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Bentley TGK, D’Andrea-Penna G, Rakic M, Arce N, LaFaille M, Berman R, Cooley K, Sprimont P. Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature. Brain Sci 2023; 13:1612. [PMID: 38137060 PMCID: PMC10741869 DOI: 10.3390/brainsci13121612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 12/24/2023] Open
Abstract
Anxiety and stress plague populations worldwide. Voluntary regulated breathing practices offer a tool to address this epidemic. We examined peer-reviewed published literature to understand effective approaches to and implementation of these practices. PubMed and ScienceDirect were searched to identify clinical trials evaluating isolated breathing-based interventions with psychometric stress/anxiety outcomes. Two independent reviewers conducted all screening and data extraction. Of 2904 unique articles, 731 abstracts, and 181 full texts screened, 58 met the inclusion criteria. Fifty-four of the studies' 72 interventions were effective. Components of effective and ineffective interventions were evaluated to develop a conceptual framework of factors associated with stress/anxiety reduction effectiveness. Effective breath practices avoided fast-only breath paces and sessions <5 min, while including human-guided training, multiple sessions, and long-term practice. Population, other breath paces, session duration ≥5 min, and group versus individual or at-home practices were not associated with effectiveness. Analysis of interventions that did not fit this framework revealed that extensive standing, interruptions, involuntary diaphragmatic obstruction, and inadequate training for highly technical practices may render otherwise promising interventions ineffective. Following this evidence-based framework can help maximize the stress/anxiety reduction benefits of breathing practices. Future research is warranted to further refine this easily accessible intervention for stress/anxiety relief.
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Affiliation(s)
- Tanya G. K. Bentley
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Gina D’Andrea-Penna
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
- Neurosciences Graduate Program, University of California San Diego, La Jolla, CA 92093, USA
| | - Marina Rakic
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Nick Arce
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Michelle LaFaille
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Rachel Berman
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Katie Cooley
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
| | - Preston Sprimont
- Health and Human Performance Foundation, Los Angeles, CA 90272, USA (R.B.); (K.C.)
- Department of Kinesiology, California State University Fullerton, Fullerton, CA 92831, USA
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Yamuna U, Madle K, Majumdar V, Saoji AA. Designing and validation of Yoga module for workers with prolonged standing. J Ayurveda Integr Med 2023; 14:100788. [PMID: 37713945 PMCID: PMC10511782 DOI: 10.1016/j.jaim.2023.100788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 07/22/2023] [Accepted: 07/22/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Prolonged standing is a part of several professions, which can have physical and psychosocial implications. Yoga as a mind-body therapy may be useful to prevent and manage such health issues. However, there is a lack of a standardized yoga module addressing the health issues of workers with prolonged standing. OBJECTIVES Thus, the present study was undertaken to design and validate a specific yoga module for the target population. METHODS A yoga module was prepared by reviewing yoga texts for the specific needs of the target population. This was validated for content validity for the experts on a Likert scale. 71 yoga experts validated the module. The content validity ratio (CVR) above 0.70 was considered to be valid. RESULTS The validated yoga module consists of joint loosening and strengthening exercises, asana, pranayama and relaxation techniques. The average CVR for the module was found to be 0.80. CONCLUSION The designed yoga module is found to be valid by the experts. The module needs to be assessed for feasibility and efficacy in the target population.
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Affiliation(s)
- U Yamuna
- The School of Yoga and Naturopathic Medicine, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA Deemed to be University), 19, Eknath Bhavan, Gavipuram Circle, KG Nagar, Bangalore, 560019, India
| | - Kshamashree Madle
- The School of Yoga and Naturopathic Medicine, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA Deemed to be University), 19, Eknath Bhavan, Gavipuram Circle, KG Nagar, Bangalore, 560019, India
| | - Vijaya Majumdar
- The School of Yoga and Naturopathic Medicine, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA Deemed to be University), 19, Eknath Bhavan, Gavipuram Circle, KG Nagar, Bangalore, 560019, India
| | - Apar Avinash Saoji
- The School of Yoga and Naturopathic Medicine, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA Deemed to be University), 19, Eknath Bhavan, Gavipuram Circle, KG Nagar, Bangalore, 560019, India.
