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Yoga and respiratory disorders

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Invited talk by Dr Ananda for World COPD Day 2017 celebrated by College of Physiotherapy, Mother Theresa Post Graduate & Research Institute of Health Sciences

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Yoga and respiratory disorders

  1. 1. Yoga & RespiratoryYoga & Respiratory DisordersDisorders YogacharyaYogacharya Dr. ANANDA BALAYOGI BHAVANANIDr. ANANDA BALAYOGI BHAVANANI MBBS, ADY, DSM, DPC, PGDFH, PGDY, MD (Alt Med), FIAY, C-IAYTMBBS, ADY, DSM, DPC, PGDFH, PGDY, MD (Alt Med), FIAY, C-IAYT DirectorDirector Centre for Yoga Therapy, Education and Research (CYTER),Centre for Yoga Therapy, Education and Research (CYTER), Sri Balaji Vidyapeeth, Puducherry. www. sbvu.ac.inSri Balaji Vidyapeeth, Puducherry. www. sbvu.ac.in
  2. 2. SRI BALAJI VIDYAPEETHSRI BALAJI VIDYAPEETH (Deemed University Accredited with “A” Grade by NAAC) Centre for Yoga Therapy, Education and Research (CYTER) Salutogenesis, our focus! Bhavanani AB. SMVMCH. 16.12.2016
  3. 3. Salutogenesis, our Focus  Moving from pathogenesis, the focus on disease towards salutogenesis, the focus on health!  Under SBV AIM HIGH (Academy of Integrative Medicine for Holistic Intervention towards General Health), Faculty of Allied Health Sciences, CYTER is striding forward on an innovative path of promoting holistic health for one and all.
  4. 4. Bridging the experiential wisdom of Yoga with empirical modern medical science. Yoga is usually found in Physical Edu & Sports deptts of universities We at CYTER, have it in a medical institution since 2010  quality of life enhancing benefits for ~ 42000 patients  educating future Yoga therapists (PGDYT, M.Phil, PhD),  creating awareness amongst medical, dental and nursing students & professionals  scientifically researching Yoga,  69 publications & 5 CMEs
  5. 5. Yoga places great importance on a proper and healthyYoga places great importance on a proper and healthy lifestyle whose main components are:lifestyle whose main components are:  ACHARACHAR – healthy physical activities & exercise– healthy physical activities & exercise  VICHARVICHAR – right thoughts and right attitude towards– right thoughts and right attitude towards life that are vital for wellbeing.life that are vital for wellbeing.  AHARAHAR – healthy, nourishing diet with adequate intake– healthy, nourishing diet with adequate intake of fresh water; balanced intake of fresh food, greenof fresh water; balanced intake of fresh food, green salads, sprouts, unrefined cereals & fresh fruits.salads, sprouts, unrefined cereals & fresh fruits. SatwicSatwic diet, prepared & served with love & affection.diet, prepared & served with love & affection.  VIHARVIHAR – proper recreational activities to relax body– proper recreational activities to relax body and mind are essential for good health.and mind are essential for good health.  VYAVAHARVYAVAHAR – healthy relationships for social health– healthy relationships for social health
  6. 6. MechanismsofYoga MechanismsofYoga
  7. 7.  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 (Jeteretal,2015) .  Scientific basis of using Yoga as adjunct therapy in COPD is well established with significant improvements in lung function, quality of life indices and bronchial provocation responses coupled with decreased regular & rescue medicines (Nagarathna1985;Vempati,2009) .  Behera reported perceptible improvement in dyspnoea &lung function in patients of bronchitis after 4 weeks Yoga therapy with postures & breathing techniques (Behera,1998) .
  8. 8. Yoga Practices Postures, Breathing, Relaxation, Meditation Fitness ↑Flexibility ↑Strength ↑Coordination/Balance ↑Respiratory Function ↑Self-Efficacy Global Human Functionality ↑Physical & Mental Health, ↑Physical, Mental, Emotional Performance, ↑Positive Behavior Change, ↑Social Responsibility, Values, Relationships, ↑Quality of Life, ↑Life Purpose & Meaning, ↑Spirituality Self-Regulation ↑Emotion Regulation ↑Stress Regulation ↑Resilience ↑Equanimity ↑Self-Efficacy Awareness ↑Attention ↑Mindfulness ↑Concentration ↑Cognition ↑Meta-cognition Spirituality ↑Transcendence ↑Unitive State ↑Flow ↑Transformation ↑Life Meaning/Purpose * Concept and image courtesy of Sat Bir S Khalsa, PhD USA
  9. 9. Proposed relationships among dyspnea, benefits of yoga,Proposed relationships among dyspnea, benefits of yoga, and outcomes of participation in a yoga program.and outcomes of participation in a yoga program. Donesky-Cuenco D, Nguyen HQ, Paul S, Carrieri-Kohlman V. Yoga Therapy Decreases Dyspnea-Related Distress and Improves Functional Performance in People with Chronic Obstructive Pulmonary Disease: A Pilot Study. J Altern Complement Med 2009; 15: 225–234.
