Review Article

Yoga and Mindfulness as Therapeutic Interventions for Stroke Rehabilitation: A Systematic Review

Table 1

Yoga as a therapeutic intervention for stroke rehabilitation.

AuthorsGroupsOutcome measures SampleDesignInteresting finding

Schmid et al., 2012 [25]Wait list (control) Yoga(1) Disability independent
(2) Fear of falling
(3) Balance
(4) Balance self-efficacy
(5) QOL
Control  
  Yoga  
Stroke patients VeteransRCT 8-week interventionIn within-group comparisons, yoga group data demonstrated significant improvement in balance

Lynton et al., 2007 [26]Yoga (1) O’Connor tweezer dexterity
(2) Boston aphasia exam
Stroke patients 6 months after stroke Beth Israel Medical Center, NY, USASingle case study 2 weeks Kundalini yoga practiceAll 3 participants showed improvement on dexterity

Bastille and Gill-Body, 2004 [27]Yoga (1) Berg balance scale
(2) Timed movement battery
(3) Stroke impact scale
Stroke patients <9 months after stroke Keene, NH, USASingle case study 4–7-week baseline period followed by 8-week intervention yoga practice3 subjects had improved TMB scores, and 2 subjects had improved BBS scores

Chan and Woollacott, 2007 [28]Exercise group (control) Yoga exercise group (intervention)(1) Geriatric depression scale
(2) State trait anxiety inventory
Control     Yoga   Poststroke population Royal Adelaide, Hospital South AustraliaSingle-blinded RCT 6-week standardized program that included home practiceParticipants in both groups exhibited a mixture of decreases, increases, and no changes in GDS15, STAI-Yl, and STAI-Y2 over the course of the trial

Garrett et al., 2011 [29]Wait list (control) Yoga (intervention)Biopsychosocial model
(1) Physiological experiences
(2) Psychological experiences
Control  
( )  Yoga  ( )
Individuals with chronic poststroke hemiparesis 9 months after stroke South AustraliaQualitative RCT 10-week yoga program involving movement, breathing, and meditation practicesParticipants reported greater sensation, feeling calmer, and becoming connected

McEwen et al., 2009 [30]Yoga (1) Performance quality rating scale (10 pt. scale) (estimate values)
(2) Canadian occupational performance measure
(3) Stroke impact scale
(4) Stanford self-efficacy for managing chronic disease (6-item scale)
(5) Activity-specific balance confidence
Rehabilitation center 1 year after stroke Toronto, CanadaSingle subject study with 2 replications CO-OP intervention conducted over ~10 sessionsIntervention was associated with significant performance improvements in self-selected functional goals

Johansson et al., 2012 [31]MBSR Treated/control(1) Self-assessment of mental fatigue (MBSR)
(2) Comprehensive psychopathological rating scale
(3) Digit symbol-coding
(4) FAS verbal fluency test
(5) Trail making test, mental fatigue, and information processing speed
   Stroke ( ) TBI, ( )  MBSR  ( )  Wait list control  ( )1 year post stroke or TBI patients USARCT 8-week MBSRMBSR may be a promising nonpharmacological treatment for mental fatigue after a stroke or TBI

Hofer et al., 2012 [32]Yoga Mental fatigue and related symptoms after neurological disorders and injuries (SQfMF) Stroke patients University Hospital of BernSingle subject study MBCTSignificant pre- to postassessment differences were observed in patients in poststroke fatigue

John et al., 2010 [33]Group A (film/music) Group B (meditation) Group C (control)(1) Hamilton rating scale for depression
(2) Berg balance scale
(3) Barthel ADL index
(4) Fatigue severity scale
Stroke patients Saudi ArabiaRCT 6-week intervention Pre- and postcontrol group designMusic therapy and meditation are more beneficial than conventional physiotherapy management alone

Van Puymbroeck et al., 2012 [34]Yoga/wait list (control)Stroke survivor's quality of life (SSQOL)Yoga  ( )  WL control  ( )6 months since last stroke USARCT 3 : 1 ratio 8-week yoga interventionResults showed improved activity, participation, and quality of life relative to controls

nr: not reported, WL: Wait list, RCT: randomized control trial, MBSR: mindfulness-based stress reduction program, MBCT: mindfulness-based cognitive therapy.