EBP 2 Project Plan

Are Asthma symptoms reduced with

regular pranayama breathing practise?
European School of Physiotherapy
Semester 2
Year 2020

Demi de Block
Ella Selovuori
Lucia Jonova
Martin So
Contents
Introduction 3
Methods (of the review) 5
Search engines and databases 5
Keywords 5
Search strategy 6
Screening 7
Quality check 7
Organizing articles 8
Use of external knowledge 8
Group organization 9
Division of tasks 9
Different roles 10
Role of coach 10
File management 11
Collaboration 11
SMART goals 11
Planning 13
Realistic time table 13
Safety net planning 16
What if? -scenarios 17
References 18
Appendix 19

2
Introduction
Asthma is a heterogeneous disease that is commonly characterized by
chronic airway inflammation, which attributes to symptoms such as; wheezing,
shortness of breath, coughing, and chest tightness that can present itself in varying
degrees of intensity over time. Anatomically we can conclude that asthma is caused
by an inflammatory response in the respiratory system that thickens the airway wall
and results in smooth muscle spasms in the bronchioles, both causing a narrowing of
the lumen making it more difficult to breath. This disease is widely known, as it
affects 300 million people globally with a casualty rate of 250,000 annually. While
there are varying degrees of the severity of asthma, it has been widely documented
that this chronic disease can greatly impair a person's pulmonary functions and
overall quality of life (Gupta et al.,2017). Under most circumstances long-term control
medications, such as inhaled corticosteroids, are used to reduce the airway
inflammation that aggravate asthma symptoms. Tracking symptoms, going in
periodically to a physician to analyze peak flow/forced expiratory volume, and
adjusting medication strength is also commonly practiced (Pruthi et al.,2019). While
these treatment protocols have been used as adequate forms of asthma symptom
control for years, new research has found that there is evidence that introducing
pranayamic breathing is an effective way at aiding in the control of asthma
symptoms.
Pranayama is a breathing technique practiced most often in yoga practices.
“In Sanskrit, pranayama is translated as conscious control of breath. Pranayama
represents a simple self-control technique and involves increasing an individual’s
breath awareness (​Erdoğan Yüce et al.,2020​). There are more forms of Pranayama
techniques, most of these are practices of breathing through the nose and plays also
with closing and opening one nostril throughout the inhales and exhales. Two most
common forms are “Kumbhaka” (“retention breath”) involves long, deep, consistent
inhalation (“Puraka”) followed by holding the inhalation (“Antara Kumbhaka”),
continues with exhalation (“Rechaka”) and finishes with breath retention (“Bahya

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Kumbhaka”). The second common type is “Ujjayi” breath (“victorious breath”). Ujjayi
consists of long inhales and exhales without breath retention and it’s done with a
“snoring” like sound. “Studies emphasize that regular pranayama applications have
positive effects on conditions such as chronic bronchitis, asthma, rhinitis, pharyngitis,
obesity, diabetes, hypertension, insulin resistance, heart attack, allergy, anxiety
disorders, and cancer.” (​Erdoğan Yüce et al.,2020​). However, for the purpose of this
literature review we intend to inquire insight and evidence on the chronic effects that
the pranayamic breathing technique has on reducing asthma patients' symptoms. In
conjunction with patients’ symptoms, we will also be assessing parameters, such as;
Forced Vital Capacity (FVC), Forced Expiratory Volume (FEV), Asthma Control Test,
Asthma Quality of Life Questionnaire (AQLQ), among others. FVC records how
much air you can blow out, while FEV measures how quickly you can do it. ACT is a
self-administered questionnaire tool that helps in identifying those with poorly
controlled asthma. By comparing the changes in these parameters to assess asthma
and completing a literature review on the current evidence, we hope to expand
awareness to increase the use of this technique in physicians and physical therapists
practices.
The possibility of pranayamic breathing positively affecting the management
of asthma symptoms has the potential to create many benefits for asthma patients,
physical therapists, and the community. In regards to asthma patients, it could open
doors to adding a more holistic approach to their treatment regimen. Along with this
gaining more personal breath control of their asthma symptoms could reduce anxiety
that asthma attacks typically induce. Since pranayamic breathing is usually coupled
with yoga practice, adding a daily yoga/breath routine could also increase patients
activity level while additionally decreasing stress levels. Finally, by inadvertently
decreasing the use of asthma patients’ medication use and doctor visits, this would
also relieve some financial stress that these individuals may hold. Benefits that a
physical therapist could have by adopting this technique into their practice would be
increasing their knowledge and expanding their field. Since physical therapy is an
ever changing career, it is important to keep up to date with the most recent and
relevant studies. Reason being, the more tools in a physical therapists’ arsenal, the
better they can be and the more patients they can aid. Mastering the pranayama
technique could even add the possibility of creating a new field of respiratory therapy
to the physical therapy world. Lastly, through creating asthmatic yoga breathing
classes this could bring asthma patients together and could double not only as a

