THE IMPACT OF YOGA ON FATIGUE, POSTURAL CONTROL AND DEPRESSION IN PEOPLE WITH MULTIPLE SCLEROSIS
Year 2026,
Volume: 28 Issue: 1
,
1
-
6
,
27.04.2026
Hilal Denizoğlu Külli
,
Meltem Kaya
,
Hikmet Uçgun
,
Büşra Kazancı Telli
Abstract
Objective: Multiple sclerosis (MS) is a chronic and progressive neurodegenerative disease that influences patients’ physical, mental, and social functioning. Yoga is one of the most popular forms of mind-body approaches in people with MS (pwMS) to overcome the symptoms of the disease. This study aimed to investigate the effect of the yoga training program on fatigue, postural control, and depression level in pwMS.
Material and Methods: Ten pwMS aged between 22-42 years were included in the study. The structured yoga training program was applied an hour per session, five times a week over 5 weeks. The yoga program consisted of basic yoga poses, breathing and warming exercises. Each session was focused on strengthening, postural control, relaxation, and flexibility. The yoga poses were asked to maintain for 15 seconds to 2 minutes. Patients were evaluated with The Fatigue Severity Scale for fatigue level, with single leg stance test for postural control, and with Beck depression inventory for depression level. Patients were evaluated before and after the therapeutic yoga program.
Results: After 5 weeks of therapeutic yoga program, statistically significant improvements were detected in terms of fatigue, postural control, and depression level in pwMS (p=0.005; p=0.005; and p=0.007, respectively).
Conclusion: This study showed that a supervised therapeutic yoga program might be effective on fatigue, postural control, and depression level in pwMS.
Ethical Statement
Istanbul Atlas University Non-Interventional Clinical Research Ethics Committee approved the study. (Approval Date: 28.04.2022 and Approval Number: E-22686390-050.01.04-17611)
Supporting Institution
The authors received no financial support for the research and authorship of this article.
References
-
Gelfand JM. Multiple sclerosis: diagnosis, differential diagnosis, and clinical presentation. Handb Clin Neurol. 2014;122:269-290.
-
Barin L, Salmen A, Disanto G, et al. The disease burden of multiple sclerosis from the individual and population perspective: Which symptoms matter most? Mult Scler Relat Disord. 2018;25:112-121.
-
Dalgas U, Langeskov-Christensen M, Stenager E, Riemenschneider M, Hvid LG. Exercise as medicine in multiple sclerosis—time for a paradigm shift: Preventive, symptomatic, and disease-modifying aspects and perspectives. Curr Neurol Neurosci Rep. 2019;19(11):88.
-
Motl RW, Pekmezi D, Wingo BC. Promotion of physical activity and exercise in multiple sclerosis: Importance of behavioral science and theory. Mult Scler J Exp Transl Clin. 2018;4(3):2055217318786745.
-
Skovgaard L, Nicolajsen PH, Pedersen E, et al. Use of complementary and alternative medicine among people with multiple sclerosis in the Nordic countries. Autoimmune Dis. 2012;2012:841085.
-
Mooventhan A, Nivethitha L. Evidence-based effects of yoga in neurological disorders. J Clin Neurosci. 2017;43:61-67.
-
McGill N. Yoga: A complementary health approach. Nations Health. 2015;45(8):28.
-
Coulter D. Anatomy of Hatha Yoga: A Manual for Students, Teachers, and Practitioners. Motilal Banarsidass Publ.; 2004.
-
Rogers KA, MacDonald M. Therapeutic yoga: Symptom management for multiple sclerosis. J Altern Complement Med. 2015;21(11):655-659.
-
de Oliveira G, Tavares MC, de Faria Oliveira JD, Rodrigues MR, Santaella DF. Yoga training has positive effects on postural balance and its influence on activities of daily living in people with multiple sclerosis: A pilot study. Explore (NY). 2016;12(5):325-332.
-
Grossman P, Kappos L, Gensicke H, et al. MS quality of life, depression, and fatigue improve after mindfulness training: A randomized trial. Neurology. 2010;75(13):1141-1149.
-
Polman CH, Reingold SC, Banwell B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69(2):292-302.
-
Krupp LB, Alvarez LA, LaRocca NG, Scheinberg LC. Fatigue in multiple sclerosis. Arch Neurol. 1988;45(4):435-437.
-
Lerdal A, Celius EG, Krupp L, Dahl AA. A prospective study of patterns of fatigue in multiple sclerosis. Eur J Neurol. 2007;14(12):1338-1343.
-
Armutlu K, Korkmaz NC, Keser I, et al. The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. Int J Rehabil Res. 2007;30(1):81-85.
