Restorative Yoga for Symptom Management in Fibromyalgia

Background: Fibromyalgia (FM) is a widespread chronic pain condition that occurs in 2.5% to 7.9% of adults in the United States. Associated symptoms include sleep disturbance, fatigue, stiffness, depressed mood, anxiety, and impaired cognitive function. The etiology and mechanism of FM are unclear. Because of the complex and individualized nature of FM, a multimodal treatment methodology that includes both pharmacological and non-pharmacological therapies is recommended for symptom management. Selected styles of yoga are among those non-pharmacological therapies recommended. Because stress is thought to be a triggering and sustaining factor in FM, a yoga style that aims to reduce stress may be appropriate for this population. Restorative yoga (RY) is one such style of yoga. Six articles reporting on yoga intervention studies conducted in persons diagnosed with FM have been published. None of these studies investigated the use of RY for symptom management in this disorder.

Objective: The primary aim of this study was to determine the feasibility of an 8-week RY intervention for symptom management in persons diagnosed with FM. The secondary aim of this study was to gather preliminary data on the perceived effects of RY on FM-related symptoms of pain, sleep disturbance, fatigue, functional status, and health-related quality of life.

Design and Methods: A mixed methods, one-group, prospective, feasibility design informed by the Theory of Planned Behavior was used to investigate the feasibility of an 8-week twice weekly 90-minute group RY class and a 20-minute RY home practice on the five non-class nights. Self-report questionnaires were completed at baseline and at weeks 4 and 8. A pre- and post-intervention interview and a 1-month follow-up were conducted.

Results: Rates for recruitment, retention, and adherence were consistent with those of other yoga interventions conducted for persons with FM; however, the RY intervention required a higher than average number of staff members and resources for the group classes as compared with other yoga styles. Statistically significant trends and minimal clinically important differences were found from baseline to week 8 in the Revised Fibromyalgia Impact Questionnaire total score, the Pain Numeric Rating Scale for the subscales pain now and average pain over the past week, the General Sleep Disturbance Scale total score, and the Pittsburgh Sleep Quality Index total score.

Conclusion: Although the study findings do not support the feasibility of delivery of RY, in a five-posture, 90-minute group class format for persons with FM, the findings support the need for further investigation of a home practice format of RY. A longitudinal, randomized, controlled trial of a home practice format RY intervention to establish intervention efficacy and symptom-self management potential for those with FM is recommended.