PATIENTS AND PARAMETERS

The details of the patients are furnished in Table 1.

The follow-up duration varied from 3 to 54 months. The first group entered the study in June 1979 and the last group in December 1983.

Table 1. Details of Patients

The various parameters, listed below, were recorded before and during each of the followup visits.

SPECIFIC PARAMETERS

1. Number of attacks per week: The average number of attacks per week over the period of study was recorded at each of the follow-up meetings. In the initial record, for seasonal asthmatics, the average number of attacks per week for the worst months of the previous year was noted. In perennial cases, the average number of attacks per week for the previous year was noted.

2. Duration of attacks: Average duration of an attack was noted as per the subject's statement and crosschecked with his diary.

3. Number of months: Number of months in the year during which the person suffered from asthma.

4. Nasal allergy: The three main symptoms of allergic rhinitis, i.e., sneezing, rhinorrhea, and nasal blockage, were scored 1 each.

5. Severity of attacks: The three grades of severity were:

	(1) Mild: Wheezing that did not disturb the sleep at night or the daily routine.
	(2) Moderate: Disturbed sleep and the daily routine, required medication orally or parenterally. Fewer than 12 injections were used per year.
	(3) Severe: Great distress, calling for an injection and/ or hospitalization. Required 12 or more injections per year.

6. Medication per week: The average number of bronchodilator tablets per week consumed by the patient during the period of follow-up was recorded. If a person was taking Ayurveda medicines, the same was calculated in terms of average number of tablets per week. In the case of powders one packet was calculated as one tablet.

7. Cortisone: The average number of tablets of cortisone per year was counted separately.

8. Injections: Total number of injections per year was noted as a different parameter. Whenever it was noted that a patient had changed over to a different system of medicine during the follow-up period, that case was discarded from the study from that date.

9. Peak expiratory flow rate: PFR (in liters/minute) was obtained by noting the best of the three exhalations on a miniature Wright's PFR meter. As this measurement is considered a sensitive indicator of the presence or absence of airway obstruction comparable to the FEV1/FVC ratios by several workers, PFR values obtained before and after the yoga training period and periodically during the long-term follow-up period are used in this study as a specific parameter in the evaluation of the response.

10. Wheezing, 11. Ronchi and 12. Crepitations: On careful ausculation of the chest their presence or absence was recorded as plus or minus.

Triggering Factors

The various triggering factors as observed by the patient were recorded at each of the visits. No grading has been used for these parameters. The presence or absence of sensitivity to these agents was recorded as plus or minus.

13. Dust.

14. Smoke, vapors, strong scents, incense sticks, etc.

15. Emotion: Anxiety, tension, unusual distress, etc.

16. Weather: Influence of weather conditions.

17. Food: Particular items of food, such as bananas, eggs, buttermilk, or ice cream, that the patients had noticed as a triggering factor.

18. Exercise: Running or heavy work inducing wheezing. The first 12 parameters, which can be considered direct indicators of a person’s asthmatic state, we call specific parameters. They include both subjective and objective ones. The second category (parameters 13 to 18) comprises the triggering factors. Other parameters that are indicators of the general effects of yoga are called general parameters.

General Parameters

19. Cough: The average duration of cough per day was graded into three degrees.

	(1) Less than 5 min per day.
	(2) 5 to 10 min per day.
	(3) More than 10 min per day.

20. Sputum: Quantity of sputum was noted. The three grades are:

21. Fever: Number of attacks in a year of the febrile periods associated with respiratory infection.

22. Sore throat: Number of attacks of acute pharyngitis or tonsillitis in a year.

23. Breathlessness on exertion:

24. Other symptoms: Patients with a history of any other associated major respiratory ailments like emphysema, chronic obstructive airway disease, tuberculosis, etc., were not included in the study. Patients with any other chronic illnesses, such as hypertension, IHD, or diabeteswere also excluded from the study. Asthma associated minor symptoms like headaches, low back pain, and general weakness were listed under this parameter. Each of the symptoms received a score of 1 for purposes of analysis under this group.

25. Pulse rate (PR): Pulse rate counted for 1 min.

26. Respiratory rate (RR): Number of inspirations in 1 min.

27-28. Blood pressure (BP): Using a sphygmomanometer, the systolic (27) and diastolic (28) BP were recorded by the ausculatory method.

29. Chest expansion: Chest expansion in centimeters was recorded by noting the difference in chest measurement between complete exhalation and deep inhalation.

30. Breath-holding time (BHT): After a standardizing deep inhalation followed by complete exhalation, the patient was asked to inhale deeply and hold the breath as long as he could while being timed.

Classification of yoga groups: During the follow-up visits, participants were encouraged to give an honest report of the regularity of their yoga practice and were grouped into three categories accordingly.

1. Regular: Those who practiced yoga for 1 hr daily for more than 16 days in a month on an average were classified as regular practitioners.

2. Irregular: This group of patients continued practicing yoga for about 1 hr a day but irregularly. Empirically we placed a patient in the irregular group if he had practiced yoga for fewer than 15 days per month on an average.

3. Discontinued: This category included all those who had discontinued practicing yoga on their own, after varying periods of regular practice after the initial training.