To evaluate the effect of a yoga-based exercise program on falls compared to a seated yoga relaxation program.
Protocol was prospectively registered (ACTRN12619001183178). Recruitment occurred between 2019 and 2021 in NSW, Australia. Inclusion criteria: aged 60+; living independently; not participating in yoga. Exclusion criteria: cognitive impairment (scoring ≤ 4 on MIS); insufficient English; inability to walk 10 metres unassisted; progressive neurological disease or a medical condition precluding exercise. Participants were randomly allocated to either: (1) group-based, supervised, 80-session Iyengar yoga-based exercise program, emphasising standing balance postures (intervention group), or (2) seated yoga relaxation program, delivered in two group-based sessions (control group). The primary outcome was rate of falls in the 12 months after randomisation, measured via monthly surveys. Secondary outcomes included mental well-being, physical activity, health-related quality of life, balance self-confidence, physical function, pain, goal attainment and sleep at 12 months post-randomisation.
Between October 2019 and October 2021, 700 participants (mean age 66, SD 5.8) were recruited and randomised, with 350 participants (50%) assigned to each group. 572 (82%) participants were female, 178 (25%) participants self-rated their balance as fair/poor, and 229 (33%) had fallen in the past year, which is consistent with population estimates. Four months into the trial, the yoga program delivery was moved online via Zoom due to COVID-19 restrictions. Contrary to expectations, there was a higher fall rate in the intervention group compared to control group (0·87 versus 0·64 falls per person-year, respectively; Incidence Rate Ratio=1·33, 95% CI 1·01 to 1·75; p-value=0·04). The intervention significantly improved physical activity, balance self-confidence and goal attainment. No significant between-group differences were identified in other secondary outcomes.
This Iyengar yoga-based exercise program increased falls in community dwellers aged 60+ years compared to seated relaxation yoga. The program effectively improved participation in planned exercise, balance self-confidence and goal attainment. The increase in falls may be due to the intervention increasing participants' confidence in their balance and physical activity levels, leading to greater exposure to higher fall-risk situations without providing sufficient improvements in their balance.
Our findings do not support recommending this Iyengar yoga-based exercise program as a fall prevention intervention among community-dwelling older people aged 60+ years in its current form. However, the adherence to the intervention was high, and there was a high level of interest in the study. Therefore, it is worth further investigating the impact of different types and delivery modes of yoga and the impact of including additional fall prevention advice.
Yoga exercise
Aged
