Research

Yoga has been practiced in some form for millennia. Still, from a Western scientific perspective we are just beginning to understand the mechanisms behind its effects. 

Although yoga is not a cure-all for physical or mental problems, a growing body of research confirms yoga therapy’s promise to offer relief from the suffering associated with a number of chronic and debilitating conditions.* IAYT, which publishes this website, hosts an annual research conference (the Symposium on Yoga Research) and publishes a peer-reviewed, PubMed-indexed journal (the International Journal of Yoga Therapy).

Following are starting points for those interested in learning more about the research that’s been done to date, with an emphasis on good-quality reviews and randomized controlled trials. These representative studies are grouped into categories, and you’ll likely find relevant information in several spots (for example, you will find Danhauer et al.’s “Review of yoga therapy during cancer treatment” listed under CANCER AND EFFECTS OF TREATMENT, as well as in the AUTOIMMUNE and MENTAL HEALTH sections). 

GENERAL RESEARCH

Cramer H, et al. The safety of yoga: A systematic review and meta-analysis of randomized controlled trials. American Journal of Epidemiology 2015;182:281-293.

Although not all yoga practices include physical movement, it’s important to know that any program that involves exercise carries an inherent risk for injury. Research suggests that yoga is at least as safe as other commonly recommended exercise programs.

Khalsa SBS, et al. (eds). The principles and practice of yoga in health care. Handspring, 2016.

This textbook includes contributions from expert researchers and yoga therapists, and it “supports the emergence of yoga therapy as a credible profession.” Healthcare professionals will appreciate the summaries of research and relevant findings.

ADDICTION AND RECOVERY

Bock B, et al. Yoga as a complementary therapy for smoking cessation: Results from BreathEasy, a randomized clinical trial. Nicotine and Tobacco Research 2019;21(11):1517-1523.

Two hundred twenty-seven adult smokers were randomized to an 8-week program of cognitive-behavioral smoking cessation and either twice-weekly Iyengar yoga or general wellness classes (control). At the end of treatment, yoga participants had 37% greater odds of achieving abstinence than wellness participants in this first rigorous randomized clinical trial of yoga as a complementary therapy for smokers attempting to quit.

Brooks J, et al. Yoga for substance use disorder in women: A systematic review. International Journal of Yoga Therapy 2021;31(1).

This systematic review of randomized controlled trials evaluated any type of yoga, including yoga as a component of mindfulness-based treatment, against any type of control in individuals with any type of addiction (i.e., alcohol, drug, and nicotine substance-use disorders). Most of the trials, which date through January 2020, suggested that various types of yoga—primarily hatha yoga and its components—led to favorable or equivalent results as an adjunct to control or treatment-as-usual interventions.

Cox A, et al. Examining the effects of mindfulness-based yoga instruction on positive embodiment and affective responses. Eating Disorders 2020;28(4):458-475.

This randomized controlled trial tested the inclusion of yoga in efforts to prevent eating disorders by considering the practice’s impact on positive embodiment and core affect. The 62 female participants (median age 23.89) were randomly assigned to a yoga class that emphasized (1) being mindfully present in one’s body, (2) changing one’s appearance, or (3) simply getting into yoga poses. Participants in the class emphasizing mindful presence experienced greater improvement in affect.

Groessl EJ, et al. Yoga for military veterans with chronic low back pain: A randomized clinical trial. American Journal of Preventive Medicine 2017;53:599-608.

This study shows that yoga improves health outcomes, including lowered pain intensity and decreased use of opioids, for veterans with chronic lower-back pain.

Halliwell E, et al. A randomized experimental evaluation of a yoga-based body image intervention. Body Image 2019;28:119-127.

This study evaluated a four-session yoga-based intervention that incorporated themes focusing on positive body image in women around the age of 20. Compared to controls, participants in the yoga intervention reported significant increases in body appreciation, body connectedness, body satisfaction, and positive mood at posttest and a 4-week follow-up.

Pearson N, et al. White paper: Yoga therapy and pain—How yoga therapy serves in comprehensive integrative pain management, and how it can do more. International Journal of Yoga Therapy 2020;30(1):117-131.

This IAYT white paper explains that “yoga therapy can make a meaningful contribution to solving the overlapping public health crises of chronic pain, opioid misuse and overdose, and mental health disorders.” The authors describe yoga therapy as a key component in comprehensive integrative pain management, noting that this patient-centered intervention “positively addresses body and mind and focuses on overall well-being, quality of life, and flourishing within one’s life circumstances.”

Uebelacker L, et al. A pilot study assessing acceptability and feasibility of hatha yoga for chronic pain in people receiving opioid agonist therapy for opioid use disorder. Journal of Substance Abuse Treatment 2019;105:19-27.

This pilot feasibility study determined that yoga interventions can be delivered on-site in opioid agonist treatment programs. Participants’ mood improved after classes, with greater decreases in anxiety and pain for those in the yoga group. Most participants also engaged with home practices.

Wimberly A, et al. Effect of yoga on antiretroviral adherence postincarceration in HIV+ individuals. Journal of Correctional Healthcare 2020;26(1):83-94.

Antiretroviral therapy adherence increased for yoga participants and decreased for treatment-as-usual participants in this randomized controlled trial of a 12-week yoga intervention. Participants were returning to civilian life after being incarcerated and were also living with HIV and substance-use problems.

ARTHRITIS

Bartlett SJ, et al. Yoga in rheumatic diseases. Current Rheumatology Reports 2013;15.

This articles summarizes key considerations for yoga in rheumatic diseases, including clear guidelines to help healthcare practitioners find qualified yoga professionals. It concludes that a growing body of evidence suggests that yoga is a safe, feasible option for many living with rheumatic conditions. Furthermore, “This holistic approach to exercise with an emphasis on mindfulness and stress reduction may also offer additional opportunities to enhance psychological well-being, reduce pain and enhance function and participation, as part of a comprehensive disease management approach.”

Gautum S, et al. Impact on yoga-based mind-body intervention on systemic inflammatory markers and co-morbid depression in active rheumatoid arthritis patients: A randomized controlled trial. Restorative Neurology and Neuroscience 2019;37(1):41-59.

After 8 weeks of yoga, this randomized controlled trial showed a significant decrease in the severity of rheumatoid arthritis: Reduced levels of various systemic inflammatory markers and a statistically significant decline in depression symptoms were seen in the group that did yoga.

Moonaz SH, et al. Yoga in sedentary adults with arthritis: Effects of a randomized controlled pragmatic trial. Journal of Rheumatology 2015;42:1194-1202.

In this 8-year clinical trial, conducted at Johns Hopkins University, a well-rounded yoga program for those with osteoarthritis and rheumatoid arthritis improved pain by 40%. Participants also demonstrated overall improvement in arthritis symptoms, physical fitness, psychological functioning, and health-related quality of life.

AUTOIMMUNE FUNCTION, IMMUNITY, AND INFLAMMATION

Chanta A, et al. Effect of hatha yoga training on rhinitis symptoms and cytokines in allergic rhinitus patients. Asian Pacific Journal of Allergy and Immunology 2022;40(2):126-133.

People in the yoga group in this small study of allergic rhinitis (hay fever) had increased peak nasal inspiratory flow and significantly decreased rhinitis symptoms and nasal blood flow after 8 weeks. The group that practiced yoga also had significantly higher nasal secretion of interleukin-2 than the control group, which could indicate a beneficial immunological effect of the practices.

Danhauer SC, et al. Review of yoga therapy during cancer treatment. Supportive Care in Cancer 2018;25:1357-1372.

This review cites consistent improvements in psychological outcomes (depression, distress, anxiety) for those doing yoga therapy during cancer treatment. The practice was also seen to improve quality of life, quality of sleep, and immune biomarkers.

Djalilova D, et al. Impact of yoga on inflammatory biomarkers: A systematic review. Biological Research for Nursing 2019;21(2):198-209.

This systematic review of 15 studies synthesized current literature examining the effect of yoga on inflammatory biomarkers in adults with chronic inflammation-related disorders. The most common biomarkers measured were interleukin-6, C-reactive protein, and tumor necrosis factor, and most of the studies reported positive effects of the yoga interventions. A higher total “dose” of yoga (more than 1,000 minutes) resulted in greater improvements in inflammation.

