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'''Yoga''' a system of physical postures, breathing techniques, and sometimes meditation used to promote physical and emotional well-being,<ref name="dict">{{Cite web|url=https://www.merriam-webster.com/dictionary/yoga | title = Definition of YOGA|website=Merrian-Webster Dictionary|language=en|access-date=2019-12-02}}</ref> that originated in ancient India.<ref>{{Cite web|url=https://www.yogabasics.com/learn/history-of-yoga/ | title = History of Yoga | last = | first = | author-link =| date = |website=Yoga Basics|archive-url=|archive-date=|url-status=|access-date=2019-12-02}}</ref> Many variations of yoga exist, but the styles embraced as a potential treatment for [[myalgic encephalomyelitis]]/[[chronic fatigue syndrome]] patients tend to be more gentle and restorative in practice.<ref name="Oka, 2017" /> ==Types== Many different types of yoga exist. Some types of yoga investigated for ME/CFS include: * '''seated or recumbent yoga''', which is done while sitting in a chair and without standing, to avoid [[orthostatic intolerance]] symptoms * '''recumbent isometric yoga''', which was developed as a treatment for ME/CFS<ref name="Oka, 2014" /> ==Theory== Yoga is both a mind-body therapy and an [[exercise]] therapy. Yoga is normally viewed as an "adf-on" or secondary therapy for [[ME/CFS]], typically aiming to reduce some symptoms like [[pain]] or [[fatigue]], and improve overall quality of life.<ref name="Oka, 2014" /> Oka et al. (2014) state that there is evidence that yoga reduces [[cancer-related fatigue]], and it is hoped that yoga may also reduce fatigue related to ME/CFS, but only if activity is kept to below the level that provokes [[post-exertional malaise]] since this would increase fatigue and other symptoms.<ref name="Oka, 2014" /> Oka et al. state that ME/CFS patients are [[deconditioning|deconditioned]] and hypothesize that the exercise involved in yoga may reduce any deconditioning symptoms.<ref name="Oka, 2014" /> Yoga has also been explored for improving [[autonomic nervous system]] symptoms,<ref name="Oka, 2018" /><ref name="Oka2019" /><ref name="Shinba2020" /> e.g., [[orthostatic intolerance]], which many ME/CFS patients have.<ref name="SEID2015">{{Citation | last =Institute of Medicine | author-link = Institute of Medicine | title = Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness|location=Washington, DC|publisher=The National Academies Press | date = 2015 | url=https://www.ncbi.nlm.nih.gov/books/NBK284902/}}</ref> ==Risks and criticism == General reports of harms and adverse effects during yoga have been increasing in recent years, and include: * [[Lower back pain]] and [[myalgia|muscle pain]] * Aggravating existing pain * Musculoskeletal pain may occur even in healthy individuals * Adverse effects from yoga may be serious rather than mild, including bone fractures, tendon or ligament injuries, muscle strain, myositis ossificans of the forearm, eye disorders, and [[dyspnea|breathing difficulties]] * A group of 2508 patients with various chronic illnesses or taking medication found that close to 30% had experienced adverse effects of yoga taught by qualified instructors * In the same group, 36% of adverse reactions were serious rather than mild * People with long-term musculoskeletal conditions, chronic diseases, in poor physical condition on the survey day, people over 70, and people who found the yoga mentally or physically stressful were at increased risk of adverse events serious enough to prevent future yoga sessions<ref name="Oka2021" /> Risks to ME/CFS patients may also include: * [[Post-exertional malaise]] since yoga is a form of exercise * Yoga instructors often used background music, especially for relaxation, but this may instead provoke [[ME/CFS]] symptoms in patients with [[noise sensitivity]] * Some patients may be housebound or bedbound and be unable to travel to yoga classes on the day * Standing poses typically used in yoga may be unsafe since many patients with ME/CFS have [[orthostatic intolerance]], risks including injury from [[fainting]], [[post-exertional malaise]] and