Yoga for Asthma? A Systematic Review of Randomized Clinical Trials

Department of Complementary Medicine, Peninsula Medical School, University of Exeter, Exeter, UK.
Journal of Asthma (Impact Factor: 1.8). 05/2011; 48(6):632-9. DOI: 10.3109/02770903.2011.584358
Source: PubMed

ABSTRACT The objective of this systematic review was to assess the effectiveness of yoga as a treatment option for asthma.
Seven databases were searched from their inception to October 2010. Randomized clinical trials (RCTs) and non-randomized clinical trials (NRCTs) were considered, if they investigated any type of yoga in patients with asthma. The selection of studies, data extraction, and validation were performed independently by two reviewers.
Six RCTs and one NRCT met the inclusion criteria. Their methodological quality was mostly poor. Three RCTs and one NRCT suggested that yoga leads to a significantly greater reduction in spirometric measures, airway hyperresponsivity, dose of histamine needed to provoke a 20% reduction in forced expiratory volume in the first second, weekly number of asthma attacks, and need for drug treatment. Three RCTs showed no positive effects compared to various control interventions.
The belief that yoga alleviates asthma is not supported by sound evidence. Further, more rigorous trials are warranted.

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    • "The present SR included all RCTs investigating the effect of yoga on HRV in individuals of any age both medically compromised and healthy. Yoga was defined as a practice rooted in traditional Hindu philosophy that ''can consist of one or more of the following: specific postures, breathing exercises, body cleansing, mindfulness meditation , and lifestyle modifications'' (Posadzki and Ernst 2011). Non-randomized or uncontrolled trials were excluded. "
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    ABSTRACT: The objective of this systematic review is to summarize and critically assess the effects of yoga on heart rate variability (HRV). Nine databases were searched from their inceptions to June 2014. We included randomized clinical trials (RCTs) comparing yoga against any type of control intervention in healthy individuals or patients with any medical condition. Risk of bias was assessed using the Cochrane criteria. Two reviewers performed the selection of studies, data extraction, and quality assessments independent of one another. Fourteen trials met the inclusion criteria. Only two of them were of acceptable methodological quality. Ten RCTs reported favourable effects of yoga on various domains of HRV, whereas nine of them failed to do so. One RCT did not report between-group comparisons. The meta-analysis (MA) of two trials did not show favourable effects of yoga compared to usual care on E:I ratio (n = 61, SMDs = 0.63; 95 % CIs [-0.72 to 1.99], p = 0.36; heterogeneity: r(2) = 0.79, χ (2) = 5.48, df = 1, (p = 0.02); I(2) = 82 %). The MA also failed to show statistically significant differences between the groups regarding the 30:15 ratio (n = 61, SMDs = 0.20; 95 % CIs [-0.43 to 0.84], p = 0.53; heterogeneity: r(2) = 0.07, χ (2) = 1.45, df = 1, (p = 0.23); I(2) = 31 %). The data from the remaining RCTs were too heterogeneous for pooling. These results provide no convincing evidence for the effectiveness of yoga in modulating HRV in patients or healthy subjects. Future investigations in this area should overcome the multiple methodological weaknesses of the previous research.
    Applied Psychophysiology and Biofeedback 06/2015; 40(3). DOI:10.1007/s10484-015-9291-z · 1.13 Impact Factor
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    • "Yoga can reduce risk factors for cardiovascular disease [11] and improve risk profiles in adults with type 2 diabetes mellitus [12]. Other conditions such as asthma seem to be relatively little improved by yoga interventions [13]. "
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    ABSTRACT: Yoga seems to be an effective means to cope with a variety of internal medicine conditions. While characteristics of yoga users have been investigated in the general population, little is known about predictors of yoga use and barriers to yoga use in internal medicine patients. The aim of this cross-sectional analysis was to identify sociodemographic, clinical, and psychological predictors of yoga use among internal medicine patients. A cross-sectional analysis was conducted among all patients being referred to a Department of Internal and Integrative Medicine during a 3-year period. It was assessed whether patients had ever used yoga for their primary medical complaint, the perceived benefit, and the perceived harm of yoga practice. Potential predictors of yoga use including sociodemographic characteristics, health behavior, internal medicine diagnosis, general health status, mental health, satisfaction with health, and health locus of control were assessed; and associations with yoga use were tested using multiple logistic regression analysis. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for significant predictors. Of 2486 participants, 303 (12.19%) reported having used yoga for their primary medical complaint. Of those, 184 (60.73%) reported benefits and 12 (3.96%) reported harms due to yoga practice. Compared to yoga non-users, yoga users were more likely to be 50--64 years old (OR = 1.45; 95%CI = 1.05-2.01; P = 0.025); female (OR = 2.45; 95%CI = 1.45-4.02; P < 0.001); and college graduates (OR = 1.61; 95%CI = 1.14-2.27; P = 0.007); and less likely to currently smoke (OR = 0.61; 95%CI = 0.39-0.96; P = 0.031). Manifest anxiety (OR = 1.47; 95%CI = 1.06-2.04; P = 0.020); and high internal health locus of control (OR = 1.92; 95%CI = 1.38-2.67; P < 0.001) were positively associated with yoga use, while high external-fatalistic health locus of control (OR = 0.66; 95%CI = 0.47-0.92; P = 0.014) was negatively associated with yoga use. Yoga was used for their primary medical complaint by 12.19% of an internal integrative medicine patient population and was commonly perceived as beneficial. Yoga use was not associated with the patients' specific diagnosis but with sociodemographic factors, mental health, and health locus of control. To improve adherence to yoga practice, it should be considered that male, younger, and anxious patients and those with low internal health locus of control might be less intrinsically motivated to start yoga.
    BMC Complementary and Alternative Medicine 07/2013; 13(1):172. DOI:10.1186/1472-6882-13-172 · 2.02 Impact Factor
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    • "Commonly used treatments include chiropractics, osteopathy, homeopathy, herbal medicines, use of salt rooms, yoga, and breathing exercises, among others. With the exception of breathing exercises, none of the therapies mentioned above have been shown to be of any clinical benefit as asthma treatments in rigorously designed scientific studies.87–89 Alternative treatments tend to be costly and are not without risk. "
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    ABSTRACT: The principal aims of asthma management in childhood are to obtain symptom control that allows individuals to engage in unrestricted physical activities and to normalize lung function. These aims should be achieved using the fewest possible medications. Ensuring a correct diagnosis is the first priority. The mainstay of asthma management remains pharmacotherapy. Various treatment options are discussed. Asthma monitoring includes the regular assessment of asthma severity and asthma control, which then informs decisions regarding the stepping up or stepping down of therapy. Delivery systems and devices for inhaled therapy are discussed, as are the factors influencing adherence to prescribed treatment. The role of the pediatric health care provider is to establish a functional partnership with the child and their family in order to minimize the impact of asthma symptoms and exacerbations during childhood.
    04/2013; 7:13-24. DOI:10.4137/CMPed.S7867
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