Table 1.
Summary of included studies
| Author, Year of publication, Country (referebce) | Objective/s | Study design | Duration of Pranayama | Participants n intervention* n control* | Gender Age | Details of intervention | Outcome measure (s) | Result |
|---|---|---|---|---|---|---|---|---|
| Anitha 2016, India[18] | Effects of Pranayama on the level of anxiety in patients with myocardial infarction | C | 5 days | 30 30 | NM NM | 10 min of Pranayama once a day in the morning for 5 consecutive days | Speilberger State Anxiety Inventory (pre- and post-test score) |
Significantly lower posttest anxiety in intervention group compared to pretest anxiety of IG (P<0.01) with no significant pre-post change in CG |
| Bhatt and Rampallivar 2016, India[19] | Effect of Pranayama on ventilator functions in asthma patients | R, C | 3 months | 40 40 | NM 18-72 years | Different types of Pranayama (Bhastrika, Kapalbhati, Anuloma-Viloma, Bhramri and Ujjayi) Few days of expert supervised sessions, followed by home continuation |
PR, SBP, DBP, RR FVC, FEV1, FEV1/FVC %, PEFR | Significant reduction in PR (P<0.05), SBP (P<0.05) and increase in FVC (P<0.05), PEFR (P<0.05) and FEV1 (P<0.001) in the IG posttest compared to pretest. No significant change in CG |
| Mobini Bidgoli et al., 2016, Iran[20] | Effect of Pranayama on anxiety in patients undergoing coronary angiography | R, C DB | 5 min | 40 40 | Both 59.1 years | Sukha Pranayama for 5 min under the supervision | Spielberger State Anxiety Inventory before, 0.5 and 1 h postintervention |
Significant reduction in mean anxiety score (P<0.0001) in IG at 0.5 and 1 h compared to pretest anxiety of IG. Significant difference in postintervention mean anxiety scores between groups (P<0.01). No significant pre-post change in CG |
| Chakrabarty et al., 2015, India[21] | Effect of Pranayama on cancer-related fatigue in breast cancer patients undergoing radiotherapy | R, C | 1.5 months | 80 80 | Female >18 years |
Pranayama (Nadi shodana, Sheethali, Brahmari) for 30 min twice daily for 5 days a week, for 6 weeks | Cancer fatigue scale | Significant reduction in cancer-related fatigue in IG posttest compared to pretest (P<0.001). Significantly lower posttest cancer related fatigue in IG compared to CG (P<0.01) |
| Chakrabarty et al., 2013, India[22] | Effect of Pranayama on the antioxidant levels in breast cancer patients undergoing radiation therapy | R, C | 1.5 months | 80 80 | Female >18 years |
Pranayama (Nadi shodana, Sheethali, Brahmari) for 30 min twice daily for 5 days a week, for 6 weeks | Serum protein thiols and glutathione | Significantly higher levels of serum protein thiols (P=0.001) and glutathione (P=0.002) posttest in the IG compared to CG |
| Chakrabarty et al., 2016, India[23] | Effect of Pranayama on Emotional changes in breast cancer patients undergoing radiation therapy | R, C | 1.5 months | 80 80 | Female >18 years | Performance of pranayama (Nadi shodana, Sheethali, Brahmari) for 30 min twice daily for 5 days a week, for 6 weeks | Emotions according to an expert-validated scale devised by the investigators | Significantly less posttest negative emotions in the IG compared to CG (P=0.001) |
| Dhruva et al., 2012, USA[24] | Effect of Pranayama on cancer chemotherapy associated symptoms and QOL | R, C | Intervention between two therapy cycles | 8 8 | Both 54.2 years | Weekly Pranayama session lasting for 60 min (inclusive of breath observation, Ujjayi, Kaplabhati, and Nadi shodana pranayama) taught by instructors, and practice of pranayama techniques for 10-15 min, twice daily at home, during two consecutive cycles of chemotherapy | Revised Piper Fatigue Scale, General Sleep Disturbance Scale, Hospital Anxiety and Depression Scale, Perceived Stress Scale and QOL (SF-12) | Significantly improved sleep disturbance (P=0.04), anxiety (P=0.04), and mental component of QOL (P=0.05) in the IG posttest. No significant change in CG |
