Abstract
Background
Yoga has emerged as a widely recognized intervention for managing stress, with growing interest in its effectiveness across various populations. Despite expanding research, there remains a need for comprehensive analysis of trends within the literature to guide future studies and clinical applications.
Objective
This study aimed to analyze bibliometric trends in research on yoga for stress management, providing insights into publication patterns, key contributors, and evolving research directions in this field.
Methods
The experimental studies related application of yoga for stress management were searched from 2000 to 2024 on Scopus database. The search criteria were refined to include publications on yoga related to stress, with a focus exclusively on articles published in English. Quantitative data analysis was conducted using bibliometric tools, with visualizations created using VOSviewer.
Results
The analysis of 1025 articles revealed a significant increase in publications over 24 years, especially in the past four years. The International Journal of Yoga Therapy and the Journal of Alternative and Complementary Medicine were leading journals in this field. The United States and India were identified as primary contributors, with Khalsa SBS and Nagendra HR being the most prolific authors. Randomized controlled trials, meta-analyses, and systematic reviews emerged as predominant study types.
Conclusion
This comprehensive bibliometric analysis highlights the growth of yoga and stress management research, emphasizing randomized controlled trials and evidence-based practices. Future studies should explore yoga’s impact on diverse populations by age, occupation, and culture to clarify its universal applicability, advancing research and clinical applications.
Keywords: Yoga, Stress, Bibliometrics, Randomized controlled trials, Evidence-based therapy, Scientometric analysis
1. Introduction
In modern society, stress has reached an alarming prevalence, establishing itself as a major concern for public health on a global scale [1]. It has significant negative impact on physical, mental and social aspects of health. Furthermore, stress is an independent risk factor for coronary heart disease, hypertension, and diabetes [2,3]. Stress is associated with exacerbation of existing chronic health conditions such as asthma, autoimmune disorders, and several pain conditions [[4], [5], [6]]. It affects sleep quality and increase the risk of binge eating and metabolic disorders [7,8]
Considering the hazardous effects of stress, various stress management techniques and therapies have been developed and their efficacy in lowering stress and lessening its effects has been assessed. Among the most researched techniques include yoga, tai chi, mindfulness meditation, massage, and cognitive behavioral treatment (CBT). Through relaxation, emotional balance, and cultivating a positive attitude on life, these practices seek to not only lower stress levels but also advance general mental and physical health. However, yoga's holistic approach can offer more extensive advantages for the body and mind [9].
Yoga is a holistic discipline that promotes a healthy lifestyle through self-restraint, balanced diet, regulated sleep, and moderate activities, along with the practice of yoga postures, breathing exercises, and meditation [10]. Traditionally, yoga also emphasizes the cultivation of compassion, kindness, and charity. However, in contemporary times, the focus of yoga practice has largely narrowed to physical postures, breathing techniques, and meditation alone. Despite this shift, research has consistently demonstrated that practicing yoga for at least 1 h daily, four times a week, over a period of three months, yields significant physical and mental health benefits [11,12]. These benefits include enhanced perception and resilience. Additionally, yoga has been found to reduce stress, improve cognitive function, and foster emotional well-being, making it a valuable tool for holistic health management [13,14].
Over the past two decades, yoga has gained substantial recognition as a valuable tool for reducing stress, resulting in a surge of research on its therapeutic potential. Despite this increase, no comprehensive bibliometric analysis has systematically mapped the progression and scope of this field. Bibliometric analysis offers a structured perspective on the research environment by charting trends in publication rates, significant thematic domains, notable authors, and patterns of international collaboration. This method has been instrumental in influencing progress in clinical practices and treatment protocols [15]. Furthermore, it facilitates the systematic identification of research deficiencies and less-explored domains, which is particularly beneficial in the rapidly evolving field of yoga, characterized by diverse perspectives and therapeutic uses. In contrast to conventional reviews, bibliometric analysis provides an objective, data-driven evaluation of research trends over time.
This analysis also aids in recognizing new trends and changes in research priorities over time, directing future investigations by emphasizing areas that necessitate further exploration and resource investment. By offering insights into the worldwide distribution of research contributions, bibliometric analysis can promote focused collaborations, providing valuable information to both researchers and policymakers regarding the most advantageous opportunities for international cooperation or interdisciplinary research. Consequently, this bibliometric analysis seeks to encapsulate the existing body of knowledge from the past 24 years and serves as a fundamental resource for guiding the future trajectory of studies related to yoga for stress management.