Falkenberg RI, et al. Yoga and immune system functioning: A systematic review of randomized controlled trials. Journal of Behavioral Medicine 2018;41:467-482.

This systematic review summarizes the key findings on yoga for improved immune function, including downregulation of proinflammatory markers (particularly IL-1beta, IL-6, and TNF-alpha) and enhancement of cell-mediated and mucosal immunity.

Gautum S, et al. Impact on yoga-based mind-body intervention on systemic inflammatory markers and co-morbid depression in active rheumatoid arthritis patients: A randomized controlled trial. Restorative Neurology and Neuroscience 2019;37(1):41-59.

After 8 weeks of yoga, this randomized controlled trial showed a significant decrease in the severity of rheumatoid arthritis: Reduced levels of various systemic inflammatory markers and a statistically significant decline in depression symptoms were seen in the group that did yoga.

Househam AM, et al. The effects of stress and meditation on the immune system, human microbiota, and epigenetics. Advances in Mind-Body Medicine 2017;31:10-25.

The stress response has wide-ranging implications in the human body-mind-spirit system, and yoga practices such as meditation appear to have the ability to address these effects via a number of channels.

Koch A, et al. Perceived stress mediates the effect of yoga on quality of life and disease activity in ulcerative colitis. Secondary analysis of a randomized controlled trial. Journal of Psychosomatic Research 2020;130:109917.

When comparing the effects of yoga to written self-care advice for people with inactive ulcerative colitis and impaired quality of life, these authors found that perceived stress was important for reducing disease activity and increasing health-related quality of life. The study advised that yoga should be considered as an adjunct intervention for highly stressed people with ulcerative colitis.

Kuloor A, et al. Impact of yoga on psychopathologies and quality of life in persons with HIV: A randomized controlled study. Journal of Bodywork and Movement Therapies 2019;23(2):278-283.

This randomized controlled trial of 60 HIV-positive participants examined the effects of yoga on anxiety, depression, and psychological well-being and quality of life. After 8 weeks of movement, breathing, relaxation, and meditation practices the yoga group showed a significant reduction in anxiety, depression, and fatigue compared to the control group; they also had significant improvements in well-being and all quality-of-life domains.

Wimberly A, et al. Effect of yoga on antiretroviral adherence postincarceration in HIV+ individuals. Journal of Correctional Healthcare 2020;26(1):83-94.

Antiretroviral therapy adherence increased for yoga participants and decreased for treatment-as-usual participants in this randomized controlled trial of a 12-week yoga intervention. Participants were returning to civilian life after being incarcerated and were also living with HIV and substance-use problems.

Yadav R, et al. Comparative efficacy of a 12-week yoga-based lifestyle intervention and dietary intervention on adipokines, inflammation, and oxidative stress in adults with metabolic syndrome: A randomized controlled trial. Translational Behavorial Medicine 2019;9(4):594-604.

This randomized controlled trial evaluated the efficacy of a 12-week yoga-based lifestyle intervention compared to dietary intervention alone on adipokines (cell-signaling proteins released by fat tissue), inflammation, and oxidative stress in 260 adults with metabolic syndrome. Those in the the yoga group showed significant improvement in a number of markers, whereas no significant changes were noted in the dietary intervention group.

CANCER AND EFFECTS OF TREATMENT

Danhauer SC, et al. Review of yoga therapy during cancer treatment. Supportive Care in Cancer 2018;25:1357-1372.

This review cites consistent improvements in psychological outcomes (depression, distress, anxiety) for those doing yoga therapy during cancer treatment. The practice was also seen to improve quality of life, quality of sleep, and immune biomarkers.

Danhauer SC, et al. Yoga for symptom management in oncology: A review of the evidence base and future directions for research. Cancer 2019;125:1979-1989.

Yoga seems to be particularly helpful in reducing stress during treatment and post-treatment disturbances in sleep and cognition.

Dong B, et al. Yoga has a solid effect on cancer-related fatigue in patients with breast cancer: A meta analysis. Breast Cancer Research and Treatment 2019;177(1):5-16.

According to this meta-analysis that included 2,183 patients, yoga had a large effect on fatigue post-treatment in people with breast cancer. There was also a small effect on fatigue between cancer treatments.

Galatino M, et al. Impact of somatic yoga and meditation on fall risk, function, and quality of life for chemotherapy-induced peripheral neuropathy syndrome in cancer survivors. Integrative Cancer Therapies 2019;18:1534735419850627.

This small preliminary study investigated the feasibility of yoga for chemotherapy-induced peripheral neuropathy. Participants were offered a somatic yoga and meditation intervention that included 8 weeks of twice-weekly 90-minute classes, a home program, and journaling. Significant improvements were found in flexibility, balance, and fall risk. Qualitative findings included fluctuation in pain perception over time, transferability of skills to daily activities, and physical function improvement.

Lin P-J, et al. Influence of yoga on cancer-related fatigue and on mediational relationships between changes in sleep and cancer-related fatigue: A nationwide, multicenter, randomized controlled trial of yoga in cancer survivors. Integrative Cancer Therapies 2019;18:1534735419855134.

Four hundred ten cancer survivors participated in this nationwide multicenter phase III randomized controlled trial. The study compared the effect of a 4-week yoga therapy program to standard care on cancer-related fatigue (CRF). Yoga therapy participants demonstrated significantly greater improvements in fatigue. Improvements in overall sleep quality and reductions in daytime dysfunction (e.g., excessive napping) were significant components of yoga’s effect on CRF. According to the authors, “Oncologists should consider prescribing yoga to cancer survivors for treating CRF and sleep disturbance.”

Lin P-J, et al. Yoga for the management of cancer treatment-related toxicities. Current Oncology Reports 2018;20:1-15.

Based on 24 clinical trials, this paper suggest that clinicians consider prescribing low-intensity yoga therapy for those suffering from certain cancer treatment–related toxicities.

Pan Y, et al. Could yoga practice improve treatment-related side effects and quality of life for women with breast cancer? A systematic review and meta-analysis. Asia-Pacific Journal of Clinical Oncology 2017;13:e79-e95.

“The current evidence demonstrates that yoga practice could be effective in enhancing health and managing some treatment-related side effects for patients recovering from breast cancer.”

Sharma M, et al. A systematic review of yoga interventions as integrative treatment in breast cancer. Journal of Cancer Research and Clinical Oncology 2016;142:2523-2540.

This systematic review notes that study methodology and standardization need to improve. Nevertheless, research on yoga as adjunctive care for breast cancer is promising.

CARDIOVASCULAR DISEASE AND HEART HEALTH

Barrows JL & Fleury J. Systematic review of yoga interventions to promote cardiovascular health in older adults. Western Journal of Nursing Research 2016;38:753-781.

According to this review of research on yoga and cardiovascular health, “Significant health benefits were reported, including favorable changes in blood pressure, body composition, glucose, and lipids.”

Christa E, et al. Effect of yoga-based cardiac rehabilitation on heart rate variability: Randomized controlled trial in patients post-MI. International Journal of Yoga Therapy 2019;29(1):43-50.

This randomized controlled trial tested the effects of a 12-week yoga-based cardiac rehabilitation program on heart rate variability—a measure of autonomic function—in 80 patients after myocardial infarction. The yoga group received 13 hospital-based structured yoga sessions as an adjunct to standard care. Control-group participants received enhanced standard care involving three brief educational sessions with a leaflet on the importance of diet and physical activity. The results revealed that yoga-based cardiac rehabilitation has additional benefits on cardiac autonomic function compared to standard care in people who have had myocardial infarction.

Cramer H, et al. Effects of yoga on cardiovascular disease risk factors: A systematic review and meta-analysis. International Journal of Cardiology 2014;173:170-183.

This meta-analysis provides evidence for clinically important benefits of yoga on most biological cardiovascular disease risk factors, including blood pressure, respiratory rate, waist circumference, waist/hip ratio, cholesterol, triglycerides, and insulin resistance.

Ghaffarilaleh G, et al. Yoga positively affected depression and blood pressure in women with premenstrual syndrome in a randomized controlled clinical trial. Complementary Therapies in Clinical Practice 2019;34:87-92.

