Yoga respiratory training improves respiratory function and cardiac sympathovagal balance in elderly subjects: a randomised controlled trial

Danilo F Santaella, Cesar R S Devesa, Marcos R Rojo, Marcelo B P Amato, Luciano F Drager, Karina R Casali, Nicola Montano, Geraldo Lorenzi-Filho, Danilo F Santaella, Cesar R S Devesa, Marcos R Rojo, Marcelo B P Amato, Luciano F Drager, Karina R Casali, Nicola Montano, Geraldo Lorenzi-Filho

Abstract

Objectives: Since ageing is associated with a decline in pulmonary function, heart rate variability and spontaneous baroreflex, and recent studies suggest that yoga respiratory exercises may improve respiratory and cardiovascular function, we hypothesised that yoga respiratory training may improve respiratory function and cardiac autonomic modulation in healthy elderly subjects.

Design: 76 healthy elderly subjects were enrolled in a randomised control trial in Brazil and 29 completed the study (age 68 ± 6 years, 34% males, body mass index 25 ± 3 kg/m²). Subjects were randomised into a 4-month training program (2 classes/week plus home exercises) of either stretching (control, n=14) or respiratory exercises (yoga, n=15). Yoga respiratory exercises (Bhastrika) consisted of rapid forced expirations followed by inspiration through the right nostril, inspiratory apnoea with generation of intrathoracic negative pressure, and expiration through the left nostril. Pulmonary function, maximum expiratory and inspiratory pressures (PE(max) and PI(max), respectively), heart rate variability and blood pressure variability for spontaneous baroreflex determination were determined at baseline and after 4 months.

Results: Subjects in both groups had similar demographic parameters. Physiological variables did not change after 4 months in the control group. However, in the yoga group, there were significant increases in PE(max) (34%, p<0.0001) and PI(max) (26%, p<0.0001) and a significant decrease in the low frequency component (a marker of cardiac sympathetic modulation) and low frequency/high frequency ratio (marker of sympathovagal balance) of heart rate variability (40%, p<0.001). Spontaneous baroreflex did not change, and quality of life only marginally increased in the yoga group.

Conclusion: Respiratory yoga training may be beneficial for the elderly healthy population by improving respiratory function and sympathovagal balance. Trial Registration CinicalTrials.gov identifier: NCT00969345; trial registry name: Effects of respiratory yoga training (Bhastrika) on heart rate variability and baroreflex, and quality of life of healthy elderly subjects.

Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1
Flowchart of study recruitment.
Figure 2
Figure 2
Individual values for maximum expiratory power (PEmax) and maximum inspiratory power (PImax). There were no significant differences at baseline between groups for both variables. The yoga group showed significant increases in PEmax and PImax at 4 months. The difference between groups became significant for PEmax at 4 months. Data are expressed as means±SD.
Figure 3
Figure 3
Individual values for sympathovagal balance (LF/HF). There was no significant difference at baseline between groups. There was a decrease in LF/HF from baseline to 4 months due to a significant decrease in the yoga group (p

Figure 4

Individual values for overall quality…

Figure 4

Individual values for overall quality of life. There was no significant difference at…

Figure 4
Individual values for overall quality of life. There was no significant difference at baseline between groups. There was a strong tendency (0.052) towards increased quality of life from baseline to 4 months, apparently due to a significant increase in the yoga group (p
Similar articles
Cited by
References
    1. Christensen K, Doblhammer G, Rau R, et al. Ageing populations: the challenges ahead. Lancet 2009;374:1196–208 - PMC - PubMed
    1. Verbrugge LM, Jette AM. The disablement process. Soc Sci Med 1994;38:1–14 - PubMed
    1. Chan ED, Welch CH. Geriatric respiratory medicine. Chest 1998;114:1704–33 - PubMed
    1. Stein PK, Barzilay JI, Chaves PH, et al. Heart rate variability and its changes over 5 years in older adults. Age Ageing 2009;38:212–18 - PMC - PubMed
    1. Fauvel JP, Cerutti C, Mpio I, et al. Aging process on spectrally determined spontaneous baroreflex sensitivity: a 5-year prospective study. Hypertension 2007;50:543–6 - PubMed
Show all 33 references
Publication types
Associated data
Full text links [x]
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM
Figure 4
Figure 4
Individual values for overall quality of life. There was no significant difference at baseline between groups. There was a strong tendency (0.052) towards increased quality of life from baseline to 4 months, apparently due to a significant increase in the yoga group (p

