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Issue Date: July 01, 2015
Published Online: February 09, 2016
Updated: January 01, 2020
Changes in Emotional Regulation and Quality of Life After Therapeutic Yoga for Individuals With Traumatic Brain Injury
Author Affiliations
  • Indiana University
  • Colorado State University
  • Indiana University
  • Indiana University
  • Indiana University
  • Indiana University
Article Information
Complementary/Alternative Approaches / Neurologic Conditions / Traumatic Brain Injury / Prevention and Intervention
Poster Session   |   July 01, 2015
Changes in Emotional Regulation and Quality of Life After Therapeutic Yoga for Individuals With Traumatic Brain Injury
American Journal of Occupational Therapy, July 2015, Vol. 69, 6911515229. https://doi.org/10.5014/ajot.2015.69S1-PO6079
American Journal of Occupational Therapy, July 2015, Vol. 69, 6911515229. https://doi.org/10.5014/ajot.2015.69S1-PO6079
Abstract

Date Presented 4/18/2015

In this mixed-methods case study (N = 3), we found improvement in emotional regulation and quality of life for people with traumatic brain injury (TBI) after 8 wk of yoga. Yoga can be utilized in conjunction with traditional medicine to enhance physical and mental functioning during the rehabilitation process.

SIGNIFICANCE: Traumatic brain injury (TBI) is trauma to the head causing damage to the brain. It is estimated that approximately 1.7 million TBIs occur annually and that millions of people are living with residual disability following TBI. People with TBI commonly have impaired cognitive, physical, emotional, and psychosocial well-being—all of which may affect daily functioning and quality of life (QoL).
INNOVATION: Residual disabilities are common after TBI, even after intense rehabilitation. This often leads individuals to explore complementary and alternative medicines, such as yoga, in conjunction with traditional treatment to improve overall health. Therapeutic yoga is an emerging area of interest in the rehabilitation community and is defined as the application of yoga for health benefits; however, it has not been tested in people with TBI.
In this study, our objective was to explore the use of yoga to improve emotional regulation (ER) and QoL after TBI. Chronic TBI is associated with decreased functioning in multiple areas of occupation. Changes in the ability to monitor and regulate emotional and social behavior are among the most devastating impairments that occur following TBI. Difficulty in ER is associated with reduced QoL. Yoga may be an appropriate complementary therapy to manage these post-TBI issues.
METHOD: We used a mixed-methods prospective case study, and the setting was a Veterans Affairs (VA) medical center. Participants included 3 individuals with mild-to-moderate, chronic TBI (>1 yr) who (1) were aged >18 yr, (2) completed all rehabilitation, and (3) self-reported persistent physical impairments. Measures included the Difficulty in Emotion Regulation Scale (DERS); the Quality of Life After Brain Injury (QOLIBRI); and a qualitative, semistructured interview completed after intervention. The intervention consisted of individual yoga sessions, two times per week, for 8 wk.
Descriptive statistics and percentage of change calculations ([Time 2 - Time 1/Time 1] × 100) were used. Qualitative data were transcribed verbatim and entered into the software program NVivo. We discussed, explored, and agreed on selected themes while conducting a line-by-line analysis of each transcript. All data were labeled or coded into appropriate primary or secondary themes. Exemplar quotes are included.
RESULTS: The average age of the participants was 44 yr; 2 participants were female, and 1 was male. All participants completed the 8-wk yoga intervention. Mean percentage of change was 16% improvement for the DERS and 6% improvement for the QOLIBRI. Qualitative data support perceived benefits of yoga. Data were categorized into primary and secondary themes. Primary themes included QoL, mind–body connection, peaceful and calm, concentration and focus, and self-control. Secondary themes included social changes, physical changes lead to life changes, confidence to do things, and self-development. These exemplar quotes demonstrate the perceived and positive impact of yoga: “I mean it’s rocked my world … it’s changed my life … physically, emotionally, mentally … it’s given me, you know, my life back. It’s … opened up so many doors … for me” and “I think it would be incredibly valuable to someone … with brain injury … because of the connection.”
CONCLUSION: Our study provides preliminary evidence that an individualized 8-wk yoga intervention may improve ER and QoL after TBI. Further research is warranted to explore the impact of yoga for this population. To further facilitate a holistic approach to occupational therapy, yoga may be an appropriate choice for persons with TBI.