title: Yoga therapy decreases dyspnea-related distress and improves functional performance in people with chronic obstructive pulmonary disease: a pilot study. Yoga-based exercise improves health-related quality of life and mental well-being in older people: a systematic review of randomised controlled trials Yoga Is as Good as Stretching-Strengthening Exercises in Improving Functional Fitness Outcomes: Results From a Randomized Controlled Trial. The Influence of Yoga-Based Programs on Risk Profiles in Adults with Type 2 Diabetes Mellitus: A Systematic Review Yoga Practice for the Management of Type II Diabetes Mellitus in Adults: A systematic review Influence of Yoga and Ayurveda on self-rated sleep in a geriatric population. Randomized, controlled, six-month trial of yoga in healthy seniors: effects on cognition and quality of life. Overview of Systematic Reviews: Yoga as a Therapeutic Intervention for Adults with Acute and Chronic Health Conditions Sleep quality, depression state, and health status of older adults after silver yoga exercises: cluster randomized trial. A 12-week Iyengar yoga program improved balance and mobility in older community-dwelling people: a pilot randomized controlled trial. Physical fitness of older adults in senior activity centres after 24-week silver yoga exercises. Silver Yoga Exercises Improved Physical Fitness of Transitional Frail Elders Effects of exercise training on bone density in older men and women. Comparative impacts of Tai Chi, balance training, and a specially-designed yoga program on balance in older fallers. Yoga as a Preventive Health Care Program for White and Black Elders: An Exploratory Study Regulation of blood volume during training in post-menopausal women. Effects of aerobic exercise training and yoga on the baroreflex in healthy elderly persons. Thai Yoga improves physical function and well-being in older adults: A randomised controlled trial. Cardiovascular and behavioral effects of aerobic exercise training in healthy older men and women. Assessing depression following two ancient Indian interventions: effects of yoga and ayurveda on older adults in a residential home. Perceived change among participants in an exercise program for older adults. Effects of Yoga on Sleep Quality and Depression in Elders in Assisted Living Facilities Appraising the evidence: what is selection bias? Improving aerobic capacity in healthy older adults does not necessarily lead to improved cognitive performance. Adapted yoga to improve physical function and health-related quality of life in physically-inactive older adults: a randomised controlled pilot trial Effects of yoga on psychological health in older adults. The Effect of Yoga on Balance and Fear of Falling in Older Adults. Effects of yoga intervention on sleep and quality-of-life in elderly: A randomized controlled trial
abstract: BACKGROUND There has been limited study of yoga training as a complementary exercise strategy to manage the symptom of dyspnea in patients with chronic obstructive pulmonary disease ( COPD ) . PURPOSE The primary purpose of this pilot study was to evaluate a yoga program for its safety , feasibility , and efficacy for decreasing dyspnea intensity ( DI ) and dyspnea-related distress ( DD ) in older adults with COPD . METHODS Clinical ly stable patients with COPD ( n = 29 ; age 69.9 + /- 9.5 ; forced expiratory volume in 1 second ( FEV(1 ) ) 47.7 + /- 15.6 % predicted ; female = 21 ) were r and omized to a 12-week yoga program specifically design ed for people with COPD or usual-care control  ( UC ) . The twice-weekly yoga program included asanas ( yoga postures ) and visama vritti pranayama ( timed breathing ) . Safety measure outcomes included heart rate , oxygen saturation , dyspnea , and pain . Feasibility was measured by patient-reported enjoyment , difficulty , and adherence to yoga sessions . At baseline and at 12 weeks , DI and DD were measured during incremental cycle ergometry and a 6-minute walk ( 6MW ) test . Secondary efficacy outcomes included physical performance , psychologic well-being , and health-related quality of life ( HRQoL ) . RESULTS Yoga training was safe and feasible for patients with COPD . While yoga training had only small effects on DI after the 6MW test ( effect size [ ES ] , 0.20 ; p = 0.60 ) , there were greater reductions in DD in the yoga group compared to UC ( ES , 0.67 ; p = 0.08 ) . Yoga training also improved 6MW distance ( + 71.7 + /- 21.8 feet versus -27.6 + /- 36.2 feet ; ES = 0.78 , p = 0.04 ) and self-reported functional performance ( ES = 0.79 , p = 0.04 ) compared to UC . There were small positive changes in muscle strength and HRQoL. CONCLUSIONS Elderly patients with COPD participated safely in a 12-week yoga program especially design ed for patients with this chronic illness . After the program , the subjects tolerated more activity with less DD and improved their functional performance . These findings need to be confirmed in a larger , more sufficiently powered efficacy study OBJECTIVE health-related quality of life ( HRQOL ) and mental well-being are associated with healthy ageing . Physical activity positively impacts both HRQOL and mental well-being .  Yoga is a physical activity that can be modified to suits the needs of older people and is growing in popularity . We conducted a systematic review with meta- analysis to determine the impact of yoga-based exercise on  HRQOL and mental well-being in people aged 60 + . METHODS search es were conducted for relevant trials in the following electronic data bases ; MEDLINE , EMBASE , Cochrane Central Register of Controlled Trials , CINAHL , Allied and Complementary Medicine Data base , PsycINFO and the Physiotherapy Evidence Data base ( PEDro ) from inception to January 2017 . Trials that evaluated the effect of physical yoga on HRQOL and /or on mental well-being  in people aged 60 + years were included . Data on HRQOL and mental well-being were extracted . St and ardised mean differences and 95 % confidence intervals ( CI ) were calculated using r and om effects models . Method ological quality of trials was assessed using the PEDro scale . RESULTS twelve trials of high method ological quality ( mean PEDro score 6.1 ) , totalling 752 participants , were identified and provided data for the meta- analysis . Yoga produced a medium effect on HRQOL ( Hedges ' g = 0.51 , 95 % CI 0.25 - 0.76 , 12 trials ) and a small effect on mental well-being ( Hedges ' g = 0.38 , 95 % CI 0.15 - 0.62 , 12 trials ) . CONCLUSION yoga interventions result ed in small to moderate improvements in both HRQOL and mental well-being in people aged 60 + years . Further , research is needed to determine the optimal dose of yoga to maximise health impact . PROSPERO REGISTRATION NUMBER ( CRD42016052458 ) BACKGROUND Despite yoga 's popularity , few clinical trials have employed rigorous methodology to systematic ally explore its functional benefits compared with more established forms of exercise . The objective of this study was to compare the functional benefits of yoga with the conventional stretching-strengthening exercises recommended for adults . METHODS Sedentary healthy adults ( N = 118 ; M age = 62.0 ) participated in an 8-week ( three times a week for 1 hour ) r and omized controlled trial , which consisted of a Hatha yoga group ( n = 61 ) and a stretching-strengthening exercise group ( n = 57 ) . St and ardized functional fitness tests assessing balance , strength , flexibility , and mobility were administered at baseline and postintervention . RESULTS A repeated measures multivariate analysis of variance showed a significant time effect for measures of balance [ F(3,18 ) = 4.88 , p < .01 , partial η(2 ) = .45 ] , strength [ F(2,19 ) = 15.37 , p < .001 , partial η(2 ) = .62 ] , flexibility [ F(4,17 ) = 8.86 , p < .001 , partial η(2 ) = .68 ] , and mobility [ F(2,19 ) = 8.54 , p < .002 , partial η(2 ) = .47 ] . Both groups showed significant improvements on measures of balance ( left-right leg and four square step ) ; strength ( chair st and s and arm curls ) ; flexibility ( back scratch and sit- and -reach ) ; and mobility ( gait speed and 8-feet up and go ) , with partial η(2 ) ranging from .05 to .47 . CONCLUSIONS These data suggest that regular yoga practice is just as effective as stretching-strengthening exercises in improving functional fitness . To our knowledge , this is the first study to examine functional benefits of yoga in comparison with stretching-strengthening exercises in sedentary , healthy , community-dwelling older adults . These findings have clinical implication s as yoga is a more amenable form of exercise than strengthening exercises as it requires minimal equipment and can be adapted for individuals with lower levels of functioning or disabilities There is growing evidence that yoga may offer a safe and cost-effective intervention for Type 2 Diabetes mellitus ( DM 2 ) . However , systematic review s are lacking . This article critically review s the published literature regarding the effects of yoga-based programs on physiologic and anthropometric risk profiles and related clinical outcomes in adults with DM 2 . We performed a comprehensive literature search using four computerized English and Indian scientific data bases . The search was restricted to original studies ( 1970–2006 ) that evaluated the metabolic and clinical effects of  yoga in adults with DM 2 . Studies targeting clinical population s with cardiovascular disorders that included adults with comorbid DM were also evaluated . Data were extracted regarding study design , setting , target population , intervention , comparison group or condition , outcome assessment , data analysis and presentation , follow-up , and key results , and the quality of each study was evaluated according to specific predetermined criteria . We identified 25 eligible studies , including 15 uncontrolled trials , 6 non-r and omized controlled trials and 4 r and omized controlled trials ( RCTs ) . Overall , these studies suggest beneficial changes in several risk indices , including glucose tolerance and insulin sensitivity , lipid profiles , anthropometric characteristics , blood pressure , oxidative stress , coagulation profiles , sympathetic activation and pulmonary function , as well as improvement in specific clinical outcomes .  Yoga may improve risk profiles in adults with DM 2 , and may have promise for the prevention and management of cardiovascular complications in this population . However , the limitations characterizing most studies preclude drawing firm conclusions . Additional high- quality RCTs are needed to confirm and further eluci date the effects of st and ardized yoga programs in population s with DM 2 The effect of practicing yoga for the management of type II Diabetes  was assessed in this systematic review through search ing related electronic data bases and the grey literature to the end of May 2007 using Ovid . All r and omized controlled clinical trials ( RCTs ) comparing yoga practice with other type of intervention or with regular practice or both , were included regardless of language or type of publication . Each study was assessed for quality by two independent review ers . Mean difference was used for summarizing the effect of each study outcomes with 95 % confidence intervals . Pooling of the studies did not take place due to the wide clinical variation between the studies . Publication bias was assessed by statistical methods . Five trials with 363 participants met the inclusion criteria with medium to high risk of bias and different intervention characteristics . The studies ’ results show improvement in outcomes among patients with diabetes type II .  These improvements were mainly among short term or immediate diabetes outcomes and not all were statistically significant . The results were inconclusive and not significant for the long-term outcomes . No adverse effects were reported in any of the included studies . Short-term benefits for patients with diabetes  may be achieved from practicing yoga . Further research is needed in this area . Factors like quality of the trials and other method ological issues should be improved by large r and omized control trials with allocation concealment to assess the effectiveness of yoga on diabetes type II . A definitive recommendation for physicians to encourage their patients to practice yoga can not be reached at present BACKGROUND AND OBJECTIVE Sleep in older persons is characterized by decreased ability to stay asleep , result ing in fragmented sleep and reduced daytime alertness . Pharmacological treatment of insomnia in older persons is associated with hazardous side effects . Hence , the present study was design ed to compare the effects of Yoga and Ayurveda on the self rated sleep in a geriatric population . METHODS Of the 120 residents from a home for the aged , 69 were stratified based on age ( five year intervals ) and r and omly allocated to three groups i.e. , Yoga ( physical postures , relaxation techniques , voluntarily regulated breathing and lectures on yoga philosophy ) , Ayurveda ( a herbal preparation ) , and Wait-list control ( no intervention ) . The groups were evaluated for self- assessment of sleep over a one week period at baseline , and after three and six months of the respective interventions . RESULTS The Yoga group showed a significant decrease in the time taken to fall asleep ( approximate group average decrease : 10 min , P<0.05 ) , an increase in the total number of hours slept ( approximate group average increase : 60 min , P < 0.05 ) and in the feeling of being rested in the morning based on a rating scale ( P<0.05 ) after six months . The other groups showed no significant change . INTERPRETATION AND CONCLUSION Yoga practice improved different aspects of sleep in a geriatric population CONTEXT There are potential benefits of mind-body techniques on cognitive function because the techniques involve an active attentional or mindfulness component , but this has not been fully explored . OBJECTIVE To determine the effect of yoga on cognitive function , fatigue , mood , and quality of life in seniors . DESIGN R and omized , controlled trial comparing yoga , exercise , and wait-list control groups . PARTICIPANTS One hundred thirty-five generally healthy men and women aged 65 - 85 years . INTERVENTION Participants were r and omized to 6 months of Hatha yoga class , walking exercise class , or wait-list control . Subjects assigned to classes also were asked to practice at home . MAIN OUTCOME MEASURES Outcome assessment s performed at baseline and after the 6-month period included a battery of cognitive measures focused on attention and alertness , the primary outcome measures being performance on the Stroop Test and a quantitative electroencephalogram ( EEG ) measure of alertness ; SF-36 health-related quality of life ; Profile of Mood States ; Multi-Dimensional Fatigue Inventory ; and physical measures related to the interventions . RESULTS One hundred thirty-five subjects were recruited and r and omized . Seventeen subjects did not finish the 6-month intervention . There were no effects from either of the active interventions on any of the cognitive and alertness outcome measures . The yoga intervention produced improvements in physical measures ( eg , timed 1-legged st and ing , forward flexibility ) as well as a number of quality -of-life measures related to sense of well-being and energy and fatigue compared to controls . CONCLUSIONS There were no relative improvements of cognitive function among healthy seniors in the yoga or exercise group compared to the wait-list control group . Those in the yoga group showed significant improvement in quality -of-life and physical measures compared to exercise and wait-list control groups Objectives . Overview the quality , direction , and characteristics of yoga interventions for treatment of acute and chronic health conditions in adult population s. Methods . We search ed for systematic review s in 10 online data bases , bibliographic references , and h and - search es in  yoga-related  journals . Included review s satisfy Oxman criteria and specify yoga as a primary intervention in one or more r and omized controlled trials for treatment in adults . The AMSTAR tool and GRADE approach evaluated the method ological quality of review s and quality of evidence . Results . We identified 2202 titles , of which 41 full-text articles were assessed for eligibility and 26 systematic review s satisfied inclusion criteria . Thirteen systematic review s include quantitative data and six papers include meta- analysis . The quality of evidence is generally low . Sixteen different types of health conditions are included . Eleven review s show tendency towards positive effects of yoga intervention , 15 review s report unclear results , and no , review s report adverse effects of yoga . Yoga appears most effective for reducing symptoms in anxiety , depression , and pain . Conclusion . Although the quality of systematic review s is high , the quality of supporting evidence is low . Significant heterogeneity and variability in reporting interventions by type of yoga , setting s , and population characteristics limit the generalizability of results BACKGROUND Sleep disturbances , depression , and low perception of health status are commonly seen in elderly population ; however , clinicians tend to underestimate or overlook the presence of these symptoms and assume them to be a part of normal aging . Non-pharmacological methods that promote a mind-body interaction should be tested to enhance the mental health of older adults . OBJECTIVE To test the effects of 6 months of silver yoga exercises in promoting the mental health of older adults in senior activity centers , especially their sleep quality , depression , and self-perception of health status . DESIGN Cluster r and omized trial . SETTING S Eight senior activity centers , southern Taiwan . PARTICIPANTS A sample of 139 participants was recruited , and 128 of them completed the study . INCLUSION CRITERIA ( 1 ) community-dwelling older adults ages 60 and over , ( 2 ) no previous training in yoga , ( 3 ) able to walk without assistance , ( 4 ) cognitively alert based on the Short Portable Mental Status Question naire ( SPMSQ ) score of eight or higher , and ( 5 ) independent or mildly dependent in self-care based on a Barthel Index ( BI ) score of 91 or higher . The mean age of the participants was 69.20 + /- 6.23 years , and the average number of chronic illness was 0.83 + /- 0.90 . The average BI score of the participants was 99.92 + /- 0.62 , and the mean SPMSQ score  was 9.90 + /- 0.30 . METHODS Participants were r and omly assigned into either the experimental ( n=62 ) or the control ( n=66 ) group based on attendance at selected senior activity centers . A 70-min silver yoga exercise program was implemented three times per week for 6 months as the intervention for the participants in the experimental group . RESULTS Most of the mental health indicators of the participants in the experimental group had significantly improved after the silver yoga interventions , and many of the indicators improved after 3 months of intervention and were maintained throughout the 6 months study . The mental health indicators of the participants in the experimental group were all better than the participants in the control group ( all p<.05 ) . CONCLUSIONS After 6 months of silver yoga exercises , the sleep quality , depression , and health status of older adults were all improved BACKGROUND Exercise that challenges balance can improve mobility and prevent falls in older adults .  