Details

Yoga-based Pulmonary Rehabilitation for the Management of Dyspnea in Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial

Raj N

Deptt of Yoga Tnpesu, Chennai

Moorthy A M

Deptt of Yoga Tnpesu, Chennai

113-128

Vol: 7, Issue: 2, 2017

Receiving Date: 2017-02-21 Acceptance Date:

2017-04-19

Publication Date:

2017-05-24

Download PDF

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity, mortality, and health care use [1]. COPD -Chronic obstructive pulmonary Disease (COPD), a common preventable and treatable disease, is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to the noxious particles or gases. Objectives: To evaluate the effectiveness of Yoga Therapy in the management of dyspnea and fatigue in patients with COPD. Materials and methods: sixty COPD(18 to 60years) were recruited. The yoga group received an yoga module for COPD that included asanas, loosening exercises, breathing practices, pranayama, meditation, yogic counseling and lectures 45 min/day, 3days/weeks on alternate days for 12 weeks. Measurements of dyspnea and fatigue on the spirometry, exercise capacity by the 6 min walk test, COPD QUESSIONAIRE, and C –Reactive protein (CRP) for inflammatory response were made before and after the intervention. Results: Statistically significant within group reductions in dyspnea (P <0.001), COPD quessionaire (P <0.001) scores, CRP (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 yoga benefits patients with COPD. Yoga can now be included as an adjunct to conventional therapy for pulmonary rehabilitation to Most cases of COPD can be prevented by programs for COPD patients

