Methods

Subjects

There were 3 categories of subjects: (i) adults (n=37), (ii) children (n=86), and (iii) patients with rheumatoid arthritis (n=20), diagnosed based on standard clinical criteria. An equal number of adults volunteers (n=37), children (n=86), and patients with rheumatoid arthritis (n=20), who did not practice yoga formed the respective control groups. Details (e.g., age range, number of subjects of each gender), are provided in Table 1. Subjects were tested for hand dominance, by asking questions about which hand was used to comb the hair, throw a ball, or to write. Two left-hand dominant subjects were excluded from the study.

Table 1 Details about subjects

Both group (yoga,control) of patients were allowed to continue medication which was prescribed for them. 10 out of 20 patients of the yoga group and 6 out of 20 patients of the control group were on NSAIDs (non-steroidal anti-inflammatory drugs) at the start of the study. The other patients were not receiving medication. The drug score was noted as number of NSAID tablets per day. This was noted every day. However, for analysis values on Day 1 and Day 14 were used.

Design of the study

The three categories of subjects, viz., adults, children and patients with rheumatoid arthritis, received yoga for varying periods based on the yoga camp they were attending. For example, the duration of the yoga training camp was 1 month for adults (n=37), 10 days for children which they did not practice yoga, but carried on with their routine activities. Hence "control” group subjects were assessed as follows: adults (n=37), after 1 month, children (n=86) after 10 days, and patients (n=20) after 14 days.

Assessments

Hand grip strength of both hands was assessed using a hand grip dynamometer (Anand Agencies, Pune, India). Subjects were tested in 6 trials, 3 for each hand alternately, with a gap of 10 seconds between trials. During the assessment subjects were asked to keep their arm extended at shoulder level, horizontal to the ground as has been described earlier (3). The maximum value obtained during the three trials was used for statistical analysis.

Interventions

Certain yoga practices were taught common to all three categories of subjects (i.e. adults, children, and patients). These included yoga asanas or postures (60 minutes), pranayama or voluntarily regulated breathing, meditation, and lectures about yoga philosophy. However, as part of the respective courses other practices were specific for each of the three category of subject, i.e., additional yoga postures for adults, memory games for children which involved chanting verses from ancient Indian texts, and joint loosening exercises for patients with rheumatoid arthritis.

Analysis

The before and after comparison of each category of subjects was analyzed for subjects of each gender separately, using the paired "t"-test (two-tailed) .