July 26, 2012
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.
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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.
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 altered yoga postures, relaxation, and meditation. Classes grew more challenging each week.
Compared with patients in the usual-care group, those who finished 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,” stated 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 health-care 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 altered 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 easy 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 bigger 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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