Pembatasan sosial maupun lockdown hingga penggunaan masker dan hand

sanitizer belum sepenuhnya mengurangi penyebaran virus corona atau COVID-19. Dampak
dari pandemi virus tersebut justru meluas hingga tak sedikit orang yang mengalami
gangguan mental seperti kecemasan tinggi, stres, depresi, hingga berusaha bunuh diri
karena terkurung dalam rumah tanpa aktivitas terutama bagi yang kehilangan pekerjaan.
Salah satu upaya untuk mengatasi persoalan psikologis ini adalah berolahraga yoga. Sebuah
penelitian terbaru yang dilakukan University of South Australia menemukan begitu besarnya
manfaat terapi yoga untuk kesehatan mental. Bahkan, yoga yang dilakukan saat isolasi
mandiri di rumah dianggap mampu menangkal COVID-19.
Menurut para ahli, meskipun nanti pandemic COVID-19 berakhir, akan muncul
masalah kesehatan lain yaitu krisis kesehatan mental. Para peneliti dari University of
Australia bekerja sama dengan Federal University of Santa Maria, UNSW Sydney, Kings
College London dan Western Sydney University, melakukan penelitian yang disebut-sebut
sebagai “studi pertama di dunia” tentang manfaat kesehatan mental dari berlatih yoga.
Dalam riset yang dilakukan dengan meneliti 19 studi yang dilaksanakan di enam negara
seperti Swedia, Jerman, Amerika Serikat, Cina, Jepang, dan India

Riset dilakukan dengan meneliti 19 studi yang dilaksanakan di enam negara seperti
Swedia, Jerman, Amerika Serikat, Cina, Jepang, dan India. Penelitian melibatkan 1080 partisipan
yang memiliki diagnosis adanya gangguan mental, seperti depresi dan kecemasan.

Hasil penelitian yang diterbitkan British Journal of Sports Medicine itu menemukan
bahwa manfaat terapi yoga mampu memperbaiki rasa kecemasan maupun kesepian. Bahkan
meningkatnya kesehatan mental akan meningkatkan imunitas tubuh.

Dalam meta-analisis dari 180 studi di enam negara yang melibatkan 1.080 partisipan
—di mana semuanya memiliki diagnosis gangguan mental—para peneliti menemukan bahwa
kesehatan mental mereka membaik setelah melakukan “yoga berbasis gerakan”. Dan manfaatnya
bertambah seiring meningkatnya aktivitas yoga yang mereka lakukan.

“Yoga berbasis gerakan” didefinisikan oleh para peneliti sebagai segala bentuk yoga
di mana fisik para partisipan bergerak aktif setidaknya 50% dari keseluruhan—melibatkan beberapa
pose.

Latihan yoga, baik dengan model kuno maupun yoga berbasis gerakan sangat
berguna untuk meningkatkan kekuatan mental. Terlebih jenis yoga berbasis gerakan yang efektif
dalam membenahi gangguan mental akibat pandemi Covid-19.

Isolasi diri di dalam rumah diisi dengan aktivitas bekerja atau belajar dari rumah. Tak
adanya interaksi sosial bersama teman kantor atau saudara yang terlalu lama menyebabkan orang
mulai mengalami kesepian

Olahraga merupakan pilihan yang sangat strategis. Selain untuk meningkatkan

kesehatan, aktivitas fisik ini juga berguna untuk meningkatkan suasana hati. Sayangnya, gym dan
pusat kebugaran telah ditutup sementara jogging di jalan tidak dianjurkan.
 Yoga berbasis gerakan dalam penelitian ini adalah segala bentuk gerakan yoga
dengan aktivitas fisik yang aktif. Bahkan gerakan fisik ini menghabiskan separo dari waktu yoga yang
dilakukan.

Yoga bisa menjadi aktivitas yang sangat berguna dalam mengisi waktu saat isolasi diri
di rumah. Manfaat terapi yoga tidak hanya menyegarkan suasana hati namun juga meningkatkan
kekebalan tubuh untuk mencegah virus Corona.

Lawan COVID-19 dengan Perkuat Sistem Imun Melalui Yoga

Pencegahan penyebaran COVID-19 utamanya bisa dilakukan dengan menjaga sistem

imun melalui pola hidup sehat serta olahraga. Jika kamu sudah yakin dengan makanan yang masuk
ke dalam tubuh, kini saatnya menambahkan olahraga ringan dalam rutinitas harian, salah satunya
adalah dengan mengikuti yoga.

