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The popularity of yoga and the understanding of its potential health benefits have recently increased. Unfortunately, not everyone can easily engage in in-person yoga classes. Over the past decade, the use of remotely delivered yoga has increased in real-world applications. However, the state of the related scientific literature is unclear.
This scoping review aimed to identify gaps in the literature related to the remote delivery of yoga interventions, including gaps related to the populations studied, the yoga intervention characteristics (delivery methods and intervention components implemented), the safety and feasibility of the interventions, and the preliminary efficacy of the interventions.
This scoping review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Item for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Scientific databases were searched throughout April 2021 for experimental studies involving yoga delivered through technology. Eligibility was assessed through abstract and title screening and a subsequent full-article review. The included articles were appraised for quality, and data were extracted from each article.
A total of 12 studies of weak to moderate quality were included. Populations varied in physical and mental health status. Of the 12 studies, 10 (83%) implemented asynchronous delivery methods (via prerecorded material), 1 (8%) implemented synchronous delivery methods (through videoconferencing), and 1 (8%) did not clearly describe the delivery method. Yoga interventions were heterogeneous in style and prescribed dose but primarily included yoga intervention components of postures, breathing, and relaxation and meditation. Owing to the heterogeneous nature of the included studies, conclusive findings regarding the preliminary efficacy of the interventions could not be ascertained.
Several gaps in the literature were identified. Overall, this review showed that more attention needs to be paid to yoga intervention delivery methods while designing studies and developing interventions. Decisions regarding delivery methods should be justified and not made arbitrarily. Studies of high methodological rigor and robust reporting are needed.
As of 2016, a total of 36 million Americans had engaged in some form of yoga practice [
However, when examining the available scientific literature, yoga interventions are most often delivered in person [
Little is known about the evidence regarding the practice and outcomes of yoga using remote delivery methods. A previous scoping review of the yoga literature [
With this, it is important to know that yoga is a multilayered ancient philosophy and practice intended to facilitate well-being through the cultivation of awareness by integrating mind and body, with an emphasis on self-realization [
Yoga can be delivered both in person and remotely, and there has been an increase in the availability and use of remotely delivered interventions in real-world applications. However, it is not known whether the scientific literature reflects this or reflects what types of populations have been enrolled in studies that have investigated the remote delivery of yoga, what the characteristics of these interventions are (including how remote delivery occurs), and what components of yoga are incorporated. Furthermore, the general feasibility and safety of these interventions or their preliminary efficacy are yet to be clearly defined. Therefore, the purpose of this scoping review was to examine the existing literature regarding the practice of yoga through remote delivery methods and identify current gaps related to (1) the populations studied, (2) the intervention characteristics (delivery methods and intervention components implemented), (3) the safety and feasibility of the interventions, and (4) the preliminary efficacy of the interventions.
This review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines [
Scientific databases, including PubMed, Scopus, Web of Science, PEDro, CINAHL, PsycINFO, IEEE Xplore Digital Library, and Cochrane Library, were searched during April 2021. The search strategies were modified for each database, with the Medical Subject Headings terms used as applicable. The following terms were used in various combinations:
Articles were included if they investigated (1) adults aged ≥18 years; (2) an experimental intervention study with pre- and posttesting for at least one group; (3) a yoga intervention using physical yoga postures (
Yoga interventions can be heterogeneous and are often poorly described in the literature [
All the data management processes discussed in this section were completed by the 3 authors (AJP, EZA, and JFD) in the following manner. The articles were divided into thirds. Then, 2 authors, screened, reviewed, and appraised, (two-thirds or 66.7% of the articles) with the third author available to resolve conflicts, such that each author (AJP, EZA, and JFD) was able to perform each task. The abovementioned criteria guided eligibility screening (completed via Rayyan QCRI [
Data extracted from selected articles (scoping review; information extracted from each selected article and examples).
