Year: 2026 | Month: July | Volume: 13 | Issue: 7 | Pages: 86-95
DOI: https://doi.org/10.52403/ijrr.20260711
Three-step Rhythmic Breathing Practice and Self-Reported COVID-19 Positivity in a Community Sample from India: An Exploratory Cross-Sectional Study
Apurvakumar Pandya1, Medha Wadhwa1, Dileep Mavalankar1, Pravin Majithia2
1Indian Institute of Public Health, Gandhinagar, Gujarat, India
2Freelance Consultant, Gandhinagar
Corresponding Author: Dr. Apurvakumar Pandya
ABSTRACT
Background: Breathing-based mind-body practices were widely discussed during the COVID-19 pandemic as adjunctive strategies for respiratory well-being, stress regulation and resilience; however, evidence for reducing SARS-CoV-2 infection risk remains limited. This study examined the association between regular three-step rhythmic breathing (3SRB) practice and self-reported COVID-19 positivity in a community sample from India.
Methods: A community-based online cross-sectional survey was conducted during July-August 2020. The analysis included 1083 valid records: 598 3SRB practitioners and 485 non-practitioners. The primary outcome was self-reported COVID-19 positivity. Descriptive statistics, chi-square and Fisher exact tests, effect-size estimates, exploratory logistic regression, modified Poisson regression with robust standard errors and duplicate-record sensitivity analysis were performed.
Results: Overall, 23 participants (2.1%) reported COVID-19 positivity. Positivity was lower among 3SRB practitioners than non-practitioners (1.3% vs 3.1%). The absolute risk difference was -1.75 percentage points (95% CI -3.55 to 0.04), risk ratio 0.43 (95% CI 0.18 to 1.01), and odds ratio 0.42 (95% CI 0.18 to 1.01). Pearson chi-square was significant (p=0.046), whereas Fisher exact (p=0.056) and Yates-corrected chi-square (p=0.075) were not. In adjusted logistic regression, the association remained protective but non-significant after adjustment for demographic, occupational, morbidity and exposure variables (aOR 0.48, 95% CI 0.19 to 1.19; p=0.113). Further adjustment for exercise and herbal use showed similar results (aOR 0.50, 95% CI 0.19 to 1.30; p=0.155). Sensitivity analysis weakened the association.
Conclusion: Lower self-reported COVID-19 positivity was observed among 3SRB practitioners, but the association was statistically weak and non-significant after adjustment and sensitivity analysis. The findings are exploratory and hypothesis-generating.
Keywords: COVID-19, three-step rhythmic breathing, 3SRB, refining exercise, India
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