Online yoga program improved physical function in patients with knee osteoarthritis

Home-based online yoga programs may help improve physical function in patients with knee osteoarthritis, a randomized trial found.

The study randomized 212 adults in Australia with symptomatic knee osteoarthritis, 105 to the control group and 107 to the yoga group. Both groups received online osteoarthritis information (control), and the yoga group also received access to an unsupervised, online, low-intensity yoga program delivered via prerecorded videos over 12 weeks (one video per week, with each session to be performed three times per week), with optional continuation thereafter. Primary outcomes were changes in knee pain during walking (0 to 10 on a numerical rating scale; minimal clinically important difference, 1.8) and physical function (0 to 68 on the Western Ontario and McMaster Universities Osteoarthritis Index; minimal clinically important difference, 6) at 12 weeks, with a secondary time point of 24 weeks. Secondary outcomes included self-reported overall knee pain, stiffness, depression, anxiety, stress, global change, quality of life, self-efficacy, fear of movement, and balance confidence. Results were published Sept. 20 by Annals of Internal Medicine.

One hundred ninety-five (92%) and 189 (89%) participants provided 12- and 24-week primary outcomes, respectively. At 12 weeks, yoga improved function compared to control (between-group mean difference in change, −4.0 [95% CI, −6.8 to −1.3]) but not knee pain during walking (between-group mean difference in change, −0.6 [95% CI, −1.2 to 0.1]). More yoga participants

than control participants achieved the minimal clinically important difference for both outcomes. At 12 weeks, knee stiffness, quality of life, and arthritis self-efficacy improved more with yoga than with the control intervention; however, benefits were not maintained at 24 weeks. Adverse events were mostly musculoskeletal pain episodes and were more often reported by yoga participants than control participants.

Participants were unblinded to the interventions, the study authors noted. They added that because the yoga program was unsupervised, it is unknown whether the participants performed the yoga elements correctly or completely, among other limitations.

“Our results are promising, but further research is needed to fully establish the effects of unsupervised online yoga and to potentially improve on our program in order to enhance treatment benefits,” the authors wrote. “Given decreasing adherence over the follow-up period and the link between adherence and clinical outcomes, longer-term behavior change strategies to maximize engagement should be identified.”