Table 1 Characteristics of the included reviews
From: Management of post-traumatic stress disorder symptoms by yoga: an overview
Review | Study design | N of primary studies (N of yoga studies) | N Sexe ratio (% women) Age | Population (N RCTs) | Yoga interventions (N RCTs) | Â | Duration Frequency N of sessions Time of session | PTSD outcomes (N) Others (N) | Control group | Specific results of yoga |
|---|---|---|---|---|---|---|---|---|---|---|
Other interventions (N RCTs) | Mains results and conclusions | |||||||||
Bisson et al 2020 UK[23] | SR + MA | 30 (5) | 1828 [15–191] n.r n.r | Veterans (7) Military (7) Civilians with PTSD (14) Children a (2) | TiY (1) KrY (2) SKY (2) |  | n.r | n.r | WLC/TAU (4) TAU (1) | Low QOE for yoga benefits on PTSD symptoms |
| Â | Â | Â | Â | Â | MBSR (5) MR (3) TMS (3) Acupuncture (2) Neurofeedback (2) Saikokeishikankyoto (1) Somatic experiencing (1) Other (8) | Â | n.r | n.r | WLC/TAU (10) WLC (4) PCT (4) Sham TMS (3) WLC/CBT-TF (2) Paroxetine (1) Psychoeducation (1) | Emerging evidence for 6 non- pharmacological and non-psychological interventions for the treatment of PTSD in adults (yoga, acupuncture, neurofeedback, somatic experiencing, saikokeishikankyoto and TMS) All interventions excepted yoga have low QOE |
Björkman et al 2021 Sweden [24] | SR + MA | 10 (5) | 605 [38–338] 57% Mean ageb: 45.5 yo | Veterans (2) Veterans and active-duty personnel (1) Veterans and civilians’ women (1) Civilians with PTSD (4) | Online hatha yoga (1) KY (1) TSY with KrY (1) KrY (1) TIY (1) |  | 8—12 weeks Weekly – 2/week 10—20 sessions 1—1.5 h | PCL (2) CAPS (2) ies (1) Depression, anxiety, sleep behavior, dissociative symptoms | WLC / TAU (1) WLC (1) Attention placebo + TAU (1) Attention placebo (1) Assessment only control (1) | No significant differences between low- or high-intensity activities (yoga versus other exercises) |
|  |  |  |  |  | Aerobic and resistance training (1) Aerobic and anaerobic (2) Resistance training (2) |  | 3—20 weeks Weekly—3/week 9—26 sessions 30 min—1 h | PCL (2) CAPS (1) HTQ (1) PDS (1) Depression, anxiety, QOL, sleep behaviour, substance abuse | TAU (2) WLC (1) WLC / TAU (1) Attention placebo (1) | Positive significant effect of exercise on PTSD symptom severity compared to non-active treatment; high heterogeneity in the results Significant positive effects of exercise for depression, sleep, reduced substance abuse, and increased QOL. No significant result for anxiety Exercise can be included as a part of PTSD treatment |
Cramer et al. 2018 Germany [25] | SR + MA | 7 (7) | 385 [21–100] 46.2% [28.7–58] yo | Veterans (3) Active military and veterans (1) Civilians with PTSD (3) | SKY (2) KY (1) KRY (2) SatY (1) TIY (1) |  | 7 days – 6 months Monthly – daily 7—32 sessions 1 h – 4.4 h | PCL (7) CAPS (3) TLEQ (1) IES (1) DES (1) DTS (1) Retention Safety | WLC (4) Attention control intervention (2) No treatment (1) | Low QOE in favor of yoga compared to no treatment Very low QOE for no differences of yoga compared to attention control interventions Very low QOE for no difference of retention between yoga and both types of control 1 adverse event |