Content area and extracted information | Examples | ||
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Study type as defined by the study authors in the introduction or methods sections | Randomized controlled trial; single-group study | |
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Country in which the study was conducted | United States | |
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Comparison group used as described by the study authors (if applicable) | Regular activity control group; active control group such as a strengthening program | |
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Number of participants (total [N] and per group [n]) | N=50 | |
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Description of population, including defining characteristics such as the health condition, as described by the study authors | Women with depression | |
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Mean age of the participants and SD (if provided) for the total sample and each group | Mean age of the total sample was 55.07 (SD 9.69) years | |
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Sex distribution of participants in the total sample and in each group | Number of women in the study out of the total number of participants | |
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Justification of delivery method in relation to the study population, as described by the study authors (ie, did the study authors describe why they delivered the intervention remotely, and if they did, what was the reason) | Yes—the study authors reported that individuals with cancer often have transportation and scheduling challenges that make it difficult to attend in-person appointments; no—the study authors did not describe why they chose remote delivery | |
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Intervention setting | Home | |
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Whether delivery was synchronous or asynchronous; delivery was considered synchronous if interventions were delivered in real time such that the instructor could interact with the participant or participants; delivery was considered asynchronous if intervention materials were prerecorded and could be accessed at any time | Synchronous (videoconferencing) and asynchronous (prerecorded video) | |
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The technology used to deliver the intervention | Name of a specific videoconferencing platform; type of prerecorded video (ie, DVD) | |
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Whether delivery was group or individual; it was considered group delivery if multiple people participated in the yoga intervention together at one time; it was considered individual delivery if a participant engaged in the intervention alone | If each participant received access to a prerecorded video and watched the video on their own (individual delivery) | |
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Whether participants had additional interactions with the study team outside of assessment sessions and prescribed intervention sessions | Participants received an in-person introduction yoga class before starting the intervention period | |
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Whether participants received supplementary materials | Participants received written instructions providing additional information on how to practice yoga | |
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Style of yoga implemented | Hatha yoga or Iyengar yoga | |
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Specific limbs of yoga implemented | Breathing; postures; meditation; relaxation | |
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Yoga instructor credentials, as reported by the study authors, including instructor training (ie, are they a yoga instructor, yoga therapist, or other health care professional) and their certification training hours | Yoga instructor (200 hours) | |
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Yoga dose: frequency and duration reported in minutes per session, sessions per week, and total number of weeks | 30 minutes per session with 2 sessions per week for 6 weeks | |
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Whether the yoga sequences were designed, adapted, or selected for the specific study population, as described by the study authors, or whether this was not reported | Yes—the study authors reported that they designed the prerecorded videos specifically for the population enrolled in the study; no—the study authors did not report whether the yoga intervention was designed for the study population | |
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Information about additional home practice (ie, did the study authors describe whether participants were encouraged to engage in additional practice outside of the prescribed intervention and how this was kept track of) | Yes—although the study authors required participants to watch the yoga video 1 time per week, the study authors encouraged participants to view the yoga video an additional 2 to 3 times per week if possible and asked them to log how often they did this | |
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Study adherence (ie, did participants complete the study overall, including the intervention period and assessment sessions) reported as how many people in each group completed the study | 66% (44/67) of the yoga group completed the study | |
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Intervention adherence (ie, did participants complete the intended yoga intervention dose); intervention adherence was reported as it was reported in each study; some studies reported it as the mean yoga practice, whereas others set a threshold or benchmark and reported intervention adherence as it related to the benchmark | Mean yoga practice was 44 min/week and the prescribed dose was 60 min/week; the benchmark for “good adherence” was participants who practiced yoga ≥6 times over 2 weeks, and 55% (37/67) of the yoga group met this benchmark | |
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The presence or absence of technological challenges, as described by the study authors | Participants experienced technological challenges in 77% (24/31) of the sessions | |
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The presence or absence of adverse events, as reported by the study authors for each study group, or whether the study authors did not report any information about adverse events | No adverse events occurred, the study did not report information about adverse events; 9 mild adverse events occurred in the yoga group and 4 mild adverse events occurred in the comparison group | |
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The outcome measures were categorized into patient-reported outcome measures, physical performance and function outcome measures, and physiological outcome measures based on what the measures assessed; subsequently, a summary of results for these outcomes was extracted (eg, were there significant improvements between groups and significant improvements within groups) | The patient-reported outcome measure—the Beck Depression Inventory—showed significant within-group improvements |
The search resulted in 1978 articles, with 1728 (87.36%) remaining after duplicates were removed. The title and abstract screening resulted in the inclusion of 2.03% (35/1728) of articles. Following a full-article review, of the 35 articles, 12 (34%) articles [
Illustration showing the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram of the search, screening, and full-article review results.
