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Originally appeared in the OT Magazine March/April 2019 (Yoga and Parkinson’s)

Laura Swink, a PhD student at Colorado State University, has completed her occupational therapy research study – an exploration of how yoga can help reduce the risk of falls in patients with Parkinson’s disease.

In collaboration with a local athletics club in the neighbouring Fort Collins, Swink combined her academic practice of occupational therapy with the holistic practice of yoga on patients with the disease.

Her research study follows a similar one conducted by her doctorial advisor, Arlene Schmid, who in 2014 undertook research on the impact of a combination of yoga and occupational therapy on patients who had experienced a stroke. This study also highlighted how the combination of factors garnered a positive result and reduced the risk of falls.

Speaking to the university’s newspaper, Swink said: “My advisor, Dr. Schmid, first developed the Merging Yoga and Occupational Therapy (MY-OT) program—a fall risk self-management program for individuals with chronic stroke. She had discovered that yoga improved balance (but not fall risk factor management), and group occupational therapy improved fall risk factor management (but not balance).

“I developed the MY-OT intervention for stroke and [Swink] then worked with experts and people with Parkinson’s to modify it to be more appropriate for people with Parkinson’s disease,” Schmid told The Collegian.

After assessing potential volunteers for the study in August 2018, she began the intervention in October 2018, having participants undertake an hour of yoga and an hour of group occupational therapy twice a week for eight weeks in a conference room donated by the owner of the Raintree Athletic Club, which easily facilitated the move from yoga class to occupational therapy.

“In the yoga part, Jennifer Atkins led the class through guided breath work and graded postures from seated, standing and supine positions,” Swink told the Collegian. “I am a registered occupational therapist and I designed the occupational therapy part to include some lecture, discussion and activities to help identify and manage risk fall factors.”

Swink hopes that the results of the study – which she has now begun to analyse – will help alleviate what she calls the “devastating consequences” of falls in Parkinson’s patients, while helping to improve patients’ quality of life.

“What I can share is that participants loved the social component of the program and were very motivated to help each other and share insight on what they have changed to reduce fall risk,” she told the Collegian.

Swink is one of many to tackle Parkinson’s with yoga. In 2012, Kaitlyn P. Roland completed her doctorial research at the University of British Columbia in Canada, which saw her measure changes in daily muscle activity and consequences for physical function and frailty.

In a blog post she wrote for the Michael J Fox Foundation for Parkinson’s Research, she detailed how the different aspect of yoga can help improve different areas of effect regarding the disease. While yoga, she writes, has become synonymous with the act of holding a static pose and performing controlled breathing – called asanas in yoga terminology – that is only one aspect of a larger yoga framework, which also includes aspects of spirituality, chanting, and philosophy.

Roland notes that, at time of writing, a number of studies examining how yoga can help those with Parkinson’s, which focus on a number of key areas.

“The issue of mobility has important implications for falls in PD [Parkinson’s disease]. Yoga participation can improve functional mobility and how a person with PD walks. Standing yoga poses target the hip extensor, knee extensor and ankle plantar flexor, which support center-of-mass during walking and may improve overall stability,” she writes.

She calls balance training, which is a necessary component of the study of yoga, important in therapeutic approaches to Parkinson’s, as per the studies, 40% of nursing home admissions are preceded by a fall. While yoga not only improves balance as a whole, it also reduces the fear of falling, which is vitally important in keeping people with Parkinson’s disease active both in terms of their health and within their community.

Yoga can also assist greatly in strength training and the improvement of postural stability. Yoga, she writes, requires isometric contraction of one muscle group to stabilise the body when performing the postures associated with the activity, and might also mimic isokinetic contractions when moving from one pose to another, which is the principle behind yoga improving strength and control within the body.

The most obvious benefit of yoga is flexibility: it relies on an extremely full range of motion, which combats rigidity in those with Parkinson’s. Not only that, but yoga is a terrific intervention for the stooped posture which is traditionally associated with the disease due to its work on the hip, spine and shoulders: studies show an increase in spinal flexibility, a more upright posture, and greater hip movements which may help with those who walk with a shuffling gait.

Roland also writes: “The psychosocial benefits associated with yoga are important for disease management, as they are not often addressed with conventional dopaminergic therapy. Yoga can offer group support, improved confidence and self-efficacy. The calming effect of yoga (by enhancing parasympathetic output) may lessen perceived stress, enhance relaxation, and benefit sleep in PD.”

With both these points and the future outcome of Swink’s study in mind, yoga could prove to be an ideal intervention for not only improving the overall health of patients with Parkinson’s, but for instilling a sense of confidence within those who live with the disease. For many with Parkinson’s, the fear of falling is a significant hinderance to their daily lives, preventing them from taking part in activities within their communities and remaining in the best of health.

By implementing strategies which can improve balance and remove fear of falling through a combination of occupational therapy and yoga, patients with Parkinson’s disease could be able to live fuller, happier and ultimately healthier lives through the power of holistic intervention.

The OT Magazine

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