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Gomes-Neto M, Durães AR, Conceição LSR, Saquetto MB, Alves IG, Smart NA, Carvalho VO. Some types of exercise interventions are more effective than others in people with coronary heart disease: systematic review and network meta-analysis. J Physiother 2024; 70:106-114. [PMID: 38503676 DOI: 10.1016/j.jphys.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/22/2023] [Accepted: 02/26/2024] [Indexed: 03/21/2024] Open
Abstract
QUESTION What are the effects of different types of exercise treatments on oxygen consumption, quality of life and mortality in people with coronary heart disease? DESIGN Systematic review with network meta-analysis of randomised controlled trials. PARTICIPANTS Adults with coronary heart disease. INTERVENTION Exercise interventions including aerobic (continuous or high-intensity interval) training, resistance training, respiratory muscle exercises, water-based exercises, yoga, Tai chi, Qigong exercises and a combination of different types of exercise. OUTCOME MEASURES Oxygen consumption, quality of life and mortality. RESULTS This review included 178 randomised controlled trials with 19,143 participants. Several exercise interventions improved peak oxygen consumption (mL/kg/min): high-intensity interval training (MD 4.5, 95% CI 3.7 to 5.4); combined water-based exercises and moderate-intensity continuous training (MD 3.7, 95% CI 1.3 to 6.0); combined aerobic and resistance exercise (MD 3.4, 95% CI 2.5 to 4.3); water-based exercises (MD 3.4, 95% CI 0.6 to 6.2); combined respiratory muscle training and aerobic exercise (MD 3.2, 95% CI 0.6 to 5.8); Tai chi (MD 3.0, 95% CI 1.0 to 5.0); moderate-intensity continuous training (MD 3.0, 95% CI 2.3 to 3.6); high-intensity continuous training (MD 2.7, 95% CI 1.6 to 3.8); and resistance training (MD 2.2, 95% CI 0.6 to 3.7). Quality of life was improved by yoga (SMD 1.5, 95% CI 0.5 to 2.4), combined aerobic and resistance exercise (SMD 1.2, 95% CI 0.6 to 1.7), moderate-intensity continuous training (SMD 1.1, 95% CI 0.6 to 1.6) and high-intensity interval training (SMD 0.9, 95% CI 0.1 to 1.6). All-cause mortality was reduced by continuous aerobic exercise (RR 0.67, 95% CI 0.53 to 0.86) and combined aerobic and resistance exercise (RR 0.58, 95% CI 0.36 to 0.94). Continuous aerobic exercise also reduced cardiovascular mortality (RR 0.56, 95% CI 0.42 to 0.74). CONCLUSION People with coronary heart disease may use a range of exercise modalities to improve oxygen consumption, quality of life and mortality. REGISTRATION PROSPERO CRD42022344545.
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Affiliation(s)
- Mansueto Gomes-Neto
- Postgraduate Program in Health Science, Federal University of Sergipe, Aracaju, Brazil; Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil.
| | - Andre Rodrigues Durães
- Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil
| | | | | | - Iura Gonzalez Alves
- Department of Medicine, Bahiana School of Medicine and Public Health, Salvador, Brazil
| | - Neil A Smart
- Department of Exercise and Sports Science, University of New England, Armidale, Australia
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Li Z, Guo K, Yang Y, Shuai Y, Fan R, Li Y, DU J, Niu J, Yang K. Exercise-based cardiac rehabilitation for patients with coronary heart disease: a systematic review and evidence mapping study. Eur J Phys Rehabil Med 2024; 60:361-372. [PMID: 38345568 PMCID: PMC11112512 DOI: 10.23736/s1973-9087.23.08165-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/20/2023] [Accepted: 12/12/2023] [Indexed: 04/13/2024]
Abstract
INTRODUCTION Exercise-based cardiac rehabilitation (CR) plays a critical role in coronary heart disease (CHD) management. There is a heritage in the effect of exercise-based CR with different exercise programs or intervention settings. This study developed an evidence matrix that systematically assesses, organizes, and presents the available evidence regarding exercise-based CR in CHD management. EVIDENCE ACQUISITION A comprehensive literature search was conducted across six databases. Two reviewers screened the identified literature, extracted relevant data, and assessed the quality of the studies. An evidence-mapping framework was established to present the findings in a structured manner. Bubble charts were used to represent the included systematic reviews (SRs). The charts incorporated information, exercise prescriptions, outcome indicators, associated P values, research quality, and the number of original studies. A descriptive analysis summarized the types of CR, intervention settings, influential factors, and adverse events. EVIDENCE SYNTHESIS Sixty-two SRs were included in this analysis, focusing on six exercise types in addition to assessing major adverse cardiovascular events (MACE), cost and rehabilitation outcomes. The most commonly studied exercise types were unspecified (28 studies, 45.2%) and aerobic (11 studies, 17.7%) exercises. All-cause mortality was the most frequently reported MACE outcome (22 studies). Rehabilitation outcomes primarily centered around changes in cardiac function (135 outcomes from 39 SRs). Only 8 (12.9%) studies were rated as "high quality." No significant adverse events were observed in the intervention group. Despite some variations among the included studies, most SRs demonstrated the benefits of exercise in improving one or more MACE or rehabilitation outcomes among CHD patients. CONCLUSIONS The proportion of high-quality evidence remains relatively low. Limited evidence is available regarding the effectiveness of specific exercise types and specific populations, necessitating further evaluation.