4
treatment class, but also a support group. This would in turn be helpful to the
community by bringing like people together for emotional support.

PICOT question

Does pranayama breathing technique improve symptoms of patients with asthma

compared to no breathing exercise intervention, over a 2-6 month time period.

Methods of the review

Search engines and databases

To identify relevant studies a systematic search was done by using 3 searching
databases: Pedro, PubMed and Cochrane. Some articles were found by cross
referencing. The most recent search happened on 14th April 2020.

Keywords
The keywords used were “breathing”; “breath”; “exercise”; “practice”; “technique”;
“yogic”; “yoga”; “pranayama”; “respiration”; “asthma”; “respiratory”; “disorder”. These
keywords were searched in all 3 databases in an advanced search combined with
“OR” and “AND” boolean operators.

Keywords synonyms:
Keyword 1: “yogic” OR “yoga”
Keyword 2: “pranayama”
Keyword 3: “breathing” OR “breath” OR “respiration”
Keyword 4: “exercise” OR “practise” OR “technique”
Keyword 5: “asthma” OR “respiratory” AND “disorder”

Table 1. Results of searched keywords

5
 PeDro PubMed Cochrane Cross TOTAL
Keyword referencing
1 AND 3 AND 5 4 12 12 28
(in title)
2 AND 5 2 5 3 10
(in title)
3 AND 4 AND 5 4 6 4 14
(in title)

TOTAL 10 23 19 12 64

Table 2. Flow chart of the search

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Search strategy
The search strategy started with a large amount of articles (5009) found in all 4
databases: Pedro, PubMed, Cochrane and additional Google scholar, which was
later excluded due to its vast content. Some of the studies might be still used in
google scholar if the full text is listed there, shown as cross referencing articles.
Narrowing down the number of articles started with including our keywords only into
the abstract/title. Searches using keywords that involved “yoga” resulted in a larger
amount of articles as well as searches involving “breathing”. When we used the
specific keyword “pranayama”, which is our specific focus, the results listed fewer
articles. With the combination of “asthma” we ended up with a number of articles
feasible for screening (64). After ignoring all duplicates, the number of articles
became 41.

Screening
After exclusion of duplicates the screening process took place.
With the ​inclusion criteria​ ​1)​studies in english(39); ​2)​studies no older than 2010(35)
With the ​exclusion criteria ​1) studies done with children(33); ​2)​studies with the
intervention of yoga as a physical and not breathing exercise(23); ​3) studies with the
intervention shorter than 4 weeks(17)

With full-text selection the final number of articles will be assessed according to its
grading and eligibility. The measurement tool used in the articles to evaluate the
results will be compared. We are interested in which articles used standard drug
therapy alongside pranayama practises and the effects on it’s results. We want to
know which studies applied a different type of intervention with pranayama. As well
as the number of participants and the severity of Asthma.

Quality check
Out of a variety of measurement tools, the PEDro scale was chosen to assess the
quality of the articles. PEDro scale is a valid measuring tool to assess the
methodological quality of clinical trials (Natalie, 2009). There are 11 criteria in the

7
PEDro grading schedule. Criterion 1 is about the generalisability of the trial, which is
not used to calculate the PEDro score reported on the PEDro website. Criteria 2-9
are related to internal validation of the articles and criteria while 10-11 examine the
presence of sufficient statistical information to interpret the result.

