOVASCULAR DYSAUTONOMIC DISORDER THAT SIGNIFICANTLY IMPACTS HEALTH AND QUALITY OF LIFE (QOL). YOGA HAS BEEN SHOWN TO HAVE A POSITIVE INFLUENCE ON CARDIOVASCULAR AUTONOMICS. THIS STUDY ASSESSED THE EFFECTIVENESS OF YOGA THERAPY ON THE RECURRENCE OF VVS AND QOL. METHODS AND RESULTS: WE RANDOMIZED SUBJECTS WITH RECURRENT REFLEX VVS (>3 EPISODES IN THE PAST 1 YEAR) AND POSITIVE HEAD-UP TILT TEST TO GUIDELINE-DIRECTED THERAPY (GROUP 1) OR YOGA THERAPY (GROUP 2). PATIENTS IN GROUP 1 WERE ADVISED GUIDELINE-DIRECTED TREATMENT AND GROUP 2 WAS TAUGHT YOGA BY A CERTIFIED INSTRUCTOR. THE PRIMARY ENDPOINT WAS VVS RECURRENCES AND QOL. BETWEEN JUNE 2015 AND FEBRUARY 2017, 97 HIGHLY SYMPTOMATIC VVS PATIENTS WERE RANDOMIZED (GROUP 1: 47 AND GROUP 2: 50). THE MEAN AGE WAS 33.1 +/- 16.6 YEARS, MALE:FEMALE OF 40:57, SYMPTOM DURATION OF 17.1 +/- 20.7 MONTHS, WITH A MEAN OF 6.4 +/- 6.1 SYNCOPE EPISODES. OVER A FOLLOW-UP OF 14.3 +/- 2.1 MONTHS GROUP 2 HAD SIGNIFICANTLY LOWER SYNCOPE BURDEN COMPARED WITH GROUP 1 AT 3 (0.8 +/- 0.9 VS. 1.8 +/- 1.4, P < 0.001), 6 (1.0 +/- 1.2 VS. 3.4 +/- 3.0, P < 0.001), AND AT 12 MONTHS (1.1 +/- 0.8 VS. 3.8 +/- 3.2, P < 0.001). THE SYNCOPE FUNCTIONAL SCORE QUESTIONNAIRE WAS SIGNIFICANTLY LOWER IN GROUP 2 COMPARED WITH GROUP 1 AT 3 (31.4 +/- 7.2 VS. 64.1 +/- 11.5, P < 0.001), 6 (26.4 +/- 6.3 VS. 61.4 +/- 10.7, P < 0.001), AND 12 MONTHS (22.2 +/- 4.7 VS. 68.3 +/- 11.4, P < 0.001). CONCLUSION: FOR PATIENTS WITH RECURRENT VVS, GUIDED YOGA THERAPY IS SUPERIOR TO CONVENTIONAL THERAPY IN REDUCING SYMPTOM BURDEN AND IMPROVING QOL. 2021 11 787 35 EFFECT OF YOGA BREATHING EXERCISES (PRANAYAMA) ON AIRWAY REACTIVITY IN SUBJECTS WITH ASTHMA. THE EFFECTS OF TWO PRANAYAMA YOGA BREATHING EXERCISES ON AIRWAY REACTIVITY, AIRWAY CALIBRE, SYMPTOM SCORES, AND MEDICATION USE IN PATIENTS WITH MILD ASTHMA WERE ASSESSED IN A RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED, CROSSOVER TRIAL. AFTER BASELINE ASSESSMENT OVER 1 WEEK, 18 PATIENTS WITH MILD ASTHMA PRACTISED SLOW DEEP BREATHING FOR 15 MIN TWICE A DAY FOR TWO CONSECUTIVE 2-WEEK PERIODS. DURING THE ACTIVE PERIOD, SUBJECTS WERE ASKED TO BREATHE THROUGH A PINK CITY LUNG (PCL) EXERCISER--A DEVICE WHICH IMPOSES SLOWING OF BREATHING AND A 1:2 INSPIRATION:EXPIRATION DURATION RATIO EQUIVALENT TO PRANAYAMA BREATHING METHODS; DURING THE CONTROL PERIOD, SUBJECTS BREATHED THROUGH A MATCHED PLACEBO DEVICE. MEAN FORCED EXPIRATORY VOLUME IN 1 S (FEV1), PEAK EXPIRATORY FLOW RATE, SYMPTOM