The psychosomatic impact of Yoga in medical education: a systematic review and meta-analysis

Figures & data

Figure 1. PRISMA protocol of literature search process.

Table 1. Summary of the 47 articles included in this study.

Author	Location	Population	Period of intervention	Conclusion
Jahan et al., 2020a [23]	Bangladesh	100 medical students (18–20 years)	10 min/day, 4 weeks	Yoga significantly improved respiratory parameters
Jahan et al., 2020b [24]	Bangladesh	100 medical students (18–20 years)	10 min/day, 4 weeks	Yoga led to a decrease in SBP, DBP and HR
Akhani et al., 2019 [25]	India	300 medical students > 18 years	6 days/weekly, 4 weeks	Yoga improves cardiorespiratory efficiency
Karthik et al., 2014 [26]	India	50 medical students (17–19 years)	30 min/day, 2 months	Yoga improves pulmonary functions
Pal et al., 2014 [27]	India	85 med students	1 h/day, 6 weeks	Right nostril breathing increases sympathetic activity. Left nostril breathing increases parasympathetic activity and promotes cardiovascular health.
Hm et al., 2012 [28]	India	60 med students (average 17.2 years)	N/A	Better sleep in Yoga groups.
Parshad et al., 2011 [29]	N/A	64 med student (21.3 ± 2.6 years)	6 weeks	Improves cardiovascular function. Proposes improvement in stress management (not supported by results)
Gopal et al., 2011 [30]	India	60 female medical students (17–20 years)	35 mins/day, 12 weeks	Yoga decreases physiological, autonomic, endocrine and psychological effects of examination stress.
K et al., 2017 [31]	India	100 med students (18.16 ± 0.38 years)	90 Days	Yoga reduces HR, SBP and DBP
Bharati, 2016 [32]	India	58 female med student	1 h/day, 5 day/week, 3 months	Yoga reduces PMS symptoms better compared to calcium carbonate
Lakshmi and Vaithianathan, 2022 [33]	India	30 (18–25 years)	12 weeks	Yoga significantly decreases HR and improved aggression
Chhetri et al., 2020 [34]	India	52 male med student (20 Yoga; 20 meditation)	20 mins	No significant change in cardiovascular parameters between Yoga and Meditation groups.
Thirupathi and K, 2016 [35]	India	60 male med students	45 min daily for 10 weeks	Yoga improves lung function
Mehta et al., 2018 [36]	India	36 med students	1h daily for 4 weeks	Yoga significantly lowers SBP and DBP
Monson et al., 2017 [37]	USA	77 Dental students	60 min biweekly for 13 weeks	Yoga reduces pain
Hc et al., 2015 [38]	India	60 med students	Yoga group has been practicing yoga for 1 year	Yoga for 1 year could reduce physiological arousal
Pandey et al., 2016 [39]	India	40 med students	1h daily, 3 months	Yoga decreases salivary cortisol, which could be used to manage stress
Lee et al., 2022 [40]	USA	64 med students	8 yoga sessions	Yoga reduced stress while not impacting exam score
Ahlers et al., 2021 [41]	USA	53 med students	20 hours of yoga in total	Virtual Wellness and Learning Communities program promotes medical student wellness
Nakashima et al., 2020 [42]	USA	108 med students	2, 30 min sessions	Yoga improves wellbeing, reduces burnout
Waechter et al., 2021 [43]	Grenada/USA	44 med students	12 weeks	No significant difference between Yoga or control group on stress, anxiety, psychological distress or academic performance
Nithiya and Palve, 2018 [44]	India	250 med students	1 month	significant decrease in anxiety, but not stress following yoga
Bansal et al., 2013 [45]	India	90 med students	45 min/day, 1 month	significant improvement in somatic symptoms, anxiety, social dysfunction, and depression following yoga.
Prasad et al., 2016 [46]	USA	27 med students	6 weeks	Yoga reduces stress and increases feelings of peace, focus and endurance
Simard and Henry, 2009 [47]	Canada	16 med students	16 weeks	Yoga decreases stress and improves general well-being
Shankarapillai et al., 2012 [48]	India	100 dental students	1 week	Yoga reduces stress
