Tele-yoga Program in COPD and Heart Failure

Tele-Yoga for Chronic Obstructive Pulmonary Disease and Heart Failure Patients: A Pilot Study

The combined diagnosis of chronic obstructive pulmonary disease (COPD) and heart failure (HF) is common but often missed because of similarities in clinical presentation, risk factors, and patient characteristics. The concurrent presence of both diseases worsens the limitations in exercise capacity and quality of life that patients experience with either disease alone. This pilot study will test the feasibility of a yoga program conducted in patients' homes using multi-point interactive videoconferencing ("Tele- Yoga") for patients with combined COPD/HF diagnoses. The investigators hypothesize that patients who receive a yoga program at home, compared to an educational control group, will experience fewer physical symptoms and better quality of life.

Inclusion Criteria:

• Patients with heart failure (HF) who also have COPD according to University of California San Francisco medical record documentation and would like to participate in a home yoga intervention and hospitalization within the past 24 months.
• Patients must: receive permission from their provider to participate in the study
• English-speaking
• Score of 3 on the Mini-Cog test
• Be between the ages of 40 and 85 years
• New York Heart Association Class I-III left ventricular systolic or diastolic HF
• Have moderate-severe COPD defined as post bronchodilator Forced Expiratory Volume (FEV1) in 1 sec < 80% predicted, FEV1/Forced Vital Capacity ratio < 70% and history of smoking
• TV, broadband internet connection, enough space to practice yoga in front of the TV, and willing to have research assistant install videoconferencing equipment.

Exclusion Criteria:

• Patients with a history of medication non-compliance as described by their provider
• Hospitalization within the last 3 months
• Myocardial infarction or recurrent angina within the last 6 months
• Severe stenotic valvular disease
• History of sudden cardiac death without subsequent automatic internal defibrillator placement
• Cognitive impairment
• Neuromuscular, orthopedic, or psychiatric illness that would interfere with yoga training
• Oxygen saturation <85% on 6 liters of nasal oxygen.