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strengtH, flExibility, And baLance THerapY After Stroke

2014-08-27 03:14:13 | BioPortfolio

Summary

Approximately 795,000 people suffer a stroke annually in the United States; 200,000 are recurrent strokes. The 17,000 veterans who suffer a stroke yearly are at great risk for a second stroke and therefore should be targeted for stroke risk factor management and prevention interventions.

Blood pressure (BP) and fear of falling related inactivity are important modifiable stroke risk factors. Both can be addressed through a yoga exercise intervention. Yoga, like tai-chi, is old world alternative medicine that has the potential to greatly impact the lives of older adults.

There are over 40 studies of yoga as a mechanism to lower BP; including 24 controlled studies. Recent reviews indicate evidence to support the use of yoga for people with hypertension, cardiovascular disease, or type 2 diabetes to manage stroke risk factors, including: BP; stress; inactivity; depression; fatigue; sleep; insulin resistance; glucose tolerance; and lipids.

Description

BACKGROUND: Approximately 780,000 people suffer a stroke annually in the United States; 200,000 are recurrent strokes. The 17,000 veterans who suffer a stroke yearly are at great risk for a second stroke and therefore should be targeted for stroke risk factor management and prevention interventions.

Blood pressure (BP) and fear of falling related inactivity are important modifiable stroke risk factors. Both can be addressed through a yoga exercise intervention. Yoga, like tai-chi, is old world alternative medicine that has the potential to greatly impact the lives of older adults.

There are over 40 studies of yoga as a mechanism to lower BP; including 24 controlled studies. Recent reviews indicate evidence to support the use of yoga for people with hypertension, cardiovascular disease, or type 2 diabetes to manage stroke risk factors, including: BP; stress; inactivity; depression; fatigue; sleep; insulin resistance; glucose tolerance; and lipids.

OBJECTIVES: Our long term goal is to develop and test a yoga exercise intervention in a large VA trial for veterans who have survived a TIA to manage secondary stroke risk factors. The objective of this pilot application is to obtain necessary information to support such a trial through the following specific aims: 1) determine the feasibility (including recruitment) of an 8 week yoga based intervention for veterans with stroke; 2) establish an appropriate dosing strategy for a post-TIA 8 week yoga exercise intervention for a future VA yoga implementation trial (Yoga Group, bi-weekly in-person vs Yoga Group Plus, bi-weekly in-person paired with almost daily at home yoga); and 3) estimate the effect size of yoga on the mean change in systolic BP to determine the appropriate VA trial sample size.

METHODS: We propose a mixed methods study to address the feasibility, dosing strategy, and estimation of effect size for the current pilot study. We will recruit 75 veterans to participate in the Yoga Group or Yoga Group Plus; 20 of the veterans will be including as a wait-list control. A registered yoga therapist (RYT) will teach all classes. Qualitative data will include semi-structured interviews after completion of the intervention regarding: veterans' perceived ability to do yoga exercise; satisfaction with the yoga intervention; satisfaction with the YRT; general health benefits for the intervention; and whether they will continue yoga practice. Quantitative data will include compliance and recruitment information as well as multiple standardized assessments before and after the 8 week intervention including: blood pressure readings; fear of falling; gait and mobility assessments; and quality of life; stress assessment; change in physical activity; quality of life. We will compare those in the 2 intervention groups to those in the wait-list control group.

IMPACT: We propose a yoga exercise intervention to manage blood pressure, the primary risk factor for stroke, to help reduce the risk a future TIA or stroke. We anticipate an important impact on veterans' healthcare as there is great potential for yoga to be used as a way to self-manage blood pressure and inactivity; thereby reducing the risk of a future TIA or stroke.

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment

Conditions

Stroke

Intervention

Yoga intervention focused on strength, flexibility, and balance therapy

Location

Richard Roudebush VA Medical Center, Indianapolis
Indianapolis
Indiana
United States
46202-2884

Status

Not yet recruiting

Source

Department of Veterans Affairs

Results (where available)

View Results

Links

Published on BioPortfolio: 2014-08-27T03:14:13-0400

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