Effects of Bhramari Pranayama on health - A systematic review

Efficacy of Bhramari pranayama and Om chanting on asthma control, quality of life, and airway inflammation in asthmatic children: an open-label randomized controlled trial

OBJECTIVES

To explore the efficacy of combination of Bhramari pranayama and om chanting as an adjunct to standard pharmacological treatment on asthma control, quality of life, pulmonary function, and airway inflammation in asthmatic children.

METHODS

Children (n = 110; 8-15 years) with uncontrolled or partly controlled asthma were recruited from the Pediatric Chest Clinic of All India Institute of Medical Sciences, New Delhi. Eligible participants were randomized to either home-based online Bhramari pranayama and om chanting plus standard treatment (YI + ST) group, or standard treatment (ST) alone group. Primary outcome measures were 12-week change in level of asthma symptom control; asthma control questionnaire (ACQ) score, spirometry indices, impulse oscillometry parameters, and pediatric asthma quality of life questionnaire (PAQLQ) score. Secondary outcome was a change in fractional exhaled nitric oxide (FeNO) levels at 12 weeks. Beginning from the enrollment, every participant was evaluated at 0, 2, 6, and 12 weeks.

RESULTS

After 12 weeks of intervention, higher proportion (68.2%) of children were found to have controlled asthma symptoms in the YI + ST group as compared to ST group (38.5%) according to per protocol analysis (p = 0.03). When compared to ST group, children in YI + ST group showed significantly lower ACQ score, higher PAQLQ score and reduced FeNO levels. No significant changes were observed for the lung function parameters.

CONCLUSION

Children practicing Bhramari pranayama and om chanting for 12 weeks have better asthma symptom control, quality of life, and reduced airway inflammation than those taking standard pharmacotherapy alone.

Effects of Pranayama on Cancer Patients: A Narrative Review of Clinical Outcomes

Pranayama, a set of yogic breathing techniques, is being studied as a potential supportive care option for cancer patients. This review intends to evaluate the effectiveness of Pranayama in enhancing the quality of life and well-being of cancer patients based on evidence from randomized controlled trials. We thoroughly searched databases for studies published between 2013 and 2023. We focused on randomized controlled trials that compared Pranayama interventions with non-yoga control groups. We assessed the primary outcomes, including psychological well-being, quality of life, physiological parameters, and treatment-related side effects. The review indicates that practicing Pranayama can lead to significant improvements in antioxidant levels, stress, anxiety, sleep quality, and overall quality of life for cancer patients. However, the evidence comes from a limited number of studies, which vary in sample sizes and methodologies. Pranayama shows promise as a complementary therapy for cancer patients, potentially enhancing their well-being and quality of life. Nonetheless, the current evidence base is limited, necessitating further research with larger sample sizes and more rigorous study designs to confirm these findings and elucidate the underlying mechanisms.

The Effect of Pranayama Applied to Hemodialysis Patients on Fatigue: A Randomized Controlled Trial

The present study was conducted to examine the effects of Pranayama applied to hemodialysis patients on fatigue. The study was completed with 91 patients, including Pranayama (n = 30), Relaxation (n = 30), and Control groups (n = 31). The patients in the Pranayama group applied the interventions 15 to 20 minutes every day, once a day, for a total of 3 months, and the patients in the relaxation practice group applied the interventions 15 to 20 minutes every day, once a day, for a total of 3 months. Before the study commenced, permission was obtained from health care institutions, the ethics committee, and the patients. The data were collected with a Questionnaire, Piper Fatigue Scale (PFS), visual analog scale, and Vital Findings Form. Piper Fatigue Scale consists of 4 subdimensions, the total score obtained from the scale varies between 0 and 10, and as the score increases, the level of fatigue also increases. It was found that the patients in the Pranayama Group had decreased PFS total and subdimension mean scores after the procedure (P < .05); however, no significant changes were detected in the PFS total and subdimension mean scores of the patients in the Relaxation and Control groups (P > .05). Although the decrease in the daily fatigue severity of the patients in the Pranayama group was at a statistically significant level (P < .05), no statistically significant changes were detected in the fatigue severity of the patients in the Relaxation and Control groups (P > .05). It was also found that the blood pressure values of the patients in the Pranayama and Relaxation groups decreased (P < .05). It was found in the present study that Pranayama reduced the fatigue levels of hemodialysis patients. In this respect, it is recommended to teach and apply Pranayama techniques to patients with the support of nurses.

Effect of yoga on adipokine levels among overweight and obese people: A systematic review

BACKGROUND

Adipokines have an important role in the pathophysiology of overweight and obesity and associated inflammatory diseases.

OBJECTIVE

The present review aims to evaluate the role of Yoga on adipokines among people with overweight and obesity.

METHODS

Authors performed a systematic search for relevant research studies as per the PRISMA guidelines in Google Scholar, Medline/Pubmed, Scopus, Web of Science, PsychInfo electronic databases. Two independent authors conducted the selection of articles, data extraction, assessment of the risk of bias for individual studies. Any disagreements were resolved by discussion with the third author.

RESULTS

Eight randomized trials and four uncontrolled trials involving a total of 1054 participants were included. Yoga with varying frequencies was administered for different durations. The studied adipokines among overweight and obese were leptin, adiponectin, interleukin-6 (IL-6), Tumor necrosis factor-alpha (TNF-α), chemerin, visfatin, plasminogen activator inhibitor-1 (PAI-1), and transforming growth factor-beta (TGF-β). The methodological quality of the included studies was low to moderate on the Cochrane risk of bias tool and Newcastle-Ottawa Quality Assessment Scale. The higher the frequency and duration of Yoga practice, the more significant changes in the adipokine levels were seen.

