Sahaja yoga in the management of moderate to severe asthma: a randomised controlled trial
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
Background:
Sahaja Yoga is a traditional system of meditation based on yogic principles which may be used for therapeutic purposes. A study was undertaken to assess the effectiveness of this therapy as an adjunctive tool in the management of asthma in adult patients who remained symptomatic on moderate to high doses of inhaled steroids.
Methods:
A parallel group, double blind, randomised controlled trial was conducted. Subjects were randomly allocated to Sahaja yoga and control intervention groups. Both the yoga and the control interventions required the subjects to attend a 2 hour session once a week for 4 months. Asthma related quality of life (AQLQ, range 0–4), Profile of Mood States (POMS), level of airway hyper responsiveness to methacholine (AHR), and a diary card based combined asthma score (CAS, range 0–12) reflecting symptoms, bronchodilator usage, and peak expiratory flow rates were measured at the end of the treatment period and again 2 months later.
Results:
Twenty one of 30 subjects randomised to the yoga intervention and 26 of 29 subjects randomised to the control group were available for assessment at the end of treatment. The improvement in AHR at the end of treatment was 1.5 doubling doses (95% confidence interval (CI) 0.0 to 2.9, p=0.047) greater in the yoga intervention group than in the control group. Differences in AQLQ score (0.41, 95% CI –0.04 to 0.86) and CAS (0.9, 95% CI –0.9 to 2.7) were not significant (p>0.05). The AQLQ mood subscale did improve more in the yoga group than in the control group (difference 0.63, 95% CI 0.06 to 1.20), as did the summary POMS score (difference 18.4, 95% CI 0.2 to 36.5, p=0.05). There were no significant differences between the two groups at the 2 month follow up assessment.
Conclusions:
This randomised controlled trial has shown that the practice of Sahaja yoga does have limited beneficial effects on some objective and subjective measures of the impact of asthma. Further work is required to understand the mechanism underlying the observed effects and to establish whether elements of this intervention may be clinically valuable in patients with severe asthma.
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Authors
R Manocha
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G B Marks
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P Kenchington
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D Peters
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C M Salome
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Author's primary institution
University of Sydney, New South Wales, Australia
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Yoga intervention for adults with mild-to-moderate asthma: a pilot study
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
Background:
Preliminary studies investigating yoga and breath work for treating asthma have been promising. Several randomized controlled trials have shown a benefit from yoga postures and breathing vs. control, but the control in these cases involved no intervention other than usual care. This study advances the field by providing an active control.
Objective:
To determine the effectiveness and feasibility of a yoga and breath work intervention for improving clinical indices and quality of life in adults with mild-to-moderate asthma. Methods: A randomized, controlled, double-masked clinical trial was conducted between October 1, 2001, and March 31, 2003. Random assignment was made to either a 4-week yoga intervention that included postures and breath work or a stretching control condition. Outcome measures were evaluated at 4, 8, 12, and 16 weeks and included the Mini Asthma Quality of Life Questionnaire, rescue inhaler use, spirometry, symptom diaries, and health care utilization.
Results:
Sixty-two participants were randomized to the intervention and control groups, and 45 completed the final follow-up measures. Intention-to-treat analysis was performed. Significant within-group differences in postbronchodilator forced expiratory volume in 1 second and morning symptom scores were apparent in both groups at 4 and 16 weeks; however, no significant differences between groups were observed on any outcome measures.
Conclusions:
Iyengar yoga conferred no appreciable benefit in mild-to-moderate asthma. Circumstances under which yoga is of benefit in asthma management, if any, remain to be determined.
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Authors
Alyse B Sabina
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Annaleila Williams
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Hilary K Wall
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Sandeep Bansal
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Geoffrey Chupp
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David L Katz
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Journal
Annals of Allergy, Asthma & Immunology
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Author's primary institution
Yale-Griffin Prevention Research Center, Derby, Connecticut 06418, USA
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The efficacy of a comprehensive lifestyle modification programme based on yoga in the management of bronchial asthma: a randomized controlled trial
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
Background:
There is a substantial body of evidence on the efficacy of yoga in the management of bronchial asthma. Many studies have reported, as the effects of yoga on bronchial asthma, significant improvements in pulmonary functions, quality of life and reduction in airway hyper-reactivity, frequency of attacks and medication use. In addition, a few studies have attempted to understand the effects of yoga on exercise-induced bronchoconstriction (EIB) or exercise tolerance capacity. However, none of these studies has investigated any immunological mechanisms by which yoga improves these variables in bronchial asthma.
