Table 2.

Systematic review included studies and data extracted from randomised control trials.

Author, Year City & Country	Sample	Intervention & Taxonomy	Control group	Duration	Evaluation	Outcome	Findings	Risk of bias
Anusuya et al., 2021  Tamilnadu  India	14 – 16 years n = 30 yoga n = 30 control (Shavasana supine rest) n = 30 males n = 30 females Total: 60	Mind Sound resonance technique (MSRT) a yoga-based relaxation technique that uses mantra (A, U, M, Om, and Maha-Mrityunjaya Mantra/Chanting) to generate resonance, which is Used to induce deep relaxation	Routine activities, along with supine rest (SR), for a similar duration of MSRT.	30 minutes a day. 6 days a week for 2 weeks	Participants were assessed with state trait anxiety inventory - short form, Mind Wandering (MQW) A questionnaire, state mindfulness attention awareness Scale, and Trail-making task at baseline and post-intervention.	Evaluate a yoga-based relaxation technique’s efficacy as an extracurricular activity on the psychological state (stress, anxiety) and cognitive function.	The study results revealed a significant reduction in anxiety and mind wandering with an increased state of mindfulness, awareness, attention, and working memory in school children.	Some concerns
Bazzano et al., 2018  New Orleans, USA	8 – 9 yearsn = 20 Yoga n = 32 control Males = NI Females = NI Total:52	Yoga education an evidence-based urriculum for utilising yoga in the classroom	32 students, received care as usual – limited information.	40 minutes a day, 400 total minutes over 8 weeks	The brief Multidimensional students’ life Satisfaction Scale-Peabody treatment Progress Battery and the Pediatric quality of life Inventory (PedsQL) student surveys post, mid intervention.	Improve the well-being of students by incorporating dual yoga and mindfulness programming into the school, measuring stress, self-esteem, depression and anxiety.	Students who received the intervention demonstrated significantly improved psychosocial and emotional quality of life compared with their peers who received standard care.	Some concerns
Bhardwaj & Agrawal 2013  Haridwar  India	10 –12 years n = 22 yoga n = 22 control group n = 26 males n =18 females Total: 44	Pranayama – breathing Bhastrika - rapid & forceful inhalation & exhalation Anulom-vilom Alternate nostril breathing Bhramri - Bumblebee Breath Various asanas – postures	Control group received no intervention.	35 minutes one month 6 days a week (except Sunday)	Indian adaptation of Battle’s self-esteem inventory for children (self-reported questionnaires) – post & pre-intervention	Develop an intervention plan based on yoga for pre-adolescent school children to enhance their self-esteem, body image and stress reduction.	The yoga group showed a significant increase in the level of total self-esteem, general self-esteem & social self-esteem.	Some concerns
Butzer et al., 2017  New YorkUSA	12 years n = 117 yoga n = 94 Control PE class n = 77 males n = 132 females Total: 209	Kripalu -meditation & breathwork Postures Sun salutations Alom vilom - Alternate nostril breathing Relaxation	P.E. as usual – no yoga was practised by control group	35 minutes twice a week for 6 months	Yoga Evaluation Questionnaire (YEQ) created by the authors Qualitative questionnaires, quantitative interviews – post-intervention & six weeks after intervention	To test the efficacy of yoga for stress management, self-esteem, emotional regulation, self-appreciation, confidence and substance misuse	Direct comparisons between the yoga intervention and PE, students' perceptions of the actual yoga lessons were mixed. Yoga may have a number of beneficial effects on factors such as relaxation, stress, mood, self-regulation, social interaction, sleep, substance use, and academic performance. Females in the study tended to experience significant long-term benefits from participating in yoga more than males.	Some concerns
Conboy et al., 2013  Western Massachusetts USA	9 – 15 years n = 47 yoga n = 25 control PE Male = NI Female = NI Total: 72	Kripalu -meditation & breathwork postures, breathing exercises, deep relaxation & meditation techniques	Regular scheduled P.E. class - no yoga was practised by control group	30 minutes 2-3 times a week for 12 weeks	Evaluation questionnaire created by the authors self-reported questionnaires qualitative interviews post & pre-intervention	Psychosocial well-being & coping/self-regulatory skills, including mood, stress, anxiety, emotion regulation, mindfulness, self-esteem, anger & positive psychology.	Students reported individual benefits, improved academic & athletic performance social benefits, such as reduced reactivity to stressful social situations. Findings support yoga’s potential to improve mental health at the individual level.	High
