HANOVER, N.H. — For almost 20 years after hitting her head on an overhanging shelf at work, Mary Nelsen struggled to remember little things: to read, to rise out of her chair, to just move through the world and engage with other people.

So when she learned in 2014 that a master’s degree student at The Dartmouth Institute for Health Policy and Clinical Practice was recruiting patients with brain injuries for a study of how practicing gentle yoga regularly might help them cope, the then-50-year-old Nelsen decided to try.

By the end of her first session of focused breathing, meditation and easing into poses with study leader and certified yoga instructor Kyla Donnelly Pearce, which included sharing her experiences with other patients, Nelsen found herself thinking about her favorite snack.

“My brain felt like a bowl of chips and dip when I was done,” Nelsen said recently, during a telephone interview from her home in Canaan. “Or like hitting the perfect wave when you’re surfing or body surfing. You feel loved.

“You want to love yourself.”

Nelsen loved the feeling enough to continue attending one of the weekly yoga sessions that evolved from the pilot program of yoga therapy for patients with acquired brain injury, or ABI.

In a report on the program, which the British medical journal Brain Injury published in December, Pearce and her team concluded that “yoga interventions have the potential to benefit multiple aspects of ABI survivors’ quality of life and contribute to rehabilitation goals, including a positive sense of self, psychological well-being and community integration.”

NEGATIVE EMOTIONS ERODED

With help from Dartmouth Institute peers and mentors, Pearce recruited 20 women and 11 men between the ages of 23 and 72. Sixteen of the subjects took the yoga classes and the other 15 went into a control group; both groups took a Quality of Life After Brain Injury test before and at the end of the study. According to the journal article, patients who took the yoga classes reported feeling “less bothered by negative emotions, including feeling lonely, bored, anxious, sad or depressed and/or angry or aggressive. Within the control group, no significant differences emerged.”

One of Pearce’s mentors, Jonathan Lichtenstein, this week described the study as “further validation of all the work demonstrating how interventions such as yoga and mindfulness can result in changes in neurochemistry and patterns of brain activation.” He added that follow-up studies could go in a number of directions.

“There are so many possibilities,” Lichtenstein, an assistant professor of psychiatry at the Geisel School of Medicine, wrote in an email. “For me, I am very interested in examining the impact of this intervention upon neuropsychological functions, such as attention, executive functioning and memory. These are areas commonly compromised following brain injury, and to demonstrate change with objective cognitive data would be very meaningful. Along the same pathway, we can learn much more about the effects of yoga and mindfulness in individuals with brain injuries through neuroimaging, with a particular focus on the alterations in functional connectivity following such an intervention.”

SENSE OF CAMARADERIE

The Sunday afternoon class that Nelsen now attends at Mighty Yoga in Lebanon is one of three weekly sessions that the LoveYourBrain foundation sponsors in New England. In all, the foundation now offers classes in seven states and two Canadian provinces, according to Pearce, the wife of LoveYourBrain co-founder Adam Pearce.

“The biggest takeaway was the importance of people having space to get to know each other,” Pearce recalled. “There was no discussion component when we started the study, but at the end of the classes, people stayed around and started comparing notes. That kind of community building organically happened. Now, a 20-minute discussion at the end of each class is part of the program.

“At the start of the study, we asked people why they wanted to be part of it. Some talked about improving things like their strength and their balance, but another, very clear message was that people came to meet other people with traumatic brain injury. Some of them had never met someone else with the same kind of condition. It kind of breaks my heart to think that someone would feel like they don’t have one person who can relate to their experience.”

Pearce observed that sense of isolation after her brother-in-law, Olympic-class snowboarder Kevin Pearce, suffered a traumatic brain injury in a fall during a training workout for the 2010 Winter Games.

“When you have a brain injury, you feel so not normal,” Kevin Pearce told the Valley News newspaper in the spring of 2016, during a LoveYourBrain retreat for patients and their caregivers in central Vermont. “You’re thrown back into the regular world. You’re expected to be as you were before this. We’re not able to do that because we’re now a new person.”

Kevin Pearce found a route around that obstacle in part through yoga classes he took during his rehabilitation. He and his brother Adam started looking for ways to incorporate the practice and principles of yoga after founding LoveYourBrain in 2012.

Then in 2014, Kyla Pearce returned from a month of yoga instructor training and was preparing to enter The Dartmouth Institute’s master’s program in public health. Soon the idea arose for her to lead a study, in the form of an 8-week pilot program of yoga sessions for people struggling to cope with brain injuries.

“There was this alignment of the stars,” recalled Kyla Pearce, now pursuing a doctorate in public health at the institute. “Everything seemed to fall into place.”

In addition to Pearce, three other instructors worked with the patients who took the pilot classes, among them Kim Hall of West Lebanon. Then working as a health coach at Dartmouth Health Connect, the Hanover-based primary-care practice serving employees of Dartmouth College and their families, Hall also was teaching yoga to people with various health issues.

She was helping rehab patients of Dartmouth-Hitchcock Medical Center in yoga sessions at the River Valley Club when she learned about the LoveYourBrain study, which was scheduled to take place at the health club.

“It was sort of a natural fit,” Hall, now a freelance yoga instructor and freelance artist, recalled this week. “I did a weekend of training in Pittsburgh, which really helped me understand about the cognitive and physical aspects of brain injuries, and the different varieties. The science behind yoga made me appreciate better that it’s not a woo-woo, New Age practice. The ancient body-mind connections that have long been part of yoga are very much in line with what modern science is starting to reveal.”

SUBHED

During the study, and now in her regular classes and in LoveYourBrain’s Sunday session, where she assists Mighty Yoga instructor Connie Ciulla, Hall continues to learn about the spectrum of conditions – from athletes with concussions resulting from incremental, repetitive injuries and traumatic accidents to stroke patients and older people with advancing dementia.

“It’s been a tremendous variety of causes and effects,” Hall said. “What seems to connect all of them is the frustration and isolation that people experience. They aren’t the same person they were before. It’s shocking to the ego, and to friends and families. It’s a real shock to the system when that person you were is taken out from under you.”

Hall recalled one athlete who had bounced back from multiple concussions and who, “over the course of time, has gone back to gentle skiing, and is going back to college, and wants to start a yoga program for people like her there.”

“She also seems happier,” Hall added. “She’s way happier.”

In addition to the focused breathing, the time for meditation and the improvements in balance and flexibility, Hall credits the peer support of the LoveYourBrain program with giving such patients hope.

“They act as mentors for each other,” Hall said. “Like in the recovery community, the idea of a sponsor is very powerful. It’s the concept of, to keep something, you’ve got to give it away. It’s pretty magical.”

At 53, Mary Nelsen can’t imagine missing her weekly dose of sharing the magic.

“We often get new people coming in, and they’re saying all the things I said 20 years ago,” Nelsen said. “It’s great to be able to give someone hope, or at least to say, ‘I’ve been there.’ “