Intradialytic yoga-based breathing and relaxation to improve anxiety, depression, and quality of life: A pilot feasibility study

ABSTRACT

Background: In-center hemodialysis patients have high rates of depression and anxiety. Pharmacologic interventions to ameliorate psychological burdens have proven to be limited in efficacy. Alternative therapies are increasingly used for those with chronic disease. A small number of studies have looked at the impact of meditation and yoga to improve symptoms of anxiety and depression and to promote a better quality of life. The aim of this study was to test the feasibility of implementing a chairside intradialytic yogabased breathing and relaxation technique. A secondary goal was assessing the efficacy of such an intervention. Methods: Eligible subjects were patients with a below average score on the Mental Component Summary (MCS) of a previously completed Kidney Disease Quality of Life (KDQOL-36) survey. Following consent, each subject was provided with an MP3 player, pre-loaded with a 12-minute recording of a specific yogic breathing and relaxation exercise, the Three-Part Breath. The intervention consisted of listening to the recording at each dialysis treatment over a 12-treatment period. Subjects completed a KDQOL-36 survey both at the start and the end of the study. A Likert scale to measure anxiety was completed at each dialysis treatment both pre-and post-intervention. Results: 11 subjects were enrolled over a 10-month period in 2020;10 completed the study. As measured by the Likert scale, anxiety was significantly reduced after listening to the recording. Notably, there was a larger reduction in anxiety on a per treatment basis in the period after the start of the Covid-19 pandemic compared to the pre-pandemic period. Over the study period, there was a significant improvement in the scores of the Effects of Kidney Disease on Quality of Life component of the KDQOL-36, and a trend toward significant improvement in the Mental Component Summary scores. Conclusions: A chairside intradialytic breathing and relaxation program can be integrated into a dialysis treatment session. The study demonstrates an improvement in scores related to anxiety, depression, and measures of quality of life. Larger and randomized trials using this intervention are needed to better understand its benefits and adverse effects, as well as the obstacles to large scale implementation.