› pdfsave › 27-01-2015744v2-e5-036.pdf · international journal of informative & futuristic...

1297 www.ijifr.com

Copyright © IJIFR 2015

Research Paper

International Journal of Informative & Futuristic Research ISSN (Online): 2347-1697

Volume 2 Issue 5 January 2015

Abstract

Children with intellectual disability having cerebral palsy will have problem in their motor functions and requires effective treatment plan in the management of such a condition. Yoga is a strengthening discipline that uses poses, sometimes referred to as postures, which include movements that may increase the body's flexibility. A study was conducted to explore the feasibility of using Yogasanas to assist children with intellectual disability having cerebral palsy to improve their hip and knee joint flexibility. The objective of the present study is to select Yogasanas based on the need and ability level of the sample and administers it for improving flexibility of hip and knee joint of Children with intellectual disability having cerebral palsy. Single group pre and post-test design was employed for 6 children with intellectual disability having cerebral palsy in the age range of 7 to 11 years. Appropriate tools to assess the flexibility of hip and knee joint were used after establishing its reliability and validity. Intervention was administered among the selected sample for 20 sessions (each session of 1 hour per day) from Monday to Friday for 20 days. The results after appropriate analysis reveal that there is significant improvement in the improvement of flexibility in hip and knee joint of children with intellectual disability having cerebral palsy. This study substantiates the positive effect of yoga on children with intellectual disability having cerebral palsy.

Effect Of Yogasanas In Improving Flexibility

Of Hip And Knee Joint Of Children With

Intellectual Disability Having Cerebral Palsy Paper ID IJIFR/ V2/ E5/ 036 Page No. 1297 - 1309 Subject Area Education

Key Words Yogasanas, Flexibility in Hip and Knee joints, Intellectual Disability, Cerebral

Palsy

Dr. C. Renuga Devi1

Assistant Professor

Department of Education

Mother Teresa Women's University

Kodaikanal, TamilNadu

1298

ISSN (Online): 2347-1697 International Journal of Informative & Futuristic Research (IJIFR)

Volume - 2, Issue - 5, January 2015 17th Edition, Page No: 1297-1309

Dr. C. Renuga Devi:: Effect Of Yogasanas In Improving Flexibility Of Hip And

Knee Joint Of Children With Intellectual Disability Having Cerebral Palsy

1. Introduction

Motor development is a very important part of growing up. Motor activities help children learn how

to use their bodies, gain confidence as they master skills, and prepare them for school. Normal

individual differences in motor ability are common and depend in part on the child's weight and

build. Atypical motor development may be an indication of developmental delays or problems such

as autism or cerebral palsy.

While all children grow and change at their own rate, some children can experience delays in their

development. Developmental delay is a descriptive term used in reference to an assessment of delay

on infants and young children in one or more of the following areas: Cognitive development,

physical development (which includes fine motor and gross motor), communication development,

social development, emotional development, or adaptive development. Developmental delay is

recognized by the failure to meet age-appropriate expectations that are based on the typical sequence

of child development. Intellectual disability is a condition in which there is delay or deficiency in all

aspects of development, i.e. there is global and noticeable deficiency in the development of motor,

cognitive, social, and language functions. This is the commonest form of developmental disability.

Cerebral palsy is a condition where there is gross delay in the development of motor functions.

Children with cerebral palsy have great difficulty in initiating and controlling their muscles and body

movements. Many of these children are perfectly well in all other aspects, such as in their speech,

learning ability and socialization. Even though both the conditions are independent in nature, if a

child with mental retardation is associated with cerebral palsy naturally the problem becomes

complex and requires effective treatment plan in the management of such a condition.

Yoga is one of the six schools of ancient Indian philosophy. Interpretation of the works of Patanjali

reveals that we have at our disposal an excellent management system called Yoga Sutra which

advocates a method of controlling the mind and body. In fact the sutras depict a crystallized picture

of what constitutes the mind, its functions and impediments. The body as a whole can be turned to

fight against problematic conditions. Systematic Yogasana practice helps prevent or arrest

deterioration and also brings about cures for many of the problematic conditions. It offers enormous

scope to help overcome various human problems, both mental and physical. Thus Yoga answers the

demands of both body and mind development.

