1
|
Cha G, Chung ML, Heebner NR, Bronas UG, Biddle MJ, Lin CY, Kang J, Wu JR, Thompson JH, Thapa A, Moser DK. Protocol for a feasibility randomized controlled trial of gentle yoga in older patients discharged from phase II cardiac rehabilitation. Contemp Clin Trials Commun 2024; 40:101320. [PMID: 38947983 PMCID: PMC11214198 DOI: 10.1016/j.conctc.2024.101320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/22/2024] [Accepted: 06/02/2024] [Indexed: 07/02/2024] Open
Abstract
Background Physical activity (PA) is essential following an acute cardiac event. Cardiac rehabilitation (CR) is commonly prescribed, and PA after CR is recommended. Because of age-related changes in functional ability and multi-comorbidity, many older cardiac patients struggle to continue performing PA at home after CR. Depressive symptoms and anxiety are prevalent in cardiac patients and associated with poor self-care, including lack of daily PA. Yoga has been demonstrated to improve psychological and physical health outcomes in cardiac patients, but it is unknown whether yoga, modified for older CR patients - Gentle Yoga - is beneficial in managing psychological distress and maintaining PA following phase II CR. Our specific aims are to:1) determine the feasibility and acceptability of a modified gentle yoga intervention delivered via video conferencing for older cardiac patients; 2) compare, at 3-month follow-up, the effects and determine effect sizes of a gentle yoga intervention versus control on psychological health and physical health. Methods We are conducting a 2-group (intervention versus control) randomized controlled pilot study. The intervention is a 12-week gentle yoga program delivered via video conference. Short-term effects will be evaluated at 3-month. Conclusion This study is designed to be suited for older cardiac patients who would not have access to supervised PA opportunities after facility-based CR to enhance PA. This study will provide data about the feasibility and acceptability of the protocol for older cardiac patients and will offer effect sizes to determine sample size for a fully powered randomized controlled trial.
Collapse
Affiliation(s)
- Geunyeong Cha
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY 40536, United States
| | - Misook L. Chung
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY 40536, United States
| | - Nicholas R. Heebner
- College of Health Science, University of Kentucky, Sports Medicine Research Institute, 720 Sports Center Drive, Lexington, KY 40506, United States
| | - Ulf G. Bronas
- School of Nursing and Division of Rehabilitation Medicine, Columbia University, 560 West 168th Street, New York, NY 10032, United States
| | - Martha J. Biddle
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY 40536, United States
| | - Chin-Yen Lin
- College of Nursing, Auburn University, 710 S Donahue Dr, Auburn, AL 36849, United States
| | - JungHee Kang
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY 40536, United States
| | - Jia-Rong Wu
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY 40536, United States
| | - Jessica H. Thompson
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY 40536, United States
| | - Ashmita Thapa
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY 40536, United States
| | - Debra K. Moser
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY 40536, United States
| |
Collapse
|
2
|
Patil SG, Sobitharaj EC, Chandrasekaran AM, Patil SS, Singh K, Gupta R, Deepak KK, Jaryal AK, Chandran DS, Kinra S, Roy A, Prabhakaran D. Effect of Yoga-Based Cardiac Rehabilitation Program on Endothelial Function, Oxidative Stress, and Inflammatory Markers in Acute Myocardial Infarction: A Randomized Controlled Trial. Int J Yoga 2024; 17:20-28. [PMID: 38899136 PMCID: PMC11185433 DOI: 10.4103/ijoy.ijoy_40_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/13/2024] [Accepted: 04/16/2024] [Indexed: 06/21/2024] Open
Abstract
Aims The aim of this study was to evaluate the effects of yoga-based cardiac rehabilitation (Yoga-CaRe) on the endothelial system, oxidative stress, and inflammatory markers in patients with acute myocardial infarction (MI). Methods A sub-study was conducted in two clinical sites of the Yoga-CaRe trial (a multicenter randomized controlled trial). Participants with acute MI were randomized and allocated to either the Yoga-CaRe program (13 sessions with encouragement to home practice) or enhanced standard care (three educational sessions). Endothelial function, oxidative stress, and inflammatory biomarkers were assessed using biomarkers such as asymmetric dimethylarginine (ADMA), endothelial nitric oxide synthase (eNOS), endothelin-1 (ET-1), E-selectin, P-selectin, vascular cell adhesion molecule (VCAM), intercellular cell-adhesion molecule-1, total nitric oxide concentration (NOx), oxidized low-density lipoprotein (Oxd-LDL), superoxide dismutase, total antioxidant capacity (TAOC), tumor necrosis factor-alpha (TNFα), and C-reactive protein (CRP) at baseline and 12 weeks. Laboratory and statistical analysis were done by staff blinded to group allocation. Results Eighty-two patients (of the 110 patients recruited) completed the study. The mean age was 53.1 ± 10.6 and 51.9 ± 10.7 years in enhanced standard care and Yoga-CaRe group, respectively. At 12 weeks, Yoga-CaRe significantly reduced ADMA, ET-1, and ICMA-1 than the enhanced standard care group. Although E-selectin and VCAM at 12 weeks were reduced in both groups, enhanced standard care had a significantly higher reduction than the Yoga-CaRe group. Among markers of oxidative stress, TAOC increased in the Yoga-CaRe group. We found no difference in eNOS, NOx, P-selectin, TNFα, CRP, and Oxd-LDL between the two groups. Conclusion Yoga-CaRe improved the endothelial function (through a reduction in ET-1 and modulating adhesion molecules) and enhanced antioxidant capacity.