SCORE, AND INHALER USE OVER THE LAST 3 DAYS OF EACH TREATMENT PERIOD WERE ASSESSED IN COMPARISON WITH THE BASELINE ASSESSMENT PERIOD; ALL IMPROVED MORE WITH THE PCL EXERCISER THAN WITH THE PLACEBO DEVICE, BUT THE DIFFERENCES WERE NOT SIGNIFICANT. THERE WAS A STATISTICALLY SIGNIFICANT INCREASE IN THE DOSE OF HISTAMINE NEEDED TO PROVOKE A 20% REDUCTION IN FEV1 (PD20) DURING PRANAYAMA BREATHING BUT NOT WITH THE PLACEBO DEVICE. THE USEFULNESS OF CONTROLLED VENTILATION EXERCISES IN THE CONTROL OF ASTHMA SHOULD BE FURTHER INVESTIGATED. 1990 12 1123 27 EFFICACY OF NATUROPATHY AND YOGA IN BRONCHIAL ASTHMA. THE AIM OF THE STUDY WAS TO TEST THE EFFICACY OF A ONE MONTH IN-PATIENT NATUROPATHY AND YOGA PROGRAMME FOR PATIENTS WITH ASTHMA. RETROSPECTIVE DATA OF 159 BRONCHIAL ASTHMA PATIENTS, UNDERGOING THE NATUROPATHY AND YOGA PROGRAMME, WAS ANALYZED FOR FORCED VITAL CAPACITY, FORCED EXPIRATORY VOLUME AT THE END OF 1 SECOND, MAXIMUM VOLUNTARY VENTILATION AND PEAK EXPIRATORY FLOW RATE ON ADMISSION, 11TH DAY, ON DISCHARGE AND ONCE IN THREE MONTHS FOR THREE YEARS. THE PAIRED SAMPLE T TEST RESULTS SHOWED SIGNIFICANT INCREASE IN THE FORCED VITAL CAPACITY AND FORCED EXPIRATORY VOLUME FROM THE DATE OF ADMISSION UP TO 6TH MONTH (P < 0.0035) POST BONFERRONI CORRECTION. MAXIMUM VOLUNTARY VENTILATION SIGNIFICANTLY INCREASED FROM ADMISSION TILL THE DATE OF DISCHARGE (P < 0.0035) AND PEAK EXPIRATORY FLOW RATE SIGNIFICANTLY INCREASED FROM ADMISSION TILL THE 36TH MONTH OF FOLLOW-UP (P < 0.0035), POST BONFERRONI CORRECTION. THIS VALIDATED THE BENEFICIAL EFFECT OF COMBINING NATUROPATHY AND YOGA FOR THE MANAGEMENT OF BRONCHIAL ASTHMA. 2014 13 2232 26 THE IMPACT OF YOGA ON INSPIRATORY MUSCLE PERFORMANCE IN VETERANS WITH COPD: A PILOT STUDY. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) CAUSES RESPIRATORY MUSCLE WEAKNESS THAT LEADS TO DISABLING DYSPNEA AND POOR FUNCTIONAL PERFORMANCE. THERAPIES ARE OFTEN GEARED TO IMPROVE INSPIRATORY MUSCLE PERFORMANCE. YOGA HAS BEEN SHOWN TO IMPROVE EXERCISE CAPACITY, QUALITY OF LIFE, AND SOME PULMONARY FUNCTION MEASURES IN COPD, BUT LITTLE RESEARCH HAS EXAMINED THE EFFECTS OF YOGA TRAINING ON INSPIRATORY MUSCLE PERFORMANCE. THE PURPOSE OF THIS STUDY WAS TO INVESTIGATE THE EFFECTS OF YOGA TRAINING ON INSPIRATORY MUSCLE PERFORMANCE IN MILITARY VETERANS USING THE TEST OF INCREMENTAL RESPIRATORY ENDURANCE (TIRE). A PROSPECTIVE PILOT STUDY EXAMINED A 6-WEEK YOGA TRAINING PROGRAM CONSISTING OF ASANA (POSES) AND