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  • 1. Y O G A F O R A S T H M A Dr. Shamanthakamani Narendran M.D. (Pead), Ph.D. (Yoga Science)
  • 2.  
  • 3.
    • Concept of health and disease
      • Modern science
      • Ancient rishis
    • Concept of yoga therapy
    • Name of the disease & terminologies
    • Signs and symptoms
    • Etiology
    • Helpful clues to diagnose
    • Physical examination
    • Intervention
    • TT according to module medicine
    • How does yoga help
    • Books to read
  • 4. Taittiriya Upanisad
    • K.Y.
    Tittiri birds Visompayana – yajnavalkya Surya tapas Shikshavalli Brahmananda Bhrugu – Varuna to his son Vallis
  • 5. Ánandamaya Kôùa Vijòanánmaya Kôùa PERFECT HEALTH Manômaya Kôùa Annamaya Kôùa Pránamaya Kôùa ÁDHIJA VYÁDHIS YOGA Panchakosa concept
  • 6. ADHI MENTAL AGITATIONS HAPHAZARD FLOW OF PRANA UNSTABLE NADIS UNDER DIGESTION AJIRNATVAM OVER DIGESTION ATI JIRNATVAM WRONG DIGESTION KUJIRNATVAM VYADHI PHYSICAL AILMENTS THE SCIENCE OF PSYCHOSOMATIC AILMENTS
  • 7. CONCEPT OF HEALTH Region of Ill health Region of Normal health Animal level Towards Divinity State of wellbeing HEALTH Super man Sick man Normal man Quadrant II Quadrant III Quadrant IV Quadrant I
  • 8. VYADHYAH PHYSICAL AILMENTS ADHIJAH GENERATED BY ADHIS ANADHIJAH NOT CAUSED BY ADHIS SARA ESSENTIAL TYPE SAMANYA ORDINARY TYPE PHYSICAL Medicines Mantras Good actions SCHEMATIC DIAGRAM OF AILMENTS SPIRITUAL Atma Jnana Self realization MENTAL Congenital Atmosphere Suitable Techniques Responsible for the cycles of birth and death of the physical body Psychosomatic ailments causes during interaction with the world Infections and contagious disease
  • 9. RESPIRATORY SYSTEM
  • 10. STRUCTURE OF LUNG
  • 11. WHAT IS ASTHMA /LUNG DISORDER? - A DISEASE WITH REVERSIBLE AIRWAY OBSTRUCTION BRONCHIAL ASTHMA & NASAL ALLERGY TIGHTNESS IN CHEST WHEEZING COUGH PHLEGM / SPUTUM SEASONAL / PERENNIAL EPISODES OF ACUTE ATTACK
  • 12. DEFINITION
    • It is an obstructive pulmonary disease characterised by hyper-responsiveness of bronchial mucosa causing narrowing of the bronchi in response to a wide range of stimuli resulting in cough, wheeze, tightness of chest and shortness of breath which is worst during night.
  • 13. Types
    • Atopic or Early onset / Extrinsic
    • Late onset (Non-atopic) / Intrinsic
  • 14. APPLIED ANATOMY & PHYSIOLOGY
    • Upper Respiratory tract
      • Nose, Nasopharynx, Larynx
      • Lined by vascular mucous membrane with ciliated epithilium
    • Lower Respiratory tract
      • Trachea, bronchi
      • Lined by ciliated epithilium as far as terminal bronchioles
  • 15.
    • Larynx and large bronchi are richly supplied with sensory nerve receptors involved in the cough reflex.
    • Acinus is the gas exchange unit of the lung and comprises branching respiratory bronchioles leading to clusters of alveoli.
    Continued…
  • 16. FLOW OF AIR The nose will do three things to the air we breathe in: a. Filter the air b. Warm the air c. Provide moisture (water vapor or humidity) to the air.
  • 17.  
  • 18.
    • RUNNING NOSE
    • SNEEZING
    • BLOCKING
    WHAT IS NASAL ALLERGY ? HYPER REACTIVITY OF NASAL LINING
  • 19. MASTERY OVER SNEEZING REFLEX
  • 20. ASTHMA HOW ?