Of the 12 studies, 8 (67%) were randomized controlled trials (RCTs) [
General study information, including the first author, type, country, study groups, and results of the quality appraisal assessment.a
Author, study type, and country | Study groups | Selection bias | Study |
Confounders | Blinding | Data collection methods | Withdrawals or dropouts | Global ratingb |
Armstrong et al [ |
Yoga video vs regular activity | Weak | Weak | Weak | Weak | Weak | Weak | Weak |
Awdish et al [ |
Yoga video; no comparison | Weak | Weak | Weak | Weak | Strong | Weak | Weak |
Donesky et al [ |
Yoga via videoconferencing vs health education phone call | Weak | Moderate | Weak | Weak | Strong | Moderate | Weak |
Gunda et al [ |
Yoga DVD; control not clearly described | Moderate | Moderate | Strong | Weak | Weak | Moderate | Weak |
Huberty et al [ |
Web-based yoga videos vs wait-list control | Moderate | Strong | Strong | Weak | Strong | Strong | Moderate |
Huberty et al [ |
Web-based yoga videos (2 doses) vs stretch and tone control | Moderate | Strong | Moderate | Moderate | Strong | Weak | Moderate |
Jasti et al [ |
Tele-yoga module | Moderate | Weak | Weak | Weak | Strong | Weak | Weak |
Kyeongra et al [ |
Yoga DVD vs in-person yoga | Strong | Moderate | Strong | Weak | Strong | Moderate | Moderate |
Mullur et al [ |
Yoga DVD vs handouts about yoga | Moderate | Weak | Strong | Weak | Moderate | Moderate | Weak |
Sakuma et al [ |
Yoga DVD vs regular activities | Moderate | Strong | Strong | Weak | Strong | Weak | Weak |
Schuver et al [ |
Yoga DVD vs DVD on walking | Moderate | Strong | Strong | Moderate | Strong | Moderate | Moderate |
Stan et al [ |
Yoga DVD vs DVD on strengthening | Moderate | Strong | Moderate | Weak | Strong | Moderate | Moderate |
aThe quality appraisal assessment was completed using the Quality Assessment Tool for Quantitative Studies with six domains contributing to the score: (1) selection bias, (2) study design, (3) confounders, (4) blinding, (5) data collection methods, and (6) withdrawals and dropouts.
bGlobal ratings were determined as follows: no weak ratings=strong, one weak rating=moderate, and ≥2 weak ratings=weak.
cRCT: randomized controlled trial.
The studies included individuals with physical and mental health conditions, as well as generally healthy adults. For example, 17% (2/12) of studies involved individuals with cancer, such as early-stage breast cancer [
Characteristics of the participants included in the reviewed studies.
Study | Population | Number of Participants | Age (years), mean (SD) | Sex, n (%) | |||||||||||
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Total | Yoga | Control | Total | Yoga | Control | Total | Yoga | Control | |||||
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Female | Male | Female | Male | Female | Male | ||
Armstrong et al [ |
Adult women | 30 | 15 | 15 | 55.07 (9.69) | 54 (10) | 55 (9) | 30 (100) | 0 (0) | 15 (100) | 0 (0) | 15 (100) | 0 (0) | ||
Awdish et al [ |
Women with pulmonary hypertension and additional chronic health conditions | 3 | 3 | N/Aa | 48, 32, and 24 | 48, 32, and 24 | N/A | 3 (100) | 0 (0) | 3 (100) | 0 (0) | N/A | N/A | ||
Donesky et al [ |
Adults with chronic obstructive pulmonary disease and heart failure | 15 | 7 | 8 | 71 (8.5) | 73 (14.3) | 70.5 (2.7) | 10 (66) | 5 (33) | 4 (57) | 3 (43) | 6 (75) | 2 (25) | ||
Gunda et al [ |
Adults with neurocardiogenic syncope | 44 | 21 | 23 | 21 (3) | 21 (3) | 22 (3) | 41 (93) | 3 (7) | 20 (95) | 1 (5) | 21 (91) | 2 (9) | ||
Huberty et al [ |
Adults with myeloproliferative neoplasm | 48 | 27 | 21 | 56.9 (10.3) | 58.3 (9.3) | 55.0 (11.4) | 45 (94) | 38 (6) | 25 (93) | 2 (7) | 20 (95) | 1 (5) | ||
Huberty et al [ |
Women who have experienced stillbirth | 90 | 30 (YLDb) and 30 (YMDc) | 30 | NSd | NS | NS | 90 (100) | 0 (0) | 30 (100; YLD) and 30 (100; YMD) | 0 (0) | 30 (100) | 0 (0) | ||
Jasti et al [ |
General adult public | 95 | 95 | N/A | 40.39 (13.33) | 40.39 (13.33) | N/A | 69 (73) | 26 (27) | 69 (73) | 26 (27) | N/A | N/A | ||
Kyeongra et al [ |
