Alleviating World Suffering: The Challenge of Negative Quality of Life
CONTEXT: Mood disorders are prevalent in people after stroke, and a disorder's onset can exacerbate stroke-related disabilities. While evidence supports the mental-health benefits of participation in exercise and yoga, it is unknown whether such benefits extend to a population with poststroke hemiparesis.
OBJECTIVE: The study investigated whether supplementing exercise with participation in a yoga program would provide further improvements in self-reported symptoms of depression and anxiety in a chronic poststroke population, and it also assessed trial feasibility for future studies.
DESIGN: The research team designed a randomized, controlled pilot trial that included an exercise-only group (EX, control) and a yoga-and-exercise group (YEX, intervention).
SETTING: The study took place at the Centre for Physical Activity in Ageing an exercise rehabilitation and activity center at the Royal Adelaide Hospital in South Australia.
PARTICIPANTS: The participants included 14 individuals with chronic poststroke hemiparesis: eight in the intervention group and six in the control group.
INTERVENTIONS: The YEX group participated in a 6-week standardized program that included yoga in weekly group sessions and home practice in addition to exercise in a weekly group class. The EX group participated only in the group exercise class weekly for 6 weeks.
OUTCOME MEASURES: The research team assessed self-reported symptoms of depression using the Geriatric Depression Scale (GDS15) and symptoms of anxiety and negative affect using the State Trait Anxiety Inventory (STAI). The team based the feasibility evaluation on recruitment outcomes, retention of participants, participants' compliance with the intervention program, and the safety of the intervention.
RESULTS: Changes in depression and state and trait anxiety did not significantly differ between intervention groups (GDS15 P=.749, STAI-Y1, P=.595, STAI-Y2, P=.407). Comparison of individuals' case results indicated clinically relevant improvements in both groups, although members of the intervention group had greater improvements. Participants reported no adverse events, and the study experienced high retention of participants and high compliance in the yoga program.
CONCLUSIONS: This pilot study provides preliminary data on the effects of yoga combined with exercise to influence mood poststroke. It is a feasible, safe, and acceptable intervention, and the field requires additional investigations with a larger sample size.
This article analyses charity shop volunteering in the UK as an instance of individual commitment towards organisations devoted to combating suffering. Drawing on semi-structured interviews focused on motives, the paper argues that some respondents found in volunteer work a way of regaining meaning, structure, and belonging after experiences of social dislocation such as retirement and bereavement. The transition from social dislocation to ontological security via volunteering illustrates the way in which ‘the social’—as expressed in fellowship, laughter, work, organisations, and institutions—moderates charitable practice. From this perspective, volunteering appears as a relational, processual, and affective practice of care; and as a sympathy catalyst—an institution that facilitates interpersonal sympathy exchanges and support for compassionate goals. The paper endorses a view of human subjectivity which takes seriously both human vulnerability and resilience—victimhood and agency—as well as the relevance of suffering and flourishing for social action. In so doing, the paper sheds light on the link between individual biographies and the institutionalised efforts to alleviate strangers’ suffering that Natan Sznaider has termed ‘public compassion’.