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Affiliation(s)
- Zijun Li
- Evidence-Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Ke Guo
- Evidence-Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yongqi Yang
- First Clinical Medical College, University of Lanzhou, Lanzhou, China
| | - Yuxi Shuai
- First Clinical Medical College, University of Lanzhou, Lanzhou, China
| | - Rui Fan
- First Clinical Medical College, University of Lanzhou, Lanzhou, China
| | - Yanfei Li
- Evidence-Based Medicine Center, School of Basic Medical Sciences, University of Lanzhou, Lanzhou, China
| | - Jiawei DU
- Second Clinical Medical College, University of Lanzhou, Lanzhou, China
| | - Junqiang Niu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, University of Lanzhou, Lanzhou, China
- First Hospital of Lanzhou University, Lanzhou, China
| | - Kehu Yang
- Evidence-Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, Lanzhou, China -
- Evidence-Based Medicine Center, School of Basic Medical Sciences, University of Lanzhou, Lanzhou, China
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Braun TD, Bhuptani PH, O’Keefe B, Abrantes AM, Marsh E, Holzhauer CG. Mindful self-compassion for veteran women with a history of military sexual trauma: feasibility, acceptability, potential benefits, and considerations. Eur J Psychotraumatol 2024; 15:2301205. [PMID: 38349003 PMCID: PMC10866049 DOI: 10.1080/20008066.2023.2301205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 12/08/2023] [Indexed: 02/15/2024] Open
Abstract
Background: Military sexual trauma (MST) is reported by up to 74% of women veterans in the United States and is a driver of poor behavioural and physical health. Self-compassion is a transdiagnostic, protective factor linked with improved posttraumatic stress disorder (PTSD), depression, and health behaviours. Thus, Mindful Self-Compassion training (MSC) may help ameliorate MST-related impacts. However, MSC can also temporarily increase distress (i.e. backdraft). Delivering it with elective trauma-informed yoga (TIY), which regulates acute distress, may help address this issue.Objective: This VA quality improvement project examined feasibility, acceptability, and reported benefits and challenges of a manualized 8-week MSC including within non-randomized subgroups: MSC (n = 4) and MSC+ elective TIY classes (MSC+; n = 4).Methods: Nine women veterans with a history of MST at a Vet Center in the Northeastern U.S.A. enrolled; eight completed, excluding one MSC+ participant. Measures included attrition (n = 9), attendance (n = 8), weekly (n = 8) and posttreatment acceptability (n = 6), validated symptom severity assessments (n = 7), and an exit interview (n = 8).Results: Among completers, MSC attendance was excellent (89%) and higher among in MSC+ vs. MSC (94% vs. 84% sessions completed). On average across the two groups, depressive and PTSD symptom severity decreased by 21% and 30%, respectively. In exit interviews, participants across groups described improved coping with distress and psychiatric symptoms, reduced stress, and improved self-care and health behaviours. Although women in both groups reported backdraft during the programme, MSC+ also reported healthier coping and improved emotional processing.Conclusion: The results of this programme evaluation infer MSC may be feasible, acceptable, and beneficial for women survivors of MST in one Vet Center in the Northeastern USA. Further, temporary elevations in MSC-related distress may be ameliorated with adjunctive TIY. Given requests of women veterans in the USA. for additional complementary and integrative health treatment options, formal research on these approaches is warranted.