  10. 10.  Yogic cleaning techniques such as dhauti kriya (upperYogic cleaning techniques such as dhauti kriya (upper GI cleaning with warm saline or muslin cloth) andGI cleaning with warm saline or muslin cloth) and neti kriya (warm saline nasal wash) remove excessiveneti kriya (warm saline nasal wash) remove excessive mucous secretions, decrease inflammation & reducemucous secretions, decrease inflammation & reduce bronchial hypersensitivity thereby increasingbronchial hypersensitivity thereby increasing provocation threshold while kapalabhati throughprovocation threshold while kapalabhati through forceful exhalations improves the capacity to exhaleforceful exhalations improves the capacity to exhale against resistanceagainst resistance (Satyaprabha,2001)(Satyaprabha,2001) ..  A nonspecific broncho-protective or broncho-A nonspecific broncho-protective or broncho- relaxing effect has been also postulatedrelaxing effect has been also postulated (Singh,1987)(Singh,1987) whilewhile  Improved exercise tolerance reported following YogaImproved exercise tolerance reported following Yoga therapy in patients of chronic severe airwaystherapy in patients of chronic severe airways obstructionobstruction (Tandon,1978)(Tandon,1978) ..
  11. 11.  It has been reported that well-performed slowIt has been reported that well-performed slow yogic breathing maintains better bloodyogic breathing maintains better blood oxygenation without increasing minuteoxygenation without increasing minute ventilation,ventilation,  reduces sympathetic activation duringreduces sympathetic activation during altitude-induced hypoxiaaltitude-induced hypoxia (Bernardietal,2001)(Bernardietal,2001) andand  decreased chemoreflex sensitivity to hypoxiadecreased chemoreflex sensitivity to hypoxia and hypercapniaand hypercapnia (Spicuzzaetal,2000)(Spicuzzaetal,2000) ..
  12. 12.  Asthmatic patients showed a statistically significantAsthmatic patients showed a statistically significant improvement in Transfer factor of the lung forimprovement in Transfer factor of the lung for carbon monoxide (TLCO), forced vital capacity (FVC),carbon monoxide (TLCO), forced vital capacity (FVC), forced expiratory volume in 1st sec (FEV1), peakforced expiratory volume in 1st sec (FEV1), peak expiratory flow rate (PEFR), maximum voluntaryexpiratory flow rate (PEFR), maximum voluntary ventilation (MVV) and slow vital capacity (SVC) afterventilation (MVV) and slow vital capacity (SVC) after 2 months Yoga practice.2 months Yoga practice.  Quality of life also increased significantly.Quality of life also increased significantly.  It was concluded that pranayama and Yoga posturesIt was concluded that pranayama and Yoga postures may be used to increase respiratory stamina, relaxmay be used to increase respiratory stamina, relax the chest muscles, expand the lungs, raise energythe chest muscles, expand the lungs, raise energy levels, and calm the bodylevels, and calm the body (Singhetal,2012)(Singhetal,2012) ..
  13. 13.  A study to assess beneficial effects of Yoga inA study to assess beneficial effects of Yoga in exercise-induced broncho-constriction inexercise-induced broncho-constriction in children aged 7-16y reported that all exercise-children aged 7-16y reported that all exercise- response-positive asthmatics became exerciseresponse-positive asthmatics became exercise response-negative asthmatics after 3 monthsresponse-negative asthmatics after 3 months of bi-weekly Yoga training (Tahan et al, 2014).of bi-weekly Yoga training (Tahan et al, 2014).  It was recommended that Yoga training canIt was recommended that Yoga training can supplement drug therapy to achieve bettersupplement drug therapy to achieve better control of asthma in children.control of asthma in children.
