Research Area
Development of a Yoga-Based Cardiac Rehabilitation
Research Title
Development of a Yoga-Based Cardiac Rehabilitation (Yoga-CaRe) Programme
Introduction
Secondary prevention of myocardial infarction reduces associated morbidity and mortality . One approach is cardiac rehabilitation (CR), a programme of information and exercise sessions, which aims to help patients recover from myocardial infarction and reduce lifestyle risk factors for cardiovascular disease. CR programmes have been shown to reduce morbidity and mortality, improve quality of life, lower medical and social costs, and increase economic productivity. As a result, CR programmes are recommended as the standard by major clinical guidelines.
Abstract
Cardiac rehabilitation (CR) after myocardial infarction is highly effective. It is unavailable in public hospitals in India due to limited resources. Our objective was to develop a scalable model of CR for India based on yoga, which could also appeal to some groups with low uptake of CR (e.g., ethnic minorities, women, and older people) globally. The intervention was developed using a structured process. A literature review and consultations with yoga experts, CR experts, and post-myocardial infarction patients were conducted to systematically identify and shortlist appropriate yoga exercises and postures, breathing exercises, meditation and relaxation practices, and lifestyle changes, which were incorporated into a conventional CR framework.
Conclusion
We report the systematic development of a structured yoga-based CR programme. It is currently being evaluated in a major randomised controlled trial across India. 3,959 patients aged 18–80 years with acute myocardial infarction are recruited from 24 cardiac centres in India. Participants are followed 3-monthly until the end of the study. The co-primary outcomes are time to occurrence of the first cardiovascular event (a composite of all-cause mortality, nonfatal myocardial infarction, nonfatal stroke, and hospitalisation for emergency re-vascularisation, unstable angina, and heart failure) and quality of life at 12 weeks. The secondary outcomes are the need for any re-vascularisation procedure (coronary artery bypass surgery (CABG) or percutaneous coronary interventions (PCI)), return to preinfarct daily activities, tobacco cessation, adherence to prescribed medications, cognitive function, anxiety and depression, and cost-effectiveness of the programme.
