Effect of Yogic Sukshma Vyayama on Cardiopulmonary Functions in Young Adults: A Quasi-Experimental Study

Effect of Yogic Sukshma Vyayama on Cardiopulmonary Functions in Young Adults: A Quasi-Experimental Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effect of Yogic Sukshma Vyayama on Cardiopulmonary Functions in Young Adults: A Quasi-Experimental Study Vipin K. Rathore, Nidheesh K. Yadav, Rudra B. Bhandari This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7601039/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : Due to the rise in unhealthy behaviors and overindulgent lifestyles, cardio-pulmonary health problems have the highest prevalence worldwide, warranting the need for alternative preventive measures. Therefore, this study evaluated the effect of a 12-week yogic sukshma vyayama intervention (YSVI) on cardio-pulmonary functions in undergraduate male students. Methods: This was a two-armed (experimental group: YG and control group: CG), non-randomised quasi-experimental study with a cohort of 80 healthy male students (mean ± standard deviation: 19.59 ± 0.98, range: 18-25 years) who were equally allocated to YG and CG. The participants of YG received YSVI for 12 weeks, and the CG underwent their usual routine. Selected cardiopulmonary indices were assessed at baseline and after the YSVI. A split-plot ANOVA was conducted to compute between-group, within-group, and interaction effects, along with Bonferroni-adjusted post-hoc tests for inter- and intra-group comparisons using SPSS version 28.0. Results: The effect size of 12-week YSVI was significant in improving lung age (0.51, p = 0.027), chest expansion (-1.171, p < 0.001), diastolic blood pressure (0.554, p = 0.018), heart rate (0.917, p < 0.001), mean arterial pressure (0.513, p = 0.029), rate pressure product (0.834, p = 0.001), and double product (0.953, p < 0.001) of YG participants compared to their controls but statistically insignificant for rest outcomes. Conclusions: YSVI was associated with improvements in several cardiopulmonary functions among young adults. As a low-cost, accessible, and safe practice, it may serve as a preventive and promotive add-on intervention. Further multi-site randomized studies are warranted to confirm these findings. yogic sukshma vyayama cardiopulmonary functions wellness health promotion Figures Figure 1 Introduction Cardio-pulmonary health is a fundamental aspect of overall human wellbeing, influencing physical performance, stress regulation, and vital physiological functions. According to the World Health Organization (WHO), cardiovascular diseases (CVDs) are the leading cause of mortality worldwide, responsible for nearly 32% of all deaths, equating to approximately 17.9 million lives lost annually (Virani et al., 2020). CVDs compromise a range of conditions, including ischemic heart disease, heart failure, and hypertension, each of which presents a significant health burden. Chronic respiratory diseases (CRDs) such as chronic obstructive pulmonary disease (COPD) and asthma are the third leading cause of death worldwide and contribute significantly to disability-adjusted life years (DALYs) (Momtazmanesh et al., 2023). In India, the prevalence of CRDs has reached approximately 32%, disproportionately affecting populations with limited access to healthcare resources (Salvi et al., 2018). The intricate relationship between the cardiovascular and respiratory systems has been well-documented in the literature (Fisher et al., 2022), as the heart and lungs operate interdependently to oxygenate blood and support cellular metabolism. Physiologically, a decrease in pulmonary function can place additional stress on the cardiovascular system by increasing vascular resistance and impairing oxygen delivery (Eriksson et al., 2013; Van Eeden et al., 2012). It has been shown that impaired lung capacity and reduced chest expansion (CE) are associated with an increased risk of hypertension, arrhythmias, and other cardiovascular complications due to the strain placed on the heart to maintain oxygenation levels (Ramalho & Shah, 2021). Therefore, measuring CE is a valuable indicator of pulmonary health, reflecting the functionality of breathing muscles, maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP), which in turn relate to overall lung volume (Lanza F. de et al., 2013; Padkao & Boonla, 2020). Research has shown that reduced CE is associated with poor pulmonary function, especially in COPD (Kaneko et al., 2016). Given the significant health burden of cardio-pulmonary diseases, there is a growing need for accessible and effective interventions that can improve both cardiovascular and respiratory health. Exercise-based rehabilitation has long been established as a key component in managing CVDs and CRDs, with studies indicating significant benefits in enhancing lung function, improving cardiovascular markers, and reducing disease-related morbidity (Dibben et al., 2023; Pinckard et al., 2019; Xiong et al., 2023). In recent years, yoga and its components – such as asanas (physical postures), pranayama (breathing exercises), dhyan (meditation), mudras (gestures), and bandhas (locks) have gained attention for their preventive and therapeutic benefits in managing cardio-pulmonary health (Kalra et al., 2022; Sahasrabudhe et al., 2021). Review and meta-analyses indicate that yoga practices are beneficial in reducing systolic and diastolic blood pressure, improving heart rate variability, and optimizing respiratory function, offering a cost-effective and accessible intervention that aligns with holistic healthcare approaches (Maity et al., 2024). Evidence from individual studies also supports these effects. For instance, yoga interventions have been shown to improve cardiovascular health markers such as blood pressure, mean arterial pressure, and heart rate(Nivethitha et al., 2021), and to increase vital capacities (VC) and forced expiratory volume (FEV)(Divya et al., 2017). One such form of yoga that has gained interest for its accessibility and adaptability is yogic sukshma vyayama (YSV). Unlike traditional yoga, which may require flexibility and endurance, YSV is designed as a series of whole-body movements incorporating joint mobilization, conscious breath regulation, and mental focus on affected body sites (Brahmachari, 1965). This can be easily practiced by individuals across all age groups and physical fitness levels, making it a viable intervention for those with compromised cardio-pulmonary functions (Dhargave et al., 2021; Ebnezar et al., 2012). Despite its widespread use in yoga teaching contexts, the empirical evidence on YSV is limited. Most studies on yoga have focused on integrated programs combining asanas, pranayama, and relaxation, with little attention to YSV as a stand-alone practice. One study that integrated YSV within a yoga program, along with physiotherapy, for individuals with Duchenne muscular dystrophy observed significant improvement in pulmonary function but did not isolate YSV’s independent contribution(Dhargave et al., 2021). Other yoga studies suggest benefits for flexibility, range of motion, and muscle strength(Polsgrove et al., 2016; Rathore et al., 2024), which may align with the potential mechanisms of YSV. The benefits of YSV as a therapeutic practice are observed anecdotally in yoga settings, yet there is less empirical evidence to substantiate its efficacy in clinical or controlled studies. A study highlighted that yoga significantly improves flexibility and strength, particularly shoulder mobility and breathing mechanics (Ganesan et al., 2020). These findings underscore the need for research that evaluates the impact of YSV intervention (YSVI) on cardiopulmonary health. Therefore, this study aims to investigate the impact of YSVI on selected pulmonary (forced vital capacity: FVC, forced expiratory volume in 1 sec: FEV1, FEV1/FVC, forced expiratory flow between 25% and 75% of forced vital capacity: FEF 25-75, peak expiratory flow rate: PEFR, maximum voluntary ventilation: MVV, lung age: LA, and chest expansion: CA) and cardiovascular indices (diastolic blood pressure: DBP, systolic blood pressure: SBP, heart rate: HR, pulse pressure: PP, mean arterial pressure: MAP, rate pressure product: RPP, and double product: DP) in healthy young adult males. Methods 2.1 Study Design This study was designed as a non-randomised, parallel-group quasi-experimental trial conducted within the University of blinded system, Haridwar, India. Ethical clearance was obtained from the Institutional Ethics Committee ( blinded /IEC/2022/02), and the study was prospectively registered in the Clinical Trial Registry of India (CTRI/2022/10/ blinded ). Written informed consent was obtained from all participants in accordance with the Indian Council of Medical Research (ICMR) bioethical guidelines. A total of 80 healthy male undergraduate students (mean ± SD: 19.59 ± 0.98 years; range 18-25 years) were recruited from two academic programs under the Patanjali Yogpeeth system during the 2022–23 academic session (odd semester). Students enrolled in the Bachelor of Science (Yoga) program (UOP main campus) formed the intervention group (YG), while students enrolled in the Bachelor of Ayurvedic Medicine and Surgery (BAMS) program (Patanjali Ayurveda College (PAC), a college established by Patanjali Yogpeeth) served as the control group (CG). Although they appeared to be different cohorts, participants in both groups shared similar campus environments, dietary facilities, hostel accommodations, and socioeconomic and cultural backgrounds, thereby minimizing institutional-level confounding. The intervention group received supervised YSVI for 12 weeks, i.e., six days per week, excluding Sundays from November 2022 to January 2023 in the yoga hall of UOP, while the control group continued routine activities without structured yoga practice. Of the 80 enrolled, 76 completed the study (39 YG; 37 CG). Reasons for attrition included <75% attendance (n=1, YG) and absence during follow-up assessments (n=3, CG). A CONSORT flowchart, as shown in Figure 1, illustrates participant recruitment, allocation, and retention. While participants and yoga instructors were aware of group allocation, outcome assessors and statisticians were blinded to assignments to reduce measurement and analytical bias. Insert Figure 1 here 2.2 Participants Initially, one hundred participants were screened from the UOP and PAC in Haridwar, North India. After applying the inclusion and exclusion criteria, 80 eligible participants were enrolled in the study. The sample size was estimated at 68, considering PEFR as the primary outcome, with an effect size of 0.807 [22], a power of 0.90, and an alpha of 0.05, as determined by G*Power software (version 3.1.9.4). To account for an estimated 20% dropouts, the final sample size was set at 80 participants, with 40 participants in each group. Students enrolled in the first-year yoga program at UOP were included in the YG, and first-year BAMS students were included in the CG as study participants. The age (mean age ± standard deviation) of the participants was 19.41 ± 1.2 years and 19.78 ± 0.67 years in the YG and CG, respectively. The body mass index (BMI) was 21.47±2.1 kg/m 2 for the YG and 21.90±2.02 kg/m 2 for the CG. Both groups were also similar in terms of their diets, accommodation, education level, socioeconomic status, and regional and cultural backgrounds. The detailed demographic characteristics are presented in Table 1. Insert Table 1 here 2.3 Inclusion and Exclusion Criteria The inclusion criteria included healthy male participants aged 18-25 with no history of cardiovascular or respiratory diseases, no prior engagement in structured yoga training, and a BMI of 18.5–24.99 kg/m². Students with chronic illnesses, those who had undergone recent surgery or injury affecting mobility, individuals involved in sports or exercise programs, and those unable to provide informed consent were excluded. 2.4 Outcome Assessments 2.4.1 Measure of pulmonary outcomes Pulmonary function tests (PFTs) were measured before and after YSVI using the RMS Helios-702 digital spirometer [23,24], calibrated by the American Thoracic Society and the European Respiratory Society (ATS/ERS) (Crapo et al., 1995). The participants were provided with an orientation about its use. After three practice sessions, PFTs (FVC, FEV1, FEV1/FVC, FEF 25-75, PEFR, MVV, LA) were recorded. The participants were asked to breathe normally before forced inspiration, followed by forceful exhalation through a nozzle fixed at the RMS at baseline and after the YSVI. 2.4.2 Assessment of chest expansion Non-stretchable tape was used to measure CE before and after the intervention by taking the difference of chest circumferences across fifth thoracic vertebrae mid-clavicular line and third intercostal space during maximum inhalation followed by exhalation (Debouche et al., 2016). Measurements were repeated three times to confirm consistency. 