EFFECT OF YOGIC PRACTICES WITH AND WITHOUT DIET MODIFICATIONS ON SELECTED RESPIRATORY PARAMETERS AMONG MIDDLE AGED ASTHMATIC WOMEN

 

* S.Srimathi, **Dr. R. Elangovan, *Ph.D Scholar, Faculty of Yoga Sciences and Therapy, Meenakshi Academy of Higher Education and Research (Deemed to be University), No.12, Vembuliamman Koil Street, West K.K.Nagar, Chennai-78, Tamil Nadu, India., **Professor & Head, Faculty of Yoga Sciences and Therapy, Meenakshi Academy of Higher Education and Research (Deemed to be University), No.12, Vembuliamman Koil Street, West K.K.Nagar, Chennai-78, Tamil Nadu, India.  E-Mail ID: relangovantnpesu@gmail.com.

 

ABSTRACT

The purpose of random group experimental study was to find out the effect of Yogic practices on selected respiratory parameters among middle aged asthmatic women. To achieve the purpose of the study, 45 middle aged asthmatic women were selected using random sampling method from fire-works factory at Sivakasi, Virudhunagar dist, aged between 35years and 50 years. The subjects were divided into two experimental (I & II) and one control group (III) of 15 subjects each. It was hypothesized that there would be significant differences on respiratory parameters such as forced vital capacity and pulmonary function among asthmatic women fire workers due to the influences of yogic practices. Experimental Group I underwent training with yogic practices and diet modification for 12 weeks, six days a week for maximum of 75 minutes in the morning .The Experimental Group II underwent training for the same period of 12 weeks. The control group III was kept in active rest. The pre-test and post test was conducted before and after the training for all three groups. Forced vital capacity and pulmonary function were measured. The data collected from the groups before and after the training period were statistically analyzed by using Analysis of Co-Variance (ANCOVA) to determine the significant difference and tested at 0.05 level of confidence. The result of the study showed that the forced vital capacity and pulmonary function increases as the result of Yogic practices. Hence the hypothesis was accepted at 0.05 level of confidence. Hence it is concluded that the Yogic practices helped to improve the forced vital capacity and pulmonary function among middle aged asthmatic women.

KEYWORDS: Yoga, asthma, forced vital capacity and pulmonary function.

INTRODUCTION

Asthma is characterized by a predisposition to chronic inflammation of the lungs in which the airways (bronchi) are reversibly narrowed. Asthma affects 7% of the population of the United States, 6.5% of British people and a total of 300 million worldwide. During asthma attacks (exacerbations of asthma), the smooth muscle cells in the bronchi constrict, the airways become inflamed and swollen, and breathing becomes difficult. This is often referred to as a tight chest and is a sign to immediately take medication.

Yoga Therapy is an important aspect of the multidimensional natural and metaphysical healing paradigm. Healthy life style with Yoga practices will be a great relief as well as managing asthma for the asthmatic adult women and means to promote the positive health as it helps in relieving stress as well as brings about the required physical, emotional and mental balance.

OBJECTIVE OF THE STUDY

The objective of the study was to find out whether there would be any significant difference on selected respiratory parameter such as forced vital capacity and pulmonary function due to yogic practices among middle aged asthmatic women.

PURPOSE OF THE STUDY

The purpose of the study was to find out the effect of Yogic practices with and without diet modification on selected respiratory parameter among middle aged asthmatic women. 

HYPOTHESIS

1. It was hypothesized that there would be significant differences due to Yogic practices with and without diet modification on selected respiratory parameters such as forced vital capacity and pulmonary function among middle aged Asthmatic women than the control group.
2. It was hypothesized that Yogic practices with diet modification would be slightly effective than Yogic practices without diet modification on selected respiratory parameters such as forced vital capacity and pulmonary function among middle aged Asthmatic women.

DELIMITATIONS

1. The study was confined to the middle aged asthmatic women.
2. The age of the subjects was between 35 and 50 years only.
3. The subjects were selected from various fireworks factories in Sivakasi only.
4. The independent variables were yogic practices and diet modification only.
5. The dependent variables were forced vital capacity and pulmonary function only.

