A Hindu holy man, or sadhu, performs yoga at the premises of Pashupatinath Temple in Kathmandu February 26, 2014. REUTERS/Navesh Chitrakar (Copyright Reuters 2016)
Yoga-based exercise programs can improve mobility among people over age 60 and possibly help prevent falls by improving balance, according to a new review of existing research.
"These results are exciting but not particularly surprising since there is evidence from other research that similar types of exercise programs, Tai Chi, for example, can improve balance and mobility in older people," said senior author Anne Tiedemann of the George Institute for Global Health at Sydney Medical School, The University of Sydney, in Australia.
"What is exciting about the results is that significant improvements occurred in balance and mobility as a result of relatively short programs of yoga - the average number of hours offered was 20 hours," Tiedemann told Reuters Health by email.
The researchers analyzed six trials, with a total of about 300 participants, looking at the effect of physical yoga on balance among men and women age 60 and older.
Five trials included people living in the community while the sixth included people in residential aged-care settings.
Some did not specify the style of yoga tested, but all utilized a certified yoga instructor and props such as blankets, chairs, blocks, pillows, straps and mats. Programs tended to include 60 to 90 minutes of yoga once or twice weekly for a total of two to six months.
Participants attended about 82 percent of classes, which is a high attendance rate compared to many other programs, Tiedemann noted.
Overall, yoga was linked to a small improvement in balance and a medium improvement in mobility - such as walking speed and how easily a person can get out of a chair - though the review authors were especially interested in the effects on balance.
To train balance, you need to undertake activities that challenge your balance and to perform these activities a standing position, Tiedemann said.
Three trials reported minor adverse events during yoga, like knee pain, low back pain or minor muscle strains, according to the report in Age and Ageing.
The researchers did not measure subsequent health events or falls after the yoga trials, so could not conclude that yoga reduces the risk of falls. Further research should investigate this question, the authors note.
Balance and mobility decline with age and the risk of falling increases significantly after the age of 65, Tiedemann said.
In previous research, she found that older people who are unable to quickly stand up from a seated position without using their arms for assistance are about twice as likely to fall in the next year as older people who can perform this task quickly.
"So reduced balance and mobility are linked to falls as well as loss of independence and lower quality of life in older age," Tiedemann said. "It's interesting to note that balance and mobility can be trained and improved at any age - it's never too late to start."
It's hard to say whether yoga improves standing or walking balance, and we can't always tell if these will have any effect on falls, which is the real problem, said Pamela Jeter, a yoga expert at Johns Hopkins University in Baltimore, Maryland, who was not part of the review.
"Balance is regulated by several systems in the body and I believe we need to understand where the deficit is coming from before we can target the intervention," Jeter told Reuters Health by email. "Yoga is great as a therapeutic approach because it can be modified to the individual need or individual balance deficit."
Psychological anxiety or fear of falling can also increase the risk, beyond just physical weakness, and the mindfulness component of yoga may be beneficial psychologically, she said.
"We would recommend that older people who are healthy enough to take part in regular physical activity could join a yoga class run by a yoga instructor who has experience with teaching older people," Tiedemann said. "The type of yoga should be that which focuses on standing balance postures rather than relaxation/ meditation as the focus."
Those with medical conditions that preclude exercise should consult a doctor before starting a yoga program, she said.