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Zaidi SZH, Mithila MV, Mavathur RN, Nagarathna R, Thulasi A, Ramsahaye AY, Naresh K, Shukla HA. Yoga Module Development and Validation for Sickle Cell Disease. Int J Yoga 2023; 16:219-225. [PMID: 38463648 PMCID: PMC10919411 DOI: 10.4103/ijoy.ijoy_169_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 03/12/2024] Open
Abstract
Introduction Sickle cell disease (SCD) is a genetic blood disorder that affects the shape and function of red blood cells (RBCs), which can lead to several health problems affecting the quality of life. SCD can be treated with certain expensive treatments such as RBC transfusion, hydroxyurea, stem cell transplantation, gene therapy, or bone marrow transplant. However, some of the most common symptoms such as pain, anxiety, and stress can also be alleviated with alternative therapies like yoga. In light of this, there is a need for the development of a specific yoga module (YM) for SCD that can complement the current therapies. Objective To develop and validate a YM for SCD. Methodology Concise literature reports on yoga practices used for varied symptoms/comorbidities associated with SCD were compiled and presented to focus groups. Based on the presented report and personal experience, the focus group created a preliminary version of the module. The preliminary module was further refined based on content validity ratio (CVR) following module validation by 33 yoga experts. Results One hour ten minutes module developed by the focus group had in total 27 practices including, loosening exercises, asanas, pranayama, relaxation techniques, and meditation. After validation by the experts, 21 practices with a CVR ≥ 0.33 were retained. The predominant reason for excluding 12 practices was intensity, which may have some adverse effect on sickle cell comorbidities. Conclusion The module developed is the first validated module for SCD.
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Affiliation(s)
- Syed Zaeem Haider Zaidi
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, Karnataka, India
| | - M V Mithila
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, Karnataka, India
| | - Ramesh Nanjundaiah Mavathur
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, Karnataka, India
| | - R Nagarathna
- Medical Director of Arogyadhama, Prashanti Kuteeram, Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, Karnataka, India
| | - Arun Thulasi
- Division of Yoga and Humanities, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, Karnataka, India
| | - Atmika Y Ramsahaye
- Division of Yoga and Humanities, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, Karnataka, India
| | - Katla Naresh
- Division of Yoga and Humanities, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, Karnataka, India
| | - Himanshu A Shukla
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, Karnataka, India
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Bentley TGK, Seeber C, Hightower E, Mackenzie B, Wilson R, Velazquez A, Cheng A, Arce NN, Lorenz KA. Slow-Breathing Curriculum for Stress Reduction in High School Students: Lessons Learned From a Feasibility Pilot. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:864079. [PMID: 36189008 PMCID: PMC9397716 DOI: 10.3389/fresc.2022.864079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/26/2022] [Indexed: 11/13/2022]
Abstract
Purpose Nearly one in three US adolescents meet the criteria for anxiety, an issue that has worsened with the COVID-19 pandemic. We developed a video-based slow diaphragmatic breathing stress-reduction curriculum for high school students and evaluated its feasibility, tolerability, and preliminary effectiveness. Methods This cluster-randomized feasibility pilot compared 5-min slow diaphragmatic breathing for 5 weeks with treatment-as-usual control among four 12th-grade public high school classes. Students individually participated after school during COVID-19-related hybrid teaching, with slow diaphragmatic breathing three times/week and breath science education once/week. Feasibility was based on completion of breathing exercises, breath science education, and preliminary effectiveness assessments, and ease/tolerability was based on qualitative assessments. Preliminary effectiveness was measured with the State-Trait Anxiety Inventory (STAI) and a timed-exhale carbon dioxide tolerance test (CO2TT) of physiological stress response. Descriptive statistics and repeated analysis of variance were performed to quantify and compare outcomes between time periods. Human subjects research approval was granted through Western IRB–Copernicus Group (WCG IRB) [ClinicalTrials.gov, Identifier: NCT05266833.] Results Forty-three students consented to participate. Breath practice compliance ranged from 29 to 83% across classes and weeks, and