Collapse
Affiliation(s)
- Satish Gurunathrao Patil
- Department of Physiology, SDM College of Medical Sciences and Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka, India
- Department of Physiology, Shri B.M.Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur, Karnataka, India
| | - Edmin Christa Sobitharaj
- Department of Physiology, Centre for Chronic Disease Control, New Delhi, India
- Department of Clinical Trials, Centre for Chronic Disease Control, New Delhi, India
| | | | - Shankar S. Patil
- Department of Medicine, Shri B.M.Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur, Karnataka, India
| | - Kalpana Singh
- Department of Biostatistics, Hamad Medical Corporation, Doha, Qatar
| | - Ruby Gupta
- Department of Lab, Centre for Chronic Disease Control, New Delhi, India
| | - Kishore Kumar Deepak
- Center for Biomedical Engineering, Indian Institute of Technology, New Delhi, India
| | - Ashok Kumar Jaryal
- Department of Physiology, Centre for Chronic Disease Control, New Delhi, India
| | | | - Sanjay Kinra
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ambuj Roy
- Department of Cardiology, All India Institute of Medical Sciences, Centre for Chronic Disease Control, New Delhi, India
| | - Dorairaj Prabhakaran
- Department of Clinical Trials, Centre for Chronic Disease Control, New Delhi, India
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Department of Epidemiology, Public Health Foundation of India, New Delhi, India
| |
Collapse
|
3
|
Purcell C, Dibben G, Hilton Boon M, Matthews L, Palmer VJ, Thomson M, Smillie S, Simpson SA, Taylor RS. Social network interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease. Cochrane Database Syst Rev 2023; 6:CD013820. [PMID: 37378598 PMCID: PMC10305790 DOI: 10.1002/14651858.cd013820.pub2] [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] [Indexed: 06/29/2023]
Abstract
BACKGROUND Globally, cardiovascular diseases (CVD, that is, coronary heart (CHD) and circulatory diseases combined) contribute to 31% of all deaths, more than any other cause. In line with guidance in the UK and globally, cardiac rehabilitation programmes are widely offered to people with heart disease, and include psychosocial, educational, health behaviour change, and risk management components. Social support and social network interventions have potential to improve outcomes of these programmes, but whether and how these interventions work is poorly understood. OBJECTIVES: To assess the effectiveness of social network and social support interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease. The comparator was usual care with no element of social support (i.e. secondary prevention alone or with cardiac rehabilitation). SEARCH METHODS: We undertook a systematic search of the following databases on 9 August 2022: CENTRAL, MEDLINE, Embase, and the Web of Science. We also searched ClinicalTrials.gov and the WHO ICTRP. We reviewed the reference lists of relevant systematic reviews and included primary studies, and we contacted experts to identify additional studies. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of social network or social support interventions for people with heart disease. We included studies regardless of their duration of follow-up, and included those reported as full text, published as abstract only, and unpublished data. DATA COLLECTION AND ANALYSIS Using Covidence, two review authors independently screened all identified titles. We retrieved full-text study reports and publications marked 'included', and two review authors independently screened these, and conducted data extraction. Two authors independently assessed risk of bias, and assessed the certainty of