Yoga-based exercise improves health-related quality of life and mental well-being in older people: a systematic review of randomised controlled trials Yoga decreases kyphosis in senior women and men with adult-onset hyperkyphosis: results of a randomized controlled trial. Physical fitness of older adults in senior activity centres after 24-week silver yoga exercises. Yoga therapy decreases dyspnea-related distress and improves functional performance in people with chronic obstructive pulmonary disease: a pilot study. Overview of Systematic Reviews: Yoga as a Therapeutic Intervention for Adults with Acute and Chronic Health Conditions Yoga Is as Good as Stretching-Strengthening Exercises in Improving Functional Fitness Outcomes: Results From a Randomized Controlled Trial. Yoga and Mindfulness as Therapeutic Interventions for Stroke Rehabilitation: A Systematic Review Differential exercise effects on quality of life and health-related quality of life in older adults: a randomized controlled trial Adapted yoga to improve physical function and health-related quality of life in physically-inactive older adults: a randomised controlled pilot trial The Influence of Yoga-Based Programs on Risk Profiles in Adults with Type 2 Diabetes Mellitus: A Systematic Review Scoping review of systematic reviews of complementary medicine for musculoskeletal and mental health conditions Health-related quality of life in older adults at risk for disability. Yoga practice improves executive function by attenuating stress levels Using silver yoga exercises to promote physical and mental health of elders with dementia in long-term care facilities. Comparative effects of two physical activity programs on measured and perceived physical functioning and other health-related quality of life outcomes in older adults. Effects of Yoga on Mental and Physical Health: A Short Summary of Reviews The Effect of Functional Tasks Exercise and Resistance Exercise on Health-Related Quality of Life and Physical Activity The effects of an 8-week Hatha yoga intervention on executive function in older adults. Once a week is not enough: effects of a widely implemented group based exercise programme for older adults; a randomised controlled trial A Pilot Randomized Controlled Trial of the Effects of Chair Yoga on Pain and Physical Function Among Community‐Dwelling Older Adults With Lower Extremity Osteoarthritis Physical activity, function, and quality of life: design and methods of the FlexToBa trial. Hatha Yoga Practice Improves Attention and Processing Speed in Older Adults: Results from an 8-Week Randomized Control Trial. Controlled pilot study of the effects of power yoga in Parkinson's disease. Older adults recently discharged from the hospital: effect of aerobic interval exercise on health-related quality of life, physical fitness, and physical activity. Systematic review of cognitive behavioural therapy for the management of headaches and migraines in adults Changes in pain intensity and health related quality of life with Iyengar yoga in nonspecific chronic low back pain: A randomized controlled study Effectiveness of exercise interventions on physical function in community-dwelling frail older people: an umbrella review of systematic reviews Physical rehabilitation interventions for adult patients with critical illness across the continuum of recovery: an overview of systematic reviews protocol
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 ) OBJECTIVES To assess whether a specifically design ed yoga intervention can reduce hyperkyphosis . DESIGN A 6-month , two-group , r and omized , controlled , single-masked trial . SETTING Community research unit . PARTICIPANTS One hundred eighteen women and men aged 60 and older with a kyphosis angle of 40 degrees or greater . Major exclusions were serious medical comorbidity , use of assistive device , inability to hear or see adequately for participation , and inability to pass a physical safety screen . INTERVENTION The active treatment group attended hour-long yoga classes 3 days per week for 24 weeks . The control group attended a monthly luncheon and seminar and received mailings . MEASUREMENTS Primary outcomes were change ( baseline to 6 months ) in Debrunner kyphometer-assessed kyphosis angle , st and ing height , timed chair st and s , functional reach , and walking speed . Secondary outcomes were change in kyphosis index , flexicurve kyphosis angle , Rancho Bernardo Blocks posture assessment , and health-related quality of life ( HRQOL ) . RESULTS Compared with control participants , participants r and omized to yoga experienced a 4.4 % improvement in flexicurve kyphosis angle ( P=.006 ) and a 5 % improvement in kyphosis index ( P=.004 ) . The intervention did not result in statistically significant improvement in Debrunner kyphometer angle , measured physical performance , or self-assessed HRQOL ( each P>.1 ) . CONCLUSION The decrease in flexicurve kyphosis angle in the yoga treatment group shows that hyperkyphosis is remediable , a critical first step in the pathway to treating or preventing this condition . Larger , more-definitive studies of yoga or other interventions for hyperkyphosis should be considered . Targeting individuals with more-malleable spines and using longitudinally precise measures of kyphosis could strengthen the treatment effect 