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12 WEEKS OF YOGIC BREATHING TO IMPROVE RESPIRATORY FUNCTION IN ELDERLY WOMEN.

Abstract

 

Age produces several respiratory limitations and reduces tolerance to physical exertion, sometimes leading to lung disease in the elderly. The study draws attention to evidence of significant improvements in quality of life in older adults practicing yoga.  

 

The hypothesis that the practice of yoga can improve respiratory function in the elderly has been demonstrated. The effects of a yoga program on lung volumes and respiratory muscle strength were verified in 36 elderly women divided into a yoga group [YG] (mean age 63.1 ± 13.3 years) and a control group (mean age 61.0 ± 6.9 years of age).  

 

The following variables were measured:
- the maximum inspiratory and expiratory pressure (PIM and PEM) were evaluated by a spirometer
- the volume of the breath (VS)
- vital capacity (VC)
- and the ventilation per minute (VE) were measured by a ventilometer.

The program included 65 min sessions, 3 times/week for 12 weeks.
Heart rate and respiratory rate decreased significantly in the Yoga group:
- 76-39 ± 8-03 vs. 74-61 ± 10.26 beats/min.
  - and 18.61 ± 3.15 vs 16.72 ± 3.12 breaths/min, (respectively)

 

In the YG, VS and VE increased noticeably  : 
- 0.55 ± 0.22 vs. 0.64 ± 0.2ml
- and 9.19 ± 2.39 vs 10.05 ± 2.11 ml, (respectively)
- as well as the CV (1.48 ± 0.45 vs 2.03 ± 0.72 ml)

Improvements were also found in PIM and PEM in the YG:
-  IMP: (62.17 ± 14.77 vs. 73.06 ± 20.16 cmH2O
- EMP:  80.56 ± 23.94 vs 86.39 ± 20.16 cmH2O, respectively).

It was concluded that a 12-week yoga program significantly improves lung function in older women.
 

Introduction

Aging promotes reduction in respiratory function (i.e., lung volumes and respiratory muscle strength) due to progressive loss of lung force (airflow) and reduction in alveolar area, at the rate of 4% per decade after the age of 30, as well as a reduction in the range of motion of the intervertebral joints (Rossi et al, 1996; Becklake et al, 1999).

Furthermore, the aging process is associated with muscle weakness and alterations in the lung parenchyma which, in turn, affects the ability to generate satisfactory airflow (Brito et al, 2009; Freitas et al, 2010).

 

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Material and methods

 

Topics

The study (experiment) included 36​​ women randomly divided into two groups of equal size (n = 18): a yoga group (YG) with a mean age of 63.1 ± 13.3 years and a control group (CG) with a mean age of 61 .0 ± 6.9 years. All the volunteers resided in Brasília. Only women over the age of 55, not practicing any type of physical exercise (including yoga) in the previous six months, without pulmonary pathology were allowed to participate in the study. All subjects gave their consent to participate in the experiment and these procedures were approved by the Institutional Ethics Committee of the Catholic University of Brasília.

 

Procedures

The aim of the present study was to analyze the influence of a 12-week yoga program on lung volume and respiratory muscle strength in older women.

Before the start of the experiment, all the women had lessons about physical exercise and laboratory tests (Brasília Catholic University-Brazil) to identify any possible medical contraindications.

 

In the week before the experiment, respiratory muscle strength tests and lung volume analyzes were performed. The subjects then followed a yoga program for 12 weeks. The program consisted of three sessions per week, lasting 65 minutes for each session. A week after the end of the program the same measures were taken.

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Yoga program

In the yoga program for the elderly, each yoga exercise session was divided into 3 parts: preparatory, main and final. Each phase is described in detail below.

 

Preparatory phase : 5 min of relaxation with nasal breathing exercises and 5 min for a warm-up. During the breathing exercises the participants were seated and performed the following exercises:
i) Adhama pranayama (Deep breathing with or without air retention)
ii) Kapalabhati (exhaling air vigorously through nostrils)

iii) Nadi Sodhana (alternate breathing, through the nostrils)

iv) Bhastrika (inhaling and exhaling as fast and hard as possible, producing a sound as loud as the sound of a bellows).  

