Long-Term Yoga and Aerobic/Strength Exercise Adherence in Older Women with Knee Osteoarthritis: A Mixed Methods Approach

Corjena K Cheung, Jean F Wyman, Cynthia Peden-McAlpine

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Hatha yoga (HY) and aerobic and strengthening exercise (ASE) programs are recommended for optimal management of osteoarthritis. However, evidence on long-term adherence to these programs and factors that influence it is lacking in older adults. The purposes of this study were to (1) describe and compare long-term HY and ASE adherence in community-dwelling older women with knee osteoarthritis 12 months post–HY/ASE intervention programs; (2) identify benefits and facilitators of, and barriers to, long-term adherence; and (3) examine other self-care interventions used after completing HY or ASE programs. Adherence was defined as following the prescribed HY/ASE program or incorporating the practice into daily habits. Five semistructured focus group interviews and 12 months of exercise diaries were obtained from 28 women (mean age 71.2 years). Long-term adherence to the prescribed HY or ASE regimen was relatively high, albeit adapted to individual needs, priorities, and preferences. Over the 12-month follow-up period, participants spent on average 3.5 days/3.1 hours per week on exercise. Most participants remained physically active by modifying their prescribed programs and integrating elements of the interventions into their own exercise regimens. Facilitators to long-term adherence were perceived benefits, having an exercise routine/habit, and program structure/instruction. Poor health status, lack of time, and exercise preferences were identified as barriers. Participants used a variety of self-care interventions including oral supplements and alternative diets for managing their osteoarthritis. This work suggests that exercise programs for osteoarthritis that incorporate individual preferences, flexible hours, and easy-to-follow instructions are most likely to result in long-term adherence.

Original languageEnglish (US)
Article number4
JournalInternational journal of yoga therapy
Issue number2022
StatePublished - 2022

Bibliographical note

Funding Information:
The authors would like to thank the Deborah E. Powell Center for Women’s Health—Mature Women’s Health and Research Grants, University of Minnesota, for their support of this project. The authors would also like to thank the Jewish Community Centers in St. Paul and St. Louis Park for providing the study sites, and the participants for their time and energy in this project.

Publisher Copyright:
© 2022, International Association of Yoga Therapists. All rights reserved.


  • adherence
  • aerobic and strengthening exercises
  • knee osteoarthritis
  • older women
  • physical activity
  • yoga

PubMed: MeSH publication types

  • Journal Article


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