Presentation is loading. Please wait.

Presentation is loading. Please wait.

Adapting Yoga for Veterans with Brain Injury

Similar presentations

Presentation on theme: "Adapting Yoga for Veterans with Brain Injury"— Presentation transcript:

1 Adapting Yoga for Veterans with Brain Injury
Amy Moran, MA, RYT Casey Linstad, CTRS Rose Collins, PhD, LP Minneapolis VA Health Care System April 28, 2011 Casey

2 Objectives Introduce the concept of Adaptive Yoga.
Experience how Adaptive Yoga feels. Broaden your vision of what Yoga can look like. Casey

3 Outline Yoga Yoga Research & Brain Injury Adaptive Yoga Program
Veteran Yogis Program Evaluation Looking to the Future Casey

4 Instructors Amy Moran, MA, RYT Casey Linstad, CTRS Sue Benson, CYT
Registered Yoga Teacher Hot Yoga, Bikram-style, Hatha Casey Linstad, CTRS Recreational Therapist Kundalini Yoga Sue Benson, CYT Certified Yoga Teacher Iyengar Yoga Casey

5 Amy

6 Yoga Breathing exercises Physical activity Relaxation Meditation
Amy Ancient Mind-Body Practice Breathing exercises Physical activity Relaxation Meditation Stress management Philosophy Lifestyle Spiritual tradition

7 Definition “…physical postures [asana], breathing techniques [pranayama], and meditation [dhyana] or relaxation…use…part of a general health regimen, and also for a variety of health conditions. ( 1 of 3 mind-body therapies that fall under the rubric of complementary and alternative medicine

8 Breathing exercises Physical activity Relaxation Meditation
Amy Ancient Mind-Body Practice Breathing exercises Physical activity Relaxation Meditation Stress management Philosophy Lifestyle Spiritual tradition Gates, 2002 8

9 Brain Injury Sequelae & Yoga Research
8 Limbs Yoga Research Brain Injury Sequelae Postures/Asana Breathing/Pranayama Sensation/Pratyahara Concentration/Dharana Meditation/Dhyana Oneness/Samadhi Restraints/Yamas Observances/Niyamas Anxiety disorders Cancer/coping Cardiovascular disease Chronic disease risk factors Depressive disorders Fibromyalgia Multiple sclerosis Muskuloskeletal conditions Pain/lower back pain Posttraumatic stress disorder (PTSD) Quality of life (QOL) Respiratory illness Sleep disturbance Stress Stroke rehabilitation Increased GABA levels in brain (lower levels associated with variety mental health conditions) Abstract reasoning Affect regulation Anxiety Attention Awareness Concentration Depression Executive functioning Impulsivity Insight Irritability Learning Memory Pain complaints Planning QOL Problem-solving PTSD Social pragmatics Amy Restraints/Yamas Moderation/Brahmacarya Observances/Niyamas Self-Study/Svadhyaya

10 Defense Centers of Excellence
Amy Why yoga for veterans?

11 Adaptive Yoga Program Casey

12 History MVAHCS Nathan Newhall Matthew Sanford Polytrauma/TBI
Corepower Yoga Matthew Sanford Mind-Body Solutions Casey

13 Adaptive Yoga All yoga is adaptive…
Adapting yoga for a variety of physical and mental health conditions. Making yoga accessible on many different levels. Demystifying yoga Dispelling myths/stereotypes What does class look like? Casey

14 Structure of Class Welcome/introductions Check-In (1-10) Practice
What is yoga? How to approach practice? Check-In (1-10) Options for practice Guidelines for practice Practice Breathing/movement Relaxation Check-Out (1-10) Check-Out #2 Describe practice (one word) Namaste Casey

15 Warm-Up Adaptive Yoga Casey

16 Casey Warm-Up

Greater numbers men, lower numbers women, both represented ERA Operation Enduring/Iraqi Freedom OEF/OIF Persian Gulf War Post-Vietnam/Peace Time Vietnam War World War II PRIMARY DIAGNOSES Traumatic brain injury (TBI) Cerebrovascular Accident (CVA)/Stroke Lower Back Pain (LBP)/Pain Major Depressive Disorder (MDD) Other mental health condition Posttraumatic Stress Disorder (PTSD) Spinal Cord Injury (SCI) Obesity SECONDARY DIAGNOSES Chemical Dependency Depression Pain (knee/joint) Osteoarthritis Other anxiety/mood disorders Posttraumatic stress disorder (PTSD) Sleep Apnea/Insomnia CAUSES OF BRAIN INJURY Blast Brain tumor Drug overdose Fall Motor vehicle accident (MVA) RELIGIOUS AFFILIATION Lutheran Pentecostal Roman Catholic Protestant Amy

