Yoga for managing knee osteoarthritis in older women: a pilot randomized controlled trial

Abstract (provisional)


Osteoarthritis (OA) is a common problem in older women that is associated with pain and disabilities. Although yoga is recommended as an exercise intervention to manage arthritis, there is limited evidence documenting its effectiveness, with little known about its long term benefits. This study's aims were to assess the feasibility and potential efficacy of a Hatha yoga exercise program in managing OA-related symptoms in older women with knee OA.


Eligible participants (N = 36; mean age 72 years) were randomly assigned to 8-week yoga program involving group and home-based sessions or wait-list control. The yoga intervention program was developed by a group of yoga experts (N = 5). The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score that measures knee OA pain, stiffness, and function at 8 weeks. The secondary outcomes, physical function of the lower extremities, body mass index (BMI), quality of sleep (QOS), and quality of life (QOL), were measured using weight, height, the short physical performance battery (SPPB), the Pittsburgh Sleep Quality Index (PSQI), the Cantril Self-Anchoring Ladder, and the SF12v2 Health Survey. Data were collected at baseline, 4 weeks and 8 weeks, and 20 weeks.


The recruitment target was met, with study retention at 95%. Based on ANCOVAs, participants in the treatment group exhibited significantly greater improvement in WOMAC pain (adjusted means [SE]) (8.3[.67], 5.8[.67]; p = .01), stiffness (4.7[.28], 3.4[.28]; p = .002) and SPPB (repeated chair stands) (2.0[.23], 2.8[.23]; p = .03) at 8 weeks. Significant treatment and time effects were seen in WOMAC pain (7.0 [.46], 5.4[.54]; p = .03), function (24.5[1.8], 19.9[1.6]; p = .01) and total scores (35.4[2.3], 28.6[2.1]; p = .01) from 4 to 20 weeks. Sleep disturbance was improved but the PSQI total score declined significantly at 20 weeks. Changes in BMI and QOL were not significant. No yoga related adverse events were observed.


A weekly yoga program with home practice is feasible, acceptable, and safe for older women with knee OA, and shows therapeutic benefits.

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Alex’s notes: I do yoga and I love it. There are various types ranging from the posture-controlling breath focus of Hatha to the physically intense and graceful movements of Vinyasa. Either way, yoga is an excellent tool for anyone to improve their flexibility, stability, and mobility. This is especially important in musculoskeletal disorders such as osteoarthritis (OA), which is the most common form of arthritis in older women – notably at the knee joint. Although previous meta-analysis have concluded yoga to be effective in treating chronic pain and low-back problems in youth, its effects in older adult populations are less studied. The study at hand thus aimed to evaluate the effectiveness of an eight week Hatha yoga program using group and home-based sessions in older women with knee OA.

36 women averaging 70-years of age and a BMI of 29 completed the study. None were currently in an exercise program or had undergone surgery or other treatments related to their OA. These women were divided into two groups – the yoga group and the control group. The yoga program included one supervised 60-minute Hatha yoga session per week with participants instructed to practice 30-minutes of yoga four times weekly at their homes.

After the eight weeks, significant reductions in pain and stiffness were found for the yoga group. Additionally, the yoga group improved significantly for a repeated chair-stand fitness test (i.e. they could get up and down out of a chair multiple times with more ease), and sleep disturbances were significantly improved at a 20-week follow-up. Overall, the yoga program was very feasible and effective in helping to manage OA in older women, and it was also very adherable with over 75% of the classes being attended.


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