Cochrane for Clinicians

Putting Evidence into Practice

Effects of Yoga in Patients with Asthma

 

Am Fam Physician. 2017 Aug 1;96(3):159-160.

Author disclosure: No relevant financial affiliations.

Clinical Question

Does yoga improve quality of life and symptoms in patients with asthma?

Evidence-Based Answer

Regular yoga improves quality of life as measured on the Asthma Quality of Life Questionnaire (mean difference = 0.57 units on a seven-point scale; 95% confidence interval [CI], 0.37 to 0.77); improves asthma symptoms (standardized mean difference = 0.37; 95% CI, 0.09 to 0.65); and reduces medication use (relative risk [RR] = 5.35; 95% CI, 1.29 to 22.11). However, the high risk of bias and heterogeneity in the included studies limit firm conclusions about the role of yoga in the care of patients with asthma.1 (Strength of Recommendation: B, based on inconsistent or limited-quality patient-oriented evidence.)

Practice Pointers

Asthma affects 24.6 million Americans.2 In the United States, asthma care costs more than $12.7 billion annually and is associated with absenteeism costs from $6 million to $383 million per state.3 Yoga practice is also prevalent in the United States, with 21 million adult practitioners. Some evidence suggests that yoga may be helpful in improving asthma symptoms and asthma-related quality of life. The authors of this review investigated the effects of yoga on patients with asthma.

This review included 15 randomized controlled trials with 1,048 participants.1 Yoga improved quality of life by a mean 0.57 units on each item of the seven-point scale on the Asthma Quality of Life Questionnaire (95% CI, 0.37 to 0.77), in which a 0.5-unit change is considered significant. Yoga also improved asthma symptoms (standardized mean difference = 0.37; 95% CI, 0.09 to 0.65), although there is no defined minimal clinically important difference for the scale used to assess this. Yoga also reduced medication use (RR = 5.35; 95% CI, 1.29 to 22.11); however, the medications assessed varied among studies, and two studies that were not included in the review demonstrated no differences in medication use.

Yoga had a mixed effect on spirometry parameters. It provided no benefit

Author disclosure: No relevant financial affiliations.

REFERENCES

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1. Yang ZY, Zhong HB, Mao C, et al. Yoga for asthma. Cochrane Database Syst Rev. 2016;(4):CD010346....

2. Centers for Disease Control and Prevention. Most recent asthma data. Updated February 27, 2017. http://www.cdc.gov/asthma/most_recent_data.htm. Accessed June 22, 2017.

3. Trogdon JG, Murphy LB, Khavjou OA, et al. Costs of chronic diseases at the state level: The Chronic Disease Cost Calculator. Prev Chronic Dis. 2015;12: E140.

4. Chung KF, Wenzel SE, Brozek JL, et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma [published correction appears in Eur Respir J. 2014;43(4):1216]. Eur Respir J. 2014;43(2):343–373.

5. Bergstrom J, Manney Kurth S, Bruhl E, et al.; Institute for Clinical Systems Improvement. Diagnosis and management of asthma. 2016. https://www.icsi.org/_asset/rsjvnd/Asthma.pdf. Accessed December 14, 2016.

These are summaries of reviews from the Cochrane Library.

This series is coordinated by Corey D. Fogleman, MD, Assistant Medical Editor.

A collection of Cochrane for Clinicians published in AFP is available at https://www.aafp.org/afp/cochrane.

 

 

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