Daly et al., (2015)  New York  USA	15 – 16-year-olds (one 17-year-old) n = 19 PE control n = 19 yoga n = 23 male n = 14 female Total: 38	Yoga postures, Breathing, relaxation Guided meditation	P.E. classes involved football and baseball, walking and running, relays, and other socially focused activities.	40 minutes 3 times a week for 16 weeks	Emotion regulation Index for children and adolescents (ERICA) a 16-item self-report measure completed by the child. Mindful attention awareness Scale, Self-compassion Scale, Multidimensional Assessment of Interoceptive Awareness	Examine the effects of yoga on a group of adolescents' emotion regulation & to determine if mindful awareness, self-compassion & body awareness contributed to positive changes	Findings suggested that yoga significantly affects the emotion regulation capacities of adolescents that are not present in P.E. alone. There was a low response rate for teachers’ questionnaires.	High
Fishbein et al., 2016  New York  USA	9 – 12 years n = 45 yoga n = 40 control regular class Male = NI Female = NI Total: 85	Hatha yoga: postures, breathing exercises, deep relaxation & meditation techniques Vinyasa - linking all the yoga poses together	Control group received no intervention. The school did not offer regular P.E. classes.	20 sessions – 3 times a week for 50 minutes	Questionnaire Multi-rater (student, teacher), multi-method (survey, cognitive, psychophysiological) data collected before & after the yoga curriculum.	To examine if yoga practice will reduce substance use (alcohol, marijuana, illicit drugs), & improve cognitive behaviour & lead to improved psychophysiological responses to stress, anger and mood are reflected in indicators such as respiratory sinus arrhythmia, heart rate, and skin conductance.	Students who received the yoga intervention, as compared to the control condition, reported decreased alcohol use; were rated by their teachers as having significant increase in social skills; and exhibited a non-significant increase in sustained attention during a stressful task. Positive outcomes, such social skills, were improved by yoga. Increases in prosocial behaviours, such as complementing others, encouraging others, offering assistance, and attempting to bring out the best in people, were seen in the intervention group.	High
Frank et al., 2017  California  USA	9th, 10th, 11th & 12th-grade students n = NI yoga intervention n = NI business- as-usual control n = 81 male n = 74 female Total: 159	Transformative life skills (TLS), a yoga and mindful awareness-based program - postures, breathing exercises, meditation	Business-as-usual with no information about the control	30 minutes per day, 3–4 times per week for 12 weeks	Attitudes toward violence Scale, positive and negative affect schedule for children (PANAS-C) - a 27-item self-report scale, Responses to stress Questionnaire (RSQ). The somatic complaints’ subscale, Self-reported questionnaires	Examine the acceptability & effectiveness of a yoga & mindful awareness-based program on at-risk adolescent students emotional distress & prosocial behaviour.	Significant improvements were seen in school engagement & concurrent reductions in unexcused absences & detentions. Findings suggest promise for yoga-based programs to enhance adolescent emotion regulation & serve as a protective factor against the onset & progression of mental health. Sustained duration or increased dosage may be required to impact more general indices of overall mood & affect significantly.	High
Gaurav et al., 2013  Pune  India	16 years n =30 yoga n =30 control business as usual Male only Total: 60	Asanas – Postures Sarvangasana – Shoulder stand Halasana – Plough Pose Bhujangasana - Cobra Pose Shalabhasana - Locust pose Dhanurasana - Bow pose Ardha-Matsyendrasana - Half Lord of the Fishes pose Paschimatanasana - Seated Forward Bend Mayurasana – peacock pose Shavasana - Corpse Pose Yoga Mudra - h& gestures Bhastrika - rapid & forceful inhalation & exhalation Kapalabhati – breath of fire Pranayama – breathing	Control group participated in daily school schedule, there was no information on what business as usual was.	6 days a week, 1 hour in the morning & 1 hour in the evening except for Sundays & public holidays for 6 weeks.	Student examination anxiety scale – self-scored test questionnaires. The total number of items on this scale were 48, divided into three categories, i.e. Anxiety, Depression & stress.	The effect of yoga training on examination anxiety, depression & academic stress among students appearing for board examination.	Significant difference between the control and experimental groups in almost all the variables. Yoga practices significantly improved overall psychological parameters. Yoga training may help to control pre-examination anxiety, depression & academic stress & may improve exam results. A repeated study on students appearing for different competitive examinations was further suggested.	Some concerns
