Yoga and Asthma Yoga Alliance Webinar May 12, 2020 Sat Bir S. - - PowerPoint PPT Presentation
Brigham & Womens Hospital Harvard Medical School Yoga and Asthma Yoga Alliance Webinar May 12, 2020 Sat Bir S. Khalsa, Ph.D. Assistant Professor of Medicine, Harvard Medical School Director of Yoga Research, Yoga Alliance Director of
Brigham & Women’s Hospital
Harvard Medical School
Sat Bir S. Khalsa, Ph.D.
Assistant Professor of Medicine, Harvard Medical School Director of Yoga Research, Yoga Alliance Director of Research, Kundalini Research Institute Editor in Chief, International Journal of Yoga Therapy Research Associate, Benson Henry Institute for Mind Body Medicine Research Affiliate, Osher Center for Integrative Medicine
Asthma:
wheezing, breathlessness, chest tightness, and nighttime or early morning coughing
Asthma Prevalence in the U.S.: Slide set ppt, Downloadable set of 18 slides graphically summarizing asthma prevalence in the United States https://www.cdc.gov/asthma/Asthma_Prevalence_in_US.pptx
– In most cases, we don’t know the exact causes of asthma and we don’t know how to cure it. – Most people with asthma can control their symptoms by:
– Without proper management, asthma can result in frequent emergency department (ED) visits, hospitalizations, and premature deaths.
Asthma Prevalence in the U.S.: Slide set ppt, Downloadable set of 18 slides graphically summarizing asthma prevalence in the United States https://www.cdc.gov/asthma/Asthma_Prevalence_in_US.pptx
Asthma:
children under 18;
patients, their families, and society: – In 2016, 1.8 million people visited an ED for asthma-related care and in 2016, 189,000 people were hospitalized because of asthma
Asthma Prevalence in the U.S.: Slide set ppt, Downloadable set of 18 slides graphically summarizing asthma prevalence in the United States https://www.cdc.gov/asthma/Asthma_Prevalence_in_US.pptx
https://www.cdc.gov/asthma/asthmadata.htm
⚫ allergen exposure, infection, exercise,
⚫ emotional stress
⚫ bronchoconstriction ⚫ bronchial hyperresponsiveness ⚫ airway inflammation
https://www.nhlbi.nih.gov/health-topics/asthma
From: Mind-body interactions in the regulation of airway inflammation in asthma: A PET study of acute and chronic stress. Rosenkranz MA, Esnault S, Christian BT, Crisafi G, Gresham LK, Higgins AT, Moore MN, Moore SM, Weng HY, Salk RH, Busse WW, Davidson RJ, Brain Behavior and Immunity, 58:18-30, 2016.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045317/pdf/nihms782546.pdf
“The fact that psychological factors can influence asthma symptoms underscores the critical role of the brain…Yet, research directed toward understanding the pathophysiology of asthma has mostly overlooked the role of the brain.” “Asthmatics under chronic stress had a larger HPA-axis response to an acute stressor, which failed to show the suppressive effects on inflammatory markers observed in those with low chronic stress.”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654539/pdf/nihms872246.pdf
Yoga Practices
Postures, Breathing, Relaxation, Meditation
Fitness
↑Flexibility ↑Strength ↑Coordination/Balance ↑Respiratory Function ↑Self-Efficacy
Global Human Functionality
↑Physical & Mental Health, ↑Physical Performance ↑Stress & Emotion Regulation, ↑Awareness/Mindfulness, ↑Meta-cognition ↑Positive Behavior, ↑Wellbeing, ↑Values, ↑Life Purpose & Meaning, ↑Spirituality
Self-Regulation
↑Stress Regulation ↑Emotion Regulation ↑Resilience ↑Equanimity ↑Self-Efficacy
Awareness
↑Attention ↑Mindfulness ↑Concentration ↑Cognition ↑Meta-cognition
Spirituality
↑Unitive State ↑Transcendence ↑Flow ↑Transformation ↑Life Meaning/Purpose
“Pranayama may have psychophysiological benefits by increasing the patient’s sense of control over stress and thus aids in reducing their autonomic arousal factors. Yoga stabilizes autonomic equilibrium with a tendency towards parasympathetic dominance rather than stress-induced sympathetic dominance. Yoga therapy readjusts the autonomic imbalance, controls the rate of breathing and relaxes the voluntary inspiratory and expiratory muscles, which results in decreased sympathetic reactivity. Yoga increases respiratory efficiency, balances activity of opposing muscle groups and slows dynamic and static movements.”
From: A study of the effect of yoga training on pulmonary functions in patients with bronchial asthma, Sodhi C, Singh S, Dandona PK, Indian Journal of Physiology and Pharmacology, 53:169-74, 2009.
From: Yoga for asthma, Yang ZY, Zhong HB, Mao C, Yuan JQ, Huang YF, Wu XY, Gao YM, Tang JL, Cochrane Database Systematic Reviews, Apr 27;4:CD010346, 2016.
“…there is preliminary evidence to support the use of yoga and mindfulness for enhancing physical and psychological health of children and adolescents with asthma. …there is a need for self- management interventions such as yoga and mindfulness, for symptom management and self-regulation of triggers. Yoga and mindfulness-based interventions offer inexpensive, non-invasive approaches which may decrease stress and anxiety and improve lung function in children and adolescents.”
