The Effects of Yoga Intervention on Gait and Balance in Community Dwelling Older Adults: A Systematic Review
McLaren O'Rear, SPT; Zoe Otteman, SPT
Faculty Mentor: Ann Marie Decker, PT, MSA, GCS, CEEAA
McLaren O'Rear, SPT; Zoe Otteman, SPT
Faculty Mentor: Ann Marie Decker, PT, MSA, GCS, CEEAA
Institution(s): Rockhurst University Department of Physical Therapy, Kansas City, MO
Purpose/Hypothesis: The paper seeks to review the effectiveness of yoga as an intervention to improve gait and balance in older adult clients. Previous studies examined yoga as a less traditional intervention for older adults and the health benefits of yoga has been studied for individuals across the lifespan; yet, there has limited study of yoga’s effects on gait and balance in the older adult.
Subjects: According to the Center of Disease Control, older Americans in 2014 suffered nearly thirty million falls. Falls result in seven million injuries annually, leading to roughly $31 billion in Medicare costs. The high cost of falls to older adults and our society as a whole, demands a careful evaluation of various interventions, which may decrease the risk of falls in the older adult and/or improve standing balance in the older adult. Yoga has been shown to be an effective exercise to enhance mood, promote sleep, increase flexibility and improve balance. The purpose of this study was to review recent studies testing the effectiveness of using yoga as an intervention to improve gait and balance in the older adult.
Methods/ Materials: A computer search conducted in April 2018 using search engines CINAHL and ProQuest for scholarly, peer-reviewed, and full-text articles. Dates searched were 2009 to 2018. Search terms were as follows: “balance”, “gait”, “older adult”, “yoga”, “fall”, and “intervention.” The original search revealed 244 articles. 225 papers were excluded based on title information. The abstracts and full-text of 19 potentially relevant articles screened to determine eligibility. Eleven of the remaining papers excluded due to studies focused on yoga not applied as an intervention, not focused on the older adults, the study did not report outcomes specific to balance and falls or the study focused on clients with chronic diseases. After complete review, eight studies selected to include in this systematic review.
Results: Of the eight papers reviewed, four were random control trials (RCT’s) and four were not. All papers examined a range of outcome measures. Outcome measures examined included functional performance that included gait and balance testing, incidence of falls, and changes in strength and flexibility. Functional performance measures ranged from Berg Balance Scale (BBS),) Short Physical performance Battery (SPPB) to Timed Up and Go (TUG) among others. Incidence of falls examined with pre and post intervention. Strength examined with dynamometer and heel rise. Flexibility assessed with back-scratch and sit-and-reach testing. Eight studies demonstrated a variety of improvements in yoga participants. Five studies demonstrated statistically significant improvements in functional performance scales such as TUG and SPPB. Three studies reported statistically significant improvements in standing balance post yoga. Fall incidence was reported in two studies; only one study reported statistically significant differences between the group participating in yoga and the control group. Three studies showed improvements in strength. One study showed some improvements in flexibility; however, the results were not statistically significant. Across all eight studies, four examined were able to confirm statistically significantly changes in outcome measures.
Conclusions: Studies reviewed included 244 participants and suggest older adults participating in yoga routinely may demonstrate improvements in functional performance, strength and experience a decrease in incidence of falls. Despite an extensive literature search, only four reviewed reported a statistically significant improvement in yoga participants. This suggests the strength of the evidence presented is limited.
Funding Source: No additional sources of funding
Purpose/Hypothesis: The paper seeks to review the effectiveness of yoga as an intervention to improve gait and balance in older adult clients. Previous studies examined yoga as a less traditional intervention for older adults and the health benefits of yoga has been studied for individuals across the lifespan; yet, there has limited study of yoga’s effects on gait and balance in the older adult.
Subjects: According to the Center of Disease Control, older Americans in 2014 suffered nearly thirty million falls. Falls result in seven million injuries annually, leading to roughly $31 billion in Medicare costs. The high cost of falls to older adults and our society as a whole, demands a careful evaluation of various interventions, which may decrease the risk of falls in the older adult and/or improve standing balance in the older adult. Yoga has been shown to be an effective exercise to enhance mood, promote sleep, increase flexibility and improve balance. The purpose of this study was to review recent studies testing the effectiveness of using yoga as an intervention to improve gait and balance in the older adult.
Methods/ Materials: A computer search conducted in April 2018 using search engines CINAHL and ProQuest for scholarly, peer-reviewed, and full-text articles. Dates searched were 2009 to 2018. Search terms were as follows: “balance”, “gait”, “older adult”, “yoga”, “fall”, and “intervention.” The original search revealed 244 articles. 225 papers were excluded based on title information. The abstracts and full-text of 19 potentially relevant articles screened to determine eligibility. Eleven of the remaining papers excluded due to studies focused on yoga not applied as an intervention, not focused on the older adults, the study did not report outcomes specific to balance and falls or the study focused on clients with chronic diseases. After complete review, eight studies selected to include in this systematic review.
Results: Of the eight papers reviewed, four were random control trials (RCT’s) and four were not. All papers examined a range of outcome measures. Outcome measures examined included functional performance that included gait and balance testing, incidence of falls, and changes in strength and flexibility. Functional performance measures ranged from Berg Balance Scale (BBS),) Short Physical performance Battery (SPPB) to Timed Up and Go (TUG) among others. Incidence of falls examined with pre and post intervention. Strength examined with dynamometer and heel rise. Flexibility assessed with back-scratch and sit-and-reach testing. Eight studies demonstrated a variety of improvements in yoga participants. Five studies demonstrated statistically significant improvements in functional performance scales such as TUG and SPPB. Three studies reported statistically significant improvements in standing balance post yoga. Fall incidence was reported in two studies; only one study reported statistically significant differences between the group participating in yoga and the control group. Three studies showed improvements in strength. One study showed some improvements in flexibility; however, the results were not statistically significant. Across all eight studies, four examined were able to confirm statistically significantly changes in outcome measures.
Conclusions: Studies reviewed included 244 participants and suggest older adults participating in yoga routinely may demonstrate improvements in functional performance, strength and experience a decrease in incidence of falls. Despite an extensive literature search, only four reviewed reported a statistically significant improvement in yoga participants. This suggests the strength of the evidence presented is limited.
Funding Source: No additional sources of funding