Participants in this randomized controlled clinical trial of yoga for people with premenstrual syndrome (PMS) suffered from depression during their menstrual cycles. They completed the Beck Depression Inventory-II before and after the intervention, and the group that did yoga experienced statistically significant improvement in depressive symptoms. The yoga group also had decreased diastolic blood pressure by the end of the 2-month study, during which they practiced yoga 3 times a week for 60 minutes per session.

Guddeti RR, et al. Role of yoga in cardiac disease and rehabilitation. Journal of Cardiopulmonary Rehabilitation and Prevention 2019;39:146-152.

“Yoga has been shown to have favorable effects on systemic inflammation, stress, the cardiac autonomic nervous system, and traditional and emerging cardiovascular risk factors.”

Ornish D, et al. Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. The Lancet 1990;336:129-133.

Dean Ornish’s team has many years of research to support the efficacy of a multifaceted lifestyle program—including yoga, meditation, nutrition, and social support—in improving cardiovascular outcomes and even reversing heart disease.

Pascoe MC, et al. Yoga, mindfulness-based stress reduction and stress-related physiological measures: A meta-analysis. Psychoneuroendocrinology 2017;86:152-168.

This meta-analysis of randomized controlled trials involving yoga postures compared to active controls found that yoga positively affects physiological measures of stress including heart rate, heart rate variability, fasting blood glucose, and cholesterol.

Telles S, et al. Blood pressure and heart rate variability during yoga-based alternate nostril breathing practice and breath awareness. Medical Science Monitor Basic Research 2014;20:184-193.

This study showed increased vagal function (and autonomic nervous activity), accounting for lowered blood pressure and increased heart rate variability during the yoga practice of alternate-nostril breathing.

Wu Y, et al. Yoga as antihypertensive lifestyle therapy: A systematic review and meta-analysis. Mayo Clinic Proceedings 2019;94(3):432-446.

This meta-analysis reviewed 49 qualifying controlled trials, totaling 3,517 participants who were on average, middle-aged, overweight, and had high blood pressure. Reduced blood pressure was seen with yoga interventions that included breathing techniques and meditation/mental relaxation practiced 3 times a week.

CHRONIC PAIN AND PALLIATIVE CARE

Anheyer D, et al. Yoga for treating headaches: A systematic review and meta-analysis. Journal of General Internal Medicine 2020;35(3):846-854.

This systematic review and meta-analysis of studies published through May 2019 investigated the effects of yoga on headache disorders as a safe, effective non-pharmacological option. Although the investigated studies had important limitations, the meta-analysis revealed a statistically significant positive overall effect in favor of yoga for headache frequency, headache duration, and pain intensity. The positive findings were seen mainly in those with tension-type headache; no statistically significant effect was observed for migraine.

Bartlett SJ, et al. Yoga in rheumatic diseases. Current Rheumatology Reports 2013;15.

This articles summarizes key considerations for yoga in rheumatic diseases, including clear guidelines to help healthcare practitioners find qualified yoga professionals. It concludes that a growing body of evidence suggests that yoga is a safe, feasible option for many living with rheumatic conditions. Furthermore, “This holistic approach to exercise with an emphasis on mindfulness and stress reduction may also offer additional opportunities to enhance psychological well-being, reduce pain and enhance function and participation, as part of a comprehensive disease management approach.”

Chuang L-H, et al. A pragmatic multicentered randomized controlled trial of yoga for chronic low back pain: Economic evaluation. Spine 2012;37:1593-1601.

Specialized group yoga classes are likely to be cost-effective in improving recurrent lower-back pain.

Deshpande A. Yoga for palliative care. Integrative Medicine Research 2018;7:211-213.

“Yoga therapy for palliative care is based on gentleness and compassion. It aims to empower the patient to accept and face the illness and death by holistic experience which has physical, mental, emotional, and spiritual dimensions.” This commentary also notes that mindfulness practices promote emotional regulation through present-moment awareness, acceptance, and nonreactivity, potentially enhancing quality of life.

Galatino M, et al. Impact of somatic yoga and meditation on fall risk, function, and quality of life for chemotherapy-induced peripheral neuropathy syndrome in cancer survivors. Integrative Cancer Therapies 2019;18:1534735419850627.

This small preliminary study investigated the feasibility of yoga for chemotherapy-induced peripheral neuropathy. Participants were offered a somatic yoga and meditation intervention that included 8 weeks of twice-weekly 90-minute classes, a home program, and journaling. Significant improvements were found in flexibility, balance, and fall risk. Qualitative findings included fluctuation in pain perception over time, transferability of skills to daily activities, and physical function improvement.

Groessl EJ, et al. Yoga for military veterans with chronic low back pain: A randomized clinical trial. American Journal of Preventive Medicine 2017;53:599-608.

This study shows that yoga improves health outcomes, including lowered pain intensity and decreased use of opioids, for veterans with chronic lower-back pain.

Kim S. Yoga for menstrual pain in primary dysmenorrhea: A meta-analysis of randomized controlled trials. Complementary Therapies in Clinical Practice 2019;36:94-99.

This meta-analysis concluded that yoga is an effective intervention for alleviating menstrual pain in women with primary dysmenorrhea.

Moonaz SH, et al. Yoga in sedentary adults with arthritis: Effects of a randomized controlled pragmatic trial. Journal of Rheumatology 2015;42:1194-1202.

In this 8-year clinical trial, conducted at Johns Hopkins University, a well-rounded yoga program for those with osteoarthritis and rheumatoid arthritis improved pain by 40%. Participants also demonstrated overall improvement in arthritis symptoms, physical fitness, psychological functioning, and health-related quality of life.

Pearson N, et al. White paper: Yoga therapy and pain—How yoga therapy serves in comprehensive integrative pain management, and how it can do more. International Journal of Yoga Therapy 2020;30(1):117-131.

This IAYT white paper explains that “yoga therapy can make a meaningful contribution to solving the overlapping public health crises of chronic pain, opioid misuse and overdose, and mental health disorders.” The authors describe yoga therapy as a key component in comprehensive integrative pain management, noting that this patient-centered intervention “positively addresses body and mind and focuses on overall well-being, quality of life, and flourishing within one’s life circumstances.”

Schmid A, et al. Yoga improves occupational performance, depression, and daily activities for people with chronic pain. Work 2019;63(2):181-189.

The authors of this pilot randomized controlled trial note that holistic interventions featuring mind and body components are likely necessary to best treat the complexities of chronic pain. They therefore developed and tested a yoga intervention for people with chronic pain and randomized them to receive either the yoga intervention or usual care for 8 weeks. The results indicated that yoga may be an effective therapeutic intervention for people in chronic pain to improve occupational performance, increase engagement in activities, and decrease depression.

Schmid A, et al. Yoga for people with chronic pain in a community-based setting: A feasibility and pilot RCT. Journal of Evidenced-Based Integrative Medicine 2019;24:2515690X19863763.

In this randomized controlled pilot study, pain severity and pain interference with daily activities were assessed in 67 people, most of whom had experienced chronic pain for more than 10 years. Significant improvements in multiple measures were seen in the group that did yoga.

Uebelacker L, et al. A pilot study assessing acceptability and feasibility of hatha yoga for chronic pain in people receiving opioid agonist therapy for opioid use disorder. Journal of Substance Abuse Treatment 2019;105:19-27.

This pilot feasibility study determined that yoga interventions can be delivered on-site in opioid agonist treatment programs. Participants’ mood improved after classes, with greater decreases in anxiety and pain for those in the yoga group. Most participants also engaged with home practices.

Ward L, et al. Yoga for functional ability, pain and psychosocial outcomes in musculoskeletal conditions: A systematic review and meta-analysis. Musculoskeletal Care 2013;11:203-217.

This article explores the effects of yoga on conditions including lower-back pain, arthritis, and kyphosis, outlining clinically significant improvements in key areas including psychosocial outcomes. The authors conclude, “Evidence suggests that yoga is an acceptable and safe intervention, which may result in clinically relevant improvements in pain and functional outcomes associated with a range of musculoskeletal conditions.”

