How yoga interventions are operationalized and reported in the context of mental health and wellbeing RCTs: a systematic review and qualitative synthesis.

Yoga is a popular intervention for mental health and wellbeing, but how it is defined and described in research varies widely, hindering replication and practical use. This systematic review analyzed 129 randomized controlled trials from 2013 to 2024 and found that yoga is most often operationalized as a mind-body or mind-body-spirit practice that includes physical postures, meditation, and breathing exercises. Some studies also frame yoga as a complementary and alternative medicine or as a broader system encompassing philosophy and practices. The review provides recommendations to improve how yoga interventions are reported, aiming to support clearer translation and implementation in mental health settings.

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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.