Sedentary adults who are overweight | 14 | 7 | 7 | 58.6 (5.4) | 58.7 (4.1) | 58.4 (6.8) | 12 (86) | 2 (14) | 6 (86) | 1 (14) | 6 (86) | 1 (14) | ||
Mullur et al [ |
Veterans with CKDe and diabetes | 10 | 5 | 5 | 64.4 (NS) | 60 (10.34) | 68.8 (5.97) | 1 (10) | 9 (90) | 1 (20) | 4 (80) | 0 (0) | 5 (100) | ||
Sakuma et al [ |
Female childcare workers | 98 | 67 | 31 | 33.6 (NS) | 32.6 (11.5) | 35.8 (13.0) | 98 (100) | 0 (0) | 67 (100) | 0 (0) | 31 (100) | 0 (0) | ||
Schuver et al [ |
Women with a history or diagnosis of depression | 40 | 20 | 20 | 42.68 (4.95) | 45.55 (12.30) | 39.8 (11.23) | 40 (100) | 0 (0) | 20 (100) | 0 (0) | 20 (100) | 0 (0) | ||
Stan et al [ |
Women with early-stage breast cancer and cancer-related fatigue | 34 | 18 | 16 | 62.1 (8.1) | 61.4 (7.0) | 63.0 (9.3) | 34 (100) | 0 (0) | 18 (100) | 0 (0) | 16 (100) | 0 (0) |
aN/A: not applicable.
bYLD: yoga low dose (60 min/week).
cYMD: yoga moderate dose (150 min/week).
dNS: not specified.
eCKD: chronic kidney disease.
In addition to extracting information about the enrolled populations, justification of the intervention delivery method based on the enrolled population was extracted when available. This was done to identify whether the study authors chose to implement remote delivery to address population-specific needs. Approximately 50% (6/12) of the studies reported some type of justification for the remote delivery method and related it to population-specific needs. Interestingly, one of these studies was designed during the COVID-19 pandemic and was conducted to provide easily accessible stress management strategies to the general public during social isolation [
As per the inclusion criteria, all reviewed studies [
By nature, 83% (10/12) of studies implementing asynchronous delivery were delivered individually [
Approximately 50% (6/12) of studies implementing asynchronous delivery used only 1 yoga video or sequence for the study’s duration [
Approximately 50% (6/12) of studies did not specify the style of yoga used [
Approximately 42% (5/12) of studies [
Approximately 33% (4/12) of studies specified using breathing exercises and physical postures [
The yoga interventions ranged in duration from 2 to 12 weeks, with individual session lengths ranging from 10 to 90 minutes and frequency ranging from once a week to daily practice. Interestingly, one of the studies included 2 different prescribed yoga doses (low, 60 min/week, and moderate, 150 min/week) [
Most studies considered remotely delivered interventions as home practice and, therefore, did not assess or account for additional home practice. However, they accounted for all the practices at home when reporting adherence (if reported). The study comparing in-person yoga with a yoga DVD specified instructions for the desired frequency of additional home practice [
Information about intervention characteristics.a
Study | Asynchronous vs synchronous | Technology | Group vs individual | Yoga style | Yoga limbs | Duration (minutes per session) | Sessions per week | Number of weeks |
Armstrong et al [ |
Asynchronous | Video (type unspecified) | Individual | NSb | Breathing, postures, and relaxation | 30 | 4 | 10 |
Awdish et al [ |
Asynchronous | DVD and mobile app | Individual | Hatha and Iyengar | Breathing, postures, and meditation | NS | 3 to 6 | 8 |
Donesky et al [ |
Synchronous | Videoconference | Group | Iyengar | Breathing, postures, meditation, and relaxation | 60 | 2 | 8 |
Gunda et al [ |
Asynchronous | DVD | Individual | NS | Breathing, postures, and relaxation | 60 | 3 | 12 |
Huberty et al [ |
Asynchronous | Web-based videos | Individual | Hatha and Vinyasa | Breathing, postures, and meditation | Requested 60 min/week | Requested 60 min/week | 12 |
Huberty et al [ |
Asynchronous | Web-based videos | Individual | Gentle Hatha | Postures and meditation | 60 min week (LDc); 150 min/week (HDd) | 60 min/week (LD); 150 min/week (HD) | 12 |
Jasti et al [ |
Asynchronous and synchronous | Unspecified tele-yoga | NS | NS | Breathing and postures | 40 | ≥1 | 4 |
Kyeongra et al [ |