CONCLUSION

The present review indicates that Yoga practices positively impacts adipokines among people with overweight and obesity. However, the present study precludes the generalizability of results due to the methodological heterogeneity, the type of Yoga intervention, and settings.

Role of yoga in stress management and implications in major depression disorder

Major Depressive Disorder (MDD) is one of the leading causes of disability affecting more than 340 million people and second largest contributor to global burden of disease. Chronic stress is a common risk factor and important contributor for MDD. Stress could be defined as the "perceived inability to cope". Stressful life events are shown to provoke a sequence of psychological and physiological adjustments including nervous, endocrine and immune mechanisms. Stress can lead to elevation of a variety of inflammatory cytokines and stress hormones, can cause autonomic dysfunction and imbalance in neurotransmitters. Yoga can reduce depressive symptoms by alleviating stress. Studies have shown that yoga can reduce inflammation, maintain autonomic balance and also has a role in maintaining the neurotransmitters. It has role on hypothalamic-pituitary-adrenal (HPA) axis, the peripheral nervous system including GABA, limbic system activity, inflammatory and endocrine responses. Yoga along with antidepressants can help in reducing the depressive symptoms in patient with MDD. Yoga is an ideal complementary and alternative therapy for mental health disorders.

Breath Phase Durations, Affect, and Attention: A Pilot Randomized Crossover Trial

Objectives

Previously, yoga volitional breathing with low inspiration to expiration ratios (i/e) (as in bhramari pranayama) improved cognition and reduced state anxiety. This study compared the effects of low, high and equal i/e ratio breathing on affect and attention.

Material and Methods

Affect, vigor and attention were assessed in forty healthy participants (group mean age± SD; 22.58±3.83; M:F= 2.33:1) while breathing with three different i/e regulated by a visual metronome on separate days viz., (i) low i/e (28:72), (ii) equal i/e (50:50), (iii) high i/e (72:28) compared to control, without conscious breath modification. Assessments were: (i) brief mood introspection scale (BMIS), (ii) global vigor and affect scale (GVAS), (iii) Spielberger's state trait anxiety inventory-state (STAI-S) and a six letter cancellation test to assess sustained attention. Data were analyzed with repeated measures analysis of variance with Bonferroni adjusted post-hoc tests.

Results

Pleasant feelings increased after low and equal i/e. Low i/e also increased positive feelings whereas equal i/e decreased scores in the cancellation test for sustained attention. All three breathing practices and the control session decreased state anxiety and increased vigor. High i/e breathing alone did not decrease negative feelings. For all the breath ratios the breath frequency cue was set at twelve breaths per minute.

Conclusion

In summary, varying breath phase ratios influenced positive and pleasant feelings but did not influence state anxiety or vigor. Understanding the mechanisms underlying the findings would be improved with concurrent physiological assessments.

Effect of Various Lengths of Respiration on Heart Rate Variability during Simple Bhramari (Humming)

Background

Heart rate varies during breathing and the heart rate variability (HRV) facilitates the autonomic homeostatic capacity. The maximum HRV was observed at around 10 s of prolonged respiration as per HRV biofeedback literature. However, there is a gap in understanding the variations in HRV by different respiration lengths during simple Bhramari practice.

Objective

To assess the effect of various respiration lengths (8, 10, 12, and 14 s) on HRV during the simple Bhramari (humming) practice.

Methodology

A total of 118 individuals (67 males, 51 females) signed up for the study based on convenience sampling at a wellness center. A randomized (simple permutation) within-subject crossover design with repeated measures was used to measure their HRV during the simple Bhramari practice. The results were analyzed with one-way ANOVA and paired samples t-test.

Results

The results indicate that, unlike the 10 s of respiration during HRV biofeedback breathing, maximum HRV during humming happens between 12 and 14 s of long breathing.

Conclusions

The unique findings of the study demonstrate the maximization of HRV between the respiration lengths of 12 and 14 s. Future work should explore expanding the research to a broader group of participants, including individuals with chronic conditions and other demographic variables and mantra chanting.

Effectiveness of yoga on Ewing's battery autonomic function test: cross-sectional study

INTRODUCTION

The cardiovascular autonomic functions can be tested by a Battery of five tests developed by Ewing and Clark in 1981 in Edinburgh. Yogic practices are immensely useful for physical, mental and spiritual development required for better autonomic function.

AIM AND OBJECTIVES

To assess the ANS (Autonomic function system) function with help of Ewing's Battery tests in yoga participants and healthy participants not practicing yoga.

MATERIALS AND METHODS

A cross-sectional study was conducted on 270 participants which were divided into two groups viz: 135 in healthy control (Group I) and 135 in yoga group (Group II). Subjects with informed consent between 40-50 years, were included in control (Group I) and those practicing yoga for past minimum 3 months were included in Group II. Anthropometric measurements were done and parasympathetic tests like Heart rate (HR) response to standing from the supine posture, to Valsalva maneuvers and to slow deep breathing were done. Also, sympathetic tests, Blood Pressure (BP) response to cold in cold pressor test (CPT), to sustained handgrip test and to standing from lying posture were carried out.

