(063) Yoga, Sexual Dysfunction, and Female Concussions: A Mind–Body Pilot Intervention

Abstract Introduction Sexual wellbeing is an important aspect of health and should be considered in the recovery paradigm of patients with brain injury secondary to concussion. Although Yoga improves concussion outcomes, its impact on sexual wellbeing of female concussion patients, particularly those with sexual dysfunction, is unknown. Objective We explored the efficacy of a brain-injury tailored Yoga program in improving sexual functioning (Aim 1a) and mood correlates (depression, anxiety, Post Traumatic Stress Disorder (PTSD); Aim 1b) in female concussion patients aged 18 years and older. We also evaluated the sustainability of the intervention (Aim 2) and participant satisfaction (Aim 3). Methods Participants were recruited from PINK Concussions, a social media support network for female concussion patients with symptoms lasting at least 1 month. Twelve participants were enrolled in a 6-week Yoga program, and an additional 15 were assigned to a wait-list control condition. Participants received a self-report survey 1-week post- Yoga intervention (week 7 and week 5 weeks post-intervention (week 11). All participants were Yoga novices, defined as practicing Yoga once or month or less. Sessions were held over Zoom and led by a certified Yoga instructor with over 10 years of experience delivering brain-injury tailored Yoga. The Female Sexual Functioning Index-6 (FSFI-6) was used to assess sexual dysfunction. Participants completed measures of depression (PHQ-9), anxiety (GAD-7), and PTSD (PCL-5). We used difference in differences estimates to calculate the average treatment effects, and the counterfactual means of the intervention group. We also used Glass’ Delta (Δ) to calculate effect sizes. Results Of the 12 enrolled in the program, 6 completed at least 3 sessions and were sent the follow-up survey. At 1-week post-Yoga intervention (Aims 1a and 1b), participants reported substantial improvements in their sexual functioning and mood symptoms. The average treatment effect was 5.5 points for sexual functioning (FSFI-6). Although intervention participants had higher anxiety at baseline, scores improved more than the controls’, with an average treatment effect of -1.35 points on the GAD-7. PTSD scores followed a similar trend, also surpassing the control group with an average treatment effect of -4.42 points on the PCL-5 scale. Depression scores (PHQ-9) also decreased but not as remarkably (-0.06). In all domains, the actual mean of the intervention group was greater than the expected, counterfactual mean. Glass’s delta (Δ) showed large and medium effect sizes for sexual functioning (-0.50) and anxiety (-0.30) respectively; but they were small for PTSD (-0.15) and depression (0.05). At 5 weeks post-intervention (Aim 2), scores declined slightly, but none returned to pre-Yoga, baseline levels. Effect sizes for sexual functioning were medium (-0.34). All other domains had small effect sizes. The mean satisfaction scores for Aim 3 was 8.7 on a 10point Likert scale (0 = extremely dissatisfied; 10 = extremely satisfied), and all participants indicated that they would recommend the Yoga program to others in their network. Conclusions Yoga has the potential to improve women’s sexual functioning after concussion and also offers a non-pharmacological alternative for treating mood and other important correlates of women’s sexual well-being. Larger randomized trials are needed. Disclosure No.