Naveen K.V Ph.D.,

Swami Vivekananda Yoga University

Bangalore, India

Derived from the Latin word "rehabilitare" meaning to make fit again.

CAN THE BRAIN CHANGE ?

GENETIC (Nature) EXPERIENCE (Nurture)

Birth 15 months 2-3 years

Nutrition Environmental stimulation Learning Social contact …… & Yoga ( which includes all the above)

1. Yogah cittavrtti nirodahYoga is the process of gaining mastery over mental modifications Patanjali’s Yoga Sutras 1:2

2. Manah prasamanopayah yogah ityabidheeyateYoga is the skill to calm the mind Yoga Vasista

3. Samatvam yoga uchyateYoga is equilibrium Bhagavadgita

general pain, back and neck pain, carpal tunnel syndrome, headaches, fibromyalgia, multiple sclerosis, epilepsy, muscular dysfunction, stroke, Parkinson disease, and attention deficit-hyperactivity disorder

Neurology. 2008 ; 70(24): 2321-8.

Yoga Therapy as an evidence based science in the management of:

1.Multiple Sclerosis2.ALZHEIMER’S Disease3.Epilepsy4.Parkinson’s Disease5.Stroke6.Carpal Tunnel Syndrome7.Chronic Pain

An auto-immune mediated progressive demyelinating disease of the CNS

The myelin sheath is destroyed and replaced by sclerotic tissue (sclerosis)

CAUSE- unknownMultiple factors- viral infection,

environmental factors, geographic location and genetic predisposition

Common in WOMEN ages 20-40

PATHOPHYSIOLOGYSensitized T cells will enter the brain

and promote antibody production that damages the myelin sheath

Plaques of sclerotic tissues appear on the demyelinated axons interrupting the neuronal transmission

PATHOPHYSIOLOGYThe most common areas affected

are Optic nerves and chiasm Cerebrum Cerebellum Spinal cord

CLINICAL MANIFESTATIONS1. Visual problems such as

diplopia, blurred vision and nystagmus

2. Motor dysfunction3. Fatigue4. Psychological problems like mood

swings, depression5. Spasticity

DIAGNOSTIC TESTS1. MRI- primary diagnostic study2. CSF Immunoglobulin G

Nine review articles and two original studies

Six months of Iyengar Yoga improved the symptoms of fatigue (1)

Three months of integrated yoga module reduced muscular rigidity (2)

A specialized yoga module for the elderly has improved gait, balance and mobility in a geriatric population (3, 4)

1. Neurology. 2004 Jun 8;62(11):2058-642. Proceedings of API. 1999; 29-303. Med Sci Monit. 2007 Dec;13(12):LE19-20.4. Arch Phys Med Rehabil. 2005 Sep;86(9):1830-7

Yoga Interventions

1.Promote physical mobilitySukshma Vyayama, Breathing exercisesAsanas with supportSchedule activity and rest periods

Yoga Interventions2. Prevent injuries Improve the gait and Balance Wide stance walking

The Practices Baddha Konasana strech (assisted) Pavanamukthasana kriya (assisted)

3. Enhance bladder and bowel control

Set a voiding schedule Adequate fluids, dietary fibers and

bowel training program

Yoga practices: Satvic Diet Yoga kriyas (gaining voluntary control

over involuntary functions)

4. Manage speech and swallowing difficulties

Speech therapy &Carefully feeding

Yoga practices:Chanting (nadanusandhana)

5. Improve Sensory and Cognitive function

For diplopia Offer emotional support by involving the

family in the care

Yoga practices Trataka Pranayama Bhakthi yoga Philosophy of yoga

6. Strengthen coping mechanism Alleviate the stress

Yoga Practices:

Chanting Meditation Relaxation techniques--------------------------------------------------------

A progressive neurologic disorder that affects the brain resulting in cognitive impairments

CAUSES:UnknownPotential factors- Amyloid

plaques in the brain, Oxidative stress, neurochemical deficiencies

CLINCAL MANIFESTATIONS1. Forgetfulness2. Recent memory loss3. Difficulty learning4. Deterioration in personal hygiene5. Inability to concentrate

LATE CLINICAL MANIFESTATIONS6. Difficulty in abstract thinking7. Difficulty communicating8. Severe deterioration in memory,

language and motor function9. Repetitive action- perseveration10. Personality changes

DIAGNOSTIC TESTNeurologic examinationPET scanEEG, CT and MRIOther tests to rule out Vit B

deficiencies and hypothyroidismAutopsy is the most definitive

Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment

Cochrane Database Syst Rev. 2008 Apr 16;(2):CD005381

Sahaja yoga improves neurocognitive functions in patients with major depression 1

Pranayama improves verbal and spatial memory scores 2

Combination of aerobic exercises and yoga improved cognitive and psychological functioning in the elderly 3

1. Psychol Rep. 1997 Oct;81(2):555-612. Indian J Physiol Pharmacol. 2006 Oct-Dec;50(4):375-833. J Gerontol. 1991 Nov;46(6):P352-61

Yoga Interventions aims at improving:

1.Physical well being2.Cognitive functioning3.Communication skills

1. Physical well being: improve mobility

Passive sukshma vyayamaSimple asanas in sitting (with props)

Group practice

2. Cognitive functioning

Nadanusandhana Pranayama

Supported by physical activities

3. Establish an effective communication system

Use simple sentences, words and gestures

1.Use of Mudras,2.Chanting syllables

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A slowly progressing neurologic movement disorder

The degenerative idiopathic form is the most common form

CAUSATIVE FACTORS: unknownPotential factors: genetics,

atherosclerosis, oxidative stress, viral infection, head trauma and environmental factors

