Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
We completed a pilot study of an 8-week Merging Yoga and Occupational Therapy for Parkinson's Disease program (MY-OT for PD). MY-OT for PD was a fall-risk self-management program that merged community-based yoga and group OT. Participants served as their own controls during the pilot study. During the intervention period (as compared with the control period), participants experienced reduced self-reported falls, improved fall management and prevention, and improved balance.
Primary Author and Speaker: Laura A. Swink
Contributing Authors: Brett Fling, Julia L. Sharp, Christine A. Fruhauf, Karen Atler, and Arlene Schmid
PURPOSE: To complete a pilot study to assess preliminary outcomes after the Merging Yoga and Occupational Therapy for Parkinson's Disease program (MY-OT for PD) program. MY-OT for PD was a 14-session program which merged a community-based yoga for PD program and group occupational therapy sessions focused on fall risk self-management.
DESIGN: We used a quasi-experimental repeated-measures design with participants serving as their own controls. Participants were recruited using convenience sampling and the following three main methods: presentation at a community adaptive yoga for PD program, presentation at a county PD support group, and flyers in the community. Participants met the following inclusion criteria: were at least 18 years old, had a self-reported diagnosis of PD, no severe cognitive impairment, could stand with or without a device, had transportation to the program/assessments, and agreed to pay $5 for each yoga class or receive a scholarship.
METHOD: Preliminary outcomes were collected at baseline (followed by an 8-week control period), pre-assessment (followed by the 8-week MY-OT for PD intervention period), and post-assessment (immediately after MY-OT for PD). Fall-risk management was assessed with five fall risk management scales (Falls Control Scale, Falls Management Scale, Fall Prevention and Management Questionnaire, Fall Management Behavior Questionnaire, and Fall Prevention Strategies Survey). Additionally, the Falls Efficacy Scale-International was used to measure concern about falling, and the Activities-Specific Balance Confidence scale assessed balance confidence. Balance was measured using the Mini Balance Evaluation Systems Test (Mini-BESTest). Weekly check-ins during the control and intervention periods were used to measure self-reported falls. We used linear mixed modelling to examine the differences in the preliminary outcomes between the control and intervention period changes.
RESULTS: Participants (n = 17) were on average 72 years old, and had been diagnosed with PD for 7 years. There were 4 fewer total falls during the intervention period (10 falls in the control period, 6 falls in the intervention period). Significantly greater improvements were seen during the intervention period, as compared to the control period, for one of the fall risk management scales (the Fall Prevention and Management Questionnaire, p = .02), and balance scores (MiniBEST, p < .01). Scores improved on all other outcomes measures following the MY-OT for PD program, but were not significant.
CONCLUSION: MY-OT for PD is a promising intervention that may reduce self-reported falls and improve fall risk management and balance. The program should continue to be adapted based on preliminary findings and manuals should be refined for future iterations.
IMPACT STATEMENT: Occupational therapists must consider their role in fall risk self-management, especially in high-risk populations like people with PD. MY-OT for PD is a standardized occupational therapist led program that reduced self-reported falls and improved balance.
References
Schmid, A. A., Van Puymbroeck, M., Portz, J. D., Atler, K. E., & Fruhauf, C. A. (2016). Merging Yoga and Occupational Therapy (MY-OT): A feasibility and pilot study. Complementary Therapies in Medicine, 28, 44-49. https://doi.org/10.1016/j.ctim.2016.08.003
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