Yoga Study for Multiple Sclerosis
Ananda’s Expanding Light Yoga and Meditation Retreat recently hosted a group of people with early stages of Multiple Sclerosis (MS) to conduct a Yoga Therapy Workshop. The purpose of the workshop was to investigate yoga’s effect on the functional abilities of an MS patient to maintain an active and fulfilling life. I have had a chance to interview Maitri Jones, a registered nurse and a staff member at the Expanding Light, who designed and conducted the study with help from many other members of Ananda around the country. Below are some excerpts from this interview:
Koral: How did the idea of this workshop come up?
Maitri: A lot of research is being done about yoga practices and meditation, using MRIs showing how these ancient teachings result in beneficial changes for the brain. Multiple Sclerosis is a disease that affects the brain and nervous system. The idea for this MS research was first started in Rome, Italy with our Ananda Yoga teachers from Assisi. They found a lot of benefits for MS patients from doing Ananda Yoga. Yogananda talked a lot about the nervous system and many of the techniques that he brought us have a positive effect on our nervous system with ultimate goal to prepare us for cosmic consciousness. That link between the nervous system and general health and well being that those of us who practice these techniques daily experience in our own lives; how we become calmer, not so reactive, less prone to depression through yoga and meditation practices are also the aspects that would help people with neurological disorders. In the Rome study, they looked at depression and fatigue primarily, and saw great improvement in those areas when people practiced Ananda Yoga.
Koral: What is the difference between the Rome study and the one conducted here at the Expanding Light?
Maitri: Their study was funded by a manufacturer of Interferon. Drugs like Interferon are helpful with MS patients, but not without side effects, such as depression and fatigue, which are already a problem with those patients. They were looking at ways of how to encourage patients to stay on the medication without being bothered by these side effects. The Rome study showed that by doing these yoga practices, specifically Ananda Yoga, people had a lot of improvement in these symptoms of fatigue and depression, so they were more likely to continue to stay on their medication, which was helping them in many other ways. Teachers in that study also found that people had improvements in their physical ability to walk and control bodily functions. But that study wasn’t focusing on those aspects. So, our study was building on theirs. We measured the psychological aspects as well as people’s physical functions, walking, balance, sit to stand test, which is a very good measure of whether someone is going to have enough muscle strength and coordination to avoid falls a common problem with MS.
Koral: How many participants did this study have?
Maitri: We had 28, which was wonderful.
Koral: How far did people come from?
Maitri: The majority came from Northern California, but we had people from as far as the East Coast. A lot of people found the “retreat” setting very appealing and mentioned in their evaluations that it exceeded their expectations.
Koral: How was the study conducted? What was involved in the study?
Maitri: The Rome study was conducted with weekly yoga classes. For us being out in the country, it wasn’t practical to expect people to come once a week for such a long distance. So, we decided to do a 5-day long program with overnight stay at the Expanding Light, where we can teach people how to practice energization, yoga and meditation and then they can go home and continue their practice on their own. The first day we spent doing some evaluation and tests regarding their physical abilities, and followed up with Beck depression scale and also fatigue severity scale. We had an MS quality of life scale, which is a combination of well-known and accepted measurements for the ability to day-to-day functioning, and then some specific things for MS, such as bladder control, bowel control, vision, etc. They filled out a number of questionnaires that way and then we did some actual physical testing. We had a physical therapist who helped us take meaningful measurements of the participants functional abilities. After our testing we started them on learning an Ananda Yoga routine broken down into its components, with specific adjustments so that they can do them in a safe way for their condition.
Koral: Were a lot of them new to yoga?
Maitri: A number of them were new, it’s hard to get a population of people who have never done yoga. A few people had a regular practice, but Energization Exercises were new for them, which is a key part of our study. Most had not been meditating. As part of the routine we taught them Energization Exercises, yoga postures, deep relaxation and a meditation technique. One of the other things that went on that we didn’t even think about beforehand was their retreat experience. When you are taking a weekly yoga class you don’t really have time to get to know others in your class. These people had five days with each other and they made some really good connections with each other. A lot of them talk about how isolated they feel with their disease. Here they were able to openly and freely talk about what was going on with themselves. A lot of them said that alone was a great benefit of the whole program.
Koral: Are they still keeping in touch?
