The Effect of Yoga on Health-Related Fitness among Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Abstract

Background: There is a need for a type of physical activity that could address the challenging cycle of physical inactivity, impaired health-related fitness, and type 2 diabetes mellitus (T2DM) conditions. Yoga could be one type of exercise to overcome the barriers to adhere to regular physical activity. The current study aimed to systematically review the effect of yoga on health-related fitness, including cardiorespiratory fitness, muscle strength, body composition, balance, and flexibility, among patients with T2DM. Methods: We systematically searched four databases and two registries (Pubmed, Scopus, Cochrane, Embase, WHO-ITCRP, and Clinicaltrials.gov) in September 2021, following a registered protocol on PROSPERO (CRD42022276225). Study inclusion criteria were T2DM patients with or without complication, yoga intervention as a single component or as a complement compared to other kinds of exercise or an inactive control, health-related fitness, and a randomized, controlled trial or quasi-experimental with control group design. The ROBINS-I tool and ROB 2.0 tool were used to assess the risk of bias in the included studies. A vote-counting analysis and meta-analysis computed using random effects’ models were conducted. Results: A total of 10 records from 3 quasi-experimental and 7 randomized, controlled trials with 815 participants in total were included. The meta-analysis favored yoga groups compared to inactive controls in improving muscle strength by 3.42 (95% confidence interval 2.42 to 4.43), repetitions of chair stand test, and improving cardiorespiratory fitness by 6.6% (95% confidence interval 0.4 to 12.8) improvement of baseline forced vital capacity. The quality of evidence for both outcomes was low. Conclusion: Low-quality evidence favored yoga in improving health-related fitness, particularly muscle strength and cardiorespiratory fitness, among patients with T2DM. Funding: All authors in this systematic review received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Effects of Yoga on Blood Glucose and Lipid Profile of Type 2 Diabetes Patients Without Complications: A Systematic Review and Meta-Analysis

“…Despite the studies of systematic review and meta-analysis having been published previously (Ramamoorthi et al, 2019 ; Wibowo et al, 2021 ), the role of yoga in diabetes treatment, especially whether yoga can significantly improve blood glucose and lipid profile, was still under debate. Besides, most of the prior meta-analyses had included prediabetes or T2DM patients with other symptoms such as severe metabolic syndrome rather than merely patients with T2DM alone and rarely confirmed whether the patients have complications, making it difficult to generalize the results to other settings.…”

The BERN Framework of Mind-Body Medicine: Integrating Self-Care, Health Promotion, Resilience, and Applied Neuroscience

“…In fact, cognitive-behavioral, as well as relaxation, meditation, and other BERN practices can show an intimate connection to intracellular processes and signaling, including mitochondrial and chromosomal activation ( Figure 2 ; also see Esch et al, 2018 , 2020b ; Stefano et al, 2019a , b ). In this regard, as stated earlier, complex BERN and other mind-body techniques such as yoga have already demonstrated their neurobiological, psychoneuroendocrinological, and -immunological as well as physiological stress-reducing and health-promoting potential (Michalsen et al, 2005 ; Wolever et al, 2012 ; Posadzki et al, 2014 ; Cramer et al, 2015 , 2017 ; Pascoe et al, 2017 ; Shin, 2021 ; Koch et al, 2022 ; Wibowo et al, 2022 ).…”

“…The combination—practically the whole package of complete BERN-MBIs—has been around for a long time: in yoga, for example, the multifactorial practice of posture, movement, relaxation (meditation, breathing exercises), nutrition and even cognitive-mental techniques (visualizations, affirmations, etc.) was implemented long ago, and this “BERN” framework is also showing impressive effectiveness in modern medicine (Cramer et al, 2017 ; Shin, 2021 ; Wibowo et al, 2022 ).…”

Alternative Behandlungsverfahren bei Vorhofflimmern

“…Eine ganze Reihe von Studien zeigt auf, dass Yoga die gesundheitsbezogene Fitness verbessert, insbesondere die Muskelkraft und die kardiorespiratorische Fitness. Dies gilt nicht nur allgemein, sondern auch für Patienten mit Diabetes mellitus [ 42 ] und auch ältere Patienten [ 34 ].…”