The Effects of Yoga and Meditation on Walking, Balance, and Mood in Ambulatory Multiple Sclerosis Patients

Friday, May 29, 2015
Griffin Hall
Darlene K Stough, RN MSCN CCRP , Neurological Institute-Mellen Center, Cleveland Clinic, Cleveland, OH
Mladen Golubic, M.D., Ph.D. , Center for Lifestyle Medicine, Cleveland Clinic, Cleveland, OH
Judi Bar, E-RYT500 , Center for Lifestyle Medicine, Cleveland Clinic, Cleveland, OH
Jane Pernotto Ehrman, M.Ed., CHES , Center for Lifestyle Medicine, Cleveland Clinic, Cleveland, OH
Daniel Musgrave, BA, RRT, CYT , Harmony Studios, Willoughby, OH
Francois Bethoux, MD , Department of Rehabilitation Services, Cleveland Clinic Mellen Center, Cleveland, OH

Background: Yoga is one of the most frequently used complementary therapies by patients with MS. Both yoga and meditation were associated with positive effects on subjective well-being, but effects on physical function were less consistently demonstrated. We hypothesized that yoga, a form of exercise which involves breathing, relaxation/meditation, and postures, is more likely to influence motor function (particularly walking and balance) than meditation alone. 

Objectives: to compare the effects of yoga and meditation with guided imagery on walking, balance, and psychological well-being in individuals with MS and walking limitations.

Methods: randomized parallel group trial comparing bi-weekly yoga practice (Yoga group) to meditative practice and walking guided imagery (Meditation group). All subjects participated in two 1-hour sessions per week for a total of 8 weeks, and were instructed to perform homework between sessions. Outcomes were measured at baseline (V1), shortly after the intervention (V2), and 4 weeks later (V3). Outcome measures included tests of walking (Timed 25 Foot Walk, 2-Minute Walk, spatiotemporal gait parameters), balance (Functional Reach Test, posturography), and self-report questionnaires of fatigue (Modified Fatigue Impact Scale), depression (Center for Epidemiologic Studies Depression scale, CES-D), stress (Perceived Stress Scale-4, PSS-4) and walking limitations (MS Walking Scale-12).

Results: 19 patients were enrolled and 13 (7 Meditation and 6 Yoga) completed all visits: age 55(6) years, 80% women, BMI 26(7), symptom duration 16(10) years, 30% walked with an assistive device. Subject characteristics were similar between groups at baseline, with the exception of variables reflecting gait disability (Yoga subjects were less disabled). There was a statistically significant between-group difference in change scores between V1 and V2 for PSS-4 (p=0.0033) and CES-D (p=0.031), favoring the Yoga group. No significant between-group difference was observed for the other variables. Both interventions were well tolerated and all participants found their allocated intervention beneficial.

Conclusions: Compared to meditation, yoga practice led to greater improvement of anxiety and depression symptoms in patients with MS and walking limitations, but there was no difference on measures of walking and balance. Further research is needed to better understand the potential benefits of yoga and meditation in MS.