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Experts pointed out that the study lacked the type of formalized exercise prescription typical of US rehabilitation programs, but remained enthusiastic.
CHICAGO, IL – A yoga-based rehabilitation program followed by an acute MI, called Yoga-CaRe, is as safe as a conventional and feasible program in an Indian population, according to new data randomized.
The problems with cardiac rehab programs are that they are expensive and require the resources of a multidisciplinary team, Dorairaj Prabhakaran, MD, DM. Center for Chronic Disease Control, New Delhi, India), who presented the study at a late-breaking scientific session presented today at the 2018 American Heart Association scientific sessions, said at TCTMD. "While we say that we only have a qualified yoga instructor and that it reduces costs. In fact, even in terms of space, all you need is a small room with a yoga mat. We do not demand more than that. [Also] It is culturally acceptable and it has become much more popular. "
For the trial, the researchers randomized 3,959 patients with acute myocardial infarction in 24 Indian centers at 14 weeks of either Yoga-CaRe or 13 lifestyle sessions, meditation and breathing exercises and yoga postures – or enhanced standard care including three educational sessions and printed pamphlets delivered by a nurse or other member of the cardiac care team. the study group were specifically selected so as not to increase the participants' heart rate to dangerous levels, said Prabhakaran.
In intention-to-treat badysis (ITT), patients treated by Yoga-CaRe had at a 42-month follow-up, there were numerically fewer effects on the primary endpoint (death, non-fatal MI, nonfatal stroke, or emergency cardiovascular hospitalization), but the differencewas not significant.
ITT Analysis: 42-Month Results
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However, in the badysis per protocol – with the graduates defined as the 1,059 participants having attended at least 10 sessions of Yoga-CaRe- Yoga-CaRe resulted in almost twice as many events on the primary endpoint at 42 months (HR 0.54, 95% CI 0.38-0.76). The secondary endpoint of self-rated quality of life, as measured by mean change in EQ-5 VAS score, was higher in patients in the Yoga-CaRe group than at 3 months (10.7 vs 9.2; P = 0.002). Yoga-CaRe was also badociated with a higher rate of return of patients to daily activities prior to infarction ( P <0.001) and not reaching more than six states of health ( P = 0.04) in 3 months. "Yoga-CaRe could be an alternative to conventional cardiac rehabilitation programs and address the unmet need for cardiac rehabilitation for patients in low- and middle-income countries," concluded Prabhakaran. The session was the biggest hurdle for participants to finish Yoga-CaRe, he said, stressing however that it was typical of any cardiac rehab program. Now that this protocol has been proven safe, Prabhakaran wished that it be examined after the other. conditions such as heart failure. "Heart failure is increasing and in India, 50% of people will die before age 5," he said. "Initially, we did not examine heart failure because we were worried about the safety of yoga in this group. Now that we demonstrate that it is safe and feasible, we will extend it to heart failure. "Yoga could also be useful for cancer rehabilitation and to prevent injuries in elderly patients," he added. Yoga as a supplement, for today Donna Arnett, MSPH, PhD (Public Health College of the University of Kentucky, Lexington), confided to TCTMD that, on the whole, the American health care system should "better bring our patients into cardiac rehabilitation". . It's a very strong, evidence-based program to prevent secondary heart attacks. " Although the study intrigues and many others have shown the benefits of yoga in terms of reducing stress, she said:" What we should see, in my opinion. Before being able to make this jump in [a yoga-based cardiac rehab] there is a direct comparison between a yoga-based cardiac rehabilitation practice and our standard cardiac rehabilitation that we have tested and that we have good evidence. If we did a randomized trial in which we placed people in each of these, then compared them and that there was no difference in effectiveness, then I could see that as another potential solution. Maybe it's a solution that would help increase the adoption rates of cardiac rehabilitation after an IM because it might be less dangerous to do yoga than to do some exercise. " Exercise Physiologist Paula Seffens, PhD (University of North Georgia, Gainesville) also noted the lack of physical exercise component in the control group, telling TCTMD that" this n & # 39; 39; was not a head-to-head comparison. "Future studies should use a more tailored design, so that in case of improvement, the arm of yoga compared to traditional exercises" we would know that They do an equal number of exercises [and] so that's something that goes beyond the simple exercise at work here, "she commented. Up 39 "There is enough scientific evidence, yoga will remain an additional treatment for heart patients," said Seffens, "but for those who want to add it, and many in his practice have chosen to do so for a variety of reasons, the different components of yoga may have advantages in terms of quality of life. "We should probably systematically teach them to take deep, slow breaths and do pranayama exercises to encourage meditation and relaxation periods as part of their new routine," she said. she suggested. However, "how we really put this into cardiac rehabilitation and did standard care, I think we just need to be careful not to go in a way that is well received by the medical community." [19659003PurviParwaniMD(MD)LomaLindaUniversityCA)whogrewupinIndiawatchingherparentsdoyogaandpracticestodayherselfregularlyechoedthenewsSeffens'EnthusiasmforYogainCardiacRehabilitationAlthoughthistrialhbadhownnobenefitofyogaoverconventionalcareitisimportanttonotethatyogahasnotdoneworseshesaidentrustedtoTCTMD"SowecansaythatnowyoucanactuallytellyourpatientsthattheycandoyogaandthattheycouldevenhaveasimilarimpactontheiroverallhealingafteranIMlikeanyanotherexercise" Regarding "the population already using yoga as an exercise strategy, this is great news for them because there is now something better than nothing that supports exercise strategy [their] and, in fact, [for] practitioners who do not believe in yoga, now they have something to do, "continued Parwani. [ad_2]Source link Tags Cardiac Feasibility Optional PostMI Randomized rehabilitation Security shows trial Yoga Related Articles |
