“IMMEDIATE EFFECT OF THORACIC MASSAGE WITH OR WITHOUT

EUCALYPTUS OIL ON SPIROMETRIC VARIABLES IN HEALTHY

VOLUNTEERS – A COMPARATIVE STUDY”

SYNOPSIS
Submitted to the Swami Vivekanand Subharti University, Meerut
In partial fulfillment of the requirements for the Degree
DOCTOR OF MEDICINE – NATUROPATHY
By
DR. BHOOMIJA TANWAR

MAHARISHI AUROBINDO SUBHARTI COLLEGE AND HOSPITAL OF

NATUROPATHY AND YOGIC SCIENCES

(Affiliated to Swami Vivekanand Subharti University, Uttar Pradesh)

1
From,

Dr. Bhoomija Tanwar

M.D. Naturopathy (Ist year)
Maharishi Aurobindo Subharti College & Hospital of
Naturopathy & Yogic Sciences, Meerut – 250005
To,
The Registrar,
Swami Vivekanand Subharti University
Meerut, Uttar Pradesh-250005
Through,
The Principal and Head of Department of PG studies
Subject: Submission of Completed Pro-forma for Registration of subject for
Dissertation.
Respected Sir,
I request you to kindly register the below mentioned subject against my name for the
submission of the dissertation to the Swami Vivekananda Subharti University, Meerut
for partial fulfillment of M.D in Naturopathy.
TITLE OF DISSERTATION:
“IMMEDIATE EFFECT OF THORACIC MASSAGE WITH OR WITHOUT
EUCALYPTUS OIL ON SPIROMETRIC VARIABLES IN HEALTHY
VOLUNTEERS – A COMPARATIVE STUDY”

Here with, I am enclosing complete proforma for registration of subject for

dissertation
Thanking You,
Date: 20 March 2023 Yours Faithfully
Place: Meerut Dr. Bhoomija Tanwar

2
 SWAMI VIVEKANAND SUBHARTI UNIVERSITY, MEERUT

Annexure II

COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT FOR

DISSERTATION

1. NAME OF THE : Dr. Bhoomija Tanwar

CANDIDATE AND Flat No. 172 Godwin Greenwood City

ADDRESS Meerut – 250002, Uttar Pradesh

PERMANENT : Behind Veterinary Hospital, Rani Sati road

ADDRESS Shastri Nagar, Sikar (332001)

2. NAME OF THE : Maharishi Aurobindo Subharti College &

INSTITUTION Hospital of Naturopathy & Yogic Sciences,

Meerut – 250005

3. COURSE OF STUDY : M.D. Naturopathy

&SUBJECT

4. DATE OF ADMISSION : 31 January 2022

TO THE COURSE

5. TITLE OF THE TOPIC : “IMMEDIATE EFFECT OF THORACIC

MASSAGE WITH OR WITHOUT

EUCALYPTUS OIL ON SPIROMETRIC

VARIABLES IN HEALTHY VOLUNTEERS

– A COMPARATIVE STUDY’’

3
6. BRIEF RESUME OF THE STUDY:
6.1 Need for the study
Respiratory diseases cause a surprisingly large amount of morbidity &
mortality which can often be avoided and prevention costs a fraction of what
treatment does. Joan Soriano and colleagues use the Global Burden of
Disorders, Injuries, and Risk Factors Study (GBD) 2017 to estimate the
prevalence and associated health burden of chronic respiratory diseases in The
Lancet Respiratory Medicine.[1,2] They discovered that about 545 million
people worldwide have chronic respiratory disease in 2017, up to 398 % since
1990. In India, chronic respiratory disorders were responsible for 9-10% of all
fatalities and 64% of all DALYs in 2016 compared to 96% and 45%,
respectively in 1990.[3] In 2016, India accounted for 32 percent of all global
DALYs related to chronic respiratory illnesses.[4]

Chronic respiratory disorders are one of the most frequent non-

communicable diseases in the India, owing to the prevalence of noxious
environmental, occupational, and behavioral inhalational exposures[5] COPD,
asthma, interstitial lung disease, pulmonary sarcoidosis, and pneumoconioses
such as silicosis and asbestosis are all included and contributing to death and
morbidity [6]As a result, knowing the global and regional prevalence, morbidity,
and mortality of chronic respiratory diseases are critical for better informing
prevention, screening and research efforts so that a better management modality
can be developed. [7]

