Publications
Integrating Chair Yoga and Manual Therapy Into Hypertension Management: Effects on Autonomic Regulation, Muscle Viscoelasticity, and Mental Well-Being
Authors: Ebru Kaya Mutlu 1, Aybike Senel 2, Meltem Besim Atakan 3, Tansu Birinci Olgun 4, Canan Demir 1, Rustem Mustafaoglu 5, Ahmet Akgul 6
Affiliations:
- Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Bandirma Onyedi Eylul University, Balikesir, Turkiye
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Amasya University, Amasya, Turkiye
- Department of Physiotherapy and Rehabilitation, Institute of Graduate Studies, Istanbul University-Cerrahpasa, Istanbul, Turkiye
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkiye
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkiye
- Department of Gerontology, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkiye
Journal: The Journal of Clinical Hypertension - July 2026, Volume 28, Issue 7, Article no. e70329 (DOI: 10.1111/jch.70329)
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Field & Applications:
- Medical
- Treatment evaluation
- Complementary and Alternative Medicine
- Physiotherapy
- Gerontology / Ageing
Myoton Clarification Note: A Guide to Interpreting the Inverse Relationship Between Logarithmic Decrement and Tissue Elasticity
Hypertension (HT) is a common chronic condition linked to increased cardiovascular risk, reduced functional capacity, altered muscle properties, and impaired psychosocial well-being. Therefore, this study aimed to compare the 12-week effects of chair-based yoga and manual therapy on cardiovascular, functional, musculoskeletal, and psychosocial outcomes in individuals with HT.
This single-blinded, randomized controlled trial included 75 participants (48 females) who were randomly allocated to three groups: Group I (Patient Education–PE), Group II (PE+Chair Yoga), and Group III (PE+Manual Therapy). Interventions were conducted twice weekly for 45 min over 12 weeks. Outcome measures included systolic and diastolic blood pressure (SBP/DBP), heart rate (HR), the 6-Minute Walk Test, muscle tone and stiffness (Myoton PRO), anxiety and depression, and mental well-being.
Both Group II and Group III led to significant within-group reductions in SBP (p = 0.02 and p = 0.03, respectively) and HR (p = 0.04 and p = 0.02, respectively), with significant group-by-time interactions favoring Groups II and III over Group I. Functional capacity improved significantly in Groups II and III compared to Group I (p = 0.04). Group III specifically demonstrated significant reductions in muscle tone (p = 0.03) and stiffness (p = 0.04). Group II showed superior improvements in anxiety scores (p = 0.04) and mental well-being compared to other groups.
Chair-based yoga and manual therapy are effective non-pharmacological strategies for enhancing autonomic regulation and reducing blood pressure in hypertensive patients. While both interventions improve cardiovascular and functional parameters, manual therapy is more effective for modulating muscle viscoelastic properties. In contrast, chair yoga provides greater benefits for psychosocial well-being and anxiety reduction.
In conclusion, both 12-week chair-based yoga and manual therapy programs are effective in reducing systolic blood pressure and heart rate while enhancing functional capacity. By targeting both the physiological (muscle viscoelasticity) and psychological (anxiety and well-being) components of the condition, these interventions offer a holistic approach to HT management. Given their high patient satisfaction and safety profile, these modalities should be considered as viable components of comprehensive cardiovascular rehabilitation and lifestyle modification programs.