Effects of Mantra Meditation versus Music Listening on Knee Pain, Function, and Related Outcomes in Older Adults with Knee Osteoarthritis: An Exploratory Randomized Clinical Trial (RCT).

Zenzi Huysmans,Kim E Innes,Sijin Wen,Terry Kit Selfe,Sahiti Kandati

doi:10.1155/2018/7683897

Abstract

Objective Disease-modifying treatments for OA remain elusive, and commonly used medications can have serious side effects. Although meditation and music listening (ML) have been shown to improve outcomes in certain chronic pain populations, research in OA is sparse. In this pilot RCT, we explore the effects of two mind-body practices, mantra meditation (MM) and ML, on knee pain, function, and related outcomes in adults with knee OA. Methods Twenty-two older ambulatory adults diagnosed with knee OA were randomized to a MM (N=11) or ML program (N=11) and asked to practice 15-20 minutes, twice daily for 8 weeks. Core outcomes included knee pain (Knee Injury and Osteoarthritis Outcome Score [KOOS] and Numeric Rating Scale), knee function (KOOS), and perceived OA severity (Patient Global Assessment). Additional outcomes included perceived stress (Perceived Stress Scale), mood (Profile of Mood States), sleep (Pittsburgh Sleep Quality Index), and health-related quality of life (QOL, SF-36). Participants were assessed at baseline and following completion of the program. Results Twenty participants (91%) completed the study (9 MM, 11 ML). Compliance was excellent; participants completed an average of 12.1±0.83 sessions/week. Relative to baseline, participants in both groups demonstrated improvement post-intervention in all core outcomes, including knee pain, function, and perceived OA severity, as well as improvement in mood, perceived stress, and QOL (Physical Health) (p's≤0.05). Relative to ML, the MM group showed greater improvements in overall mood and sleep (p's≤0.04), QOL-Mental Health (p<0.07), kinesiophobia (p=0.09), and two domains of the KOOS (p's<0.09). Conclusions Findings of this exploratory RCT suggest that a simple MM and, possibly, ML program may be effective in reducing knee pain and dysfunction, decreasing stress, and improving mood, sleep, and QOL in adults with knee OA.

Highlights

Osteoarthritis (OA) is the most common form of arthritis and a leading cause of chronic pain and disability in the U.S, affecting at least 30.8 million American adults [1]
In this community-based pilot randomized clinical trial (RCT), we investigated the effects of a simple mantra meditation (MM) program versus a music listening (ML) program on knee pain, function, and related indices in 22 ambulatory older adults with physicianconfirmed OA of the knee
Body mass index (BMI) averaged 34±1.5, and prevalence of comorbidity was high in this sample; 82% of participants reported at least one, and 45% indicated at least 2 chronic comorbid conditions (Table 1)

Summary

Introduction

Osteoarthritis (OA) is the most common form of arthritis and a leading cause of chronic pain and disability in the U.S, affecting at least 30.8 million American adults [1]. Pharmaceuticals remain the treatment mainstay for the vast majority of patients with OA [14, 15], medications used to alleviate OA pain can be costly and carry substantial side effects that are both more common and more problematic in older adults [16,17,18,19]. While the existing literature and guideline recommendations do not support the use of opioids for the management of knee OA, these medications are frequently used [15, 20]. A recent analysis of U.S commercial and Medicare claims data from over 6 million privately insured patients aged 40-75 years (2009-15) indicated that opioid use is elevated among those with knee OA (33-35%) and that likelihood of narcotic use was 6- to 8-fold higher in this population relative to those without diagnosed knee OA [20]

Results

Discussion

Conclusion