Yoga for Osteoarthritis: a Systematic Review and Meta-analysis
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.
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.
KeywordsYoga Arthritis Osteoarthritis Arthritis Rheumatology Pain Meta-analysis
DJH is supported by an NHMRC Practitioner Fellowship. JA is supported by an ARC Professorial Future Fellowship (FT140100195).
(1) RL, HC, and DH contributed to the conception and design of the study and acquisition of data; RL conducted the analysis; RL, HC, DH, and JA contributed to the interpretation of data. (2) RL, HC, and DH contributed to the drafting the article; RL, HC, DH, and JA revised it critically for important intellectual content. (3) All authors gave final approval of the version to be submitted.
Compliance with Ethics Guidelines
Conflict of Interest
Romy Lauche, Jon Adams, and Holger Cramer each declare no potential conflicts of interest.
David J. Hunter has received person fees from Merck Serono, Pfizer, Lilly, and TLCBio,
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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