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6. Ayurveda in Knee Osteoarthritis—Secondary Analyses of a Randomized Controlled Trial

Author

Kessler, Christian S., primary, Jeitler, Michael, additional, Dhiman, Kartar S., additional, Kumar, Abhimanyu, additional, Ostermann, Thomas, additional, Gupta, Shivenarain, additional, Morandi, Antonio, additional, Mittwede, Martin, additional, Stapelfeldt, Elmar, additional, Spoo, Michaela, additional, Icke, Katja, additional, Michalsen, Andreas, additional, Witt, Claudia M., additional, and Wischnewsky, Manfred B., additional

Published
2022
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7. Ayurveda in Knee Osteoarthritis—Secondary Analyses of a Randomized Controlled Trial

Author

Kessler, Christian S, Jeitler, Michael; https://orcid.org/0000-0003-3277-9090, Dhiman, Kartar S, Kumar, Abhimanyu, Ostermann, Thomas; https://orcid.org/0000-0003-2695-0701, Gupta, Shivenarain, Morandi, Antonio, Mittwede, Martin, Stapelfeldt, Elmar, Spoo, Michaela, Icke, Katja; https://orcid.org/0000-0002-4170-8430, Michalsen, Andreas, Witt, Claudia M; https://orcid.org/0000-0002-5440-7805, Wischnewsky, Manfred B, Kessler, Christian S, Jeitler, Michael; https://orcid.org/0000-0003-3277-9090, Dhiman, Kartar S, Kumar, Abhimanyu, Ostermann, Thomas; https://orcid.org/0000-0003-2695-0701, Gupta, Shivenarain, Morandi, Antonio, Mittwede, Martin, Stapelfeldt, Elmar, Spoo, Michaela, Icke, Katja; https://orcid.org/0000-0002-4170-8430, Michalsen, Andreas, Witt, Claudia M; https://orcid.org/0000-0002-5440-7805, and Wischnewsky, Manfred B

Abstract

Background: Ayurveda is widely practiced in South Asia in the treatment of osteoarthritis (OA). The aim of these secondary data analyses were to identify the most relevant variables for treatment response and group differences between Ayurvedic therapy compared to conventional therapy in knee OA patients. Methods: A total of 151 patients (Ayurveda n = 77, conventional care n = 74) were analyzed according to the intention-to-treat principle in a randomized controlled trial. Different statistical approaches including generalized linear models, a radial basis function (RBF) network, exhausted CHAID, classification and regression trees (CART), and C5.0 with adaptive boosting were applied. Results: The RBF network implicated that the therapy arm and the baseline values of the WOMAC Index subscales might be the most important variables for the significant between-group differences of the WOMAC Index from baseline to 12 weeks in favor of Ayurveda. The intake of nutritional supplements in the Ayurveda group did not seem to be a significant factor in changes in the WOMAC Index. Ayurveda patients with functional limitations > 60 points and pain > 25 points at baseline showed the greatest improvements in the WOMAC Index from baseline to 12 weeks (mean value 107.8 ± 27.4). A C5.0 model with nine predictors had a predictive accuracy of 89.4% for a change in the WOMAC Index after 12 weeks > 10. With adaptive boosting, the accuracy rose to 98%. Conclusions: These secondary analyses suggested that therapeutic effects cannot be explained by the therapies themselves alone, although they were the most important factors in the applied models. Keywords: Ayurveda; traditional Indian medicine; knee osteoarthritis; complementary medicine; integrative medicine

Published
2022

8. Mündlichkeit

Author

Auffarth, Christoph, Stapelfeldt, Elmar, Auffarth, Christoph, editor, Bernard, Jutta, editor, Mohr, Hubert, editor, Imhof, Agnes, editor, and Kurre, Silvia, editor

Published
1999
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9. Ayurvedic vs. Conventional Nutritional Therapy Including Low-FODMAP Diet for Patients With Irritable Bowel Syndrome—A Randomized Controlled Trial

Author

Jeitler, Michael, primary, Wottke, Till, additional, Schumann, Dania, additional, Puerto Valencia, Laura M., additional, Michalsen, Andreas, additional, Steckhan, Nico, additional, Mittwede, Martin, additional, Stapelfeldt, Elmar, additional, Koppold-Liebscher, Daniela, additional, Cramer, Holger, additional, Wischnewsky, Manfred, additional, Murthy, Vijayendra, additional, and Kessler, Christian S., additional

Published
2021
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10. Ayurvedic vs. Conventional Nutritional Therapy Including Low-FODMAP Diet for Patients With Irritable Bowel Syndrome ��� A Randomized Controlled Trial

Author

Jeitler, Michael, Wottke, Till, Schumann, Dania, Puerto Valencia, Laura M., Michalsen, Andreas, Steckhan, Nico, Mittwede, Martin, Stapelfeldt, Elmar, Koppold-Liebscher, Daniela, Cramer, Holger, Wischnewsky, Manfred, Murthy, Vijayendra, and Kessler, Christian S.