1.1 Yoga

The word Yoga comes from sanskrit root ‘Yug’ meaning to join on Yoke, implying the integration of

every aspect of human being from the inner most to external. The father of modern Yogashashtra,

Patanjali Maharshi defines Yoga as ‘’Yogaschitta Vrutti Nirodhaha’’ that is controlling the nature of

the mind. Yoga can be defined by the following statement. (Krishnamacharya Yoga Mandiram,

1982)

To bring two thing together, to meet and to unite.

To cause the movement of the mind to converge

To enable one to achieve his potential.

To bring about focusing of attention

1.2 Asana

The word asana means posture originates from the Sanskrit word as which means ‘to be’, ‘to stay’,

or ‘to remain’ in a particular position. Thus, the word asana refer to a posture or a particular position,

which may be performed in various ways, i.e,

1299





i.Standing.

ii.Supine (lying on back).

iii.Prone (lying on the stomach).

iv.Sitting.

v.Kneeling (Smith, 1980).

Posture simply refers to a particular position. As per Desikachar (1982) there are two qualities of an

asana:

The individual doing an asana should experience comfort (Sukh).

He should also maintain a certain amount of steadiness in a given posture without much effort or

tension (Sthira).

To achieve both these qualities, a long period of practice is needed. The comfort and steadiness in a

posture is most often achieved through total concentration of the mind on the posture. The practice of

an asana must co-ordinate with breathing. When the mind concentrates on a particular object, the

body becomes fixed and somewhat relaxed. But one is unable to hold that position for long.

Apparently the body was not in a relaxed natural posture, though one may have felt so for a little

while. The idea behind the practice of asanas is to discipline the body to assume a posture in which

greater concentration can be achieved.

1.3 Yogic view of the body

Yoga is regarded as a science as well as a method that allows man to live a harmonious life while

favouring his spiritual progress through the control of mind and body. The great yogis tell us that

those who know how to combine yogic postures (Asanas), breathing exercises (Pranayama), and the

control of the mind or concentration (Dharana) may attain a state of perfection. The object of asana

and Pranayamas is the improvement of the human body from the physical point of view, while the

control of mind, i.e., the constructive power of consciousness, is beneficial to the inner force,

developing a positive, optimistic outlook on life.

Through the practice of the physical postures, or asanas, the spinal column as the muscles and joints

are maintained in a healthy and supple state. The practices of yoga not only help to keep the young

body strong and supple but also incorporate mental activities, disciplines that help to develop

attention and concentration, and stimulate the creative abilities that are latent within the child.

Yoga is an ancient Indian tradition which through diverse physical and mental practices the

practitioner strives to achieve a state of all around health. The practice of yoga has already been

shown to be of therapeutic benefit in cases with psychosomatic ailments such as bronchial asthma

(Nagarathna & Nagendra, 1985; Nagendra & Nagarathna, 1986). After 9 months of yogic practice,

mentally retarded children also showed improvement in general mental ability, psychomotor

coordination, and intelligent and social behaviour (Uma, Nagarathna, Nagendra, Vaidehi, &

Seethalakshmi, 1989).

1.4 Yoga and Flexibility

Yoga besides its relaxing, spiritual function is also a wonderful flexibility training program. The

most important factor is that stretch has to be included as an essential part of any fitness program.

Yoga is an excellent choice, because it not only stretches the muscles, but also the joints, which get

the kind of gentle stretch necessary for enhanced flexibility.

When the entire body is trained together, it develops a sense of harmony and balance. When

opposing muscle groups are trained together, flexibility will come faster as the opposing muscle

groups’ work together not against or without each other. The series of yoga poses called asanas work

1300





by safely stretching the muscles. This releases the lactic acid that builds up with muscle use and

causes stiffness, tension, pain, and fatigue. In addition, yoga increases the range of motion in joints.

It may also increase lubrication in the joints. The outcome is a sense of ease and fluidity throughout

the body.

