Cardiorespiratory Adaptations to Yoga: Mechanisms, Training Stimulus, and Implications for Vo₂Max: A Literature Review
DOI:
https://doi.org/10.37287/ijghr.v8i6.2661Keywords:
aerobic capacity, cardiorespiratory fitness, exercise, VO₂max , yogaAbstract
The effects of yoga on cardiorespiratory fitness and VO₂max remain inconsistent, partly because yoga practices vary substantially in modality and physiological training stimulus. This literature review synthesized evidence on the effects of yoga on VO₂max and cardiorespiratory fitness, with emphasis on training stimulus and potential physiological mechanisms. A total of 1,072 records published between 2001 and 2024 were identified through PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar using keywords related to yoga, VO₂max, aerobic capacity, cardiorespiratory fitness, and physiological adaptation. Following screening and eligibility assessment, 13 studies were included in the review. Data were synthesized according to yoga modality, training frequency, intervention duration, participant characteristics, and methods used to assess cardiorespiratory fitness. Most chronic intervention studies reported improvements in VO₂max or aerobic capacity, with increases of approximately 1.9–9.8 mL/kg/min. Improvements were observed following Hatha, intensive Hatha, integrated yoga, and high-intensity cardio yoga, whereas Bikram yoga, once-weekly high-intensity Hatha yoga, and habitual yoga practice showed no significant improvements. The findings suggest that cardiorespiratory adaptation may depend more on the magnitude and cumulative dose of physiological training stimulus than on the yoga modality itself. Yoga may improve cardiorespiratory fitness when practiced with sufficient and repeated physiological stimulus. However, substantial heterogeneity limits generalization across modalities.
References
Ardavani, A., Aziz, H., Phillips, B. E., Doleman, B., Ramzan, I., Mozaffar, B., Atherton, P. J., & Idris, I. (2021). Indicators of response to exercise training: A systematic review and meta-analysis. In BMJ Open (Vol. 11, Number 7). BMJ Publishing Group. https://doi.org/10.1136/bmjopen-2020-044676
Atakan, M. M., Li, Y., Koşar, Ş. N., Turnagöl, H. H., & Yan, X. (2021). Evidence-based effects of high-intensity interval training on exercise capacity and health: A review with historical perspective. In International Journal of Environmental Research and Public Health (Vol. 18, Number 13). MDPI. https://doi.org/10.3390/ijerph18137201
Bandyopadhyay, A., Halder, K., Pathak, A., Kumar, B., & Saha, M. (2022). Surya Namaskar. International Journal of Yoga, 15(2), 163–167. https://doi.org/10.4103/ijoy.ijoy_8_22
Batrakoulis, A. (2022). Psychophysiological Adaptations to Yoga Practice in Overweight and Obese Individuals: A Topical Review. In Diseases (Vol. 10, Number 4). Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/diseases10040107
Beutler, E., Beltrami, F. G., Boutellier, U., & Spengler, C. M. (2016). Effect of regular yoga practice on respiratory regulation and exercise performance. PLoS ONE, 11(4). https://doi.org/10.1371/journal.pone.0153159
Bhagel, P., & Saha, M. (2021). Effects of yogic intervention on pulmonary function and respiratory muscle strength parameters: A systematic literature review and meta-analysis. In Journal of Biosciences (Vol. 46, Number 3). Springer. https://doi.org/10.1007/s12038-021-00192-0
Brinsley, J., Smout, M., Girard, D., & Davison, K. (2022). Acute mood and cardiovascular responses to moderate intensity vinyasa yoga, static yin yoga and aerobic exercise in people with depression and/or anxiety disorders: A 5-arm randomised controlled trial. Mental Health and Physical Activity, 22. https://doi.org/10.1016/j.mhpa.2022.100450
Capela Santos, D., Jaconiano, S., Macedo, S., Ribeiro, F., Ponte, S., Soares, P., & Boaventura, P. (2023). Yoga for COVID-19: An ancient practice for a new condition – A literature review. In Complementary Therapies in Clinical Practice (Vol. 50). Churchill Livingstone. https://doi.org/10.1016/j.ctcp.2022.101717
