Yoga, Breathing and asana can help people with COPD (Chronic Obstructive Lung Disease) and other lung diseases.
Yoga, Breathing and Yoga exercises (asana) help relieving COPD effects and improves lung function.
COPD (Chronic obstructive lung disease) is the fifth leading cause of disability and is touted to be the third leading cause of death in the world by 2030, according to WHO ‘global burden of disease.’
COPD is characterised by persistent cough, irreversible airflow obstruction, dyspnea, increased work of breathing, gradual decline in lung function and a high rate of morbidity and mortality. The three lung disorders i.e. bronchitis, bronchial asthma and emphysema can lead to COPD.
The management of COPD aims at reduction of symptoms, complications, exacerbations, improves exercise tolerance and improve quality of life.
Recent research indicates that various programs like Pulmonary Rehabilitation, Tai chi and Yogic Breathing training can help in relieving dyspnea and improves lung function.
How yoga helps a person with COPD?
- Yoga helps to improve overall lung function
- Helps to reduce respiratory rate
- Improves lung volumes
- Improves maximum voluntary ventilation
- Improves breath holding capacity
- Yoga Breathing helps prevent decline of lung function
- Reduce dyspnea and breathlessness
- Improves exercise tolerance and exercise capacity
- Helps to strengthen respiratory muscles
- Helps to improve energy level
- Yoga helps relieve COPD associated Stress and anxiety
How yoga improves Lung function – possible physiology
Yoga Breathing helps to de-stress: During pranayama practitioner not only tries to breathe but also concentrates on breathing. This act of concentration helps to relives all worries and eventually de-stress by activating parasympathetic “rest-relax” nervous system.
Yoga Breathing causes rise in thoracic pulmonary compliances and Bronchodilation: Inflation of lung and alteration of breathing pattern can cause stimulation of pulmonary stretch receptors, which reflexively relaxes muscles of larynx and tracheobronchial tree. This ultimately reduces airway resistance.
Yoga Breathing helps efficient emptying and filling of lungs: Increase in respiratory muscle strength, cleansing of airways secretions and efficient use of diaphragmatic and abdominal muscles as a consequence of yoga, contributes to efficient lung functioning.
Yoga Breathing increases lung compliance: Yoga Pranayama helps to reduce elastic and viscous resistance present in lungs at the time of inhalation. It acts as a physiological stimulator to release lung surfactant and prostaglandins, which increases lung compliance.
Yoga Breathing improves respiratory muscle efficiency: Breathing exercises and stretching postures strengthen principal respiratory muscles at the same time relaxes accessory muscles of respiration
Yoga Breathing improves oxygenation: Recent research suggests that pranayama increases oxygen intake for up to five times as it involves vertical breathing; which allows alveoli of both lungs to open up and provides a vast expanse of alveolar membrane for exchange of gases.
COPD patients should start a yoga program with pranayama (breath retraining), which helps to strengthen the respiratory muscles and gives some control over dyspnea also it increases readiness for asana practice.
Breath retraining and Dyspnea control strategies
First step in breath retraining is identification of present breathing patterns that includes respiratory rate and length of inhalation and exhalation this will help you to identify any irregularities in breathing patterns. Breath retraining involves continuous breath awareness, monitoring and auto correction of irregular breathing pattern with the help of breathing strategies. Some of the dyspnea episodes occurs as a result of incorrect or reverse breathing i.e. abdomen going in and not out during inspiration. So learning the correct pattern helps in following complications:
Shortness of Breath: Pursed lip breathing helps in relaxation and alleviation of shortness of breath. Counting along with pursed lip while breathing helps to slow down breathing.
Hyperventilation: Conscious slow breathing as done in various techniques of pranayama helps to ease over breathing.
Accessory Muscles Breathing: The moment you notice recruitment of neck and shoulder muscles during inhalation, start relaxing your body and at the same time start doing pursed lip breathing slowly, steadily and consistently. Restore diaphragmatic breathing to ensure efficient breathing.
Dynamic Hyperinflation of lungs: Due to Obstructive condition all the air does not come out and gets trapped in the air sacs and affects the exchange of gases along the alveolar membrane. Again pursed lip breathing helps to get the excess air out of the alveoli.
Hypoventilation: Breathing less than your normal occurs when diaphragm does move efficiently and lungs doesn’t breathe normally. After recognizing under breathing gently stretch your spine, engage breathing muscles and work up to a normal pattern of breathing.
