DISCUSSION

Mc Fadden and team have studied the relation between the clinical and physiological manifestations in acute asthma (10). They found that even when patients were asymptomatic after an attack, their lung functions were only 40-50% of their predicted normal and when they were without signs (i.e., audible rhonchi in the chest) their mechanical lung functions were 60-70% of their predicted normal. Hence they warn that although the patients are asymptomatic after an attack this may form a base for further attacks. In our series too (I group) we have observed that although there was a significant increase in PFR, it was much below their predicted normal values. However, we noticed an overall significant reduction in mean attacks per week and medication scores during the 15 days of practice as well as in the long term follow-up in these patients (8). Hence, these results point to the fact that yoga-chair-breathing is effective as well as risk-free and could be used in all cases during attacks.

Philip has reported the differential effects of suggestion and relaxation on asthmatics in a controlled study (2). Relaxation training improved respiratory efficiency on short-term basis and also the patients tolerance to Mecholyl. The authors point out that anxiety may influence by increasing the autonomic arousal which may provoke, aggravate, or prolong the attack induced by external agents. Relaxation training helps to break the vicious cycle of anxiety and bronchospasm by deconditioning and lowering the general level of arousal of autonomic nervous system.

Yoga-chair-breathing that helps to divert the mind and move the individual into a relaxed serene Mood works similarly by warding off this panic element. Self-confidence is built up by observing the co-participants getting over their attacks (group therapy effect). The understanding of the theory of yoga helps to develop an internal awareness thus leading to a perception of the respiratory passages. The slowing down of the entire system leads to stabilisation of the nervous system, thus reducing the hyperactivity in both the afferent and efferent neurological pathways involved in the minimum dose of the bronchodilator drugs and prevent the progression to status asthmaticus (acute severe asthma).