Gallegos et al. 2017 United states [26] | SR + MA | 19 (4) | 1173 n.r n.r | Veterans (14) Civilians with PTSD (5) | KrY (1) TIY (1) KY (1) MBX (1) |  | 6 – 10 weeks Weekly—2/week 8—16 sessions 1 h – 1.5 h | CAPS (7) PCL (6) PVSDS (1) IES (1) | WLC (2) SWHE (1) ACG (1) | Marginally significant effects of yoga due to low statistical power and heterogeneity in treatments effects |
|  |  |  |  |  | Mindfulness (9): MBSR (8), MBB (1) Other meditationsc (6) including SKY (2) d Combination of mindfulness and meditative practices (1) |  | 5 days – 12 weeks 2/week – Daily 6—22 sessions 20 min—6 h | PCL (3) CAPS (1) | TAU (3) WLC (3) PCGT (3) Individual psychotherapy (1) Prolonged Exposure (1) PTSD education group (1) Sitting quietly (1) Sleep hygiene (1) Telehealth psychoeducation (1) | Overall small to moderate ES in favor of meditation and yoga interventions No differences between intervention types, study population, outcome measures, or control condition Meditation and yoga are promising complementary approaches and can be provided as second-line treatment in PTSD |
Hilton et al. 2017 USA [27] | SR + MA | 10 (3) | 643 [28–146] 32.9% [41,–59] yo | Military (6) Civilians with PTSD (4) | KY (1) KrY (1) TIHY (1) |  | 8 – 12 weeks Monthly – weekly 8—14 sessions 1 h – 1.5 h | PCL (2) CAPS (1) Anxiety Depression Adverse events | WLC + TAU (2) TAU, waitlist, women’s health education (1) | Yoga has significant effects on PTSD symptoms and on depression Metaregression: no systematic differences among intervention types on PTSD outcomes (MR/yoga/MBSR) |
|  |  |  |  |  | MBSR (5) MR (2) |  | 4 – 8 weeks Weekly – 2/week 6—9 sessions 26 min – 2.5 h | CAPS (5) PCL (7) Anxiety Depression QOL Adverse events | TAU (3) WLC + TAU (2) PCGT (1) Psycho-education telehealth (1) | Low QOE for significant decrease in PTSD symptoms of all adjunctive interventions compared to any control No adverse events and no significant results for anxiety |
Kysar-Moon et al 2021 USA [28] | SR + MA | 3 (3) | 152 [38–64] 100% [18–70] yo, mean age 41.7 yo | Veterans and civilian women (1) Civilians with PTSD (2) | TSY (1) TIY (1) Trauma-focused yoga (1) |  | 6—12 weeks Weekly – 2/week 10—12 sessions n.r | CAPS (1) PCL (1) n.r (1) Depression | WLC (1) SWHE (1) ACG (1) | No significant effects on PTSD symptoms No significant effects on depression symptoms |
Rosenbaum et al 2015 Australia [3] | SR + MA | 4 (2) | 200 [17–81] n.r [34–52] yo | Civilian with PTSD (3) Veteran (1) | KrY (1) TIY (1) |  | 6—12 weeks Weekly – 2/week 10—12 sessions 1 h—1.15 h | PSS-I (1) CAPS (1) Depression | Health education (1) No treatment (1) | No specific result for yoga intervention |
| Â | Â | Â | Â | Â | Combined aerobic and resistance-based intervention (1) Aerobic intervention (stationary cycling) (1) | Â | n.r n.r 12 sessions n.r | PSS-I (1) PCL (1) Depression Cardiovascular risk | TAU (2) | Physical activity significantly reduced PTSD and depressive symptoms compared to control Insufficient datas for anthropometric measures |
