International Standard Serial Number 2321-7049

International Journal of Medical & Pharmaceutical Sciences Research and Review Vol. 1 (4)
INTERNATIONAL JOURNAL OF MEDICAL &
PHARMACEUTICAL SCIENCES RESEARCH & REVIEW
Research Article…..!

Received: 20-10-2013; Accepted: 11-11-2013

EFFECT OF 12 WEEKS OF KAPALABHATI PRANAYAMA TRAINING
ON CARDIO-RESPIRATORY PARAMETERS IN YOUNG, HEALTHY
VOLUNTEERS OF JIPMER POPULATION
Dinesh T1,Gaur G S2, Sharma V K3,Velkumary S4, Ananda Balayogi
Bhavanani 5
1
Department of Physiology, Vinayaka Mission’s Medical College, Karaikal –
609605.
2
Department of Physiology, Jawaharlal Institute of Postgraduate Medical
Education & Research, Puducherry – 605006.
3
Department of Physiology, Jawaharlal Institute of Postgraduate Medical
Education & Research, Puducherry – 605006.
4
Department of Physiology, Jawaharlal Institute of Postgraduate Medical
Education & Research, Puducherry – 605006
5
Deputy Director, CYTER, Mahatma Gandhi Medical College and Research
Institute, Puducherry - 607 402.
Corresponding Author: Dr. Dinesh T, Assistant Professor.
ABSTRACT

BACKGROUND

In the recent decades, interest has been increasing all over the world in the
applications of yogic techniques in the field of therapeutics and research.
Pranayama are breathing techniques that exert profound physiological effects on
pulmonary, cardiovascular and mental functions.

www.ijmpsrr.com Page 53
 International Standard Serial Number 2321-7049
OBJECTIVE

To study the effect of 12 weeks of Kapalabhati pranayama training on cardio-

respiratory parametersin healthy, young subjects.

KEYWORDS: Kapalabhati pranayama, Heart Rate, Blood Pressure, Respiratory

rate.
INTRODUCTION
Yogic system was developed by the sages of India which has been practiced
down the ages. In the recent decades, interest has been increasing all over the
world in the applications of yogic techniques in the field of therapeutics and
research. With increased awareness and interest in alternative and complementary
remedies, yogic techniques including pranayama are gaining importance and
becoming acceptable to the public as well as scientific community(1). Pranayama
are breathing techniques that exert profound physiological effects on pulmonary,
cardiovascular and mental functions. The science of pranayama deals with the
knowledge, control and enrichment of this vital force which results in rhythmic
respiration, calm and alert state of mind. Pranayama has variable effect on cardio-
(2)
respiratory system . Regular practice of pranayama improves cardio-vascular
and respiratory functions, improves autonomic tone towards parasympathetic
system, decreases the effect of stress and strain on the body and improves
physical and mental health (1, 3, 5). The word kapalbhati is made up of two words:
kapal meaning 'skull' (here skull includes all the organs under the skull too) and
bhati meaning 'shining, illuminating'. The technique of Kapalabhati involves
short and strong forceful exhalations and inhalation happens automatically. The
aim of the study is to find out the beneficial effects of Kapalabhati pranayama
training on cardio-respiratory parameters in young, healthy, volunteers of both
genders.

www.ijmpsrr.com Page 54
 International Standard Serial Number 2321-7049
MATERIALS AND METHODS

The Present study was conducted in Department of Physiology, JIPMER on 62

healthy volunteers. The distribution was n=32 Pranayama training group and
control groups n=30. Kapalabhati pranayama started with 30 times for 1 min and
increased to 5 minutes/day, twice daily, thrice/ week for 12 weeks. Cardio-
respiratory parameters including resting heart rate (HR), systolic blood pressure
(SBP) and diastolic blood pressure (DBP) measured after 10 minutes of supine
rest.Respiratory rate (RR) was recorded before and after 12 weeks of study
period.

The Present study was conducted in Department of Physiology, JIPMER on 62

healthy volunteers of both genders, after obtaining clearance from the Institute
Ethics Committee. Subjects were randomized into pranayama (n=32) and control
groups (n=30), after getting informed, written consent. Mean age of the
volunteers was 18.54 + 1.65 yrs. The subjects were familiarized with the aim and
objective of the study as well as laboratory environment.

