Yoga rehabilitation after PCI improves quality of life, not primary exercise capacity

A randomized trial of 200 adults with revascularized coronary artery disease found that yoga-based cardiac rehabilitation after percutaneous coronary intervention (PCI) improved several quality-of-life and psychological measures at six months, as well as self-reported physical activity. The study did not, however, find a statistically significant improvement in its primary endpoint of maximal exercise duration when all randomized participants were included in the analysis. The results support yoga-based rehabilitation as a complementary approach, while the absence of a significant primary-endpoint difference limits stronger conclusions about functional capacity.

The participants were adults who had recently undergone PCI for either acute or chronic coronary syndrome. They had a median age of 53 years, and 174 of the 200 participants were men. The researchers assigned 98 participants to a structured yoga-based cardiac rehabilitation program and 102 to standard care. The trial was prospectively registered with the Clinical Trials Registry of India as CTRI/2017/07/008951. Its primary endpoint was the change in exercise capacity at six months, measured as the maximum duration participants could tolerate on a treadmill test conducted with the Bruce protocol.

In the primary intention-to-treat analysis, median maximal exercise duration at six months was 7 minutes in the yoga-based rehabilitation group, compared with 6.32 minutes in the standard-care group. The difference was not statistically significant, with a reported p-value of 0.449. Thus, the randomized comparison did not establish that yoga-based rehabilitation was superior to standard care on the prespecified treadmill endpoint. A separate analysis restricted to participants compliant with the yoga intervention reported a statistically significant result at six months, with p=0.03, and the authors described this as suggesting better maximal exercise duration. The supplied medians for that analysis were 7.01 minutes in the yoga group and 7.12 minutes in the comparison group, however, so the numerical direction does not straightforwardly match that characterization. The per-protocol finding should therefore be interpreted cautiously, and the intention-to-treat result remains the principal assessment of the program’s overall effect.

Patient-reported outcomes showed a more consistent pattern of benefit. At six months, the yoga-based rehabilitation group had significantly higher scores in the physical-health and psychological-health domains of the WHO-BREF quality-of-life questionnaire, with p-values below 0.001, as well as in its environment domain, with p=0.007. Participants in that group also had lower anxiety scores, with p=0.002, and lower stress scores, with p=0.024. These measurements indicate improvements across several assessed aspects of quality of life and psychological status. They do not show that yoga reduced recurrent coronary events or other major cardiovascular outcomes.

Self-reported physical activity also differed substantially between groups. Measured with the International Physical Activity Questionnaire, median activity at six months was 1,697.5 METs in the yoga-based rehabilitation group and 500.25 METs in the standard-care group, with p below 0.001. Major adverse cardiovascular and cerebrovascular events were also key secondary outcomes, but the supplied results do not report a significant difference in their rates. Accordingly, the study supports the program for selected patient-centered outcomes while leaving its effect on the primary functional measure uncertain. The trial was limited to 200 adults assessed at a six-month primary endpoint, and the published findings do not establish whether the observed benefits generalize to other populations, settings or longer follow-up periods. Adherence emerged as a possible influence on treadmill performance, but the complier analysis requires caution because the overall randomized comparison did not show a significant advantage on that endpoint.

Subject of Research: Randomized trial of yoga-based cardiac rehabilitation after percutaneous coronary intervention

Article Title: Evaluating the functional impact of yoga-based cardiac rehabilitation following percutaneous coronary intervention

Article References: Sharma, G., Makkar, N., Mohanty, S., Gupta, A., Singh, U., Sharique, M., Singh, D., Naik, N., Haldar, P., & Seth, S. (2026). Evaluating the functional impact of yoga-based cardiac rehabilitation following percutaneous coronary intervention. BMC Medicine. https://doi.org/10.1186/s12916-026-05335-4

Image Credits: AI Generated

DOI: 10.1186/s12916-026-05335-4

Keywords: yoga, cardiac rehabilitation, percutaneous coronary intervention, randomized trial, quality of life, exercise capacity, physical activity, psychological outcomes, coronary artery disease, Evaluating, functional, impact