期刊论文详细信息
BMC Complementary and Alternative Medicine
Randomised controlled trial of a 12 week yoga intervention on negative affective states, cardiovascular and cognitive function in post-cardiac rehabilitation patients
Dennis Chang5  Ben Colagiuri1  Bianca Machliss2  Alan Bensoussan5  Birinder S Cheema5  A Robert Denniss4  Hosen Kiat3  Alan Yeung5 
[1] School of Psychology, University of Sydney, Sydney, Australia;Yoga Synergy, Sydney, Australia;Cardiac Health Institute, Eastwood, Australia;Departments of Cardiology, Westmead and Blacktown Hospitals, Sydney, Australia;National Institute of Complementary Medicine, School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia
关键词: Cardiac rehabilitation;    Depression;    Stress;    Anxiety;    Yoga;   
Others  :  1085856
DOI  :  10.1186/1472-6882-14-411
 received in 2014-05-28, accepted in 2014-10-15,  发布年份 2014
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【 摘 要 】

Background

Negative affective states such as anxiety, depression and stress are significant risk factors for cardiovascular disease, particularly in cardiac and post-cardiac rehabilitation populations.

Yoga is a balanced practice of physical exercise, breathing control and meditation that can reduce psychosocial symptoms as well as improve cardiovascular and cognitive function. It has the potential to positively affect multiple disease pathways and may prove to be a practical adjunct to cardiac rehabilitation in further reducing cardiac risk factors as well as improving self-efficacy and post-cardiac rehabilitation adherence to healthy lifestyle behaviours.

Method and design

This is a parallel arm, multi-centre, randomised controlled trial that will assess the outcomes of post- phase 2 cardiac rehabilitation patients assigned to a yoga intervention in comparison to a no-treatment wait-list control group. Participants randomised to the yoga group will engage in a 12 week yoga program comprising of two group based sessions and one self-administered home session each week. Group based sessions will be led by an experienced yoga instructor. This will involve teaching beginner students a hatha yoga sequence that incorporates asana (poses and postures), pranayama (breathing control) and meditation. The primary outcomes of this study are negative affective states of anxiety, depression and stress assessed using the Depression Anxiety Stress Scale. Secondary outcomes include measures of quality of life, and cardiovascular and cognitive function. The cardiovascular outcomes will include blood pressure, heart rate, heart rate variability, pulse wave velocity, carotid intima media thickness measurements, lipid/glucose profiles and C-reactive protein assays. Assessments will be conducted prior to (week 0), mid-way through (week 6) and following the intervention period (week 12) as well as at a four week follow-up (week 16).

Discussion

This study will determine the effect of yoga practice on negative affective states, cardiovascular and cognitive function in post-phase 2 cardiac rehabilitation patients. The findings may provide evidence to incorporate yoga into standardised cardiac rehabilitation programs as a practical adjunct to improve the management of psychosocial symptoms associated with cardiovascular events in addition to improving patients’ cognitive and cardiovascular functions.

