Eight weeks of properly guided mindfulness meditation can help overcome the fear of resuming physical activity and improve the quality of life in those who have had a heart attack. To signal the value of Mindfulness to improve the psychological and physical conditions of those who have recovered from severe cardiac ischemia, proposing its use in rehabilitation programs (with particular attention to the fear of being able to make physical efforts which greatly limits the recovery of good conditions) is a research conducted in Turkey, presented at the congress of the European Society of Cardiology (Esc) Acute CardioVascular Care 2021. The study was coordinated by Canan karadas Hacettepe University of Ankara and examined 56 subjects who had had a heart attack, with an average age of 55.
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In a completely random way, the participants in the research were divided into two groups: in one a Mindfulness path was proposed, in the other, a control group, a series of standard information visits. rehabilitation with an individual educational session on the structure and function of the heart, coronary arteries and cardiac pathologies. The meditation program began with a brief informative session on the technique and with an “application” session, under the supervision of the expert, lasting a quarter of an hour. In this first “lesson” they tried to sit comfortably in a chair with their back straight and their eyes closed and then learn to breathe deeply – inhaling through the nose and exhaling through the mouth using the diaphragm – bringing the concentration right on their breath and on the present moment, to clear the field of anxieties and worries.
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Then, the same instructions of the trainers were sent through simple messages on the smartphone, with the commitment to repeat the exercises every day, always for 15 minutes. The “motivation” for treatment was reinforced through further messages and direct telephone contacts. Feeling of fatigue, fear of moving and quality of life were checked after 4, 8 and 12 weeks through specific tests, such as the Piper Fatigue Scale and the Tampa Scale for Kinesiophobia Heart questionnaire.
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In addition, the subjects included in the research were subjected to the MacNew Heart Disease Health-Related Quality of Life questionnaire, specific for the evaluation of the feelings created in patients regarding the impact of heart disease on daily life on the physical, psychological and social front. The first positive data were observed already at the first appointment, after four weeks of “treatment”, compared to what was observed in the control group, and were maintained and amplified in the 8 and 12 week surveys. In general terms, the quality of life was markedly better after eight weeks and the emotional “structure” of the subjects was stronger at the twelfth week. all this, it must be said, without significant changes in the two groups in terms of the response to physical fatigue. According to study author Karadas, “research shows that awareness can reduce fear of movement and improve the quality of life in heart attack survivors, with effects that extend beyond the completion of the surgery.”
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On the front of the hypotheses relating to the mechanism of action on the quality of life, one hypothesis points to the fact that with meditation positive thoughts tend to take the place of the negative vision linked to the previous heart attack. This would lead to patients feeling less emotionally and physically vulnerable. But, regardless of the working hypothesis, the study confirms how the use of non-pharmacological treatments may have an important value for the rehabilitation process of heart patients. “It is fascinating to discover how non-pharmacological therapies such as meditation constitute at least an added value to traditional medical therapies – he explains Maurizio Bussotti, head of the Rehabilitation Cardiology Unit of the Irccs Maugeri Institute in Milan – for those who work in a rehabilitation context this is known. Physical therapy and psychological support are fundamental elements for recovery after acute morbid events “.
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An event such as a heart attack or cardiac surgery, or the discovery of being affected by chronic disabling and progressive diseases such as heart failure or pulmonary hypertension, are in fact and almost inevitably the cause of anxiety and depression. We are afraid that at any moment some new unfortunate event may happen, we discover ourselves vulnerable, we are afraid in facing the normality of everyday life. “Patients’ working life, emotional life and social life are compromised. It is for this reason – continues Bussetti – that psychological intervention is recognized as fundamental by all the guidelines of the main cardiovascular diseases, moreover with high levels of scientific evidence. Mindfulness, which draws heavily on Buddhist meditation and yoga techniques, is now an integral part of cognitive-behavioral psychotherapy. In our experience, in the context of cardiorespiratory rehabilitation, we have been using a type of therapeutic program for years, that we could define holistic, because it is a synthesis of physical physiotherapy, of muscle relaxation exercises derived from Mindfulness and of breath control exercises derived from yoga. Activities that allow the patient to focus his attention on the here and now, on the present moment, abandoning the many worries and fears about the future muscle xing and slowing of respiratory activity lower the level of anxiety, resulting in an improvement in the quality of life “.
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