A pilot study of yoga as self-care for arthritis in minority communities

Kimberly R Middleton, Michael M Ward, Steffany Haaz, Sinthujah Velummylum, Alice Fike, Ana T Acevedo, Gladys Tataw-Ayuketah, Laura Dietz, Barbara B Mittleman, Gwenyth R Wallen, Kimberly R Middleton, Michael M Ward, Steffany Haaz, Sinthujah Velummylum, Alice Fike, Ana T Acevedo, Gladys Tataw-Ayuketah, Laura Dietz, Barbara B Mittleman, Gwenyth R Wallen

Abstract

Background: While arthritis is the most common cause of disability, non-Hispanic blacks and Hispanics experience worse arthritis impact despite having the same or lower prevalence of arthritis compared to non-Hispanic whites. People with arthritis who exercise regularly have less pain, more energy, and improved sleep, yet arthritis is one of the most common reasons for limiting physical activity. Mind-body interventions, such as yoga, that teach stress management along with physical activity may be well suited for investigation in both osteoarthritis and rheumatoid arthritis. Yoga users are predominantly white, female, and college educated. There are few studies that examine yoga in minority populations; none address arthritis. This paper presents a study protocol examining the feasibility and acceptability of providing yoga to an urban, minority population with arthritis.

Methods/design: In this ongoing pilot study, a convenience sample of 20 minority adults diagnosed with either osteoarthritis or rheumatoid arthritis undergo an 8-week program of yoga classes. It is believed that by attending yoga classes designed for patients with arthritis, with racially concordant instructors; acceptability of yoga as an adjunct to standard arthritis treatment and self-care will be enhanced. Self-care is defined as adopting behaviors that improve physical and mental well-being. This concept is quantified through collecting patient-reported outcome measures related to spiritual growth, health responsibility, interpersonal relations, and stress management. Additional measures collected during this study include: physical function, anxiety/depression, fatigue, sleep disturbance, social roles, and pain; as well as baseline demographic and clinical data. Field notes, quantitative and qualitative data regarding feasibility and acceptability are also collected. Acceptability is determined by response/retention rates, positive qualitative data, and continuing yoga practice after three months.

Discussion: There are a number of challenges in recruiting and retaining participants from a community clinic serving minority populations. Adopting behaviors that improve well-being and quality of life include those that integrate mental health (mind) and physical health (body). Few studies have examined offering integrative modalities to this population. This pilot was undertaken to quantify measures of feasibility and acceptability that will be useful when evaluating future plans for expanding the study of yoga in urban, minority populations with arthritis.

Trial registration: ClinicalTrials.gov: NCT01617421.

Figures

Figure 1
Figure 1
Protocol flow.
Figure 2
Figure 2
Self care model.

References

    1. Marshall JF. Acceptability of fertility regulating methods: designing technology to fit people. Prev Med. 1977;6(1):65–73. doi: 10.1016/0091-7435(77)90005-6.
    1. Winikoff B. Meeting of Scientific Group on Medical Methods for Termination of Pregnancy. Geneva: World Health Organization; 1994. Acceptability of first-trimester medical abortion; pp. 1–32.
    1. Birdee GS, Legedza AT, Saper RB, Bertisch SM, Eisenberg DM, Phillips RS. Characteristics of yoga users: results of a national survey. J Gen Intern Med. 2008;23(10):1653–1658. doi: 10.1007/s11606-008-0735-5.
    1. Bertisch SM, Wee CC, Phillips RS, McCarthy EP. Alternative mind-body therapies used by adults with medical conditions. J Psychosom Res. 2009;66(6):511–519. doi: 10.1016/j.jpsychores.2008.12.003.
    1. Haber D. Yoga as a preventive health care program for white and black elders: an exploratory study. Int J Aging Hum Dev. 1983;17(3):169–176. doi: 10.2190/HU5C-32FH-APVU-N6FY.
    1. Saper RB, Sherman KJ, Cullum-Dugan D, Davis RB, Phillips RS, Culpepper L. Yoga for chronic low back pain in a predominantly minority population: a pilot randomized controlled trial. Altern Ther Health Med. 2009;15(6):18–27.
