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Yoga and Stress - Michaela Pascoe

Supplementary Table 1: TIDiER table describing characteristics of the interventions

Reference

Intervention Control Personnel delivering treatment

Individual/Group

Mode of delivery

Invention Duration/ Frequency

Babbar, 2016

"A predetermined sequence consisting of 23 postures, 1 breathing technique executed for 2min, and an 8-10min final resting pose were performed based on a review of prior studies on prenatal yoga and a collaboration of prenatal yoga instructors. Each pose was held for 3-5 deep breaths. All yoga participants were provided a 12 page color pamphlet consisting of information on yoga poses that were performed in class and could safely be performed at home"

"Subjects randomized to the control intervention participated in a Power-Point presentation derived from and received a copy of the following ACOG pamphlets: exercise during pregnancy, obesity and pregnancy, and nutrition during pregnancy. ACOG-recommended exercises that can be performed during and after pregnancy were also reviewed. All participants remained seated and were provided a bottle of water during the intervention"

I: Yoga instructor (prenatal yoga certified training); C: Yoga instructor

Group and individual

In person and at home

Single 60 min session plus home practice (ns)

Blumenthal, 1991

"The supervised yoga classes provided a control group for the effects of social stimulation and attention from trainers, without producing an aerobic training stimulus"

"During the first 2 weeks, subjects were assigned 6-beat training ranges equivalent to 50% of their maximal heart rate (HR) reserve [(HR max - HR rest) 0.50 + HR rest] during an initial bicycle exercise test. At the start of the third week, the exercise prescription intensity was increased to 60% of maximal heart rate reserve. During the fourth week, training ranges equivalent to 70% of maximal heart rate reserve were

Not specified Group In person

16 wks – I: 60 min/2x wk; C: 60 min/3x wk


assigned. This training range was maintained for the remainder of the training regimen. In addition to the progressive increase in intensity, the duration of cycle ergometry started at 8min at the first session, and increased by 2min each subsequent session. By the fourth week, all subjects were cycling for 30min continuously at an intensity equivalent to 70% of maximal heart rate reserve. The subjects then engaged in brisk walking/jogging and arm ergometry at their prescribed training range for 15min. Each aerobic exercise session began with a 10min warm-up exercise period and concluded with 5min of cool-down exercises"

Bower, 2014

"A typical sequence of postures included in a mid-intervention class and the duration of each posture is as follows: 1) Supta Baddhakonasana 10min, 2) Setubandha Sarvangasana on bolsters 5min, 3) Adhomukha Svanasana 5min, 4) Salamba Sirsasana 5min, 5) Viparita Dandasana 5min, 6) Setubandha Sarvangasana on a wooden bench 5min, 7) Viparita Karani 10min, and 8) Supported Savasana 10min"

"Health Education classes were didactic in nature and consisted of lectures about topics of interest to breast cancer survivors followed by questions and discussion. The topics included 1) cancer-related fatigue; 2) introduction to cancer survivorship; 3) psychosocial issues in cancer survivorship; 4) weight and chronic disease management; 5) cancer genetic predisposition testing and counseling for breast/ovarian cancer syndromes; 6) stress and cancer; 7) diet, nutrition, and cancer survivorship; 8) sleep hygiene; 9) cognitive problems after cancer treatment; 10) osteoporosis and cancer survivorship; 11) body image and sexuality; and 12) finding meaning and achieving goals"

I: Junior Iyengar yoga instructor under guidance of senior teacher; C: Psychologist

Group In person

12 wks –I: 90 min/2x wk; C: 120 min/wk

Bowma "Yoga comprised a warm-up period, "Aerobic training comprised a 10min Not specified Group In 6 wks –


n, 1997 followed by a series of static yoga postures and breathing exercises, ending with a 20min relaxation period that involved subjects relaxing in the horizontal position (Hatha yoga)"

warm-up period followed by 20min cycling at workload to increase the heart rate to 70–80% of maximum heart rate measured during the maximal exercise test. Subjects wore heart rate wrist monitors so that heart rates could be monitored constantly during the training periods, and bicycle resistance levels were adjusted to keep the subject’s heart rate in the desired range. Training ended with a 10min warm down"

person I: 90 min/2x wk;C: 40 min – (frequency ns)

Carlson, 2015

"The intervention consists of three primary components: theoretical material related to relaxation, meditation, and the body-mind connection; experiential practice of meditation during the group meetings and home-based practice; and group process focused on problem solving related to impediments to effective practice, practical day-to-day applications of mindfulness, and supportive interaction between group members."

"The program encourages openness and emotional expression, with an aim toward developing a mutual support system among members as well as improving interactions with family and treating physicians. Through group discussion, it also aims to facilitate coping skills and to detoxify negative emotions surrounding mortality" OR "A 1-day (6-hour) didactic stress management seminar"

I: Clinical psychologist and trained nurse; C1 (SET): Clinical psychologist and trained nurse; C2 (SMS): Social worker

Group In person

I: 8 wks – 90 min/wk, plus 1x6 hr retreat;C1 (SET): 12 wks – 90 min/wk (Both total 18 hr); C2 (SMS): single 6 hr session

Chacko 2016

Mindfulness-based behavioural therapy (MBBT): "The intervention integrated mindfulness with adapted versions of traditional behavioral strategies for obesity (e.g. goal setting, problem-

Weight management counselling: "Participants assigned to the standard intervention received an individualized counseling session. Participants spoke privately to the dietician about their efforts

