MATERIAL AND METHODS

The details of 86 patients with established bronchial asthma satisfying the clinical criteria of Crofton, Douglas and Shivpuri (5, 6) are presented in Table - 1.

Table 1
Age and other physical features in Asthma patients selected for study (n=86)

The group chosen had an average of 4.9 attacks per week. An attack was defined as an episode of wheezing and dyspnoea which stopped the patient from continuing his relaxation practices and would have normally required an inhaler or tablet according to the patient’s earlier experience. None of these patients could get their episodes relieved without resorting to drugs. Before taking up yoga therapy, 30% of the patients used steroids to overcome their episodes of airway obstruction. These patients were undergoing an integrated approach of yoga training in seven of our camps (of two weeks duration) spread over three years covering various seasons. (7-9). During the training programme, the patients were taught the yoga chair breathing procedure with the following eight steps :

1. Relaxation using Chair as an arm support

	a) Sit on the carpet with legs stretched. Pull the chair towards the chest with head and arms collapsed on the seat of the chair.
	b) Tense the entire body from toes to head and relax.
	c) Regional relaxation from toes to head.

             
Fig. Chair breathing. Demonstration of neck movements

2. Neck muscle relaxation with chair support. (Fig.)

	a) Move the neck backwards and forwards slowly to relax the posterior neck muscles - five times.
	b) Inhale as deeply and as slowly as possible while bending the neck backwards, exhale while moving forwards - five times.
	c) Chant ‘AA’ in a low tone while bending the neck forwards - five times.

3. Neck movements in Vajrasana

	a) Move the neck forwards and backwards as before (2a), remove the chair and sit in Vajrasana - five times.
	b) Inhale while going back, exhale while bending forward - five times
	c) Chant 'AAA' while bending the neck forward - five times.

4. Sasankasan

	a) Bend backward and forward from the waist while sitting in Vajrasana - five times.
	b) Synchronise the breathing with this movement - five times.
	c) Chant 'MMM' (Bhramari Pranayama) while bending forward - five times.

5. Tadasana (about one minute): Relax from toes to head while standing in tadasana.

6. Neck movements in Tadasana 

	a) Forward and backward - five times
	b) With breathing - five times
	c) With breathing and Bhramari - five times

7. Ardha Chakrasana - Pada Hastasana

	a) Bend forward from Tadasana to Padahastasana slowly and raise unto Tadasana, and bend backward to Arda Chakrasana return to Tadasana - five times
	b) Tadasana - Pada Hastasana - Tadasana - Ardha Chakrasana- Tadasana series with breathing- five times
	c) Movement, breathing and Bhramari- five times

8. Savasana

	a) Feel the natural abdominal movements building up
	b) With breathing- five times
	c) Movement, breathing and 'AA' sound

The whole procedure normally takes 25 minutes to 60 minutes. These patients developed a wheeze when they were learning the relaxing yoga practices. Right then, they were asked to come out of the regular yoga training, pull a nearby chair, sit on the ground and start the eight step yoga-chair-breathing procedure. The PFR reading was taken using a mini Wright's PFR Meter before and after the procedure. The total time taken in seconds for the complete procedure was noted using a stopwatch. The subjective feeling of well being and the presence of wheezing before and after were recorded in remarks column.

Those who did not improve at the end of second round of this relaxation procedure were advised to take their usual bronchodilator drug to get back to normalcy. Sometimes, the patients were in a hurry to go home and did not have enough time to complete their procedure. During the first few episodes, the patients were given suggestions to follow the procedure in the specified way. This helped them to overcome their panic and anxiety elements. The doctor incharge kept watch during the episode and administered drugs when found necessary. Later, the patients followed the procedure by themselves. The data presented relate to these latter events. They were also asked to resort to yoga chair breathing even at home and keep a diary of attacks and report their experiences. While large number of such cases on each patient was available, no more than three episodes per patient have been included in this presentation. The patients used this yoga-chair-breathing procedure whenever they felt the onset of an attack during their post -training rehabilitation phase.