by Nina

A Poppy Bud by Melina Meza

“Preliminary evidence suggests yoga may help sedentary individuals with arthritis safely increase physical activity, and improve physical and psychological health and HRQOL.”

Well, I really like everything about that sentence except that last acronym, which turns out to stand for “health-related quality of life.” (I not only wouldn’t have guessed that’s what HRQOL stood for in a million years, but as just looking at the acronym is causing my stress levels to spike a bit, it is causing the opposite effect of its own meaning.)

But, anyway, that sentence is the conclusion from the abstract of a scientific study Yoga in Sedentary Adults with Arthritis: Effects of a Randomized Controlled Pragmatic Trial by Moonaz, et al  that I wanted to tell you about. We have written a number of posts about arthritis in the past (see Arthritis of the Hip Joint, Arthritis of the Spine, Arthritis of the Shoulder, and Arthritis of the Knee, among others) so it’s obvious we’re convinced of the benefits that yoga provides for people (including me!) with this condition. But still it is always good to have a scientific study to back us up. And this new study is both the largest randomized controlled trial of osteoarthritis and rheumatoid arthritis and the first to “assess physical health and fitness using self-reported and performance measures along with psychological function and HRQOL.” 

The goal of this study was to add to the evidence of the positive results of practicing yoga for people with arthritis who were previously sedentary. The hypothesis was that yoga would “improve physical health, fitness, psychological function, health-related quality of life (HRQOL), and arthritis self-efficacy with no worsening of rheumatoid arthritis (RA) disease activity.” The researchers thought that yoga is effective for arthritis because it combines physical activity with powerful stress management techniques (breath work, relaxation, and mindfulness). So they asked a registered yoga therapist to work the Johns Hopkins Arthritis Center faculty to develop an eight-week yoga program to introduce yoga to beginners who had either rheumatoid arthritis or osteoarthritis of the knees. The yoga program emphasized individualized adaptations and monitoring.


Although the full study isn’t available to the general public, I was able to obtain a copy (thank you, Brad). So here’s a basic summary: 

1. The study was done on 75 sedentary adults 18 years or older, with rheumatoid arthritis or knee arthritis. Participants were mostly female (96%), white (55%), and college-educated (51%), with a mean age of 52 years.

2. The subjects either participated in eight weeks of Integral-based hatha yoga (two sixty minute classes and 1 home practice) or were waitlisted. (Eight weeks was selected for the yoga program because that would allow enough time to introduce independent practice and is also a common length for introductory series.)

3. Two yoga therapists with ten+ years of experience led the yoga classes, and they closely supervised the students and provided individual attention. 

4. The yoga classes included: breath work and chanting (5 min), warm-up and flow sequence (Surya Namaskara, 15 min), and static poses (asanas, 20 min) to increase strength, flexibility, and balance. Classes ended with deep relaxation (Savasana, 10 min), a closing chant, and meditation (5 min).

The static poses included gentle forward bends, backbends, twists, balance poses, standing, sitting, and lying poses, and were modified for individual participants by the teacher and/or the participant themselves. Props included: blocks, straps, blankets, and chairs. The participants were encouraged to try new skills while at the same time avoiding discomfort and staying safe. For home practice, the teachers provided weekly written instructions with pictures along with selected readings that described the benefits of yoga techniques (breathing, meditation, mindfulness). To allow the participants to gain the skills and confidence that would enable them to stay with the program long-term, the teachers helped them gradually develop their home practice. 

5. During the yoga program, the participants kept up their regular use of arthritis medications and the study coordinators checked in with them about changes. 

6. The group that waitlisted received their usual care for eight weeks. (They were asked to maintain their current levels of physical activity and inform coordinators of changes in health or arthritis medications. After their final assessments, they were invited to participate in upcoming classes.)

7. After eight weeks and again after nine months, both groups were measured for fitness, psychological functioning, and HRQO using “standardized protocols.”

The researchers concluded that eight weeks of yoga classes and home practice was associated with “clinically significant improvements in physical and mental health, fitness, psychological function, and HRQOL, with no adverse outcomes.” And they said that the strongest evidence of benefit was for reducing pain and improving mood, both of which were carefully tracked in the two groups. 

Less pain and a better mood sounds pretty good to me! And an additional benefit that yoga provides, which wasn’t measured in this study, is that by moving your joints through their entire range of motion, yoga keeps your arthritic joints nourished (see Yoga for Osteoarthritis). I know from personal experience that practicing yoga with an arthritic joint (a hip in my case) can be pretty challenging, but I’m more convinced than ever about how it important it is not to give up.



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