the evidence using GRADE. Primary outcomes were all-cause mortality, cardiovascular-related mortality, all-cause hospital admission, cardiovascular-related hospital admission, and health-related quality of life (HRQoL) measured at > 12 months follow-up. MAIN RESULTS: We included 54 RCTs (126 publications) reporting data for a total of 11,445 people with heart disease. The median follow-up was seven months and median sample size was 96 participants. Of included study participants, 6414 (56%) were male, and the mean age ranged from 48.6 to 76.3 years. Studies included heart failure (41%), mixed cardiac disease (31%), post-myocardial infarction (13%), post-revascularisation (7%), CHD (7%), and cardiac X syndrome (1%) patients. The median intervention duration was 12 weeks. We identified notable diversity in social network and social support interventions, across what was delivered, how, and by whom. We assessed risk of bias (RoB) in primary outcomes at > 12 months follow-up as either 'low' (2/15 studies), 'some concerns' (11/15), or 'high' (2/15). 'Some concerns' or 'high' RoB resulted from insufficient detail on blinding of outcome assessors, data missingness, and absence of pre-agreed statistical analysis plans. In particular, HRQoL outcomes were at high RoB. Using the GRADE method, we assessed the certainty of evidence as low or very low across outcomes. Social network or social support interventions had no clear effect on all-cause mortality (risk ratio (RR) 0.75, 95% confidence interval (CI) 0.49 to 1.13, I2 = 40%) or cardiovascular-related mortality (RR 0.85, 95% CI 0.66 to 1.10, I2 = 0%) at > 12 months follow-up. The evidence suggests that social network or social support interventions for heart disease may result in little to no difference in all-cause hospital admission (RR 1.03, 95% CI 0.86 to 1.22, I2 = 0%), or cardiovascular-related hospital admission (RR 0.92, 95% CI 0.77 to 1.10, I2 = 16%), with a low level of certainty. The evidence was very uncertain regarding the impact of social network interventions on HRQoL at > 12 months follow-up (SF-36 physical component score: mean difference (MD) 31.53, 95% CI -28.65 to 91.71, I2 = 100%, 2 trials/comparisons, 166 participants; mental component score MD 30.62, 95% CI -33.88 to 95.13, I2 = 100%, 2 trials/comparisons, 166 participants). Regarding secondary outcomes, there may be a decrease in both systolic and diastolic blood pressure with social network or social support interventions. There was no evidence of impact found on psychological well-being, smoking, cholesterol, myocardial infarction, revascularisation, return to work/education, social isolation or connectedness, patient satisfaction, or adverse events. Results of meta-regression did not suggest that the intervention effect was related to risk of bias, intervention type, duration, setting, and delivery mode, population type, study location, participant age, or percentage of male participants. AUTHORS' CONCLUSIONS: We found no strong evidence for the effectiveness of such interventions, although modest effects were identified in relation to blood pressure. While the data presented in this review are indicative of potential for positive effects, the review also highlights the lack of sufficient evidence to conclusively support such interventions for people with heart disease. Further high-quality, well-reported RCTs are required to fully explore the potential of social support interventions in this context. Future reporting of social network and social support interventions for people with heart disease needs to be significantly clearer, and more effectively theorised, in order to ascertain causal pathways and effect on outcomes.
