Yoga a Boon for Patients With Rheumatoid Arthritis
To assess the short term impact of yoga on rheumatoid arthritis, Shirley Telles and colleagues simultaneously monitored disability and pain, hand grip strength, as well as rheumatoid factor levels and C Reactive Protein in patients with rheumatoid arthritis following yoga.
64 participants comprising of 47 women and 17 men, suffering from rheumatoid arthritis (RA) attended a one-week residential yoga camp organized by the Patanjali Research Foundation, Patanjali Yogpeeth, Haridwar, India. The aim of the exercise was to check whether the yoga program reduced the disability index scores and decreased the rheumatoid factor in participants of both sexes.
The camp had two sessions each day, from 5 am to 7.30 am, and from 5 pm to 7.30 pm. A study based on the Stanford Health Assessment Questionnaire (HAQ) was carried out on participants. At the start of the program, the participants in a group average age of 46.5 ± 9.6 years were assessed on HAQ, hand grip strength, rheumatoid factor, and C-reactive protein levels. These factors were re-assessed on the last day. The results were compared using a t-test for paired data.
Hand grip strength was measured using a standard method and a hydraulic hand grip dynamometer. Participants' hands were tested one by one, alternately in a single trial. Serum rheumatoid factor and C-reactive protein levels were measured by immunoturbidometry.
Participants at the camp practiced pranayamas or voluntarily regulated yoga breathing, 50 percent of the time that they were there. Loosening exercises - including flexion, extension, and rotation of the shoulder and wrists, known as sukshma vyayama was practiced by them 25 percent of the time. It also comprised of flexion and extension of the elbow and fingers. Added to these was slow and deep breathing, and yoga postures, known as asanas, practiced 25 percent of the whole duration. Some movements were similar to those used in a study on yoga for carpal tunnel syndrome.
The breathing techniques included:
• kapalabhati - high frequency yoga breathing at the rate of 1.0 Hz,
• anulom-vilom pranayama - breathing through alternate nostrils,
• brahmari and udgeeth pranayamas - exhalation with specific sounds, and
• bahya and ujjayi pranayamas - breathing while holding the breath briefly, or with a voluntarily partially constricted glottis.
All participants showed reduced disability scores of the HAQ and rheumatoid factor levels, with an increase in bilateral hand grip strength in male participants.
The researchers concluded - 'This single group study indicated that a brief intensive yoga program was beneficial in RA, with decreased disability, better functionality and changes in the rheumatoid factor levels suggesting improvement'. However, there were limitations to the study such as lack of a control group for comparison, self-selected group, and a residential facility serving strict vegetarian diet.