Keywords: Chronic obstructive pulmonary disease; Dyspnea; Yoga

References

  1. Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, et al. Globalstrategy for the diagnosis, management, and prevention of chronic obstructivepulmonary disease: GOLD executive summary. Am J RespirCrit Care Med2007;176:532e55
  2. Laney AS, Weissman DN. Respiratory diseases caused by coal mine dust. J Occup Environ Med 2014;56(Suppl. 10):S18e22.
  3. Santo Tomas LH. Emphysema and chronic obstructive pulmonary disease incoal miners. CurrOpinPulm Med 2011;17:123e5.
  4. Waschki B, Kirsten A, Holz O, Müller KC, Meyer T, Watz H, et al. Physicalactivity is the strongest predictor of all-cause mortality in patients with COPD:a prospective cohort study. Chest 2011;140:331e42.
  5. RabinovichRA,Vilaro´J,Roca J. EvaluationexercisetoleranceinCOPDpatients:the 6-minute walking test. Arch Bronconeumol 2004;40:80e5.
  6. Feldman GJ. Improving the quality of life in patients with chronic obstructivepulmonary disease: focus on indacaterol. Int J Chron Obstruct Pulmon Dis2013;8:89e96.
  7. Parshall MB, Schwartzstein RM, Adams L, Banzett RB, Manning HL, BourbeauJ,et al. An official American thoracic society statement: update on the mecha-nisms, assessment, and management of dyspnea. Am J RespirCrit Care Med2012;185:435e52
  8. Bauer TT, Schultze-Werninghaus G, Kollmeier J, Weber A, Eibel R, Lemke B,etal.Functionalvariablesassociatedwiththeclinicalgradeofdyspneaincoalminers with pneumoconiosis and mild bronchial obstruction. OccupEnvironMed 2001;58:794e9.
  9. Theander K, Unosson M. Fatigue in patients with chronic obstructive pul-monary disease. J AdvNurs 2004;45:172e7.
  10. Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, et al. Anofficial American thoracic society/European respiratory society statement: keyconcepts and advances in pulmonary rehabilitation. Am J RespirCrit Care Med2013;188:e13e64
  11. McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonaryrehabilitation for chronic obstructive pulmonary disease. Cochrane DatabaseSyst Rev 2015;2:CD003793
  12. Hodgkin J, Celli B, Connors G. Guidelines for pulmonary rehabilitation pro-grams.4thed.Chicago:AmericanAssociationofCardiovascular&PulmonaryRehabilitation;2009.
  13. Rachiwong S, Panasiriwong P, Saosomphop J, Widjaja W, Ajjimaporn A. Effectsof modified hatha yoga in industrial rehabilitation on physicalfitnessandstress of injured workers. J OccupRehabil 2015;25:669e74
  14. Fulambarker A, Farooki B, Kheir F, Copur AS, Srinivasan L, Schultz S. Effect ofyoga in chronic obstructive pulmonary disease. Am J Ther 2012;19:96e100.
  15. Soni R, Munish K, Singh K, Singh S. Study of the effect of yoga training ondiffusion capacity in chronic obstructive pulmonary disease patients: acontrolled trial. Int J Yoga 2012;5:123e7.
  16. Donesky-Cuenco DA, Nguyen HQ, Paul S, Carrieri-Kohlman V. Yoga therapydecreases dyspnea-related distress and improves functional performance inpeople with chronic obstructive pulmonary disease: a pilot study. J AlternComplement Med 2009;15:225e34.
  17. SantanaMJ,S-ParrillaJ,MirusJ,LoadmanM,LienDC,FeenyD.Anassessmentof the effects of Iyengar yoga practice on the health-related quality of life ofpatientswithchronicrespiratorydiseases:apilotstudy.CanRespirJ2013;20:e17e23.
  18. Nagarathna R, Nagendra HR. Yoga for bronchial asthma: a controlled study. BrMed J (Clin Res Ed) 1985;291:1077e9
  19. Chandwani KD, Perkins G, Nagendra HR, Raghuram NV, Spelman A,Nagarathna R, et al. Randomized, controlled trial of yoga in women withbreast cancer undergoing radiotherapy. J ClinOncol 2014;32:1058e65.
  20. VadirajaR,RaghavendraHS,NagarathnaR,NagendraHR,RekhaM,VanithaN,et al. Effects of a yoga program on cortisol rhythm and mood states in earlybreast cancer patients undergoing adjuvant radiotherapy: a randomizedcontrolled trial. Integr Cancer Ther 2009;8:37e46.
  21. Raghuram N, Parachuri VR, Swarnagowri MV, Babu S, Chaku R, Kulkarni R,et al. Yoga based cardiac rehabilitation after coronary artery bypass surgery:one-year results on LVEF, lipid profile and psychological statesea random-ized controlled study. Indian Heart J 2014;66:490e502.
  22. Mashyal P, Bhargav H, Raghuram N. Safety and usefulness of laghushankhaprakshalana in patients with essential hypertension: a self controlledclinicalstudy. J Ayurveda Integr Med 2014;5:227e35.
  23. Rao YC, Kadam A, Jagannathan A, Babina N, Rao R, Nagendra HR. Efficacy ofnaturopathy and yoga in bronchial asthma. Indian J Physiol Pharmacol2014;58:233e9
  24. McDermott KA, Rao MR, Nagarathna R, Murphy EJ, Burke A, NagendraRH,et al. A yoga intervention for type 2 diabetes risk reduction: a pilot ran-domized controlled trial. BMC Complement Altern Med2014;14:212
  25. Ebnezar J, Nagarathna R, Yogitha B, Nagendra HR. Effect of integrated yogatherapy on pain, morning stiffness and anxiety in osteoarthritis of the kneejoint: a randomized control study. Int J Yoga 2012;5:28e36.
  26. Tekur P, Nagarathna R, Chametcha S, Hankey A, Nagendra HR.A comprehensive yoga programs improves pain, anxiety and depression inchroniclowbackpainpatientsmorethanexercise:anRCT.ComplementTherMed 2012;20:107e18.
  27. Satyapriya M, Nagarathna R, Padmalatha V, Nagendra HR. Effect of integratedyoga on anxiety, depression&well-being in normal pregnancy. ComplementTherClinPract 2013;19:230e6.
  28. Radhakrishna S, Nagarathna R, Nagendra HR. Integrated approach to yogatherapy and autism spectrum disorders. J Ayurveda Integr Med 2010;1:120e4.
  29. Duraiswamy G, Thirthalli J, Nagendra HR, Gangadhar BN. Yoga therapy as anadd-on treatment in the management of patients with schizophreniaearandomized controlled trial. ActaPsychiatrScand 2007;116:226e32.
