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Dawoud A, Blitz J, Moonaz S, Grout L. Feasibility and Acceptability of Yoga for Adolescents with Juvenile Idiopathic Arthritis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:812. [PMID: 39062261 PMCID: PMC11276325 DOI: 10.3390/children11070812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/05/2024] [Accepted: 06/28/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND/OBJECTIVES Yoga is effective for adults with arthritis but unstudied in adolescents with juvenile idiopathic arthritis (JIA). METHODS A pilot study assessed the feasibility and acceptability of an 8-week group yoga intervention for adolescents ages 14-18 with JIA. Each 75-min session included breathing techniques, relaxation, mindfulness, and modified yoga postures, using yoga props and a rope wall. An online video was available for home practice. The outcome measures administered at the baseline and at 8 weeks were physician global assessment with joint count, visual assessment with a joint damage assessment index, the Pediatric Quality of Life Arthritis Module 3.0 (Peds QL), and the visual analog scale for pain. RESULTS Thirteen out of 25 participants attended ≥1 class with a mean of 5.7 ± 2.2 classes. Common reasons for non-enrollment included distance, schedule, and lack of interest. The average distance to classes was 29.0 ± 41.7 miles. There was a trend toward improvement for joint count (p = 0.07), global assessment (p = 0.10), and the Pain and Hurt domain of the Peds QL (p = 0.13), but no other outcomes approached significance. Satisfaction data from an anonymous survey (n = 8) were high in all areas. CONCLUSIONS Adolescents with JIA who attended yoga reported enjoyment, pain reduction, and interest in continued practice with no adverse events. Future studies should consider stakeholder engagement to reduce barriers and larger sample sizes to test the effectiveness.
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Affiliation(s)
- Adina Dawoud
- Division of Pediatric Rehabilitation Medicine, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA (J.B.)
| | - Jill Blitz
- Division of Pediatric Rehabilitation Medicine, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA (J.B.)
| | - Steffany Moonaz
- Department of Clinical and Health Sciences Research, Southern California University of Health Sciences, Whittier, CA 90604, USA
| | - Leah Grout
- Department of Clinical and Health Sciences Research, Southern California University of Health Sciences, Whittier, CA 90604, USA
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Biswas I, Nalbant G, Lewis S, Chattopadhyay K. Key characteristics of effective yoga interventions for managing osteoarthritis: a systematic review and meta-analysis. Rheumatol Int 2024:10.1007/s00296-024-05652-y. [PMID: 38935121 DOI: 10.1007/s00296-024-05652-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024]
Abstract
This systematic review aimed to synthesise the content, structure, and delivery characteristics of effective yoga interventions for managing osteoarthritis symptoms, including joint pain and joint function. JBI guidelines were followed. 17 databases were searched for randomised controlled trials (RCTs) assessing yoga's effectiveness on osteoarthritis symptoms. Meta-analyses and a narrative synthesis were conducted to address the objective. The systematic review and meta-analysis included 18 and 16 articles (representing 16 and 14 RCTs), respectively. Overall, the included studies had low methodological quality scores. 10 of 14 yoga interventions effectively reduced pain (standardised mean difference (SMD) - 0.70; 95% confidence interval (CI) - 1.08, - 0.32) and/or improved function (- 0.40; - 0.75, - 0.04). Notably, 8 effective interventions had centre-based (supervised, group) sessions, and 6 included additional home-based (unsupervised, individual) sessions. Effective interventions included 34 yogic poses (12 sitting, 10 standing, 8 supine, 4 prone), 8 breathing practices, and 3 meditation and relaxation practices. 8 interventions included yogic poses, and 7 also incorporated breathing practices and/or meditation and relaxation practices. 4 interventions included yogic pose modifications for osteoarthritis. The median duration of centre-based sessions was 8 weeks and each session was around 53 min, mostly delivered once a week. The median duration of home-based sessions was 10 weeks and each session was 30 min, usually instructed to practice 4 times a week. Given previous studies' limitations, a high-quality long-term RCT should be conducted using synthesised findings of previous effective yoga interventions.
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Affiliation(s)
- Isha Biswas
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, NG5 1PB, UK.
