ArticlePDF AvailableLiterature Review

Effects of Yoga on Stress Among Healthy Adults: A Systematic Review

Authors:
  • ELTE Eötvös Loránd University Budapest Hungary

Abstract and Figures

Background: Yoga was recommended in both clinical and nonclinical populations as therapy methods. The diversity of yoga practice as a therapy method has rarely been discussed and it is essential to address the effects of yoga on stress. Primary study objective: This article aims to investigate the effect of different types of yoga on stress in healthy population. On the other hand, the authors intended to figure out yoga effects on stress systematically. Methods/design: A systematic literature review was conducted to identify articles that assess the effect of yoga and yoga-related interventions on stress reduction in nonclinical populations. Studies were classified according to the length of the intervention, yoga type, and measures of outcome. The studies were selected throughout last 5 years (January 2014 to November 2018) by using the key searching term yoga and stress incorporation with tension and pressure. The selection process followed the Prisma flow diagram. Results: Totally, 12 articles elaborating on the effects of yoga or yoga-related interventions on stress management and remission were included in the review. This review included various types of yoga practice (e.g., Hatha yoga, Bikram yoga, Kundalini yoga, Sudarshan Kriya yoga, Kripalu yoga, Yin yoga). A time spectrum was conducted from 4 wks to 28 wks. This review revealed that most types of yoga have positive effects on stress reduction in heathy populations. Conclusion: Further studies are recommended to examine the long-term effect of yoga and underlying psychological mechanisms causing stress and mental restrain. In addition, it is suggested to consider age as a risk factor affecting the effect of yoga on stress.
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Eects of Yoga on Stress Among Healthy Adults:
A Systematic Review
Feifei Wang, MSc; Attila Szabo, PhD, DSc
REVIEW ARTICLE
ABSTRACT
Background Yoga was recommended in both clinical
and nonclinical populations as therapy methods. e
diversity of yoga practice as a therapy method has rarely
been discussed and it is essential to address the eects of
yoga on stress.
Primary Study Objective is article aims to investigate
the eect of dierent types of yoga on stress in healthy
population. On the other hand, the authors intended to
gure out yoga eects on stress systematically.
Methods/Design A systematic literature review was
conducted to identify articles that assess the eect of yoga and
yoga-related interventions on stress reduction in nonclinical
populations. Studies were classied according to the length
of the intervention, yoga type, and measures of outcome. e
studies were selected throughout last 5 years (January 2014 to
November 2018) by using the key searching term yoga and
stress incorporation with tension and pressure. e selection
process followed the Prisma ow diagram.
Results Totally, 12 articles elaborating on the eects of
yoga or yoga-related interventions on stress management
and remission were included in the review. is review
included various types of yoga practice (e.g., Hatha yoga,
Bikram yoga, Kundalini yoga, Sudarshan Kriya yoga,
Kripalu yoga, Yin yoga). A time spectrum was conducted
from 4 wks to 28 wks. is review revealed that most types
of yoga have positive eects on stress reduction in heathy
populations.
Conclusion Further studies are recommended to
examine the long-term eect of yoga and underlying
psychological mechanisms causing stress and mental
restrain. In addition, it is suggested to consider age as a
risk factor aecting the eect of yoga on stress. (Altern
er Health Med. [E-pub ahead of print.])
Feifei Wang, MSc, is PhD student in Education at the
Institute of Sports and Health Promotion, ELTE Eötvös
Loránd University, in Budapest, Hungary. Attila Szabo,
PhD, DSc, is Doctor of the Hungarian Academy of Sciences,
Professor of Psychology, Institute of Psychology, and
Institute of Health Promotion and Sport Sciences, ELTE
Eötvös Loránd University, in Budapest, Hungary.
Corresponding author: Feifei Wang, MSc
E-mail address: feifei.wang@ppk.elte.hu
INTRODUCTION
Yoga has become popular as a therapeutic and relaxation
intervention among all age groups, including the older
adults. Although there are many types and styles of yoga,
typical yoga practices combine stretching and holding various
poses (called asanas) with deep, rhythmed breathing and
meditation, with the goal of increasing physical exibility
and strength in skeletons.1 A treasury of 112 types of yoga
written by Singh explicitly answered the context of yoga
types, by which the highest reality was reached.2 Nevertheless,
despite the wide variety of yoga, its implementation was
successful worldwide in scientic research.