decreased on average over the 5 weeks. Compliance with the breath science videos ranged from 43 to 86%, and that with the weekly STAI-State and CO2TT measures varied from 36 to 86%. Compliance with ease/tolerability assessments ranged from 0 to 60%. Preliminary effectiveness assessments' compliance varied across classes from 83 to 89% during baseline, and 29 to 72% at follow-up. The curriculum was rated as somewhat-to-definitely useful/beneficial, and definitely-to-very easy/tolerable. Students reported enjoying the diaphragmatic breathing, CO2TT, and breath science education; some found the extended exhales challenging and the curriculum and assessments time-consuming. Preliminary effectiveness analyses indicated no significant changes in STAI or CO2TT from baseline to followup or from before to after breathing exercises (p > 0.05 for all). Conclusions Implementation of this 5-week slow breathing curriculum was feasible and tolerable to this cohort. Compliance, tolerability, and effectiveness may be improved with in-class participation. Future research on simple and accessible slow-breathing exercises is warranted to address today's adolescent stress-management crisis. Trial Registration ClinicalTrials.gov, Identifier: NCT05266833
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Affiliation(s)
- Tanya G. K. Bentley
- The Health and Human Performance Foundation, Los Angeles, CA, United States
- *Correspondence: Tanya G. K. Bentley
| | | | - Emily Hightower
- The Health and Human Performance Foundation, Los Angeles, CA, United States
| | - Brian Mackenzie
- The Health and Human Performance Foundation, Los Angeles, CA, United States
| | - Rob Wilson
- The Health and Human Performance Foundation, Los Angeles, CA, United States
| | - Aly Velazquez
- The Health and Human Performance Foundation, Los Angeles, CA, United States
- Department of Kinesiology, San Francisco State University, San Francisco, CA, United States
| | - Anna Cheng
- The Health and Human Performance Foundation, Los Angeles, CA, United States
| | - Nicholas N. Arce
- The Health and Human Performance Foundation, Los Angeles, CA, United States
| | - Kent A. Lorenz
- Department of Kinesiology, San Francisco State University, San Francisco, CA, United States
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Jayakumar T, Kalyani A, Kashyap Bannuru Nanjundaswamy R, Tonni SS. A Preliminary Study on the Effect of Bhramari Pranayama on Voice of Prospective Singers. J Voice 2022:S0892-1997(22)00143-6. [PMID: 35690530 DOI: 10.1016/j.jvoice.2022.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/12/2022] [Accepted: 05/12/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Bhramari Pranayama (BP) is a yogic breathing technique that involves producing a vibrating constant pitch sound emulating the buzzing of bumblebee. Since BP deals with breathing and humming in the sustained pitch, it is hypothesized that it can have implications for improving voice quality in individuals. However, there is a dearth of research available to support this assumption. Further, there are no published reports on the effect of BP on voice quality in prospective singers group. AIM Current study was taken up to explore the effect induced by BP in the voice characteristics/quality of prospective singers. METHOD The participants included 30 healthy prospective singers in the age range of 18-35 years who were attending music schools within the state of Karnataka, India. BP regimen was demonstrated to all individuals. The voice recordings of the participants were obtained on day 0 and day 30 of BP practice. Acoustic analysis was performed to obtain AVQI and its constituent parameters and voice parameters from the MDVP program. RESULT Among the AVQI and its constituent parameters, Cepstral peak prominence-smoothed, Slope LTAS, and Tilt LTAS showed significant differences before and after BP. MDVP showed a significant difference in tremor measures before and after the practice of BP. DISCUSSION Results of the present study indicated positive effects of BP on the voice characteristics of the prospective singers and it is reflected in objective acoustic outcome parameters of AVQI and MDVP. This supports the assumption that BP which involves yogic breathing will have beneficial effects on vocal physiology in turn leading to improved voice quality in these individuals. However, it is of future interest to validate these findings on larger samples and populations with different outcome measures. Also, future studies are warranted to verify the efficacy of BP in improving vocal quality and vocal efficiency of individuals with dysphonia.
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Affiliation(s)
- Thirunavukkarasu Jayakumar
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, University of Mysore, Mysuru, Karnataka, India.
