Yoga for COPD patients and smokers

Over the past year, we’ve published a few articles describing the benefits of tai chi for COPD patients. The combination of the slow, graceful tai chi movements with deep breathing/meditation exercises appears to hold promise for COPD patients in reducing shortness of breath, improving balance and coordination, and improving overall sense of well being. To view our past tai chi articles, visit www.breathebetterblog.blogspot.com and enter the search term “tai chi” in the search box provided in the left hand column of the page.

Tai chi has also been shown to help COPD patients extend the length of time they maintain an exercise program – an important element of successful long-term COPD self management. Researchers speculate the main factor driving this additional benefit is that many tai chi class participants find the sessions more interesting/enjoyable than limiting their exercise to stationary exercise equipment (such as walking on a treadmill). Therefore, because many COPD patients consider this form of exercise fun, they keep their programs going for longer periods of time.

Along similar lines, we recently read a new study published online ahead of print that showed interesting benefits for COPD patients from practicing another form of meditative exercise, yoga. Unlike tai chi which emphasizes balanced movement, yoga involves more stationary exercises where one sits or stands in specific positions while concentrating on deep breathing and clearing one’s mind through meditation.

In this particular study conducted by researchers at a Chicago based Veterans Administration hospital, the 22 male COPD patients who completed the study participated in yoga classes 1 hour per day, 3 days per week over a 6 week period. Patients were encouraged to practice the yoga exercises at home but were not required to do so. (Fulambarker A, et al. Effect of Yoga in Chronic Obstructive Pulmonary Disease. Am J Ther. 2010 Oct 22. [Epub ahead of print])

The researchers described the content of the yoga sessions as involving 6 specific yoga exercises, “Yoga exercises comprised pranayama, asanas, kapalabhati, sithali, and meditation during the 1-hour yoga session. The participants were encouraged to practice the same at home on a daily basis. Pranayama involves slow deep breathing, breathing through one nostril at a time, slow expiration, breath holding, and usage of abdominal muscles for expiration. Kapalabhati involves rapid abdominal contractions to force a volume of air out of the lungs. Sithali involves breathing through a curled tongue. Asanas comprise shoulder warm-ups, standing forward bend, cat and cow, downward dog with lunge, child pose, bridge, and seated twist. Meditation was done after the abovementioned exercises. Asana techniques were modified to accommodate the level of performance of the subjects with COPD.”

The researchers’ main goal in conducting the study was to understand whether yoga improved COPD patients’ sense of well being as measured by a common quality of life survey used to assess COPD patients (St. George’s Respiratory Questionnaire). The study participants completed the survey before the yoga program and again afterwards. The researchers tallied the self-reported ratings and compared the differences between the pre and post study surveys. The results showed a 19% improvement in self-reported quality of life among the COPD patients practicing yoga.

The more compelling/interesting outcomes of the COPD yoga study were statistically significant improvements in lung function. Specifically, study participants underwent diagnostic lung function tests at the beginning and end of the study. In particular the researchers tested the COPD patients for maximum inspiratory pressure, maximum expiratory pressure, forced vital capacity, and forced expiratory volume. On all of these measures, the yoga practicing COPD patients experienced statistically significant improvements. For example, maximum inspiratory pressure improved by 23% and maximum expiratory pressure improved by 14%. The improvements in forced vital capacity and forced expiratory volume were smaller but considered by the researchers to still be statistically significant.

The study authors speculated the reasons for the improvement in lung function as follows, “The beneficial effect of yoga observed in our study may be related to deep breathing (pranayama) and meditation causing a reduction in breathing frequency as in other studies. It may modulate airway reactivity, increase respiratory sensation through conditioning of the breathing pattern, reduce oxygen consumption, decrease hypoxic and hypercapnic responses with better blood oxygenation without increasing minute ventilation, increase respiratory endurance and muscle strength at least on a short-term basis, and modulate the autonomic function with a documented short-term decrease in resting heart rate and sympathetic reactivity. There is also evidence to suggest that it modulates the respiratory center and increases respiratory sensation through conditioning of the breathing pattern.”

We believe these research results show promising benefits for COPD patients participating in a yoga program and that those benefits may extend to smokers and others who suffer from chronic shortness of breath. Indeed, the yoga study authors noted that asthma patients participating in previous yoga studies have shown reduced shortness of breath symptoms and decreased use of bronchodilators (but no improvement in lung function).

Therefore, for those of you interested in adding a low impact and fun form of exercise to your weekly routine that also help relieve shortness of breath symptoms, tai chi or yoga are options worth exploring. Many community centers and health clubs offer tai chi and yoga classes specifically geared for people with chronic health conditions where the exercises are modified for people with limited mobility and other health issues. In addition, there are a wide range of videos available through retail outlets and online merchants that teach basic tai chi and yoga exercises. We’ve listed a handful of these videos on our Breathe Better Marketplace hosted by amazon.com for those who are interested.