Zeidan F, et al. Brain mechanisms supporting modulation of pain by mindfulness meditation. The Journal of Neuroscience 2011;31:5540-5548.

“After 4 days of mindfulness meditation training, meditating in the presence of noxious stimulation significantly reduced pain unpleasantness by 57% and pain intensity ratings by 40% when compared to rest.” This study also explored the impact of the practice of mindfulness meditation on brain areas associated with pain modulation.

Zeidan F, et al. Mindfulness meditation-based pain relief employs different neural mechanisms than placebo and sham mindfulness meditation-induced analgesia. The Journal of Neuroscience 2015;35:15307-15325.

“Recent findings have demonstrated that mindfulness meditation significantly reduces pain.” The practice of meditation activates specific brain areas known to be involved in pain modulation. In this study, mindfulness meditation provided a stronger analgesic effect than a placebo or sham meditation.

DIABETES AND METABOLIC ISSUES

Bock B, et al. Feasibility of yoga as a complementary therapy for patients with type 2 diabetes: The Healthy Active and in Control (HA1C) study. Complementary Therapies in Medicine 2019;42:125-131.

This randomized clinical trial compared a yoga program with a supervised walking program and found the yoga intervention to be highly feasible and acceptable to participants. The yoga program also produced improvements in blood glucose and psychosocial measures of diabetes management.

Innes KE & Selfe TK. Yoga for adults with type 2 diabetes: A systematic review of controlled trials. Journal of Diabetes Research 2016;2016:6979370.

A growing body of evidence suggests that yoga may improve health outcomes for adults with type II diabetes mellitus (DM2). Thirty-three papers reported results of 25 controlled trials (13 nonrandomized, 12 randomized) with a total of 2,170 participants: “Collectively, findings suggest that yogic practices may promote significant improvements in several indices of importance in DM2 management, including glycemic control, lipid levels, and body composition.”

Patil S, et al. Effect of yoga on cardiac autonomic dysfunction and insulin resistance in non-diabetic offspring of type-2 diabetes parents: A randomized controlled study. Complementary Therapies in Clinical Practice 2019;34:288-293.

Can yoga practice help to prevent people whose parents have type 2 diabetes from developing the disease themselves? This study of 64 non-diabetic offspring of people with type 2 diabetes found significant improvements in cardiac autonomic function and insulin resistance with an 8-week yoga intervention. Control-group participants did not show significant changes in any variables, leading the researchers to conclude that yoga may be useful for reducing the risk of diabetes in people whose parents have the condition.

Ramamoorthi R, et al. The effect of yoga practice on glycemic control and other health parameters in the prediabetic state: A systematic review and meta-analysis. PLoS One 2019;14(10):e0221067.

In this systematic review of studies published between 2002 and 2018, the yoga interventions were seen to improve fasting blood glucose, low-density lipoprotein, triglycerides, total cholesterol, systolic blood pressure, and other type 2 diabetes parameters. The authors note that these results suggest that yoga may be considered a comprehensive and alternative approach to preventing type 2 diabetes.

Singh A, et al. Partitioning of radiological, stress, and biochemcial changes in pre-diabetic women subjected to diabetic yoga protocol. Diabetes and Metabolic Syndrome 2019; 13(4):2705-2713.

This randomized controlled trial divided 37 prediabetic female participants into yoga and control groups. After 3 months, biochemical analysis revealed that the yoga group’s HbA1c (glycosylated hemoglobin, a measure of blood sugar levels over weeks) and glucose levels were significantly reduced, suggesting that yoga might halt or delay the conversion of prediabetes into diabetes.

Vizcaino M & Stover E. The effect of yoga practice on glycemic control and other health parameters in type 2 diabetes mellitus patients: A systematic review and meta-analysis. Complementary Therapies in Medicine 2016;28:57-66.

Another systematic review and meta-analysis indicates moderate evidence for yoga’s improvement of fasting glucose levels compared to standard care alone.

Yadav R, et al. Comparative efficacy of a 12-week yoga-based lifestyle intervention and dietary intervention on adipokines, inflammation, and oxidative stress in adults with metabolic syndrome: A randomized controlled trial. Translational Behavorial Medicine 2019;9(4):594-604.

This randomized controlled trial evaluated the efficacy of a 12-week yoga-based lifestyle intervention compared to dietary intervention alone on adipokines (cell-signaling proteins released by fat tissue), inflammation, and oxidative stress in 260 adults with metabolic syndrome. Those in the the yoga group showed significant improvement in a number of markers, whereas no significant changes were noted in the dietary intervention group.

HEALTHY AGING

Acevedo BP, et al. The neural mechanisms of meditative practices: Novel approaches for healthy aging. Current Behavioral Neuroscience Reports 2016;3:328-339.

“This review suggests that mind-body practices can target different brain systems that are involved in the regulation of attention, emotional control, mood, and executive cognition that can be used to treat or prevent mood and cognitive disorders of aging, such as depression and caregiver stress, or serve as ‘brain fitness’ exercise. Benefits may include improving brain functional connectivity in brain systems that generally degenerate with Alzheimer’s disease, Parkinson’s disease, and other aging-related diseases.”

Afonso RF, et al. Greater cortical thickness in elderly female yoga practitioners—A cross-sectional study. Frontiers in Aging Neuroscience 2017;9:1-6.

Through neuroimaging, this study showed greater cortical thickness in elderly people who did yoga compared to healthy age-matched controls, suggesting increased brain health with the practice.

Chaix R, et al. Epigenetic clock analysis in long-term meditators. Psychoneuroendocrinology 2017;85:210-214.

This DNA research concludes that “the cumulative effects of a regular meditation practice may, in the long-term, help to slow the epigenetic clock and could represent a useful preventive strategy for age-related chronic diseases.”

Epel E, et al. Can meditation slow rate of cellular aging? Cognitive stress, mindfulness, and telomeres. Annals of the New York Academy of Sciences 2009;1172:34-53.

The length of telomeres, the “endcaps” of chromosomes, is considered an indicator of longevity. The authors of this article “propose that some forms of meditation may have salutary effects on telomere length by reducing cognitive stress and stress arousal and increasing positive states of mind and hormonal factors that may promote telomere maintenance.”

Gothe N, et al. Yoga effects on brain health: A systematic review of the current literature. Brain Plasticity 2019;5(1):105-122.

This article summarizes the documented positive effects of yoga practice on brain structure and function as assessed with MRI, fMRI, and SPECT. Collectively, the studies demonstrated a positive effect of yoga practice on the structure and/or function of the hippocampus, amygdala, prefrontal cortex, cingulate cortex, and brain networks, including the default mode network. These studies offer promising early evidence that behavioral interventions like yoga may mitigate age-related and neurodegenerative declines, as many of these brain regions demonstrate significant age-related atrophy.

Lin P-J, et al. Influence of yoga on cancer-related fatigue and on mediational relationships between changes in sleep and cancer-related fatigue: A nationwide, multicenter, randomized controlled trial of yoga in cancer survivors. Integrative Cancer Therapies 2019;18:1534735419855134.

Four hundred ten cancer survivors participated in this nationwide multicenter phase III randomized controlled trial. The study compared the effect of a 4-week yoga therapy program to standard care on cancer-related fatigue (CRF). Yoga therapy participants demonstrated significantly greater improvements in fatigue. Improvements in overall sleep quality and reductions in daytime dysfunction (e.g., excessive napping) were significant components of yoga’s effect on CRF. According to the authors, “Oncologists should consider prescribing yoga to cancer survivors for treating CRF and sleep disturbance.”

Lu YH, et al. Twelve-minute daily yoga regimen reverses osteoporotic bone loss. Topics in Geriatric Rehabilitation 2016;32:81-87.

This clinical trial measured bone mineral density with DEXA scans, finding that, “Bone mineral density improved in spine, hips, and femur of the 227 moderately and fully compliant patients.”

Santaella DF, et al. Greater anteroposterior default mode network functional connectivity in long-term elderly yoga practitioners. Frontiers in Aging Neuroscience 2019;11:158.

“Recent literature data suggests that Yoga and other contemplative practices may revert, at least in part, some of the aging effects in brain functional connectivity, including the Default Mode Network (DMN).” Older women who had practiced yoga for at least 8 years showed greater DMN connectivity. “This finding may contribute to the understanding of the influences of practicing Yoga for a healthier cognitive aging process.”

