The Evaluation of Yoga Interventions for Individuals With Limited Mobility: Pain, Psychological Variables, and Mindfulness
Curtis, Kathryn Joanna Brenda
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Objective: The aim of this dissertation was to evaluate specialized yoga interventions for populations with complex chronic health conditions involving chronic pain and limited mobility. Method: Three research trials were conducted at two rehabilitation hospitals in Toronto. In Study 1, participants (N = 10) admitted to Bridgepoint Health were recruited to participate in an 8-week, Hatha yoga program. In Study 2, participants with spinal cord injury (SCI, N = 12) were recruited to participate in an 8-week, Hatha yoga program at the Lyndhurst Centre. In Study 3, participants with SCI (N = 23) were randomized to a 6-week, Iyengar yoga group (IY, n = 11) or to a wait-list control group (WLC, n = 12). Questionnaires on pain, psychological variables, and mindfulness, were collected at two or three points in time. Results: In Study 1, repeated measures ANOVAs revealed a main effect of time for anxiety, self-compassion, and the magnification aspect of pain catastrophizing, such that anxiety and pain catastrophizing decreased and self-compassion increased from pre- to post-intervention. In Study 2, there were no significant changes in the quantitative measures but qualitative analysis of the semi-structured interviews revealed main themes regarding benefits along emotional, mental and physical domains. In Study 3, linear mixed effects growth models were conducted to evaluate main effects of group at T2, controlling for T1 scores. Depression scores were lower and self-compassion scores were higher at T2 in the IY group compared to the WLC group. The two groups were combined and analyzed across time by comparing pre- and post-intervention scores. Main effects of time were found for depression scores, self-compassion, mindfulness (total score and subscale scores for mindful observing and mindful non-reactivity), such that depressive symptoms decreased and self-compassion and the various facets of mindfulness increased from pre- to post-intervention. Discussion: The results from these studies show that a yoga program reduces depressive symptoms and increases self-compassion for individuals with SCI, and may also decrease anxiety and pain catastrophizing, and increase mindfulness for populations experiencing pain and limited mobility.