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The Effect of Pranayama Breathing Technique on Asthma Control, Pulmonary Function and Quality of Life

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT04110951
Recruitment Status : Completed
First Posted : October 1, 2019
Last Update Posted : October 1, 2019
Information provided by (Responsible Party):
Gülyeter Erdoğan Yüce, TC Erciyes University

Brief Summary:
Most of the asthma patients prefer complementary and integrative applications as they continue to experience asthma symptoms despite pharmacological treatment. Pranayama, one of these treatments, is a breathing-based technique and is a part of yoga, an ancient Indian science. This study was carried out as randomized controlled single blind study in order to analyze the effect of pranayama breathing technique applied to individuals suffering from asthma on asthma control, pulmonary functions and quality of life. The study comprised 50 patients in total, as 25 patients in pranayama group and 25 patients in control group. The approval of ethics committee, permissions from the institutions, and informed voluntary approval of the individuals were obtained to conduct the research. The data of the research were collected through the application of Asthma Control Test (ACT), Asthma Quality of Life Questionnaire (AQLQ), pulmonary function test (PFT), and patient observation chart. Pranayama breathing technique was applied to pranayama group 20 minutes once a day for four weeks, and relaxation technique was applied to relaxation group similarly in addition to standard treatment. ACT, AQLQ, and PFT were evaluated twice as before and after the one month of application process. Meanwhile, the patients' PEF measurements were followed with individual PEF meter on daily basis. The value of p<0.05 was accepted statistically significant in the data analyses.

Condition or disease Intervention/treatment Phase
Asthma Behavioral: Pranayama Breathing Technique Behavioral: Relaxation technique Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 50 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Participant)
Primary Purpose: Supportive Care
Official Title: The Effect of Pranayama Breathing Technique on Asthma Control, Pulmonary Function and Quality of Life: A Single-Blind Randomized Controlled Trial
Actual Study Start Date : February 1, 2018
Actual Primary Completion Date : December 25, 2018
Actual Study Completion Date : May 17, 2019

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Asthma

Arm Intervention/treatment
Experimental: Pranayama group
Kapalbhati, Ujjayi and Anuloma-Viloma pranayama techniques were applied to the experimental group. Within this scope, a three days of applied training program was prepared and a guide involving the steps of Pranayama breathing technique was formed. The patients in of pranayama group were trained by the researcher who had yoga trainer certificate. After completing three days of training and observations regarding their accomplishment of applications properly, a pranayama breathing technique video showing how the pranayama breathing technique is done with its details was downloaded to their smartphones and a guide including the application steps was distributed to the patients. The patients were required to apply pranayama technique, in company with the video, 20 min every day and a month in total.
Behavioral: Pranayama Breathing Technique
Yogic Breathing Technique

Active Comparator: Relaxation group
As there was not placebo breathing control treatment appropriate to yoga breathing technique, relaxation technique was decided to apply in the second group to equalize psychological effects of the treatment. Progressive relaxation technique was taught to the relaxation group during the same training span.A three days of applied training program and Relaxation Technique Application Guide, including steps of progressive relaxation technique, were prepared within this scope. After completing three days of training and observations regarding their accomplishment of applications properly, a relaxing music to listen during applications and a training video involving progressive relaxation directives were downloaded to smartphones of the patients. Also, Relaxation Technique Application Guide involving application steps were distributed to the patients. The patients were required to apply relaxation technique, in company with the video, 20 min every day and a month in total.
Behavioral: Relaxation technique
Progressive relaxation technique

Primary Outcome Measures :
  1. Asthma Control Test [ Time Frame: change from baseline score at the end of one month ]
    Asthma Control Test (ACT) is composed of 5 main sections involving asthma influence level of patients due to daily actions of patients, frequency of asthma symptoms at daytimes and nights, need of urgent relaxing drug, and evaluation of disease by patients. Patients are required to respond each question with values between 1 and 5. Total score of these 5 questions ranges between 5 and 25

  2. Asthma Quality of Life Questionnaire [ Time Frame: change from baseline score at the end of one month ]
    Standard Asthma Quality of Life Questionnaire (AQLQ) is a quality of life questionnaire specific to asthma comprising 32 questions. AQLQ was developed by Juniper et al. (1993) to use in clinical studies. The questionnaire evaluates responses through a 7 scores scale (1: severely impaired; 7: not impaired at all) based on changes in last two weeks regarding asthma. Standard AQLQ involves 12 questions about symptoms, 11 questions about activity limitation, 5 questions about emotional functions, and 4 questions about environment stimuli. Mean scores are calculated for subcategories and overall scores. The mean of obtained scores are evaluated between 1 and 7. The minimum score change clinically accepted important in the questionnaire is 0.50 and this situation is called "minimal significant difference" .

  3. Peak Ekspiratuar Flow [ Time Frame: change from baseline score at the end of one month ]
    Peak Ekspiratuar Flow (PEF) measurement kind of test which can be accomplished through mobile hand-held tools that enable patients to follow their situations even at their own homes in asthma diagnose and treatment. Repeatability of the test is very high though its application is connected with effort. As PEF measurement gives information about big airways, lower values are obtained in comparison to FEV1 value at 30-50% of the patients. In PEF follow-up, the best PEF value of patient value is primarily defined. Because, the follow-up of patient is conducted in terms of his/her best value not in terms of prediction value indifferent to spirometer in PEF follow-up.

