EFFECT OF YOGIC PRACTICES ON DISABILITY AMONG AGED MEN WITH RHEUMATOID ARTHRITIS

 

* V.Srinivasa Rao, ** Dr. R. Elangovan, *Ph.D Scholar, Faculty of Yoga Sciences and Therapy, Meenakshi Academy of Higher Education and Research (Deemed to be University), No.12, Vembuliamman Koil Street, West K.K.Nagar, Chennai-78, Tamil Nadu, India.,Email id: vhfvja@gmail.com, **Professor & Head, Faculty of Yoga Sciences and Therapy, Meenakshi Academy of Higher Education and Research (Deemed to be University), No.12, Vembuliamman Koil Street, West K.K.Nagar, Chennai-78, Tamil Nadu, India.  E-Mail ID: relangovantnpesu@gmail.com.

ABSTRACT

The purpose of the random group experimental study was to find out the effect of Yogic practices on Disability among aged men with Rheumatoid Arthritis. To achieve the purpose of the study, 30 aged men aged between 60 and 70 from Vijayawada suffering with rheumatoid arthritis were randomly selected by using random group sampling method and were assigned into two groups, experimental group I and control group II of 15 subjects in each. It was hypothesized that there would be significant differences on Disability due to Yogic practices than the control group. Pretest was taken for all subjects on selected dependent variable before the start of the training program. Yogic practices were given to the experimental group for 45 minutes, six days a week for six weeks.  Post test was conducted after the finish of the training period of six weeks. The data collected from the subjects were statistically analyzed by using Analysis of Co-variance (ANCOVA) to find out the significant differences. The test of significance was fixed at 0.05 level of confidence. The result of the study showed that Disability significantly reduced due to the yogic practices among aged men with Rheumatoid Arthritis. Hence the hypothesis was accepted at 0.05 level of confidence. It is concluded that yogic practices are beneficial for aged men with Rheumatoid Arthritis to reduce the disability.

KEY WORDS: Rheumatoid Arthritis, Yogic practices

 

INTRODUCTION

The term arthritis is commonly referred to as inflammation of joints. However, this term is commonly used as a synonym for joint pains or any other associated ailments. Arthritis though can be broadly classified into osteoarthritis and Rheumatoid Arthritis, Arthritis is mostly seen in people who are above 60 years of age, however, there have been instances where people of all ages including children were affected by this condition. There are more than 100 types of joint pains that a human suffers and these are together referred to as Arthritis. Arthritis is incurable but there are many medications and therapeutic measures that help patients keep symptoms under check. There are over 100 forms of arthritis that affect the joints in the knees, ankles, wrists, thumbs, vertebral column, and more. Most common forms of Arthritis are

TYPES OF ARTHRITIS

Ø Osteoarthritis

Ø Rheumatoid Arthritis

Ø Psoriatic Arthritis

Ø Fibromyalgia

Ø Gout

Ø Lupus

Ø Septic Arthritis

Ø Thumb Arthritis

Ø Reactive Arthritis

Ø Juvenile Idiopathic Arthritis

There are over 100 forms of arthritis that affect the joints in the knees, ankles, wrists, thumbs, vertebral column, and more. The most common forms of Arthritis are:

Osteoarthritis:

Osteoarthritis is the most common form of arthritis and is caused when the soft cushiony cartilage layer between bones gets worn out and the bones start directly rubbing with each other. This causes a lot of pain and is a degenerative disease. This is also known as wear and tear disease as the cartilage gets worn out. Though this is a disease that every person slowly develops as they age, other factors contribute to Osteoarthritis. These include obesity, sex, genetic reasons, joint injuries, repeated stress on certain joints, and a few metabolic diseases that also cause osteoarthritis. It is advised to consult an orthopaedic doctor if you feel pain in your joints and is not going away even after taking painkillers and muscle relaxants.

 

Rheumatoid Arthritis:

Rheumatoid Arthritis is an autoimmune condition where the body starts attacking the joints. It causes painful inflammation (swelling) between the joints making it extremely uncomfortable. This is not limited to just the bone cells, but also affects the skin, eyes, lungs, heart, and blood vessels. When a person is affected by rheumatoid arthritis, the immune system of the body starts affecting the lining between the bones, thereby making it painful and difficult to resume physical activities. In its early stages, rheumatoid arthritis attacks smaller joints like the ones present in your fingers and the ones that attach your toes to the foot. As the disease progresses, it starts attacking larger joints like knees, ankles, hip, elbows, and shoulders. It is advisable to visit a doctor if you are experiencing swelling in the joints, and/or are finding it difficult to move the joints after waking up or when trying to resume physical activity after a long break.

Signs of arthritis

Ø Fever

Ø Weight loss

Ø Fatigue

Ø Anaemia

Ø Swelling, stiffness, and pain in one or multiple joints

Ø Morning stiffness in and around the affected joints

Ø Pain and stiffness that worsens with inactivity and improves with physical activity.

