Article
Perceived stress mediates the effect of yoga on quality of life and disease activity in ulcerative colitis. Secondary analysis of a randomized controlled trial
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Authors
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Anna Katharina Koch
- Kliniken Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Deutschland
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Margarita Schöls
- Kliniken Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Deutschland
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Jost Langhorst
- Klinikum Bamberg, Department of Internal and Integrative Medicine, Bamberg, Deutschland
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Gustav Dobos
- Kliniken Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Deutschland
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Holger Cramer
- Kliniken Essen-Mitte, Department of Internal and Integrative Medicine, Faculty of Medicine, University of Duisburg-Essen, Essen, Deutschland
| Published: | February 12, 2020 |
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Outline
Text
Background/research question: Yoga positively affects health-related quality of life and disease activity in ulcerative colitis. The underlying modes of action remain unclear. Within the present study we hypothesized that patients´ perceived stress mediates the effects of yoga on health-related quality of life and disease activity.
Methods: This is a secondary analysis of a randomized controlled trial comparing the effects of yoga to written self-care advice in patients with inactive ulcerative colitis and impaired quality of life (ClinicalTrials.gov registration number: NCT02043600). Perceived stress was assessed using the Perceived Stress Questionnaire, health-related quality of life was measured using the Inflammatory Bowel Disease Questionnaire and disease activity captured using the Clinical Activity Index. Outcomes were assessed at weeks 0, 12 and 24.
Results: Seventy-seven patients participated. Thirty-nine patients attended the 12 supervised weekly yoga sessions (71.8% women; 45±13.3 years) and 38 patients written self-care advice (78.9% women; 46.1±10.4 years). Perceived stress correlated significantly with health-related quality of life (r = -.61, p < .001) and disease activity (r = .33, p < .01) at week 24. Perceived stress at week 12 fully mediated the effects of yoga on health-related quality of life (B = 16.23; CI [6.73; 28.40]) and disease activity (B = -.28; CI [-.56; -.06]) at week 24.
Conclusion: Our findings confirm the importance of perceived stress in reducing disease activity and increasing health-related quality of life in patients with ulcerative colitis. Practitioners should keep psychosocial risk in mind as a risk factor for disease exacerbation, and consider yoga as an adjunct intervention for highly stressed patients with ulcerative colitis.
Competing interests: Nothing to declare.
References
- 1.
- Cramer H, Schafer M, Schols M, Kocke J, Elsenbruch S, Lauche R, Engler H, Dobos G, Langhorst J. Randomised clinical trial: yoga vs written self-care advice for ulcerative colitis. Aliment Pharmacol Ther. 2017;45(11):1379-1389
