Prof. J.P.N. Mishra
Upadhyay (2008) evaluated the responses of Alternate Nostril Breathing (ANB) the Nadisudhi pranayama, on some cardio-respiratory functions were investigated in healthy young adults. The subjects performed ANB exercise (15 minutes every day in the morning) for four weeks. Cardiorespiratory parameters were recorded before and after 4-weeks training period. A significant' increment in Peak expiratory flow rate (PEFR L/min) and Pulse pressure (PP) was noted. Although Systolic blood pressure (SBP) was decreased insignificantly, the decrease in pulse rate (PR), respiratory rate (RR), diastolic blood pressure (DBP) were significant. Results indicate that regular practice of ANB (Nadisudhi) increases parasympathetic activity.
Distasio (2008) tried to integrate yoga into cancer care. Yoga classes in the United States generally consist of asanas (postures), which are designed to exercise every muscle, nerve, and gland in the body. The postures are combined with pranayama, or rhythmic control of the breath. As a complementary therapy, yoga integrates awareness of breath, relaxation, exercise, and social support elements that are key to enhancing quality of life in patients with cancer. Yoga practice may assist cancer survivors in managing symptoms such as depression, anxiety, insomnia, pain, and fatigue. As with all exercise programs, participants need to be aware of potential risks and their own limitations. The purpose of the programme was to familiarize nurses with yoga as a complementary therapy, including current research findings, types of yoga, potential benefits, safety concerns, teacher training, and ways to integrate yoga into cancer care. Finally the investigator reported the encouraging results.
Cardio-respiratory and metabolic changes during respiratory exercises and meditation practices was evaluated by Danucalov (2008). The novelty of this study was to investigate the changes in cardiorespiratory and metabolic intensity brought about by the practice of pranayama (breathing exercises of yoga) and meditation during the same hatha yoga session. The technique applied was the one advocated by the hatha yoga system. Nine yoga instructors-five females and four males, mean age of 44+/-11, 6, were subjected to analysis of the gases expired during three distinct periods of 30 min: rest, respiratory exercises and meditative practice. A metabolic open circuit computerized system was applied (V02000, Med Graphics-USA). The oxygen uptake (VO(2)) and the carbon dioxide output (VCO(2)) were statistically different (P Kitko (2007) proposed rhythmic breathing as a nursing intervention. This article was created to assist the nurse to better understand the no pharmacologic benefits of pranayama or rhythmic breathing as a nursing intervention. Rhythmic breathing as a nursing intervention is integral to the art of nursing practice and can facilitate comfort and healing in the hospitalized patient. The author opined that rhythmic breathing may serve as a beneficial adjuvant nursing intervention. Jerath (2006) studied physiology of long pranayamic breathing. Neural respiratory elements may provide a mechanism that explains how slow deep breathing shifts the autonomic nervous system. Pranayamic breathing, defined as a manipulation of breath movement, has been shown to contribute to a physiologic response characterized by the presence of decreased oxygen consumption, decreased heart rate, and decreased blood pressure, as well as increased theta wave amplitude in EEG recordings, increased parasympathetic activity accompanied by the experience of alertness and reinvigoration' The mechanism of how pranayamic breathing interacts with the nervous system affecting metabolism and autonomic functions remains to be clearly understood. The author hypothesised that voluntary slow deep breathing functionally resets the autonomic nervous system through stretch-induced inhibitory signals and hyper-polarization currents propagated through both neural and non-neural tissue which synchronizes neural elements in the heart, lungs, limbic system and cortex. During inspiration, stretching of lung tissue produces inhibitory signals by action of slowly adapting stretch receptors (SARs) and hyper-polarization current by action of fibroblasts. Both inhibitory impulses and hyper-polarization current are known to synchronize neural elements leading to the modulation of the nervous system and decreased metabolic activity indicative of the parasympathetic state. The researcher proposed pranayama's physiologic mechanism through a cellular and systems level perspective, involving both neural and non-neural elements. This theoretical description describes a common physiological mechanism underlying pranayama and elucidates the role of the respiratory and cardiovascular system on modulating the autonomic nervous system. Along with facilitating the design of clinical breathing techniques for the treatment of autonomic nervous system and other disorders, this model will also validate pranayama as a topic requiring more research. Villien et al (2005) stated that training to yoga respiration selectively increases respiratory sensation in healthy man. Because yoga practitioners think they are benefiting from their breath training they hypothesized that yoga respiration training (YRT) could modify the respiratory sensation. Yoga respiration (YR) ("Ujjayi") consisted of very slow, deep breaths (2-3 min (-1)) with sustained breath-hold after each inspiration and expiration. At inclusion in the study and after a 2-month YRT program, we determined in healthy subjects their euphonic ventilator pattern and their capacity to discriminate external inspiratory resistive loads (respiratory sensation), digital tactile mechanical pressures (somesthetic sensation) and sound-pressure stimulations (auditory