tachycardia * [[Dizziness]] has been reported even during seated isometric yoga * [[Short-term memory problems]] and [[cognitive dysfunction]] may prevent patients from understanding the instructions, and concentrating may cause [[fatigue]] in patients * Patients may accidentally over-stretch, increasing [[pain]] * Patients who need assistance weh everyday activities may be unable to participate, and patients with [[severe and very severe ME#verysevere|severe or very severe ME]] may be unable to sit for long enough to do seated yoga<ref name="Oka, 2014" /> ==Notable studies related to ME/CFS== *2005, Prospective observational study of treatments for unexplained chronic fatigue<ref name="Bentler, 2005">{{Cite journal | last1 = Bentler | first1 = SE | authorlink1 = | last2 = Hartz | first2 = AJ | authorlink2 = Arthur Hartz | last3 = Kuhn | first3 = EM | authorlink3 = | title = Prospective observational study of treatments for unexplained chronic fatigue | journal = J Clin Psychiatry | volume = 66 | issue = 5 | page = 625-32 | date = 2005 | pmid = 15889950 | doi = }}</ref> - [https://www.ncbi.nlm.nih.gov/pubmed/15889950 (Abstract)] *2014, Isometric yoga improves the fatigue and pain of patients with chronic fatigue syndrome who are resistant to conventional therapy: a randomized, controlled trial<ref name="Oka, 2014">{{Cite journal | last1 = Oka | first1 = Takakazu | authorlink1 = | last2 = Tanahashi | first2 = Tokusei| authorlink2 = | last3 = Chijiwa | first3 = Takeharu | authorlink3 = | last4 = Lkhagvasuren | first4 = Battuvshin | authorlink4 = | last5 = Sudo | first5 = Nobuyuki | authorlink5 = | last6 = Oka | first6 = Kae | authorlink6 = | title = Isometric yoga improves the fatigue and pain of patients with chronic fatigue syndrome who are resistant to conventional therapy: a randomized, controlled trial| journal = Biopsychosocial Medicine | volume = 8 | issue = 27 | page = | date = 2014 | pmid = | doi = 10.1186/s13030-014-0027-8}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4269854/ (Full Text)] *2017, Development of a recumbent isometric yoga program for patients with severe chronic fatigue syndrome/myalgic encephalomyelitis: A pilot study to assess feasibility and efficacy<ref name="Oka, 2017">{{Cite journal | last1 = Oka | first1 = Takakazu | authorlink1 = | last2 = Wakita | first2 = H. | authorlink2 = | last3 = Kimura | first3 = K. | authorlink3 = | title = Development of a recumbent isometric yoga program for patients with severe chronic fatigue syndrome/myalgic encephalomyelitis: A pilot study to assess feasibility and efficacy| journal = Biopsychosocial Medicine | volume = 11 | issue = 5 | page = | date = 2017 | pmid = | doi = 10.1186/s13030-017-0090-z}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5335724/ (Full Text)] *2018, Changes in fatigue, autonomic functions, and blood biomarkers due to sitting isometric yoga in patients with chronic fatigue syndrome<ref name="Oka, 2018">{{Cite journal | last1 = Oka | first1 = Takakazu | authorlink1 = | last2 = Tanahashi | first2 = Tokusei| authorlink2 = | last3 = Sudo | first3 = Nobuyuki | authorlink3 = | last4 = Lkhagvasuren | first4 = Battuvshin | authorlink4 = | last5 = Yamada | first5 = Yu | authorlink5 =| title = Changes in fatigue, autonomic functions, and blood biomarkers due to sitting isometric yoga in patients with chronic fatigue syndrome| journal = Biopsychosocial Medicine | volume = 12 | issue = 3 | page = | date = 2018 | pmid = | doi = 10.1186/s13030-018-0123-2}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5891891/ (Full Text)] *2019, The longitudinal effects of seated isometric yoga on blood biomarkers, autonomic functions, and psychological parameters of patients with chronic fatigue syndrome: a pilot study<ref name="Oka2019">{{Cite journal | last =Oka | first = Takakazu|author-link = | last2 = Tanahashi | first2 = Tokusei | author-link2 = | last3 = Lkhagvasuren | first3=Battuvshin | author-link3 = | last4 = Yamada | first4 = Yu | author-link4 = | date = Dec 2019 | title = The longitudinal effects of seated isometric yoga on blood biomarkers, autonomic functions, and psychological parameters of