Yoga stretches not only the muscles but all of the soft tissues of the body that includes ligaments,

tendons, and the fascia sheath that surrounds your muscles. In one study, participants had up to 35%

improvement in flexibility after only eight weeks of yoga. The greatest gains were in shoulder and

trunk flexibility. It is widely known that the words yoga and stretching go hand in hand. Everyone

should stretch regularly as part of a general fitness regime. Yoga stretches not only the muscles, but

also the joints. A body which may have been quite rigid at the beginning of learning yoga will start

to experience a remarkable flexibility in all parts, even those parts which have not been consciously

worked upon.

Yoga is good for increasing joint flexibility. Yoga and flexibility go hand in hand. While doing

yoga postures, an individual may need to stretch more, which will make his / her body gain more

support and get rid of any stiffness that you may have felt earlier. The asanas in yoga stretch and

strengthen the muscles as well as the joints. Thus good joint flexibility is so different from the

normal stretching exercise that which we do otherwise. Yoga postures are more systematic, scientific

and works with joints, muscles and ligaments like no other fitness workout.

1.5 Yoga for Children with Intellectual Disability

Yoga exercise has also been incorporated in manpower development and training curriculum dealing

with intellectual disability and attempts are on way to make it inclusive in school curriculum. Yoga

for children with intellectual disability

Should help co-ordinate the activities of the mind and body.

Should tend to reduce the distracted state of mind, helping the mind concentrate on the present

activity.

Should help improve his activities of daily living to a degree which could not be achieved before.

1.6 Postures for Persons with Intellectual Disability

Initially, the asana that are taught to persons with intellectual disability should be easy to grasp and

easy to perform. Hence, many of the asana and breathing techniques need suitable adaptations. While

adapting them to suit needs the following principles should be kept in mind.

Pre-requisite skills

Developmental age

Interest and needs

Physical characteristics

Socio cultural and other environmental factors

Availability of materials and resources

Availability of medical, consultation and treatment service

Parental concerns and priorities

Teacher strengths

Future placement goals

Community values and attitudes

1301





1.7 Asana Sequence

During practice the individual must not be allowed to do single asana alone. A certain amount of

preparation is necessary before the individual does that particular asana. Therefore, a sequence is

built up to provide this preparation. Once the main posture is performed, counter poses are necessary

to relieve the strain caused by the main asana. Sequence of asana is built by keeping the following

principles in mind:

Goal and purpose of asana should be clear

Single asana should not be practiced

Series of asana should be practiced together

Relaxing the body in a posture is of vital importance. Remove all tensions in the final posture.

Relax for a few minutes in between the Asanas.

Do not overexert beyond the capacity to maintain the postures for long durations.

Daily practice is essential for fast progress.

Yoga is a strengthening discipline that uses poses, sometimes referred to as postures, which include

movements that may increase the body's flexibility. Yoga poses range from very simple, such as lying

completely relaxed on the floor to moderate and difficult postures that may challenge body's limits.

When a person has learnt yoga and become comfortable with additional poses, body will experience

better balance, flexibility, range of motion and strength. A toned and balanced body may lead to fewer

injuries during routine activities.

2. Need of the Study

Children with intellectual disability in addition to their low intellectual functioning will encounter

with mobility difficulties if they are associated with Cerebral Palsy. When yoga is implemented

regularly to children with intellectual disability associated with cerebral palsy it will help such

children in:

greater freedom of movement

increased physical efficiency and performance

increased balance and coordination

decreased risk of low back pain

increased relaxation and stress reduction

decreased risk of injury

The yoga poses helps the deep abdominals to support and hence the body awareness is increased and

will help in maintaining proper posture. The increased flexibility and strength gained through yoga

will help in maintaining better posture in standing and sitting poses which ultimately develops core

strength. The object of yoga is to enable an individual to reach a better knowledge of ourselves. It is

a method designed to reveal the sources of creative hidden inside the human psyche and thus

involves the manifold expression of our being. When yoga is practiced correctly and conscientiously,

it becomes a sure way of restoring balance, helping to develop determination and resistance, and

above all, to find serenity and inner pace. Flexibility allows ease of movement, and increases stamina

and dexterity. Other benefits include an increase in bodily awareness and a relaxation in the stretched

muscle groups. Both of these benefits have positive implications for skill acquisition, recovery, and

performance. Hence in order to study about the flexibility of hip and knee joint of children with

intellectual disability associated with cerebral palsy the researcher has attempted to administer

Yogasanas in a systematic way among the selected sample.

