Exercise as it relates to Disease/Yoga’s effect on asthmatic university students

What is the background to this research?

_{Woman demonstrating 'Tree Pose' during yoga session}

A controlled study of 17 university students, ages ranging from 19 to 52 years, assessed the influence of yoga as a treatment for asthmatic patients. This research is able to give us an objective scientific outlook on a topic that is often guessed or assumed. Given yoga’s exercise techniques (encouraging participants to focus on various breath work while holding stretch poses), it has been the topic of much conversation on non-scientific articles for its positive influence for those suffering from asthma. This could be due to the similarity of focused and calm breathing techniques. Asthma is a chronic airway inflammatory disorder within the lungs and can be life threatening due to the bronchial hyperresponsiveness of the airway, causing obstructive breathing. Breathing techniques are a non-pharmacological therapy used in conjunction with other medicines and is considered crucial upon an asthma attack.

Where is the research from?

This study was conducted in 1998 within the Northern Colorado Allergy Asthma Clinic, Texas. The participants within this study were students of the University of Texas Health Science Centre. Assembling university students provided strong foundations to this study due to their prior knowledge and experience within the field of scientific research. Choosing this particular demographic could also indicate higher levels of interest throughout the research.

This study is apart of Pubmed’s extensive medical research database. Pubmed is referred as the premier source for biomedical literature, known to be a reliable and highly authoritative resource. The author’s of this research have all provided previous respiratory studies such as Kirby Duvall’s insight into respiratory symptoms and Krishna Murthy’s study on particle composition’s relationship with lung inflammation.

Lead author Pudupakkam Vedanthan has provided various studies on asthma, He is also the lead editor of ‘Textbook of Allergy for the Clinical, second edition’. This textbook was reviewed and well regarded by Annals of allergy, Asthma and Immunology. They explained “chapters are well written, well referenced and provide an up-to-date resource to all levels of training”.

No sponsorships have been found within the mentioned studies nor were there links to respiratory profit organisations. Due to this, it’s assumed that all research had been conducted within the researchers scope of practice and conducted for research purposes only. There's no perceived bias toward the research by that of the researcher. An objective approach has been taken throughout the experiment.

What kind of research was this?

This research was a clinical study with a small population and a refined demographic as all participants were university student from an individual school. when measured against other larger more diverse studies of a similar topic such as Jacqui Wise's 2016 study, the evidence provided by the smaller study heavily outweighed that of the larger. While Wise predominately relied on Asthma Quality of Life Questionnaire to base results on, the clinical study backed their research on multiple variables such as expiatory flow rate, medication use, self reported statistical analyses and improvement in both severity and frequency of asthma symptoms. Whilst providing different methods and varied evidence, both studies complimented each other by concluding a similar result.

What did the research involve?

Nine subjects that were randomly assigned to the yoga group, while eight subjects were randomly assigned to the non-yoga controlled group. The investigating physicians throughout the experiment didn’t know which patients were undergoing the yoga intervention. The study period lasted 16 weeks, including three 45 minute classes a week. Classes included yoga methods such as postures, breathing techniques, meditation and discussion sessions.

Pulmonary function was assessed weekly with a spirometry, measuring both FEV¹ (amount of air forced from lungs in one second) and FVC (total volume of the lungs when filled with as much air as possible). The mean of these recordings were used in the results.

All participants were given a peak flow meter and asked to record their peak flow reading both morning and evening. Students were also given a weekly symptoms questionnaire as a self-assessment which was analysed by researchers using ‘Mann-Whitney's test’.

When recruiting candidates from a scientific background, although previous experience can be helpful, it could also be detrimental to the reality of the results; Students, having knowledge of how studies are conducted, could be eager to significantly influence the results. This problem has been dulled by multiple physiological variables such as the FEV¹ and FVC measurements, but due to the small size of this study, it is possible that sampling bias may still have been present and in turn, influenced the results.

What were the basic results?

No significant improvement of respiratory function was observed from FEV¹ and FVC. Peak flow rate data revealed that there were no significant differences in the AM and PM peak flow rates between the groups. The average weighted score of the questionnaire showed the yoga group with a score of 7.00 and the control group a score of 1.75. Although having a large range between the two, when based upon the Mann-Whitney test, there is no significant difference.

The researches believe that their Hypothesis may have failed due to inappropriate exposure of the patients to the yoga philosophy, lack of positive attitude toward yoga therapy and the short study period.

Weighted Score of the Responses from Weekly Questionnaire _{Values represent means, standard deviation in parentheses, NS not significant.}

Groups	Total Score	Mean	Mean Pulmonary	Mean Nonpulmonary
Yoga	7.00 (10.16)	0.23 (0.31)	0.01 (0.72)	0.36 (0.33)
Controlled	1.75 (24.14)	0.06 (0.81)	0.05 (1.28)	0.07 (0.53)
Significance	NS	NS	NS	NS

What conclusions can we take from this research?

This research has provided a well designed experiment to investigate yoga and the breath work technique’s effect on asthmatic patients. Having conducted this research 24 years ago, assembling a greatly diversified participant group would have deemed difficult without the aid of today's connecting technology. With this in mind, the results of this 1998 clinical study very closely reflects that of Wise’s 2016 ethnically diverse study, therefore extinguishing the belief that this experiment may present more accurate with a larger, more diverse group of participants.

This research is validated by the extensive physiological evidence that still stands parallel to recent findings. Due to these results, yoga has been found to not have any significant effect on those suffering from asthma.

Practical advice

_{A medical illustration depicting spirometry}

Some limitations that may present in the wider community, most of which can be tailored for individuals. Some altering would be need for those suffering from other movement restricting conditions such as sciatica, or those in wheelchairs. A variation of yoga poses would be needed for inclusive engagement. Lack of exposure to yoga may present implications prior to workouts. This is avoidable by exposing these individuals to varied posing and breath work techniques prior to physical movement.

Self-assessment of pulmonary function will require using and interpreting a spirometry machine. when this study was conducted in 1998, the spirometry machine required a health professional and large stationary equipment. Thanks to recent advancements, measuring various respiratory functions is now practical for the general public.

Further information/resources

A beneficial read that further elaborates on this topic is one written by Julia White. White has participated in yoga since childhood. She explains stress’s effect on an asthma attacks and yoga’s benefits on calming these attacks.

A medically reviewed article, written by Erin Kelly, presents 30 essential yoga poses which could be a valuable resource for those looking to self-investigate the effects of yoga on their asthma.