Date Presented 4/21/2018
We examined the impact of an 8-week yoga intervention on quality of life and fall risk factors for people with diabetes. All outcome measure scores significantly improved for participants randomized to the yoga intervention.
Primary Author and Speaker: Arlene Schmid
Additional Authors and Speakers: Matthew P. Malcolm, Karen E. Atler, Laura A. Grimm, Tara Klinedinst, Carol Chop
Contributing Authors: Jen Portz
PURPOSE: The purpose of this study was to assess the effects of a yoga intervention for people with Type 2 diabetes mellitus (T2DM) on quality of life (QoL) and fall risk factors compared with usual care. People with T2DM are more likely to fall than people without T2DM; thus, interventions to address fall risk factors must be developed and tested. Yoga interventions have been tested for people with T2DM but have focused on glycemic control and not on QoL or fall prevention. People with other chronic illnesses or disabilities have participated in yoga interventions and have consistently demonstrated improved QoL and outcomes related to falls, such as pain, balance, mobility, and strength.
METHOD: This study was a pilot randomized trial with participant allocation to 8 wk of yoga or usual care. Participants were recruited from a primary care pain clinic and were included if they self-reported chronic pain for ≥6 mo, age >18, no exercise restrictions, and no consistent yoga practice for the past year and consented to participate in the study. Data were collected before and after the 8-wk intervention. Participants were randomized to yoga or usual care after baseline assessments. The assessor was blinded. Participants self-reported demographics and falls in the past 6 mo and completed the Rand 36-item Short Form Survey to assess QoL. Fall risk factors were assessed with the Fullerton Advanced Balance Scale for balance, the 10-m walk for gait speed, the 6-min walk for endurance, and the chair-to-stand test for lower extremity strength.
The yoga intervention occurred over 8 wk and included physical postures, breath work, and meditation and relaxation. Yoga became progressively more challenging over the 8 wk, moving from all seated postures to include seated, standing, and supine postures. Participants in usual care did not receive any additional training or education. Both groups received monthly self-management education focused on health and wellness (e.g., smoking cessation, healthy eating).
Because of the small sample size, Mann–Whitney U tests were used to compare outcome measure data between the yoga and usual care groups. Wilcoxon signed-rank tests were used to compare outcome measure data between baseline and postintervention for both groups.
RESULTS: The average age of the 18 participants was 55 ± 10, 12 were female, and 10 had at least some college education; nine participants were randomized to each group. Half of the sample reported a fall in the past 6 mo, with no difference between groups. On average, the yoga group attended 10.3 ± 4.5 of the 16 sessions. The yoga group showed significant improvements in balance (14.2 ± 14.1 vs. 20.4 ± 13.5; p = .03, 44% ↑), upper extremity strength (7.7 ± 6.3 vs. 10.8 ± 6.5; p = .02, 40% ↑), lower extremity strength (4.1 ± 3.8 vs. 6.7 ± 4.8; p = .02, 64% ↑), and QoL scores (81.1 ± 7.7 vs. 91.9 ± 8.9; p = .04, 13% ↑). Balance scores became significantly worse during the 8 wk for the control group (27.1 ± 9.9 vs. 21.7 ± 13.4; p = .01, 20% ↓).
CONCLUSION: To our knowledge, this is the first intervention study addressing fall risk factors and fall prevention in the seemingly at-risk population of people with Type 2 diabetes mellitus. Data from this small RCT indicate that yoga may be therapeutic and may improve multiple outcomes in this population.
IMPACT STATEMENT: Yoga may be an intervention that positively impacts multiple important outcomes for people with T2DM. Occupational therapy practitioners may consider adding yoga to manage chronic health conditions such as T2DM. This intervention research directly addresses a chronic condition and prevention of falls.
References
Field, T. (2016). Yoga research review. Complementary Therapies in Clinical Practice, 24, 145–161. https://doi.org/10.1016/j.ctcp.2016.06.005
Schmid, A. A., Miller, K. K., Van Puymbroeck, M., & DeBaun-Sprague, E. (2014). Yoga leads to multiple physical improvements after stroke, a pilot study. Complementary Therapies in Clinical Practice, 22, 994–1000. https://doi.org/10.1016/j.ctim.2014.09.005
Schmid, A. A., Van Puymbroeck, M., Altenburger, P., Schalk, T., Miller, K., Damush, T., . . . Williams, L. (2012). Poststroke balance improves with yoga. Stroke, 43, 2402–2407. https://doi.org/10.1161/strokeaha.112.658211
Tilling, L. M., Darawil, K., & Britton, M. (2006). Falls as a complication of diabetes mellitus in older people. Journal of Diabetes and Its Complications, 20, 158–162. https://doi.org/10.1016/j.jdiacomp.2005.06.004