e eects of yoga on health have been illustrated many
times. Studies have shown that yoga benets health both in
clinical patients and nonclinical populations. Yoga as a
treatment for insomnia among patiens with cancer and
survivors was systematically reviewed and suggested
promising evidence of yoga for its ecacy in improving
insomnia and sleep quality impairment.3 Evidence showed
psychophysiological eects of yoga, and it was suggested to
increase endogenous secretion of melatonin, which, in turn,
might be responsible for improving the sense of well-being.4
In addition, meditation also showed physiological eect by
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increasing cardiac output, which inherently inuence basal
metabolic rate.5 As to cognitive function, yoga practice
showed no signicant improvement in healthy population;
however, yoga practice disclosed inspiring results in quality
of life and physical measures.6 Nevertheless, yoga-based
intervention program is feasible and ecacious in creating
positive improvements of health and wellness.7
e psychological eect of yoga has been examined in
previous study. Yoga appears to work on depression, anxiety,
and self-ecacy. For instance, a systematic review carried out
in 2004 investigated the eectiveness of yoga on the treatment
of anxiety and anxiety disorders. Evidence reported
encouraging results with obsessive compulsive disorder
despite the diversity of intervention conditions and decient
quality of the studies.8 Demonstrated by a recent review that
involved 27 studies, of which 19 studies reported signicant
reduction in state and/or trait anxiety.9 In women who suer
from anxiety disorders, 2-month yoga class can lead to
signicant reduction in perceived levels of anxiety.10
e eect of yoga and stress has been examined in wide
range of age groups and social status including prisoner and
oce set.11,12 e mechanism of yoga and stress has been
underlined. Positive aect, self-compassion, inhibition of the
posterior hypothalamus and salivary cortisol from a current
systematic review were all shown to mediate the relationship
between yoga and stress.13 Due to the diversity of yoga
practices and the vulnerable evidence existed in yoga types
and stress in healthy populations, the present study sought to
better characterize the benets of yoga on stress. is
systematic review evaluates the current scientic evidence of
yoga practice on stress. We hypothesize that any types of yoga
will have benecial eects on stress. We examined this
question across a large age range.
METHODS
To examine our hypothesis, we conducted a systematic
review.
Databases and Search Terms
e PICO standard15 was used as a supportive guideline
in the study selection. Before assessing by PICO, all
manuscripts initially considered relevant by title and abstract
were eligible for inclusion. Details in PICO standard:
P (population): Regular healthy participants (not
hospitalized patients or with clinical diseases, not
pregnant ladies, not in day-night shiing works).
I (intervention/exposure): Organizing yoga-based
intervention.
C (comparison): Studies comparing healthy adults
conducting yoga practice versus healthy adults not
conduction yoga practice, where such comparison
has been performed;
O (outcome): Eects of yoga practice on stress.
Inclusion and Exclusion Criteria
e source of stress diers in adults regarding to the life
management and social engagement. We accepted only
studies conducted within adults (18 years and older in this
study). Trials were excluded if any participants who were
clinical patients with physical or mental symptoms, shi
working personnel, or people with sleep disorder or perinatal
women. e reason why we excluded shi-working personnel
was that shi workers may suer extra stress compared with
the heathy population with regular life routine. Pregnant
women who have to go to hospital for regular medical check
was excluded due to their special body condition. People who
undergo sub-health condition (eg, people with sleep
disorders, insomnia) were also excluded because stress may
interact with subhealth conditions.
Studies which conducted with multiple or mixed
research methods were excluded. In addition, we also
excluded publication of reviews articles and letter to editors
in this study. If multiple published reports from the same
trial were available, only the report that contain the most
qualied information were taken into consideration.
Nevertheless, we did not take the sample size as an exclusion
criterion. Meanwhile, reviews or longitudinal studies were
not included. e inclusion and exclusion criteria are
presented in Table 1.
Quality Assessment
We used the Critical Appraisal Skills Programme
(2018)16 checklist to assess the quality of the selected
studies. ese checklists were designed to be used as
educational pedagogic tools, as part of a workshop setting,
therefore we do not suggest a scoring system. e core
Table 1. Inclusion and exclusion criteria used when selecting articles in the systematic review
Inclusion criteria Exclusion criteria
Population People above 18 years old People with clinical symptoms (physical or mental disorder, or undergoing regular
medical check) or in shi-work schedule
Intervention/exposure Yoga based study on stress
Empirical or observational
Original studies
Review (systematic review; meta-analysis)
longitudinal study (follow-up study or retrospective study); Mixed study methods
Comparison Contain intervention and controlled
groups
Case-control studies
Outcome Outcome elaborated the eect of yoga on stress
Other Timeframe from January 2014 to
November 2018
Questionable analysis methods.
Non-English study
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of risk of bias examined all of the included studies from
5 domains:
1. Was the allocation sequence adequately generated?
2. Was allocation adequately concealed?
3. Was knowledge of the allocated intervention
adequately prevented during the study?
4. Were incomplete outcome data adequately addressed?
5. Are reports of the study free of suggestion of selective
outcome reporting, and each of questions was given
3 answers: yes, no or unclear. Higgins suggested that if
a trial address all the 5 domains with “yes,” the trial
will be considered to have “low overall risk of bias”;
however, in cases in which even one of those
5vdomains get an “unclear” or “no“ assignment, the
trial will be considered to have an “ unclear or high
overall risk of bias.18 e details risk of bias assessment
is listed in Table 2.
CASP checklists were based on JAMAUsers’ guides to the
medical literature adapted from Guyatt et al,17 which piloted
with health care practitioners. e checklist was adopted
when rating the selected studies, we did not make comments
on the studies. All items are rated as “yes,” “no,” or “can’t
tell,” and Figure 1 summarizes the items by the checklist.
Bias Assessment
Publication bias always need to be taken into
consideration in systematic review. However, up to now,
there is no exact tool to assess the publication bias. With the
comprehensive search strategy, we relied on the tool for risk
of bias assessment produced by Cochrane to explore the
potential eects of publication bias on our results. ere are
2 dimensions concerning the validity of the study to assess
whether the study is asking appropriate research question
(external validity), and whether it answers its research
question “correctly” (internal validity).18 e Cochrane tool
Table 2. Assessment of Risk of Bias
Studies
Adequate
sequence
generation?
Allocation
concealment?
Blinding
(of outcome
assessors)
Incomplete
outcome data
addressed?
Selective
outcome
reporting?
