|LETTER TO EDITOR
|Year : 2022 | Volume
| Issue : 2 | Page : 148-150
Feasibility and acceptability of tele-yoga program in patients suffering from major noncommunicable disorders during COVID-19 pandemic
Akanksha Singh1, Reshma Pandurang Jogdand1, Sumana Venugopal2, Parameshwar Some1, Umashankar Ramchandra1, KS Nibedita1, Amit Kumar Singh1, Hemant Bhargav2, Raghuram Nagarathna3, Hongasandra Ramarao Nagendra4
1 Department of Yoga and Life Science, Arogyadhama, S-VYASA University, Bengaluru, Karnataka, India
2 Department of Integrative Medicine, NIMHANS, Bengaluru, Karnataka, India
3 Division of Life Sciences, S-VYASA University, Bengaluru, Karnataka, India
4 Department of Yoga and Life Science, S-VYASA University, Bengaluru, Karnataka, India
|Date of Submission||28-Feb-2022|
|Date of Acceptance||16-Jun-2022|
|Date of Web Publication||10-Nov-2022|
Dr. Hemant Bhargav
Department of Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Lakkasandra, Hosur Road, Bengaluru - 560 029, Karnataka
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Singh A, Jogdand RP, Venugopal S, Some P, Ramchandra U, Nibedita K S, Singh AK, Bhargav H, Nagarathna R, Nagendra HR. Feasibility and acceptability of tele-yoga program in patients suffering from major noncommunicable disorders during COVID-19 pandemic. J Appl Conscious Stud 2022;10:148-50
|How to cite this URL:|
Singh A, Jogdand RP, Venugopal S, Some P, Ramchandra U, Nibedita K S, Singh AK, Bhargav H, Nagarathna R, Nagendra HR. Feasibility and acceptability of tele-yoga program in patients suffering from major noncommunicable disorders during COVID-19 pandemic. J Appl Conscious Stud [serial online] 2022 [cited 2023 Feb 8];10:148-50. Available from: http://www.jacsonline.in/text.asp?2022/10/2/148/360864
Rapid urbanization and fast lifestyle have become important contributors to rapidly rising burden of noncommunicable diseases (NCDs) (Bhattacharya et al., 2020). The COVID-19 pandemic is still continuing after 2 years. This has significantly increased the burden on healthcare workers and hampered the primary care to the needy population in India. Reports suggest that those suffering from obesity, hypertension, type 2 diabetes mellitus, and other chronic NCDs such as cancer are at increased risk for COVID-19 infection and related complications (Kluge et al., 2020). Psychological stress is also an important contributor that hinders compliance with positive lifestyle changes and aggravates NCDs and their complications (Segerstrom and Miller, 2014).
During COVID times, telemedicine has emerged as an effective measure to overcome barriers and enhance access to healthcare services. Tele-yoga is an adapted version of yoga to suit the needs of social distancing during the current pandemic and has been applied successfully for stress reduction in India (Jasti et al., 2020). Tele-yoga can be a helpful tool in primary, secondary, and tertiary prevention of NCDs.
As a part of our clinical services, we have been offering tele-yoga services to patients from all over India and abroad. We performed a cross-sectional study that aimed at understanding the feasibility, adaptability, and acceptability of tele-yoga intervention in patients suffering from major NCDs. Out of 233 patients who were contacted, 123 (49 males, 74 females; i.e., 60% females) patients consented to take part in this study by filling up the online consent form at the baseline. The average age range of the subjects was 44.91 ± 12.88 years, and they belonged to the following states and union territories in India: Karnataka (42%), Telangana (11%), Tamil Nadu (6%), Maharashtra (6%), West Bengal (5%), Delhi (5%), Uttar Pradesh (4%), Odisha (4%), Andhra Pradesh (4%), Kerala (3%), Gujarat (2%), Meghalaya (1%), and Pondicherry (1%). Remaining 6% of the patients belonged to countries such as the United States of America (3%), the United Kingdom (1.5%), Singapore (1%), and Indonesia (0.5%).
The patients suffered from the following major NCDs: chronic low back pain (20%), type 2 diabetes mellitus (18%), hypertension (13%), chronic arthritis (12%), obesity (9%), hypothyroidism (8%), chronic respiratory disorders (8%), cardiac illnesses (4%), chronic neurological disorders (4%), and cancer (4%). Out of 123 patients included in this study, 107 (87%) had practiced yoga before. Sixty-three (51%) patients performed yoga under the supervision of a trained instructor, whereas 54 (44%) practiced on their own at home learning it from television, YouTube, and Internet [Table 1].
