Safety, feasibility and impact of a 12-week yoga program in adults Fontan patients: a pilot study

Background: Reduced exercise capacity and compromised pulmonary function are common findings following Fontan palliation. Although yoga practice has been associated with improved respiratory function in individuals with acquired heart disease, little is known about the potential impact in the Fontan population. Methods: We assessed the safety, feasibility, and efficacy of a 12-week in-person yoga program in adult Fontan patients. Participants with stable Fontan physiology and without limiting comorbidities were included. Study patients were encouraged to continue yoga practice regularly after study completion. Study outcomes included cardiopulmonary exercise testing (CPET) and pulmonary function testing (PFT). Comparisons were made within group (pre/post intervention) at 12 weeks and between group (study patients compared with non-intervention controls) at last follow-up. Results: Ten patients were enrolled and 5 completed the program. No adverse events were reported. There were no statistically significant changes in CPET or PFT measures after the 12-week intervention. At last follow-up [median 77 months (IQR 61-91)], delta forced vital capacity (FVC) differed between the yoga and usual care groups (-0.1L [-0.1, 0.2]) versus -0.2L [-0.4, -0.2], p = 0.032). There were no other significant between-group differences. Conclusions: A 12-week yoga program was well-tolerated in adult Fontan patients. While there was no apparent short-term improvement in CPET or PFT parameters, regular yoga practice may contribute to stabilization of FVC at longer term follow-up. Further studies are warranted to evaluate the clinical impact of yoga post Fontan palliation.