Yoga for asthma ppt dr anupama

Anupama krishnan V.P.S.V Ayurveda College Kottakkal

1Welcome


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Dr Anupama Krishnan

Dept of Swasthavritha

V.P.S.V Ayurveda College

Kottakkal

Yoga for Asthma


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Asthma• Greek word "panting“• Common chronic inflammatory disease

airways• Collection of inflammatory mediators• Inflammation of airways• Exaggerated broncho constrictor response

to stimuli• Reversible airflow obstruction ,

bronchospasm• Recurrent variable episodes of airway

obstruction


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Relevance• Two million emergencies• 6% of Under five children• More than 250,OOO death world

wide• Sickness absentism


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Population disparity

Current asthma prevalence is higher among

Children than adults

Boys than girls

Women than men


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Signs & Symptoms• Recurrent episodes of wheezing• Shortness of breath• Chest tightness, coughing• Difficult expulsion of sputum by coughing• Worse at night, morning• Adverse impact: exercise ,cold air


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Linked ailments Somatic

• Gastro-esophageal reflux disease (GERD)

• Rhino sinusitis

• Obstructive sleep apnea

Psychological

• Anxiety disorders (52% )

• Mood disorders in (4O%)


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Cause• Increases severity , responsiveness• Pollution , Occupational Hazard• Cold exposure• Hypersensitivity immune reaction• Family history• Epi genetics• Stress


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Cause• Genes: 100 genes linked to asthma • Stress and psychological factors: encourages

smoking, modifies immune system • Physical exertion: Strenous exercise • Viral infections: Syncytial virus and rhinovirus• Overweight adults: BMI ( 25-30) 38% chance• Obese adults - BMI( 30 or greater) have twice


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Cause Bronchial hyper- responsiveness

cGMP (cyclic Guanine Mono Phosphate) NOT BALANCED cAMP (cyclic Adenosin Monophosphate )


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Cause• Allergens: dust, cockroaches, hay, pollen,

fungi, food animal proteins - allergic asthma. • Allergic reactions triggered by antibodies in

the blood - airway inflammation


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Cause• Medicinal drugs: Beta Blockers. • Tobacco Smoke: Wheezing ,respiratory

infections, Increased case , mortality• Adolescent smoking• Environmental factors: Indoor air pollution

(mold, fumes from household chemicals, nitrogen oxide from gas stoves).


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Changes• Allergens activate immunocompetent cells

• B-lymphocytes produce antibodies of Ig E

class

• Excessive B-lympocytes activation,Ig E

production


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Changes

• Antigen-Antibody reaction

• Hyperergic inflammation

• Mucous edema, spasm of smooth myocytes

• Viscous exudate formation bronchial lumen


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Changes• Bronchial wall :Infiltration mast cells

eosinophils, basophils, T-lymphocytes

• Bronchial epithelium : Destruction

• Bronchial smooth muscles: Hypertrophy

• Submucous glands: Hyperplasy

• Microvessels : Dilation


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Phase

Three phases

• Prodromal period

• Height period

• Period of reverse changes


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Phase

Three phases

• Prodromal period

• Height period

• Period of reverse changes


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PhaseProdromal phase

• Profuse watery discharge• Sneezing, dryness in naso pharynx• Paroxysmal cough with viscous sputum • Excessive sweating• Skin reactions


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PhasePeak Period• Expiratory dyspnea • Forced position with supporting on arms• Poorly productive cough• Cyanotic skin and mucous tunics• Hyper expansion of thorax :all accessory

muscles during breathing


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Phase Period of reverse changes

• Dyspnea ,breathlessness relieve or disappear • Sputum becomes less viscous• Cough productive• Breath easier


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Classification.Depending : etiology Exogenous (atopic) Endogenous (non-atopic) .Depending: clinical course Intermittent (beginning, early) Persistent (chronic, late)


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Classification

• Depending on control assessment

Well-controlled Partially controlled

Uncontrolled


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Asthma Control• Daytime symptoms <2 /week;• Engage in normal daily activity;• Absence of night time awakenings• Bronchodilators administration <2 /week;• Absence of asthma flare• Normal/near :lung function parameters.