2. Methods and materials
2.1. Data extraction and search approach
This research adhered to the bibliometric analysis guidelines established in 2021 [16] Scientometric analysis depends on literature databases, and for this study, data were extracted from Scopus, PubMed and Web of Science database. The search was conducted on June 10, 2024, using combined search terms: TITLE-ABS-KEY (yoga OR "yoga practice" OR "yoga therapy" OR "yoga intervention" OR "yoga training" OR "yoga and health" OR "yoga and wellness" OR "yoga and stress" OR "yoga and anxiety" OR "yoga and depression" OR "yoga and mental health" OR "yoga and physical health" OR "yoga and fitness" OR "yoga and mindfulness" OR "yoga and meditation" OR "hatha yoga" OR "ashtanga yoga" OR "vinyasa yoga" OR "kundalini yoga" OR "bikram yoga" OR "iyengar yoga" OR "yoga benefits" OR "yoga outcomes" OR "yoga research" OR "yoga effects" OR "yoga programs" OR "yoga studies" OR "yoga for stress relief" OR "yoga for mental health" OR "yoga for physical health" OR "yoga for rehabilitation" OR "yoga for chronic illness" OR "yoga for pain management" OR "yoga for flexibility" OR "yoga for strength" OR "yoga for relaxation" OR "yoga and quality of life") AND (stress∗ OR "psychological stress" OR "emotional stress" OR "mental stress" OR "stress management" OR "stress response" OR "stress disorder" OR "occupational stress" OR "work-related stress" OR "job stress" OR "chronic stress" OR "acute stress" OR "stress resilience" OR "stress relief" OR "stress reduction" OR "stress symptoms" OR "stress levels" OR "stress factors" OR "stress and health" OR "stress and well-being" OR "stress assessment" OR "stress interventions" OR "stress measurement" OR "stress research" OR "stress prevention" OR "stress coping" OR "stress and anxiety" OR "stress and depression" OR "post-traumatic stress" OR "stress and burnout" OR "stress and fatigue"). In the present study, the inclusion and exclusion criteria were carefully defined to ensure the focus remained on high-quality, relevant research articles. The review specifically targeted studies on yoga for stress published in English from 2000 to 2024, ensuring that the findings reflected the most recent advancements in the field. This temporal limitation was implemented to concentrate on contemporary research that is most relevant to current stress management practices, particularly given the evolving understanding of the physiological and psychological dimensions of stress.
2.1.1. Inclusion criteria
Only peer-reviewed research articles and review papers were included to guarantees that the study encompassed comprehensive and original contributions to the field. Studies were included if they examined stress as either a primary or secondary outcome, with both physiological (e.g., heart rate, cortisol levels) and psychological (e.g., anxiety, emotional well-being) dimensions being considered. This broad definition ensured a holistic evaluation of yoga's impact on stress across both physical and emotional aspects.
2.1.2. Exclusion criteria
Furthermore, studies published before 2000 were excluded, as this review aimed to focus on the most recent findings that reflect contemporary research trends. Non-English articles were excluded. Conference proceedings, abstracts, and editorials were excluded to avoid incomplete or non-empirical data. Articles lacking a clear therapeutic focus on yoga for stress, mindfulness or mindfulness-based intervention were also exclude. Research articles were retrieved on yoga for stress published in English over the past 24 years (from 2000 to 2024), ensuring relevance to our study objectives.
The search yielded 853 articles from PubMed, 1,905 from Web of Science, and 2,640 from Scopus after applying automation tools. After manually filtering the data, 418 relevant articles were identified from PubMed, 953 from Web of Science, and 1,025 from Scopus. To eliminate duplicate records, all datasets were processed using R Studio, revealing that nearly all unique articles were already indexed in Scopus. Given this outcome, selecting Scopus as the primary database ensures statistical robustness and a higher volume of relevant data spanning 24 years. Fig. 1 displays the adapted PRISMA flowchart illustrating the study process [[17], [18]].
Fig. 1.
Prisma flow diagram.
2.2. Visualization and bibliometric analysis: tools and methodologies
To ensure accurate bibliometric analysis, the study employed R Studio 4.3.3 with the Bibliometrix package 4.1.2 and VOSviewer 1.6.8, following a systematic workflow. First, eligible records were independently reviewed and imported into R Studio for data extraction and preprocessing. The Bibliometrix [19] package facilitated automated science mapping, enabling detailed analysis of metrics such as the number of publications (Np), citations (Nc), and the h-index. These metrics were used to evaluate research productivity, impact, and influence, with Bibliometrix offering flexibility through its integration with other R packages for advanced statistical analysis. The processed data was then visualized using VOSviewer [20], which created network maps where nodes represented entities like countries, authors, or keywords, and links indicated relationships such as co-authorship or term co-occurrence. The strength of relationships was depicted by link weights, while node size and proximity reflected significance and relatedness. This integration of Bibliometrix for detailed analysis and VOSviewer for intuitive visualization ensured comprehensive insights into bibliometric trends and patterns, combining analytical depth with clear graphical representation.
