Yoga leads to sustained improvement in fatigue and mood in rheumatoid arthritis: preliminary results of a randomized controlled trial

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). 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.