Fast vs. Slow Pranayama for Breathing, Heart, Balance, and Well-Being in Students

Forced Vital Capacity (FVC) represents the maximum volume of air that can be forcibly expelled from the lungs after taking the deepest possible breath. Measurements will be performed in accordance with ATS/ERS guidelines. All pulmonary function measurements will be performed using a spirometer (COSMED PONY FX®, Italy). The highest value obtained from three acceptable and repeatable maneuvers will be recorded in liters (L).

FEV1 measures the volume of air exhaled during the first second of the FVC maneuver. It is a critical indicator of airway patency and respiratory muscle function. Data collection will be conducted using the COSMED PONY FX (Italy) device, following the ATS/ERS standardization guidelines. Results will be expressed in liters (L).

This parameter represents the ratio of FEV1 to FVC, which is used to differentiate between obstructive and restrictive ventilatory patterns. The measurements will be obtained using the COSMED PONY FX (Italy) spirometer, adhering to ATS/ERS guidelines. The result is expressed as a decimal ratio or percentage.

Peak Expiratory Flow (PEF) is the maximum flow rate achieved during a forced expiratory maneuver starting from full inspiration. It reflects the caliber of the large airways and the strength of the expiratory muscles. The measurements will be recorded using the COSMED PONY FX (Italy) spirometer according to ATS/ERS criteria, with the highest value reported in liters per second (L/s) or liters per minute (L/min).

Peak cough flow (PCF) will be assessed using a handheld flow meter (Expirite® DL-F03). For all primary measurements, the highest value obtained from three replicates will be used in the analysis.

It will be evaluated with a pulse oximeter (Freely SHO-3002) attached to the fingertip.

Cardiovascular parameters will be measured after participants rest in a supine position for 10 minutes. Systolic and diastolic blood pressure measurements will be taken with a non-invasive OMRON M2 Intelli IT HEM-7143T1-EBK automatic blood pressure monitor (OMRON Healthcare Europe B.V., Netherlands).

Static balance will be assessed using the one-leg stance test. In this test, participants will be asked to lift the foot on the tested side approximately 5 cm above the medial malleolus of the other foot while standing and maintain this position. The test will conclude when the foot touches the ground. Successful completion of the test is demonstrated by the participant's ability to maintain the position for 30 seconds. The best score from three repetitions will be recorded.

Dynamic balance ability will be assessed with the Y Balance Test (YDT). The YDT is a frequently used dynamic test to objectively assess lower extremity function and balance. Performance on this test is quantified as a measure of maximum reach in a specific direction or as a calculated composite score (average reach across all reach directions). During the test, participants are asked to maintain balance while reaching in the anterior, posterolateral, and posteromedial directions using their right and left feet. To calculate the test score, the average reach distance in each direction is calculated in centimeters by averaging three trials for each direction. This value is then divided by the participant's leg length and multiplied by 100 to calculate the distance in each direction as a percentage.

Beck Anxiety Inventory (BAI) It is a 21-item, four-point Likert-type scale designed to measure an individual's anxiety severity over the past week. Each item is scored from 0 to 3. A total score between 8 and 15 indicates low anxiety; 16-25 indicates moderate anxiety; and 26-63 indicates high anxiety.

Beck Depression Inventory (BDI) The BDI is a 21-item inventory; each item represents a symptom of depression. The BDI, a self-report instrument, is the most widely used depression measurement tool worldwide. Respondents rate 21 symptoms of depression on a 4-point scale ranging from 0 to 3. Therefore, total scores range from 0 to 63, with higher scores indicating greater depression severity.

Stress level is going to evaluate with the Perceived Stress Scale (PSS), it consists of 14 items and is designed to measure the degree to which a person perceives certain life situations as stressful. Participants rate each item on a 5-point Likert-type scale ranging from "Never (0)" to "Very often (4)." Seven of the positively worded items are reverse-scored. Scores range from 0 to 56. Higher scores indicate greater perceived stress.

The Fatigue Severity Scale (FSS), consists of nine items. For each question, the patient is asked to select a number between 1 and 7 indicating how much they agree with each statement, with 1 indicating strongly disagree and 7 indicating strongly agree. A score of 4 or higher generally indicates severe fatigue.

Pittsburgh Sleep Quality Index (PSQI) The PSQI is a self-assessment tool that provides detailed information about sleep quality and the type and intensity of sleep disturbances over the past month. The index consists of 24 items, five of which are answered by the individual's sleep partner or roommate. The PSQI provides scores for seven components: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, sleeping pill use, and daytime dysfunction. Each item is scored between 0 and 3. The sum of the scores for these seven components provides the PSQI score. The total PSQI score ranges from 0 to 21. A total score of 5 or less is considered to have "good" sleep quality, while a score above 5 indicates "poor" sleep quality. A PSQI score above 5 indicates that the individual has severe sleep problems in at least two different components or mild or moderate problems in more than three components. The sc