Yoga benefits who?

E-pub: Cramer et al. Yoga for Multiple Sclerosis: A Systematic Review and Meta-Analysis. PLoS One. 2014 Nov 12;9(11):e112414.

While yoga seems to be effective in a number of neuropsychiatric disorders, the evidence of efficacy in multiple sclerosis remains unclear. The aim of this review was to systematically assess and meta-analyze the available data on efficacy and safety of yoga in patients with multiple sclerosis. Medline/PubMed, Scopus, the Cochrane Central Register of Controlled Trials, PsycINFO, CAM-Quest, CAMbase, and IndMED were searched through March 2014. Randomized controlled trials (RCTs) of yoga for patients with multiple sclerosis were included if they assessed health-related quality of life, fatigue, and/or mobility. Mood, cognitive function, and safety were defined as secondary outcome measures. Risk of bias was assessed using the Cochrane tool. Seven RCTs with a total of 670 patients were included. Evidence for short-term effects of yoga compared to usual care were found for fatigue (standardized mean difference [SMD] = -0.52; 95% confidence intervals (CI) = -1.02 to -0.02; p = 0.04; heterogeneity: I2 = 60%; Chi2 = 7.43; p = 0.06) and mood (SMD = -0.55; 95%CI = -0.96 to -0.13; p = 0.01; heterogeneity: I2 = 0%; Chi2 = 1.25; p = 0.53), but not for health-related quality of life, muscle function, or cognitive function. The effects on fatigue and mood were not robust against bias. No short-term or longer term effects of yoga compared to exercise were found. Yoga was not associated with serious adverse events. In conclusion, since no methodological sound evidence was found, no recommendation can be made regarding yoga as a routine intervention for patients with multiple sclerosis. Yoga might be considered a treatment option for patients who are not adherent to recommended exercise regimens.


Yoga includes practices, philosophy and religion and has different schools, principles and goals. For the majority of people in the western world, yoga is usually a type of exercise that makes you stretch without breaking too much sweat (hot yoga excluded). The seven studies analysed included 670 people in the yoga (any type, duration or objective) or control (exercise, no exercise or other non-pharmacological intervention) groups.

You may know that government and health bodies recommendations for exercise are generic and similar for very different individuals. As for diets, the exercise recommendations are not evidence based: some forms of exercise can be deleterious for some people. On the other hand, sitting on the sofa and being inactive are definitely associated with bad health outcomes. So what is your objective when engaging in yoga? It may or not be "fatigue", "mood" and "health-related QoL".

The conclusion of this study makes you believe that there are recommended exercise regimens, which is not true. The best option is to choose whichever strategy keeps you active. In a more ideal world, you may want to have an individualised recommendation keeping in mind blood pressure, vital capacity, weight, and neurological objectives and adjust the strategy based on outcomes.

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