Asynchronous | DVD | Individual | Vinyasa | Breathing and postures | Required one 90-minute session, encouraged 2 more for “home practice” | Required one 90-minute session, encouraged 2 more for “home practice” | 8 |
Mullur et al [ |
Asynchronous | DVD | Individual | NS | Breathing and postures | 10 | As often as possible | 12 |
Sakuma et al [ |
Asynchronous | DVD | Individual | NS | Breathing and postures | 7.5 | Daily | 2 |
Schuver et al [ |
Asynchronous | DVD | Individual | Gentle Hatha | Breathing, postures, and meditation | 60 to 75 | 2 | 12 |
Stan et al [ |
Asynchronous | DVD | Individual | NS | Breathing and postures | 90 | 3 to 5 | 12 |
aInformation about the intervention characteristics such as the delivery method, including whether the intervention was delivered synchronously or asynchronously; the type of technology used; whether the intervention was delivered to a group or individual; and yoga intervention components, including the yoga style, yoga limbs, and intervention dose (frequency and duration).
bNS: not specified.
cLD: low dose.
dHD: high dose.
The extracted data that were related to feasibility included information about adherence and occurrence or absence of technological challenges. The components of adherence were subcategorized into intervention adherence (ie, whether participants completed the intended yoga intervention dose) and study adherence (ie, whether participants completed the study overall). The following sections present the results related to adherence. We reported the results as specified in each study and used the term
Adherence to the intervention was assessed or reported differently across studies. Approximately 33% (4/12) of studies did not report on intervention adherence [
One of the studies set a benchmark for adherence (completion of 90% of the prescribed yoga dose in 9 out of 12 weeks). In this study, there was a low-dose group, in which 44% (8/18) of the participants met the benchmark, and a moderate-dose group, in which 6% (1/16) met the benchmark [
The mean yoga practice was also reported in several studies to indicate yoga intervention adherence. In the study comparing a yoga DVD with a walking DVD, a mean practice of 119.75 (SD 58.95) minutes for the yoga group was reported and a mean practice of 78.25 (SD 52.50) was reported for the walking group [
In addition to intervention adherence, study adherence was reported as the number of individuals who completed the study compared with those who were enrolled. Approximately 33% (4/12) of studies did not report whether any individuals dropped out or whether all those enrolled completed the study [
The study implementing synchronous yoga reported technological challenges in 77% (24/31) of the yoga sessions and a mean enjoyment of 8.3 (SD 2.7) on a 10-point scale [
Approximately 33% (4/12) of studies did not specify the occurrence or absence of adverse events [
Patient-reported outcomes included various measures assessing anxiety, depression, sleep, fatigue, quality of life, general health, syncope functional status, multifactorial myeloproliferative neoplasm symptoms, sexual function, and pain. One of the studies did not analyze whether there were statistically significant differences between pre- and postmeasurements, despite having collected the data [
Physical performance and functional outcome measures comprised flexibility, strength, the 6-minute walk test, and balance. One of the studies assessing the effect of yoga on flexibility in older women showed statistically significant improvements in the sit and reach test in the yoga group, along with improvements in trunk extension, shoulder flexion, and left and right ankle flexibility [
Physiological measures that showed significant improvements in at least one study included heart rate, blood pressure, oxygen saturation, presyncope and syncope events, and specific blood tests. One of the studies on veterans with diabetes showed statistically significant improvements in heart rate, diastolic blood pressure, and capillary blood glucose [
Outcome measures assessed in each study.
