Impact of yoga and meditation based lifestyle intervention on quality of life and disease activity in rheumatoid arthritis

Background: Apart from usual medical therapy, recovery of patients with rheumatoid arthrits (RA) in which quality of life (QoL) is greatly compromised is dependent on several physical and psychological factors. With advancing therapeutc options, achieving a state of remission has become the treatment goal in RA. Objectve: The objectve was to explore the effect of yoga and meditaton-based lifestyle interventon (YMLI) on disease actvity, QoL, and infammatory markers in actve RA group compared with usual-care control group. Methods: A total of 56 individuals were randomized into two groups: YMLI group and usual-care control group which were assessed pre (day 0) and post (8 weeks) interventon for reactve oxygen species (ROS), C-reactive protein (CRP), erythrocyte sedimentaton rate (ESR), and a panel of pro-infammatory (interleukin [IL]-6, IL-17A, tumor necrosis factor-α [TNF-α]) and ant-infammatory cytokines (transforming growth factor-β [TGF-β] and soluble human leukocyte antgen-G [sHLA-G]). Parameters of disease actvity, disability quotent, pain acuity, and QoL were also assessed by Disease Actvity Score (DAS28), Health Assessment Questonnaire (HAQ), Visual Analog Scale (VAS), and World Health Organizaton QoL (WHOQOL-BREF), respectvely. Results: YMLI partcipants showed significant improvements in DAS28 (P < 0.05∗∗∗), HAQ (P < 0.05∗∗∗), VAS (P < 0.05∗∗∗), and WHOQOL-BREF scale (P < 0.05∗∗∗) in all the four domains of physical health, psychological health, social relationships, and environmental health over the control group. In YMLI group, there was reducton in mean levels of CRP (P < 0.05∗∗∗), ROS (P > 0.05), TNF-α (P 0.05∗∗), IL-6 (P < 0.05∗∗), IL-17A (P < 0.05∗∗), and ESR (P 0.05∗) and elevaton in sHLA-G (P < 0.05∗∗) and TGF-β (P 0.05∗∗) at 8 weeks compared to baseline level (day 0). Conclusion: The present study demonstrated that yoga results in the regression of infammatory processes by reducing infammatory cytokines and regulatng the levels of soluble HLA-G significantly in actve RA patients. YMLI has significantly reduced pain percepton, disability quotent, and disease actvity and improved QoL. Thus, yoga aids in achieving immunological tolerance and molecular remission and hence can be beneficial as an adjunct therapy.