Reduce Fear of Falling in the Elderly with Yoga
By John M. de Castro, Ph.D.
“Yoga makes you have a strong core, so when moving around in your daily life, you are not just flapping around. You are stable, in control.” – Anne Bachner
The process of aging affects every aspect of the physical and cognitive domains. Every system in the body deteriorates including motor function with a decline in strength, flexibility, and balance. Impaired balance is a particular problem as it can lead to falls. In the U.S. one third of people over 65 fall each year and 2.5 million are treated in emergency rooms for injuries produced by falls. About 1% of falls result in deaths making it the leading cause of death due to injury among the elderly.
Falls, with or without injury, also carry a heavy quality of life impact. A growing number of older adults, fear falling and, as a result, limit their activities and social engagements. This can result in further physical decline, depression, social isolation, and feelings of helplessness. It is obviously important to discover methods to improve balance and decrease the number of falls in the elderly. Yoga practice helps to develop strength, flexibility, and balance. It would seem likely, then, that practicing yoga would reduce the likelihood of falling by the elderly.
In today’s Research News article “A mixed methods evaluation of yoga as a fall prevention strategy for older people in India.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5928579/ ), Keay and colleagues recruited elderly participants (> 60 years of age) and provided them with 2 1-hour yoga classes per week for 3 months. The program emphasized standing poses that develop balance. The participants were measured before and after training for overall health, body size, fear of falling, history of falls, physical performance, and blood pressure. At the end of training the participants also attended focus groups with discussion focused on “perceptions of the yoga program, perceived benefits of yoga and understanding fall injury/reporting falls.”
They found that there were no adverse events and no falls reported during the program. After the 3-month yoga program the elderly participants were significantly faster in the sit-stand test, had increased stride length while walking, and significantly lower body weight and fear of falling. Hence, participation in a yoga program improved the physical abilities of the elderly. It should be noted that there wasn’t a control or comparison condition so conclusions should be reached cautiously.
The results suggest that practicing yoga is beneficial for elderly men and women. These results are sufficiently encouraging to support conducting a large randomized controlled trial. The participants in the present study were quite healthy at the beginning of the trail, so ceiling effects may have prevented the detection of further benefits. Indeed, the participants all successfully passed the most difficult balance test during the baseline test, leaving no room for improvement, In a future trial, it would be good to include participants whose health and physical abilities weren’t quite as good. Regardless, the results suggest that yoga practice is beneficial for the elderly.
So, reduce fear of falling in the elderly with yoga.
“the number of falls in older adults declined 48 percent in the six months after they began attending yoga classes compared to the six months prior.” – Breann Schossow
CMCS – Center for Mindfulness and Contemplative Studies
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Keay, L., Praveen, D., Salam, A., Rajasekhar, K. V., Tiedemann, A., Thomas, V., … Ivers, R. Q. (2018). A mixed methods evaluation of yoga as a fall prevention strategy for older people in India. Pilot and Feasibility Studies, 4, 74. http://doi.org/10.1186/s40814-018-0264-x
Falls are an emerging public health issue in India, with the impact set to rise as the population ages. We sought to evaluate the acceptability, feasibility and likely impact of a yoga-based program aimed at improving balance and mobility for older residents in urban India.
Fifty local residents aged 60 years and older were recruited from urban Hyderabad, Andhra Pradesh. They were invited to attend a 1-h yoga class, twice weekly for 3 months. Mixed methods were used to evaluate the acceptability and feasibility (qualitative) and likely impact (quantitative). Two focus groups and eight interviews with participants were conducted to evaluate the acceptability and feasibility of a yoga program. Thematic analysis was conducted in context of perceptions, barriers and benefits of yoga participation and fall ascertainment. Physical performance using the Short Physical Performance Battery, fear of falling, blood pressure and weight loss were measured before and after the program.
The interviews and focus groups provided insights into the preferred format for classes, including session times, level of supervision and location. Improvements were seen in the Short Falls Efficacy Scale-International (Short FES-I (15.9 ± 4.0 vs 13.8 ± 2.1 s, p = 0.002)), the number of steps taken in the timed 4-m walk (T4MW (9.0 ± 1.8 vs 8.6 ± 1.8, p = 0.04)), Short FES-I scores (9.4 ± 2.9 vs 8.6 ± 2.9, p = 0.02) and weight (63.8 ± 12.4 vs 62.1 ± 11.6, p = 0.004) were lower. No changes were seen in standing balance, blood pressure or T4MW time.
Yoga was well accepted and resulted in improved ability to rise from a chair, weight loss, increased step length and reduced fear of falling. These results provide impetus for further research evaluating yoga as a fall prevention strategy in India.