1. Yoga for the Pediatric Patient Adam S. Fischer, Student Physical Therapist Andrew J. Walsh, Student Physical Therapist Bellarmine University DPT Program Background Yoga is a form of physical activity that benefits both the body and mind. Although there are many forms, each incorporates progressive dynamic and static posing, breathing, and relaxation techniques. Yoga originated in India and is founded in Buddhism, Jainism, and Hinduism over 4-5 thousand years ago. Recent literature has explored the numerous benefits of yoga as an adjunct therapeutic intervention for many pediatric diagnoses. Benefits of Yoga as an Intervention for the Pediatric Diagnoses 1., 2., 3., 4. Neuromuscular -Increased motor planning, speed, and performance -Increased mental and social acuity -Decreased auditory reaction time -Decreased visual reaction time Cardiopulmonary -Decreased autonomic dysfunction -Normalized breathing pattern -Decreased respiratory rate -Decreased blood pressure -Decreased heart rate Psychosocial -Decreased eating disorders -Increased quality of life -Increased stress coping -Improved body image -Decreased aggression -Increased attention -Increased focus Musculoskeletal -Decreased joint pain and dysfunction -Increased muscular endurance -Increased strength -Increased flexibility -Improved posture References 1. Mary Lou Galantino, PT, PhD, MSCE, Robyn Galbavy, PT, MPT, Lauren Quinn, DPT. Therapeutic Effects of Yoga for Children: A Systematic Review of the Literature. Pediatric Physical Therapy. 2008; 20:66-80 2. Subhadra Evans, PhD, Beth Sternlieb, BFA, Lonnie Zeltzer, MD, Jennie C. I. Tsao, PhD. Iyengar Yoga and the Use of Props for Pediatric Chronic Pain: A Case Study. Alternative Therapies. 2013; 19:66-70 3. Lisa C. Kaley-Isley, PhD, John Peterson, MD, Colleen Fischer, PhD, Emily Peterson, CYT. Yoga as a Complementary Therapy for Children and Adolescents: A Guide for Clinicians. 4. Gurjeet S. Birdee, MD, MPH, Gloria Y. Yeh, MD, MPH, Peter M. Wayne, PhD, Russel S. Phillips, MD, Roger B. Davis, ScD, and Paula Gardiner, MD, MPH. Clinical Applications of Yaga for the Pediatric Population: A Systematic Review. Academic Pediatrics. 2009; 9(4):212-220 5. http://www.longestlife.com/ebook/change.html (cardiopulmonary image) http://www.longestlife.com/ebook/change.html 6. http://armymedical.tpub.com/MD0010/MD00100027.htm (musculoskeletal image) http://armymedical.tpub.com/MD0010/MD00100027.htm 7. http://neuromuscular.wustl.edu/lab/patterns2.htm (neuromuscular image) http://neuromuscular.wustl.edu/lab/patterns2.htm 8. http://drrovner.com/psychological-evaluation-and-testing (psychosocial image) http://drrovner.com/psychological-evaluation-and-testing 9. http://www.ksrealitybites.com/2010/10/yoga-can-benefit-childhood- cancer.html (child bridge pose image) http://www.ksrealitybites.com/2010/10/yoga-can-benefit-childhood- cancer.html 10. http://commons.wikimedia.org/wiki/File:Yoga-Ohm.jpg (Om image) http://commons.wikimedia.org/wiki/File:Yoga-Ohm.jpg 11. http://www.thebikramyoga.net/advanced-bikram-yoga-poses/ (silhouette pose image) http://www.thebikramyoga.net/advanced-bikram-yoga-poses/ Interventions 1., 2., 3., 4. 1 hour interventions of Iyengar yoga 2x weekly for 1 month, 3x weekly for the second month, and 2x weekly the last 2 months, totaling ≈ 36 1 hour treatments 1.5 hour interventions of Sahaja Yoga for 2x weekly for 1.5 months, including regular meditation 0.5 hour interventions of yoga comprised of deep breathing, physical postures, and relaxation exercises 2x weekly for 3 weeks -0.5 hour of pediatric oriented yoga exercises 3x weekly for 4 consecutive weeks vs. regular PE class -2.5 hour interventions 1x daily for 2 weeks vs. 1.25 hour interventions 1x daily for 4 weeks of Pranayama, Asanas, and meditation -1.5 and 1 hour morning and evening interventions of yogic postures and breathing for 40 consecutive days -1.25 hour interventions of yoga for 7x weekly for 31 consecutive days vs. physical training alone (random placement) -1 hour interventions of Asanas and Pranayama yoga 2x daily for 7 consecutive days -5 hour intervention of integrated yogic practices weekly for 1 academic year -27 rounds of yoga breathing techniques 4x daily for 10 consecutive days -8 hour interventions of yoga training daily for 10 days -1 hour yoga classes weekly including postures, breathing practices, relaxation training, and a gazing concentration exercise -Intervention combined yoga postures, rolling pin massage, and progressive muscle relaxation intervention with 40 adolescents diagnosed with adjustment disorder and depression. -8 week, individualized yoga treatment added to standard outpatient treatment for adolescents diagnosed with an eating disorder -Twenty-five adolescents diagnosed with IBS took a one-hour instructional class then were asked to practice daily with a 14 minute yoga video at home Results 1., 2., 3., 4. -Cardiopulmonary & Psychosocial Respiratory rate (RR) and heart rate (HR) decreased, with no significant change in skin resistance, with identification of usefulness of yoga programming for children in community home environments -Psychosocial Possible long term increase in emotional balance and reduction in fears, with feelings of helplessness clearly reduced -Cardiopulmonary Significant improvement in yoga intervention group in the reduction of asthma attacks, scores for drug treatment, and peak flow rate -Cardiopulmonary Peak expiratory flow rate showed a significant improvement towards normalcy; 69% of total group reduced or stopped medication for asthma and improved in measured parameters (# of attacks, sputum production, etc.) -Psychosocial Improved delayed recall of spatial information -Cardiopulmonary Decreased exercise induced broncho-constriction -Neuromuscular Improvement in static motor performance -Psychosocial Significant improvements pre- to post-test were found for five of the Global Index scales, including: restless/impulsive, emotional ability, and ADHD Index. -Psychosocial The intervention was administered once to assess its immediate effects. The yoga participants (and not the controls) reported decreased anxiety and increased positive affect, and they were observed to show less anxious fidgeting and behavior. -Psychosocial Demonstrated greater decreases in eating disorder symptoms -Cardiopulmonary Pulmonary functions, exercise capacity, and exercise-induced bronchoconstriction were all reported to improve post- intervention -Psychosocial lower levels of functional disability, less use of emotion-focused avoidance, and lower anxiety following the program -Psychosocial Participants showed positive outcomes of weight loss, improved self concept, and improved anxiety symptoms -Cardiopulmonary Increased maximal expiratory pressure and volume