Effect of Yoga Breathing (Pranayama) on Exercise Tolerance in Patients with Chronic Obstructive Pulmonary Disease: A Randomized, Controlled Trial
Effect of Yoga Breathing (Pranayama) on Exercise Tolerance in Patients with Chronic Obstructive Pulmonary Disease: A Randomized, Controlled Trial
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DOI：
10.1089/acm.2017.0102
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发表时间：
2017-09-01
影响因子：
2.6
通讯作者：
Hanania, Nicola A.
中科院分区：
文献类型：
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作者：
Kaminsky, David A.;Guntupalli, Kalpalatha K.;Hanania, Nicola A.
目的：肺康复治疗对慢性阻塞性肺疾病（COPD）患者运动耐量的影响。然而，许多患者无法获得肺康复计划。我们假设，一个替代肺康复，以提高运动耐量的做法是调息，或瑜伽呼吸，这可以在家里独立完成。我们还试图确定是否瑜伽非专业人士可以充分教pranayama患者。设计：概念验证，随机，双盲，对照试点试验。设置/位置：两个学术肺的做法。主题：43例有症状的，中度至重度COPD患者。干预：12周pranayama加教育与教育单独。两名瑜伽专业人员培训的研究协调员进行所有的调息教学和监测的教学质量和实践的调息研究participations. OutcomeMeasures：主要结果是在6分钟步行距离（6 MWD）的变化。次要结果包括肺功能的变化，氧化应激和全身炎症的标志物，以及呼吸困难和生活质量的测量。调息组6 MWD增加（最小二乘均值[95%置信区间] = 28个月[-5至61]），对照组降低（-15米[-47至16]），具有几乎显著的治疗效果（p = 0.06），有利于调息。呼吸控制法也导致吸气能力和空气滞留的小改善。两组有显着的改善，在各种措施的症状，但在呼吸系统阻抗或氧化应激或全身inflammation.Conclusion标志物没有整体差异：这项试点研究成功地证明，调息与改善运动耐量的COPD患者。外行人员能够充分地教病人练习调息。这些结果表明，调息可能对有症状的COPD患者有显着的临床益处，这一概念需要在未来更大的临床试验中得到证实。
Objective: Pulmonary rehabilitation improves exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). However, many patients do not have access to pulmonary rehabilitation programs. We hypothesized that an alternative to pulmonary rehabilitation to improve exercise tolerance is the practice of pranayama, or yoga breathing, which could be done independently at home. We also sought to determine whether yoga nonprofessionals could adequately teach pranayama to patients.Design: Proof-of-concept, randomized, double-blind, controlled pilot trial.Settings/Location: Two academic pulmonary practices.Subjects: Forty-three patients with symptomatic, moderate-to-severe COPD.Interventions: Twelve weeks of pranayama plus education versus education alone. Two yoga professionals trained the research coordinators to conduct all pranayama teaching and monitored the quality of the teaching and the practice of pranayama by study participants.Outcome measures: The primary outcome was a change in the 6-min walk distance (6MWD). Secondary outcomes included changes in lung function, markers of oxidative stress and systemic inflammation, and measures of dyspnea and quality of life.Results: The 6MWD increased in the pranayama group (least square mean [95% confidence interval] = 28m [-5 to 61]) and decreased in the control group (-15m [-47 to 16]), with a nearly significant treatment effect (p = 0.06) in favor of pranayama. Pranayama also resulted in small improvements in inspiratory capacity and air trapping. Both groups had significant improvements in various measures of symptoms, but no overall differences in respiratory system impedance or markers of oxidative stress or systemic inflammation.Conclusion: This pilot study successfully demonstrated that pranayama was associated with improved exercise tolerance in patients with COPD. Lay personnel were able to adequately teach patients to practice pranayama. These results suggest that pranayama may have significant clinical benefits for symptomatic patients with COPD, a concept that needs to be confirmed in future, larger clinical trials.