  14. 14.  In a recent study of 120 non-smoking maleIn a recent study of 120 non-smoking male and female patients of asthma in the ageand female patients of asthma in the age group of 17-50 years, 8 weeks of Yogagroup of 17-50 years, 8 weeks of Yoga breathing exercises used adjunctively withbreathing exercises used adjunctively with standard pharmacological treatmentstandard pharmacological treatment significantly improved quality of lifesignificantly improved quality of life (Sodhietal,2014)(Sodhietal,2014) ..
  15. 15. Deep breathing is economical *Deep breathing is economical * NormalNormal ShallowShallow DeepDeep VolumeVolume (ml)(ml) 500500 200200 10001000 Rate/minRate/min 1212 3030 66 VentilationVentilation (ml)(ml) 60006000 60006000 60006000 Dead spaceDead space (ml)(ml) 150150 150150 150150 Dead space VDead space V (ml)(ml) 18001800 45004500 900900 Alveolar VAlveolar V (ml)(ml) 42004200 15001500 51005100 * Prof Madanmohan, Director CYTER and Head Department of Physiology, MGMC & RI
  16. 16. Deep breathing is economical *Deep breathing is economical * NormalNormal ShallowShallow DeepDeep VolumeVolume (ml)(ml) 500500 200200 10001000 Rate/minRate/min 1212 3030 66 VentilationVentilation (ml)(ml) 60006000 60006000 60006000 Dead spaceDead space (ml)(ml) 150150 150150 150150 Dead space VDead space V (ml)(ml) 18001800 45004500 900900 Alveolar VAlveolar V (ml)(ml) 42004200 15001500 51005100 * Prof Madanmohan, Director CYTER and Head Department of Physiology, MGMC & RI
  17. 17. Sarvanga Asana & variations
  18. 18. Bala AsanaBala Asana Meru AsanaMeru Asana Padhasta AsanaPadhasta Asana
  19. 19. Chant Your Way ToChant Your Way To Healthy SinusesHealthy Sinuses  Chanting creates sound vibrations encouraging airChanting creates sound vibrations encouraging air to move back & forth between sinus membranesto move back & forth between sinus membranes and nasal passages.and nasal passages.  This helps open the tiny ducts connecting the noseThis helps open the tiny ducts connecting the nose to the sinuses, allowing the sinuses to drainto the sinuses, allowing the sinuses to drain properly.properly.  Sinuses are effectively ventilated by humming.Sinuses are effectively ventilated by humming.  Previous research has shown that poor sinusPrevious research has shown that poor sinus ventilation increases the risk for sinusitis.ventilation increases the risk for sinusitis.
  20. 20.  Daily humming or "Om" chanting may preventDaily humming or "Om" chanting may prevent infections from actually taking hold, according toinfections from actually taking hold, according to Jon Lundberg and Eddie Weitzberg of theJon Lundberg and Eddie Weitzberg of the Karolinska Institute, Sweden.Karolinska Institute, Sweden.  They found that humming increased nitric oxideThey found that humming increased nitric oxide levelslevels fifteenfoldfifteenfold, compared to quiet exhalations, compared to quiet exhalations without sound.without sound.  The exhalations of people with healthy sinusesThe exhalations of people with healthy sinuses tend to have high nitric oxide levels, indicatingtend to have high nitric oxide levels, indicating that more air is able to flow between the sinusesthat more air is able to flow between the sinuses and the nose.and the nose.  Nada Pranayamas of Yoga such asNada Pranayamas of Yoga such as BhramariBhramari andand thethe PranavaPranava are similar to the humming used inare similar to the humming used in the study.the study.  Vowel sounds are useful in sleep apnea!Vowel sounds are useful in sleep apnea!
