Wednesday, 26 June 2013

Cerebral palsy yoga case-study

YOU & ME Yoga trainers' coursework now involves doing three case-studies. To demonstrate the trainer's competence teaching the system to students with varying abilities. They must provide visual and written evidence of their carefully selected yoga programmes to safely accommodate each individual's particular needs and abilities, along with records of practice, achievement and evaluation.

Here Pat Pickering, a YOU & ME Yoga practitioner talks about her yoga training with a very special client called Jane, which is followed by her case-study.

Jane is twenty-six years old, has athetoid cerebral palsy and is quite intelligent.  Most of the time she uses a wheelchair, but she enjoys the opportunity to sit in a normal chair.  She is capable of sitting unaided.  Her athetoid movements sometimes make purposeful movements difficult, but her personality is such that any frustrations are so slight as to be practically negligible.
Jane always indicates when she wants to use the toilet, but requires assistance to get in and out of her wheelchair and to adjust her clothing.  She finger-feeds when eating sandwiches, but needs to be fed with a spoon when having a hot meal.  She drinks independently but needs to use a two-handled cup with a spout.
Jane uses the Hydrotherapy pool and enjoys it, but this is only possible once a week. She is an active member of the Makaton sign language group, and is encouraged to use speech as much as possible when signing.  Her vocabulary is limited and is sometimes difficult to understand.  Although she understands most of what is said to her, it is wise to keep language simple when addressing her. She is a very enthusiastic, happy and lively young lady. 
During the first few weeks of introducing Jane to the idea of yoga we asked her how she felt about life in a wheelchair, and from this we were able to prioritize her future course of action.  She told us she would like to sit up straighter and hold her head up.  She has the typical extensor thrust of chin, and said she suffers from a lot of neck ache.  She also told us that she hoped to gain more control of her arm movements, by gaining more strength in her arms and hands to assist with eating, drinking and using her Makaton signing.  She said that toileting was a problem, because it was uncomfortable to be handled so much by various staff assistants, and she wants to work towards being able to pull herself up from her chair to go to the toilet without help. 
So together we looked through the YOU & ME Instruction Pack of the Postures. As Jane could understand the seven different coloured parts of the body, in relation to selecting one Posture card in each of the seven different colours, it was possible for her to contribute to selecting and arranging her own yoga programme plan.

Jane made very good progress.  She is always telling people what she can do, and they are keenly interested in her progress.  Apart from progress with her YOU & ME Yoga, there has been evidence of progress with other members of staff in other learning areas.  Jane is participating more actively and confidently in the swimming-pool.  Her sitting position in her chair is more upright.  Her biggest accomplishment is pulling herself from her wheelchair onto the toilet, and back again without needing to be lifted and handled at all, only her clothing needing adjustment.  She is very pleased about this, and also about having starred in her own video, which was great fun for her especially when it was shown at home and all the family watched her on ‘telly’.

Jane’s Breathing and Relaxation

Jane found breathing very difficult when we started the practice. The first few sessions were spent discussing and practicing breathing with use of the diaphragm. It was important that Jane could see the tummy movements on the in- and out-breath. When lying down she couldn’t see this herself, so I lay down beside her with a book on my tummy so that she could see that the book was moving up and down as we breathed together.  

After some time, she was sometimes able to control and slow down her breathing. I demonstrated this process further by showing her the diaphragm apparatus’ and helped her to see what happens to the lungs in relation to the diaphragm while breathing.  These breathing practices have been helpful with her Postures, because previously she would perform the Postures too quickly and with a jolt at times.  And use of the ‘ahhhh’ when breathing out helped her to control her movements at a slower pace.

After Jane completes her yoga sequence of seven Postures she spends ten minutes relaxing her whole body.  This is a very important part of her programme, as she needs to relax and breathe easily.  This in itself wasn’t easy for her, but the video filmed at our Centre showed how she learned to relax and breathe much better. 
Pat Pickering, Day Service Officer, YOU & ME Practitioner

Learning Difficulties and Associated Conditions Explained with YOGA CASE STUDIES
ISBN-13: 978-1904117025 
YOU & ME Relaxation Techniques for Special Needs
ISBN-13: 978-1904117162 
YOU & ME Breathing Techniques for Special Needs
ISBN-13: 978-1904117193

Introduction to YOU & ME Yoga DVD  
ASIN: 1904117139
Colour-Code Instruction Pack of the Postures
ISBN-13: 978-1904117056

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