A National Survey of Yoga Instructors and their Delivery of Yoga Therapy

Abstract

Yoga therapy may improve a variety of symptoms and health conditions, but little is known about how yoga therapy is being delivered in the real world. The purpose of this study was to describe the delivery of yoga therapy by yoga instructors across the U.S. In this cross-sectional survey, certified instructors were recruited from the Iyengar Yoga National Association, United States (IYNAUS) (n = 966) via an email that contained a link to an anonymous online survey that collected information on demographics, their delivery of yoga therapy, and the health conditions and symptoms seen and records kept by the instructors. A total of 487 instructors (50.4%) completed the survey. Instructors ranged from 28 to 82 years in age (m = 56.4 + 10.1 years) and had been teaching for 17.0 + 10.0 years. The majority (n = 384, 81.4%) reported teaching some form of therapeutic yoga either in groups (n = 261, 55%) and/or privately (n = 340, 73.4%). All instructors (100%) reported modifying poses in their regular yoga classes for students because of health conditions or symptoms. Other than attendance, the majority (n = 255, 57.3%) reported keeping no records on their sessions. Students came to instructors for help with over 54 health conditions, most commonly musculoskeletal conditions and injuries (n = 267, 62.8%), followed by pregnancy (n = 56, 13.2%) and hypertension (n = 22, 5.2%). Nearly all (n = 373, 85.6%) reported pain to be the symptom that brought students to yoga therapy most frequently. Whereas yoga in randomized controlled trials typically is delivered to individuals in large, homogenous groups, the instructors reported that most yoga therapy is being provided individually or in small, general therapeutic classes that include a variety of health conditions. Research is needed to examine the effectiveness of yoga therapy under such conditions. A clear set of guidelines for assessing and documenting the effectiveness of yoga therapy using standardized, valid, and reliable methods is needed, particularly for pain-related conditions.

Characteristics of Yoga Providers and Their Sessions and Attendees in the UK: A Cross-Sectional Survey

“…We have provided a contemporary description of yoga providers and their practice across the country; we found that yoga providers were mostly aged 45–64 years, female and white, and yoga was mostly practiced by women. The predominance of women in both delivery and practice in the UK is similar to that seen in previous surveys here [ 34 , 38 ] and other high-income countries [ 26 , 27 , 39 ] and contrasts with findings from India where practitioners were more likely to be men [ 40 , 41 ]. The potential reason for the popularity of yoga among men in India might be that the roots of yoga and the growth of yoga as a practice were predominantly in males [ 42 ].…”

“…This study showed that attendees commonly disclosed their health conditions, and the high rate of disclosure suggests that yoga providers were generally aware of the health conditions of their attendees. The most commonly disclosed health conditions in yoga sessions were mental health issues and hypertension, both in our study and in studies from the UK and other countries [ 34 , 38 , 39 ]. There is growing evidence on the benefits of yoga for a variety of health conditions, including mental health conditions [ 10 , 46 ] and hypertension [ 11 ], and yoga is commonly being used as a way for supporting well-being and managing a variety of health issues [ 34 ].…”

The Implementation of Patient-Reported Outcome Measures in Yoga Therapy

“…Evaluating the impact of PROs on tre a t m e n t . According to the national yoga therapy survey published in this edition (Ross et al, 2016), nearly all of the yoga instructors surveyed reported that pain was the most common symptom that motivated individuals to seek yoga therapy. This may mean that pain should be included routinely in PRO measurement in yoga therapy.…”

“…Yoga therapists are interested in knowing whether their therapeutic interventions are helpful in improving health and wellbeing in their yoga therapy clients. A national survey of yoga instructors published in this journal revealed that nearly all instructors ask their clients whether their therapeutic interventions are effective (Ross, 2016). Yet fewer than half of these instructors maintain any type of records other than attendance, and less than 2% use a valid, standardized questionnaire to assess the effectiveness of yoga therapy (Ross, 2016).…”