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 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 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 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 Aim . This paper reports a systematic review and critical appraisal of the evidence on the effectiveness of behavioral therapies such as yoga and mindfulness practice s for stroke rehabilitation . Background . The experience of stroke can have a negative impact on both psychological and physical health and on quality of life . Yoga and relevant practice s are promising therapies that have been used with patients with a variety of conditions . In order to draw conclusions on effectiveness for stroke patients , the evidence requires systematic assessment . Methods . A comprehensive search of major biomedical and complementary medicine data bases was conducted . Relevant research was categorized by study type and appraised according to study design . Results . Five r and omized controlled clinical trials and four single case studies were found . Additionally , one qualitative research study was identified . Studies reported positive results , including improvements in cognition , mood , and balance and reductions in stress . Modifications to different yoga practice s make comparison between studies difficult , and a lack of controlled studies precludes any firm conclusions on efficacy . Conclusion . Yoga and mindfulness could be clinical ly valuable self-administered intervention options for stroke rehabilitation . Further research is needed to evaluate these specific practice s and their suitability in stroke rehabilitation Abstract Purpose Maintaining quality of life ( QOL ) and physical and mental health status are important outcomes throughout the aging process . Although cross-sectional studies suggest a relationship between global QOL and physical activity , it is unclear whether such a relationship exists as a function of exercise training . Methods We examined the effects of two exercise intervention arms on health-related quality of life ( HRQOL ) and global QOL .  Low-active , older adults ( n = 179 ) were r and omly assigned to either a 12-month aerobic walking group or a strengthening and flexibility group .  HRQOL and QOL were measured at baseline , 6 , and 12 months . Results There was a significant group by time effect on QOL [ F(2,176 ) = 3.11 , p = 0.047 , η2 = 0.03 ] . There was also a significant overall group by time effect for HRQOL [ F(4,174 ) = 2.46 , p = 0.047 , η2 = 0.05 ] , which was explained by the significant group by time interaction for mental health status ( p = 0.041 , η2 = 0.02 ) favoring the walking condition . Further analyses using latent class analysis revealed three classes of individuals with differential patterns of change in QOL and HRQOL across time . These classes reflected no change , declines , and improvements in these constructs across time . Conclusions Walking appears to enhance the mental aspect of HRQOL and global QOL when compared to a non-aerobic intervention . Additionally , the patterns of change in QOL and HRQOL were not linear over time . Our findings are in contrast to previous reports that these outcomes change a little or not at all in r and omized trials 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 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 Objective To identify potentially effective complementary approaches for musculoskeletal (MSK)–mental health ( MH ) comorbidity , by synthesis ing evidence on effectiveness , cost-effectiveness and safety from systematic review s ( SRs ) . Design Scoping review of SRs . Methods We search ed literature data bases , registries and reference lists , and contacted key authors and professional organisations to identify SRs of r and omised controlled trials for complementary medicine for MSK or MH . Inclusion criteria were : published after 2004 , study ing adults , in English and scoring > 50 % on Assessing the Method ological Quality of Systematic Review s ( AMSTAR ) ; quality appraisal checklist ) . SRs were synthesis ed to identify research priorities , based on moderate/good quality evidence , sample size and indication of cost-effectiveness and safety . Results We included 84 MSK SRs and 27 MH SRs . Only one focused on MSK – MH comorbidity . Meditative approaches and yoga may improve MH outcomes in MSK population s. Yoga and tai chi had moderate/good evidence for MSK and MH conditions . SRs reported moderate/good quality evidence ( any comparator ) in a moderate/large population for :  low back pain ( LBP )  ( yoga , acupuncture , spinal manipulation/mobilisation , osteopathy ) , osteoarthritis ( OA ) ( acupuncture , tai chi ) , neck pain  ( acupuncture , manipulation/manual therapy ) , myofascial trigger point pain ( acupuncture ) , depression ( mindfulness-based stress reduction ( MBSR ) , meditation , tai chi , relaxation ) , anxiety ( meditation/MBSR , moving meditation , yoga ) , sleep disorders ( meditative/mind – body movement ) and stress/distress ( mindfulness ) . The majority of these complementary approaches had some evidence of safety — only three had evidence of harm . There was some evidence of cost-effectiveness for spinal manipulation/mobilisation and acupuncture for LBP , and manual therapy/manipulation for neck pain , but few SRs review ed cost-effectiveness and many