In a randomized controlled trial of 117 adults aged 40 and older with clinically diagnosed knee osteoarthritis, researchers compared a structured yoga program to a traditional strengthening exercise regimen over 12 weeks, with follow-up outcomes assessed at 24 weeks. In addition to clinical outcomes, the study included a cost-effectiveness analysis over a three-month period, evaluating both healthcare and broader societal impacts.
The findings come at a critical time, as healthcare systems globally face rising costs associated with chronic musculoskeletal conditions, a press release noted. Knee osteoarthritis alone places a significant burden on both patients and healthcare infrastructure, with costs expected to grow substantially in the coming decades.
Addressing a growing healthcare challenge
Knee OA impacts mobility and quality of life, and also contributes to increased healthcare utilization, lost productivity and early retirement. Traditional treatment guidelines emphasize exercise and weight management as first-line approaches, yet patient adherence to structured strengthening programs can be inconsistent due to accessibility challenges, physical limitations and personal preferences.
Moonaz’s research explores whether yoga, a mind-body practice integrating movement, breathwork and relaxation, can serve as a viable alternative that meets both clinical and economic demands.
Comparing yoga to traditional exercise
The study builds on prior randomized controlled trial data comparing yoga and strengthening exercise programs for individuals with knee OA. Over a 12-week period, both groups experienced similar reductions in knee pain. However, by 24 weeks, participants in the yoga group demonstrated slightly greater improvements in physical function, symptom management and overall quality of life.
These findings suggest yoga matches traditional exercise in effectiveness and may offer added benefits in long-term patient outcomes.
Evaluating cost-effectiveness
What sets this study apart is its focus on economic value, an increasingly important factor in healthcare decision-making. Using a cost-utility framework, researchers analyzed outcomes based on quality-adjusted life years (QALYs), healthcare costs and broader societal impacts such as productivity loss.
“Clinical effectiveness is essential. We don’t want to spend limited resources on treatments that aren’t going to improve biopsychosocial outcomes for patients,” said Moonaz. “In reality, though, we must also consider cost-effectiveness, because even a clinically effective treatment might not provide sufficient benefits to justify the resources it requires. Ideally, we want to optimize both so that patients receive the best possible outcomes with the most efficient use of resources.”
She added that knee osteoarthritis represents a particularly high-burden condition, making cost-effectiveness a critical factor when comparing treatment options with similar clinical benefits.
The results indicated:
- Yoga delivers comparable clinical outcomes to strengthening exercise
- Participants experienced slightly better quality-of-life improvements
- Yoga may provide strong value for money, particularly when factoring in societal costs
The study utilized established economic evaluation methods, including incremental cost-effectiveness ratios (ICERs) and net monetary benefit (NMB), ensuring alignment with international health economics standards.
Implications for healthcare systems
As healthcare systems navigate limited resources and increasing demand, cost-effective, patient-centered interventions are essential. This research suggests integrating yoga into care pathways for knee osteoarthritis could:
- Expand access to treatment options
- Improve patient adherence and engagement
- Reduce overall economic burden on healthcare systems
“Yoga itself is a whole-person intervention,” Moonaz explained. “Many people think of the poses and how they can improve physical function, but yoga is actually much more than that. It offers movement, breathwork, mindfulness, relaxation and community support to help break the stress-pain cycle and improve well-being across multiple domains.”
She noted that offering yoga alongside traditional approaches such as physical therapy provides patients with more options to manage their condition in ways that align with their preferences and needs.
“Clinical effectiveness alone is not enough to guide real-world decisions,” the study noted. “Understanding value for money is essential for allocating limited healthcare resources and supporting patient-centered care.”
Advancing whole health at SCU
This study reflects SCU’s commitment to advancing integrative, evidence-informed approaches to healthcare. By examining both clinical outcomes and economic impact, Moonaz’s work highlights how whole health strategies can deliver meaningful benefits for patients while addressing broader system-level challenges.
“The favorable findings for both clinical effectiveness and cost-effectiveness suggest that clinicians may want to offer yoga as an option for patients,” Moonaz said. “It’s important, however, that programs are designed specifically for individuals with arthritis to ensure safety and effectiveness.”
She added that as evidence continues to grow, healthcare payers may also begin to consider covering evidence-based yoga programs to expand access and improve patient outcomes.
For more information, visit scuhs.edu.
About Southern California University of Health Sciences
Southern California University of Health Sciences (SCU) is one of the world’s only integrative, whole-health universities, teaching students to blend the best of conventional medicine with proven complementary approaches and to treat the whole person (body, mind and spirit). Founded in 1911, SCU has been challenging convention and pushing healthcare forward for more than 100 years. Today, the institution offers graduate, undergraduate and certificate programs in a wide range of disciplines, including Chiropractic, Sports Medicine, Physical & Occupational Therapy, Genetic Counseling, Genetics & Genomics, Medical Science, Physician Assistant, Ayurveda, Acupuncture and Chinese Herbal Medicine, Whole Health Leadership and beyond. Learn more at scuhs.edu.
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