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Meta-Analysis
. 2023 Jul 12;13(7):e064758.
doi: 10.1136/bmjopen-2022-064758.

Mind-body exercise interventions for prevention of post-traumatic stress disorder in trauma-exposed populations: a systematic review and meta-analysis

Leona Tan  1   2 , Jessica Strudwick  2 , Mark Deady  2 , Richard Bryant  3 , Samuel B Harvey  2
Affiliations
Meta-Analysis

Mind-body exercise interventions for prevention of post-traumatic stress disorder in trauma-exposed populations: a systematic review and meta-analysis

Leona Tan et al. BMJ Open. .

Abstract

Objective: Mind-body exercise (MBE) interventions, such as yoga, are increasingly recognised as an adjunct treatment for trauma-related mental disorders but less is known about their efficacy as a preventative intervention. We aimed to systematically review if, and what type of, MBE interventions are effective at preventing the development of post-traumatic stress disorder (PTSD) or acute stress disorder (ASD) in trauma-exposed populations.

Design: Systematic review and meta-analysis.

Methods: A systematic search of MEDLINE, PsycINFO, EMBASE and CENTRAL databases was conducted to identify controlled trials of MBE interventions aimed at preventing the development of PTSD or ASD in high-risk populations. Risk of bias was assessed using the revised Cochrane risk-of-bias and ROBINS-I tools. Pooled effect sizes using Hedges' g and 95% CIs were calculated using random effects modelling for the main meta-analysis and planned subgroup and sensitivity analyses.

Results: Six studies (N analysed=399) were included in the final meta-analysis. Overall, there was a small effect for MBE interventions in preventing the development of PTSD (g=-0.25, 95% CI -0.56 to 0.06) among those with previous or ongoing exposure to trauma. Although a prespecified subgroup analyses comparing the different types of MBE intervention were conducted, meaningful conclusions could not be drawn due to the small number of studies. None of the included studies assessed ASD symptoms.

Conclusion: Limited evidence was found for MBE interventions in reducing PTSD symptomology in the short term. Findings must be interpreted with caution due to the small number of studies and possible publication bias.

Prospero registration number: CRD42020180375.

Keywords: Adult psychiatry; Anxiety disorders; MENTAL HEALTH; PSYCHIATRY.

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Conflict of interest statement

Competing interests: LT, JS, RAB, MD and SBH declare support from the Australian Government, the icare Foundation and New South Wales Health for the submitted work. MD and SBH are employed by the Black Dog Institute, a not-for-profit research institute that provides mental health training to a range of organisations.

Figures

Figure 1
Figure 1
Flow diagram of screening and selection process. MBE, mind-body exercise; NRCT, non-randomised controlled trial; PTSD, post-traumatic stress disorder; RCT, randomised controlled trial.
Figure 2
Figure 2
Forest plot of the effect of mind-body exercise interventions on symptoms of post-traumatic stress disorder.
See this image and copyright information in PMC

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