| | - Amrutha Kalyani
- Department of Swasthavritta and Yoga, Shri B M Kankanwadi Ayurveda Mahavidyalaya PG Studies and Medical Research Centre, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
| | | | - Sanjeev S Tonni
- Department of Swasthavritta and Yoga, Shri B M Kankanwadi Ayurveda Mahavidyalaya PG Studies and Medical Research Centre, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India
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Yamuna U, Majumdar V, Saoji AA. Effect of Yoga on homocysteine level, symptomatology and quality of life in industrial workers with Chronic Venous Insufficiency: Study protocol for a randomized controlled trial. ADVANCES IN INTEGRATIVE MEDICINE 2022. [DOI: 10.1016/j.aimed.2022.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Impact of COVID-19 on Swimming Training: Practical Recommendations during Home Confinement/Isolation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094767. [PMID: 33947100 PMCID: PMC8124287 DOI: 10.3390/ijerph18094767] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/27/2021] [Accepted: 04/27/2021] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic has had severe effects on communities globally, leading to significant restrictions on all aspects of society, including in sports. Several significant decisions were made to postpone or cancel major swimming events by FINA (Fédération Internationale de Natation). Swimmers were no longer allowed to continue their usual training in swimming pools and were confined to their homes. These unusual circumstances may represent a good opportunity to strengthen different areas of swimmer preparation and potentially enhance performance when resuming regular aquatic training. We searched major databases for relevant information, and the present article provides practical information on home-based training for swimmers of all ages. The COVID-19 crisis and its consequences on the swimming community have created a myriad of challenges for swimmers around the world, including maintaining their fitness level and preparing to return optimally and safely to pool training and competitions. Unfortunately, the mental consequences that might arise after the pandemic may also have an impact. We strongly recommend encouraging the swimmers to consider quarantine as an opportunity for development in specific areas of preparation and learn how to best cope with this special situation of self-isolation and/or "physical distancing" for their mental health and in case a similar situation is faced again in the future.
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Rain M, Subramaniam B, Avti P, Mahajan P, Anand A. Can Yogic Breathing Techniques Like Simha Kriya and Isha Kriya Regulate COVID-19-Related Stress? Front Psychol 2021; 12:635816. [PMID: 33935886 PMCID: PMC8081973 DOI: 10.3389/fpsyg.2021.635816] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/23/2021] [Indexed: 12/19/2022] Open
Abstract
The global impact of Coronavirus Disease 2019 (COVID-19) is tremendous on human life, not only affecting the physical and mental health of population but also impacting the economic system of countries and individual itself. The present situation demands prompt response toward COVID-19 by equipping the humans with strategies to overcome the infection and stress associated with it. These strategies must not only be limited to preventive and therapeutic measures, but also aim at improving immunity and mental health. This can be achieved by yogic breathing techniques. In this perspective, we emphasize the importance of yogic breathing, Simha Kriya and Isha kriya, the simple yet effective breathing techniques.
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Affiliation(s)
- Manjari Rain
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Balachundhar Subramaniam
- Center for Anesthesia Research Excellence, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Pramod Avti
- Department of Biophysics, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pranay Mahajan
- Department of Hospital Administration, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Akshay Anand
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.,Centre for Mind Body Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.,Centre of Phenomenology and Cognitive Sciences, Panjab University, Chandigarh, India
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Leyro TM, Versella MV, Yang MJ, Brinkman HR, Hoyt DL, Lehrer P. Respiratory therapy for the treatment of anxiety: Meta-analytic review and regression. Clin Psychol Rev 2021; 84:101980. [PMID: 33540222 PMCID: PMC8302658 DOI: 10.1016/j.cpr.2021.101980] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 11/30/2020] [Accepted: 01/19/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Respiratory abnormalities are a hallmark of anxiety symptomatology and may serve as clinically useful modifiers for alleviating anxiety symptoms. However, gold-standard anxiety treatments (e.g., cognitive-behavioral interventions) often do not directly address respiratory components despite their theoretical utility and clinical accessibility. This review examined the clinical effectiveness of respiratory interventions, interventions that directly target respiration abnormalities and processes, in treating trait anxiety symptoms. METHODS The final analysis included 40 randomized controlled trials including at least one measure of trait anxiety, a respiratory-focused intervention group, and a non-respiratory control-group (active or inactive treatment). Overall effects of respiratory focused interventions were examined, as well as the effect of hypothesized moderators. RESULTS Respiratory component interventions yielded significantly greater improvements (moderate to large effect) in anxiety symptoms than controls, with the stronger effects observed in comparison to inactive, rather than active, control conditions. Significant heterogeneity in findings suggests that variability in intervention design, population, and control comparison may obfuscate interpretation of findings. CONCLUSIONS Evidence supports the clinical utility of respiratory interventions as either an independent anxiety treatment, or as an adjunct to other interventions. Clinical and research implications of findings along with recommendations for ongoing investigations in this domain are discussed.
