This is Part II of a two-part series examining the effects of non-traditional exercise on secondary condition prevention (for Part I, see the December 2007 column at http://www.ncpad.org/521/2438/Focus~on~Secondary~Condition~Prevention~~Non-Traditional~Exercise~as~a~Way~of~Preventing~Secondary~
Conditions~-~Part~I).

The New Year is a time to invest in 'New Year's Resolutions' that include goals toward an improved quality of life and a commitment to health and fitness. Achieving these goals may be more enjoyable than you had imagined if you explore the opportunity to participate in non-traditional forms of exercise. This month's column examines yoga for people with multiple sclerosis (MS) and the effect it has had in reducing the secondary condition of fatigue.

People with MS often experience fatigue, which can, in some cases, be an extremely limiting secondary condition (Branas et al., 2000) leading to impairments in health-related quality of life (Merkelbach et al., 2002). Fatigue is common in the legs and may appear as constant and persistent tiredness, or can be triggered by physical exertion and improve with rest for people with MS (Shannon, 2007).

Yoga can be beneficial for people with disabilities, including people with MS, through both the physical postures and breath work involved. Poses can be modified or adapted to meet the needs of the individual. The NCHPAD fact sheet titled 'Yoga for Individuals with Disabilities' (found at http://www.ncpad.org/295/1834/Yoga~for~Individuals~with~Disabilities) contains information about chair yoga which was developed for people with arthritis, chronic obstructive pulmonary disease, multiple sclerosis, Parkinson's disease, Osteoporosis, and stroke. Overall health benefits of yoga include improvements in the following:

• Digestion: Bending and stretching poses help move and stimulate the digestive system;
• Cardiovascular and Cardiopulmonary Function: Specific types of yoga can be a good form of aerobic exercise;
• Lymphatic Circulation: The lymphatic system relies on muscle activity and body movement for its circulation, therefore physical activity and stretching aids in lymphatic circulation;
• Muscular Strength and Flexibility: Regular yoga practice can strengthen the muscles and increase overall flexibility.

Oken et al. (2004) found that a 26-week program of Iyengar yoga was effective in reducing fatigue for people with MS. Sessions were 90 minutes each, and modifications were made to the Iyengar yoga class in order to assist participants with spasticity and balance problems in performing the movements. All poses were supported with either a chair or with the individual lying on the floor or leaning against a wall. Nineteen poses were included in the class, and the sequence of poses was scheduled to minimize the need to change positions frequently between standing and sitting. Each pose was held for approximately 10 to 30 seconds with between-pose rest periods lasting 30 seconds to 1 minute. Instructors emphasized breathing for concentration and relaxation during each session, and each class concluded with a 10-minute deep relaxation with the individual lying on his or her back. Progressive relaxation, visualization, and meditation techniques were also part of each session.

As you are making your New Year's resolutions, consider non-traditional forms of exercise such as yoga, or check with your local parks and recreation department to find out what type of accessible exercise programs are available in your area. Use NCPAD's searchable programs database at http://www.ncpad.org/directories/15/Programs to find a program in your area. Happy New Year!

For more resources on yoga, click on the following links:

• NCHPAD Resources:
  • Adapted Yoga for Children and Youth with Cerebral Palsy at http://www.ncpad.org/297/1849 /Adapted~Yoga~for~Children~and~Youth~with~Cerebral~ Palsy
  • SCI Reconnecting the Body and Mind with Yoga at http://www.ncpad.org/485/2369/SCI~-~Reconnecting~the~Body~and~Mind~with~Yoga
• Website:
  • Eric Small's Yoga Today for People with Multiple Sclerosis: http://www.yogams.com/

For information on NIA, another non-traditional form of exercise that fuses movement from the martial arts, the healing arts, and dance, check out the August 2007 FITT column called 'Find the Joy of Movement in NIA' at http://www.ncpad.org/490/2374/Find~the~Joy~of~Movement~in~Nia

References

• Branas, P., Jordan, R., Fry-Smith, A. et al. (2000). Treatments for fatigue in multiple sclerosis: A rapid and systematic review. Health Technology Assess, 4, 27.
• Merkelbach, S., Sittinger, H., & Koenig, J. (2002). Is there a differential impact of fatigue and physical disability on quality of life in multiple sclerosis? J Nerv Ment Dis, 190, 388-393.
• Oken, B.S., Kishiyama, S., Zajdel, D., Bourdette, D., Carlsen, J., Haas, M., Hugos, C., Kraemer, D.F., Lawrence, J., and Mass, M. (2004). Randomized controlled trial of yoga and exercise in multiple sclerosis. Neurology, 62(11):2058-64.
• Shannon, J.B. (Ed) (2007). Multiple Sclerosis Sourcebook. Omnigraphics Inc. Publisher.

I encourage you to write to me with suggestions for future column topics or to comment on the information provided in this column. You can reach me by e-mail at jenrow@uic.edu.