Sivaramakrishnan D, et al. The effects of yoga compared to active and inactive controls on physical function and health-related quality of life in older adults: A systematic review and meta-analysis of randomised controlled trials. The International Journal of Behavorial Nutrition and Physical Activity 2019;16(1):33.

“This study provides robust evidence for promoting yoga in physical activity guidelines for older adults as a multimodal activity that improves aspects of fitness like strength, balance and flexibility, as well as mental wellbeing.”

Wang MY, et al. Physical-performance outcomes and biomechanical correlates from the 32-week Yoga Empowers Seniors Study. Evidence-Based Complementary and Alternative Medicine 2016;2016:6921689.

This study on yoga for older adults showed improved functional abilities and strength.

MENTAL HEALTH, INCLUDING ANXIETY, DEPRESSION, AND INSOMNIA

Acevedo BP, et al. The neural mechanisms of meditative practices: Novel approaches for healthy aging. Current Behavioral Neuroscience Reports 2016;3:328-339.

“This review suggests that mind-body practices can target different brain systems that are involved in the regulation of attention, emotional control, mood, and executive cognition that can be used to treat or prevent mood and cognitive disorders of aging, such as depression and caregiver stress, or serve as ‘brain fitness’ exercise. Benefits may include improving brain functional connectivity in brain systems that generally degenerate with Alzheimer’s disease, Parkinson’s disease, and other aging-related diseases.”

Balasubramaniam M, et al. Yoga on our minds: A systematic review of yoga for neuropsychiatric disorders. Frontiers in Psychiatry 2013;3:1-16.

This review of randomized controlled trials concluded that emerging evidence supports the benefits of yoga as an ancillary treatment for depression and sleep disorders.

Brinsley J, et al. Effects of yoga on depressive symptoms in people with mental disorders: A systematic review and meta-analysis. British Journal of Sports Medicine 2021;55(17):992-1000.

This systematic review and meta-analysis suggests that active yoga practices may ease depressive symptoms for those with a range of mental health issues.

Cocchiara, RA, et al. The use of yoga to manage stress and burnout in healthcare workers: A systematic review. Journal of Clinical Medicine 2019;8:284.

A review shows promising outcomes for stress management and burnout prevention in healthcare workers. Improvements were shown in physical health and quality of sleep. The researchers conclude that “stress levels and burnout are consistently reduced in subjects who practice yoga techniques and mind–body meditation.”

Danhauer SC, et al. Review of yoga therapy during cancer treatment. Supportive Care in Cancer 2018;25:1357-1372.

This review cites consistent improvements in psychological outcomes (depression, distress, anxiety) for those doing yoga therapy during cancer treatment. The practice was also seen to improve quality of life, quality of sleep, and immune biomarkers.

Gaitzsch H, et al. The effect of mind-body interventions on psychological and pregnancy outcomes in infertile women: A systematic review. Archives of Women’s Mental Health 2020;23:479-491.

“Preliminary evidence suggests that mind-body interventions, including mindfulness-based interventions and yoga, may be effective in reducing mental health difficulties and psychological distress in infertile patients undergoing fertility treatments.”

Gard T, et al. Potential self-regulatory mechanisms of yoga for psychological health. Frontiers in Human Neuroscience 2014;8:770.

This paper, published by an interdisciplinary team including scientists at Harvard University, discusses the potential for yoga to help psychological health through self-regulation.

Gautum S, et al. Impact on yoga-based mind-body intervention on systemic inflammatory markers and co-morbid depression in active rheumatoid arthritis patients: A randomized controlled trial. Restorative Neurology and Neuroscience 2019;37(1):41-59.

After 8 weeks of yoga, this randomized controlled trial showed a significant decrease in the severity of rheumatoid arthritis: Reduced levels of various systemic inflammatory markers and a statistically significant decline in depression symptoms were seen in the group that did yoga.

Ghaffarilaleh G, et al. Effects of yoga on quality of sleep of women with premenstrual syndrome. Alternative Therapies in Healthcare and Medicine 2019;25(5):40-47.

As disturbed sleep is a common and potentially debilitating component of premenstrual syndrome (PMS), this study sought to determine whether yoga practice could improve sleep quality in those suffering from PMS. The women randomized to the yoga group were offered three 60-minute yoga sessions a week for 10 weeks and expressed significant sleep improvement by the end of the study.

Ghaffarilaleh G, et al. Yoga positively affected depression and blood pressure in women with premenstrual syndrome in a randomized controlled clinical trial. Complementary Therapies in Clinical Practice 2019;34:87-92.

Participants in this randomized controlled clinical trial of yoga for people with premenstrual syndrome (PMS) suffered from depression during their menstrual cycles. They completed the Beck Depression Inventory-II before and after the intervention, and the group that did yoga experienced statistically significant improvement in depressive symptoms. The yoga group also had decreased diastolic blood pressure by the end of the 2-month study, during which they practiced yoga 3 times a week for 60 minutes per session.

Hagen I & Nayar US. Yoga for children and young people’s mental health and well-being: Research review and reflections on the mental health potentials of yoga. Frontiers in Psychiatry 2014;5:1-6.

This paper concludes that “yoga may help children and young people cope with stress and thus, contribute positively to balance in life, well-being, and mental health.” According to the review, “yoga in schools helps students improve resilience, mood, and self-regulation skills pertaining to emotions and stress.”

Koch A, et al. Perceived stress mediates the effect of yoga on quality of life and disease activity in ulcerative colitis. Secondary analysis of a randomized controlled trial. Journal of Psychosomatic Research 2020;130:109917.

When comparing the effects of yoga to written self-care advice for people with inactive ulcerative colitis and impaired quality of life, these authors found that perceived stress was important for reducing disease activity and increasing health-related quality of life. The study advised that yoga should be considered as an adjunct intervention for highly stressed people with ulcerative colitis.

Kuloor A, et al. Impact of yoga on psychopathologies and quality of life in persons with HIV: A randomized controlled study. Journal of Bodywork and Movement Therapies 2019;23(2):278-283.

This randomized controlled trial of 60 HIV-positive participants examined the effects of yoga on anxiety, depression, and psychological well-being and quality of life. After 8 weeks of movement, breathing, relaxation, and meditation practices the yoga group showed a significant reduction in anxiety, depression, and fatigue compared to the control group; they also had significant improvements in well-being and all quality-of-life domains.

Kwok J, et al. Effects of mindfulness yoga vs stretching and resistance training exercises on anxiety and depression for people with Parkinson disease: A randomized clinical trial. JAMA Neurology 2019;76(7):755-763.

One hundred eighty-seven adults with Parkinson’s disease who were able to stand unaided and walk with or without an assistive device were randomized to receive mindfulness yoga or stretching and resistance training. The yoga group had significantly better improvement in outcomes than the stretching and resistance training group, particularly for anxiety, depression, perceived hardship, perceived equanimity, and disease-specific quality of life.

Lin P-J, et al. Influence of yoga on cancer-related fatigue and on mediational relationships between changes in sleep and cancer-related fatigue: A nationwide, multicenter, randomized controlled trial of yoga in cancer survivors. Integrative Cancer Therapies 2019;18:1534735419855134.

Four hundred ten cancer survivors participated in this nationwide multicenter phase III randomized controlled trial. The study compared the effect of a 4-week yoga therapy program to standard care on cancer-related fatigue (CRF). Yoga therapy participants demonstrated significantly greater improvements in fatigue. Improvements in overall sleep quality and reductions in daytime dysfunction (e.g., excessive napping) were significant components of yoga’s effect on CRF. According to the authors, “Oncologists should consider prescribing yoga to cancer survivors for treating CRF and sleep disturbance.”

Nugent N, et al. Benefits of yoga on IL-6: Findings from a randomized controlled trial of yoga for depression. Behavorial Medicine 2021;47(1):21-30.

The 87 participants in this randomized controlled trial had experienced a current or recent episode of major depression, had elevated depression symptoms, and were taking antidepressant medication. Inflammatory markers were measured over time in a hatha yoga group and a health education group. Participants in the yoga intervention, which included breathing practices, movement, rest, and meditation, showed a significant reduction in interleukin-6 concentrations.