Zhu et al., 2022 China [29] | SR + MA | 16 (9) | 871 [21–116] 45.5% [18–65] y.o | Adults with PTSD | SKY (2) KrY (2) KY (1) SatY (1) TiY (1) Hatha yoga (1) Online yoga (1) |  | 1—16 weeks Weekly—daily 5 – 32 sessions 1 h—4.4 h | PCL (7) CAPS (3) IES (1) Anxiety Depression | Regular daily life (4) No treatment (2) TAU (1) Mandatory ordinary assistance protocol (1) Toning exercise (1) | No specific result for yoga intervention |
MBSR (4) MBX (1) Brief mindfulness training (1) Integrative exercise (1) |  | 4—8 weeks Weekly—daily 4—64 sessions 1—2.5 h | PCL (5) CAPS (1) BRUMS (1) Anxiety Depression | TAU (3) Regular daily life (2) WLC (1) PCGT (1) | Mind–body exercises had significant effects on PTSD symptoms, depression, and anxiety in patients with PTSD | |||||
Liu et al 2018 USA [30] | SR | 13 (3) | 953 [29–226] n.r (yoga = 100%) n.r | Veterans (5)Veteran civilian adult women (2)Civilians including (6) adults, nurse, refugees, women with chronic PTSD, childrena | KrY (2) TIY (1) |  | 10 weeksb Weeklyb 10—20 sessions 1 h -1.15 h | CAPS (2) PCL (1) DTS (1) DES (1) | ACG (2) Women’s health education classes (1) | 2/3 RCTs found significant difference after yoga intervention None of the studies provided power analysis calculations for primary outcomes |
|  |  |  |  | Mindfulness/ meditation (7) Spiritually based intervention (1) Acupuncture (1) Relaxation training (1) |  | 8 weeks – 12 weeks Weekly—2/week 1 to 16 sessions 20 min to 7 h | PCL (7) CAPS (4) PTSD SSS (1) PSS-SR (1) Researcher-devised self-report assessment of PTSD (1) Biological levels (1) | TAU (2) DI (1) WLC (1) No treatment (2) Psychoeducation (1) PCGT (1) CBT + WLC (1) Exposure + EMDR (1) | Integrative body-mind-spirits interventions have positive effects for treating PTSD | |
Niles et al 2018 USA [31] | SR | 22 (6) | 1258 [21–146] 46.4% Mean ageb = 44,9 | Veterans (8) Active-duty personnel or civilian and veterans (2) Civilians with PTSD (12) | SKY (2) KrY (2) KY (1) TIHY (1) |  | 7 days—6 months 2/week—daily 7—20 sessions 1 h – 4.4 h | CAPS (3) PCL (5) ies (1) DTS (1) 17 scales for additional measures | WLC (2) OF (1) ACG (2) SWHE (1) | All studies have large within-group effects and 4/6 RCTs significant moderate to large effect size between-group Acceptable and feasible intervention |
|  |  |  |  | Mindfulness (9): MBSR (4), MR (2), MBX (1), telehealth mindfulness (1), PCBMT (1) Relaxation (7) |  | 4 – 16 weeks Weekly – 2/week 3—16 sessions 20 min—7 h | CAPS (10), PCL (10) IES (3) SI-PTSD (1) PTS-T (1) PTSDSS (2) PSS-SR (1) 17 scales for additional measures | WLC (3) TAU (3) PCGT (2) ACG (2) DI (1) EMDR (1) CBT (1) Telehealth psychoeducation (1) Others (4) | Mind–body therapies have encouraging evidence but still have methodologic weaknesses Not enough studies have evaluated the secondary outcomes | |
Sciarrino et al. 2017 USA [32] | SR | 7 (7) | 391 [22–100] n.r n.r | Military (2) Veterans and civilian women (1) Civilians with PTSD (4) | SKY (1) KrY (1) KY (1) SatY (1) TSY (1) Hatha yoga (1) MBX + yoga postures (1) |  | 5 days – 16 weeks Monthly – daily 10—32 sessions 1 h – 4.4 h | PCL (4) CAPS (2) PDS (1) | WLC (3) No treatment (2) SWHE (1) Demobilization program (1) | 5/7 RCTs found significant results in favor of yoga compared to control |