    1. Wilson A, Marchesiello K, Khalsa SB. Perceived benefits of Kripalu yoga classes in diverse and underserved populations. International Journal of Yoga Therapy. 2008;18(1):65–71.
    1. Middleton KR, Wallen GR, Rivera-Goba M, Mittleman B. A description of self-efficacy, depression, pain, disability and CAM usage among minorities with rheumatic diseases. San Diego, CA: Society of Behavioral Medicine’s 29th Annual Meeting and Scientific Sessions; 2008.
    1. Wallen GR, Middleton KR, Rivera-Goba MV, Mittleman BB. Validating English- and Spanish-language patient-reported outcome measures in underserved patients with rheumatic disease. Arthritis Res Ther. 2011;13(1):R1. doi: 10.1186/ar3219.
    1. Wallen GR, Middleton KR, Miller-Davis C, Tataw-Ayuketah G, Todaro A, Rivera-Goba M, Mittleman BB. Patients’ and community leaders’ perceptions regarding conducting health behavior research in a diverse, urban clinic specializing in rheumatic diseases. Prog Community Health Partnersh. 2012;6(4):405–415. doi: 10.1353/cpr.2012.0052.
    1. Middleton KR, Wallen GR. Assessing complementary and alternative medicine usage in disease specific minority patients. Denver, CO: American Public Health Association 138th Annual Meeting and Exposition; 2010.
    1. Cheng YJ, Hootman JM, Murphy LB, Langmaid GA, Helmick CG. Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation –- United States, 2007–2009. Morb Mortal Wkly Rep. 2010;59(39):1261–1265.
    1. Furner SE, Hootman JM, Helmick CG, Bolen J, Zack MM. Health-related quality of life of U.S. Adults with arthritis: analysis of data from the behavioral risk factor surveillance system, 2005, and 2007. Arthritis Care Res. 2003;2011:788–799.
    1. Osteoarthritis. .
    1. McCall T. Yoga as medicine: The yogic prescription for health and healing. 1. New York: Bantam Dell; 2007.
    1. Rheumatoid arthritis. .
    1. Bolen J, Schieb L, Hootman JM, Helmick CG, Theis K, Murphy LB, Langmaid G. Differences in the prevalence and severity of arthritis among racial/ethnic groups in the United States, National Health Interview Survey, 2002, 2003, and 2006. Prev Chronic Dis. 2010;7(3):A64.
    1. NHIS arthritis surveillance. .
    1. Introduction to exercise. .
    1. Move your body and fight arthritis. .
    1. Physical activity and arthritis. .
    1. Practice management: Exercise and arthritis. .
    1. Shih M, Hootman JM, Kruger J, Helmick CG. Physical activity in men and women with arthritis national health interview survey, 2002. Am J Prev Med. 2006;30(5):385–393. doi: 10.1016/j.amepre.2005.12.005.
    1. Yoga for health: An introduction. .
    1. Yoga. .
    1. Mehta S, Mehta M, Mehta S. Yoga: The Iyengar way. 1. London: Alfred A. Knopf, Inc.; 1990.
    1. Garfinkel M, Schumacher RH Jr. Yoga. Rheumatic Disease Clinics of North America. 2000;26(1):125–132. doi: 10.1016/S0889-857X(05)70126-5.
    1. Arias AJ, Steinberg K, Banga A, Trestman RL. Systematic review of the efficacy of meditation techniques as treatments for medical illness. J Altern Complement Med. 2006;12(8):817–832. doi: 10.1089/acm.2006.12.817.
    1. Streeter CC, Jensen JE, Perlmutter RM, Cabral HJ, Tian H, Terhune DB, Ciraulo DA, Renshaw PF. Yoga asana sessions increase brain GABA levels: a pilot study. J Altern Complement Med. 2007;13(4):419–426. doi: 10.1089/acm.2007.6338.
