Authors’ Reply: Yoga—An Alternative form of Therapy in Patients with Blunt Chest Trauma: A Randomized Controlled Trial

Abstract

Quality of Life (QoL): It was measured using WHO BREF questionnaire which objectively measures the level of well-being of patients in the preceding 2 weeks. Higher the values of scores, better is the QoL. In our study, at baseline the physical component of QoL (p-QoL) was significantly less in the Yoga therapy group (YTP) (49.4 ± 16.91) compared to physiotherapy group (CTP) (55.6 ± 10.72) (p = 0.05) (Table 2) [1]. This was a chance finding as patients were randomly assigned to both the groups. At 4 weeks, there was increase in the scores of p-QoL and was 74.73 ± 9.99 in YTP group and 69.7 ± 14.08 in CTP group (p = 0.13) (Table 4) [1]. There was significant change in p-QoL score between baseline to 4 weeks in YTP (49.4 ± 16.91 vs 74.73 ± 9.99, p\\ 0.001). This suggests that the p-QoL which was significantly less in YTP group at baseline was nullified at 4 weeks duration. Hence, this difference suggests beneficial effects of the YTP. The use of generalized estimation equation (GEE) is particularly useful for estimating the relationship between independent variables and dependent variable if the outcome variable is measured repeatedly over a time period (Table 5) [1]. But we measured QoL only at baseline and at 4 weeks and expressed the values at baseline and at 4 weeks, and compared between two therapies; GEE was not calculated. Standard Chest physiotherapy group (CTP): Dedicated physiotherapists administered standard chest physiotherapy as per institutional protocol which includes incentive spirometry, active breathing exercises (diaphragmatic breathing and segmental breathing), percussion, vibration (manual), assisted coughing and mobilisation, in patients with isolated chest injuries. They also taught them these techniques for self-exercise. These exercises were carried out for about 30 min duration by the physiotherapists. We would like to further emphasize that in both the groups, same set of chest physiotherapy methods were used and Yoga was an additional therapy in YTP group. After discharge, the patients were advised to practice chest physiotherapy and Yogic exercises as applicable at home on daily basis and were reviewed at 1 week, 2 weeks, and at 4 weeks. Overall, the compliance of the patients was good based on assessment on follow-up physical visits but was not recorded in a diary.