Variations in the severity of symptoms, DAS28, and Disability Index among different Vata predominant Deha-Prakriti individuals of Amavata (~Rheumatoid Arthritis) - An Analytical Observational Study

Abstract

Background: Subgrouping of diseased population, based on Deha-Prakriti (DP), phenotypic classification of Ayurveda will explore the variation in the disease severity, which further aid in the management of the disease more precisely and selectively. But there is a paucity in the data generation. Amavata (~Rheumatoid Arthritis) is one of such diseases, resulting from the conglomeration of Ama and aggravated Vata gets lodged in the joints. Aim & Objective: To evaluate variations in the severity of symptoms, duration of morning stiffness, DAS28 (Disease Activity Score in 28 Joints), and Disability Index (DI) among different Vata predominant Deha-Prakriti (DP) individuals of Amavata (~Rheumatoid Arthritis). Materials & Methodology: The study was conducted among 155 clinically diagnosed patients of Amavata, who were screened for DP assessment through the CCRAS-PAS scale. Those who were found to have Vata predominant DP were sub-grouped into Single Vataja (V), Vata-Pittaja (VP), and Vata-Kaphaja (VK) DP, based on the proportion of the doshas in the output of scale. Demographic profile, the severity of the symptoms, duration of the morning stiffness, DAS28, and DI were assessed and calculated using SPSS software version 20.0, p≤0.05 was considered statistically significant. Results: Kruskal-Walli’s test revealed that Single Vata predominant DP patients were found to have severe Sandhi-shula (Joint pain) (p<0.0001), Shunatanga (Numbness of the joint) (p-value at 0.0069), Nidra-Viparyaya (Irregular sleep patterns) (p-value at 0.0012) than VP and VK DP individuals. Sandhi-Shotha (Joint swelling) (p-value at 0.0299), Angamarda (generalized body pains) (p-value at 0.0130), Alasya (laziness) (p<0.0001), Gaurava (Heaviness) (p<0.0001), and Apaka (delayed digestion) (p-value at 0.0254) were found severe in VK DP, whereas Trishna (Thirsty) (p<0.0001), Nidraviparyaya (p-value at 0.0012) were more severe in VP DP individuals. One-way ANOVA revealed that the duration of morning stiffness (2.03±0.2 hours, p-value at 0.446), DAS28 (6.85±0.175, p-value at 0.0035), and DI (1.87±0.54, p-value at 0.0003) were found significantly high in single Vataja than VP and VK Deha-Prakriti. Conclusion: The disease severity in terms of duration of morning stiffness, DAS28, and DI were found more severe in Single Vataja DP. The severity of the signs and symptoms also varied according to DP.