Haden et al.,2014  New York  USA	11 years n = 15 yoga n = 15 control PE class Male = NI Female = NI Total: 30	Ashtanga-informed yoga practice - breathing postures, mediation Vinyasa flow - linking all the poses together for one breath Savasana - body awareness	P.E group did soccer and volleyball, indoor walking program to encourage moderate levels of physical activity	3 times a week, 30 minutes per session for 12 weeks	Positive and negative affect Scales [PANAS] for children, Child behaviour Check List [CBCL] completed by parents. Self-perception Profile for children [SPPC], Warwick-Edinburgh mental well-being Scale (WEMWBS) Self-reported questionnaires for both parents & children. Home practice was encouraged.	Determine the effects of yoga on children’s emotional & behavioural Functioning, stress, anger, depression, somatic complaints, anxiety & self-esteem when compared with P.E. classes	Yoga & P.E. did not significantly impact middle school children’s functioning, possibly due to inadequate sample size, an inadequate dose of the intervention & failure to measure mindfulness & body awareness & failure to gain enthusiasm from school personnel.	Some concerns
Hagins & Rundle, 2016  New York  USA	9th, 10, and 11th- grade students Mean age 5 years n = 48 yoga n = 64 control PE class Male = NI Female = 54 Total: 112	mindfulness & yoga-based exercises	P.E. class included weightlifting, stationary biking, jumping jacks, push-ups, and games such as soccer and volleyball.	40 minutes twice a week over a total of 58 classes. Every 4 weeks, a thematic unit introduced across the academic year	Response to stress questionnaire (RSQ), teacher and student versions of the behaviour Rating Inventory of Executive function (BRIEF), Self-reported questionnaires measured stress, emotional regulation & executive function.	Examine the effects of a year-long school-based yoga program on academic performance & explore potential mediating effects of emotional regulation & stress.	Students assigned to yoga classes had a significantly higher GPA. In focus groups at the end of the year, yoga students expressed improvements in self-regulation & decreases in mental stress. Authors suggested that if yoga genuinely alters self-regulation, studies should optimally measure not only self-report but also observational behavioural measures & physiological measures (e.g., response to stress, heart rate variability).	Some concerns
Hagins et al., 2013  New York  USA	10 years n = 15 yoga 10 male & 5 Female n = 16 control PE 7 male & 8 Female Total: 31	Breathing Asana – posture Vinyasa - linking all the poses together Savasana - body scan	yoga and P.E. classes occurred for the same duration and frequency and at the same time of day throughout the study. PE class included games such as soccer and volleyball.	50 minutes per session – 3 times a week for 15 weeks	The mental arithmetic task (MAT) measuring stress reactivity in children: Heart rate & Blood pressure post-intervention Self-reported questionnaires from children & parents	Measure if a yoga program can significantly reduce stress reactivity compared to P.E. class & explore the feasibility of implementing behavioural stressors in a New York city public school.	15 weeks of the yoga program did not provide significant differences in stress reactivity compared to P.E. control group.	Some concerns
Halliwell et al., 2018  South West England, United Kingdom	9 – 11 years n = 190 yoga n = 154 control PE class Total: 344 girls, no data on boys	Warrior pose Downdog, Crab, Cobra, Updog, Plank, Locust, Dolphin, Boat, Eagle, Tree, Forward Folds, Chair, Airplane, Bridge, breathing exercise humming, Relaxation	The control group attended P.E. lessons as usual.	40 minutes weekly for 4 weeks	The Appearance subscale of the body esteem Scale for children, the body Surveillance subscale of the Objectified body consciousness Scale-youth, body Appreciation Scale-2 for children, the positive and negative affect Scale for children	Impact of a 4-week yoga intervention on pre-adolescents' body image and mood. All participants completed the postintervention questionnaires 1 week after the final yoga session and follow-up questionnaires 6 weeks later.	Significant improvements in body image and mood across the yoga and the P.E. control group. While P.E. was conceptualised as a placebo control condition, it may have been an intervention, prompting positive effects on body image and mood. Yoga delivered once a week for 4 weeks may not be sufficient to afford benefits over P.E.	High