Overall
assessment of
risk of bias
Hewett et al22 (2018) yes yes yes yes yes Low
Hylander et al31 (2017) yes unclear yes yes yes Uncertain
Marques et al26 (2017) yes yes yes yes yes Low
Maddux et al25 (2017) yes yes yes yes yes Low
Park et al24 (2017) yes yes yes yes yes Low
Chandra et al23 (2017) yes yes yes unclear no Uncertain
Garcia-Sesnich et al28 (2017) unclear yes no unclear yes Uncertain
Hunt et al32 (2017) yes no no yes yes High
Peterson et al27 (2017) yes yes no yes unclear High
Harkess et al29 (2016) yes yes unclear yes yes Uncertain
Lindahl et al1 (2016) yes yes no unclear no High
Bilderbeck et al11 (2015) unclear no yes yes unclear High
Note: “Low” indicates low risk of bias; “High” indicates high risk of bias; “Uncertain” indicates the risk of bias is uncertain.
Figure 1. Checklist of Quality Assessment of Selected Studies
Note: %Y = percentage of “Yes”; %N = percentage of “No”; %CT = % of “Cannot tell.
Hewett et al22 (2018)
Hylander et al31 (2017)
Marques et al26 (2017)
Maddux et al25 (2017)
Park et al24 (2017)
Chandra et al23 (2017)
Garcia-Sesnich et al28 (2017)
Hunt et al32 (2017)
Peterson et al27 (2017)
Harkess et al29 (2016)
Lindahl et al1 (2016)
Bilderbeck et al11 (2015)
0% 20% 40% 60% 80% 100%
% Yes
% No
% CT
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RESULTS
Study Selection Flow
Database searching using the method described led to
the retrieval of 1469 studies (PubMed: 732, Scopus: 737). An
additional source (International Journal of Yoga) online Web
site was checked. All of the studies were ltered step by step.
From tittle and abstract, it is feasible to spotted out the
ineligible participants (eg, clinical patients, people under
regular medical check) and research methods (eg, reviews,
protocols). Aer screening tittles and abstract, 75 articles
went through full-text examination. e articles were
examined by the aforementioned exclusion criteria. Finally,
12 studies were included in the system review. e ow chart
of study selection process was showed in Figure 2.
Characteristics of Included Studies
e 12 studies involved 672 participants. e details of
involved articles are presented in Table 3. Based on the
eligibility criteria, studies with both case and control group
comparison were included. Dierent intervention methods
were performed in various ages groups in adults. Various
types of yoga practice (eg, Hatha yoga, Bikram yoga,
Kundalini yoga, Sudarshan Kriya yoga, Kripalu yoga, Yin
yoga) with 3 spectrum from 4 weeks to 28 weeks were
conducted. Single studies were published in 2015 and 2018,
2 studies were published in 2016, and the rest of the included
studies were published in 2017. All of the studies organized
case group and control group and measured the participants
pre-post intervention. Participants were distributed
Figure 2. Study Selection Process
Identication
Records identied through database searching
(n
=
1469)
Full-text articles excluded (n
=
47) with reasons:
Clinical patients
Shied workers
People with pyschological problems
Participants are perinatal women
Mix-methods studies
Review
Stree as mediator for Yoga
Letter to editor
Screening
Eligibility
Included
Additional records identied through other sources
(n
=
1)
Records aer duplicates removed
(n
=
1266)
Records screened
(n
=
1266)
Records excluded by title and
abstract (n
=
1191)
Full-text articles assessed for
eligibility (n
=
75)
Studies included in qualitative
synthesis (n
=
28)
Studies included in quantitative
synthesis (systematic analysis)
(n
=
12)
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e association between age and yoga eect was under
investigation. Stress management interventions were highly
regarded by rst-year college students and demonstrated
dominant eects by Park et al.24 e yoga-based intervention
consisted of Kripalu yoga (a form of hatha yoga) was reported
as being helpful in school and at home.24 Power yoga was
organized in males (n
=
43, age: 45.5 years [10.0]) and females
(n
=
43, age: 47.1 [10.4]), and aer 16 weeks’ intervention, the
PSS scores dropped signicantly.25 Nevertheless, the included
articles showed clues of the interaction between age and the
function of yoga practice. A group of older women (age:
83.16
±
7.4 years) participated chair-based yoga, consisted of
an exercise class intervention which based on the essential
philosophy of Hatha yoga and its asanas, presented dierences
with a large eect size (P
=
.052, d
=
.85) in the exercise group
(age: 83.73
±
6.86 years) and control group
(age: 82.73
±
8.46 years).26 In addition, the examination of
Kundalini Yoga (KY) aer 3 months of regular practice
presented statistical signicance of perceived stress score
compared with control group in the basal measurement.27
The 3-day retreat program, named Shambhavi
Mahamudra kriya, is a yogic practice that includes both deep
breathing and meditation techniques suggested that may
represent a natural treatment for stress reduction.28 However,
it is suggested to take long-term eect of yoga intervention
into consideration. Harkess29 yielded that short-term yoga
randomized or nonrandomized. Stress was measured by
perceived stress scale (PSS) in all of the studies. Studies either
use 4-item or 10-item of PSS. Additional scales such as Beck
Depression Inventory (BDI),19 Depression, Anxiety and
Stress Scale (DASS-21),20 and Kessler Psychological Distress
Scale (K10)21 were used in these studies.