It was determined that a PEDro score of 6 or higher would be the selection baseline
for articles in the systemic review. It was based on research conducted by Hariohm.
Studies score below 6 were considered fair or poor quality (Hariohm et al., 2015). It
ensures the quality of articles selected up to a certain standard.

On the other hand, several limitations of PEDro grading schedule should be

addressed. PEDro scale is not a direct measure of the validity of a study’s
conclusions (Hariohm et al.,2015), those scored high on the PEDro scale do not
necessarily provide evidence that the intervention is clinically effective. It was
suggested that additional consideration should be included for the validity of
conclusions. It was implemented by excluding studies with the duration of the
intervention (pranayama) that is shorter than 1 month. Moreover, to enhance the
inter-tester reliability of the PEDro score, the PEDro score of all articles would be the
mean of PEDro scales graded by two graders. If the difference of the PEDro scores
graded is greater than one standard deviation, an independent grader will serve as
the final grader.

Organizing articles
All articles are downloaded in pdf format and are stored in a shared google file. The
articles are arranged in alphabetical order.

Use of external knowledge

The quality of the literature review will be enhanced by the use of external knowledge
in 3 ways. First of all, In terms of contents, we will invite an editor to proofread and
edit the texts. Secondly, to ensure the validation of the finding and conclusion of the
literature review, we will approach a chest physiotherapist who specializes in chest
physiotherapy program for asthma patients to help us better understand the
limitations and potential error of the intervention (Pranayama) and improve the
practical implication of the studies. Thirdly, to enhance the methodology of this

8
literature review, we will counsel the lecturer of Evidence-Based Practice, Nils
Jongerius for improvements of methodology approach.

Group organization
Division of tasks
Tasks for the project plan were divided within the group by discussing together and
according to each member’s preference. Workload of task was taken into
consideration when dividing tasks. The whole group decided together on the PICOT
question. Usage of search engines was divided randomly. All members were
responsible for searching articles meeting with inclusion and exclusion criteria. Final
screening of articles was done by Lucia. Task division for the project plan is
presented on the table below.

Table 3. Project plan task division

TASK NAME BACK-UP
PICOT formulation ALL -
Database searching:
PubMed Lucia -
Pedro Demi,Lucia Lucia
Cochrane Martin Ella
Google scholar Ella Demi
In and exclusion Lucia -
criteria
Writing tasks:
Introduction Demi, Lucia Ella
Methods Lucia, Demi Ella
Group organization Ella Martin
Editing and grammar Demi Ella
correction
Checking the Martin Demi
references
Updating meeting Ella Lucia
times
File management Ella, Lucia Martin
Planning Demi, Ella, Martin Lucia

9
Quality, organizing Martin Lucia
articles and use of
external knowledge

Task division for literature review was done with the same principle as the task
division for the project plan, by each member’s preference and joint discussion.
There’s a chance this plan will change, but the group will do it’s best to stick to the
plan. The same people, who were responsible for introduction and methods chapters,
will continue with the same task during semester 3 updating and correcting previously
written chapters.

Table 4. Literature review tasks

TASK NAME BACK-UP
Grading of the articles Lucia, Martin Demi
Independent grader Ella -
Writing tasks:
Abstract, conclusion Lucia, Demi Martin
Introduction (updating, Ella, Demi Lucia
correcting)
Methods (updating, correcting) Lucia, Martin Ella
Discussion Demi, Martin Ella
Editing, grammar correction Demi Ella
Checking the references Martin Lucia
Updating meeting times Ella Martin
File management Lucia, Ella Demi

Roles
Roles between group members were divided by preference. Lucia is the leader of the
group and communicates with the coach and other group members. Ella is the
secretary and updates documents with content of the group's meetings, what was
discussed, which tasks are done and yet to be done. Backup of the files is done by
the secretary as well.