 

Along with these breathing exercises, techniques for the abdominal muscles were also performed:  

  1. Udyana Bhanda (abdominal contraction of the breathing region, normally or after forced exhalation) 

  2. Jalandhara Bandha (contraction of the muscles of the larynx after an inhalation).

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Main stage: 

50 min to repeat 15 positions (asanas), with 15 to 20s for each repetition. The positions were as follows:  

  1. tree pose (vrikasana)

  2. triangle position (triconasana)

  3. ballerina (Natarajasana)

  4. hands on feet (padahastasana)

  5. the wheel position (Chakrasana)

  6. spinal twist (vakrasana)

  7. forward stretch from a seated position (pashimotanasana)

  8. snake pose (bhujangasana)

  9. the turtle position (Kurmasana)

  10. cat pose (katuspadasana)

  11. the grasshopper position (Salabhasana)

  12. head on knees (janusirsharsana)

  13. bow pose (dhanurasana)

  14. sailing (sarvangasana) 

  15. the sickle (Viparitakarani)

 

Final phase: 10 min for the final relaxation, and a natural and spontaneous breathing through the nostrils, while lying on the back, and eyes closed (shavasana).  

 

Statistical analysis

The results are presented as means and standard deviations. The significance level was set at 0.05 p≤.

 

Results

The morphological measurements and those of physiological rest are presented in Table 1. The initial (pre) values did not differ between the two groups. Heart rate decreased significantly in the yoga group (p≤0.05), but not in the control group. Respiratory rate decreased significantly (p ≤ 0.05) in the yoga group between pre and post testing.

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BODY MASS (kg)

HEART RATE (beats/min)

RESPIRATORY RATE (resp./min)

BREATH VOLUME  (VS)

VENTILLATION PER MINUTE (VE)
VITAL CAPACITY (CV)

PEAK INSPIRATORY PRESSURE (MIP) PEAK EXPIRATORY PRESSURE (MEP) 

Discussion

This study tested the hypothesis that practicing yoga can improve respiratory function in older people. The main conclusion of this study is that the subjects who were subjected to the yoga program realized significant changes in their lung volume and in the strength of the respiratory muscles. Additionally, resting heart rate and respiratory rate also decreased significantly after the 12-week program.

 

The significant decrease in heart rate and respiratory rate in the Yoga group likely occurred due to increased parasympathetic activity. Indeed, this effect has been observed previously in young adults (Gopal et al., 1973) and in subjects whose age ranged from 20 to 46 years (Vempati and Telles, 2002).  

 

This effect may be possible for healthy people and also for those with chronic heart failure. Probably, the increase in vagal activity (that of the vagus nerve) and the reduction in sympathetic activity can decrease the HR (heart rate = heart rate) and RR (respiration rate = respiration rate) observed during the slow breathing, and it is associated with yoga breathing which significantly reduces the reflex response to hypoxia, likely through improved oxygen delivery to the tissues (Aktar et al., 2013).  

 

Moreover, in addition to meditation and relaxation techniques, the subjects in the present study were put through a program that also included static positions, which could be considered a physically demanding exercise. Therefore, the combination of these two elements can justify the decrease in HR and FR.

 

 

In the yoga group, we also observed an increase in breath volume (VS),  vital capacity (VC), and ventilation per minute (VE). In our opinion, these adaptations could be the result of the use of pranayama (breathing technique) as well as asanas (static physical positions) in the yoga program.  

 

The performance of pranayamas influences the action of the diaphragm in proportion to the amount of inhaled air. Pranayamas also aim to address the relationship between muscle tension (before and after loading), elastic lung properties, as well as the difference in ventilation due to vertical and horizontal positions. In our opinion, all these characteristics indicate that this exercise is essential to explain the changes in the variables mentioned above.

 

 

In the present study, a tangible increase in the maximum inspiratory and expiratory pressure (PIM and MEP) was also noticed after the yoga program. This effect may be due to an adaptation of the respiratory muscles to the training included in the program. The study by Weiner et al. (2003) in elderly subjects with chronic obstructive pulmonary disease provides evidence for this hypothesis. The authors observed that the training of the abdominal muscles made it possible to maintain the width of the muscle fibers of the diaphragm, and influenced its capacity to generate force at the start of the contraction of the inspiratory muscles.  

 

Some exercises in the yoga program exhibited the typical characteristics of airway muscle conditioning. Such is the case for: Kapalabhati (sequence of forced exhalations) and Udiyana Bhandha (abdominal contraction after a forced expiration), which were at​​ both performed with a static technique (to limit the contraction) and with a dynamic technique (several retention contractions after exhalation).

 

In addition, the increase in muscle flexibility favors the action of the expiratory muscle group, which could justify the increase in the maximum inspiratory pressure.

 

Conclusion

We concluded that practicing 12 weeks of yoga significantly improved lung function in older women. To our knowledge, this study is the first to report such progress in a Western population of this group of subjects.  

 

These results draw attention to the importance of the practice of yoga in the elderly as preventive exercises to improve the quality of life of these populations.

 

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ORIGINAL ARTICLE (ENG)  : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4332178/

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