Effects of yoga on exercise capacity in patients with lymphangioleiomyomatosis: a nonrandomized controlled study

Xiangfeng Li,Yanli Yang,Lu Zhang,Yi Zu,Yu Li,Ying Xiang,Wenshuai Xu,Ling Chen,Wei Liu,Kai-Feng Xu,Lixia Chen,Yun Xiang

doi:10.1186/s13023-020-1344-6

Abstract

ObjectiveTo evaluate the effects of yoga on exercise capacity and quality of life in patients with lymphangioleiomyomatosis (LAM), a rare cystic lung disease in women.Patients and methodsThis was a nonrandomized, controlled study conducted in Beijing, China (August 27, 2017 – April 26, 2018). Twenty-six participants were allocated to the intervention (yoga) group (n = 13) or control group (n = 13). The yoga intervention involved a 24-week program of yoga class training for 90 min once a week and no fewer than 2 at-home sessions per week (at least 15 min per session). The 6-min walking distance (6MWD), lung function, serum vascular endothelial growth factor-D (VEGF-D) levels, quality of life, and symptoms of anxiety and depression were measured at baseline, 12-week and 24-week follow-up. An incremental cardiopulmonary exercise test was conducted at baseline and the 24-week follow-up.ResultsEleven patients completed the yoga training program. The yoga group exhibited improvements in the following outcomes versus those of the control group: 6MWD (+ 55 ± 29 m vs + 18 ± 49 m, P = 0.04), anaerobic threshold (3.4 ± 2.4 ml/min/kg vs 1.6 ± 1.4 ml/min/kg, P = 0.035) and peak work load (11.7 ± 14.6 W vs 0.2 ± 9.1 W, P = 0.027). There was no significant difference in peak oxygen consumption (VO2peak), lung function, VEGF-D level, and quality of life between the yoga and control groups. No adverse effects were found in the yoga group.ConclusionYoga is a feasible and safe intervention for pulmonary rehabilitation and potentially improves exercise capacity in patients with LAM.Trial registration(Clinical trial registration number at www.chictr.org.cn: ChiCTR-OON-1701274)

Highlights

Lymphangioleiomyomatosis (LAM) is a rare disease that typically occurs in females and is characterized as diffuse pulmonary cystic changes [1]
The yoga group exhibited improvements in the following outcomes versus those of the control group: 6-min walking distance (6MWD) (+ 55 ± 29 m vs + 18 ± 49 m, P = 0.04), anaerobic threshold (3.4 ± 2.4 ml/min/kg vs 1.6 ± 1.4 ml/min/kg, P = 0.035) and peak work load (11.7 ± 14.6 W vs 0.2 ± 9.1 W, P = 0.027)
There was no significant difference in peak oxygen consumption (VO2peak), lung function, vascular endothelial growth factor-D (VEGF-D) level, and quality of life between the yoga and control groups

Summary

Introduction

Lymphangioleiomyomatosis (LAM) is a rare disease that typically occurs in females and is characterized as diffuse pulmonary cystic changes [1]. LAM can be effectively treated with sirolimus (rapamycin), which slows disease progression [2]. Most LAM patients complain of reduced exercise capacity and impaired quality of life because of airflow obstruction, abnormal diffusion capacity, dynamic. Pulmonary rehabilitation consisting of a 24-week aerobic exercise and muscle strength training significantly improved endurance time, St. George Respiratory Questionnaire (SGRQ) scores, 6-min walking distance (6MWD), dyspnea and peak oxygen consumption (VO2peak) [4]. The current evidence suggests that yoga exercises have beneficial effects on improvements in lung function and exercise capacity and could be used as an adjunct pulmonary rehabilitation program in patients with chronic obstructive pulmonary disease (COPD) [5]. We aimed to assess the effects and safety of yoga on cardiopulmonary exercise tests, lung function, quality of life, dyspnea, anxiety and depression in LAM patients

Methods

Results

Conclusion