Collapse
Affiliation(s)
- Carrie Purcell
- Faculty of Wellbeing, Education and Language Studies, The Open University in Scotland, Edinburgh, UK
| | - Grace Dibben
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Michele Hilton Boon
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Lynsay Matthews
- School of Health and Life Sciences, University of the West of Scotland, Glasgow, UK
| | - Victoria J Palmer
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Meigan Thomson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Susie Smillie
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - Sharon A Simpson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| |
Collapse
|
4
|
Miura H, Miura T, Kohzuki M, Takahashi T, Akizuki M, Ebihara S. Exercise intensity of real-time remotely delivered yoga via videoconferencing: Comparison with in-person yoga. Complement Ther Clin Pract 2023; 52:101770. [PMID: 37244081 DOI: 10.1016/j.ctcp.2023.101770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/18/2023] [Accepted: 05/08/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND AND PURPOSE Yoga has been studied as a rehabilitation option, but barriers to attendance remain. Videoconferencing, where participants can receive online, real-time instruction and supervision, may reduce the barriers. However, whether exercise intensity is equivalent to that of in-person yoga, and the relationship between proficiency and intensity remain unclear. The present study aimed to investigate whether the intensity of exercise is different between real-time remotely-delivered yoga via videoconferencing (RDY) and in-person yoga (IPY) and its relationship to proficiency. MATERIALS AND METHODS Healthy yoga beginners (n = 11) and yoga practitioners (n = 11) performed yoga (Sun Salutation) consisting of 12 physical postures in real-time remotely delivered via videoconferencing and in-person (RDY, IPY, respectively), each for 10 min on different days, in random order, using an expiratory gas analyzer. Oxygen consumption was collected, metabolic equivalents (METs) were calculated based on the data, exercise intensity was compared between RDY and IPY, and differences of METs between beginners and practitioners in both interventions were also assessed. RESULTS Twenty-two participants (mean age ± standard deviation, 47.2 ± 10.8 years) completed the study. There were no significant differences in METs between RDY and IPY (5.0 ± 0.5, 5.0 ± 0.7, respectively, P = 0.92), and no difference by proficiency level in both RDY (beginners: 5.0 ± 0.4, practitioners: 5.0 ± 0.6, P = 0.77) and IPY (beginners: 5.0 ± 0.7, practitioners: 5.0 ± 0.7, P = 0.91). No serious adverse events occurred in both interventions. CONCLUSION The exercise intensity of RDY is equivalent to IPY regardless of proficiency with no adverse events in RDY occurring in this study.
Collapse
Affiliation(s)
- Hisako Miura
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-0872, Japan.
| | - Takahiro Miura
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-0872, Japan.
| | - Masahiro Kohzuki
- Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata City, Yamagata, 990-2212, Japan.
| | - Tamao Takahashi
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-0872, Japan.
| | - Mina Akizuki
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-0872, Japan.
| | - Satoru Ebihara
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-0872, Japan.
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Ghazvineh D, Daneshvar M, Basirat V, Daneshzad E. The Effect of Yoga on the Lipid Profile: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Front Nutr 2022; 9:942702. [PMID: 35911119 PMCID: PMC9329825 DOI: 10.3389/fnut.2022.942702] [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: 06/16/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives Yoga is a mind-body stress-relieving exercise that increases mental and physical health, which may have a role in the improvement of metabolic disorders. The present study has reviewed the effect of yoga on lipid profiles as a systematic review and meta-analysis. Methods We evaluated the available randomized controlled trials on the effects of yoga-based programs, and lipid profiles by searching PubMed/Medline, Scopus, Web of Science, and the Cochrane central register of control trials up to January 2022. Both fixed and random effect analyses were used to find the relationships. Subgroup analysis was performed based on the continent, duration of the included studies, gender, and health condition of participants to discover the sources of heterogeneity. Result Fifty-three studies were included in the current systematic review and meta-analysis with a total sample size of 13,191. There was a striking association between yoga and total cholesterol (−10.31 mg/dl; 95% CI: −14.16, −6.45; I2 = 82.5%, P < 0.001), low-density lipoprotein cholesterol (−8.64 mg/dl; 95% CI: −12.03, −5.25; I2 = 75.0%, P < 0.001), high-density lipoprotein cholesterol (1.98 mg/dl; 95% CI: 0.81, 3.14; I2 = 91.6%, P < 0.001), triglycerides (−13.50 mg/dl; 95% CI: −20.09, −6.92; I2 = 90.7%, P < 0.001) and very low-density lipoprotein (−3.94 mg/dl; 95%CI: −6.31, −1.56; I2 = 72.2%, P < 0.001). Conclusion It seems yoga interventions had a substantial effect on lipid profiles, however, more qualified trials or cohort studies are needed to conclude exactly.