Banyak manfaat yang kamu dapatkan dari melakukan olahraga yang bisa dilakukan di
rumah ini. Apa saja manfaatnya? Berikut penjelasan bagaimana yoga dapat memperkuat sistem
imun tubuh:

Dunia psikologi percaya jika stres dapat berdampak buruk pada kondisi kesehatan
fisik manusia. Saat stres, tubuh lebih rentan dihantam virus dan kuman yang bisa memperburuk
kondisi kesehatanmu. Yoga dipercaya mampu membuat tubuh lebih rileks dan pikiran lebih tenang.

Saat sistem imun lemah, bakteri jahat bisa masuk ke dalam saluran pernapasan dan
menyebabkan terjadinya pneumonia dan bronchitis. Yoga membantu teknik pernapasan lebih lancar
dengan melonggarkan saluran napas dan membuat paru-paru lebih elastis sekaligus kuat saat
bernapas.

Gerakan yoga dapat memperkuat daya tahan tubuh:

Yoga memiliki rangkaian gerakan mudah hingga rumit, yang bisa dilakukan sendiri
saja di rumah ataupun membutuhkan pelatih. Berikut gerakan yoga yang dipercaya mampu
memperkuat daya tahan tubuhmu:

Studi: Yoga Membantu Mengatasi Stres Akibat Pandemi COVID-19

“Ketika isolasi mandiri diterapkan, banyak orang harus bekerja dari rumah dan tidak
bisa bertemu dengan teman-teman atau keluarga. Ini membuat mereka kesepian dan terputus dari
dunia luar,” ungkap Jacinta Brinsley, pemimpin penelitian dari University of South Australia.

“Olahraga selalu menjadi strategi terbaik bagi orang-orang yang memiliki perasaan
tersebut agar mood dan kesehatannya membaik. Namun, dengan ditutupnya gym dan terbatasnya
pilihan olahraga—bahkan jogging bersama teman juga kurang dianjurkan—orang-orang dipaksa
untuk mencari alternatif. Di sinilah yoga bisa sangat membantu,” tambahnya.

Brinsley memaparkan, studi mereka menunjukkan bahwa yoga dapat membantu

mengatasi gejala gangguan mental, termasuk kecemasan, stres pascatrauma, dan depresi.
 “Ini adalah kabar baik bagi mereka yang kesulitan menghadapi kondisi yang penuh
dengan ketidakpastian ini,” pungkasnya.

Studi tersebut dipublikasikan pada British Journal of Sports Medicine.

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Role of Yoga in improving respiratory distress and anxiety

during COVID-19 pandemic - An evidence based review

Introduction:
The world is currently at one of the greatest risk of novel Coronavirus named SARS
CoV-2 aka COVID-19 pandemic. Coronavirus outbreak had initiated in December 2019 in Hubei
province, Wuhan, China. COVID-19 has greatly affected the world economically as well as socially
along with mild to severe health effects. Treating COVID-19 patients with pneumonia-like symptoms
along with shortness of breath, dry cough and fever; is now a cause of concern for researchers and
healthcare experts.
Initially, Hydroxychloroquine and then, Remdesivir along with other drugs like
antibiotics have been suggested by medical researchers for management of COVID-19 disease.
However, along with exclusive symptoms, a lot of people are susceptible to mental problems along
with physical health problems due to enforcement of exaggerated lockdown. Majority cases were
observed with depression, anger, anxiety, suicidal tendency as well as confusion. Due to isolation
and lack of contact with family, exhaustion was also observed in the medical workers and security
forces like police staff.
Since the community transmission has reached its peak, invention of vaccines and
medicines has been rapidly initiated by Pharma companies. Researchers have been trying to find
alternate sources for prevention and treatment of COVID-19. The experts have also worked upon
proving the role of Yoga and meditation in improving physical and mental health during this global
emergency. It was also found from a study that people with chronic lungs and heart
disease are at greater risk for severe cardiovascular and respiratory complications from COVID-19.
Simultaneously, practicing Yoga and meditation regularly has resulted in significantly
improved performance also in co-morbidity condition. Effectiveness of Yoga and Pranayama in
respiratory distress and anxiety in the wake of COVID-19 pandemic has been comprehensively
reviewed in this article.
Objectives and Research Question:
The aim of this review is to identify if Yoga and Pranayama can be a possible
supplemental treatment for respiratory distress and anxiety during COVID-19 after systematically
reviewing the scientific literature.
Methodology:
An online database search was done on Google Scholar for publications in the last 5
years for inclusion of relevant and latest scientific publications. Bibliographies of the reviews were
also consulted. Only studies clearly mentioning methodology as RCTs and systematic reviews either
in the title or the text of the publication were included and language of publications was restricted
to English. The search algorithms of “yoga and respiratory health,” “pranayama and respiratory
health,” “breathing exercises and respiratory health,” “breathing techniques and respiratory health”
“pranayama and ventilatory function,” “yoga and lung function” “yoga, respiratory distress and
anxiety” “yoga, respiratory distress and health” were used. The studies were screened for
duplication. Next step was screening of abstracts. Articles for whom full text pdf was not available
were excluded. Full text review of included studies was done. Outcomes were analysed for effects of
yoga on breathlessness, fatigue, stress, and quality of life as parameters of respiratory distress and
anxiety.
Results:
Primary searched yielded a result of 1060 studies. Three independent reviewers
checked the abstracts collected from the search engine. Title and abstracts were screened and
duplicate studies were removed. After checking for the inclusion and exclusion criteria and other
parameters of selection, a total of 20 studies with available full text PDFs were filtered for review.
Out of the studies, 12 were RCTs and 8 were systematic reviews. A short summary of the studies and
the main outcomes/conclusions is presented in table 1 and 2.

