Yoga breathing for seniors: what lung function studies show

Yoga breathing may strengthen breathing muscles. Studies in older adults show benefits, limits, and reasons to choose supervised practice carefully.

日本語で読む（Japanese version）

You pause mid-sentence to catch your breath while talking with your family. What you want from yoga may be less about a difficult pose and more about making breathing easier to manage. Research offers some support for that interest. In a randomized controlled trial of care-home residents whose average age was 85, yoga breathing training improved the strength used to breathe in and out, as well as the endurance involved in repeated breathing.[2]

The striking point is who took part. These residents could not participate in whole-body exercise training, yet a program focused on breathing gave them another way to practice.[2] Other research has examined lung function in older women and in healthy adults, sometimes combining postures with breathing instructions.[3][5][8] Together, these studies give breathing a place in discussions about starting yoga later in life.

They do not all measure the same thing. Producing more pressure when inhaling is different from exhaling a larger volume of air. A change in a laboratory test also needs to be distinguished from a change in everyday symptoms. Here, the focus is respiratory muscle strength and lung function. Changes in posture belong in this feature’s discussion of the back and spinal curvature; walking speed belongs in its walking article. Keeping the questions separate helps make the breathing evidence useful.

Breathing muscles can be a focus of practice

Yoga breathing practices are often called pranayama: exercises in which breathing receives deliberate attention. Some research studies make these exercises the main activity. Others combine breathing instructions with asanas, or yoga postures.[8][10] The name alone does not tell you whether participants practiced breathing, movement, or a combination, and those activities should not automatically be treated as interchangeable.

Studies in older adults have used maximum inspiratory pressure and maximum expiratory pressure to assess respiratory muscle strength. Maximum inspiratory pressure measures the greatest pressure generated when breathing in; maximum expiratory pressure measures the greatest pressure generated when breathing out.[2][3] These are measures of the force involved in breathing. They do not directly tell us how much air enters the lungs. Respiratory muscle research and lung function research overlap, but each can describe a different part of breathing.

This makes the results of the trial in residents with an average age of 85 particularly interesting. Their inhaling and exhaling strength improved after yoga breathing training.[2] The familiar phrase “working on your breathing” can sound as though it refers only to feeling calmer. In this trial, the researchers measured pressure. The result supports considering breathing practice as a way to train the muscles involved, alongside any interest someone may have in the experience of quiet practice.

A systematic review in healthy people also reported improvements in maximum inspiratory pressure, maximum expiratory pressure, and maximum voluntary ventilation.[8] Maximum voluntary ventilation is a test of the ability to move air through repeated, effortful breathing. In the care-home trial, it was used as an indicator of respiratory muscle endurance.[2] The researchers were therefore interested in more than a single inhalation or exhalation: they also assessed the capacity to keep the breathing action going.

These measures suggest a more precise goal than simply taking the biggest possible breath. Inhaling and exhaling can be activities to practice, with the results described in terms of pressure or ventilation. However, the maximum effort required for a test is different from pushing to a limit during every practice session. A test procedure is not a home exercise prescription. Understanding what a study measured gives you useful language for a conversation with an instructor or clinician.

For an older person unsure about yoga because of difficulty with whole-body exercise, the breathing trial widens the discussion. Its participants were not selected because they could perform elaborate floor postures.[2] That does not mean every breathing program will be suitable, or that a general class provides the same supervision as a research program. It means the ability to perform complicated poses need not be the only question when considering whether breathing-focused activity is worth discussing.

A trial included residents unable to do whole-body exercise

The randomized trial enrolled 81 residents, of whom 90% were women. Their average age was 85. They were unable to walk independently for more than 10 m and could not participate in whole-body exercise training.[2] Those details define the population behind the finding. The trial provides direct evidence in frail older adults with substantial activity limitations.

Participants were randomly assigned to a control group, a group using a device for inspiratory muscle training, or a yoga respiratory training group. The device provided a threshold-based form of training for the muscles used to inhale. Both experimental groups followed supervised, interval-based programs, with periods of rest included. Training took place 5 days per week for 6 weeks.[2] The comparison involved repeated, supervised practice with rest intervals.

Measurements were taken before training, during the program, after training, and at follow-up. The outcomes were maximum inspiratory pressure, maximum expiratory pressure, and maximum voluntary ventilation.[2] This combination allowed the researchers to examine inhaling strength, exhaling strength, and the endurance involved in ventilation. The study focused on respiratory muscle function.

A total of 71 residents completed the study: 24 in the control group, 23 in the device-training group, and 24 in the yoga breathing group. The yoga breathing group improved in all three measured areas. Depending on the outcome, its gains in strength and endurance were greater than those in the control group and/or the device-training group.[2] The advantage over each comparison group depended on which outcome was measured.

