Knee Osteoarthritis Clinical Trial
Official title:
Yoga Versus Aerobic and Strengthening Exercises for Managing Knee Osteoarthritis
The purpose of the study is to examine the short and long term effects of Hatha yoga compared to the current recommended exercise program in promoting physical function, alleviating osteoarthritis (OA)-related symptoms, fear of falling, and improving mood, spiritual health, physical activity level, and quality of life in older adults with knee OA, and to determine the effect sizes for use in power calculations to design a larger efficacy clinical trial.
The specific aims of this pilot project are to:
Aim 1: Examine the short and long term effect of participation in an 8-week intervention of
Hatha yoga (HY) on pain, stiffness, physical function of the lower extremities, physical
activity, mood, fear of falling, spiritual health, and quality of life in older women with
knee OA, compared with the effect in those older adults who participated in
aerobic/strengthening exercise (AE) or received general OA education (GE).
Aim 2: Describe the adherence rate (class and home practices) and exercise acceptability of
the HY and AE programs.
A randomized controlled trial design with three groups were used: 1) A Hatha yoga (HY)
intervention group, 2) an aerobic and local muscle strengthening exercise (AE) control group,
and 3) a general OA education (GE) true control group. Both yoga and exercise groups involved
group and home practice sessions. Participants in the GE group received education on OA
management after randomization. A weekly phone call were placed to them during the
intervention period to reinforce OA knowledge. Data were collected from all participants at
baseline, 4 weeks, and 8 weeks during the intervention, and quarterly for one year during the
follow up period.
Study Endpoints
1. Primary endpoint: OA status (pain, stiffness and function) at 8 weeks.
2. Secondary endpoint: physical function of lower extremities, mood, and quality of life at
8 weeks.
3. Tertiary endpoint: Long term exercise adherence and effects on outcome measures, program
acceptability, and safety.
Sample Size and Recruitment Eight-three community dwelling older adults ages 60 years - 100
years old with a diagnosis of symptomatic knee OA were recruited. Recruitment were done
through conducting presentations at various senior centers; distributing press release to
various community newsletters, local and senior newspapers, and through working with my
co-investigators, and accessing the data base and mailing invitation letters out to patients
meeting demographic and diagnostic criteria from the University of Minnesota Physician
Practice.
Each weekly group based session is 45 minute in length for all groups. Participants in the
yoga group were recommended to practice for additional 30 minutes four times a week at home.
Participants in the A/E class were recommended to practice 3 times on non-consecutive days at
home as recommended by the current physical activity guidelines for older adults. To assist
participants with maintaining exercise adherence and practicing yoga and
aerobic/strengthening exercises at home correctly, handouts illustrating yoga/exercise
activity were distributed at the end of each class. Participants also were asked to videotape
and keep a log of their exercise practice during the intervention period. Video camera were
provided. Long term exercise adherence was assessing using an exercise diary. Participants
were asked to keep an exercise diary during the follow up period. A focus group will be
conducted at the end of the follow-up period to examine the experience of using HY or AE for
managing knee OA, and factors that affect participants' HY/AE adherence.
Descriptive statistics will be used to analyze and report demographic data and
feasibility/acceptability data. Inferential statistics (t-test or non-parametric equivalent
such as Mann-Whitney, and chi-square test) will be used to analyze the OA symptoms, physical
and psychological outcomes. The α level will be set at ≤ .05.
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