  4. Forced Expiratory Volume First Second [ Time Frame: change from baseline score at the end of one month ]
    Forced expiratory volume in first second (FEV1), measured during breathing function test and a flow velocity, is the best indicator of obstruction in asthma. However, FEV1 reflects real obstruction only with powerful and maximum effort as it mostly related with effort.

  5. Forced Vital Capacity [ Time Frame: change from baseline score at the end of one month ]
    Effort related part of forced vital capacity (FVC) reflects airways, pulmonary expriratory muscles and the situation of lung elastic recession power.

  6. FEV1/FVC [ Time Frame: change from baseline score at the end of one month ]
    FEV1/FVC rate is an important final parameter in defining obstruction as there is not a great change observed in FVC values at early stages of the disease in most of the asthma patients.

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Can communicate,
  • To have an increase of %12 or 200 ml in FEV1 value after inhaler bronchodilator at breathing function test,
  • To have chronic asthma diagnose with 6 months approved by doctors and receiving treatment,
  • Asthma controls are not under control or partly under control in relation to GINA (Global Initiative for Asthma) values,
  • Taking beta2-agonist and/or ICS twice a week or more to control asthma symptoms,
  • There is not any chance in inhaler bronchodilator drug potions during the last four weeks,
  • Can use a smart phone.

Exclusion Criteria:

  • To have lung diseases such as COPD,
  • To have tuberculosis and respiratory infection,
  • To have diabetes and coronary artery disease,
  • Smokers
  • Pregnant or nursing mother,
  • Doing regular exercise,
  • Benefitng from other complementary and integrative health applications during treatments

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT04110951

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Nevşehir Haci Bektaş Veli Üniversitesi
Nevşehir, Nerkez, Turkey, 50000
Sponsors and Collaborators
TC Erciyes University
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Arulmozhi S, Joice SP, Maruthy KN. Effect of pranayama on respiratory muscle strength in chronic asthmatics. National Journal of Physiology, Pharmacy and Pharmacology, 2018; 8(12): 1700-1703.
Bhatt A, Rampallivar S. Effect of pranayam on ventilatory functions in patients of bronchial asthma. Journal of evolution of medical and dental sciences-jemds, 2016; 5(28): 1453-1455.
Gulati K, Babita R. A clinical study to evaluate the effects of yogic intervention on pulmonary functions, inflammatory markers and quality of life in patients of bronchial asthma. EC Pharmacology and Toxicology, 2017; 3: 174-181.
Hoang KAT, Nguyen HM. The effectiveness of practicing pranayama yoga on some respiratory indicators in patients suffering from bronchial disease. International Journal of Science Culture and Sport (IntJSCS), 2015; 3(2): 6-12.
Husseın NA, Afıfy AM, Obaya HE, Rafea AS. Effects of Ujjayi Pranayama Trainning on Selected Ventilatory Function Test in Patients with Mild Bronchial Asthma. Med. J. Cairo Univ., 2016; 84(2): 445-452.
Kant S, Agnihotri S. Asthma diagnosis and treatment-1029. Yoga as an adjuvant therapy in asthma management. In World Allergy Organization Journal, 2013; 6(1): 28.
Karmakar S, Karmakar S. The Role of Yoga in Bronchial Asthma. J Complement Med Alt Healthc. J, 2018; 7(2): 1-4.
Malarvizhi M, Maheshkumar K. Effect of 6 months of yoga practice on quality of life among patient with asthma: a randomized control trial. Advances in Integrative Medicine, 2018, 1-8.
Manivannan D. Effect of Yoga Therapy on Clinical Profile and PEFR among Women with Bronchial Asthma. Indian Journal of Ancient Medicine and Yoga, 2017; 10(4): 125-130.
Morse D. Yoga for asthma. International Journal of Yoga Therapy, 2007; 17(1): 81-88. Morse, 2007
Murthy KJ, Sahay BK, Sitaramaraju P, Sunita M, Yogi R, Annapurna N, Ramesh M, Prasad V, Reddy E. Effect of pranayama (rechaka, puraka and kumbaka) on bronchial asthma-an open study. Lung India, 1984; 2(2): 187-191.
Pandit DP, Vaidya SM. Effect of yoga on pulmonary function tests in patients of bronchial asthma. International Journal 2013; 2(3): 58-63.

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Responsible Party: Gülyeter Erdoğan Yüce, Principal Investigator, TC Erciyes University Identifier: NCT04110951    
Other Study ID Numbers: TDK-2017-7652
First Posted: October 1, 2019    Key Record Dates
Last Update Posted: October 1, 2019
Last Verified: September 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Plan Description: There are no plans.

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Gülyeter Erdoğan Yüce, TC Erciyes University:
Breathing exercises
Quality of life
Additional relevant MeSH terms:
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Respiratory Aspiration
Bronchial Diseases
Respiratory Tract Diseases
Lung Diseases, Obstructive
Lung Diseases
Respiratory Hypersensitivity
Hypersensitivity, Immediate
Immune System Diseases
Respiration Disorders
Pathologic Processes