Yoga for Osteoarthritis: a Systematic Review and Meta-analysis.

Author: Lauche R1,2, Hunter DJ3, Adams J4, Cramer H4,5
1Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia.
2Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Buger Str. 80, Bamberg, 96049, Germany.
3Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia.
4Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia.
5Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
Conference/Journal: Curr Rheumatol Rep.
Date published: 2019 Jul 23
Other: Volume ID: 21 , Issue ID: 9 , Pages: 47 , Special Notes: doi: 10.1007/s11926-019-0846-5. , Word Count: 263

PURPOSE OF REVIEW: This study aims to systematically review and summarise the efficacy and safety of yoga for osteoarthritis. Medline (through PubMed), Scopus, and the Cochrane Library were searched through April 2018 for randomised controlled trials of yoga for osteoarthritis. Primary outcomes were pain intensity, function, and quality of life; secondary outcomes were mental health and safety. Risk of bias was assessed using the Cochrane tool and quality of evidence through GRADE.

RECENT FINDINGS: Nine trials including 640 individuals with mainly lower extremity osteoarthritis aged 50-80 years were identified, with 80.3% female participants (median). Meta-analyses revealed very low-quality evidence for the effects of yoga on pain (vs. exercise: standardised mean difference (SMD) = - 1.07; 95%CI - 1.92, - 0.21; p = 0.01; vs. non-exercise: SMD = - 0.75; 95%CI - 1.18, - 0.31; p < 0.001), physical function (vs. exercise: SMD = 0.80; 95%CI 0.36; 1.24; p < 0.001; vs. non-exercise: SMD = 0.60; 95%CI 0.30, 0.98; p < 0.001), and stiffness (vs. exercise: SMD = - 0.92; 95%CI - 1.69, - 0.14; p = 0.008; vs. non-exercise: SMD = - 0.76; 95%CI - 1.26, - 0.26; p = 0.003) in individuals with knee osteoarthritis. Effects were not robust against potential methodological bias. No effects were found for quality of life, and depression, or for hand osteoarthritis. Safety was rarely reported. The findings of this meta-analysis indicate that yoga may be effective for improving pain, function, and stiffness in individuals with osteoarthritis of the knee, compared to exercise and non-exercise control groups. Due to the low methodological quality and potential risk of bias, only a weak recommendation can be made at this time for the use of yoga in adults with osteoarthritis of the knee.

KEYWORDS: Arthritis; Meta-analysis; Osteoarthritis; Pain; Rheumatology; Yoga

PMID: 31338685 DOI: 10.1007/s11926-019-0846-5