Eects of Yoga on Stress
Greater improvement (or decrease) in perceived stress
showed signicant relation to greater yoga class attendance.11
Despite the duration, length, frequency, and types of yoga
practice conducted in dierence trials, positive results of
yoga were found. Baseline and postintervention characteristics
were measured of the 8 participants who completed Hatha
yoga intervention, and perceived stress levels assessed by the
PSS significantly decreased after the intervention
(preintervention, 13.6
±
1.2 versus postintervention, 8.9
±
1.2),
with a large eect size of 1.38.1 A 16-week Bikram yoga
program conducted randomized control study also revealed
a signicant decrease in perceived stress (P
=
.001,
η2
p
=
0.173, 4.7 [95% CI: 2.1, 7.4)] at end of intervention in the
experimental versus the control group.22 Sudarshan Kriya Yoga
(SKY) including Sudarshan kriya, Bhastrika pranayama, and
Yoga nidra, is believed to be a powerful rhythmic breathing
technique, and proved to be a more positive alternative of
“medication” for stress management in previous study.23
Table 3. e details of selected studies
Study Participants Intervention
method
Duration Study design Outcome Measurements of assessing
stress
Hewett et al22 (2018) 63 Adults (37.2 ± 10.8 y) Bikram yoga 16 weeks A randomized
controlled trial
P.E. 10-item Perceived Stress
Scale (PSS)
Hylander et al31 (2017) 49 middle-aged
participants
Yin yoga 5 weeks A case-control study P.E. 4-iterm Perceived Stress
Scale (PSS-4)
Marques et al26 (2017) 34 women (83.16 ± 7.4 y) Chair-based Yoga 28 weeks Case-control study P.E. Perceived Stress Scale (PSS)
Maddux et al25 (2017) 80 students (mean age
46 y)
Power yoga 16 weeks Pre-post intervention P.E. 10-item Perceived Stress
Scale (PSS)
Park et al24 (2017) 51 rst-year
undergraduates
Kripalu yoga 8 weeks A randomized
controlled trial
P.E. 21-item Depression, Anxiety
and Stress Scale (DASS-21)
Chandra et al23 (2017) 20 humans aged 21- to
30-y- old
Sudarshan Kriya
yoga
30 days Case-control study P.E. Stress Determination Test
(SDT)
Garcia-Sesnich et al28
(2017)
26 people aged 18- to
45-y-old
Kundalini Yoga 3 months Case-control study P.E. Perceived Stress Scale (PSS)
(Spanish version)
Hunt et al32 (2017) 60 undergraduate
students
Mindfulness
training;
Yoga alone
4 weeks Case-control study
Pre-post intervention
P.E. Beck Depression Inventory
(BDI)
Spielberger State/Trait
Anxiety Inventory
Peterson et al27 (2017) 142 individuals
(43 ± 13.90 y)
Multicomponent
Breath-Based Yoga
6 weeks Pre-post intervention P.E. 10-item Perceived Stress
Scale (PSS)
Harkess et al29 (2016) 84 middle-aged women Yoga class 2 months A case-control trial P.E. Kessler Psychological
Distress Scale (K10);
Perceived Stress Scale (PSS)
Lindahl et al1 (2016) 8 participants
(66.5 ± 0.3 y)
60-min Hatha yoga
sessions
7 weeks Pre-post intervention P.E. Perceived Stress Scale (PSS)
Bilderbeck et al11 (2015) 55 participants
(prisoners)
Yoga course 10 weeks Pre-post intervention P.E. Perceived Stress Scale (PSS)
Note: P.E.= Positive Eect; N.E.= Negative Eect; N/L= No eect or Lack of evidence
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on baroreex in elder population.37 us, yoga practice with
physical movement and gestures should be taken into
consideration before conducting among older adults.
Limitations
Limitations exist in this review. Methodological problems
appeared in most of the selected studies including sample
size limitation, short intervention period, and other factors.
As mentioned previously, we did not take small sample size
as an exclusion criterion, but a small sample may bias the
validity of the study. In addition, the eect size of the
included studies was not considered in the statistical analysis.
CONCLUSION
ough the association of exercise and age by previous
study showing that many critical questions remain regarding
the relationship of aging and exercise, the positive eects of
yoga were highly regarded. Both cognitive behavior therapy
and yoga are promising stress management techniques.38
Given that yoga and cognitive behavior therapy (CBT) have
not been indicated any dierence in coping with stress, it is
suggested to explore the deeper function of yoga and CBT in
neurology level. Due the various subcategories of yoga, a
comprehensive knowledge of yoga is recommended.
Moreover, physical activity has many well‐established
health benets, and physiological benets of yoga help
people become more resilient to stressful conditions, but
strenuous exercise increases muscle oxygen ux and elicits
intracellular events that can lead to increased oxidative
injury.39 Nevertheless, more studies should be conducted to
underlay biological mechanisms leading to its stress reduction
eect in healthy populations.
AUTHOR DISCLOSURE STATEMENT
e authors declare that there is no conict of interests regarding the publication of this
paper. Feifei Wang conceived, designed and wrote the paper; Attila Szabo improved the
approach of the systematic review and revised the nal version of the paper. Both
authors read and approved the nal version of the manuscript. ere is no interest
conict to disclose.
