CVR Physiotherapy › Technique cards › Therapy skills
Applied yoga in cardio-respiratory conditions
Yoga is in the syllabus (Ch 4l) and is widely used by Indian patients, but it was not asked on its own in 2016–2026. Know what it can add (better quality of life, breathing control, relaxation), what it cannot replace (exercise training and medicines), and which practices are unsafe for heart and lung patients.
- Syllabus
- Ch 4(l) Applied yoga in cardio-respiratory conditions; practical: relaxation and yoga skills
- Priority
- Syllabus. Not asked on its own in 2016–2026; possible short note or viva.
- Asked as
- Not asked 2016–2026
- Usual split
- Possible 3- or 7-mark note
- Checked against
- Yoga-CaRe trial (2020); Cochrane review of yoga for asthma (2016); meta-analysis of yoga in COPD (2019); Ministry of AYUSH Common Yoga Protocol. Full list under Sources.
- Content checked
- 19 October 2026. Next review due October 2027.
- My revision
-
1What yoga includes
- Asanas (postures): stretching, strength and balance.
- Pranayama (breathing practices): slow deep breathing, alternate-nostril breathing (anulom-vilom), humming breath (bhramari), ujjayi; forceful practices such as kapalbhati and bhastrika; breath retention (kumbhaka).
- Relaxation and meditation: shavasana, yoga nidra, guided relaxation.
- India's Ministry of AYUSH publishes a Common Yoga Protocol of gentle loosening practices, postures, pranayama and meditation.
How it may help: slower, deeper breathing and better breathing control; less anxiety and sympathetic drive; flexibility and posture; a culturally familiar way to stay active.
2What the evidence shows
| Condition | Evidence |
|---|---|
| Coronary heart disease after MI | Yoga-CaRe (India, 3,959 patients, 2020): yoga-based cardiac rehab improved self-rated health and return to pre-infarct activities, but did not significantly reduce major cardiac events. A good option where usual cardiac rehab is not available |
| Asthma | Cochrane (2016): moderate-quality evidence that yoga probably gives small improvements in quality of life and symptoms; no clear change in lung function |
| COPD | Meta-analysis (2019, 11 trials, 586 patients): about 25 m more on the 6MWT and slightly better FEV1, mainly with breathing-focused yoga rather than postures |
| Hypertension | Trials show modest falls in BP, best with regular breathing and relaxation practice; an add-on to medicines and lifestyle change |
| Heart failure | Small trials suggest better quality of life and exercise tolerance with gentle, supervised yoga |
Claim vs evidence
Common claim
Yoga cures asthma, reverses heart disease and replaces medicines.
Evidence
Yoga gives small to moderate gains in symptoms, quality of life and fitness. It does not replace medicines, aerobic and strength training or risk-factor control.
Write in the exam
"Yoga as an adjunct to standard rehabilitation: breathing-focused pranayama, gentle asanas and relaxation, avoiding breath-holding, straining and head-down postures."
3A sample supervised session (stable COPD or after cardiac rehab Phase II)
- Loosening (5–10 minutes): neck, shoulder, wrist, ankle and gentle trunk movements with relaxed breathing.
- Asanas (15–20 minutes), held comfortably while breathing normally: tadasana (standing tall), vrikshasana (tree pose, near a wall), ardha kati chakrasana (side bend), supported trikonasana, vajrasana or sitting forward bends if comfortable, bhujangasana (if allowed by surgery and back), with rests.
- Pranayama (10 minutes): slow deep breathing with a longer breath out, anulom-vilom without breath retention, bhramari.
- Relaxation (10 minutes): shavasana or yoga nidra.
- 3–5 times a week, as part of, not instead of, aerobic and strength training.
4Precautions and contraindications
- Breath-holding (kumbhaka) and straining: they raise BP sharply (Valsalva): avoid in heart disease, hypertension, aneurysm, after eye or brain surgery.
- Forceful pranayama (kapalbhati, bhastrika): avoid in uncontrolled hypertension, heart disease, recent abdominal or chest surgery, hernia, pregnancy, epilepsy, and during an asthma or COPD flare (can trigger bronchospasm or hyperventilation).
- Inversions and head-down postures (sirsasana, sarvangasana, halasana): avoid in hypertension, heart failure, glaucoma, reflux, neck problems and in breathless patients.
- After sternotomy: no weight-bearing on the arms, prone lying on the chest or strong back bends for about 6–8 weeks; follow sternal precautions.
- Osteoporosis (long-term steroids): avoid loaded spinal flexion and twisting.
- Unstable states: unstable angina, uncontrolled arrhythmia, acute exacerbations, fever: no session.
- Keep taking all medicines; teach the warning signs (chest pain, dizziness, marked breathlessness) and stop if they appear; learn from a trained teacher in a supervised group.
5Exam corner
Not asked on its own in the 20 papers (2016–2026). It fits the "long-term management" part of COPD, asthma and cardiac answers in one or two lines, with its precautions.
Test yourself
3 mGive three precautions when using yoga in a patient after myocardial infarction.
No breath-holding or straining (Valsalva); no forceful pranayama such as kapalbhati; no inversions; after CABG keep sternal precautions; keep intensity light to moderate and stop for chest pain or dizziness; continue medicines.
MCQThe Yoga-CaRe trial after MI showed:A. Fewer deaths and heart attacksB. Better self-rated health and return to activities, without a significant fall in major eventsC. Harm from yogaD. No effect on anything
B.
Sources
- MUHS BPTh syllabus (2012), CVR Ch 4(l).
- Prabhakaran D, et al. Effect of yoga-based cardiac rehabilitation on health outcomes following acute myocardial infarction (Yoga-CaRe). J Am Coll Cardiol 2020.
- Yang ZY, et al. Yoga for asthma. Cochrane Review 2016.
- Cramer H, et al. Yoga for chronic obstructive pulmonary disease: a systematic review and meta-analysis. Clin Rehabil 2019.
- Ministry of AYUSH, Government of India. Common Yoga Protocol.
Educational notes for exam preparation. Not medical advice.
Version 1. Content checked 19 October 2026. Next review October 2027.