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Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
Online ISSN 1973-9095
Marian E. PAPP 1, Petra LINDFORS 2, Per E. WANDELL 1, Malin NYGREN-BONNIER 3, 4
1 Department of Neurobiology Care Sciences and Society, Division of Family Medicine, Karolinska Institutet, Stockholm, Sweden; 2 Department of Psychology, Stockholm University, Stockholm, Sweden; 3 Department of Neurobiology Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; 4 Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Huddinge, Sweden
BACKGROUND: Knowledge of hatha yogic exercises, the most used yoga style, for increasing functional capacity in patients with obstructive pulmonary diseases remains limited.
AIM: The aim was to evaluate the effects and feasibility of hatha yoga (HY) compared to a conventional training program (CTP) on functional capacity, lung function and quality of life in patients with obstructive pulmonary diseases.
DESIGN: RCT (randomized clinical trial).
SETTING: The study was performed at the Karolinska University Hospital, Stockholm, Sweden among outpatients.
POPULATION: Thirty-six patients with obstructive pulmonary disease.
METHODS: Forty patients were randomized with 36 (24 women, median age=64, age range: 40-84 yrs) participating in HY (n=19) or CTP (n=17). Both HY and CTP involved a 12-week program with a 6-month follow-up. Functional capacity (using the 6-minute walk test, 6MWT), lung function (spirometry), respiratory muscle strength (respiratory pressure meter), oxygen saturation (SpO2), breathlessness (Borg), respiratory rate (f) and disease-specific quality of life (CRQ) were measured at baseline, at 12 weeks and at a 6-month follow-up.
RESULTS: Testing for interactions (group x time) with ANOVAs showed significant effects on the CRQ fatigue (p=0.04) and emotional (p=0.02) domains, with improvements in the CTP group after the 12-week intervention (p=0.02 and 0.01, respectively) but not in the HY group. Within each group, significant improvements emerged for the 6MWD after 12-week intervention (HY: mean difference 32.6 m; CI 10.1-55.1, p=0.014; CTP: mean difference 42.4 m; CI 17.9-67.0, p=0.006). Within-group improvements in CRQ appeared in both groups. Within the HY group, the respiratory rate (f) decreased and SpO2 increased. Improved effects after follow-up emerged only for the CTP group for 6MWD (p=0.04), diastolic blood pressure (p=0.05) and CRQ emotional domain (p=0.01).
CONCLUSIONS: After 12 weeks, 6MWD improved significantly within both groups. Within the HY group, improvements in the CRQ mastery domain, f and SpO2 emerged. Within the CTP group, there were improvements in lung function parameter forced vital capacity (FVC), respiratory muscle strength and all CRQ-domains. The CTP also exhibited effects on CRQ after the 6months follow-up.
CLINICAL REHABILITATION IMPACT: Similar effects of HY and CTP show that HY seems feasible and safe as a form of physical exercise for pulmonary disease patients. As part of the rehabilitation, HY may constitute an alternative to other physical training activities and may be a useful addition to formal rehabilitation programs.