RESULTS

P value was found to be statically significant among yoga group as compared with healthy control group in all the sympathetic and parasympathetic tests except in CPT. As per the Ewing's criteria, normal, early, diseased and severe CAN (Cardiac autonomic neuropathy) in healthy controls findings were 11.11%, 58.51%, 37.03%, 17.77% and in yoga participants findings were 37.7%, 34.8%, 6.66% and 8.88% respectively. According to Bellavere's classification, maximum diseased CAN were found in healthy control as compared to yoga group. As per AIIMS (All India Institute of Medical Sciences) criteria, parasympathetic neuropathy was observed in 11.85% of the healthy controls and in 6.66% of the yoga group, and that maximum sympathetic neuropathy was observed in 11.11% of the healthy patients and only 3.7% of the yoga group.

CONCLUSION

More emphasis should be given on implementation of yoga from early ages at the institutional levels, hospital levels. Yoga practices will suffice and lead to improvement of unhealthy ANS condition. Overall, Yoga showed better ANS function than healthy control group.

Humming (Simple Bhramari Pranayama) as a Stress Buster: A Holter-Based Study to Analyze Heart Rate Variability (HRV) Parameters During Bhramari, Physical Activity, Emotional Stress, and Sleep

Objective In this study, our goal was to understand the comparative impact of humming, physical activity, emotional stress, and sleep on several heart rate variability (HRV) parameters, including the stress index (SI), and to assess the effectiveness of humming (simple Bhramari) as a stress buster based on the HRV parameters. Methods This pilot study assessed the long-term HRV parameters of 23 participants in terms of four activities: humming (simple Bhramari), physical activity, emotional stress, and sleep. The single-channel Holter device measured the readings, and data was analyzed using Kubios HRV Premium software for time and frequency-domain HRV parameters, including the stress index. Regarding statistical analysis, single-factor ANOVA followed by paired t-test was used to compare the results of HRV parameters "during" the four activities to understand if humming generates the outcome to enhance the autonomic nervous system. Results Our findings revealed that humming generates the lowest stress index compared to all three other activities (physical activity, emotional stress, and sleep). Several additional HRV parameters also supported the positive impact on the autonomic nervous, equivalent to stress reduction. Conclusions Humming (simple Bhramari) can be an effective stress-buster based on the assessment of several HRV parameters during its practice and in comparison with other activities. A regular daily humming routine can help enhance the parasympathetic nervous system and slow down sympathetic activation.

The Effect of Vinyasa Yoga Practice on the Well-Being of Breast-Cancer Patients during COVID-19 Pandemic

BACKGROUND

Vinyasa yoga practice improves body fitness and potentially positively affects practitioners' well-being and health. Due to the diverse intensity of practice and positions customized to the practitioner's needs, it can also support cancer patients. Undertaking physical activity that has a potentially positive effect on well-being and health was particularly important during the self-isolation that followed the COVID-19 pandemic. The purpose of this study was to evaluate the impact of three-month mild and moderate intensity vinyasa yoga practice on breast-cancer patients' stress perception, self-confidence, and sleep quality during COVID-19 induced self-isolation.

METHODS

Female breast-cancer patients participated in twelve-weeks of online vinyasa practice during the COVID-19 induced self-isolation period. Meetings were held once a week, where 60-min vinyasa yoga sequences were followed by 15 min of relaxation. Patients completed pre- and post-intervention surveys to evaluate changes in the following outcomes: stress perception, self-confidence, and sleep quality. Forty-one female patients enrolled in the Vinyasa course completed the pre-intervention survey, while 13 attended all the meetings and completed the post-intervention survey.

RESULTS

The effect of the twelve-week yoga and relaxation practice significantly reduced sleep problems and stress of oncological patients. The participants also declared an improvement in their general well-being and self-acceptance.

CONCLUSION

Dynamic forms of yoga combined with mindfulness techniques can be applied to patients treated for oncological diseases. It contributes to improving their well-being. However, in-depth studies are needed to analyze the complexity of this effect.

Sarveghna Lakshmi. A study on immediate and training effect of Bhramari pranayama on heart rate variability in healthy adolescents

Introduction and Aim: Bhramari pranayama (Humming bee breath) is the most common slow pranayama practice involving inhalation through both nostrils followed by exhalation which produces sound of humming bee. Practicing pranayama reduces the effects of stress on different systems by increasing the vagal tone. With the ongoing COVID-19 pandemic, there are heightened feelings of stress, anxiety and depression and pranayama can be an effective way to improve our mental and emotional well-being. This study has been chosen to assess the effect of Bhramari pranayama on autonomic functions and to compare the immediate and training effects of Bhramari pranayama in the study group. Materials and Methods: An observational study was conducted in a medical college among 110 students aged between 18-22 years for a period of 2 months. The participants were instructed to do 9 rounds of Bhramari pranayama every day for 3 weeks. The immediate and training effect of pranayama practice on HRV (Heart Rate Variability) was assessed. The parameters of HRV (time and frequency domains) were assessed by PHYSIOPAC- PP4 (MEDICAID SYSTEMS, Chandigarh). Results: After training of Bhramari pranayama for 3 weeks, there was a decrease in Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and PNN50 and a decrease in frequency domain parameters, LFnu and LF/HF ratio were observed significantly. Conclusion: The study shows the possibility that Bhramari pranayama has a beneficial effect on HRV in medical students, as the autonomic balance produces the improvement of parasympathetic tone.  