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practice may yield some benets to stressed individuals, but
the long-term evaluation is required to determine the optimal
dose for improvements and maintenance.29 In the study,
women (n
=
116) between the ages of 35 and 65 years were
allocated to a twice-weekly, hour-long yoga class for a period
of 2 months, or into a waitlist control. Following the statistical
methods of mixed-model analyses of variances and quadratic
time (Time 2) included for PSS examination, the study
showed that stress level did not improve signicantly.29
e eectiveness of yoga and mindfulness practice on
stress need to be claried. ere are dierences and
interactions between yoga and mindfulness. Both meditation
and yoga are implementations of mindfulness therapy.30 e
YOMI program, a psychoeducational training program that
bridges psychological theory and knowledge with the practice
of mindfulness and yin yoga, contributed signicantly to
decreased levels of perceived stress increased levels of
mindfulness to participants.31 Hunt et al32 conducted a
multigroup study with 4 groups (“Mindfulness Training
Alone”; “Yoga Alone”; “Multicomponent Mindfulness
Training groups”; “Study Break with a erapy Dog”)
dismantled yoga and explicated mindfulness training in a
brief stress reduction intervention in college students.32 It is
suggested that the “mindfulness training alone group
experienced the least stress challenge compared with
combined group and yoga alone group.
DISCUSSION
e evidence of positive eect of yoga on stress
management becomes apparent. All types of yoga and yoga-
based interventions (eg, mindfulness-based yoga, meditation-
based yoga) illustrated signicant benet to stress release.
e inuences of yoga on stress have been studied from a
wide spectrum. e diversity of yoga practice and in
conjunction with mindfulness intervention are suggested to
help stress reduction and management. Yoga has a long
history and recognized as a form of mind-body medicine.
e physical postures and breathing exercises improve the
stress outcomes such as physical and mental tension.33 is
can be a strong explanation for the mechanism of yoga on
stress. A systematic review supported the nding that yoga
has positive eect on stress reduction in healthy adult
populations.34
Further studies to ascertain yoga’s long-term eects was
suggested by Chong et al.34 In our study, we found that the
interventions duration seems to be an essential factor of yoga
eectiveness. Studies with longer intervention period
produced convincible results. Even though short-term
intervention also showed benecial result toward stress.
However, the benecial eects of short term yoga may not
translate into long term eects as well.35
Aging is associated with a decline in physical function,
which is the combination of a loss of muscle mass and
reduced muscle function.36 Eight studies in this review
conducted with middle aged and older adult participants. It
was indicated that Yoga practice showed modiable eects
Wang—Yoga and Stress Among Healthy Adults
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... In fact, there were only 12 and 17 studies on the general population reported in a systematic review (F. Wang & Szabo, 2020) and a meta-analysis (Hendriks et al., 2017), respectively. Secondly, most empirical studies used small sample sizes, and their study designs were of low quality. ...
... Whilst practising yoga, and hot yoga in particular, is potentially beneficial to healthy adults (F. Wang & Szabo, 2020), it can also be a promising way to help vulnerable groups in society, such as people with mild psychological disorders or at risk of other mental problems. Mental illnesses cost the global economy at least $1 trillion in lost productivity annually, with depression being the leading risk factor (World Health Organization, 2017). ...
... This would be highly desirable in future research (F. Wang & Szabo, 2020). Thirdly, although we recruited a community sample and used random assignment in our study design, it would be worth paying more attention to certain sample characteristics in future studies. ...
... Practicing yoga has revealed multiple benefits on psychological wellbeing. For instance, it has been shown to enhanced mood, alleviate anxiety (Cramer et al., 2018) [15] , and reduce perceived stress (Wang & Szabo, 2020) [76] . While anxiety is defined as a natural human reaction to stress described by sensations of tension, apprehensive thoughts and physical changes, that is activated whenever a person perceives a danger or threat (APA, 2021) [1] , performance anxiety refers to a propensity to consider performing circumstances as threatening and to react to these situations with specific negative emotions (e.g. ...
... One component of yoga is conscious relaxation (yoga nidra, savasana), which consists of reestablishing contact with various body parts, cultivating moment-tomoment awareness, accepting physical sensations, and letting go of disruptive thoughts (Kaufman, Glass, & Pineau, 2019; Polsgrove, Haus, & Lockyer, 2019) [31,61] . These aspects of yoga appear to be efficacious strategies to enhance awareness of the leading stressors that should be managed, and reject less powerful and significant stressors, thereby enabling athletes to better cope with stress (Marinov, Gencheva, Angelcheva, Ignatov, & Dimitrov, 2017; White, Bethell, Charnock, Leckey, & Penpraze, 2021) [54,77] . Finally, the practice of yoga also impacted positively on performance indicators in various populations. ...
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Yoga and the practice of mindfulness have gained popularity as performance psychology interventions, by promoting a relaxed state of focus, increasing body flexibility, and improving awareness during performances. Like professional athletes, circus performers invest a great deal of time, resources, and mental and physical energy in their performances. The present pilot project focuses on the effect of the Bali Yoga Program, adapted for athletes (BYP-A), on the general psychological state, quality of life, performance anxiety, and perceived athletic performance of circus artists studying at the National Circus School in Montreal. Over 8 weeks, student circus artists (n= 18) attended 90-min yoga session. Results showed that following the intervention, participants reported decreased depressive and somatic symptoms, decreased cognitive and somatic performance anxiety and enhanced coping abilities (relaxation, mental distractions). BYP-A has initially shown to provide benefits for circus artists, such as factors related to improved psychological health and mental state related to performance. Future avenues for research should explore yoga intervention more thoroughly and pursue to investigate the differences existing between circus arts and other performance fields.
