Can yoga improve psychological health among older adults?
Date of publication of the randomized controlled trial: September 2014
Design
Randomized controlled trial (RCT).
Participants
98 older adults (mean age: 77.0 years, male %: 30.2%) who had no prior yoga experience.
Intervention
A 6-week chair yoga program, which is a modified form of Hatha yoga with components of breathing and physical exercise which allows practice while sitting. Each session lasted for 45 minutes, once per week.
Comparator
Comparison 1: Chair yoga versus chair exercise;
Comparison 2: Chair yoga versus wait-list.
Major Outcomes
Outcome 1: Anger, measured by the State Anger Expression Inventory;
Outcome 2: Anxiety, measured by the State Anxiety Inventory;
Outcome 3: Depression, measured by the Geriatric Depression Scale;
Outcome 4: Well-being, measured by Lawton’s PGC Morale Scale;
Outcome 5: General self-efficacy, measured by the General Self-Efficacy Scale;
Outcome 6: Self-efficacy for daily living, measured by the Chronic Disease Self-Efficacy Scales;
Outcome 7: Self-control, measured by Self-Control Schedule.
Settings
This trial was performed in an outpatient setting.
Comparison    Chair yoga versus chair exercise
Main Results
Compared to chair exercise, participants of chair yoga had significantly reduced level of anger (effect size:0.89, p<0.001), anxiety (effect size: 0.27, p<0.002), depression (effect size: 0.47, p<0.001). Also, there is a significant improvement on well-being (effect size: 0.14, p<0.001), general self-efficacy (effect size: 0.63, p<0.001), self-efficacy for daily living (effect size: 0.52, p<0.001) and self-control (effect size: 0.39, p<0.001).
Comparison 1: Chair yoga versus chair exercise among older adults
Outcomes No. of studies (Total number of participants) Mean score / No. of participants Heterogeneity test (I2) Effect size p value Overall quality of evidence*
Intervention Comparator
1 1 (98) Not reported Not reported Not applicable as there is only 1 study. 0.89 <0.001 Very High
2 1 (98) Not reported Not reported Not applicable as there is only 1 study. 0.27 <0.002 Moderate
3 1 (98) Not reported Not reported Not applicable as there is only 1 study. 0.47 <0.001 Moderate
4 1 (98) Not reported Not reported Not applicable as there is only 1 study. 0.14 <0.001 Moderate
5 1 (98) Not reported Not reported Not applicable as there is only 1 study. 0.63 <0.001 High
6 1 (98) Not reported Not reported Not applicable as there is only 1 study. 0.52 <0.001 High
7 1 (98) Not reported Not reported Not applicable as there is only 1 study. 0.39 <0.001 Moderate
Keys: NA
Comparison    Chair yoga versus wait-list
Main Results
Compared to wait-list, participants of chair yoga had significantly reduced level of anger (effect size:0.90, p<0.001), anxiety (effect size: 0.39, p<0.002), depression (effect size: 0.49, p<0.001). Also, there is a significant improvement on well-being (effect size: 0.49, p<0.001), general self-efficacy (effect size: 1.10, p<0.001), self-efficacy for daily living (effect size: 0.81, p<0.001) and self-control (effect size: 0.59, p<0.001).
