Designing Yoga Practices for People with COPD (obstructive breathing)
|Vijai P. Sharma, Ph.D., psychologist and registered yoga teacher
Abstract: Overall goal, objectives, strategies, adaptation guidelines for a "breath friendly" asanas (yoga postures) strength and flexibility and breathing techniques for slowing the breathing and lengthening the exhalation are provided so yoga teachers and therapists can design appropriate practices for their students. Two sequences, one "mild" and the other of "moderate" intensity for asanas and pranayama are provided as examples.
Adaptation Guidelines for a "breath friendly" practice
Yoga for COPD Segment 2-week 3 &4 (Mild) Designed by Gary Kraftsow* with a few modifications by the author
* cited with permission of G. Kraftsow
Exercise # 1: Supine/seated conscious breathing (*description bottom of the page)
Exercises #2 Arms movement: pillow may be used under the neck to relax the neck and shoulders. If strenuous, arm raise may be done on exhale.
Exercises #3 Bridge Pose: If strenuous, both pelvic raising and lowering may be done on exhale. Only if you feel up to it, you may do other arm variations such as moving over the head or sliding arms up and down in the stay position
Exercises #4 Cat-Child Pose: After completion of the Cat-Child Pose and prior to the Warrior Pose, Uttansana may be added. Optional Standing Forward Bend (Uttansana): If desired, a student may do 1-6 repetitions of Uttansana with bent knees and sliding hands up and down the legs while moving in and out of the pose.
Exercises #5 Warrior Pose: Keep the hands at the abdominal level in order to keep the shoulders down. If suitable, other arms and hands variations such as pelvic level or mid-chest level may be utilized to augment the effects
Exercises #6 Forward Bend to Chair: Keep the chair against the wall for safety. Avoid arm raise for a student with neck and shoulder rigidity. If standing and sitting each time for forward bending is strenuous, bend with hands resting on the chair and perform dynamic Ardha Utkatasana-like movements) Optional Supported Tree Pose: Stand near the wall/ chair and raise your foot at or below the knee for 1-4 breath. Then switch to the other leg for1-4 breaths. If you feel unstable, rest your hand on the chair to steady yourself.
Exercises #7 Triangle with chair: Keep the chair against the wall for safety. Unlike the traditional Triangle, look down or at the front wall. Only if comfortable, turn up the neck towards the ceiling.
Exercises #8 Forward Bending from Chair: Entire set of forward bending may be performed while sitting in the chair. For a more challenging pose, you may stand and sit down every time to bend forward.
Exercises #9 Bridge Pose: If strenuous, pelvic raising and lowering both may be done on exhale. Only if you feel up to it, you may do other arm variations such as moving over the head or sliding arms up and down in the stay position
Exercise # 10 Knee to Chest: Both the knee pressing and legs raising may be done on exhale. In such a case, press the knees to the chest while exhaling. Bring the knees away from the chest while inhaling. Raise legs towards the ceiling while exhaling.
*Description of Exercise # 1 (Supine/Seated) Conscious Breathing:
Lie down and make yourself comfortable. Put a folded blanket under your back to raise the lower and upper chest. Use additional blanket or small pillow under your neck and knees to be comfortable. Feet are comfortably apart and turned out. If you feel stress in the back, bend your knees and place feet flat on the floor. Arms at sides, palms turned up, few inches away from the body and shoulders in contact with the floor and relaxed. Relax your forehead and the entire face. Relax both arms and shoulders. Relax both legs and hips. Relax the entire upper body. Relax the whole body from head to toes. Don't go to sleep. Stay AWAKE but relaxed!
Bring your attention to your breath and let it relax. As you inhale feel the breath moving down from chest into the abdomen and pelvis. As you exhale, feel the breath moving upward from pelvis and abdomen to the nostrils. Maintain the feeling of breath flowing downward as you inhale and the breath flowing upward as you exhale. Take 6-12 breaths with such a feeling.
Adaptation: If lying down is not comfortable, sit in a chair and follow the above guidelines for relaxed and conscious breathing.
1. Supine/Seated "Joint Breathing:"
(3 breaths each joint-approximately 5 minutes)
Lie down and make yourself comfortable. Use rolled blanket or small pillow under your neck and knees to be comfortable. Feet are comfortably apart and turned out. If you feel stress in the back, bend your knees and place feet flat on the floor. Arms at sides, palms turned up, few inches away from the body and shoulders in contact with the floor and relaxed. Relax your forehead and the entire face. Relax both arms and shoulders. Relax both legs and hips. Relax the entire upper body. Relax the whole body from head to toes. Don't go to sleep. Stay AWAKE but relaxed!
*If your breathing is not stabilized yet, do a few more repetitions of the whole body breathing.
2. (Sitting) Humming Breath (6 breaths):
In a seated position, press the tip of your tongue against the hard palate and make a soft humming sound such as "hummm….." As you begin to approach the end of your breath, exhale without the humming sound. Instead of producing humming sound of the beetle, if you prefer, you may sing a short line of your favorite song. Again, as you approach the end of your breath, exhale without the humming sound.
3.(Sitting) Vowel Singing (6 breaths)
In a seated position, sing the vowels (Ah, EE and OO) slowly and gently. As you begin to approach the end of your breath, exhale softly without the vowel sound.
Exercises for Breath Awareness
How long are your exhalations and inhalations?
How many breaths you take in a minute?
Where do you feel your breathing most?
#1. Hands on lower tummy, middle finger tips touch navel-- 2 breaths
Yoga for COPD (Moderate to Strong Practice)
NOTE: individuals with higher functional ability may follow the traditional rules of coordinating breathing with movements. However, if inhalation during movement challenges your breathing such as in a backward bending pose, exhale while going into and out of the pose, and inhale during the stationary position prior to initiating the movement.
1. Supine/Seated Conscious Breathing
Additional poses-optional 1
Additional poses-Optional 2
Details of Breathing exercises are provided in the 'Mild to Moderate" sequence for COPD
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