... Ten studies had 1-24% males [25,27,28,39,51,64,65,73,89,92], another 10 had 25-49% males [25,34,38,58,69,73,74,92,95,97] and 10 studies had greater than 50% males as participants [27,29,32,53,54,60,76,89,92,93]. All of the study participants were older adults, 11 studies did not report additional age information [37,46,52,57,68,86,88,90,91,97,99]. Six studies provided an age range [28,35,41,77,94,95], seven studies included participants with a mean age 50-59 years [36,51,66,67,69,80,83], 19 studies with a mean age of 60-69 [25,40,42,43,48,50,56,59,63,70,71,73,81,84,85,87,93], 21 studies with a mean age of 70-79 [22, 27, 29, 30, 32-34, 38, 39, 46, 53-55, 58, 60, 72, 75, 76, 79, 82, 96] and 10 studies included participants with a mean age greater than 80 years [44,47,49,61,62,64,65,74,78,92]. ...
... Generally speaking, the findings of this study are consistent with previous reviews and meta-analyses; yoga can have a positive impact on psychomotor, affective and cognitive domains. Of these reviews, five were exclusive to yoga [16,17,[99][100][101], while the others included other mind-body, breathing and exercise interventions for adults and children [1-3, 5, 6, 18] The review by McCall involved older adults with acute and chronic health conditions, the review by Sivaramakrishnan involved older adults and Sieczkowska's review was focused on those with rheumatic arthritis. Both meta-analyses demonstrated support for yoga as an intervention with large effects for emotional, social, health and physical function; neutral support for mental health, pain and vitality [16,17,101]. ...
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Chair yoga is a specific form of yoga practiced while seated on a chair, or standing using a chair for support; this adaptation allows those with impaired standing ability to practice safely. The purpose of this scoping review was to analyze the published literature regarding the use of chair/adapted yoga with older adults. Two researchers performed the review. Data sources: PubMed Central, CINAHL, Medline Full Text, Nursing and Allied Health, SPORT discus and TRIP were accessed. Study selection: Inclusion criteria included pre-test/post-test studies with a yoga intervention for older adults using a chair. Exclusion criteria were studies with seated exercise interventions not specific to yoga, mindfulness or breathing techniques with no physical activity, yoga with no use of a chair, not specific to older adults and reviews. The search strategy was performed by two reviewers. Data extraction: Covidence, a systematic review production tool, was utilized to aid article analysis. Data synthesis: Summation of study type, sample, dosing, intervention type, setting, outcome domains and results were included. Of the 3147 studies initially identified, 75 met the inclusion criteria. This review included 32 RCTs, 11 quasi-experimental, 21 cohort, nine qualitative studies and 2 case-series studies. Most studies reported affective and psychomotor domains of learning (n = 51) and favored chair/adapted yoga as an intervention over the control. A few studies included a second intervention. Twenty two of the 75 studies were focused on community dwelling older adults, followed by participants with orthopedic diagnoses (n = 16), and cognitive impairment (n = 9). The quality of literature supporting chair/adapted yoga is fairly substantial for both community dwelling and those with certain physical and cognitive diagnoses. It is recommended that this intervention continue to be utilized and studied.
... While yoga has become a prominent part of the modern-day physical activity landscape [7,8], studies have shown that yoga participation is still relatively low and appears confined mainly to specific population subgroups [9][10][11][12][13], with white, well-educated females occupying a particularly prominent place. Given yoga's wide range of potential health benefits [14][15][16][17][18], there is ample space for participation to grow, particularly among non-dominant subpopulations such as men. Strategies for yoga promotion could benefit from knowledge of participation parameters such as people's perception of the activity and reasons for participation [19,20]. ...
... Yoga's potential health benefits [14][15][16][17][18] make it a promising health behavior for both genders. However, as indicated above, uptake among men lags far behind that of women [9][10][11][12] and various factors may contribute to this phenomenon. ...
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... 2021 for publications available in English about the potential role of Yoga in COVID-19 pandemic. There is some evidence that certain home-based activities can improve mental wellness during (2020) reported the beneficial effects on stress of activities such as exercise, listening to relaxing music, muscle relaxation and Yoga [3]. Yoga seems the perfect physical activity to carry on at home in order to cope with psychological issues while simultaneously maintaining the social isolation necessary to reduce the spread investigate the effects of modern postural yoga on positive mental health (PMH) indicators such as mindfulness, affect, resilience and well-being in clinical and non-clinical populations. ...
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... There are five traditional forms of yoga: gyan yoga, karma yoga, bhakti yoga, raja yoga, and hatha yoga. Yoga is effective for treating anxiety, depression, and psychological distress, and also has a positive effect on stress reduction in healthy adults [11,13,16]. ...
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The practice of meditation today has an objective to test the malleability of the brain based on neuroplasticity. Science is discovering the physiological and psychological benefits of meditation, since it is fundamental to consider all aspects that influence health. Among a large number of meditation techniques currently used, this chapter focuses on the benefits of practicing mindfulness and yoga used in addition to medicine and psychology resources for patients undergoing assisted human reproduction. Growing knowledge about psychological implications of infertility demonstrates that medical and psychological factors cannot be separated, both in terms of diagnosis and treatment. Assisted reproductive techniques and infertility treatments are multidimensional stressors. Fertility problems are accompanied by much emotional distress, and infertile women have higher levels of anxiety and depression than normal. In addition, mood disorders are common in both women and men undergoing in vitro fertilization procedures. This chapter will present studies which show that mindfulness and yoga could be helpful for people suffering from infertility, undergoing in vitro fertilization, or even improving semen quality.
