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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; 44:1647-1677. [PMID: 38935121 PMCID: PMC11343886 DOI: 10.1007/s00296-024-05652-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [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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2
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Todd AR, Tracy MF, Hall SF, Herrmann AA, Chrenka EA, Hanson LR. Improving Access to Yoga for Chronic Pain in a Spanish-Speaking Community: A Quality Improvement Initiative. Pain Manag Nurs 2024; 25:395-401. [PMID: 38735818 DOI: 10.1016/j.pmn.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 02/20/2024] [Accepted: 03/25/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND The recent increase in opioid misuse and overdose among the Hispanic population signifies the need for an initiative to increase efforts in pain management in the Hispanic population. Yoga is an evidence-based therapeutic intervention that is effective for several pain-associated disorders. However, in the United States, it is primarily taught in English and not always accessible. This quality improvement (QI) project aimed to assess the outcome of implementing a yoga program on pain and quality of life in the Hispanic population. METHODS Twenty Spanish-speaking community center members participated in a linguistically-tailored yoga program over the course of 10 weeks that included educational, demonstration, and practice videos. Outcome measures of the QI program included changes in pain interference, physical function, opioid medication use, the overall impression of change in pain, satisfaction with the program, and the likelihood of continuation of yoga practice. RESULTS Data collected from participants (n = 16) after the 10-week period indicated that nearly 60% experienced an improvement in their overall impression of change in pain; their reported likelihood of continuation of yoga practice at home or another location were 6.8 and 7.4, respectively, on a 10-point scale. While pain interference was unaffected, there was an improvement in markers of physical function, including a two-fold improvement in general activity without limitations. The mean average intensity of pain decreased by 33%. CONCLUSION The use of a linguistically-tailored yoga program improved self-reported overall pain, physical function, average intensity of pain, and initiated an interest in participants in utilizing yoga practice for self-management of pain. This QI project provides results that can be used for further implementation initiatives at other sites and consideration of use in diverse populations.
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Affiliation(s)
| | | | - Sara F Hall
- HealthPartners Neuroscience Center, Saint Paul, Minnesota; Regions Hospital, Saint Paul, Minnesota
| | - Amanda A Herrmann
- HealthPartners Neuroscience Center, Saint Paul, Minnesota; HealthPartners Institute, Minneapolis, Minnesota
| | | | - Leah R Hanson
- HealthPartners Neuroscience Center, Saint Paul, Minnesota; HealthPartners Institute, Minneapolis, Minnesota
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3
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Lor M, Xiong S, Yang NB, Koleck TA. Systematic Review of Pain Research Among Limited English Proficiency Patient Populations in Health care. Pain Manag Nurs 2024; 25:160-169. [PMID: 38104018 DOI: 10.1016/j.pmn.2023.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Pain remains a global health problem affecting all populations. There is limited knowledge, however, about the effect of limited English proficiency (LEP) on pain care and outcomes. AIM This systematic review determines the current state of pain research for LEP populations. METHOD We searched peer-reviewed studies in PubMed, CINAHL, PsychInfo, and Google Scholar from 1970 to 2021. Two authors independently screened abstracts and full texts, evaluated the quality of the studies using the Mixed Methods Appraisal Tool, and extracted study characteristics, content, and findings into Microsoft Excel. RESULTS Twenty-five studies met our inclusion criteria. Of the 25 articles, 15 were quantitative, three were mixed methods, five were qualitative, one was quasi-experimental, and one was a randomized controlled trial. Four studies addressed all items of the Mixed Methods Appraisal Tool. Most pain research among patients with LEP was conducted in the United States (n = 17) and in hospital settings (n = 16). The majority of studies focused on one language (n = 15) with Spanish (n = 8) being the most studied language. Sample sizes ranged from seven to 18,593. Studies focused on three main themes: pain communication (n = 14), pain management (n =5) and/or outcomes (n = 1), and pain prevalence (n = 3). CONCLUSIONS The findings revealed that the pain research on LEP populations is still in its infancy, with varied areas of focus using descriptive research designs. More pain intervention research for LEP populations is needed to reduce pain disparities.