3. Results
3.1. Publication count
The study analyzed a total of 1025 articles on yoga for stress. The number of published papers increased consistently each year, growing from 2 in 2000 to 63 by mid-2024. Over the past four years, there has been a notable surge in publications, with an annual growth rate of 15.46 % See (Fig 2). The increase in yoga-related publications from 2020 to 2024 seems closely linked to the COVID-19 pandemic, which brought unprecedented focus to mental health and stress management worldwide. As lockdowns, social distancing, and lifestyle disruptions intensified stress and anxiety, there was a surge in interest in yoga as a self-care tool, given its accessibility and established mental health benefits. This period saw a marked rise in studies examining yoga's potential to alleviate stress, anxiety, and other mental health challenges, positioning yoga as a versatile and effective approach to coping with pandemic-related psychological burdens [21,22]. The study included various paper types: randomized controlled trials (273), Non randomized controlled trials (342), Feasibility Study (22), Pilot study (83), Surveys (18), case studies (07), qualitative study (30), protocols (13), content and development validation (05), systematic reviews (28), only meta-analyses (10), meta-analyses with systematic reviews (22), and neither systematic nor meta-analysis reviews (103), articles that are not review (69).
Fig. 2.
Global trends in yearly publications on stress through yoga from 2000 to 2024 (data search upto June 2024).
3.2. Interpretation of keyword clusters in yoga and stress research
Research publications on yoga, analyzed through VOSviewer, were organized into twelve clusters. The leading 10 keywords were Yoga (n = 559), stress (n = 199), mindfulness (n = 98), anxiety (n = 94), meditation (n = 91), depression (n = 80), mental health (n = 52), quality of life (n = 51), pranayama (n = 34), and well-being (n = 34). The visual analysis revealed key research trends, with a focus on adolescents, women, older adults, and teachers as the main participants. The most frequently observed study types included randomized controlled trials, meta-analyses, and systematic reviews. Fig. 3 displays the co-occurrence of the top 115 keywords. Each node is depicted as a circle labeled with different words. Big circles indicate more frequently used words. The broadness and length of the lines connecting the nodes illustrate the potency of the associations between them [23,24].
Fig. 3.
Network map of yoga research on stress.
The keyword analysis identified six primary clusters, each representing a significant thematic focus within the field of yoga and stress research. These clusters provide a comprehensive framework for understanding the multidimensional role of yoga in stress management and its associated domains.
3.2.1. Cluster 1 (Pink): psychological and stress-related disorders
This cluster emphasizes the connection between yoga and mental health issues such anxiety, PTSD, depression, and perceived stress. This cluster is significant because it demonstrates the potential of yoga to address mental health issues, especially through interventions that focus on trauma healing and emotional regulation. This suggests that future research could be focused on comparing yoga to other treatment modalities in managing these conditions.
3.2.2. Cluster 2 (blue): physiological stress markers
Keywords such as cortisol, heart rate variability and blood pressure emphasize the physiological outcomes of yoga practice. This cluster underlines the potential of yoga to help regulate stress biomarkers and improve the function of the autonomic nervous system. It supports the need for mechanistic studies exploring how yoga impacts stress pathways biologically.
3.2.3. Cluster 3 (Green): mindfulness and well-being
Centered on mindfulness, this cluster links yoga with holistic well-being, burnout prevention, and occupational health. This is significant as it shows the dual role of yoga in mental and physical health, especially in high-stress occupations. Research in this area may focus on workplace interventions and their cost-effectiveness.
3.2.4. Cluster 4 (Red): chronic conditions and fatigue
This cluster includes topics like cancer, breast cancer, fatigue, and complementary therapies. It shows the growing contribution of yoga which is becoming a part of integrative medicine in the management of chronic diseases and related fatigue. Future research could investigate how customized yoga programs for patients with chronic conditions can improve quality of life and treatment adherence.
3.2.5. Cluster 5 (Orange): prenatal and lifestyle factors
With terms like pregnancy, prenatal yoga, and lifestyle, this cluster focuses on yoga's application during specific life stages and its influence on lifestyle-related stress factors. This suggests a need for studies targeting special populations (e.g., pregnant women) and exploring yoga as a preventive lifestyle intervention.
3.2.6. Cluster 6 (Purple): intervention and methodology
This cluster includes keywords like randomized controlled trials, qualitative studies, and meta-analysis, indicating the growing methodological rigor in yoga research. It reflects the need for large-scale, high-quality studies to validate yoga's effectiveness. This is crucial for bridging the gap between anecdotal evidence and clinical practice.
This network visualization (Fig. 4) highlights the key themes and trends in yoga and stress research from 2016 to 2020. Core keywords such as yoga, stress, meditation, anxiety, and mindfulness dominate, reflecting their foundational role. Clusters reveal distinct focus areas: mental health outcomes (depression, PTSD, burnout), physiological markers (cortisol, heart rate variability, oxidative stress), lifestyle applications (prenatal yoga, obesity), and methodological rigor (Randomized controlled trial, meta-analysis). Earlier studies (blue) laid the groundwork on broad topics like stress, while recent research (yellow) emphasizes biomarkers and specialized interventions, including trauma-sensitive yoga. Future research should integrate findings across mental health and physiological domains, refine evidence-based methodologies, and explore emerging areas like self-compassion and yoga's role in specific populations, such as adolescents and pregnant individuals (Fig. 4).
