Intended for healthcare professionals

Practice Uncertainties

Does yoga reduce the risk of falls in older people?

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3246 (Published 03 September 2020) Cite this as: BMJ 2020;370:m3246
  1. Garry A Tew, associate professor of exercise and health sciences1,
  2. Lesley Ward, research fellow1,
  3. Catherine Hewitt, professor of trials and statistics2,
  4. Anne Tiedemann, associate professor3
  1. 1Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-upon-Tyne, UK
  2. 2York Trials Unit, Department of Health Sciences, University of York, York, UK
  3. 3Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Sydney, Australia
  1. Correspondence to: G Tew garry.tew{at}northumbria.ac.uk

What you need to know

  • Exercise programmes that involve balance and functional exercises are effective at preventing falls in older people living in the community

  • Yoga provides small to moderate improvement in balance and mobility in this population, but there is lack of evidence on effect of yoga on falls

  • Health professionals can recommend yoga to older people to promote physical function and mental wellbeing if there are no clinical contraindications, but there is currently insufficient evidence to recommend yoga specifically for preventing falls

Nearly a third of people aged over 65 years and over half of people older than 80 have a fall at least once a year.123 Falls and fall related injuries can be life changing and may result in chronic disability, admission to assisted living, or death. A fall can also precipitate a fear of falling, which may lead to restriction of activity and hence physical deconditioning. This in turn increases the risk of future falls.45

Clinical guidelines from several countries recommend multifactorial interventions for preventing falls in older people, with exercise as a key component.367 A recent Cochrane review (108 randomised controlled trials, 23 407 participants) concluded there is strong evidence that well designed exercise programmes reduce the number of falls by about a quarter among older people living in the community.8 Such programmes also reduce the number of people experiencing one or more falls. Exercise that mainly involved balance and functional training reduced falls.

Yoga is a mind-body practice that typically involves a combination of physical postures, breathing exercises, and concentration/meditation. Yoga has become a popular means of promoting physical and mental wellbeing9 and is shown to improve health related quality of life in older people.10 Evidence from observational studies suggests it is an acceptable and attractive form of exercise …

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