The Effect of Breathing Yoga "Bhramary Pranayama" on Fatigue and Depression in Patients with Multiple Sclerosis: A Randomized Clinical Trial

Background:Multiple sclerosis (MS) causes different physical and mental symptoms, especially fatigue and depression. Yoga is a form of complementary and alternative medicine treatment. Bhramari pranayama breathing exercise is a yoga practice. This study aimed to investigate the effect of Bhramari pranayama yoga on the severity of fatigue and depression in MS patients.Materials and Methods:In this randomized clinical trial, 78 patients visiting the MS Association in an urban area of Iran were randomly assigned to two groups using the minimization method. The intervention group (n = 38) performed Bhramari pranayama yoga for 20 min, twice a day for 4 weeks. The control group (n = 40) received routine care from the MS Association. The participants in the two groups were evaluated before and after the intervention using Fatigue Severity Scale and Beck Depression Inventory-II. The data were analyzed using SPSS-26 software.Results:The data showed no statistically significant difference between the two groups in the mean scores of fatigue and depression before the intervention. However, after the intervention, there was a statistically significant difference between the two groups in the mean scores of fatigue (P < 0.01; confidence interval [CI]: -25.34, -17.81; effect size: -2.80) and depression (P = 0.001; CI: -18.91, -11.25; effect size: -1.92).Conclusion:Yoga can reduce the severity of fatigue and depression in MS patients. Thus, Bhramari pranayama, as a yoga exercise that can be easily learned and practiced is recommended to specialists, MS clinic officials and patients.