found no data . Conclusions Only one SR studied MSK – MH comorbidity . Research priorities for complementary medicine for both MSK and MH ( LBP , OA , depression , anxiety and sleep problems ) are yoga , mindfulness and tai chi . Despite the large number of SRs and the prevalence of comorbidity , more high- quality , large r and omised controlled trials in comorbid population s are needed BACKGROUND The number of older adults living in the United States continues to increase , and recent research has begun to target interventions to older adults who have mobility limitations and are at risk for disability . The objective of this study is to describe and examine correlates of health-related quality of life in this population subgroup using baseline data from a larger intervention study . METHODS The Lifestyle Interventions and Independence for Elders-Pilot study ( LIFE-P ) was a r and omized controlled trial that compared a physical activity intervention to a non-exercise educational intervention among 424 older adults at risk for disability . Baseline data ( collected in April-December 2004 , analyzed in 2006 ) included demographics , medical history , the Quality of Well-Being Scale ( QWB-SA ) , a timed 400-m walk , and the Short Physical Performance Battery ( SPPB ) . Descriptive health-related quality of life ( HRQOL ) data are presented . Hierarchical linear regression models were used to examine correlates of HRQOL . RESULTS The mean QWB-SA score for the sample was 0.630 on an interval scale ranging from 0.0 ( death ) to 1.0 ( asymptomatic , optimal functioning ) . The mean of 0.630 is 0.070 lower than a comparison group of healthy older adults . The variables associated with lower HRQOL included white ethnicity , more comorbid conditions , slower 400-m walk times , and lower SPPB balance and chair st and scores . CONCLUSIONS Older adults who are at risk for disability had reduced HRQOL . Surprisingly , however , mobility was a stronger correlate of HRQOL than an index of comorbidity , suggesting that interventions addressing mobility limitations may provide significant health benefits to this population BACKGROUND Prolonged activation of the hypothalamus-pituitary-adrenal system is thought to have deleterious effects on brain function . Neuroendocrine studies suggest that brain exposure to higher cortisol concentrations contribute to cognitive deficits as we age . Mind-body techniques such as yoga have shown to improve stress levels by restoring the body 's sympathetic-parasympathetic balance . The objective of this study was to determine whether yoga practice moderated the stress response result ing in improved executive function . METHODS Sedentary community dwelling older adults ( N=118 , Mean age=62.02 ) were r and omized to an 8-week yoga intervention or a stretching control group . At baseline and following 8 weeks , all participants completed measures of executive function , self-reported stress and anxiety  and provided  saliva sample  s before and after cognitive testing to assess cortisol . RESULTS Yoga participants showed improved accuracy on executive function measures and an attenuated cortisol response compared to their stretching counterparts who showed increased cortisol levels and poor cognitive performance at follow up . The change in cortisol levels as well as self-reported stress and anxiety levels predicted performance on the running span task , n-back working memory and task switching paradigm ( β's=0.27 - 0.38 , p's≤0.05 for yoga and β's=-0.37 - 0.47 , p's≤0.01 for stretching control ) . CONCLUSION Eight weeks of regular yoga practice result ed in improved working memory performance that was mediated by an attenuated response to stress as measured by self-report stress and objective salivary cortisol measurements . This trial offers evidence for non-traditional physical activity interventions such as yoga that may be helpful in restoring HPA balance in older adults , thereby preventing cognitive decline BACKGROUND This study aim ed to test the effects of yoga exercises on the physical and mental health of elderly people with dementia living in long-term care facilities . METHODS A quasi-experimental , pretest-post-test design was used . A convenience sample of 68 residents in long-term care facilities in southern Taiwan , aged 60 years and above with mild to moderate dementia , was selected . An experimental group of 33 elders participated in a 12-week yoga training program of three 55-minute sessions a week ; a control group of 35 elders maintained their usual daily activities . Data were collected before and after completing the 12-week study . Measurements included body composition , cardiopulmonary functions , body flexibility , muscle strength and endurance , balance , joints motion , depression , and problem behaviors . RESULTS The yoga-trained participants had better physical and mental health than those who did not participate , including lowered blood pressure , reduced respiration rate , strengthened cardiopulmonary fitness , enhanced body flexibility , improved muscle strength and endurance , improved balance , and increased joints motion ( all p values < 0.05 ) . In addition , the depression state ( p < 0.001 ) and problem behaviors ( p < 0.001 ) of these demented elders were significantly reduced . CONCLUSION Yoga exercise has positive benefits for