Effects of yoga breathing exercises on pulmonary function in patients with Duchenne muscular dystrophy: an exploratory analysis

Abstract

OBJECTIVE: Duchenne muscular dystrophy (DMD) is the most common form of muscular dystrophy in children, and children with DMD die prematurely because of respiratory failure. We sought to determine the efficacy and safety of yoga breathing exercises, as well as the effects of those exercises on respiratory function, in such children. METHODS: This was a prospective open-label study of patients with a confirmed diagnosis of DMD, recruited from among those followed at the neurology outpatient clinic of a university hospital in the city of São Paulo, Brazil. Participants were taught how to perform hatha yoga breathing exercises and were instructed to perform the exercises three times a day for 10 months. RESULTS: Of the 76 patients who entered the study, 35 dropped out and 15 were unable to perform the breathing exercises, 26 having therefore completed the study (mean age, 9.5 ± 2.3 years; body mass index, 18.2 ± 3.8 kg/m2). The yoga breathing exercises resulted in a significant increase in FVC (% of predicted: 82.3 ± 18.6% at baseline vs. 90.3 ± 22.5% at 10 months later; p = 0.02) and FEV1 (% of predicted: 83.8 ± 16.6% at baseline vs. 90.1 ± 17.4% at 10 months later; p = 0.04). CONCLUSIONS: Yoga breathing exercises can improve pulmonary function in patients with DMD.

Musculoskeletal simulation can help explain selective muscle degeneration in Duchenne muscular dystrophy

“…Multiscale models of the musculoskeletal system of humans and animals can be built to reflect these biomechanical differences, and simulations can then be carried out to examine whether the differences affect the response of muscles to exercise and to determine to what extent the findings from animal studies may be applied to humans. Some human studies have shown improvement in function and endurance of dystrophic muscles from exercises, but the contraction‐induced damage to muscles still remains the biggest concern, and the necessary parameters (type, intensity, frequency, duration, etc.) that define appropriate beneficial exercises have not been established .…”

Comparison of Experimental Protocols of Physical Exercise for mdx Mice and Duchenne Muscular Dystrophy Patients

“…Non-assisted training involved resistive inspiratory muscle training [103, 104] or yoga [109]. Assisted training involved the use of special apparatus [101, 108], video games [102], breathing through a valve [105, 106, 110] or resistance to a load [107] (Table 2B).…”

“…Non-assisted training improved maximal resistance, duration of ventilation [103], inspiratory airway pressure [104], forced expiratory volume in 1 s [109], and vital capacity [104, 109]. Assisted training improved maximal voluntary respiration, maximal achieved respiration [102], maximal sniff assessed oesophageal and transdiaphragmatic pressure [105], static inspiratory/expiratory pressures [107] and inspiratory mouth pressure, as well as 12 s maximal voluntary ventilation [108, 110], duration of progressive isocapnic hyperventilation manoeuvre [102] and respiratory muscle endurance [105, 106].…”

Effect of Yoga Breathing Exercises on Ventilatory Function

“…Spirometry is a procedure that measures the volume of air an individual inhales or exhales as a function of time [1][2][3][4][5][6][7][8][9][10][11] . The measurement was performed with the subject in an upright position, usually seated.…”

“…Over-worked, under-slept, and feeling pressure may impair breathing pattern. There are some yoga breathing exercise techniques that improve ventilatory function [1][2][3][4] .…”