Combining Yoga Exercise with Rehabilitation Improves Balance and Depression in Patients with Chronic Stroke: A Controlled Trial

You'll just have to hope your stroke hospital sees this and brings in the protocols to accomplish this. Never mind; your hospital doesn't read research and since this is for chronic you would have been discharged already. Once you are discharged your stroke hospital has no responsibility for getting you recovered.

Combining Yoga Exercise with Rehabilitation Improves Balance and Depression in Patients with Chronic Stroke: A Controlled Trial

by

Yen-Ting Lai

^1,2,3,

Chien-Hung Lin

^4,5,6,

City C. Hsieh

⁷,

Jung-Cheng Yang

^2,3,

Han-Hsing Tsou

^8,9,10,

Chih-Ching Lin

^4,11,

Szu-Yuan Li

^4,11,

Hsiang-Lin Chan

^12,† and

Wen-Sheng Liu

^{4,6,8,9,13,14,*,†}

¹ Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei 100, Taiwan

² Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu 300, Taiwan

³ Department of Physical Medicine and Rehabilitation, National Taiwan University Hsin-Chu Hospital, Hsinchu 300, Taiwan

⁴ Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan

⁵ Department of Pediatrics, Taipei Veterans General Hospital, Taipei 112, Taiwan

⁶ College of Science and Engineering, Fu Jen Catholic University, New Taipei City 242, Taiwan

⁷ Department of Kinesiology, National Tsing Hua University, Hsinchu 300, Taiwan

⁸ Institute of Food Safety and Health Risk Assessment, National Yang Ming Chiao Tung University, Taipei 112, Taiwan

⁹ Institute of Food Safety and Health Risk Assessment, National Yang-Ming University, Taipei 112, Taiwan

¹⁰ Kim Forest Enterprise Co., Ltd., New Taipei City 221, Taiwan

 

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^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this manuscript.

Academic Editors: Francesco Cappello and Magdalena Gorska-Ponikowska

Appl. Sci. 2022, 12(2), 922; https://doi.org/10.3390/app12020922

Received: 1 December 2021 / Revised: 26 December 2021 / Accepted: 10 January 2022 / Published: 17 January 2022

(This article belongs to the Special Issue Celebrating Applied Sciences Reaches 20,000 Articles Milestone: Feature Papers in Applied Biosciences and Bioengineering Section)

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Abstract

Background:  

 

We combined yoga with standard stroke rehabilitation and compared it to the rehabilitation alone for depression and balance in patients. Methods: Forty patients aged from 30 to 80 who had suffered a stroke 90 or more days previously were divided evenly with age stratification and patients’ will (hence not randomized). In the intervention group 16 completed 8-week stroke rehabilitation combined with 1 h of yoga twice weekly. Another 19 patients completed the standard rehabilitation as the control group.  

Results: 

 

The yoga group showed significant improvement in depression (Taiwanese Depression Questionnaire, p = 0.002) and balance (Berg Balance Scale, p < 0.001). However, the control group showed improvement only in balance (p = 0.001) but not in depression (p = 0.181). Further analysis showed both sexes benefitted in depression, but men had a greater improvement in balance than women. Depression in left-brain lesion patients improved more significantly than in those with right-brain lesion, whereas balance improved equally despite lesion site. For patients under or above the age of 60, depression and balance both significantly improved after rehabilitation. Older age is significantly related to poor balance but not depression. Conclusions: Combining yoga with rehabilitation has the potential to improve depression and balance. Factors related to sex, brain lesion site and age may influence the differences.

Keywords: stroke; yoga; balance disability; depression

1. Introduction

Stroke is highly prevalent in high-income countries (1015–1184 cases per 100,000 people in 2013) [1] Imbalance and post-stroke depression are common among stroke patients and may severely impair their activities of daily living [2,3]. The majority of stroke patients (around 83%) had a balance disability [4]. In a meta-analysis, the percentage of post-stroke depression was about 31% [5], and depression is associated with falls and negatively correlated with functional status [6]. The risk of falls for stroke patients is 1.77 times compared to healthy adults so post-stroke rehabilitation is essential [7].

Exercise increases serotonin which works against depression [8]. Carek et al. reported both aerobic and anaerobic exercises are effective [9]. Increased exercise frequency and group therapy seem be beneficial [10]. The practice of exercises promotes improvements in the levels of depression in people who suffered an ischemic stroke [11]. Franklin et al. reported yoga practices might be also protective [12]. Yoga is widely integrated into physical therapies [13]. However, few reports have focused on the impact of yoga in stroke patients [14,15,16]. Yoga can lower blood pressure, serum cholesterol and increase in internal reasons for exercise [17,18]. Furthermore, yoga consists of dynamic/static postures to stretch muscles and joints, and improve balance and coordination [19]. Bastille and Gill-Body [14] reported an 8-week intervention (1.5-h yoga sessions two times per week) for patients with chronic post-stroke hemiparesis improved balance. Chronic stroke is defined as the condition 90 days after stroke [20]. About 95% of patients achieved their best neurological recovery within 11 weeks, while minor stroke related to faster recovery [21].

Previous studies enrolled patients who began yoga “after” completing the post stroke rehabilitation program. However, no study focused combining yoga into a standard rehabilitation. We compared depression and balance among chronic stroke patients who underwent combining yoga and standard rehabilitation and those with standard rehabilitation alone.

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