both the physical and mental health of elders with dementia living in long-term care facilities . It is recommended that yoga be included as one of the routine activities in these long-term care facilities BACKGROUND Although inactivity is an important contributor to impaired functioning and disability with age , little is known concerning how improvements in physical functioning and well-being in older adults vary with the type of physical activity undertaken . METHODS One hundred three adults age 65 years and older , recruited via population -based methods , were r and omized to 12 months of community-based , moderate-intensity endurance and strengthening exercises ( Fit & Firm ) or stretching and flexibility exercises ( Stretch & Flex ) . A combination of class- and home-based exercise formats was used . Measured and self-rated physical performance along with perceived functioning and well-being were assessed pre- and postintervention . RESULTS Fit & Firm subjects showed greater 12-month improvements in both measured and self-rated endurance and strength compared to Stretch & Flex subjects . Stretch & Flex subjects reported greater improvements in bodily pain , and Stretch & Flex men evidence d greater improvements in flexibility relative to Fit & Firm subjects . Although overall exercise adherence was high in both exercise conditions ( approximately 80 % ) , subjects in both conditions showed better adherence to the home- versus class-based portions of their exercise prescriptions . CONCLUSIONS Community-based programs focusing on moderate-intensity endurance and strengthening exercises or flexibility exercises can be delivered through a combination of formats that result in improvement in important functional and well-being outcomes . This represents one of the first studies to report significant improvements in an important quality of life outcome -bodily pain-with a regular regimen of stretching and flexibility exercises in a community-based sample of older adults This report summarizes the current evidence on the effects of  yoga interventions on various components of mental and physical health , by focussing on the evidence described in review articles . Collectively , these review s suggest a number of areas where yoga may well be beneficial , but more research is required for virtually all of them to firmly establish such benefits . The heterogeneity among interventions and conditions studied has hampered the use of meta- analysis as an appropriate tool for summarizing the current literature . Nevertheless , there are some meta-analyses which indicate beneficial effects of yoga interventions , and there are several r and omized clinical trials ( RCT 's ) of relatively high quality indicating beneficial effects of yoga for pain-associated disability and mental health .  Yoga may well be effective as a supportive adjunct to mitigate some medical conditions , but not yet a proven st and -alone , curative treatment . Larger-scale and more rigorous research with higher method ological quality and adequate control interventions is highly encouraged because yoga may have potential to be implemented as a beneficial supportive/adjunct treatment that is relatively cost-effective , may be practice d at least in part as a self-care behavioral treatment , provides a life-long behavioural skill , enhances self-efficacy and self-confidence and is often associated with additional positive side effects Background : Data regarding the effect of exercise programmes on older adults ’  health-related quality of life ( HRQOL ) and habitual physical activity are inconsistent . Objective : To determine whether a functional tasks exercise programme ( enhances functional capacity ) and a resistance exercise programme ( increases muscle strength ) have a different effect on the HRQOL and physical activity of community-dwelling older women . Methods : Ninety-eight women were r and omised to a  functional tasks exercise programme ( function group ) , a resistance exercise programme ( resistance group ) , or normal activity group ( control group ) . Participants attended exercise classes three times a week for 12 weeks . The SF-36 Health Survey question naire and self-reported physical activity were obtained at baseline , directly after completion of the intervention ( 3 months ) , and 6 months later ( 9 months ) . Results : At 3 months , no difference in mean change in HRQOL and physical activity scores was seen between the groups , except for an increased SF-36 physical functioning score for the resistance group compared with the control group ( p = 0.019 ) and the function group ( p = 0.046 ) . Between 3 and 9 months , the self-reported physical functioning score of the function group decreased to below baseline ( p = 0.026 ) , and physical activity ( p = 0.040 ) decreased in the resistance group compared with the function group . Conclusions : Exercise has a limited effect on the HRQOL and self-reported physical activity of community-living older women . Our results suggest that in these subjects HRQOL measures may be affected by ceiling effects and response shift . Studies should include performance-based measures in addition to self-report HRQOL measures , to obtain a better underst and ing of the effect of exercise interventions in older adults BACKGROUND Few scientific studies have examined movement-based