    1. Wood C. Mood change and perceptions of vitality: a comparison of the effects of relaxation, visualization and yoga. J R Soc Med. 1993;86(5):254–258.
    1. Goyeche J, Ago Y, Ikemi Y. Asthma: The yoga perspective. Part I. The somatopsychic imbalance in asthma: Towards a holistic therapy. J Asthma Res. 1980;17(3):111–121. doi: 10.3109/02770908009105671.
    1. Krishnamurthy MN, Telles S. Assessing depression following two ancient indian interventions: effects of yoga and ayurveda on older adults in a residential home. J Gerontol Nurs. 2007;33(2):17–23.
    1. Pilkington K, Kirkwood G, Rampes H, Richardson J. Yoga for depression: the research evidence. J Affect Disord. 2005;89(1–3):13–24.
    1. Haaz S, Bartlett SJ. Yoga for arthritis: a scoping review. Rheumatic Disease Clinics of North America. 2011;37:33–46. doi: 10.1016/j.rdc.2010.11.001.
    1. Patel SC, Parker DA. Isolated rupture of the lateral collateral ligament during yoga practice: a case report. The Journal of Bone & Joint Surgery. 2008;16(3):378–380.
    1. Hanus SH, Homer TD, Harter DH. Vertebral artery-occlusion complicating yoga exercises. Arch Neurol. 1977;34(9):574–575. doi: 10.1001/archneur.1977.00500210076015.
    1. Walker M, Meekins G, Hu SC. Yoga neuropathy. A snoozer. Neurologist. 2005;11(3):176–178. doi: 10.1097/01.nrl.0000159986.75426.d5.
    1. Fishman L, Saltonstall E. Yoga for arthritis. New York: W.W. Norton & Company, Inc; 2008.
    1. Long R. Scientific keys volume I: the key muscles of hatha yoga. 3. Bandha: Yoga; 2006.
    1. Nayak NN, Shankar K. Yoga: a therapeutic approach. Phys Med Rehabil Clin N Am. 2004;15(4):783–798. doi: 10.1016/j.pmr.2004.04.004.
    1. Madanmohan, Mahadevan SK, Balakrishnan S, Gopalakrishnan M, Prakash ES. Effect of six weeks yoga training on weight loss following step test, respiratory pressures, handgrip strength and handgrip endurance in young healthy subjects. Indian J Physiol Pharmacol. 2008;52(2):164–170.
    1. Cowen VS, Adams TB. Physical and perceptual benefits of yoga asana practice: results of a pilot study. J Bodyw Mov Ther. 2005;9(3):211–219. doi: 10.1016/j.jbmt.2004.08.001.
    1. Schmid AA, Van Puymbroeck M, Koceja DM. Effect of a 12-week yoga intervention on fear of falling and balance in older adults: a pilot study. Arch Phys Med Rehabil. 2010;91(4):576–583. doi: 10.1016/j.apmr.2009.12.018.
    1. Bosch PR, Traustadottir T, Howard P, Matt KS. Functional and physiological effects of yoga in women with rheumatoid arthritis: a pilot study. Altern Ther Health Med. 2009;15(4):24–31.
    1. Ulger O, Yagli NV. Effects of yoga on balance and gait properties in women with musculoskeletal problems: a pilot study. Complement Ther Clin Pract. 2011;17(1):13–15. doi: 10.1016/j.ctcp.2010.06.006.
    1. Madanmohan, Thombre D, Balakumar B, Nambinarayanan T, Thakur S, Krishnamurthy N, Chandrabose A. Effect of yoga training on reaction time, respiratory endurance and muscle strength. Indian J Physiol Pharmacol. 1992;36(4):229–233.
    1. Barnes P, Powell-Griner E, McFann K, Nahin R. Complementary and alternative medicine use among adults: United States, 2002. Adv Data. 2004;343:1–19.
    1. Blumenthal JA, Emery CF, Madden DJ, George LK, Coleman RE, Riddle MW, McKee DC, Reasoner J, Williams RS. Cardiovascular and behavioral effects of aerobic exercise training in healthy older men and women. J Gerontol. 1989;44(5):M147–M157. doi: 10.1093/geronj/44.5.M147.
