Effects of Yoga Intervention in Children: A Systematic Review of the Literature
Stephanie Prinsen, SPT and Austin Krier, SPT
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16 Comments on “Effects of Yoga Intervention in Children: A Systematic Review of the Literature”
First off, I think you all did a wonderful job of thoroughly researching a topic that could have a lot of benefits to our youth if people choose to really start utilizing it effectively! We recently discussed the effectiveness of yoga in class the other day, and one of the big things Dr. Zimney talked about was the different levels of yoga. For instance, while some people simply do it for the workout, others make it more of a lifestyle and implement the more spiritual side of it as well. That being said, did these studies discuss what level of yoga they had their subjects utilizing? Was it simple exercises/stretches, or was it an entire spiritual lifestyle? Again, thank you for sharing this fascinating information!
Hi Kelsey- awesome question! None of our articles specified the “level” of yoga that was being practiced. Due to the nature of working with children the studies that expanded on their program outlined very simple step-by-step instructions as to what postures to perform and what to focus on- so yes, simple postures and breathing routines. A few yoga programs did incorporate some education on coping/stress management – however none of the yoga programs addressed spiritual belief systems or faith practices. Although, this would be an interesting area to look into considering our aim to provide holistic care!
Great job on the research! Very interesting and applicable information for PT’s. I noticed that most of the studies implemented the yoga interventions for 6-8 weeks with the exception of a few longer and shorter studies. Was there any acknowledgement on the appropriate dosage (frequency, intensity,duration) of yoga for kids with/without disabilities? Also, what might be some good tips/tricks to get your adolescent patient excited and on board about a possible HEP? Thanks for sharing your findings!
Hey Chloe – this is a great question. Interestingly enough, the majority of the studies did not provide a justification as to why they chose the dosage they did. The few studies that did based their numbers on previously ran pilot studies. Currently, there’s not enough standardization across these studies to determine proper dosage. We need the program to be standardized, the outcome measures, and the tools measuring the outcome measures to be standardized. The other big player in this is the lack of reported treatment integrity. In other words, did the yoga program actually get carried out the way they said it did? This is especially important in children with disabilities, as we know behaviors and other confounding variables can occur that get in the way of our program- what good is prescribing a 16 week yoga program based off a certain study when for all we know only 50% of the sessions were actually attended.
I know as PT’s we want to know the dosage and be able to educate patients on what they need to and when they need to do it. However, I would not think of yoga as a cure that needs a prescription rather as a tool and a coping strategy that patients can use as they find beneficial for them. You will end up meeting the child wherever they are at in terms of how much they can handle and process, building up from there, and finding that “sweet spot” for them based on feedback.
And yes! If you are interested in teaching it or getting your hands on some materials there is tons out there! Some of the curriculum our studies utilized were: Mindfulness Based Stress Reduction, Transformative Life Skills, YogaEd, If I Was a Bird Yoga, and Get Ready to Learn.
Great job on the poster presentation of your research! Was there a certain population of children that had seen greater effectiveness from the yoga programs than another? Was it more beneficial for children with a specific disability/medical condition?
Hey Courtney – this is an important question however not one I am able to make claims to. In order to do this, outcome measures, yoga programs, and disorders would have to be standardized across multiple studies and I believe a meta-analysis would have to be performed! Dr. Karges can correct me if I’m wrong!
Awesome research Steph and Austin! You guys did a nice job keeping all this information concise and making the poster clean and easy to read. I noticed there were many different types of outcome measures used for the various studies. How do you think this affected the results of your findings? For example, some studies utilized effects of ADHD as an outcome of the yoga intervention, but since yoga has so many positive effects as you mentioned, do you think there were many other positive effects of the intervention that were not seen because of the outcomes measure used?
Dr. Berg-Poppe gets full credit for the conciseness and cleanliness of our poster! And you’re right, so many outcome measures! The problem this creates is that it is difficult to generalize results when we are measuring a certain outcome measure in 10 different ways- another layer on top of this is that many of the outcome measures are subjective outcome measures such as child, teacher and parent report. These add another layer of bias if blinding was not done (which, in many cases it wasn’t).
To the last part of your question, I believe there are many positive benefits that the RCT research cannot capture. With some of my past 1st graders on the autism spectrum, I was able to see how yoga allowed them to have a moment for themselves – this is something that RCT’s have a hard time measuring and speak more to the power of case studies and qualitative research.
This was a great topic which could really add to pediatric research! I noticed that you listed your inclusion criteria as any individual under the age of 21. When considering research involving both typical and/or atypically developing children, did you notice any variations in yoga interventions utilized with younger children compared to studies involving early or late adolescents?
