Improve the Psychological Condition of Patients with Spinal Cord Injury with Yoga

 

By John M. de Castro, Ph.D.

 

“yoga can be practiced by someone with a spinal cord injury under the supervision of a qualified and experienced yoga therapist. The wide range of practices that range across physical postures, breathing techniques and meditative practices allow for a tailored approach that is within the limitations of the patient/practitioner.” – Narayan Gopalkrishnan ·

 

Spinal cord injury is devastating to the individual. It results in a permanent cutting off the muscles of the body from the central nervous system and as a result paralysis. The severity of the paralysis depends on the location of the injury of the spine with the higher the injury the more widespread the paralysis. In the U.S. there are approximately 17,000 new cases of spinal cord injury each year. The World Health Organization summarizes the problem:

• “Every year, around the world, between 250 000 and 500 000 people suffer a spinal cord injury (SCI).
• The majority of spinal cord injuries are due to preventable causes such as road traffic crashes, falls or violence.
• People with a spinal cord injury are two to five times more likely to die prematurely than people without a spinal cord injury, with worse survival rates in low- and middle-income countries.
• Spinal cord injury is associated with lower rates of school enrollment and economic participation, and it carries substantial individual and societal costs.”

 

Beyond, the devastating physical consequences of spinal cord injury are difficult psychological, behavioral, emotional, and social issues. The vast majority of patients experience chronic pain and a decreased quality of life. In addition, depression and anxiety disorders are common. Since, spinal cord injury is permanent, it is important to address the pain and psychosocial consequences of the injury that may be present throughout the lifetime. These can be changed and can help the victim engage in a happier and more productive life. Mindfulness training may help. It has shown to be effective in reducing chronic pain, treat depression and anxiety disorders, and improve quality of life following a variety of diseases. Yoga practice includes mindfulness training and also gentle physical exercise which may also be beneficial for patients with limited mobility. Hence, it would seem reasonable to examine the ability of yoga training in treating the psychological consequences of spinal cord injury.

 

In today’s Research News article “Evaluation of a specialized yoga program for persons with a spinal cord injury: a pilot randomized controlled trial.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422575/, Curtis and colleagues recruited adults with injuries at a variety of levels of the spinal cord and randomly assigned them to receive either 6 weeks of 50-minute sessions twice a week of seated Iyengar yoga training or a wait-list control. Following the initial 6 weeks the control group also received the yoga training. They were measured before and after training for psychological inflexibility and experiential avoidance, anxiety, depression, self-efficacy, post-traumatic growth, resilience, self-compassion, mindfulness, pain, and pain catastrophizing.

 

They found that the 6-week yoga training produced significant decreases in depression and increases in self-compassion. There were also significant increases in overall mindfulness, in particular observing and non-reactivity. These findings were true regardless of whether the yoga condition was compared to the control condition or whether the scores before treatment were compared to those after treatment. There is a need for a better controlled randomized clinical trial and longer treatment and follow-up periods. But, the present results support the idea that yoga practice is a safe and effective treatment for the psychological consequences of spinal cord injury.

 

These results are suggestive that yoga practice improves the patients’ psychological ability to accept and cope with their situation. The increased self-compassion suggests that the patients become better able to look at their situation with warmth and non-judgement, accepting it and themselves as they are. The decreased depression suggests that the patients become better able to accept their situation and control their emotional reactions. Finally, the increases in mindfulness, suggest that they become better at mindfully observing their immediate situation and not to evaluate it, but accept it as it is. All of these benefits suggest that yoga practice can be successfully implemented with patients with spinal cord injuries, producing improvements in their psychological well-being.

 

So, Improve the Psychological Condition of Patients with Spinal Cord Injury with Mindfulness.

 

“Yoga is ideal for spinal cord injury survivors because the gentle stretching encourages healthy breathing patterns, and can reduce the pain of spending all or most of your day in a wheelchair.” – Zawn Villines

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Curtis, K., Hitzig, S. L., Bechsgaard, G., Stoliker, C., Alton, C., Saunders, N., … Katz, J. (2017). Evaluation of a specialized yoga program for persons with a spinal cord injury: a pilot randomized controlled trial. Journal of Pain Research, 10, 999–1017. http://doi.org/10.2147/JPR.S130530

 

Abstract

Objectives

The purpose of this randomized controlled trial was to evaluate the effects of a specialized yoga program for individuals with a spinal cord injury (SCI) on pain, psychological, and mindfulness variables.

Materials and methods

Participants with SCI (n=23) were outpatients or community members affiliated with a rehabilitation hospital. Participants were randomized to an Iyengar yoga (IY; n=11) group or to a 6-week wait-list control (WLC; n=12) group. The IY group participated in a twice-weekly 6-week seated IY program; the WLC group participated in the same yoga program, after the IY group’s yoga program had ended. Pain, psychological, and mindfulness measures were collected at two time points for both groups (within 1–2 weeks before and after program 1 and at a third time point for the WLC group (within 1 week after program 2).

Results

Linear mixed-effect growth models were conducted to evaluate the main effects of group at T2 (postintervention), controlling for T1 (preintervention) scores. T2 depression scores were lower (F1,18=6.1, P<0.05) and T2 self-compassion scores higher (F1,18=6.57, P< 0.05) in the IY group compared to the WLC group. To increase sample size and power, the two groups were combined and analyzed across time by comparing pre- and postintervention scores. Main effects of time were found for depression scores, (F1,14.83=6.62, P<0.05), self-compassion, (F1,16.6=4.49, P<0.05), mindfulness (F1,16.79=5.42, P<0.05), mindful observing (F1,19.82=5.06, P<0.05), and mindful nonreactivity, (F1,16.53=4.92, P<0.05), all showing improvement after the intervention.

Discussion

The results indicated that a specialized 6-week yoga intervention reduced depressive symptoms and increased self-compassion in individuals with SCI, and may also have fostered greater mindfulness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422575/