2.4.3 Measure of cardiovascular outcomes Cardiovascular outcomes (SBP, DBP, and HR) were measured in the morning hours (6–8 AM) in a quiet setting using an Omron T9P automated blood pressure machine and an Oscillometric device validated in clinical settings (Brown et al., 2011; Scragg et al., 2014). Before taking the measurement, participants were advised to relax in a comfortable chair for five minutes to ensure calmness. Rest indices MAP, PP, RPP, and DP were computed by using the formula MAP = DBP + PP/3, RPP = (HR x SBP)/100, and DP = HR x MAP (Sharma et al., 2013). 2.5 Intervention Participants in the YG underwent supervised YSVI sessions from November 2022 to January 2023, lasting 12 weeks (60 minutes/day, 6 days/week) (5:00 – 6:00 AM IST), excluding other yoga practical course activities. As conceptualized and taught by Dhirendra Brahmachari (1965), YSVI incorporates whole-body joint mobilization and stretching synchronized with breath regulation and a focus on affected body sites (Brahmachari, 1965), similar to meditation in motion. The protocol is detailed in Table 2. Sessions were conducted simultaneously each day under supervised conditions to ensure consistency and reliability. No adverse events or unintended effects were observed or reported during the intervention. Participants were monitored for discomfort or harm throughout the study. The participants in the control group (CG) did not receive any intervention and continued their usual routine. Insert Table 2 here 2.6 Data analysis strategies IBM SPSS (version 28, SPSS South Asia Private Limited, Bangalore, India) was used for data analysis. For the normal baseline demographic data (age, weight, height, and BMI), means ± standard deviations (M±SD ) were compared to assess the match between YG and CG, along with the computation of an independent t- test. For the normal data regarding FVC, FEV1, FEV1/FVC, FEF 25-75, PEFR, MVV, LA, CE, SBP, DBP, HR, PP, MAP, RPP, DP) with insignificant Shapiro–Wilk test, Split-plot ANOVA was run to compute within-group (time: before-1 and after-2), between-group (groups: YG-1, CG-1) and interaction effects (G*T) along with Bonferroni adjusted post hoc tests for inter and intra-group pairwise comparisons. Results Of the 80 participants, 76 completed the 12-week YSVI, comprising 39 participants in the YG and 37 in the CG. The dropout rate was minimal compared to the estimated rate, with only one participant from the YG and three from the CG. 3.1 Pulmonary functions 3.1.1 Effect on forced vital capacity FVC increased ( F (1, 74) = 3.107, p = 0.082, η p 2 = 0.04) after the YSVI. The group effect ( F (1, 74) = 0.023, p = 0.879, η p 2 < 0.001) was non-significant, with a significant interaction effect (G*T) ( F (1, 74) = 13.233, p = 0.001, η p 2 = 0.152). Inter-group pairwise comparison of post-intervention data showed a non-significant effect in FVC in YG compared to CG (ES = -0.202, p = 0.367, 95% CI [-0.400, 0.100]), as shown in Table 3 and Supplemental Table 5. Insert Table 3 here Insert Supplemental Table 5 here 3.1.2 Effect on forced expiratory volume in one second FEV1 increased ( F (1, 74) = 2.995, p = 0.088, η p 2 = 0.039) after the YSVI. The group effect ( F (1, 74) = 0.486, p = 0.488, η p 2 = 0.007) was non-significant, with a significant effect (G*T) ( F (1, 74) = 7.6, p = 0.007, η p 2 = 0.093). Inter-group pairwise comparison of post-intervention showed a non-significant effect in FEV1 in YG compared to CG (ES = 0, p = 0.977, 95 % CI [-0.357, 0.058]). 3.1.3 Effect on FEV1/FVC FEV1/FVC increased ( F (1, 74) = 0.5, p = 0.33, η p 2 = 0.01) after the YSVI. The group effect ( F (1, 74) = 0.97, p = 0.488, η p 2 = 0.007) was non-significant, with a significant effect (G*T) ( F (1, 74) = 5.22, p = 0.03, η p 2 = 0.07). Inter-group pairwise comparison of post-intervention results showed a non-significant effect in FEV1/FVC in YG compared to CG (ES = 0.376, p = 0.104, 95% CI = [-4.017, 3.337]). 3.1.4 Effect on the forced expiratory flow between 25 % and 75% vital capacity FEF increased significantly ( F (1, 74) = 11.056, p = 0.001, η p 2 = 0.013) 25-75 after the YSVI. The group effect ( F (1, 74) = 0.86, p = 0.357, η p 2 = 0.011) was non-significant, with non-significant (G*T) ( F (1, 74) = 0.381, p = 0.539, η p 2 = 0.005). Inter-group pairwise comparison of post-intervention showed a non-significant effect in FEF 25-75 in YG compared to CG (ES = -0.239, p = 0.308, 95 % CI [-0.232, 0.540]. 3.1.5 Effect on peak expiratory flow rate PEFR increased significantly ( F (1, 74) = 12.779, p = 0.001, η p 2 = 0.147) after the YSVI. The group effect ( F (1, 74) = 1.247, p = 0.268, η p 2 = 0.017) was non-significant, with a significant effect (G*T) ( F (1, 74) = 5.192, p = 0.026, η p 2 = 0.006). Inter-group pairwise comparison of post-intervention results showed a non-significant effect in PEFR in YG compared to CG (ES = 0.097, p = 0.661, 95% CI = [-1.130, 0.126]). 3.1.6 Effect on maximum voluntary ventilation MVV increased ( F (1, 74) = 3.116, p = 0.082, η p 2 = 0.04) after the YSVI. The group effect ( F (1, 74) = 0.472, p = 0.494, η p 2 = 0.006) was non-significant, with a significant effect (G*T) ( F (1, 74) = 7.784, p = 0.007, η p 2 = 0.095). Inter-group pairwise comparison of post-intervention results showed a non-significant effect in MVV in YG compared to CG (ES = -0.011, p = 0.962, 95% CI [-14.265, 2.331]). 3.1.7 Effect on lung age LA decreased ( F (1, 74) = 0.063, p = 0.802, η p 2 = 0.001) after the YSVI. The group effect ( F (1, 74) = 1.923, p = 0.17, η p 2 = 0.025) was non-significant, with a significant effect (G*T) ( F (1, 74) = 17.781, p < 0.001, η p 2 = 0.194). Inter-group pairwise comparison of post-intervention results showed a significant effect in LA in YG compared to CG (ES = 0.51, p = 0.027, 95% CI = [-2.11, -0.13]). 3.1.7 Effect on chest expansion CE increased significantly ( F (1, 74) = 128.132, p < 0.001, η p 2 = 0.634) after the YSVI. The group effect ( F (1, 74) = 8.891, p = 0.004, η p 2 = 0.107) was significant, with a significant effect (G*T) ( F (1, 74) = 56.003, p < 0.001, η p 2 = 0.431). Table 3. Inter-group pairwise comparison of post-intervention results showed a significant effect in CE in YG compared to CG (ES = -1.171, p < 0.001, 95% CI [0.746, 1.71]). 3.2 Cardiovascular functions 3.2.1 Effect on systolic blood pressure SBP decreased significantly ( F (1, 74) = 128.132, p < 0.001, η p 2 = 0.634) after the YSVI. The group effect ( F (1, 74) = 8.891, p = 0.004, η p ² = 0.107) was significant, with a significant interaction effect (G*T) ( F (1, 74) = 56.003, p < 0.001, η p ² = 0.431). Inter-group pairwise comparison of post-intervention showed a non-significant effect in SBP in YG compared to CG (ES = -0.015, p = 0.361, 95 % CI [-0.877, 6.624], as shown in Table 4. Insert Table 4 here 3.2.2 Effect on diastolic blood pressure DBP decreased ( F (1, 74) = 0.874, p = 0.353, η p 2 = 0.012) after the YSVI. The group effect ( F (1, 74) = 0.163, p = 0.688, η p 2 = 0.002) was non-significant, with a significant effect (G*T) ( F (1, 74) = 17.409, p < 0.001, η p 2 = 0.19). Inter-group pairwise comparison of post-intervention data showed a significant effect in DBP in YG compared to CG (ES = 0.554, p = 0.018, 95% CI = [-1.053, 5.875]). 3.2.3 Effect on heart rate HR decreased significantly ( F (1, 74) = 3.984, p = 0.05, η p 2 = 0.051) after the YSVI. The group effect ( F (1, 74) = 6.862, p = 0.011, η p 2 = 0.085) was significant, with a non-significant effect (G*T) ( F (1, 74) = 0.89, p = 0.348, η p 2 = 0.012). Inter-group pairwise comparison of post-intervention data showed a significant effect in HR in YG compared to CG (ES = 0.917, p < 0.001, 95% CI = [-8.453, 1.275]). 3.2.4 Effect on pressure product PP decreased ( F (1, 74) = 0.007, p = 0.934, η p 2 < 0.001) after the YSVI. The group effect ( F (1, 74) = 0.60, p = 0.442, η p 2 = 0.008) was non-significant, with a non-significant effect (G*T) ( F (1, 74) = 0.88, p = 0.352, η p 2 = 0.012). Inter-group pairwise comparison of post-intervention results showed a non-significant effect in PP in YG compared to CG (ES = -0.26, p = 0.245, 95% CI [-3.364, 4.289]). 3.2.5 Effect on mean arterial pressure MAP decreased ( F (1, 74) = 1.3, p = 0.258, η p 2 = 0.017) after the YSVI. The group effect ( F (1, 74) = 0.016, p = 0.901, η p 2 < 0.001) was non-significant, with a significant effect (G*T) ( F (1, 74) = 23.08, p < 0.001, η p 2 = 0.238). Inter-group pairwise comparison of post-intervention data showed a significant effect in MAP in YG compared to CG (ES = -0.513, p = 0.029, 95% CI [-0.507, 5.637]). 3.2.6 Effect on rate-pressure product RPP decreased significantly ( F (1, 74) = 4.88, p = 0.03, η p 2 = 0.062) after the YSVI. The group effect ( F (1, 74) = 3.60, p = 0.062, η p 2 = 0.046) was non-significant, with a significant effect (G*T) ( F (1, 74) = 4.83, p = 0.031, η p 2 = 0.061). Inter-group pairwise comparison of post-intervention results showed a significant effect in RPP in YG compared to CG (ES = 0.834, p = 0.001, 95% CI = [-8.998, 4.964]). 3.2.7 Effect on double product DP decreased significantly ( F (1, 74) = 5.31, p = 0.024, η p 2 = 0.067) after the YSVI. The group effect ( F (1, 74) = 4.05, p = 0.048, η p 2 = 4.05) was significant, with a significant effect (G*T) ( F (1, 74) = 8.34, p = 0.005, η p 2 = 0.101) as shown in Table 4 and Supplemental Table 5 . Inter-group pairwise comparison of post-intervention results showed a significant effect in DP in YG compared to CG (ES = 0.953, p < 0.001, 95% CI = [-673.12, 433.83]). Discussion This study investigated the effects of a 12-week YSVI on pulmonary and cardiovascular functions in healthy undergraduate male students. The findings showed that YSVI significantly improved several pulmonary parameters, including CE, LA, and intra-group increases in FVC, FEV1, MVV, FEF25–75, and PEFR. On the cardiovascular side, YSVI led to significant reductions in DBP, HR, MAP, RPP, and DP. SBP and PP showed trends of reduction, but were not statistically significant between groups. Collectively, these results suggest that YSVI is effective in enhancing pulmonary efficiency and reducing cardiovascular stress even among healthy young adults. Pulmonary Functions The present study found that FVC and FEV1 increased after YSVI, although inter-group comparisons were not statistically significant. Previous yoga-based interventions, particularly those incorporating pranayama, have consistently demonstrated significant improvements in FVC and FEV1 (Budhi et al., 2019; Dhansoia et al., 2022; Mundhe et al., 2025; Prasad et al., 2022). These findings are typically attributed to enhanced respiratory muscle strength, improved lung compliance, and increased thoracic mobility acquired through controlled breathing practices (Anshu et al., 2023; Chaudhary et al., 2024; Hakked et al., 2017). The modest improvements in our study may be attributable to participants’ already healthy baseline function, leaving limited room for measurable inter-group differences. The FEV1/FVC ratio showed a non-significant increase. While some studies have reported improved ratios following yoga practice (Prasad et al., 2022), others found little change in healthy individuals (Mane et al., 2014). Since the FEV1/FVC ratio is primarily used to identify obstructive patterns, its stability in our sample may indicate that YSVI has greater utility in populations with compromised lung function. FEF25-75 and PEFR improved intra-group but were not significantly different between groups. These outcomes reflect mid-expiratory flow and maximal expiratory effort, both of which are sensitive to airway caliber (Qin et al., 2021; Rajbhoj et al., 2023). Prior studies have demonstrated higher PEFR values among yoga practitioners, attributing them to stronger respiratory musculature and improved airway patency (D’Souza & Avadhany, 2014; Shyam Karthik et al., 2014). The partial alignment with our findings suggests that YSVI may improve expiratory flow mechanics; however, a longer intervention or a clinical population might show more apparent effects. MVV also improved significantly within the intervention group. This finding aligns with earlier reports that yoga enhances ventilatory endurance by training both inspiratory and expiratory muscles through repeated slow, deep breathing (Budhi et al., 2019; Halder et al., 2012). Enhanced MVV suggests that YSVI may increase overall ventilatory capacity, which has implications for exercise tolerance and pulmonary reserve (Sutbeyaz et al., 2010). The most significant effect was observed in LA and CE, both of which showed significant between-group differences. Reduced LA suggests slowed respiratory aging, consistent with findings that yoga-based interventions preserve pulmonary elasticity and efficiency over time (Liu et al., 2014; Santaella et al., 2011). Increased CE reflects improved thoracic flexibility and respiratory muscle function (Csepregi et al., 2022). Similar results have been reported in interventions emphasizing thoracic