Yoga Versus Exercises for Managing OA
Condition: Knee Osteoarthritis
MeSH terms: Osteoarthritis; Osteoarthritis, Knee
Study type: Interventional

Summary: 
      The purpose of the study is to examine the short and long term effects of Hatha yoga compared
      to the current recommended exercise program in promoting physical function, alleviating
      osteoarthritis (OA)-related symptoms, fear of falling, and improving mood, spiritual health,
      physical activity level, and quality of life in older adults with knee OA, and to determine
      the effect sizes for use in power calculations to design a larger efficacy clinical trial.
    

Detailed description: 
      The specific aims of this pilot project are to:

      Aim 1: Examine the short and long term effect of participation in an 8-week intervention of
      Hatha yoga (HY) on pain, stiffness, physical function of the lower extremities, physical
      activity, mood, fear of falling, spiritual health, and quality of life in older women with
      knee OA, compared with the effect in those older adults who participated in
      aerobic/strengthening exercise (AE) or received general OA education (GE).

      Aim 2: Describe the adherence rate (class and home practices) and exercise acceptability of
      the HY and AE programs.

      A randomized controlled trial design with three groups were used: 1) A Hatha yoga (HY)
      intervention group, 2) an aerobic and local muscle strengthening exercise (AE) control group,
      and 3) a general OA education (GE) true control group. Both yoga and exercise groups involved
      group and home practice sessions. Participants in the GE group received education on OA
      management after randomization. A weekly phone call were placed to them during the
      intervention period to reinforce OA knowledge. Data were collected from all participants at
      baseline, 4 weeks, and 8 weeks during the intervention, and quarterly for one year during the
      follow up period.

      Study Endpoints

        1. Primary endpoint: OA status (pain, stiffness and function) at 8 weeks.

        2. Secondary endpoint: physical function of lower extremities, mood, and quality of life at
           8 weeks.

        3. Tertiary endpoint: Long term exercise adherence and effects on outcome measures, program
           acceptability, and safety.

      Sample Size and Recruitment Eight-three community dwelling older adults ages 60 years - 100
      years old with a diagnosis of symptomatic knee OA were recruited. Recruitment were done
      through conducting presentations at various senior centers; distributing press release to
      various community newsletters, local and senior newspapers, and through working with my
      co-investigators, and accessing the data base and mailing invitation letters out to patients
      meeting demographic and diagnostic criteria from the University of Minnesota Physician
      Practice.

      Each weekly group based session is 45 minute in length for all groups. Participants in the
      yoga group were recommended to practice for additional 30 minutes four times a week at home.
      Participants in the A/E class were recommended to practice 3 times on non-consecutive days at
      home as recommended by the current physical activity guidelines for older adults. To assist
      participants with maintaining exercise adherence and practicing yoga and
      aerobic/strengthening exercises at home correctly, handouts illustrating yoga/exercise
      activity were distributed at the end of each class. Participants also were asked to videotape
      and keep a log of their exercise practice during the intervention period. Video camera were
      provided. Long term exercise adherence was assessing using an exercise diary. Participants
      were asked to keep an exercise diary during the follow up period. A focus group will be
      conducted at the end of the follow-up period to examine the experience of using HY or AE for
      managing knee OA, and factors that affect participants' HY/AE adherence.

      Descriptive statistics will be used to analyze and report demographic data and
      feasibility/acceptability data. Inferential statistics (t-test or non-parametric equivalent
      such as Mann-Whitney, and chi-square test) will be used to analyze the OA symptoms, physical
      and psychological outcomes. The α level will be set at ≤ .05.
    

Intervention name(s): Hatha yoga; Aerobic and strengthening exercises; General education
Intervention type(s): Other; Other; Other
Intervention description(s): A sequence of 8 - 10 core yoga poses, breathing and relaxation techniques were practiced in each yoga class, and 2 - 3 new poses were introduced progressively in each of the yoga session. Props such as blocks, blankets, belts, mats, and chairs were used during the session.; A 15 minute of gentle aerobic exercise and a 30 minute of strengthening program that includes both isometric (without moving the joints) and isotonic (moving the joints) exercises of the lower extremities were taught to the participants.; One-time Arthritis Foundation educational brochures focusing on the disease process, diet and exercise and OA management education were given.
Other intervention name(s): Yoga
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: Yoga; exercises; knee osteoarthritis; older adults