18 Amy

19 Adaptive Yoga Star Pose/ Tarasana Amy

20 Specific Adaptations Casey

21 Physical “Adaptations”
Breathing Eyes Inversions Touching/adjustments Modify up Props Visualization Casey

22 Spinal Twist/ Ardha Matsyendrasana
Adaptive Yoga Casey

23 Cognitive “Adaptations”
Repetition Recreational therapy assistance Simple demonstrations Several models to follow Group adjustments Non-comparison, non-competition, non-criticism Casey Within class Between classes 3 teachers + peers Sitting in a circle People figure out what works for them, this may require they “struggle” a little bit Promotes independent thinking and decision-making skills

24 Language Matters Yoga is an opportunity to…
Practice with what is available to you today Choose option that makes sense for your body today Option/alternative vs. challenge/modification Relaxation vs. meditation Stress response & relaxation response You are the expert of your own body Your body gives you information Practice listening to your body Use wisdom -what is too much/not enough Language Matters Casey

25 Adapted Asana Demonstration
Awkward/chair pose Holding posture Utkatasana Eagle Pose Compression posture Garurasana Tree Pose Balancing posture Tadasana Cobra Pose Spine Strengthening Bhujangasana Amy & Casey

26 Awkward Pose/ Utkatasana Adaptive Yoga Amy

27 Eagle Pose/ Garurasana Adaptive Yoga Amy

28 PROGRAM EVALUATION Amy Feedback from veterans Qualitative
Informal observations Comments/quotes One word descriptions of practice Quantitative Check-in/check-out numbers Quality of life survey Formal interviews

29 Amy

30 Amy

31 Descriptive Words Relaxed/Relaxing Calm/Calming RELAXED or RELAXING
CALM or CALMING Frequency Amy Words used to describe practice Overwhelmingly positive Some neutral words A few negative words Top 2 Descriptors Relaxed/Relaxing Calm/Calming Descriptor

32 In their own words… “I know more about yoga today – I want to learn more. Felt better after the first time.” “The stiffness in my arm is almost gone from all the stretching. I feel relaxed after each class. I have a beginner course at home and try to do yoga every day.” “Made my back feel better. Also improved mood. Visualizing is powerful.” “Helps me with ortho problems as well as bipolar & PTSD episodes.” “Very relaxing and interesting.” “It is great, really helps with the stress.” Amy

33 INTERVIEWS Amy Feedback from veterans Qualitative
Informal observations Comments/quotes One word descriptions of practice Quantitative Check-in/check-out numbers Quality of life survey Formal interviews

34 What did you think of yoga before you started practicing?
“I didn’t understand it. It seemed hokey, bogus, tricks, people blowing smoke.” -Olaf “I’ve been watching it on Channel 2. Some people have issues but I was anxious to try it.” -Jim “Eastern, control, in shape, has it together.” -Jo “DUMB. Would have never considered it.” -Rick “I thought it was painful, impossible, that I had to be strong. I didn’t think I could do it.” -Suzanne Amy

35 What did you think of yoga now?
“Very relaxing, helps me prepare for the week, to be more accepting. Can’t do what I did 30 years ago.” -Olaf “It has given me a more relaxed feeling. I didn’t think I would be using muscles that I haven’t used. I generally get stiff from not moving.“ -Jim “My perception of yoga was always positive, but I have an even more positive attitude now.” All positive, calming, lovely, gold, and blue-green, and feels good.” -Jo “I like the stretching. Loosens up your body. Pain has gone away in my shoulder. Relaxing and warmth of your body.” -Rick “I like it now because it’s relaxing, breathing is healing. I can lose weight through mindful breathing. Here, I am comfortable, I’m not overweight.” -Suzanne Amy

36 What was the hardest thing for you when you started practicing?
“The breathing. I could go even slower. Sometimes I have to tune the teacher out.” -Olaf “First time was getting to class, long hallway.” -Jim Always felt I was behind on the positions, getting more familiar and catching up.” -Jo “Moving my arm and not being able to stand (in a wheelchair). This continued from my rehab process. I can do this for the rest of my life.” -Rick “Relaxing different parts of my body. I’m still not sure if I am relaxing them or not! I’m amazed that you know my tongue is on the roof of my mouth! How do you know that?” -Suzanne Amy

