Restorative Yoga & Cognition

Kate Bailey, PT, DPT, MS owns a private practice in Seattle that focuses on pelvic health for all genders and ages and works under a trauma-informed model where patient self-advocacy and embodiment are a priority. In addition to being a physical therapist, I’ve been teaching Pilates for nearly 20 years and yoga for over 10. Kate’s course, Restorative Yoga for Physical Therapists, combines live discussions and labs with pre-recorded lectures and practices that will be the basis for experiencing and integrating restorative yoga into physical therapy practice. Kate brings over 15 years of teaching movement experience to her physical therapy practice with specialties in Pilates and yoga with a focus on alignment and embodiment.

Stress is a primary topic of conversation in all domains of our lives. Are we getting the right nutrition and exercises? Are we “balancing” our lives well? How are we attempting to stave off burnout whether we are a clinician or a patient? The stress of having medical needs, particularly when they are complex can be overwhelming: multiple appointments to juggle with education from a wide variety of medical perspectives (hopefully aligning relatively well), and then just trying to keep up with normal adulting responsibilities. If you are a clinician the idea of burnout and being drained emotionally is likely a familiar one. 

When thinking about stress and overwhelm, there are a plethora of physiological consequences ranging from small, workable symptoms to severe mental and physical outcomes. In this blog we’ll look at cognition from two studies: one that looked at those experiencing breast cancer related cognitive impairment and a second looking at third year medical student wellbeing. 

Cognition can be separated into two domains: Fluid intelligence and crystallized intelligence. 

Fluid intelligence is the ability to process new information and solve novel problems in real time. Think about having to come up with questions for your doctor when managing medications, or simply learning what that medication does and what possible side effects to watch out for. Fluid intelligence is the domain in which we learn new precautions after a surgical procedure or learn about what to do if in a pain flare. Fluid intelligence includes learning, problem solving and comprehension. 

Crystallized intelligence is the ability to use knowledge that was previously acquired through education and experience. This is how we use past experience to inform decision making. How we start at entry level education and then build on that with continuing education. Its how people who have dealt with chronic illness or pain can approach new medical issues in perhaps a more adaptable manner. 

In a study by Deng et al. fluid and crystallized intelligence changes were studied using two different kinds of yoga as the catalyst. Restorative yoga compared to Vinyasa yoga, said another way, a restful practice versus a vigorous practice. The restorative group had no improvements in crystallized cognition. But they did have statistically significant improvements in fluid cognitions with effect sizes growing from participants being in the 42nd percentile to the 55th percentile among the general population after 24 weeks of practice. The change in ability to learn, comprehend and problem solve whilst working through cancer related cognitive impairment is incredibly important. The vinyasa group had no statistically significant changes in fluid cognition, but did have improvements in crystallized cognition. Thus depending on which cognitive domain is troubling the patient more, you can offer a bit of support in that decision making process. 

While much of the continuing education offered to clinicians is in regards to how to become more skillful for your patients, we also need support for clinicians to ensure their own wellbeing. This can come in the form of boundaries, support groups, mental health counseling, etc. It can also come in the form of establishing a simple weekly practice of restorative yoga. In a study by Adesanya et al, 3rd year medical students were offered a 45 minute restorative class once a week for 6 weeks. This is the time in a medical student’s life where a primary focus on didactics transitions into clinical care. With this practice, once a week, medical students reported improved wellbeing marked by increased relaxation and reduced stress related to decision making. It was also noted that the efficiency of the practice was more feasible for the clinical life of having to decide how to spend one’s time outside of work. While restorative yoga is not a substitute for aerobic, strength and mobility training, it is imperative to see the cognitive benefits of this practice and how that might improve our decision making in the domains of our selfceare (nutrition, exercise, sleep), as well as our mental and relational health (friendships, partnerships, colleagues). 

Resources:

1. Deng, G., Bao, T., Ryan, E. L., Benusis, L., Hogan, P., Li, Q. S., Dries, A., Konner, J., Ahles, T. A., & Mao, J. J. (2022). Effects of Vigorous Versus Restorative Yoga Practice on Objective Cognition Functions in Sedentary Breast and Ovarian Cancer Survivors: A Randomized Controlled Pilot Trial. Integrative Cancer Therapies, 21, 153473542210892. https://doi.org/10.1177/15347354221089221
2. ‌Adesanya, O., Thompson, C., Meller, J., Naqvi, M., & TetyanaL Vasylyeva. (2023). Restorative yoga therapy for third-year medical students in pediatrics rotation: Working to improve medical student well-being. 12(1), 76–76. https://doi.org/10.4103/jehp.jehp_1027_22

Restorative Yoga for Physical Therapists

Price: $275.00          Experience Level: Beginner          Contact Hours: 10.75 hours

Course Dates:  August 12, 2023

Description: This course is an online course that combines live Zoom discussions and labs, pre-recorded lectures, and pre-recorded practices that will be the basis for experiencing and integrating restorative yoga into physical therapy practice.

It is well known that stress is an important contributor to overall quality of life, chronic pain, and disease risk. Our society’s focus on high productivity and achievement often creates chronic fatigue and reduced ability to regulate our nervous systems. Sleep may be the only time a person actually rests during the day. For those who have survived trauma, even sleep is not restful. And so we stay in a state of stress that is difficult to manage.

Restorative yoga is an accessible practice that can teach patients (and practitioners) how to rest systematically, for short periods of time, on a regular basis to encourage the parasympathetic nervous system to balance with the sympathetic nervous system for improved neuroregulation. We will also talk about the difference between meditation and restorative yoga, and how they can support each other in order to support the ability to drop into relaxation.

Designed for the virtual classroom, the lectures are pre-recorded for viewing at convenience. A set of restorative postures, each taking 20-30 minutes are offered prior to the live meetings so that participants can experience what a patient might experience when restorative yoga is a component of their home program. We will then discuss participant experiences, questions and strategize how to reduce barriers to relaxation so that patients can integrate this practice into their lifestyle. There will also be live labs for breathing techniques and specific meditations that may be helpful to patients working with an unregulated nervous system.