Yoga as an intervention for anxiety in children and adolescents: A meta-analysis

Abstract

There is growing interest in yoga as a complementary therapy for anxiety reduction in children. However, the available evidence has primarily relied on uncontrolled studies, which may overestimate treatment effects. The aims of this study are to systematically appraise the rigour of current research investigating yoga as an intervention for children and adolescents (aged 3-21 years) and to complete a meta-analysis of the data to determine the effectiveness and optimal dosage of yoga for anxiety. Ten independent controlled trials, involving a pooled sample of 3879 children and adolescents, were identified from the Embase, PubMed and PsycINFO databases. Study reporting quality was assessed using the QualSyst tool. Standardised mean group differences (Hedges’ g) in addition to 95% confidence intervals, p values and heterogeneity statistics (Q, I2, Tau) were calculated using a random effects model. Although five studies identified immediate improvements in anxiety symptoms with yoga, the overall pooled effect was not significant (g = 1.06, [CI: -.16, 2.27], p = 0.08). The findings were, however, characterised by a single outlier study - the removal of which changed the overall significance (g = .59, [CI: .16, 1.13], p =.01). Subgroup analyses identified a ‘dose-response’ effect, with very large and significant effects being associated with yoga interventions that extended beyond 9 weeks (g = 1.81 [CI: .32 to 3.29] p = 0.02). These studies provide preliminary data to suggest that yoga may have some mental health benefits for children. Further controlled research incorporating follow-up assessment is warranted given the findings in this review.