Collapse
Affiliation(s)
- Dorsa Ghazvineh
- Department of Physical Education, Islamic Azad University of Karaj, Karaj, Iran
| | - Mojtaba Daneshvar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Basirat
- Department of Gastroenterology, School of Medicine, Isfahan University of Medical Sciences and Health Services, Isfahan, Iran
| | - Elnaz Daneshzad
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- *Correspondence: Elnaz Daneshzad,
| |
Collapse
|
7
|
Utilization of Mind–Body Intervention for Integrative Health Care of COVID-19 Patients and Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116618. [PMID: 35682203 PMCID: PMC9180827 DOI: 10.3390/ijerph19116618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/23/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022]
Abstract
Recent findings suggest a correlation between COVID-19 and diabetes, although the underlying causes are still little understood. COVID-19 infection tends to induce severe symptoms in patients with underlying diabetes, increasing their mortality rate. Moreover, COVID-19 itself appears to be a diabetogenic factor. In addition, mental health conditions, such as depression due to lockdown and anxiety about infection, were found to affect glycemic control and immunity, highlighting the importance of mental health care during the pandemic. Mind–Body Intervention (MBI), which includes meditation, yoga, and qigong, has emerged as a tool for mental health management due to its effects on stress reduction and the promotion of mental and physical well-being. Here, we review the latest randomized controlled trials to determine the effects of MBI on glycemic control and the immune system and discuss the underlying mechanisms by which MBI facilitates the virtuous cycle of stress management, glycemic control, and immune modulation. Furthermore, we examine the actual utilization of MBI during the COVID-19 pandemic era through recent studies. With proper online education, non-pharmacological MBI may be more widely used as an important tool for self-health care that complements the usual treatment of COVID-19 patients and survivors.
Collapse
|
8
|
Bruce C, Achan V, Rathore S. Yoga-Based Cardiac Rehabilitation: Current Perspectives from Randomized Controlled Trials in Coronary Artery Disease. Vasc Health Risk Manag 2021; 17:779-789. [PMID: 34880621 PMCID: PMC8648328 DOI: 10.2147/vhrm.s286928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/19/2021] [Indexed: 11/23/2022] Open
Abstract
Coronary artery disease carries a high morbidity and mortality worldwide, and exercise-based cardiac rehabilitation programmes play a large role in secondary prevention. Exercise-based rehabilitation programmes are expensive, and in certain subgroups uptake is poor. Yoga has been suggested to show improvements in cardiovascular health which would support its use in cardiac rehabilitation programmes. We carried out a review of current randomized controlled trials to determine if yoga-based cardiac rehabilitation leads to reduced cardiac risk factors, and improved physiological and psychological outcomes in patients with coronary artery disease compared to standard care. Six randomized controlled studies were identified after a medical database search, and meta-analysis was carried out for the different outcomes. Overall, the addition of yoga to standard care resulted in improved subjective feeling of cardiac health and quality of life. There was also a trend towards improvement in left ventricular systolic function. Improvement in cardiac risk factors, MACE and psychological health in this cohort has still to be proven, but was not inferior to standard or enhanced care, and the benefits became more pronounced at longer follow-up. Future studies with longer follow-up and larger patient numbers would aid in accurately assessing the long-term benefit of yoga-based rehabilitation.
Collapse
Affiliation(s)
- Charo Bruce
- Department of Cardiology, Frimley Park Hospital, Frimley, Surrey, UK
| | - Vinod Achan
- Department of Cardiology, Frimley Park Hospital, Frimley, Surrey, UK
| | - Sudhir Rathore
- Department of Cardiology, Frimley Park Hospital, Frimley, Surrey, UK
| |
Collapse
|
9
|
Boy E, Lelo A, Tarigan AP, Machrina Y, Yusni Y, Harahap J, Sembiring RJ, Syafril S, Rusip G, Freeman CA. Salat Dhuha Improves Haemodynamic: A Randomized Controlled Study. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND: The prevalence of hypertension increases with age, more than 1 in every two elderly have hypertension, dominated by women. The primary prevention of hypertension is a worldwide public health concern. Salat Dhuha is a moderate-intensity physical activity. Salat with a two-movement cycle (rakaat) demonstrated improved hemodynamic in adults.
AIM: Our study purpose was to asses the effects of 2 and 8 rakaats of Salat Dhuha in improving systolic and diastolic blood pressure and heart rate in healthy elderly women.
METHODS: Elderly women in the Senior Care Residence (aged 60–74 years) participated in a 6-week controlled study. We completed a formal physical, clinical, and blood assessments before admission. Participants with a history of hypertension were excluded from the study. The participants were randomized into 2 groups, i.e., “8 rakaats group” (n = 13) and “2 rakaats group” (n = 13) of Salat Dhuha. Two participants dropped out from the present study. At baseline and at the end of 6 weeks study period, blood pressure and heart rate were recorded. All data obtained were statistically analyzed.
RESULTS: Both groups demonstrated the benefits of Salat Dhuha in improving hemodynamic parameters (systolic and diastolic blood pressure and heart rate). However, the reduction of systolic blood pressure in the “2 rakaats group” (2.16 mmHg) was less than in the “8 rakaats group” (5.50 mmHg), the reduction of diastolic blood pressure in the “2 rakaats group” (0.75 mmHg) was less than the “8 rakaats group” (2.41 mmHg) and the reduction of heart rate in “2 rakaats group” (2.08 bpm) was less than the “8 rakaats group” (6.08 bpm). All differences were statistically significant (p < 0.05).
CONCLUSION: This study demonstrated that the Salat Dhuha has a significant potential in improving hemodynamic parameters for elderly women which the more frequent rakaat will give more benefit than less frequent rakaat.
Collapse
|
10
|
Suksatan W, Tankumpuan T. Mind-Body Interventions in Patients With Heart Failure: State of the Science. J Appl Gerontol 2021; 41:1232-1243. [PMID: 34719969 DOI: 10.1177/07334648211053000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Complementary and alternative medicine are broadly considered mind-body interventions (MBIs) that support physical and mental wellness in patients with heart failure (HF). The aims of this review were to integrate and summarize current evidence from MBIs in patients with HF and to identify gaps for future research. We used PRISMA guideline and conducted a literature search through six databases. Fifteen publications met the criteria, published between 2013 and 2021. This review stipulated that MBIs included yoga, Tai Chi, meditation, reflexology, massage, relaxation, and breathing interventions. The findings emphasized that MBIs could reduce physical and psychological symptoms and improve health outcomes in patients with HF. MBIs had encouraging results for patients with HF on selected physiological and behavioral outcomes. Despite the early state of the evidence in this field, it seems that MBIs will play an essential role in the future for alleviating the symptoms of patients with HF.
Collapse
Affiliation(s)
- Wanich Suksatan
- Faculty of Nursing, 511652HRH Princess Chulabhorn College of Medical Science, Bangkok, Thailand.,Trudy Busch-Valentine School of Nursing, Saint Louis University, Saint Louis, MO, USA
| | | |
Collapse
|
11
|
Moonaz S, Nault D, Cramer H, Ward L. CLARIFY 2021: explanation and elaboration of the Delphi-based guidelines for the reporting of yoga research. BMJ Open 2021; 11:e045812. [PMID: 34353794 PMCID: PMC8344321 DOI: 10.1136/bmjopen-2020-045812] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 07/07/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Reporting of yoga research often lacks the detail required for clinical application, study replication, summary research and comparative effectiveness studies. METHODS To improve the transparency of reporting yoga interventions, and building on the development of previous reporting guidelines, a group of international yoga research stakeholders developed the consensus-based CheckList stAndardising the Reporting of Interventions For Yoga (CLARIFY) guidelines. RESULTS The 21-item CLARIFY checklist outlines the minimum details considered necessary for high-quality reporting of yoga research. This paper provides a detailed explanation of each of the 21 items of the CLARIFY checklist, together with model examples of how to integrate each item into publications of yoga research. The CLARIFY guideline serves as an extension for existing research reporting guidelines, and is flexible for use across all study designs. CONCLUSION We strongly encourage the uptake of these reporting guidelines by researchers and journals, to facilitate improvements in the transparency and utility of yoga research.
Collapse
Affiliation(s)
- Steffany Moonaz
- Department of Integrative Health Research, Maryland University of Integrative Health, Laurel, Maryland, USA
| | - Daryl Nault
- Department of Integrative Health Research, Maryland University of Integrative Health, Laurel, Maryland, USA
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Lesley Ward
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle Upon Tyne, Northumberland, UK
| |
Collapse
|
12
|
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: 10] [Impact Index Per Article: 3.3] [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.
Collapse
|
13
|
Li J, Gao X, Hao X, Kantas D, Mohamed EA, Zheng X, Xu H, Zhang L. Yoga for secondary prevention of coronary heart disease: A systematic review and meta-analysis. Complement Ther Med 2020; 57:102643. [PMID: 33338581 DOI: 10.1016/j.ctim.2020.102643] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/15/2020] [Accepted: 12/07/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Yoga has been widely practiced and has recently shown benefits in patients with coronary heart disease (CHD), however, evidence is inconsistent. METHODS We conducted a systematic review and meta-analysis by searching PubMed/Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE and Web of Science from inception to May 31, 2020 for randomised controlled trials (RCTs) comparing yoga with usual care or non-pharmacological interventions in patients with CHD. The primary outcomes were all-cause mortality and health related quality of life (HR-QoL). Secondary outcomes were a composite cardiovascular outcome, exercise capacity and cardiovascular risk factors (blood pressure, lipid profiles and body mass index). RESULTS Seven RCTs with a total of 4671 participants were included. Six RCTs compared yoga with usual care and one compared yoga with designed exercise. The mean age of the participants ranged from 51.0-60.7 years and the majority of them were men (85.4 %). Pooled results showed that compared with usual care, yoga had no effect on all-cause mortality (RR, 1.02; 95 % CI, 0.75-1.39), but it significantly improved HR-QoL (SMD, 0.07; 95 % CI, 0.01 - 0.14). A non-significant reduction of the composite cardiovascular outcome was observed (133 vs. 154; RR, 0.63; 95 % CI, 0.15-2.59). Serum level of triglyceride and high density lipoprotein cholesterol, blood pressure and body mass index were also significantly improved. The study comparing yoga with control exercise also reported significantly better effects of yoga on HR-QoL (85.75 vs. 75.24, P < 0.001). No severe adverse events related to yoga were reported. CONCLUSIONS Yoga might be a promising alternative for patients with CHD as it is associated with improved quality of life, less number of composite cardiovascular events, and improved cardiovascular risk factors.
Collapse
Affiliation(s)
- Jingen Li
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, 55902, United States
| | - Xiang Gao
- Internal Medicine Division, Tieying Hospital of Fengtai District, Beijing, 100078, China
| | - Xuezeng Hao
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Dimitrios Kantas
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, 55902, United States
| | - Essa A Mohamed
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, 55902, United States
| | - Xiangying Zheng
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Hao Xu
- Cardiovascular Diseases Centre, Xiyuan Hospital, China Academy of Chinese Medical Sciences, National Clinical Research Centre for Chinese Medicine Cardiology, Beijing, 100091, China.
| | - Lijing Zhang
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
| |
Collapse
|
14
|
Shawahna R, Abdelhaq I. Exploring perceived benefits, motives, barriers, and recommendations for prescribing yoga exercises as a nonpharmacological intervention for patients with epilepsy: A qualitative study from Palestine. Epilepsy Behav 2020; 106:107041. [PMID: 32247178 DOI: 10.1016/j.yebeh.2020.107041] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/09/2020] [Accepted: 03/12/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Yoga is believed to play a role in stabilizing the electroencephalogram and the autonomic nervous system, thus might help control seizures in people with epilepsy (PWE). This qualitative study was conducted to explore experiences of Palestinian PWE with regard to benefits, motives, barriers, and recommendations of prescribing yoga exercises as a nonpharmacological intervention. METHODS Purposive and snowball sampling techniques were used to recruit PWE who practiced yoga. Semi-structured in-depth interviews (n = 18) were conducted with the study participants. The interpretive description method was used to qualitatively analyze the data collected during the interviews. RESULTS Following the thematic analysis adopted for this study, four major themes emerged. These themes were as follows: perceived benefits of yoga, motives to practice yoga, barriers to practice yoga, and recommendations on effective yoga practice for PWE. The perceived benefits included improvements in management of seizures, psychological, physical, and social well-being. People with epilepsy were motivated by the health benefits of yoga. Barriers of adherence to practice included personal and logistic factors. The interviewees recommended tailoring yoga sessions to the needs of PWE. CONCLUSION This explorative qualitative study reported perceived benefits, motives, barriers, and recommendations of yoga as a nonpharmacological intervention for PWE. People with epilepsy used yoga as a beneficial nonpharmacological intervention to improve their health and reduce the negative effects of epilepsy on their physical and psychosocial well-being. Future studies are needed to investigate the health benefits of yoga when sessions are tailored to the needs of PWE.
Collapse
Affiliation(s)
- Ramzi Shawahna
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine; An-Najah BioSciences Unit, Centre for Poisons Control, Chemical and Biological Analyses, An-Najah National University, Nablus, Palestine.
| | - Imad Abdelhaq
- Department of Physical Education, Faculty of Educational Sciences and Teachers' Training, An-Najah National University, Nablus, Palestine
| |
Collapse
|