By Dr Ananya Mandal, MD
Yoga in Rheumatoid arthritis
Yoga is an ancient exercise form that can incorporate several elements of exercise that may be beneficial for rheumatoid arthritis. These exercises can improve strength and flexibility of the joints as well. There have been a few studies that examine the benefit of yoga in Rheumatoid Arthritis (RA).
Yoga originated in ancient India and have evolved and spread throughout the world. In Sanskrit, yoga means to connect. Yoga exercises are typically associated with connecting the mind and the body.
The physical practice of yoga, referred to as “hatha,” that originally was meant to prepare for meditation. Nowadays hatha yoga is widely used to increase physical activity and reduce stress. Yoga often involves a posture as well as deep breathing and/or chanting.
Evidence shows that yoga may improve physical function of the affected joints as well as reduce the number of tender and swollen joints affected by RA. However, it is important that the exercises are performed under supervision especially by those who have limited mobility or spinal problems. For these individuals the yoga postures may be modified to reduce joint stress. In addition props may be used to maintain balance.
The benefits of yoga include increased blood flow and warmed muscles. Further as the poses change to include bending in, pulling in, moving out and rotation and holding the poses, the strength increases. The muscles need to contract to hold a pose. This is called an isometric contraction where the muscle contracts without changing in size.
The poses also move the joint through their full range of motion and thus increase flexibility. The standing poses improve balance by strengthening stabilizing muscles and reduce falls.
RA patients often reduce activity due to pain. However, inactivity leads to shortening of muscles and tendons, joint contractures and weakened ligaments. Regular physical activity may decrease pain and preserve stability.
For RA patients there are several safety features that exercises should have. Their exercises in addition should focus on stretching and strength, posture and balance. This can be achieved by Yoga. Yoga is multifaceted that includes mental engagement, breathing, stress reduction, and meditative concentration along with physical activity. Yoga thus may offer an alternative to traditional exercise with potential psychological benefits or increased enjoyment that improves adherence to exercise regimens.
Tai chi in Rheumatoid arthritis
Tai chi originated in ancient China. It has been used widely among patients of various types of arthritis in China for thousands of years. The practice has gained popularity in the West in the recent years.
According to the 2007 National Health Interview Survey, around 2.5 million Americans have practiced tai chi for health. Now there is scientific evidence that this form of physical activity may help patients with RA.
Tai chi is originally a form of martial art. There are several styles of Tai chi and each is different from the other. Many of the styles including Sun, Yang, Hao and Wu are suitable for people with RA. There is diaphragmatic breathing and relaxation along with some basic postures that flow smoothly from one to the other through slow, gentle, graceful movements. Intensity in Tai Chi is low and equivalent to walking 6 km/h, and gives a moderate increase in heart rate.
The advantages of Tai chi include the facts that it is suitable for almost anyone; it can integrate the body and mind and is enjoyable. The practice is easy to learn and uses gentle and circular movements that improves adherence and compliance to the exercises and reduces the risk of discontinuation.
In RA Tai chi can help improve flexibility, strengthen muscles and maintain fitness. It is inexpensive to learn and perform. Tai chi can be practiced in any setting because it requires no equipment and a minimal space.
Over time with practice Tai chi can help maintain a good posture and is said to improve the Qi or life energy that controls and regulates all functions of the body.
The benefits of Tai chi in RA include improved balance, strength, flexibility, heart and lung function, elevation of mood, improvement of sleep and reduction of depression and anxiety. It reduces pain, improves health-related quality of life and improves self efficacy.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)
Last Updated: Mar 13, 2013