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Neurology Now:
DEPARTMENT: Living Well

Battling MS Fatigue with Yoga

Lindsey, Heather

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Deborah Jacobs has lived with multiple sclerosis (MS) for 25 years, so she has tried lots of strategies to ease her symptoms over the years. Of late, however, she has discovered that yoga helps her combat the fatigue related to the disease.

“Yoga makes me feel calm and energized,” says Jacobs, 54, who has taken a weekly yoga class especially for people with MS since September. “I would normally be exhausted this time of day if I wasn't taking the class,” she adds.

Recent research confirms her experience. A June 2004 study in the journal Neurology found that taking a weekly yoga class, along with home practice, lessens the fatigue that accompanies MS. In the six-month study, 69 volunteers with MS were divided into three groups: one-third practiced yoga, one-third performed regular aerobic exercise, and one-third did neither. Previous surveys found yoga to be beneficial, but this was the first study that compared yoga to aerobic exercise and to no exercise at all.

“The improvement in fatigue was clearly noticeable,” says Barry Oken, M.D., the lead author of the study, who is medical director of Clinical Neurophysiology at Oregon Health & Science University in Portland and a professor of Neurology and Behavioral Neuroscience there. The study wasn't limited to yoga. It also found that aerobic exercise, riding a stationary bike, had a similar effect. It's important for MS patients to engage in some sort of physical activity,” says Dr. Oken. “It could be either a stationary bike or yoga. It really depends on patient preference.”

Jack Burks, M.D., a clinical professor of Medicine in the department of Neurology at the University of Nevada School of Medicine in Reno, has recommended yoga to his MS patients for the past 25 years.

“Yoga does not cure people, but they tend to feel better when doing it,” he says.

Figure. Yoga does no...
Figure. Yoga does no...
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“It's encouraging to see study results that document the improvement in patients,” he adds. While the research found that patients experienced improvements in fatigue, it did not find that their mood or thinking clarity improved. However, the number of participants in the study may have been too small to measure such benefits, he explains.

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Other Potential Benefits

The study may not have documented that yoga improves mood, but engaging in yoga and aerobic exercise classes does seem to be have this effect, possibly because people get to socialize, says Dr. Burks. Jacobs agrees. “Meeting with a group of people during yoga class affects me in a positive way,” she says.

Yoga has also made her stronger and improved her posture, she says, adding that she also sleeps better on nights after taking her yoga class.

One potential benefit of yoga, says Dr. Oken, is improved flexibility, which could theoretically help with spasticity (the muscle tightness that affects people with MS). And it is also an excellent way to reduce stress. But, Dr. Oken notes, these potential benefits for MS patients have not yet been studied.

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How often patients should exercise depends on what they can do. Exercising for a half hour, three times a week, works for some people, while others may be able to handle more or less, says Dr. Burks. “I don't recommend exercising to the point of extreme fatigue,” he notes.

Dr. Oken recommends doing yoga and exercise at home as much as possible. He noted that everyone's needs are different, and that people with neurological problems should discuss their exercise plan with their doctor.

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Special MS Yoga Classes

Yoga has become so popular that there are now special classes for people with MS, and these are a wise choice for patients, says Dr. Oken. The classes are designed for people in wheelchairs or those with limited mobility, he explains. In Jacobs’ class, for instance, some of the typical standing yoga poses are adapted so they can be done while seated. Despite such adaptations, Jacobs is impressed by the abilities her classmates demonstrate. She was astonished when she learned that one of her substitute yoga instructors uses a wheelchair outside of class. “I was amazed at what she was able to do,” says Jacobs.

The class has given her confidence in her physical abilities. “When I first saw someone do a shoulder stand, I thought, ‘Oh my God, I'm not going to do that,’ but the class has given me courage to do it. I can do a shoulder stand now.”

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For more information

American Academy of Neurology

The Brain Matters www.thebrainmatters.org

National Institute of Neurological Disorders and Stroke

(800) 352-9424

TTY: (301) 468-5981

www.ninds.nih.gov

The National Multiple Sclerosis Society

(800) FIGHT-MS (344-4867)

www.nationalmssociety.org

Click on these links to find articles on yoga and exercise benefits:

www.nationalmssociety.org/imswi01-yoga.asp

www.nationalmssociety.org/orc/more_content/Yoga_and_MS.pdf

www.nationalmssociety.org/Sourcebook-Exercise.asp

Multiple Sclerosis Association of America

(800) 532-7667, (856) 488-4500

www.msaa.com

Multiple Sclerosis Foundation

(888) MSFOCUS (673-6287), (954) 776-6805

www.msfocus.org

©2005 American Academy of Neurology

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