 

Symptoms

The symptoms of Arthritis may vary from mild to severe depending on the condition and the joints it affects. Arthritis affects at least one-third of the world’s adults and sometimes, it can get very painful. Clinical trials have witnessed patients demonstrate pain that marks a bearing of seven on ten on the pain scale. The major symptoms of Arthritis include:

• Pain
• Stiffness
• Decreased range of motion.
• Swelling and redness
• Increase in joint pains and swellings.
• Decreased motion range.
• Fatigue
• The onset condition spreading to new joints.
• Pain when resuming physical activities after a nap or a break

 

RISK FACTORS

Many researchers believe that RA is most likely to develop in people who have a genetic predisposition to RA and are exposed to certain environmental factors, experience hormone changes, and/or undergo intestinal microbial changes.

• Age. RA can begin at any age, but the likelihood increases with age. The onset of RA is highest among adults in their sixties.
• Sex. New cases of RA are typically two-to-three times higher in women than men.
• Genetics/inherited traits. People born with specific genes are more likely to develop RA. These genes, called HLA (human leukocyte antigen) class II genotypes, can also make your arthritis worse. The risk of RA may be highest when people with these genes are exposed to environmental factors like smoking or when a person is obese.
• Smoking. Multiple studies show that cigarette smoking increases a person’s risk of developing RA and can make the disease worse.
• History of live births. Women who have never given birth may be at greater risk of developing RA.
• Early Life Exposures. Some early life exposures may increase risk of developing RA in adulthood. For example, one study found that children whose mothers smoked had double the risk of developing RA as adults. Children of lower income parents are at increased risk of developing RA as adults.
• Obesity. Being obese can increase the risk of developing RA. Studies examining the role of obesity also found that the more overweight a person was, the higher his or her risk of developing RA became.

Rheumatoid arthritis (RA) has many physical and social consequences and can lower quality of life. It can cause pain, disability, and premature death.

• Premature heart disease. People with RA are also at a higher risk for developing other chronic diseases such as heart disease and diabetes. To prevent people with RA from developing heart disease, treatment of RA also focuses on reducing heart disease risk factors. For example, doctors will advise patients with RA to stop smoking and lose weight.
• Obesity. People with RA who are obese have an increased risk of developing heart disease risk factors such as high blood pressure and high cholesterol. Being obese also increases risk of developing chronic conditions such as heart disease and diabetes. Finally, people with RA who are obese experience fewer benefits from their medical treatment compared with those with RA who are not obese.
• Employment. RA can make work difficult. Adults with RA are less likely to be employed than those who do not have RA. As the disease gets worse, many people with RA find they cannot do as much as they used to. Work loss among people with RA is highest among people whose jobs are physically demanding. Work loss is lower among those in jobs with few physical demands, or in jobs where they have influence over the job pace and activities.

OBJECTIVES OF THE STUDY

The objective of the study was to find out whether there would be any significant difference on disability among aged men with Rheumatoid Arthritis due to yogic practices.

 

PURPOSE OF STUDY

The purpose of the study was to find out the effect of yogic practices on disability among aged men with Rheumatoid Arthritis.

HYPOTHESIS

It was hypothesized that there would be significant differences on disability among aged men with Rheumatoid Arthritis due to yogic practices than the control group.

 

DELIMITATIONS

• The study was confined to 30 aged men with Rheumatoid Arthritis only.
• Subjects were selected from Vijayawada only.
• Age was ranged between 60 and 70 years only.
• The independent variable was yogic practices only.
• The study was conducted on Disability as dependent variable only.

LIMITATIONS

• The factors like Socio-Economical status were not taken into consideration.
• The climatic conditions were not considered.
• Factors like Life style habits were not taken into consideration.
• Subject’s day to day activities were not taken into account.
• Diet and Medication followed by subjects was not controlled.

 

 

REVIEW OF RELATED LITERATURE

Deepeshwar et.al., (2018) investigated the effect of integrated approach of yoga therapy (IAYT) intervention in individual with knee Osteoarthritis through Randomized controlled clincial trail on sixty-six individual pre diagnosed with knee osteoarthritis aged between 30 and 75 years were randomized into two groups, i.e., Yoga (n = 31) and Control (n = 35). Yoga group received IAYT intervention for 1 week at yoga center of S-VYASA whereas Control group maintained their normal lifestyle. The Falls Efficacy Scale (FES), Handgrip Strength test (left hand LHGS and right hand RHGS), Timed Up and Go Test (TUG), Sit-to-Stand (STS), and right & left extension and flexion were measured on day 1 and day 7. The results showed significant reduction in TUG (p < 0.001), Right (p < 0.001), and Left Flexion (p < 0.001) whereas significant improvements in LHGS (p < 0.01), and right extension (p < 0.05) & left extension (p < 0.001) from baseline in Yoga group. Hence it was concluded that

IAYT practice showed an improvement in TUG, STS, HGS, and Goniometer test, which suggest improved muscular strength, flexibility, and functional mobility.