  21. 21. Neti: The Yogic NasalNeti: The Yogic Nasal Cleansing TechniqueCleansing Technique Types of Neti:Types of Neti:  Jala NetiJala Neti -Nasal irrigation with lukewarm saline-Nasal irrigation with lukewarm saline  Sutra Neti -cleaning with a thread or catheterSutra Neti -cleaning with a thread or catheter  Dugdha Neti -Nasal irrigation with milkDugdha Neti -Nasal irrigation with milk  Ghrta Neti -Nasal irrigation with melted gheeGhrta Neti -Nasal irrigation with melted ghee  Jala KapalabhatiJala Kapalabhati  Vyutkrama KapalabhatiVyutkrama Kapalabhati  Seetkrama KapalabhatiSeetkrama Kapalabhati
  22. 22. Benefits of Neti KriyaBenefits of Neti Kriya  Removes mucus and dust particles from the nasalRemoves mucus and dust particles from the nasal passages and the sinuses.passages and the sinuses.  All the five Jnanendriyas are purified, cleansed andAll the five Jnanendriyas are purified, cleansed and activated by Neti Kriyaactivated by Neti Kriya  Excellent preventive against cold, cough, sinusitisExcellent preventive against cold, cough, sinusitis and infections of the respiratory tract.and infections of the respiratory tract.  Neti also renders the nose resistant to irritants likeNeti also renders the nose resistant to irritants like water, cotton, rubber, ghee, milk and thus helps inwater, cotton, rubber, ghee, milk and thus helps in hypersensitivity eg. Allergic Rhinitis.hypersensitivity eg. Allergic Rhinitis.  Helps to overcome addictions especially to tobaccoHelps to overcome addictions especially to tobacco and alcohol.and alcohol.
  23. 23. Nasal irrigationNasal irrigation  Hypertonic nasal irrigation is a therapy thatHypertonic nasal irrigation is a therapy that flushes the nasal cavity with saline solution,flushes the nasal cavity with saline solution, facilitating a wash of the structures within.facilitating a wash of the structures within.  Originally part of the Yogic tradition as Neti, thisOriginally part of the Yogic tradition as Neti, this technique is anecdotally regarded as safe andtechnique is anecdotally regarded as safe and effective.effective.  It has been suggested as adjunctive therapy forIt has been suggested as adjunctive therapy for sinusitis related symptoms.sinusitis related symptoms.  Potential efficacy is supported by the observationPotential efficacy is supported by the observation that hypertonic saline improves mucociliarythat hypertonic saline improves mucociliary clearance, ciliary beat frequency thins mucus, andclearance, ciliary beat frequency thins mucus, and may decrease inflammation.may decrease inflammation.
  24. 24.  David Shoseyov and colleagues have shown thatDavid Shoseyov and colleagues have shown that hypertonic saline improves both clinical scores andhypertonic saline improves both clinical scores and plain Waters’ projection radiology scores inplain Waters’ projection radiology scores in children with chronic sinusitis.children with chronic sinusitis.  They have also commented that the treatment isThey have also commented that the treatment is tolerable, inexpensive, and effective.tolerable, inexpensive, and effective.  Dr. Marple, professor of otolaryngology at theDr. Marple, professor of otolaryngology at the University of Texas says that saline nasal irrigationUniversity of Texas says that saline nasal irrigation is a highly effective, minimally invasiveis a highly effective, minimally invasive intervention for people suffering from nasal issues.intervention for people suffering from nasal issues.  He however adds,He however adds, “But it’s just not as sexy to talk“But it’s just not as sexy to talk about. People want to hear about surgery orabout. People want to hear about surgery or antibiotics.”antibiotics.”
  25. 25.  David Rabago and colleagues at the University ofDavid Rabago and colleagues at the University of Wisconsin have shown that daily hypertonic salineWisconsin have shown that daily hypertonic saline nasal irrigation improves sinus-related quality ofnasal irrigation improves sinus-related quality of life, decreases symptoms, and decreaseslife, decreases symptoms, and decreases medication use in patients with frequent sinusitis.medication use in patients with frequent sinusitis.  They also recommended that primary careThey also recommended that primary care physicians can feel comfortable recommendingphysicians can feel comfortable recommending this therapy.this therapy.
  26. 26. Kunjal Kriya  One of the Shat Karmas  Immense value for mucous (Kapha) disorders  Done in the morning on an empty stomach.  One or two litres of lukewarm saline drunk rapidly  Abdomen churned with Nauli Kriya or Agnisara  Induce vomiting with fingers  Mechanism: Close functional relationship between upper GIT and airways with reflex action in nerves supplying both esophagus and bronchi.