Methods:
The present randomized controlled trial (RCT) was conducted on 57 adult subjects with mild or moderate bronchial asthma who were allocated randomly to either the yoga (intervention) group (n = 29) or the wait-listed control group (n = 28). The control group received only conventional care and the yoga group received an intervention based on yoga, in addition to the conventional care. The intervention consisted of 2-wk supervised training in lifestyle modification and stress management based on yoga followed by closely monitored continuation of the practices at home for 6-wk. The outcome measures were assessed in both the groups at 0 wk (baseline), 2, 4 and 8 wk by using Generalized Linear Model (GLM) repeated measures followed by post-hoc analysis.
Results:
In the yoga group, there was a steady and progressive improvement in pulmonary function, the change being statistically significant in case of the first second of forced expiratory volume (FEV1) at 8 wk, and peak expiratory flow rate (PEFR) at 2, 4 and 8 wk as compared to the corresponding baseline values. There was a significant reduction in EIB in the yoga group. However, there was no corresponding reduction in the urinary prostaglandin D2 metabolite (11β prostaglandin F2α) levels in response to the exercise challenge. There was also no significant change in serum eosinophilic cationic protein levels during the 8-wk study period in either group. There was a significant improvement in Asthma Quality of Life (AQOL) scores in both groups over the 8-wk study period. But the improvement was achieved earlier and was more complete in the yoga group. The number-needed-to-treat worked out to be 1.82 for the total AQOL score. An improvement in total AQOL score was greater than the minimal important difference and the same outcome was achieved for the sub-domains of the AQOL. The frequency of rescue medication use showed a significant decrease over the study period in both the groups. However, the decrease was achieved relatively earlier and was more marked in the yoga group than in the control group.
Conclusion:
The present RCT has demonstrated that adding the mind-body approach of yoga to the predominantly physical approach of conventional care results in measurable improvement in subjective as well as objective outcomes in bronchial asthma. The trial supports the efficacy of yoga in the management of bronchial asthma. However, the preliminary efforts made towards working out the mechanism of action of the intervention have not thrown much light on how yoga works in bronchial asthma.
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Authors
Ramaprabhu Vempati
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Ramesh Lal Bijlani
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Kishore Kumar Deepak
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Journal
BMC Pulmonary Medicine
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Author's primary institution
Department of Physiology, All India Institute of Medical Sciences, New Delhi
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Efficacy of naturopathy and yoga in bronchial asthma--a self controlled matched scientific study.
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
Asthma is one of the common psychosomatic illness influenced by many factors. Bronchodilators give temporary relief and have side effects. The present study is aimed at finding the efficacy of a non-pharmacological approach of naturopathy and Yoga in bronchial asthma.
A total no of 37 patients (19 men, 18 women) with mean age 35.06 yrs (men), 40.74 yrs (women) admitted to INYS, Bangalore, for the period of 21 days. The treatment included 1. Diet therapy 2. Nature cure treatment and 3. Yoga therapy. The various parameters including lung function test were measured on admission and once a week.
Results showed the significant improvement in PEFR, VC, FVC, FEV1, FEV/FEC %, MVV, ESR and absolute eosinophil count.
The patients reported a feeling of well being, freshness and comfortable breathing. Naturopathy and yoga helps in inducing positive health, alleviating the symptoms of disease by acting at physical and mental levels.
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Authors
TN Sathyaprabha
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H Murthy
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BT Murthy
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Journal
Indian Journal of Physiology and Pharmacology
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Author's primary institution
Department of Physiology, St John's Medical College, Bangalore
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Effect of mindfulness training on asthma quality of life and lung function: a randomised controlled trial
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
Background:
This study evaluated the efficacy of a mindfulness training programme (mindfulness-based stress reduction (MBSR)) in improving asthma-related quality of life and lung function in patients with asthma.