Trial Registration

ACTRN12612000358842

【 授权许可】

   
2014 Yeung et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Cardiovascular diseases (CVDs): Fact sheet No 317. 2011 http://www.who.int/mediacentre/factsheets/fs317/en/index.html webcite
  • [2]Kessler RC, Angermeyer M, Anthony JC, DE GRAAF R, Demyttenaere K, Gasquet I, DE GIROLAMO G, Gluzman S, Gureje O, Haro JM: Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry 2007, 6(3):168.
  • [3]Vogelzangs N, Seldenrijk A, Beekman ATF, van Hout HPJ, de Jonge P, Penninx BWJH: Cardiovascular disease in persons with depressive and anxiety disorders. J Affect Disord 2010, 125(1–3):241-248.
  • [4]Fan AZ, Strine TW, Jiles R, Mokdad AH: Depression and anxiety associated with cardiovascular disease among persons aged 45 years and older in 38 states of the United States, 2006. Prev Med 2008, 46(5):445-450.
  • [5]Kolman L, Shin NM, Krishnan SM, Schwartz S, Gracik T, Jackson EA, Rubenfire M: Psychological distress in cardiac rehabilitation participants. J Cardiopulm Rehabil Prev 2011, 31(2):81.
  • [6]Milani RV, Lavie CJ: Impact of cardiac rehabilitation on depression and its associated mortality. Am J Med 2007, 120(9):799-806.
  • [7]Bonnet F, Irving K, Terra JL, Nony P, Berthez ne F, Moulin P: Anxiety and depression are associated with unhealthy lifestyle in patients at risk of cardiovascular disease. Atherosclerosis 2005, 178(2):339-344.
  • [8]Roest AM, Martens EJ, de Jonge P, Denollet J: Anxiety and risk of incident coronary heart disease: a meta-analysis. J Am Coll Cardiol 2010, 56(1):38-46.
  • [9]Dickens C, McGowan L, Percival C, Tomenson B, Cotter L, Heagerty A, Creed F: Contribution of depression and anxiety to impaired health-related quality of life following first myocardial infarction. Br J Psychiatry 2006, 189(4):367-372.
  • [10]Clark LA, Watson D: Theoretical and empirical issues in differentiating depression from anxiety. New Haven: Lawrence Erlbaum Associates Inc; 1991.
  • [11]Lovibond PF, Lovibond SH: The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther 1995, 33(3):335-343.
  • [12]Schwartz AR, Gerin W, Davidson KW, Pickering TG, Brosschot JF, Thayer JF, Christenfeld N, Linden W: Toward a causal model of cardiovascular responses to stress and the development of cardiovascular disease. Psychosom Med 2003, 65(1):22.
  • [13]Lavie CJ, Milani RV: Prevalence of anxiety in coronary patients with improvement following cardiac rehabilitation and exercise training. Am J Cardiol 2004, 93(3):336-339.
  • [14]Rozanski A, Blumenthal JA, Kaplan J: Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation 1999, 99(16):2192-2217.
  • [15]Martens EJ, de Jonge P, Na B, Cohen BE, Lett H, Whooley MA: Scared to death? Generalized anxiety disorder and cardiovascular events in patients with stable coronary heart disease: the heart and soul study. Arch Gen Psychiatry 2010, 67(7):750.
  • [16]Grippo AJ, Johnson AK: Stress, depression and cardiovascular dysregulation: a review of neurobiological mechanisms and the integration of research from preclinical disease models. Stress 2009, 12(1):1-21.
  • [17]Chrousos GP: Stress and disorders of the stress system. Nat Rev Endocrinol 2009, 5(7):374-381.
  • [18]Brotman DJ, Golden SH, Wittstein IS: The cardiovascular toll of stress. Lancet 2007, 370(9592):1089-1100.
  • [19]Benninghoven D, Kaduk A, Wiegand U, Specht T, Kunzendorf S, Jantschek G: Influence of anxiety on the course of heart disease after acute myocardial infarction–risk factor or protective function? Psychother Psychosom 2006, 75(1):56-61.
  • [20]Shen BJ, Myers HF, McCreary CP: Psychosocial predictors of cardiac rehabilitation quality-of-life outcomes. J Psychosom Res 2006, 60(1):3-11.
