Yoga research: The importance of protocols and a wider community

Western science and medicine professionals are increasingly researching yoga. Robust research not only helps yoga practices to be accepted in Western healthcare (and importantly, delivered to people in need), it also helps yoga therapists and teachers to understand and deliver therapeutically effective practices. As yoga research becomes more sophisticated and nuanced, the importance of an element known as treatment fidelity or protocol fidelity is emerging as a critical area of focus for yoga researchers, therapists, and teachers.

What is protocol fidelity?

Protocol fidelity means that the practices researched remain consistent as they are delivered to the people in the study, throughout its duration. For example, if a study is seeking to understand the effects of a series of 12 yoga postures on low-back pain, the postures need to be done in the same way, at the same weekly frequency, and for the same number of weeks. Without this kind of standard we cannot test the idea that these yoga poses will help to relieve low-back pain. Scientific inquiry requires this kind of rigor. 

A primary point of yoga therapy is that it is tailored to the individual, which might seem contradictory to the requirements for scientific study of the practices’ effectiveness. However, knowing what kind of yoga may be best for an individual and their conditions is greatly informed by rigorous research. When a yoga therapist considers what practices might most help a client, they look to research to inform the postures, style of yoga, meditation or breathing practices, and combinations of these that might most help the person.

Yoga is a complex and ancient field with significant therapeutic value. Although well-designed and executed research will continue to support and clarify yoga interventions for health and well-being, the way yoga needs to be researched differs from the way a yoga therapist or teacher might work with a client or class outside of a research setting.

Yoga vs. yoga in research

New research compares two kinds of yoga—hatha and restorative—for low-back and neck pain in active-duty military personnel. By comparing two kinds of yoga, this study brings attention to the yoga protocol. A question of this research is not “will yoga help this kind of pain?” but rather “which kind of yoga will help this pain (the most)?”

In another recent study, in addition to measuring health outcomes of yoga for worry versus cognitive behavioral therapy for anxiety in older adults, researchers measured the competence and adherence of the yoga teachers who delivered the research protocol. The teachers scored high in competence, but not as high in adherence: The teachers were good yoga teachers, but did not always teach the yoga that the researchers were trying to study. Perhaps competent yoga teachers choose to teach to the people in their classes over teaching something that may not meet their students’ needs, but is what is being researched. This led the researchers to suggest that teaching yoga for research purposes might require a specific skill set.

The yoga community: Therapists, teachers, practitioners, and researchers

This worry and anxiety study concluded that these findings “foster dialog between the yoga research and practice communities.” Science has changed greatly over the course of human history because people searched in organized and rigorous ways to expand our knowledge and understanding. The rigor and granularity that modern science demands can help to clarify the mechanism of yoga practices for Western healthcare practitioners and yoga professionals alike. Studies comparing kinds of yoga are a step in this direction, as are studies that specifically consider fidelity to the protocol.

The International Association of Yoga Therapists supports rigorous yoga research and uses this site for the public, its professional site, its membership magazine Yoga Therapy Today, its scholarly journal the International Journal of Yoga Therapy, and annual conferences such as the Symposium on Yoga Therapy and Research to publish and share the latest information.