Somatic yoga therapy for functional neurological disorder: A feasibility randomised controlled trial

Background: Functional neurological disorder (FND) is characterised by disabling motor, sensory, and/or seizure symptoms, associated with substantial functional impairment. Contemporary models highlight the possible involvement of altered affective and autonomic regulation and interoceptive processing in FND. However, accessible, mechanism-informed interventions remain limited. Somatic yoga, integrating movement, breathwork and body awareness, may help target altered emotional processing and bodily regulation in FND.Methods: This single-site, two-arm randomised feasibility trial allocated adults with a clinician-confirmed diagnosis of FND to six weeks of somatic yoga (weekly remote sessions plus home practice manual) or to a music-based relaxation control. Feasibility outcomes included recruitment, retention, adherence, and acceptability. Secondary outcomes, assessed at baseline, week 3, week 6 and three-month follow-up, included FND symptom burden, psychological symptoms (anxiety, depression, dissociation), general functioning, health-related quality-of-life, interoceptive awareness, and autonomic symptoms.Results: Seventy-six enquiries were received. Thirty participants consented (100%), 27 were randomised (90%), 23 commenced the trial (77%) and 21 completed the trial (70%). Recruitment and retention targets were met, with 100% retention in the yoga arm. Adherence was high across both groups, although digital logging of home practice posed usability challenges. Exploratory analyses indicated large effect sizes for self-reported FND symptom improvement and interoceptive awareness in the yoga group, with effects sustained at follow-up.Conclusions: Individually delivered somatic yoga was found to be feasible, acceptable and safe for people with FND. Our results also suggest potential benefits of somatic yoga for FND symptom improvement and interoceptive awareness, supporting progression to a fully powered trial.