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Remote Yoga Program Feasible and Benefits Individuals with Functional Neurological Disorder

Danielle Kipnis, MA, of Columbia University, discussed key components of a yoga program for individuals with functional neurological disorder and from the evaluation, found it feasibility as an intervention.

Based on a recent study presented at the 2022 International Parkinson and Movement Disorders Society Congress, held September 15-18, in Madrid, Spain, by Danielle Kipnis, MA, and colleagues, an individualized remote yoga program was feasible and benefited individuals with functional neurological disorders (FND).1

The practice of yoga decreased FND symptom severity in the individual and increased function for perceived health, quality of life (QoL), and self-efficacy. During the conference presentation, Kipnis said the practice of yoga “may help persons with FND better recognize symptom triggers and manage them within daily routines.”

Along with preliminary research, yoga’s effects on the mind and body in people with neurological conditions suggest a multisystem approach would be a beneficial option treatment for FND.2 Furthermore, no previous studies have been conducted for the evaluation of the effects of yoga on FND. Yoga may be used as a mode of exercise and act as a stimulation to sustain potential changes in neural plasticity.3

The virtual yoga sessions held within the study established breathing and movement exercises that the participants incorporated into their daily routine and used the techniques to address specific symptoms of FND. An individual with muscle spasms, pain, and double vision as their primary symptoms improved on all assessments and domains all while another with dystonia, brain fog, and chronic fatigue, among other symptoms, improved on PMDRS, but did not see change on self-report assessments. In addition, there were no adverse events that occurred. Kipnis et al wrote that the participants, "indicated sessions helped manage pain, symptom attacks, and increase physical activity.” As the program was held in a remote setting, this feature allowed sessions to be accessible, provided the participants a space in the comfort their own home and eliminated any commuting difficulties if it was in-person instead.

The study had 4 female participants, (P1: age, 54 years; primary symptoms – muscle spasms, pain, double vision; P2: age, 42 years; primary symptoms – partial paralysis, tremors, pain, migraines; P3: age, 40 years; primary symptoms – dystonia, brain fog, chronic fatigue, sensory sensitivity, gait and speech issues, seasonal muscle pain; P4: age, 28 years; primary symptoms – nonepileptic seizures and tremor withdrawn).1 Two participants withdrew due to noncompliance with sessions possibly being related to FND symptoms, causing them to feel they were unable to participate. The participants engaged in 45-minute one-on-one remote yoga sessions conducted via Zoom which were held 2 times weekly for 8 weeks that started in July 2021. The primary symptoms of the participants were muscle spasms, general pain, and double vision.

The yoga sessions were individualized and followed a structure that included breath control, somatic awareness, seated and standing movements, balance, and relaxation. Early sessions were held to train for longer, deeper breaths through counting and matching rhythmic movement. As for postures positions, they progressed from seated, to standing using a chair, to no support at all. Similarly, balance progressed from using support to no support. The overall sessions addressed how the participant felt each day and focused on relaxation. Kipnis et al wrote “evaluations were at baseline, midway, and post-intervention on function/FND symptom severity, perceived health, QoL, and self-efficacy.”1

Although the results from the study show promise as an effective treatment for the future of persons with FND, the condition of varies among different types of individuals greatly. Kipnis et al noted that further research is needed on understanding how different individuals with FND will respond to a yoga program. More, larger scale studies are needed to understand the effectiveness of yoga for persons with FND including non-traditional research methods and investigating neurobiology via imaging.

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REFERENCES
1. Kipnis D, Kwei K, Shah H, Quinn L.Yoga for Functional Neurological Disorder (FND) – A Case Study. Presented at: MDS Annual Meeting; September 15-18, 2022; Madrid, Spain. Abstract.
2. Jin X, Wang L, Liu S, ZhuL, Loprinzi PD, Fan X. The Impact of Mind-Body Exercises on Motor Function, Depressive Symptoms, and Quality of Life in Parkinson’s Disease: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health.2019;17(1):31. doi: 10.3390/ijerph17010031
3. Park JE, Hong JY, Lee SY. Transcranial Direct Current Stimulation and Yoga for Functional Movement Disorders. Neurologist. 2021;26(6):231-236. Published 2021 Nov 4. doi:10.1097/NRL.0000000000000345