ORIGINAL PAPER
Ujjayi pranayama in systemic lupus women: randomized-controlled effect on cortisol, stress, depression, anxiety, and fatigue
 
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1
Department of Internal Medicine and Geriatrics, Faculty of Physical Therapy, Badr University in Cairo, Cairo, Egypt
 
2
Department of Physical Therapy for Woman’s Health, Faculty of Physical Therapy, Badr University in Cairo, Cairo, Egypt
 
3
Basic Science Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
 
4
Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
 
 
Submission date: 2023-04-28
 
 
Acceptance date: 2023-08-11
 
 
Online publication date: 2024-08-14
 
 
Corresponding author
Ahmed Mohamed Abdelhalim Elfahl   

Department of Internal Medicine and Geriatrics, Faculty of Physical Therapy, Badr University in Cairo, Entertainment Area, Badr City, Cairo, Egypt
 
 
Physiother Quart. 2024;32(3):21-28
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The aim of this study was to investigate the effects of ujjayi pranayama on non-lethal problems and cardiorespiratory functions in women with systemic lupus erythematosus (SLE).

Methods:
This randomized controlled trial involved a home-based training of ujjayi pranayama for 6 weeks. Forty SLE women were randomly assigned to either the ujjayi-pranayama group (n = 20), who performed 30 min of ujjayi pranayama daily (15 min in the morning and evening), or the waitlist control group (n = 20). Various measures, including State-Trait Anxiety Inventory (STAI), cortisol, Stress Vulnerability Scale (SVS), Beck Depression Inventory II (BDI-II), Fatigue Severity Scale (FSS), Pittsburgh Sleep Quality Index (PSQI), pulse rate (Pul-r), respiratory rate (Res-r), systolic blood pressure (SBPr), and diastolic blood pressure (DBPr) were assessed.

Results:
Significant reductions were observed via paired tests in Pul-r (75.95 ± 3.63 vs 72.95 ± 3.17; p < 0.001), Res-r (16.70 ± 3.62 vs 14.80 ± 2.94; p < 0.001), SBPr (126.60 ± 4.75 vs 121.30 ± 4.30; p < 0.001), DBPr (82.15 ± 3.57 vs 78.05 ± 3.44; p < 0.001), PSQI (7.45 ± 1.27 vs 5.10 ± 1.20; p < 0.001), FSS (4.80 ± 1 vs 3.75 ± 1.11; p < 0.001), BDI-II (13.70 ± 2.77 vs 6.80 ± 1.50; p < 0.001), STAI (66.70 ± 4.72 vs 47.55 ± 6.15; p < 0.001), cortisol (8.51 ± 1.36 vs 6.34 ± 1.36; p < 0.001), and SVS (12.65 ± 1.78 vs 6.45 ± 1.57; p < 0.001) in the ujjayi pranayama group only.

Conclusions:
Ujjayi pranayama significantly improved non-lethal problems and cardiorespiratory functions in women with lupus.

 
REFERENCES (51)
1.
Ismail AMA, Saad AE, Abd-Elrahman NAF, Elfahl AMA. Response of lipid profile to laser acupuncture along with diet and pilates exercise in obese women with systemic lupus erythematosus: a randomized controlled trial. J Acupunct Meridian Stud. 2023;16(4):152–8; doi: 10.51507/j.jams.2023.16.4.152.
 
2.
Molina E, Gould N, Lee K, Krimins R, Hardenbergh D, Timlin H. Stress, mindfulness, and systemic lupus erythematosus: an overview and directions for future research. Lupus. 2022;31(13):1549–62; doi: 10.1177/09612033221122980.
 
3.
Sharif K, Watad A, Coplan L, Lichtbroun B, Krosser A, Lichtbroun M, Krosser A, Lichtbroun M, Bragazzi NL, Amital H, Afek A, Shoenfeld Y. The role of stress in the mosaic of autoimmunity: An overlooked association. Autoimmun Rev. 2018;17(10):967–83; doi: 10.1016/j.autrev.2018.04.005.
 
4.
Taub R, Horesh D, Rubin N, Glick I, Reem O, Shriqui G, Agmon-Levin N. Mindfulness-based stress reduction for systemic lupus erythematosus: a mixed-methods pilot randomized controlled trial of an adapted protocol. J Clin Med. 2021(19);10:4450; doi: 10.3390/jcm10194450.
 
5.
Fangtham M, Kasturi S, Bannuru RR, Nash JL, Wang C. Non-pharmacologic therapies for systemic lupus erythematosus. Lupus. 2019;28(6):703–12; doi: 10.1177/0961203319841435.
 
