Preventive and Curative Aspect of Yoga in Management of Asthma in Children

Asthma is a disease characterized by an increased responsiveness of the trachea and bronchi to various stimuli. It manifests by widespread narrowing of the airways causing paroxysmal dyspnea, wheezing and cough [8].

In Asthma, airway obstruction is caused because of following reasons: (i) Edema and inflammation of mucous membrane lining the airways, (ii) Excessive secretion of mucus, inflammatory cells and cellular debris and (iii) Spasm of the smooth muscle of bronchi. In the early stages, PaCO₂ level falls because of the hyperventilation that is caused by dyspnea. When obstruction becomes more severe, alveolar hypo ventilation increases that in turn leads to the retention of the CO₂ with a rise of PaCO₂. With the exhaustion of buffer mechanisms, pH of the blood falls that leads to respiratory acidemia [8].
 

The goals of management are (i) Maintenance of regular pulmonary function (ii) Maintenance of usual physical activity (iii) Prevention of the cough or wheezing with minimal chronic symptoms and (iv) Avoiding adverse consequence of medication. Efficient management of asthma involves two major therapies that are pharmacotherapy and non pharmacotherapy, along with identification and elimination of exacerbating factors and education of patient and parents about temperament of disease. Pharmacotherapy (i.e. Oral and inhaled medicine) includes bronchodilators, corticosteroids, mast cell stabilizers, leukotrienes modifiers and immunotherapy. Initially this therapy is helpful in management of the disease, but later there be enhance in financial burden, morbidity and mortality. Non-pharmacotherapy includes Yogic techniques i.e., Asana (Physical exercises) and Pranayama (Breathing exercises) [9].
 

(i) To implement yogic techniques as drugless, substitute methods to prevent and cure asthma amid pediatrics age groups 7 to 12 years.

(ii) To reduce burden of escalating medicine cost in medicinal intervention of asthma therapy.

(iii) To avail the additional health benefits of Yogic techniques.
 

Following are the some Asanas that are beneficial in the cases of Asthma [12,13].

Suryanamaskara: Enhances blood circulation and nutrient absorption. It increase lungs capacity, reduces irritation, short temperament, common cold & coughs.

The Shoulder Stand Pose- Sarvanga-asana:Beneficial in several endocrine gland anomalies, enhances blood circulation and nutrient absorption and increase lungs capacity. It is beneficial in irritation, short temper, common cold, urinary disorders.

The Plow Pose - Hala-asana:It increases lungs capacity, digestive power, endocrine function increase, muscles strength and flexibility in hands and body.

Cobra Pose - Bhujanga-asana:This posture increases the lungs capacity and gastric fire. It destroys all diseases; provide greater strength in these areas and flexibility in the lower back.

Common Benefits of Aasana:It increases the working efficiency of the all systems especially cardio respiratory system, increase capacity of lungs and reduces attack of asthma, increases functions of circulatory system, endocrine system, increases muscles strength, flexibility and immunity.

Effect of pranayama [14]

Improvement of respiratory efficiency reduces dead space volume of lungs, increases blood production and circulation, promotes new stem cell formation and also increases immunity. Rapid Kapalbhati Pranayama (Hyperventilation) is balancing the acid base homeostasis. In Kapalbhati Pranayama convenient is forced exhalation that causes contraction and relaxation activity in diaphragm and abdominal muscles that has beneficial effects on various organ of the stomach therefore organs of the stomach becomes strong and active that leads to plenty secretions from endocrine glands. Lungs take air 180-220 cubic inches. Normally 30 cubic inches air used during inhale and exhale and around 150 cubic inches remains in the lungs as residual air. A deep long breath with Pranayama is able to use up to 100 cubic inches of the air that making major part of the lungs air active. If the residual air gets purified, the food digested properly, organs become strong, and the body as a whole is cleaned .Short, incomplete and fast breathing does not live long life. The longer the breathing cycle and slower the rate of breathing, the longer is the life. This is secret behind the long life of tortoise and shorter life of Pigeon. By practicing Pranayama individual survive able to increase the life span and maintain their health.

Yoga is an ancient discipline designed to bring balance and health to the physical, mental, emotional, and spiritual dimension of the individual. Various studies have shown the effectiveness of these techniques in asthma [15-17].

Pranayama has been suggested to be useful in the management of respiratory conditions such as asthma. Yoga includes deep, nasal breathing that strengthens the diaphragm and enables the lungs to fill completely to provide oxygen to the lower lobes. Nostril breathing helps in warming the air and filter out irritants making asthmatic attacks take away likely. In Pranayama focus is turned to the breath and inhalation is balanced with exhalation with slow, deep breaths. Asthma is a condition in that the bronchioles constrict causing symptoms such as wheezing, shortness of breath, and chest tightness [18]. Bidwell et al. found that a 10 week yoga intervention improved respiratory function and quality of life in a small population of asthmatic women [19]. In a larger randomized controlled trial the yoga group demonstrated improved pulmonary measures, including peak expiratory flow rate and initial forced expiratory volume as well as decreased event of exercise induced broncho constriction [20]. Manocha et al. found that airway hyper responsiveness to methacholine improved significantly in the Yoga group evaluate with controls [21].