Predictors of and barriers to adherence in a 16-week randomised controlled trial of Bikram yoga in stressed and sedentary adults. (February 2019)

• Record Type: Journal Article
• Authors: Hewett, Zoe L.; Pumpa, Kate L.; Smith, Caroline A.; Fahey, Paul P.; Cheema, Birinder S.
• Is Part Of: Complementary therapies in medicine. Volume 42(2019)
• Page Start: 374
• Page End: 380
• Publication Date: 2019-02
• Subjects: ACT Australian Capital Territory -- AIx augmentation index -- BMI body mass index -- DASS-21 21-item Depression-Anxiety-Stress scale -- DXA dual-energy x-ray absorptiometry -- GSE General Self-Efficacy -- HF high frequency -- HDL high-density lipoprotein -- HRQoL health-related quality of life -- HRV heart rate variability -- hsCRP high-sensitivity c-reactive protein -- LF low frequency -- LDL low-density lipoprotein -- Ln natural logarithm -- PSS Perceived Stress Scale -- pNN50 proportion of the number of pairs of successive NN intervals that differ by 50ms divided by the total NN intervals -- RCT randomised controlled trial -- RMSSD root mean square of successive differences between adjacent NN intervals -- SDNN standard deviation of NN intervals -- SPSS Statistical Package for the Social Sciences -- TC total cholesterol; Hatha yoga -- Hot yoga -- Inactivity -- Health -- Compliance; Alternative medicine -- Periodicals; Complementary Therapies -- Periodicals; Médecines parallèles -- Périodiques; Thérapeutique -- Périodiques; Alternative medicine; Electronic journals; Periodicals; 615.5
• DOI: 10.1016/j.ctim.2018.12.015
• Languages: English
• ISSNs: 0965-2299

Abstract

Highlights: Average class attendance over 16 weeks was 54% of the minimum prescribed classes. Four participants (14%) met or exceeded the minimum requirement of 48 classes. Higher adherence was associated with older age, less pain, fewer physical limitations, poorer blood lipid profile, and higher HRV. Difficulty committing to the trial, lack of enjoyment and adverse events were barriers to adherence. Consideration of predictors of and barriers to adherence to Bikram yoga intervention is advised for future studies in this field. Abstract: Background: Bikram yoga may enhance health outcomes in healthy adults and those at risk for chronic disease, however, challenges remain in achieving optimal adherence to this practice. This study investigated factors influencing adherence to a 16-week Bikram yoga intervention in stressed and sedentary adults. Methods: Experimental group participants (n = 29) were instructed to attend 3–5 Bikram yoga classes weekly for 16 weeks. Baseline demographics, behaviours and health measures were investigated as predictors of adherence. Barriers were assessed via documentation of adverse events, and exit survey responses. Results: Participants (38.2 ± 10.1 years) were predominantly overweight-obese (83%), female (79%), and attended 27 ± 18 classes. Higher adherence was associated with older age ( p = 0.094), less pain ( p = 0.011), fewer physical limitations ( p = 0.011), poorer blood lipid profile, and higher heart rate variability (HRV; total power, ( p = 0.097)). In multi-variable analysis, three variables: age ( β = 0.492, p = 0.006), HRV ( β = 0.413, p = 0.021) and pain ( β = 0.329, p = 0.048) remained predictors of adherence. Difficulty committing to the trial, lack of enjoyment and adverse events were barriers to adherence. Conclusions: These findings should be considered in the development of future Bikram yoga trials to facilitate higher levels of adherence, which may enhance health outcomes and inform community practice. Future trials should investigate and address additional barriers and facilitators of Bikram yoga practice.