From: Yoga for bronchial asthma: a controlled study, Nagarathna R, Nagendra HR, British Medical Journal, 291:1077-9, 1985.
From: Study of pulmonary and autonomic functions of asthma patients after yoga training, Khanam AA, Sachdeva U, Guleria R, Deepak KK, Indian Journal of Physiology and Pharmacology 40:318-324, 1996.
From: The efficacy of a comprehensive lifestyle modification programme based on yoga in the management of bronchial asthma: a randomized controlled trial. Vempati R, Bijlani RL, Deepak KK, BMC Pulmonary Medicine, 30;9:37, 2009. https://bmcpulmmed.biomedcentral.com/track/pdf/10.1186/1471-2466-9-37
From: The efficacy of a comprehensive lifestyle modification programme based on yoga in the management of bronchial asthma: a randomized controlled trial. Vempati R, Bijlani RL, Deepak KK, BMC Pulmonary Medicine, 30;9:37, 2009. https://bmcpulmmed.biomedcentral.com/track/pdf/10.1186/1471-2466-9-37
From: The efficacy of a comprehensive lifestyle modification programme based on yoga in the management of bronchial asthma: a randomized controlled trial. Vempati R, Bijlani RL, Deepak KK, BMC Pulmonary Medicine, 30;9:37, 2009. https://bmcpulmmed.biomedcentral.com/track/pdf/10.1186/1471-2466-9-37
From: Yoga training improves quality of life in women with asthma. Bidwell AJ, Yazel B, Davin D, Fairchild TJ, Kanaley JA. Journal of Alternative and Complementary Medicine, 18:749-55, 2012.
From: Effect of yoga practices on pulmonary function tests including transfer factor of lung for carbon monoxide (TLCO) in asthma patients. Singh S, Soni R, Singh KP, Tandon OP, Indian Journal of Physiology and Pharmacology, 56:63-8, 2012.
https://ijpp.com/IJPP%20archives/2012_56_1_Jan%20-%20Mar/63-68.pdf
From: The effect of yoga on respiratory functions, symptom control and life quality of asthma patients: A randomized controlled study. Bahçecioğlu Turan G, Tan M, Complementary Therapies in Clinical Practice, 38:101070, 2020.
Exercise Response Positive Asthmatics
Maximum FEV1 % Fall
Exercise Response Positive Asthmatics Exercise Response Negative Asthmatics
Figure 2. Maximum FEV 1 % Fall Before and After Yoga Training
From: Is yoga training beneficial for exercise-induced bronchoconstriction? Tahan F, Eke Gungor H, Bicici E, Alternative Therapies in Health and Medicine, 20:18-23, 2014.
From: Impact of yoga on biochemical profile of asthmatics: A randomized controlled study, Agnihotri S, Kant S, Kumar S, Mishra RK, Mishra SK, International Journal of Yoga, 7:17-21, 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4097911/?report=printable
“We found that the breathing exercises or yoga and/or pranayama are generally multi-component packaged interventions, and are described as follows: Papworth technique, Buteyko technique, Yoga and/or Pranayam. These techniques primarily modify the pattern of breathing to reduce hyperventilation resulting in normalisation of CO2 level, reduction of bronchospasm and resulting breathlessness. In addition they also change the behaviour, decrease anxiety, improve immunological parameters, and improve endurance of the respiratory muscles that may ultimately help asthmatic
varying severity, and found to benefit children with chronic (mild and moderate) and uncontrolled asthma, but not acute severe asthma.”
http://www.eurekaselect.com/169203/article
“A total of 10 trials (466 children, 6-14 years age) were included.” “Breathing exercises and yoga/pranayama may be a useful adjunct in the treatment of childhood asthma. At present, it cannot be recommended as a standard of care due to insufficient data.”
From: A study of the effect of yoga training on pulmonary functions in patients with bronchial asthma. Sodhi C, Singh S, Dandona PK, Indian Journal of Physiology and Pharmacology, 53:169-74, 2009.
https://ijpp.com/IJPP%20archives/2009_53_2/169-174.pdf
From: The effect of various breathing exercises (pranayama) in patients with bronchial asthma of mild to moderate severity. Saxena T, Saxena M, International Journal of Yoga, 2:22-5, 2009.
FEV1 % Yoga Yoga
https://www.ncbi.nlm.nih.gov/pmc/art icles/PMC3017963/?report=printable
From: Assessment of the quality of life in patients with bronchial asthma, before and after yoga: a randomised trial. Sodhi C, Singh S, Bery A, Iranian Journal of Allergy Asthma and Immunology, 13:55-60, 2014.
http://ijaai.tums.ac.ir/index.php/ijaai/article/view/476/361
From: A modified breathing exercise program for asthma is easy to perform and effective. Karam M, Kaur BP, Baptist AP, Journal of Asthma, 54:217-222, 2017.
From: Effect of high-frequency yoga breathing on pulmonary functions in patients with asthma: A randomized clinical trial, Raghavendra P, Shetty P, Shetty S, Manjunath NK, Saoji AA, Annals of Allergy Asthma and Immunology, 117:550-551, 2016.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429656/pdf/10.1177_2333794X19837455.pdf