Mobile App-Based Yoga and Meditation in Rheumatoid Arthritis

June 18, 2026 updated by: Tugba Civi Karaaslan

Effectiveness of a Mobile Application-Based Yoga and Meditation Program in Patients With Rheumatoid Arthritis: A Single-Blind Randomized Controlled Trial.

The goal of this single-blind, randomized controlled trial is to evaluate the clinical effectiveness and short-term economic impact of a mobile application-based, personalized yoga and meditation program in adult patients with Rheumatoid Arthritis (RA).

The main questions it aims to answer are:

Does an 8-week digital yoga and meditation intervention reduce anxiety and improve other clinical/psychological outcomes (such as depression, pulmonary function, reaction time, quality of life, and stress) compared to standard medical care? Does this digital intervention reduce short-term healthcare utilization and associated direct medical costs?

Researchers will compare the Mobile App Group (receiving personalized yoga and meditation via the Meditopia app) to a Control Group (receiving usual medical care) to evaluate the effectiveness and cost-efficiency of the intervention.

Participants in the experimental group will:

Use a mobile application to practice 15-30 minutes of yoga and 15-30 minutes of meditation daily, at least 4 days a week over an 8-week period.

Complete clinical, psychometric, and economic assessments at baseline, week 4, and week 8.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

102

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: Pedram Shahriyari, PT
  • Phone Number: +905346838530

Study Locations

  • Turkey (Türkiye)
    • Istanbul
      • Istanbul, Istanbul, Turkey (Türkiye), 34500
        • Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Adults aged between 18 and 65 years.
  • Diagnosed with Rheumatoid Arthritis (RA) by a rheumatologist.
  • Disease in a stable phase (remission or low disease activity).
  • Access to a smartphone or tablet and sufficient proficiency in using mobile applications.
  • Cognitive sufficiency to provide written and verbal informed consent in Turkish.

Exclusion Criteria:

