By Greg Gargiulo
Findings of a randomized controlled trial published in the September issue of Archives of Physical Medicine and Rehabilitation suggest a 12-week yoga program modified for older fallers may be as effective as tai chi and standard balance training for improving postural stability.
Tai chi and standard balance training are both commonly used to improve balance in older adults in the interest of reducing the risk of falls. The new findings suggest that yoga, with its growing appeal and focus on balance, may also be worth considering in this context.
“Right now yoga is exploding on the scene and becoming more and more popular all over the world,” said Joseph Signorile, PhD, senior author of the study and professor of kinesiology and sports sciences at the University of Miami in Coral Gables, FL. “That, in addition to other characteristics like its gentle feeling and mental and spiritual components, make yoga attractive an exercise intervention.”
Signorile and a team of researchers that included Meng Ni from the Laboratory of Neuromuscular Research and Active Aging at the University of Miami and Kiersten Mooney of BalaVinyasa Yoga in Naples, FL—both largely responsible for the execution and modifications of the yoga program—evaluated 39 healthy individuals older than 60 years (32 women; mean age, 74 years) living without assistance but who had fallen at least once in the past year. Participants were randomly assigned to the balance, tai chi, or targeted yoga groups; each intervention entailed two one-hour classes per week for 12 weeks.
The tai chi (Chen style) and standard balance interventions involved programs already in use with older adults at risk for falls, but the yoga intervention required some modification for that patient population. The customized power Vinyasa yoga consisted of various poses—chair, tree, plank, and warrior 1 and 2 poses in particular—that targeted muscles important to balance in a multidirectional pattern of movement from one pose to the next; patients were allowed to use the wall for support if needed in the early stages of the program. All patients were assessed before and one week after training with a series of field and laboratory tests for balance, gait, and postural control.
Patients in all three groups experienced significant improvements in all field tests, as well as lab tests for both static and dynamic balance. Compliance for all programs was generally good, with five dropouts in the tai chi group but only one in the standard balance training group and two in the yoga group. Although the study population was predominantly women, the researchers noted that women are at a greater risk for falls and participate in yoga more regularly than men.
Though the results are supportive of an attractive modality growing in popularity, more research is required to determine whether the improvements in postural stability associated with yoga are ultimately associated with a lower risk of falls in the long term. Both tai chi and multimodal exercise programs that include balance training have been associated with reduced rates of falls in older adults.
“Until someone does a very extensive longitudinal study, it’s difficult to make a statement about yoga and falls. But we do feel comfortable stating we did utilize very good markers of the potential for falls in an older population,” Signorile said.
Marieke Van Puymbroeck, PhD, an associate professor and recreational therapy coordinator at Clemson University in SC who has extensive experience studying yoga for balance, agreed that the preliminary findings are encouraging.
“This study provides empirical support that a twelve-week yoga program can improve balance for an older population,” Van Puymbroeck said. “While the authors did not measure if falls, or fear of falling, actually reduced, they showed improvements in areas that would likely lead to a reduction in falls.”
Van Puymbroeck also agreed that longer-term studies are warranted.
“I’d like to see a large study next that is really comprehensive, with both physical and psychological measures and six-month follow up, to see how balance changes impact the individual,” she said.
Ni M, Mooney K, Richards L, et al. Comparative impacts of tai chi, balance training, and a specially-designed yoga program on balance in older fallers. Arch Phys Med Rehabil 2014;95(9): 1620-1628.