Feasibility and preliminary effects of a yoga program developed for adults with [LC]: pilot randomized controlled trial, 2026, Welfordsson+

[SNT Gatchaman]

Feasibility and preliminary effects of a yoga program developed for adults with post COVID-19 condition Breathe Easy: pilot randomized controlled trial

Spoiler: Authors

Welfordsson; Brodén; Niemi; Diwan; Shah; Pattanadara; Hallgren

INTRODUCTION
Effective medical management of post COVID-19 condition (post COVID) remains challenging. Symptoms are heterogenous, debilitating, and impact health-related quality of life (HR-QoL). Complementary treatments are needed that can be self-managed and improve health. Yoga is a promising strategy that may help reduce post-COVID symptoms but remains understudied.

METHODS
We co-designed a unique yoga intervention for adults with post COVID and evaluated its feasibility and preliminary effects. Two-group parallel, pilot randomized controlled trial with blinded follow-up. Participants were randomized (1:1) to the 12-week yoga program or a health promotion (HP) intervention. All participants received usual medical treatment for post COVID. Twenty-nine participants aged 30-65 years were recruited and randomized (86% follow-up). The primary outcome was feasibility and the secondary outcome was HR-QoL (SF-36). Data were analysed as intention-to-treat using linear mixed modelling. The trial was prospectively registered and approved by the Swedish Ethical Review Authority (2023/06518-01).

RESULTS
Through a consensus development process involving yoga experts in India and Sweden, post COVID researchers, and patient advocates, we successfully co-designed and pilot tested a yoga program developed for adults with post COVID. The intervention was feasible with high adherence (≥2 sessions/week = 65%; ≥1 session/week = 95%) and no serious adverse events reported. Preliminary (underpowered) analyses showed no pre-to-post intervention group differences (SF-36 physical health: B = -1.30, 95% CI = -3.60, 1.00, p =.269; mental health: B = 3.49, 95% CI = -0.06, 7.04, p =.054).

CONCLUSION
Participation in a yoga program developed for patients with post COVID was feasible. Adequately powered trials are needed to assess whether yoga may help to improve symptoms associated with the condition.

HIGHLIGHTS
• We led a consensus development process involving yoga experts in India and Sweden;

• We pilot tested a yoga program developed specifically for adults with post COVID-19 condition;

• The intervention was feasible with high adherence (≥2 sessions/week) and no serious adverse events reported;

• Larger randomized controlled trials of yoga for post COVID-19 patients are warranted.

Web | DOI | PDF | Complementary Therapies in Medicine | Open Access

 

[SNT Gatchaman]

To date, there is no single intervention shown to effectively reduce the multidimensional symptoms of post COVID, but a recent review by the Swedish Agency for Health Technology Assessment found that exercise-based interventions, including those that focus on breathing exercises, may be effective for improving healthrelated QoL (HR-QoL). Treatment and management of post COVID is largely symptom based; an approach that has proven to be limited with many patients continuing to experience debilitating symptoms years after the initial infection. Lifestyle-based approaches are needed to ease the symptoms and sequelae of post COVID.

The trial was co-designed with input from the Swedish COVID Association, a patient organisation with nearly 5,000 members

As part of this process, we conducted a literature review (unpublished) of existing yoga trials for post COVID and related health conditions (e.g., chronic fatigue syndrome) to identify which components of yoga were shown to be most effective in the treatment of these conditions. Following this review, we began an iterative process of modifying the program through an ongoing exchange of expert opinion until a consensus was reached.

We conducted an open-label, two-group parallel, pilot randomized controlled trial (RCT) with blinded follow-up assessments.

We excluded those who had: […] (7) post orthostatic tachycardic syndrome (POTS) […]

The yoga teacher noted that the 30–45-minute classes were too long for some participants, but not long enough for others. Another issue raised was that heterogeneity in symptom burden and physical ability led to difficultly establishing a suitable difficulty level for yoga classes.

Flexibility in participation format was noted by many participants as crucial for attending classes. An additional finding was that several participants perceived the group environment to be supportive, and it was reported that participants often stayed on to talk and socialise after the classes.

An additional five participants described some exacerbation of their post COVID symptoms shortly after starting yoga classes, though this did not impair participation and did not meet the threshold for being classified as harm. These included four participants who reported increased fatigue or excessive tiredness and one participant who described an exacerbation of dyspnea.