1302





3. Objectives of the Study

I. To study the effect of selected Yogasanas in improving flexibility of Hip and Knee Joints of

Children with Intellectual Disability having Cerebral Palsy.

II. To compare the pre and posttest mean scores of the selected samples in Hip joint flexibility

through selected Yogasanas.

III. To compare the pre and posttest mean scores of the selected samples in Knee joint flexibility

through selected Yogasanas.

4. Methodology

The objective of the present study is to select yogasanas based on the need & ability level of the

sample and administer it for improving flexibility of Hip and Knee Joints of Children with

Intellectual Disability having Cerebral Palsy. Single group pre and post test design which is

categorized under informal experimental design was employed in the study.

4.1 Sample Size

Six children (both boys and girls) in the age group of 7-11 years with intellectual disability having

cerebral palsy with an intelligence quotient of 50 -70 who can follow the position and asanas were

selected as samples for the present study using purposive sampling technique under non probability

sampling method.

4.2 Research Procedure

A systematic procedure is applied to carry out the current study so that objective can be achieved

meaningfully. Once the conceptual framework was prepared, the objectives were finalized. As per

the objectives, the suitable research participants for research were identified. The researcher assessed

the students to collect base line data by administrating Sit and Reach Test. A sequence of asanas was

developed for the study after collecting the baseline data of the sample. Goniometer to measure the

flexibility and sit and reach test to assess the flexibility of hip and knee joint was administered to

study the effectiveness of asanas in flexibility of hip and knee joint.

The flexibility of hip and knee joint of the identified children was measured and recorded as pretest

scores. The best among the three trails was taken as the test score as prescribed in the standard

measurement procedure. Selected Yogasanas was administered for the samples for 20 sessions (one

hour per day for 5days - Monday to Friday in a week for 20 days). After 20 sessions of treatment the

hip and knee joint flexibility of the samples was measured to find out the effectiveness of yogasans

in improving the flexibility of hip and knee joint of the selected sample.

4.3 Nature of the tool

The following tools are developed to study the effect of selected Yogasanas in improving flexibility

of Hip and Knee Joints of Children with Intellectual Disability having Cerebral Palsy:

Table 4.3.1: Tools to study the effect of selected Yogasanas

S. N Tool Purpose

1 Goniometer (Equipment used in

Physiotherapy) To measure the flexibility in hip and knee joint.

2 Centimeter tape or scale To measure the flexibility in hip and knee joint.

1303





4.4 Reliability and Validity of the tool

The selected asana sequence based on the need and ability level of the sample was circulated among

5 yoga therapist and 5 Physiotherapists for their opinion. Based on the opinion obtained sequence

and asanas were finalized to suit the need of the sample. Since Goniometer and Sit and reach test is

standardized tool to measure the flexibility opinion regarding its use in the current study was sought

from the Physiotherapist.

5. Results and Discussion Paired t test on pretest and post test scores, mean and standard deviation was administered to find out

the effect of selected yogasans in improving the flexibility of hip and knee joint of children with

mental retardation having cerebral palsy. Individual performance analysis was also done to find out

the improvement in individual hip and knee joint flexibility.

5.1 Yogasanas and Flexibility of Hip joint

Performance of the selected sample on Hip joint flexibility was measured through pre and post

intervention. The mean score (100.00) attained by the sample at the pre intervention phase was

compared with that at post intervention (118.33). This difference was found to be statistically

significant ( t = 5.5, df = 5) at 1% level. This indicates that use of yogasans had positive effect on

flexibility of hip joint in children with intellectual disability having cerebral palsy.

