Functional and physiological effects of yoga in women with rheumatoid arthritis: a pilot study

Department of Physical Therapy, A.T. Still University, USA.
Alternative therapies in health and medicine (Impact Factor: 1.24). 07/2009; 15(4):24-31.
Source: PubMed


Stress, both psychological and physiological, has been implicated as having a role in the onset and exacerbations of rheumatoid arthritis (RA).
This study investigated whether neuroendocrine and physical function in women with RA can be altered through a yoga intervention.
Exercise intervention.
University research conducted at a medical clinic.
Sixteen independently living, postmenopausal women with an RA classification of I, II, or III according to the American College of Rheumatology functional classification system served as either participants or controls.
The study group participated in three 75-minute yoga classes a week over a 10-week period.
At baseline and on completion of the 10-week intervention, diurnal cortisol patterns and resting heart rate were measured. Balance was measured using the Berg Balance Test. Participants completed the Health Assessment Questionnaire (HIQ), a visual analog pain scale, and the Beck Depression Inventory.
Yoga resulted in a significantly decreased HAQ disability index, decreased perception of pain and depression, and improved balance. Yoga did not result in a significant change in awakening or diurnal cortisol patterns (P = .12).

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Available from: Tinna Traustadóttir, Feb 24, 2015
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    • "Stress may play a role in worsening symptoms of OA, and contribute to flare-ups of inflammation in RA [15]. There is promising evidence that yoga therapy may help both osteoarthritis and rheumatoid arthritis [25,44,66-75]. The most important limitations of the existing research regarding the impact of yoga are: lack of minority representation, inadequate sample size, overly broad age range, lack of specification regarding the tradition of yoga utilized, and lack of a theoretical model to inform treatment implementation and assessment of outcomes [76]. "
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    ABSTRACT: Background While arthritis is the most common cause of disability, non-Hispanic blacks and Hispanics experience worse arthritis impact despite having the same or lower prevalence of arthritis compared to non-Hispanic whites. People with arthritis who exercise regularly have less pain, more energy, and improved sleep, yet arthritis is one of the most common reasons for limiting physical activity. Mind-body interventions, such as yoga, that teach stress management along with physical activity may be well suited for investigation in both osteoarthritis and rheumatoid arthritis. Yoga users are predominantly white, female, and college educated. There are few studies that examine yoga in minority populations; none address arthritis. This paper presents a study protocol examining the feasibility and acceptability of providing yoga to an urban, minority population with arthritis. Methods/design In this ongoing pilot study, a convenience sample of 20 minority adults diagnosed with either osteoarthritis or rheumatoid arthritis undergo an 8-week program of yoga classes. It is believed that by attending yoga classes designed for patients with arthritis, with racially concordant instructors; acceptability of yoga as an adjunct to standard arthritis treatment and self-care will be enhanced. Self-care is defined as adopting behaviors that improve physical and mental well-being. This concept is quantified through collecting patient-reported outcome measures related to spiritual growth, health responsibility, interpersonal relations, and stress management. Additional measures collected during this study include: physical function, anxiety/depression, fatigue, sleep disturbance, social roles, and pain; as well as baseline demographic and clinical data. Field notes, quantitative and qualitative data regarding feasibility and acceptability are also collected. Acceptability is determined by response/retention rates, positive qualitative data, and continuing yoga practice after three months. Discussion There are a number of challenges in recruiting and retaining participants from a community clinic serving minority populations. Adopting behaviors that improve well-being and quality of life include those that integrate mental health (mind) and physical health (body). Few studies have examined offering integrative modalities to this population. This pilot was undertaken to quantify measures of feasibility and acceptability that will be useful when evaluating future plans for expanding the study of yoga in urban, minority populations with arthritis. Trial registration NCT01617421
    Full-text · Article · Apr 2013 · Health and Quality of Life Outcomes
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    • "There was a decrease in the rheumatoid factor levels along with less pain and better function following a week of yoga.[55] Another pilot study involving 12 sessions of yoga for rheumatoid arthritis (RA) demonstrated statistically significant improvements in RA.[56] Sixteen postmenopausal women with RA subjected to three 75- min yoga classes a week over a 10-week period showed a significant decrease in Health assessment Questionnaire disability index, perception of pain and depression, and improved balance.[57] "
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    ABSTRACT: Yoga is an ancient Indian way of life, which includes changes in mental attitude, diet, and the practice of specific techniques such as yoga asanas (postures), breathing practices (pranayamas), and meditation to attain the highest level of consciousness. Since a decade, there has been a surge in the research on yoga, but we do find very few reviews regarding yogic practices and transcendental meditation (TM) in health and disease. Keeping this in view, a Medline search was done to review relevant articles in English literature on evaluation of physiological effects of yogic practices and TM. Data were constructed; issues were reviewed and found that there were considerable health benefits, including improved cognition, respiration, reduced cardiovascular risk, body mass index, blood pressure, and diabetes. Yoga also influenced immunity and ameliorated joint disorders.
    Full-text · Article · Oct 2012 · North American Journal of Medical Sciences
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    • "Twenty postmenopausal women (ages between 45 and 75 years) were allocated to yoga (n = 11) or control (n = 9) groups based on the time schedule that was convenient for them.16 Patients with active RA based on the American College of Rheumatology (ACR) 1987 revised criteria and in functional class I, II, or III as defined by ACR classification of functional status, receiving concurrent stable doses of disease-modifying antirheumatic drugs (DMARDs) for a minimum of 4 weeks before the start of the trial, not taking more than 7.5 mg/day of glucocorticoids, who were able to get down to the floor and back up with no more than minimal assistance, and those naïve to yoga were included in the study. "
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    ABSTRACT: We reviewed published literature regarding the use of yoga for managing rheumatoid arthritis to determine whether adequate evidence exists to suggest its usefulness as a therapy. A search for previous studies involving yoga and rheumatoid arthritis in PubMed yielded eight reports. These studies reported the benefits of yoga in the physical and mental health of patients with rheumatoid arthritis (RA), suggesting that yoga is a useful add-on therapy for RA patients. However, all studies showed limitations with respect to sample size, study design, description and duration of yoga intervention, and assessment tools and statistical methods used. Additionally, the studies did not attempt to understand the mechanisms underlying observed benefits. Hence, evidence suggests a definite role of yoga in RA improvement, reducing pain, improving function, and creating a positive mental state. However, detailed analysis and additional studies are necessary to verify these observations.
    Full-text · Article · Aug 2012 · Open Access Journal of Sports Medicine
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