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1- Islamic Azad University
2- 2- Rajaie Cardiovascular Medical and Research Center
Abstract:   (1268 Views)
Background: Cardiovascular disease is main reason for morbidity and mortality in developed countries and even developing. Upon estimate of World Health Organization, by 2030, deaths from cardiovascular disease will reach 23.6 million. Among CVD, Coronary artery disease is the most common cause of heart disease, especially in the elderly. The prevalent way for cardiovascular disease treatment, is coronary artery bypass graft surgery. Most of patients that experience this surgery, suffer from mood disorders. The surgery, in turn, has stress responses that Causing long-term admission, psychological disorders and reduces patient's compliance with the cardiac rehabilitation program. One of the pre-requisites for treatment is a cardiac rehabilitation, which reduces the risk of cardiac events and improves psychological disorders by physical exercise. But depression and anxiety are conditions that affect the patient's compliance with medical advice, including cardiac rehabilitation program. Therefore, since increase the popularity of yoga as a simultaneous treatment of mind-body, the present study was conducted to investigate the effect of long-term combined exercise (yoga-cardiac rehabilitation) on the levels of depression and anxiety of (CABG) patients. Because, despite the fact that there is a lot of documentation and evidence of the benefits and safety of yoga for chronic patients, but according to the latest data at the American Heart Association, at this point in time, we have no evidence of how we can combine yoga with the cardiac rehabilitation program.
Methods: The subjects of this semi-experimental study were twenty seven male patients (40- 75 years old) who had CABG surgery for at least one month. They were randomly assigned in control group (cardiac Rehabilitation training or CRT, n=13) and experimental group (Combined yoga- cardiac rehabilitation training or COMT, n=14). Entrance criteria include Ejection fraction more than 35%, no experience for Emergency artery bypass graft surgery, lack of  intense Illness and psychiatric disorders, lack of  motor disorders that prevent rehabilitation exercises, lack of yoga exercises experience and associated illness (renal failure, cancer, diabetes), The distance less than 200 km from cardiac rehabilitation center. The levels of depression and anxiety were evaluated by a Symptom Checklist-90-Revised (SCL-90-R) in two stages (before and after interventions). The results of the related studies indicated high reliability (correlation more than 0.9) and high reliability (correlation more than 0.7) especially in the field of depression. The CTR group performed cardiac rehabilitation program with 60-85% of maximum heart rate for 1 hour three days a week.The COMT group performed a yoga and cardiac rehabilitation for 1 hour three days a week (one session in between- 12 session rehabilitation training, 12 session yoga training). The subjects completed a training session at the cardiac Rehabilitation Center of Shahid Rajaie cardiovascular, medical and research center in Tehran for 8 weeks. For understanding yoga training intensity, we used a 20-point scale of Borg’s rate of perceived exertion. The optimal pressure sensation in these patients was considered based on the results of studies equal to 11-13. Subjects who stopped attending for any reason were excluded from the study (CRT group n=7 and COMT group n=7). Data analysis was done using SPSS (V.22) software (α=0.05). The distribution of data related to the variables of research was studied using Shapiro's test. Dependent t-test was used for intra-group comparisons and independent t-test was used for comparison between groups. 
Results: Our investigations show that there were not any different between depression(P=0.595) and anxiety (P=0.911)   levels in pre-test and depression(P=0.727) and anxiety (P=0.268) levels in post-test between two groups. Also we observed a significant reduction in depression (P=0.002) and anxiety (P=0.011) levels of patients with CABG surgery in CRT group, and also significant reduction in depression (P=0.006) and anxiety (P=0.047) levels of patients in COMT group for patients after CABG surgery.
Conclusion: Regarding the effectiveness of both COMT and CRT interventions in our study, cardiac rehabilitation centers can offer combined training model based on their facilities and patients desire after CABG surgery ( because of safety and low costs of yoga training).
     
Type of Study: Original Research Article | Subject: Psychology
Received: 2019/04/17 | Accepted: 2019/07/29

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