Role of the coach

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We expect the coach to provide guidance and point us in the right direction in order
for us to finish the project with high quality. We ensure this by asking advice on our
regular meetings with the coach.

File management
The team leader Lucia created a Google Drive folder that was shared to the whole
group. The folder is an efficient way to store and manage a large amount of files. All
group members are able to update and edit the documents at any time. The group
has concluded that the shared Drive folder works well and is a safe place to store
information. The same system will be used during semester 3.
The folder contains a file where all articles for the review are stored, so the entire
group can access the articles at all times. In the folder, tables of task division and
timetable can also be found. This makes it possible for each member to follow
whether the group is well on time and makes sure that all the tasks are taken care of.
Updating the file with all minutes of the group's meetings is the secretary’s
responsibility.

Collaboration
Communication happens only virtually since it is not possible to organize meetings in
person. Communication happens mostly through a whatsapp group. The group
schedules weekly video call meetings where progress is discussed. Meeting times
are set well in advance accustomed to everyone’s schedules, ensuring that the whole
group will be able to attend.

SMART goals
Each group member thought of an individual goal that also relates to the group
project and is something we can learn during semester 2 and apply for the rest of our
ESP career.

Table 5. Individual and group SMART goals

Group member SMART goal

Ella I would like to improve my time

management skills, by preparing all my

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 tasks on time and sticking to our group’s
internal deadlines, as this benefits the
whole group and me. I aim to do this by
writing a weekly schedule on my agenda.
By organizing my time well during this
project I believe it’ll be helpful during the
rest of the semester and next year in ESP.

Demi I strive to enhance my communication skills

by improving on the “hamburger feedback
method” that we were taught and practiced
in Interventions 1. This is a form of
constructive feedback that has a main
purpose of helping people let down their
guard, and receive the criticism with more
of an open mind and without being as
defensive. Mastering this technique would
be especially helpful in group work since
there could be times where I think one of
my group members could use critiquing in a
specific task they are doing. I hope to be
able to practice this throughout the project,
especially when it comes to critiquing other
peers' group work.

Martin Conducting clinical research is an important

task for a physiotherapist. For this reason,
my goal is to enhance my ability to write a
validate systematic review with the use of
the Pedro scale. I would like to reach this
goal by the end of SEM 3. The scale of 8
out of 11 will be a good indicator of
achievement.

Lucia My goal for this group work is to be able to

navigate myself effectively in different
searching databases. Searching and
evaluating evidence based information is
crucial for my future career, knowledge and
will ensure my development after studies as
well. I will focus on the methods part of this
project and evaluation of articles. With the
goal of receiving feedback from group
members and from our coach. Ideally in
SM3 finishing with the mark 7.

Goal for the whole group Collaboration skill is not only vital to the
PAP project in the next academic year, but
also to our future career path as a
physiotherapist according to the KNGF
profile.Therefore our team goal is to ensure
everyone in the group is actively

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 participating and contributing. A peer review
within our group will be conducted, so that
everyone in the group can understand their
strengths and weaknesses respectively.

Planning
Realistic time table​:
The time tables below were created in consideration to keep everyone organized and
on track to meet the intended deadline. Below the timeline for the project plan and
literature review are listed. The planning for the internal and external deadlines for
the project plan (Table 4.) was tight since we started our project plan relatively late.
This caused us to have to work overtime in the last week before the project plan was
due with no buffer week in between. Starting this earlier would have allowed us to
take our time and be able to look through everything more thoroughly.

Table 6. Time table for the project plan outline including the task responsibility of each group
member with internal (I) and external (E) deadlines.