Synthesized Findings:

In the study T. Dinesh et al, Pulmonary function parameters (PFT) such as forced vital
capacity (FVC), forced expiratory volume in first second (FEV1), ratio between FEV1 and FVC (FEV1
/FVC), peak expiratory flow rate (PEFR), maximum voluntary ventilation (MVV), and forced
expiratory flow 25-75 (FEF25-75), were recorded at baseline and after 12 weeks of pranayama
training using the computerized spirometer were assessed. Twelve weeks of pranayama training in
young subjects showed improvement in the commonly measured PFT. This indicates that pranayama
training improved pulmonary function and that this was more pronounced in the fast pranayama
group(1). The study Beutler et al studied lung function and respiratory muscle strength, breath-hold
duration, hypercapnic ventilatory response, incremental exercise test, passive exercise and constant
load exercise test. This study showed that long-term yoga practice can alter the automatic output of
the brainstem respiratory center in resting conditions and also reduce hypercapnic respiratory drive,
possibly as the result of repetitive exposure to hypercapnia during specific respiratory exercises.
These changes do not seem to give healthy young yogic individuals an advantage during whole-body
exercise(2). Barassi et al demonstrated appreciable short-term improvement in lung function
assessed by spirometry. They concluded that yoga breathing can be a beneficial preoperative
support for thoracic surgery(3). Ma et al showed findings that suggested breathing intervention
groups showed a significant decrease in negative affect after intervention, compared to baseline. In
the diaphragmatic breathing condition, there was a significant interaction effect of the group by time
on sustained attention, whereby the breathing intervention group showed significantly increased
sustained attention after training, compared to baseline. There was a significant interaction effect of
group and time in the diaphragmatic breathing condition on cortisol levels, whereby the breathing
intervention group had a significantly lower cortisol level after training, while the control group
showed no significant change in cortisol levels. In conclusion, diaphragmatic breathing could
improve sustained attention, affect, and cortisol levels. This study provided evidence demonstrating
the effect of diaphragmatic breathing, a mind-body practice, on mental function, from a health
psychology approach, which has important implications for health promotion in healthy individuals.
(4) The study by Gupta et al showed pranayam has been demonstrated as useful for individuals with
moderate to severe COPD. Significant improvements in the IA's CAT scores
after 3 mo of practice suggests that pranayam can improve the subjective experience of health,
disease severity, and functional status for COPD patients, without much improvement in FEV1
actually occurring and with airflow limitation not fully reversible but usually progressive. The
research team concluded that pranayam is a useful adjunct treatment and can be an effective
rehabilitation program for individuals with COPD (5). Ramanathan et al showed significant
improvements of lung function with adjuvant yoga therapy can be attributed to comprehensive yoga
therapy package administered to participants resulting in decreased airway resistance and better
lung compliance attributed to nonspecific bronchio-protective / broncho-relaxing effect. Significant
improvement in QoL scores can be attributed to improved vital capacity as well as enhanced self-
confidence /self-reliance. We conclude that there is a positive and additive role of adjuvant therapy
with standard medical management of COPD(6). In the study by Chitnis et al, a significant change
was seen in Forced Expiratory Volume1(FEV1), Forced Expiratory Volume 1/Forced Vital Capacity
(FEV1/FVC), Peak Expiratory Flow Rate (PEFR), and Maximal Voluntary Ventilation (MVV), chest
expansion at all 3 levels in both groups after 6 weeks of intervention(7). D‟Souza et al study showed
MIP increased significantly in both the groups postintervention, but the yoga group performed
significantly higher than the PE group. The effects of
training did not fade off even after 3 months of detraining. This study suggests that
practice of yoga for a short duration (3 months) of time can significantly improve respiratory muscle
strength in the pediatric population(8). In the study by Soni et al it was concluded that yogic
breathing exercises improve diffusion capacity. They are beneficial to COPD patients and they
can be used as an adjunct therapy with the conventional medical therapy(9). Study
by Ranjita et al showed findings indicating that Integrated Approach of Yoga Therapy benefits coal
miners with COPD, reducing dyspnea; fatigue and PR, and improving functional performance and
peripheral capillary SpO2%. Yoga can now be included as an adjunct to conventional therapy for
pulmonary rehabilitation programs for COPD patients(10). The study by Nagarathna et al showed