expansion through targeted yogic exercises (Padkao & Boonla, 2020). YSVI practices such as vaksha-sthala-shakti-vikasaka specifically mobilize the thoracic cage and intercostal musculature, resulting in greater compliance of the chest wall and improved respiratory efficiency. The large effect size observed in CE underscores YSVI’s role in improving thoracic flexibility, which is crucial not only for pulmonary health but also for cardiovascular efficiency. Cardiovascular Functions This study demonstrated that YSVI produced significant improvements in several cardiovascular parameters, particularly DBP, HR, MAP, RPP, and DP. These findings indicate that YSVI may reduce cardiac workload and improve autonomic balance, even in healthy young adults. SBP showed a mild reduction within the intervention group, but the inter-group difference was not statistically significant. Previous meta-analyses of yoga interventions suggest that SBP reductions are more evident in hypertensive or pre-hypertensive populations than in normotensive individuals (Geiger et al., 2025; Kumar et al., 2023; Nalbant et al., 2022). Since the participants in this study were young and healthy, the limited change in SBP is not unexpected. In contrast, DBP decreased significantly in the YSVI group compared with controls. Similar results have been reported in earlier studies examining slow-breathing and yoga-based interventions (Garg et al., 2023; Naik et al., 2018). The likely explanation is a reduction in peripheral vascular resistance due to enhanced endothelial function and parasympathetic dominance. By promoting relaxation and slow, controlled breathing, YSVI may also reduce sympathetic outflow, which contributes to lowering DBP (Anasuya et al., 2020; Pathan et al., 2023). The significant reduction in HR observed in this study is consistent with previous yoga research (Pramanik et al., 2009; Tyagi & Cohen, 2016). A lower resting HR reflects improved vagal tone and reduced sympathetic drive, both of which are beneficial for cardiovascular efficiency. Physiologically, regular practice of controlled breathing and focused movements, as incorporated in YSVI, may recalibrate the autonomic nervous system and shift the sympathovagal balance toward parasympathetic predominance (Shinba et al., 2020). MAP, a key determinant of organ perfusion and vascular load, also decreased significantly in the YG. Similar findings have been reported in yoga studies where reductions in MAP were attributed to improved baroreceptor sensitivity and neurohumoral modulation (Anasuya et al., 2020; Mohammadi et al., 2022; Selvamurthy et al., 1998). A lower MAP in healthy individuals may provide long-term protection against vascular dysfunction and hypertension (Murugesan, 2024). The reduction in RPP and DP further supports the cardioprotective role of YSVI. Both indices are widely recognized markers of myocardial oxygen demand and cardiac workload (Kiviniemi et al., 2019). Studies have shown that yoga practices decrease these parameters by simultaneously lowering HR and blood pressure (Hari Krishna et al., 2014). Reduced RPP and DP imply that the heart requires less effort to maintain systemic circulation, which could have important preventive implications in populations at risk of hypertension and ischemic heart disease. PP did not change significantly after YSVI. PP is primarily influenced by arterial compliance and stroke volume, which are less likely to show variation in young, healthy individuals (Alfie et al., 1999; Salomão et al., 2023). This suggests that YSVI may exert greater effects on PP in older adults or those with reduced arterial elasticity rather than in a young population with preserved vascular compliance. This study demonstrates the benefit of YSVI for respiratory and cardiovascular health, especially in young adults. Previous research studies have focused on yoga postures and pranayama, documenting the benefits of general yoga practices. However, these studies have overlooked the effects of YSVI (meditation in motion) on cardiopulmonary functions, unlike our study findings. Unlike dynamic yoga activities, YSVI as a meditation in motion is optimal for cardiopulmonary and overall health, empowering yoga modules for individuals with different age groups, fitness levels, health profiles, genders, socioeconomic statuses, cultures, regions, constitutions, and dispositions, making it a promising intervention if practiced under the supervision of the expert with sound experiential and experimental yoga knowledge and skills. Conclusion, limitations, and recommendations This study provides preliminary evidence that a 12-week Yogic Sukshma Vyayama intervention (YSVI) can improve selected pulmonary (FVC, FEV1, PEFR, MVV, lung age, chest expansion) and cardiovascular (DBP, HR, MAP, RPP, DP) parameters in young healthy adults. As a low-cost, accessible, and non-pharmacological practice, YSVI appears to be a promising promotive and preventive adjunct for cardiopulmonary health. Several limitations must be acknowledged. The study employed a quasi-experimental, non-randomised design, with allocation based on academic cohorts rather than random assignment. Although groups were matched at baseline, the absence of randomisation raises the possibility of selection bias. The sample was limited to male undergraduate students from a single institution, which restricts generalisability across genders, age groups, and sociocultural contexts. 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Baseline characteristics of the participants Outcome Group n M±SD p≤ Age (year) YG 39 19.41±1.2 0.096 CG 37 19.78±0.67 Weight (kg) YG 39 62.66±6.62 0.333 CG 37 63.23±5.73 Height (cm) YG 39 170.87±5.64 0.418 CG 37 170±5.12 BMI (kg/m2) YG 39 21.47±2.1 0.875 CG 37 21.90±2.02 Footnotes: n = Number of participants in each group; M±SD = Mean ± Standard Deviation; p = level of significance. Table 2. YSVI Protocol Duration 3 months (12 weeks) Timing Morning (5:00 – 6:00 AM IST) Session hour 60 minutes Session days Monday-Saturday Yoga Type Name of the Practice Interval (in minutes) Prayer Gayatri mantra 1 Yogic Sukshma Vyayama (10 rounds each) Uchchaana-sthalattha, Vishuddhi-chakra-shuddhi, Buddhi tatha dhruti-shakti-vikasaka, Smarana-shakti-viksaka, 5 Griva Shakti vikasaka 1,2, & 3, Kapola-sakthi-vardhaka 5 Skandha tatha bahu mula Shakti vikasaka, Bhuja bandha Shakti vikasaka, Kaphoni Shakti vikasak, Bhujavalli shakti vikasaka, Purna bhuja shakti vikasaka 20 Udara-sakthi-vikasaka (1 -10), Vaksha-sthala-shakti-vikasaka 1& 2, Kati-shakti-vikasaka (1-5) 20 Relaxation Shavasana 9 Total Interval 60 Footnotes: IST: Indian Standard Time; The numbers written in parentheses () are the practice repetitions. Table 3. Inter-group and intra-group comparisons of pulmonary outcomes Outcomes Intragroup Effects Intergroup p -value (ES) YG (n = 39) CG (n = 37) YG-CG Before ( M±SD ) After ( M±SD ) Before ( M±SD ) After ( M±SD ) After FVC 3.32±0.52 3.51±0.54*** 3.47±0.57 3.40±0.55 0.367 (-0.202) FEV1 3.05±0.48 3.18±0.52* 3.20±0.42 3.18±0.46 0.977 (0) FEV1/FVC 92.6±9.7 90.9±9.5* 93.0±5.5 93.9±6.1 0.104 (0.376) FEF 25-75 4.37±0.90 4.52±0.91** 4.22±0.78 4.32±0.76 0.308 (-0.239) PEFR 7.07±1.20 7.57±1.09*** 7.57±1.54 7.68±1.18 0.661 (0.097) MVV 122.19±19.27 127.24±20.72* 128.16±16.88 127.03±18.27 0.962 (-0.011) LA 20.2±2.4 19.7±2.3* 20.4±1.7 20.8±2.0* 0.027 (0.51) # CE 3.88±1.19 5.23±1.15*** 3.72±0.9 4±0.94* <0.001 (-1.171) ### Footnotes: *ES, effect size; *and # indicate intra-group and inter-group comparison respectively; * p <0.05, ** p < 0.01, *** p < 0.001; # p < 0.05, ## p < 0.01, ### p < 0.001. Table 4. Inter-group and Intra-group comparisons of cardiovascular outcomes Outcomes Intragroup Effects Intergroup p- value (ES) YG (n = 39) CG (n = 37) YG-CG Before ( M±SD ) After ( M±SD ) Before ( M±SD ) After ( M±SD ) After SBP 124.8±9.3 122.1±6.7** 122.0±6.9 123.6±7.7 0.361 (-0.015) DBP 77.9±8.6 74.2±7.2*** 75.5±6.4 77.8±5.7* 0.018 (0.554) # HR 76.9±10.6 74.0±6.0* 80.5±10.7 79.5±6.0 <0.001(0.917) ### PP 46.9±9.8 47.8±8.7 46.5±6.6 45.8±6.5 0.245 (-0.26) MAP 93.5±7.5 90.2±5.7*** 91.0±5.8 93.1±5.6* 0.029 (0.513) # RPP 96.2±16.1 90.4±9.0** 98.2±14.3 98.2±9.7 0.001 (0.834) ## DP 7217.2±1278.5 6684.0±762.7*** 7336.8±1134 7396.8±732.7 <0.001 (0.953) ### Footnotes: *ES, effect size; *and # indicate intra-group and inter-group comparison respectively; * p <0.05, ** p < 0.01, *** p < 0.001; # p < 0.05, ## p < 0.01, ### p < 0.001. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7601039","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":517334015,"identity":"345cf704-8f49-439a-8a2d-21bbc5f58713","order_by":0,"name":"Vipin K. Rathore","email":"","orcid":"","institution":"University of Patanjali","correspondingAuthor":false,"prefix":"","firstName":"Vipin","middleName":"K.","lastName":"Rathore","suffix":""},{"id":517334016,"identity":"571f94fe-e36f-4ec5-bcb8-899ed119fa18","order_by":1,"name":"Nidheesh K. Yadav","email":"","orcid":"","institution":"Shoolini University","correspondingAuthor":false,"prefix":"","firstName":"Nidheesh","middleName":"K.","lastName":"Yadav","suffix":""},{"id":517334017,"identity":"94274edf-0e62-440d-97a6-455d6e46f125","order_by":2,"name":"Rudra B. Bhandari","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4klEQVRIiWNgGAWjYJCCAzxgkoHxAZDi4SNFC7MBSAsbUdZAtbBJgGiCWgyOt1888HbPvcS+24efVX7NsZNhY2B++OgGPi1nzhQcnPOsOHHmuTSz27LbkoEOYzM2zsGn5UZOwmGeAwmJG84wmN2W3MYM1MLDJk2kFvZvxZLb6onRkn4AqoXHjPHjtsOEtUieOcNwcM6BBOOZZ3iKpRm3HedhYybgF77j7Y8/vDmQINt3hn3jx5/bqu352ZsfPsanReEAjwGcwwyOIGY8ykFAvoH9AZzD+IOA6lEwCkbBKBiZAAC8C1IGsyTiRAAAAABJRU5ErkJggg==","orcid":"","institution":"University of Patanjali","correspondingAuthor":true,"prefix":"","firstName":"Rudra","middleName":"B.","lastName":"Bhandari","suffix":""}],"badges":[],"createdAt":"2025-09-12 13:23:35","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7601039/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7601039/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":91967108,"identity":"1350a15c-ec24-405c-895c-7f65b9a5662d","added_by":"auto","created_at":"2025-09-23 08:30:58","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":177593,"visible":true,"origin":"","legend":"\u003cp\u003eCONSORT Flow Chart\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7601039/v1/14833a1b3d435d5f3d49cbe0.png"},{"id":91968201,"identity":"a239c053-83c7-4d16-928b-d0dfdaad3f93","added_by":"auto","created_at":"2025-09-23 08:38:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1205173,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7601039/v1/3749d5a0-2231-4bbd-a99d-7ba9e0c8185a.pdf"},{"id":91967109,"identity":"b47bb5e8-38f1-4637-be48-966fc5fddbd4","added_by":"auto","created_at":"2025-09-23 08:30:58","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":17787,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementalTable5.docx","url":"https://assets-eu.researchsquare.com/files/rs-7601039/v1/f5e76ab5ff157432164dc83c.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effect of Yogic Sukshma Vyayama on Cardiopulmonary Functions in Young Adults: A Quasi-Experimental Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eCardio-pulmonary health is a fundamental aspect of overall human wellbeing, influencing physical performance, stress regulation, and vital physiological functions. According to the World Health Organization (WHO), cardiovascular diseases (CVDs) are the leading cause of mortality worldwide, responsible for nearly 32% of all deaths, equating to approximately 17.9 million lives lost annually (Virani et al., 2020). CVDs compromise a range of conditions, including ischemic heart disease, heart failure, and hypertension, each of which presents a significant health burden. Chronic respiratory diseases (CRDs) such as chronic obstructive pulmonary disease (COPD) and asthma are the third leading cause of death worldwide and contribute significantly to disability-adjusted life years (DALYs) (Momtazmanesh et al., 2023). In India, the prevalence of CRDs has reached approximately 32%, disproportionately affecting populations with limited access to healthcare resources (Salvi et al., 2018).\u003c/p\u003e\n\u003cp\u003eThe intricate relationship between the cardiovascular and respiratory systems has been well-documented in the literature (Fisher et al., 2022), as the heart and lungs operate interdependently to oxygenate blood and support cellular metabolism. Physiologically, a decrease in pulmonary function can place additional stress on the cardiovascular system by increasing vascular resistance and impairing oxygen delivery (Eriksson et al., 2013; Van Eeden et al., 2012). It has been shown that impaired lung capacity and reduced chest expansion (CE) are associated with an increased risk of hypertension, arrhythmias, and other cardiovascular complications due to the strain placed on the heart to maintain oxygenation levels (Ramalho \u0026amp; Shah, 2021). Therefore, measuring CE is a valuable indicator of pulmonary health, reflecting the functionality of breathing muscles, maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP), which in turn relate to overall lung volume (Lanza F. de et al., 2013; Padkao \u0026amp; Boonla, 2020). Research has shown that reduced CE is associated with poor pulmonary function, especially in COPD (Kaneko et al., 2016).