Virtual Yoga Program Beneficial for Individuals With Functional Neurological Disorder

Danielle Kipnis, MA

Recent research on movement disorders demonstrates that virtual yoga sessions for people with functional neurological disorders (FND) may be beneficial for them. Practicing yoga helps to decrease the severity that individuals experience from FND and increase the function of perceived health, quality of life, and self-efficacy. Yoga may also be beneficial for assisting to better recognize symptom triggers for people with FND and help manage them more effectively during daily routines.¹

Yoga’s effects on the mind and body from past research in people with neurological conditions suggest that a multisystem approach would be a beneficial option treatment for FND and that it may be used as a stimulation to sustain potential changes in neural plasticity. To learn more about the practice of yoga with people who have functional neurological disorders, NeurologyLive® spoke with Danielle Kipnis, MA, of Columbia University. Kipnis provided her insight on what was gathered from her research with her colleagues and what should be down in future studies within this field.

The virtual yoga sessions performed in her study, which was presented at the 2022 International Parkinson and Movement Disorders Society Congress, held September 15-18, in Madrid, Spain, included breathing and movement exercises which the participants incorporated into their daily routine, using the techniques to address specific symptoms of FND.

NeurologyLive®: What does yoga look like for people with functional neurological disorder?

Danielle Kipnis, MA: The yoga that I do with people who have FND is pretty different than what you would experience going to a studio class or even putting on maybe an online class. I'm really tailoring it to the person and their abilities as functional neurological disorder can really affect people very differently. Some people are pretty mobile and have some tremors here and there, some people might be very immobilized, and really can't stand up or get on the floor or anything like that. The emphasis is really I look at yoga as breath and movement and I take that pretty broadly when I'm working with people with FND.

What have you gathered from the research?

The point of this research more than necessarily showing that “Look, yoga really made these numbers change on these surveys that I chose.” It is really more to dive into “What does this actually look like for this population?” I've realized from this research is that people with FND don’t really fit into one box. When we start to develop a yoga intervention for FND, again, we're targeting the trying to shift the nervous systems from the sympathetic to the parasympathetic. We're trying to work with breath to do that and to retrain some messaging in the brain by working with the parasympathetic nervous system through the graph. I've done some research on FND that shows that there's hyperconnectivity between emotional and motor centers of the brain. My theory with some of this work is that the yoga can bridge that gap a little bit.

Did you find any surprising results in your research?

The quantitative data isn't necessarily jaw dropping for everyone but the results are pretty broad. When I analyzed the data, I think part of what I need to look at is if we're looking at FND, are there categories of FND that affect people and maybe yoga is really useful for people that manifest one way, but not necessarily another. That is something that I need to think about a little bit further as I look at the data. I'd say that's probably the biggest surprise was that the results were really a huge range of results.

Why did you decided to incorporate a 45-mintue yoga session with the participants?

I made it 45 minutes as I've found that 60 minutes can be a little bit long for some people, especially for people that are a little bit more debilitated. Since I was trying to do two times a week, two times a week for 60 minutes might be pushing it a little bit. I was trying to keep it as accessible to keep people from withdrawing as much as I could. When you break down that 45 minutes, I'd say, the first five minutes is usually just to check in to see how the person is doing, how they are feeling today and how they feel after the last session. Then we start with mindfulness that moves into breathing. I do a lot of like really gentle movement with breath, oftentimes seated in a chair just to help people kind of get a rhythm or their breath. For example, like moving your arms up with an inhale and then moving your arms down with an exhale. Then depending on the person, we might get into some bigger movements standing up, or we might just continue with some breath and movements seated in a chair. We close out with usually some relaxation and some meditation. Depending on the person, that might be seated in the chair, it might be lying down in more of a traditional shavasana or even seated on the floor. That's what the 45 minutes breaks down to.

What would you have done differently in your research?

For future studies, I do want to try to incorporate to maybe do it in person, it's all been remote. I think that the remote actually has huge benefits, but I would be curious to do some in person research, and then see what the differences are there. I'd also love to do some imaging studies down the line as well, like actually looking at the brain and seeing if we can even see anything happening. In terms of gaps of this type of research, I think yoga research in general isn't a lot of imaging research. It's all based in a yoga intervention for people with PTSD and it'll be survey based. I'm really interested in seeing what's actually happening on a neurological level. One day, I hope that yoga research can get to that point right now, we really just need to establish the efficacy of the practice in all these different ways. I certainly think it's getting there. It's doing the work.

Transcript edited for clarity.

REFERENCE
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.