Applied Evidence

Yoga as therapy: When is it helpful?

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Balance and stability in the elderly

With its emphasis on strength, balance, and body awareness, yoga would seem a helpful intervention for older patients at risk of injury from falls. Unfortunately this area of research lacks significant numbers of controlled trails. In a Cochrane review of exercise interventions for improving balance in the elderly, the reviewers were unable find any studies specifically using yoga that met their criteria.30 Jeter et al31 attempted a review more recently, and found 15 studies meeting inclusion criteria, 5 of which were RCTs. Overall, however, the poor quality of the studies and variation in both the type of yoga used as intervention and measurements of balance precluded pooled analysis, although some studies did have positive results.

A small but well-designed pilot RCT was recently published showing that an Iyengar yoga intervention significantly improved timed one-leg balancing among community dwelling older adults.32 However, this study did not show a significant difference in a standardized fall risk survey after the intervention.32

Cautioning against yoga in this context are several articles chronicling increased risks of some yoga exercises, especially for those with osteoporosis or other risks for fractures.33 At this point, the well-documented risks of yoga practice in this group probably outweigh the unsubstantiated rewards.

Genevieve Verrastro, MD, MAHEC Family Health Center at Biltmore, 123 Hendersonville Road, Asheville, NC 28803;

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