Objective

To evaluate the effects of a single session of mindful exercise on anxiety and examine whether effects varied according to participant characteristics, mindful exercise exposure, or research design features.

Methods

Consistent with PRISMA guidelines for conduct and reporting, we identified randomized or non-randomized controlled trials (RCTs) that: (1) sampled healthy or unhealthy participants, (2) used a single session of yoga, Tai chi, or Qigong practice, and (3) assessed self-reported anxiety outcomes. Databases searched included Google Scholar, PubMed, PsycINFO, and Web of Science, from which 18 yoga, 5 Tai chi, and 4 Qigong articles were published before August 31, 2020. Studies involved 2341 participants (1904 in yoga studies, 232 in Tai chi studies, 205 in Qigong studies) were selected. Hedges d effect sizes were calculated. Random effect models and multilevel meta-analysis were used to estimate the pooled effects. I2 tests were applied to assess the heterogeneity. In yoga studies, moderating effects were tested by multilevel meta-regression analysis of putative moderators representing participant characteristics, features of mindful exercise exposure, and aspects of research design. Because of the limited number of Tai chi and Qigong studies, sensitivity analyses were conducted by omitting potential outlying effects and evaluating the overall pooled effect. Study quality was judged using the PEDro scale.

Results

A single session of yoga reduced anxiety by a heterogeneous (I2 = 82.7%) standardized mean effect size 0.32 (95% CI, 0.16 to 0.48, t = 4.108, p = 0.0002). In the multilevel univariate regression model, reductions were larger in participants who had previous yoga experience, or practiced Hatha yoga, or engaged in higher intensity yoga. Larger effects were also found when yoga was compared to no treatment or minimal treatment control than when yoga was compared to non-yoga exercise and when anxiety was measured 0–10 min immediately after yoga. In the multilevel multiple regression model, the effects remained larger for yoga history and yoga versus no treatment or minimal treatment control compared to yoga versus non-yoga exercise. Meta-regression analysis did not suggest other significant (p > 0.05) moderating effects on anxiety outcomes. The low heterogeneous (I2 = 10%) mean effect of a single session of Tai chi on anxiety was −0.06 (95% Cl, −0.38 to 0.24, t = −0.37, p = 0.68). The homogeneous (I2 = 0%) mean effect of a single session of Qigong on anxiety was 0.70 (95% CI, 0.22 to 1.18, t = 4.06, p = 0.02).

Conclusion

A single session of yoga may have small-to-moderate efficacy for the management of anxiety, but the limited number of studies for Tai chi and Qigong studies makes it premature to conclude their practical effectiveness. In addition, the overall quality of the included studies was relatively low. Cautions should be taken when applying a single session of mindful exercise to reduce anxiety in practice. Further high-quality randomized controlled trials are needed to mitigate methodological bias typically found in the retrieved studies.

中文翻译：

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单次正念运动对焦虑的影响：系统评价和荟萃分析

客观的

评估单次正念运动对焦虑的影响，并检查其影响是否因参加者特征，正念运动暴露或研究设计特征而异。

方法

根据PRISMA的行为和报告指南，我们确定了以下随机或非随机对照试验（RCT）：( 1）对健康或不健康的参与者进行了抽样；（2）使用了一次瑜伽，太极或气功练习，以及（3）评估自我报告的焦虑结局。搜索的数据库包括Google Scholar，PubMed，PsycINFO和Web of Science，在2020年8月31日之前发表了18篇瑜伽，5篇太极拳和4篇气功文章。研究涉及2341名参与者（1904年参加瑜伽研究，232名参加太极拳）。研究中，选择了205个气功研究）。计算对冲d效应的大小。使用随机效应模型和多级荟萃分析来评估合并效应。应用I2测试评估异质性。在瑜伽课上 通过代表参与者特征，正念运动暴露特征以及研究设计各方面的假定主持人的多级元回归分析，对调节作用进行了测试。由于太极拳和气功研究的数量有限，因此通过省略潜在的孤立效应并评估总体综合效应进行了敏感性分析。使用PEDro量表评估研究质量。

结果

一次瑜伽练习可以减少焦虑（I2 = 82.7％）标准化平均效果大小0.32（95％CI，0.16至0.48，t = 4.108，p = 0.0002）。在多级单变量回归模型中，以前有瑜伽经验，练习过Hatha瑜伽或从事过更高强度瑜伽的参与者的减少幅度更大。当将瑜伽与不进行任何治疗或进行最小程度的治疗控制相比时，与将瑜伽与非瑜伽运动进行比较以及在瑜伽后立即进行0-10分钟的焦虑测量相比，也发现了更大的效果。在多级多元回归模型中，与瑜伽与非瑜伽运动相比，瑜伽历史和瑜伽与未治疗或最小控制相比效果更大。荟萃回归分析未显示出对焦虑结果的其他显着（p> 0.05）调节作用。一次太极拳对焦虑的低异质性（I2 = 10％）平均效应为-0.06（95％Cl，-0.38至0.24，t = -0.37，p = 0.68）。单次气功对焦虑的均一（I2 = 0％）平均效应为0.70（95％CI，0.22至1.18，t = 4.06，p = 0.02）。

结论

瑜伽的单次治疗对焦虑症的治疗可能具有中度至中度的功效，但太极和气功研究的研究数量有限，因此尚无法断定其实际疗效。此外，纳入研究的总体质量相对较低。在进行单节正念运动时应格外小心，以减少实际中的焦虑。需要进一步的高质量随机对照试验来减轻通常在检索到的研究中发现的方法学偏见。