Arizona State University, Tempe, USA.
Colorado School of Public Health, Denver, USA.
BMC Complement Med Ther. 2020 Jun 5;20(1):173. doi: 10.1186/s12906-020-02926-3.
About 1 in every 150 pregnancies end in stillbirth. Consequences include symptoms of post traumatic stress disorder (PTSD), depression, and anxiety. Yoga has been used to treat PTSD in other populations and may improve health outcomes for stillbirth mothers. The purpose of this study was to determine: (a) feasibility of a 12-week home-based, online yoga intervention with varying doses; (b) acceptability of a "stretch and tone" control group; and (c) preliminary efficacy of the intervention on reducing symptoms of PTSD, anxiety, depression, perinatal grief, self-compassion, emotional regulation, mindfulness, sleep quality, and subjective health.
Participants (N = 90) were recruited nationally and randomized into one of three groups for yoga or exercise (low dose (LD), 60 min per week; moderate dose (MD), 150 min per week; and stretch-and-tone control group (STC)). Baseline and post-intervention surveys measured main outcomes (listed above). Frequency analyses were used to determine feasibility. Repeated measures ANCOVA were used to determine preliminary efficacy. Multiple regression analyses were used to determine a dose-response relationship between minutes of yoga and each outcome variable.
Over half of participants completed the intervention (n = 48/90). Benchmarks (≥70% reported > 75% satisfaction) were met in each group for satisfaction and enjoyment. Participants meeting benchmarks (completing > 90% of prescribed minutes 9/12 weeks) for LD and MD groups were 44% (n = 8/18) and 6% (n = 1/16), respectively. LD and MD groups averaged 44.0 and 77.3 min per week of yoga, respectively. The MD group reported that 150 prescribed minutes per week of yoga was too much. There were significant decreases in PTSD and depression, and improvements in self-rated health at post-intervention for both intervention groups. There was a significant difference in depression scores (p = .036) and grief intensity (p = .009) between the MD and STC groups. PTSD showed non-significant decreases of 43% and 56% at post-intervention in LD and MD groups, respectively (22% decrease in control).
This was the first study to determine the feasibility and preliminary efficacy of an online yoga intervention for women after stillbirth. Future research warrants a randomized controlled trial.
ClinicalTrials.gov. NCT02925481. Registered 10-04-16.
大约每 150 次妊娠中就有 1 次以死胎告终。其后果包括创伤后应激障碍（PTSD）、抑郁和焦虑等症状。瑜伽已被用于治疗其他人群的 PTSD，并且可能改善死胎母亲的健康状况。本研究旨在确定：（a）不同剂量的 12 周家庭式在线瑜伽干预的可行性；（b）“拉伸与塑形”对照组的可接受性；以及（c）干预对减轻 PTSD、焦虑、抑郁、围产期悲伤、自我同情、情绪调节、正念、睡眠质量和主观健康症状的初步疗效。
参与者（N=90）在全国范围内招募，并随机分为瑜伽或运动三组中的一组（低剂量（LD），每周 60 分钟；中剂量（MD），每周 150 分钟；拉伸与塑形对照组（STC））。基线和干预后调查测量了主要结果（见上文）。频率分析用于确定可行性。重复测量方差分析用于确定初步疗效。多元回归分析用于确定瑜伽时间与每个结果变量之间的剂量反应关系。
超过一半的参与者完成了干预（n=48/90）。每个组的满意度和享受度都达到了（>75%的人报告>75%的满意度）基准。LD 和 MD 组分别有 44%（n=8/18）和 6%（n=1/16）的参与者完成了 LD 和 MD 组的基准（完成>90%规定的 12 周/9 次）。LD 和 MD 组平均每周进行 44.0 和 77.3 分钟的瑜伽。MD 组报告每周 150 分钟的瑜伽量过多。两组干预组在 PTSD 和抑郁方面的得分均有显著下降，自我评估的健康状况也有所改善。MD 和 STC 组之间的抑郁评分（p=0.036）和悲伤强度（p=0.009）存在显著差异。LD 和 MD 组在干预后 PTSD 分别下降了 43%和 56%（对照组下降了 22%）。
这是第一项确定在线瑜伽干预对死胎后妇女的可行性和初步疗效的研究。未来的研究需要进行随机对照试验。
ClinicalTrials.gov。NCT02925481。注册于 2016 年 10 月 4 日。