Subjects
irritable bowel syndrome, integrative medicine, clinical trials, Medizin, nutrition – clinical, Clinical Trial, complementary medicine, Medicine, nutrition - clinical, ddc:610, Traditional Indian Medicine, Ayurveda, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
Abstract

Aims: To compare the effects of Ayurvedic and conventional nutritional therapy in patients with irritable bowel syndrome (IBS). Methods: Sixty-nine patients with IBS were randomized to Ayurvedic (n = 35) or conventional nutritional therapy according to the recommendations of the German Nutrition Society including the low-FODMAP diet (n = 34). Study visits took place at baseline and after 1, 3, and 6 months. The primary outcome was IBS symptom severity (IBS-SSS) after 3 months; secondary outcomes included stress (CPSS), anxiety and depression (HADS), well-being (WHO-5) and IBS-specific quality of life (IBS-QOL). A repeated measures general linear model (GLM) for intent-to-treat-analyses was applied in this explorative study. Results: After 3 months, estimated marginal means for IBS-SSS reductions were 123.8 [95% confidence interval (95% CI) = 92.8–154.9; p < 0.001] in the Ayurvedic and 72.7 (95% CI = 38.8–106.7; p < 0.001) in the conventional group. The IBS-SSS reduction was significantly higher in the Ayurveda group compared to the conventional therapy group (estimated marginal mean = 51.1; 95% CI = 3.8–98.5; p = 0.035) and clinically meaningful. Sixty-eight percentage of the variance in IBS-SSS reduction after 3 months can be explained by treatment, 6.5% by patients' expectations for their therapies and 23.4% by IBS-SSS at pre-intervention. Both therapies are equivalent in their contribution to the outcome variance. The higher the IBS-SSS score at pre-intervention and the larger the patients' expectations, the greater the IBS-SSS reduction. There were no significant group differences in any secondary outcome measures. No serious adverse events occurred in either group. Conclusion: Patients with IBS seem to benefit significantly from Ayurvedic or conventional nutritional therapy. The results warrant further studies with longer-term follow-ups and larger sample sizes. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT03019861, identifier: NCT03019861. CA extern

Published
2021
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13. Reliability of Ayurvedic Diagnosis for Knee Osteoarthritis Patients: A Nested Diagnostic Study Within a Randomized Controlled Trial

Author

Kessler, Christian S., primary, Morandi, Antonio, additional, Kumar, Abhimanyu, additional, Dhiman, Kartar S., additional, Gupta, Shivenarain, additional, Icke, Katja, additional, Bühner, Carina, additional, Stapelfeldt, Elmar, additional, Wischnewsky, Manfred, additional, Kronpaß, Ludwig, additional, Murthy, Vijayendra, additional, Michalsen, Andreas, additional, and Witt, Claudia M., additional

Published
2019
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17. Comparative effectiveness of Ayurveda and conventional care in knee osteoarthritis - a randomized controlled trial (CARAKA)

Author

Kessler, Christian, Dhiman, Kartar, Kumar, Abhimanyu, Ostermann, Thomas, Gupta, Shivenarain, Morandi, Antonio, Mittwede, Martin, Stapelfeldt, Elmar, Spoo, Michaela, Icke, Katja, Michalsen, Andreas, and Witt, Claudia

Subjects
musculoskeletal diseases, Integrative Medicine, Indian Medicine, ddc: 610, Osteoarthritis, Complementary Medicine, 610 Medical sciences, Medicine, musculoskeletal system, human activities, Ayurveda, RCT
Abstract

Background: Ayurveda is used to treat knee osteoarthritis (OA) despite limited evidence. We aimed to evaluate the effectiveness of complex multimodality Ayurvedic treatment in comparison to conventional care in OA knee patients. Methods: Patients with OA of the knee according to ACR criteria were[for full text, please go to the a.m. URL], 44. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh); 30. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh); 26. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

Published
2016
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18. Ayurvedic versus conventional dietary and lifestyle counseling for mothers with burnout-syndrome: A randomized controlled pilot study including a qualitative evaluation

Author

Kessler, Christian S., primary, Eisenmann, Clemens, additional, Oberzaucher, Frank, additional, Forster, Martin, additional, Steckhan, Nico, additional, Meier, Larissa, additional, Stapelfeldt, Elmar, additional, Michalsen, Andreas, additional, and Jeitler, Michael, additional

Published
2017
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19. The Effect of a Complex Multi-modality Ayurvedic Treatment in a Case of Unknown Female Infertility

