June 5, 2011 An Indiana University study that exposed older veterans with stroke to yoga produced promising results as researchers explore whether this popular mind-body practice can help stroke victims cope with their increased risk for painful and even deadly falls.
The pilot study involved 19 men and one woman, average age of 66. For eight weeks, they participated in a twice weekly hour-long group yoga class taught by a yoga therapist who dramatically modified the poses to meet the veterans' needs.
A range of balance items measured by the Berg Balance Scale and Fullerton Advance Balance Scale improved by 17 percent and 34 percent respectively by the end of the program. But equally exciting to lead researcher Arlene A. Schmid, rehabilitation research scientist at the Richard L. Roudebush VA Medical Center in Indianapolis, was the measurable gain in confidence the study participants had in their balance.
"It also was interesting to see how much the men liked it," said Schmid, assistant professor of occupational therapy in the School of Health and Rehabilitation Sciences at Indiana University-Purdue University Indianapolis. Many of the veterans wanted the study to continue or asked for a take-home exercise plan so they could continue the practice. "They enjoyed it so much partly because they weren't getting any other treatment. They had already completed their rehabilitation but felt there still was room for improvement."
Schmid discussed her findings at the American College of Sports Medicine meeting in Denver during her poster presentation, "Preliminary Evidence of Yoga on Balance and Endurance Outcomes for Veterans with Stroke" in the session for Fitness and Performance Testing for Posture, Stability and Balance.
Statistics concerning strokes and falls are grim, with studies showing that strokes can quadruple the risk of falling and greatly increase the risk of breaking a hip after a fall. An estimated 80 percent of people who have strokes will also have some degree of impaired balance.
The study participants performed poses initially while seated in chairs and then progressed to seated and standing poses. Eventually, they all performed poses on the floor, something Schmid considers significant because of a reluctance many older adults have to working on the floor.
"Everything was modified because we wanted them to be successful on day one," Schmid said. "Everyone could be successful at some level."
A score of less than 46 on the Berg Balance Scale indicates a fall risk. Schmid said the study participants on average began the study with a score of 40 and then improved to 47, moving them past the fall risk threshold. The study participants also showed significant improvements in endurance based on a seated two-minute step test and a six-minute walk test.
Schmid said research into therapeutic uses for yoga is "really taking off," particularly in mental health fields. Clinically, she has been watching a small trend of occupational therapists and physical therapists also becoming yoga therapists. The yoga performed in the study was modified to the extent that Schmid said it would be very difficult to find a comparable class offered publicly. Such a class should be taught by a yoga therapist who has had additional training in anatomy and physiology and how to work with people with disabilities. Schmid hopes to expand the study so she and her colleagues can explore whether such classes are effective on a larger scale.
The study was funded by the Department of Veterans Affairs, QUERI.
Study coauthors are Amanda N. Gerwig and Kristine K. Miller, IUPUI and Roudebush VAMC; Nancy Schalk, Heartland Yoga Community, Indianapolis; Marieke Van Puymbroek, IU Bloomington; Peter Alterburger and Tracy Dierks, IUPUI.
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