embodied contemplative practice s such as yoga and their effects on cognition . The purpose of this r and omized controlled trial was to examine the effects of an 8-week Hatha yoga intervention on executive function measures of task switching and working memory capacity . METHODS Community-dwelling older adults ( N = 118 ; mean age = 62.0 ) were r and omized to one of two groups : a Hatha yoga intervention or a stretching-strengthening control . Both groups participated in hour-long exercise classes 3 × /week over the 8-week study period . All participants completed established tests of executive function including the task switching paradigm , n-back and running memory span at baseline and follow-up . RESULTS Analysis of covariances showed significantly shorter reaction times on the mixed and repeat task switching trials ( partial η(2 ) = .04 , p < .05 ) for the Hatha yoga group . Higher accuracy was recorded on the single trials ( partial η(2 ) = .05 , p < .05 ) , the 2-back condition of the n-back ( partial η(2 ) = .08 , p < .001 ) , and partial recall scores ( partial η(2 ) = .06 , p < .01 ) of running span task . CONCLUSIONS Following 8 weeks of yoga practice , participants in the yoga intervention group showed significantly improved performance on the executive function measures of working memory capacity and efficiency of mental set shifting and flexibility compared with their stretching-strengthening counterparts . Although the underlying mechanisms need to be investigated , these results dem and larger systematic trials to thoroughly examine effects of yoga on executive function as well as across other domains of cognition , and its potential to maintain or improve cognitive functioning in the aging process Objectives : To determine the effects of gymnastics on the health related quality of life ( HRQoL ) and functional status of independently living people , aged 65 to 80 years .  Gymnastics formed part of the More Exercise for Seniors ( MBvO in Dutch ) programme , a group based exercise programme for older adults in the Netherl and s. It has been widely implemented since 1980 . Design : R and omised controlled trial with pretest and post-test measurements . Intervention : The exercise programme given by experienced instructors lasted 10 weeks and was given weekly ( MBvO1 ; n = 125 , six groups ) or twice weekly ( MBvO2 ; n = 68 , six groups ) . The control group ( n = 193 ) was offered a health education programme . Setting : Community dwelling of older people , with a comparatively low level of fitness as assessed with the Groningen Fitness test for the Elderly . Results : No significant effects were found on the HRQoL ( Vitality Plus Scale , TAAQoL , and R AND -36 ) and the functional status ( Physical Performance Test and the Groningen Activity Restriction Scale ) . The MBvO2 group , with a low level of physical activity at baseline , showed the only improvement found on the Vitality Plus Scale ( F = 4.53 ; p = 0.01 ) . Conclusions : MBvO gymnastics once a week did not provide benefits in HRQoL and functional status after 10 weeks . However , participants with a low level of physical activity may benefit from MBvO gymnastics if they participate twice a week . To improve the health of the general public , sedentary older adults should be recruited and encouraged to combine MBvO with the health enhancing physical activity guidelines OBJECTIVES To determine effects of Sit ' N ' Fit Chair Yoga , compared to a Health Education program ( HEP ) , on pain and physical function in older adults with lower extremity osteoarthritis ( OA ) who could not participate in st and ing exercise . DESIGN Two-arm r and omized controlled trial . SETTING One HUD senior housing facility and one day senior center in south Florida . PARTICIPANTS Community-dwelling older adults ( N = 131 ) were r and omly assigned to chair yoga  ( n = 66 ) or HEP ( n = 65 ) . Thirteen dropped after assignment but prior to the intervention ; six dropped during the intervention ; 106 of 112 completed at least 12 of 16 sessions ( 95 % retention rate ) . INTERVENTIONS Participants attended either chair yoga or HEP . Both interventions consisted of twice-weekly 45-minute sessions for 8 weeks . MEASUREMENTS Primary : pain , pain interference ; secondary : balance , gait speed , fatigue , functional ability measured at baseline , after 4 weeks of intervention , at the end of the 8-week intervention , and post-intervention ( 1 and 3 months ) . RESULTS The chair yoga group showed greater reduction in pain interference during the intervention ( P = .01 ) , sustained through 3 months ( P = .022 ) . WOMAC pain ( P = .048 ) , gait speed ( P = .024 ) , and fatigue ( P = .037 ) were improved in the yoga group during the intervention ( P = .048 ) but improvements were not sustained post intervention . Chair yoga had no effect on balance . CONCLUSION An 8-week chair yoga program was associated with reduction in pain , pain interference , and fatigue , and improvement in gait speed , but only the effects on pain interference were sustained 3 months post intervention . Chair yoga should be further explored as a nonpharmacologic intervention for older people with OA in the lower extremities . TRIAL REGISTRATION Clinical Trials.gov : NCT02113410 The Flexibility , Toning , and Balance ( FlexToBa ) Trial is a two-armed r and omized controlled trial which will contrast the effects of a DVD-delivered , home-based , physical activity intervention and a Healthy Aging attention control condition on physical activity , functional performance , functional limitations , and quality of life in low active , older adults . This innovative trial will recruit 300 participants across central Illinois who will be r and omized into the intervention arm or control arm of the study . The intervention will last 6 months with a 6 month follow-up . Assessment s at baseline , post intervention and follow-up will include physical activity ( self-report and accelerometry ) , a battery of functional performance measures , functional limitations , quality of life , and an array of psychological health measures . In addition , measures of external validity will be included to determine public health significance of a successful outcome . Participants will engage in a progressive series of activities focusing on flexibility , strengthening , and balance exercises which are demonstrated by a trained exercise leader and age-appropriate models on a series of DVDs . Delivery of the intervention has its basis in social cognitive theory . The specific aims of the trial are ( a ) to determine the effects of the DVD-delivered FlexToBa program on physical activity , functional performance , functional limitations , and quality of life , ( b ) to examine the mediators of the relationships between physical activity and functional limitations and quality of life , ( c ) to assess external validity indicators relative to the intervention , and ( d ) to determine differential effects of the intervention on psychosocial health measures BACKGROUND Age-related cognitive decline is well documented across various aspects of cognitive function , including attention and processing speed , and lifestyle behaviors such as physical activity play an important role in preventing cognitive decline and maintaining or even improving cognitive function . PURPOSE The purpose of this study was to evaluate the effects of an 8-week Hatha yoga intervention on attention and processing speed among older adults . METHODS Participants ( n = 118 ; mean age , 62 ± 5.59 ) were r and omly assigned to an 8-week Hatha yoga group or a stretching control group and completed  cognitive assessment s-Attention Network Task , Trail Making Test parts A and B , and Pattern Comparison Test-at baseline and after the 8-week intervention . RESULTS Analyses of covariance revealed significantly faster reaction times for the yoga group on the Attention Network Task 's neutral , congruent , and incongruent conditions ( p ≤ 0.04 ) . The yoga intervention also improved participants ' visuospatial and perceptual processing on the Trail Making Test part B ( p = 0.002 ) and pattern comparison ( p < 0.001 ) tests . CONCLUSIONS These results suggest that yoga practice that includes postures , breathing , and meditative exercises lead to improved attentional and information processing abilities . Although the underlying mechanisms remain largely speculative , more systematic trials are needed to explore the extent of cognitive benefits and their neurobiological mechanisms OBJECTIVES To evaluate the effects of a specially design ed power yoga program ( YOGA ) on bradykinesia , rigidity , muscular performance and quality of life in older patients with PD . DESIGN R and omized controlled trial . SETTING University laboratory , US . INTERVENTION Twenty-six patients with mild to moderate PD were r and omly assigned to a YOGA or control group ( CON ) . The YOGA program was three months , incorporating two sessions/wk of yoga classes . MAIN OUTCOME MEASURES Upper and lower limb bradykinesia and rigidity scores from the Unified Parkinson 's Disease Rating Scale , one repetition maximums ( 1RM ) and peak powers on biceps curl , chest press , leg press , hip abduction and seated calf , and quality of life ( PDQ-39 ) . RESULTS The YOGA group produced significant improvement in both upper and lower limbs bradykinesia scores , rigidity score , 1RM for all 5 machines and leg press power ( p<.05 ) . Significant improvements were seen in the PDQ-39 overall score , mobility and activities of daily living domain for the YOGA group . CONCLUSION The 3-month YOGA program significantly reduced bradykinesia and rigidity , and increased muscle strength and power in older patients with PD . Power training is an effective training modality to improve physical function and quality of life for PD OBJECTIVES To compare the effect of high-intensity aerobic interval exercise ( HIA ) with home-based exercise ( HB ) in older adults with chronic disease soon after discharge from the hospital . DESIGN R and omized controlled trial . SETTING Hospital . PARTICIPANTS Community-dwelling older adults aged 70 to 92 ( N = 115 ) were recruited while in the hospital . After discharge , they were r and omized to HIA group ( n = 59 ) or HB ( n = 56 ) . INTERVENTION High-intensity aerobic interval exercise ( HIA ) consisted of endurance , strength , and balance exercises . The HB consisted of low-intensity exercises and telephone follow-up from a physical therapist . MEASUREMENTS Health-related quality of life ( HRQOL ) was assessed using the Medical Outcomes Study 36-item Short Form Survey , physical fitness was measured using the Senior Fitness Test , and