HEALTH CARE PROVIDERS
This book, by Harry D. Fischer, M.D. and Winnie Yu, is a book written to help people who are diagnosed with rheumatoid arthritis (RA). Co-authored by a medical doctor and a health writer, this text is practical in content, and written in straight – forward, understandable language.
The 14 Chapters include definitions, the importance of creating a medical team, use of self-help, traditional and non-traditional methods when treating RA. It also provides a glossary of terms, a list of resources and a bibliography. Each chapter ends with a case study from a person who has RA and how they applied the topic of the chapter to his or her life.
Chapter 6, Exercising with RA, doesn’t specifically address using yoga for Arthritis, but it does support the idea that the medical experts now agree that when treating RA, there needs to be a balance between exercise and rest.
A person who is diagnosed with RA or a Yoga Therapist helping clients with RA would find it a useful resource.
However, this book is already twelve years old; therefore, some of the medicines and research may not be up to date. Also, although the authors include a bibliography, they do not cite specific sources in their text. It would be up to the reader to delve further.
Reviewed by Amy Welden, M. Ed., RYT-200, Certified Yoga for Arthritis Instructor
You can purchase the book through Amazon HERE.
Predictors of Fatigue in Rheumatoid Arthritis Patients in Remission or a Low Disease Activity State
Fatigue is a very common and often debilitating symptom in patients with rheumatoid arthritis (RA). Research shows that fatigue is a problem even for RA patients who are in remission or a low disease activity state1. This article expands upon the investigation of this type of lingering fatigue in RA patients, and the relationship between fatigue and other factors such as disease-activity measures, physical functioning and demographics.
This study looked at data from patients enrolled in a large, 11-year, Norwegian study (The Norwegian Disease-Modifying Antirheumatic Drugs Register). From the larger sample of 1.5 million patients, researchers first selected 2,193 patients who had been treated with Methotrexate only or Methotrexate in combination with biologics. They then looked more closely at the 32% who were in remission or a low-activity disease state after 6 months of treatment.
More than one in four (28%) of these patients continued to report high levels of fatigue in spite of having low disease activity.
Results show that greater pain and poorer physical functioning were both predictors of fatigue. Other notable factors associated with fatigue include being female, being younger and having a greater number of tender and swollen joints.
Interestingly, patients taking the combination of medications showed greater reductions in fatigue in comparison to those taking just Methotrexate. However, as the authors point out, these results should be interpreted cautiously as the patients in the combined therapy group initially reported greater pain and disease activity in comparison to the Methotrexate only group.
While this article offers a glimpse into factors associated with fatigue, more research is needed on ways to reduce this lingering and debilitating symptom beyond what is offered by pharmacologic treatment alone. Preliminary research appears to support a combination or integrative approach to RA-disease management that includes coping-skill management, physical activity, and mindfulness-based training.2
Yoga, which has previously been shown to reduce pain and improve physical function3, also promotes mindfulness and some of the other skills mentioned above. With an individually tailored approach, yoga, in conjunction with conventional medication, may have the potential to be particularly helpful in addressing the pervasive effects of fatigue for those living with RA.
LINK to the full article.
Submitted by Dana Halkowski
1. Curtis JR, Shan Y, Harrold L, Zhang J, Greenberg JD, Reed GW. Patient perspectives on achieving treat-to-target goals: a critical examination of patient-reported outcomes. Arthritis Care Res (Hoboken) 2013;65:1707–1712.
2. Cramp F, Hewlett S, Almeida C, Kirwan JR, Choy EH, Chalder T, et al. Non-pharmacological interventions for fatigue in rheumatoid arthritis. Cochrane Database Syst Rev. 2013;8:CD008322.
3. Moonaz SH, Bingham CO 3rd, Wissow L, Bartlett SJ. Yoga in Sedentary Adults with Arthritis: Effects of a Randomized Controlled Pragmatic Trial. Journal of Rheumatology, 2015 Jul:42(7):1194-202.doi: 10.3899/jrheum.141129.
We had a very successful training course at Yogaville this year. We have 7 new Certified Yoga for Arthritis teachers. Here are some highlights that speak to the differences between the Level I Intensive and the Level II Certification course.
We all participated in a student led chair class. This is considerably less nerve wracking and more cooperative than the group teaching experience from Level I, as we’ve all been teaching Yoga for Arthritis courses for some time now.
student chair sample.mp4
We each presented something on our work with Yoga for Arthritis. These included some good safety considerations on working with clients who’ve had hip replacements, the benefits of guided imagery and how to manage classes that are so popular you triple your class minimums.
One of my favorite sections was our restorative class in chairs. That’s been a struggle for me. How to get clients as relaxed and comfortable as possible in a chair is a challenge. If I can get people to the smile stage, I’ve done my job.
And of course, being an evidenced based program, one of the features is a review of the current research. Here’s a short clip of us discussing Cognitive and Emotional Control of Pain and its Disruption in Chronic Pain by Bushnell, Ceko and Low.
The Level II Certification really prepares you to work with greater confidence, take on more one on one clients, and cooperate with other professionals and clinicians. If you’re pondering taking your training to the next level, we have one training left in 2016, October 29-31 at the Integral Yoga Institute NY.
