Yoga for Seniors: Understanding the Benefits and Risks of Participation George Salem, PhD USC Division of Biokinesiology & Physical Therapy

Yoga maybe an ideal exercise activity for seniors

Yoga is fun!

Yoga can be done at home or in a class

Yoga may improve or maintain flexibility

Yoga may improve or maintain strength

Yoga may improve or maintain balance

Yoga is mindful

Yoga can be modified

Yoga Empowers Seniors Study (YESS) Primary Aim: Measure physical demands of the yoga postures / asanas 1* Aim was to Quantify the Physical Demands Associated with Yoga Participation We did so by collecting Biomechanical data in a Motion Analysis Laboratory Here, we see a PPT being instrumented for biomechanical analysis

YESS: Methods Opening Middle & Closing Sequences In order to be True to Yoga, we had our PPTs go through the yoga program with the guidance of our instructor. They performed opening, middle, and closing sequences.

YESS: Methods Biomechanical analysis Joint Moment of Force: JMOF Here we see a PPT performing the TREE pose. Marker data along with GRF data are used to create a Musculoskeletal Model With the model we can then quantify the joint angles, reaction forces, and joint torques produced during the asana. We call these joint torques Joint Moments of Force. We were particularly interested in the JMOF about the hip because Hip Abductor Strength is associated with Balance, Gait performance, and Fall risk.

YESS: Results * * Muscular Endurance – 2 Min Step Test: * p < 0.05 15.2% * 12.4% Here are data from the 2-min Step Test. It is a measure of Hip Muscular Endurance * p < 0.05

YESS: Results * * Muscular Endurance – Heel Rise Test: * p < 0.05 33.9% * 19.4% The Heel Rise Test is a measure of plantar flexor (calf muscle) Endurance * p < 0.05

YESS: Results Knee Extensor Strength: There was no change in knee extensor strength

YESS: Results Static Balance

YESS: Results Yoga-related side effects Yoga-Related Problem # of occurrences (number with prior condition) Shoulder Pain 6 (6) Upper Back Pain 1 (1) Low Back Pain 3 (2) Knee Pain 1 (0) Thigh Pain Heartburn (Reflux) Leg/foot pain (Venous Insufficiency) We also wanted to see if we could identify poses which may have contributed to the reported AE’s in the study. We found that the most common side effect of the program was Shoulder Pain. Thus,m was sought to identify which poses may be contributing to shoulder problems in those PPTs that had had previous problems

YESS: Results Yoga-related side effects Yoga-Related Problem # of occurrences (number with prior condition) Shoulder Pain 6 (6) Upper Back Pain 1 (1) Low Back Pain 3 (2) Knee Pain 1 (0) Thigh Pain Heartburn (Reflux) Leg/foot pain (Venous Insufficiency)

YESS: Results Shoulder flexor JMOF – across poses We then looked at the JMOF in order to identify those poses which had both a High Flexion Angle and a High Flexor Joint Moment We identified both the Side Stretch and the Downward Facing Dog as those poses which had high angles and moments. This also has implications for program design and prescription: It suggests that these poses should be modified further or replaced for PPTs that have had a previous shoulder problem.

Yoga is popular with over 1-million senior participants

Yoga maybe an ideal exercise activity for seniors

Yoga appears to increase/maintain fitness

YESS: Results Yoga-related side effects Yoga-Related Problem # of occurrences (number with prior condition) Shoulder Pain 6 (6) Upper Back Pain 1 (1) Low Back Pain 3 (2) Knee Pain 1 (0) Thigh Pain Heartburn (Reflux) Leg/foot pain (Venous Insufficiency) We also wanted to see if we could identify poses which may have contributed to the reported AE’s in the study. We found that the most common side effect of the program was Shoulder Pain. Thus,m was sought to identify which poses may be contributing to shoulder problems in those PPTs that had had previous problems

Senior yoga requires proper instruction

Yoga should be one component of balanced exercise program

Thank you!