Calendar Deadline Inter Task Persons

week nal / responsible
exte
rnal

6 I Starting the project plan All

9 28-02-20 E PICOT question due All

14 I Group meeting #1 Ella, Lucia

16 I Revised PICOT, search All

and review 5 articles
each

16 15-04-20 I Group meeting #2 Demi, Lucia,

Ella, Martin

16 16-04-20 E Group meeting #1 with Demi, Ella,

Niels Lucia

16 17-04-20 I Fill in individual SMART All

goals

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 16 17-04-20 I Create and edit time Demi
schedule table

16 17-04-20 I Create task division Lucia

table and flow chart

16 17-04-20 I Create “what if” table Martin

16 17-04-20 I Group meeting #3 Demi, Ella,

Lucia, Martin

16 Screening of the articles Lucia

Writing All

16 19-04-20 I Individual writing

deadline:
Introduction Demi, Ella
Methods Lucia
Group organization Ella
Planning Demi
Quality check Martin
References

17 20-04-20 E Draft shared for Peer

Feedback

17 22-04-20 I Meeting with Niels about All

grading and feedback

17 I Review feedback with All

group and decide on
corrections that need to
be made

19 08-05-20 E Deadline project plan

take at 23:00

20-22 I Review feedback from All

the project plan take and
prepare for retake if
needed

22 03-06-20 E Deadline project plan

retake

E Project plan outline

retake

The time table for the literature review is written with deadlines taken from the EBP 3
course manual in mind. These deadlines are of course subject to change, but for
now this is the best estimate that we can make with the circumstances given to us.

14
In order to stay on track and well ahead, internal deadlines were set consciously at
least a week ahead of the suggested deadline in order to have time to look over our
work and provide the best quality project plan. Presented below in Table 5 is the
literature review project plan.

Table 7. Timetable for the literature review including the task responsibility of each group
member with internal (I) and external (E) deadlines.

Calendar Deadline Internal Task Persons

week /extern responsible
al

36 01-09-20 I Start of the project

36 03-09-20 I Grading of the Lucia, Martin

articles

36 04-09-20 I Article selection for Ella

the independent
grader

37 10-09-20 I First group meeting, All

discuss upcoming
deadlines

37 11-09-20 E Group discussion All

with the coach,
mid-term checkup

37-38 18-09-20 I Writing deadline:

Introduction Ella
Methods Lucia, Martin
Results All

39 25-09-20 I Group meeting All

discuss about writing
and group
participation

39-40 01-10-20 I Writing deadline:

Discussion, Demi, Martin
conclusions, abstract Lucia, Demi

40 02-10-20 I Group meeting All

progress check,
discuss corrections

40 02-10-20 I Correction deadline All

40-41 08-10-20 Language, grammar, Demi

and editing check
deadline

15
 41 08-10-20 E Literature review
take

42 I Work on All
improvements

43 27-10-20 E Literature review

retake

43 27-10-20 I End of the project

Safety net planning

The group together sets meetings well in advance accommodating everyone’s
schedules. Everyone is expected to participate unless there’s a good reason not to,
in which case that member will be updated of the content of the meeting. All group
members decide together about task division and deadlines. If one fails to follow
deadlines, the leader of the group will approach this person and discuss it. If this
behavior repeats itself, the coach will be contacted.
The whole group is expected to participate in the project and meetings and
communicate clearly and honestly, but if abnormal behavior occurs, the leader is the
contact person. Secretary will assist the leader in making sure that the group follows
rules, receives meeting times and attends.
In case one of the members drops out during the project, we have back-up persons
for each task ensuring that the project will be completed on time.

What if..?
The following table includes potential crisis scenarios and prevention taken.

Table 8. What if? -scenarios, their possibility to happen, the level of threat and actions for the
scenario to be avoided. L = low, M = moderate, H = high.

Scenario Possibility to Threat Action to avoid

happen the scenario

An insufficient L H After making the

grade is obtained draft, always ask
the backup to
make correction
and improvement

16
 The action plan is L H We make use of a
not yet finished buffer week before
before the the official deadline
submission
deadline

Individual workload M M Redistribution the

increase due to the job tasks among
illness of groupmates, to
groupmates or make sure the
accidents workload is even

The division of job L M We create a job

tasks is unclear, tasks table in
which lead to which all job tasks
conflicts and the person in
charge are listed in
black and white

The articles are no H L Try to download

longer available on the pdf file of the
the databases articles if it is
available, or
screen shot the
articles.

