title: Effect of integrated yoga therapy on pain, morning stiffness and anxiety in osteoarthritis of the knee joint: A randomized control study.
abstract: OBJECTIVE
  To study the effect of integrated yoga on pain, morning stiffness and anxiety in osteoarthritis of knees.
  
  
  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(th) (post 1) and 90(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%).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopedics, Ebnezar Orthopaedic Centre, Parimala Speciality Hospital, Bangalore, India.
authors.forename: John
authors.initials: J
authors.lastname: Ebnezar
authors.forename: Raghuram
authors.initials: R
authors.lastname: Nagarathna
authors.forename: Bali
authors.initials: B
authors.lastname: Yogitha
authors.forename: Hongasandra Ramarao
authors.initials: HR
authors.lastname: Nagendra