\u003c/p\u003e\n\u003cp\u003eGiven the significant health burden of cardio-pulmonary diseases, there is a growing need for accessible and effective interventions that can improve both cardiovascular and respiratory health. Exercise-based rehabilitation has long been established as a key component in managing CVDs and CRDs, with studies indicating significant benefits in enhancing lung function, improving cardiovascular markers, and reducing disease-related morbidity (Dibben et al., 2023; Pinckard et al., 2019; Xiong et al., 2023). In recent years, yoga and its components \u0026ndash; such as asanas (physical postures), pranayama (breathing exercises), dhyan (meditation), mudras (gestures), and bandhas (locks) have gained attention for their preventive and therapeutic benefits in managing cardio-pulmonary health (Kalra et al., 2022; Sahasrabudhe et al., 2021). Review and meta-analyses indicate that yoga practices are beneficial in reducing systolic and diastolic blood pressure, improving heart rate variability, and optimizing respiratory function, offering a cost-effective and accessible intervention that aligns with holistic healthcare approaches (Maity et al., 2024). Evidence from individual studies also supports these effects. For instance, yoga interventions have been shown to improve cardiovascular health markers such as blood pressure, mean arterial pressure, and heart rate(Nivethitha et al., 2021), and to increase vital capacities (VC) and forced expiratory volume (FEV)(Divya et al., 2017). One such form of yoga that has gained interest for its accessibility and adaptability is yogic sukshma vyayama (YSV). Unlike traditional yoga, which may require flexibility and endurance, YSV is designed as a series of whole-body movements incorporating joint mobilization, conscious breath regulation, and mental focus on affected body sites (Brahmachari, 1965). This can be easily practiced by individuals across all age groups and physical fitness levels, making it a viable intervention for those with compromised cardio-pulmonary functions (Dhargave et al., 2021; Ebnezar et al., 2012). Despite its widespread use in yoga teaching contexts, the empirical evidence on YSV is limited. Most studies on yoga have focused on integrated programs combining asanas, pranayama, and relaxation, with little attention to YSV as a stand-alone practice. One study that integrated YSV within a yoga program, along with physiotherapy, for individuals with Duchenne muscular dystrophy observed significant improvement in pulmonary function but did not isolate YSV\u0026rsquo;s independent contribution(Dhargave et al., 2021). Other yoga studies suggest benefits for flexibility, range of motion, and muscle strength(Polsgrove et al., 2016; Rathore et al., 2024), which may align with the potential mechanisms of YSV. The benefits of YSV as a therapeutic practice are observed anecdotally in yoga settings, yet there is less empirical evidence to substantiate its efficacy in clinical or controlled studies. A study highlighted that yoga significantly improves flexibility and strength, particularly shoulder mobility and breathing mechanics (Ganesan et al., 2020). These findings underscore the need for research that evaluates the impact of YSV intervention (YSVI) on cardiopulmonary health. Therefore, this study aims to investigate the impact of YSVI on selected pulmonary (forced vital capacity: FVC, forced expiratory volume in 1 sec: FEV1, FEV1/FVC, forced expiratory flow between 25% and 75% of forced vital capacity: FEF 25-75, peak expiratory flow rate: PEFR, maximum voluntary ventilation: MVV, lung age: LA, and chest expansion: CA) and cardiovascular indices (diastolic blood pressure: DBP, systolic blood pressure: SBP, heart rate: HR, pulse pressure: PP, mean arterial pressure: MAP, rate pressure product: RPP, and double product: DP) \u0026nbsp;in healthy young adult males.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cem\u003e2.1 Study Design\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis study was designed as a non-randomised, parallel-group quasi-experimental trial conducted within the University of \u003cstrong\u003eblinded\u0026nbsp;\u003c/strong\u003esystem, Haridwar, India. Ethical clearance was obtained from the Institutional Ethics Committee (\u003cstrong\u003eblinded\u003c/strong\u003e/IEC/2022/02), and the study was prospectively registered in the Clinical Trial Registry of India (CTRI/2022/10/\u003cstrong\u003eblinded\u003c/strong\u003e). Written informed consent was obtained from all participants in accordance with the Indian Council of Medical Research (ICMR) bioethical guidelines.\u003c/p\u003e\n\u003cp\u003eA total of 80 healthy male undergraduate students (mean \u0026plusmn; SD: 19.59 \u0026plusmn; 0.98 years; range 18-25 years) were recruited from two academic programs under the Patanjali Yogpeeth system during the 2022\u0026ndash;23 academic session (odd semester). Students enrolled in the Bachelor of Science (Yoga) program (UOP main campus) formed the intervention group (YG), while students enrolled in the Bachelor of Ayurvedic Medicine and Surgery (BAMS) program (Patanjali Ayurveda College (PAC), a college established by Patanjali Yogpeeth) served as the control group (CG). Although they appeared to be different cohorts, participants in both groups shared similar campus environments, dietary facilities, hostel accommodations, and socioeconomic and cultural backgrounds, thereby minimizing institutional-level confounding.\u003c/p\u003e\n\u003cp\u003eThe intervention group received supervised YSVI for 12 weeks, i.e., six days per week, excluding Sundays from November 2022 to January 2023 in the yoga hall of UOP, while the control group continued routine activities without structured yoga practice. Of the 80 enrolled, 76 completed the study (39 YG; 37 CG). Reasons for attrition included \u0026lt;75% attendance (n=1, YG) and absence during follow-up assessments (n=3, CG). A CONSORT flowchart, as shown in Figure 1, illustrates participant recruitment, allocation, and retention. While participants and yoga instructors were aware of group allocation, outcome assessors and statisticians were blinded to assignments to reduce measurement and analytical bias.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eInsert Figure 1 here\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e2.2 Participants\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eInitially, one hundred participants were screened from the UOP and PAC in Haridwar, North India. After applying the inclusion and exclusion criteria, 80 eligible participants were enrolled in the study. The sample size was estimated at 68, considering PEFR as the primary outcome, with an effect size of 0.807 [22], a power of 0.90, and an alpha of 0.05, as determined by G*Power software (version 3.1.9.4). To account for an estimated 20% dropouts, the final sample size was set at 80 participants, with 40 participants in each group.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eStudents enrolled in the first-year yoga program at UOP were included in the YG, and first-year BAMS students were included in the CG as study participants. The age (mean age \u0026plusmn; standard deviation) of the participants was 19.41 \u0026plusmn; 1.2 years and 19.78 \u0026plusmn; 0.67 years in the YG and CG, respectively. The body mass index (BMI) was 21.47\u0026plusmn;2.1 kg/m\u003csup\u003e2\u003c/sup\u003e for the YG and 21.90\u0026plusmn;2.02 kg/m\u003csup\u003e2\u003c/sup\u003e for the CG. Both groups were also similar in terms of their diets, accommodation, education level, socioeconomic status, and regional and cultural backgrounds. The detailed demographic characteristics are presented in Table 1.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eInsert Table 1 here\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e2.3 Inclusion and Exclusion Criteria\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe inclusion criteria included healthy male participants aged 18-25 with no history of cardiovascular or respiratory diseases, no prior engagement in structured yoga training, and a BMI of 18.5\u0026ndash;24.99 kg/m\u0026sup2;. Students with chronic illnesses, those who had undergone recent surgery or injury affecting mobility, individuals involved in sports or exercise programs, and those unable to provide informed consent were excluded.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e2.4 Outcome Assessments\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e2.4.1 Measure of pulmonary outcomes\u003c/p\u003e\n\u003cp\u003ePulmonary function tests (PFTs) were measured before and after YSVI using the RMS Helios-702 digital spirometer [23,24], calibrated by the American Thoracic Society and the European Respiratory Society (ATS/ERS) (Crapo et al., 1995). The participants were provided with an orientation about its use. After three practice sessions, PFTs (FVC, FEV1, FEV1/FVC, FEF 25-75, PEFR, MVV, LA) were recorded. The participants were asked to breathe normally before forced inspiration, followed by forceful exhalation through a nozzle fixed at the RMS at baseline and after the YSVI.\u003c/p\u003e\n\u003cp\u003e2.4.2 Assessment of chest expansion\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNon-stretchable tape was used to measure CE before and after the intervention by taking the difference of chest circumferences across fifth thoracic vertebrae mid-clavicular line and third intercostal space during maximum inhalation followed by exhalation (Debouche et al., 2016). Measurements were repeated three times to confirm consistency.\u003c/p\u003e\n\u003cp\u003e2.4.3 Measure of cardiovascular outcomes\u003c/p\u003e\n\u003cp\u003eCardiovascular outcomes (SBP, DBP, and HR) were measured in the morning hours (6\u0026ndash;8 AM) in a quiet setting using an Omron T9P automated blood pressure machine and an Oscillometric device validated in clinical settings (Brown et al., 2011; Scragg et al., 2014). Before taking the measurement, participants were advised to relax in a comfortable chair for five minutes to ensure calmness. Rest indices MAP, PP, RPP, and DP were computed by using the formula MAP = DBP + PP/3, RPP = (HR x SBP)/100, and DP = HR x MAP (Sharma et al., 2013).\u003csup\u003e\u0026nbsp;\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e2.5 Intervention\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eParticipants in the YG underwent supervised YSVI sessions from November 2022 to January 2023, lasting 12 weeks (60 minutes/day, 6 days/week) (5:00 \u0026ndash; 6:00 AM IST), excluding other yoga practical course activities. As conceptualized and taught by Dhirendra Brahmachari (1965),\u0026nbsp;YSVI incorporates whole-body joint mobilization and stretching synchronized with breath regulation and a focus on affected body sites (Brahmachari, 1965), similar to meditation in motion. The protocol is detailed in Table 2. Sessions were conducted simultaneously each day under supervised conditions to ensure consistency and reliability. No adverse events or unintended effects were observed or reported during the intervention. Participants were monitored for discomfort or harm throughout the study. The participants in the control group (CG) did not receive any intervention and continued their usual routine.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eInsert Table 2 here\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e2.6 Data analysis strategies\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIBM SPSS (version 28, SPSS South Asia Private Limited, Bangalore, India) was used for data analysis. For the normal baseline demographic data (age, weight, height, and BMI),\u0026nbsp;\u003cem\u003emeans \u0026plusmn; standard deviations (M\u0026plusmn;SD\u003c/em\u003e) were compared\u0026nbsp;to assess the match between YG and CG, along with the computation of an independent \u003cem\u003et-\u003c/em\u003etest. For the normal data regarding FVC, FEV1, FEV1/FVC, FEF 25-75, PEFR, MVV, LA, CE, SBP, DBP, HR, PP, MAP, RPP, DP) with insignificant Shapiro\u0026ndash;Wilk test, Split-plot ANOVA was run to compute within-group (time: before-1 and after-2), between-group (groups: YG-1, CG-1) and interaction effects (G*T) along with Bonferroni adjusted post hoc tests for inter and intra-group pairwise comparisons.\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eOf the 80 participants, 76 completed the 12-week YSVI, comprising 39 participants in the YG and 37 in the CG. The dropout rate was minimal compared to the estimated rate, with only one participant from the YG and three from the CG.