Methods:
A randomised controlled trial compared an 8-week MBSR group-based programme (n=42) with an educational control programme (n=41) in adults with mild, moderate or severe persistent asthma recruited at a university hospital outpatient primary care and pulmonary care clinic. Primary outcomes were quality of life (Asthma Quality of Life Questionnaire) and lung function (change from baseline in 2-week average morning peak expiratory flow (PEF)). Secondary outcomes were asthma control assessed by 2007 National Institutes of Health/National Heart Lung and Blood Institute guidelines, and stress (Perceived Stress Scale (PSS)). Follow-up assessments were conducted at 10 weeks, 6 and 12 months.
Results:
At 12 months MBSR resulted in clinically significant improvements from baseline in quality of life (differential change in Asthma Quality of Life Questionnaire score for MBSR vs control: 0.66 (95% CI 0.30 to 1.03; p<0.001)) but not in lung function (morning PEF, PEF variability and forced expiratory volume in 1 s). MBSR also resulted in clinically significant improvements in perceived stress (differential change in PSS score for MBSR vs control: −4.5 (95% CI −7.1 to −1.9; p=0.001)). There was no significant difference (p=0.301) in percentage of patients in MBSR with well controlled asthma (7.3% at baseline to 19.4%) compared with the control condition (7.5% at baseline to 7.9%).
Conclusions:
MBSR produced lasting and clinically significant improvements in asthma-related quality of life and stress in patients with persistent asthma, without improvements in lung function.
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Authors
Lori Pbert
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J Mark Madison
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Susan Druker
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Nicholas Olendzkki
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Robert Magner
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George Reed
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Jeroan Allison
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James Carmody
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Author's primary institution
University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Yoga for Asthma? A Systematic Review of Randomized Clinical Trials
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
Objective:
The objective of this systematic review was to assess the effectiveness of yoga as a treatment option for asthma. Method. Seven databases were searched from their inception to October 2010. Randomized clinical trials (RCTs) and non-randomized clinical trials (NRCTs) were considered, if they investigated any type of yoga in patients with asthma. The selection of studies, data extraction, and validation were performed independently by two reviewers.
Results:
Six RCTs and one NRCT met the inclusion criteria. Their methodological quality was mostly poor. Three RCTs and one NRCT suggested that yoga leads to a significantly greater reduction in spirometric measures, airway hyperresponsivity, dose of histamine needed to provoke a 20% reduction in forced expiratory volume in the first second, weekly number of asthma attacks, and need for drug treatment. Three RCTs showed no positive effects compared to various control interventions.
Conclusions:
The belief that yoga alleviates asthma is not supported by sound evidence. Further, more rigorous trials are warranted.
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Authors
Paul Posadzki
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Edzard Ernst
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Journal
Journal of Asthma
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Author's primary institution
Department of Complementary Medicine, Peninsula Medical School, University of Exeter, Devon, United Kingdom
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Long-term effects of breathing exercises and yoga in patients with bronchial asthma
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
To compare the effects of breathing exercises (BE) or Yoga (Y) on the course of bronchial asthma we studied 36 subjects with a mild disease.
The patients were randomly divided into 3 groups. 2 of them participated in a 3 weeks training program of BE or Y while the third group rested without any additional treatment (control group, C). At the end of the training period the patients were asked to practise BE or Y on their own.
Drug therapy and lung function parameters before and after a beta 2-agonist metered dose inhaler (albuterol, ALB) were recorded prior to the training program and in 4 weeks intervals for 4 months thereafter. The response to the beta 2-agonist was documented continuously in 28 patients. The mental state of the patients was elucidated by questionnaires. Prior to the study a significant effect of inhaled ALB on the FEV1 was shown without any significant between group differences.
Both, BE and Y, caused a significant amelioration of the mental state but only the BE induced a significant improvement of lung function parameters compared to the individual baseline values.