  30. Nagarathna R, Nagendra HR. Integrated approach of yoga therapy for positivehealth. 2nd ed. Bangalore: Swami Vivekananda Yoga Prakashan; 2013
  31. Nagendra HR, Nagarathna R. An integrated approach of yoga therapy forbronchial asthma: a 3-54-month prospective study. J Asthma 1986;23:123e37.
  32. Nagarathna R, Nagendra HR. Yoga for bronchial asthma. 1st ed. Bangalore:Swami Vivekananda Yoga Prakashan; 2012
  33. Nagarathna R, Nagendra HR. Yoga for common ailments. 2nd ed. Bangalore:Swami Vivekananda Yoga Prakashan; 2003. p. 64e71
  34. Santaella DF, Devesa CR, Rojo MR, Amato MB, Drager LF, Casali KR, et al. Yogarespiratory training improves respiratory function and cardiac sympathovagalbalance in elderly subjects: a randomised controlled trial. BMJ Open 2011;1:e000085
  35. Lokeswarananda S. Taittiriyaupanisad. 1st ed. Kolkata: The RamakrishnaMission Institute of Culture; 2005. p. 142e52.
  36. Nagendra HR. The basis for an integrated approach in yoga therapy. Kanya-kumari: Vivekananda Kendra Prakashan Trust; 1980
  37. Mody BS. Acute effects of Surya Namaskar on the cardiovascular&metabolicsystem. J BodywMovTher 2011;15:343e7
  38. Bhavanani AB, Udupa K, Madanmohan, Ravindra PN. A comparative study ofslow and fast suryanamaskar on physiological function. Int J Yoga 2011;4:71e6
  39. Saraswati SS. Asana, pranayama, mudra bandha. 4th ed. Munger: Yoga Pub-lications Trust; 2012
  40. Muktibodhananda S. Hatha yoga pradipika. 2nd ed. Munger: Yoga Publica-tions Trust; 2004.
  41. Nagarathna R, Nagendra HR, Seethalakshmi R. Yogaechair breathing foracute episodes of bronchial asthma. Lung India 1991;9:141e4
  42. Saraswati SS. Four chapters on freedom. 1st ed. Munger: Yoga PublicationsTrust; 2008.
  43. Jerath R, Edry JW, Barnes VA, Jerath V. Physiology of long pranayamicbreathing: neural respiratory elements may provide a mechanism that ex-plains how slow deep breathing shifts the autonomic nervous system. MedHypotheses 2006;67:566e71
  44. Dinesh T, Gaur G, Sharma V, Madanmohan T, HarichandraKumarK,Bhavanani A. Comparative effect of 12 weeks of slow and fast pranayamatraining on pulmonary function in young, healthy volunteers: a randomizedcontrolled trial. Int J Yoga 2015;8:22e6.
  45. Nagendra HR. Pranayama the art and science. 3rd ed. Bangalore: SwamiVivekananda Yoga Prakashan; 2007
  46. UpadhyayDhungel K, Malhotra V, Sarkar D, Prajapati R. Effect of alternatenostril breathing exercise on cardiorespiratory functions. Nepal Med Coll J2008;10:25e7
  47. Telles S, Desiraju T. Oxygen consumption during pranayamic type of veryslow-rate breathing. Indian J Med Res 1991;94:357e63
  48. Telles S, Raghavendra BR, Naveen KV, Manjunath NK, Kumar S, SubramanyaP.Changes in autonomic variables following two meditative states described inyoga texts. J Altern Complement Med 2013;19:35e42.
  49. Telles S, Nagarathna R, Nagendra HR. Autonomic changes while mentallyrepeating two syllableseone meaningful and the other neutral. Indian JPhysiolPharmacol 1998;42:57e63.
  50. Telles S, Nagarathna R, Nagendra HR. Autonomic changes during “OM”meditation. Indian J PhysiolPharmacol 1995;39:418e20.
  51. Vempati RP, Telles S. Yoga-based guided relaxation reduces sympathetic ac-tivityjudged from baseline levels. Psychol Rep 2002;90:487e94
  52. Telles S, Reddy SK, Nagendra HR. Oxygen consumption and respirationfollowing two yoga relaxation techniques. Appl Psychophysiol Biofeedback2000;25:221e7
  53. Crapo RO, Casaburi R, Coates AL, Enright PL, MacIntyre NR, McKay RT, et al.ATS statement: guidelines for the six-minute walk test. Am J RespirCritCareMed 2002;166:111e7
  54. Schermer T, Leenders J, in 't Veen H, van den Bosch W, Wissink A, SmeeleI,et al. Pulse oximetry in family practice: indications and clinical observationsin patients with COPD. FamPract 2009;26:524e31.
  55. Liu XC, Pan L, Hu Q, Dong WP, Yan JH, Dong L. Effects of yoga training inpatients with chronic obstructive pulmonary disease: a systematic review andmeta-analysis. J Thorac Dis 2014;6:795e802.
  56. Redelmeier DA, Bayoumi AM, Goldstein RS, Guyatt GH. Interpreting smalldifferences in functional status: the six minute walk test in chronic lungdisease patients. Am J RespirCrit Care Med 1997;155:1278e82
  57. WeinerP,MagadleR,Berar-YanayN,DavidovichA,WeinerM.Thecumulativeeffect of long-acting bronchodilators, exercise, and inspiratory muscletrainingontheperceptionofdyspneainpatientswithadvancedCOPD.Chest2000;118:672e8.
  58. Mahler DA, Fierro-Carrion G, Mejia-Alfaro R, Ward J, Baird JC. Responsivenessof continuous ratings of dyspnea during exercise in patients with COPD. MedSci Sports Exerc 2005;37:529e35
  59. Pomidori L, Campigotto F, Amatya TM, Bernardi L, Cogo A. Efficacy andtolerability of yoga breathing in patients with chronic obstructive pulmonarydisease: a pilot study. J CardiopulmRehabilPrev 2009;29:133e7
  60. Bernardi L, Sleight P, Bandinelli G, Cencetti S, Fattorini L, Wdowczyc-SzulcJ,et al. Effect of rosary prayer and yoga mantras on autonomic cardiovascularrhythms: comparative study. BMJ 2001;323:1446e9
  61. Gosselink R. Controlled breathing and dyspnea in patients with chronicobstructivepulmonarydisease(COPD).JRehabilResDev2003;40(5Suppl.2):25e33.
  62. KatiyarSK,BihariS.RoleofpranayamainrehabilitationofCOPDpatientsearandomized controlled study. Indian J Allergy Asthma Immunol 2006;20:98e104.
  63. Tandon OP, Tripathi Y, editors. Best and Taylor's physiological basis of medicalpractice. 13th ed. Gurgaon: Wolters Kluwer Health/Lippincott Williams andWilkins Publishers; 2012
Back

Disclaimer: All papers published in IJRST will be indexed on Google Search Engine as per their policy.

We are one of the best in the field of watches and we take care of the needs of our customers and produce replica watches of very good quality as per their demands.