One in six Australians will have a stroke in their lifetime [1].

That’s about 51,000 strokes per year, or one every ten minutes. 
Worldwide, stroke is the second most common cause of premature death, after heart disease, and is the leading cause of disability among adults [2].

During a stroke, the blood supply to the brain is interrupted by a blocked or ruptured blood vessel. Cells in the brain are deprived of oxygen and nutrients, causing them to die. Damage is localised to the area of brain where the blood supply was interrupted. But in cases where the blood vessel has ruptured, bleeding increases pressure in the brain region, causing greater damage.

Symptoms of stroke include drooping of the face or mouth, loss of feeling and movement in the arms, and a loss of ability to speak clearly and or understand what others are saying. Only a doctor can diagnose a stroke but contact emergency services immediately if it’s suspected. The longer a stroke is untreated, the higher the likelihood of long-term brain damage.

Strokes may cause long-term difficulties with attention, decision-making, memory, speech, understanding others, movement and balance. While these difficulties are typically targeted in rehabilitation and long-term stroke management approaches, other less obvious consequences of stroke, such as poorer emotional well-being, may not be appropriately addressed [3].

Evidence-based lifestyle interventions such as yoga have a role to play in addressing unmet psychological, social and spiritual needs after a stroke [4].

►Emotional well-being

Peoples' lives change markedly after a stroke [5]. Along with poorer health, survivors often have reduced independence and must rely on others for basic needs. This changes the dynamics of their family environment, social interactions, lifestyle and ability to work.

While some stroke survivors are able to adapt to these changes, a significant proportion have trouble coping. Not surprisingly, stroke survivors commonly experience poorer emotional well-being, depression and anxiety [6.].

Not only can depression make daily challenges harder to cope with, and affect movement and balance [7], research shows those with post-stroke depression are likely to have poorer physical health outcomes and are more likely to die prematurely [8].

►How yoga can help after a stroke

Yoga is a system of self-development that has evolved over many thousands of years since its inception in ancient contemplative societies in southern Asia.

Yoga aims to integrate mind and body. This is appropriate for survivors, as strokes have consequences for both physical and mental function. Yoga’s holistic approach views health as relating to one’s mental, physical and social potential, not merely the absence of disease [9].

Fatigue and low exercise tolerance often make it difficult for stroke survivors to participate in standard modes of exercise. But yoga can be individualised and adapted to suit most individuals despite their movement abilities. In fact, yoga can be more accessible to those seeking to keep active after stroke than other forms of exercise [10].

With this level of accessibility, yoga can increase confidence and promote participation in other forms of physical activity and daily activities [11]. A study from the Unites States found eight weeks of yoga improved stroke survivors' balance and reduced their fear of falling [11].

►Meditation and mindfulness

Beyond movement and physical activity, yoga involves contemplative practices such as meditation [12]. This means paying attention to breathing and body sensations while moving or keeping still.

Regular meditation has been shown to promote mindfulness, a skill for purposefully maintaining attention in the present moment in an open and accepting way. Mindfuless training has been associated with a number of benefits, including improved emotional well-being and cognitive function [13].

Some commentators have proposed that mindfulness techniques engage the brain in particular ways that strengthen parts of the brain responsible for attention, decision making, working memory, and emotional regulation [14].

Regardless, feeling in control and able to cope provides a sense of self-mastery, leading to better stress management and emotional well-being [15]. Yoga can help us develop the skills necessary to remain in control of our physical and mental reactions when we face challenging situations.

►Starting out

Yoga sessions at Inner Focus Physiotherapy are conducted by registered Physiotherapists who are trained in neurological rehabilitation. Private initial assessments are conducted to assess impairments, and yoga treatments are conducted privately or in small fully supervised groups.

For more information on commencing a yoga program with an instructor who is also an experienced physiotherapist, please visitwww.innerfocusphysio.com.au or call 93821339.

►REFERENCES:

1. https://strokefoundation.com.au/…/fac…/no-postcode-untouched

2. Feigin, V. L., Forouzanfar, M. H., Krishnamurthi, R., Mensah, G. A., Connor, M., Bennett, D. A., ... & Murray, C. (2014). Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. The Lancet, 383(9913), 245-255.

3. Fang, J., Chen, L., Chen, L., Wang, C., Keeler, C. L., Ma, R., ... & Ji, C. (2014). Integrative medicine for subacute stroke rehabilitation: a study protocol for a multicentre, randomised, controlled trial. BMJ open, 4(12), e007080.

4. Asimina Lazaridou, Phaethon Philbrook, and Aria A. Tzika, “Yoga and Mindfulness as Therapeutic Interventions for Stroke Rehabilitation: A Systematic Review,” Evidence-Based Complementary and Alternative Medicine, vol. 2013, Article ID 357108, 9 pages, 2013. doi:10.1155/2013/357108

5. Garrett, R., Immink, M. A., & Hillier, S. (2011). Becoming connected: the lived experience of yoga participation after stroke. Disability and rehabilitation, 33(25-26), 2404-2415.

6. Anderson, C., Hackett, M., Parag, V., & Yapa, C. (2005). Frequency of Depression After Stroke: A Systematic Review of Observational Studies.

7. Metz, G. A. (2007). Stress as a modulator of motor system function and pathology. Reviews in the Neurosciences, 18(3-4), 209-222.

8. Williams, L. S., Ghose, S. S., & Swindle, R. W. (2014). Depression and other mental health diagnoses increase mortality risk after ischemic stroke.American Journal of Psychiatry.

9. Bircher, J. (2005). Towards a dynamic definition of health and disease.Medicine, Health Care and Philosophy, 8(3), 335-341.

10. Immink, M. A. (2014). Fatigue in neurological disorders: a review of self-regulation and mindfulness-based interventions. Fatigue: Biomedicine, Health & Behavior, 2(4), 202-218.

11. Schmid, A. A., Van Puymbroeck, M., Altenburger, P. A., Schalk, N. L., Dierks, T. A., Miller, K. K., ... & Williams, L. S. (2012). Poststroke balance improves with yoga a pilot study. Stroke, 43(9), 2402-2407.

12. Nash, J. D., & Newberg, A. (2013). Toward a unifying taxonomy and definition for meditation. Frontiers in psychology, 4.

13. Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. General hospital psychiatry, 4(1), 33-47.

14.http://www.cmu.edu/…/f…/mindfulness-training-and-health.html