Journal Article

Online mindfulness as a promising method to improve exercise capacity in heart disease: 12-month follow-up of a randomized controlled trial

Younge, John O., Gotink, Rinske A., van Rossum, Liesbeth F. C., Wery, Machteld F., Roos-Hesselink, Jolien W., Rizopoulos, Dimitris, Hunink, Myriam M. G., Utens, Elisabeth M. W. J., Michels, Michelle

2017

Overview

There is increasing evidence that mindfulness can reduce stress, and thereby affect other psychological and physiological outcomes as well. Earlier, we reported the direct 3-month results of an online modified mindfulness-based stress reduction training in patients with heart disease, and now we evaluate the effect at 12-month follow-up. 324 patients (mean age 43.2 years, 53.7% male) were randomized in a 2:1 ratio to additional 3-month online mindfulness training or to usual care alone. The primary outcome was exercise capacity measured with the 6 minute walk test (6MWT). Secondary outcomes were blood pressure, heart rate, respiratory rate, NT-proBNP, cortisol levels (scalp hair sample), mental and physical functioning (SF-36), anxiety and depression (HADS), perceived stress (PSS), and social support (PSSS12). Differences between groups on the repeated outcome measures were analyzed with linear mixed models. At 12-months follow-up, participants showed a trend significant improvement exercise capacity (6MWT: 17.9 meters, p = 0.055) compared to UC. Cohen's D showed significant but small improvement on exercise capacity (d = 0.22; 95%CI 0.05 to 0.39), systolic blood pressure (d = 0.19; 95%CI 0.03 to 0.36), mental functioning (d = 0.22; 95%CI 0.05 to 0.38) and depressive symptomatology (d = 0.18; 95%CI 0.02 to 0.35). All other outcome measures did not change statistically significantly. In the as-treated analysis, systolic blood pressure decreased significantly with 5.5 mmHg (p = 0.045; d = 0.23 (95%CI 0.05-0.41)). Online mindfulness training shows favorable albeit small long-term effects on exercise capacity, systolic blood pressure, mental functioning, and depressive symptomatology in patients with heart disease and might therefore be a beneficial addition to current clinical care. www.trialregister.nl NTR3453.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Accessibility / Adhesion / Adult / Adults / Age / Anxiety / Biology and Life Sciences / Blood / Blood Pressure / Breathing / Cardiology / Cardiomyopathy / Cardiovascular disease / Cardiovascular diseases / Care and treatment / Case-Control Studies / Chronic conditions / Clinical trials / Cognitive ability / Computer programs / Congestive heart failure / Coronary artery disease / Cortisol / Death / Emotions / Epidemiology / Exercise / Feasibility studies / Female / Guidelines / Hair / Health aspects / Health care / Heart diseases / Heart Diseases - physiopathology / Heart Diseases - psychology / Heart Rate / Humans / Hydrocortisone - analysis / Hypertension / Inflammation / Internet / Intervention / Laboratories / Long-term effects / Male / Measuring instruments / Medicine and Health Sciences / Mental depression / Mental disorders / Messages / Methods / Middle Aged / Mind body relationship / Mindfulness / Mindfulness meditation / Myocardial infarction / Online Systems / Pain / Patient education / Physical training / Physiological effects / Populations / Psychiatry / Psychology / Public health / Quality of life / Radiology / Respiration / Respiratory Rate / Risk factors / Social interactions / Social Sciences / Social Support / Statistical analysis / Stress / Stress management / Stress, Psychological / Stresses / Tension / Training