Yoga Breath Training to Improve Cardiorespiratory Synchrony in Spinal Cord Injury

NCT ID: NCT06514950

Last Updated: 2025-10-27

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 20 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-08-01
• Study Completion Date: 2026-04-01

Brief Summary

The goal of this interventional study is to understand how regular yogic breathing practice, particularly a slow resistive yogic breathing technique called Ujjayi, would benefit individuals between the ages of 18 and 60 with spinal cord injuries. Previously yogic breathing has shown to improve respiratory function and sleep- we'd like to explore this further.

The main questions this study aims to answer are:

• How does Ujjayi breathing affect breathing patterns in individuals with spinal cord injuries?
• How does Ujjayi breathing affect lung function in individuals with spinal cord injuries?
• How does Ujjayi breathing affect the part of the nervous system responsible for ventilatory control in individuals with spinal cord injuries?
• How does Ujjayi breathing affect ventilatory perfusion (how well air and blood flow match in the lungs for efficient gas exchange) in individuals with spinal cord injuries?
• How does Ujjayi breathing affect sleep quality in individuals with spinal cord injuries?

Participants will undergo six weeks of training in Ujjayi breathing. Before and after this period, they will visit the lab for measurements of blood pressure, pulse, blood oxygen levels, and breathing. They will also perform several tests:

• Pulmonary function testing to assess lung capacity and respiratory muscle strength.
• Pace breathing frequency to four pre-recorded audio files at various breathing rates.
• Breathing exercises involving higher levels of carbon dioxide for a short time.
• Breathing exercises involving lower levels of oxygen for a short time.
• At-home sleep evaluation.

Between the two laboratory testing sessions, participants will practice yogic resistance breathing (Ujjayi breathing) for six weeks.

Detailed Description

This study investigates the impact of a type of slow-resistive yogic breathing, Ujjayi Pranayama, on cardiopulmonary function in 20 men and women aged 18-60 with spinal cord injuries classified under the American Spinal Injury Association Impairment Scale (AIS) score of A, B, or C. Participants will undergo baseline and post-intervention laboratory assessments over six weeks at Spaulding Hospital Cambridge, with cardiovascular and respiratory measurements taken during controlled and uncontrolled breathing conditions. Ujjayi Pranayama training, focusing on resistance breathing during exhalation and inhalation, will include coaching sessions in weeks 1 and 4, supplemented by virtual support for home practice (~20 min, twice daily). The study aims to determine whether regular yogic breathing practice enhances sleep quality, hypercapnic ventilatory response, and overall cardiopulmonary synchrony, potentially reducing respiratory and cardiovascular risks associated with SCI.

Conditions

Spinal Cord Injuries

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: NONE

Study Groups

Ujjayi yogic breathing training

This study will be a small (N = 20) prospective cohort study with a single unblinded intervention of Ujjayi resistance breathing.

Group Type: EXPERIMENTAL

Ujjayi Yogic Breathing

Intervention Type: BEHAVIORAL

Participants will undergo 6 weeks of resistive yogic breathing (Ujjayi) upon exhalation (first three weeks) and upon inhalation and exhalation (second three weeks).

Interventions

Ujjayi Yogic Breathing

Participants will undergo 6 weeks of resistive yogic breathing (Ujjayi) upon exhalation (first three weeks) and upon inhalation and exhalation (second three weeks).

Intervention Type: BEHAVIORAL

Other Intervention Names

resistive breathing

Eligibility Criteria

Inclusion Criteria

• Spinal cord injury
• American Spinal Injury Association Impairment Scale (AIS) score of A, B, or C
• Aged 18-60 years
• Wheelchair user
• Medically stable and able to follow directions
• Body mass index of 18.5 - 35 kg/m2

Exclusion Criteria

• Resting blood pressure of >140/90 mmHg
• Current use of tobacco or cardioactive medications (except medication to support blood pressure)
• Significant arrhythmia
• Bleeding disorder
• Pulmonary disease
• Coronary artery disease
• Diabetes
• Renal disease
• Cancer
• Epilepsy or other neurological diseases
• Current use of CPAP/BIPAP
• Has smartphone or device incompatible with the PranaTM application

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Spaulding Rehabilitation Hospital

OTHER

Sponsor Role: lead

Responsible Party

J. Andrew Taylor

PhD

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

J. Andrew Taylor, MS, PhD

Role: PRINCIPAL_INVESTIGATOR

Harvard Medical School/Spaulding Rehabilitation Hospital

Locations

Spaulding Rehabilitation Hospital

Cambridge, Massachusetts, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

J. Andrew Taylor, MS, PhD

Role: CONTACT

jandrew_taylor@hms.harvard.edu

617-758-5503

Maria Sukhoplyasova, BSc

Role: CONTACT

msukhoplyasova@partners.org

617-758-5506

Facility Contacts

Glen Picard, MS

Role: primary

GPICARD@PARTNERS.ORG

617-758-5511

References

Shields RK. Muscular, skeletal, and neural adaptations following spinal cord injury. J Orthop Sports Phys Ther. 2002 Feb;32(2):65-74. doi: 10.2519/jospt.2002.32.2.65.

Reference Type: BACKGROUND

PMID: 11838582 (View on PubMed)

Zimmer MB, Nantwi K, Goshgarian HG. Effect of spinal cord injury on the respiratory system: basic research and current clinical treatment options. J Spinal Cord Med. 2007;30(4):319-30. doi: 10.1080/10790268.2007.11753947.

Reference Type: BACKGROUND

PMID: 17853653 (View on PubMed)

Tollefsen E, Fondenes O. Respiratory complications associated with spinal cord injury. Tidsskr Nor Laegeforen. 2012 May 15;132(9):1111-4. doi: 10.4045/tidsskr.10.0922. English, Norwegian.

Reference Type: BACKGROUND

PMID: 22614314 (View on PubMed)

Burns SP, Kapur V, Yin KS, Buhrer R. Factors associated with sleep apnea in men with spinal cord injury: a population-based case-control study. Spinal Cord. 2001 Jan;39(1):15-22. doi: 10.1038/sj.sc.3101103.

Reference Type: BACKGROUND

PMID: 11224009 (View on PubMed)

van den Berg ME, Castellote JM, de Pedro-Cuesta J, Mahillo-Fernandez I. Survival after spinal cord injury: a systematic review. J Neurotrauma. 2010 Aug;27(8):1517-28. doi: 10.1089/neu.2009.1138.

Reference Type: BACKGROUND

PMID: 20486810 (View on PubMed)

Waddimba AC, Jain NB, Stolzmann K, Gagnon DR, Burgess JF Jr, Kazis LE, Garshick E. Predictors of cardiopulmonary hospitalization in chronic spinal cord injury. Arch Phys Med Rehabil. 2009 Feb;90(2):193-200. doi: 10.1016/j.apmr.2008.07.026.

Reference Type: BACKGROUND

PMID: 19236973 (View on PubMed)

Tran K, Hukins C, Geraghty T, Eckert B, Fraser L. Sleep-disordered breathing in spinal cord-injured patients: a short-term longitudinal study. Respirology. 2010 Feb;15(2):272-6. doi: 10.1111/j.1440-1843.2009.01669.x. Epub 2009 Nov 30.

Reference Type: BACKGROUND

PMID: 19947995 (View on PubMed)

Burns SP, Rad MY, Bryant S, Kapur V. Long-term treatment of sleep apnea in persons with spinal cord injury. Am J Phys Med Rehabil. 2005 Aug;84(8):620-6. doi: 10.1097/01.phm.0000171008.69453.b9.

Reference Type: BACKGROUND

PMID: 16034232 (View on PubMed)

Raguindin PF, Frankl G, Itodo OA, Bertolo A, Zeh RM, Capossela S, Minder B, Stoyanov J, Stucki G, Franco OH, Muka T, Glisic M. The neurological level of spinal cord injury and cardiovascular risk factors: a systematic review and meta-analysis. Spinal Cord. 2021 Nov;59(11):1135-1145. doi: 10.1038/s41393-021-00678-6. Epub 2021 Aug 20.

Reference Type: BACKGROUND

PMID: 34417550 (View on PubMed)

Schuster AK, Fischer JE, Thayer JF, Mauss D, Jarczok MN. Decreased heart rate variability correlates to increased cardiovascular risk. Int J Cardiol. 2016 Jan 15;203:728-30. doi: 10.1016/j.ijcard.2015.11.027. Epub 2015 Nov 6. No abstract available.

Reference Type: BACKGROUND

PMID: 26587729 (View on PubMed)

Solinsky R, Vivodtzev I, Hamner JW, Taylor JA. The effect of heart rate variability on blood pressure is augmented in spinal cord injury and is unaltered by exercise training. Clin Auton Res. 2021 Apr;31(2):293-301. doi: 10.1007/s10286-020-00677-2. Epub 2020 Mar 12.

Reference Type: BACKGROUND

PMID: 32166421 (View on PubMed)

Ely MR, Schleifer GD, Singh TK, Baggish AL, Taylor JA. Exercise Training Does Not Attenuate Cardiac Atrophy or Loss of Function in Individuals With Acute Spinal Cord Injury: A Pilot Study. Arch Phys Med Rehabil. 2023 Jun;104(6):909-917. doi: 10.1016/j.apmr.2022.12.001. Epub 2022 Dec 23.

Reference Type: BACKGROUND

PMID: 36572202 (View on PubMed)

Solinsky R, Mercier H, Picard G, Taylor JA. Cardiometabolic Effects of High-Intensity Hybrid Functional Electrical Stimulation Exercise after Spinal Cord Injury. PM R. 2021 Sep;13(9):937-944. doi: 10.1002/pmrj.12507. Epub 2020 Dec 4.

Reference Type: BACKGROUND

PMID: 33027550 (View on PubMed)

Chou RC, Taylor JA, Solinsky R. Effects of hybrid-functional electrical stimulation (FES) rowing whole-body exercise on neurologic improvement in subacute spinal cord injury: secondary outcomes analysis of a randomized controlled trial. Spinal Cord. 2020 Aug;58(8):914-920. doi: 10.1038/s41393-020-0445-3. Epub 2020 Feb 24.

Reference Type: BACKGROUND

PMID: 32094516 (View on PubMed)

Bertisch SM, Hamner J, Taylor JA. Slow Yogic Breathing and Long-Term Cardiac Autonomic Adaptations: A Pilot Study. J Altern Complement Med. 2017 Sep;23(9):722-729. doi: 10.1089/acm.2016.0074. Epub 2017 Apr 18.

Reference Type: BACKGROUND

PMID: 28418684 (View on PubMed)

Chiodo AE, Sitrin RG, Bauman KA. Sleep disordered breathing in spinal cord injury: A systematic review. J Spinal Cord Med. 2016 Jul;39(4):374-82. doi: 10.1080/10790268.2015.1126449. Epub 2016 Mar 15.

Reference Type: BACKGROUND

PMID: 27077573 (View on PubMed)

Aboussouan LS. Sleep-disordered Breathing in Neuromuscular Disease. Am J Respir Crit Care Med. 2015 May 1;191(9):979-89. doi: 10.1164/rccm.201412-2224CI.

Reference Type: BACKGROUND

PMID: 25723731 (View on PubMed)

Norrbrink Budh C, Hultling C, Lundeberg T. Quality of sleep in individuals with spinal cord injury: a comparison between patients with and without pain. Spinal Cord. 2005 Feb;43(2):85-95. doi: 10.1038/sj.sc.3101680.

Reference Type: BACKGROUND

PMID: 15570322 (View on PubMed)

Somers VK, White DP, Amin R, Abraham WT, Costa F, Culebras A, Daniels S, Floras JS, Hunt CE, Olson LJ, Pickering TG, Russell R, Woo M, Young T; American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology; American Heart Association Stroke Council; American Heart Association Council on Cardiovascular Nursing; American College of Cardiology Foundation. Sleep apnea and cardiovascular disease: an American Heart Association/american College Of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council On Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). Circulation. 2008 Sep 2;118(10):1080-111. doi: 10.1161/CIRCULATIONAHA.107.189375. Epub 2008 Aug 25. No abstract available.

Reference Type: BACKGROUND

PMID: 18725495 (View on PubMed)

Sankari A, Vaughan S, Bascom A, Martin JL, Badr MS. Sleep-Disordered Breathing and Spinal Cord Injury: A State-of-the-Art Review. Chest. 2019 Feb;155(2):438-445. doi: 10.1016/j.chest.2018.10.002. Epub 2018 Oct 12.

Reference Type: BACKGROUND

PMID: 30321507 (View on PubMed)

Burns SP, Little JW, Hussey JD, Lyman P, Lakshminarayanan S. Sleep apnea syndrome in chronic spinal cord injury: associated factors and treatment. Arch Phys Med Rehabil. 2000 Oct;81(10):1334-9. doi: 10.1053/apmr.2000.9398.

Reference Type: BACKGROUND

PMID: 11030498 (View on PubMed)

Leduc BE, Dagher JH, Mayer P, Bellemare F, Lepage Y. Estimated prevalence of obstructive sleep apnea-hypopnea syndrome after cervical cord injury. Arch Phys Med Rehabil. 2007 Mar;88(3):333-7. doi: 10.1016/j.apmr.2006.12.025.

Reference Type: BACKGROUND

PMID: 17321826 (View on PubMed)

Bascom AT, Sankari A, Badr MS. Spinal cord injury is associated with enhanced peripheral chemoreflex sensitivity. Physiol Rep. 2016 Sep;4(17):e12948. doi: 10.14814/phy2.12948.

Reference Type: BACKGROUND

PMID: 27597767 (View on PubMed)

Raurich JM, Rialp G, Llompart-Pou JA, Ayestaran I, Perez-Barcena J, Ibanez J. Respiratory CO(2) response in acute cervical spinal cord injury (CO(2) response in spinal cord injury). Spinal Cord. 2014 Jan;52(1):39-43. doi: 10.1038/sc.2013.115. Epub 2013 Oct 8.

Reference Type: BACKGROUND

PMID: 24100664 (View on PubMed)

Stanescu DC, Nemery B, Veriter C, Marechal C. Pattern of breathing and ventilatory response to CO2 in subjects practicing hatha-yoga. J Appl Physiol Respir Environ Exerc Physiol. 1981 Dec;51(6):1625-9. doi: 10.1152/jappl.1981.51.6.1625.

Reference Type: BACKGROUND

PMID: 6798002 (View on PubMed)

Other Identifiers

2024P001385

Identifier Type: -

Identifier Source: org_study_id