The FEV1 increased significantly by 356.3 +/- 146.2 ml (p < 0.05) and the VC by 225.0 +/- 65.5 ml (p < 0.01). These long-term changes were not significantly different from the actual response to ALB. BE decreased the RV significantly by 306.3 +/- 111.6 ml (p < 0.05), an effect significantly higher compared to the beta 2-agonist (p < 0.01). BE in combination with ALB caused an additive effect.
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Authors
Flue T
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Richter J
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Fabel H
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Zysno E
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Wagner TO
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Author's primary institution
Universitatsmedizin
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Evaluation of Yoga therapy programme for patients of bronchial asthma.
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
A study of the effect of yoga therapy programme on 46 indoor patients of chronic bronchial asthma on exercise capacity, pulmonary functions and blood gases was conducted.
Exercise capacity was measured by 3 tests: (i) 12 min walk test (12-md); (ii) physical fitness index (PFI) by modified Harvard step test; and (iii) Exercise-Liability index (ELI).
Yoga therapy programme resulted in a significant increase in the pulmonary functions and exercise tolerance. A one-year follow-up study showed a good to fair response with reduced symptoms score and drug requirements in these subjects. It is concluded that yoga therapy is beneficial for bronchial asthma.
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Authors
Jain SC
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Talukdar B
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Journal
Singapore Medical Journal
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Author's primary institution
Central Research Institute for Yoga
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Effect of yoga breathing exercises (pranayama) on airway reactivity in subjects with asthma
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
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 FEV, (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.
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Authors
V. Singh
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A. Wisniewski
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J. Britton
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A. Tattersfield
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Author's primary institution
Respiratory Medicine Unit
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An Integrated Approach of Yoga Therapy for Bronchial Asthma: A 3 - 54 month prospective study
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
After an initial integrated yoga training program of 2 to 4 weeks, 570 bronchial asthmatics were followed up for 3 to 54 months. The training consisted of yoga practices—yogasanas, Prānāyāma, meditation, and kriyas—and theory of yoga.
Results show highly significant improvement in most of the specific parameters. The regular practitioners showed the greatest improvement. Peak expiratory flow rate (PFR) values showed significant movement of patients toward normalcy after yoga, and 72, 69, and 66% of the patients have stopped or reduced par-enteral, oral, and cortisone medication, respectively.
These results establish the long-term efficacy of the integrated approach of yoga therapy in the management of bronchial asthma.
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Authors
H.R. Nagendra & R. Nagarathna
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Journal
Journal of Asthma
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Author's primary institution
Yoga Therapy and Research Center
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Yoga for bronchial asthma: a controlled study.
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
Fifty three patients with asthma underwent training for two weeks in an integrated set of yoga exercises, including breathing exercises, suryanamaskar, yogasana (physical postures), pranayama (breath slowing techniques), dhyana (meditation), and a devotional session, and were told to practise these exercises for 65 minutes daily.
They were then compared with a control group of 53 patients with asthma matched for age, sex, and type and severity of asthma, who continued to take their usual drugs.
There was a significantly greater improvement in the group who practised yoga in the weekly number of attacks of asthma, scores for drug treatment, and peak flow rate.
This study shows the efficacy of yoga in the long term management of bronchial asthma, but the physiological basis for this beneficial effect needs to be examined in more detail.
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Authors
H.R. Nagendra & R. Nagarathna
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Author's primary institution
Yoga Therapy and Research center
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Yoga for asthma: a systematic review and meta-analysis
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
Background
Although yoga is frequently used by patients with asthma, its efficacy in alleviating asthma remains unclear.
Object
To systematically assess and meta-analyze the available data on efficacy and safety of yoga in alleviating asthma.
Methods
MEDLINE/PubMed, Scopus, the Cochrane Central Register of Controlled Trials, PsycINFO, CAM-Quest, CAMbase, and IndMED were searched through January 2014. Randomized controlled trials of yoga for patients with asthma were included if they assessed asthma control, symptoms, quality of life, and/or pulmonary function. For each outcome, standardized mean differences (SMDs) or risk ratios (RRs) and 95% confidence intervals (CIs) were calculated. Risk of bias was assessed using the Cochrane tool.
