Case study: Using yoga to prevent falls in older people
"The low levels of participation in current fall prevention programs made us wonder if yoga could be beneficial for preventing falls."
Falling in older people is a major public health issue and a barrier to healthy ageing. In Australia, at least one in three people aged 65 and over fall each year – this is around one million people annually. Falls have a major impact in older age and can lead to long term disability, reduced mobility, poor quality of life, aged care admission and even death.
“Regular exercise has been shown to prevent falls, promote independence and to contribute to other aspects of healthy ageing, but the majority of older Australians are not sufficiently active. There is a clear need for more effective strategies that promote physical activity for healthy ageing,” said The George Institute’s former A/Prof Anne Tiedemann.
Clinical guidelines recommend that in order to prevent falls, older people should do exercises that challenge balance, progress in intensity over time, are carried out for at least two hours a week and are ongoing. Unfortunately, population surveys show that as little as 6% of older people take part in the types of exercise programs that are proven to prevent falls.
What did The George Institute do?
“The low levels of participation in current fall prevention programs made us wonder if yoga could be beneficial for preventing falls. Yoga is appealing to older people and its potential for preventing falls has not been investigated,” said A/Prof Tiedemann.
“I led a study in collaboration with Prof Cathie Sherrington to evaluate the feasibility and effectiveness of a group-based yoga program, compared with the usual care among people aged 60 and over. This was designed as a pilot study in preparation for a definitive trial to determine if yoga prevents falls among older people.”
The study aimed to measure the impact of participating in a yoga class compared to being given an information booklet on fall prevention. The research team recruited 54 people aged 60 and over who were living in Sydney’s inner west. Half of the group participated in twice-weekly Iyengar yoga classes for 12 weeks, while the other half received the booklet. At the end of the 12 weeks, the researchers compared the two groups on their ability to complete some functional tests of balance and mobility that have been previously shown to predict fall risk.
Results and success
The researchers found that at the end of the study, the group that took part in yoga could perform significantly faster in a test involving standing up and sitting down quickly without using the arms for support. The yoga group also walked significantly faster in a four metre walking test and could stand on one leg for longer, indicating improved balance. Previous research has shown that older people who perform well in these tests are about half as likely to fall as people who cannot perform these tests well.
“These results demonstrated the potential impact that yoga may have on reducing fall risk. The yoga program was also found to be safe and fun for the older participants, and attendance at the classes was very good. What is really encouraging is that the seniors’ yoga classes that were started for our pilot study have continued as a paid course, with many of the original participants staying on. This shows the program’s appeal and sustainability,” said A/Prof Tiedemann.
The study was published in Journals of Gerontology: Medical Sciences and received media coverage on 7 News Sydney, ABC 702 breakfast radio, the Daily Telegraph and more.
What does the future hold?
“Our pilot study demonstrated that yoga participation improved balance and mobility in a relatively small group of people. We have now designed the definitive trial to evaluate whether participation in yoga-based exercise is effective in preventing falls,” said A/Prof Tiedemann.
An application for funding is currently under review through the NHMRC Project Grants scheme. A large trial involving 500 people and a one-year follow-up period is planned to accurately determine if yoga participation can prevent falls in older people.