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Classification. Depending :•Frequency of exacerbations• Limitations of patient’s physical activity • Lung function persistent asthma is divided into Mild, Moderate Severe


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Complications• Pneumothorax

• Lung atelectasis

• Pneumonia

• Acute or subacute cor pulmonale

• Asthmatic status.


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Complications• Fibrosing bronchitis

• Small bronchi deformation and obliteration

• Emphysema

• Pneumosclerosis

• Chronic respiratory failure

• Chronic cor pulmonale.


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Investigation

• Eosinophilia• Moderate leukocytosis • Increased serum level of Ig E• ECG(right axis deviation,v1-v2 changes)• Chest X ray

Hyperlucency of lung fields

Expanded intercostal spaces Horizontal rib position.

Investigation


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Assessment• Diagnosis ,severity assessment

• Parameters of lung function

• Forced expiratory volume in 1 second (FEV1)

• Peak expiratory flow (PEF)

• Measured during spirometry at forced breathing-

out.


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Current Management• Mild attack- Bronchodilators

• Moderate attack- Bronchodilators & Steroids

• Severe Attack- O2, Bronchodilators & Steroids


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Ideal Management• Avoid trigger factors• Correct distorted position• Correct faulty breathing habit• Strengthen expiratory procedure• General muscle relaxation• Resolve supressed emotions• Self awareness


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Solution


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• Systematic methodology

• Development of Physical, Mental ,Intelluctual

Emotional ,Spiritual components

• Overall personality grooming

Yoga


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Yoga• Aggregate of Panchamahabhoota

• Harmonious flow of Pranic energy (vital energy)

• Channels of transport and communication Nadis

• Dormant potential-Kundalini

• Energy substratums –Shad chakra


Physical bodyEnergy sheathEmotional sheathIntellectual sheathBliss sheath

Annamaya kosa

Pranamaya kosa

Manomaya kosa

Vijnanamaya kosa

Anandamaya kosa

Man has 5 major sheaths of existence

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Adhi affects mind

Vyadhi-affects bod


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Concept of disease…• Adhi

• Lack of Knowledge• Desires and Arrogance• Improper eating• Unintelligent behaviour• Negative thoughts • Infliction of injury


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• Resultant Entropy of Prana

• Vijnanamayakosa - Ignorance

• Manomaya kosa - Stress,Negative thoughts

• Pranamayakosa - Functional disorders

• Annamayakosa - Physical ailment Vyadhi


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Yogic view

Lack of discrimination power

Negative emotions at mind level

Leads to disturbance in the prana channels

Interruption in flow of prana

Vyadhi


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Yogic view Manomayakosa(Adhi)

Pranamayakosa(Vyadhi)

Annamayakosa(Vyadhi)

Asthma


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Yoga Resume• Rebalancing pranic energy

• Revitalizing mind

• Readjustment of body system


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MANAGEMENT


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• Psychological level

• Vital energy level

• Somatic level


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Psychological level

• Achieve deep Internal awareness

• Solve psychological & emotional conflicts


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Prana level

• Mastery over Life energy

• Correcting disturbances in Prana flow

• Correct alternation in the prana flow


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Somatic level• Relaxation & improve tolerence• Immune system balance• Postural normalcy• Respiratory stamina• Drainage secretion• Desensitization


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ANNAMAYAKOSA

Satkriya

Loosening movements

Yogasana


Suddhi kriyas (Shatkarmas)

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SUDDHI KRIYA• Neti (jala neti & sutra neti)

• Kapalabhati

• Dhauti (jala dhauti)


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SUDDHI KRIYABenefits• Clean the airway passage• Tone up the function of lungs and respiratory

muscle• Desensitize the hyperactive mucus

membrane• Enhance the internal awareness


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Neti


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नेति�

Click icon to add picture


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Sutraneti

• सूतं्र वि�तस्तितसुस्ति�ग्धं �ासा�ाले प्र�ेशयेत् । मुखान्नि�र्ग�मयेच्चैषां �ेवित: न्निसदै्धर्नि�"र्गद्यते ॥

(H.Y.2/29)

• Pull a thread 12 inches in length through one of the nostrils. Pull it out through the mouth.