| Franzblau et al., 2008, USA[25] | Effects of Pranayama on depression in abused women | R, C | 4 days | 20 20 | Female 18-45 years | Division of participants into 4 groups. Intervention types are: practice of yogic breathing (45 min per day); giving testimony (45 min per day); practice of yogic breathing and giving testimony (90 min per day). CG group had no intervention | BDI-II | Significant reduction in BDI-II score posttest in groups who underwent yogic breathing (P<0.005), giving testimony (P<0.005) and the combination of both (P<0.005), but not in the CG |
| Goyal et al., 2014, India[26] | Effect of Pranayama in patients with hypertension (Stage 1) | C | 1.5 months | 25 25 | Both 20-50 years | Practice of pranayama (Nadi shodana: 2-10 min, Chandar bhedi: 2-10 min, Brahmari: 10 cycles, Omkar chanting: 10 cycles) daily for 6 weeks | PR, BP, RPP (HR*SBP) | PR decreased significantly in both the groups as compared to baseline. RPP decreased significantly in both groups compared to baseline, however the decrease was significantly more (P<0.01) in IG in comparison to CG |
| Katiyar and Bihari 2006, India[27] | Effect of Pranayama in patients with COPD | R, C SB | 3 months | 24 24 | Both 52.2 ears | Performance of pranayama (Bhastika, Kapalabhati, Vhasya, Anulom-Vilom, Bhramid and Udgeedh pranayama) for at least 30 min daily, 6 days a week, for 3 months | FVC, FEV1, PEFR, 6 min walk test, PO2, pCO2 and (SGRQ) score | Significant posttest increase of PEF (P<0.05), distance walked in 6 min test (P<0.05) and significant decrease in SGRQ score (P<0.02) in IG compared to CG |
| Kochupillai et al., 2005, India[28] | Effect of Pranayam on Immune Functions in cancer patients | C | 6 months | 21 6 | NM 22-65 years | Pranayama (Ujjayi and Bhastrika) followed by SK (taught at 6 a day workshop) daily at home for 6 months | Immune functions: CD3+, CD4+, CD8+, and NK cell count at baseline, week 1, 12 and 24 | Significant increase of NK cell count at 12 (P=0.001) and 24 weeks (P=0.0001) compared to baseline in IG. Significant increase in NK cell count in IG at week 24 compared to CG (P<0.05) |
| Mourya et al., 2009, India[29] | Effect of Pranayama in patients with hypertension (Stage 1) | R, C | 3 months | 20, 20 20 | Both 20-60 years |
Practice of breathing exercises (fast [n=20] or slow [n=20]) for 15 min twice daily 10-12 h apart, for 3 months | BP and autonomic function tests (SLR, immediate HR response to standing [30:15 ratio], Valsalva ratio, HR variation with respiration [EIR], hand-grip test and cold presser response) | Significant reduction in posttest SBP and DBP in slow-breathing group and fast-breathing group with a greater reduction in slow-breathing group. Significant increase in SLR, 30:15 ratio, EIR, DBP response in hand grip test, and rise in both SBP and DBP in cold pressor test in patients practicing the slow-breathing exercise compared to baseline (P<0.001) and CG (P<0.001) |
| Prakasamma and Bhaduri 1984, India[30] | Effect of Pranayama as a nursing intervention in the care of patients with pleural effusion | C | 20 days | 10 10 | Male 16-50 years |
Anuloma-viloma Pranayama for 30 min daily for 20 days after aspiration of pleural fluid | FVC, FEV1, MVV, PEFR, CE and RS | Significant increase in posttest FVC, CE in IG (P<0.1) compared to CG |
| Prem et al., 2013, India[31] | Effect of Pranayama on QOL and pulmonary function in patients with bronchial asthma | R, CSB | 3 months | 40 40 | Both 18-60 years | Patients trained to perform diaphragmatic breathing, thoracic breathing, upper lobe breathing and full yogic breathing progressing to right nostril breathing, left nostril breathing and alternate nostril breathing for 3-5 days with a session of 60 min each day. They were instructed to practice the exercise at home for 15 min twice daily for 3 months | AQLQ score, Asthma Control Questionnaire and FEV1, FEV1/FVC | IG showed a significant improvement (P=0.042) in total asthma QOL Questionnaire score The study also included a parallel 3rd group who practiced Buteyko techniques as an intervention (n=40) |
| Saxena and Saxena 2009, India[15] | Effect of Pranayama in patients with mild to moderate bronchial asthma | R, C | 3 months | 25 25 | Both 18-45 years |
Practice of breathing exercises (deep breathing, Sasankasana breathing, Anuloma-viloma, Bhramari, Omkara) for 20 min twice daily for 3 months | Symptoms score, FEV1%, PEFR | Significant improvement in posttest symptoms (P<0.01), FEV 1% (P<0.001) and PEFR (P<0.001) in IG compared to CG |
| Singh et al., 1990, UK[32] | Effect of Pranayama on airway reactivity in subjects with bronchial asthma | C CO |
0.5 months | 22 22 | Both 19-54 years | Practice of slow deep breathing through the Pink City Lung Exerciser for 15 min, twice a day, for 2 weeks | FEV1, FVC, PEFR, symptom score, inhaler use, PD20 histamine level | PD20 increased significantly in IG compared to CG (P=0.013) |
| Sodhi et al., 2014, India[33] | Effect of Pranayama Yoga on the QOL in patients with bronchial asthma | R, C | 8 weeks | 60 60 | Both 17-50 years |
Pranayama (deep breathing, Kaplabhati, Bhastrika, Ujjayi and Sukha purvaka pranayama) for 45 min, twice daily on all days of the week for 8 weeks | AQLQ score, number and severity of asthmatic attacks, dosage of medication required | Significant improvement in total score of AQLQ compared to baseline (P<0.01) in IG, but not in CG. Significant reduction in daily number and severity of attacks in the IG posttest compared to baseline (P<0.01) and compared to CG (P<0.05). Significant reduction in the dosage of medication required in the IG compared to baseline (P<0.05), but not in the CG |
| Sodhi et al., 2009, India[34] | Effect of Pranayama on pulmonary functions in patients with bronchial asthma | R, C | 8 weeks | 60 60 | Both IG - 20-50 years CG - 17-50 years |
Yoga breathing exercises (deep breathing, Kaplabhati, Bhastrika, Ujjayi and Sukha purvaka pranayama) for 45 min, twice daily on all days of the week for 8 weeks | PEFR, FVC, FEV1, FEF25-75, FEV1/FVC % | Significant increase in PEFR, FVC, FEV1, FEF25-75, FEV1/FVC % at 4 weeks and 8 weeks in the IG compared to baseline (P<0.01), but not in the CG |
PEF=Peak expiratory flow, AQLQ=Asthma QOL Questionnaire, BP: Blood pressure, BDI-II=Beck depression inventory-II, C=Controlled, CE=Chest expansion, CG=Control group, CO=Cross-over, COPD=Chronic Obstructive Pulmonary Disease, DB=Double blind, DBP=Diastolic BP, FEV1=Forced expiratory volume in 1 s, FVC=Forced vital capacity, IG=Intervention group, NM=Not mentioned, PEFR=PEF rate, PR=Pulse rate, R=Randomized, RPP=Rate pressure product, RR=Respiratory rate, RS=Radiological score, SB=Single blind, SBP=Systolic BP, SGRQ=St. George’s Respiratory Questionnaire, SLR=Standing-to-lying ratio, NK=Natural killer, SLR=Standing-to-lying ratio, QOL=Quality of life, SK=Sudharshan Kriya, HR=Heart rate, SF=Short form, EIR=End inspiratory rate, MVV=Maximal voluntary ventilation, FEF25-75=Forced Expiratory Flow