PRANAYAMA (CONTROLLED BREATHING). SUBJECTS HAD BASELINE INSPIRATORY MUSCLE WEAKNESS. THE TIRE MEASURED INSPIRATORY MUSCLE PERFORMANCE VIA THE PRO2 DEVICE, PROVIDING MAXIMAL INSPIRATORY PRESSURE, SUSTAINED MAXIMAL INSPIRATORY PRESSURE, AND INSPIRATORY DURATION. SECONDARY MEASURES INCLUDED 6-MINUTE WALK DISTANCE, ST. GEORGE RESPIRATORY QUESTIONNAIRE, HOSPITAL ANXIETY AND DEPRESSION SCALE, AND SPIROMETRY. MEAN AGE AND BMI OF SUBJECTS WERE 67 +/- 3.6 YEARS AND 20.7 +/- 3.3, RESPECTIVELY. THE MAJORITY OF SUBJECTS HAD SEVERE (28.7%) OR VERY SEVERE (57.1%) COPD. STATISTICALLY SIGNIFICANT IMPROVE M E N T S WERE SEEN IN MAXIMAL INSPIRATORY PRESSURE (39.0 +/- 14.1 CMH2O TO 56.4 +/- 20.6 CMH2O) AND SUSTAINED MAXIMAL INSPIRATORY PRESSURE (244.1 +/- 100.6 PTU TO 308.1 +/- 121.2 PTU). NO STATISTICALLY SIGNIFICANT IMPROVEMENTS WE RE OBSERVED IN 6-MINUTE WALK DISTANCE, ST. GEORGE RESPIRATORY QUESTIONNAIRE, HOSPITAL ANXIETY AND DEPRESSION SCALE, OR SPIROMETRY. YOGA TRAINING HAS THE POTENTIAL IN IMPROVE INSPIRATORY MUSCLE PERFORMANCE IN VETERANS WITH SEVERE TO VERY SEVERE COPD WHO PRESENT WITH INSPIRATORY MUSCLE WEAKNESS. THIS IS OF IMPORTANCE BECAUSE IMPROVING INSPIRA-TORY MUSCLE PERFORMANCE HAS BEEN SHOWN TO IMPROVE COPD OUTCOMES. 2021 14 276 37 ADDITIONAL IMPROVEMENT OF RESPIRATORY TECHNIQUE ON VASCULAR FUNCTION IN HYPERTENSIVE POSTMENOPAUSAL WOMEN FOLLOWING YOGA OR STRETCHING VIDEO CLASSES: THE YOGINI STUDY. BACKGROUND: HYPERTENSION REMAINS HIGHLY PREVALENT IN POSTMENOPAUSAL WOMEN, ALONG WITH VASCULAR DYSFUNCTION AND INCREASED OXIDATIVE STRESS. IN SUCH CONTEXT, REGULAR EXERCISES, YOGA PRACTICE, AND SLOW BREATHING HAVE BEEN RECOMMENDED TO TREAT HYPERTENSION. HOWEVER, THE EFFECTS OF THE MULTIPLE COMPONENTS OF YOGA, INCLUDING THE RESPIRATORY TECHNIQUES INVOLVED IN THE PRACTICE, ON HYPERTENSION AND ON VASCULAR AND ENDOTHELIAL FUNCTION HAVE NEVER BEEN EVALUATED. OBJECTIVE: THIS STUDY AIMED TO INVESTIGATE THE ADDITIONAL EFFECTS OF RESPIRATORY TECHNIQUE ON VASCULAR FUNCTION AND OXIDATIVE STRESS PROFILE IN HYPERTENSIVE POSTMENOPAUSAL WOMEN (HPMWS) FOLLOWING YOGA OR STRETCHING VIDEO CLASSES. STUDY DESIGN: HYPERTENSIVE POSTMENOPAUSAL WOMEN WERE RECRUITED AND RANDOMIZED FOR 12 WEEKS, TWICE A WEEK, OF SUPERVISED YOGA OR STRETCHING VIDEO CLASSES OF 75 MIN FOR 12 WEEKS ASSOCIATED OR NOT WITH RESPIRATORY TECHNIQUE. BASELINE AND POST-INTERVENTION MEASUREMENTS INCLUDED PULSE WAVE VELOCITY (PWV), FLOW-MEDIATED DILATION (FMD), AND OXIDATIVE STRESS