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• Should pass easily and smoothly through the valve at the back of the nose (the choanae) -nasopharynx near the Eustachian tubes curling under the upper palate


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Benefits कपालशोन्निध�ी चै� दि+व्यदृवि.प्र+ायिय�ी ।

जतू्रर्ध्व��जातरोर्गौधं �ेवितराशु वि�हंवित च ॥(H.Y.2/30)

• Cleanses the skull(sinuses) • Makes the eyes sharp• Removes diseases above the shoulders.


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Benefits

• Frictional massage: membranes are strengthened , work more efficiently

• Blood supply to the nerves of the air passages are energized

• Relieves mouth breathing• Stimulates nerves and related brain functions of

the eyes, tear ducts. sinus, ears, and head.


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Jala neti• Flushing nasal cavity with saline water

• Inhibition of the seasonal Ig E increase to Dactylis glomerata by daily saline nasal sinus irrigation during the grass pollen season.

(J. Subiza et al., 1999)


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Procedure• Mix in salt to the proportion of one teaspoon

for half a litre of water. • Equates to 0.9%( isotonic solution)just to

alter the taste

• Filter it , fill the neti pot


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•Water simply flows up one nostril to just above the bridge of the nose•Backwards into the middle cavity •Water flows down ,out the other side of the nose. •Passes by the frontal and mid nasal sinuses


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Rinses dirt ,bacteria

Gravity & venturi effect

Vaccum pressure

Sinus passages are drained


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Benefits• Stimulating , tones nerves, glands & organs entire

nasal & cranial area• Correct working envt: temperature humidity

regulation in the nose• Balance nasal breathing- balance whole body

nervous function- better physical and mental health

• Improves sensitivity of the olfactory nerves• Helps to restore lost sense of smell


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Kapala bhati •Perform exhalation and inhalation rapidly like the bellows

Bhala and Kapal - cranium or foreheadBhati - light or splendour

• Perception and knowledge• Frontal brain purification


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Normal breathing Inspiration-active Expiration –passive

Kapalabhati Exhalation - active Inhalation – passive

• Reversal in the flow of the nerve impulses to and from brain stimulation and awakening of the brain centres.


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Benefits• Clears the respiratory passages• Forceful breaths - allergens , infectious

materials evacuated• Improve flexibility of diaphragm - improves

circulation• Increase the total lung capacity ,improves

respiratory efficiency


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वमन धौति� कंुजल ति�या


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Vamana dhauti

विपबेत्�ारिर चाकण्ठं् पूरिरतं सुधी:ऊर्ध्व�ा; दृष्टि." क्षणं कृत्�ा तज्जलं �मयेत्पु�:वि�त्यमभ्यसयोरे्ग� कफविपतं्त वि��ारयेत्

(G.S 1/38)• Drink water pull up to the throat, looking for

a short while upwards vomit it out again• Daily practice, disorders phlegum ,bile cured.


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Procedure

• In empty stomach in morning• After evacuation of bladder,bowel• 1lt lukewarm water- 1tbs salt (1% saline)• Drink as quickly as possible until cant take it

more• When stomach is full - urge to vomit seems

automatic - almost involuntary gesture


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G.S 1/38


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Benefits • Cleanses entire digestive,respiratory tract

• Rid of excess bile, mucus and toxins

• Restore body's natural balance, chemical composition

• Increase in production of gastric enzymes


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Duration

• Jalaneti- daily upto 14 days

• Sutra neti- weekly twice

• Vamana dhauti- weekly once


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Sookshma Vyayama“Movements of all joints -slow rhythmic pattern”

• Relieve stiffness of the joints

• Stretch and relax muscle

• Stimulate production of synovial fluid

• Improve strength and stamina


Loosening exercise

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Loosening exercise for legs


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Loosening exercise for hands


