How yoga interventions are operationalized and reported in the context of mental health and wellbeing RCTs: a systematic review and qualitative synthesis.
Mary C Frazier, Masha Remskar, Samantha M Harden, Karsen S Barley, Danielle E David, Marina Z Guillen, Daryn E Olsen, Kayla M Markley, Megan J Pullin, Jacinta Brinsley
BMC complementary medicine and therapies December 22, 2025 Peer reviewed DOI: 10.1186/s12906-025-05162-9 via PubMed
Summary
Yoga is commonly defined as a mind-body or mind-body-spirit practice that includes physical postures, meditation, and breathwork. A systematic review of 5206 studies identified 129 relevant randomized controlled trials that focused on yoga's impact on mental health and wellbeing. The review highlights inconsistencies in how yoga is described in research, which complicates its evaluation and implementation. The findings aim to enhance the clarity and effectiveness of yoga interventions in mental health contexts.
Study at a glance
| Design | systematic review |
|---|---|
| Sample size | 129 |
| Population | randomized controlled trials involving yoga as the primary intervention for mental health and wellbeing |
| Key finding | Yoga is operationalized as a mind-body or mind-body-spirit practice comprising mental, physical, and breathing components. |
Abstract
BACKGROUND: Yoga is a popular intervention demonstrating promising impacts for mental health and wellbeing. Despite growing research interest, yoga remains poorly operationalized and inconsistently described in scientific literature, hindering dissemination, rigorous evaluation, and replication. This systematic review aims to address this critical knowledge gap by examining how yoga is operationalized in recent mental health and wellbeing research. METHODS: We conducted a systematic review of literature from January 2013 to August 2024. Terms relating to yoga, mental health, wellbeing, and interventions were used to search MEDLINE, CINAHL, Embase, Emcare, PsycINFO, and Scopus. Randomized controlled trials that included yoga as the primary intervention and reported a validated measure of mental ill-health, mental wellbeing, or quality of life, were included. Inductive qualitative analyses of yoga definitions and descriptions were conducted. RESULTS: Of 5206 studies identified, 129 were included with exclusion primarily due to study design. Qualitative analysis resulted in a total of 1291 meaning units (MU). Yoga definitions suggest that yoga is operationalized as a practice, complementary and alternative medicine, or system (e.g., encompassing philosophy and practices) with mind-body or mind-body-spirit aspects. Components of yoga included physical such as postures, mental such as meditation, and breath. CONCLUSIONS: This is the first systematic review to comprehensively analyze how yoga is operationalised and reported in recent experimental mental health and wellbeing research. Generally, yoga is operationalized as a mind-body or mind-body-spirit practice comprising mental, physical, and breathing components. We provide recommendations to improve the translation and implementation of yoga interventions. TRIAL REGISTRATION: This study was prospectively registered with PROSPERO (CRD42023455373). Clinical trial number: not applicable.