Romatizmal Hastalıklarda Yoga

Öz

Yoga, binlerce yıl önce Hindistan’da ortaya çıkan, bireyin fiziksel, zihinsel, duygusal ve spirütüel boyutlarına denge ve sağlık getirmek için tasarlanan eski bir disiplindir. Son yıllarda sağlık için yoga uygulaması dünya çapında popüler hale gelmiştir. Esnekliği artırmak, genel kondisyonu, genel sağlığı, fiziksel uygunluğu iyileştirmek ve stresi azaltmak yogaya başlamak için en çok bildirilen nedenlerdir. Yoga yararlı etkilerinden dolayı alternatif bir terapatik yaklaşım olarak bilinir. Klinik yoga, hastalığı önlemek, iyileştirmek ve/veya düzeltmek için geleneksel yoga uygulamalarının kullanımını içerir. Romatizmal hastalıklar eklemlerde ağrı, şişlik, sertlik ve fonksiyon kaybına neden olarak bireylerin yaşam kalitesinde azalma ve engelliliğe neden olabilir. Artrit hastalarının yönetiminde ilaç ve cerrahi müdahalenin yanı sıra öz-yönetim, fizik tedavi, ergoterapi, kilo kaybı gibi farmakolojik olmayan yaklaşımlar önerilmektedir. Öz yönetimin ve fiziksel aktivitenin artmasının rolü, artritin tedavisinde büyük önem taşır. Terapatik etkilerinden dolayı yoga romatizmal hastalığı olanlar için alternatif bir yaklaşım olarak düşünülebilir. Son yıllarda romatoid artrit, osteoartrit ve fibromyalji gibi romatizmal hastalıklarda yoganın etkinliğinin araştırıldığı çalışmalar artmaktadır. Mekanizması tam olarak açıklanamasa da yoganın özellikle ağrı üzerine olumlu etkileri olduğu bildirilmiştir. Ayrıca hastalık semptomları, fonksiyon, psikolojik durum, uyku ve yaşam kalitesinde iyileşmeler bildirilmiştir. Fiziksel duruşlar, nefes çalışmaları, meditasyon ve yoga felsefesi birlikte uygulandığında daha etkili sonuçlar gözlenmiştir. Fakat çalışmalardaki randomizasyon eksiklikleri, küçük örneklem büyüklükleri, yoga müdahalelerinin standardizasyonunun olmaması ve müdahalelerin değişen dozajları nedeniyle çalışma sonuçlarının dikkatli yorumlanması gereklidir. Çalışmaların tüm bu sınırlamalarına rağmen, yoga artrit için umut verici bir yöntemdir. Yoga, romatoid atrit, osteoartrit, fibromyalji sendromu olan hastalar için yardımcı bir tedavi olarak düşünülebilir.

Anahtar Kelimeler

• yoga
• romatizmal hastalıklar
• romatoid artrit
• osteoartrit
• fibromyalji

Yoga in Rheumatic Diseases

Öz

Yoga is an ancient discipline that emerged in India thousandans of years ago, designed to bring balance and health to the physical, mental, emotional and spiritual dimensions of the individual. Yoga practice for health has become popular worldwide in recent years. Increasing flexibility, improving overall condition, overall health, physical fitness, and reducing stress are the most reported reasons for starting yoga. Yoga is known as an alternative therapeutic approach due to its beneficial effects. Clinical yoga involves the use of traditional yoga practices to prevent, cure and / or ameliorate disease. Rheumatic diseases can cause pain, swelling, stiffness and loss of function in the joints, leading to decreased quality of life and disability. In the management of arthritis patients, non-pharmacological approaches such as self-management, physical therapy, ergotherapy, weight loss, as well as drug and surgical intervention are recommended. The role of self-management and increased physical activity is of great importance in the treatment of arthritis. Due to its therapeutic effects, yoga can be considered as an alternative approach for those with rheumatic disease. In recent years, studies investigating the effectiveness of yoga in rheumatic diseases such as rheumatoid arthritis, osteoarthritis and fibromyalgia have been increasing. Although the mechanism is not fully explained, yoga has been reported to have positive effects especially on pain. In addition, improvements in disease symptoms, function, psychological state, sleep and quality of life have been reported. More effective results were observed when physical postures, breathing exercises, meditation and yoga philosophy were applied together. However, due to lack of randomization in studies, small sample sizes, lack of standardization of yoga interventions and changing dosages of interventions, study results should be interpreted with caution. Despite all these limitations of studies, yoga is a promising method for arthritis. Yoga can be considered as an adjunct therapy for patients with rheumatoid atritis, osteoarthritis, fibromyalgia syndrome.