    • INFLAMMATION
    • SWELLING OF THE LINING
    • THICK STICKY SPUTUM
    BRONCHO SPASM BRONCHO SPASM INFLAMMATION
  • 21. BRONCHO- CONSTRICTION BRONCHO- DILATATION BRONCHO SPASM PARASYMPATHETIC HYPER- REACTIVITY SYMPATHETIC HYPO- SENSITIVITY ASTHMA PARASYMPATHETIC SYMPATHETIC
  • 22. PARASYMPATHETIC SYMPATHETIC PSYCHE
  • 23. ASTHMA IMMUNE HYPER REACTIVITY IMMUNO GLOBULIN INVADERS TAILOR MADE KILLERS LYMPHOCYTE FACTORY HELPER CELLS PERCEIVE DANGER TRAINED KILLERS ATTACK
  • 24. MAST CELLS MAST CELLS IN LINING OF BRONCHUS POLLEN IMMUNO GLOBULIN E CHEMICALS RELEASED
  • 25. PSYCHO NEURO IMMUNOLOGY STRESS & ALLERGY THYMUS B T CAUSES ALLERGY BRONCHUS
  • 26. HEREDITY NON SPECIFIC GENE IDENTIFIED CAUSES OF ASTHMA PERSONALITY TYPE ALLERGIES COMMON IN FAMILIES D N A
  • 27. HEREDITY CAUSES OF ASTHMA TRIGGERS: EXTERNAL INTERNAL NON SPECIFIC EMOTIONS SPECIFIC SEASONAL PERENNIAL, ELDERLY
  • 28.
    • DUST
    • SMOKE, VAPOURS
    • STRONG SMELL, SCENTS
    • CHANGES IN TEMPERATURE, HUMIDITY
    • WEATHER - WINTER, SUMMER EXERCISE
    • INFECTION
    CAUSES OF ASTHMA NON SPECIFIC
  • 29.
    • HOUSE DUST MITE
    • POLLEN
    • FOOD- FISH, EGG, MILK, PULSES etc.,
    • FUNGI
    • SPECIFIC:
    • ANTIGEN - PROTEINS
    • ANTIBODY - IMMUNOGLOBULINS IgE
  • 30. TRIGGERS INTERNAL PERSONALITY - thin built, intelligent, emotionally sensitive, inability to express, suppressed feelings CAUSES OF ASTHMA “ IF SHE CANNOT CRY WITH TEARS, SHE WHEEZES AND SNEEZES ”
  • 31. INCIDENCE
    • 10-20% population
    • Prevalence increasing
    • Mortality due to asthma unchanged in spite of medical advances
  • 32. ETIOLOGY Skin test positive Family history of allergic disorders Skin test negative Family history absent Allergens Infection Exercise Environment Occupation Drugs Emotion Early Onset Extrinsic Atopic Late Onset Intrinsic Non-atopic
  • 33. CLINICAL FEATURES
    • Episodic Asthma
    • No symptoms between episodes
    • Paroxysms of wheeze and dyspnea
    • Triggered by allergens, exercise, viral infections, eg. cold
  • 34. CLINICAL FEATURES
    • Severe Acute Asthma
    • Was known as ‘status asthmaticus’
    • Life-threatening situation
    • Orthopnea
    • Unproductive cough with respiratory distress
    • Tachycardia, pulsus paradoxus, sweating, central cyanosis
  • 35. CLINICAL FEATURES
    • Chronic Asthma
    • Chest tightness, wheeze, breathlessness on exertion
    • Spontaneous cough and wheeze during night
    • Episodes of severe acute asthma with respiratory infection
  • 36. CLINICAL FEATURES
    • During the attack the chest is held in the position of full inspiration
    • Decreased breath sounds with rhonchi
    • ‘Silent chest’ during severe attack
    • ‘Pigeon-chest’ deformity
  • 37. INVESTIGATION
    • X-ray Chest
    • Pulmonary function tests
      • FEV1, VC, PEF
    • Arterial blood gases
      • PaO2, PaCO2
    • Skin hypersensitivity tests
  • 38. PREVENTIVE MEASURES Avoid contact with dogs, cats, horses or other animals Animal dander Vacuum clean mattress daily Shake out blankets daily Dust bedroom thoroughly Mites in house dust Try to avoid exposure to flowering vegetation. Keep bedroom windows closed Pollens
  • 39. PREVENTIVE MEASURES Avoid exposure or change occupation Industrial chemicals Identify and eliminate from diet Foods Avoid all preparations of relevant drugs Drugs (eg, beta-adrenoceptor antagonists) Substitute latex foam pillows and terylene quilts Feathers in pillows or quilts
  • 40. MANAGEMENT
    • Hyposensitization
    • Subcutaneous injection of initially very small, but gradually increasing doses of extracts of allergens
  • 41. CHRONIC PERSISTENT ASTHMA 4 plus regular oral steroids 3 plus regular bronchodilators High dose inhaled corticosteroids Regular inhaled corticosteroids – small dose Occasional short-acting-Beta2-adrenoceptor agonists 5 4 3 2 1
  • 42. ACUTE SEVERE ASTHMA
    • Oxygen
    • High doses of inhaled beta2 adrenoceptor agonists
    • Systemic steroids
    • Assisted ventilation
  • 43.
