Meta-Analyses Demonstrate Mind-body Interventions Reduce Pain Levels And Symptoms Of Depression In People With Osteoarthritis

PURPOSE: People living with osteoarthritis often experience pain and psychological symptoms such as depression. Optimal approaches for improving such health outcomes are yet to be determined. These meta-analyses examine nonpharmacological approaches for pain levels and symptoms of depression in people living with osteoarthritis. METHODS: Relevant studies published from inception up until April 2022 were sourced by searching electronic databases EMBASE, PUBMED & MEDLINE, Web of Science, CINAHL and PEDro. Studies were assessed for methodological quality. Random-effects meta-analyses were performed to calculate pooled effect sizes (ES) and 95% confidence intervals (CI) for pain levels and depression. Heterogeneity was determined using the I2 Index. Subgroup analyses examined intervention subtypes: aerobic/resistance exercise, therapeutic approaches, movement meditation (yoga/tai-chi/qigong), and multimodal approaches (i.e., combined physical activity and therapeutic/mindfulness/education-based approaches). RESULTS: For pain levels, 29 interventions were included (n = 4382; 65 ± 6.9 years; 70% female). Nonpharmacological approaches were significantly associated with reduced pain levels (ES = 0.43, 95%CI [0.25,0.61], p < .001; I2 = 72%). Sub-group analysis revealed effect sizes for reducing pain were significant for movement meditation (ES = 0.52; p < .001), multimodal approaches (ES = 0.37; p < .001), and therapeutic approaches (ES = 0.21; p < .001). Resistance or aerobic exercise alone did not significantly improve pain. For depression, 28 interventions were included (n = 3377; 63 ± 7.0 years; 69% female). Nonpharmacological approaches were significantly associated with reduced symptoms of depression (ES = 0.29, 95%CI [0.08,0.49], p < .001; I2 = 73%). Effect sizes for reducing symptoms of depression were significant for movement meditation (ES = 0.30; p = .008), and multimodal interventions (ES = 0.12; p < .001). Resistance/aerobic exercise or therapeutic approaches alone did not improve symptoms of depression. CONCLUSION: Mind-body approaches such as movement meditation and multimodal approaches were more effective than aerobic/resistance exercise or therapy alone for reducing pain levels and symptoms of depression in people with osteoarthritis.