Intervention: Qualified mindfulness instructor

Group In person

MBBT: 10 wks, 90 min class per week


solving, stimulus control, self-monitoring, social support). The structure of the intervention was adapted from the established Mindfulness-based stress reduction (MBSR) course. We also incorporated elements from Mindfulness-based eating awareness (MB-EAT). We did not include explicit calorie and exercise goals since our target was not intensive weight loss but rather long-term weight maintenance. Sessions began with formal mindfulness practice (sitting meditation, loving-kindness meditation, body scan, mindful chair yoga, walking meditation), followed by group sharing on the week’s experience, and ended with a didactic portion covering a behavioral concept or skill taught from the perspective of mindfulness".

in weight management. The dietician provided guidance on nutrition, exercise and lifestyle strategies tailored to post-surgical patients. This intervention was chosen as a control to mirror the usual nutrition standard-of-care that bariatric patients receive annually post-surgery".

plus home practice plus 4h retreat. Con: 1h session

Cohen, 2011

"In each class, participants were led through a sequence of adjusting the body into timed postures (asanas) and breathing techniques (pranayama) using props. Included specific postures that were easy to adapt for older, obese populations. During the second-half of the program (Weeks 6–12), IY participants also participated in home practice using a 25min DVD"

"The classes were designed to include motivational and behavioral components educating participants about LSM to reduce elevated BP including weight reduction/maintenance, sodium reduction, alcohol restriction and increasing intake of fruits, vegetables and low-fat, calcium-rich foods"

I: Yoga instructor; C: Registered dietician


I: In person and at home ;C: In person and phone.

I: 12 wks – 70 min/2x wk for 6wks then 70 min/wk/6 wks plus home practice 25m; C: 6 wks –


60 min/wk for 4 wks and 30 min/wk/4 wks

Cohen, 2016

"Forrest Yoga 90min class sequence. Breath work: 5–7min. Warm up Poses: 25min. Seated poses – i.e. Side bends, forward bends, twists, and hip and shoulder openers. Abdominals: 2–3min Bridge with or without variations, Dolphin or Turbo Dog with or without variations Inversions and Wall Work. Hot Poses: 40min. Sun salutations, B series with standing poses or standing pose series. Backbends–only incorporated if class focus is on backbends. Apex Poses. Cool/ Warm Down: 5–7min. Warm Down Poses: i.e. abdominals, deep twists. Cool Down Poses: i.e. forward bends, side bends, straddle, splits. Deep relaxation: 5–7 min"

"Small group health education classes and a walking program. Every other week subjects attend a nutritional lecture taught by a study dietitian. On alternate weeks the BPEP subjects attend motivational talks about a variety of topics including weight loss, walking programs, and healthy lifestyle choices or they are given educational DVDs or literature to read on the weeks that they are not attending a BPEP class. In total the BPEP program includes 12 BPEP classes and 12 motivational experiences. Additionally, BPEP subjects are expected to walk" gradually increasing the duration at each session.

I: Yoga instructor; C: Not specified



24 wks – I: 90 min/2x biwk/12 wks, 90 min/2x wk/12 wks plus 90 min home practice;

C: 1x wk (duration ns) plus up to 180 min/10,000 steps 6x wk

Corey, 2014

"Participants were given props for their home practice, encouraged to select a regular time each day for home practice, and to find an environment that would be quiet, warm, safe,

"Sustained stretching with the goal of mobilizing the soft tissues to improve muscle length and range of motion by holding each stretch for 30s and repeating each stretch 3 times. Photographs and

I: Certified yoga instructors; C: Personal trainer or a


In person

52 wks – 90 min/2x wk for 12 wks


comfortable and dark. They were instructed to find a comfortable position: stay warm by covering with a blanket, enhance relaxation by covering the eyes, release the muscles throughout the body, and to remain in the pose for at least 10-15min. Participants were informed that thoughts and feelings will come and go, which is normal, and to just observe them without judging them. This restorative yoga intervention focused on the effects of physical relaxation and there were no additional instructions for breathing, the repeating of mantras, body scans or other forms of meditation. At the first group class session, all participants received a 30min didactic presentation on healthy lifestyle including nutrition and physical activity information tailored for individuals with the metabolic syndrome"

instructions for performing 27 sitting and standing stretches (as well as recommended combinations) were provided in the manual. The stretches covered most areas of the body including neck and arm stretches, back and leg stretches, and whole body stretching. At the first group class session, all participants received a 30min didactic presentation on healthy lifestyle including nutrition and physical activity information tailored for individuals with the metabolic syndrome"

licensed physical therapist

then 1x wk/12 wks then 1x mo/6 mo plus home practice 30 min/3x wk

Creswell, 2016

"Mindful eating exercise and body scan meditation after gentle stretching. Meditation included sitting, walking meditation and mindful movement (gentle hatha yoga postures) and meditation on various objects of attention, such as breath sensations, body sensations, sounds, moods or emotions, and thoughts and the spaces between thoughts. The instructor modeled and encouraged attitudes of mindfulness. Participants were asked to notice pleasant and unpleasant events

"Imagery exercises focused on visualizing a stream and later a comfortable and safe place. Participants worked in pairs to develop scripts for pleasant, relaxing place imagery, and guided one another in this exercise. Discussions included exercise for stress management, nutrition. Participants engaged in stretches led using counting or joke-telling in order to avoid the development of body awareness and acceptance. Stress and health, hobbies and interests were topics for discussion. Participants used drawing to explore their