This past weekend, Dr. Moonaz and Jenn Daks attended the Juvenile Arthritis (JA) annual meeting in Philadelphia. Along with over 1,000 other parents/caregivers, siblings, young adults, teens and children living with arthritis they joined in the mission to be #strongerthanja.
Dr. Moonaz and Jenn spent the weekend building community,
teaching and educating conference attendees about the benefits of, and research supporting tailored practices of yoga for those living with arthritis. From smiling faces, to stories of hope and transformation, they were blown away by people’s positive reactions to their classes. Dr. Moonaz and Jenn are both very excited to continue to work with the Arthritis Foundation to to educate, advocate and to grow stronger than juvenile arthritis.
Researchers examined data from a longitudinal study of people age 45-79 with or at risk of knee OA. From this larger study, researchers selected participants who had thigh strength measurements taken at regular intervals over the course of the four-year study. The researchers then compared those who at some point reported receiving a total knee replacement (TKR) with those who had not received a TKR during the same time period.
Participants between the groups were “matched” on similar characteristics including, but not limited to-age, BMI, pain and disease severity. Researchers then compared thigh strength changes over time, between the two groups, and how those changes in strength corresponded to the incidence of knee replacement.
Results of the study show that thigh strength is able to predict the risk of undergoing TKR in women. Specifically, women with lower thigh strength are also more likely to undergo knee replacement surgery.
This study is important in identifying a predictor of knee replacement surgery that may be directly influenced by the individual. For exercise instructors, such as yoga teachers, this research highlights the importance of including exercises that focus on strengthening the thigh muscles. For students, it shows the importance of participating in safe, effective activities that provide life-long opportunities for thigh strengthening.
Summarized by: Dana Halkowski, MA, RYT-200, Level I Yoga For Arthritis Instructor
The original article can be found in PubMed HERE.
Holger Cramer, Lesley Ward, Robert Saper, Daniel Fishbein, Gustav Dobos and Romy Lauche
In 2008, more than 13 million people started practicing yoga explicitly to improve health status1. As yoga gains attention as a therapeutic medium, questions and concerns of its safety have been highlighted in the lay press. This important article highlights research findings on the safety of yoga using rigorous methods. It is important that students and teachers of yoga, healthcare providers and everyone in-between has access to accurate information about the safety of this practice.
Results of this study show that yoga is a safe practice2. Overall, adverse events associated with the practice of yoga were relatively low. Interestingly, when comparing yoga with individuals receiving care as usual, or no treatment, no differences in the frequency of adverse events were observed. Results show slight increases in adverse events when comparing yoga to psychological/educational interventions lasting approximately 3 months. The theory behind these findings suggest that longer-term studies may inherently increase the risk for any type of adverse event, and warrant further investigation.
This information can serve to bolster and inform safe yoga practices beyond closely supervised research studies. If you are a student of yoga, you can begin or continue to receive the many benefits of this ancient healing practice by seeking well qualified practitioners with specialized knowledge and training. As teachers, we must ensure the safety of our students by seeking specialized training to promote safe practices. And as the public, we can report on the facts, promoting a more realistic view of yoga: acknowledging that there are risks involved, however generally speaking yoga has been shown to be a safe and effective therapeutic intervention.
 Barnes, P. M., Bloom, B. & Nahin, R. L. Complementary and alternative medicine use among adults and children: United States, 2007. National Health Statistics Report; no. 12. National Center for Health Statistics. 2008.
Cramer, H., Ward, L., Saper, R., Fishbein, D., Dobos, G. and Lauche, R. (2015). The safety of yoga: A systematic review and meta-analysis of randomized controlled trials. American Journal of Epidemeology, 182(4), 281-293. doi: 10.1093/aje/kwv071.
A recent CDC publication was released about the use of complementary health therapies among children and young adults.
A highlight of this paper is the growing presence of yoga, as a healing modality in the lives of our youth!
Data from 2007-2012 show a significant increase in the use of yoga from 2.3% to 3.1% of children and young adults. In the report, yoga represented the strongest growth area for prevalence of use. Despite these findings, there is a significant gap in the research on complementary health approaches among children. Coupled with data that suggest an increase of chronic health conditions among children, the time is now to be looking into these therapies.
The importance of this study resonates both on a national and organizational level.
Yoga for Arthritis is currently looking to expand the reach of our services to serve people with arthritis across the lifespan. Specifically, YFA is looking to develop a yoga program for children living with arthritis. Join us as we set out to pioneer this innovative new line of research and bring the ancient healing arts of yoga, coupled with modern medical knowledge to our youth who are clearly seeking complementary approaches to help improve the wellness of their minds, bodies and spirit!
If you have experience teaching yoga with children, we want to hear about it as we begin formulating a program and specialized teacher training! Feel free to e-mail us at email@example.com with your thoughts and perspective.
Please also post comments below and let's get the conversation started!
Click here for the full article.
