1. An Investigation of Functional Movement Impairments in Yoga Practitioners Before and After Yoga Posture Training and with Targeted Exercise Intervention
Sean Buchner, SPT*; Amanda Folger, SPT*; Brenda Boucher, PT PhD*
*Department of Physical Therapy, College of Health Professions
Purpose:
Movement impairments involve faulty movement patterns including abnormalities in posture and musculature. Spine and/or extremity deficits cluster to form various movement impairments, which may result in mechanical breakdown over time. 1,2,3 The purpose of this study was threefold:
Investigate the extent to which common movement impairments were found in a group of asymptomatic yoga practitioners prior to participation in an 8-week yoga training course.
Assess the extent to which movement impairments initially identified changed upon completion of an 8-week yoga training course.
Determine response to a follow-up 6-week home exercise program (HEP) that addressed individual impairments of participants.
Our study focused on the following movement impairments as described by Sarhmann: lumbar extension rotation (LER), dominant hamstrings (DH), scapular depression and downward rotation (SDDR), anterior glide and medial rotation of the shoulder (sAGMR), and anterior glide and medial rotation of the hip (hAGMR). 1,2,3,4
Methods:
Prior to initiation of an 8-week yoga training course, each participant was assessed using functional movements, and postural and muscular length/strength measurements. Identified deficits were placed into appropriate categories, ranked from 0-3 (0 = absent, 3 = severe). Assessment of movement impairments, as defined by Sahrmann, were performed for each participant prior to initiation and at completion of the training course. 1,5,6
Conclusion:
In the sample studied, movement impairments existed at a high rate among yoga practitioners, and the severity increased after participation in a yoga training course. The severity of movement impairments decreased among all subjects after a targeted exercise program (Figure 5).
Figure 1: Movement Impairment Syndromes (MIS) exhibited in regular yoga practitioners.
Figure 2: Magnification of initially present MIS with the addition of 8-week yoga training program.
Figure 3: Reduction in severity of MIS post 6-week targeted home exercise program (HEP).
Clinical Relevance:
The study identified the presence of movement impairments in a regularly practicing yoga population and revealed an increased severity of these impairments following an 8-week yoga training course. This suggests that yoga may accentuate faulty movement patterns present in individuals who practice regularly. Although a cause-and-effect inference cannot be made, we believe our findings suggest positive implications for the use of specific exercises to reduce faulty movement patterns in individuals with similar presentation of movement impairments.
Results:
Movement impairments existed in all subjects prior to participation in an 8-week yoga training course (Figure 1). At completion of the training course, re-assessment revealed significant increase in severity of movement impairments (Figure 2). Post 6-week individualized HEP, a significant decrease in severity of MIS was found in all subjects (Figure 3), with an average of 23% change from baseline (Figure 4).
Figure 5: Magnification and Improvement of MIS with the introduction of individualized HEP (mean change in MIS: 23%)
Posterior Gluteus Medius (PGM) testing position. Dysfunction is indicative of hip anterior glide medial rotation (hAGMR). 1,7
Serratus Anterior testing position. Dysfunction in this muscle was found to indicate movement impairments SDDR and sAGMR. 1,7
References:
Sahrmann SA. Diagnosis and Treatment of Movement Impairment Syndromes. St. Louis, MO. Mosby, Inc. A Harcourt Health Sciences Company,1st ed; 2002.
Sahrmann, S. Movement system impairment syndromes of the extremities, cervical and thoracic spines. St. Louis, Mo. : Elsevier/Mosby; 2011
Van Dillen LR, Sahrmann SA, Wagner JM. Classification, Intervention, and Outcomes for a Syndrome Person With Lumbar Rotation With Flexion. J of Phys Ther. 2005; 85:
Harris-Hayes M, Sahrmann SA, Norton BJ, Salsich BG. Diagnosis and Management of a Patient With Knee Pain Using the Movement System Impairment Classification System. J of Orthop Sports Phys Ther. 2008; 38(4):
Flynn, T Cleland J and Whitman J. User’s guide to the musculoskeletal examination. EIM; 2008.
Hislop H, Avers D, Brown M, Daniels L. Daniels And Worthingham's Muscle Testing\. St. Louis, Mo.: Elsevier; 2014.
Participants:
12 subjects, 3 males and 9 females, mean age 28 years old (±8.06SD) inclusion criteria: >18 years of age, >3 mo participation in yoga, registration and completion of an 8-week yoga training course, functional AROM and PROM in all extremities, > 3 mo without major injury, and no current spine abnormalities.
Posterior Gluteus Medius (PGM) strengthening. Disassociation of hip rotation from pelvis and spine to target hAGMR.. 1
Serratus Anterior strengthening. Scapula protracted to promote neuromuscular recruitment with arm flexion. 1
Figure 4: Percent change of MIS