Not specified Group In person

3days (full time retreat)


and record their physical sensations, moods or emotions. Discussions included exploration of pleasant and unpleasant events, stress and stress physiology, reacting and responding to stress, life challenges, plans for meeting unemployment and job-seeking stress with mindfulness"

own social circles of support. Imagery exercises included reflecting on the future and where participants imagined themselves being in five years"

Cusumano, 1993

"Hatha Yoga Condition was led first in some warm-up exercises. They then followed the hatha yoga series of postures: Candle, plough, fish, forward bend, cobra, locust, bow, and spinal twist. Each experimenter modeled the identical series of postures while giving the instructions verbally to their respective hatha yoga group"

"Progressive Muscle Relaxation (PMR). Relaxing muscles by deliberately applying tension to certain muscle groups, then stopping the tension, and focusing your attention to noticing how the muscles relax while the tension is flows away"

Study researchers

Group In person

3 wks – 80 min/wk

Ebnezar, 2012

"Integrated yoga therapy and physiotherapy with transcutaneous electrical stimulation and ultrasound. Integrated yoga therapy practice included loosening practices, strengthening practices followed by yoga asanas and relaxation techniques with devotional songs. The daily routine (home practice): safe rhythmic repetitive stretching movements synchronized with breathing. Relaxation techniques: Three types of guided relaxation techniques were interspersed between the physical practices of sukshmavyayamas and asanas. Asanas - We selected asanas in standing and supine position that would relax and strengthen the knee joints.

"Physiotherapy with transcutaneous electrical stimulation and ultrasound. The therapeutic physical exercises (TPE) included loosening and strengthening practices for the hands, elbows, arms and shoulders followed by a brief period of rest and specific knee practices followed by supine rest with light music"

Certified therapists



14 wks 60 min/day for 15 days then home practice 40 min/day


Pranayama, Meditation, Lectures and Counseling: Yogic concepts of health and disease, yama, niyama, bhakti yoga, Jnana yoga and karma yoga were presented in the theory classes"

Field, 2013

"A routine that was specifically designed for women in their second and third trimester of pregnancy. This routine was outlined in a manual and videotaped for DVD demonstrations for the instructor and for the pregnant women. This routine included only basic sitting, kneeling and standing yoga poses as follows: spinal twist, table pose, cat/cow, kneeling balance, kneeling warrior, runner’s stretch, stork pose, tree pose, eagle pose, warrior 1, warrior 2, reverse warrior, side-angle pose, triangle pose, sitting angular pose, cow’s head pose, butterflies and prayer position"

"The social support group: These were leaderless group sessions that featured free-flowing verbal interactions between the pregnant women which were not monitored but were recorded (staff member attended but was silent and did not control the conversations"

I: Yoga instructor; C: None

Group In person

12 wks – 20 min/wk

Goldberg, 2014

"MBSR taught to participants in the usual manner with some differences: subjects entered the intervention with the purpose of smoking cessation; a quit date was provided, addiction questionnaires and carbon monoxide testing was performed, and course instructions focused on how one might apply mindfulness to craving and withdrawal symptoms. Subjects were encouraged not to focus on smoking cessation as a "goal" for the intervention, instead to direct their intention toward developing a mindful

"Based on the American Lung Association Clinics The basic American Lung Association clinic format. The first session provided an in-depth discussion of the general health effects of smoking. The second session introduced coping strategies for urges to smoke. Quit Day occurred at this third session. At a fourth session benefits of quitting were reiterated and possible withdrawal symptoms discussed. The remaining sessions focused upon maintenance. Discussion included relaxation techniques, exercise or physical fitness programs, avoiding weight gain,

I: MBSR instructor. C: not specified

Group In person

8 wks - 1xwk (duration ns) PLUS (I only) home practice 45 min/6x wk


orientation toward their lives" and coping with tension. Session 7 was a celebration and awards were given to everyone who completed the program"

Gothe, 2016

"The hatha yoga intervention was designed as a beginner but progressive program Postures, breathing and meditative exercises were introduced. Yoga practice was done barefoot and participants used yoga mats, yoga blocks and belts during the sessions. Some of the yoga exercises practiced by the participants included: warrior pose, easy lotus pose, sun salutations, deep breathing exercises such as alternate nostril breathing, and meditative exercises focusing on thoughts, breath and mantra repetitions."

"Each class consisted of a warm up and a cool down and the participants completed 10–12 repetitions of 8–10 different exercises. The exercises were progressive over the course of 8-weeks and resistance bands, blocks and chairs were used to perform the exercises which included bicep curls, tricep extensions, flutter kicks seated in the chair etc. These exercises targeted all major muscle groups"

I: Certified yoga instructors; C: Certified fitness trainers

Group In person

8 wks – 60 min/3x wk

Granath, 2006

"Sessions 1–3 had their origin in a yoga program designed for back treatment. In sessions 4–6 a program involving basic movements, normally used as an introduction to Kundalini yoga, was implemented. Sessions 7–9 were aimed at balancing body, energy and mind. The final session involved exercises that can be used daily to alleviate tension in the shoulders, neck and head, or when some extra energy is needed. At each session, participants were given a compendium that contained a theoretical account of a specific theme, and advice, suggestions and yoga exercises relevant to that theme. Each session included a 15min discussion of different topics, such as life behaviours,

