Academic journal article International Journal of Yoga

Effect of Integrated Yoga Therapy on Pain, Morning Stiffness and Anxiety in Osteoarthritis of the Knee Joint: A Randomized Control Study

Academic journal article International Journal of Yoga

Effect of Integrated Yoga Therapy on Pain, Morning Stiffness and Anxiety in Osteoarthritis of the Knee Joint: A Randomized Control Study

Article excerpt

Byline: John. Ebnezar, Raghuram. Nagarathna, Bali. Yogitha, Hongasandra. Nagendra

Aim: To study the effect of integrated yoga on pain, morning stiffness and anxiety in osteoarthritis of knees. Materials and Methods: Two hundred and fifty participants with OA knees (35-80 years) were randomly assigned to yoga or control group. Both groups had transcutaneous electrical stimulation and ultrasound treatment followed by intervention (40 min) for two weeks with follow up for three months. The integrated yoga consisted of yogic loosening and strengthening practices, asanas, relaxation, pranayama and meditation. The control group had physiotherapy exercises. Assessments were done on 15 [sup]th (post 1) and 90 [sup]th day (post 2). Results: Resting pain (numerical rating scale) reduced better (P<0.001, Mann-Whitney U test) in yoga group (post 1=33.6% and post 2=71.8%) than control group (post 1=13.4% and post 2=37.5%). Morning stiffness decreased more (P<0.001) in yoga (post 1=68.6% and post 2=98.1%) than control group (post 1=38.6% and post 2=71.6%). State anxiety (STAI-1) reduced (P<0.001) by 35.5% (post 1) and 58.4% (post 2) in the yoga group and 15.6% (post 1) and 38.8% (post 2) in the control group; trait anxiety (STAI 2) reduced (P<0.001) better (post 1=34.6% and post 2=57.10%) in yoga than control group (post 1=14.12% and post 2=34.73%). Systolic blood pressure reduced (P<0.001) better in yoga group (post 1=−7.93% and post 2=−15.7%) than the control group (post 1=−1.8% and post 2=−3.8%). Diastolic blood pressure reduced (P<0.001) better in yoga group (post 1=−7.6% and post 2=−16.4%) than the control group (post 1=−2.1% and post 2=−5.0%). Pulse rate reduced (P<0.001) better in yoga group (post 1=−8.41% and post 2=−12.4%) than the control group (post 1=−5.1% and post 2=−7.1%). Conclusion: Integrated approach of yoga therapy is better than physiotherapy exercises as an adjunct to transcutaneous electrical stimulation and ultrasound treatment in reducing pain, morning stiffness, state and trait anxiety, blood pressure and pulse rate in patients with OA knees.

Introduction

Patients with osteoarthritis (OA) of knee are characterized primarily by articular cartilage degeneration and a secondary peri-articular bone response. [sup][1] Worldwide, the prevalence rate of OA is 9.6% for men and 18% for women >60 years. [sup][2] In India OA is the second most common rheumatologic problem and has a prevalence rate of 22 to 39. [sup][3] Clinically it presents as pain in and around the joint, joint stiffness usually after rest, crepitation and restricted joint movements associated with muscle weakness. [sup][4] The strongest risk factors for OA are age [sup][5] and genetics. [sup][6] Other risk factors include female gender, obesity, cigarette smoking, intra-articular fractures, chondrocalcinosis, crystals in joint fluid/cartilage, prolonged immobilization, joint hypermobility, instability, peripheral neuropathy, prolonged occupational or sports stress. [sup][7]

Chrousos and Gold observed that the development of age-related diseases occurs at different rates in different individuals and psychological distress appears to be an important factor promoting earlier onset of age-related diseases. [sup][8] Aging being a strong risk factor for OA, psycho emotional stresses would also have a contributory role in initiation and aggravation of degenerative changes of OA. It has been suggested that the presence of depressive symptoms predicts future musculoskeletal disorders but not vice versa. [sup][9] Linton S.J reviewed the psychological risk factors in back and neck pain which indicated a clear link between psychological variables with neck and back pain. Stress, distress or anxiety as well as mood and emotions, cognitive dysfunction and pain behavior were found to be significant factors. …

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