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Objective: This research identifies practical lessons regarding the delivery of teleyoga. Our objectives are to (1) describe challenges and opportunities experienced by yoga instructors when moving the Successful AGEing (SAGE) yoga programme online, and (2) describe how yoga instructors adapted to manage the challenges and leverage opportunities presented by teleyoga. Methods: This study is a secondary analysis of the data from a previous realist process evaluation of the SAGE yoga trial. The SAGE yoga trial is testing the effect of a yoga-based exercise programme on falls among 700 community-dwelling people aged 60+ years. We draw on focus groups and interviews with four SAGE yoga instructors which we analysed using previously developed programme theories combined with inductive coding and an analytical workshop. Results: The concerns of the yoga instructors about teleyoga can be characterised into four broad issues: threats to safety, altered interpersonal dynamics, facilitating mind-body connection and difficulties with technology. The SAGE instructors identified eight modifications they used to manage these challenges: a 1:1 participant interview prior to programme commencement, more descriptive verbal instructions, increased focus on interoception, increased attention and support, slower more structured class flow, simplifying poses, adapting the studio environment and IT support. Conclusions: We have created a typology of strategies for addressing challenges in the delivery of teleyoga for older people. As well as maximising engagement with teleyoga, these manageable strategies could be applied by other instructors to a wide range of telehealth classes, improving the uptake and adherence of beneficial online programmes and services.
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INTRODUCTION: Falls significantly reduce independence and quality of life in older age. Balance-specific exercise prevents falls in people aged 60+ years. Yoga is growing in popularity and can provide a high challenge to balance; however, the effect of yoga on falls has not been evaluated. This trial aims to establish the effect on falls of a yoga exercise programme compared with a yoga relaxation programme in community-dwellers aged 60+ years. METHOD AND ANALYSIS: This randomised controlled trial will involve 560 community-dwelling people aged 60+ years. Participants will be randomised to either: (1) the Successful AGEing (SAGE) yoga exercise programme or (2) a yoga relaxation programme. Primary outcome is rate of falls in the 12 months post randomisation. Secondary outcomes include mental well-being, physical activity, health-related quality of life, balance self-confidence, physical function, pain, goal attainment and sleep quality at 12 months after randomisation. The number of falls per person-year will be analysed using negative binomial regression models to estimate between-group difference in fall rates. Generalised linear models will assess the effect of group allocation on the continuously scored secondary outcomes, adjusting for baseline scores. An economic analysis will compare the cost-effectiveness and cost-utility of the two yoga programmes. ETHICS AND DISSEMINATION: Protocol was approved by the Human Research Ethics Committee at The University of Sydney, Australia (approval 2019/604). Trial results will be disseminated via peer-reviewed articles, conference presentations, lay summaries. TRIAL REGISTRATION NUMBER: The protocol for this trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619001183178).
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BACKGROUND: Exercise that challenges balance can improve mobility and prevent falls in older adults. Yoga as a physical activity option for older adults is not well studied. This trial evaluated the feasibility and effect of a 12-week Iyengar yoga program on balance and mobility in older people. METHODS: We conducted a blinded, pilot randomized controlled trial with intention-to-treat analysis. Participants were 54 community dwellers (mean age 68 years, SD 7.1) not currently participating in yoga or tai chi. The intervention group (n = 27) participated in a 12-week, twice-weekly yoga program focused on standing postures and received a fall prevention education booklet. The control group (n = 27) received the education booklet only. Primary outcome was standing balance component of the short physical performance battery with addition of one-legged stance time (standing balance). Secondary outcomes were the timed sit-to-stand test, timed 4-m walk, one-legged stand with eyes closed, and Short Falls Efficacy Scale-International. Feasibility was measured by recording class attendance and adverse events. RESULTS: Fifty-two participants completed follow-up assessments. The intervention group significantly improved compared with control group on standing balance (mean difference = 1.52 seconds, 95% CI 0.10-2.96, p = .04), sit-to-stand test (mean difference = -3.43 seconds, 95% CI -5.23 to -1.64, p < .001), 4-m walk (mean difference = -0.50 seconds, 95% CI -0.72 to -0.28, p < .001), and one-legged stand with eyes closed (mean difference = 1.93 seconds, 95% CI 0.40-3.46, p = .02). Average class attendance was 20 of 24 classes (83%). No serious adverse events occurred. CONCLUSIONS: This trial demonstrates the balance and mobility-related benefits and feasibility of Iyengar yoga for older people. The fall prevention effect of Iyengar yoga warrants further investigation.