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Affiliation(s)
- Maichou Lor
- University of Wisconsin-Madison, School of Nursing, Madison, Wisconsin.
| | - Shoua Xiong
- University of Wisconsin-Madison, School of Nursing, Madison, Wisconsin
| | - Nancy B Yang
- University of Wisconsin-Madison, School of Nursing, Madison, Wisconsin
| | - Theresa A Koleck
- University of Pittsburg, School of Nursing, Pittsburgh, Pennsylvania
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4
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Burley CV, Casey AN, Jones MD, Wright KE, Parmenter BJ. Nonpharmacological approaches for pain and symptoms of depression in people with osteoarthritis: systematic review and meta-analyses. Sci Rep 2023; 13:15449. [PMID: 37723233 PMCID: PMC10507102 DOI: 10.1038/s41598-023-41709-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/30/2023] [Indexed: 09/20/2023] Open
Abstract
People with osteoarthritis often experience pain and depression. These meta-analyses examined and compared nonpharmacological randomized controlled trials (RCTs) for pain and symptoms of depression in people living with osteoarthritis. RCTs published up until April 2022 were sourced by searching electronic databases EMBASE, PUBMED & MEDLINE, Web of Science, CINAHL and PEDro. Random-effects meta-analyses were performed to calculate pooled effect sizes (ES) and 95% confidence intervals (CI) for pain and depression. Subgroup analyses examined intervention subtypes. For pain, 29 interventions (n = 4382; 65 ± 6.9 years; 70% female), revealed a significant effect on reducing pain (ES = 0.43, 95% CI [0.25, 0.61], p < 0.001). Effect sizes were significant (p < 0.001) for movement meditation (ES = 0.52; 95% CI [0.35, 0.69]), multimodal approaches (ES = 0.37; 95% CI [0.22, 0.51]), and psychological therapy (ES = 0.21; 95% CI [0.11, 0.31]), and significant (p = 0.046) for resistance exercise (ES = 0.43, 95% CI [- 0.07, 0.94]. Aerobic exercise alone did not improve pain. For depression, 28 interventions (n = 3377; 63 ± 7.0 years; 69% female), revealed a significant effect on reducing depressive symptoms (ES = 0.29, 95% CI [0.08, 0.49], p < 0.001). Effect sizes were significant for movement meditation (ES = 0.30; 95% CI [0.06, 0.55], p = 0.008) and multimodal interventions (ES = 0.12; 95% CI [0.07, 0.18], p < 0.001). Resistance/aerobic exercise or therapy alone did not improve depressive symptoms. Mind-body approaches were more effective than aerobic/resistance exercise or therapy alone for reducing pain and depression in people with osteoarthritis.Systematic review registration: PROSPERO CRD42022338051.
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Affiliation(s)
- Claire V Burley
- UNSW Medicine & Health Lifestyle Clinic, School of Health Sciences, University of New South Wales, Sydney, Australia.
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, Australia.
| | - Anne-Nicole Casey
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Matthew D Jones
- Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Kemi E Wright
- Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Sydney, Australia
| | - Belinda J Parmenter
- UNSW Medicine & Health Lifestyle Clinic, School of Health Sciences, University of New South Wales, Sydney, Australia
- Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Sydney, Australia
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5
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de Orleans Casagrande P, Coimbra DR, de Souza LC, Andrade A. Effects of yoga on depressive symptoms, anxiety, sleep quality, and mood in patients with rheumatic diseases: Systematic review and meta-analysis. PM R 2023; 15:899-915. [PMID: 35726183 DOI: 10.1002/pmrj.12867] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 04/29/2022] [Accepted: 05/31/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the effects of yoga on depressive symptoms, anxiety, sleep quality, and mood of patients with rheumatic diseases through a systematic literature review with meta-analysis. LITERATURE SURVEY This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement and the Cochrane recommendations and risk of bias tool. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO). Studies were selected using the PICOS (participants, intervention, comparison, outcome, and study) strategy. Searches were carried out until March 2022 and performed in Web of Science, PubMed, SportDiscus, Scopus, Cochrane, and EBSCO databases. METHODOLOGY Data were extracted to identify the differences between yoga and control and exercise groups and effect sizes. SYNTHESIS In total, 27 studies were included for qualitative analysis and 18 for meta-analysis. The studies found investigated yoga in patients with osteoarthritis, fibromyalgia, rheumatoid arthritis, and chronic fatigue syndrome. Regarding the risk of bias, the majority of studies showed a high risk or uncertain risk of bias in several criteria. Regarding the meta-analysis, yoga was favored to decrease depressive symptoms (standard mean difference [SMD]:-0.88; 95% confidence interval [CI]:-1.42; -0.34), anxiety (SMD: -0.51; 95% CI = -0.81 to -0.20), and improve sleep quality SMD = -0.96; 95% CI = -1.36 to -0.56). No differences were found between yoga and other exercise modalities in depression (p < .01). CONCLUSIONS Yoga is effective in improving depression, anxiety, and sleep quality of patients with rheumatic diseases. However, research in this field still needs further studies, because of methodological issues in the studies and a reduced number of studies conducted on each rheumatic disease and on the effects of yoga on each variable.