| | - Gamze Nalbant
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, NG5 1PB, UK
| | - Sarah Lewis
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, NG5 1PB, UK
| | - Kaushik Chattopadhyay
- Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, NG5 1PB, UK
- The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Nottingham, NG5 1PB, UK
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3
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Uebelacker LA, Braun TD, Taylor LE, Saper R, Baldwi M, Abrantes A, Tremont G, Toribio A, Kirshy S, Koch R, Lorin L, Van Noppen D, Anderson B, Roseen EJ, Stein MD. Evaluation of intervention components to maximize yoga practice among people with chronic pain taking opioid agonist therapy: A factorial experiment using the multiphase optimization strategy framework. Contemp Clin Trials 2024; 137:107411. [PMID: 38103784 PMCID: PMC10922864 DOI: 10.1016/j.cct.2023.107411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/01/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Chronic pain affects up to half of individuals taking opioid agonist therapy (OAT; i.e., methadone and buprenorphine) for opioid use disorder (OUD), and yoga-based interventions may be useful for decreasing pain-related disability. Whereas more yoga practice (i.e., higher "dosage") may improve pain-related outcomes, it can be challenging for people with chronic pain taking OAT to attend class regularly and sustain a regular personal yoga practice. Therefore, we plan to optimize a yoga-based intervention (YBI) package in order to support class attendance and personal practice, thus maximizing the yoga dose received. STUDY DESIGN Using the Multiphase Optimization Strategy (MOST) framework, we will conduct a factorial experiment to examine four intervention components that may be added to a weekly yoga class as part of a YBI. Components include: 1) personal practice videos featuring study yoga teachers, 2) two private sessions with a yoga teacher, 3) daily text messages to inspire personal practice, and 4) monetary incentives for class attendance. The primary outcome will be minutes per week engaged in yoga (including class attendance and personal practice). We plan to enroll 192 adults with chronic pain who are taking OAT for OUD in this 2x2x2x2 factorial experiment. CONCLUSION Results of the study will guide development of an optimized yoga-based intervention package that maximizes dosage of yoga received. The final treatment package can be tested in a multisite efficacy trial of yoga to reduce pain interference in daily functioning in people with chronic pain who are taking OAT. TRIAL REGISTRATION Pre-registration of the study was completed on ClinicalTrials.gov (identifier: NCT04641221).
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Affiliation(s)
- Lisa A Uebelacker
- Alpert Medical School of Brown University, Providence, RI, United States of America; Butler Hospital, Providence, RI, United States of America.
| | - Tosca D Braun
- Alpert Medical School of Brown University, Providence, RI, United States of America; Butler Hospital, Providence, RI, United States of America.
| | - Lynn E Taylor
- University of Rhode Island, Kingston, RI, United States of America
| | - Robert Saper
- Cleveland Clinic, Cleveland, OH, United States of America
| | - Marielle Baldwi
- Boston University Chobanian & Avedision School of Medicine, Boston, MA, United States of America; Boston Medical Center, Boston, MA, United States of America
| | - Ana Abrantes
- Alpert Medical School of Brown University, Providence, RI, United States of America; Butler Hospital, Providence, RI, United States of America
| | - Geoffrey Tremont
- Alpert Medical School of Brown University, Providence, RI, United States of America; The Boston University School of Public Health, Boston, MA, United States of America
| | - Alisha Toribio
- Boston University Chobanian & Avedision School of Medicine, Boston, MA, United States of America; Boston Medical Center, Boston, MA, United States of America
| | - Shannon Kirshy
- Butler Hospital, Providence, RI, United States of America
| | - Ryan Koch
- Butler Hospital, Providence, RI, United States of America
| | - Lucy Lorin
- Boston University Chobanian & Avedision School of Medicine, Boston, MA, United States of America; Boston Medical Center, Boston, MA, United States of America
| | | | | | - Eric J Roseen
- Boston University Chobanian & Avedision School of Medicine, Boston, MA, United States of America; Boston Medical Center, Boston, MA, United States of America
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Kocyigit BF, Adilbekov E, Zharmenov S, Akyol A, Yessirkepov M. Evaluating the efficacy of hippotherapy: a promising intervention in rheumatology, pain medicine, and geriatrics. Rheumatol Int 2023; 43:2185-2191. [PMID: 37700080 DOI: 10.1007/s00296-023-05451-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023]
Abstract
Using animals for medical care has a long history. Animals have long been recognized for their ability to improve human health and well-being throughout nations and civilizations. Animal-assisted therapy is a concept that incorporates intentional and regulated interactions between individuals and animals to achieve therapeutic aims. Hippotherapy is an animal-assisted therapy consisting of medical procedures and practices that use horses to restore and enhance physical and mental health. The effectiveness of hippotherapy is evidenced by its ability to have a favorable influence on various domains, encompassing physical, psychosocial, and educational aspects. This multifaceted method entails the active involvement of the sensory, musculoskeletal, vestibular, and visual systems. Hippotherapy is an unconventional modality, leveraging horses' cyclic and repetitive motions to activate the postural reflex structures of individuals. Various studies have mostly focused on determining the efficacy of hippotherapy in the context of neurological conditions, neuro-rehabilitation, and psychiatric disorders. The primary objective of this study was to present the effectiveness of hippotherapy in the fields of rheumatology, pain medicine, and geriatrics. In addition, we provided a summary of the potential underlying mechanisms of hippotherapy. Finally, we conducted a comparison of hippotherapy and horse riding simulator interventions to provide their respective strengths and restrictions.