  • [21]Balady GJ, Williams MA, Ades PA, Bittner V, Comoss P, Foody JAM, Franklin B, Sanderson B, Southard D: Core components of cardiac rehabilitation/secondary prevention programs: 2007 update. A scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Prevention, and Nutrition, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation 2007, 115(20):2675-2682.
  • [22]Bunker S, McBurney H, Cox H, Jelinek M: Identifying participation rates at outpatient cardiac rehabilitation programs in Victoria, Australia. J Cardiopulm Rehabil Prev 1999, 19(6):334.
  • [23]Scott IA, Lindsay KA, Harden HE: Utilisation of outpatient cardiac rehabilitation in Queensland. Med J Aust 2003, 179(7):341-345.
  • [24]Pinto BM, Goldstein MG, Papandonatos GD, Farrell N, Tilkemeier P, Marcus BH, Todaro JF: Maintenance of exercise after phase II cardiac rehabilitation: a randomized controlled trial. Am J Prev Med 2011, 41(3):274-283.
  • [25]Bock BC, Carmona-Barros RE, Esler JL, Tilkemeier PL: Program participation and physical activity maintenance after cardiac rehabilitation. Behav Modif 2003, 27(1):37-53.
  • [26]Kovoor P, Lee AKY, Carrozzi F, Wiseman V, Byth K, Zecchin R, Dickson C, King M, Hall J, Ross DL: Return to full normal activities including work at two weeks after acute myocardial infarction. Am J Cardiol 2006, 97(7):952-958.
  • [27]La Forge R: Mind-body fitness: encouraging prospects for primary and secondary prevention. J Cardiovasc Nurs 1997, 11(3):53.
  • [28]Blumenthal JA, Emery CF, Madden DJ, George LK, Coleman RE, Riddle MW, McKee DC, Reasoner J, Williams RS: Cardiovascular and behavioral effects of aerobic exercise training in healthy older men and women. J Gerontol 1989, 44(5):M147.
  • [29]Smith C, Hancock H, Blake-Mortimer J, Eckert K: A randomised comparative trial of yoga and relaxation to reduce stress and anxiety. Complement Ther Med 2007, 15(2):77-83.
  • [30]Michalsen A, Grossman P, Acil A, Langhorst J, Lüdtke R, Esch T, Stefano GB, Dobos GJ: Rapid stress reduction and anxiolysis among distressed women as a consequence of a three-month intensive yoga program. Med Sci Monit 2005, 11(12):561.
  • [31]Uebelacker LA, Epstein-Lubow G, Gaudiano BA, Tremont G, Battle CL, Miller IW: Hatha yoga for depression: critical review of the evidence for efficacy, plausible mechanisms of action, and directions for future research. J Psychiatr Pract 2010, 16(1):22.
  • [32]Da Silva TL, Ravindran LN, Ravindran AV: Yoga in the treatment of mood and anxiety disorders: a review. Asian J Psychiatr 2009, 2(1):6-16.
  • [33]Chong C, Tsunaka M, Tsang H, Chan EP, Cheung WM: Effects of yoga on stress management in healthy adults: a systematic review. Altern Ther Health Med 2011, 17(1):32-38.
  • [34]Cramer H, Lauche R, Langhorst J, Dobos G: Yoga for depression: a systematic review and meta analysis. Depress Anxiety 2013, 30(11):1068-1083.
  • [35]Hartley L, Dyakova M, Holmes J, Clarke A, Lee MS, Ernst E, Rees K: Yoga for the primary prevention of cardiovascular disease. Cochrane Systematic Review 2014, 5:1-37.
  • [36]Cramer H, Lauche R, Haller H, Dobos G, Michalsen A: A systematic review of yoga for heart disease. Eur J Prev Cardio 2014, 0(00):1-12.
  • [37]Cramer H, Lauche R, Haller H, Steckhan N, Michalsen A, Dobos G: Effects of yoga on cardiovascular disease risk factors: a systematic review and meta-analysis. Int J Cardiol 2014, 173(2):170-183.
  • [38]Mahajan A, Reddy K, Sachdeva U: Lipid profile of coronary risk subjects following yogic lifestyle intervention. Indian Heart J 1999, 51(1):37.
  • [39]Michalsen A, Dob G: Beneficial effects of Iyengar yoga in patients with stress, stress-related disorders and cardiovascular risk-implications of recent research. Scientific Evidence on the Therapeutic Efficacy of Iyengar Yoga 2007, 14.
