Effects of Remotely Delivered Yoga Interventions on Quality of Life and Symptom Burden in Women with Breast Cancer: A Systematic Review and Meta-Analysis.

Background/Objectives: Breast cancer (BC) survivors frequently experience persistent psychological and physical symptoms and reduced health-related quality of life (HRQoL). Yoga has emerged as a promising supportive intervention in this context; however, evidence regarding remotely delivered yoga programs remains limited. This systematic review aimed primarily to evaluate the effects of remotely delivered yoga interventions on HRQoL among women with BC. Secondary outcomes included psychological and physical symptoms, as well as feasibility, adherence, and safety. Methods: Randomized controlled trials (RCTs) and non-randomized studies assessing remote, home-based, or hybrid yoga interventions delivered through digital platforms, videos, or remote support were searched in PubMed, Scopus, Web of Science, and the Cochrane Library (PROSPERO registration number: CRD420261362619). Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. A random-effects meta-analysis was performed for HRQoL outcomes from independent RCT populations, using standardized mean differences (Hedges' g). Results: Twenty-six publications representing 19 independent study cohorts were included. Eighteen publications reported randomized controlled trials and eight reported non-randomized studies. In the meta-analysis, the 9 RCTs that reported effects on HRQoL showed a moderate improvement in this outcome (Hedges' g = 0.56, 95% CI 0.17-0.96), with substantial between-study heterogeneity (I2 = 72.4%). Secondary psychological and physical outcomes showed potential benefits, but findings varied across studies. Feasibility and adherence were generally favorable, while no serious yoga-related adverse events were reported among studies assessing safety. Conclusions: Remote and home-based yoga interventions may improve HRQoL in women with BC; however, the consistency and generalizability of this effect are limited by substantial between-study heterogeneity and variability in intervention delivery. Further standardized and adequately powered RCTs are needed to confirm clinical effectiveness and inform long-term implementation in breast cancer care.