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.1 Pulmonary functions\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e3.1.1 Effect on forced vital capacity\u003c/p\u003e\n\u003cp\u003eFVC increased (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 3.107, \u003cem\u003ep\u003c/em\u003e = 0.082, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e=\u0026nbsp;\u003c/em\u003e0.04) after the YSVI. The group effect (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u003c/sub\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e= 0.023, \u003cem\u003ep\u003c/em\u003e = 0.879, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e\u0026lt; 0.001) was non-significant, with a significant interaction effect (G*T) (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u003c/sub\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e= 13.233, \u003cem\u003ep\u003c/em\u003e = 0.001, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e= 0.152). Inter-group pairwise comparison of post-intervention data showed a non-significant effect in FVC in YG compared to CG (ES = -0.202, p = 0.367, 95% CI [-0.400, 0.100]), as shown in Table 3 and \u003cstrong\u003eSupplemental Table 5.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eInsert Table 3 here\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eInsert Supplemental Table 5 here\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e3.1.2 Effect on forced expiratory volume in one second\u003c/p\u003e\n\u003cp\u003eFEV1 increased (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 2.995, \u003cem\u003ep\u003c/em\u003e = 0.088, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e=\u0026nbsp;\u003c/em\u003e0.039) after the YSVI. The group effect (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u003c/sub\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e= 0.486, \u003cem\u003ep\u003c/em\u003e = 0.488, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e= 0.007) was non-significant, with a significant effect (G*T) (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u003c/sub\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e= 7.6, \u003cem\u003ep\u003c/em\u003e = 0.007, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e= 0.093). Inter-group pairwise comparison of post-intervention showed a non-significant effect in FEV1 in YG compared to CG (ES = 0, \u003cem\u003ep\u003c/em\u003e = 0.977, 95 % CI [-0.357, 0.058]).\u003c/p\u003e\n\u003cp\u003e3.1.3 Effect on FEV1/FVC\u003c/p\u003e\n\u003cp\u003eFEV1/FVC increased (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 0.5, \u003cem\u003ep\u003c/em\u003e = 0.33, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e=\u0026nbsp;\u003c/em\u003e0.01) after the YSVI. The group effect (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u003c/sub\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e= 0.97, \u003cem\u003ep\u003c/em\u003e = 0.488, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e= 0.007) was non-significant, with a significant effect (G*T) (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u003c/sub\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e= 5.22, \u003cem\u003ep\u003c/em\u003e = 0.03, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e= 0.07). Inter-group pairwise comparison of post-intervention results showed a non-significant effect in FEV1/FVC in YG compared to CG (ES = 0.376, \u003cem\u003ep\u003c/em\u003e = 0.104, 95% CI = [-4.017, 3.337]).\u003c/p\u003e\n\u003cp\u003e3.1.4 Effect on the forced expiratory flow between 25 % and 75% vital capacity\u003c/p\u003e\n\u003cp\u003eFEF increased significantly (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 11.056, \u003cem\u003ep\u003c/em\u003e = 0.001, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e=\u0026nbsp;\u003c/em\u003e0.013) 25-75 after the YSVI. The group effect (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u003c/sub\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e= 0.86, \u003cem\u003ep\u003c/em\u003e = 0.357, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e= 0.011) was non-significant, with non-significant (G*T) (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u003c/sub\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e= 0.381, \u003cem\u003ep\u003c/em\u003e = 0.539, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e= 0.005). Inter-group pairwise comparison of post-intervention showed a non-significant effect in FEF 25-75 in YG compared to CG (ES = -0.239, \u003cem\u003ep\u003c/em\u003e = 0.308, 95 % CI [-0.232, 0.540].\u003c/p\u003e\n\u003cp\u003e3.1.5 Effect on peak expiratory flow rate\u003c/p\u003e\n\u003cp\u003ePEFR increased significantly (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 12.779, \u003cem\u003ep\u003c/em\u003e = 0.001, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e=\u0026nbsp;\u003c/em\u003e0.147) after the YSVI. The group effect (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u003c/sub\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e= 1.247, \u003cem\u003ep\u003c/em\u003e = 0.268, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e= 0.017) was non-significant, with a significant effect (G*T) (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u003c/sub\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e= 5.192, \u003cem\u003ep\u003c/em\u003e = 0.026, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e= 0.006). Inter-group pairwise comparison of post-intervention results showed a non-significant effect in PEFR in YG compared to CG (ES = 0.097, \u003cem\u003ep\u003c/em\u003e = 0.661, 95% CI = [-1.130, 0.126]).\u003c/p\u003e\n\u003cp\u003e3.1.6 Effect on maximum voluntary ventilation\u003c/p\u003e\n\u003cp\u003eMVV increased (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 3.116, \u003cem\u003ep\u003c/em\u003e = 0.082, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e=\u0026nbsp;\u003c/em\u003e0.04) after the YSVI. The group effect (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u003c/sub\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e= 0.472, \u003cem\u003ep\u003c/em\u003e = 0.494, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e= 0.006) was non-significant, with a significant effect (G*T) (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u003c/sub\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e= 7.784, \u003cem\u003ep\u003c/em\u003e = 0.007, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e= 0.095). Inter-group pairwise comparison of post-intervention results showed a non-significant effect in MVV in YG compared to CG (ES = -0.011, \u003cem\u003ep\u003c/em\u003e = 0.962, 95% CI [-14.265, 2.331]).\u003c/p\u003e\n\u003cp\u003e3.1.7 Effect on lung age\u003c/p\u003e\n\u003cp\u003eLA decreased (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 0.063, \u003cem\u003ep\u003c/em\u003e = 0.802, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e=\u0026nbsp;\u003c/em\u003e0.001) after the YSVI. The group effect (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u003c/sub\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e= 1.923, \u003cem\u003ep\u003c/em\u003e = 0.17, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e= 0.025) was non-significant, with a significant effect (G*T) (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u003c/sub\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e= 17.781, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/em\u003e= 0.194). Inter-group pairwise comparison of post-intervention results showed a significant effect in LA in YG compared to CG (ES = 0.51, \u003cem\u003ep\u003c/em\u003e = 0.027, 95% CI = [-2.11, -0.13]).\u003c/p\u003e\n\u003cp\u003e3.1.7 Effect on chest expansion\u003c/p\u003e\n\u003cp\u003eCE increased significantly (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 128.132, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.634) after the YSVI. The group effect (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 8.891, \u003cem\u003ep\u003c/em\u003e = 0.004, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.107) was significant, with a significant effect (G*T) (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 56.003, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.431). Table 3. Inter-group pairwise comparison of post-intervention results showed a significant effect in CE in YG compared to CG (ES = -1.171, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001, 95% CI [0.746, 1.71]).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.2 Cardiovascular functions\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e3.2.1 Effect on systolic blood pressure\u003c/p\u003e\n\u003cp\u003eSBP decreased significantly (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 128.132, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.634) after the YSVI. The group effect (\u003cem\u003eF\u003c/em\u003e\u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 8.891, \u003cem\u003ep\u003c/em\u003e = 0.004, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003c/em\u003e² = 0.107) was significant, with a significant interaction effect (G*T) (\u003cem\u003eF\u003c/em\u003e\u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 56.003, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003c/em\u003e² = 0.431). Inter-group pairwise comparison of post-intervention showed a non-significant effect in SBP in YG compared to CG (ES = -0.015, \u003cem\u003ep\u003c/em\u003e = 0.361, 95 % CI [-0.877, 6.624], as shown in Table 4.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eInsert Table 4 here\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e3.2.2 Effect on diastolic blood pressure\u003c/p\u003e\n\u003cp\u003eDBP decreased (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 0.874, \u003cem\u003ep\u003c/em\u003e = 0.353, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.012) after the YSVI. The group effect (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 0.163, \u003cem\u003ep\u003c/em\u003e = 0.688, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.002) was non-significant, with a significant effect (G*T) (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u003c/sub\u003e = 17.409, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.19). Inter-group pairwise comparison of post-intervention data showed a significant effect in DBP in YG compared to CG (ES = 0.554, \u003cem\u003ep\u003c/em\u003e = 0.018, 95% CI = [-1.053, 5.875]).\u003c/p\u003e\n\u003cp\u003e3.2.3 Effect on heart rate\u003c/p\u003e\n\u003cp\u003eHR decreased significantly (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 3.984, \u003cem\u003ep\u003c/em\u003e = 0.05, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.051) after the YSVI. The group effect (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 6.862, \u003cem\u003ep\u003c/em\u003e = 0.011, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.085) was significant, with a non-significant effect (G*T) (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 0.89, \u003cem\u003ep\u003c/em\u003e = 0.348, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.012). Inter-group pairwise comparison of post-intervention data showed a significant effect in HR in YG compared to CG (ES = 0.917, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001, 95% CI = [-8.453, 1.275]).\u003c/p\u003e\n\u003cp\u003e3.2.4 Effect on pressure product\u003c/p\u003e\n\u003cp\u003ePP decreased (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 0.007, \u003cem\u003ep\u003c/em\u003e = 0.934, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e \u0026lt; 0.001) after the YSVI. The group effect (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 0.60, \u003cem\u003ep\u003c/em\u003e = 0.442, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.008) was non-significant, with a non-significant effect (G*T) (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 0.88, \u003cem\u003ep\u003c/em\u003e = 0.352, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.012). Inter-group pairwise comparison of post-intervention results showed a non-significant effect in PP in YG compared to CG (ES = -0.26, \u003cem\u003ep\u003c/em\u003e = 0.245, 95% CI [-3.364, 4.289]).\u003c/p\u003e\n\u003cp\u003e3.2.5 Effect on mean arterial pressure\u003c/p\u003e\n\u003cp\u003eMAP decreased (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 1.3, p = 0.258, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.017) after the YSVI. The group effect (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 0.016, \u003cem\u003ep\u003c/em\u003e = 0.901, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e \u0026lt; 0.001) was non-significant, with a significant effect (G*T) (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u003c/sub\u003e = 23.08, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.238). Inter-group pairwise comparison of post-intervention data showed a significant effect in MAP in YG compared to CG (ES = -0.513, \u003cem\u003ep\u003c/em\u003e = 0.029, 95% CI [-0.507, 5.637]).