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Effectiveness of Yoga in reducing IL-6 serum level in elderly with knee osteoarthritis


Introduction: Osteoarthritis (OA) is a progressive degenerative disease. Yoga exercise is one of the non-pharmacological treatments for knee OA. It can improve joint function through a mind-body connection mechanism. It is also non-invasive and relatively safe to do at all ages, including the elderly. Interleukin-6 is one of the circulating inflammation biomarkers in knee OA. This study showed yoga's effectiveness objectively by measuring inflammatory biomarkers' changes, namely interleukin-6 (IL-6) in knee OA cases.

Methods: This research was a randomized control trial. The study was conducted in 8 weeks when the blood sampling and serum IL-6 level quantifications were taken.

Results: There was a significant difference (p <0.005) and large Effect Size (ES > 0,8) in serum IL-6 levels before and after treatment between yoga and the control group.

Conclusion: Therefore, we conclude that yoga is a lifestyle modification intervention that improves the clinical condition of knee OA by altering the inflammatory control pathways activity. We highly recommend that future studies use a larger sample size and analyze more specific biomarkers describing joint degradation in knee OA cases.


  1. McDonough C.M and Jette A.M. The contribution of OA to functional limitations and disability. Clin Geriatr Med., 2010; 26(3): 387–399.
  2. Bridget L, March L, Hoy D, Penserga E, and Brooks P. The epidemiology of OA in Asia. Int J Rheum Dis., 2011; 14(2): 113-121.
  3. Nguyen T.V. OA in Southeast Asia. Int. J. Clin. Rheumatol., 2014; 9(5): 405-408.
  4. Salmon J.H, Rat A.C, Sellam J, Michel M, Eschard J.P, Guillemin F, Jolly D, and Fautrel B. Economic impact of lower-limb OA worldwide: a systematic review of cost-of-illness studies. Osteoarthr Cartil., 2016; 24: 1500-1508.
  5. Farr J, Larry E. Miller, and Block JE Quality of life in patients with knee OA: A Commentary on nonsurgical and surgical Treatments. Open Orthop J., 2013; 7: 619–623.
  6. Deepeshwar S, Tanwar M, Kavuri V, and Budhi R.B. Effect of yoga based lifestyle intervention on patients with knee OA: A Randomized controlled trial. Front Psychiatry., 2018; 8: 180-190.
  7. Ghasemi G.A, Golkar A and Marandi SM Effects of Hata yoga on knee OA. Int J Prev Med., 2013; 4(1): 133-138.
  8. Stannus O, Jones G, Cicuttini F, Parameswaran V, Quinn S, Burgess J, Ding C. Circulating levels of IL-6 and TNF-a are associated with knee radiographic OA and knee cartilage loss in older adults. Osteoarthr Cartil., 2010; 18: 1441-1447.
  9. Salehi-Abari, I. ACR Revised Criteria for Early Diagnosis of Knee OA. Autoimmune Dis Ther Approaches., 2016; 3(1): 118-123.
  10. World Health Organization. Body Mass Index-BMI. [Internet]. 2020. Available from : topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi. Accessed April 2, 2020.
  11. Blagojevic M, Jinks C, Jeffery A. Risk factors for onset of OA of the knee in older adults: a systematic review and meta-analysis. Osteoarthr Cartil., 2010; 18: 24–33.
  12. Anderson A.S, Loeser, R.F. Why is OA an Age-Related Disease?. Best Pract Res Clin Rheumatol., 2010; 24(1): 15-26.
  13. Freund A, Orjalo A.V, Desprez PY Inflammatory networks during cellular senescence: causes and consequences. Trends Mol Med., 2010; 16: 238–246.
  14. Naik E, Dixit V.M. Mitochondrial reactive oxygen species drive proinflammatory cytokine production. J Exp Med., 2011; 208(3): 417–420.
  15. Loeser R.F, Glodring S.R, Scanzello C.R, Goldring M.B. Osteoartritis A disease of the joint as an organ. Arthritis Rheum., 2012; 64: 1697-1707.
