Alysha Walter’s research while affiliated with East Carolina University and other places

Aim Researchers have reported measurable improvements in emotional and physical health among adults post-stroke after participating in complementary and integrative health techniques. The aim of this manuscript was to systematically review the effectiveness of active complementary and integrative health interventions as a treatment modality for adults post-stroke. Method For this review, active interventions were defined as those that required participants to be in control of initiating their own body movement. Five active complementary and integrative health techniques were reviewed and included: Feldenkrais Method, qigong, Pilates, Tai Chi, and yoga. A key word search was conducted in Medline, Cochrane Library, EBSCO, Google Scholar, and PubMed. Inclusion criteria for studies were (1) randomized controlled trials on the effects of active complementary and integrative health interventions, (2) all participants had to be post-stroke, and (3) studies appeared in English in a peer-reviewed journal. Results Articles in this review included one Qigong, five Pilates, nine Tai Chi, and five yoga studies. All 20 manuscripts reported improvements for participants. Participants in Pilates experienced improvements in quality of life. Improvements in functional balance, standing and dynamic balance, reaction time, maximum excursion, and quality of life were reported in the Pilates studies. Participants in the TC studies experienced a range of positive results including center of gravity, increased reaction time, improved aerobic endurance, fewer falls, sway length and velocity, functional reach, dynamic gait, walking speed, and static and dynamic balance. Improvements after participation in the yoga manuscripts consisted of reduced depression, decreased state and trait anxiety, improved balance, reduction in fear of falling, and enhanced quality of life. Conclusion Based on the small number of randomized controlled trials, this systematic review reported the effectiveness of four active mind-body interventions for individuals post-stroke. The strongest evidence was for the use of Tai Chi, followed by Pilates and yoga. • Implications for rehabilitation • Clinicians should consider the benefits of qigong, Pilates, Tai Chi, and yoga to best meet individual patient needs and goals. • Clinicians who offer qigong, Pilates, Tai Chi, and/or yoga should be qualified to instruct the specific active complementary and integrative health technique or refer patients to those who are qualified. • Locate qigong, Pilates, Tai Chi, and yoga classes that are appropriate for people post-stroke in the community to help integrate patients into a program after treatment.

An informal caregiver (ICG) is an individual who provides care (unpaid) to a person with a disability or disease. ICGs report the extreme time spent as an ICG lowers their availability to participate in leisure. Research involving ICGs who participated in leisure resulted in lower depression levels, perceived stress, and burden. Studies involving ICGs who participate in yoga may experience health improvements, but due to the small number of studies involving ICGs feasibility aspects need to be further addressed. ICGs attended an 8-week therapeutic yoga program that examined feasibility components. The feasibility questionnaire implemented at the end of the study resulted in high scores indicating the majority of participants felt the yoga study was feasible. Three qualitative feasibility categories (i.e. programmatic aspects, safety concerns, and care recipient separation) emerged from the focus group/individual interviews. Future studies should replicate a similar structured yoga program to strengthen the positive feasibility results.

Parkinson's disease (PD) is a neurodegenerative disorder marked by progressive degenerative motor symptoms (e.g., tremors, impaired balance and gait) and nonmotor symptoms (e.g., fatigue, sleep disturbances, pain) that can negatively influence health-related quality of life (HRQoL). Previous studies have shown that yoga for individuals with PD improves balance, strength, and mobility. However, little research has been conducted to determine the effect of yoga on nonmotor symptoms of PD. The purpose of this study was to examine changes in nonmotor symptoms among individuals with PD following an 8-week yoga intervention. Data used for analyses were part of a larger study that researched improvements in motor function for individuals with PD. Participants (N = 27) were randomly assigned to experimental (n = 15) and control (n = 12) groups and completed pre- and postintervention quantitative measures. Within-group improvements were statistically significant for fatigue measured by the Parkinson's Fatigue Scale, balance confidence measured by the Activities Balance Confidence Scale, the belief in one's ability to manage falls measured by the Falls Management Scale, activity constraints measured by the Activities Constraint Questionnaire, and PD-specific quality of life measured by the Parkinson's Disease Questionnaire-8. Across-group changes were statistically significant for activity constraints. Findings indicate yoga may be an efficacious intervention for improving nonmotor symptoms as well as HRQoL for individuals with PD.

