Is one yoga style better than another? A systematic review of associations of yoga style and conclusions in randomized yoga trials

https://doi.org/10.1016/j.ctim.2016.02.015Get rights and content

Highlights

  • The odds of positive conclusions in yoga trials were compared between yoga styles.

  • A total of 306 RCTs were included that applied 53 different yoga styles.

  • The proportion of positive conclusions did not differ between yoga styles.

  • The choice of a yoga style can be based on personal preferences and availability.

Abstract

Objective

To determine whether the odds of positive conclusions in randomized controlled trials (RCTs) of yoga, differ between yoga styles.

Design

Systematic review of yoga RCTs. Medline/PubMed, Scopus, the Cochrane Library, IndMED and the tables of content of specialist yoga journals, not listed in medical databases, were screened up to 12 February, 2014 for RCTs comparing yoga interventions to non-yoga interventions. The RCTs’ conclusions were classified as positive (yoga is helpful for a respective condition) or not positive; and these were compared between different yoga styles using the Chi squared test and multiple logistic regression analysis.

Results

A total of 306 RCTs were included. These applied 52 different yoga styles, the most commonly used of which were: hatha yoga (36 RCTs), Iyengar yoga (31 RCTs), pranayama (26 RCTs), and the integrated approach to yoga therapy (15 RCTs). Positive conclusions were reached in 277 RCTs (91%); the proportion of positive conclusions did not differ between yoga styles (p = 0.191).

Conclusion

RCTs with different yoga styles do not differ in their odds of reaching positive conclusions. Given that most RCTs were positive, the choice of an individual yoga style can be based on personal preferences and availability.

Introduction

Yoga is gaining increased popularity as a therapeutic practice. More than 20 million Americans (9% of the population of the United States of America) reported they practiced yoga in 2012. More than two thirds of practitioners utilized yoga explicitly to improve their health status.1 In the United States of America and Europe, yoga is most often associated with physical postures (asanas), breathing techniques (pranayama) and meditation (dhyana).2 A large variety of different yoga styles have emerged that put varying focus on physical and mental practices.2, 3 It is often claimed that the diverse yoga styles differ in terms of efficacy and safety in improving the practitioners’ health.4 However, these claims are rarely based on sound scientific evidence. Thus, the aim of this analysis was to estimate how far results and conclusions of randomized controlled trials (RCTs) on yoga differ between different yoga styles.

Section snippets

Methods

This was a secondary analysis of a previously published bibliometric analysis of yoga RCTs.5 Reporting is in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines,6 where applicable. But because PRISMA is designed as a guideline for efficacy reviews assessing differences between interventions,6 and this review has used a slightly different approach (identifying associations of study characteristics with study conclusions), not all PRISMA

Study characteristics

The complete results of the literature search have been published elsewhere.8 This review included a total of 306 RCTs9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103

Discussion

As previously reported, more than 90% of all 306 published RCTs on yoga reached positive conclusions.8 This secondary analysis found that the proportion of positive, neutral or negative conclusions was independent of the applied yoga style. This might be interpreted as demonstrating that the efficacy of yoga does not depend on the specific yoga style that was used but that all (or most) yoga styles can be regarded as equally effective. However, it should be noted that most yoga styles were

Acknowledgments

This review was supported by a grant from the Rut- and Klaus-Bahlsen-Foundation. The funding source had no influence on the design or conduct of the review; the collection, management, analysis, or interpretation of the data; or often in the preparation, review, or approval of the manuscript. The authors would like to thank Jana Hochstein, Essen, Germany, for her assistance in data extraction; Dr. Petra Klose, Essen, Germany, and Dr. Hoda Azizi, Mashhad, Iran, for their assistance in assessing

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