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Affiliation(s)
- Pedro de Orleans Casagrande
- Laboratory of Sport and Exercise Psychology (LAPE) of College of Health and Sport Science (CEFID) of the Santa Catarina State University (UDESC), Physical Education Department, Florianópolis, Brazil
| | - Danilo Reis Coimbra
- Federal University of Juiz de Fora (UFJF), Life Sciences Institute, ICV, Faculty of Physical Education and Sport, Physical Education Department, Governador Valadares, Brazil
| | - Loiane Cristina de Souza
- Laboratory of Sport and Exercise Psychology (LAPE) of College of Health and Sport Science (CEFID) of the Santa Catarina State University (UDESC), Physical Education Department, Florianópolis, Brazil
| | - Alexandro Andrade
- Laboratory of Sport and Exercise Psychology (LAPE) of College of Health and Sport Science (CEFID) of the Santa Catarina State University (UDESC), Physical Education Department, Florianópolis, Brazil
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6
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Silva DF, Santos MERA, Carmo TSD, Moura MEDC, Arruda IPDDEMA, Pereira SDC. Yoga implications for preventing accidental falls in older adults: a systematic review. FISIOTERAPIA EM MOVIMENTO 2022. [DOI: 10.1590/fm.2022.35201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Abstract Introduction: Studies have shown the importance of healthy habits in older adults, emphasizing physical activity or mobility for a better quality of life and to delay physical degeneration in this population. Yoga is one of several exercises recommended for therapeutic purposes to reduce the risk of falls, a common occurrence in this age group. Objective: To synthesize the existing evidence regarding the effects of yoga on quality of life and physical-functional capacity and its contribution to fall prevention in older people. Methods: This systematic review was conducted in August 2020 on the Medline/Pubmed, LILACS, SCOPUS, Web of Science and PEDro databases, with no restrictions for language or year of publication. In line with the eligibility criteria, randomized or quasi-randomized clinical trials were included. Results: A total of 1,190 articles were found, 18 of which were included for data collection. The average sample size was between 16 and 120 participants, consisting of older individuals of both sexes ranging in age from 62 to 85 years. Conclusion: Regular yoga practice has a beneficial effect on the quality of life and physical-functional capacity of older adults, thereby contributing to fall prevention. However, evidence is still limited and further studies are suggested to better elucidate the scope of the effects of yoga as a therapeutic resource.
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7
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Yoga for Healthy Aging: Science or Hype? ACTA ACUST UNITED AC 2021; 3. [PMID: 34368806 PMCID: PMC8341166 DOI: 10.20900/agmr20210016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Yoga, one of the world’s oldest health systems is receiving new attention for claims that it can contribute to healthy aging. Until recently, scientific evidence for its efficacy has relied heavily on small and poorly-designed research, but this is changing. Multiple, well-designed studies provide data showing that yoga practice has positive effects on cellular aging, mobility, balance, mental health, and prevention of cognitive decline—all areas of concern for older adults. Since the cost of implementing yoga-based community and home-based interventions is low—policymakers are also eyeing yoga practice as a cost-effective way to reduce medical costs and improve outcomes among a growing aging population. This commentary reviews the evidence for both physical and mental health benefits from yoga, as well as concerns about injuries that have been associated with certain types of yoga practice. It reveals a surprising range of yoga programs and difficulty levels that provide opportunities for almost anyone to participate and gain health benefits with practice.