Yoga as a physical activity option for older adults is not well studied . This trial evaluated the feasibility and effect of a 12-week Iyengar yoga program on balance and mobility in older people . METHODS We conducted a blinded , pilot r and omized controlled trial with intention-to-treat analysis . Participants were 54 community dwellers ( mean age 68 years , SD 7.1 ) not currently participating in yoga or tai chi . The intervention group ( n = 27 ) participated in a 12-week , twice-weekly yoga program focused on st and ing postures and received a fall prevention education booklet . The control group ( n = 27 ) received the education booklet only . Primary outcome was st and ing balance component of the short physical performance battery with addition of one-legged stance time ( st and ing balance ) . Secondary outcomes were the timed sit-to-st and test , timed 4-m walk , one-legged st and with eyes closed , and Short Falls Efficacy Scale-International . Feasibility was measured by recording class attendance and adverse events . RESULTS Fifty-two participants completed follow-up assessment s. The intervention group significantly improved compared with control group on st and ing balance ( mean difference = 1.52 seconds , 95 % CI 0.10 - 2.96 , p = .04 ) , sit-to-st and test ( mean difference = -3.43 seconds , 95 % CI -5.23 to -1.64 , p < .001 ) , 4-m walk ( mean difference = -0.50 seconds , 95 % CI -0.72 to -0.28 , p < .001 ) , and one-legged st and with eyes closed ( mean difference = 1.93 seconds , 95 % CI 0.40 - 3.46 , p = .02 ) . Average class attendance was 20 of 24 classes ( 83 % ) . No serious adverse events occurred . CONCLUSIONS This trial demonstrates the balance and mobility-related benefits and feasibility of Iyengar yoga for older people . The fall prevention effect of Iyengar yoga warrants further investigation AIMS AND OBJECTIVES Promoting physical fitness of young-older adults is essential in reducing healthcare expenditures which would occur in the future for those with chronic health problems . The silver yoga exercise programme was developed to accommo date the reduced body flexibility experienced by many older adults and was critically review ed by experts and pilot-tested with community-dwelling older adults . This study aim ed to test older adults ' physical fitness after a 24-week silver yoga exercise programme and to examine whether the programme could be further shortened to fit senior activity centres ' programme design s. DESIGN A quasi-experimental , pre-post tests design was used : baseline , at 12-week and at 24-week periods . METHODS Convenience sample s of 204 subjects were recruited from eight senior activity centres and 176 subjects completed the study . Subjects were r and omly assigned into three groups based on the centres : ( 1 ) Experiment I : complete silver yoga with stretching and meditation , ( 2 ) Experiment II : shortened silver yoga without the guided-imagery meditation and ( 3 ) Wait-list control . The interventions were conducted three times per week for 24 weeks . Physical fitness indicators included body compositions , cardiovascular-respiratory functions , physical functions and the range of motion . RESULTS At the end of the 24-week period , the physical fitness of subjects in Experiments I and II had significantly improved whether or not guided-imagery meditation was used and all had better physical fitness than subjects in the control group ( all p < 0.05 ) . CONCLUSIONS The physical fitness of older adults in both the 70-minute complete silver yoga group and the 55-minute shortened silver yoga group had significantly improved after the interventions . It was recommended that the silver yoga programme be shortened by eliminating the guided-imagery meditation . RELEVANCE TO CLINICAL PRACTICE The shortened silver yoga exercise programme is recommended to be incorporated as an activity programme in community- setting s to promote the physical fitness of older adults Background : Promoting the health of transitional frail elders ( e.g. , through therapeutic-based yoga exercises ) is essential to reduce healthcare expenditures caused by chronic health problems . Objective : The purpose of this study was to determine the efficacy of 24 weeks of the senior-tailored silver yoga ( SY ) exercise program for transitional frail elders . Methods : A convenience sample of 69 elders in assisted living facilities were assigned r and omly to the  SY group ( n = 38 ) or to the  control group ( n = 31 ) on the basis of the facilities where they resided , and 55 of them completed this quasi-experimental pretest and posttest study . Intervention was conducted three times per week , 70 minutes per session , for 24 weeks . Physical fitness ( body composition , cardiovascular-respiratory functions , body flexibility , muscle power and endurance , balance , and agility ) were examined at baseline , at 12 weeks , and at the end of the 24th week of the study . Results : At the end of the study , the physical fitness indicators of participants in the SY group had improved significantly , and they had better physical fitness than participants in the control group ( all p values < .05 ) . Discussion : It was recommended that the SY exercises be incorporated as an activity program in assisted living facilities to promote the physical fitness of transitional frail elders OBJECTIVES To determine the effects of up to 14 months of aerobic exercise on measures of bone density in older adults . DESIGN R and omized controlled trial with subjects assigned to either an aerobic exercise condition , non-aerobic