• Check in, centering, balanced hatha yoga set considering contraindications, relaxation (with imagery as appropriate),
• Balanced pranayama considering contraindications, meditation/centering.
• Include at least one suggestion from Karma, Bhakti, Raja, or Jnana Yoga tailored for this client.

I adapted the care plan while the client was recovering from the surgery. The session focused on the movement of the joints with breath and restorative yoga/guided imagery. Two months after the surgery (when the client was clear from his surgeon and PT), the session focused on building strength, flexibility and stretching the hamstring. Before the surgery, the asana practices were done on a chair or the floor. After the surgery, I was able to incorporate standing poses into the session.

The client initial goals were to reduce lower back pain and improve range of motion, both of which had been achieved. The reduction of pain was due to the laminectomy to correct lumbar stenosis. The improvement of range of motion was from gentle movements (recommended by his physical therapist and I) that combine with breath. After the surgery, the goals changed to increase strength and flexibility, both of which have been achieved.

The physical level improves. The client can walk and carry on his daily activities without pain. Average PEG score decreased 5.5 to 3 from the first the last session. Average Global Health score improves slightly (from 3.2 to 3.6).

The energetic level also improves. He has more energy and sleep well.

His emotion also improves. He is less stress and worry about his future.

The sense of self remains the same as. He still identify himself with what he can do physically.

He also loves being outdoors; he often goes for a walk which brings him joy. He continue his daily meditation practice.

The client is grateful for the yoga therapy session. The asana practice is complementary to his PT. Breathing and mediation are helpful in managing stress, although his mind still wander a lot during meditation.

1. Three-part breathing, alternate nostril breathing and meditation daily 15 minutes.
2. Deep relaxation after PT/yoga practices. I recorded an 8-minute guided imagery and emailed it to him.
3. Listen to the body and not over doing (brahmacharya).

I would do 'I am' exercise at the last session to better understand why the client still feels that his health has not improved significantly (based on Global Health assessment). This will help guide my conversation with the client.

The mentor has provided tremendous support for this case study. I did the 'I am' exercise with this client. I think that I need to use it more often with other clients for me to be proficient in applying this technique.

Yes, I did. I learned how to adapt asanas for lumbar stenosis and post-operation. I also enjoyed discussed yogic wisdom with the client.