Yoga therapy as an adjunct to conventional management of systemic sclerosis: A case series

Abstract

Systemic sclerosis (SSc) is an autoimmune disorder leading to significant disability and loss of Quality of Life (QoL). Yoga has become popular in recent times for its potential therapeutic benefits. Since there are no scientific reports on the use of Yoga for SSc, we present two female cases (aged 49 and 29 respectively) of limited SSc (duration of illness 4 and 3 years respectively) who underwent Yoga therapy as an adjunct to conventional management in a residential setting for a period of five and four weeks, respectively. During their stay, they underwent a specifically designed Yoga module. After their discharge, they were followed-up for four weeks, during which they were asked to continue practicing Yoga for 1 h every day. Both of them reported a reduction in pain, stiffness, symptom scores, and improved QoL on discharge and at the follow-up compared to the values on admission. Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP), as biomarkers of inflammation, reduced on the discharge when compared to the baseline. No adverse events were noted during the stay and the follow-up. Thus, the present case series indicate a possible beneficial role of Yoga as an adjunct therapy to conventional management of SSc. Further studies in the area are warranted to ascertain the efficacy of Yoga for SSc.

EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis

“…Non-pharmacological management of connective tissue diseases (CTDs) may be invasive and non-invasive, and includes, but is not limited to patient education,9 self-management,10 physical exercise,11 lifestyle or behaviour interventions (eg, photoprotection or smoking cessation),12 13 psychological counselling,14 cognitive behavioural therapy,15 relaxation or yoga,16 17 dietary, nutritional or microbiome interventions,18 19 stretching,20 massage,21 hand and foot interventions, assistive technology and devices,22 mouth exercise therapy,23 dental health and hygiene,24 modalities such as paraffin baths,25 shockwave therapy,26 acupuncture27 and transcutaneous electrical nerve stimulation,28 hydrotherapy and manual lymph drainage (MLD) 29. Furthermore, it may include skin and wound care, ulcer management (eg, debridement),30 minor surgical procedures such as calcinosis removal and detection and management of malnutrition 31…”

An Online Program of Seated Gentle Yoga & Yogic Breathing Improves Symptoms in Scleroderma: A Quality Improvement Study

“…However, while the overall number of people practicing yoga in the US rose by ~ 150% from 2012 to 2018 26 , people with scleroderma are less likely to take up yoga due to the previously discussed barriers and that few yoga programs are designed to accommodate their speci c needs 27,28 . Studies nd that practicing yoga and regulated breathing techniques not only produce positive psychological effects but also bene cial physiological effects in the autonomic nervous system, metabolism, immune system, in ammatory processes, electrophysiology, and relaxation response [29][30][31] . For example, yoga is found to reduce feelings of anxiety and depression and support a positive quality of life 32,33 in several disease states; decrease in ammatory biomarkers associated with scleroderma such as IL-1β, IL-8, IL-6 and MCP-1 34,35 , and increase salivary nerve growth factor, immunomodulators, and tumor suppressing factors 36,37 while reducing salivary pro-in ammatory cytokines associated with stress 38 .…”