Mind-Body Help for People With Chronic Disease

by Ralph La Forge, MS on Apr 23, 2009

Mindful exercise programs—particularly yoga, tai chi and qigong—have played increasing roles in managing a number of chronic-disease states in recent years. By providing mindful exercise programs, wellness professionals can offer vital help in managing several chronic-disease states, including cardiovascular disease (CVD), diabetes and hypertension. “Mindful exercise” here denotes low- to moderate-level physical exercise coupled with a significant meditative/contemplative and breath work component. Wellness professionals should work only with clients whose disease course is stable (i.e., they have no unstable symptoms).

Appropriate Activities

Mindful activities that are helpful for clients with stable chronic disease share these characteristics:

  • They can be taught at relatively low intensity levels (e.g., 2–4 METs) and can be individualized.
  • They decrease real-time cognitive arousal (i.e., they calm the mind) and stress hormone activation.
  • They enhance proprioception (muscle sense) and kinesthesis.
  • They improve muscular strength, posture and balance.
  • They improve self-efficacy and confidence.

Mindful Exercise Guidelines

In general, mind-body teaching guidelines are very similar for CVD, diabetes and hypertension:

  • Be Schooled in the Fundamentals. If you aspire to work with clients who have chronic conditions, be sure you know and can follow current pre-exercise assessment and exercise training guidelines for those with medical conditions (ACSM 2006, AACVPR 2004).
  • Begin Gently. With clients who have stable CVD, type 2 diabetes or stage 1 hypertension (systolic blood pressure 140–160 mm Hg), begin with low-level (2- to 4-MET) mindful exercise forms that do not generate large and rapid increases in heart rate and blood pressure. Tai chi chuan, tai chi chih, restorative yoga and viniyoga are examples of suitable lower-level programs.
  • Progress Very Gradually. Bear in mind that energy expenditure costs relate directly to cardiorespiratory costs. Therefore, be very judicious in graduating the energy cost of the exercise, not only from session to session but also within each session.

Sidebar: Benefits of Mindful Exercise

Research indicates that hatha yoga and tai chi offer numerous health benefits. Here is just a sampling of the positive results that can occur:

  • lower resting systolic blood pressure
  • increased pulmonary function, e.g., FEV-1
  • lower resting respirations
  • enhanced arterial endothelial function
  • increased muscular strength and flexibility
  • increased balance control
  • improved posture
  • decreased fracture risk and falls in seniors
  • improved relaxation and psychological well-being
  • decreased state anxiety and depression scores
  • improved glucose tolerance
Source: La Forge 2003; Innes 2005.

For more information and a complete reference list, please see the full article in the April issue of IDEA Fitness Journal or read it online in the IDEA Library.

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About the Author

Ralph La Forge, MS

Ralph La Forge, MS IDEA Author/Presenter

Ralph La Forge, MS, is a physiologist and board-certified clinical lipid specialist. He is the managing director of the cholesterol disorder physician education program at Duke University Division of Endocrinology, Metabolism and Nutrition in Durham, North Carolina. He is also a physiologist at the U.S. Indian Health Service Division of Diabetes Treatment and Prevention in Albuquerque and Santa Fe NM. He is currently President of the American Council on Clinical Lipidology (National Lipid Association). He has multiple consulting agreements with biotech firms and health care organizations throughout North America.