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Affiliation(s)
- Tosca D. Braun
- Alpert Medical School of Brown University, Providence, RI, USA
- Butler Hospital, Providence, RI, USA
- VA Central Western Massachusetts, Leeds, MA, USA
| | - Prachi H. Bhuptani
- Alpert Medical School of Brown University, Providence, RI, USA
- Rhode Island Hospital, Providence, RI, USA
| | | | - Ana M. Abrantes
- Alpert Medical School of Brown University, Providence, RI, USA
- Butler Hospital, Providence, RI, USA
| | | | - Cathryn Glanton Holzhauer
- VA Central Western Massachusetts, Leeds, MA, USA
- University of Connecticut School of Medicine, Farmington, CT, USA
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Loewenthal JV, Farkas EJ, McGough K, Tomita B, Wayne PM, Orkaby AR. The impact of yoga on aging physiology: A review. J Nutr Health Aging 2024; 28:100005. [PMID: 38388108 DOI: 10.1016/j.jnha.2023.100005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 11/29/2023] [Indexed: 02/24/2024]
Abstract
Frailty represents diminished reserve across multiple physiologic systems, accompanied by increased vulnerability to stressors and increased morbidity and mortality. With population aging, strategies to prevent and manage frailty are priorities in clinical medicine and public health. Current evidence-based approaches to frailty management are multimodal in nature. Yoga, an increasingly popular and highly adaptable mind-body practice, is multi-component, incorporating physical postures, breathing practices, meditation, and other elements, and may be a strategy for frailty management. Here, we summarize the evidence linking yoga practice to mitigation of age-related degradation across multiple physiologic systems, including cardiovascular, pulmonary, musculoskeletal, and nervous systems. We discuss putative mechanisms of action including modulation of the hypothalamic-pituitary-adrenal axis. Finally, we consider implications for clinical practice and future research.
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Affiliation(s)
- Julia V Loewenthal
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Eva J Farkas
- Tufts University School of Medicine, Boston, MA, USA
| | - Katherine McGough
- University of Missouri-Columbia School of Medicine, Columbia, MO, USA
| | | | - Peter M Wayne
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA; Osher Center for Integrative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ariela R Orkaby
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; New England Geriatric Research, Education, and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA
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Vollbehr NK, Schmidt AT, Bartels-Velthuis AA, Ostafin BD, Hoenders HJR. The ethics of yoga in (mental) healthcare: Beyond the traditional Eightfold path. Complement Ther Med 2023; 77:102979. [PMID: 37640167 DOI: 10.1016/j.ctim.2023.102979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/13/2023] [Accepted: 08/25/2023] [Indexed: 08/31/2023] Open
Affiliation(s)
- Nina K Vollbehr
- Lentis Psychiatric Institute, Center for Integrative Psychiatry, Groningen, the Netherlands; University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands.
| | - Andreas T Schmidt
- University of Groningen, Faculty of Philosophy, Groningen, the Netherlands
| | - Agna A Bartels-Velthuis
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
| | - Brian D Ostafin
- University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands
| | - H J Rogier Hoenders
- Lentis Psychiatric Institute, Center for Integrative Psychiatry, Groningen, the Netherlands; University of Groningen, Faculty of Religon, Culture and Society, Groningen, the Netherlands
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Dutta A, Mooventhan A, Nivethitha L. Yoga as Adjunct Therapy for Chronic Heart Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Avicenna J Med 2023; 13:151-162. [PMID: 37799183 PMCID: PMC10550367 DOI: 10.1055/s-0043-1774738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
Background Chronic heart failure (CHF) is a prevalent cardiovascular condition that can significantly impact the quality of life and increase mortality risk. Yoga is a mind-body therapy that has been studied as a potential complementary treatment for CHF. However, the effectiveness of yoga in improving outcomes in patients with CHF remains uncertain. Methods We conducted a systematic review of randomized controlled trials (RCTs) evaluating the effects of yoga on outcomes in patients with CHF. We searched the PubMed, Embase, Scopus, Cochrane Library, and IndMED databases from inception to March 2023. The outcomes of interest were left ventricular ejection fraction (LVEF), cardiac biomarkers, exercise capacity, quality of life, and cardiac function. Results We identified 11 RCTs that met our inclusion criteria, involving a total of 552 participants. The meta-analysis showed that yoga was associated with significant improvements in peak VO 2 (mean difference [MD]= 3.29; 95% Confidence Interval [CI]: 1.64 to 4.94; I 2 = 0%), exercise capacity (MD=101.54; 95% CI: 6.24 to 196.83; I 2 = 96%), quality of life (MD = -19.99; 95% CI: -25.76 to -14.22; I 2 = 43%), NT-proBNP (MD = -288.78; 95% CI: -492.20 to -85.37; I 2 = 94%), and 6-minute walk test (MD = 101.54; 95% CI: 6.24-196.83; I 2 = 96%), but not in the left ventricular ejection fraction (MD = 4.28; 95% CI: -1.14 to 9.70; I 2 = 93%). Subgroup analysis suggested that the effect of yoga on the quality of life is more pronounced in patients with the "New York Heart Association" (NYHA) class I and II CHF patients and in those who practiced yoga for longer durations. No serious adverse events related to yoga were reported. Most of the included studies were of "low" quality. Conclusion Current evidence suggests that yoga may be an effective complementary and integrative therapy for improving peak VO 2 exercise capacity, NT-proBNP, and quality of life in patients with CHF. However, the low-quality evidence does not render us to conclude anything beyond doubt or draw any firm clinical recommendation. Future high-quality studies are needed to explore the optimal duration and frequency of yoga practice and its effects on long-term outcomes in this population.
