Yoga for Multiple Sclerosis: A Systematic Review and Meta-Analysis

Abstract

While yoga seems to be effective in a number of neuropsychiatric disorders, the evidence of efficacy in multiple sclerosis remains unclear. The aim of this review was to systematically assess and meta-analyze the available data on efficacy and safety of yoga in patients with multiple sclerosis. Medline/PubMed, Scopus, the Cochrane Central Register of Controlled Trials, PsycINFO, CAM-Quest, CAMbase, and IndMED were searched through March 2014. Randomized controlled trials (RCTs) of yoga for patients with multiple sclerosis were included if they assessed health-related quality of life, fatigue, and/or mobility. Mood, cognitive function, and safety were defined as secondary outcome measures. Risk of bias was assessed using the Cochrane tool. Seven RCTs with a total of 670 patients were included. Evidence for short-term effects of yoga compared to usual care were found for fatigue (standardized mean difference [SMD] = −0.52; 95% confidence intervals (CI) = −1.02 to −0.02; p = 0.04; heterogeneity: I2 = 60%; Chi2 = 7.43; p = 0.06) and mood (SMD = −0.55; 95%CI = −0.96 to −0.13; p = 0.01; heterogeneity: I2 = 0%; Chi2 = 1.25; p = 0.53), but not for health-related quality of life, muscle function, or cognitive function. The effects on fatigue and mood were not robust against bias. No short-term or longer term effects of yoga compared to exercise were found. Yoga was not associated with serious adverse events. In conclusion, since no methodological sound evidence was found, no recommendation can be made regarding yoga as a routine intervention for patients with multiple sclerosis. Yoga might be considered a treatment option for patients who are not adherent to recommended exercise regimens.

Feasibility and Impact of an 8-Week Integrative Yoga Program in People with Moderate Multiple Sclerosis–Related Disability

“…12 Compared with non-yogic exercise programs, yoga was not superior in any of these domains. Cramer et al 12 reported that none of the trials reviewed [34][35][36][37][38][39][40][41] were robust against methodological bias. Furthermore, the forms of yoga and dosing varied across studies, and sufficient detail to reproduce the programs was generally absent.…”

“…11 A recent meta-analysis concluded that yoga was more effective than usual care in improving mood and perceived fatigue but not muscle function, cognitive function, or health-related QOL in people with MS. 12 Yoga was no more effective than the interventions with which it was compared. 12 An overarching limitation of the literature is the lack of well-described, reproducible yoga inter-participants were encouraged to attend all the classes. The class content, summarized in Table 1, was progressed over 8 weeks.…”

Effect of Exercise Interventions On Perceived Fatigue in People With Multiple Sclerosis: Synthesis of meta-analytic Reviews

“…A summary description of included reviews is presented in [8,17,18]. These reviews included RCTs only.…”

“…In the three reviews which reported the age of participants, one included studies with a wide range of sample age (18-65 years) [19], whereas, the other two reviews by Cramer et al, Asano and Finlayson included studies with participants ranging from 32-54 to 34-50 years old, respectively [8,17]. Two reviews stated the types of MS in the included studies [8,19].…”

“…While the majority of the reviews included trials on a wide range of exercise interventions, one review included only studies on the effects of yoga [17]. The review by Motl and Gosney categorized the interventions in the included trials as either aerobic or nonaerobic [20].…”