Crowley, E., Powell, C., Carson, B. P., & Davies, R. W. (2022). The Effect of Exercise Training Intensity on VO2max in Healthy Adults:An Overview of Systematic Reviews and Meta-Analyses. In Translational Sports Medicine (Vol. 2022). John Wiley and Sons Ltd. https://doi.org/10.1155/2022/9310710
Dutta, A., Mooventhan, A., & Nivethitha, L. (2023). Yoga as Adjunct Therapy for Chronic Heart Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Avicenna Journal of Medicine, 13(03), 151–162. https://doi.org/10.1055/s-0043-1774738
Franklin, B. A., Eijsvogels, T. M. H., Pandey, A., Quindry, J., & Toth, P. P. (2022). Physical activity, cardiorespiratory fitness, and cardiovascular health: A clinical practice statement of the American Society for Preventive Cardiology Part II: Physical activity, cardiorespiratory fitness, minimum and goal intensities for exercise training, prescriptive methods, and special patient populations. In American Journal of Preventive Cardiology (Vol. 12). Elsevier B.V. https://doi.org/10.1016/j.ajpc.2022.100425
Furrer, R., Hawley, J. A., & Handschin, C. (2023). Themolecular athlete: Exercise physiology frommechanisms to medals. In Physiological Reviews (Vol. 103, Number 3, pp. 1693–1787). American Physiological Society. https://doi.org/10.1152/physrev.00017.2022
Gallo-Villegas, J. A., & Calderón, J. C. (2023). Epidemiological, mechanistic, and practical bases for assessment of cardiorespiratory fitness and muscle status in adults in healthcare settings. In European Journal of Applied Physiology (Vol. 123, Number 5, pp. 945–964). Springer Science and Business Media Deutschland GmbH. https://doi.org/10.1007/s00421-022-05114-y
Gifford, J. R., Blackmon, C., Hales, K., Hinkle, L. J., & Richards, S. (2024). Overdot and overline annotation must be understood to accurately interpret (Formula presented.) physiology with the Fick formula. Frontiers in Physiology, 15. https://doi.org/10.3389/fphys.2024.1359119
Giridharan, S., Ansari, J., & Pannerselvam, H. (2024). The Impact of Yoga on Heart Rate Variability: A Systematic Review of Randomized Controlled Trials. International Research Journal of Ayurveda & Yoga, 7(12), 30–41. https://doi.org/10.48165/irjay.2024.71205
Grässler, B., Thielmann, B., Böckelmann, I., & Hökelmann, A. (2021). Effects of Different Training Interventions on Heart Rate Variability and Cardiovascular Health and Risk Factors in Young and Middle-Aged Adults: A Systematic Review. In Frontiers in Physiology (Vol. 12). Frontiers Media S.A. https://doi.org/10.3389/fphys.2021.657274
Heinonen, I. (2025). Cardiac output limits maximal oxygen consumption, but what limits maximal cardiac output? Experimental Physiology, 110(5), 666–674. https://doi.org/10.1113/EP091594
Jakicic, J. M., Davis, K. K., Rogers, R. J., Sherman, S. A., Barr, S., Marcin, M. L., Collins, K. A., Collins, A. M., Yuan, N., & Lang, W. (2021). Feasibility of Integration of Yoga in a Behavioral Weight-Loss Intervention: A Randomized Trial. Obesity, 29(3), 512–520. https://doi.org/10.1002/oby.23089
Joyner, M. J., & Dominelli, P. B. (2021). Central cardiovascular system limits to aerobic capacity. Experimental Physiology, 106(12), 2299–2303. https://doi.org/10.1113/EP088187
Katla, N., Ramsahaye, A., Thulasi, A., Ilavarasu, J., Jagannathan, A., Bhargav, H., Varambally, S., & Gangadhar, N. (2022). Yoga Module Development and Validation. International Journal of Yoga, 15(3), 175–186. https://doi.org/10.4103/ijoy.ijoy_59_22
Ko, K. yan, Kwok, Z. C. M., & Chan, H. Y. L. (2023). Effects of yoga on physical and psychological health among community-dwelling older adults: A systematic review and meta-analysis. In International Journal of Older People Nursing (Vol. 18, Number 5). John Wiley and Sons Inc. https://doi.org/10.1111/opn.12562
Laborde, S., Allen, M. S., Borges, U., Dosseville, F., Hosang, T. J., Iskra, M., Mosley, E., Salvotti, C., Spolverato, L., Zammit, N., & Javelle, F. (2022). Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a meta-analysis. In Neuroscience and Biobehavioral Reviews (Vol. 138). Elsevier Ltd. https://doi.org/10.1016/j.neubiorev.2022.104711