Haaz et.al., (2011) systematically review the existing literature on the use of yoga for persons with arthritis. We included peer-reviewed research from clinical trials (published from 1980-2010) that used yoga as an intervention for arthritis patients and reported quantitative findings. Eleven studies were identified, including four RCTs and four NRCTs. All trials were small and control groups varied. No adverse events were reported and attrition was comparable or better than typical for exercise interventions. Evidence was strongest for reduction in disease symptoms (tender/swollen joints, pain) and disability, as well as improved self-efficacy and mental health. Interventions, research methods and disease diagnoses were heterogeneous. Larger, rigorous RCTs are necessary to more effectively quantify the effects of yoga for arthritic populations

METHODOLOGY

To achieve the purpose of the study, 60 came forward, 45 were screened and 30 aged men with Rheumatoid Arthritis were randomly selected by using random group sampling method and assigned into two groups, experimental group I and control group II each consisting 15 subjects in each group. The subjects are from Vijayawada aged between 60 and 70 years. Pretest was taken for all subjects on selected dependent variable i.e Disability before the training program. Yogic practices were given to the experimental group for 45 minutes, six days a week for six weeks.  Post test was conducted after the finish of the training period of six weeks. The data collected from the subjects were statistically analyzed by using Analysis of Co-variance (ANCOVA) to find out the significant differences. The test of significance was fixed at 0.05 level of confidence.

Class Design

The series of six classes was designed to stretch the participants’ bodies by mobilizing all the major joints in the body as well as the minor joints in hands and feet, to provide limited strengthening of arms and legs, and to offer an introduction to deep relaxation.

 

The practices given were Tadasana, veerabadrasana, uatkatasana, Adhomuka swanasana, Makarasana, One leg Apanasana, Bhujangasan, Marjalasana, Chakravakasana, Dwipadapitham, Salabasana, Harmstringstreatchs, Pranayamam, Sukha pranayama, AnulomaViloma ,ranayam, BhramariPranayamam, Mudras, Apana vayu mudra, Shank Mudra, Prithvi Mudra, Relaxation, Yoga Nidra. All the asanas are modified as per Krishnamacharya Tradition viniyoga

RESULTS AND DISCUSSION

The pre and post test scores of Disability was measured and subjected to statistical treatment. The results using Analysis of Co-variance (ANCOVA) is presented in the table.

Table I

ANALYSIS OF CO-VARIANCE OF THE MEANS OF TWO EXPERIMENTAL GROUPS AND THE CONTROL GROUP ON DISABILITY (scores in percentage)

Test	Exp group I	Control Group II	Source of Variation	Degrees of Freedom	Sum of Squares	Mean Sum of Squares	F-Ratio
Pre	89.53	87.73	Between	1	24.30	24.30	0.96
			Within	28	706.67	25.24
Post	83.47	89.93	Between	1	313.63	313.63	5.45*
			Within	28	1612.67	57.60
Adjusted Post	83.12	90.28	Between	1	371.92	371.92	6.66*
			Within	27	1507.20	55.82

 

 

 

 

 

 

 

 

 

 

 

 

* Significant at 0.05 level of confidence. (Table F ratio at 0.05 level, of confidence for df 1 and 28= 4.20, 1    and    27= 4.21)

The obtained F value on pre test scores 0.96 was lesser than the required F value of 4.20 to be significant at 0.05 level. This proved that there was no significant difference between the groups a pretest and posttest and the randomization at the pretest was equal. The post test scores analysis proved that there was significant difference between the groups, as obtained F value 5.45 was greater than the required F value of 4.20. This proved that the differences between the post test means of the subjects were significant in experimental group than the control group. The obtained F value 6.66 was greater than the required F value of 4.21. This proved that there was a significant difference among the means due of LaghooShankaprakshalana the above study was sustained by renowned experts Deepeshwar et.al., (2018)

 

DISCUSSION ON HYPOTHESIS

It was hypothesized that there would be significant differences on Disability due to yogic practices among aged men with Rheumatoid Arthritis than the control group. The results proved that there were significant differences on Disability (Reduced) due to yogic practices than the control group among aged men with Rheumatoid Arthritis. Hence the hypothesis was accepted at 0.05 level of confidence.

CONCLUSION

It was concluded that yogic practices reduced disability significantly among aged men with Rheumatoid Arthritis. Hence, yogic practices are beneficial to aged men with Rheumatoid Arthritis to reduce disability.

REFERENCES

1. 1. Deepeshwar, S., Tanwar, M., Kavuri, V., & Budhi, R. B. (2018). Effect of Yoga Based Lifestyle Intervention on Patients With Knee Osteoarthritis: A Randomized Controlled Trial. Frontiers in psychiatry, 9, 180. https://doi.org/10.3389/fpsyt.2018.00180
   2. Haaz, S., & Bartlett, S. J. (2011). Yoga for arthritis: a scoping review. Rheumatic diseases clinics of North America, 37(1), 33–46. https://doi.org/10.1016/j.rdc.2010.11.001