-
Springer BA, Marin R, Cyhan T, Roberts H, Gill NW. Normative values for the unipedal stance test with eyes open and closed. J Geriatr Phys Ther. 2007;30(1):8-15.
-
Beck AT, Steer RA, Carbin MG. Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clin Psychol Rev. 1988;8(1):77-100.
-
Goldman Consensus Group. The Goldman consensus statement on depression in multiple sclerosis. Mult Scler. 2005;11(3):328-337.
-
Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: Psychometric properties. J Cogn Psychother. 1998;12(2):163-172.
-
Wood B, van der Mei IA, Ponsonby AL, et al. Prevalence and concurrence of anxiety, depression and fatigue over time in multiple sclerosis. Mult Scler. 2013;19(2):217-224.
-
Heine M, van de Port I, Rietberg MB, van Wegen EEH, Kwakkel G. Exercise therapy for fatigue in multiple sclerosis. Cochrane Database Syst Rev. 2015;(9):CD009956.
-
Harrison AM, Safari R, Mercer T, et al. Which exercise and behavioural interventions show most promise for treating fatigue in multiple sclerosis? A network meta-analysis. Mult Scler. 2021;27(11):1657-1678.
-
Rodgers S, Manjaly ZM, Calabrese P, et al. The effect of depression on health-related quality of life is mediated by fatigue in persons with multiple sclerosis. Brain Sci. 2021;11(6):751.
-
Palukuru S, Patil SS, Nagarathna R, Singh A, Nibedita KS. Content validity of an integrated yoga module for practice during remission in relapsing-remitting multiple sclerosis patients. Ann Neurosci. 2021;28(1-2):29-38.
-
Razazian N, Kazeminia M, Moayedi H, et al. The impact of physical exercise on the fatigue symptoms in patients with multiple sclerosis: A systematic review and meta-analysis. BMC Neurol. 2020;20(1):93.
-
Nilsagård Y, Gunn H, Freeman J, et al. Falls in people with MS—An individual data meta-analysis. Mult Scler. 2015;21(1):92-100.
-
Abasiyanik Z, Kahraman T, Ertekin O, Baba C, Ozakbas S. Prevalence and determinants of falls in persons with multiple sclerosis without a clinical disability. Mult Scler Relat Disord. 2021;49:102771.
-
Quinn G, Comber L, McGuigan C, Hannigan A, Galvin R, Coote S. Risk factors for falling in people with multiple sclerosis. Clin Rehabil. 2021;35(5):765-774.
-
Van Liew C, Huisinga JM, Peterson DS. Evaluating reactive balance in persons with multiple sclerosis. Gait Posture. 2022;92:30-35.
-
Guner S, Inanici F. Yoga therapy and ambulatory multiple sclerosis. J Bodyw Mov Ther. 2015;19(1):72-81.
-
Citaker S, Gunduz AG, Guclu MB, et al. Relationship between foot sensation and standing balance in patients with multiple sclerosis. Gait Posture. 2011;34(2):275-278.
-
Van Emmerik REA, Remelius JG, Johnson MB, Chung LH, Kent-Braun JA. Postural control in women with multiple sclerosis. Gait Posture. 2010;32(4):608-614.
-
Pan Y, Huang Y, Zhang H, Tang Y, Wang C. Effects of Baduanjin and yoga in multiple sclerosis. Complement Ther Med. 2022;70:102862.
-
Abasiyanik Z, Yigit P, Ozdogar AT, et al. Effects of yoga and Pilates training in multiple sclerosis. Explore (NY). 2021;17(5):424-429.
-
Velikonja O, Curic K, Ozura A, Jazbec SS. Influence of sports climbing and yoga in multiple sclerosis. Clin Neurol Neurosurg. 2010;112(7):597-601.
-
Jones CD, Motl R, Sandroff BM. Depression in multiple sclerosis. Mult Scler Relat Disord. 2021;51:102904.
-
Oken BS, Kishiyama S, Zajdel D, et al. Randomized controlled trial of yoga and exercise in multiple sclerosis. Neurology. 2004;62(11):2058-2064.
-
Brunner D, Abramovitch A, Etherton J. A yoga program for cognitive enhancement. PLoS One. 2017;12(8):e0182366.
-
Cramer H, Lauche R, Azizi H, Dobos G, Langhorst J. Yoga for multiple sclerosis: A systematic review and meta-analysis. PLoS One. 2014;9(11):e112414.
-
Kroencke DC, Lynch SG, Denney DR. Fatigue in multiple sclerosis. Mult Scler. 2000;6(2):131-136.
