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Effect of Nadi Shuddhi Pranayama on perceived stress and cardiovascular autonomic functions in 1st year undergraduate medical students

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Background: First year medical students have reported a high level of perceived stress. Yogic breathing technique “Pranayama” is said to balance two limbs of autonomic nervous system and therefore advocated for stress reduction and prevention of related diseases. Aims and Objectives: The present study was conducted to evaluate the effects of Nadi Shuddhi Pranayama on perceived stress and cardiovascular autonomic functions in 1st year medical students. Materials and Methods: The present study was carried out in one of the tertiary care hospitals of Mumbai. A total of 60 subjects (age 18–22 years) practised Nadi Shuddhi Pranayama daily for 12 weeks under the supervision of certified yoga trainer. Following parameters were recorded before and after 12 weeks of training; perceived stress scale (PSS) score, heart rate (HR), systolic blood pressure (SBP) and diastolic BP (DBP), DBP response to isometric handgrip (IHG) test. Results: There was a significant decrease in PSS scores after intervention. A significant decrease was also seen in cardiovascular autonomic functions such as HR, SBP, DBP, and DBP response to IHG test. Conclusion: Regular practice of Nadi Shuddhi Pranayama helps in reducing stress in 1st year medical students as evidenced by the corresponding decrease in cardiovascular autonomic parameters. KEY WORDS: Nadi Shuddhi Pranayama; Perceived Stress Scale; Cardiovascular Autonomic Functions; Medical Students
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... Among the studies included in the review, there were 3 randomized controlled trials (Phang et al. 2015;Shapiro et al. 1998;Warnecke et al. 2011) and 14 non-randomized studies (Bond et al. 2013;Brennan et al. 2016;Bughi et al. 2006;Dayalan et al. 2010;Dhanvijay and Chandan 2018;Finkelstein et al. 2007;Gruzelier et al. 2001;Hassed et al. 2009;Phang et al. 2016;Prasad et al. 2016;Rosenzweig et al. 2003;Scholz et al. 2016;Simard and Henry 2009;Whitehouse et al. 1996). Risk bias of randomized studies based on the Cochrane quality assessment tool is reported in Table 1. ...
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The stress either physical or mental, leads to cardiovascular morbidity. Newly admitted medical students are likely to be exposed to various stresses like change of environment, demanding medical education and different teaching protocol in a medical college. Pranayama is known since ancient times to relieve stress and stabilize autonomic function of the body. Therefore it was decided to study effect of Pranayama on stress and cardiovascular autonomic function. The subjects were first M.B.B.S students and the sample size was 59 consisting of 27 males and 32 females. The group of students thus selected was briefed about the study. After the orientation session, informed written consent was taken, stress questionnaire was put and the autonomic function tests were done. This was followed by practice of Pranayama for 2 months, 1 hour/day for 5 days/week and again stress questionnaire was put and the autonomic function tests were performed on the study group. The above tests were done before and after the practice of Pranayama. The results obtained were analyzed using SPSS software. The stress level has reduced after 2 months of practicing various pranayama as evident by decrease in total stress score which is highly significant. VLF and LF in n.u have reduced significantly after practice of pranayama signifying reduction in sympathetic drive to heart. HF in n.u has increased significantly after practice of pranayama for 2 months showing the increase in parasympathetic output to the heart. LF/ HF ratio reduced significantly after 2 months of practice of pranayama indicating a better sympatho vagal balance with resting balance tilting toward better parasympathetic control.