Yoga noninferior to strengthening exercises for managing knee OA

In patients with knee osteoarthritis (OA), yoga is only as good as strengthening exercises at reducing pain, according to a study.

The single-centre study included 117 adults (mean age 62.5 years, 72.6 percent female) with knee OA and knee pain levels of at least 40 on a 100-mm visual analogue scale (VAS). These patients had moderate pain at baseline, with the mean VAS knee pain score being 53.8.

The patients were randomly allocated to either the yoga (n=58) or strengthening exercise (n=59) group. Both interventions involved two supervised and one home-based session per week for 12 weeks followed by three unsupervised home-based sessions per week for another 12 weeks.

Intention-to-treat analysis showed that over 12 weeks, the primary outcome of VAS knee pain score decreased by 17.7 mm with yoga and by 16.7 mm with strengthening exercises. The difference of −1.1 mm remained within the prespecified noninferiority margin.

Seven of the 27 secondary outcomes assessed over 12 and 24 weeks favoured yoga over strengthening exercises. Compared with the strengthening exercise group, the yoga group showed greater improvements over 24 weeks for Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain (−44.5 mm), WOMAC function (−139 mm), WOMAC stiffness (−17.6 mm), patient global assessment (−7.6 mm), and 40-m fast-paced walk test (1.8). Additionally, the yoga group had greater improvements in depression at 12 weeks (Patient Health Questionnaire–9 score −1.1) and quality of life at 24 weeks (Assessment of Quality of Life–8 Dimensions score 0.04).

Adverse events were generally mild and similar in both groups.

The findings suggest that yoga may represent as an alternative or complementary exercise option in the management of knee OA in clinical practice.