Laughter in Combination with Yoga Exercises: Changes in Psychological Distress and Quality of Life in Patients with Coronary Heart Disease (CHD)

The Open Psychology Journal 30 July 2020 DOI: 10.2174/1874350102013010144



Emotional distress (such as depression, anxiety, and stress) predisposes individuals to the risk of heart disease and impact on patient's prospective recovery period. Targeting those factors through psychological intervention can accelerate the healing process. Simulated laughter as a form of therapy in combination with yoga exercise and diaphragmatic breathing exercise may lead to mental and physical relaxation and elevate the quality of life.


This study aimed to measure any psychological distress changes (anxiety, depression, and stress) and simultaneously determine any alterations in the quality of life after intervening laughter-yoga therapy in CHD patients.


We conducted an experimental clinical trial which administered a pretest-posttest questionnaire. Also, collected data at a ten-session therapy while patients were referring to the rehabilitation program for their postoperative Coronary artery bypass grafting (CABG) at Tehran Heart Centre. Experimental Participants (N=150) and the control group (N=150) were selected by the convenient sampling method. Subjects participated in 45-minute Laughter Yoga(LY) sessions conducted by an instructor specialised in laughter yoga. A clinical psychologist administered the anxiety, stress, and depression scale (DASS) and Quality of Life Questionnaire (SF-36). We interpreted its eight subscales separately, such as measuring physical function, physical role, physical pain, general health, vitality, emotional role, mental health social function and quality of life.


Depression in the pretest group was 17.49, which degraded to 4.02 in the posttest; anxiety in the pretest test group was 17.44, which diminished to 4.20 in posttest; also, the mean of stress in the groups showed that in the trial group, the quantity degraded from 16.09 to 3.89. However, those values remained consistent in pre-posttest in the control group. Furthermore, the mean of the quality of life (QoL) in the experimental group was 227.2 in the pretest, which was 605.33 in the posttest, and significantly increased. Accordingly, the impact of laughter-yoga on physical function, physical role, physical pain, general health, vitality, emotional role, mental health, social performance is reported.


Current research has shown that coronary heart disease (CHD) patients suffer considerably from emotional disturbances (depression, anxiety and stress) accordingly decreased quality of life. Intervening the laughter-yoga treatment by alleviating psychological distress is positively helpful to heal CHD patients. Ultimately, suggestions for further research are offered.

Keywords: Laughter yoga, Psychological distress, Quality of life, Coronary heart disease, Emotional role, Mental health.
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