Home-Based Physical Activity Program With Health Coaching for participants With Chronic Obstructive Pulmonary Disease in Sweden: A Proof-of-Concept Pilot Study.

Home-based interventions are at the center stage of current health care demands. There is a clear need to translate pulmonary rehabilitation into a home-based setting. This 8-week pilot study aimed to determine the feasibility of a home-based physical activity program for participants with chronic obstructive pulmonary disease (COPD) in Sweden. Patients with COPD, aged 40 years or older and clinically stable in the past 3 months, were recruited. The program used a fitness tracker to monitor step count, weekly health coaching calls using motivational interviewing, and video-guided mindful movements. The outcome measures were adherence to the 8-week program's video-guided exercises (number of times videos were watched), adherence to health coaching calls (minimum 8), monthly and daily step count, and quality of life (QoL) using the chronic respiratory questionnaire. Thirteen participants were enrolled, and 12 participants adhered to health coaching calls and step monitoring. We had 643 video-exercise views, which exceeded the minimum standard (576 views). The mean difference comparing total monthly steps from baseline and the 8-week time point was 47,039 steps (95% CI, -113,625 to 1623.5; P=.06). The minimal clinical improvement of 500 daily steps was found for 8 of the patients. No significant improvement was found in the QoL measures and mental health. We found the home-based physical activity program to be a feasible intervention. Patients reported high adherence to tracking step counts, health coaching calls, and video-guided exercise. No improvements in QoL or monthly step count emerged; however, we found high adherence and a positive trend in the number of monthly step counts, and improvements of at least 500 daily step counts improved in most patients with this small sample size.

Experiences of physical activity and exercise among women with obstructive pulmonary disease.

BACKGROUND: With more women being diagnosed with obstructive pulmonary disease, it is important to know how women experience non-pharmacological rehabilitation including different types of physical activity and exercise. OBJECTIVE: This study aimed to explore how women with obstructive pulmonary disease experienced participating in pulmonary rehabilitation including yoga or strength- and endurance training to promote physical activity. A second aim included exploring experiences of physical activity and exercise through life. METHODS: Fifteen women with asthma or chronic obstructive pulmonary disease were interviewed about their experiences of participating in an exercise intervention and about their experiences of physical activity and exercise in their lives. The transcribed interviews were analyzed using qualitative content analysis. RESULTS: An overall theme, "Wishing to succeed in attending physical activity and exercise," emerged. Three categories were identified: 1) strategies to overcome insecurity; 2) a life situation which enables and hinders; and 3) an inner drive and focus on myself. CONCLUSIONS: The women's wishes to be physically activity and exercise involved hindering and enabling factors. Specifically, their gender roles as women were described as a hinder. This suggests a need to include a gender perspective when promoting physical activity and exercise to women with obstructive pulmonary disease.

Changes in physical activity levels and relationship to balance performance, gait speed, and self-rated health in older Swedish women: a longitudinal study.

BACKGROUND AND AIM: Physical activity levels in older people often decrease and may mean impaired physical functioning leading to an increased fall risk. The aim of this study was to investigate self-reported change in physical activity dose and deterioration in balance performance, gait speed, and self-rated health (SRH) in older women between two time points in a follow-up study. METHODS: A cohort of community-living women, aged 69-79 years (n = 351) were evaluated by questionnaire and clinical tests on balance, gait speed, and SRH at baseline. One hundred and eighty-six women were followed-up by these tests 8.5 years after inclusion. The non-parametric Wilcoxon signed-rank test and Mann-Whitney U test were used for the analysis. RESULTS: The greatest changes were seen in one-leg standing time (OLST) with eyes closed (- 60%) and eyes open (- 42%). The population was divided into high exercise (HE, n = 49) and low exercise (LE, n = 51) groups. At baseline the HE group had an OLST of 19 s with eyes open and 3 s with eyes closed. In the LE group, these values were 7.3 s and 2 s. At follow-up, differences between HE and LE concerning tandem walk forwards (steps) (HE = 8.5; LE = 2.5) and backwards (HE = 11; LE = 3.5) emerged. The HE group estimated SRH (VAS-scale) 30 mm higher at baseline and 17 mm higher at follow-up than the LE group. CONCLUSION: Greater physical activity seems to be an important predictor for maintaining physical function and SRH in older women.

A randomized controlled pilot study of the effects of 6-week high intensity hatha yoga protocol on health-related outcomes among students.

OBJECTIVE: Modern hatha yoga exercises (YE) provide an alternative form of physical activity which may reduce stress, facilitate recovery and improve health. This study investigated the short-term effects of high intensity hatha yoga exercises (HIY) on health-related outcomes. METHODS: A 6-week randomized controlled study was performed to compare HIY with a control group not changing their exercise behavior. Healthy students (N = 44; median age: 25 years, range 20-39 years; HIY: n = 21, including 3 men; control group: n = 23, including 3 men) novice to yoga participated in the intervention which included one weekly class and recommended home training. Participants provided self-reports in questionnaires before and after the intervention. Self-reports included anxiety and depression (Hospital Anxiety and Depression Scale), stress (Perceived Stress Scale), sleep quality (Pittsburgh Sleep Quality Index), insomnia (Insomnia Severity Index), subjective health complaints (Common Symptoms in General Practice Index) and self-rated health (single-item). RESULTS: After the 6-week intervention, there were no between-group differences in anxiety, depression, stress, sleep or self-rated health. However, when investigating associations within the HIY-group, a higher HIY-dose was related to less depression (r = 0.47; p = 0.03), improved sleep quality (r = 0.55; p = 0.01), and less insomnia (r = 0.49; p = 0.02). CONCLUSIONS: There were no short-term between-group effects of HIY on mental distress, sleep or self-rated health. However, within the HIY-group, a higher dose was associated with improved mental health in terms of depression and with improved sleep. Although future studies with larger samples are needed, these preliminary findings suggest short-term positive effects of HIY on health-related outcomes among students. TRIAL REGISTRATION NUMBER: NCT01305096.

