Key features of effective yoga interventions in addition to standard medical treatment for rheumatoid arthritis: a systematic review and meta-analysis

Biswas, Isha; Kaur, Jaspreet; Pearce, Fiona; Lewis, Sarah; Chattopadhyay, Kaushik

Abstract

Objective: This systematic review aimed to synthesise the content, structure, and delivery characteristics of effective yoga interventions in addition to standard medical treatment for rheumatoid arthritis (RA).

Methods: JBI guidelines were followed. 17 databases were searched for randomised controlled trials (RCTs) assessing yoga’s effectiveness in treating RA outcomes - disease activity score, pain, and function. Meta-analyses and narrative synthesis were conducted.

Results: Nine articles representing 5 RCTs were included and had low methodological quality scores. Yoga interventions, in addition to standard medical treatment, improved disease activity scores (standardised mean difference (SMD) -0.46; 95% confidence interval (CI) -0.73 to -0.18) and function (-0.42; -0.78 to -0.07) but did not effectively reduce pain (-1.06; -2.62 to 0.50) compared to standard medical treatment alone. All 5 RCTs found yoga’s beneficial effects on one or more outcomes. All yoga interventions included centre-based (supervised, group) sessions, and 2 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. 2 interventions offered RA-specific yogic pose modifications. Centre-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. Conclusion: 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 synthesised key features of effective yoga interventions.

Keywords: meta-analysis; rheumatoid arthritis; systematic review; treatment; yoga

PROSPERO registration number: CRD42022320337

Citation

Biswas, I., Kaur, J., Pearce, F., Lewis, S., & Chattopadhyay, K. (2025). Key features of effective yoga interventions in addition to standard medical treatment for rheumatoid arthritis: a systematic review and meta-analysis. ACR Open Rheumatology, 7(5), Article e70054. https://doi.org/10.1002/acr2.70054

• Journal Article Type: Article
• Acceptance Date: Mar 24, 2025
• Online Publication Date: May 10, 2025
• Publication Date: 2025-05
• Deposit Date: Apr 2, 2025
• Publicly Available Date: Apr 2, 2025
• Journal: ACR Open Rheumatology
• Electronic ISSN: 2578-5745
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 7
• Issue: 5
• Article Number: e70054
• DOI: https://doi.org/10.1002/acr2.70054
• Public URL: https://nottingham-repository.worktribe.com/output/47278310
• Publisher URL: https://acrjournals.onlinelibrary.wiley.com/doi/full/10.1002/acr2.70054