LaMonte, M. J. (2022). Cardiorespiratory Fitness in the Prevention and Management of Cardiovascular Disease. In Reviews in Cardiovascular Medicine (Vol. 23, Number 11). IMR Press Limited. https://doi.org/10.31083/j.rcm2311382
Lang, J. J., Prince, S. A., Merucci, K., Cadenas-Sanchez, C., Chaput, J. P., Fraser, B. J., Manyanga, T., McGrath, R., Ortega, F. B., Singh, B., & Tomkinson, G. R. (2024). Cardiorespiratory fitness is a strong and consistent predictor of morbidity and mortality among adults: an overview of meta-analyses representing over 20.9 million observations from 199 unique cohort studies. In British Journal of Sports Medicine (Vol. 58, Number 10, pp. 556–566). BMJ Publishing Group. https://doi.org/10.1136/bjsports-2023-107849
Lee, J., & Zhang, X. L. (2021). Physiological determinants of VO2max and the methods to evaluate it: A critical review. In Science and Sports (Vol. 36, Number 4, pp. 259–271). Elsevier Masson s.r.l. https://doi.org/10.1016/j.scispo.2020.11.006
Lee, K. H., Ju, H. M., & Yang, W. H. (2021). Metabolic Energy Contributions During High-Intensity Hatha Yoga and Physiological Comparisons Between Active and Passive (Savasana) Recovery. Frontiers in Physiology, 12. https://doi.org/10.3389/fphys.2021.743859
Mallett, G., Schoenfeld, B., Purdom, T., & Galpin, A. (2025). Physiological factors that affect maximal oxygen uptake and lactate threshold during endurance training. In Science and Sports (Vol. 40, Number 1, pp. 10–23). Elsevier Masson s.r.l. https://doi.org/10.1016/j.scispo.2023.09.007
Manresa-Rocamora, A., Sarabia, J. M., Javaloyes, A., Flatt, A. A., & Moya-Ramón, M. (2021). Heart rate variability-guided training for enhancing cardiac-vagal modulation, aerobic fitness, and endurance performance: a methodological systematic review with meta-analysis. In International Journal of Environmental Research and Public Health (Vol. 18, Number 19). MDPI. https://doi.org/10.3390/ijerph181910299
Martinez, M. W., Kim, J. H., Shah, A. B., Phelan, D., Emery, M. S., Wasfy, M. M., Fernandez, A. B., Bunch, T. J., Dean, P., Danielian, A., Krishnan, S., Baggish, A. L., Eijsvogels, T. M. H., Chung, E. H., & Levine, B. D. (2021). Exercise-Induced Cardiovascular Adaptations and Approach to Exercise and Cardiovascular Disease: JACC State-of-the-Art Review. In Journal of the American College of Cardiology (Vol. 78, Number 14, pp. 1453–1470). Elsevier Inc. https://doi.org/10.1016/j.jacc.2021.08.003
Matko, K., Sedlmeier, P., & Bringmann, H. C. (2021). Differential Effects of Ethical Education, Physical Hatha Yoga, and Mantra Meditation on Well-Being and Stress in Healthy Participants—An Experimental Single-Case Study. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.672301
Mattavelli, I., Vignati, C., Farina, S., Apostolo, A., Cattadori, G., De Martino, F., Pezzuto, B., Zaffalon, D., & Agostoni, P. (2023). Beyond VO2: the complex cardiopulmonary exercise test. In European Journal of Preventive Cardiology (Vol. 30, pp. II34–II39). Oxford University Press. https://doi.org/10.1093/eurjpc/zwad154
Mølmen, K. S., Almquist, N. W., & Skattebo, Ø. (2025). Effects of Exercise Training on Mitochondrial and Capillary Growth in Human Skeletal Muscle: A Systematic Review and Meta-Regression. In Sports Medicine (Vol. 55, Number 1, pp. 115–144). Springer Science and Business Media Deutschland GmbH. https://doi.org/10.1007/s40279-024-02120-2
Murugesan, P. (2024). Yoga and Cardiovascular Diseases – A Mechanistic Review. International Journal of Yoga, 17(2), 83–92. https://doi.org/10.4103/ijoy.ijoy_55_24
Nalbant, G., Hassanein, Z. M., Lewis, S., & Chattopadhyay, K. (2022). Content, Structure, and Delivery Characteristics of Yoga Interventions for Managing Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. In Frontiers in Public Health (Vol. 10). Frontiers Media S.A. https://doi.org/10.3389/fpubh.2022.846231
Neha Saboo, & Sudhanshu Kacker. (2022). Effect of a 6-month yoga intervention on heart rate variability among pre-diabetics.
