TOPLINE:

Yoga and strengthening exercises both reduced knee pain in patients with knee osteoarthritis (OA) over 12 weeks, with no significant difference between them. Over 24 weeks, yoga led to modest improvements in function and quality of life.

METHODOLOGY:

• A randomized comparative effectiveness superiority trial conducted at a single center in Tasmania, Australia, compared the effectiveness of yoga with that of strengthening exercises for managing knee OA symptoms.
• A total of 117 participants with knee OA (mean age, 62.5 years; 72.6% women) were randomly assigned to either a yoga program (n = 58) or a strengthening exercise program (n = 59), each involving 24-week sessions.
• Participants attended two in-person group sessions led by physiotherapists and yoga teachers and one home-based session per week for 12 weeks, followed by three home-based sessions weekly for another 12 weeks. Outcomes were assessed at multiple intervals, including at baseline and at 4, 8, 12, 16, 20, and 24 weeks.
• The primary outcome was the change in knee pain, measured using the visual analog scale score, over 12 weeks, with a minimal clinically important difference of 15 mm and a noninferiority margin of 10 mm.
• Secondary outcomes included changes in the visual analog scale score; the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for pain, function, and stiffness; quality of life; and depression over 24 weeks.

TAKEAWAY:

• Both the yoga and strengthening exercise groups showed clinically relevant improvements in knee pain scores over 12 weeks (−17.7 mm; 95% CI, −22.4 to −13.0 mm and −16.7 mm; 95% CI, −21.4 to −11.8 mm, respectively), with no significant difference between the groups.
• The reduction in the knee pain score was within the prespecified noninferiority margin in the yoga group compared with the strengthening exercise group.
• The yoga group showed modestly greater improvements than the strengthening group in WOMAC pain, function, and stiffness scores, as well as in quality of life and physical performance on the fast-paced walk test over 24 weeks.
• Adherence was similar between the groups over 12 weeks; however, the incidence of adverse events related to the intervention was higher in the yoga group, with no serious adverse events reported.

IN PRACTICE:

“[The study] findings suggest that integrating yoga as an alternative or complementary exercise option in clinical practice may help in managing knee OA,” the authors wrote.

SOURCE:

The study was led by Bedru J. Abafita, MSc, Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia. It was published online on April 8, 2025, in JAMA Network Open.

LIMITATIONS:

Participants were recruited from a single state in Australia, which limited the generalizability of the findings. The program was specifically designed for patients with arthritis, which may not have reflected the safety or effectiveness of general community-based yoga classes. The long-term effects of yoga and strengthening exercises beyond 24 weeks need further investigation.

DISCLOSURES:

This study was funded by the Rebecca L. Cooper Medical Research Foundation as part of a fellowship. One author reported being an employee and shareholder of Eli Lilly and Company, and another author reported being a certified yoga therapist. No other relevant financial relationships were reported.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.