  • [40]Pullen PR, Nagamia SH, Mehta PK, Thompson WR, Benardot D, Hammoud R, Parrott JM, Sola S, Khan BV: Effects of yoga on inflammation and exercise capacity in patients with chronic heart failure. J Card Fail 2008, 14(5):407-413.
  • [41]Schmidt T, Wijga A, Von Zur MA, Brabant G, Wagner T: Changes in cardiovascular risk factors and hormones during a comprehensive residential three month kriya yoga training and vegetarian nutrition. Acta Physiol Scand Suppl 1997, 640:158.
  • [42]Vijayalakshmi P, Madanmohan BAB, Patil A, Babu K: Modulation of stress induced by isometric handgrip test in hypertensive patients following yogic relaxation training. Indian J Physiol Pharmacol 2004, 48(1):59-64.
  • [43]Manchanda S, Narang R, Reddy K, Sachdeva U, Prabhakaran D, Dharmanand S, Rajani M, Bijlani R: Retardation of coronary atherosclerosis with yoga lifestyle intervention. J Assoc Physicians India 2000, 48(7):687.
  • [44]Khattab K, Khattab AA, Ortak J, Richardt G, Bonnemeier H: Iyengar yoga increases cardiac parasympathetic nervous modulation among healthy yoga practitioners. Evid Based Complement Altern Med 2007, 4(4):511-518.
  • [45]Cheema BS, Houridis A, Busch L, Raschke-Cheema V, Melville GW, Marshall PW, Chang D, Machliss B, Lonsdale C, Bowman J: Effect of an office worksite-based yoga program on heart rate variability: outcomes of a randomized controlled trial. BMC Complement Altern Med 2013, 13(1):82.
  • [46]Borg-Olivier S, Machliss B: Applied Anatomy & Physiology of Yoga. Sydney: Yoga Synergy Pty Limited; 2007.
  • [47]Dahle CL, Jacobs BS, Raz N: Aging, vascular risk, and cognition: blood glucose, pulse pressure, and cognitive performance in healthy adults. Psychol Aging 2009, 24(1):154.
  • [48]Pase MP, Pipingas A, Kras M, Nolidin K, Gibbs AL, Wesnes KA, Scholey AB, Stough C: Healthy middle-aged individuals are vulnerable to cognitive deficits as a result of increased arterial stiffness. J Hypertens 2010, 28(8):1724.
  • [49]Grodstein F: Cardiovascular risk factors and cognitive function. Alzheimers Dement 2007, 3(2):S16-S22.
  • [50]Cohen RA, Moser DJ, Clark MM, Aloia MS, Cargill BR, Stefanik S, Albrecht A, Tilkemeier P, Forman DE: Neurocognitive functioning and improvement in quality of life following participation in cardiac rehabilitation. Am J Cardiol 1999, 83(9):1374-1378.
  • [51]Lovibond SH, Lovibond PF: Manual for the Depression Anxiety Stress Scales. Sydney: Psychology Foundation; 1995. [http://www.psy.unsw.edu.au/dass/ webcite]. ISBN 7334-1423-0
  • [52]Sivasankaran S, Pollard-Quintner S, Sachdeva R, Pugeda J, Hoq SM, Zarich SW: The effect of a six-week program of yoga and meditation on brachial artery reactivity: Do psychosocial interventions affect vascular tone? Clin Cardiol 2006, 29(9):393-398.
  • [53]Andrew MJ, Baker RA, Kneebone AC, Knight JL: Mood state as a predictor of neuropsychological deficits following cardiac surgery. J Psychosom Res 2000, 48(6):537-546.
  • [54]Lovibond S, Lovibond PF: Manual for the depression anxiety stress scales. Sydney: Psychology Foundation of Australia; 1996.
  • [55]Ware JE, Gandek B: Overview of the SF-36 health survey and the international quality of life assessment (IQOLA) project. J Clin Epidemiol 1998, 51(11):903-912.
  • [56]McHorney CA, War JE Jr, Lu JFR, Sherbourne CD: The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 1994, 32(1):40-66.
  • [57]Jette DU, Downing J: Health status of individuals entering a cardiac rehabilitation program as measured by the medical outcomes study 36-item short-form survey (SF-36). Phys Ther 1994, 74(6):521-527.
  • [58]Thayer JF, Yamamoto SS, Brosschot JF: The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. Int J Cardiol 2010, 141(2):122-131.
  • [59]Kleiger RE, Miller JP, Bigger JT Jr, Moss AJ: Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol 1987, 59(4):256-262.