Optimize your Breathing
Consult an expert to establish the best breathing patterns and apply them consistently until it became automatic.
Perform deep breathing as much as you can. Gradually learn to exhale longer than inhalation. Perform breathing exercises daily for toning of respiratory muscles
Abdominal Breathing: It is the most beneficial practice for COPD patients. During inhalation focus should be on descending of diaphragm and expanding of lower ribs and abdomen, which causes more satisfactory inhalation. While during exhalation focus should be on diaphragmatic ascend with lower ribs squeezing and abdominals contraction assisting in emptying of lungs.
Pursed-lip Breathing: Inhale through nose, if possible and exhale through pursed lip to control breathlessness. Pursed lip encourages abdominal contraction, which forces diaphragm upwards assisting in complete emptying of lungs. It helps to slow exhalation down and may also help to strengthen respiratory muscles.
Diaphragmatic Breathing: In some COPD patients breathing problem aggravates in lying position so perform diaphragmatic breathing exercise in reclined position. It can be performed with a sandbag kept on abdomen for strengthening of the muscle. Gradually weight of the sandbag can be increased. One should practice both abdominal as well as intercostal breathing techniques.
Yoga Asana practice
In general, there is no drug, which can hinder the progression of COPD, but practice of yoga Asana with Breath control has been shown to reduce disability in many of the patients with respiratory diseases.
As we know if not checked timely COPD can cause further impairment, resulting in inactivity, which in turn can deteriorate lung functioning. So the comprehensive training including breathing exercises and yoga postures can increase strength and endurance of entire musculature. Yoga postures that actively involve neck, thorax, shoulder and pelvis can strengthen respiratory musculature. Yoga postures involving forward bends, backbends, spinal side bends and twists can help the person with COPD. If lying is uncomfortable you can modify the posture by keeping bolster under the head or can perform it in sitting or standing position.
Guidelines for practice of yoga asana
While practicing yoga asana, try to maintain exhalation little longer than inhalation. You can practice pursed lip breathing while performing postures to avoid dyspnea attack.
It is important to coordinate breathing with movement. For e.g. in standing forward bend exhale while bending forward and inhale while coming up. The coordinated Breathing allows efficient exhalation along with strengthening of respiratory muscles.
Backbends as in beginning of sun salutation is helpful in opening the chest and allows maximum space for lungs to expand.
Mountain pose performed with stretched arms helps to increase spinal extension as well as improves chest mobility.
Warrior 1 Pose is helpful in strengthening both inspiratory and expiratory musculature.
Standing side bends as done in triangle pose is beneficial to improve flexibility and strength of intercostal muscles. One can incorporate breathing with this posture to gain maximum benefits. Look down if you experience breathing difficulty in looking up at the extended hand while performing the posture. If standing side bends is difficult for someone, sitting side bends are good alternative.
Cat pose is highly restorative as it improves spinal mobility along with assisting in inhalation and exhalation.
Combining cat pose with Vajra asana in a flowing manner as done in Vinyasa yoga i.e. coming to Vajrasana from Cat pose while exhaling and going back to Cat pose while inhaling can help strengthen breathing muscles and allows maximum exhalation.
Bhujang asana (Cobra pose) is helpful in strengthening breathing muscles. Try to maintain the posture for a minute or two to get added benefits.
Avoid Poses that restrict breathing like Bal asana (child pose) as it can cause pressure against diaphragm.
Stop immediately if you feel breathless while performing any posture. Immediately sit with leaning forward and arms supported on the back of chair and perform deep-pursed lip breathing.
With increase in strength and stamina a person with COPD can increase repetitions of the postures and can create an aerobic effect, improving cardiac efficiency as well. Respiratory system and circulatory system work in coordination to supply oxygenated blood to the body in a more efficient way. With increase in conditioning of respiratory muscles oxygenation improves and it can halt the progression of the disease. It is important to end the session with pursed lip breathing and progressive muscle relaxation techniques.
Yoga Asana and Yoga Breathing helps to manage, reverse (to some extent) and halt the progression of respiratory diseases.
It also provides a great way to manage stress, which can aggravate respiratory ailments and helps to achieve a positive outlook towards life. It provides a holistic approach in dealing with various respiratory disorders. Yoga Breathing (Pranayama) is one of the best remedy to tackle any kind of respiratory illness, simply by slowing breath one can add years to life.