Author ORCID Identifier

https://orcid.org/0000-0003-1015-6319

Semester

Summer

Date of Graduation

2026

Document Type

Dissertation

Degree Type

PhD

College

School of Medicine

Department

Exercise Physiology

Committee Chair

Bethany Barone Gibbs

Committee Member

Paul Chantler

Committee Member

Miriam Leary

Committee Member

Courtney Pilkerton

Committee Member

Sally Sherman

Abstract

Introduction: Cardiovascular disease (CVD) has been the number one cause of death worldwide and within the United States (US) for decades. Effective and practical prevention modalities are needed to reduce the burden of this often-preventable condition. Physical activity is an effective and modifiable behavior for CVD risk management; however, only one in four adults meet current physical activity guidelines. Some types of yoga, including vinyasa yoga, are a form of physical activity, and vinyasa yoga efficiently incorporates moderate-intensity aerobic activity, muscular-strengthening movements, and flexibility components. Yet, minimal rigorous research evaluates yoga’s effects on health. The purpose of this dissertation is to further understand valid CV assessments and the impact of yoga, specifically vinyasa yoga, on CV health.

Methods and Results: To determine the comparative validity and reliability of the Vicorder device for pulse wave analysis (PWA) assessment, the first project was a measurement study and included a single-session, randomized order design in 30 adults representative of a range of adult ages and both sexes. After participants completed a 10-minute supine rest, PWA was measured with the Vicorder (research measure; two assessments) and the SphygmoCor XCEL (criterion; single assessment) with a standardized movement break incorporated between assessments. The Vicorder produced highly reliable PWA metrics with mostly moderate validity, though agreement was lower suggesting measured values cannot be used interchangeably with the SphygmoCor XCEL device. For the second project, to understand the available evidence pertaining to the impact of yoga on subclinical CV outcomes, a systematic review with meta-analysis was conducted. Three databases were searched for experimental trials reporting outcomes from yoga interventions of at least four weeks in duration and including the physical poses of yoga. Outcomes considered were heart rate variability (HRV) and indicators of arterial stiffness. Yoga improved HRV and pulse pressure based on findings from pooled meta-analyses. Meta-analyses could not be conducted for other indicators of arterial stiffness due to less than two studies assessing and reporting those outcomes, highlighting a key gap for future research. The final project sought to determine the feasibility, acceptability, and preliminary efficacy of a 12-week remotely-delivered vinyasa yoga intervention. A pilot randomized controlled trial (RCT) was conducted in 30 adults with elevated or high blood pressure in a US sample from West Virginia between from July 2025-June 2026. The study demonstrated high feasibility based on recruitment, retention, and adherence. Participants evaluated the program as highly acceptable. Further, the intervention significantly improved many health-related components of fitness. Some other CV and self-reported psychological health and well-being outcomes provided preliminary evidence of small-to-moderate benefits (based on Cohen’s d) but were not statistically significant.

Conclusions: These investigations determined that the Vicorder is a useful device for PWA assessment in clinical research. Yoga generally benefitted HRV and pulse pressure in meta-analyses. Vinyasa yoga appears to be an acceptable form of physical activity for adults with high blood pressure and demonstrated preliminary efficacy for improving some aspects of health (e.g., physical fitness); however, changes in CV and most other health outcomes were not statistically different between the intervention and control groups. Still, these findings inform the design of future, larger trials of longer duration testing similar standardized yoga protocols to fully establish the health benefits of yoga.

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