Date of Award

2022

Document Type

Scholarly Project

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

First Advisor

Anne Haskins

Abstract

Background: Musculoskeletal disorders (MSDs) are the leading cause of disability in the U. S. representing more than half of the chronic conditions of people over 50 years old (United States Bone and Joint Initiative, 2020), costly financially (Yelin, Weinstein, & King, 2016) and detrimental to the physical and psychosocial well-being of people (Andrawis, 2018). Most occupational therapy practitioners follow pre-set intervention protocols using repetitive rote exercise to treat individuals with upper extremity MSDs (Strohman, 2007). The treatment is not an optimal method because disability caused by upper extremity injuries is greatly associated with depression, catastrophic thinking, and decreased quality of life (Jayakumar et al., 2018). Best practice includes evaluation and intervention planning that addresses an individual’s mind, body, and spirit in numerous ways, including the use of yoga. Health care practitioners from various professions are using yoga therapy as research has supported its effectiveness in improving physical health and overall well-being for a variety of population with different health conditions, but yoga’s use in occupational therapy specifically for the rehabilitation of upper extremity MSDs has been limited (McCall, Ward, Roberts, & Heneghan, 2013). The purpose of this scholarly project was to develop a yoga rehabilitation program for use in occupational therapy intervention planning for individuals with upper extremity injuries.

Methods: The product was informed through a needs assessment conducted through a literature review and onsite work. The literature review was completed using CINAHL Complete, PubMED, and MEDLINE through the University of North Dakota’s library system, American Journal of Occupational Therapy (AJOT), Google Scholar, Centers for Disease Control and Prevention (CDC), occupational therapy textbooks, and yoga practice resources. The key search terms included combinations and expansions of occupational therapy, upper extremity/upper limb/upper body injuries, upper extremity functions, upper extremity musculoskeletal disorders (UEMSDs)and conditions, yoga/yoga therapy/yoga therapeutics and posture/postural control. The Biopsychosocial model (Wade & Halligan, 2017) was chosen to support the process of program development and a conceptual model was created based on the Biopsychosocial model for occupational therapists as a theoretical foundation when applying the program.

Product/Outcome: This work culminated in a product that is a yoga rehabilitation program that includes a new conceptual framework for occupational therapists based on the Biopsychosocial model, a yoga protocol for the rehabilitation of upper extremity injuries, and a yoga practice handbook for the participants. This holistic yoga intervention program includes the techniques of pranayama, asanas, and dhyana. The yoga postures (asanas) promote the individual’s balance, strength, and flexibility, while the breathing work (pranayama), meditation (dhyana), imagery (bhavana), and deep rest (nidra) technologies can facilitate the individual’s awareness and decrease the stress, anxiety, and pain (Taylor, Yarian, & Cooper, 2014). The product includes detailed guidelines and modification for individuals with upper extremity injuries to practice the specific yoga techniques. The yoga protocol for the rehabilitation of upper extremity injuries includes 1) program introduction, 2) program goals and objectives, 3) brief introduction of yoga, 4) yoga therapy and the rehabilitation for upper extremity injuries, 5) preparation for yoga practice, 6) the principles of yoga practice, 7) yoga anatomy and guidelines of practice for upper extremity injuries, 8) yoga intervention procedure, 9) The Health Insurance Portability and Accountability Act (HIPPA) release 10) occupational therapy assessments for upper extremity injuries, 11) participant health and well-being survey (program pre-survey), 12) yoga therapy for the rehabilitation of upper extremity injuries (program post-survey), 13) yoga therapy participant health chart, and 14) yoga practice weekly time log sheet. The yoga practice handbook includes 1) preparation for yoga practice, 2) the principles of yoga practice, 3) yoga practice guidelines for the rehabilitation of upper extremity injuries table, and 4) general upper extremity muscles’ function. Through practicing the yoga techniques included in the program for eight weeks, individuals with upper extremity injuries will improve their physical health through increased strength and flexibility and learn strategies to promote their psychosocial well-being.

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