    • ASTHMA MANAGEMENT
    • ANNAMAYA KOSA LEVEL:
    • DIET - SATVIK SIMPLE VEGETARIAN
    • AVOID LATE, HEAVY SUPPER
    • AVOID SENSITIVE FOODS WHEN ASTHMA IS AGGRAVATED
    • DESENSITISE TO SENSITIVE FOODS DURING INTERVALS OF GOOD SEASON OR REMISSION
    • LIFE STYLE OF MODERATION
    • YAMA, NIYAMA
  • 44.
    • VOLUNTARY CONTROL OVER INVOLUNTARY NERVOUS SYSTEM
    • PANIC REDUCED
    • RELAX BODY- MIND COMPLEX REDUCE DEMAND
    • WHY 8 STEPS IN CHAIR BREATHING?
    • TO MAINTAIN STEADY AWARENESS OF BREATHING FOR 20-30 minutes
    ACUTE EPISODES - CHAIR BREATHING
  • 45.
    • GRADUALLY BUILD UP TO DIFFERENT POSTURES AND DYNAMIC ASANAS
    • COMPLEMENTARY POSTURES -
    • DRAINAGE OF SECRETION - FORWARD BEND
    ASANAS AVOID NONE
  • 46. OPEN UP CHEST IMPROVE LUNG CAPACITY BACKWARD BENDS BHUJANGA, DHANUR,USTRA GENERAL STAMINA - DYNAMIC ASANAS SITHILEKARANA, SURYA NAMASKARA BALANCE OF PRANA ASANAS HOW ?
  • 47.
    • BETTER TOLERANCE TO EXERCISE- STIMULUS-RELAX
    • GRADED GRADUAL IMPROVEMENT OF EXERTION TOLERANCE
    • PRANIC BALANCE
    ASANAS HOW ?
  • 48. KRIYAS CLEAN THE PASSAGES -NETI CLEAR THE DIGESTION - DHOUTI SHANKHA PRAKSHALANA ALLERGY - HYPER-REACTIVITY
  • 49. STAMINA BUILDING JALA NETI - WATER NON SPECIFIC IRRITANT - ACCEPT SUTRA NETI - RUBBER TUBE STRONGER NON SPECIFIC IRRITANT KRIYAS GRADED CRADUALLY INCREASING STIMULUS ON BACKGROUND OF DEEP REST
  • 50. PRANAMAYA KOSA: PRANA BLOCKS - IMBALANCE REMOVED RIGHT - LEFT BALANCE. SAV MAY HELP IDEALLY RECOGNISE THE NASAL DOMINENCE MOMENT TO MOMENT AND CORRECT THE IMBALANCE
  • 51.
    • ABDOMINAL BREATHING:
    • TRAINING DIAPHRAGMATIC BREATHING HELPS REDUCE EFFORT OF BREATHING
    • * RELEASES PRANIC BLOCKS IN CHEST
    • * IMPROVES DIGESTION
    • e) BHASTRIKA - IMPROVES GENERAL STAMINA
  • 52.
    • MANOMAYA KOSA:
    • MEDITATION - DIRECT METHOD TO REST ANS AND IMMUNE SYSTEM
    • STRESS REDUCTION
  • 53.
    • EMOTION CULTURE
    • REPLACE EMOTIONAL SENSITIVITY BY EMOTIONAL MASTERY
    • CONFLICTS ARISE BECAUSE OF EMOTIONAL HYPER SENSITIVITY
    DEVOTIONAL SESSION
  • 54.
    • VIJNANA MAYA KOSA:
    • YOGIC COUNSELLING
    • * SURRENDER TO DIVINE ACCEPTANCE
    • JOY IN JOY OF OTHERS WORK IN RELAXATION
    • ACTION IN CONTENTMENT etc.,
    • HAPPINESS ANALYSIS
    • REDUCE RUSH AND SPEED
  • 55.
    • ANANDAMAYA KOSA:
    • SWITCH OFF TO DWELL IN INNER BLISS FREQUENTLY
    • RECOGNISE THAT ARE MADE OF THAT STUFF ANANDAMAYA
    • CAN EXPAND AND SLOW DOWN
  • 56. INTEGRATED YOGA MODULE FOR ASTHMA
    • Breathing practices
    • Hands in and out breathing
    • Hands stretch breathing
    • Ankle stretch breathing
    • Dog breathing
    • Rabbit breathing
    • Tiger breathing
    • Sasankasana breathing
    • Straight leg raise breathing
    • Instant relaxation technique (IRT)
  • 57.
