PMID- 36122378 OWN - NLM STAT- MEDLINE DCOM- 20221019 LR - 20221101 IS - 1539-3704 (Electronic) IS - 0003-4819 (Linking) VI - 175 IP - 10 DP - 2022 Oct TI - Effectiveness of an Unsupervised Online Yoga Program on Pain and Function in People With Knee Osteoarthritis : A Randomized Clinical Trial. PG - 1345-1355 LID - 10.7326/M22-1761 [doi] AB - BACKGROUND: Yoga is a mind-body exercise typically done in groups in person, but this delivery method can be inconvenient, inaccessible, and costly. Effective online programs may increase access to exercise for knee osteoarthritis. OBJECTIVE: To evaluate the effectiveness of an unsupervised 12-week online yoga program. DESIGN: Two-group superiority randomized trial. (Australian New Zealand Clinical Trials Registry: ACTRN12620000012976). SETTING: Community. PARTICIPANTS: 212 adults with symptomatic knee osteoarthritis. INTERVENTION: Both groups received online osteoarthritis information (control). The yoga group also received access to an unsupervised online yoga program delivered via prerecorded videos over 12 weeks (1 video per week, with each session to be performed 3 times per week), with optional continuation thereafter. MEASUREMENTS: Primary outcomes were changes in knee pain during walking (0 to 10 on a numerical rating scale) and physical function (0 to 68 on the Western Ontario and McMaster Universities Osteoarthritis Index) at 12 weeks (primary time point) and 24 weeks, analyzed using mixed-effects linear regression models. Secondary outcomes were self-reported overall knee pain, stiffness, depression, anxiety, stress, global change, quality of life, self-efficacy, fear of movement, and balance confidence. Adverse events were also collected. RESULTS: A total of 195 (92%) and 189 (89%) participants provided 12- and 24-week primary outcomes, respectively. Compared with control at 12 weeks, yoga improved function (between-group mean difference in change, -4.0 [95% CI, -6.8 to -1.3]) but not knee pain during walking (between-group mean difference in change, -0.6 [CI, -1.2 to 0.1]), with more yoga participants than control participants achieving the minimal clinically important difference (MCID) for both outcomes. At 12 weeks, knee stiffness, quality of life, and arthritis self-efficacy improved more with yoga than the control intervention. Benefits were not maintained at 24 weeks. Adverse events were minor. LIMITATION: Participants were unblinded. CONCLUSION: Compared with online education, an unsupervised online yoga program improved physical function but not knee pain at 12 weeks in people with knee osteoarthritis, although the improvement did not reach the MCID and was not sustained at 24 weeks. PRIMARY FUNDING SOURCE: National Health and Medical Research Council and Centres of Research Excellence. FAU - Bennell, Kim L AU - Bennell KL AD - Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia (K.L.B., S.S., P.L.T., S.H., D.M., A.J.K., B.M., R.S.H.). FAU - Schwartz, Sarah AU - Schwartz S AD - Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia (K.L.B., S.S., P.L.T., S.H., D.M., A.J.K., B.M., R.S.H.). FAU - Teo, Pek Ling AU - Teo PL AUID- ORCID: 0000-0003-1657-1820 AD - Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia (K.L.B., S.S., P.L.T., S.H., D.M., A.J.K., B.M., R.S.H.). FAU - Hawkins, Stephanie AU - Hawkins S AD - Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia (K.L.B., S.S., P.L.T., S.H., D.M., A.J.K., B.M., R.S.H.). FAU - Mackenzie, Dave AU - Mackenzie D AUID- ORCID: 0000-0003-3604-9378 AD - Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia (K.L.B., S.S., P.L.T., S.H., D.M., A.J.K., B.M., R.S.H.). FAU - McManus, Fiona AU - McManus F AUID- ORCID: 0000-0002-1001-8146 AD - Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia (F.M.). FAU - Lamb, Karen E AU - Lamb KE AUID- ORCID: 0000-0001-9782-8450 AD - Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, and Methods and Implementation Support for Clinical Health Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia (K.E.L.). FAU - Kimp, Alexander J AU - Kimp AJ AUID- ORCID: 0000-0003-2757-2239 AD - Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia (K.L.B., S.S., P.L.T., S.H., D.M., A.J.K., B.M., R.S.H.). FAU - Metcalf, Ben AU - Metcalf B AUID- ORCID: 0000-0002-4945-3217 AD - Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia (K.L.B., S.S., P.L.T., S.H., D.M., A.J.K., B.M., R.S.H.). FAU - Hunter, David J AU - Hunter DJ AUID- ORCID: 0000-0003-3197-752X AD - Sydney Musculoskeletal Health, The University of Sydney, Sydney, New South Wales, Australia (D.J.H.). FAU - Hinman, Rana S AU - Hinman RS AUID- ORCID: 0000-0001-6368-9456 AD - Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia (K.L.B., S.S., P.L.T., S.H., D.M., A.J.K., B.M., R.S.H.). LA - eng SI - ANZCTR/ACTRN12620000012976 PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20220920 PL - United States TA - Ann Intern Med JT - Annals of internal medicine JID - 0372351 SB - IM MH - Australia MH - Exercise Therapy/methods MH - Humans MH - *Osteoarthritis, Knee/complications/therapy MH - Pain/etiology MH - Pain Measurement MH - Quality of Life MH - Treatment Outcome MH - *Yoga EDAT- 2022/09/20 06:00 MHDA- 2022/10/20 06:00 CRDT- 2022/09/19 17:02 PHST- 2022/09/20 06:00 [pubmed] PHST- 2022/10/20 06:00 [medline] PHST- 2022/09/19 17:02 [entrez] AID - 10.7326/M22-1761 [doi] PST - ppublish SO - Ann Intern Med. 2022 Oct;175(10):1345-1355. doi: 10.7326/M22-1761. Epub 2022 Sep 20.