There was a significantly greater improvement in the group who practised yoga in the weekly
number of attacks of asthma, scores for drug treatment, and peak flow rate. This study shows the
efficacy of yoga in the long term management of bronchial asthma(11). The systematic review by
Saoji et al concluded the preponderance of literature points to beneficial effects of yogic breathing
techniques in both physiological and clinical setups. Advantageous effects of yogic breathing on the
neurocognitive, psychophysiological, respiratory, biochemical and metabolic functions in healthy
individuals were elicited. They were also found useful in management of various clinical conditions.
Overall, yogic breathing could be considered safe, when practiced under guidance of a trained
teacher. Considering the positive effects of yogic breathing, further large scale studies with rigorous
designs to understand the mechanisms involved with yogic breathing are warranted(12). The review
by Nivethitha et al suggested a slow type of yogic breathing technique was reported to produce
beneficial effects on cardiovascular and autonomic variables while fast breathing techniques do not
produce such effects. There is lack of consistency in the results of specific nostril yogic breathing
techniques and the mechanisms behind the effects of various prāṇāyāma. This review suggests that
different types of Prāṇāyāma techniques produce different effects and the mechanisms behind these
effects are not fully understood(13). Zaccaro et al concluded in their exhaustive review that they
found interesting albeit limited evidence of a relationship between physiological parameters and
psychological/behavioral outcomes in healthy subjects undergoing slow breathing techniques. They
found reliable associations between increase of HRV power and of LF power, increase of EEG alpha
and decrease of EEG theta power, induced by slow breathing techniques at 6 b/min, and positive
psychological/behavioral effects. The modulation of central nervous system activity by slow
breathing techniques, resulting in increase of EEG alpha power and decrease of EEG theta power
was reliably found to be associated with positive outcomes, improving vigor-activity, and reducing
anxiety, depression, anger and confusion when considering psychological/behavioral outcomes(14).
Review by Jayawardena et al demonstrated a significant effect on cardiorespiratory functions, in
patients with bronchial asthma, with the improvement of pulse rate, systolic blood pressure, and
respiratory function measurements.
Furthermore, reduction in the frequency of attacks, severity, and medication
requirement was also observed, with improved quality of life (QOL). In patients with chronic
obstructive pulmonary disease, symptom, activity, and impact scores were improved. QOL
improvement was also noted in cancer patients(15). The systematic review by Shreya Ghiya
concluded that This technique provides high level evidence for positive outcomes for the autonomic
nervous and cardiopulmonary systems. There is also high level of evidence regarding improvement
in cognitive functioning with regular practice of alternate nostril breathing. More clinical trials are
required to evaluate the effects of alternate nostril breathing in clinical populations and to
synthesize effective frequency and duration parameters(16). Meta-analysis by Patel et al with
quantitative and qualitative synthesis of the studies suggested that the benefits of yoga may exceed
those of conventional exercise interventions for self-rated health status, aerobic fitness, and
strength. However, the effect sizes were modest, and the evidence was mixed for yoga's effect on
depression, sleep, and bone-mineral density. Studies did not find an effect on cognition(17).
Reychler et al did systematic review where six studies that evaluated the effects of yoga and the
others focused on tai chi or qi gong separately or combined. The duration of the programs ranged
from 6 weeks to 6 months and the frequency from 2 to 7 times a week. Each session reached 30 to
90 minutes. This systematic review highlights the potential of these therapies as complementary
therapeutic approaches in COPD patients(18).
Conclusion:
Treatment of ARDS in COVID-19 is an ongoing challenge and there is restriction on
the use of glucocorticoids and antibiotics due to lack of information about disease‟s epidemiology.
Majority of the patients suffer from respiratory distress once the disease reaches an acute phase. In
this review, we have tried to present an adjunctive supplemental therapy in the form of Yoga and
Pranayam which is a non-invasive, non-pharmacological intervention and as demonstrated by the
numerous studies included in his review, with exhaustive evidence base for implementation. Yoga
and Pranayam has been concluded as a safe alternative intervention with no adverse effects in all
the studies. There are, however, limitations in the size of the study populations and hence prior to
development of any protocol further large scale clinical trials would be advisable.