Vance N.1,2, Danzl M.2, Ulanowski E.2
1Norton Healthcare, Physical Therapy, Louisville, United States, 2Bellarmine University, Physical Therapy, Louisville, United States
Background: Symptoms of Essential Tremor (ET) include tremor, decreased balance, diminished quality of life, and anxiety. Yoga is demonstrated in other patient populations to reduce stress, improve balance, and improve breathing coordination and quality. To date, an examination of the effects of yoga for patients with ET has not been described in the literature.
Purpose: The purpose of this report is to describe the design and outcomes of an innovative community-based group yoga program for individuals with ET, led by a physical therapist. A secondary objective is to suggest potential key components for exercise through yoga for individuals with ET that warrant future investigation.
Methods: The effects of yoga on symptoms associated with ET were investigated using a pre-test post-test outcomes study design. Nine subjects with a medical diagnosis of ET were recruited from local ET support groups, community exercise groups, and the rehabilitation services department of a large urban hospital. The intervention consisted of a one-hour guided yoga class, once a week, over an 8-week period. The program was provided by a licensed physical therapist who was also a neuro-resident and 200-hour registered yoga teacher. The specific yoga class was a modified version of the power vinyasa style of yoga. The class focused on incorporating the principles of vinyasa. Data collected included measures associated with symptoms of ET, including the Fullerton Advanced Balance Scale (FAB), McGill Quality of Life Questionnaire, TRG Essential Tremor Rating Assessment Scale (TRS) and The Beck Anxiety Inventory.
Results: Two subjects withdrew secondary to living and transportation changes and one subject withdrew due to medical needs associated with an unrelated condition. Each of the six subjects who completed the study demonstrated an improvement in tremor (range of 2-20% improvement on the TRS Activities of Daily Living subscale; range of 1.3-34.7% improvement on the TRS Performance subscale) and balance (range of 2.5-20% improvement on the FAB). Regarding quality of life, two participants rated an improvement in physical well-being and two reported improvement in emotional well-being. Five of six participants maintained baseline measure of very low anxiety.
Conclusion(s): Preliminary outcomes indicate that regular participation in a yoga class, led by a physical therapist, can lead to improvements in tremor reduction, balance with functional activities, and quality of life. This work provides a springboard for future research to further examine the effects of yoga for individuals with ET.
Implications: This report provides a description of yoga as an intervention for individuals with ET. Although there is limited research in this area and the overall level of evidence is low, yoga is a safe intervention that could potentially benefit patients with ET. The findings of this study also demonstrate a possible need for introducing yoga and principles of relaxation more frequently into neurological physical therapy practice. An additional clinical implication of this work is that individuals in the sample presented with balance impairments, highlighting the need for education to individuals with ET and assessments of fall risk and subsequent balance training for individuals with ET.
Funding acknowledgements: No funding was provided for this research.
Topic: Neurology
Ethics approval: Bellarmine Universitys Institutional Review Board approved this research (IRB #437). Informed consent was obtained from each participant.
All authors, affiliations and abstracts have been published as submitted.
