Yoga in Systemic Lupus Erythematosus: Results of a Pragmatic Trial
DOI:
https://doi.org/10.12970/2310-9874.2014.02.03.3Keywords:
Systemic Lupus Erythematosus (SLE), yoga, intervention.Abstract
Objective: To evaluate the feasibility and potential benefits of initiating a yoga program adapted for persons with systemic lupus erythematosus (SLE).
Methods: We conducted a pragmatic trial of standard treatment (control group) or standard treatment plus yoga classes (intervention group) in persons with SLE. The intervention consisted of 16 yoga classes over an eight-week period. Evaluation of feasibility and benefits included measurements of compliance and results of post-intervention surveys and focus group discussions following completion of the yoga intervention.
Results: The average age was 38.6±12.6, 96% were female, the mean SLE disease duration was 9.8±7.9 years, and mean SLE Disease Activity Index (SLEDAI-2K) score was 4.0±4.0. There were no significant differences between baseline characteristics between the groups. In the yoga intervention group, class attendance averaged 63% (range 39-87%); home practice averaged 1.2±1.3 hours/week. Results of post intervention surveys and focus group discussions indicated that all participants who had received the yoga intervention experienced improvement in physical and psychological well-being, including improvement in stress and pain management, improved sleep quality and decreased fatigue. Participants expressed satisfaction with the yoga program and recommended longer and more frequent classes. All yoga participants voiced interest in continuing the adapted program but were hesitant to try programs not tailored for chronic diseases like SLE.
Conclusions: Our adapted yoga program was well tolerated and positive effects were experienced. The results suggest that an adapted yoga program provides persons with SLE with an opportunity to experience yoga and its accompanying benefits.
References
Dubois EL. Dubois' Lupus Erythematosus. 2nd revised ed. Los Angeles: USA Press 1976.
Mills JA. Systemic lupus erythematosus. N Engl J Med 1994; 330(26): 1871-9. http://dx.doi.org/10.1056/NEJM199406303302608
Boumpas DT, Fessler BJ, Austin HA, et al. Systemic lupus erythematosus: emerging concepts. Part 2: Dermatologic and joint disease, the antiphospholipid antibody syndrome, pregnancy and hormonal therapy, morbidity and mortality, and pathogenesis. [Review] Ann Intern Med 1995; 123(1): 42-53. http://dx.doi.org/10.7326/0003-4819-123-1-199507010-00007
Boumpas DT, Austin HA, Fessler BJ, et al. Systemic lupus erythematosus: emerging concepts. Part 1: Renal, neuropsychiatric, cardiovascular, pulmonary, and hematologic disease. [Review] Ann Intern Med 1995; 122(12): 940-50. http://dx.doi.org/10.7326/0003-4819-122-12-199506150-00009
Meacock R, Dale N, Harrison MJ. The humanistic and economic burden of systemic lupus erythematosus: a systematic review. Pharmacoeconomics 2013; 31: 49-61. http://dx.doi.org/10.1007/s40273-012-0007-4
Da Costa D, Dobkin PL, Pinard L, et al. The role of stress in functional disability among women with systemic lupus erythematosus: a prospective study. Arthritis Care Res 1995; 12(2): 112-119.
Dobkin PL, Fortin PR, Joseph L, Esdaile JM, Danoff DS, Clarke AE. Psychosocial contributors to mental and physical health in patients with systemic lupus erythematosus. Arthritis Care Res 1995; 11(1): 23-31.
Dobkin PL, Da Costa D, Fortin PR, et al. Living with lupus: a prospective pan-Canadian study. J Rheumatol 2001; 28(11): 2442-2448.
