European Journal of Cardiovascular Medicine

Aging leads to a progressive decline in respiratory efficiency due to structural and functional changes in the lungs and chest wall. Reduced lung elasticity, weakened respiratory muscles, and diminished alveolar surface area contribute to impaired gas exchange and increased risk of respiratory diseases (1). Additionally, age-related changes in the nervous system alter the autonomic control of breathing, leading to decreased respiratory drive and inefficiency in ventilation. The thoracic cage also undergoes stiffening due to calcification of costal cartilage, further limiting lung expansion. These factors collectively result in decreased forced vital capacity (FVC) and forced expiratory volume in one second (FEV1), leading to compromised respiratory function.

Yogic exercises, including pranayama (breathing techniques) and asanas (postures), have gained recognition as effective non-pharmacological interventions to enhance pulmonary function (2,3). Physiologically, these practices improve pulmonary compliance, increase alveolar recruitment, and enhance respiratory muscle endurance. Deep breathing exercises stimulate the parasympathetic nervous system, reducing sympathetic overactivity that is commonly associated with stress-related respiratory dysfunctions. Furthermore, controlled breathing patterns improve ventilatory efficiency by optimizing tidal volume and reducing the dead space ventilation, which is particularly beneficial in elderly individuals with compromised lung function (4). This article evaluates the impact of yogic breathing and exercises on pulmonary function tests (PFTs) in the elderly, with a focus on their physiological benefits.

Physiological Aspects of Pulmonary Function Decline in Aging Aging affects pulmonary function through various physiological changes:

1. Reduced Lung Compliance: The loss of elastic recoil

in lung tissue leads to decreased forced expiratory volume (FEV1) and forced vital capacity (FVC).

2. Weakened Respiratory Muscles: Age-related sarcopenia affects the diaphragm and intercostal muscles, leading to inefficient ventilation.
3. Altered Gas Exchange: Thickening of the alveolar-capillary membrane and reduced pulmonary perfusion impair oxygenation.
4. Increased Airway Resistance: Loss of airway elasticity contributes to higher resistance and reduced expiratory flow rates.
5. Impaired Neural Control: Aging affects the central respiratory centers, leading to slower response to hypoxia and hypercapnia, thereby compromising adaptive breathing mechanisms.

Yogic Exercises and Their Impact on Pulmonary Function Tests Yogic exercises, including asanas and breathing techniques, have been shown to counteract age-related pulmonary decline. Specific benefits include:

1. Pranayama (Deep Breathing Techniques):

• AnulomVilom (Alternate Nostril Breathing): Enhances lung ventilation, improves alveolar recruitment, and reduces airway resistance.
• Bhastrika (Bellows Breathing): Strengthens respiratory muscles and increases lung capacity.
• Kapalabhati (Cleansing Breath): Promotes diaphragmatic breathing and clears secretions from airways.

2. Yoga Asanas:

• Bhujangasana (Cobra Pose): Expands the thoracic cavity, increasing lung volume.
• Matsyasana (Fish Pose): Opens up the chest and improves lung compliance.
• Tadasana (Mountain Pose): Encourages deep breathing and enhances respiratory endurance.

A randomized controlled study was conducted with 100 elderly participants (aged 60–80 years). Participants were divided into two groups: an intervention group performing yogic exercises and deep breathing techniques for 12 weeks, and a control group with no specific intervention. Pulmonary Function Tests (PFTs) were recorded before and after the intervention using a spirometer, measuring Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), and Peak Expiratory Flow Rate (PEFR). Statistical analysis was performed to determine significant changes in lung function.

The following table summarizes the pre- and post-intervention results for pulmonary function parameters:

The results indicate that a 12-week yogic exercise and deep breathing intervention significantly improved pulmonary function in elderly participants. The observed increase in FVC and FEV1 suggests improved lung compliance and respiratory muscle strength. The rise in PEFR indicates

enhanced airway clearance and reduced airway resistance(5,7). Physiologically, these improvements may be attributed to increased diaphragmatic engagement, better lung expansion, and enhanced oxygen exchange.

Additionally, the autonomic regulation provided by pranayama likely contributed to improved breath control and reduced respiratory rate, facilitating more efficient ventilation (8). Deep breathing enhances vagal tone, promoting parasympathetic dominance, which leads to a reduction in stress-induced hyperventilation and improved oxygen delivery to tissues (10). Furthermore, slow, controlled breathing reduces oxidative stress and inflammation, both of which are implicated in age-related lung function decline (9).

The control group exhibited no significant improvements, highlighting the importance of an active intervention. These findings suggest that incorporating yoga and deep breathing into daily routines may serve as a viable non-pharmacological approach to mitigating pulmonary function decline in older adults (11). Future studies should explore the long-term effects of these interventions and their role in preventing chronic obstructive pulmonary diseases (COPD) and other age-related respiratory disorders.

Clinical Implications

 The integration of yogic breathing and exercises into routine healthcare for older adults can significantly improve pulmonary function and respiratory efficiency. These interventions offer a cost-effective, non-invasive approach to managing age-related respiratory decline and preventing chronic pulmonary diseases.

Yogic exercises and deep breathing techniques provide substantial physiological benefits for pulmonary function in older adults. By enhancing lung capacity, improving respiratory muscle strength, and optimizing oxygenation, these practices serve as effective strategies for maintaining respiratory health in aging populations. Further research and clinical trials are needed to establish standardized protocols and validate long-term benefits.

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