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Diana M. Taibi, PhD, RNBiobehavioral Nursing & Health SystemsUniversity of Washington

WUN, 2010Building a Program of Research on Yoga for Osteoarthritis

Yoga for Osteoarthritis: Background on OA Osteoarthritis Affects ~ 27 million adults in USCost $128 billion in annual direct & indirect costsDisparityMore common in white persons, greater disease burden in African American & Hispanic personsAge Prevalence >50% in persons 65 y/oSymptomsPain, sleep disturbance, depressed moodDisabilityLeading cause of disability in the U.S. Yoga for Osteoarthritis: Background on YogaMultimodal mind-body interventionPoses, breathing, relaxation & meditation

Published studies showed improvements in:

Arthritis grip strength, range of motion, function, joint tenderness, painLow Back Painpain, functional abilitySleeptime awake, sleep quality ratings, total sleep time

DevelopmentCollaborative relationshipsDesign Yoga for OA programDevelop materials for instructor training & program dissemination

Yoga for OA ProgramResearchFeasibility & acceptabilityEfficacy EffectivenessPreliminary Study: Yoga for OA-Related Insomnia in WomenDesign: one-group, pre/postN=14, age = 65.2 6.9 y.Intervention: 8 weekly classes (75 min) nightly home practice (20 min)

Preliminary Study: Yoga for OA-Related Insomnia in WomenGood AdherenceAttended 7.2 1.0 of the 8 classesPracticed: 5.83 1.66 nights/week22.59 6.20 min/session

EfficacySignificant improvement in sleep outcomes

K01: A Yoga Program for OA Symptoms and Disability in Older AdultsTraining Aims Gain specialized knowledge of gerontologyOHSU courseworkHartford Summer Institute at NYUBecome active in Gerontological Society of America

Expand clinical trials trainingWork with Dr. Michael Vitiellos study teamInstitute of Translational Health Sciences

7Research AimsTo develop a Yoga for OA intervention for disability and symptom (pain, sleep disturbance, and depression) reduction that is specifically tailored to the physical needs and limitations of older persons with OA.

To test the feasibility and acceptability of the program.

To conduct preliminary efficacy testing of the program via a small-scale RCT comparing the Yoga for OA.

K01: A Yoga Program for OA Symptoms and Disability in Older Adults8A Conceptual Model of the OA Symptom and Disability Cycle

(modified from Vitiello, et al., (2009). J Clinical Sleep Med, 5(4), 355-362.)Intervention: ViniyogaConsultant: Robin RothenbergEmphasis on healthy structural alignmentRepetition, rather than holding posesShown to reduce low back pain

12 weeks, 75 minute classes weekly, 20 minutes home practice daily

10Yoga for Osteoarthritis: Study DesignPre- AssessmentInterventionPost-study periodPost- AssessmentFollow-up Assessment1 week12 weeks3 months1 week1 weekYoga (n=41*)Attention Control (n=25)Design: Randomized Crossover TrialParticipants: N=50 , men & women 65 y/o with OA. *First 16 will complete Phase 1 only for feasibility.Outcomes: Pain, disability, sleep, & depressed mood questionnaires; objective disability (timed walk, ROM measure by physical therapist) & sleep (actigraphy)

RandomizationLong-term GoalsTimingGoal2010-2015K01- funded development and efficacy testing2015-2020R01/K02-funded large efficacy study2020-2025R01-funded dissemination and effectiveness testingYoga for OA: ImplicationsWill provide data for obtaining grant funding for a large efficacy trial

Health implicationsReduced disability & symptomsImproved quality of life

Standardized, evidence-based yoga programSafe & effective to recommend to patientsStarting place for adults unfamiliar with yoga

Chart11511.386.166.7830147584

Series 1Series 2

Sheet1Series 1Series 2Series 3Insomnia Severity Index1511.382Sleep time (diary)6.166.782Sleep latency (diary)30143Sleep efficiency (diary)75845To resize chart data range, drag lower right corner of range.