Investigating the comparative effectiveness of yoga and relaxation therapy on irritability, muscle tension, and sleep problems in patients with rheumatism

Effect of yoga and relaxation therapy on irritability

Authors

Abstract

BACKGROUND: Rheumatoid arthritis (RA), a debilitating autoimmune disease, has a significant impact on both the physical and mental well-being of those affected due to its long-lasting nature. The study aimed to investigate the comparative effectiveness of yoga and relaxation therapy in improving the control of irritability, increased muscle tension, and sleep problems encountered by individuals with rheumatism.

METHODS: A semi-experimental study was conducted using a pre-test, post-test, and follow-up design that spanned three months. The research involved three groups: one group of 18 participants who received yoga therapy, another group of 15 participants who received relaxation therapy, and a control group of 19 participants who did not receive any therapy. The population for this research involved all patients with rheumatism referred to the Iranian Rheumatism Center in Tehran City, Iran, between July and November 2023. Sixty individuals were selected using purposive sampling. The yoga therapy group received eight in-person sessions lasting 90 minutes each once a week, while the relaxation therapy group practiced at home with six 90-minute sessions once a week. The research utilized several tools, including the Irritability Questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and a standardized visual scale for muscle tension measurement. The research data were analyzed using analysis of variance (ANOVA) and multivariate analysis of covariance (MANCOVA) with SPSS software.

RESULTS: The irritability variable showed a noteworthy disparity between the yoga therapy and relaxation therapy groups compared to the control group (P < 0.05). Both intervention approaches in this study influenced the irritability variable. Conversely, there was no notable distinction in muscle tension between the yoga therapy, relaxation therapy, and control groups (P > 0.05). Sleep problems displayed significant differences between the relaxation therapy and control groups (P = 0.004). However, the yoga therapy intervention in this study did not affect the sleep problem.

CONCLUSION: Based on the results of the current research, it appears that both yoga therapy and relaxation therapy could be beneficial in decreasing irritability in individuals with rheumatism. Additionally, relaxation therapy has the potential to enhance sleep quality in these patients.

References

Moore JM, Norris JM, Clark ML. Exposure to Air Pollutants and Rheumatoid Arthritis Biomarkers: A Scoping Review. InSeminars in Arthritis and Rheumatism 2024 Jan 5 (p. 152365). WB Saunders. https://doi.org/10.1016/j.semarthrit.2024.152365

Prabha J, Kumar M, Kumar D, Chopra S, Bhatia A. Nano-platform Strategies of Herbal Components for the management of Rheumatoid Arthritis: A Review on the Battle for Next-Generation Formulations. Curr Drug Deliv. 2023 Aug 25. doi: 10.2174/1567201821666230825102748 .[PubMed: 37622715].

Ali Akbari M, Hassanzadeh Hanoui M, Alipour A, Bayat N. The Effectiveness of Schema Therapy on Coping Styles in Rheumatoid Arthritis Patients. Health Psychology. 2023 Apr 21;12(45):147-62. doi: 10.30473/hpj.2023.67051.5754

Chen L, Wu B, Mo L, Chen H, Zhao Y, Tan T, Chen L, Li Y, Yao P, Tang Y. Associations between biological ageing and the risk of, genetic susceptibility to, and life expectancy associated with rheumatoid arthritis: a secondary analysis of two observational studies. Lancet Healthy Longev. 2024 Jan;5(1):e45-e55. doi: 10.1016/S2666-7568(23)00220-9 .[PubMed: 38081205].

Lwin MN, Serhal L, Holroyd C, Edwards CJ. Rheumatoid Arthritis: The Impact of Mental Health on Disease: A Narrative Review. Rheumatol Ther. 2020 Sep;7(3):457-471. doi: 10.1007/s40744-020-00217-4 .[PubMed: 32535834].

Saatchi B, Olshansky EF, Fortier MA. Irritability: A concept analysis. Int J Ment Health Nurs. 2023 Oct;32(5):1193-1210. doi: 10.1111/inm.13140 .[PubMed: 36929104].

Abdelnaser NM, Abdul Basset SA, Elkhouly RM, Mahdy HA, Ibrahim AA. Vitamin D Level in Rheumatoid Arthritis Patients in Saudi Arabia and its Correlation with Disease Activity and Mood Changes. Benha medical journal. 2023 Sep 1;40(2):317-32. 10.21608/bmfj.2022.174640.1707

Farrow M, Biglands J, Alfuraih AM, Wakefield RJ, Tan AL. Novel Muscle Imaging in Inflammatory Rheumatic Diseases-A Focus on Ultrasound Shear Wave Elastography and Quantitative MRI. Front Med (Lausanne). 2020 Aug 12;7:434. doi: 10.3389/fmed.2020.00434 .[PubMed: 32903395].