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8
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Suárez-Iglesias D, García-Porro M, Clardy A, Ayán Pérez C. Feasibility and effects of a chair-based yoga program for adults with neurodisability. Disabil Rehabil 2021; 44:5220-5230. [PMID: 34100670 DOI: 10.1080/09638288.2021.1933617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Purpose: This study focuses on exploring the feasibility and the effects of practicing chair-based yoga for 10 weeks on health-related quality of life (HRQoL) and interoceptive body awareness (BA) in adults with neurodisability and moderate to severe physical dependence.Materials and Methods: A pre- and post-testing control group design was followed. Participants were 34 service users at a rehabilitation center. The intervention group (IG, n = 17, 53% men, mean age of 48.6 ± 11.4 years) took part in the 10-week chair-based yoga program. The control group (CG, n = 17, 53% men, mean age of 53.1 ± 11.0 years) received usual care. The outcome measures were feasibility (recruitment rate, attrition, completion rate, adherence, participation, safety and tolerability), HRQoL (WHOQoL-BREF questionnaire), and BA (the Multidimensional Assessment of Interoceptive Awareness, MAIA). Participants in the IG completed a questionnaire to measure their personal experience of participating in the program.Results and Conclusions: This study provides implications for a 10-week chair-based yoga program as a feasible, well-tolerated, and safe intervention, reinforced by the participants' retrospective judgment. Compared to the CG, the program produced statistically significant improvements over BA, such as subscales of MAIA Noticing (p = .031, Hedges gs = 0.76), Emotional Awareness (p < .001, Hedges gs = 1.68), and Trusting (p = .036, Hedges gs = 0.74), but not HRQoL, for the IG. Chair-based yoga programs could be a rehabilitation strategy in the socio-health care of a varied population with physical mobility impairments leading to wheelchair use.Implications for RehabilitationA 10-week chair-based yoga intervention was shown to be a feasible, well-tolerated, and safe therapy which allowed people of varying abilities to participate equitable.Chair-based yoga can help people with moderate to severe physical dependence due to neurodisability to improve their interoceptive body awareness.Chair-based yoga does not have a significant impact on the health-related quality of life of this sample of participants.
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Affiliation(s)
- David Suárez-Iglesias
- VALFIS ResearchGroup, Institute of Biomedicine (IBIOMED), Faculty of Physical Activity and Sports Sciences, University of León, León, Spain
| | - Mabel García-Porro
- CRE Discapacidad y Dependencia, Institute for Older Persons and Social Services (IMSERSO), León, Spain
| | - Aisling Clardy
- UNESCO Chair in Disability Inclusive Physical Education, Sport, Recreation and Fitness, Munster Technological University (MTU), Kerry, Ireland
| | - Carlos Ayán Pérez
- Departamento de Didácticas Especiais, Universidade de Vigo, Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Pontevedra, Spain
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9
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Zhang W, Roster K, Hays RD, Wang C. Analysis of Movement-Based Mind-Body Interventions to Guide the Implementation of Osteoarthritis Exercise Programs: A Descriptive Review of Randomized Controlled Trials. J Altern Complement Med 2021; 27:442-457. [PMID: 33902322 DOI: 10.1089/acm.2020.0420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Clear and complete reporting of the components of complex interventions is required in clinical trials to ensure that research can be reliably replicated and successfully translated into clinical practice. Movement-based mind-body exercises, such as Tai Chi, qigong, and Yoga (TQY), are considered complex interventions and recommended for individuals with osteoarthritis in the latest guidelines of the American College of Rheumatology. This review analyzes the intervention reporting of randomized controlled trials of TQY to guide the implementation in osteoarthritis exercise programs. Methods: We searched PubMed, Cochrane Central Register of Controlled Trials, and EMBASE for TQY exercise trials in osteoarthritis between 2000 and 2020. Pairs of researchers independently screened the records, extracted study characteristics, and assessed 19 items on the Consensus on Exercise Reporting Template (CERT) checklist. For each of these items, the numbers of studies that clearly reported the item were calculated. We then identified the items in the studies that are key to delivering home-based exercises for further analysis. Results: We included 27 publications reporting 22 TQY interventions in the analysis. None of the studies reported sufficient details on all the 19 CERT items. The median completeness of reporting score was 11 and ranged from 6 to 15 of 19. The most frequently incompletely reported items (number reporting and percentage of studies) were "starting level rule" (n = 1, 5%) and "progression rule" (n = 1, 5%). Other incompletely reported items included "fidelity or adherence (planned)" (n = 9, 41%), "motivations" (n = 9, 41%), and "progression description" (n = 5, 23%). Conclusions: The content analysis highlights motivational strategies for long-term adherence to home-based exercises, which may help clinicians develop interventions for their patients. Details of TQY exercises interventions for osteoarthritis are incompletely reported in the included studies. The study suggests that improvements in content reporting are especially needed on items related to exercise intensity and program progression decisions, and motivational strategies in future implementation.
