OA13.01
Purpose: While yoga is gaining increased popularity in North America and Europe, its safety has been questioned in the lay press. The aim of this systematic review was to assess published case reports and case series on adverse events associated with yoga.
Methods: Medline/Pubmed, Scopus, CAMBase, IndMed and the Cases Database were screened through August 2013. A specific practice was regarded as ‘yoga’ if it was a) explicitly labeled as yoga, b) labeled as a specific yoga practice, and/or c) the described practice clearly resembled typical yoga practices. Adverse events were classified as yoga-associated if they appeared in temporal connection with yoga practice and/or a causal relationship was assumed in the report.
Results: Out of 741 records, 37 case reports and 2 case series reporting a total of 78 cases were included. Eleven cases had medical preconditions, mainly glaucoma (n=3; 3.8%), and osteopenia (n=3; 3.8%). Pranayama (n=4; 5.1%), hatha yoga (n=3; 3.8%), and Bikram yoga (n=3; 3.8%) were the most common yoga practices; headstand (n=11; 14.1%), forceful breathing (n=4; 5.1%), shoulder stand (n=3; 3.8%), and lotus position (N=3; 3.8%) were the most common yoga postures and breathing techniques cited. Twenty-eight adverse events (36.8%) affected the musculoskeletal system; 14 (17.9%) the nervous system; and 9 (11.5%) the eyes. Sixteen cases (20.5%) reached full recovery; 9 cases (11.5%) partial recovery; 1 case (1.3%) no recovery; and 1 case (1.3%) died. Fifty-one cases (65.4%) did not report clinical outcomes.
Conclusion: As with any physical or mental practice, yoga should be practiced carefully under the guidance of qualified instructors. Beginners should avoid extreme practices such as headstand, lotus position and forceful breathing. Individuals with medical preconditions should work with their physician and yoga teacher to appropriately adapt postures; patients with glaucoma should avoid inversions and patients with compromised bone and other musculoskeletal disorders should avoid forceful yoga practices.
Contact: Holger Cramer, h.cramer@kliniken-essen-mitte.de
