M. Ganesan1, J. Roche2, S. Subramanian3, V. Rajagopalan4, M. Chase5
1University of St Augustine, Physical Therapy, San Marcos, United States, 2Wayne State University, Department of Health Care Sciences, Physical Therapy Program, Detroit, United States, 3UT Health, Department of Physical Therapy, San Antonio, United States, 4Oxford College of Physiotherapy, RGUHS, Department of Physical Therapy, Bangalore, India, 5Cuyamaca College, Library, El Cajon, United States
Background: Duchenne muscular dystrophy (DMD) is an X-chromosome-linked muscle disease, which affects biological males. DMD severely limits mobility and function due to progressive degeneration of both skeletal and cardiac muscle and leads to early death. Disease progression and associated impairments are only minimally controlled by medications, rehabilitative therapies, and respiratory hygiene, thus leading caregivers to seek alternative therapies. Since yoga can improve mobility and optimize cardio-respiratory function in healthy individuals, it is appealing to ascertain if individuals with DMD may also benefit from yoga.
Purpose: The primary objective of this research was to review the literature on the effect of yoga intervention on the symptomatology of DMD.
Methods: Comprehensive search strategies were performed in PubMed/MEDLINE, Sport Discus, ProQuest Health and Medicine Collection, Web of Science Core Collection, and CINAHL. The search strategies combined keyword variants and database-specific subject headings for each of the two main concepts: DMD and yoga. Results were filtered for academic/scholarly journal articles published in the English language between January 1, 2001, and September 10, 2022. Articles were excluded if the studies did not involve individuals with DMD and did not look at yoga intervention. Based on our inclusion criteria, we found five intervention studies that involved yoga and DMD. The methodological quality of these studies was assessed by two independent evaluators using the modified Down’s and Black checklist, which has 27 items, and yields scores that can range from zero (lowest quality) to 28 (highest quality). Arbitration was performed by the third evaluator when there were discrepancies in scores between the two evaluators. Based on the range of total scores, the studies were categorized as “excellent” (24-28), “good” (19-23), “fair” (14-18), and “poor” (≤13) in quality.
Results:
Out of the five studies, four studies were ranked as fair (scores of 17, 15, 15, 15) and one was ranked as poor in quality (score 3), with a total sample size of 427 participants. All studies used yoga as an adjunct to standard pharmacological and/or rehabilitative therapies. The study designs were pre versus post (2-studies) or randomized controlled (3-studies). The studies mostly used a combination of various yoga techniques, such as asanas (postures), dhyana (meditation), and pranayama (breathing practice). The outcome measures included respiratory function (3-studies), heart rate variability (1-study), mobility (1-study), and self-care (1-study), pediatric quality of life status (1-study). All five studies reported improvement in outcomes using yoga as an adjunct to standard care. A meta-analysis was not performed due to the lack of uniformity in the outcome measures used in the studies.
Conclusions: Yoga as an adjunct to standard care might have the potential to improve outcomes in patients with DMD. However, there is a lack of high-quality evidence on the effect of yoga on the symptomatology of DMD, thus emphasizing the need for additional well-designed studies on this subject.
Implications: In physiotherapy practice, interprofessional educational experiences on yoga might help physiotherapists become more aware of the potential benefits of yoga for patients with DMD, thus encouraging physiotherapists to incorporate yoga techniques into clinical practice and research.
Funding acknowledgements: This study did not receive any funds
Keywords:
Muscular dystrophy
Yoga
Review
Muscular dystrophy
Yoga
Review
Topics:
Neurology
Research methodology, knowledge translation & implementation science
Neurology
Research methodology, knowledge translation & implementation science
Did this work require ethics approval? No
Reason: Our IRB stated that the review does not involve collecting data from human subjects, it does not require IRB permission. Enclosed is the letter from IRB.
All authors, affiliations and abstracts have been published as submitted.