    1. Raub JA. Psychophysiologic effects of hatha yoga on musculoskeletal and cardiopulmonary function: a literature review. J Altern Complement Med. 2002;8(6):797–812. doi: 10.1089/10755530260511810.
    1. Sunkaria R, Kumar V, Saxena S. A comparative study on spectral parameters of HRV in yogic and non-yogic practitioners. International Journal of Medical Engineering and Informatics. 2010;2(1):1–14. doi: 10.1504/IJMEI.2010.029800.
    1. Jain S, Jain M, Sharma CS. Effect of yoga and relaxation techniques on cardiovascular system. Indian J Physiol Pharmacol. 2010;54(2):183–185.
    1. Telles S, Nagarathna R, Nagendra HR, Desiraju T. Physiological changes in sports teachers following 3 months of training in yoga. Indian J Med Sci. 1993;47(10):235–238.
    1. Konar D, Latha R, Bhuvaneswaran JS. Cardiovascular responses to head-down-body-up postural exercise (Sarvangasana) Indian J Physiol Pharmacol. 2000;44(4):392–400.
    1. Sivasankaran S, Pollard-Quintner S, Sachdeva R, Pugeda J, Hoq SM, Zarich SW. The effect of a six-week program of yoga and meditation on brachial artery reactivity: Do psychosocial interventions affect vascular tone. Clin Cardiol. 2006;29(9):393–398. doi: 10.1002/clc.4960290905.
    1. Selvamurthy W, Sridharan K, Ray US, Tiwary RS, Hegde KS, Radhakrishan U, Sinha KC. A new physiological approach to control essential hypertension. Indian J Physiol Pharmacol. 1998;42(2):205–213.
    1. Raju PS, Prasad KV, Venkata RY, Murthy KJ, Reddy MV. Influence of intensive yoga training on physiological changes in 6 adult women: A case report. J Altern Complement Med. 1997;3(3):291–295. doi: 10.1089/acm.1997.3.291.
    1. Ashok C. Impact of asanas and pranayama on blood oxygen saturation level. Br J Sports Med. 2010;44(Suppl 1):i69.
    1. Oken BS, Zajdel D, Kishiyama S, Flegal K, Dehen C, Haas M, Kraemer DF, Lawrence J, Leyva J. Randomized, controlled, six-month trial of yoga in healthy seniors: Effects on cognition and quality of life. Altern Ther Health Med. 2006;12(1):40–47.
    1. Pandya DP, Vyas VH, Vyas SH. Mind-body therapy in the management and prevention of coronary disease. Compr Ther. 1999;25(5):283–293. doi: 10.1007/BF02944271.
    1. Bera TK, Gore MM, Oak JP. Recovery from stress in two different postures and in Shavasana–A yogic relaxation posture. Indian J Physiol Pharmacol. 1998;42(4):473–478.
    1. Banasik J, Williams H, Haberman M, Blank SE, Bendel R. Effect of Iyengar yoga practice on fatigue and diurnal salivary cortisol concentration in breast cancer survivors. J Am Acad Nurse Pract. 2011;23(3):135–142. doi: 10.1111/j.1745-7599.2010.00573.x.
    1. Curtis K, Osadchuk A, Katz J. An eight-week yoga intervention is associated with improvements in pain, psychological functioning and mindfulness, and changes in cortisol levels in women with fibromyalgia. Journal of Pain Research. 2011;4:189–201.
    1. Kamei T, Toriumi Y, Kimura H, Ohno S, Kumano H, Kimura K. Decrease in serum cortisol during yoga exercise is correlated with alpha wave activation. Percept Mot Skills. 2000;90(3 Pt 1):1027–1032.
    1. West J, Otte C, Geher K, Johnson J, Mohr DC. Effects of Hatha yoga and African dance on perceived stress, affect, and salivary cortisol. Ann Behav Med. 2004;28(2):114–118. doi: 10.1207/s15324796abm2802_6.
