Overview of Systematic Reviews: Yoga as a Therapeutic Intervention for Adults with Acute and Chronic Health Conditions

Table 4

Overview of reviews—primary outcomes (yoga meta-analyses).

Review	Condition	Outcome		Intervention(s)	Comparison	Effect size; (95% CI)	𝑃 value	No. of participants (studies)	Quality of Evidence (grade)	Heterogeneity analysis	Comments
		Description	Measuring instrument(s)
Büssing et al., 2012 [10]	Pain	Effect size of pain	VAS, MPQ, CMDQ	Hatha, Iyengar, and unspecified yoga	Physical activity,; educational sessions,; waiting list, lecture,; routine care, and conversation	SMD −0.74; (−0.97, −0.52)	<0.0001	776 (12)	Moderate* (low)	Chi square test 19.73,; df = 11 (𝑃=0.05); 𝐼-square = 44%; Moderate heterogeneity detected	“Methodological quality of the studies had no relevant impact on the study outcome; of note, studies with higher quality had a better pain outcome as compared with studies with low quality”
Cabral et al.,; 2011 [11]	Psychiatric disorder	Treatment of psychiatric disorder: depression, anxiety, PTSD, and schizophrenia)	BDI, HADS, digit span test, wellbeing scores, stress hormone levels (cortisol and ACTH)	Integrated, Sudarshan Kriya, Hatha, Sahaj, Meditation yoga, Siddha Samadhi, and Iyengar	Other treatment	SMD −3.25; (−5.36, −1.14)	0.002	343 (10)	n.r	Cochran 𝑄 test = 369.69; (𝑃<.001); for fixed model data; Heterogeneity indicated	“Funnel plot and Egger regression test (𝑃=0.007) indicate publication bias; failsafe 𝑁=212 interpreted to suggest 21.2 missing studies needed to nullify observed effect”
Langhorst et al., 2012 [20]	Fibromyalgia syndrome	Pain	VAS	Yoga of Awareness, water yoga	Waitlist, treatment as usual	SMD −0.54; (−0.96, −0.11)	0.01	88 (2)	(Low)	𝐼-square = 0%	“Evidence of a short-term relief of four key domains of FMS by Yoga: pain, fatigue, depression, quality of life” No evidence of sleep improvement with yoga v. active or waitlist controls
Lee et al., 2009 [21]	Menopause	Menopausal symptoms	MENSI	Iyengar, unspecified yoga	No treatment	SMD 0.07; (−0.25, 0.39)	0.66	91 (2)	2.5/5*; (low)	Chi square test 0.28,; df = 1 (𝑃=0.60); 𝐼-square = 0%; No heterogeneity detected	“Evidence is insufficient to suggest that yoga is an effective intervention for menopause”
Lin et al.,; 2011 [22]	Psychological health, quality of life, and physical health of cancer patients	Anxiety, depression, distress, and stress	HADS, PSS, STAI, SOSI, POMS, SCL-90-R, STAI, CES-D, PANAS, IES, DMI	Integrated yoga, MBSR: gentle yoga, Tibetan, and unspecified yoga	Waitlist, n.r	SMD −0.95; (−1.63, −0.27)	0.006	744 (10)	5.25/10**; (low)	Chi square test 33, 96, df = 4; (𝑃=0.006); 𝐼-square = 88%; Very high heterogeneity detected	“Findings show potential benefits of yoga for people with cancer in improvements of psychological health…clinical heterogeneity to be considered when interpreting results”
		Quality of life	SF-12, FACT_B, FACT_G, and EORTC QLQ-C30	Restorative, Hatha, and unspecified yoga	n.r	SMD −0.29; (−0.58, 0.01)	0.51	210 (3)	4.7/10**; (low)	Chi square test 1.34,; df = 2 (𝑃=0.60); 𝐼-square = 0%; No heterogeneity detected
		Physical health	SF-12, FACT_B, and FACT_G	Restorative, Hatha, Tibetan, and MBSR: gentle yoga	n.r	SMD −0.16; (−0.37, −0.06)	0.15	367 (4)	5.25/10**; (low)	Chi square test 3.96,; df = 3 (𝑃=0.15); 𝐼-square = 24%; Some heterogeneity detected
Slade and Keating,; 2007 [31]	Chronic low back pain	Medium-term pain	n.r	Viniyoga, Iyengar	Trunk strength and aerobics, book and lectures	SMD 0.92; (0.47, 1.37)	n.r	88 (2)	7.7/10**; (n.r)	n.r	“Indicated significant and large effects for medium-term pain in favour of yoga”

n.r: not reported; BDI: Beck Depression Inventory; VAS: Visual Analogue Scale; MENSI: Menopausal Self-inventory; MPQ: McGill pain questionnaire; PPI: Present Pain Index; CMDQ: Cornell Musculoskeletal Discomfort Questionnaire; HADS: Hospital Anxiety and Depression Scale; PSS: Perceived Stress Scale; STAI: State of Trait Anxiety Inventory; SOSI: Symptoms of stress inventory; POMS: Profile of Mood States; SCL-90-R: Symptoms Checklist Revised; CES-D: Center for Epidemiologic Studies Depression Scale; PANAS: Positive and Negative Affect Schedule; IES: Impact of Events Scale; DMI: Distressed Mood Index; SF-36: Medical Outcomes Study Short-Form Health Survey; SF-12: The 12-Item Short Form Health Survey; FACT_B: Functional Assessment of Cancer Therapy-Breast; FACT_G: Functional Assessment of Cancer Therapy-General; EORTC QLQ-C30: European Organization for research and Treatment of Cancer Quality of Life Questionnaire Version 3.0; MBSR: Mindfulness-based stress reduction.
*Average Jadad score.
**Average PEDro scale.