Maitri: They all have each other’s emails. Each person also had a phone or email buddy, who they promised to keep in touch with. Of course, the staff is also available for follow-up. That’s one of the hardest things, when they go home, how would they integrate it into their lives. So, we hope that they will be able to support each other in these ways.
Koral: Have you heard from them whether they are able to continue their practices?
Maitri: The people have emailed me so far seem to be working the practice into their lives. I have heard from a number of people who are using it and enjoying it. If it’s something you enjoy, you are more likely to do it. We asked people to do it three times a week, one participant called me and asked if she could do it more than that. Of course they are encouraged to do that.
Koral: What is next after this initial step?
Maitri: We have a 16 week study period, where they will continue and record their practices. We’ll bring them back for a follow-up in May, which I am sure will be a great re-union for them. Many of them told me how much they were already looking forward to that. We’ll give them the same evaluation tests and compare the results.
Koral: What is the expected outcome?
Maitri: We are expecting that people will have some improvements in their physical ability. In the energization exercises and yoga postures, you have to develop some neuromuscular coordination to be able to do those things. Isolating your left lower back is a challenge even people without MS. Part of this study we also gave them some classes on why we expect this to work. One was with Dr. Peter VanHouten on the research on brain, how changeable the brain and the nervous system is. Whatever part of the brain you start training and using more, that part of the brain grows more neurons, create more interconnections and you get a lot more efficient in whatever you are practicing. We expect that when people are practicing using their various muscles and isolating muscles, doing things that require balance and coordination, their brains and nervous system are going to support that practice even if there is damage in those areas. Many people with MS have poor balance. They told me that Tree Pose was the hardest for them, but even after 5 days they noticed they were able to do it much better, which is very encouraging. We also have them do deep relaxation, diaphragmatic breathing, visualization, which helps them engage the parasympathetic nervous system, which we expect that to be beneficial with depression and anxiety.
Koral: Once all the results are collected, what are you going to do with them?
Maitri: We are very lucky to have Brian Coleman-Salgado, who is connected with CSU Sacramento, as our principal investigator. He made sure that our study design was approved by their Protection of Human Subjects Committee, so he prepared us in such a way that if we’d like to publish the results they would be compliant with the Federal Standards.
Koral: Where would they be published?
Maitri: Probably rehab-type journals or medical journals as well as yoga based publications such as with the International Journal of Yoga Therapy. It is more and more accepted by the medical community that yoga is an evidence based therapy. Doctors and insurance companies are more likely to recommend yoga practices when there is evidence that it helps people become healthier.
Koral: What is special about Ananda Yoga? Why would it help more than other practices of yoga?
Maitri: I think this research will add to the body of knowledge of yoga in general because we use classical yoga poses and meditation and relaxation techniques that are similar to what other yoga traditions use. The unique thing about what we are doing here is the Energization Exercises and affirmations. The affirmations bring in the element of connecting the mind and body while you are holding the pose so that it is not only a physical exercise, but that you are using it to find an inner strength and inner connection, which particularly helps with anxiety and overall sense of well-being, especially when you are dealing with not just the physical effects of the disease but all the psychological effects.
Koral: Are you planning on doing any other types of studies, either more of MS or other neurological diseases?
Maitri: We had a lot of positive response for this study and we are not even done with it. This will be a jumping off point for further studies. We will continue to refine this particular study over time, especially when we find that a specific portion of the study was particularly helpful. So, we will continue to improve it over time. If this turns out to be helpful for MS – which we believe so – it certainly has implications on other neurological diseases and conditions that are worth investigating. Also, when we show how much someone with a neurological disease is benefited by this, it also implies that others who are disease-free can improve not only their physical, but also their mental, psychological and spiritual well-being. This study certainly has potential for that. Americans like to first see the proof of something being beneficial before they jump on it.
Koral: If people would like to participate in future studies or interested about the results, who should they contact?
Maitri: They can contact me at the Expanding Light. The next study is being planned for January 2009. We might also plan for some retreat programs – not necessarily studies – that are targeted for MS patients. Not everyone with MS can meet the guidelines of a study and the commitment level that is required, but many MS patients can still benefit from applying these techniques.
Koral: I wish you best of luck in successfully concluding and publishing this study. You are doing a great service to humanity. Thank you very much for taking the time to meet with me.
Maitri: Thank you for the opportunity.
Further information about this study is available at http://www.expandinglight.org/yoga/misc/multiple-sclerosis.htm