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• Loosening of Neck


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Skandha chakra

• Shoulder rotation• Increase flexibility,• Tone the shoulder muscle


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Postures• Forward Bending

• Backward Bending

• Lateral Stretch Standing poses

• Twisting Poses

• Inversions


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Forward bending

• Stretches the posterior part of the lungs• Relieves fatigue

“Forward leaning has been noted clinically to be effective in COPD , most adopted body position,decreases dyspnea

increases exercise capacity” ( Am J Respir Crit Care Med Vol 173. pp 1390–1413, 2006)


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Backward Bending • Allows for deep inhalation. • Ribs expand and separate ,space for

lungs to inflate• Heart stretched out along with left

ventricle• Cardiac muscle toned up• Clear bronchial tree of mucus• Opens thoracic cage • Allows blood from right ventricle to

enter without strain


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Lateral Stretch Standing poses

• Expand the intercostals • Tone up the lung walls• Stretch the lungs


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Twisting Poses• Increase elasticity of intercostals • Squeeze , stretch lungs• Squeeze lateral parts of lungs• Free flowing breath


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Inversions

• Help drainage from the basal parts of the lungs


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Asana Standing

o Ardhakatichakraasana o Padahasthasanao Ardhachakrasanao Trikonsanao Parivritta trikonasana

Sittingo Sukhasanao Sasankasanao Ushtrasanao Paschimottanasanao Suptha vajrasanao Vakrasanao Ardhamatsyendrasana Prone

o Bhujangasana o Salabhasana

Supineo Sarvangasanao Halasanao Matsyasana


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Padahasthasana

Padahasthasana• Stretch the entire backside of the body from

head to heels• Allows lungs , heart to rest• Stretches posterior part of lungs• Relieves fatigue


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Ardhachakrasana

• Ribs expand and separate

• Provide more room for lungs to inflate.

• Stretches intercoastal muscle

• Increase lungs capacity.


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Trikonasana

• Stretching of Deltoid

• Latissimus dorsi

• Intercoastal muscle


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Parivritta trikonasana


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Sukhasana

• Normalize breathing pattern • Lungs diaphragm require space to inflate

deflate during respiratory process. • Spine kept erect• Open space for organs respiratory muscles • Vital in taking efficient breath


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Sasankasana

•Calming the nerves •Providing a feeling of tranquillity


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Ushtrasana

•Tone up abdominal viscera •Improves the flexibility of scapula trapezius muscles


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Paschimottanasana

• Keep the upper shoulders neck area relaxed• Calm and soothe nervous system• Stress reliever• Remove anxiety, anger


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Suptavajrasana

• Brings more oxygen to system• Tones spinal nerves, neck back muscles• Stretches ribcage• Diminishing anger aggression relaxes mind


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Vakrasana

Ardhamatsyendrasana


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• Lungs chest cavity is expanded• Stretches muscles in the shoulders, chest

and abdominals• Opens chest helps to clear passages of

heart and lungs

Bhujangasana


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Salabhasana

• Tightens the abdominal muscles and expands the upper part of the body. • Enhancing capacity


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oSarvangasanaCleans the airways in lower zone Balance prana, calms down the mind

oMatsyasanaClear the air way narrowing


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Pranamaya kosa• Breathing exercise

• Kapalabhathi

• Suryanuloma viloma

• Suryabhedana


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Pranamayakosa

• Breathing practise & pranayama

• Warmth generating

• Avoid cooling practise


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• Full utilization all lobes of lungs

• Normalizing breathing pattern

• Uniform and Rhythmic breathing


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SECTIONAL BREATHING

• Abdominal breathing(diaphramatic )

• Thoracic breathing (intercoastal)

• Upper lobar breathing(clavicular)

• Full yogic breathing(combination)


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Breathing Practice

• Hand in and out• Hands stretch breathing ( 90°, 135°, 180°)


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Benefits• Opening the lower, middle and upper zone of

the chest• Deep internal awareness• Prana balance• Trains the chest wall muscle for rhythmic

breathing• Improve concentration and calm down the

mind


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Ankle stretch breathing•Breath awareness

•Expansion constriction of airways n mid zone

•Strengthen clavicular muscle

•Relax body and mind


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Dog breathing•Full diaphragm contraction empties locked up air in alveoli•Cleanses lower middle portion of lungs•Relaxing bronchi•Calms body and mind


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Rabbit breathing• Effortless rapid breathing• Increasing speed of diaphragmatic movements• Open up prana block in upper chest


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Tiger breathing

• Empties the lungs – Allow better aeration during stretch

• Expansion contraction of chest wall – harmonious functioning of muscle

• Awareness of expansion of air sac• Complete emptying of air sac and airways


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Tiger Breathing


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Sasankasana breathing

• Expels air trap in the lower zone• Releases prana block• Train in diaphragmatic breathing


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“ Yoga chair breathing for acute episode of bronchial asthma.”