Results
Fourteen randomized controlled trials with 824 patients were included. Evidence for effects of yoga compared with usual care was found for asthma control (RR, 10.64; 95% CI, 1.98 to 57.19; P = .006), asthma symptoms (SMD, −0.37; 95% CI, −0.55 to −0.19; P < .001), quality of life (SMD, 0.86; 95% CI, 0.39 to 1.33; P < .001), peak expiratory flow rate (SMD, 0.49; 95% CI, 0.32 to 0.67; P < .001), and ratio of forced expiratory volume in 1 second to forced vital capacity (SMD, 0.50; 95% CI, 0.24 to 0.75; P < .001); evidence for effects of yoga compared with psychological interventions was found for quality of life (SMD, 0.61; 95% CI, 0.22 to 0.99; P = .002) and peak expiratory flow rate (SMD, 2.87; 95% CI, 0.14 to 5.60; P = .04). No evidence for effects of yoga compared with sham yoga or breathing exercises was revealed. No effect was robust against all potential sources of bias. Yoga was not associated with serious adverse events.
Conclusion
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.
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Authors
Holger Cramer PHD, Paul Posadzki PHD, Gustav Dobos MD, Jost Langhorst MD
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Author's primary institution
Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Yoga as an alternative and complementary treatment for asthma: a systematic review
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
The morbidity and mortality associated with asthma make it a worldwide health concern. Corticosteroid therapy is the most popular method to treat asthma, but yoga has been identified as an alternative therapy to expensive drugs. A systematic review of studies meeting the following criteria is presented: (a) be published in the English language; (b) included in CINAHL, Medline, or Alt HealthWatch; (c) between the years 1972 and 2012; (d) include yoga as an intervention; (e) use any quantitative study design; and (f) measures one of the following outcomes: forced expiratory volume in 1 second, peak expiratory flow rate, airway resistance, or Asthma Quality of Life Questionnaire score. Of the 15 studies systematically analyzed, 10 documented significant improvement because of yoga. Limitations include lack of a theory-based approach, self-reporting errors, and intervention adherence issues.
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Authors
Manoj Sharma, Taj Haider, Parth P. Bse
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Journal
Journal of Evidence-Based Complementary & Alternative Medicine
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Author's primary institution
University of Cincinnati, Cincinnati, OH, USA
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Yoga training improves quality of life in women with asthma
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
Objectives:
Individuals with asthma frequently suffer with a decrease in quality of life. Yoga has been shown to improve autonomic function in the healthy population and has been used as an alternative therapy to help improve symptoms associated with various diseases.
Purpose:
The purpose of this study was to assess whether 10 weeks of yoga training can improve quality of life and heart rate variability (HRV) in patients with asthma.
Design:
Nineteen (19) females were randomly assigned to a yoga group or a control group for a 10-week intervention while still following guidelines established by their physician. All subjects answered the St. George's Respiratory Questionnaire (SGRQ) to assess quality of life and performed an isometric handgrip exercise test to assess HRV.
Results:
Based on the SGRQ, significant improvements (45%, p<0.05) in quality of life were observed with the yoga training, while no changes were found in the control group. Resting hemodynamic measures improved significantly in the yoga group compared to the control group (p<0.05). The yoga group decreased parasympathetic modulation (HFnu [normalized units]) pre- to postintervention (0.45±0.60 to 0.35±0.06 nu, p<0.05, respectively) in response to the isometric forearm exercise (IFE), whereas the control group did not change. Additionally, the yoga group increased sympathetic (LFnu) (pre 0.47±0.07 to post 0.60±0.07 nu, p<0.05) and sympathovagal modulation (logLF/HF) (pre 4.61±0.39 to post 5.31±0.44, p<0.05, respectively) during IFE with no change in the control group.
Conclusions:
Yoga training improved quality of life in women with mild-to-moderate asthma and resulted in decreased parasympathetic and increased sympathetic modulation in response to an IFE.
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Authors
Amy J. Bidwell, Beth Yazel, David Davin, Timothy J. Fairchild, Jill A. Kanaley
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Journal
The Journal of Alternative and Complementary Medicine
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Author's primary institution
Department of Exercise Science, Syracuse University, New York
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Asthma
Jean Hall by KarenYeomans.com
