Perceived benefits and barriers to yoga participation after stroke: A focus group approach

Effects of mind-body exercise on physical and psychosocial well-being of stroke patients: A systematic review and network meta-analysis

This study conducted pairwise and network meta-analysis to evaluate the effectiveness of three mind-body exercise interventions (Tai Chi, Qigong, and yoga) on physical capacity, psychological well-being, and quality of life in stroke patients. The research encompassed 30 studies involving 2107 participants and utilized the Risk of Bias 2.0 tool for quality assessment. Pairwise analysis revealed that all three mind-body exercises significantly enhanced patients' quality of life. Tai Chi demonstrated the most comprehensive improvements in balance, limb motor function, activities of daily living, and depression. Network meta-analysis indicated that Qigong was the most effective in improving balance and quality of life for post-stroke patients, followed by Tai Chi. These findings underscore the positive impact of mind-body exercises on both physical and psychosocial outcomes in stroke patients. However, further research involving rigorously designed and adequately powered trials is necessary to enhance the level of evidence in this area.

Complementary Health Approaches and Integrative Health in Occupational Therapy

This AOTA Position Statement describes the use of complementary and integrative health approaches in occupational therapy practice and presents ethical and pragmatic matters, including diversity, equity, inclusion, cultural humility, continuing competence, standards of practice, and supporting evidence.

The Feasibility and Benefits of a Virtual Yoga Practice for Stroke Survivors With Aphasia

PURPOSE

The purpose of this study was to (a) examine the feasibility of a virtual, adapted, aphasia-friendly yoga program for people with aphasia; (b) evaluate evidence of improvement in patient-reported outcomes and word retrieval; (c) explore the immediate impact of a yoga session on participant subjective emotional state; and (d) assess participant motivation and perceived benefits of participating in a yoga program.

METHOD

This feasibility study employed a mixed-method design to document the feasibility of a virtual, 8-week adapted yoga program. A pre-/posttreatment design was used to assess patient-reported outcome measures for resilience, stress, sleep, and pain, as well as word-finding abilities. Semistructured interviews with participants were thematically analyzed to provide insight into participants' motivation and perceptions regarding their experience.

RESULTS

Comparisons of pre- and postprogram group means suggest that participation in an 8-week adapted yoga program may positively impact perceptions of resilience (large effect), stress (medium effect), sleep disturbance (medium effect), and pain (small effect) for people with aphasia. Findings from within-session reports and brief, semistructured interviews with participants indicated positive outcomes and subjective experiences and suggest that people with aphasia are motivated to participate in yoga for a variety of reasons.

CONCLUSIONS

This study is an important first step in confirming the feasibility of an adapted, aphasia-friendly yoga program offered via a remote platform for people with aphasia. The findings support recent work suggesting that yoga may be a potent adjunct to traditional rehabilitation efforts to improve resilience and psychosocial aspects in persons with aphasia.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.22688125.

Are movement-based mindful exercises (QIGONG, TAI CHI, AND YOGA) beneficial for stroke and Parkinson's disease? A scoping review

OBJECTIVE

To synthesize evidence from systematic reviews on the effects of qigong, tai chi, and yoga in people with neurological diseases.

METHODS

A systematic search was conducted in PubMed, PsycINFO, Embase, CINAHL and Cochrane Library until September 2022. Methodological quality was assessed using the AMSTAR 2 tool. A qualitative synthesis of included reviews and meta-analyses was performed. Citation matrices and the corrected covered area were used to explore the overlap of randomized controlled trials among reviews.

RESULTS

Nineteen systematic reviews (containing 74 trials and 80 meta-analyses) in people with Parkinson's disease (PD) or stroke were included. The critical domains of the AMSTAR 2 were not satisfied in more than half of the reviews, and only 4 evaluated the certainty of the evidence. The overlap was very high (21.7%) and high (11%) for tai chi studies in PD and stroke, respectively. In people with PD, qigong, yoga, and tai chi can improve balance, with tai chi being beneficial to increase functional mobility. For stroke patients, tai chi was better than controls to enhance motor function and independence, but not for health-related quality of life and quality of sleep. Findings on balance, walking ability and depression were inconclusive in stroke population.

CONCLUSIONS

Qigong, tai chi, and yoga appear to be effective to improve balance performance in people with PD. Tai chi practice enhances motor function and independency in stroke patients.

A Person-Centered Approach Understanding Stroke Survivor and Family Caregiver Emotional Health

ABSTRACT

BACKGROUND: The purpose of this study was to incorporate a person-centered approach to understand the emotional health needs and perspectives of stroke survivors (SSs) and their caregivers. METHODS: In collaboration with 4 SSs and caregivers as research partners, quantitative data were collected to assess poststroke emotional health needs, and qualitative data were collected to gain insight into SS and caregiver emotional health perspectives after stroke. RESULTS: Forty surveys (n = 26 SSs, n = 14 caregivers) were collected. The predominate emotional health needs were frustration (65%), anxiety (54%), and stress (50%) for SSs and stress (71%), worry (57%), and frustration (57%) for caregivers. Two group interviews (n = 7 SSs, n = 3 caregivers) were completed. Four emerging themes were identified: receiving support from those in similar situations, poststroke emotional responses, situations experienced in healthcare settings, and a hypervigilance for sudden and unexpected events. CONCLUSION: Emotional healthcare services for SSs and their caregivers may consider providing reoccurring mental health education and multifaceted treatment approaches, including provision of peer support, and addressing the unique emotional stressors SSs and caregivers may be experiencing. The small sample size precludes generalizing the results into the broader stroke population. However, by leveraging the lived experience of SSs and their caregivers, the results may help find ways to support SSs' and caregivers' emotional health.

Occupational therapists’ use of yoga in post-stroke care: A descriptive qualitative study

Introduction

Over the past decade, yoga has gained popularity in health care. The benefits of yoga can go beyond the physical to address the psychosocial and emotional. Such gains can be beneficial for people who have had a stroke. As a leading cause of disability, stroke can lead to challenges returning to daily activities. Occupational therapists may use yoga to promote engagement in daily activities after stroke. This study aimed to understand how and why occupational therapists integrate yoga into stroke rehabilitation.

Methods

This study involved occupational therapists practicing in the United States. Ten occupational therapists using yoga in practice participated in a semi-structured interview. Interview data were transcribed and analyzed using deductive and inductive coding. Themes emerged from the data related to the benefits of using yoga in stroke rehabilitation.

Results

According to this study, yoga is currently being used as a treatment technique and merged with occupational therapy. Yoga may promote client-centered recovery; bring “context” to therapy; and address physical, emotional, and psychosocial needs following stroke.

Conclusion

Individuals who have had a stroke may face challenges related to both physical and psychosocial engagement. The use of yoga in occupational therapy may be beneficial after stroke for both physical and psychosocial rehabilitation.

Understanding interest, barriers, and preferences related to yoga practice among cancer survivors

PURPOSE

Despite growing evidence supporting the benefits of yoga for cancer-related symptom management, yoga usage among cancer survivors is low. To translate the evidence of yoga benefits into community practice, it is critical to understand interest in yoga as well as barriers and preferences that influence yoga usage among cancer survivors.

METHOD

We conducted a cross-sectional survey study among cancer survivors, 18 years or older, with a primary diagnosis of cancer, and receiving treatment or follow-up care at outpatient clinics at five regional academic cancer center sites. We collected data and performed bivariate and multivariable analyses on self-reported yoga usage and interest in and barriers to practicing yoga, as well as preferred location and time for yoga practice.

RESULTS

Of 857 participants, 70.0% had never practiced yoga and 52.3% were interested in practicing yoga. Among those interested, 52.5% had never practiced yoga. Lower interest was independently associated with being male (odds ratio [OR] = 0.30, 95% confidence interval [CI] = 0.20-0.44, p < 0.001), unemployed (OR = 0.60, 95% CI = 0.39-0.91, p = 0.016), and white (OR = 0.42, 95% CI = 0.23-0.78, p = 0.005). Commonly cited barriers among those who were interested but had never practiced were not aware of yoga benefits (36.3%), difficulty motivating (28.7%), experiencing symptoms (22.9%), and not enough time (22.0%). Participants indicated "on-site and at a studio near home" (41.5%) as preferred location and evenings (3-8 pm, 34.0%) as preferred time for yoga practice.

