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Results of a Standardized Test in 232 Patients

Majid Ali, M.D.

There is a need for a test to optimally manage chronic stress-related disorders with the following characteristics: (1) it should be simple and convenient for the staff to perform; (2) the results obtained should be objective and quantitative; (3) it should provide clear metrics for measuring the effects of self-regulatory measures; and (4) it should be easily teachable to patients as a self-administered test for follow-up use at home. In 2007, I designed a test to meet these criteria and designated it as the "Autonomic Breathing Test (ABT)." Here I present the results obtained with the test performed for 232 patients. I organize this column in seven sections: (1) the development of the ABT; (2) training of the staff and patients in ABT in practitioners' offices; (3) the test results observed in 232 chronically ill patients; (4) discussion of the results; (5) the value of the ATB in acute illness; (6) improved mitochondrial function with Limbic Breathing; and (7) the clinical application of the test in cardiovascular disorders. Below, are introductory comments to provide a framework of reference.

Altering the Health Script of Life

One can radically alter one's medical history by simply altering breathing. In The Cortical Monkey and Healing (1991), I described the development of the principles and practice of Limbic Breathing and its physiologic benefits observed during the preceding five years.1 Specifically, I presented the results of experiments performed to objectify and quantify changes observed with Limbic Breathing in: (1) the blood levels of oxygen and carbon dioxide; (2) blood pH; (3) blood lactic acid; (4) white blood counts; and (5) electrophysiological parameters, such as electromyopotentials, electrodermal conductance, pulse pressure, and others. In What Do Lions Know About Stress (1996) 2 and Healing Miracles and the Bite of the Gray Dog (1997),3 I furnished additional clinical and laboratory data to establish the clinical value of Limbic Breathing and related self-regulatory methods. In Integrative Cardiology (2000),4 I presented a large body of data concerning autonomic responses to Limbic Breathing as measured by power spectral analysis of heart rate variability. In my column of July 2007,5 I summarized many earlier observations and illustrated simple steps for beginner, intermediate, and advanced methods of Limbic Breathing.

1. The Development of the Autonomic Breathing Test

We overbreathe to breathlessness—and sicken ourselves in many ways. Rapid and shallow breathing—"subclinical hyperventilation" seems an appropriate designation for it—is the mark of our time. It steadily disrupts
oxygen homeostasis. Since the core issues in the health/dis-ease/disease continuum are oxygen signaling and oxygen-driven cellular energetics and most of the mechanisms of disruption are mediated by the autonomic nervous system, it seemed appropriate to base the test on the mode of breathing and select autonomic parameters—the heart rate and blood pressure —as quantitative metrics. The next issue was to standardize the training methodology and select the periods of breathing for optimal yield. This was done by testing the effects of various time periods, carefully considering the factors of simplicity, feasibility in a clinical setting, availability of staff, and the clinical usefulness of the data obtained. The previously described method of Beginner Limbic Breathing 1 was modified, designated as "Feather Breathing," (described in the next section) and selected for training in slow breathing. Tables 1 and 2 show the steps for performing the test and recording the results respectively.

Name: ___________________________

Age: ________

Date: _______

Main Diagnoses ________________________________________________________

Part A

The test subject breathes as usual for one minute. The practitioner takes the pulse rate, measures blood pressure, asks the subject to describe in three words how she/he feels, and records the findings on the ABT Record Sheet (Table 2).

Part B
The subject is given instruction in Feather Breathing (described below), and then asked
to practice it for three minutes.

Part C
The subject is asked to continue Feather Breathing for one minute without
further guidance. The practitioner then takes the pulse rate, measures blood pressure,
and asks the subject to describe in three words how she/he feels, and records the
findings on the ABT Record Sheet.

 Table 2. Autonomic Breathing Test Record Sheet
Before Training Part A  
Date Breaths/
BP Use 3 wordsto describe how you feel
Week 1        
Week 2        
Week 3        
Week 4        
Week 5        
Week 6        

 After Training Part C

Date Breaths/
BP Change in Total Heart Beats/Day*
Use 3 words to describe how
you feel
Week 1        
Week 2        
Week 3        
Week 4        
Week 5        
Week 6        

Feather Breathing

Feather Breathing is the term used for a simple form of Limbic Breathing in which the focus is purely on effortlessly prolonged exhalation. In Feather Breathing, one:

Imagines that there is a thin feather almost touching the nostrils;
Breathes out through the nostrils so slowly as not to move the delicate pringle of the feather;
Exhales for as long as possible, but comfortably;
Completely ignores the mode and duration of breathing in—exhalation after a gentle prolonged inspiration is always good and the issues of breathing through one or the other nostril or mouth breathing are not relevant in Feather Breathing inspiration;
Does not allow the mind to compete with simple mechanics of Feather Breathing; and
After initial training, slides in and out of Feather Breathing at work and at home without conscious effort.

The primary strength of Limbic Breathing is the prevention and/or reversal of the adverse effects of subliminal hyperventilation on oxygen homeostasis. Feather Breathing dramatically improves oxygen transport and functionalities in times of stress and autonomic dysequilibrium. I return to this subject in the section entitled "Improved Mitochondrial Function with Limbic Breathing."

2. Training of the Staff and Patients in ABT in Clinical Practice

It should be evident from the above description of the ABT that it does not require any special staffing, equipment, or space. The test can be administered to patients singly or in groups. At the Institute of Integrative Medicine, the ABT was administered by all members of the staff—doctors, nurses, and office assistants—depending on the staff availability and workload. For this study of 232 patients, the participation of a large number of staff may be considered as a source of variability. However, in my view, it should be considered as a strength since it more closely reflected the reality and imperatives of busy clinical practice at a large center. In one area, however, there was complete agreement among the staff: everyone emphasized strongly to the patients that the benefits of Limbic Breathing last long after the period of slow breathing is complete.

3. The ABT Test Results Observed in 232 Patients

No attempt was made to select patients for this study. The Institute only draws chronically ill people with autoimmune, environmental, nutritional, degenerative, and neoplastic disorders. All 232 patients were included sequentially. This approach maximized the clinical relevance of the test as applied to integrative practices in which the focus is on caring for the whole person rather than on a disease. The data for all patients are presented in Table 3.


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