6.
Middleton KR, Haaz Moonaz S, Hasni SA, Magaña Ló­pez M, Tataw-Ayuketah G, Farmer N, Wallen GR. Yoga for systemic lupus erythematosus (SLE): clinician experiences and qualitative perspectives from students and yoga instructors living with SLE. Complement Ther Med. 2018;41:111–7; doi: 10.1016/j.ctim.2018.09.001.
 
7.
Ismail AMA, Ali SM, Ghuiba K, Elfahl AMA, Tolba AMN, Ghaleb HAM. Autonomic functions, tinnitus annoyance and loudness, and quality of life: randomized-controlled responses to bee-humming (vibrational) respiratory training in tinnitus elderly. Complement Ther Clin Pract. 2022;48:101611; doi: 10.1016/j.ctcp.2022.101611.
 
8.
Patil ST, Bormane DS. Electroencephalograph signal analysis during ujjayi pranayama. In: Lim CT, Goh JCH (eds.) 13th International Conference on Biomedical Engineering. IFMBE Proceedings 2009; vol. 23. Berlin, Heidelberg: Springer; doi: 10.1007/978-3-540-92841-6_1.
 
9.
Niranjan P, Balaram P. Immediate effect of ujjayi pranayama on attention and anxiety among university students: a randomised self-control study. J Clin Diagn Res. 2022;16(2):1–4; doi: 10.7860/JCDR/2022/51480.15934.
 
10.
Kumar T. Influence of yogic practice on mental fatigue of weight lifters of Karnataka. Int J Res Anal Rev. 2019;6(1):284–90.
 
11.
Mahour J, Verma P. Effect of ujjayi pranayama on cardiovascular autonomic function tests. Natl J Physiol Pharm Pharmacol. 2017;7(4):391–5; doi: 10.5455/njppp.2017.7.1029809122016.
 
12.
Panwar S, Chourishi A, Makwana J. Effect of pranayama (yoga) on pulmonary function test of young healthy students. Int J Pharma Bio Sci. 2012;3(4):12–6.
 
13.
Wulandari S, Wantini NA. Effectiveness of happy prenatal yoga (ujjayi pranayama and nadi sodhasana techniques) in reducing physical discomfort in trimester III pregnancy [in Indonesian]. J Kebidanan Indones. 2021;12(2):18–27; doi: 10.36419/jki.v12i2.492.
 
14.
Dhruva A, Miaskowski C, Abrams D, Acree M, Cooper B, Goodman S, Hecht FM. Yoga breathing for cancer chemotherapy-associated symptoms and quality of life: results of a pilot randomized controlled trial. J Altern Complement Med. 2012;18(5):473–9; doi: 10.1089/acm.2011.0555.
 
15.
Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, Schaller JG, Talal N, Wincheste RJ. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982;25(11):1271–7; doi: 10.1002/art.1780251101.
 
16.
Usha M, Bhat JS, Radish Kumar B, Bajaj G, Poovitha Shruthi P. Immediate effects of ‘ujjayi pranayama’ on aerodynamic, acoustic and self perception parameters of voice in teachers. J Ayurveda Integr Med 2022;13(1):100490; doi: 10.1016/j.jaim.2021.07.006.
 
17.
Gupta A, Shokhand H. Ujjayi pranayama in hypothyroidism: a scoping review. Int J Phys Educ Sports Health. 2022;9(1):107–10; doi: 10.22271/kheljournal.2022.v9.i1b.2350.
 
18.
Navarrete-Navarrete N, Peralta-Ramírez MI, Sabio-Sán­chez JM, Coín MA, Robles-Ortega H, Hidalgo-Tenorio C, Ortego-Centeno N, Callejas-Rubio JL, Jiménez-Alonso J. Efficacy of cognitive behavioural therapy for the treatment of chronic stress in patients with lupus erythematosus: a randomized controlled trial. Psychother Psychosom. 2010;79(2):107–15; doi: 10.1159/000276370.
 
19.
Newmeyer M, Keyes B, Gregory S, Palmer K, Buford D, Mondt P, Okai B. The Mother Teresa Effect: the modulation of spirituality in using the CISM model with mental health service providers. Int J Emerg Ment Health. 2014;16(1):251–8; doi: 10.4172/1522-4821.1000104.
 