  16. Claassen H, Schict M, Brandt J, Reuse K, Schadlich R, Goldringc M.B, Guddatd S.S, Thatea A, and Paulsen F. C-28/12 andT/C-28a2 chondrocytes as well as human primary articular chondrocytes express sex hormone and insulin receptors-useful cells in study of cartilage metabolism. Ann Anat Anatomischer Anzeiger., 2011; 193: 23-29.
  17. Haaz, S. and Bartlett, S.J. Yoga for Arthritis: A Scoping Review. Rheum Dis Clin N Am., 2011; 37: 33-46.
  18. Awasthi V, Singh A, Srivastava R.N, Verma N.S, Kumar S, Mahadi A.A. A Randomized Controlled Trial: Evaluation of Yoga with IL6 as Biomarker in the Management of Knee OA. Int J Heal Sci Res., 2015; 73(5): 73-79.
  19. Horsburgh S, Robson-Ansley P, Adams R, Smith C. Exercise and inflammation related epigenetic modifications: focus on DNA methylation. Exerc Immunol Rev., 2015; 21: 26-41.
  20. Kiecolt-Glaser J.K, Bennett J.M, Andridge R, Peng J, Shapiro C.L, Malarkey W.B, Emery C.F, Layman R, Mrozek E.E, and Glaser R. Yoga's impact on inflammation, mood, and fatigue in breast cancer survivors: a randomized controlled trial. J Clin Oncol., 2014; 32: 1040–1049.
  21. Kiecolt-Glaser JK, Christian L, Preston H, Houts CR, Malarkey WB, Emery C.F, and Glaser R. Stress, inflammation, and yoga practice. Psychosom Med., 2010; 72(2): 113-121.
  22. Kaliman P., Álvarez-Lópeza, M.J., Cosín-Tomása, M., Rosenkranzc, M.A., Lutzc, A, Davidson R.J. Rapid changes in histone deacetylases and inflammatory gene expression in expert meditators. Psychoneuroendocrinology., 2014; 40: 96–107.
  23. Lavretsky H, Epel ES, Siddarth P, Nazarian N, Cyr N.S, Khalsa D.S, Lin J, Blackburn E, Epel ES, and Irwin M.R. A pilot study of yogic meditation for family dementia caregivers with depressive symptoms: effects on mental health, cognition, and telomerase activity. Int J Geriatr Psychiatry., 2013; 28(1): 57 –65.
  24. Niles H, Mehta D.H, Corrigan A.A, Bhasin M.K, Denninger J.W. Functional genomics in the study of mind-body therapies. Ochsner J., 2014; 14(4): 681-695.
  25. Buric, I, Farias M, Jong J, Mee C, Brazil IA What is the molecular signature of mind-body interventions? A systematic review of gene expression changes induces by meditation and related practices. Front Immunol., 2017; 8: 670-687.
  26. Creswell J.D, Irwin M.R, Lisa J, Burklund, Lieberman M.D, Arevalo J.M.G, Ma J, Breen E.C, and Cole S.W. Mindfulness-based stress reduction training reduces loneliness and pro-inflammatory gene expression in older adults: a small randomized controlled trial. Brain Behav Immun., 2012; 26(7): 1095-1100.
  27. Irwin MR, Cole SW. Reciprocal regulation of the neural and innate immune systems. Nat Rev Immunol., 2011; 11: 625–632.
  28. Black D.S, Cole S, Irwin M.R, Breen E., Cyr N.M.S, Nazarian N, Khalsa D.S, and Lavretsky H. Yogic meditation reverses NF-κB and IRF-related transcriptome dynamics in leukocytes of family dementia caregivers in a randomized controlled trial. Psychoneuroendocrinology., 2013; 38(3): 348–355.
  29. Vijayaraghava, A, Doreswamy V. Exercise and the cytokines-interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α): A review. Ann Med Physiol., 2017; 1(1): 3-8.
  30. McDougall, JJ. Osteoarthritis is a neurological disease – an hypothesis. Osteoarthr Cartil., 2019; 100005: 1–6.

How to Cite

Wahyuni, N., Adiputra, N., Adiatmika, I. P. G., Sundari, L. P. R., & Indrayani, A. W. (2023). Effectiveness of Yoga in reducing IL-6 serum level in elderly with knee osteoarthritis. Bali Medical Journal, 12(3), 2463–2468.




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Nila Wahyuni
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Nyoman Adiputra
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I Putu Gede Adiatmika
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Luh Putu Ratna Sundari
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Agung Wiwiek Indrayani
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