Hägglund Ewa, Hagerman Inger, Dencker Kerstin, Strömberg Anna
1 Department of Cardiology, Karolinska Institutet, Karolinska University Hospital Huddinge, Sweden.
2 Division of Nursing Science, Department of Medical and Health Sciences, Linköping University, Sweden.
Eur J Cardiovasc Nurs. 2017 Jun;16(5):381-389. doi: 10.1177/1474515117690297. Epub 2017 Jan 27.
The aims of this study were to determine whether yoga and hydrotherapy training had an equal effect on the health-related quality of life in patients with heart failure and to compare the effects on exercise capacity, clinical outcomes, and symptoms of anxiety and depression between and within the two groups.
The design was a randomized controlled non-inferiority study. A total of 40 patients, 30% women (mean±SD age 64.9±8.9 years) with heart failure were randomized to an intervention of 12 weeks, either performing yoga or training with hydrotherapy for 45-60 minutes twice a week. Evaluation at baseline and after 12 weeks included self-reported health-related quality of life, a six-minute walk test, a sit-to-stand test, clinical variables, and symptoms of anxiety and depression.
Yoga and hydrotherapy had an equal impact on quality of life, exercise capacity, clinical outcomes, and symptoms of anxiety and depression. Within both groups, exercise capacity significantly improved (hydrotherapy p=0.02; yoga p=0.008) and symptoms of anxiety decreased (hydrotherapy p=0.03; yoga p=0.01). Patients in the yoga group significantly improved their health as rated by EQ-VAS ( p=0.004) and disease-specific quality of life in the domains symptom frequency ( p=0.03), self-efficacy ( p=0.01), clinical summary as a combined measure of symptoms and social factors ( p=0.05), and overall summary score ( p=0.04). Symptoms of depression were decreased in this group ( p=0.005). In the hydrotherapy group, lower limb muscle strength improved significantly ( p=0.01).
Yoga may be an alternative or complementary option to established forms of exercise training such as hydrotherapy for improvement in health-related quality of life and may decrease depressive symptoms in patients with heart failure.
本研究旨在确定瑜伽和水疗训练对心力衰竭患者健康相关生活质量的影响是否相同，并比较两组之间以及组内对运动能力、临床结局以及焦虑和抑郁症状的影响。
本研究为随机对照非劣效性研究。共有40例心力衰竭患者，其中女性占30%（平均年龄±标准差为64.9±8.9岁），被随机分配接受为期12周的干预，一组每周进行两次45至60分钟的瑜伽练习，另一组进行水疗训练。在基线和12周后进行评估，评估内容包括自我报告的健康相关生活质量、六分钟步行试验、坐立试验、临床变量以及焦虑和抑郁症状。
瑜伽和水疗对生活质量、运动能力、临床结局以及焦虑和抑郁症状的影响相同。两组内运动能力均显著提高（水疗组p = 0.02；瑜伽组p = 0.008），焦虑症状均减轻（水疗组p = 0.03；瑜伽组p = 0.01）。瑜伽组患者在EQ-VAS评分中健康状况显著改善（p = 0.004），在症状频率（p = 0.03）、自我效能感（p = 0.01）、作为症状和社会因素综合指标的临床总结（p = 0.05）以及总体总结评分（p = 0.04）等疾病特异性生活质量方面也有显著改善。该组抑郁症状减轻（p = 0.005）。在水疗组中，下肢肌肉力量显著提高（p = 0.01）。
对于改善心力衰竭患者的健康相关生活质量，瑜伽可能是水疗等既定运动训练形式的替代或补充选择，并且可能减轻患者的抑郁症状。