Lin JZ, Liu Y, Ma JD, Mo YQ, Chen CT, Chen LF, Li QH, Yang ZH, Zheng DH, Ling L, Miossec P, Dai L. Reduced skeletal muscle independently predicts 1-year aggravated joint destruction in patients with rheumatoid arthritis. Ther Adv Musculoskelet Dis. 2020 Aug 23;12:1759720X20946220. doi: 10.1177/1759720X20946220 .[PubMed: 32922525].

Irwin MR, Straub RH, Smith MT. Heat of the night: sleep disturbance activates inflammatory mechanisms and induces pain in rheumatoid arthritis. Nat Rev Rheumatol. 2023 Sep;19(9):545-559. doi: 10.1038/s41584-023-00997-3 .[PubMed: 37488298].

Azizli A, Sargın G, Senturk T. The effect of disease-modifying antirheumatic drugs on sleep and quality of life in older patients with rheumatoid arthritis. J Rheum Dis. 2023 Apr 1;30(2):99-105. doi: 10.4078/jrd.22.0053.[PubMed: 37483477].

Katz P, Pedro S, Michaud K. Sleep Disorders Among Individuals With Rheumatoid Arthritis. Arthritis Care Res (Hoboken). 2023 Jun;75(6):1250-1260. doi: 10.1002/acr.24999 .[PubMed: 35997482].

Andrea Cortés-Ladino C, Augusto Arias-Ortiz W, Porras-Ramírez A. Effectiveness of Yoga and Acupuncture in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2023 Oct 6;2023:9098442. doi: 10.1155/2023/9098442.[PubMed: 37842334].

Gautam S, Kumar R, Kumar U, Kumar S, Luthra K, Dada R. Yoga maintains Th17/Treg cell homeostasis and reduces the rate of T cell aging in rheumatoid arthritis: a randomized controlled trial. Scientific Reports. 2023 Sep 11;13(1):14924. https://doi.org/10.1038/s41598-023-42231-w

Panjwani U, Dudani S, Wadhwa M. Sleep, Cognition, and Yoga. Int J Yoga. 2021 May-Aug;14(2):100-108. doi: 10.4103/ijoy.IJOY_110_20.[PubMed: 34188381].

Halappa NG. Integration of yoga within exercise and sports science as a preventive and management strategy for musculoskeletal injuries/disorders and mental disorders - A review of the literature. J Bodyw Mov Ther. 2023 Apr;34:34-40. doi: 10.1016/j.jbmt.2023.04.055 .[PubMed: 37301554].

Grekhov RA, Suleimanova GP, Trofimenko AS, Shilova LN. Psychosomatic Features, Compliance and Complementary Therapies in Rheumatoid Arthritis. Curr Rheumatol Rev. 2020;16(3):215-223. doi: 10.2174/1573397115666191212114758 .[PubMed: 31830886].

Gupta N. Effect of Progressive Muscular Relaxation Technique (PMRT) on Anger-Expression of White-Collar Workers. IJRAR-International Journal of Research and Analytical Reviews (IJRAR). 2020 Feb;7(1):205-12.

Ismail AMA. Complementary role of Benson's relaxation technique in post orgasmic illness syndrome. Aging Male. 2023 Dec;26(1):2174511. doi: 10.1080/13685538.2023.2174511 .[PubMed: 36724808].

Kılıç N, Parlar Kılıç S. The effect of progressive muscle relaxation on sleep quality and fatigue in patients with rheumatoid arthritis: A randomized controlled trial. Int J Nurs Pract. 2023 Jun;29(3):e13015. doi: 10.1111/ijn.13015 .[PubMed: 34569129].

Kang H. Sample size determination and power analysis using the G* Power software. Journal of educational evaluation for health professions. 2021 Jul 30;18. DOI: https://doi.org/10.3352/jeehp.2021.18.17

Pradhan B. Yoga and mindfulness based cognitive therapy: a clinical guide. Springer; 2014 Nov 5.

Ajami M, Sajjadian I. The Effectiveness of Yoga and Mindfulness-Based Cognitive Therapy on Negative and Positive Emotions and Cognitive Emotion Regulation in People with Inflammatory Bowel Disease. Journal of Research in Behavioural Sciences. 2022 Jan 10;19(4):718-30. http://dx.doi.org/10.52547/rbs.19.4.718

Yu DS, Lee DT, Woo J. Effects of relaxation therapy on psychologic distress and symptom status in older Chinese patients with heart failure. J Psychosom Res. 2007 Apr;62(4):427-37. doi: 10.1016/j.jpsychores.2006.10.012

Bernstein DA, Borkovec TD, Hazlett-Stevens H. New directions in progressive relaxation training: A guidebook for helping professionals. Greenwood Publishing Group; 2000 Feb 28.