Pulling the Trigger: The Effect of a 5-Minute Slow Diaphragmatic Breathing Intervention on Psychophysiological Stress Responses and Pressurized Pistol Shooting Performance

This study examined the effect of slow diaphragmatic breathing on psychophysiological stress responses and pressurized performance. Sixty-seven participants (40 female; Mage = 20.17 ± 2.77 years) were randomly assigned to either a diaphragmatic-breathing, paced-breathing, or control group. Participants completed a nonpressurized shooting task and then received instructions about a pressurized version. Next, the diaphragmatic group was told to breathe at 6 breaths/min, the paced group at 12 breaths/min, and the control group received no instructions. Following a 5-min intervention period, participants completed the pressurized task while performance was assessed. Psychophysiological stress responses (e.g., cognitive anxiety, heart rate) were recorded throughout. Results revealed that diaphragmatic breathing had mixed effects on stress responses, with some unaffected (e.g., heart rate) and others reduced (e.g., cognitive anxiety), and little effect on performance. Findings suggested that slow diaphragmatic breathing might not aid pressurized performance but could benefit psychological stress responses.

Combating the psychological impact of COVID-19 pandemic through yoga: Recommendation from an overview

Globally, the psychological health of the people is being affected due to the COVID-19 pandemic. Given the fact that numerous systematic reviews already exist on yoga and mental health, it becomes vital to undertake an overview on the same. The objective of the overview was to summarise the evidence from different systematic reviews of distinct yoga interventions used to improve mental health and recommend yoga practices for the same. The protocol was registered on PROSPERO (CRD42020185221). MEDLINE via Pubmed, Cochrane Database of Systematic Reviews and Google Scholar were searched for relevant literature. Search terms used were "Yoga practice, mental health and systematic review". Reviews from earliest possible date till May 2020, including those examining the effects of any single or combination of yoga interventions on mental health reported on children, youth and adults were selected. The Assessment of Multiple Systematic Reviews (AMSTAR) tool was used to evaluate the evidence of the included reviews. Out of the 90 reviews found, eight unique reviews were selected for the overview. Overall, 243 studies were analyzed, with an overlap of only 6 studies across the reviews. Out of 8 reviews, only 2 were of high quality and the rest were of moderate quality. Owing to heterogeneity of the included studies, only descriptive analysis was possible. The results of the review indicate moderate to positive effects of yoga on the mental health parameters. Practicing yoga (physical postures, Bhramary Pranayam, mindfulness meditation, sahaj yoga and laughter therapy) can be beneficial to improve psychological health of the people during the COVID-19 pandemic.

Effects of Classical Breathing Exercises on Posture, Spinal and Chest Mobility among Female University Students Compared to Currently Popular Training Programs

Worldwide, university students’ physical health and posture are declining due to a sedentary lifestyle. The aim of our study was to evaluate the effectiveness of physiotherapeutic breathing exercises on posture and spinal mobility among healthy female university students compared to other training methods. Sixty-one female students of the University of Debrecen were assigned to breathing exercise (BE; n = 15), yoga (Y; n = 16), Pilates (P; n = 15) programmes and interval-training (IT; n = 15). Each training session lasted one hour, performed twice a week for 7 weeks. Students were assessed using standardized clinical tests. All programmes resulted in significant improvement in chest expansion. Results of Schober’s test showed substantial improvement using BE (p < 0.05), Y, P (p ≤ 0.01) programmes. Significant changes in occiput-to-wall distance (Y, P p ≤ 0.01) (BE p ≤ 0.001) were observed in three groups except the IT group. Fingertip-to-floor test (Y, P p < 0.05) results showed significant changes in two groups. The most outstanding effects on lateral flexion were achieved using BE (right, left p ≤ 0.001) programme. A comparison with results achieved using yoga and Pilates revealed that the physiotherapeutic breathing exercise programme is an equally effective method to significantly improve spinal mobility and correct postural problems in healthy young women.

Effects of Slow Deep Breathing on Acute Clinical Pain in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Slow deep breathing (SDB) may help patients with acute pain. The primary aim of this systematic review and meta-analysis is to investigate the effects of SDB on acute pain. Secondary aims include investigating the effects of SDB on acute pain-related physical and emotional functioning. An a priori protocol was registered and a database search was conducted by a reference librarian. Randomized controlled trials (RCT) were eligible for inclusion and exclusion criteria included studies of SDB for non-pain indications and studies that applied SDB as a component of an encompassing intervention. The risk or bias was assessed using the Cochrane Collaboration's revised tool for assessing risk of bias in randomized trials. Meta-analysis was conducted using the random effects model. A total of 11 968 studies were screened and seven RCTs met inclusion criteria; five were judged to have low risk of bias. Meta-analysis of post-intervention pain scores demonstrated that SDB was associated with significantly lower pain scores compared with a control group, but with high levels of heterogeneity. Subgroup analyzes demonstrated that trials of burn pain were associated with a larger reduction in pain which partially explains the heterogeneity. Very low certainty evidence suggests that SDB may reduce acute pain intensity. Further research is needed to identify patients who are candidates for SDB and determine the best approach to deliver this therapy.

Volitional Yoga Breathing Influences Attention and Anxiety: An Exploratory Randomized Crossover Study

BACKGROUND

Previous studies assessed yoga breathing practices individually. This exploratory, randomized crossover study assessed attention and anxiety following four yoga breathing practices, breath awareness, and quiet seated rest.

MATERIALS AND METHODS

Thirty-eight male volunteers between 20 and 37 years (group mean age ± SD; 24.08 ± 4.01 years) were assessed in six sessions in random order (www.randomizer.org) on separate days. The sessions were: (i) alternate nostril yoga breathing, (ii) bellows yoga breathing, (iii) bumblebee yoga breathing, (iv) high-frequency yoga breathing, (v) breath awareness, and (vi) quiet seated rest. The sessions were for 18 min each. Six letter cancellation test (SLCT) and Spielberger's State Trait Anxiety Inventory-state (STAI-s) were administered pre and post each session. Data analysis used general linear mixed model analysis, with fixed effect of states (pre and post) and sessions.

