Yoga for asthma

Abstract

BACKGROUND: Asthma is a common chronic inflammatory disorder affecting about 300 million people worldwide. As a holistic therapy, yoga has the potential to relieve both the physical and psychological suffering of people with asthma, and its popularity has expanded globally. We searched all databases from their inception to 22 July 2015, and used no restriction on language of publication. We checked the reference lists of eligible studies and relevant review articles for additional studies. We attempted to contact investigators of eligible studies and experts in the field to learn of other published and unpublished studies. Selection criteria: We included randomized controlled trials (RCTs) that compared yoga with usual care (or no intervention) or sham intervention in people with asthma and reported at least one of the following outcomes: quality of life, asthma symptom score, asthma control, lung function measures, asthma medication usage, and adverse events. Data collection and analysis:We extracted bibliographic information, characteristics of participants, characteristics of interventions and controls, characteristics of methodology, and results for the outcomes of our interest from eligible studies. For continuous outcomes, we used mean difference (MD) with 95% confidence interval (CI) to denote the treatment effects, if the outcomes were measured by the same scale across studies. Alternatively, if the outcomes were measured by different scales across studies, we used standardized mean difference (SMD) with 95% CI. For dichotomous outcomes, we used risk ratio (RR) with 95% CI to measure the treatment effects. We performed meta-analysis with Review Manager 5.3. We used the fixed-effect model to pool the data, unless there was substantial heterogeneity among studies, in which case we used the random-effects model instead. For outcomes inappropriate or impossible to pool quantitatively, we conducted a descriptive analysis and summarized the findings narratively. MAIN RESULTS: We included 15 RCTs with a total of 1048 participants. Most of the trials were conducted in India, followed by Europe and the United States. The majority of participants were adults of both sexes with mild to moderate asthma for six months to more than 23 years. Five studies included yoga breathing alone, while the other studies assessed yoga interventions that included breathing, posture, and meditation. Interventions lasted from two weeks to 54 months, for no more than six months in the majority of studies. The risk of bias was low across all domains in one study and unclear or high in at least one domain for the remainder.There was some evidence that yoga may improve quality of life (MD in Asthma Quality of Life Questionnaire (AQLQ) score per item 0.57 units on a 7-point scale, 95% CI 0.37 to 0.77; 5 studies; 375 participants), improve symptoms (SMD 0.37, 95% CI 0.09 to 0.65; 3 studies; 243 participants), and reduce medication usage (RR 5.35, 95% CI 1.29 to 22.11; 2 studies) in people with asthma. The MD for AQLQ score exceeded...

Yoga and Qigong for Health: Two Sides of the Same Coin?

“…Yoga (including pranayama) has been suggested as an adjuvant therapy in the treatment of childhood asthma, although it cannot yet be recommended as a standard of care due to the insufficiency of data on its efficacy [55]. A Cochrane review on this pathology showed moderate-quality evidence that yoga may provide small improvements in asthma patients' symptomatology [56]. In patients with respiratory diseases, namely, asthma, pranayama has physiological and psychological benefits, although more high-quality RCTs are required to obtain definitive evidence [57].…”

Evidence for lifestyle interventions in asthma

“…Meditation can be part of yoga, a spiritual system with engrained practices such as holding specific body positions and breathing. The effect of yoga and meditation on asthma is hypothesised to come from the retraining that occurs with the breathing and movement patterns, thus enabling an improvement in tidal volume, breathing rates and muscle relaxation [62].…”

“…In a Cochrane systematic review of 15 RCTs that used yoga as an intervention, the results were heterogeneous [62]. Five studies found that yoga significantly improved quality of life, and three studies found a significant reduction in symptoms.…”

“…Others that were followed-up in the 2-year period but practised yoga less consistently did show a reduction in symptoms and medication use, but not as strong as daily users. The inconsistent results may be explained by the variability of the yoga interventions, with differing types of yoga, regularity of practice and combinations of breathing, posture and medication use involved [62]. More evidence is needed, particularly focusing on standardised yoga interventions with longer follow-up, but yoga remains a promising lifestyle intervention that could be useful in an asthma population.…”

Breathing exercises for adults with asthma

“…However, the clinical effectiveness of breathing exercises for managing asthma is unclear 4 . Other related treatments such as yoga have shown moderate‐quality evidence for small improvements in quality of life and symptoms in asthmatics 5 . This Cochrane review is an update of the previous 2013 review evaluating the evidence for the efficacy of breathing exercises in the management of people with asthma.…”