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Osteoarthritis Cartilage. 2018 May;26(5):620-630. doi: 10.1016/j.joca.2018.01.022. Epub 2018 Feb 7.

Effectiveness of an Ayurveda treatment approach in knee osteoarthritis - a randomized controlled trial.

Author information

1
Charité́ - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; Immanuel Hospital Berlin, Department for Complementary Medicine, Königstr. 63, 14109 Berlin, Germany.
2
Ministry of AYUSH, AYUSH Bhawan, B Block, GPO Complex, INA, New Delhi 110023, India; Central Council for Research in Ayurvedic Sciences (CCRAS), Jawahar Lal Nehru Bhavan, No.61-65, Institutional Area, Janakpuri, New Delhi 110058, India.
3
Ministry of AYUSH, AYUSH Bhawan, B Block, GPO Complex, INA, New Delhi 110023, India; All India Institute of Ayurveda, Mathura Road, Gautampuri, Sarita Vihar, New Delhi 110076, India.
4
University of Witten Herdecke, Department of Psychology and Psychotherapy, Alfred-Herrhausen-Straße 50, Witten, Germany.
5
European Academy of Ayurveda, Forsthausstr. 6, 63633 Birstein, Germany; Department of Kaya Cikitsa, J.S. Ayurveda College & P.D. Patel Ayurveda Hospital, College Road, Nadiad 387001, India.
6
Ayurvedic Point, School of Ayurvedic Medicine, Corso Sempione 63, 20149 Milan, Italy.
7
European Academy of Ayurveda, Forsthausstr. 6, 63633 Birstein, Germany; University of Frankfurt, Department of Religious Sciences, Grüneburgplatz 1, 60323 Frankfurt, Germany.
8
Immanuel Hospital Berlin, Department for Complementary Medicine, Königstr. 63, 14109 Berlin, Germany.
9
Charité́ - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
10
Charité́ - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; Immanuel Hospital Berlin, Department for Complementary Medicine, Königstr. 63, 14109 Berlin, Germany. Electronic address: a.michalsen@immanuel.de.
11
Charité́ - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, 10117 Berlin, Germany; Institute of Complementary and Integrative Medicine, University Hospital and University of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland; University of Maryland School of Medicine, Center for Integrative Medicine, 520 W. Lombard Street, East Hall, Baltimore, MD 21201, USA.

Abstract

OBJECTIVE:

Ayurveda is commonly used in South Asia to treat knee osteoarthritis (OA). We aimed to evaluate the effectiveness of Ayurvedic treatment compared to conventional conservative care in patients with knee OA.

METHOD:

According to American College of Rheumatology (ACR) criteria knee OA patients were included in a multicenter randomized, controlled, open-label trial and treated in 2 hospital clinics and 2 private outpatient clinics in Germany. Participants received either a multi-modal Ayurvedic treatment or multi-modal conventional care with 15 treatments over 12 weeks respectively. Primary outcome was the change on the Western Ontario and McMaster University Osteoarthritis (WOMAC) Index after 12 weeks. Secondary outcomes included WOMAC subscales; the pain disability index and a pain experience scale, numeric rating scales for pain and sleep quality, quality-of-life and mood, rescue medication use, and safety issues.

RESULTS:

One hundred fifty-one participants (Ayurveda n = 77, conventional care n = 74) were included. Changes of the WOMAC Index from baseline to 12 weeks were more pronounced in the Ayurveda group (mean difference 61.0 [95%CI: 52.4;69.6]) than in the conventional group (32.0 [95%CI: 21.4;42.6]) resulting in a significant between-group difference (p < 0.001) and a clinically relevant effect size (Cohen's d 0.68 [95% CI:0.35;1.01]). Similar trends were observed for all secondary outcomes at week 12. Effects were sustained at follow-ups after 6 and 12 months.

CONCLUSION:

Results suggest that Ayurvedic treatment is beneficial in reducing knee OA symptoms. Further studies should be conducted to confirm the magnitude of the effect and to clarify the role of different treatment components and non-specific effects. REGISTRATION: at clinicaltrials.gov (NCT01225133; initial release 10/06/2010).

KEYWORDS:

Ayurveda; Complementary medicine; Integrative medicine; Knee osteoarthritis

PMID:
29426006
DOI:
10.1016/j.joca.2018.01.022
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