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Affiliation(s)
- Burhan Fatih Kocyigit
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Adana Health Practice and Research Center, Adana, Turkey.
| | | | - Samat Zharmenov
- Department of Surgical Diseases, Kazakhstan Medical University "KSPH", Almaty, Kazakhstan
- Aura Med Clinic, Almaty, Kazakhstan
| | - Ahmet Akyol
- Physiotherapy and Rehabilitation Application and Research Center, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Marlen Yessirkepov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
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Allende S, Mathersul DC, Schulz-Heik JR, Avery TJ, Mahoney L, Bayley PJ. Yoga is effective for treating chronic pain in veterans with Gulf War Illness at long-term follow-up. BMC Complement Med Ther 2023; 23:319. [PMID: 37704984 PMCID: PMC10498617 DOI: 10.1186/s12906-023-04145-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/29/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Clinical Practice Guidelines for Gulf War Illness (GWI) recommend integrative health approaches such as yoga for relief from symptoms, yet little is known about the long-term efficacy of yoga in reducing symptoms of GWI. Here, we evaluated the long-term efficacy of yoga and cognitive-behavioral therapy (CBT) chronic pain treatment in a randomized controlled trial (RCT) of 75 Veterans (57 men, 42-71 ± 7.1 years of age) with Gulf War Illness (GWI). METHODS Participants received either 10 weeks of yoga or 10 weeks of CBT for chronic pain. The primary outcome measures were pain severity, and pain interference (Brief Pain Inventory-Short Form). The secondary outcome measures were fatigue, as indicated by a measure of functional exercise capacity (6-Minute Walk Test), depression, autonomic symptom severity, and quality of life. Piecewise linear mixed models were used to examine study hypotheses. RESULTS Compared to the CBT group, yoga was associated with greater reductions in pain severity during the 6-month follow-up period (group × time interaction: b = 0.036, se = 0.014, p = .011). Although we did not find between-group differences in the other primary or secondary outcome measures during follow-up (p's > 0.05), exploratory analyses revealed within-group improvements in pain interference, total pain (an experimental outcome variable which combines pain severity and interference), and fatigue in the yoga group (p's < 0.05) but not in the CBT group. CONCLUSIONS This is the first study to report long-term follow-up results of yoga as a treatment for GWI. Our results suggest that yoga may offer long-term efficacy in reducing pain, which is a core symptom of GWI. TRIAL REGISTRATION Secondary analyses of ClinicalTrials.gov NCT02378025.
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Affiliation(s)
- Santiago Allende
- War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA, USA.
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
| | - Danielle C Mathersul
- War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA, USA
- School of Psychology, Murdoch University, Murdoch, WA, 6150, Australia
- Centre for Molecular Medicine and Innovative Therapeutics, Health Futures Institute, Murdoch University, Murdoch, WA, 6150, Australia
| | - Jay R Schulz-Heik
- War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Peninsula Behavioral Health, CA, Palo Alto, 94306, USA
| | - Timothy J Avery
- War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Veterans Affairs, Peninsula Vet Center, Menlo Park, CA, 94025, United States of America
| | - Louise Mahoney
- War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Peter J Bayley
- War Related Illness and Injury Study Center, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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Salbaş E, Karahan AY. The effectiveness of hippotherapy simulation exercises for muscle strength, disease activity and quality of life in sedentary adults with ankylosing spondylitis. Ann Med 2023; 55:2249822. [PMID: 37643349 PMCID: PMC10467537 DOI: 10.1080/07853890.2023.2249822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/31/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023] Open
Abstract
INTRODUCTION/OBJECTIVE Newly created systems called hippotherapy simulators (HS) mimic the primitive movements of a live horse. As they are new systems, research examining their usefulness has been well received. The aim of this study is to research the effects of HS on disease activity, quality of life and muscle strength in patients with ankylosing spondylitis (AS). METHODS In a prospective, assessor-blinded, block-randomized trial, 48 AS patients were randomly assigned in a 1:1 ratio to receive either HS or conventional home (CH) exercise therapy. All Participants received 48 sessions, that is 4 sessions a week for 12 consecutive weeks. The primary outcome measures included the quadriceps muscle strength, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI) and Ankylosing Spondylitis Quality of Life Scale (ASQoL). RESULTS Both groups demonstrated significant improvement in BASDAI, BASFI, BASMI, ASQoL and muscle strength scores compared to the baseline (p < 0.05). BASDAI, BASFI and BASMI scores decreased significantly in the HS group compared to the CH group at week 12 (p=.005, p=.003, p=.045, respectively), but there was no significant difference between the groups in terms of ASQoL and muscle strength scores at week 12 (p=.245, p=.212, respectively). CONCLUSIONS The results of this clinical trial of HS exercises for AS patients indicate a positive effect on disease activity, quality of life and muscle strength. Therefore, horse-riding simulator exercises can be used as an alternative method for the management of individuals with AS.
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Affiliation(s)
- Ender Salbaş
- Physical Medicine and Rehabilitation, Bandirma Training and Research Hospital, Balikesir, Turkey
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