Delrae Fawcett returns to update us on the results of the Yoga for the Treatment of Brain Injury study conducted by the University of British Columbia.
To many of us, concussions have long been thought of as nothing more than bonking your head, followed by someone (usually a parent or coach) telling you not to sleep (which is no longer recommended- by the way). We likely all know someone who had one, or we may even have had one or two ourselves. However, recently these seemingly benign injuries have been getting significant attention for their potentially long-lasting effects and impairments. Current data shows that approximately 15% of people who experience a concussion, go on to experience symptoms months or even years afters their injury, and some never fully recover.
Care of patients with chronic symptoms after concussion is fragmented and inconsistent across care providers, and regions. In part, this is a reflection of the lack of evidence-based treatments. The typical clinical post-concussion syndrome includes cognitive impairment, balance problems, sleep disturbance, dizziness, headaches, noise and light sensitivity, and emotional dysregulation. Interventions with some degree of evidence include meditation, psychological counselling, graded exercise, and pharmacotherapy. The variable nature of the symptoms often necessitates multiple approaches to treatments (e.g. medications for headache, physiotherapy for balance issues, psychotherapy for depression and cognitive rehabilitation for memory problems, etc.). Unfortunately, outside of private concussion clinics, access to most of these services is impractical and expensive. Thus creating a large accessibility gap for the treatment of concussion in within British Columbia, and possibly even nationally.
In the face of this clear need, yoga stands out as a tremendous opportunity to fill this void safely, economically, and practically. Yoga, modified for concussion, combines many of the currently accepted therapeutics (meditation, gradual return to exercise, balance retraining, and sleep regulation) into a single effective, engaging, and accessible option that has the potential to improve symptoms, wellbeing, and reduce the economic burden on patients and the health care system. We designed this pilot study to evaluate the efficacy of this intervention for individuals with post-concussive symptoms.
Participants were asked to engage in bi-weekly surveys assessing the severity of their symptoms, anxiety, and depression. Additionally, we collected saliva samples to measure cortisol levels. Cortisol is commonly referred to as the stress hormone, as it is an indicator of sympathetic nervous system activity. The sympathetic nervous system is responsible for our “fight or flight” response to a threat, and is often heightened in many disease states.
Participants committed to a 16-week study, the initial 8 weeks they were asked not to partake in any yoga related activities, followed by the 8-week yoga intervention.
The Mindful Brain Yoga intervention consisted of a gentle 60-minute beginner-level, trauma-informed hatha yoga class, three times a week for 8 weeks. In addition to yoga postures, the intervention included weekly themes, breath-work, and meditation, and specific considerations were taken into account for the traumatic brain injury population. The intervention was developed by a certified Yoga Therapist experienced in working with individuals with MTBI, and the classes were taught by two certified Yoga Therapists with experience teaching in clinical mental health and hospital settings. The teachers were educated in the symptoms and potential limitations of the population, as well as the rational for the specific practices outlined in the intervention.
What we found:
The average symptom scores for the Yoga-Intervention period were significantly lower than the average scores for the non-yoga period. Showing that reported symptoms were lower during the time the participants were engaging in the yoga practice.
Additionally, average scores for anxiety, depression, and cortisol were lower in the Yoga-Intervention period than the no-yoga period; however, the differences were not large enough to determine whether it was due explicitly to the yoga. There were no negative events reported during our study, which points to the safety of this calm and gentle style yoga for this population.
Our results showed trends towards improvements in overall concussion symptoms, depression, anxiety, and stress (through cortisol samples) and although this is a pilot study, it speaks to the safety, affordability, and accessibility of yoga as a treatment option for concussion symptoms. Yoga can be practised in one of the many yoga studios popping up, or even just in our own living rooms following a YouTube video.
These changes highlight the potential benefits of yoga for treating people with post-concussion symptoms. However, due to the small number of participants and the lack of control group, further research is needed in this area.
Delrae Fawcett is a Vancouver-based Research Coordinator at the University of British Columbia with a MSc in Health Psychology. She is passionate about yoga, health and wellness and believes in practising and living what you preach.