Healing with laughter: the therapeutic power of laughter yoga in pediatric health - a systematic review.

BACKGROUND: Laughter yoga is a non-pharmacological and non-invasive therapeutic approach that integrates voluntary laughter with controlled breathing exercises. This systematic review aimed to evaluate research investigating the impact of laughter yoga on children's health outcomes. METHODS: This systematic review included studies with randomized controlled trial (RCT) and quasi-experimental designs, adhering to the PRISMA guidelines. This systematic review, conducted between December 18, 2023, and October 31, 2024, was guided by the PRISMA guidelines and a predefined protocol based on the PICOS-based protocol. Eligible studies included randomized controlled trials (RCTs) and quasi-experimental designs. A comprehensive literature search was conducted in Google Scholar, Medline/PubMed, Cochrane Library, Science Direct, CINAHL Complete, and OVID databases. Study selection was based on the PICOS framework, and methodological quality was assessed using the Joanna Briggs Institute-Meta Analysis Statistical Assessment and Review Instrument (JBI-MAStARI). Based on the inclusion criteria, six studies were incorporated into the review. RESULTS: The total sample across the included studies was 305 participants, with 66% of the studies involving at least 50 participants. Findings indicated that laughter yoga contributed to a reduction in anxiety and stress levels in children (p < 0.05), while no statistically significant effect was observed on depression scores (p > 0.05). Although no substantial improvement in self-esteem was reported, positive changes in self-concept were noted. Furthermore, laughter yoga was associated with an increase in salivary IgA levels (p < 0.01), whereas no significant influence on cortisol levels was found (p > 0.05). Additionally, the intervention was reported to alleviate pain, fatigue, and burnout while enhancing hope and overall happiness. CONCLUSIONS: Study results showed that laughter yoga promoted the increase in happiness and self-concept in children and improved their ability to cope with stress. It also provided a physiological improvement by positively affecting pain and fatigue. In light of these results, it is recommended that laughter yoga be used more widely in children's daily lives and clinical practices.