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Affiliation(s)
- Abhijit Dutta
- International Cooperation Section, Ministry of Ayush, Government of India, New Delhi, India
| | - Aruchunan Mooventhan
- Department of Research, Government Yoga and Naturopathy Medical College, Chennai, Tamil Nadu, India
| | - L. Nivethitha
- Department of Naturopathy, Government Yoga and Naturopathy Medical College, Chennai, Tamil Nadu, India
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Seffah K, Zaman MA, Awais N, Satnarine T, Haq A, Hernandez GN, Khan S. Exploring the Role of Wearable Electronic Medical Devices in Improving Cardiovascular Risk Factors and Outcomes Among Adults: A Systematic Review. Cureus 2023; 15:e36754. [PMID: 37123755 PMCID: PMC10132699 DOI: 10.7759/cureus.36754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 03/27/2023] [Indexed: 03/29/2023] Open
Abstract
There is a developing trend of using wearable electronic devices as health aides, spurred on by telecommunication companies as fitness devices and marketed as such. They have been shown to count steps, pulse, and record arrhythmias, doubling as communication devices and prompting healthcare providers in some instances. We sought to determine if there was a direct correlation between device use and increased physical activity as recommended by the World Health Organization, or if this physical activity increase was only marginal at best. In addition, we sought to investigate if there were additional benefits to using these devices besides increased self-awareness of health. This systematic review used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Keywords for searching articles centered around cardiovascular disease, wearable electronic devices, and their synonyms. Most of the data were obtained from PubMed, although other contributing databases were used, including ResearchGate, Science.gov, ScienceDirect, and PubMed Medical Subject Headings database. Only full-text articles were used. We identified 62 articles that met our search criteria but narrowed them down to 19 following qualitative assessment. Increased physical activity was found to be the one parameter that stood out by way of benefit from the device. Other findings, such as reduced waist circumference, obesity, glycated hemoglobin, and lipid levels, shared mixed results. At this time, we do not have a definition of what duration of device use is deemed standard for health. We have no consensus on which devices are superior health-wise. Our study, however, indicates that these devices, used with adequate health professional supervision, have a role to play in motivation and increased physical activity, enough to cause impactful gains in cardiovascular health.
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Haverkamp W, Sittner W, Haverkamp A, Knebel F. [Alternative treatment strategies for atrial fibrillation : Benefits from yoga?]. Herzschrittmacherther Elektrophysiol 2023; 34:59-65. [PMID: 36580092 PMCID: PMC9798365 DOI: 10.1007/s00399-022-00915-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
Atrial fibrillation, the most common sustained cardiac arrhythmia, is associated with significant morbidity, mortality, and healthcare utilization. Since the procedures used to treat atrial fibrillation have a number of limitations and risks, there is a growing interest in alternative treatment strategies for patients with atrial fibrillation. One such option is yoga. To date, only a few studies are available on its effect on atrial fibrillation. However, these suggest that yoga may indeed be able to reduce the frequency of the arrhythmia and its progression. The risk factors for atrial fibrillation and quality of life in affected patients are also positively affected. As adverse effects and complications are extremely rare with competent guidance, yoga may already be recommended now. However, further clinical studies are needed to provide recommendations that meet evidence-based criteria.
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Affiliation(s)
- Wilhelm Haverkamp
- Abteilung für Kardiologie und Metabolismus, Med. Klinik für Kardiologie, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
- Klinik für Innere Medizin II: Schwerpunkt Kardiologie, Sana Klinikum Lichtenberg, Berlin, Deutschland.
- Kardiologie im Spreebogen, Berlin, Deutschland.
