Examining the safety, feasibility and efficacy of yoga for persons with arthritis

Abstract

Arthritis is the leading cause of disability, affecting 21% of adults in the United States. The two most prevalent forms of arthritis are osteoarthritis (OA) or rheumatoid arthritis (RA). The costs of arthritis are enormous to the individual and society, including substantial healthcare costs and lost productivity as well as activity limitations, reduced participation in family and society. In addition to the physical symptoms that include pain, stiffness and swelling, persons with arthritis commonly experience psychosocial comorbidities such as depression, isolation and an inability to perform daily activities.

Physical activity is recommended as an essential component of arthritis disease management to slow the loss of muscle, mobility and function. While many forms of exercise are safe and effective for people with arthritis, most people are not able to maintain an activity program for more than a few months.

Yoga is a mind-body activity with origins in ancient India. It consists of deep breathing, centering, isometric poses that focus on strength, flexibility or balance, moving sequences, progressive relaxation, chanting and/or meditation. The combination of physical activity with stress-reduction techniques and an emphasis on individual modification has the potential to benefit persons with arthritis. Additionally, yoga can be practiced in a small space with limited resources.

This dissertation is an examination of the effects of a regular program of yoga on selected health and psychosocial outcomes in examination of the feasibility and effects of yoga on selected clinical, physical and psychosocial outcomes for adults with OA and RA.

The specific aims of this study were: (1) To conduct a systematic review of the literature on the use of yoga interventions for persons with OA and/or RA; (2) To identify factors related to program adherence; and (3) to estimate the effects of regular yoga on selected health and psychosocial outcomes.

A review of the existing literature indicated that yoga appears to be safe and feasible for persons with rheumatoid and/or osteoarthritis, and may confer a variety of physical and psychological benefits. Our preliminary results suggested that yoga was associated with significant improvements in physical health, physical function, flexibility, balance, depressive symptoms, positive affect and pain for persons with arthritis, as well as a reduction in the number of tender/swollen joints for persons with rheumatoid arthritis. Adherence to our yoga program was the same or higher than traditional exercise programs (e.g., group aerobics, resistance training) and persons who began the program were likely to complete it. No related adverse events were reported during the trial, although 8 people were withdrawn from the study for health-related occurrences such as diagnosis of another inflammatory condition or unrelated surgery.

Thus, results of this preliminary RCT suggest that a gentle, gradual yoga program tailored to the needs of people with arthritis was safe, feasible and potentially associated with improvements in physical health, which may be mediated by changes in physical fitness, psychological functioning and disease symptoms. There is a need for larger studies conducted in a variety of setting using standardized methodology to contribute additional evidence regarding the utility of yoga as a part of comprehensive arthritis self-management.