We live in an age of chronic illness. Stroke is a widespread chronic health condition in the United States, and the third leading cause of death. It is also the leading cause of serious, long term disability in the U.S. The risk for stroke is moderated by age but nearly a quarter of all strokes occur in those under the age of 55. Risk factors include smoking and other health-degrading habits, atrial fibrillation, high blood pressure, and high stress (The Internet Stroke Center).

In examining how to prevent stroke and improve U.S. health outcomes, researchers have found that yoga and the accompanying physical postures, breathwork, and meditation have the ability to serve two important health-promoting functions when it comes to stroke treatment.

Prevention 

Yoga practice has been shown to improve cardiovascular functioning, increasing blood flow, levels of hemoglobin and red blood cells, allowing more oxygen to reach the body’s cells, enhancing their function. Additionally, yoga practice helps to thin the blood, thereby directly decreasing the risk of heart attack and stroke, as they are often caused by blood clots. Consistently getting the heart rate into aerobic range lowers the risk of heart attack. While not all yoga is aerobic, even those yogic that do not increase heart rate into the aerobic range can improve cardiovascular functioning. Yoga also lowers stress levels which has been linked to decreased risk of cardiovascular health issues like stroke (Woodyard, 2011).

Regular yoga practice helps contribute to a healthy lifestyle which serves to prevent against cardiovascular problems like stroke and the debilitating effects they cause.

Rehabilitation  

After a stroke, there can be serious physical, cognitive, emotional and social repercussions that can become debilitating and decrease overall quality of life. Common issue after stroke include limited range of motion, balance problems, memory problems, decreased social functioning and lower levels of positive mood, even depression and anxiety can occur. Yoga offers a holistic approach to address all of these repercussions.

Yoga practice helps to rewire the brain. During a stroke, neuronal tissue and connections upon which functioning is based can become injured or destroyed. Yoga becomes a way of therapeutically recovering because the intense focus and attention it requires help to rewire neurons and rebuild connections which support functioning. This helps to reconnect neurons for movement, affect control, and even aspects of cognition. If this practices sense of focus can be applied off the mat as well, it can generalize to other real-time activities which may have faltered or been lost due to stroke (Flint Rehab, 2018).

Yoga can also have extremely positive rehabilitative effects on balance, range of motion, strength, and endurance. One study showed that an 8-week yoga program for stroke survivors (practice 2 times a week for an hour) improved their pain, neck range of motion, passive hip range of motion, upper extremity strength, walking ability, and endurance (Schmid, Miller, Van Puymbroeck & DeBaun-Sprague, (2014). Another study showed that yoga for stroke can demonstrate improvements in balance and gait speed as well (Flint Rehab, 2018).

Yoga is also very effective in addressing the mental and emotional aspects of recovery. One study showed that yoga is beneficial in reducing anxiety and depressive symptoms as well as lowering trait anxiety (this is as preventative as it is rehabilitative) and increasing rates of perceived quality of life (Thayabranathan, et al., 2017). Another study revealed that memory-related quality of life scores significantly improved after yoga intervention and that those participating in the intervention exhibited clinically relevant decreases in state and trait anxiety (Immink, Hillier, & Petkov, 2014.)

Research also reveals that yoga has benefits for socio-emotional recovery as well. A 10-week yoga program analysis showed emergent themes from the analysis including greater sensation; feeling calmer and becoming connected. These themes respectively revealed additional perceived physical improvements in terms of strength, range of movement or walking ability, an improved sense of calmness and the possibility for reconnecting and accepting a different body (Garrett, Immink, & Hillier). Yoga class participation and attendance can also serve to build a protective social support for stroke survivors and insulate them from any loss of social abilities or social life as a result of disability.

In Practice

The fact that yoga can be modified for any level or place on the path to recovery, it is a highly accessible practice even for those experiencing paralysis. Those with very low motor functioning can begin with meditation and mental practice, and those slightly more mobile can go from gentle chair yoga and build up toward the use of props to support muscular engagement in asanas.

An additional reason that yoga is particularly beneficial for stroke recovery is its emphasis on breathing. This helps encourage practitioners to create health breathing habits and fight the bad habit of holding your breath—particularly while exercising, which can stress the cardiovascular system and cause inflammation and stress.

An additional note worth mentioning for stroke survivor practicing yoga is that if you experience impaired movement or balance, it is extremely important that you practice in a class or one-on-one yoga practice with an instructor. In order to maximize your safety, modify all poses to your ability level.

The literature indicates that yoga can have profound preventative and rehabilitative effects on one of the leading causes of death and disability: stroke. Yoga helps to prevent stroke by lowering risk factor levels and can help to rebuild functions lost due to damage incurred during a stroke. Yoga’s status as an all-levels practice and emphasis on breathing makes it particularly suited for stroke treatment!
If you or someone you know would like to prevent stroke or heal from a stroke, join us for a class at Better Living Yoga in order to honor May as National Stroke Awareness Month!

Aubree is a yoga teacher, artist, and writer. YYT 200, owner of Root To Rise Holistics (@roottoriseholistics on Instagram).

References:

The Internet Stroke Center. (2019). Stroke statistics. National Institute of Health Specialized Programs of Translational Research in Acute Stroke (SPOTRIAS) Network.

Woodyard C. (2011). Exploring the therapeutic effects of yoga and its ability to increase quality of life. International journal of yoga, 4(2), 49–54. doi:10.4103/0973-6131.85485

Schmid, A. A., Miller, K. K., Van Puymbroeck, M., & DeBaun-Sprague, E. (2014). Yoga leads to multiple physical improvements after stroke, a pilot study. Complementary therapies in medicine, 22(6), 994-1000.
Flint Rehab (2018). 5 Huge, Overlooked Benefits of Yoga for Stroke Recovery. Retrieved from: https://www.flintrehab.com/2018/benefits-of-yoga-for-stroke-recovery/

Thayabaranathan, T., Andrew, N. E., Immink, M. A., Hillier, S., Stevens, P., Stolwyk, R., … & Cadilhac, D. A. (2017). Determining the potential benefits of yoga in chronic stroke care: a systematic review and meta-analysis. Topics in stroke rehabilitation, 24(4), 279-287.

Immink, M. A., Hillier, S., & Petkov, J. (2014). Randomized controlled trial of yoga for chronic poststroke hemiparesis: motor function, mental health, and quality of life outcomes. Topics in stroke rehabilitation, 21(3), 256-271.

Garrett, R., Immink, M. A., & Hillier, S. (2011). Becoming connected: The lived experience of yoga participation after stroke. Disability and Rehabilitation, 33(25-26), 2404-2415.