References

    1. Christensen K, Doblhammer G, Rau R, et al. Ageing populations: the challenges ahead. Lancet 2009;374:1196–208
    1. Verbrugge LM, Jette AM. The disablement process. Soc Sci Med 1994;38:1–14
    1. Chan ED, Welch CH. Geriatric respiratory medicine. Chest 1998;114:1704–33
    1. Stein PK, Barzilay JI, Chaves PH, et al. Heart rate variability and its changes over 5 years in older adults. Age Ageing 2009;38:212–18
    1. Fauvel JP, Cerutti C, Mpio I, et al. Aging process on spectrally determined spontaneous baroreflex sensitivity: a 5-year prospective study. Hypertension 2007;50:543–6
    1. Kaye DM, Esler MD. Autonomic control of the aging heart. Neuromolecular Med 2008;10:179–86
    1. Drewnowsky A, Evans WJ. Nutrition, physical activity, and quality of life in older adults: summary. J Gerontol A Biol Sci Med Sci 2001;V56A:89–94
    1. Pomidori L, Campigotto F, Amatya TM, et al. Efficacy and tolerability of Yoga breathing in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil Prev 2009;29:133–7
    1. Raupach T, Bahr F, Herrmann P, et al. Slow breathing reduces sympathoexcitation in COPD. Eur Respir J 2008;32:387–92
    1. Pal GK, Velkumary S, Madanmohan Effects of short-term practice of breathing exercises on autonomic functions in normal human volunteers. Indian J Med Res 2004;120:115–21
    1. Bernardi L, Porta A, Gabutti A, et al. Modulatory effects of respiration. Auton Neurosci 2001;90:47–56
    1. Bernardi L, Passino C, Spadacini G, et al. Reduced hypoxic ventilatory responde with preserved blood oxygenation in Yoga trainees and himalayan buddhist monks at altitude: evidence of a different adaptative strategy? Eur J Appl Physiol 2007;99:511–18
    1. Miller MR, Hankinson J, Brusasco V, et al. ATS/ERS Task Force Standardisation of spirometry. Eur Respir J 2005;26:319–38
    1. Duarte AA, Pereira CA, Barreto SC, et al. Validation of new Brazilian predicted values for forced spirometry in Caucasians and comparison with predicted values obtained using other reference equations (In English, Portuguese). J Bras Pneumol 2007;35:527–35
    1. Black LF, Hyatt RE. Maximal respiratory pressures: normal values and relationship to age and sex. Am Rev Respir Dis 1969;99:696–702
    1. Chobanian AV, Bakris GL, Black HR, et al. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee Seventh report of the Joint National Committee on prevention, detectioon, evaluation, and treatment of high blood pressure. Hypertension 2003;42:1206–52
    1. Tobin MJ, Guenther SM, Perez W, et al. Accuracy of the respiratory inductive plethysmograph during loaded breathing. J Appl Physiol 1987;62:497–505
    1. . Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Eur Heart J 1996;17:354–81
    1. Montano N, Ruscone TG, Porta A, et al. Power spectrum analysis of heart rate variability to assess the changes in sympathovagal balance during orthostatic tilt. Circulation 1994;90:1826–31
    1. Montano N, Porta A, Cogliati C, et al. Heart rate variability explored in the frequency domain: a tool to investigate the link between heart and behavior. Neurosci Biobehav Rev 2009;33:71–80
    1. Bertinieri G, Di Rienzo M, Cavallazzi A, et al. A new approach to analysis of the arterial baroreflex. J Hypertens Suppl 1985;3:S79–81
    1. Bertinieri G, Di Rienzo M, Cavallazzi A, et al. Evaluation of baroreceptor reflex by blood pressure monitoring in unanesthetized cats. Am J Physiol 1988;254:H377–83
    1. Chachamovit E, Fleck MP, Trentini C, et al. Brazilian WHOQOL-OLD Module Version: a Rasch analysis of a new instrument. Rev Saude Publica 2008;42:308–16
    1. Fleck MP, Chachamovich E, Trentini C. Development and validation of the Portuguese version of the WHOQOL-OLD module. Rev Saude Publica 2006;40:785–91
    1. Kuvalayananda Swami. Pranayama. Trad. Roldano Giuntoli. São Paulo: Phorte, 2008:312
    1. Bernardi L, De Barbieri G, Rosengård-Bärlund M, et al. New method to measure and improve consistency of baroreflex sensitivity values. Clin Auton Res 2010;20:353–61
    1. Janssens JP. Aging of the respiratory system: impact on pulmonary function tests and adaptation to exertion. Clin Chest Med 2005;26:469–84, vi–vii.
    1. . American College of Sports Medicine Position Standard. Exercise and physical activity for older adults. Med Sci Sports Exerc 1998;30:992–1008
    1. Vempati R, Bijlani RL, Deepak KK. The efficacy of a comprehencive lifestile modification programme based on Yoga in the manegement of bronchial asthma: a randomized controlled trial. BMC Pulm Med 2009;9:37.
    1. Cooper S, Oborne J, Newton S, et al. Effect of two breathing exercises (Buteyko and pranayama) in Asthma: a randomized controlled trial. Thorax 2003;58:674–9
    1. Slader CA, Reddel HK, Spencer LM, et al. Double blind randomized controlled trial of two different breathing techniques in the management of asthma. Thorax 2006;61:651–6
    1. Oken BS, Zajdel D, Kishiyama S, et al. Randomized, controlled, six-month trial of yoga in health seniors: effects on cognition and quality of life. Altern Ther Health Med 2006;12:40–7
    1. Sharma R, Gupta N, Bijlani RL. Effect of yoga based lifestile intervention on subjective well-being. Indian J Physiol Pharmacol 2008;52:123–31

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren