Date Presented 4/7/2016
We examined the impact of the Merging Yoga and Occupational Therapy intervention on balance, balance confidence, and fall risk factor management for people with stroke. All outcome measures improved with significant changes in balance, balance confidence, and two risk factor management assessments.
Primary Author and Speaker: Arlene A. Schmid
Additional Speakers: Katie Hinsey, Ruby Bolster, Leslie Willis
Contributing Authors: Marieke Van Puymbroeck, Brian Tracy, Jennifer Portz
PURPOSE: To assess the change in balance, balance confidence, and fall risk factor management after an 8-wk intervention entitled Merging Yoga and Occupational Therapy (MY-OT).
BACKGROUND: Nearly 75% of people with a stroke report a poststroke fall, and to date, there are no effective fall prevention interventions for people with chronic stroke. Preliminary data show that (1) yoga improves balance and balance confidence but not fall risk factor management and (2) that group OT focused on fall prevention improves fall risk factor management but not balance or balance confidence. Thus, the yoga and OT interventions were merged for this study with the emphasis on improving balance, balance confidence, and fall risk factor management to reduce the risk of future falls.
DESIGN: Primary analyses of a noncontrolled pretest–posttest pilot study
PARTICIPANTS: Fourteen people with stroke completed the study. Inclusion criteria for participation: >6 mo; >59 yr old; falls history or current fear of falling; completion of stroke rehabilitation; ability to stand with or without assistive device; impaired balance with a score of <46 on the Berg Balance Scale (BBS); ability to speak English; score >4 out of 6 on the short Mini-Mental State Examination; commitment to attend 16 sessions.
METHOD: Outcome measure data were collected at baseline and after the 8-wk intervention. Measures included the BBS for balance; the Activities Balance Confidence scale (ABC) for balance confidence, and five fall risk factor management assessments (Falls Control Scale, Falls Management Scale, Fall Prevention and Management Questionnaire, Fall Management Behavior Questionnaire, and the Fall Prevention Strategy Survey).
Participants completed the MY-OT intervention that included an hour of group OT and an hour of yoga, twice a week for 8 wk. Yoga included modified physical postures, breathing exercises, and meditation. Group OT focused on behaviors and attitudes, activity, stroke effects, and the environment.
ANALYSIS: Normality of data was assessed; paired t tests (or Wilcoxon signed-rank tests as appropriate) were used to compare balance and 8-wk data.
RESULTS: Average age was 73 yr, 7 participants were female, and 98% were >1 yr poststroke. Multiple variables significantly improved: BBS scores (32.77 vs 42.66, p < .001), ABC (53.34 vs. 62.06, p = .036), Falls Management Behavior Questionnaire (32 vs 41.38, p = .001), and the Fall Prevention Strategies Survey (12.08 vs 17.15, p = .008). The three other fall risk factor management scores improved, but not significantly.
DISCUSSION: The results indicate that people with stroke benefited from the MY-OT study, with changes in physical balance, balance confidence, and fall risk factor management. Although further study is necessary because of the small sample size, preliminary results indicate that merging a holistic intervention, such as yoga, with group OT can improve physical, emotional, and cognitive variables in people with chronic stroke.
IMPACT STATEMENT: Merging yoga, a holistic mind–body intervention, with group OT can positively affect physical, emotional, and cognitive variables for people with chronic stroke and should be considered as a possible intervention.