physical activity was assessed using the Physical Activity Scale for the Elderly . RESULTS Intention-to-treat analysis showed that both groups improved their HRQOL and physical activity after 3 months . Improvements on the Senior Fitness Test ( chair st and , arm curl and 6-minute walk ( 6MWT ) ) were significantly greater in the HIA group than the HB group . The mean difference was 25.9 m on the 6MWT ( P = .001 , effect size d = 0.2 ) , 1.3 per 30 seconds on the chair st and s mean ( P = .001 , effect size d = 0.3 ) , and 1.6 per 30 seconds on the arm curl ( P = .001 , effect size d = 0.4 ) . CONCLUSION High-intensity aerobic interval exercise ( HIA ) participants significantly improved their physical fitness . Both groups increased their HRQOL and physical activity . The findings suggest that exercise therapy should be incorporated as a part of the treatment for older people at risk for functional decline Aim : This systematic review aim ed to establish if cognitive behavioural therapy ( CBT ) can reduce the physical symptoms of chronic headache and migraines in adults . Methods : Evidence from search es of eight data bases was systematic ally sought , appraised and synthesis ed . Screening of title and abstract s was conducted independently by two review ers . Full papers were screened , data extracted and quality assessed by one review er and checked by a second . Data were synthesis ed narratively by intervention due to the heterogeneity of the studies . The inclusion criteria specified r and omised controlled trials with CBT as an intervention in adults suffering from chronic headaches/migraines not associated with an underlying pathology/medication overuse .  CBT was judged on the basis of authors describing the intervention as CBT . The diagnosis of the condition had to be clinician verified . Studies had to include a comparator and employ headache/migraine-specific outcomes such as patient-reported headache days . Results : Out of 1126 screened titles and abstract s and 20 assessed full papers , 10 studies met the inclusion criteria of the review . Some studies combined CBT with another intervention , as well as employing varying numbers of comparators . CBT was statistically significantly more effective in improving some headaches-related outcomes in CBT comparisons with waiting lists ( three studies ) , in combination with relaxation compared with relaxation only ( three studies ) or antidepressant medication ( one study ) , with no statistically significant differences in three studies . Conclusions : The findings of this review were mixed , with some studies providing evidence in support of the suggestion that people experiencing headaches or migraines can benefit from CBT , and that CBT can reduce the physical symptoms of headache and migraines . However , methodology inadequacies in the evidence base make it difficult to draw any meaningful conclusions or to make any recommendations Background : Nonspecific chronic low back ( nCLBP ) pain is prevalent among adult population and often leads to functional limitations , psychological symptoms , lower quality of life ( QOL ) , and higher healthcare costs . The purpose of this study was to determine the efficacy of Iyengar yoga therapy on pain intensity and health related quality of life ( HRQOL ) with nCLBP . Aim of the Study : To compare the effect of Iyengar yoga therapy and conventional exercise therapy on pain intensity and HRQOL in nonspecific chronic low back pain . Material s and Methods : Experimental study with r and om sampling technique . Subjects/Intervention : Sixty subjects who fulfilled the selection criteria were r and omly assigned to Iyengar yoga ( yoga  group , n = 30 ) and  control group ( exercise group  , n = 30 ) . Participants completed low back pain evaluation form and HRQOL-4 question naire before their intervention and again 4 weeks and 6 month later . Yoga group underwent 29 yogic postures training and exercise group had undergone general exercise program for 4 weeks . Statistics : Repeated measures analysis of variance ( ANOVA ) was used to analyze group differences over time , while controlling for baseline differences . Results : Patients in both groups experienced significant reduction in pain and improvement in HRQOL . In visual analogue scale ( VAS ) yoga group showed reduction of 72.81 % ( P = 0.001 ) as compared to exercise group 42.50 % ( P = 0.001 ) . In HRQOL , yoga group showed reduction of 86.99 % ( P = 0.001 ) as compared to exercise group 67.66 % ( P = 0.001 ) . Conclusion : These results suggest that Iyengar yoga provides better improvement in pain reduction and improvement in HRQOL in nonspecific chronic back pain than general exercise Objectives : This umbrella review aim ed to determine the effectiveness of exercise interventions , alone or in combination with other interventions , in improving physical function in community-dwelling older people identified as pre-frail or frail . Introduction : Exercise is said to have a positive impact on muscle mass and strength which improves physical function and hence is beneficial for the treatment of frailty . Several systematic review s discuss the effects of exercise interventions on physical function parameters , such as strength , mobility , gait , balance and physical performance , and indicate that multi-component exercise , including