There is a new kind of swimsuit on the market! One takes out the hassle, tugging, hopping and strain out of putting on a traditional swimsuit. This patented design was co-designed by someone who has arthritis, who relied on swimming to manage her symptoms. It has the look and feel of a traditional swimsuit, yet it is made out of two, diagonal half suits that can accommodate for mobility limitations.
This swimsuit was brought to our attention by one of our very own YFA teachers! We were immediately intrigued and set out to find a tester, someone from our community who could give us first-hand feedback on the suit. And so we found Rosemary R...
(continue reading for her review of this swimsuit)
As a 20 year veteran of teaching water aerobics, I like to keep current in all aspects the industry. For many years there haven't been any new developments in the swimwear category--until now. I discovered Step in 2 Now swimsuits in an aquatic professional journal, and immediately looked at their website. I love the concept and was glad that Yoga For Arthritis asked me to try it out.
This suit is intended for someone with limited range-of-motion, and I had a rotator cuff injury which severely challenged my arm mobility. Pulling on a regular aqua fitness suit was torture; it took way too much time, and internal and external shoulder rotation was extremely painful. It certainly didn't encourage me to get in the pool 3 days a week to teach, exercise, or for my own aqua physical therapy. We know that water aerobics and other water-based activities are excellent no-impact fitness and even therapeutic options for people with joint pain, but if you can't get into the clothes, you can't benefit from participation!
Step in 2 Now suits aim to address that challenge. The two pieces are easy to slide into, and it doesn't require any twisting or turning to get the shoulder straps up. My students originally called it the "Flintstone Suit", but ultimately stated that the design is genius.
What I like about the suit:
What to reconsider:
I would recommend Step in 2 Now bathing suits to those who have movement limitations that make swimsuit wear a challenge, or who are tired of the "tug and pull" method of getting into a swim suit. Its unique, attractive design will encourage individuals to get into the pool, instead of having another excuse to avoid it.
Click here to see a video of the Stepin2Now Suit.
Click here to purchase a suit and take advantage of the exclusive, 25% YFA discount!
This past weekend I had been making my way through a box chock-full of Yoga for Arthritis goodies - magazines, research articles, training materials and these interesting looking products called Yoga Toes and Yoga Hands. Ladies, if you have ever gotten a pedicure and used those foam toe separators - you will know exactly what the design idea behind Yoga Toes are.
The claims for Yoga Toes are that they help with alignment of the toe structure, stretching and strengthening of toe muscles. Ideally these would all be important benefits for people with Arthritis.
I have to say that my feelings about this product are mixed. I found that the toe separators were quite wide and therefore made it uncomfortable and difficult to even get this device on my foot. My feet joints are not affected by Arthritis, however I could imagine someone who has pain, inflammation and even some misalignment in their toes would find this product to be the cause of a fair amount of pain.
On the positive side, I was able to eventually get used to the feeling - kept the toes on while planning a yoga class for about half an hour. After taking them off I noticed a nice stretch throughout my foot, feeling that I had greater flexibility and space in my joints than before using the Yoga Toes. Yoga Toes are easy enough to use while sitting for a long time, in bed and can be used at different temperatures - put them in the fridge if cold helps your pain or bring them into a warm bath to encourage even more muscle relaxation.
To purchase Yoga Toes, Click Here
I had a similar experience with the Yoga Hands. Now, I do have some pain and stiffness in my fingers so I was curious and especially sensitive to how this would feel. I have to say that the Hands were somewhat more comfortable than the Toes. The foam separators in the hands seemed to soften the intensity of the stretch in my fingers, while still giving me a similar feeling of stretch and some pain relief after having them on for about ten minutes.
While the Yoga Toes come in different sizes, the Yoga Hands only come in one size and these felt a bit too bulky and big on my hands. I could imagine this would be worth using on days of less pain or for people with less severe effects of Arthritis, however someone with more severe pain might find considerable amounts of
discomfort when using this product.
To purchase Yoga Hands, Click Here
If you have ever used or had experience with people who have used these products please let us know. Know of anything with similar benefits please send us your feedback!
Join in the celebrations as Yoga for Arthritis Founder, Dr. Moonaz helps to expand the reach and understanding of yoga in our society.
Dr. Moonaz will be contributing her expertise in the field by co-authoring a chapter in the forthcoming textbook: "Principles and Practice of Yoga in Healthcare".
This professional-level textbook will capture commentary from the leading researchers, scientists and therapists in the field of yoga therapy, and is expected to become a key resource in the field of yoga therapy. This textbook is largely devoted to a review of the published research on yoga therapy, and is an academic medically-oriented textbook primarily intended as a guide for clinical yoga therapy application for professionals including MD’s, healthcare providers, yoga therapists, and yoga instructors.
Dr. Moonaz's contribution will help to establish a working definition of yoga and yoga therapy. Traditional components of yoga will be discussed in more depth, such as the postures/asanas, pranayama and meditation and how each is used in empirically-based interventions. In teasing out some of the finer details of these components, health-care professionals can expect to gain clarity and a deeper understanding on the elusiveness of “yoga” that is used in some research studies.
Update Jan 2017. This book has been released and you can find a review and purchase information on our website HERE.