  27. 27. Breath-body harmonizing practicesBreath-body harmonizing practices  Tala and Ardhakati kriyas  Nasarga Mukha Bhastrika  with Jathis  in Meru Asana  in Ushtra Asana  Vyagraha Pranayama  Pawan Mukta Kriya  Bhujangini Mudra
  28. 28. Surya NamaskarSurya Namaskar  Ancient Yogic method of worshiping the sunAncient Yogic method of worshiping the sun through a sequence of 12 postures that streamlinethrough a sequence of 12 postures that streamline the functioning of all systems of the human body.the functioning of all systems of the human body.  Includes a breath sequence & chantingIncludes a breath sequence & chanting  Helps improve all aspects of physical fitnessHelps improve all aspects of physical fitness including cardio-respiratory efficiency.including cardio-respiratory efficiency.  When done with the Surya Namaskar Mantras itWhen done with the Surya Namaskar Mantras it has the added benefits of ventilating the sinuses.has the added benefits of ventilating the sinuses.  Helps develop breath-body movementHelps develop breath-body movement coordination - corrects psychosomatic disorders bycoordination - corrects psychosomatic disorders by reuniting the body and mind through the breath.reuniting the body and mind through the breath.
  29. 29. Postures done from StandingPostures done from Standing Meru AsanaMeru AsanaArdha Kati ChakrasanaArdha Kati Chakrasana
  30. 30. Postures donePostures done from Sittingfrom Sitting Ushtra AsanaUshtra Asana ArdhaArdha MatsyendrasanaMatsyendrasana Chatus Pada Asana and Vyagrah PranayamaChatus Pada Asana and Vyagrah Pranayama
  31. 31. Postures done from lying DownPostures done from lying Down Bhujanga AsanaBhujanga Asana Matsya AsanaMatsya Asana Bala AsanaBala Asana Pawan Mukta AsanasPawan Mukta Asanas
  32. 32. Vibhaga PranayamaVibhaga Pranayama Adham PranayamaAdham Pranayama Low Chest BreathingLow Chest Breathing Madhyam Pranayama Mid Chest Breathing Adhyam Pranayama Upper Chest Breathing Mahat Yoga Pranayama Integrated Complete Breath
  33. 33. PranayamasPranayamas  Bhastrika PranayamaBhastrika Pranayama  Bellows breathingBellows breathing  Surya BhedanaSurya Bhedana  Breathe in right andBreathe in right and out left nostrilout left nostril  Pranava PranayamaPranava Pranayama  Chanting Akara,Chanting Akara, Ukara, Makara andUkara, Makara and OmkaraOmkara  Anu Nasika PranayamaAnu Nasika Pranayama  Blasting out through theBlasting out through the nostrils in a specificnostrils in a specific patternpattern  Kukkriya PranayamaKukkriya Pranayama  Dog pant breathingDog pant breathing  Bhramari PranayamaBhramari Pranayama  Bee sound breathingBee sound breathing
  34. 34. HATHENASHATHENAS Asanas, Kriyas and Mudras to mindfully utilize all parts of the lungs by consciously forcing air into all of the bronco-pulmonary segments. “Yatho mana, tatho prana” Where the mind goes, there the energy flows!
  35. 35. Adhama (low lung areas) Madhyama (mid lung areas) Adhyama (high lung areas) Mahat Yoga (unified lung areas) HATHENAS
  36. 36. VibhagaVibhaga PranayamaPranayama  Adham PranayamaAdham Pranayama  abdominal and lower limb disordersabdominal and lower limb disorders  Madhyam PranayamaMadhyam Pranayama  chest and upper limb disorderschest and upper limb disorders  Adhyam PranayamaAdhyam Pranayama  head and neck disordershead and neck disorders  Mahat Yoga PranayamaMahat Yoga Pranayama  affects the whole bodyaffects the whole body Focusing consciousness into broncho-pulmonary segments
  37. 37. Pranava PranayamaPranava Pranayama  Using foundation of VibhagaUsing foundation of Vibhaga  Chanting Akara, Ukara, Makara andChanting Akara, Ukara, Makara and Omkara NadaOmkara Nada  2 to 3 times longer exhalations2 to 3 times longer exhalations  Appropriate hand gestures (Mudras)Appropriate hand gestures (Mudras)
  38. 38. Adham PranayamaAdham Pranayama “A” Breathing Part of Body Part of Brain Lower Chest Lower Reptilian complex
  39. 39. Madhyam PranayamaMadhyam Pranayama “U” Breathing Part of Body Part of Brain Mid Chest Mid Mammalian complex
  40. 40. Adhyam PranayamaAdhyam Pranayama “M” Breathing Part of Body Part of Brain Upper Chest Upper Neo-cortex
  41. 41. Pranava AUM PranayamaPranava AUM Pranayama “AUM” Breathing Part of Body Part of Brain Whole Chest Whole Body Whole Brain
  42. 42. RelaxationRelaxation Makara AsanaMakara Asana Shpanda Nishpanda KriyaShpanda Nishpanda Kriya KayaKaya KriyaKriya
