Rheumatoid arthritis (RA) is a chronic, disabling disease that can compromise daily functioning, and health related quality of life (HRQOL), especially for young populations for whom long-term medication use can pose risks. This R21 project will compare a standardized group administered Iyengar Yoga program (IYP) for adolescents and young adults (AYA) with RA to a waitlist control condition comprised of standard care. IY is particularly suitable for clinical rehabilitation and research, as extensive and standardized teacher-training makes it replicable and safe. Our hypotheses are: 1) The IYP will be safe, acceptable and feasible for a young RA population, with <20% attrition;2) IYP participants will demonstrate significantly greater improvement on the primary outcomes of functioning and HRQOL relative to the control group following the 8 week IYP;treatment gains will be maintained at 2 months following completion of the IYP;3) IYP participants will also evidence significant improvement relative to controls on the secondary outcomes of pain, joint count, and mood. This project is built within a theoretical model purporting that Iyengar Yoga incorporates specific psychological and physical components that confer benefits on RA disability and HRQOL. Using a matched group design, 84 RA patients aged 16-21 years will receive an 8 week IYP (16 - 1.5 hour sessions twice weekly) or be assigned to the 8 week control condition, after which they will receive the 8 week IYP. Baseline, post-treatment, and two month follow-up assessments include standardized measures of general and arthritis-specific function, HRQOL, pain, mood, and inflamed joint count as well as qualitative interviews, and blood pressure/resting heart rate measurements. This study will be the first controlled evaluation of IYP for an AYA RA population and the study is grounded within a theoretical model that integrates the biopsychosocial model of rehabilitation. To maximize the knowledge gained from the study, we employ a quantitative/qualitative mixed methods approach to understanding treatment outcomes and predictors of treatment response. Ultimately our study will contribute to the development of a readily transportable IYP that may be used in multi-center trials and disseminated widely to other research and clinical settings, thus providing heuristic and practical value. Relevance: Conventional treatments for AYA with RA pose risks because of the need for long-term intervention. This study addresses the need for safe and effective rehabilitation approaches to RA by testing a standardized IY program within a rigorously conducted, theoretically-driven design to promote the science behind a treatment that could positively impact the lives of many young people with a disabling disease.

Public Health Relevance

Conventional treatments for AYA with RA pose risks because of the need for long-term intervention. This project addresses the need for safe and effective rehabilitative approaches to RA by testing a standardized Iyengar Yoga program within a rigorously conducted, theoretically based study in order to provide the science behind a treatment that could positively impact the lives of many young people with disabling arthritis.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21AR057318-02
Application #
7895761
Study Section
Special Emphasis Panel (ZRG1-RPHB-H (02))
Program Officer
Tonkins, William P
Project Start
2009-07-17
Project End
2011-06-30
Budget Start
2010-07-01
Budget End
2011-06-30
Support Year
2
Fiscal Year
2010
Total Cost
$154,380
Indirect Cost
Name
University of California Los Angeles
Department
Pediatrics
Type
Schools of Medicine
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Evans, Subhadra; Moieni, Mona; Lung, Kirsten et al. (2013) Impact of iyengar yoga on quality of life in young women with rheumatoid arthritis. Clin J Pain 29:988-97
Evans, Subhadra; Moieni, Mona; Sternlieb, Beth et al. (2012) Yoga for youth in pain: the UCLA pediatric pain program model. Holist Nurs Pract 26:262-71
Evans, Subhadra; Cousins, Laura; Tsao, Jennie Ci et al. (2011) A randomized controlled trial examining Iyengar yoga for young adults with rheumatoid arthritis: a study protocol. Trials 12:19
Evans, Subhadra; Moieni, Mona; Subramanian, Saskia et al. (2011) ""Now I see a brighter day"": expectations and perceived benefits of an Iyengar yoga intervention for young patients with rheumatoid arthritis. J Yoga Phys Ther 1: