Yoga Empowers Seniors Study (YESS)

Safe and Effective Yoga Prescription of Seniors: Biomechanical Considerations

This is an Intervention Development Study (IDS) to quantify the physical demands (using biomechanical investigation) of a 2-phase (beginning & intermediate), 32-week yoga program designed for community-dwelling older adults. Additionally, the IDS will explore the adherence and adverse events of participation in the program. Data from the IDS will be used to develop evidenced-based yoga programs, which the investigators postulate will be associated with fewer musculoskeletal side effects compared to non-evidence based yoga programs. The investigators also postulate that evidenced-based tailoring of yoga for seniors will enhance adherence and efficacy. The programs developed during this IDS will be tested in an expanded, Phase II, Randomized Controlled Trial.

Study Overview

• Status: Completed
• Conditions: Healthy Older Adults
• Intervention / Treatment: Behavioral: yoga

Detailed Description

Yoga is currently being recommended to restore and preserve strength, flexibility, balance, & physical capacity in older adults; however, our clinical trial experiences suggest that without proper evidenced-based prescription, Yoga participation can be ineffective or even injurious for seniors. To address this lack of evidence-based knowledge, the proposed IDS will: 1) quantify the physical demands of a 32-wk Yoga program designed for independent ambulatory seniors; 2) characterize the relations between these demands and participant physical characteristics; 3) examine the adherence, efficacy, & safety of the program; and 4) characterize the relations among reported adverse events, baseline participant characteristics, and Yoga physical demands.

• Study Type: Interventional
• Enrollment (Actual): 27
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • California
    • Los Angeles, California, United States, 90024
      • UCLA

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Community dwelling men and women volunteers, aged 65 years or older.

Exclusion Criteria:

• Safety exclusions:

  --the following safety exclusions are adopted in order to decrease potential *cardiovascular

  • musculoskeletal
  • neurological risks to the participants:
• active angina
• uncontrolled hypertension (SBP greater than 160 or DBP greater than 90)
• high resting pulse or respiratory rate (HR >90 or RR>24 after 5 minutes seated)
• unstable asthma or exacerbated COPD
• cervical spine instability or other significant neck injury
• rheumatoid arthritis
• unstable ankle, knee, hip, shoulder, elbow, or wrist joints
• hemiparesis or paraparesis
• movement disorders (e.g. Parkinson's disease), peripheral neuropathies, stroke with residual deficits, severe vision or hearing problems
• walker or wheelchair use
• insufficient hearing to permit safety in a yoga group setting
• not able to attend in-person classes
• has not had check-up by regular provider within 12 months (if not taking any prescription medications) or in the past 6 months (if any regular medicines taken); cannot pass specific movement safety tests (tests described in section on screening visits, below)

• Feasibility/adherence exclusions:

  1. unable to understand their commitment to the project, (laboratory visits & regular program participation)
  2. cognitive limitations significant enough to preclude informed consent or to raise concerns about participation safety

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Non-Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: yoga; 32 weeks of yoga training	Behavioral: yoga; yoga classes 2 times per week for 32 weeks; Other Names: activity intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
peak joint moments	These are the torques produced by the muscles during performance of the yoga poses	difference from baseline to 16 wk
peak joint moments	These are the torques produced by the muscles during performance of the yoga poses	difference from 16 wk to 32 wk

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
time to stand and sit from a chair 5 times	In the 5-Repetition Chair Stand Test, we record the time it takes for a participant to repeatedly stand and sit on a chair 5 times.	baseline, 16 and 32 weeks
number of heel-rise repetitions	The Heel-Rise Test is a measure of plantar-flexion endurance. Here, we record the number of full range-of-motion, heel-rise repetitions the participants can complete before fatigue.	baseline, 16 and 32 weeks
Time to complete Up & Go test	In the Up & Go Test, a measure of mobility, we record the number of seconds it takes to rise from a chair, walk 8 feet, return and sit in the chair.	baseline, 16 and 32 weeks
Number of marching steps completed within 2 minutes	In the 2-Minute Step Test, a measure stepping endurance, we record the number of complete marching steps the participant can perform within a 2-minute period	baseline, 16 and 32 weeks
Distance participant can reach forward from a sitting position	The sit and reach test measures overall sagittal-plane flexibility. The participant is asked to reach as far as possible toward their dominant limb while remaining seated.	baseline, 16 and 32 weeks
Distance between fingers of opposing hands as participant attempts to touch fingers while reaching posteriorly.	The Back Scratch Test measures upper extremity flexibility. Here the distance between finger-tips is recorded as the participant reaches posteriorly and attempts to touch opposing hands.	baseline, 16 and 32 weeks
Maximum passive wrist flexion, extension, radial-deviation, and ulnar-deviation, range of motion (in degrees).	These tests measure the range of motion of the wrist in the sagittal and frontal planes.	baseline, 16 and 32 weeks
Maximum height participant can reach while standing	Here we quantify the maximum vertical height participants can reach while standing.	baseline, 16 and 32 weeks
Maximum distance participant can reach forward while standing	THe Maximum Forward Reach test is a measure of strength and flexibility. Here we record the maximum distance the participant can reach forward while standing.	baseline, 16 and 32 weeks
stride length during walking	Here we quantify the stride length of participants during walking at a self-selected pace.	baseline, 16 and 32 weeks
Maximum joint angle	Here we quantify the maximum joint angles of the ankle, knee, hip, trunk, shoulder, elbow, and wrist during performance of the yoga poses.	baseline, 16 and 32 weeks
Sway distance of the center of pressure	Here we quantify the movement of the center of pressure as participants stand as still as possible	baseline, 16 and 32 weeks
Electromyographic activity of muscles	Here we record the electromyographic activity of the Anterior Deltoid, Triceps surae, Obliques, Rectus Abdominus, Erector Spinae, Gluteus Maximus, Lateral Hamstrings, Vastus Lateralis, Gastrocnemius, and Gluteus Medius, muscles during performance of the yoga poses.	baseline, 16 and 32 weeks
SF-36 score	Health related quality of life and mood will be assessed with the RAND Short Form-36 (Hays, 1993). The SF-36 includes sub-scales that measure: 1) health-related limitations in physical function; 2) health-related limitations in role and in social function; 3) emotional function (including positive and negative mood states); 4) pain.	baseline and 36 weeks

Collaborators and Investigators

• Sponsor: University of Southern California
• Collaborators: University of California, Los Angeles
• Investigators: Principal Investigator: George Salem, PhD, University of Southern California

Publications and helpful links

General Publications

• Wang MY, Yu SS, Hashish R, Samarawickrame SD, Kazadi L, Greendale GA, Salem G. The biomechanical demands of standing yoga poses in seniors: The Yoga empowers seniors study (YESS). BMC Complement Altern Med. 2013 Jan 9;13:8. doi: 10.1186/1472-6882-13-8.

Study record dates

Study Major Dates

• Study Start: July 1, 2009
• Primary Completion (Actual): April 1, 2011
• Study Completion (Actual): April 1, 2011

Study Registration Dates

• First Submitted: July 20, 2011
• First Submitted That Met QC Criteria: August 4, 2011
• First Posted (Estimate): August 5, 2011

Study Record Updates

• Last Update Posted (Estimate): November 16, 2016
• Last Update Submitted That Met QC Criteria: November 14, 2016
• Last Verified: November 1, 2016

More Information

Terms related to this study

• Keywords: yoga biomechanics seniors
• Other Study ID Numbers: 1R01AT004869-01 (U.S. NIH Grant/Contract)