Although exercise is often recommended for managing osteoarthritis (OA), limited evidence-based exercise options are available for older adults with OA. This study compared the effects of Hatha yoga (HY) and aerobic/strengthening exercises (ASE) on knee OA. Randomized controlled trial with three arms design was used: HY, ASE, and education control. Both HY and ASE groups involved 8 weekly 45-min group classes with 2–4 days/week home practice sessions. Control group received OA education brochures and weekly phone calls from study staff. Standardized instruments were used to measure OA symptoms, physical function, mood, spiritual health, fear of falling, and quality of life at baseline, 4 and 8 weeks. HY/ASE adherences were assessed weekly using class attendance records and home practice video recordings. Primary analysis of the difference in the change from baseline was based on intent-to-treat and adjusted for baseline values. Eight-three adults with symptomatic knee OA completed the study (84% female; mean age 71.6 ± 8.0 years; mean BMI 29.0 ± 7.0 kg/m2). Retention rate was 82%. Compared to the ASE group at 8 weeks, participants in the HY group had a significant improvement from baseline in perception of OA symptoms (−9.6 [95% CI −15.3, −4]; p = .001), anxiety (−1.4 [95% CI −2.7, −0]; p = .04), and fear of falling (−4.6 [−7.5, −1.7]; p = .002). There were no differences in class/home practice adherence between HY and ASE. Three non-serious adverse events were reported from the ASE group. Both HY and ASE improved symptoms and function but HY may have superior benefits for older adults with knee OA.
Trial registration The full trial protocol is available at clinicaltrials.gov (NCT02525341).
Knee osteoarthritis Hatha yoga Aerobic and strengthening exercises Older adults
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The authors want to thank Catherine Justice, Registered Yoga Teacher, and Mary Clapp, Certified Personal Trainer for implementing the intervention classes, and the Directors of the Jewish Community Centers for providing the classrooms and assisting in recruitment.
This study was funded by the University of Iowa Hartford Center Geriatric Nursing Excellent Pilot Grant, and Deborah E. Powell Center of Mature Women’s Health and Research Grants. It is also supported in part by the National Center for Advancing Translational Sciences Award UL1TR000114. The study sponsors played no role in study design, methods, participant recruitment, data collection, data analysis or development of this manuscript.
The authors CC and JW conceived the study and carried out the design. UB provided exercise consultation and assisted with the development of the ASE intervention program. TM participated in the design of the study and provided geriatric consultations. KR provided statistical consultations. MM performed the statistical analyses. CC, KR, and MM interpreted the results. CC drafted the manuscript. All authors critically reviewed, revised, and approved the final manuscript.
Compliance with ethical standards
Conflict of interest
The authors, Corjena Cheung, Jean Wyman, Ulf Bronas, Teresa McCarthy, Kyle Rudser, and Michelle Mathison declare that they have no financial, personal, or potential conflict of interests that could potentially or inappropriately influence (bias) their work and conclusions have no conflict of interest. The University of Minnesota’s Institutional Review Board granted approval of the study.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study. Measures were taken throughout the study to ensure safety to prevent yoga or exercise-related injury. Participants’ data were kept private and confidential.
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