Yoga

Yoga a system of physical postures, breathing techniques, and sometimes meditation used to promote physical and emotional well-being, that originated in ancient India. 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.

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

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.

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. Oka et al. state that ME/CFS patients are deconditioned and hypothesize that the exercise involved in yoga may reduce any deconditioning symptoms.

Yoga has also been explored for improving autonomic nervous system symptoms, e.g., orthostatic intolerance, which many ME/CFS patients have.

Risks and criticism
General reports of harms and adverse effects during yoga have been increasing in recent years, and include:
 * Lower back pain and 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 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

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 or very severe ME may be unable to sit for long enough to do seated yoga

Notable studies related to ME/CFS

 * 2005, Prospective observational study of treatments for unexplained chronic fatigue - (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 - (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 - (Full Text)
 * 2018, Changes in fatigue, autonomic functions, and blood biomarkers due to sitting isometric yoga in patients with chronic fatigue syndrome - (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 - (Full text)
 * 2019, Changes in circulating microRNA after recumbent isometric yoga practice by patients with myalgic encephalomyelitis/chronic fatigue syndrome: an explorative pilot study (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 (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 (Full text)

Video



 * 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, "Relief for Chronic Fatigue Through Yoga" by Alice Lesch Kelly in Yoga Journal
 * Mar 28, 2013, "How I yoga for ME/CFS" Blog post in My Journey thru M.E. by Jess Bruce
 * Apr 15, 2015, "Breathe Deep: Dan Moricoli on Yoga and Recovering From Chronic Fatigue Syndrome" by Cort Johnson in Health Rising