Biswas Isha, Kaur Jaspreet, Pearce Fiona, Lewis Sarah, Chattopadhyay Kaushik
Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
Division of Translational Medical Sciences, Centre of Biomolecular Sciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
ACR Open Rheumatol. 2025 May;7(5):e70054. doi: 10.1002/acr2.70054.
This systematic review aimed to synthesize the content, structure, and delivery characteristics of effective yoga interventions in addition to standard medical treatment for rheumatoid arthritis (RA).
The Joanna Briggs Institute guidelines were followed. Seventeen databases were searched for randomized controlled trials (RCTs) assessing yoga's effectiveness in treating RA outcomes (disease activity score, pain, and function). Meta-analyses and narrative synthesis were conducted.
Nine articles representing five RCTs were included and had low methodological quality scores. Yoga interventions, in addition to standard medical treatment, improved disease activity scores (standardized mean difference [SMD] -0.46, 95% confidence interval [CI] -0.73 to -0.18) and function (SMD -0.42, 95% CI -0.78 to -0.07) but did not effectively reduce pain (SMD -1.06, 95% CI -2.62 to 0.50) compared to standard medical treatment alone. All five RCTs found yoga's beneficial effects on one or more outcomes. All yoga interventions included center-based (supervised, group) sessions, and two included additional home-based (unsupervised, individual) sessions. All interventions incorporated 20 yogic poses (6 standing, 5 supine, 5 prone, and 4 seated), 7 breathing practices, and 4 meditation and relaxation practices. Two interventions offered RA-specific yogic pose modifications. Center-based sessions were delivered at least once weekly for 8 weeks' median duration and around 68 minutes per session. Home-based yoga was recommended thrice weekly for a 10-week mean duration and 40 minutes per session.
Yoga might be useful in addition to standard medical treatment for RA. Given previous studies' methodological limitations, a high-quality RCT should be conducted based on our synthesized key features of effective yoga interventions.
本系统评价旨在综合有效瑜伽干预措施在类风湿关节炎（RA）标准药物治疗基础上的内容、结构及实施特点。
遵循乔安娜·布里格斯研究所指南。检索17个数据库，查找评估瑜伽治疗RA疗效（疾病活动评分、疼痛和功能）的随机对照试验（RCT）。进行荟萃分析和叙述性综合分析。
纳入9篇代表5项RCT的文章，方法学质量得分较低。在标准药物治疗基础上，瑜伽干预改善了疾病活动评分（标准化均数差[SMD] -0.46，95%置信区间[CI] -0.73至-0.18）和功能（SMD -0.42，95%CI -0.78至-0.07），但与单独的标准药物治疗相比，未有效减轻疼痛（SMD -1.06，95%CI -2.62至0.50）。所有5项RCT均发现瑜伽对一项或多项结局有有益影响。所有瑜伽干预均包括基于中心的（有监督的团体）课程，两项还包括额外的家庭式（无监督的个人）课程。所有干预均包含20种瑜伽体式（6种站立、5种仰卧、5种俯卧和4种坐姿）、7种呼吸练习以及4种冥想和放松练习。两项干预提供了针对RA的瑜伽体式调整。基于中心的课程每周至少进行一次，中位时长为8周，每次约68分钟。家庭式瑜伽建议每周进行三次，平均时长为10周，每次40分钟。
在RA的标准药物治疗基础上，瑜伽可能有用。鉴于既往研究的方法学局限性，应根据我们综合的有效瑜伽干预关键特征进行高质量的RCT。