"The cognitive behaviour therapy program consists of a modified version of a treatment used for coronary heart disease. Each session in the cognitive behaviour therapy program was divided into 5 sections: relaxation, discussion on home assignments, psycho-education, management techniques, and introduction of new home assignments. For relaxation, the principles of ‘‘applied relaxation’’ were used. The homework assignments followed the same basic structure, including 4 parts: registration tasks (e.g. stress behaviour, anger and irritation, problems, etc.), daily drills (training new management techniques, such as listening without interrupting, eating slowly, etc.), case studies, and relaxation training. The

I: Yoga instructor; C: Instructors (not specified)


In person

I: 11 wks –10x (duration ns);C:16wks – 10x (duration ns) plus home work


restoration, reflection, self-respect, physical exercise and food/eating habits. The yoga participants also received home assignments, which involved physical exercises and reading through the compendium in question. Various themes were presented, including personal goals, breathing, body postures, meditation and mantra knowledge and intuition"

psycho-education section consisted in the presentation of stress-related topics, such as the psychophysiology of stress, theoretical stress models, time urgency, irritation and anger. The management methods employed concerned problem-solving, assertiveness training, goal setting, time management, cognitive and behavioural restructuring and relapse prevention. Each session was followed by a meeting in which group leaders evaluated the content of the session"

Grossman 2016

MBSR: "Each session covered specific exercises and topics within the context of mindfulness practice and training. These included various types of formal mindfulness practice, mindful awareness of dynamic yoga postures, and mindfulness during stressful situations, and social interactions. The all-day retreat included a combination of previously used and newly introduced mindfulness exercises. Pre- and postintervention personal interviews were conducted to help patients formulate realistic individual goals for the intervention. Postintervention interviews addressed participants’ personal experiences during the course and assessed the degree to which pretreatment goals had been met".

Relaxation and physical therapy: "The active control intervention was planned to control for the nonspecific aspects of the MBSR curriculum. Equivalent amounts of social support and weekly topical educational discussions were provided. Use Progressive Muscle Relaxation training (PMR), and fibromyalgia-specific gentle stretching exercises served as counterparts for mindfulness and yoga elements of the MBSR curriculum. Patients received compact discs with instructions for daily exercises. Pre- and postintervention interviews were given by individual instructors using the same protocol as with the MBSR group".

MBSR: certified counsellor with MBSR training with experience in teaching fibromyalgia patients. Con: psychologists

Group In person

MBSR: 8 wks, 2.5hr session per week plus 1x7.5hr session per week plus daily home practice 45-60 min. Con: 2.5hr session per week plus


daily home practice 45-60 min.

Hagins, 2013

"The class consisted of 1) an opening ritual (centering, conscious breathing); 2) 30min asana practice (standing, seated, backbends/inversions) with each pose held for a 5 count, or occasionally taught as a “vinyasa flow” linking all the poses together for one breath; 3) brief seated meditation; 4) closing ritual of guided relaxation in Savasana (body scan). Homework on a specific aspect of the practice was encouraged each week. All classes integrated the 8 limbs of yoga but in an indirect and varied manner (no required memorization of Sanskrit terms)"

"The PE class used common games such as soccer and volleyball as well as an indoor walking program to encourage moderate levels of physical activity and to provide an opportunity for social interaction among students. Approximately 75% of the total time was spent in physical activity of games or walking, while approximately 25% was spent being physically inactive during attendance and instruction on rules of the various games or related instruction"


Group In person


Hagins, 2014

"Meditation 5-7min: assumed a seated position on the floor or a chair and closed their eyes and began meditating. Class began with a led meditation focusing on the body and breath in month 1, the nervous system in month 2, and the mind in month 3. Physical postures (Asana) 35min. Regulated breathing 10min. Relaxation 5min"

"The active control exercise class was nonaerobic and consisted of a warm-up for 5-7min, exercises 30-35min (e.g., “step-touch,” squats, upper extremity resistive band work, abdominal strengthening), and stretching/cool down 13-20min"

I: Yoga instructor; C: Fitness instructor


In person

12 wks – 55 min plus home practice (frequency ns)

Harinath, 2004

Yogic asanas 45min, pranayama 15min/morning, preparatory yogic postures15min, pranayama 15min, and meditation 30min/evening. Posture of each asana was maintained for 2min, shavasana practiced for 2min after

"Routine army physical training exercise daily. These exercises consisted of body flexibility exercises for 40min and slow running for 20min during morning hours and games for 1hr in the evening"


Group In person

12 wks – 1 hr/2x day


completing four asanas. During morning hours subjects practiced Bhastrika/Bhrahmari pranayama. In the evening they performed Sheetali, Sheetkari, Bhrahmari, and Nadi Shodhan pranayama. The ratio of inhalation, retention, and exhalation of breath in Nadi Shodhan pranayam was 1:2:2. The pranayama and meditation were performed in padmasan (sitting) posture. During meditation the subjects were asked to concentrate on the Agya Chakra presumably located near the prefrontal area and then on Sahasrar Chakra near the location of pineal gland for each breath of expiration while they chanted “OM” in a soft voice"

Hayney, 2014

"MM including body scan, a supine meditation, gentle Hatha Yoga practiced with mindful awareness of the body, a sitting meditation with mindfulness of breath, body, feelings, thoughts, emotions, and choice less awareness. A walking Meditation, awareness of pleasant and unpleasant events, breathing, routine activities, interpersonal communications and daily home assignments including a minimum of 45min/day of formal mindfulness practice and 5-15min of informal practice. Individual and group dialogue and inquiry oriented around home assignments, including an exploration of hindrances to mindfulness and development”