|Table 1: Overview of our findings on feasibility and acceptability of tele-yoga program in patients with major noncommunicable disorders|
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Before filling the survey form, patients practiced a tele-yoga program for stress management (which was modified to suit their needs as per the disease condition) for 4.52 ± 2.31 weeks. The patients attended this program in group sessions as per the major disorder they were suffering from. When patients were asked about their preference regarding group versus one-on-one session, 56% (n = 69) of them preferred group tele-yoga sessions and rest 44% (n = 54) preferred one-on-one sessions. Regarding their feedback on the most beneficial tele-yoga practices, patients reported the following in the order of preference: (i) 55% reported that all the components of tele-yoga were beneficial (i.e., Asanas, Pranayama, meditation, relaxation techniques, and philosophical discussions on yoga for managing stress), (ii) 14% of the patients found loosening practices to be most beneficial, (iii) Asanas including Suryanamaskara (11%), (iv) Pranayama (11%), (v) relaxation techniques and mediations (5%), and (vi) discussions on yoga philosophy (4%).
When asked about the difficulty level in learning yoga practices through tele-mode, 51% (n = 63) patients reported it to be very easy, 30% (n = 37) of them found it easy, and 14% (n = 17) of them found it to be slightly difficult. Only 5% (n = 6) of the patients reported that learning yoga through tele-mode was difficult. Regarding the number of supervised sessions required to learn the tele-yoga module completely, patients reported that, on an average, 12.16 ± 8.31 sessions are required.
Patients reported reduction in stress levels after an average of 4.52 ± 2.31 weeks of tele-yoga practice (average perceived stress scores reduced from 20.46 ± 6.88 at baseline to 15.28 ± 5.33; n = 123) after tele-yoga intervention (paired t-test, P < 0.01; effect size = 0.8). As compared to our previous study on healthy subjects (Jasti et al., 2020), we observed that patients suffering from NCDs had higher stress levels as compared to healthy subjects (average percieved stress scale: PSS score score on healthy subjects: 17.46 ± 6.97) at the baseline. Furthermore, the impact of tele-yoga program was higher on stress levels of patients as compared to healthy subjects as the effect size almost doubled from 0.43 in healthy (2) to 0.8 in patients with NCDs in the current study.
Patients also reported several other health benefits that included the following on a Likert scale of 1–10 (1 being the least and 10 being the best): (1) improvement in the quality of sleep (average rating of 6.91±2.45; n = 123), (2) improvement in quality of life (average rating of 7.5 ± 2.10; n = 123), and (3) improvement in energy levels (average rating of 8.5 ± 3.33, n = 123). In addition, 16 (13%) patients reported a reduction in pain killer use after the yoga practice, whereas one patient reported an increase (0.8%). When patients were asked to rate the overall usefulness of the tele-yoga program in reducing stress and improving well-being, the average rating was 8.22 ± 1.83; n = 123, suggesting that the tele-yoga program had good acceptability. In addition, 90% (n = 76) of patients reported that they would like to continue the yoga practice and make yoga a part of their lifestyle.
Regarding side effects of the tele-yoga program, 13 out 13 out of 123 patients (10.6%) reported that they observed some side effects due to tele-yoga program. Most commonly observed side effects for those involving musculoskeletal system were (1) muscle cramps and body pain (n = 9), (2) aggravation of low back pain (n = 3), (3) feeling tired during the practice (n = 2), and (4) knee sprain (n = 1). Other 110 (90%) of the patients reported no side effects at all.
To summarize, our preliminary research suggested that tele-yoga program can be a safe, feasible, and useful intervention for reducing stress levels and improving well-being in patients suffering from major NCDs [Table 1]. Future studies should test the efficacy of the tele-yoga program in this population using a randomized controlled design.
HB would like to acknowledge the Department of Science and Technology (DST), Government of India, for the financial support to this research through reference no. DST/005/504/2018/01112 under the Science and Technology of Yoga and Meditation (SATYAM) scheme to carry out this work. HB is also an Early Career Fellow funded by the Wellcome Trust DBT India Alliance.
Conflicts of interest
There are no conflicts of interest.
| References|| |
Bhattacharya, S., Juyal, R., Hossain, M. M., & Singh, A. (2020). Non-communicable diseases viewed as “collateral damage” of our decisions: Fixing accountabilities and finding solutions in primary care settings. Journal of Family Medicine and Primary Care, 9 (5)
Jasti, N., Bhargav, H., George, S., Varambally, S., & Gangadhar, B. N. (2020). Tele-yoga for stress management: Need of the hour during the COVID-19 pandemic and beyond? Asian Journal of Psychiatry, 54
Kluge, H. H. P., Wickramasinghe, K., Rippin, H. L., Mendes, R., Peters, D. H., Kontsevaya, A.,… Breda, J. (2020). Prevention and control of non-communicable diseases in the COVID-19 response. The Lancet, 395 (10238)
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