\u003c/p\u003e\n\u003cp\u003e3.2.6 Effect on rate-pressure product\u003c/p\u003e\n\u003cp\u003eRPP decreased significantly (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 4.88, \u003cem\u003ep\u003c/em\u003e = 0.03, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.062) after the YSVI. The group effect (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 3.60, \u003cem\u003ep\u003c/em\u003e = 0.062, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.046) was non-significant, with a significant effect (G*T) (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74) =\u003c/sub\u003e 4.83, \u003cem\u003ep\u003c/em\u003e = 0.031, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.061). Inter-group pairwise comparison of post-intervention results showed a significant effect in RPP in YG compared to CG (ES = 0.834, \u003cem\u003ep\u003c/em\u003e = 0.001, 95% CI = [-8.998, 4.964]).\u003c/p\u003e\n\u003cp\u003e3.2.7 Effect on double product\u003c/p\u003e\n\u003cp\u003eDP decreased significantly (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e=\u003csub\u003e\u0026nbsp;\u003c/sub\u003e5.31, \u003cem\u003ep\u003c/em\u003e = 0.024, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.067) after the YSVI. The group effect (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 4.05, \u003cem\u003ep\u003c/em\u003e = 0.048, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 4.05) was significant, with a significant effect (G*T) (\u003cem\u003eF\u003c/em\u003e \u003csub\u003e(1, 74)\u0026nbsp;\u003c/sub\u003e= 8.34, \u003cem\u003ep\u003c/em\u003e = 0.005, \u003cem\u003eη\u003csub\u003ep\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.101) as shown in Table 4 and \u003cstrong\u003eSupplemental Table 5\u003c/strong\u003e. Inter-group pairwise comparison of post-intervention results showed a significant effect in DP in YG compared to CG (ES = 0.953, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001, 95% CI = [-673.12, 433.83]).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study investigated the effects of a 12-week YSVI on pulmonary and cardiovascular functions in healthy undergraduate male students. The findings showed that YSVI significantly improved several pulmonary parameters, including CE, LA, and intra-group increases in FVC, FEV1, MVV, FEF25\u0026ndash;75, and PEFR. On the cardiovascular side, YSVI led to significant reductions in DBP, HR, MAP, RPP, and DP. SBP and PP showed trends of reduction, but were not statistically significant between groups. Collectively, these results suggest that YSVI is effective in enhancing pulmonary efficiency and reducing cardiovascular stress even among healthy young adults.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePulmonary Functions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe present study found that FVC and FEV1 increased after YSVI, although inter-group comparisons were not statistically significant. Previous yoga-based interventions, particularly those incorporating pranayama, have consistently demonstrated significant improvements in FVC and FEV1 (Budhi et al., 2019; Dhansoia et al., 2022; Mundhe et al., 2025; Prasad et al., 2022). These findings are typically attributed to enhanced respiratory muscle strength, improved lung compliance, and increased thoracic mobility acquired through controlled breathing practices (Anshu et al., 2023; Chaudhary et al., 2024; Hakked et al., 2017). The modest improvements in our study may be attributable to participants\u0026rsquo; already healthy baseline function, leaving limited room for measurable inter-group differences.\u003c/p\u003e\n\u003cp\u003eThe FEV1/FVC ratio showed a non-significant increase. While some studies have reported improved ratios following yoga practice (Prasad et al., 2022), others found little change in healthy individuals (Mane et al., 2014). Since the FEV1/FVC ratio is primarily used to identify obstructive patterns, its stability in our sample may indicate that YSVI has greater utility in populations with compromised lung function.\u003c/p\u003e\n\u003cp\u003eFEF25-75 and PEFR improved intra-group but were not significantly different between groups. These outcomes reflect mid-expiratory flow and maximal expiratory effort, both of which are sensitive to airway caliber (Qin et al., 2021; Rajbhoj et al., 2023). Prior studies have demonstrated higher PEFR values among yoga practitioners, attributing them to stronger respiratory musculature and improved airway patency (D\u0026rsquo;Souza \u0026amp; Avadhany, 2014; Shyam Karthik et al., 2014). The partial alignment with our findings suggests that YSVI may improve expiratory flow mechanics; however, a longer intervention or a clinical population might show more apparent effects.\u003c/p\u003e\n\u003cp\u003eMVV also improved significantly within the intervention group. This finding aligns with earlier reports that yoga enhances ventilatory endurance by training both inspiratory and expiratory muscles through repeated slow, deep breathing (Budhi et al., 2019; Halder et al., 2012). Enhanced MVV suggests that YSVI may increase overall ventilatory capacity, which has implications for exercise tolerance and pulmonary reserve (Sutbeyaz et al., 2010).\u003c/p\u003e\n\u003cp\u003eThe most significant effect was observed in LA and CE, both of which showed significant between-group differences. Reduced LA suggests slowed respiratory aging, consistent with findings that yoga-based interventions preserve pulmonary elasticity and efficiency over time (Liu et al., 2014; Santaella et al., 2011). Increased CE reflects improved thoracic flexibility and respiratory muscle function (Csepregi et al., 2022). Similar results have been reported in interventions emphasizing thoracic expansion through targeted yogic exercises (Padkao \u0026amp; Boonla, 2020). YSVI practices such as vaksha-sthala-shakti-vikasaka specifically mobilize the thoracic cage and intercostal musculature, resulting in greater compliance of the chest wall and improved respiratory efficiency. The large effect size observed in CE underscores YSVI\u0026rsquo;s role in improving thoracic flexibility, which is crucial not only for pulmonary health but also for cardiovascular efficiency.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCardiovascular Functions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study demonstrated that YSVI produced significant improvements in several cardiovascular parameters, particularly DBP, HR, MAP, RPP, and DP. These findings indicate that YSVI may reduce cardiac workload and improve autonomic balance, even in healthy young adults.\u003c/p\u003e\n\u003cp\u003eSBP showed a mild reduction within the intervention group, but the inter-group difference was not statistically significant. Previous meta-analyses of yoga interventions suggest that SBP reductions are more evident in hypertensive or pre-hypertensive populations than in normotensive individuals (Geiger et al., 2025; Kumar et al., 2023; Nalbant et al., 2022). Since the participants in this study were young and healthy, the limited change in SBP is not unexpected.\u003c/p\u003e\n\u003cp\u003eIn contrast, DBP decreased significantly in the YSVI group compared with controls. Similar results have been reported in earlier studies examining slow-breathing and yoga-based interventions (Garg et al., 2023; Naik et al., 2018). The likely explanation is a reduction in peripheral vascular resistance due to enhanced endothelial function and parasympathetic dominance. By promoting relaxation and slow, controlled breathing, YSVI may also reduce sympathetic outflow, which contributes to lowering DBP (Anasuya et al., 2020; Pathan et al., 2023).\u003c/p\u003e\n\u003cp\u003eThe significant reduction in HR observed in this study is consistent with previous yoga research (Pramanik et al., 2009; Tyagi \u0026amp; Cohen, 2016). A lower resting HR reflects improved vagal tone and reduced sympathetic drive, both of which are beneficial for cardiovascular efficiency. Physiologically, regular practice of controlled breathing and focused movements, as incorporated in YSVI, may recalibrate the autonomic nervous system and shift the sympathovagal balance toward parasympathetic predominance (Shinba et al., 2020).\u003c/p\u003e\n\u003cp\u003eMAP, a key determinant of organ perfusion and vascular load, also decreased significantly in the YG. Similar findings have been reported in yoga studies where reductions in MAP were attributed to improved baroreceptor sensitivity and neurohumoral modulation (Anasuya et al., 2020; Mohammadi et al., 2022; Selvamurthy et al., 1998). A lower MAP in healthy individuals may provide long-term protection against vascular dysfunction and hypertension (Murugesan, 2024).\u003c/p\u003e\n\u003cp\u003eThe reduction in RPP and DP further supports the cardioprotective role of YSVI. Both indices are widely recognized markers of myocardial oxygen demand and cardiac workload (Kiviniemi et al., 2019). Studies have shown that yoga practices decrease these parameters by simultaneously lowering HR and blood pressure (Hari Krishna et al., 2014). Reduced RPP and DP imply that the heart requires less effort to maintain systemic circulation, which could have important preventive implications in populations at risk of hypertension and ischemic heart disease. PP did not change significantly after YSVI. PP is primarily influenced by arterial compliance and stroke volume, which are less likely to show variation in young, healthy individuals (Alfie et al., 1999; Salom\u0026atilde;o et al., 2023). This suggests that YSVI may exert greater effects on PP in older adults or those with reduced arterial elasticity rather than in a young population with preserved vascular compliance.\u003c/p\u003e\n\u003cp\u003eThis study demonstrates the benefit of YSVI for respiratory and cardiovascular health, especially in young adults. Previous research studies have focused on yoga postures and pranayama, documenting the benefits of general yoga practices. However, these studies have overlooked the effects of YSVI (meditation in motion) on cardiopulmonary functions, unlike our study findings. Unlike dynamic yoga activities, YSVI as a meditation in motion is optimal for cardiopulmonary and overall health, empowering yoga modules for individuals with different age groups, fitness levels, health profiles, genders, socioeconomic statuses, cultures, regions, constitutions, and dispositions, making it a promising intervention if practiced under the supervision of the expert with sound experiential and experimental yoga knowledge and skills.\u0026nbsp;\u003c/p\u003e"},{"header":"Conclusion, limitations, and recommendations ","content":"\u003cp\u003eThis study provides preliminary evidence that a 12-week Yogic Sukshma Vyayama intervention (YSVI) can improve selected pulmonary (FVC, FEV1, PEFR, MVV, lung age, chest expansion) and cardiovascular (DBP, HR, MAP, RPP, DP) parameters in young healthy adults. As a low-cost, accessible, and non-pharmacological practice, YSVI appears to be a promising promotive and preventive adjunct for cardiopulmonary health.\u003c/p\u003e\n\u003cp\u003eSeveral limitations must be acknowledged. The study employed a quasi-experimental, non-randomised design, with allocation based on academic cohorts rather than random assignment. Although groups were matched at baseline, the absence of randomisation raises the possibility of selection bias. The sample was limited to male undergraduate students from a single institution, which restricts generalisability across genders, age groups, and sociocultural contexts. Moreover, the intervention lasted only twelve weeks, and no follow-up was undertaken, making it difficult to comment on the durability of effects. While statistical analyses revealed significant improvements in several indices, the quasi-experimental nature of the study precludes causal conclusions. Further rigorously designed interventional studies are recommended to determine the long-term and follow-up effects of YSV on cardio-pulmonary functions, including normal/clinical samples from diverse age groups, sociocultural backgrounds, regions, races, and genders, to enhance both internal and external validity and the implications of our findings.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAlfie, J., Waisman, G. D., Galarza, C. R., \u0026amp; C\u0026aacute;mera, M. I. (1999). Contribution of stroke volume to the change in pulse pressure pattern with age. \u003cem\u003eHypertension\u003c/em\u003e, \u003cem\u003e34\u003c/em\u003e(4 II), 808\u0026ndash;812. https://doi.org/10.1161/01.HYP.34.4.808/ASSET/28A0587F-EBBF-460C-926F-49C769F59850/ASSETS/GRAPHIC/HY10T0040004.JPEG\u003c/li\u003e\n\u003cli\u003eAnasuya, B., Deepak, K. K., Jaryal, A. K., \u0026amp; Narang, R. (2020). 