PARAMETERS. HYPERTENSIVE POSTMENOPAUSAL WOMEN (59 +/- 0.7 YEARS) WHO ENDED THE PROTOCOL WERE DISTRIBUTED INTO THREE GROUPS: (1) CONTROL GROUP (YOGA OR STRETCHING, C, N = 14); (2) YOGA + RESPIRATORY TECHNIQUE (Y+, N = 10); (3) STRETCHING + RESPIRATORY TECHNIQUE (S+, N = 9). RESULTS: DIASTOLIC BLOOD PRESSURE AND FMD [BASELINE: C: 6.94 +/- 1.97%, Y+: 7.05 +/- 1.65%, AND S+: 3.54 +/- 2.01% VS. POST: C: 16.59 +/- 3.46% (P = 0.006), Y+: 13.72 +/- 2.81% (P = 0.005), AND S+: 11.79 +/- 0.99% (P = 0.0001)] HAVE SIGNIFICANTLY INCREASED IN ALL GROUPS WHEN BASELINE AND POST-PRACTICE VALUES WERE COMPARED. HOWEVER, RESTING HEART RATE AND PWV [BASELINE: Y+: 10.44 +/- 3.69 AND S+: 9.50 +/- 0.53 M/S VS. POST: Y+: 9.45 +/- 0.39 (P = 0.003) AND S+: 8.02 +/- 0.47 M/S (P = 0.003)] DECREASED SIGNIFICANTLY ONLY IN THE Y+ AND S+ GROUPS (BASELINE VS. POST). SYSTEMIC ANTIOXIDANT ENZYME ACTIVITIES (SUPEROXIDE DISMUTASE AND CATALASE) INCREASED IN ALL GROUPS, AND HYDROGEN PEROXIDE AND LIPOPEROXIDATION REDUCED IN Y+ AND S+ (BASELINE VS. POST). CONCLUSIONS: TWELVE WEEKS OF YOGA OR STRETCHING VIDEO CLASSES PROMOTED POSITIVE CHANGES IN SEVERAL OUTCOMES GENERALLY REGARDED AS CARDIOVASCULAR RISK FACTORS IN HPMWS, AND THESE CHANGES WERE EVEN MORE PRONOUNCED BY THE ASSOCIATION WITH RESPIRATORY TECHNIQUE. 2020 15 2786 39 YOGA THERAPY AS AN ADJUVANT IN MANAGEMENT OF ASTHMA. OBJECTIVE: TO ASSESS THE EFFECT OF YOGA ON CONTROL OF ASTHMA IN CHILDREN WITH BRONCHIAL ASTHMA. METHODS: THIS HOSPITAL-BASED INTERVENTIONAL RANDOMIZED CONTROLLED TRIAL CONDUCTED IN THE DEPARTMENT OF PEDIATRICS AT A TERTIARY CARE CENTER OF NORTH INDIA FROM NOVEMBER 2017 TO OCTOBER 2018 ENROLLED 140 NEWLY DIAGNOSED CASES OF ASTHMA OF AGE 10-16 Y WHO WERE RANDOMLY DIVIDED INTO TWO GROUPS. SEVENTY CHILDREN IN THE CASE GROUP PRACTICED YOGA UNDER SUPERVISION FOR A PERIOD OF 3 MO IN ADDITION TO PHARMACOLOGICAL TREATMENT. SEVENTY CONTROLS RECEIVED ONLY PHARMACOLOGICAL TREATMENT. PULMONARY-FUNCTION TESTS WERE DONE AT BASELINE, 6 WK, AND 12 WK ALONG WITH QUALITY OF LIFE (QOL) ASSESSMENT BY PEDIATRIC ASTHMA QUALITY OF LIFE QUESTIONNAIRE (PAQLQ). THE OUTCOME MEASURES ASSESSED WERE FORCED VITAL CAPACITY (FVC), FORCED EXPIRATORY VOLUME IN ONE SECOND (FEV1), FEV1/FVC AND PEAK EXPIRATORY FLOW RATE (PEFR). QOL EVALUATION WAS DONE IN 3 DOMAINS: ACTIVITY LIMITATION, SYMPTOMS, AND EMOTIONAL FUNCTION. RESULTS: THE ASTHMATIC CHILDREN PRACTICING YOGA HAVE SHOWN SIGNIFICANT IMPROVEMENT IN FVC, FEV1, FEV1/FVC AND PEFR WHICH