Randomized controlled trial of yoga and exercise in multiple sclerosis
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
Objective:
To determine the effect of yoga and of aerobic exercise on cognitive function, fatigue, mood, and quality of life in multiple sclerosis (MS).
Methods:
Subjects with clinically definite MS and Expanded Disability Status Score less than or equal to 6.0 were randomly assigned to one of three groups lasting 6 months: weekly Iyengar yoga class along with home practice, weekly exercise class using a stationary bicycle along with home exercise, or a waiting-list control group. Outcome assessments performed at baseline and at the end of the 6-month period included a battery of cognitive measures focused on attention, physiologic measures of alertness, Profile of Mood States, State-Trait Anxiety Inventory, Multi-Dimensional Fatigue Inventory (MFI), and Short Form (SF)-36 health-related quality of life.
Results:
Sixty-nine subjects were recruited and randomized. Twelve subjects did not finish the 6-month intervention. There were no adverse events related to the intervention. There were no effects from either of the active interventions on either of the primary outcome measures of attention or alertness. Both active interventions produced improvement in secondary measures of fatigue compared to the control group: Energy and Fatigue (Vitality) on the SF-36 and general fatigue on the MFI. There were no clear changes in mood related to yoga or exercise.
Conclusion:
Subjects with MS participating in either a 6-month yoga class or exercise class showed significant improvement in measures of fatigue compared to a waiting-list control group. There was no relative improvement of cognitive function in either of the intervention groups
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Authors
B. S. Oken
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S. Kishiyama
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D. Zajdel
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D. Bourdette
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J. Carlsen
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M. Haas
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C. Hugos
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F. Kraemer
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J. Lawrence
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M.
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Author's primary institution
From the Departments of Neurology , Oregon Health & Science University, Portland
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MS quality of life, depression, and fatigue improve after mindfulness training. A randomized trial
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
Objective:
Health-related quality of life (HRQOL) is often much reduced among individuals with multiple sclerosis (MS), and incidences of depression, fatigue, and anxiety are high. We examined effects of a mindfulness-based intervention (MBI) compared to usual care (UC) upon HRQOL, depression, and fatigue among adults with relapsing-remitting or secondary progressive MS.
Methods:
A total of 150 patients were randomly assigned to the intervention (n = 76) or to UC (n = 74). MBI consisted of a structured 8-week program of mindfulness training. Assessments were made at baseline, post intervention, and 6 months follow-up. Primary outcomes included disease-specific and disease-aspecific HRQOL, depression, and fatigue. Anxiety, personal goal attainment, and adherence to homework were secondary outcomes.
Results:
Attrition was low in the intervention group (5%) and attendance rate high (92%). Employing intention-to-treat analysis, MBI, compared with UC, improved nonphysical dimensions of primary outcomes at post intervention and follow-up (p < 0.002); effect sizes, 0.4–0.9 post treatment and 0.3–0.5 at follow-up. When analyses were repeated among subgroups with clinically relevant levels of preintervention depression, fatigue, or anxiety, post intervention and follow-up effects remained significant and effect sizes were larger than for the total sample.
Conclusions:
In addition to evidence of improved HRQOL and well-being, these findings demonstrate broad feasibility and acceptance of, as well as satisfaction and adherence with, a program of mindfulness training for patients with MS. The results may also have treatment implications for other chronic disorders that diminish HRQOL.
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Authors
P. Grossman
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L. Kappos
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H. Gensicke
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M. D'Souza
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D.C. Mohr
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I.K. Penner
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C. Steiner
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Author's primary institution
Psychosomatic Medicine, Division of Internal Medicine, University Hospital Basel, Switzerland
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Mindfulness of movement as a coping strategy in multiple sclerosis: A pilot study
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
This study investigated the effectiveness of a short course of mindfulness of movement to help with symptom management in eight people with multiple sclerosis.
Progress was compared to a control group who were asked to continue with their current care. Each participant received six individual one-to-one sessions of instruction. They were also provided with audio and videotape aides. Each participant was assessed on a test of balance, pre- and post-intervention, and at 3-month follow-up. All participants completed a rating of change of 22 symptoms relevant to multiple sclerosis. A close relative or friend was also asked to assess independently the degree of change.
