Bhavanani AB. Efficacy of Yoga in Respiratory Disorders: Some Research Finding. Tamilnadu and Puducherry State Conference on Pulmonary Diseases TAPPCON 2017 at SBVU, Pondicherry. Pg 55-57.

1. STRONGER TOGETHER
• • • •

2. EFFICACY OF YOGA IN RESPIRATORYDISORDERS:
SOME RESEARCH FINDING
Yogacharya Dr. Ananda Balayogi Bhavanani,
MBBS, MD (AM), C-IAYT.
Director, Centre for Yoga Therapy, Education and Research (CYTER),
Sri Balaji Vidyapeeth, Pondicherry. Email: yoga@mgmcri.ac.in
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
(Jeter et al, 2015).
Scientific basis of using Yoga as
an adjunct therapy in chronic obstructive
pulmonary disease (COPD) is well established
with significant improvements in lung function,
quality oflife indices and bronchial provocation
responses coupled with decreased need for
regular and rescue medicinal usage (Nagarathna
& Nagendra, 1985; Vempati et al, 2009).
Beherareportedperceptibleimprovement
in dyspnoea and lung function in patients of
bronchitis after 4 weeks ofYoga therapy that used
a variety of postures and breathing techniques
(Behera, 1998).
Yogic cleaning techniques such as dhauti
kriya (upper gastrointestinal cleaning with warm
saline or muslin cloth) and neti kriya (warm
saline nasal wash) remove excessive mucous
secretions, decrease inflammation and reduce
bronchial hypersensitivity thereby increasing
provocation thresholdwhile kapalabhatithrough
forceful exhalations improves the capacity to
exhale against resistance (Satyaprabha et al,
2001).
A nonspecific bronchoprotective or
bronchorelaxing effect has been also postulated
(Singh, 19875) while improved exercise tolerance
has been reported following Yoga therapy in
patients of chronic severe airways obstruction
(Tandon, 1978).
It has been reported that well-performed
slow yogic breathing maintains better blood
oxygenation without increasing minute
ventilation, reduces sympathetic activation
during altitude-induced hypoxia (Bernardi et al,
2001) and decreased chemoreflex sensitivity to
hypoxia and hypercapnia (Spicuzza et al, 2000)
BhramariisoneoftheSwaraPranayamas
and helps tone up the nervous system thus
producing a state of extreme calmness and
bliss. Sit on your heels in the Vajrasana with
your spine erect. Perform Shanmuki Mudra
with your thumbs closingthe external auditory
canals. The first two fingers are then placed
over the closed eyelids while the ring fingers
regulate the flow of air through the nostrils.
The little fingers are placed over the closed
lips. This Mudra helps in uniting the energies
of the nerves of the hands with the facial and
trigeminal nerves of the face. Take in a slow
and deep breath in for six counts. Then let out
the breath very slowly while making a sound
in the nasal passages like the high-pitched
sound ofa female bee. Perform nine rounds of
this practice and then release your hands back
to your thighs to enjoy a few minutes of deep
contemplation while sitting in Vajrasana.
Asthmatic patients showed a statistically
significant improvement in Transfer factor ofthe
lung for carbon monoxide (TLCO), forced vital
capacity (FVC), forced expiratory volume in 1st
sec (FEVI), peak expiratory flow rate (PEFR),
maximum voluntary ventilation (MVV) and
slow vital capacity (SVC) after ,2 months of
Yoga practice. Quality of life "lso increased
significantly. It was concluded t~at pranayama
and Yoga postures may be used to increase
respiratory stamina, relax the vhest muscles,

