The Safety of Yoga: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Area of Science:

• Integrative and Complementary Medicine
• Clinical Research Methodology
• Patient Safety

Background:

• Yoga's increasing use as a therapeutic intervention raises questions about its safety.
• Previous assessments of yoga's adverse events have been limited.
• A systematic review and meta-analysis is needed to evaluate yoga's safety profile.

Purpose of the Study:

• To systematically assess and meta-analyze the frequency of adverse events in randomized controlled trials (RCTs) of yoga.
• To compare the safety of yoga with usual care, exercise, and psychological/educational interventions.
• To identify any differences in serious adverse events and dropouts due to adverse events.

Main Methods:

• Systematic search of MEDLINE/PubMed, Scopus, Cochrane Library, and IndMED databases up to February 2014.
• Inclusion of 94 RCTs (1975-2014) reporting adverse events, totaling 8,430 participants.
• Categorization of adverse events as serious (life-threatening, disabling, requiring intensive treatment) or nonserious.

Main Results:

• No significant differences in intervention-related, nonserious, or serious adverse events, or dropouts due to adverse events were found when comparing yoga with usual care or exercise.
• Yoga groups experienced more intervention-related adverse events (OR = 4.21) and nonserious adverse events (OR = 7.30) compared to psychological or educational interventions.
• The frequency of serious adverse events and dropouts due to adverse events was comparable between yoga and psychological/educational interventions.

Conclusions:

• Yoga demonstrates a safety profile comparable to usual care and exercise.
• While yoga may lead to more minor adverse events than psychological or educational interventions, serious risks are similar.
• Enhanced reporting of safety data in future yoga RCTs is essential for a definitive safety assessment.