The mindfulness group reported improvement over a broad range of symptoms. This was verified by the relatives’ independent rating and maintained at 3 month follow-up. The control group showed no improvement but instead tended towards a deterioration on many of the items. The physical assessment of balance also showed a significant improvement for the mindfulness group. This improvement was maintained at 3 month follow-up.
In conclusion, training in mindfulness of movement appeared to result in improved symptom management for this group of people with multiple sclerosis. This was a pilot study, using small numbers, so the results need to be treated with caution. Several improvements to the experimental design are suggested. The role of individual therapeutic ingredients is discussed.
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Authors
Nigel Mills
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Janet Allen
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Journal
General Hospital Psychiatry
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Author's primary institution
South Wales Doctoral Course in Clinical Psychology, South Wales, UK
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Influence of sports climbing and yoga on spasticity, cognitive function, mood and fatigue in patients with multiple sclerosis
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
Objectives:
Spasticity, cognitive impairment, depression and fatigue significantly reduce the quality of life in multiple sclerosis (MS) patients. To find out whether nonpharmalogical treatment approaches can reduce these symptoms we investigated effects of sports climbing (SC) and yoga on spasticity, cognitive impairment, mood change and fatigue in MS patients. Sports climbing (SC) and yoga are aerobic physical activities comprised a series of stretching techniques, implementation of which demands body control and planning of complex movements.
Materials and methods:
20 subjects with relapsing–remitting or progressive MS, 26–50 years of age, with EDSS ≤ 6 and EDSS pyramidal functions score (EDSSpyr) > 2 were enrolled in a randomized prospective study. The participants were randomly divided into SC and yoga group. We evaluated spasticity, cognitive function, mood and fatigue before and after both programs, that lasted 10 weeks, with standardized assessment methods.
Results:
There were no significant improvements in spasticity after SC and yoga. In the SC group we found a 25% reduction (p = 0.046) in EDSSpyr. There were no differences in executive function after the completion of both programs. There was a 17% increase in selective attention performance after yoga (p = 0.005). SC reduced fatigue for 32.5% (p = 0.015), while yoga had no effect. We found no significant impact of SC and yoga on mood.
Conclusions:
Yoga and SC might improve some of the MS symptoms and should be considered in the future as possible complementary treatments.
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Authors
Orjana Velikonja
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Katarina Curic
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Ana Ozura
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Sasa Sega Jazbec
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Journal
Clinical Neurology and Neurosurgery
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Author's primary institution
University of Ljubljana, Medical Faculty, Vrazov trg 2, 1104 Ljubljana, Slovenia
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The Effects of a Yoga Intervention on Balance, Speed and Endurance of Walking, Fatigue and Quality of Life in People with Multiple Sclerosis
Practice
- Yoga
- Meditation
- Mindfulness
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Abstract
Multiple sclerosis (MS) is a disease of the central nervous system that results in many symptoms including mobility limitation, fatigue and redacted quality of life.
The purpose of this study was to determine the effect of a yoga intervention on balance, speed and endurance of walking, fatigue and quality of life in MS patients.
21 women with MS (34.38±5,68) with Expanded Disability Status Scale scores 1.0 to 4.0, have been randomly assigned to a yoga group or control group. Yoga group subjects participated in a thrice weekly 60-70 minute sessions of Hatha yoga intervention for 8-weeks. Balance, speed and endurance of walking, fatigue and quality of life were measured by Berg Balance scores; 10-m time and 2-minute distance walking, Fatigue Severity Scale (FFS) and Multiple Sclerosis Quality of Life-54 questionnaire (MSQOL-54) respectively.
Comparison of results of pre and post intervention revealed significant improvement on balance score, walking endurance, FFS and some of MSQOL-54 scale scores in the yoga group (p≤0.05 respectively). There were no clear changes in10-m times (p= 0.132), related to yoga group. No changes were observed for control group.
These results suggest that yoga intervention can be beneficial for patients with MS.
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Authors
Azra Ahmadi
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Masuod Nikbakh
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Ali Arastoo
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Abdol-Hamid Habibi
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Journal
Journal of Human Kinetics
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Author's primary institution
School of Physical Education & Sports Science, Ahwaz Shahid Chamran University, Iran
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Multiple sclerosis
Lizzie Reumont by KarenYeomans.com