20.
Jackson-Koku G. Beck Depression Inventory. Occup Med. 2016;66(2):174–5; doi: 10.1093/occmed/kqv087.
 
21.
Zonana-Nacach A, Roseman JM, McGwin G Jr, Friedman AW, Baethge BA, Reveille JD, Alarcón G S. Systemic lupus erythematosus in three ethnic groups. VI: factors associated with fatigue within 5 years of criteria diagnosis. LUMINA Study Group. Lupus in minority populations: nature vs nurture. Lupus. 2000;9(2):101–9; doi: 10.1191/096120300678828046.
 
22.
Inoue M, Shiozawa K, Yoshihara R, Yamane T, Shima Y, Hirano T, Makimoto K. Predictors of poor sleep quality in patients with systemic lupus erythematosus. Clin Rheumatol. 2017;36(5):1053–62; doi: 10.1007/s10067-017-3545-5.
 
23.
Lundervold DA. Behavioral medicine applications in geriatric primary care: coping with neuropsychiatric sequelae of systemic lupus erythematosus (SLE). Int J Behav Consult Ther. 2015;9(4):2–5.
 
24.
Haija AJ, Schulz SW. The role and effect of complementary and alternative medicine in systemic lupus erythematosus. Rheum Dis Clin North Am. 2011;37(1):47–62; doi: 10.1016/j.rdc.2010.11.005.
 
25.
Almaqhawi A, Khan A, Albarqi M, Almulhim A, Ali SI, Elbarbary HS. Psychological impact of the COVID-19 pandemic on healthcare professionals in the Al Ahsa Region, Saudi Arabia. Fam Med Prim Care Rev. 2022;24(1):27–31; doi: 10.5114/fmpcr.2022.113010.
 
26.
Martsenkovskyi D, Babych V, Martsenkovska I, Napryeyenko O, Napryeyenko N, Martsenkovsky I. Depression, anxiety, stress and trauma-related symptoms and their association with perceived social support in medical professionals during the COVID-19 pandemic in Ukraine. Adv Psychiatry Neurol. 2022;31(1):6–14; doi: 10.5114/ppn.2022.114657.
 
27.
Elsheikh S, Elnahas N, Wahab Soliman A, Ismail A. Effect of Bhramari versus Sheetali pranayama on quality of life in hypertensive patients. Adv Rehabil. 2023;37(2):1–8; doi: 10.5114/areh.2023.127506.
 
28.
Ismail AMA, Saif HFAEA, Taha MM. Effect of alternate nostril breathing exercise on autonomic functions, ocular hypertension, and quality of life in elderly with systemic hypertension and high-tension primary open-angle glaucoma. Geriatr Nurs. 2023;52:91–7; doi: 10.1016/j.gerinurse.2023.05.012.
 
29.
Arias AJ, Steinberg K, Banga A, Trestman RL. Systematic review of the efficacy of meditation techniques as treatments for medical illness. J Altern Complement Med. 2006;12(8):817–32; doi: 10.1089/acm.2006.12.817.
 
30.
Ismail AMA, Abd Elfatah Abo Saif HF, El-Moatasem Mohamed AM. Effect of Jyoti-Trataka on intraocular pressure, autonomic control, and blood glucose in diabetic patients with high-tension primary open-angle glaucoma: a randomized-controlled trial. J Complement Integr Med. 2021;19(4):1013-8; doi:10.1515/jcim-2021-0041.
 
31.
Tomar R, Singh N. Effect of ujjayi pPranayama on selected physiological variables. Ovidius Univ Ann Series Phys Educ Sport/Sci Mov Health. 2011;11(1):140–6.
 
32.
Stenström CH, Arge B, Sundbom A. Dynamic training versus relaxation training as home exercise for patients with inflammatory rheumatic diseases: a randomized controlled study. Scand J Rheumatol. 1996;25(1):28–33; doi: 10.3109/03009749609082664.
 
33.
de Orleans Casagrande P, Coimbra DR, de Souza LC, Andrade A. Effects of yoga on depressive symptoms, anxiety, sleep quality, and mood in patients with rheumatic diseases: systematic review and meta-analysis. PM R. 2022;15(7)899–915; doi: 10.1002/pmrj.12867.
 
34.
Greco CM, Rudy TE, Manzi S. Effects of a stress-reduction program on psychological function, pain, and physical function of systemic lupus erythematosus patients: a randomized controlled trial. Arthritis Rheum. 2004;51(4):625–34; doi: 10.1002/art.20533.
 
35.
Zahiri S, Jahani S, Sayadi N, Cheraghian B, Rajaei E. The effects of an educational intervention on fatigue and activities of daily living in patients with systemic lupus erythematosus. Nurs Midwifery Stud. 2022;11(1):24–30; doi: 10.4103/nms.nms_109_21.
 