RESULTS

A significant main effect of states was observed on total attempted (F1,407 = 5.374, p = 0.021) and net attempted scores (F1,407 = 6.178, p = 0.013) of the SLCT, with a significant increase in scores following high-frequency yoga breathing (padj = 0.031 for total attempted scores; padj = 0.029 for net attempted scores). Also, a significant main effect of states on STAI-s scores was observed (F1,407 = 33.979, p < 0.001), with a significant decrease in scores following alternate nostril yoga breathing (padj = 0.001), bellows yoga breathing (padj = 0.008), bumblebee yoga breathing (padj = 0.002), and high-frequency yoga breathing (padj = 0.042) compared to the corresponding pre state. There was a significant main effect of sessions (F5,407 = 3.043, p = 0.010) on STAI-s scores, with scores post alternate nostril yoga breathing significantly lower than post breath awareness (padj = 0.037).

CONCLUSION

Following high-frequency yoga breathing sustained attention was better than before while state anxiety decreased in post-pre comparisons of alternate nostril yoga breathing, bellows yoga breathing, bumblebee yoga breathing, and high-frequency yoga breathing. The differences between breathing practices may be due to differences in degree of volitional regulation of breathing and in the breath patterns modified volitionally. The generalizability of the findings was limited by including an all male, yoga experienced sample. Future research should include participants of both genders and could include different levels of yoga experience, with assessments including objective measures of attention and anxiety.

Potential for integrating yoga within pulmonary rehabilitation and recommendations of reporting framework

There is a rising burden of chronic obstructive pulmonary disease (COPD) in India. Pulmonary rehabilitation (PR), is a universally recommended multidisciplinary therapeutic strategy for the management of COPD; however, its needs are unmet. The diversity in the healthcare systems, availability of PR specialists and sociocultural multiformity requires contextualised and innovative PR models. Culturally sensitive elements, such as yoga, have some evidence of a positive impact in the management of COPD. Yoga and PR are based on similar principles with a holistic approach of involving physical activities, behaviour change techniques and psychological support to improve disease outcomes. Arguably the principles of PR and yoga are complementary but there are some important differences in the intensities of activities, exercise types and inclusion of mindfulness in components that must be considered. Components of PR enable aerobic capacity building, strengthening of muscles of the upper and lower extremities and building awareness towards disease management. Yoga, on the other hand, primarily can focus on core strengthening, breathing control, mindfulness and self-awareness. We discuss the potential of integrating the sociocultural appeal of yoga with PR delivered at international standards, and how an integrated approach may lead to optimal referral, uptake and completion.

The Effect of Pranayamic Breathing as a Positive Psychology Exercise on Foreign Language Learning Anxiety and Test Anxiety Among Language Learners at Tertiary Level

This study investigated the impact of pranayamic breathing (PB) as a positive psychology exercise on mitigating foreign language anxiety (FLLA) and test anxiety (TA) of undergraduate English students studying at a Turkish university. Additionally, the study examined the effects of PB on academic achievement in listening and reading comprehension skills of the participants as well as exploring learners’ and their instructor’s perceptions of using PB techniques in their classrooms. The sample consisted of 140 sophomore English language learners. Two intact classes, each comprising 70 participants, were selected as the experimental and the control group using convenience sampling. Two basic PB techniques, Nadi Shodhana Pranayama and Bhramari Pranayama, were implemented to the experimental group on a weekly basis for a total of 7 weeks. In this mixed-method study, the quantitative data were gathered using English Language Learning Anxiety Scale, Foreign Language Test Anxiety Scale, and listening and reading achievement pre- and post-tests, while the qualitative data were collected using semi-structured interviews, and the teacher’s reflective journal. The findings revealed that the implementation of positive psychology technique of pranayama breathing mitigated the FLLA and TA levels significantly and also improved listening and reading comprehension skills of the participants to a considerable extent. The findings also demonstrated that both the students and their instructor perceived PB implementation as a useful and a practical medium in alleviating the anxious feelings, promoting the general class atmosphere and regulating daily habits despite the implementational challenges shared by the instructor.

Bhramari Pranayama - A simple lifestyle intervention to reduce heart rate, enhance the lung function and immunity

Individuals with chronic diseases have a higher risk of infection and show lung function impairment. Poor lifestyle choices such as physical inactivity, poor diet, stress, excess tobacco, and alcohol, and sleep disruption increase the risk of chronic inflammation and immune impairment but the evidence does not quantify the specific risk factor(s) and their correlation with the immune system impairment. COVID-19 related uncertainty has created a more urgent need to understand the need to identify interventions that could help in managing the risk factors, especially for healthy individuals who are at a higher risk of infection and/or immune system impairment. The role of three parameters, the Resting Heart Rate (HR), increased Heart Rate Variability (HRV), and lung function is considered as risk factors for systemic inflammation and chronic diseases. The evidence on Bhramari Pranayama is presented for possible lifestyle interventions to reduce the risk of infection, increase lung function, enhance autonomic function, and improve sleep quality in healthy individuals.

Effect of six months pranayama training on stress-induced salivary cortisol response among adolescents-Randomized controlled study

BACKGROUND

A combination of yoga practices has been documented to reduce stress and stress-induced cortisol levels. The objective of the current study is to examine the effects of six months of a single pranayama practice (Bhramari [Bhr. P]) on reducing salivary cortisol response to the cold pressor test (CPT) among adolescents.