Comparison 2: Chair yoga versus wait-list among older adults
Outcomes No. of studies (Total number of participants) Mean score / No. of participants Heterogeneity test (I2) Effect size p value Overall quality of evidence*
Intervention Comparator
1 1 (98) Not reported Not reported Not applicable as there is only 1 study. 0.90 <0.001 Very High
2 1 (98) Not reported Not reported Not applicable as there is only 1 study. 0.39 <0.002 Moderate
3 1 (98) Not reported Not reported Not applicable as there is only 1 study. 0.49 <0.001 Moderate
4 1 (98) Not reported Not reported Not applicable as there is only 1 study. 0.49 <0.001 Moderate
5 1 (98) Not reported Not reported Not applicable as there is only 1 study. 1.10 <0.001 Very High
6 1 (98) Not reported Not reported Not applicable as there is only 1 study. 0.51 <0.001 Very High
7 1 (98) Not reported Not reported Not applicable as there is only 1 study. 0.59 <0.001 High
Keys: NA
Comparison    Chair yoga versus chair exercise
Main Results
Compared to chair exercise, participants of chair yoga had significantly reduced level of anger (effect size:0.89, p<0.001), anxiety (effect size: 0.27, p<0.002), depression (effect size: 0.47, p<0.001). Also, there is a significant improvement on well-being (effect size: 0.14, p<0.001), general self-efficacy (effect size: 0.63, p<0.001), self-efficacy for daily living (effect size: 0.52, p<0.001) and self-control (effect size: 0.39, p<0.001).
Comparison 1: Chair yoga versus chair exercise among older adults
Outcomes 1 2 3 4 5 6 7
No. of studies (Total number of participants) 1 (98) 1 (98) 1 (98) 1 (98) 1 (98) 1 (98) 1 (98)
Mean score / No. of participants Intervention Not reported Not reported Not reported Not reported Not reported Not reported Not reported
Comparator Not reported Not reported Not reported Not reported Not reported Not reported Not reported
Effect size 0.89 0.27 0.47 0.14 0.63 0.52 0.39
p value <0.001 <0.002 <0.001 <0.001 <0.001 <0.001 <0.001
Overall quality of evidence* Very High Moderate Moderate Moderate High High Moderate
Keys: NA
Comparison    Chair yoga versus wait-list
Main Results
Compared to wait-list, participants of chair yoga had significantly reduced level of anger (effect size:0.90, p<0.001), anxiety (effect size: 0.39, p<0.002), depression (effect size: 0.49, p<0.001). Also, there is a significant improvement on well-being (effect size: 0.49, p<0.001), general self-efficacy (effect size: 1.10, p<0.001), self-efficacy for daily living (effect size: 0.81, p<0.001) and self-control (effect size: 0.59, p<0.001).
Comparison 2: Chair yoga versus wait-list among older adults
Outcomes 1 2 3 4 5 6 7
No. of studies (Total number of participants) 1 (98) 1 (98) 1 (98) 1 (98) 1 (98) 1 (98) 1 (98)
Mean score / No. of participants Intervention Not reported Not reported Not reported Not reported Not reported Not reported Not reported
Comparator Not reported Not reported Not reported Not reported Not reported Not reported Not reported
Effect size 0.90 0.39 0.49 0.49 1.10 0.51 0.59
p value <0.001 <0.002 <0.001 <0.001 <0.001 <0.001 <0.001
Overall quality of evidence* Very High Moderate Moderate Moderate Very High Very High High
Keys: NA
Conclusion
Benefits
Compared to chair exercise and wait-list, chair yoga significantly improves the psychological health in terms of reduction in anger, anxiety, depression, as well as improvement in well-being, general self-efficacy, self-efficacy for daily living and self-control among older adults. Comparison 1: For Outcome 1, the overall quality of evidence is very high. Further research is most unlikely to have an important impact on our confidence in this estimate of effect. For Outcome 5-6, the overall quality of evidence is high. Further research is unlikely to have an important impact on our confidence in this estimate of effect. For Outcome 2-4 & 7, 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. Comparison 2: For Outcome 1, 5-6, the overall quality of evidence is very high. Further research is most unlikely to have an important impact on our confidence in this estimate of effect. For Outcome 7, the overall quality of evidence is high. Further research is unlikely to have an important impact on our confidence in this estimate of effect. For Outcome 2-4, 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
No adverse events were reported.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/24366852
The synopsis is based on the following article:
Bonura KB, Tenenbaum G. Effects of yoga on psychological health in older adults. Journal of Physical Activity and Health. 2014 Sep;11(7):1334-41.


* 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.