  43. 43. Nada Yoga techniquesNada Yoga techniques  Nasarga mukha bhastrikaNasarga mukha bhastrika  Hakara kriyaHakara kriya  Kukkriya pranayamaKukkriya pranayama  Simha nadaSimha nada  Bhramari pranayamaBhramari pranayama  Brahma mudraBrahma mudra  Pranava pranayama and dhyanaPranava pranayama and dhyana
  44. 44. An Integrated ApproachAn Integrated Approach  The need of the modern age is an integrated approach towards therapy utilizing Yoga in coordination & collaboration with other systems of medicine such as Allopathy, Ayurveda, Siddha and Naturopathy  Physiotherapy, osteopathy and chiropractic practices may be used with the Yoga if needed  Advise on diet and life style is very important  Adoption of right attitudes through Yogic counseling
  45. 45. Recent research on Yoga andRecent research on Yoga and COPD from CYTERCOPD from CYTER
  46. 46. Comparison of delta changes in lung function in adjuvant yoga therapy group and control (medication alone) group before and after the four weeks study period. ***p<0.001 by Student’s unpaired ‘t’ test for inter group comparison.***p<0.001 by Student’s unpaired ‘t’ test for inter group comparison. *** ***
  47. 47. *p<0.05, **p<0.01 & ***p<0.001 by Student’s unpaired ‘t’ test for inter group comparison.*p<0.05, **p<0.01 & ***p<0.001 by Student’s unpaired ‘t’ test for inter group comparison. Comparison of delta in symptoms, activities, impact & total SGRQ scores in adjuvant yoga therapy and control (medication alone) groups before & after 4 weeks study period. *** ***** * SS – symptoms score, AS – activity score, IS – impacts score, QS – quality score (total)
  48. 48.  Which patients tend to respond to integrative medicineWhich patients tend to respond to integrative medicine interventions?interventions? (Kligler etal,2012)(Kligler etal,2012) ..  Responders demonstrated an attitude of "change asResponders demonstrated an attitude of "change as challenge;" a view of themselves as "independent" andchallenge;" a view of themselves as "independent" and "leaders;" an ability to accept one's illness while still"leaders;" an ability to accept one's illness while still maintaining a feeling of control over one's choices; amaintaining a feeling of control over one's choices; a connection to the deeper context or meaning ofconnection to the deeper context or meaning of complementary and alternative medicine (CAM) interventions,complementary and alternative medicine (CAM) interventions, as opposed to just "previous experience" of CAM; and a senseas opposed to just "previous experience" of CAM; and a sense of determination, commitment, and "willingness to fight" forof determination, commitment, and "willingness to fight" for what one needs from the health care system.what one needs from the health care system.  Non-responders were more often uncertain and anxious inNon-responders were more often uncertain and anxious in their relationship to their asthma, tending to fall back ontheir relationship to their asthma, tending to fall back on denial, and lacking a connection to the deeper context ordenial, and lacking a connection to the deeper context or philosophy of CAM interventions.philosophy of CAM interventions.
  49. 49.  All of these mechanisms can help bring about both objective and subjective improvements in the condition of patients with respiratory disorders.  Yoga as a therapy is also cost effective, relatively simple and carries minimal risk  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. In Conclusion..In Conclusion..
  50. 50.  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 (Crameretal,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."
  51. 51. Some final words…….Some final words…….  The ancient art and science of Yoga has infinite possibilities of solutions for the health related issues faced by modern humankind.  We however want it to be a miracle pill, that we take only once - immediate solution to all problems!  Yoga is a w-holistic science and must be learnt and practiced with a holistic view.  The dedicated practice of Yoga as a way of life is no doubt a panacea for psychosomatic, stress related disorders helping us to regain our birthright of natural health and universal happiness.  The integration of Yoga and modern medicine can help create a healthier and happier world.