METHODS

Twenty-six healthy adolescents between the ages of 11 and 19 were randomly assigned to either yoga group (n-13) or control group (n-13). Yoga group participants were trained to do Bhr. P for 45 min, thrice a week for six months. All participants underwent CPT at baseline and at end of six months. Saliva samples were collected at baseline (t0), at 20 min (t1), 40 min (t2), and 60 min after the CPT (t3).

RESULTS

Contradictory to our hypothesis, participants in the yoga group exhibited a higher salivary cortisol response to the CPT at t1 (p = 0.04) when compared to the control group. However, the t3 salivary cortisol levels showed a statistically significant reduction (p = 0.03) in yoga group when compared to the control group. A significant interaction with time (F (1, 88) = 316.5, p = .001, ηp²:0.91) and between the group × time (F (3, 88) = 2.83, p = 0.04, ηp²:0.8) was found after the intervention.

CONCLUSIONS

An increase in the cortisol responsiveness observed in the study is an indication of the adaptive capability achieved through regular yoga training, evidenced by an initial rise in cortisol followed by a rapid fall below baseline after 60 min. Further research is required to conclusively determine the changes in cortisol levels over time in response to stress in long-term yoga practitioners.

Immediate effects of the practise of Sheethali pranayama on heart rate and blood pressure parameters in healthy volunteers

OBJECTIVES

Sheetali pranayama, a cooling pranayama is best known for its calming and relaxing nature, widely used for many conditions like depression, anxiety and hypertension. The aim of the study was to evaluate the immediate effect of the practice of Sheetali pranayama on heart rate and blood pressure parameters in healthy volunteers.

METHODS

Apparently, 60 healthy volunteers were involved, from both sexes. They were split into pranayama (n=30) and control (n=30) groups at random. Sheetali pranayama was performed for 5 min (5 cycles) in the pranayama group and normal breathing (12-16 breaths/min) was permitted in the control group. Heart rate (HR) and blood pressure (BP) were recorded with RMS polyrite in the supine position after 5 min of rest.

RESULTS

The HR in the pranayama group significantly decreased (p=0.04). Systolic (SBP) and diastolic blood (DBP) pressure, pulse pressure (PP) and mean arterial pressure (MAP) decreased significantly (p<0.05) relative to control after pranayama practice. Pre-Post inter-group results has also shown that the pranayama group has substantially decreased HR and BP indices.

CONCLUSIONS

Present study shows that the practice of Sheetlai pranayama creates a relaxed state, and parasympathetic activity overrides sympathetic activity in this state. It indicates that in healthy volunteers, pranayama strengthens the resting cardiovascular parameters.

Can Yogic Breathing Techniques Like Simha Kriya and Isha Kriya Regulate COVID-19-Related Stress?

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.

Effect of yoga and meditation on tinnitus: a systematic review

OBJECTIVE

The present systematic review aimed to explore the published literature on the application of yoga and meditation for tinnitus.

METHOD

A systematic search was carried out to identify the eligible studies exploring the effect of yoga and meditation on tinnitus in PubMed, Scopus and Cochrane Library electronic databases. Studies on the application of yoga and meditation on tinnitus were identified following a three-step screening process by both the authors independently. A mixed-methods appraisal tool was used to perform the quality appraisal of the included studies.

RESULTS

Five studies were shortlisted and included in the present review. Four studies had used different types of yoga and pranayama, while one used relaxation therapy. Three studies concluded that there were positive effects of yoga on tinnitus, such as a reduction in severity, stress, anxiety and irritability associated with tinnitus and improved quality of life.

CONCLUSION

This review highlights the application of yoga and meditation in management of tinnitus along with regular otological and audiological treatment options. Furthermore, there is a need to have more randomised controlled trials in this area to evidence the effect of yoga and meditation on tinnitus empirically.

Breathing therapy and emotional freedom techniques on public speaking anxiety in Turkish nursing students: A randomized controlled study

BACKGROUND AND OBJECTIVE

Public speaking is a common challenge that university students have to face. This study aims to determine the effects of Breathing Therapy and Emotional Freedom Techniques (EFT) on public speaking anxiety in Turkish nursing students.

METHODS

This randomized controlled study included 76 nursing students. Data were collected using the Descriptive Characteristics Form, Subjective Units of Disturbance Scale, The State-Trait Anxiety Inventory, and the Speech Anxiety Scale.

RESULTS

Before the administration of Breathing Therapy and EFT, the students' median scores from the Subjective Units of Disturbance Scale, the State-Trait Anxiety Inventory, and the Speech Anxiety Scale were similar. However, the median scores of the Subjective Units of Disturbance Scale, the State-Trait Anxiety Inventory, and the Speech Anxiety Scale scores significantly decreased in both of the experimental groups after the interventions (p <0.001). EFT (d = 3.18) was more effective than Breathing Therapy (d = 1.46) in reducing Speech anxiety.

CONCLUSION

It was found that Breathing Therapy and EFT are effective methods to reduce stress, anxiety, and speaking anxiety.

Comparative effectiveness of breathing exercises in patients with chronic obstructive pulmonary disease

BACKGROUND AND PURPOSE

This study aims to determine the best choice of breathing exercises (BE) for patients with chronic obstructive pulmonary disease (COPD) via a network meta-analysis.

