June 29, 2011

Yoga for Stroke

Stroke patients with balance problems progressed from wheelchairs to standing poses.

In a pilot study from Indiana University, adding yoga to conventional stroke therapy helped patients recover better.

Patients improved both their balance and their endurance. But the researchers were just as impressed with the gain in confidence patients had in their balance after completing the yoga program.

Most yoga instructors have little experience at working with the disabled, and few therapists have training in yoga. But this is beginning to change.

An estimated 80% of people with strokes have impaired balance. Not only does make day to day life difficult, it can also greatly increase the risk of falling and breaking a hip. Studies have found that strokes can quadruple the risk of falls.

On two scales that measure balance, patient balance improved by 17% (Berg Scale) and 34% (Fullerton Scale) on average. The average score on the Berg Scale improved from 40 to 47. A score of less than 46 is considered to mean that a person is at risk of fall, so the yoga classes helped the patients pass beyond that threshold.

The patients also showed significant improvements in endurance, as measured by a two-minute step test and a six-minute walk test.

The study was of 20 veterans, average age 66, who had completed their stroke rehabilitation but felt they could still use additional help. They attended twice weekly hour-long classes taught by a yoga therapist who modified the yoga poses to take into account the patients' disabilities. The program lasted for eight weeks. Nineteen of the 20 participants were men.

Initially, the patients performed yoga poses while sitting in a chair. Later on, they progressed to standing poses and eventually performed poses while sitting on the floor, a location many older adults are reluctant to work from.

Patient reaction was enthusiastic. Many wanted the study to continue or asked for a take-home exercise plan so they could continue on their own. All patients had officially ended their rehabilitation before the yoga study, so they were getting no other treatment. But they knew they still needed to get better.

Right now, there's not much opportunity for stroke patients to attend such classes. Most yoga instructors have little experience at working with the disabled, and few therapists have training in yoga. But this is beginning to change. Yoga has become a much more mainstream medical practice in the last few years, and more occupational and physical therapists are becoming qualified yoga instructors and adding yoga to their repertoire.

Larger scale studies that could better demonstrate the usefulness of yoga in stroke recovery are now being planned.

"Preliminary Evidence of Yoga on Balance and Endurance Outcomes for Veterans with Stroke" was presented at the 2011 (58th) annual meeting of the American College of Sports Medicine on June 4, 2011. The meeting was held in Denver from May 31-June 4.

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