37 Why do you continue to practice?
“I can’t even explain. It gives me so much. It gets me out of my house. I have time on my drive down. I like people, but I hate crowds. I can’t do this myself. Here I can be with people. I’m comfortable here. There’s nothing better for me. I get cabin fever (in the winter), depressed, compulsive eating.” -Olaf “It feels good, a positive experience – always. Helps to control myself, calming. Lessens stress in my life.” -Jo “Stretching feels really good. I get really stiff, but am so relaxed after meditation. My mood is much better.” -Suzanne Amy

38 Adaptive Yoga Star Pose/ Tarasana Why continue to practice?
“I relax more each time. Better breathing even with COPD. I use breathing techniques to relax and hopefully my muscles will start working better.” -Jim Amy

39 Adaptive Yoga Warm-Up Why continue to practice?
Amy “Fitness, being with my friends here. Stretching and loosening my body.” -Rick

40 On days that you practice, do you notice anything different?
“I feel good when I leave. Relaxed. I look forward to coming. I get energized about it. I feel better in general. It’s not a chore.” -Olaf “Yes, I think it has a calming effect. I used to show more anger, I show less now. I’m more relaxed.“ -Jim “Feel that mind/body more in control – I’m more centered. I feel good about myself.” -Jo “My body is looser, relaxed, warm. Able to move further each time (arm).” -Rick “I feel better. I feel happier, more relaxed. Whatever was bothering me before is gone.” -Suzanne Amy

41 If you were going to tell another Veteran about yoga, what would you say?
“Do it! What do you have to lose? It’s a very individual experience. Unless they try it more than once, they won’t have a clue. Cannot describe. It is very individual.” -Olaf “I would recommend it because you’re working with aspects you never worked with breath before. Movements that you don’t think will be strenuous are strenuous.” -Jim “Yes! I would recommend it for vets, anyone. Would let them know I think it helps with my perception of myself, PTSD, depression, and weight issues.” -Jo “I would recommend trying it. Gets your body loose no matter what you do.” -Rick “Yoga is for everybody. They even have people in wheel chairs practicing yoga. That was a whole new perspective for me. I used to be nervous around people in wheelchairs, now they’re my friends.” -Suzanne Amy

42 Learning & Planning… Casey From a recreational therapy perspective…
From a mental health perspective… From a yoga perspective… From a human perspective…

43 Specific Lessons Work in progress Constant re-evaluation
Challenging our own assumptions Every class is different Things change Going with the flow… Many ways to be challenged Broadening criteria for success Casey

44 Plans for the Future Expansion Tailored classes Measurement tools
Dedicated space Supplies/props Tailored classes Women’s clinic Spinal cord injury Measurement tools Biofeedback equipment Physiological measures Research Funding Casey

45 Relaxation & Closing… Casey From a mental health perspective…
From a yoga perspective… From a human perspective…

46 Relaxation… Guided relaxation Take time to prepare for relaxation…
Types of relaxations Self-Acceptance Chakra/Rainbow Healing/Golden Light Forest/Nature Starry Night Casey

47 Adaptive Yoga Savasana Casey

48 Bringing Practice to a Close…
Checking-out Share a word to describe your practice Bow & Namaste “The Teacher in me Honors the Teacher in you.” Casey