    1. Devi SK, Chansouria JPN, Malhotra OP, Udupa KN. Certain neuroendocrine responses following the practice of Kundalini yoga. Alternative Medicine. 1986;1(3):247–255.
    1. Bukowski EL, Conway A, Glentz LA, Kurland K, Galantino ML. The effect of iyengar yoga and strengthening exercises for people living with osteoarthritis of the knee: a case series. Int Q Community Health Educ. 2006;26(3):287–305. doi: 10.2190/IQ.26.3.f.
    1. Garfinkel MS, Schumacher HR Jr, Husain A, Levy M, Reshetar RA. Evaluation of a yoga based regimen for treatment of osteoarthritis of the hands. J Rheumatol. 1994;21(12):2341–2343.
    1. Kolasinski SL, Garfinkel M, Tsai AG, Matz W, Van Dyke A, Schumacher HR. Iyengar yoga for treating symptoms of osteoarthritis of the knees: a pilot study. J Altern Complement Med. 2005;11(4):689–693. doi: 10.1089/acm.2005.11.689.
    1. Taibi DM, Vitiello MV. A pilot study of gentle yoga for sleep disturbance in women with osteoarthritis. Sleep Med. 2011;12(5):512–517. doi: 10.1016/j.sleep.2010.09.016.
    1. Badsha H, Chhabra V, Leibman C, Mofti A, Kong KO. The benefits of yoga for rheumatoid arthritis: Results of a preliminary, structured 8-week program. Rheumatol Int. 2009;29(12):1417–1421. doi: 10.1007/s00296-009-0871-1.
    1. Evans S, Moieni M, Taub R, Subramanian SK, Tsao JC, Sternlieb B, Zeltzer LK. Iyengar yoga for young adults with rheumatoid arthritis: results from a mixed-methods pilot study. J Pain Symptom Manage. 2010;39(5):904–913. doi: 10.1016/j.jpainsymman.2009.09.018.
    1. Haslock I, Monro R, Nagarathna R, Nagendra HR, Raghuram NV. Measuring the effects of yoga in rheumatoid arthritis. Br J Rheumatol. 1994;33(8):787–788.
    1. Telles S, Naveen KV, Gaur V, Balkrishna A. Effect of one week of yoga on function and severity in rheumatoid arthritis. Biomed Central Research Notes. 2011;4:118.
    1. Haaz S, Bartlett S, Bathon J. Initial findings of an RCT of yoga on physical and psychological functioning in RA and OA. Boston, Massachusetts: American College of Rheumatology; 2007.
    1. Ebnezar J, Nagarathna R, Bali Y, Nagendra HR. Effect of an integrated approach of yoga therapy on quality of life in osteoarthritis of the knee joint: a randomized control study. International Journal of Yoga. 2011;4(2):55–63. doi: 10.4103/0973-6131.85486.
    1. Evans S, Subramanian S, Sternlieb B. Yoga as treatment for chronic pain conditions: a literature review. International Journal on Disability and Human Development. 2008;7(1):25–32.
    1. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007 (National health statistics reports no.12) Hyattsville, MD: National Center for Health Statistics; 2008.
    1. Marquez D, McAuley E. Gender and acculturation influences on physical activity in Latino adults. nn. Behav Med. 2006;31(2):138–144. doi: 10.1207/s15324796abm3102_5.
    1. Potter J, Odutola J, Gonzales CA, Ward MM. Validation of English and Spanish-language versions of a screening questionnaire for rheumatoid arthritis in an underserved community. The Journal of Rheumatology. 2008;35(8):1545–1549.
    1. Fike A. NIAMS Community Health Clinic Demographics (6/2008-6/2011) 2011.
    1. Verbrugge L. Health Diaries. Med Care. 1980;18(1):73–95. doi: 10.1097/00005650-198001000-00006.
    1. Richardson A. The health diary: An examination of its use as a data collection method. J Adv Nurs. 1994;19:782–791. doi: 10.1111/j.1365-2648.1994.tb01151.x.