Fig. 4.
Overlay visualization of keywords.
3.3. Leading 10 authors based on the number of publications on yoga for stress
The study identified 3796 authors who contributed to papers on yoga for stress. Table 1 Presented the leading ten authors with the most publications were highlighted in studies related to yoga and stress. Khalsa SBS led with 25 papers (25/1025, 2.4 %), followed by Nagendra HR with 19 papers (19/1025, 1.9 %), and both authors had notable h-index values of 14 and 11, respectively.
Table 1.
Identifies the leading 10 authors with the most publications on yoga for stress.
| Rank | Authors | Articles | Country | n% | Citations | Average citation | H- index |
|---|---|---|---|---|---|---|---|
| 1 | Khalsa SBS | 25 | USA | 2.4 | 896 | 35.84 | 14 |
| 2 | Nagendra HR | 19 | India | 1.9 | 866 | 45.57 | 11 |
| 3 | Dada R | 13 | India | 1.3 | 341 | 26.23 | 8 |
| 4 | Park CL | 12 | USA | 1.2 | 636 | 53 | 8 |
| 5 | Nagarathna R | 11 | India | 1.1 | 661 | 60.09 | 8 |
| 6 | Bhargav H | 9 | India | 0.9 | 72 | 8 | 3 |
| 7 | Braun TD | 9 | USA | 0.9 | 179 | 19.88 | 7 |
| 8 | Cramer H | 9 | Germany | 0.9 | 627 | 69.66 | 7 |
| 9 | Dusek JA | 9 | USA | 0.9 | 260 | 28.88 | 6 |
| 10 | Telles S | 9 | India | 0.9 | 283 | 31.44 | 8 |
The co-authorship analysis charts shows authors who have published at least 3 articles on managing stress with yoga. Each node represents an institution, with the size of the node indicating volume of publications. The links between nodes illustrate co-authorship relationships, and the broadness of these lines denotes the potency of the connections, as determined by the total link strength. A network map was developed featuring 182 authors, each with a minimum of three publications, and organized into nine clusters (Fig. 5). Active collaborations are commonly observed within the same cluster, as seen with Khalsa Satbir and Dusek Jeffery. There were also inter-cluster collaborations, such as those between Khalsa Satbir and Park Crystal.
Fig. 5.
The co-authorship analysis charts.
3.4. Leading journals in terms of yoga for stress (2000–24)
Overall, 494 academic sources have published articles on yoga for stress research. The leading ten journals contributed 228 publications on this subject. See Table 2, the International Journal of Yoga Therapy had the highest number of publications (n = 39), followed by the Journal of Alternative and Complementary Medicine (n = 35) and Complementary Therapies in Medicine (n = 32). The Journal of Alternative and Complementary Medicine also had the highest number of citations (n = 1886) and an impact factor of 2.38. Of the top 10 journals, half were dedicated to complementary and alternative medicine, while the others were general medical journals or those focusing on psychiatry and psychology. The International Journal of Yoga Therapy has been publishing research on yoga for stress since 2011 and continues to be a leading source.
Table 2.
Top 10 journals in yoga for stress.
| Rank | Sources | Articles | n% | H index | Impact factor | Total Citations |
|---|---|---|---|---|---|---|
| 1 | International journal of yoga therapy | 39 | 3.8 | 11 | 0.51 | 340 |
| 2 | Journal of alternative and complementary medicine | 35 | 3.41 | 20 | 2.38 | 1886 |
| 3 | Complementary therapies in medicine | 32 | 3.12 | 16 | 3.3 | 764 |
| 4 | Complementary therapies in clinical practice | 24 | 2.34 | 11 | 2.2 | 474 |
| 5 | Evidence-based complementary and alternative medicine | 24 | 2.34 | 19 | 2.7 | 1207 |
| 6 | Alternative therapies in health and medicine | 18 | 1.75 | 10 | 1.03 | 593 |
| 7 | Indian journal of Physiology and Pharmacology | 15 | 1.46 | 11 | 0.26 | 368 |
| 8 | BMC complementary and alternative medicine | 14 | 1.36 | 12 | 3.9 | 610 |
| 9 | Frontiers in psychology | 14 | 1.36 | 4 | 2.6 | 37 |
| 10 | Frontiers in psychiatry | 13 | 1.26 | 6 | 3.2 | 303 |
3.5. Contribution of countries
Research on yoga for managing stress was published by 47 countries/regions. The USA was a central hub in this field, closely collaborating with India, Australia, and Canada. India and Australia also frequently collaborated on related research. However, the volume of collaborative research outputs between countries was notably lower compared to the number of independent research outputs within individual countries.
3.5.1. Top 10 countries contributing papers on yoga for stress
We extracted top 10 countries that contributed maximum number of research publications on yoga and stress. USA topped with maximum number of publications 406. Turkey was the 10th in list having 18 publications (See Table 3)
Table 3.