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Chapter
Arterial hypertension is a major cause of premature death worldwide. It is also the most important risk factor for cardiovascular diseases. The reactivity of the cardiovascular system to stressors is associated with the development of arterial hypertension. Yoga and meditative practices, including mindfulness-based interventions, provide the tools to manage this cardiovascular reactivity through restoration of psycho-physiological balance. Due to its holistic approach to the individual, the practice of yoga emphasizes cultivation of healthy habits and ways of living. Yoga and meditative practices also focus on the development of conscious awareness of the present moment, allowing perception of experiences in the most objective way, overcoming identification with the ever-changing external and internal environment, thereby reducing reactivity, improving acceptance, and restoring the body-mind equilibrium. With research evidence questioning antihypertensive drug treatment in mild hypertension, the time is ripe to implement evidence-based yoga practices accompanied with yoga’s holistic approach in mainstream healthcare. Keywords: Arterial hypertension, Blood pressure, Yoga and hypertension, Meditation, Mindfulness-based interventions, Hypertensive patients, Cardiovascular risk factors, Non-communicable diseases.
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Mindfulness-based stress reduction (MBSR) can help college students cope effectively with stress, reducing negative affect in the short term and resulting in higher (more adaptive) heart rate variability (HRV). However, HRV is a measure of cardiovascular fitness, as well as parasympathetic control of the stress response. MBSR is a multicomponent intervention and it is unclear to what extent movement, including gentle yoga, mindfulness training, or the synergy between the two, has an impact on emotional and physiological outcomes. The current study dismantled yoga and explicit mindfulness training in a brief stress reduction intervention in college students. Participants were randomly assigned to either mindfulness training and meditation alone (no movement); yoga alone (no explicit mindfulness training); combined yoga and mindfulness training and meditation; an active placebo control consisting of study breaks with party games, access to a therapy dog, and healthful snacks; or a no-treatment control. All active treatments resulted in decreases in anxiety and dysphoria over the 4 weeks of treatment relative to the no-treatment control, although by week 4, only the combined and yoga groups were significantly different from the control group on both measures. The no-treatment control group showed the lowest HRV at rest and during the challenge. The combined and yoga groups showed the highest HRV at rest, followed by moderate declines in HRV during the challenge, suggesting adaptive vagal withdrawal. The mindfulness training alone group was the only group to show no decrease in HRV during the challenge, suggesting that they were the least stressed by the challenge.
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Objectives: The purpose of this study was to investigate the effect of 16 weeks of Bikram yoga on perceived stress, self-efficacy and health related quality of life (HRQoL) in sedentary, stressed adults. Design: 16 week, parallel-arm, randomised controlled trial with flexible dosing. Methods: Physically inactive, stressed adults (37.2±10.8 years) were randomised to Bikram yoga (three to five classes per week) or control (no treatment) group for 16 weeks. Outcome measures, collected via self-report, included perceived stress, general self-efficacy, and HRQoL. Outcomes were assessed at baseline, midpoint and completion. Results: Individuals were randomised to the experimental (n=29) or control group (n=34). Average attendance in the experimental group was 27±18 classes. Repeated measure analyses of variance (intention-to-treat) demonstrated significantly improved perceived stress (p=0.003, partial η(2)=0.109), general self-efficacy (p=0.034, partial η(2)=0.056), and the general health (p=0.034, partial η(2)=0.058) and energy/fatigue (p=0.019, partial η(2)=0.066) domains of HRQoL in the experimental group versus the control group. Attendance was significantly associated with reductions in perceived stress, and an increase in several domains of HRQoL. Conclusions: 16 weeks of Bikram yoga significantly improved perceived stress, general self-efficacy and HRQoL in sedentary, stressed adults. Future research should consider ways to optimise adherence, and should investigate effects of Bikram yoga intervention in other populations at risk for stress-related illness. Trial registration: Australia New Zealand Clinical Trials Registry ACTRN12616000867493. Registered 04 July 2016. URL: http://www.anzctr.org.au/ACTRN12616000867493.aspx.
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Background and Objectives: Chronic stress contributes to psychopathology and the practise of yoga is suggested to decrease stress and improve well-being. However, the literature often reports methodological problems (cross-sectional designs, sample sizes ≤ 20, and limited exploration of community populations). The aim of this study was to address these limitations and evaluate the potential psychological benefits of yoga to a non-clinical population. Methods: Women (N = 116) reporting chronic stress participated in this longitudinal study. Participants were allocated to a twice-weekly, hour-long yoga class for a period of two months, or a waitlist-control. Indicators of psychological well-being were measured at baseline, post-test and one-month follow-up. Results: Psychological distress decreased over time in both groups, however the control group experienced decreases in positive effect compared with the yoga group. Curvilinear trends were observed, indicating that trajectories of improvement seen at post-test were not robustly seen at follow-up. Conclusion: The study indicates that short-term yoga practise may yield some benefits to stressed individuals, but that evaluation over a longer term of practise may be required to determine the optimal dose for improvements and maintenance. Differential treatment effects may be difficult to detect in studies with populations that may already be motivated to improve their health. © 2016 The Author(s). This open access article is distributed under a Creative Commons Attribution (CC-BY) 4.0 license.
