Development of a yoga module targeting cardiovascular health for patients with post-myocardial left ventricular dysfunction in India

Background: Yoga is known to contribute towards cardiovascular health. This paper describes the development of a need-based yoga program which is suitable to be integrated into the cardiac rehabilitation of post-myocardial infarction patients with left ventricular dysfunction. Materials and Methods: Based on the assessment of the need of the patients, literature review, and expert opinion, a yoga module was developed using the qualitative method of inquiry. The program included warm-up exercises, yogic asanas, pranayama, meditation and counseling sessions. A structured questionnaire eliciting comments on the contents was given independently to ten experts working in the field of health and yoga for validation. The final module was derived after incorporating the suggestions of the experts. Results: Using the raters' expertise in cardiology and yoga practice, the practices which constitute the module were optimized. Majority of the experts (raters) agreed with the duration of 1 h training for 1month under supervision as adequate for subsequent practice at home. There was a 0.786 inter-rater reliability estimated using the interclass coefficient (ICC) and 0.789 internal consistency of the questions, measured using Cronbach's alpha. Both values indicate "good" reliability and consistency of the yoga module.Conclusion: The developed yoga module was found to be acceptable. Future randomized control trials will be necessary to validate the effectiveness of this module and if the module demonstrates to be effective by clinical studies, it may add a therapeutic option in the rehabilitation of patients with heart failure following myocardial infarction, which can be applied in the hospitals and community level.