    1. Stone AA, Shiffman S, Schwartz JE, Broderick JE, Hufford MR. Patient non-compliance with paper diaries. Br Med J. 2002;324(7347):1193–1194. doi: 10.1136/bmj.324.7347.1193.
    1. Burman M. Health diaries in nursing research and practice. Image Journal of Nursing Scholarship. 1995;27(2):147–152. doi: 10.1111/j.1547-5069.1995.tb00839.x.
    1. Garfinkel M. Yoga as a complementary therapy. Geriatrics and Aging. 2006;9(3):190–194.
    1. Yoga helpful for rheumatoid arthritis. .
    1. Haaz S, Bingham C, Bathon J, Bartlett S. Joint Tenderness and Swelling in RA Patients with Participation Modified Yoga Program. San Diego, CA: American Public Health Association; 2008.
    1. Marks R, Allegrante JP. A review and synthesis of research evidence for self-efficacy-enhancing interventions for reducing chronic disability: Implications for health education practice (Part II) Health Promotion Practice. 2005;6:148–156. doi: 10.1177/1524839904266792.
    1. Health-Related Quality of Life(HRQOL) .
    1. Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004;31(2):143–164. doi: 10.1177/1090198104263660.
    1. Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191–215.
    1. Bandura A. Self-efficacy: The exercise of control. 1. W.H. Freeman & Company; 1997.
    1. Bandura A. Health promotion from the perspective of Social Cognitive Theory. Psychology & Health. 1998;13(4):623–649. doi: 10.1080/08870449808407422.
    1. Multidimensional Health Assessment Questionnaire (MDHAQ) .
    1. Health literacy interventions and outcomes: An updated systematic review. .
    1. Committee on Health Literacy. Health literacy: A prescription to end confusion. 1. Washington, DC: The National Academies Press; 2004.
    1. Davis TC, Michielutte R, Askov EN, Williams MV, Weiss BD. Practical assessment of adult literacy in health care. Health Educ Behav. 1998;25(5):613–624. doi: 10.1177/109019819802500508.
    1. Davis TC, Long SW, Jackson RH, Mayeaux EJ, George RB, Murphy PW, Crouch MA. Rapid estimate of adult literacy in medicine: A shortened screening instrument. Fam Med. 1993;25(6):391–395.
    1. Arozullah AM, Yarnold PR, Bennett CL, Soltysik RC, Wolf MS, Ferreira RM, Lee SY, Costello S, Shakir A, Denwood C. Development and validation of a short-form, rapid estimate of adult literacy in medicine. Med Care. 2007;45(11):1026–1033. doi: 10.1097/MLR.0b013e3180616c1b.
    1. Health literacy measurement tools. .
    1. Lee SY, Bender DE, Ruiz RE, Cho YI. Development of an easy-to-use Spanish Health Literacy test. Health Serv Res. 2006;41(4 Pt 1):1392–1412.
    1. Cella D, Riley W, Stone A, Rothrock N, Reeve B, Yount S, Amtmann D, Bode R, Buysse D, Choi S. The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005-2008. Journal of Clinical Epidemiology. 2010;63(11):1179–1194. doi: 10.1016/j.jclinepi.2010.04.011.
    1. Science. .
    1. Dynamic tools to measure health outcomes from the patient perspective. .
    1. Walker SN, Hill-Polerecky DM. Psychometric evaluation of the Health-Promoting Lifestyle Profile II. Nebraska: University of Nebraska Medical Center; 1996.
    1. Callaghan DM. Health-promoting self-care behaviors, self-care self-efficacy, and self-care agency. Nurs Sci Q. 2003;16(3):247–254. doi: 10.1177/0894318403016003016.
    1. Carlson ED. A case study in translation methodology using the Health-Promotion Lifestyle Profile II. Public Health Nurs. 2000;17(1):61–70. doi: 10.1046/j.1525-1446.2000.00061.x.
    1. Lorig K, Stewart A, Ritter P, Gonzalez V, Laurent D, Lynch J. Outcome measures for health education and other health care interventions. Thousand Oaks, Ca: SAGE Publications, Inc.; 1996.