Pascoe MC & Bauer IE. A systematic review of randomised control trials on the effects of yoga on stress measures and mood. Journal of Psychiatric Research 2015;68:270-282.

This first systematic review of randomized controlled trials on yoga’s effects on mood and the brain found that yoga decreases blood pressure, heart rate, and expression of stress markers such as cortisol and cytokines.

Pearson N, et al. White paper: Yoga therapy and pain—How yoga therapy serves in comprehensive integrative pain management, and how it can do more. International Journal of Yoga Therapy 2020;30(1):117-131.

This IAYT white paper explains that “yoga therapy can make a meaningful contribution to solving the overlapping public health crises of chronic pain, opioid misuse and overdose, and mental health disorders.” The authors describe yoga therapy as a key component in comprehensive integrative pain management, noting that this patient-centered intervention “positively addresses body and mind and focuses on overall well-being, quality of life, and flourishing within one’s life circumstances.”

Saeed SA, et al. Depression and anxiety disorders: Benefits of exercise, yoga, and meditation. American Family Physician 2019;99:620-627.

This paper outlines the benefits of exercise, yoga, and meditation for depression: “Yoga as monotherapy or adjunctive therapy shows positive effects, particularly for depression.” Importantly, the authors also note that, “There are no apparent negative effects of mindfulness-based interventions, and their general health benefits justify their use as adjunctive therapy for patients with depression and anxiety disorders.”

Schmid A, et al. Yoga improves occupational performance, depression, and daily activities for people with chronic pain. Work 2019;63(2):181-189.

The authors of this pilot randomized controlled trial note that holistic interventions featuring mind and body components are likely necessary to best treat the complexities of chronic pain. They therefore developed and tested a yoga intervention for people with chronic pain and randomized them to receive either the yoga intervention or usual care for 8 weeks. The results indicated that yoga may be an effective therapeutic intervention for people in chronic pain to improve occupational performance, increase engagement in activities, and decrease depression.

Scott T, et al. Psychological function, Iyengar yoga, and coherent breathing: A randomized controlled dosing study. Journal of Psychiatric Practice 2019;(6):437-450.

This study sought to understand the amount, or dose, of yoga needed to improve symptoms of major depressive disorder. Both the high weekly dose of yoga (three 90-minute classes plus four 30-minute homework sessions) and the low dose (two 90-minute classes plus three 30-minute homework sessions) produced improvement in psychological symptoms that correlated with cumulative yoga practice. Possibly because of the small sample size of 32 participants, the study did not detect significant differences between the doses—both interventions reduced symptoms of depression and anxiety and increased feelings of positivity.

Streeter CC, et al. Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Medical Hypotheses 2012;78:571-579.

Yoga has far-reaching potential for the treatment of a broad array of disorders exacerbated by stress.

Streeter C, et al. Thalamic gamma aminobutyric acid level changes in major depressive disorder after a 12-week Iyengar yoga and coherent breathing intervention. Journal of Alternative and Complementary Medicine 2020;26(3):190-197.

In this study a 12-week yoga intervention was associated with significantly increased levels of gamma aminobutyric acid (GABA) and decreased depressive symptoms in participants with major depressive disorder. GABA is a well-known mood-regulating neurotransmitter, which makes this study especially interesting.

Uebelacker LA & Broughton MK. Yoga for depression and anxiety: A review of published research and implications for healthcare providers. Rhode Island Medical Journal 2013;99:20-22.

As an affordable and relatively accessible practice with research supporting cognitive and biological mechanisms, yoga is a promising modality for depression and anxiety management. According to this review, “The current evidence base is strongest for yoga as efficacious in reducing symptoms of unipolar depression.” It outlines potential risks that may be mitigated by working with a qualified yoga therapist.

Valencia L, et al. Yoga in the workplace and health outcomes: A systematic review. Occupational Medicine 2019;69(3):195-203.

Thirteen studies were included in this systematic review of randomized controlled trials of adult employees and yoga in the workplace through April 2017. Overall effects of yoga on mental health outcomes, especially stress. were beneficial.

Van der Riet P, et al. Exploring the impacts of mindfulness and yoga upon childbirth outcomes and maternal health: An integrative review. Scandinavian Journal of Caring Sciences 2019;34(3):552-565.

“The evidence presented in this review suggests that mindfulness and yoga practice are feasible and cost-effective interventions to enhance maternal mental health, particularly for women experiencing mental health challenges.”

Vollbehr N, et al. A mindful yoga intervention for young women with major depressive disorder: Design and baseline sample characteristics of a randomized controlled trial. International Journal of Methods in Psychiatric Research 2020;29(2):e1820.

This randomized controlled trial examined the efficacy and cost-effectiveness of 9 weeks of mindful yoga for major depressive disorder in females aged 18–34. Eighty-eight of the 171 participants received the yoga intervention plus treatment as usual, whereas the control group received just treatment as usual. Although the results of the full study are pending, the authors note that mindful yoga may be well?suited to target depression?related processes such as rumination, self?criticism, intolerance of uncertainty, body awareness, and dispositional mindfulness. Furthermore, because of its attractiveness to participants, yoga may help to circumvent stigma associated with seeking treatment for depression.

Wang F & Szabo A. Effects of yoga on stress among healthy adults: A systematic review. Alternative Therapies in Health and Medicine 2020;26(4):AT6214.

This systematic review of scientific literature from 2014 to 2018 focused on 12 articles that assessed the effect of yoga and yoga-related interventions on stress reduction in nonclinical populations. Various types of yoga were included in studies ranging from 4–28 weeks long, and most had positive effects on stress in the healthy populations studied.

Yadav A, et al. Effects of diaphragmatic breathing and systematic relaxation on depression, anxiety, stress, and glycemic control in type 2 diabetes mellitus. International Journal of Yoga Therapy 2021;31(1).

One hundred patients with type 2 diabetes were randomly assigned to two equal groups: Those in one group received conventional diabetes treatment, whereas those in a yoga group received conventional treatment plus training in diaphragmatic breathing and systematic relaxation. After 6 months, a significant decrease was seen in depression, anxiety, and stress scores in the yoga group.

Zou L, et al. Effects of meditative movements on major depressive disorder: A systematic review and meta-analysis of randomized controlled trials. Journal of Clinical Medicine 2018;7:195.

Meditative movement, such as yoga, shows significant benefit for depression and anxiety severity, as well as remission rate. This systematic review and meta-analysis states that, “Given the fact that meditative movements are safe and easily accessible, clinicians may consider recommending meditative movements for symptomatic management in this population.”

MUSCULOSKELETAL CONDITIONS

Fishman LM, et al. Serial case reporting yoga for idiopathic and degenerative scoliosis. Global Advances in Health and Medicine 2014;3:16-21.

In this case series, side-plank pose significantly reduced scoliotic curve when practiced properly for 6.8 months.

Lu YH, et al. Twelve-minute daily yoga regimen reverses osteoporotic bone loss. Topics in Geriatric Rehabilitation 2016;32:81-87.

This clinical trial measured bone mineral density with DEXA scans, finding that, “Bone mineral density improved in spine, hips, and femur of the 227 moderately and fully compliant patients.”

Ward L, et al. Yoga for functional ability, pain and psychosocial outcomes in musculoskeletal conditions: A systematic review and meta-analysis. Musculoskeletal Care 2013;11:203-217.

This article explores the effects of yoga on conditions including lower-back pain, arthritis, and kyphosis, outlining clinically significant improvements in key areas including psychosocial outcomes. The authors conclude, “Evidence suggests that yoga is an acceptable and safe intervention, which may result in clinically relevant improvements in pain and functional outcomes associated with a range of musculoskeletal conditions.”

NEUROLOGICAL HEALTH AND CONDITIONS, BRAIN INJURY, AND DEMENTIA

Acevedo BP, et al. The neural mechanisms of meditative practices: Novel approaches for healthy aging. Current Behavioral Neuroscience Reports 2016;3:328-339.