Khalsa et al., 2012  oston  USA	15 – 19 years mean age = 16.8 n = 74 yoga n = 47 control PE class n = 70 male n = 51 male Total: 121	Kripalu yoga - postures, breathing, relaxation, meditation, awareness	P.E. classes-as-usual group - no treatment control	30–40 minutes 2-3 sessions per week over 11 weeks	The self-report of Personality (SRP) version of the behaviour Assessment Survey for children Version 2 (BASC-2) for children, the resilience Scale (RS), the perceived stress Scale (PSS), the Inventory of positive psychological Attitudes-32R (IPPA). Self-report questionnaires measuring mood, anxiety, perceived stress, resilience & other mental health variables	The benefits of yoga on mental health, anger management & stress	Yoga participants showed statistically significant differences over time compared to control group on measures of anger control and fatigue/inertia. Yoga interventions are feasible in a school setting within the school curriculum. Generally, positive qualitative feedback suggested that the yoga intervention was perceived as an acceptable practice by parents and students in the school setting.	High
Mendelson et al., 2010  Baltimore  USA	10 – 15 years n = 51 yoga n = 46 control wait list Male = NI Female = 59 Total: 97	Asanas - postures Breathing meditation	Control group received no intervention.	45 minutes 4 days per week for 12 weeks	Depressive symptoms the short mood and feelings Questionnaire—child Version, positive and negative emotions the emotion Profile Inventory (EP), Relations with peers and school people in My life (PIML), the Responses to stress Questionnaire – focus groups with children and teachers	To evaluate the feasibility & acceptability of yoga intervention & to assess its promise for improving stress, cognitive & emotional regulation	Yoga group reported significant improvements on problematic physiological & cognitive patterns of response to stress among youth. Yoga showed promise in implementation in urban public schools.	High
Noggle et al., 2012  Western Massachusetts USA	16 – 17 yearsn = 36 yoga n = 15 PE control Male = NI Female = 61% Total: 52	Kripalu yoga - postures, breathing, relaxation, meditation, awareness	P.E.-as-usual group (learning the history, rules, tournament, tennis, volleyball, hockey, football, frisbee, and baseball, ropes course, backcountry living skills, stress management first aid and planned parenthood health and wellness. Yoga was not included	30 minutes 2-3 sessions per week for 10 weeks	The Profile of mood States-short form (POMS-SF), he positive and negative affect schedule for children (PANAS-C), the 10-item perceived stress Scale (PSS), the Inventory of positive psychological Attitudes-32R (IPPA), the 25-item resilience Scale (RS), the State-Trait anger Expression Inventory-2™ (STAXI-2), the Child Acceptance and mindfulness measure (CAMM) Yoga evaluation questionnaire at the end of the study to students in the yoga group.	Evaluate preventive efficacy for psychosocial well-being. Yoga would improve overall well-being such as stress, mood, and anxiety by both decreasing negative aspects & increasing positive aspects.	Yoga group showed statistically significant improvements in anger control, resilience, and fatigue/inertia. No changes were observed in positive affect, perceived stress, positive psychological traits, resilience, or anger expression. Both positive outcomes (& lack of outcomes) were tentative & required replication in larger, more definitive trials.	Some concerns
Pandit & Satish, 2014  Tamil Nadu India	9 – 12 years n = 46 yoga n = 32 Health training group n = 27 control waitlist Male = NI female = NI Total: 105	Asanas – Postures Surya namaskar – Sun salutation Breathing Meditation	Health training group was a non-yogic intervention, limited information on the health training and a control waitlist.	12 sessions over 6 months	Self awareness and emotional regulation Scale, Raven’s programme matrices test cancellation test, Questionnaires, self-awareness & regular scales,	Differences between the 3 groups- the yoga intervention group, the non-yogic intervention group & the time-lagged group on the anthropometric, cognitive, personality factors & self-awareness & self-reported behavioural regulation over both short term (3 months) & long term (6 months) period on anxiety and anger.	Significant improvement in yoga intervention group compared to non-yogic intervention and time lagged comparison group. Effects of yoga were not seen until 3 months later. It does not work if children are busy with other activities at school. The study presented a strong case for utilising yoga as a health intervention embedded in the curriculum. They recommended that yoga research with children should focus on long-term intervention studies, and yoga may be used in many contexts.	High