3. expand the lungs, raise energy levels, and calm
the body (Singh et al, 2012).
Asthmatic patients showed a statistically
significant improvement in Transfer factor ofthe
lung for carbon monoxide (TLCO), forced vital
capacity (FVC), forced expiratory volume in 1st
sec (FEVl), peak expiratory flow rate (PEFR),
maximum voluntary ventilation (MVV) and
slow vital capacity (SVC) after 2 months of
Yoga practice. Quality of life also increased
significantly. It was concluded that pranayama
and Yoga postures may be used to increase
respiratory stamina, relax the chest muscles,
expand the lungs, raise energy levels, and calm
the body (Singh et al, 2012).
A study to assess beneficial effects of
Yoga in exercise-induced broncho-constriction
in children aged 7-16yreported that all exercise-
response-positive asthmatics became exercise
response-negative asthmatics after 3 months
of bi-weekly Yoga training (Tahan et al, 2014).
It was recommended that Yoga training can
upplement drug therapy to achieve better
control of asthma in children.
In a recent study of 120 non-smoking
male and female patients of asthma in the age
group of 17-50 years, 8 weeks of Yoga breathing
exercises used adjunctively with standard
pharmacological treatment significantly
improved quality oflife (Sodhi et al, 2014).
A novel RCT tried to develop a
better understanding of which patients with
chronic illness tend to respond to integrative
medicine interventions, by identifying a set of
characteristics or qualities that are associated
with a positive outcome (Kligler et al,
2012). This was undertaken as an integrative
medicine approach to asthma and incorporated
journaling, Yoga breathing instruction, and
nutritional manipulation and supplementation.
Responders demonstrated an attitude of
"change as challenge;" a view of themselves as
"independent" and "leaders;" an ability to accept
This practice is a one pointed
concentration on the form and Nada or
sound ofthe sacred Pranava AUM, known as
the Mantra of all Mantras. This can be done
from any ofthe sitting posturesbut make sure
that your back is erect. It is best to do this
after performing a few rounds of conscious
deep breathing so that the mind is in a calm
state. Pranava Dhyana harmonizes the body,
emotions and mind. It is an important part
ofthe Rishiculture Ashtanga Yoga tradition as
taughtbyYogamaharishiDrSwamiGitananda
Giri. In this practice emphasis is first placed
on making the sounds AAA, UUU and
MMM separately and then in combination.
This is followed by the performance of the
practice mentally without the audible sound.
A performance of three to nine rounds of
the Pranava Dharana when done daily helps
to relax the Body-Emotion-Mind complex
and provides complete healing through the
production of healing vibrations at all levels
of our existence. This is the cornerstone of
Yogic breath therapy and can produce health
and wellbeing for all. When the concentrative
aspect of the practice is taken to its peak, a
state of meditation or Pranava Dhyana can
ensue.
one's illness while still maintaining a feeling of
control over one's choices; a connection to the
deeper context or meaning of complementary
and alternative medicine (CAM) interventions,
as opposedtojust"previous experience" ofCAM;
and a sense of determination, commitment, and
"willingnessto fight" for what one needs from the
health care system. Non-responders were more
often uncertain and anxious in their relationship
to their asthma, tending to fall back on denial,
and lacking a connection to the deeper context
.or philosophy ofCAM interventions.
All of these mechanisms can help
bring about both objective and subjective
improvements in the condition of patients
with bronchitis. Yoga as a therapy is also cost

4. effective, relatively simple and carries minimal
risk and hence 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.
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 (Cramer
et al, 2014). They concluded that there was no
evidence for effects ofYoga compared with sham
Yoga or breathing exercises and that no effectwas
robust against all potential sources ofbias. 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:'
References:
1. BeheraD. Yogatherapyinchronicbronchitis.
J Assoc Physicians India 1998; 46: 207-8.
2. Bernardi L, Passino C, Wilmerding Vetal.
Breathing patterns and cardiovascular
autonomic modulation during hypoxia
induced by simulated altitude. J Hypertens
2001; 19: 947-58
3. Bhavanani AB. Yoga Chikitsa: The
application ofYoga as atherapy. Pondicherry,
India: Dhivyananda Creations, 2013.
4. Cramer H, Posadzki P, Dobos G, Langhorst
J. Yoga for asthma: a systematic review
and meta-analysis. Ann Allergy Asthma
Immunol2014;112(6):503-510.
5. Jeter 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.
6. Kligler B, McKee MD, SackettE, Levenson H,
Kenney J, Karasz A. An integrative medicine
approach to asthma: who responds? J Altern
Complement Med 2012; 18 (10): 939-45.
7. Nagarathna R, Nagendra HR. Yoga for
bronchial asthma: a controlled study. BMJ
1985;291: 1077-79.
8. Satyaprabha TN, Murthy H, Murthy
BTC. Efficacy of naturopathy and Yoga in
bronchial asthma - a selfcontrolled matched
scientific study. IJPP 2001; 45: 80-6.
9. Singh 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.
10. Singh V. Effect of respiratory exercises
on asthma. The Pink City lung exerciser.
Journal ofAsthma 1987; 24: 355-359.
11. Sodhi 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.
12. Spicuzza L, Gabutti A, Porta C, Montano N,
Bernardi L. Yoga and chemoreflex response
to hypoxia and hypercapnia. Lancet 2000 ;
356: 1495-96.
13. Tahan F, Eke Gungor H, Bicici E. Is Yoga
training beneficial for exercise-induced
bronchoconstriction? Altern Ther Health
Med 2014;20 (2):18-23.
14. Tandon M K. Adjunct treatment with Yoga
in chronic severe airways obstruction.
Thorax 1978; 33: 514-517
15. Vempati 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.