Yoga Is as Effective as Standard Pulmonary Rehabilitation in Improving Dyspnea, Inflammatory Markers, and Quality of Life in Patients With COPD

Abstract

PURPOSE: The effectiveness of yoga as a form of rehabilitation therapy as compared to pulmonary rehabilitation in COPD is unclear. We investigated to see whether yoga was as effective as standard pulmonary rehabilitation on inflammatory markers, dyspnoea and quality of life in patients with COPD. METHODS: 60 patients with COPD were randomly divided into 2 groups. One group (group 1) was taught yoga exercises including asanas , pranayam , meditation and relaxation technique. The second group (group 2) underwent pulmonary rehabilitation. Both groups underwent one hour of training twice a week for the first 4 weeks. For the remaining 8 weeks the supervised session was fortnightly and the remaining sessions were at home.Baseline evaluation for both group included lung functions, dyspnoea assessment (Borg scale, VAS, six minute walk test), quality of life (QOL) and serum inflammatory markers ( CRP and Il-6). Repeat assessment of all these parameters was done at the end of 12 weeks in both groups. RESULTS: Median level of CRP and Il-6 in group 1 at base line was 1.0(0.0-12.0) mg/dl, 23.10 (5.48-170.03) pg/ml respectively. Median level of CRP and Il-6 in group 2 at base line was 1.15(0-14.0) mg/dl and 6.65(.06-80.02) pg/ml respectively. Median level of CRP and Il-6 in group 1 after 12 weeks was .70(0.10-10.0) mg/dl, 32.74(0.50-206.00) pg/ml respectively. Median level of CRP and Il-6 in group 2 after 12 weeks was .80(0.3-6.6) mg/dl, 36.28(6.88-198.03) pg/ml respectively. Mean values of 6MWT, Borg scale and VAS in group 1 at baseline was 419.0+/-128.12 meters, 1.50(0.5-7.0), 55.17+/-8.55mm and after 12 weeks was 456.43+/-91.41meters, 1.0 (0.0-4.0), 70.36+/-8.81 mm respectively. Mean values of 6MWT, Borg scale and VAS in group 2 at baseline was 391.88+/-113.10 meters, 3.00(0.0-7.0) 49.67+/-17.61mm and after 12 weeks was 424.66+/-78.21meters, .50(0.0-7.0), 67.24+/-17.55 mm respectively. There was significant improvement in these parameters in both groups. The QOL at 12 weeks showed significant change from baseline value in group 1. The QOL score showed a non significant change at 12 weeks from baseline in group 2. CONCLUSIONS: Yoga and PMR exercises done in a structured manner result in similar improvement in pulmonary functions, 6 minute walk distance, Borg scale, severity of dyspnoea, quality of life and levels of C-reactive protein after 12 weeks of training. CLINICAL IMPLICATIONS: Yoga is a cost-effective form of rehabilitation and is as effective as a standard PMR. Yoga programs can be adopted as integral part of long term management of COPD.