Abstract Parkinson's disease (PD) affects nearly 10 million people worldwide, leading to decreased mobility and balance and potential loss of independence. Yoga has been associated with improved function for people with PD, but the predictive factors for improved functional outcomes as a result of yoga participation remain unexamined. The objective of this secondary data analysis was to identify predictive factors of functional improvement for people with PD after an 8-week yoga intervention. Stepwise multiple linear regression was used to identify significant predictors of improvement in balance, fall control, PD symptoms, and activity constraints. Lower cognitive functioning was predictive of improvement in perceived control over falls, body responsiveness was predictive of improvement in PD-specific symptoms, and gait velocity was predictive of improvement in balance and activity constraints. Future research is warranted to evaluate the use of screeners to predict who is the best fit for yoga therapy. Additional research is needed to evaluate the need to include cognitive self-management training concurrent with yoga therapy.

[This corrects the article DOI: 10.1155/2018/8516351.].

Individuals with Parkinson’s Disease (PD) experience significant limitations in motor function, functional gait, postural stability, and balance. These limitations often lead to higher incidences of falls, which have significant complications for individuals with PD. Yoga may improve these functional deficits in individuals with PD. The objective of this study was to determine changes in motor function, functional gait, postural stability, and balance control for community dwelling individuals with PD. This randomized, wait-list controlled pilot study examined the influence of an 8-week yoga intervention for people with PD who met the following inclusion criteria: endorsing a fear of falling, being able to speak English, scoring 4/6 on the minimental state exam, and being willing to attend the intervention twice weekly for 8-weeks. Participants in the yoga group (n=15) experienced improvements in motor function, postural stability, functional gait, and freezing gait, as well as reductions in fall risk. Participants in the wait-list control (n=12) also significantly improved in postural stability, although their fall risk was not reduced. Individuals in the yoga group significantly reduced their fall risk. An 8-week yoga intervention may reduce fall risk and improve postural stability, and functional and freezing gait in individuals with PD. This clinical trial is registered as protocol record Pro00041068 in clinicaltrials.gov.

Parkinson's disease (PD) often leads to poor balance, increased falls, and fear of falling, all of which can reduce participation in life activities. Yoga, which usually includes physical exercise, can improve functioning and life participation; however, limited research has been conducted on the effects of yoga on life participation of individuals with PD. This study had two purposes: (1) to identify and understand the perceived activities and participation outcomes associated a therapeutic yoga intervention for individuals with PD; and (2) to compare the perceived activities and participation outcomes with the outcomes measured in the clinical trial. A single-blind, randomized, waitlist-controlled, phase II exploratory pilot study using an after-trial embedded mixed methods design (clinical trial Pro00041068) evaluated the effect of an 8-week Hatha Yoga intervention on individuals with PD. Directed content analysis was used to analyze focus group interviews with participants who completed the yoga intervention. Quantitative and qualitative data were merged and compared using a data comparison matrix. Qualitative analysis indicated many activities and participation outcomes. Comparison of qualitative and quantitative data indicated the yoga intervention led to improved balance, mobility, and functional gait, and fewer falls. These outcomes reached beyond the intervention and into participants' daily lives. Results support the use of Hatha Yoga as a community-based rehabilitation intervention for individuals with PD. Yoga, as part of an interdisciplinary approach to treatment, can improve many types of activities and participation outcomes (e.g., mobility, social relationships, self-care, handling stress, recreation).

This systematic review examined available literature on mind and body complementary health practices for informal caregivers (ICG). The United States Department of Health and Human Services defines mind and body complementary health practices as acupuncture, massage therapy, chiropractic osteopathic manipulation, healing touch, hypnotherapy, guided imagery, breathing exercises, progressive muscle relaxation, yoga, tai chi, qi gong, Rolfing Structural Integration, Feldenkrais method, Alexander technique, and Trager psychophysical integration. Literature related to these mind and body practices were searched using PubMed, Elton B. Stephens Co. (EBSCO), and Google Scholar databases. The screening process resulted in 220 sources that appeared for the search terms "ICG" and each of the mind and body practices. Four yoga manuscripts met the final inclusion criteria. While the level of evidence for ICG is weak generally, examples of improvements after yoga participation included reduced depression levels and state anxiety, and improvement in physical fitness. Implications for recreational therapy practice are discussed.