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Affiliation(s)
- Weijun Zhang
- Center for East-West Medicine, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.,Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Ron D Hays
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Chenchen Wang
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Department of Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
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Klempel N, Blackburn NE, McMullan IL, Wilson JJ, Smith L, Cunningham C, O’Sullivan R, Caserotti P, Tully MA. The Effect of Chair-Based Exercise on Physical Function in Older Adults: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1902. [PMID: 33669357 PMCID: PMC7920319 DOI: 10.3390/ijerph18041902] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/13/2022]
Abstract
Physical activity is an important determinant of health in later life. The public health restrictions in response to COVID-19 have interrupted habitual physical activity behaviours in older adults. In response, numerous exercise programmes have been developed for older adults, many involving chair-based exercise. The aim of this systematic review was to synthesise the effects of chair-based exercise on the health of older adults. Ovid Medline, EMBASE, CINAHL, AMED, PyscInfo and SPORTDiscus databases were searched from inception to 1 April 2020. Chair-based exercise programmes in adults ≥50 years, lasting for at least 2 weeks and measuring the impact on physical function were included. Risk of bias of included studies were assessed using Cochrane risk of bias tool v2. Intervention content was described using TiDieR Criteria. Where sufficient studies (≥3 studies) reported data on an outcome, a random effects meta-analysis was performed. In total, 25 studies were included, with 19 studies in the meta-analyses. Seventeen studies had a low risk of bias and five had a high risk of bias. In this systematic review including 1388 participants, results demonstrated that chair-based exercise programmes improve upper extremity (handgrip strength: MD = 2.10; 95% CI = 0.76, 3.43 and 30 s arm curl test: MD = 2.82; 95% CI = 1.34, 4.31) and lower extremity function (30 s chair stand: MD 2.25; 95% CI = 0.64, 3.86). The findings suggest that chair-based exercises are effective and should be promoted as simple and easily implemented activities to maintain and develop strength for older adults.
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Affiliation(s)
- Natalie Klempel
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey BT37 0QB, UK; (N.K.); (N.E.B.); (I.L.M.); (J.J.W.)
| | - Nicole E. Blackburn
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey BT37 0QB, UK; (N.K.); (N.E.B.); (I.L.M.); (J.J.W.)
| | - Ilona L. McMullan
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey BT37 0QB, UK; (N.K.); (N.E.B.); (I.L.M.); (J.J.W.)
| | - Jason J. Wilson
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey BT37 0QB, UK; (N.K.); (N.E.B.); (I.L.M.); (J.J.W.)
