Clinical yoga program utilization in a large health care system.

Abstract

Affairs (VA) offers yoga for multiple conditions. Little information is available regarding how frequently yoga is utilized, by whom, or for which medical conditions. Here we describe referral patterns and patient adoption rates in a clinical yoga program, including telehealth yoga, at VA Palo Alto Health Care System (VAPAHCS). Referral and demographic data were extracted from the electronic medical records of 953 veterans (692 male, 261 female) referred to the outpatient clinical yoga program between 2010 and 2016. Attendance data were extracted from the same time plus 1 year. Referee demographics were compared to the overall VAPAHCS population. Twenty-two of the 187 referring providers accounted for half (50.4%) of referrals, predominantly from primary care and mental health clinics. Compared to the overall VAPAHCS patient population, referees were similar age and more likely to be female. Attendance was associated with age (older veterans were more likely to attend) but not gender. Those referred for mental health reasons were more likely to attend yoga compared to those referred for physical symptoms or for wellness (e.g., strength, health, mindfulness). Telehealth yoga follow through was lower but attendance rate similar to in-person yoga. These data provide an overview of referral and uptake in a large VA setting. Overall, referral was performed by a few providers in mental health and primary care clinics. The typical demographic of attendee was a White male from the Vietnam War era, reflective of the VA population. Impact StatementWe describe how veterans at the VA Palo Alto Health Care System are referred to a clinical yoga program for the treatment of various physical, psychological, and wellness goals. Here veterans of diverse demographic groups attend yoga classes via both telehealth and in-person modalities. Pain clinic referrals may require additional support as they attended less yoga than from other sources, yet research indicates they may particularly benefit from yoga.

Mind-body exercise interventions for prevention of post-traumatic stress disorder in trauma-exposed populations: a systematic review and meta-analysis

“…Mind-body exercise is widely practised and increasingly offered clinically as an adjunct or supplementary treatment for those with trauma-related disorders 44. MBE may also be a suitable means to, at least partially, prevent trauma-related psychopathology in high-risk trauma-exposed populations.…”

“…Mind-body exercise is widely practised and increasingly offered clinically as an adjunct or supplementary treatment for those with trauma-related disorders. 44 MBE may also be a suitable means to, at least partially, prevent trauma-related psychopathology in high-risk traumaexposed populations. As far as we are aware, this is the first systematic review and meta-analysis that examines the evidence for MBE interventions to prevent the development of trauma-related disorders, including ASD and PTSD.…”

“…5 Nonetheless, MBE is recognised as a promising emerging intervention 42 and is increasingly offered in clinical populations as an adjunct or supplementary treatment for mental disorders, including PTSD. 44 While the evidence base for MBE interventions as a treatment approach is yet to be established, research suggests that MBE may be an ideal candidate as a preventative intervention for PTSD because of its acceptability, ability to actively target cognitive and emotional processing as well as somatic and autonomic nervous system functioning. 45 46 A recent brain imaging study on PTSD patients found that participants who were treated with mindfulness-based stress reduction (MBSR), a broader intervention programme that includes yoga and meditation, had increased activation in brain regions involved in both cognitive and emotional processing 47 and that have been previously implicated in the pathophysiology of PTSD.…”

“…Despite this, MBE is yet to be recommended as a stand-alone treatment due to the limited number of high-quality controlled trials 5. Nonetheless, MBE is recognised as a promising emerging intervention42 and is increasingly offered in clinical populations as an adjunct or supplementary treatment for mental disorders, including PTSD 44…”

Alternative interventions in clinical mental health settings: A survey of mental health professionals' perceptions

“…Mental health benefits of these practices for people with severe mental illness have also been identified, including yoga in schizophrenia [ 21 ] and major depressive disorder [ 22 ], and pranayama [ 23 ] and chanting [ 24 ] for post-traumatic stress disorder. Authors of other studies have recommended use of breathwork [ 25 , 26 ] and yoga [ 27 , 28 ] as either standalone or adjunctive mental health interventions.…”