Feasibility and preliminary efficacy of an online yoga program for managing symptoms of post-treatment lyme disease syndrome

We evaluated the feasibility and efficacy of a 12-week synchronous online yoga program for managing post-treatment Lyme disease syndrome (PTLDS) symptoms, focusing on pain, physical functioning, and cognitive performance. Thirteen participants with PTLDS (aged 21-60 years; 92% female) participated in 75-minute weekly sessions led by certified yoga instructors, with 15-20 min of daily homework on five non-treatment days. Outcome measures included the Health-Related Quality of Life - Short Form (SF-36), Brief Pain Inventory (BPI), and the Cambridge Neuropsychological Test Automated Battery (CANTAB). The primary feasibility goals were met with a retention rate of 92.50%, treatment adherence of 82.70%, and a treatment satisfaction score of 3.4/4. The missing data rate was low at 3.90%. Significant improvements were observed in pain levels, as indicated by the SF-36 pain scale (t[11] = -3.19, p = 0.01, d = -0.92), and pain interference significantly decreased during daily activities, as measured by the BPI (t[11] = 2.61, p = 0.02, d = 0.75). Participants also reported fewer physical limitations during personal activities (t[11] = -2.46, p = 0.03, d = -0.71; SF-36). Cognitive improvement was indicated by a significant reduction in errors on the CANTAB Spatial Working Memory task (t[8] = 3.11, p = 0.02, d = 1.04). Online yoga is feasible and associated with significant reductions in pain, improved physical functioning, and enhanced cognitive performance among participants with PTLDS. These findings suggest that online yoga may be a scalable, accessible, and effective intervention for managing PTLDS symptoms.