Is yoga effective in improving physical functioning and health related quality of life among older people?
Date of publication of the systematic review: October 2012
Design
Systematic review of 8 randomized controlled trials (RCTs).
Participants
704 older people (mean age range: 67.0 to 73.7 years, male % range: 0% to 60%).
Intervention
Yoga with duration 60 to 90 minutes once to twice a week for 12 weeks to 6 months.
Comparator
Comparison 1: Yoga versus aerobic exercise;
Comparison 2: Yoga versus wait list controls.
Major Outcomes
Outcome 1: Change in aerobic fitness measured by maximal aerobic consumption capacity (VO2max) from baseline to the end of treatment;
Outcome 2: Change in physical health related quality of life measured by Short Form-36 (SF-36) physical component scale from baseline to the end of treatment;
Outcome 3: Change in mental health related quality of life measured by SF-36 mental component scale from baseline to the end of treatment.
Settings
6 studies were conducted in community settings, 1 study was in residential home setting and another study was in an outpatient setting.
Comparison    Yoga versus aerobic exercise
Main Results
Compared to aerobic exercise, yoga showed significant improvement in aerobic fitness (pooled standardized mean difference (pooled SMD): 0.54, 95% CI: 0.08 to 1.00) among older people.
Comparison 1: Yoga versus aerobic exercise in older people
Outcome No. of studies (Total number of participants) Standardized mean/ No. of participants Heterogeneity test (I2) Pooled SMD (95% CI) Overall quality of evidence*
Intervention Comparator
1 4 (282) Not reported Not reported Modest, around 50.0% but exact value not reported. 0.54 (0.08 to 1.00) Low
Keys: SMD = standardized mean difference; CI = confidence interval.
Comparison    Yoga versus wait list controls
Main Results
Compared to wait list controls, yoga showed significant improvement in physical health related quality of life (pooled SMD: 0.65, 95% CI: 0.02 to 1.28) and mental health related quality of life (pooled SMD: 0.66, 95% CI: 0.10 to 1.22) among older people.
Comparison 2: Yoga versus wait list control in older people
Outcomes No. of studies (Total number of participants) Standardized mean/ No. of participants Heterogeneity test (I2) Pooled SMD (95% CI) Overall quality of evidence*
Intervention Comparator
2 4 (422) Not reported Not reported 82.0% 0.65 (0.02 to 1.28) Moderate
3 4 (422) Not reported Not reported 77.0% 0.66 (0.10 to 1.22) Moderate
Keys: SMD = standardized mean difference; CI = confidence interval.
Comparison    Yoga versus aerobic exercise
Main Results
Compared to aerobic exercise, yoga showed significant improvement in aerobic fitness (pooled standardized mean difference (pooled SMD): 0.54, 95% CI: 0.08 to 1.00) among older people.
Comparison 1: Yoga versus aerobic exercise in older people
Outcome 1
No. of studies (Total number of participants) 4 (282)
Standardized mean/ No. of participants Intervention Not reported
Comparator Not reported
Pooled SMD (95% CI) 0.54 (0.08 to 1.00)
Overall quality of evidence* Low
Keys: SMD = standardized mean difference; CI = confidence interval.
Comparison    Yoga versus wait list controls
Main Results
Compared to wait list controls, yoga showed significant improvement in physical health related quality of life (pooled SMD: 0.65, 95% CI: 0.02 to 1.28) and mental health related quality of life (pooled SMD: 0.66, 95% CI: 0.10 to 1.22) among older people.
Comparison 2: Yoga versus wait list control in older people
Outcomes 2 3
No. of studies (Total number of participants) 4 (422) 4 (422)
Standardized mean/ No. of participants Intervention Not reported Not reported
Comparator Not reported Not reported
Pooled SMD (95% CI) 0.65 (0.02 to 1.28) 0.66 (0.10 to 1.22)
Overall quality of evidence* Moderate Moderate
Keys: SMD = standardized mean difference; CI = confidence interval.
Conclusion
Benefits
Compared to aerobic exercise, yoga was effective in improving aerobic fitness among older people. Compared to wait list control, yoga was effective in improving both physical and mental health related quality of life among older people. For outcome 1, the overall quality of evidence is low. Further research is likely to have an important impact on our confidence in this estimate of effect. For outcomes 2 and 3, 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.
Harms
The systematic review authors reported that very little had been reported about potential adverse events. The poor adverse event reporting in most of the studies limited any conclusions about the safety of yoga.
Link to Original Article
http://www.ncbi.nlm.nih.gov/pubmed/22909385
The synopsis is based on the following article:
Patel NK, Newstead AH, Ferrer RL. The effects of yoga on physical functioning and health related quality of life in older adults: a systematic review and meta-analysis. J. Altern. Complement. Med. 2012 Oct; 18(10): 902-17.


* 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.