Yoga for correction of lymphedema′s impairment of gait as an adjunct to lymphatic drainage: A pilot observational study

Abstract

Introduction:Yoga used as a major component of integrative treatment protocol in 14 Indian village camps improved quality-of-life in 425 lymphatic filariasis patients. They experienced better mobility and reduced disability. This paper documents the gait abnormalities observed in lower limb lymphedema patients and the locomotor changes following integrative treatment.Materials and Methods:Yoga postures were performed as explained by traditional yoga practice in two sessions: Before ayurvedic oil massage without compression bandages and after the massage with compression bandages. Each yoga posture lasted for 5 min and the whole session ended in 45 min. Throughout each session, we advised patients to do long, diaphragmatic breathing, concentrating on each breath. The flexion of joints was coordinated with exhalation and extension with inhalation. We educated the patients to do longer expiration than inspiration.Results and Discussion:A total of 98 patients (133 limbs) attending the 6th month follow-up were evaluated. The most common gait abnormality was antalgic gait. Structural and functional abnormalities were observed in hip, knee and ankle joints. We found that yoga as an adjunct to other components in integrative treatment improved the gait problems. Long standing lymphedema caused altered gait and joint deformities. This was mostly due to inactivity causing muscle weakness and edema within and around the muscles. Both large and small limbs have shown significant volume reduction (P < 0.01) during follow-up after 6 months.Conclusion:There can be a mixed etiology for gait related problems in lymphedema patients. Further studies are recommended to understand the causes of deformities in lymphedema patients and an exact role of yoga.

The effects of yoga on shoulder and spinal actions for women with breast cancer-related lymphoedema of the arm: A randomised controlled pilot study

“…In addition faulty body posture has been reported after breast cancer treatment of mastectomy [31] a high risk factor for BCRL, indicating a forward leaning of the trunk and lack of symmetry in the trunk and shoulders. These changes may be a result of the swelling, the different weight distribution of the lymphoedematous limb and changed biomechanics of the trunk and shoulder girdle from breast cancer treatment, similar to what has been reported for those with lower limb lymphoedema [32]. Nevertheless it must be acknowledged that it is not uncommon for women in this age group (median age 58) to have pelvic obliquity from various age and life related stresses on the lower body and pelvis including the effects of childbirth [33] affecting postural alignment, pelvic stability, and walking gait and hence the observed pelvic obliquity may not be solely associated with BCRL.…”

“…We have previously reported reduced symptoms and tissue density in the upper arm and reduction in fluid of the affected arm for the intervention group [ 17 ]. It is likely that these improvements made the action of abduction easier in the same way reduction of fluid and improved postural alignment and stability improved walking gait of those with lower limb lymhoedema [ 32 ].…”

Assessing the Quality of the Life of Lymphatic Filariasis Patients with Elephantoid Legs in a Post Mass Drug Administration (MDA) Phase Residing in Cherthala Taluk, Alappuzha

“…The disease affects the economic status of the diseased people and their family indirectly as they had to quit their job or reduce the working time comparing to other studies where the least domain specific mean score was found to be mobility. 7,8,9,10 In contrast to the study conducted in Tiruchirappalli, 7 the highest domain specific score was found in psychological health in the present study. Hence it can be concluded that the patients were well-adjusted with their disease emotionally.…”

Increased exhalation to inhalation ratio during breathing enhances high‐frequency heart rate variability in healthy adults

“…Our study suggests a potential mechanism for physiological and psychological benefits of interventions that focus on breathing modulation (e.g., yoga and meditation), by directly enhancing the parasympathetic nervous system modulated via cardiovagal activity as indicated by increased RMSSD and HF-HRV. Intervention studies have shown that breathing with long exhalation can improve physiological outcomes such as treatment of cardiovascular diseases and enhancement of the immune system, as well as lead to psychological outcomes such as increased relaxation, stress reduction, mindfulness, and positive energy (Aggithaya et al, 2015;Brown & Gerbarg, 2009;Jacobs, 2001;Van Diest et al, 2014). Future studies using larger sample sizes are needed to replicate these findings, including examining the onset and offset of HRV changes that result from varying E:I ratio.…”