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Berlin, Deutschland.
| | | | - Annika Haverkamp
- Fakultät für Medizin, Universität Regensburg, Regensburg, Deutschland
| | - Fabian Knebel
- Klinik für Innere Medizin II: Schwerpunkt Kardiologie, Sana Klinikum Lichtenberg, Berlin, Deutschland
- Medizinische Klinik mit Schwerpunkt Kardiologie, Campus Mitte, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
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Pandey A, Pandey A, Pandey AS, Bonsignore A, Auclair A, Poirier P. Impact of Yoga on Global Cardiovascular Risk as an Add-On to a Regular Exercise Regimen in Patients With Hypertension. Can J Cardiol 2023; 39:57-62. [PMID: 36604096 DOI: 10.1016/j.cjca.2022.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 09/09/2022] [Accepted: 09/10/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND We aimed to determine whether the addition of yoga to a regular exercise training regimen improves cardiometabolic risk profile. METHODS Sixty individuals with diagnosed hypertension (≥ 140/90 mm Hg for 3 measurements on different days) were recruited in an exercise training program. In addition to aerobic exercise training, participants were randomised into either a yoga or a stretching control group. Participants, over the 3-month intervention regimen, performed 15 minutes of either yoga or stretching in addition to 30 minutes of aerobic exercise training 5 times weekly. Blood pressure, anthropometry, high-sensitivity C-reactive protein (hs-CRP), glucose, and lipid levels as well as the Framingham and Reynolds Risk Scores were measured. RESULTS At baseline, there was no difference in age, sex, smoking status, body mass index, blood pressure, heart rate, lipid and glucose levels, and Framingham Risk Score between groups. After the 3-month intervention period, the decrement in systolic and diastolic blood pressures (before vs after stretching: 126 ± 11/76 ± 7 vs 122 ± 11/73 ± 8 mm Hg; before vs after yoga: 130 ± 13/77 ± 10 vs 119 ± 11/69 ± 8 mm Hg) and heart rate was greater (P < 0.001) in the yoga group, with similar decreases in lipid, glucose, and hs-CRP levels and Framingham Risk Score in both groups. Reynolds Risk Score decrement was higher in the yoga vs the control group (absolute reduction -1.2 ± 1.2 vs -0.6 ± 0.8; relative reduction 13.2 ± 11.8% vs 9.3 ± 6.5%; P < 0.05). CONCLUSION In patients with hypertension, the practice of yoga incorporated in a 3-month exercise training program was associated with greater improvement in resting blood pressure and heart rate and Reynolds Risk Score compared with stretching.
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Affiliation(s)
- Ashok Pandey
- Cambridge Cardiac Care Centre, Cambridge, Ontario, Canada; University of Guelph, Guelph, Ontario, Canada
| | - Avinash Pandey
- Cambridge Cardiac Care Centre, Cambridge, Ontario, Canada; McMaster University, Hamilton, Ontario, Canada; University of Ottawa, Ottawa, Ontario, Canada
| | - A Shekhar Pandey
- Cambridge Cardiac Care Centre, Cambridge, Ontario, Canada; McMaster University, Hamilton, Ontario, Canada
| | | | - Audrey Auclair
- Institut de Cardiologie, et de Pneumologie, de Québec, Université Laval, Québec, Canada
| | - Paul Poirier
- Institut de Cardiologie, et de Pneumologie, de Québec, Université Laval, Québec, Canada; Faculty of Pharmacy, Laval University, Québec, Canada.
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Coura AGL, de Arruda Neta ADCP, de Lima RLFC, Bersch-Ferreira ÂC, Weber B, Vianna RPDT. Tracking of Dietary Patterns in the Secondary Prevention of Cardiovascular Disease after a Nutritional Intervention Program-A Randomized Clinical Trial. Nutrients 2022; 14:nu14224716. [PMID: 36432401 PMCID: PMC9695891 DOI: 10.3390/nu14224716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/24/2022] [Accepted: 11/01/2022] [Indexed: 11/11/2022] Open
Abstract
Individuals with a history of previous cardiovascular events have an increased risk of mortality and morbidity, so adherence to a healthy dietary pattern is essential. We aimed to evaluate and compare dietary patterns between the control and the experimental group from the BALANCE Program. A total of 2360 individuals aged 45 years or older with previous cardiovascular disease were included. The individuals were randomized into two groups: intervention (dietary prescription with nutritional recommendations, nutritional education program based on playful strategies, suggestions of typical and accessible Brazilian foods and intensive monitoring) and control (conventional nutritional counseling). The dietary patterns were identified using factor analysis with the principal component extraction method, and the t-Student tests and ANOVA test were performed to evaluate the associated factors. Four dietary patterns were identified for both groups: "Traditional", "Snack", "Western", "Cardioprotective". There was an increase in the variances of the "Cardioprotective" pattern in both groups. Regarding the "Western" pattern, there was a significant reduction in the variances of the experimental group (10.63% vs. 8.14%). Both groups had improvements in eating habits, especially in the first year of follow-up. The greater increase in adherence to the traditional and cardioprotective pattern in the experimental group justifies the initiative of the BALANCE program.
