Yoga in autoimmune disorders: a systematic review of randomized controlled trials

Yoga, a mind-body therapy, is widely utilized for managing health outcomes in autoimmune disorders (ADs). Despite its extensive use, no systematic review has been conducted to assess the impact of yoga on ADs.

The objective was to evaluate the evidence of yoga on health outcomes in ADs based on randomized controlled trials (RCTs).

A comprehensive search was conducted across Scopus, Web of Science, PubMed, Medline, and PsycINFO from January 2000 to June 2024, as well as relevant reference lists. RCTs evaluating the efficacy of yoga-based interventions with at least 8 weeks duration in the 5 most commonly studied ADs-multiple sclerosis (MS), rheumatoid arthritis (RA), ankylosing spondylitis (AS), inflammatory bowel disease (IBD), and autoimmune periodontitis-were included. The methodological quality was assessed using the PEDro scale. Vote counting based on the direction of effect was used to determine effectiveness.

Twenty-six RCTs involving 1,960 patients with intervention durations ranging from 8 to 24 weeks were included. Twelve studies were of good methodological quality, 8 were fair, and the remaining 2 were of poor quality. Yoga demonstrated positive evidence in improving fatigue, balance, QoL, and depression among MS patients, along with reductions in inflammatory biomarkers and depression in RA patients. Studies on AS showed positive evidence in physical function, disease activity, and quality of life, as well as in clinical attachment loss in autoimmune periodontitis. However, the small number of RCTs in IBD, AS, and autoimmune periodontitis limited the strength of these findings. No adverse events were reported, although studies were limited by small sample sizes and short-term interventions.

This systematic review found a positive impact of Yoga on various physical, biochemical, and psychological measures in 5 common ADs. Yoga may be considered an adjunct therapy in the conventional management of ADs.