Mind-body-soul intervention: A cardiac surgical prehabilitation program.

Dear Editor,

Perioperative medicine encompasses a wide gamut of patient care dimensions ranging from preparation for surgery, intraoperative management, and assistance in postoperative recuperation. The dimensions are intricately linked, with the preoperative-rehabilitation or prehabilitation representing a lucrative domain with the objective of improving patient outcomes. The aforementioned fact becomes rather pertinent in the cardiac surgical setting considering the complexity of procedures, comorbid patient status, and co-existing frailty syndromes. Moreover, the relatively longer in-patient waiting time in cardiac surgical arena presents a colossal opportunity for the conduct of well-directed multi-pronged prehabilitation programmes aimed at aerobic conditioning, respiratory muscle training, lifestyle modifications, improved social functioning (psycho-education for anxiety amelioration and prevention of postoperative cognitive dysfunction), and spiritual healing.[1]

We describe our experience with a mind–body–soul intervention cardiac prehabilitation program carried out as Rajyoga meditation, training, and practice sessions. The word Rajyoga derives from the combination of Raja denoting king and yoga signifying the union of soul (spiritual energy) and the supreme soul (an ocean of spiritual energy).[2] This meditation has been recently envisaged as a “Heart Booster,” wherein it is being increasingly incorporated as an integral part of lifestyle modifications as an adjunctive tool to affect favorable modulations such as cessation of smoking, tobacco chewing, and associated control of blood pressure, cholesterol, and glucose levels.[3]

In our own series of evaluation of the prehabilitation program, we discovered a scientific proof of the conducive modulatory impact of Rajyoga meditation on postoperative anxiety and serum cortisol levels following coronary artery bypass grafting surgery.[4] In an earlier experience with an autogenic relaxation therapy, we outlined a beneficial impact on patients suffering from chronic headache syndromes with regards to the headache parameters and cortisol levels.[5] Our ongoing evaluation of the effect of Rajyoga meditation on the cognitive correlates in patients undergoing congenital cardiac surgery (employing visual analog scale for anxiety, happiness scale, and post-hospitalization behavior questionnaire) is being contemplated by a dedicated multidisciplinary team of cardiac anesthesiologists, physiotherapists, and trained Rajyoga teachers from Rajyoga education and research foundation of Brahma Kumaris World Spiritual University (BKWSU), a Non-Governmental Organization (NGO) that has a consultative status with United Nations Organization (UNO), United Nations Children’s Fund (UNICEF), and World Health Organization (WHO).[5]

To conclude, the prehabilitative programs can be conceptualized as stress diuretic sessions (akin to the diuretic treatment of heart failure) aimed at effective pre-emptive preparation of our patients in comprehending and mitigating the upcoming major surgical stress in the most efficient manner.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.