Date of Award

2018

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not yoga therapy improves physical pain in females and males over the age of 18 with diagnosed rheumatoid arthritis.

DESIGN: Review of three randomized control trials (RCTs), two written in English and one written in Hindi and translated to English, which were published in 2011, 2013, and 2015.

DATA SOURCES: Three randomized control trials, one of which was a double blind study, published in peer-reviewed journals found via PubMed.

OUTCOMES MEASURED: Physical pain due to rheumatoid arthritis was measured using Short form (SF36) Physical Component Summary, which assesses 8 domains (including pain) with higher scores representing better health related quality of life and Simple Descriptive Pain Intensity Scale (SDPIS), which measures the pain intensity ranging from no pain (0) to worst possible pain (5). Statistics were reported using NNT, mean difference from baseline, ANOVA, and p values.

RESULTS: All three studies showed significant improvement in physical pain in males and females with rheumatoid arthritis. Evans et al. showed the numbers needed to treat is four, meaning four patients need to participate in yoga therapy in order to prevent one negative outcome, and a P value of 0.02. In Singh et al., repeated-measure ANOVAs were conducted, but the values were not presented in the article. The authors did state that the ANOVAs showed a “statistically significant difference between two states (before and after) in pain intensity.” A P value of <0.001 was reported for this study. In Moonaz et al., a mean difference from baseline of 9.6 at eight weeks was reported. This represents results from SF36 Physical Component summary, which assesses eight domains including: physical function, physical roles, and bodily pain. A P value of <0.05 was also reported.

CONCLUSIONS: All three studies showed that there was an improvement in physical pain severity caused by rheumatoid arthritis after participation in yoga therapy. However, further studies with larger sample sizes that examine the specific yoga positions used will be needed to strengthen the conclusion that yoga therapy is effective in treating physical pain in men and women over the age of 18 diagnosed with rheumatoid arthritis.

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