sensation). Data were compared to a gender-, age-, and weight-matched control group of healthy subjects who did not undergo the YRT program but were explored at the same epochs. After the 2-month YRT program, the respiratory sensation increased. Thus, both the exponent of the Steven's power law (Psi=kPhin) and the slope of the linear-linear plot between Psi and mouth pressure (Pm) were significantly higher, and the intercept with ordinate axis of the Psi versus Pm relationship was lower. After YRT, the peak Pm developed against inspiratory loads was significantly lower, reducing the load-induced activation of respiratory afferents. YRT induced long-lasting modifications of the ventilator pattern with a significant lengthening of expiratory duration and a modest tidal volume increase. No significant changes in somesthetic and auditory sensations were noted. In the control group, the respiratory sensation was not modified during a 15-min period of yoga respiration; despite the peak Pm changes in response to added loads were then significantly reduced. These data suggest that training to yoga respiration selectively increases the respiratory sensation, perhaps through its persistent conditioning of the breathing pattern. Chandran CK (2004) studied respiratory ftmctions in Kalaripayattu practitioners. Kalaripayattu, an ancient traditional martial art form of Kerala, is considered as the basis for all martial arts viz. Karate, Kungfu, etc. physiological studies are more concentrated on Karate, Kungfu and other martial arts due to their global acceptance. Considering the limited knowledge available regarding the physiological profiles of Kalaripayattu practitioners, the present study was taken up for filling the lacunae in the field. Lung function tests were carried out in ten Kalari practitioners. Residual volume was measured by indirect method. Higher lung volumes and flow rates were achieved in Kalari practitioners compared to age and height-matched controls. Better mechanical factors and lower airway resistance influenced during Kalari practice might have benefited in improving hung volumes and flow rates. Madanmohan et al (2003) reported after studding the effect of yoga training on handgrip, respiratory pressures and pulmonary functions that yoga training of six months duration produces a significant increase in Hand Grip Strength (HGS), Forced Expiratory Volume (FEV), and Peak Expiratory Flow Rate (PEFR) in the experimental group. Vyas et al (2002) in another scientific study demonstrated that respiratory and cardiovascular functions and lipid profile of those practicing Raj yoga Meditation (short and long term duration) were compared with those of non-meditators. Lipid profile showed a significant lowering of serum cholesterol in short term and long term meditators as compared to non-meditators. Lipid profile of short and long term meditators was better than the same of non-meditators inspite of similar routine physical activities. Vital capacity, tidal volume and breath holding were significantly higher in short and long term meditators than non-meditators. This proves that Raja Yoga Meditation brings in significant improvement in lipid profile along with respiratory and cardiovascular parameters. Sathyaprabha et al (2001) studied efficacy of Naturopathy and Yoga in bronchial asthma - a self-controlled matched scientific study. 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% MW, 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. In a study on 287 college students (both men and women), Birkel and Edgren (2000) found that yoga training produced a significant improvement in vital capacity across all categories of subjects that included smokers, asthmatics as well as those with no lungs disease. Bowler et al (1998) studied the effect of Buteyko breathing techniques (BBT) in the management of asthma. The 39 subjects recruited from the community, aged 12 to 70 years, with asthma and substantial medication use. Medication use; morning peak expiratory flow (PEF); forced expiratory volume in one second (FEV1); end-tidal (ET) C02; resting minute volume (MV); and quality of life (QOL) score, measured at three months. No change in daily PEF or FEV1 was noted in either group. At three months, the BBT group had a median reduction in daily beta 2-agonist dose of 904 micrograms (range, 29 micrograms to 3129 micrograms), whereas the control group had a median reduction of 57 micrograms (range, -2343 micrograms to 1143 micrograms) (P = 0.002). Daily inhaled steroid dose fell 49% (range, -100% to 150%) for the BBT group and 0 (range, -82% to + 100%) for the control group (P - 0.06). A trend towards greater improvement in QOL score was noted for BBT subjects (P = 0.09). Initial MV was high and similar in both groups; by three months, MV was lower in the BBT group than in the control group (P = 0.004). ET C02 was low in both groups and did not change with treatment. Those practicing BBT reduced hyperventilation and their use of beta 2-agonists. A trend toward reduced inhaled steroid use and better quality of life was observed in these patients without objective changes in measures of airway caliber. Raju et al (1997) reported that yoga training results in a significant increase in maximal work output with a significant reduced level of oxygen consumption per unit work. Telles et al (1996) have evaluated the effect of right nostril breathing on a few physiological parameters including oxygen consumption, blood pressure and pulse volume. There was a significant (P <.05, paired t test) increase in oxygen consumption (17%) and in systolic blood pressure (mean increase 9.4 mm Hg) and a significant decrease in digit pulse volume (45.7%). The latter two changes are interpreted to be the result of increased cutaneous vasoconstriction. After both Surya Anuloma