Figure: 5.1.1: Comparison of the pretest and posttest mean scores of the selected sample in hip joint flexibility

through selected yogasanas

100

118.3333

Hip joint-pre Hip joint-post

Mean 100 118.3333

3

Asanas

1. Ardhabathakonasanam

2. Bathakonasanam

3. Ardhapachimothanasam

4. Pachimothanasam

5. Gomugasanam (sitting)

6. Trikonasanam (sitting)

Provide intervention to the samples to develop

flexibility in hip and knee joint.

4 Sit and reach test To test the flexibility of muscles in hip and knee

joint.

1304





5.2 Yogasanas and Flexibility of Knee joint

Performance of the selected sample on knee joint flexibility was measured through pre and post

intervention. The mean score (117.50) attained by the sample at the pre intervention phase was

compared with that at post intervention (126.66). This difference was found to be statistically

significant ( t = 3.84, df = 5) at 5% level. This indicates that use of Yogasanas had positive effect on

flexibility of knee joint in children with intellectual disability having cerebral palsy.

Figure: 5.2.1: Comparison of the pretest and posttest mean scores of the selected sample in Knee joint

flexibility through selected yogasans

5.3 Individual Performance Analysis

Individual performance analysis of the selected sample is also recorded to find out the effect of

Yogasanas among the selected sample. The posttest performance of each sample as against their

pretest performance scores shows that there exists significant improvement in the flexibility of the

knee and hip joint as a result of the systematic administration of Yogasanas. Comparison of pre and

post test scores of each sample is presented as below:

Table 5.3.1: Case 1- Yogasanas Comparison of pre and post test scores of each sample

Case 1

Name S. J

Sex Male

Age 7 years

Knee joint Pretest 120

Post test 125

Hip joint Pretest 80

Post test 110

Knee joint-Pre Knee joint-Post

Mean 117.5 126.6667

117.5

126.6667

Knee joint-Pre

Knee joint-Post

1305





Figure: 5.3.1: Comparison of Pre and Post test Scores of Case 1 in Hip and Knee Joint Flexibility

through Selected Yogasanas

Table 5.3.2: Case 2- Yogasanas Comparison of pre and post test scores of each sample

Case 2


through Selected Yogasanas

0

20

40

60

80

100

120

140

Knee Joint Hip Joint

120

80

125

110

Pre Test

Post Test

0

20

40

60

80

100

120

140


125

100

135

120

Pre Test

Post Test

Name I.J

Sex Male

Age 7 years


Post test 135


Post test 120

1306





Table 5.3.3: Case 3 - Yogasanas Comparison of pre and post test scores of each sample

Case 3

Figure5.3.3: Comparison of Pre and Post test Scores of Case 3 in Hip and Knee Joint Flexibility through

selected Yogasanas


Case 4

Pre Test

Post Test

0

20

40

60

80

100

120

140

Knee JointHip Joint

130

110

135

125

Pre Test

Post Test

Name R.S

Sex Male

Age 8 years


Post test 135


Post test 125

Name J.J

Sex Female

Age 11 years


Post test 135


Post test 125

1307






through selected Yogasanas


Case 5

Figure5.3.5:Comparison of Pre and Post test scores of Case 5 in Hip and Knee Joint Flexibility through

selected Yogasanas

110 115 120 125 130 135

Knee Joint

Hip Joint

130

120

135

125

Post Test

Pre Test

0 50 100 150

Knee Joint

Hip Joint

120

100

130

120

Post Test

Pre Test

Name V.M

Sex Female

Age 7 years


Post test 130


Post test 120

1308






Case 6

Figure 5.3.6: Comparison of Pre and Post test Scores of Case 6 in Hip and Knee Joint Flexibility through

selected Yogasanas

6. Scope of the Study

I. Sequence of asana to improve the flexibility of hip and knee joint can be identified and a

flexibility training package of such sequence can be developed and standardized for

implementing it to a large sample. This will enable the children to enhance their active

participation in activities of daily living.

II. Educational institutions enrolling children with mental retardation having cerebral palsy can

be equipped with yoga administrators which will help the children to improve their

flexibility in hip and knee joint.

III. Apart from providing treatment to the sample, training can be provided to the class teacher in

performing and developing asana sequence according to the need and ability of the child.

