An Iyengar yoga–based exercise program increased fall rates compared with seated relaxation yoga, according to findings from the SAGE Trial published in The Lancet Healthy Longevity.
The pragmatic, randomized controlled trial enrolled about 700 participants aged 60 years and older living independently in Australia (mean age 67 years; 81% female). Participants were randomly assigned to either an Iyengar-style yoga group (n=350) or a seated yoga relaxation group (n=350) for 12 months. Those in the Iyengar group attended 80 one-hour supervised classes held twice weekly, while controls participated in two one-hour relaxation workshops. Most sessions were conducted online because of the COVID-19 pandemic.
Participants recorded falls over the course of the year, as well as secondary outcomes including self-rated balance, mental wellbeing, physical activity, quality of life, physical function, sleep quality, pain, and goal attainment.
Within the Iyengar group, 41% of participants reported at least one or more falls, compared to only 29% of the seated yoga group, while the rate of injurious falls was similar between both groups (15% vs 13%). Subgroup analysis found that participants with no history of falls and a higher rate of physical activity at baseline had higher fall rates than those who were less active. Self-reported balance confidence was higher in the Iyengar group (mean difference 2.94 [0·60–5·28]), as well as the number of hours per week of planned physical activity (0.96 hours per week [0.43-1.49]), and goal attainment (0.60 [0.26-0.94]). The researchers speculated that this increased confidence may have encouraged participants to engage in more physical activity, thereby exposing themselves to greater risk.
“The SAGE yoga programme's foundation in the Iyengar style, emphasising static postures, differs from most successful fall prevention interventions that have targeted dynamic balance and functional activities, and included fall prevention advice,” wrote lead study author Juliana S Oliveira, PhD, of the Women-Newborn-Children’s Service, Gold Coast University Hospital, Gold Coast, Australia, and colleagues.
Six participants reported musculoskeletal-related adverse events associated with the yoga program, and no serious adverse events occurred.
Yoga continues to be popular among older adults as a way to maintain balance and mobility. The authors concluded that that further research investigating the effect of different styles of yoga that incorporate more dynamic balance on fall risk and prevention is warranted.
The study authors reported no conflicts of interest.
Source: The Lancet Healthy Longevity