patients with chronic fatigue syndrome: a pilot study|url=https://bpsmedicine.biomedcentral.com/articles/10.1186/s13030-019-0168-x|journal=BioPsychoSocial Medicine|language=en|volume=13|issue=1|pages=28|doi=10.1186/s13030-019-0168-x|issn=1751-0759|pmc = 6836361|pmid=31709006|access-date=|quote=|via=}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836361/ (Full text)] *2019, Changes in circulating microRNA after recumbent isometric yoga practice by patients with myalgic encephalomyelitis/chronic fatigue syndrome: an explorative pilot study<ref name="Takakura2019">{{Cite journal | last =Takakura | first = Shu | last2 = Oka | first2 = Takakazu | last3 = Sudo | first3 = Nobuyuki | date = 2019 | title=Changes in circulating microRNA after recumbent isometric yoga practice by patients with myalgic encephalomyelitis/chronic fatigue syndrome: an explorative pilot study|url=https://pubmed.ncbi.nlm.nih.gov/31827600/|journal=BioPsychoSocial Medicine|volume=13|pages=29|doi=10.1186/s13030-019-0171-2|issn=1751-0759|pmc=6886179|pmid=31827600}}</ref> [https://pubmed.ncbi.nlm.nih.gov/31827600/ (Full text)] *2020, Changes in Heart Rate Variability after Yoga are Dependent on Heart Rate Variability at Baseline and during Yoga: A Study Showing Autonomic Normalization Effect in Yoga-Naïve and Experienced Subjects<ref name="Shinba2020">{{Cite journal | last =Shinba | first = Toshikazu | last2 = Inoue | first2 = Tomoko | last3 = Matsui | first3 = Takemi | last4 = Kimura | first4 = Kazuo Keishin | last5 = Itokawa | first5 = Masanari|last6 = Arai | first6 = Makoto | date = 2020 | title=Changes in Heart Rate Variability after Yoga are Dependent on Heart Rate Variability at Baseline and during Yoga: A Study Showing Autonomic Normalization Effect in Yoga-Naïve and Experienced Subjects|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336948/|journal=International Journal of Yoga|volume=13|issue=2|pages=160–167|doi=10.4103/ijoy.IJOY_39_19|issn=0973-6131|pmc=7336948|pmid=32669772}}</ref> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336948/ (Full text)] *2021, Health-related benefits and adverse events associated with yoga classes among participants that are healthy, in poor health, or with chronic diseases<ref name="Oka2021">{{Cite journal | last =Oka | first = Takakazu | last2 = Lkhagvasuren | first2=Battuvshin | date = 2021-10-07 | title = Health-related benefits and adverse events associated with yoga classes among participants that are healthy, in poor health, or with chronic diseases|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8499562/|journal=BioPsychoSocial Medicine|volume=15|pages=17|doi=10.1186/s13030-021-00216-z|issn=1751-0759|pmc=8499562|pmid=34620198}}</ref> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8499562/ (Full text)] ==Video== {{Video|id=https://www.youtube.com/watch?v=ithZVKBRyok572s|description=Seated isometric yoga program for ME CFS. Takakazu Oka, Oct 6, 2018.<ref name="Oka2019"/>}} <br style="clear:both"> *[https://www.youtube.com/watch?v=dEkEZqdBk08 Recumbent Isometric Yoga] - Bateman Horne Center Feb 28, 2021 ==Blog== *[[Aroga Yoga]] - a yoga and wellness blog by a yogini who has been living with [[ME/CFS]] since the age of 13 yrs. ==Learn more== *Aug 28, 2007, [http://www.yogajournal.com/article/health/rest-for-the-weary/ "Relief for Chronic Fatigue Through Yoga"] by Alice Lesch Kelly in ''Yoga Journal'' *Mar 28, 2013, [https://myjourneythrume.wordpress.com/2013/03/28/how-i-yoga-for-mecfs/ "How I yoga for ME/CFS"] Blog post in ''My Journey thru M.E.'' by Jess Bruce *Apr 15, 2015, [https://www.healthrising.org/blog/2015/04/15/breathe-deep-moricoli-yoga-chronic-fatigue-syndrome/ "Breathe Deep: Dan Moricoli on Yoga and Recovering From Chronic Fatigue Syndrome"] by [[Cort Johnson]] in ''[[Health Rising]]'' ==See also== *[[Aroga Yoga]] *[[Exercise]] *[[Tai chi]] *[[Post-exertional malaise]] ==References== {{Reflist}} [[Category:Potential treatments]] [[Category:Drug-free pain management]] [[Category:Mind body treatments]] [[Category:Depression alternative treatments]] [[Category:Exercise treatments]]
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