- Sport and Exercise Sciences Research Institute, School of Sport, Newtownabbey BT37 0QB, UK
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey BT37 0QB, UK
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Science, Anglia Ruskin University, Cambridge CB1 1PT, UK;
| | - Conor Cunningham
- Institute of Public Health, City Exchange, 11–13 Gloucester St, Belfast BT1 4LS, UK;
| | - Roger O’Sullivan
- The Bamford Centre for Mental Health & Wellbeing Ulster University, Coleraine BT52 1SA, UK;
| | - Paolo Caserotti
- Centre for Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark;
| | - Mark A. Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey BT37 0QB, UK
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11
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Miller KJ, Areerob P, Hennessy D, Gonçalves-Bradley DC, Mesagno C, Grace F. Aerobic, resistance, and mind-body exercise are equivalent to mitigate symptoms of depression in older adults: A systematic review and network meta-analysis of randomised controlled trials. F1000Res 2020; 9:1325. [PMID: 34158928 PMCID: PMC8191520 DOI: 10.12688/f1000research.27123.2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Exercise has been identified as an allied health strategy that can support the management of depression in older adults, yet the relative effectiveness for different exercise modalities is unknown. To meet this gap in knowledge, we present a systematic review and network meta-analysis of randomised controlled trials (RCTs) to examine the head-to-head effectiveness of aerobic, resistance, and mind-body exercise to mitigate depressive symptoms in adults aged ≥ 65 years. Methods: A PRISMA-NMA compliant review was undertaken on RCTs from inception to September 12
th, 2019. PubMed, Web of Science, CINAHL, Health Source: Nursing/Academic Edition, PsycARTICLES, PsycINFO, and SPORTDiscus were systematically searched for eligible RCTs enrolling adults with a mean age ≥ 65 years, comparing one or more exercise intervention arms, and which used valid measures of depressive symptomology. Comparative effectiveness was evaluated using network meta-analysis to combine direct and indirect evidence, controlling for inherent variation in trial control groups. Results: The systematic review included 82 RCTs, with 69 meeting eligibility for the network meta-analysis (
n = 5,379 participants). Pooled analysis found each exercise type to be effective compared with controls (Hedges’
g = -0.27 to -0.51). Relative head-to-head comparisons were statistically comparable between exercise types: resistance versus aerobic (Hedges’
g = -0.06,
PrI = -0.91, 0.79), mind-body versus aerobic (Hedges’
g = -0.12,
PrI = -0.95, 0.72), mind-body versus resistance (Hedges’
g = -0.06,
PrI = -0.90, 0.79). High levels of compliance were demonstrated for each exercise treatment. Conclusions: Aerobic, resistance, and mind-body exercise demonstrate equivalence to mitigate symptoms of depression in older adults aged ≥ 65 years, with comparably encouraging levels of compliance to exercise treatment. These findings coalesce with previous findings in clinically depressed older adults to encourage personal preference when prescribing exercise for depressive symptoms in older adults. Registration: PROSPERO
CRD42018115866 (23/11/2018).
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Affiliation(s)
- Kyle J Miller
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
| | - Pinyadapat Areerob
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
| | - Declan Hennessy
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
| | | | - Christopher Mesagno
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
| | - Fergal Grace
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
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Miller KJ, Areerob P, Hennessy D, Gonçalves-Bradley DC, Mesagno C, Grace F. Aerobic, resistance, and mind-body exercise are equivalent to mitigate symptoms of depression in older adults: A systematic review and network meta-analysis of randomised controlled trials. F1000Res 2020; 9:1325. [PMID: 34158928 PMCID: PMC8191520 DOI: 10.12688/f1000research.27123.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/08/2021] [Indexed: 08/29/2023] Open
Abstract
Background: Exercise has been identified as an allied health strategy that can support the management of depression in older adults, yet the relative effectiveness for different exercise modalities is unknown. To meet this gap in knowledge, we present a systematic review and network meta-analysis of randomised controlled trials (RCTs) to examine the head-to-head effectiveness of aerobic, resistance, and mind-body exercise to mitigate depressive symptoms in adults aged ≥ 65 years. Methods: A PRISMA-NMA compliant review was undertaken on RCTs from inception to September 12 th, 2019. PubMed, Web of Science, CINAHL, Health Source: Nursing/Academic Edition, PsycARTICLES, PsycINFO, and SPORTDiscus were systematically searched for eligible RCTs enrolling adults with a mean age ≥ 65 years, comparing one or more exercise intervention arms, and which used valid measures of depressive symptomology. Comparative effectiveness was evaluated using network meta-analysis to combine direct and indirect evidence, controlling for inherent variation in trial control groups. Results: The systematic review included 82 RCTs, with 69 meeting eligibility for the network meta-analysis ( n = 5,379 participants). Pooled analysis found each exercise type to be effective compared with controls (Hedges' g = -0.27 to -0.51). Relative head-to-head comparisons were statistically comparable between exercise types: resistance versus aerobic (Hedges' g = -0.06, PrI = -0.91, 0.79), mind-body versus aerobic (Hedges' g = -0.12, PrI = -0.95, 0.72), mind-body versus resistance (Hedges' g = -0.06, PrI = -0.90, 0.79). High levels of compliance were demonstrated for each exercise treatment. Conclusions: Aerobic, resistance, and mind-body exercise demonstrate equivalence to mitigate symptoms of depression in older adults aged ≥ 65 years, with comparably encouraging levels of compliance to exercise treatment. These findings coalesce with previous findings in clinically depressed older adults to encourage personal preference when prescribing exercise for depressive symptoms in older adults. Registration: PROSPERO CRD42018115866 (23/11/2018).
