Improve Fatigue in Severe Chronic Disease with Yoga

Improve Fatigue in Severe Chronic Disease with Yoga


By John M. de Castro, Ph.D.


“Yoga has stood out as an especially effective treatment for CFS because of its holistic approach to healing; unlike drugs, diets, physical therapy, or psychotherapy alone, yoga is a means to address physical, mental, and spiritual issues, all of which play roles in CFS.” – Lis Wagner


Chronic Fatigue Syndrome (CFS) otherwise known as Myalgic encephalomyelitis (ME) occurs in about 0.2% of the population. It produces a profound, prolonged, and debilitating tiredness. Myalgic encephalomyelitis (ME) when severe can produce a chronic and extreme tiredness, so severe that sufferers can become bed-bound or need to use a wheel-chair. Myalgic encephalomyelitis (ME) also produces muscle pain, brain fog and dizziness, poor memory, disturbed sleep and trouble with digestion. All this may be combined with the kind of malaise that comes with a post-viral infection.


Myalgic encephalomyelitis (ME) is thought to be caused by a combination of stress plus a virus or a toxin, shock, or poisoning. But the exact cause is not known. There is no known cure. Usual treatments for CFS/ME are targeted at symptom relief and include exercise and drugs. Mindfulness has been shown to reduce fatigue due to a number of conditions. Yoga is a mindfulness practice that also includes exercise. So, yoga practice may be an effective treatment for the symptoms of Chronic Fatigue Syndrome (CFS) / Myalgic encephalomyelitis (ME).


In today’s Research News article “Development of a recumbent isometric yoga program for patients with severe chronic fatigue syndrome/myalgic encephalomyelitis: A pilot study to assess feasibility and efficacy.” See summary below or view the full text of the study at:

Oka and colleagues recruited patients (26-61 years old) who were diagnosed with severe Myalgic encephalomyelitis (ME). In a previous study, a program of isometric yoga in a sitting position was successfully shown to reduce fatigue in ME patients. But, in severe conditions sitting yoga proved to be too difficult. So, they developed an isometric yoga program that could be practiced while lying down, recumbent. Isometric yoga involves static postures with contraction of muscles without movement. Yoga was practiced for 3 months every 2 to 4 weeks for 20 minutes when the patients came to the hospital. They were also encouraged to practice at home. Fatigue was measured before and after the last practice and before and after the 3-month practice period.


They found that there was very good compliance with patients practicing at home on average of 6 days per week. There were no adverse events and patients reported high satisfaction with the program. Importantly, on the short-term, before and after the final yoga session there was a significant decrease in fatigue produced by the yoga session, nearly cutting it in half. So, the 20-minute practice appeared to energize the patients. On the long-term between before and after the 3-months of practice there was also a significant decrease in fatigue. Hence the program appeared to be well accepted, was energizing, and significantly improved the primary symptom of Myalgic encephalomyelitis (ME), fatigue.


It should be mentioned that this pilot study did not have a control condition and as such conclusions must be tempered. The results, however, are sufficiently encouraging that a randomized controlled clinical trial is warranted. The trial should contain at least one other form of exercise to determine if the effects are specific to yoga or the results of any light exercise program. It should be noted that these patients could not tolerate even sitting yoga practice. So, it is particularly encouraging the a tolerable variation of isometric yoga practice was so beneficial.


So, improve fatigue in severe chronic disease with yoga.


“teaching yoga to those with ME, or indeed any chronic condition, is about teaching students the value of pacing, of slowing down; of breathing properly and learning to relax, whilst facilitating them to get back in touch with their spiritual centre and to live more in the moment.” – Yoga Abode


CMCS – Center for Mindfulness and Contemplative Studies


This and other Contemplative Studies posts are also available on Google+ and on Twitter @MindfulResearch


Study Summary

Oka, T., Wakita, H., & Kimura, K. (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. Biopsychosocial Medicine, 11, 5.




Our previous randomized controlled trial demonstrated that isometric yoga in a sitting position reduces fatigue in patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). However, some patients experience difficulties sitting or practicing isometric yoga in a sitting position for long periods. To date, therapeutic interventions for patients with severe symptoms have not been established. Therefore, we developed a recumbent isometric yoga program, which takes approximately 20 min to complete, designed to reduce fatigue in patients with severe CFS/ME. The aim of this pilot study was to assess the feasibility, safety, and usefulness of this program.


This pilot study included 12 adult patients with CFS/ME. Six patients were reluctant to practice isometric yoga in a sitting position because of the severity of their fatigue (group 1). The remaining six patients had previously practiced isometric yoga in a sitting position (group 2). For 3 months, the patients of both groups practiced recumbent isometric yoga every 2 to 4 weeks with a yoga instructor and at home on other days if they could. The short-term effects of isometric yoga on fatigue were assessed using the Profile of Mood Status (POMS) questionnaire immediately before and after their final session with the yoga instructor. The long-term effects of isometric yoga on fatigue were assessed using the Chalder Fatigue Scale (FS) questionnaire before and after the intervention period. Adverse events, satisfaction with the program, and preference of yoga position (sitting or recumbent) were also recorded.


All subjects completed the intervention. In both groups, the POMS fatigue score was significantly decreased after practicing the 20-min yoga program and the Chalder FS score was decreased significantly after the 3-month intervention period. There were no serious adverse events. All subjects in group 2 preferred the recumbent isometric yoga program over a sitting yoga program.


This study suggests that recumbent isometric yoga is a feasible and acceptable treatment for patients with CFS/ME, even for patients who experience difficulty practicing isometric yoga in the sitting position.


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