Dementia not only involves cognitive impairment, it also involves impairment of physical function. This leading cause of limitation in activities of daily living in older adults with dementia requires safe, effective, and evidence-based non-pharmacological approaches. One such approach is chair yoga. A non-invasive, low-impact intervention, chair yoga is practiced sitting or standing using a chair as support and combines flexibility, balance, strength, breathing, relaxation and mindfulness training.
Unfortunately, barriers such as lack of transportation, living in rural areas, dependency on caregivers, and especially the COVID-19 pandemic have prevented many older adults with dementia from participating in in-person group yoga classes. These burdens call for an innovative way to deliver a chair yoga intervention for those unable to travel to a community center.
The considerable time and cost associated with traveling to in-person yoga sessions over several weeks could be burdensome for many patients.”
Juyoung Park, Ph.D., lead author, principal investigator, and professor at the Phyllis and Harvey Sandler School of Social Work within Florida Atlantic University’s College of Social Work and Criminal Justice
Researchers from FAU’s College of Social Work and Criminal Justice, the Christine E. Lynn College of Nursing and the Schmidt College of Medicine and collaborators conducted a new interdisciplinary study to evaluate a remotely supervised online chair yoga intervention targeting older adults with dementia and measuring clinical outcomes. virtually via Zoom under remote guidance. The study assessed the feasibility of this intervention and explored the relationship between chair yoga and clinical outcomes of pain interference, mobility, fall risk, sleep disturbances, autonomic reactivity and loneliness
The results of the study, published in the journal Complimentary Therapies in Clinical Practice, showed that remotely supervised online chair yoga is a feasible approach to managing physical and psychological symptoms in socially isolated older adults with dementia based on of retention (70%) and adherence (87.5). percent), with no injuries or other adverse events.
“This finding is important, as older adults with dementia and their caregivers can be challenged in their attempts to attend chair yoga programs in community facilities,” said Park, who conducted the research with his student and co-author Hannah Levine, a medical student at FAU. “Our telehealth-based chair yoga intervention was found to be convenient for both participants and their caregivers because it was easily accessible from home and did not require transportation or dressing, which reduced burden and caregiver stress.”
Participants in the pilot study took part in 60-minute sessions twice a week for eight weeks. During the chair yoga session, the yoga interventionist was highlighted on the Zoom screen to allow participants to see only the interventionist. This focus allowed participants to focus on the yoga sessions without being distracted by other participants on the screen.
“Participants in our study worked with a certified yoga interventionist and their caregivers and practiced breathing techniques and intentional practice; physical postures; and guided relaxation and visualization,” Park said.
Participants also interacted on Zoom with other participants or the facilitator to maintain social bonds while maintaining physical distance. Psychosocial and physiological (i.e., cardiac) data were collected remotely at baseline, mid-intervention, and post-intervention.
“Cardiac and psychosocial data collected remotely can provide a more complete assessment of the effects of an intervention,” said María de los Ángeles Ortega Hernández, DNP, APRN, GNP-BC, PMHNP-BC, CDP, FAANP, FAAN, director of the FAU Louis and Anne Green Memory and Wellness Center, associate dean of clinical practice and professor, FAU Christine E. Lynn College of Nursing. “Importantly, online chair yoga classes provide a means to reduce health disparities by opening access to interventions for people who cannot travel to a clinic or facility.”
The primary objective of the study was to assess the feasibility (retention, adherence, and safety) of conducting a remotely supervised, online chair intervention at home and completing outcome measures virtually. The secondary objective was to examine the relationship between the intervention and chronic pain, physical function or psychological symptoms. Finally, an exploratory aim was to assess the ease and ability of caregivers and participants to record cardiac data remotely for off-line analyzes of the effect of the intervention on parasympathetic regulation and global heart rate.
“An important feature of our technology-based intervention is that it could enable socially isolated older adults with dementia living at home, particularly those in underserved communities where people are increasingly digitally connected, to receive supervised chair yoga remotely that provides physical exercise, social and psychological benefits,” said Lisa Ann Kirk Wiese, Ph.D., co-author and associate professor, FAU’s Christine E. Lynn College of Nursing.
Co-authors of the study are Keri Heilman, Ph.D., assistant professor at the University of North Carolina School of Medicine, Chapel Hill; Marlysa Sullivan and Jayshree Surage, both with the University of Maryland Integrative Health; Lillian Hung, Ph.D., Assistant Professor and Canada Research Chair in Elder Care, University of British Columbia, School of Nursing; and Hyochol “Brian” Ahn, Ph.D., professor and associate dean for research, Florida State University, College of Nursing.
“The results of our study can inform future research and practice in implementing online chair yoga or another exercise program to promote health and well-being in older adults with dementia living at home,” said Park.
Source:
Florida Atlantic University
Journal reference:
Park, J., et al. (2022) Remotely Supervised Home-Based Online Chair Yoga Intervention for Older Adults with Dementia: A Feasibility Study Complementary Therapies in Clinical Practice. doi.org/10.1016/j.ctcp.2022.101617.