WAS BETTER AS COMPARED TO CONTROLS. IMPROVEMENT WAS ALSO NOTED IN MEAN-PAQLQ SCORE IN CASES WHICH WAS STATISTICALLY SIGNIFICANTLY BETTER AS COMPARED TO CONTROLS. CONCLUSION: YOGA APPEARS TO HAVE SIGNIFICANT POSITIVE EFFECT ON CONTROL OF ASTHMA MEASURED BY PULMONARY-FUNCTION TEST AND QOL. THEREFORE YOGA THERAPY CAN BE RECOMMENDED AS AN ADJUVANT IN MANAGEMENT OF ASTHMA ALONG WITH STANDARD PHARMACOLOGICAL MANAGEMENT. 2021 16 2662 50 YOGA IN BURN: ROLE OF PRANAYAMA BREATHING EXERCISE ON PULMONARY FUNCTION, RESPIRATORY MUSCLE ACTIVITY AND EXERCISE TOLERANCE IN FULL-THICKNESS CIRCUMFERENTIAL BURNS OF THE CHEST. BACKGROUND: CIRCUMFERENTIAL BURN OF CHEST (CBC) IS A SIGNIFICANT TYPE OF BURN AND CONSIDERS AS A MAJOR CAUSE OF RESTRICTIVE LUNG DISEASE (RLD). PATIENT WHO HAS CBC WITH RLD LEADS TO RESPIRATORY SYMPTOMS SUCH AS BREATHING DIFFICULTY, AIRWAY OBSTRUCTION, REDUCED EXERCISE CAPACITY AND ALTERED PULMONARY FUNCTIONS. HOWEVER, STUDIES EXAMINING THE ROLE OF PRANAYAMA BREATHING EXERCISE ON PULMONARY FUNCTION, RESPIRATORY MUSCLE ACTIVITY AND EXERCISE TOLERANCE IN FULL THICKNESS CIRCUMFERENTIAL BURN OF CHEST ARE LACKING. OBJECTIVE: TO FIND THE SHORT TERM EFFECTS OF PRANAYAMA BREATHING EXERCISE ON PULMONARY FUNCTION, RESPIRATORY MUSCLE ACTIVITY AND EXERCISE TOLERANCE IN FULL THICKNESS CIRCUMFERENTIAL BURNS OF CHEST. METHODS: THROUGH SIMPLE RANDOM SAMPLING METHOD THIRTY SUBJECTS (N = 30) WITH RLD FOLLOWING CBC WERE ALLOCATED TO PRANAYAMA BREATHING EXERCISE GROUP (PBE-G; N = 15) AND CONVENTIONAL BREATHING EXERCISE GROUP (CBE-G; N = 15). THEY RECEIVED PRANAYAMA BREATHING EXERCISE AND CONVENTIONAL BREATHING EXERCISE FOR 4 WEEKS RESPECTIVELY. ALL THE SUBJECTS RECEIVED CHEST MOBILITY EXERCISE AS COMMON TREATMENT. PRIMARY (NUMERIC PAIN RATING SCALE - NPRS, FORCED EXPIRATORY VOLUME (FEV1), FORCED VITAL CAPACITY (FVC) AND MAXIMUM VOLUNTARY VENTILATION (MVV) AND SECONDARY (ELECTROMYOGRAM OF STERNOCLEIDOMASTOID, SCALENE, EXTERNAL INTERCOSTAL AND DIAPHRAGM MUSCLE, 6 MIN WALK TEST & GLOBAL RATING OF CHANGE - GRC) OUTCOME MEASURES WERE MEASURED AT BASELINE, AFTER FOUR WEEKS AND AFTER THREE MONTHS FOLLOW UP. RESULTS: BASELINE DEMOGRAPHIC AND CLINICAL VARIABLES SHOW HOMOGENOUS DISTRIBUTION BETWEEN THE GROUPS (P > 0.05). FOUR WEEKS FOLLOWING DIFFERENT BREATHING EXERCISES, PBE-G GROUP SHOWS MORE SIGNIFICANT CHANGES IN PAIN INTENSITY, PULMONARY FUNCTION, RESPIRATORY MUSCLE ACTIVITY, EXERCISE TOLERANCE AND GLOBAL RATING OF CHANGE THAN CBE-G GROUP (P