Table 1.

Characteristics of included studies

Author and year	Country	Major inclusion criteria, including diagnosis	Population characteristics (age in years (M ± SD), sex(F/M), joint affected, duration of OA, any other therapy/medication for OA)					Sample size (n)	Intervention (I)	Comparator (C)
			Age in years (M ± SD)/M (95% CI)	Sex (F/M)	Joint affected	Duration of OA	Any other therapy/medication for OA
Garfinkel, 1994 [54]	USA	Pain and/or stiffness in the hands Diagnosis: ACR guidelines	I = NR C = NR	Both sexes, (14/11)	Hands	NR	NR	25 (I = 14, C = 11)	I = Yoga program (yoga and relaxation techniques) and health education on OA	C = ’Largely’ drug-based treatment program
Ebnezar, 2011, 2012a, 2012b [55–57]	India	Persistent, moderate to severe walking pain for 3 months before recruitment Kellegren and Lawrence radiologic grading of II–IV in X-rays taken within last 6 months Diagnosis: ACR guidelines	I = 59.56 ± 8.18, 59.56 ± 9.54 (Ebnezar 2012b) C = 59.42 ± 10.66	Both sexes, I:88/37 C:86/39	Knee	< 1 year: I = 62, C = 59 1–2 years: I = 39, C = 40 > 2 years I = 24, C = 26	NR	250 (I = 125, C = 125)	I = IYT practice [including lectures and counselling on yoga and health] + (physiotherapy + TENS + ultrasound)	C = 40 min of non-yogic physiotherapy exercisesa supervised by certified therapists + (physiotherapy + TENS + ultrasound)
Cheung, 2014 [58]	USA	Community-dwelling adults aged 65–90 years Symptomatic OA diagnosis for 6 or more months No previous yoga training Not currently participating in a supervised exercise programme Diagnosis: ACR guidelines	I = 71.90 (69.30,74.60) C = 71.90 (69.00, 75.00)	Females, 36	Knee	≥ 6 months	Medication for arthritis (NS)	36 (I = 18, C = 18)	I = Hatha yoga	C = Wait-list control (60 min session/week and 30 min/day four times a week at home)
Park, 2016 [59]	USA	Community-dwelling adults aged ≥ 65 years Self-reported joint pain caused by OA Pain for 3 or more months Diagnosis: by a board-certified nurse practitioner using the criteria-based on OA symptoms	All = 75.30 ± 7.50	Both sexes, (75/25)	One or more lower extremity joints	NR	NR	100 (I1 = 32, I2 = 20, C1 = 28, C2 = 20)	I1 = Sit ‘N’ Fit chair yoga (English) I2 = Sit ‘N’ Fit chair yoga (Spanish)	C1 = HEP (English) C2 = HEP (Spanish)
Cheung, 2017 [60]	USA	Community-dwelling adults aged ≥ 60 years Self-reported medical diagnosis of symptomatic OA for 6 or more months No previous training in any form of yoga Not currently participating in a supervised exercise programme Diagnosis: NR	I = 68.90 ± 7.70 C1 = 74.40 ± 7.50 C2 = 71.80 ± 8.00	Both sexes, (70/13)	Knee	≥ 6 months	NR	83 (I = 32, C1 = 28, C2 = 23)	I = Hatha yoga	C1 = ASEb (centre-based supervised group sessions and home-based unsupervised individual sessions, for 8 weeks) C2 = Education attention for 8 weeks (education brochures from the Arthritis Foundation on how to manage OA pain, and physical activity and exercise for OA)
McCaffrey, 2017 [61]	USA	Community-dwelling adults aged ≥ 65 years Self-reported joint pain caused by OA Moderate chronic pain for 15 or more days per month for 3 or more months Diagnosis: by a nurse practitioner based on OA symptoms	I = 75.90 ± 8.20 C = 74.50 ± 6.50	Both sexes, (85/27) I = 66/19, C = 19/8	One or more lower extremity joints	NR	Pain medication n = 70 (unclear if before or during the trial) History of non-pharmacological pain management n = 45	112 (I = 85, C = 27)	I = Sit ‘N’ Fit Yoga program (chair yoga)	C = HEP (health education sessions, including social interaction through games, lecture and discussion, by a health educator regarding OA)