Sunita et al., 2022 [49]	India	105 female med students	40 min, 12 weeks	Yoga decreases anxiety, depression, and anger while increasing sense of wellbeing
Bond et al., 2013 [50]	USA	27 med students	Once/week, 11 weeks	Yoga increasing self-regulation and self-compassion. While not significant, it decreases perceived stress while increasing empathy
Erogul et al., 2014 [51]	USA	57 med students	20 min/day, 8 week	Yoga decreased perceived stress and increased self-compassion
Mehta and Taneja, 2013 [52]	India	36 med students	1h/day, 4 weeks	Yoga increases general well-being
Kukade and K, 2022 [53]	India	64 med students	1 h/day, 3 months	Yoga significantly improves happiness, psychological wellbeing, mindfulness, spiritual well-being, and sleep.
Alire et al., 2020 [54]	USA	77 dental students	90 min, for 10 weeks	Yoga significantly decreased stress-related symptoms
Singh et al., 2020 [55]	N/A	120 female dental students	40 min/day for 4 weeks	Yoga reduces stress. But yoga combined with motivational videos has a more substantial effect
Shapiro et al., 1998 [56]	USA	73 med students	2.5 h/week, 7 weeks	yoga group reported less depression, state anxiety, trait anxiety, GSI, and increases in empathy as well as spirituality
Danilewitz et al., 2016 [57]	Canada	30 med students	8, 1–1.5 hour weekly sessions	No significant result was found. However, it was suggested that peer-led yoga could improve wellbeing
Sreenivas et al., 2022 [58]	India	60 med students	30h of practice	Yoga improved attention and mental focus. It also could enhanced academic performance
Santhanam Kumar et al., 2020 [59]	India	20 med students	15 min	Yoga improved memory but had no significant effect on attention, processing speed, executive function or cognitive function.
Thomas and D, 2017 [60]	India	40 male med students	1 month	Yoga improves attentional control and working memory.
Kondam et al., 2017 [61]	India	80 med students	6 months	Yoga significantly improves memory, language fluency and visuospatial skills
Braun et al., 2019 [62]	USA	132 dental and dental hygiene students	1h	Yoga increases state mindfulness for students with high level of stress
P et al., 2018 [63]	India	100 med students	30 min, 5 days/week, 12 weeks	Yoga improves attention, concentration, and memory
Premalatha et al., 2021 [64]	India	73 dental students	6 days/week, 3 months	Yoga promotes academic performance
Shrestha et al., 2022 [65]	Nepal	176 med students	N/A (Questionnaire only)	Practicing yoga could help students to management their stress, increase their attention, and maintain physical and mental health.
Ankamreddy et al., 2019 [66]	India	150 med students	N/A (Questionnaire only)	Students have a positive outlook toward yoga but lack motivation.
Deshpande and Chari, 2016 [67]	India	116 med, 42 dental, 21 physiotherapy and 89 nursing students	2h/day, 5 days	Short term yoga practice did not significantly affect the perception of students toward the benefits of this activity
Nadig and Shah, 2020 [68]	India	206 dental students	N/A (Questionnaire only)	Wile 92% of students were aware of the benefits of yoga, only 35% practiced it regularly

Figure 2. Distribution of Articles Across Investigation Categories. A total of 47 articles were included in our analysis.

Figure 3. The Meta-analysis on the Effect of Yoga on systolic SBP (A), DBP (B), and HR (C) Among Medical and Dental Students.

Figure 4. The Meta-analysis on the Effect of Yoga on Stress (4A) and Anxiety (4B) Among Medical and Dental Students.

Table

Cardiovascular System	CVS
Systolic Blood Pressure	SBP
Diastolic Blood Pressure	DBP
Heart Rate	HR
Tidal volume	TV
Vital capacity	VC
Forced vital capacity	FVC
Forced expiratory volume (1 second)	FEV1
Peak expiratory flow rate	PEFR

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