PARAMETERS ANALYZED

Cardio-respiratory parameters including resting HR, SBP and DBP were

measured after 10 minutes of supine rest using digital BP monitor (Citizen- CH
432B, Japan) and respiratory rate (RR) was recorded passively by observing the
abdominal movements while recording the HR and BP. The same procedure was
followed while recording post values at the end of 12 weeks of pranayama
training.

www.ijmpsrr.com Page 55
 International Standard Serial Number 2321-7049
PRANAYAMA TRAINING

Supervised pranayama training was given to the study group by a certified yoga
instructor at Advanced Centre for Yoga Therapy Education and Research
(ACYTER), JIPMER, Puducherry according to the guidelines of Morarji Desai
National Institute of Yoga, New Delhi and they practiced Kapalabhati pranayama
started with 30 times or one minute and increased to 5 minutes/day, twice daily,
thrice/week for 12 weeks. Rests of the days, subjects were motivated to practice
at their home. Control group did not involve in any pranayama training during
this 12 weeks study period.

STATISTICAL ANALYSIS

Data for all parameters at baseline and post test were collected according to the
study protocol and computerized in Microsoft Excel database. Data were
summarized by using descriptive statistics such as percentage, mean and SD for
different parameters. Longitudinal changes in each group were compared by
using Student’s paired t-test. P<0.05 was considered statistical significant.

RESULTS
Pranayama training resulted in marginal decrease (P>0.05) in all basal
cardiovascular parameters while RR decreased significantly (P<0.01). On the
other hand, there was a significant (P<0.05) increase in RR.

Mean age of the volunteers was (18.54 + 1.65). The analysis on the effect of 12
Weeks of Kapalbhati pranayama on cardio-respiratory parameters has been given
in Table No.1 that shows a significant decrease in RR from 17.34 ± 2.09 to 16.41
± 0.61(P=0.03) and Marginaldecrease in other parameters (P>0.05) such as SBP,
DBP and HR.

www.ijmpsrr.com Page 56
 International Standard Serial Number 2321-7049
Table. 1 Effect of 12 weeks of Kapalabhati pranayama training (n=32) on cardio-
respiratory parameters: heart rate (HR), systolic blood pressure (SBP), diastolic
blood pressure (DBP) and respiratory rate (RR). Values are expressed as mean ±
SD.

Parameters Before pranayama training After pranayama training

HR(beats/min) 85.47 ± 10.47 83.75 ± 8.91**

SBP (mmHg) 112 ± 11.71 110.68 ± 10.74*

DBP (mmHg) 72.44 ± 10.92 72.16 ± 9.52*

RR(beats/min) 17.34 ± 2.09 16.41 ± 0.61***

Analysis done by Student’s paired t-test. *P<0.05, **P<0.01, ***P<0.001.

Table. 2 Changes in control group (n=30) after 12 weeks of study period

oncardio-respiratory parameters: heart rate (HR), systolic blood pressure (SBP),
diastolic blood pressure (DBP) and respiratory rate (RR). Values are expressed as
mean ± SD.

Parameters Before 12 weeks study period After 12 weeks study period

HR (beats/min) 86.33 ± 9.65 87.47 ± 7.78*

SBP (mmHg) 107.23 ± 13.55 111.4 ± 11.24**

DBP (mmHg) 71.45 ± 6.791 73.73 ± 9.239*

RR(beats/min) 17.23 ± 1.22 18.33 ± 1.81*

Analysis done by Student’s paired t-test. *P<0.05, **P<0.01, ***P<0.001.

www.ijmpsrr.com Page 57
 International Standard Serial Number 2321-7049
DISCUSSION
Pranayama involves manipulation of breath movement and the breath is a
dynamic bridge between the body and mind. The psychosomatic effects of
different pranayama are believed to derive from differences in duration of the
phases of the breathing cycle, tidal volume and other factors including the use of
mouth, nostrils, and constriction of the laryngeal muscles and position of the
(6)
glottis . Resting HR is determined mainly by parasympathetic tone and
decrease in HR and BP indicates a decrease in sympathetic activity and / or
increase in parasympathetic activity (7,8). Our results demonstrate that there was a
significant reduction in RR in pranayama group. On the contrary, there was a
significant increase in RR in the control group. There was statistically
insignificant, but definite trend towards decrease in HR, SBP and DBP in the
pranayama group. According to the traditional wisdom of yoga, pranayama is the
key for bringing about psychosomatic integration and harmony. By voluntarily
(9)
controlling breathing pattern, it is possible to influence ANS functions . Very
few references are available on the effect of fast pranayama training on cardio-
respiratory parameters in individuals. Our results are in agreement with that of
Raghu raj et al in 1998 found practicing fast pranayama like Kapalabhati for 12
weeks lead to decrease in sympathetic activity and are not in agreement with
observations of few other studies. Madanmohan et al in 2005 evaluated short-
term effect of three weeks of fast pranayama (bhastrika) practice on cardio-
respiratory variables and reported an increase in sympathetic activity whereas Pal
et al in 2004 found no change in autonomic activity by the practice of 12 weeks
(10,11)
of Kapalabhati pranayama . Another study conducted by Kullok et al in
1990 explained changes in autonomic activity by breathing exercises on the basis
of known anatomical asymmetries in the respiratory, cardiovascular and nervous
system and that the coupling mechanisms between each of these systems: lung-
(13)
heart, heart-brain and lungs-brain are also asymmetrical . We propose that
www.ijmpsrr.com Page 58
 International Standard Serial Number 2321-7049
these changes may have occurred by pranayama practice due to improved
autonomic tone towards parasympathodominance resulting in hypo metabolic
state, relaxed state of mind and improved cardiac vagal tone. When the mind is
relaxed and resting, parasympathetic activity increases and RR decreases.
Increase in parasympathetic activity decreases resting HR and decrease in
sympathetic tone in skeletal muscle, blood vessels, decreases peripheral vascular
resistance and hence, decrease in DBP and improved tissue perfusion. Further our
study substantiates the claim that Kapalabhati pranayama practice is beneficial on
cardio-respiratory function in healthy, volunteers.

