Effect of Pilates Vs. Yoga on Respiratory Muscle Strength in Patients with Chronic Obstructive Pulmonary Disease (Copd) A Case Study

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) leads to progressive respiratory muscle weakness, which is independently associated with dyspnea, reduced exercise capacity, and increased mortality. Mind-body exercises such as Yoga and Pilates have shown promise in improving respiratory muscle strength. However, individual responses vary, and detailed case-level reports are lacking. This single case study examines the effect of an 8‑week structured Yoga program on respiratory muscle strength, functional capacity, dyspnea, quality of life, and cardiovascular fitness in one patient with moderate COPD.

Case presentation: A 54‑year‑old male (Patient ID Y017) with a 29 pack‑year smoking history, diagnosed with GOLD Stage 2 COPD (FEV₁ = 55% predicted, FEV₁/FVC = 0.62), and clinically stable for 6 weeks prior to enrolment. Baseline respiratory muscle strength was severely reduced: maximal inspiratory pressure (MIP) = 46 cmH₂O (51% predicted), maximal expiratory pressure (MEP) = 67 cmH₂O (52% predicted). He had marked dyspnea (mMRC grade 3), poor health-related quality of life (COPD Assessment Test score = 24), and reduced functional exercise capacity (6‑minute walk distance = 340 m). Resting heart rate was 90 bpm, and estimated VO₂ max was 18.6 mL/kg/min.

Intervention: The patient participated in a supervised Yoga program consisting of 45‑minute sessions, three times per week for 8 consecutive weeks (total 24 sessions). The protocol included asanas (modified postures: Tadasana, Trikonasana, Cat-Cow, Bhujangasana, Setu Bandhasana, Viparita Karani) and pranayama (Ujjayi, Kapalabhati, Bhastrika, Kumbhaka), with progressive intensity.

Results: Post-intervention, MIP increased by 52% to 70 cmH₂O, and MEP increased by 21% to 81 cmH₂O. The 6‑minute walk distance improved by 32 m (from 340 to 372 m). The CAT score decreased by 4 points (from 24 to 20), surpassing the minimal clinically important difference (2 points). Resting heart rate reduced from 90 bpm to 83 bpm, and estimated VO₂ max increased to 20.5 mL/kg/min. The patient experienced a mild COPD exacerbation during week 7 (managed with outpatient antibiotics and corticosteroids, no hospitalization), but completed the protocol with 79.2% adherence. No serious adverse events occurred.

Conclusion: In this single case of moderate COPD, an 8‑week Yoga program produced clinically meaningful improvements in inspiratory muscle strength, functional capacity, dyspnea, and quality of life, despite a mild exacerbation. The findings support the use of pranayama‑based Yoga as a feasible and effective adjunct to pulmonary rehabilitation, particularly when inspiratory muscle weakness is prominent. Further single-case replications and larger trials are warranted.