"Borg’s Rating of Perceived Exertion was used to guide participants toward moderate intensity, sustained exercise, with a target rating of 12 to 16 points on the 6-20 point scale"

I: Individual trained in program; C: Senior exercise physiology staff

Group In person

8 wks – 2.5 hr/wk plus home practice 45min/day


Hughes, 2013

"MBSR included instruction and practice in mindfulness meditation skills along with discussion of stress, coping, and homework assignments. The MBSR therapist participated in the mindfulness exercises with group members during the weekly sessions. Group members were taught three main varieties of mindfulness skills: the body scan exercise, sitting meditation, and yoga exercises. The body scan exercise entails lying down with one’s eyes closed and deliberately focusing one’s attention on various parts of the body, with the goal of noticing nuances of sensations going on within the body. In sitting meditation, participants sit in a relaxed and wakeful posture with eyes closed and deliberately bring their attention to the sensations of breathing. Finally, group members learned a series of physically non strenuous yoga exercises designed to bring mindful attention to bodily sensations during gentle movements and stretching. The daily homework exercises consisted of repeating body scan work, sitting meditation, and yoga exercises at home to provide practice and generalization of the skills. Group members were provided audiotapes or CDs with guided MBSR exercises to assist their homework. In addition, group members were encouraged to bring mindful attention to daily activities such as

"PMR patients received instruction and practice in PMR skills, which involved learning to achieve a state of relaxation by alternately tensing and relaxing various muscle groups, along with homework assignments. The PMR therapist participated in the exercises with group members during the weekly sessions. Sessions progressed from 16-muscle group relaxation to 7 muscle groups, 4 muscle groups, and finally relaxation by recall. Relaxation by recall was intended to allow participants learning PMR to apply relaxation skills during their daily lives, and there was an explicit instruction on generalizing the relaxation response to stressful situations. Group members were instructed to practice these exercises outside group meetings. They were provided with audio recordings of to assist their home PMR exercises"

I: MBSR therapist; C: PMR therapist



8wks – 150 min/wk plus home practice of at least 45 min/6x wk


walking, standing, and eating"Innes, 2012

"Participants randomized to the yoga program completed a gentle Iyengar yoga program specifically designed for older, sedentary adults. Participants were asked to complete home practice on non-class days, with the aid of a DVD and a booklet illustrating the yoga home practice routines. The yoga program included the following 23 active and restorative poses (asanas): Mountain; Standing wide apart legs; Warrior I and II; Fierce or chair pose; Extended hands and feet pose; 1/2 forward bend; Triangle; Reverse triangle; Downward facing dog; Marichi’s pose; Seated twist in chair; One leg straight forward spinal stretch; Seated wide angle; Seated bound angle; Extended legs up the wall; Lying down holding big toe; Turned around belly; Supported boat; Supported bridge; Crossed legs back arch; Lying down bound angle; Reclined mountain; and Corpse pose. Poses were modified and props (blankets, chairs, and straps) used as needed to allow participants to perform the sequences easily and safely. Each session began with a simple yogic centering and breathing exercise and ended with a 10–15min guided supine relaxation practice (Savasana)"

"Educational Film (Control) Intervention. Each class began with a brief meet and greet period, followed by viewing of an educational film chosen for its relevance and interest to our study population, then concluded with a 10–15min group discussion. To increase credibility and reduce participant bias, the educational film program was presented to potential participants as an informative, engaging, and relaxing alternative to the yoga classes"

I: Yoga Instructor; C: Health professional

I: Group and individual;C: Group

I: In person and at home ;C: In person

8 wks – I: 90 min/2x wk plus home practice of at least 30 min/5x wk;C: 90 min/2x wk

Jedel, 2014

"The MBSR intervention followed the 8-week curriculum developed by

"The focus of the course was mind/body medicine and was comprised of lectures

I: Physician with MBSR

Group In person

8 wks – I: 2-2.5


Kabat-Zinn [18] and weekly sessions that spanned 2 to 2.5 hours involved instruction and practice in formal “exercises” or “meditations” (i.e., sitting meditation, body scans, and yoga postures) and informal practices (awareness of personal reactions to everyday events) aimed to promote mindfulness in daily life. Homework assignments, intended to reinforce techniques and general strategies, involved 45 min/day of MBSR, 6 days/wk, guided by compact disc. A physician (AH) with more than 15 years of MBSR expertise taught the course, except for 2 classes when a psychologist experienced in MBSR substituted"

and videos. Course topics included the effect of stress on physical and psychological health, the physiology of the ‘flight-or-fight response’, the effect of stress on sleep, and stress and special populations. Homework comprised of articles that supplemented the course content".

expertise; C: Clinical psychologist

hr/1x wk plus home practice 45 min/6x wk;C: 1x wk plus home work (duration ns)

Jones, 2016

"In each class, women practiced breathing exercises, 11–13 poses, and Yoga Nidra, a deep relaxation practice. Women joined the class as they were recruited. For home practice, participants received written instructions, a DVD of the poses, a CD of the Yoga Nidra practice and yoga equipment (mat, blankets, bolster, and strap). Participants weekly turned in diaries, which tracked their home use of poses and Yoga Nidra. The yoga practice was designed to promote relaxation and not necessarily to affect resting breathing rate"

