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COMBINE PHYSIOTHERAPY AND YOGA AS DAILY ROUTINES FOR THE 60+ AGE GROUP

Phyoga is a set of exercises combining Yogic asana with physiotherapy based programs including Pilates to treat various clinical impairments. There are evidences for physical therapy and Yoga in managing rehabilitative goals, hence Phyoga can be considered as a spectacular system in all age groups enabling a better quality of life. Phyoga as a platform always has a peculiar exercise in order to treat the diseases such as Phyoga for osteoporosis, Phyoga for respiratory problems, Phyoga for Low back pain, Phyoga for Neck pain and many more.

The geriatric age group is always at high risk due to several physiological changes. There is a need to develop healthy aging in order to reduce disability and promote quality of life. As a person ages, changes occur in overall health and function. Optimal aging is reflected by the capacity to participate in life with consideration of the interactions among the various aspects of health. An older adult who is physically inactive frail eventually has an influence on mental, behavioral, and musculoskeletal disorders. Age-related changes often culminate in decreased participation in activities of daily living.

EFFECT OF YOGA AS A DAILY ROUTINE FOR GERIATRIC AGE GROUP

Yoga is said to be an outstandingly practised physical activity for older adults. It aims to promote overall movement and health related quality of life. Yoga is said to improve muscle strength, regulates blood pressure, maintain cardiovascular system, manage sleep and eradicate psychosocial nervousness. There are evidences which prove that yoga can be practised as the best activity to improve mobility and prevent deformities in older adults. Various yogic practices aim at maintaining balance and helps in improving motor skills.

Asana are stretching practices in yoga that are non- strenuous, non- fatiguing and can be performed comfortably. It improves flexibility, strength and balance to reduce stress and conditions related to it, specifically to alleviate some diseases such as Asthma and Diabetes.

Some of the yogic asana which can be practiced as a daily routine are:

Tadasana strengthens thighs, knee and ankle, corrects posture, reduces flat feet, relieve sciatica, firms abdomen and buttock.

Trikonasana stretches the hip, groins, hamstrings, calves, shoulder, chest and spine; strengthens the thighs, knees, and ankles; helps relieve stress, stimulates the abdominal organs, improve digestion and prevent constipation

Ardhachakrasana improves lungs capacity, stimulates pancreas and controls high blood sugar, brings flexibility to your spine; tones arms, thighs, waist, and shoulders, relieves pain in neck and shoulders.

Padhastasana alleviates flatulence, constipation and indigestion; spinal nerves are stimulated and toned, increases vitality, improves the metabolism, improves concentration.

Vajrasana is an easiest form of yoga. It helps relieve constipation, strengthens lower back, legs.

Suk asana eliminates stress and anxiety, induces calmness of mind, improves blood circulation in hips, legs, spine, back, and pelvis area, and helps digestive organs immensely and thigh.

Pranayama helps in normalizing the regulation of circulatory and respiratory responses. It helps in treating mental problems like anxiety and depression due to its hormonal activity, it relaxes the mind, alleviates mood and creates healthy attitude resulting in emotional stability.

Mudras are physic, emotional and devotional gestures. Brahma Mudra works with breath and sound vibration. It induces a sense of relaxation and rejuvenates the head and neck region which reduces stress in older age group.

EFFECT OF PHYSIOTHERAPY AS A DAILY ROUTINE FOR GERIATRIC AGE GROUP

An era of physiotherapy as a multifaceted process requires teamwork and efforts of various specialists like psychologists, sociologists, occupational therapist and nurses.  A prior assessment is done before planning a physiotherapy start-up for older adults in order to achieve proper functional outcome.

Initial care is started with community physiotherapy in a person`s own home or at a clinic. An individual can be guided by a private physiotherapy or government assisted health care services. Older adults must start with light physical activity everyday such as walking at a slow pace, cleaning and dusting, moving around the house, making the bed. One should avoid sitting for longer periods to avoid postural changes.

A 4-6 weeks exercise program can be started to improve strength and flexibility with a short period of rest before repeating the activity. Exercises such as arm, back and leg stretch can be started. Sitting exercises help to improve mobility and prevent falls. Exercises such as chest stretch, upper body twist, hip marching, arm raises, neck rotation can be encouraged with group physiotherapy

Simple balance exercises such as sideways walking, simple grapevine, heel-to-toe walk, one leg stand, step-up and step-down can be done near a wall or a chair to avoid losing balance. A gradual increase in repetitions will help improve health and mobility. Strengthening exercises can be started by using a chair or gentle movements with moderate activities such as brisk walking, pushing-pulling activity and dancing etc. In order to increase the effort, vigorous activities like running or jogging, walking or riding fast on hills, energetic dancing can be continued. Chair based strengthening exercises such as mini squats, sit to stand, heel raises and calf raises; sideways leg lifts, hip strengthening exercises, wall push-ups, biceps curls can be practised with slow repetitions.

