Effects of mindfulness-based yoga and physical exercise on psychological well-being in individuals with visual impairment: a three-armed randomized controlled trial

Individuals with visual impairment (VI) experience elevated psychological distress and reduced subjective well-being, yet the comparative effects of Mindfulness-based Yoga (MY) and Physical Exercise (PE) remain unclear. This multicenter, assessor-masked, three-arm randomized controlled trial conducted in India (December 2021–January 2025) enrolled 164 adolescents and young adults with VI randomized to MY, PE, or a wait-list control group. Co-primary outcomes included serum biomarkers (dopamine, serotonin, cortisol, β-endorphin, and melatonin), psychological distress assessed using the Hospital Anxiety and Depression Scale, and subjective well-being measured using the Oxford Happiness Questionnaire.

Secondary outcomes included sleep quality, physical function, perceived social support, and holistic well-being assessed at baseline, 8 weeks, and 32 weeks. Baseline characteristics were comparable across groups. No significant group effects or group × time interactions were observed for primary outcomes, including biomarkers, anxiety, depression, and happiness.

Exploratory within-group analyses identified changes in selected biomarkers; however, these findings were not accompanied by significant between-group effects and should be interpreted cautiously. Similarly, no significant group effects or group × time interactions were observed for any secondary outcome. Several psychological, physical, and well-being measures improved over time across the study period, but these changes occurred similarly across all groups.

MY and PE were delivered in institutional settings, but neither intervention demonstrated superiority over the other or the wait-list control condition. Future studies with longer follow-up, improved adherence strategies, and focused outcomes are needed. Trial registration: Registered on 23 August, 2021, in Clinical Trial Registration of India CTRI/2021/08/035853. (https//ctri.nic.in/Clinicaltrials/login.php) The authors wish to thank Mahantesh NK, PhD, Samarthanam Trust for the Disabled; Saibaba Goud, MS, PhD, Devnar Foundation for the Blind; Anupama Janardhanan, MD, Dr.

Agarwal’s Eye Hospital; NR Lalithamba, PhD, Chethana Enabling Unit, Government First Grade College, Vijayanagar, Bengaluru; Hemavathi S, MPhil, Narmada_A Unit for Differently Abled Persons of APS College, NR Colony, Bengaluru; Geetha V, MCom, MBA, HOD of Computer Applications Department, JSS Polytechnic for the Differently Abled, Mysuru; Shantha KN, yoga instructor, Sri Sri School of Yoga; Deepa Samji, yoga instructor, Sri Sri School of Yoga; Babita Jand, yoga instructor, Sri Sri School of Yoga; Kavita Chauhan, yoga instructor; Srividya, PhD, yoga instructor, Karnataka Samskrutha University; Suman Nova A, PhD, physical exercise instructor; Abhishek R, physical exercise instructor; Ramu M, physical exercise instructor; Satya Prakash, phlebotomist, Anveshana Lab, S-VYASA University, Bengaluru; Jianen Zhang, MBA, Guangxi University, Nanning, China. We thank research scholars from Clinical Biochemistry Laboratory, Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru, India, namely Anju Srinivas, PhD; Deepthi V Chalapathi, PhD; Vaibhavishree M, MSc; Sumaiya Kalaigar, PhD; Navyashree M J, PhD; Lakshmi K Gowda, PhD; Prajwal G, PhD. We also thank all the participants in the study.

This trial was supported by Dr. Subhash Chander Mahajan (retired Airforce Pilot of India and USA, retired Vice President of General Motors). Grant reference: INKA99383440303409U.