Experiences of hatha yogic exercises among patients with obstructive pulmonary diseases: A qualitative study.

BACKGROUND AND AIM: Obstructive pulmonary diseases can involve dyspnea and deconditioning. Hatha yogic exercises are a form of psychophysical attention-based activity. Research of experiences after participating in an adapted hatha yoga (YE) intervention remains limited. The aim of the present study was to explore the experiences of patients with obstructive pulmonary diseases (asthma and chronic obstructive pulmonary disease) in a 12-week hatha yoga intervention (YE). METHOD: Fifteen patients (10 women and 5 men, median age = 61, range: 44-76 years) who had participated in YE were interviewed after the intervention. Interview data were analyzed using qualitative content analysis. RESULTS: Three main categories emerged: "To focus and be aware of oneself", "To gain new knowledge through practice" and "To master one's own situation". The overall theme "From limitation to opportunity - to experience breathing as a tool in daily life" illustrates a learning process on different levels. The participants described improved physical symptoms and breathing techniques, greater energy/stamina and body awareness along with a new sense of control over their breathing in different situations. CONCLUSIONS: Patients with obstructive pulmonary diseases may strengthen their self-awareness and improve control of symptoms and learning new ways of breathing after practicing YE, which may provide a tool to control disease symptoms in daily life. Trial registration number NCT02233114.

Effects of yogic exercises on functional capacity, lung function and quality of life in participants with obstructive pulmonary disease: a randomized controlled study.

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: Randomized clinical trial. SETTING: The study was performed at the Karolinska University Hospital, Stockholm, 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 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). CONCLUSIONS: 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.

Effects of High-Intensity Hatha Yoga on Cardiovascular Fitness, Adipocytokines, and Apolipoproteins in Healthy Students: A Randomized Controlled Study.

BACKGROUND: Yoga exercises are often used as a form of body and mind exercise to increase performance. However, knowledge about the physiologic effects of performing high-intensity Hatha yoga exercises over a longer time period remains limited. OBJECTIVE: To investigate the effects of high-intensity yoga (HIY) on cardiovascular fitness (maximal oxygen consumption, estimated from the Cooper running test), ratings of perceived exertion (RPE), heart rate (HR), heart rate recovery (HRR), blood pressure (BP), adipocytokines, apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), and glycosylated hemoglobin (HbA1c) in healthy students. METHODS: The 44 participants (38 women and 6 men; median age, 25 years [range, 20-39 years]) were randomly assigned to an HIY or a control group. The HIY program was held for 6 weeks (60 minutes once a week). Cardiovascular fitness, RPE, HR, HRR, BP, adipocytokines, HbA1c, ApoA1, and ApoB were measured at baseline and after 6 weeks in both groups. RESULTS: HIY had no significant effects on cardiovascular fitness (mean dose: 390 minutes [range, 210-800 minutes]), HR, HRR, BP, or any of the blood parameters. However, secondary findings showed that [corrected] ApoA1 (1.47 ± 0.17 to 1.55 ± 0.16 g/L; p = 0.03) and adiponectin (8.32 ± 3.32 to 9.68 ± 3.83 mg/L; p = 0.003) levels increased significantly in the HIY group after 6 weeks. CONCLUSIONS: Six weeks of HIY did not significantly improve cardiovascular fitness. However, secondary findings showed that [corrected] ApoA1 and adiponectin levels increased significantly in the HIY group. This finding suggests that HIY may have positive effects on blood lipids and an anti-inflammatory effect.

Increased heart rate variability but no effect on blood pressure from 8 weeks of hatha yoga - a pilot study.

BACKGROUND: Yoga exercises are known to decrease stress and restore autonomic balance. Yet knowledge about the physiological effects of inversion postures is limited. This study aimed to investigate the effects of inversion postures (head below the heart) on blood pressure (BP) and heart rate variability (HRV). METHODS: Twelve healthy women and men took part in an 8-week yoga program (60 min once a week). BP was measured with an automatic Omron mx3 oscillometric monitoring device and HRV with a Holter 24-hour ECG at baseline and 8 weeks after the intervention. RESULTS: There was no significant effect of inversion postures on BP. Nine out of 12 participants showed a significant increase in HRV (p < 0.05) at night (2 hours) on pNN50% (12.7 ± 12.5 to 18.2 ± 13.3). There were no significant changes in other HRV measures such as NN50, LF, HF, LF/HF ratio, LF normalized units (n.u.), HF n.u. and RMSSD. CONCLUSION: Eight weeks of hatha yoga improved HRV significantly which suggests an increased vagal tone and reduced sympathetic activity.