yoga , or a wait list non-exercise control group for 4 months . Aerobic fitness and bone density were evaluated in all subjects at baseline ( Time 1 ) and after 4 months ( Time 2 ) . A semi-crossover design was utilized with all subjects completing 4 months of aerobic exercise , followed by another evaluation ( Time 3 ) . All subjects were then given the option of 6 additional months of aerobic exercise , after which they had a fourth evaluation ( Time 4 ) . SETTING An outpatient exercise rehabilitation facility at a large , major medical center . SUBJECTS One-hundred-one healthy men ( n = 50 ) and women ( n = 51 ) over age 60 ( Mean age = 67.0 ) , recruited from the community . INTERVENTION The exercise program included stretching , cycle ergometry , and walking three times per week for 60 minutes throughout the course of the study . OUTCOME MEASURES Aerobic fitness ( VO2max ) as assessed by cycle ergometry , and bone density ( bone mineral content ) measured by single photon absorptiometry . RESULTS Subjects achieved a 10%-15 % increase in VO2max after 4 months of exercise training , and 1%-6 % further improvement with additional training . Aerobic fitness was associated with significant increases in bone density in men , but not women , who maintained aerobic exercise for 14 months OBJECTIVE To compare the effect of a custom- design ed yoga program with 2 other balance training programs . DESIGN R and omized controlled trial . SETTING Research laboratory . PARTICIPANTS A group of older adults ( N=39 ; mean age , 74.15 ± 6.99 y ) with a history of falling . INTERVENTIONS Three different exercise interventions ( Tai Chi , st and ard balance training , yoga ) were given for 12 weeks . MAIN OUTCOME MEASURES Balance performance was examined during pre- and posttest using field tests , including the 8-foot up- and -go test , 1-leg stance , functional reach , and usual and maximal walking speed . The static and dynamic balances were also assessed by postural sway and dynamic posturography , respectively . RESULTS Training produced significant improvements in all field tests ( P<.005 ) , but group difference and time × group interaction were not detected . For postural sway , significant decreases in the area of the center of pressure with eyes open ( P=.001 ) and eyes closed ( P=.002 ) were detected after training . For eyes open , maximum medial-lateral velocity significantly decreased for the sample ( P=.013 ) . For eyes closed , medial-lateral displacement decreased for Tai Chi ( P<.01 ) . For dynamic posturography , significant improvements in overall score ( P=.001 ) , time on the test ( P=.006 ) , and 2 linear measures in lateral ( P=.001 ) and anterior-posterior ( P<.001 ) directions were seen for the sample . CONCLUSIONS Yoga was as effective as Tai Chi and st and ard balance training for improving postural stability and may offer an alternative to more traditional programs A ten-week yoga program was implemented with sixty-one white and forty-five low-income black elders at two community sites , along with a pretest-posttest control group research design with r and om assignment at each site . White elders attended class regularly , practice d yoga on their own on a daily basis , improved psychological well-being , and lowered their systolic blood pressure level , in comparison to a control group . Black elders , on the other h and , attended the once-a-week class regularly but did not practice on their own on a daily basis . Thus , they did not improve psychological well-being nor reduce blood pressure level in comparison to a control group . Social analysts suggest that low-income minority elders need more frequent contact with structured leadership in order to adhere to a daily routine that may lead to psychological and physical change . Other directions for controlled follow-up studies are suggested UNLABELLED In younger people the increase in aerobic capacity following training is related , in part , to blood volume ( BV ) expansion and the consequent improvements in maximal cardiac output . This training-induced hypervolemia is associated with a decrease in cardiopulmonary baroreflex ( CPBR ) control of peripheral vascular tone . PURPOSE To test the hypothesis that improvement in peak oxygen consumption ( VO2peak ) during training in older women is associated with specific central adaptations , such as BV expansion and a reduction in CPBR control of vascular tone . METHODS Seventeen healthy older women were r and omized into training ( N = 9 , 71 + /- 2 yr ) and control ( N = 8 , 73 + /- 3 yr ) groups . The training group exercised three to four times per wk for 30 min at 60 % peak heart rate for 12 wk and then 40 - 50 min at 75 % peak heart rate for 12 wk . The control group participated in yoga exercises over the same time period . We measured resting BV ( Evans blue dye ) , VO2peak , and the forearm vascular resistance response to unloading low pressure mechanoreceptors during low levels of lower body negative pressure ( through -20 mm Hg ) before and after aerobic training . The slope of the increase in forearm vascular resistance ( response ) per unit decrease in central venous pressure ( stimulus ) was used to assess CPBR responsiveness . RESULTS Aerobic training increased VO2peak 14.2 % from 24.2 mL x kg(-1 ) x min(-1 ) to 27.7 mL x kg(-1 ) x min(-1 ) ( P < 0.05 ) , a smaller improvement than typically seen in younger subjects .  Blood volume ( 59.9 + /- 1.9 and 60.9 + /- 1.9 mL x kg[-1 ] ) and CPBR function ( -3.98 + /- 0.92 and -3.46 + /- 0.94 units x mm(-1 ) Hg ) were similar before and after training . CONCLUSIONS These data indicate that the inability to induce adaptations in CPBR function may limit BV expansion during training in older women . In addition , the absence of these specific adaptations may contribute to the relatively poor improvements in VO2peak in older women during short ( 10 - 12 wk ) periods of training It is unclear whether the age-associated reduction in baroreflex sensitivity is modifiable by exercise training . The effects of aerobic exercise training and yoga , a non-aerobic control intervention , on the baroreflex of elderly persons was determined . Baroreflex sensitivity was quantified by the alpha-index , at high frequency ( HF ; 0.15 - 0.35 Hz , reflecting parasympathetic activity ) and mid-frequency ( MF ; 0.05 - 0.15 Hz , reflecting sympathetic activity as well ) , derived from spectral and cross-spectral analysis of spontaneous fluctuations in heart rate and blood pressure . Twenty-six ( 10 women ) sedentary , healthy , normotensive elderly ( mean 68 years , range 62 - 81 years ) subjects were studied . Fourteen ( 4 women ) of the sedentary elderly subjects completed 6 weeks of aerobic training , while the other 12 ( 6 women ) subjects completed 6 weeks of yoga .  