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Affiliation(s)
- Amanda Gonçalves Lopes Coura
- Postgraduate Program in Nutrition Sciences, Federal University of Paraíba, João Pessoa 58059-900, Brazil
- Correspondence:
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Kalra S, Miraj M, Ajmera P, Shaik RA, Seyam MK, Shawky GM, Alasiry SM, Mohamed EH, Alasiri HM, Alzhrani M, Alanazi A, Alqahtani M, Shaikh AR, Al-Otaibi ML, Saleem S, Pal S, Jain V, Ahmad F. Effects of Yogic Interventions on Patients Diagnosed With Cardiac Diseases. A Systematic Review and Meta-Analysis. Front Cardiovasc Med 2022; 9:942740. [PMID: 35990980 PMCID: PMC9386118 DOI: 10.3389/fcvm.2022.942740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/20/2022] [Indexed: 11/29/2022] Open
Abstract
Objective Presently, evidence-based research studies on the efficacy of complimentary therapies like yoga for patients with different cardiac diseases are limited and conflicting. The objective of this study is to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) on yogic interventions compared with usual care or non-pharmacological treatment in patients diagnosed with cardiac diseases. Methods We conducted an electronic search of literature published from 2006 to May 2021 through five databases. PRISMA statement was used to develop and report a systematic review and meta-analysis protocol. Sixteen RCTs were included in the systematic review and 11 RCTs were used for meta-analysis. Outcome measures were blood pressure, lipid profile, and psychosocial measures. The Cochrane collaboration tool was used to assess bias risk. Results The results show that yogic interventions resulted in significant reduction in systolic (d = 046; 95% CI.08–0.84; I2 = 81.86%) and diastolic blood pressures (d = 0.56; 95% CI.13–0.99, I2 = 84.84%). A medium statistically significant increase in HDL (d =0.67; 95% CI 0 to 1.33; I2 79.7%) and a low but significant effect on LDL (d = 0.23; 95% CI −0.08–0.54; I2 32.61%), total cholesterol (d =0.28; 95% CI −0.14–0.7; I2 63.72%), and triglycerides (d = 0.43; 95% CI −0.1–0.97; I2 76.64%) were observed. Pooled effect sizes showed a medium to low statistically significant effect on psychosocial indicators viz., QoL, stress, anxiety, and depression. Conclusion The meta-analysis found strong evidence of effectiveness of yogic interventions on lipid profile, blood pressure, and psychosocial outcomes in patients with diagnosed cardiac diseases.
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Affiliation(s)
- Sheetal Kalra
- School of Physiotherapy, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Mohammad Miraj
- Department of Physiotherapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
- *Correspondence: Mohammad Miraj
| | - Puneeta Ajmera
- School of Allied Health Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi, India
| | - Riyaz Ahamad Shaik
- Department of Community Medicine/Public Health, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Mohamed K. Seyam
- Department of Physiotherapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
| | - Ghada M. Shawky
- Department of Physiotherapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
| | - Sharifa M. Alasiry
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
| | - Elsayed H. Mohamed
- Department of Physical Therapy, Buraydah Private Colleges, Buraydah, Saudi Arabia
| | - Hatim M. Alasiri
- Department of Internal Medicine, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Msaad Alzhrani
- Department of Physiotherapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
| | - Ahmad Alanazi
- Department of Physiotherapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
| | - Mazen Alqahtani
- Department of Physiotherapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
- College of Applied Medical Sciences, Al Maarefa University, Riyadh, Saudi Arabia
| | - Abdul Raheem Shaikh
- Department of Physiotherapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
| | - Mohammad Lafi Al-Otaibi
- Department of Orthopedic Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Shakir Saleem
- Department of Public Health, College of Health Science, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Sajjan Pal
- Faculty of Physiotherapy, SGT University, Gurugram, India
| | | | - Fuzail Ahmad
- Department of Physiotherapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al Majmaah, Saudi Arabia
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How to realize the effect of Kundalini yoga and Chinese Chi meditation on the HRV and ANS with GAN architecture? ‘HRV-GAN’: An alternative approach. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2022.103822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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13
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Harnessing the benefits of yoga for myositis, muscle dystrophies, and other musculoskeletal disorders. Clin Rheumatol 2022; 41:3285-3297. [PMID: 35854165 PMCID: PMC9295887 DOI: 10.1007/s10067-022-06280-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 06/01/2022] [Accepted: 06/16/2022] [Indexed: 12/02/2022]
Abstract
The recent global increase in popularity of home-based yoga, an ancient Indian technique practiced for thousands of years, has translated into its use as a complementary therapy for a multitude of ailments. This review aims to examine the published literature regarding the effects of yoga therapy on systemic chronic diseases; in particular on the inflammatory myopathies (IMs) and other muscle disorders. Despite the fact that the evidence base for yoga in inflammatory myositis is in its infancy, collateral results in other disorders such as muscular dystrophies are promising. A beneficial effect of yoga in chronic pain has been shown alongside an improvement in motor function and muscle strength. Patients with Duchenne muscular dystrophy with respiratory involvement may find improvement in lung function. Elderly patients may experience reduction in falls secondary to an improvement in balance while practicing long-term yoga therapy. Further benefits are improving disorders of mental health such as depression and anxiety. A reported improvement in overall quality of life further suggests its efficacy in reducing morbidity in patients with chronic diseases, who often suffer co-existent psychological comorbidities.
