Laughter Yoga for Improving Sexual Function and Psychosocial Outcomes in Multiple Sclerosis

Effects of Laughter Yoga on Sexual Functioning, Anxiety, Depression, Fatigue, and Quality of Life in Patients With Multiple Sclerosis: A Quasi-Experimental Study

The goal of this clinical trial is to evaluate whether laughter yoga can improve sexual functioning and reduce psychological symptoms in adults diagnosed with multiple sclerosis (MS). The main questions it aims to answer are:

Does laughter yoga improve sexual functioning in individuals with MS?

Does laughter yoga reduce anxiety, depression, and fatigue, and improve quality of life in this population?

Participants will:

Attend 10 online laughter yoga sessions over 5 weeks (2 sessions per week, 40 minutes each)

Complete online questionnaires before, during, and after the intervention to assess sexual functioning, anxiety, depression, fatigue, and quality of life

This quasi-experimental study investigates the effectiveness of laughter yoga in improving sexual functioning and psychosocial outcomes in adults with multiple sclerosis (MS). Laughter yoga is a behavioral intervention combining voluntary laughter with yogic breathing techniques, aiming to enhance emotional well-being and reduce stress-related symptoms.

The study includes three assessment points: baseline (pretest), five weeks after the baseline (pre-intervention), and post-intervention. The intervention consists of 10 structured laughter yoga sessions conducted via Zoom over a 5-week period. Each session lasts approximately 40 minutes and includes rhythmic clapping, deep breathing exercises, playful activities, and simulated laughter practices guided by a certified laughter yoga facilitator.

Validated self-report instruments are used to assess sexual functioning, anxiety, depression, fatigue, and quality of life. The study specifically targets individuals with MS who report sexual problems and experience mild to moderate psychological symptoms.

The primary aim is to determine the effect of laughter yoga on sexual functioning (measured by MSISQ-19). Secondary outcomes include changes in anxiety, depression, fatigue, and health-related quality of life. This study seeks to explore laughter yoga as a feasible, non-pharmacological, and low-cost approach to improving multidimensional well-being in MS patients.

Inclusion Criteria:

• Age 18 years or older
• Diagnosed with multiple sclerosis (MS)
• Literate and able to complete self-report questionnaires
• Expanded Disability Status Scale (EDSS) score < 4
• HADS-Anxiety score > 10
• HADS-Depression score > 7
• Reporting sexual problems based on MSISQ-19
• Having an active sexual life
• Access to internet and a device capable of video conferencing
• Willing to participate and able to attend all 10 laughter yoga sessions

Exclusion Criteria:

• MS relapse or acute exacerbation within the last 3 months
• Severe cognitive impairment or communication difficulties
• Current participation in any laughter therapy, yoga, or similar psychosocial intervention
• Diagnosis of a major psychiatric disorder (e.g., schizophrenia, bipolar disorder)
• Unwillingness or inability to provide informed consent