Study and type | Comparison | Outcomes |
Armstrong et al [ |
Yoga video vs regular activity |
Sit and reach testb Trunk extensionb Trunk flexion Shoulder extension Shoulder flexionb Left ankle flexibilityb Right ankle flexibilityb |
Awdish et al [ |
Yoga video; no comparison |
Subjective changes via journalingc Health Promoting Lifestyle Profile 2c 6-minute walk testc Oxygen saturationc |
Donesky et al [ |
Yoga via videoconferencing vs health education phone call |
Safety: see the Adverse Events and Safety section Acceptability: see the Intervention Adherence section Technical issues: see the Patient-Reported Outcome Measures section Upper and lower body muscle strength 6-minute walk test Symptoms following the 6-minute walk testb Quality of life: St George’s Respiratory Questionnaire and Kansas City Cardiomyopathy Questionnaired Depression Personal Health Questionnaire-8 Overall dyspnea: Dyspnea-12 questionnaire General Sleep Disturbance Scale |
Gunda et al [ |
Yoga DVD; control not clearly described |
Log of the number of presyncope and syncope events: in the intervention group, for those who finished the yoga regimen, there was a statistically significant improvement in the number of episodes of syncope and presyncope SFSQe: statistically significant decrease in the mean SFSQ score from the control phase to completion of the intervention phase Head-up tilt table: resting heart rate Blood pressure |
Huberty et al [ |
Web-based yoga videos vs wait-list control |
Yoga participation: see the Intervention Adherence section Adverse events: see the Adverse Events and Safety section Blood draw feasibility and practicality Inflammatory biomarkersc Fatigue: single item from the multifactor MPN-SAFc,f Multifactor MPN-SAF: total symptom scorec Quality of life: single item from the NIHg PROMISh Global Health measurec Sleep disturbance: Sleep Disturbance Scale Short Form 8ac Pain intensity: Pain Intensity Short Form 3ac Anxiety distress: Emotional Anxiety Short Form 8ac Depression emotional Distress: Depression Short Form 8ac Mental health: PROMISc Sexual function: 8-item for men; 10-item for womenc Physical health: PROMISc |
Huberty et al [ |
Web-based yoga videos, including 2 different doses vs stretch and tone control |
Adherence: see the Intervention Adherence section Acceptability: all groups achieved satisfaction benchmarks Adverse events: see the Adverse Events and Safety section Demand: no group met the demand benchmark Impact of Event Scale State-trait Anxiety Inventory Patient Health Questionnaire-9i Perinatal Grief Scalei Self-Compassion Scalei Self-rated health (Short Form-12)i: a significant decrease in low-dose and control groups Emotion Regulation Questionnaire Mindful Attention Awareness Scale Pittsburg Sleep Quality Index |
Jasti et al [ |
Tele-yoga module |
Adherence: see the Intervention Adherence section Difficulty rating: mean score indicated that the yoga module was easy to practice Feasibility: 92.6% of participants found the yoga to be safe and feasible Yoga Performance Assessment scaled Perceived Stress Scaled |
Kyeongra et al [ |
Yoga DVD vs in-person yoga |
Adherence: see the Intervention Adherence section Modifiable Activity Questionnaire Program satisfaction: see the Patient-Reported Outcome Measures section |
Mullur et al [ |
Yoga DVD vs handout about yoga |
Capillary blood glucoseb Heart rateb Diastolic blood pressureb Hemoglobin A1c Systolic blood pressure Weight BMI |
Sakuma et al [ |
Yoga DVD vs regular activities |
Measure of body pain according to the Visual Analog Scale (range 0-100)j Japanese version of the General Health Questionnaire Body weight BMI Flexibility (measure not described reported in comparator) Grip strength Functional reach test |
Schuver et al [ |
Yoga DVD vs walking DVD |
Beck Depression Inventoryd Ruminative Responses Scalek |
Stan et al [ |
DVD vs strengthening DVD |
Feasibility: see the Intervention Adherence section Safety: see the Adverse Events and Safety section Fatigue: Multidimensional Fatigue Symptom Intervention Short Formd Quality of life: Functional Assessment of Cancer Therapies–Breastd |
aRCT: randomized controlled trial.
bStatistically significant between-group difference favoring the remote-delivered yoga group.
cOnly effect sizes were calculated.
dStatistically significant within-group differences.
eSFSQ: Syncope Functional Status Questionnaire.
fMPN-SAF: Myeloproliferative Neoplasm Symptom Assessment Form.
gNIH: National Institutes of Health.
hPROMIS: Patient-Reported Outcomes Measurement Information System.
iStatistically significant improvements in the yoga group compared with the control group. Yoga comprised 2 different yoga intervention doses. For further details, refer to the study by Huberty et al [
jStatistically significant improvement for individuals who demonstrated good adherence to the yoga group (≥6 times per 2 weeks) for low back pain, upper arm or neck pain, and menstrual pain.
kStatistically significant between-group difference when controlling for baseline levels.
