Foundations for Yoga Practice in Rehabilitation

Introduction

The science of rehabilitation is a living, changing art. So is yoga. There are benefits to studying both, and even greater value to combining the two in clinical practice. Biomedical care and holistic paths like yoga can bilaterally advance from joining hands as synergistic sciences.

Yoga, as both a science and as an art, “elicits a neurochemical response mediated by neurophysiological mechanisms” (Garner, 2016), and its practice in rehabilitation can honor its historical roots and rich cultural philosophy while concurrently evolving as an evidence-based therapy. While biomedical care saves lives with its demonstrated excellence in acute, crisis-based disease intervention (Garner, 2016), it’s weaker record with chronic disease prevention and management (Pomeroy, 2012; Van hecke, Torrance, & Smith, 2013; Elliott, Smith, Hannaford, Smith, & Chambers, 2002) makes yoga, specifically yoga that is evidence-based and evidence-informed, the perfect adjunct to clinical rehabilitation disciplines. Simply put, yoga’s inclusion in healthcare can improve rehabilitation, including its preventive, acute, and chronic care aspects, while also fostering creative, innovative dialogue that can transform healthcare, now and for the future.

The central theme of this chapter is to provide a foundation for a novel yogic model of rehabilitation practice using proposed common psychotherapeutic and physiological factors that affect patient outcomes. This model is girded by Ten Precepts. They can guide the use of yoga in rehabilitation, a medical, therapeutic yoga, in order to foster evidence-based and evidence-informed practice, which are representative of best practice techniques in rehabilitation.

The Ten Precepts follow and are discussed in this chapter. The evidenced-based practice of yoga in rehabilitation and wellness practice should (Garner, 2016):

• 1.

  View the person and their potential for injury or disease through a biopsychosocial model of assessment (Institute of Medicine, 2011; WHO, 2002) in order to affect all-health outcomes through reducing allostatic load.

• 2.

  Encourage establishing interdisciplinary integrative yoga education in healthcare (IOM, 2000; Pergolizzi et al., 2013) in order to protect the consumer of yoga and maximize clinical efficacy.

• 3.

  Attend to the breath prior to introduction of postures.

• 4.

  Advocate for biopsychosocial stability as a primary focus with mobility as a secondary focus, pursuing structural alignment of postures guided by six physiological principles.

• 5.

  Inform dynamic execution of breath and postures via: 1) internally supported postures(Asana) or 2) passive rehabilitation methods via externally supported postures (Asana) based on the value of their functional carryover to ADL’s (activities of daily living), like walking or lifting items, for example.

• 6.

  Combine Ayurvedic (sister science and medical side of yoga) clinical evaluation methods for analysis in yoga prescription.

• 7.

  Include evidence-based sound, music, and voice analysis as therapy to affect allostatic load, systemic inflammation, neural plasticity, and/or ventral/myelinated vagus nerve stimulation via pre-frontal cortex, motor cortex, cranial nerves and cardiorespiratory neural mechanisms, which also exert influence on pressure systems that affect laryngeal/thoracic, respiratory, and pelvic diaphragms.

• 8.

  Teach non-weight-bearing headstands (sirsAsana) and non-cervical-weight bearing shoulder stands (salamba sarvangAsana), emphasizing protection of vulnerable joints that include the small joints of the hands, feet, and the spine and pelvis.

• 9.

  Be non-dogmatic and welcoming to all disciplines of yoga, respecting all spiritual belief systems.

• 10.

  Guide the practitioner to seek the self, pursuant to one’s duty/mission (dharma).