(R.Nagarathna, H.R.Nagendra 1991)


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Results...• Patients asymptomatic after an attack but

their lung functions were only 40- 50%

• Significant increase PEFR

• Yoga chair breathing is effective and risk free


Pranayama

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Pranayama

• Nadisudhi pranayama

• Ujjayi

• Suryabhedhana pranayama

• Surya anuloma viloma


• Link between body & mind

• Prana - breath/vital energy extension breath scientific way • Ayama - to extent/stretch regulating vital energy

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Nadisudhi pranayama

प्राणायामेन युके्तन सव�रोगक्षयो भवे�्• Balance ida and pingala nadi• Pure oxygenated air is breathed into the lungs

improve circulation• Strengthen lungs increases overall lung capacity• Reduce stress• Improve mental health• Regulate metabolism


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Ujjayi• Sit erect spine straight. • Inhale slowly while drawing the air by both

the nostrils.• touch of air experienced in throat • Sound is produced. • Slow exhalation is to be done


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Suryabhedana• Sit in Padmasana or Sidhasana.

• Inhale slowly and deeply through your right nostril, your left nostril shut with your ring finger and little finger.

• Next, close your right nostril with the thumb of your right hand. and then exhale through your left nostril, keeping your right nostril closed.

• Repeat the act 5 – 10 times.


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(Pingala Nadi)•Stimulate sympathetic nervous system•Increases the body temperature•Removes blockages in pranic energy channels•Purifying sinus


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Surya Anuloma viloma• Help in clearing the nasal passage• Breath – Slow & smooth


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“Effect of short term yoga practice on ventilatory function test.”

(Makwana k et al.,1988)

• Maximal voluntary ventilation(MVV) improved.

• Increase the compliance of lung - surfactants


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Cont..... Physiology Importance of Surfactant

• Stabilize alveoli• Prevent collapse and sticking of alveoli• Maintain the dryness of the alveoli• Prevent the edema of the alveoli


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Results..Exercise support expiration beneficial.Forcefully expiratory exercise helpful.


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MANOMAYA KOSA

• Inhibit Negative thought

• Install Positive outlook


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• Training thoughts

• Culturing emotions

• Developing Right Brain lobe

• Evoke Handle Diffuse thoughts


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Manomayakosa• Pratyahara• Dharana• Dhyana • Cyclic meditation• Chanting of mantras ,bhajans


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Surya namaskara


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Surya namaskara

Annamaya kosaStrengthen and relax muscleRhythmic contraction and relaxation of the

chest muscleAwareness

Pranamaya kosaBalancing pranaReleasing prana block

Manomaya kosaEmotional balance


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Surya namaskara

“ A comparative study of slow and fast surya namaskara on physiological function”

(Anand balayogi bhavanani et al.,2011)

• Different posture of suryanamaskara improve chest wall expansion

• Improving strength all major respiratory muscles specially inter costal muscles.


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Vijnanamaya kosa• Elimination of misconception • Measures

CounsellingAwareness classesSelf studySpiritual discoursePsychotherapy


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Vijnanamaya kosa

• Awareness classes

• Yama

• Niyama

• Relaxation


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Relaxation• Assimilation and Discrimination power• Vital Energy store• Relaxation


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ANANDAMAYAKOSA

• Unparallel Bliss experience

• Karma yoga, Bhakti yoga

• Happy Assembly


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Yoga Practice• Energy Management• Stamina Improvement • Self Discipline• Awareness• Determination• Perservance


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Thank You

Yoga for asthma ppt dr anupama

Healthcare

Transcript of Yoga for asthma ppt dr anupama