Published: Oct 28, 2013 | Updated: Oct 28, 2013
By Kristina Fiore, Staff Writer, MedPage Today

Full Story:  http://www.medpagetoday.com/MeetingCoverage/CHEST/42512

CHICAGO — With its focus on breathing exercises, yoga may improve some of the symptoms of chronic pulmonary obstructive disease (COPD) along with boosting quality of life, researchers said here.

In a small study of patients in India, 12 weeks of twice weekly yoga classes improved several measurements of dyspnea and living quality, Randeep Guleria, MD, of All India Institute of Medical Sciences in New Delhi, and colleagues reported at the CHEST meeting.

“Yoga is a simple, cost-effective method that improves dyspnea and quality of life in COPD,” Guleria said during the presentation.

Zachary Morris, MD, of Henry Ford Hospital in Detroit, who moderated the session at which the findings were presented, agreed that yoga may fill an unmet need, given a known lack of success for standard pulmonary rehabilitation programs.

“I was skeptical until I heard this talk, but it actually makes a lot of sense,” Morris said. “Pulmonary rehabilitation failure rates are so high because patients go home, feel fine, and don’t do [their exercises]. But this is something they can continue to do, and that they want to do at home.”

Indeed, Guleria said patients were told they only needed to do yoga twice per week at home, but ended up doing it much more often.

To assess whether yoga could have an impact on COPD, the researchers enrolled 29 patients (25 men, four women) with a mean age 56. They were taught several yoga techniques, including physical postures, breathing techniques, and meditation and relaxation techniques.

For the first 4 weeks of the study, patients came to the hospital for hour-long yoga sessions twice a week. Then for the next 8 weeks, patients were told to do their yoga exercises at home, and only came to the hospital for one class every other week.

The researchers measured several parameters of COPD at baseline and at 12 weeks, including lung function, dyspnea severity, quality of life, and inflammation.

Over the 3 months of the study, they found significant improvement in dyspnea severity, for all the ways it was measured:

• Medical Research Council (MRC) grade: 2.59 versus 2.07 (P<0.001)
• 6-minute walking test: 417.86 versus 448.85 meters (P=0.014)
• Borg scale: 2.00 versus 1.00 (P<0.001)
• Visual Analog Scale (VAS): 55.69 versus 70.74 mm (P<0.001)

They also saw significant improvements in nearly all measures of quality of life:

• Activity score: 53.16 versus 41.76 (P=0.004)
• Impact score: 41.32 versus 24.34 (P<0.001)
• Total score: 50.96 versus 31.43 (P<0.001)

However, there were no significant improvements on pulmonary function tests or on inflammatory markers, including interleukin-6 (IL-6), IL-8, and TNF-alpha. But Guleria noted that there was a trend toward improvement in C-reactive protein levels, although it wasn’t significant.

Guleria said the benefits likely have to do with the fact that “yoga is a way of life … and meditation improves general spiritual well being.”

Also, it focuses on breathing, which could effectively be looked at as respiratory exercises and “could help as far as [lung] muscle function is concerned.”

It’s also a “more acceptable” physical activity to many patients, compared with something more rigorous or routine as walking on a treadmill, Guleria said.

He added that his team is now doing another study to compare their COPD patient yoga program with standard pulmonary rehabilitation.

“It will be interesting to see whether in 6 months yoga drops off as does pulmonary rehabilitation,” Morris said.