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Effects of MediYoga among patients with paroxysmal atrial fibrillation
Sophiahemmet University.ORCID iD: 0000-0001-5329-6384
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction

Patients with paroxysmal atrial fibrillation often experience impaired health-related quality of life. Standard treatment is not always sufficient and changes in life-style habits are suggested as a complement. Also, studies have suggested differences in gender where women have extended side effects of rhythm medications, more symptoms and estimate lower health-related quality of life than men. Yoga has been shown to increase health-related quality of life and decrease blood pressure, heart rate and cardiac biomarkers. The overall aim of this thesis was to study the effects of MediYoga among patients with paroxysmal atrial fibrillation. In addition, to evaluate perceptions and experiences of MediYoga as well as gender differences.

Methods and results

Paper I: This is a randomized, controlled pilot study in which 80 patients were randomized to MediYoga, n=40, or a control group, n=40 at an University Hospital, in Stockholm, Sweden. The yoga groups had been performing MediYoga for one hour/week over a 12 weeks period. Assessments as health-related quality of life questionnaires (i.e. SF-36, EQ-5D Visual Analogue Scale), blood pressure and heart rate were collected at baseline and at the end of study. The results showed an improvement of health-related quality of life in the yoga group. Blood pressure and heart rate also decreased in the yoga group.

Paper II: In this prospective randomized study at an University Hospital, Stockholm, Sweden, with stratification in gender, 132 patients, with symptomatic PAF, were randomized to yoga (n=44), relaxation (n=44) and a control group (n=44). The yoga groups had been performing MediYoga for one hour/week over a 12 weeks period. Assessments as health-related quality of life questionnaires (i.e. SF-36, ASTA), blood pressure, heart rate as well as NT-proBNP were collected at baseline and at the end of the study. The results showed no differences in the ASTA and SF-36 between the groups. However, improvements were seen in health-related quality of life, SF-36, with-in the MediYoga group. Both systolic and diastolic blood pressure decreased in the MediYoga group compared to the control group but there was no difference compared to the relaxation group. There were no differences in heart rate and NT-proBNP between or with-in the groups after 12 weeks.

Paper III: A study with a qualitative design was conducted using individual semistructured interviews. The study included 12 participants (7 men and 5 women) who had participated in the yoga group in Paper II. The data were analysed using qualitative content analysis with an inductive method and a manifest approach. Three categories were found in the analysis; “A time for a sense of existence and presence”, “A way of gaining well-being and increased consciousness” and “Access to a tool to gain willpower and relieve symptoms”.

Paper IV: A comparative design examining gender differences among those who had performed MediYoga (women n=37, men n=34). The yoga groups had been performing MediYoga for one hour/week over a 12 weeks period. Data (i.e healthrelated quality of life [SF-36], blood pressure and heart rate) were collected at baseline and the end of the study. There were no differences between the women or men group in SF-36 at end of study, however, there was improvement with-in the women group in the subscales vitality, social function, mental health and the domain mental component summary score. In the male group, there were improvement within the subscales role-physical, bodily pain, general health, vitality, social function, role-emotion and the domain mental component summary score (SF-36). There were no differences between the groups in systolic and diastolic blood pressure as well as heart rate at the end of the study. With-in the women group differences were observed in systolic and diastolic blood pressure, however, no difference was seen in heart rate. With-in the men group improvement were seen in diastolic blood pressure but no differences were seen in systolic blood pressure or heart rate.

Conclusions

MediYoga improves health-related quality of life as well as blood pressure among patients with PAF. Also, both genders report benefits, and patients describe MediYoga as an accessible tool with which to handle emotions and symptoms. MediYoga may be a part of a self-management program, as a complementary treatment, among patients with PAF.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet , 2019. , p. 63
National Category
Nursing
Identifiers
URN: urn:nbn:se:shh:diva-3254ISBN: 978-91-7676-877-8 (print)OAI: oai:DiVA.org:shh-3254DiVA, id: diva2:1293848
Public defence
2019-01-18, Aulan, entréplan, Danderyds sjukhus, Stockholm, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2019-03-05 Created: 2019-03-05 Last updated: 2019-03-07Bibliographically approved
List of papers
1. Effects of yoga in patients with paroxysmal atrial fibrillation - a randomized controlled study.
Open this publication in new window or tab >>Effects of yoga in patients with paroxysmal atrial fibrillation - a randomized controlled study.
2016 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no 1, p. 57-63Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Patients with atrial fibrillation often have an impaired quality of life (QoL). Practising yoga may decrease stress and have positive effects on mental and physical health. The aim of this study was to investigate whether yoga can improve QoL and decrease blood pressure and heart rate in patients with paroxysmal atrial fibrillation (PAF).

METHODS: In this pilot study, 80 patients diagnosed with PAF were randomized to standard treatment (control group, n=40) or standard treatment in combination with yoga (yoga group, n=40) during a 12-week period. QoL, blood pressure and heart rate were evaluated at baseline and at the end of the study (12 (+2) weeks). EuroQoL-5D (EQ-5D) Visual Analogue Scale (VAS) and the two dimensions in Short-Form Health Survey (SF-36) were used to evaluate QoL.

RESULTS: At baseline there was a significant difference in QoL between the groups in EQ-5D VAS- scale (p=0.02) and SF-36 mental health score (p<0.001) in which the control group had higher scores. At the end of the study, the yoga group averaged higher SF-36 mental health scores. There was a significant difference between the two groups (p=0.016), but no differences in EQ-5D VAS- scale and physiological health score was seen between the two groups. At the end of the study, the yoga group had significantly lower heart rate (p=0.024) and systolic (p=0.033) and diastolic blood pressure (p<0.001) compared to the control group.

CONCLUSIONS: Yoga with light movements and deep breathing may lead to improved QoL, lower blood pressure and lower heart rate in patients with PAF compared to a control group. Yoga could be a complementary treatment method to standard therapy.

Keywords
Paryxysmal atrial fibrillation, Blood pressure, Heart rate, Quality of life, Yoga
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:shh:diva-2155 (URN)10.1177/1474515116637734 (DOI)26976659 (PubMedID)
Available from: 2016-03-23 Created: 2016-03-23 Last updated: 2019-03-05Bibliographically approved
2. MediYoga as a part of self-management program among patients with Paroxysmal Atrial Fibrillation
Open this publication in new window or tab >>MediYoga as a part of self-management program among patients with Paroxysmal Atrial Fibrillation
Show others...
(English)Manuscript (preprint) (Other academic)
Keywords
Paroxysmal atrial fibrillation, Yoga, Health-related quality of life, Blood pressure, Heart rate, NT-proBNP
National Category
Nursing
Identifiers
urn:nbn:se:shh:diva-3251 (URN)
Available from: 2019-03-05 Created: 2019-03-05 Last updated: 2019-03-05Bibliographically approved
3. Perceptions and experiences of MediYoga among patients with paroxysmal atrial fibrillation: An interview study
Open this publication in new window or tab >>Perceptions and experiences of MediYoga among patients with paroxysmal atrial fibrillation: An interview study
2018 (English)In: Complementary Therapies in Medicine, ISSN 0965-2299, E-ISSN 1873-6963, Vol. 41, p. 29-34, article id S0965-2299(18)30040-2Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: We investigated the perceptions and experiences of a therapeutic yoga form, MediYoga, which is evolved from Kundaliniyoga among patients with symptomatic paroxysmal atrial fibrillation (PAF).

DESIGN AND SETTING: an inductive exploratory design was chosen with individual semi-structured interviews. The study was conducted with 12 participants (7 men and 5 women, average age 63.5) at a university hospital, Sweden. Informed consent was obtained from all participants. The data were analyzed using a qualitative content analysis with an inductive method and a manifest approach.

RESULTS: Three categories were found in the analysis. In the category "A time for a sense of existence and presence", the patients described an increased thoughtfulness and experiences of gaining access to an inner self. The category "A way of gaining well-being and increased consciousness" describes patients` feelings of relaxation and feeling of comfort, with components of mental and physical well-being. Furthermore, "Access to a tool to gain willpower and relieve symptoms" describes the perceptions from patients to obtained access to a tool for handling the emotions, such as fear and anxiety, as well as symptoms that they could struggling with between, and during, their episodes of atrial fibrillation. No adverse events were reported by the yoga group, during the study.

CONCLUSIONS: Patients with PAF described MediYoga as an accessible tool to manage emotions and symptoms related to episodes of AF. MediYoga may also assist in enhancing body awareness, whereby physical, mental and spiritual components are integrated. MediYoga may strengthen self-management among patients with PAF.

Keywords
Content analysis, MediYoga, Paroxysmal atrial fibrillation, Quality of life, Self-management, Yoga
National Category
Nursing
Identifiers
urn:nbn:se:shh:diva-3172 (URN)10.1016/j.ctim.2018.09.002 (DOI)30477856 (PubMedID)
Available from: 2018-11-30 Created: 2018-11-30 Last updated: 2019-03-05Bibliographically approved
4. Differences in gender in health-related quality of life, blood pressure and heart rate among patients with paroxysmal atrial fibrillation after performning MediYoga
Open this publication in new window or tab >>Differences in gender in health-related quality of life, blood pressure and heart rate among patients with paroxysmal atrial fibrillation after performning MediYoga
(English)Manuscript (preprint) (Other academic)
Keywords
Gender, Paroxysmal atrial fibrillation, Quality of life, Blood pressure, Heart rate, Yoga
National Category
Nursing
Identifiers
urn:nbn:se:shh:diva-3252 (URN)
Available from: 2019-03-05 Created: 2019-03-05 Last updated: 2019-03-06Bibliographically approved

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