resistance , aerobic , balance and flexibility training , appears to be the best way in which to improve physical function parameters in frail older people . However , there is still uncertainty as to which exercise characteristics ( type , frequency , intensity , duration and combinations ) are the most effective and sustainable over the long-term . Inclusion criteria : Participants were adults , 60 years or over , living in the community and identified as pre-frail or frail . Quantitative systematic review s , with or without meta- analysis that examined the effectiveness of exercise interventions of any form , duration , frequency and intensity , alone or in combination with other interventions design ed to alter physical function parameters in frail older people , were considered . The quantitative outcome measures were physical function , including muscular strength , gait , balance , mobility and physical performance . Methods : An iterative search strategy for ten bibliometric data bases and gray literature was developed . Critical appraisal of seven systematic review s was conducted independently by two review ers using a st and ard Joanna Briggs Institute tool . Data was extracted independently by two review ers using a st and ard Joanna Briggs Institute data extraction tool and summarized using a narrative synthesis approach . Results : Seven systematic review s were included in this umbrella review , with a total of 58 relevant r and omized controlled trials and 6927 participants . Five systematic review s examined the effects of exercise only , while two systematic review s reported on exercise in combination with a nutritional approach , including protein supplementations , as well as fruit and dairy products . The average  exercise frequency was 2–3 times per week ( mean 3.0 ± 1.5 times per week ; range 1–7 weekly ) for 10–90 minutes per session ( mean of 52.0 ± 16.5 mins ) and a total duration of 5–72 weeks with the majority lasting a minimum of 2.5 months ( mean 22.7 ± 17.7 weeks ) . Multi-component exercise interventions can currently be recommended for pre-frail and frail older adults to improve muscular strength , gait speed , balance and physical performance , including resistance , aerobic , balance and flexibility tasks . Resistance training alone also appeared to be beneficial , in particular for improving muscular strength , gait speed and physical performance . Other types of exercise were not sufficiently studied and their effectiveness is yet to be established . Conclusions : Interventions for pre-frail and frail older adults should include multi-component exercises , including in particular resistance training , as well as aerobic , balance and flexibility tasks . Future research should adopt a consistent definition of frailty and investigate the effects of other types of exercise alone or in combination with nutritional interventions so that more specific recommendations can be made Background Patients admitted to the intensive care unit with critical illness often experience significant physical impairments , which typically persist for many years following resolution of the original illness . Physical rehabilitation interventions that enhance restoration of physical function have been evaluated across the continuum of recovery following critical illness including within the intensive care unit , following discharge to the ward and beyond hospital discharge . Multiple systematic review s have been published appraising the exp and ing evidence investigating these physical rehabilitation interventions , although there appears to be variability in review methodology and quality . We aim to conduct an overview of existing systematic review s of physical rehabilitation interventions for adult intensive care patients across the continuum of recovery . Methods / design This protocol has been developed according to the Preferred Reporting Items for Systematic Review s and Meta-Analyses Protocol ( PRISMA -P ) guidelines . We will search the Cochrane Systematic Review Data base , Data base of Abstract s of Review s of Effectiveness , Cochrane Central Register of Controlled Trials , MEDLINE , Excerpta Medica Data base and Cumulative Index to Nursing and Allied Health Literature data bases . We will include systematic review s of r and omised controlled trials of adult patients , admitted to the intensive care unit and who have received physical rehabilitation interventions at any time point during their recovery . Data extraction will include systematic review aims and rationale , study types , population s , interventions , comparators , outcomes and quality appraisal method . Primary outcomes of interest will focus on findings reflecting recovery of physical function . Quality of reporting and method ological quality will be appraised using the PRISMA checklist and the Assessment of Multiple Systematic Review s tool . Discussion We anticipate the findings from this novel overview of systematic review s will contribute to the synthesis and interpretation of existing evidence regarding physical rehabilitation interventions and physical recovery in post-critical illness patients across the continuum of recovery . Systematic review registration PROSPERO CRD42015001068
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 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 .