Strengths and limitations
IBS, depression
ADVERSE EVENTS, RECRUITMENT
This study is the first to evaluate the efficacy and feasibility of a virtual yoga intervention. The yoga intervention was developed based on IBS mechanistic rationale supported by an international yoga foundation and delivered by an experienced yoga instructor and at-home practice was supported by videos. We recruited patients from across Canada, using heterogeneous recruitment methods including gastroenterologist offices, primary care physician clinics, and social media. These results may not be generalizable as our sample is largely composed of educated White women with a high family income. Our data are also limited by the lack of data capture on the frequency of yoga practice, if any, in the control group, and lack of information as to the time that had passed between previous yoga practice and the current study. Our sample did not include patients with severe depression. Finally, 7 of 11 treatment participants did not start the intervention.Future studies should consider including objective measures of autonomic function testing (e.g., electrocardiogram), sympathetic reactivity tests (e.g., mental arithmetic test), and parasympathetic reactivity tests (e.g., heart rate variability in deep breathing) to determine physiological mechanisms of yoga response. Future studies with a larger sample size should also investigate the effects of yoga on IBS subgroups (IBS-diarrhea-predominant, constipation-predominant, or mixed) individually and the long-term effects of yoga.Our study results suggest that virtually delivered yoga is safe and feasible. Yoga improved IBS symptoms and a breadth of other psychological and physiological outcomes that are understudied but frequently affect patients with IBS. The intervention was also found to be safe without any adverse events. The virtual delivery of yoga represents an opportunity to increase access to effective management therapies for patients with IBS. Combining the convenience and flexibility of virtual programs and the social benefits of in-person interactions into hybrid programming may improve program efficacy, intervention adherence, and patient outcomes.