LIMITATIONS

1. Various social, cultural and economic differences among the subjects were not considered.
2. Influence of heredity and environmental factors were not taken in to account.
3. The subjects’ living conditions, life style, personal habits and family were not taken into consideration.
4. The subjects’ routine activities were considered as limitations of the study.
5. Subjects were instructed to follow the dietary patterns. Personal observation on the dietary patterns of the subjects was not controlled.

REVIEW OF RELATED LITERATURE

Puckett J.L, Taylor R.W,et.al.,(2010) conducted the study on an elevated bronchodilator response predicts large airway inflammation in mild asthma at Department of Biomedical Engineering, University of California at Irvine, Irvine,California. In this study, Exhaled nitric oxide (eNO) is elevated in asthmatics and is a purported marker of airway inflammation. The bronchodilator response (BDR) has also been shown to correlate with markers of airway inflammation, including eNO at 50 ml/sec (FE (NO, 50)) which is comprised of NO from both the proximal and distal airways. Using eNO at multiple flows and a two-compartment model of NO exchange,the eNO signal can be partitioned into its proximal [J’aw (NO) (nl/sec)] and distal contributions [CA (NO) (ppb)]. We hypothesized that the BDR reflects the inflammatory status of the larger airways with smooth muscle, and thus would correlate with Jaw (NO). In 179 predominantly (95%) Hispanic children with mild asthma (69 steroid naïve), and 21 non-asthmatic non-atopic controls, spirometry and eNO at multiple flows were measured prior and 10 min following inhalation of albuterol. A trumpet-shaped axial diffusion model of NO exchange was used to characterize Jaw (NO) and CA (NO).The BDR correlated moderately (r = 0.44) with proximal airway NO (Jaw (NO)), but weakly (r = 0.26) with distal airway/alveolar NO (CA (NO)), and only in inhaled corticosteroid naïve asthmatics. A BDR cut point as low as >/=8% had a positivepredictive value of 83% for predicting an elevated Jaw (NO) or FE (NO, 50). We conclude that the BDR reflects inflammation in the large airways, and may be an effective clinical tool to predict elevated large airway inflammation. Pediatr Pulmonol. 2010 Wiley-Liss, Inc.

Mandhane PJ, et .al., (2010) conducted the study on A child's asthma quality of life rating does not significantly influence management of their asthma at Division of Respiratory Medicine, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. A randomized control trial of the Roaring Adventures of Puff (RAP) education program was completed among 287 grade two-five children with asthma. Parents and children completed a quality of life (QOL) questionnaire pre-intervention, six and 12 months post-intervention. We hypothesized that RAP altered how parent's assessed their child's QOL with a resultant change in asthma management. Pre-intervention, parents rated their child's overall QOL higher than their child (parent 5.41 [95% CI 5.24, 5.58] vs. child 4.54 [95% CI 4.32, 4.75]; P <0.001: paired t-test). For every point increase in the parent's overall QOL score, the child was 36% less likely to receive inhaled corticosteroids in the prior two weeks (OR 0.64,95% CI 0.46, 0.88; P = 0.024) and 46% less likely to have missed school due to asthma in the prior six months (OR 0.54, 95% CI 0.36, 0.82; P = 0.016: logistic regression). The child's QOL assessment, beyond that provided by their parent, was not associated with the asthma management outcomes examined. They conclude, Parent's QOL perception, and not the child's, is associated with asthma management. RAP decreased the parent'sQOL symptoms assessment and was important in determining the child's asthma management. Pediatr Pulmonol. (c) 2010 Wiley-Liss, Inc.

METHODOLOGY

To fulfil the goal of the random group experimental study, 110 came forward, 90 were screened and 45 middle aged asthmatic women were selected at random working at various fire factories at Sivakasi. The age of the subjects ranged between 35 and 50years. The subjects were assigned into two experimental groups and one control group with 15 subjects each. First experimental group was involved in yogic practices for 12 weeks with diet modification, Second experimental group was involved in yogic practices for 12 weeks only and the third control group kept in active rest.

The Yogic Practices given to the experimental group include Sitilikarana, Vyayama ,Surya Namaskar  ,Vrkshasana , Padahastasana , Halasana ,Sarvangasana , Matsyasana , Bhujangasana ,Shalabasana ,Ustrasana , Sethubandha sarvangasana,Parvatasana, Savasana ,Mahamudra , Ujjai in vajrasana, Kapalapathi in padmasana, Nadishodhana in siddhaasana, and Meditation.