METHODS

We searched randomized controlled trials (RCTs) of adults with COPD investigating any BEs in MEDLINE, Embase, Cochrane Library, and ClinicalTrials.gov databases. The effects of comparative treatment on the St. George Respiratory Questionnaire as the outcome were analysed and ranked according to a surface under the cumulative classification curve (SUCRA) analysis.

RESULTS

The network meta-analysis included six RCTs involving 280 patients with four intervention groups, comprising control, diaphragmatic breathing training (DBT), yoga, and singing course. Performing SUCRA, we reported that yoga is 75% likely to be the best treatment available as DBT with 66%, instead of 35% for singing and 21% for control.

CONCLUSION

DBT and yoga seem to be the best choices for breathing exercises in people with COPD.

A randomized trial of the immediate effect of Bee-Humming Breathing exercise on blood pressure and heart rate variability in patients with essential hypertension

OBJECTIVES

Bee-Humming Breathing (BHB) exercise is a simple yogic practice recommended for its favorable effect on cardiac physiology, including blood pressure (BP) and autonomic nervous system. However, strong evidence supporting its effectiveness is lacking. The present study was designed to evaluate the immediate effect of BHB exercise on blood pressure parameters and heart rate variability (HRV) in patients with essential hypertension.

STUDY METHODS

We conducted a randomized control trial including 70 patients with essential hypertension, randomly allocated to perform either BHB exercise (n=35) or placebo slow breathing exercise (n = 35) for 5-minutes duration. Blood pressure and HRV were measured before, during, and after the practice.

RESULTS

There was no significant decrease in systolic [effect size (95% CI): 2.22 (-13.20, 17.64); p 0.77], diastolic [4.54 (-17.40, 26.48); p 0.68] and mean blood pressures [1.37 (-8.78, 11.52); p 0.78] after BHB exercise in comparison to the control group in our study. The HRV analysis showed a significant increase in the HF power [6.8 (1.47, 12.12); p 0.01], and decrease in the LF power [-26.47 (-34.25, -18.68); p < 0.01] during the recovery phase of the 5-minute BHB exercise in comparison to the control group.

CONCLUSIONS

This is the first randomized controlled trial to show that though a single short session of BHB exercise in hypertensive patients does not significantly reduce BP, it significantly augments the parasympathetic tone as indicated by a significant improvement in HRV parameters.

CLINICAL TRIAL REGISTRATION NUMBER

CTRI/2018/08/015215.

Effect of Bhramari pranayama practice on simple reaction time in healthy adolescents - a randomized control trial

Objectives The improvement in the/reaction time is important, as it is an indicator of cognitive function. Therefore, there is a need, especially for adolescents in the form of techniques or courses that can improve the reaction time. Yoga was found to cause a better improvement in the health of the individuals. The present study intended to show the effects of Bhramari pranayama (Bhr.P) on reaction time in the healthy adolescents. Methods Of the 730 potential subjects screened, 520 apparently healthy adolescents randomly assigned to either the Bhr.P group (n-260) or control group (n-260). Bhr.P group practiced the bhramari pranayama for 3 days in a week for 6 months. The Auditory Reaction Time (ART) and the Visual Reaction Time (VRT) were assessed before and after Bhr.P pranayama practice. Results Bhr.P group shows significant shortening of response time in both VRT (from 267.13 ± 52.65 to 249.87 ± 39.41 ms) and ART (from 237.42 ± 48.12 to 227.91 ± 34.60 ms) after 6 months of Bhr.P practice. In control group subjects, no such significant changes were found (p > 0.05). Conclusions Shortening of RT implies an improvement in the information processing and reflexes. This beneficial effect of Bhr.P on reaction time can be used for improving cognitive function in the adolescents for their academic performances.

Immediate effect of Kapalbhathi pranayama on short term heart rate variability (HRV) in healthy volunteers

OBJECTIVES

Kapalbhathi Pranayam (Kapal = forehead; bhati = shining) is a breathing exercise that has been practiced to cleanse the frontal brain in traditional practices like yoga. Still, there exists a dearth of literature on the effect of Kapalbhathi pranayama on physiological systems. So this present study was carried out to find the immediate effect of "kapalbhathi Pranayam" practice for the period of 5 min on cardiac autonomic function among the healthy volunteers.

MATERIALS AND METHODS

Apparently 50 healthy volunteers includes both sex were participated. They were randomly divided into Pranayama (n-25) and control (n-25) group. Pranayama group was practiced kapalbhathi pranayama 5 min (5 cycles) and control group was allowed to do normal breathing (12-16 breath/min). Lead II ECG was recorded for 5 min using simple AD converter before, immediately after practice and 20 min of recovery period.

RESULTS

One way Analysis of variance (ANOVA) followed by post hoc test was done using R statistical software. There was a significant (p < 0.05) parasympathetic withdrawal (Root Mean Square of the Successive Differences (RMSSD) - p < 0.04 and HF n.u - p < 0.05) was found in the pranayama group immediately after practice and its was changed to parasympathetic domination (RMSSD - p < 0.04 and HF n.u - p < 0.05) after 20 min of recovery period.

CONCLUSION

The present study suggested that though there was parasympathetic withdrawal immediately after practicing kapalbhathi pranayama, 20 min after the recovery period showed a parasympathetic domination in the pranayama group subjects. However, further studies are required to warrant the findings of this study.

