Efficacy of a 4-week yoga module on the sympatho-vagal balance among healthcare workers in a tertiary care hospital: a randomised controlled trial

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Occupational stress / Sympatho-vagal imbalance (n=108). Intervention: DIPAS yoga module vs. Medium-paced walking for 30 minutes, minimum 5 days per week. Primary outcome: Change in heart rate variability (HRV) after 4 weeks of intervention.

Anita Verma; Vartika Saxena; Bela Goyal; Apar Avinash Saoji; Yogesh Saxena

doi:10.1136/bmjsem-2024-002448

January 1, 2025BMJ Open Sport & Exercise MedicineOpen Access

Efficacy of a 4-week yoga module on the sympatho-vagal balance among healthcare workers in a tertiary care hospital: a randomised controlled trial

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Key result

Trial protocol evaluates a 4-week yoga module versus walking for improving heart rate variability.

n=108

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Why the study?

Healthcare workers in tertiary care hospitals face significant stress that may adversely impact sympatho-vagal balance, and yoga may influence autonomic nervous system function.

Does a 4-week yoga module improve sympatho-vagal balance, as measured by heart rate variability, in healthcare workers compared to medium-paced walking?

Key Points

To investigate the efficacy of a 4-week yoga module on sympatho-vagal balance and autonomic nervous system regulation among healthcare workers in a tertiary care hospital.
Randomized controlled trial involving 108 healthcare workers aged 19–60 years assigned to either a 4-week DIPAS yoga intervention group or a medium-paced walking control group (CTRI/2024/09/074132).
The primary outcome is the change in heart rate variability (HRV) measured via time-domain (R-R intervals, RMSSD, 30:15 ratio) and frequency-domain (LF, HF, LF/HF ratio) parameters using a 5-minute clean ECG signal from baseline to day 29.
Secondary outcomes assess immediate changes in state anxiety using the Spielberger State-Trait Anxiety Inventory and selective attention using the Six Letter Cancellation Task before and after sessions on days 1, 14, and 28.
As a study protocol, primary outcome evaluation will compare heart rate variability metrics between the yoga and walking groups using independent and paired t-tests alongside multivariate linear models adjusting for baseline covariates.
Secondary outcome assessments will track immediate pre- and post-intervention changes in state anxiety scores and letter cancellation task performance across both arms on days 1, 14, and 28.

Study Design

Type

RCT (n=108)

Randomization

1:1 allocation using a computer-generated random number sequence concealed in opaque and sealed envelopes

Multicenter

No

Structured PICO

Does a 4-week yoga module improve sympatho-vagal balance, as measured by heart rate variability, in healthcare workers compared to medium-paced walking?

P

Population

A planned randomized controlled trial of 108 healthcare workers aged 19-60 years to evaluate the efficacy of a 4-week yoga module on sympatho-vagal balance compared to a walking control group.

I

Intervention

DIPAS yoga module (30-min sessions comprising loosening exercises, asanas, breathing techniques, and meditative practices) practiced for a minimum of 5 days per week for 4 weeks.

C

Comparator

Medium-paced walking (3-6 km/hr, covering 1500-3000 metres in 30 min) practiced for a minimum of 5 days per week for 4 weeks.

O

Outcome

Change in heart rate variability (HRV), including time domain (R-R interval, RMSSD, 30:15 ratio) and frequency domain (LF, HF, LF/HF), assessed on day 0 and day 29.surrogate

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Implication

This study protocol describes an ongoing trial to determine if a 4-week structured yoga module improves sympatho-vagal balance and cardiovascular resilience in stressed healthcare workers.

Abstract

Healthcare workers (HCWs) actively involved in patient care at tertiary care hospitals face significant stress and workload, which may adversely impact their sympatho-vagal balance (SVB). Research has extensively investigated SVB using various techniques, such as heart rate variability (HRV). With its multifaceted approach, yoga has been suggested to influence autonomic nervous system function and, consequently, SVB. Thus, this study aims to investigate the efficacy of a 4-week yoga module on SVB among HCWs. This randomised controlled trial will involve 108 HCWs aged 19-60 years. Participants will be randomised to either (1) a yoga intervention group or (2) a medium-paced walking control group. The primary outcome is a change in HRV after 4 weeks of intervention. Secondary outcomes comprise immediate change in state anxiety, selective attention and HRV compared pre- and post-intervention on days 1, 14 and 28. Intention-to-treat and per-protocol analysis will be performed to gain a comprehensive understanding of the effects of intervention. Multivariate linear model will adjust covariates in baseline HRV data in both groups. Independent t-test will compare pre- and postdata on all outcomes between groups. Paired t-test will be used to compare pre- and postdata on all outcomes within the group. The study protocol is registered on the Clinical Trials Registry - India (CTRI) (CTRI/2024/09/074132).

Discussion

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Cite This Study

Verma et al. (2025) conducted an RCT in Occupational stress / Sympatho-vagal imbalance (n=108). DIPAS yoga module vs. Medium-paced walking for 30 minutes, minimum 5 days per week was evaluated on Change in heart rate variability (HRV) after 4 weeks of intervention. The efficacy of a 4-week DIPAS yoga module on sympatho-vagal balance compared to medium-paced walking is being investigated in this study protocol, and results are not yet available.

synapsesocial.com/papers/6a6a143d327391d1bb1a7a65 https://doi.org/10.1136/bmjsem-2024-002448

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Efficacy of a 4-week yoga module on the sympatho-vagal balance among healthcare workers in a tertiary care hospital: a randomised controlled trial

Figures

Key Points

Study Design

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Efficacy of a 4-week yoga module on the sympatho-vagal balance among healthcare workers in a tertiary care hospital: a randomised controlled trial

Figures

Key Points

Study Design

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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