The leading 10 countries producing research papers on yoga for stress.
| Rank | Country | Articles | n% |
|---|---|---|---|
| 1 | USA | 406 | 39.6 |
| 2 | India | 297 | 28.97 |
| 3 | Australia | 59 | 5.75 |
| 4 | Canada | 46 | 4.48 |
| 5 | United Kingdom | 45 | 4.39 |
| 6 | Germany | 39 | 3.8 |
| 7 | Sweden | 32 | 3.12 |
| 8 | Brazil | 24 | 2.34 |
| 9 | Japan | 18 | 1.75 |
| 10 | Turkey | 18 | 1.75 |
3.5.2. Top 10 countries with highly impactful publications
Table 4 highlights the top 10 countries that have produced highly impactful papers. Hong Kong ranks first with the highest citation per document at 60.66 from only 9 documents, followed by Singapore with 51.6 citations per document from 5 documents, and Germany with 43.31 citations per document from 39 documents.
Table 4.
Countries with highly impactful publications in yoga for stress.
| Rank | Country | Articles | Citations | Citation/Document |
|---|---|---|---|---|
| 1 | Hongkong | 9 | 546 | 60.66 |
| 2 | Singapore | 5 | 258 | 51.6 |
| 3 | Germany | 39 | 1689 | 43.31 |
| 4 | Netherland | 14 | 598 | 42.71 |
| 5 | United States | 406 | 15,293 | 37.66 |
| 6 | United Kingdom | 45 | 1631 | 36.24 |
| 7 | Sweden | 32 | 1129 | 35.28 |
| 8 | Australia | 59 | 1774 | 30.06 |
| 9 | Brazil | 24 | 696 | 29 |
| 10 | Taiwan | 14 | 402 | 28.71 |
In Fig. 6, the network visualization map illustrates the global collaboration trends in yoga and stress management research, with a prominent role played by the United States, which sits at the center of this collaborative network. The dense connections extending from the United States to countries such as the United Kingdom, Canada, and Australia reflect strong international research partnerships, suggesting these nations’ significant investment in studying yoga as a therapeutic practice. The intensity of these connections, represented by line thickness, may indicate the frequency and depth of collaboration, potentially encompassing high-impact research studies and joint projects.
Fig. 6.
Active collaboration between various countries.
India, though connected to fewer countries, also shows notable engagement in this collaborative network. As the birthplace of yoga, India's contributions are essential, and its partnerships with other countries underscore a trend where traditional practices are increasingly validated through global research efforts. These connections suggest that India is actively participating in the scientific exploration of yoga's effectiveness in stress management, bridging traditional knowledge with contemporary scientific methods.
Furthermore, the thickness of the connecting lines may point to multi-center trials or research funded by international agencies aimed at creating evidence-based guidelines for integrating yoga into clinical practice. For example, collaborations between the United States and countries like Australia and Canada may represent large-scale projects or longitudinal studies focusing on mental health and stress, addressing a shared public health need. These collaborations not only enrich the quality of research in this field but also enhance the global visibility and scientific rigor of yoga as a viable therapy for stress management (Fig. 7).
Fig. 7.
Countries collaboration map.
The global distribution map of documents on yoga for stress (Fig. 8) reveals that the United States leads with 406 publications, followed by India with 297, and Australia with 59. Canada, United Kingdom, and Germany have significantly fewer publications, with 46, 45, and 39 respectively. This distribution indicates a strong research focus in the United States and India, suggesting these countries are at the forefront of exploring yoga's impact on stress. The lower numbers in other regions highlight potential areas for increased research and collaboration.
Fig. 8.
Global distribution of documents.
3.6. Top 10 institutions contributing papers on yoga for stress
A total of 1305 unique affiliations contributed to the research publications in this theme. Out of these, 72 institutions each published at least 10 papers. The majority of these institutions are based in the USA, India, Australia, and Canada, highlighting the significant contributions from these regions. These institutions play a crucial role in enhancing their respective countries’ influence in this field. The All-India Institute of Medical Sciences (India) was the most prolific, with 92 papers, followed by Harvard Medical School (USA) with 57 papers, and the University of California (USA) with 52 publications (Table 5).
Table 5.
Top 10 institutions in contributing publication on yoga for stress.
| Rank | Affiliation | Country | Articles | n% |
|---|---|---|---|---|
| 1 | All India Institute Of Medical Sciences | India | 92 | 8.97 |
| 2 | Harvard Medical School | USA | 57 | 5.56 |
| 3 | University of California | USA | 52 | 5.07 |
| 4 | University of Calgary | Canada | 44 | 4.29 |
| 5 | National Institute of Mental Health and Neurosciences | India | 27 | 2.63 |
| 6 | University of Duisburg-Essen | Germany | 27 | 2.63 |
| 7 | Charité – Universitätsmedizin Berlin | Germany | 26 | 2.53 |
| 8 | University of Connecticut | USA | 26 | 2.53 |
| 9 | Kripalu Center for Yoga & Health | USA | 24 | 2.34 |
| 10 | Boston University School of Medicine | USA | 20 | 1.95 |
3.7. Preeminently cited papers
Among the leading ten most cited publications in this analysis, three were randomized controlled trials investigating the effects of yoga on stress. One paper was a clinical trial that compared the effects of hatha yoga with African dance on stress. Of the five review articles, two concentrated on Sudarshan Kriya as a neurophysiological model for addressing stress, anxiety, and depression. Another was a systematic review investigating risk factors associated with insulin resistance syndrome and cardiovascular disease, exploring yoga's potential protective benefits (Table 6).