Heart rate decreased following yoga ( 69 + /- 8 vs. 61 + /- 7 min-1 , P < 0.05 ) but not aerobic training ( 66 + /- 8 vs. 63 + /- 9 min-1 , P = 0.29 ) . VO2 max increased by 11 % following yoga ( P < 0.01 ) and by 24 % following aerobic training ( P < 0.01 ) . No significant change in alpha MF ( 6.5 + /- 3.5 vs. 6.2 + /- 3.0 ms mmHg-1 , P = 0.69 ) or alpha HF ( 8.5 + /- 4.7 vs. 8.9 + /- 3.5 ms mmHg-1 , P = 0.65 ) occurred after aerobic training . Following yoga , alpha HF ( 8.0 + /- 3.6 vs. 11.5 + /- 5.2 ms mmHg-1 , P < 0.01 ) but not alpha MF ( 6.5 + /- 3.0 vs. 7.6 + /- 2.8 ms mmHg-1 , P = 0.29 ) increased . Short- duration aerobic training does not modify the alpha-index at alpha MF or alpha HF in healthy normotensive elderly subjects .  alpha HF but not alpha MF increased following yoga , suggesting that these parameters are measuring distinct aspects of the baroreflex that are separately modifiable OBJECTIVES Compare two 12-week low-intensity exercise regimens on components of physical function and quality of life in community-dwelling healthy yet sedentary adults aged over 60 . DESIGN This study used a r and omised , multi-arm , controlled trial design . METHODS Thirty-nine sedentary participants ( 29 women ) , aged 67.7±6.7 years were r and omly allocated to either a 12-week Thai Yoga ( TY ) or Tai Chi ( TC ) for 90min twice per week , or telephone counselling Control ( C ) . A Senior Fitness Test ( chair-st and , arm-curl , sit-&-reach , back-scratch , 8-foot up-&-go and 6-min walk  ) and Short-Form 36 Health Survey , Centre for Epidemiological Studies of Depression , Physical Activity Scale for the Elderly and the Physical Activity Enjoyment Scale were assessed at baseline , six , 12 weeks , and three months after the completion of the regimen . RESULTS After 12 weeks , chair-st and ( mean difference , 2.69 ; 95 % CI , 0.97 - 4.41 ; P<0.001 ) , arm-curl ( 2.23 ; 95 % CI , 0.06 - 4.52 ; P=0.009 ) , sit-&-reach ( 1.25 ; 95 % CI , 0.03 - 2.53 ; P=0.013 ) , back-scratch ( 2.00 ; 95 % CI , 0.44 - 3.56 ; P=0.005 ) , 8-foot up-&-go ( -0.43 ; 95 % CI , -0.85 to 0.01 ; P=0.013 ) , 6-min walk ( 57.5 ; 95 % CI , 20.93 - 94.07 ; P<0.001 ) , vitality ( 13.27 ; 95 % CI , 2.88 - 23.66 ; P=0.050 ) and enjoyment ( 7.96 ; 95 % CI , 3.70 - 12.23 ; P=0.001 ) significantly improved in TY compared to C , however no change was observed in TC compared to C. TY improved in chair-st and ( 2.31 ; 95 % CI , 0.59 - 4.03 ; P=0.007 ) , sit-&-reach ( 1.38 ; 95 % CI , 0.10 - 2.66 ; P=0.007 ) , 6-min walk ( 32.31 ; 95 % CI , -4.26 - 68.88 ; P=0.015 ) , vitality ( 12.88 ; 95 % CI , 2.50 - 23.27 ; P=0.040 ) and enjoyment ( 5.65 ; 95 % CI , 1.39 - 9.92 ; P=0.010 ) compared to TC after 12 weeks . CONCLUSIONS The findings suggest that older adults can make significant improvements in their health and well-being by engaging in low intensity Thai Yoga exercise The cardiovascular and behavioral adaptations associated with a 4-month program of aerobic exercise training were examined in 101 older men and women ( mean age = 67 years ) . Subjects were r and omly assigned to an Aerobic Exercise group , a Yoga and Flexibility control group , or a Waiting List control group . Prior to and following the 4-month program , subjects underwent comprehensive physiological and psychological evaluations . Physiological measures included measurement of blood pressure , lipids , bone density , and cardiorespiratory fitness including direct measurements of peak oxygen consumption ( VO2 ) and anaerobic threshold . Psychological measures included measures of mood , psychiatric symptoms , and neuropsychological functioning . This study demonstrated that 4 months of aerobic exercise training produced an overall 11.6 % improvement in peak VO2 and a 13 % increase in anaerobic threshold . In contrast , the Yoga and Waiting List control groups experienced no change in cardiorespiratory fitness . Other favorable physiological changes observed among aerobic exercise participants included lower cholesterol levels , diastolic blood pressure levels , and for subjects at risk for bone fracture , a trend toward an increase in bone mineral content . Although few significant psychological changes could be attributed to aerobic exercise training , participants in the two active treatment groups perceived themselves as improving on a number of psychological and behavioral dimensions The effects of yoga and ayurveda on geriatric depression were evaluated in 69 persons older than 60 who were living in a residential home . Participants were stratified by age and gender and r and omly allocated to three groups : Yoga , Ayurveda , or Wait-list Control . The 15-item Geriatric Depression Scale was used to assess depressive symptoms prior to the intervention , and after 3 months and 6 months post-intervention . Participation in one of the three groups lasted 24 weeks . The yoga program ( 7 hours 30 minutes per week ) included physical postures , relaxation techniques , regulated breathing , devotional songs , and lectures . The Ayurveda Group received an herbal preparation twice daily for the whole period . The depression symptom scores of the Yoga Group at both 3 and 6 months decreased significantly , from a group average baseline of 10.6 to 8.1 and 6.7 , respectively ( p < .001 , paired t-test ) . The other groups showed no change . Hence , an integrated approach of yoga including the mental and philosophical aspects in addition to the physical practice s was useful for institutionalized older persons Data regarding perceived change were collected as part of a study of the effects of aerobic exercise training on psychological , cognitive , and physiological functioning among 101 healthy older adults . Subjects were assigned r and omly to an aerobic exercise group , a yoga control group , or a waiting list group for 16 weeks , after which all subjects participated in aerobic exercise for another 16 weeks . Exercise participants perceived positive changes in a wide range of significant life areas , and perceived improvement was more closely related to objective improvement for physiological indicators than for indicators of cognitive functioning or psychological well-being Background : Being relocated to an assisted living facility can result in  sleep disturbances and depression in elders . This may be attributed to or worsened by lack of regular physical activity . Appropriate exercise programs may be an important component of quality of life in this group of transitional frail elders . Purpose : This study aim ed to test the effects of a 6-month yoga exercise program in improving sleep quality and decreasing depression in transitional frail elders living in assisted living facilities . Methods : A quasi-experimental pretest- and -posttest design was used . A convenience sample of 69 elderly residents of assisted living facilities was divided r and omly into a yoga exercise ( n = 38 ) and control group ( n = 31 ) based on residence location . A total of 55 participants completed the study . The intervention was implemented in three small groups , and each practice group was led by two pretrained certified yoga instructors three times per week at 70 min per practice session for 24 weeks . The outcome measures of sleep quality ( Pittsburgh Sleep Quality Index ) and depression state ( Taiwanese Depression Question naire ) were examined at baseline , at the 12th week , and at the 24th week of the study . Results : After 6 months of performing yoga exercises , participants ' overall sleep quality had significantly improved , whereas depression , sleep disturbances , and daytime dysfunction had decreased significantly ( p < .05 ) . In addition , participants in the intervention group had better results on all outcome indicators than those of participants in the control group ( p < .05 ) . Conclusions and Implication s for Practice : It is recommended that yoga exercise be incorporated as an activity program in assisted living facilities or in other long-term care facilities to improve sleep quality and decrease  depression  in institutionalized elders Almost all studies are prone to error — they use sample s drawn from a population to estimate what is occurring or what might occur in the whole population . These errors can broadly be divided into two : r and om error and systematic error . R and om error is the play of chance and results in an estimate of effect ( for example , relative risk ) being equally likely to be above or below the true value . Its role is assessed with statistical measures such as p values and confidence intervals . Systematic error is called bias , and also leads to the estimate being above or below the true value . Systematic error can be further divided into information bias , which relates to the misclassification of data , and selection bias , which is the focus of this article . # # # Bias Any trend in the collection , analysis , interpretation , publication or review of data that can lead to conclusions that are systematic ally different from the truth . ( Last J. A dictionary of epidemiology , 2001 ) Bias limits the conclusions that can be drawn from an analysis . It is particularly problematic because , unlike confounding , little can be done to “ allow ” or “ control ” for it once the data have been collected . As such it is in many ways an issue of study design , planning and practice . Selection bias in epidemiological studies occurs when there is a systematic difference between the characteristics of those selected for the study and those who are not . It also occurs in intervention studies when there are systematic The effects of aerobic exercise training in a sample of 85 older adults were investigated . Ss were assigned r and omly to either an aerobic exercise group , a nonaerobic exercise ( yoga ) group , or a waiting-list control group . Following 16 weeks of the group-specific protocol , all of the older Ss received 16 weeks of aerobic exercise training . The older adults demonstrated a significant increase in aerobic capacity ( cardiorespiratory fitness ) . Performance on reaction-time tests of attention and memory retrieval was slower for the older adults than for a comparison group of 24 young adults , and there was no improvement in the older adults ' performance on these tests as a function of aerobic exercise training . Results suggest that exercise-related changes in older adults ' cognitive performance are due either to extended periods of training or to cohort differences between physically active and sedentary individuals Background Yoga is a holistic therapy of exp and ing popularity , which has the potential to produce a range of physical , mental and social benefits . This trial evaluated the feasibility and effects of an adapted yoga programme on physical function and health-related quality of life in physically-inactive older adults . Methods In this r and omised controlled pilot trial , 52 older adults ( 90 % female ; mean age 74.8 years , SD 7.2 ) were r and omised 1:1 to a yoga programme or wait-list control .  The  yoga  group ( n = 25 ) received a physical activity education booklet and were invited to attend ten yoga sessions during a 12-week period . The control group ( n = 27 ) received the education booklet only .  