Kaynakça

1. 1. Ross A, Thomas S. The health benefits of yoga and exercise: a review of comparison studies. The journal of alternative and complementary medicine. 2010;16(1):3-12.
2. 2. Stephens I. Medical yoga therapy. Children. 2017;4(2):12.
3. 3. Taylor MJ. Yoga therapeutics: an ancient, dynamic systems theory. Techniques in Orthopaedics. 2003;18(1):115-25.
4. 4. Garfinkel M, Schumacher Jr HR. Yoga. Rheumatic Disease Clinics of North America. 2000;26(1):125-32.
5. 5. Worby C. Her yönüyle yoga. Çiğdem Fromm (Çev). 2007;2(22):24-46.
6. 6. Pandurangi AK, Keshavan MS, Ganapathy V, Gangadhar BN. Yoga: past and present. American Journal of Psychiatry. 2017;174(1):16-7.
7. 7. Birdee GS, Legedza AT, Saper RB, Bertisch SM, Eisenberg DM, Phillips RS. Characteristics of yoga users: results of a national survey. Journal of general internal medicine. 2008;23(10):1653-8.
8. 8. Bartlett SJ, Moonaz SH, Mill C, Bernatsky S, Bingham CO. Yoga in rheumatic diseases. Current rheumatology reports. 2013;15(12):387.