Overall, there were no statistically significant within-group changes or betweengroup differences in effects on physical or mental HR-QoL

For physical health (PCS), the HP group trended towards improvement over the 12-week intervention period (mean withingroup change = 2.7; 95%CI= −1.1, 6.3), whereas the yoga group was essentially unchanged at 12-week follow-up (mean within-group change = −0.1; 95%CI= −4.5, 4.3).

 

[Hutan]

First thought - 'not yoga again'

Second thought - looked at the tags 'exercise therapy', 'yoga', 'null result' - thank you SNT, those tags tell me all I need to know

Third thought - 'no pre to post-test intervention group differences' and yet

Larger randomized controlled trials of yoga for post COVID-19 patients are warranted.

 

[Kitty]

Feasibility and preliminary effects of a __________ program developed for adults with [LC]

1) Insert random activity
2) Write some stuff
3) Publish
4) Congratulations, you are now a scientist

 

[Felis Catus]

1) Insert random activity
2) Write some stuff
3) Publish
4) Congratulations, you are now a scientist

I was reading a thread on an exercising programme the other day wondering if anything would've changed if you replaced "exercising programme" with "lemon juice", apart from a dropout rate.

Feasibility and preliminary effects of a juice protocol developed for adults with [LC]: pilot randomized controlled trial, 2026, Catus & Kitty

 

[NelliePledge]

Coming soon a unique kale intervention

 

[rvallee]

It's impossible to avoid the conclusion that in its current form, the evidence-based medicine framework is such a giant failure that it would be preferable to shut it down entirely without a replacement if meaningful reforms cannot be put forward. It can be reformed, but barring this, it clearly does mostly harm and likely no good at all.

The idea that there is a specific type of program that can achieve what they think is ludicrous, Bigfoot territory.

This stuff truly rivals NFTs in its usefulness.

 

[rvallee]

Coming soon a unique kale intervention

Oh that opens up the possibility of endless combinations and permutations of cooking, ripeness, flavors and so on. Easily hundreds of citations to pad the academic stonks. Now that's EBM brain!

 

[Kitty]

Oh that opens up the possibility of endless combinations and permutations of cooking, ripeness, flavors and so on. Easily hundreds of citations to pad the academic stonks.

Next, someone finds a uniquely effective wild kale that only grows in the remote mountains of southeast Asia, hand picked by local goatherds.

$199 for a month's supply.

 

[Utsikt]

So this was intended to be a full trial, but issues with staffing, funding and recruitment made them change it into a pilot.

You’d think recruitment rates would be a part of assessing the feasibility of a new intervention, but I guess not.

5. Sample size and deviations from the study protocol​

As there were no published studies of yoga for post COVID when the protocol was submitted, we based our power estimate on data from our recent RCT of yoga for well-being among physically inactive older adults.34 With an expected dropout rate of 20% and 1:1 allocation, the total number of participants needed to power the analyses was estimated to be eighty-eight (total).

Due to unforeseen changes in human resources and available funding, this recruitment target could not be achieved. To acknowledge this change, we have amended our description of the study as a pilot trial with a focus on reporting feasibility and preliminary effects.

We acknowledge that in a small pilot sample, baseline imbalances may meaningfully influence outcomes, despite randomization and statistical adjustment. Such imbalances complicate interpretation of between-group comparisons and may either exaggerate or mask true intervention effects. Examination of the secondary outcomes is also redundant due to inadequate power.

 

[rvallee]

So this was intended to be a full trial, but issues with staffing, funding and recruitment made them change it into a pilot.

As Michael Sharpe put in a recent presentation about his life's work: "pilot everything". It actually became "do every trial as a pilot, this way you can always fall back on that". It doesn't even matter, even if they can't manage to do a full trial, they'll still conclude that they should do a full trial. Again.

It's truly amazing how they can all go "there's this limitation, and also that one, and we didn't do this, couldn't do that, wouldn't bother with some requirements, everything should be taken with a mountain of salt because none of this is reliable, but just go right ahead and deploy while moving on to a dozen identical sub-replications".

What is the point of trials if the results don't even matter?! A marketing department doing focus groups where they find that no one wants to buy their product but chooses to insist anyway would get fired so quickly.