Table 6.
Ten leading cited papers.
| Rank | Title | Author | Journal | Year | Total Citations |
|---|---|---|---|---|---|
| 1 | Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and Depression: Part I—Neurophysiologic Model | BROWN RP | Journal of Alternative and Complementary Medicine | 2005 | 358 |
| 2 | Effective and viable mind-body stress reduction in the workplace: a randomized controlled trial | WOLEVER RQ | Journal of Occupational Health Psychology | 2012 | 357 |
| 3 | Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder | STREETER CC | Medical Hypotheses | 2012 | 352 |
| 4 | Psychological adjustment and sleep quality in a randomized trial of the effects of a Tibetan yoga intervention in patients with lymphoma | COHEN L | Cancer | 2004 | 350 |
| 5 | Meditation practices for health: state of the research | OSPINA MB | Evidence report/technology assessment | 2007 | 286 |
| 6 | Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and Depression: Part II—Clinical Applications and Guidelines | BROWN RP | Journal of Alternative and Complementary Medicine | 2005 | 286 |
| 7 | Yoga as an Adjunctive Treatment for Posttraumatic Stress Disorder: A Randomized Controlled Trial | VAN DER KOLK BA | The Journal of Clinical Psychiatry | 2014 | 267 |
| 8 | Potential self-regulatory mechanisms of yoga for psychological health | GARD T | Frontiers in Human Neuroscience | 2014 | 264 |
| 9 | Effects of hatha yoga and African dance on perceived stress, affect, and salivary cortisol | WEST J | Annals of Behavioral Medicine | 2004 | 243 |
| 10 | Risk Indices Associated with the Insulin Resistance Syndrome, Cardiovascular Disease, and Possible Protection with Yoga: A Systematic Review | INNES KE | Journal of the American Board of Family Medicine | 2005 | 238 |
4. Discussion
This study conducted a bibliometric analysis of 1025 publications on yoga for stress sourced from the Scopus database, revealing a consistent rise in publications over the past four years. The International Journal of Yoga Therapy and the Journal of Alternative and Complementary Medicine were identified as the leading journals in this field. Among the top ten authors, five were from India and four from the USA. Major contributors included All India Institute of Medical Sciences (AIIMS) and Harvard Medical School, reflecting the growing recognition of yoga's role in stress management within the medical community.
The United States and India have emerged as leading countries in publishing research papers on yoga for stress management. India naturally has a strong interest in promoting yoga as a scientific approach to address modern health problems, especially stress, due to yoga's deep cultural and historical roots. On the other hand, the growing interest in complementary and alternative medicine in the United States has triggered a number of studies on the effectiveness of yoga in reducing stress, supported by extensive research resources and evidence-based practices. Collaborative efforts between researchers in both countries have also contributed significantly to this field See (Fig 5).
North America and India play a leading role in research on yoga for stress, and the main contributors include the United States, India, Germany, Canada, and Australia. These countries are leading yoga research because of their strong economic and scientific positions and a deep tradition of international collaboration. This collaboration synthesizes traditional knowledge and modern scientific methods, enhancing the quality of research by integrating diverse fields such as psychology, neuroscience, and holistic medicine.
Journals such as Complementary Therapies in Medicine, Complementary Therapies in Clinical Practice, and Evidence-Based Complementary and Alternative Medicine regularly publish studies on the role of yoga in stress management. These journals contribute to the growing body of evidence that makes yoga an important part of holistic health care by publishing studies examining the physical and mental benefits of yoga.
Currently, researchers are exploring biomarkers of stress, stress responses, and ways to measure stress factors. Despite these advances, the field is still in its early stages, and collaboration between institutions is limited. Expanding international partnerships and cross-country collaborations could foster more consistent research contributions and improve stress management strategies through yoga.
4.1. Clinical implications
The bibliometric trends in this study highlight the increasing recognition of yoga as an effective tool for stress management, suggesting its growing role as a complementary therapy in clinical settings. The rise in publications over recent years indicates that yoga is gaining traction for managing stress-related conditions such as anxiety, depression, and burnout. Healthcare professionals may become more interested in including yoga in therapy regimens as research grows. Yoga could be a standard component of stress management programs in hospitals, mental health clinics, and rehabilitation facilities with additional clinical trial confirmation. It could also have an impact on policy, enabling yoga to be included in healthcare guidelines and making it more accessible to a variety of clinical populations.
4.2. Trends and hot spots
The analysis of keywords highlights that “stress” is a central theme, strongly associated with terms like “anxiety,” “depression,” “yoga,” “meditation,” and “mindfulness.” This reflects a clear connection between mental health challenges and complementary therapies. Furthermore, physiological measures such as “heart rate variability” and “blood pressure” are frequently mentioned, suggesting an interest in the physical impacts of stress. Emerging trends from 2016 to 2020 show a growing recognition of yoga and meditation as effective methods for stress management. The increased focus on physiological indicators highlights a more holistic approach to understanding and addressing stress. Additionally, the fact that "COVID-19″ has come up in recent discussions highlights how much the pandemic has affected stress levels and how crucial it is to have efficient stress management techniques throughout worldwide [25].
4.3. Interpretation of the findings
The study revealed that yoga is commonly employed for various comorbid conditions, encompassing psychiatric and physical both the issues such as depression, anxiety, fatigue, pain, and cancer. It was noted that the predominant study types included randomized controlled trials, meta-analyses, systematic reviews, and reviews. To evaluate the effectiveness of yoga for stress, measurement tools like quality of life, cortisol levels, the perceived stress scale, and sleep quality metrics were frequently utilized.
Yoga has been compared to interventions like Tai Chi, massage, and cognitive behavioral therapy (CBT). Both yoga and Tai Chi enhance flexibility, balance, and mental focus, promoting stress reduction and overall well-being [26]. Massage mainly offers physical relaxation, while yoga also provides mental clarity and emotional balance [27]. CBT, focused on altering thought patterns, is effective for mental health but lacks yoga's holistic approach, which combines physical postures, breathing exercises, and meditation [28]. Overall, yoga's integrative nature may offer more comprehensive benefits for both mind and body.
Yoga is an effective stress management tool for several reasons. Firstly, it is easy to practice, requiring no special equipment or environment, making it accessible to individuals of all ages and fitness levels. Additionally, yoga is cost-effective, as it can be practiced at home without the need for expensive classes or materials. What sets yoga apart is its comprehensive approach, addressing both the physical and mental aspects of stress. Through its combination of physical postures, breathing exercises, and meditation, yoga not only helps alleviate physical tension but also cultivates mental clarity and emotional balance. Furthermore, regular yoga practice has been shown to improve stress resilience and foster a more positive attitude, equipping individuals with the tools to better manage stress and its associated challenges [[29], [30], [31]].
Stress is a global issue impacting individuals across all age groups and backgrounds, making it a prevalent concern worldwide. However, the number of publications on managing stress through yoga remains limited. It is imperative for countries to increase their efforts in this area and foster more international collaborations. Our findings reveal that the top countries producing highly impactful research are few, with Hong Kong leading with only 9 documents, 546 citations, and an average of 60.66 citations per document. Singapore follows with 5 documents, 258 citations, and 51.6 citations per document, and Germany with 39 documents, 1689 citations, and 43.31 citations per document.
In terms of individual contributions, Khalsa Satbir ranks first among the top 10 authors with 25 documents on yoga for stress, which is fewer compared to the 38 documents by Morin CM on cognitive behavioral therapy for insomnia [18]. Among the top 10 journals publishing research on yoga for stress, BMC Complementary and Alternative Medicine holds the highest impact factor of 3.9, which is relatively low. In addition to the leading authors in the field, there are psychologists and doctors who, though not originally from a yoga background, are actively contributing to research on yoga and stress. Notable among them are Dada R, Clark P, and Braun T, who have become significant contributors to this area of study.
Keyword co-occurrence and highly cited articles reveal that yoga and its components are prominent research and application frontiers in numerous countries and regions. However, large-scale clinical trials and related studies are still needed for further verification. Regarding the types of studies, randomized controlled trials are fewer compared to non-randomized controlled trials. Randomized controlled trials are considered the gold standard in experimental research for their effectiveness [32], yet there are only 273 compared to over 520 non-randomized controlled trials. Future research should prioritize the use of randomized controlled trials to enhance the quality and credibility of publications on yoga for stress management.
4.4. Challenges in conducting randomized controlled trials on yoga for stress management
Randomized controlled trials on yoga for stress management face several challenges, which impact the reliability and generalizability of the findings. One of the important problems is blinding the participants, as participants are usually aware of the intervention (yoga). Moreover, creating appropriate control groups is challenging, as traditional controls may not adequately compare with the active yoga intervention. The variability in yoga styles, duration, intensity, and instructor experience complicates the standardization of protocols, leading to inconsistent results. Additionally, high dropout rates due to the time commitment and perceived lack of personal benefit undermine study validity. Recruitment bias, with participants often being self-selected from those already interested in yoga, limits the external validity of findings. Addressing these issues requires more rigorous trial designs, including standardized yoga protocols, improved control group strategies, and more diverse participant recruitment to enhance the generalizability of results [33,34].
