| DISCUSSION The results showed a tendency towards a decrease in the usage of beta adrenergic inhaler during 16 weeks of regular practice of yoga. Varandani.5 reported a 74% rate of improvement in 255 asthma patients who used yoga therapy alone (no medication except for emergencies) at Yogic Treatment-cum-Research Center in Jaipur, India. Similarly, a 76% rate of improvement was found in 114 asthma cases treated during a 1-year period by only yoga methods.7 In another report, Vahia6 claimed a 93% improvement rate in 15 asthmatics undergoing yoga therapy. Other studies carried out in Yoga centers in India also claimed that other standard yoga practices were effective with asthma as well. 5,715,16 We hypothesized that results similar to those reported elsewhere would be obtained here with asthma patients of different ethnicity. In contrast, our studies showed no significant improvement in medication usage in patients practicing yoga. Failure to confirm our hypothesis may be due to inappropriate exposure of the patients to the Yoga philosophy, a short study period, and a possible lack of positive attitude with asthmatic patients in the Indian environment at institutions solely devoted to yoga, where yoga was born and has been known for thousands of However other investigators reported decreased blood pressures it hypertensive subjects. 17,18 who practiced yogic technique combined with biofeedback.19-21 In our study, no significant improvement of respiratory function, such as FEV1 and FMEF 0.25-0.75, was observed after yoga therapy in the yoga group and only FVC values improved slightly during the study period. The improvement of FVC alone without improvement of either FEV1 or FMEF 0.25-0.75 is not indicative of changes consistent with asthma. A similar result was obtained in a much larger study by Nagarathna et al.10 wherein 51 patients were evaluated over a 6 month period, although the authors do report a significant improvement of FVC with no improvement of FEV1, or FMEF 0.25-0.75 or peak flow rates. Early studies on Hatha Yoga by Udupa et al.2 showed a significant improvement in respiratory function, with lowered rate of respiration, increased expansion of the chest, vital capacity, and breath-holding time in 12 young, (23.0+3.36 years) normal male volunteers. The Weekly Questionnaire revealed that the yoga subjects were more positive and relaxed compared to the control group. Using mental and muscular relaxation therapy, The yoga group in general exhibited a more positive attitude, feeling of well being and felt less panicky over the period of the study. There was little difference between the two groups regarding the pulmonary weighted score. This could be due to the possibility that the yoga did not result in any significant change in their asthma control in the short period of the study or that the subject number may be small to derive any conclusions. Using mental and muscular relaxation therapy, Erskine31 observed a moderate correlation between objective respiratory measurement of improvement (FEV1) and subjective assessment of improvement. TABLE VI  The proble reasons for the lack of statistical difference in several of the parameters between the two groups may be due to the fact that the number of subjects was too small; their pulmonary physiology is basically normal to start with, and such yoga practices need to be performed over a longer period of time. These points need to be considered in future studies in this field. The yoga group reported a better sense of well being overall with more positive attitude and enthusiasm based on the Weekly Questionnaire, This could be all important factor to be considered in view of the study period, the majority of control group patients switched to the yoga practice. The patients in the yoga group continued to perform yoga exercises on a regular basis. The long-term effects and the relative therapeutic value of the yoga techniques in asthma remains to be established. ACKNOWLEDGEMENT The author thank Susan Greene and Randy Lamb for their yoga coaching and perseverance the Department of Statistics. Colorado State University for statistical analysis of the data, and Kamala Vedanthan for arranging the audio and video education. |