Park, 2017[62]	USA	Ages ≥ 65 years Self-reported joint pain Moderate chronic pain (≥ 4 on a pain bother scale at least 15 days per month for ≥ 3 months Diagnosis: by a geriatric nurse practitioner	I = 75.90 ± 8.20 C = 74.50 ± 6.50	Both sexes, (I:44/19, C:41/8)	One or more lower extremity joints	NR	NR	112 (I = 63, C = 49)	I = Sit ‘N’ Fit chair yoga	C = HEP (45-min health education sessions by a healthcare provider on OA)
Deepeshwar, 2018 [63]	India	OA > 3 months Diagnosis: by a physician	I = 59.80 ± 10.21 C = 61.07 ± 9.17	Both sexes, (I: 25/6, C: 25/10)	Knee	> 3 months	NR	66 (I = 31, C = 35)	I = IAYT	C = Conventional treatment without any form of yoga intervention
Kaur, 2018 [64]	India	Diagnosed with mild or moderate OA Not advised for surgery (viz. early OA) Diagnosis: ACR criteria for classification of idiopathic knee OA	I = 52.42 ± 4.60 C = 54.23 ± 4.80	Females, 83	Knee	NR	NR	83 (I = 43, C = 40)	I = Distribution of SIM + intervention package (group training through lectures and demonstrations (yoga asana & guided meditation)) one-to-one training through demonstration	C = Distribution of SIM
Kuntz, 2018 [65]	Canada	Ages ≥ 50 years Diagnosis: ACR guidelines	I = 65.50 ± 5.60 C1 = 63.70 ± 8.90 C2 = 71.10 ± 9.30	Females, 31	Knee	NR	Pain medications n = 19 (during the trial)	31 (I = 10, C1 = 11, C2 = 10)	I = Yoga exercise	C1 = Traditional exercise (knee strengthening and aerobic warm-up, balance exercises, and stretching C2 = No exercise (group-based, guided meditative relaxation classes led by a certified yoga-instructor)
Zacharia, 2018 [66]	USA	Community-dwelling adults aged 40–64 years Insufficiently active (< 30 min a day of moderate activity, five days a week, or < 150 min of moderate activity a week) or sedentary Diagnosis: NR	All = 57 ± 4.10 not reported separately for I/C	Both sexes, not reported separately for I/C	Lower limb joints (hip, knee, ankle, or feet)	> 6 months	Pain medications n = 5 (unclear if before or during the trial)	20 (I = 10, C = 10)	I = Hatha Yoga Program (Phase-1) + relapse Prevention programme (Phase-2)	C = No intervention
McCaffrey, 2019 [67]	USA	Ages ≥ 62 years Reported OA- associated pain Chronic pain at least 15 days of the month for ≥ 3 months Diagnosis: by a nurse practitioner	All = 78.80 ± 8.90, I = 79.00 ± 2.50 C = 78.00 ± 2.10	Both sexes, (I: 5/4, C: 5/4)	Lower extremity joints (hip, knee, other LEs)	NR	I = Tylenol (acetaminophen), tramadol, ibuprofen n = 3 C = Tylenol (acetaminophen), ibuprofen n = 5 (unclear if before or during the trial)	18 (I = 9, C = 9)	I = Chair yoga (based on traditional Hatha yoga postures)	C = Chair exercisec
Vaghela, 2020 [68]	India	-Ages 40–80 years -Diagnosis: clinical ACR criteria	I = 56.58 ±  10.12 C = 54.27 ±  8.44	Both sexes, (I:28/15, C:30/10)	Knee	NR	NR	83 (I = 43, C = 40)	I = Conventional physiotherapy + yoga therapy	C = Conventional physiotherapy: 1. Transelectrical nerve Stimulation (10 min) 2. Isometrics quadriceps exercise 3. Straight leg‑raising exercise in supine 4. Terminal knee extension or vastus medialis oblique strengthening exercise in supine and high sitting 5. Straight leg abduction exercise in side lying