    1. Gonzalez VM, Stewart A, Ritter PL, Lorig K. Translation and Validation of Arthritis Outcome Measures Into Spanish. Arthritis and Rheumatism. 1995;38(10):1429–1446. doi: 10.1002/art.1780381010.
    1. Haaz S. Doctoral disseration. Baltimore: Proquest LLC; 2010. Examining the safety, feasibility and efficacy of yoga for persons with arthritis.
    1. Self-rated health. .
    1. Idler EL, Benyamini Y. Self-rated health and mortality: A review of twenty-seven community studies. J Health Soc Behav. 1997;38(1):21–37. doi: 10.2307/2955359.
    1. McGee DL, Liao Y, Cao G, Cooper RS. Self-reported health status and mortality in a multiethnic US cohort. Am J Epidemiol. 1999;149(1):41–46. doi: 10.1093/oxfordjournals.aje.a009725.
    1. Johnson KL, Carroll JF, Fulda KG, Cardarelli K, Cardarelli R. Acculturation and self-reported health among Hispanics using a socio-behavioral model: The North Texas Healthy Heart Study. Biomed Central Public Health. 2010;10:53. doi: 10.1186/1472-6963-10-53.
    1. Shetterly SM, Baxter J, Mason LD, Hamman RF. Self-rated health among Hispanic vs non-Hispanic white adults: The San Luis Valley Health and Aging Study. Am J Public Health. 1996;86(12):1798–1801. doi: 10.2105/AJPH.86.12.1798.
    1. Billek B. Unpublished Master’s thesis. Pittsburgh, PA: University of Pittsburgh; 1990. Objective measures of postural stability.
    1. Haupstein T, Goldie P. Visual judgements of steadiness in one-legged stance: Reliability and validity. Physiother Res Int. 2000;5(3):141–156. doi: 10.1002/pri.195.
    1. Whitney SL, Poole JL, Cass SP. A review of balance instruments for older adults. The American Journal of Occupational Therapy. 1998;52(8):666–671. doi: 10.5014/ajot.52.8.666.
    1. Duncan PW, Weiner DK, Chandler J, Studenski S. Functional reach: A new clinical measure of balance. J Gerontol. 1990;45(6):M192–197. doi: 10.1093/geronj/45.6.M192.
    1. Podsiadlo D, Richardson S. The Timed "Up and Go": A test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142–148.
    1. Timed Up and Go (TUG)
    1. Schwartz A, Villa M, Prill M, Kelsey J, Galinus J, Delay R, Nevitt M, Bloch D, Marcus R, Kelsey J. Falls in older Mexican-American women. J Am Geriatr Soc. 1999;41(11):1371–1378.
    1. Tinetti ME, Lui WL, Claus EB. Predictors and prognosis of inability to get up after falls among elderly persons. Journal of the American Medical Association. 1993;269(1):65–70. doi: 10.1001/jama.1993.03500010075035.
    1. Wang CY, Olson SL, Protas EJ. Physical-performance tests to evaluate mobility disability in community-dwelling elders. Journal of Aging and Physical Activity. 2005;13(2):184–197.
    1. Murphy MA, Olson SL, Protas EJ, Overby AR. Screening for falls in community-dwelling elderly. Journal of Aging and Physical Activity. 2003;11(1):66–80.
    1. Adams J, Burridge J, Mullee M, Hammond A, Cooper C. Correlation between upper limb functional ability and structural hand impairment in an early rheumatoid population. Clin Rehabil. 2004;18(4):405–413. doi: 10.1191/0269215504cr732oa.
    1. Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C. Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. J Hand Ther. 2001;14(2):128–146. doi: 10.1016/S0894-1130(01)80043-0.
    1. Bingham HS, III, Bartlett CO, Susan J. Arthritis Rheum. vol. 60. Baltimore, Maryland: ; 2009. Adherence to an 8-week yoga program for RA and OA: Who drops out and why; p. 1978.
    1. Moonaz S. Perspectives from a yoga researcher and therapist. Presentation given at NIH. 2010.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe