Yoga compared with waiting‐list control (yoga) for stroke

Patient or population: adults with stroke

Settings: community

Intervention: yoga

Comparison: wait‐list control (yoga)

Quality of life: Stroke Impact Scale (SIS)

SIS measures quality of life across five domains: physical (strength, hand‐function, mobility, activities of daily living), emotion, memory, communication, social participation, plus 1 global question about stroke recovery. Each dimension is scored on a 100‐point scale; the higher the score, the higher the quality of life

Baseline and post‐intervention

22
(1)

⊕⊕⊝⊝
very low

The quality of evidence was graded as very low due to small sample size, incomplete data, and the small number of studies i.e.1

Quality of life: Stroke‐specific QoL Scale (SS QoL)

The Stroke‐specific QoL Scale measures quality of life across 12 domains (49 items): self‐care, vision, language, mobility, work, upper extremity, thinking, personality, mood, family, social, and energy

Each item is scored on a 5‐point Likert scale; the higher the score, the higher the quality of life (score 0‐245)

Baseline and post‐intervention

47

(1)

⊕⊕⊝⊝
very low

The quality of evidence was graded as very low due to small sample size, incomplete data, and the small number of studies i.e.1

Balance: Berg Balance Scale (BBS)

14‐item physical performance measure of static and dynamic balance (score: 0‐56)

Baseline and post‐intervention

69
(2)

⊕⊝⊝⊝
very low

The quality of the evidence was graded as very low due to high risk of bias in relation to sample size, incomplete data, and unrepresentative sample, across the 2 studies

Gait: Comfortable Gait Speed (CGS)

Gait measured over 7 metres (3 repetitions; average time calculated)

Baseline and post‐intervention

22
(1)

⊕⊕⊝⊝
very low

The quality of evidence was graded as very low due to small sample size, and incomplete data

Depression: Geriatric Depression Scale (GDS15)

A 15‐item self‐report assessment used to identify depression in the elderly. A yes/no response is required for each item (score 0 or 1). Cummulative score: 0‐4 normal, 5‐9 Mild depression, 10‐15 More severe depression

Baseline and post‐intervention

22
(1)

⊕⊝⊝⊝
very low

The quality of evidence was graded as very low due to small sample size, incomplete data, and the small number of studies

Anxiety: State Trait Anxiety (STAI‐Y1)

A 40‐item, self‐report assessment of anxiety affect. State anxiety can be defined as fear, nervousness, discomfort, and the arousal of the autonomic nervous system induced temporarily by situations perceived as dangerous. Score 20‐80; higher scores suggest higher levels of anxiety

Baseline and post‐intervention

22
(1)

⊕⊝⊝⊝
very
low

The quality of evidence was graded as very low due to small sample size, incomplete data, and the small number of studies

Anxiety: Trait Anxiety Inventory (STAI‐Y2)

A 40‐item, self‐report assessment of anxiety affect. Trait anxiety can be defined as a relatively enduring disposition to feel stress, worry, and discomfort. Score 20‐80; higher scores suggest higher levels of anxiety

Baseline and post‐intervention

22
(1)

⊕⊝⊝⊝
very low

The quality of evidence was graded as very low due to small sample size, incomplete data, and the small number of studies

Disability: modified Rankin Scale (mRS)

A measure of disability, with 6 categories: 0 (no symptoms), 1 (no significant disability), 2 (slight disability), 3 (moderate disability), 4 (moderately severe disability), 5 (severe disability), 6 (dead); reported as dependent/independent

Baseline and post‐intervention

47
(1)

⊕⊝⊝⊝
very low

The quality of evidence was graded as very low due to small sample size, incomplete data, and unrepresentative sample

Adverse events

Post‐intervention

⊕⊝⊝⊝
very low

No evidence available

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; OR: Odds Ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.