Niemeyer, M., Knaier, R., & Beneke, R. (2021). The Oxygen Uptake Plateau—A Critical Review of the Frequently Misunderstood Phenomenon. In Sports Medicine (Vol. 51, Number 9, pp. 1815–1834). Springer Science and Business Media Deutschland GmbH. https://doi.org/10.1007/s40279-021-01471-4
Nivethitha, L., Mooventhan, A., & Manjunath, N. K. (2021). Evaluation of Cardiovascular Functions during the Practice of Different Types of Yogic Breathing Techniques. International Journal of Yoga, 14(2), 158–162. https://doi.org/10.4103/ijoy.ijoy_61_20
Papp, M. E., Lindfors, P., Nygren-Bonnier, M., Gullstrand, L., & Wändell, P. E. (2016). Effects of High-Intensity Hatha Yoga on Cardiovascular Fitness, Adipocytokines, and Apolipoproteins in Healthy Students: A Randomized Controlled Study. Journal of Alternative and Complementary Medicine, 22(1), 81–87. https://doi.org/10.1089/acm.2015.0082
Park, S. Y., & Yang, W. H. (2023). Applied high-intensity interval cardio yoga improves cardiometabolic fitness, energetic contributions, and metabolic flexibility in healthy adults. Frontiers in Physiology, 14. https://doi.org/10.3389/fphys.2023.1279505
Pingali, H., & Hunter, S. D. (2023). Exploring mechanisms of blood pressure regulation in response to device-guided and non-device-guided slow breathing: A mini review. In Autonomic Neuroscience: Basic and Clinical (Vol. 244). Elsevier B.V. https://doi.org/10.1016/j.autneu.2022.103050
Prasanna Venkatesh, L., & Vandhana, S. (2022). Insights on Surya namaskar from its origin to application towards health. In Journal of Ayurveda and Integrative Medicine (Vol. 13, Number 2). Elsevier B.V. https://doi.org/10.1016/j.jaim.2021.10.002
Ross, R., Arena, R., Myers, J., Kokkinos, P., & Kaminsky, L. A. (2024). Update to the 2016 American Heart Association cardiorespiratory fitness statement. In Progress in Cardiovascular Diseases (Vol. 83, pp. 10–15). W.B. Saunders. https://doi.org/10.1016/j.pcad.2024.02.003
Sharma, S., Kaushik, D., Saini, S., Sharma, H., & Metri, K. (2025). Effect of Yoga-based Interventions on Heart Rate Variability and Anxiety Among Students: A Systematic Review and Meta-analysis. In Annals of Neurosciences. SAGE Publications Inc. https://doi.org/10.1177/09727531251394924
Sharpe, E., Lacombe, A., Sadowski, A., Phipps, J., Heer, R., Rajurkar, S., Hanes, D., Jindal, R. D., & Bradley, R. (2021). Investigating components of pranayama for effects on heart rate variability. Journal of Psychosomatic Research, 148. https://doi.org/10.1016/j.jpsychores.2021.110569
Shin, S. (2021). Meta-analysis of the effect of yoga practice on physical fitness in the elderly. International Journal of Environmental Research and Public Health, 18(21). https://doi.org/10.3390/ijerph182111663
Smith, J. A. B., Murach, K. A., Dyar, K. A., & Zierath, J. R. (2023). Exercise metabolism and adaptation in skeletal muscle. In Nature Reviews Molecular Cell Biology (Vol. 24, Number 9, pp. 607–632). Nature Research. https://doi.org/10.1038/s41580-023-00606-x
Souza, H. C. D., Philbois, S. V., Veiga, A. C., & Aguilar, B. A. (2021). Heart Rate Variability and Cardiovascular Fitness: What We Know so Far. In Vascular health and risk management (Vol. 17, pp. 701–711). NLM (Medline). https://doi.org/10.2147/VHRM.S279322
Taylor, J. L., Bonikowske, A. R., & Olson, T. P. (2021). Optimizing Outcomes in Cardiac Rehabilitation: The Importance of Exercise Intensity. In Frontiers in Cardiovascular Medicine (Vol. 8). Frontiers Media S.A. https://doi.org/10.3389/fcvm.2021.734278
Wagner, P. D. (2023). Determinants of maximal oxygen consumption. Journal of Muscle Research and Cell Motility, 44(2), 73–88. https://doi.org/10.1007/s10974-022-09636-y
Wibowo, R. A., Nurámalia, R., Nurrahma, H. A., Oktariani, E., Setiawan, J., Icanervilia, A. V., & Agustiningsih, D. (2022). The Effect of Yoga on Health-Related Fitness among Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. In International Journal of Environmental Research and Public Health (Vol. 19, Number 7). MDPI. https://doi.org/10.3390/ijerph19074199
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