In addressing the research gaps in yoga for stress management, it is crucial to focus on areas that require more robust evidence through randomized controlled trials, which are essential for evidence-based practice in integrative medicine. While there is growing interest in yoga's benefits for mental health, particularly for conditions like depression, anxiety, post-traumatic stress disorder, and perceived stress, more comparative randomized controlled trials are needed to evaluate yoga's effectiveness relative to other conventional treatments. Additionally, physiological markers such as cortisol, heart rate variability, and blood pressure, which are often linked to stress, should be further studied in controlled trials to establish definitive biological mechanisms. Another important gap exists in understanding the impact of yoga on specific populations, including adolescents, pregnant women, veterans, and those in high-stress occupations, with tailored interventions needed for these groups. Finally, integrating yoga into healthcare systems requires more research on its feasibility, cost-effectiveness, and long-term benefits, ensuring that yoga is not only an accessible but also a sustainable treatment option for stress management.
5. Strengths
This study is the first to report a comprehensive bibliometric analysis on yoga and stress, utilizing a robust dataset of 1025 articles exclusively from the Scopus database over the past 24 years. By employing advanced tools like VOSviewer and Bibliometrix, it provides in-depth visualization and clustering of key research trends. The results identify the most influential countries, institutions, authors, and publications, offering a clear and objective reflection of the current state of research and emerging trends in the field. This analysis delivers valuable reference information and serves as a strong foundation for guiding future studies, highlighting its significance in advancing the understanding of yoga's role in stress management.
6. Limitations
This study has several limitations. It covers only the past 24 years, potentially overlooking earlier research, and relies solely on the Scopus database, excluding PubMed or Web of Science, which might offer a broader perspective. Self-citations may influence author impact assessments, and excluding keywords like "relaxation techniques, Meditation, Pranayama, Om meditation, Cyclic meditation, etc.” could limit insights. Analyzing only English-language publications introduces language bias, potentially excluding relevant non-English studies. Additionally, citation-based metrics may undervalue newer high-quality research. Future studies could address these limitations by including multiple databases, broader keyword strategies, and multilingual analyses to enhance comprehensiveness.
7. Future suggestions
The area of yoga and stress management can be developed further by investigating a number of specific study questions. These include investigating the physiological effects of yoga on stress markers like cortisol and heart rate variability, comparing the relative efficacy of various yoga practices in lowering stress and anxiety, and researching the benefits of yoga on long-term stress resilience. Furthermore, studying how well yoga works in high-stress professions like teaching and healthcare, as well as comparing yoga's role in stress management across cultures, may yield insightful information. By concentrating on these specific research topics, it may be possible to fill up current knowledge gaps, gain a deeper understanding of yoga's therapeutic potential, and offer precise guidelines for evidence-based stress management techniques.
Randomized controlled trials and longitudinal studies should be given top priority in future research in order to validate current data, encourage real-world applications, and evaluate yoga's long-term impacts. Increasing cooperation between nations and organizations with limited involvement would be beneficial in advancing an all-encompassing and international strategy. These collaborations can foster information sharing and creative study approaches, which could improve our comprehension of yoga's possible impacts on outcomes linked to stress. Research comparing yoga to other stress-reduction methods like mindfulness-based stress reduction (MBSR) or cognitive behavioral therapy (CBT) might identify more successful integrative strategies.
Incorporating wearable technology and standard yoga techniques may further enhance data collecting and study repeatability. A more thorough comprehension of yoga's universal benefits will be possible by examining its effects on stressed people across age ranges, professions, and cultural backgrounds. Lastly, research on neural pathways will help us better understand the therapeutic benefits of yoga by examining how it affects oxidative stress and cortisol levels. By addressing these topics, the field will progress, fill in gaps in the literature, and provide data on yoga's stress-reduction benefits that are widely applicable.
8. Conclusion
In conclusion, this study presents a comprehensive bibliometric analysis of research published in Scopus over the past 24 years on yoga for stress management. It identifies key trends, highlights the main centers of collaborative research, and reflects the growing global interest on the potential of yoga in stress management. Future research should prioritize randomized controlled trials and longitudinal studies to strengthen the evidence base and promote international collaboration. Comparative studies with other stress management techniques and incorporating new technologies such as wearable devices may further refine our understanding of the therapeutic benefits of yoga. Studying the effects of yoga on diverse populations and neural pathways will be helpful in closing existing research gaps and promoting more effective, evidence-based practices for stress management.
Funding sources
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Authors contribution
Author 1: Conceptualization, Writing – original draft, Methodology, Software, Resources, Data curation/Study design, Author 2: Conceptualization, Validation, Writing – review and editing, Supervision.
Data statements
The author can provide the data upon request.
Declaration of generative AI in scientific writing
No generative AI or AI-assisted technologies were used in the creation of this study except for the use of software and grammerly to improve language and readability.
Conflict of interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgements
Authors are grateful for Mr. Rohit Kumar from the Department of Physics, Central University of Rajasthan, for his support throughout this study.
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