International Journal of Yoga
Users online: 214 
Ahead of print | Login 
 
Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size 
About us Editors Current Issue Past Issues Instructions submission Subscribe Advertise
 


 
   Table of Contents     
COMMENTARY  
Year : 2015  |  Volume : 8  |  Issue : 1  |  Page : 68-69
Effect of yoga regimen on lung functions including diffusion capacity in coronary artery disease patients


Department of Physiology, Integral Health Clinic, All India Institute of Medical Sciences, New Delhi, India

Click here for correspondence address and email

Date of Web Publication3-Dec-2014
 

How to cite this article:
Yadav RK. Effect of yoga regimen on lung functions including diffusion capacity in coronary artery disease patients. Int J Yoga 2015;8:68-9

How to cite this URL:
Yadav RK. Effect of yoga regimen on lung functions including diffusion capacity in coronary artery disease patients. Int J Yoga [serial online] 2015 [cited 2019 Dec 8];8:68-9. Available from: http://www.ijoy.org.in/text.asp?2015/8/1/68/146068
This paper presents the results from a randomized controlled trial (RCT) that evaluated the effect of a 3 month yoga regimen on pulmonary functions and diffusion factor of the lung for carbon monoxide (DLCO) in patients with stable coronary artery disease (CAD) on conventional treatment. Patients with CAD have compromised pulmonary functions, generally associated with stress and anxiety. Role of neuro-hormonal modulators and cytokines has been outlined in disease characteristics and pathophysiology of pulmonary dysfunction. Treatment is mostly symptomatic, and, therefore, it is important to address the causal factors in CAD. Since yoga, especially pranayama, is shown to be efficacious in improving the pulmonary functions in patients with respiratory diseases, it may be beneficial in patients with CAD also. [1],[2],[3] The results from the present study bring forth clinically important finding, where patients with CAD showed a significant improvement in the pulmonary functions and DLCO following a 3 month yoga regimen versus the control group. Since, this is the first study of its kind, it is important to appraise this study critically with respect to its strengths and limitations, and possibly future directions.

In this assessor-blind RCT, patients with stable CAD received either conventional treatment alone (n = 40, control group) or conventional treatment along with a yoga regimen for a period of 3 months (n = 40). The trial design appears to be adequate, and the study groups appropriately chosen. However, the study design did not include either a subgroup analysis or stratified randomization based on gender, which becomes the major limitation of the study. It is well-known that the pulmonary functions vary largely with gender, which was not accounted for in this study. The yoga regimen included pranayama, diet modulation, and holistic teaching. The duration of intervention appears adequate. However, it is not clear whether patients modified their diet or not as advised by a dietician. This is an important aspect of triggering or preventing any allergen-induced bronchial spasm. [4] Further, weight-loss and change in body mass index was not evaluated in this study as obesity also affects pulmonary function. [5] As concomitant therapy, patients received conventional therapy including angiotensin converting enzyme inhibitors or calcium channel blockers with aspirin. Since aspirin is likely to have an anti-inflammatory action, [6] which might bias the results if the distribution of these patients in two arms was unequal, could have been statistically evaluated. The assessments were done by a blinded assessor, which is the strength of the study. The assessments included pulmonary function tests (PFT), and DLCO at Baseline, day 22, and day 90 along with heart rate, and blood pressure assessment at Baseline and day 90. One of the key strengths of the study is that DLCO was evaluated for the first time in patients with stable CAD, and receiving the yogic intervention in an RCT. However, to my understanding one of the major limitations of the study was that the markers of stress and inflammation were not evaluated, which could have also thrown some light on the mechanism of the benefits observed in this study. This would have added to the strength of the study as yoga has been shown to reduce stress, inflammation, [7] and anxiety [8] which are the common causal factors for pulmonary dysfunction. The correlation of improvement in PFT, and DLCO with markers of stress, inflammation and anxiety would have given more strength to the findings, and also wider acceptability. Interestingly, none of the patients dropped out of the study despite the fact that study was for 3 months, indicating a good compliance. Overall, the study had several strengths and a few limitations, which can be addressed and overcome in future studies, and provide robust data for efficacy of a yoga-based regimen in improving pulmonary function in patients with stable CAD.

 
   References Top

1.
Liu XC, Pan L, Hu Q, Dong WP, Yan JH, Dong L. Effects of yoga training in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis. J Thorac Dis 2014;6:795-802.  Back to cited text no. 1
[PUBMED]    
2.
Tahan F, Eke Gungor H, Bicici E. Is yoga training beneficial for exercise-induced bronchoconstriction? Altern Ther Health Med 2014;20:18-23.  Back to cited text no. 2
[PUBMED]    
3.
Santana MJ, S-Parrilla J, Mirus J, Loadman M, Lien DC, Feeny D. An assessment of the effects of Iyengar yoga practice on the health-related quality of life of patients with chronic respiratory diseases: A pilot study. Can Respir J 2013;20:e17-23.  Back to cited text no. 3
    
4.
Luna-Pech JA, Torres-Mendoza BM, Luna-Pech JA, Garcia-Cobas CY, Navarrete-Navarro S, Elizalde-Lozano AM. Normocaloric diet improves asthma-related quality of life in obese pubertal adolescents. Int Arch Allergy Immunol 2014;163:252-8.  Back to cited text no. 4
    
5.
Ali Z, Ulrik CS. Obesity and asthma: A coincidence or a causal relationship? A systematic review. Respir Med 2013;107:1287-300.  Back to cited text no. 5
    
6.
Harrison MT, Short P, Williamson PA, Singanayagam A, Chalmers JD, Schembri S. Thrombocytosis is associated with increased short and long term mortality after exacerbation of chronic obstructive pulmonary disease: A role for antiplatelet therapy? Thorax 2014;69:609-15.  Back to cited text no. 6
    
7.
Yadav RK, Magan D, Mehta N, Sharma R, Mahapatra SC. Efficacy of a short-term yoga-based lifestyle intervention in reducing stress and inflammation: Preliminary results. J Altern Complement Med 2012;18:662-7.  Back to cited text no. 7
    
8.
Yadav RK, Magan D, Mehta M, Mehta N, Mahapatra SC. A short-term, comprehensive, yoga-based lifestyle intervention is efficacious in reducing anxiety, improving subjective well-being and personality. Int J Yoga 2012;5:134-9.  Back to cited text no. 8
[PUBMED]  Medknow Journal  

Top
Correspondence Address:
Raj Kumar Yadav
Department of Physiology, Integral Health Clinic, All India Institute of Medical Sciences, New Delhi - 110 029
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


PMID: 25558136

Rights and PermissionsRights and Permissions




 

Top
 
 
  Search
 
    Similar in PUBMED
    Email Alert *
    Add to My List *
* Registration required (free)  


    References

 Article Access Statistics
    Viewed1009    
    Printed34    
    Emailed0    
    PDF Downloaded16    
    Comments [Add]    

Recommend this journal