49 Adaptive Yoga Casey Prayer Pose

50 Adaptive Yoga Casey Namaste

51 Namaste! Amy

52 Adaptive Yoga Contacts
Casey Linstad*, CTRS *Veteran referrals Amy Moran, MA, RYT Rose Collins, PhD, LP Amy

53 References (1) Bennet, S.M., Weintraub, A., & Khalsa, S.B.S. (2008). Initial evaluation of the LifeForce yoga program as a therapeutic intervention for depression. International Journal of Yoga Therapy, 18, Bower, J.E., Woolery, A., Sternliebb, B., & Garet D. (2005). Yoga for cancer patients and survivors. Cancer Control, 12, Carson, J.W., Carson, K.M., Jones, K.D., Bennet, R.M., Wright, C.L., & Mist, S.D. (2010). A pilot randomized controlled trial of the yoga of awareness program in the management of fibromyalgia. Pain, 151, Descilo, T., Vedamurtachar, A., Gerbarg, P.L., Nagaraja, D., Gangadhar, B.N., Damodaran, B., Adelson, B., Braslow, L.H., Marcus, S., & Brown, R.P. (2009). Effects of a yoga breath intervention alone and in combination with an exposure therapy for post-traumatic stress disorder and depression in survivors of the 2004 south-east Asia tsunami. Acta Psychiatrica Scandinavica, 1-12. Duraiswamy, G., Thirthalli, J., Gangadhar, B.N. (2007). Yoga therapy as an add-on treatment in the management of patients with schizophrenia: A randomized controlled trial. Acta Psychiatrica Scandinavica, 116, Gates, R. (2002). Meditations from the mat: Daily reflections on the path of yoga. New York: Random House. Greendale, G.A., McDivit, A., Carpenter, A., Seeger, L. & Huang, M. Yoga for women with hyperkyphosis: Results of a pilot study. American Journal of Public Health, 92, Innes, K.E., Bourguignon, C., & Taylor, A.G. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: A systematic review. (2005). Journal of the American Board of Family Practitioners, 18, Iyengar, B.K.S. (1979). Light on Yoga. New York: Schocken. Jadhav, S.G. & Havalappanavar, N.B. (2009). Effect of yoga intervention on anxiety and subjective well- being. Journal of the Indian Academy of Applied Psychology, 35, Kirkwood, G., Rampes, H., Tuffrey, V., Richardson, J., & Pilkington, K. (2005). Yoga for anxiety: A systematic review of the research evidence. British Journal of Sports Medicine, 39, Amy

54 References (2) Lynton, H., Kligler, B., & Shiflett, S. (2007). Yoga in stroke rehabilitation: A systematic review and results of a pilot study. Topics in Stroke Rehabilitation, 14, 1-8. Manjunath, N.K. & Telles, S. (2005). Influence of yoga and ayurveda on self-rated sleep in a geriatric population. Indian Journal of Medical Research, 121, Michalsen, A., Grossman, P., Acil, A., Langhorst, J., Luedtke, R., Esch, T., Stefano, G.B., & Dobbs, G.J. (2005). Rapid stress reduction and anxiolysis among distressed women as a consequence of a three-month intensive yoga program. Medical Science Monitor, 11, Moadel, A.B., Shah, C., Wylie-Rosett, J., Harris, M.S., Patel, S.R., Hall, C.B., & Sparano, J.A. (2007). Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: Effects of quality of life. Journal of Clinical Oncology, 25, Pilkington, K., Kirkwood, G., Rampes, H., & Richardson, J. (2005). Yoga for depression: The research evidence. Journal of Affective Disorders, 89, Pritchard, M. Ellison-Bowers, P., & Birdsall, B. Impact of Integrative Restoration (iRest) meditation on perceived stress levels in multiple sclerosis and cancer outpatients. Stress and Health, 26, Ross, A. & Thomas, S. (2010). The health benefits of yoga and exercise: A review of comparison studies. The Journal of Alternative and Complementary Medicine, 16, 3-12. Shapiro, D., Cook, I.A., Davydov, D.M., Ottaviana, C., Leuchter, A.F., Abrams, M. (2007). Yoga as a complementary treatment of depression: Effects of traits and moods on treatment outcomes. eCAM, 4, Sherman, K.J., Cherkin, D. C., Erro, J., Miglioretti, D.L., & Deyo, R.A. (2005). Comparing yoga, exercise, and a self-care book for chronic low back pain. Annals of Internal Medicine, 143, Streeter, C.C., Jensen J.E., Perlmutter, R.M., Cabral, H.J., Tian, H., Terhune, D.B., Tiraulo, D.A., & Renshaw, P.F. Yoga asana sessions increase brain GABA levels: A pilot study. Journal of Alternative and Complementary Medicine, 13, Woolery, A., Myers, H., Sternlieb, B., & Zeltzer, L. (2004). A yoga intervention for young adults with elevated symptoms of depression. Alternative Therapies, 10, Yang, K. (2007). A review of yoga programs for four leading risk factors of chronic disease. eCAM, 4, Amy

55 Questions… Adaptive Yoga Casey & Amy

Download ppt "Adapting Yoga for Veterans with Brain Injury"

Similar presentations

Ads by Google