References
Aggarwal T, Khatrl A, Siddiqui S, Hasan S, Singh D, Kulshreshtha M et al. Pranayama has
additive beneficial effect along with medication in bronchial asthma patients. Indian journal of
physiology and pharmacology. 2012;(12):77-78.

de Morton N. The PEDro scale is a valid measure of the methodological quality of clinical
trials: a demographic study. Australian Journal of Physiotherapy. 2009;55(2):129-133.

Erdoğan Yüce G, Taşcı S. Effect of pranayama breathing technique on asthma control,

pulmonary function, and quality of life: A single-blind, randomized, controlled trial.
Complementary Therapies in Clinical Practice. 2020;38:101081.

Gupta P, Agarwal D, Sood S. Improvement in pulmonary functions and clinical parameters

due to addition of breathing exercises in asthma patients receiving optimal treatment. Indian
Journal of Allergy, Asthma and Immunology. 2017;31(2):61.

Hariohm K, Prakash V, Saravankumar J. Quantity and quality of randomized controlled trials

published by Indian physiotherapists. Perspectives in Clinical Research. 2015;6(2):91.

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Hussein H, Afify A, Obaya H, Rafea A. Effects of Ujjayi Pranayama Training on Selected
Ventilatory Function Test in Patients with Mild Bronchial Asthma. Medical Journal of Cario
University. 2016;84(2):445-452.

Jose J, Thomas V, Janso K. Effect of anulom vilom pranayama as an adjuvant treatment

modality to improve the level of dyspnea in chronic asthma patients. International Journal of
Advances in Medicine. 2018;5(2):241.

Maher C, Sherrington C, Herbert R, Moseley A, Elkins M. Reliability of the PEDro Scale for
Rating Quality of Randomized Controlled Trials. Physical Therapy. 2003;83(8):713-721.

Murthy K, Sahay B, Sitaramaraju P, Sunita M, Yogi R, Annapurna N et al. Effect Of

PRANAYAMA (Rechaka, Puraka And Kumbaka) On Bronchial Asthma - An Open Study.
Lung India. 1984;2(2):187-191.

Parmar J, Nagarwala R. Effects of Pranayama on Bronchial Asthma. International Journal of

Physiology. 2014;2(1):96.

Phogat P. Effects of pranayama training on respiratory function of asthma patients in south

region of Haryana. International Journal of Yogic, Human Movement and Sports Sciences 2.
2019;4(2):142-145.

Prem V, Sahoo R, Adhikari P. Comparison of the effects of Buteyko and pranayama breathing
techniques on quality of life in patients with asthma – a randomized controlled trial. Clinical
Rehabilitation. 2012;27(2):133-141.

Pruthi S. Asthma treatment: 3 steps to better asthma control [Internet]. Rochester; Mayo
Clinic. 2019 [cited 19 April 2020]. URL:
https://www.mayoclinic.org/diseases-conditions/asthma/in-depth/asthma-treatment/art-20044
284

Purwar S, Sushma R, Yadav S. OA01.18. Clinical evaluation of Amritadi kwatha along with
pranayama in the management of Tamaka swasa w.s.r. bronchial asthma. Ancient Science of
Life. 2012;32(5):18.

Putra M, Sriyono S, Yasmara D. Yoga Pranayama Increase Peak Expiratory Flow (PEF) in
Patient with Asthma. Advances in Health Sciences Research. 2017;3:207-210.

Raghavendra P, Shetty P, Shetty S, Manjunath N, Saoji A. Effect of high-frequency yoga

breathing on pulmonary functions in patients with asthma. Annals of Allergy, Asthma &
Immunology. 2016;117(5):550-551.

Richard S. A Comparison of the Effects of Diaphragmatic Breathing Exercises and Yoga

Pranayama Techniques on Pulmonary Function in Individuals with Exercise Induced Asthma
[Internet].Texas; Texas State Univerity.c 2017 [cited 19 April 2020]. URL:
https://digital.library.txstate.edu/handle/10877/6792

Saxena T, Saxena M. The effect of various breathing exercises (pranayama) in patients with
bronchial asthma of mild to moderate severity. International Journal of Yoga. 2009;2(1):22.