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S., Gaur, G. S., \u0026amp; Pal, G. K. (2018). Effect of Modified Slow Breathing Exercise on Perceived Stress and Basal Cardiovascular Parameters. \u003cem\u003eInternational Journal of Yoga\u003c/em\u003e, \u003cem\u003e11\u003c/em\u003e(1), 53. https://doi.org/10.4103/IJOY.IJOY_41_16\u003c/li\u003e\n\u003cli\u003eNalbant, G., Hassanein, Z. M., Lewis, S., \u0026amp; Chattopadhyay, K. (2022). Content, Structure, and Delivery Characteristics of Yoga Interventions for Managing Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. \u003cem\u003eFrontiers in Public Health\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e, 846231. https://doi.org/10.3389/FPUBH.2022.846231/BIBTEX\u003c/li\u003e\n\u003cli\u003eNivethitha, L., Mooventhan, A., \u0026amp; Manjunath, N. K. (2021). Evaluation of Cardiovascular Functions during the Practice of Different Types of Yogic Breathing Techniques. \u003cem\u003eInternational Journal of Yoga\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e(2), 158\u0026ndash;162. https://doi.org/10.4103/ijoy.ijoy_61_20\u003c/li\u003e\n\u003cli\u003ePadkao, T., \u0026amp; Boonla, O. (2020). Relationships between respiratory muscle strength, chest wall expansion, and functional capacity in healthy nonsmokers. \u003cem\u003eJ Exerc Rehabil\u003c/em\u003e, \u003cem\u003e16\u003c/em\u003e, 189\u0026ndash;196.\u003c/li\u003e\n\u003cli\u003ePathan, F. K. M., Pandian, J. S., Shaikh, A. I., Ahsan, M., Nuhmani, S., Iqbal, A., \u0026amp; Alghadir, A. H. (2023). Effect of slow breathing exercise and progressive muscle relaxation technique in the individual with essential hypertension: A randomized controlled trial. \u003cem\u003eMedicine\u003c/em\u003e, \u003cem\u003e102\u003c/em\u003e(47), e35792. https://doi.org/10.1097/MD.0000000000035792\u003c/li\u003e\n\u003cli\u003ePinckard, K., Baskin, K. K., \u0026amp; Stanford, K. I. (2019). Effects of Exercise to Improve Cardiovascular Health. \u003cem\u003eFrontiers in Cardiovascular Medicine\u003c/em\u003e, \u003cem\u003e6\u003c/em\u003e, 69. https://doi.org/10.3389/fcvm.2019.00069\u003c/li\u003e\n\u003cli\u003ePolsgrove, M. J., Eggleston, B. M., \u0026amp; Lockyer, R. J. (2016). Impact of 10-weeks of yoga practice on flexibility and balance of college athletes. \u003cem\u003eInternational Journal of Yoga\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(1), 27. https://doi.org/10.4103/0973-6131.171710\u003c/li\u003e\n\u003cli\u003ePramanik, T., Sharma, H. O., Mishra, S., Mishra, A., Prajapati, R., \u0026amp; Singh, S. (2009). Immediate effect of slow pace bhastrika pranayama on blood pressure and heart rate. \u003cem\u003eJournal of Alternative and Complementary Medicine\u003c/em\u003e, \u003cem\u003e15\u003c/em\u003e(3), 293\u0026ndash;295. https://doi.org/10.1089/acm.2008.0440\u003c/li\u003e\n\u003cli\u003ePrasad, R., Garg, R., \u0026amp; Sahay, S. (2022). To study the effect of yoga asana and pranayama on pulmonary function test in chronic obstructive pulmonary disease (copd) patients. \u003cem\u003eSantosh University Journal of Health Sciences\u003c/em\u003e, \u003cem\u003e8\u003c/em\u003e(2), 126\u0026ndash;129. https://doi.org/10.4103/SUJHS.SUJHS_26_22\u003c/li\u003e\n\u003cli\u003eQin, R., An, J., Xie, J., Huang, R., Xie, Y., He, L., Xv, H., Qian, G., \u0026amp; Li, J. (2021). FEF25-75% Is a More Sensitive Measure Reflecting Airway Dysfunction in Patients with Asthma: A Comparison Study Using FEF25-75% and FEV1%. \u003cem\u003eJournal of Allergy and Clinical Immunology: In Practice\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(10), 3649-3659.e6. https://doi.org/10.1016/j.jaip.2021.06.027\u003c/li\u003e\n\u003cli\u003eRajbhoj, P. H., Pathak, S. D., \u0026amp; Patil, S. N. (2023). The effects of yoga practice on lung function and sIL-2R biomarkers in individuals working and living in the lonavala industrial area: A randomized controlled trial. \u003cem\u003eIndian J Occup Environ Med\u003c/em\u003e, \u003cem\u003e27\u003c/em\u003e, 159\u0026ndash;165.\u003c/li\u003e\n\u003cli\u003eRamalho, S. H. R., \u0026amp; Shah, A. M. (2021). Lung function and cardiovascular disease: A link. \u003cem\u003eTrends in Cardiovascular Medicine\u003c/em\u003e, \u003cem\u003e31\u003c/em\u003e(2), 93\u0026ndash;98. https://doi.org/10.1016/j.tcm.2019.12.009\u003c/li\u003e\n\u003cli\u003eRathore, V., Singh, S., \u0026amp; Katiyar, V. K. (2024). Exploring the therapeutic effects of yoga on spine and shoulder mobility: A systematic review. \u003cem\u003eJournal of Bodywork and Movement Therapies\u003c/em\u003e, \u003cem\u003e40\u003c/em\u003e, 586\u0026ndash;596. https://doi.org/10.1016/J.JBMT.2024.04.029\u003c/li\u003e\n\u003cli\u003eSahasrabudhe, S. D., Orme, M. W., Jones, A. V., Tillu, G., Salvi, S. S., \u0026amp; Singh, S. J. (2021). Potential for integrating yoga within pulmonary rehabilitation and recommendations of reporting framework. \u003cem\u003eBMJ Open Respiratory Research\u003c/em\u003e, \u003cem\u003e8\u003c/em\u003e(1), e000966. https://doi.org/10.1136/bmjresp-2021-000966\u003c/li\u003e\n\u003cli\u003eSalom\u0026atilde;o, L. P., Magalh\u0026atilde;es, G. S., da Silva, J. F. P., dos Santos, L. M., Gomes Moura, I. C., Rezende, B. A., \u0026amp; Rodrigues-Machado, M. G. (2023). Factors associated with arterial stiffness assessed by pulse pressure amplification in healthy children and adolescents: a cross-sectional study. \u003cem\u003eBMC Pediatrics\u003c/em\u003e, \u003cem\u003e23\u003c/em\u003e(1), 1\u0026ndash;10. https://doi.org/10.1186/S12887-023-03942-1/TABLES/4\u003c/li\u003e\n\u003cli\u003eSalvi, S., Kumar, G. A., Dhaliwal, R. S., Paulson, K., Agrawal, A., Koul, P. A., Mahesh, P. A., Nair, S., Singh, V., Aggarwal, A. N., Christopher, D. J., Guleria, R., Mohan, B. V. M., Tripathi, S. K., Ghoshal, A. G., Kumar, R. V., Mehrotra, R., Shukla, D. K., Dutta, E., \u0026hellip; Dandona, L. (2018). The burden of chronic respiratory diseases and their heterogeneity across the states of India: the Global Burden of Disease Study 1990\u0026ndash;2016. \u003cem\u003eThe Lancet Global Health\u003c/em\u003e, \u003cem\u003e6\u003c/em\u003e(12), e1363\u0026ndash;e1374. https://doi.org/10.1016/S2214-109X(18)30409-1\u003c/li\u003e\n\u003cli\u003eSantaella, D. F., Devesa, C. R. S., Rojo, M. R., Amato, M. B. P., Drager, L. F., Casali, K. R., \u0026amp; others. (2011). Yoga respiratory training improves respiratory function and cardiac sympathovagal balance in elderly subjects: a randomised controlled trial. \u003cem\u003eBMJ Open\u003c/em\u003e, \u003cem\u003e1\u003c/em\u003e.\u003c/li\u003e\n\u003cli\u003eScragg, R., Slow, S., Stewart, A. W., Jennings, L. C., Chambers, S. T., Priest, P. C., Florkowski, C. M., Camargo, C. A., \u0026amp; Murdoch, D. R. (2014). Long-term high-dose vitamin D3 supplementation and blood pressure in healthy adults a randomized controlled trial. \u003cem\u003eHypertension\u003c/em\u003e, \u003cem\u003e64\u003c/em\u003e(4), 725\u0026ndash;730. https://doi.org/10.1161/HYPERTENSIONAHA.114.03466\u003c/li\u003e\n\u003cli\u003eSelvamurthy, W., Sridharan, K., Ray, U. S., Tiwary, R. S., Hegde, K. S., Radhakrishan, U., \u0026amp; Sinha, K. C. (1998). A NEW PHYSIOLOGICAL APPROACH TO CONTROL ESSENTIAL HYPERTENSION. \u003cem\u003eIndian J Physiol Pharmacol\u003c/em\u003e, \u003cem\u003e42\u003c/em\u003e(2), 205\u0026ndash;213.\u003c/li\u003e\n\u003cli\u003eSharma, V., Trakroo, M., Subramaniam, V., Sahai, A., Bhavanani, A., \u0026amp; Rajajeyakumar, M. (2013). Effect of fast and slow pranayama on perceived stress and cardiovascular parameters in young health-care students. \u003cem\u003eInternational Journal of Yoga\u003c/em\u003e, \u003cem\u003e6\u003c/em\u003e(2), 104. https://doi.org/10.4103/0973-6131.113400\u003c/li\u003e\n\u003cli\u003eShinba, T., Inoue, T., Matsui, T., Kimura, K. K., Itokawa, M., \u0026amp; Arai, M. (2020). Changes in Heart Rate Variability after Yoga are Dependent on Heart Rate Variability at Baseline and during Yoga: A Study Showing Autonomic Normalization Effect in Yoga-Na\u0026iuml;ve and Experienced Subjects. \u003cem\u003eInternational Journal of Yoga\u003c/em\u003e, \u003cem\u003e13\u003c/em\u003e(2), 160. https://doi.org/10.4103/IJOY.IJOY_39_19\u003c/li\u003e\n\u003cli\u003eShyam Karthik, P., Chandrasekhar, M., Ambareesha, K., \u0026amp; Nikhil, C. (2014). Effect of pranayama and suryanamaskar on pulmonary functions in medical students. \u003cem\u003eJournal of Clinical and Diagnostic Research\u003c/em\u003e, \u003cem\u003e8\u003c/em\u003e(12), BC04\u0026ndash;BC06. https://doi.org/10.7860/JCDR/2014/10281.5344\u003c/li\u003e\n\u003cli\u003eSutbeyaz, S. T., Koseoglu, F., Inan, L., \u0026amp; Coskun, O. (2010). Respiratory muscle training improves cardiopulmonary function and exercise tolerance in subjects with subacute stroke: A randomized controlled trial. \u003cem\u003eClinical Rehabilitation\u003c/em\u003e, \u003cem\u003e24\u003c/em\u003e(3), 240\u0026ndash;250. https://doi.org/10.1177/0269215509358932;PAGEGROUP:STRING:PUBLICATION\u003c/li\u003e\n\u003cli\u003eTyagi, A., \u0026amp; Cohen, M. (2016). Yoga and heart rate variability: A comprehensive review of the literature. \u003cem\u003eInternational Journal of Yoga\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(2), 97. https://doi.org/10.4103/0973-6131.183712\u003c/li\u003e\n\u003cli\u003eVan Eeden, S., Leipsic, J., Paul Man, S. F., \u0026amp; Sin, D. D. (2012). The relationship between lung inflammation and cardiovascular disease. \u003cem\u003eAmerican Journal of Respiratory and Critical Care Medicine\u003c/em\u003e, \u003cem\u003e186\u003c/em\u003e(1), 11\u0026ndash;16. https://doi.org/10.1164/rccm.201203-0455PP\u003c/li\u003e\n\u003cli\u003eVirani, S. S., Alonso, A., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Delling, F. N., Djousse, L., Elkind, M. S. V., Ferguson, J. F., Fornage, M., Khan, S. S., Kissela, B. M., Knutson, K. L., Kwan, T. W., Lackland, D. T., \u0026hellip; Tsao, C. W. (2020). Heart disease and stroke statistics\u0026mdash;2020 update a report from the American Heart Association. \u003cem\u003eCirculation\u003c/em\u003e, \u003cem\u003e141\u003c/em\u003e(9), E139\u0026ndash;E596. https://doi.org/10.1161/CIR.0000000000000757\u003c/li\u003e\n\u003cli\u003eXiong, T., Bai, X., Wei, X., Wang, L., Li, F., Shi, H., \u0026amp; Shi, Y. (2023). Exercise Rehabilitation and Chronic Respiratory Diseases: Effects, Mechanisms, and Therapeutic Benefits. \u003cem\u003eInternational Journal of COPD\u003c/em\u003e, \u003cem\u003e18\u003c/em\u003e, 1251\u0026ndash;1266. https://doi.org/10.2147/COPD.S408325\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003cstrong\u003e. Baseline characteristics of the participants\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eOutcome\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eGroup\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003en\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eM±SD\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep≤\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003eAge (year)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eYG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e19.41±1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003e0.096\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e19.78±0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003eWeight (kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eYG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e62.66±6.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003e0.333\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e63.23±5.73\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003eHeight (cm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eYG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e170.87±5.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003e0.418\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e170±5.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003eBMI (kg/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eYG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e21.47±2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003e0.875\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e21.90±2.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFootnotes:\u003c/em\u003e\u003c/strong\u003e \u003cem\u003en\u0026nbsp;\u003c/em\u003e= Number of participants in each group;\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003cem\u003eM±SD\u0026nbsp;\u003c/em\u003e= Mean \u003cem\u003e±\u0026nbsp;\u003c/em\u003eStandard Deviation; \u003cem\u003ep\u0026nbsp;\u003c/em\u003e= level of significance.