“This review suggests that mind-body practices can target different brain systems that are involved in the regulation of attention, emotional control, mood, and executive cognition that can be used to treat or prevent mood and cognitive disorders of aging, such as depression and caregiver stress, or serve as ‘brain fitness’ exercise. Benefits may include improving brain functional connectivity in brain systems that generally degenerate with Alzheimer’s disease, Parkinson’s disease, and other aging-related diseases.”

Brenes G, et al. The effects of yoga on patients with mild cognitive impairment and dementia: A scoping review. The American Journal of Geriatriac Psychiatry 2019;27(2):188-197.

A literature review on the effect of yoga in people with mild cognitive impairment and dementia examined 8 studies that reported on yoga as either the primary intervention or one component of a multi-component intervention. Results suggest that yoga may have beneficial effects on cognitive functioning, particularly attention and verbal memory.

Gothe N, et al. Yoga effects on brain health: A systematic review of the current literature. Brain Plasticity 2019;5(1):105-122.

This article summarizes the documented positive effects of yoga practice on brain structure and function as assessed with MRI, fMRI, and SPECT. Collectively, the studies demonstrated a positive effect of yoga practice on the structure and/or function of the hippocampus, amygdala, prefrontal cortex, cingulate cortex, and brain networks, including the default mode network. These studies offer promising early evidence that behavioral interventions like yoga may mitigate age-related and neurodegenerative declines, as many of these brain regions demonstrate significant age-related atrophy.

Green E, et al. Systematic review of yoga and balance: Effect on adults with neuromuscular impairment. The American Journal of Occupational Therapy 2019;73:1-11.

A systematic review on yoga for balance shows moderate evidence of decreased fall risk in community-dwelling older adults and people with cerebrovascular accidents, Alzheimer’s disease, and multiple sclerosis.

Kwok J, et al. Effects of mindfulness yoga vs stretching and resistance training exercises on anxiety and depression for people with Parkinson disease: A randomized clinical trial. JAMA Neurology 2019;76(7):755-763.

One hundred eighty-seven adults with Parkinson’s disease who were able to stand unaided and walk with or without an assistive device were randomized to receive mindfulness yoga or stretching and resistance training. The yoga group had significantly better improvement in outcomes than the stretching and resistance training group, particularly for anxiety, depression, perceived hardship, perceived equanimity, and disease-specific quality of life.

Lazar SW, et al. Meditation experience is associated with increased cortical thickness. NeuroReport 2005;16:1893-1897.

Meditation is associated with increased cortical thickness, a positive indicator of brain health and function.

Silviera K & Smart C. Cognitive, physical, and psychological benefits of yoga for acquired brain injuries: A systematic review of recent findings. Neuropsychological Rehabilitation 2020;30(7):1388-1407.

This systematic review explored cognitive, physical, and psychological outcomes in controlled trials of yoga for acquired brain injury. Six eligible studies, four of which focused specifically on stroke rehabilitation, were reviewed. For people with acquired brain injury broadly, improvements were found after yoga for psychological and physical adjustment, quality of life, and respiratory functioning. For stroke specifically, physical and memory recovery were greater in the yoga groups compared to exercise controls.

Sullivan MB, et al. Yoga therapy and polyvagal theory: The convergence of traditional wisdom and contemporary neuroscience for self-regulation and resilience. Frontiers in Human Neuroscience 2018;12:1-15.

This paper describes ancient yoga wisdom in terms of neuroscientific topics of self-regulation and resilience.

Tang Y-Y, et al. The neuroscience of mindfulness meditation. Nature Reviews Neuroscience 2015;16:213.

This exploration offers images and an explanatory model for the brain-activation patterns associated with mindfulness meditation.

Walter A, et al. Changes in nonmotor symptoms following an 8-week yoga intervention for people with Parkinson’s disease. International Journal of Yoga Therapy 2019;29(1):91-99.

This small study found positive changes in nonmotor symptoms among individuals with Parkinson’s disease following an 8-week yoga intervention. The participants who did yoga experienced statistically significant improvements in fatigue, balance confidence, and Parkinson’s-specific quality of life.

Yan J, et al. Effects of mind-body exercises on the physiological and psychosocial well-being of individuals with Parkinson’s disease: A systematic review and meta-analysis. Complementary Therapies in Medicine 2016;29:121-131.

“This review found that mind-body exercises demonstrated immediate moderate to large beneficial effects on motor symptoms, postural instability, and functional mobility among individuals with mild to moderate Parkinson’s disease.”

Zaccari B, et al. Yoga vs cognitive processing therapy for military sexual trauma–related posttraumatic stress disorder: A randomized clinical trial. JAMA Network Open Access 2023;6(12):e2344862.

This comparative effectiveness randomized clinical trial found that Trauma Center Trauma-Sensitive Yoga worked as well as cognitive processing therapy in reducing PTSD symptom severity in women veterans with military sexual trauma. The nearly 43% higher treatment completion rate for the yoga intervention indicates that such programs could address PTSD treatment limitations in Veterans Affairs facilities.

Zeidan F, et al. Mindfulness meditation improves cognition: Evidence of brief mental training. Consciousness and Cognition 2010;19:597-605.

“Brief mindfulness training significantly improved visuo-spatial processing, working memory, and executive functioning.” Even just a few days of meditation training may improve ability to sustain attention, a benefit previously reported in long-term meditators.

PEDIATRICS

Hagen I & Nayar US. Yoga for children and young people’s mental health and well-being: Research review and reflections on the mental health potentials of yoga. Frontiers in Psychiatry 2014;5:1-6.

This paper concludes that “yoga may help children and young people cope with stress and thus, contribute positively to balance in life, well-being, and mental health.” According to the review, “yoga in schools helps students improve resilience, mood, and self-regulation skills pertaining to emotions and stress.”

Khalsa SBS & Butzer B. Yoga in school settings: A research review. Annals of the New York Academy of Sciences 2016;1373:45-55.

This review of 47 publications found that “yoga in the school setting is a viable and potentially efficacious strategy for improving child and adolescent health.” Yoga addresses the whole child, emphasizing a social and emotional learning model.

Lack S, et al. An integrative review of yoga and mindfulness-based approaches for children and adolescents with asthma. Journal of Pediatric Nursing 2020;52:76-81.

This review shows that for children and adolescents with asthma, “Interventions involving either mindfulness or yoga may be effective in reducing stress and anxiety and improving quality of life and lung function.”

REPRODUCTIVE AND WOMEN'S HEALTH

Chethana B, et al. Prenatal yoga: Effects on alleviation of labor pain and birth outcomes. The Journal of Alternative and Complementary Medicine 2018;24(12):1181-1188.

“[Y]oga is a noninvasive, easy to learn mind-body medicine and complementary health practice, effective in alleviation of labor pain and possibly improving birth outcome.”

Gaitzsch H, et al. The effect of mind-body interventions on psychological and pregnancy outcomes in infertile women: A systematic review. Archives of Women’s Mental Health 2020;23:479-491.

“Preliminary evidence suggests that mind-body interventions, including mindfulness-based interventions and yoga, may be effective in reducing mental health difficulties and psychological distress in infertile patients undergoing fertility treatments.”

Ghaffarilaleh G, et al. Effects of yoga on quality of sleep of women with premenstrual syndrome. Alternative Therapies in Healthcare and Medicine 2019;25(5):40-47.

As disturbed sleep is a common and potentially debilitating component of premenstrual syndrome (PMS), this study sought to determine whether yoga practice could improve sleep quality in those suffering from PMS. The women randomized to the yoga group were offered three 60-minute yoga sessions a week for 10 weeks and expressed significant sleep improvement by the end of the study.

Ghaffarilaleh G, et al. Yoga positively affected depression and blood pressure in women with premenstrual syndrome in a randomized controlled clinical trial. Complementary Therapies in Clinical Practice 2019;34:87-92.

Participants in this randomized controlled clinical trial of yoga for people with premenstrual syndrome (PMS) suffered from depression during their menstrual cycles. They completed the Beck Depression Inventory-II before and after the intervention, and the group that did yoga experienced statistically significant improvement in depressive symptoms. The yoga group also had decreased diastolic blood pressure by the end of the 2-month study, during which they practiced yoga 3 times a week for 60 minutes per session.