Sharmila P, Sreelekha B. Effectiveness of Pranayama on Bio-physiological Parameters

Among Patients with Bronchial Asthma. Nursing Journal of India. 2019;110(4):153-155.

Shobha B. A clinical study on Shringyadi Churna with and without Pranayama in the
management of Tamaka Shwasa (bronchial asthma). Global Journal of Research on
Medicinal Plants & Indigenous. 2013;2(3):172-177.

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Appendix

Articles Additional information from

abstract
1 Comparison of the effects of Buteyko and
Pranayama breathing techniques on
quality of life in patients with asthma -- a
randomized controlled trial

2 1 month
Effect of pranayama breathing technique ? patients
on asthma control, pulmonary function, Quality of life questionnaire was
and quality of life: A single-blind, used and patient observation chart
randomized, controlled trial. Measured by:​ (ACT), Asthma Quality
of Life Questionnaire (AQLQ),
pulmonary function test (PFT), and
patient observation chart

3
Pranayama has additive beneficial effect 80:pranayama group
along with medication in
bronchial asthma patients 20: controlled group

3 months

Measured by: FEV+FVC+PEFR

4 Effect of two breathing exercises (Buteyko 6 months
and pranayama) in asthma: a randomised 69 patients completed the study
controlled trial

5 12 weeks
The effect of various breathing exercises 50 patients
(pranayama) in patients with bronchial Pranayama and meditation
asthma of mild to moderate severity

6 Effect 30 patients
of pranayama (rachaka, 75 days
puraka and kumbhaka) on
bronchial asthma. An open
study

7 Effects of Pranayama on 30 patients

Bronchial Asthma ? days
2014
Measured by:
FEV+PEFR+quality
of life

19
8 Yoga Pranayama Increase 6 pranayama group
Peak Expiratory Flow 6 controlled group
(PEF) in Patient ? days
with Asthma 2017

9 Improvement in pulmonary functions and 60 patients

clinical parameters due to addition of 3 months
breathing exercises in asthma patients 2017
receiving optimal treatment Measured by PEFR

10 Effect of high-frequency yoga breathing on

pulmonary functions in patients with
asthma: A randomized clinical trial.
11 Effects 15 pranayama group
of pranayama training on 15 controlled group
respiratory function 3 months
of asthma patients in south 2019
region of Haryana
Measured by FVC

12 Effects of 20- ujjayi(type of

Ujjayi Pranayama Training pranayama)
on Selected Ventilatory +diaphramic
Function Test in Patients breathing
with Mild Bronchial Asthma 20- controlled-only
diaphramic breathing
2 months
2016
Measure by
FEV+FVC

13 A Clinical Study on Group 1:ayurvedic

Shringyadi Churna with medicine
and Without Pranayama in Group 2:ayurvedic
the Management of medicine +
Tamaka Shwasa pranayama
(Bronchial Asthma) Group 3: placebo
12 weeks

14 Clinical evaluation of 60 patients:

Amritadi kwatha along Group 1: trial drug
with pranayama in the Group 2: standart
management of Tamaka drug
swasa wsr Group 3: trial drug +
bronchial asthma pranayama

20
15 ​Effect of anulom
vilom pranayama as an
adjuvant treatment
modality to improve the
level of dyspnea in
chronic asthma patients
20 patients
4 weeks
Measured by level of
dyspnea (one of the
asthma symptoms)
Anulom-vilom(type of
pranayama)

16 … of the Effects of 22 patients

Diaphragmatic Breathing
Exercises and
Yoga Pranayama Techniqu
es on Pulmonary Function
in Individuals with Exercise
Induced Asthma
17 Effectiveness
of Pranayama on
Bio-physiological
Parameters Among
Patients with
Bronchial Asthma
Group1:diaphragmati
c breathing exercise
Group 2: pranayama
Group 3: controlled
4 weeks
Measured by: FEV +
FVC + quality of life
questionnaire
Not enough info in
the preview
But looks nice
Focuses also on
anxiety of the
patients

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