CONCLUSION

Although more than 50% of patients indicated interest in practicing yoga, use of yoga is low among cancer survivors. Barriers and patient preferences for yoga practice need to be addressed to design effective yoga programs for this population.

Personal and social factors that influence physical activity levels in community-dwelling stroke survivors: A systematic review of qualitative literature

OBJECTIVES

To determine the personal and social factors perceived to influence physical activity levels in stroke survivors.

DATA SOURCES

Four electronic databases (MEDLINE, CINAHL, PubMed and Embase) were searched from inception to November 2020, including reference and citation list searches.

STUDY SELECTION

The initial search yielded 1499 papers, with 14 included in the review. Included articles were peer-reviewed, qualitative studies, reporting on the perceived factors influencing physical activity levels of independently mobile community-dwelling adults, greater than 3 months post stroke.

DATA EXTRACTION

Data extracted included location, study aim, design, participant and recruitment information and how data were collected and analysed.

DATA SYNTHESIS

Thematic analysis was undertaken to identify meanings and patterns, generate codes and develop themes. Five main themes were identified: (i) Social networks are important influencers of physical activity; (ii) Participation in meaningful activities rather than 'exercise' is important; (iii) Self-efficacy promotes physical activity and physical activity enhances self-efficacy; (iv) Pre-stroke identity related to physical activity influences post-stroke physical activity; and (v) Formal programmes are important for those with low self-efficacy or a sedentary pre-stroke identity.

CONCLUSIONS

Physical activity levels in stroke survivors are influenced by social activities and support, pre-stroke identity, self-efficacy levels and completion of activities that are meaningful to stroke survivors.

Perceptions of benefits and barriers to Yoga practice across rural and urban India: Implications for workplace Yoga

BACKGROUND

Even though Yoga is useful for prevention of obesity, diabetes and hypertension it is not universally practiced. The purpose of the study was to determine the benefits and barriers confronted by the community members while incorporating Yoga into routine practice and at workplace.

OBJECTIVE

This study explored the motivators and barriers to Yoga practice by estimating how these elements can be useful for development and incorporation of Yoga as a workplace activity and as a profession.

METHODS

A nationwide multi-centered prospective study was conducted recruiting individuals of different age groups and geographical zones in India. Participants of Yoga intervention group were administered a questionnaire with 19 items on benefits (YBS) and 18 items on barriers for Yoga practice (BFYS). Data was analyzed using SPSS v21 software.

RESULTS

Majority of the participants perceived Yoga improves "physical fitness", "relaxes mind and body", improves "stamina", across age groups. "Lifestyle", "Family commitments", "Physical over-exertion", "No Encouragement from family", "Occupational commitments" and "Few places to do Yoga" were perceived barriers across various geographical zones. Despite knowing the benefits of Yoga, these barriers prevented individuals from integrating it into their daily routine.

CONCLUSIONS

The present study may be considered as a starting point for development of Yoga as a workplace activity and a profession based on the perceptions of its various benefits and barriers faced by a large study population spanning an entire nation.

Living the Full Catastrophe: A Mindfulness-Based Program to Support Recovery from Stroke

Decades of research suggest that Mindfulness-Based Stress Reduction (MBSR) training supports a greater capacity to live with chronic medical conditions and contributes to lowering stress levels. This paper introduces a model for a Mindfulness-Based Recovery from Stroke (MBRfS) for promoting stroke recovery, informed by the lived experience of the author (a stroke survivor and certified MBSR instructor), the research literature regarding MBSR training, and the specific challenges of stroke recovery. Four themes emerged from the autoethnographic analysis that informed the proposed model: Readiness to accept the stroke event and the acquired brain injury, navigating uncertainties of stroke recovery with awareness and self-responsibility for outcomes, trusting the inherent wisdom of the body as a stroke recovery "teacher", and increased capacity to integrate complex emotions with self-compassion, and a sense of wholeness. A four-component MBRfS model is offered, which consists of an integration amongst a modified MBSR framework, emergent attitudinal themes, and insights from the autoethnographic vignettes. The MBRfS model offers a path for providing participants with a supportive experience within stroke recovery. Recommendations and suggestions for future studies are offered to support the development of MBRfS for stroke survivors and their caregivers, as well as contributing to healthcare providers.