Changes in fatigue, autonomic functions, and blood biomarkers due to sitting isometric yoga in patients with CFS, 2018, Oka et al

Andy

Andy

Retired committee member
Have put this in the Psychosocial forum as it's printed in BioPsychoSocial Medicine, which states it is "The official journal of the Japanese Society of Psychosomatic Medicine"
Abstract
Background
In a previous randomized controlled trial, we found that sitting isometric yoga improves fatigue in patients with chronic fatigue syndrome (CFS) who are resistant to conventional therapy. The aim of this study was to investigate possible mechanisms behind this finding, focusing on the short-term fatigue-relieving effect, by comparing autonomic nervous function and blood biomarkers before and after a session of isometric yoga.

Methods
Fifteen patients with CFS who remained symptomatic despite at least 6 months of conventional therapy practiced sitting isometric yoga (biweekly 20 min practice with a yoga instructor and daily home practice) for eight weeks. Acute effects of sitting isometric yoga on fatigue, autonomic function, and blood biomarkers were investigated after the final session with an instructor. The effect of a single session of sitting isometric yoga on fatigue was assessed by the Profile of Mood Status (POMS) questionnaire immediately before and after the session. Autonomic nervous function (heart rate (HR) variability) and blood biomarkers (cortisol, DHEA-S, TNF-α, IL-6, IFN-γ, IFN-α, prolactin, carnitine, TGF-β1, BDNF, MHPG, and HVA) were compared before and after the session.

Results
Sitting isometric yoga significantly reduced the POMS fatigue score (p < 0.01) and increased the vigor score (p < 0.01). It also reduced HR (p < 0.05) and increased the high frequency power (p < 0.05) of HR variability. Sitting isometric yoga increased serum levels of DHEA-S (p < 0.05), reduced levels of cortisol (p < 0.05) and TNF-α (p < 0.05), and had a tendency to reduce serum levels of prolactin (p < 0.1). Decreases in fatigue scores correlated with changes in plasma levels of TGF-β1 and BDNF. In contrast, increased vigor positively correlated with HVA.

Conclusions
A single session of sitting isometric yoga reduced fatigue and increased vigor in patients with CFS. Yoga also increased vagal nerve function and changed blood biomarkers in a pattern that suggested anti-stress and anti-inflammatory effects. These changes appear to be related to the short-term fatigue-relieving effect of sitting isometric yoga in patients with CFS. Furthermore, dopaminergic nervous system activation might account for sitting isometric yoga-induced increases in energy in this patient population.
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Open access at https://bpsmedicine.biomedcentral.com/articles/10.1186/s13030-018-0123-2
 
I googled "isometric yoga" and found this study from two of the same researchers from 2014.

Isometric yoga improves the fatigue and pain of patients with chronic fatigue syndrome who are resistant to conventional therapy: a randomised, controller trial

This trial enrolled 30 patients with CFS who did not have satisfactory improvement after receiving conventional therapy for at least six months. They were randomly divided into two groups and were treated with either conventional pharmacotherapy (control group, n = 15) or conventional therapy together with isometric yoga practice that consisted of biweekly, 20-minute sessions with a yoga instructor and daily in-home sessions (yoga group, n = 15) for approximately two months.

Conclusions
Isometric yoga as an add-on therapy is both feasible and successful at relieving the fatigue and pain of a subset of therapy-resistant patients with CFS.
 
I don't understand the point of measuring stuff before and after a single session of isometric yoga.

Firstly there is no healthy control group to compare it with, so the changes found may occur in everybody, not just ME/CFS patients.

Secondly, they were looking at transient effects immediately after a session. It's quite possible than just sitting quietly resting for the same length of time could have the same effects.

Why on earth didn't they do all the blood tests at the start of the 8 weeks training too, so they could see whether there was a cumulative effect.

What a wasted effort.
 
I also think the stage you're at in terms of ME makes a difference.

In the early years I felt I got some benefit from yoga when I was in a good phase. Really bad idea in a bad patch, I found.

Now, many more years on, it just completely wipes me out, no matter how careful I am and even if I enjoy it at the time.

Yet, another enjoyable past time no longer available to me.
 
This study needed a control group who are sitting upright (and supported) for the same amount of time, regularly. For people with mod/severe ME, this 'sitting' would give their autonomic / cardiovascular system practice at delivering blood to the brain, against gravity.

Alternatively, they could study supine yoga breathing exercises, which might be more do-able for many pwME.
 
When I read the thread title I thought it must be a surreal Monty Python style spoof.

15 patients? Why doesn't publishing stuff like this ruin people's careers? Are the authors incapable of feeling embarrassment?

Plenty of yoga schools in my area manage to come up with much better adverts.
 
On the day of the final trial yoga session:

I had better have a shower. Where is my good pair of track suit pants? Oh, scrunched up at the bottom of the washing basket where I left them after the last session. What on earth am I going to wear? The ones from the washing basket it is. Now to walk to the train. Am I going to make it on-time? I had better walk faster. Gosh, it's crowded. Am I going to get a seat?

Ok, now to walk to the Institute of Psychosomatic Medicine. I hope no one sees me going in. Up the stairs, need to go fast because I'm late.

So, how do I feel? Well, yep, I'm stressed, tired and dizzy.

[20 to 30 minutes of a nice sit down, breathing and slowly waving arms about, smiling with the nice instructor.]

Thank goodness that's over. I can go home now and have a lie down. In fact, thank goodness that whole trial is over. How do I feel? Well pretty good actually, thanks. Yep, a lot better than before that yoga session.
 
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Andy said:
Have put this in the Psychosocial forum as it's printed in BioPsychoSocial Medicine, which states it is "The official journal of the Japanese Society of Psychosomatic Medicine"
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Ha, I wonder has the Japanese Society of Psychosomatic Medicine extended its purview to biological and social casual factors? Or does it just like the sound of "biopsychosocial"?
 
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Kalliope said:
a subset of therapy-resistant patients with CFS.
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Goodness me, are there "therapy-resistant" patients?

Let's see, results from PACE data based on their own prespecified (subjective) definition of recovery found that less than 1 out of every 10 patients getting CBT or GET recovered after a year, and when you factor out spontaneous rates of recovery, that goes down to less than 1 in 20.

So, er, gosh, there seem to be a heck of a lot of "therapy-resistant" patients!
 
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