Yoga and Cognitive Function Research

YOGA REDUCES FATIGUE IN MS PATIENTS.

The study, published in the journal Neurology, found that yoga is as good as a traditional aerobic exercise program in improving measures of fatigue, a common and potentially disabling symptom of MS. It was the first randomized, controlled trial of yoga in people with MS.

A parallel study by the same OHSU authors, presented in April at the 56th annual meeting of the American Academy of Neurology, found that cognitive function does not improve among healthy seniors in a six-month yoga program or exercise class, but physical health and quality of life appear to be enhanced.

The MS study was not designed to determine the impact of yoga on the disease itself, said the study's lead author, Barry Oken, M.D., professor of neurology and behavioral neuroscience in the OHSU School of Medicine. Rather, it was intended to determine the effect of yoga and aerobic exercise on cognitive function, fatigue, mood and quality of life among people with MS.

YOGA REDUCES FATIGUE IN MS PATIENTS, OHSU STUDY FINDS
But cognitive function not affected by popular mind-body medicine
technique

PORTLAND, Ore. -- Just six months of yoga significantly reduces fatigue
in people with multiple sclerosis, but it has no effect on alertness and
cognitive function, says a new Oregon Health & Science University study.
The study, published today in the journal Neurology, found that yoga is
as good as a traditional aerobic exercise program in improving measures
of fatigue, a common and potentially disabling symptom of MS. It was the
first randomized, controlled trial of yoga in people with MS.

A parallel study by the same OHSU authors, presented in April at the
56th annual meeting of the American Academy of Neurology, found that
cognitive function does not improve among healthy seniors in a six-month
yoga program or exercise class, but physical health and quality of life
appear to be enhanced.

The MS study was not designed to determine the impact of yoga on the
disease itself, said the study's lead author, Barry Oken, M.D.,
professor of neurology and behavioral neuroscience in the OHSU School of
Medicine. Rather, it was intended to determine the effect of yoga and
aerobic exercise on cognitive function, fatigue, mood and quality of
life among people with MS.

"There are some claims out there that yoga helps MS itself, that it can
decrease the number of lesions" in the brain caused by MS, said Oken,
director of the Oregon Center for Complementary and Alternative Medicine
in Neurological Disorders (ORCCAMIND) at OHSU. "I'm not sure that that's
not the case, because stress may have an impact on MS. But that was not
what we were trying to show."

Study co-author Dennis Bourdette, M.D., professor of neurology in the
OHSU School of Medicine and director of the Multiple Sclerosis Center of
Oregon, said yoga was studied because many people with MS already are
using it and reporting benefits.

"We wanted to see whether or not it was beneficial when studied
scientifically and how it compared with a type of exercise that
physicians are more comfortable recommending -- exercise on a stationary
bicycle supervised by a physical therapist," said Bourdette, chairman of
the School of Medicine's Department of Neurology and associate director
of ORCCAMIND.

An earlier survey of nearly 2,000 MS patients in Oregon and southwest
Washington found about 30 percent of respondents tried yoga. Of those,
57 percent reported it to be "very beneficial," Bourdette noted. Indeed,
many chapters of the National MS Society sponsor yoga programs.

"So it is used fairly commonly, and I believe with publication of our
results it will gain even more acceptance and use," he said. The study
"also clearly demonstrates that yoga postures can be modified for use
among people with MS who have disabilities caused by their condition and
that yoga can be done safely and effectively."

The study examined 69 MS patients in three groups: one taking weekly
Iyengar yoga classes along with home practice; another taking a weekly
exercise class using a stationary bicycle along with home exercise; and
a third group placed on a waiting list to serve as a control.

Participants were monitored for attention, alertness, mood, anxiety,
fatigue and overall quality of life.

The yoga classes were offered once a week for 90 minutes. Participants
were taught up to 19 poses, each held for 10 seconds to 30 seconds with
rest periods of 30 seconds to a minute. They also performed breathing
exercises to promote concentration and relaxation, as well as
progressive relaxation, visualization and meditation techniques. And
daily home practice was strongly encouraged.

The MS study's aerobic exercise component was similar to the yoga
intervention, with one class per week plus home exercise. It consisted
of bicycling on recumbent or dual-action stationary bicycles, and each
class began and ended with about five minutes of stretching.

Participants were given exercise bikes to use at home and were
encouraged to use them outside of the weekly class.

While the yoga and aerobic exercise programs produced no significant
changes in alertness, attention or other measures of cognitive function
in MS patients compared with the waiting-list group, the study found
there were improvements in two fatigue measurement tests.

"We think they're equally beneficial for symptoms of fatigue from MS,"
Oken said of yoga and aerobic exercise.

The study cautioned that the reasons behind the reduction in MS fatigue
symptoms are unclear. The socialization aspect of the yoga and exercise
classes, as well as a placebo effect -- simply telling participants that
the exercise program was specifically designed to improve psychological
well-being -- could be credited.

Yoga is a type of so-called mind-body medicine that includes tai-chi,
meditation, and dance, music and art therapy. It is a commonly practiced
method involving behavioral, psychological, social and spiritual
approaches to health, and it is centered around meditation, breathing
and postures.

Of the active or hatha yoga techniques, Iyengar yoga is the most common
type practiced in the United States. Participants assume a series of
stationary positions that employ isometric contraction and relaxation of
different muscle groups to create specific body alignments. There also
is a relaxation component.

"I see it mostly as a kind of physical activity with a stress-reduction
component and body awareness features," Oken said of yoga. "It has this
aspect of bringing your attention to the present moment. But it's hard
to know if that's due to relaxation or getting your mind not to worry
for a little bit."

Whatever the workout method, exercise seems to help MS patients reduce
fatigue symptoms, Bourdette said.

"This is true whether the regular exercise is yoga, swimming, using a
stationary bicycle or any other physical activity," he said. "Sometimes
the effects are quite dramatic and other times less so. But everyone
with MS who exercises regularly reports benefit."

The parallel study on the effects of yoga and exercise on healthy
seniors focused on 136 participants aged 65 to 85. It showed there were
some improvements in physical measures, such as cardiovascular fitness,
and quality-of-life measures, such as energy and fatigue.
There was no improvement in measures of cognitive function, however,
compared with a waiting-list control group.
"I was hoping to show some cognitive benefit, but the main benefit was a
decrease in fatigue and higher energy levels," Oken explained. "I think
those relative benefits are only going to be seen over quite a long
period of time. In healthy people, it's probably going to be a fairly
subtle effect."

Both studies were funded by the National Institutes of Health.

Find more information at http://www.ohsu.edu/orccamind/.

See also community CAM research.