CONCLUSION

12 weeks of Kapalabhati pranayama training showed improvement in the cardio-

respiratory parameters with significant decrease in RR may be attributed to a
calm and stable mind-emotion complex in our subjects. Hence we conclude that
pranayama training is useful in reducing RR through psycho-somatic
mechanisms and that this enhances the health and well being of young subjects.

ACKNOWLEDGEMENT
we acknowledge programme director, coordinator, yoga instructors of ACYTER,
JIPMER. Author would like to thank Professors, Assistant Professors, Ph. D,
scholars of Department of Physiology, JIPMER who helped us for the conduct of
this project.

www.ijmpsrr.com Page 59
 International Standard Serial Number 2321-7049
REFERENCES
1. Udupa K, Madanmohan, Ananda AB, Vijayalakshmi P, Krishnamoorthy N.
(2003) Effect of pranayama training on cardiac function in normal young
volunteers. Indian J Physiology Pharmacology volume 47: PP27-33.
2. Veerabhadrappa SG, Baljoshi VS, Khanapure S, Herur A, Patil S, Ankad RB,
Chinagudi SJ. (2011) .Effect of yogic bellows on cardiovascular autonomic
reactivity. Cardiovascular Diseases research journal Volume ; 2(4): 223-27.
3. Udupa KN, Singh RH. (1972) The scientific basis of yoga. JAMA; volume
220(10): PP1365
4. Wallace RK, Benson H, Wilson AF. A wakeful hypo metabolic physiologic
state.( 1971) American J Physiology; volume 221(3): 795-99.
5. Bhargava R, Gogate MG, Mascarenhas JF. (1988 )Autonomic responses to
breath holding and its variations following pranayama. Indian J Physiology
Pharmacol; volume 32(4): PP 257-64.
6. Telles, Desiraju T. Heart rate alterations in different types of pranayama. (1992)
Indian J PhysiologyPharmacology; volume 36(4): PP 287-88.

7. Gopal KS, Bhatnagar OP, Subramanian N, Nishith SD. (1973); Effect of

yogasanas and pranayama on BP,pulse rate and some respiratory functions.
IndianJ Physiology Pharmacology volume17: PP 273–76.
8. Upadhyay DK, Malhotra V, Sarkar D, (2008) Prajapati R. Effect of alternate
nostril breathing exercise on cardio respiratory functions. Nepal Med Coll J;
volume10(1): PP 25-27.
9. Jerath R, Edry JW, Branes VA, Jerath V. (2006) Physiology of long
pranayama breathing: Neural respiratory elements may provide a mechanism
that explains how slow deep breathing shifts the autonomic nervous system.
Med Hypotheses PP 67:56–71.
10. Raghu raj P, Ramakrishna AG, Nagendra HR. (1998 )Effect of two related
yogic breathing techniques on heart rate variability. Indian J Physiology
Pharmacology volume; 42(4): PP 467-72.
11. Madanmohan, Udupa K, Bhavanani AB, Vijayalakshmi P, Surendiran A. (2005)
Effect of slow and fast pranayamas on reaction time and cardiorespiratory
variables. Indian J PhysiologyPharmacology volume; 49: PP 313–18.

www.ijmpsrr.com Page 60
 International Standard Serial Number 2321-7049
12. Pal GK, Velkumary S, Madanmohan(2004). Effect of short- term practice of
breathing exercises on autonomic functions in normal human volunteers.
Indian J Med Research; volume 120:PP115–21.
13. Kullok S, Maver C, Backon J, Kullok J. (1990 ) Interactions between non-
symmetric mechanical vector forces in the body and the autonomic nervous
system. Med Hypotheses; volume 32: PP173–80.

www.ijmpsrr.com Page 61