The selected variables such as respiratory parameters and pulmonary functions were measured by spirometer and pulmonary function test.

RESULTS AND DISCUSSIONS

The data pertaining to the variables collected from two groups before and after the training period were statistically analysed by using Analysis of Co-Variance (ANCOVA) to determine the significant difference and tested at 0.05 level of significance. The analysis of Covariance (ANCOVA) on FVC (forced vital capacity) of yogic practices on and control group was analysed and presented in table 1.                      

 

                                                                     TABLE – I

ANALYSIS OF CO-VARIANCE OF THE MEANS OF TWO EXPERIMENTAL GROUPS AND THE CONTROL GROUP IN FORCED VITAL CAPACITY

(Scores in litres)

Tests/ Groups	EX.GR-I	EX.GR-II	CG	S O V	Sum of Squares	Df	Mean Squares	“F” Ratio
Pre Test	2.43	2.46	2.44	B	0.01	2	0.00	0.02
				W	9.80	42	0.23
Post Test	3.38	2.76	2.43	B	6.98	2	3.49	9.40*
				W	15.60	42	0.37
Adjusted Post Test	3.39	2.96	2.38	B	7.01	2	3.50	9.29*
				W	15.46	41	0.38

           * Significant at 0.05 level of confidence. (Table F ratio at 0.05 level of confidence for

           df 2 and 42 = 3.22, 2 and 41 = 3.23).

The obtained F ratio on pre- test scores 0.02 was lesser than the required F value of 3.22 to be significant at 0.05 level. This proved that there was no significant difference between the groups in pre- test and the randomization at the pre- test was equal. The post test scores analysis proved that there was significant difference between the groups, as they obtained F value 9.40 was greater than the required F value of 3.22. This proved that the differences between the post-test means of the subjects were significant. Taking into consideration the pre and post test scores among the groups, adjusted mean scores calculated. The obtained F value was 9.29, which was greater than required F value of 3.23. This proved that there was significant difference among the means due to 12 weeks of yogic practices with diet modification and yogic practices without diet modification on selected variables as in line with study conducted by Puckett J.L, Taylor R.W,et.al.,(2010).

To find out which of the paired means had a significant difference, the Scheffe’s post-hoc test is applied and the results are presented in table II.

 

TABLE – II

SCHEFFE’S POST-HOC TEST FOR FORCED VITAL CAPACITY

Mean Values			MD	Required C.I
EX.GR-I	EX.GR-II	CG
3.39	2.96		0.63*	0.57
3.39		2.38	1.01*
	2.96	2.38	0.58*

                             *Significant at 0.05 level of confidence

Table II shows that the adjusted post-test mean difference in Forced vital capacity between EX.GR-I (yogic practices with diet modification) and CG and between EX.GR-II (yogic practices without diet modification)    and CG 0.63,1.01 and 0.58 are  respectively, which were statistically significant at 0.05 level of confidence. At the same time that there was no significant difference on forced vital capacity between the EX.GR-I (yogic practices with diet modification) and EX.GR-II (yogic practices without diet modification). However, EX.GR-I (yogic practices with diet modification) was to be found better in reduce the Forced vital capacity than the EX.GR-II (yogic practices without diet modification).

The ordered adjusted means on Forced Vital Capacity were presented through bar diagram for better understanding of the results of this study in Figure-1.

FIGURE-1

Bar diagram showing the mean difference among Experimental Group I,

Experimental Group II and Control Group of Forced Vital Capacity

(Scores in litres)

                       *Significant at 0.05 level of confidence

 RESULTS OF PULMONARY FUNCTION

The Pulmonary function was measured through Spiro meter. The Table III shows the variance of pulmonary function test among EX.GR-I (Yogic practices with diet modification), EX.GR-II (Yogic practices without diet modification) and Control Group (No training) of Asthmatic women fire workers. 

TABLE – III

ANALYSIS OF COVARIANCE OF THE MEANS OF TWO EXPERIMENTAL GROUPS AND THE CONTROL GROUP IN PULMONARY FUNCTION

(Scores in liters)

Tests/ Groups	EX.GR-I	EX.GR-II	CG	S O V	Sum of Squares	df	Mean Squares	“F” Ratio
Pre Test	3.50	3.59	3.50	B	0.08	2	0.04	0.19
				W	8.69	42	0.21
Post Test	4.43	3.47	2.07	B	42.04	2	21.02	31.62*
				W	27.92	42	0.66
Adjusted Post Test	4.41	3.51	2.06	B	42.28	2	21.14	34.43*
				W	25.17	41	0.61

           * Significant at 0.05 level of confidence. (Table F ratio at 0.05 level of confidence for df 2   

           and 42 = 3.22, 2 and 41 = 3.23).