"Trainers tracked heart rate, workload and perceived exertion to help participants maintain appropriate target heart rate during the exercise sessions. Energy expenditure goals were set for each week (ranging from 1000 to 1500 kilocalories per week) based on the results of a baseline graded exercise treadmill test"

I: Yoga instructors; C: Fitness trainers

I: Group and individual;C: Individual


12 wks – I: 90 min/wk plus home practice 20 min/day/6x wk;C: 40-60 min/3x wk

Jung, 2015

"K-MBSR program based on an audio-CD, which facilitated mindful walking,

"Specific topics included diet, exercise, stress management, foot care,

I: Nurse training in

Group In person

8 wks – I: 60-


eating, and breathing and silent sitting meditation. Each week focused on a different subject: Orientation of the program; The characteristic of mindfulness; From acting to being; The power of breathing; Mindfulness breathing; Staying present; Mindfulness hatha yoga; The day of mindfulness; Your own meditation way"

hypoglycemic medications, hypoglycemia symptoms and management strategies, and potential complications. Lectures were the main instructional method used. Subsequent to the completion of each educational program, participants answered closed-ended questions concerning the main theme. Participants also shared their experiences during the educational program" OR "Walking exercise: The walking technique used included holding the head high, looking forward, moving the shoulders naturally, keeping the back straight, swinging the arms freely with a slight bend at the elbow, and walking smoothly by rolling each foot from heel to toe. Participants were monitored via telephonic interviews and asked to maintain exercise diaries. They shared their experiences of during each weekly meeting"

K-MBSR; C: Not specified

120 min/wk plus home practice;C: 1x wk (meeting) 1x wk (telephone interview) plus home practice 30-60 min/3-4x wk

Kanaya, 2014

"Participants received a structured 30min didactic presentation on healthy lifestyle including nutrition and physical activity information with printed materials at their first group class session. The restorative yoga intervention poses consisted of five main resting poses with several modifications to each pose. These included forward and backward bending, twisting, inverted and reclining positions, and most poses were held for 10–15min at a time with eyes covered with a towel or an eye

"Participants received a structured 30min didactic presentation on healthy lifestyle including nutrition and physical activity information with printed materials at their first group class session. The stretching intervention consisted of 27 seated or standing stretches that involved all parts of the body. Stretching was designed to promote flexibility, range of motion, and postural alignment without strong exertion or relaxation. The yoga poses and stretches were photographed and recorded on DVD for the participants to use for their home intervention"

I: Yoga instructor; C: Physical instructor



12 wks – 2x wk for 12 wks then 1x wk for 12 wks then 1x mo/24 wks plus home practice of at least 30


pillow. The yoga poses and stretches were photographed and recorded on DVD for the participants to use for their home intervention"

min/3x wk (duration ns)

Long Parma, 2015

"Hatha yoga exercise program. The program took into account potential limitations of limb movement, higher body fatness, and the lower aerobic and strength conditioning characteristic of post-treatment breast cancer survivors. Modifications were developed for each posture to accommodate the limitations that might be encountered within this population. Participants were neither encouraged nor discouraged from seeking other forms of exercise but were highly encouraged to attend the yoga classes offered. In addition, an audio CD and an instruction booklet for the specific protocol were provided to the participants for use at home when class attendance was not feasible"

"Comprehensive Exercise group. Individualized exercise programs were prescribed by an ACSM certified Clinical Exercise Specialist. The program components were based on the participants’ individual baseline fitness results and included components of aerobic, resistance and flexibility training" OR "Participant exercise of their own choosing, though they were encouraged to attend Deriving Inspiration and Vitality through Activity program (DIVA) activity classes"

I: Yoga instructor; C: Fitness instructor



26 wks – I: 60 min/3x wk plus at home practice;C1 & C2: 60 min/3x wk

Nidhi, 2012

"The concepts were taken from traditional yoga texts (Patanjali yoga sutras, Upanishads, and Yoga Vasishtha) that place emphasis on a holistic approach to health management at the physical, mental, emotional, and intellectual levels. The practices consisted of asanas (yoga postures), pranayama, relaxation techniques, and meditation, along with lectures on yogic lifestyle and yogic counseling for stress management. All adolescents received individualized counseling aiming at

"Exercises consisted of a set of physical movements and safe non yogic breathing followed by supine rest (without instructions). The adolescents also received 1 counseling session"

Yoga Instructor

Group In person

12 wks – I: 60 min/7x wk plus at least 1 counseling session;C: 60 min/7x wk plus


cognitive restructuring based on yoga philosophy"

1 counseling session

Palta, 2012

"The sessions consisted of an opening meditation, sharing of successes, a review of home practices, a lesson to practice and apply mindfulness skills to self-care and interpersonal relationships, a guided breath meditation, a closing meditation, an invitation to do specific home practices, and a healthy fruit-and-vegetable snack"

"To initiate communication among participants, the research assistants provided pre-planned conversation starters that mirrored the topics in the intervention group. Following the session, participants were offered a fruit-and vegetable snack identical to the foods served to the intervention group"

I: Interventionist trained in MBSR; C: Research assistant

Group In person

8 wks – 90 min/wk

Patil, 2015

"The yoga training includes loosening practices; asanas (maintaining postures), pranayama (breathing exercises) and cyclic meditation yoga based guided relaxation technique. Yoga practice (asanas, pranayama & meditation) was taught for the first 2 weeks and the complete module was practiced thereafter. Loosening practices and asanas were practiced for 15–20min while pranayama and relaxation technique/meditation for 40–45min. Emphasis was placed on practicing all the components of yoga in a relaxed way with slow and paced breathing"

