Barriers and facilitators to yoga practice among people living with arthritis: a qualitative systematic review

The global burden of arthritis is high and increasing. Systematic reviews suggest that yoga, an ancient mind-body discipline, may help in arthritis treatment. This systematic review aimed to synthesise the barriers and facilitators to yoga practice in people with arthritis. JBI methodological guidance for qualitative systematic reviews was followed. MEDLINE, Embase, CINAHL Plus, PsycInfo, AMED, and Web of Science were searched to identify published studies, and ProQuest Dissertations and Theses for unpublished studies. Databases were searched until 07 November 2024, with no language restrictions. Study screening, assessment of methodological quality, and data extraction were completed independently by two reviewers. Data were synthesised using a meta-aggregative approach. Of 1330 identified records, nine articles, representing eight studies, were included in the review. All studies were conducted in high-income countries (the USA, UK, and New Zealand), with a majority of female participants. Methodological quality ranged from moderate to high; six of the eight studies met at least seven of the ten quality assessment criteria. 112 findings were extracted from the articles and grouped into 20 categories based on similarity in meaning. These were formulated into five synthesised findings: (i) Yoga, arthritis, and the body: the anticipated and experienced impacts of yoga on physical well-being influenced yoga practice; (ii) Yoga, arthritis, and the mind: levels of motivation and perceived impact on mental well-being influenced yoga practice; (iii) Yoga, arthritis, and the mind-body impact: yoga’s mind-body benefits supported coping with arthritis and encouraged continued practice; (iv) Yoga, arthritis, and session accessibility and structure: factors related to session accessibility and structure influenced engagement with yoga; and (v) Yoga, arthritis, and the session environment: a supportive social environment in yoga sessions impacted yoga practice. Each synthesised finding revealed a range of barriers and facilitators to yoga practice in people with arthritis. Within the included studies, there appeared to be more facilitators than barriers, suggesting that yoga could be a valuable addition to arthritis treatment. Future interventions to support yoga practice in this group should promote these facilitators and address the barriers to ensure successful implementation. PROSPERO registration number: CRD42023483350.