Viloma Pranayama (SAV) and normal breathing sessions, there was a significant decrease in skin resistance (two factors ANOVA, Tukey test). These findings show that SAV has a sympathetic stimulating effect. This technique and other variations of unilateral forced nostril breathing deserve further study regarding therapeutic merits in a wide range of disorders. Mishra (1995) has studied the effect of short-term practice of Deergha Swas Preksha and Anuloma Viloma Pranayama on physical fitness and mental health of university students and observed that it plays a significant role in obtaining integrated health state along with individual performance Telles et al (1994) have studied the process of breathing through a particular nostril and its relationship with the metabolism and autonomic activities and observed that the right nostril pranayama group showed a significant increase of 37% in baseline oxygen consumption. The alternate nostril pranayama group showed an 18% increase and the left nostril pranayama group showed an increase of 24%. This increase in metabolism could be due to increased sympathetic discharge to the adrenal medulla. The left nostril pranayama group showed an increase in volar galvanic skin resistance, interpreted as a reduction in sympathetic nervous system activity. Similar authors have also studied the autonomic changes during "OM" meditation and found that there was a statistically significant reduction in heart rate during meditation and a comparable increase in the cutaneous vascular resistance. Raju et al (1994) compared the effects of yoga & physical exercise in athletes. The effect of pranayama a controlled breathing practice, on exercise tests was studied in athletes in two phases; sub-maximal and maximal exercise tests. At the end of phase I (one year) both the groups (control and experimental) achieved significantly higher work rate and reduction in oxygen consumption per unit work. There was a significant reduction in blood lactate and an increase in P/L ratio in the experimental group, at rest. At the end of phase II (two years), the oxygen consumption per unit work was found to be significantly reduced and the work rate significantly increased in the experimental group. Blood lactate decreased significantly at rest in the experimental group only. Pyruvate and pyruvate-lactate ratio increased significantly in both the groups after exercise and at rest in the experimental group. The results in both phases showed that the subjects who practiced pranayama could achieve higher work rates with reduced oxygen consumption per unit work and without increase in blood lactate levels. The blood lactate levels were significantly low at rest. Joshi et al (1992) have reported that pranayama training improves ventilator functions in the form of increase in FEV, FEV1 and PEFR. Madanmohan et al (1992) observed that yoga training produces a significant reduction in VRT (visual reaction time) and ART (auditory reaction time). Telles and Desiraju (1991) have studied oxygen consumption during pranayama type of very slow rate breathing and found that the short kumbhaka pranayamic breathing caused a statistically significant increase (52%) in the oxygen consumption (and metabolic rate) compared to the pre-pranayamic base-line period of breathing. In contrast to the above, the long kumbhaka pranayamic breathing caused a statistically significant lowering (19% of the oxygen consumption (and metabolic rate). Singh et al (1990) studied effect of yoga breathing exercises (pranayama) on airway reactivity in subjects with asthma. 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) exercisera 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 FEV1 (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. Chen et al (1989) have reported, by studying relationship between respiratory muscle function and age, sex, and other factors, that inspiratory muscle endurance is greater in physically active men than sedentary men. Makwana et al (1988) and Yadav and Das (2001) found a significant increase in FEV, FEV1, and PEFR after yoga training. Gore et al (1987) have evaluated immediate effect of one minute kapalabhati on respiratory functions by using the parameters of respiratory rate, oxygen uptake, minute ventilation, inspiratory capacity, expiratory reserve volume, vital capacity and maximum breathing capacity. They found that there was a significant reduction in respiratory rate and minute ventilation while respiratory volumes were remained unchanged. Shrikrishna (1985) has scientifically investigated the essence of pranayama and stated that different practices of pranayama do show widespread effects on the various body functions and the changes in the respiratory, cardio-vascular, biochemical, metabolic, and neural functions. The changes in the respiratory functions during these practices are of such a nature that they do not lead to any significant disturbance in the body homeostasis their effect on the level of oxygen and carbon dioxide in the blood doesn't show any significant change. Thus confirming that though these practices involves a lot of change in the respiratory parameters like respiration rate, tidal volume, minute ventilation etc.