"Brisk Walking consists of flexibility or stretching practices for 20min followed by brisk-walk for 35min and rest for 5min"

Authorized instructors

Group In person


Raghavendra, 2009

"Asanas (postures done with awareness), breathing exercises, pranayama (voluntarily regulated nostril breathing), meditation, and yogic relaxation techniques with imagery

"Supportive therapy with education to control for factors such as attention, support, and a sense of control. The goals of supportive therapy were education, reinforcing social support, and coping

I: Yoga instructor; C: Social worker

Individual

In person

6 wks – I: 60 min/3-4x wk (18-24


(mind sound resonance technique and cyclic meditation). Goals of the program were to develop a sense of calmness and relaxation with a perceptible change in coping with day-to-day stressful life experiences"

preparation" sessions) plus home practice 3-4x wk;C: 15 min/1x/10 days (3-4 sessions)

Rao, 2008

"Integrated yoga program. The yoga intervention consisted of a set of breathing exercises, pranayama (voluntarily regulated nostril breathing) and yogic relaxation techniques. These practices were based on the principles of attention diversion and relaxation to cope with day-to-day stressful experiences. These sessions were administered by an instructor at the subjects’ bedside prior to surgery and during their postoperative recuperation in the hospital. Following their discharge, subjects were asked to practice at home for the next four weeks. Subjects were also provided audiotapes of an instructors’ voice to help them practice at home so that a familiar voice could be heard on the cassette"

"Supportive counseling sessions included two important components: 1) education and reinforcing social support and 2) shoulder exercise for postoperative rehabilitation"

I: Yoga instructor; C: Physiotherapist

Individual


4 wks – I: 4x plus at home practice;C: 4x plus 60 min session plus at home practice (duration and frequency ns)

Ray, 2001

"The yoga group underwent training in selected Hatha yogic exercises. The schedule consisted of hatha yogic

"The PT group performed regular exercises according to the physical training program (PT) in the army. The PT schedule

Qualified instructor

Group In person

26 wks – I: 60


asanas and meditation" consisted of slow running up to 4km/30min, body flexibility exercises 10min, pull ups 5min, and games 15min"

min/6x wk;C: 60 min/7x wk

Ruby, 2016

Protein Stretching/Yoga Training. standardized meal plans (50% carbohydrate, 25% protein, and 25% fat)4-6 meals/day and stretching/yoga training. Traditional yoga “asanas,” or poses, with the modern elements of Pilates training emphasizing stretching, flexibility, and strengthening were used. Routines included balance, stamina, strengthening and toning poses including basic sun salutations, core strengthening, stretching, and a final relaxation phase. Participants were provided a training journal containing pictures and descriptions, as well as DVD’s containing all the poses to assist them in completing the routines with proper form and technique. The level of intensity ranged from 7-9 on the intensity scale at each session"

"Standardized meal plans (50% carbohydrate, 25% protein, and 25% fat) of 20-25g per serving consumed 4-6 times per day; 1 within an hour of waking in the morning and the other 2.5-3 hours apart during the day" OR "standardized meal plans and resistance exercise. Each exercise was performed at a resistance to induce muscular fatigue in 10-15 reps or for 30-60s. A 60s recovery was allowed between exercises. Each exercise session was completed within 60min and was preceded and followed by a 5-7min dynamic warm-up and a stretching cool-down, respectively. The level of intensity or resistance was maintained within a range of 7-9 on the intensity level scale"

Yoga instructor


In person


Saptharishi, 2009

"Yoga (unspecified). This group was taught yoga by a qualified yoga teacher of the institute. They were encouraged to practice yoga. This included relaxation techniques like pranayama (breathing exercises); and asanas like savasana, ardha matsyendrasana, naadishudhi asana, single leg, and double leg raise"

"Participants of physical exercise group were motivated to undergo physical exercise in the form of brisk walking. As a way of encouraging them, the investigator accompanied them on several occasions" OR "salt reduction: The participants were given practical suggestions on reducing their salt intake. Participants asked to use separate salt packets and their food was cooked separate from that of other family

I: Yoga teacher; C: Investigator


In person

8wks – I: 30-45 min/5x wk;C: 50-60 min/4x wk


members. The ‘questionnaire method’ was used for assessing compliance. Fortnightly random quantification of salt intake was done using the feedback from participants.

Sawane, 2015

"Iyengar yoga techniques were followed by the yoga trainers. Different yoga asanas (yogic postures) were practiced for 40min and pranayamic breathing exercises were practiced for 20min. The subjects practiced shavāsana for 10min (lying still and relaxed with slow deep breathing). The yoga group subjects were instructed not to practice any yogic technique other than the prescribed ones"

"Swimming comprised freestyle in first 6 weeks (including training in first 2–3 weeks) and freestyle and breast stroke in last 6 weeks including 10min of floating on the water. For novice swimmers, continuous swimming for 60min is difficult; therefore, intermittent floating with deep slow breathing (total 10min) was introduced. Swimmer group was advised to refrain from other physical exercises during the study"