Yoganın Multipl Sklerozlu İnsanlarda Yorgunluk, Postüral Kontrol ve Depresyon Üzerine Etkisi
Year 2026,
Volume: 28 Issue: 1
,
1
-
6
,
27.04.2026
Hilal Denizoğlu Külli
,
Meltem Kaya
,
Hikmet Uçgun
,
Büşra Kazancı Telli
Abstract
Objective: Multipl skleroz (MS), hastaların fiziksel, zihinsel ve sosyal işlevlerini etkileyen kronik ve ilerleyici nörodejeneratif bir hastalıktır. Yoga, MS’li bireylerde hastalığın semptomları ile başa çıkmak için uygulanan en popüler zihin-beden yaklaşımlarından biridir. Bu çalışmanın amacı; MS’li bireylerde yoga eğitim programının yorgunluk, postüral kontrol ve depresyon düzeyine etkisini araştırmaktı.
Gereç ve Yöntemler: Çalışmaya yaşları 22-42 yıl aralığında olan 10 MS’li birey dâhil edildi. Yapılandırılmış yoga eğitim program, 5 hafta boyunca haftada beş kez, her seans bir saat olacak şekilde uygulandı. Yoga programı temel yoga pozlarını, solunum ve ısınma egzersizlerini içermekteydi. Her seansta kuvvetlendirme, postüral kontrol, gevşeme ve esnekliğe odaklanıldı. Yoga pozlarının 15 saniye ile 2 dakika arasında sürdürülmesi istendi. Hastaların yorgunluk şiddetini değerlendirmek için yorgunluk şiddet ölçeği, postüral kontrolünü değerlendirmek için tek ayak üzerinde durma testi, depresyon düzeylerini değerlendirmek için Beck depresyon envanteri kullanıldı. Hastalar hem terapötik yoga programı öncesinde hem de sonrasında değerlendirildi.
Bulgular: Beş hafta süren terapötik yoga programından sonra MS hastalarının yorgunluk, postüral kontrol ve depresyon düzeyinde istatistiksel olarak anlamlı gelişmeler tespit edildi (sırasıyla p=0,005; p=0,005 ve p=0,007).
Sonuç: Bu çalışma, MS’li bireylerde denetimli uygulanan terapötik yoga programının yorgunluk, postüral kontrol ve depresyon düzeyi üzerinde etkili olabileceğini göstermiştir.
References
-
Gelfand JM. Multiple sclerosis: diagnosis, differential diagnosis, and clinical presentation. Handb Clin Neurol. 2014;122:269-290.
-
Barin L, Salmen A, Disanto G, et al. The disease burden of multiple sclerosis from the individual and population perspective: Which symptoms matter most? Mult Scler Relat Disord. 2018;25:112-121.
-
Dalgas U, Langeskov-Christensen M, Stenager E, Riemenschneider M, Hvid LG. Exercise as medicine in multiple sclerosis—time for a paradigm shift: Preventive, symptomatic, and disease-modifying aspects and perspectives. Curr Neurol Neurosci Rep. 2019;19(11):88.
-
Motl RW, Pekmezi D, Wingo BC. Promotion of physical activity and exercise in multiple sclerosis: Importance of behavioral science and theory. Mult Scler J Exp Transl Clin. 2018;4(3):2055217318786745.
-
Skovgaard L, Nicolajsen PH, Pedersen E, et al. Use of complementary and alternative medicine among people with multiple sclerosis in the Nordic countries. Autoimmune Dis. 2012;2012:841085.
-
Mooventhan A, Nivethitha L. Evidence-based effects of yoga in neurological disorders. J Clin Neurosci. 2017;43:61-67.
-
McGill N. Yoga: A complementary health approach. Nations Health. 2015;45(8):28.
-
Coulter D. Anatomy of Hatha Yoga: A Manual for Students, Teachers, and Practitioners. Motilal Banarsidass Publ.; 2004.
-
Rogers KA, MacDonald M. Therapeutic yoga: Symptom management for multiple sclerosis. J Altern Complement Med. 2015;21(11):655-659.
-
de Oliveira G, Tavares MC, de Faria Oliveira JD, Rodrigues MR, Santaella DF. Yoga training has positive effects on postural balance and its influence on activities of daily living in people with multiple sclerosis: A pilot study. Explore (NY). 2016;12(5):325-332.
-
Grossman P, Kappos L, Gensicke H, et al. MS quality of life, depression, and fatigue improve after mindfulness training: A randomized trial. Neurology. 2010;75(13):1141-1149.
-
Polman CH, Reingold SC, Banwell B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69(2):292-302.
-
Krupp LB, Alvarez LA, LaRocca NG, Scheinberg LC. Fatigue in multiple sclerosis. Arch Neurol. 1988;45(4):435-437.
-
Lerdal A, Celius EG, Krupp L, Dahl AA. A prospective study of patterns of fatigue in multiple sclerosis. Eur J Neurol. 2007;14(12):1338-1343.
-
Armutlu K, Korkmaz NC, Keser I, et al. The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. Int J Rehabil Res. 2007;30(1):81-85.
-
Springer BA, Marin R, Cyhan T, Roberts H, Gill NW. Normative values for the unipedal stance test with eyes open and closed. J Geriatr Phys Ther. 2007;30(1):8-15.
-
Beck AT, Steer RA, Carbin MG. Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clin Psychol Rev. 1988;8(1):77-100.
-
Goldman Consensus Group. The Goldman consensus statement on depression in multiple sclerosis. Mult Scler. 2005;11(3):328-337.
-
Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: Psychometric properties. J Cogn Psychother. 1998;12(2):163-172.
-
Wood B, van der Mei IA, Ponsonby AL, et al. Prevalence and concurrence of anxiety, depression and fatigue over time in multiple sclerosis. Mult Scler. 2013;19(2):217-224.
-
Heine M, van de Port I, Rietberg MB, van Wegen EEH, Kwakkel G. Exercise therapy for fatigue in multiple sclerosis. Cochrane Database Syst Rev. 2015;(9):CD009956.
-
Harrison AM, Safari R, Mercer T, et al. Which exercise and behavioural interventions show most promise for treating fatigue in multiple sclerosis? A network meta-analysis. Mult Scler. 2021;27(11):1657-1678.
-
Rodgers S, Manjaly ZM, Calabrese P, et al. The effect of depression on health-related quality of life is mediated by fatigue in persons with multiple sclerosis. Brain Sci. 2021;11(6):751.
-
Palukuru S, Patil SS, Nagarathna R, Singh A, Nibedita KS. Content validity of an integrated yoga module for practice during remission in relapsing-remitting multiple sclerosis patients. Ann Neurosci. 2021;28(1-2):29-38.
-
Razazian N, Kazeminia M, Moayedi H, et al. The impact of physical exercise on the fatigue symptoms in patients with multiple sclerosis: A systematic review and meta-analysis. BMC Neurol. 2020;20(1):93.
-
Nilsagård Y, Gunn H, Freeman J, et al. Falls in people with MS—An individual data meta-analysis. Mult Scler. 2015;21(1):92-100.
-
Abasiyanik Z, Kahraman T, Ertekin O, Baba C, Ozakbas S. Prevalence and determinants of falls in persons with multiple sclerosis without a clinical disability. Mult Scler Relat Disord. 2021;49:102771.
-
Quinn G, Comber L, McGuigan C, Hannigan A, Galvin R, Coote S. Risk factors for falling in people with multiple sclerosis. Clin Rehabil. 2021;35(5):765-774.
-
Van Liew C, Huisinga JM, Peterson DS. Evaluating reactive balance in persons with multiple sclerosis. Gait Posture. 2022;92:30-35.
-
Guner S, Inanici F. Yoga therapy and ambulatory multiple sclerosis. J Bodyw Mov Ther. 2015;19(1):72-81.
-
Citaker S, Gunduz AG, Guclu MB, et al. Relationship between foot sensation and standing balance in patients with multiple sclerosis. Gait Posture. 2011;34(2):275-278.
-
Van Emmerik REA, Remelius JG, Johnson MB, Chung LH, Kent-Braun JA. Postural control in women with multiple sclerosis. Gait Posture. 2010;32(4):608-614.
-
Pan Y, Huang Y, Zhang H, Tang Y, Wang C. Effects of Baduanjin and yoga in multiple sclerosis. Complement Ther Med. 2022;70:102862.
-
Abasiyanik Z, Yigit P, Ozdogar AT, et al. Effects of yoga and Pilates training in multiple sclerosis. Explore (NY). 2021;17(5):424-429.
-
Velikonja O, Curic K, Ozura A, Jazbec SS. Influence of sports climbing and yoga in multiple sclerosis. Clin Neurol Neurosurg. 2010;112(7):597-601.
-
Jones CD, Motl R, Sandroff BM. Depression in multiple sclerosis. Mult Scler Relat Disord. 2021;51:102904.
-
Oken BS, Kishiyama S, Zajdel D, et al. Randomized controlled trial of yoga and exercise in multiple sclerosis. Neurology. 2004;62(11):2058-2064.
-
Brunner D, Abramovitch A, Etherton J. A yoga program for cognitive enhancement. PLoS One. 2017;12(8):e0182366.
-
Cramer H, Lauche R, Azizi H, Dobos G, Langhorst J. Yoga for multiple sclerosis: A systematic review and meta-analysis. PLoS One. 2014;9(11):e112414.
-
Kroencke DC, Lynch SG, Denney DR. Fatigue in multiple sclerosis. Mult Scler. 2000;6(2):131-136.