Online Yoga May Help Relieve Pain, Boost Mental Health in AS: Study

Three-month yoga program leads to significant drop in disease activity scores

Margarida Maia PhD avatar

by Margarida Maia PhD |

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Engaging in online yoga classes, or tele-yoga, may help people with ankylosing spondylitis (AS) relieve pain, overcome some functional limitations, and improve their mental health, a study from India suggests.

The study, “Tele-yoga in the management of ankylosing spondylitis amidst COVID pandemic: A prospective randomized controlled trial,” was published in Complementary Therapies in Clinical Practice.

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AS symptoms can make it difficult to perform daily activities

AS is a type of arthritis that affects the joints in the spine, causing inflammation and swelling. Because this usually happens around the joints of the spine, the main symptoms of AS include pain, stiffness, and loss of the ability to move the spine through its full range of motion.

This can make it hard for people with AS to carry on with their daily activities, which is one of the reasons why some may experience a drop in their mental health and quality of life.

Staying active, exercising, and practicing good posture may help make living with AS less difficult by preserving joint health.

“Yoga is associated with a reduced risk of heart disease in chronic conditions such as hypertension, diabetes mellitus, and metabolic syndrome,” the researchers wrote. “In addition to its beneficial effects on physiological and metabolic actions, yoga also influences positive mental health actions. It helps reduce stress and its effects and improves anxiety and depression associated with various chronic diseases.”

However, how well a yoga practice works for those with AS is unclear.

To know more, a team of researchers from across India designed a three-month yoga program for people with AS that consisted of yoga postures, breathing exercises, meditation, and relaxation techniques.

Because the study took place during the COVID-19 pandemic, all classes were offered online, twice a week for an hour per class.

Yoga is associated with a reduced risk of heart disease in chronic conditions such as hypertension, diabetes mellitus, and metabolic syndrome

Drop in disease activity reported in 57 adults who completed yoga program

The researchers invited 130 adults who had been diagnosed with AS for at least three years to take part in the study. The participants were randomly assigned to one of two groups. One group engaged in the three-month yoga program at home in addition to their standard care; the other (control) group received their standard care only.

Some participants dropped out of the study because they did not have the time to follow the program or lacked motivation (four patients in the yoga group), could not be reached by phone or were unwilling to continue in the study (eight patients in the control group), or were diagnosed with COVID-19 (one patient in the yoga group and five in the control group).

In total, 109 adults (57 in the yoga group and 52 in the control group) completed the study. Most (83.5%) were men and their mean age was similar in the two groups (34.4 vs. 35.1 years).

At the beginning of the study and at the three-month mark, the researchers used the Bath Ankylosing Spondylitis Disease Activity Index to assess disease activity, including pain. While the mean scores did not change in the control group, they dropped significantly in the yoga group, from 6.04 to 4.91 points, indicating less active disease.

Practicing tele-yoga also helped patients feel less anxious and depressed.

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The yoga group also had significantly lower Bath Ankylosing Spondylitis Functional Index scores (4.07 vs. 4.93 points for the control group). The index measures the functional capacity of people with AS to perform activities of daily living, and higher scores indicate worse impairment.

Similar observations were made when looking at the results of the Ankylosing Spondylitis Quality of Life questionnaire.

The researchers found a link between disease outcomes and mental health. This means that the better the patients felt in terms of disease activity, functional capacity, and quality of life, the less anxious and depressed they were.

Exactly how yoga works to boost overall health remains unclear, but “yoga practice may have improved joint mobility and spinal flexibility,” while increasing tolerance to pain and reducing stress, the researchers noted.

All participants were comfortable with a virtual yoga intervention, which suggests a yoga (or tele-yoga) practice as a possible intervention for people with AS, the team wrote.