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Effect of integrated yoga therapy on pain, morning stiffness and anxiety in osteoarthritis of the knee joint: a randomized control study
Ebnezar J, Nagarathna R, Yogitha B, Nagendra HR
International Journal of Yoga 2012 Jan;5(1):28-36
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 to 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 15th (post 1) and 90th 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.

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