The Safety of Yoga: A Meta-analysis of RCTs
The Safety of Yoga: A Meta-analysis of RCTs
As yoga has gained popularity as a therapeutic intervention, its safety has been questioned in the lay press. Thus, this review aimed to systematically assess and meta-analyze the frequency of adverse events in randomized controlled trials of yoga. MEDLINE/PubMed, Scopus, the Cochrane Library, and IndMED were screened through February 2014. Of 301 identified randomized controlled trials of yoga, 94 (1975–2014; total of 8,430 participants) reported on adverse events. Life-threatening, disabling adverse events or those requiring intensive treatment were defined as serious and all other events as nonserious. No differences in the frequency of intervention-related, nonserious, or serious adverse events and of dropouts due to adverse events were found when comparing yoga with usual care or exercise. Compared with psychological or educational interventions (e.g., health education), more intervention-related adverse events (odds ratio = 4.21, 95% confidence interval: 1.01, 17.67; P = 0.05) and more nonserious adverse events (odds ratio = 7.30, 95% confidence interval: 1.91, 27.92; P < 0.01) occurred in the yoga group; serious adverse events and dropouts due to adverse events were comparable between groups. Findings from this review indicate that yoga appears as safe as usual care and exercise. The adequate reporting of safety data in future randomized trials of yoga is crucial to conclusively judge its safety.
Rooted in Indian philosophy, yoga has been a part of traditional Indian spiritual, philosophical, and psychological practice for millennia. The original goal of yoga was uniting mind, body, and spirit through ethical, spiritual, and physical practices. Nowadays, it is regarded mainly as a means to promote physical and mental well-being through physical postures (asanas), breathing techniques (pranayama), and meditation (dyana). These more physically oriented yoga forms are gaining increased popularity as a therapeutic practice. In 2008, about 7% of the American adult population reported practicing yoga. About half of those started practicing explicitly to improve their health status, resulting in more than 13 million people practicing yoga for health reasons.
Although yoga has long been promoted as without harm, this view has been challenged in recent years in a number of lay-press articles. In particular, a book and articles by New York Times correspondent William J. Broad reported a number of alarming cases of yoga-associated injuries and deaths. As these publications seem to have led to a general uncertainty as to the safety of yoga among yoga practitioners and those interested in starting practice, it is important to systematically assess the safety of yoga. While 2 systematic reviews have focused on assessing yoga-associated adverse events, none of them included all randomized controlled trials on yoga available to date, and none included a meta-analysis.
Therefore, this review aimed to systematically assess and meta-analyze the frequency of adverse events in yoga randomized controlled trials.
Abstract and Introduction
Abstract
As yoga has gained popularity as a therapeutic intervention, its safety has been questioned in the lay press. Thus, this review aimed to systematically assess and meta-analyze the frequency of adverse events in randomized controlled trials of yoga. MEDLINE/PubMed, Scopus, the Cochrane Library, and IndMED were screened through February 2014. Of 301 identified randomized controlled trials of yoga, 94 (1975–2014; total of 8,430 participants) reported on adverse events. Life-threatening, disabling adverse events or those requiring intensive treatment were defined as serious and all other events as nonserious. No differences in the frequency of intervention-related, nonserious, or serious adverse events and of dropouts due to adverse events were found when comparing yoga with usual care or exercise. Compared with psychological or educational interventions (e.g., health education), more intervention-related adverse events (odds ratio = 4.21, 95% confidence interval: 1.01, 17.67; P = 0.05) and more nonserious adverse events (odds ratio = 7.30, 95% confidence interval: 1.91, 27.92; P < 0.01) occurred in the yoga group; serious adverse events and dropouts due to adverse events were comparable between groups. Findings from this review indicate that yoga appears as safe as usual care and exercise. The adequate reporting of safety data in future randomized trials of yoga is crucial to conclusively judge its safety.
Introduction
Rooted in Indian philosophy, yoga has been a part of traditional Indian spiritual, philosophical, and psychological practice for millennia. The original goal of yoga was uniting mind, body, and spirit through ethical, spiritual, and physical practices. Nowadays, it is regarded mainly as a means to promote physical and mental well-being through physical postures (asanas), breathing techniques (pranayama), and meditation (dyana). These more physically oriented yoga forms are gaining increased popularity as a therapeutic practice. In 2008, about 7% of the American adult population reported practicing yoga. About half of those started practicing explicitly to improve their health status, resulting in more than 13 million people practicing yoga for health reasons.
Although yoga has long been promoted as without harm, this view has been challenged in recent years in a number of lay-press articles. In particular, a book and articles by New York Times correspondent William J. Broad reported a number of alarming cases of yoga-associated injuries and deaths. As these publications seem to have led to a general uncertainty as to the safety of yoga among yoga practitioners and those interested in starting practice, it is important to systematically assess the safety of yoga. While 2 systematic reviews have focused on assessing yoga-associated adverse events, none of them included all randomized controlled trials on yoga available to date, and none included a meta-analysis.
Therefore, this review aimed to systematically assess and meta-analyze the frequency of adverse events in yoga randomized controlled trials.