    • Loosening Exercises
    • Forward and backward bending
    • Side bending
    • Pavanamuktasana kriya
    • Quick relaxation technique (QRT)
    • Yogasanas
    • Standing
    • Ardhakati cakrasana
    • Ardha cakrasana
    • Padahastasana
  • 58.
    • Sitting
    • Vajrasana
    • Vakrasana
    • Ardha Matsyendrasana
    • Pascimottanasana
    • Prone
    • Bhujangasana
    • Salabhasana
    • Supine
    • Sarvangasana
    • Matsyasana
    • Halasana
    • Deep relaxation technique (DRT)
  • 59.
    • Pranayama
    • Surya Anuloma Viloma pranayama
    • Candra Anuloma Viloma pranayama
    • Nadisuddi pranayama
    • Sitali/ Sitkari/ Sadanta pranayama
    • Bhramari pranayama
    • Meditation
    • Nadanusandhana
    • OM-Dhyana (meditation)/
    • Cyclic meditation
  • 60.
    • Acute attack - chair breathing
    • Vamanadhouti + DRT – Once a week
    • Laghu Sankapraksalana + DRT - Daily
  • 61. INTEGRATED YOGA MODULE FOR ASTHMA
    • Breathing practices
    • Hands in and out breathing
    • Ankle stretch breathing
    • Tiger breathing
    • Rabbit breathing
    • Dog breathing (eyes closed)
    • Straight leg raise breathing
    • Back stretch
    • Tiger stretch
    • Yoga chair breathing
    • Sithilikarana Vyayama (loosening exercises)
    • Pavanamuktasana kriya
    • Suryanamaskar
  • 62.
    • Yogasanas
    • Ardhakati cakrasana
    • Padahastasana
    • Ardha cakrasana
    • Vakrasana/ Ardha-Matsyendrasana
    • Bhujangasana
    • Salabhasana
    • Sarvangasana
    • Matsyasana
    • Deep relaxation technique (DRT)
  • 63.
    • Pranayama
    • Kapalabhati
    • Vibhaga pranayama (Sectional breathing)
    • Surya Anuloma
    • Nadi suddhi
    • Bhramari
    • Meditation (Dhyana Dharana)
    • Nadanusandhana
    • OM meditation
    • Kriyas
    • Jala Neti
    • Sutra Neti
    • Vaman Dhouti
  • 64. SPECIFIC PRACTICE
    • Yoga tries to cure asthma by cleaning the lungs and making patient emotionally strong so that he/she does not react to stressful situations.
    • As the disease is primarily of the lungs and respiratory system the pranayama and asanas selected are to restore the health of lungs and the respiratory system.
    • The postures prescribed drain mucus from the lungs, and relax lung muscles.
    • Yoga also teaches to breathe correctly.
    • Yoga not only clears lungs but also gives the will power to give up smoking through Meditation.
  • 65.
    • Daily Practice :
    • Jal Neti Kriya
    • Bhastrika Pranayam
    • Nadi Shodak Pranayam
    • Ujjayi Pranayam
    • Pranayama massages
    • the body cells and inner organs.
    • The Breathing Exercises oxygenate lungs, and increase their flexibility.
    • By strengthening immune system, they also reduce dependency on medication.
  • 66.
    • General considerations : This problem is often associated with bronchitis or allergy.
    • Contraindications : There are few contraindications of yoga for patients with asthma which is not complicated (e.g. acute bronchitis). The environment in which yoga is practised should be, as far as possible, free of the substances which may cause allergic reaction.
    • Recommendations : These patients often benefit from many yogic practices including relaxation and meditation, see publications of Bihar School of Yoga.
  • 67.
    • Recommended Asanas :
    • Chair breathing -
    • Ekpada Uttana Asana - helps in activating the bronchial lining.
    • Tadasana (Palm Tree Pose) - strengthens bronchioles and lungs; builds up muscles of chest.
    • Ustrasana (Camel Pose) - activates facial tissues, the nasal passage, the pharynx & the lungs.
    • Simhasana (Lion Pose) - cures throat trouble, voice deficiency and tonsillitis; activates the larynx, trachea and all bronchioles; invigorates the thyroid cartilages.
  • 68.
    • Sarvangasana (Shoulder Stand) - corrects any disorder of circulatory system.
    • Matsyasana (Fish Pose)- - corrects the disorders of the respiratory system as all organs concerned with respiration such as, the nasal passage, the pharynx, the larynx are exercised. system.
    • Padmasana (Lotus Pose)- relaxes the body; appropriate asana for pranayam.
    • Savasana (Corpse pose) - removes fatigue and quitens the mind; must be practiced at the end of asana.
    • Pause for half a minute between the asanas.
  • 69. THANK YOU

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