Ciccone S1, Khaing AM2, Barth CA3
1The International Commitee of the Red Cross, Physical Rehabilitation Programme, Geneva, Switzerland, 2Ministry of Health and Sport, Kyaing Tong, Myanmar, 3The International Commitee of the Red Cross, Geneva, Switzerland

Background: Science has proven the positive effect of yoga and its component parts on the body and mind. According to research, it increases flexibility and strength, contributes to stress reduction, reduces blood sugar, and regulates the central and autonomic nervous system, and due to its ability to encourage neuroplasticity can alter long-standing dysfunctional behavior. More specifically in the management of post-traumatic stress disorder and mental health disorders, yoga has been shown to benefit the mind and body globally. However, literature review shows lack of evidence of adapted yoga in physical rehabilitation of persons with lower limb amputation, especially in developing countries.

Purpose: To develop and to test an adapted yoga practice for persons with lower limb amputation.

Methods: The following steps were followed for developing the treatment practice:
  1. Literature review
  2. Consultation of (adapted) yoga manuals and compilation of appropriate exercises combining both physiotherapy and yoga principles as well as professional experiences
  3. Preparing treatment plan including various options for adaptations
  4. Peer review by Y4A (Yoga for Amputees) trainer
  5. Feasibility testing on service users with lower limb amputation in a physical rehabilitation centre in Myanmar
  6. Thorough testing on one service user over a course of two weeks taking individual needs into account

Results: Method one to four resulted in the treatment practice. This treatment practice was tested in step five and six and proved to be easily implementable. Instructions were understandable both verbally and non-verbally (i.e. visual and tactile cues) to keep translation to a minimum. No specific equipment was needed. All used equipment and materials were locally available, such as chairs, mats, belts and cushions.

Conclusion(s): The treatment practice is targeted at physiotherapists with either good knowledge of yoga practice or after a thorough briefing of an experienced and appropriately trained physiotherapist as profound knowledge about yoga asanas (postures) and pranayama (breathing techniques) and how to modify is a prerequisite for the implementation of adapted yoga. Adapted yoga is both a physical and contemplative practice and therefore to build on the body and mind connection on different levels. Research suggests that “the subjectively lived body and the living body of the organism are interrelated.” Therefore the change in the feeling of well-being of the person with lower limb amputation is an extremely important indicator of outcomes. Preliminary unpublished results demonstrate positive outcomes on the physical body, which is supported by quantifiable results and observations. Asana practices are easily adaptable for the specific needs of persons with lower limb amputations, using locally available materials.

Implications: This treatment practice demonstrates the potential of adapted yoga to enhance rehabilitation of persons with lower limb amputations and should be further tested in a larger cohort.

Keywords: Amputation, Adapted Yoga, Myanmar

Funding acknowledgements: Funded by the International Committee of the Red Cross (ICRC) and the Myanmar Ministry of Health and Sports (MoHS)

Topic: Disability & rehabilitation; Musculoskeletal: lower limb; Orthopaedics

Ethics approval required: No
Institution: The International Commitee of the Red Cross
Ethics committee: Ethical Commitee of the Canton of Geneva
Reason not required: This abstract describes the steps that have been undertaken in order to develop a treatment practice of adapted yoga for persons with lower limb amputation and as such states non-original operational research with any personal data.

All authors, affiliations and abstracts have been published as submitted.

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