Wekking EM. Psychiatric symptoms in systemic lupus erythematosus: an update. PsychosomMed 1993; 55(2): 219-28. http://dx.doi.org/10.1097/00006842-199303000-00011
Bussing A, Ostermann T, Ludtke R, Michalsen A: Effects of yoga interventions on pain and pain-associated disability: a meta-analysis. J Pain 2012; 13: 1-9. http://dx.doi.org/10.1016/j.jpain.2011.10.001
Uhlig T. Tai Chi and yoga as complementary therapies in rheumatologic conditions. Best Pract Res Clin Rheumatol 2012; 26: 387-98. http://dx.doi.org/10.1016/j.berh.2012.05.006
Ward L, Stebbings S, Cherkin D, Baxter GD. Yoga for Functional Ability, Pain and Psychosocial Outcomes in Musculoskeletal Conditions: A Systematic Review and Meta-Analysis. Musculoskeletal Care 2013; 11(4): 203-17. http://dx.doi.org/10.1002/msc.1042
Bosch PR, Traustadottir T, Howard P, Matt KS: Functional and physiological effects of yoga in women with rheumatoid arthritis: a pilot study. Altern Ther Health Med 2009; 15: 24-31.
Evans S, Moieni M, Taub R, et al. Iyengar yoga for young adults with rheumatoid arthritis: results from a mixed-methods pilot study. J Pain Symptom Manage 2010; 39: 904-13. http://dx.doi.org/10.1016/j.jpainsymman.2009.09.018
Evans S, Moieni M, Lung K, et al. Impact of Iyengar Yoga on Quality of Life in Young Women with Rheumatoid Arthritis. Clin J Pain 2013 Nov; 29(11): 988-97. http://dx.doi.org/10.1097/AJP.0b013e31827da381
Evans S, Moieni M, Subramanian S, Tsao JC, Sternlieb B, Zeltzer LK. "Now I see a brighter day": expectations and perceived benefits of an Iyengar yoga intervention for young patients with rheumatoid arthritis. J Yoga Phys Ther 2011; 1: 101. http://dx.doi.org/10.4172/2157-7595.1000101
Badsha H, Chhabra V, Leibman C, Mofti A, Kong KO. The benefits of yoga for rheumatoid arthritis: results of a preliminary, structured 8-week program. Rheumatol Int 2009; 29: 1417-21. http://dx.doi.org/10.1007/s00296-009-0871-1
Telles S, Naveen KV, Gaur V, Balkrishna A. Effect of one week of yoga on function and severity in rheumatoid arthritis. BMC Res Notes 2011; 4: 118. http://dx.doi.org/10.1186/1756-0500-4-118
Singh VK, Bhandari RB, Rana BB.Effect of yogic package on rheumatoid arthritis. Indian J Physiol Pharmacol 2011; 55: 329-35.
Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH, The Committee on Prognosis Studies in SLE. Derivation of the SLEDAI. A disease activity index for lupus patients. Arthritis Rheum 1992; 35(6): 630-40. http://dx.doi.org/10.1002/art.1780350606
Gladman DD, Ginzler E, Goldsmith C, et al. The development and initial validation of the SLICC/ACR damage index for SLE. Arthritis Rheum 1996; 39(3): 363-9. http://dx.doi.org/10.1002/art.1780390303
Shapiro D, Cook IA, Dmitry M. et al. Yoga as a Complementary Treatment of Depression: Effects of Traits and Moods on Treatment Outcome Evid Based Complement Alternat Med 2007; 4(4): 493-502. http://dx.doi.org/10.1093/ecam/nel114
Tilbrook HE, Cox H, Hewitt CE, et al. Yoga for chronic low back pain: a randomized trial. Ann Intern Med 2011; 155: 569-78. http://dx.doi.org/10.7326/0003-4819-155-9-201111010-00003
Carson JW, Carson KM, Jones KD, Mist SD, Bennett RM. Follow-up of yoga of awareness for fibromyalgia: results at 3 months and replication in the wait-list group. Clin J Pain 2012; 28: 804-13. http://dx.doi.org/10.1097/AJP.0b013e31824549b5
Ward L, Treharne GJ, Stebbings S. The suitability of yoga as a potential therapeutic intervention for rheumatoid arthritis: a focus group approach. Musculoskeletal Care 2011; 9: 211-21. http://dx.doi.org/10.1002/msc.217
