Indications : Hamstring and hip abductor strengthening. Instructions: 1. Stand erect with both the feet together (mountain pose/ tadasana ). 2. Shift more weight into the left foot and make the left leg straight. 3. Bend your right knee, keeping the tips of your toes on the floor; externally rotate your right leg as far as you can, keeping your left leg and pelvis in line. 4. Move your right foot up to the inside of your left thigh as high as possible; hold around the ankles with your right hand to move the foot higher on your inner left thigh. 5. Lift your chest and raise your arms over your head so that the palms come together and the arms are straight. 6. Stay in the posture for 5–10 breaths. 7. To exit, bring your right foot and your arms down to come back to Mountain Pose. Repeat for the left leg. Modifications using props: 1. If unable to balance unsupported, stand with your back against a wall. 2. Practice in front of a mirror to check your alignment (Worle et al., 2010) .
4. Exhale as you straighten your right leg while lifting your left one; turn your pelvis and trunk to the left, and lift your left shoulder so that the shoulder girdle is in line with the right arm. 5. If you can keep your balance, stretch your left arm up in line with the shoulder girdle. If you can still keep your balance, turn your head to look up at your left hand. 6. Stay in the posture for 5–10 breaths. 7. To exit, exhale as you bend your right knee exactly in line with the right foot, come back to triangle pose, and then to a standing position with the legs apart and the feet parallel. Repeat on the other side. Modifications using props: 1. If unable to balance on one hand and foot, perform with your back against a wall for added support. 2. If unable to touch the floor, support your lower hand on a yoga brick or on a chair depending on your flexibility (Wörle et al., 2010). TREE POSE (VRKSASANA) Figure 7: Tree Pose
POSES FOR BALANCE
According to the literature, balance training after TKA produces significantly greater improvements in walking capacity, balance- specific performance measures, and subjective measures of physical function compared to conventional training immediately postoperatively, and at the 6- to 12-month follow-up period (Doma et al., 2018). Yoga practice can help patients regain their sense of balance and proprioceptive awareness in a newly implanted knee. A systematic review and meta-analysis of the evidence showed a significant effect of yoga on the mobility outcomes of gait speed and timed chair stands in people age 60 and over (Youkhana et al., 2016). The results provide evidence that health professionals can confidently recommend yoga for those age 60 and older to improve balance and physical mobility, and yoga-based exercise shows potential as a fall prevention intervention. A 2020 randomized controlled trial assessed the effects of a twice weekly, 12-week yoga intervention on balance using the Balance Evaluation Systems Test (BESTest). The yoga asanas included warrior I, warrior II, warrior III, and tree poses. The yoga intervention group demonstrated improved performance on the BESTest for each system of balance (biomechanical constraints, stability limits/verticality, transitions/anticipatory, reactive, sensory orientation, and stability in gait; Myers et al., 2020). Mountain pose, warrior I pose, chair pose, and tree pose have been shown to provide statistically significant results in balance measured by Time Up and Go Test (TUG) and Modified Clinical Test of Sensory Interaction in Balance (CTSIB-M), among geriatric subjects. The poses began with chair support for the geriatric population, and by four weeks were progressed without support (Patel et al., 2019). Goddess pose, chair pose, pyramid
pose, and tree pose have been shown to improve dynamic body balance after a six-week yoga intervention (Singh et al., 2022). Based on these findings from the literature, it can be concluded that the double-leg poses mountain pose, warrior I, chair pose, goddess pose, pyramid pose and single-leg poses tree pose and warrior III pose are clinically shown to improve balance. MOUNTAIN POSE (TADASANA) Figure 8: Mountain Pose
Indications : Double-leg balance.
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