Measures of physical function ( e.g. , Short Physical Performance Battery ; SPPB ) , health status ( EQ-5D ) and mental well-being ( Warwick-Edinburgh Mental Well-being Scale ; WEMWBS ) were assessed at baseline and 3 months . Feasibility was assessed using course attendance and adverse event data , and participant interviews . Results Forty-seven participants completed follow-up assessment s. Median class attendance was 8 ( range 3 to 10 ) . At the 3-month follow-up , the yoga group had a higher SPPB total score compared with the control group ( mean difference 0.9 , 95 % confidence interval [ CI ] -0.3 to 2.0 ) , a faster time to rise from a chair five times ( mean difference − 1.73 s , 95 % CI −4.08 to 0.62 ) , and better performance on the chair sit- and -reach lower-limb flexibility test ( mean difference 5 cm , 95 % CI 0 to 10 ) . The yoga group also had superior health status and mental well-being ( vs. control ) at 3 months , with mean differences in EQ-5D and WEMWBS scores of 0.12 ( 95 % CI , 0.03 to 0.21 ) and 6 ( 95 % CI , 1 to 11 ) , respectively . The interviews indicated that participants valued attending the yoga programme , and that they experienced a range of benefits . Conclusions The adapted yoga programme appeared to be feasible and potentially beneficial in terms of improving mental and social well-being and aspects of physical function in physically-inactive older adults . An appropriately-powered trial is required to confirm the findings of the present study and to determine longer-term effects . Trial registration Clinical Trials.govNCT02663726 BACKGROUND The objective of this study was to assess the effect of a yoga intervention on psychological health  in older adults . METHOD A r and omized controlled trial study , conducted at 2 North Florida facilities for older adults . Subjects were 98 older adults , ages 65 to 92 . Participants were r and omly assigned to chair yoga , chair exercise , and control groups and assessed preintervention , postintervention , and 1-month follow-up on the State Anger Expression Inventory , State Anxiety Inventory , Geriatric Depression Scale , Lawton 's PGC Morale Scale , General Self-Efficacy Scale , Chronic Disease Self-Efficacy Scales , and Self- Control Schedule . RESULTS Yoga participants improved more than both exercise and control participants in anger ( Cohen 's d = 0.89 for yoga versus exercise , and 0.90 for yoga versus control , pretest to posttest ; and d = 0.90 and 0.72 , pretest to follow-up ) , anxiety ( d = 0.27 , 0.39 and 0.62 , 0.63 ) , depression ( d = 0.47 , 0.49 and 0.53 , 0.51 ) , well-being ( d = 0.14 , 0.49 and 0.25 , 0.61 ) , general self-efficacy ( d = 0.63 , 1.10 and 0.30 , 0.85 ) , and self-efficacy for daily living ( d = 0.52 , 0.81 and 0.27 , 0.42 ) . Changes in self-control moderated changes in psychological health . CONCLUSIONS Over a 6-week period , our findings indicate yoga 's potential for improving psychological health in older adults OBJECTIVE To determine the effect of yoga on balance and fear of falling in older adults . DESIGN R and omized controlled trial . SETTING Jah and idegan Center in Shiraz , southern Iran . PARTICIPANTS Forty persons ( 17 men and 23 women ) between the ages of 60 - 74 years with a Modified Falls Efficacy Scale ( MFES ) score < 8 and a Berg Balance Scale ( BBS ) score < 45 . After completing the MFES question naire and BBS measurement , the participants were divided into intervention and control groups . BBS measurement and the MFES  question naire were completed again immediately after the intervention . INTERVENTION The intervention group participated in 2 yoga practice sessions per week for 8 weeks . The control group received no intervention . MAIN OUTCOME MEASUREMENTS Fear of falling was measured with the MFES and balance was measured with the BBS . RESULTS We found significant changes in both variables ( P < .0001 ) . Mean differences before and after the intervention for the BBS for yoga and control groups were 10.19 and -1.16 , respectively . Mean differences before and after the intervention for the MFES for yoga and control groups were 1.62 and -0.21 , respectively . CONCLUSION Yoga is a potential intervention to reduce fear of falling and improve balance in older adults Context : Yoga as a life-style practice has demonstrated beneficial effects . The role of yoga in the elderly for such benefits merits investigation . Aims : The aim of this study is to examine the effects of yoga intervention on quality -of-life ( QOL ) and sleep quality in the elderly living in old age homes . Setting s and Design : Single blind controlled study with block r and omization of elderly homes . Material s and Methods : A total of 120 subjects from nine elderly homes were r and omized in to yoga group ( n=62 ) and waitlist group ( n=58 ) . Subjects in the yoga group were given yoga intervention daily for 1 month and weekly until 3 months and were encouraged to practice yoga without supervision until for 6 months . Subjects in waitlist group received no intervention during this period . Subjects were evaluated with World Health Organization Quality of Life (WHOQOL)-BREF for measuring QOL and Pittsburgh Sleep Quality Index for sleep quality in the baseline and after 6 months . Statistical Analysis : Independent t-test and repeated measures analysis of covariance respectively was used to measure the difference in outcome measures between the two groups at baseline and after the study period . Results : Subjects in the yoga group had significantly higher number of years of formal education . Subjects in the yoga group had significant improvement in all the domains of QOL and total sleep quality after controlling for the effect of baseline difference in education between the two groups . Conclusion : Yoga intervention appears to improve the QOL and sleep quality of elderly living in old age homes . There is a need for further studies overcoming the limitations in this study to confirm the benefits of yoga for elderly in QOL and sleep quality
target: Conclusion This review is the first to compare the effects of yoga with active and inactive controls in older adults not characterised by a specific clinical condition .
  Results indicate that yoga interventions improve multiple physical function and HRQoL outcomes in this population compared to both control conditions .
  This study provides robust evidence for promoting yoga in physical activity guidelines for older adults as a multimodal activity that improves aspects of fitness like strength , balance and flexibility , as well as mental wellbeing .
background: Background Yoga has been recommended as a muscle strengthening and balance activity in national and global physical activity guidelines .
  However , the evidence base establishing the effectiveness of yoga in improving physical function and health related quality of life ( HRQoL ) in an older adult population not recruited on the basis of any specific disease or condition , has not been systematic ally review ed .
  The objective of this study was to synthesis e existing evidence on the effects of yoga on physical function and HRQoL in older adults not characterised by any specific clinical condition .