-they actually do not making more oxygen available to the body (unless the previous values are abnormally low due to some disease state like bronchial asthma). The real value of pranayama is not its oxygen value but its effect on the nervous system. The observation on the effect of pranayama on cardio-vascular, biochemical and metabolic functions shows that the magnitude of the response depends on the physical efforts involved in the different techniques of pranayama. The intensity of these responses is least in ujjayi pranayama and highest in kapalabhati kriya with Bhastrika pranayama in between. However all the practices lead to identical neural response in the form of increased alpha pattern of the brain waves as seen in EEG. This increase in alpha waves all over the brain is called synchronization and it was always more when objects reported a subjective feeling of more mental calmness and alert restfulness. Pedro de Vicente monjo et al (1984) have stated that kapalabhati stimulates a rapid breathing physiologically and mechanically it gives a direct message to the heart by the movement of the heart rhythm, whereas during Uddtyana Bhandha the shape of heart, which is pulled down during inhalation, is pushed up. Pranayama appears to be a specialized respiratory exercise capable of inducing series of beneficial effects besides causing significant improvement of respiratory functions. Yogic asanas have been observed to lower rate of respiration, increase FEV1/FVC, increase slow vital capacity maximal vo untary ventilation, peak respiratory flow rate (PEFR), expansion of chest, vital capacity, ability to hold breath and reduce bronchial hyperactivity. This has been concluded by Murthy et al (1984) Kumar et al gave similar results in 1985 by studying pranayama. Madanmohan et al (1983), Rai et al (1982), and Gopal et al (1973) have also reported that pranayama improves cardio-respiratory functions. Stanescu et al (1981) studied pattern of breathing and ventilator response to C02 in subjects practicing Hatha yoga. Studding eight Belgian subjects well advanced in the practice of Hatha yoga and compared them with eight sex-, age-, and height-matched control subjects. Practice of yoga (range 4-12 yr) involves control of posture and manipulation of breathing, including slow near- vital capacity maneuvers accompanied by apnea at end inspiration and end expiration. Average values for the yoga and the control group (in parentheses) are as follows: ventilation (VE) 5 53 1 X min-1 (7.07); tidal volume (VT), 1.03 liters (0.56); rate of breathing, 5.5 min-1 (13.4); end-tidal PC02,39.0 Torr (35.3). All differences are significant (P less than 0.05). Ventilator response to C02 (rebreathing technique) was significantly lower in the yoga group (P less than 0.01). The regression relating VE to VT during rebreathing of C02 was VE = 8.1 (VT - 0.23) for the yoga group and VE = 15.8 (VT - 0.16) for the control group (P less than 0.005). We attribute these changes to chronic manipulation of respiration. Bhole et al (1970) have reported a significant increase in vital capacity after three weeks of yoga training. Kuvalayananda (1931) has scientifically investigated different techniques of pranayama and its effect on different systems of human body. During pranayama in both inspiration and expiration as well as in retention of breath, the thoracic movement and massage to the internal organs are greatly accentuated. If there be any congestion it is relieved because of the pressure exerted. The nerves and muscles which control the functions of the bowels and the kidneys, are all toned up. The same is the case with the lungs. By opening out the chest to its fullest extent several times a day and by putting the lungs on a stretch to the utmost possible extent, these organs are best educated to perform their functions satisfactorily, as in the case of bowels and kidneys so in the case of the lungs The training given to them for a short time prepares them for efficient working during the remaining part of the day. Thus pranayama is a very valuable exercise for the organs of elimination. Organs of digestion and absorption do not stand on a different level so far as the effects of pranayama on them are concerned. The stomach, the pancreas and the liver, which plays a very prominent role in the digestion of food and drink, are all exercised in pranayama on account of the massage given by the diaphragm and the abdominal muscles. In a very large number of people who are dyspeptic and constipated, the liver becomes habitually congested and consequently faulty in function For relieving this congestion pranayama is an excellent exercise. An unhealthy pancreas gets very good stimulus and correction by pranayamic exercises. A liberal supply of oxygen to the circulating blood current is of supreme importance for the health of an individual. This supply is effectively improved by means of the pranayama. Pranayama is capable of improving the oxygen supply of the blood as no other exercise does. Kuvalayananda (1934) stated that during pranayama especially during bhastrika, the circulation of the blood becomes very rapid and the quality of the blood is also rendered very rich. This richer and more liberal blood supply brought to the endocrine glands makes them healthier. The same is the case of brain, the spinal cord, the cranial, the spinal and the sympathetic nerves. The advantage derived from a richer and more liberal blood supply is not the only advantage the nervous system gets from pranayama. The nerves are directly exercised. During puraka the diaphragm is contracted and lowered and the abdominal muscles are kept controlled, that is, slightly contracted. The combined action of the diaphragm and the abdominal muscles pulls up the lower part of the spinal column. If Jalandhara bhandha is practiced the upper part of the spinal column is also pulled up. This pulling up of the spinal column as a whole gives exercise to the sympathetic and the roots of the spinal nerves. Suffice it to say that the whole nervous system is very finely exercised by the practice of pranayama. Thus the nervous and the endocrine systems, which are of supreme importance in human physiology and also the respiratory, the circulatory, and the digestive system upon which the health of the first two systems depends, are all simultaneously exercised in pranayama. Every round either of ujjayi or bhastrika makes the organism healthier.