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Aim The present study focuses on analyzing the effects of Sudarshan Kriya yoga (SKY) on EEG as well as ECG signals for stress regulation. To envision the regulation of stress Determination Test (DT) has been used. We have chosen a control group for contriving a cogent comparison that could be corroborated using statistical tests. Subjects and Methods A total of 20 subjects were taken in the study, of which 10 were allotted to a control group. Electroencephalograph was taken during a DT task, before and after SKY the sky session with 30 days of SKY session given to the experimental group. No SKY was given to the control group. Results We quantified mental stress using EEG, ECG and DT synergistically and used SKY to regulate it. We observed that alpha band power decreases in the frontal lobe of the brain with increasing mental stress while frontal brain asymmetry decreases with increasing stress tolerance. Conclusions These EEG, ECG and DT shows a significant decrement in mental stress and improvement in cognitive performance after SKY, indicating SKY as a good alternative of medication for stress management.
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Context: Stress is defined as an alteration of an organism's balance in response to a demand perceived from the environment. Diverse methods exist to evaluate physiological response. A noninvasive method is salivary measurement of cortisol and alpha-amylase. A growing body of evidence suggests that the regular practice of Yoga would be an effective treatment for stress. Aims: To determine the Kundalini Yoga (KY) effect, immediate and after 3 months of regular practice, on the perception of psychological stress and the salivary levels of cortisol and alpha-amylase activity. Settings and design: To determine the psychological perceived stress, levels of cortisol and alpha-amylase activity in saliva, and compare between the participants to KY classes performed for 3 months and a group that does not practice any type of yoga. Subjects and methods: The total sample consisted of 26 people between 18 and 45-year-old; 13 taking part in KY classes given at the Faculty of Dentistry, University of Chile and 13 controls. Salivary samples were collected, enzyme-linked immunosorbent assay was performed to quantify cortisol and kinetic reaction test was made to determine alpha-amylase activity. Perceived Stress Scale was applied at the beginning and at the end of the intervention. Statistical analysis used: Statistical analysis was applied using Stata v11.1 software. Shapiro-Wilk test was used to determine data distribution. The paired analysis was fulfilled by t-test or Wilcoxon signed-rank test. T-test or Mann-Whitney's test was applied to compare longitudinal data. A statistical significance was considered when P < 0.05. Results: KY practice had an immediate effect on salivary cortisol. The activity of alpha-amylase did not show significant changes. A significant decrease of perceived stress in the study group was found. Conclusions: KY practice shows an immediate effect on salivary cortisol levels and on perceived stress after 3 months of practice.
Article
Introduction Chair-based Yoga (CBY) practice could be used as a therapy easily adaptable to older people’s needs, as a tool to attenuate immunosenescence and to improve emotional status. The main goal of the study was to assess the changes mediated by CBY practice on salivary IgA and lysozyme levels, health-related emotional status (HrES) and functional fitness parameters in older women living in social caregiver centers. Methods Thirty-four older women (age: 83,16 ± 7,4 years) participated in the study and were divided in two groups, an Exercise Group (EG, n = 15) using CBY and a Control Group (CG, n = 10). All the subjects were assessed before and after the exercise program. EG practiced exercise 2–3 times per week for a period of 28 weeks, and the CG was not involved in any type of exercise program. Saliva samples, physical fitness tests and HrES psychometric rate scales were collected during rest, at baseline, and at the end of the exercise program. Results Flexibility was improved in the exercise group. IgA and lysozyme levels and IgA and lysozyme secretion rates tended to increase or were maintained in the EG, and a trend towards an improvement in the participants HrES was also found but only in the EG. Conclusions The present study shows a positive effect of CBY program in older women, which may lead to an improved well-being and used as a good therapeutic co-adjuvant to usual medication treatment.
Article
We examined the feasibility and differential efficacy of cognitive-behavioral stress management (CBSM) and yoga for first-year college students to reduce stress and improve mental and physical health. Thirty-four incoming first-year female students were assigned to 8 weeks of yoga, CBSM, or a wait-list control. Assessments were made at baseline, end of intervention, and 4 months after intervention end. Both CBSM and yoga produced salutary changes in psychosocial and behavioral health as well as health-related measures of physical function and activity relative to the control group. Stress-management interventions are feasible and highly regarded by first-year women and demonstrate promising effects.
Article
Background and objectives: The YOMI program is a psychoeducational training and physical practice-based program that bridges knowledge from evidence-based psychotherapy with the practice of mindfulness and yin yoga. It consists of 10 content-specific sessions and does not include home assignments. The primary purpose of this randomized controlled trial is to evaluate the effects of the five-week YOMI program on perceived stress, worry and mindfulness in a non-clinical sample. Design and method: In this randomized controlled trial participants were assigned to two groups. Group 1 participated in the five-week intervention twice a week while Group 2 was assigned to a waiting-list condition and participated in the intervention after Group 1. All measures were administered through self-report questionnaires, conducted via a web-based program. Results and conclusions: The results of the study indicated significant effects of the YOMI program on decreasing stress and worry, and increasing mindfulness. Notably these changes were still present at five-week follow up. Consistent with the hypotheses, results suggested that the YOMI program established a group setting where individuals learned to use tools and methods to facilitate better self-directed practice. The study shows moderate to large effect sizes.