Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia.
Department of Internal and Integrative Medicine, Sozialstiftung Bamberg, Buger Str. 80, Bamberg, 96049, Germany.
Curr Rheumatol Rep. 2019 Jul 23;21(9):47. doi: 10.1007/s11926-019-0846-5.
This study aims to systematically review and summarise the efficacy and safety of yoga for osteoarthritis. Medline (through PubMed), Scopus, and the Cochrane Library were searched through April 2018 for randomised controlled trials of yoga for osteoarthritis. Primary outcomes were pain intensity, function, and quality of life; secondary outcomes were mental health and safety. Risk of bias was assessed using the Cochrane tool and quality of evidence through GRADE.
Nine trials including 640 individuals with mainly lower extremity osteoarthritis aged 50-80 years were identified, with 80.3% female participants (median). Meta-analyses revealed very low-quality evidence for the effects of yoga on pain (vs. exercise: standardised mean difference (SMD) = - 1.07; 95%CI - 1.92, - 0.21; p = 0.01; vs. non-exercise: SMD = - 0.75; 95%CI - 1.18, - 0.31; p < 0.001), physical function (vs. exercise: SMD = 0.80; 95%CI 0.36; 1.24; p < 0.001; vs. non-exercise: SMD = 0.60; 95%CI 0.30, 0.98; p < 0.001), and stiffness (vs. exercise: SMD = - 0.92; 95%CI - 1.69, - 0.14; p = 0.008; vs. non-exercise: SMD = - 0.76; 95%CI - 1.26, - 0.26; p = 0.003) in individuals with knee osteoarthritis. Effects were not robust against potential methodological bias. No effects were found for quality of life, and depression, or for hand osteoarthritis. Safety was rarely reported. The findings of this meta-analysis indicate that yoga may be effective for improving pain, function, and stiffness in individuals with osteoarthritis of the knee, compared to exercise and non-exercise control groups. Due to the low methodological quality and potential risk of bias, only a weak recommendation can be made at this time for the use of yoga in adults with osteoarthritis of the knee.
本研究旨在系统地综述瑜伽对骨关节炎的疗效和安全性。通过 Medline（通过 PubMed）、Scopus 和 Cochrane 图书馆检索了截至 2018 年 4 月关于瑜伽治疗骨关节炎的随机对照试验。主要结局为疼痛强度、功能和生活质量；次要结局为心理健康和安全性。使用 Cochrane 工具评估偏倚风险，并通过 GRADE 评估证据质量。
共纳入 9 项试验，包括 640 例年龄 50-80 岁的下肢骨关节炎患者，其中 80.3%为女性（中位数）。Meta 分析显示，瑜伽对疼痛（与运动相比：标准均数差（SMD）=-1.07；95%CI-1.92，-0.21；p=0.01；与非运动相比：SMD=-0.75；95%CI-1.18，-0.31；p<0.001）、躯体功能（与运动相比：SMD=0.80；95%CI 0.36；1.24；p<0.001；与非运动相比：SMD=0.60；95%CI 0.30，0.98；p<0.001）和僵硬（与运动相比：SMD=-0.92；95%CI-1.69，-0.14；p=0.008；与非运动相比：SMD=-0.76；95%CI-1.26，-0.26；p=0.003）的疗效为极低质量证据。未发现对生活质量和抑郁，以及手部骨关节炎的影响。安全性很少被报道。这项荟萃分析的结果表明，与运动和非运动对照组相比，瑜伽可能对改善膝关节骨关节炎患者的疼痛、功能和僵硬有效。由于方法学质量低和潜在的偏倚风险，目前只能对膝关节骨关节炎成人使用瑜伽给予弱推荐。
