Yoga Therapy for Parkinson's Disease and Multiple Sclerosis. Jean Danford

strengthen and energise Muladhara. It is unlikely that there would be a permanent change. It has to be worked regularly to improve quality of life.

      On an emotional level, there will be a degree of fear held here that will block energy flow, fear of falling and fear of the condition itself.

      The sacral chakra: Swadhisthana

      Dopamine is responsible for the experience of pleasure as well as being vital in transmitting messages to the muscles. It is here in Swadhisthana that we find the link into ‘desire’; this can be over-stimulated by the medication treating Parkinson’s. It can result in out-of-balance behaviour, or over-spending and seeking out pleasurable stimulation as desires intensify (medication is needed to keep this in balance).

      As this centre is also to do with power, issues around loss of power will deplete the sacral centre. This may show in MS as mobility is affected and people with MS may become more reliant on others.

      Freeing up the lower back, pelvis and hips can help keep the energy flowing.

      The solar plexus chakra: Manipura

      This is the chakra associated with self-confidence and being comfortable with our own identity as well as linking with the process of digestion. A diagnosis of Parkinson’s or MS can really knock self-esteem and self-confidence; there is a loss of sense of self and it is difficult to ‘digest’ the new situation. It is important when teaching to keep language positive and upbeat, giving encouragement and building week by week, encouraging the class to stay active, to mark achievements and to set goals that are achievable.

      The heart chakra: Anahata

      Although the Anahata chakra governs the physical heart and the function of respiration, it is here that we really engage with our emotions and where fear can block the energy flow – fear of the future, fear of losing oneself, losing touch with the true self, anxiety for just the everyday activities that become harder. As people become more dependent on others, relationships are tested. All of this will impact on Anahata. We may also lose love for ourselves, not liking what we are becoming.

      The heart centre is linked to the thymus, a major organ of the immune system; this may be significant for MS, as it is a disease of the immune system.

      The throat chakra: Vishuddhi

      The throat is a command centre, governing to some extent the chakras below it. It is the centre of communication, governing speech and the voice.

      In Parkinson’s the voice is often affected as the muscles weaken. People with Parkinson’s may not be able to vocalise their feelings, may be unable to express themselves, or may feel shame about their condition. Using the voice is both empowering and strengthening. Mantras may be useful in energising this centre, or singing, if a mantra is not appropriate – both will also ease and exercise the lungs. Using laughter to encourage is also helpful.

      The brow chakra: Ajna

      If we look at the physical aspects of this centre, we can see that it is here that the Parkinson’s malfunction originates – cells in the brain being unable to produce dopamine. So we have a disruption of the energy of Ajna. Ajna governs mental faculty, so here, again, we see loss of control. The brain is still able to function, but in some cases there is loss affecting memory and communication with other parts of the body, as motor function is lost.

      In modern terms, we are told that it is possible to retrain our memory patterns, our nerve functions, owing to the plasticity of the brain. Understanding in this field is in the early days, but yoga provides a great opportunity to work the body/brain connection.

      The crown chakra: Sahasrara

      This is usually thought of as our spiritual connection. Each person often has a very personal experience of their own spiritual connection, and mostly this subject is outside of the remit of an hour-long class.

      We cannot know each individual viewpoint without a deep conversation, but there are some difficulties in upholding a meditative practice. Disease, dullness, carelessness, laziness, false perception, failure to establish the practice, physical unsteadiness, distress, despair and disturbed breathing, these are all are obstacles to progress, as detailed by Patanjali in 1.30–31. However, if there is consistent application towards opening at this level, who knows what may be achieved?

      Practices for working on the chakras can be found on pages 246–256.

      The five vayus (the five movements or functions of prana)

      From the yogic point of view the body is a collection of energy channels. The vayus describe physical flow and function within the systems of the body. This is seen in digestion and elimination, circulation of the blood, the electrical and chemical communication of the nervous system and the action of breathing. The biological workings of the body, its maintenance and repair, its constructive and destructive processes are directed by vayu. Vayu is the cosmic life force or bio energy that creates these channels.

      We have five types of prana in the body: prana, apana, vyana, udana and samana.

      •Prana vayu flow is inwards and upward. It nourishes the brain and the eyes and governs reception of all things: food, air, senses and thoughts. This is the fundamental energy in the body, and directs and feeds into the four other vayus. Inhaling is the most obvious action of prana.

      •Apana vayu energy pervades the lower abdomen. The flow of apana vayu is downwards and out, and its energy nourishes the organs of digestion, reproduction and elimination. Apana vayu governs the elimination of all substances from the body: carbon monoxide, urine, stools, etc.

      •Vyana vayu is situated in the heart and lungs and flows throughout the entire body. The flow of vyana vayu moves from inside to outside. It governs the circulation of all substances throughout the body, and assists the other vayus with their functions. We see its action in the circulation of blood and the peripheral nervous system.

      •Udana vayu has a circular flow around the neck and head. It functions to ‘hold us up’ and governs speech, self-expression and growth.

      •Samana vayu is situated in the abdomen with its energy centred in the navel. The flow of samana vayu moves from outside to inside. It governs the digestion and assimilation of all substances: food, air, experiences, emotions and thoughts.

      In any diseased state these energies are out of balance, and the life force is not flowing. Yoga asana seeks to bring balance and flow in these vital forces. Prana and apana are the major forces, prana supporting and sustaining life and therefore supporting all of the others, and apana, energy leaving the body, is also essential for health. If apana is not flowing effectively, we suffer from congestive conditions, poor breathing, sluggish digestion, constipation and low-energy states.

      Because of the individuality of the disease process, the effect on the vayu may be seen differently in each person. In general, in Parkinson’s one would assume that udana, the upward-moving energy, supporting thinking and the brain, speech and self-expression, would be depleted. But as in any illness it is best to work on balancing the whole and to strengthen the whole, rather than focusing on just one element.

Yoga Therapy

      There are many different ways to deliver Yoga Therapy, and some will work in a traditional way that will include Ayurveda treatments. As it takes many years to train in Ayurveda medicine, the methods of Yoga Therapy offered here seek to bring improvement in the health and wellbeing of people with MS and Parkinson’s for their common symptoms and to improve their quality of life, without the specialist Ayurvedic approach.

      Yoga Therapy is at its most effective when it is tailored for each individual. A student’s needs may vary, as there may be multiple health issues that need to be taken into consideration in planning practices. Even when working with a small ‘therapy’ group, each individual must be evaluated and considered, and contraindications for the individual taken into account. Before enrolling anyone into a specialist class, it is essential to take a full medical history. With both Parkinson’s and MS, people often reach a stage of immobility and may not be able to attend a class that includes asana. Working one-to-one is more suitable for these people, and