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Affiliation(s)
- Teresa M Leyro
- Department of Psychology, Rutgers, The State University of New Jersey, United States.
| | - Mark V Versella
- Department of Psychology, Rutgers, The State University of New Jersey, United States
| | - Min-Jeong Yang
- Department of Psychology, Rutgers, The State University of New Jersey, United States; Department of Health Outcomes and Behavior, Moffitt Cancer Center, United States
| | - Hannah R Brinkman
- Department of Psychology, Rutgers, The State University of New Jersey, United States
| | - Danielle L Hoyt
- Department of Psychology, Rutgers, The State University of New Jersey, United States
| | - Paul Lehrer
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, United States
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Agarwal D, Chovatiya R, Rana M. Equanimity in the time of COVID: The past ameliorates the present. J Clin Anesth 2020; 67:110022. [PMID: 32871468 PMCID: PMC7456456 DOI: 10.1016/j.jclinane.2020.110022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 08/01/2020] [Indexed: 10/25/2022]
Affiliation(s)
- Deepti Agarwal
- Feinberg School of Medicine, Northwestern Medical Group, 1000 N Westmoreland Rd., Lake Forest, IL 60045, United States of America.
| | - Rani Chovatiya
- The University of Illinois at Chicago, 1740 W. Taylor St, Suite 3200W, MC 515, Chicago, IL 60612, United States of America.
| | - Maunak Rana
- The University of Chicago, 5841 S. Maryland Avenue, MC 4028, Chicago, IL 60637, United States of America.
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Pathania M, Bhardwaj P, Pathania N, Rathaur VK, Amisha. A review on exploring evidence-based approach to harnessing the immune system in times of corona virus pandemic: Best of modern and traditional Indian system of medicine. J Family Med Prim Care 2020; 9:3826-3837. [PMID: 33110775 PMCID: PMC7586565 DOI: 10.4103/jfmpc.jfmpc_504_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/25/2020] [Accepted: 05/06/2020] [Indexed: 02/06/2023] Open
Abstract
Coronavirus (COVID-19) is the most dreaded pandemic of our times, which lead to a state of chaos among the mightiest nations of the world. The immune system plays a great role in response to any foreign organisms be it bacteria or viruses. Virus-based pandemics like SARS, MERS, COVID-19 have time and again been surfacing leading to mortality and morbidity worldwide. These pandemics have also resurfaced the role of public health and its modes which have been fading in the presence of lucrative hi-tech medical industry. Although Chinese system of medicine has been explored, there is still more to be done in exploring solutions from time tested Indian systems of medicine like Ayurved and Yog. Its time to rethink and explore ways to harness our immune system and look for evidence-based solutions providing the best of both medical systems to the patients, i.e., modern medicine as well as Ayurved and Yog. The present review is a narrative review wherein studies were searched from databases like PubMed, Cochrane, Scopus, and web pages. Given a paucity of studies hereby we explored existing pieces of evidence, thereby concluding that more randomized controlled trials need to be done for assessing the role of Ayurved, Yog, and other Indian systems of medicine to enrich the armamentarium in the fight against such viruses in future. Family physicians can play a vital role in not only suggesting treatment but also changes in lifestyle of the patients as well as their family. Evidence based knowledge of ancient Indian system will open a new door of integration for overall well being of patient with a scientific outlook.
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Affiliation(s)
- Monika Pathania
- Department of Medicine, AIIMS, Rishikesh, Uttarakhand, India
| | - Praag Bhardwaj
- Department of Medicine, AIIMS, Rishikesh, Uttarakhand, India
| | - Nitish Pathania
- Department of Kayachikitsa, Sri Sri College of Ayurvedic Science and Research, Bangaluru, Karnataka, India
| | - Vyas K Rathaur
- Department of Pediatrics, AIIMS, Rishikesh, Uttarakhand, India
| | - Amisha
- PG-1 Resident, University of Arkansas, Little Rock, USA
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12
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Tyagi R, Gupta V, Kumar R, Wander GS. Traditional Indian practices: Time to revisit and re-adopt for a healthier lifestyle. J Anaesthesiol Clin Pharmacol 2020; 36:S166-S171. [PMID: 33100675 PMCID: PMC7574014 DOI: 10.4103/joacp.joacp_299_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/07/2020] [Accepted: 06/13/2020] [Indexed: 11/04/2022] Open
Abstract
The COVID-19 pandemic has affected human life significantly. In spite of significant advancement of medical technology, management is still focused on preventive strategies due to non availability of vaccine or any definitive treatment. The preventive strategies include hand hygiene, social distancing, isolation/quarantine along with the methods for boosting immunity. The ancient literature and several traditional practices of our country guide a hygienic life style and address several preventive aspects of transmission of infection across the society. Furthermore, healthy eating habits and use of various herbs and spices as regular food ingredients has been proven for boosting the immunity. In this review, we have tried to correlate the traditional practices with the available scientific evidences.
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Affiliation(s)
- Ruchita Tyagi
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Vivek Gupta
- Department of Cardiac Anaesthesia and Intensive Care, Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - Rajiv Kumar
- Department of Cardiac Surgery, Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - G S Wander
- Department of Cardiology, Hero DMC Heart Institute, Ludhiana, Punjab, India
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Nagarathna R, Nagendra HR, Majumdar V. A Perspective on Yoga as a Preventive Strategy for Coronavirus Disease 2019. Int J Yoga 2020; 13:89-98. [PMID: 32669762 PMCID: PMC7336943 DOI: 10.4103/ijoy.ijoy_22_20] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 03/29/2020] [Accepted: 04/01/2020] [Indexed: 02/01/2023] Open
Abstract
The pandemic outbreak of coronavirus disease 2019 (COVID-19) infection caused by severe acute respiratory syndrome-coronavirus 2 has led to profound public health crisis. In particular, individuals with preexisting conditions of heart disease, diabetes, cerebrovascular diseases and the elderly are most vulnerable to succumb to this infection. The current COVID-19 emergency calls for rapid development of potential prevention and management strategies against this virus-mediated disease. There is a plethora of evidence that supports the add-on benefits of yoga in stress management, as well as prevention and management of chronic noncommunicable diseases. There are some studies on the effect of yoga in communicable diseases as well but very few for acute conditions and almost none for the rapidly spreading infections resulting in pandemics. Based on the available scientific evidences on yoga in improving respiratory and immune functions, we have formulated very simple doable integrated yoga modules in the form of videos to be practiced for prevention of the disease by children, adults, and the elderly.
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Affiliation(s)
- R Nagarathna
- Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - H R Nagendra
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Vijaya Majumdar
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
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Santino TA, Chaves GSS, Freitas DA, Fregonezi GAF, Mendonça KMPP. Breathing exercises for adults with asthma. Cochrane Database Syst Rev 2020; 3:CD001277. [PMID: 32212422 PMCID: PMC7096190 DOI: 10.1002/14651858.cd001277.pub4] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Breathing exercises have been widely used worldwide as a non-pharmacological therapy to treat people with asthma. Breathing exercises aim to control the symptoms of asthma and can be performed as the Papworth Method, the Buteyko breathing technique, yogic breathing, deep diaphragmatic breathing or any other similar intervention that manipulates the breathing pattern. The training of breathing usually focuses on tidal and minute volume and encourages relaxation, exercise at home, the modification of breathing pattern, nasal breathing, holding of breath, lower rib cage and abdominal breathing. OBJECTIVES To evaluate the evidence for the efficacy of breathing exercises in the management of people with asthma. SEARCH METHODS To identify relevant studies we searched The Cochrane Library, MEDLINE, Embase, PsycINFO, CINAHL and AMED and performed handsearching of respiratory journals and meeting abstracts. We also consulted trials registers and reference lists of included articles. The most recent literature search was on 4 April 2019. SELECTION CRITERIA We included randomised controlled trials of breathing exercises in adults with asthma compared with a control group receiving asthma education or, alternatively, with no active control group. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study quality and extracted data. We used Review Manager 5 software for data analysis based on the random-effects model. We expressed continuous outcomes as mean differences (MDs) with confidence intervals (CIs) of 95%. We assessed heterogeneity by inspecting the forest plots. We applied the Chi2 test, with a P value of 0.10 indicating statistical significance, and the I2 statistic, with a value greater than 50% representing a substantial level of heterogeneity. The primary outcome was quality of life. MAIN RESULTS We included nine new studies (1910 participants) in this update, resulting in a total of 22 studies involving 2880 participants in the review. Fourteen studies used Yoga as the intervention, four studies involved breathing retraining, one the Buteyko method, one the Buteyko method and pranayama, one the Papworth method and one deep diaphragmatic breathing. The studies were different from one another in terms of type of breathing exercise performed, number of participants enrolled, number of sessions completed, period of follow-up, outcomes reported and statistical presentation of data. Asthma severity in participants from the included studies ranged from mild to moderate, and the samples consisted solely of outpatients. Twenty studies compared breathing exercise with inactive control, and two with asthma education control groups. Meta-analysis was possible for the primary outcome quality of life and the secondary outcomes asthma symptoms, hyperventilation symptoms, and some lung function variables. Assessment of risk of bias was impaired by incomplete reporting of methodological aspects of most of the included studies. We did not include adverse effects as an outcome in the review. Breathing exercises versus inactive control For quality of life, measured by the Asthma Quality of Life Questionnaire (AQLQ), meta-analysis showed improvement favouring the breathing exercises group at three months (MD 0.42, 95% CI 0.17 to 0.68; 4 studies, 974 participants; moderate-certainty evidence), and at six months the OR was 1.34 for the proportion of people with at least 0.5 unit improvement in AQLQ, (95% CI 0.97 to 1.86; 1 study, 655 participants). For asthma symptoms, measured by the Asthma Control Questionnaire (ACQ), meta-analysis at up to three months was inconclusive, MD of -0.15 units (95% CI -2.32 to 2.02; 1 study, 115 participants; low-certainty evidence), and was similar over six months (MD -0.08 units, 95% CI -0.22 to 0.07; 1 study, 449 participants). For hyperventilation symptoms, measured by the Nijmegen Questionnaire (from four to six months), meta-analysis showed less symptoms with breathing exercises (MD -3.22, 95% CI -6.31 to -0.13; 2 studies, 118 participants; moderate-certainty evidence), but this was not shown at six months (MD 0.63, 95% CI -0.90 to 2.17; 2 studies, 521 participants). Meta-analyses for forced expiratory volume in 1 second (FEV1) measured at up to three months was inconclusive, MD -0.10 L, (95% CI -0.32 to 0.12; 4 studies, 252 participants; very low-certainty evidence). However, for FEV1 % of predicted, an improvement was observed in favour of the breathing exercise group (MD 6.88%, 95% CI 5.03 to 8.73; five studies, 618 participants). Breathing exercises versus asthma education For quality of life, one study measuring AQLQ was inconclusive up to three months (MD 0.04, 95% CI -0.26 to 0.34; 1 study, 183 participants). When assessed from four to six months, the results favoured breathing exercises (MD 0.38, 95% CI 0.08 to 0.68; 1 study, 183 participants). Hyperventilation symptoms measured by the Nijmegen Questionnaire were inconclusive up to three months (MD -1.24, 95% CI -3.23 to 0.75; 1 study, 183 participants), but favoured breathing exercises from four to six months (MD -3.16, 95% CI -5.35 to -0.97; 1 study, 183 participants). AUTHORS' CONCLUSIONS Breathing exercises may have some positive effects on quality of life, hyperventilation symptoms, and lung function. Due to some methodological differences among included studies and studies with poor methodology, the quality of evidence for the measured outcomes ranged from moderate to very low certainty according to GRADE criteria. In addition, further studies including full descriptions of treatment methods and outcome measurements are required.
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Affiliation(s)
- Thayla A Santino
- Federal University of Rio Grande do NorteDepartment of Physical TherapyAv. Senador Salgado Filho, 3000NatalRio Grande do NorteBrazil59.078‐970
| | | | - Diana A Freitas
- Centro Universitário Facex (UNIFACEX)Rua Orlando Silva, 2896Bairro Capim MacioNatalRio Grande do NorteBrazil59080‐020
| | - Guilherme AF Fregonezi
- Federal University of Rio Grande do NortePneumoCardioVascular Lab, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH) & Department of Physical TherapyNatalRio Grande do NorteBrazil59078‐970
| | - Karla MPP Mendonça
- Federal University of Rio Grande do NortePhD Program in Physical TherapyAvenida Senador Salgado Filho, 300Bairro Lagoa NovaNatalRio Grande do NorteBrazil59078‐970
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Abstract
This study tests the hypothesis that yoga breathing (pranayama) improves lung function in healthy volunteers during a 6-week protocol. A randomized controlled pilot study demonstrated an improvement in peak expiratory flow rate and forced expiratory volume. The easy-to-learn approach can be translated to the inpatient and outpatient settings.
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Comparison of Maximum Oxygen Uptake and Rating Perceived Exertion in Woman's Kabaddi Athletes (Without Breathy Voice to Severe Breathy Voice). J Voice 2018; 34:490.e1-490.e6. [PMID: 30529027 DOI: 10.1016/j.jvoice.2018.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 09/21/2018] [Accepted: 10/29/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE There is limited research on voice problems of athletes, especially Kabaddi athletes who use their voice during Kabaddi exercises and may damage their vocal folds and impair their voice quality. The present study aimed to compare maximum oxygen uptake (VO2max) and rating perceived exertion (RPE) in Woman's Kabaddi athletes without breathy voice (BV) to severe BV. MATERIALS AND METHODS Seventy woman's Kabaddi athletes (mean age of 20.5 ± 2.7 years, height of 163 ± 3.6 cm, weight of 61.4 ± 5.4 kg) at the club and national team level (without BV to severe BV) were compared in this study. Data were collected by imaging the larynx by a stroboscopic device (there is gap and asymmetry between vocal folds, presence of mass on vocal folds, muscle tension dysphonia, hoarseness, and harshness), evaluating the voice parameters by Vocal Assessment software (mean F0 (Hz), F0SD (Hz), jitter (%), shimmer (%), Normal Noise Energy (NNE) (dB)), and calculating VO2max by Bruce treadmill test. RPE was calculated by a 15-point (6-20) Borg test. RESULTS The results showed that 39 (55.17%) subjects had moderate and high BV symptoms and 31 (44.28%) had no symptoms of BV and low BV. The mean fundamental frequency in the group with moderate and severe BV was equal to 2.59 Hz opposite the mean fundamental frequency in the group without BV and low BV was equal to 0.65 Hz, and in contrast, the jitter (0.47%) opposite (0.19%) and the shimmer was equal to (6.64%) opposite (0.67%) and the NNE was equal to (-3.08 dB) In front of (-11.95 dB). There was no significant difference between VO2max in two groups of Woman's Kabaddi athletes as well as RPE in two groups of Woman's Kabaddi athletes at significant level of P ≤ 0.05. CONCLUSIONS Severe BV is affected by voice abuse. Voice abuse during Kabaddi is negatively affecting the quality of voice. After Kabaddi sport, athletes are complained from obstruction, hoarseness, and harshness due to disturbances in vocal folds and throat dryness. According to the data obtained from this study, abuse has a negative effect on vocal folds, which is followed by BV in various degrees in Kabaddi athletes.
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Saoji AA, Raghavendra BR, Manjunath NK. Effects of yogic breath regulation: A narrative review of scientific evidence. J Ayurveda Integr Med 2018; 10:50-58. [PMID: 29395894 PMCID: PMC6470305 DOI: 10.1016/j.jaim.2017.07.008] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 07/04/2017] [Accepted: 07/09/2017] [Indexed: 01/27/2023] Open
Abstract
Pranayama or breath regulation is considered as an essential component of Yoga, which is said to influence the physiological systems. We present a comprehensive overview of scientific literature in the field of yogic breathing. We searched PubMed, PubMed Central and IndMed for citations for keywords “Pranayama” and “Yogic Breathing”. The search yielded a total of 1400 references. Experimental papers, case studies and case series in English, revealing the effects of yogic breathing were included in the review. The preponderance of literature points to beneficial effects of yogic breathing techniques in both physiological and clinical setups. Advantageous effects of yogic breathing on the neurocognitive, psychophysiological, respiratory, biochemical and metabolic functions in healthy individuals were elicited. They were also found useful in management of various clinical conditions. Overall, yogic breathing could be considered safe, when practiced under guidance of a trained teacher. Considering the positive effects of yogic breathing, further large scale studies with rigorous designs to understand the mechanisms involved with yogic breathing are warranted.
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Affiliation(s)
- Apar Avinash Saoji
- Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA Yoga University), Bangalore, India.
| | - B R Raghavendra
- Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA Yoga University), Bangalore, India
| | - N K Manjunath
- Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA Yoga University), Bangalore, India
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