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Yoga for Treating Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

PainSci » bibliography » Ye et al 2020
Tags: treatment, self-treatment, arthritis, stretch, exercise, yoga, aging, pain problems, muscle

PainSci notes on Ye 2020:

This is mostly a garbage-in-garbage-out scientific review of yoga for rheumatoid arthritis, incapable of answering the question because no one has ever studied it properly. However, I am going to cite it anyway, and make fun of an amusing (and telling) contradiction in the abstract. The summary leads with “yoga may be beneficial” in a couple vague ways, but in the very next sentence “the balance of evidence shows that yoga had no significant effect” on pretty much anything that actually matters (pain, swelling). Technically, this not a contradiction, because they are talking about different outcomes. But almost any fan of yoga is going to be all you had me at “may be beneficial.”

Plus both “conclusions” aren’t actually conclusions anyway, because the data is so thin and junky.

What very little positive signal there is here is likely a benefit of almost any kind of physical activity — no magic-of-yoga required.

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

PURPOSE: Rheumatoid arthritis (RA) is a pervasive inflammatory autoimmune disease that seriously impairs human health and requires more effective non-pharmacologic treatment approaches. This study aims to systematically review and evaluate the efficacy of yoga for patients with RA.

METHODS: Medline (through PubMed), Cochrane Library, EMBASE (through SCOPUS), and Web of Science database were screened through for articles published until 20 July 2020. Randomized controlled trials (RCTs) of yoga in patients with RA were included. Outcomes measures were pain, physical function, disease activity, inflammatory cytokines, and grip strength. For each outcome, standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. Result: Ten trials including 840 patients with RA aged 30-70 years were identified, with 86% female participants. Meta-analysis revealed a statistically significant overall effect in favor of yoga for physical function (HAQ-DI) (5 RCTs; SMD = -0.32, 95% CI -0.58 to -0.05, I2 = 15%, P = 0.02), disease activity (DAS-28) (4 RCTs; SMD = -0.38, 95% CI -0.71 to -0.06, I2 = 41%, P = 0.02) and grip strength (2 RCTs; SMD = 1.30, 95% CI 0.47-2.13, I2 = 63%, P = 0.002). No effects were found for pain, tender joints, swollen joints count or inflammatory cytokines (i.e., CRP, ESR, IL-6, and TNF-α).

SUMMARY: The findings of this meta-analysis indicate that yoga may be beneficial for improving physical function, disease activity, and grip strength in patients with RA. However, the balance of evidence showed that yoga had no significant effect in improving pain, tender joints, swollen joints count, and inflammatory cytokines in patients suffering from RA. Considering methodological limitations, small sample size, and low-quality, we draw a very cautious conclusion in the results of the estimate of the effect. High-quality and large-scale RCTs are urgently needed in the future, and the real result may be substantially different.

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