PathophysiologyDecreased levels of dopamine due to

destruction of pigmented neuronal cells in the substantia nigra in the basal ganglia

Clinical symptoms do not appear until 60% of the neurons have disappeared

CLINICAL MANIFESTATIONS 1. Tremor- resting, pill-rolling 2. Rigidity- cog-wheel, lead-pipe 3. Bradykinesia- abnormally slow

movement 4. Dementia, depression, sleep

disturbances and hallucinations 5. excessive sweating, paroxysmal

flushing, orthostatic hypotension

Forced exercise improves manual dexterity and other motor functions (1)

Exercise can influence the reduced balance and leg muscle strength and freezing of gait and hence prevent falls in PD patients (2)

Taichi improved balance and mobility (3)

Neurorehabil Neural Repair. 2009 (ahead of print) BMC Neurol. 2009 Jan 22;9:4 Gait Posture. 2008 Oct;28(3):456-60

Yoga Intervention1. Improve mobility2. Improve Motor skills and enhance Self-

care activities3. Improving communication skills4. Adopting coping strategies

Yoga Intervention1. Improve mobility

Assisted balancing postures Lower limb and hip strengthening

practices▪ Uattana padasana, vakrasana (modified),

lumbar stretch, cycling in supine Attention and concentration

▪ Pranayama and chanting

Improve Motor skills and enhance Self- care activities Sukshma vyayama – shakthi vikasaka

practices Mudras Pranayama

Improving communication skills And Coping strategies

Breathing and awarenessCyclic meditation (modified)Relaxation techniques

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A group of syndromes characterized by recurring seizures

CAUSES1. idiopathic 6. brain tumors2. Birth trauma 7. head Injury3. perinatal infection 8. metabolic

disorders 4. infectious disease 9. CVA5. ingestion of toxins

Recurring seizures may be classified as GENERALIZED or PARTIAL SEIZURES

Generalized Seizures- cause a generalized electrical abnormality within the brain

Partial seizures- these seizures arise from a localized part of the brain and cause specific symptoms

1. General Tonic-Clonic seizure- (Grand mal) characterized by loss of consciousness and alternating movements of the extremities

2. Absence Seizure (Petit mal)- common in children, begins with a brief change in the LOC, indicated by blinking, rolling of eyes and blank stares

3. Myoclonic seizure- characterized by brief, involuntary muscular jerks of body extremities

4. Akinetic seizure- general loss of postural tone and a temporary loss of consciousness- a drop attack

1. Simple partial seizure- typically limited to one cerebral hemisphere

2. Complex partial seizure- begins with an aura, then with impaired consciousness, with purposeless behaviors like lip-smacking, chewing movements

DIAGNOSTIC TESTS1. EEG2. CT3. MRI4. LP5. Angiography

Yoga a commonly used CAM in the management of epilepsy (1)

yoga meditation protocol (YMP) was useful as an adjunctive treatment in patients with drug-resistant chronic epilepsy (2)

Studies on sahaja yoga and epilepsy - reduced level of stress and seizure frequency (3)

10 weeks yoga program modulated the autonomic balance and reduced seizure frequency (4)

1. Curr Neurol Neurosci Rep. 2006 Jul;6(4):347-532. J Altern Complement Med. 2006 May;12(4):367-713. Appl Psychophysiol Biofeedback. 2000 Mar;25(1):1-124. Epilepsy Behav. 2008 Feb;12(2):245-52

Yoga Intervention

Ability to manage triggering stimuliStress management andCoping strategies

Managing a triggering stimuli Meditation and pranayam – helps de-

focussing Strategies such as attend and ignore

would facilitate Pratyahara the best tool in yoga

Stress management and coping strategies

Regular integrated yoga practiceAsanas, Pranayama, Meditation, Kriyas and Relaxation techniques

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A Rapidly developing loss of brain function(s) due to a disturbance in the blood supply to the brain.

CAUSATIVE FACTORS:This can be due to ischemia (lack of

blood supply) caused by thrombosis or embolism or due to a hemorrhage

Modifiable risk factors Advanced age, Hypertension (high blood pressure), Previous stroke or

transient ischemic attack (TIA), Diabetes, High cholesterol, Cigarette smoking and Atrial fibrillation

Symptoms Early recognition: Sudden-onset of face weakness, arm drift,

and abnormal speech

Based on the area of the brain affected: Hemiplegia and muscle weakness of the face Numbness Reduction in sensory or vibratory sensation Trouble walking Altered movement coordination Vertigo and or disequilibrium

Associated symptoms: Loss of consciousness, headache, and vomiting

Pathophysiology loss of blood supply to part of the brain,

initiating the ischemic cascade Infarction of the affected brain tissue Brain tissue ceases to function

Diagnostic tools neurological examination, CT scans (most often without contrast

enhancements) or MRI scans, Doppler ultrasound, and arteriography

A slice of brain from the autopsy of a person who suffered an acute middle cerebral artery (MCA) stroke

CT scan showing an intracerebral hemorrhage

Kundalini yoga practice of 12 weeks showed an improvement in aphasia as well as in fine motor coordination in stroke patients (1)

A Yoga-based exercise program was beneficial in people with chronic poststroke hemiparesis (2)

Top Stroke Rehabil. 2007 Jul-Aug;14(4):1-8 Phys Ther. 2004 Jan;84(1):33-48

Offers variety of techniques to work at different levels viz. Physical Mental Social Emotional Spiritual

Hence a comprehensive package

involves the interaction between yoga therapy physician, therapist (PT), patients/clients, other health professionals, families, care givers, and communities

Hence Yoga Therapy offers a Holistic Healing Experience