July 26, 2012
Study
Highlights:
- Group yoga can help patients’ balance improve long after a stroke.
- Yoga for chronic stroke patients appears to be cost effective and might help
them become more active.
DALLAS, July 26, 2012 — Group yoga can improve balance in stroke survivors
who no longer receive rehabilitative care, according to new research in the
American Heart Association journal
Stroke.
In a small pilot study, researchers tested the potential benefits of yoga
among chronic stroke survivors — those whose stroke occurred more than six
months earlier.
“For people with chronic stroke, something like yoga in a group environment
is cost effective and appears to improve motor function and balance,” said
Arlene Schmid, Ph.D., O.T.R., lead researcher and a rehabilitation research
scientist at Roudebush Veterans Administration-Medical Center and Indiana
University, Department of Occupational Therapy in Indianapolis, Ind.
The study’s 47 participants, about three-quarters of them male veterans,
were divided into three groups: twice-weekly group yoga for eight weeks; a
“yoga-plus” group, which met twice weekly and had a relaxation recording to use
at least three times a week; and a usual medical care group that did no
rehabilitation.
The yoga classes, taught by a registered yoga therapist, included modified
yoga postures, relaxation, and meditation. Classes grew more challenging each
week.
Compared with patients in the usual-care group, those who completed yoga or
yoga-plus significantly improved their balance.
Balance problems frequently last long after a
person suffers a stroke, and are related to greater
disability and a higher
risk of falls, researchers said.
Furthermore, survivors in the yoga groups had improved scores for
independence and quality of life and were less afraid of falling.
“For chronic stroke patients, even if they remain disabled, natural
recovery and acute rehabilitation therapy typically ends after six months, or
maybe a year,” said Schmid, who is also an assistant professor of occupational
therapy at Indiana University-Purdue University in Indianapolis and an
investigator at the Regenstrief Institute.
Improvements after the six-month window can take longer to occur, she said,
“but we know for a fact that the brain still can change. The problem is the
healthcare system is not necessarily willing to pay for that change. The study
demonstrated that with some assistance, even chronic stroke patients with
significant paralysis on one side can manage to do modified yoga poses.”
The oldest patient in the study was in his 90s. All participants had to be
able to stand on their own at the study’s outset.
Yoga may be more therapeutic than traditional exercise because the
combination of postures, breathing and meditation may produce different effects
than simple exercise, researchers said.
“However, stroke patients looking for such help might have a hard time
finding qualified yoga therapists to work with,” Schmid said. “Some occupational
and physical therapists are integrating yoga into their practice, even though
there’s scant evidence at this point to support its effectiveness.”
Researchers can draw only limited conclusions from the study because of its
small number of participants and lack of diversity. The study also didn’t have
enough participants to uncover differences between the yoga and control groups.
The scientists hope to conduct a larger study soon.
Researchers also noticed improvements in the mindset of patients about
their disability. The participants talked about walking through a grocery store
instead of using an assistive scooter, being able to take a shower and feeling
inspired to visit friends.
“It has to do with the confidence of being more mobile,” Schmid said.
Although they took time to unfold, “these were very meaningful changes in life
for people.”
Co-authors are Marieke Van Puymbroeck, Ph.D., C.T.R.S.; Peter A.
Altenburger, Ph.D., P.T.; Nancy L. Schalk, R.Y.T.; Tracy A. Dierks, Ph.D;
Kristine K. Miller, P.T.; Teresa M. Damush, Ph.D.; Dawn M. Bravata, M.D.; and
Linda S. Williams, M.D. Author disclosures are on the manuscript.
The VA Quality Enhancement Research Initiative (QUERI) funded the
research.
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