Quach et al., 2016  Ohio  USA	12 – 17 years n = 68 yoga n = 61 mindfulness n = 57 control waitlist P.E n = Female 62% n = male 38% Total: 198	Hatha yoga: postures, breathing exercises, relaxation	The waitlist control group attended regular P.E. classes, they did not receive the yoga or mindfulness intervention.	45 minutes twice a week for 4 weeks	The perceived stress Scale 10, the screen for Child anxiety and related emotional Disorders (SCARED), the Child Acceptance and mindfulness measure (CAMM) Questionnaires -Daily home practice via CD/Audio monitored through a written home practice log - collected once a week.	Examine the effectiveness of mindfulness meditation & hatha yoga on perceived stress, anxiety & anger control.	Significant increase in working memory capacity for participants in the meditation group. Participants in the mindfulness meditation condition showed significant improvements in memory, whereas those in the hatha yoga and waitlist control groups did not. No statistically significant between-group differences were found for stress or anxiety.	Some concerns
Telles et al., 2013  Haridwar  India	8 – 12 years n = 49 yoga n = 49 PE n = 68 male n = 38 Female Total: 108	Asana – postures Pranayama – breathing	P.E group jogging, Relay races/games, Spinal twisting, Bending sideways, rapid bending forwards & backwards.	45 minutes a day, 5 days a week for 3 months	Eurofit bathing 10 items Teacher rating performance	To compare the effects of yoga with P.E. on physical fitness, cognitive functions, obedience, social skills and self-esteem	Both groups showed significant improvements in a test for physical fitness. Social self-esteem improved after P.E. compared to yoga. These are possible effects of two interventions, with a degree of uncertainty due to the absence of a third control group.	Some concerns
Velásquez et al., 2015  Bogotá, Columbia	10 – 15 years n = 68 yoga n = 57 control n = 40 male n = 55 Female Total: 125	Satyananda yoga – integrate all aspects of the individual: Physical, energetic, mental, emotional, psychic & spiritual Asanas – postures Pranayama – breathing. Yog Nidra – relaxation/meditation	The control group received no intervention	2 hr sessions (Unknown per week) over 12 weeks 24 sessions in total	Self-reported questionnaires (Strengths & Difficulties questionnaire) focus group meetings asking open-ended questions at the end of the intervention.	The efficacy of a yoga programme implemented in a low-socioeconomic status school for the prevention of depression, anxiety, & aggression.	Yoga intervention showed statistically significant differences when compared to PE classes. Yoga may be beneficial in decreasing depression problems, especially for elementary school students and boys. The study relied on student feedback only and not from the teachers.	High
White 2012  Boston  USA	9 – 11 years n = 70 yoga n = 85 waitlist control Girls only Total: 125	Yoga-based mindfulness, Asanas – Postures	The control group participants were offered yoga classes after the completion of the experimental group.	2.5 hours weekly class for 8 weeks 45 minutes of homework guided by a compact disk	self-assessed questionnaires - the Feel Bad Scale, the school-agers coping Strategies Inventory, the Global self-worth subscale of the self-perception Profile for children, the Healthy self-regulation subscale of the mindful Thinking and Action Scale for adolescents,	Assess if yoga reduces perceived stress, enhances coping abilities, self-esteem & self-regulation & explore the relationship between the dose of the intervention & outcomes.	No significant differences between groups were found. The intervention group reported higher perceived stress scores & greater frequency of coping – bias may be due to self-assessment questionnaires.	High

Abbreviations: Mind wandering questionnaire (MWQ) is a questionnaire tool used by the researchers to measure low mood and depression, n = number, NI = No Information, P.E. = Physical Education.