Author

Kessler, Christian, Stapelfeldt, Elmar, Michalsen, Andreas, Kowalcek, Ingrid, Kronpaß, Ludwig, and Dhruva, Anand

Abstract

Background: Treatment of female infertility has been growing globally in recent years. In spite of improvements in medical strategies and the improved outcomes for infertile couples, treatment attempts remain largely unsuccessful. A growing number of patients pursue complementary and alternative medicine treatment options like Ayurveda that offers a variety of inpatient and outpatient treatments for infertility. Case Report: A case of a 38 year-old woman with infertility of unknown origin is presented. She received 18 conventional fertility treatments in 5 different fertility centers and 3 different countries. After several complications, the patient quitted conventional treatment and admitted to an Ayurvedic outpatient clinic where she received a complex Ayurvedic treatment, which included botanicals, dietary and lifestyle advice, manual therapy, yoga, and spiritual elements. The patient then became pregnant and gave birth to a healthy boy in 2012. Conclusions: Ayurveda may be a useful complementary option in the case of futile conventional treatment attempts in female infertility. Nevertheless, the evidence base for Ayurvedic interventions remains weak and requires well-designed clinical trials. This case raises some questions, such as whether the exposure to a large number of assisted reproduction procedures can lead to more health problems than health benefits. The Ayurvedic approach to fertility strives first to improve the health of the patient leading to a higher likelihood of pregnancy. As this is a case report, we are not able to exclude temporal factors stimulating the pregnancy. However, the chronology suggests that this approach might have been an important factor in the eventual pregnancy. © 2015 S. Karger GmbH, Freiburg

Published
2024
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20. āhāra - Ayurveda-Ernährung

Author

Stapelfeldt, Elmar

Abstract

Masala: Newsletter Virtuelle Fachbibliothek Südasien, Bd. 9, Nr. 3 (2014), Beginn und Erscheinungsfrequenz: Nummer: 1, Jahr: 2014, Bände pro Jahr: 4

Published
2014
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26. Complex ayurvedic treatment for osteoarthritis of the knee (CARAKA-Trial) – First results of a randomized controlled trial comparing ayurveda and conventional standard care

Author

Kessler, Christian S., primary, Ostermann, Thomas, additional, Gupta, Shivenarain, additional, Stapelfeldt, Elmar, additional, Spoo, Michaela, additional, Morandi, Antonio, additional, Rosenberg, Mark, additional, Michalsen, Andreas, additional, and Witt, Claudia, additional

Published
2015
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38. Comparative effectiveness of a complex Ayurvedic treatment and conventional standard care in osteoarthritis of the knee – study protocol for a randomized controlled trial

Author

Witt, Claudia M, primary, Michalsen, Andreas, additional, Roll, Stephanie, additional, Morandi, Antonio, additional, Gupta, Shivnarain, additional, Rosenberg, Mark, additional, Kronpaß, Ludwig, additional, Stapelfeldt, Elmar, additional, Hissar, Syed, additional, Müller, Matthias, additional, and Kessler, Christian, additional

Published
2013
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45. The Effect of a Complex Multi-modality Ayurvedic Treatment in a Case of Unknown Female Infertility.

Author

Kessler, Christian, Stapelfeldt, Elmar, Michalsen, andreas, Kowalcek, Ingrid, Kronpaß, Ludwig, and Dhruva, anand

Abstract

Background: Treatment of female infertility has been growing globally in recent years. In spite of improvements in medical strategies and the improved outcomes for infertile couples, treatment attempts remain largely unsuccessful. A growing number of patients pursue complementary and alternative medicine treatment options like Ayurveda that offers a variety of inpatient and outpatient treatments for infertility. Case Report: A case of a 38 year-old woman with infertility of unknown origin is presented. She received 18 conventional fertility treatments in 5 different fertility centers and 3 different countries. After several complications, the patient quitted conventional treatment and admitted to an Ayurvedic outpatient clinic where she received a complex Ayurvedic treatment, which included botanicals, dietary and lifestyle advice, manual therapy, yoga, and spiritual elements. The patient then became pregnant and gave birth to a healthy boy in 2012. Conclusions: Ayurveda may be a useful complementary option in the case of futile conventional treatment attempts in female infertility. Nevertheless, the evidence base for Ayurvedic interventions remains weak and requires well-designed clinical trials. This case raises some questions, such as whether the exposure to a large number of assisted reproduction procedures can lead to more health problems than health benefits. The Ayurvedic approach to fertility strives first to improve the health of the patient leading to a higher likelihood of pregnancy. As this is a case report, we are not able to exclude temporal factors stimulating the pregnancy. However, the chronology suggests that this approach might have been an important factor in the eventual pregnancy. © 2015 S. Karger GmbH, Freiburg [ABSTRACT FROM AUTHOR]

Published
2015
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