Great question Cayla! All of the studies really focused on the basic postures, breathing, stretching, etc. of yoga even given that freq/duration were all over the board. It would have to be assumed that researchers varied the delivery of the yoga program based on their audience. For example, some studies incorporated pictures with younger populations. However, this leads to a bigger limitation in all of the studies which is lack of treatment integrity or are the researchers carrying out the intervention like they said they did. And in order to measure treatment integrity the methods in which the intervention is being carried out need to be explicitly stated, which very few of our studies did.
Out in practice, it would be helpful to see what specific adaptations were used for certain children in order to utilize them – unfortunately, very few studies went into this much depth especially the studies with atypically developing children.
Great research guys! My main question is why did you decide to examine/include children under the age of 21 rather than children younger than 8 or 10 even? Or if you are going to include children under the age of 21 do you think you would have seen different results had you compared 2 separate groups such as younger and older children?
This is a good question – most of the research was done in children under twelve or so. There were some studies looking at teenagers too. I think it would be interesting to split up even toddlers from children- since there is so much maturation between 3 years and 8 years!
My justification for including people up to age 21 is that school systems allow people with disabilities (at least in MN) to stay in school up to 21 years of age. So, if it was a school base program like some were, this would allow us to include if it had someone over the age of 18!
I think the results would be more definitive and specific if we broke it down by age range, for sure!
Very interesting research topic! I really enjoy yoga and have noticed many of the benefits you listed. My question for you two is how are you going to incorporate this research into your future practice? Additionally, how might you educate patients/parents on the benefits of yoga interventions if they have reservations due to the spiritual aspects some people may associate with yoga?
Stephanie and Austin, I see that one of the listed references included in the systematic review looked at mindfulness and the impact on stress and anxiety. Did you find any information that compared yoga routines that included mindfulness vs yoga routines that did not incorporate mindfulness and the effects it had on outcomes in children?
Great topic and I really enjoyed how you laid the ground work for what studies need to take place next to help further the understanding of the benefits of yoga in this population. I was wondering what outcome measures you found specifically from the teachers prospectives on student behaviors, interaction, etc., since they were noted to be significant? Based on these results, do you think it would be potentially beneficial to implement a dance/yoga class into elementary school?
This is such an interesting topic of study! I was wondering if you saw any trends in the literature of the sequence of yoga/mindful mediation practiced in the studies? I know that was not part of the original purpose but I think it would make for useful research to determine if any yoga sequence is beneficial versus a specific sequence. I am excited about the potential for yoga to be implemented in pediatric therapy sessions.
USD PT Research 
First off, I think you all did a wonderful job of thoroughly researching a topic that could have a lot of benefits to our youth if people choose to really start utilizing it effectively! We recently discussed the effectiveness of yoga in class the other day, and one of the big things Dr. Zimney talked about was the different levels of yoga. For instance, while some people simply do it for the workout, others make it more of a lifestyle and implement the more spiritual side of it as well. That being said, did these studies discuss what level of yoga they had their subjects utilizing? Was it simple exercises/stretches, or was it an entire spiritual lifestyle? Again, thank you for sharing this fascinating information!
LikeLike
Hi Kelsey- awesome question! None of our articles specified the “level” of yoga that was being practiced. Due to the nature of working with children the studies that expanded on their program outlined very simple step-by-step instructions as to what postures to perform and what to focus on- so yes, simple postures and breathing routines. A few yoga programs did incorporate some education on coping/stress management – however none of the yoga programs addressed spiritual belief systems or faith practices. Although, this would be an interesting area to look into considering our aim to provide holistic care!
LikeLike
Great job on the research! Very interesting and applicable information for PT’s. I noticed that most of the studies implemented the yoga interventions for 6-8 weeks with the exception of a few longer and shorter studies. Was there any acknowledgement on the appropriate dosage (frequency, intensity,duration) of yoga for kids with/without disabilities? Also, what might be some good tips/tricks to get your adolescent patient excited and on board about a possible HEP? Thanks for sharing your findings!
LikeLike
Hey Chloe – this is a great question. Interestingly enough, the majority of the studies did not provide a justification as to why they chose the dosage they did. The few studies that did based their numbers on previously ran pilot studies. Currently, there’s not enough standardization across these studies to determine proper dosage. We need the program to be standardized, the outcome measures, and the tools measuring the outcome measures to be standardized. The other big player in this is the lack of reported treatment integrity. In other words, did the yoga program actually get carried out the way they said it did? This is especially important in children with disabilities, as we know behaviors and other confounding variables can occur that get in the way of our program- what good is prescribing a 16 week yoga program based off a certain study when for all we know only 50% of the sessions were actually attended.
I know as PT’s we want to know the dosage and be able to educate patients on what they need to and when they need to do it. However, I would not think of yoga as a cure that needs a prescription rather as a tool and a coping strategy that patients can use as they find beneficial for them. You will end up meeting the child wherever they are at in terms of how much they can handle and process, building up from there, and finding that “sweet spot” for them based on feedback.