  • Presence of acute RA flare-ups.
  • Severe psychiatric diagnoses (e.g., psychosis, bipolar disorder, or severe major depression).
  • Severe cognitive impairment or dementia.
  • Pregnancy.
  • Regular practice of meditation or mindfulness within the last 6 months.
  • Participation in any other stress management program within the last 3 months.
  • Receipt of mental health services within the last 6 months.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Mobile Application Group
Participants in this group will receive a personalized 8-week yoga and meditation program via the Meditopia mobile application, in addition to their usual medical care.
Behavioral: Mobile App-Based Yoga and Meditation
The intervention consists of an 8-week individualized program. It includes yoga sequences selected by a physiotherapist based on the patient's functional capacity and joint mobility. It also includes mindfulness-based and emotion regulation-focused meditation content selected by a clinical psychologist. Participants are expected to practice for 15-30 minutes of yoga and 15-30 minutes of meditation daily, at least 4 days a week.The intervention is delivered through the Meditopia mobile application.
No Intervention: Control Group
Participants in this group will continue their usual medical follow-up and routine care without any structured digital mind-body intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Hospital Anxiety and Depression Scale - Anxiety (HADS-A)
Time Frame: Baseline (T0), Week 4 (T1), and Week 8 (T2).
Evaluated using the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A). The HADS-A is a 7-item self-report scale scored from 0 to 21. Higher scores indicate a greater symptom burden of anxiety.
Baseline (T0), Week 4 (T1), and Week 8 (T2).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Perceived Stress Scale (PSS-10)
Time Frame: Baseline (T0), Week 4 (T1), and Week 8 (T2)
Measured by the Perceived Stress Scale (PSS-10), a 10-item tool (scored 0-40) assessing how unpredictable or uncontrollable patients find their lives.
Baseline (T0), Week 4 (T1), and Week 8 (T2)
Fatigue Severity Scale (FSS)
Time Frame: Baseline and Week 8
The Fatigue Severity Scale (FSS) is a 9-item self-report scale used to evaluate the impact of fatigue on daily functioning and social life. Each item is scored on a 7-point Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree). The total score is calculated as the mean of the 9 items, with a final score ranging from 1 to 7. A higher mean score indicates a greater severity of fatigue and a more significant impact of fatigue on the individual's daily activities.
Baseline and Week 8
Pittsburgh Sleep Quality Index (PSQI)
Time Frame: Baseline (T0), Week 4 (T1), and Week 8 (T2)
The Pittsburgh Sleep Quality Index (PSQI) is a 19-item self-report questionnaire used to assess sleep quality and disturbances over a one-month time interval. It evaluates seven 'component' scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. Each component is scored from 0 to 3, yielding a global score ranging from 0 to 21. A total global score of greater than 5 is generally used to indicate poor sleep quality. Higher global scores represent poorer sleep quality and more significant sleep disturbances.
Baseline (T0), Week 4 (T1), and Week 8 (T2)
Rheumatoid Arthritis Quality of Life (RAQOL)
Time Frame: Baseline (T0), Week 4 (T1), and Week 8 (T2)
The Rheumatoid Arthritis Quality of Life (RAQOL) questionnaire is a disease-specific instrument designed to assess the quality of life in patients with rheumatoid arthritis using a needs-based model. It consists of 30 items with a binary response format (Yes/No). Each 'Yes' response is scored as 1, and each 'No' response is scored as 0. The total score ranges from 0 to 30, with higher scores representing a poorer quality of life and a greater negative impact of the disease on the individual's life. The scale focuses on various domains, including mood, social life, hobbies, everyday tasks, and physical contact.
Baseline (T0), Week 4 (T1), and Week 8 (T2)
Chronic Illness Self-Management (CISM) Scale
Time Frame: Baseline (T0) and Week 8 (T2)
The Chronic Illness Self-Management (CISM) scale is a 23-item tool designed to assess the self-management behaviors and perceptions of individuals living with chronic conditions. It consists of four subscales: Self-Stigma (7 items), Coping with Stigma (5 items), Healthcare Effectiveness (5 items), and Treatment Adherence (6 items). Each item is evaluated based on the patient's experience, providing a comprehensive measure of how well the individual manages the challenges associated with their illness. Higher scores in specific domains indicate better self-management capabilities and adaptation to the chronic condition.
Baseline (T0) and Week 8 (T2)
Forced Vital Capacity (FVC)
Time Frame: Baseline (T0), Week 4 (T1), and Week 8 (T2)
Quantitative measurement of respiratory function will be performed using a calibrated spirometer in accordance with the ATS/ERS standardization protocols. FVC (expressed in Liters) will be recorded in a seated position to assess the presence and severity of extra-articular pulmonary involvement. The best of at least three acceptable maneuvers will be used for analysis.
Baseline (T0), Week 4 (T1), and Week 8 (T2)
Forced Expiratory Volume in 1 Second (FEV1)
Time Frame: Baseline (T0), Week 4 (T1), and Week 8 (T2)
Quantitative measurement of respiratory function assessed using a calibrated spirometer in accordance with the ATS/ERS standardization protocols. FEV1 measures the volume of air exhaled in the first second of the forceful exhalation.
Baseline (T0), Week 4 (T1), and Week 8 (T2)
FEV1/FVC Ratio
Time Frame: Baseline (T0), Week 4 (T1), and Week 8 (T2)
The ratio of Forced Expiratory Volume in 1 second to Forced Vital Capacity, calculated from the spirometry maneuver to assess obstructive or restrictive pulmonary patterns.
Baseline (T0), Week 4 (T1), and Week 8 (T2)
Peak Expiratory Flow (PEF)
Time Frame: Baseline (T0), Week 4 (T1), and Week 8 (T2)
Quantitative measurement of respiratory function assessed using a calibrated spirometer in accordance with the ATS/ERS standardization protocols. PEF measures the maximum speed of expiration.
Baseline (T0), Week 4 (T1), and Week 8 (T2)
Visual Reaction Time (BlazePod)
Time Frame: Baseline (T0), Week 4 (T1), and Week 8 (T2)
Visual reaction time will be measured using the BlazePod device, a portable visual-cognitive technology designed to assess response speed to light stimuli. Simple and selective reaction time tasks will be performed where participants respond by touching or tapping the pod when it illuminates. To ensure reliability, each participant will complete multiple trials (typically 5-10), and the average reaction time in milliseconds will be calculated after excluding outliers. The testing procedure will be standardized regarding lighting conditions, distance, and participant positioning. This measurement serves as a neurocognitive performance indicator to evaluate the systemic and cognitive effects of the intervention.
Baseline (T0), Week 4 (T1), and Week 8 (T2)
Total Direct Healthcare Costs (Partial Cost Analysis)
Time Frame: Baseline (T0) and Week 8 (T2)
A partial cost analysis will be conducted from a healthcare system perspective to evaluate the short-term economic impact of the digital intervention. Data on healthcare resource utilization-including the number of planned or unplanned rheumatology/internal medicine outpatient visits, emergency room admissions, and the number and duration of hospitalizations-will be collected retrospectively for the 8-week period using a structured 'Healthcare Utilization Questionnaire'. To calculate the total direct medical cost per patient, these frequency data will be multiplied by official unit costs derived from the current Social Security Institution (SGK) Health Implementation Communiqué (SUT) tariffs and supported by relevant cost-of-illness literature in Turkey. This analysis aims to provide preliminary empirical evidence on the cost-effectiveness of integrating mobile mind-body interventions into the routine management of Rheumatoid Arthritis.
Baseline (T0) and Week 8 (T2)
System Usability Scale (SUS)
Time Frame: At the end of the 8-week intervention
The System Usability Scale will be administered only to participants in the intervention group to evaluate the usability, ease of use, and overall acceptability of the digital system used during the intervention. The SUS is a validated 10-item questionnaire scored on a 5-point Likert scale. Total scores range from 0 to 100, with higher scores indicating better perceived usability and user satisfaction with the system.
At the end of the 8-week intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Tugba Civi Karaaslan

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

June 1, 2026

Primary Completion (Estimated)

May 1, 2027

Study Completion (Estimated)

June 1, 2027

Study Registration Dates

First Submitted

May 15, 2026

First Submitted That Met QC Criteria

June 18, 2026

First Posted (Actual)

June 24, 2026

Study Record Updates

Last Update Posted (Actual)

June 24, 2026

Last Update Submitted That Met QC Criteria

June 18, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IUC-2025-641

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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