0

20

40

60

80

100

120


80 90

100 110

Pre Test

Post Test

Name V.K

Sex Female

Age 9 years


Post test 100


Post test 110

1309





7. Conclusion

The researcher through this study has attempted to bring into light the effectiveness of selected

asanas in improving hip and knee joint flexibility among children with intellectual disability having

cerebral palsy. The findings of the study reveal that there is considerable improvement in the hip and

knee joint flexibility among the selected sample.Quality of life is enhanced by improving and

maintaining a good range of motion in the joints. Overall flexibility should be developed with

specific joint range of motion needs in mind as the individual joints vary from one to another. Loss

of flexibility can be a predisposing factor for physical issues such as pain syndromes or balance

disorders. The hip joints are capable of a wide range of motion, including rotation, flexion and

extension. Increasing the flexibility of hip joints allows moving with less restriction and minimizes

the risk of injury to the knees, hips, ankles and lower back.Yoga, besides its relaxing, spiritual

function, is also a wonderful flexibility training program. In addition, yoga increases the range of

motion in joints. It also increase lubrication in the joints. Systematic and regular practice of yoga can

make body more flexible, giving the muscles and joints a greater range of motion. This study

substantiates the positive effect of yoga on children with intellectual disability having cerebral palsy.

References

[1] S.Chanchani & R.Chanchani, Yoga for children: A Complete Illustrated guide to Yoga, UBS

Publishers Distributors, New Delhi (1997).

[2] T.K.V.Desikachar, The Yoga of T. Krishnamacharya , Krihsnamacharya Yoga Mandiram, Madras (1982).

[3] M.L. Gharote, Guidelines for Yogic Practices, Medha Publications, Lonawala (1982).

[4] B.K.S.Iyengar, Light on Pranayama: Pranayama Dipika, Unwin Paperbacks, London (1981).

[5] B.K.S.Iyengar, Yoga Sutra of Patanjali: Translation and Commentary, Ramamani Iyengar Memorial

Institute, Pune (1987).

[6] C.Kisner, and A.L.Colby, Therapeutic Exercise Foundation and Techniques (4th Edition), F.A.Davis

Company, Philadelphia (2002).

[7] Krishnamacharya Yoga Mandiram and Vijay Human Services, Teaching Yogasana to the mentally

retarded persons a guide book for personnel serving the mentally retarded persons, Krihsnamacharya

Yoga Mandiram, Madras (1998).

[8] Madanmohan, D.P.Thombre, B.Balakumar, T.K.Nambinarayanan, S.Thakur, N.Krishnamurthy, and

A.Chandrabose, Effect of Yoga Training on Reaction time, respiratory Endurance and Muscle strength,

Indian j Physiol Pharmacol, 36 (4), PP 229 -233 (1992)

http://www.ijpp.com/IJPP%20archives/1992_36_4/229-233.pdf visited on 24/09/13.

[9] R.Nagarathna, and H.R.Nagendra, Yoga for bronchial asthma: a controlled study, British Medical Journal,

291, PP 1077-10 (1985) http://svyasa.edu.in visited on 24/09/13

[10] H.R.Nagendra, and R.Nagarathna, An integrated approach of yoga therapy for bronchial asthma: a 3-54

months prospective study, Journal of Asthma, 23(3), PP 123-137 (1986)

http://www.ncbi.nlm.nih.gov/pubmed/3745111visited on 24/09/13.

[11] H.R. Nagendra, Yoga its basis and applications, Swami Vivekananda Yoga Prakashna, Bangalore (2000)

[12] S.S. Sareswathi, Yoga Education for children, Bihar school of yoga pubilication Trust,Rikhia (1999).

[13] K.Uma, H.R. Nagendra, R.Nagarathna, and S.Vaidehi, The integrated approach of yoga: a therapeutic

tool for mentally handicapped children: a one year controlled study, Journal of Mental Deficiency

Research, 33, PP 415-421 (1989) www.cebp.nl/vault_public/filesystem/?ID=2185 visited on 24/09/13.

› pdfsave › 27-01-2015744v2-e5-036.pdf · international journal of informative & futuristic...

Documents