  52. 52. “Health and happiness are your birthright. Do not forsake your golden culture for the plastic playthings of the modern world. Learn and live Yoga for then you will know true health and happiness” Yogamaharishi Dr Swami Gitananda Giri Guru Maharaj (1907-1993) Founder ICYER at Ananda Ashram, Pondicherry
  53. 53. Accredited with ‘AA’ grade by NAAC
  54. 54. ReferencesReferences:: 1.1. Behera D. Yoga therapy in chronic bronchitis. J Assoc Physicians India 1998; 46: 207-8.Behera D. Yoga therapy in chronic bronchitis. J Assoc Physicians India 1998; 46: 207-8. 2.2. Bernardi L, Passino C, Wilmerding Vetal. Breathing patterns and cardiovascular autonomic modulation duringBernardi L, Passino C, Wilmerding Vetal. Breathing patterns and cardiovascular autonomic modulation during hypoxia induced by simulated altitude. J Hypertens 2001; 19 : 947-58hypoxia induced by simulated altitude. J Hypertens 2001; 19 : 947-58 3.3. Bhavanani AB. Yoga Chikitsa: The application of Yoga as a therapy. Pondicherry, India: Dhivyananda Creations, 2013.Bhavanani AB. Yoga Chikitsa: The application of Yoga as a therapy. Pondicherry, India: Dhivyananda Creations, 2013. 4.4. Cramer H, Posadzki P, Dobos G, Langhorst J. Yoga for asthma: a systematic review and meta-analysis. Ann AllergyCramer 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.Asthma Immunol 2014;112(6):503-510. 5.5. Jeter PE, Slutsky J, Singh N, Khalsa SB. Yoga as a therapeutic intervention: A bibliometric analysis of publishedJeter 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.research studies from 1967 to 2013. J Altern Complement Med. 2015;21:586–92. 6.6. Kligler B, McKee MD, Sackett E, Levenson H, Kenney J, Karasz A. An integrative medicine approach to asthma: whoKligler 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.responds? J Altern Complement Med 2012; 18 (10): 939-45. 7.7. Nagarathna R, Nagendra HR. Yoga for bronchial asthma: a controlled study. BMJ 1985; 291: 1077-79.Nagarathna R, Nagendra HR. Yoga for bronchial asthma: a controlled study. BMJ 1985; 291: 1077-79. 8.8. Satyaprabha TN, Murthy H, Murthy BTC. Efficacy of naturopathy and Yoga in bronchial asthma - a self controlledSatyaprabha TN, Murthy H, Murthy BTC. Efficacy of naturopathy and Yoga in bronchial asthma - a self controlled matched scientific study. IJPP 2001; 45: 80-6.matched scientific study. IJPP 2001; 45: 80-6. 9.9. Singh S, Soni R, Singh KP, Tandon OP. Effect of Yoga practices on pulmonary function tests including transfer factor ofSingh 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.lung for carbon monoxide (TLCO) in asthma patients. Indian J Physiol Pharmacol 2012; 56 (1):63-8. 10.10. Singh V. Effect of respiratory exercises on asthma. The Pink City lung exerciser. Journal of Asthma 1987; 24: 355-359.Singh V. Effect of respiratory exercises on asthma. The Pink City lung exerciser. Journal of Asthma 1987; 24: 355-359. 11.11. Sodhi C, Singh S, Bery A. Assessment of the quality of life in patients with bronchial asthma, before and after Yoga: aSodhi 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.randomised trial. Iran J Allergy Asthma Immunol 2014;13 (1) :55-60. 12.12. Spicuzza L, Gabutti A, Porta C, Montano N, Bernardi L. Yoga and chemoreflex response to hypoxia and hypercapnia.Spicuzza L, Gabutti A, Porta C, Montano N, Bernardi L. Yoga and chemoreflex response to hypoxia and hypercapnia. Lancet 2000 ; 356: 1495-96.Lancet 2000 ; 356: 1495-96. 13.13. Tahan F, Eke Gungor H, Bicici E. Is Yoga training beneficial for exercise-induced bronchoconstriction? Altern TherTahan F, Eke Gungor H, Bicici E. Is Yoga training beneficial for exercise-induced bronchoconstriction? Altern Ther Health Med 2014;20 (2):18-23.Health Med 2014;20 (2):18-23. 14.14. Tandon M K. Adjunct treatment with Yoga in chronic severe airways obstruction. Thorax 1978; 33: 514-517Tandon M K. Adjunct treatment with Yoga in chronic severe airways obstruction. Thorax 1978; 33: 514-517 15.15. Vempati R, Bijlani RL, Deepak KK. The efficacy of a comprehensive lifestyle modification programme based on Yoga inVempati 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.the management of bronchial asthma: a randomized controlled trial. BMC Pulm Med 2009 ; 30; 9:37.

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