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The longitudinal effects of seated isometric yoga on blood biomarkers, autonomic functions, & psychological parameters of [PwCFS], 2019, Oka et al

Discussion in 'PsychoSocial ME/CFS Research' started by Andy, Nov 13, 2019.

  1. Andy

    Andy Committee Member (& Outreach when energy allows)

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    Full 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
    Open access, https://bpsmedicine.biomedcentral.com/articles/10.1186/s13030-019-0168-x
     
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  2. Hutan

    Hutan Moderator Staff Member

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    Well, knock me over with a feather (yep, that's sarcasm).

    Benefits in 2 out of 3 questionnaire measures.
    Benefits in 0 out of 11 objective measures.
     
  3. chrisb

    chrisb Senior Member (Voting Rights)

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    I wonder whether health economists have ever calculated the "opportunity" cost of all this. Societies subsidise the costs of training people to produce "research" of little worth, and complain about shortages of doctors.
     
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  4. Trish

    Trish Moderator Staff Member

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    I think this result has value. It shows up the completely vacuous uselessness of these questionaires so much used by the BPS brigade. Even, dare I suggest, useful evidence for the NICE review to make clear that all questionnaires show is patients willingness to try to please the therapist by showing they have really tried hard to improve. A mutual exercise in self delusion.
     
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  5. Wonko

    Wonko Senior Member (Voting Rights)

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    I think it shows that some people like yoga.

    I used to like lifting the odd heavy thing, and if asked immediately after I would have answered that I felt better, relative to before.

    This does not mean that lifting heavy things made me better, in fact it may well have made me much worse, but it did temporarily make me feel better, moodwise.

    There us a definite possibility that, as well as any endorphin thing, that it was simply a result of both having done what I set out to (a rare thing), and 'relief' that it was over, for now.
     
  6. Peter Trewhitt

    Peter Trewhitt Senior Member (Voting Rights)

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    Is this research of value in that it has found something that did not seem to make the participants worse on objective measures?

    Could such help towards defining what we can do without worsening our symptoms? In some ways, given how little we understand the underlying mechanisms of ME and given that PEM is its core symptom, shouldn’t current research into psychological factors and behavioural modification such as activity programmes be aimed at helping define what people can do without worsening their symptoms rather than the unsuccessful [even harmful] rehabilitation attempts seen so far, such as graded exercise therapy?

    It is an ongoing issue on patient forums as to what exercise people can do with ME, and whether yoga is ‘good’ for people with ME. Exercise is increasingly becoming central to our culture for many people and for them having guidelines as to how they can safely exercise without worsening their symptoms might have positive implications for their sense of well being. Obviously any such guidelines would require fall back positions for people when their condition is worsening and different approaches with different levels of severity. Here we have seated yoga, there could also be recumbent yoga. Also I seem to recall from many years ago reading that imagining movements stimulates electrical activity in the muscles where the movement is imagined, suggesting the possibility of yoga without any actual movement.

    I am not suggesting this is developed for rehabilitation, but as a possible approach to countering deconditioning and as recreation for those that see exercise as central to their self identity and well being.
     
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  7. Trish

    Trish Moderator Staff Member

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    I'm not sure about that. I think to find out if there was real worsening or improvement they would need to use biological measures that are already known to be markers of objective worsening or improvement. I have no idea what the measures they used are supposed to show.

    There is not strength or stamina test, included, and no activity measure. It may be that they just feel a bit happier because they have been given something to do they can manage. Perhaps they found they had to cut back other activity in order to manage the exercises.

    Too many unknowns.
     
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  8. Peter Trewhitt

    Peter Trewhitt Senior Member (Voting Rights)

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    Point taken, I was not intending to say that this research has demonstrated that seated yoga is not harmful for people with ME, rather wanting to suggest that we need research that helps work out what people can do without worsening the symptoms.
     
