• Posted March 14, 2023

Yoga Can Help Seniors Regain Their Strength

Practicing yoga might help older adults become a little surer on their feet, a new research review suggests.

The review, of 33 small clinical trials, found that older adults who participated in yoga programs typically gained some lower-body strength and boosted their walking speed.

Experts said the findings suggest that yoga might help older adults manage some of the strength and movement limitations that can come with age.

At the same time, it's hard to give specific advice based on the research that's been done, according to lead researcher Dr. Julia Loewenthal, a geriatrician at Brigham and Women's Hospital in Boston.

The trials varied in the groups they studied, she said -- sometimes healthy older adults living at home, sometimes nursing home residents, sometimes people with health conditions like knee arthritis or Parkinson's disease.

The studies also differed in the style of yoga they used, Loewenthal said.

Yoga is an ancient practice that blends physical postures, breathing practices and meditation. In the modern world, though, yoga classes vary widely in style -- with some favoring a vigorous physical practice that requires people to move quickly and get up and down from the floor.

For seniors looking to start a yoga practice, Loewenthal said that an Iyengar-based class could be a good fit: That style of yoga focuses on good form in the poses, can be adapted to individuals, and uses props -- like blocks, chairs and other supports -- to help people achieve the postures.

Loewenthal also recommended that older adults with chronic medical conditions talk to their doctor before taking up yoga.

The review, published March 14 in the Annals of Internal Medicine, looked at 33 clinical trials conducted in various countries. Some randomly assigned older adults to participate in a yoga program or not; others compared yoga against another activity, like tai chi or conventional exercise.

For the most part, the trials were small and short-term, ranging from about one to seven months.

Overall, Loewenthal's team found, seniors who practiced yoga typically made gains in lower-body strength and gait speed, versus their peers who remained inactive. In trials that compared yoga with other activities, there was no clear winner.

"There didn't seem to be any advantage of yoga over exercise or tai chi," Loewenthal said. "We can't say whether yoga offers any special benefits."

Loss of leg strength and walking speed can be indicators of frailty -- a decline in the body's strength and functioning that puts older adults at increased risk of disability, falls and hospitalization.

The trials in the review did not, however, specifically measure frailty as an outcome, Loewenthal said. So it's not clear whether yoga can help prevent or manage frailty, per se.

Dr. Neil Alexander is a geriatrics specialist at the University of Michigan and director of the VA Ann Arbor Geriatric Research Education and Clinical Center.

He said the review was "well done," but the trial data leave too many unknowns to draw conclusions. One big missing piece, according to Alexander, is what, exactly, yoga practitioners did to boost their leg strength and gait speed.

"You don't know what they worked on," he said.

Alexander noted that at this point, tai chi is much better studied than yoga, and has been shown to help older adults reduce their risk of falls. (Tai chi focuses on slow, fluid movement combined with mental imagery and deep breathing.)

There's still a need for comparable research into yoga, Alexander said.

That does not mean, however, that seniors should stay away from yoga until then. Alexander, who practices Iyengar yoga himself, agreed that a class in that style can be a good starting point.

"You need an adaptable style of yoga," Alexander said. "You don't want a 'flow-based' yoga where you're moving in and out poses."

And while you can easily find a yoga class on YouTube, Alexander stressed the importance of beginners having in-person instruction, where they can get individual attention.

"I tell people you need to start with a class," he said.

That does bring up an obstacle of cost, Loewenthal said. Yoga classes are not covered by insurance, and can be pricey.

She recommended that older adults look into places other than conventional yoga studios -- like their local senior center, hospitals or YMCA. They might offer classes that are both designed for older adults and low-cost or even free.

More information

The U.S. National Institute on Aging has advice on physical activity for older adults.

SOURCES: Julia Loewenthal, MD, geriatrician, Brigham and Women's Hospital, Boston; Neil Alexander, MD, professor, geriatric and palliative medicine, University of Michigan, and director, VA Ann Arbor Geriatric Research Education and Clinical Center, Ann Arbor, Mich.; Annals of Internal Medicine, March 14, 2023, online