And yes! If you are interested in teaching it or getting your hands on some materials there is tons out there! Some of the curriculum our studies utilized were: Mindfulness Based Stress Reduction, Transformative Life Skills, YogaEd, If I Was a Bird Yoga, and Get Ready to Learn.
LikeLike
Great job on the poster presentation of your research! Was there a certain population of children that had seen greater effectiveness from the yoga programs than another? Was it more beneficial for children with a specific disability/medical condition?
LikeLike
Hey Courtney – this is an important question however not one I am able to make claims to. In order to do this, outcome measures, yoga programs, and disorders would have to be standardized across multiple studies and I believe a meta-analysis would have to be performed! Dr. Karges can correct me if I’m wrong!
LikeLike
Awesome research Steph and Austin! You guys did a nice job keeping all this information concise and making the poster clean and easy to read. I noticed there were many different types of outcome measures used for the various studies. How do you think this affected the results of your findings? For example, some studies utilized effects of ADHD as an outcome of the yoga intervention, but since yoga has so many positive effects as you mentioned, do you think there were many other positive effects of the intervention that were not seen because of the outcomes measure used?
LikeLike
Dr. Berg-Poppe gets full credit for the conciseness and cleanliness of our poster! And you’re right, so many outcome measures! The problem this creates is that it is difficult to generalize results when we are measuring a certain outcome measure in 10 different ways- another layer on top of this is that many of the outcome measures are subjective outcome measures such as child, teacher and parent report. These add another layer of bias if blinding was not done (which, in many cases it wasn’t).
To the last part of your question, I believe there are many positive benefits that the RCT research cannot capture. With some of my past 1st graders on the autism spectrum, I was able to see how yoga allowed them to have a moment for themselves – this is something that RCT’s have a hard time measuring and speak more to the power of case studies and qualitative research.
LikeLike
This was a great topic which could really add to pediatric research! I noticed that you listed your inclusion criteria as any individual under the age of 21. When considering research involving both typical and/or atypically developing children, did you notice any variations in yoga interventions utilized with younger children compared to studies involving early or late adolescents?
LikeLike
Great question Cayla! All of the studies really focused on the basic postures, breathing, stretching, etc. of yoga even given that freq/duration were all over the board. It would have to be assumed that researchers varied the delivery of the yoga program based on their audience. For example, some studies incorporated pictures with younger populations. However, this leads to a bigger limitation in all of the studies which is lack of treatment integrity or are the researchers carrying out the intervention like they said they did. And in order to measure treatment integrity the methods in which the intervention is being carried out need to be explicitly stated, which very few of our studies did.
Out in practice, it would be helpful to see what specific adaptations were used for certain children in order to utilize them – unfortunately, very few studies went into this much depth especially the studies with atypically developing children.
LikeLike
Great research guys! My main question is why did you decide to examine/include children under the age of 21 rather than children younger than 8 or 10 even? Or if you are going to include children under the age of 21 do you think you would have seen different results had you compared 2 separate groups such as younger and older children?
LikeLike
This is a good question – most of the research was done in children under twelve or so. There were some studies looking at teenagers too. I think it would be interesting to split up even toddlers from children- since there is so much maturation between 3 years and 8 years!
My justification for including people up to age 21 is that school systems allow people with disabilities (at least in MN) to stay in school up to 21 years of age. So, if it was a school base program like some were, this would allow us to include if it had someone over the age of 18!
I think the results would be more definitive and specific if we broke it down by age range, for sure!
LikeLike
Very interesting research topic! I really enjoy yoga and have noticed many of the benefits you listed. My question for you two is how are you going to incorporate this research into your future practice? Additionally, how might you educate patients/parents on the benefits of yoga interventions if they have reservations due to the spiritual aspects some people may associate with yoga?
LikeLike
Stephanie and Austin, I see that one of the listed references included in the systematic review looked at mindfulness and the impact on stress and anxiety. Did you find any information that compared yoga routines that included mindfulness vs yoga routines that did not incorporate mindfulness and the effects it had on outcomes in children?
LikeLike
Great topic and I really enjoyed how you laid the ground work for what studies need to take place next to help further the understanding of the benefits of yoga in this population. I was wondering what outcome measures you found specifically from the teachers prospectives on student behaviors, interaction, etc., since they were noted to be significant? Based on these results, do you think it would be potentially beneficial to implement a dance/yoga class into elementary school?
LikeLike
This is such an interesting topic of study! I was wondering if you saw any trends in the literature of the sequence of yoga/mindful mediation practiced in the studies? I know that was not part of the original purpose but I think it would make for useful research to determine if any yoga sequence is beneficial versus a specific sequence. I am excited about the potential for yoga to be implemented in pediatric therapy sessions.
LikeLike