  • [60]Tsuji H, Venditti FJ Jr, Manders ES, Evans JC, Larson MG, Feldman CL, Levy D: Reduced heart rate variability and mortality risk in an elderly cohort. The Framingham Heart Study. Circulation 1994, 90(2):878-883.
  • [61]Liao D, Carnethon M, Evans GW, Cascio WE, Heiss G: Lower heart rate variability is associated with the development of coronary heart disease in individuals with diabetes. Diabetes 2002, 51(12):3524-3531.
  • [62]Camm AJ, Pratt CM, Schwartz PJ, Al-Khalidi HR, Spyt MJ, Holroyde MJ, Karam R, Sonnenblick EH, Brum JMG: Mortality in patients after a recent myocardial infarction. Circulation 2004, 109(8):990-996.
  • [63]Carney RM, Freedland KE: Depression and heart rate variability in patients with coronary heart disease. Cleve Clin J Med 2009, 76(Suppl 2):S13-S17.
  • [64]Miu AC, Heilman RM, Miclea M: Reduced heart rate variability and vagal tone in anxiety: trait versus state, and the effects of autogenic training. Auton Neurosci 2009, 145(1):99-103.
  • [65]Camm AJ, Malik M, Bigger J, Breithardt G, Cerutti S, Cohen R, Coumel P, Fallen E, Kennedy H, Kleiger R: Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Circulation 1996, 93(5):1043-1065.
  • [66]Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, Pannier B, Vlachopoulos C, Wilkinson I, Struijker-Boudier H: Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006, 27(21):2588-2605.
  • [67]Boutouyrie P, Tropeano AI, Asmar R, Gautier I, Benetos A, Lacolley P, Laurent S: Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients. Hypertension 2002, 39(1):10-15.
  • [68]Cruickshank K, Riste L, Anderson SG, Wright JS, Dunn G, Gosling RG: Aortic pulse-wave velocity and its relationship to mortality in diabetes and glucose intolerance. Circulation 2002, 106(16):2085-2090.
  • [69]Mattace-Raso FUS, van der Cammen TJM, Hofman A, van Popele NM, Bos ML, Schalekamp MADH, Asmar R, Reneman RS, Hoeks APG, Breteler M: Arterial stiffness and risk of coronary heart disease and stroke. Circulation 2006, 113(5):657-663.
  • [70]Hansen TW, Staessen JA, Torp-Pedersen C, Rasmussen S, Thijs L, Ibsen H, Jeppesen J: Prognostic value of aortic pulse wave velocity as index of arterial stiffness in the general population. Circulation 2006, 113(5):664-670.
  • [71]Weber T, Ammer M, Rammer M, Adji A, O’Rourke MF, Wassertheurer S, Rosenkranz S, Eber B: Noninvasive determination of carotid-femoral pulse wave velocity depends critically on assessment of travel distance: a comparison with invasive measurement. J Hypertens 2009, 27(8):1624.
  • [72]Stein JH, Korcarz CE, Hurst RT, Lonn E, Kendall CB, Mohler ER, Najjar SS, Rembold CM, Post WS: Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force endorsed by the Society for Vascular Medicine. J Am Soc Echocardiogr 2008, 21(2):93-111.
  • [73]Touboul PJ, Hennerici M, Meairs S, Adams H, Amarenco P, Bornstein N, Csiba L, Desvarieux M, Ebrahim S, Fatar M: Mannheim carotid intima-media thickness consensus (2004–2006). Cerebrovasc Dis 2007, 23(1):75-80.
  • [74]Robertson CM, Fowkes FGR, Price JF: Carotid intima–media thickness and the prediction of vascular events. Vasc Med 2012, 17(4):239-248.
  • [75]Wesnes K, Ward T, McGinty A, Petrini O: The memory enhancing effects of a ginkgo biloba/panax ginseng combination in healthy middle-aged volunteers, Psychopharmacol.(Berl) 152 (2000). Full Text via CrossRef View Record in Scopus Cited By in Scopus 2000, 143:353-361.
  • [76]Sahakian B, Owen A: Computerized assessment in neuropsychiatry using CANTAB: discussion paper. J R Soc Med 1992, 85(7):399.
  • [77]Robbins T, James M, Owen A, Sahakian B, McInnes L, Rabbitt P: Cambridge Neuropsychological Test Automated Battery (CANTAB): a factor analytic study of a large sample of normal elderly volunteers. Dement Geriatr Cogn Disord 1994, 5(5):266-281.