Not specified Not specified

Not specified

12 wks – I: 60 min/6x wk;C: 60 min/7x wk

Sieverdes, 2014

"Hatha yoga session included roll call and session preparation instructions, approximately 15min. Introduction, attunement, and pranayamas (breathing exercises), approximately 5–7min. Warm-up, approximately 5–7min: moving the joints and major muscle groups before performing asanas sequences. Asanas sequences, approximately 50–60min: postural exercise sessions. Relaxation followed by discussion 5–7min. General concepts were introduced and practiced early in the intervention, with progressively more poses and variations of instruction incorporated throughout the 12-week period. Worksheets illustrating the postures were given to each student. During the class, discussion included ways to use yogic

"The active control group attended and participated in music and art classes that were led by a teacher and were part of the regular school curriculum"

I: Yoga instructor; C: Teacher

I: Group and individual;C: Group


12 wks – 90 min/2-3x wk


techniques outside of class and at home by applying what they learned in different environments"

Telles, 1998

"Individuals with normal vision learn yoga by observing a demonstration while listening to instructions. Persons with visual impairment received detailed verbal instructions to compensate. In addition, the instructor spent time with each subject correcting their practice (e.g., repositioning their limbs) with verbal instructions. Subjects received special emphasis on relaxing between practices and being aware of body sensations. Practices included simple yoga postures and yoga breathing exercises (50min), followed by guided relaxation (10min). Throughout the practices, the emphasis was on awareness (of physical and other sensations) and relaxation"

"The physical activity group spent time in the garden doing a comparable amount of physical activity as the yoga group, such as bending forward and stretching upward"

Yoga instructor

Group In person


Thiyagarajan, 2015

"Yoga therapy class consisted of Yogic counseling Preparatory practices, Breath–body coordination practices and joint loosening practices 10min; Asanas, 14min, Pranayamas or breathing techniques: 7min, Relaxation techniques, 14min. Subjects were motivated to do the same at home in the remaining days of the week"

"Standard lifestyle modification (LSM) intervention. Reduce dietary salt intake (6g per day) and alcohol consumption, increase fruit and vegetable content in diet as per DASH (dietary approach to stop hypertension) criteria, perform aerobic physical activity and reduce or maintain body weight (maintain between BMI of 18.5–24.9 kg/m2)"




12 wks – I: 45 min/3x wk plus home practice;C: 30 min/most days plus diet

Yang, 2011

"This Vinyasa style yoga program included various physical postures (Asanas) such as sun-salutations,

"Participants in the control group received general health-education materials mailed to their home, including content pertaining

I: Yoga instructor; C: Written

I: Group and individu

I: In person and at

12 wks – I: 60


standing poses, seated/kneeling poses and counter poses. Each movement was combined with various breathing patterns of inhalation and exhalation (Pranayamas). All postures were modified to meet the participants’ needs and to assure safety. For example, tree pose, a one-leg balance pose, was performed using a chair or wall for support when a participant had difficulty with balance. Each 1-h session of the yoga program began with a warm-up (5–7min) and ended with a relaxation period (10min). To facilitate and guide home practice, participants were given an audio recording (CD) of the yoga instructions recorded by the yoga instructor"

to risk factors associated with type-2 diabetes and the prevention of diabetes that included tips for healthy eating out, cardiovascular risk factors (hypertension and high cholesterol), consuming a balanced diet and engaging in physical activity. During the 3mth measurement, we discussed health-education content and responded to their questions and interpreted this to be a confirmation that they had reviewed the materials"

materials al;C: Individual

home; C: At home.

min/2x wk plus home practice (duration and frequency ns);C: 1x2 wks (mail).

Ziv, 2013

"Relaxation and stress management. CALM-BP group attended relaxation and stress management intervention that included a weekly 1h relaxation session of yoga and qigong movements, breathing and meditation and a weekly group support counselling meeting that focused on stress management. A 10-min qigong guided imagery audio CD was distributed for daily use. A 45-min group walk to achieve 60–75% of the maximal recommended heart rate according to age, and were asked to walk at home similarly at least three additional times a week. The CALM-BP group dietary plan was based on naturopathic whole grain rice. The rice

"Physical exercise. Attended a 45-min group walk to achieve 60–75% of the maximal recommended heart rate according to age, and were asked to walk at home similarly at least three additional times a week. A weekly lecture focused on conscious grocery shopping and healthful home cooking. Instructions were based on the new DASH eating plan. Weekly sessions included a communal meal prepared by participants according to the group eating plan. A list of specific food dishes for each participant was allocated in advance for each session"

I: Qualified trainer; C: Qualified trainer and nutritionist



16 wks –I: 60 min/wk plus home practice 10 min/day;I & C: 45 min/wk, lecture and meal 1x wk


based diet was initiated with a lower percentages of protein, lower percentages of fat and higher potassium. Weekly sessions included a communal meal prepared by participants according to the group eating plan. A list of specific food dishes for each participant was allocated in advance for each session"

(duration ns) plus home practice 45 min/3x wk

ACOG = American congress of obstetricians and gynecologists; ACSM = American college of sports medicine; BP = blood pressure; BPEP =

blood pressure education program; CALM-BP = comprehensive approach to lowering measured blood pressure; DASH = dietary approach to stop

hypertension; HR = heart rate; IY = Iyengar yoga; K-MBSR = Korean mindfulness-based stress reduction program; LSM = lifestyle

modifications; MBSR = mindfulness-based stress reduction program; MM = mindfulness meditation; ns = not specified; PE = physical education;

PMR = progressive muscle relaxation; SET = supportive-expressive group therapy; SMS = stress management seminar

ars.els-cdn.com · web viewassigned. this training range was maintained for the remainder of the...

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