The purpose of this scoping review was to examine the existing literature regarding the practice of yoga through remote delivery methods and identify current gaps related to (1) the populations studied, (2) the intervention characteristics (delivery methods and intervention components implemented), (3) the safety and feasibility of the interventions, and (4) the preliminary efficacy of the interventions. In summary, the studied populations included adults across their life spans, including individuals with physical and mental health conditions and some generally healthy adults. The review showed that, to date, most studies implementing remotely delivered yoga have implemented asynchronous delivery. In addition, the delivered interventions were primarily
This scoping review showed that remotely delivered yoga has been successfully implemented in a heterogeneous sample of populations with and without chronic conditions. This is similar to the body of literature investigating the impact of in-person yoga [
It is unclear why some populations were enrolled in studies investigating remotely delivered yoga, whereas others were not. In an attempt to gain a better understanding of this, information related to the authors’ motivation to implement remote delivery was extracted. However, as reported in the
When examining delivery method characteristics, most studies (10/12, 83%) implemented asynchronous delivery. This is similar to the results of another scoping review that investigated web-based mindfulness interventions for people with physical health conditions, which showed that 69% (11/16 studies) implemented asynchronous delivery [
Although more studies included in our review implemented asynchronous delivery than synchronous delivery, the one study investigating synchronous delivery reported high adherence and enjoyment [
When examining the other intervention characteristics, such as the implemented style and limbs of yoga, our findings are similar to those found in the in-person yoga literature [
This scoping review had some limitations. First, only studies with pre- and posttesting were included. This was stipulated in the eligibility criteria and was intended to facilitate the exploration of preliminary efficacy. However, this may have resulted in the exclusion of studies, such as feasibility studies or qualitative analyses, which could have provided additional insight into the current state of the literature. Specifically, we are aware of 4 studies [
This scoping review had several strengths. A broad range of databases was searched, which allowed a comprehensive search. This review provides a robust quality assessment of the included studies, provides a realistic picture of the literature and facilitates the interpretation of the findings. In addition, this review covers a broad range of content areas, including (1) the populations studied, (2) the intervention characteristics (delivery methods and intervention components implemented), (3) the safety and feasibility of the interventions, and (4) the preliminary efficacy of the interventions. This broad range of content allows readers to obtain a full picture of the state of the related literature and understand the current gaps. This is intended to help provide a path forward to optimize future research.
Multiple steps can be taken to address the gaps identified in this review and optimize future research. Future studies involving larger sample sizes should assess populations similar to those enrolled in the reviewed studies to determine whether the results can be replicated. In addition, populations not examined in the included studies, such as those with neurological conditions or other populations that have been shown to benefit from in-person yoga, should be enrolled in future studies that implement remotely delivered yoga. Future studies should justify the choice of delivery methods and relate this justification to population-specific needs. Moreover, future studies should consider and investigate the interactions among delivery methods, yoga intervention components, and other study characteristics. They should explore the implementation of synchronous delivery and compare different delivery methods. Specifically, synchronous yoga interventions using widely available and commonly used videoconferencing platforms should be investigated to determine whether this approach limits technological challenges and facilitates feasibility. Finally, future studies should report information regarding adverse events, adherence, and other safety and feasibility measures to provide robust information regarding the implementation of these interventions.
This review synthesized the literature regarding the remote delivery of yoga and provided information about gaps in the literature related to study populations, intervention characteristics, intervention safety and feasibility, and intervention efficacy. Overall, this review revealed a broad gap in the literature, showing that little attention has been paid to yoga intervention delivery methods. Future studies and yoga intervention development guidelines should further consider the delivery methods when developing interventions. For instance, population-specific needs and barriers should be accounted for when determining delivery methods. In addition, more studies implementing synchronous delivery methods and studies comparing delivery methods should be conducted, and robust reporting of intervention characteristics is required.
The search strategy used for this scoping review, including the search terms used for each database, along with notes detailing the search methods.
chronic obstructive pulmonary disease
heart failure
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews
randomized controlled trial
AJP approved the search strategy, completed the search, participated in the abstract and title screening, participated in the full-article review, extracted the results, synthesized the data, completed the first draft of the manuscript, and revised the manuscript.
EZA approved the search strategy, participated in the abstract and title screening, participated in the full-article review, extracted results, synthesized data, and revised the manuscript.
JFD approved the search strategy, participated in the abstract and title screening, participated in the full-article review, extracted the results, synthesized data, and revised the manuscript.
None declared.