Effects of Yoga on Functional Gait and Health-Related Quality of Life for Adults With Diabetic Peripheral Neuropathy

PURPOSE: To determine whether health-related quality of life (HRQOL) and functional gait improved in individuals with diabetic peripheral neuropathy (DPN) after participating in an 8-wk yoga intervention.

RATIONALE: Impairment in functional gait can influence one’s ability to be mobile in one’s desired environment and engage in meaningful occupations. An inability to engage in preferred occupations can lead to occupational deprivation, thereby causing impairments in HRQOL. Occupational therapy seeks to optimize healthy and satisfying living through participation in meaningful occupations. Therefore, this study sought to address yoga as an occupation that could become meaningfully engaged in to prevent or reverse the consequences of DPN on functional gait and HRQOL.

DESIGN: These are primary analyses of a noncontrolled pretest–posttest pilot study.

PARTICIPANTS: The sample (N = 15) was recruited via an approved recruitment flyer, diabetic and pain management support groups, and a diabetic resource fair. Inclusion criteria included diagnosis of DPN; age of ≥18 yr; ability to speak English; ability to converse/ answer questions/communicate; and ability to walk 10 m with or without a device. People were excluded if they had consistently engaged in yoga for >1 yr; were unable to attend twice weekly yoga sessions for 8 wk; or had terminal illness with life expectancy of.

METHOD: Participants completed an 8-wk yoga intervention, with sessions 2×/wk for 1 hr each session. Sessions included modified yoga, including physical postures, breathing exercises, and meditation. The yoga was modified for persons with DPN and included seated, standing, and floor postures. The outcome measures used were collected at baseline and 8 wk. The Neuro-QoL was used to assess HRQOL. The 6-Minute Walk Test was conducted to examine walking endurance and the 10-Meter Walk Test was used to evaluate walking speed.

ANALYSIS: Normality of data was assessed using the Shapiro–Wilk test. Change from baseline to 8-wk assessments for each variable was calculated using paired-samples t tests (or Wilcoxon signed-rank tests for non-normal data). A Bonferroni correction was used to control for multiple comparisons for the three variables assessed (α = .05/3 = .0167).

RESULTS: HRQOL improved by 8% (p = .054). Both components of functional gait improved significantly, walking endurance by 15% (mean [M] = 1,018.48, standard deviation [SD] = 406.99, vs. M = 1,167.18, SD = 447.75, p = .014) and walking speed (m/s) by 23% (M = 0.74, SD = 0.25, vs. M = 0.91, SD = 0.28, p < .001).

DISCUSSION: The results demonstrate that yoga is a potential intervention to promote positive improvements in HRQOL and functional gait, including both walking speed and walking endurance, in individuals with DPN. Studenski et al. determined that decreased gait speed has been linked to increased likelihood of death in older adults. Knowing that gait is such an important determinant of health, it is very promising to see the significant improvements in both walking speed and walking endurance in this study.

Additionally, although not significant, changes in HRQOL demonstrate consistent trends toward improvement. Functional gait influences occupational engagement and subsequently HRQOL. It is especially valuable for occupational therapists to study yoga as an occupation, which has shown initial benefits for both functional gait and HRQOL.

These findings should be of interest to occupational therapists because both HRQOL and functional gait play a role in one’s occupational engagement. This study demonstrates a potential intervention that shows both positive outcomes for the variables assessed, as well as an occupation that can be participated in as a means to those outcomes.