Anatomically the respiratory system is classified into upper & lower

respiratory tracts. The upper respiratory tract which is situated outside of the
chest cavity is composed of the airways of the nose, nasal cavities, pharynx,
larynx and upper trachea, whereas the trachea and the lungs which contain the
bronchial tubes and alveoli make up the lower respiratory tract. The respiratory
system also includes pleural membranes and the respiratory muscles that
construct the chest cavity such as the diaphragm and intercostal muscles to aid
the process of respiration.[8]

Respiration is a process that aids in gaseous exchange and the

4
elimination of carbon dioxide from tissues. The respiratory process has three
core features:
1. Pulmonary ventilation refers to a gaseous exchange between the
atmosphere & lung alveoli.
2. Diffusion of air between alveoli & capillaries.
3. Exchange of oxygen & carbon dioxide throughout the body tissues &
cells alveolar ventilation. [9]

The following are the notable lung volumes and their descriptions:·
a. Inspiratory Reserve Volume (IRV) - IRV is the maximum
amount of air that is inspired after standard respiration. This reserve
volume is 1900-3000 ml in an average adult.[10]
b. Tidal Volume (TV) - The standard amount of air inspired &
expired out of lungs during each respiration is known as TV. In
healthy males and females, the standard tidal volume is 500mL and
400mL, respectively [9,10]
c. Expiratory Reserve Volume (ERV) - The amount of air forcefully
exhaled is followed by a standard tidal volume. The average adult
has 700-1200mL. [10]
d. Residual Volume (RV) - The residual amount of air left after a
complete exhalation which is 1200mL in a healthy adult. [11]
e.
Inspiratory capacity (IC)- Maximum volume of air that can be
inspired after normal exhalation or it can be estimated as a
summation of Inspiratory reserve volume & tidal volume. [12]
f.
Total Lung Capacity (TLC)-It is the total amount of air that
the lungs can hold after maximum inspiration, or the sum of all
volume compartments. 6,000mL is an average range. [12]
g. Vital Capacity (VC)-After maximum inhalation, it is the entire
amount of air exhaled. The amount varies depending on age and
body size. Tidal volume, Inspiratory reserve volume, and
expiratory reserve volume are added together to get this figure.
[13]

h.
Functions Residual Capacity (FRC)-The amount of air that
remains in the lungs after a typical exhale. It's estimated by

5
 summing the volumes of residual and expiratory reserves. The
usual range is between 1800 and 2200 mL. [13]
Considering lung pathology continues to be a leading cause of
morbidity and mortality the clinical understanding of lung physiology and how
it links to pathology is necessary. Hypoxia is primary cause of pulmonary
system dysfunction. Hypoventilation, right-to-left shunt, V/Q mismatch and
diffusion restrictions are the four classifications of hypoxia a etiology. [14]
a. Hypoventilation:

Hypoventilation is caused by any disorder that reduces the ventilatory

rate of the alveoli. CNS depressants, Obesity, rib fractures, kyphoscoliosis and
neurologic abnormalities are all possible causes. [14]
b. Right-to-left-shunt:

When deoxygenated blood flows from the right heart to the left heart, it
bypasses the lungs. Anatomically and physiologically this condition can arise.
Congenital cardiac malformations (such as teratology of Fallot) and
arteriovenous malformations are two anatomical sources of anatomical shunts.
When blood flows to an unventilated alveolus, physiologic shunts form; this
happens when air cannot diffuse across the alveolus, such as in acute
respiratory distress syndrome or pleural effusions. [14]
c. V/Q mismatches:

Blood flow and ventilation are mismatched in V/Q mismatches, as the

name suggests. For adequate gas exchange, ventilation and perfusion should
match. V/Q is normally 0.8. When ventilation exceeds perfusion, a high V/Q
ratio arises.
A pulmonary embolism is a famous example of this in which perfusion
to a portion of the lung is entirely restricted yet ventilation is unaffected. When
there is normal blood flow to an area of the lung but ventilation is obstructed,
the V/Q ratio is low. In COPD, for example the alveolus surface area is
reduced, resulting in insufficient gas exchange. [14]
d. Diffusion limitations:

When oxygen cannot adequately travel from the alveoli to the

pulmonary capillaries, it is called diffusion limitation. This condition can occur

6
when the alveoli are destroyed (as in COPD) or when the lung parenchyma is
destroyed or thickened (i.e., interstitial fibrosis). These are sometimes
associated with V/Q mismatches. [15,16]
Over the last few decades, there has been a significant expansion in the
use of complementary and alternative medicine (CAM) both within and outside
[17]
of the standard health care system. This trend has been documented in
several international investigations, both in the general population and in
[18,19,20,21,22,23]
various patient groups. Additionally, CAM is widely utilised to
prevent disease and promote good health. [24]
In the scientific community, naturopathy is a well-known component of
complementary and alternative medicine (CAM). Furthermore, the World
Health Organization defines complementary and alternative medicine (CAM)
as "a broad group of healthcare practices that are not fully integrated into the
dominant healthcare system. In some countries, CAM and traditional medicine
are used interchangeably." [25]
Naturopathy is a health-care method that consists of a traditional
healing system based on philosophical concepts that date back to ancient India.
It has its own conceptions of health and disease as well as therapy principles.
Ancient texts such as the Vedas go into great length on these activities.
Naturopathy is a therapy that focuses on preventing disease. It considers man to
be a full health unit and treats the body physically, psychologically, socially
(morally) and spiritually to promote overall health. Also the system believes
[26,27].
that one follows nature's laws, he can avoid diverse range of diseases.
Naturopathy encompasses therapies that use natural materials such as
hydrotherapy,[28] heliotherapy,[29] mud therapy,[30] chromotherapy, [31]

[32]
manipulative therapy, fasting therapy,[33] food therapy,[34] (which includes
plant-based natural supplements), acupuncture, acupressure with reflexology[35]
and so on. Naturopathy is defined as a "style of life" rather than a technique for
treating aches and pains.[36] Naturopathy focuses on treating the disease's
fundamental cause rather than merely the symptoms.[37] The best-suited CAM
therapy for our unique 'Lifestyle clinic' model to control NCDs is a
combination of Yoga therapy and Naturopathy. [38]
Aromatherapy is based on an ancient herbal medicine tradition that
dates back thousands of years in nations like Egypt and India. [39]Aromatherapy

7
is a complementary therapy that uses essential oils as the primary therapeutic
agent to treat a variety of ailments. Various methods are used to extract
essential or volatile oils from the flowers, barks, stems, leaves, roots, fruits and
other parts of the plant. It was created when scientists discovered essential oil‟s
antibacterial and skin permeability qualities. Aromatherapy utilises these oils to
infiltrate the human skin surface with a distinct aura through inhalation, topical
application and baths. Once in the system, the oils remodulate and work in a
friendly manner at the site of the malfunction or the affected area. This sort of
therapy employs a variety of permutations and combinations to treat a variety
of ailments including depression, indigestion, headache, sleeplessness,
muscular discomfort, respiratory issues, skin disorders, swollen joints and
urine-related complications among others. When other factors of life and food
are taken into account, essential oils are proven to be more useful. Moreover,
aromatherapy is cost- effective, easy and reported for having less adverse
effects than other conventional therapy. [40]
The use of extracts from Eucalyptus species leaves treating various
diseases, particularly respiratory disorders has a long folkloric history,
particularly among Australian Aborigines.[41] The genus Eucalyptus was first
described in 1788 by French botanist Charles L'Héritier de Brutelle, based on a
specimen of Eucalyptus obliqua from Adventure Bay on Bruny Island,
Tasmania.[42] The word Eucalyptus comes from the prefix "Eu" which means
"true" and "calyptus" which means "to cover" and refers to the flower's bottom
bud which is made up of joined calyx and corolla sections that seal the flower
until it blooms.[42]
Eucalyptus oil is an ethnomedicinally important and widely used
essential oil (EO) with a variety of therapeutic properties including
analgesic,[43] antimicrobial,[44] anti-oxidant,[45] antibacterial,[46] antiviral,[47]
sedative,[48] CNS stimulant,[49] pulmonary decongestant,[50] antispasmodic,[51]
etc. Furthermore, eucalyptus essential oil (EEO) has been used in the treatment
of bronchitis, sinusitis[52] and asthma.[53] Due to its therapeutic potential for
chronic obstructive pulmonary disease[54]and infections.[55]Wounds,[56]Malaria,
cancer [57] last but not least COVID-19 is the least.[58]
These oils also have been utilized to maintain and stimulate numerous
systems such as the neurological system in the treatment of neuralgia,

8
 headaches and debility. Immunity to measles, flu, colds and chickenpox gets
boosted by the immune system. It can also be used to treat genitourinary system
leucorrhea and cystitis. The oils of this plant have been used to treat throat
infections, bronchitis, coughs, asthma, catarrh and sinusitis related with the
respiratory system. [59,60,61]

6.2 Previous Research

Cohen describes a study with a better methodology (1982). In this study,
24 non-smoking adults with common colds were randomly assigned to inhale
either hot water vapor (control) or a mixture of 9% eucalyptus oil, 56% menthol
and 35% camphor. A variety of tests revealed moderate improvements in
respiratory function. There were differences between the groups between the
treated participants and the controls on various measures, including forced
expiratory and forced vital capacity volume. According to the authors, aromatic
inhalation reduced the alterations in airway dynamics that occur during the
common cold. As a result, the study lends some credence to this age-old therapy
method. It would be worthwhile to replicate this experiment using subjective
outcome data to see if inhaling essential oils relieves symptoms of the common
cold.[62]
In 1986, Linsenmann and Swoboda performed a trial on Pinimenthol, a
patented preparation containing eucalyptus, camphor menthol and essential oils
of two pine species in Vaseline which was given to 100 male patients with
chronic obstructive pulmonary disease. Three times a day patients applied the
formulations to their chest and back. At 1, 7 and 14 days after starting therapy,
outcome measurements such as lung function and assessments of cough,
wheeze and dyspnoea were taken. Pinimenthol patients had moderate
improvements in lung function that were statistically superior to the placebo
group. Dyspnoea and cough symptoms as well as the presence of wheeze,
improved substantially more in the therapy group than in the control group.[63]
Fischer & et al., 2013 in his study described that 200mg cineole capsules 3
times per day has mucolytic, anti-inflammatory & bronchodilatory effects thus
improving symptoms & exacerbations in conditions like COPD, asthma and
rhinosinusitis. Furthermore, the study concluded that the compound cineole
significantly reduces the frequency of cough in acute bronchitis in just 4 days of

9
intervention. [64]
Liza Dion et al. 2007 reported that aromatherapy massage with
geranium & lavender diluted with neutral cream (1:1) which also contains 1,8-
cineole respectively in the nursing population has significantly reduced heart
rate, blood pressure & stress levels after the intervention. Massage techniques
used in this study were effleurage in posterior cervical & thoracic for 6 sessions
each of 15 minutes. Thus concluding that aromatherapy massage is an effective
means of reducing biophysiological parameters.[65]
Monika Kurzaj et al. (2013) conducted a study on 30 COPD patients.
All of the patients received routine pharmaceutical treatment as well as basic
physiotherapy. The experimental group of 20 patients had a series of 6 massage
sessions for 30 minutes and included stroking, grinding, vibrating, and kneading
techniques along with standard treatments. The BODE index was used to
evaluate the patients before and after treatment. The BODE index increased in
both groups after a week of therapy but the experimental group had a
significantly greater difference.[66]
U.R. Juergens, U.Dethlefsen et al performed a 12-week trial in 32
asthma patients on the anti-inflammatory effect of 1,8-cineole capsules for 200
mg three times daily. In the cineole group oral glucocorticoid dosage was
reduced by 3.75 mg on average compared to 0.91 mg in the control group.
Before treatment the average daily dose of prednisolone was 5-24 mg. Even at a
lower prednisolone dosage the cineole group reported maintaining lung function
capacity (peak expiratory flow rate, FEV1, and RAW) four times longer than
the placebo group.[67]
Wolfgang Kehrl et al 2004 compared the efficacy and safety of cineole
capsules with placebo capsules in 152 patients, 76 patients in each group with
acute rhinosinusitis. 200mg cineole capsules were taken three times a day as the
active ingredient. After 4 and 7 89days, the clinical symptoms of inflammation
such as conjunctivitis, tracheitis, pharyngitis and bronchitis improved
significantly in the cineole group. Furthermore, CRP levels have decreased
statistically significantly, although leucocyte count and erythrocyte
sedimentation rate have remained unchanged. Moreover, subjective
observations of headache with or without bending discomfort to trigeminal
nerve pressure points, impairment of general condition, nasal blockage and

10
 nasal secretions improved by over 80% after seven days. Cineole was found to
be beneficial in treating the symptoms of non-purulent rhinosinusitis in this
study.[68]
6.3 Aims and objectives of the Study
 Aim: To study the immediate effect of aroma massage on pulmonary
function among the healthy individuals.
 Objectives: To study the immediate effect of thorax aroma massage on
spirometric variables among healthy volunteers
 Primary : spirometry (Force vital capacity, forced expiratory volume)
FVC/FEV1,FVC,FEV1
 Secondary : Blood pressure, Pulse rate, Spo2
7. MATERIALS & METHODS:
7.1 Source of Data
Subjects will be recruited from Maharishi Aurobindo Subharti College &
Hospital of Naturopathy & Yogic Sciences, Subharti University, Meerut-
250005.
7.2 Method of Collection of Data
A. Criteria for Diagnosis:
Since this study is among healthy individuals no criteria for diagnosis is
applicable in this present study.

B. Inclusion Criteria
 Both genders
 Age between 18 – 30 years.
 Subjects who are willing to participate in the study after signing
the informed consent form.
C. Exclusion Criteria

11
  Volunteers with diagnosed medical conditions.
 Recent surgeries
 Inflammatory skin conditions
 Subjects under the influence of any psychoactive substances, sedatives,
anxiolytics, anti-depressants and consuming alcohol and nicotine.
 Pyrexia due to any reason
 Cardiovascular co-morbidities
 Pregnant and lactating women
 Female under menstruation.

D. Study Plan
 Design:Prospective Randomized Control Trial
 Sample size: Potential subjects will be screened and among them a
minimum of 200 healthy eligible subjects will be recruited for the study.
 Grouping: Selected individuals will be grouped into 2 i.e., intervention
& control each with 100 individuals.
a. Method:
The study subjects will be identified and screened as per the demands of
the Inclusion & Exclusion criteria. Signed informed consent form will
be obtained from every participant after an appraisal about the purpose
of the study. Selected subjects will be allocated into two groups as
illustrated in the Fig 1.
Group 1: (n=100): Intervention group : n =100 [ massage with sesame
oil with eucalyptus oil]
Group 2: (n=100): Control group : n = 100 [ massage with sesame oil]
 Baseline assessment will be done before intervention and post
assessment will be done immediately after intervention. The data
collected will be tabulated and analysed using appropriate statistical
methods.

12
 Fig1: Illustration of study plan
E. Intervention:
Skilled based hand touch with numerous techniques for specific duration
of time when applied to a specific region for therapeutic purpose is
manipulative therapy.[69] Massage and manipulation are interchangeably used
terms for various techniques with more than 75 forms of practice.[70,71]
Massage is widely practiced measure with multiple benefits on physical
and psychological dimension of health such as relaxation, reduces muscular
pain and anxiety. [72]
Pre-Requisites – Eucalyptus oil, lukewarm sesame oil, bath towel.
Proportion for aroma oil- 1:1 [73]
Procedure of Thoracic Manipulation
Individual is made to lie in supine position on massage table (73inch x
30 inch) comfortably with the hip flexed. Sesame oil will be smeared on the
thorax and the following procedures in order will be performed. Initially patient
is asked to relax by taking few deep breathing. Individual arm should be
relaxed with distance from sides to straighten the pectoralis muscle. The
operator should stand facing patient‟s feet to employ movement from sternum

13
 towards the axilla (covering clavicle to lower borders of the last ribs) as
centripetal friction is to perform movement with the direction of blood supply in
veins using thumb and palms. To stimulate glandular activity and mechanical
effects skin is grasped and compressed using both hands in alteration in a
rhythmic manner but with care to avoid bruising followed by friction again.
Following palmar kneading employed using whole palmar surface to induce
mechanical effects followed by percussion. Percussion involves blows using
wrist joint to enhance elasticity in different modes (used here )as follows:
 Tapping – beating with finger tips.
 Hacking – performed with loosely yet slightly apart ulnar border of the
hand is employed to induce vibratory effects.
 Spatting – palmar surface with rigidly extended fingers is employed to
induce hyperthermic effects.
 Beating – movement performed using loose fist where dorsal or palmar
surface of the hand facing body region which has excitatory effect
which give rise to vasodilation.
 Clapping- movement in which palmar surface of the hand is shaped to
entrap air while coming in contact with the body surface producing a
loud sound.

The massage will be completed by stroking of thorax and the entire

procedure is done for 35 minutes.[74]
MOVEMENT IN ORDER DURATION
1. Centripetal friction 5 minutes
2. Fulling or Superficial kneading 5 minutes
3. Centripetal friction 5 minutes
4. Palmar kneading 5 minutes
5. Percussion inclusive of tapping, hacking, spatting, 5 minutes
beating, clapping
6. Assistive respiration 5 minutes
7. Resistive respiration 5 minutes
Table 1: Movements & duration allotted for each procedure
F Assessments
The assessments will be taken immediately before and after the intervention.

14
Electrophysiological parameters
1.Spirometry - “physiological test that measures individual inhalation and
exhalation volumes of air as a function of time”.[75,76]

Fig2: Pulmonary Function Test

Preparation
 Competency of spirometry requires regular follow up.
 Both hard and soft copy should be cross checked to avoid technical
inaccuracy.
 Skilled professional should perform the test to minimise technical error
and to maintain quality handling.
 Utmost effort is desired from patients side to elude mismanagement and
for accurate diagnosis.
Procedure to be followed for taking spirometry[77]
Standard guidelines should be taken into consideration while performing
the test
1. Break between inspiration and expiration while documentation should
be less than 1 second to measure expiratory flow with respect to time
and volume.
2. Documentation should be done more than 15 seconds with more severe

15
 conditions to come up with volume plateau.
3. The greatest value obtained are FVC and FEV1 which should not be
more than 5% or 150ml of any of the three values.
4. The technical curve ratio (FEV1/FVC) should be considered with giant
sum of the remaining two (FVC,FEV1).
Following parameters will be assessed:
I. FVC – Forced vital capacity.
II. FEV1 - Forced expiratory capacity in one second.
III. FEV1/FVC – Tiffeneau- Pinelli index

Blood pressure:

The blood pressure will be measured with a digital or mercury

sphygmomanometer. The subject will be asked to lie down and sit for 3 minutes

to allow the circulatory system to rest, the left upper arm will be placed at the

height of the heart and the blood flow will gradually stop and the valve will be

discharged the vibration will be detected with a digital or mercury

sphygmomanometer and the systolic and diastolic pressure will be recorded. [78]

Pulse Rate:

The pulse rate can be measured at numerous locations throughout the body.

These are the locations on the body where an artery lies just beneath the skin

and can be pressed against a bone, allowing you to feel each beat. The radial

point is a frequent place to take a pulse reading and record the number of beats

per minute.[79]

SPO2:

Pulse oximeters detect oxygen (O2) saturation in arterial blood by detecting

light absorption at two wavelengths: 660nm (red) and 940nm (infrared) [2]. The

wavelength ratio is then empirically calibrated against direct measurements of

arterial blood oxygen saturation (SaO2) and the resulting calibration curve is

utilized to generate the pulse oximeter's estimate of arterial saturation

16
(SpO2). [80]

Breath holding time:

The subject was told to sit comfortably in the chair during the recording of

breath holding time.

Breath holding time after expiration and inspiration:

 The subject was instructed to exhale or inhale completely, and the lips

and nose clip were both tightly closed. When inhaling or exhaling, care

was given to prevent air leakage from the lips and nose.

 The subject was advised to maintain breath-holding for as long as he

could. Subject was told right away to take his hand off chest if found it

hard to hold breath any longer.

 It was evaluated whether the subject could hold his or her breath for the

given number of seconds.

Scoring:

A stopwatch was used to time each subject's ability to hold their breath three

times. The final values were taken from the best of the 3 readings.[81]

Respiratory rate:

Respiratory rate is a representation of your minute breathing rate. To determine

breathing rate, count how many breaths you take in a minute when at rest. To

measure accurately:

 Try to relax by sitting down.

 The ideal position for measuring respiratory rate is a chair or bed that

has a back.

 To calculate breathing rate, count the number of times your chest or

abdomen rise in a minute.[82]

17
G. Data extraction:

 Baseline data will be done before intervention and post data will be done
immediately after intervention. The spirometry will be done by RMS
HELIOS 401 machine.
 The blood pressure will be measured by using a digital or mercury
sphygmomanometer.
 The SpO2 will be measured by using a pulse oximeter.

H. Statistical analysis:
Appropriate statistical tests will be done to assess mean differences across the
baseline, before and after the assessment on the quantity and quality of data.
These tests will be done using Statistical Analysis Software „Statistical Package
for Social Sciences‟ (SPSS for Windows). The level of statistical significance
Considered will be p≤0.05 for the analysis and interpretation.
I. Follow Up Study: 30 min follow up
7.3 Laboratory investigations: No
7.4 Has Ethical Clearance been Obtained from your Institution: No

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7 Labaki WW, Han MK. Chronic respiratory diseases: a global view. The
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12 Ranu H, Wilde M, Madden B. Pulmonary function tests. The Ulster
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MAHARISHI AUROBINDO SUBHARTI COLLEGE AND HOSPITAL OF
NATUROPATHY AND YOGIC SCIENCES, MEERUT

9 Signature of the candidate

10 Remarks of Guide

10.1 Name of the Guide

Designation of the Guide

Signature

10.2 H.O. D

Signature

10.3 Remark of Chairman & Principal

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Signature

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