Jiang Q, et al. Effects of yoga intervention during pregnancy: A review for current status. American Journal of Perinatology 2015;32:503-514.

This review concluded that yoga is a safe and effective intervention during pregnancy. “[Y]oga can be safely used for pregnant women who are depressed, at high-risk, or experience lumbopelvic pain. Moreover, yoga is a more effective exercise than walking or standard prenatal exercises.”

Kim S. Yoga for menstrual pain in primary dysmenorrhea: A meta-analysis of randomized controlled trials. Complementary Therapies in Clinical Practice 2019;36:94-99.

This meta-analysis concluded that yoga is an effective intervention for alleviating menstrual pain in women with primary dysmenorrhea.

Telles S, et al. Blood pressure and heart rate variability during yoga-based alternate nostril breathing practice and breath awareness. Medical Science Monitor Basic Research 2014;20:184-193.

This study showed increased vagal function (and autonomic nervous activity), accounting for lowered blood pressure and increased heart rate variability during the yoga practice of alternate-nostril breathing.

Van der Riet P, et al. Exploring the impacts of mindfulness and yoga upon childbirth outcomes and maternal health: An integrative review. Scandinavian Journal of Caring Sciences 2019;34(3):552-565.

“The evidence presented in this review suggests that mindfulness and yoga practice are feasible and cost-effective interventions to enhance maternal mental health, particularly for women experiencing mental health challenges.”

RESPIRATORY HEALTH AND DISEASE

Balkrishna A. Blood pressure and heart rate variability during yoga-based alternate nostril breathing practice and breath awareness. Medical Science Monitor Basic Research 2014;20:184-193.

This study showed increased vagal function (and autonomic nervous activity), accounting for lowered blood pressure and increased heart rate variability during the yoga practice of alternate-nostril breathing.

Bernardi F, et al. Acute fall and long-term rise in oxygen saturation in response to meditation. Psychophysiology 2017;54:1951-1966.

Meditation, a key component of yoga, seems to improve efficiency of gas exchange and oxygenation. This paper concluded that, “Meditation induces favorable changes in cardiovascular and respiratory end points of clinical interest.”

Lack S, et al. An integrative review of yoga and mindfulness-based approaches for children and adolescents with asthma. Journal of Pediatric Nursing 2020;52:76-81.

This review shows that for children and adolescents with asthma, “Interventions involving either mindfulness or yoga may be effective in reducing stress and anxiety and improving quality of life and lung function.”

Ratarasarn K & Kundu A. Yoga and tai chi: A mind-body approach in managing respiratory symptoms in obstructive lung diseases. Current Opinion in Pulmonary Medicine 2020;26:186-192.

“Yoga and Tai Chi are widely available in the community and have been shown to be beneficial in patients with COPD as well as many of the co-morbid conditions associated with COPD.”

Saoji AA, et al. Effects of yogic breath regulation: A narrative review of scientific evidence. Journal of Ayurveda and Integrative Medicine 2019;10:50-58.

Yoga breathing demonstrated advantageous effects on the neurocognitive, psychophysiological, respiratory, biochemical, and metabolic functions in healthy individuals. These techniques were also found to be useful in the management of various clinical conditions.

Turan G & Tan M. The effect of yoga on respiratory functions, symptom control, and quality of life of asthma patients: A randomized controlled study. Complementary Therapies in Clinical Practice 2020;38:101070.

This study was conducted to determine the effect of yoga on asthma. Respiratory function, symptom control, and quality of life were assessed in 112 people in an outpatient clinic for chest diseases. Six weeks of twice-weekly yoga positively influenced all of these measures.

STRESS

Cocchiara, RA, et al. The use of yoga to manage stress and burnout in healthcare workers: A systematic review. Journal of Clinical Medicine 2019;8:284.

A review shows promising outcomes for stress management and burnout prevention in healthcare workers. Improvements were shown in physical health and quality of sleep. The researchers conclude that “stress levels and burnout are consistently reduced in subjects who practice yoga techniques and mind–body meditation.”

Epel E, et al. Can meditation slow rate of cellular aging? Cognitive stress, mindfulness, and telomeres. Annals of the New York Academy of Sciences 2009;1172:34-53.

The length of telomeres, the “endcaps” of chromosomes, is considered an indicator of longevity. The authors of this article “propose that some forms of meditation may have salutary effects on telomere length by reducing cognitive stress and stress arousal and increasing positive states of mind and hormonal factors that may promote telomere maintenance.”

Househam AM, et al. The effects of stress and meditation on the immune system, human microbiota, and epigenetics. Advances in Mind-Body Medicine 2017;31:10-25.

The stress response has wide-ranging implications in the human body-mind-spirit system, and yoga practices such as meditation appear to have the ability to address these effects via a number of channels.

Koch A, et al. Perceived stress mediates the effect of yoga on quality of life and disease activity in ulcerative colitis. Secondary analysis of a randomized controlled trial. Journal of Psychosomatic Research 2020;130:109917.

When comparing the effects of yoga to written self-care advice for people with inactive ulcerative colitis and impaired quality of life, these authors found that perceived stress was important for reducing disease activity and increasing health-related quality of life. The study advised that yoga should be considered as an adjunct intervention for highly stressed people with ulcerative colitis.

Pascoe MC & Bauer IE. A systematic review of randomised control trials on the effects of yoga on stress measures and mood. Journal of Psychiatric Research 2015;68:270-282.

This first systematic review of randomized controlled trials on yoga’s effects on mood and the brain found that yoga decreases blood pressure, heart rate, and expression of stress markers such as cortisol and cytokines.

Pascoe MC, et al. Yoga, mindfulness-based stress reduction and stress-related physiological measures: A meta-analysis. Psychoneuroendocrinology 2017;86:152-168.

This meta-analysis of randomized controlled trials involving yoga postures compared to active controls found that yoga positively affects physiological measures of stress including heart rate, heart rate variability, fasting blood glucose, and cholesterol.

Streeter CC, et al. Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Medical Hypotheses 2012;78:571-579.

Yoga has far-reaching potential for the treatment of a broad array of disorders exacerbated by stress.

Valencia L, et al. Yoga in the workplace and health outcomes: A systematic review. Occupational Medicine 2019;69(3):195-203.

Thirteen studies were included in this systematic review of randomized controlled trials of adult employees and yoga in the workplace through April 2017. Overall effects of yoga on mental health outcomes, especially stress. were beneficial.

Wang F & Szabo A. Effects of yoga on stress among healthy adults: A systematic review. Alternative Therapies in Health and Medicine 2020;26(4):AT6214.

This systematic review of scientific literature from 2014 to 2018 focused on 12 articles that assessed the effect of yoga and yoga-related interventions on stress reduction in nonclinical populations. Various types of yoga were included in studies ranging from 4–28 weeks long, and most had positive effects on stress in the healthy populations studied.

URINARY HEALTH AND CONDITIONS

Brenes G, et al. A group-based yoga program for urinary incontinence in ambulatory women: Feasibility, tolerability, and change in incontinence frequency over 3 months in a single-center randomized trial. The American Journal of Geriatric Psychiatry 2019;27(2):188-197.

This study created a rigorous control group in the form of a nonspecific muscle stretching and strengthening program matched for time and attention with a group that received a yoga intervention. Fifty-six women aged 50 and older who reported at least daily stress-, urgency-, or mixed-type incontinence participated in this randomized trial. After 3 months, total incontinence frequency decreased by an average of 76% from baseline in the yoga group compared to 56% in the control group. Stress-incontinence frequency also decreased by an average of 61% in the yoga group versus 35% in the control group.

Huang A, et al. PD32-01 a randomized trial of a group-based therapeutic yoga program for ambulatory women with urinary incontinence. The Journal of Urology 2018;199:e645.

“Findings provide preliminary evidence to support the feasibility, efficacy, and safety of a group-based yoga therapy intervention to improve urinary incontinence in women.”

Sha K, et al. Yoga’s biophysiological effects on lower urinary tract symptoms: A scoping review. Journal of Alternative and Complementary Medicine 2019;25:279-287.

This review of relevant research concludes that yoga may reduce lower urinary tract symptoms by “increasing the strength of pelvic floor muscle and/or regulating the autonomic nervous system and activating the central nervous system.”