Craig KJ, Hietanen H, Markova IS, Berrios GE. The Irritability Questionnaire: a new scale for the measurement of irritability. Psychiatry research. 2008 Jun 30;159(3):367-75. https://doi.org/10.1016/j.psychres.2007.03.002

Mirbagheri AM, Zanjani Z, Omidi A, Azadchehr MJ. Investigating the Effect of Acceptance and Commitment Therapy on Irritability and Emotional Numbness in Children of Veterans Suffering from War-Induced Posttraumatic Stress Disorder. Journal of Military Medicine. 2022 Oct 1;24(4). https://doi.org/10.30491/JMM.24.4.1241

Buysse DJ, Reynolds III CF, Monk TH, Hoch CC, Yeager AL, Kupfer DJ. Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI). Sleep. 1991 Jul 1;14(4):331-8. https://doi.org/10.1093/sleep/14.4.331

Mirzaei F, Khodabakhshi-Koolaee A. The relationship between sleep quality and perceived social support with loneliness in elderly men. Journal of Gerontology. 2018 Jan 10;2(4):11-20. URL: http://joge.ir/article-1-182-en.html

Shafiei Z, Nourian K, Babaee S, Nazari A, Atashi V. Effectiveness of massage therapy on muscular tension and relaxation of patients after coronary artery bypass graft surgery-a randomized clinical trial. Journal of Clinical Nursing and Midwifery. 2014 Jan 10;2(4):8-16. URL: http://78.39.35.47/article-1-64-en.html

Childs‐Fegredo J, Fontana E, Moran M, Faulkner P. Yoga‐integrated psychotherapy for emotion dysregulation: A pilot study. Counselling and Psychotherapy Research. 2023 Sep;23(3):638-52. https://doi.org/10.1002/capr.12602

Wu Y, Yan D, Yang J. Effectiveness of yoga for major depressive disorder: A systematic review and meta-analysis. Front Psychiatry. 2023 Mar 23;14:1138205. doi: 10.3389/fpsyt.2023.1138205 .[PubMed: 37032928].

Sayadi AR, Khodadadi A, Akbari A, Abbasabadi Z. The effect of movement therapy with progressive muscle relaxation on the depression rate of patients admitted to the psychiatric ward of Moradi Rafsanjan Educational and Medical Center in 2021. J Med Life. 2023 Jan;16(1):129-134. doi: 10.25122/jml-2021-0436.[PubMed: 36873116].

Sundharamoorthi P, Samuel AJ, Gopal R, Balakrishnan S, Vimala AG. Effectiveness of Relaxation Therapy in Cancer Pain Management and Its Impact On Psychosocial Issues In Cancer Patients.

Anderson R, Mammen K, Paul P, Pletch A, Pulia K. Using Yoga Nidra to Improve Stress in Psychiatric Nurses in a Pilot Study. J Altern Complement Med. 2017 Jun;23(6):494-495. doi: 10.1089/acm.2017.0046 .[PubMed: 28530462].

Ferendiuk E, Biegańska JM, Kazana P, Pihut M. Progressive muscle relaxation according to Jacobson in treatment of the patients with temporomandibular joint disorders. Folia Med Cracov. 2019;59(3):113-122. doi: 10.24425/fmc.2019.131140 .[PubMed: 31891364].

Bakavoly ME, Sajjadi M, Ghasemi R, Ajamzibad H. Comparison of the Impacts of Benson Relaxation Technique and Foot Reflexology Massage on Sleep Quality of Patients with Systolic Heart Failure: A Randomized Clinical Trial. Iran J Nurs Midwifery Res. 2023 Jul 24;28(4):448-454. doi: 10.4103/ijnmr.ijnmr_332_21 .[PubMed: 37694200].

Zhu J, Chen X, Zhen X, Zheng H, Chen H, Chen H, Liao H, Zhu J, Wang C, Zheng Z, Chen R, Wang Y. Meta-analysis of effects of yoga exercise intervention on sleep quality in breast cancer patients. Front Oncol. 2023 Jun 30;13:1146433. doi: 10.3389/fonc.2023.1146433 .[PubMed: 37456259].

Downloads

Published

2025-01-19

How to Cite

1.
Mozafari M, Azadeh Ghahfarokhi M, Fouladi S, Amirzadeh-Gougheri K, Torabi E. Investigating the comparative effectiveness of yoga and relaxation therapy on irritability, muscle tension, and sleep problems in patients with rheumatism: Effect of yoga and relaxation therapy on irritability. Chron Dis J. 2025;13(1):1–10.

Issue

Section

Original Article(s)