36.
Solati K, Mousavi M, Kheiri S, Hasanpour-Dehkordi A. The effectiveness of mindfulness-based cognitive therapy on psychological symptoms and quality of life in systemic lupus erythematosus patients: a randomized controlled trial. Oman Med J. 2017;32(5):378–85; doi: 10.5001/omj.2017.73.
 
37.
Williams EM, Penfield M, Kamen D, Oates JC. An intervention to reduce psychosocial and biological indicators of stress in African American lupus patients: the balancing lupus experiences with stress strategies study. Open J Prev Med. 2014;4(1):22–31; doi: 10.4236/ojpm.2014.41005.
 
38.
Kim SD, Kim HS. Effects of a relaxation breathing exercise on fatigue in haemopoietic stem cell transplantation patients. J Clin Nurs. 2005;14(1):51–5; doi: 10.1111/j.1365-2702.2004.00938.x.
 
39.
Chakrabarty J, Vidyasagar M, Fernandes D, Joisa G, Varghese P, Mayya S. Effectiveness of pranayama on cancer-related fatigue in breast cancer patients undergoing radiation therapy: a randomized controlled trial. Int J Yoga. 2015;8(1):47–53; doi: 10.4103/0973-6131.146062.
 
40.
Ali Ismail AM, Saad AE, Fouad Abd-Elrahman NA, Abdelhalim Elfahl AM. Effect of Benson’s relaxation therapy alone or combined with aerobic exercise on cortisol, sleeping quality, estrogen, and severity of dyspeptic symptoms in perimenopausal women with functional dyspepsia. Eur Rev Med Pharmacol Sci. 2022; 26(22):8342–50; doi: 10.26355/eurrev_202211_30367.
 
41.
Ismail AMA. Complementary role of Benson’s relaxation technique in post orgasmic illness syndrome. Aging Male. 2023;26(1):2174511; doi: 10.1080/13685538.2023.2174511.
 
42.
Dwivedi N, Dwivedi SK. Impact of ujjayi pranayama on anxiety. Int J Soc Sci Rev. 2020;8(7–9):333–5.
 
43.
Zaccaro A, Piarulli A, Laurino M, Garbella E, Menicucci D, Neri B, Gemignani A. How breath-control can change your life: a systematic review on psycho-physiological correlates of slow breathing. Front Hum Neurosci. 2018;12:353; doi: 10.3389/fnhum.2018.00353.
 
44.
Ma X, Yue Z-Q, Gong Z-Q, Zhang H, Duan N-Y, Shi Y-T, Gao-Xia Wei G-X, Li Y-F. The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults. Front Psychol. 2017;8:874; doi: 10.3389/fpsyg.2017.00874.
 
45.
Vedamurthachar A, Janakiramaiah N, Hegde JM, Shetty TK, Subbakrishna DK, Sureshbabu SV, Gangadhar BN. Antidepressant efficacy and hormonal effects of Sudarshana Kriya Yoga (SKY) in alcohol dependent individuals. J Affect Disord. 2006;94(1–3):249–53; doi: 10.1016/j.jad.2006.04.025.
 
46.
Singh TN, Devi WG, Sangeeta. Effect of ujjayi pranayama on selected physiological variables on school girls of Chandigarh. Int J Physiol Nutr Phys Educ. 2018;3(2):1211–3.
 
47.
Lathadevi GV, Maheswari TU, Nagashree R. Modulation of cardiovascular response after Ujjayi pranayama and Shavasana training in normal human volunteers. J Clin Diagn Res. 2012;6(4)(Suppl 2):571–3.
 
48.
Adhikari A. Effect of meditation and pranayama practice on selected physiological variables among university level kho-kho players. Int J Yogic Hum Mov Sports Sci. 2022;7(1):46–8.
 
49.
Gaur MP. The effect of Ujjayi Pranayama on selected bio-chemical variables. Res Directions. 2014;1(9):1–6.
 
50.
Mazumdar I, Suryavanshi A. Effect of Ujjayi and Bhastrika Pranayama on selected physiological variables of physically challenged students. Br J Sports Med. 2010;44(Suppl 1):1–82; doi: 10.1136/bjsm.2010.078725.229.
 
51.
Bal BS, Kumar S, Sharawat A. Impact of ujjayi pranayama on components of health-related fitness. Natl J Phys Educ Sports Science 2015;1(2):48–53.
 
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