Research: PAPP and COLLEAGUES,

Listed in Issue 269

Abstract

PAPP and COLLEAGUES, 1. Department of Neurobiology Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden - marian.papp@ki.se ; 2. Department of Neurobiology Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden; 3. Department of Psychology, Stockholm University, Stockholm, Sweden; 4. Department of Neurobiology Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; 5. Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Huddinge, Sweden conducted a randomized clinical trial 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.

Background

Knowledge of hatha yogic exercises, the most used yoga style, for increasing functional capacity in patients with obstructive pulmonary diseases remains limited.

Methodology

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: Randomized clinical trial. Setting: The study was performed at the Karolinska University Hospital, Stockholm, among outpatients. Population: Thirty-six patients with obstructive pulmonary disease. Forty patients were randomized with 36 (24 women, median age =64, age range: 40-84 years) 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), 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. No between group effects emerged, however, within each group, significant improvements emerged for the six-minute walk distance (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). Secondary Outcomes: within-group improvements in CRQ appeared in both groups. Within the HY group, f decreased and SpO2 increased. Improved effects after follow-up emerged only for the CTP group for diastolic blood pressure (P=0.05) and CRQ emotional and fatigue domain (P=0.01).

Conclusion

There were no between-group differences. 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, respiratory muscle strength and all CRQ-domains. The CTP also exhibited effects on CRQ after the 6months follow-up. Clinical Rehabilitation Impact: Limited effects of HY and CTP emerged. 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.

References

Papp ME1, Wändell PE2, Lindfors P3, Nygren-Bonnier M4,5. Effects of yogic exercises on functional capacity, lung function and quality of life in participants with obstructive pulmonary disease: a randomized controlled study. Eur J Phys Rehabil Med. 53(3):447-461. Jun 2017. doi: 10.23736/S1973-9087.16.04374-4. Epub Nov 10 2016.

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