PILATES FOR OLDER ADULTS

Pilate method has become a popular modality in recent years; through a system of exercises that together aim to create a strong and limber body as well as a strong will of mind that can control the body. These comprehensive and diverse set of exercises helps in improving the strength and overall conditioning including flexibility, mobility and aerobic performances for people of all ages and has been used as an adjuvant method in rehabilitation of injuries of older adults.

Pilate exercises are divided into two broad categories: mat and apparatus exercises. In mat exercises, participants typically sit or lie supine or prone and use gravity to help stabilize the core whereas Apparatus exercises on other hand uses apparatus to train a variety of movement patterns and postures. The Reformer, for example is made of a sliding horizontal platform within a box-like frame upon which a person sits, stands, kneels or reclines; varying resistance to movement is provided via light springs attached to the moving platform and through a simple pulley system.

Basic six principles of Pilates; centring, concentration, control, precision, breath, and flow are a key structures in training mental health improvements and enables good control of the body.

A strong trunk stabilisation is essential for performance of basic motor activities such as walking, leaning over or catching and lifting objects for elderly individuals. This can be achieved by activation of transverses abdominal muscle, pelvic floor muscles. Spinal stabilisation can be done by reaching the strong core and making movements through the legs and reaching the attachment of muscle to the spine, for e.g. making circles through one leg.

Some suitable Pilate exercises can be done by elderly adults to improve balance and mobility. These exercises are generally practised in a group session which also helps in mind civilisation. Pilates kneeling with rear leg rise, posturing like a mermaid, side circles in clock wise and anticlockwise direction are popularly practised. At initial stage chair based Pilates are helpful in reducing risk of falls and improving mobility. It will be similar to Pilates, but the authenticity of the basic Pilates movements will be lessened as the exercises themselves are modified for use with a chair.

 Striving to maintenance of proper body posture and assuming of neutral position during all phases of exercise is emphasised. All movements are performed in neutral positions, without enhancing of physiological spine curvatures. Transition from standing to lying down on the back is performed by the exercise such as rolling of the spine.

PRECAUTIONS WHILE PERFORMING PILATES

  • There are some moves that some people should avoid. For instance, if there is a bulging disk, then moves involving rolling on spine would obviously be avoided.
  • Always start Pilates on the advice of doctors/physiotherapists as it is crucial to ask about conditions/pathologies.
  • Screening for various conditions, injuries, and devising safe workarounds are always advised.
  • Conditions like Benign paroxysmal positional vertigo, Cancer, Severe anxiety disorder, Inguinal hernia, Severe pain, recent surgery, neurologic imbalance, significant hypertension, poor understanding of Pilates are avoided

COMBINING YOGA AND PHYSIOTHERAPY INCLUDING PILATES- PHYOGA

The enrichment and combination of physiotherapy and yoga offers an evidence based approach to overall patient care. These exercises can be used in clinical and non-clinical settings; can affect various body structures and systems such as musculoskeletal, nervous, visceral and endocrine functions.

The rationale for this combination is that yoga`s philosophy and physical exercises; asana share a number of basic underlying principles of the physiotherapeutic process.

 Extrapolation of yoga`s quintessence into physiotherapeutic practice would potentially combine all the benefits in terms of muscle relaxation, breathing and heart rate, level of concentration, overall functionality and life satisfaction via normalized cardio-respiratory, endocrine, musculoskeletal and central nervous system within one physiotherapeutic modality.

Pilates being one of the physiotherapy based exercise method connects mind and body using breathing pattern is a similar method used in Yogic asana. Similarly, described training concept assumes reinforcing the muscles of the whole body, especially emphasising conscious action exerted on deep muscular structures. It focuses on the ‘‘power house’’ or what is known today as the core; includes the abdominal, gluteal, and paraspinal muscles. Pilates builds stamina, not only physical, but mental. Immense strength and tone in the body. The risk of strain or injury is lessened with good alignment, particularly with more challenging and dynamic exercises which is compared to more complex Yoga.

Correction of breathing pattern in breathing exercises whilst doing pranayama is useful for various groups of compromised patients, specifically those with cardiopulmonary disturbances. Yogic exercises can influence the musculoskeletal and nervous system via mobilization of both joints and nerves respectively. For example, one of McKenzie’s static procedures and Cobra asana are almost the equivalent and can directly lead to alleviation of pain symptoms of low back and cervical pain.

According to physiotherapeutic perspective somatic dysfunction can be released, flexibility and range of movement can be improved with regards to physiotherapeutic processes. Yoga and Pilates are a set of “static – dynamic procedures” can be considered as mean to self – mobilization of the nervous system and the joints, spine.

Beneficial effects of yoga and physical exercises as a whole affect musculoskeletal system, scoliosis prevention and passive correction of pelvic distortion, postural re-education, increased range of motion in spinal column and improved blood circulation in vertebral arteries as well as the prevention of soft tissue injuries among geriatrics.

Various benefits due to combined physiotherapy and yoga are useful for making better quality of life for geriatric age group. Hence Phyoga is a promising and new concept which must be practised under the guidance of Physiotherapist or Yogi or Pilate practitioner.

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Start PHYOGA because it is proven, results areevident. Your life matters…happy ageing!

DR KHADIJA PALLAVUR

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