  9. John Mac

    John Mac Senior Member (Voting Rights)

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    I was brought up as a catholic and one of the obligations as a child was to periodically go to confession and I remember one of my teachers telling the class that when you walk out after having confessed you will immediately feel better as this was god taking the weight of your sins off you, and I though wow that's how I did feel after confession, and then one day I realised I had exactly the same feeling after walking out of the dentist.
    I then realised that what I was feeling was just relief after having gotten a chore out of the way.
     
    Last edited: Nov 13, 2019
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  10. rvallee

    rvallee Senior Member (Voting Rights)

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    So as usual, poor psychometric questionnaires are a largely useless tool for evaluation. Chapter 328946.

    30 years. Still depending on useless questionnaires while avoiding objective outcomes like the plague. It's not like nuclear fusion or other hard problems that are seeing constant progress, just slow and expensive. Zero progress. Millions wasted, in lives and in funding. Pathetic.
     
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  11. mango

    mango Senior Member (Voting Rights)

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    :mad:
     
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  12. Hutan

    Hutan Moderator Staff Member

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    I think the result doesn't tell us anything much on its own (i.e. that the questionnaires have incorrectly identified improvement, or that no change in the objective measures suggests no harm was done). This is for the reason that Trish noted above; we don't know how useful the chosen objective markers are in measuring improvement or declining health.

    Really, every study with interventions aiming to improve ME/CFS should involve the use of personal activity monitors.

    I haven't looked at the study properly - here are just some things that jumped out:

    We've discussed these yoga experiments before. The fact that someone with ME turns up for the first time to a yoga class with elevated cortisol and an increased heart rate is not surprising - the whole job of getting to the clinic is a major effort. That these markers normalise after a class of what sounded like particularly gentle relaxing seated yoga is not surprising.

    I don't think we picked up this point from the last study though - if you are a patient waiting to have blood drawn, especially when the patient before you is having a hard time with it, that might well have an effect on cortisol and heart rate.

    Screen Shot 2019-11-14 at 7.46.08 AM.png

    I thought this table was interesting - reference value range; and the plasma biomarkers before and after the intervention. Have a look at the TGF-B1, BDNF and a-MSH values against the reference ranges. Mean BDNF and a-MSH actually departed further from the reference range over the two months of yoga classes (although the change wasn't statistically significant).

    This too was interesting. The people who reported an improvement in fatigue (as measured by the Chalder scale) didn't necessarily report an improvement in depression (as measured by the HADS-D tool).

    This was annoying:
    The CFS mean score of 55 for alexithymia is higher than the average (given here as 48) but lower than the 61 required to conclude that someone has difficulty recognising their emotions. It would be good to look into the TAS-20 test to see if chronic illness can affect it. There are only 20 questions, so you'd only need to skew a few questions to change the mean significantly. Another study reported that people with chronic diseases are more alexithymic (worse at identifying their emotions):

    In the online test for alexithymia I just did, there were questions about how I think about the future. I don't know if those are in the TAS-20 but, if they are, then it suggests that there's a problem with the TAS-20 in cohorts with chronic disease - because of course how you think about the future is different. If we haven't already, we should pull apart the TAS-20 sometime.

    I could go on, I haven't even got started about my ongoing issues with commentaries about cortisol in ME/CFS.
     
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  13. Trish

    Trish Moderator Staff Member

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    Can you give a link? All the ones I found were paywalled.
     
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  14. Hutan

    Hutan Moderator Staff Member

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    Last edited: Nov 13, 2019
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  15. alex3619

    alex3619 Senior Member (Voting Rights)

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    As soon as I see Chalder Fatigue Scale my scepticism meter overloads. They could do MUCH better.
     
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  16. NelliePledge

    NelliePledge Moderator Staff Member

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    as soon as I see Chalder fatigue scale i think catastrophic ;)
     
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  17. Trish

    Trish Moderator Staff Member

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    As soon as I see the CFQ I think lazy researchers. One look at the questions and scoring system should tell them it's meaningless.
     
  18. Amw66

    Amw66 Senior Member (Voting Rights)

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    If anyone can find the
    PROMS scale from the adolescent research to compare with CFQ it may be worth doing. It may flag up if there is a difference when involving those with the illness when defining a questionnaire/ scale ( or not)
     
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