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THU0573 (2020)
YOGA LEADS TO SUSTAINED IMPROVEMENT IN FATIGUE AND MOOD IN RHEUMATOID ARTHRITIS: PRELIMINARY RESULTS OF A RANDOMIZED CONTROLLED TRIAL
S. Puksic1, J. Mitrovic1,2, M. I. Culo1, M. Zivkovic3, B. Orehovec3, M. Lucijanic4, D. Bobek5, J. Morovic-Vergles1,2
1University Hospital Dubrava, Clinical Immunology, Rheumatology and Allergology, Zagreb, Croatia
2Univ. of Zagreb, School of Medicine, Zagreb, Croatia
3University Hospital Dubrava, Clin. Dep. of Laboratory Diagnostics, Zagreb, Croatia
4University Hospital Dubrava, Hematology, Zagreb, Croatia
5University Hospital Dubrava, Physical Med. and Rehabilitation with Rheumatology, Zagreb, Croatia

Background: Rheumatoid arthritis (RA) patients experience reduced health-related quality of life (HRQOL). Previous studies suggest that yoga, a mind-body practice, can improve physical and mental health but it has not been extensively studied in RA.


Objectives: To investigate the effect of yoga on HRQOL and secondary on fatigue, anxiety, depression and disease activity in RA patients


Methods: 43 RA patients (mean (SD) age 55 (10) years, median (IQR) disease duration 5 (3,8) years, 93% female), stable on standard pharmacological treatment and DAS28CRP < 5.1 were randomly assigned to 12 weeks yoga intervention (2x/week 90 min; n=22) or arthritis-related educational lectures control (1x/week 60 min; n=21). Yoga based on „Yoga in daily life system“ included asanas, relaxation, pranayama and meditation. Study evaluations at baseline, post-intervention and 3-month follow-up included The Short Form-36 (SF-36) scores for Physical Component Summary (PCS) and Mental Component Summary (MCS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Hospital Anxiety and Depression scale (HADS) and Disease Activity Score-28CRP (DAS28CRP) questionnaires. Data were presented as change from baseline to each time point. Between group differences were analyzed using the t-test for normally and Mann-Whitney U test for non-normally distributed variables. P values <0.05 were considered statistically significant.


Results: 35 patients (17 = intervention, 18 = control group) completed the trial period. Significant improvement in FACIT-F (p=0.013), HADS anxiety (p=0.047) and HADS depression (p=0.004) was found in yoga group compared to control at post-intervention and maintained at follow-up (p=0.025, p=0.02 and p=0.045, respectively). There was no significant difference found between groups for SF-36 MCS, PCS and DAS28CRP at all time points (all p>0.05). No serious adverse events were observed during trial period.


Conclusion: Although no change in SF-36 scores and disease activity was observed, yoga practice produced significant and sustained improvement in fatigue and mood which strongly account for decreased life quality in RA. Despite limitations our findings suggest that yoga may be of benefit in management of RA patients.

Changes in outcomes

N= 37 (postintervention ) N= 35 (follow-up )
Variables Baseline mean (SD ) Change from baseline (95%CI ) Difference between groups (95%CI, p-value ) Change from baseline (95%CI ) Difference between groups (95%CI, p-value )
FACIT-F (0-52) Yoga 33.89 (10.77) Control 35.37 (9.3) 4.18 (-0.26,8.61) -2.17 (-5.58,1.25) 6.66 (1.53,11.78) p= 0.013 3.29 (-1.23,7.82) -3.33 (-7.27,0.61) 6.63 (0.85,12.4) p=0.025
HADS-A (0-21) Yoga 7.39 (3.72) Control 6.89 (2.86) -1.94 (-3.28,-0.6) 0.056 (-1.39,1.51) -1.83 (-3.64,-0.024) p= 0.047 -2.24 (-3.63,-0.84) 0.17 (-1.38,1.71) -2.4 (-4.4,-0.04) p=0.02
HADS-D (0-21) Yoga 5.11 (3.03) Control 5.0 (1.82) -1.06 (-1.92,-0.2) 0.83 (-0.06,1.72) -1.73 (-2.88,-0.58) p= 0.004 -0.2 (-1.1,0.63) 0.94 (0.12,1.77) -1.18 (-2.33,-0.03) p=0.045
SF-36:MCS (0-100) Yoga 49.49 (11.99) Control 49.71 (8.99) 2.97 (-4.15,10.09) -1.59 (-7.51,4.33) 3.86 (-4.66,12.33) p= 0.366 1.25 (-3.62,6.12) -0.45 (-5.56,4.65) 1.7 (-5.09,8.49) p=0.618
SF-36:PCS (0-100) Yoga 52.57 (10.11) Control 48.30 (9.76) 0.44 (-3.13,4.02) -1.16 (-4.81,2.48) 1.61 (-3.31,6.53) p= 0.511 -1.54 (-5.44,2.35) 0.35 (-3.21,3.92) -1.9 (-6.98,3.18) p=0.453
DAS28CRP Yoga 2.32 (0.81) Control 2.91 (0.84) -0.0024 (-0.42,0.42) -0.096 (-0.45,0.26) 0.093 (-0.44,0.63) p=0.724 0.11 (-0.43,0.66) -0.54 (-0.92,-0.17) 0.66 (0.02,1.3) p=0.092

Disclosure of Interests: Silva Puksic: None declared, Josko Mitrovic: None declared, Melanie-Ivana Culo: None declared, Marcela Zivkovic: None declared, Biserka Orehovec: None declared, Marko Lucijanic: None declared, Dubravka Bobek: None declared, Jadranka Morovic-Vergles Speakers bureau: Abbvie., Roche, MSD, Eli Lilly, Pfizer, Mylan, Amgen, Fresenius Kabi

Citation: Ann Rheum Dis, volume 79, supplement 1, year 2020, page 524
Session: Rehabilitation (Poster Presentations)