9. 9. Ross A, Friedmann E, Bevans M, Thomas S. National survey of yoga practitioners: mental and physical health benefits. Complementary therapies in medicine. 2013;21(4):313-23.
10. 10. Ward L, Stebbings S, Sherman KJ, Cherkin D, Baxter GD. Establishing key components of yoga interventions for musculoskeletal conditions: a Delphi survey. BMC complementary and alternative medicine. 2014;14(1):196.
11. 11. Wren AA, Wright MA, Carson JW, Keefe FJ. Yoga for persistent pain: new findings and directions for an ancient practice. Pain. 2011;152(3):477.
12. 12. Morey JN, Boggero IA, Scott AB, Segerstrom SC. Current directions in stress and human immune function. Current opinion in psychology. 2015;5:13-7.
13. 13. Salleh MR. Life event, stress and illness. The Malaysian journal of medical sciences: MJMS. 2008;15(4):9.
14. 14. Steptoe A, Hamer M, Chida Y. The effects of acute psychological stress on circulating inflammatory factors in humans: a review and meta-analysis. Brain, behavior, and immunity. 2007;21(7):901-12.
15. 15. Gouin J-P, Glaser R, Malarkey WB, Beversdorf D, Kiecolt-Glaser J. Chronic stress, daily stressors, and circulating inflammatory markers. Health Psychology. 2012;31(2):264.
16. 16. Thirthalli J, Naveen G, Rao M, Varambally S, Christopher R, Gangadhar B. Cortisol and antidepressant effects of yoga. Indian journal of psychiatry. 2013;55(Suppl 3):S405.
17. 17. Riley KE, Park CL. How does yoga reduce stress? A systematic review of mechanisms of change and guide to future inquiry. Health psychology review. 2015;9(3):379-96.
18. 18. Sharma M. Yoga as an alternative and complementary approach for arthritis: a systematic review. Journal of evidence-based complementary & alternative medicine. 2014;19(1):51-8.
19. 19. Evans S, Moieni M, Taub R, Subramanian SK, Tsao JC, Sternlieb B, et al. Iyengar yoga for young adults with rheumatoid arthritis: results from a mixed-methods pilot study. Journal of pain and symptom management. 2010;39(5):904-13.
20. 20. Winzenberg T, Shaw K, Zochling J. Nonpharmacological interventions for rheumatoid arthritis. Australian family physician. 2007;36(10):840.
21. 21. Skapenko A, Prots I, Schulze-Koops H. Prognostic factors in rheumatoid arthritis in the era of biologic agents. Nature Reviews Rheumatology. 2009;5(9):491-6.
22. 22. Badsha H, Chhabra V, Leibman C, Mofti A, Kong KO. The benefits of yoga for rheumatoid arthritis: results of a preliminary, structured 8-week program. Rheumatology international. 2009;29(12):1417-21.
23. 23. Bosch PR TT, Howard P, Matt KS. Functional and physiological effects of yoga in women with rheumatoid arthritis: a pilot study. Altern Ther Health Med. 2009;15(4):24-31.
24. 24. Telles S, Naveen KV, Gaur V, Balkrishna A. Effect of one week of yoga on function and severity in rheumatoid arthritis. BMC research notes. 2011;4(1):118.
25. 25. Evans S, Moieni M, Lung K, Tsao J, Sternlieb B, Taylor M, et al. Impact of iyengar yoga on quality of life in young women with rheumatoid arthritis. The Clinical journal of pain. 2013;29(11):988.
26. 26. Telles S, Singh N. Is yoga a suitable treatment for rheumatoid arthritis: Current opinion. Open access journal of sports medicine. 2012;3:81.
27. 27. Cheung C, Park J, Wyman JF. Effects of yoga on symptoms, physical function, and psychosocial outcomes in adults with osteoarthritis: a focused review. American Journal of Physical Medicine & Rehabilitation. 2016;95(2):139-51.
28. 28. Kan L, Zhang J, Yang Y, Wang P. The effects of yoga on pain, mobility, and quality of life in patients with knee osteoarthritis: a systematic review. Evidence-Based Complementary and Alternative Medicine. 2016;2016.
29. 29. Ebnezar J, Nagarathna R, Yogitha B, Nagendra HR. Effects of an integrated approach of hatha yoga therapy on functional disability, pain, and flexibility in osteoarthritis of the knee joint: a randomized controlled study. The Journal of Alternative and Complementary Medicine. 2012;18(5):463-72.
30. 30. Kolasinski SL, Garfinkel M, Tsai AG, Matz W, Dyke AV, Schumacher Jr HR. Iyengar yoga for treating symptoms of osteoarthritis of the knees: a pilot study. Journal of Alternative & Complementary Medicine. 2005;11(4):689-93.
31. 31. Ghasemi GA, Golkar A, Marandi SM. Effects of hata yoga on knee osteoarthritis. International journal of preventive medicine. 2013;4(Suppl 1):S133.
32. 32. Taibi DM, Vitiello MV. A pilot study of gentle yoga for sleep disturbance in women with osteoarthritis. Sleep medicine. 2011;12(5):512-7.
33. 33. Cheung C, Wyman JF, Resnick B, Savik K. Yoga for managing knee osteoarthritis in older women: a pilot randomized controlled trial. BMC complementary and alternative medicine. 2014;14(1):160.
34. 34. Hansen Ed. Yoga for seniors with arthritis: A pilot study. International Journal of Yoga Therapy. 2010;20(1):55-60.
35. 35. Brenneman EC, Kuntz AB, Wiebenga EG, Maly MR. A yoga strengthening program designed to minimize the knee adduction moment for women with knee osteoarthritis: a proof-of-principle cohort study. PloS one. 2015;10(9).
36. 36. Ebnezar J, Nagarathna R, Bali Yogitha HRN. Effect of integrated yoga therapy on pain, morning stiffness and anxiety in osteoarthritis of the knee joint: a randomized control study. International Journal of Yoga. 2012;5(1):28.
37. 37. Cabral P, Meyer HB, Ames D. Effectiveness of yoga therapy as a complementary treatment for major psychiatric disorders: a meta-analysis. The primary care companion to CNS disorders. 2011;13(4).
38. 38. Busch AJ, Webber SC, Brachaniec M, Bidonde J, Dal Bello-Haas V, Danyliw AD, et al. Exercise therapy for fibromyalgia. Current pain and headache reports. 2011;15(5):358.
39. 39. Carson JW, Carson KM, Jones KD, Bennett RM, Wright CL, Mist SD. A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia. PAIN®. 2010;151(2):530-9.
40. 40. Curtis K, Osadchuk A, Katz J. An eight-week yoga intervention is associated with improvements in pain, psychological functioning and mindfulness, and changes in cortisol levels in women with fibromyalgia. Journal of pain research. 2011;4:189.