Can yoga-based exercises improve balance and mobility in elderly?
Date of publication of the systematic review: December 2015
Design
Systematic review of 6 randomized controlled trials (RCTs).
Participants
A total of 307 participants (mean age range: 63 to 84 years, male %: 28%) were included.
Intervention
All studies adopted physical yoga exercise as intervention, including Iyengar yoga (2/6), Hatha yoga (1/6) and both Iyengar and Hatha yoga (1/6) or others. Duration, frequency and length of program varied from 60 to 90 minutes, 1 to 2 times per week and 8 to 24 weeks.
Comparator
Comparison: Yoga-based exercise versus various controls, including no intervention, wait-list, usual care, or fall prevention education.
Major Outcomes
Outcome 1: Balance measured by Berg balance scale, Short Physical Performance Battery, or one leg stand;
Outcome 2: Mobility measured by sit to stand test or gait speed test.
Settings
The reviewers did not state whether the study was conducted in in-patient or out-patient settings.
Comparison    Yoga-based exercise versus control group
Main Results
Compared to control groups, yoga-based exercise provided significant effect on improving balance (pooled effect size: 0.04, 95% CI: 0.15 to 0.65) and mobility (pooled effect size: 0.5, 95% CI: 0.06 to 0.95) in elderly.
Comparison: Yoga-based exercise versus no intervention, wait-list, usual care, or fall prevention education in elderly
Outcomes No. of studies (Total no. of participants) Mean score / No. of participants Heterogeneity test (I2) Pooled Effect size (95% CI) Overall quality of evidence*
Intervention Comparator
1 6 (307) Not reported Not reported 0% 0.40 (0.15 to 0.65) Moderate
2 3 (225) Not reported Not reported 51.8% 0.5 (0.06 to 0.95) Low
Keys: CI: confidence interval.
Comparison    Yoga-based exercise versus control group
Main Results
Compared to control groups, yoga-based exercise provided significant effect on improving balance (pooled effect size: 0.04, 95% CI: 0.15 to 0.65) and mobility (pooled effect size: 0.5, 95% CI: 0.06 to 0.95) in elderly.
Comparison: Yoga-based exercise versus no intervention, wait-list, usual care, or fall prevention education in elderly
Outcomes 1 2
No. of studies (Total no. of participants) 6 (307) 3 (225)
Mean score / No. of participants Intervention Not reported Not reported
Comparator Not reported Not reported
Pooled Effect size (95% CI) 0.40 (0.15 to 0.65) 0.5 (0.06 to 0.95)
Overall quality of evidence* Moderate Low
Keys: CI: confidence interval.
Conclusion
Benefits
Yoga-based exercise had shown significant impact on improving balance and mobility compared to various controls including no intervention, wait-list, usual care, or fall prevention education. For Outcome 1, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect. For Outcome 2, the overall quality of evidence is low. Further research is likely to have an important impact on our confidence in this estimate of effect.
Harms
One case of falling during yoga intervention was reported with no sustained injury. Three studies reported minor adverse events including knee pain, low back pain and muscle strain.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/26707903
The synopsis is based on the following article:
Youkhana S, Dean CM, Wolff M, Sherrington C, Tiedemann A. Yoga-based exercise improves balance and mobility in people aged 60 and over: a systematic review and meta-analysis. Age and Ageing. 2015 Dec 25:afv175.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.