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Affiliation(s)
- Kyle J. Miller
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
| | - Pinyadapat Areerob
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
| | - Declan Hennessy
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
| | | | - Christopher Mesagno
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
| | - Fergal Grace
- School of Health and Life Sciences, Federation University, Ballarat, Victoria, 3350, Australia
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Park J, Sherman DG, Agogo G, Hoogendijk EO, Liu Z. Frailty modifies the intervention effect of chair yoga on pain among older adults with lower extremity osteoarthritis: Secondary analysis of a nonpharmacological intervention trial. Exp Gerontol 2020; 134:110886. [PMID: 32088398 PMCID: PMC7438234 DOI: 10.1016/j.exger.2020.110886] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/12/2020] [Accepted: 02/20/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE In an 8-week nonpharmacological pain intervention trial among older adults with lower extremity osteoarthritis (OA), we aimed to examine: a) the baseline frailty level of the participants; b) whether such intervention is more beneficial for baseline frailer older adults than for their counterparts with less frailty; and c) whether the intervention could also alter frailty. METHODS Participants were randomly assigned to either chair yoga (CY) or health education program (HEP) groups and attended twice-weekly 45-minute CY or HEP sessions for 8 weeks. Following a standard procedure, 82 variables were used to construct a frailty index (FI, 0-1). Primary outcomes were: Western Ontario and McMaster Universities (WOMAC) pain and pain interference. Linear mixed-effects models were used to evaluate the modifying effect of baseline frailty on the intervention effect of CY on primary outcomes. Similar models were used to evaluate the effect of CY on frailty. RESULTS A total of 112 participants (n = 63 CY, n = 49 HEP; 75.3 [SD = 7.5] years) with 85 females (75.9%) were included. The mean values of baseline FI for the CY and HEP groups were similar (0.428 [0.05] and 0.433 [0.05], P = 0.355). Each 0.01 increment in baseline FI was associated with higher WOMAC pain (beta = 0.28, P < 0.001) and pain interference (beta = 0.51, P < 0.001). There was a significant interaction effect between intervention, time, and baseline FI (P = 0.020 for WOMAC pain; P = 0.010 for pain interference), indicating that participants with higher level of baseline FI had greater declines in WOMAC pain and pain interference. There was no significantly greater decline in FI for the CY group compared to the HEP group (between-group difference - 0.01; P = 0.509) and there were no significant trend changes in FI (P for interaction = 0.605). CONCLUSIONS Frailty modifies the intervention effect of CY on pain among older adults with lower extremity OA, underscoring the importance of assessing frailty to improve the management of pain in this population.
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Affiliation(s)
- Juyoung Park
- Florida Atlantic University, Phyllis and Harvey Sandler School of Social Work, Boca Raton, FL, USA
| | - Diane G Sherman
- Florida Atlantic University, Phyllis and Harvey Sandler School of Social Work, Boca Raton, FL, USA
| | - George Agogo
- Centers for Disease Control and Prevention (CDC), Village Market, Nairobi, Kenya; Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Emiel O Hoogendijk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC-location VU University Medical Center, Amsterdam, Netherlands
| | - Zuyun Liu
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA; Department of Precision Health and Data Science, School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Effect of yoga on the quality of life of patients with rheumatic diseases: Systematic review with meta-analysis. Complement Ther Med 2019; 46:9-18. [DOI: 10.1016/j.ctim.2019.07.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/16/2019] [Accepted: 07/08/2019] [Indexed: 12/13/2022] Open
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Lauche R, Hunter DJ, Adams J, Cramer H. Yoga for Osteoarthritis: a Systematic Review and Meta-analysis. Curr Rheumatol Rep 2019; 21:47. [PMID: 31338685 DOI: 10.1007/s11926-019-0846-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
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. RECENT FINDINGS 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.
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Affiliation(s)
- Romy Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia. .,Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Buger Str. 80, Bamberg, 96049, Germany.
| | - David J Hunter
- Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Holger Cramer
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia.,Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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