Yoga Noninferior to Strengthening Exercise for Knee Osteoarthritis
In a randomized clinical trial conducted in southern Tasmania, researchers found that yoga was noninferior to strengthening exercises for managing knee osteoarthritis (OA) pain, while offering modest benefits in additional health domains.
Data from the trial, conducted from April 2021 to December 2022, was analyzed through mid-2024. It enrolled 117 adults aged 40 years or older experiencing moderate knee pain, defined by a score of 40 or higher on a 100-mm visual analog scale (VAS). Participants were randomly assigned to either a yoga group (n = 58) or a strengthening exercise group (n = 59), both of which underwent 12 weeks of mixed supervised and home-based sessions, followed by 12 weeks of unsupervised home sessions.
The study's primary outcome measured the between-group difference in VAS knee pain scores at 12 weeks. Results showed a mean difference of −1.1 mm (95% CI, −7.8 to 5.7 mm), which was not statistically significant but met the noninferiority threshold of 10 mm, suggesting comparable efficacy in pain reduction.
Notably, among the 27 secondary outcomes assessed, 7 showed statistically significant advantages for yoga over 12 and 24 weeks, including improvements in pain, function, and stiffness measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC); patient global assessment scores; and performance on a 40-meter fast-paced walk test.
Additionally, participants in the yoga group reported better depression scores at 12 weeks and improved quality of life at 24 weeks, as measured by validated instruments. Adverse events were mild and similar across both groups.
Despite no significant difference in pain reduction at 12 weeks, the broader health benefits observed suggest yoga could serve as a viable, holistic alternative or complement to traditional strengthening exercises for knee OA management in clinical settings.
Abafita BJ; Singh A, Aitken D, et al. Yoga or Strengthening Exercise for Knee Osteoarthritis: A Randomized Clinical Trial. JAMA Netw Open. 2025;8(4):e253698. doi:10.1001/jamanetworkopen.2025.3698
