Respiratory Rehabilitation through Pranayama and Yogic Practice: Effects on Spirometric Indices, Inflammatory Biomarkers, and Quality of Life in Adults with Chronic Obstructive Pulmonary Disease

Abstract

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder associated with substantial global morbidity and mortality, necessitating adjunctive non-pharmacological interventions. Pranayama, a yogic breathing practice, demonstrates therapeutic potential in pulmonary rehabilitation; however, evidence integrating pulmonary, haematological, and quality-of-life outcomes in GOLD-staged COPD remains limited. This study evaluated adjunctive efficacy of pranayama on pulmonary function, biomarkers, and quality of life. This prospective cohort study enrolled 100 GOLD Stage II and III COPD patients and were allocated into an intervention group receiving pranayama and yogic asana - Kapalabhati, Anuloma-viloma, Bhastrika, Sasangasana and Bhramari for 30 minutes daily alongside pharmacotherapy, and a control group receiving pharmacotherapy alone. Spirometric indices, SpO2, mMRC score, SGRQ, leucocyte counts, CRP, and creatine kinase were assessed at baseline and six weeks. The intervention group demonstrated significant improvements across all outcome domains compared to controls (p = 0.0010). FEV1 increased from 1.33 L to 1.89 L (+0.56 L), FVC from 2.03 L to 2.38 L (+0.35 L), FEV1/FVC ratio from 0.66 to 0.80 (+0.13), and PEFR from 3.24 L/min to 4.19 L/min (+0.95 L/min). Peripheral oxygen saturation improved from 90.9 to 92.1%, and mMRC dyspnea score declined from 2.48 to 0.76. SGRQ domains including symptoms, activity and impact showed substantial reduction. Total leucocyte count, neutrophil, eosinophil, C-reactive protein, and creatine kinase decreased while lymphocyte percentage increased, indicating a favourable immunomodulatory response. Six weeks of structured pranayama as an adjunct to pharmacotherapy conferred multidimensional clinical benefits across pulmonary function, dyspnea severity, health-related quality of life, haematological indices, and inflammatory biomarkers in GOLD Stage II and III COPD patients. Pranayama represents a safe, cost-effective, evidence-based rehabilitation that warrants integration into comprehensive COPD management protocols, particularly within resource-constrained healthcare settings.