Mindfulness with paced breathing reduces blood pressure

Elevated blood pressure (BP) is a major avoidable cause of premature morbidity and mortality in the United States (US) and worldwide, due primarily to increased risks of stroke as well as myocardial infarction. While there are therapeutic lifestyle changes and adjunctive pharmacologic medications of proven benefit, recent interest has increasingly focused on Complementary and Alternative Medicine, in particular, Mind-Body Interventions. With respect to BP, it is tempting to speculate that mindfulness with paced breathing will have beneficial effects in the short run that may translate into lowered risks of stroke in the long run. Paced breathing is deep diaphragmatic breathing with typical rates equal to or less than 5-7 breaths per minute compared with the usual rate of 12-14. One plausible mechanism of benefit is that paced breathing stimulates the parasympathetic nervous system which alters neuronal function in specific areas of the brain and reduces stress chemicals. The hypothesis that mindfulness with paced slow breathing reduces BP could be directly tested in randomized trials designed a priori to do so. Subsequently, a finding that mindfulness with paced breathing reduces BP would also lead to direct tests in randomized trials of reductions of carotid atherosclerosis and, if so, a larger scale trial to test whether there is a direct impact of mindfulness with paced breathing on reducing the risks of stroke and MI. If rigorous testing of this medical hypothesis led to positive results this would have large and important clinical and policy implications in the US and worldwide.

Effects of yoga breathing practice on heart rate variability in healthy adolescents: a randomized controlled trial

Background

This study was conducted among healthy adolescents to assess the effects of a yoga breathing practice (Bhramari pranayama, Bhr.P) towards cardiac autonomic function using heart rate variability (HRV) parameters.

Methods

Of the 730 eligible subjects screened, 520 healthy adolescents who met the inclusion and exclusion criteria were randomly assigned to either yoga breathing group (n = 260) or control group (n = 260). The yoga breathing group practiced Bhr.P. five days a week for a duration of six months while the control group continued with their daily routine without any intervention. Outcome measures were time and frequency domain of HRV in both groups which were assessed before and after the intervention using Lead II ECG. Linear models were used in the analysis of short term HRV.

Results

After 6 months of yoga breathing, the time domain parameters of short term HRV showed significant (P < 0.05) improvement towards the parasympathetic domain. Frequency domain parameters also showed the same direction of changes. In contrast, control group subjects showed a trend towards a sympathetic domain.

Conclusion

The present study showed a positive shift in cardiac autonomic modulation towards parasympathetic predominance after 6 months of yoga breathing practice among apparently healthy adolescents.

How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing

Background: The psycho-physiological changes in brain-body interaction observed in most of meditative and relaxing practices rely on voluntary slowing down of breath frequency. However, the identification of mechanisms linking breath control to its psychophysiological effects is still under debate. This systematic review is aimed at unveiling psychophysiological mechanisms underlying slow breathing techniques (<10 breaths/minute) and their effects on healthy subjects.

Methods: A systematic search of MEDLINE and SCOPUS databases, using keywords related to both breathing techniques and to their psychophysiological outcomes, focusing on cardio-respiratory and central nervous system, has been conducted. From a pool of 2,461 abstracts only 15 articles met eligibility criteria and were included in the review. The present systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results: The main effects of slow breathing techniques cover autonomic and central nervous systems activities as well as the psychological status. Slow breathing techniques promote autonomic changes increasing Heart Rate Variability and Respiratory Sinus Arrhythmia paralleled by Central Nervous System (CNS) activity modifications. EEG studies show an increase in alpha and a decrease in theta power. Anatomically, the only available fMRI study highlights increased activity in cortical (e.g., prefrontal, motor, and parietal cortices) and subcortical (e.g., pons, thalamus, sub-parabrachial nucleus, periaqueductal gray, and hypothalamus) structures. Psychological/behavioral outputs related to the abovementioned changes are increased comfort, relaxation, pleasantness, vigor and alertness, and reduced symptoms of arousal, anxiety, depression, anger, and confusion.

Conclusions: Slow breathing techniques act enhancing autonomic, cerebral and psychological flexibility in a scenario of mutual interactions: we found evidence of links between parasympathetic activity (increased HRV and LF power), CNS activities (increased EEG alpha power and decreased EEG theta power) related to emotional control and psychological well-being in healthy subjects. Our hypothesis considers two different mechanisms for explaining psychophysiological changes induced by voluntary control of slow breathing: one is related to a voluntary regulation of internal bodily states (enteroception), the other is associated to the role of mechanoceptors within the nasal vault in translating slow breathing in a modulation of olfactory bulb activity, which in turn tunes the activity of the entire cortical mantle.

Effect of Bhramari Pranayama on the Acoustic and Aerodynamic Parameters of Voice in Normophonic Females

Summary. Objective

Pranayama is known for improving various health conditions. The present study is aimed at investigating the effects of bhramari pranayama on aerodynamic and acoustic parameters of voice in healthy individuals.

Study Design

This is a pretest-posttest design study.

Methods

A total of 24 participants in the age range of 20 to 25 years completed the bhramari pranayama regimen for 30 sessions. Aerodynamic and acoustic assessments were done before and after pranayama sessions. Maximum phonation duration, pitch, loudness, subglottal pressure, glottal airflow, laryngeal resistance and conductance along with acoustical parameters such as average F0, jitter, and shimmer, soft phonation index, noise to harmonic ratio, cepstral peak prominence, and smoothened cepstral peak prominence were analysed.

Results

The results revealed significant improvement in the maximum phonation duration, glottal airflow and pressure, average fundamental frequency, and cepstral peak prominence after practice suggesting that it has an effect on voice parameters.

Conclusion

Bhramari pranayama is effective in improving the acoustic and aerodynamic parameters of voice. The same needs to be investigated in hyper- and hypofunctional voice disorders in the future studies.