Background & Aims
Treatments for patients with fibromyalgia (FM) and comorbid myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) have not yet been fully established. Special care must be taken when developing meditative exercise therapy for these patients, as even minimal exercise is likely to cause post-exertional malaise (PEM) and worsen pain. We initially have developed seated isometric yoga program and demonstrated that it reduced fatigue and pain in patients with ME/CFS. However, as some patients were too severe to practice it, we developed a recumbent isometric yoga program for more severe patients and those with comorbid FM. The aim of this study was to investigate the efficacy of recumbent isometric yoga in patients with ME/CFS including those with comorbid FM.
Methods
The study involved 24 adult patients (mean age was 37.9 ± 10.4 years) with ME/CFS, including 6 women with FM, who had ME/CFS without satisfactory improvement after at least 3 months of conventional treatment. They also received an additional recumbent isometric yoga practice consisting of biweekly 20-minute sessions with a yoga instructor and daily home sessions over 12 weeks. The following parameters were compared before and after the intervention: Chalder fatigue scale (FS) to assess fatigue severity, Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression, Medical Outcomes Study Short Form 8 (SF-8TM), standard version to assess health-related quality (QOL) of life and body pain. Adverse events and benefits were recorded from all subjects. The differences in the patients’ Chalder FS, HADS and SF-8TM scores measured before and after the intervention were tested by using a paired-sample t test. All data were expressed as mean ± SD.
Results
All participants completed the intervention. Overall, after the isometric yoga intervention, Chalder FS score (23.4±5.7 to 18.0±5.9, p<0.01), HADS anxiety score (7.9±4.2 to 5.8±3.6, p<0.01), and HADS-depression score (10.3±4.0 to 7.5±3.7, p<0.01) significantly decreased. The isometric yoga intervention also improved SF-8TM global health subscale score (36.8±7.2 to 41.7±9.1, p<0.05) without worsening of bodily pain subscale score (41.5±9.6 to 44.5±9.6, n.s.). In 6 FM patients with ME/CFS, isometric yoga practice significantly reduced Chalder FS score (30.2±2.3 to 23.8±4.8, p<0.01), whereas it didn’t change other parameters significantly possibly because of small number. No patients reported serious adverse events such as post-exertional malaise. Initially, some patients reported worsening pain. However, with practice, most patients began to feel relief of pain and stiffness even after one yoga practice.
Conclusions
The present study suggests that recumbent isometric yoga is a beneficial adjunctive therapy for patients with ME/CFS, including those who also had comorbid FM.
References
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3.Takakura S, Oka T, Sudo N: Changes in circulating microRNA after recumbent isometric yoga practice by patients with myalgic encephalomyelitis/chronic fatigue syndrome: an explorative pilot study. Biopsychosoc Med 2019, 13:29.
4.Oka T, Tanahashi T, Lkhagvasuren B, Yamada Y: The longitudinal effects of seated isometric yoga on blood biomarkers, autonomic functions, and psychological parameters of patients with chronic fatigue syndrome: a pilot study. Biopsychosoc Med 2019, 13:28.
5.Oka T, Tanahashi T, Sudo N, Lkhagvasuren B, Yamada Y: Changes in fatigue, autonomic functions, and blood biomarkers due to sitting isometric yoga in patients with chronic fatigue syndrome. Biopsychosoc Med 2018, 12:3.
6.Oka T, Wakita H, Kimura K: Development of a recumbent isometric yoga program for patients with severe chronic fatigue syndrome/myalgic encephalomyelitis: A pilot study to assess feasibility and efficacy. Biopsychosoc Med 2017, 11:5.
7.Oka T, Tanahashi T, Chijiwa T, Lkhagvasuren B, Sudo N, Oka K: Isometric yoga improves the fatigue and pain of patients with chronic fatigue syndrome who are resistant to conventional therapy: a randomized, controlled trial. Biopsychosoc Med 2014, 8(1):27.
Presenting Author
Takakazu Oka
Poster Authors
Topics
- Treatment/Management: Complementary and Alternative therapies