  • [78]Simpson PM, Surmon D, Wesnes KA, Wilcock G: The cognitive drug research computerized assessment system for demented patients: a validation study. Int J Geriatr Psychiatry 1991, 6(2):95-102.
  • [79]Castelli WP, Garrison RJ, Wilson PWF, Abbott RD, Kalousdian S, Kannel WB: Incidence of coronary heart disease and lipoprotein cholesterol levels. JAMA 1986, 256(20):2835-2838.
  • [80]Williams KJ, Tabas I: The response-to-retention hypothesis of early atherogenesis. Arterioscler Thromb Vasc Biol 1995, 15(5):551-561.
  • [81]Glass CK, Witztum JL: Atherosclerosis: the road ahead review. Cell 2001, 104(4):503-516.
  • [82]Chapman MJ, Ginsberg HN, Amarenco P, Andreotti F, Borén J, Catapano AL, Descamps OS, Fisher E, Kovanen PT, Kuivenhoven JA: Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management. Eur Heart J 2011, 32(11):1345.
  • [83]Psaty BM, Anderson M, Kronmal RA, Tracy RP, Orchard T, Fried LP, Lumley T, Robbins J, Burke G, Newman AB: The association between lipid levels and the risks of incident myocardial infarction, stroke, and total mortality: The Cardiovascular Health Study. J Am Geriatr Soc 2004, 52(10):1639-1647.
  • [84]Laakso M: Cardiovascular disease in type 2 diabetes from population to man to mechanisms. Diabetes Care 2010, 33(2):442-449.
  • [85]Fuller JH, Shipley MJ, Rose G, Jarrett RJ, Keen H: Coronary-heart-disease risk and impaired glucose tolerance The Whitehall Study. Lancet 1980, 315(8183):1373-1376.
  • [86]Donahue R, Abbott R, Reed D, Yano K: Postchallenge glucose concentration and coronary heart disease in men of Japanese ancestry. Honolulu Heart Program. Diabetes 1987, 36(6):689-692.
  • [87]Singer D, Nathan D, Anderson K, Wilson P, Evans J: Association of HbA1c with prevalent cardiovascular disease in the original cohort of the Framingham Heart Study. Diabetes 1992, 41(2):202-208.
  • [88]Ridker PM, Hennekens CH, Buring JE, Rifai N: C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000, 342(12):836-843.
  • [89]Ridker PM, Rifai N, Stampfer MJ, Hennekens CH: Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men. Circulation 2000, 101(15):1767-1772.
  • [90]Blake GJ, Rifai N, Buring JE, Ridker PM: Blood pressure, C-reactive protein, and risk of future cardiovascular events. Circulation 2003, 108(24):2993-2999.
  • [91]Ridker PM, Rifai N, Rose L, Buring JE, Cook NR: Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med 2002, 347(20):1557-1565.
  • [92]Chase J-AD: Systematic review of physical activity intervention studies after cardiac rehabilitation. J Cardiovasc Nurs 2011, 26(5):351-358.
  • [93]Gupta R, Sanderson BK, Bittner V: Outcomes at one-year follow-up of women and men with coronary artery disease discharged from cardiac rehabilitation: what benefits are maintained? J Cardiopulm Rehabil Prev 2007, 27(1):11-18.
  • [94]Willich S, Müller-Nordhorn J, Kulig M, Binting S, Gohlke H, Hahmann H, Bestehorn K, Krobot K, Völler H: Cardiac risk factors, medication, and recurrent clinical events after acute coronary disease. A prospective cohort study. Eur Heart J 2001, 22(4):307-313.
  • [95]Boesch C, Myers J, Habersaat A, Ilarraza H, Kottman W, Dubach P: Maintenance of exercise capacity and physical activity patterns 2 years after cardiac rehabilitation. J Cardiopulm Rehabil Prev 2005, 25(1):14-21.
  • [96]Bittner V, Oberman A: Efficacy studies in coronary rehabilitation. Cardiol Clin 1993, 11(2):333-347.
  • [97]Ljubic MA, Deane FP, Zecchin RP, Denniss R: Motivation, psychological distress and exercise adherence following myocardial infarction. Aust J Rehabil Counsell 2006, 12(1):21.
  • [98]Kirkwood G, Rampes H, Tuffrey V, Richardson J, Pilkington K: Yoga for anxiety: a systematic review of the research evidence. Br J Sports Med 2005, 39(12):884-891.
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