title: Yoga in Sedentary Adults with Arthritis: Effects of a Randomized Controlled Pragmatic Trial.
abstract: OBJECTIVE
  To evaluate the effect of Integral-based hatha yoga in sedentary people with arthritis.
  
  
  METHODS
  There were 75 sedentary adults aged 18+ years with rheumatoid arthritis (RA) or knee osteoarthritis randomly assigned to 8 weeks of yoga (two 60-min classes and 1 home practice/wk) or waitlist. Poses were modified for individual needs. The primary endpoint was physical health [Medical Outcomes Study Short Form-36 (SF-36) physical component summary (PCS)] adjusted for baseline; exploratory adjusted outcomes included fitness, mood, stress, self-efficacy, SF-36 health-related quality of life (HRQOL), and RA disease activity. In everyone completing yoga, we explored longterm effects at 9 months.
  
  
  RESULTS
  Participants were mostly female (96%), white (55%), and college-educated (51%), with a mean (SD) age of 52 years (12 yrs). Average disease duration was 9 years and 49% had RA. At 8 weeks, yoga was associated with significantly higher PCS (6.5, 95% CI 2.0-10.7), walking capacity (125 m, 95% CI 15-235), positive affect (5.2, 95% CI 1.4-8.9), and lower Center for Epidemiologic Studies Depression Scale (-3.0, 95% CI -4.8 - -1.3). Significant improvements (p < 0.05) were evident in SF-36 role physical, pain, general health, vitality, and mental health scales. Balance, grip strength, and flexibility were similar between groups. Twenty-two out of 28 in the waitlist group completed yoga. Among all yoga participants, significant (p < 0.05) improvements were observed in mean PCS, flexibility, 6-min walk, and all psychological and most HRQOL domains at 8 weeks with most still evident 9 months later. Of 7 adverse events, none were associated with yoga.
  
  
  CONCLUSIONS
  Preliminary evidence suggests yoga may help sedentary individuals with arthritis safely increase physical activity, and improve physical and psychological health and HRQOL. Clinical Trials NCT00349869.
authors.affiliation: From the Maryland University of Integrative Health, Laurel; Department of Medicine, and School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA; Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada.S.H. Moonaz, PhD, Maryland University of Integrative Health; C.O. Bingham III, MD, Department of Medicine, Division of Rheumatology, Johns Hopkins University; L. Wissow, MD, MPH, School of Public Health, Johns Hopkins University; S.J. Bartlett, PhD, Associate Professor of Medicine, Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University.
authors.forename: Steffany Haaz
authors.initials: SH
authors.lastname: Moonaz
authors.affiliation: From the Maryland University of Integrative Health, Laurel; Department of Medicine, and School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA; Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada.S.H. Moonaz, PhD, Maryland University of Integrative Health; C.O. Bingham III, MD, Department of Medicine, Division of Rheumatology, Johns Hopkins University; L. Wissow, MD, MPH, School of Public Health, Johns Hopkins University; S.J. Bartlett, PhD, Associate Professor of Medicine, Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University.
authors.forename: Clifton O
authors.initials: CO
authors.lastname: Bingham
authors.affiliation: From the Maryland University of Integrative Health, Laurel; Department of Medicine, and School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA; Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada.S.H. Moonaz, PhD, Maryland University of Integrative Health; C.O. Bingham III, MD, Department of Medicine, Division of Rheumatology, Johns Hopkins University; L. Wissow, MD, MPH, School of Public Health, Johns Hopkins University; S.J. Bartlett, PhD, Associate Professor of Medicine, Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Wissow
authors.affiliation: From the Maryland University of Integrative Health, Laurel; Department of Medicine, and School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA; Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada.S.H. Moonaz, PhD, Maryland University of Integrative Health; C.O. Bingham III, MD, Department of Medicine, Division of Rheumatology, Johns Hopkins University; L. Wissow, MD, MPH, School of Public Health, Johns Hopkins University; S.J. Bartlett, PhD, Associate Professor of Medicine, Division of Clinical Epidemiology, Royal Victoria Hospital, McGill University. susan.bartlett@mcgill.ca.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Bartlett
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000534:rehabilitation*; D011788:Quality of Life; D057185:Sedentary Behavior; D016896:Treatment Outcome; D015013:Yoga
keywords: HRQOL; MOBILITY; OSTEOARTHRITIS; RHEUMATOID ARTHRITIS; YOGA
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