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eYSVI\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Protocol\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"left\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e3 months (12 weeks)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTiming\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eMorning (5:00 – 6:00 AM IST)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSession hour\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e60 minutes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSession days\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eMonday-Saturday\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYoga Type\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eName of the Practice\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eInterval (in minutes)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrayer\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGayatri mantra\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eYogic\u003cbr\u003e\u0026nbsp;Sukshma\u003cbr\u003e\u0026nbsp;Vyayama\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(10 rounds each)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUchchaana-sthalattha, Vishuddhi-chakra-shuddhi, Buddhi tatha dhruti-shakti-vikasaka, Smarana-shakti-viksaka,\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGriva Shakti vikasaka 1,2, \u0026amp; 3, Kapola-sakthi-vardhaka\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSkandha tatha bahu mula Shakti vikasaka, Bhuja bandha Shakti vikasaka, Kaphoni Shakti vikasak, Bhujavalli shakti vikasaka, Purna bhuja shakti vikasaka\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUdara-sakthi-vikasaka (1 -10), Vaksha-sthala-shakti-vikasaka 1\u0026amp; 2, Kati-shakti-vikasaka (1-5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eRelaxation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eShavasana\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal Interval\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003e\u003cem\u003eFootnotes:\u003c/em\u003e\u003c/strong\u003e IST: Indian Standard Time; The numbers written in parentheses () are the practice repetitions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eTable 3. Inter-group and intra-group comparisons of pulmonary outcomes\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eOutcomes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntragroup Effects\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eIntergroup \u003cem\u003ep\u003c/em\u003e-value (ES)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eYG (n = 39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eCG (n = 37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eYG-CG\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eBefore (\u003cem\u003eM±SD\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAfter (\u003cem\u003eM±SD\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eBefore (\u003cem\u003eM±SD\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAfter (\u003cem\u003eM±SD\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAfter\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eFVC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.32±0.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.51±0.54***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.47±0.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.40±0.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.367 (-0.202)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eFEV1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.05±0.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.18±0.52*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.20±0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.18±0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.977 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eFEV1/FVC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e92.6±9.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e90.9±9.5*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e93.0±5.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e93.9±6.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.104 (0.376)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eFEF 25-75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.37±0.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.52±0.91**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.22±0.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4.32±0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.308 (-0.239)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePEFR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.07±1.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.57±1.09***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.57±1.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7.68±1.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.661 (0.097)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMVV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e122.19±19.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e127.24±20.72*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e128.16±16.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e127.03±18.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.962 (-0.011)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eLA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e20.2±2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e19.7±2.3*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e20.4±1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e20.8±2.0*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.027 (0.51) #\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eCE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.88±1.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5.23±1.15***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3.72±0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4±0.94*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026lt;0.001 (-1.171) ###\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003e\u003cem\u003eFootnotes:\u003c/em\u003e\u003c/strong\u003e *ES, effect size; *and # indicate intra-group and inter-group comparison respectively; *\u003cem\u003ep\u003c/em\u003e\u0026lt;0.05, **\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.01, ***\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001; #\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.05, ##\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.01, ###\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4. Inter-group and Intra-group comparisons of cardiovascular outcomes\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eOutcomes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntragroup Effects\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eIntergroup \u003cem\u003ep-\u003c/em\u003evalue (ES)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eYG (n = 39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003eCG (n = 37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eYG-CG\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eBefore (\u003cem\u003eM±SD\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAfter (\u003cem\u003eM±SD\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eBefore (\u003cem\u003eM±SD\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAfter (\u003cem\u003eM±SD\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAfter\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSBP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e124.8±9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e122.1±6.7**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e122.0±6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e123.6±7.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.361 (-0.015)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eDBP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e77.9±8.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e74.2±7.2***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e75.5±6.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e77.8±5.7*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.018 (0.554) #\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e76.9±10.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e74.0±6.0*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e80.5±10.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e79.5±6.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026lt;0.001(0.917) ###\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e46.9±9.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e47.8±8.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e46.5±6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e45.8±6.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.245 (-0.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMAP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e93.5±7.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e90.2±5.7***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e91.0±5.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e93.1±5.6*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.029 (0.513) #\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eRPP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e96.2±16.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e90.4±9.0**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e98.2±14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e98.2±9.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.001 (0.834) ##\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eDP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7217.2±1278.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6684.0±762.7***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7336.8±1134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7396.8±732.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026lt;0.001 (0.953) ###\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFootnotes:\u003c/em\u003e\u003c/strong\u003e *ES, effect size; *and # indicate intra-group and inter-group comparison respectively; *\u003cem\u003ep\u003c/em\u003e\u0026lt;0.05, **\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.01, ***\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001; #\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.05, ##\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.01, ###\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"yogic sukshma vyayama, cardiopulmonary functions, wellness, health promotion","lastPublishedDoi":"10.21203/rs.3.rs-7601039/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7601039/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e:\u003cem\u003e \u003c/em\u003eDue to the rise in unhealthy behaviors and overindulgent lifestyles, cardio-pulmonary health problems have the highest prevalence worldwide, warranting the need for alternative preventive measures. Therefore, this study evaluated the effect of a 12-week yogic sukshma vyayama intervention (YSVI) on cardio-pulmonary functions in undergraduate male students.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e This was a two-armed (experimental group: YG and control group: CG), non-randomised quasi-experimental study with a cohort of 80 healthy male students (mean ± standard deviation: 19.59 ± 0.98, range: 18-25 years) who were equally allocated to YG and CG. The participants of YG received YSVI for 12 weeks, and the CG underwent their usual routine. Selected cardiopulmonary indices were assessed at baseline and after the YSVI. A split-plot ANOVA was conducted to compute between-group, within-group, and interaction effects, along with Bonferroni-adjusted post-hoc tests for inter- and intra-group comparisons using SPSS version 28.0.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThe effect size of 12-week YSVI was significant in improving lung age (0.51, \u003cem\u003ep\u003c/em\u003e = 0.027), chest expansion (-1.171, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001), diastolic blood pressure (0.554, \u003cem\u003ep\u003c/em\u003e = 0.018), heart rate (0.917, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001), mean arterial pressure (0.513, \u003cem\u003ep\u003c/em\u003e = 0.029), rate pressure product (0.834, \u003cem\u003ep\u003c/em\u003e = 0.001), and double product (0.953, \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001) of YG participants compared to their controls but statistically insignificant for rest outcomes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eYSVI was associated with improvements in several cardiopulmonary functions among young adults. As a low-cost, accessible, and safe practice, it may serve as a preventive and promotive add-on intervention. Further multi-site randomized studies are warranted to confirm these findings.\u003c/p\u003e","manuscriptTitle":"Effect of Yogic Sukshma Vyayama on Cardiopulmonary Functions in Young Adults: A Quasi-Experimental Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-23 08:30:53","doi":"10.21203/rs.3.rs-7601039/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6290c72f-cf36-41a4-9dc4-ce7293583795","owner":[],"postedDate":"September 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-23T08:30:53+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-23 08:30:53","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7601039","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7601039","identity":"rs-7601039","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}