Bokaeian, 2021 [69]	Iran	Ages 45–76 years Knee pain of 30 or greater on the 100-mm VAS Diagnosis: Unilateral or bilateral tibiofemoral joint OA of grades 2–3 based on the Kellgren–Lawrence grading system	I = 54.90 ± 5.00 C1 = 57.00 ± 4.90 C2 = 56.70 ± 4.70	Both sexes, (45/14) (I: 16/6, C1: 15/4, C2: 14/4)	Knee	Knee pain > 1 month	NR	59 (I = 22, C1 = 19, C2 = 18)	I = Yoga exercises and medial-thrust gait (YogaMT) training	C1 = Knee muscle strengthening C2 = Treadmill walking
Park, 2021 [70]	USA	Ages ≥ 60 years Moderate chronic OA pain of any joint for ≥ 15 days per month for ≥ 3 months Diagnosis: NR	All = 75.30 ± 7.50, not reported separately for I/C	Both sexes, (85/27)	NR	NR	Current pain medication n = 71 History of non-pharmacological pain management n = 68	112 (I = 47, C = 65)	I = Chair yoga	C = Health education programme consisting of information on OA by a healthcare provider
Bennell, 2022 [71]	Australia	Ages ≥ 45 years Activity-related knee pain for at least 3 months Average walking pain score of ≥ 4 on an 11-point numerical rating scale over the previous week No knee morning stiffness lasting ≥ 30 min) Diagnosis: NICE clinical criteria*	I = 62.80 ± 8.20 C = 61.80 ± 7.20	Both sexes, (I: 70/37, C: 78/27)	Knee	Knee pain > 3 months	Current pain medications: I&C = NSAIDs, acetaminophen, topical NSAIDs, oral corticosteroids and oral opioids History of treatment in last 3 months:  Massage/manual therapy  Gait aid  Thermal therapy/electrotherapy  Orthotics, arch supports, or wedging in shoes  Knee braces  Land-based and water exercises  Joint injections  Acupuncture  Knee surgery	212 (I = 107, C = 105)	I = Online yoga programme plus online education	C = 24-weeks unlimited access to a customized trial website containing downloadable educational covering understanding OA, treatment options, exercise and physical activity, weight loss, understanding and managing pain, sleep, and patient stories

Only yoga-related interventions were mentioned under intervention, and no intervention or any other active interventions were mentioned under comparator. OA: osteoarthritis, ACR: American College of Rheumatology, NR: Not reported, ADL: Activities of daily living, IYT: Integrated Yoga Therapy, TENS: Transcutaneous Electrical Stimulation, HEP: Health Education Programme, IAYT: Integrative Approach for Yoga Therapy, SIM: Self-Instruction Manual, NSAIDs: Non-Steroidal Anti-Inflammatory Drug.

^aPhysiotherapy exercises included loosening and strengthening practices for upper and lower limb joints, rest, specific knee practices, and supine rest followed by light music.

^bWeekly group sessions by an instructor for 8 weeks (15 min mild aerobic exercise and 30 min of strengthening exercises including both isometric (without moving the joints) and isotonic (moving the joints) exercises. Home practice: aerobic exercise for 15–30 min/day, four times/week, and the strengthening exercises for 30 min/day, two times/week on non-consecutive days.

^cChair exercise consisting of progressive resistive exercises incorporating body weight and/or external resistance using cuff weights, resistance bands, and balls, NICE clinical criteria: (age ≥ 45 years, activity-related knee pain, and no knee morning stiffness lasting ≥ 30 min)