The authors described yoga respiratory training as a potentially effective and well-tolerated option for frail older adults when whole-body exercise was not possible.[2] That conclusion gives the trial practical interest. The residents trained under supervision, with rest intervals and repeated sessions adapted to their activity limitations.[2] A breathing technique’s name alone cannot stand in for that complete program.

For relatives helping an older parent consider activity, the study can open a useful conversation. Ask about the conditions that would make participation possible: whether walking and posture limitations can be communicated, whether rest is possible, and how suitability will be discussed. A care-home intervention and a general yoga studio are different settings. The evidence can support asking about breathing-focused practice without assuming that either setting automatically reproduces the other.

The encouraging finding is that inability to take part in whole-body training did not exclude these residents from a supervised breathing program that improved respiratory muscle function.[2] That is a meaningful addition to the search for an appropriate activity. The finding applies to these residents and their supervised program.

Older women’s breathing rate and strength changed together

Another study divided 36 older women into a yoga group and a control group. The average age was 63.1 years in the yoga group and 61.0 years in the control group. The yoga program consisted of 65-minute sessions, 3 times per week, for 12 weeks.[3] The figures below describe changes before and after practice in the yoga group. They should not be presented as the numerical difference between the yoga and control groups.

The yoga group’s breathing rate fell from 18.61 to 16.72 breaths per minute. At the same time, maximum inspiratory pressure rose from 62.17 to 73.06 cmH2O, and maximum expiratory pressure rose from 80.56 to 86.39 cmH2O.[3] The unit cmH2O expresses pressure. Breathing rate and respiratory muscle pressure describe different things, so their movement together is more informative than a statement that participants merely learned to breathe more slowly.

The study also reported improvements in vital capacity, tidal volume, and minute ventilation.[3] Vital capacity concerns the volume of air that can be moved; tidal volume refers to the amount in an individual breath; minute ventilation concerns the amount moved over a minute. These outcomes place the pressure findings alongside measures of air volume. They broaden the picture of what changed in the same participants without turning all the measurements into one interchangeable score.

A separate before-and-after study involved 20 medically stable volunteers aged 65 and older. Under a physiotherapist’s supervision, they practiced yoga combining active movement, postures, and controlled breathing twice per week for 6 weeks. Respiratory muscle strength and respiratory function improved.[1] This is useful supporting evidence from an older population, but the study had no control group. It cannot separate the effect of yoga from all other possible influences on change over time.

The care-home trial, the study in older women, and this smaller study used different approaches.[1][2][3] One emphasized breathing for people unable to perform whole-body exercise; the others included movement and posture. Their schedules also differed. The shared interest is that breathing-related function was studied directly in older participants. The differences help explain why choosing an activity requires more detail than asking whether it is called yoga.

Respiratory disease introduces another set of circumstances. A nonrandomized study recruited 30 people with chronic obstructive pulmonary disease, or COPD. Participants practiced yoga within what they were able to do, and assessments were made at the end of each month for about 3 months. The researchers evaluated lung function, peripheral oxygen saturation, and exercise tolerance using a 6-minute walking test.[11] Participants worked within their individual abilities.

The reported average increase in FEV1%, a percentage-based measure of the air exhaled in the first second, was 5.2 in participants under 65 and 11.4 in those over 65. The older age group had the larger increase. However, there were no significant differences according to duration of illness or disease severity.[11] This was an age-group comparison within a small, nonrandomized study. It does not establish that being older will reliably produce a larger benefit for everyone with COPD.

The researchers also assessed the ratio between first-second exhaled volume and forced vital capacity. Both age groups showed similar responses on that measure.[11] The age difference reported for FEV1% therefore did not appear across every outcome. The authors also reported relief from frequent exacerbations of respiratory symptoms.[11] The small, nonrandomized design limits the conclusions; yoga remains an activity to discuss alongside COPD treatment.

Across the older-adult and COPD studies, the useful theme is the possibility of studying breathing and posture practice under different conditions.[1][2][3][11] The results are not a single schedule or a single promise. They give an older person and their family more specific questions: which component is being practiced, what was measured, and how closely the research participants resemble the person considering a class?

Numbers: breathing practice and lung function

• Average age 85; 81 participants: a randomized trial in care-home residents unable to participate in whole-body exercise.[2]
• 5 days per week for 6 weeks: the supervised breathing-training schedule in that trial.[2]
• 36 women; 3 sessions per week for 12 weeks: the size and frequency of the older-women study.[3]
• Maximum inspiratory pressure rose from 62.17 to 73.06 cmH2O in the yoga group.[3]
• Breathing rate fell from 18.61 to 16.72 breaths per minute in the same group.[3]
• In an analysis of 11 studies in healthy adults, the effect size for forced vital capacity was 0.53, with a confidence interval of 0.10–0.96.[5]