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Hui BPH, Parma L, Kogan A, Vuillier L. Hot Yoga Leads to Greater Well-being: A Six-week Experience-sampling RCT in Healthy Adults. INTERVENCION PSICOSOCIAL 2022; 31:67-82. [PMID: 37360056 PMCID: PMC10268545 DOI: 10.5093/pi2022a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 12/18/2021] [Indexed: 06/28/2023]
Abstract
Practicing hot yoga may bring significant psychological benefits, but it is largely unstudied. We examined the effects of hot yoga on multifaceted well-being indicators with 290 healthy yoga-naïve volunteers partaking in a six-week randomized controlled trial. Participants completed questionnaires pre- and post-intervention, and reported their emotional experiences four times per day throughout an experience-sampling study. Results revealed that the hot yoga group (n = 137) improved their well-being from pre- to post-treatment, comparing to the wait-list control group (n = 153). These improvements included life satisfaction, general health, mindfulness, peace of mind, and eudaimonic well-being (ΔR2 ranging from .01 to .08)-but not flourishing, which describes major aspects of social-psychological functioning. Multilevel analyses demonstrated that momentary positive emotional experiences increased significantly throughout the trial in the yoga group only (conditional R2 = .68), particularly when attending a yoga class (conditional R2 = .50). Interestingly, this increase in momentary positive emotion explained the improvement in post-intervention mindfulness, peace of mind, and general health by 21%, 31%, and 11%, respectively. Finally, the benefits of hot yoga were more notable in individuals with lower levels of baseline eudaimonic well-being (conditional R2 = .45), flourishing (conditional R2 = .61), and mental well-being (conditional R2 = .65), even after ruling out any possible ceiling effects. To sum up, this study demonstrated multiple psychological benefits of hot yoga and its potential to be an effective positive psychology intervention. Future research-especially considering an active control group-is warranted.
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Affiliation(s)
- Bryant P. H. Hui
- Hong Kong Polytechnic UniversityHong KongHong Kong Polytechnic University, Hong Kong SAR
| | - Laurie Parma
- University of CambridgeUnited KingdomUniversity of Cambridge, United Kingdom
| | - Aleksandr Kogan
- University of CambridgeUnited KingdomUniversity of Cambridge, United Kingdom
| | - Laura Vuillier
- Bournemouth UniversityUnited KingdomBournemouth University, United Kingdom
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15
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Characteristics of Yoga Providers and Their Sessions and Attendees in the UK: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042212. [PMID: 35206399 PMCID: PMC8871723 DOI: 10.3390/ijerph19042212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 12/10/2022]
Abstract
Yoga is an ancient Indian philosophy and way of life that is being used as a method of improving health and wellbeing. Evidence shows that yoga has several health benefits, such as managing many noncommunicable diseases, such as hypertension, and improving mental health. The popularity of yoga is growing in the UK, but it is mostly unregulated with little information available about yoga providers and their sessions and attendees. This study aimed to explore who is providing yoga; what sessions are available, where, and at what cost; and who attends these sessions in the UK and whether yoga providers were aware of health conditions in their sessions. A cross-sectional survey was undertaken among yoga providers in the UK. They were approached through four major UK yoga associations. In total, 407 yoga providers participated. Most providers were aged 45–64 years (69%), female (93%), and white (93%). The median number of group sessions and one-to-one sessions delivered per week was four and two, respectively. The most common styles were Hatha (28%), Iyengar (26%), and Vinyasa (15%). Sessions had a varying emphasis on different yogic practices, but 59% of providers allocated most time to yogic poses (asana), 18% to breathing practices (pranayama), and 12% to meditation (dhyana) and relaxation practices. Most (73%) reported that their attendees disclosed their health conditions to them, most commonly mental health issues (41%), hypertension (25%), and heart diseases (9%). This study showed that yoga sessions are widely available in the UK, often provided and practiced by women, and concentrate on yogic poses. Sessions concentrate on the asana and tend not to include many of the more holistic aspects of yoga that are practiced in South Asian countries. Yoga providers are often aware of health conditions but may benefit from training to deliver sessions suitable for specific health conditions.
