I wrote the following as a blog in April 2016. I am reposting it here as preparation to announce an exciting program development to try to better meet the needs of those we serve.
April is OT month, established by the American Occupational Therapy Association to celebrate and promote the profession. This OT month I am reflecting on yoga, as relatively new adjunct to my personal fitness routine, that I encourage my patients to explore. In January 2013 my New Year resolution was to try hot yoga as part of management of my Meniere’s. It’s a resolution that I continue to “keep.”
The majority of my 22 years of OT have been with individuals with a neurological injury or illness such a traumatic brain injury or spinal cord injury. The people I work tend to have been catastrophically injured, often with multiple fractured bones and other traumatic injuries. The goals we work on in OT are often related to cognition (attention, memory, and organization) and related to movement (mobility, range of motion, muscle strength, and coordination). The more I “kept” my New Year resolution in yoga, the more I’d think about the benefits for the patients I serve, and the more I’ve promoted and encouraged my patients to try yoga.
I have recommended and advocated for yoga for many who have replied with some variation of “it’s not for me” based on their perception of yoga as being “too feminine” activity or views that it doesn’t fit with their self-image. I respect diversity of opinion and views, but I continue to be an advocate for yoga.
Perhaps the more obvious benefits yoga are related to movement. Yoga poses are excellent exercise to improve range of motion (joint movement), and to increase muscle strength through weight bearing and isometric muscle exercise.
Yoga is excellent “gross motor” exercise which from a neurological standpoint is the foundation to address residual hemi paresis (one sided weakness) and improve fine motor coordination. Yoga poses provide proprioceptive input to increase our proprioceptive sense (awareness of body in space, awareness of arms and legs to body). Movement and yoga poses provide input to our vestibular sense (balance).
Controlled breathing and breathing exercise in yoga has tremendous carry over benefit to the neuro rehabilitation goals to support healthy respiratory function for endurance, and to maximize clear speech production. Breathing and breath control as taught in yoga can be used to reduce anxiety, and incorporated as relaxation techniques.
Dove tailing the relaxation benefits of breathing exercise includes practice of “mindfulness” of yoga, being in the moment, and paying attention to our thoughts and to our bodies, which can also be used for relaxation, which in combination with breathing exercise can help some people manage pain.
Additional benefits of engaging in “mindfulness” of yoga practice may include improved focus (attention, concentration) because yoga is an excellent opportunity as cognitive exercise in concentrating in the moment, attention, listening skills, and following directions. I recommend my patients listen to the verbal and demonstrated instructions of the yoga teacher to perform movements and poses, as a specific opportunity to activate visual spatial and visual perception processing areas of the brain. The demands can be increased or decreased depending if the teacher is facing the same direction of the student, or if the student has to visually reverse how they see the instructor pose in exercise of left / right directionality.
For many of my patients, especially if new to trying to establish a fitness routine, I recommend the approach of a choosing a scheduled class as a means to try to increase commitment and increase accountability to exercise. Yoga fits this format of attending a scheduled class to increase commitment.
As OT planning for discharge, I work with patients and families to identify community resources and natural supports the person will use when therapy has ended. I encourage people to consider yoga with a live instructor, with intent to provide verbal instructions, in natural setting natural structure of community class, not 1:1 “therapy.”
Subtitled: An Old Dog can learn new Tricks …
As a student of yoga, I have experienced all of the benefits that I detailed above. As an OT, I have learned some principles that I carry over to my OT practice.
Yoga is a “Practice.” Not a performance, not test, not a competition. This fits well with OT philosophy and terminology
Mindfulness. Awareness. In the moment. Too often we are not present. Sadly I’ve witness other therapists with their nose in their table or laptop not engaging w their patient because of “point of service documentation” demands. Yoga continues to be a source of reinforcement for me to stay in the moment with each patient, and not be distracted by thoughts of what I need to do next. It is in this attention to the moment that we can best listen and hear.
Meaningful and specific verbal instructions. I’ve learned in yoga how powerful choice of words are, that a make significant difference in success with achieving a pose. I continue to try to choose my words carefully for the greatest clarity and greatest impact for those I serve.
Meaningful and specific tactile cues. The power of touch. I’ve learned from yoga that gentle tactile cues to facilitate and stimulate desired movement can more powerful than a firm, strong touch.
“Namaste.” I’ve not adopted ending an OT session as we end yoga practice with “the light and love in me honors the light the love that is in you” but I do try to slow down and convey a more meaningful closure than a rushed parting at the end of the therapy session.
The Celtic Maze pattern symbolizes the journey of life and the path of experience, & learning. It symbolizes that there are twists, and turns, the challenges and obstacles in life, but that there are always open doors.