A systematic review and meta-analysis to determine the effect of pranayama in reducing anxiety and stress in adolescents.

Abstract

Background: Pranayama has garnered increasing attention in recent years due to its potential therapeutic effects on mental and physical health. However, a lack of age-specific synthesis of its efficacy, especially among adolescents, highlights the need for focused evaluation in this population. Therefore, this study aims to systematically review and meta-analyze (SRMA) the effectiveness of pranayama in reducing stress and anxiety in adolescents.

Methods: A systematic search was done on four databases, namely, the Cochrane Library, Medline (PubMed), Embase, and Web of Science, for articles published between 1st January 2015 and 31st December 2024. Independent screening of the articles was done by two reviewers, and duplicates were removed using NESTED Knowledge. Quality assessment of the studies was done using Cochrane and the JBI tools. A meta-analysis was undertaken in "Comprehensive Meta-Analysis (CMA)" software, and heterogeneity was evaluated using the I² statistic.

Results: Eighteen studies were included in this SRMA of which 11 were RCTs and 7 were quasi-experimental studies. The overall standardized mean difference (SMD) was -1.166 [95 % CI: -1.979 to -0.353], indicating a moderate effect on stress reduction in favor of deep breathing. GRADE assessment revealed very low certainty of evidence due to serious concerns in the risk of bias, inconsistency, and imprecision domains.

Conclusions: Integrating pranayama into adolescents' daily lives can help reduce their anxiety and stress levels. Rigorous research is required to generate good quality scientific evidence in this field.