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Strömberg A, Thylén I, Orwelius L, Klompstra L, Jaarsma T. Tele-Yoga in Long Term Illness-Protocol for a Randomised Controlled Trial Including a Process Evaluation and Results from a Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11343. [PMID: 34769859 PMCID: PMC8582719 DOI: 10.3390/ijerph182111343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/13/2021] [Accepted: 10/23/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND For people with long-term illness, debilitated by severe symptoms, it can be difficult to attend regular yoga classes. We have therefore developed a tele-health format of yoga that can be delivered in the home. The tele-yoga was co-designed with members of a patient-organisation, yoga-instructor, and IT-technician. It includes live-streamed group-yoga sessions twice a week and an app with instructions on how to self-perform yoga. AIM To describe a study protocol for a randomised controlled trial (RCT) including a process evaluation and report on a pilot study evaluating method- and intervention-related components including feasibility, safety, and efficacy. METHODS Ten participants with heart failure aged between 41-76 years were randomised to tele-yoga (n = 5) or to the control group (n = 5). In the pilot study recruitment, enrolment, randomisation, and data collection of all outcomes including primary, secondary and process evaluation measures were tested according to the study protocol. Fidelity, adherence and acceptability to the tele-yoga group training and app use was determined. Safety was assessed by adverse events. RESULTS The pilot revealed that the methodological aspect of the protocol worked sufficiently in all aspects except for missing data in the physical test of two participants and one participant in the control-group that dropped out of the study at three months follow-up. The tele-yoga training did not lead to any adverse events or injuries, adherence of tele-yoga was sufficient according to preset limits. The tele-yoga intervention also showed some favourable trends of improvements in the composite-end point compared to the active control group. However, since data only was presented descriptively due to the small sample size, the impact of these trends should be interpreted carefully. CONCLUSION Our pilot study showed promising results in feasibility, safety, and acceptability of the tele-yoga intervention. Some changes in the protocol have been made to decrease the risk of missing data in the measures of physical function and in the full-scale RCT now ongoing the results of the sample size calculation for 300 participants have included the estimated level of drop outs and missing data.
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Affiliation(s)
- Anna Strömberg
- Department of Health Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden; (I.T.); (L.K.); (T.J.)
- Department of Cardiology, Linköping University, 581 85 Linköping, Sweden
| | - Ingela Thylén
- Department of Health Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden; (I.T.); (L.K.); (T.J.)
- Department of Cardiology, Linköping University, 581 85 Linköping, Sweden
| | - Lotti Orwelius
- Department of Anaesthesia and Intensive Care, Linköping University, 581 85 Linköping, Sweden;
- Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden
| | - Leonie Klompstra
- Department of Health Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden; (I.T.); (L.K.); (T.J.)
| | - Tiny Jaarsma
- Department of Health Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden; (I.T.); (L.K.); (T.J.)
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Susceptibility of Women to Cardiovascular Disease and the Prevention Potential of Mind-Body Intervention by Changes in Neural Circuits and Cardiovascular Physiology. Biomolecules 2021; 11:biom11050708. [PMID: 34068722 PMCID: PMC8151888 DOI: 10.3390/biom11050708] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/25/2021] [Accepted: 05/05/2021] [Indexed: 12/28/2022] Open
Abstract
Women have been reported to be more vulnerable to the development, prognosis and mortality of cardiovascular diseases, yet the understanding of the underlying mechanisms and strategies to overcome them are still relatively undeveloped. Studies show that women's brains are more sensitive to factors affecting mental health such as depression and stress than men's brains. In women, poor mental health increases the risk of cardiovascular disease, and conversely, cardiovascular disease increases the incidence of mental illness such as depression. In connection with mental health and cardiovascular health, the presence of gender differences in brain activation, cortisol secretion, autonomic nervous system, vascular health and inflammatory response has been observed. This connection suggests that strategies to manage women's mental health can contribute to preventing cardiovascular disease. Mind-body interventions, such as meditation, yoga and qigong are forms of exercise that strive to actively manage both mind and body. They can provide beneficial effects on stress reduction and mental health. They are also seen as structurally and functionally changing the brain, as well as affecting cortisol secretion, blood pressure, heart rate variability, immune reactions and reducing menopausal symptoms, thus positively affecting women's cardiovascular health. In this review, we investigate the link between mental health, brain activation, HPA axis, autonomic nervous system, blood pressure and immune system associated with cardiovascular health in women and discuss the effects of mind-body intervention in modulating these factors.
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Islam MS, Chaudhuri I, Mobin MA, Islam M, Mahmud MS, KutubUddin M, Kabir KMA, Kamrujjaman M. The Perspective of Acquired Immunity to Combat against Infectious Diseases: An Overview. Health (London) 2021. [DOI: 10.4236/health.2021.139077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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