 

The obtained F ratio on pre- test scores 0.19 was lesser than the required F value of 3.22 to be significant at 0.05 level. This proved that there was no significant difference between the groups in pre- test and the randomization at the pre- test was equal. The post test scores analysis proved that there was significant difference between the groups, as they obtained F value 31.62 was greater than the required F value of 3.22. This proved that the differences between the post test means of the subjects were significant. Taking into consideration the pre and post test scores among the groups, adjusted mean scores calculated. The obtained F value was 34.43, which was greater than required F value of 3.23. This proved that there was significant difference among the means due to 12 weeks of yogic practices with diet modification and yogic practices without diet modification on selected variables as in line with study conducted by Mandhane PJ, et .al., (2010).

To find out which of the paired means had a significant difference, the Scheffe’s post-hoc test is applied and the results are presented in table IV.

TABLE – IV

SCHEFFE’S POST-HOC TEST FOR PULMONARY FUNCTION

Mean Values			MD	Required C.I
EX.GR-I	EX.GR-II	CG
4.41	3.51		0.90*	0.73
4.41		2.06	2.35*
	3.51	2.06	1.45*

                             * Significant at 0.05 level of confidence

Table IV shows that the adjusted post-test mean difference in Pulmonary function test between EX.GR-I (yogic practices with  diet modification)  and CG and between EX.GR-II (yogic practices without  diet modification)  and CG are 0.90, 2.35 and 1.45 respectively, which were statistically significant at 0.05 level of confidence. At the same time that there was no significant difference on Pulmonary function between the EX.GR-I (yogic practices with diet modification) and EX.GR-II (yogic practices without diet modification). However, EX.GR-I (yogic practices with diet modification) was to be found better in reduce the pulmonary function than the EX.GR-II (yogic practices without diet modification).

The ordered adjusted means on Pulmonary Function were presented through bar diagram for better understanding of the results of this study in Figure -2.

 

FIGURE-2

Bar diagram showing the mean difference among Experimental Group I,

Experimental Group II and Control Group of Pulmonary Function

(Scores in litres)

                                * Significant at 0.05 level of confidence

 

DISCUSSION ON HYPOTHESIS

It was hypothesized that there would be significant differences on selected respiratory parameters such as forced vital capacity and pulmonary function due to yogic practices with and without diet modifications among middle aged asthmatic women than the control group. The results proved that there were significant differences on forced vital capacity (Increased) and pulmonary function (Increased) due to yogic practices than the control group among middle aged asthmatic women. The hypothesis was accepted at 0.05 level of confidence.

It was hypothesized that there would be significant differences on selected respiratory parameters such as forced vital capacity and pulmonary function due to yogic practices with diet modifications and yogic practices without diet modifications among middle aged asthmatic women. The results from the post hoc test proved that there were significant differences on forced vital capacity (Increased) and pulmonary function (Increased) due to yogic practices with diet modifications than due to yogic practices without diet modifications among middle aged asthmatic women.

 

CONCLUSION

It was concluded that yogic practices with and without diet modifications increased forced vital capacity and pulmonary function significantly among middle aged asthmatic women. Hence, yogic practices with and without diet modifications are beneficial to middle aged asthmatic women.

REFERENCES

 

1. Puckett, J.L., Taylor, R.W., Leu, SY. et al. Clinical patterns in asthma based on proximal and distal airway nitric oxide categories. Respir Res 11, 47 (2010). https://doi.org/10.1186/1465-9921-11-47
2. Mandhane, P. J., Paredes Zambrano de Silbernagel, P., Aung, Y. N., Williamson, J., Lee, B. E., Spier, S., Noseworthy, M., Craig, W. R., & Johnson, D. W. (2017). Treatment of preschool children presenting to the emergency department with wheeze with azithromycin: A placebo-controlled randomized trial. PloS one, 12(8), e0182411. https://doi.org/10.1371/journal.pone.0182411